Erectile Dysfunction among People Who Use Ketamine and Poly-Drugs

Despite the rise in recreational use of ketamine in Malaysia, there have been no studies of users or of the health-related consequences they face. This study was initiated to examine ketamine use and its health consequences. 

A structured questionnaire was used to elicit information. A final sample of 127 males was divided into persons who used only ketamine and those who were poly-drug users. Each group was further divided into long-period and short-period users. Urine toxicology screening for ketamine and other illicit drugs commonly used in Malaysia was also done. 

Our findings corroborate those of earlier studies that link ketamine use to urological problems such as frequent urination, dysuria, incontinence, painful bladder, nocturia, and urinary urgency. A new finding in this study is the significant association between ketamine use and erectile dysfunction, such that higher odds of reporting erectile dysfunction were linked to long-period users. Our findings strengthen the case for early intervention, as ketamine users are drawn from young and unmarried male participants. 

The association of ketamine use with erectile dysfunction, if substantiated, will help physicians in their diagnosis of erectile dysfunction, particularly among youths.

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By:  Suppiah B1, Vicknasingam B2, Singh D3, Narayanan S4.

• 1 Graduate Student, Centre for Drug Research , Universiti Sains Malaysia , Penang , Malaysia.
• 2 Associate Professor, Centre for Drug Research , Universiti Sains Malaysia , Penang , Malaysia.
• 3 Senior Lecturer, Centre for Drug Research , Universiti Sains Malaysia , Penang , Malaysia.
• 4 Professor, School of Social Sciences , Universiti Sains Malaysia , Penang , Malaysia. 
• J Psychoactive Drugs. 2016 Mar 25:1-7. 

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Risk & Protective Factors for Recreational & Hard Drug Use among Malaysian Adolescents & Young Adults

This study investigated risk and protective factors for recreational and hard drug use in Malaysian adolescents and young adults.

Participants (n=859; M age=17.24 years, SD=2.75 years, range=13-25 years; 59% male) were recruited from secondary schools, technical colleges, a juvenile detention center and a national training center in Malaysia. A version of the Communities That Care survey validated for use in Malaysia (Razali & Kliewer, 2015) was used to assess study constructs.

One in 6 adolescents and 1 in 3 young adults reported lifetime recreational and hard drug use, with greater use reported by males across all drug categories. Structural equation modeling was used to determine the strongest risk and protective factors for recreational and hard drug use. The overall pattern of findings was similar for recreational and hard drug use. Shared risk factors for lifetime recreational and hard drug use included 

• early initiation of antisocial behavior, 
• peer antisocial behavior, 
• and peer reinforcement for engaging in antisocial behavior; 

Shared protective factors included 

• religious practices and 
• opportunities for prosocial school involvement. 

Multiple group analyses comparing adolescents and young adults indicated that patterns of risk and protective factors predicting drug use differed across these age groups. There were fewer significant predictors of either recreational or hard drug use for young adults relative to adolescents.

Results suggest that interventions should target multiple microsystems (e.g., peer groups, family systems, school environments) and be tailored to the developmental stage of the individual.

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By: Razali MM1, Kliewer W2.

• 1No. 25, Jalan Segar 7 Taman Segar 35900 Tanjong Malim, Perak Malaysia. Electronic address: mohdrazalim@vcu.edu.
• 2Virginia Commonwealth University, United States.

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Increasing Use of 'Party Drugs' in People Living with HIV on Antiretrovirals: A Concern for Patient Safety

Use of 'party drugs', a particular set of recreational drugs used in the context of 'ChemSex', is frequent among MSM living with HIV. A recently published observational study showed that more than half of HIV-infected MSM interviewed reported use of illicit substances in the previous 3 months, with frequent concomitant use of three or more drugs. These substances are a combination of 'club drugs' (methylenedioxymethamphetamine, gamma-hydroxybutyrate, ketamine, benzodiazepine) and drugs that are more specifically used in a sexualized context (methamphetamine, mephedrone, poppers and erectile dysfunction agents). 

Although formal data on pharmacokinetic or pharmacodynamic interactions between recreational drugs and antiretroviral agents are lacking, information regarding potentially toxic interactions can be theorized or sometimes conclusions may be drawn from case studies and cohort observational studies. 

However, the risk of coadministering party drugs and antiretrovirals should not be overestimated. The major risk for a drug-drug interaction is when using ritonavir-boosting or cobicistat-boosting agents, and maybe some nonnucleoside reverse transcriptase inhibitors. Knowledge of the metabolic pathways of 'party drugs' may help in advising patients on which illicit substances have a high potential for drug-drug interactions, as this is not the case for all.

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By: Bracchi M1, Stuart D, Castles R, Khoo S, Back D, Boffito M.

• 1aSt Stephen's AIDS Trust bDean Street Clinic, Chelsea and Westminster Hospital cJonathan Mann Clinic, Homerton Hospital dUniversity of Liverpool, Liverpool eImperial College, London, UK. 
  
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Profiling Online Recreational/Prescription Drugs' Customers and Overview of Drug Vending Virtual Marketplaces

Internet and social networking sites play a significant role in the marketing and distribution of recreational/prescription drugs without restrictions. We aimed here at reviewing data relating to the profile of the online drug customer and at describing drug vending websites.

The PubMed, Google Scholar, and Scopus databases were searched here in order to elicit data on the socio-demographic characteristics of the recreational marketplaces/online pharmacies' customers and the determinants relating to online drug purchasing activities.

Typical online recreational drugs' customers seem to be Caucasian, men, in their 20s, highly educated, and using the web to impact as minimally as possible on their existing work/professional status. Conversely, people without any health insurance seemed to look at the web as a source of more affordable prescription medicines. Drug vending websites are typically presented here with a "no prescription required" approach, together with aggressive marketing strategies.

The online availability of recreational/prescriptions drugs remains a public health concern. A more precise understanding of online vending sites' customers may well facilitate the drafting and implementation of proper prevention campaigns aimed at counteracting the increasing levels of online drug acquisition and hence intake activities

Via: http://ht.ly/Sa3wP 

By: Orsolini L1,2, Francesconi G1, Papanti D1,3, Giorgetti A4, Schifano F5.

• 1United Hospitals, Academic Department of Experimental and Clinical Medicine, Polytechnic University of Marche, Ancona, Italy.
• 2School of Life and Medical Sciences, University of Hertfordshire, Hatfield, Herts, England.
• 3Medical School of Trieste, Italy.
• 4School of Medicine and Surgery, Polytechnic University of Marche, Ancona, Italy.
• 5FRCPsych, Chair in Clinical Pharmacology and Therapeutics, School of Life and Medical Sciences, University of Hertfordshire, Hatfield, Herts, England.