Drug and alcohol dependence最新文献

Sleep disturbance is associated with greater subjective and neural negative emotionality in people with alcohol use disorder 酒精使用障碍患者的睡眠障碍与更大的主观和神经负面情绪有关

IF 3.6 2区医学 Q1 PSYCHIATRY

Drug and alcohol dependence

Pub Date : 2026-04-01 Epub Date: 2026-02-10 DOI: 10.1016/j.drugalcdep.2026.113084

Erica N. Grodin , Dylan E. Kirsch , Wave Ananda Baskerville , Lara A. Ray

Background

Sleep disturbance is ubiquitous in alcohol use disorder (AUD). Sleep disturbance within AUD has been mapped onto the three-stage addiction cycle. The Addictions Neuroclinical Assessment (ANA) is a neuroscience-based framework, which measures functional domains that correspond to the stages of the addiction cycle. The present study investigated the relationship between sleep disturbance and AUD neuroclinical phenomenology and underlying neurobiology.

Methods

In two independent studies, participants completed assessments of sleep disturbance through the Pittsburgh Sleep Quality Index (PSQI; n = 115) or the Insomnia Severity Index (ISI; n = 102). A subset of individuals (n = 52) completed a functional magnetic resonance imaging scan to assess the neurobiology of the incentive salience and negative emotionality domains.

Results

Both studies found that sleep disturbance was associated with negative emotionality (ps≤0.001), but not incentive salience (ps>0.14) or executive function (p = 0.62). Individuals with sleep disturbance had greater activation in the frontal pole, anterior cingulate, medial frontal cortex, and posterior cingulate cortex when viewing negative vs. neutral images, compared to those without sleep disturbance, indicating an underlying neural substrate for the heightened negative emotionality neuroclinical profile.

Conclusions

These results suggest that sleep disturbances in AUD are associated with a neurofunctional profile of enhanced negative emotionality and identify a potential neurobiology underlying this association. These findings suggest that sleep disturbance may be a promising treatment target to improve negative emotionality in this group.

背景：睡眠障碍在酒精使用障碍（AUD）中普遍存在。AUD患者的睡眠障碍被映射到成瘾周期的三个阶段。成瘾神经临床评估（ANA）是一个基于神经科学的框架，它测量与成瘾周期阶段相对应的功能域。本研究探讨了睡眠障碍与AUD神经临床现象和潜在神经生物学之间的关系。方法在两项独立研究中，参与者通过匹兹堡睡眠质量指数（PSQI, n = 115）或失眠严重程度指数（ISI, n = 102）完成睡眠障碍评估。一部分个体（n = 52）完成了功能性磁共振成像扫描，以评估激励显著性和消极情绪域的神经生物学。结果两项研究均发现睡眠障碍与负性情绪相关（ps≤0.001），但与激励显著性（ps>0.14）或执行功能无关（p = 0.62）。与没有睡眠障碍的人相比，有睡眠障碍的人在观看消极和中性图像时，在额极、前扣带、内侧额叶皮层和后扣带皮层有更大的激活，这表明潜在的神经基础加剧了消极情绪的神经临床特征。结论：AUD患者的睡眠障碍与负性情绪增强的神经功能相关，并确定了这种关联背后的潜在神经生物学机制。这些发现表明，睡眠障碍可能是改善这一群体负面情绪的一个有希望的治疗目标。

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引用次数: 0

The intersectionality of cannabis use and depression symptoms on functional brain topology in adults 大麻使用和成人脑功能拓扑抑郁症状的交叉性

IF 3.6 2区医学 Q1 PSYCHIATRY

Drug and alcohol dependence

Pub Date : 2026-04-01 Epub Date: 2026-02-10 DOI: 10.1016/j.drugalcdep.2026.113082

Che Liu , Janna Cousijn , Emese Kroon , Francesca M. Filbey

Background

Although behavioral and epidemiological studies demonstrate high co-morbidity between cannabis use and depression, the underlying neurobiological mechanisms of this relationship remain poorly understood.

Methods

This study evaluated the interaction between cannabis use and depression on brain resting state functional connectivity using graph theory network properties in 223 individuals who currently use cannabis (26.8 ± 8.1 years, 61.9 % males) and 172 controls (25.0 ± 6.8 years, 48.3 % males).

Results

Graph theory analyses showed that the cannabis group relative to the control group had shorter characteristic path length, higher global efficiency and transitivity as well as increased local efficiency and clustering coefficient in salience, frontoparietal, and subcortical networks. Depression symptoms significantly moderated the effect of group on global measures, such that the effect of cannabis use status on characteristic path length, global efficiency and transitivity weakened in those with higher depression scores. Post-hoc analyses indicated a dose-response relationship such that the higher cannabis use frequency, the shorter characteristic path length, higher global efficiency, and transitivity; but no significant moderating effect of depression symptoms emerged on these associations.

Conclusions

These findings suggest that the co-occurrence of depression symptoms and cannabis use, compared to cannabis use alone, may be associated with less efficient and less integrated brain network function. Among those who use cannabis, the effects of cannabis use frequency on these global measures do not vary with depression symptoms, suggesting that depression’s moderating effect is conditional on cannabis use status, not dose. These findings underscore the complex interplay between cannabis use and depression in altering functional brain organization.

虽然行为和流行病学研究表明大麻使用和抑郁症之间有很高的共发病率，但这种关系的潜在神经生物学机制仍然知之甚少。方法采用图论网络特性对223例大麻吸食者（26.8±8.1岁，男性占61.9%）和172例对照者（25.0±6.8岁，男性占48.3%）的脑静息状态功能连通性进行评价。结果图论分析表明，与对照组相比，大麻组显著性网络、额顶叶网络和皮层下网络的特征路径长度更短，整体效率和传递性更高，局部效率和聚类系数更高。抑郁症状显著减缓了群体对整体措施的影响，因此，在抑郁得分较高的人群中，大麻使用状况对特征路径长度、整体效率和传递性的影响减弱。事后分析表明，剂量-反应关系表明，大麻使用频率越高，特征路径长度越短，整体效率和传递性越高；但在这些关联中没有出现明显的抑郁症状缓和作用。这些发现表明，与单独使用大麻相比，抑郁症症状和大麻同时出现可能与脑网络功能效率低下和整合程度较低有关。在大麻使用者中，大麻使用频率对这些全球措施的影响并不因抑郁症状而异，这表明抑郁症的缓和作用取决于大麻使用状况，而不是剂量。这些发现强调了大麻使用和抑郁症在改变大脑功能组织方面的复杂相互作用。

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引用次数: 0

Association between the initiation of strong chū-hai consumption and the incidence of hazardous and harmful alcohol use in Japan: An online survey-based cohort study 在日本，开始大量消费chū-hai与危险和有害酒精使用发生率之间的关系：一项基于在线调查的队列研究

IF 3.6 2区医学 Q1 PSYCHIATRY

Drug and alcohol dependence

Pub Date : 2026-04-01 Epub Date: 2026-02-03 DOI: 10.1016/j.drugalcdep.2026.113075

Takashi Yoshioka , Ryuhei So , Tomohiro Shinozaki , Matthew Rossheim , Shiori Tsutsumi , Satoshi Funada , Ayame Hanada , Tetsuji Minami , Takahiro Tabuchi

Objective

To investigate the association between the initiation of strong chū-hai—an inexpensive Japanese ready-to-drink beverage with high-alcohol-content—consumption and the newly incident hazardous and harmful alcohol use among individuals who consume alcohol.

Methods

This cohort study is based on a three-year longitudinal internet survey conducted in Japan from 2022 to 2024. Respondents who completed all three annual surveys, did not drink strong chū-hai in 2022, and consumed alcohol without presenting hazardous or harmful alcohol use in both 2022 and 2023, were included. The outcome was defined as having newly developed hazardous and harmful alcohol use in 2024, defined as a score of ≥ 8 on the Alcohol Use Identification Test. We fitted a multivariable logistic regression model to examine confounder-adjusted association between initiating strong chū-hai consumption and the incidence of hazardous and harmful alcohol use.

Results

Of 5358 respondents from 33,000 surveyed in 2022, approximately 10 % (n = 533) initiated strong chū-hai consumption in 2023. In 2024, the prevalence of hazardous and harmful alcohol use was higher for those who initiated strong chū-hai consumption (7.7 %) than those who did not (3.1 %). Multivariable analysis revealed that initiating strong chū-hai consumption was associated with higher odds of hazardous and harmful alcohol use the year following (adjusted odds ratio 1.90, 95 % confidence interval 1.19–3.06, p = 0.008).

Conclusions

The initiation of strong chū-hai consumption was associated with the incidence of hazardous and harmful alcohol use. Considering the global increase in sales of ready-to-drink alcoholic beverages, our findings serve as an important caution for policymakers worldwide.

目的探讨高酒精含量的日本廉价烈性chū-hai-an即饮饮料与饮酒人群中新发生的危险和有害酒精使用之间的关系。方法本队列研究基于日本从2022年到2024年为期三年的纵向网络调查。受访者完成了所有三项年度调查，在2022年没有喝烈性酒chū-hai，并且在2022年和2023年都没有出现危险或有害的酒精使用。结果定义为在2024年有新的危险和有害酒精使用，定义为酒精使用识别测试得分≥8。我们拟合了一个多变量logistic回归模型，以检验混杂因素调整后的强烈chū-hai消费与危险和有害酒精使用发生率之间的关联。在2022年接受调查的33,000名受访者中，5358名受访者中，约有10% （n = 533）在2023年开始了强劲的chū-hai消费。2024年，开始大量消费chū-hai的人（7.7%）的危险和有害酒精使用流行率高于未开始大量消费chū-hai的人（3.1%）。多变量分析显示，开始强烈的chū-hai消费与次年危险和有害酒精使用的较高几率相关（调整优势比1.90,95%置信区间1.19-3.06,p = 0.008）。结论强烈的chū-hai消费与危险和有害酒精使用的发生率相关。考虑到即饮酒精饮料的全球销售增长，我们的研究结果为全球政策制定者提供了重要的警告。

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引用次数: 0

Achieving SVR is associated with long term reduced hazardous alcohol use for people who inject drugs receiving HCV treatment: The HERO study 对于接受丙型肝炎病毒治疗的注射吸毒者，实现SVR与长期减少危险酒精使用有关：HERO研究

IF 3.6 2区医学 Q1 PSYCHIATRY

Drug and alcohol dependence

Pub Date : 2026-04-01 Epub Date: 2026-02-10 DOI: 10.1016/j.drugalcdep.2026.113081

Emily Waters , Jessica Obeysekare , Snehal Lopes , Irene Pericot-Valverde , Brianna L. Norton , Judith I. Tsui , Shruti H. Mehta , Lynn E. Taylor , Paula J. Lum , Judith Feinberg , Arthur Y. Kim , Kimberly Page , Jessica Anderson , Cristina Murray-Krezan , Moonseong Heo , Alain H. Litwin , the HERO Study Group

Background/Aims

People who inject drugs (PWID) have high rates of HCV infection. Concurrent alcohol use is associated with higher rates of HCV and acceleration of HCV-related liver disease. This study analyzed alcohol use among PWID both during and after treatment of HCV with direct-acting antivirals.

Approach/Results

We conducted a secondary analysis of the HERO study, a multisite pragmatic randomized trial, in which PWID with active drug use (n = 755) were assigned to either patient navigation or modified directly observed therapy models of HCV care. Alcohol use was measured using the modified Addiction Severity Index (ASI) and the Alcohol Use Disorders Identification Test-Concise (AUDIT-C). Linear mixed-effects models were used to analyze changes in alcohol use between baseline, treatment (weeks 4, 8, and 12), and after-treatment follow-up visits (weeks 24, 72, 120, 168). Overall, there were no significant differences in ASI or AUDIT-C scores by sustained virological response (SVR) or treatment arm. Among patients who achieved SVR, there was a significant reduction in AUDIT-C scores at all follow-up visits compared to baseline (all, p < 0.05). Among those with high AUDIT-C score at baseline, there were significant reductions in drinking at all visits compared to baseline in both treatment arms (all, p ≤ 0.001).

Conclusions

Among PWID who achieved SVR or with high AUDIT-C scores at baseline, there was a significant reduction in AUDIT-C scores at all visits after baseline. The treatment period for HCV may represent a unique opportunity to address dual causes of liver disease, especially for individuals with hazardous alcohol use.

背景/目的注射吸毒者（PWID）的丙型肝炎病毒感染率很高。同时饮酒与较高的丙型肝炎发病率和丙型肝炎相关肝病的加速相关。本研究分析了PWID患者在使用直接抗病毒药物治疗HCV期间和之后的酒精使用情况。方法/结果我们对HERO研究进行了二次分析，这是一项多地点实用随机试验，其中主动用药的PWID （n = 755）被分配到患者导航组或修改的直接观察治疗模式的HCV护理组。使用改进的成瘾严重程度指数（ASI）和酒精使用障碍识别测试-简明（AUDIT-C）来测量酒精使用。使用线性混合效应模型分析基线、治疗（第4、8和12周）和治疗后随访（第24、72、120、168周）期间酒精使用的变化。总体而言，持续病毒学反应（SVR）或治疗组的ASI或AUDIT-C评分无显著差异。在达到SVR的患者中，与基线相比，所有随访时的AUDIT-C评分均显著降低（均p <； 0.05）。在基线时AUDIT-C评分较高的患者中，与基线相比，两个治疗组在所有就诊时的饮酒量均显著减少（均p≤0.001）。在达到SVR或基线时审计- c评分较高的PWID中，基线后所有就诊的审计- c评分均显著降低。丙型肝炎的治疗期可能是解决肝病双重原因的独特机会，特别是对于危险饮酒的个体。

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引用次数: 0

A pilot trial of using ecological momentary intervention to deliver tetris for alcohol craving among women 一项使用生态瞬时干预的试点试验，为女性的酒精渴望提供俄罗斯方块

IF 3.6 2区医学 Q1 PSYCHIATRY

Drug and alcohol dependence

Pub Date : 2026-04-01 Epub Date: 2026-01-16 DOI: 10.1016/j.drugalcdep.2026.113052

Christine K. Hahn , Alexandra N. Brockdorf , Jeffrey M. Pavlacic , Christopher L. Metts , Kathleen T. Brady , Michaela Hoffman , Constance Guille , Michael E. Saladin , Sudie E. Back

Innovative and accessible interventions are critical to address rising rates of alcohol misuse and low rates of alcohol treatment engagement among women. Ecological momentary interventions (EMI) that use technology to deliver interventions in real-time may be a promising avenue to reduce barriers to alcohol interventions for women and ensure they receive intervention when they need it most. Craving is a key proximal predictor of alcohol use that may be beneficial to target using EMI. Tetris is a visuospatial task that may disrupt craving by placing competing demands on visual working memory. This study tested a Tetris EMI for craving and alcohol use among women who reported alcohol misuse. Forty women completed a two-week experimental EMA protocol involving a daily interval-contingent survey assessing past-day alcohol craving and consumption, as well as four daily signal-contingent surveys assessing momentary craving. Participants assigned to the intervention condition (n = 20) were prompted to complete Tetris for four minutes in response to momentary craving and those assigned to the control condition (n = 20) were prompted to wait four minutes before re-rating craving. Participants also completed baseline and post-experimental questionnaires. Results indicated that the Tetris EMI was highly acceptable and generally feasible. The EMI predicted average decreases in momentary craving for those who reported high levels of recognition of possible harms related to their drinking and readiness to change. However, the EMI did not lead to decreases in average daily craving or drinking. Findings suggest craving is a modifiable target for EMIs among women who are more ready for treatment.

创新和可获得的干预措施对于解决妇女酒精滥用率上升和酒精治疗参与率低的问题至关重要。利用技术实时提供干预措施的生态瞬时干预（EMI）可能是一种很有希望的途径，可以减少对妇女进行酒精干预的障碍，并确保她们在最需要的时候得到干预。渴望是酒精使用的一个关键的近端预测因子，可能对使用EMI的目标有益。俄罗斯方块是一项视觉空间任务，它可能通过对视觉工作记忆施加竞争性要求来破坏渴望。这项研究在报告酒精滥用的女性中测试了俄罗斯方块EMI对渴望和酒精使用的影响。40名女性完成了为期两周的实验EMA方案，包括每日间隔随机调查评估过去一天的酒精渴望和消费，以及每日四次信号随机调查评估瞬间渴望。被分配到干预组的参与者（n = 20）被要求完成4分钟的俄罗斯方块来回应短暂的渴望，而被分配到控制组的参与者（n = 20）被要求在重新评估渴望之前等待4分钟。参与者还完成了基线和实验后问卷调查。结果表明，俄罗斯方块电磁干扰是高度可接受和普遍可行的。EMI预测，对于那些高度认识到饮酒可能带来的危害并准备改变的人来说，他们的瞬时渴望平均会减少。然而，EMI并没有导致平均每日渴望或饮酒的减少。研究结果表明，对于那些更愿意接受治疗的女性来说，渴望是一个可以改变的目标。

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引用次数: 0

Patterns of structural brain differences in cocaine use disorder: Integrating multilevel frequentist, Bayesian, and coordinate-based meta-analyses 可卡因使用障碍的大脑结构差异模式：整合多层次频率、贝叶斯和基于坐标的meta分析

IF 3.6 2区医学 Q1 PSYCHIATRY

Drug and alcohol dependence

Pub Date : 2026-04-01 Epub Date: 2026-01-31 DOI: 10.1016/j.drugalcdep.2026.113064

Augusto Martins Lucas Bittencourt , Bernardo Penteado Favero , Camila Haas , Eduardo Tavares Portolan , Enzo Gallardo , Leonardo Melo Rothmann , Rodrigo Grassi-Oliveira , Thiago Wendt Viola

Background

Cocaine Use Disorder (CUD) has been associated with differences in gray matter (GM) measures, but prior meta-analyses have yielded inconsistent results due to methodological variability, publication bias, and selective reporting. To address these gaps, this study integrates multilevel frequentist, Bayesian, and coordinate-based approaches to provide a comprehensive, anatomically resolved synthesis of structural neuroimaging findings in CUD.

Methods

Following PRISMA guidelines (PROSPERO: CRD42024585260), 47 studies were included that compared GM indices between individuals with CUD and healthy controls. Multilevel random-effects meta-analyses were conducted to quantify cortical and subcortical group differences while accounting for clinically relevant moderators. Bayesian hierarchical models were used to conduct sensitivity analyses addressing potential reporting bias, and a coordinate-based Activation Likelihood Estimation (ALE) analysis evaluated spatial convergence across voxel-based morphometry studies.

Results

The analyses indicated that CUD showed lower GM measures in prefrontal and temporal cortical regions, particularly the ITG and the rostral middle frontal gyrus. Subcortical analyses showed lower GM volume in the amygdala, hippocampus, thalamus, pallidum, nucleus accumbens, brainstem, and cerebellum. Longer duration of cocaine use and greater clinical severity were associated with larger negative effect-size estimates for cortical measures. Bayesian regularization yielded consistent cortical effect-size estimates across sensitivity analyses, whereas the coordinate-based ALE analysis identified no clusters surviving family-wise error correction.

Conclusions

Together, results from this meta-analysis identify consistent patterns of GM differences across cortico-subcortical regions in individuals with CUD. These findings provide an integrated neuroanatomical reference framework that may inform future longitudinal studies and the evaluation of candidate neuroimaging biomarkers.

可卡因使用障碍（CUD）与灰质（GM）测量的差异有关，但先前的荟萃分析由于方法的可变性、发表偏倚和选择性报道而产生了不一致的结果。为了解决这些差距，本研究整合了多层次频率学、贝叶斯和基于坐标的方法，提供了一个全面的、解剖学上解决的CUD结构神经影像学结果的综合。方法按照PRISMA指南（PROSPERO: CRD42024585260）纳入47项研究，比较CUD患者与健康对照者的GM指数。在考虑临床相关调节因子的同时，进行了多水平随机效应荟萃分析，以量化皮层组和皮层下组的差异。使用贝叶斯层次模型进行敏感性分析，解决潜在的报告偏差，并使用基于坐标的激活似然估计（ALE）分析评估基于体素的形态测量学研究的空间收敛性。结果CUD组在前额叶和颞叶皮质区，尤其是ITG和吻侧额中回的GM测量值较低。皮层下分析显示，杏仁核、海马、丘脑、苍白球、伏隔核、脑干和小脑的GM体积较低。更长的可卡因使用时间和更大的临床严重程度与皮质测量的更大的负效应大小估计值相关。贝叶斯正则化在敏感性分析中产生一致的皮质效应大小估计，而基于坐标的ALE分析确定没有群集在家庭误差校正中幸存下来。综上所述，本荟萃分析的结果确定了CUD患者皮质-皮质下区域GM差异的一致模式。这些发现提供了一个完整的神经解剖学参考框架，可以为未来的纵向研究和候选神经成像生物标志物的评估提供信息。

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引用次数: 0

Long-term use of Benzodiazepines and Z-drugs: A register-based cohort study in Taiwan 长期使用苯二氮卓类药物与z -药物：台湾一项基于登记的队列研究

IF 3.6 2区医学 Q1 PSYCHIATRY

Drug and alcohol dependence

Pub Date : 2026-04-01 Epub Date: 2026-02-10 DOI: 10.1016/j.drugalcdep.2026.113078

Meng-Chiao Chou , Yueh-Pin Lin , Chun-Hung Pan , Sheng-Siang Su , Shang-Ying Tsai , Chiao-Chicy Chen , Chian-Jue Kuo

Background

Benzodiazepines (BZDs) and Z-drugs are commonly prescribed for anxiety and insomnia, but their long-term use remains a public health concern. Evidence from Asia remains limited. This study investigated trajectories and predictors of long-term use in Taiwan by using a population-based cohort.

Methods

We conducted a register-based cohort study by using a nationally representative sample from Taiwan’s National Health Insurance Research Database (NHIRD), covering a 20-year period from January 1, 2000, to December 31, 2019 after a 1-year washout. Incident users were identified and followed to evaluate long-term use patterns on the basis of two discontinuation thresholds: 90 days and 365 days. Cox regression models were used to estimate adjusted hazard ratios (aHRs) for long-term use by demographic, physical, and psychiatric factors.

Results

Among 896,163 incident users, 3.8% progressed to long-term use under the 90-day definition, increasing to 14.7% under the 365-day definition. Under the 90-day definition, clonazepam and hypnotic BZDs showed the highest persistence (10.3% and 8.4%). More than 70% of initiations occurred in nonpsychiatric specialties. Long-term use was associated with male sex, older age, and higher Charlson Comorbidity Index; strong predictors included cancer, pneumonia, moderate-to-severe renal disease, alcohol- or drug-induced mental disorders, and personality disorders.

Conclusion

In Taiwan, most BZD and Z-drug use is short-term, and their usage patterns are affected by both clinical and system-level factors. These findings highlight the need for risk-based monitoring, cross-specialty prescribing oversight, and further research into treatment substitution strategies.

苯二氮卓类药物（BZDs）和z类药物通常用于治疗焦虑和失眠，但它们的长期使用仍然是一个公共卫生问题。来自亚洲的证据仍然有限。本研究以人口为基础，探讨台湾长期用药的轨迹及预测因子。在两个终止阈值（90天和365天）的基础上，确定并跟踪事件用户，以评估长期使用模式。Cox回归模型用于估计人口统计学、生理和精神病学因素对长期使用的校正风险比（aHRs）。在896163名事件用户中，3.8%在90天定义下发展为长期使用，在365天定义下增加到14.7%。在90天的定义下，氯硝西泮和催眠性bzd的持久性最高（10.3%和8.4%）。超过70%的入会发生在非精神科专业。长期使用与男性、年龄较大和较高的Charlson合并症指数相关；强预测因子包括癌症、肺炎、中重度肾脏疾病、酒精或药物引起的精神障碍和人格障碍。结论台湾地区BZD和z类药物的使用多为短期用药，其使用模式受临床和制度因素的影响。这些发现强调了基于风险的监测、跨专业处方监督和对治疗替代策略的进一步研究的必要性。

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引用次数: 0

Impulsivity as a dynamic mechanism linking young adult sleep and drinking behavior during naturally occurring drinking episodes 冲动作为一种动态机制，在自然发生的饮酒事件中连接年轻人的睡眠和饮酒行为

IF 3.6 2区医学 Q1 PSYCHIATRY

Drug and alcohol dependence

Pub Date : 2026-03-01 Epub Date: 2026-01-23 DOI: 10.1016/j.drugalcdep.2026.113054

Jack T. Waddell , Andrea M. Wycoff , Mary Beth Miller

Background

Impulsivity is implicated in theories linking sleep and drinking behavior. While well-studied across individuals, research regarding sleep, impulsivity, and drinking in real-world contexts is lacking. This study tested a theoretical pathway wherein better-than-average sleep predicts decreased impulsivity while drinking, which then predicts lesser drinking and negative alcohol consequences experienced during drinking episodes.

Method

Young adults (N = 131) completed 21 days of ecological momentary assessment, including morning reports, self-initiated drink reports after first drink, and follow-up drinking reports 60/120 min later. Past-day drinking quantity, negative alcohol consequences, and sleep (duration, nighttime awakenings, and morning readiness to start day) were measured each morning. Impulsivity (urgency, lack of premeditation, lack of perseverance, and sensation seeking) was measured during drink initiation/follow-up reports.

Results

In two of the four multilevel mediation models (one for each facet of impulsivity), better sleep (higher morning readiness and longer sleep duration) predicted decreased state impulsivity (lack of premeditation and sensation seeking) while drinking, which indirectly predicted fewer negative consequences via lighter drinking quantity. Above and beyond state impulsivity while drinking, higher morning readiness indirectly predicted fewer negative consequences via lighter drinking quantity. Increased urgency also indirectly predicted negative consequences via heavier drinking quantity but was unrelated to sleep. Findings were unchanged when accounting for cumulative sleep debt, except relations between morning readiness and sensation seeking while drinking.

Conclusions

Dampened state impulsivity while drinking may explain protective associations between good sleep health and less risky drinking. Sleep interventions may be effective at reducing impulsivity while drinking and alcohol-related harms.

冲动性与睡眠和饮酒行为有关。虽然对个体的研究很充分，但在现实环境中关于睡眠、冲动和饮酒的研究还很缺乏。这项研究测试了一个理论途径，其中比平均水平更好的睡眠预示着饮酒时冲动的减少，这预示着饮酒期间饮酒和负面酒精后果的减少。方法年轻成人（N = 131）完成21天的生态瞬间评估，包括晨间报告、首次饮酒后的主动饮酒报告和60/120分钟后的随访饮酒报告。每天早上测量过去一天的饮酒量、负面酒精后果和睡眠（持续时间、夜间醒来和早晨开始一天的准备情况）。冲动性（紧迫感、缺乏预谋、缺乏毅力和寻求感觉）在饮酒开始/后续报告中被测量。结果在四个多层次中介模型中的两个模型（冲动性各一个）中，较好的睡眠（较高的早晨准备和较长的睡眠时间）预测饮酒时状态冲动性（缺乏预谋和感觉寻求）的降低，通过较轻的饮酒量间接预测较少的负面后果。除了饮酒时的状态冲动之外，早晨准备程度越高间接预示着饮酒量越少的负面后果越少。紧迫感的增加也间接预示着大量饮酒带来的负面影响，但与睡眠无关。当考虑到累积的睡眠债务时，研究结果没有变化，除了早晨准备和喝酒时寻求感觉之间的关系。结论：饮酒时的抑制状态冲动可能解释了良好睡眠健康和低风险饮酒之间的保护性联系。睡眠干预可能对减少饮酒时的冲动和酒精相关危害有效。

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引用次数: 0

Perspectives on collaboration between drug courts and MOUD providers: Impact of interagency implementation strategies 药物法庭和mod提供者之间合作的观点：机构间执行战略的影响。

IF 3.6 2区医学 Q1 PSYCHIATRY

Drug and alcohol dependence

Pub Date : 2026-03-01 Epub Date: 2026-01-29 DOI: 10.1016/j.drugalcdep.2026.113065

Ekaterina Pivovarova , Faye S. Taxman , Barbara Andraka-Christou , Alexandra Boland , Dara Drawbridge , David Smelson , Stephenie C. Lemon , Peter D. Friedmann

Background

Effective working relationships between drug courts and community providers are critical to improving access to medications for opioid use disorder (MOUD), but collaboration is often inadequate. We adapted and piloted a package of implementation strategies (Clinical Organizations and Legal Agency Alliance Building; COLAAB) designed to enhance collaboration between recovery courts and MOUD agencies. COLAAB activities included structured interagency meetings, agency tours, academic liaison, and development of local resource guides.

Methods

After the implementation of COLAAB in three courts, we conducted semi-structured interviews (n = 24) with drug court and MOUD staff to assess the impact of COLAAB on collaboration, communication, and referrals. Data were analyzed using a modified iterative categorization approach.

Results

Drug court and MOUD agency staff perceived COLAAB as facilitating interagency relationships and referrals to MOUD, increasing MOUD agencies’ understanding of drug courts, improving communication quality, strengthening understanding and trust in MOUD providers and drug courts, and reducing time to referrals to MOUD. COLAAB also increased the MOUD agency staff’s awareness of other community providers and helped build their potential referral networks. COLAAB may have also enhanced drug court staff’s willingness to speak with clients about MOUD and MOUD provider staff’s willingness to discuss clients’ criminal legal involvement.

Discussion

Our pilot study provides preliminary evidence that court-MOUD agency collaborations can be enhanced through active learning about one another’s practices and services, participation in regularly scheduled meetings or activities, and the identification and use of resources that support efficient interagency referral processes.

背景：药物法院和社区提供者之间的有效工作关系对于改善阿片类药物使用障碍（mod）药物的可及性至关重要，但合作往往不足。我们调整并试行了一套执行战略（临床组织和法律机构联盟建设；COLAAB），旨在加强康复法院和国防部机构之间的合作。COLAAB的活动包括有组织的机构间会议、机构参观、学术联络和开发当地资源指南。方法：在三个法院实施COLAAB后，我们对毒品法院和国防部的工作人员进行了半结构化访谈（n = 24），以评估COLAAB对合作、沟通和转诊的影响。使用改进的迭代分类方法对数据进行分析。结果：药品法院和药品法院机构工作人员认为COLAAB促进了机构间关系和转介到药品法院，增加了药品法院机构对药品法院的了解，提高了沟通质量，加强了对药品法院和药品法院的理解和信任，减少了转介到药品法院的时间。COLAAB还提高了国防部工作人员对其他社区提供者的认识，并帮助他们建立潜在的转诊网络。COLAAB可能还增强了毒品法庭工作人员与客户谈论毒品成瘾问题的意愿，以及毒品成瘾提供者工作人员讨论客户刑事法律参与的意愿。讨论：我们的试点研究提供了初步证据，表明可以通过积极了解彼此的实践和服务、参与定期安排的会议或活动，以及识别和使用支持有效的机构间转诊流程的资源，来加强法院与机构间的合作。

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引用次数: 0

Daily patterns of substance use among young adults who vape nicotine and cannabis: Latent class analysis of smartphone-based daily diary data 吸食尼古丁和大麻的年轻人的日常物质使用模式：基于智能手机的日常日记数据的潜在类分析。

IF 3.6 2区医学 Q1 PSYCHIATRY

Drug and alcohol dependence

Pub Date : 2026-03-01 Epub Date: 2026-01-29 DOI: 10.1016/j.drugalcdep.2026.113060

Deanna M. Halliday , Lisbeth Lund , Pamela M. Ling , Nhung Nguyen

Introduction

Using multiple tobacco and cannabis products is common among young adults and raises concerns about addiction and health risks. Few studies address daily use patterns of multiple products on the same day. We used daily diaries to identify patterns of substance use and associated factors among young adults who reported vaping nicotine and cannabis.

Methods

We collected smartphone-based daily diaries from 113 California young adults (mean age=23.8) who vaped nicotine or cannabis for 20 + days in the past month. For 30 consecutive days, participants reported their daily use of nicotine/tobacco, cannabis, alcohol, craving for nicotine and cannabis vaping, and mood. We used multilevel latent class analysis to identify daily substance use patterns and mixed-effects logistic regression to identify factors associated with these patterns, controlling for baseline covariates (e.g., demographics, nicotine/cannabis dependence).

Results

Three latent classes emerged: Class 1 – “Nicotine vaping days” (52.7 % of the assessments), Class 2 – “Nicotine and cannabis co-vaping days” (39.9 %), and Class 3 -“Combustible tobacco and cannabis use days” (7.4 %). Higher levels of feeling sad on a given day were associated with increased likelihood of that day belonging to Class 1 (adjusted OR = 1.11, 95%CI95 %CI = 1.01 – 1.23). Higher cravings for cannabis vaping on a given day were associated with increased likelihood of that day belonging to Class 2 (adjusted OR = 1.81, 95 % CI = 1.63 – 2.01).

Conclusion

Interventions should be tailored to varying daily substance use patterns among young adults who vape. Efforts targeting vaping cessation may also address combustible product use.

导言：使用多种烟草和大麻产品在年轻人中很常见，这引起了对成瘾和健康风险的关注。很少有研究涉及在同一天使用多种产品的日常使用模式。我们使用每日日记来确定报告吸食尼古丁和大麻的年轻人的物质使用模式和相关因素。方法：我们收集了113名加利福尼亚年轻人（平均年龄为23.8岁）在过去一个月里吸食尼古丁或大麻20多天的智能手机日记。在连续30天的时间里，参与者报告了他们每天使用尼古丁/烟草、大麻、酒精、对尼古丁和大麻电子烟的渴望以及情绪。我们使用多水平潜类分析来确定日常物质使用模式，并使用混合效应逻辑回归来确定与这些模式相关的因素，控制基线共变量（例如，人口统计学，尼古丁/大麻依赖）。结果：出现了三个潜在类别：第1类-“尼古丁雾化日”（占评估的52.7%），第2类-“尼古丁和大麻共同雾化日”（39.9%），第3类-“可燃烟草和大麻使用日”（7.4%）。在某一天感到悲伤的程度越高，这一天属于第一类的可能性就越大（调整后OR = 1.11, 95%CI = 1.01 - 1.23）。在某一天吸食大麻的欲望越高，当天属于第2类的可能性就越大（调整后OR = 1.81, 95% CI = 1.63 - 2.01）。结论：干预措施应针对吸电子烟的年轻人不同的日常物质使用模式。针对戒烟的努力也可能涉及可燃产品的使用。

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引用次数: 0