No abstract

No abstract

ObjectiveTo determine factors related to recent methamphetamine-associated psychosis (MAP) among individuals recently using methamphetamine (MA).DesignCross-sectional study carried out between July 2015 and June 2017.SettingFour mental health hospitals and one substance abuse treatment centre in Thailand.ParticipantsIndividuals recruited onto the study included those aged 18 years or over, of both sexes, who reported MA use in the month prior to admission.MeasuresAny recent psychosis was confirmed using the Mini International Neuropsychiatric Interview-Plus psychotic module. The Timeline Follow Back was used to determine days of MA use. The severity of MA dependence was assessed using the Severity of Dependence Scale. Quantitative hair analysis was carried out to confirm recent use of MA and to measure the amount of MA use. We compared several characteristics between those who had recently experienced psychosis and those who had not.ResultsThis study included 120 participants without MAP and 113 participants with MAP. The mean age was 28 years and the mean abstinence was 17 days. The levels of MA concentration in hair were not significantly different between groups (p=0.115). Based on the final logistic regression model, the independent factors associated with MAP (OR and 95% CI) included being male (OR 4.03, 95% CI 1.59 to 10.20), ≥16 days of MA use in the past month (OR 2.35, 95% CI 1.22 to 4.52), MA dependence (OR 9.41, 95% CI 2.01 to 44.00) and hospitalisation history related to substance abuse (OR 3.85, 95% CI 2.03 to 7.28).ConclusionsHealth professionals should closely monitor the development of MAP in MA-dependent men who frequently use MA and have a history of hospitalisation for substance abuse. The measure of MA concentration levels in the hair may add no benefit for the prediction of the development of MAP.

No abstract

Background:To date, blood and urine analyses have been the major methods of detecting methamphetamine (MA) use in Thailand. Recently, hair analysis has been introduced as an alternative and complementary procedure. Objectives: To validate a simple, rapid, and economical method of analyzing hair for MA and its metabolite, amphetamine (AM). Methods: The analysis employed solid-phase microextraction (SPME) coupled with gas chromatography and mass spectrometry (GC-MS). Simplicity, rapidity, and economy were achieved, in part, by optimizing SPME conditions and by eliminating deuterated reagents and the derivatization step in GC-MS. The validated method was employed to detect and quantify MA in 1,111 hair samples of young Thai research volunteers who reported using MA in the form of so-called "yaba" tablets at least 3 times during the previous 3 months. Results: Validated data from the study indicated that the method's linearity, accuracy, precision, limit of detection (LOD) and limit of quantitation (LOQ) met international standards for hair analysis of MA. Expressed as ng of MA per mg of hair (ng/mg), the LOQ was 0.5 ng/mg (102.39% accuracy, 5.46% precision). The method was less sensitive for quantification of AM in hair, with a LOQ of 2.5 ng/mg (103.41% accuracy, 6.95% precision). Using 0.5 ng/mg as a cutoff in the analysis of samples provided by admitted MA users, the study yielded an overall detection rate for MA of 35.5%, with a range of 0.51-54.61 ng/mg; the mean MA level was 4.90 ± 6.78 (±SD) ng/mg. Thirty-one percent of the participants reported they had consumed fewer than 10 yaba tablets during the previous 3 months. Of this group, 29% had hair samples that tested positive for MA. Detection rates trended upwards with increased yaba use. No relationship was found between the number of yaba tablets reportedly consumed and the concentration of MA detected in hair. Conclusions: This study validated a rapid, simple, and economical SPME/GC-MS technique for quantification of MA in hair. The method was less sensitive for quantification of AM.