Rolling through TikTok: An analysis of 3,4-methylenedioxymethamphetamine-related content.

INTRODUCTION: TikTok has quickly gained popularity through its platforming of large amounts of short video content. Given its widespread popularity, unrestricted access and poor content monitoring may allow 3,4-methylenedioxymethamphetamine (MDMA)-related content to influence perception of MDMA use. We aimed to investigate how MDMA-related videos are portrayed on TikTok and explore MDMA-related harm reduction content. METHODS: MDMA-related hashtags and sounds were utilised to collect data from TikTok (n = 498). Video views, likes, comments and shares were recorded and quantified, and videos were coded for depiction/sentiment towards MDMA and thematic content. RESULTS: The total sample view count was 82,413,781. Videos had a median view count of 28,900 (SD = ±561,645), median like count of 2269 (SD = ±102,904), median comment count of 52 (SD = ±755), and median share count of 34 (SD = ±3292). Most videos depicted MDMA neutrally (40.6%), while 34.9% were positive. MDMA intoxication was presumed in 40.2% of videos. The analysis produced seven themes, of which humour was the most common (80.5%). Harm reduction content was present in nine videos, viewed 999,700 times, and consisted of mixed subject matter. DISCUSSION AND CONCLUSIONS: Similar themes and issues surrounding drug-related content on TikTok are relevant to MDMA, and intoxication was present in a significant portion of the sample. Better monitoring or regulation of content could potentially offset harm that may arise from consumption of such content. Promotion of harm reduction content could also be trialled to minimise harm.

Injecting drug use among gay and bisexual men in New Zealand: Findings from national human immunodeficiency virus epidemiological and behavioural surveillance.

INTRODUCTION AND AIMS: Gay and bisexual men (GBM) who inject drugs are disproportionately affected by human immunodeficiency virus (HIV) because of dual transmission risks. New Zealand has a progressive history of harm reduction and was the first country to publicly fund needle exchange programs in 1988 for people who inject drugs (PWID). We combine national HIV epidemiological and bio-behavioural surveillance data to understand HIV risk among this subpopulation. DESIGN AND METHODS: We examine trends in new HIV diagnoses 1996-2018 by mode of transmission, and compare HIV cases attributed to sex between men (MSM-only), MSM/injecting drug use (IDU) and IDU-only. IDU among GBM in a national HIV behavioural surveillance survey was also examined. We compare GBM by IDU status (never, 'recent', previous) and identified predictors of recent IDU. RESULTS: Of 1653 locally-acquired HIV diagnoses 1996-2018, 77.4% were MSM-only, 1.5% MSM/IDU, 1.4% IDU-only and 14.2% heterosexual mode of transmission. On average, just one HIV diagnosis attributed to MSM/IDU and IDU, respectively, occurred per annum. MSM/IDU cases were more likely than MSM-only cases to be indigenous Maori ethnicity. Of 3163 GBM survey participants, 5.4% reported lifetime IDU and 1.2% were recent IDU. Among GBM, HIV positivity was 20% among recent IDU and 5.3% among never injectors. Predictors of recent IDU were: age under 30; more than 20 male partners; female partner; condomless intercourse; HIV positivity. DISCUSSION AND CONCLUSION: New Zealand has averted high endemic HIV rates seen among GBM and PWID in other countries and results have been sustained over 30 years.

Ibogaine treatment outcomes for opioid dependence from a twelve-month follow-up observational study.

BACKGROUND: The psychoactive indole alkaloid ibogaine has been associated with encouraging treatment outcomes for opioid dependence. The legal status of ibogaine in New Zealand provides a unique opportunity to evaluate durability of treatment outcomes. OBJECTIVE: To examine longitudinal treatment effects over a 12-month period among individuals receiving legal ibogaine treatment for opioid dependence. METHOD: This observational study measured addiction severity as the primary outcome in 14 participants (50% female) over 12 months post-treatment using the Addiction Severity Index-Lite (ASI-Lite) following a single ibogaine treatment by either of two treatment providers. Secondary effects on depression were assessed via the Beck Depression Inventory-II (BDI-II). The Subjective Opioid Withdrawal Scale (SOWS) was collected before and immediately after treatment to measure opioid withdrawal symptoms. RESULTS: Nonparametric comparisons via Friedman Test between baseline and 12-month follow-up for participants completing all interviews (n = 8) showed a significant reduction for the ASI-Lite drug use (p = 0.002) composite score. Reductions in BDI-II scores from baseline to 12-month follow-up were also significant (p < 0.001). Significant reductions in SOWS scores for all participants (n = 14) were also observed acutely after treatment (p = 0.015). Patients with partial data (n = 4) also showed reductions in ASI-Lite drug use scores and family/social status problems. One patient enrolled in the study died during treatment. CONCLUSION: A single ibogaine treatment reduced opioid withdrawal symptoms and achieved opioid cessation or sustained reduced use in dependent individuals as measured over 12 months. Ibogaine's legal availability in New Zealand may offer improved outcomes where legislation supports treatment providers to work closely with other health professionals.