Search Results (315)

In recent years, the consumption of Amanita muscaria has gained popularity as a perceived natural alternative to psychoactive substances, often promoted online for its supposed therapeutic properties. However, the safety of such preparations remains largely unverified, particularly with regard to toxic element content. The present study focused on evaluating how different preparation methods affect the concentrations of cadmium (Cd) and lead (Pb) in the most commonly consumed Amanita muscaria products. A total of 50 mushroom caps were collected in October 2024 from the Stąporków Forest District in central Poland. Seven types of preparations were analyzed: dried with skin, dried without skin, tincture (mineralized and direct), boiled, fermented, infusion, and decoction. Samples were analyzed using atomic absorption spectrometry (AAS); depending on the preparation type, some underwent acid digestion prior to measurement. Statistically significant differences in lead concentrations were observed between the various preparation types (p = 0.002; η² = 0.97). Lead levels in the direct tincture were significantly higher than those in the boiled (p = 0.001), infusion (p = 0.001), decoction (p = 0.009), and dried without skin (p = 0.04) forms. Significant differences in cadmium concentrations were also found (p = 0.006; η² = 0.94), with lower Cd levels in the decoction compared to the dried with skin (p = 0.009) and without skin (p = 0.001), as well as in the fermented form compared to the dried samples (p = 0.03 and p = 0.004, respectively). These findings demonstrate that the type of preparation significantly influences the levels of cadmium and lead in Amanita muscaria products. While aqueous and fermented preparations showed reduced metal concentrations, none can be considered entirely safe, as even lower levels of Cd and Pb may pose health risks with frequent or excessive consumption. Full article

Substance use during pregnancy is an increasingly important yet under-recognized threat to maternal and child health. This narrative review synthesizes the current evidence available on the epidemiology, pathophysiology, clinical management, and policy landscape of prenatal exposure to alcohol, tobacco, opioids, benzodiazepines, cocaine, cannabis, methamphetamines, and other synthetic drugs. All major psychoactive substances readily cross the placenta and can remain detectable in breast milk, leading to a shared cascade of obstetric complications (hypertensive disorders, placental abruption, pre-term labor), fetal consequences (growth restriction, structural malformations), and neonatal morbidities such as neonatal abstinence syndrome and sudden infant death. Mechanistically, trans-placental diffusion, oxidative stress, inflammatory signaling, and placental vascular dysfunction converge to disrupt critical neuro- and cardiovascular developmental windows. Early identification hinges on the combined use of validated screening questionnaires (4 P’s Plus, CRAFFT, T-ACE, AUDIT-C, TWEAK) and matrix-specific biomarkers (PEth, EtG, FAEE, CDT), while effective treatment requires integrated obstetric, addiction, and mental health services. Medication for opioid use disorders, particularly buprenorphine, alone or with naloxone, confers superior neonatal outcomes compared to methadone and underscores the value of harm-reducing non-punitive care models. Public-health strategies, such as Mexico’s “first 1 000 days” framework, wrap-around clinics, and home-visiting programs, demonstrate the potential of multisectoral interventions, but are hampered by structural inequities and punitive legislation that deter care-seeking. Research gaps persist in polysubstance exposure, culturally tailored therapies, and long-term neurodevelopmental trajectories. Multigenerational, omics-enabled cohorts, and digital longitudinal-care platforms represent promising avenues for closing these gaps and informing truly preventive perinatal health policies. Full article

Numerous individuals suffer from mental health issues including depression and anxiety, resulting in substantial societal burden. Data suggests individuals are choosing to self-medicate with Novel Psychoactive Substances (NPS); however, this phenomenon is poorly understood. We aimed to investigate which NPS are being used to self-medicate, evaluate their perceived effectiveness and examine influencing factors. Data from respondents (n = 274) (Mean Age [SD] = 29.8 ± 9.1, Male = 71%, Female = 18%, non-binary 5%) were collected via an online survey, with five participants (male = 2; nonbinary = 3) undertaking further semi-structured interviews and the data examined using a Framework analysis. NPS used included bromazolam, etizolam, clonazolam, 1P-LSD and 2-FDCK. Individuals perceived self-medication to be more effective than conventional treatment (p < 0.001). A Framework analysis identified the following themes surrounding mood and anxiety disorder self-medication: (1) depression being chronic, treatment resistant and often comorbid; (2) individuals attempting to mimic existing treatments; (3) individuals having high levels of pharmacological knowledge; (4) difficulties in controlling benzodiazepine self-medication. This study brings important insight into self-medication practices with NPSs, adding to data demonstrating an increase in bromazolam use. Data suggests self-medication follows conventional treatment and, therefore, we outline the importance of affordable emerging treatment options for depression and anxiety. Full article

New psychoactive substances (NPSs) have emerged as a significant global public health challenge due to their ability to mimic traditional drugs. Among these, mephedrone has gained attention because of its widespread use and associated toxicities. This review provides a comprehensive analysis of the structure, pharmacokinetic properties, and metabolic pathways of mephedrone, highlighting its phase I and phase II metabolites as potential biomarkers for detection and forensic applications. A comprehensive literature search was performed without date restrictions. The search employed key terms such as “mephedrone metabolites”, “pharmacokinetics of mephedrone”, “phase I metabolites of mephedrone”, and “phase II metabolites of mephedrone”. Additionally, the reference lists of selected studies were screened to ensure a thorough review of the literature. Mephedrone is a chiral compound existing in two enantiomeric forms, exhibiting different affinities for monoamine transporters and distinct pharmacological profiles. In vivo animal studies indicate rapid absorption, significant tissue distribution, and the formation of multiple phase I metabolites (e.g., normephedrone, dihydromephedrone, 4-carboxymephedrone) that influence its neurochemical effects. Phase II metabolism involves conjugation reactions leading to metabolites such as N-succinyl-normephedrone and N-glutaryl-normephedrone, further complicating its metabolic profile. These findings underscore the importance of elucidating mephedrone’s metabolic pathways to improve detection methods, enhance our understanding of its toxicological risks, and inform future therapeutic strategies. Full article

Tau protein is essential for the structural stability of neurons, particularly through its role in microtubule assembly and axonal transport. However, when abnormally hyperphosphorylated or cleaved, Tau can aggregate into insoluble forms that disrupt neuronal function, contributing to the pathogenesis of neurodegenerative diseases such as Alzheimer’s disease (AD). Emerging evidence suggests that similar Tau-related alterations may occur in individuals with chronic exposure to psychoactive substances. This review compiles experimental, clinical, and postmortem findings that collectively indicate a substance-specific influence on Tau dynamics. Alcohol and opioids, for instance, promote Tau hyperphosphorylation and fragmentation through the activation of kinases such as GSK-3β and CDK5, as well as proteases like caspase-3, leading to neuroinflammation and microglial activation. Stimulants and dissociatives disrupt insulin signaling, increase oxidative stress, and impair endosomal trafficking, all of which can exacerbate Tau pathology. In contrast, cannabinoids and psychedelics may exert protective effects by modulating kinase activity, reducing inflammation, or enhancing neuroplasticity. Psychedelic compounds such as psilocybin and harmine have been demonstrated to decrease Tau phosphorylation and facilitate cognitive restoration in animal models. Although the molecular mechanisms differ across substances, Tau consistently emerges as a convergent target altered in substance-related cognitive disorders. Understanding these pathways may provide not only mechanistic insights into drug-induced neurotoxicity but also identify Tau as a valuable biomarker and potential therapeutic target for the prevention or treatment of cognitive decline associated with substance use. Full article

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

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

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

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

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

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

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

Background/Objectives: The homeless population (HP) is a heterogeneous group characterized by the absence of stable and conventional housing, often relying on public spaces and deteriorated environments for shelter and survival, either temporarily or permanently. This group is exposed to multiple health vulnerabilities, with substance use disorder (SUD) identified as a significant risk factor for suicidal behavior. The aim of this study was to conduct a scoping review of the relationship between PAS use and suicide among homeless individuals. Methods: A comprehensive literature search was performed using five databases: PubMed, Scopus, SciELO, LILACS, and Google Scholar. Studies were selected based on their relevance to the topic, and data were extracted regarding substance use, suicide-related outcomes, and associated sociodemographic and clinical factors. Results: The findings indicated a strong association between PAS use and increased suicidal ideation and behavior among homeless individuals, particularly among youth, men, and women. Opioids and alcohol were the most frequently reported substances in this context. Additional factors such as unemployment, exposure to violence, social inequalities, and mental health disorders further exacerbated the risk of suicide in this population Conclusions: The reviewed literature underscores the urgent need for integrated, context-sensitive interventions addressing both substance use and mental health among the homeless. Tailored public health strategies focused on prevention, harm reduction, and psychosocial support are essential to reducing suicide risk and promoting overall well-being in this highly vulnerable group. Full article

Introduction: Caffeine, in the form of coffee, tea and energy drinks, is recognised as the world’s most utilised psychoactive substance and consumed by approximately 80% of the global population daily. Emerging studies have suggested a more complex relationship in terms of the mental health outcomes that can arise after consumption. This is the first systematic review and meta-analysis that aims to explore the effects of caffeine consumption on the risk of suicide attempts, ideation and self-harm. Methods: This PRISMA-adherent systematic review involved a systematic search of PubMed, Embase, Cochrane and PsycINFO for all studies that evaluated the effects of caffeine consumption on the risk of suicide attempts, ideation and self-harm. Random effects meta-analyses and meta-regression were used for primary analysis. Results: Seventeen studies were included. The results demonstrated that coffee consumption of more than 60 cups per month significantly decreases the risk of suicide attempts. In contrast, energy drink consumption from as low as one cup per month was significantly associated with an increased risk of both suicide attempts and ideation. Meta-regression demonstrated a strong association between the dosage consumed and suicidality outcomes. Systematic review highlighted that male gender and substance usage significantly increased caffeine consumption. Conclusion: The results studied the associations between coffee and energy drink intake with suicide risk and suicidal ideation. Coffee intake was associated with reduced odds of suicide ideation and attempts, while consuming energy drinks was associated with an increased risk of both adverse outcomes. Further studies would be essential to elucidate the psychosocial factors and causative links underlying this association. Understanding the relationship between caffeine consumption and mental health outcomes is crucial to develop public health strategies to boost the mental health of consumers. Full article

Background/Objectives: Suicide is a major public health concern with severe consequences for individuals, families, and communities. Each year, approximately 800,000 individuals die by suicide, equating to one suicide-related death every 40 s. This study aims to determine the prevalence of suicidal ideation and psychoactive substance use among middle and high school students in Morocco and to examine the relationship between suicidal ideation, substance use, depression, and early trauma. Methods: From January to June 2023, a cross-sectional study was conducted in the Marrakech region of central Morocco among middle and high school students selected using stratified cluster random sampling. Data were collected through anonymous self-administered questionnaires. The Suicidal Ideation Attributes Scale (SIDAS) was used to assess the frequency of suicidal ideation among participants. The Diagnostic and Statistical Manual of Mental Disorders (DSM) criteria were applied for substance use and depression assessment, while early trauma was evaluated using the Adverse Childhood Experiences (ACE) questionnaire. Results: A total of 791 students participated in the study. The prevalence of suicidal ideation was 16.66%, while 25% of students reported current psychoactive substance use. Significant positive correlations were found between suicidal ideation and early trauma (r = 0.12; p < 0.004), depression (r = 0.52; p < 0.001), and substance use (r = 0.12; p < 0.001). Conclusions: The findings highlight the importance of considering multiple risk factors in suicide assessment and prevention. The interplay between these factors often exhibits bidirectional and significant associations. Implementing early screening, management, and treatment strategies for individuals exhibiting suicidal ideation and mental health disorders is crucial to reducing the burden of suicide. Full article