Tıp Fakültesi / Faculty of Medicine

Permanent URI for this collectionhttps://hdl.handle.net/11727/1403

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Author: search.filters.author.Kotan, Vahap OzanSubject: search.filters.subject.cannabis

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    Differences in Sociodemographic Characteristics, Clinical Features and Serum Liver Function Tests of Male Cannabis and Synthetic Cannabinoid Users
    (2017) Kotan, Vahap Ozan; Yucens, Bengu Baz; Kotan, Zeynep; Ozkaya, Guven; Okay, Ihsan Tuncer; Tikir, Baise; Goka, Erol
    Objective: Synthetic cannabinoid (SC) use has recently become a growing substance abuse problem, with serious harmful clinical effects. Young males, especially cannabis (C) users, are at great risk of SC use. The aim of this study is to determine sociodemographic characteristics, clinical features and serum liver function tests of SC users and compare with those of C users. Methods: Out of 118 SC users applied to outpatient clinic of Ankara Numune Training and Research Hospital Alcohol and Substance Addiction Treatment Center, 74 males included in this cross-sectional study. Patients with a concurrent use of any medication or substance other than C/SCs or patients with any physical illness which could affect serum liver function tests were excluded. 44.6% (n=33) of 74 patients were only SC users at least for last three months and 55.4% (n=41) were combined C and SC (C&SC) users. SC users were compared with 34 age and BMI-matched only C using males. Results: Rates of being single and divorced; rates of living with friends and alone were found to be higher in SC users. Adverse effects and withdrawal sypmtoms were found to be similar in C users and SC users. According to serum liver function test results, levels of gama-glutamil transpeptidase, alkaline phosphatase, total/direct bilirubin, albumin, prothrombin time and international normalized ratio were similar. Serum aspartate aminotransferase levels (31.2 +/- 22.0 IU/L and 41.5 +/- 21.5 IU/L respectively, p=0.026) and serum alanine aminotransferase levels (28.4 +/- 18.9 IU/L and 44.3 +/- 25.9 IU/L respectively, p=0.015) differed between C users and C&SC users. Results in this study revealed that increased serum levels of aminotransferases were especially associated with combined use of C and SCs. Conclusions: C abuse seems to be a precursor of SCs abuse, and risk of starting SCs use could be bigger for C users, who live alone or with friends, whereas living together with a family could be preventative. Combined use of C and SCs seem to increase the risk of hepatocellular injury compared to either C or SCs alone.
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    The severity of dissociative symptoms among patients with cannabis and synthetic cannabinoid use disorder: association with substance use characteristics and suicide
    (2019) Yucens, Bengu; Kotan, Vahap Ozan; Okay, Ihsan Tuncer; Goka, Erol
    OBJECTIVE: Cannabis (C) and synthetic cannabinoids (SCs) are commonly used substances. Pharmacodynamic and pharmacokinetic differences predict that SCs involve a greater risk of dependence than C. Dissociative symptoms and suicidality are also frequent in treatment-seeking substance users, however, there is not enough data about the dissociative effects of C and SCs. The present study aimed to examine SC users in terms of demographic features and severity of dissociative symptoms in comparison to C users. It was also aimed to explore the relationships between dissociation and suicide attempts. METHODS: The study was performed at the Alcohol and Substance Research, Treatment, and Training Centre of Ankara Numune Training and Research Hospital, Turkey. 84 patients with C or SC use disorder included in the study and all the participants were administered a sociodemographic data form assessing also substance use features and suicide attempts and Dissociative Experiences Scale (DES). The patients were separated into three groups as only C users (CU), only SC users (SCU) and both C and SC users (C&SCU) and also categorized as DES score <30 as the low dissociation level and DES score of >= 30 as the high dissociation level. Correlations between variables were tested using Spearman correlation coefficients and the predictors of high dissociation level were evaluated using logistic regression analysis. A value of p<0.05 was considered statistically significant. RESULTS: DES mean score was 28.82 in all participants. Dissociation levels (rho = 0.058) and high dissociator rates (rho = 0.443) were similar among CU, SCU, and C&SCU groups. Age at onset of substance use was negatively correlated with the severity of dissociative symptoms (r = -0.22, rho = 0.042). DES mean score of patients with a history of suicide attempt was 40.51, significantly higher than that of those without (23.47). Age at onset of substance use, lifetime years of substance use, type of substance used (C, SC, and C&SC usage) were not significant predictors, only the history of suicide attempt was the significant predictor of high dissociation level (B = 1.886, S.E. = 0.542, Wald = 12.104, df = 1, rho = 0.001, OR = 6.596, 95% CI = 2.279-19.089). CONCLUSIONS: The findings support that dissociation levels are high in C and SC users as in other substance users, however, dissociative effects of C and SCs do not differ from each other. Besides the dissociative effects of C and SC use, there is also a significant effect of the suicide attempt history on the severity of dissociative symptoms. Although the relationship between dissociation and type of substance used is not clear, there is an association between dissociation and the history of suicide attempt. C and SC users are also concerned with dissociative symptoms that should be considered by the clinician since it affects the treatment modality and treatment response.