Addiction Science & Clinical Practice
March 11, 2015
Michael F. Weaver, John A. Hopper, Erik W. Gunderson
135 citations
Designer drugs, marketed as 'legal highs,' include substituted cathinones (e.g., mephedrone, methylone, MDPV), synthetic cannabinoids (e.g., Spice), and synthetic hallucinogens (e.g., 25I-NBOMe). Their availability changes rapidly to evade legal controls and detection. Young adults are the main users, with growing use in the military. Acute toxicity frequently causes severe psychiatric and medical effects such as anxiety, agitation, psychosis, and tachycardia, and deaths have been reported for each drug type. Clinicians should consider these drugs when evaluating substance use in young adults or patients with acute neuropsychiatric symptoms. Treatment of acute intoxication is supportive, while long-term treatment of designer drug use disorder lacks evidence-based guidance.
Addiction Science & Clinical Practice
September 4, 2022
Lukas Andreas Basedow, Melina Felicitas Wiedmann, Veit Roessner et al.
17 citations
Adolescent patients with both post-traumatic stress disorder (PTSD) and substance use disorders (SUDs) reported more frequent past-year use of MDMA (ecstasy) than those with SUD alone or with traumatic experiences but no current PTSD. No such differences appeared for tobacco, alcohol, cannabis, or stimulants. The link between PTSD and higher MDMA use was partly explained by using the drug to cope with mental health symptoms. This suggests a specific coping mechanism for MDMA, possibly due to its unique psychoactive effects, rather than a general pattern of self-medication across all substances.
Addiction Science & Clinical Practice
January 19, 2020
Jennifer Rozylo, Keren Mitchell, Mohammadali Nikoo et al.
A high-risk patient with opioid use disorder who had previously failed buprenorphine/naloxone induction due to withdrawal symptoms was successfully started on a therapeutic dose using a microdosing regimen combined with assertive outreach. The team gradually increased the dose without causing withdrawal, and the patient continued consistent medication use for four weeks, gradually reducing illicit substance use. The case suggests that microdosing can minimize barriers to buprenorphine/naloxone induction and supports the need for larger studies.