Synthetic Users Research Articles

DRUGS USE HABITS AND PERSONALITY TRAITS OF SYNTHETIC DRUGS USERS: A DESCRIPTIVE CROSS - SECTIONAL STUDY

Background and objectives: Several studies in the world showed that distinctive personality traits linked to an increased risk of substance abuse than the general population. In addition, personality also played an important role in treatment outcome in patients with substance use disorders. Objectives: 1. To describe drugs use habits of synthetic drugs users. 2. To investigate personality traits by Minnesota Multiphasic Personality Inventory - 2 in the participants. Subjects and methods: This is a descriptive cross - sectional study on 40 inpatients with using synthetic drugs at the Department of Mental Health, Hue Central Hospital and Psychiatric Hospital. Using a designed questionnaire to assess synthetic drug use habits in the participants. Minnesota Multiphasic Personality Inventory – 2 (MMPI -2) was used to investigate personality in the subjects. Using ICD – 10 diagnostic criteria to identify mental and behavioral disorders due to drug use. Results: The meanage of first drug use in the participants was 26.6 ± 5.9 years old. 85% of patients used multiple drugs, 82.5% of patients used drugs from 2 to 5 times per a week and 82.5% of patients used drugs at different locations. There were 37.5% of patients with harmful or dependent alcohol use, and 30 patients, accounting for 75%, were smokers.The personality traits in the participants were paranoia personality trait (42.5%), schizophrenic personality trait (37.5%), hypochondriasis personality trait (32.5%), psychasthenia personality trait (27.5%), deviant personality (25%), hypomanic personality (20%), hysterical personality 15%, depressive personality trait (2.5%). There were no cases of gender deviation and social introvert personality. Most of the patients had 2 or more personality disorder traits (72.5%).There were 3 patients accounting for 7.5% without any personality disorder traits. Conclusion: synthetic drug users often used multiple drugs, several times per a week and in different locations. schizophrenic and paranoia personality traits account for the highest rate in the participants. Majority of patients had combination of personality traits Key words: MMPI, personality traits, synthetic drug users, drug use habits

Drug use characteristics and correlates of multiple risk behaviors among synthetic drug users

ABSTRACT Objective: Understanding drug use characteristics can help inform preventive education and behavioral therapy. The aims of the current study are to describe drug use characteristics and examine factors associated with multiple risk behaviors among synthetic drug users in China. Method: Cross-sectional data were obtained in 2015 from 846 (457 men and 389 women) adult synthetic drug users in China. SAS 9.4 was used for all data analyses. Results: Multiple regression analyses showed that female participants were more likely to have engaged in a suicide attempt, while male participants were more likely to have engaged in group sex under the influence of drugs, gambling, vandalism, beating up others, motorcycle racing, and other criminal activities. Moreover, age, occupation, education level, household socioeconomic status, age of drug initiation, and drug use frequency were associated with multiple risk behaviors. Conclusions: Future health promotion efforts to reduce risk behaviors among synthetic drug users need to focus on reducing drug use frequency and helping them find possible ways to improve livelihoods. The gender differences in risk behaviors also suggest the needs of gender-specific prevention intervention strategies such as mental health services and reduction of partner influence among female users, and reduction of peer influence among male users.

Detection of Fentanyl Analogs and Synthetic Opioids in Real Hair Samples.

Novel synthetic opioids include various analogs of fentanyl and emerging non-fentanyl compounds with different chemical structures, such as AH-7921, MT-45 and U-47700. In recent years, these drugs have rapidly emerged on the drug market, and their abuse has been increasing worldwide. The motivations for use of these new compounds include their legal status, ready availability, low cost, users' curiosity or preference for their particular pharmacological properties and the intention to avoid detection. Furthermore, more common drugs like heroin are now increasingly being replaced or cut with fentanyl or new designer opioids; thus, many drug users are unintentionally or unknowingly using synthetic fentanyl analogs. In this scenario, the detection of new psychoactive substances in hair can provide insight into their current diffusion among the population and social characteristics of these synthetic drug users. In this manuscript, we describe a simple, fast, specific and sensitive UHPLC-MS-MS method able to detect 13 synthetic opioids (including fentanyl analogs) and metabolites in hair samples. Furthermore, the method includes the detection of 4-anilino-N-phenethyl-piperidine (4-ANPP), which is considered both a precursor and a metabolite of several fentanyl analogs. The method was applied to 34 real hair samples collected in New York City from subjects who had reported past-year non-medical opioid and/or heroin use. In total, 17 samples tested positive for at least one target analyte, with oxycodone (nine samples) and tramadol (eight samples) being the most common. Among these, the method was able to quantify furanyl-fentanyl and fentanyl in the pg/mg range in two samples. Simultaneously, also 4-ANPP was detected, giving evidence for the first time that this compound can be selected as a marker of fentanyl analogs use via hair testing. In conclusion, this study confirmed the increasing diffusion of new synthetic opioids and "fentalogs" with high potency among non-medical opioid users.

Synthetic drug use and HIV infection among men who have sex with men in China: A sixteen-city, cross-sectional survey.

IntroductionIncreasing evidence suggests an association between synthetic drug use and HIV infection among men who have sex with men (MSM). The aim of this study was to evaluate synthetic drug use prevalence, describe characteristics of synthetic drug users, and investigate whether synthetic drug use is associated with HIV infection among Chinese MSM.MethodsA cross-sectional survey was conducted in 16 Chinese cities among males >18 years old who reported having had sex with men in the prior 3 months, but did not already have a known HIV-positive serostatus. Participants were grouped according to lifetime synthetic drug use and characteristics were compared using Chi-square test. Determinants of HIV infection were assessed using univariate and multivariate regression.ResultsAmong 3,135 participants, 1,249 reported lifetime synthetic drug use, for a prevalence of 39.8%. Nearly all users (96.3%) reported using inhaled alkyl nitrites (“poppers”). Synthetic drug users were more likely to be younger (<30 years, p<0.001), single (p<0.001), and more educated (p<0.001), and were more likely to engage in higher risk sexual behavior compared to non-drug users. Overall HIV prevalence was 7.8% (246/3,135). However, prevalence among synthetic drug users was 10.6% (132/246) compared to 6.0% (114/246) for non-drug users (p<0.001). Factors associated with an increased odds of HIV infection included inconsistent condom use with male partners (adjusted odds ratio [OR] = 2.18, 95% confidence interval [CI] = 1.64–2.91) and synthetic drug use (adjusted OR = 2.04, CI = 1.56–2.70).ConclusionPrevalence of synthetic drug use, especially poppers use, prevalence was high in our study, and users had 2-fold greater odds of HIV acquisition. It is clear that there is an urgent need for increased prevention, testing, and treatment interventions for this key, dual-risk population in China. Moreover, we call on the Chinese Government to consider regulating poppers so that users can be properly warned about their associated risks.

Increased synthetic drug abuse and trends in HIV and syphilis prevalence among female drug users from 2010-2014 from Beijing, China.

The objective of this study was to monitor the trend of addiction drug use and its relationship with sexually transmitted infections (STIs) among female drug users (FDUs). Serial cross-sectional surveys were conducted during 2010-2014 among FDUs in Beijing to collect information on addiction drug usage, sexual behaviors, and STI prevalence. Characteristics were analyzed and compared between traditional and synthetic drug users among FDUs by logistic regression method. A total of 3859 FDUs were surveyed during 2010-2014, with the median age being 32.7 years old. The proportion of synthetic drug users among FDUs increased from 43.7% in 2010 to 70.7% in 2014. Compared with traditional drug users, synthetic drug users were younger (P < 0.001), lacked education (P < 0.001), were unmarried (P < 0.001), and were non-local residents (P < 0.001). No significant difference was found with condom usage during sexual activity between traditional and synthetic drug FDUs. However, the engagement of commercial sexual activities (P < 0.001) and syphilis prevalence (P < 0.001) among synthetic drug users were significantly higher than traditional drug users. Synthetic drug abuse appears to be correlated with commercial sex behavior and higher syphilis prevalence among FDUs. Tailored strategies on health education to curb the prevalence of synthetic drug abuse are urgently needed in Beijing.

The synergistic effect of dual use of amphetamine-type stimulants and ketamine on drug-induced psychotic symptoms in Chinese synthetic drug users.

The use of amphetamine-type stimulants (ATS) and ketamine is of particular clinical concern because of its associated psychotic symptoms. In Chinese clinical practice, ATS and ketamine are commonly used simultaneously, but very few studies have reported the symptom profile of users who use both drugs. This study determined whether the combined use of ATS and ketamine is associated with more psychotic symptoms than either ATS or ketamine alone. According to drug use characteristics, 375 Chinese synthetic drug users were categorized into 2 pairs of comparison groups: ATS-only (n=125) vs. ATS-mainly (ATS most of the time and ketamine sometimes, n=150) and ketamine-only (n=38) vs. ketamine-mainly (ketamine most of the time and ATS sometimes, n=62). We used the Chinese Brief Psychiatric Rating Scale (BPRS) to assess these patients’ psychotic symptoms. ATS-mainly group had more anxiety/depression and anergia symptoms than ATS-only group (p<0.001), and ketamine-mainly group had more thinking-disorder, activity and hostility-suspicion symptoms than ketamine-only group (p≤0.001). These findings indicate that ATS may exacerbate the thinking-disorders, activity and hostility-suspicion symptoms of ketamine users, and ketamine may exacerbate anxiety/depression and anergia symptoms of ATS users.

Pattern and related factors of cognitive impairment among chronic methamphetamine users.

Methamphetamine (MA) use is increasingly prevalent in East and Southeast Asia and commonly associated with cognitive impairment. The present study estimated the characteristics of cognitive impairment and explored the associated potential factors among chronic MA users. The data were from the baseline visit of a longitudinal study among synthetic drug users. The baseline survey was conducted in detoxification and rehabilitation centers in Guangdong province, China, from September to December in 2013. A total of 528 participants were included in our analysis. Cognitive impairment was measured by the Montreal Cognitive Assessment (MoCA). Logistic regression was performed to explore the risk factors associated with cognitive impairment. Approximately 69.89% of the study participants exhibited cognitive impairment according to MoCA scores. Multiple logistic regression analyses indicated that older age (≥30 years old), a longer duration of MA use (>24 months), and a higher frequency of MA use (everyday) were associated with cognitive impairment, with adjusted odds ratios (ORs) of 1.58 (95% confidence interval [CI]: 1.07-2.34), 1.53 (95%CI: 1.01-2.31), and 1.55 (95%CI: 1.05-2.30), respectively. Methamphetamine users that had a higher level of education had a lower risk of cognitive impairment(OR = .59; 95%CI: .38-.93). Cognitive impairment occurred frequently among chronic MA users. The causal relationship between cognitive impairment and MA use needs to be ascertained in longitudinal studies in future work. Our study provides evidence for the development of intervention strategies for the prevention of MA use and associated cognitive impairment. (Am J Addict 2017;26:145-151).

Tracking the evolution of drug abuse in China, 2003-10: a retrospective, self-controlled study.

To characterize trends in drug abuse in China before and after the 2005 initiation of the 'People's War on Drugs'. Retrospective self-controlled study. Annual, nation-wide surveillance from 2003 to 2010 of all registered drug users in China's National Surveillance System on Drug Abuse (NSSDA). A total of 1,184,124 drug users registered in NSSDA were involved in this study and were classified into three groups based on registered dates-pre-war group (n=230,278) registered 2003-04, phase I group (n=518,651) registered 2005-07 and phase II group (n=435,195) registered 2008-10. Indicators included proportions of:(i) new and relapsed drug users, (ii) heroin and synthetic drug users among new users, (iii) people aged 35 years or younger and (iv) women. Comparisons were made across groups using annual data to describe temporal trends. Between 2003 and 2010 the proportion of heroin users decreased by 52.3% and synthetic drugs use increased 860.7% among new users, while a 12.8% decrease in the proportion of heroin users and a 918.8% increase in synthetic drug use in all users was detected. Compared with the pre-war group, the proportion of relapsed users decreased 2.6% and 29.1% in the phase I and phase II groups, respectively, but a significant increase in the proportion of new users was found in phase I (OR=1.24, CI=1.15-1.35, p<0.0001), followed by an apparent decrease in phase II compared with phase I (OR=0.75, CI=0.70-0.80, p<0.0001). Similarly, the proportion of heroin users decreased 15.1 and 24.2% among new drug users in phase I and phase II in comparison with the pre-war group. The decrease in proportions of drug users in China between 2003/4 and 2008/10 may suggest some positive influence of the 'People's War on Drugs', especially in the decreased proportion of relapsed users. In contrast, there was a rapid increase in new synthetic drug use over the same period.

Risk control and rational recreation: A qualitative analysis of synthetic drug use among young urbanites in China

BackgroundTo fight against the rapid growth of synthetic drugs, the Chinese government has strengthened the controls and regulation, incorporated synthetic drugs into the new detoxification system, and changed the inconsistent governance of synthetic and traditional drugs. This, however, has not stopped the spread of synthetic drugs among young urbanites. While scholars have focused on the loopholes and defects of specific drug control regulations, ethnographic inquiries illustrate how and why control does not work, or is even resisted by young drug users. MethodsIn-depth qualitative interviews were conducted with 28 individuals aged between 20 and 35, recruited from a cohort of synthetic drug users in a Shanghai drug rehabilitation centre. Audio-recorded interviews elicited accounts of their daily experiences of drug use as well as their perspectives on the impact of the government's new drug control policies. ResultsThe main themes voiced by our respondents include: (1) synthetic drugs are not addictive, and are used to feel ‘high’; (2) synthetic drugs are used to achieve their goals, which are otherwise impossible through mainstream means; (3) users are confident that they will be able to manage the use of synthetic drugs without harm to themselves; (4) their worries concern administrative punishment rather than consequences to health. ConclusionThe participants of this study did not support the government's attempts to control the use of synthetic drugs. They viewed their use as rational recreation under the perceived boundaries of ‘acceptable risks’. Even in the context of severe control, synthetic drugs have strong appeal to youths. Drug policy should acknowledge the experiences of users and consider the socio-cultural contexts of youth drug-taking. The personal experience of participants could help improve the Chinese Drug Control Act and regulations.

Changes in method for obtaining better outcomes in the recruitment of synthetic drug users

Objective: To describe the problems encountered and resolved in the course of using respondent-driven sampling (RDS), targeted canvassing (TARC), and ethnographic fieldwork (EFW) to recruit ecstasy and/or lysergic acid diethylamide (LSD) users. Method: This study is nested within a larger project designed to investigate the course of drug use, sexual risk behaviors, and psychiatric comorbidities in 240 ecstasy/LSD users. Eligible participants were males and females with ages ranging from 18 to 39 years, who reported ecstasy and/or LSD use at least once during the 90 days prior to interview and were not under treatment for drug and alcohol problems. Strategies were implemented sequentially, over four-month time frames for each method, aiming at fulfilling study objectives. Results: The final sample included 174 participants (64.36% males). Eight (4.6%) were selected using RDS, 26 (14.94%) with TARC, and 140 (80.45%) using EFW. RDS recruited participants with a higher education level, employed, and with a higher monthly income. Conversely, a higher frequency of drug usage and a higher number of drugs ever used were evident among participants selected via EFW. Conclusions: Different recruitment techniques reached different types of participants. EFW showed the best performance, granting access to the largest number of participants and with a higher number of drugs ever used. Both RDS and TARC required more time to recruit participants and yielded a lower number of eligible subjects. Participants recruited via RDS had a higher socioeconomic level but also a shorter lifetime history of drug use.

HIV infection among new synthetic drug abusers: a pilot study in Beijing

Background Following the increased human immunodeficiency virus (HIV) notification (infection) rates via sexual transmission and increased abuse of new synthetic drugs instead of heroin in China, a study on HIV infections and risk factors among synthetic drugs and heroin users in Beijing was conducted to provide a cue for further development of targets and strategies of HIV/AIDS control and prevention for different drug populations. Methods A total of 428 subjects including 224 heroin users and 204 new synthetic drug users was recruited from communities in Beijing by convenience sampling. A χ2 test was used to compare HIV and syphilis infections between the two subpopulations. Logistic regression models were used to evaluate factors related to HIV, syphilis infections and abuse of synthetic drugs. Results Unbalanced distributions of demographics were detected between the two subpopulations. Compared with heroin users, most users of synthetic drugs were migrants, single and of younger age (age ≤30 years). Ten HIV infections and twenty-four syphilis infections were confirmed among 428 subjects. No significant difference in HIV infection was found between the two subpopulations (crude odds ratio (OR) =0.46, 95% confidence interval (CI): 0.07-15.80 and adjusted odds ratio (AOR) =1.26, 95% CI: 0.09-18.28) while four times as many syphilis infections were identified among users of synthetics drugs (AOR=3.92, 95% CI: 1.06-14.56). HIV and syphilis infections appeared to work synergistically. The migrants who were of Han ethnicity, single and who had stayed in Beijing for more than six months were more likely to abuse synthetics drugs. Conclusions The new synthetic drug users and heroin users are different subpopulations. We optimistically speculate that HIV has not yet been introduced into the former in Beijing, but considering higher syphilis infections in synthetic drug users and the role of syphilis in HIV infection, synthetic drug users, as a possible and important driver of the HIV/AIDS epidemic in Beijing, should be paid more attention in HIV prevention and control strategies.

MONITORING SYNTHETIC DRUG MARKETS, TRENDS, AND PUBLIC HEALTH

The Drugs Information and Monitoring System (DIMS) in The Netherlands is a toxicoepidemiologic monitor of drug markets that was established in 1992. Its main focuses are to identify the compounds of synthetic drugs, describe prevalence and trends, and identify health risks. Here we discuss the insights gained in the Ecstasy market, based on the weekly testing of more than 100 drug samples, and key information of synthetic drug users delivering drug samples and personnel participating in the DIMS network. Pills used as Ecstasy may contain a wide variety of compounds. The percentage of samples containing MDMA increased slowly reaching almost 75% in 1996, but decreasing sharply in 1997. Amphetamines (“speed” and “ice”) and experimental varieties were found in at least one third of the pills. Origins and effects of this development are discussed, as well as the risk assessment. In 1998 the percentage of MDMA pills increased more than ever before, indicating among other things that consumers prefer the conventional product. However, the use of “speed” and other drugs may also be stimulated by the decrease in 1997 of the percentage of MDMA pills. With more new types of drugs likely in the next century, a monitor such as DIMS provides important surveillance and data for public health and preventive aims. [Translations are provided in the International s Section of this issue.]