Drug and alcohol dependence最新文献_第4页

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

Explainable machine learning for predicting opioid-related aberrant behavior: A multimodal approach using clinical text and structured data 预测阿片类药物相关异常行为的可解释机器学习：使用临床文本和结构化数据的多模式方法。

IF 3.6 2区医学 Q1 PSYCHIATRY

Drug and alcohol dependence

Pub Date : 2026-01-03 DOI: 10.1016/j.drugalcdep.2026.113021

Mubashir Farooq , Asif Ali Banka

Purpose

The rising misuse of opioids, overdose deaths, and opioid use disorder (OUD) associated with chronic pain treatment present a significant public health challenge, continuing to fuel the opioid epidemic. Since opioid-related aberrant behaviours (ORABs) are early indicators of potential misuse, it is crucial to develop advanced predictive models for safe opioid management.

Methods

This study introduces an explainable machine learning framework to predict confirmed aberrant behaviours by integrating clinical text with structured data from the Opioid-Related Aberrant Behavior Detection Dataset (ODD). A multimodal, clinically applicable, and explainable predictive model is developed in this study. The study used GloVe (Global Vectors for Word Representation) embeddings and ClinicalBERT contextual embeddings for EHR text, applied Synthetic Minority Oversampling Technique (SMOTE) for data balancing, and trained various machine learning algorithms.

Results

The performance of models was assessed using multiple evaluation metrics. Additionally, SHAP (Shapley Additive exPlanations) was employed to address explainability concerns and to assess feature importance via an ablation study. Results demonstrated that Opioid Risk Ensemble achieved an AUROC of 96.0 % and an accuracy of 98.8 %, indicating that opioids, benzodiazepine prescriptions, and factors related to the central nervous system are significant predictors, as confirmed by SHAP analysis. Furthermore, the Opioid Risk Neural Network, applied with ClinicalBERT embeddings, achieved an AUROC of 98.75 % and an accuracy of 98.47 % on the held-out test set, with SHAP interpretation providing insights into the most influential clinical note terms.

Conclusion

The multimodal, explainable AI approach will be valuable for modern healthcare decision-making, supporting risk prediction for ORABs.

目的：与慢性疼痛治疗相关的阿片类药物滥用、过量死亡和阿片类药物使用障碍（OUD）的增加是一项重大的公共卫生挑战，继续助长阿片类药物的流行。由于阿片类药物相关异常行为（ORABs）是潜在滥用的早期指标，因此开发先进的阿片类药物安全管理预测模型至关重要。方法：本研究引入了一个可解释的机器学习框架，通过整合临床文本和阿片类药物相关异常行为检测数据集（ODD）的结构化数据来预测已确认的异常行为。本研究建立了一个多模态、临床适用且可解释的预测模型。该研究使用GloVe （Global Vectors for Word Representation）嵌入和ClinicalBERT上下文嵌入用于EHR文本，应用合成少数派过采样技术（SMOTE）进行数据平衡，并训练了各种机器学习算法。结果：采用多种评价指标对模型的性能进行评价。此外，采用Shapley加性解释（Shapley Additive explanation）来解决可解释性问题，并通过消融研究评估特征的重要性。结果表明，阿片类药物风险集合的AUROC为96.0%，准确率为98.8%，表明阿片类药物、苯二氮卓类药物处方和与中枢神经系统相关的因素是重要的预测因子，SHAP分析证实了这一点。此外，应用ClinicalBERT嵌入的阿片类风险神经网络在hold out测试集中实现了98.75%的AUROC和98.47%的准确率，SHAP解释提供了对最具影响力的临床笔记术语的见解。结论：多模式、可解释的人工智能方法将为现代医疗保健决策提供价值，支持orab的风险预测。

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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

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

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。

{"title":"Test-retest reliability of mgTHC consumption in the self-administered Cannabis Exposure Index (CEI)","authors":"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","doi":"10.1016/j.drugalcdep.2026.113028","DOIUrl":"10.1016/j.drugalcdep.2026.113028","url":null,"abstract":"<div><h3>Introduction</h3><div>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).</div></div><div><h3>Methods</h3><div>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.</div></div><div><h3>Results</h3><div>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).</div></div><div><h3>Conclusion</h3><div>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.</div></div>","PeriodicalId":11322,"journal":{"name":"Drug and alcohol dependence","volume":"279 ","pages":"Article 113028"},"PeriodicalIF":3.6,"publicationDate":"2026-01-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145974310","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Leveraging a digital health intervention to improve recovery outcomes among people with substance misuse experiencing housing insecurity 利用数字健康干预措施，改善住房不安全的药物滥用者的康复结果

IF 3.6 2区医学 Q1 PSYCHIATRY

Drug and alcohol dependence

Pub Date : 2026-01-03 DOI: 10.1016/j.drugalcdep.2026.113022

Vidya Eswaran , Fanghong Dong , Xiao Li , Hannah S. Szlyk , Nathaniel A. Dell , Erin Kasson , Jessica Williams , Patricia A. Cavazos-Rehg

Background

People with substance use disorders (PwSUD) who experience housing insecurity have disproportionate overdose deaths. Digital interventions may improve care among PwSUD, but evidence specifically for housing-insecure PwSUD, who face unique barriers, remains limited.

Methods

We examined the efficacy of a mHealth tool (uMAT-R) among people who have misused substances and reported current housing insecurity. Substance use, cravings, access to basic needs, social disconnection, and digital literacy were assessed at baseline and 1 month and compared by uMAT-R use. Generalized estimating equations were employed to assess the efficacy of the intervention.

Results

Participants who logged into uMAT-R were less likely to report other non-opioid illicit drug use (aOR (95 %CI): 0.49(0.29, 0.85)). Similarly, those who messaged the e-coach were less likely to report using opioids (aOR(95 %CI): 0.39(0.21, 0.73)) or other illicit drugs (aOR (95 % CI): 0.53(0.30, 0.92)) during past 30-days. Significant interaction effects were found in uMAT-R use by time in cravings (Coef (95 %CI): −2.11(-4.07, −0.17)) and perceived burdensomeness (Coef(95 %CI): −2.62 (-4.91, −0.36)). Messaging an e-coach by time was significantly associated with improved health literacy (Coef (95 %CI): 0.61(0.05, 1.18)) and decreased thwarted belongingness (Coef(95 %CI): −0.36 (-0.71, −0.02).

Conclusion

Our preliminary findings suggest that people who have misused substances and experience housing insecurity may benefit from uMAT-R, which was associated with improved recovery outcomes. Future research is needed to examine the unique barriers experienced by this population and how mHealth tools can be used to provide tailored, equitable access to supportive resources to reduce barriers and promote long-term recovery.

经历住房不安全的物质使用障碍（PwSUD）患者有不成比例的过量死亡。数字干预可能会改善残疾人的护理，但专门针对面临独特障碍的住房不安全的残疾人的证据仍然有限。方法我们检查了移动健康工具（uMAT-R）在滥用药物和报告当前住房不安全的人群中的功效。在基线和1个月时评估物质使用、渴望、基本需求获取、社会脱节和数字素养，并与uMAT-R使用情况进行比较。采用广义估计方程来评估干预的有效性。结果登录uMAT-R的参与者报告其他非阿片类非法药物使用的可能性较小(aOR （95% CI): 0.49(0.29, 0.85)）。同样，那些给电子教练发信息的人在过去30天内报告使用阿片类药物(aOR（95% CI): 0.39(0.21, 0.73)）或其他非法药物(aOR（95% CI): 0.53(0.30, 0.92)）的可能性较小。在渴望使用uMAT-R的时间(Coef（95% CI): - 2.11(-4.07, - 0.17)）和感知负担(Coef（95% CI): - 2.62(-4.91, - 0.36)）中发现了显著的交互效应。按时间向电子教练发送信息与提高健康素养(Coef（95% CI): 0.61(0.05, 1.18)）和减少受挫归属感(Coef(95% CI): - 0.36（-0.71, - 0.02）显著相关。结论我们的初步研究结果表明，滥用药物和经历住房不安全的人可能受益于uMAT-R，这与改善的康复结果有关。未来的研究需要检查这一人群所经历的独特障碍，以及如何使用移动健康工具来提供量身定制的、公平的支持性资源，以减少障碍并促进长期康复。

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引用次数: 0

Developmental windows of vulnerability: Substance-specific effects of prenatal exposure timing on child psychopathology 脆弱性的发育窗口：产前暴露时间对儿童精神病理的物质特异性影响

IF 3.6 2区医学 Q1 PSYCHIATRY

Drug and alcohol dependence

Pub Date : 2026-01-03 DOI: 10.1016/j.drugalcdep.2026.113029

Qiaojun Li , Zhen Pang , Yansong Lu , Lu Jiang , Mengyao Sun , Jiayuan Xu

Background

Prenatal alcohol, tobacco, and cannabis exposure are known risks for childhood psychopathology symptoms, but gaps persist in identifying substance-specific developmental vulnerability windows. Exposure timing relative to maternal pregnancy awareness may alter outcomes, yet this temporal specificity remains unclarified, limiting targeted risk assessment and prevention.

Methods

Data from 7777 children in the Adolescent Brain Cognitive Development Study (enrolled 2016–2018) were analyzed. Prenatal substance exposure timing was categorized as pre-awareness (exposure before maternal awareness of pregnancy) and post-awareness (exposure after maternal awareness of pregnancy). Six domains of childhood psychopathology symptoms were assessed via the Child Behavior Checklist (CBCL). Linear mixed-effects models were applied to investigate the timing effects of prenatal substance exposure on childhood psychopathology symptoms, adjusting for covariates.

Results

The analysis revealed distinct temporal patterns of risk for each substance. Childhood psychopathology symptoms were specifically linked to pre-awareness exposure for alcohol and post-awareness exposure for cannabis. In contrast, post-awareness alcohol use and pre-awareness cannabis use showed no significant associations. Prenatal tobacco exposure conferred modest risks across all timings without temporal divergence.

Conclusions

Prenatal substance exposure has substance-specific, timing-dependent effects on childhood psychopathology relative to maternal pregnancy awareness. Findings support distinct developmental vulnerability windows, highlighting the need to include substance type and timing in public health guidelines and clinical risk stratification.

背景产前酒精、烟草和大麻暴露是儿童精神病理症状的已知风险，但在确定特定物质的发育脆弱性窗口方面仍然存在差距。与孕妇妊娠意识相关的暴露时间可能会改变结果，但这种时间特异性仍不明确，限制了有针对性的风险评估和预防。方法对参与2016-2018年青少年大脑认知发展研究的7777名儿童的数据进行分析。产前物质暴露时间分为前意识（在母亲意识到怀孕之前暴露）和后意识（在母亲意识到怀孕之后暴露）。通过儿童行为检查表（CBCL）评估儿童精神病理症状的六个领域。采用线性混合效应模型，对协变量进行调整，研究产前物质暴露对儿童精神病理症状的时间效应。结果分析揭示了每种物质不同的风险时间模式。儿童精神病理症状与意识前接触酒精和意识后接触大麻特别相关。相比之下，意识觉醒后饮酒和意识觉醒前吸食大麻没有显著关联。产前烟草暴露在所有时间都具有适度的风险，没有时间差异。结论产前物质暴露对母亲妊娠意识相关的儿童精神病理具有物质特异性、时间依赖性的影响。研究结果支持不同的发育脆弱性窗口，强调需要在公共卫生指南和临床风险分层中包括物质类型和时间。

{"title":"Developmental windows of vulnerability: Substance-specific effects of prenatal exposure timing on child psychopathology","authors":"Qiaojun Li , Zhen Pang , Yansong Lu , Lu Jiang , Mengyao Sun , Jiayuan Xu","doi":"10.1016/j.drugalcdep.2026.113029","DOIUrl":"10.1016/j.drugalcdep.2026.113029","url":null,"abstract":"<div><h3>Background</h3><div>Prenatal alcohol, tobacco, and cannabis exposure are known risks for childhood psychopathology symptoms, but gaps persist in identifying substance-specific developmental vulnerability windows. Exposure timing relative to maternal pregnancy awareness may alter outcomes, yet this temporal specificity remains unclarified, limiting targeted risk assessment and prevention.</div></div><div><h3>Methods</h3><div>Data from 7777 children in the Adolescent Brain Cognitive Development Study (enrolled 2016–2018) were analyzed. Prenatal substance exposure timing was categorized as pre-awareness (exposure before maternal awareness of pregnancy) and post-awareness (exposure after maternal awareness of pregnancy). Six domains of childhood psychopathology symptoms were assessed via the Child Behavior Checklist (CBCL). Linear mixed-effects models were applied to investigate the timing effects of prenatal substance exposure on childhood psychopathology symptoms, adjusting for covariates.</div></div><div><h3>Results</h3><div>The analysis revealed distinct temporal patterns of risk for each substance. Childhood psychopathology symptoms were specifically linked to pre-awareness exposure for alcohol and post-awareness exposure for cannabis. In contrast, post-awareness alcohol use and pre-awareness cannabis use showed no significant associations. Prenatal tobacco exposure conferred modest risks across all timings without temporal divergence.</div></div><div><h3>Conclusions</h3><div>Prenatal substance exposure has substance-specific, timing-dependent effects on childhood psychopathology relative to maternal pregnancy awareness. Findings support distinct developmental vulnerability windows, highlighting the need to include substance type and timing in public health guidelines and clinical risk stratification.</div></div>","PeriodicalId":11322,"journal":{"name":"Drug and alcohol dependence","volume":"279 ","pages":"Article 113029"},"PeriodicalIF":3.6,"publicationDate":"2026-01-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145923354","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0