An international survey on the awareness, use, preference and health perception of Novel Psychoactive Substances (NPS)

© 2017 John Wiley & Sons, Ltd. This is the peer reviewed version of the following article: Deligianni, E, Corkery, JM, Schifano, F, Lione, LA. An international survey on the awareness, use, preference, and health perception of novel psychoactive substances (NPS). Hum Psychopharmacol Clin Exp. 2017; 32:e2581, which has been published in final form at https://doi.org/10.1002/hup.2581. This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Use of Self-Archived Versions.ObjectiveThis survey investigated the level of public awareness, preference and motivation of NPS use as well as knowledge of potential associated health risks.Methods A Bristol Online Survey was advertised through social media and a drug forum ‘’Bluelight’’ between 7 January and 7 February 2015. ResultsResponses were received from 17 countries, mainly from Europe. Most responses (83%) came from University educated students. Two-thirds (65%) of the 168 respondents were aware of NPS. Awareness was significantly increased in those with bisexual/homosexual orientation (p0.05). Nearly half of the NPS users perceived NPS to carry either a low risk to health (20%) or did not know whether or not they posed a health risk (29%).ConclusionsThese survey data indicate that awareness of NPS and, importantly, perception of the potential health risks associated with NPS use is lacking. NPS awareness and use is higher in those in employment but is unaffected by the level of education. This highlights the need for targeted drugs education intervention by policy-makers in schools and universities.Peer reviewe

Entertainment starts with an E: the ecstasy market in Greece

The purpose of this article is to provide an account of the social organisation of the ecstasy market in Greece. Concern about ecstasy production, distribution and use in Greece has risen since ecstasy appeared in the country in the early to mid-1990s, and continues to be fuelled by media reports which reinforce the perception that there are huge profits for traders. Moreover, the Greek authorities have adopted a 'war on drug' rhetoric when it comes to ecstasy trafficking. Thus, the fact that such mentalities are commonplace, while the knowledge deficit about the particular market remains gaping, makes it an imperative to examine the structure and dynamics of the ecstasy market in the country. We aim here to provide an account of the 'extent' and nature of the ecstasy market in Greece as well as a presentation of the 'actors' involved. We also explicitly focus on the issue of price of ecstasy tablets in the country, which we regard as key to the understanding of the logic of this particular market. Our investigation of various aspects of the market concludes with a number of more systematic observations regarding the particular business

Detection of newly emerging psychoactive substances using Raman spectroscopy and chemometrics

A novel approach for the identification of New Psychoactive Substances (NPS) by means of Raman spectroscopy coupled with Principal Components Analysis (PCA) employing the largest dataset of NPS reference materials to date is reported here. Fifty three NPS were selected as a structurally diverse subset from an original dataset of 478 NPS compounds. The Raman spectral profiles were experimentally acquired for all 53 substances, evaluated using a number of pre-processing techniques, and used to generate a PCA model. The optimum model system used a relatively narrow spectral range (1300 -1750 cm-1) and accounted for 37% of the variance in the dataset using the first three principal components, despite the large structural diversity inherent in the NPS subset. Nonetheless, structurally similar NPS (i.e., the synthetic cannabinoids FDU-PB-22 & NM-2201) grouped together in the PCA model based on their Raman spectral profiles, while NPS with different chemical scaffolds (i.e., the benzodiazepine flubromazolam and the cathinone -PBT) were well delineated, occupying markedly different areas of the three-dimensional scores plot. Classification of NPS based on their Raman spectra (i.e., chemical scaffolds) using the PCA model was further investigated. NPS that were present in the initial dataset of 478 NPS but were not part of the selected 53 training set (validation set) were observed to be closely aligned to structurally similar NPS within the generated model system in all cases. Furthermore, NPS that were not present in the original dataset of 478 NPS (test set) were also shown to group as expected in the model (i.e., methamphetamine and N-ethylamphetamine). This indicates that, for the first time, a model system can be applied to potential ‘unknown’ psychoactive substances, which are new to the market and absent from existing chemical libraries, to identify key structural features to make a preliminary classification. Consequently, it is anticipated that this study will be of interest to the broad scientific audience working with large structurally diverse chemical datasets and particularly to law enforcement agencies and associated scientific analytical bodies worldwide investigating the development of novel identification methodologies for psychoactive substances.Peer reviewe

Drug policy and the public good: A summary of the second edition

The second edition of Drug Policy and the Public Good presents up-to-date evidence relating to the development of drug policy at local, national, and international levels. The book explores both illicit drug use and nonmedical use of prescription medications from a public health perspective. The core of the book is a critical review of the scientific evidence in five areas of drug policy: 1) primary prevention programs in schools and other settings; 2) treatment interventions and harm reduction approaches; 3) attempts to control the supply of illicit drugs, including drug interdiction and law enforcement; 4) penal approaches, decriminalization and other alternatives; and 5) control of the legal market through prescription drug regimes. It also discusses the trend toward legalization of some psychoactive substances in some countries and the need for a new approach to drug policy that is evidence-based, realistic, and coordinated. The accumulated evidence provides important information about effective and ineffective policies. Shifting the emphasis toward a public health approach should reduce the extent of illicit drug use, prevent the escalation of new epidemics, and avoid the unintended consequences arising from the marginalization of drug users through severe criminal penalties

The new psychoactive substances 5-(2-aminopropyl)indole (5-IT) and 6-(2-aminopropyl)indole (6-IT) interact with monoamine transporters in brain tissue

In recent years, use of psychoactive synthetic stimulants has grown rapidly. 5-(2-Aminopropyl)indole (5-IT) is a synthetic drug associated with a number of fatalities, that appears to be one of the newest 3,4-methylenedioxymethamphetamine (MDMA) replacements. Here, the monoamine-releasing properties of 5-IT, its structural isomer 6-(2-aminopropyl)indole (6-IT), and MDMA were compared using in vitro release assays at transporters for dopamine (DAT), norepinephrine (NET), and serotonin (SERT) in rat brain synaptosomes. In vivo pharmacology was assessed by locomotor activity and a functional observational battery (FOB) in mice. 5-IT and 6-IT were potent substrates at DAT, NET, and SERT. In contrast with the non-selective releasing properties of MDMA, 5-IT displayed greater potency for release at DAT over SERT, while 6-IT displayed greater potency for release at SERT over DAT. 5-IT produced locomotor stimulation and typical stimulant effects in the FOB similar to those produced by MDMA. Conversely, 6-IT increased behaviors associated with 5-HT toxicity. 5-IT likely has high abuse potential, which may be somewhat diminished by its slow onset of in vivo effects, whereas 6-IT may have low abuse liability, but enhanced risk for adverse effects. Results indicate that subtle differences in the chemical structure of transporter ligands can have profound effects on biological activity. The potent monoamine-releasing actions of 5-IT, coupled with its known inhibition of MAO A, could underlie its dangerous effects when administered alone, and in combination with other monoaminergic drugs or medications. Consequently, 5-IT and related compounds may pose substantial risk for abuse and serious adverse effects in human users

Substance Use During Imprisonment in Low- and Middle-Income Countries

Substance use disorders are among the most common health problems of people involved in the criminal justice system. Scaling up addiction services in prisons is a global public health and human rights challenge especially in poorly resourced countries. The aim of the present study was to systematically review the prevalence of substance use in prison populations in low- and middle-income countries (LMIC). We searched for studies reporting prevalence rates of nicotine, alcohol, illicit drug and injection drug use during imprisonment in unselected samples of imprisoned people in LMIC. Data were meta-analyzed and sources of heterogeneity examined by meta-regression. The prevalence of nicotine use during imprisonment ranged from 5% to 87% with a random-effects pooled estimate of 56% (95% CI: 45, 66) with significant geographical heterogeneity. Alcohol use varied from 1% to 76%. The pooled prevalence was 16% (95% CI: 9, 25). A quarter of the people who are imprisoned (25%, 95% CI: 17, 33; range: 0, 78) used illicit drugs during imprisonment. The prevalence of injection drug use varied from 0% to 26% with a pooled estimate of 1.6% (95% CI: 0.8, 3.0). Secondary analyses investigated lifetime substance use. The high prevalence of smoking in prison suggests that policies around smoking need careful review. Furthermore, the findings underscore the importance of timely, scalable and available treatments for alcohol and illegal drugs in people involved with the criminal justice system

HIV and incarceration: prisons and detention

The high prevalence of HIV infection among prisoners and pre-trial detainees, combined with overcrowding and sub-standard living conditions sometimes amounting to inhuman or degrading treatment in violation of international law, make prisons and other detention centres a high risk environment for the transmission of HIV. Ultimately, this contributes to HIV epidemics in the communities to which prisoners return upon their release

An Insight into Z-Drug Abuse and Dependence: An Examination of Reports to the European Medicines Agency Database of Suspected Adverse Drug Reactions

© The Author(s) 2019. Published by Oxford University Press on behalf of CINP.BACKGROUND: Although originally marketed as safe alternatives to the habit-forming benzodiazepines, growing numbers of zaleplon, zolpidem, and zopiclone ("Z-drugs") clinical concerns relating to their potential of abuse, dependence, and withdrawal have been reported over time. We aimed here at assessing these issues analyzing datasets of adverse drug reactions provided by the European Medicines Agency through the EudraVigilance system. METHODS: Analyzing the adverse drug reactions databases of each Z-drug, descriptive analyses have been performed on cases and proportional reporting ratios (PRRs) computed. RESULTS: An overall number of 33 240 (e.g., 23 420 zolpidem; 9283 zopiclone; and 537 zaleplon) misuse-, abuse-, dependence-, and withdrawal-related adverse drug reactions, corresponding to some 6246 unique patients given Z-drugs, were here identified. Cases were studied and described, including demographic characteristics and clinical data such as concomitant drugs, doses, routes of administration, and outcomes of the reactions (being fatalities recorded). Considering PRR values and in comparison with zopiclone, zolpidem was more frequently involved in both misuse/abuse and withdrawal issues. Zolpidem and zopiclone presented with the same dependence risk, but zopiclone was most involved in overdose adverse drug reactions. Compared with zaleplon, zopiclone presented higher dependence and overdose-related issues but slightly lower misuse/abuse and withdrawal PRR values. CONCLUSION: Current data may only represent a gross underestimate of the real prevalence of Z-drug misuse. Caution should be exercised when prescribing those molecules, especially for patients with psychiatric illnesses and/or history of drug abuse. We recommend the need to invest in proactive pharmacovigilance activities to better and promptly detect, understand, and prevent any possible misuse potential of prescribed medications.Peer reviewe