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Background: Users of new psychoactive substances including 4-fluoroamphetamine (4-FA/4-FMP) frequently share their experiences or opinions in online drug forums. We have tested the potential of computerised analysis of drug users' forum posts for monitoring and early detection of trends. Specifically, we tested whether changes in the volume of 4-FA related posts and sentiments expressed in those posts can be observed around the time 4-FA was increasingly reported by Dutch drug monitoring sources (2012-2017).Methods: Opening posts from two popular Dutch internet-based drug discussion forums, written between January 1 st, 2012 and January 1 st, 2018 were scraped: Portions of the forum posts about 4-FA were collected. To contrast 4-FA findings against other categories of forum posts, we also collected posts on two other substances (ecstasy and cocaine) and posts not related to a specific substance. Sentiments expressed in these posts were inferred using text recognition software, and analysed for trends using linear mixed modelling.Results: The number of 4-FA posts increased between 2012 and 2015: 76 posts in 2012, 138 in 2013, 322 in 2014, 323 in 2015, and decreased thereafter: 264 in 2016 and 135 in 2017; X2(5) = 271.8, p < .001. Over time, a decrease in positive sentiment towards 4-FA can be observed starting in 2015, compared to the period before 2015, coinciding with more news searches and reports on adverse events related to 4-FA use. Linear mixed modelling analysis confirmed a significantly higher sentiment score in 2015 compared to 2017 for 4-FA, B = 0.062; SE = 0.023; t(1252) = 2.70; p = 0.007, but not for posts on other substances.Conclusion: Changes in the volume and sentiments of forum posts coincided with news media exposure related to 4-FA and with trends observed by established drug monitoring sources. Hence, internet forum monitoring facilitates early discovery of trends in the popularity, prevalence and adverse events related to new psychoactive substances. [ABSTRACT FROM AUTHOR]

Background: Frequent Cannabis use has been linked to a variety of negative mental, physical, and social consequences. We assessed the effects of digital prevention and treatment interventions on Cannabis use reduction in comparison with control conditions.Methods: Systematic review with two separate meta-analyses. Thirty randomized controlled trials met the inclusion criteria for the review, and 21 were included in the meta-analyses. Primary outcome was self-reported Cannabis use at post-treatment and follow-up. Hedges's g was calculated for all comparisons with non-active control. Risk of bias was examined with the Cochrane risk-of-bias tool.Results: The systematic review included 10 prevention interventions targeting 8138 participants (aged 12 to 20) and 20 treatment interventions targeting 5195 Cannabis users (aged 16 to 40). The meta-analyses showed significantly reduced Cannabis use at post-treatment in the prevention interventions (6 studies, N = 2564, g = 0.33; 95% CI 0.13 to 0.54, p =  0.001) and in the treatment interventions (17 comparisons, N = 3813, g = 0.12; 95% CI 0.02 to 0.22, p =  0.02) as compared with controls. The effects of prevention interventions were maintained at follow-ups of up to 12 months (5 comparisons, N = 2445, g = 0.22; 95% CI 0.12 to 0.33, p <  0.001) but were no longer statistically significant for treatment interventions.Conclusions: Digital prevention and treatment interventions showed small, significant reduction effects on Cannabis use in diverse target populations at post-treatment compared to controls. For prevention interventions, the post-treatment effects were maintained at follow-up up to 12 months later. [ABSTRACT FROM AUTHOR]

Background: Depression and harmful alcohol use are two of the top five leading causes of years of life lost to disability in high-income countries. Integrated treatment targeting both at the same time is often considered more complicated and difficult and, therefore, more expensive. Consequently, integrated internet-based interventions could be a valuable addition to traditional care.Methods: A three-arm randomized controlled trial was conducted comparing the effectiveness of (1) an integrated, minimal-guidance, adherence-focused self-help intervention designed to reduce both alcohol use and depression symptoms (AFGE-AD); (2) a similar intervention designed to reduce alcohol use only (AFGE-AO), and (3) internet access as usual (IAU) as a control condition, in at least moderately depressed alcohol misusers from February 2016-March 2020. We recruited 689 alcohol misusers (51.6 % males, mean age = 42.8 years) with at least moderate depression symptoms not otherwise in treatment from the general population. Six months after baseline, 288 subjects (41.8 %) were reachable for the final assessment.Results: All interventions yielded reduced alcohol-use after six months (AFGE-AD: -16.6; AFGE-AO: -19.8; IAU: -13.2). Those who undertook active-interventions reported significantly fewer standard drinks than controls (AFGE-AD: p = .048, d=0.10; AFGE-AO: p = .004, d=0.20). The two active-intervention groups also reported significantly less severe depression symptoms than controls (AFGE-AD: p = .006, d=0.41; AFGE-AO: p = .008, d=0.43). Testing revealed noninferiority between the two interventions.Conclusions: This study documented sustained effectiveness of the first integrated, fully internet-based self-help intervention developed for the reduction of both alcohol use and depression symptoms in at least moderately depressed adult alcohol misusers recruited from the general population. [ABSTRACT FROM AUTHOR]