The American journal of drug and alcohol abuse
November 1, 2016
Joseph J Palamar, Patricia Acosta, Scott Sherman et al.
73 citations
Over a third (35.1%) of young adults aged 18–25 attending electronic dance music parties at nightclubs and festivals in New York City reported having used at least one novel psychoactive substance (NPS) in their lifetime. Synthetic cannabinoids were the most common (16.3%), followed by psychedelic phenethylamines (14.7%), synthetic cathinones (6.9%), other psychedelics (6.6%), tryptamines (5.1%), and dissociatives (4.3%). Use of Ecstasy/MDMA/Molly, LSD, and ketamine, identifying as bisexual, more frequent nightclub or festival attendance, and being surveyed outside a festival (versus a nightclub) were associated with higher risk of NPS use. The findings indicate that prevention and harm reduction efforts should target this high-risk population.
The American journal on addictions
August 1, 2016
Joseph J Palamar, Monica J Barratt, Jason A Ferris et al.
49 citations
Nearly half (46.4%) of a self-selected sample of US nightclub attendees reported lifetime use of at least one new psychoactive substance (NPS). Synthetic cannabinoids were the most common (24.8%), followed by tryptamines (23.0%), psychedelic phenethylamines (21.7%), euphoric stimulants (16.2%), and synthetic cathinones (10.5%). Females and older respondents (ages 22-60) had lower odds of any NPS use. Frequent nightclub attendance, especially weekly versus less than once a month, was linked to higher odds of NPS use overall. The authors suggest harm reduction initiatives are needed for this population, where environmental factors may amplify risks from lesser-known substances.
The International journal on drug policy
May 1, 2023
Joseph J Palamar, Austin Le, Charles M Cleland et al.
41 citations
Among people attending electronic dance music parties in New York City nightclubs and festivals, self-reported use of several drugs changed from 2017 to 2022. Past-year and past-month use of psilocybin mushrooms, ketamine, poppers, synthetic cathinones, and novel psychedelics increased, while past-year heroin use and past-month cocaine, novel stimulant, and nonmedical benzodiazepine use decreased. After the COVID-19 pandemic, the odds of using mushrooms, poppers, and 2C series drugs rose, whereas the odds of using cocaine, ecstasy, heroin, methamphetamine, novel stimulants, and prescription opioids nonmedically fell. These trends in a sentinel population can inform public health surveillance.
Addictive behaviors
September 1, 2022
Kevin H Yang, Benjamin H Han, Joseph J Palamar
30 citations
LSD use was linked with a higher likelihood of major depressive episodes and suicidal thinking, while salvia divinorum use was associated with increased suicidal thinking and DMT/AMT/Foxy use with suicidal planning. In contrast, ecstasy (MDMA) use was linked with a lower likelihood of serious psychological distress, major depressive episodes, and suicidal thinking. These findings from a large US national survey indicate that different hallucinogens have distinct associations with depression and suicidality, highlighting the need for further research on risks and consequences of nonmedical hallucinogen use.
Journal of affective disorders
March 15, 2025
Kevin H Yang, Wayne Kepner, Charles M Cleland et al.
19 citations
Ketamine use among US adults increased significantly from 2015 to 2019 and again from 2021 to 2022. From 2015 to 2019, use rose among both adults with and without depression, but from 2021 to 2022, an increase occurred only among those without depression. Depression was linked to higher odds of ketamine use in 2015–2019 but not in later years. New correlates emerged in 2021–2022, including adults aged 26–34 and college graduates. Use of other drugs, especially ecstasy/MDMA and gamma-hydroxybutyrate, was consistently associated with higher odds of ketamine use. These shifts may reflect changes in the ketamine landscape or survey methodology.
Journal of addiction medicine
Kevin H Yang, Wayne Kepner, Anamika Nijum et al.
11 citations
An estimated 0.9% of US individuals aged 12 or older used ecstasy/MDMA in the past year, based on a national survey from 2015 to 2020. Use was more common among younger people, with those aged 35–49 as the reference; those over 50 had very low odds of use. Bisexual women and people identifying as Asian, Black, or multiracial had higher odds of use compared with heterosexual men or White individuals. Past-year use of other drugs, prescription drug misuse, nicotine dependence, and alcohol use disorder were also associated with increased odds. The findings can help inform prevention and harm reduction strategies for high-risk subpopulations.
Drug and alcohol dependence
March 1, 2025
Joseph J Palamar, Jennifer S Jewell, Omar El-Shahawy et al.
9 citations
Reported ketamine poisonings in the US rose from 205 in 2019 to 414 in 2023, the highest in reporting history. Most cases involved ingestion (57.2%) and misuse or abuse (36.2%). The proportion of cases involving suspected suicide attempts doubled from 12.7% to 25.9%, and ingestion increased from 46.0% to 65.2%. Cases with major effects or death decreased from 23.4% to 15.6%. Overall, 18.6% of cases experienced a major event or death, but prevalence was lower for those who inhaled ketamine compared to those who did not. Both medical and recreational use and related adverse events need monitoring, especially as off-label prescribing of take-home oral formulations appears to be increasing.
Drug and alcohol dependence
May 1, 2024
Joseph J Palamar, Nicole D Fitzgerald, Thomas H Carr et al.
9 citations
Seizures of psilocybin mushrooms by U.S. law enforcement rose sharply between 2017 and 2022, suggesting increasing availability. The number of seizures grew from 402 in 2017 to 1,396 in 2022, a 368.9% increase, with the Midwest accounting for the most seizures (36.0%) and the West next (33.5%). The total weight seized rose from 226.0 kg to 844.0 kg, a 2,749.7% increase; the West had the greatest total weight (1,864.2 kg, 42.6%) followed by the South (1,831.9 kg, 41.8%). Significant increases occurred in all four U.S. regions. The authors call for more prevention and harm reduction education.
Addiction (Abingdon, England)
April 20, 2025
Joseph J Palamar, Nina Abukahok, Patricia Acosta et al.
7 citations
About 2.7% of adults attending electronic dance music nightclubs in New York City reported using Tusi (also called pink cocaine or tusibí) in the past year. Tusi is a drug mixture often containing ketamine and other substances, and users may be unaware of its composition. Hispanic individuals had five times higher odds of use compared with white individuals. People who used ecstasy/MDMA, ketamine, or 2C series drugs in the past year were more likely to also use Tusi. Those reporting Tusi use were more likely to test positive for cocaine, ketamine, MDMA, methamphetamine, or synthetic cathinones via saliva testing, and some tested positive for cocaine, ketamine, or methamphetamine even without reporting past-year use of those drugs.
Disease-a-month : DM
March 1, 2025
Andrew M Farrar, Isabelle H Nordstrom, Kaitlyn Shelley et al.
7 citations
MDMA, commonly known as ecstasy or molly, is a substituted amphetamine used recreationally for euphoria, increased energy, and prosocial effects like empathy. Acute adverse effects include hyperthermia, dehydration, bruxism, and diaphoresis, while post-intoxication issues such as insomnia, anhedonia, anxiety, depression, and memory impairment can persist for days. MDMA acts by releasing dopamine, norepinephrine, and serotonin through interference with vesicular storage and transporter function. Illicit MDMA is often adulterated or replaced with other drugs like synthetic cathinones or methamphetamine, complicating medical intervention. This review covers MDMA's legal status, use patterns, pharmacological properties, health effects, and drug interactions, emphasizing harm reduction strategies to aid healthcare providers in treating adverse effects.
Fundamental & clinical pharmacology
July 1, 2026
Nina Abukahok, Steven Lawrence, Samrachana Adhikari et al.
In the New York metropolitan area, over a third of clinics advertising ketamine for psychiatric conditions offer it for at-home use, raising safety concerns. A 2025 systematic web search identified 233 clinics; 36.5% prescribed ketamine for at-home use, 51.5% listed a medical doctor, 42.9% advertised oral ketamine, and depression was the most common condition treated (94.0%). Clinics advertising oral ketamine were over four times more likely to offer at-home use, while those listing a medical doctor were about half as likely. The findings suggest a consumer-oriented advertising approach that may warrant monitoring and clearer guidance to mitigate safety risks.
Current addiction reports
January 1, 2025
Nina Abukahok, Nicole D Fitzgerald, Joseph J Palamar
Tusi, or 'pink cocaine,' is a drug mixture containing ketamine and MDMA, often with additional substances like synthetic cathinones, cocaine, or methamphetamine. Its inconsistent chemical makeup complicates surveillance and harm reduction. Drug checking services have identified ketamine and MDMA as main components, with ketamine concentrations increasing over time in Spain. Surveys in Spain and Colombia show rising initiation, polysubstance use, and misclassification of tusi's contents. Harms stem largely from the polysubstance mixtures rather than any single component, yet mortality data typically focus on individual drugs. Tusi represents a novel trend: a blend of substances defined by its color and nightlife association, requiring standardized surveys, expanded drug checking, and improved toxicological monitoring.