Alcohol, marijuana, and ecstasy (3,4-methylenedioxymethamphetamine MDMA, 'Molly') are among the most prevalent substances used by young adults; however, few studies have focused on the specific ...sexual effects associated with use. Examining subjective sexual effects (e.g. increased libido) associated with use can inform prevention efforts. Data were analysed from 679 nightclub and dance festival attendees in New York City (ages 18-25) to examine and compare self-reported sexual effects associated with use of alcohol, marijuana, and ecstasy. Results suggest that compared to marijuana, alcohol and ecstasy were more strongly associated with heightened perceived sexual effects (i.e. perceived sexual attractiveness of self and others, sexual desire, length of intercourse, and sexual outgoingness). Increased body and sex organ sensitivity and increased sexual intensity were most commonly associated with ecstasy use. Sexual dysfunction was most common while using alcohol or ecstasy, especially among males, and females were more likely to report sexual dysfunction after using marijuana. Post-sex regret was most common with alcohol use. Alcohol, marijuana, and ecstasy each have different sexual effects; therefore, each is associated with different risks and benefits for users. Findings can inform prevention and harm reduction as young adults are prone to use these substances.
The burden of substance use in Kenya is significant. The objective of this study was to systematically summarize existing literature on substance use in Kenya, identify research gaps, and provide ...directions for future research.
This systematic review was conducted in line with the PRISMA guidelines. We conducted a search of 5 bibliographic databases (PubMed, PsychINFO, Web of Science, Cumulative Index of Nursing and Allied Professionals (CINAHL) and Cochrane Library) from inception until 20 August 2020. In addition, we searched all the volumes of the official journal of the National Authority for the Campaign Against Alcohol & Drug Abuse (the African Journal of Alcohol and Drug Abuse). The results of eligible studies have been summarized descriptively and organized by three broad categories including: studies evaluating the epidemiology of substance use, studies evaluating interventions and programs, and qualitative studies exploring various themes on substance use other than interventions. The quality of the included studies was assessed with the Quality Assessment Tool for Studies with Diverse Designs.
Of the 185 studies that were eligible for inclusion, 144 investigated the epidemiology of substance use, 23 qualitatively explored various substance use related themes, and 18 evaluated substance use interventions and programs. Key evidence gaps emerged. Few studies had explored the epidemiology of hallucinogen, prescription medication, ecstasy, injecting drug use, and emerging substance use. Vulnerable populations such as pregnant women, and persons with physical disability had been under-represented within the epidemiological and qualitative work. No intervention study had been conducted among children and adolescents. Most interventions had focused on alcohol to the exclusion of other prevalent substances such as tobacco and cannabis. Little had been done to evaluate digital and population-level interventions.
The results of this systematic review provide important directions for future substance use research in Kenya.
PROSPERO: CRD42020203717.
Ecstasy (MDMA) is a popular recreational drug, but its illegal production and trade in the Netherlands have developed into a serious public order and ecological problem which endanger and question ...the harm reduction approach of the Dutch ecstasy policy.
The market characteristics, adverse health effects, risk profile, and link to criminal activity of ecstasy were reviewed.
Ecstasy is often used in combination with other substances (i.e. polydrug use). Compared to several other illicit drugs and alcohol, ecstasy has a very low abuse and dependence liability and, as yet, there is little evidence of long-term harm. A potential health risk associated with ecstasy is acute hyperthermia, however this occurs at an unknown incidence rate and seems to be more prevalent when ecstasy is consumed in combination with heavy exercise at high ambient temperatures or when used in combination with other substances, including alcohol. Organized crime related to the production and trafficking of ecstasy in the Netherlands is a growing problem.
This review provides a science-based summary that can be used to assist the public and political debate surrounding future Dutch ecstasy policy to reduce ecstasy-related organized crime while maintaining the principle of harm reduction.
Molecular-level investigations of the Central Nervous System have been revolutionized by the development of computational methods, computing power, and capacity advances. These techniques have ...enabled researchers to analyze large amounts of data from various sources, including genomics, in vivo, and in vitro drug tests. In this review, we explore how computational methods and informatics have contributed to our understanding of mental health disorders and the development of novel drugs for neurological diseases, with a special focus on the emerging field of psychedelics. In addition, the use of state-of-the-art computational methods to predict the potential of drug compounds and bioinformatic tools to integrate disparate data sources to create predictive models is also discussed. Furthermore, the challenges associated with these methods, such as the need for large datasets and the diversity of in vitro data, are explored. Overall, this review highlights the immense potential of computational methods and informatics in Central Nervous System research and underscores the need for continued development and refinement of these techniques and more inclusion of Quantitative Structure-Activity Relationships (QSARs).
Novel psychoactive substances (NPS) are synthetic substances belonging to diverse groups, designed to mimic the effects of scheduled drugs, resulting in altered toxicity and potency. Up to now, ...information available on the pharmacology and toxicology of these new substances is very limited, posing a considerable challenge for prevention and treatment. The present in vitro study investigated the possible mechanisms of toxicity of two emerging NPS (i) 4′-methyl-alpha-pyrrolidinoexanophenone (3,4-MDPHP), a synthetic cathinone, and (ii) 2-chloro-4,5-methylenedioxymethamphetamine (2-Cl-4,5-MDMA), a phenethylamine. In addition, to apply our model to the class of synthetic opioids, we evaluated the toxicity of fentanyl, as a reference compound for this group of frequently abused substances. To this aim, the in vitro toxic effects of these three compounds were evaluated in dopaminergic-differentiated SH-SY5Y cells. Following 24 h of exposure, all compounds induced a loss of viability, and oxidative stress in a concentration-dependent manner. 2-Cl-4,5-MDMA activates apoptotic processes, while 3,4-MDPHP elicits cell death by necrosis. Fentanyl triggers cell death through both mechanisms. Increased expression levels of pro-apoptotic Bax and caspase 3 activity were observed following 2-Cl-4,5-MDMA and fentanyl, but not 3,4-MDPHP exposure, confirming the different modes of cell death.
This paper examines the strategies that ex-heavy users of MDMA employed to quit, control, or cut down MDMA use. It uses data from an online qualitative study of the life stories of ex-heavy MDMA ...users, taking a harm reduction perspective, rather than focusing on the pharmaceutical and problematic aspects of MDMA use. The research applied a mixed-methods approach using an online survey containing open-ended questions directed at self-identified ex-heavy users of MDMA. Participants were 104 ex-heavy users. The relevant data centered around three main themes: ex-users' stories of quitting/cutting down MDMA, advice for taking MDMA safely, and advice for quitting or cutting down MDMA. Although stopping or cutting down MDMA use was generally described as a natural process over time, ex-users also employed several strategies to quit or cut down MDMA use, including conscious lifestyle changes and distancing themselves from the associated scenes and people. Participants' advice on taking MDMA safely involved considering the drug, the mind-set, the social and physical environment and ensuring hydration. These data suggest that from ex-heavy users' perspectives, management of MDMA use is conceptualized as a deliberate and thoughtful process of which most users are in control, rather than a matter of being dependent upon or overpowered by a drug, so harm reduction and other interventions should be structured accordingly.
Rationale:
Novel, evidence-based treatments are required for treatment-resistant post-traumatic stress disorder (PTSD). 3,4-Methylenedioxymethamphetamine (MDMA) has beneficially augmented ...psychotherapy in several small clinical trials.
Objective:
To review the use of MDMA-assisted psychotherapy in treatment-resistant PTSD.
Methods:
Systematic searches of four databases were conducted from inception to February 2020. A meta-analysis was performed on trials which were double-blinded, randomised, and compared MDMA-assisted psychotherapy to psychotherapy and placebo. The primary outcomes were the differences in Clinician Administered PTSD Scale (CAPS-IV) score and Beck’s Depression Inventory (BDI). Secondary outcome measures included neurocognitive and physical adverse effects, at the time, and within 7 days of intervention.
Results:
Four randomised controlled trials (RCTs) met inclusion criteria. When compared to active placebo, intervention groups taking 75 mg (MD −46.90; 95% (confidence intervals) CI −58.78, −35.02), 125 mg (MD −20.98; 95% CI −34.35, −7.61) but not 100 mg (MD −12.90; 95% CI −36.09, 10.29) of MDMA with psychotherapy, had significant decreases in CAPS-IV scores, as did the inactive placebo arm (MD −33.20; 95% CI −40.53, −25.87). A significant decrease in BDI when compared to active placebo (MD −10.80; 95% CI −20.39, −1.21) was only observed at 75 mg. Compared to placebo, participants reported significantly more episodes of low mood, nausea and jaw-clenching during sessions and lack of appetite after 7 days.
Conclusion:
These results demonstrate potential therapeutic benefit with minimal physical and neurocognitive risk for the use of MDMA-assisted psychotherapy in TR-PTSD, despite little effect on Beck’s Depression Inventory. Better powered RCTs are required to investigate further.
International Prospective Register of Systematic Reviews:
CRD42019109132 available online at www.crd.york.ac.uk/prospero.
Highlights • Crystal samples of ecstasy showed clear differences in relation to tablets. • Proportion of samples containing only MDMA was higher in crystals. • Caffeine was the main adulterant ...detected both in crystals and tablets. • Recent increase in the amount of MDMA in tablets was not observed in crystals. • Since 2009, the number of adulterants identified increased in both formats.
The first study of 3,4-methylenedioxymethamphetamine (MDMA)-assisted therapy for the treatment of social anxiety in autistic adults commenced in the spring of 2014. The search for psychotherapeutic ...options for autistic individuals is imperative considering the lack of effective conventional treatments for mental health diagnoses that are common in this population. Serious Adverse Events (SAEs) involving the administration of MDMA in clinical trials have been rare and non-life threatening. To date, MDMA has been administered to over 1133 individuals for research purposes without the occurrence of unexpected drug-related SAEs that require expedited reporting per FDA regulations. Now that safety parameters for limited use of MDMA in clinical settings have been established, a case can be made to further develop MDMA-assisted therapeutic interventions that could support autistic adults in increasing social adaptability among the typically developing population. As in the case with classic hallucinogens and other psychedelic drugs, MDMA catalyzes shifts toward openness and introspection that do not require ongoing administration to achieve lasting benefits. This infrequent dosing mitigates adverse event frequency and improves the risk/benefit ratio of MDMA, which may provide a significant advantage over medications that require daily dosing. Consequently, clinicians could employ new treatment models for social anxiety or similar types of distress administering MDMA on one to several occasions within the context of a supportive and integrative psychotherapy protocol.
•Pure MDMA used in approved clinical settings is far safer than recreational use of Ecstasy or Molly.•MDMA-assisted therapy could reduce social anxiety symptoms and increase social adaptability.•The need to develop effective treatments for social anxiety in autistic adults is presently unmet.•MDMA does not require ongoing administration to achieve lasting benefits.
•Wastewater analysis shows that cocaine, MDMA and amphetamine use is stable over two editions of a Swiss music festival.•Wastewater analysis confirms that MDMA is internationally prevalent in ...festivals, as well as amphetamine to a lesser extent.•MDMA and amphetamine are more consumed during the festival compared to normal times, when there is no festival.•Police seizures supports the hypothesis of an existing market for MDMA and amphetamine during the festival.
This article describes the application of a recently proposed framework for deploying wastewater-based epidemiology (WBE) to monitor illicit drug use within festivals (Benaglia et al., 2019). The festival under study was a week-long music festival in Switzerland (Swiss Festival) which attracted around 50,000 people daily. Wastewater sampling was performed during its 2014 and 2015 editions. As the Swiss Festival’s wastewater is conveyed to the sewage treatment plant (STP) of the nearby city, to assess illicit drug use when there is no festival (i.e. the background consumption) wastewater sampling was also carried out during an off-festival week in 2015. During the 2014 and 2015 editions of the Swiss Festival, WBE highlighted that the most consumed illicit drugs were cannabis, MDMA, cocaine and amphetamine. Excluding cannabis, the means per capita loads of all illicit drugs were not statistically different between both editions of the Swiss Festival. The results were then compared to those of an Australian festival which had also been subject of a quantitatively assessed illicit drug use study (Lai et al., 2013). This comparison confirmed that MDMA is highly prevalent, as well as amphetamine, although to a lesser extent. Consumption of cocaine (in Switzerland) and methamphetamine (in Australia) is also high, but their use seems to be related to their availability (i.e. to the country where the festival takes place). Furthermore, it was observed that MDMA and amphetamine are more consumed during the festival compared to normal times, when there is no festival. This might suggest that their availability is increased and therefore, that a market for these substances potentially exists during the festival. This last hypothesis was assessed by consulting drug seizures made by the police during the 2015 Swiss Festival. Despite very limited data, police records suggested that most of the drugs were purchased at the festival, which supports the previous hypothesis. Results validate, on the one hand, WBE as a useful indicator to monitor illicit drug use within festivals and on the other hand, the suggested framework for deploying WBE in such environment. In addition, this study suggests the need for prevention and harm reduction measures targeted on MDMA and amphetamine during the Swiss Festival, such as drug checking laboratories.
PDF
