Among 593 people who had used MDMA more than five times in their lives, 15% met criteria for abuse and 59% for dependence under the DSM-IV classification. The diagnostic categories showed moderate test-retest reliability across St. Louis, Miami, and Sydney. The most common dependence criteria were continued use despite knowing it caused physical or psychological problems (87%) and withdrawal (68%). Physically hazardous use was the most prevalent abuse criterion. Seventeen of 19 withdrawal symptoms were reliably reported. Discrepant responses between interviews were mostly due to changing interpretation of questions rather than lying. The pattern of withdrawal symptoms suggests MDMA dependence should be classified separately from other hallucinogens.
Heroin poses the highest risk among 37 commonly misused substances in Taiwan, followed by (meth)amphetamine and ketamine. Misuse of new psychoactive substances (NPS) such as synthetic cannabinoids, synthetic cathinones, phenethylamines, piperazines, and tryptamines has been rising. An expert Delphi procedure assessed drug-related harms across four dimensions—addiction, misuse, social harm, and physical harm—using 11 indicators, 7 of which significantly predicted harm. National misuse prevalence was an important predictor. The findings provide a mechanism to improve rational scheduling and management of NPS.
Seizures of psilocybin mushrooms by U.S. law enforcement rose sharply between 2017 and 2022, suggesting increasing availability. The number of seizures grew from 402 in 2017 to 1,396 in 2022, a 368.9% increase, with the Midwest accounting for the most seizures (36.0%) and the West next (33.5%). The total weight seized rose from 226.0 kg to 844.0 kg, a 2,749.7% increase; the West had the greatest total weight (1,864.2 kg, 42.6%) followed by the South (1,831.9 kg, 41.8%). Significant increases occurred in all four U.S. regions. The authors call for more prevention and harm reduction education.
A survey conducted in 20 US urban cities over a single weekend detected recent use of recreational cannabis, psilocybin, and cocaine. Reported prevalence of these substances varied by region, indicating that prevention messages should be customized for different areas of the country.