Fifteen-minute consultation: Recognition and management of the child or young person who has ingested a novel psychoactive substance

2020 ◽  
Vol 105 (6) ◽  
pp. 336-341
Author(s):  
Lee Tubman ◽  
Niall Mullen ◽  
Derek K Tracy

Intoxicated children and young people (CYP) attending the paediatric emergency department (PED) are typically under the influence of alcohol or established recreational agents such as cannabis or ecstasy. The last decade or so has seen an increase in the numbers of CYP in PED who have used novel psychoactive substances (NPS). In this review, we describe four different functional classes of NPS, their legal status, clinical effects, acute management and interventions to reduce harm.

2017 ◽  
Vol 41 (S1) ◽  
pp. S311-S311
Author(s):  
M. Lupi ◽  
T. Acciavatti ◽  
S. Marini ◽  
E. Cinosi ◽  
R. Santacroce ◽  
...  

IntroductionComorbidities between psychiatric diseases and consumption of traditional substances of abuse are common. Nevertheless, there is no data regarding the use of novel psychoactive substances (NPS) in the psychiatric population.ObjectivesThe purpose of this multicentre survey is to investigate the consumption of a wide variety of psychoactive substances in a young psychiatric sample.MethodsBetween September 2013 and November 2015, a questionnaire has been administered, in ten Italian psychiatric care facilities, to a sample of 671 psychiatric patients (48.5% men; 51.5% women), aged between 18 and 26 years (mean age: 22.24).Results8.2% of the sample declared use of NPS at least once in a lifetime and 2.2% have assumed NPS in the last three months. The NPS more used were synthetic cannabinoids (4.5%), followed by methamphetamine (3.6%). The three psychiatric diagnosis with more frequent NPS consumption were bipolar disorder (23.1%), personality disorders (11.8%) and schizophrenia and related disorders (11.6%). Bipolar disorder was associated with NPS consumption (P < .001). Among the illicit drugs investigated, 31.4% of the sample was cannabis smoker and 10.7% cocaine user. Moreover, 70.6% of the sample declared alcohol use and 47.7% had binge drinking conducts. In univariate regression analysis, bipolar disorder was positive associated with binge drinking while obsessive compulsive disorder resulted negative associated.ConclusionsThe use of novel psychoactive substances in a young psychiatric population appears to be a frequent phenomenon, probably still underestimated. Bipolar disorder shows an association with NPS use. Therefore, careful and constant monitoring and accurate evaluations of possible clinical effects related to their use are necessary.Disclosure of interestThe authors have not supplied their declaration of competing interest.


2016 ◽  
Vol 54 (4) ◽  
pp. 319-323 ◽  
Author(s):  
Derrick Lung ◽  
Nathan Wilson ◽  
Francois-Thibaut Chatenet ◽  
Clemence LaCroix ◽  
Roy Gerona

2014 ◽  
Vol 2014 ◽  
pp. 1-7 ◽  
Author(s):  
Giovanni Martinotti ◽  
Matteo Lupi ◽  
Tiziano Acciavatti ◽  
Eduardo Cinosi ◽  
Rita Santacroce ◽  
...  

Objective. Comorbidities between psychiatric diseases and consumption of traditional substances of abuse (alcohol, cannabis, opioids, and cocaine) are common. Nevertheless, there is no data regarding the use of novel psychoactive substances (NPS) in the psychiatric population. The purpose of this multicentre survey is to investigate the consumption of a wide variety of psychoactive substances in a young psychiatric sample and in a paired sample of healthy subjects.Methods. A questionnaire has been administered, in different Italian cities, to 206 psychiatric patients aged 18 to 26 years and to a sample of 2615 healthy subjects matched for sex, gender, and living status.Results. Alcohol consumption was more frequent in the healthy young population compared to age-matched subjects suffering from mental illness (79.5% versus 70.7%;P<0.003). Conversely, cocaine and NPS use was significantly more common in the psychiatric population (cocaine 8.7% versus 4.6%;P=0.002) (NPS 9.8% versus 3%;P<0.001).Conclusions. The use of novel psychoactive substances in a young psychiatric population appears to be a frequent phenomenon, probably still underestimated. Therefore, careful and constant monitoring and accurate evaluations of possible clinical effects related to their use are necessary.


2018 ◽  
Vol 63 (2) ◽  
pp. 39-44 ◽  
Author(s):  
David E Henshall ◽  
Callum WD Innes ◽  
Scott R Morrison ◽  
Blair Wilson ◽  
Ryan A Brown ◽  
...  

Background and aims Novel psychoactive substances are compounds intended to mimic the effects of illicit drugs. They provide a unique challenge to healthcare, as complications of their use and their impact on services are relatively unknown. This study aims to determine nature of presentations, patient demographics and impact on healthcare. Methods Novel psychoactive substances users who presented to a large urban emergency department over 4 weeks were prospectively identified and followed for 1 year. Patients over 13 years old were eligible for inclusion. Information regarding patient demographics and presentations was collected. Results During the study period, 53 patients (39 male), mean age 32.6 ± 8.9 (±standard deviation), presented 148 times with complaints relating to novel psychoactive substances use. Study population characteristics included history of illicit drug use (83.0%), intravenous drug use (64.2%), psychiatric diagnosis or symptoms (56.6%), methadone prescription (52.8%) and having no fixed abode (37.7%). Injection was the most common method of use (72.3%), Burst the most commonly named agent (19.6%) and behavioural change the most common presenting complaint (31.1%). Patients collectively spent 10,620 h in hospital over 1 year. Conclusion This study highlights differences between the young population targeted by government campaigns regarding novel psychoactive substances use and the presenting population to hospital, and the associated burden on the National Health Service.


MISSION ◽  
2020 ◽  
pp. 39-44
Author(s):  
Concettina Varango ◽  
Francesca Musarella ◽  
Mara Cella ◽  
Antonella Varango

Questo articolo nasce dall'esigenza di informare un pi&ugrave; ampio pubblico sul pericolo rappresentato da queste sostanze, far conoscere le NPS (Novel Psychoactive substances) agli operatori del settore (personale di laboratorio, personale delle unit&agrave; di emergenza/ urgenza, operatori sanitari, ricercatori, ecc.) al fine di agevolare l'analisi di campioni sconosciuti e divulgare i dati scientifici che cominciano ad emergere da studi clinici e preclinici sui loro effetti tossici e farmacologici.&nbsp;Dal 2009 sono comparsi nel gruppo delle N.P.S., i nuovi oppioidi sintetici, molecole estremamente potenti che comportano una seria minaccia per la salute pubblica. Si tratta di prodotti dalla notevole potenza (il fentanyl, per esempio, capostipite di questa famiglia, ha un'azione circa 100 volte maggiore rispetto a quella della morfina) che vengono utilizzati sia per s&eacute; sia come adulteranti di partite di sostanze classiche, soprattutto eroina, causando scie di decessi per overdose.&nbsp;


2008 ◽  
Vol 2 (3) ◽  
pp. 393-414 ◽  
Author(s):  
Edward MacRae

The article deals with the different effects of tolerant and prohibitionist policies associated with psychoactive substance use in Brazil. Whereas the licit use of ayahuasca has been successfully incorporated into mainstream Brazilian society, the ritual use of cannabis by one of the Santo Daime religious groups has never been fully accepted and remains a constant source of problems for the ayahuasca churches, their followers and society at large.


2011 ◽  
Vol 58 (2) ◽  
pp. 151-155
Author(s):  
Ivan Dimitrijevic ◽  
Zoran Zoricic ◽  
Miodrag Milenovic ◽  
Ivan Palibrk ◽  
Draga Dimitrijevic ◽  
...  

Proper diagnosis of psychoactive substance abuse and addiction, as well as acute intoxication, withdrawal syndrome and overdosing are of great importance in patients who are preparing for surgical intervention. There are some specific details in their preoperative preparation whether they underwent emergency or elective surgery. Good knowledge of the characteristics of psychoactive substance abuse and addiction, interaction of psychoactive substances and anesthetics and any other drugs that could be used in the perioperative period is important especially for anastesiologist. In this work we present key issues for recognizing theese patients as well as some guidelines for adequate preoperative preparation and postoperative care.


Author(s):  
Elizabeth A. Bennett

Cannabis (marijuana) is the most commonly consumed, universally produced, and frequently trafficked psychoactive substance prohibited under international drug control laws. Yet, several countries have recently moved toward legalization. In these places, the legal status of cannabis is complex, especially because illegal markets persist. This chapter explores the ways in which a sector’s legal status interacts with political consumerism. The analysis draws on a case study of political consumerism in the US and Canadian cannabis markets over the past two decades as both countries moved toward legalization. It finds that the goals, tactics, and leadership of political consumerism activities changed as the sector’s legal status shifted. Thus prohibition, semilegalization, and new legality may present special challenges to political consumerism, such as silencing producers, confusing consumers, deterring social movements, and discouraging discourse about ethical issues. The chapter concludes that political consumerism and legal status may have deep import for one another.


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