Fronto-temporal cortical atrophy in ‘nyaope’ combination heroin and cannabis use disorder

Ndlovu, Nhanisi A.; Morgan, Nirvana; Malapile, Stella; Subramaney, Ugasvaree; Daniels, Willie M. U.; Naidoo, Jaishree; Heuvel, Martijn P. van den; Calvey, Tanya

doi:10.1016/j.drugalcdep.2021.108630

Cited by 5 publications

(19 citation statements)

References 45 publications

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“…After screening by title and abstract, 43 articles remained. A total of 19 articles [ 6 , 13 , 14 , 29 – 44 ] fulfilled the criteria for inclusion and were therefore eligible for analysis (Fig. 1 ) [ 25 ].…”

Section: Resultsmentioning

confidence: 99%

“…All 19 studies were conducted in South Africa, with 13 taking place in Gauteng Province [ 13 , 29 – 32 , 35 , 36 , 39 – 44 ], two in Western Cape [ 6 , 43 ], two in KwaZulu-Natal [ 33 , 38 ], one in Mpumalanga [ 29 ], one in Northwest [ 29 ], and one in Eastern Cape [ 14 ]. One study did not specify the province within South Africa [ 37 ], whereas another study was conducted across the country [ 34 ].…”

Section: Resultsmentioning

confidence: 99%

“…An additional was study conducted in three provinces: Gauteng, Mpumalanga, and Northwest [ 29 ]. There were a range of different methodologies among included studies: six studies had a qualitative design [ 14 , 29 – 33 ], five were cross-sectional studies [ 6 , 13 , 34 – 36 ], four were case reports [ 37 – 40 ], two were retrospective cohort studies [ 41 , 42 ], one was a prospective cohort study [ 43 ], and one study had a case–control design [ 44 ]. The most frequently noted limitations included low participant totals in studies, study eligibility being restricted to adult participants, and a heavy reliance on self-reporting.…”

Section: Resultsmentioning

confidence: 99%

“…In the majority of studies, nyaope users were most frequently between 18 and 29 years of age [ 13 , 29 – 31 , 33 – 36 , 39 – 41 , 44 ], though a number of studies also demonstrated that there are nyaope users in their 30s and 40s [ 13 , 29 – 31 , 34 , 35 , 43 , 44 ]. While those under 18 years were not eligible for inclusion in many of the included studies, some studies showed that nyaope usage is also occurring in adolescents as young as 13 years of age [ 6 , 14 , 37 ].…”

Section: Resultsmentioning

confidence: 99%

“…Prior substance use and co-substance use were also frequently noted as risk factors for nyaope usage [ 6 , 29 , 33 , 35 – 39 , 44 ]. The most commonly used substance associated with nyaope use was cannabis [ 29 , 33 , 35 – 37 ], and other substances commonly used were tobacco and alcohol [ 6 , 29 , 35 , 36 , 38 , 39 , 44 ]. One study found that 52% of nyaope users previously used cannabis, 13% used cigarettes, and 14% used other drugs [ 29 ].…”

Section: Resultsmentioning

confidence: 99%

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A Systematic Review of Risk Factors and Consequences of Nyaope Usage: The Illicit Street Drug Containing HIV Antiretrovirals

et al. 2022

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South Africa currently has the highest number of cases of HIV in the world. HIV antiretrovirals (ARVs) are publicly available across the country to address this crisis. However, a consequence of widely available ARVs has been the diversion of these drugs for recreational usage in a drug cocktail commonly known as “nyaope” or “whoonga,” which poses a significant public health concern. To better understand nyaope, we conducted a systematic review investigating the risks and consequences associated with its usage. Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, searches were conducted in eight different databases and screened thereafter. Articles were eligible for inclusion if they included analysis of least one nyaope user and considered either demographics, risk factors, or consequences of usage. Data extracted included study characteristics and limitations, as well as demographic factors, risk factors for usage in the general population, and consequences. Quality assessments were performed using the Joanna Briggs Institute’s tools. Searches produced a total of 228 articles and, after screening, a total of 19 articles were eligible for inclusion. There was a pooled total of 807 nyaope users, all in South Africa. Major risk factors for usage were being male, unemployed, not completing secondary education, pressure from peer groups, having HIV, prior use of cannabis, and to a lesser extent, usage of other substances such as alcohol and tobacco. While young adults tend to be at high-risk, evidence indicates that adolescents are also at-risk. Consequences of usage include high rates of infection, cortical atrophy, depression, and addiction. Addiction was shown to lead to individuals stealing from friends and family to pay for the drugs. HIV-positive nyaope users were more likely to partake in risk behaviours and tended to have high viral loads. Nyaope’s rise has been linked to many health and social issues. Considering that this may also disrupt HIV control efforts in South Africa, there is an urgent need to address the rise of nyaope.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

See 3 more Smart Citations

A Systematic Review of Risk Factors and Consequences of Nyaope Usage: The Illicit Street Drug Containing HIV Antiretrovirals

et al. 2022

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Multimodal frontal neuroimaging markers predict longitudinal craving reduction in abstinent individuals with heroin use disorder

Wen,

Yang,

et al. 2024

Journal of Psychiatric Research

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The Impact of Drugs and Substance Abuse on Viral Pathogenesis—A South African Perspective

Ratshisusu,

Simani,

Blackard

et al. 2024

Viruses

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Illicit drug and alcohol abuse have significant negative consequences for individuals who inject drugs/use drugs (PWID/UDs), including decreased immune system function and increased viral pathogenesis. PWID/UDs are at high risk of contracting or transmitting viral illnesses such as human immunodeficiency virus (HIV), hepatitis B virus (HBV), and hepatitis C virus (HCV). In South Africa, a dangerous drug-taking method known as “Bluetoothing” has emerged among nyaope users, whereby the users of this drug, after injecting, withdraw blood from their veins and then reinject it into another user. Hence, the transmission of blood-borne viruses (BBVs) is exacerbated by this “Bluetooth” practice among nyaope users. Moreover, several substances of abuse promote HIV, HBV, and HCV replication. With a specific focus on the nyaope drug, viral replication, and transmission, we address the important influence of abused addictive substances and polysubstance use in this review.

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Fronto-temporal cortical atrophy in ‘nyaope’ combination heroin and cannabis use disorder

Cited by 5 publications

References 45 publications

A Systematic Review of Risk Factors and Consequences of Nyaope Usage: The Illicit Street Drug Containing HIV Antiretrovirals

A Systematic Review of Risk Factors and Consequences of Nyaope Usage: The Illicit Street Drug Containing HIV Antiretrovirals

Multimodal frontal neuroimaging markers predict longitudinal craving reduction in abstinent individuals with heroin use disorder

The Impact of Drugs and Substance Abuse on Viral Pathogenesis—A South African Perspective

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