Drug and alcohol dependence最新文献_第4页

Safety, tolerability, and drug-drug interactions of NYX-783 and oxycodone in persons using opioids recreationally: Preliminary results from a randomized, double-blind, placebo-controlled phase 1 study 在娱乐性阿片类药物使用者中，NYX-783和羟考酮的安全性、耐受性和药物相互作用：一项随机、双盲、安慰剂对照的1期研究的初步结果

IF 3.6 2区医学 Q1 PSYCHIATRY

Drug and alcohol dependence

Pub Date : 2026-02-01 Epub Date: 2026-01-15 DOI: 10.1016/j.drugalcdep.2026.113041

Zachary M. Harvanek , Marcella M. Mignosa , Razi Kitaneh , Henrique N.P. Oliva , Anna Borelli , Emalee Dauginikas , Nia Fogelman , Elcin Sakmar , Jane Taylor , Ralph DiLeone , Rajita Sinha , Gustavo A. Angarita

Background

Novel treatments are needed for opioid use disorder (OUD). NYX-783, an NMDA positive allosteric modulator, affects synaptic plasticity and learning, key processes in. Although prior preclinical and studies in healthy humans have established its safety and tolerability, studies are needed in the context of opioid use.

Methods

Nine men who used opioids recreationally and passed a safety session were enrolled in inpatient study. Participants received single doses of NYX-783 (50 mg, 150 mg) and placebo and in combination with two oxycodone doses (15 mg, 30 mg), across six inpatient drug-drug interaction (DDI) sessions in a randomized, double-blind, crossover design. The primary endpoints included cardiovascular and respiratory safety, tolerability, and pharmacokinetics.

Results

No severe nor serious adverse events were reported and 85 % of adverse events were mild. NYX-783 reduced oxycodone’s calmative effects (p < .0005). There was no effect of NYX-783 on feeling drug effect and high, nor wanting, liking, or disliking the drug. For the DDI sessions, there was no significant timepoint-by-NYX-783-by-oxycodone interaction for pulse, systolic & diastolic blood pressure, temperature, pupillary dilation, subjective drug effects, nor electrocardiogram’s segments. There was a significant timepoint-by-NYX-by-oxycodone interaction for plasma NYX plasma levels (F = 3.19; DF = 8; p = 0.003) in which NYX levels were significantly higher when combined with 30 mg of oxycodone vs. 15 mg of oxycodone (p < 0.0001).

Conclusions

NYX-783’s tolerability, safety, capacity to reduce oxycodone’s calmative effects and benign DDI profile offers support for future, larger (i.e., Phase 1B/2 A) trials specifically targeting its safety and therapeutic potential in OUD.

背景：阿片类药物使用障碍（OUD）需要新的治疗方法。NYX-783是一种NMDA阳性变构调节剂，影响突触可塑性和学习。尽管先前的临床前研究和健康人的研究已经确定了其安全性和耐受性，但需要在阿片类药物使用的背景下进行研究。方法将9例娱乐性使用阿片类药物并通过安全测试的男性纳入住院研究。在随机、双盲、交叉设计中，参与者接受单剂量NYX-783 （50 mg、150 mg）和安慰剂，并联合两剂羟考酮（15 mg、30 mg），共6次住院药物-药物相互作用（DDI）治疗。主要终点包括心血管和呼吸安全性、耐受性和药代动力学。结果无严重不良事件发生，85%为轻度不良事件。NYX-783降低了羟考酮的镇静作用（p < .0005）。NYX-783对感觉药物效果和快感没有影响，也没有想要、喜欢或不喜欢药物的影响。对于DDI疗程，nyx -783-羟考酮在脉搏、收缩压和舒张压、温度、瞳孔扩张、主观药物效应和心电图段方面没有显著的时间点相互作用。血浆NYX水平与NYX-羟考酮存在显著的时间点相互作用（F = 3.19; DF = 8; p = 0.003），其中与羟考酮15 mg相比，30 mg羟考酮联合使用NYX水平显著更高（p < 0.0001）。结论snyx -783的耐受性、安全性、降低氧可酮镇静作用的能力和良性DDI特征为未来更大规模的（即1B/ 2a期）试验提供了支持，这些试验专门针对其在OUD中的安全性和治疗潜力。

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引用次数: 0

Association of tobacco and other substance use with nicotine pouch awareness and use in US adolescents 烟草和其他物质使用与美国青少年尼古丁袋意识和使用的关系。

IF 3.6 2区医学 Q1 PSYCHIATRY

Drug and alcohol dependence

Pub Date : 2026-02-01 Epub Date: 2025-12-24 DOI: 10.1016/j.drugalcdep.2025.113016

Dae-Hee Han , Tahsin Rahman , Richard A. Miech , Alyssa F. Harlow , Hongying D. Dai , Junhan Cho , Steve Y. Sussman , Louisiana M. Sanchez , Leah R. Meza , Adam M. Leventhal

Introduction

Evidence on the association between tobacco/nicotine and other substance use (TOSU) and adolescent nicotine pouch (NP) awareness and use is lacking but vital for policy and prevention planning.

Methods

The sample was drawn from the 2023 Monitoring the Future study, a nationally representative survey of U.S. adolescents (8th, 10th, 12th graders). One-third of participants were randomly selected to complete questions on NP awareness and use (lifetime, past 12-month, past 12-month frequency) and past 30-day TOSU measures (yes/no). We estimated risk ratios (RRs) and incident rate ratios (IRRs) to examine the associations between TOSU and NP awareness and use.

Results

Overall (n = 6958; 53.4 % female), 35.4 % reported NP awareness, 2.5 % reported lifetime use, and 1.8 % reported past 12-month use. Past 30-day use of tobacco/nicotine products was each positively associated with NP awareness (RRs:1.42–1.70), lifetime (RRs:7.14–20.40), and past 12-month (RRs:5.84–22.44) use, with the strong associations for youth with vs. without smokeless tobacco use. Cannabis, alcohol, and other drug past 30-day use were each associated with NP awareness (RRs:1.49–1.68), lifetime (RRs:3.47–10.49), and past 12-month (RRs:4.70–15.70) use.

Conclusions

NP awareness and use prevalence were disproportionately high among adolescents with various forms of TOSU in 2023, especially smokeless tobacco. These findings suggest the importance of monitoring NP use among youth with TOSU while recognizing that awareness may also reflect broader marketing, product availability, or incidental exposure. Policy and prevention efforts should address NP use alongside TOSU with established health risks.

关于烟草/尼古丁和其他物质使用（TOSU）与青少年尼古丁袋（NP）意识和使用之间关系的证据缺乏，但对政策和预防规划至关重要。方法：样本来自2023年监测未来研究，这是一项针对美国青少年（8年级，10年级，12年级）的全国代表性调查。随机选择三分之一的参与者完成关于NP意识和使用的问题（寿命，过去12个月，过去12个月的频率）和过去30天的TOSU测量（是/否）。我们估计了风险比（rr）和事故率比（IRRs）来检验TOSU与NP意识和使用之间的关系。结果：总体而言（n = 6958； 53.4%为女性），35.4%报告NP意识，2.5%报告终生使用，1.8%报告过去12个月使用。过去30天烟草/尼古丁制品的使用与NP意识（RRs:1.42-1.70）、终生（RRs:7.14-20.40）和过去12个月（RRs:5.84-22.44）的使用均呈正相关，与无烟烟草使用的青少年有很强的相关性。大麻、酒精和其他药物使用超过30天分别与NP意识（RRs:1.49-1.68）、终生（RRs:3.47-10.49）和过去12个月（RRs:4.70-15.70）使用相关。结论：2023年，各类TOSU青少年（尤其是无烟烟草）的NP知晓率和使用率不成比例地高。这些发现表明，监测青少年TOSU患者NP使用的重要性，同时认识到意识也可能反映了更广泛的市场、产品可用性或偶然接触。政策和预防工作应解决NP和TOSU的使用与确定的健康风险。

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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 : 2026-02-01 Epub 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

Sociodemographic, behavioral, and geospatial factors associated with syringe services program use in San Francisco, California 社会人口、行为和地理空间因素与注射器服务计划在旧金山，加利福尼亚的使用。

IF 3.6 2区医学 Q1 PSYCHIATRY

Drug and alcohol dependence

Pub Date : 2026-02-01 Epub Date: 2026-01-13 DOI: 10.1016/j.drugalcdep.2026.113046

Esther O. Chung , Bradley Ray , Jamie L. Humphrey , Megan Lindstrom , Cariné E. Megerian , Barrot H. Lambdin , Alex H. Kral

Background

Syringe services programs (SSPs) are a cornerstone of preventing infectious disease and overdose for people who use drugs. Given efforts to achieve universal access, we examined factors associated with SSP use, including proximity.

Methods

We used cross-sectional data from 713 people who use drugs across San Francisco, California (September 2023-September 2024). We assessed proximity to an SSP by calculating the walking time between where participants slept the night before and nearest SSP location. We conducted multivariable negative binomial models to explore factors associated with SSP use and assess whether the association between proximity and SSP use was modified by race-ethnicity.

Results

Almost 80 % of participants used an SSP at least once in the past 3 months. Age, race-ethnicity, mode of use, and proximity to SSP were negatively associated with SSP use. Participants who only smoked used SSPs less often than those who used in other ways (adjusted rate ratio [aRR]=0.77, 95 % CI: 0.61–0.97), as well as those more than a 20-minute walk to an SSP (aRR=0.54, 95 % CI: 0.36–0.83). The effect size between walking time to SSP and SSP use was substantially larger for Black participants than non-Black (Black: aRR=0.38, 95 % CI: 0.15–0.60 vs. non-Black: aRR=0.72, 95 % CI: 0.40–1.31).

Conclusions

Geographic distance was a barrier to SSP use, especially for Black participants. SSPs may not reach people who only smoke drugs. SSPs should be added to areas with limited geographic access and include safer smoking supply distribution.

背景：注射器服务计划（ssp）是预防传染病和吸毒过量的人的基石。鉴于实现普遍可及的努力，我们研究了与SSP使用相关的因素，包括邻近性。方法：我们使用了2023年9月至2024年9月在加利福尼亚州旧金山使用药物的713人的横断面数据。我们通过计算参与者前一天晚上睡觉的地方和最近的SSP地点之间的步行时间来评估与SSP的接近程度。我们使用多变量负二项模型来探索与SSP使用相关的因素，并评估邻近性与SSP使用之间的关系是否受到种族的影响。结果：近80%的参与者在过去3个月内至少使用过一次SSP。年龄、种族、使用方式和接近SSP与SSP使用呈负相关。仅吸烟的参与者使用SSP的频率低于以其他方式吸烟的参与者（调整率比[aRR]=0.77, 95% CI: 0.61-0.97），以及步行超过20分钟到SSP的参与者（aRR=0.54, 95% CI: 0.36-0.83）。黑人受试者到SSP的步行时间和使用SSP之间的效应量明显大于非黑人受试者（黑人：aRR=0.38, 95% CI: 0.15-0.60 vs.非黑人：aRR=0.72, 95% CI: 0.40-1.31）。结论：地理距离是使用SSP的障碍，尤其是对黑人参与者。ssp可能无法触及只吸食毒品的人。ssp应增加到地理通道有限的地区，并包括更安全的吸烟供应分配。

{"title":"Sociodemographic, behavioral, and geospatial factors associated with syringe services program use in San Francisco, California","authors":"Esther O. Chung , Bradley Ray , Jamie L. Humphrey , Megan Lindstrom , Cariné E. Megerian , Barrot H. Lambdin , Alex H. Kral","doi":"10.1016/j.drugalcdep.2026.113046","DOIUrl":"10.1016/j.drugalcdep.2026.113046","url":null,"abstract":"<div><h3>Background</h3><div>Syringe services programs (SSPs) are a cornerstone of preventing infectious disease and overdose for people who use drugs. Given efforts to achieve universal access, we examined factors associated with SSP use, including proximity.</div></div><div><h3>Methods</h3><div>We used cross-sectional data from 713 people who use drugs across San Francisco, California (September 2023-September 2024). We assessed proximity to an SSP by calculating the walking time between where participants slept the night before and nearest SSP location. We conducted multivariable negative binomial models to explore factors associated with SSP use and assess whether the association between proximity and SSP use was modified by race-ethnicity.</div></div><div><h3>Results</h3><div>Almost 80 % of participants used an SSP at least once in the past 3 months. Age, race-ethnicity, mode of use, and proximity to SSP were negatively associated with SSP use. Participants who only smoked used SSPs less often than those who used in other ways (adjusted rate ratio [aRR]=0.77, 95 % CI: 0.61–0.97), as well as those more than a 20-minute walk to an SSP (aRR=0.54, 95 % CI: 0.36–0.83). The effect size between walking time to SSP and SSP use was substantially larger for Black participants than non-Black (Black: aRR=0.38, 95 % CI: 0.15–0.60 vs. non-Black: aRR=0.72, 95 % CI: 0.40–1.31).</div></div><div><h3>Conclusions</h3><div>Geographic distance was a barrier to SSP use, especially for Black participants. SSPs may not reach people who only smoke drugs. SSPs should be added to areas with limited geographic access and include safer smoking supply distribution.</div></div>","PeriodicalId":11322,"journal":{"name":"Drug and alcohol dependence","volume":"279 ","pages":"Article 113046"},"PeriodicalIF":3.6,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146021044","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

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 : 2026-02-01 Epub 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

Retreatment with nicotine replacement therapy: Predictors of re-enrolment in a cohort of people who smoke seeking treatment in ambulatory settings 用尼古丁替代疗法进行再治疗：在门诊环境中寻求治疗的吸烟者队列中重新登记的预测因素

IF 3.6 2区医学 Q1 PSYCHIATRY

Drug and alcohol dependence

Pub Date : 2026-02-01 Epub Date: 2026-01-23 DOI: 10.1016/j.drugalcdep.2026.113056

Xue Man , Peter Selby , Laurie Zawertailo , Scott Veldhuizen

Background

People who re-enrol in smoking cessation treatment repeatedly may benefit from more intensive or alternative interventions. We aimed to measure differences across participants in propensity to re-enrol in a large treatment program, to describe re-enrolment patterns, and to examine specific participant characteristics that predict re-enrolment.

Methods

We analyzed 172,050 enrolments into the Ontario-wide Smoking Treatment for Ontario Patients (STOP) program between 2014 and 2023. STOP provides up to 26 weeks of nicotine replacement therapy (NRT) and allows re-enrolment after one year. We used probabilistic deduplication to identify 128,481 unique individuals. To analyze re-enrolment, we fit a mixed-effects Cox proportional hazards survival model for recurrent events, with demographic, clinical, and contextual variables included as fixed effects.

Results

Of all enrolments, 25.3 % (43,569) were repeat entries. Participant-level variance was very high (σ2 =1.66, median hazard ratio = 3.4), indicating large residual individual-level differences in propensity to re-enrol. The strongest predictors of reenrolment were time to first cigarette after waking (p < 0.001), lifetime quit attempts (p < 0.001), type of NRT provided (p < 0.001) and total visits in previous enrolment (HR 1.10, 95 % CI 1.10–1.11), clinic type (p < 0.001), schizophrenia (HR 1.51, 95 % CI 1.41–1.60), and enrolment during the COVID-19 era (HR 1.31, 95 % CI 1.20–1.44).

Conclusion

Propensity to re-enrol varied markedly across individuals, implying that there is a subgroup of treatment-seeking people who are less likely to achieve longterm abstinence. Alternative interventions or long-term nicotine replacement may be justified for these individuals.

背景：反复参加戒烟治疗的患者可能受益于更强化或替代的干预措施。我们的目的是测量参与者重新参加大型治疗计划的倾向的差异，描述重新参加的模式，并检查预测重新参加的特定参与者特征。方法：我们分析了2014年至2023年安大略省吸烟治疗（STOP）项目的172,050名入组患者。STOP提供长达26周的尼古丁替代疗法（NRT），并允许在一年后重新注册。我们使用概率重复数据删除来识别128,481个独特的个体。为了分析再入组情况，我们拟合了一个混合效应的Cox比例风险生存模型，将人口统计学、临床和环境变量作为固定效应。结果在所有入组患者中，25.3%（43,569）为重复入组。参与者水平方差非常高（σ2 =1.66，中位风险比= 3.4），表明再入倾向存在较大的残差。再入组的最强预测因子是醒来后第一次吸烟的时间（p < 0.001）、终生戒烟尝试（p < 0.001）、提供的NRT类型（p < 0.001）和之前入组的总就诊次数（HR 1.10, 95% CI 1.10 - 1.11）、诊所类型（p < 0.001）、精神分裂症（HR 1.51, 95% CI 1.41-1.60）和在COVID-19时期入组（HR 1.31, 95% CI 1.20-1.44）。结论：个体间重新登记的倾向差异显著，这意味着有一个寻求治疗的亚群不太可能实现长期戒断。替代干预或长期尼古丁替代可能对这些个体是合理的。

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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 : 2026-02-01 Epub 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

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 : 2026-02-01 Epub 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。

{"title":"Effectiveness and clinical predictors of a virtual based combined cognitive behavioral and motivational enhancement group therapy for adults with cannabis use disorder","authors":"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","doi":"10.1016/j.drugalcdep.2026.113048","DOIUrl":"10.1016/j.drugalcdep.2026.113048","url":null,"abstract":"<div><h3>Background</h3><div>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.</div></div><div><h3>Methods</h3><div>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.</div></div><div><h3>Results</h3><div>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.</div></div><div><h3>Conclusion</h3><div>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.</div></div>","PeriodicalId":11322,"journal":{"name":"Drug and alcohol dependence","volume":"279 ","pages":"Article 113048"},"PeriodicalIF":3.6,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145974309","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

“Not in my backyard”: The impact of recovery residences on property values “不在我家后院”：恢复性住宅对房地产价值的影响

IF 3.6 2区医学 Q1 PSYCHIATRY

Drug and alcohol dependence

Pub Date : 2026-02-01 Epub Date: 2026-01-14 DOI: 10.1016/j.drugalcdep.2026.113044

Ryan Ramphul , Sheryl A. McCurdy , Jooyeon Lee , Yanchen Liu , Yixiao Chen , Serena A. Rodriguez , Kathryn R. Gallardo , Sreelatha Akkala , Hadiza Theyra-Enias , J. Michael Wilkerson

Background

In 2023, an estimated 39.6 million adults aged ≥ 18 years had a substance use disorder (SUD) and 94.7 % did not seek treatment. Recovery residences provide essential support for individuals recovering from SUD, yet their presence in residential neighborhoods often raises concerns on potential decline in property values. Our study examines the relationship between presence of recovery residences and median home values at the census tract level in Texas.

Methods

We used publicly available tract-level data on area, total population, housing units, CDC/ATSDR Social Vulnerability Index (SVI), and median home values. Data on the recovery residences were obtained from a cross-sectional statewide survey of substance use service providers. Census tracts with and without recovery residences were matched using a k-nearest neighbors (KNN) algorithm. Logistic regression and permutation tests were used to assess differences in median home values between matched tracts.

Results

Results from comparison of 329 census tracts with recovery residences and 1161 matched controls showed no significant association between presence of recovery house and property values, after adjusting for population and the covariates that are used for KNN matching. Sensitivity analysis showed no significant association between median home value and the presence of recovery housing.

Conclusions

Our findings suggest no significant association between the likelihood of a tract having recovery residence and home values. Policymakers should consider these findings when addressing zoning restrictions and community opposition to recovery housing.

2023年，估计有3960万≥18岁的成年人患有物质使用障碍（SUD）， 94.7%的人没有寻求治疗。康复住宅为从SUD中康复的个人提供必要的支持，但它们在居民区的存在经常引起人们对房地产价值潜在下降的担忧。我们的研究考察了在德克萨斯州人口普查区水平的恢复住宅和房屋价值中位数之间的关系。方法采用可公开获得的区域数据，包括面积、总人口、住房单位、CDC/ATSDR社会脆弱性指数（SVI）和房屋价值中位数。康复住宅的数据是从全州范围内对物质使用服务提供者的横断面调查中获得的。使用k近邻（KNN）算法对有和没有恢复住宅的人口普查区进行匹配。使用逻辑回归和排列检验来评估匹配区域间房屋中位数价值的差异。结果对329个人口普查区的恢复住宅和1161个匹配对照的比较结果显示，在调整人口和用于KNN匹配的协变量后，恢复住宅的存在与财产价值之间没有显着关联。敏感性分析显示，房屋价值中位数与恢复住房的存在之间没有显着关联。结论：我们的研究结果表明，康复住宅的可能性与房屋价值之间没有显著的关联。政策制定者在解决分区限制和社区对恢复住房的反对时，应该考虑这些发现。

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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 : 2026-02-01 Epub 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