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A police officer sprays gasoline on packages of cocaine, seized from a ship stopped in international waters. Reuters photo. Because of my addiction I was in a severe health condition and had to be hospitalized in the end. I was weighing only 43 kilos when I was admitted,' Seyyide Yoruk told Xinhua in a telephone interview. This year-old repentant drug addict said her family considers drug abuse as 'something ashamed of' in a largely conservative and patriarchal Muslim society, which makes it very difficult for the addicts to look for a clean life and there are few state-sponsored medical facilities that can properly take care of them. There is the real deal which is pure and difficult to reach and the synthetic one that you can buy for 20 liras 5. No one knows what's inside and it can cause deadly overdoses,' Yoruk said. He said his country seizes more drugs than Europe and trafficking of drugs from Iran and Afghanistan usually goes through Turkey. In , Turkish authorities detained 47, people, including foreigners, for drug-related offenses, Akdag said. He was referring to the cheap synthetic drug called bonsai which is holding a large number of youths prisoner of its effects. Operations have led to the seizure of 5,, illegal drugs in the pill-form, including ecstasy, amphetamine and prescriptions, Akdag said. Despite harsh legislation and intense police work, synthetic drug abuse is on the rise among low-income Turkish youths, even in conservative neighborhoods in big cities. Drugs have even made their way to small villages in rural areas where kids aged 9 or 10 are using it,' Fatih Yuzuguler, a former addict, told Xinhua. The year-old Kurdish man said he pretty much used every drug from cannabis to cocaine and methamphetamine to heroin. Yuzuguler now tries to help new addicts and their families to sever ties with narcotics, which is a very hard task in an impoverished and conservative environment. Like a diabetic we struggle to keep away from our kind of sweets,' said Yoruk. He called on the state to establish a comprehensive mechanism for the social problem, and raise awareness of the plight of young addicts. Turkish Interior Minister Suleyman Soylu stirred a controversy last week when he publicly encouraged his police force to use extra judicial methods to deal with drug smugglers. Do it and blame me. Even if it costs five, 10, 20 years in jail, we'll pay,' Soylu was quoted by the local press as saying. He argued that Turkey must fight drug dealers as it fights the Kurdistan Workers' Party PKK which has engaged in a three-decade deadly insurgency against the Turkish state. No one can poison our future,' he said. The interior ministry said last year that the PKK earns million dollars a year from the illegal drug trade since , with cannabis as its main source of funding. The age of drug usage has decreased to 9 in Turkey, according to Ulkumen Rodoplu, the founding president of the Emergency Mede iMessage Association of Turkey. Spotlight: Turkey desperate for sustainable solutions to epidemic drug problem Source: Xinhua Spotlight: Turkey desperate for sustainable solutions to epidemic drug problem. Xinhua Weibo. Sina Weibo. Tencent Weibo. Sohu Weibo. NetEase Weibo. Source: Xinhua Editor: huaxia. Back to Top.

Spotlight: Turkey desperate for sustainable solutions to epidemic drug problem

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Official websites use. Share sensitive information only on official, secure websites. In this study, we aimed to contribute to the literature by evaluating synthetic cannabinoid bonsai and additional drugs. This prospective study was conducted on patients who admitted to the emergency department ED with bonsai intake between December 20, and January 1, , according to the patient history obtained from the patients. One hundred sixty-eight patients with negative urinary metabolites results were excluded from the study, 49 patients with positive urinary metabolites were included in the study. Patients were divided into two groups. The first group consisted of patients with only bonsai intake and the second group consisted of patients with bonsai and concomitant drug intake. The groups were compared in terms of symptoms, findings, blood gas values, duration of the symptoms, discharge time, hospitalization, and mortality rate. The mean age of 49 patients included in the study was Concomitant drug intake was identified in Concomitant drug use was as follows: cocaine The most common symptom was palpitations tachycardia The median time to remission of symptoms and median follow-up time of the patients in the emergency room were 3 hours and 6 hours, respectively. While the bonsai intake alone is not considered mortal to the patients and most of them can be discharged from the ED after signs and symptoms disappear, concomitant drug use can increase the toxic effects of bonsai intake. That is why the follow-up of patients taking concomitant drugs, and the treatment process should be carried out more carefully. Synthetic cannabinoids SC are chemical substances that cause marijuana-like effects and their intake has increased worldwide in recent years 1 , 2. In recent years, due its cannabis effects, availability and low cost, its use has rapidly increased, especially among adolescents and young adults 4 , 5. Despite the lack of current data regarding the prevalence of SC use in Turkey, some studies show that the use of SCs is rapidly becoming widespread among the young population in Turkey 4. Such products usually consisted of plant mixtures with little psychoactive effects. Since , however, the composition of these herbal products seems to have substantially changed to include potent new psychoactive compounds known as synthetic cannabinoids bonsai. Since , 11 subgroups of SC produced by different manufacturers were identified 6. JWH, arguably the most widely known synthetic cannabinoid, belongs to the group of aminoalkylindoles and is considered to be three times as potent as THC 7 , 8. Synthetic cannabinoids that have emerged more recently show an even greater structural diversity, e. SCs have sympathomimetic effects such as palpitations, sweating, agitation, and restlessness 1. Although pathologies such as acute coronary syndrome ACS , pulmonary embolism PE , ischemic stroke, seizures and acute kidney injury AKI due to SCs have been reported, there was no evidence whether these findings were caused by SCs or other drugs taken along side with SCs 10 - Drug addicts are reported to tend to use multiple substances simultaneously. Due to the fact that this substance has recently been used as a drug, information about its toxic effects and interactions with other used drugs is quite inadequate In addition, we aimed to investigate the relationship between the use of additional drugs and clinical findings, hospitalization, and mortality. One hundred sixty-eight patients with negative urinary metabolites were excluded from the study. Urine samples of the patients with positive urinary metabolites were screened simultaneously for other drugs acetaminophen, amphetamines, methamphetamines, barbiturates, benzodiazepines, cocaine, methadone, opiates, phencyclidine, tricyclic antidepressants, and tetrahydrocannabinol using toxicology panel Alere Triage TOX Drug Screen. Ethanol levels were measured in blood samples taken from the patients. The demographic characteristics, concomitant drug use, symptoms, findings, arterial blood gas values pH, pO 2 , pCO 2 , lactate, and base deficit , duration of symptoms, time to discharge, and hospitalization rates of the patients were evaluated. The groups were compared in terms of symptoms, findings, arterial blood gas values, duration of symptoms, time to discharge, and hospitalization rates. Distributions of continuous and discrete numerical variables were analyzed with the Kolmogorov-Smirnov test. The Student t- test and the Mann-Whitney U test were used for analyzing parametric and nonparametric data. This study was approved by the Ethical committee of the Antalya Training and Research hospital, and the consent forms were taken from the patients. Patients were determined to be frequently The general aim for using bonsai was for pleasure Friends were the most common Additional drug intake was identified in In history, other drug use was as follows: cocaine The most common symptoms in patients in Group 1 were vertigo The most common physical examination findings in Group 1 were tachycardia The most common ECG finding in both groups was Sinus tachycardia While all patients from Group 1 were discharged from the ED after the examination and treatment, in Group 2, Patients whose symptoms did not regress or clinically worsen during follow-up in the emergency room and patients whose vital signs were unstable were hospitalized. Although exitus was not seen in Group 1 and the mortality rate was found to be 9. Table 2. The median time to remission of symptoms and median follow-up time of the patients in the ED were 3 hours and 6 hours, respectively. One patient had suffered cardiopulmonary arrest before admission and died in the ED. While 2 patients who developed respiratory depression hospitalized in the intensive care unit ICU died within 48 hours, the other 2 patients were discharged from ICU after a 24— hour follow up. Minor atheroma plaque was detected in the patient hospitalized with the diagnosis of ACS and the patient was also discharged after disappearing of the symptoms. The patient, whose subsegmental PE was detected on thoracic CT angiography, was discharged after treatment. Dialysis has been used to treat the patient who developed acute renal failure and was discharged with recovery after ICU follow up. The patient who was hospitalized due to seizure in ED was also discharged without recurrence of seizure by recommending polyclinic control. No additional pathology developed after the follow-up of the patients discharged from the ED. SCs use is a major public health problem among adolescents and young adults, and substance users generally prefer to use many additional substances together There could be many reasons for the intake of a combination of drugs. The main reason is to increase the psychoactive experience and get rid of the side effects of other drugs In another study by Barratt et al. The age and sex ratio in our study was similar to the literature. We believe that the main reason why SCs are preferred by young people is a cheap price. The reason why drug use is more common among men may be due to the fact that men are more independent and spend more time in areas where drug use is more common. Yilmaz et al. In our study, bonsai users were found to be mostly primary school graduates also. We believe that drug addicts prefer the easily accessible and cheapest drug on the market because of their low education level and low incomes. Wasting time and money on searching for drugs is likely to be a result of a low level of education in drug-users. The main reasons for the rapid spread of SCs among people may be related to the fact that they look like cannabis , are used in a similar way, were not identified in the toxicological screening tests previously, are easily accessible and cheap 1 , Although cigarette smoking was found to be the most common way to consume SCs in the studies, other forms of intake such as evaporation, oral or rectal way have also been reported 4 , 5. Indeed, in our study, it was found that patients had a low level of income, mostly used cannabis before, used SCs for pleasure and in the form of smoking. We believe that the reason for switching to SCs is due to the fact that SCs resemble marijuana in every aspect and are easily accessible and cheaper. The most common physical effect reported after SC intake is tachycardia In their study on SC users, Barrat et al. Forrester reported that the leading symptoms were palpitations and chest pain in Negative inotropic effect and vasodilator effect of CB1 receptor have been demonstrated In our study, consistent with the literature, the most frequent symptom was palpitation and the most common finding was tachycardia. Being CB1 receptor agonist, we believe that bonsai leads to tachycardia by causing an increase in the amount of dopamine. In addition, it should be kept in mind that additional drug use and additional symptoms such as anxiety and hypotension might lead to an increase in tachycardia by causing hormonal activation. Although no difference was found regarding symptoms and findings between the groups in our study, the duration of symptoms of the patients with additional drug intake was found to be longer, according to the results of the analysis of the patients included in our study. In our study, we determined that pCO2 values were slightly higher and PaO2 was lower and that patients with concomitant drug intake were more acidotic. We believe that the additional drugs affect respiration directly or indirectly and that this effect is greater in patients with additional drug especially opiates intake. Although it is known that symptoms and findings associated with SC intake last less than 8 hours and the patients are discharged, there are also reported patients with symptoms and findings that have lasted longer than 24 hours In our study, the median time to remission of symptoms and median follow-up time were 3 hours and 6 hours, respectively. The duration of symptoms was significantly longer in patients with additional drug intake. Time to remission of symptoms was shorter than 8 hours in accordance with the literature. Monte et al. The rate of hospitalization is In our study, hospitalized patients were found to have a worse clinical condition. Also, it should be noted that the effect generated by bonsai might strengthen the side effects of other drugs. In the literature, many studies on bonsai are retrospective and do not use diagnostic tests. Although significant results have been revealed, our study has some limitations. First, our study is a single-center study. IB is responsible for the integrity of the work as a whole from inception to the published article. EA, CK and FY are responsible for the integrity of the work as a whole from inception to published article and contributed to the interpretation of the data. HE and IK contributed to the drafting of the article. MK is responsible for data analysis. AI contributed to data acquisition. Our work does not infringe on any rights of others, including privacy rights, and intellectual property rights. There is no human rights violation in our manuscript. Each author declares that he or she has no commercial associations e. As a library, NLM provides access to scientific literature. Acta Biomed. Find articles by İnan Beydilli. Find articles by Murat Duyan. Find articles by Engin Deniz Arslan. Find articles by İlhan Korkmaz. Find articles by Arefe İmak. Find articles by Ertan Ararat. Received Jun 3; Accepted Jun 23; Issue date Open in a new tab. Similar articles. Add to Collections. Create a new collection. Add to an existing collection. Choose a collection Unable to load your collection due to an error Please try again. Add Cancel. Physical examination findings Hypertension.

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