Thank you for taking the time to provide feedback. It will be used to make improvements to this website. Table of contents Section 1: Introduction Section 2: Prevalence, effects and risks. Chapter 2: Prevalence and patterns of psychostimulant use. Chapter 3: Pharmacology of psychostimulants. Section 3: Clinical considerations. Chapter 5: Psychosocial interventions.
Chapter 6: Management of acute psychostimulant toxicity. Chapter 7: Psychostimulant withdrawal and detoxification. A 28 gauge needle abbreviated 28G is therefore thinner than a 25 gauge needle, which is in turn thinner than an 18 gauge needle. Most intravenous injectors use either a standard insulin set which typically has a 27G or 28G needle and an orange cap , or a standard tuberculin set with a 25G needle frequently referred to as a blue tip because of its color, but they can vary in color.
The smaller gauge needle you use, the smaller the puncture wound, and therefore the less opportunity for infection to occur.
Using a smaller gauge needle is also likely to result in less bleeding. Intramuscular injections must be given with larger gauge needles frequently 21G or 23G , and certain substances such as injectable steroids and hormones can only be administered intramuscularly.
Drugs that are cut with a lot of impurities, like white powder or tar heroin, may clog the point of the syringe. The higher the gauge therefore the thinner the needle and the smaller the hole , the more likely it is that the point may get clogged.
This is particularly true with brown tar heroin. A needle that is too short may miss your vein, and one that is too long may go right through it or be difficult to properly position.
Longer needles are often appropriate for intramuscular injections. Most people who inject find that, if given the opportunity to try out different brands of needles and syringes, they will find one that they prefer over all others. Different manufacturers create needles and syringes of varying quality. Some brands of needles are more comfortable to inject with than others, and the plungers on some brands of syringes are easier to manipulate than on others.
With some types of injection equipment, the needle detaches from the syringe, resulting in two separate pieces. Standard insulin injection equipment is typically one piece, while tuberculin needles and syringes are often detachable. Detachable, two-piece equipment often has a larger reservoir above the needle in which a lot of blood can collect.
Lastly, you might find that using a butterfly set—often used for drawing blood in hospitals —is helpful when getting off in the hands or feet, but this type of set can be difficult to obtain. Ask your local exchange if they have any. Standard insulin and tuberculin syringes are typically 1cc in size and are calibrated by.
Syringes other than 1cc in size may be difficult to obtain. As important as choosing an appropriate needle and syringe is how you use them. Below are some very important guidelines you should follow in order to make the process of injecting as safe as possible. In the same way that hospitals will use a needle and syringe only once and then dispose of it, this is the gold standard that anyone who injects drugs should also strive for.
Needles dull quickly, even after just a few uses. Using dull needles causes unnecessary trauma to the veins and surrounding tissue, results in a larger puncture wound and increased bleeding, and is simply not as comfortable as using a new, sharp needle every time. Attempting to sharpen a needle on a matchbook, for instance is dangerous because it can create a burr on the needle that can cause significant damage to the veins, or weaken the point and cause it to break off in your vein.
Using a new, sharp, sterile needle and syringe for every injection and then disposing of it is simply the safest possible way to go. Blood or other matter that remains in a needle and syringe after someone has used it can be passed on to anyone else who uses that same injection equipment. The same applies to cookers, cottons and spoons. In this way, life-threatening viruses such as hepatitis C and HIV can be transmitted from one person injecting to another. The only definite way to avoid disease transmission of this sort is to never share needles, syringes, or other injection equipment.
Sharing injection equipment even after it has been cleaned is definitely a second-best choice because blood and other matter can remain in a needle or syringe even after cleaning with bleach. Even though injection equipment might look clean to the naked eye, tiny amounts of blood can remain in the works which can result in infection. Follow these instructions carefully:. If you do not have bleach, you can substitute hydrogen peroxide, a solution of dishwashing liquid and water, or rubbing alcohol.
Do not use soap or dishwashing liquid that has not been mixed with water — they are too thick and will get stuck in the syringe. It is unclear whether bleach kills hepatitis C, even after two minutes. This should also kill any HIV that might be in the equipment. And remember that sharing water is one of the most efficient ways to pass on or contract a virus or other infection-causing organism.
If you purchase needles and syringes on the street, clean them before you use them: sometimes used equipment is re-packaged and sold as new. Most injectors draw their drug solution from a cooker or spoon into a syringe through some type of filter—most often a piece of cotton or other absorbent material.
Preparing your shot as sanitarily and hygienically as possible can help you avoid many illnesses and infections, some of which can be quite serious and require hospitalization see chapter 3. Some drugs will dissolve in water without being heated; some people cook their cocaine, for instance, while many more do not because it can clot when heated, mess up your shot, and clog your needle.
Though brown heroin will dissolve without an acid, heating it along with an acid like powdered vitamin C will help dissolve it more easily. Finally, pills must be crushed up or pulverized as finely as possible before being dissolved for injection. And inject pills only as a last resort; injecting the particles from a pill can cause all sorts of problems, particularly abscesses. For this reason, you should avoid muscle-popping or skin-popping pills if possible.
Indeed, few pharmacological modulations has been shown to significantly increase the occurrence of affiliative behaviors in non-human primates [ 6 — 9 ]. The neurobiology of entactogens mainly involves a modulation of the metabolism of monoamine signaling [ 14 ]. MDMA specifically stimulates serotonin, dopamine and noradrenalin efflux by altering the functioning of their respective transporters [ 15 — 18 ]. Besides that, MDMA also displays a micromolar affinity to some noradrenergic, serotoninergic, muscarinic, histaminergic and dopaminergic receptors [ 19 , 20 ].
The complex neurobiology of MDMA, which could be partially explained by a differential effect of each of its enantiomer [ 21 , 22 ], also involves second order secretion of hormones such as prolactin, oxytocin and cortisol [ 23 , 24 ]. It has been suggested that that some of the subjective effects of MDMA are specifically driven by these hormonal modulations [ 13 , 25 — 29 ].
In rodents, for instance, an increase of the amount of adjacent lying behavior following an MDMA administration was correlated with an activation of the oxytocinergic neurons, likely through serotoninergic signaling and especially 5-HT1a receptors [ 30 — 32 ]. When considering projection pathways and receptor localization, the serotoninergic system of macaques is broadly similar to that of humans [ 33 ].
Non-human primates might thus be useful to bridge the neurobiology of entactogens in rodents and in humans. Many studies using single-housed non-human primates have focused on the deleterious potential of MDMA on serotoninergic projections [ 34 — 38 ]. However, the effect of MDMA administration on the social behavior of non-human primates has never been assessed quantitatively. In this experiment, we used a custom-designed multi-camera 3D tracking system [ 39 ], to record for extended periods of time the behaviors of 3 socially housed males juvenile long-tailed macaques Macaca fascicularis following a subcutaneous injection of either a saline solution or of MDMA at three doses 1.
They were housed as a mini-colony in a large enclosure 15m 3 allowing direct physical interaction, but also to isolate the monkeys when needed by means of a system of sliding partitions.
When isolated, the monkeys could communicate visually and vocally at all times. Animals were fed with monkey chow, fresh fruits and vegetables. The cages were enriched with ropes, mirrors and woodchips to promote foraging. During behavioral recordings, the presence of objects in their cage was carefully controlled, so that the objects inserted at the beginning of each recording session was the only one of interest present in the cage. At the present time, all tested animals are still alive and used for behavioral observation studies.
In order to reduce the stress of the injection, the animals were extensively trained prior to the experimental test with fake injections and positive reinforcement using clicker training. These doses were based on those known to produce a subjective and physiological effect in Humans [ 23 ] and monkeys [ 40 ] while respecting posology known not to produce any measurable damage to the serotoninergic projections of the animals [ 34 ]. Indeed, for each animal, an interval of at least one week was respected between successive MDMA injections.
During experimental sessions, one animal was injected with MDMA while the two others were injected with saline [ 41 ]. After the injection, a unique colored toy was introduced inside the home cage and left until the next morning. The recording sessions started at 5 p. These procedures were performed over a 3-month period. We used a custom-designed multi-camera 3D tracking system [ 39 ], to record and monitor the behavior of primates in their living space.
This system can track the location of multiple animals in real-time, provided they are wearing a unique color marker restraining collar or head-post.
Animal positions X, Y, Z were estimated by triangulation from the set of image coordinates of their respective color targets when viewed by at least 2 cameras.
Measurements for 3 animals and 1 colored toy were taken simultaneously at 15 Hz rate, with a nominal spatial accuracy of 1 cm. Position recordings were then processed to derive animal relevant behavioral measurements, except grooming which has been scored manually from raw videos. The sum of the time spent engaged in the seven recorded behaviors matches the whole duration of the recording sessions. The behavior of each animal injected with MDMA was compared with the same animal behavior during the closest control session up to 4 days before the experimental session thus allowing the use of pair-wise non parametric statistics Wilcoxon signed-rank test.
Data analysis and statistics were performed using custom scripts written in Matlab R The mean activity budget of the considered animals for all 3-hours saline control sessions is presented in S1 Fig.
Additionally, individual data are presented in S2 Fig. We did not quantify abnormal behaviors such as stereotypy but the treatments seemed to be well tolerated by the animals as no adverse events were detected.
Several significant dose-dependent behavioral effects have been found. At small dose 1. At medium dose 1. At large dose 2. In addition, together with other non-significant conditions, the time course of these significant effects is presented in Fig 2.
The effect of the medium dose of MDMA on grooming behavior reached its maximum around minutes after the injection. The effect of the small doses of MDMA on object manipulation behavior contains two distinct peaks, one around 80 minutes post injection, and the other at the end of the recording sessions, while the control session only displays one peak at around minutes post injection. At both medium and large doses, MDMA injections induced a rapid and long lasting inhibition of foraging behavior.
At large doses, MDMA induced an increase in time spent in locomotor activity reaching its maximum at around minutes post-injection. Mean difference in frequency of each measured behavior between MDMA injections and their respective saline control injections.
Positive values mean that the behavior was increased by MDMA injection. Error bars represent the SEM. Number of sessions: MDMA 1. Despite our relatively small number of subjects, the measured dose-dependent behavioral effects of MDMA injection on juvenile male long-tailed macaques are mostly consistent with its known effects e.
As a member of the methamphetamine family, a large dose of MDMA injection has a stimulant effect via releasing of norepinephrine and stimulation of adrenergic alpha 1 receptors [ 42 — 44 ]. Interestingly, previous studies report an opposite effect of MDMA on the locomotor activity of rhesus macaques [ 35 , 45 , 46 ]. Such contradiction might be explained by the fact that in previous studies, macaques were housed individually.
In our study, the mere presence of others might have favored the known stimulant effect of MDMA. Methamphetamines are also known to induce an anorexigenic effect, which is fairly consistent with the long-lasting observed decrease in foraging after the injection of medium and large doses of MDMA.
It is worth noticing that the use of foraging behavior might represent a suitable model of consummatory and maybe exploratory behaviors in macaques. The effect of small doses of MDMA upon object play behavior could be interpreted in different ways, however the lack of data available on the hormonal correlates of solitary object play and the physiological consequences of small dose of MDMA injection makes it hard to distinguish among these.
A possible explanation for the observed increase in object play at low MDMA doses could be a decrease of social fear, based on previous findings showing the influence of peers on object play [ 47 — 49 ].
However, the fact that small dose of MDMA has little impact on social contact or grooming behaviors is not in favor of this explanation. Another interpretation could be that at small dose, MDMA modulates the intrinsic motivation to manipulate objects. This might be driven by a genuine increase of curiosity, a need to alleviate a stress, or a hallucinogen-like effect.
However, none of these explanations are likely based on the other observed behaviors. In our experiment, a small dose of MDMA did not significantly increase foraging behavior, which is inconsistent with a general increase in curiosity. Even if it has been shown in previous a study of [ 50 ], a possible increase in anxiety by MDMA injections seems also unlikely to explain a modulation of object play behavior. Interestingly, at medium dosage, MDMA induced an increase of social grooming, an effect of undeniable prosocial nature.
However, MDMA only increases received but not given social grooming, which suggest that such prosocial effect might be explained by an increase of non-aggressive postures more than by a genuine increase in motivation for social affiliation [ 53 ].
A recent study has shown that sertraline a selective serotonin reuptake inhibitor administration on macaques also induce a dose-dependent increase of grooming behaviors [ 8 ], hence the observed prosocial effects of MDMA could be mediated by a modulation of the serotoninergic system.
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