Intoxicação de cães por maconha: sinais clínicos e tratamento / Marijuana poisoning in dogs: clinical signs and treatment

Intoxicações por drogas recreativas como Cannabissativa, comumente conhecida como maconha, estão cada vez mais presentes nas clínicas de atendimento veterinário. A Cannabis contém mais de 500 compostos diferentes e mais de 80 canabinoides conhecidos; destes, o delta-9 tetrahidrocanabinol (THC) é o mais psicoativo e responsável pela maioria dos sintomas de intoxicação. Os canabinoides são substâncias exógenas extraídas da Cannabis e se ligam aos receptores CB1 e CB2 do sistema endocanabinoide. Em cães, dentre os sinais clínicos de intoxicação mais presentes destacam-se: agitação, ataxia, midríase, aumento da sensibilidade ao som, hiperestesia, sialorreia, distúrbios neurológicos, espasmos musculares e início agudo de incontinência urinária. Muitas vezes o diagnóstico de intoxicação por maconha é difícil, principalmente porque os tutores resistem em admitir a exposição a drogas ilícitas com receio das implicações legais. O médico-veterinário deve ganhar a confiança do tutor do animal para que o diagnóstico possa ser realizado precocemente e iniciado o tratamento mais adequado para a situação. O tratamento inclui monitoramento clínico, cuidados de suporte, administração de fluidos intravenosos, administração de carvão ativado, indução de vômitos, administração de antieméticos, suporte térmico (aquecimento/resfriamento) e monitoramento da pressão arterial. Os médicos-veterinários são os principais responsáveis pela educação dos tutores nessas circunstâncias, sendo de grande importância enfatizar para os tutores manterem agentes tóxicos fora do acesso dos animais.(AU)

Intoxications by recreational drugs such as Cannabissativa, commonly known as marijuana, are increasingly present in veterinary care clinics. Cannabis contains over 500 different compounds and over 80 known cannabinoids; of these, delta-9 tetrahydrocannabinol (THC) is the most psychoactive and responsible for most symptoms of intoxication. Cannabinoids are exogenous substances extracted from Cannabis and bind to the CB1 and CB2 receptors of the endocannabinoid system. Among the most common clinical signs of intoxication in dogs are: agitation, ataxia, mydriasis, increased sensitivity to sound, hyperesthesia, drooling, neurological disorders, muscle spasms and acute onset of urinary incontinence. The diagnosis of marijuana intoxication is often difficult, mainly because tutors resist in admitting exposure to illicit drugs for fear of the legal implications. The Veterinarian must gain the trust of the animal's tutor so that the diagnosis can be carried out early and the most appropriate treatment for the situation can be initiated. Treatment includes: clinical monitoring, supportive care, administration of intravenous fluids, administration of activated charcoal, induction of vomiting, administration of antiemetics, thermal support (warming/cooling), and blood pressure monitoring. Veterinarians are primarily responsible for the education of tutors in these circumstances, and it is of great importance to emphasize that tutors must keep toxic agents away from animal's acess.(AU)

The new psychoactive substances 25H-NBOMe and 25H-NBOH induce abnormal development in the zebrafish embryo and interact in the DNA major groove.

Toxicological effects of 25H-NBOMe and 25H-NBOH recreational drugs on zebrafish embryos and larvae at the end of 96 h exposure period were demonstrated. 25H-NBOH and 25H-NBOMe caused high embryo mortality at 80 and 100 µg mL-1, respectively. According to the decrease in the concentration tested, lethality decreased while non-lethal effects were predominant up to 10 and 50 µg mL-1 of 25H-NBOH and 25H-NBOMe, respectively, including spine malformation, egg hatching delay, body malformation, otolith malformation, pericardial edema, and blood clotting. We can disclose that these drugs have an affinity for DNA in vitro using biophysical spectroscopic assays and molecular modeling methods. The experiments demonstrated that 25H-NBOH and 25H-NBOMe bind to the unclassical major groove of ctDNA with a binding constant of 27.00 × 104 M-1 and 5.27 × 104 M-1, respectively. Furthermore, these interactions lead to conformational changes in the DNA structure. Therefore, the results observed in the zebrafish embryos and DNA may be correlated.

Misuse of pharmaceuticals by regular psychostimulant users is linked to mental health problems / El uso indebido de psicofármacos entre los usuarios regulares de psicoestimulantes está relacionado con problemas de salud mental

Abstract: Introduction: Misuse of pharmaceutical drugs, particularly by young people, is an issue of rising concern. Poly-substance use is common among regular psychostimulant users (RPU), and mental health problems are associated with pharmaceutical misuse, but RPU do not generally acknowledge their use as problematic. Objective: To examine links between mental health and misuse of non-prescription pharmaceuticals in a group of regular users of illicit psychostimulants. Method: Face to face structured interviews were conducted in April 2015 with 763 regular users of illicit psychostimulants as part of the Annual Ecstasy and Related Drugs Reporting System study in Australia. Results: At least half of the RPU in this study reported extra-medical or misuse of pharmaceuticals in the last six months in addition to regular use of illicit psychostimulants. Higher levels of psychological distress were recorded for RPU who also reported recent illicit use of opioids, antidepressants, benzodiazepines, or over-the-counter (OTC) codeine. Recent misuse of benzodiazepines or OTC codeine was associated with self-reported mental health problems and having attended a mental health professional. Those reporting recent misuse of opioids were at increased risk of mental health problems and more likely to record high levels of psychological distress, but less likely to have received prescription medications for their mental health problem. Discussion and conclusion: Regular users of illicit psychostimulants who also misuse pharmaceuticals are at increased risk of mental health problems, even after accounting for their use of illicit psychostimulants. Screening of this group for mental health problems is recommended.

Resumen: Introducción: El uso indebido de psicofármacos, particularmente entre los jóvenes, es un tema de creciente preocupación. El policonsumo de sustancias es común entre los usuarios regulares de psicoestimulantes (URP), y, pese a que hay problemas de salud mental asociados con el uso indebido de medicamentos, los URP generalmente no reconocen su consumo como problemático. Objetivo: Examinar las relaciones entre la salud mental y el uso indebido de psicofármacos no prescritos en un grupo de URP. Método: Se realizaron entrevistas cara a cara con 763 URP como parte del Estudio Anual del Sistema de Reporte de Éxtasis y Drogas Relacionadas en Australia. Resultados: Al menos la mitad de los URP en este estudio informaron el uso extramédico o indebido de psicofármacos en los últimos seis meses, además del uso regular de psicoestimulantes ilícitos. Se hallaron niveles más altos de distrés psicológico para los URP, quienes también informaron de un uso ilícito reciente de codeína, opiáceos, antidepresivos o benzodiazepinas sin prescripción médica. El uso indebido reciente de codeína o benzodiazepinas sin prescripción se asoció a problemas autorreportados de salud mental y a asistencia a consulta con un profesional de salud mental. Aquellos que informaron el uso indebido reciente de opioides mostraron mayor riesgo de problemas de salud mental y mayor probabilidad de registrar altos niveles de distrés psicológico, pero menor probabilidad de haber recibido psicofármacos prescritos para su problema de salud mental. Discusión y conclusión: Los URP que también consumen indebidamente psicofármacos están en mayor riesgo de presentar problemas de salud mental, incluso después de considerar su consumo de psicoestimulantes ilícitos. Se recomienda una evaluación por tamizaje para problemas de salud mental en este grupo.

Stimulant doping agents used in Brazil: prevalence, detectability, analytical implications, and challenges.

This article presents the prevalence of stimulant doping among Brazilian athletes, the analytical approaches used, as well as a general evolution of the detectability of the stimulants being used. Results from the Brazilian accredited doping control laboratory are compared with the global statistics disclosed by the World Anti-Doping Agency. The high prevalence of stimulant doping in Brazil can be attributed to several reasons, including "self-administration," a "body-shaping" culture, and the use of nutritional supplements.

Catatonia em um adolescente após uso de mefedrona como droga recreativa / Catatonia in a teenager after use of mephedrone as a recreational drug

Objetivos: Os autores relatam um caso de catatonia secundária à exposição a mefedrona, um derivado semissintético do alcalóide catinona, e fazem uma revisão da literatura sobre essa substância que vem sendo usada crescentemente como droga recreativa.Descrição do caso: Um adolescente de 14 anos foi levado ao serviço de emergência por apresentar quadro de agitação psicomotora grave com auto e heteroagressividade seguido de estupor, mutismo e acinesia. Ao exame na admissão apresentava-se sem resposta a estímulos. A investigação complementar não mostrou alterações relevantes. Durante a hospitalização apresentou dois episódios de agitação psicomotora grave e no restante do tempo manteve estado pseudocomatoso. Após ser conhecido o consumo de mefedrona previamente ao início do quadro, e perante a hipótese diagnóstica de catatonia, iniciou-se com lorazepam, com o que o paciente apresentou recuperação rápida ecompleta.Conclusões: Segundo a bibliografia consultada, este é o primeiro relato publicado de catatonia associada ao consumo de mefedrona. O caso ilustra uma manifestação psiquiátrica grave secundária à exposição a essa droga recreativa, facilmente adquirida pelos adolescentes apesar de já terem sido descritos casos fatais associados ao seu consumo.

Aims: The authors report a case of catatonia secondary to exposure to mephedrone, a semisynthetic derivativeof the alkaloid cathinone, and review the literature on this substance that has been increasingly used as a recreational drug.Case description: A 14 year old boy was taken to the emergency room presenting severe psychomotor agitation with self and heteroaggressiveness followed by stupor, mutism and akinesia. On the admission examination the patient was unresponsive to stimuli. Complementary examination showed no significant changes. During hospitalization he had two episodes of severe psychomotor agitation and in the rest of the time he kept a pseudo-comatose state. After knowledge on the consumption of mephedrone prior to the onset of symptoms and facing the diagnostic hypothesis of catatonia, lorazepam was started, after which the patient showed rapid and complete recovery.Conclusions: According to the reviewed literature, this is the first published report of catatonia associated with consumption of mephedrone. The case illustrates a severe psychiatric manifestation secondary to exposure to this recreational drug, easily acquired by adolescents despite fatalities associated with its consumption have already been described.

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.

Uso prescrito de cloridrato de metilfenidato e correlatos entre estudantes universitários brasileiros / Prescribed use of methylphenidate hydrochloride and its correlates among Brazilian college students

CONTEXTO: A prevalência do uso prescrito de metilfenidato (MPH) e correlatos ainda é pouco conhecida no Brasil.OBJETIVO: Estimar a prevalência do uso prescrito de MPH e correlatos em uma amostra populacional de universitários brasileiros.MÉTODOS: Doze mil setecentos e onze universitários foram solicitados a responder a um questionário sobre o uso de drogas. Em relação ao uso na vida de MPH, os universitários foram divididos em dois grupos: usuários de MPH (MPHU) e não usuários de MPH (MPHNU). Um modelo de regressão quasibinomial foi usado para avaliar a correlação desse uso com as demais variáveis.RESULTADOS: 0,9% dos universitários relataram ter feito uso de MPH na vida (MPHU). Ser da região Centro-Oeste (RP = 4,8; p < 0,01) e Sul (RP = 5,2; p < 0,05), morar em repúblicas (RP = 5,8; p < 0,001), já ter feito uso prescrito de anfetaminas (RP = 8,9; p < 0,001) e benzodiazepínicos (< 3 semanas: RP = 4,4; p < 0,001; ≥ 3 semanas: RP = 6,7; p < 0,001) e fazer uso recente e de risco de álcool (RP = 4,0; p < 0,05) foram variáveis associadas ao MPHU.CONCLUSÃO: A associação do uso de álcool e de outras drogas com o uso prescrito de MPH entre universitários sugere a importância da triagem do padrão do uso de álcool e de outras drogas entre estudantes com sintomas de transtorno de déficit de atenção e hiperatividade (TDAH).

BACKGROUND: The prevalence of prescribed use of methylphenidate (MPH) and its correlates are not well-known in Brazil.OBJECTIVE: To estimate the prevalence of prescribed use of MPH and its correlates in a sample of Brazilian college students.METHODS: Twelve-thousand seven hundred and eleven college students filled out a drug use questionnaire. They were divided into two groups based on the lifetime use of MPH: MPH users (MPHU) and MPH non-users (MPHNU). Quasi-binomial regression models were carried out in order to evaluate the correlation among MPHU and other variables.RESULTS: A lifetime use of MPH was reported from 0.9% of college students (MPHU). Being from the Midwest (PR = 4.8, p < 0.01) and South (PR = 5.2, p < 0.05), living in students housing (PR = 5.8, p < 0.001), prescribed use of amphetamines (PR = 8.9, p < 0.001) and benzodiazepines (< 3 weeks: PR = 4.4, p < 0.001; ≥ 3 weeks: PR = 6.7, p < 0.001), and harmful use of alcohol (PR = 4.0, p < 0.05) were correlated with MPHU.DISCUSSION: The association of alcohol and drug use with prescribed use of MPH among college students suggests the importance of screening drinking patterns and use of other drugs among students with ADHD symptoms.