T. M. Brunt

Amsterdam University Medical Center | VUmc · Department of Psychiatry

Hallucinogen persisting perception disorder (HPPD) is a drug-induced condition associated with inaccurate visual representations. Since the underlying mechanism(s) are largely unknown, this review aims to uncover aspects underlying its etiology. Available evidence on HPPD and drug-related altered visual processing was reviewed and the majority of H...

In The Netherlands, pharmaceutical-grade cultivated cannabis is distributed for medicinal purposes as commissioned by the Ministry of Health. Few studies have thus far described its therapeutic efficacy or subjective (adverse) effects in patients. The aims of this study are to assess the therapeutic satisfaction within a group of patients using pre...

Most studies on the subjective effects of ecstasy are based on the assumption that the substance that was taken is 3,4-methylenedioxymethamphetamine (MDMA). However, many tablets sold as ecstasy contain other substances and MDMA in varying doses. So far, few attempts have been made to take this into account while assessing subjective effects. This...

Nitrous oxide (N2O), used medically as an anaesthetic, has gained popularity as a recreational drug, with rising prevalence particularly among young adults. While its reinforcing and addictive potential remains debated, N2O is proven to be neurotoxic, especially with prolonged, heavy use, which is often unexpected for users. The neurotoxicological...

Premature geboorten kunnen leiden tot acute complicaties en deze complicaties ontstaan vaak door de onderontwikkeling van organen bij te vroeg geboren baby’s. Ook op de lange termijn kunnen verscheidene complicaties optreden zoals een cognitieve achterstand, motorische beperkingen en gedragsproblemen. Deze problemen kunnen de schoolprestaties en de...

Comorbid problems often coincide in individuals with autism spectrum disorder (ASD). Many parent-mediated systemic interventions have been developed for children to address these comorbid problems, with varying success. This study presents a systemic parent-mediated intervention, The Essential 5®. The effects of this intervention on comorbid social...

Sex under the influence of psychoactive substances (SUIPS) has gained much attention in the press and scientific literature over the last years, especially among men who have sex with men (MSM). Concerns have thus far been expressed in relation to short-term physical health risks, like contracting bloodborne diseases, like viruses. However, much le...

Wat Ouders Willen 2' met betrekking tot nazorg naar kwaliteitscriteria set nazorg van gezonde, te vroeg, of ziek geboren baby's en familie Jacobien, J.D.M. Wagemaker MSc Dr. Fabiënne B.A. Naber Dr. Tibor M. Brunt Leidschendam, 6 februari 2019 Onderzoek Veel2Do is mogelijk gemaakt dankzij het PGO-fonds

Background Preterm care involves clinical measures almost exclusively aimed at keeping the preterm alive and ready for discharge from hospital. Children are then enrolled in clinical follow‐up care after this stressful period, but mental or specialised care for parents and child is often not embedded in the routine of a neonatal hospital ward and t...

Goede zorg na een gecompliceerde bevalling is cruciaal, voor ouders en kind. Helaas is die zorg versplinterd, of richt zich alleen op het kind. Het Kleine Heldenhuis in Rotterdam zorgt voor opvang van het héle gezin. Dat verdient navolging, vinden de auteurs.

Introduction: The use of anabolic androgenic steroids (AAS) and other image- and performance-enhancing drugs is a growing public health concern. AAS use is associated with various physical and mental harms, including cardiovascular risks, cognitive deficiencies, and dependence. The aim of this study was to determine whether patterns of AAS use and...

beschermt bij moeilijke start E en veel voorkomende oorzaak van een moeilijke start is de premature geboorte van een kind. Een premature geboorte vereist meestal uitgebreide klinische zorg en een verlengd verblijf op de afdeling neonatologie van een zieken-huis. Ook op de langere termijn zijn er risico's verbonden aan prematuriteit, waaronder ontwi...

The recreational use of nitrous oxide (N2O) has increased over the years. At the same time, more N2O intoxications are presented to hospitals. The incidental use of N2O is relatively harmless, but heavy, frequent and chronic use comes with considerable health risks. Most importantly, N2O can inactivate the co-factor cobalamin, which, in turn, leads...

Background: This paper describes an online survey of men who have sex with men (MSM) and use drugs before or during sex ('chemsex') via injection ('slamming' or 'practising slamsex'). Approximately 15-30% of the MSM population in The Netherlands have practiced chemsex at some point, and 0.5-3.1% of them ever had 'slamsex'. This study investigates...

Gamma hydroxyboterzuur (GHB) werd in de jaren zestig ontwikkeld als anestheticum, maar vanwege de onvoorspelbare werkingsduur raakte het voor deze indicatie spoedig in onbruik. Tegenwoordig wordt GHB (onder de merknaam Xyrem®) voornamelijk toegepast bij narcolepsie, kataplexie, alcoholverslaving en voor de ontwenning van GHB ('taperen') bij patiënt...

Although MDMA (ecstasy) is a relatively safe recreational drug and is currently considered for therapeutic use for the treatment of posttraumatic stress disorder (PTSD) and alcohol use disorder (AUD), recreational MDMA use occasionally elicits hyperthermia and hyponatremia, sometimes with a fatal outcome. Specific risk factors for both adverse effe...

Background: GHB (gamma-hydroxybutyric acid; sodium oxybate) is a general anaesthetic that is clinically used for the treatment of narcolepsy, cataplexy, alcohol withdrawal and alcohol relapse prevention. In addition, GHB is recreationally used. Most clinical and recreational users regard GHB as an innocent drug devoid of adverse effects, despite it...

Background and aims: Injecting drug use is a matter of public health concern, associated with risks of overdoses, addiction and increased risk of bloodborne viral transmissions. Self-reported data on substances injected can be inaccurate or subject to bias or drug users might be oblivious to their injected substances or adulterations. Gathering of...

The endocannabinoid system is a complex neuronal system involved in a number of biological functions, like attention, anxiety, mood, memory, appetite, reward and immune responses. It is at the centre of scientific interest, which is driven by therapeutic promise of certain cannabinoid ligands and the changing legalization of herbal cannabis in many...

Objective Ecstasy is one of the most commonly used illicit substances in Western countries. The aim of this study is to identify characteristics of ecstasy users in a large population-based sample of adults aged 18-45 years. Method With generalized estimating equation models we explored the association between self-reported lifetime ecstasy use an...

Purpose: The novel phenethylamines 4-fluoroamphetamine (4-FA) and 2,5-dimethoxy-4-bromophenethylamine (2C-B), fall in the top 10 most used new psychoactive substances (NPS) amongst high-risk substance users. Various phenethylamines and NPS are also highly used in populations with mental disorders; depression or attention deficit hyperactivity diso...

4‐bromo‐2,5‐dimethoxyphenethylamine (2C‐B) is a designer drug. In Europe, 2C‐B is easily obtained and used for recreational purposes. It is known for its stimulating effects similar to those of 3,4‐methylenedioxymethamphetamine, although in higher doses it has more hallucinogenic effects. Here, we report a case of 2C‐B ingestion, confirmed by liqui...

Background Synthetic cannabinoids (SCs) are a class of new psychoactive substances that have been rapidly evolving around the world throughout recent years. Many different synthetic cannabinoid analogues are on the consumer market and sold under misleading names, like “spice” or “incense.” A limited number of studies have reported serious health ef...

Purpose: Substance use disorder often coexists with other psychiatric disorders, resulting in the simultaneous use of recreational and prescription drugs. The authors aimed to identify potential pharmacokinetic and pharmacodynamic interactions between new psychoactive substances of the cathinone class and specific prescription drugs. Methods: Th...

Background:: The unprecedented proliferation of new psychoactive substances (NPS) threatens public health and challenges drug policy. Information on NPS pharmacology and toxicity is, in most cases, unavailable or very limited and, given the large number of new compounds released on the market each year, their timely evaluation by current standards...

Novel psychoactive substances in the Netherlands and beyond: Challenges for clinical toxicology and pharmacology

A synthesis of current facts and figures on the use of drugs, alcohol, and tobacco and their consequences is reported annually in the National Drug Monitor. Highlights 2017: • The use of the stimulants ecstasy, cocaine and amphetamines increased between 2014-2016, whereas the prevalence of smoking decreased. • The number of registered drug overdos...

Commentary to: Will growth in cryptomarket drug buying increase the harms of illicit drugs?

Study objective: We study adverse health effects after use of the new psychoactive substance 4-fluoroamphetamine. Methods: All patients who reported 4-fluoroamphetamine exposure and for whom the Dutch Poisons Information Center was consulted by their physician in 2016 were included in a prospective cohort study. The clinical course was investiga...

The immunomodulatory adjuvant and antihelminth levamisole is increasingly used as an adulterant in cocaine worldwide. An accumulating body of clinical and toxicological literature has appeared since 2010 describing neutropenia, agranulocytosis, leukoencephalopathy and vasculitis in cases associated with levamisole-adulterated cocaine. Mostly, neutr...

Background Ecstasy is a widely used psychoactive drug that users often take because they experience positive effects such as increased euphoria, sociability, elevated mood, and heightened sensations. Ecstasy use is not harmless and several immediate and long term side effects have been identified. Lifetime ecstasy use is likely to be partly influen...

Introduction: Studies investigating risk-related behavior in relation to new psychoactive substance (NPS) use are sparse. The current study investigated characteristics of NPS users by comparing risk-related behavior of NPS users to that of illicit drugs (ID) users and licit substances users and non-users (NLC) users. Methods: In this cross-sect...

Background and aims: On-line drug markets flourish and consumers have high expectations of on-line quality and drug value. The aim of this study was to (i) describe on-line drug purchases and (ii) compare on-line with off-line purchased drugs regarding purity, adulteration and price. Design: Comparison of laboratory analyses of 32 663 drug consu...

Background and aims: In recent years, the prevalence of ecstasy use has increased in most European countries. Users can acquire information on ecstasy tablet composition through the internet. This study compares online information from two websites, Pillreports and Partyflock, to the validated Dutch Drugs Information and Monitoring System (DIMS) d...

The number of gamma-hydroxybutyric (GHB) acid users and GHB-dependent patients is increasing. Recreational GHB users generally regard GHB use and the frequently occurring GHB-induced comatose states as harmless. However, like with other sedative drugs such as ketamine and alcohol, such overdosing may cause neurotoxic damage, resulting in cognitive...

Gamma-hydroxybutyrate (GHB) has been used as a recreational drug in the nightlife setting since the 1990s in many Western countries. Problematic GHB use and addiction has been observed in certain countries recently. In this chapter, the epidemiology of GHB addiction is described as well as characteristics of recreational GHB use as GHB-dependent cl...

Gamma-hydroxybutyrate (GHB) is a short-chain fatty acid that naturally occurs in the brain, where it acts as a neurotransmitter and as a neuromodulator. GHB is a gamma-aminobutyric acid (GABA) analogue that passes the blood-brain barrier. GHB exerts its actions by binding to the GHB receptor in the brain, and in supraphysiologic concentrations, by...

Drug testing is a harm reduction strategy that has been adopted by certain countries in Europe. Drug users are able to hand in their drugs voluntarily for chemical analysis of composition and dose. Drug users will be alerted about dangerous test results by the drug testing systems directly and through warning campaigns. An international collaborati...

Context: Ibogaine is a psychoactive indole alkaloid found in the African rainforest shrub Tabernanthe Iboga. It is unlicensed but used in the treatment of drug and alcohol addiction. However, reports of ibogaine's toxicity are cause for concern. Objectives: To review ibogaine's pharmacokinetics and pharmacodynamics, mechanisms of action and repo...

Background: Recently, the number of new psychoactive substances (NPS) appearing on the illicit drug market has shown a marked increase. Although many users perceive the risk of using NPS as medium or low, these substances can pose a serious health risk and several NPS have been implicated in drug-related deaths. In Europe, frequently detected NPS...

Background and aims: Between 2000 and 2005 the average percentage of Δ(9) -tetrahydrocannabinol (THC) in marijuana as sold in Dutch coffeeshops has increased substantially; the potency of domestic products (Nederwiet and Nederhasj) has particularly increased. In contrast with imported marijuana, Nederwiet hardly contained any cannabidiol (CBD), a...

Terneergeslagen zitten ze in de familiekamer van de intensive care. Zojuist is hun vriend overleden aan de gevolgen van een overdosering ecstasy. ‘Ik begrijp het niet, hoe kan dit nou?’, vraagt de vriendin van de overledene zich vertwijfeld af. ‘We zouden met z’n vijven voor een keertje stevig gaan dansen. We hebben alle voorzorgsmaatregelen genome...

AimsTo investigate the temporal pattern of appearance of a new psychoactive substance (4-fluoroamphetamine) on the Dutch drug market, as well as its patterns of use and effects.DesignData from the Drug Information and Monitoring System (DIMS) was used to investigate the emergence of 4-fluoroamphetamine on the Dutch drug market. An online questionna...

Cannabis use is associated with an increased risk of psychosis in vulnerable individuals. Cannabis containing high levels of the partial cannabinoid receptor subtype 1 (CB1) agonist tetrahydrocannabinol (THC) is associated with the induction of psychosis in susceptible subjects and with the development of schizophrenia, whereas the use of cannabis...

The prevalence of GHB use in Flanders and the Netherlands among the general population is relatively low, but problematic GHB use has increased, as evidenced by the Dutch figures of addiction and emergency first aid. The extent of use in the Netherlands and Flanders is examined on the basis of prevalence among the general population to the group of...

Background: The international drug market has dramatically changed with the emergence of various new psychoactive substances that are mostly being sold on the internet. One of those new psychoactive substances is methoxetamine (MXE), a structural analogue of ketamine. Case description: A 30-year-old man with no history of illness was presented t...

Background and aims: Increased delta-9-tetrahydrocannabinol (THC) concentrations in cannabis may lead to higher THC exposure, cannabis dependence and treatment need, but users may also adapt the actual intake of THC through reduced inhalation of THC containing smoke (titration). We investigated whether consumers of stronger cannabis use less canna...

A growing body of evidence shows that gamma-hydroxybutyric acid (GHB) is an addictive substance. Its precursors gamma-butyrolactone (GBL) and 1,4-butanediol (1,4-BD) show the same properties and may pose even more risks due to different pharmacokinetics. There are indications that problematic GHB use is increasing in the European Union. This review...

After cannabis, cocaine is the most commonly used illicit drug in Europe. An estimated 13 million Europeans have used it at least once in their lifetime. Also, in the USA cocaine is one of the most prevalent illicit drugs, with an annual prevalence of seven million people. Cocaine is a well-known addictive stimulant drug and scientific literature c...

4-Methylamphetamine (4-MA) was originally developed as an appetite suppressant, but development was halted due to side effects. It has recently resurfaced as a new psychoactive substance in Europe, and is mostly found together with amphetamine. Around 11.5% of tested Dutch speed samples were positive for 4-MA. In Belgium, 4-MA was also found in spe...

Chronic use at high dose of illicit drugs, alcohol and tobacco is associated with physical disease. The relative physical harm of these substances has not been described before, but will benefit the guiding of policy measures about licit and illicit substances. The physical harm of 19 addictive substances (including alcohol and tobacco), consisting...

Background: The number of admissions to addiction treatment centers in the Netherlands for gamma hydroxybutyrate (GHB) dependence is rapidly growing. Until now, treatment seeking GHB users have hardly been studied. This study characterizes inpatients in treatment for GHB dependence in terms of sociodemographics, motives for substance use and reaso...

In several countries, including the Netherlands, the use of ghb seems to be increasing. Many recreational users of ghb consider the drug to be harmless and to have no serious side effects. In recent years the number of patients with ghb addition has been increasing steadily. To draw attention to the possible development of neurotoxicity due to chro...

The Dutch Minister of Health requested the Coordination point Assessment and Monitoring new drugs (CAM) to re-assess the overall risk of GHB. The present paper is a extended redraft of a state of art report used in the risk evaluation procedure. The prevalence of GHB use is low, but the relative proportion of GHB intoxications compared to other ill...

The findings in this thesis show that drug monitoring can be used to resolve some health issues and that it can also be applied to gain insights for the development of drug policy. Through all layers of drug politics, nationally or internationally, the DIMS is consulted for information updates. The data in this thesis show that the illicit psychost...

Physical damage due to drug dependence Excessive use of alcohol, tobacco and illicit drugs cause long term physical health damage. Smoking can cause lung cancer, and alcohol abuse may lead to liver cirrhosis and tumors in the oral cavity, esophagus and liver. The medical treatment of the diseases leads to financial costs. The health effects and tr...

Tibor Brunt onderzocht het Drug Informatie en Monitoring Systeem (DIMS), een landelijk netwerk dat de samenstelling van drugs als ecstasy en cocaïne analyseert. Die middelen zijn van gebruikers zelf afkomstig. Het is een effectieve manier om riskante stoffen te detecteren die aan de drugs worden toegevoegd, en om te meten welke gevolgen dat heeft v...

Recently, several reports have indicated instability of the ecstasy market in the Netherlands and other EU countries. In the current study, we demonstrate this instability in the Netherlands, showing a decrease of ecstasy tablets containing 3,4-methylenedioxymetamphetamine (MDMA) by more than 50% in 2009. In addition, we describe a partial replacem...

The general hypothesis exists that NH4 level in cigarettes and NO level in cigarette smoke do affect the nicotine availability in the lungs and subsequently play a role in the tobacco addiction. The objective of this report was to investigate whether correlations exist between the cigarette parameters: NH4 level, NO emission and the declared tar an...

The Ministry of Health in the Netherlands has made illicit drug testing for drug users possible since the 1990s, in order to prevent serious health hazards associated with unexpected dangerous substances. This system of illicit drug testing is called the Drug Information and Monitoring System (DIMS). In nearly two decades, more than 100 000 drug sa...

A recent decline in MDMA-like substances in ecstasy tablets has been reported by a number of countries in the European Union. This study describes the instability of the ecstasy market in The Netherlands during 2008 and 2009, and investigates whether this had any impact on drug testing or patterns of drug use. The health concerns of drug users hand...

the drug information and Monitoring system (diMs) in the netherlands monitors trends and new substances circulating on the drug market from the perspective of health care (Vogels, et al., 2009, addiction 104:2057-66). our aim was to investigate whether a recent instability of the psychostimulant market has led to the introduction of new substances...

A major component of the illicit drug market can be subcategorized as the psychostimulant drug market, with cocaine and amphetamine as popular constituents. In The Netherlands, an increase in both health care outcomes addiction treatment and hospital admissions was noted for both amphetamine and cocaine throughout a period of 17 years (1992-2008)....

The present paper outlines the results of analyses carried out on the content of tablets sold as ecstasy, collected in the Netherlands by the Drugs Information Monitoring System (DIMS) from January 1993 to December 2008. During a period of 16 years, the DIMS analysed the content of 33 006 tablets sold as ecstasy that were handed in by numerous indi...

To report on trends in the content and adulterants present in street cocaine (powder) in the Netherlands and to describe the associated health hazards. Drug consumers handed in samples of cocaine powder from 1999 to 2007 for analysis. Reports were compiled of users' experiences with the samples received. MEASUREMENTS AND ANALYSIS: Linear regression...

A new ecstasy-like substance, meta-chlorophenylpiperazine (mCPP), has been detected in street drugs in the Netherlands. Theoretically, mCPP possesses the potential to become a non-neurotoxic alternative for methylenedioxymethamphetamine (MDMA), the regular psychoactive substance of ecstasy. Since its introduction on the Dutch market of synthetic dr...

Adult males of linyphiid spider genera with a domed masculine prosoma shape and/or with a protuberance on the prosoma, showed a marginally significant higher killing potential (predation on spiders of various families surpassing the individuals of the killing genera in three body size measures) than did adult males of linyphiid genera possessing a...

In contrast to the popular belief that adult female spiders often kill and eat their adult male partners in the context of copulation, we present a few instances of adult male spiders killing and eating adult females of their own species in the laboratory. However, in line with the popular belief, we also found a few instances of adult females kill...

It has been suggested that ammonium compounds in tobacco generate nitrogen monoxide (NO) in cigarette smoke. This causes the smoke to retain the broncho-dilatory properties of the tobacco, which leads to an increased uptake of nicotine and thus to a potentially higher addiction to tobacco. The objective of this study was to ascertain putative corre...

we present behavioral lateralizations of spiders and ants and their probable survival value. they clearly conform to the vertebrate lateralizations reviewed by vallortigara & rogers (v&r) and to earlier arthropod studies. we suggest two complementary reviews: (1) differences in lesion susceptibility and muscle strength between left and right body s...

Interspecific predation of spiders was studied in the laboratory in view of possible competition in the wild. Certain species killed other species even if handicapped by smaller size. Thirty eight spider species were involved in such a relationship and their predatory relationships were significantly reliable and transitive ('linear' or 'non-triang...