Addiction (Abingdon, England)
April 1, 2017
Daan van der Gouwe, Tibor M Brunt, Margriet Van Laar et al.
72 citations
Drug users in the Netherlands increasingly buy drugs online, especially new psychoactive substances. Analysis of 32,663 drug samples from 2013 to 2016, including 928 bought online, found that online purchases rose from 1.4% to 4.1% of samples. Purity and adulteration showed no large differences between online and offline drugs for most substances, though small variations existed for some: 4-FA was 59% pure online versus 52% offline, while MDMA powder was 45% pure online versus 61% offline. Online prices were 10–23% higher than offline for six of ten substances.
Addiction (Abingdon, England)
May 1, 2007
Sundeep Singh
52 citations
Salvia divinorum, a hallucinogen popular among adolescents, typically produces short-lived effects like depersonalization and levitation that resolve within 30 minutes. However, a case of a 15-year-old user with a history of salvia and marijuana use showed prolonged mental status changes lasting three days, including paranoia, déjà vu, blunted affect, thought blocking, and slow speech. The authors suggest that salvia may be associated with undocumented long-term effects such as persistent déjà vu, highlighting the need for more research into its clinical effects, especially given its easy availability online in the United States.
Addiction (Abingdon, England)
January 1, 2022
Thomas Knuijver, Arnt Schellekens, Maarten Belgers et al.
49 citations
A single dose of ibogaine (10 mg/kg) in 14 patients with opioid use disorder caused an average QTc prolongation of 95 ms (range 29–146 ms); half of the subjects reached a QTc over 500 ms. No life-threatening cardiac events occurred, but severe temporary ataxia (inability to walk without support) was universal. Withdrawal and psychomimetic effects were mostly manageable; 11 of 14 patients did not return to morphine within 24 hours. The findings indicate that ibogaine induces clinically relevant but reversible QTc prolongation, bradycardia, and severe cerebellar toxicity.
Addiction (Abingdon, England)
April 28, 2025
Rebecca E Harding, Tamsin Barton, Maeve Niepceron et al.
14 citations
Ketamine use disorder (KUD) is linked to frequent physical and psychological symptoms, including bladder problems (60%), nasal problems (60%), 'K-cramps' (56%), and abstinence-related cravings (71%), low mood (62%), and anxiety (59%). A survey of 274 current or former users, 40% treatment-seeking and 60% not, found that treatment-seeking individuals consumed more ketamine daily (2.67 g vs. 1.68 g). Despite these symptoms, 56% did not seek treatment; among those who did, only 36% were satisfied with care. Services were often seen as not tailored to ketamine (43%) and only somewhat effective (43%). Cost and affordability were the top factors for choosing treatment.
Addiction (Abingdon, England)
January 1, 2025
Leigh Coney, Amy Peacock, Daan van der Gouwe et al.
8 citations
Drugs sold on cryptomarkets are not uniformly higher in quality than those bought offline. For MDMA tablets, MDMA powder, cocaine, and LSD, the advertised substance is more likely to be present when sourced from cryptomarkets. Strength is higher for cryptomarket MDMA powder, cocaine, and methamphetamine, but lower for MDMA tablets and amphetamine. Adulteration is less likely in cryptomarket MDMA powder and cocaine, but more likely in amphetamine and LSD. Cocaine from cryptomarkets also has fewer adulterants. The relationship between source and drug quality depends on the specific substance and market dynamics.
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.
Addiction (Abingdon, England)
April 4, 2025
Asem Abdelrahman, Mo Belal
4 citations
Ketamine-induced cystitis is a recognized complication from addictive ketamine use, a dissociative anesthetic. This overview covers its pathophysiology, clinical presentation, diagnosis, management, and implications for addiction treatment. The British Association of Urological Surgeons consensus is a key management reference, with additional literature showing the multifaceted nature of ketamine bladder and its impact on those with substance use disorders.
Addiction (Abingdon, England)
January 20, 2026
Tibor Markus Brunt
2 citations
Ibogaine, a psychoactive alkaloid, reduces craving and withdrawal symptoms in opioid and cocaine-dependent individuals through multiple pharmacological mechanisms, as shown by observational, open-label, and limited randomized placebo-controlled trials. However, it poses a rare but clinically significant cardiotoxic risk: QTc prolongation and potentially fatal ventricular arrhythmias like Torsades des Pointes, which have occurred at therapeutic doses even in people without pre-existing cardiac conditions. Large interindividual variability in CYP2D6 metabolism may increase cardiovascular risk for some. Recent safety efforts include different dosing, cardiovascular monitoring, and developing ibogaine analogues that retain anti-addictive effects without cardiotoxicity in preclinical models. Future treatment should occur under controlled medical supervision with CYP2D6 genotyping and rigorous cardiac monitoring.
Addiction (Abingdon, England)
July 23, 2025
Tran Thi Thanh Hue, Hieu K T Ngo, Zhe Wang et al.
2 citations
Methamphetamine use in Hanoi, Vietnam, declined significantly from a peak of 359.2 to 125.6 mg/day/1000 people between 2018 and 2023, while ketamine use rose from 149.7 to 465.9 mg/day/1000 people, becoming the most commonly used illicit drug. Cocaine and heroin remained low, and MDMA was stable. After COVID-19 restrictions eased, cocaine and codeine consumption showed statistically significant declines, whereas ketamine and heroin increased slightly but not significantly. Wastewater analysis of a canal serving over 430,000 people reveals a dynamic drug market shifting toward synthetic substances, with ketamine overtaking methamphetamine as the most used drug by end of 2022.
Addiction (Abingdon, England)
January 16, 2025
Noa Krawczyk, Megan Miller, Emma Yuanqi Gu et al.
2 citations
People in online opioid-use-disorder communities hold diverse views on using psychedelics to manage opioid use. Many report that psychedelics reduce physical dependence symptoms, shift motivations away from opioids, and address underlying mental health issues. Others see the promise as exaggerated, noting that many eventually return to opioid use or consider psychedelics dangerous. The findings underscore an urgent need for controlled studies to understand psychedelics' effects on opioid use, their integration with existing treatments, and safety strategies.
Addiction (Abingdon, England)
July 7, 2026
Johanna J Nugteren-Van Lonkhuyzen, Irma S Van den Hengel-Koot, Claudine C Hunault et al.
Between 2012 and 2025, the annual rate of poisonings from new psychoactive substances (NPS) reported to the Dutch Poisons Information Center rose by 19% per year, with the number of poisonings increasing from 32 to 829. Among 19,316 total recreational drug poisonings, 4,289 involved NPS. Cathinones, phenethylamines, and benzodiazepines accounted for 83% of NPS poisonings, though the dominant category shifted over time: benzodiazepines in 2012 and 2024, phenethylamines from 2013 to 2018, and cathinones from 2019 to 2023 and 2025. The most frequently reported NPS were 3-MMC, bromazolam, 4-FA, 2C-B, and mephedrone. Poisonings with other NPS categories were rare, and none involved aminoindanes or piperazines.
Addiction (Abingdon, England)
March 30, 2026
Sarah J Catchlove, Katrin Oliver, Michael Savic et al.
In Australia, where psychedelic-assisted therapies were recently legalized for certain mental health conditions, service leaders and clinicians view psilocybin-assisted therapy in three distinct ways: as a treatment of last resort for resistant conditions, as a tool to overcome therapeutic plateaus in ongoing care, and as a catalyst for rapid progress at any treatment stage. Focus groups with nine clinicians and nine health service leaders revealed that both groups see the therapy as a complex intervention dependent on the interplay between medication, therapist skill, client readiness, and care context. Clinicians emphasized careful integration and aftercare, while leaders highlighted operational and ethical tensions within regulatory requirements. The authors suggest that implementation approaches must be reflexive and adaptive.
Addiction (Abingdon, England)
January 29, 2026
Yi-Hsuan Liu, Chia-Chun Hung, Marc N Potenza et al.
Recreational ketamine use, primarily administered by smoking, is associated with dose-dependent psychiatric symptoms and cognitive deficits. Heavier use correlates with greater psychological distress, especially anxiety and hostility. Users show reduced accuracy on high-load working memory tasks and have smaller left hippocampal volume, most notably in the hippocampal-amygdaloid-transition-area. Functional connectivity between this region and several brain networks is increased and aligns with NMDA-receptor distribution. These findings suggest that chronic, smoking-administered ketamine use selectively affects hippocampal subregions and related circuitry, potentially explaining working memory impairments.
Addiction (Abingdon, England)
December 1, 2025
Zachary Bryant, Kirsten Morley, Jessica A Kerr et al.
MDMA (Ecstasy) use in early adulthood appears to be associated with higher odds of anxiety disorders by the mid-30s, but not with depressive disorders. Compared with non-users, those who reported past-year MDMA use had 1.73 times the odds of an anxiety disorder; persistent use at two or more waves was linked to 2.05 times the odds, infrequent use to 2.11 times, and frequent use to 2.56 times the odds. These findings come from a longitudinal population-based study in Victoria, Australia, following 1,943 adolescents into their mid-30s.