This study aimed to review the current state and trends in cannabis use in Japan, using data from several national epidemiological surveys. The number of cannabis users in the general population was estimated approximately 1.3 million people. Cannabis use increased between 2015 and 2017. In 2017, the lifetime prevalence of cannabis use was greater than that of inhalants, and cannabis had become the most abused drug in Japan. The increase in cannabis users is thought influenced by increased access to illegal cultivation and positive thinking about cannabis use among many people, especially younger individuals.

This paper investigates the problem of identifying errors-in-variables (EIV) models, where the both input and output measurements are corrupted by white noises, and addresses a new efficient recursive identification algorithm. The identification problem of EIV models with unknown noise variances has been studied extensively and several methods have been proposed. To be further developed in terms of estimation accuracy, the bias compensated weighted least squares (BCWLS) method with only requirement of input noise variance estimate has been proposed by using the biased weighted least squares estimate. However, the recursive form for the standard least squares estimate cannot be applied to recursively compute the BCWLS estimate because the weight matrix is not diagonal. To recursively compute the BCWLS estimate, the recursive forms for the WLS estimate and the input noise variance estimate are derived when the biased WLS estimate is two-stage least squares type estimate. The results of a simulated example indicate that the proposed recursive algorithm provides good results.

This paper investigates the problem of identifying errors-in-variables (EIV) models, where the both input and output measurements are corrupted by white noise, and addresses a new method to solve the problem. The identification problem of EIV models with unknown noise variances has been extensively studied and several methods have been proposed. To be further developed in terms of estimation accuracy, a generalized eigenvector method with no requirement of a priori knowledge about the noise variances is proposed by using the biased weighted least squares estimator. The proposed generalized eigenvalue problem can be derived by removing only the bias induced by the output noise, and thus the system parameter can be obtained as the generalized eigenvector without requiring the use of iterative identification procedure. Moreover, the bias compensation principle based algorithm, which is suitable for on-line implementation, is derived to solve the proposed generalized eigenvalue problem. The results of simulated examples indicate that the proposed approach provides good parameter estimates.

This paper shows the feature extraction for gas discrimination from the transient response of a gas sensor using a subspace-based system identification technique. We have proposed an approximation and analysis method for the transient response using a subspace-based identification method. This is based on Prony's method and can extract time constants and gain parameters of multicomponents of a sensor output response. The estimated parameters can be used to improve gas discrimination in multivariate analysis as elements of pattern vectors. Transient responses of semiconductor-type gas sensors were evaluated using the proposed method. We show that the method can extract features connected with characteristics of measured gases from these sensor responses.

Artificial respirators are widely used in various scenes. Doctors are required to pay scrupulous attention for the use of the artificial respirators. The ideal setting method of artificial respirator is a setting method in consideration of the pulmonary characteristic of the patient. However, we cannot know the pulmonary characteristic of the patient by the measurement of data. Therefore, we must depend on the experience and the intuition of the doctor for the setting of the artificial respirator now. Purpose of this study are to develop a method to estimate the static P-V curve and the pulmonary elastance of the patient and to set a ventilation condition of the artificial respirator. The static P-V curve and the pulmonary elastance expresses the important feature of the lung, and the static P-V curve is a basis for deciding the air-way pressure limit value. In our previous work, we suggested the estimation method of the pulmonary elastance using a recursive parameter estimation. In this study, a parameter estimation of the fuzzy rule’s in estimation technique is improved. The patient data used for parameter estimation are weighted by a conformity degree of the fuzzy variables. Therefore, the data of big conformity degree become important in parameter estimation. In the experiment, a estimation example using real patient data is given to illustrate the superiority of the proposed method.

PURPOSEThe purpose of this study was to evaluate the efficacy of the Serigaya Methamphetamine Relapse Prevention Program (SMARPP), which is the workbook-based group therapy for individuals with drug dependence, through investigating 1-year follow-up outcomes.METHOD AND SUBJECTSThe sample was drawn from 231 outpatients diagnosed as DSM-IV substance use disorder, who had firstly consulted the drug dependence clinic of the Center Hospital, National Center of Neurology and Psychiatry between September 2009 and June 2013. Of the 231 potential subjects, 79 had participated in SMARPP at least once, and finally 37 who had continued contact this clinic for more than 1 year after due-day of finishing the first SMARPP course were determined as the subjects. We collected the outcome information retrospectively based on clinical records.RESULTAt the 1-year follow-up point, 67.6% of the subjects had continued abstinent at least for a month, and 60% of them had continued full-abstinent for more than 1 year. One of the factors which influenced their abstinence was "having no experience of using new psychoactive substances" (p = 0.029). As for 70.3% of subjects, drug-use frequency decreased and the only factor for their improvement was "participating in SMARPP many times" (p = 0.040). Of the subjects, 23 patients corresponded to methamphetamine use disorder, and 65.2% of them had continued abstinent at least for a month at the 1-year follow-up point. Additionally, 60% of them had continued full-abstinent for more than 1 year.DISCUSSION AND CONCLUSIONOur study demonstrated possible effectiveness of SMARPP for patients with drug use disorder, especially methamphetamine-use-disorder. The factors of abstinence or decrease of drug-use frequency may be to participate in SMARPP many times, not to abuse "not illegal" drugs such as new psychoactive substances or hypnotics/anxiolytics and to continue treatment for more than 1 year after due-day of finishing the program.

Aim: The aim of this study was to examine changes in the psychosocial backgrounds and clinical features of patients with psychiatric disorders associated with new psychoactive substances (NPS) between 2012 and 2014 in Japan.Methods: Clinical features of patients with NPS-related disorders were compared using data from the Nationwide Mental Hospital Surveys on Drug-related Psychiatric Disorders undertaken in 2012 and 2014. NPS patients were compared with a control group comprising patients with methamphetamine-related disorders, using data from the same period.Results: In NPS patients, changes were observed in the following three areas between 2012 and 2014: (i) a decrease in the number of employed patients; (ii) an increase in the ratio of patients diagnosed with dependence syndrome; and (iii) a decrease in the ratio of patients diagnosed with psychotic disorder. In methamphetamine patients, only one change was observed: protective custody or arrest record relating to the Pharmaceutical Affairs Act.Conclusion: This study suggests that the number of patients dependent upon NPS, and those exhibiting social dysfunction, increased between 2012 and 2014. There is a need to focus future measures against NPS dependence: not only on stopping the supply of drugs, but also on reducing the demand for them.

This paper addresses the problem of identifying errors-in-variables models, where the both input and output measurements are corrupted by white noise. The Koopmans-Levin method, which is a computationally simple consistent estimation method for errors-in-variables situations, requires a priori knowledge about the values of variances or the ratio to measurement noises. To achieve the consistent estimation without a priori knowledge about the measurement noise variances, the method presented in this paper uses the idea that removes the bias induced by the output measurement noise using instrumental variable technique. Then the parameter estimation problem can be solved as the generalized eigenvalue problem, hence the proposed method is computationally simple. The results of simulated example indicate that the proposed method provides good parameter estimates.

In this paper, the methods of consistent estimation for identification of linear discrete-time system in the presence of input and output noises, which is usually called “errors-in-variables” (EIV) models, are studied. It is well known that the least squares (LS) method gives biased parameter estimates for EIV situations. To solve this bias problem, the instrumental variable (IV) methods and the least correlation (LC) method are often used. The IV and LC based methods can be applied in more general noise conditions, but these methods suffer from poor accuracy of the estimated parameters because the coefficient matrix of these methods may often become ill-conditioned. In order to obtain numerically stable estimates, the methods presented in this paper use the biased extended LC (XLC) estimates. The biased XLC estimates can be defined by using the extended vectors and the pre-filters. According to the bias compensation principle (BCP) technique, the proposed bias-compensated XLC (BCXLC) methods are developed. The way to reduce the computational load is examined. The results of simulated examples indicate that the proposed methods provide numerically stable and good estimates.

Aim Prescription drug abuse, including benzodiazepines, is a growing health problem in J apan. This study examined the community pharmacist's clinical behavior regarding patients who overdose on prescribed drugs, and explored the possibility of overdose prevention by community pharmacists. Methods We surveyed all registered community pharmacies with dispensing functions ( n = 1867) in the Saitama Pharmaceutical Association. An anonymous self‐administered questionnaire was mailed to each pharmacy. Respondents were asked about clinical behavior such as medication counseling and referral to the prescriber if prescription drug overdose was identified. Results Among respondents, 26% of community pharmacists reported clinical experience of working with patients who overdosed on prescribed drugs in the previous year. Half of respondents evaluated their practice such as medication counseling and referral to the prescriber as ‘good’. On multivariate analysis, a ‘poor’ self‐evaluation of referral to the prescriber was significantly associated with the following perceptions: ‘insufficient confidence in communication with prescribers’ (odds ratio [OR], 2.7; 95% confidence interval [95%CI]: 1.4–5.3), and ‘to avoid trouble with prescribers’ (OR, 1.7; 95%CI: 1.0–2.7). Conclusion Japanese community pharmacists could prevent prescription drug abuse in their practice, but the pharmacists who have insufficient confidence in communication with prescribers and who are afraid of trouble with a prescriber, reported poor self‐evaluation for referral to the prescribers. All prescribers should understand the importance of referral by community pharmacists, to assist community pharmacists in playing a critical role in prevention of prescription drug abuse.

As for substance-related disorders, there were several differences between ICD-10 and DSM-IV, however, the concept of "dependence" had been essential for both criteria. DSM-5 published in 2013 had erased dependence. This confuses us. It is important to recognize dependence again. "Abuse" is the self-intake behavior of drug against the social norms. Repeated abuse results in dependence. Dependence is a state of loss of control against drug use due to craving. Abuse can produce "acute intoxication", and repeated abuse under dependence can produce "chronic intoxication". It is important to understand abuse, dependence and "intoxication" based on their relationship from the point of time course.

In this study, we compared the efficacy of a group relapse prevention program using the cognitive behavioral therapy-based workbook, Serigaya Methamphetamine Relapse Prevention Program (SMARPP), between patients abusing the so-called "dappou drugs" (designer drug in Japan, and those abusing methamphetamine (MAP). Both groups participated in the SMARPP at the Center Hospital, National Center of Neurology and Psychiatry. Results showed that, no significant differences were found in the rates of participation in the program or self-reported frequency of drug or alcohol use between the patients abusing "dappou drugs" or MAP. However, patients using "dappou drugs" reported no significant increase in their confidence in their ability to resist the temptation to use drugs on the self- report drug abuse scales after the SMARPP intervention, while patients abusing MAP reported a significant positive difference in their ability to resist temptation. In addition, insight into substance abuse problems and motivation to participate in further treatment slightly declined in those using "dappou drugs," while there was a significant increase reported by the patients using MAP. These results suggested that the SMARPP might not be as effective for patients abusing "dappou drugs" as for those abusing MAP. The development of a relapse prevention program specifically designed for patients abusing "dappou drugs" is required.

AimThe aim of this study was to evaluate the effect of a relapse-prevention program for methamphetamine (MAP)-dependent inmates in a prison.MethodsParticipants were 251 male inmates with MAP-abuse problems. We compared scores on the Self-efficacy Scale for Drug Dependence (SSDD) and the Stages of Change Readiness and Treatment Eagerness Scale (SOCRATES) before and after intervention with a self-teaching workbook and group therapy.ResultsFor all participants, only SSDD scores increased during the pre-intervention period. SOCRATES-8D scores increased after the start of the intervention using the self-teaching workbook, and both SSDD and SOCRATES-8D scores increased when group therapy was implemented. Changes in scores in participants with moderate and high MAP dependence were considerably different from the scores of those with low dependence during the pre-intervention and the self-teaching workbook periods.ConclusionIntervention using a self-teaching workbook and group therapy in prisons might be effective for inmates with more than moderate severity of MAP abuse.

Aim 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. Methods 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. Results 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. Conclusion 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.

In this paper, feature extraction based on a subspace-based identification technique for a transient response of a semiconductortype gas sensor is proposed. A typical gas sensor response can be interpreted as the sum of step responses of the first- or high order lag system, and we have investigated the feature extraction method of the sensor output, which can be approximated by Prony’s method. The method gives the time constant and gain parameters of the sensor response, which includes useful information for a discrimination of sample gases. In this paper, we show a feature extraction method based on a subspace-based identification for the step response of the sensor. The sum of exponentials model in Prony’s method can be represented as a state space model. Then, the system matrices can be estimated by the multi-input multi-output (MIMO) output error state space model identification (MOESP)-like procedure. Numerical simulation shows that the proposed algorithm can be effective in feature extraction, and the method can be applied to the sensor response to mixture gases.

Aims The aim of this study was to examine the prevalence of 3, 4-methylenedioxymethamphetamine (MDMA) use and to identify characteristics of MDMA users among rave attendees in Japan. This is the first rave-population study focusing on MDMA use in Japan. Methods The anonymous self-administrative questionnaire was conducted using laptop computers at four rave parties at three different venues in Tokyo, Japan. Participants were asked about lifetime use of MDMA and other club drug use, characteristics of rave attendance, and their demographics. Results Questionnaires were completed by 300 rave attendees (47.3% female), 68.3% of whom were aged 2029 years, and 92.3% of whom had completed high school. Among the participants, 8.0% reported MDMA use. Compared with non-drug controls (the participants who had never used any illicit drugs), MDMA users were significantly more likely to be 3039-year-old men. In addition, compared with cannabis users (non-MDMA users who had used cannabis), MDMA users were significantly more likely to use other drugs and reported more adverse health effects due to polydrug use. Furthermore, MDMA users were significantly more likely to go to raves and preferred smaller venues. Conclusions Our results clearly suggest that rave attendees have a higher lifetime prevalence of MDMA use than the Japanese general population (0.2% reported in 2007). MDMA users are deeply involved in rave parties, and MDMA use may have high potential to generate close relationships among rave attendees. Therefore, MDMA users may have more opportunities to access MDMA than cannabis users and non-drug controls.

AIMS:The purpose of the present study was to examine whether the possible effectiveness of the juvenile version of the Serigaya Methamphetamine Relapse Prevention Program (SMARPP-Jr.) self-teaching workbook we developed for relapse prevention of drug abuse depends on the severity of the subject's drug-related problems.METHODS:Subjects were 85 adolescent drug abusers who were detained in a juvenile classification home. We compared changes between the subjects' scores on rating scales administered both before and after interventions with the self-teaching workbook, and we examined associations between the effectiveness of the intervention and the severity of the subjects' drug-related problems.RESULTS:Regardless of the severity of their drug-related problems, the subjects' rating scale scores were significantly different after the intervention, which suggests that use of the workbook increased their awareness of the problems caused by drug dependence and their motivation to obtain treatment. However, use of the workbook did not significantly change their confidence in their capacity to resist drug craving.CONCLUSION:Although the self-teaching workbook is a convenient intervention tool that can increase subject awareness and motivation for treatment, it is likely that continuous community-based support systems are required to prevent relapse.

The nonmedical use or abuse of prescription drugs, including psychotropic medicines, is a growing health problem in Japan. Patient access to psychotropic drugs, specifically from the oversupply of medications due to overlapping prescriptions, may increase the risk of drug abuse and dependence. However, very little is known about such overlapping prescriptions. Today, the dispensing of prescriptions is generally moving from inside to outside of hospitals, with psychotropic drugs mainly dispensed at community pharmacies. In this study, we used health insurance claims (i.e., receipts) for dispensing as the main source of information in an investigation of overlapping prescriptions of psychotropic drugs. A total of 119 patients were found to have received overlapping prescriptions, as identified by community pharmacists who were members of the Saitama Pharmaceutical Association, using patient medication records, followed by medication counseling and prescription notes for the patient. According to our findings, the most frequently overlapping medication was etizolam. Etizolam can be prescribed for more than 30 days since it is not regulated under Japanese law as a "psychotropic drug." Generally, when a drug can be prescribed for a greater number of days, it increases the likelihood of an overlapping prescription during the same period. As a result, the long-term prescription of etizolam increases the risk of overlapping prescriptions. We also found that the patients who received overlapping prescriptions of etizolam were mostly elderly and the most common pattern was prescription from both internal medicine and orthopedics physicians. Etizolam has wide range of indications that are covered by health insurance. Our results suggest that patients who received overlapping prescriptions of etizolam may receive prescriptions from different prescribers for different purposes. Therefore, it may be appropriate to regulate etizolam as a "psychotropic drug" under Japanese law, thus setting a limit on the period for which it can be prescribed in order to help prevent long-term and overlapping prescriptions.

BACKGROUND AND AIMS:The aims of present study are to clarify the clinical features of patients with benzodiazepine use disorder (BZsUD), and to examine the characteristics of psychiatric treatments which may cause BZsUD.METHODS:We conducted a medical chart and interview survey to 87 outpatients with benzodiazepine use disorder, who had consecutively visited the four hospitals, specialized in addiction problems, located in metropolitan area, during a month of December, 2011.RESULTS:Consequently, 88.5% of the patients with BZsUD reported to obtain BZs to be abused from general psychiatric clinics, and 83.9% contracted BZsUD in process of general psychiatric treatment. Among the patients who contracted BZsUD in process of psychiatric treatment, 43.8% were speculated to have the other substance-related disorders such as methamphetamine or alcohol-related disorder at start of the psychiatric treatment. Further, approximately 70% of them reported that surplus BZs were prescribed without consideration of storing drugs, and over 40% also reported that BZs were prescribed without a medical examination.CONCLUSIONS:The findings of the present study may let us to propose the following four measures to be taken for prevention of BZsUD: First, latent substance-related disorders should not be overlooked, second, short-acting and high-potency BZs should not be prescribed if possible, third, storing and abusing BZs should always be considered, and finally, BZs should be prescribed with a medical examination.