43 research outputs found
Fundam Clin Pharmacol
BACKGROUND: Due to its psychoactive effects, ketamine has become a drug used for non-medical purpose. OBJECTIVES: To assess the latest trends in ketamine use among people with substance use disorder and to characterize its clinical complications using complementary health data sources of the French Addictovigilance Network. METHODS: First, we extracted all reports involving ketamine from 2012 to 2021 from the database of the OPPIDUM program (i.e., a multicentric program conducted in collaboration with hundreds of substance abuse treatment facilities that collects data on drugs used by subjects with substance use disorders). We described the reports globally and the changes from 2012 to 2021. Second, we extracted all cases involving ketamine from July 2020 to December 2022 from the French National Pharmacovigilance Database (BNPV). We identified the cases related to ketamine use among people with substance use disorder and described them. RESULTS: There was a 2.5-fold increase in the number of ketamine users with substance use disorder in the OPPIDUM program, from 35 (0.7%) subjects in 2012 to 89 (1.7%) subjects in 2021. There was an increase in the proportion of subjects who were daily users, had distress upon discontinuation, and presented addiction. There were 238 cases related to ketamine use among people with substance use disorder in the French National Pharmacovigilance Database from July 2020 to December 2022. Among them, 94 (39.5%) cases involved ketamine use disorder, 20 (8.4%) cases involved urinary tract and kidney symptoms, and 13 (5.5%) cases involved hepatobiliary symptoms. CONCLUSION: The trend observed over 10Â years reflects the growth in ketamine use among people with substance use disorder, although it does not allow to estimate the rates of non-medical use of ketamine in the general population. Ketamine-induced uropathy and cholangiopathy are reported in ketamine users with substance use disorder, especially in case of repeated and/or prolonged use of high doses
Nouvelles drogues de synthèse en addictovigilance
Depuis 2005, 215 nouvelles drogues ont été signalées dans l’Union européenne. Ces
produits de synthèse, créés pour esquiver la législation sur les stupéfiants, sont des
dérivés de médicaments ou drogues existants. Leur disponibilité est sans limite. Les
effets recherchés incluent des effets stimulants, entactogènes, hallucinogènes,
psychédéliques ou dissociatifs. Plusieurs classes chimiques sont représentées :
phénéthylamines, tryptamines, pipérazines, cathinones, cannabinoïdes, ... La toxicité
inclut des effets comportementaux et physiques, les conséquences cardiovasculaires étant
les plus redoutables. Cependant, de faibles variations de structure chimique peuvent
entraîner des effets quantitativement différents, majorant ainsi la toxicité ou la
dépendance. Ces substances ont une existence réelle sur le territoire national comme le
montrent les données de l’Observatoire Français des Drogues et des Toxicomanies ainsi que
celles du réseau des Centres d’Addictovigilance. La législation concernant ces produits
change régulièrement avec de plus en plus de pays les classant comme «stupéfiants» pour en
limiter l’usage.
Abréviations : voir en fin d’article
New Synthetic Drugs in Addictovigilance
New substances, also known as “designer drugs” or “legal highs” are increasingly
available to drug users. Two hundred and fifteen hitherto unlisted substances have been
notified by European Union member states since 2005. These synthetic drugs, which have
been developed to side-step the legislation on drugs, are analogues or derivatives of
existing drugs and medications. The availability of these “legal highs”, sold on Internet
under various denominations such as bath salt, plant fertilizer, chemical not intended for
human use, or spice, is unlimited. The effects felt by users vary, and the substances may
be stimulant, entactogenic, hallucinogenic, psychedelic or dissociative. The
pharmacological targets also vary, and may be either the increase of extracellular levels
of neurotransmitters via different mechanisms (reuptake inhibition,
stimulation of intracellular release) or else fixation on specific receptors. Several
chemical classes, themselves divided into sub-classes, are involved: phenethylamines,
tryptamines, piperazines, cathinones, cannabinoids etc. The toxicity of the main members
of these categories is increasingly well known, the most deleterious being behavioural
effects, physical manifestations, and cardiovascular consequences. However, small
variations in their chemical structure can generate effects that are quantitatively
different, thus enhancing their toxicity or addictive potential, and much remains to be
achieved in terms of knowledge about these new drugs. These substances are indeed present
on the French territory, as shown by data provided by the Observatoire Français
des Drogues et Toxicomanies, and notifications by the French Addictovigilance
network. Screening in clinical toxicology laboratories is not widespread, since these
molecules are not detected by the standard screening tests, so that there is probably an
under-estimation of the use of these new drugs. The legislation on these substances
changes regularly, with more and more countries classifying them as “narcotics” or illegal
psychotropic drugs so as to restrict their use, applying a generic classification when
possible.
Abbreviations: see end of article