Addiction最新文献

Aims: To identify the brain activity profiles associated with alcohol consumption and to address its causes. Furthermore, we sought to examine the relationship between these electrophysiological markers and the excitation-inhibition balance, as well as to explore the potential moderating role of sex in these associations.

Design: Longitudinal study involving a neuroimaging assessment that included magnetoencephalography (MEG) and magnetic resonance imaging (MRI), along with a battery of self-report questionnaires. A follow-up assessment was conducted two years later using the same set of neuroimaging and behavioural measures.

Setting and participants: 56 adolescents aged 13 to 17 years recruited from high schools in the community of Madrid, Spain, prior to the initiation of alcohol use.

Measurements: We extracted measures of power spectral density and excitation-inhibition balance across the brain from MEG recordings and cognitive traits related to risk behaviors from a battery of self-report questionnaires. Alcohol consumption was evaluated during the follow-up visit through structured individual interviews.

Findings: Power-spectra in beta-band showed a positive correlation with alcohol use during both stages (baseline: rho = 0.33, P < 0.05; follow-up: rho = 0.35; P < 0.05) and a negative correlation with excitation-inhibition ratio (baseline: P < 0.001; rho = -0.56; follow-up: P < 0.01; rho = -0.37). Finally, biological sex showed strong moderation effect, where females drove the predictive relationship (P < 0.001; rho = 0.64; β = -0,61).

Conclusion: Spontaneous electrophysiological brain activity may provide an early biomarker of future alcohol use in females and appears to be associated with activity profiles prone to inhibition.

Alcohol-free and low-alcohol drinks (no/lo drinks) are now widely available and popular with consumers in high-income countries; however, it is unclear whether clinicians and others working to prevent or treat severe alcohol-related health problems should take a zero-tolerance approach to these alcohol-like products or encourage patients to try them. We argue that no/lo drinks may have an important role to play for people who drink at high-risk levels and those with alcohol use disorders (AUD) or alcohol-related liver disease (ARLD), particularly where debate and guidance related to treatment of these problems considers goals other than abstinence. The limited available evidence available suggests no/lo drinks may be useful in supporting attempts to reduce alcohol consumption or maintain abstinence among high-risk drinkers who do not have severe AUD or ARLD; however, they may also entail significant risks of relapse in those recovering from AUD. We therefore need further experimental and longitudinal studies testing whether use of no/lo drinks can lead to, or support, reductions in alcohol consumption. We particularly need high-quality experimental studies to test whether exposure to and sustained use of no/lo drinks affects treatment and recovery outcomes. Evidence is also needed on which subgroups of AUD and ARLD patients would benefit or be at risk from use of either alcohol-free or low-alcohol drinks. Finally, guidance should recognise that many patients already use these products and that a zero-tolerance approach may alienate patients or erode trust in clinicians.

Background and aim: Cannabis use is prevalent in Australia; however, limited research has explored the proportion of high-risk, disordered cannabis use within nationally representative samples. This study aimed to address this gap by measuring the proportion of individuals meeting criteria for high-risk cannabis use and identifying its correlates in a representative Australian dataset.

Methods: Observational study using data from the 2022-2023 Australian National Drug Strategy Household Survey on respondents self-reporting cannabis use in the past three months (n = 1504). Cannabis use risk was assessed using the World Health Organization's ASSIST-Lite (WHO-ASSIST-Lite). Multinomial logistic regression examined associations between risk and cannabis use patterns, psychological distress and sociodemographic characteristics.

Results: Most respondents had low or no risk of cannabis-related problems [71.6%, 95% confidence interval (CI)_= 68.6-74.6%], with 22.2% (95% CI = 19.4-25.0%) at moderate risk and 6.2% (95% CI = 4.6-7.8%) at high risk. Daily consumption of cannabis was strongly associated with an increased risk of high-risk use [relative risk ratio (RRR) = 5.70, 95% CI = 3.25-9.98, P < 0.001] compared with weekly use. Early initiation, particularly before age 15, was also associated with greater probability of high-risk use (RRR = 2.52, 95% CI = 1.25-5.08, P = 0.009), as was initiation between ages 15-17 (RRR = 2.25, 95% CI = 1.19-4.25, P = 0.013), compared with initiation at age 18 or older. Respondents who reported psychological distress had an increased risk of high-risk cannabis use (RRR = 3.19, 95% CI = 1.66-6.11, P < 0.001).

Conclusion: A substantial proportion of Australians who consume cannabis appear to meet criteria for high-risk use. Daily use, early age of initiation and high psychological distress may be key risk factors.

Background and aim: Cannabis use is associated with psychiatric comorbidities, and the use of elta-9-tetrahydrocannabinol (THC) and cannabidiol (CBD) produces different neurophysiological and pharmacological effects. This study estimated the strength of associations between vaping of THC and CBD with depressive and anxiety symptoms in adolescents.

Design: Observational data were drawn from three years of the nationally representative US National Youth Tobacco Survey (2021-2023). The survey adopted a probabilistic stratified, three-stage cluster design.

Setting: The United States.

Participants: A total of 69 899 adolescents aged 11 to 18, with 51.3% males.

Measurements: CBD and THC cannabis vaping behaviours; Patient Health Questionnaire 2-item and Generalised Anxiety Disorder 2-item, which respectively assess depressive and anxiety symptoms. Logistics regression analyses were conducted after multiple imputation and adjusting for covariates.

Findings: Relative to those who did not vape, adolescents who vaped THC only [adjusted odds ratio (aOR) = 1.40, 95% confidence interval (CI) = 1.20-1.64] or dual CBD/THC (aOR = 1.51, 95% CI = 1.22-1.86) were more likely to experience depressive symptoms; whereas those who vaped CBD only (aOR = 1.74, 95% CI = 1.24-2.46) or THC only (aOR = 1.18, 95% CI = 1.01-1.38) were more likely to experience anxiety symptoms. When the sample was restricted to adolescents who had vaped cannabis products, those who only vaped CBD had a higher likelihood of experiencing anxiety symptoms (aOR = 1.51, 95% CI = 1.05-2.17), relative to those who exclusively vaped THC.

Conclusions: Among adolescents, Δ-9-tetrahydrocannabinol (THC) vaping and dual THC/cannabidiol vaping might be associated with an increased risk of experiencing depressive symptoms. In contrast, adolescents who vape cannabidiol may have a higher likelihood of experiencing anxiety symptoms.

Aim: To examine the socioeconomic differences in the effectiveness of alcohol use disorders (AUD) pharmacotherapy and risk of AUD hospitalisation.

Design: A prospective register-based cohort study.

Setting: Sweden.

Participants: Individuals who were registered as living in Sweden in 2005 (16-64 years) with a first-time AUD diagnosis and complete information on their socioeconomic position (SEP) between 2005 and 2019 (n = 148 626).

Measurement: The outcome was AUD hospitalisation. The use of AUD pharmacotherapy was treated as a time-varying exposure. SEP was the moderator. The association between the joint-exposure (pharmacotherapy use and SEP) and AUD hospitalisation was assessed using a competing-risk regression model, adjusted for sociodemographic factors, previous mental health diagnoses and use of other psychiatric medications.

Findings: Pharmacotherapy use was associated with a lower risk of AUD hospitalisation among high SEP individuals [subdistribution hazard ratio (SHR) = 0.83, 95% confidence interval (CI) = 0.77-0.90], but not among those with low SEP (SHR = 1.02, 95% CI = 0.94-1.10) and middle SEP (SHR = 1.01, 95% CI = 0.94-1.09), compared with low SEP individuals when not using pharmacotherapy.

Conclusions: In Sweden, alcohol use disorder (AUD) pharmacotherapy appears to be effective to reduce the risk of AUD hospitalisation only among individuals of high socioeconomic position.

Background and aims: Nicotine pouches entered the UK market in 2019. Although research has shown that young people's prevalence of use has been low, it has been reported to be increasing and a cause for concern. This paper reports the findings of the first qualitative study in the UK to explore the views of 14-16 year olds' knowledge, awareness of, access to and use of nicotine pouches, augmented by the views of school staff, as part of a wider study investigating the marketing and use of new nicotine products (NNPs) in Scotland (NIPS Study).

Design: Qualitative study using 16 focus groups conducted February-March 2025, and in-person and telephone interviews (nine individual and two paired) with school staff.

Setting: Four schools in Scotland based in areas of differing socio-economic status and two levels of urbanity.

Participants: Seventy-seven third-year (S3; 14-15 years) and fourth-year (S4; 15-16 years) pupils who vaped or were at-risk of vaping. School staff (n = 13) with a senior teaching or pastoral care/guidance role.

Measurements: Focus groups with pupils and interviews with staff explored perceptions and use of nicotine pouches and other NNPs. The qualitative data underwent thematic analysis.

Findings: Pupils were knowledgeable about nicotine pouches and thought that they were easy to access. Experimental use was commonplace and regular use was reported, particularly among boys. This was in stark contrast to the views of the staff, who were largely unaware of pouches and perceived that pupils were not using them. Young people liked that nicotine pouches could be used discreetly as well as experiencing a 'nicotine rush'; however, pupils reported adverse effects from the use of pouches, from pain in the gums to more serious episodes of sickness and fainting.

Conclusions: Young people in Scotland appear to have high awareness and knowledge of nicotine pouches, and experimental use and adverse effects are common. More established use is reported among older boys than other students, who are able to use these products discreetly in schools. School staff appear to be aware of pupils vaping but largely unaware of pouch use.

Background and aims: Quality of life (QoL) often declines during the menopausal transition, and alcohol use may worsen menopause-related symptoms. This study examined the longitudinal association between alcohol consumption and menopause-specific quality of life (MENQOL) questionnaire scores.

Design: Cohort study.

Setting: Hospital-based health screening center, with repeated measures from 2014 to 2023 (mean follow-up 7.43 years, average of 4.74 visits).

Participants: 3622 women aged 42-52 years (mean baseline age 44.33, standard deviation = 2.48) in premenopausal or early menopausal transition stages who underwent annual or biennial health examinations between 2014 and 2018.

Measurements: MENQOL scores ranged from 1 to 8, with higher scores indicating poorer QoL. Alcohol use was categorized as non-drinker, former, light (0.1 to <10 g/day), moderate (10 to <20 g/day) or heavy (≥20 g/day), and problematic drinking was assessed by the Alcohol Use Disorders Identification Test (AUDIT). Baseline ovarian reserve was measured using anti-Müllerian hormone (AMH).

Findings: Adjusted mean differences in MENQOL scores versus non-drinkers were 0.12 (P = 0.026) for light, 0.14 (P = 0.033) for moderate and 0.20 (P = 0.008) for heavy drinkers. Domain-specific analysis showed that alcohol consumption, particularly heavy drinking, was statistically significantly associated with poorer vasomotor, psychosocial and physical domains; however, the sexual domain was non-significantly associated. Among women with below-median AMH, each 1-point AUDIT increase was associated with higher MENQOL overall (0.05, P = 0.001) and in vasomotor (0.05, P = 0.008), psychosocial (0.05, P = 0.011) and physical (0.06, P = 0.001) domains; associations were weaker or non-significant above the median. No interactions were found between alcohol use and time or menopausal stage. In lagged analysis, AUDIT ≥ 20 was associated with higher MENQOL at the next visit (1.25, P = 0.004).

Conclusion: Light, moderate and heavy drinking appear to be associated with poorer scores on the menopause-specific quality of life questionnaire, with greater vulnerability in women with lower anti-Müllerian hormone levels.

Background and aims: Providing comprehensive access to medications for opioid use disorder (MOUD) for people transitioning from United States (US) jails and prisons is important to addressing the substance use disorder (SUD) epidemic. Such policies have augmented public health in other countries, but a precise estimate of its potential impact in the US is lacking. This study sought to estimate: (1) the annual number of opioid overdose deaths (OODs) among individuals released from US jails and prisons, and (2) the number of OODs preventable by providing comprehensive MOUD programs in carceral settings and linkage to care post-release.

Methods: Nationally weighted synthetic estimates of opioid overdose mortality incidence rates among people released from US jails and prisons in a given year were calculated using mortality rates obtained from published studies. Previously published mortality rates were adjusted, using state-year multipliers, to account for temporal variation among study cohorts. Adjusted rates were weighted and combined to produce synthetic national estimates, then rescaled to reflect national OOD patterns from 2017 to 2022. These rescaled mortality rates were then applied to US jail and prison release statistics to estimate the annual number of OODs among the recently incarcerated. Estimates of MOUD efficacy 12 months post-release were used to estimate the number of potential lives saved through expanded MOUD access.

Results: We estimate that 21,784 people [95% synthetic confidence interval (SCI) 18,425 to 25,142] released from US jails and prisons in 2022 died from opioid overdose that year, constituting 27% of annual OODs nationwide. If all jails and prisons provided SUD screening upon entry, MOUD while incarcerated and linkage to care upon release, we estimate that 13,288 OODs (95% SCI 11,239 to 15,337), or 16% of the national total, may have been prevented in 2022.

Conclusions: Approximately 27% of opioid overdose deaths in the United States in 2022 occurred among individuals recently released from carceral settings. Expanding access to medications for opioid use disorder to people in custody and those recently released could potentially prevent a substantial portion of opioid overdose deaths in the United States.