Recreational Use Research Articles

“California on the Vistula River?” Cannabis users’ engagement with licit and illicit cannabis markets in Poland

Purpose Poland, like many other countries, is experiencing a shift in its drug policy as reflected with the decision of its government to legalise medical cannabis in 2017. This paper aims to explore the engagement of cannabis consumers with legal and illegal markets for cannabis in Poland. Design/methodology/approach Data comes from the Polish Ministry of Health and a survey of 571 cannabis users. The questionnaires were posted on Polish Facebook groups consisting of users, and other people interested in science/politics associated with cannabis. The users were asked if they currently use the illegal market to buy cannabis, and if yes then why. Findings Most respondents report that they do not engage with the illegal market for cannabis. Those who described themselves as medical users now enjoy a better access to cannabis, but even recreational users are finding ways to use the system. Some, however, continue to use the illegal market for cannabis due to reasons associated with honesty, access, price and quality of cannabis. Research limitations/implications Given a convenience sample, generalisable conclusions cannot be made on the impact of the medical cannabis policy on the illegal market for cannabis yet. However, what can be concluded is that increasingly more users are likely opting out for the regulated medical market than the traditional illegal market. This could be associated with an increasing willingness of medical practitioners to prescribe medical cannabis. Originality/value Only a handful of articles have been written on the Polish medical cannabis policy. This is the first article to show that the Polish medical cannabis policy has changed very significantly since the early enactment. Very probably contrary to the wishes of the policymakers who wanted to create a stricter model than the one in California, for example, which they named as more permissive one.

Characteristics of Non-Therapeutic Pregabalin Users Detected by a Community Pharmacies Network in a Region of Southern Europe.

Background: Since 2008, several cases of pregabalin abuse have been reported to the European Monitoring Centre for Drugs and Drug Addiction (EMCDDA). Despite this evidence, gabapentinoids are increasingly being prescribed. Moreover, pregabalin is being used in a recreational setting for its dissociative effects and euphoria. Objectives: To assess the characteristics of non-therapeutic users of pregabalin and to show behavioral trends associated with requests for the medicine at community pharmacies. Methods: The Medicine Abuse Observatory (MAO), an epidemiological surveillance system, was able to analyze trends about the most diverted drugs and the behavioral patterns of the population from community pharmacies. We have conducted an observational and cross-sectional study from January 2022 to April 2023, to determinate trends in the behavior of patients who have requested pregabalin in the Catalan Sephanet. Results: Behavior with respect to sex was similar in all health problems, although one difference was raised when considering neuropathic pain, in which the females were more involved (72.7%), especially around 2.5 times more than the males (27.3%, p < 0.05). The study showed a potential recreational use related to patients aged <25 years and patients aged 25-35 years (p < 0.05). Neuropathic pain was mainly identified in patients >65 years. In 75% of the cases, there was a preceding prescription. Conclusions: This study underlines the evidence of non-therapeutic use of pregabalin among the Catalan population and the need to take control measures. Actions should be promoted, both at the level of prescription and dispensing, and focusing on education and knowledge about the risks that may appear with the use of pregabalin.

7172 Osteoporosis Associated with Antiretroviral Therapy - Case report

Abstract Disclosure: C.E. Guillen Lopez: None. L.A. Sanchez Ato: None. A. Patel: None. A. Molkina: None. T. Ayub: None. L. Robles: None. A. Arce Gastelum: None. Osteoporosis presents a substantial public health challenge, contributing significantly to morbidity and mortality through fractures. While postmenopausal osteoporosis is common, secondary osteoporosis affects a significant number of patients, including over 30% of postmenopausal and 50-80% of men. People living with HIV (PLWH) experience age-related medical comorbidities earlier and more extensively than those without HIV. The compromised bone health in PLWH is attributed to factors associated with the virus, antiretroviral therapy (ART) side effects, and health disparities such as inadequate nutrition, low body weight, hypogonadism, vitamin D deficiency, and increased recreational substance use. More recently, it has become apparent that vertebral fractures are more common in PLWH, with a prevalence of 11.1% and a 2.30-fold more significant risk than the general population. Low bone mass density (BMD) is twice as common in PLWH, increasing to 3 times as common in PLWH on ART. ART initiation leads to transient bone loss with nucleotide reverse transcriptase inhibitors such as tenofovir disoproxil fumarate (TDF) and protease inhibitors, causing higher BMD loss. In contrast, integrase and specific reverse-transcriptase inhibitors have minimal adverse effects on BMD. The newer formulation, tenofovir alafenamide (TAF), is believed to have a more favorable impact on bone health than TDF. The repercussions of diminished bone health, particularly osteoporotic fractures, have significant medical and economic implications. They are leading to early mortality, disability, and a loss of independence. The HIV Medicine Association (HIVMA) and Infectious Diseases Society of America (IDSA) recommend BMD screening for all HIV-infected patients at 50 years. 58-year-old male PLWH reveals a history of osteoporosis with multiple spinal (L1, L4-5, S1) and bilateral wrist fractures on TDF for 15 years. The patient has been treated with bisphosphonates. Alendronate was initially prescribed, but due to acid reflux side effects, zoledronic acid was a better option. Despite various ART regimens, Dolutegravir/Lamivudine was started four years ago without further fractures. Recent bone density assessments showed improvement in the lumbar spine, returning to a normal range with a T-score of 0.6. However, the left femoral neck remains at -2.5, and the right femoral neck is at -2.2, showing minimal change. To enhance BMD in PLWH on ART, transitioning to alternatives with lower bone loss associations and using bisphosphonates as tolerated are suggested. As the HIV-infected population ages, proactive screening for low BMD is vital to manage evolving health needs and prevent bone-related complications. A holistic approach includes evaluation for secondary etiologies of osteoporosis, medical treatment, and vitamin D and calcium supplementation. Presentation: 6/3/2024

Advancements in Rapid Detection Technologies for Club Drugs in Beverages

Advancements in Rapid Detection Technologies for Club Drugs in Beverages

B-283 Biological Consequences of Nitrous Oxide Abuse: Insights from Targeted Metabolomics Investigation

Abstract Background The recreational use of nitrous oxide (N2O), commonly known as laughing gas, has experienced a notable surge in popularity in recent times. According to the European Monitoring Centre for Drugs and Drug Addiction (EMCDDA), N2O is recognized as one of the most widely used psychoactive substances in Europe as of 2022. Its use also extends to Asia and America, according to literature. However, prolonged consumption of N2O has been associated with neurological complications linked to the functional inactivation of vitamin B12, disrupting One Carbon Metabolism. This study aims to explore the metabolic effects of N2O intoxication through a targeted metabolomics approach. Methods We conducted a prospective collection of clinical and biological information from 37 N2O users and 37 non-users (control group). Utilizing a targeted metabolomics method, we analyzed plasma amino acids using liquid chromatography coupled with mass spectrometry. Our statistical analysis encompassed principal component analyses, random forests, Mann-Whitney tests, Student's t-tests, and Spearman rank tests. Results Metabolomic analyses have demonstrated effective differentiation between patient groups. In comparison to controls, N2O consumers displayed reduced plasma levels of taurine, cystine, and methionine, alongside elevated plasma levels of serine and sarcosine. These findings suggest a potential influence of N2O on the cystine-methionine metabolic pathway. The decrease in methionine levels may be attributed to the decreased activity of methionine synthase (MS) due to vitamin B12 inactivation, which could partially explain the observed increase in serine levels. The rise in sarcosine levels could be explained by an increase in betaine-homocysteine S-methyltransferase (BHMT) activity. Moreover, dysfunction in cystathionine-β-synthase (CBS) or cystathionine γ-lyase (γ-CYS) may lead to the accumulation of upstream metabolites (such as serine) and a reduction in downstream metabolites (such as cysteine and taurine). Conclusions This study sheds light on potential new impacts of N2O, particularly on the plasma levels of serine, cystine, and taurine, indicating a potential modulation of enzymes involved in the conversion of homocysteine to taurine (CBS and/or γ-CYS). Additional investigations are required in a larger group of patients, which corresponds to the aims of the EFLM Task &amp; Finish Group: Biomarkers of Diagnosis and Follow-up of Nitrous Oxide Abuse: https://www.eflm.eu/site/who-we-are/committee/science-committee/fu/tfg-biomarkers-of-diagnosis

B-301 Deciphering Neuropathy features in the Context of Nitrous Oxide abuse: An Integrated Analysis of Electrophysiology and Metabolism

Abstract Background Nitrous oxide (N2O), used medically for its analgesic and anxiolytic properties, has emerged as a common recreational substance, leading to a rise in chronic toxicity cases. N2O abuse induces peripheral neurological damage with a spectrum of clinical presentations, ranging from mild sensory disturbances to severe motor deficits. Neurological complications from N2O include axonal and demyelinating neuropathies, leading to diagnostic and prognostic challenges. The pathophysiology of N2O toxicity is linked to functional inactivation of vitamin B12, resulting in biochemical and electrophysiological alterations. This study aims to enhance understanding of N2O pathophysiology by examining metabolic changes in consumers with axonal and demyelinating patterns. Methods This study included 35 patients with recent N2O abuse (last declarative consumption within the past week) who were treated at Lille University Hospital between March 2020 and April 2023 and underwent electromyography. The collected clinical features encompassed sensory symptoms, motor weakness, gait abnormalities and deep tendon reflexes. Patients were classified based on clinical phenotypes, distinguishing between length-dependent and non-length dependent, sensory or sensory-motor involvement and their peripheral neuropathy disability (PND) score (ranging from I to IV). Neurophysiological data analysis followed the criteria of Hadden et al. to identify patients with demyelinating criteria, while those lacking demyelinating criteria were categorized as “axonal” in the neuropathy group. Simultaneously, biochemical evaluations of serum vitamin B12 and B9 by CLIA methods (Roche), along with plasma homocysteine by LC/MS/MS and CLIA methods (Snibe), methylmalonic acid (MMA), and methionine by LC/MS/MS, were systematically performed for all patients. Results 40% of the selected patients exhibited demyelination criteria. The demyelinated group showed a significantly higher disability PND score compared to the axonal group (3.0 and 2.2, respectively; p-value = 0.028). Elevated levels of homocysteine and methylmalonic acid were found in all patients. Interestingly, plasma concentrations of homocysteine were significantly higher in the group of patient with axonal outcomes compared to the demyelinating group (90 µM and 114 µM; p-value = 0.04), suggesting an involvement of homocysteine in the type of lesion related to N2O abuse. Conclusions This study highlights the diverse electrophysiological manifestations of N2O-induced neuropathy and highlight the potential role of metabolic parameters as biomarkers to understand the pathophysiology. Indeed, lower hyperhomocysteinemia levels were observed in demyelinating patterns, highlighting a potentially biochemical difference between the groups: plasma homocysteine could also be used as a marker of neurological severity. The homocysteine assay used in these conditions must enable the patient to be managed rapidly: it would therefore be preferable to use rapid methods such as immunoanalysis. On the other hand, plasma methylmalonic acid did not differ between groups, which also suggests that other mechanisms have yet to be identified in the pathophysiology of N2O abuse.

Urbanization alters sandy beach scavenging assemblages and dogs suppress ecosystem function

AbstractUrbanization is rapidly transforming coastal landscapes around the world, altering the structure and function of marine, intertidal, and terrestrial ecosystems. In tandem, coastal areas are hotspots for human recreation, leading to shifts in wildlife behavior and activity patterns. Together, urban development and recreational use of wildlife habitats can shape wildlife behavior, abundance, and ecosystem dynamics at different spatial and temporal scales. In this study, we explore the impact of urbanization and human and domestic dog activity on the structure of vertebrate scavenging assemblages and the ecosystem functions they provide in sandy beach ecosystems across 40 km of the central California coast, USA. We surveyed vertebrate scavenging assemblages using baited camera traps on 17 beaches spanning a gradient of coastal urbanization. We found that urbanization extent within small spatial scales (i.e., 1 or 3 km radii of each site) and the rate of beach visitation by domestic dogs or humans were the best additive predictors of assemblage structure. We identified pronounced urbanization‐associated shifts in the composition of vertebrate scavenger guilds but found that the rate of carrion processing was more strongly influenced by domestic dog habitat use and diel period. Scavenging activity was substantially lower on beaches with more domestic dogs, suggesting that dogs interfere with critical scavenging ecosystem functions on sandy beaches. Our results underscore the pervasive and nuanced effects of urbanization and recreation on the dynamics of land–sea connectivity and suggest a need for comprehensive consideration of cross‐ecosystem linkages in ongoing shoreline conservation and development efforts.

S4399 Ketamine-Induced Liver Injury (KILI) From Recreational Use: A Rare Phenomenon

S4399 Ketamine-Induced Liver Injury (KILI) From Recreational Use: A Rare Phenomenon

Quantifying the sediment sorption of organic ultraviolet filter chemicals using solvophobic theory

Hydrophobic organic chemicals (HOCs) that enter the aquatic environment often negatively impact organisms, endangering aquatic biodiversity. Understanding sediment sorption equilibria for these chemicals can properly direct mitigation efforts. In addition, many HOCs of environmental concern lack sufficient environmental fate data to adequately assess their risk to ecosystems and humans. In this study, a sorption method addressing solvophobic effects was used to quantify the sorption of an HOC of current environmental concern, OD-PABA (padimate O, 2-ethylhexyl-4-(dimethylamino)benzoate), to a variety of sediments. OD-PABA is an organic ultraviolet filter chemical used in commercial sun protection products; it has been shown to exhibit cytotoxic effects and is known to photochemically transform under natural sunlight conditions. Given its commercial use, it enters the aquatic environment via recreational use and wastewater treatment plant effluent. OD-PABA is strongly hydrophobic; to mitigate the adsorption of OD-PABA to the container walls during sorption experiments, a precise concentration of methanol was used to avoid solvophobic effects. This sorption method was used to determine the sorption capacities for OD-PABA of four sediment samples, each with unique geochemical characteristics. Sediment-water distribution coefficients (Kd) were quantified and were normalized to various sediment characteristics to assess the main driving force(s) for sorption of OD-PABA. Organic carbon content was found to be a main driving force, with organic carbon-normalized distribution coefficients (log Koc) ranging from 4.4 to 4.6 for sediments with total organic carbon (TOC) > 10%); the clay fraction was also found to be important, especially for sediments with low TOC. The sorption of para-aminobenzoic acid (PABA), a water-soluble analog of OD-PABA was also investigated to assess the experimental approach, yielding a log Koc of 2.1 for the sediment with the greatest TOC.

Design, Fabrication and Aerodynamic Analysis of a RC Airplane

Abstract An internal receiver and a hand-held transmitter enable the remote operation of a (model) airplane, often known as an RC plane or airplane, to be operated remotely. The objective is to create a high-performance, stable, and maneuverable RC airplane maintaining an optimum AOA suitable for recreational and hobbyist use. Since the used electronic components are freely available in markets and do not require user programming, this paper did not focus on them. In this study, computational fluid dynamic (CFD) analysis was used to discuss wing shape, and control surface configuration to optimize lift, drag, and stability also calculated the optimum angle of attack which was found to be below 15 degrees. The N10 airfoil was taken into consideration for the wing design based on its asymmetrical shape for better lift and aerodynamic performance. Overall, this article provides valuable insights and guidelines for the design and development of RC airplanes, fostering advancements in this exciting field of aviation.

Clinical Benefits and Safety of Medical Cannabis Products: A Narrative Review on Natural Extracts.

Interest in medical cannabis and cannabis-based medicinal products (CBMPs) has increased greatly in recent years. Two cannabinoids are of principal importance; delta-9-tetrahydrocannabinol (∆9-THC), the primary psychoactive component, and also cannabidiol (CBD), considered non-intoxicating. Each has distinct mechanisms of action and different therapeutic potentials. CBMPs differ in their ∆9-THC and CBD components; predominantly ∆9-THC, balanced formulations with equivalent ∆9-THC and CBD elements, and CBD-predominant products. In this narrative review, we evaluate the published evidence for the clinical benefits of CBMPs and overall benefits in well-being. We also review the overall safety profile and discuss the potential for dependence with CBMPs. Evidence can be drawn from a wide range of randomized and other controlled studies and from observational real-world studies. Most data from observational registry studies are supportive of ∆9-THC-based products (∆9-THC-predominant or balanced CBMPs) in the management of chronic neuropathic pain. Balanced products are also effective in reducing spasticity in multiple sclerosis. Most CBMPs show benefit in providing symptomatic benefits in reducing anxiety, nausea, and in improving sleep, but the place of specific products is more subtle, and choice guided by specific circumstances. Symptomatic improvements are accompanied by improved quality of life and well-being. Safety data indicate that CBMPs are generally well tolerated in most patients without specific contraindications. The majority of adverse effects are non-serious, and transient; most are principally associated with ∆9-THC and are dose-dependent. In contrast to recreational cannabis use, there is little evidence from clinical studies that CBMPs have any potential for dependence.

Smartphone: A frightening technology: Mini review

Smartphones have become an integral part of everyday life, and are present in almost every household in the world. Used wisely, these devices offer many advantages. However, their excessive and recreational use poses major problems, particularly for children. Parents are very concerned about this phenomenon. This concern has been confirmed by a large number of studies pointing to the negative effects, but strategies for mitigating them are often less talked about. This study recognizes these concerns and stresses the importance of a balanced perspective, taking into account both real problems and exaggerations or misinformation. It also emphasizes the need to implement measures to reduce the impact of this complex situation. The correct application of these precautions will enable the benefits to be reaped while minimizing the potential drawbacks. It is essential not to demonize smartphones, but to recognize their usefulness in modern life, while encouraging responsible and constructive use.

Chemsex and rising substance use linked to sexually transmitted infections among men who have sex with men living with HIV in Bangkok, Thailand

ObjectivesWe report longitudinal trends in alcohol and recreational drug use, and their associations with sexual behaviors and clinical outcomes in a Thai cohort of predominantly men who have sex with men (MSM) living with HIV. MethodsFrom 2017 to 2019, participants in the RV254/SEARCH010 acute HIV cohort answered questions every 24 weeks about drug use and sexual behaviors. Longitudinal trends were assessed using the χ2 test for trend. Logistic regression was used to estimate odds ratios (ORs) and 95% confidence intervals (CIs) for factors potentially associated with recreational drug and alcohol use. ResultsAmong 604 participants, the median age was 26 (interquartile range 23-31) years, and 93.5% were MSM. Alcohol consumption was reported in 83.3% and recreational drug use in 46.9% during the study period, with rising trends in both over the years. Participants who reported recreational drug use were more likely to have hepatitis C (OR 3.42, 95% CI 1.88-6.21), syphilis (OR 2.69, 1.75-4.13), gonorrhea (OR 7.74, 5.04-11.89), and chlamydia (OR 1.61, 1.12-2.31), and to engage in group sex (OR 7.74, 5.04-11.89). Participants who used any recreational drugs had more frequent viral blips (23.1% vs 14.2%, P = 0.007) and reported missed doses of antiretroviral drugs more often (52.4% vs 36.9%, P <0.001), but had no significant difference in viral suppression (94.1% vs 97.4%, P = 0.06). ConclusionsAmong MSM living with HIV in Bangkok, recreational drug use has increased in recent years and was associated with hepatitis C and sexually transmitted infections, especially among men who participate in group sex. Prevention strategies and other interventions may improve treatment adherence and other HIV outcomes.

Pornography use, problematic pornography use, impulsivity, and sensation seeking: a meta-analysis.

While some individuals engage in recreational pornography use (PU), others may develop an uncontrolled pattern of use termed problematic pornography use (PPU). PPU is characterized by persistent, excessive, or compulsive engagement with pornographic content, despite distress and adverse consequences. Impulsivity has been identified as a factor associated with PU and PPU. The present meta-analysis aims to sum up the existing research on the relationship between impulsivity and PU/PPU and investigate whether age and gender could moderate this relationship. A keyword-based systematic literature search was performed to identify articles that assessed PU/PPU and impulsivity. Extracted correlations were converted into Fisher's Z. Meta-regression analyses were also performed. Publication bias was assessed by Egger's regression intercept. Outcomes included general impulsivity and its dimensions (ie, negative and positive urgency, lack of premeditation and perseverance), sensation seeking, PU, and PPU. Meta-analytic results of the random effects model showed a significant positive correlation between impulsivity as total score and PU (n = 1504, k = 4, Fisher's Z = 0.21, P < .001) and PPU (n = 20174, k = 13, Fisher's Z = 0.17, P < .001). Significant and positive associations were also found between sensation seeking and PU (n = 11707, k = 11, Fisher's Z = 0.14, P < .001) and PPU (n = 20152, k = 9, Fisher's Z = 0.06, P < .001). Concerning the relationship between PPU and different dimensions of impulsivity, almost all the associations were significant and positive. The dimension of positive urgency and attentional and nonplanning impulsivity showed the strongest association. Age (β = -0.50, Q = 101.26, df = 11, P < .001) and gender (female = 1; β = -0.46, Q = 102.54, df = 12, P < .001) moderated the association between general impulsivity and PPU. No risk of publication bias emerged. Prevention programs of PPU should focus on impulsivity and certain key dimensions (eg, positive urgency, attentional and nonplanning impulsivity) and be tailored to individual impulsivity profiles, considering age and gender differences. The primary strength of this meta-analysis is that it considers various conceptualizations of impulsivity. However, the results are to be interpreted with caution since >30% of relevant studies had to be excluded because information could not be gathered from the study authors. These results suggest that general impulsivity is linked to PU and PPU and that specific dimensions of impulsivity (ie, attentional impulsivity, nonplanning impulsivity, and positive urgency) can serve as risk factors for PPU.

Temporal and spatial trends of fentanyl co-occurrence in the illicit drug supply in the United States: a serial cross-sectional analysis

BackgroundFentanyl and its analogs contribute substantially to drug overdose deaths in the United States. There is concern that people using drugs are being unknowingly exposed to fentanyl, increasing their risk of overdose death. This study examines temporal trends and spatial variations in the co-occurrence of fentanyl with other seized drugs. MethodsWe identified fentanyl co-occurrence (the proportion of samples of non-fentanyl substances that also contain fentanyl) among 9 substances or substance classes of interest: methamphetamine, cannabis, cocaine, heroin, club drugs, hallucinogens, and prescription opioids, stimulants, and benzodiazepines. We used serial cross-sectional data on drug reports across 50 states and the District of Columbia from the National Forensic Laboratory Information System, the largest available database on the U.S. illicit drug supply, from January 2013 to December 2023. FindingsWe analyzed data from 11,940,207 samples. Fentanyl co-occurrence with all examined substances increased monotonically over time (Mann-Kendall p<0.0001). Nationally, fentanyl co-occurrence was highest among heroin samples (approx. 50%), but relatively low among methamphetamine (≤1%), cocaine (≤4%), and other drug samples. However, co-occurrence rates have grown to over 10% for cocaine and methamphetamine in several Northeast states in 2017-2023. InterpretationFentanyl co-occurs most commonly with heroin, but its presence in stimulant supplies is increasing in some areas, where it may pose a disproportionately high risk of overdose. FundingThis work was partly supported by FDA grant U01FD00745501. This article reflects the views of the authors and does not represent the views or policies of the FDA or US Department of Health and Human Services.

Cannabinoids and the heart-apsychiatrist's perspective.

The partial legalization of cannabis in Germany in 2024 will affect both medical and recreational use of cannabis. Tetrahydrocannabinol (THC), the main psychoactive component of the cannabis plant, influences heart rate and blood pressure through the endocannabinoid system. Acute and chronic use can pose cardiovascular risks. There is evidence of alink between cannabis use and cardiovascular events such as stroke and myocardial infarction, although studies show conflicting results. The non-psychoactive cannabidiol (CBD) could have anti-inflammatory and antioxidant effects. Smoking cannabis poses additional cardiovascular risks similar to tobacco. Given these risks, cardiologists should routinely ask their patients about possible cannabis use and inform them about the potential cardiovascular dangers. The article also highlights the psychiatric risks of cannabis use, including dependence and psychosis, and emphasizes the need for interdisciplinary collaboration between cardiologists and psychiatrists to effectively manage cannabis-related health problems.

Laser‐scribed graphene toward scalable fabrication of electrochemical paper-based devices for lidocaine detection in forensic and pharmaceutical samples

Lidocaine (LID), a tertiary amine drug, is widely used as a local anesthetic for topical anesthesia and also presents antiarrhythmic and analgesic properties. Given its use can induce a temporary loss of sensory, motor, and autonomic function, it has been associated with criminal instances of drug-facilitated sexual assault. Herein, we manufactured an electrochemical paper-based analytical device (ePAD) using the laser-scribed graphene (LSG) technique for LID detection in pharmaceutical and forensic applications. The paper-based devices were characterized by scanning electron microscopy (SEM) and Raman spectroscopy, confirming the porosity and graphene-derived nature of the LSG material. In addition, to enhance the electrocatalytic properties, the LSG electrode was modified with a nanocomposite based on the mixture of multi-walled carbon nanotubes (MWCNT) and poly(3,4-ethylenedioxythiophene) polystyrene sulfonate (PEDOT:PSS). Electrochemical characterizations of the non-modified and MWCNT/PEDOT:PSS-modified electrodes by impedance spectroscopy (EIS), cyclic voltammetry (CV), and differential pulse voltammetry (DPV), revealed the enhancement of the electrochemical properties of the modified electrode, providing higher detectability for LID detection. An analytical curve was built using DPV technique and exhibited a linear response in the concentration range of 31 to 248 µmol L−1 LID. The limits of detection (LOD) and quantification (LOQ) of the method were 0.72 µmol L−1 and 2.39 µmol L−1, respectively. The manufacturing reproducibility of the method was assessed by testing 8 sensors from different batches and provided a relative standard deviation (RSD) of 4.92 % (n = 8). The developed sensor was applied to LID determination in a commercial anesthetic sample and, as proof of the applicability of potential use in crime scenes of drug-facilitating crimes, we analyzed spiked LID in alcoholic drinks (vodka and tequila samples). The recovery percentages ranged from 79 % to 109 %, highlighting the practical use of our portable method for in-field analysis. In addition, four seized cocaine samples containing LID were successfully analyzed to demonstrate the potential use as a LID screening tool in street drug samples.

Getting help early: An online mental health self-assessment tool for young people.

Online self-assessments are becoming more popular. They can serve as a screening tool for specific conditions or assess mental health more broadly but often lack in depth evaluation. This study presents preliminary data from an online self-assessment tool for young people within the age range of 12-30 years (Link: redcap.hmri.org.au/surveys/?s = MK7RCELJ79). It covers key symptoms of mood and psychotic disorders and risk factors, such as eating issues, substance use, suicidality, and deliberate self-harming behaviours. Participants self-assessed their level of functioning, access to ongoing interventions, and satisfaction with the help received. Based on the severity of mental health problems and the level of risk, different recommendations of how to seek help were provided. Out of 303, 114 participants gave permission to analyse their data. A high-risk profile was defined by anxiety symptoms, panic attacks, suicidal ideation, and urges to self-harm. These individuals were more likely to report psychotic or depression symptoms, recreational substance use and low day-to-day functioning. Ongoing treatment and the satisfaction with it were not determined by the severity of symptoms. These preliminary results suggest that the online self-assessment tool reaches the intended young audience, particularly those with some degree of mental health problems.

Recreational ketamine use and its impact on health

Ketamine, also known as 2-(2-chlorophenyl)-2-(methylamino)-cyclohexanone, is a dissociative anesthetic that has gained popularity as a recreational substance among young people, especially in nightclubs and at parties. It acts as a noncompetitive NMDA receptor antagonist, inducing a dissociative state that manifests as catalepsy, unconsciousness and amnesia. Recreational use of ketamine and the number of illicit seizures of ketamine have increased in recent years, prompting a review of current evidence on its toxicity. Recreational ketamine use is associated with a number of toxic effects, both acute and chronic. Predominant among the acute effects are psychotic symptoms, hallucinations and aggression, which can lead to serious injuries. Chronic ketamine use leads to intractable urological problems and neuropsychiatric problems, Long-term effects also include gastrointestinal problems such as abdominal pain and liver function abnormalities. This review summarizes current evidences on the acute and chronic ketamine toxicity associated with its recreational use.

Frequency, Risk Factors, and Methods of Deliberate Self-Harm Observed in Medical Students and Doctors in Pakistan.

To determine the frequency of deliberate self-harm (DSH), risk factors leading to DSH, and the methods adopted by medical students and young doctors to execute DSH. A cross-sectional study was conducted on medical college students and young doctors aged 18-26 years. After approval by the parent institute's ethical board, different medical students and doctors from Pakistani medical colleges of both male and female populations were recruited through non-probability sampling. Responses were collected from one to two medical colleges from each province. A high number of 490 (60.9%) out of 805 participants reported a history of at least one form of self-harm. Forty-four participants (0.05%) reported having attempted suicide in the past. The mean scores for the self-harm inventory scale were 2.51±3.25, the self-esteem scale 26.51±4.43, and the social support scale 23.1±6.96. Smoking, recreational drug use, History of mental illness, and family history of mental illness were significantly associated with increased odds of self-harm in medical students. On adjusted binary logistic regression, female gender, harmonious relationship with parents, satisfaction with the result, social support, and higherself-esteem were protective against deliberate self-harm. DSH is a critical issue among medical students and is becoming prevalent. Higher odds of DSH are associated with smoking and recreational drug use. Higher self-esteem and better social support are protective against DSH.