Substance use, harm reduction attitudes and behaviors among attendees of nature rave parties in Israel.

BACKGROUND: Few studies have analyzed harm reduction behaviors and attitudes among rave party attendees. Since the late 1980s, there has been a large Israeli rave scene, also known as 'Nature Parties'. However, only a few studies have been conducted among nature party attendees and almost all of them are from a qualitative perspective. This study's aim was to fill the gap and conduct quantitative research to investigate the patterns of substance use, harm reduction attitudes and behaviors among Israeli nature rave party attendees. METHODS: A cross-sectional online survey recruited 1,206 people who reported having attended nature rave parties. All of the participants were aged 18-60 years (M = 29.9; SD = 7.4), and 770 (64%) were male. RESULTS: The most common illicit substances used at Israeli nature rave parties in the past year were cannabis (62.2%), followed by LSD (41.4%), MDMA (31.7%), mushrooms/psilocybin (23.9%), ketamine (19.6%) and cocaine (17.2%). A significant but weak association was found between harm reduction behaviors and attitudes toward harm reduction interventions (r = .26, p < .001) and attitudes toward drug testing kits (r = .33, p < .001). It seems that although we found higher positive harm reduction attitudes, it is harder to implement harm reduction behaviors. Logistic regressions demonstrated stronger associations with high harm reduction behaviors and higher levels of positive attitudes toward drug testing kits (OR = 4.53; CI 2.97-6.90; p < .001), higher levels of positive attitudes toward harm reduction interventions (OR = 4.06; CI 2.62-6.29; p < .001), marital status of widower/divorced (OR = 2.22; CI 1.49-3.32; p < .001), using MDMA (OR = 1.63; CI 1.19-2.23; p < = .01) and using LSD (OR = 1.41; CI 1.03-1.94; p < = .05). CONCLUSIONS: Formal harm reduction policies and interventions are needed for Israeli nature rave parties in addition to prevention and information programs, which are also very rare. Future studies should examine the subjects of harm reduction attitudes and behaviors among the public, policy makers and professionals.

Cannabis use is associated with lower retention in methadone maintenance treatment, but not among schizophrenic- and other chronically psychotic patients.

The findings of studies on cannabis use and retention in methadone maintenance treatment (MMT) are inconsistent.To study cannabis use and its relationship to patients' outcomes in MMT with/without lifetime DSM-IV-TR schizophrenia/chronic-psychosis diagnosis.Since June 1993, 877 patients with available lifetime DSM-IV-TR psychiatric diagnosis were followed-up until December 2017. Urine drug screens on admission and after one year were analyzed.Lifetime schizophrenia/psychosis was diagnosed in 50 (5.7%) patients. They did not differ from the other 827 by admission cannabis use (18.0% vs. 12.3%) and had similar 1-year retention rates (76.0% vs.77.0%, respectively). Cumulative retention of the cohort excluding schizophrenia/chronic-psychosis was longer for the 667 patients who did not use cannabis after 1-year (9.1 years, 95%CI 8.4-9.9) compared with the 118 cannabis-users after 1-year (6.0 years, 95% CI 4.8-7.2, p<.001). Among the schizophrenia/chronic-psychosis group, cannabis was not related to retention (38 non-users, 7.9 years 95%CI 5.2-10.5 vs. 9 cannabis-users, 9.9 years, 95% CI 3.8-16.0, p=.5). Survival was shorter for the 41 schizophrenia/chronic-psychosis non-users (15.2 years, 95% CI 12.8-17.7) than for the 719 non-schizophrenia/chronic-psychosis non-users (18.5, 95%CI 17.9-19.2, p = 0.009). However, survival was comparable among the 9 cannabis-users with schizophrenia/chronic-psychosis (20.1, 95% CI 16.2-24.1) and 101 other cohort users (18.6, 95% CI 16.9-20.4).Cannabis use is associated with decreased retention among MMT patients, however the effects of cannabis on schizophrenia/psychosis patients on retention and survival cannot be verified due to the small sample size and the limited data regarding chronicity of cannabis use. Future larger, prospective studies are needed.

Novel technologies for cancer biomarker discovery: humoral proteomics.

The repertoires of serum autoantibodies differ between healthy people and cancer patients. While in healthy individuals these autoantibodies are directed against a limited number of self-proteins, in cancer patients the antibody repertoires are much further expanded with a wider range of reactivities against other proteins. Although cancer patients clearly mount humoral immune responses, they are not very effective in preventing the progression of the disease. However, the implication from the presence of these new and abnormal antibody specificities relates to their potential as novel tools for early detection before clinical manifestations. Proteomics technologies, with their unique ability to identify both tumor antigens and their cognate serum autoantibodies, hold great promise in facilitating the development of early detection kits and possibly also as conduits for the isolation of tumor antigens for immunotherapy.

Antibodies as oncogenes: a hypothesis.

We would like to put forward the hypothesis that cancer patients may produce autoantibodies that promote uncontrolled cell growth and thereby function as oncogenes. Dying cells release proteins that stimulate the production of autoantibodies, an event also known to occur during the earliest stages of tumor growth. If some of these autoantibodies are directed against cell surface hormone receptors, they could oligomerize the receptors and inadvertently transmit growth signals. The abnormal signals could result in uncontrolled cell proliferation and, eventually, oncogenesis. Thus, some specific autoantibodies from among the large repertoires of autoantibodies present in the sera of cancer patients are, in reality, oncogenes. If such oncogenic autoantibodies are indeed present and can be identified, inhibition of their molecular action may be an effective therapeutic modality.

Proteomics in cancer vaccine development.

Proteomics is a new scientific field aimed at the large-scale characterization of the protein constituents of biologic systems. It facilitates comparisons between different protein preparations by searching for minute differences in their protein expression repertoires and the patterns of their post-translational modifications. These attributes make proteomics perfectly suited for searching for proteins and peptides expressed exclusively or preferentially in cancer cells as candidates for cancer vaccines. The main proteomics technologies include 2D polyacrylamide gel electrophoresis, multidimensional high-performance liquid chromatography, mass spectrometry and protein arrays. Proteomics technologies used to analyze cancer culture cells, fresh tumor specimens, human leukocyte antigen peptides, serum and serum antibodies (serologic proteomics) have successfully identified tumor markers. Turning the potential vaccine candidates identified by proteomics technologies into clinical treatments awaits demonstration.

MHC-bound antigens and proteomics for novel target discovery.

The MHC molecules present normal as well as disease-related and pathogen-derived peptides to T cells as a way of alerting the immune system of the health status of a cell. Proteomic technologies involving immunoaffinity purification are now extensively used to separate MHC complexes from their peptide cargo, and then the peptides are sequenced by tandem mass spectrometry. The identified peptides are tested as vaccine candidates for viral diseases, immunostimulants for treating cancer, and immune-tolerance-inducing agents for autoimmune disorders. One of the challenges in devising novel HLA-peptide-based immunotherapies is to decipher whether a therapeutic window exists between the induction of tumor immunity and the onset of autoimmunity, which can have dangerous sequelae. This review will cover these topics with an overview of the vast possibilities emerging in the field of proteomic analyses of MHC-bound antigens as novel targets for immunotherapy.