Psychoactives, Volume 2, Issue 1 (March 2023) – 6 articles

Background: Ayahuasca is a serotoninergic hallucinogen that plays a central role in the Amazonian traditional medicine. Its psychoactive effects are associated with the presence of N,N-dimethyltryptamine (DMT), and monoamine oxidase inhibitors (MAO-A). Advances in neuroimaging investigations have provided insight into ayahuasca’s neurobiological mechanisms of action. Methods: Selecting only studies with neuroimaging results related to human ayahuasca consumption, we included six articles from a previous systematic review of serotoninergic hallucinogen neuroimaging studies up to 2016. Furthermore, we updated the data with a new systematic search from 2016 to 2022. We searched the PubMed, SciELO, and LILACS databases using the search terms “(ayahuasca OR DMT) AND (MRI OR fMRI OR PET OR SPECT OR imaging OR neuroimaging)”. Results: Our updated search provided five new articles for a total of 11 included in this review. The results on the Default Mode Network (DMN) are evident and may indicate a path to short term neuromodulation. Acutely, local neural networks appeared to become expanded, while overall brain connectivity declined. On chronic consumers, anatomical changes were reported, most notably related to cingulate cortex. Conclusion: Ayahuasca seems to change acute brain connectivity similarly to other psychedelics. The results are preliminary and further studies are warranted. Full article

In the European Union (EU), cannabidiol (CBD) products extracted from Cannabis sativa L. require pre-marketing authorisation under the novel food regulation. Currently, 19 CBD applications are being assessed by the European Food Safety Authority (EFSA). During the initial assessment of the dossiers, the EFSA Panel on Nutrition, Novel Foods, and Food Allergens (NDA) identified several knowledge gaps that need to be addressed before the evaluation of CBD can be finalised. The effects of CBD on the liver, gastrointestinal tract, endocrine system, nervous system, psychological function, and reproductive system need to be clarified. The contribution of this research is to provide an evidence-based assessment of the potential risks associated with CBD products, and to provide recommendations for risk management in the European Union while awaiting the finalisation of novel food applications. The available literature allows for a benchmark dose (BMD)–response modelling of several bioassays, resulting in a BMD lower confidence limit (BMDL) of 20 mg/kg bw/day for liver toxicity in rats. Human data in healthy volunteers showed increases in the liver enzymes alanine aminotransferase and aspartate aminotransferase in one study at 4.3 mg/kg bw/day, which was defined by the EFSA NDA panel as the lowest observed adverse effect level (LOAEL). The EFSA NDA panel recently concluded that the safety of CBD as a novel food cannot be assessed, resulting in a so-called clock stop for the applications until the applicants provide the required data. The authors suggest that certain CBD products still available on the EU market as food supplements despite the lack of authorisation should be considered “unsafe”. Products exceeding a health-based guidance value (HBGV) of 10 mg/day should be considered “unfit for consumption” (Article 14(1) and (2)(b) of Regulation No. 178/2002), while those exceeding the human LOAEL should be considered “injurious to health” (Article 14(1) and (2)(a) of Regulation No 178/2002). Full article

High-quality palliative care has been shown to provide benefits for cancer patients, including greater longevity when initiated earlier in treatment. Previous research conducted among terminal patients in the Illinois Medical Cannabis Program has suggested that cannabis may be used as a complement to palliative care and as an alternative to prescription opioid medications. However, there is little research exploring this phenomenon among non-terminal cancer patients receiving palliative care. In this study, we used primary cross-sectional survey data to (1) identify the factors associated with the utilization of palliative care, (2) examine the associations between the utilization of palliative care and self-reported improvements in physical and psychological symptoms, and (3) estimate the differences in the average 30-day pain levels for non-terminal cancer patients receiving palliative care who reported using opioids compared with other non-terminal cancer patients in palliative care who did not report using opioids. In our sample, 87 out of 542 (16%) non-terminal cancer patients were receiving palliative care, and of these 87 patients, 54 (62%) reported opioid use in the past 12 months. Non-terminal cancer patients in the sample who reported low psychological well-being, frequent gastrointestinal symptoms, and prescription opioid use in the past 12 months had greater odds of palliative care utilization. Palliative care utilization was also positively associated with self-reported improvements in gastrointestinal symptoms. The concurrent use of cannabis and prescription opioids was associated with higher average 30-day pain levels and with higher average pain levels at the initiation of cannabis use among those non-terminal cancer patients engaged in palliative care services. Full article

The use of plant-based medicine dates back centuries, and cannabis (Cannabis sativa) is one such plant that has been used medicinally and illicitly. Although cannabis contains hundreds of cannabinoids and other natural products, its potential medicinal use was largely ignored by modern researchers due to the legal restrictions and heavy regulations introduced in the 1930s. As restrictions on cannabis access have eased since the 1990s there is renewed interest in the research of cannabinoids and the other components in the cannabis plant. The focus of this review article is an overview of cannabis and the analytical challenges in the quality control and biological analysis. The pharmacological effects of psychoactive cannabinoids, delta-9-tetrahydrocannabinol (Δ⁹-THC) and delta-8-trans- tetrahydrocannabinol (Δ⁸-THC) is discussed, along with an abundant non-intoxicating cannabinoid, cannabidiol (CBD). The analytical methods for the quality control assays of cannabis products include gas chromatography and liquid chromatography coupled to different detectors, including mass spectrometry. This review will highlight various analytical methods for the quality control of cannabis products and the quantitation of cannabinoids in biological matrices for forensics and toxicology. Full article

This study aimed to assess the proportion of adolescents and young people (AYP) in Nigeria who changed their frequency of e-cigarette use and tobacco smoking during the COVID-19 pandemic; and factors associated with the increase, decrease or no change in e-cigarette use and tobacco smoking (including night smoking). This study was a cross-sectional study of AYP recruited from all geopolitical zones in the country. Multivariate logistic regression analyses were conducted to determine if respondents’ health HIV and COVID-19 status and anxiety levels were associated with changes in e-cigarette use and tobacco smoking frequency. There were 568 (59.5%) e-cigarette users, of which 188 (33.1%) increased and 70 (12.3%) decreased e-cigarette use and 389 (68.5%) increased night e-cigarette use. There were 787 (82.4%) current tobacco smokers, of which 305 (38.8%) increased and 102 (13.0%) decreased tobacco smoking and 534 (67.9%) increased night tobacco smoking. Having a medical condition was associated with lower odds of increased e-cigarette use (AOR:0.649; p = 0.031). High anxiety (AOR:0.437; p = 0.027) and having a medical condition (AOR:0.554; p = 0.044) were associated with lower odds of decreased e-cigarette use. Having COVID-19 symptoms (AOR:2.108; p < 0.001) and moderate anxiety (AOR:2.138; p = 0.006) were associated with higher odds of increased night e-cigarette use. We found complex relationships between having a medical condition, experiencing anxiety, changes in tobacco smoking and e-cigarette use among AYP in Nigeria during the COVID-19 pandemic that need to be studied further. Full article

New psychoactive substances (NPSs) have concerned authorities worldwide, and monitoring them has become increasingly complex. In addition to the frequent emergence of new chemical structures, the composition of adulterants has changed rapidly. Reliable reference data on NPS are not always available, and identifying them has become an operational problem. In this study, we evaluated the infrared spectral data of 68 seized samples suspected of containing a synthetic cathinone (N-ethylpentylone). We used quantum chemistry tools to simulate infrared spectra as a benchmark and obtained infrared spectra for different cathinones, structurally analogous amphetamines, and possible adulterants. We employed these in silico data to construct different chemometric models and investigated the internal and external validation and classification requirements of the models. We applied the best models to predict the classification of the experimental data, which showed that the seized samples did not have a well-defined profile. Infrared spectra alone did not allow N-ethylpentylone to be distinguished from other substances. This study enabled us to evaluate whether experimental, in silico, and applied statistical techniques help to promote forensic analysis for decision-making. The seized samples required in-depth treatment and evaluation so that they could be correctly analyzed for forensic purposes. Full article