Drug and alcohol dependence最新文献

Rising and disparate trends in the private/for-profit acquisition of nonprofit substance use treatment facilities, US, 2019–2024 私人/营利性收购非营利性物质使用治疗设施的上升和不同趋势，美国，2019-2024

IF 3.6 2区医学 Q1 PSYCHIATRY

Drug and alcohol dependence

Pub Date : 2026-01-13 DOI: 10.1016/j.drugalcdep.2026.113045

George Pro , Jonathan Cantor , Mofan Gu , Kari Weber , Brooke Montgomery

Background

Private acquisition of public and nonprofit healthcare facilities is increasing throughout the United States (US). While privatization can be beneficial, growing evidence has demonstrated higher costs, larger patient volumes, and worsening outcomes. These trends are also apparent in substance use disorder (SUD) treatment facilities at a time when overdose and treatment demand are at an all time high. This study was designed to measure whether increases in private acquisitions of nonprofit substance use treatment facilities are happening faster in underrepresented and underresourced communities.

Methods

We used the Mental health and Addiction Treatment Tracking Repository (MATTR) to identify SUD treatment facilities that were nonprofit/public owned in 2019 (N = 2826 facilities). Our outcome was whether a facility became privatized and owned by a for-profit company by 2024. We linked MATTR to demographic census data and modeled privatization using a generalized estimating equation with a modified Poisson distribution, log link function, and robust standard errors.

Results

Twenty percent (n = 572) of public/nonprofit SUD treatment facilities were privatized between 2019 and 2024. Privatization of nonprofit/public facilities was more common in communities with lower household incomes (p < 0.01).

Conclusion

Private acquisition of nonprofit/public SUD treatment facilities increased between 2019 and 2024. Acquisitions were disproportionately located in communities with higher rates of low-income households. Private acquisition can be beneficial for some facilities, but a growing evidence base is demonstrating how privatization is generally followed by worsening health outcomes in the process of restructuring and reselling at a profit. Treatment systems must not be extractive. Oversight and community involvement may help ensure mutual beneficence.

背景：在美国，私人收购公共和非营利医疗机构的情况正在增加。虽然私有化可能是有益的，但越来越多的证据表明，成本更高，患者人数更多，结果更差。这些趋势在药物使用障碍（SUD）治疗设施中也很明显，因为过量和治疗需求处于历史高位。本研究旨在衡量在代表性不足和资源不足的社区，私人收购非营利性药物使用治疗设施的增长是否更快。方法使用心理健康和成瘾治疗跟踪库（matr）识别2019年非营利性/公营的SUD治疗机构（N = 2826家机构）。我们的结果是，到2024年，一个设施是否会私有化，并由一家营利性公司拥有。我们将matr与人口普查数据联系起来，并使用带有修正泊松分布、日志链接函数和鲁棒标准误差的广义估计方程来建模私有化。结果2019 - 2024年，20% （n = 572）的公立/非营利SUD治疗机构实现了私有化。非营利性/公共设施私有化在家庭收入较低的社区更为常见（p < 0.01）。结论2019 - 2024年间，非营利性/公立SUD治疗设施的私人收购有所增加。收购不成比例地位于低收入家庭比例较高的社区。私人收购对某些设施可能是有益的，但越来越多的证据表明，私有化之后，在重组和转售过程中，健康结果通常会恶化。处理系统不能是萃取性的。监督和社区参与可能有助于确保互惠互利。

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引用次数: 0

Alcohol quantity mediates the association between daily alcohol and cannabis co-use and alcohol consequences 酒精量介导每日酒精和大麻共同使用与酒精后果之间的关联

IF 3.6 2区医学 Q1 PSYCHIATRY

Drug and alcohol dependence

Pub Date : 2026-01-12 DOI: 10.1016/j.drugalcdep.2026.113043

Rachel L. Gunn , Alexander W. Sokolovsky , Lindy K. Howe , Nancy P. Barnett , Kristina M. Jackson , Sharon Lipperman-Kreda , Robert Miranda Jr. , Timothy Trull , Jane Metrik

Background

Alcohol and cannabis are commonly used substances for young adults, and person-level co-use (i.e., concurrent or simultaneous use of both) is associated with increased likelihood of experiencing positive and negative alcohol-related consequences. However, findings regarding within-person effects (i.e.,day-level) co-use on consequences are mixed, possibly due to inconsistency in including alcohol quantity (i.e., total number of standard drinks consumed) when examining the association between co-use and consequences. In the present study, we examined whether the number of drinks mediates the association between co-use and positive or negative alcohol consequences at the day level.

Methods

Data from morning reports in a 28-day field-based study of young adults reporting frequent past 60-day alcohol and cannabis use (N = 115) were used to test multilevel mediation models.

Results

We found significant mediation for both positive and negative alcohol consequences; consuming more alcoholic drinks on co-use days, relative to alcohol-only days, was associated with a higher likelihood of experiencing negative consequences and a lower likelihood of positive consequences. These results suggest that daily number of drinks is a significant driver of the relationship between co-use and alcohol-related consequences at the day-level.

Conclusions

In the context of increased cannabis use among young adults, this finding provides critical information for prevention and intervention efforts aimed at reducing the alcohol-related consequences associated with co-use days. Overall, reducing total alcohol consumption remains a prominent harm-reduction strategy among this population.

酒精和大麻是年轻人常用的物质，个人层面的共同使用（即同时或同时使用两者）与经历与酒精有关的积极和消极后果的可能性增加有关。然而，关于共同使用对后果的个人影响（即日水平）的发现是混合的，可能是由于在检查共同使用与后果之间的关系时，包括酒精量（即消耗的标准饮料总数）不一致。在目前的研究中，我们研究了饮酒的数量是否介导了共同使用和积极或消极酒精后果之间的联系。方法对过去60天频繁使用酒精和大麻的年轻人（N = 115）进行了一项为期28天的实地研究，研究数据来自晨间报告，用于检验多层次中介模型。结果我们发现酒精对积极和消极后果都有显著的中介作用；与只喝酒的日子相比，在一起喝酒的日子里喝更多的酒，经历负面后果的可能性更高，而产生积极后果的可能性更低。这些结果表明，每天的饮酒量是共同使用和酒精相关后果之间关系的重要驱动因素。结论：在年轻人大麻使用增加的背景下，这一发现为预防和干预工作提供了重要信息，旨在减少与共同使用天数相关的酒精相关后果。总的来说，减少酒精消费总量仍然是这一人群减少危害的主要策略。

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引用次数: 0

Identification of hazardous alcohol use in outpatient psychiatric care: A comparison of biomarker phosphatidylethanol (PEth) and self-report 鉴定精神科门诊危险酒精使用：生物标志物磷脂酰乙醇（PEth）和自我报告的比较

IF 3.6 2区医学 Q1 PSYCHIATRY

Drug and alcohol dependence

Pub Date : 2026-01-12 DOI: 10.1016/j.drugalcdep.2026.113047

Lena Lundholm , Johan Skånberg , Sara Wallhed-Finn , Fabian Lenhard

Background

Phosphatidylethanol (PEth) is a reliable biomarker of recent hazardous alcohol use but is resource-intensive and not always feasible in routine mental health care. The Alcohol Use Disorders Identification Test (AUDIT-10) and its short form, AUDIT-C, are widely used self-report tools that may offer practical alternatives. This study examined whether AUDIT scores can serve as proxies for PEth and whether machine learning models enhance prediction.

Methods

Data were collected from 4063 psychiatric outpatients who completed both PEth testing and AUDIT assessments. Regression models evaluated associations between AUDIT scores and PEth concentrations. Receiver Operating Characteristic (ROC) analyses determined cut-offs for hazardous alcohol use (PEth ≥ 0.3 µmol/L). Logistic regression, random forest, and XGBoost models were trained using AUDIT-10/AUDIT-C scores, age, and gender.

Results

AUDIT-10 and AUDIT-C correlated strongly with PEth (pseudo-R² = 30–47 %). ROC analyses showed good discrimination for hazardous use: AUDIT-10 AUC = 0.80 (optimal cut-off ≥5) and AUDIT-C AUC = 0.83 (optimal cut-off ≥4). XGBoost models improved classification modestly, yielding AUCs of 0.90 (AUDIT-10) and 0.88 (AUDIT-C), with balanced accuracies of 79–83 %, outperforming logistic regression and random forest.

Conclusions

AUDIT-10 and AUDIT-C are effective, accessible tools for identifying hazardous alcohol use in psychiatric populations, supporting their role as practical alternatives when PEth testing is unavailable. Machine learning methods offer incremental gains, but simple cut-off scores remain clinically useful. Findings highlight the value of integrating brief alcohol screening into psychiatric care to guide timely interventions, while considering PEth’s biological variability.

磷脂酰乙醇（PEth）是近期危险酒精使用的可靠生物标志物，但它是资源密集型的，在常规精神卫生保健中并不总是可行的。酒精使用障碍鉴定测试（AUDIT-10）及其简短形式AUDIT-C是广泛使用的自我报告工具，可能提供实际的替代方案。本研究考察了审计分数是否可以作为PEth的代理，以及机器学习模型是否可以增强预测。方法收集4063例完成PEth检测和AUDIT评估的精神科门诊患者的数据。回归模型评估了审计分数和PEth浓度之间的关系。受试者工作特征（ROC）分析确定了有害酒精使用的截止值（PEth≥0.3µmol/L）。使用AUDIT-10/AUDIT-C分数、年龄和性别训练逻辑回归、随机森林和XGBoost模型。结果audit -10和AUDIT-C与PEth相关性较强（拟r²= 30 ~ 47%）。ROC分析显示对危险用途有很好的辨别能力：AUDIT-10 AUC = 0.80（最佳临界值≥5），AUDIT-C AUC = 0.83（最佳临界值≥4）。XGBoost模型适度改善了分类，产生的auc为0.90 （AUDIT-10）和0.88 (AUDIT-C)，平衡精度为79 - 83%，优于逻辑回归和随机森林。结论：audit -10和AUDIT-C是识别精神科人群有害酒精使用的有效、可获得的工具，在无法进行PEth检测时支持它们作为实际替代方案的作用。机器学习方法提供增量收益，但简单的截止分数在临床上仍然有用。研究结果强调了将简短的酒精筛查纳入精神科护理以指导及时干预的价值，同时考虑到PEth的生物学变异性。

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引用次数: 0

Effectiveness and clinical predictors of a virtual based combined cognitive behavioral and motivational enhancement group therapy for adults with cannabis use disorder 基于虚拟的认知行为和动机增强组合治疗成人大麻使用障碍的有效性和临床预测因素

IF 3.6 2区医学 Q1 PSYCHIATRY

Drug and alcohol dependence

Pub Date : 2026-01-12 DOI: 10.1016/j.drugalcdep.2026.113048

Dhvani D. Mehta , Rachel Goud , Marcos Sanches , Leslie Buckley , Matthew E. Sloan , Julianne Vandervoort , Bernard Le Foll , Narges Beyraghi , Pamela Kaduri , Laurie Zawertailo , Peter Selby , Victor M. Tang

Background

Cannabis use has increased in recent years, while perceptions of harm have declined. Cognitive behavioural therapy (CBT), motivational enhancement therapy (MET), and their combinations (CBT-MET) are evidence-based interventions for CUD, though their effectiveness when delivered virtually is underexplored. This study evaluated the clinical efficacy of a virtual 12-week group-based CBT-MET program in individuals with CUD and examined baseline predictors of treatment response.

Methods

A retrospective analysis was conducted on 116 adults enrolled in a virtual group-based CBT-MET program between 2020 and 2023. Participants completed weekly self-report assessments of cannabis use and biweekly assessments of depression (PHQ-9) and anxiety (GAD-7). Cannabis craving (MCQ) and a measure of problematic cannabis use (CUDIT) were assessed at baseline and post-treatment. Wilcoxon signed-rank tests evaluated changes among completers (≥ 75 % attendance), and linear mixed models identified baseline predictors of change over time.

Results

Of the 116 participants, 79 (68 %) completed the program, indicating high retention. Among completers, significant reductions were observed in cannabis use frequency (p < 0.01), quantity (p < 0.01), craving (p < 0.01), depression (p < 0.01), and anxiety (p = 0.02). Higher baseline cannabis use predicted greater reductions in cannabis frequency and quantity, while higher self-efficacy predicted lower cannabis use frequency across treatment. Individuals with co-occurring substance use disorders other than tobacco demonstrated smaller reductions in cannabis quantity.

Conclusion

Virtual CBT-MET was feasible and led to significant reductions in cannabis use and psychiatric symptoms among individuals with CUD. Baseline cannabis use patterns and self-efficacy were key predictors of reduction in cannabis use, highlighting the need for personalized approaches in future interventions.

近年来，大麻的使用有所增加，而对其危害的认识却有所下降。认知行为疗法（CBT）、动机增强疗法（MET）及其组合疗法（CBT-MET）是基于证据的CUD干预措施，尽管它们的有效性尚未得到充分探索。本研究评估了一个虚拟的12周基于小组的CBT-MET项目在CUD患者中的临床疗效，并检查了治疗反应的基线预测因素。方法对2020年至2023年间参加虚拟分组CBT-MET项目的116名成年人进行回顾性分析。参与者完成了每周一次的大麻使用自我报告评估，以及两周一次的抑郁（PHQ-9）和焦虑（GAD-7）评估。在基线和治疗后评估大麻渴望（MCQ）和问题大麻使用（CUDIT）的测量。Wilcoxon符号秩检验评估了完成者（≥75%出勤率）的变化，线性混合模型确定了随时间变化的基线预测因子。结果在116名参与者中，有79人（68%）完成了课程，表明保留率很高。在完成者中，大麻使用频率（p < 0.01）、数量（p < 0.01）、渴望（p < 0.01）、抑郁（p < 0.01）和焦虑（p = 0.02）显著降低。较高的基线大麻使用量预示着大麻使用频率和数量的更大减少，而较高的自我效能预示着整个治疗过程中大麻使用频率的降低。同时患有除烟草以外其他物质使用障碍的个人大麻数量减少幅度较小。结论虚拟CBT-MET是可行的，可以显著减少CUD患者的大麻使用和精神症状。基线大麻使用模式和自我效能是减少大麻使用的关键预测因素，突出表明在今后的干预措施中需要采取个性化的方法。

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引用次数: 0

β-Nicotyrine and e-cigarette abuse liability II: Behavioral economic demand and intracranial self-stimulation in rats β-尼古丁与电子烟滥用倾向II：大鼠的行为经济需求和颅内自我刺激。

IF 3.6 2区医学 Q1 PSYCHIATRY

Drug and alcohol dependence

Pub Date : 2026-01-07 DOI: 10.1016/j.drugalcdep.2026.113025

J.R. Smethells , S. Wilde , P. Muelken , A.C. Harris , M.G. LeSage

Background

Given the prominence of electronic nicotine delivery systems (ENDS), understanding the product characteristics that underlie ENDS abuse liabilty is a public health research priority. β-Nicotyrine (β-Nic) is a uniquely prevalent constituent (up to 25 % of nicotine [Nic] levels) in ENDS aerosols that may contribute to ENDS abuse liability. Previously, we found clinically relevant concentration of β-Nic doubled the elimination half-life and prolong the interoceptive (discriminative stimulus) properties of Nic in rats, but that it had little or no psychoactive effects itself. The present study used i.v. self-administration (23 hrs/day) and intracranial self-stimulation (ICSS) paradigms to further evaluate if β-Nic alone has abuse liability or if it enhances the abuse liability of Nic.

Methods

We examined if β-Nic (> 25 % of Nic levels) substitutes for Nic (0.03 mg/kg/inf) during drug self-administration, and whether combinations of Nic and β-Nic alter the acquisition and behavioral economic demand of i.v. Nic. Reinforcement-enhancing and aversive effects of β-Nic alone or in combination with Nic were also evaluated using ICSS.

Results

Moderately high β-Nic doses (0.03 & 0.10 mg/kg/inf) increased demand for Nic (0.03 mg/kg/inf). β-Nic alone did not maintain self-administration, affect ICSS, or influence the effects of Nic on ICSS.

Conclusion

β-Nic itself does not have abuse potential in either i.v. self-administration or ICSS models, but it does increase the reinforcing efficacy of self-administered Nic. As such, β-Nic may play a role in the abuse liability of ENDS, which has important treatment and regulatory implications.

背景：鉴于电子尼古丁传递系统（ENDS）的重要性，了解ENDS滥用责任背后的产品特性是公共卫生研究的优先事项。β-烟碱（β-Nic）是ENDS气溶胶中一种独特的普遍成分（高达尼古丁[Nic]含量的25%），可能导致ENDS滥用。在此之前，我们发现临床相关浓度的β-Nic在大鼠体内的消除半衰期加倍，并延长Nic的内感受性（区别刺激）特性，但其本身几乎没有或没有精神活性作用。本研究采用自我静脉给药（23小时/天）和颅内自我刺激（ICSS）模式进一步评估β-Nic是否单独存在滥用倾向或是否增加了Nic的滥用倾向。方法：观察β-Nic （β-Nic占Nic水平的25%）在给药过程中是否能替代Nic (0.03mg/kg/inf)，以及β-Nic与β-Nic联用是否会改变静脉注射Nic的获取和行为经济需求。用ICSS评价β-Nic单独或与Nic联合的增强效应和厌恶效应。结果：中等高β-Nic剂量（0.03和0.10mg/kg/inf）增加了对Nic的需求（0.03mg/kg/inf）。单独β-Nic不能维持自我给药、影响ICSS或影响Nic对ICSS的作用。结论：β-Nic本身在静脉给药和ICSS模型中均不存在滥用的可能，但β-Nic能提高自我给药的补强作用。因此，β-Nic可能在ENDS的滥用责任中发挥作用，这具有重要的治疗和监管意义。

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引用次数: 0

Gabapentin utilization and nontherapeutic use relative to select comparator drugs, United States 2013–2022 美国2013-2022年加巴喷丁的使用和非治疗性使用相对于选择比较药物

IF 3.6 2区医学 Q1 PSYCHIATRY

Drug and alcohol dependence

Pub Date : 2026-01-07 DOI: 10.1016/j.drugalcdep.2026.113026

Sara Karami , Jae Wook Yoo, Corinne Woods, Saranrat Wittayanukorn Conrad, Jana McAninch, Tamra Meyer, Celeste Mallama

Background

Gabapentin prescribing has increased over the past decade, including as part of efforts to reduce opioid analgesic use. Data on trends and scope of harms from gabapentin nontherapeutic use (NTU) are needed.

Methods

For gabapentin and selected contextual comparator drugs (pregabalin, diazepam, oxycodone), we describe utilization using a dispensed prescriptions all-payer claims database (2013–2023) and adverse events for NTU exposure cases using Poison Center data (2013–2022). We then calculated utilization-adjusted NTU exposure case rates, based on prescription units dispensed, for each drug.

Results

From 2013–2023, the number of units (e.g., tablets) dispensed increased for gabapentin (4.4–7.7 billion [B]) and pregabalin (0.68–1.0B) and decreased for diazepam (0.7–0.3B) and oxycodone (4.2–2.5B). From 2013–2022, gabapentin NTU exposure cases (N = 8729) exceeded pregabalin (N = 1257) and diazepam (N = 2452) but not oxycodone (N = 17,808) NTU exposure cases. Gabapentin NTU exposure cases and utilization-adjusted NTU exposure case rates increased from 2013-2017, then decreased through 2022; trends were similar for pregabalin, decreased throughout for diazepam, and fluctuated for oxycodone. From 2013–2022, gabapentin annual utilization-adjusted NTU exposure case rates most closely resembled those of pregabalin (range: 0.09–0.16 versus 0.08–0.22 exposure cases per million units dispensed), while diazepam and oxycodone exhibited higher rates (range: 0.33–0.55 and 0.39–0.85 exposure cases per million units dispensed, respectively). Most gabapentin (68 %) and comparator (55–80 %) NTU exposure cases involved multiple substances, particularly opioids, resulting in more severe clinical outcomes than single-substance exposures.

Conclusions

Our study highlights the harms from gabapentin NTU, particularly in combination with opioids.

背景加巴喷丁的处方在过去十年中有所增加，包括作为减少阿片类镇痛药使用的努力的一部分。需要关于加巴喷丁非治疗性使用（NTU）的趋势和危害范围的数据。方法对于加巴喷丁和选定的对照药物（普瑞巴林、地西泮、羟考酮），我们使用处方全付款人索赔数据库（2013-2023年）描述其使用情况，并使用毒物中心数据（2013-2022年）描述NTU暴露病例的不良事件。然后，我们根据分配的处方单位计算每种药物的利用率调整后的NTU暴露病例率。结果2013-2023年，加巴喷丁（44 - 77亿[B]）和普瑞巴林（0.68-1.0B）的用药单位（如片）增加，地西泮（0.7-0.3B）和羟考酮（4.2-2.5B）的用药单位（如片）减少。2013-2022年，加巴喷丁NTU暴露病例（N = 8729）超过普瑞巴林（N = 1257）和地西泮（N = 2452），但不超过羟考酮（N = 17808） NTU暴露病例。加巴喷丁NTU暴露病例和利用调整后的NTU暴露病例率从2013-2017年上升，然后到2022年下降；普瑞巴林的趋势相似，地西泮的趋势下降，羟考酮的趋势波动。2013-2022年，加巴喷丁年度利用调整后的NTU暴露病例率与普瑞巴林最接近（范围：0.09-0.16和0.08-0.22），而地西泮和羟考酮的暴露病例率更高（范围：0.33-0.55和0.39-0.85）。大多数加巴喷丁（68%）和比较剂（55 - 80%）NTU暴露病例涉及多种物质，特别是阿片类药物，导致比单一物质暴露更严重的临床结果。结论我们的研究强调了加巴喷丁NTU的危害，特别是与阿片类药物合用。

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引用次数: 0

Use of gabapentin with or without a prescription in substance use treatment settings: A national analysis of urine drug testing data, 2016–2023 加巴喷丁在药物使用治疗环境中的使用：2016-2023年全国尿检数据分析

IF 3.6 2区医学 Q1 PSYCHIATRY

Drug and alcohol dependence

Pub Date : 2026-01-03 DOI: 10.1016/j.drugalcdep.2026.113020

Matthew S. Ellis , Penn Whitley , Steven D. Passik

Background

Gabapentin prescriptions have increased due to off-label use, including managing withdrawal/comorbidities in substance use disorder (SUD) treatment, despite gaps in evidence bases and corresponding increases in nonmedical use. This study sought to identify trends in gabapentin use with and without a prescription in SUD treatment settings.

Methods

This retrospective, serial cross-sectional study analyzed urine drug tests (UDT) (n = 206,161) ordered from 2053 SUD settings in all 50 U.S. states, from 2016 to 2023. Specimens were analyzed by liquid chromatography–tandem mass spectrometry to assess positivity for gabapentin and other prescription and illicit drugs, with prescribed medications documented in requisitions. Multivariable regression assessed characteristics/diagnoses associated with gabapentin use with and without a prescription.

Results

Gabapentin was prescribed to 5.9 % of the sample, increasing from 3.9 % in 2016–7.6 % in 2023. Use of gabapentin without a prescription was identified in 11.3 % of the sample, decreasing from 15.2 % to 9.9 %. Gabapentin prescribing was associated with anxiety/mood disorders, insomnia, pain, and sedative, alcohol, or stimulant SUDs. Use without a prescription was associated with anxiety/mood disorders, and sedative or opioid SUDs. Detection was higher across all illicit substances among those engaged in gabapentin use without a prescription.

Conclusions

Gabapentin prescribing significantly increased in SUD treatment settings despite a lack of strong evidence bases for its utility. While rates of gabapentin use outside a prescription were nearly double than for prescribed use, this appears to be decreasing over time. Polysubstance use and potential gaps in multimorbidity care may contribute to the use of gabapentin without a prescription.

背景：加巴喷丁的处方由于标签外使用而增加，包括治疗物质使用障碍（SUD）治疗中的戒断/合并症，尽管证据基础存在差距，非医疗使用也相应增加。本研究旨在确定加巴喷丁在SUD治疗中有处方和无处方使用的趋势。方法：这项回顾性、连续横断面研究分析了美国50个地区2053个SUD设置的尿药检（UDT）（n = 206161）各州，从2016年到2023年。采用液相色谱-串联质谱法对标本进行分析，以评估加巴喷丁和其他处方药和非法药物的阳性反应，并在申请单中记录处方药。多变量回归评估了加巴喷丁在有和没有处方的情况下使用的相关特征/诊断。结果：加巴喷丁的处方率为5.9%，较2016年的3.9%（2023年为7.6%）有所上升。在11.3%的样本中发现未经处方使用加巴喷丁，从15.2%下降到9.9%。加巴喷丁处方与焦虑/情绪障碍、失眠、疼痛、镇静、酒精或兴奋剂sud有关。无处方使用与焦虑/情绪障碍、镇静或阿片类药物相关。在无处方使用加巴喷丁的人群中，所有非法物质的检出率更高。结论：加巴喷丁的处方在SUD治疗环境中显著增加，尽管缺乏其效用的有力证据基础。虽然加巴喷丁非处方用药的比例几乎是处方用药的两倍，但随着时间的推移，这一比例似乎正在下降。多物质使用和多病护理的潜在差距可能导致加巴喷丁无处方使用。

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引用次数: 0

Effects of acute adolescent stress on the acquisition and maintenance of intravenous oxycodone self-administration in male and female rats 青春期急性应激对雄性和雌性大鼠静脉注射羟考酮获得和维持的影响

IF 3.6 2区医学 Q1 PSYCHIATRY

Drug and alcohol dependence

Pub Date : 2026-01-03 DOI: 10.1016/j.drugalcdep.2026.113030

Corinne A. Gallagher , Daniel J. Chandler , Daniel F. Manvich

Background

The persistent threat of the opioid epidemic warrants investigation into risk factors that predispose individuals to opioid use disorder (OUD). Adolescent stress has been linked to enhanced risk for OUD in humans, however, attempts to model this preclinically have yielded mixed results. Additionally, few studies have explored whether adolescent stress modulates the reinforcing effects of prescription opioids. Here we investigate the impact of acute adolescent stress on oxycodone self-administration in male and female rats.

Methods

Adolescent male and female rats underwent acute restraint stress during concurrent exposure to predator odor, or control handling. Approximately one week later, subjects were allowed to acquire IV oxycodone self-administration (0.03 mg/kg/inf) over 10 sessions (2 h/day) under a fixed-ratio 1 (FR1) schedule of reinforcement. Following three additional FR1 sessions and seven sessions under FR3, rats underwent two progressive-ratio tests (0.03 mg/kg/inf and 0.06 mg/kg/inf, respectively). Separate groups of adolescent rats underwent similar experimental manipulations but were trained on sucrose reinforcement.

Results

Adolescent stress did not affect the rate of acquisition of IV oxycodone self-administration. However, oxycodone self-administration escalated during post-acquisition FR1 sessions and remained elevated during FR3 sessions in stressed rats as compared to unstressed controls. Adolescent stress exposure did not affect responding during progressive-ratio tests, nor did it affect any measure of sucrose pellet reinforcement.

Conclusions

The present results are the first to demonstrate adolescent stress-induced enhancement of oxycodone reinforcement in rats and provide a preclinical model for investigating the neurobiological mechanisms by which adolescent stress increases vulnerability for prescription opioid misuse.

背景：阿片类药物流行的持续威胁需要调查导致个体易患阿片类药物使用障碍（OUD）的危险因素。青少年压力与人类OUD风险增加有关，然而，在临床前建立这种模型的尝试产生了不同的结果。此外，很少有研究探讨青少年压力是否调节处方阿片类药物的强化作用。本文研究了急性青春期应激对雄性和雌性大鼠羟考酮自我给药的影响。方法雄性和雌性青春期大鼠在同时暴露于捕食者气味或对照处理时产生急性约束应激。大约一周后，受试者被允许在固定比率1 （FR1）强化计划下进行静脉注射羟考酮自我给药（0.03 mg/kg/inf），分10次（2小时/天）。在FR1下增加3次和FR3下增加7次后，大鼠进行了两次进行性比率测试（分别为0.03 mg/kg/inf和0.06 mg/kg/inf）。单独的青少年大鼠组进行了类似的实验操作，但接受了蔗糖强化训练。结果青少年应激不影响静脉注射羟考酮的获得率。然而，与非应激对照组相比，应激大鼠的羟考酮自我给药量在获得后FR1会话期间上升，在FR3会话期间保持升高。青少年压力暴露不影响在递进比率测试中的反应，也不影响任何蔗糖颗粒强化的测量。结论本研究首次证实了青春期应激诱导大鼠羟考酮强化增强，并为研究青春期应激增加处方阿片类药物滥用易感性的神经生物学机制提供了临床前模型。

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引用次数: 0

Impact of metabolic syndrome components on fibrosis severity and mortality in alcohol-related liver disease 代谢综合征成分对酒精相关性肝病纤维化严重程度和死亡率的影响

IF 3.6 2区医学 Q1 PSYCHIATRY

Drug and alcohol dependence

Pub Date : 2026-01-03 DOI: 10.1016/j.drugalcdep.2026.113027

Kodjo Kunale Abassa , Hongsheng Yu , Shuyan Tan , Mingkai Li , Zhenwei Zhong , Haoxiong Zhou , Yunwei Guo

Background/ Aim

The prognosis of concomitant chronic liver disease and metabolic syndrome (MetS) has been established. However, data on the impact of individual MetS components on mortality in patients with alcohol-related liver cirrhosis (ALC) remain scarce.

Methods

A cross-sectional cohort of 120 patients with alcohol-related liver disease (ArLD) and a longitudinal cohort of 789 patients with ALC were retrospectively enrolled. Patients were categorized into three groups based on the number of MetS components present: Group 1 included patients with no MetS components; Group 2 included those with 1 or 2 components; and Group 3 included patients with ≥ 3 components. Kaplan–Meier and regression analyses were performed to assess the severity of fibrosis in patients with ArLD and to compare mortality outcomes among those with ALC.

Results

Patients with ArLD in group 3 had the highest odds of significant fibrosis [adjusted OR = 2.80 (95 % CI: 1.01–7.76)] and advanced fibrosis [adjusted OR = 17.1 (95 % CI: 3.58–81.9)]. Elevated glucose levels were the only independent factor associated with both significant and advanced fibrosis. Furthermore, the presence of ≥ 3 MetS components predicted higher all-cause mortality (adjusted HR = 5.91, 95 % CI: 2.98–11.75) and liver-related mortality (adjusted HR = 4.73, 95 % CI: 2.05–10.94) in patients with ALC, with glucose and triglycerides levels emerging as the most significant independent risk factors. The presence of diabetes further exacerbated mortality risk in patients with ≥ 3 MetS components.

Conclusions

MetS, particularly abnormal fasting glucose, exacerbated liver fibrosis and significantly worsened mortality in patients with ArLD.

背景/目的慢性肝病合并代谢综合征（MetS）的预后已经确定。然而，关于个体MetS成分对酒精相关性肝硬化（ALC）患者死亡率影响的数据仍然很少。方法回顾性纳入120例酒精相关性肝病（ArLD）患者的横断面队列和789例ALC患者的纵向队列。根据存在的MetS成分的数量将患者分为三组：第一组包括没有MetS成分的患者；第2组为1组分或2组分；第3组包括≥3种成分的患者。Kaplan-Meier和回归分析评估了ArLD患者纤维化的严重程度，并比较了ALC患者的死亡率结果。结果第3组ArLD患者发生显著纤维化（调整OR = 2.80 (95% CI: 1.01-7.76)）和晚期纤维化（调整OR = 17.1 (95% CI: 3.58-81.9)）的几率最高。血糖水平升高是唯一与显著和晚期纤维化相关的独立因素。此外，≥3个MetS成分的存在预示着ALC患者更高的全因死亡率（校正HR = 5.91, 95% CI: 2.98-11.75）和肝脏相关死亡率（校正HR = 4.73, 95% CI: 2.05-10.94），其中葡萄糖和甘油三酯水平成为最重要的独立危险因素。糖尿病的存在进一步加剧了具有≥3个MetS成分的患者的死亡风险。结论smets，尤其是空腹血糖异常，加重了ArLD患者的肝纤维化，并显著加重了死亡率。

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引用次数: 0

Test-retest reliability of mgTHC consumption in the self-administered Cannabis Exposure Index (CEI) 自用大麻暴露指数（CEI）中mgTHC消费的重测信度

IF 3.6 2区医学 Q1 PSYCHIATRY

Drug and alcohol dependence

Pub Date : 2026-01-03 DOI: 10.1016/j.drugalcdep.2026.113028

Deborah S. Hasin , Jacob Borodovsky , Melanie Wall , Mohammad I. Habib , Eilis Murphy , Jun Liu , Malki Stohl , Cara A. Struble , Ofir Livne , Eliana Greenstein , Efrat Aharonovich , Caroline G. Wisell , Alan J. Budney

Introduction

Cannabis legalization and adult use are expanding across the U.S., requiring greater knowledge of cannabis risks and benefits. Cannabis use measures traditionally assessed frequency but omitted quantity, an essential element of consumption that is complicated by increasingly varied cannabis products and use patterns. To address this, we developed the self-administered CEI (Cannabis Exposure Inventory) to determine milligrams of THC used per using day (mgTHC/using day). In this study, we examined the test-retest reliability of the CEI mgTHC measure and key component items (i.e., products, routes of administration).

Methods

Participants were recruited through social media (Facebook and Instagram ads) and Qualtrics Research panels. Eligible participants (n = 511) completed initial and retest CEI surveys. Chance-corrected agreement between initial and retest surveys on mean mgTHC/using day was indicated with Intraclass Correlation Coefficients (ICCs); kappa (k) indicated reliability of key dichotomous component variables.

Results

Overall, ICC for mean mgTHC/using day= 0.77, indicating substantial reliability. In demographic subgroups, ICCs were 0.54 (‘other’ race/ethnicity) to 0.86 (Hispanic). ICCs for mean mgTHC/using day among those who used for medical-only, recreational-only and medical-plus-recreational reasons were 0.72, 0.69 and 0.77, respectively; ICCs for those in non-legalized, medical-only and medical-plus-recreational states were 0.70, 0.92 and 0.75, respectively. Binary measures generally exhibited substantial reliability (mean k, last 30 days=0.74; last 7 days=0.73).

Conclusion

Findings support the CEI mgTHC measure as a reliable instrument for quantifying cannabis use, addressing a critical gap in cannabis measurement. This measure offers a promising approach to provide urgently-needed information on potential harms and benefits of THC exposure.

大麻合法化和成人使用正在美国各地扩大，需要更多的大麻风险和好处的知识。大麻使用措施传统上评估频率，但忽略了数量，这是消费的一个基本要素，而大麻产品和使用模式的日益多样化使其复杂化。为了解决这个问题，我们开发了自我管理的CEI（大麻暴露清单）来确定每个使用日使用的四氢大麻酚毫克数（mgTHC/使用日）。在本研究中，我们检验了CEI mgTHC测量和关键成分项目（即产品，给药途径）的重测信度。方法通过社交媒体（Facebook和Instagram广告）和Qualtrics Research小组招募参与者。符合条件的参与者（n = 511）完成了初始和复测CEI调查。用类内相关系数（ICCs）表明，初次和复测调查中平均mgTHC/使用日的一致性经过机会校正；Kappa (k)表示关键二分类成分变量的信度。结果总体而言，平均mgTHC/使用日的ICC = 0.77，具有较高的可靠性。在人口统计学亚组中，icc为0.54（“其他”种族/民族）至0.86（西班牙裔）。仅用于医疗、仅用于娱乐和医疗加娱乐的患者的平均mgTHC/使用日icc分别为0.72、0.69和0.77；非合法化州、纯医疗州和医疗加娱乐州的ICCs分别为0.70、0.92和0.75。二元测量通常表现出相当高的信度（平均k，最近30天=0.74；最近7天=0.73）。结论研究结果支持CEI mgTHC测量作为量化大麻使用的可靠工具，解决了大麻测量的关键空白。这项措施提供了一种很有希望的方法，可以提供有关四氢大麻酚暴露的潜在危害和益处的迫切需要的信息。

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引用次数: 0