Drug and alcohol review最新文献

{"title":"Emergence of Medetomidine in the Unregulated Drug Supply and Its Association With Hallucinogenic Effects.","authors":"Adams L Sibley, Madigan L Bedard, Samuel Tobias, Brooke A Chidgey, Irina G Phillips, Alice Bell, Nabarun Dasgupta","doi":"10.1111/dar.70024","DOIUrl":"https://doi.org/10.1111/dar.70024","url":null,"abstract":"<p><strong>Introduction: </strong>The unregulated drug supply in the United States is rapidly evolving, and veterinary tranquillisers have emerged as adulterants of concern, especially in illicitly-manufactured fentanyl. Following the proliferation of xylazine, medetomidine, a more potent sedative, has recently appeared in multiple US states. This study describes the characteristics of medetomidine samples from a national mail-based drug checking program and aims to determine whether medetomidine is associated with hallucinogenic effects.</p><p><strong>Methods: </strong>We conducted a retrospective analysis of 11,363 drug samples between December 2022 and April 2025. Samples were sent voluntarily by people who use drugs. Participant-reported sensations and sample characteristics (e.g., colour, texture) were gathered at point-of-contact. Composition was analysed using gas-chromatography mass spectrometry. We estimated adjusted prevalence ratios for hallucinations in medetomidine-containing samples using generalised estimating equations.</p><p><strong>Results: </strong>Medetomidine was identified in 278 samples (2.4%), with pronounced growth beginning June 2024. Medetomidine commonly appeared with fentanyl (58.8%) and/or xylazine (55.9%). Most samples were powders (85.3%). Among all 11,363 samples, those containing medetomidine in primary abundance (n = 136) were more likely to be associated with reported hallucinations (17.6%) compared to all other samples (1.2%; adjusted prevalence ratio: 11.95, 95% confidence interval 6.36, 22.44).</p><p><strong>Discussion and conclusions: </strong>Medetomidine is an emerging adulterant, although its risk profile is under-described. Our findings suggest medetomidine may cause hallucinogenic effects, contradicting clinical use for preventing delirium in postsurgical settings. Unexpected hallucinations may serve as a sentinel signal for medetomidine's presence in local drug markets. Education is needed for people who use drugs and clinicians about novel adverse effects of medetomidine.</p>","PeriodicalId":11318,"journal":{"name":"Drug and alcohol review","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144946394","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Correction to “Defining Terminology and Outcome Measures for Evaluating Overdose Response Technology: An International Delphi Study”","authors":"","doi":"10.1111/dar.70020","DOIUrl":"10.1111/dar.70020","url":null,"abstract":"<p>W. Rioux, D. Viste, N. Sedaghat, et al., “Defining Terminology and Outcome Measures for Evaluating Overdose Response Technology: An International Delphi Study,” <i>Drug and Alcohol Review 44</i>, no. 5 (2025): 1430–1443. https://doi.org/10.1111/dar.14055.</p><p>These changes are in regard to authorship mistakes for the above article. Dr Nicholas Bartlett has been added as the 13th author and the surname of the 5th author has been corrected to ‘Tay Wee Teck’.</p><p>The online article has been corrected.</p><p>We apologise for this error.</p>","PeriodicalId":11318,"journal":{"name":"Drug and alcohol review","volume":"44 6","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/dar.70020","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144871968","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Co-Designing AI-Generated Vaping Awareness Materials With Adolescents and Young Adults: A Qualitative Study.","authors":"Tianze Sun, Gary Chung Kai Chan, Daniel Stjepanović, Tesfa Yimer, Giang Thu Vu, Carmen Lim, Caitlin McClure-Thomas, Charlotte Russel, Jason Connor, Wayne Hall, Leanne Hides, David Hammond, Timo Dietrich, Daniel Erku, Benjamin Johnson, Janni Leung","doi":"10.1111/dar.70022","DOIUrl":"10.1111/dar.70022","url":null,"abstract":"<p><strong>Introduction: </strong>Developing mass meda campaigns to address rising youth vaping rates in Australia is timely and resource-intensive. Generative AI offers scalable content production, but little is known about youth perceptions of AI-generated multimedia materials or how their feedback can inform co-design processes.</p><p><strong>Methods: </strong>We conducted a two-phase qualitative study in Queensland, Australia. Phase 1 explored adolescent (n = 10, ages 13-20) responses to 120 vaping awareness materials produced using an automated-AI framework. Focus group participants sorted materials into 'effective' and 'ineffective' piles and provided feedback. Based on feedback and quality criteria, 25 revised materials were created using an AI co-design framework incorporating iterative, few-shot prompting and manual text-image integration. Phase 2 explored young adult (n = 9, ages 18-25) perceptions of revised materials via semi-structured interviews. Inductive thematic analysis was conducted.</p><p><strong>Results: </strong>Phase 1 participants rejected automated-AI-generated materials due to misaligned text-image combinations, artificial imagery, unrealistic vaping devices, and inauthentic language. Phase 2 identified six key characteristics of effective AI-co-designed materials that aligned with established health communication principles including visual appeal; focus on immediate consequences; relevance to youth; provision of practical advice; avoidance of ambiguity and fearmongering; and integration of multiple themes to reach diverse youth audiences.</p><p><strong>Discussion and conclusions: </strong>AI tools can rapidly generate messages but an AI-co-design framework incorporating expert input and audience feedback is required to produce materials that are relevant, authentic, and evidence-based. This framework offers a promising pathway for developing timely, scalable responses to public health challenges such as youth vaping; though continued research is needed for effective and ethical implementation across diverse contexts.</p>","PeriodicalId":11318,"journal":{"name":"Drug and alcohol review","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144871967","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Survey Questions on Quantity and Frequency Are Differentially Effective by Age in Predicting Future Alcohol Consumption.","authors":"Sarah Callinan, Simon D'Aquino, Ben Riordan, Jonas Raninen, Michael Livingston, Paul M Dietze, Gerhard Gmel, Robin Room","doi":"10.1111/dar.70019","DOIUrl":"10.1111/dar.70019","url":null,"abstract":"<p><strong>Introduction: </strong>Cross sectional research has demonstrated that screening tool questions on frequency of alcohol consumption are a better predictor of dependence and harmful drinking in younger adults; questions about quantity per occasion are a better predictor in older adults. The aim of this study is to see if this relationship also holds longitudinally.</p><p><strong>Methods: </strong>A total of 9076 respondents aged 15 and over completed at least two waves of the longitudinal annual Household Income and Labour Dynamics in Australia survey 10 years apart between 2001-2010 and 2012-2020. Standardised scores from responses to questions on drinking quantity and frequency in the first survey were used to predict consumption 10 years later in groups stratified by age.</p><p><strong>Results: </strong>Frequency of consumption was a significantly better predictor of future consumption than quantity in younger drinkers (aged < 36; β = 9.3, 95% confidence interval [CI] 8.6-10.0), than older drinkers (aged > 49; β = 5.1, 95% CI 4.8-5.5) while quantity was a better predictor in older drinkers (β = 8.2, 95% CI 7.2-9.3) than younger drinkers (β = 3.4, 95% CI 3.1-3.7).</p><p><strong>Discussion and conclusions: </strong>Some commonly used screening items, such as drinking quantity and frequency, are differentially effective at identifying future heavy drinkers between age groups. Development of age-specific screening tools could potentially lead to more accurate identification of people who could benefit from intervention to reduce their alcohol consumption.</p>","PeriodicalId":11318,"journal":{"name":"Drug and alcohol review","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144871970","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Naloxone Carriage Among People Who Inject Drugs in New York City.","authors":"Sarah Kimball, Chenziheng A Weng, Courtney McKnight, Mehrdad Khezri, Don Des Jarlais","doi":"10.1111/dar.70018","DOIUrl":"10.1111/dar.70018","url":null,"abstract":"<p><strong>Introduction: </strong>Naloxone carriage allows for timely use to reverse opioid-involved overdoses. This study seeks to determine the prevalence of naloxone carriage, as well as associated factors, among people who inject drugs in New York City.</p><p><strong>Methods: </strong>Using respondent-driven sampling, people who inject drugs across New York City were recruited to complete a cross-sectional survey between 2021 and 2024. Naloxone carriage was defined as self-reporting naloxone carriage 'most of the time' or 'always'. Variables related to demographics, substance use, overdose, treatment history, syringe source and prior naloxone experience were included. Data were analysed using bivariable and multivariable logistic regression.</p><p><strong>Results: </strong>In this sample of 361 participants, 162 (45%) reported naloxone carriage. The majority of participants were male (71%; n = 258) with an average age of 48.48 (SD 10.23). The odds of carrying naloxone were significantly higher among those who experienced recent food insecurity (adjusted odds ratio [aOR] 2.18; 95% confidence interval [CI] 1.34, 3.56), reported fewer years of injection drug use (aOR 1.03; 95% CI 1.01, 1.05), used naloxone to reverse someone else's overdose (aOR 2.54; 95% CI 1.56, 4.14), received syringes from a syringe service program (aOR 3.33; 95% CI 1.61, 7.14), and used test shots as an overdose prevention strategy (aOR 2.55; 95% CI 1.33, 3.56).</p><p><strong>Discussion and conclusions: </strong>While a higher prevalence than other studies, less than half the sample reported naloxone carriage. There are modifiable factors that can increase naloxone carriage at the individual level. However, given the low prevalence of naloxone carriage, there is a need for further intervention, particularly at the systemic level.</p>","PeriodicalId":11318,"journal":{"name":"Drug and alcohol review","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144871969","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Rapid Review of Addiction Practice Supervision","authors":"Alexander El Amanni,&nbsp;Allen Bartley","doi":"10.1111/dar.70013","DOIUrl":"10.1111/dar.70013","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Issues</h3>\u0000 \u0000 <p>Clinical supervision is important in addiction practice to uphold ethics, maintain best practice and provide support for practitioners facing work-related stress or risk of burnout. However, addiction practice supervision research is limited and the theoretical foundations have not been critically reviewed. The lack of evidence on available models for supervisors and practitioners drove the need for a targeted review.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Approach</h3>\u0000 \u0000 <p>This rapid review, informed by Cochrane guidelines, employed a systematic protocol using a broad keyword search on Google Scholar, Scopus, CINAHL and Embase to identify theories and models in supervision for addiction treatment settings. The search returned 274 results, with 11 resources meeting the eligibility criteria following the PRISMA selection process.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Key Findings</h3>\u0000 \u0000 <p>Ten models and theories were identified which fell into one of four categories: Integrative (three), Blended (two), Competency-based (two) and Other (three). All three integrative models were developmental clinical supervision models.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Implications</h3>\u0000 \u0000 <p>This review shows that developmental supervision models are prominent in the literature, with addiction practice supervision generally favouring clinical supervision. The lack of empirical studies, however, suggests a gap that future research should address.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Despite the limited scope of this rapid review, a strong theoretical foundation for addiction practice supervision was identified. Most models are developmental, with many combining various approaches; some also feature specific adaptations for relevance, while a few are ethical evaluation. This diversity shows promise and the need for further research to assess these models.</p>\u0000 </section>\u0000 </div>","PeriodicalId":11318,"journal":{"name":"Drug and alcohol review","volume":"44 6","pages":"1704-1710"},"PeriodicalIF":2.6,"publicationDate":"2025-08-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/dar.70013","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144820902","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Differences in Reporting Alcohol Consumption During Pregnancy by Method of Asking; and the Association of Drinking While Pregnant With Caregiving Responsibilities","authors":"Pablo Reguera-Pozuelo,&nbsp;Ismael Fernández-Cuervo,&nbsp;Nathalia Garrido-Torres,&nbsp;Antonio Luis Partida-Márquez,&nbsp;Verónica García-Rumi,&nbsp;Sergio Anillo,&nbsp;Irene Luján Sosa,&nbsp;Antonio Manuel Martín Rendón,&nbsp;María Begoña Moreno Dueñas,&nbsp;Rocío Pineda Cachero,&nbsp;María Isabel Rodríguez Cocho,&nbsp;Carmen Gallardo Trujillo,&nbsp;Angela Cejudo López,&nbsp;Lidia Zamudio Juan,&nbsp;Mercedes Guerrero Benítez,&nbsp;Rosario Figueroa,&nbsp;Andrés Román-Jarrín,&nbsp;Lucas Cerrillos-González,&nbsp;Miguel Ruiz-Veguilla,&nbsp;Benedicto Crespo-Facorro","doi":"10.1111/dar.70012","DOIUrl":"10.1111/dar.70012","url":null,"abstract":"","PeriodicalId":11318,"journal":{"name":"Drug and alcohol review","volume":"44 6","pages":"1816-1819"},"PeriodicalIF":2.6,"publicationDate":"2025-08-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144820901","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Relationship Between Patient-Reported Experiences and Treatment Satisfaction Among Men and Women in Residential Substance Use Treatment","authors":"Chloe J. Haynes,&nbsp;Alison K. Beck,&nbsp;Peter J. Kelly,&nbsp;Dennis Kaip,&nbsp;Megan Wells,&nbsp;Jaymee Issa,&nbsp;David Kelly,&nbsp;Leanne Hides,&nbsp;Briony Larance","doi":"10.1111/dar.70011","DOIUrl":"10.1111/dar.70011","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Understanding the experiences of women participating in residential alcohol and other drug (AOD) treatment is important in ensuring treatment effectively meets women's needs. Patient-reported experience measures aid in assessing women's experiences of treatment but are often used to quantify women's treatment satisfaction without additional context regarding specific treatment experiences. This study examined the relationship between the domains of the <i>Patient Reported Experience Measure for Addiction Treatment (PREMAT)</i> and overall treatment satisfaction, including whether relationships differed by gender.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>\u0000 <i>N</i> = 138 participants (30.9% women) from a not-for-profit residential AOD treatment service completed a survey regarding their experiences of and satisfaction with treatment, including the PREMAT. Descriptives, chi-square and Mann–Whitney <i>U</i> statistics examined gender differences in demographics. A generalised linear model assessed the relationship between PREMAT domain scores and overall treatment satisfaction (Client Satisfaction Questionnaire), controlling for age and weeks in treatment, including whether relationships differed by gender. Relative weight statistics examined the relative statistical importance of each PREMAT domain to overall satisfaction.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>There were no gender differences on PREMAT item, domain or total scores. Controlling for age and weeks in treatment, significant predictors of overall treatment satisfaction were the PREMAT ‘self-determination and empowerment’ and ‘personal responsibility’ domains. The impact of ‘personal responsibility’ on overall satisfaction was weaker for women compared to men.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Discussion and Conclusions</h3>\u0000 \u0000 <p>Fostering individualised care and support, self-determination, empowerment and personal responsibility for care, are important aspects of residential treatment for both men and women. Further development of women-specific PREMs that address gendered experiences of treatment is warranted.</p>\u0000 </section>\u0000 </div>","PeriodicalId":11318,"journal":{"name":"Drug and alcohol review","volume":"44 6","pages":"1691-1703"},"PeriodicalIF":2.6,"publicationDate":"2025-08-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/dar.70011","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144774928","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Self-Reported Cannabis Prices and Expenditures From Legal and Illegal Sources Five Years After Legalisation of Non-Medical Cannabis in Canada","authors":"Samantha Rundle,&nbsp;Daniel Danh Hong,&nbsp;Maryam Iraniparast,&nbsp;Vicki Rynard,&nbsp;Elle Wadsworth,&nbsp;Rosalie Liccardo Pacula,&nbsp;Beau Kilmer,&nbsp;David Hammond","doi":"10.1111/dar.70009","DOIUrl":"10.1111/dar.70009","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>The price of cannabis has important implications for many outcomes discussed in legalisation debates. This paper reports on legal and illegal prices of different cannabis products.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>National surveys were conducted in 2022 and 2023 among Canadians aged 16–65 years as part of the International Cannabis Policy Study. Self-reported price, purchase quantity and legal versus illegal source of the‘last’ cannabis purchased was examined from 2686 respondents who used cannabis in the past 12 months for nine cannabis product types.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>On average, consumers report that 78% of all their cannabis came from legal sources in the past year. Differences in the self-reported price paid between legal and illegal purchases varied by product type. Price per unit was higher from legal sources for dried flower (+23.8%, <i>p</i> &lt; 0.001), vapes (+18.7%, <i>p</i> = 0.006) and hash (+38.4%, <i>p</i> &lt; 0.001), and lower for capsules (−28.4%, <i>p</i> = 0.008). No statistically significant difference was found for drops (−3.3%. <i>p</i> = 0.76), edibles (+3.9%, <i>p</i> = 0.49), cannabis drinks (−8.8%, <i>p</i> = 0.21), concentrates (+13.8%, <i>p</i> = 0.15) and tinctures (−17.0%, <i>p</i> = 0.28). Substantial quantity discounts for dried flower were observed from both legal and illegal sources.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Discussion and Conclusion</h3>\u0000 \u0000 <p>Differences between legal and illegal cannabis prices have narrowed considerably, likely due to declines in the price of cannabis from legal stores since the opening of legal markets in Canada. Some differences are expected across the two markets considering differences in standard quantities purchased and the presence of quantity discounts in these markets. Analyses omitting purchase quantity may overestimate the price differential between legal and illegal sources.</p>\u0000 </section>\u0000 </div>","PeriodicalId":11318,"journal":{"name":"Drug and alcohol review","volume":"44 6","pages":"1658-1665"},"PeriodicalIF":2.6,"publicationDate":"2025-08-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/dar.70009","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144783779","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Lead Astray? The Hidden Contaminants in Australian Anabolic–Androgenic Steroid Market and Their Potential Health Impact","authors":"Alison Craven,&nbsp;Jason Ferris,&nbsp;Suzanne Nielsen,&nbsp;Timothy Piatkowski","doi":"10.1111/dar.70007","DOIUrl":"https://doi.org/10.1111/dar.70007","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Unregulated anabolic–androgenic steroid (AAS) markets are a global phenomenon with significant variability in product composition and purity. This study aimed to determine the chemical composition of AAS sold in Australia.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This study analysed anonymously donated AAS samples. Samples were chemically analysed by an independent forensic laboratory using gas chromatography–mass spectrometry, liquid chromatography–mass spectrometry and inductively coupled plasma analysis to identify active ingredients, contaminants and heavy metals, with results interpreted in the context of harm reduction.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Analysis of 28 AAS samples (16 injectable, 10 oral, 2 raw powders) revealed that 15 samples were mislabelled or mis-sold. When considering the 21 samples with clearly defined expected labelled dosages, 4 of these were within a ±5% deviation of the expected purity. Twelve heavy metals were detected in injectable and oral products, with mean concentrations ranging from 0.07 to 62.54 μg/mL in injectables and 1.94–47,901 μg/g in orals. Seven metals were identified in raw powders (mean 23.0 μg/g, range 0.96–51.73 μg/g).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Discussion and Conclusions</h3>\u0000 \u0000 <p>The variability and contamination of AAS products pose significant health risks. Implementing a comprehensive surveillance and testing system is essential. This approach would track trends, identify contaminants and provide consumers with real-time, accurate information to support informed decision-making and harm reduction.</p>\u0000 </section>\u0000 </div>","PeriodicalId":11318,"journal":{"name":"Drug and alcohol review","volume":"44 6","pages":"1641-1647"},"PeriodicalIF":2.6,"publicationDate":"2025-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/dar.70007","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144930010","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}