Addiction最新文献

Background and aims: Efficacy of brief alcohol interventions for young adults with internalizing distress (i.e. symptoms of depression, anxiety and stress) is unclear. We tested the moderating effect of internalizing distress on the efficacy of alcohol single- and multicomponent personalized feedback interventions (PFIs).

Design: Secondary data were analyzed from a randomized controlled trial (RCT) testing the efficacy of single and multicomponent PFIs, compared with an attention-only control condition.

Setting: Participants were sampled from two West Coast universities in the United States. All study protocols were completed online.

Participants: Participants (n = 1137) were college students (63% female; M_age = 20.1 years; 62.6% non-Hispanic white) who reported on internalizing distress at baseline. Some individuals reported clinically significant symptoms (depression: mild/moderate = 24.0%, severe/extremely severe = 10.5%; anxiety: mild/moderate = 19.6%, severe/extremely severe = 11.4%; and stress: mild/moderate = 37.5%, severe/extremely severe = 6.0%).

Interventions: There were four different alcohol single-component PFIs administered and an attention-only PFI control. Alcohol PFIs varied in their complexity and single-component PFIs (i.e. personalized normative feedback) were compared with multicomponent PFI (i.e. containing additional alcohol-focused psychoeducation).

Measurements: Baseline levels of internalizing distress were measured using the summed total of the Depression, Anxiety and Stress Scales (DASS). Drinking outcomes (alcohol consumption, peak eBAC, alcohol-related consequences) were measured at baseline, 3, 6 and 12 months post-intervention.

Findings: Alcohol PFI (compared with attention-only control) reduced alcohol consumption and related consequences at 6-month [rate ratio (RR)_Consumption = 0.85, P = 0.004] or 12-month follow-ups (RR_Consumption = 0.76, P < 0.001; RR_Consequences = 0.85, P = 0.020), regardless of baseline DASS score. Participants with higher DASS scores (compared with those with lower DASS scores) reported lower 6-month alcohol consumption after receiving a single-component intervention (RR = 0.80, P < 0.001). However, individuals with higher DASS scores (compared to those with lower DASS scores) reported more 6-month alcohol-related consequences after receiving a multicomponent intervention (RR = 0.78, P = 0.004).

Conclusions: Personalized feedback interventions may demonstrate efficacy towards reducing drinking in young adults and appear similarly beneficial across levels of internalizing distress, although lower-complexity interventions may be more efficacious.

The opioid overdose epidemic remains a critical public health crisis. In recent years, synthetic opioids like fentanyl and nitazenes, have driven a sharp rise in deaths. Naloxone, an opioid receptor antagonist, has been established as a key intervention for reversing opioid overdoses and saving lives. However, there remains a critical need to optimize naloxone dosing strategies. This article examines the challenges of both under-dosing and over-antagonism in naloxone administration, emphasizing the importance of a tailored approach to overdose management. A 'just the right dose' approach is essential for minimizing the risks of over-antagonism while still reversing opioid overdose. This involves starting with a modest naloxone dose and carefully titrating it based on the patient's response, considering factors such as opioid type, overdose severity, and opioid tolerance. A tailored approach to naloxone dosing may present challenges for non-medically trained responders but it can ensure that as many people as possible receive the right dose of naloxone when they need it. Training programs should also emphasize the importance of first aid and supportive care, including airway management and alerting emergency services, as well as careful monitoring of the patient's response.

Ketamine-induced cystitis is an increasingly recognized complication associated with the addictive use of ketamine, a dissociative anesthetic. This article provides a comprehensive overview, focusing on its pathophysiology, clinical presentation, diagnosis, management strategies, and implications for addiction treatment. The British Association of Urological Surgeons consensus serves as a foundational reference for management, while additional literature is integrated to highlight the multifaceted nature of Ketamine Bladder and its impact on individuals with substance use disorders.

Aims: This exploratory study aimed to describe longitudinal patterns of e-cigarette use initiation and progression to frequent use across mid-to-late adolescence and young adulthood and determine risk factors for and consequences of these initiation patterns.

Design: Using 12 waves of a prospective cohort data across 2014-2023, we identified latent classes with distinct patterns of timing of e-cigarette use initiation and frequent use progression (20 + days/month). We then estimated: (1) associations of baseline risk factors with membership in latent classes and (2) associations of latent classes with e-cigarette/other substance use frequency and e-cigarette dependence at a subsequent 1-year follow-up.

Setting: Southern California, United States.

Participants: Baseline e-cigarette never users [n = 2291; mean age (standard deviation) = 15.0 (0.4) years; 55.1% female; 44.6% Hispanic].

Measurements: Repeated self-reported e-cigarette use initiation and past-30-day frequency, other substance use and e-cigarette dependence.

Findings: Four distinct groups were identified: (1) early high school/gradual progression (13.9%); (2) late high school/gradual progression (4.3%); (3) young adulthood/quick progression (21.3%); and (4) low initiation risk/no progression (60.5%). In addition to two high school initiator groups with gradual progression to frequent vaping over 3 years, we identified the young adulthood/quick progression group who initiated e-cigarette use after high school and progressed to frequent use within 1.2 years. Late initiators who progressed quickly reported the highest prevalence of JUUL use as their first device (34.2%) and the highest levels of vaping frequency and e-cigarette dependence at the final assessment, compared with the other groups.

Conclusions: In the United States, there appear to be four distinct classes of developmental patterns of e-cigarette use initiation and progression to frequent use during mid-to-late adolescence and young adulthood, including a newly identified group characterized by late use initiation (post secondary school) and rapid progression (1.2 years) to frequent use. Rapid progression from late initiation to frequent use may be influenced by the widespread availability and usage of JUUL among US youth in 2018-2019.