Drug consumption estimates are of relevance because of public health effects as well as associated criminal activities. Wastewater analysis of drug residues enables the estimation of drug consumption and drug markets. Short-term and long-term trends of cocaine, MDMA (ecstasy), amphetamine (speed) and methamphetamine (crystal meth), were studied for the city of Amsterdam. MDMA (+41%) and cocaine (+26%) showed significantly higher weekend vs. week consumption, while no differences were observed for the other drugs. The consumption of MDMA, cocaine, amphetamine and methamphetamine significantly increased between 2011 and 2019. Weekly trends emerging from wastewater analyses were supported by qualitative and quantitative data from a recreational drug use monitoring scheme. However, information collected in panel interviews within nightlife networks and surveys among visitors of pubs, clubs and festivals only partially reflected the long term increase in consumption as registered from wastewater analysis. Furthermore, methamphetamine use was not well presented in survey data, panel studies and test service samples, but could be monitored trough wastewater analysis. This illustrates that wastewater analysis can function as an early warning if use and user groups are small or difficult to reach trough other forms of research. All in all, this study illustrates that wastewater-based epidemiology is complementary to research among user groups, and vice versa. These different types of information enable to connect observed trends in total drug consumption to behaviour of users and the social context in which the use takes place as well as validate qualitative signals about (increased) consumption of psychoactive substances. Such a multi angular approach to map the illicit drug situation on local or regional scale can provide valuable information for public health.
MULTIFILE
To prepare medical students appropriately for the management of toxicological emergencies, we have developed a simulation-based medical education (SBME) training in acute clinical toxicology. Our aim is to report on the feasibility, evaluation and lessons learned of this training. Since 2019, each year approximately 180 fifth-year medical students are invited to participate in the SBME training. The training consists of an interactive lecture and two SBME stations. For each station, a team of students had to perform the primary assessment and management of an intoxicated patient. After the training, the students completed a questionnaire about their experiences and confidence in clinical toxicology. Overall, the vast majority of students agreed that the training provided a fun, interactive and stimulating way to teach about clinical toxicology. Additionally, they felt more confident regarding their skills in this area. Our pilot study shows that SBME training was well-evaluated and feasible over a longer period.
DOCUMENT
The last decades have seen an increase in the use of illicit recreational drugs. In this article we take a detailed look at the current state of normalisation of the three most popular illicit recreational drugs among Dutch university students in the Netherlands (MDMA/Ecstasy, cocaine and amphetamine) by zooming in on five established aspects of normalisation and expanding on one of those aspects: social accomodation, by adding a behavioural subcomponent (setting of use). For this purpose, we used quantitative data, obtained from four studies (2016, 2017, 2019 and 2020) among Dutch university students in a prototypical university city in the Netherlands (Groningen). Results show that three aspects of normalisation are clearly observable. The drugs are perceived as highly accessible, the last year prevalence of use is high, and experimenting, especially with MDMA/Ecstasy, is common. Accurate knowledge of the drugs and acceptance of occasional use, account in some measure for social accommodation. However, as students do not talk openly about their drug use with everyone in their environment, one cannot speak of cultural accommodation. Thus, although clear signs of normalisation of illicit recreational drugs, especially MDMA/Ecstasy, are observable among Dutch university students, there is no full-scale normalisation of these drugs.
DOCUMENT
Introduction: Hardly any research exists on the relationship between substance use and sexual behaviors in patients with a substance use disorder. This study aimed to examine this relation by looking into perceived positive effects on sexual behavior, perceived negative effects and risky sexual behavior due to substance use in patient groups of users of alcohol, stimulants, sedatives and Gamma hydroxybutyrate (GHB). In addition, the current study aimed to address the question whether sexual behavior (e.g. number of sexual partners, sexualactivity) differs between these patient groups.Method: A total of 180 patients with a substance use disorder (i.e. alcohol, amphetamine, cannabis, cocaine, GHB and opiates) participated. A self-report questionnaire was administered with questions on substance use,sexual behaviors (e.g. sexual activity, masturbation, use of pornography) and statements about the perceived changes in sexual functioning and behavior under influence of the primary substance of abuse.Results: All four groups reported changes in sexual thoughts, feelings and behavior due to the use of their primary substance. More than half of the patients reported enhancements in sexual domains (i.e. sexual pleasure,sexual arousal, sexual behavior), but also decrements or risky behaviors and about a quarter stated that their sexual thoughts, feelings and behaviors were often associated with the use of their primary substance of abuse.Patients with a GHB use disorder reported the strongest relation between drug use and sexual behavior. Users of HB not only reported more enhancement in several sexual domains, but also less decline in sexual domains compared to the other patient groups and more risky behavior or more sexual activity than some of the other groups of patients.Conclusions: The results underline the importance of addressing the relationship between substance use and sexual behavior in treatment programs, as patients may be hesitant to stop their use of substances when they experience many positive effects in their sexual behavior. Future research directions are suggested.
DOCUMENT
BackgroundSubstance use disorders (SUDs) are prevalent in the general population, tend to follow a chronic course, are associated with many individual and social problems, and often have their onset in adolescence. However, the knowledge base from prospective population surveys and treatment-outcome studies on the course of SUD in adolescents is limited at best. The present study aims to fill this gap and focuses on a subgroup that is particularly at risk for chronicity: adolescents in addiction treatment. We will investigate the rate of persistent SUD and its predictors longitudinally from adolescence to young adulthood among youth with DSM-5 SUD from the start of their addiction treatment to 2 and 4 years following treatment-entry. In addition to SUD, we will investigate the course of comorbid mental disorders, social functioning, and quality of life and their association with SUD over time.Methods/designIn a naturalistic, multi-center prospective cohort design, we will include youths (n = 420), who consecutively enter addiction treatment at ten participating organizations in the Netherlands. Inclusion is prestratified by treatment organization, to ensure a nationally representative sample. Eligible youths are 16 to 22 years old and seek help for a primary DSM-5 cannabis, alcohol, cocaine or amphetamine use disorder. Assessments focus on lifetime and current substance use and SUD, non-SUD mental disorders, family history, life events, social functioning, treatment history, quality of life, chronic stress indicators (hair cortisol) and neuropsychological tests (computerized executive function tasks) and are conducted at baseline, end of treatment, and 2 and 4 years post-baseline. Baseline data and treatment data (type, intensity, duration) will be used to predict outcome – persistence of or desistance from SUD.DiscussionThere are remarkably few prospective studies worldwide that investigated the course of SUD in adolescents in addiction treatment for longer than 1 year. We are confident that the Youth in Transition study will further our understanding of determinants and consequences of persistent SUD among high-risk adolescents during the critical transition from adolescence to young adulthood.Trial registrationThe Netherlands National Trial Register Trial NL7928. Date of registration January 17, 2019.
DOCUMENT
Based on the results of two research projects from the Netherlands, this paper explores how street oriented persons adapt and use digital technologies by focusing on the changing commission of instrumental, economically motivated, street crime. Our findings show how social media are used by street offenders to facilitate or improve parts of the crime script of already existing criminal activities but also how street offenders are engaging in criminal activities not typically associated with the street, like phishing and fraud. Taken together, this paper documents how technology has permeated street life and contributed to the ‘hybridization’ of street offending in the Netherlands—i.e. offending that takes place in person and online, often at the same time.
DOCUMENT
Predation risk is a major driver of the distribution of prey animals, which typically show strong responses to cues for predator presence. An unresolved question is whether naïve individuals respond to mimicked cues, and whether such cues can be used to deter prey. We investigated whether playback of wolf sounds induces fear responses in naïve ungulates in a human-dominated landscape from which wolves have been eradicated since 1879. We conducted a playback experiment in mixed-coniferous and broadleaved forest that harboured three cervid and one suid species. At 36 locations, we played wolf sounds, sounds of local sheep or no sounds, consecutively, in random order, and recorded visit rate and group size, using camera traps. Visit rates of cervids and wild boar showed a clear initial reduction to playback of both wolf and sheep sounds, but the type of response differed between sound, forest type and species. For naïve wild boar in particular, responses to predator cues depended on forest type. Effects on visit rate disappeared within 21 days. Group sizes in all the species were not affected by the sound treatment. Our findings suggest that the responses of naïve ungulates to wolf sound seem to be species specific, depend on forest type and wear off in time, indicating habituation. Before we can successfully deter ungulates using predator sound, we should further investigate how different forest types affect the perception of naïve ungulates to these sounds, as responses to predator sound may depend on habitat characteristics.
MULTIFILE
