Larissa J Maier
Dr. Maier is currently traveling in South America to learn more about indigenous culture, plant medicine, and community healing. This journey of personal development and connection with nature will inspire her future work to create social impact and inform policymaking.
Dr. Maier is passionate about drug policy, health, equality, and human rights. She is committed to ending the criminalization of people who use drugs and increasing access to harm reduction services. During her 3.5 years as a postdoc at the University of California, San Francisco (UCSF) funded by the SNSF, NIDA, and NIDA INVEST, she investigated the implementation of local, federal, and international cannabis and opioid policies. Dr. Maier earned her BSc, MSc, and Ph.D. from the University of Zurich and graduated summa cum laude. She worked at the Swiss Research Institute for Public Health and Addiction (ISGF) in Zurich and at the United Nations Office on Drugs and Crime (UNODC) in Vienna.
Dr. Maier is a member of the Core Research Team of Global Drug Survey (GDS) aiming to make drug use safer, regardless of the legal status of the drug. At UCSF, she led the Science Policy Group (SPG) and the Psychedelic and Entheogen Academic Council (PEAC) and joined the U.S. National Science Policy Network (NSPN). She served on several committees to facilitate international relations, diversity, and early career networking at the College on Problems of Drug Dependence (CPDD), the European Society of Prevention Research (EUSPR), the International AIDS Society (IAS), the International Society of Substance Use Professionals (ISSUP), the International Society for the Study of Drug Policy (ISSDP), the Society for Prevention Research (SPR), the Society of Addiction Psychology (APA Division 50), and the United Nations Associations of the USA SF Chapter (UNA-SF).
Dr. Maier is passionate about drug policy, health, equality, and human rights. She is committed to ending the criminalization of people who use drugs and increasing access to harm reduction services. During her 3.5 years as a postdoc at the University of California, San Francisco (UCSF) funded by the SNSF, NIDA, and NIDA INVEST, she investigated the implementation of local, federal, and international cannabis and opioid policies. Dr. Maier earned her BSc, MSc, and Ph.D. from the University of Zurich and graduated summa cum laude. She worked at the Swiss Research Institute for Public Health and Addiction (ISGF) in Zurich and at the United Nations Office on Drugs and Crime (UNODC) in Vienna.
Dr. Maier is a member of the Core Research Team of Global Drug Survey (GDS) aiming to make drug use safer, regardless of the legal status of the drug. At UCSF, she led the Science Policy Group (SPG) and the Psychedelic and Entheogen Academic Council (PEAC) and joined the U.S. National Science Policy Network (NSPN). She served on several committees to facilitate international relations, diversity, and early career networking at the College on Problems of Drug Dependence (CPDD), the European Society of Prevention Research (EUSPR), the International AIDS Society (IAS), the International Society of Substance Use Professionals (ISSUP), the International Society for the Study of Drug Policy (ISSDP), the Society for Prevention Research (SPR), the Society of Addiction Psychology (APA Division 50), and the United Nations Associations of the USA SF Chapter (UNA-SF).
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Peer reviewed papers by Larissa J Maier
METHODS: The Global Drug Survey is an annually conducted anonymous web survey on substance use. Two data sets from male and female Global Drug Survey (GDS) participants aged 16 to 65 years with no previous ADHD diagnosis were analysed to assess12-month PCE in 15 countries. GDS2015 (n = 79,640) examined the patterns of and motives for stimulant PCE, while GDS2017 (n = 29,758) focused on both the use of stimulant and sedative drugs for PCE.
RESULTS: When comparing the study samples 2015 and 2017, PCE with prescription and illegal stimulants and modafinil increased across all countries. People who used stimulant drugs and modafinil for PCE rated the perceived effect on cognitive performance most beneficial, while alcohol was the substance with the most adverse effect.
CONCLUSION: The analysis of data on stimulant use for PCE in the largest global sample highlights relatively low-risk PCE use patterns except for participants with illegal stimulant use for PCE. The globalisation of ADHD, physicians' prescribing behaviour and changes in drug policy are likely to influence the country-specific rate of PCE among non-ADHD individuals what calls for further investigation.
Methods: The Global Drug Survey was administered in late 2016. Across 26 countries including Australia, Germany, Italy, Mexico, Switzerland, the UK and the USA a total of 45,942 people who had recently used drugs completed the drug policing module. Key variables assessed included the incidence and frequency of drug-related police encounters in the last 12 months that involved: a) being stopped and searched; b) encountering a drug detection dog; c) being given a caution or warning; d) being charged and arrested; and e) paying a bribe. Multi-level models were used to control for pre-existing national differences in drug use prevalence and non-drug specific policing (including the total number of police personnel in each country).
Results: Drug-related police encounters were most commonly reported in Italy and Scotland. Conversely, police encounters were most likely to lead to arrest in Norway, Finland and Sweden. The type and locations of encounters further differed across countries, with for example stop and search most reported in Greece and Colombia, and encounters with drug detection dogs most reported in Scotland, Italy, UK and Australia. Multi-level models showed that the incidence of reported policing encounters continued to differ significantly across countries after controlling for pre-existing national differences in drug use prevalence and policing, and that drug policing encounters were 4 to 14 times more common in some nations than others.
Conclusion: The findings unearth significant cross-national differences in the incidence and nature of drug-related policing of people who use drugs. This suggests that there may be opportunities for countries to learn from each other about how and why they differ, and the potential benefits of switching to lower intensity modes of drug policing.
Methods: An anonymous self-selected online survey of people who use drugs (Global Drug Survey 2016; N=96,894) which measured perceived drug effects of LSD and its analogues.
Results: Most LSD analogue users (91%) had also tried LSD. The proportion of UK and US respondents reporting LSD analogue use in the last 12 months was higher than for LSD only. LSD analogue users described the effects as psychedelic (93%), over half (55%) obtained it
online, and almost all (99%) reported an oral route of administration. The modal duration (8 hours) and time to peak (2 hours) of LSD analogues were not significantly different from LSD. Ratings for pleasurable high, strength of effect, comedown, urge to use more drugs, value for money and risk of harm following use were significantly lower for LSD analogues
compared with LSD.
Conclusions: LSD analogues were reported as similar in time to peak and duration as LSD, but weaker in strength, pleasurable high and comedown. Future studies should seek to replicate these findings with chemical confirmation and dose measurement.
Methods and analysis: This paper presents the protocol for a 3-arm multicentre randomised controlled trial (RCT) to test the efficacy and cost-effectiveness of the combined internet-based self-help intervention Take Care of You (TCOY) to reduce alcohol misuse and depression symptoms in comparison with a waiting list control group and a comparable intervention focusing on problematic alcohol use only. The active interventions consist of modules designed to reduce alcohol use, based on the principles of motivational interviewing and methods of cognitive behavioural therapy, together with additional modules in the combined study arm to reduce symptoms of
depression. Data will be collected at baseline, as well as at 3 and 6 months postrandomisation. The primary outcome is the quantity of alcohol used in the past 7 days. A number of secondary outcome measures will be studied. These include the Centre of Epidemiologic Studies of Depression Scale (CES-D) and a combined measure with the criteria of values below the cut-off for severe alcohol use disorder and for CES-D. Data analysis will follow the intention-to-treat principle using (generalised) linear mixed models. In order to investigate the interventions’ cost-utility and costeffectiveness, a full economic evaluation will be performed.
Ethics and dissemination: This RCT will be executed in compliance with the Helsinki Declaration and has been approved by 2 local Ethics Committees. Results will be reported at conferences and in peerreviewed publications. Participant-friendly summaries of trial findings will be published on the TCOY websites.
Trial registration number: ISRCTN10323951.
Methods: Using the largest Swiss Internet panel, a sample of 10,171 employees and students (unweighted N = 10,084) aged 15 to 74 years was recruited and asked to complete a self-administered online survey. The data were weighted for age, sex, and language region to provide results that were representative of the Swiss population. Multinomial logistic regression models were conducted to identify predictors of pharmacological cognitive enhancement (PCE) and pharmacological mood enhancement (PME) over the past year. Two self-medication models and an overall model were determined.
Results: Current medical treatment for a mental disorder was the best predictor of both PCE and PME use as serious self-medication. The overall model revealed that cannabis use, frequent stress, and long-term stress were predictors of both PCE and PME, whereas negative stressors and time pressure at work did not remain in the final model. Furthermore, past-year PCE with and without PME was associated with being male, being a student, and using illegal drugs other than cannabis, whereas being female and having low self-efficacy predicted past-year PME only.
Conclusions: Consideration of the predictor variables identified in this study may help to identify the potential PCE and PME users for whom measures to prevent drug abuse and manage stress are most appropriate. More specifically, the use of PCE and PME as self-medication to enhance performance at work or while studying needs further consideration in the neuroenhancement debate.
Methods/design: The study will use a three-arm randomized controlled trial (RCT) design to test the efficacy of a web-based self-help intervention with or without guided chat counseling compared with that of a waiting list control condition in reducing or stopping cocaine use. The primary outcome measure will be the weekly quantity of cocaine used. Secondary outcome measures will include the number of cocaine use days in the past 30 days, the severity of cocaine dependence, the use of alcohol, tobacco, and/or other illicit drugs, changes in mental health symptoms, and treatment retention. The self-help intervention will consist of eight modules that are designed to reduce cocaine use and depression symptoms. These modules are based on the principles of Motivational Enhancement Therapy and Cognitive Behavioral Therapy, such as Behavioral Self-Management. The three individual chat therapy sessions will be based on the same therapy approaches and will be tailored to participants’ self-help data and aim to assist the reinstatement of social rewards and the improvement of social support and relationships.
Discussion: This study will be the first RCT to test the effectiveness of a web-based self-help intervention in combination with or without chat counseling in reducing cocaine use. The expected findings will contribute substantial knowledge that may help design effective guided and unguided web-based treatment for cocaine users. Moreover, the study will elucidate to what extent a therapeutic alliance with cocaine users can be established in a guided Internet-delivered setting. Additionally, the present study will investigate changes in social support with specific guided therapy interventions that aim to ameliorate social support and social perceptions and compare these changes with those in an unguided self-help intervention
Trial Registration: Current Controlled Trials ISRCTN12205466. Registered 24 February 2015.
no drug has been proven as safe and effective for cognitive enhancement in otherwise healthy individuals. European studies have investigated the misuse of prescription and illicit stimulants to increase cognitive performance as well as the use
of tranquilizers, alcohol, and cannabis to cope with stress related to work or
education. Young people in educational settings report pharmacological neuroenhancement more frequently than those in other settings. Although the regular use of drugs for neuroenhancement is not common in Europe, the irregular and low-dose
usage of neuroenhancers might cause adverse reactions. Previous studies have revealed that obtaining adequate amounts of sleep and using successful learning techniques effectively improve mental performance, whereas pharmacological neuroenhancement is associated with ambiguous effects. Therefore, nonsubstance-related alternatives should be promoted to cope with stressful situations. This paper reviews the recent research on pharmacological neuroenhancement in
Europe, develops a clear definition of the substances used, and formulates recommendations for practitioners regarding how to react to requests for neuroenhancement drug prescriptions. We conclude that monitoring the future development of pharmacological neuroenhancement in Europe is important to provide effective preventive measures when required. Furthermore, substance use to cope with stress related to work or education should be studied in depth because it is likely more prevalent and dangerous than direct neuroenhancement.
prevalence of neuroenhancement among Swiss university students is unknown. Investigating the prevalence of
neuroenhancement among students is important to monitor problematic use and evaluate the necessity of prevention
programs.
Study aim: To describe the prevalence of the use of prescription medications and drugs of abuse for neuroenhancement
among Swiss university students.
Method: In this cross-sectional study, students at the University of Zurich, University of Basel, and Swiss Federal Institute of
Technology Zurich were invited via e-mail to participate in an online survey.
Results: A total of 28,118 students were contacted, and 6,275 students completed the survey. Across all of the institutions,
13.8% of the respondents indicated that they had used prescription drugs (7.6%) or drugs of abuse including alcohol (7.8%)
at least once specifically for neuroenhancement. The most frequently used prescription drugs for neuroenhancement were
methylphenidate (4.1%), sedatives (2.7%), and beta-blockers (1.2%). Alcohol was used for this purpose by 5.6% of the
participants, followed by cannabis (2.5%), amphetamines (0.4%), and cocaine (0.2%). Arguments for neuroenhancement
included increased learning (66.2%), relaxation or sleep improvement (51.2%), reduced nervousness (39.1%), coping with
performance pressure (34.9%), increased performance (32.2%), and experimentation (20%). Neuroenhancement was
significantly more prevalent among more senior students, students who reported higher levels of stress, and students who
had previously used illicit drugs. Although ‘‘soft enhancers’’, including coffee, energy drinks, vitamins, and tonics, were used
daily in the month prior to an exam, prescription drugs or drugs of abuse were used much less frequently.
Conclusions: A significant proportion of Swiss university students across most academic disciplines reported
neuroenhancement with prescription drugs and drugs of abuse. However, these substances are rarely used on a daily
basis and more sporadically used prior to exams.
METHODS: The Global Drug Survey is an annually conducted anonymous web survey on substance use. Two data sets from male and female Global Drug Survey (GDS) participants aged 16 to 65 years with no previous ADHD diagnosis were analysed to assess12-month PCE in 15 countries. GDS2015 (n = 79,640) examined the patterns of and motives for stimulant PCE, while GDS2017 (n = 29,758) focused on both the use of stimulant and sedative drugs for PCE.
RESULTS: When comparing the study samples 2015 and 2017, PCE with prescription and illegal stimulants and modafinil increased across all countries. People who used stimulant drugs and modafinil for PCE rated the perceived effect on cognitive performance most beneficial, while alcohol was the substance with the most adverse effect.
CONCLUSION: The analysis of data on stimulant use for PCE in the largest global sample highlights relatively low-risk PCE use patterns except for participants with illegal stimulant use for PCE. The globalisation of ADHD, physicians' prescribing behaviour and changes in drug policy are likely to influence the country-specific rate of PCE among non-ADHD individuals what calls for further investigation.
Methods: The Global Drug Survey was administered in late 2016. Across 26 countries including Australia, Germany, Italy, Mexico, Switzerland, the UK and the USA a total of 45,942 people who had recently used drugs completed the drug policing module. Key variables assessed included the incidence and frequency of drug-related police encounters in the last 12 months that involved: a) being stopped and searched; b) encountering a drug detection dog; c) being given a caution or warning; d) being charged and arrested; and e) paying a bribe. Multi-level models were used to control for pre-existing national differences in drug use prevalence and non-drug specific policing (including the total number of police personnel in each country).
Results: Drug-related police encounters were most commonly reported in Italy and Scotland. Conversely, police encounters were most likely to lead to arrest in Norway, Finland and Sweden. The type and locations of encounters further differed across countries, with for example stop and search most reported in Greece and Colombia, and encounters with drug detection dogs most reported in Scotland, Italy, UK and Australia. Multi-level models showed that the incidence of reported policing encounters continued to differ significantly across countries after controlling for pre-existing national differences in drug use prevalence and policing, and that drug policing encounters were 4 to 14 times more common in some nations than others.
Conclusion: The findings unearth significant cross-national differences in the incidence and nature of drug-related policing of people who use drugs. This suggests that there may be opportunities for countries to learn from each other about how and why they differ, and the potential benefits of switching to lower intensity modes of drug policing.
Methods: An anonymous self-selected online survey of people who use drugs (Global Drug Survey 2016; N=96,894) which measured perceived drug effects of LSD and its analogues.
Results: Most LSD analogue users (91%) had also tried LSD. The proportion of UK and US respondents reporting LSD analogue use in the last 12 months was higher than for LSD only. LSD analogue users described the effects as psychedelic (93%), over half (55%) obtained it
online, and almost all (99%) reported an oral route of administration. The modal duration (8 hours) and time to peak (2 hours) of LSD analogues were not significantly different from LSD. Ratings for pleasurable high, strength of effect, comedown, urge to use more drugs, value for money and risk of harm following use were significantly lower for LSD analogues
compared with LSD.
Conclusions: LSD analogues were reported as similar in time to peak and duration as LSD, but weaker in strength, pleasurable high and comedown. Future studies should seek to replicate these findings with chemical confirmation and dose measurement.
Methods and analysis: This paper presents the protocol for a 3-arm multicentre randomised controlled trial (RCT) to test the efficacy and cost-effectiveness of the combined internet-based self-help intervention Take Care of You (TCOY) to reduce alcohol misuse and depression symptoms in comparison with a waiting list control group and a comparable intervention focusing on problematic alcohol use only. The active interventions consist of modules designed to reduce alcohol use, based on the principles of motivational interviewing and methods of cognitive behavioural therapy, together with additional modules in the combined study arm to reduce symptoms of
depression. Data will be collected at baseline, as well as at 3 and 6 months postrandomisation. The primary outcome is the quantity of alcohol used in the past 7 days. A number of secondary outcome measures will be studied. These include the Centre of Epidemiologic Studies of Depression Scale (CES-D) and a combined measure with the criteria of values below the cut-off for severe alcohol use disorder and for CES-D. Data analysis will follow the intention-to-treat principle using (generalised) linear mixed models. In order to investigate the interventions’ cost-utility and costeffectiveness, a full economic evaluation will be performed.
Ethics and dissemination: This RCT will be executed in compliance with the Helsinki Declaration and has been approved by 2 local Ethics Committees. Results will be reported at conferences and in peerreviewed publications. Participant-friendly summaries of trial findings will be published on the TCOY websites.
Trial registration number: ISRCTN10323951.
Methods: Using the largest Swiss Internet panel, a sample of 10,171 employees and students (unweighted N = 10,084) aged 15 to 74 years was recruited and asked to complete a self-administered online survey. The data were weighted for age, sex, and language region to provide results that were representative of the Swiss population. Multinomial logistic regression models were conducted to identify predictors of pharmacological cognitive enhancement (PCE) and pharmacological mood enhancement (PME) over the past year. Two self-medication models and an overall model were determined.
Results: Current medical treatment for a mental disorder was the best predictor of both PCE and PME use as serious self-medication. The overall model revealed that cannabis use, frequent stress, and long-term stress were predictors of both PCE and PME, whereas negative stressors and time pressure at work did not remain in the final model. Furthermore, past-year PCE with and without PME was associated with being male, being a student, and using illegal drugs other than cannabis, whereas being female and having low self-efficacy predicted past-year PME only.
Conclusions: Consideration of the predictor variables identified in this study may help to identify the potential PCE and PME users for whom measures to prevent drug abuse and manage stress are most appropriate. More specifically, the use of PCE and PME as self-medication to enhance performance at work or while studying needs further consideration in the neuroenhancement debate.
Methods/design: The study will use a three-arm randomized controlled trial (RCT) design to test the efficacy of a web-based self-help intervention with or without guided chat counseling compared with that of a waiting list control condition in reducing or stopping cocaine use. The primary outcome measure will be the weekly quantity of cocaine used. Secondary outcome measures will include the number of cocaine use days in the past 30 days, the severity of cocaine dependence, the use of alcohol, tobacco, and/or other illicit drugs, changes in mental health symptoms, and treatment retention. The self-help intervention will consist of eight modules that are designed to reduce cocaine use and depression symptoms. These modules are based on the principles of Motivational Enhancement Therapy and Cognitive Behavioral Therapy, such as Behavioral Self-Management. The three individual chat therapy sessions will be based on the same therapy approaches and will be tailored to participants’ self-help data and aim to assist the reinstatement of social rewards and the improvement of social support and relationships.
Discussion: This study will be the first RCT to test the effectiveness of a web-based self-help intervention in combination with or without chat counseling in reducing cocaine use. The expected findings will contribute substantial knowledge that may help design effective guided and unguided web-based treatment for cocaine users. Moreover, the study will elucidate to what extent a therapeutic alliance with cocaine users can be established in a guided Internet-delivered setting. Additionally, the present study will investigate changes in social support with specific guided therapy interventions that aim to ameliorate social support and social perceptions and compare these changes with those in an unguided self-help intervention
Trial Registration: Current Controlled Trials ISRCTN12205466. Registered 24 February 2015.
no drug has been proven as safe and effective for cognitive enhancement in otherwise healthy individuals. European studies have investigated the misuse of prescription and illicit stimulants to increase cognitive performance as well as the use
of tranquilizers, alcohol, and cannabis to cope with stress related to work or
education. Young people in educational settings report pharmacological neuroenhancement more frequently than those in other settings. Although the regular use of drugs for neuroenhancement is not common in Europe, the irregular and low-dose
usage of neuroenhancers might cause adverse reactions. Previous studies have revealed that obtaining adequate amounts of sleep and using successful learning techniques effectively improve mental performance, whereas pharmacological neuroenhancement is associated with ambiguous effects. Therefore, nonsubstance-related alternatives should be promoted to cope with stressful situations. This paper reviews the recent research on pharmacological neuroenhancement in
Europe, develops a clear definition of the substances used, and formulates recommendations for practitioners regarding how to react to requests for neuroenhancement drug prescriptions. We conclude that monitoring the future development of pharmacological neuroenhancement in Europe is important to provide effective preventive measures when required. Furthermore, substance use to cope with stress related to work or education should be studied in depth because it is likely more prevalent and dangerous than direct neuroenhancement.
prevalence of neuroenhancement among Swiss university students is unknown. Investigating the prevalence of
neuroenhancement among students is important to monitor problematic use and evaluate the necessity of prevention
programs.
Study aim: To describe the prevalence of the use of prescription medications and drugs of abuse for neuroenhancement
among Swiss university students.
Method: In this cross-sectional study, students at the University of Zurich, University of Basel, and Swiss Federal Institute of
Technology Zurich were invited via e-mail to participate in an online survey.
Results: A total of 28,118 students were contacted, and 6,275 students completed the survey. Across all of the institutions,
13.8% of the respondents indicated that they had used prescription drugs (7.6%) or drugs of abuse including alcohol (7.8%)
at least once specifically for neuroenhancement. The most frequently used prescription drugs for neuroenhancement were
methylphenidate (4.1%), sedatives (2.7%), and beta-blockers (1.2%). Alcohol was used for this purpose by 5.6% of the
participants, followed by cannabis (2.5%), amphetamines (0.4%), and cocaine (0.2%). Arguments for neuroenhancement
included increased learning (66.2%), relaxation or sleep improvement (51.2%), reduced nervousness (39.1%), coping with
performance pressure (34.9%), increased performance (32.2%), and experimentation (20%). Neuroenhancement was
significantly more prevalent among more senior students, students who reported higher levels of stress, and students who
had previously used illicit drugs. Although ‘‘soft enhancers’’, including coffee, energy drinks, vitamins, and tonics, were used
daily in the month prior to an exam, prescription drugs or drugs of abuse were used much less frequently.
Conclusions: A significant proportion of Swiss university students across most academic disciplines reported
neuroenhancement with prescription drugs and drugs of abuse. However, these substances are rarely used on a daily
basis and more sporadically used prior to exams.
Abschliessende Empfehlungen auf einen Blick
Sichtbarkeit von SafeZone.ch erhöhen: effektvolle Platzierung und Verlinkung auf relevanten
regionalen Websites und Auftritt über soziale Medien; Einbezug der Zielgruppe und
Verbreitung über externe Personen mit grossem Netzwerk.
Französische Version: nach Möglichkeit französischsprachige Kantone mit einbeziehen und Angebot in allen drei grossen Landessprachen anbieten.
Spezifische Diversifikationsthemen: Einbauen und Zielgruppe darauf aufmerksam machen.
Aktivität im Forum erhöhen: interessierte Personen zum Austausch im Forum motivieren.
Netzwerkarbeit: Aufrechterhalten der bestehenden kantonalen und regionalen Netzwerke und Einbindung weiterer interessierter Institutionen und Fachkräfte.
Qualitätssicherung: hat sich bewährt und dient der Professionalisierung des Angebots.
In den letzten Jahren haben sich verschiedene Strategien und Massnahmen zur Reduktion des
Tabakkonsums in Europa als erfolgreich erwiesen, wobei diese hauptsächlich Erfolge bei mittleren
und oberen Einkommensschichten verzeichnen konnten. Unterschiede im Zugang zu Angeboten der
Tabakprävention und fehlende Gesundheitskompetenz bei benachteiligten Bevölkerungsgruppen
können bereits bestehende soziale Ungleichheiten vergrössern. Sowohl auf politischer Ebene als
auch bei der Planung von spezifischen Interventionen soll daher das Ziel der Chancengleichheit mit
einer chancengerechten Ausgestaltung von Angeboten als wichtiger Aspekt einfliessen, um zu verhindern,
dass gesundheitliche Ungleichheiten sowie damit verbundene Beeinträchtigungen in den benachteiligten
Gruppen grösser werden.