Detection of "bath salts" and other novel psychoactive substances in hair samples of ecstasy/MDMA/"Molly" users

BACKGROUND: Ecstasy (MDMA) in the US is commonly adulterated with other drugs, but research has not focused on purity of ecstasy since the phenomenon of “Molly” (ecstasy marketed as pure MDMA) arose in the US. METHODS: We piloted a rapid electronic survey in 2015 to assess use of novel psychoactive substances (NPS) and other drugs among 679 nightclub/festival-attending young adults (age 18–25) in New York City. A quarter (26.1%) of the sample provided a hair sample to be analyzed for the presence of select synthetic cathinones (“bath salts”) and some other NPS. Samples were analyzed using fully validated UHPLC-MS/MS methods. To examine consistency of self-report, analyses focused on the 48 participants with an analyzable hair sample who reported lifetime ecstasy/MDMA/Molly use. RESULTS: Half (50.0%) of the hair samples contained MDMA, 47.9% contained butylone, and 10.4% contained methylone. Of those who reported no lifetime use of “bath salts”, stimulant NPS, or unknown pills or powders, about four out of ten (41.2%) tested positive for butylone, methylone, alpha-PVP, 5/6-APB, or 4-FA. Racial minorities were more likely to test positive for butylone or test positive for NPS after reporting no lifetime use. Frequent nightclub/festival attendance was the strongest predictor of testing positive for MDMA, butylone, or methylone. DISCUSSION: Results suggest that many ecstasy-using nightclub/festival attendees may be unintentionally using “bath salts” or other NPS. Prevention and harm reduction education is needed for this population and “drug checking” (e.g., pill testing) may be beneficial for those rejecting abstinence

Self-reported use of novel psychoactive substances in a US nationally representative survey: Prevalence, correlates, and a call for new survey methods to prevent underreporting

Background: In recent years, there has been an increase in emergence and use of novel psychoactive substances (NPS) in the US and worldwide. However, there is little published epidemiological survey data estimating the prevalence of use in the US. Method: Data on self-reported NPS use came from the National Survey of Drug Use and Health (2009–2013), a national representative sample of non-institutionalized individuals in the US. Subjects were asked to provide names of (non-traditional) drugs they used that they were not specifically asked about. We examined lifetime prevalence and sociodemographic correlates of self-reported use of new and uncommon synthetic drugs (NPS) among subjects ages 12–34-years-old. Results: 1.2% of subjects self-reported any use of the 57 NPS we examined. Use of psychedelic tryptamines (primarily DMT) was most common, followed by psychedelic phenethylamines (e.g., 2C series) and synthetic cannabinoids. Prevalence of self-reported use of NPS increased from 2009 to 2013 and use was most common among males, whites, older subjects, those of lower income, and among those residing in cities. Lifetime use of various other illicit drugs (e.g., LSD, cocaine, ecstasy/MDMA) was highly prevalent among NPS users. Conclusion: This the first study reporting on use of a variety of NPS in a nationally representative US sample; however, use appears to be underreported as other national data suggest higher rates of NPS (e.g., synthetic cannabinoid) use. Developing more adaptable survey tools and systematically assessing NPS use would allow researchers to ask about hundreds of NPS and improve reporting as new drugs continue to rapidly emerge

Alcohol Protective Behavioral Strategies in Young Spanish Adults in the Community: A Prospective Study of Perceived Effi cacy and Social Norms

Background: Protective behavioral strategies (PBS) have been shown to be useful for reducing excessive alcohol use and alcohol-related problems. However, research on the explanatory factors of PBS is limited. This paper prospectively examines the contribution of perceived effi cacy of PBS in reducing alcohol-related consequences and perceived descriptive norms of close peers´ PBS use in young adults. The mediating role of perceived effi cacy of PBS between descriptive norms of PBS use and personal PBS use is also examined. Method: Targeted sampling was used to recruit a community-based sample of 339 young Spanish adults aged 18-25 years, who completed baseline and two-month follow-up questionnaires. Three types of PBS (serious harm reduction-SHR, manner of drinking-MOD, and stopping/limiting drinking-SLD) were measured. Results: Both perceived effi cacy and descriptive norms at baseline were positively associated with personal PBS use (SHR, MOD and SLD) at follow-up. A partial mediation effect of perceived effi cacy between descriptive norms and personal PBS use was found for the three PBS subscales. Conclusions: Our fi ndings support the usefulness of correcting misperceptions of PBS use by peers in interventions aimed at reducing excessive drinking and alcohol-related consequences in young adults in the community. Moreover, PBS perceived effi cacy should be included as a component of these interventions.Antecedentes: las estrategias conductuales de protección (ECP) han mostrado utilidad para reducir el consumo excesivo de alcohol y sus problemas asociados, aunque la investigación sobre sus factores explicativos es escasa. Este trabajo examina la contribución de la efi cacia percibida de las ECP para reducir las consecuencias negativas del alcohol, y la norma descriptiva percibida del uso de PBS de los iguales, en adultos jóvenes. Además, analiza el papel mediador de la efi cacia percibida entre norma descriptiva y ECP. Método: mediante muestreo dirigido a poblaciones diana, 339 jóvenes españoles (18-25 años) comunitarios cumplimentaron cuestionarios basal y de seguimiento (dos meses), midiéndose tres tipos de ECP (reducción de daños-RR, forma de beber-FB, parar/limitar el consumo- PLC). Resultados: efi cacia y norma se asociaron positivamente con el uso de ECP (RR/FB/PLC) en el seguimiento. Para los tres tipos de ECP se detectó un efecto de mediación parcial de la efi cacia percibida entre la norma y el uso de ECP. Conclusiones: corregir percepciones erróneas del uso de ECP de los iguales puede ser útil en las intervenciones dirigidas a reducir el uso excesivo de alcohol y sus consecuencias en adultos jóvenes comunitarios, al igual que la inclusión de la efi cacia percibida como uno de sus componentes

Demographic trends among older cannabis users in the United States, 2006–13

Background and Aims: The ageing US population is providing an unprecedented population of older adults who use recreational drugs. We aimed to estimate the trends in the prevalence of past-year use of cannabis, describe the patterns and attitudes and determine correlates of cannabis use by adults age 50 years and older. Design: Secondary analysis of the National Survey on Drug Use and Health survey from 2006 to 2013, a cross-sectional survey given to a nationally representative probability sample of populations living in US households. Setting: USA. Participants: A total of 47 140 survey respondents aged ≥ 50 years. Measures: Estimates and trends of past-year use of cannabis. Findings: The prevalence of past-year cannabis use among adults aged ≥ 50 increased significantly from 2006/07 to 2012/13, with a 57.8% relative increase for adults aged 50–64 (linear trend P < 0.001) and a 250% relative increase for those aged ≥ 65 (linear trend P = 0.002). When combining data from 2006 to 2013, 6.9% of older cannabis users met criteria for cannabis abuse or dependence, and the majority of the sample reported perceiving no risk or slight risk associated with monthly cannabis use (85.3%) or weekly use (79%). Past-year users were more likely to be younger, male, non-Hispanic, not have multiple chronic conditions and use tobacco, alcohol or other drugs compared with non-past-year cannabis users. Conclusions: The prevalence of cannabis use has increased significantly in recent years among US adults aged ≥ 50 years

Barriers to accurately assessing prescription opioid misuse on surveys.

Surveys are the leading method of gathering data on prevalence and correlates of prescription opioid misuse. As the opioid crisis continues in the United States, reliable data on misuse have become increasingly important as under- and overreporting is common. This perspective discusses six potential barriers to researchers accurately assessing opioid misuse on surveys. These barriers include lack of respondent drug knowledge, researchers not properly defining opioids for respondents, querying overall opioid misuse rather than misuse of specific opioids, varying terminology (e.g., of opioids and misuse), and lack of understanding of medical versus nonmedical use or misuse. Finally, a recent barrier is use of counterfeit or adulterated drugs that contain fentanyl, its analogs, or other new synthetic opioids, which can lead to underreporting of exposure. Survey researchers should consider such barriers when querying opioid misuse

Prevalence of self-reported adverse effects associated with drug use among nightclub and festival attendees, 2019–2022

Background: Research investigating adverse effects from drug use has focused extensively on poisonings and mortality. This study focuses on drug-related adverse effects not necessarily resulting in hospitalization or death among a population known for high prevalence of party drug use—electronic dance music (EDM) nightclub and festival attendees. Methods: Adults entering EDM venues were surveyed in 2019–2022 (n = 1952). Those reporting past-month use of a drug were asked whether they had experienced a harmful or very unpleasant effect after use. We examined 20 drugs and drug classes with a particular focus on alcohol, cannabis, cocaine, and ecstasy. Prevalence and correlates of adverse effects were estimated. Results: Almost half (47.6%) of adverse effects involved alcohol and 19.0% involved cannabis. 27.6% of those using alcohol reported an adverse effect, while 19.5%, 15.0%, and 14.9% of participants reported an effect from use of cocaine, ecstasy, and cannabis, respectively. Use of less prevalent drugs, such as NBOMe, methamphetamine, fentanyls, and synthetic cathinones, tended to be associated with higher prevalence of adverse effects. The most consistent risk factor was younger age, while past-month use of a greater number of drugs was often a protective factor against adverse effects. For most drugs, taking too much was the most common perceived reason for the adverse effect, and visiting a hospital after use was most prevalent among those experiencing an adverse effect from cocaine (11.0%). Conclusions: Adverse drug effects are common in this population and results can inform prevention and harm reduction in this population and the general population

A qualitative investigation exploring why dance festivals are risky environments for drug use and potential adverse outcomes

Background: Dance festivals have been shown to be high-risk events for use of drugs such as ecstasy/MDMA and possible adverse efects associated with use. However, few studies have examined what makes festivals such risky environments. We aimed to determine festival-specifc risk factors for adverse outcomes related to drug use. Methods: In-depth interviews were conducted with 35 key informants in North America who deemed themselves experts in new psychoactive substances, and identifed as drug checkers, sellers, or experienced users. Interviews were coded in an inductive manner, and we conducted thematic analysis to identify relevant themes. Results: We identifed four main themes focusing on festival attendance as a risk factor for risky drug use and related outcomes: attendees inexperienced with electronic dance music parties and party drugs, risky drug purchasing, risky drug use practices, and festival-specifc environmental risk factors. Festivals attract a wide array of people not experienced with party drugs, yet drugs like ecstasy are commonly sought by such individuals inside festivals. Relying on strangers inside to purchase drugs is a risk factor for purchasing adulterated product. Fear of security/police at festivals leads to risky drug-taking such as ingesting one’s full batch of drugs at the entrance. These risks are compounded by environmental factors including crowding, hot temperature, and lack of water (which lead to dehydration), long/ consecutive event days (which can lead to exhaustion), and inadequate medical emergency response. Conclusions: We determined modifable risk factors which can both inform future research and future prevention and harm reduction eforts in this scene