Psychoactives

Objective: To explore the perceived influence of psychedelic experiences on participants’ relationship with the natural world. Method: A total of 272 participants reporting previous use of psychedelics completed free-text response requests via an online survey. Thematic analysis was used to explore group participant responses. Results: Participants who described a pre-existing relationship with nature reported that psychedelics acted to re-establish and bolster their connection to nature. Those reporting no previously established connection to nature described psychedelics as helping them bond with the natural world. Underlying both of these were reports of transpersonal experiences, of which ‘interconnectedness’ was most frequently linked to shifts in attitudes and behaviours. Participants were also asked to reflect on previous psychedelic experiences that took place in nature and reported a range of benefits of the natural setting. Conclusions: These findings suggest that psychedelics have the capacity to elicit a connection with nature that is passionate and protective, even among those who were not previously nature oriented. More research is needed to explore the potential implications of psychedelic use outside laboratory-controlled settings in order to enhance these important effects. Full article

Psychedelics have been studied extensively in their broad treatment potential for a variety of mental health disorders. Recently, scholars have turned their attention to the role of psychotherapy in the augmentation, follow-up, and support mechanisms relevant to psychedelic administration. While it is tempting to position psychedelic substances as standalone medicines akin to SSRIs or SNRIs, their unique neurochemical action and potential for psychological transformation calls for a broader examination of the role of counseling and psychotherapy, within the context of a bio-psychosocial model. I outline well-established and emerging therapeutic modalities that are well-placed in complementary and augmented psychedelic treatment. I do so with the intention of opening a broader conversation to those situated in medical and medical-adjacent fields, including psychoanalysts, counselors, support workers, and other allied professionals. Ultimately, practitioners working in medical-aligned fields hold diversly vested interests in understanding the place of psychedelic therapies in mental health, and more attention should be given to a balanced consideration of treatment and support mechanisms. Full article

Purpose: When compared to the general population, people experiencing homelessness have significantly higher rates of TBI (traumatic brain injury). Individuals experiencing homelessness and a TBI require social support because it can serve as a protective factor in reducing the risks of substance use and positively impact housing stability. This study aimed to better understand how social networks influence housing stability among individuals experiencing homelessness and a TBI. Materials and methods: A purposive sampling design was utilized to recruit and survey 115 adults experiencing homelessness. Quantitative questions captured data on demographic information, brain injury-related variables, homelessness-related variables, social network support types and characteristics, and correlates of housing instability including self-report substance use variables. Results: Findings showed that substance use was, indeed, a barrier to stay in or afford housing. Additionally, rates of social support were uniformly low across the sample, showing the unique vulnerabilities associated with homelessness and TBI and homelessness in general. Conclusion: Intervention efforts may consider fostering support networks, as social support has been linked to both housing stability and non-housing outcomes such as reduced substance use, improved health, and community reintegration. Full article

Engagement in risky sexual behaviour after consuming different substances is more prevalent among Indian men. Sometimes, practicing risky sexual behaviour increases the risk of sexually transmitted diseases (STDs), including HIV, among individuals. Around 6 percent of the adult Indian population are diagnosed with STDs every year. Thus, the chief purpose of this study was to investigate the association between the use of substances and engagement in risky sexual behaviour. Descriptive statistics, Pearson’s chi-square test of association, and multivariate binary logistic regression models were performed in this present study by using the data obtained from the NFHS-5 (2019–2021). The results showed that respondents who consumed alcohol were more likely to engage in extramarital sexual affairs (AOR: 1.94; 95% CI: 1.79–2.09; p < 0.001) and sexual intercourse without any precautions (AOR: 1.23; 95% CI: 1.17–1.29; p < 0.001). Poor socio-economic conditions and low levels of educational attainment were found as crucial factors for involvement in risky sexual behaviour. Increasing awareness among individuals through mass media may be considered an effective way to prevent risky sexual behaviour. Full article

Adolescence is a phase of life between childhood and adulthood marked by rapid biological, social and psychological changes. During this phase, individuals bear a more emotional and curious mind and may engage in risky behaviours. Decades of investigations have revealed that substance use usually begins in adolescence. The main essence of this paper is to carry out an elaborative review of earlier works to recognize familiar risks and protective factors for substance use among adolescents at the global level. Additional emphasis was given to identifying the various statistical modelling approaches, widely used in earlier studies, to promote research methodological issues for future research in this specific domain. Articles published from 1991 to 2021 on adolescent substance use were downloaded, and after carrying out a preliminary full-text review, 50 articles were selected keeping the priority of the aforementioned objectives. After an intensive review, risk factors were identified and clustered around five broad domains such as individual, parental, familial, peer and environmental factors. Protective factors were also categorized under the headings of five broad domains viz. individual, parental, familial, social and interventional. Specific statistical modelling techniques were identified to evaluate the relative risk of specific groups of adolescents being in the clutches of substance use. It is necessary to recognise the potential risk and protective factors and their combined effect on substance use among adolescents to prevent this menace from society. For a better understanding of research about the exact vulnerable age of onset of substance use during the adolescence period, both the orthogonally placed risk and protective factors necessarily need to be distinguished with an attempt to protect adolescents from the further abuse of substances, as recognised by parents and society. To prevent substance use, interventions such as regulating substance price & accessibility, school intervention programs, academic monitoring, social support, clear expectations between parents and child, addressing family trauma, awareness activities, healthy lifestyle habits, mental health support, family health counselling and substance abuse treatment should be implemented. Full article

Post-traumatic stress disorder (PTSD) is a severe mental illness with grave social, political, economic, and humanitarian implications. To apply the principles of personalized omics-based medicine to this psychiatric problem, we implemented our previously introduced drug efficiency index (DEI) to the PTSD gene expression datasets. Generally, omics-based personalized medicine evaluates individual drug action using two classes of data: (1) gene expression, mutation, and Big Data profiles, and (2) molecular pathway graphs that reflect the protein–protein interaction. In the particular case of the DEI metric, we evaluate the drug action according to the drug’s ability to restore healthy (control) activation levels of molecular pathways. We have curated five PTSD and one TRD (treatment-resistant depression) cohorts of next-generation sequencing (NGS) and microarray hybridization (MH) gene expression profiles, which, in total, comprise 791 samples, including 379 cases and 413 controls. To check the applicability of our DEI metrics, we have performed three differential studies with gene expression and pathway activation data: (1) case samples vs. control samples, (2) case samples after treatment or/and observation vs. before treatment, and (3) samples from patients positively responding to the treatment vs. those responding negatively or non-responding patients. We found that the DEI values that use the signaling pathway impact activation (SPIA) metric were better than those that used the Oncobox pathway activation level (Oncobox PAL) approach. However, SPIA, Oncobox PAL, and DEI evaluations were reliable only if there were differential genes between case and control, or treated and untreated, samples. Full article

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

Despite higher rates of hookah (i.e., waterpipe) tobacco smoking among sexual minority (SM) adults, little is known on concurrent substance use, including alcohol or other drugs, among SM hookah smokers as compared to their heterosexual counterparts. Utilizing data from the Population Assessment of Tobacco and Health Study (2013–2015), weighted analyses compared concurrent substance use among current SM adult hookah smokers versus heterosexuals. Findings revealed that SM hookah smokers had a higher prevalence of concurrent alcohol, marijuana and other drug use, including stimulants and sedatives, than heterosexuals (p < 0.05). As compared to heterosexuals, SM women and young adult (18–24 years old) smokers had higher odds of marijuana use (Women: Wave 1 odds ratio (OR), 2.16, [95% CI = 1.30–3.60]; Wave 2 OR, 2.67 [95% CI = 1.36–5.25]); young adults: Wave 1 OR, 1.55, [95% CI = 0.99–2.43]; Wave 2 OR, 2.19, [95% CI = 1.22–3.94]). In this population-based, representative sample of U.S. adults, concurrent hookah smoking and substance use differed between SM and heterosexuals. Sexual minority women and young adult hookah tobacco smokers were at increased risk for concurrent marijuana use, increasing the risk for health-related consequences in this group vulnerable to tobacco and substance use. Full article

Previous studies have shown that cannabis consumers are willing to pay more money for higher-quality products; however, the definition of “quality” cannabis has not been defined. Despite the known health risks of THC overuse, THC potency has been adopted as the primary market-driving feature of cannabis products. The purpose of this study was to objectively identify features of cannabis that contribute to its appealing subjective effects. In the course of conducting cannabis competitions, commercially available cannabis inflorescences were distributed to healthy volunteers (“judges”) in a randomized, double-blind fashion. Anonymous online survey data about the subjective effects of each cannabis sample were analyzed independently, by researchers not involved with the competitions. Pleasant subjective aroma (but not terpene expression, THC potency, or THC dose) was positively correlated with pleasant subjective effects. There was also a moderate but significant negative association between the amount of cannabis consumed and subjective appeal. These results suggest that, unlike THC potency, pleasant aroma is predictive of pleasant subjective effects. Similar to other agricultural commodities such as coffee and tea, aroma appears to be a robust indicator of the quality of cannabis inflorescence. These findings have wide-reaching public health implications, given the well-established health risks of THC overuse. Full article

Exposure to psychoactive substances is undoubtedly a serious public health issue that should be carefully analyzed from different perspectives. Regarding the types of toxic effects inflicted by these xenobiotics, it is already known that many of the common abused psychoactives have shown positive genotoxicity findings in complementary genetic toxicology assays. Nevertheless, while there are several experimental articles and reviews on this topic, it is also clear that additional information, particularly mechanistic studies, is still needed. This article addresses these issues, pointing out some aspects of the potential genotoxicity of psychoactive substances that should be further explored, and suggests some possible approaches that could be valuable in future toxicological studies. Full article

Alcohol use disorder (AUD) represents major public and socioeconomic issues. Alcohol exerts its pharmacological effects by altering different neurotransmitter systems, such as g-aminobutyric acid (GABA), glutamate, opioids, etc. Recent evidence suggests that the dynorphin (DYN)/kappa opioid receptor (KOR) system mediates the negative affective states associated with alcohol withdrawal. This system is also involved in stress-mediated alcohol intake in alcohol-dependent subjects. The DYN/KOR system probably exerts its action in the central nucleus of the amygdala (CeA) to mediate the negative affective states associated with alcohol withdrawal. This article aims to review the current literature regarding the role of the DYN/KOR system in the actions of alcohol. We first review the literature regarding the effect of alcohol on the level of the peptide and its receptor, and the role of the endogenous DYN/KOR system in alcohol reward and negative affective states associated with alcohol withdrawal is then discussed. We also review the literature regarding the effects of KOR ligands on these processes. Full article

Purpose: Survivors of pediatric brain tumor experience substantial post-treatment challenges, facing greater cognitive impairment and lower Health-Related Quality of Life (HRQoL) compared to survivors of other childhood cancers. Early studies report methylphenidate to benefit cognition and HRQoL in paediatric survivors of cancer via improved processing speed and attention. Parental opinion is an important element of treatment decision making, however parents’ views on methylphenidate treatment have not been reported. This study explored parental perceptions of their child’s treatment with methylphenidate. Materials and methods: An evaluation of 10 parents of children with previous brain tumour receiving methylphenidate was performed. Data were gathered by qualitative parental-report HRQoL questionnaire (PedsQL parent form) and by a questionnaire developed for use in this population. Results: Preliminary data suggest that parents are positive about the use of methylphenidate as an interventional measure, and believed this to have a beneficial impact on their child’s HRQoL. Conclusion: Early data from a small sample of parents suggest that methylphenidate may be effective in supporting HRQoL within this population. Parental information supports an increasing evidence base for the benefits of methylphenidate as an intervention for the management of long-term difficulties associated with paediatric cancer. Full article