Drug science, policy and law最新文献

{"title":"The use of chlordiazepoxide for outpatient gamma-butyrolactone (GBL) detoxification: An observational study","authors":"Alfred Balston, K. Hunjan, M. Kelleher","doi":"10.1177/20503245231167544","DOIUrl":"https://doi.org/10.1177/20503245231167544","url":null,"abstract":"Various detoxification regimens are used for gamma-hydroxybutyrate (GHB) and gamma-butyrolactone (GBL), including diazepam, barbiturates, baclofen and GHB itself. However, these regimens are primarily derived from inpatient units, and literature on outpatient GBL detoxification is sparse with no previous reports on chlordiazepoxide. We describe the characteristics of outpatient GBL detoxification using chlordiazepoxide. Observational study of all patients who attended a community outpatient addiction service in South London between August 2015 and November 2017 seeking detoxification from GBL. The outpatient caseload is predominantly patients with alcohol, opioid and stimulant dependence. Routine clinical data including patient demographics, GBL usage, daily chlordiazepoxide dose and Clinical Institute Withdrawal Assessment for Alcohol-revised (CIWA-Ar) score were recorded. In the study period there were 17 attendances for GBL detoxification, 14 of which were undertaken in the outpatient setting. Twelve (86%) patients who had an outpatient detoxification were male, all of whom were men who have sex with men. Of 14 outpatient GBL detoxifications managed with chlordiazepoxide, 10 were successfully completed. One of the four patients that did not complete detoxification required inpatient treatment in an acute hospital. The average successful detoxification took 10 ± 3.1 days. For patients who completed a detoxification, the median maximum CIWA-Ar score on day one of the detoxification was 11 (range 2–17), with the mean dose of chlordiazepoxide used on day one being 140 mg (range 80–225 mg). Chlordiazepoxide can be used for outpatient GBL detoxification in combination with a provision for crisis admission to hospital. CIWA-Ar score can be applied to GBL withdrawal to measure severity and inform a reducing regimen of chlordiazepoxide.","PeriodicalId":92502,"journal":{"name":"Drug science, policy and law","volume":"118 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85948441","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Minorities’ diminished psychedelic returns","authors":"S. M. Viña, A. L. Stephens","doi":"10.1177/20503245231184638","DOIUrl":"https://doi.org/10.1177/20503245231184638","url":null,"abstract":"Although there is a growing support for the use of psychedelics to improve the health of marginalized groups, there are some critical gaps. First, no empirical studies have examined the effects of psychedelics on Black Americans. Second, there is little research on population effects of psychedelics. Third, little research has tested how cultural set and setting may affect the relationship between psychedelics and health. Specifically, how could economic inequality or the criminal justice system jeopardize the relationship between psychedelics and health for Black people. This study tests race and gender differences in multiple aspects of lifetime classic psychedelic use, specifically drug use, arrest history, economic inequality, and psychological distress. This project uses pooled data of Black and White respondents from the National Survey of Drug Use and Health (2008–2019) ( N = 490,586). The analysis includes a series of logistic and ordinary least square regression models conducted in Stata 17. Results demonstrate that Black people are policed more even though they use less drugs than Whites. Higher class White men are more likely to use psychedelics, while class does not predict use among Black people. Finally, for White men and women, the positive association of psychedelics are enhanced by class, while the negative effect of arrest history on health are buffered by psychedelics. However, Black people do not gain health benefits from psychedelics regardless of class or arrest history. Results suggest that systemic inequality deters use and eliminates all health benefits of psychedelics for Black people.","PeriodicalId":92502,"journal":{"name":"Drug science, policy and law","volume":"17 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74449237","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Case report: Prolonged amelioration of mild red-green color vision deficiency following psilocybin mushroom use","authors":"B. Barnett, N. Sweat, P. Hendricks","doi":"10.1177/20503245231172536","DOIUrl":"https://doi.org/10.1177/20503245231172536","url":null,"abstract":"Recent survey data indicate that some people report long-term improvement in color vision deficiency (CVD), also known as color blindness, following use of psychedelics such as lysergic acid diethylamide (LSD) and psilocybin. However, there are no objective data reported in the medical literature quantifying the degree or duration of CVD improvement associated with psychedelic use. Here we present the case of a subject with red-green CVD (mild deuteranomalia) who self-administered the Ishihara Test to quantify the degree and duration of CVD improvement following the use of 5 g of dried psilocybin mushrooms. Self-reported Ishihara Test data from the subject revealed partial improvement in CVD peaking at 8 days and persisting for at least 16 days post-psilocybin administration. This improvement may have lasted longer, though the subsequent observations are confounded by additional substance use. A single use of psilocybin may produce partial improvements in CVD extending beyond the period of acute effect, despite this condition typically resulting from a genetic defect. Systematic exploration of this possible phenomenon is needed to confirm our findings, gauge their generalizability, and determine the mechanism of action.","PeriodicalId":92502,"journal":{"name":"Drug science, policy and law","volume":"75 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82062556","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A roadmap for psychedelic pharmacy in Canada: A proposed policy and operations approach for controlled access to select psychedelics for treatment of mental illness","authors":"Jaden Brandt","doi":"10.1177/20503245231170340","DOIUrl":"https://doi.org/10.1177/20503245231170340","url":null,"abstract":"The unprecedented progress in the science and clinical investigation of psychedelic medicine will require those in healthcare leadership and the legislative policy arena to conceptualize how future reforms, policy creation, and clinical practice should occur to broaden access to these agents while simultaneously maximizing effectiveness and mitigating harm. The pharmacy profession has surprisingly had little engagement on this front. This article provides a perspective commentary and overview of potential future strategies in legal reform, professional regulatory authority policy creation, and pharmacy operations regarding the psychedelic agents’ psilocybin and methylenedioxymethamphetamine, using Canada as a national case study.","PeriodicalId":92502,"journal":{"name":"Drug science, policy and law","volume":"48 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"91367965","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Perceived barriers to access to hepatitis C for people who inject drugs in Morocco: A qualitative explorative study","authors":"Z. Belrhiti, Fatima Zohra Serghini","doi":"10.1177/20503245231199163","DOIUrl":"https://doi.org/10.1177/20503245231199163","url":null,"abstract":"Worldwide, approximately there are 15.6 million people who inject drugs. Recently, a rising prevalence of hepatitis C virus among the people who inject drugs community (8.2 million, 40 to 80% of people who inject drugs) urged governments to implement targeted preventive and structural interventions. Yet, social stigma, poor interaction with health workers, and limited health literacy are critical challenges to equitable access to care. This study explores the perceived barriers and facilitators of people who inject drugs access to hepatitis C virus care in Morocco. We adopted an explorative qualitative single-embedded case study design. We conducted 19 semi-structured interviews and a focus group discussion with people who inject drugs, health workers, and social community health workers. We performed an inductive qualitative data analysis using thematic analysis. We coded data using NVivo software. We summarized our findings using a causal loop diagram of critical barriers and facilitators. Multi-layered and interdependent factors constrain access to care for people who inject drugs. People who inject drugs are considered a vulnerable population experiencing irregular housing, lack of family support, gender-based stigmatization, and incarcerations. Individual factors include limited hepatitis C virus health literacy, mistrust in health workers, and poor interaction with health workers within healthcare facilities. Both individual and structural elements decrease their perceived self-worth and self-esteem and reinforce their perceived social stigmatization. This leads to a lack of motivation to engage in hepatitis C virus care delivery. We found that peer educators are perceived as trustworthy and credible sources of hepatitis C virus health-related knowledge. Poor access to hepatitis C virus treatment for people who inject drugs involved an intertwined set of individual factors (level of knowledge, perceived social stigma, reduced self-esteem, and self-worth) and structural factors such as poor interaction with health workers and mistrust in healthcare institutions. More attention needs to be paid to alleviate structural barriers by integrating peer education, multiagency collaboration, community engagement, and capacity building of health workers for equitable access of people who inject drugs to hepatitis C virus care.","PeriodicalId":92502,"journal":{"name":"Drug science, policy and law","volume":"35 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73384733","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"From prohibited to prescribed: The rescheduling of MDMA and psilocybin in Australia","authors":"Octavian Dixon Ritchie, Cameron N Donley, Gabrielle Dixon Ritchie","doi":"10.1177/20503245231198472","DOIUrl":"https://doi.org/10.1177/20503245231198472","url":null,"abstract":"","PeriodicalId":92502,"journal":{"name":"Drug science, policy and law","volume":"18 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76378726","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"MDMA-assisted psychotherapy with adolescents suffering from PTSD: Do or don’t? a qualitative study with youth, parents, and clinicians","authors":"Anoek S van Vugt, J. Zijlmans, Ramon Lindauer, Levi van Dam","doi":"10.1177/20503245231198477","DOIUrl":"https://doi.org/10.1177/20503245231198477","url":null,"abstract":"PTSD in adolescence causes much suffering and has substantial health-care costs. Many patients with severe PTSD do not respond to psychotherapy or continue to have symptoms despite trauma-focused psychotherapies and psychopharmacological treatment. A recent alternative in the search for cost-effective treatments for PTSD in adults is 3,4-methylenedioxymethamphetamine-assisted psychotherapy (MDMA-assisted psychotherapy). However, no research has yet been conducted on the therapeutic potential of MDMA for adolescents. The purpose of this study is to investigate the perspectives of adolescents, parents, and clinicians about the possible clinical application of MDMA-assisted psychotherapy for adolescents with PTSD. We performed focus groups in three samples: (a) 16–24-year-olds who had undergone trauma therapy ( N  =  9), (b) parents of traumatized children ( N  =  4), and (c) trauma clinicians ( N  =  6). Focus group topics included: perception of and associations with MDMA, opinions on MDMA-assisted psychotherapy, risks/benefits, and precautions to take prior to possible adolescent clinical trials with MDMA-assisted psychotherapy. In all groups, initial participant attitudes towards MDMA were predominantly unfavorable, except for several adolescents who had conducted preliminary research on the subject. After a standardized explanation of MDMA-assisted psychotherapy, provided in each group, all but one participant changed their minds and supported the idea of implementing MDMA-assisted psychotherapy for adolescents. They all emphasized the importance of conducting research first. Our findings suggest that when provided with information on what MDMA-assisted psychotherapy entails, adolescents, parents, and clinicians are open to the idea of exploring this type of treatment for adolescents.","PeriodicalId":92502,"journal":{"name":"Drug science, policy and law","volume":"52 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90533206","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Preliminary findings from project Twenty21 Australia: An observational study of patients prescribed medicinal Cannabis for chronic pain, anxiety, posttraumatic stress disorder and multiple sclerosis","authors":"Kylie O’Brien, J. Beilby, Michelle Frans, M. Lynskey, M. Barnes, Mihindu Jayasuriya, Alkyoni Athanasiou-Fragkouli, Philip Blair, D. Nutt","doi":"10.1177/20503245231164718","DOIUrl":"https://doi.org/10.1177/20503245231164718","url":null,"abstract":"Since medical access to medicinal cannabis (MC) was legalised in Australia in 2016, numbers of people prescribed MC have increased exponentially. There is a need for safety and effectiveness data on the longer-term use of MC in real-world settings. This paper describes the methodology of Project Twenty21 Australia, an observational study that commenced early in 2022 and its preliminary findings. This study tests whether medicinal cannabis is effective in four primary conditions: chronic pain, anxiety, posttraumatic stress disorder and multiple sclerosis (MS). Participants are prescribed MC from within a Project Formulary, completing questionnaires at baseline then 3 monthly for up to 12 months. Between the start of the study in February and 30 August 2022, 278 participants had been recruited into the study: 50.7% female, 48.2% male and 1.1% non-binary with average age 39.2 years (18–77). Patients reported a low quality of life and high levels of co-morbidity. Three-month data, available for 71 participants, indicate that MC was associated with substantial improvements in self-reported quality of life, general health, mood/depression and sleep with standardised effect size estimates ranging from 0.57 to 0.93. Three adverse reactions were reported. This paper describes the protocol used for an observational study conducted in Australia assessing the effectiveness of MC in four main conditions. We have established the feasibility of collecting real-world data on symptoms and quality of life in people receiving treatment with MC. Preliminary evidence suggests that MC may be effective in improving quality of life, general health, mood and sleep.","PeriodicalId":92502,"journal":{"name":"Drug science, policy and law","volume":"2 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84548593","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Could classic psychedelics influence immigrants’ acculturation process? A narrative review contemplating how","authors":"Benjamin A. Korman","doi":"10.1177/20503245231191400","DOIUrl":"https://doi.org/10.1177/20503245231191400","url":null,"abstract":"Rising international migration, paired with increasing public support for far-right political parties, poses a growing challenge to the countries tasked with successfully integrating immigrants into their society. Further complicating this matter is the fact that the acculturation process which immigrants undergo to fully integrate into their host society can be long, difficult, and taxing to their mental health, physical health, and sense of belonging. A better understanding of how the unique burdens faced by immigrants might be alleviated or more easily processed is therefore vital for the success of both immigrants and their host countries. Drawing on initial findings suggesting that classic psychedelics can help individuals process incidents of discrimination, make healthier decisions, and experience deeper feelings of connectedness to others, this literature review presents a roadmap for determining what classic psychedelics may offer immigrants, a large and rapidly growing international minority group.","PeriodicalId":92502,"journal":{"name":"Drug science, policy and law","volume":"31 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84372783","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A phenomenological analysis of Fellini's films to understand the effect of LSD therapy on his creativity","authors":"A. Metastasio, Silvio Mignogna, Riccardo Paci, M. Mancini, Fabio Melelli, Enrico Lando, O. Corazza, G. Stanghellini","doi":"10.1177/20503245231186723","DOIUrl":"https://doi.org/10.1177/20503245231186723","url":null,"abstract":"Since its discovery in 1943, LSD has been used by artists, scientists, and intellectuals, amongst others, to stimulate their creative insights. Federico Fellini, one of the most important film directors in the XX century, used LSD when it was still legal under the guidance of his psychoanalyst during a phase of personal and creative crisis. This article proposes a phenomenological analysis of how his filmmaking and his creativity was enhanced after using LSD in such controlled therapeutic settings, according to four main domains: (a) time, (b) space, (c) body and others and (d) perception of the self. In particular, time flows irregularly and is punctuated by disorienting flashbacks, colours become supernaturally brilliant and detached from objects, sounds pop up independently from any visible source, and human bodies become often deformed, grotesque and caricatural. The boundaries between dream- and reality-worlds also collapses. His films became so distinctive and original that an adjective was coined felliniesque.","PeriodicalId":92502,"journal":{"name":"Drug science, policy and law","volume":"28 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88180342","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}