OBJECTIVE: 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.
METHODS: 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.
RESULTS: 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.
CONCLUSIONS: 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.

Mississippi youth are demographically unique compared to those of the nation. The aim of the study was to examine the drug use among adolescents in Mississippi compared to that in the US, which included determining prevalence and trends in drug use as well as drugs on school property and estimating the differences in drug use prevalence by gender and by race. National and Mississippi Youth Risk Behavior Surveillance System (YRBSS) data from 2001 to 2021 were obtained for analysis. Summary statistics, prevalence ratio, and survey Chi-squared tests of independence statistics were generated for the comparison for all students, and by gender and race separately. Trend analysis was conducted using logistic regression combined with joinpoint regression. The six survey questions being studied were the following: have you ever used marijuana, an inhalant, heroin, methamphetamines, or injected drugs, and were you offered, sold, or given an illegal drug on school property during the last 12 months. Survey packages in R were used to account for the complex sampling design of YRBSS data. On the national level, all six drug-related risk behaviors being studied showed a significant decrease from 2001 to 2021. In Mississippi, however, only \"ever used marijuana\" showed a decrease trend, while three remain unchanged, and two increased. The 2021 YRBSS data show that Mississippi adolescents exhibited a significantly higher prevalence of drug use, and are more likely to be offered, sold or given an illegal drug on school property. This research showed detailed findings on drug use-related issues in Mississippi, which is alarming. This poses an important challenge for public health in Mississippi and sounds an urgent call for drug use intervention among Mississippi adolescents. More concerted actions at the community, school and government level are needed for reducing youth drug use and controlling the drug traffic on school property.

Surface-enhanced Raman spectroscopy (SERS) is extensively researched in diverse disciplines due to its sensitivity and non-destructive nature. It is particularly considered a potential and promising technology for rapid on-site screening in drug detection. In this investigation, a technique was developed for fabricating nanocrystals of Ag@Au SNCs. Ag@Au SNCs, as the basic material of SERS, can detect amphetamine at concentrations as low as 1 μg/mL. The Ag@Au SNCs exhibits a strong surface plasmon resonance effect, which amplifies molecular signals. The SERS spectra of ten substances, including amphetamine and its analogs, showed a strong peak signal. To establish a qualitative distinction, we examined the Raman spectra and conducted density functional theory (DFT) calculations on the ten aforementioned species. The DFT calculation enabled us to determine the vibrational frequency and assign normal modes, thereby facilitating the qualitative differentiation of amphetamines and its analogs. Furthermore, the SERS spectrum of the ten mentioned substances was analysed using the support vector machine learning algorithm, which yielded a discrimination accuracy of 98.0 %.

Cardiovascular disease and cancers are the leading cause of mortality amongst people accessing treatment for alcohol and other drug use. The current study aimed to examine risk factors for chronic disease amongst people attending residential alcohol and other drug treatment services.
Participants (N = 325) were attending residential alcohol and other drug treatment services across Australia. Diabetes and cardiovascular disease risk scores were calculated using established risk estimation algorithms. Differences in existing health conditions, risk factors for chronic diseases and risk algorithms were calculated for males and females.
In addition to alcohol and other drug use (including tobacco use), 95% of the sample had at least one other risk factor for chronic disease. Of participants not already diagnosed, 36% were at a high risk of developing type 2 diabetes and 11% had a high risk of developing cardiovascular disease. The heart age of participants was 11 years older than actual age (Mage = 40.63, Mheart age = 52.41). Males had a higher cardiovascular disease risk than females.
A large proportion of people accessing residential alcohol and other drug treatment were at risk of chronic disease. Future research is needed that uses objective indicators of physical health. Such research will help to develop our understanding of prevention and intervention initiatives that could be adopted by treatment providers to improve the physical health of their consumers.

Hyperventilation syndrome is described as a constellation of symptoms that are typically benign but can become a medical emergency in the setting of severe metabolic derangement secondary to shifts in a patient\'s pH. A 36-year-old male with a history of intravenous (IV) drug abuse presented to the emergency department (ED) in distress, complaining of diffuse muscle cramping with tetany and peripheral vasospasm. This case report discusses his initial ED testing and treatment when ionized calcium was low and serum calcium was high.

Whether a person was voluntarily or intentionally intoxicated at the time of commission of a violent offence is a common question in forensic contexts. While a person who was intoxicated may not be able to form the requisite specific intent to commit some offences, voluntary intoxication usually disentitles a person from an insanity or \"mental impairment\" defence. However, a person may also consume alcohol or use a substance without becoming intoxicated and the presence of alcohol, substances or metabolites of substances in a person\'s urine or blood is not conclusive when the question of intoxication is relevant. A jury (or a judge sitting without a jury) may require expert opinion evidence when cannabis or methamphetamine intoxication are implicated in the alleged offending.

Methamphetamines remain a public health problem due to the extensive burden of illicit drug use on society. Callout events in the pre-hospital environment related to methamphetamine use is increasing. In addition, there has been an increase in reported mental health side effects and breakdown in relationships and social networks. Descriptive phenomenology research design was undertaken and data analysed using thematic analysis. Semi-structured interviews were utilized to collect data exploring the experience of first responders attending callouts to people affected by methamphetamines in the pre-hospital environment. Interviews included paramedics (8) and police officers (10) from across Australia. Overall, participants reported responding to people affected by methamphetamines was complex in nature. Complexity was affected by extensive social circumstances, people presenting in states of crisis, lack of coordinated approach, and unsuitable care environments. The social impact of methamphetamine addiction is extensive. Staff working as first responders have an opportunity to help reduce the social impact and crises, referring people to follow-up care and drug and alcohol support services. Further research is needed to determine if a standardized approach, between first responders and EDs, should be developed to help streamlines services and improve how the individual services respond as a group to people affected by substances.

This study investigated the recent changes in illegal substances availability on the Tanzanian mainland as a result of the government\'s surge operations as a deterrent approach against illicit drug production, trafficking and usage from 2017 to 2020, as well as the consequences of the COVID-19 pandemic on the drug market. Overall, 247467 seizures of illegal substances weighing 25357.9 kg were tested at The Government Chemist Laboratory Authority (GCLA), an average of 6339.5 kg annually. According to the findings, cannabis was the most frequently encountered substance, accounting for 80.6%, 88.2%, and 83% of all incidents, samples, and weight, respectively. Heroin came in second with 12.6% of the total incidents and 7.4% of the total number of samples, while khat came in second with 15.2% of the weight of the seized illegal substances during the period under study. Apart from a 202 and 4709 decline in heroin incidents and samples, the weight jumped from 15.3 kg in 2017 to 303.5 kg in 2020. Generally, the overall weight of the seizures decreased by 67.3% from 13036.4 kg in 2017-3890.7 kg in 2020. The results were particularly noticeable in the case of cannabis, which plunged by 76.5% from 11771.1 kg in 2017-2727 kg in 2020. Despite the eruption of the COVID-19 pandemic and associated lockdowns and travel limitations, heroin seizures increased by 67.4% in 2020 compared to the preceding three years combined.

The use of illicit stimulants continues to pose a significant challenge to different health sectors. In Australia, four particular stimulants, namely amphetamines and their derivatives, methamphetamine, ecstasy or 3,4-methylenedioxy-methamphetamine (MDMA), and cocaine cause a significant challenge to EDs as managing patients who use stimulants can be labor and resource intensive. While Australian data are available for stimulant-related ambulance attendances and hospitalizations, little is known about ED presentations of people who use stimulants. The aim of this paper is to systematically review the available literature related to the rates and patterns of ED presentations of people who use stimulants in Australia. A search was conducted on EBSCOhost, CINAHL Complete, and PubMed databases, as well as Google Scholar. Search terms consisted of combinations of the following terms: 1) stimulant AND ED AND Australia; 2) stimulants AND emergency presentations OR accident and emergency AND Australia, 3) amphetamine OR methamphetamine OR ecstasy OR cocaine AND ED AND Australia. Articles that met the inclusion criteria were included in the review and subjected to a quality appraisal. Data were extracted from the selected papers, including patient demographics, presentation rates, type of stimulant, reasons for presentations, police or ambulance service involvement, comorbidities, mental health issues, triage codes, admissions, and separations. The results of the review are reported using the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines. Studies were eligible if they were English-language peer-reviewed articles published between January 2011 and December 2021 and if they included data on Australian ED presentations of people who use non-prescription illicit stimulants. Studies were excluded if they did not include stimulant-related ED presentations or focused on ED presentations related to prescription stimulants, including Ritalin and Adderall, non-stimulant drugs, or caffeine for attention deficit disorder (ADD) or attention-deficit hyperactivity disorder (ADHD). The selected articles were appraised for quality, rigor, and risk of bias by two authors. The studies were assessed using the Newcastle Ottawa Scale (NOS) for cross-sectional, cohort, and case-control studies depending on the methodology identified in the study. A total of 19 articles were included in this study. Males represented 53 to 85% of ED presentations of people who use stimulants with an age range of 0 to 65 and are more likely to be transported by police or ambulance. People who use stimulants presented to EDs with varying psychological and behavioral concerns such as psychosis, self-harm, suicidal ideations, hallucinations, agitations, and aggressiveness, as well as medical conditions, including heart palpitations, nausea and vomiting, and significant physical injuries.

Background: Healthcare databases have the potential to become efficient tools for epidemiological research in People Who Inject Drugs (PWID). The validity of ICD-10 codes for specific substances in this population has not been assessed.Objectives: Validate ICD-10 diagnosis codes relating to the use of specific substance classes in a cohort of endocarditis patients.Methods: Our study sample consisted of 379 first-episode infective endocarditis patients (Male: 208, Female: 171), aged 18-55, admitted to any of three hospitals in London, Ontario from 2007 to 2018. Of these, 287 used drugs. We validated ICD-10 substance use codes for opioids (F11), stimulants (F15), cocaine (F14) and multiple substances (F19). Sensitivity, specificity, Positive Predictive Value (PPV) and Negative Predictive Value (NPV) were calculated for each code, using self-reported substance use documented on medical record review as a gold standard. We conducted a comparative analysis between code-negative users and code-positive users for each substance.Results: All substance use codes shared the same pattern: high specificity, high PPV and low sensitivity, with code F11 yielding the highest PPV (96.3%; 95% C.I.: 90.8-98.6) and sensitivity (42.6%; 95% C.I. 36.3-49.1). The code-positives and code-negatives for each substance did not differ significantly in any characteristics compared.Conclusion: Our results suggest that the individual ICD-10 codes analyzed should not be used for research without adjustment for low sensitivity. However, due to high PPV and specificity, these codes may still have potential for research use. Because code-negative patients did not differ from code-positive patients, their data may be extrapolated to the overall group of substance users.