Amphetamine Use Research Articles

Mild Encephalopathy/Encephalitis with Reversible Splenial Lesions after Amphetamine and Opioid Use.

A 47-year-old woman with a history of substance abuse, depression, and insomnia experienced a collapse. Upon arrival at the hospital, the patient displayed low systolic blood pressure, confusion, dehydration, and renal failure. Urine tests confirmed an amphetamine and opioid overdose. Her condition fluctuated with reduced consciousness, myoclonic movements, fever, and suspected psychogenic seizures. Brain magnetic resonance imaging revealed abnormalities in the splenium of the corpus callosum, which later resolved. The patient's condition gradually improved without any specific treatment. This unique case represents the first report of mild encephalopathy/encephalitis with reversible splenial lesions associated with amphetamine and opioid use.

Risk of Incident Psychosis and Mania With Prescription Amphetamines.

Amphetamine prescribing has increased in the United States in recent years. Previous research identified an increased risk of incident psychosis with prescription amphetamines. The purpose of this study was to examine the impact of dose levels of prescription amphetamines on the risk of this rare but serious adverse outcome. A case-control study using electronic health records was conducted to compare the odds of incident psychosis or mania with past-month exposure to prescription amphetamines. Case subjects were patients ages 16-35 hospitalized at McLean Hospital for incident psychosis or mania between 2005 and 2019. Control subjects were patients with an initial psychiatric hospitalization for other reasons, most commonly depression and/or anxiety. Amphetamine doses were converted to dextroamphetamine equivalents and divided into terciles. Secondary analyses evaluated the odds of psychosis or mania with methylphenidate use. Among 1,374 case subjects and 2,748 control subjects, the odds of psychosis and mania were increased for individuals with past-month prescription amphetamine use compared with no use (adjusted odds ratio=2.68, 95% CI=1.90-3.77). A dose-response relationship was observed; high doses of amphetamines (>30 mg dextroamphetamine equivalents) were associated with 5.28-fold increased odds of psychosis or mania. Past-month methylphenidate use was not associated with increased odds of psychosis or mania compared with no use (adjusted odds ratio=0.91, 95% CI=0.54-1.55). Although use of hospitalized control subjects excludes individuals with less severe disease, leading to selection bias, the study results suggest that caution should be exercised when prescribing high doses of amphetamines, with regular screening for symptoms of psychosis or mania.

Optimizing Brain-Computer Interfaces for Methampetamine Use Disorder through Quantitative Electroencephalography (QEEG) and Transcranial Doppler Analysis: Article Review

A Brain-Computer Interface (BCI) is a system that allows a person to control external devices using only their brain activity. It works by translating brain signals into commands that can be understood by a computer. Several lines of evidence demonstrated the deleterious effect of methamphetamine (MA) on neurological and psychological functions. The use of amphetamines, such as MA, is associated with cerebrovascular complications such as cerebrovascular accidents (CVA) ,hemorrhage, hypoxic damage and vasculitis. Interestingly, while changes to cerebral blood flow (CBF) in response to acute amphetamine exposure have been reported. Transcranial Color Doppler (TCCD) is a non-invasive medical imaging technique that uses ultrasound waves to measure blood flow velocity in the major arteries of the brain, specifically within the circle of Willis. The research paper you referenced explores the use of TCCD as a potential measurement modality for BCIs. Quantitative electroencephalogram (qEEG) is a powerful tool for understanding brain function qEEG can reveal specific brain wave patterns associated with drug addiction, potentially providing insights into the neurobiological mechanisms underlying cravings, withdrawal symptoms, and relapse risk in Methamphetamine User Disorder (MUD). There is growing research interest in using Transcranial dopller as a measurement modality for BCIs.Here are some of the key considerations for using Transcranial doppler in BCIs: Mental Tasks, signal processing and classification, accuracy and reliability. Transcranial doppler provides information about blood flow in specific arteries but lacks detailed spatial information about brain activity. These patterns could vary depending on the type of drug, the severity of addiction, and individual differences. Transcranial doppler in measuring middle cerebral artery (MCA) blood flow velocity parameters (peak systolic velocity (PSV) and mean flow velocity (MFV)). qEEG can help researchers investigate the complex interplay between addiction and other brain disorders, like depression or anxiety. Characteristic qEEG in drugs addiction Increased Theta (4-8 Hz) and delta (1-4 Hz) brain waves are often associated with sleep and relaxation. However, research has shown that individuals with drug addiction may have increased theta and delta activity, particularly in the frontal and temporal regions of the brain. Altered Beta (13-30 Hz) brain waves are generally associated with wakefulness, alertness, and cognitive processing. Studies have observed both increases and decreases in beta activity in individuals with drug addiction, depending on the type of drug, the stage of addiction, and the specific brain regions being examined. The results of this research have important practical implications for building an diagnostic and functional assement with a better understanding of an using technology.

Management of Amphetamine and Methamphetamine Use Disorders: A Systematic Review and Network Meta-analysis of Randomized Trials

Management of Amphetamine and Methamphetamine Use Disorders: A Systematic Review and Network Meta-analysis of Randomized Trials

Paracentral Acute Middle Maculopathy and Risk of Cardiovascular Disease, Stroke, and Death: A Longitudinal Study

To evaluate the risk of acute cardiovascular events (CVE), including cardiovascular diseases, cerebrovascular diseases, and all-cause mortality in patients with paracentral acute middle maculopathy (PAMM). Retrospective cohort study METHODS: We studied 43 individuals with optical coherence tomography -documented PAMM attending Moorfields Eye Hospital between January 2014 and June 2021. We excluded patients with preceding (< 2 years) major adverse cardiac events. We stratified patients by age (<50 years & ≥50 years) and whether associated with retinal vascular diseases (RVD) or isolated (iPAMM). We assessed risk factors, clinical characteristics, and visual prognosis of the patients. CVE risk was estimated using Kaplan-Meier curves, the log-rank test, and Cox proportional hazards regression. In young patients with iPAMM patients (n=12), underlying predisposing factors included six (50%) sickle cell disease and five (41.6%) others, including breakthrough bleeding in pregnancy, migraine, genetic cardiomyopathy, amphetamine use; among those with PAMM+RVD (n=12) one (9%) had a vascular disorder, and four (44.4%) oral contraceptive use. In the older group of 20 patients, 15 (75%) had at least one coronary risk factor. During a median follow-up of 14 months (range 12-54), older subjects with iPAMM had a higher risk of developing CVE than those with PAMM+RVD (p<0.001). Notably, iPAMM displayed a significantly earlier peak in peri-PAMM CVE risk compared to PAMM+RVD (median: 1 month, range 1-40 months vs. 36 months, range 12-54 months). Relative to those with PAMM+RVD, risk of CVE was significantly higher in patients with iPAMM, adjusted for age and sex (hazard ratio: 6.37, 95% Confidence Interval 1.68-24.14, p=0.017). No young patients experienced adverse CVE. At baseline, older iPAMM patients mean best corrected visual acuity of 0.7 (0-1.8) LogMAR, which improved significantly to 0.2 (0-1.30) LogMAR at the latest visit (p=0.033). Young individuals with iPAMM have a higher prevalence of predisposing factors compared to those presenting with combined PAMM+RVD. Older patients with iPAMM had a higher risk of CVE than those with PAMM+RVD, especially in the peri-onset timeframe. This suggests the need for a prompt cardiovascular assessment to rule out systemic etiologies and optimize cardiovascular risk factors, in addition to ongoing ophthalmology input.

Substance misuse disorder in Saudi Arabia: A comprehensive examination of current demographic patterns, trends, and intervention requirements

IntroductionThis review examines substance misuse disorder (SMD) in Saudi Arabia, drawing insights from 43 prior studies. It explores the prevalence and patterns of SMD across diverse demographics. MethodologyOur analysis integrated data from various studies involving adolescents, university students, psychiatric patients, and the general population as well as postmortem cases. It identifies key risk factors and challenges in managing SMD, underscoring the importance of comprehensive data collection for evidence-based policymaking. ResultsSMD in Saudi Arabia were categorized into two groups: common traditionally abused drugs (such as Captagon, khat, heroin, ethanol, and cannabis) and substances that have emerged in recent years (e.g., methamphetamine “Shabu”, pregabalin, and benzodiazepines). Trends in SMD include early substance initiation and increased amphetamine and polysubstance use. Conclusion and recommendationsDrug-related challenges persist in Saudi Arabia; however, because of limited data from recent epidemiological studies on drug disorders, the full extent is unknown. Saudi Arabia is unique because it as an Islamic country with strict regulations against drug trafficking and a religious prohibition on drugs and alcohol, which contributes to distinct trends in substance misuse disorder (SMD). Although some aspects mirror global patterns, others exhibit regional characteristics specific to the country. Despite data variability, actionable recommendations have emerged for SMD prevention and treatment. During the COVID-19 pandemic, a high number of reports was evident; however, SMD publications often reiterate old findings and overlook emerging psychoactive substances (EPS), such as ‘Shabu”, pregabalin, and benzodiazepines. Further studies are needed, including educational initiatives, national surveys, stricter drug regulations, and an early warning system for traditional SMD and EPS.

Associations between high temperature exposure and overdose fatalities (amphetamine, cocaine, and opioid use) in Quebec from 2015 to 2022

Associations between high temperature exposure and overdose fatalities (amphetamine, cocaine, and opioid use) in Quebec from 2015 to 2022

Gonorrhea and Chlamydia Opt-Out Screening of Justice-Involved Females During Intake at the Los Angeles County Jail: The Pivotal Role of Correctional Health Systems.

Chlamydia and gonorrhea are two of the most common sexually transmitted infections (STIs) worldwide, presenting major public health challenges and resulting in billions of dollars in direct medical costs in the U.S. Incarcerated females have a particularly elevated risk of these infections, which can result in serious sequelae if left untreated. On December 13, 2021, the Los Angeles County Jail system began offering opt-out urogenital chlamydia and gonorrhea screening to all newly incarcerated females. We retrospectively analyzed electronic health record data for completed urogenital chlamydia/gonorrhea screening among newly incarcerated females between December 13, 2021, and May 31, 2023. We used multivariable logistic regression to examine the association of STIs and treatment non-initiation outcomes with various demographic and self-reported variables. Of the 13,739 female entrants offered STI testing, 10,717 (78%) completed screening, with 1151 (11%) having a chlamydial infection, 788 (7%) having a gonococcal infection, and 1626 (15%) having >1 infection. STI positivity was associated with age 18-34, reported houselessness, amphetamine use, and history of a positive prior treponemal antibody test. STI treatment non-initiation was associated with shorter jail stay for both chlamydial ([aOR] = 87.4, 95% CI (34.2, 223.2)) and gonococcal ([aOR] = 9.0, 95% CI (5.2, 15.7)) infections. The STI prevalence among female detainees tested was manyfold higher than that of the general population. The implementation of routine opt-out STI screening in carceral settings provides a unique opportunity to benefit the health of both the correctional population and potentially that of the surrounding community.

Neural correlates of impulsivity in amphetamine use disorder

Impulsivity is a trait associated with several psychiatric conditions, not least addictive disorders. While the neural mechanisms behind certain aspects of impulsivity have been studied extensively, there are few imaging studies examining this neurocircuitry in populations with substance use disorders. Therefore, we aimed to examine the functional connectivity of relevant neural networks, and their possible association with trait impulsivity, in a sample with severe amphetamine use disorder and a control group of healthy subjects. We used data collected in a randomized clinical trial studying the acute effects of oral naltrexone in amphetamine use disorder. Our final sample included 32 amphetamine users and 27 healthy controls. Trait impulsivity was rated with the Barratt Impulsiveness Scale-11, and functional connectivity was measured during resting-state fMRI, looking specifically at networks involving prefrontal regions previously implicated in studies of impulsivity. Amphetamine users had higher subjective ratings of impulsivity as compared to healthy controls, and these scores correlated positively with a wide-spread prefrontal hyperconnectivity that was found among the amphetamine users. These findings highlight the importance of aberrant prefrontal function in severe addiction.

Not the Yeast of Our Worries: A Case of Amphetamine-Induced Esophagitis

A 68-year-old male with active amphetamine use presented to the hospital with acute emesis, odynophagia, and mid-sternal chest pain. Imaging was initially concerning for esophageal perforation. After full evaluation including barium esophagram and serial computed tomography (CT) of the chest, no esophageal perforation was confirmed. He underwent endoscopy, which identified white, circumferential plaques along the length of the esophagus. Gross appearance on endoscopy was consistent with Candidal esophagitis. Ultimately, pathology was negative for fungal elements, and esophagitis was attributed to amphetamine use. We report a rare case of amphetamine-induced esophagitis and discuss the initial management of esophageal perforation, risk factors for, and diagnostic mimickers of Candidal esophagitis.

Impulsiveness, suicide, and aggression in a sample of patients with disorders of methyl amphetamine use.

Research has showed a link between patients with methamphetamine dependence and the risk of impulsiveness, aggression, and the risk of suicide. But, this link has not been studied in patients abusing methamphetamine, and it is unknown how impulsiveness, aggression, and the risk of suicide affect them. This cross-sectional study included 130 adult patients diagnosed with the disorder of the use of amphetamine, methamphetamine, cannabinoids, alcohol, other substances, and polysubstance admitted in the Addiction Department for Mental Health. Participants were interviewed for detailed psychiatric history using a structured questionnaire comprising of structured clinical interview for diagnosis I, Arabic version of the Barratt Impulsiveness Scale-11 (BIS), Beck Scale for Suicidal Ideation for the evaluation of suicidal ideation and behavior, and the Aggression and Hostility scale for adolescents and youth. SPSS was used for data analysis; Initial analysis included descriptive statistics: frequencies and percentages for categorical variables and mean and standard deviation for continuous variables. Chi-square test/Fisher's exact test assessed for association between categorical variables, whereas one-way analysis of variance (ANOVA)/ Kruskal-Wallis test was used to compare continuous variables. Patients who used methamphetamine either alone (23%) or with polysubstance (42.6%) were associated with higher suicidal risk than patients who did use other substances than methamphetamine (36.1%). A comparison of the three groups on impulsivity, showed significant difference regarding total scores, motor preservation, and non-planning self-control. No significant differences found between three groups on the aggression scores. There was a higher rate of impulsivity and suicidal risk in patients with methamphetamine dependence in comparison to dependence on other substances, while there was no difference with regard to aggression between patients with methamphetamine dependence and those dependent on other substances. This finding raises the issue of methamphetamine use disorder as a new substance of dependence.

Prevalence and correlates of sexual intercourse under influence of alcohol among Thai adolescents: lessons from a nationwide school-based survey.

Having sex under the influence of alcohol is a risky behavior and this study explored its prevalence and correlates among school-going Thai adolescents. The data from the 2021 Thailand Global School-based Student Health Survey (GSHS), including a nationally representative sample of students in grades 7-12th, was used to extract the relevant variables including demographic, psychosocial, substance use, and risky sex behaviors. Logistic regression was used to assess the odds of engaging in sex while intoxicated across the independent variables while accounting for age and sex differences. Approximately 30.45 % of respondents reported alcohol intoxication and 37.75 % reported engaging in sexualintercourse while intoxicated at least once. Older adolescents (>14 years), males, and those in 11 and 12 grades were more likely to engage in sexual intercourse while intoxicated. Psychosocial factors such as loneliness and anxiety-induced insomnia were associated with increased likelihood, particularly among females. Substance use, including marijuana and amphetamine use, as well as cigarette smoking, correlated with higher odds of engaging in sexual intercourse while intoxicated. Both genders who engaged in sex while intoxicated reported having multiple sexual partners, with males more likely to use condoms. The intricate relationship between poor mental health, substance use, and risky sex behaviors along with their association with sex under alcohol influence emphasizes the need for a holistic approach to address the common risk factors and implement effective school-based screening strategies to identify the risk groups, educate them, and prevent the burden of risky sex under alcohol intoxication.

Naloxone Use During Pregnancy-Data From 26 US Jurisdictions, 2019-2020.

We aimed to determine the prevalence of self-reported naloxone use during pregnancy among people in the United States with a recent live birth. A secondary objective was to characterize people at increased risk of overdose who did and did not use naloxone. We analyzed data from the Pregnancy Risk Assessment Monitoring System from 26 US jurisdictions that conducted an opioid supplement survey from 2019 to 2020. Respondents with increased risk of experiencing an opioid overdose were identified based on self-reported use of illicit amphetamines, heroin, cocaine, or receiving medication for opioid use disorder (MOUD) during pregnancy. Weighted prevalence estimates and 95% confidence intervals were calculated for reported naloxone use at any point during pregnancy among people with an increased risk of overdose. Naloxone use during pregnancy was reported by <1% of the overall study population (unweighted N = 88/34,528). Prevalence of naloxone use was 5.0% (95% CI: 0.0-10.6) among respondents who reported illicit amphetamine use, 15.2% (1.8-28.6) among those who reported heroin use, and 17.6% (0.0-38.1) among those who reported cocaine use. Naloxone use was 14.5% (8.4-20.6) among those who reported taking MOUD. Among people with increased risk of overdose, no significant differences in naloxone use were observed by age, race/ethnicity, education level, residential metropolitan status, or insurance status. Prevalence of naloxone use among people with an increased risk of overdose during pregnancy ranged from 5.0% to 17.6%. Access to naloxone, overdose prevention education, and treatment for substance use disorders may help reduce morbidity and mortality.

Amphetamine use for attention deficit hyperactive disorder during breastfeeding and children's neurodevelopmental outcomes: A pilot study

Attention deficit hyperactive disorder (ADHD) medication use rises among women of childbearing age and during pregnancy. Little is known on the safety of amphetamine stimulants for ADHD treatment during breastfeeding. Most data on the safety of these medications are from recreational abuse of methamphetamine. This study followed children (N = 13) exposed to amphetamine stimulants during breastfeeding. Assessments by Pediatric Quality of Life and Denver Developmental Scale evaluated neurodevelopment and outcomes. Study results showed normal neurodevelopment with no significant adverse effects. Findings suggest amphetamines are likely compatible with breastfeeding; however larger studies are needed.

Substance Use Disorder Admission Rates Before and After the Lockdown in a Large Addiction Center in Saudi Arabia: A Retrospective Cohort Study

Objective: This study aimed to examine the potential changes in substance use disorder (SUD) admission rates before and after the lockdown in a major addiction center in Saudi Arabia. Method: This retrospective cohort study extracted data from Al-Amal Hospital Electronic Health Record in the city of Dammam, Eastern region of Saudi Arabia. A total of 2,426 cases included in the analysis for patients who received services from the SUD treatment programs from 1/1/2015 to 31/12/2021. Results: Before the pandemic, there was a consistent increase in the admission rates for patients with substance use disorder. The highest proportion of increase were among unemployed, young, newly admitted patients. During lockdown, there was nearly a 70% reduction in SUDs-related admission rate. The age group 18–25 was seven-times more likely to be admitted for SUD after the lockdown. Amphetamine-related admissions were two times more likely to be admitted after the lockdown (Odds ratio (OR) 2.04; confidence interval (CI) 95%[1.64, 2.54]). Conclusions: There was nearly 70% reduction in SUDs admission rates during the lockdown. After the lockdown, a significant proportional increase in amphetamine use disorder admissions was observed mostly among the patients age group 18–24 with a history of a previous admissions. Determining populations at risk for high health care utilization is crucial in building a comprehensive and effective prevention strategy. Therefore, the need to adopt coordinated strategies and innovative, comprehensive approaches to benefit individuals with SUD is imperative to face the increased rate of SUD related admissions.

The occurrence and severity of obsessive-compulsive disorder in the opium and amphetamine users

ABSTRACT Objective Simultaneous occurrence of psychological disorders such as obsessive-compulsive disorder (OCD) has been reported in patients with a history of substance abuse. We evaluated the occurrence and severity of OCD in opium and amphetamine users. Methods In this cross-sectional study, patients with a history of opium use (n = 100) or with a history of amphetamine use (n = 100) were studied. The diagnosis of OCD was based on the Yale-Brown Obsessive Compulsive questionnaire. Results Regarding the prevalence of OCD in the two groups of opium and amphetamine users, 36% and 22% suffered from very mild OCD, 48% and 36% from mild OCD, 13% and 27% from moderate OCD and 3% and 15% from severe OCD. The severity of OCD was independent of gender and marital status in both groups. In amphetamine users’ group, OCD severity was linked to patients’ age and time for drug usage. Conclusion The severity of OCD is much more severe in amphetamine-dependent patients than in opium-dependent patients. In opioid-dependent patients, the severity of OCD is independent of gender, age, marital status, or duration of drug use, but in amphetamine-dependent patients, the severity of disorder is directly related to age and duration of amphetamine use.

Enantiomeric profile of amphetamines in seized drug samples and in blood of impaired drivers in Iceland: The rise of (R)-methamphetamine?

Amphetamine (AMP) and methamphetamine (METH) use is increasing globally. Illegal AMP is generally a racemic mixture, whereas AMP-containing attention-deficit hyperactivity disorder drugs prescribed in Iceland consist of S-AMP. AMP is also a main metabolite of interest after METH intake. Distinguishing between legal and illegal AMP intake is vital in forensic toxicology. A chiral UPLC-MS-MS method was used to determine the enantiomeric profile of AMP and METH in circulation in Iceland by analysing blood samples from drivers suspected of driving under the influence of drugs (DUID) and seized drug samples from 2021 and 2022. All seized AMP samples (n = 48) were racemic, whereas all but one seized METH sample (n = 26) were enantiopure. Surprisingly, a large portion of the enantiopure METH samples was R-METH. DUID blood samples positive for AMP (n = 564) had a median blood concentration of 180 ng/mL (range 20-2770 ng/mL) and a median enantiomeric fraction (EFR) of 0.54 (range 0-0.73), whereas samples positive for METH (n = 236) had a median blood concentration of 185 ng/mL (range 20-2300 ng/mL) and a median EFR of 0.23 (range 0-1). The findings of this study show a significantly lower blood concentration in drivers with only S-AMP detected compared with when the R-isomer is also detected. No significant difference in blood concentration was detected between the sample groups containing S-METH, R-METH or both enantiomers. The occurrence of R-METH in both seized drug samples and DUID cases indicates a change in drug supply and a need for better scientific knowledge on R-METH abuse.

Medications for attention deficit hyperactivity disorder associated with increased risk of developing glaucoma.

Attention deficit hyperactivity disorder (ADHD) therapies including atomoxetine, methylphenidate, and amphetamines are some of the most prescribed medications in North America. Due to their sympathomimetic action, these drugs are contraindicated in patients with a history of angle closure glaucoma (ACG). This study aims to determine the risk of ACG and open angle glaucoma (OAG) among users of these treatments. This is a retrospective cohort study with a case control analysis using the PharMetrics Plus Database (IQVIA, USA). We created a cohort of new users of atomoxetine, methylphenidate, and amphetamines and they were followed to the first diagnosis of (1) ACG or OAG; or (2) end of follow up. For each case, four age-matched controls were selected. A conditional logistic regression model was used to adjust for confounders and to calculate adjusted incidence-rate-ratios (aIRRs). A total of 240,257 new users of the ADHD medications were identified. The mean age was 45.0 ± 19.4 years and 55% of the cohort was female. Regular users of atomoxetine and amphetamines had a higher aIRR for developing ACG compared with non-users (aIRR = 2.55 95% CI [1.20-5.43] and 2.27 95% CI [1.42-3.63], respectively); while users of methylphenidate had a higher aIRR for developing OAG (aIRR = 1.23 95% CI [1.05-1.59]). Use of amphetamines and atomoxetine had a higher risk for ACG, while use of methylphenidate was associated with a higher risk for OAG. Given the prevalence of ADHD medication use (medically and recreationally), our current data on their associated risk of glaucoma have profound public health implications.

Enantiomer-specific analysis of amphetamine in urine, oral fluid and blood.

Illegal amphetamine is usually composed of a racemic mixture of the two enantiomers (S)- and (R)-amphetamine. However, when amphetamine is used in medical treatment, the more potent (S)-amphetamine enantiomer is used. Enantiomer-specific analysis of (S)- and (R)-amphetamine is therefore used to separate legal medical use from illegal recreational use. The aim of the present study was to describe our experience with enantiomer-specific analysis of amphetamine in urine and oral fluid, as well as blood, and examine whether the distribution of the two enantiomers seems to be the same in different matrices. We investigated 1,722 urine samples and 1,977 oral fluid samples from prison inmates, and 652 blood samples from suspected drugged drivers, where prescription of amphetamine was reported. Analyses were performed using ultra high performance liquid chromatography-tandem mass spectrometry (UHPLC-MS-MS). The enantiomer separation was achieved by using a chiral column, and results from the method validation are reported. Samples containing <60% (S)-amphetamine were interpreted as representing illegal use of amphetamine. The distribution of the two enantiomers was compared between different matrices. In urine and oral fluid, the mean amount of (S)-amphetamine was 45.2 and 43.7%, respectively, while in blood, the mean amount of (S)-amphetamine was 45.8%. There was no statistically significant difference in the amount of (S)-amphetamine between urine and oral fluid samples and between urine and blood samples, but the difference was significant in blood compared to oral fluid samples (P < 0.001). Comparison of urine and oral fluid between similar populations indicated that enantiomers of amphetamine can be interpreted in the same way, although marginally higher amounts of (R)-amphetamine may occur in oral fluid. Oral fluid, having several advantages, especially during collection, could be a preferred matrix in testing for illegal amphetamine intake in users of medical amphetamine.

Alcohol withdrawal and amphetamine co-use in an animal model for attention deficit hyperactivity disorder

ABSTRACT Background: Non-medical use of amphetamine and other stimulants prescribed for treatment of attention deficit/hyperactivity disorder (ADHD) is of special concern when combined with alcohol consumption. In a previous study, we modeled chronic ethanol-amphetamine co-use in adolescent Long-Evans (LE) rats and provided evidence that amphetamine attenuates alcohol withdrawal symptoms. Objectives: This project modeled co-use of amphetamine with alcohol in adolescents with ADHD-like symptoms by examining ethanol-amphetamine administration in adolescent Spontaneously Hypertensive Rats (SHR), an experimental model for the study of ADHD. Withdrawal symptoms were compared among SHR and two control rat strains, LE and Wistar Kyoto (WKY). Methods: At postnatal day 32, parallel groups of 12–24 male SHR, WKY and LE rats were administered a liquid diet containing ethanol (3.6%) and/or amphetamine (20 mg/L). Following administration periods up to 26 days, rats were withdrawn from their treatment and tested for overall severity of alcohol withdrawal symptoms, general locomotor activity, and anxiety-like behavior. Results: Overall withdrawal severity was lower for SHR than for LE (p < .001) or WKY (p = .027). Co-consumption of amphetamine decreased withdrawal severity for LE (p = .033) and WKY (p = .011) but not SHR (p = .600). Only WKY showed increased anxiety-like behavior during withdrawal (p = .031), but not after amphetamine co-administration (p = .832). Conclusion: Alcohol withdrawal severity may be attenuated when co-used with amphetamine. However, as a model for ADHD, SHR adolescents appeared resistant to developing significant signs of alcohol withdrawal following alcohol consumption. Whether alcohol withdrawal symptoms are attenuated or absent, potential consequences could include a decreased awareness of an emerging problem with alcohol use.