Spain. Country Drug Report 2017

Este informe ofrece una perspectiva avanzada del fenómeno de las drogas en España, que trata los aspectos de la oferta, el consumo y los problemas de salud pública, así como la estrategia y las respuestas en la materia.This report presents the top-level overview of the drug phenomenon in Spain, covering drug supply, use and public health problems as well as drug policy and responses

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

Novel psychoactive substance use by mental health service consumers: an online survey of inpatient health professionals’ views and experiences

Purpose: There is evidence that novel psychoactive substances (NPS) are commonly used by people with severe mental illness. The aim of the study was to undertake a scoping survey to explore inpatient mental health workers' perceptions of NPS use by consumers. Design/methodology: A cross-sectional online survey of mental health professionals. Participants were opportunistically recruited through social media and professional networks. Findings: A total of 98 participants (of 175 who started the survey) were included in the analysis. All reported that some patients had used NPS prior to admission. Over 90% of participants reported observing at least one adverse event relating to NPS use in the previous month. The majority of participants reported that patients had used NPS during their inpatient admission. Three quarters were not clear if their workplace had a policy about NPS. Most wanted access to specific NPS information and training. Participants reported that they lacked the necessary knowledge and skills to manage NPS use in the patients they worked with. Research Limitations/Implications: Whilst we are cautious about the generalizability (due to methodological limitations), our findings provide useful insight into the perceptions of inpatient staff regarding the extent and impact of NPS use including concerns regarding impact on mental and physical health, as well as ease of availability and a need for specific training and guidance. Practical Implications: Mental health professionals require access to reliable and up to date information on changing trends in substance use. Local policies need to include guidance on the safe clinical management of substance use and ensure that NPS information is included. Originality/value: To the best of our knowledge this is the first survey of the perceptions of mental health staff working in inpatient mental health settings regarding NPS.The findings suggest that NPS is a common phenomenon in inpatient mental health settings, and there is a need for more research on the impact of NPS on people with mental health problems

Uses, Effects and Toxicity of Synthetic Cannabinoids from the Perspective of People with Lived Experiences

Synthetic cannabinoids (SCs) are a class of synthetic chemicals with cannabis-like properties, and little is known about their pharmacological and toxicological effects. The objective of this study was to explore the effects of SCs and the underlying motivations of use among participants with lived experiences. Content analysis of experiences of people using SCs was carried out based on online discussions. A total of 1660 posts from 50 threads between 2004 and 2016 were examined. Relevant information was recorded on characteristics of users as well as on characteristics of SCs, the modality of their use, and the SC-related experienced effects and toxicity. Users exchanged online significant information on SCs consumption. While a growing amount of attention has been given to the chemical and pharmacological profile of SCs, very little is known about the subjective components of such use. It remains important to study the lived experiences of people who used novel psychoactive substances (NPSs) to implement prevention and treatment, and to guide future research in the field

Detecting a signal in the noise : Monitoring the global spread of novel psychoactive substances using media and other open source information

This is an open access article under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non-commercial and no modifications or adaptations are made. Date of Acceptance: 16/02/2015To determine the feasibility and utility of using media reports and other open-source information collected by the Global Public Health Intelligence Network (GPHIN), an event-based surveillance system operated by the Public Health Agency of Canada, to rapidly detect clusters of adverse drug events associated with ‘novel psychoactive substances’ (NPS) at the international levelPeer reviewedFinal Published versio

Incarceration history is associated with HIV infection among community-recruited people who inject drugs in Europe : A propensity-score matched analysis of cross-sectional studies

Publisher Copyright: © 2023 Society for the Study of Addiction.Aims: We measured the association between a history of incarceration and HIV positivity among people who inject drugs (PWID) across Europe. Design, Setting and Participants: This was a cross-sectional, multi-site, multi-year propensity-score matched analysis conducted in Europe. Participants comprised community-recruited PWID who reported a recent injection (within the last 12 months). Measurements: Data on incarceration history, demographics, substance use, sexual behavior and harm reduction service use originated from cross-sectional studies among PWID in Europe. Our primary outcome was HIV status. Generalized linear mixed models and propensity-score matching were used to compare HIV status between ever- and never-incarcerated PWID. Findings: Among 43 807 PWID from 82 studies surveyed (in 22 sites and 13 countries), 58.7% reported having ever been in prison and 7.16% (n = 3099) tested HIV-positive. Incarceration was associated with 30% higher odds of HIV infection [adjusted odds ratio (aOR) = 1.32, 95% confidence interval (CI) = 1.09–1.59]; the association between a history of incarceration and HIV infection was strongest among PWID, with the lowest estimated propensity-score for having a history of incarceration (aOR = 1.78, 95% CI = 1.47–2.16). Additionally, mainly injecting cocaine and/or opioids (aOR = 2.16, 95% CI = 1.33–3.53), increased duration of injecting drugs (per 8 years aOR = 1.31, 95% CI = 1.16–1.48), ever sharing needles/syringes (aOR = 1.91, 95% CI = 1.59–2.28) and increased income inequality among the general population (measured by the Gini index, aOR = 1.34, 95% CI = 1.18–1.51) were associated with a higher odds of HIV infection. Older age (per 8 years aOR = 0.84, 95% CI = 0.76–0.94), male sex (aOR = 0.77, 95% CI = 0.65–0.91) and reporting pharmacies as the main source of clean syringes (aOR = 0.72, 95% CI = 0.59–0.88) were associated with lower odds of HIV positivity. Conclusions: A history of incarceration appears to be independently associated with HIV infection among people who inject drugs (PWID) in Europe, with a stronger effect among PWID with lower probability of incarceration.Peer reviewe

Benefits and barriers to expanding the availability of take-home naloxone in Australia: A qualitative interview study with service providers

Aims: To investigate the perspectives and experiences of service providers regarding provision of take-home naloxone to people who use opioids in Victoria, Australia. Methods: Content analysis of qualitative semi-structured interviews with 15 service providers who are either involved with take-home naloxone programs or whose work brings them in contact with people who use opioids. Findings: Statements about take-home naloxone were universally positive. Both direct and indirect benefits of take-home naloxone were described. Alongside potential reductions in opioid overdose-related harms, service providers highlighted the empowering effects of providing people who use opioids with take-home naloxone. No significant risks were described. Service providers supported the expansion of naloxone availability, but also identified several intertwined barriers to doing so. Key among these were costs, current regulations and scheduling, availability of prescribers and stigma related to illicit and injecting drug use. Conclusions: Expanding the availability of naloxone is a key component of strategies to reduce harms associated with opioid overdose. Our article provides Australian evidence of the successful operational implementation of peer-to-peer THN delivery within a range of drug primary health services and needle syringe programs. Further research is required to better understand the implications of and impediments to scale-up of this potentially life-saving public health intervention

Psychotropic Medications and Crash Risk in Older Drivers: A Review of the Literature

Objective. An extensive review of Australian and international literature was undertaken,examining the association between psychotropic medications and crash risk involving olderdrivers. Methods. The review summarizes the findings in experimental and epidemiological studiesrelated to (a) prevalence of psychotropic medication use among older drivers; (b) side effectsof driving under the influence of psychotropic medications; and (c) association between psychotropicmedications and crash risk for older drivers. Results. Current evidence indicates that severaltypes of psychotropic medications have the potential to impair driving ability and increasethe risk of crash involvement. A major limitation is that few studies have specifically examinedthe effects on older drivers, despite the fact that the majority of the population using psychotropicmedications are older. Discussion. More knowledge about the safety of therapeutic useof psychotropic medications is needed. Large-scale, whole-population, epidemiological studies,such as data linkage studies, may be the optimal study design