Synthetic cannabinoids awareness among patients with opioid use disorder in Serbia - A survey based cross-sectional pilot study.

Introduction: There is limited data on the awareness and use of synthetic cannabinoids (SCs) in high-risk population in Serbia, despite SCs becoming more and more common at illicit drug market. Aim: This pilot study aimed to examine the awareness and prevalence of use of SCs in patients with an opioid-use disorder and to identify patient characteristics and other factors associated with SCs use. Patients and methods: This cross-sectional study was conducted at the Clinic for Psychiatry, Clinical Center Vojvodina, Serbia, the largest tertiary health care institution in this region of the country. All patients hospitalized due to the treatment of opioid dependence during November and December 2017 were included (response rate 100%), and filled-out an anonymous questionnaire specifically developed for the purpose of this study. Differences between patients reporting SCs use and those who did not were compared using chi-square test with values of p < 0.05 were considered significant. Results: Out of 64 patients (median age 36.37 years), one third (32.81%) reported using SCs. Socio-demographic characteristics of the subjects were not associated with SCs use. There were differences in the most common sources of information reported between the SCs users and non-users. Majority of SCs users (76.0%) were informed about SCs through friends, compared with just 26.0% of non-users (<0.001). Nearly all study participants (93.8%) were daily tobacco users. The share of respondents reporting alcohol and marihuana use was significantly higher among the SCs users (52.0% vs. 20.9%, p = 0.011 and 15.6% vs. 12.5%, p = 0.015), respectively. Higher share of SCs users used multiple psychoactive substances (38.1% vs. 16.3%), and this difference was statistically significant (p = 0.047). The most commonly reported adverse effect of SCs among users included dry mouth (81.0%), trouble thinking clearly (52.4%) and panic attacks (52.4%). Conclusion: Understanding the awareness and use of SCs among high-risk drug users, as well as associated factors can help improve substance-use disorder treatment in our setting. Educational activities targeting public are urgently needed to raise awareness on SCs, considering that social contacts are the main sources of information on SC for this vulnerable population. Users of SCs have also reported using other psychoactive substances more often, and this calls for a holistic approach addressing multiple factors to improve substance-use treatment in our setting.

[Manufacturing process of high quality phytopreparation on example of herbal sedative].

INTRODUCTION: Rational phytotherapy is a modern concept of using plant-originated drugs which has emerged from the need to improve phytotherapy in order to make the use of herbal remedies more efficient and safer. The aim of this study was to give the health-care workers more information on the manufacturing process of high quality phytopreparation following principles of Good Manufacturing Practice and Good Laboratory Practice on the example of herbal sedative, Odoval S capsules. MATERIAL AND METHODS: This study was designed to reflect the production process of a high-quality and safe herbal remedy, starting from defining the formulation and the production procedure to the quality control of raw materials, characterization of the final product, and testing stability of active ingredients in the capsules. RESULTS: Formulation of the phytopreparation, validation of the production process, quality control and stability testing, all together have resulted in the production of capsules with defined valeric acid content (1 mg valeric acid per capsule). DISCUSSION: The preparation is recommended to relieve the symptoms caused by chronic stress (anxiety, irritability, fatigue, lack of concentration, heart palpitations) and for mild insomnia. CONCLUSION: This paper presents the complete cycle of the production of a phytopreparation on the example of a new herbal sedative--Odoval S capsules.

AD/HD in the genesis of conduct disorder--does biopsychosocial approach make sense?

There are numerous theories approaching the source of mental disorders (including conduct disorder) from different perspectives - biological, psychological, social and multifactorial. The question that arises is which theory is to be used to explain the issue. In the interpretation of phenomena in psychiatry, Kecmanovic discusses possibilities of different approaches (biological, psychological, social and biopsychosocial models) and concludes that none of them provide a complete solution as to how to approach different disorders. The question, therefore, is how to proceed? Although according to Kecmanovic, the biopsychosocial model, as Engel has formulated it, "provides only ingredients not a prescription", it is our opinion that it indeed does not need to provide prescriptions- it is sufficient if it indicates the necessary ingredients. The prescription itself is to be found in novel scientific disciplines, in particular neuropsychology and epigenetics. Gilbert, on the other hand, points out that the bio- psychosocial approach is holistic, and more than that. "The bio psychosocial approach addresses the complexity of interactions between different domains of functioning and argues that it is the interaction of domains that illuminates important processes" e.g. a hierarchical dimension of the model as one and development as another dimension provide the basis for a comprehensive perspective on psychiatric disorders, in this case of AD/HD as a risk factor for conduct disorder.