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Introduction: While research with sexual minority men (SMM) has focused on disparities related to HIV, substance use and mental health, synergistic psychosocial pathways driving these epidemics remain underexplored. We used syndemic theory to assess how psychosocial factors sustain methamphetamine use and hinder recovery efforts for SMM living with HIV., Methods: A triangulation of network analyses and constructivist grounded theory approaches is utilised to elucidate pathways through which psychosocial factors influence methamphetamine use among this population. Survey data (N = 129) are used for quantitative analyses and a purposive sub-sample (n = 24) was recruited for semi-structured interviews for qualitative analyses., Findings: The network analysis revealed two statistically significant bivariate associations: between post-traumatic stress disorder and depression symptoms (b = 0.37, SD = 0.07, 95% confidence interval [0.23, 0.49]) and between depression symptoms and negative affect (b = 0.26, SD = 0.07, 95% confidence interval [0.12, 0.38]). Findings from the constructivist grounded theory analysis supplement the network analysis by offering a nuanced take on how negative affect, post-traumatic stress disorder, and depression symptoms operate synergistically to promote methamphetamine use and impede recovery efforts., Discussion and Conclusions: Participants relay experiences of using methamphetamine to cope with these psychosocial factors through avoidance, escapism, mood elevation, and numbing of emotions. Findings suggest that centring these psychosocial factors may inform more effective, holistic interventions for this high-priority population., (© 2024 Australasian Professional Society on Alcohol and other Drugs.)

Introduction: There has been a significant increase in methamphetamine/amphetamine use in North America, particularly among people who use opioids. Despite its association with several negative health consequences, the population of people who use methamphetamine/amphetamine with opioids is not well characterised. The aim of this study was to investigate correlates of methamphetamine/amphetamine use among adults with prescription-type opioid use disorder (POUD) starting methadone or buprenorphine/naloxone as part of a pragmatic randomised treatment trial in Canada., Methods: Multivariable logistic regression analyses were used to determine factors associated with baseline methamphetamine/amphetamine use (measured by urine drug test [UDT]) among participants of a pan-Canadian pragmatic trial conducted between 2017 and 2020 comparing supervised methadone versus flexible take-home dosing buprenorphine/naloxone models of care in people with POUD (e.g., licit or illicit, including fentanyl, prescribed or not)., Results: The sample included 269 participants, of which 142 (52.8%) had positive baseline methamphetamine/amphetamine UDT. In the multivariable model, positive fentanyl UDT (adjusted odds ratio [AOR] 13.21, 95% confidence interval [CI] 6.45, 28.30), non-fatal overdose in the last 6 months (AOR 2.26, CI 1.01, 5.17) and a lifetime history of opioid agonist therapy exposure prior to study entry (AOR 2.30, CI 1.09, 4.87) remained positively associated with baseline methamphetamine/amphetamine use., Discussion and Conclusions: In this sample of people with POUD, methamphetamine/amphetamine use was associated with markers of complex and severe OUD, including overdose risk. This suggests the need for targeted interventions to optimise treatment outcomes and prevent future overdoses in this population., Clinical Trial Registration: Available at: ClinicalTrials.gov NCT03033732., (© 2024 The Authors. Drug and Alcohol Review published by John Wiley & Sons Australia, Ltd on behalf of Australasian Professional Society on Alcohol and other Drugs.)

Objectives: The primary focus of this study is to determine if rural methamphetamine positive patients experience longer hospital length of stays compared to urban methamphetamine positive patients following an orthopaedic trauma., Methods: Patients presenting with traumatic orthopaedic injuries and urine drug screen were categorized into urban, suburban, and rural cohorts found in the Rural Urban Commuting Area codes based on home residence zip codes. Demographic, injury, hospital stay, and follow-up data were collected from the medical records. Comparisons between cohorts were determined by Chi square, Fisher exact, unpaired t-Tests, or ranked sum tests., Design: A retrospective cohort analysis., Setting: Academic Level I Trauma Center., Patient Selection Criteria: Patient records were examined between January 2013 to January 2023 for a traumatic orthopaedic injury and a urine drug screen result at the time of presentation to an academic Level I trauma center., Outcome Measures and Comparisons: Methamphetamine use status, patient age at time of admission, sex, marital status, insurance status, home zip code, orthopaedic injury location, complications, if the patient underwent surgery for orthopaedic injuries, admission date, discharge date, and discharge location were measured., Results: 249 patients met inclusion criteria for this analysis. Methamphetamine positive patients are significantly more likely to be younger, more likely to have surgery for orthopaedic injuries, experience a medical complication, or be discharged to home or a rehabilitation facility compared to methamphetamine negative patients. Urban patients experienced a shorter length of stay compared to suburban and rural patients, regardless of methamphetamine use status. Patients with Medicare, military, workers compensation, or commercial insurance are significantly more likely to attend follow-up appointments than patients with Medicaid or self-pay., Conclusions: Methamphetamine positive patients overall do not experience a longer length of hospital stay compared to methamphetamine negative patients. Rural methamphetamine positive patients experience a longer length of hospital stay compared to urban methamphetamine positive patients., Competing Interests: Declaration of competing interest The author group has the following disclosures: Ashwin R. Garlapaty: Nothing to disclose Anna N. Sullentrup: Nothing to disclose Terrell Christian: Nothing to disclose Kylee Rucinski: Nothing to disclose Brett D. Crist: Has the following disclosures: • AO Trauma North America: Board or committee member • Arthrex, Inc.: Other financial or material support • Curvafix: Paid consultant; paid presenter or speaker • DePuy, A Johnson & Johnson Company: Paid presenter or speaker • Fragility Fracture Network-USA: Board or committee member • Globus Medical: IP royalties • International Geriatric Fracture Society: Board or committee member • Journal of Hip Preservation: Editorial or governing board • Journal of Orthopaedic Trauma: Editorial or governing board • Kinetic Concepts, Inc.: Paid consultant; paid presenter or speaker • Orthocentric: Unpaid consultant • Orthopaedic Trauma Association: Board or committee member • RomTech: Stock or stock options • SLACK Incorporated: Editorial or governing board • Synthes: Paid consultant; research support • Urgo Medical: Unpaid consultant, (Copyright © 2024. Published by Elsevier Ltd.)

Objective: Methamphetamine causes considerable short- and long-term adverse health effects. Our aim was to assess the effects of methamphetamine use on pulmonary hypertension and lung diseases at the population level., Methods: This population-based retrospective study used data from the Taiwan National Health Insurance Research Database between 2000 and 2018 that included 18,118 individuals with methamphetamine use disorder (MUD) and 90,590 matched participants of the same age and sex without substance use disorder as the non-exposed group. A conditional logistic regression model was used to estimate associations of methamphetamine use with pulmonary hypertension and lung diseases such as lung abscess, empyema, pneumonia, emphysema, pleurisy, pneumothorax, or pulmonary hemorrhage. Incidence rate ratios (IRRs) of pulmonary hypertension and hospitalization due to lung diseases were determined between the methamphetamine group and non-methamphetamine group using negative binomial regression models., Results: During an 8-year observation period, 32 (0.2%) individuals with MUD and 66 (0.1%) non-methamphetamine participants suffered from pulmonary hypertension, and 2652 (14.6%) individuals with MUD and 6157 (6.8%) non-methamphetamine participants suffered from lung diseases. After adjusting for demographic characteristics and comorbidities, individuals with MUD were 1.78 times (95% confidence interval (CI) = 1.07-2.95) more likely to have pulmonary hypertension and 1.98 times (95% CI = 1.88-2.08) more likely to have a lung disease, especially emphysema, lung abscess, and pneumonia in descending order. Furthermore, compared to the non-methamphetamine group, the methamphetamine group was associated with higher risks of hospitalization caused by pulmonary hypertension and lung diseases. The respective IRRs were 2.79 and 1.67. Individuals with polysubstance use disorder were associated with higher risks of empyema, lung abscess, and pneumonia compared to individuals with MUD alone, with respective adjusted odds ratios of 2.96, 2.21, and 1.67. However, pulmonary hypertension and emphysema did not differ significantly between MUD individuals with or without polysubstance use disorder., Conclusions: Individuals with MUD were associated with higher risks of pulmonary hypertension and lung diseases. Clinicians need to ensure that a methamphetamine exposure history is obtained as part of the workup for these pulmonary diseases and provide timely management for this contributing factor., Competing Interests: Declaration of Competing Interest All authors declare no conflicts of interest., (Copyright © 2023 Sociedade Portuguesa de Pneumologia. Published by Elsevier España, S.L.U. All rights reserved.)

Introduction: Helplines are often the first contact with the alcohol and other drug (AOD) treatment system. We examined call data from an AOD helpline in Victoria, Australia, to explore the association between COVID-19 lockdown measures and frequency of calls., Methods: This was a retrospective analysis of AOD helpline data collected between January 2018 and September 2020, for alcohol, methamphetamine and cannabis use concerns. Linear and logistic regression analyses examined differences in pre-COVID-19 (January 2018 to March 2020) and during COVID-19 (March 2020 to September 2020) caller characteristics, and interrupted time-series analyses examined changes in frequency of calls relative to lockdown measures., Results: There were 14,340 calls for alcohol (n = 10,196, 71.10%), methamphetamine (n = 2522, 17.59%) and cannabis (n = 1622, 11.31%). Relative to pre-COVID-19, during COVID-19 there was an increase in the rate of change over time in number of alcohol calls (b = 0.39), increase in first-time alcohol callers (OR = 1.29), and reduction in first-time methamphetamine callers (OR = 0.80). During COVID-19, alcohol callers had lower Socio-Economic Indicators for Areas scores (b = -3.06) and cannabis callers were younger (b = -2.07). During COVID-19, there were reductions in alcohol calls involving counselling/support (OR = 0.87) and information provision (OR = 0.87), cannabis calls involving information provision (OR = 0.71) and methamphetamine calls involving referral (OR = 0.80)., Discussion and Conclusions: In the first 6 months of the pandemic, frequency of alcohol-related calls increased over time, and first-time alcohol-related callers increased. The number of calls for cannabis and methamphetamine remained stable. Results suggest the helpline was not used to its full capacity, suggesting a role for further promotion during times of crises., (© 2024 The Authors. Drug and Alcohol Review published by John Wiley & Sons Australia, Ltd on behalf of Australasian Professional Society on Alcohol and other Drugs.)

Background: The methamphetamine epidemic threatens progress towards ending the HIV epidemic in the United States. Further characterizing the prevalence and impact of methamphetamine use among people with HIV (PWH) is necessary to inform integrated HIV and methamphetamine treatment strategies., Methods: We conducted a retrospective chart review to characterize methamphetamine use among 3092 PWH at an urban HIV Medicine clinic between July 1, 2022 and June 30, 2023. The chi-squared test was utilized to assess for statistically significant differences in demographics and HIV and other health outcomes among PWH who use and do not use methamphetamine., Results: The prevalence of methamphetamine use among PWH in this cohort was 17%. PWH who used methamphetamine were more likely to be <40 years of age, identify as White race, live in neighborhoods with low Healthy Places Index scores, identify as lesbian, gay, or bisexual, report male sex with men (MSM), MSM and injection drug use (IDU), or IDU as HIV transmission risk factor, miss scheduled HIV primary care visits, and screen positive for hepatitis C virus antibody, gonorrhea, chlamydia, and major depressive disorder. PWH who use methamphetamine were also less likely to be virally suppressed and have a CD4 + cell count ≥200 cells/mm 3 ., Conclusion: Methamphetamine use is prevalent among PWH at this urban HIV Medicine Clinic and is associated with worse HIV and other health outcomes which likely increase the risk of HIV transmission. The integration of methamphetamine use disorder treatment into HIV primary care is necessary to work toward ending the syndemics of methamphetamine and HIV., (Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.)

Background: Sexual minority men are disproportionately affected by methamphetamine use, with recent studies suggesting an increase in use specifically among Black sexual minority men. Black sexual minority men face unique structural barriers to achieving optimal health. Given its harmful effects, and in light of existing health disparities, an increase in methamphetamine use among Black sexual minority men poses a significant public health concern., Objective: The Health Impacts and Struggles to Overcome the Racial Discrimination of Yesterday (HISTORY) study is investigating the potential impacts of exposure to the census tract-level structural racism and discrimination (SRD) on methamphetamine use among Black sexual minority men in Atlanta, Georgia, and will identify intervention targets to improve prevention and treatment of methamphetamine use in this population., Methods: This study uses a mixed methods and multilevel design over a 5-year period and incorporates participatory approaches. Individual-level quantitative data will be collected from a community-based cohort of Black sexual minority men (N=300) via periodic assessment surveys, ecological momentary assessments, and medical record abstractions. Census tract-level measures of SRD will be constructed using publicly available administrative data. Qualitative data collection will include longitudinal, repeated in-depth interviews with a subset (n=40) of study participants. Finally, using a participatory group model-building process, we will build on our qualitative and quantitative data to generate causal maps of SRD and methamphetamine use among Black sexual minority men, which in turn will be translated into actionable recommendations for structural intervention., Results: Enrollment in the HISTORY study commenced in March 2023 and is anticipated to be completed by November 2024., Conclusions: The HISTORY study will serve as a crucial background upon which future structural interventions can be built, to mitigate the effects of methamphetamine use and SRD among Black sexual minority men., International Registered Report Identifier (irrid): DERR1-10.2196/63761., (©Samuel C O Opara, Sabriya L Linton, Brian W Weir, Natalie D Crawford, David P Holland, Antonio Newman Jr, McKinsey Bullock, Marcus O Reed, Srija Dutta, Kamini Doraivelu, Charles Stephens, Justin C Smith, Yeeli Mui, Sophia A Hussen. Originally published in JMIR Research Protocols (https://www.researchprotocols.org), 31.10.2024.)

Methamphetamine use and HIV disproportionately affect sexual and gender minority (SGM) people assigned male at birth. Identifying risk factors for methamphetamine use is crucial to inform preventive interventions. In this cohort study with 1,296 SGM people assigned male at birth, ages 16 to 29, and who resided in Chicago, Poisson regression analyses indicated the prevalence of methamphetamine use increased from 2015 to 2023 [Incidence Rate Ratio (IRR) = 1.07; 95% CI = 1.01 to 1.13; P = 0.02]. This increase was most pronounced among those ages 25 or older at baseline (IRR = 2.20; 95% CI = 1.33 to 3.63; P = 0.002), and 23.9 [Interquartile Range (IQR) = 22.1 to 26.9] was the median age of first-time methamphetamine use. In 826 participants with a prior HIV diagnosis or previous inflammatory measurements, Cox proportional-hazards models examined risk factors for incident, first-time methamphetamine use. Adjusting for other substance use, the rate of incident, first-time methamphetamine use was two-fold greater after HIV diagnosis [adjusted hazard ratio (aHR) = 2.02; 95% CI = 1.27 to 3.23; P = 0.003]. For each SD higher C-reactive protein, the rate of incident, first-time methamphetamine use was 18% greater (aHR = 1.18; 95% CI, 1.05 to 1.34; P = 0.008). HIV seroconversion and inflammation could increase the risk of initiating methamphetamine use in SGM people assigned male at birth., Competing Interests: Competing interests statement:The authors declare no competing interest.

Background: The number of methamphetamine-related deaths has been increasing in recent decades. However, current data primarily rely on a few large-scale national surveys, highlighting the need for diverse data sources. Post-mortem studies offer advantages that compensate for the limitations of cohort studies. In this study, we aimed to (1) examine mortality rates and years of potential life lost, (2) compare proportionate mortality with previous cohort studies, and (3) quantitatively investigate causes of death as potential risk factors associated with each manner of death., Methods: We analyzed 740 cases from 2013 to 2019 in Taiwan., Results: The mean age of cases was 38.4 years, with a notable loss of 30 or more years of potential life, and 79.6% were male. The crude mortality rate was 0.45 per 100,000 person-years. The proportionate mortality indicated that autopsy dataset, compared to cohort studies, provided more accurate estimations for accidental deaths, equivalent suicides, underestimated natural deaths, and overestimated homicides. Accidental deaths were evident in 67% of cases with 80% attributed to drug intoxication. Multiple substances were detected in 61% of cases, with psychiatric medications detected in 43% of cases. Higher methamphetamine concentrations and a greater proportion of multiple substances and benzodiazepines were detected in suicidal deaths. Among accidental deaths, traffic accidents (7.9%) were the second most common cause, particularly motorcycle riders., Conclusion: Using autopsy dataset as a secondary source, we identified that over half of the cases involved drug intoxication-related accidental deaths. The significant proportion of cases involving multiple substances, psychiatric medications, and drug-impaired driving raises concerns.

Background: The most recent wave of the opioid epidemic has contributed to record number of drug overdoses. Most fatal outcomes are associated with opioids and methamphetamine; two substances that tend to be used at high rates among criminal justice populations. Despite the steady rise in the number of overdoses in local detention centers, many correctional facilities do not conduct routine screens for opioid and methamphetamine use disorders. This study examines the utility of the UNCOPE, a 6-item brief screen, to detect probable Diagnostic and Statistical Manual for Mental Disorders , fifth edition (DSM-5) diagnoses for these 2 specific substance use disorders (SUDs). The study also examines key indicators of these specific SUDs., Methods: Data were collected from comprehensive substance use assessments conducted with 717 adults who were recently admitted to 4 county jails., Results: Findings indicate that 3 positive UNCOPE responses accurately detected 99.8% of opioid use disorder diagnoses and 98.7% of methamphetamine use disorder diagnoses. Receiver operating characteristic curve results generate an area under the curve at 0.99 for severe opioid use cases and 0.98 for severe methamphetamine use cases. Subsequent analyses indicate 2 of the 6 items on the UNCOPE function to accurately identify 100% of cases classified with opioid use disorder and 99.6% of cases classified with methamphetamine use disorder., Conclusions: Evidence suggests that UNCOPE is a practical and efficient approach to identifying opioid and methamphetamine use disorders. In addition, 2 items can serve as an ultra-brief method to detecting these conditions at the time of admission to detention centers., Competing Interests: Declaration of Conflicting InterestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Methamphetamine is the illicit stimulant of choice in Australia. Countless initiatives have been employed to reduce methamphetamine use and drug-related harm. Wastewater analysis (WWA) has been used effectively as an objective measure of drug use at a population level and can be compared to indicators of harm, such as the number of drug-related fatalities. This paper attempts to describe methamphetamine use in the context of changes in levels measured in wastewater in South Australia whilst recognising considerable interventions over an 8-year period. Validated liquid chromatography-mass spectrometry methods were used to determine methamphetamine (and MDMA) levels in wastewater over an 8-year interval. The number of drug-induced deaths and driver fatalities involving methamphetamine (and MDMA) was presented and described in the context of changes in use measured by WWA. A rise in methamphetamine use according to WWA was evident up to 2017, followed by a gradual decrease to 2020 back to 2015 levels. Both driver fatalities and drug-induced deaths correlated well with use measured by WWA over the 8-year period. Multiple initiatives to curb supply, distribution and harm within the state and nationally have been implemented. The decrease in methamphetamine use after 2017 suggests that timely interventions have successfully reduced overall drug use and has led to fewer fatalities. This study shows that the response to increasing methamphetamine use in South Australia has resulted in a reversal of the upward trend in consumption and fewer drug-related fatalities., (© 2024 The Authors. Drug Testing and Analysis published by John Wiley & Sons Ltd.)

Women with substance use disorders (SUDs) have been widely reported to face barriers in seeking treatment. We sought to identify barriers that prevented women who use methamphetamine (WWUM) from accessing the decade-old Voluntary Treatment Centers (VTCs) in Malaysia. A total of 153 WWUM who were undergoing rehabilitation for methamphetamine use at a compulsory drug detention center (CDDC) were recruited for this cross-sectional study. Data were collected by canvasing a structured questionnaire through face-to-face meetings. Of the total sample, 131 (86%) were Malays, with a mean age of 32.1 years. The commonly cited treatment barriers were the belief that methamphetamine use was not problematic (42%), not knowing how to seek treatment (38%), feeling embarrassed to seek treatment (33%), the lack of family support (24%), and the long waiting time for enrollment (23%). Logistic analyses indicated that a longer duration of use increased the odds of not acknowledging methamphetamine use as a problem while older participants had lower odds of holding a similar view. A longer duration of use also increased the odds of claiming treatment was not needed but lowered the odds of asserting a lack of confidence in treatment. Furthermore, Malays had higher odds of lacking family support in seeking treatment while being employed lowered the odds of not wanting treatment. Addressing these concerns will hopefully encourage higher participation of WWUM in voluntary treatment programs.

Background: The emergence of New Psychoactive Substances (NPS), including synthetic psilocybin, has raised concern among health experts due to the numerous health and socioeconomic consequences. The current trend is shifting to the hazardous use of synthetic psilocybin in vaping, and little is known about the prevalence of use, specifically among amphetamine-type stimulants (ATS) users., Methods: Interviewer-administered questionnaires were conducted in drug detention centers between March and October 2022. The study was conducted using ASSIST 3.0 and obtained information on the respondents' socio-demographic characteristics and clinical profiles. N  = 355 ATS users were enrolled in this study., Results: The results show a high prevalence of psilocybin vaping among ATS users (182/355, 53.1%). Most of the respondents were males (85.1%) and unmarried (69.3%), with a mean age of 29.2 (SD = 7.3). Across all respondents, five factors were associated with psilocybin vaping: tobacco smoking, aOR =5.790 (95% CI: 1.723, 8.183); cannabis uses, aOR= 9.152 (95% CI: 2.693, 10.396); and alcohol use, aOR= 3.137 (95% CI: 1.461, 5.817). Respondents of the Malay race had higher odds of being involved in psilocybin vaping compared to other races, with aOR= 1.638 (0.043, 2.459). Meanwhile, a reduction in age by 1.9 will increase the likelihood of involvement in psilocybin vaping with aOR = 1.897 (95% CI: 0.857, 1.938)., Conclusion: Psilocybin in vaping is growing among ATS users and across all populations. Unfortunately, knowledge regarding the long-term effects on health is limited. Further studies should highlight the harmful effects of psilocybin and the potential risk of psilocybin vaping among the younger population.

Background: Post-traumatic stress disorder (PTSD) and substance use disorder (SUD) frequently occur together. Serotonergic agents are preferred medications to treat PTSD, while bupropion is reserved due to limited evidence. Ongoing studies suggest bupropion may be effective for treating methamphetamine use disorder (MUD). Investigators aimed to evaluate if bupropion would confer benefit to patients with Diagnostic and Statistical Manual of Mental Disorders, Fifth edition diagnoses for PTSD and MUD compared to traditional pharmacotherapy. Methods: This report describes four patients with comorbid PTSD and MUD who had a positive response to medication regimens containing bupropion compared to non-bupropion regimens for their trauma symptoms. Investigators were able to compare this to a control group of 41 patients receiving serotonergic agents alone. Case Report: PTSD checklist-civilian scores at time of medication initiation, site discharge, and post-discharge in the bupropion and non-bupropion group were 77, 35, and 29, compared to 51 ± 15, 52 ± 20 and 53 ± 10, respectively. Rates of relapse, average time to relapse, and hospital utilization in the bupropion vs non-bupropion group were 25.0% vs 48.8%, 107 days vs 210 ± 191 days, and 0% vs 29.3%, respectively. Discussion: Use of bupropion showed a greater reduction in PTSD symptom severity and a lower frequency of methamphetamine relapse and hospital utilization. Though missing data limited inclusion of patients in all outcomes, quantitative data suggests benefit with bupropion in comorbid PTSD and MUD. Conclusion: This case series suggests the potential for earlier initiation of bupropion treatment in those with PTSD who have comorbid MUD., Competing Interests: Declaration of Conflicting InterestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Methamphetamine is a synthetic psychostimulant that is showing a rising trend of usage among adolescents and youths. Its harmful side effects and high risk of developing addiction is a public health problem. Recognizing the knowledge, attitudes, and practices (KAP) on methamphetamine is critical in the planning of an intervention strategy. Currently there is a lack of KAP questionnaires on methamphetamine. The study aims to develop and validate a KAP questionnaire on methamphetamine-use for use among Malaysian adolescents. Following an extensive literature review, face and content validity were carried out among healthcare workers, the public, students, and local subject matter experts. A pilot study was conducted amongst 50 students to assess the test-retest reliability. The questionnaire was then distributed to two groups of 269 and 331 individuals for the Exploratory (EFA) and Confirmatory Factor Analysis (CFA), respectively. The internal reliability was also assessed among these groups. The content validation consisting of Item Content Validity Index (I-CVI, ranging from 0.875 to 1.00), and Scale Content Validity Index (S-CVI/Ave = 0.941) both showed good validation scores. Test-retest reliability showcased an Intraclass Correlation Coefficient (ICC) of > 0.7, indicating its reliability. The model was constructed via the EFA resulting in four constructs, and the model's goodness of fit was confirmed with CFA. An internal reliability was calculated with Cronbach's Alpha and showed acceptable reliability (α-values > 0.6) for all constructs. The KAP questionnaire of methamphetamine use is a valid and reliable tool that can be used among Malaysian adolescents. The model arising from this study, can also be used as a guide for future intervention models for adolescent methamphetamine-use disorder., (© 2024. The Author(s).)

Background: Methamphetamine (MA) (Mkpurummiri) is seen as the most common, accessible and new drug of use/abuse in south east Nigeria. Despite the overwhelming evidence of the dire consequences of this drug to the users, there is lack of empirical research to determine its prevalence in this area where use is assumed to be common. This study aimed to determine the prevalence of MA use, characteristics of the users and the control measures., Methods: A descriptive cross-sectional survey research design was conducted from May through November 2023 among adolescents/adults at the age bracket of 15-64 years in the five states of south east, Nigeria. Three hundred and seventy-one (371) respondents were recruited using purposive/convenience sampling methods. A semi structured questionnaire was the instrument used. Data were analyzed using percentage, bivariate and multivariate logistics regression statistics. The Prevalence of MA was determined using percentages whereas the factors that are associated with MA use were expressed using multivariate logistics regression statistics AORs and 95%CIs. The level of significance was set at P < 0.05., Results: The prevalence of Methamphetamine (Mkpurummiri) was (21.8%). The most common reason for MA use was depression (86.5%), the most common route of administration was inhalation (64.9%). The most common characteristic of MA (Mkpurummiri) user was aggressive/violent behaviour (94.1%).The control measures were self-control (92.2%), parental monitoring (85.7%), drug education (83.1%) and legal control (80.8%). The multivariate logistics regression statistics AOR shows that off-campus were 3 times (AOR = 0.298; CI = 0.12-0.73 P = 0.008), family house 4 times (AOR = 0.241; CI = 0.09-0.65; P = 0.005 ≤ 0.05 ) less likely than on-campus to predict MA use. Recently married were 3.25 times (aOR = 3.25; CI = 1.47-7.18), divorced 3.45 times (aOR = 3.45; CI = 1.23-9.58), polygamy 2.3 times (aOR = 2.3; CI = 1.08-4.90; P = 0.031 ≤ 0.05 ), tradition 4.44 times (aOR = 4.44; CI = 1.77-11.15; P = 0.001 ≤ 0.05 ) , more likely than others to use MA., Conclusions: MA use prevalence was relatively high, and marital status, living arrangements, family type and religion were the predictors. These findings underscore the need for concerted effort among the relevant government agencies, community stakeholders, families, religious bodies and school authorities to designing MA use policy/laws with special focus on adopting the punitive measure used in checking cocaine users. This may help to arrest and prosecute the manufacturers, distributors and users of MA., (© 2024. The Author(s).)

Background and Objectives: Recent increases in methamphetamine use among people seeking treatment for opioid use disorder (OUD) has created significant demand for effective approaches to support this clinical population. This study assessed the extent to which office-based opioid treatment (OBOT) patients, who were diagnosed with methamphetamine use disorder (MUD), engaged with providers., Methods: A retrospective analysis was conducted of adult patients (n = 470) seeking treatment for OUD who attended at least one visit between March 2020 and March 2023 at a rural regional OBOT provider. Approximately one quarter (28.7%) of patients were diagnosed with MUD in addition to receiving an OUD diagnosis. Bivariate methods and multivariate negative binomial regression models were estimated to examine the associations between clinical measures and the numbers of office visits, peer visits, and telehealth visits., Results: Regression results indicated patients who met criteria for MUD in addition to OUD attended a higher rate of peer visits (incidence rate ratio [IRR] = 2.63, p = .036) when compared to patients who did not meet criteria for MUD. In contrast, patients with MUD and OUD diagnoses displayed significantly lower (IRR = 0.68, p < .001) engagement rates through fewer office visits relative to those who did not meet MUD criteria., Discussion and Conclusions: Patients seeking treatment for OUD who meet criteria for MUD are more likely to engage through peer support specialists rather than office visits., Scientific Significance: This study demonstrates the ways patients who meet criteria for OUD and MUD engage with providers to receive treatment., (© 2024 The American Academy of Addiction Psychiatry (AAAP).)

Background: Over the past two decades methamphetamine-related harms have increased in Australia. Previous analysis of methamphetamine-related deaths has covered limited timeframes, and largely focused on drug-toxicity deaths. This paper examines long-term trends in methamphetamine-related deaths over 20 years, including deaths due to a range of specific causes., Methods: Descriptive analyses were conducted on Australian methamphetamine-related deaths (2001-2023) by cause, extracted from the National Coronial Information System, an online database containing deaths reported to coroners in Australia and New Zealand. Joinpoint trend analyses were used to assess changes over time between 2001 and 2020 (with data from 2021 to 2023 likely incomplete and thus excluded)., Results: Unintentional drug toxicity was the cause of 49.8 % of methamphetamine-related deaths, intentional self-harm (including toxicity) 23.3 %, unintentional injury 15.1 %, natural causes 9.6 %, and assaults 2.3 %. Between 2001 and 2020, joinpoint analysis showed three trend change points among all-cause methamphetamine-related mortality rates, resulting in four distinct periods: two periods where they increased (2001-2006 - annual percentage change (APC) = 15.4 %; 2009-2016 - APC 25.5 %), and two where they decreased (2006-2009 - APC = -11.8 %; 2017-2020 - APC = -2.9 %). Similar patterns were evident among rates of intentional self-harm and unintentional injury. Deaths caused by unintentional drug toxicity saw two trend change points (2011, 2016), and rates increased across all three periods. Natural cause deaths had three trend change points (2007, 2010, 2015), and rates continued to rise after 2015, largely driven by increases in circulatory diseases., Conclusion: Cause-specific models highlighted diverse trends. Recent trends show unintentional drug toxicity deaths have slightly increased, intentional self-harm stabilised, and unintentional injury and assault deaths have declined. Deaths from natural causes involving methamphetamine continued to increase, highlighting a public health concern and a potential need for early circulatory disease screening among people who use methamphetamine., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 The Author(s). Published by Elsevier B.V. All rights reserved.)

Background: Treatment for methamphetamine and other stimulants can be effective but treatment attrition and continued use are very high. Abstinence is the conventional outcome used to evaluate treatment success, but defining treatment success in this way misses opportunities to promote improved health even when abstinence is not achieved. Reducing methamphetamine and stimulant use without abstinence is associated with many positive outcomes. However, little is known about drug use patterns during treatment or trends in use over time., Methods: We used the Treatment Episode Dataset-Discharges (TEDS-D) to identify treatment episodes that had a stimulant drug indicated as the primary substance of use (2017-2021; N=251,841; methamphetamine, cocaine, other amphetamines, or other stimulants). Our outcome was the change in the frequency of drug use between admission and discharge (decreased use with abstinence, decreased use without abstinence, increased use). We used multiple logistic regression to model a change in drug use frequency, predicted by year, stimulant type, and their interaction., Results: Nearly two-thirds of the sample (60 %) had methamphetamine indicated as the primary stimulant of use. There was a decrease in the predicted rate of abstinence over time and worsening trends were strongest among those using methamphetamine. Daily and periodic drug use at both admission and discharge (no change in use) became worse over time, particularly for those using methamphetamine., Conclusion: Treatment outcomes worsened over time and declined fastest among those reporting methamphetamine. Abstinence was rare and most treatment clients did not change their drug use behavior. We recommend a renewed focus on evidence-based harm reduction while the nation's treatment systems continue grappling with the stimulant crises., Competing Interests: Declaration of Competing Interest All authors involved declare they have no conflicts of interest., (Copyright © 2024 Elsevier B.V. All rights reserved.)

Background: Although methamphetamine use has been increasing in recent years and occurring within new populations and in broader geographical areas, there is limited research on its use and effect in pregnancy., Objective: This study aimed to examine the association between prenatal methamphetamine use and maternal and neonatal outcomes in a large, contemporary birth cohort., Study Design: This was a retrospective cohort study using California-linked vital statistics and hospital discharge data from 2008 to 2019. Methamphetamine use was identified using the International Classification of Disease, Ninth Revision and Tenth Revision, codes. Chi-square tests and multivariable Poisson regression models were used to evaluate the associations between methamphetamine use and maternal and neonatal outcomes., Results: A total of 4,775,463 pregnancies met the inclusion criteria, of which 18,473 (0.39%) had methamphetamine use. Compared with individuals without methamphetamine use, individuals with methamphetamine use had an increased risk of nonsevere hypertensive disorders (adjusted risk ratio, 1.81; 95% confidence interval, 1.71-1.90), preeclampsia with severe features (adjusted risk ratio, 3.38; 95% confidence interval, 3.14-3.63), placental abruption (adjusted risk ratio, 3.77; 95% confidence interval, 3.51-4.05), cardiovascular morbidity (adjusted risk ratio, 4.30; 95% confidence interval, 3.79-4.88), and severe maternal morbidity (adjusted risk ratio, 3.53; 95% confidence interval, 3.29-3.77). In addition, adverse neonatal outcomes were increased, including preterm birth at <37 weeks of gestation (adjusted risk ratio, 2.85; 95% confidence interval, 2.77-2.94), neonatal intensive care unit admission (adjusted risk ratio, 2.46; 95% confidence interval, 2.39-2.53), and infant death (adjusted risk ratio, 2.73; 95% confidence interval, 2.35-3.16)., Conclusion: Methamphetamine use in pregnancy is associated with an increased risk of adverse maternal and neonatal outcomes that persists after adjustment for confounding variables and sociodemographic factors. Our results can inform prenatal and postpartum care for this high-risk, socioeconomically vulnerable population., (Copyright © 2024 Elsevier Inc. All rights reserved.)

Objectives: Stimulant use is a growing problem, but little is known about service utilization among patients with stimulant use disorder (StUD). In the context of the overdose crisis, much research has focused on patients with opioid use disorder (OUD). It is unclear how the characteristics, treatment receipt, and hospitalization of patients with StUD differ from patients with OUD., Methods: Electronic health record data were extracted for national Veterans Health Administration patients with a visit from March 1, 2020, to February 28, 2021 with StUD and/or OUD (N = 132,273). We compared patients with StUD without OUD to those with (1) co-occurring StUD + OUD and (2) OUD without StUD. Patient characteristics, substance use disorder treatment, and hospitalizations in the year following patients' first study period visit were descriptively compared. Treatment and hospitalization were also compared in adjusted regression models., Results: Compared with patients with OUD + StUD, those with StUD without OUD were less likely to receive outpatient (adjusted odds ratio [aOR] 0.49, 95% confidence interval [CI] 0.47-0.50) or any treatment (aOR 0.47, 95% CI 0.46-0.49). Compared with patients with OUD without StUD, those with StUD without OUD were less likely to receive outpatient (aOR 0.51, 95% CI 0.49-0.52) or any treatment (aOR 0.56, 95% CI 0.54-0.58) and more likely to receive residential treatment (aOR 2.18, 95% 2.05-2.30) and to be hospitalized (aOR 1.62, 95% 1.56-1.69)., Conclusions: Patients with StUD may be less likely to receive treatment and more likely to be hospitalized than patients with OUD. Efforts focused on mitigating hospitalization and increasing treatment receipt for patients with StUD are needed., Competing Interests: LAL consults on telehealth for substance use disorder treatment for Providers Clinical Support System with funding from the Substance Abuse and Mental Health Services Administration, and for National Center for Quality Assurance with funding from Alkermes. The other authors report no conflicts of interest., (Copyright © 2024 American Society of Addiction Medicine.)

Background: In the U.S., overdose deaths and substance treatment admissions related to methamphetamine are rising. This study aims to measure and compare U.S. temporal trends in methamphetamine-involved psychiatric hospitalizations., Methods: We conducted a population-based, trend analysis of U.S. psychiatric hospitalizations and calculated quarterly (Q) rates per 100,000 population of substance-involved psychiatric hospitalizations. We assessed U.S. regional quarterly percentage hospitalization rate changes using Joinpoint regression., Results: From Q4 2015-Q4 2019, there were 963,202 psychiatric hospitalizations, 50,223 (5.2 %) involved methamphetamine and 102,877 (10.7 %) involved opioids and/or cocaine without methamphetamine. Methamphetamine-involved psychiatric hospitalization rates increased by 68.0 %, psychiatric hospitalizations rates involving opioid and/or cocaine without methamphetamine decreased by 22 %, while nonsubstance-involved psychiatric hospitalizations rates remained unchanged. The largest significant increases in methamphetamine-involved psychiatric hospitalization rates were among people >61 years old, males, and Midwesterners. Methamphetamine-involved psychiatric hospitalization rates doubled among Black patients. The largest average percent increase among methamphetamine-involved psychiatric hospitalizations was 10.2 % from Q4 2015-Q2 2017 in the Midwest., Conclusion and Relevance: Most psychiatric hospitalizations did not involve substances. Methamphetamine-involved psychiatric hospitalizations greatly increased while opioid-involved psychiatric hospitalizations decreased, but involved more total encounters. Greater access to harm reduction services, contingency management programs, and mental health services is urgently needed., Competing Interests: Declaration of Competing Interest None of the authors have conflicts to declare., (Copyright © 2024 Elsevier B.V. All rights reserved.)

Purpose: The correctional system continues to face challenges with responding to and managing methamphetamine use among incarcerated individuals. This study aims to uncover what resources and policies could better help correctional workers deal with these challenges. The authors also examined methamphetamine's impact on correctional work and staff well-being., Design/methodology/approach: An online survey was distributed to correctional workers ( n = 269) in Manitoba, Canada, featuring questions about their experiences related to methamphetamine use in populations under their care, what supports are needed to adequately address the concern, and the potential effects on self and their occupational responsibilities. Using NVivo software, survey responses were analysed using an emergent theme approach., Findings: Correctional workers believed policies and protocols for managing methamphetamine use and withdrawal are currently inadequate. Correctional workers reported having monthly contact with incarcerated individuals experiencing methamphetamine withdrawal, posing safety concerns to them and other incarcerated individuals. Respondents proposed more education and training on managing incarcerated people withdrawing from methamphetamines, related to the symptoms of use and withdrawal and how to support persons detoxing. Increased human and material resources were reported as being needed (e.g. more nurses onsite and better screening devices). Respondents also desired more medical intervention, safe living spaces for methamphetamine users and programming to support addiction., Originality/value: The current study unpacks correctional workers' perspectives, support desires and their experiences managing methamphetamine use amongst incarcerated people. The authors discuss the required knowledge to respond to gaps in prison living, re-entry and related policy needs., (© Emerald Publishing Limited.)

Background: Methamphetamine use and related direct and indirect problems are increasing all over the world. The coexistence of lifetime marijuana use (LMU) and methamphetamine use disorder (MUD) may also be accompanied by psychotic symptoms (MAP). Methamphetamine and marijuana use are known to pose risks for cardiovascular diseases (CVDs). However, ten-year CVD risk and inflammation markers of LMU-MUD (non-psychosis group) and LMU-MAP (psychosis group) subjects and the relationship of various sociodemographic and clinical variables with these markers have not yet been examined., Methods: Thirty-two male subjects were included in non-psychosis group and 72 male subjects in psychosis group. Sociodemographic and clinical characteristics were recorded. Psychotic symptom severity of psychosis group subjects was measured. The ten-year CVD risk was calculated using QRISK ® 3 model., Results: Age, cigarettes/pack-years, alcohol use onset age, drug use onset age, methamphetamine use onset age, duration of methamphetamine use, education and marital status of the groups were similar (p > 0.05). There was a statistical difference between the non-psychosis and psychosis groups in terms of self-mutilation history (p < 0.001), suicidal attempt history (p = 0.007), homicidal attempt history (p = 0.002), psychiatric hospitalization history (p = 0.010). Ten-year QRISK ® 3 score was 4.90 ± 9.30 in the psychosis group, while it was 1.60 ± 1.43 in the non-psychosis group (p = 0.004). The mean heart age of the psychosis group was 14 years higher than their chronological age, while the mean heart age of the non-psychosis group was 8 years higher. Neutrophil to lymphocyte ratio (NLR) (p = 0.003) was higher in the psychosis group. A significant correlation was detected between ten-year QRISK ® 3 and positive psychotic symptoms in the psychosis group (r = 0.274, p = 0.020). Regression analysis showed that self-mutilation history, NLR and relative risk obtained from QRISK ® 3 can be used to distinguish non-psychosis group and psychosis group subjects (sensitivity = 91.7; Nagelkerke R 2 0.438; p = 0.001)., Conclusions: This study is important as it demonstrates for the first time that among the subjects using marijuana and methamphetamine, those with psychotic symptoms have a higher NLR and ten-year CVD risk., (© 2024. The Author(s).)

Our study assessed the association between methamphetamine (i.e., crystal meth, CM) use and awareness and interest in event-driven (ED) PrEP among HIV-negative and those with unknown serostatus cisgender males and transgender people. We performed log-binomial regression analysis to predict awareness (i.e., having heard of ED PrEP) and being interested in ED PrEP. We found that participants who recently used CM were less likely to know of ED PrEP (aPR = 0.83, 95% CI [0.69, 0.99]) but more interested in ED PrEP (aPR = 1.12, 95% CI [1.01, 1.30]), after accounting for demographic and HIV-related behaviors. Opportunities to expand PrEP uptake and improve adherence among individuals who report CM use are essential to impact the HIV epidemic significantly. Continued research on the needs and best practices to work with this community is needed to ensure a successful rollout and implementation of ED PrEP.

Background: Methamphetamine-associated cardiomyopathy (MACM) is a known complication of methamphetamine use; however, risk factors and outcomes of patients with MACM are not well understood., Study Objectives: This study aims to identify risk factors, emergency department (ED) interventions, and outcomes for MACM., Methods: This case-control study was conducted between 2012 and 2020 at two academic EDs. ED patients ≥18 years with an index visit that included documented methamphetamine use were included. Patients with documented MACM during follow-up (3 months-3 years) were considered cases (MACM). A control group comprised of patients with documented methamphetamine use but no known MACM was matched at a 2:1 ratio. Logistic regression was used to model risk factors for MACM., Results: A total of 9833 patients with methamphetamine use were identified. From this, 160 MACM patients were matched to 322 controls. The mean age was 48.4 years, and 143 patients (29.7%) were female. MACM patients were more likely to be admitted on their index visit (45.6% vs. 34.8%, p = 0.021). Significant variables associated with MACM included: admission at the index visit (odds ratio [OR] 1.51), diabetes (OR 3.02), kidney disease (OR 5.47), and pulmonary disease (OR 2.39). MACM patients had more ED visits in the follow-up period (10.1 vs. 7, p = 0.009) and were admitted at a higher rate across all visits (32.5% vs. 15.4%, p = 0.009). Additionally, MACM patients had significantly longer hospital stays than controls (mean 18 additional days, p = 0.009)., Conclusion: Patients who developed MACM had traditional risk factors for heart failure and experienced significantly more ED visits, more hospitalizations, and longer hospital stays than matched controls., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 The Authors. Published by Elsevier Inc. All rights reserved.)

With the substantial increase in the use of stimulants, especially methamphetamine, in recent years, the present study aimed to cluster methamphetamine users based on personality traits and self-efficacy, and compare their mental health, sleep quality, and the risk of relapse in the identified clusters. This cross-sectional study was conducted through convenience sampling on 501 methamphetamine users in addiction treatment centers in Kermanshah, western Iran. The data were collected using the Schwarzer General Self-Efficacy Scale, Zuckerman-Kuhlman Personality Questionnaire, Goldberg and Hiller General Health Questionnaire (GHQ), Zuckerman-Kuhlman Personality Questionnaire, and Stimulant Relapse Risk Scale (SRRS). A total of 501 methamphetamine users were distinguished into three clusters with frequencies of 111 (22.2%), 298 (59.5%), and 92 (18.4%) members through hierarchical cluster analysis. The participants in the first cluster were characterized by low self-efficacy, high neuroticism, sensation seeking, and aggressiveness, along with low extroversion and activity, low positive health, high negative health, low sleep quality, and high risk of drug relapse. The participants in the second cluster reported moderate levels of self-efficacy, neuroticism, sensation seeking, activity, and aggressiveness, high extroversion, and moderate levels of mental health, sleep quality, and the risk of relapse. Moreover, the participants in the third cluster reported the highest level of self-efficacy, the lowest level of neuroticism, sensation seeking, and aggressiveness, moderate extroversion and high activity, low relapse risk, high sleep quality, as well as high positive and low negative health symptoms. The third cluster was significantly different from the other two clusters in terms of the mentioned factors. The findings of this study suggest that low self-efficacy and the presence of neuroticism, sensation seeking, and high aggressiveness contribute to reduced mental health and sleep quality, as well as an increased risk of relapse in methamphetamine users., (© 2024. The Author(s).)

Introduction: Individuals involved with the criminal justice system face challenges in receiving and maintaining substance use disorder (SUD) treatment and support. Although telephone monitoring (TM) could reduce these barriers, data on TM for community-dwelling individuals involved with the criminal justice system and research on individuals who drop out of TM are scarce. We examined the factors associated with dropping out early from the Voice Bridges Project, which provides TM for individuals on probation for drug-related convictions through community mental health centers in Japan., Methods: Participants (n = 546) were individuals aged ≥20 years with methamphetamine-related convictions who were on probation. Univariate analyses examine the associations between one-year follow-up status and baseline variables, and multivariate Cox proportional hazards regression analyses identify the risk and protective factors associated with dropping out. Stratified analyses report results based on sex and halfway-house residency., Results: The one-year dropout rate was 43.6 % (n = 238). Multivariate analysis identified two risk factors for dropping out-halfway-house residency and suicide attempts in the past year, and two protective factors-higher education and the current use of SUD services. Sex-stratified analyses showed that halfway-house residency was a risk factor for both men and women. Attempted suicide was a risk factor for women. Conversely, higher education and current use of SUD services were protective factors for men., Conclusions: Our results identify unique risk factors for women, such as a recent history of suicide attempts, and distinctive protective factors for men, including higher education and current use of SUD services, emphasizing the importance of sex-specific approaches. Furthermore, the study reveals that irrespective of sex, vulnerable individuals, such as halfway-house residents, are at a higher risk of dropping out from TM., Competing Interests: Declaration of competing interest Toshihiko Matsumoto received financial support for this research from the Ministry of Health, Labour and Welfare, Japan. Shiori Tsutsumi received financial support for this research from the Japan Science and Technology Agency and Keio University. The authors declare that although they received funding as mentioned above, this financial support did not influence the outcomes, interpretation, or presentation of the research findings. The research was conducted independently, and the views expressed in this paper are those of the authors and not necessarily those of the funding agencies., (Copyright © 2024 The Authors. Published by Elsevier Inc. All rights reserved.)

Background: The current fourth wave of the United States opioid overdose epidemic is characterized by the co-use of opioids and stimulants, including illicit opioids and methamphetamine. The co-use of these two drugs, known as "goofballing," is associated with higher risk for several adverse outcomes, including more frequent injections, greater health risks, and higher morbidity. Considering these differences, this unique subpopulation of people who inject drugs (PWID) may also have unique unmet needs and harm reduction preferences., Methods: We collected self-reported data from participants (N = 50) of a syringe services program (SSP), including basic needs and harm reduction preferences. Using bivariate analyses, we examined differences between SSP participants who do and do not co-use illicit opioids and methamphetamine. Co-use was defined as reporting the use of both drugs, which may or may not have been used simultaneously., Results: In the overall sample, the mean level of need was highest for bus passes or other transportation, a person who can help you get the services you need, medication for opioid use disorder, and a job or job training. Additionally, all participants reported being either interested or very interested in fentanyl test strips, safe consumption sites, delivery of syringe service supplies, and delivery of naloxone. Those who endorsed co-use had a greater need for food, healthcare, substance use disorder treatment, a support person to help them access needed services, and bus passes or transportation., Conclusions: Unmet needs were prevalent, and the desire for more harm reduction services was high among these PWID. Results also suggest people who co-use illicit opioids and methamphetamine may have the greatest unmet needs and desire for additional harm reduction services., (© 2024. The Author(s).)

Competing Interests: We declare no competing interests.

Methamphetamine use is on the rise among sexual and gender minority people who have sex with men (SGMSM), escalating their HIV risk. Despite pre-exposure prophylaxis (PrEP) being an effective biomedical HIV prevention tool, its uptake in relation to methamphetamine use patterns in SGMSM has not been studied. In a U.S. cohort study from 2017 to 2022, 6,253 HIV-negative SGMSM indicated for but not using PrEP were followed for four years. Methamphetamine use was categorized (i.e., newly initiated, persistently used, never used, used but quit), and PrEP uptake assessed using generalized estimating equation (GEE), adjusted for attrition. Participants had a median age of 29, with 51.9% White, 11.1% Black, 24.5% Latinx, and 12.5% other races/ethnicities. Over the four years, PrEP use increased from 16.3 to 27.2%. GEE models identified risk factors including housing instability and food insecurity. In contrast, older age, health insurance, clinical indications, and prior PrEP use increased uptake. Notably, Latinx participants were more likely to use PrEP than Whites. Regarding methamphetamine use, those who newly initiated it were more likely to use PrEP compared to non-users. However, those who quit methamphetamine and those who persistently used it had PrEP usage rates comparable to those of non-users. Though PrEP uptake increased, it remained low in SGMSM. Methamphetamine use was associated with PrEP uptake. Healthcare providers should assess methamphetamine use for harm reduction. Prioritizing younger, uninsured SGMSM and addressing basic needs can enhance PrEP uptake and reduce HIV vulnerabilities., (© 2024. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)

Background: Amidst an increasingly toxic drug supply in North America, people who inject drugs may be transitioning to smoking them. We aimed to assess changes in injecting and smoking opioids and methamphetamine among a cohort of people who inject drugs from San Diego, California., Methods: Over five six-month periods spanning October 2020-April 2023, we assessed prevalence of injecting and smoking opioids or methamphetamine and whether participants used these drugs more frequently by smoking than injecting. Multivariable Poisson regression via generalized estimating equations was used to examine time trends., Results: Of 362 participants, median age was 40 years; a minority were female (29%), Hispanic/Latinx/Mexican (45%), and housed (33%). Among this cohort, of whom 100% injected (and 84% injected and smoked) in period one (October 2020-April 2021), by period five (November 2022-April 2023), 34% only smoked, 59% injected and smoked, and 7% only injected. By period five, the adjusted relative risk (aRR) of injecting opioids was 0.41 (95% Confidence Interval [CI]: 0.33, 0.51) and the aRR for injecting methamphetamine was 0.50 (95% CI: 0.39, 0.63) compared to period one. Risks for smoking fentanyl rose significantly during period three (aRR=1.44, 95% CI: 1.06, 1.94), four (aRR=1.65, 95% CI: 1.24, 2.20) and five (aRR=1.90, 95% CI: 1.43, 2.53) compared to period one. Risks for smoking heroin and methamphetamine more frequently than injecting these drugs increased across all periods., Conclusions: Opioid and methamphetamine injection declined precipitously, with notable increases in smoking these drugs. Research is needed to understand the health consequences of these trends., Competing Interests: Declaration of Competing Interest None., (Copyright © 2024 The Author(s). Published by Elsevier B.V. All rights reserved.)

Objective: Anxiety and depression are prevalent mental health problems in people who use illicit stimulants. Improved understanding of the temporal relationship between methamphetamine, ecstasy/MDMA, or cocaine use with anxiety or depression informs public health interventions and treatment options for those experiencing this co-occurrence. This narrative systematic review sought to examine associations and temporality between the use of methamphetamine, ecstasy/MDMA, or cocaine, with anxiety or depressive symptoms. Method Systematic searches of 4 electronic databases were conducted up to August 2023. Study eligibility included the measurement of anxiety and/or depressive symptoms, and frequency of illicit stimulant use (methamphetamine, cocaine, or ecstasy/MDMA) at two separate time points, with data analysis of the association between these variables. The Joanna Briggs Critical Appraisal Checklist was utilised to assess quality. Data was extracted, and a narrative synthesis incorporating an eight-criteria framework to assess associations was conducted. Results 4432 studies were screened for eligibility; 11 studies (3 RCTs and 8 prospective cohort studies) were included. Evidence for an association between depressive symptoms and methamphetamine use was demonstrated in six studies, with temporal evidence in three studies supporting methamphetamine use preceding depressive symptoms. Three studies reported an association between cocaine use and depressive symptoms. Evidence for associations with any of the illicit stimulants and anxiety symptoms was lacking., Conclusions: There was some evidence to support a case for temporality, particularly for methamphetamine use and depressive symptoms. Investing in longitudinal studies is pivotal to understanding the dynamic and reciprocal relationship between illicit stimulant use and anxiety or depressive symptoms. A limitation of the study was the variation in the measurement and analysis of outcomes., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 The Author(s). Published by Elsevier Ltd.. All rights reserved.)

This cross-sectional study aims to evaluate the immune system status and hematological disturbances among individuals who abuse amphetamines and cannabis. Substance abuse, particularly of amphetamines and cannabis, has been associated with various adverse effects on the body, including potential impacts on the immune system and hematological parameters. However, limited research has been conducted to comprehensively assess these effects in a cross-sectional design. Additionally, fungal infections are on the rise internationally, and immune-compromised people are particularly susceptible. The study will recruit a sample of amphetamine and cannabis abusers (n = 50) at the Eradah Hospital in the Qassim Region of Buraydah and assess their sociodemographic and biochemical variables, including blood indices and differential WBC indices, liver, and kidney profiles. Additionally, 50 sputum samples in total were cultured for testing for fungus infections. To obtain the descriptive statistics, the data was imported into Microsoft Excel and subjected to statistical analysis using SPSS 22.0. Amphetamine and cannabis abuser's sociodemographic variables analysis observed that the majority (52%) were aged 18-30, with 56% in secondary school. Unemployment was a significant issue, and most had no other health issues. The majority (50%) had 5-10 years of abuse, while 32% had less than 5 years, and only 18% had been drug abusers for more than 10 years. There were significant changes (p < 0.001) in all different leukocyte blood cells, including neutrophils, lymphocytes, monocytes, eosinophils, and basophils. Furthermore, a microscopic examination of blood films from individuals who misuse the combination of the medications "amphetamine and cannabis" reveals hazardous alterations in Neutrophils. Out of 50, 35 sputum samples showed positive growth on Sabouraud dextrose agar (SDA) with chloramphenicol antibiotic, indicating a unicellular fungal growth. The present study explores the immune system and hematological disturbances linked to amphetamine and cannabis abuse, providing insights into health risks and targeted interventions. The findings complement previous research on drug users' hematological abnormalities, particularly in white blood cells. Routine hematological tests help identify alterations in homeostatic conditions, improving patient knowledge and preventing major issues. Further research is needed on multi-drug abuse prevention, early detection, and intervention. The cross-sectional design allows for a snapshot of the immune system and hematological status among abusers, laying the groundwork for future longitudinal studies. Key Words: Drug Effect, Immunity, Epidemiology, Oxidative Stress, Inflammation., (© 2024. The Author(s).)

There are limited quantitative studies describing the association between meth use in the context of male-male sexual partnerships and PrEP care engagement. We assessed the longitudinal relationship between individual and partnership level meth use with inconsistent PrEP engagement among young gay, bisexual and other men who have sex with men (GBMSM) in Los Angeles. The primary exposure was meth use at the partnership level with a ternary variable (neither partner nor participant used meth, either used meth, or both used meth). Generalized estimating equations were used to assess odds of inconsistent PrEP engagement at different levels of partner-participant meth use, adjusting for age at visit, number of recent male partners and partner intimacy. Among inconsistent PrEP engagement, 61% (n = 84, vs. 79.5%, n = 346 continuous) reported that neither they nor their partner used meth, 22% (n = 31, vs. 18%, n = 56) reported that either partner or participant used meth and 17% (n = 24, vs. 8%, n = 33) reported that both partner and participant used meth (P < 0.01). There were increased odds of inconsistent PrEP engagement when both partner and participant reported meth use (aOR: 3.82; 95%CI: 1.83-7.99) and when either partner or participant reported meth use (aOR: 2.46; 95%CI: 1.28-4.75). Meth use plays an important role in consistent PrEP engagement among GBMSM in mSTUDY. PrEP users who use meth with partners may benefit from integrated interventions addressing both meth use and PrEP engagement., (© 2023. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)

Objectives: Although methamphetamine use is common, the scope of methamphetamine use and outcomes for patients admitted to the hospital is unclear. This study aims to identify the prevalence of methamphetamine use from January 2012 to January 2022, coingestions, hospital course, and readmission rate of admitted patients., Methods: This was a retrospective cohort study conducted on patients admitted to our center with the following inclusions: age older than 18 years, positive/"pending confirm" value for methamphetamine on urine drug screen, and/or an International Classification of Diseases , Tenth Revision , code related to stimulant use disorder as an active issue. Urine drug screen data are reported as methamphetamine +/- and polysubstance (PS) +/-. Patient demographics, admission diagnosis, and hospital course were extracted. Statistical tests used included t tests and Mann-Whitney U tests., Results: A total of 19,159 encounters were included, representing 12,057 unique patients. The median (interquartile range) age was 43 (33-54) years. Of all encounters, 35.3% were methamphetamine + and PS -, and 46.3% were methamphetamine + and PS +. Hospitalizations increased from 883 in 2012 to 2532 in 2021. The median (IQR) hospital stay was 48 (48-120) hours. Of all encounters, 16.8% included an intensive care unit (ICU) admission, and the median ICU stay was 42 (21-87) hours. A total of 2988 patients (24.7%) were readmitted within the study period, and 4988 (71.5%) returned within 1 year of the previous encounter. In context of all emergency department admissions from 2013 to 2022, 13.1% had a urine drug screen + for methamphetamine., Conclusions: Hospitalizations with recent methamphetamine use doubled at our institution from 2012 to 2022. In addition, 1 in 4 is readmitted (typically within 1 year), and a minority requires ICU care., Competing Interests: The authors report no conflicts of interest., (Copyright © 2024 American Society of Addiction Medicine.)

Background: This study investigates the association between Methamphetamine (MA) intoxication and suicidal ideation/behavior in patients presenting to emergency departments. Amidst rising MA use and co-use with opioids, this "twin epidemic" has manifested in increasing admissions for MA intoxication, often accompanied by psychiatric symptoms that can escalate to suicidal behaviors., Method: This retrospective study utilized patient records and analyzed data from 629 patients admitted to a Texas emergency department in 2020, with MA intoxication confirmed via urine tests and patient interviews. The suicidal tendencies were assessed using the Columbia-Suicide Severity Scale. The 629 patients were divided into three groups for analysis: Group I ( n  = 188), MA positive with suicidal ideation (SI) (MA + SI+); Group II ( n  = 202), MA-positive without SI (MA + SI-); and Group III ( n  = 239), MA-negative with SI (MA- SI+). Multiple regression analysis was used to elicit clinical features predicting patients presenting to the emergency department with acute MA intoxication., Results: Results reveal that approximately half of patients with acute MA intoxication reported suicidal thoughts, indicating a significant association between MA use and suicidal tendencies. Females exhibited higher rates of suicidal thoughts, behavior, and subsequent medical attention compared to males. Sociodemographic characteristics and clinical features differed among MA-positive patients with and without SI. Multivariable regression analysis identified factors influencing MA use, including cannabis use, male gender, agitation, and an inverse association with alcohol use. Notably, the severity and potential lethality of suicidal behavior in MA-intoxicated patients paralleled those observed in psychiatric patients without MA use., Conclusion: These results underscore the urgent need for targeted interventions to address the complex interplay between MA use and suicidal risks in the emergency department setting, as well as broader public health strategies to combat the increasing prevalence of MA use.

ATS dependence in Malaysia is growing tremendously across multiracial Malaysian groups, increasing concerns among public health experts and the community. This study highlighted the chronicity of ATS dependence and factors associated with ATS use. Interviewer-administered questionnaires were administered using ASSIST 3.0. A total of N  = 327 multiracial people who use ATS were enrolled in this study. The study findings show that 190/327 (58.1%) respondents were ATS dependent. Malays reported the highest number of ATS-dependent (55.8%), followed by Bajau (21.6%) and Kadazan-Dusun (16.8%) ethnic. Across all races, three factors were significantly associated with the ATS dependence: respondents who had a lifetime history of needle sharing aOR = 0.023 (95% CI: 0.003, 0.183) and a lifetime history of heroin use aOR = 0.192 (95% CI: 0.093, 0.396) were at a reduced odd of ATS dependent. Meanwhile, being married reduced the likelihood of becoming dependent on ATS with aOR = 0.378 (95% CI: 0.206, 0.693) compared to being single or divorced. This study revealed that the use of ATS among multiracial Malaysians is alarmingly high, including those in detention centers. Comprehensive harm reduction strategies are urgently needed to prevent the spreading of infectious diseases and other negative health consequences associated with ATS use.

Introduction: Chronic non-recreational use of methamphetamine (shabu) is increasing among the Filipino population in Barcelona. The Asian population presents a different stroke pattern, with a higher incidence of haemorrhage, and different vascular risk factors and health behaviours. The objective of this study is to describe the stroke profile and incidence of methamphetamine use in patients of Filipino origin admitted to our centre., Patients and Methods: Demographic data, vascular risk factors, clinical data and prognosis were recorded. Methamphetamine exposure was analysed in plasma samples collected on admission, which were then analysed by liquid chromatography-mass spectrometry., Results: Of a total of 6,418 stroke patients, 73 (1.1%) were identified as being of Filipino origin. The mean age was 54.4 ± 12.1 years, 54% were male and the stroke was ischaemic in 64.4% of cases. Arterial hypertension was the main risk factor. Ten (13.7%) patients tested positive for methamphetamine and amphetamine. These results confirm recent substance use prior to the stroke, mostly in men (80%). In patients who were consumers, 60% had a haemorrhagic stroke, with a poor functional prognosis at three months in 55.6% of patients., Conclusions: In our setting, patients of Filipino ethnicity admitted for stroke related to the consumption of shabu belonged a younger age bracket, with a lower prevalence of vascular risk factors and a predominance of the haemorrhagic subtype. Methamphetamine testing in Filipino stroke patients is recommended due to the high prevalence of methamphetamine use in our country.

Aims: To determine whether the risk of psychotic symptoms during weeks of methamphetamine use was dependent on, increased by, or independent of having a family history of psychosis., Design: Secondary analysis of 13 contiguous 1-week periods of data (1370 weeks). A risk modification framework was used to test each scenario., Setting: Geelong, Wollongong and Melbourne, Australia., Participants: Participants in a randomized controlled trial of treatment for methamphetamine dependence (n = 148) who did not have a primary psychotic disorder on enrolment., Measurements: Psychotic symptoms in the previous week were defined as a score of 3+ on any of the Brief Psychiatric Rating Scale items of hallucinations, unusual thought content or suspiciousness. Any (vs no) methamphetamine use in the previous week was assessed using the Timeline Followback method. Self-reported family history of psychosis was assessed using the Diagnostic Interview for Psychosis., Findings: The risk of psychotic symptoms in the past week was independently associated with methamphetamine use in that week (relative risk [RR] = 2.3, 95% CI = 1.3-4.3) and with having a family history of psychosis (RR = 2.4, 95% CI = 0.9-7.0); the joint risk among participants with a family history of psychosis during weeks when they were using methamphetamine was large (RR = 4.0, 95% CI = 2.0-7.9). There was no significant interaction between a family history of psychosis and methamphetamine use in predicting psychotic symptoms (interaction RR = 0.7 95% CI = 0.3-1.8), but there was a small non-significant excess risk due to the interaction (0.20 95% CI = -1.63 to 2.03)., Conclusions: Among people dependent on methamphetamine, the relative risk of psychotic symptoms during weeks of methamphetamine use does not appear to be dependent on, or increased by, having a family history of psychosis. However, a family history of psychosis does appear to be an independent risk factor that contributes to the absolute risk of psychotic symptoms in this population., (© 2023 The Authors. Addiction published by John Wiley & Sons Ltd on behalf of Society for the Study of Addiction.)

Background: Illicit stimulant use remains a public health concern that has been associated with multiple adverse outcomes, including cognitive deficits. The effects of stimulant use on cognition may be particularly deleterious in persons with HIV. Stimulant use intensity may be an important factor in the magnitude of observed deficits over time., Methods: We completed neurocognitive testing in a sample of people who use stimulants with (n = 84) and without HIV (n = 123) at baseline and up to 4 follow-up time points over approximately 1 year. Participants reported on substance use at each visit, including frequency of use and stimulant dependence. Mixed effects models examined the relationship between stimulant-related factors and neurocognitive function over time., Results: Participants were mostly male (57%), African American (86%), and 47.41 years old on average. All participants actively used stimulants at enrollment and use remained prevalent throughout the follow-up period, with an average of ≥24 days of use in the past 90 days at all time points. Retention was excellent, with 86% completing all 4 follow-up assessments. Mixed effects models showed that stimulant dependence was associated with lower neurocognitive performance independent of HIV status (p = 0.002), whereas frequency of use had a greater negative impact on performance in participants with HIV compared to those without HIV (p = 0.045)., Conclusions: Our key finding is that stimulant-related factors are associated with neurocognitive performance over time, but in complex ways. These findings have important implications for harm reduction approaches, particularly those that target cognitive function., Competing Interests: Declaration of Competing Interest All authors declared no conflict of interest., (Copyright © 2023. Published by Elsevier B.V.)

Background and Aims: Few studies of the impacts of the coronavirus disease 2019 (COVID-19) public health measures on drug markets and drug use patterns have used longitudinal data. We aimed to examine whether COVID-19 measures were associated with increases in methamphetamine price, decreases in methamphetamine use frequency and subsequent changes in secondary outcomes of other drug use frequency in metropolitan Melbourne and regional Victoria., Design: Longitudinal analysis framework was used from a longitudinal cohort of people who use methamphetamine., Setting: Victoria state, Australia., Participants: One hundred eighty-five VMAX study participants who reported a methamphetamine purchase after the onset of the pandemic were used for the price paid analysis. Methamphetamine or other drug use frequency analysis was performed using 277 participants who used methamphetamine during the pandemic or in the year before the pandemic., Measurements: Price paid per gram of methamphetamine derived from the most recent purchase price and most recent purchase quantity. Frequency of methamphetamine and other drug use measured as the average number of days per week used in the last month., Findings: Compared with pre-COVID-19 period, methamphetamine prices increased by AUD351.63 (P value <0.001) and by AUD456.51 (P value <0.001) in Melbourne and regional Victoria, respectively, during the period in which the most intense public health measures were implemented in Victoria. Although prices decreased after harder restrictions were lifted (by AUD232.84, P value <0.001 and AUD263.68, P value <0.001, in Melbourne and regional Victoria, respectively), they remained higher than pre-COVID-19 levels. A complementary 76% decrease was observed in relation to methamphetamine use frequency in regional Victoria (P value = 0.006) that was not offset by any changes in the frequency of use of other drugs such as alcohol, tobacco or other illicit drugs., Conclusion: COVID-19 public health measures in Victoria state, Australia, appear to have been associated with major price changes in the methamphetamine market and decreased frequency of use of the drug., (© 2023 The Authors. Addiction published by John Wiley & Sons Ltd on behalf of Society for the Study of Addiction.)

Objective: The high rate of treatment failure is a common problem in the treatment of methamphetamine use. Therefore, the aim of this research is to identify the most common causes of relapse in methamphetamine users., Method: This is a qualitative study and of content analysis type. Information was collected using purposeful sampling and through semi-structured interviews and focus group discussions. The statistical population consisted of all people with the methamphetamine-use disorder in 2022 who were in the abstinence phase and participated in the meetings of the Narcotics Anonymous (NA) Center of Bojnord. Theoretical sampling continued until data saturation. A total of 10 one-on-one interviews were conducted, each lasting between 45 to 80 min. Additionally, two focus group interviews were conducted with six members in each group, lasting between 95 to 110 min and data saturation was achieved through these interviews. Data analysis was done using the content analysis method (Sterling). Recoding and Holsti's method were used to measure reliability; validity was then calculated through content validity assessment., Findings: The results of the thematic analysis showed that laps and relapse factors were identified and categorized into 5 organizing themes, including negative emotional states, positive emotional states, negative physical states, interpersonal factors, and environmental factors, consisting of 39 basic themes., Result: Identifying the risk factors leading to laps and relapse in methamphetamine users and increasing the knowledge in this field can lay the groundwork for preventive therapeutic interventions in this community., (© 2023. The Author(s).)

Background and Objectives: Methamphetamine (MA) is one of the most common addictive substances and has become the second most commonly used drug worldwide. Obsessive-compulsive disorder (OCD) has been shown to influence the effectiveness of addiction treatment, and there may be overlapping neurobiological mechanisms between OCD and addiction. The aim of this study was to investigate the prevalence and clinical correlates of OCD among MA patients., Methods: A total of 457 MA patients were recruited, and clinical and demographic data were collected. The Yale-Brown Obsessive-Compulsive Scale was utilized for OCD symptoms, and the Obsessive-Compulsive Drug Use Scale was used for MA craving., Results: The prevalence of OCD among MA patients was 7.7%. Compared to those patients without OCD, patients with OCD had a longer length of abstinence and higher OCDUS frequency of craving subscale and total scores. Multiple regression showed that longer length of abstinence and higher MA carving were independently associated with OCD in MA patients., Discussion and Conclusions: Chinese Han MA patients have a high prevalence of OCD. Some clinical parameters may be associated with OCD in MA patients., Scientific Significance: This is the first study to examine the prevalence, sociodemographic and clinical correlates of OCD in MA patients in a Chinese Han population., (© 2022 The American Academy of Addiction Psychiatry (AAAP).)

Background: The transition from methamphetamine (MA) casual use (MCU) to compulsive use is enigmatic as some MA users can remain in casual use, but some cannot. There is a knowledge gap if gut microbiota (GM) play a role in differing MCU from MA use disorder (MUD). We aimed to investigate the clinical features and GM differences between individuals with MCU and MUD., Method: We recruited two groups of MA users -MCU and MUD - and matched them according to age and body mass index (n=21 in each group). Participants were accessed using the Semi-Structured Assessment for Drug Dependence and Alcoholism, and their fecal samples were undergone 16S ribosomal DNA sequencing. We compared the hosts' clinical features and GM diversity, composition, and structure (represented by enterotypes) between the two groups. We have identified differential microbes between the two groups and performed network analyses connecting GM and the clinical traits., Result: Compared with the casual users, individuals with MUD had higher incidences of MA-induced neuropsychiatric symptoms (e.g., paranoia, depression) and withdrawal symptoms (e.g., fatigue, drowsiness, and increased appetite), as well as stronger cravings for and intentions to use MA, and increased MA tolerance. The GM diversity showed no significant differences between the two groups, but four genera (Halomonas, Clostridium, Devosia, and Dorea) were enriched in the individuals with MUD (p<0.05). Three distinct enterotypes were identified in all MA users, and Ruminococcus-driven enterotype 2 was dominant in individuals with MUD compared to the MCU (61.90% vs. 28.60%, p=0.03). Network analysis shows that Devosia is the hub genus (hub index = 0.75), which is not only related to the counts of the MUD diagnostic criteria (ρ=0.40; p=0.01) but also to the clinical features of MA users such as reduced social activities (ρ=0.54; p<0.01). Devosia is also associated with the increased intention to use MA (ρ=0.48; p<0.01), increased MA tolerance (ρ=0.38; p=0.01), craving for MA (ρ=0.37; p=0.01), and MA-induced withdrawal symptoms (p<0.05)., Conclusion: Our findings suggest that Ruminococcus-driven enterotype 2 and the genera Devosia might be two influential factors that differentiate MA casual use from MUD, but further studies are warranted., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2023 He, Yang, Ma, Wen, Liu, Zhang and Liu.)

Background: This study examined the association between methamphetamine use and psychotic symptoms in a New Zealand general population birth cohort ( n = 1265 at birth)., Methods: At age 18, 21, 25, 30, and 35, participants reported on their methamphetamine use and psychotic symptoms in the period since the previous interview. Generalized estimating equations modelled the association between methamphetamine use and psychotic symptoms (percentage reporting any symptom, and number of symptoms per participant). Confounding factors included childhood individual characteristics, family socioeconomic circumstances and family functioning. Long term effects of methamphetamine use on psychotic symptoms were assessed by comparing the incidence of psychotic symptoms at age 30-35 for those with and without a history of methamphetamine use prior to age 30., Results: After adjusting for confounding factors and time-varying covariate factors including concurrent cannabis use, methamphetamine use was associated with a modest increase in psychosis risk over five waves of data (adjusted odds ratio (OR) 1.33, 95% confidence interval (CI) 1.03-1.72 for the percentage measure; and IRR 1.24, 95% CI 1.02-1.50 for the symptom count measure). The increased risk of psychotic symptoms was concentrated among participants who had used at least weekly at any point (adjusted OR 2.85, 95% CI 1.21-6.69). Use of methamphetamine less than weekly was not associated with increased psychosis risk. We found no evidence for a persistent vulnerability to psychosis in the absence of continuing methamphetamine use., Conclusion: Methamphetamine use is associated with increased risk of psychotic symptoms in the general population. Increased risk is chiefly confined to people who ever used regularly (at least weekly), and recently.

Background : Psychotropic substance use, for chemsex in particular, is common in gay or bisexual men (GBM) with HIV infection. This case-control study examined the association between Axis I psychiatric disorders and active psychotropic substance use, and identified factors affecting the prevalence of psychiatric disorders in HIV-infected GBM. Methods : Participants were 62 HIV-infected self-identified GBM who reported psychotropic substance use in the past 1 year (cases), and 55 HIV-infected self-identified GBM without psychotropic substance use in the past 1 year and had negative toxicology tests at recruitment (controls). The Chinese-bilingual Structured Clinical Interview for DSM-IV (Axis I, Patient version) was followed to establish the psychiatric diagnoses. Socio-demographic data, level of social support, HIV-related data, and pattern of psychotropic substance use were collected. Results : Cases had lower level of social support, more depressive disorders (AOR 3.4, 95% CI 1.3-8.7, p=0.01) and psychotic disorders (AOR 7.2, 95% CI 1.2-41, p=0.03) but not anxiety disorders. Significant difference in the prevalence of psychiatric disorders was only evident for disorders with onset after HIV diagnosis. Methamphetamine dependence, weekly methamphetamine use for 2 years or more, using methamphetamine beyond chemsex, duration of HIV diagnosis were significant predictors for psychiatric disorders in the cases. Conclusion : Active psychotropic substance use in HIV-infected gay or bisexual men was associated with an overall 3-fold increase in Axis I psychiatric disorders. Coordinated efforts from HIV, psychiatric and substance use services are needed to prevent harms arising from chemsex and to identify those in need and facilitate treatment access.

Background: The comorbidity between substance use disorder and major depressive disorder is a typical dual diagnosis in the field of substance addiction. However, the prevalence and correlates of depression in methamphetamine addicts and whether it is associated with drug craving and alexithymia have been rarely reported in the Chinese population., Methods: We recruited 585 methamphetamine-dependent males from a drug rehabilitation center in China and 203 healthy controls. Demographic and drug use data were collected. Depression was assessed using the Mini International Neuropsychiatric Interview (M.I.N·I.). Methamphetamine cravings and alexithymia were assessed using the Desire for Drugs Questionnaire (DDQ) and the Toronto Alexithymia Scale (TAS)., Results: The prevalence rate of depression in methamphetamine-dependent men was 16.58 % (97/585). The scores of DDQ desire and intention, DDQ negative reinforcement, total DDQ, difficulty identifying feelings (DIF), difficulty describing feelings (DDF), and total TAS score of depressed patients were higher than those of non-depressed patients. However, only DDQ negative reinforcement score, DIF, DDF, and total TAS score remained significant after Bonferroni correction. Additionally, logistic regression analysis found that age, DIF score, and DDQ negative reinforcement score were significant factors contributing to depression in methamphetamine-dependent men., Conclusion: Our findings suggest that the prevalence of depression is significantly higher in methamphetamine-dependent men than in the healthy Chinese population. Furthermore, age, components of alexithymia and drug craving are risk factors for depression in methamphetamine addicts., Competing Interests: Conflict of Interest None., (Copyright © 2022. Published by Elsevier B.V.)

Introduction: To describe trends in methamphetamine use, markets and harms in Australia from 2003 to 2019., Methods: Data comprised patterns of use and price from sentinel samples of people who inject drugs and who use MDMA/other illicit stimulants and population-level amphetamine-related police seizures, arrests, hospitalisations, treatment episodes and deaths from approximately 2003 to 2019. Bayesian autoregressive time-series models were analysed for: no change; constant rate of change; and change over time differing in rate after one to three changepoints. Related indicators were analysed post hoc with identical changepoints., Results: The percentage of people who inject drugs reporting weekly use increased from 2010 to 2013 onwards, while use among samples of people who regularly use ecstasy and other illicit stimulants decreased. Seizures and arrests rose steeply from around 2009/10 to 2014/15 and subsequently plateaued. Price increased ($15.9 [95% credible interval, CrI $9.9, $28.9] per point of crystal per year) from around 2009 to 2011, plateauing and then declining from around 2017. Hospitalisation rates increased steeply from around 2009/10 until 2015/16, with a small subsequent decline. Treatment also increased (19.8 episodes [95% CrI 13.2, 27.6] with amphetamines as the principal drug of concern per 100 000 persons per year) from 2010/11 onwards. Deaths involving amphetamines increased (0.285 per 100 000 persons per year) from 2012 until 2016., Discussion and Conclusions: These findings suggest that problematic methamphetamine use and harms escalated from 2010 to 2012 onwards in Australia, with continued demand and a sustained market for methamphetamine. [Correction added on 30 May 2022, after first online publication: In the Abstract under 'Discussion and Conclusions' 'onwards' has been added after … 2010 to 2012]., (© 2022 The Authors. Drug and Alcohol Review published by John Wiley & Sons Australia, Ltd on behalf of Australasian Professional Society on Alcohol and other Drugs.)