Illicit drugs in Brazil: environmental consequences and consumption patterns.

This article reviews the literature on the consumption, street drug analysis, distribution, and main environmental impacts of illicit drugs in Brazil and analyzes the III National Survey on Drug Use by the Brazilian Population. The literature review is based on articles published in national and international journals between 2018 and 2023. This review consists of two analyses, the first of which addresses publications from the last 6 years on the monitoring of illicit drugs in Brazil and a second analysis based on the III National Survey on Drug Use that addresses the different possibilities of contact with drugs. The results revealed that the Southeast region of Brazil has the highest number of studies on the subject, especially in the state of São Paulo, while the North and Northeast regions have the lowest number of studies. The Midwest regions only have studies in the federal capital city, Brasília, while no studies were found in states bordering countries that produce illicit drugs, such as Paraguay and Bolivia. Analytical methods that use the concept of miniaturization, green chemistry, and the adoption of acceptance methods are frequent in most articles. Chemometric and statistical tools are widely used for the analysis, development, and conclusion of identification and quantification methods. Among the articles studied, there was a predominance in the analysis of cocaine metabolites and cannabis metabolites in the aquatic environment, where their concentrations ranged from 0.01 to 2000 ng L-1. Studies also reported bioaccumulation in marine biota with concentrations of up to 4.58 µg kg-1 for mussels and sediments, posing a risk to algae, crustaceans, and fish. Furthermore, the data show that the consumption of illicit drugs is increasing in Brazil, especially among young people.

Recovery of DNA from acetaminophen exploring physical state and sampling methods.

Research into the recovery of DNA from illicit drug samples has shown it is possible to get forensically useful profiles from such substrates. However, it is not yet known if the different physical states that drugs can be found in influences the quantity and quality of DNA that can be recovered or what is the best sampling method to adopt for powdered samples. This research used acetaminophen in four different states - large crystalline, powder, in solution, or residue - to determine the efficacy of current DNA technology in recovery and analysis of the resulting sample. Five replicates of each were prepared. Human blood was deposited on or mixed with the drug and left for 1 hour. The surface of the drug was sampled by wet/dry swabbing (where appropriate), or the entire sample was deposited in a tube, and the DNA then extracted using DNA-IQ™. The amount of DNA recovered (ng), degradation index, number of PCR cycles (Ct) required for the IPC to reach threshold, number of alleles in the DNA profile and average peak height (APH) were assessed. All samples, irrespective of the physical state they were collected from, returned full DNA profiles that corresponded to the DNA profile of the blood donor, with no degradation or inhibition detected. It was also found the wet/dry swabbing method returned higher levels of DNA than inclusion of the entire sample into the tube for powdered acetaminophen and the appropriate method to use will be dependent on casework circumstances. The findings of this research further develops our understanding of the recovery of DNA from drugs, and supports the need for further investigation to understand under what conditions DNA can be recovered from illicit substances.

Use of Prescribed and Non-Prescribed Treatments for Cluster Headache in a Swedish Cohort.

BACKGROUND: Cluster headache (CH) is a debilitating condition, but current therapies leave CH patients in pain. The extent of this problem in Sweden is unknown. METHODS: An anonymized questionnaire was sent to 479 Swedish CH patients to investigate patterns and perceived effects of treatments. RESULTS: Three hundred fourteen answers were analyzed. The population was representative regarding age of onset and sex. Less than half (46%) were satisfied with their abortive treatments, 19% terminated functioning abortive treatments due to side effects. Additionally, 17% of chronic CH patients had not tried the first-line preventive drug verapamil. A small subset had tried illicit substances to treat their CH (0-8% depending on substance). Notably, psilocybin was reported effective as an abortive treatment by 100% (n = 8), and with some level of effect as a preventive treatment by 92% (n = 12). For verapamil, some level of preventive effect was reported among 68% (n = 85). CONCLUSIONS: Our descriptive data illustrate that many Swedish CH patients are undertreated, lack functional therapies, and experience side effects. Further studies are warranted to search for new treatment strategies as well as a revision of current treatment guidelines with the aim of reducing patient disease burden to the greatest extent possible.

Evaluation of a student pharmacist approach to NCAA substance education for student athletes.

BACKGROUND AND PURPOSE: The National Collegiate Athletic Association (NCAA) requires schools to provide anti-doping education to student athletes. The purpose of this project was to assess the effectiveness of student pharmacist-led education on NCAA student athletes' knowledge of banned supplements and nutritional/dietary supplements. EDUCATIONAL ACTIVITY AND SETTING: Student athletes at one Midwest public university were provided a 20-min educational presentation on banned substances and nutritional and dietary supplements delivered by two student pharmacists. Student athletes were invited to complete a knowledge assessment at baseline and after the presentation. The assessment consisted of two demographic questions and 13 knowledge questions. FINDINGS: Two hundred thirty-three student athletes provided matched pre- and post-intervention data for analysis. There was an increase in the mean knowledge scores (13 points maximum); 9.8 (75%) before and 11.1 (85%) after the intervention. Student athletes gained more knowledge in the topic areas of stimulant medications and identification of credible drug sources. They gained less knowledge in the topic area of anabolic steroid use. SUMMARY: Student pharmacist-led education resulted in statistically significant increases in student athlete knowledge of banned substances and nutritional/dietary supplements. The educational presentation is adaptable and easily transferable to other universities. Schools of pharmacy should consider implementing student pharmacist-led education to student athletes to meet NCAA education requirements.

Attention deficit hyperactivity disorder symptoms and lifetime use of psychoactive substances among French university students: A cross-sectional study.

In a cross sectional study of 13,837 university students, we aimed to explore the association between attention deficit hyperactivity disorder (ADHD) symptoms and lifetime psychoactive substance use (LPSU) on a wide range of illicit substances. Logistic and Hurdel multivariable regressions were used. ADHD symptoms were significantly associated with the lifetime use of ketamine, magic mushrooms, poppers, and nine other psychoactive substances. There was an association between ADHD symptoms and both LPSU and truncated count of lifetime psychoactive substance use. High levels of ADHD symptoms are associated with the use of a large variety and multiple LPSU.

Presentations of active substance use in the emergency department: A single center's perspective study in Riyadh, Saudi Arabia.

OBJECTIVES: To explore the most common clinical presentations of active substance users in our institution's Emergency Department (ED). METHODS: This was a retrospective chart review of all patients that were brought to the ED of King Saud University Medical City in Riyadh, Saudi Arabia thought to be actively using illicit substances, between January 2019 and December 2021. Those with incomplete data were excluded. RESULTS: A total of 582 patients were included in the study, 532 (91.4%) males, the majority were in the age group 21-30 years old (53.1%). Most patients were fully alert (n=405, 69.6%). Overall, cannabis was used by 349 (60%) of patients. Seventy-four patients presented to the ED because of motor vehicle collisions, the majority were males (98.6%), 35 (47.3%) were the driver of the vehicle and 40 (54.1%) were on cannabis. Males had 5.5 times more medical illness presentations and 10.8 times traumatic illness presentations when compared to females predominantly presenting with psychological illness presentations. CONCLUSION: Among Saudi users of illicit substances, the majority were young men with medical illness presentations. The rate of traumatic injuries / vehicular and road traffic accidents is at 15.3%, and cannabis and amphetamine were the most used substances. Screening for active substance use should be conducted using both patient histories and laboratory testing for all high-risk presentations and not solely based on clinical assessment.

Trauma activation patient preinjury toxicology-positive proportions and associated risk conditions: A retrospective study.

BACKGROUND: Unlike prior guidelines for a positive toxicology screen, the 2022 national trauma data bank dictionary requires the exclusion of postinjury drugs. We aimed to (1) investigate the proportion of drugs in the toxicology screen that were given postinjury; (2) determine preinjury toxicology-positive associations with smoking, psychiatric, and drug abuse histories in an activation patient (ACT-Pt) cohort; and (3) explore whether ACT-Pt varied toxicology testing rates would produce similar preinjury toxicology-positive results. METHODS: In this retrospective study, the historic parent database included consecutive trauma center admissions where toxicology testing was discretionary. A supplementary electronic medical record audit of ACT-Pts age 18-60 years assessed smoking, psychiatric, and drug abuse histories. Subsequently, ACT-Pt age 18-100 years testing was encouraged by attending surgeons and, later routine testing was implemented. RESULTS: Of 2,076 patients in the historic parent database, discretionary toxicology testing occurred in 23.9% (n = 496) and the positive proportion was 58.9% (n = 292). However, 23.6% (n = 69) of the positive screens had the drug given postinjury. The preinjury positive-toxicology proportion was 45.0% (223/496). Preinjury toxicology positivity was greater in ACT-Pts age 18-60 years (52.3%) than in other patients (activations >60 years of age or consultations) (33.7%; p < 0.0001; odds ratio [OR] = 2.2). Smoking, psychiatric, and drug abuse histories were more common in ACT-Pts age 18-60 years preinjury toxicology-positive patients (74.4%, 51.3%, and 98.7%) than in negative patients (36.6%, 25.2%, and 25.2%; p < 0.0001). In ACT-Pts age 18-100 years, when compared to historic discretionary testing (32.7%), testing was increased with encouraged testing (62.1%; p < 0.0001; OR = 3.4) and routine testing (73.1%; p < 0.0001; OR = 5.6). ACT-Pt preinjury toxicology positivity was similar for historic discretionary (47.9%), encouraged (57.6%), and routine (51.3%) (p = 0.3670) testing. The meta-analytic toxicology-positive proportion for the three testing strategies was 49.8%. CONCLUSIONS: Substantial toxicology-positive findings are due to postinjury drug administration. Toxicology positivity is associated with ACT-Pts age 18-60 years and smoking, psychiatric, and drug abuse histories. ACT-Pt age 18-100 years preinjury toxicology positivity is 50% and does not vary with different testing proportions and strategies.

Preliminary investigation into isolation and extraction of DNA recovered from drug residues.

It is a commonly held belief that drug residues may affect the integrity of DNA and/or interfere with DNA analysis, and therefore DNA on drug paraphernalia and the associated drugs may be overlooked as a source of evidence. This study investigated whether DNA could be isolated from a drug residue-bearing surface to ascertain whether a forensically useful DNA profile could be obtained. Human blood and pre-extracted "naked" DNA were deposited on samples of acetaminophen, codeine, morphine, oxycodone, ketamine, and synthetic cannabinoids and left for an hour before DNA extraction using DNA-IQ™. To investigate DNA integrity, the absolute amount of DNA recovered, degradation index, and number of PCR cycles required for the IPC to reach threshold (Ct), number of reportable alleles and average peak height (APH) in the DNA profile, were examined. The samples were also qualitatively analysed using LC:MS to determine if any residual drugs were present in the samples post-DNA extraction. Overall, the drugs had no to minimal degradation or inhibitory effects on the DNA with sufficient DNA recovered to generate a partial or full DNA profile in 80% of naked DNA samples and 100 % of blood samples. The amount of DNA collected was sufficient for further analysis in 86% of naked DNA samples, and 100% of blood samples, with all median APH values being over the 175 RFU standard. Chemical analysis showed that traces of the drug were still present in the samples after DNA extraction was performed. Therefore, this study demonstrates forensically useful DNA can be recovered from surfaces bearing drug residues, even when sampling directly from the samples of drugs.

Risk factors for substance use in Swedish adolescents: A study across substances and time points.

Aim: The public health model for prevention of disease and disorder has been influential in informing interventions regarding substance use. While a number of risk factors within this model have been found to predict substance use, few studies have explored the associations across substances, at different time points and in the same individuals. The aim of this study was to test this model across legal and illegal substance use among adolescents, and to identify potential changes in associations over time. Methods: Data from two waves of a nationally representative cohort study among Swedish adolescents were used. Baseline data were collected in 2017 (9th grade) with a follow-up in 2019 (11th grade). Using modified Poisson regression analyses, we explored cross-sectional associations between factors from different domains and prevalence of cigarette use, binge-drinking and illegal drug use at both baseline and follow-up. Results: The results in part supported the public health model. Substance use was predicted by factors within the family, school and the individual/peer domain, but several associations were not statistically significant. The only consistent risk factors across substances and time points were lack of parental monitoring, truancy and minor criminal activities. Conclusion: Despite widely different prevalence rates across substances, some risk factors were consistently associated with adolescent substance use. Nonetheless, the findings challenge the assumption that risk factors are stable over adolescence. They suggest a need for flexible prevention interventions spanning across substances and legal boundaries of substances, but also over domains to reflect the heterogenous needs of adolescents.

Substance Use among Adolescents: A Retrospective Study (2017-2018) in the Toxicology Unit, University Hospital of Lille, France.

Research on adolescent substance use is of utmost importance. Using local toxicological data, both prevalence and pattern of substance use (SU) and substance-related death (SRD) can be assessed to design effective prevention programs. A retrospective study of toxicology investigations of all adolescents referred to the medico-legal section of the Toxicology Unit of the University Hospital of Lille, France, for a 2-year period from 2017 to 2018. In the total sample of 1961 cases, adolescents accounted for 3.3% of the cases (n = 65). Among the adolescents, 16.9% were aged 10−14 years and 83.1% were aged >14−19 years. About 69.2% were males. Less than 70% of all presented adolescents used substances. More than two-thirds (74%) of positive detections were male. Illicit substances (43%) were the most detected substance followed by alcohol (20%) and prescription substances (20%). Tetrahydrocannabinol (THC) was extremely common as it was found in 29% of all adolescents. Cocaine and amphetamines were detected in 13.8% of total tested adolescents. Polysubstance use was common between alcohol and THC and among males. About one-third of deaths were due to substance use. About 54% of SRD was associated with polysubstance detection. It is recommended that illicit substances, ethanol, and prescription substances are targeted for testing among adolescents in order to provide appropriate prevention.

Licit and illicit drug use across trimesters in pregnant women endorsing past-year substance use: Results from National Survey on Drug Use and Health (2009-2019).

PURPOSE: Given the health consequences, perinatal substance use is a significant public health concern, especially as substance use rates increase among women; ongoing data regarding the rates of substance use across trimesters of pregnancy is needed. METHODS: The present study utilized cross-sectional population-based data from the National Survey of Drug Use and Health (NSDUH) between 2009 and 2019. We aimed to explore both licit and illicit substance use assessed within each trimester among women endorsing past-year substance use. The NSDUH sample included 8,530 pregnant women. RESULTS: Perinatal substance use was less prevalent among women in later trimesters; however, past-month substance use was observed for all substances across trimesters. The prevalence of past-month licit substance use among pregnant women ranged from 5.77 to 22.50% and past-month illicit substance use ranged from 4.67 to 14.81%. In the second trimester, lower odds of past-month substance use were observed across tobacco, alcohol, and marijuana (odds ratios [ORs] ranging from 0.29 to 0.47), when compared to the first trimester. A similar lower rate of past-month substance use was observed in the third trimester compared to the first trimester, across tobacco, alcohol, and marijuana use, as well as cocaine, prescription pain medication, and tranquilizer use (ORs ranging from 0.02 to 0.42). The likelihood of polysubstance use was lower among women in the second and third trimesters compared to the first trimester (ORs ranging from 0.09 to 0.46). CONCLUSION: Findings indicate that a minority of women continue to use substances across all trimesters. This is especially true among women using licit substances and marijuana. These results highlight the need for improved interventions and improved access to treatment for these women.

Age, period, and cohort effects on trends in outpatient addiction care utilization in the general Berlin population from 2008 to 2016.

BACKGROUND: The aim of this study was to decompose independent effects of age, period, and cohort on trends in outpatient addiction care utilization resulting from alcohol (AUD) and illicit substances use disorders (ISUD). Decomposing trends in addiction care utilization into their independent effects by age, period, and cohort may lead to a better understanding of utilization patterns. METHODS: Individuals seeking help in Berlin outpatient addiction care facilities between 2008 and 2016 with an age range of 18-81 years for AUD (n = 46,706) and 18-70 years for ISUD (n = 51,113) were standardized to the general Berlin population using data from the German Federal Statistical Office. Classification of utilization as AUD- (F10) or ISUD-related (F11, F12, F14, F15, F16, F18, F19) help-seeking was based on primary diagnoses according to the International Statistical Classification of Diseases and Related Health Problems. Age was measured in years and period as year of data collection. Cohort was defined as the mathematical difference between period and age. Age, period, and cohort analyses were conducted using the intrinsic estimator model on AUD- and ISUD-related outpatient addiction care utilization. RESULTS: Age effects on AUD-related utilization were highest in 18- to 19-year-old and in 39- to 59-year-old individuals. ISUD-related utilization declined almost continuously with increasing age. Period effects on AUD- and ISUD-related utilization were small. AUD-related utilization was highest in cohorts born from 1951 to 1986. ISUD-related utilization increased in cohorts born between 1954 and 1973 where utilization peaked, followed by a decline of the same order. CONCLUSIONS: Age and cohort effects were the strongest drivers of trends in AUD- and ISUD-related outpatient addiction care utilization. Onset of help-seeking in earlier phases of AUD development should be enhanced as well as help-seeking for AUD and ISUD in general. The highest cohort-related rates in the baby boomer and following cohorts for AUD and ISUD underline an increased demand for addiction care.

Eating disorders and subsequent risk of substance use disorders involving illicit drugs: a Danish nationwide register-based cohort study.

PURPOSE: No study has investigated the ongoing risk of substance use disorders involving illicit drugs (ISUD) after first eating disorder (ED) and whether the pattern of risk differs according to types of ED and ISUD. Therefore, we aimed to longitudinally assess the risk of a subsequent diagnosis of any ISUD (pooled category) and specific ISUD after a first-time diagnosis of anorexia nervosa (AN), bulimia nervosa (BN), or unspecified ED (USED). METHODS: A retrospective cohort study using data from Danish nationwide registers identified 20,759 ED patients and 83,038 matched controls (1:4 ratio). Risk of any ISUD diagnosis after first ED diagnosis was estimated by generating hazard ratios (HR). Logistic regression was applied to assess associations between each ED and specific ISUD. RESULTS: Patients with AN, BN, and USED (without a prior ISUD diagnosis) exhibited an increased relative risk of a subsequent diagnosis of any ISUD compared with respective controls, and the elevated risk persisted over 10 years (AN, adjusted HRs ranging from 1.60 [99% CI 1.15-2.24] to 5.16 [3.14-8.47]; BN, 2.35 [1.46-3.79] to 14.24 [6.88-29.47]; USED, 2.86 [1.35-3.79] to 8.56 [3.31-29.47]). The highest estimates were observed during the first year of follow-up. Each ED type was associated with an increased likelihood of all types of ISUD. AN and USED were most strongly associated with sedatives/hypnotics, BN with other illegal substances (e.g., ecstasy and hallucinogens). CONCLUSIONS: ED patients have a considerable risk for subsequent ISUD. Prevention efforts and treatment targeting ISUD are likely required to improve ED treatment prognosis.

From the Streets to the Judicial Evidence: Determination of Traditional Illicit Substances in Drug Seizures by a Rapid and Sensitive UHPLC-MS/MS-Based Platform.

According to the 2021 World Drug Report, around 275 million people use drugs of abuse, and 36 million people suffer from addiction, fostering a thriving market for illicit substances. In Italy, 30,083 people were reported to the Judicial Authority for offenses in violation of the Italian Law D.P.R. 309/1990. These offences are sentenced after a qualitative-quantitative analysis of seized materials. Given the large quantity of seized drugs and the need to perform accurate analytical determinations, Italian forensic laboratories struggle to complete analyses in a short time, delaying the entire reporting process needed to achieve sentencing. For this purpose, an UHPLC-MS/MS-based platform was developed at the University of Milano-Bicocca to support law-enforcement authorities. Software was designed to easily manage street seizure acquisition, documentation registration, and sampling. A sensitive UHPLC-MS/MS method was fully validated for the quantification of the traditional illicit substances (cocaine, heroin, 6-MAM, morphine, amphetamine, methamphetamine, MDMA, ketamine, GHB, GBL, LSD, trans-∆9-THC, and THCA) at the ppb level. The final report is relayed to the Prefecture in 3-4 days, even within 24 h for urgent requests. The platform allows for semi-automatic data handling to minimize erroneous results for an accurate report generation by standardized procedures.

Acute Inhalant-Induced Atrial Fibrillation With Severe Hypocalcemia: A Case Report and Review of the Pathophysiology.

The recreational use of inhalants is associated with various detrimental health effects ranging from inebriation to cardiac arrest. It also presents a challenging clinical problem as the diagnosis is made by the presentation and patient's history, which is often difficult to obtain in an intoxicated or obtunded individual. The incidence of inhalant use is relatively high. National surveys have reported that nearly 21.7 million Americans aged 12 and older have used inhaled substances at least once in their lives. There is no reversal agent or antidote for inhalants and supportive care is generally recommended. We present a case of a young patient presenting with acute inhalant toxicity accompanied by atrial fibrillation with a rapid ventricular response and severe hypocalcemia.

Oral Health Implications of Risky Behaviors in Adolescence.

Adolescence is a time for new discoveries, which may lead teens to engage in impulsive behaviors. Although social media and the Internet have brought great benefits to the world, they can also have a negative influence on adolescents, facilitating their engagement in risky behaviors. Positive parenting and healthy friendships in adolescence have a protective effect against sensation-seeking behaviors. Dental practitioners also have a significant role in steering young patients toward healthy behaviors. They play an essential role in the early recognition, initiation of appropriate interventions, and referrals for treatment of youth at risk.

Biomimetic Sensors to Detect Bioanalytes in Real-Life Samples Using Molecularly Imprinted Polymers: A Review.

Molecularly imprinted polymers (MIPs) come with the promise to be highly versatile, useful artificial receptors for sensing a wide variety of analytes. Despite a very large body of literature on imprinting, the number of papers addressing real-life biological samples and analytes is somewhat limited. Furthermore, the topic of MIP-based sensor design is still, rather, in the research stage and lacks wide-spread commercialization. This review summarizes recent advances of MIP-based sensors targeting biological species. It covers systems that are potentially interesting in medical applications/diagnostics, in detecting illicit substances, environmental analysis, and in the quality control of food. The main emphasis is placed on work that demonstrates application in real-life matrices, including those that are diluted in a reasonable manner. Hence, it does not restrict itself to the transducer type, but focusses on both materials and analytical tasks.

Investigation of patterns and dynamics of substance users: A long-term toxicology study on a sample of the Greek population between 2005 and 2019.

The purpose of the present study is to investigate dynamics underlying drug abuse and identify statistical correlations/patterns of forensic findings and sociodemographic factors in a population of illicit substance users. The following long-term studies were conducted: (a) a retrospective autopsy cohort study on autopsy incidents with available toxicological screening results (N = 482) in investigation of any possible forensic associations of exposure to illicit drugs; and (b) a cross-sectional study on a sample of arrested drug law offenders with available toxicological screening results (N = 195) as well as cluster analysis in order to possibly identify user profiles. Although outside the scope of the present study, ethanol was generally considered to be the main substance of abuse, as more than half of the premature deaths reported tested positive on the ethanol toxicology screen. Cannabis and opioid use was associated with unintentional causes of death, while an association of deliberate self-harm was noted with opioid and benzodiazepine use. Both cannabis and opioid use correlated with significantly younger ages (more than a decade) of premature death. Most frequently, an onset of substance use was reported in the early 20s with cannabis use. Although 65.3% of the subjects were diagnosed as dependent and unable to eliminate substance use on their own, only 7.7% of the subjects in the users' population had ever accessed appropriate support through rehabilitation programs.

Associations between Substance Use and Depressive Symptoms among Women Experiencing Intimate Partner Violence.

Associations between substance use and depression among women experiencing intimate partner violence (IPV) have received limited empirical attention. This study examined how demographics, frequency of IPV and problematic substance use were related to depressive symptoms among women exposed to recent IPV. Participants included 112 women (Mage = 32.26; 67% Black) recruited from community organizations in the U.S. Midsouth, many of whom had used substances (80.2%) and were living below the poverty threshold (71.3%). Results from a hierarchical multiple regression analysis revealed that, after accounting for age and income, more frequent IPV and more problematic tobacco use were associated with higher depressive symptoms. Neither alcohol nor illicit substance use were significantly associated with depressive symptoms. These findings highlight a meaningful connection between problematic tobacco use and depressive symptoms, indicating the potential benefits of incorporating tobacco use psychoeducation and cessation strategies into treatment programs for women experiencing depression in the context of IPV.

[Survey of anxiolytic drug dependence in patients treated in psychiatric and addiction rehabilitation wards]. / A gyógyszerfüggoség elofordulásának vizsgálata pszichiátriai és addiktológiai rehabilitációs osztályokon kezelt betegek között.

Introduction: Anxiolytic drug dependence is a cause for growing concern worldwide including Hungary. Psychiatric patients and patients with other drug addictions are at increased risk for anxiolytic drug dependence. Yet, there is only limited scientific information about the real extent of this issue. Aim: To examine the frequency of use of benzodiazepine-containing drugs and comparing the consumption habits of patients treated in psychiatric and addiction rehabilitation wards in a hospital in Budapest. Method: The survey was based on an anonymously and voluntarily completed questionnaire during a face-to-face interview of 103 patients in two wards. The 19-item questionnaire targeted anxiolytic drug use and related behavioral patterns. Statistical analysis: Socio-demographic data were given with means and standard deviations or with percentages as appropriate. For the comparison between the two groups of patients, t-test, Mann­Whitney U-test or chi-square test were used in accordance with the distribution of the sample. Results: Symptoms indicating anxiolytic dependence, use of multiple anxiolytics, and combination of anxiolytic drugs with alcohol were very frequent in both wards. However, there were some significant differences between the two samples. Anxiolytic drug abuse and illicit drug use were significantly more frequent in patients at the addiction ward. Indicators of social status, particularly the place of residence, significantly influenced non-prescription misuse of anxiolytic drugs. Conclusions: The results draw attention to the high frequency of anxiolytic drug misuse and dependence in psychiatric and addiction patients warranting urgent action to confront this challenge. Orv Hetil. 2020; 161(15): 594­600.