Methylone is one of the most common synthetic cathinones popularized as a substitute for 3,4-meth... more Methylone is one of the most common synthetic cathinones popularized as a substitute for 3,4-methylenedioxymethamphetamine (MDMA, midomafetamine) owing to its similar effects among users. Both psychostimulants exhibit similar chemistry (i.e., methylone is a β-keto analog of MDMA) and mechanisms of action. Currently, the pharmacology of methylone remains scarcely explored in humans. Herein, we aimed to evaluate the acute pharmacological effects of methylone and its abuse potential in humans when compared with that of MDMA following oral administration under controlled conditions. Seventeen participants of both sexes (14 males, 3 females) with a previous history of psychostimulant use completed a randomized, double-blind, placebo-controlled, crossover clinical trial. Participants received a single oral dose of 200 mg of methylone, 100 mg of MDMA, and a placebo. The variables included physiological effects (blood pressure, heart rate, oral temperature, pupil diameter), subjective effec...
Cannabis is the most widely consumed illegal drug in the world and synthetic cannabinoids are inc... more Cannabis is the most widely consumed illegal drug in the world and synthetic cannabinoids are increasingly gaining popularity and replacing traditional cannabis. These substances are a type of new psychoactive substance that mimics the cannabis effects but often are more severe. Since, people with opioids use disorder use widely cannabis, they are a population vulnerable to use synthetic cannabinoids. In addition, these substances are not detected by the standard test used in the clinical practice and drug-checking is more common in recreational settings. A cross-sectional study with samples of 301 opioid use disorder individuals was carried out at the addiction care services from Barcelona and Badalona. Urinalysis was performed by high-sensitivity gas chromatography-mass spectrometry (GC-MS) and ultra-high-performance liquid chromatography-high –resolution mass spectrometry (UHPLC-HRMS). Any synthetic cannabinoid was detected in 4.3% of the individuals and in 23% of these samples t...
OBJECTIVES To compare alcohol and other drugs abuse, state impulsivity, craving and the relations... more OBJECTIVES To compare alcohol and other drugs abuse, state impulsivity, craving and the relationship between craving and impulsivity in alcohol-dependent patients with or without dual disorder attending to an alcohol treatment center in Cadiz town. METHOD An observational, descriptive and transversal study performed on 112 alcohol dependent patient sample who were seeking treatment in ARCA outpatient treatment center in Cadiz. The sample was divided in two groups, according to present dual diagnosis or not. The sample was assessed with an AdHoc sociodemographic and clinical questionnaire and specific scales and interviews that included: 5.0 Mini International Neuropsychiatric Interview results (MINI), State Impulsivity Scale (SIS), and Multidimensional Alcohol Craving Scale (MACS). RESULTS The prevalence of dual diagnosis was 50%, being the most prevalent disorders: Current and recurrent Major Depressive Episode Mood Disorder, Current Dysthymic Mood Disorder, Panic Disorder and Anxi...
Background:Recent studies have demonstrated that alcohol consumption can modulate the immune syst... more Background:Recent studies have demonstrated that alcohol consumption can modulate the immune system by directly activating natural immunity and triggering inflammatory processes in the central nervous system and in peripheral organs, such as the liver and pancreas. Patients with alcohol use disorders have an elevated frequency of comorbid mental disorders and gut diseases (i.e. fatty liver and pancreatitis) that complicate diagnosis, treatment and prognosis.Aims:The present study aims to explore possible associations in circulating plasma cytokine concentrations in abstinent patients diagnosed with alcohol use disorders.Methods:To this end, 85 abstinent subjects with alcohol use disorders from an outpatient setting and 55 healthy subjects were evaluated for both substance and mental disorders. The plasma levels of cytokines interleukin 1 beta, interleukin 4, interleukin 6, interleukin 17A, interferon gamma and tumour necrosis alpha were determined and their association with (a) hist...
Cannabis is the most widely consumed illicit drug. Although it is too early to confirm the impact... more Cannabis is the most widely consumed illicit drug. Although it is too early to confirm the impact of legalization, the use of cannabis appears to be on the rise in some countries due to its authorization for medical/recreational purposes. Among different types of therapeutic approaches to reduce cannabis use, computerized interventions are becoming a new treatment option. To assess their efficacy, a systematic review and meta-analysis was conducted. A systematic review and meta-analysis was performed employing randomized controlled clinical trials indexed in MEDLINE and PsycINFO. The principal outcome measure was cannabis use, and the secondary one was the use of other substances during interventions. A subgroup analysis was conducted by length of follow-up, number of sessions, age group, type of analysis, and type of control condition. The meta-analysis included nine studies with 2963 participants. Computerized interventions resulted in significant reductions in the use of cannabis...
Background Observational studies have reported a high prevalence of obesity and diabetes in subje... more Background Observational studies have reported a high prevalence of obesity and diabetes in subjects on methadone therapy; there are, however, limited data about metabolic syndrome. The aim of the study was to evaluate the prevalence of metabolic syndrome and related factors in individuals with heroin use disorder on methadone therapy. Methods A cross-sectional study in individuals with heroin use disorder on methadone therapy at a drug abuse outpatient center. Medical examinations and laboratory analyses after a 12-hour overnight fast were recorded. Metabolic syndrome was diagnosed according to the National Cholesterol Education Program Adult Treatment Panel III (ATP III) criteria. Results One hundred and twenty-two subjects were included, with a mean age of 46.1 ± 9 years, a median body mass index (BMI) of 25.3 kg/m2 (interquartile range [IQR]: 21.2–28), and 77.9% were men. Median exposure to methadone therapy was 13 years (IQR: 5–20). Overweight and obesity were present in 29.5% ...
IntroductionAfter mephedrone's ban in March 2010 new cathinones proliferated widely, even a n... more IntroductionAfter mephedrone's ban in March 2010 new cathinones proliferated widely, even a new branch of atypical derivatives was launched into the market, represented by MDPV. The cardiovascular and central nervous system toxicity draws attention to this new family of cathinones, also known as pyrovalerones. MDPV was scheduled in 2011, leading to the apparition of Alpha-PVP from which there is little information.ObjectivesThe aim of the present study is to describe the evolution of different cathinones in the samples delivered for analysis to the harm reduction NGO energy control from March 2009 to March 2016 in Spain.MethodsEnergy control is a Spanish harm reduction NGO that offers to drug users the possibility of analyzing the substances they intend to consume. From March 2009 to March 2016 a total of 24,528 samples were analyzed by the NGO from which 760 contained cathinones. Substance analysis was done by gas chromatography–mass spectrometry.ResultsFrom 2009 to 2016, cathi...
CNS & Neurological Disorders - Drug Targets, 2017
Concurrent use of cannabis and alcohol is frequent. According different studies, the prevalence i... more Concurrent use of cannabis and alcohol is frequent. According different studies, the prevalence is among 20-34% depending on different samples studied. In contrast with the wide evidence available about neuropsychiatric effects associated to the use of cannabis or alcohol separately, there are few studies of the neuropsychiatric effects of their combination. Our aim was to review the literature regarding this topic. We performed a search in MEDLINE and from 114 potentially eligible studies, 27 were selected. Most of them studied the relation between cannabis and alcohol, and with them combined to other substances of abuse, but only a few considered their concurrent effect among mental disorders (ADHD, bipolar disorder) and neuropsychological performance. More research in the neuropsychiatric effects of the concomitant use of cannabis and alcohol is needed.
CNS & Neurological Disorders - Drug Targets, 2017
Cannabis is the most widely used illicit drug. The two most important natural cannabinoids are de... more Cannabis is the most widely used illicit drug. The two most important natural cannabinoids are delta-9-tetrahydrocannabinol (THC) and cannabidiol (CBD). The THC content of cannabis has been increasing during the last years and recently appeared in the market as a series of synthetic cannabinoids with potent agonist activity. Recreational users frequently combine cannabis with other drugs of abuse as alcohol, amphetamines and derivatives, nicotine and cocaine. In addition, these subjects can be taking medicines for acute and chronic medical conditions. The increasing use of medicinal cannabis for chronic pain and neurological and psychiatric disorders can produce potential interactions with medications used for the symptomatic treatment of these or other diseases. THC and CBD are metabolized mainly in the liver by cytochrome P-450 isoenzymes (mainly CYP2Cs and CYP3A4). In vitro studies indicate that THC and CBD both inhibit CYP1A1, 1A2 and 1B1 enzymes, and recent studies have indicated that CBD is also a potent inhibitor of CYP2C19 and CYP3A4. Both cannabinoids may interact with other medications metabolized by the same pathway or by inducers/inhibitors of the isoenzymes. Cannabis produces sedation, impairs psychomotor performance, and increases blood pressure and heart rate. Pharmacodynamic interactions with other sedatives can potentiate the central effects but can be decreased by psychostimulants. This review focuses on the interactions between cannabinoids and alcohol, other drugs of abuse, and prescription medicines.
Background Mephedrone (4-methylmethcathinone, 4-MMC), a ring-substituted synthetic cathinone deri... more Background Mephedrone (4-methylmethcathinone, 4-MMC), a ring-substituted synthetic cathinone derivative has become established as a permanent illicit drug in the dynamic new psychoactive substances (NPS) scene. Objective This review summarizes current knowledge on mephedrone concentrations in biological samples from cases of acute intoxications (fatal and non-fatal), pharmacokinetics studies, wastewater and anonymous pooled urine analysis in order to provide an overview of the reliable scientific knowledge on toxicokinetics of mephedrone in humans. Method The PubMed® database complemented with Google Scholar® was systematically searched to find published cases of mephedrone intoxications. The searches were done using the keyword "mephedrone OR 4-methylmethcathinone" in association to each of the following strategies: i) "intoxication OR poisoning"; ii) "(blood OR serum OR plasma") OR "urine" OR ("saliva OR oral fluid") OR "hair&...
4-Methyl-N-methylcathinone (mephedrone) is a popular new psychoactive substance (NPS) that is str... more 4-Methyl-N-methylcathinone (mephedrone) is a popular new psychoactive substance (NPS) that is structurally related to the parent compound cathinone, the β-keto analogue of amphetamine. Mephedrone appeared on the street drug market as a substitute for 3,4-methylenedioxy-N-methylamphetamine (MDMA, ecstasy) and was subsequently banned due to the potential health risks associated with its use. Nevertheless, mephedrone continues to be widely consumed among specific populations, with unique patterns of misuse. To date, most information about the biological effects of mephedrone comes from user experiences, epidemiological data, clinical cases, toxicological findings, and animal studies, whilst there are very few data regarding its human pharmacodynamics and pharmacokinetics. This chapter reviews the available published data on patterns of mephedrone use, its acute and chronic effects, and its pharmacokinetic properties. More human research is needed to elucidate the safety, toxicity, and addiction potential of mephedrone and related NPS.
Opioid dependence is a complex disorder, not caused by a single gene, but also related to genetic... more Opioid dependence is a complex disorder, not caused by a single gene, but also related to genetic common factors shared with other substances, specific genetic factors, environmental factors and the effects of the substance in the central nervous system. The different contribution of each factor depends on the stage of the addictive disorder. Murine models present some candidate genes, but these results have not been definitively replicated in human association studies. A review of the studies published evaluating the possible association between opioide dependence disorder and specific polymorphisms in opioide receptor genes, reward system dopamine receptor genes and other genes related to opioide metabolism is presented. The main conclusion is the lack of definitive results that could be related to the few number of replication studies of previous ones, the limitations associated to the study of complex diseases and, genetic heterogeneity. Future research use well defined phenotypes, study of candidate genes implicated in endophenotypes variations and tacking account the relevance of the interactions gene-environment.
Methylone is one of the most common synthetic cathinones popularized as a substitute for 3,4-meth... more Methylone is one of the most common synthetic cathinones popularized as a substitute for 3,4-methylenedioxymethamphetamine (MDMA, midomafetamine) owing to its similar effects among users. Both psychostimulants exhibit similar chemistry (i.e., methylone is a β-keto analog of MDMA) and mechanisms of action. Currently, the pharmacology of methylone remains scarcely explored in humans. Herein, we aimed to evaluate the acute pharmacological effects of methylone and its abuse potential in humans when compared with that of MDMA following oral administration under controlled conditions. Seventeen participants of both sexes (14 males, 3 females) with a previous history of psychostimulant use completed a randomized, double-blind, placebo-controlled, crossover clinical trial. Participants received a single oral dose of 200 mg of methylone, 100 mg of MDMA, and a placebo. The variables included physiological effects (blood pressure, heart rate, oral temperature, pupil diameter), subjective effec...
Cannabis is the most widely consumed illegal drug in the world and synthetic cannabinoids are inc... more Cannabis is the most widely consumed illegal drug in the world and synthetic cannabinoids are increasingly gaining popularity and replacing traditional cannabis. These substances are a type of new psychoactive substance that mimics the cannabis effects but often are more severe. Since, people with opioids use disorder use widely cannabis, they are a population vulnerable to use synthetic cannabinoids. In addition, these substances are not detected by the standard test used in the clinical practice and drug-checking is more common in recreational settings. A cross-sectional study with samples of 301 opioid use disorder individuals was carried out at the addiction care services from Barcelona and Badalona. Urinalysis was performed by high-sensitivity gas chromatography-mass spectrometry (GC-MS) and ultra-high-performance liquid chromatography-high –resolution mass spectrometry (UHPLC-HRMS). Any synthetic cannabinoid was detected in 4.3% of the individuals and in 23% of these samples t...
OBJECTIVES To compare alcohol and other drugs abuse, state impulsivity, craving and the relations... more OBJECTIVES To compare alcohol and other drugs abuse, state impulsivity, craving and the relationship between craving and impulsivity in alcohol-dependent patients with or without dual disorder attending to an alcohol treatment center in Cadiz town. METHOD An observational, descriptive and transversal study performed on 112 alcohol dependent patient sample who were seeking treatment in ARCA outpatient treatment center in Cadiz. The sample was divided in two groups, according to present dual diagnosis or not. The sample was assessed with an AdHoc sociodemographic and clinical questionnaire and specific scales and interviews that included: 5.0 Mini International Neuropsychiatric Interview results (MINI), State Impulsivity Scale (SIS), and Multidimensional Alcohol Craving Scale (MACS). RESULTS The prevalence of dual diagnosis was 50%, being the most prevalent disorders: Current and recurrent Major Depressive Episode Mood Disorder, Current Dysthymic Mood Disorder, Panic Disorder and Anxi...
Background:Recent studies have demonstrated that alcohol consumption can modulate the immune syst... more Background:Recent studies have demonstrated that alcohol consumption can modulate the immune system by directly activating natural immunity and triggering inflammatory processes in the central nervous system and in peripheral organs, such as the liver and pancreas. Patients with alcohol use disorders have an elevated frequency of comorbid mental disorders and gut diseases (i.e. fatty liver and pancreatitis) that complicate diagnosis, treatment and prognosis.Aims:The present study aims to explore possible associations in circulating plasma cytokine concentrations in abstinent patients diagnosed with alcohol use disorders.Methods:To this end, 85 abstinent subjects with alcohol use disorders from an outpatient setting and 55 healthy subjects were evaluated for both substance and mental disorders. The plasma levels of cytokines interleukin 1 beta, interleukin 4, interleukin 6, interleukin 17A, interferon gamma and tumour necrosis alpha were determined and their association with (a) hist...
Cannabis is the most widely consumed illicit drug. Although it is too early to confirm the impact... more Cannabis is the most widely consumed illicit drug. Although it is too early to confirm the impact of legalization, the use of cannabis appears to be on the rise in some countries due to its authorization for medical/recreational purposes. Among different types of therapeutic approaches to reduce cannabis use, computerized interventions are becoming a new treatment option. To assess their efficacy, a systematic review and meta-analysis was conducted. A systematic review and meta-analysis was performed employing randomized controlled clinical trials indexed in MEDLINE and PsycINFO. The principal outcome measure was cannabis use, and the secondary one was the use of other substances during interventions. A subgroup analysis was conducted by length of follow-up, number of sessions, age group, type of analysis, and type of control condition. The meta-analysis included nine studies with 2963 participants. Computerized interventions resulted in significant reductions in the use of cannabis...
Background Observational studies have reported a high prevalence of obesity and diabetes in subje... more Background Observational studies have reported a high prevalence of obesity and diabetes in subjects on methadone therapy; there are, however, limited data about metabolic syndrome. The aim of the study was to evaluate the prevalence of metabolic syndrome and related factors in individuals with heroin use disorder on methadone therapy. Methods A cross-sectional study in individuals with heroin use disorder on methadone therapy at a drug abuse outpatient center. Medical examinations and laboratory analyses after a 12-hour overnight fast were recorded. Metabolic syndrome was diagnosed according to the National Cholesterol Education Program Adult Treatment Panel III (ATP III) criteria. Results One hundred and twenty-two subjects were included, with a mean age of 46.1 ± 9 years, a median body mass index (BMI) of 25.3 kg/m2 (interquartile range [IQR]: 21.2–28), and 77.9% were men. Median exposure to methadone therapy was 13 years (IQR: 5–20). Overweight and obesity were present in 29.5% ...
IntroductionAfter mephedrone's ban in March 2010 new cathinones proliferated widely, even a n... more IntroductionAfter mephedrone's ban in March 2010 new cathinones proliferated widely, even a new branch of atypical derivatives was launched into the market, represented by MDPV. The cardiovascular and central nervous system toxicity draws attention to this new family of cathinones, also known as pyrovalerones. MDPV was scheduled in 2011, leading to the apparition of Alpha-PVP from which there is little information.ObjectivesThe aim of the present study is to describe the evolution of different cathinones in the samples delivered for analysis to the harm reduction NGO energy control from March 2009 to March 2016 in Spain.MethodsEnergy control is a Spanish harm reduction NGO that offers to drug users the possibility of analyzing the substances they intend to consume. From March 2009 to March 2016 a total of 24,528 samples were analyzed by the NGO from which 760 contained cathinones. Substance analysis was done by gas chromatography–mass spectrometry.ResultsFrom 2009 to 2016, cathi...
CNS & Neurological Disorders - Drug Targets, 2017
Concurrent use of cannabis and alcohol is frequent. According different studies, the prevalence i... more Concurrent use of cannabis and alcohol is frequent. According different studies, the prevalence is among 20-34% depending on different samples studied. In contrast with the wide evidence available about neuropsychiatric effects associated to the use of cannabis or alcohol separately, there are few studies of the neuropsychiatric effects of their combination. Our aim was to review the literature regarding this topic. We performed a search in MEDLINE and from 114 potentially eligible studies, 27 were selected. Most of them studied the relation between cannabis and alcohol, and with them combined to other substances of abuse, but only a few considered their concurrent effect among mental disorders (ADHD, bipolar disorder) and neuropsychological performance. More research in the neuropsychiatric effects of the concomitant use of cannabis and alcohol is needed.
CNS & Neurological Disorders - Drug Targets, 2017
Cannabis is the most widely used illicit drug. The two most important natural cannabinoids are de... more Cannabis is the most widely used illicit drug. The two most important natural cannabinoids are delta-9-tetrahydrocannabinol (THC) and cannabidiol (CBD). The THC content of cannabis has been increasing during the last years and recently appeared in the market as a series of synthetic cannabinoids with potent agonist activity. Recreational users frequently combine cannabis with other drugs of abuse as alcohol, amphetamines and derivatives, nicotine and cocaine. In addition, these subjects can be taking medicines for acute and chronic medical conditions. The increasing use of medicinal cannabis for chronic pain and neurological and psychiatric disorders can produce potential interactions with medications used for the symptomatic treatment of these or other diseases. THC and CBD are metabolized mainly in the liver by cytochrome P-450 isoenzymes (mainly CYP2Cs and CYP3A4). In vitro studies indicate that THC and CBD both inhibit CYP1A1, 1A2 and 1B1 enzymes, and recent studies have indicated that CBD is also a potent inhibitor of CYP2C19 and CYP3A4. Both cannabinoids may interact with other medications metabolized by the same pathway or by inducers/inhibitors of the isoenzymes. Cannabis produces sedation, impairs psychomotor performance, and increases blood pressure and heart rate. Pharmacodynamic interactions with other sedatives can potentiate the central effects but can be decreased by psychostimulants. This review focuses on the interactions between cannabinoids and alcohol, other drugs of abuse, and prescription medicines.
Background Mephedrone (4-methylmethcathinone, 4-MMC), a ring-substituted synthetic cathinone deri... more Background Mephedrone (4-methylmethcathinone, 4-MMC), a ring-substituted synthetic cathinone derivative has become established as a permanent illicit drug in the dynamic new psychoactive substances (NPS) scene. Objective This review summarizes current knowledge on mephedrone concentrations in biological samples from cases of acute intoxications (fatal and non-fatal), pharmacokinetics studies, wastewater and anonymous pooled urine analysis in order to provide an overview of the reliable scientific knowledge on toxicokinetics of mephedrone in humans. Method The PubMed® database complemented with Google Scholar® was systematically searched to find published cases of mephedrone intoxications. The searches were done using the keyword "mephedrone OR 4-methylmethcathinone" in association to each of the following strategies: i) "intoxication OR poisoning"; ii) "(blood OR serum OR plasma") OR "urine" OR ("saliva OR oral fluid") OR "hair&...
4-Methyl-N-methylcathinone (mephedrone) is a popular new psychoactive substance (NPS) that is str... more 4-Methyl-N-methylcathinone (mephedrone) is a popular new psychoactive substance (NPS) that is structurally related to the parent compound cathinone, the β-keto analogue of amphetamine. Mephedrone appeared on the street drug market as a substitute for 3,4-methylenedioxy-N-methylamphetamine (MDMA, ecstasy) and was subsequently banned due to the potential health risks associated with its use. Nevertheless, mephedrone continues to be widely consumed among specific populations, with unique patterns of misuse. To date, most information about the biological effects of mephedrone comes from user experiences, epidemiological data, clinical cases, toxicological findings, and animal studies, whilst there are very few data regarding its human pharmacodynamics and pharmacokinetics. This chapter reviews the available published data on patterns of mephedrone use, its acute and chronic effects, and its pharmacokinetic properties. More human research is needed to elucidate the safety, toxicity, and addiction potential of mephedrone and related NPS.
Opioid dependence is a complex disorder, not caused by a single gene, but also related to genetic... more Opioid dependence is a complex disorder, not caused by a single gene, but also related to genetic common factors shared with other substances, specific genetic factors, environmental factors and the effects of the substance in the central nervous system. The different contribution of each factor depends on the stage of the addictive disorder. Murine models present some candidate genes, but these results have not been definitively replicated in human association studies. A review of the studies published evaluating the possible association between opioide dependence disorder and specific polymorphisms in opioide receptor genes, reward system dopamine receptor genes and other genes related to opioide metabolism is presented. The main conclusion is the lack of definitive results that could be related to the few number of replication studies of previous ones, the limitations associated to the study of complex diseases and, genetic heterogeneity. Future research use well defined phenotypes, study of candidate genes implicated in endophenotypes variations and tacking account the relevance of the interactions gene-environment.
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Papers by Marta Torrens