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PloS One 2024Illicitly manufactured fentanyls and stimulants are implicated in the escalating US mortality from drug overdose. San Francisco, California (SF) has seen declining...
BACKGROUND
Illicitly manufactured fentanyls and stimulants are implicated in the escalating US mortality from drug overdose. San Francisco, California (SF) has seen declining fentanyl injection while smoking has increased. Beliefs and behaviors surrounding this development are not well understood.
METHODS
The study used rapid ethnography to explore fentanyl and methamphetamine use in SF. The team conducted semi-structured interviews (n = 34) with participants recruited from syringe service programs. Video-recorded smoking sequences (n = 12), photography and daily field notes supplemented interview data.
RESULTS
Difficulty injecting and fear of overdose motivated transitions from injecting to smoking. Fentanyl was extremely cheap-$10/gram-with variability in quality. Foil was the most commonly used smoking material but glass bubbles, bongs and dabbing devices were also popular. No reliable visible methods for determining fentanyl quality existed, however, participants could gauge potency upon inhalation, and developed techniques to regulate dosage. Several participants reported at least hourly use, some reporting one or more grams of daily fentanyl consumption. Smoking was also very social, with people sharing equipment, drugs and information. Participants raised concerns about hygiene and overdose risk to others arising from shared equipment. Reportedly potent fentanyl 'residue' accumulated on smoking materials and was commonly shared/traded/stolen or consumed accidentally with diverse preferences for its use.
CONCLUSION
Our data highlight fentanyl residue as a new overdose risk with potential mismatch between the potency of the residual drug and the recipient's tolerance. Further, large doses of fentanyl are being consumed (estimated at approximately 50 mg of pure fentanyl/day). Smoking fentanyl has potential health benefits over injecting and may be protective against overdose, but substantial uncertainty exists. However, SF overdose mortality hit a record high in 2023. Recommendations to reduce fentanyl smoking overdose risks through pacing, greater awareness of dosages consumed and checking tolerance of residue recipients are potentially viable interventions deserving further exploration.
Topics: Fentanyl; Humans; San Francisco; Male; Female; Adult; Smoking; Drug Overdose; Middle Aged; Substance Abuse, Intravenous; Methamphetamine
PubMed: 38776268
DOI: 10.1371/journal.pone.0303403 -
Current Addiction Reports Sep 2023Latinx sexual minority adolescents (LSMA) are at an intersection of ethnic and sexual minority (SM) status and may experience heighten risk of substance use and related...
PURPOSE OF REVIEW
Latinx sexual minority adolescents (LSMA) are at an intersection of ethnic and sexual minority (SM) status and may experience heighten risk of substance use and related problems. These youth may also hold unique protective factors that help mitigate the effects of minority stress and curb substance use. Little is known, however, about the intersectional minority stressors (i.e., due to ethnicity and SM status) and protective factors related to substance use among this population.
RECENT FINDINGS
According to the minority stress model, there are unique minority stressors and resiliency factors that can help explain differences in behavioral health rates between white SM and SM of color. Research supports the notion that minority stressors (e.g., stigma/risk, homophobic bullying, and family rejection of SM status) confer risk for substance use among LSMA. In terms of resilience, less is known, but there may be some protective factors that have not been measured that could explain lower rates in some substances (i.e., club drugs and methamphetamine).
SUMMARY
Little is known about how the intersections of ethnicity and SM status are associated with substance use in adolescence. Future research should assess the temporal relationship of multilevel (i.e., intrapersonal, relational, and system), intersectional (i.e., ethnicity and SM status) minority stressors and protective factors unique to LSMA on substance use. We propose that the findings from these future studies will help to create socioculturally appropriate behavioral health treatments that consider the intersectional risks and strengths within the LSMA population.
PubMed: 38774111
DOI: 10.1007/s40429-023-00503-5 -
Theranostics 2024Methamphetamine (METH) withdrawal anxiety symptom and relapse have been significant challenges for clinical practice, however, the underlying neuronal basis remains...
Methamphetamine (METH) withdrawal anxiety symptom and relapse have been significant challenges for clinical practice, however, the underlying neuronal basis remains unclear. Our recent research has identified a specific subpopulation of choline acetyltransferase (ChAT) neurons localized in the external lateral portion of parabrachial nucleus (eLPB), which modulates METH primed-reinstatement of conditioned place preference (CPP). Here, the anatomical structures and functional roles of eLPB projections in METH withdrawal anxiety and primed reinstatement were further explored. In the present study, a multifaceted approach was employed to dissect the LPB projections in male mice, including anterograde and retrograde tracing, acetylcholine (Ach) indicator combined with fiber photometry recording, photogenetic and chemogenetic regulation, as well as electrophysiological recording. METH withdrawal anxiety-like behaviors and METH-primed reinstatement of conditioned place preference (CPP) were assessed in male mice. We identified that eLPB send projections to PKCδ-positive (PKCδ) neurons in lateral portion of central nucleus of amygdala (lCeA) and oval portion of bed nucleus of the stria terminalis (ovBNST), forming eLPB-lCeA and eLPB-ovBNST pathways. At least in part, the eLPB neurons positively innervate lCeA neurons and ovBNST neurons through regulating synaptic elements of presynaptic Ach release and postsynaptic nicotinic acetylcholine receptors (nAChRs). METH withdrawal anxiety and METH-primed reinstatement of CPP respectively recruit eLPB-lCeA pathway and eLPB-ovBNST pathway in male mice. Our findings put new insights into the complex neural networks, especially focusing on the eLPB projections. The eLPB is a critical node in the neural networks governing METH withdrawal anxiety and primed-reinstatement of CPP through its projections to the lCeA and ovBNST, respectively.
Topics: Animals; Methamphetamine; Male; Mice; Substance Withdrawal Syndrome; Anxiety; Mice, Inbred C57BL; Neurons; Choline O-Acetyltransferase; Septal Nuclei; Behavior, Animal
PubMed: 38773977
DOI: 10.7150/thno.95383 -
The Science of the Total Environment Jul 2024Wastewater-based epidemiology (WBE) can provide objective and real time information about the use of addictive substances. A national study was conducted by measuring...
Wastewater-based epidemiology (WBE) can provide objective and real time information about the use of addictive substances. A national study was conducted by measuring the most consumed illicit drugs, other drugs whose consumption is not so widespread but has increased significantly in recent years, and benzodiazepines in untreated wastewater from seven wastewater treatment plants (WWTPs) in six Spanish cities. Raw composite wastewater samples were collected from December 2020 to December 2021, a period in which the Spanish and regional governments adopted different restriction measures to contain the spread of the COVID-19 pandemic. Samples were analyzed using a validated analytical methodology for the simultaneous determination of 18 substances, based on solid-phase extraction and liquid-chromatography tandem mass spectrometry. Except for heroin, fentanyl, 6-acetylmorphine and alprazolam, all the compounds were found in at least one city and 9 out of 18 compounds were found in all the samples. In general, the consumption of illicit drugs was particularly high in one of the cities monitored in December 2020, when the restrictions were more severe, especially for cannabis and cocaine with values up to 46 and 6.9 g/day/1000 inhabitants (g/day/1000 inh), respectively. The consumption of MDMA, methamphetamine and mephedrone was notably higher in June 2021, after the end of the state of alarm, in the biggest population investigated in this study. Regarding the use of benzodiazepines, the highest mass loads corresponded to lorazepam. This study demonstrates that WBE is suitable for complementing epidemiological studies about the prevalence of illicit drugs and benzodiazepines during the COVID-19 pandemic restrictions.
Topics: Illicit Drugs; COVID-19; Spain; Benzodiazepines; Cities; Humans; Wastewater; Water Pollutants, Chemical; Pandemics; Substance Abuse Detection; SARS-CoV-2
PubMed: 38772484
DOI: 10.1016/j.scitotenv.2024.173356 -
The Saudi Dental Journal May 2024The purpose of this comprehensive literature review is to present the available evidence on the effects of methamphetamine on mental and oral health, as well as provide... (Review)
Review
The purpose of this comprehensive literature review is to present the available evidence on the effects of methamphetamine on mental and oral health, as well as provide an overview of the most widely used medical and dental care strategies in the management of meth mouth. For this purpose, PubMed and Google Scholar electronic databases were searched for relevant articles, yielding 115 search results, which were further scrutinized for their relevance, leaving 55 for a detailed review. The analysis of the gathered data indicates that a comprehensive patient-centered approach that takes into consideration the physical, mental, and social aspects is crucial for mitigating the detrimental effects of increasing methamphetamine use.
PubMed: 38766295
DOI: 10.1016/j.sdentj.2024.02.011 -
Psychiatry and Clinical... Sep 2023This study aims to investigate the validity and reliability of the Turkish adaptation of the 16-item Risk of Relapse Assessment Scale (RRAS) for methamphetamine abusers.
BACKGROUND
This study aims to investigate the validity and reliability of the Turkish adaptation of the 16-item Risk of Relapse Assessment Scale (RRAS) for methamphetamine abusers.
METHODS
A total of 160 patients diagnosed with methamphetamine use disorder were included in this study to evaluate the validity and reliability of the scale. The comparison of the relationship between the Risk of Relapse Assessment Scale, the Substance Craving Scale, and the Relapse Prediction Scale was also carried out. The validity of the Risk of Relapse Assessment Scale was examined in the first step by exploratory factor analysis. The suitability of the data for exploratory factor analysis was evaluated by Kaiser-Meyer-Olkin test and Barlett's test. Cronbach's coefficient and corrected item-total correlation value were used to test the reliability of the scale. The validity results of Risk of Relapse Assessment Scale were tested by confirmatory factor analysis. The significance level was set at < .05 for all analyses.
RESULTS
Considering the examination of the internal consistency values of the Risk of Relapse Assessment Scale, Cronbach's value was detected to be 0.90, and Cronbach's value of the subscales ranged from 0.72 to 0.90. The study determined that the goodness of fit values for RRAS were / =2.13, < .001, goodness of fit index = 0.88, comparative fit index = 0.92, normed fit index = 0.86, Trucker-Lewis index = 0.90, root mean square error of approximation = 0.08, and standardized root mean squared residual = 0.06.
CONCLUSION
Our findings demonstrate that Risk of Relapse Assessment Scale is a valid and reliable measurement tool for assessing the risk of methamphetamine relapse in Turkish.
PubMed: 38765309
DOI: 10.5152/pcp.2023.23671 -
Addictive Behaviors Sep 2024Recent insights into substance use cessation suggest that outcomes short of long-term abstinence are clinically meaningful and may offer more realistic incremental...
BACKGROUND
Recent insights into substance use cessation suggest that outcomes short of long-term abstinence are clinically meaningful and may offer more realistic incremental goals, particularly for highly vulnerable individuals. With the goal of informing tobacco treatment programs, we examined distinct patterns of cigarette smoking and their association with the ongoing use of other substances in women who experience housing instability.
METHODS
We recruited participants from a longitudinal study of women experiencing housing instability. Between June 2017 and January 2019, participants completed six monthly survey interviews regarding social conditions and the use of multiple substances. We examined associations between cigarette smoking intensity, including number of cigarettes smoked per day, heavy smoking, and an increase in number of cigarettes smoked from the previous 30-days, and other substance use in the past 7-days.
RESULTS
Of the 243 participants, 69 % were current smokers and 58 % were daily smokers. Number of cigarettes smoked per day (Adjusted odds ratio [AOR] 1.02, 95 % CI 1.00-1.03), heavy cigarette smoking, compared to none or light smoking (AOR 2.02, 95 % CI 1.46-2.79), and an increase in number of cigarettes smoked from the previous 30-days (AOR 1.06, 95 % CI 1.01-1.12) were all significantly associated with methamphetamine use in the past 7-days. Associations with other substance use were not as strong.
CONCLUSIONS
In a sample of unstably housed women, where almost half used multiple substances, methamphetamine use was associated with higher cigarette smoking intensity. Our findings highlight a potential role for integrating tobacco and methamphetamine use treatment to reduce tobacco use among unstably housed women.
Topics: Humans; Female; Cigarette Smoking; Adult; Longitudinal Studies; Substance-Related Disorders; Middle Aged; Housing; Ill-Housed Persons; Young Adult
PubMed: 38761684
DOI: 10.1016/j.addbeh.2024.108066 -
Harm Reduction Journal May 2024Research regarding the contribution of specific psychoactive substances to suicidality has yielded equivocal results. The present study examined the prevalence and...
OBJECTIVES
Research regarding the contribution of specific psychoactive substances to suicidality has yielded equivocal results. The present study examined the prevalence and factors associated with suicidal thoughts and behaviors among a population-based sample of untreated illicit substance users.
METHODS
A total of 616 illicit substance users who were recruited from high-risk areas of Shiraz using snowball sampling participated in the study. Eligible participants were individuals aged 18 years and older who regularly used one illicit psychoactive substance (e.g., opioids, heroin, cannabinoids, stimulants, hallucinogens) for at least one year and who had received no treatment for their drug use during the past year. Data were collected regarding socio-demographic characteristics, mental history, and substance use habits. Data regarding suicidal thoughts and behaviors were assessed using the Beck Suicidal Ideation Scale (BSIS) and self-reports of previous suicide attempts. Multiple logistic regression analysis was used to identify independent variables associated with suicidality.
RESULTS
Among the participants, 23.6% reported having had suicidal thoughts during the past week and 6.7% reported having attempted suicide during the past year. Methamphetamine was reported as the primary substance of use among approximately half of the participants who attempted suicide during past year (49.2%). Multiple logistic regression analysis showed that current suicidal thoughts were independently associated with having no job, a history of mental health condition, previous suicidal attempts, concurrent use of more than one substance, and using methamphetamine and heroin as the primary substances. Suicidal thoughts were not associated with increased odds of regular opium and cannabis use.
CONCLUSION
Both methamphetamine and heroin use are significantly associated with current suicidal thoughts. Evaluation of the risk of suicidality by physicians and mental health care professionals in both community and outpatient settings would be especially appropriate among those individuals using these psychoactive substances.
Topics: Humans; Male; Female; Suicidal Ideation; Adult; Young Adult; Substance-Related Disorders; Suicide, Attempted; Adolescent; Iran; Middle Aged; Prevalence; Risk Factors; Illicit Drugs
PubMed: 38755587
DOI: 10.1186/s12954-024-01015-9 -
Ecotoxicology and Environmental Safety Jul 2024Methamphetamine (METH) is a psychostimulant drug belonging to the amphetamine-type stimulant class, known to exert male reproductive toxicity. Recent studies suggest...
Methamphetamine (METH) is a psychostimulant drug belonging to the amphetamine-type stimulant class, known to exert male reproductive toxicity. Recent studies suggest that METH can disrupt the gut microbiota. Furthermore, the gut-testis axis concept has gained attention due to the potential link between gut microbiome dysfunction and reproductive health. Nonetheless, the role of the gut microbiota in mediating the impact of METH on male reproductive toxicity remains unclear. In this study, we employed a mouse model exposed to escalating doses of METH to assess sperm quality, testicular pathology, and reproductive hormone levels. The fecal microbiota transplantation method was employed to investigate the effect of gut microbiota on male reproductive toxicity. Transcriptomic, metabolomic, and microbiological analyses were conducted to explore the damage mechanism to the male reproductive system caused by METH. We found that METH exposure led to hormonal disorders, decreased sperm quality, and changes in the gut microbiota and testicular metabolome in mice. Testicular RNA sequencing revealed enrichment of several Gene Ontology terms associated with reproductive processes, as well as PI3K-Akt signaling pathways. FMT conveyed similar reproductive damage from METH-treated mice to healthy recipient mice. The aforementioned findings suggest that the gut microbiota plays a substantial role in facilitating the reproductive toxicity caused by METH, thereby highlighting a prospective avenue for therapeutic intervention in the context of METH-induced infertility.
Topics: Animals; Methamphetamine; Male; Gastrointestinal Microbiome; Mice; Testis; Reproduction; Spermatozoa; Mice, Inbred C57BL; Central Nervous System Stimulants; Fecal Microbiota Transplantation
PubMed: 38754198
DOI: 10.1016/j.ecoenv.2024.116457 -
Drug and Alcohol Dependence Reports Jun 2024We investigate the relationship between the supply of methamphetamine and overdose death risk in Ohio. Ohio and the overall US have experienced a marked increase in...
BACKGROUND
We investigate the relationship between the supply of methamphetamine and overdose death risk in Ohio. Ohio and the overall US have experienced a marked increase in overdose deaths from methamphetamine combined with fentanyl over the last decade. The increasing use of methamphetamine may be increasing the risk of overdose death. However, if people are using it to substitute away from more dangerous synthetic opioids, it may reduce the overall risk of overdose death.
METHODS
Ohio's Bureau of Criminal Investigation's crime lab data include a detailed list of the content of drug samples from law enforcement seizures, which are used as a proxy for drug supply. We use linear regressions to estimate the relationship between the proportion of methamphetamine in lab samples and unintentional drug overdose death rates from January 2015 through September 2021.
RESULTS
Relatively more methamphetamine in crime lab data in a county-month has either no statistically significant relationship with overdose death rates (in small and medium population counties) or a negative and statistically significant relationship with overdose death rates (in large population counties). Past overdose death rates do not predict future increases in methamphetamine in crime lab data.
CONCLUSIONS
The results are consistent with a relatively higher supply of methamphetamine reducing the general risk of overdose death, possibly due to substitution away from more dangerous synthetic opioids. However, the supply of methamphetamine appears unrelated to the past illicit drug risk environment. The non-lethal and yet serious health effects of MA use were not explored and, thus, even if the presence of MA reduces the population-level overdose mortality rate, the rise of other adverse health effects may counteract any public health benefits of fewer deaths.
PubMed: 38745681
DOI: 10.1016/j.dadr.2024.100238