Clinical characteristics of ‘dappou herb’ use-disorder patients at the drug dependence clinic: A comparison with methamphetamine use-disorder patients

Chiba Hospital.
Seishin shinkeigaku zasshi = Psychiatria et neurologia Japonica 07/2013; 115(5):463-76.
Source: PubMed


Use of the so-called "dappou herb," a street drug typically produced by mixing herbs with synthetic cannabinoid (estimated to be the pharmacologically effective ingredient), has recently spread to young people in Japan who consider it a new recreational drug. It is not legally regulated because no illicit ingredients have been detected in the drug by conventional screening tests. It is easily obtained via the Internet or from street vendors. As the population abusing this drug has grown, medical problems such as psychosis, disturbances of consciousness caused by acute intoxication, and social problems such as traffic accidents while under the influence of the drug have been increasingly reported. However, few psychiatric symptoms associated with it have been identified, and little is known about the psychosocial features of abusers. The purpose of the present study was to examine the clinical and psychosocial features of outpatients with dappou herb use disorder.
Subjects were 15 male outpatients with dappou herb use disorder who had their first medical examination at the Drug Dependence Clinic in the Center Hospital, National Center of Neurology and Psychiatry between November 2009 and April 2012. The control group comprised 28 age-matched oupatients who had methamphetamine use disorder, the most serious drug-related problem in Japan since the 1950s. They underwent their first medical examination at the same clinic during the same time frame as the study subjects. Clinical and psychosocial information on subjects and controls including life histories (educational, occupational, and criminal) and clinical information (history of psychoactive substance use, access to the mainly abused drug, and DSM-IV diagnoses of substance use disorder and comorbid psychiatric disorders) were collected from medical records. These variables were compared between the two groups.
Analyses revealed differences in the life history and clinical characteristics between the subjects and controls. The subjects had a higher level of education, more work experience, and a less marked history of anti-social behavior other than illicit drug use and possession than the controls. However, a clinical history of psychiatric disorders, other than substance-related disorders, before drug abuse began was more frequently found in the subjects than in the controls.
The present study demonstrates that patients with dappou herb use disorder may differ from those with methamphetamine use disorder in terms of their background, psychosocial factors, and clinical features. These findings suggest that the dappou herb may be creating a new type of drug abuser in Japan. Our study also indicates that some patients abusing this herb may have been "self-medicating" for symptoms of other psychiatric disorders such as depression or anxiety, given that they were more likely to have received psychiatric treatment before the start of drug abuse. This suggests that the legal regulation of this drug as well as early comprehensive intervention for adolescents with mental health problems may be required to prevent abuse of the dappou herb. Two limitations of this study should be noted. The definition of the dappou herb was vague because the ingredients are still unclear. In addition, the sample size of this study was very small. However, no studies using larger samples have been reported in Japan. Future studies that overcome these limitations are needed.

3 Reads
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: The aim of this study was to clarify the clinical features of designer-drug-abusing patients through comparisons with methamphetamine-abusing patients and hypnotics/anxiolytics-abusing patients. Information on 126 designer-drug-abusing patients, 138 methamphetamine-abusing patients, and 87 hypnotics/anxiolytics-abusing patients was extracted from the 2012 database of 'The Nationwide Mental Hospital Survey on Drug-related Psychiatric Disorders' and the clinical variables of designer-drug-abusing patients compared with those of the other two groups. Multivariate analysis indicated the following significant differences between designer-drug-abusing patients and the other two types of patients: designer-drug-abusing patients were younger, included more men, had higher education and fewer relationships with antisocial groups, and included more patients meeting ICD-10 F1 sub-classification categories of 'Harmful use' and 'Psychotic disorders' than methamphetamine-abusing patients. Compared with hypnotics/anxiolytics-abusing patients, designer-drug-abusing patients were younger, included more men and more patients meeting criteria for 'Psychotic disorders', and more frequently cited 'peer pressure', 'unable to refuse', and 'seeking stimulation' as reasons for using the drug. The advent of designer drugs has created a new class of drug abuse, and abuse of designer drugs may carry a strong psychosis-inducing risk, exceeding that of methamphetamine.
    Full-text · Article · Jan 2014 · Psychiatry and Clinical Neurosciences
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Background: Spread of new psychoactive substances (NPS) is a worldwide problem. In Japan, NPSs with psychoactive ingredients are called as "dappou drugs" or "kiken drugs." Their potential effect on the Japanese society cannot be ignored. Findings: We conducted an awareness survey of So-called Dappou Drugs or Kiken Drugs among the students of Ibaraki University, a national university in Japan, in April 2014. 3976 students (2425 men, 1406 women and 145 unspecified) participated in this study. 2813 (70.7 %) respondents were aware of dappou drugs. Only 39.5 % of the respondents selected the option of "ingredients that cause delusions and/or hallucinations may be included" in dappou drugs. 23.4 % of the respondents selected "the number of (dappou drug) users requiring emergency hospitalization due to acute intoxication is increasing". Of the respondents, 19 (0.5 %) reported that they had been invited to use dappou drugs previously, and 40 (1.0 %) had witnessed and/or heard of somebody close to them using the drugs. Those who drank alcohol every day and those who smoked had a higher chance of witnessing and/or hearing of somebody close to them using dappou drugs than those who did not drink or smoke, respectively. Conclusions: Japanese university students do not have sufficient knowledge about dappou drugs or kiken drugs to protect themselves from potential drug misuse. It is both important and urgent to educate Japanese university students about the harmful effects of dappou drugs; in addition, it is important to provide such knowledge before the students are allowed to legally drink and smoke.
    Full-text · Article · Oct 2015 · Substance Abuse Treatment Prevention and Policy