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15 pages, 642 KiB  
Article
Evaluation of the Profile of Selected Bioactive Compounds and the Potential of Barley Wort Enriched with Malted and Unmalted Hemp Seeds for Brewing Applications
by Marek Zdaniewicz, Robert Duliński, Jana Lakatošová, Janusz Gołaszewski and Krystyna Żuk-Gołaszewska
Molecules 2025, 30(15), 3261; https://doi.org/10.3390/molecules30153261 - 4 Aug 2025
Abstract
The incorporation of Cannabis sativa L. seeds into barley wort was investigated to enhance the functional profile of beer. Hemp seeds (cv. Henola) were malted via controlled steeping, germination, and kilning, then added to barley malt at 10% and 30% (w/ [...] Read more.
The incorporation of Cannabis sativa L. seeds into barley wort was investigated to enhance the functional profile of beer. Hemp seeds (cv. Henola) were malted via controlled steeping, germination, and kilning, then added to barley malt at 10% and 30% (w/w) in both malted and unmalted forms. Standard congress mashing produced worts whose physicochemical parameters (pH, extract, colour, turbidity, filtration and saccharification times) were assessed, alongside profiles of fermentable sugars, polyphenols, B-group vitamins, and cannabinoids. Addition of hemp seeds reduced extract yield without impairing saccharification or filtration and slightly elevated mash pH and turbidity. Maltose and glucose levels declined significantly at higher hemp dosages, whereas sucrose remained stable. Wort enriched with 30% unmalted seeds exhibited the highest levels of trans-ferulic (20.61 µg/g), gallic (5.66 µg/g), trans-p-coumaric (3.68 µg/g), quercetin (6.07 µg/g), and trans-cinnamic (4.07 µg/g) acids. Malted hemp addition enhanced thiamine (up to 0.302 mg/mL) and riboflavin (up to 178.8 µg/mL) concentrations. Cannabinoids (THCA-A, THCV, CBDV, CBG, CBN) were successfully extracted at µg/mL levels, with the total cannabinoid content peaking at 14.59 µg/mL in the 30% malted treatment. These findings demonstrate that hemp seeds, particularly in malted form, can enrich barley wort with bioactive polyphenols, vitamins, and non-psychoactive cannabinoids under standard mashing conditions, without compromising key brewing performance metrics. Further work on fermentation, sensory evaluation, stability, and bioavailability is warranted to realise hemp-enriched functional beers. Full article
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22 pages, 1078 KiB  
Review
The Cannabinoid Pharmacology of Bone Healing: Developments in Fusion Medicine
by Gabriel Urreola, Michael Le, Alan Harris, Jose A. Castillo, Augustine M. Saiz, Hania Shahzad, Allan R. Martin, Kee D. Kim, Safdar Khan and Richard Price
Biomedicines 2025, 13(8), 1891; https://doi.org/10.3390/biomedicines13081891 - 3 Aug 2025
Viewed by 21
Abstract
Background/Objectives: Cannabinoid use is rising among patients undergoing spinal fusion, yet its influence on bone healing is poorly defined. The endocannabinoid system (ECS)—through cannabinoid receptors 1 (CB1) and 2 (CB2)—modulates skeletal metabolism. We reviewed preclinical, mechanistic and clinical evidence to clarify how individual [...] Read more.
Background/Objectives: Cannabinoid use is rising among patients undergoing spinal fusion, yet its influence on bone healing is poorly defined. The endocannabinoid system (ECS)—through cannabinoid receptors 1 (CB1) and 2 (CB2)—modulates skeletal metabolism. We reviewed preclinical, mechanistic and clinical evidence to clarify how individual cannabinoids affect fracture repair and spinal arthrodesis. Methods: PubMed, Web of Science and Scopus were searched from inception to 31 May 2025 with the terms “cannabinoid”, “CB1”, “CB2”, “spinal fusion”, “fracture”, “osteoblast” and “osteoclast”. Animal studies, in vitro experiments and clinical reports that reported bone outcomes were eligible. Results: CB2 signaling was uniformly osteogenic. CB2-knockout mice developed high-turnover osteoporosis, whereas CB2 agonists (HU-308, JWH-133, HU-433, JWH-015) restored trabecular volume, enhanced osteoblast activity and strengthened fracture callus. Cannabidiol (CBD), a non-psychoactive phytocannabinoid with CB2 bias, accelerated early posterolateral fusion in rats and reduced the RANKL/OPG ratio without compromising final union. In contrast, sustained or high-dose Δ9-tetrahydrocannabinol (THC) activation of CB1 slowed chondrocyte hypertrophy, decreased mesenchymal-stromal-cell mineralization and correlated clinically with 6–10% lower bone-mineral density and a 1.8–3.6-fold higher pseudarthrosis or revision risk. Short-course or low-dose THC appeared skeletal neutral. Responses varied with sex, age and genetic background; no prospective trials defined safe perioperative dosing thresholds. Conclusions: CB2 activation and CBD consistently favor bone repair, whereas chronic high-THC exposure poses a modifiable risk for nonunion in spine surgery. Prospective, receptor-specific trials stratified by THC/CBD ratio, patient sex and ECS genotype are needed to establish evidence-based cannabinoid use in spinal fusion. Full article
(This article belongs to the Topic Cannabis, Cannabinoids and Its Derivatives)
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40 pages, 1142 KiB  
Review
The Blurred Lines Between New Psychoactive Substances and Potential Chemical Weapons
by Loreto N. Valenzuela-Tapia, Cristóbal A. Quintul, Nataly D. Rubio-Concha, Luis Toledo-Ríos, Catalina Salas-Kuscevic, Andrea V. Leisewitz, Pamela Cámpora-Oñate and Javier Campanini-Salinas
Toxics 2025, 13(8), 659; https://doi.org/10.3390/toxics13080659 - 1 Aug 2025
Viewed by 159
Abstract
The historical use of toxic chemicals to cause intentional harm has evolved from blister agents in World War I to highly lethal organophosphates and emerging families of chemicals, such as Novichok. In turn, medical or recreational substances like fentanyl, lysergamides, and phencyclidine pose [...] Read more.
The historical use of toxic chemicals to cause intentional harm has evolved from blister agents in World War I to highly lethal organophosphates and emerging families of chemicals, such as Novichok. In turn, medical or recreational substances like fentanyl, lysergamides, and phencyclidine pose a growing risk of hostile use, particularly related to the rapid proliferation of new psychoactive substances (NPSs). A narrative literature review was conducted covering specialized databases (PubMed, ScienceDirect, SciELO, Google Scholar) and sources from international organizations (OPCW, UNODC, ONU), analyzing historical and recent cases of the use of nerve agents in conflicts and the use of NPSs for hostile purposes. The main families of conventional agents (G, V, A series, and Novichok) and NPSs (lysergamides, PCP, fentanyl derivatives) were identified, highlighting their ease of synthesis, high toxicity profiles, and the regulatory gaps that facilitate their illicit production. In this scenario, it is essential to strengthen regulatory frameworks, surveillance systems, and ethical protocols in chemical research, as well as to promote international cooperation to prevent these substances from becoming chemical threats. Full article
(This article belongs to the Section Drugs Toxicity)
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12 pages, 275 KiB  
Article
Sexual Orientation and Gender Identity Associated with Sexual Practices, Psychoactive Substance Use and Sexually Transmitted Infections Among HIV PrEP Users
by Marcos Morais Santos Silva, Lucas Cardoso dos Santos, Mayara Maria Souza de Almeida and Lucia Yasuko Izumi Nichiata
Healthcare 2025, 13(15), 1841; https://doi.org/10.3390/healthcare13151841 - 29 Jul 2025
Viewed by 332
Abstract
HIV disproportionately affects key populations (MSM, transgender people, sex workers and psychoactive substance users), who face greater social vulnerability and limited healthcare access. This study aimed at analyzing sexual orientation and gender identity and their association with sexual practices, sexually transmitted infections and [...] Read more.
HIV disproportionately affects key populations (MSM, transgender people, sex workers and psychoactive substance users), who face greater social vulnerability and limited healthcare access. This study aimed at analyzing sexual orientation and gender identity and their association with sexual practices, sexually transmitted infections and psychoactive substance use among PrEP users. Method: A cross-sectional study was conducted between January 2018 and June 2021 with 736 Brazilian PrEP users from a health service in São Paulo. Sociodemographic data, sexual behaviors, STI history (past 3 months) and psychoactive substances use (past 3 months) were extracted from clinical records. The associations were analyzed using binomial logistic regression (p < 0.05). Results: Most of the participants were cisgender men (93.4%) and homosexual (84.8%), with a mean age of 34.9 years old. Condomless sex was reported by 98.5%, and 18.4% had some recent sexually transmitted infection, mainly syphilis. Psychoactive substance use was reported by 55.4%, especially marijuana, club drugs, erectile stimulants and poppers. Transgender and cisgender women were more likely to report sex work and crack use. Homosexual and bisexual participants had higher odds of using erectile stimulants. Conclusions: The study reveals key links between gender, sexual orientation and risk behaviors, highlighting the need for inclusive, targeted prevention. Full article
(This article belongs to the Special Issue Gender, Sexuality and Mental Health)
15 pages, 259 KiB  
Article
COVID-19 Pandemic and Sleep Health in Polish Female Students
by Mateusz Babicki, Tomasz Witaszek and Agnieszka Mastalerz-Migas
J. Clin. Med. 2025, 14(15), 5342; https://doi.org/10.3390/jcm14155342 - 29 Jul 2025
Viewed by 187
Abstract
Background: Insomnia and excessive sleepiness are significant health problems with a complex etiology, increasingly affecting young people, especially students. This study aimed to assess the prevalence of sleep disturbances and patterns of psychoactive drug use among female Polish students. We also explored [...] Read more.
Background: Insomnia and excessive sleepiness are significant health problems with a complex etiology, increasingly affecting young people, especially students. This study aimed to assess the prevalence of sleep disturbances and patterns of psychoactive drug use among female Polish students. We also explored the potential impact of the COVID-19 pandemic on sleep behaviors. We hypothesized that sleep disorders are common in this group, that medical students are more likely to experience insomnia and excessive sleepiness, and that the pandemic has exacerbated both sleep disturbances and substance use. Methods: This cross-sectional study utilized a custom survey designed using standardized questionnaires—the Athens Insomnia Scale and Epworth Sleepiness Scale—that was distributed online using the Computer-Assisted Web Interviewing method. A total of 11,988 responses were collected from 31 January 2016 to 1 January 2021. Inclusion criteria were being female, having a college student status, and giving informed consent. Results: Among the 11,988 participants, alcohol use declined after the pandemic began (p = 0.001), while sedative use increased (p < 0.001). Insomnia (AIS) was associated with study year, university profile, and field of study (p < 0.001), with the highest rates in first-year and non-medical students. It was more common among users of sedatives, psychostimulants, and multiple substances. No significant change in insomnia was found before and after the pandemic. Excessive sleepiness (ESS) peaked in first-year and medical students. It decreased during the pandemic (p < 0.001) and was linked to the use of alcohol, psychostimulants, cannabinoids, and multiple substances. Conclusions: These findings highlight that female students are particularly vulnerable to sleep disorders. The influence of the COVID-19 pandemic on sleep disturbances remains inconclusive. Given the varied results in the existing literature, further research is needed. Full article
(This article belongs to the Section Epidemiology & Public Health)
28 pages, 1775 KiB  
Review
Forensic Narcotics Drug Analysis: State-of-the-Art Developments and Future Trends
by Petar Ristivojević, Božidar Otašević, Petar Todorović and Nataša Radosavljević-Stevanović
Processes 2025, 13(8), 2371; https://doi.org/10.3390/pr13082371 - 25 Jul 2025
Viewed by 513
Abstract
Narcotics trafficking is a fundamental part of organized crime, posing significant and evolving challenges for forensic investigations. Addressing these challenges requires rapid, precise, and scientifically validated analytical methods for reliable identification of illicit substances. Over the past five years, forensic drug testing has [...] Read more.
Narcotics trafficking is a fundamental part of organized crime, posing significant and evolving challenges for forensic investigations. Addressing these challenges requires rapid, precise, and scientifically validated analytical methods for reliable identification of illicit substances. Over the past five years, forensic drug testing has advanced considerably, improving detection of traditional drugs—such as tetrahydrocannabinol, cocaine, heroin, amphetamine-type stimulants, and lysergic acid diethylamide—as well as emerging new psychoactive substances (NPS), including synthetic cannabinoids (e.g., 5F-MDMB-PICA), cathinones (e.g., α-PVP), potent opioids (e.g., carfentanil), designer psychedelics (e.g., 25I-NBOMe), benzodiazepines (e.g., flualprazolam), and dissociatives (e.g., 3-HO-PCP). Current technologies include colorimetric assays, ambient ionization mass spectrometry, and chromatographic methods coupled with various detectors, all enhancing accuracy and precision. Vibrational spectroscopy techniques, like Raman and Fourier transform infrared spectroscopy, have become essential for non-destructive identification. Additionally, new sensors with disposable electrodes and miniaturized transducers allow ultrasensitive on-site detection of drugs and metabolites. Advanced chemometric algorithms extract maximum information from complex data, enabling faster and more reliable identifications. An important emerging trend is the adoption of green analytical methods—including direct analysis, solvent-free extraction, miniaturized instruments, and eco-friendly chromatographic processes—that reduce environmental impact without sacrificing performance. This review provides a comprehensive overview of innovations over the last five years in forensic drug analysis based on the ScienceDirect database and highlights technological trends shaping the future of forensic toxicology. Full article
(This article belongs to the Special Issue Feature Review Papers in Section “Pharmaceutical Processes”)
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39 pages, 2934 KiB  
Review
Phytocannabinoids as Novel SGLT2 Modulators for Renal Glucose Reabsorption in Type 2 Diabetes Management
by Raymond Rubianto Tjandrawinata, Dante Saksono Harbuwono, Sidartawan Soegondo, Nurpudji Astuti Taslim and Fahrul Nurkolis
Pharmaceuticals 2025, 18(8), 1101; https://doi.org/10.3390/ph18081101 - 24 Jul 2025
Viewed by 457
Abstract
Background: Sodium–glucose cotransporter 2 (SGLT2) inhibitors have transformed type 2 diabetes mellitus (T2DM) management by promoting glucosuria, lowering glycated hemoglobin (HbA1c), blood pressure, and weight; however, their use is limited by genitourinary infections and ketoacidosis. Phytocannabinoids—bioactive compounds from Cannabis sativa—exhibit multi-target [...] Read more.
Background: Sodium–glucose cotransporter 2 (SGLT2) inhibitors have transformed type 2 diabetes mellitus (T2DM) management by promoting glucosuria, lowering glycated hemoglobin (HbA1c), blood pressure, and weight; however, their use is limited by genitourinary infections and ketoacidosis. Phytocannabinoids—bioactive compounds from Cannabis sativa—exhibit multi-target pharmacology, including interactions with cannabinoid receptors, Peroxisome Proliferator-Activated Receptors (PPARs), Transient Receptor Potential (TRP) channels, and potentially SGLT2. Objective: To evaluate the potential of phytocannabinoids as novel modulators of renal glucose reabsorption via SGLT2 and to compare their efficacy, safety, and pharmacological profiles with synthetic SGLT2 inhibitors. Methods: We performed a narrative review encompassing the following: (1) the molecular and physiological roles of SGLT2; (2) chemical classification, natural sources, and pharmacokinetics/pharmacodynamics of major phytocannabinoids (Δ9-Tetrahydrocannabinol or Δ9-THC, Cannabidiol or CBD, Cannabigerol or CBG, Cannabichromene or CBC, Tetrahydrocannabivarin or THCV, and β-caryophyllene); (3) in silico docking and drug-likeness assessments; (4) in vitro assays of receptor binding, TRP channel modulation, and glucose transport; (5) in vivo rodent models evaluating glycemic control, weight change, and organ protection; (6) pilot clinical studies of THCV and case reports of CBD/BCP; (7) comparative analysis with established synthetic inhibitors. Results: In silico studies identify high-affinity binding of several phytocannabinoids within the SGLT2 substrate pocket. In vitro, CBG and THCV modulate SGLT2-related pathways indirectly via TRP channels and CB receptors; direct IC50 values for SGLT2 remain to be determined. In vivo, THCV and CBD demonstrate glucose-lowering, insulin-sensitizing, weight-reducing, anti-inflammatory, and organ-protective effects. Pilot clinical data (n = 62) show that THCV decreases fasting glucose, enhances β-cell function, and lacks psychoactive side effects. Compared to synthetic inhibitors, phytocannabinoids offer pleiotropic benefits but face challenges of low oral bioavailability, polypharmacology, inter-individual variability, and limited large-scale trials. Discussion: While preclinical and early clinical data highlight phytocannabinoids’ potential in SGLT2 modulation and broader metabolic improvement, their translation is impeded by significant challenges. These include low oral bioavailability, inconsistent pharmacokinetic profiles, and the absence of standardized formulations, necessitating advanced delivery system development. Furthermore, the inherent polypharmacology of these compounds, while beneficial, demands comprehensive safety assessments for potential off-target effects and drug interactions. The scarcity of large-scale, well-controlled clinical trials and the need for clear regulatory frameworks remain critical hurdles. Addressing these aspects is paramount to fully realize the therapeutic utility of phytocannabinoids as a comprehensive approach to T2DM management. Conclusion: Phytocannabinoids represent promising multi-target agents for T2DM through potential SGLT2 modulation and complementary metabolic effects. Future work should focus on pharmacokinetic optimization, precise quantification of SGLT2 inhibition, and robust clinical trials to establish efficacy and safety profiles relative to synthetic inhibitors. Full article
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21 pages, 810 KiB  
Review
Molecular Crosstalk and Therapeutic Synergy: Tyrosine Kinase Inhibitors and Cannabidiol in Oral Cancer Treatment
by Zainab Saad Ghafil AlRaheem, Thao T. Le, Ali Seyfoddin and Yan Li
Curr. Issues Mol. Biol. 2025, 47(8), 584; https://doi.org/10.3390/cimb47080584 - 23 Jul 2025
Viewed by 293
Abstract
Head and neck squamous cell carcinoma (HNSCC) is the sixth most common malignancy worldwide, with oral squamous cell carcinoma (OSCC) accounting for a significant portion of cases. Despite advancements in treatment, only modest gains have been made in HNSCC/OSCC control. Epidermal growth factor [...] Read more.
Head and neck squamous cell carcinoma (HNSCC) is the sixth most common malignancy worldwide, with oral squamous cell carcinoma (OSCC) accounting for a significant portion of cases. Despite advancements in treatment, only modest gains have been made in HNSCC/OSCC control. Epidermal growth factor receptor (EGFR) tyrosine kinase inhibitors (TKIs) have emerged as targeted therapies for OSCC in clinical trials. However, their clinical efficacy remains a challenge. Cannabidiol (CBD), a non-psychoactive phytochemical from cannabis, has demonstrated anticancer and immunomodulatory properties. CBD induces apoptosis and autophagy and modulates signaling pathways often dysregulated in HNSCC. This review summarizes the molecular mechanisms of EGFR-TKIs and CBD and their clinical insights and further discusses potential implications of combination targeted therapies. Full article
(This article belongs to the Special Issue Novel Drugs and Natural Products Discovery)
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18 pages, 3083 KiB  
Article
Targeting Vascular and Inflammatory Crosstalk: Cannabigerol as a Dual-Pathway Modulator in Rosacea
by Suji Kim and Ji Hyun Lee
Int. J. Mol. Sci. 2025, 26(14), 6840; https://doi.org/10.3390/ijms26146840 - 16 Jul 2025
Viewed by 273
Abstract
Rosacea is a chronic inflammatory skin condition characterized by persistent erythema and abnormal vascular response. Although current treatments focus on symptomatic relief, they often provide only temporary improvement and may be associated with side effects or recurrence. Cannabigerol (CBG), a non-psychoactive cannabinoid, has [...] Read more.
Rosacea is a chronic inflammatory skin condition characterized by persistent erythema and abnormal vascular response. Although current treatments focus on symptomatic relief, they often provide only temporary improvement and may be associated with side effects or recurrence. Cannabigerol (CBG), a non-psychoactive cannabinoid, has recently garnered attention for its pharmacological activities, including anti-inflammatory, antioxidant, neuroprotective, and skin barrier–supportive effects. However, its role in modulating pathological responses in rosacea remains unclear. In this study, we investigated the therapeutic potential of topically applied CBG in an LL-37-induced rosacea-like mouse model. Clinical and histological assessments revealed that CBG markedly reduced erythema, epidermal hyperplasia, and mast cell infiltration. Quantitative reverse transcription polymerase chain reaction (qRT-PCR) showed downregulation of Il1b, Il4, Il6, Il13, Il22, Il31, Tlr2, Vegfa, and Mmp9. Immunohistochemistry and Western blot analyses further demonstrated suppression of CD31, vascular endothelial growth factor (VEGF), and Yes-associated protein (YAP) and transcriptional coactivator with PDZ-binding motif (TAZ), along with reduced activation of the Janus kinase/signal transducer and activator of transcription (JAK/STAT) pathway, including decreased levels of JAK1, STAT3, and phosphorylated STAT3. These findings suggest that topical CBG alleviates rosacea-like skin inflammation by targeting inflammatory and vascular pathways, including JAK/STAT and YAP/TAZ signaling. Full article
(This article belongs to the Special Issue Molecular Research Progress of Skin and Skin Diseases: 2nd Edition)
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8 pages, 212 KiB  
Case Report
‘Crystal Meth’ Use in an Addiction Outpatient Clinic in Italy: A Multifaceted Challenge
by Filippo Besana, Stefano Pasquariello, Attilio Negri and Valentina Costa
Psychoactives 2025, 4(3), 25; https://doi.org/10.3390/psychoactives4030025 - 16 Jul 2025
Viewed by 307
Abstract
Shaboo is a street name commonly used in parts of Asia, particularly the Philippines and Thailand, to refer to methamphetamine, a powerful and highly addictive stimulant. Its long-term effects are related to chronic exposure to the drug effects, primarily neurotoxicity phenomena, which could [...] Read more.
Shaboo is a street name commonly used in parts of Asia, particularly the Philippines and Thailand, to refer to methamphetamine, a powerful and highly addictive stimulant. Its long-term effects are related to chronic exposure to the drug effects, primarily neurotoxicity phenomena, which could lead to cognitive impairment, or psychiatric symptoms. We aim to present one case of problematic shaboo use in a patient referring to an addiction outpatient clinic in Northern Italy. This case highlights that the treatment of these patients involves careful multidisciplinary management. An accurate knowledge of the physical and psychological effects of New Psychoactive Substances is essential, as well as the implementation of a tailored psychological and social support program. Full article
19 pages, 769 KiB  
Systematic Review
Ayahuasca, Pain, and Inflammation: A Systematic Review of Preclinical Studies
by Bianca Villanova, Giordano Novak Rossi, Lorena Terene Lopes Guerra, José Carlos Bouso, Jaime Eduardo Cecilio Hallak and Rafael Guimarães dos Santos
Psychoactives 2025, 4(3), 24; https://doi.org/10.3390/psychoactives4030024 - 15 Jul 2025
Viewed by 427
Abstract
Pain is a protective mechanism that can be classified into acute and chronic types. Ayahuasca is a psychoactive brew rich in dimethyltryptamine or DMT (a 5-HT2A receptor agonist), and harmine (a monoamine-oxidase (MAO) inhibitor) used for religious and therapeutic purposes. Previous preclinical [...] Read more.
Pain is a protective mechanism that can be classified into acute and chronic types. Ayahuasca is a psychoactive brew rich in dimethyltryptamine or DMT (a 5-HT2A receptor agonist), and harmine (a monoamine-oxidase (MAO) inhibitor) used for religious and therapeutic purposes. Previous preclinical and anecdotal evidence suggests that ayahuasca and its compounds have antinociceptive and anti-inflammatory effects due to 5-HT2A agonism and MAO inhibition. Thus, the current study aims to provide a systematic review of the antinociceptive and anti-inflammatory effects of ayahuasca and its alkaloids in preclinical models. All studies published up to December 2024 were screened and evaluated for eligibility. A total of 1535 publications were identified, of which 29 adhered to the predefined criteria. Reviewed articles reported antinociceptive effects of ayahuasca, harmine, and harmaline. Regarding anti-inflammatory effects, the compounds of ayahuasca, especially harmine, have demonstrated a reduction and an increase in pro-inflammatory and anti-inflammatory cytokines, respectively. Although there are promising results regarding the antinociceptive and anti-inflammatory effects of ayahuasca and its alkaloids, further investigation is needed. Full article
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13 pages, 381 KiB  
Review
Overdose Epidemic in Québec: Population-Level Approaches and Clinical Implications
by Samuel Cholette-Tétrault, Nissrine Ammari and Mehrshad Bakhshi
Psychoactives 2025, 4(3), 23; https://doi.org/10.3390/psychoactives4030023 - 13 Jul 2025
Viewed by 347
Abstract
Canada’s national surveillance shows an 11% year-over-year decline in deaths from opioid and other unregulated drug poisonings, and a 10% drop in related hospitalisations in 2024. In stark contrast, Québec, home to more than nine million residents, and Montréal, the country’s second-largest city, [...] Read more.
Canada’s national surveillance shows an 11% year-over-year decline in deaths from opioid and other unregulated drug poisonings, and a 10% drop in related hospitalisations in 2024. In stark contrast, Québec, home to more than nine million residents, and Montréal, the country’s second-largest city, experienced a continued rise in suspected drug-poisoning mortality through 2024, with fentanyl or analogues detected in almost two-thirds of opioid deaths. We conducted a narrative synthesis of provincial coroner and public-health surveillance tables, Health Canada dashboards, and the 2022–2025 Québec Strategy on Psychoactive-Substance Overdose Prevention. Results indicate a 40% increase in opioid-related mortality since 2018, a parallel uptick in stimulant toxicity, and a five-fold rise in overdose reversals at Montréal supervised-consumption services during the COVID-19 pandemic recovery. We aim to summarise the key problems underlying this epidemic and offer province-specific public-health strategies while also sending a call to action for first-line clinicians and psychiatrists to integrate overdose-risk screening, take-home naloxone, and stimulant-use-disorder treatments into routine care. We further urge Québec healthcare professionals to deepen their knowledge of provincial services such as supervised-injection sites and stay up to date with the rapidly evolving substance-use-prevention literature. Québec’s divergent trajectory underscores the need for region-tailored harm-reduction investments and stronger policy-to-clinic feedback loops to reduce preventable deaths. Full article
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17 pages, 643 KiB  
Review
Current Pharmacotherapies for Alcohol Use Disorder in Italy: From Neurobiological Targets to Clinical Practice
by Andrea Mastrostefano, Giuseppe Greco, Chiara De Bacco, Flavio Davini, Giacomo Polito, Edoardo Carnevale, Giuseppe Anastasi and Sergio Terracina
Targets 2025, 3(3), 24; https://doi.org/10.3390/targets3030024 - 11 Jul 2025
Viewed by 303
Abstract
Alcohol is a prevalent psychoactive substance and a risk factor for developing injuries and non-communicable diseases, representing a significant health and economic burden. Alcohol involves numerous molecular pathways. Its metabolism is regulated by alcohol dehydrogenases and aldehyde dehydrogenases; it also stimulates cholinergic interneurons, [...] Read more.
Alcohol is a prevalent psychoactive substance and a risk factor for developing injuries and non-communicable diseases, representing a significant health and economic burden. Alcohol involves numerous molecular pathways. Its metabolism is regulated by alcohol dehydrogenases and aldehyde dehydrogenases; it also stimulates cholinergic interneurons, increasing the sensitivity of 5-HT3 receptors, while chronic alcohol consumption alters the mesolimbic dopaminergic system involved in reward processing. The treatment of alcohol use disorder (AUD) is essential to manage complex patients, following an evidence-based approach. The aim of this narrative review is to provide a clear and practical summary to support and assist healthcare professionals in the Italian context. Approved pharmacological treatments for AUD include oral naltrexone and acamprosate, sodium oxybate, disulfiram, and nalmefene. Off-label therapies include baclofen, topiramate, gabapentin, pregabalin, ondansetron, and cytisine. A more informed clinical and practical approach that understands the altered neuronal signaling pathways is essential for offering effective, efficient, appropriate, and safe therapeutic algorithms for complex patients with alcohol use disorder. A comprehensive framework should include integrated treatments with a personalized approach. Full article
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32 pages, 3113 KiB  
Review
Exploring the Impact of Chirality of Synthetic Cannabinoids and Cathinones: A Systematic Review on Enantioresolution Methods and Enantioselectivity Studies
by Ana Sofia Almeida, Rita M. G. Santos, Paula Guedes de Pinho, Fernando Remião and Carla Fernandes
Int. J. Mol. Sci. 2025, 26(13), 6471; https://doi.org/10.3390/ijms26136471 - 4 Jul 2025
Viewed by 388
Abstract
New psychoactive substances (NPSs) are emerging narcotics or psychotropics that pose a public health risk. The most commonly reported NPSs are synthetic cannabinoids and synthetic cathinones. Synthetic cannabinoids mimic the effects of Δ9-tetrahydrocannabinol (Δ9-THC), often with greater potency, while synthetic cathinones act as [...] Read more.
New psychoactive substances (NPSs) are emerging narcotics or psychotropics that pose a public health risk. The most commonly reported NPSs are synthetic cannabinoids and synthetic cathinones. Synthetic cannabinoids mimic the effects of Δ9-tetrahydrocannabinol (Δ9-THC), often with greater potency, while synthetic cathinones act as stimulants, frequently serving as cheaper alternatives to amphetamines, 3,4-methylenedioxymethamphetamine (MDMA) and cocaine. While some synthetic cannabinoids exhibit chirality depending on their synthesis precursors, synthetic cathinones are intrinsically chiral. Biotargets can recognize and differentiate between enantiomers, leading to distinct biological responses (enantioselectivity). Understanding these differences is crucial; therefore, the development of enantioresolution methods to assess the biological and toxicological effects of enantiomer is necessary. This work systematically compiles enantioselectivity studies and enantioresolution methods of synthetic cannabinoids and synthetic cathinones, following PRISMA guidelines. The main aim of this review is to explore the impact of chirality on these NPSs, improving our understanding of their toxicological behavior and evaluating advances in analytical techniques for their enantioseparation. Key examples from both groups are presented. This review highlights the importance of continuing research in this field, as demonstrated by the differing properties of synthetic cannabinoid and synthetic cathinone enantiomers, which are closely linked to variations in biological and toxicological outcomes. Full article
(This article belongs to the Section Biochemistry)
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17 pages, 1064 KiB  
Article
Assessment of Abuse Potential of Three Indazole-Carboxamide Synthetic Cannabinoids 5F-ADB, MDMB-4en-PINACA and ADB-4en-PINACA
by Yanling Qiao, Xuesong Shi, Kaixi Li, Lixin Kuai, Xiangyu Li, Bin Di and Peng Xu
Int. J. Mol. Sci. 2025, 26(13), 6409; https://doi.org/10.3390/ijms26136409 - 3 Jul 2025
Viewed by 474
Abstract
5F-ADB, MDMB-4en-PINACA and ADB-4en-PINACA are three potent indazole-carboxamide synthetic cannabinoids (SCs) that have been widely abused in recent years. However, the pharmacological research on these compounds remains limited, especially in vivo research data. The purpose of the present study was to investigate the [...] Read more.
5F-ADB, MDMB-4en-PINACA and ADB-4en-PINACA are three potent indazole-carboxamide synthetic cannabinoids (SCs) that have been widely abused in recent years. However, the pharmacological research on these compounds remains limited, especially in vivo research data. The purpose of the present study was to investigate the pharmacological effects of 5F-ADB, MDMB-4en-PINACA and ADB-4en-PINACA in mice, comparing their in vivo effects with those caused by Δ9-tetrahydrocannabinol (Δ9-THC), the main psychoactive substance in cannabis. We evaluated the cannabinoid-specific pharmacological effects of 5F-ADB, MDMB-4en-PINACA and ADB-4en-PINACA using the tetrad assay (locomotion inhibition, hypothermia, analgesia and catalepsy). Then we conducted conditioned place preference (CPP) and precipitated withdrawal assay to assess the rewarding effect and physical dependence, with Δ9-THC as a positive control. The results showed that all of the three SCs exhibited potential tetrad effects in a dose-dependent manner, with median effective dose (ED50) values ranging from 0.03 to 0.77 mg/kg. In the CPP tests, they all exhibited a significant biphasic effect of conditioned place preference (CPP) and conditioned place aversion (CPA). A significant increase in paw tremors and head twitches was observed in the rimonabant-precipitated withdrawal assay, indicating that the repeated administration of these SCs can lead to potential physical dependence. All effective doses were lower than Δ9-THC. These findings strongly suggested that the three SCs exhibited similar but stronger cannabinoid-specific tetrad effects, rewarding effect and physical dependence compared with Δ9-THC, indicating their high abuse potential and possible threats to human health. The rank order of abuse potential for these drugs was 5F-ADB > MDMB-4en-PINACA > ADB-4en-PINACA > Δ9-THC. Full article
(This article belongs to the Section Molecular Pharmacology)
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