Abstract: - Urinschnelltests sind ein häufig genutztes, einfaches und kostengünstiges Verfahren zur Dokumentation einer (Nicht-)Einnahme von Drogen und Medikamenten. – Urinschnelltests können bei einer Reihe häufig verwendeter Medikamentenwirkstoffe falsch-positive Reaktionen zeigen. – Die Resultate von Urinschnelltests haben aufgrund der möglichen Kreuzreaktionen lediglich hinweisenden, jedoch nicht beweisenden Charakter. – Vom Betroffenen bestrittene positive Resultate müssen mittels einer Bestätigungsanalyse überprüft werden. – Eine passive Cannabisexposition als Ursache eines positiven Cannabis-Urinschnelltests ist im Allgemeinen als Schutzbehauptung anzusehen. – Opiatkonsum, Codeineinnahme und Genuss von Mohnsamen (Mohnkuchen etc.) können nicht mittels (nicht-apparativen) Schnelltests unterschieden werden.

Abstract: Présentation des résultats de l’étude “La signification du neuroenhancement pour les praticiennes et praticiens des domaines de la psychiatrie/psychothérapie et de la médecine de premier recours”, qui a visé à mieux comprendre les expériences et la position des médecins confrontés à des demandes pour des produits de neuroenhancement dans leurs cabinets.

Abstract: Objective To systematically review cohort studies of mortality among people who inject drugs, examine mortality rates and causes of death in this group, and identify participant- and study-level variables associated with a higher risk of death. Methods Tailored search strings were used to search EMBASE, Medline and PsycINFO. The grey literature was identified through online grey literature databases. Experts were consulted to obtain additional studies and data. Random effects meta-analyses were performed to estimate pooled crude mortality rates (CMRs) and standardized mortality ratios (SMRs). Findings Sixty-seven cohorts of people who inject drugs were identified, 14 of them from low- and middle-income countries. The pooled CMR was 2.35 deaths per 100 person–years (95% confidence interval, CI: 2.12–2.58). SMRs were reported for 32 cohorts; the pooled SMR was 14.68 (95% CI: 13.01–16.35). Comparison of CMRs and the calculation of CMR ratios revealed mortality to be higher in low- and middle-income country cohorts, males and people who injected drugs that were positive for human immunodeficiency virus (HIV). It was also higher during off-treatment periods. Drug overdose and acquired immunodeficiency syndrome (AIDS) were the primary causes of death across cohorts. Conclusion Compared with the general population, people who inject drugs have an elevated risk of death, although mortality rates vary across different settings. Any comprehensive approach to improving health outcomes in this group must include efforts to reduce HIV infection as well as other causes of death, particularly drug overdose.

Abstract: La révision totale de la loi sur l’alcool est actuellement débattue au Parlement. Les auteurs sont convaincus que cette loi n’atteindra son objectif en matière de santé publique que si les mesures de libéralisation proposées s’accompagnent d’autres mesures de prévention cohérentes.

Abstract: Marijuana is the most widely used illicit drug, however its effects on cognitive functions underling safe driving remain mostly unexplored. Our goal was to evaluate the impact of cannabis on the driving ability of occasional smokers, by investigating changes in the brain network involved in a tracking task. The subject characteristics, the percentage of D9-Tetrahydrocannabinol in the joint, and the inhaled dose were in accordance with real-life conditions. Thirty-one male volunteers were enrolled in this study that includes clinical and toxicological aspects together with functional magnetic resonance imaging of the brain and measurements of psychomotor skills. The fMRI paradigm was based on a visuo-motor tracking task, alternating active tracking blocks with passive tracking viewing and rest condition. We show that cannabis smoking, even at low D9-Tetrahydrocannabinol blood concentrations, decreases psychomotor skills and alters the activity of the brain networks involved in cognition. The relative decrease of Blood Oxygen Level Dependent response (BOLD) after cannabis smoking in the anterior insula, dorsomedial thalamus, and striatum compared to placebo smoking suggests an alteration of the network involved in saliency detection. In addition, the decrease of BOLD response in the right superior parietal cortex and in the dorsolateral prefrontal cortex indicates the involvement of the Control Executive network known to operate once the saliencies are identified. Furthermore, cannabis increases activity in the rostral anterior cingulate cortex and ventromedial prefrontal cortices, suggesting an increase in self-oriented mental activity. Subjects are more attracted by intrapersonal stimuli (“self”) and fail to attend to task performance, leading to an insufficient allocation of task-orientedre sources and to sub-optimal performance. These effects correlate with the subjective feeling of confusion rather than with the blood level of D9-Tetrahydrocannabinol. These findings bolster the zero-tolerance policy adopted in several countries that prohibits the presence of any amount of drugs in blood while driving.