Uso de club drugs entre estudantes de graduação: prevalência, características associadas e a influência dos pares / Club drugs use among undergraduate students: prevalence, associated characteristics and peer influence

OBJETIVO: Medir a prevalência do uso na vida, no último ano e no último mês de duas club drugs ­ o ecstasy e o LSD ­, bem como as características associadas ao uso dessas substâncias, no último mês, entre estudantes de graduação de uma universidade no Sul do Brasil. MÉTODOS: Trata-se de um estudo transversal conduzido no ano de 2015 com amostragem aleatória sistemática por conglomerados. Participaram 1.423 estudantes de graduação. Foi utilizado um modelo de análise multivariável em três níveis hierárquicos por meio da regressão de Poisson com ajuste robusto da variância. RESULTADOS: As prevalências de uso na vida, no último ano e no último mês de club drugs foram de 12,7%, 7,8% e 3,8%, respectivamente. Indivíduos do sexo masculino, com orientação sexual homossexual ou bissexual, mais jovens, que moravam com seus pares, solteiros, e que relataram uso no último mês de tabaco e maconha apresentaram maior probabilidade de ter feito uso no último mês de alguma club drug. Entretanto, a variável mais fortemente associada a esse desfecho foi ter algum amigo que já fez uso de alguma droga ilícita na vida (RP = 19,54). CONCLUSÕES: O ambiente universitário parece ser um terreno fértil para a difusão do uso de club drugs. O fortalecimento de uma rede de apoio institucional da universidade, capaz de propor atividades de prevenção, bem como de identificar, acolher e encaminhar casos em que haja abuso e dependência dessas substâncias, pode ser uma estratégia importante para lidar com essa problemática.

OBJECTIVE: To measure the prevalence of lifetime, last-year, and last-month use of two club drugs ­ ecstasy and LSD ­, as well as the characteristics associated with the last-month use of these substances among undergraduate students at a university in southern Brazil. METHODS: This was a cross-sectional study conducted in 2015 with a clustered systematic sampling strategy. Overall, 1,423 undergraduate students participated. A three-level hierarchical multivariate analysis model was used through Poisson regression with robust adjustment of variance. RESULTS: Prevalence of lifetime, last-year, and lastmonth use of club drugs were 12.7%, 7.8% and 3.8%, respectively. Male participants, with homosexual or bisexual sexual orientation, younger, who lived with their peers, who were single, and who reported last-month use of tobacco and marijuana had higher probability of last-month use club drugs. However, the variable most strongly associated with this outcome was having a friend with lifetime use of illicit drugs (PR = 19.54). CONCLUSIONS: University environment seems to be a fertile ground for the spread of the use of club drugs. The strengthening of the university's institutional assistance network, capable of proposing prevention activities, as well as identifying, supporting and referring cases where there is abuse and dependence on these substances can be an important strategy to deal with this problem.

Comparison of risk for HIV, syphilis and HCV infection between club drug users and traditional drug users in TaizhouCity / 上海预防医学

Objective To compare the risk for HIV, syphilis and HCV infection between club drug users and traditional drug users in Taizhou City of Zhejiang Province, in order to provide evidence for further behavioral intervention. Methods Drug users in Taizhou were surveyed with the questionnaires for national HIV sentinel surveillance during 2016-2019.Blood samples were collected for detection of HIV, syphilis and HCV antibodies. Results A total of 1 612 drug users were surveyed, in which club drug users accounted for 78.7% and traditional drug users 21.3%.Significant differences were observed in gender, age, educational level, ethnic background, and household registration between these two groups (P < 0.05).Among club drug users, injecting drug users accounted for 7.1%, lower than traditional drug users (P < 0.001).Among the injecting drug users, those who shared needles with others accounted for 8.9%, similar to the traditional drug users (P>0.05).In the past year, the proportion of having sex after drug abuse among club drug users was 77.9%, higher than traditional drug users (P=0.002).The proportion of condom use during sex were nearly 30.0% for both club drug users and traditional drug users.Of the club drug users, 0.2% were infected with HIV, which was not significantly different from that in traditional drug users (P>0.05).The prevalence of syphilis among club drug users was 12.6%, higher than traditional drug users (P < 0.05);whereas the HCV prevalence (10.4%) was lower among club drug users (P < 0.001). Conclusion The threats of blood-borne transmission and sexual transmission of diseases are common among club drug users, suggesting the need of targeted intervention measures.

Determinação de club dugs em sangue total por cromatografia líquida acoplada a espectrometria de massas com analisador hí­brido quadrupolo-tempo de voo (LC-QTOF-MS) / Determination of club drugs in whole blood by liquid chromatography coupled with mass spectrometry with hybrid quadrupole time-of-flight mass analyzer (LC-QTOF)

As chamadas club drugs compreendem um vasto grupo de substâncias frequentemente utilizadas em bares, festas e raves, com a finalidade de intensificar o contato social e a estimulação sensorial. Englobam desde substâncias sintéticas comumente conhecidas, como a anfetamina, a metanfetamina, o MDMA, até moléculas de surgimento mais recente, denominadas novas substâncias psicoativas. Isoladas ou associadas a outras drogas, é possível que sejam causa de morte per se, ou que predisponham o usuário a envolver-se em situações potencialmente fatais, sendo necessário que os órgãos de Perícia Criminal (Institutos Médico Legais e Institutos de Criminalística) estejam aptos a detectar e quantificar essas substâncias em amostras biológicas. O presente trabalho teve como objetivo desenvolver um método analítico para identificação e quantificação de club drugs em sangue total, utilizando cromatografia líquida acoplada a espectrometria de massas com analisador híbrido quadrupolotempo de voo (LC-QTOF). Após o desenvolvimento do método, este foi validado utilizando as diretrizes do guia de validação do Scientific Working Group for Forensic Toxicology (SWGTOX), sendo analisados de linearidade, limite de detecção, limite de quantificação, efeito matriz, precisão intradia, precisão interdia, exatidão e integridade de diluição, além de recuperação e eficiência do processo. O método desenvolvido compreendeu a determinação de MDA, MDMA, 2C-B, DOB, cetamina, mCPP, cocaína e cocaetileno. Amostras provenientes de casos reais de morte não natural, oriundas do Instituto Médico Legal Aristoclides Teixeira de Goiânia - GO foram analisadas pelo método desenvolvido. 56 casos foram selecionados, em sua maioria com histórico de morte por projétil de arma de fogo e acidente de transito. Das 56 amostras analisadas, 28,5% (n=16) foram positivas para cocaína e/ou cocaetileno. As demais substâncias pesquisadas não foram encontradas nas amostras

Club drugs are a large group of substances consumed in pubs, parties and raves, aiming to intensify social contact and sensorial stimulation. The term comprises largely known substances such as amphetamine, methamphetamine, 3,4-methylenodioxymethamphetamine (MDMA), as well as so-called new psychoactive substances, which are synthetic drugs recently developed or recently introduced in drug market. Club drugs can be taken alone, combined with each other or, most frequently, with alcohol or other commonly abused drugs such as cocaine. In any of these situations, club drugs can possibly be the cause of death or potentialize the involvement of the user with crime and potentially fatal behavior. Thus, official organisms in charge of criminal investigation must be capable of identifying and quantifying these substances in biological samples. The present work aimed the development of an analytical method to identify and quantify club drugs in whole blood, using liquid chromatography - mass spectrometry with hybrid analyzer quadrupole - time of flight (LC-QTOF). After analytical development, the method was validated according to do Scientific Working Group for Forensic Toxicology (SWGTOX) guidelines, evaluating linearity, limit of detection, limit of quantification, matrix effect, precision, intermediate precision, bias and dilution integrity, besides recovery and process efficiency. The developed method comprised MDA, MDMA, 2C-B, DOB, ketamine, mCPP, cocaine and cocaethylene determination. Real samples related to non-natural deaths were collected at Institute of the Legal Medicine Aristoclides Teixeira, Goiânia, Goiás, Brazil, and analyzed by the developed method. 56 cases were selected, most of them related to fire gun injury and traffic events, 28,5% (n=16) of them being positive for cocaine and/or cocaethylene. None of the other drugs comprised in the analysis were detected in these samples

Behaviors on drug-abuse and prevalence of sexually transmitted diseases among drug users in Tianjin, China, from 2011 to 2015 / 中华流行病学杂志

Objective To understand the change of behavioral characteristics among drug users (DUS) in Tianjin and the prevalence rates of major sexually transmitted disease infections.A series of cross-sectional surveys were used.Methods Between April and June,2011 to 2015,a cross-sectional survey with face to face interview,was undertaken.Interview was conducted among DUS who entered the drug rehabilitation center and blood samples were drawn to test for HIV/syphilis/ HCV infections.Multivariate logistic regression analysis was used to analyze the relationship between the infection of major sexually transmitted diseases and drug abuse or sexual behavior.Results 2 000 DUS were included during the 5-year study,with the average age of the DUS as 34.5 ± 8.7.Female accounted for 17.9％ and club drug (new drugs) users accounted 45.4％ of the participants,with its proportion increasing over the years.Comparing to traditional drug users,club drug users showed more sexual activities with partners,but lower proportion of condom use.Prevalence rates of HIV/ Syphilis and HCV were 1.3％,11.0％,52.0％,respectively.The prevalence of syphilis among club drug users was significantly higher than those on traditional-drug use (x2=67.778,P＜0.001).Data from Binary logistic regression analysis showed that club drug use (adjusted OR=1.607,95％ CI:1.191-2.170) and females (adjusted OR=5.287,95％ CI:3.824-7.311) were associated with syphilis infection among DUS.Conclusion Drug abuse behavior changed among the drug abuse in Tianjin.Proportion of club drug use continued to increase so as the risk of infected sexually transmitted diseases.

Behaviors on drug-abuse and prevalence of sexually transmitted diseases among drug users in Tianjin, China, from 2011 to 2015 / 中华流行病学杂志

Objective To understand the change of behavioral characteristics among drug users (DUS) in Tianjin and the prevalence rates of major sexually transmitted disease infections.A series of cross-sectional surveys were used.Methods Between April and June,2011 to 2015,a cross-sectional survey with face to face interview,was undertaken.Interview was conducted among DUS who entered the drug rehabilitation center and blood samples were drawn to test for HIV/syphilis/ HCV infections.Multivariate logistic regression analysis was used to analyze the relationship between the infection of major sexually transmitted diseases and drug abuse or sexual behavior.Results 2 000 DUS were included during the 5-year study,with the average age of the DUS as 34.5 ± 8.7.Female accounted for 17.9％ and club drug (new drugs) users accounted 45.4％ of the participants,with its proportion increasing over the years.Comparing to traditional drug users,club drug users showed more sexual activities with partners,but lower proportion of condom use.Prevalence rates of HIV/ Syphilis and HCV were 1.3％,11.0％,52.0％,respectively.The prevalence of syphilis among club drug users was significantly higher than those on traditional-drug use (x2=67.778,P＜0.001).Data from Binary logistic regression analysis showed that club drug use (adjusted OR=1.607,95％ CI:1.191-2.170) and females (adjusted OR=5.287,95％ CI:3.824-7.311) were associated with syphilis infection among DUS.Conclusion Drug abuse behavior changed among the drug abuse in Tianjin.Proportion of club drug use continued to increase so as the risk of infected sexually transmitted diseases.

Los nuevos empresarios: Trayectoria del uso a la venta de drogas en contextos de fiesta / The new businessmen: Pathways from drug use to drug dealing in party contexts

Drugs use at party contexts has increased in recent decades. Drugs dealing facilitates consumer access to substances, whose sales practices vary according to drugs use, places for the consumption and the drug social function. Drug dealing is socially constructed from a set of practices ranging from reasons to dealing and those related to the consolidation as a common practice. The aim of this research was to describe and analyze the drugs users' experience in party contexts, about their dealer's construction process. An interpretative multiple-case study with the snowball technique was carried out to get the participants. The information was obtained by a semi-structured interview and nonparticipant observation at the dealing places. The information obtained points out the group's participation on the selection of the dealer as the initiation of drugs dealing, the extroversion features and communication skills as an important profile to be a dealer; specially, the capability to satisfy the group's emotional request through the drugs. Also, benefits as acceptation, protection and the warmth from the group and the economical earning. The dealer/businessmen consolidation is socially constructed according to the new identity assumed, the group participation and the specific activities as a business.

El uso de drogas en contextos de fiesta se ha incrementado en las últimas décadas. El narcomenudeo facilita el acceso a sustancias de consumo, cuyas prácticas de venta varían conforme a la droga de uso, los espacios de consumo y la función de la droga en los grupos que la consumen. La venta de drogas implica una serie de prácticas que la construyen y que incluyen los motivos del inicio de venta, el proceso de desarrollo y las relacionadas con la consolidación de la venta como práctica habitual. El objetivo de esta investigación fue describir y analizar la experiencia de usuarios de drogas en contextos de fiesta respecto al proceso en que se construyen como dealers. Para lo anterior, se realizó un estudio interpretativo de casos múltiples, empleando la técnica de "bola de nieve" para captar a los participantes. La observación se obtuvo por medio de una entrevista semiestructurada y la observación no participante en escenarios de venta. Se obtuvo información relacionada con los elementos del salto del uso a la venta como la elección del dealer por el grupo, su perfil para ser elegido como la extroversión y habilidades de comunicación; y sobre todo su capacidad para satisfacer la demanda de emociones de los miembros de su grupo por medio de las drogas de venta. Además, de la aceptación, protección y afecto del grupo y las ganancias económicas. La consolidación como dealer/empresario se construye conforme se asumen una nueva identidad, la participación del grupo y las actividades específicas de la empresa.

Recent analytical strategies on "Date-Rape" Drugs and its metabolites.

Recently, much attention has been given to develop simple analytical methods for screening wide range of date-rape drugs. Drug abuse that changes human behavior and guides to crimes has become a serious problem throughout the world. The determination of various classes of abused drugs is an important in many fields of analytical toxicology, such as forensic analysis and antidoping analysis. The detection method must provide more accurate and reliable results from the test specimens. In this regard, attempt is made in this review to summarize the recent applications of these methods in keeping track with complexity of the sample matrices. The following topics are discussed under the headings of different sampling approaches for screening the drugs related to drug facilitated sexual assault and more commonly utilized analytical methods such as liquid chromatography, gas chromatography and capillary electrophoresis separation techniques coupled with mass spectrometry detector. Therefore, relentless efforts should continue to be deployed toward research and development in low cost, fast and efficient ways of detecting illicit drug from all kind of specimens for reliable and more accurate results.

Club drugs: review of the ‘rave’ with a note of concern for the Indian scenario.

'Club drugs’ which include Ecstasy, gamma-hydroxybutyrate (GHB), ketamine, and Rohypnol (flunitrazepam) have become popular with participants in ‘raves’, because they are perceived to enhance energy, endurance, sociability and sexual arousal. These drugs vary in their pharmacologic properties, physiological and psychological effects, and potential consequences. The use of club drugs by young people has increased in the last decade, and continue to get modified and evolve, making them very difficult to monitor. Further, these drugs are not picked up by routine drugs screening procedures, thereby making these popular with the criminals. India, which is in a phase of social transition, also faces this rising menace. Despite the nature and extent of this problem, this area has been under-researched. Data from India are sparse barring a few newspaper and police reports. Keeping abreast of current trends in club drug use prepares the clinician to recognize the clinical effects of club drug use, to manage club drug related emergencies, and to generate social awareness.