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1.
Clin Toxicol (Phila) ; 59(11): 947-955, 2021 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-34348072

RESUMO

Background Recreational use of nitrous oxide (N2O) is associated with many side effects, of which neurological complications are most common. Nitrous oxide abuse is also associated with psychiatric symptoms, but these have received less attention so far. Vitamin B12 deficiency may play a role in the development of these psychiatric symptoms.Aims To explore the relationship among the occurrence of recreational nitrous oxide-induced psychiatric symptoms, accompanying neurological symptoms, vitamin B12 status and choice of treatment.Methods A retrospective search for case reports was conducted across multiple databases (Pubmed, Embase, Web of Science, PsycINFO and CINAHL). Keywords included variants of "nitrous oxide", "case report" and "abuse". No restrictions to language or publication date were applied.Results The search retrieved 372 articles. A total of 25 case reports were included, representing 31 patients with psychiatric complications following nitrous oxide abuse. The most often reported symptoms were: hallucinations (n = 16), delusions (n = 11), and paranoia (n = 11). When neurological symptoms were present, patients were treated more frequently with vitamin B12 supplementation.Conclusions This review highlights the need to recognize that psychiatric symptoms may appear in association with nitrous oxide use. Approximately half of the cases that presented with nitrous oxide-induced psychiatric complaints did not show neurological symptoms, and their vitamin B12 concentration was often within the hospital's reference range. Psychiatrists and emergency physicians should be aware of isolated psychiatric symptoms caused by recreational nitrous oxide abuse. We suggest asking all patients with new psychiatric symptoms about nitrous oxide use and protocolizing the management of nitrous oxide-induced psychiatric symptoms.


Assuntos
Anestésicos Inalatórios/efeitos adversos , Transtornos Mentais/induzido quimicamente , Óxido Nitroso/efeitos adversos , Uso Recreativo de Drogas , Transtornos Relacionados ao Uso de Substâncias/complicações , Deficiência de Vitamina B 12/complicações , Administração por Inalação , Adolescente , Adulto , Anestésicos Inalatórios/administração & dosagem , Suplementos Nutricionais , Feminino , Humanos , Masculino , Transtornos Mentais/diagnóstico , Transtornos Mentais/psicologia , Transtornos Mentais/terapia , Pessoa de Meia-Idade , Óxido Nitroso/administração & dosagem , Prognóstico , Medição de Risco , Fatores de Risco , Transtornos Relacionados ao Uso de Substâncias/diagnóstico , Vitamina B 12/uso terapêutico , Deficiência de Vitamina B 12/diagnóstico , Deficiência de Vitamina B 12/tratamento farmacológico , Adulto Jovem
3.
BMC Pregnancy Childbirth ; 21(1): 530, 2021 Jul 28.
Artigo em Inglês | MEDLINE | ID: mdl-34315424

RESUMO

BACKGROUND: A woman's health at the time of conception lays the foundation for a healthy pregnancy and the lifelong health of her child. We investigated the health behaviours of UK women planning pregnancy. METHODS: We analysed survey data from the 'Planning for Pregnancy' online tool (Tommy's, UK). We described all women planning pregnancy and compared the frequency of non-adherence to preconception recommendations in women who had already stopped contraception (active planners) and those who had not (non-active planners). RESULTS: One hundred thirty-one thousand one hundred eighty-two women from across the UK were included, of whom 64.8% were actively planning pregnancy. Of the whole cohort, twenty percent were smokers and less than one third took folic acid supplements (31.5%). Forty two percent engaged in less than the recommended 150 min of weekly physical activity and only 53.3% consumed five portions of fruit or vegetables 4 days a week. Smokers were 1.87 times more likely to be active planners than non-smokers (95% CI 1.79-1.94), and women who took folic acid were 7 times more likely to be active planners (95% CI 6.97-7.59) compared to women who did not. Smoking, drug use and lack of folic acid supplementation were common in younger women and those who were underweight. CONCLUSIONS: This unique survey of UK women has identified poor adherence to preconception recommendations in those planning pregnancies and supports the need for a greater public health focus on preconception health. This study provides a contemporary basis from which to inform preconception health advice and a benchmark to measure changes over time.


Assuntos
Comportamentos Relacionados com a Saúde , Conhecimentos, Atitudes e Prática em Saúde , Cuidado Pré-Concepcional , Adulto , Consumo de Bebidas Alcoólicas/epidemiologia , Cafeína/administração & dosagem , Estudos de Coortes , Suplementos Nutricionais , Feminino , Ácido Fólico/administração & dosagem , Frutas , Humanos , Gravidez , Uso Recreativo de Drogas/estatística & dados numéricos , Fumar/epidemiologia , Reino Unido/epidemiologia , Verduras , Adulto Jovem
6.
Prehosp Disaster Med ; 36(4): 403-407, 2021 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-34187607

RESUMO

BACKGROUND: Dedicated on-site medical services have long been recommended to improve health outcomes at mass-gathering events (MGEs). In many countries, they are being reviewed as a mandatory requirement. While it is known that perceptions of risk shape substance use plans amongst outdoor music festival (OMF) attendees, it is unclear if attendees perceive the presence of on-site medical services as a part of the safety net. The aim of this paper is to better understand whether attendees' perceptions of on-site medical services influence high-risk behaviors like alcohol and recreational drug use at OMFs. METHOD: A questionnaire was distributed to a random sample of attendees entering and attending two separate 20,000-person OMFs; one in Canada (Festival A) and one in New Zealand (Festival B). Responses focused on demographics, planned alcohol and recreational drug use, perceptions of medical services, and whether the absence of medical services would impact attendees' planned substance use. RESULTS: A total of 851 (587 and 264 attendees for Festival A and Festival B, respectively) attendees consented and participated. Gender distribution was equal and average ages were 23 to 25. At Festival A, 48% and 89% planned to use alcohol and recreational drugs, respectively, whereas at Festival B, it was 92% and 44%. A great majority were aware and supportive of the presence of medical services at both festivals, and a moderate number considered them a factor in attendance and something they would not attend without. There was significant (>10%) agreement (range 11%-46%; or 2,200-9,200 attendees for a 20,000-person festival) at both festivals that the absence of medical services would affect attendees' planned use of alcohol and recreational drugs. CONCLUSIONS: This study found that attendees surveyed at two geographically and musically distinct OMFs had high but differing rates of planned alcohol and recreational drug use, and that the presence of on-site medical services may impact attendees' perceptions of substance use risk. Future research will aim to address the limitations of this study to clarify these findings and their implications.


Assuntos
Drogas Ilícitas , Música , Transtornos Relacionados ao Uso de Substâncias , Férias e Feriados , Humanos , Uso Recreativo de Drogas , Transtornos Relacionados ao Uso de Substâncias/epidemiologia
7.
PLoS One ; 16(6): e0253261, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34138920

RESUMO

University athletes are at high risk for both substance use and mental health problems. This study examined associations between substance use, mental health symptoms, and the resting state functional connectivity (rsFC) of key neural regions involved in self-monitoring and emotional regulation in a sample of female varsity athletes. 31 female university athletes completed measures of substance use, mental health symptoms, and underwent functional MRI scans during the pre-season. Athletes who were substance users had higher symptoms of depression than non-users (p = 0.04; Hedge's g = 0.81). RsFC differences were observed between users and non-users in orbital frontal cortex (OFC) and bilateral hippocampal seeds, and negative associations between depression symptoms and rsFC in the left hippocampus and posterior cingulate cortex were observed in cannabis users. In female athletes, substance use is associated with greater self-reported depression symptoms and altered rsFC in self-monitoring and emotional regulation regions of the brain.


Assuntos
Atletas/psicologia , Encéfalo/diagnóstico por imagem , Saúde Mental , Uso Recreativo de Drogas/psicologia , Adolescente , Adulto , Mapeamento Encefálico , Feminino , Humanos , Imageamento por Ressonância Magnética , Projetos Piloto , Adulto Jovem
8.
AIDS Behav ; 25(12): 3883-3897, 2021 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-33932187

RESUMO

We analysed the impact of recreational drug use (RDU) on different outcomes in people living with HIV (PLHIV). A multicentre retrospective cohort study was performed with two cohorts of PLHIV included: people using recreational drugs (PURD) vs. people not using recreational drugs (PNURD). Overall, 275 PLHIV were included. RDU was associated with men having sex with men (OR 4.14, 95% CI [1.14, 5.19]), previous sexually transmitted infections (OR 4.00, 95% CI [1.97, 8.13]), and current smoking (OR 2.74, 95% CI [1.44, 5.19]). While the CD4/CD8 ratio increased amongst PNURD during the follow-up year, it decreased amongst PURD (p = 0.050). PURD presented lower scores of self-reported and multi-interval antiretroviral adherence (p = 0.017, and p = 0.006, respectively), emotional well-being (p < 0.0001), and regular follow-up (p = 0.059), but paid more visits to the emergency unit (p = 0.046). RDU worsens clinical, immunological, and mental health outcomes amongst PLHIV.


Assuntos
Infecções por HIV , Drogas Ilícitas , Infecções por HIV/tratamento farmacológico , Infecções por HIV/epidemiologia , Humanos , Masculino , Uso Recreativo de Drogas , Estudos Retrospectivos , Espanha/epidemiologia
9.
Clin Toxicol (Phila) ; 59(11): 969-974, 2021 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-33849370

RESUMO

OBJECTIVE: Adulteration, substitution or contamination of illicit substances can have clinically significant implications when other illicit substances are included. Such circumstances can present as clusters of poisonings, including severe toxicity and death following exposure to unexpected illicit substances. We report a cluster of laboratory-confirmed lysergic acid diethylamide (LSD) in a powder that was sold as cocaine and used recreationally. METHODS: The Prescription, Recreational and Illicit Substance Evaluation (PRISE) program established by the New South Wales Ministry of Health includes State-based hospital toxicology services, Poisons Information Centre, Forensic & Analytical Science Service and emergency services to identify clusters of severe and unusual toxicity associated with substance use. PRISE criteria include a known cluster (geographically or situationally related) of people with acute severe toxicity, especially when accompanied by a toxidrome that is inconsistent with the history of exposure. A timely comprehensive drug screen and quantification is performed in eligible cases and the results are related to the clinical features. The need for a public health response is then considered. Four individuals inhaled a white powder that was sold as cocaine and developed severe toxicity that was not consistent with cocaine which prompted transfer to hospital for further management. RESULTS: LSD was confirmed in four subjects, and the concentrations in 3 of the individuals were 0.04-0.06 mg/L which are among the highest reported in the literature. Common clinical features were hallucinations, agitation, vomiting, sedation, hypertension, and mydriasis. One subject required intubation and admission to the intensive care unit, two required overnight admission, and the fourth was discharged following oral diazepam after observation. No subject suffered persistent injury. CONCLUSIONS: A close working relationship between pre-hospital emergency services, hospital-based clinical services, public health authorities, and analytical laboratories appears to be advantageous. Favourable clinical outcomes are observed from LSD poisoning despite high exposures with good supportive care.


Assuntos
Estimulantes do Sistema Nervoso Central , Transtornos Relacionados ao Uso de Cocaína , Cocaína , Contaminação de Medicamentos , Overdose de Drogas/diagnóstico , Alucinógenos/envenenamento , Dietilamida do Ácido Lisérgico/envenenamento , Uso Recreativo de Drogas , Administração Intranasal , Adulto , Transtornos Relacionados ao Uso de Cocaína/epidemiologia , Overdose de Drogas/epidemiologia , Overdose de Drogas/terapia , Alucinógenos/administração & dosagem , Humanos , Insuflação , Dietilamida do Ácido Lisérgico/administração & dosagem , Masculino , New South Wales/epidemiologia , Centros de Controle de Intoxicações , Pós , Detecção do Abuso de Substâncias , Adulto Jovem
10.
Clin Toxicol (Phila) ; 59(10): 918-925, 2021 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-33666139

RESUMO

BACKGROUND: Diphenhydramine is frequently misused and ingested recreationally for its antihistaminergic and antimuscarinic effects and is often involved in both serious and fatal poisonings, either in isolation or in combination with other xenobiotics. OBJECTIVE: This analysis sought to determine which patient and encounter characteristics were associated with severe outcome after diphenhydramine overdose. METHODS: This is an analysis of the multi-center ToxIC registry (2010-2016). Descriptive analysis of all cases with diphenhydramine listed as the "primary agent" contributing to toxicity were included. Analysis sought to determine which patient and encounter characteristics were associated with severe outcome, defined as occurrence of seizure, ventricular dysrhythmia, or intubation. To determine which patient and encounter characteristics were individually associated with severe outcome, we performed chi-square tests. Fisher's exact tests were used in the case of sparse data. We also performed multivariable logistic regression to further determine independent risk factors for severe outcome in diphenhydramine overdose. RESULTS: Eight hundred and sixty-three cases remained after exclusion with 15.6% (n = 135) of all patients having one or more severe outcome. The most common severe outcome was seizures which occurred in 98 (11.6%) of all ingestions. Females comprised 59.1% (n = 510) of all ingestions. Most ingestions were intentional (86.0%, n = 742) with the most common known reason for an intentional ingestion being self-harm, accounting for 37.5% (n = 324) of all ingestions. Self-harm ingestions and ingestions in males were more commonly associated with intubation. When examining outcomes by age, there were no significant differences overall or in any individual outcome except intubation in which children 0-12 were less likely to be intubated as compared to teens and adults. Signs and symptoms most strongly associated with a severe outcome included acidemia (pH < 7.2), QRS prolongation (QRS > 120 ms), and elevated anion gap (AG > 20). DISCUSSION: Acidemia, QRS prolongation, and elevated anion gap are associated with severe outcomes in diphenhydramine toxicity. Further research is warranted to determine their predictive characteristics.


Assuntos
Difenidramina/envenenamento , Antagonistas dos Receptores Histamínicos H1/envenenamento , Drogas Ilícitas/envenenamento , Antagonistas Muscarínicos/envenenamento , Envenenamento/etiologia , Uso Recreativo de Drogas , Transtornos Relacionados ao Uso de Substâncias/complicações , Tentativa de Suicídio , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Criança , Pré-Escolar , Bases de Dados Factuais , Overdose de Drogas , Feminino , Humanos , Lactente , Recém-Nascido , Masculino , Pessoa de Meia-Idade , Oregon , Envenenamento/diagnóstico , Envenenamento/fisiopatologia , Envenenamento/terapia , Prognóstico , Sistema de Registros , Medição de Risco , Fatores de Risco , Transtornos Relacionados ao Uso de Substâncias/diagnóstico , Adulto Jovem
11.
Clin Toxicol (Phila) ; 59(11): 1027-1030, 2021 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-33733968

RESUMO

INTRODUCTION: Misuse/abuse of pregabalin is increasing worldwide. French Poison Control Centers (PCCs) recently received several unusual calls regarding the recreational use of pregabalin in adolescents. This study aims to describe this new and specific population of pregabalin misusers. METHODS: We extracted all cases of pregabalin intentional exposures reported to the French National Database of Poisonings (FNDP) from 2004 to 2020. We compared the proportion of recreational exposure to pregabalin between adolescents (10-17 years) and adults (>18 years). We reviewed all cases of pregabalin recreational exposures in adolescent in order to describe the characteristics of this population. RESULTS: During the study period, 382 cases of acute intentional exposure to pregabalin were reported in adolescents and 1188 in adults, 94/382 (24.6%) and 43/1188 (3.6%) were pregabalin recreational use, respectively (p < .0001). Almost all cases of pregabalin recreational use in adolescent were reported from 2018 (86/94; 91%). Most of those adolescent patients were males (male/female ratio - 5.3:1) and the median age was 15 years (range: 11-17.8). They were homeless or living in migrant shelters in most of the cases (73/90, 81%). Two-third of these exposures (62/94; 66%) involved other toxicant(s) than pregabalin. Most of the patients remains asymptomatic (10/94; 11%), or developed minor to moderate neurological symptoms (76/94; 81%). Eight developed severe symptoms (8/94; 8%) including coma (5/8) or generalized seizures (2/8). Five patients (5/8) required oro-tracheal intubation. No fatality was reported. CONCLUSIONS: We observed a sharp increase in pregabalin recreational use in adolescents in France. It should lead to prevention campaigns, targeted at the population at risk described in this study.


Assuntos
Comportamento do Adolescente , Drogas Ilícitas , Pregabalina , Uso Recreativo de Drogas/tendências , Transtornos Relacionados ao Uso de Substâncias/epidemiologia , Adolescente , Adulto , Fatores Etários , Criança , Feminino , França/epidemiologia , Humanos , Masculino , Medição de Risco , Fatores de Risco , Transtornos Relacionados ao Uso de Substâncias/diagnóstico , Transtornos Relacionados ao Uso de Substâncias/psicologia
12.
Clin Toxicol (Phila) ; 59(10): 896-904, 2021 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-33724118

RESUMO

OBJECTIVE: To analyse the relative percentage of acute recreational drug toxicity emergency department (ED) presentations involving the main drug groups according to age and sex and investigate different patterns based on sex and age strata. METHODS: We analysed all patients with acute recreational drug toxicity included by the Euro-DEN Plus dataset (22 EDs in 14 European countries) between October 2013 and December 2016 (39 months). Drugs were grouped as: opioids, cocaine, cannabis, amphetamines, gamma-hydroxybutyrate (GHB), hallucinogens, new psychoactive substances (NPS), benzodiazepines and ketamine. Descriptive data by age and sex are presented and compared among age/sex categories and among drug families. RESULTS: Of 17,371 patients were included during the 39-month period, 17,198 (99.0%) had taken at least one of the investigated drugs (median age: 31 years; 23.9% female; ethanol co-ingestion recorded in 41.5%, unknown in 31.2%; multiple drug use in 37.9%). Opioids (in 31.4% of patients) and amphetamines (23.3%) were the most frequently involved and hallucinogens (1.9%) and ketamine (1.7%) the least. Overall, female patients were younger than males, both in the whole cohort (median age 29 vs. 32 years; p < 0.001) and in all drug groups except benzodiazepines (median age 36 vs. 36 years; p = 0.83). The relative proportion of each drug group was different at every age strata and some patterns could be clearly described: cannabis, NPS and hallucinogens were the most common in patients <20 years; amphetamines, ketamine and cocaine in the 20- to 39-year group; GHB/GBL in the 30- to 39-year group; and opioids and benzodiazepines in patients ≥40 years. Ethanol and other drug co-ingestion was more frequent at middle-ages, and multidrug co-ingestion was more common in females than males. CONCLUSION: Differences in the drugs involved in acute drug toxicity presentations according to age and sex may be relevant for developing drug-prevention and education programs for some particular subgroups of the population based on the increased risk of adverse events in specific sex and/or age strata.


Assuntos
Serviço Hospitalar de Emergência/tendências , Drogas Ilícitas/envenenamento , Envenenamento/epidemiologia , Uso Recreativo de Drogas/tendências , Transtornos Relacionados ao Uso de Substâncias/epidemiologia , Doença Aguda , Adolescente , Adulto , Fatores Etários , Idoso , Bases de Dados Factuais , Europa (Continente)/epidemiologia , Feminino , Humanos , Drogas Ilícitas/classificação , Masculino , Pessoa de Meia-Idade , Envenenamento/diagnóstico , Sistema de Registros , Medição de Risco , Fatores de Risco , Fatores Sexuais , Transtornos Relacionados ao Uso de Substâncias/diagnóstico , Fatores de Tempo , Adulto Jovem
13.
Pharmacol Biochem Behav ; 204: 173158, 2021 05.
Artigo em Inglês | MEDLINE | ID: mdl-33675838

RESUMO

BACKGROUND: It is commonly believed that drugs, including stimulants, are used recreationally because of their ability to induce pleasurable subjective effects. However, recreational drug use sometimes occurs in the absence of positive subjective effects, suggesting that other factors contribute. Here, we examine the extent to which the direct subjective effects of amphetamine, a commonly misused stimulant, predict subsequent choice of the drug vs placebo. METHODS: Healthy adults (N = 112) participated in a five-session amphetamine choice study. On the first four sessions, participants sampled either 20 mg d-amphetamine or placebo in color-coded capsules two times each. On the fifth session, they chose which color (d-amphetamine or placebo) they preferred. We examined the choice of drug vs placebo in relation to demographic characteristics, baseline mood states, personality and subjective and cardiovascular responses to acute administration of the drug. RESULTS: Eighty-one participants chose amphetamine (Choosers) while 31 chose placebo (Non-choosers). Overall, amphetamine produced typical stimulant-like effects on subjective questionnaires, and it elevated heart rate and blood pressure vs placebo. Choosers reported greater positive mood, elation and stimulant-like effects following amphetamine compared to Non-choosers. The Choosers also exhibited a greater increase in systolic blood pressure, but not heart rate. The groups did not differ on demographic characteristics, mood states before drug administration or personality. CONCLUSIONS: These findings support the idea that pleasurable subjective responses to amphetamine, including positive mood, elation, and stimulant-like effects influence behavioral choice of the drug.


Assuntos
Estimulantes do Sistema Nervoso Central/administração & dosagem , Comportamento de Escolha/efeitos dos fármacos , Dextroanfetamina/administração & dosagem , Adulto , Afeto/efeitos dos fármacos , Nível de Alerta/efeitos dos fármacos , Pressão Sanguínea/efeitos dos fármacos , Estimulantes do Sistema Nervoso Central/farmacologia , Dextroanfetamina/farmacologia , Feminino , Voluntários Saudáveis , Frequência Cardíaca/efeitos dos fármacos , Humanos , Masculino , Personalidade/efeitos dos fármacos , Uso Recreativo de Drogas , Adulto Jovem
14.
Cogn Behav Ther ; 50(4): 276-294, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33706676

RESUMO

The COVID-19 pandemic presents unique stressors (e.g. social isolation) that may increase substance use risk among young adults with a history of emotional disturbance. This study examined whether emotional disorder symptoms and transdiagnostic vulnerabilities during adolescence predicted young adult substance use during COVID-19, and whether using substances to cope with the pandemic's social conditions mediated these associations. Adolescents (N = 2,120) completed baseline surveys assessing transdiagnostic emotional vulnerabilities (anhedonia, distress intolerance, anxiety sensitivity, negative urgency) and symptoms (major depression[MD], generalized anxiety[GAD], panic disorder[PD], social phobia[SP], obsessive-compulsive disorder[OCD]) in adolescence (September-December 2016; M[SD] age = 17.45[0.38]). At follow-up (May-August 2020; M[SD] age = 21.16[0.39]), past 30-day substance use and using substances to cope with social isolation during the pandemic were reported. Adjusted models showed that baseline distress intolerance, anxiety sensitivity, negative urgency, and MD symptoms each significantly predicted higher number of past-month single-substance using days and number of substances used at follow-up (ßs = 0.04-0.06). In each case, associations were mediated by tendency to use substances to cope with the pandemic (ßindirect range: 0.028-0.061). To mitigate disproportionate escalation of substance use in young adults with a history of certain types of emotional disturbance, interventions promoting healthy coping strategies to deal with the pandemic's social conditions warrant consideration.


Assuntos
Adaptação Psicológica , Transtornos de Ansiedade/psicologia , COVID-19/psicologia , Transtorno Depressivo/psicologia , Uso Recreativo de Drogas/psicologia , Sintomas Afetivos/psicologia , Ansiedade/psicologia , Feminino , Humanos , Masculino , Pandemias , Adulto Jovem
15.
Pharmacol Biochem Behav ; 204: 173169, 2021 05.
Artigo em Inglês | MEDLINE | ID: mdl-33684453

RESUMO

BACKGROUND: This paper examines the epidemiology of extra-medical use of prescription medications for sleep among a nationally representative sample of U.S. adults. METHODS: We analyzed data from the 2015-2018 National Surveys on Drug Use and Health. The sample includes 3410 U.S. adults who reported extra-medical use of prescription medications for sleep. Multinomial logistic regression models identified correlates of type of drug used [i.e., sedatives and/or tranquilizers-only (ST-only), prescription pain relievers-only (PPR-only), or sedatives, tranquilizers, and prescription pain relievers (ST + PPR)], and logistic regression models identified correlates of reasons for extra-medical use (i.e., sleep-only vs. sleep and recreational). RESULTS: About 60% (95%CI = 58.9, 63.5) of the sample reported extra-medical use of ST-only, followed by PPR-only (29.9%, 95%CI = 27.5, 32.5), and ST + PPR (8.9%, 95%CI = 7.7, 10.4). Recreational use was reported by 28.4% (95% CI = 26.5, 30.4) of the sample. The odds of extra-medical use of PPR-only (aRRR = 3.1, 95%CI = 2.1, 4.5) and ST + PPR (aRRR = 1.9, 95%CI = 1.2, 3.1) as opposed to ST-only, were greater among Non-Hispanic Blacks than Non-Hispanic Whites. Compared to non-alcohol users, those with a past-12 months diagnosis of alcohol use disorder were more likely to use ST + PPR rather than ST-only (aIRR = 2.0, 95%CI = 1.1, 3.7). Non-Hispanic Blacks (aOR = 0.6, 95%CI = 0.4, 08) and individuals living in rural areas (aOR = 0.5, 95%CI = 0.3, 09) were less likely to report extra-medical use of prescription medications for recreational reasons than Non-Hispanic Whites and those residing in large metropolitan areas, respectively. CONCLUSIONS: Extra-medical use of PPR-only and ST + PPR as an aid to sleep, is prevalent among Non-Hispanic Blacks, young adults, and those residing in rural areas. Most individuals reported that extra-medical use of prescription medications was primarily motivated by sleep reasons, rather than by sleep and recreational reasons. Potential interventions include access to sleep treatments, education on the effectiveness and risk associated with extra-medical use and co-use of prescription medications for sleep, and research on sleep-related disparities.


Assuntos
Analgésicos/uso terapêutico , Hipnóticos e Sedativos/uso terapêutico , Uso Indevido de Medicamentos sob Prescrição/estatística & dados numéricos , Transtornos do Sono-Vigília/tratamento farmacológico , Tranquilizantes/uso terapêutico , Adolescente , Adulto , Alcoolismo/epidemiologia , Analgésicos Opioides/uso terapêutico , Prescrições de Medicamentos/estatística & dados numéricos , Feminino , Humanos , Modelos Logísticos , Masculino , Pessoa de Meia-Idade , Prevalência , Uso Recreativo de Drogas/estatística & dados numéricos , Sono , Medicamentos Indutores do Sono/uso terapêutico , Transtornos Relacionados ao Uso de Substâncias/epidemiologia , Inquéritos e Questionários , Estados Unidos/epidemiologia , Adulto Jovem
16.
Neurotox Res ; 39(3): 975-985, 2021 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-33770366

RESUMO

Nitrous oxide (N2O), also known as "laughing gas," is a colorless, nonirritating gas. Clinically, it is widely used as an inhaled anesthetic, analgesic, and anxiolytic. In recent years, recreational abuse of N2O has become increasingly common, especially among young adults and adolescents, but many of them lack awareness of the possible side effects associated with this drug. N2O abuse can damage multiple systems, especially the nervous system, but the exact mechanism of N2O toxicity remains controversial. At present, an increasing number of cases of nervous system damage caused by N2O abuse have been reported both at home and abroad. Discontinuation of N2O use and timely supplementation with vitamin B12 are essential for a good prognosis. Long-term abuse without timely treatment will eventually lead to irreversible neurological damage. In this article, we discuss the epidemiology of N2O abuse, neurotoxicity mechanisms, clinical manifestations, relevant auxiliary examinations, treatments, and prognosis to improve social awareness of N2O exposure risk, especially among users and clinicians.


Assuntos
Drogas Ilícitas/toxicidade , Óxido Nitroso/toxicidade , Uso Recreativo de Drogas/tendências , Transtornos Relacionados ao Uso de Substâncias/epidemiologia , Humanos , Síndromes Neurotóxicas/diagnóstico , Síndromes Neurotóxicas/tratamento farmacológico , Síndromes Neurotóxicas/epidemiologia , Óxido Nitroso/administração & dosagem , Transtornos Relacionados ao Uso de Substâncias/diagnóstico , Transtornos Relacionados ao Uso de Substâncias/tratamento farmacológico , Resultado do Tratamento , Vitamina B 12/administração & dosagem
17.
Subst Abuse Treat Prev Policy ; 16(1): 16, 2021 02 12.
Artigo em Inglês | MEDLINE | ID: mdl-33579324

RESUMO

BACKGROUND: Most U.S. states have legalized cannabis for medical and/or recreational use. In a 6-month prospective observational study, we examined changes in adult cannabis use patterns and health perceptions following broadened legalization of cannabis use from medical to recreational purposes in California. METHODS: Respondents were part of Stanford University's WELL for Life registry, an online adult cohort concentrated in Northern California. Surveys were administered online in the 10 days prior to state legalization of recreational use (1/1/18) and 1-month (2/1/18-2/15/18) and 6-months (7/1/2018-7/15/18) following the change in state policy. Online surveys assessed self-reported past 30-day cannabis use, exposure to others' cannabis use, and health perceptions of cannabis use. Logistic regression models and generalized estimating equations (GEE) examined associations between participant characteristics and cannabis use pre- to 1-month and 6-months post-legalization. RESULTS: The sample (N = 429, 51% female, 55% non-Hispanic White, age mean = 56 ± 14.6) voted 58% in favor of state legalization of recreational cannabis use, with 26% opposed, and 16% abstained. Cannabis use in the past 30-days significantly increased from pre-legalization (17%) to 1-month post-legalization (21%; odds ratio (OR) = 1.28, p-value (p) = .01) and stayed elevated over pre-legalization levels at 6-months post-legalization (20%; OR = 1.28, p = .01). Exposure to others' cannabis use in the past 30 days did not change significantly over time: 41% pre-legalization, 44% 1-month post-legalization (OR = 1.18, p = .11), and 42% 6-months post-legalization (OR = 1.08, p = .61). Perceptions of health benefits of cannabis use increased from pre-legalization to 6-months post-legalization (OR = 1.19, p = .02). Younger adults, those with fewer years of education, and those reporting histories of depression were more likely to report recent cannabis use pre- and post-legalization. Other mental illness was associated with cannabis use at post-legalization only. In a multivariate GEE adjusted for sociodemographic characteristics and diagnoses, favoring legalization and the interaction of time and positive health perceptions were associated with a greater likelihood of using cannabis. CONCLUSIONS: Legalized recreational cannabis use was associated with greater self-reported past 30-day use post-legalization, and with more-positive health perceptions of cannabis use. Future research is needed to examine longer-term perceptions and behavioral patterns following legalization of recreational cannabis use, especially among those with mental illness.


Assuntos
Cannabis , Uso Recreativo de Drogas , Adulto , California/epidemiologia , Estudos de Coortes , Humanos , Legislação de Medicamentos , Percepção , Estudos Prospectivos , Uso Recreativo de Drogas/tendências
19.
PLoS One ; 16(1): e0245022, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33412556

RESUMO

The present study examined the patterns of use among a sample of 68 users of hallucinogenic plants and mushrooms in Slovenia. In compiling the lists of all the participants, 26 different plants/mushrooms, mixtures, or products were found to have been used. The main reason for beginning to use these substances was curiosity, and most people began using them in their 20s. The most used were Psilocybe spp., being mentioned by approximately 91% of the participants; 50% of the respondents in the study had made use of no other natural hallucinogens besides these. Many of the plants or mushrooms were used only a small number of times. No matter what items had been used, the internet often played a role in first hearing about them. Dosing and the means of using the various hallucinogens were often quite varied, as were the settings where they were taken. Knowledge of the dangers of these hallucinogenic plants and mushrooms as well as their occurrence in nature were likewise vastly varied. Though public opinion often associates the use of mind-altering substances with problematic drug use and partying, the majority of the individuals interviewed seemed to present a greater desire to experience the interesting effects, to overcome personal difficulties, and for individual and spiritual growth.


Assuntos
Agaricales , Usuários de Drogas , Alucinógenos/administração & dosagem , Psilocibina/administração & dosagem , Uso Recreativo de Drogas , Adolescente , Adulto , Etnobotânica , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Motivação , Eslovênia , Adulto Jovem
20.
Drug Alcohol Depend ; 220: 108516, 2021 03 01.
Artigo em Inglês | MEDLINE | ID: mdl-33485009

RESUMO

BACKGROUND: Studies have examined patterns of substance use among Men who have Sex with Men (MSM), but few have examined factors predicting transitioning from one substance use pattern to another. We investigated transitioning from one substance use pattern to another over a 12-year period (2004-2016) among the Multicenter AIDS Cohort Study participants. METHOD: Alcohol, marijuana, heroin, cocaine, poppers, uppers (e.g., methamphetamines) and erectile dysfunction(ED) medications use in the last 6 months from 3568 US MSM was dichotomized (no/yes) to classify participants into substance use classes at each follow up visit. We fit latent transition models to calculate transition probabilities of moving from one substance use class to another over a 3, 4 and 6-year time period. Then fit regression models to identify factors associated with the probability of each participant staying in or moving from the same substance use class. RESULTS: Overall, cocaine and ED medication use declined but marijuana and heroin use increased over 2004-2016. We observed most participants (84.6 %-100 %) stayed in the same class. Increased age was associated with transition from the Minimal-use class to the Alcohol-only class (aOR = 1.06,95 %CI:1.01-1.13;p < 0.01) and non-White MSM reported lower odds of moving from the Alcohol-only class to the Alcohol-Popper class (aOR = 0.50,95 %CI:0.30-0.82;p <0.01). There were no difference in the transition probabilities by HIV-status. CONCLUSION: Despite decline in substance use in general, participants are highly stable in their choice of substances. However, treating MSM as a homogeneous group can lead to an under-appreciation of the diversity of prevention needs and treatment of substance using MSM.


Assuntos
Consumo de Bebidas Alcoólicas/tendências , Análise de Classes Latentes , Uso Recreativo de Drogas/tendências , Minorias Sexuais e de Gênero , Adulto , Estudos de Coortes , Humanos , Masculino , Pessoa de Meia-Idade , Estados Unidos/epidemiologia
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