Synthetic Cannabinoids (SCs) in metaphors: A metaphorical analysis of user experiences of synthetic cannabinoids in two countries.

New psychoactive substances (NPS) remain a global public health and clinical challenge. Popular NPS include synthetic cannabinoids (SCs). A conceptual metaphorical analysis of user experiences of SCs was conducted in two European countries (Western and Central European). Metaphors are increasingly used to better understand drug user experiences and as medium to inform and guide clinical responses. Semi-structured interviews with 12 SC users were conducted in Hungary (n = 6) and Ireland (n = 6). Thematically segmented texts of SC usage (1) motivation, (2) effects, (3) consequences and (4) the setting were selected. A systematic analysis of conceptual metaphors was conducted on the selected texts. The conceptual target and source domains of the experiences of SC usage (motivation, effects, consequences) were analysed. Four conceptual source domains were found in all of the segmented and analysed narratives of psychological factors (motivations, effects, consequences): change in the vertical perception, perceiving that SC is everywhere, feeling disconnected, recognition of lack of control and identifying the SC as a destroying entity. The conceptual metaphors reflect how users perceive experiences of SC use, the discrepancy between the experience of embodiment and disembodiment. This study provides clinicians with an insight into the experiences of SC motivations, effects and consequences and can be used to inform and guide clinical and therapeutic responses in the support of those recovering from SC dependence

REVIEWING TRANSFERABILITY in ECONOMIC EVALUATIONS ORIGINATING from EASTERN EUROPE

__Objectives:__ The aim of this study is to analyze the quality and transferability issues reported in published peer-reviewed English-language economic evaluations based in healthcare settings of the Central and Eastern European (CEE) and former Soviet countries. __Methods:__ A systematic search of economic evaluations of healthcare interventions was performed for Armenia, Azerbaijan, Belarus, Bulgaria, Estonia, Georgia, Turkmenistan, Kazakhstan, Lithuania, the former Yugoslav Republic of Macedonia, Republic of Moldova, Romania, the Russian Federation, Serbia, Slovenia, and Ukraine. The included studies were assessed according to their characteristics, quality (using Drummond’s checklist), use of local data, and the transferability of inputs and results, if addressed. __Results:__ Most of the thirty-four economic evaluations identified were conducted from a healthcare or payer perspective (74 percent), with 47 percent of studies focusing on infectious diseases. The least frequently and transparently addressed parameters were the items’ stated perspectives, relevant costs included, accurately measured costs in appropriate units, outcomes and costs credibly valued, and uncertainties addressed. Local data were often used to assess unit costs, baseline risk, and resource usage, while jurisdiction-specific utilities were included in only one study. Only 32 percent of relevant studies discussed the limitations of using foreign data, and 36 percent of studies discussed the transferability of their own study results to other jurisdictions. __Conclusions:__ Transferability of the results is not sufficiently discussed in published economic evaluations. To simplify the transferability of studies to other jurisdictions, the following should be comprehensively addressed: uncertainty, impact of influential parameters, and data transferability. The transparency of reporting should be improved

Discriminative characteristics of marginalised novel psychoactive users: A transnational study

New psychoactive substances (NPS) continue to be considered as a major public health concern in many European countries. The study was implemented within the framework of a transnational project of six European countries (Germany, Hungary, Ireland, Netherlands, Poland, Portugal). Our aim here is to report on the distinct and differentiating characteristics of marginalised NPS users. Three subgroups of a total of 3023 adult NPS users (socially marginalised, night life, online community) were examined regarding their socio-demographic characteristics, substance use, and external motives towards NPS use. Poland and Hungary reported higher rates of NPS use in comparison to traditional controlled drugs. The external/contextual motives did not play a central role in the background of NPS use, the least important motives were alleged legality and non-detectability of these substances. Marginalised (defined as those accessing low threshold harm reduction services) users’ substance use patterns are different from the other two groups in terms of showing more intense and riskier drug use. The most important variables which contributed to be categorised as a marginalised NPS user were lower level education, being older, having an unfavourable labour market position and using drugs intravenously. Contextual motives did not play a decisive role in being categorised as a marginalised user when drug use pattern was controlled. These identified discriminative features of marginalised drug users should inform policy makers to develop and implement tailor-made interventions targeting this user group to successfully tackle the elevated public health concerns associated with NPS use

Comparison of weighting methods used in multicriteria decision analysis frameworks in healthcare with focus on low- and middle-income countries

Criteria weighting is a key element of multicriteria decision analysis that is becoming extensively used in healthcare decision-making. In our narrative review we describe the advantages and disadvantages of various weighting methods.An assessment of the eight identified primary criteria weighting methods was compiled on domains including their resource requirements, and potential for bias.In general, we found more complex methods to have less potential for bias; however, resource intensity and general participant burden is greater for these methods.The selection of the most appropriate method depends on the decision-making context. The simple multiattribute rating technique (SMART) method combined with swing-weighting technique and the analytic hierarchy process methods may be the most feasible approaches for low- and middle-income countries

Why do people use new psychoactive substances? Development of a new measurement tool in six European countries.

This study was supported by the European Union (New Psychoactive Substances: transnational project on different user groups, user characteristics, extent and patterns of use, market dynamics, and best practices in prevention [HOME/2014/JDRU/AG/DRUG/7077]), the Hungarian National Research, Development and Innovation Office (Grant number: KKP126835; NKFIH1157-8/2019-DT). The study was also supported for the realization of this international cofinanced science project in 2016-2017 by the Polish Ministry of Science and Higher Education. Máté Kapitány-Fövény acknowledges the support by the János Bolyai Research Scholarship of the Hungarian Academy of Sciences and the support by the ÚNKP-19 New National Excellence Program of the Hungarian Ministry for Innovation and Technology. The funding institutions had no role in the study design or the collection, analysis and interpretation of the data, writing the manuscript, or the decision to submit the paper for publication