Neuropsychological effects associated with recreational cocaine use

Rationale

Recent evidence suggests that recreational cocaine use is on the increase, with the UK reporting one of the highest levels of use in the EU (EMCDDA 2010). Nevertheless, very few studies have addressed the neuropsychological effects associated with non-dependent recreational cocaine use.

Objectives

The current study aimed to assess whether recreational cocaine users show neuropsychological deficits on a battery of tests, previously shown to be sensitive to cocaine-dependent and psychosis-prone individuals. Schizotypal traits were also measured.

Methods

Recreational cocaine users (n?=?17) were compared with controls (n?=?24) on drug use patterns, the General Health Questionnaire, the Brief Schizotypal Personality Questionnaire (SPQ-B) and four neuropsychological tasks: spatial working memory, intra/extra-dimensional set shifting, the Stocking of Cambridge and the rapid visual processing.

Results

Relative to controls, recreational cocaine users produced significantly more errors on the intra/extra-dimensional set shift task and completed fewer stages, made significantly more six box stage errors on the spatial working memory task, and made significantly more errors and fewer hits, with overall poorer detection rates on the rapid visual processing task. Recreational cocaine users reported significantly higher scores on the cognitive perceptual and disorganised thinking SPQ-B subscales and total SPQ-B scores compared to controls.

Conclusions

Recreational cocaine users displayed impairments on tasks tapping sustained attention, attentional shifting and spatial memory and reported higher schizotypal trait expression. These findings are consistent with the emerging literature suggesting subtle cognitive deficits, putatively reflecting underlying dopaminergic dysfunction, in non-dependent, recreational cocaine users.     

Factors associated with recent-onset injection drug use among drug users in Pakistan

Seventy-two recent-onset injection drug users and 241 non-injection drug users were recruited in Quetta and Lahore, Pakistan, in 2003. Trained interviewers administered questionnaires regarding drug use behaviors and perceived changes in drug cost/supply. Logistic regression identified independent correlates of recent-onset injection. In Lahore, a perceived increase in drug cost was associated with higher odds of recent-onset injection, with no association in Quetta. Recent-onset injection was also associated with family history of drug use, group drug use, and sharing snorting/chasing tools. Changes in perception of the drug supply may be associated with recent-onset injection drug use. Familial/social influences were also associated with recent-onset injection, suggesting peer-led interventions could discourage transition to injection drug use.     

美沙酮维持治疗受治者偷吸情况及其影响因素分析

目的：了解美沙酮维持治疗受治者毒品偷吸情况及影响因素,为进一步采取有效措施提高治疗效果提供依据。方法：对治疗时间20d以上的知情同意的受治者进行横断面问卷调查和尿液吗啡定性检测,并结合门诊记录信息进行分析.结果：毒品偷吸率54．2％（96／177）。Logistic回归分析结果显示无固定工作、接受治疗时间短、吸毒时间长和有注射吸毒史等是影响偷吸的可能因素。结论：受治者在治疗期间偷吸毒品是较常见的现象,应加强思想教育和心理辅导、增加激励机制和社会帮教等提高维持时间,减少偷吸率。     

Factors associated with readiness to change drug use among needle-exchange users

To determine if frequent needle-exchange program (NEP) use is associated with lower readiness to change drug use, NEP clients in Providence, RI were interviewed regarding their drug use, HIV risk, health, and past use of drug treatment services in 1997-1998. Readiness to change drug use was assessed using a nine-step decision ladder. Based on this assessment, 14.3% of the sample were classified as precontemplators (24/168), 29.2% were in the contemplation stage (49/168), and 56.5% were in the determination or ready to change stage (95/168). We found that mean number of NEP visits was 25.5 among precontemplators, 28.7 among contemplators, and 22.5 among those in the determination stage. In multivariate analysis, an inverse relationship between having ever been in alcohol treatment and higher readiness to change drug use was the only significant association. In this exploratory study, we found that more frequent NEP participation did not impact readiness to change drug use among intravenous drug users. Given the high proportion of NEP clients ready to change drug use, improving linkages between NEPs and substance abuse treatment appears warranted.     

The risk of psychotic symptoms associated with recreational methamphetamine use

Introduction and Aims. To determine whether recreational methamphetamine use is associated with an increased risk of psychotic symptoms. Design and Method. A cross‐sectional survey of 157 people attending dance events in Sydney, Australia. Participants were assessed for psychotic symptoms in the past year using items from the Psychosis Screen. Participants with and without psychotic symptoms were compared on methamphetamine use, polydrug use and other demographic factors. An ordinal logistic regression was used to determine the probability of psychotic symptoms by methamphetamine use and level of polydrug use. Results. Psychotic symptoms in the past year were predicted by methamphetamine use and heavier polydrug use in the past year, and a history of a psychotic disorder (schizophrenia, schizoaffective or bipolar affective disorder). After removing participants with a history of a psychotic disorder (n = 16) and adjusting for polydrug use, methamphetamine use increased the probability of two or more psychotic symptoms (indicative of psychosis risk) from 9% to 21%. There was a non‐significant increase in the risk of psychotic symptoms with higher levels of polydrug use. Methamphetamine use was typically monthly or less often (83%), and most users described their use as recreational (85%). Discussion and Conclusions. Within the context of polydrug use, recreational methamphetamine use is associated with a twofold to threefold increase in the probability of psychotic symptoms.[McKetin R, Hickey K, Devlin K, Lawrence K. The risk of psychotic symptoms associated with recreational methamphetamine use. Drug Alcohol Rev 2010]     

Functional fun: Legitimising adult recreational drug use

BackgroundRecent statistics from the Crime Survey for England and Wales report a slight increase in past year drug use for the over thirty-age range (Home Office, 2014). This paper explores how adult ‘recreational’ drug takers account for their illicit consumption alongside otherwise conforming lives.MethodsTwenty-six in-depth interviews were conducted with individuals between the ages of 30 and 59. Each participant had taken drugs in the past year, their main source of income was not a result of criminal activity and they were not currently receiving drug treatment. Discursive Psychology was used to analyse how the participants describe, reason and justify their use.ResultsThe analysis resulted in the development of three discursive frameworks that demonstrate the different ways in which illicit drug use can be legitimised. The ‘drug cultures’ framework achieves this through highlighting the accommodation of drugs within social networks. The ‘planned celebration’ framework outlines the occasional frequency of drug use to legitimise consumption. The ‘situational opportunity’ framework positions the wide access and availability of drugs as the influence of their behaviour.ConclusionIf drug takers can articulate their ability to control their use and maintain functionality within their lives, then both drug taker and drug use may be legitimated. In order to better understand the conceptualisation of drug use and the acceptable boundaries of behaviour, this research has demonstrated that it is more appropriate to conceptualise drug use on a spectrum that runs from control through to dysfunction, rather than either recreational or problematic.     

Alcohol and recreational drug use by HIV-seropositive homosexual men

The objectives of this study were to describe the patterns of alcohol and recreational drug use of HIV-seropositive homosexual men and to determine the effect of alcohol use on HIV risk-taking behaviour. Of particular interest was the effect of knowledge of HIV status on these behaviours. Information on alcohol and drug use was obtained from 485 HIV-seropositive homosexual and bisexual men presenting to a HIV-antibody testing and medical management clinic. Heavy alcohol use was common, with 46.2% reporting consumption of six or more standard drinks on one day recently. Men who knew that they were HIV infected drank significantly more than those men who had yet to learn of their HIV status at the time of interview. There was clear evidence in this study for a role of alcohol use in HIV risk-taking behaviour. Almost one-third (27%) of the HIV-seropositive men reported unprotected anal intercourse during the previous 3 months with approximately one-third of these (27/76, 35·5%) nominating alcohol as contributing to their high HIV-risk behaviour.     

Factors associated with teenage ecstasy use

Aims: The aim of this article was to investigate the factors associated with ecstasy use in school-aged teenagers.

Methods: This was a longitudinal study of adolescent drug use, which was undertaken in three towns in Northern Ireland. A questionnaire was administered annually to participants. In this article ecstasy use patterns amongst a cohort of young people aged 14–16 years participating in the Belfast Youth Development Study (BYDS) was explored.

Findings: The percentage of those who had used ecstasy at least once increased from 7% when aged 14 years to 9% at 15 and 13% at 16 years. Female gender, delinquency, problem behaviours at school and the number of evenings spent out with friends each week were found to be significant variables predicting ‘ever use’ of ecstasy in all 3 years by logistic regression.

Conclusions: The findings suggest that ecstasy use patterns may be changing from their historical perception as a ‘party’ drug, as the demographic profile ecstasy of users in this study reflected the traditional profile of illicit drug use during adolescence, which raises challenges for addressing the problems associated with this drug.     

Delayed onset of seizures and toxicity associated with recreational use of Bromo-dragonFLY

Introduction

Many countries have specific legislation, such as the Controlled Substances Act (1970) in the United States and the Misuse of Drugs Act (1971) in the United Kingdom to control recreational drugs. There is a growing market and supply of “novel” recreational drugs, which include the misuse of pharmaceutical compounds and research chemicals. These are often not covered under current legislation, despite the fact that they often have both similar chemical structures and/or clinical effects to controlled recreational drugs.

Case Report

A male patient presented to an emergency department with delayed of severe agitation, hallucinations, and tonic-clonic seizures following the use of Bromo-dragonFLY and an unknown white powder. He settled following IV benzodiazepines and supportive care, and was discharged with no evidence to long-term sequelae: Analysis of the white powder by gas chromatography/mass spectrometry (GC/MS), ultraviolet/visible spectrophotometry (UV/VIS) and thin layer chromatography (TLC) showed the presence of Bromo-dragonFLY (1-(8-bromobenzol[1,2-b;4,5-b’]difuran-4-yl)-2-aminopropane); serum analysis by GC/MS and liquid chromatography with tandem mass spectrometry (LC/MS/MS)_confirmed that a combination of Bromo-dragonFLY (0.95 ng/mL). ketamine (20 ng/mL) and canabis had been used by the patient. No other recreational drugs were detected in an extensive toxicological screen of serum and urine samples.

Discussion

This is the first confirmed case to be reported of toxicity with delayed onset of severe agitation, hallucinations and tonic-clonic seizures associated with recreational use of Bromo-dragonFLY (1-(8-bromobenzol[1,2-b;4,5-b’]difuran-4-yl)-2-aminopropane) in combination with ketamine and cannabis. In our view, this case provides further support for the need for a systematic approach to toxicological screening of patients with recreational drug toxicity, to identify emerging drugs and provide evidence for legislative authorities to assist in revising the legal status of emerging recreational drugs.     

Acute toxicity associated with the recreational use of the ketamine derivative methoxetamine

Purpose  

Long-term regular use of ketamine has been reported to be associated with severe symptomatic urinary tract problems. Methoxetamine, an arylcyclohexylamine derivative of ketamine, is marketed as a “bladder safe” derivative of ketamine, and no cases of acute toxicity following analytically confirmed methoxetamine use have been reported to date. We report here a case series of three individuals with acute toxicity related to the analytically confirmed use of methoxetamine.     

Non-puerperal lactation associated with antidepressant drug use

Aims The aim of the present study was to estimate the relative risk of non-puerperal lactation in patients using antidepressants in general, and specifically for serotonergic (selective serotonin reuptake inhibitors (SSRIs) and clomipramine) and non-serotonergic antidepressants.
Methods All suspected adverse drug reactions in women and reported from January 1986 until August 1996 to the Netherlands Pharmacovigilance Foundation, a spontaneous adverse drug reaction reporting programme, were analysed. Adverse drug reaction (ADR) reporting odds ratios, defined as the ratio of the exposure odds among reported cases of non-puerperal lactation to the exposure odds of reported other ADRs, were calculated adjusted for age and year of reporting.
Results Thirty-eight cases of non-puerperal lactation were reported, of which 15 were associated with the use of antidepressant drugs. In general, antidepressants were associated with a higher risk of non-puerperal lactation in comparison with other drugs (ADR reporting odds ratio 8.3 [ 95%CI: 4.3–16.1]). Serotonergic antidepressants (selective serotonin reuptake inhibitors (SSRIs) and clomipramine) were associated with a higher risk (OR 12.7 [95%CI: 6.4–25.4]), whereas other antidepressants were not (OR 1.6 [95%CI: 0.2–11.6]), compared with all other drugs.
Conclusions Our results indicate that serotonergic antidepressants are associated with an approximately eight times higher risk of non-puerperal lactation compared with other antidepressants. This effect is probably mediated by an indirect inhibition effect of serotonin on the dopaminergic transmission. This finding is in line with the occurrence of other antidopaminergic effects, such as extrapyramidal symptoms, in patients using serotonergic antidepressants.     

Memory deficits associated with recreational use of “ecstasy” (MDMA)

Evidence from both animal, and human, studies suggests that repeated administration of 3,4-methylenedioxymethamphetamine (MDMA; “ecstasy”) produces lasting decreases in serotonergic activity. Serotonin is believed to play a modulatory role in a variety of psychological processes, including learning and memory. There are recent reports that polydrug users, who have used ecstasy recreationally, exhibit selective impairments in memory. However, these studies did not compare ecstasy users with polydrug users who had not taken ecstasy, leaving open the possibility that the memory deficits may be associated with a history of use of other illicit drugs.  The present study used the Rivermead Behavioural Memory test to investigate immediate and delayed recall in: 25 polydrug-users who had taken more than 20 tablets of ecstasy (MDMA group), 22 participants (polydrug controls) who had never taken ecstasy, but, otherwise has personal characteristics (e.g. age, gender, education, height, weight), and illicit drug use histories, that were generally not significantly different from those of the MDMA group, and 19 participants who had not used illicit drugs but who also had similar personal characteristics (non-drug controls). Participants in the MDMA group recalled significantly fewer ideas (approximately 75% of the number of ideas recalled by participants in either of the other two groups), in both immediate and delayed recall conditions. The two illicit drug-using groups did differ in their estimated IQ scores and their duration of use of LSD, but only the latter proved to be a statistically significant covariate, and the difference in recall performance between the MDMA and polydrug controls groups remained statistically significant when this variable was treated as a covariate. The present findings provide the first evidence that deficits in memory performance in recreational ecstasy users are primarily associated with past exposure to ecstasy, rather than with the other legal and illicit drugs consumed by these individuals, and are consistent with reduced serotonergic modulation of mnemonic function as a result of long-term neurotoxic effects of MDMA in humans. Received: 12 January 1998/Final version: 14 May 1998     

Factors associated with alcohol use in later adolescence

The relative influence of a number of family and individual characteristics on the frequency and intensity of alcohol use in a group of older adolescents was assessed. The sample consisted of 8,661 persons ranging in age from 20 to 21 years obtained from the "High School and Beyond" study. Logistic regression analyses performed on both frequency and intensity of alcohol use indicated that white males from higher socioeconomic backgrounds, living in urban or suburban areas and having an external locus of control and a weak family orientation, tended to drink more frequently and consume a larger quantity of alcohol per drinking episode. Results are explained from a sociocultural perspective.     

Factors associated with suicide attempts among injection drug users

Injection drug users (IDUs) entering an urban low-threshold opiate detoxification unit in Munich, Germany, between 1991 and 1997 were asked for lifetime suicide attempts and administered a questionnaire, including sociodemographic, IDU-related, and drug user treatment related variables. Among 1,049 participants, 20% had ever tried to commit suicide. In the logistic regression, female gender, older age, drug user treatment experience, lack of drug user counseling, and emergency treatment were associated with attempted suicide. Regular screening for suicidal behavior in IDUs should be undertaken with a special focus to mention risk factors. The study's limitations are noted. This study was partially sponsored by the German Ministry of Health.     

Factors associated with drug treatment dropout among injection drug users in Puerto Rico

This study examined factors associated with drug treatment dropout among injection drug users (IDUs) in Puerto Rico, a group that has contributed significantly to the self-sustaining AIDS epidemic in the island since the mid-1980s. A total of 557 IDUs were recruited from communities in a semirural region of Puerto Rico, as part of a longitudinal study testing the efficacy of a two-facet intervention model, based on motivational interviewing. Of 124 IDUs who had entered drug treatment at follow-up, 33 (26.6%) dropped out before completing all recommended sessions. Multiple logistic regression analysis showed that age, homelessness, and speedball use were significantly associated with drug treatment dropout. Conversely, participants who received the two-facet intervention were significantly less likely to drop out of drug treatment. Receiving psychiatric services also reduced the odds of treatment dropout. Improving adherence to drug treatment and reducing dropout rates are complex processes that need to be addressed at the individual behavioral and social support levels, as well as the program process and resource levels.     

Dragnet: A pilot study of adult recreational drug use via the WWW

This study was intended (1) to explore the potential of using the World Wide Web (WWW) of the Internet to sample hidden populations and (2) to collect exploratory data on the hidden population of nonabusive, recreational users of illicit drugs. The survey modules were designed to assess demographics and lifestyle, drug experiences (including absence of DSM‐IV criteria for abuse or dependence), legal history (drug‐related arrests, etc.), and mental health as measured by the General Well‐Being Schedule (GWBS). The survey was completed by 276 persons, aged 18 to 62, with a mean age of 32.34. The sample was predominantly white (93%), male (78%), college educated (75%), and employed full‐time (76%). The WWW is a useful tool for reaching hidden populations but is likely to impose a bias toward male, better educated, and more computer‐involved samples on the respondents reached. This survey further documents the existence of a nonclinical population of drug users which is generally healthy, well‐adjusted, and productive.     

Factors associated with alcohol use in university students.

A survey was conducted of drinking, drug use attitudes, beliefs, personality and demographic characteristics of students on a university campus. Gender, ethnic and social group differences were also examined. It was concluded that a biopsychosocial matrix of determinants influenced alcohol consumption and its excessive consumption. Two general factors emerged from analyses of the results. They may be interpreted as entering into a complex approach-avoidance conflict where the net approach tendency determines overall alcohol consumption. Personality characteristics and presumably their biological correlates, as well as set and setting, or attitudes, beliefs and environmental influences contribute to the approach-avoidance conflict that determines abstinence or varying amounts of alcohol consumption.