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This case-control study uses positron emission tomography to compare translocator protein distribution volume, a quantitative marker of gliosis, in brain regions of interest between healthy persons and persons with persistent depressive and cognitive symptoms after mild to moderate acute COVID-19 infection. Key Points: Question: Is translocator protein distribution volume (TSPO VT), an index of gliosis (an inflammatory change), measured by positron emission tomography, elevated in the brain after acute COVID-19 infection with sequelae of depressive and cognitive symptoms? Findings: In this case-control study, TSPO VT was elevated in 20 participants with persistent depressive and cognitive symptoms after initially mild to moderate COVID-19 infection when compared with 20 healthy controls, more prominently in the ventral striatum and dorsal putamen. The TSPO VT in the dorsal putamen of COVID-19 cases negatively correlated with motor speed. Meaning: These findings suggest that gliosis, especially in the ventral striatum and dorsal putamen, may reflect injury, ongoing inflammation, or both and provide directions for further therapeutic development. Importance: Persistent depressive symptoms, often accompanied by cognitive symptoms, commonly occur after COVID-19 illness (hereinafter termed COVID-DC, DC for depressive and/or cognitive symptoms). In patients with COVID-DC, gliosis, an inflammatory change, was suspected, but measurements of gliosis had not been studied in the brain for this condition. Objective: To determine whether translocator protein total distribution volume (TSPO VT), a marker of gliosis that is quantifiable with positron emission tomography (PET), is elevated in the dorsal putamen, ventral striatum, prefrontal cortex, anterior cingulate cortex, and hippocampus of persons with COVID-DC. Design, Setting, and Participants: This case-control study conducted at a tertiary care psychiatric hospital in Canada from April 1, 2021, to June 30, 2022, compared TSPO VT of specific brain regions in 20 participants with COVID-DC with that in 20 healthy controls. The TSPO VT was measured with fluorine F 18–labeled N-(2-(2-fluoroethoxy)benzyl)-N-(4-phenoxypyridin-3-yl)acetamide ([18F]FEPPA) PET. Main Outcomes and Measures: The TSPO VT was measured in the dorsal putamen, ventral striatum, prefrontal cortex, anterior cingulate cortex, and hippocampus. Symptoms were measured with neuropsychological and psychological tests, prioritizing outcomes related to striatal function. Results: The study population included 40 participants (mean [SD] age, 32.9 [12.3] years). The TSPO VT across the regions of interest was greater in persons with COVID-DC (mean [SD] age, 32.7 [11.4] years; 12 [60%] women) compared with healthy control participants (mean [SD] age, 33.3 [13.9] years; 11 [55%] women): mean (SD) difference, 1.51 (4.47); 95% CI, 0.04-2.98; 1.51 divided by 9.20 (17%). The difference was most prominent in the ventral striatum (mean [SD] difference, 1.97 [4.88]; 95% CI, 0.36-3.58; 1.97 divided by 8.87 [22%]) and dorsal putamen (mean difference, 1.70 [4.25]; 95% CI, 0.34-3.06; 1.70 divided by 8.37 [20%]). Motor speed on the finger-tapping test negatively correlated with dorsal putamen TSPO VT (r, −0.53; 95% CI, −0.79 to −0.09), and the 10 persons with the slowest speed among those with COVID-DC had higher dorsal putamen TSPO VT than healthy persons by 2.3 (2.30 divided by 8.37 [27%]; SD, 2.46; 95% CI, 0.92-3.68). Conclusions and Relevance: In this case-control study, TSPO VT was higher in patients with COVID-DC. Greater TSPO VT is evidence for an inflammatory change of elevated gliosis in the brain of an individual with COVID-DC. Gliosis may be consequent to inflammation, injury, or both, particularly in the ventral striatum and dorsal putamen, which may explain some persistent depressive and cognitive symptoms, including slowed motor speed, low motivation or energy, and anhedonia, after initially mild to moderate COVID-19 illness. [ABSTRACT FROM AUTHOR]

Aims: Canada's 2018 Cannabis Act allows youth (age 12–17 years) to possess up to 5 g of dried cannabis (or equivalent) for personal consumption/sharing. This study assessed whether the Cannabis Act was associated with changes in police‐reported cannabis offences among youth in Canada. Design Time series model using national daily criminal incident data from January 1, 2015–December 31, 2018 from the Canadian Uniform Crime Reporting Survey (UCR‐2). Seasonal autoregressive integrated moving average time series models, stratified by sex, assessed the relations between legalization and youth cannabis‐related offences. Setting: Canada, 2015–2018. Cases Police‐reported cannabis‐related offenses among youth age 12–17 years (male, n = 32 178; female, n = 9001). Measurements Outcomes: police‐reported cannabis‐related crimes, property crimes, and violent crimes. Covariate: calendar‐month. Findings For females, legalization was associated with a step‐effect decrease of 4.56 (95% confidence interval [CI] = 3.32, 5.81; P < 0.001) police‐reported cannabis‐related criminal offences per day, an effect equivalent to a 64.6% (standard error [SE] = 33.5%) reduction. For males, legalization was associated with a drop of 12.73 (95% CI = 8.82, 16.64; P < 0.001) cannabis‐related offences per day, equaling a decrease of 57.7% (SE = 22.6%). Results were inconclusive as to whether there were associations between cannabis legalization and patterns of property crimes or violent crimes. Conclusions: Implementation of the Cannabis Act in Canada in 2018 appears to have been associated with decreases of 55%–65% in cannabis‐related crimes among male and female youth. [ABSTRACT FROM AUTHOR]

Investigates whether hair of drug users, who takes ecstacy (MDMA), contains MDMA in the absence of other drugs in Toronto, Ontario. GC-MS analysis of scalp hair; Presence of MDMA and amphetamine/methamphetamine in the subjects; Number of subjects with MDMA metabolite equal to or greater than those of MDMA.

We previously reported that the 2018 Canadian Cannabis Act , allowing youth to possess up to 5 g dried cannabis or equivalent for personal use/sharing, was associated with short-term (76 days) post-legalization reduction in police-reported cannabis-related crimes among youth. To establish whether the change might be sustained, we now estimate this association during a much longer time period by including an additional three years of post-legalization data. Using national daily police-reported criminal incident data from January 1, 2015–December 31, 2021 from the Canadian Uniform Crime Reporting Survey (UCR-2), the study employed Seasonal Autoregressive Integrated Moving Average (SARIMA) time series models to assess the associations between legalization and youth (12–17 years) cannabis-related offenses (male, n = 34,508; female, n = 9529). Legalization was associated with significant reductions in both male and female police-reported cannabis-related offenses: females, 4.04 daily incidents [95% confidence interval (CI), 3.08; 5.01], a 62.1% decrease [standard error (se), 34.3%]; males, 12.42 daily offenses (95% CI, 8.99; 15.86), a reduction of 53.0% (se , 22.7%). There was no evidence of associations between cannabis legalization and patterns of property or violent crimes. Results suggest that the impact of the Cannabis Act on reducing cannabis-related youth crimes is sustained, supporting the Act 's objectives to reduce cannabis-related criminalization among youth and associated effects on the Canadian criminal justice system. • Canada's Cannabis Act aimed to reduce youth cannabis-related criminalization. • We assessed all Canadian police-reported youth offenses, 2015–2021. • A time series approach evaluated pre- and post-legalization youth crime trends. • Legalization was associated with 50–60% decrease in youth cannabis crimes. • No evidence of associations between legalization and property or violent crimes. [ABSTRACT FROM AUTHOR]

• Canada's cannabis legalization sought to decrease cannabis-related crime. • Study used Canadian adult police-reported criminal incidents from 2015 to 2021. • Cannabis legalization was successful in reducing cannabis-related crime among adults. • No spillover effects of legalization on adult property or violent crimes. A central goal of the Cannabis Act (October 17, 2018) – Canada's national cannabis legalization framework – aimed to reduce cannabis-related criminalization and consequent impact on the Canadian criminal justice system. We assessed whether Canada's cannabis legalization was associated with changes in adult police-reported cannabis-related, property, or violent criminal incidents. Seasonal Autoregressive Integrated Moving Average (SARIMA) time series models evaluated relations between legalization and adult cannabis-related, property, and violent crimes, using criminal incident data from the Canadian Uniform Crime Reporting Survey (UCR-2; January 1, 2015–December 31, 2021). National police-reported adult cannabis-related offenses (n = 247,249), property crimes (n = 2,299,777), and violent crimes (n = 1,903,762). Implementation of the Cannabis Act was associated with decreases in adult police-reported cannabis-related offenses: females, −13.2 daily incidents (95% CI, −16.4; −10.1; p < 0.001) – a reduction of 73.9% [standard error (se), 30.6%]; males, −69.4 daily offenses (95% CI, −81.5; −57.2; p < 0.001) – a drop of 83.2% (se, 21.2%). Legalization was not associated with significant changes in the adult property-crime or violent-crime series. Our findings suggest that Canada's cannabis legalization was successful in reducing cannabis-related criminalization among adults. There was also a lack of evidence for spillover effects of cannabis legalization on adult property or violent crimes. [ABSTRACT FROM AUTHOR]

Reports on medical examinations conducted in a drug overdose case in Canada. Concentration of ions of drug PMA present in the blood; Effectiveness of examination of hair in cases of drug overdose.

Background: Worldwide momentum toward legalization of recreational cannabis use has raised a common concern that such policies might increase cannabis-impaired driving and consequent traffic-related harms, especially among youth. The current study evaluated this issue in Canada.Methods: Utilizing provincial emergency department (ED) records (April 1, 2015-December 31, 2019) from Alberta and Ontario, Canada, we employed Seasonal Autoregressive Integrated Moving Average (SARIMA) models to assess associations between Canada's cannabis legalization (via the Cannabis Act implemented on October 17, 2018) and weekly provincial counts of ICD-10-CA-defined traffic-injury ED presentations. For each province (Alberta/Ontario), SARIMA models were developed on two driver groups: all drivers, and youth drivers (aged 14-17 years in Alberta; 16-18 years, Ontario).Results: There was no evidence of significant changes associated with cannabis legalization on post-legalization weekly counts of drivers' traffic-injury ED visits in: (1) Alberta, all drivers (n = 52,752 traffic-injury presentations), an increase of 9.17 visits (95 % CI -18.85; 37.20; p = 0.52); (2) Alberta, youth drivers (n = 3265 presentations), a decrease of 0.66 visits (95 % CI -2.26; 0.94; p = 0.42); (3) Ontario, all drivers (n = 186,921 presentations), an increase of 28.93 visits (95 % CI -26.32; 84.19; p = 0.30); and (4) Ontario, youth drivers (n = 4565), an increase of 0.09 visits (95 % CI -6.25; 6.42; p = 0.98).Conclusions: Implementation of the Cannabis Act was not associated with evidence of significant post-legalization changes in traffic-injury ED visits in Ontario or Alberta among all drivers or youth drivers, in particular. [ABSTRACT FROM AUTHOR]

Aim: To establish whether the population-level pattern of cannabis use by quantity is similar to the distributions previously reported for alcohol, in which a small subset of drinkers accounts for a majority of total population alcohol consumption.Method: The current study pooled Waves 1-3 of the 2018 National Cannabis Survey (n = 18,900; 2584 past-three-month cannabis users), a set of stratified, population-based surveys designed to assess cannabis consumption and related behaviors in Canada. Each survey systematically measured self-reported cannabis consumption by quantity across seven of the major cannabis-product types. In order to enable the conversion of self-reported consumption of non-flower cannabis products into a standard joint equivalent (SJE: equal to 0.5 g of dried cannabis), we created conversion metrics for physical production equivalencies across cannabis products.Results: Similar to the findings in the alcohol literature, study results show that cannabis consumption is highly concentrated in a small subset of users: the upper 10% of cannabis users accounted for approximately two-thirds of all cannabis consumed in the country. Males reported consuming more cannabis by volume than females (approximately 60% versus 40%), with young males (15-34 years old) being disproportionately represented in the heaviest-using subgroups.Conclusions: Most of the cannabis used in Canada is consumed by a relatively small population of very heavy cannabis users. Future research should attempt to identify the characteristics of the heaviest-using groups, as well as how population-level cannabis consumption patterns relate to the calculus of cannabis-related harms in society. [ABSTRACT FROM AUTHOR]

Parkinson's disease is a progressive neurological disorder characterized by rest tremor, bradykinesia, rigidity and postural instability. The cause is unknown, but growing evidence suggests that it may be due to a combination of environmental and genetic factors. Treatment during the early stage of Parkinson's disease has evolved, and evidence suggests that dopamine agonist monotherapy may prevent the response fluctuations that are associated with disease progression. L-dopa therapy, however, remains the most efficacious treatment. Treatment during the advanced stage focuses on improving control of a number of specific clinical problems. Successful management of motor response fluctuations (e.g., "wearing off," on-off fluctuations, nighttime deterioration, early morning deterioration and dyskinesias) and of psychiatric problems is often possible with specific treatment strategies. Surgical treatment is an option for a defined patient population.