Use Of Other Psychoactive Substances Research Articles

Trends in the nonmedical misuse of benzodiazepines and Z-hypnotics among school-aged adolescents (2016-2021): gender differences and related factors.

The misuse of psychotropic medication has increased during the past decade, especially among adolescents. The aim of our study was to describe the prevalence and patterns of the nonmedical use of benzodiazepines (BDZ) and Z-hypnotics among school-aged adolescents through the lens of sex. In addition, we sought to analyze the temporal evolution of the nonmedical use of these drugs during the period 2016-2021. The temporal evolution of the nonmedical use of these drugs was analyzed based on survey data collected in 2016, 2018 and 2021, which includes the first years of the COVID-19 pandemic. To assess the possible effect of the COVID-19 pandemic, the year at survey was conducted was introduced as a categorical variable. We used data from the Spanish State Survey on Drug Use in Secondary Education, which covers drug use among students aged 14-18 years. Using multivariate logistic regression models, we estimated the independent effect of different variables (sociodemographic data, use of other psychoactive substances, risk perception and availability) on the nonmedical use of BDZ and Z-hypnotics. In total, survey data from 95,700 adolescents were included in our analysis. The nonmedical use of BDZ and Z-hypnotics increased among adolescents during the study period. The adjusted odds ratio (AOR) from 2016 to 2018 was 1.11 (95% CI 0.94-1.31) and from 2018 to 2021 the AOR was 1.26 (95% CI 1.08-1.46), using 2016 and 2018, respectively, as reference years. The nonmedical use of BDZ and Z-hypnotics was more likely in adolescent girls than boys (AOR = 2.11). The nonmedical use of prescription opioids (AOR = 3.44), novel psychoactive substances and other illicit psychoactive drugs (AOR = 4.10) were risk factors for the nonmedical use of BDZ and Z-hypnotics in both sexes. Use of cannabis (AOR = 1.38) was a predictor of nonmedical use in female adolescents only. This study shows that the trend of the nonmedical use of BDZ and Z-hypnotics among school-aged adolescents in Spain increased between 2016 and 2021. Among adolescents aged 14 to 18, the probability of nonmedical use of these psychoactive substances was twice as high for female adolescents as for male adolescents.

Psychosocial and medication interventions to stop or reduce alcohol consumption during pregnancy.

Despite the known harms, alcohol consumption is common in pregnancy. Rates vary between countries, and are estimated to be 10% globally, with up to 25% in Europe. To assess the efficacy of psychosocial interventions and medications to reduce or stop alcohol consumption during pregnancy. We searched the Cochrane Drugs and Alcohol Group Specialised Register (via CRSLive), Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, Embase, CINAHL, Web of Science, and PsycINFO, from inception to 8 January 2024. We also searched for ongoing and unpublished studies via ClinicalTrials.gov and the World Health Organization (WHO) International Clinical Trials Registry Platform (ICTRP). All searches included non-English language literature. We handsearched references of topic-related systematic reviews and included studies. We included randomised controlled trials that compared medications or psychosocial interventions, or both, to placebo, no intervention, usual care, or other medications or psychosocial interventions used to reduce or stop alcohol use during pregnancy. Our primary outcomes of interest were abstinence from alcohol, reduction in alcohol consumption, retention in treatment, and women with any adverse event. We used standard Cochrane methodological procedures. We included eight studies (1369 participants) in which pregnant women received an intervention to stop or reduce alcohol use during pregnancy. In one study, almost half of participants had a current diagnosis of alcohol use disorder (AUD); in another study, 40% of participants had a lifetime diagnosis of AUD. Six studies took place in the USA, one in Spain, and one in the Netherlands. All included studies evaluated the efficacy of psychosocial interventions; we did not find any study that evaluated the efficacy of medications for the treatment of AUD during pregnancy. Psychosocial interventions were mainly brief interventions ranging from a single session of 10 to 60 minutes to five sessions of 10 minutes each. Pregnant women received the psychosocial intervention approximately at the end of the first trimester of pregnancy, and the outcome of alcohol use was reassessed 8 to 24 weeks after the psychosocial intervention. Women in the control group received treatment as usual (TAU) or similar treatments such as comprehensive assessment of alcohol use and advice to stop drinking during pregnancy. Globally, we found that, compared to TAU, psychosocial interventions may increase the rate of continuously abstinent participants (risk ratio (RR) 1.34, 95% confidence interval (CI) 1.14 to 1.57; I2 =0%; 3 studies; 378 women; low certainty evidence). Psychosocial interventions may have little to no effect on the number of drinks per day, but the evidence is very uncertain (mean difference -0.42, 95% CI -1.13 to 0.28; I2 = 86%; 2 studies; 157 women; very low certainty evidence). Psychosocial interventions probably have little to no effect on the number of women who completed treatment (RR 0.98, 95% CI 0.94 to 1.02; I2 = 0%; 7 studies; 1283 women; moderate certainty evidence). None of the included studies assessed adverse events of treatments. We downgraded the certainty of the evidence due to risk of bias and imprecision of the estimates. Brief psychosocial interventions may increase the rate of continuous abstinence among pregnant women who report alcohol use during pregnancy. Further studies should be conducted to investigate the efficacy and safety of psychosocial interventions and other treatments (e.g. medications) for women with AUD. These studies should provide detailed information on alcohol use before and during pregnancy using consistent measures such as the number of drinks per drinking day. When heterogeneous populations are recruited, more detailed information on alcohol use during pregnancy should be provided to allow future systematic reviews to be conducted. Other important information that would enhance the usefulness of these studies would be the presence of other comorbid conditions such as anxiety, mood disorders, and the use of other psychoactive substances.

Effect of the COVID-19 Emergency State in the Latvian General Population with Depression and Distress on Changes of Patterns of Smoking and Psychoactive Substance Use

Abstract The World Health Organisation warned that the COVID-19 pandemic could have psychiatric consequences, such as elevated levels of depression and increased alcohol and psychoactive substance use. On 12 March 2020, Latvia declared a state of emergency, which was repealed on 10 June 2020. A nationwide representative online study in the general population of Latvia was conducted from 7 to 27 July 2020. The Centre for Epidemiologic Studies Depression Scale was used to determine the presence of distress/depression. A structured questionnaire was used to determine psychoactive substance use. The study sample included 2608 respondents. In the study population, prevalence of depression and distress was estimated to be 5.7% (95% CI 4.92–6.71) and 7.82% (95% CI 6.85–8.91), respectively. Patients with depression and distress smoked more tobacco than respondents without distress/depression. During the state of emergency, there were changes in smoking habits in patients with depression, in contrast with respondents without reported depressive symptoms, with a tendency to smoke either more (28% vs. 7.4%) or less (22% vs. 9.7%). Patients with distress smoked more than healthy patients (30.9% vs. 7.4%). Patients with depression and distress were significantly more likely to consume more alcohol during an emergency (14.0% and 17.7%). Patients with depression were more likely to use less alcohol during an emergency than healthy respondents (18.0% vs. 10.6%). There was no statistically significant difference in the use of other psychoactive substances among those who were depressed or in distress. Participants with depression were more likely to change their smoking habits during the state of emergency and to consume smaller alcohol amounts compared to participants without symptoms. Participants with distress smoked more and consumed larger alcohol amounts compared to healthy participants.

Ayahuasca ceremonies: set and setting features across Italy and Colombia

PurposeAyahuasca ceremonies are currently practiced all over the world. This study aims to investigate ayahuasca ceremonies in Colombia (where ayahuasca use is culturally entrenched) and Italy (where ayahuasca use has only recently spread).Design/methodology/approachIn total, 32 Italian (53% males; 47% females) and 28 Colombian (79% males; 21% females) ayahuasca ceremony participants completed an online survey. Ceremonial setting and set (motivations for ayahuasca use, ayahuasca perceived effects and features of participants, i.e. drug use and problematic use, interpersonal dependency, spiritual orientation and quality of life) were investigated. Mann–Whitney U test, Pearson’s χ2 test and Fisher’s exact test were used to compare the Italian and Colombian samples.FindingsNo differences emerged in the ceremonial setting. Slight differences were observed in motivations for ayahuasca intake and religious beliefs, but not in the preparation for ceremonies, quality of life, interpersonal dependence and spiritual orientation. Italians showed greater use of other psychoactive substances and more drug use problems.Practical implicationsPrevention regarding safer practices of consumption should be promoted to avoid improper uses.Originality/valueFew studies have explored ayahuasca ceremonies (set and setting characteristics) in countries with different traditions on ayahuasca consumption. The results highlight that the use and experience of ayahuasca can take on different meanings depending on the cultural context.

Trends in use of antipsychotics and psychoactive drugs in older patients after major surgery.

Professional society guidelines recommend limiting the use of antipsychotics in older patients with postoperative delirium. How these recommendations affected the use of antipsychotics and other psychoactive drugs in the postoperative period has not been studied. This retrospective cohort study included patients 65 years or older without psychiatric diagnoses who underwent major surgery in community hospitals (CHs) and academic medical centers (AMCs) in the United States. The outcome was the rate of hospital days exposed to antipsychotics, antidepressants, antiepileptics, benzodiazepines, hypnotics, and selective alpha-2 receptor agonist dexmedetomidine in the postoperative period by hospital type. The study included 4,098,431 surgical admissions from CHs (mean age 75.0 [standard deviation, 7.1] years; 50.8% female) during 2008-2018 and 2,310,529 surgical admissions from AMCs (75.0 [7.4] years; 49.4% female) during 2009-2018. In the intensive care unit (ICU) setting, the number of exposed days per 1000 hospital-days declined for haloperidol (CHs: 33-21 days [p < 0.01]; AMCs: 24-15 days [p < 0.01]) and benzodiazepines (CHs: 261-136 days [p < 0.01]; AMCs: 150-77 days [p < 0.01]). The use of atypical antipsychotics, antidepressants, antiepileptics, and dexmedetomidine increased, while hypnotic use varied by the hospital type. In the non-ICU setting, the rate declined for haloperidol in CHs but not in AMCs (CHs: 10-6 days [p < 0.01]; AMCs: 4-3 days [p = 0.52]) and for benzodiazepines in both settings (CHs: 126-56 days [p < 0.01]; AMCs: 30-27 days [p < 0.01]). The use of antiepileptics and antidepressants increased, while the use of atypical antipsychotics and hypnotics varied by the hospital type. The use of haloperidol and benzodiazepines in the postoperative period declined at both CHs and AMCs. These trends coincided with the increasing use of other psychoactive drugs.

Associations between mental health challenges, sexual activity, alcohol consumption, use of other psychoactive substances and use of COVID-19 preventive measures during the first wave of the COVID-19 pandemic by adults in Nigeria

BackgroundThe aims of this study were to assess: 1) the associations among sexual activity, alcohol consumption, use of other psychoactive substances and mental health during the COVID-19 pandemic; and 2) the associations between COVID-19 preventive measures, alcohol consumption and use of psychoactive substances.MethodsThis was a secondary analysis of data collected from adults in Nigeria between July and December 2020. The variables extracted included change in sexual activity, alcohol consumption and use of other psychoactive substances, COVID-19 preventive behaviors (wearing face masks, washing hands, physical distancing), anxiety, depression, post-traumatic stress disorder (PTSD) and sociodemographic variables (age, sex, education, HIV status, employment status). Multivariable logistic regressions were conducted. A model was run to regress depression, anxiety, PTSD, increased alcohol consumption, and increased use of other psychoactive substances, on increased sexual activity. In separate models, anxiety, depression, and PTSD were regressed on increased alcohol consumption and on increased use of other psychoactive substances. Finally, three models were constructed to determine the associations between increased alcohol consumption and increased use of other psychoactive substances on three separate COVID-19 preventive behaviors. All models were adjusted for sociodemographic variables.ResultsIncreased alcohol consumption (AOR:2.19) and increased use of other psychoactive substances (AOR: 3.71) were significantly associated with higher odds of increased sexual activity. Depression was associated with significantly higher odds of increased alcohol consumption (AOR:1.71) and increased use of other psychoactive substances (AOR:3.21). Increased alcohol consumption was associated with significantly lower odds of physical distancing (AOR:0.59).ConclusionThere was a complex inter-relationship between mental health, sexual health, increased use of psychoactive substances. The consumption of alcohol also affected compliance with physical distancing. Further studies are needed to understand the observed relationships.

Psychosocial Factors Associated With Alcohol Use among Persons Aged 18-35 Years in Kangundo North Ward, Machakos County, Kenya

Purpose: The objective of this study was to explore the psychosocial factors associated with alcohol use among persons aged 18-35 years in Kangundo North Ward, Machakos County. &#x0D; Methodology: A cross sectional study design where data was collected using a structured questionnaire. Data entry was done and analyzed using SPSS version 23, descriptive statistics was used. Logistic regressions were used to explore the psychosocial factors associated with alcohol use where Odds ratios were used. Multivariate and bivariate analysis were done to establish association between psychosocial factors and alcohol use.&#x0D; Findings: 310 respondents were interviewed, the response rate was 100%, 86% were males while 14% were females, 86% of alcohol consumers were males, while 14% who consumed alcohol were females. 89% were aged between 18-24 years, 8% were aged between 25-29 years while 3% were 30-35 years. The study revealed that youths aged 18-35 years suffer a wide variety of challenges.49% of the respondents had experienced financial difficulties, 11% were victims of robbery, these stressful life events can lead to one using alcohol. Majority of respondents had ever experienced stressful event with 50% using alcohol as a solution to relieve the stress. 50.32% indicated that they started taking alcohol after the stressful experiences, 48% had experienced physical violence,5% sexual violence,45% emotional violence while 24% had undergone harsh childhood experiences. The study findings revealed that (28%) had consumed tobacco, (17%) miraa, (8%) marijuana, (1%) inhalants while (46%) had never consumed any psychoactive substance. There was significant association between experiences of emotional, sexual abuse, harsh childhood experiences and use of other psychoactive substances with alcohol use (p&lt;0.05).&#x0D; Unique Contribution to Theory, Practice and Policy: Targeted interventions aimed at addressing psychosocial factors associated with alcohol use is vital. The study adds to the pool of knowledge that psychosocial issues such as stressful life events, gender based violence, harsh childhood experiences and use of other psychoactive substances contribute to alcohol use. Awareness on Gender based violence and other psychoactive substances such as cigarette and marijuana use needs to be enhanced. The findings of the study may inform the local county government of Machakos and Kangundo Sub-county administrators in formulating policies to help address alcohol use among persons aged 18-35 years.

Neurotensin and Alcohol Use Disorders: Towards a Pharmacological Treatment.

Harmful alcohol use is responsible for a group of disorders collectively named alcohol use disorders (AUDs), according to the DSM-5 classification. The damage induced by alcohol depends on the amount, time, and consumption patterns (continuous and heavy episodic drinking). It affects individual global well-being and social and familial environments with variable impact. Alcohol addiction manifests with different degrees of organ and mental health detriment for the individual, exhibiting two main traits: compulsive drinking and negative emotional states occurring at withdrawal, frequently causing relapse episodes. Numerous individual and living conditions, including the concomitant use of other psychoactive substances, lie in the complexity of AUD. Ethanol and its metabolites directly impact the tissues and may cause local damage or alter the homeostasis of brain neurotransmission, immunity scaffolding, or cell repair biochemical pathways. Brain modulator and neurotransmitter-assembled neurocircuitries govern reward, reinforcement, social interaction, and consumption of alcohol behaviors in an intertwined manner. Experimental evidence supports the participation of neurotensin (NT) in preclinical models of alcohol addiction. For example, NT neurons in the central nucleus of the amygdala projecting to the parabrachial nucleus strengthen alcohol consumption and preference. In addition, the levels of NT in the frontal cortex were found to be lower in rats bred to prefer alcohol to water in a free alcohol-water choice compared to wild-type animals. NT receptors 1 and 2 seem to be involved in alcohol consumption and alcohol effects in several models of knockout mice. This review aims to present an updated picture of the role of NT systems in alcohol addiction and the possible use of nonpeptide ligands modulating the activity of the NT system, applied to experimental animal models of harmful drinking behavior mimicking alcohol addiction leading to health ruin in humans.

Associations between HIV Status, SARS-CoV-2 Infection, Increase in Use of Psychoactive Substances and Oral Ulcers among People Who Used Psychoactive Substances during the First Wave of the COVID-19 Pandemic

The aim of this study was to assess the associations between HIV status, SARS-CoV-2 infection, increase in use of psychoactive substances and oral ulcers among people who use psychoactive substances. This was a secondary analysis of the data of 1087 people who used psychoactive substances collected during the first wave of the COVID-19 pandemic. The data extracted were confounding (age, sex, the highest level of education attained, employment status, emotional distress status), dependent (oral ulcers) and independent (SARS-CoV-2 infection, increase in alcohol consumption, smoking and use of other psychoactive substances, living with HIV) variables. A multivariate logistic regression model was constructed to determine the associations between the dependent and independent variables after adjusting for the confounding variables. Participants who had a history of SARS-CoV-2 infection (AOR:10.37) and people living with HIV (AOR:1.91) had higher odds of reporting oral ulcers. The finding suggests that people who used psychoactive substances, had COVID-19 and lived with HIV were at increased risk for oral ulcers during the first wave of the COVID-19 pandemic. Increased use of psychoactive substances was not associated with a significant increase in the risk for oral ulcers. Further research is needed to better understand the reasons for these findings.

Psychedelics and psychological strengths

Classical psychedelics appear efficacious in improving psychological well-being in randomized clinical trials, but their effects in the population at large are relatively unknown. In the present paper, which includes three studies conducted by online survey with a collective 3,157 participants, classical psychedelic users showed greater psychological strengths and well-being, and lower levels of distress, after controlling for demographic variables, respondents’ beliefs about the potential benefits of psychedelics, and their use of other psychoactive drugs. These benefits contrast with patterns for cannabis and alcohol users, both of whom showed comparatively maladaptive profiles. Reported relationships between psychedelic use and the combined index of psychological strengths was fully mediated by self-transcendence. We show an effect of motivation for psychedelic use, where those who reported a ‘growth’ motivation showed the most robustly adaptive psychological profile. Psychedelic users reported more lifetime meditation experience, and within psychedelic users, greater frequency of use correlated with greater hours of lifetime seated meditation practice. Meditation experience did not account for the differences in strengths, well-being, and distress. In these studies, psychedelic users showed an adaptive psychological pattern on a wider array of strengths than previously studied, which were not attributable to several salient covariates. While causality cannot be inferred from this study, findings align with and advance past research which provides evidence for the potential benefits associated with psychedelics.

Altered functional connectivity and oscillatory dynamics in polysubstance and cannabis only users during visuospatial processing.

Cannabis use is often associated with the use of other psychoactive substances, which is subsequently linked to an increased risk for addiction. While there is a growing body of neuroimaging literature investigating the cognitive effect of long-term cannabis use, very little is known about the potential additive effects of cannabis polysubstance use. Fifty-six adults composed of 18 polysubstance users (i.e., cannabis plus at least one other illicit substance), 19 cannabis-only users, and 19 nonusers completed a visuospatial attention task while undergoing magnetoencephalography. A data-driven approach was used to identify oscillatory neural responses, which were imaged using a beamforming approach. The resulting cortical regions were probed for group differences and used as seeds for whole-brain connectivity analysis. Participants exhibited robust theta, alpha, beta, and gamma responses during visuospatial processing. Statistical analyses indicated that the cannabis-only group had weaker occipital theta relative to the nonusers, and that both polysubstance and cannabis-only users had reduced spontaneous gamma in the occipital cortices during the pre-stimulus baseline period relative to nonusers. Finally, functional connectivity analyses revealed that polysubstance users had sharply reduced beta connectivity between occipital and prefrontal, as well as occipital and left temporal cortices. Cannabis use should be considered in a polysubstance context, as our correlational design suggests differences in functional connectivity among those who reported cannabis-only versus polysubstance use in occipital to prefrontal pathways critical to visuospatial processing and attention function. Future work should distinguish the effect of different polysubstance combinations and use more causal designs.

A Case Study on Mental and Behavioural Disorders Due to Multiple Drug Use and Use of Other Psychoactive Substances (Icd F19)

Psychosis is associated with schizophrenia, which is primarily associated with severe impairments. And it has an impact on how other aspects of our lives, including work, family, friends, and education, operate (WHO, 2022). A person's behavior and brain are both affected by substance use disorder. It results in an inability to manage the use of a drug or medication, whether it is legal or illicit. The patient, who was diagnosed with a substance use disorder similar to schizophrenia, was the subject of this qualitative investigation. This study adopted a single-case study design. The data were collected by using a mental status examination questionnaire, and the data were analyzed by content analysis. The study participant was a 22-year-old male who has been educated in logistics management and is self-employed. The participant was an inpatient at a private mental health center. This study found that mental and behavioural disorders due to multiple drug use or other psychoactive substances can be managed through cognitive-behavioural therapy, aversion therapy, family therapy, outpatient rehabilitation, inpatient rehabilitation, and pharmacotherapy. This study also provides an insight into how schizophrenia compares to substance use disorder in terms of symptoms, causal factors, and management plans.

Mapping diagnostic trajectories from the first hospital diagnosis of a psychiatric disorder: a Danish nationwide cohort study using sequence analysis

A key clinical problem in psychiatry is predicting the diagnostic future of patients presenting with psychopathology for the first time. The objective of this study was to establish a comprehensive map of subsequent diagnoses after a first psychiatric hospital diagnosis. Through the Danish National Patient Registry, we identified patients aged 18 years or older with an inpatient or outpatient psychiatric hospital contact and who had received one of the 20 most common first-time psychiatric diagnoses (defined at the ICD-10 two-cipher level, F00-F99) between Jan 1, 1995, and Dec 31, 2008. For each first-time diagnosis, the 20 most frequent subsequent psychiatric diagnoses (F00-F99), and death, occurring during 10 years of follow-up were identified as outcomes. To assess diagnostic stability, we used social sequence analyses, assigning a subsequent diagnosis to each state with a length of 6 months following each first-time diagnosis. The subsequent diagnosis was defined as the last diagnosis given within each 6-month period. We calculated the normalised entropy of each sequence to show the uncertainty of predicting the states in a given sequence. Cox proportional hazards models were used to assess the risk of receiving a subsequent diagnosis (at the one-cipher level, F0-F9) after each first-time diagnosis. The cohort consisted of 184 949 adult patients (77 129 [41·7%] men and 107 820 [58·3%] women, mean age 42·5 years [SD 18·5; range 18 to >100). Ethnicity data were not recorded. Over 10 years of follow-up, 86 804 (46·9%) patients had at least one subsequent diagnosis that differed from their first-time diagnosis. Measured by mean normalised entropy values, persistent delusional disorders (ICD-10 code F22), mental and behavioural disorders due to multiple drug use and use of other psychoactive substances (F19), and acute and transient psychotic disorders (F23) had the highest diagnostic variability, whereas eating disorders (F50) and non-organic sexual dysfunction (F52) had the lowest. The risk of receiving a subsequent diagnosis with a psychiatric disorder from an ICD-10 group different from that of the first-time diagnosis varied substantially among first-time diagnoses. These data provide detailed information on possible diagnostic outcomes after a first-time presentation in a psychiatric hospital. This information could help clinicians to plan relevant follow-up and inform patients and families on the degree of diagnostic uncertainty associated with receiving a first psychiatric hospital diagnosis, as well as likely and unlikely trajectories of diagnostic progression. Mental Health Services, Capital region of Denmark. For the Danish translation of the abstract see Supplementary Materials section.

Quelle est la part du tabagisme dans l’augmentation du risque suicidaire chez les jeunes fumeurs ? Revue systématique

The correlation between smoking and suicide is well documented in the general population: there is an increased risk of suicide among tobacco smokers. However, the association between smoking and suicidal behaviors (ideations, plans, attempts) in youth is poorly elucidated. This is a systematic review of the literature examined data on the relationship between active and passive smoking and suicidal ideation (SI), suicide planning (SP), and suicide attempts (SA) among youth in the general population. Medline searches were performed for the period 1980-2020. Cross-sectional, case-control, prospective population-based studies of young people (age less than 18years) were included in this review; studies of specific populations (patients with an identified pathology of any kind) were excluded. This review included 43studies: 23studies on the association between active smoking and SI, SI and/or PS, TS; three studies on the association between passive smoking and suicidal behavior, three studies on the association between smoking and suicidal behavior in young people in psychiatric hospital settings, and five studies comparing the suicidal behavior of girls and boys. Analysis of the data collected lead to the conclusion that active or passive smoking is associated with suicidal behavior in young people. Smoking appears to contribute to psychopathological disorders, including depression, the use of other psychoactive substances, or psychosocial suffering which are often associated with an increased risk of suicide in young people. The correlations between smoking and the presence of mental disorders have been highlighted; tobacco use may contribute to the development of depression, anxiety and stress. Further studies are needed to verify the existence of a causal link between smoking and suicide. Smoking is associated with the risk of suicidal behavior in young people; it should be included among the criteria for assessing suicidal risk in youth. Smoking cessation, which improves psychological well-being, should be further integrated into the prevention of suicidal behavior.

Psychoactive substance use among students: A cross-sectional analysis.

Little is known about psychoactive substance use in students, apart from tobacco, alcohol, and cannabis. This study investigated the prevalence of substance use and overlap between various psychoactive substances in students. This cross‐sectional study was conducted in 10 066 students included in the i‐Share cohort between January 1, 2015, and December 31, 2017. The baseline questionnaire was the key source of information. Psychoactive substances of interest (PSI) were cannabis, cocaine, amphetamines, nitrous oxide, poppers, and MDMA. Their patterns of use were categorized as lifetime, past year, and current use. The use of other psychoactive substances including alcohol and tobacco was described in PSI users and non‐users. Most participants were female (75%), and their average age was 21 years. Lifetime use of at least one PSI was reported by 65.5% of participants. Cannabis was the most frequently used substance both over lifetime (57% of students) and past year (35%), followed by poppers and nitrous oxide (28% and 26% of students over lifetime, respectively). Among polydrug users (n = 1242), 65% used only nitrous oxide and poppers, showing a strong link between these two substances. Regular alcohol use, binge drinking, and current tobacco use were higher in PSI users than in non‐users. Substance use was higher than previously found in both French and European studies in young people. Nitrous oxide use was particularly high. Regular alcohol use, binge drinking, and tobacco use could be used as markers to identify students at risk of PSI use to be targeted by prevention programs.

Coping motives mediate the relationship between PTSD and MDMA use in adolescents with substance use disorders

BackgroundPost-traumatic stress disorder (PTSD) and substance use disorders (SUDs) often co-occur in adolescent patients. Previous research has shown that these patients differ from SUD patients without PTSD in terms of their substance use patterns. In this study, we aimed to test whether substance use in this population is related to an attempt to self-medicate PTSD-related symptoms.MethodsGerman adolescent patients (aged 13–18 years) at an outpatient clinic for SUD treatment, n = 111 (43% female), completed a self-designed questionnaire on use motives, a measure of PTSD-related experiences, and underwent a standardized psychiatric interview including structured substance use questions. Participants were subsequently classified as ‘no traumatic experiences (‘noTEs’ but SUD), ‘traumatic experiences but no current PTSD diagnosis’ (‘TEs’ with SUD), and ‘PTSD’ with SUD. After establishing a self-designed motive measurement through exploratory and confirmatory factor analyses, we calculated non-parametric group differences and a mediation analysis in a linear regression framework.ResultsThe past-year frequency of MDMA use was highest in the PTSD group and lowest in the noTE group (H (2) = 7.2, p = .027, η2 = .058), but no differences were found for frequencies of tobacco, alcohol, cannabis, or stimulant use (all H ≤ 4.9, p ≥ .085, η2 ≤ .033). While controlling for sex, the three groups showed a similar pattern (highest in the PTSD group and lowest in the noTE group) for coping scores (F (103) = 5.77, p = .004, η2 = .101). Finally, mediation analyses revealed an indirect effect of coping score (b = 0.61, 95% CI [0.29, 1.58], p = .145) on the association between group membership and MDMA use frequency.ConclusionsIn adolescent SUD patients, we found an association of current PTSD and lifetime traumatic experiences with higher MDMA use that could be partially explained by substance use being motivated by an attempt to cope with mental health symptoms. This indicates a coping process involved specifically in MDMA use compared to the use of other psychoactive substances, possibly due to unique psychoactive effects of MDMA.

Psychedelic drug use and schizotypy in young adults

Despite recently resurrected scientific interest in classical psychedelics, few studies have focused on potential harms associated with abuse of these substances. In particular, the link between psychedelic use and psychotic symptoms has been debated while no conclusive evidence has been presented. Here, we studied an adult population (n = 1032) with a special focus on young (18–35 years) and healthy individuals (n = 701) to evaluate the association of psychedelic drug use with schizotypy and evidence integration impairment typically observed in psychosis-spectrum disorders. Experimental behavioural testing was performed in a subsample of the subjects (n = 39). We observed higher schizotypy scores in psychedelic users in the total sample. However, the effect size was notably small and only marginally significant when considering young and healthy subjects (Cohen’s d = 0.13). Controlling for concomitant drug use, none of our analyses found significant associations between psychedelic use and schizotypal traits. Results from experimental testing showed that total exposure to psychedelics (frequency and temporal proximity of use) was associated with better evidence integration (Cohen’s d = 0.13) and a higher sensitivity of fear responses (Cohen’s d = 1.05) to the effects instructed knowledge in a reversal aversive learning task modelled computationally with skin conductance response and pupillometry. This effect was present even when controlling for demographics and concomitant drug use. On a group level, however, only difference in sensitivity of fear responses to instructed knowledge reached statistical significance. Taken together, our findings suggest that psychedelic drug use is only weakly associated with psychosis-like symptoms, which, in turn, is to a large extent explained by psychiatric comorbidities and use of other psychoactive substances. Our results also suggest that psychedelics may have an effect on flexibility of evidence integration and aversive learning processes, that may be linked to recently suggested therapeutic effects of psychedelic drugs in non-psychotic psychiatric populations.

The problem of teenage tobacco smoking: yesterday, today, tomorrow

The global prevalence of tobacco and nicotine-containing product use has now reached epidemic proportions, a problem particularly relevant when it comes to adolescents. Major trends in the prevalence of tobacco use among adolescents include the flattening of gender differences, the decreasing age of initiation of smoking, and the emergence of alternative uses of nicotine-containing products. The main provisions of the book devoted to tobacco use prevention among children and teenagers as the problem of the present time, edited by professors N.A. Geppe, I.M. Osmanov, N.F. Gerasimenko with the participation of a large group of authors, published in 2021 by MedCom-Pro Publishing House are presented in this work. The issues of negative influence of tobacco and nicotine-containing products not only on the somatic state of teenage smokers but also on their psychological status are reflected. Health risks associated with smoking electronic cigarettes and vape cigarettes by adolescents are described, and the correlation between smoking electronic cigarettes by adolescents and the use of other psychoactive substances is noted. As an example of Russian experience of express-prevention of smoking among adolescents the program developed at the Department of Children's Diseases of Sechenov First Moscow State Medical University (Sechenov University) by candidate of medical sciences N.G. Mashukova, candidate of medical sciences, "PARUS" (Teenage Anti-Smoking Russian Universal Training System), gave recommendations on prevention of tobacco smoking in children and teenagers in conditions of real pediatric practice, noted that introduction into practice of anti-smoking programs aimed at development of motivation to quit smoking is the most perspective measure in prevention of tobacco smoking in teenagers today.

Depression, distress and their association with patterns of psychoactive substance use during the COVID-19 emergency state in latvia

Introduction The WHO warned that the COVID-19 pandemic could have psychiatric consequences such as elevated levels depression, increased alcohol and drug use, and other behaviours that exert a strong influence on health. In Latvia a state of emergency was announced on March 12th, was extended twice and lifted on June 10th.ObjectivesTo estimate the prevalence of depression and distress in the general population of Latvia and association with substance use during the state of emergency.MethodsThe nationwide representative online study in the general population of Latvia was conducted in July 2020 during three week period. The Center for Epidemiologic Studies Depression Scale (CES-D) was used to determine the presence of distress/depression. The structured questionnaire to determine psychoactive substance use was applied. Proportions of independent variables across the study groups were compared using Chi-square test.Results The study sample included 2608 respondents. The prevalence of depression and distress was estimated at 5.7% (95%CI 4.92 – 6.71) and 13.5% (95%CI 6.85 – 8.91), respectively. Patients with depression (28% vs. 7.4%, p &lt;0.001) and distress (30.9% vs. 7.4% p &lt;0.05) smoked more tobacco compared to respondents without distress/depression. Those with depression or distress were significantly more likely to consume more alcohol during the emergency state than people without depression or distress (14.0% and 17.7% vs. 6.6%, p &lt;0.001). The changes in the use of other psychoactive substances in those who had depression or distress were not statistically significant.ConclusionsPreparing support systems to mitigate mental health consequences is needed urgently.

Reductions in alcohol use following medical cannabis initiation: results from a large cross-sectional survey of medical cannabis patients in Canada

BackgroundEvidence details how cannabis can influence the use of other psychoactive substances, including prescription medications, alcohol, tobacco and illicit drugs, but very little research has examined the factors associated with these changes in substance use patterns. This paper explores the self-reported use of cannabis as a substitute for alcohol among a Canadian medical cannabis patient population. MethodsData was derived from a survey of 2102 people enrolled in the Canadian medical cannabis program. We included 973 (44%) respondents who reported using alcohol on at least 10 occasions over a 12 month period prior to initiating medical cannabis, and then used retrospective data on the frequency and amount of alcohol use pre-and post medical cannabis initiation to determine which participant characteristics and other variables were associated with reductions and/or cessation of alcohol use. ResultsOverall, 419 (44%) participants reported decreases in alcohol usage frequency over 30 days, 323 (34%) decreased the number of standard drinks they had per week, and 76 (8%) reported no alcohol use at all in the 30 days prior to the survey. Being below 55 years of age and reporting higher rates of alcohol use in the pre-period were both associated with greater odds of reducing alcohol use, and an intention to use medical cannabis to reduce alcohol consumption was associated with significantly greater odds of both reducing and ceasing alcohol use altogether. ConclusionsOur findings suggest that medical cannabis initiation may be associated with self-reported reductions and cessation of alcohol use among medical cannabis patients. Since alcohol is the most prevalent recreational substance in North America, and its use results in significant rates of criminality, morbidity and mortality, these findings may result in improved health outcomes for medical cannabis patients, as well as overall improvements in public health and safety.