Drug and alcohol dependence最新文献_第5页

The association between benzodiazepine proliferation in the unregulated drug supply and experiences of violence: A gender-based analysis 不受管制的药物供应中的苯二氮卓类药物扩散与暴力经历之间的关系：基于性别的分析。

IF 3.6 2区医学 Q1 PSYCHIATRY

Drug and alcohol dependence

Pub Date : 2025-12-17 DOI: 10.1016/j.drugalcdep.2025.113009

Anmol Swaich , Kali Rufus-Sedgemore , JinCheol Choi , Kora DeBeck , Jade Boyd , M-J Milloy , Thomas Kerr , Kanna Hayashi

Background

Rising contamination of illicitly-manufactured benzodiazepines in unregulated opioids in Canada poses concern as their strong sedative effects may increase vulnerability to violence for people who use drugs (PWUD), particularly women. The current study longitudinally examined the relationship between suspected exposure to benzodiazepines (SEB) and violent victimization, assessing for gender differences.

Methods

Data were drawn from 1049 participants (40.9 % women) from three harmonized prospective cohorts of community-recruited PWUD in Vancouver, Canada between 2021 and 2023. We conducted gender-stratified analyses, with a three-level exposure variable 1) primary SEB: through using unregulated benzodiazepines, 2) secondary SEB: only through using other unregulated drugs, and 3) no exposure (reference category). Patterns of unregulated opioid and stimulant use were examined as effect modifiers.

Findings

At baseline, 249 (58.0 %) women and 349 (56.3 %) men reported any SEB; 84 (19.6 %) women and 126 (20.3 %) men reported experiencing violence. For all participants, secondary SEB was significantly related to higher odds of violence (adjusted odds ratio [AOR]=1.48; 95 % confidence interval [CI]:1.14–1.92), however this association did not persist for primary SEB (AOR=1.26; 94 % CI:0.73–2.18). In gender-stratified analyses, the association between secondary SEB and violence was only significant for women (AOR=1.62; 95 % CI:1.10–2.38). Secondary SEB was also associated with higher odds of violence when participants reported daily stimulant and no daily opioid use (AOR=2.76; 95 % CI:1.58–4.82).

Conclusions

Our findings suggest lack of agency over exposure to benzodiazepines, as created by drug supply unpredictability, may exacerbate risk of violence among women who use drugs and PWUD who do not frequently use opioids.

背景：加拿大不受管制的阿片类药物中非法制造的苯二氮卓类药物的污染日益严重，这令人担忧，因为它们具有强烈的镇静作用，可能会增加吸毒者（特别是妇女）遭受暴力的脆弱性。目前的研究纵向检查了疑似接触苯二氮卓类药物（SEB）与暴力受害之间的关系，评估了性别差异。方法：数据来自2021年至2023年加拿大温哥华社区招募的PWUD的三个协调前瞻性队列的1049名参与者（40.9%为女性）。我们进行了性别分层分析，暴露变量为三个水平：1)原发性SEB：通过使用不受管制的苯二氮卓类药物；2)继发性SEB：仅通过使用其他不受管制的药物；3)无暴露（参考类别）。不受管制的阿片类药物和兴奋剂的使用模式被检查为效果调节剂。结果：基线时，249名（58.0%）女性和349名（56.3%）男性报告有SEB；84名（19.6%）女性和126名（20.3%）男性报告遭受暴力。对所有参与者来说，继发性SEB与较高的暴力发生率显著相关（调整后的优势比[AOR]=1.48； 95%可信区间[CI]:1.14-1.92），但这种关联在原发性SEB中不存在（AOR=1.26; 94% CI:0.73-2.18）。在性别分层分析中，继发性SEB与暴力之间的关联仅在女性中显著（AOR=1.62; 95% CI:1.10-2.38）。当参与者报告每天使用兴奋剂而没有每天使用阿片类药物时，继发性SEB也与较高的暴力发生率相关（AOR=2.76; 95% CI:1.58-4.82）。结论：我们的研究结果表明，由于药物供应的不可预测性，缺乏对苯二氮卓类药物的监管，可能会加剧使用药物的妇女和不经常使用阿片类药物的PWUD的暴力风险。

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引用次数: 0

Baseline electrophysiological markers of reward and error processing are associated with improved outcomes in prize-based contingency management 奖励和错误处理的基线电生理标记与基于奖励的应急管理的改善结果相关。

IF 3.6 2区医学 Q1 PSYCHIATRY

Drug and alcohol dependence

Pub Date : 2025-12-12 DOI: 10.1016/j.drugalcdep.2025.113003

Sarah E. Forster , Steven D. Forman , Michael Walsh Dickey , Greg J. Siegle , Stuart R. Steinhauer

Background

Veterans are disproportionately affected by cocaine use disorder (CUD), a condition without approved pharmacotherapies, marked by high return to use rates. Prize-Based Contingency Management (PBCM) is an effective behavioral intervention, but treatment response varies. Electrophysiological and cognitive measures may help identify who is likely to benefit from specific PBCM variants. This study evaluates whether neurocognitive profiles predict differential response to monetary versus tangible reward-based PBCM, with the goal of informing measurement-based, personalized treatment.

Methods

Forty-five Veterans with CUD completed EEG and cognitive assessments before randomization to a 12-week treatment trial evaluating PBCM with either tangible or voucher rewards. Manipulation checks validated the measurement approach for candidate neurocognitive predictors. Treatment outcomes were analyzed using longitudinal logistic regression across 24 possible PBCM sessions. A forward selection approach guided model building, and generalizability was assessed using leave-one-out cross-validation.

Results

Manipulation checks confirmed expected neurocognitive effects across tasks. Modeling identified greater anticipatory alpha suppression to tangible reward, larger ERN amplitudes, and lower craving as significant predictors of abstinence. Voucher PBCM, younger age, and earlier timepoints were also associated with better outcomes. Model 1 demonstrated good discrimination (AUC = 0.773), with no added benefit from predictor-by-treatment interactions.

Conclusions

This study highlights the potential of neurocognitive markers associated with PBCM outcomes in Veterans with CUD to inform treatment development and personalization. Baseline features did not predict differential outcomes by reward type; instead, tangible rewards were generally linked to poorer outcomes. Findings therefore also support the broad utility of abstract, voucher-based rewards in PBCM treatment.

背景：退伍军人不成比例地受到可卡因使用障碍（CUD）的影响，这是一种未经批准的药物治疗的情况，其特点是高使用率。基于奖励的应急管理（PBCM）是一种有效的行为干预，但治疗反应各不相同。电生理和认知测量可以帮助确定谁可能从特定的PBCM变异中受益。本研究评估了神经认知特征是否能预测对金钱奖励与基于有形奖励的PBCM的不同反应，目的是为基于测量的个性化治疗提供信息。方法：45名患有CUD的退伍军人在随机分配到一个为期12周的治疗试验之前完成了脑电图和认知评估，该试验评估PBCM的有形或代金券奖励。操作检查验证了候选神经认知预测因子的测量方法。采用纵向逻辑回归分析24个可能的PBCM疗程的治疗结果。前向选择方法指导模型构建，并使用留一交叉验证评估泛化性。结果：操作检查证实了预期的跨任务神经认知效应。模型确定了对有形奖励更大的预期α抑制，更大的神经网络振幅和更低的渴望作为戒断的重要预测因子。代金券PBCM、更年轻和更早的时间点也与更好的结果相关。模型1显示出良好的判别（AUC = 0.773），没有从预测-治疗相互作用中获得额外的好处。结论：本研究强调了与CUD退伍军人PBCM结果相关的神经认知标志物的潜力，为治疗开发和个性化提供了信息。基线特征不能预测不同奖励类型的差异结果；相反，有形奖励通常与较差的结果有关。因此，研究结果也支持抽象的、基于凭证的奖励在PBCM治疗中的广泛应用。

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引用次数: 0

Within-person prospective associations between depressive symptoms, abstinence self-efficacy and smoking cessation following smoking cessation treatment 戒烟治疗后抑郁症状、戒断自我效能和戒烟之间的个人前瞻性关联

IF 3.6 2区医学 Q1 PSYCHIATRY

Drug and alcohol dependence

Pub Date : 2025-12-12 DOI: 10.1016/j.drugalcdep.2025.113004

María Ramos-Carro , Rubén Rodríguez-Cano , Carmela Martínez-Vispo , Ana López-Durán , Elisardo Becoña

Background

Abstinence self-efficacy and depressive symptoms have independently been associated with smoking outcomes in previous research. However, their bidirectional relationships with smoking abstinence over time remain underexplored. This study examined bidirectional and prospective associations between depressive symptoms, abstinence self-efficacy, and smoking abstinence from the end of a cognitive-behavioral smoking cessation intervention to 12-month follow-up.

Methods

This study was conducted with 685 adults (62.04 % female; M_age=45.51) who sought smoking cessation treatment at the Smoking Cessation and Addictive Disorders Unit (University of Santiago de Compostela, Spain). Abstinence was defined as not smoking, not even a puff, in the prior 24 h at the end of the intervention and not smoking in the prior 7 days at each follow-up. A Random Intercept Cross-Lagged Panel Model was performed to examine the bidirectional and prospective associations between study variables.

Results

At the within-person level, smoking abstinence at posttreatment and 3-month follow-up predicted greater abstinence self-efficacy and fewer depressive symptoms at 3- and 6-month follow-up, respectively. In contrast, higher abstinence self-efficacy at posttreatment was associated with lower odds of abstinence at 3-month follow-up, and abstinence self-efficacy at 3 months predicted more depressive symptoms at 6 months. Depressive symptoms did not significantly predict abstinence self-efficacy or smoking abstinence in the cross-lagged associations at any time point.

Conclusion

Quitting smoking predicts higher abstinence self-efficacy and lower depressive symptoms after posttreatment, but these effects diminish after 6-month follow-up. Notably, higher levels of abstinence self-efficacy at the end of treatment may increase smoking risk during the first three months postquitting.

背景：在以往的研究中，戒烟自我效能感和抑郁症状与吸烟结果独立相关。然而，随着时间的推移，它们与戒烟的双向关系仍未得到充分研究。本研究调查了从认知行为戒烟干预结束到12个月随访期间抑郁症状、戒烟自我效能和戒烟之间的双向和前瞻性关联。方法：本研究纳入685名成年人（62.04%为女性，年龄45.51岁），他们在戒烟和成瘾性疾病部门（西班牙圣地亚哥德孔波斯特拉大学）寻求戒烟治疗。戒烟的定义是在干预结束前的24小时内不吸烟，甚至不抽一口烟，并且在每次随访前的7天内不吸烟。采用随机截距交叉滞后面板模型来检验研究变量之间的双向和前瞻性关联。结果：在个人水平上，治疗后戒烟和随访3个月戒烟分别预示着戒烟自我效能感的提高和随访3个月和随访6个月时抑郁症状的减少。相比之下，治疗后较高的戒断自我效能与3个月随访时较低的戒断几率相关，3个月的戒断自我效能预示着6个月时更多的抑郁症状。抑郁症状在任何时间点都不能显著预测戒断自我效能或戒烟的交叉滞后关联。结论：戒烟可提高戒断自我效能感，降低抑郁症状，但随访6个月后这些影响减弱。值得注意的是，治疗结束时较高水平的戒烟自我效能可能会增加戒烟后头三个月的吸烟风险。

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引用次数: 0

Does making early evening social plans impact alcohol use outcomes over evening hours? 制定晚间社交计划是否会影响晚上的饮酒结果？

IF 3.6 2区医学 Q1 PSYCHIATRY

Drug and alcohol dependence

Pub Date : 2025-12-12 DOI: 10.1016/j.drugalcdep.2025.113005

Sharon Lipperman-Kreda , Christina F. Mair , Paul J. Gruenewald , M. Kristina Wharton , Rachel L. Gunn , Lindy K. Howe

Puropse: This study examined associations of evening plans to engage in different social activities with drinking behaviors and negative consequences experienced over weekend evening hours among underage young adults. Methods: Ecological Momentary Assessment (EMA) data were collected from underage youth (19–20 years) in California in 8 evenings over 4 successive weekends. At 6 pm, participants reported their social (i.e., any social plans tonight) and contextual (i.e., planning to be outside own home tonight) evening plans and whether they planned to drink that evening. They subsequently reported alcohol use and negative consequences within the past two hours at 8 pm, 10 pm, midnight, and the next morning. We used mixed effects logistic and negative binomial models controlling for demographics, history of alcohol use, drinking motives, and weekend day. Analyses were based on data obtained from 230 participants who reported on 1469 evenings. Results: In about 37 % and 46 % of evenings in which participants reported having social plans or plans to be outside own home, they reported no plans to drink alcohol, respectively. Social evening plans were positively associated with subsequent alcohol use (OR=3.312, p < 0.001), the number of drinks consumed (IRR=2.009, p < 0.001), and the number of negative consequences experienced (IRR=1.526, p < 0.05), independent of plans to drink that evening. Having any social evening plans was positively associated with planned (vs. unplanned) drinking (OR=7.080, p < 0.001). Conclusions: Social evening plans may be important determinants of drinking behaviors and negative consequences across evening hours among underage young adults. Results can guide future interventions to reduce heavier drinking and associated harms.

目的：本研究调查了未成年年轻人在周末晚上参加不同社交活动的计划与饮酒行为和负面后果之间的联系。方法：在连续4个周末的8个晚上收集加州未成年青少年（19-20岁）的生态瞬时评价（EMA）数据。在下午6点，参与者报告了他们的社交计划（例如，今晚有什么社交计划）和相关计划（例如，计划今晚离开自己的家），以及他们当晚是否计划喝酒。他们随后报告了在过去两个小时内（晚上8点、10点、午夜和第二天早上）饮酒和负面后果。我们使用混合效应逻辑模型和负二项模型控制人口统计学、酒精使用史、饮酒动机和周末天数。分析基于230名参与者的数据，他们报告了1469个晚上的情况。结果：在37%和46%的参与者报告有社交计划或计划离开自己家的晚上，他们分别报告没有喝酒的计划。社交晚间计划与随后的酒精使用呈正相关（OR=3.312, p）。结论：社交晚间计划可能是未成年年轻人夜间饮酒行为和负面后果的重要决定因素。结果可以指导未来的干预措施，以减少酗酒和相关危害。

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引用次数: 0

The relationship between co-use of tobacco and alcohol and cognitive decline in middle-aged and older Chinese males: A cross-lagged panel network analysis 中国中老年男性烟酒共同使用与认知能力下降的关系：一个交叉滞后的面板网络分析

IF 3.6 2区医学 Q1 PSYCHIATRY

Drug and alcohol dependence

Pub Date : 2025-12-12 DOI: 10.1016/j.drugalcdep.2025.113006

Rongqian Li, Yunfei Guo, Yuran Qiu

Background

The co-use of tobacco and alcohol can impair cognitive function, but whether the frequency of this co-use interacts with cognitive decline in middle-aged and elderly Chinese men remains unclear.

Methods

We analyzed three waves of the China Health and Retirement Longitudinal Study (CHARLS) data (2015, 2018, and 2020). The analytic sample included 2044 individuals who co-used tobacco and alcohol, 1339 who smoked only, and 1714 who drank alcohol only. Cognitive function was assessed using the Mini-Mental State Examination (MMSE) subscale, and smoking and drinking frequencies were calculated separately. Two directed networks were constructed using the cross-lagged panel network (CLPN) model to explore reciprocal relationships between cognitive function and smoking and drinking frequencies, with network centrality metrics identifying key bridging variables.

Results

From 2015–2018, higher smoking frequency was associated with poorer memory, and greater alcohol consumption with worse memory and orientation. From 2018–2020, increased alcohol consumption led to declines in attention/calculation and memory, while higher smoking frequency decreased attention/calculation. Additionally, poorer memory was associated with reduced alcohol consumption. Network indices ranked alcohol consumption as the strongest cross-domain driver, and memory as the most affected cognitive node.

Conclusion

For middle-aged and older Chinese men who co-use tobacco and alcohol, cognitive abilities—especially memory and attention—are significantly impaired. Some cognitive functions, such as memory, are linked to subsequent alcohol use frequency. Combining smoking and alcohol cessation with cognitive support for memory may help alleviate cognitive aging in this high-risk group.

背景：烟酒共同使用可损害认知功能，但这种共同使用的频率是否与中国中老年男性的认知能力下降相互作用尚不清楚。方法：我们分析了三波中国健康与退休纵向研究（CHARLS）数据（2015年、2018年和2020年）。分析样本包括2044名同时使用烟草和酒精的人，1339名只吸烟的人，1714名只喝酒的人。认知功能采用简易精神状态检查量表（MMSE）评估，吸烟和饮酒频率分别计算。使用交叉滞后面板网络（CLPN）模型构建了两个定向网络，以探索认知功能与吸烟和饮酒频率之间的相互关系，网络中心性指标确定了关键的桥接变量。结果：从2015年到2018年，吸烟频率越高，记忆力越差，饮酒越多，记忆力和定向能力越差。从2018年到2020年，酒精消费量的增加导致注意力/计算能力和记忆力下降，而吸烟频率的增加导致注意力/计算能力下降。此外，记忆力较差与饮酒减少有关。网络指数显示，饮酒是跨领域影响最大的因素，而记忆是受影响最大的认知节点。结论：对于同时吸烟和饮酒的中老年中国男性来说，认知能力——尤其是记忆力和注意力——明显受损。一些认知功能，如记忆，与随后的饮酒频率有关。戒烟和戒酒结合对记忆的认知支持可能有助于缓解这一高危人群的认知衰老。

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引用次数: 0

Enhancing data compatibility in an evolving landscape: Medical cannabis and polysubstance use protocols in the PhenX Toolkit 在不断发展的环境中增强数据兼容性：PhenX工具包中的医用大麻和多物质使用协议。

IF 3.6 2区医学 Q1 PSYCHIATRY

Drug and alcohol dependence

Pub Date : 2025-12-11 DOI: 10.1016/j.drugalcdep.2025.113001

Anne Buu , Johannes Thrul , Amanda Bunting , Tamara Haegerich , Wayne Huggins , Christian Hopfer , Denise Vidot , Cataia Ives , Ryan McNeil , Sarah Zemore , Corrie Vilsaint , Elizabeth Fallon , Christine Hill , Carol Hamilton , John Kelly

Introduction

With increasing legalization of medical cannabis and prevalence of polysubstance use in the United States comes the need for standard psychometrically validated measures to study these substances’ health effects in the population. The PhenX (consensus measures for Phenotypes and eXposures) Toolkit (www.phenxtoolkit.org) is a freely accessible catalog of recommended measurement protocols to promote data compatibility across studies, but this extensive catalog did not include measures in these important areas.

Methods

In 2024, a PhenX Working Group of experts followed a well-established consensus process to identify and recommend measurement protocols suitable for inclusion in studies on medical cannabis and polysubstance use. The broader scientific community was invited to review and provide feedback that was considered in the process of finalizing recommendations.

Results

In 2025, the PhenX Toolkit released 15 new medical cannabis and polysubstance use protocols, which assess medical and other cannabis use—including consumption levels, product types, sources, motives, expectancies, medical card status, provider–patient communication, and biochemical validation—as well as polysubstance use patterns and related overdose risk. These protocols complement existing substance-related content in PhenX Toolkit and facilitate future development of knowledge on health effects of cannabis and polysubstance use and clinical guidance on safety or dosing for medical cannabis.

Conclusion

Researchers are encouraged to adopt these measurement protocols, so results across studies can be better compared and combined to efficiently and reliably evaluate the health effects of medical cannabis and polysubstance use. Measures in these domains will continue to be updated as new knowledge is gained.

导言：随着医用大麻的日益合法化和多物质使用在美国的普遍存在，需要标准的心理测量学验证措施来研究这些物质对人口健康的影响。PhenX（表型和暴露的共识测量）工具包（www.phenxtoolkit.org）是一个免费访问的推荐测量方案目录，以促进研究之间的数据兼容性，但这个广泛的目录不包括这些重要领域的测量。方法：2024年，一个PhenX专家工作组遵循了一个完善的共识过程，以确定和推荐适合纳入医用大麻和多物质使用研究的测量方案。更广泛的科学界被邀请审查并提供反馈，这些反馈在最后确定建议的过程中得到了考虑。结果：2025年，PhenX工具包发布了15个新的医用大麻和多物质使用方案，评估了医用和其他大麻的使用情况，包括消费水平、产品类型、来源、动机、预期、医疗卡状态、提供者-患者沟通和生化验证，以及多物质使用模式和相关的过量风险。这些议定书补充了PhenX工具包中现有的与物质有关的内容，并促进了关于大麻和多物质使用对健康影响的知识的未来发展，以及关于医用大麻安全性或剂量的临床指导。结论：鼓励研究人员采用这些测量方案，以便更好地比较和综合各项研究的结果，以有效和可靠地评估医用大麻和多物质使用对健康的影响。这些领域的措施将随着获得新知识而不断更新。

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引用次数: 0

Gender convergence in young adults’ drinking in Australia 澳大利亚年轻人饮酒的性别趋同。

IF 3.6 2区医学 Q1 PSYCHIATRY

Drug and alcohol dependence

Pub Date : 2025-12-11 DOI: 10.1016/j.drugalcdep.2025.113000

Emma Vieira , Nicholas Taylor , Amy Pennay , Cassandra Wright , Michael Livingston

Background

Despite recent declines in alcohol consumption for younger generations, risky drinking still peaks in young adulthood (18−29). While men have historically consumed more alcohol than women, there may be changes emerging in gendered patterns of drinking. This study investigated if a ‘gender convergence’ in young adults’ drinking has occurred in Australia, whereby women and men’s drinking rates have become more similar over time.

Methods

Three national Australian survey data sources were used to assess drinking trends from 2001 to 2023 in young adult women and men, aged 18–29. Gender convergence was tested for annual volume, past-year drinking status, and long-term, risky single-occasion, and high risky single-occasion drinking. Analyses included linear and logistic regressions with interactions between gender and year to assess gender differences in trends over time.

Results

Drinking declined for young adults across all measures and surveys between 2001 and 2023. For all surveys, evidence for convergence in annual volume was found from 2013 to 2023. Some evidence for convergence was noted in recent years for past-year drinking (2019–2023) and risky drinking (2021–2022). For all measures, convergence occurred due to men’s drinking decreasing at faster rates than women’s.

Conclusions

This study provides evidence for gender convergences in young adults’ drinking in Australia. Notably, this convergence occurs within the context of a broader drinking decline for both women and men, whereby men’s drinking has decreased at a faster rate. These findings reflect emerging evidence from other high-income countries and suggest that future research understanding the drivers for men’s steeper drinking declines is warranted.

背景：尽管近年来年轻一代的饮酒量有所下降，但危险饮酒仍在青年期（18-29岁）达到顶峰。虽然历史上男性的饮酒量比女性多，但性别饮酒模式可能正在发生变化。这项研究调查了澳大利亚年轻人饮酒是否出现了“性别趋同”，即随着时间的推移，女性和男性的饮酒率变得越来越相似。方法：使用三个澳大利亚国家调查数据来源来评估2001年至2023年18-29岁年轻成年男女的饮酒趋势。对年饮酒量、过去一年饮酒状况、长期、高风险单次饮酒和高风险单次饮酒进行了性别趋同测试。分析包括线性和逻辑回归与性别和年份之间的相互作用，以评估随时间变化趋势的性别差异。结果：从2001年到2023年的所有测量和调查中，年轻人的饮酒量都有所下降。从2013年到2023年，所有调查都发现了年业务量趋同的证据。近年来，在过去一年的饮酒（2019-2023年）和高风险饮酒（2021-2022年）中发现了一些趋同的证据。对于所有的测量，趋同的发生是由于男性饮酒的下降速度比女性快。结论：本研究为澳大利亚年轻人饮酒的性别趋同提供了证据。值得注意的是，这种趋同发生在女性和男性饮酒量普遍下降的背景下，其中男性饮酒量下降的速度更快。这些发现反映了来自其他高收入国家的新证据，并表明未来有必要研究男性饮酒量急剧下降的驱动因素。

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引用次数: 0

Alcohol-seeking associations with resting state functional connectivity of the amygdala 寻找酒精与静息状态杏仁核功能连接的关联。

IF 3.6 2区医学 Q1 PSYCHIATRY

Drug and alcohol dependence

Pub Date : 2025-12-11 DOI: 10.1016/j.drugalcdep.2025.112999

Mario Dzemidzic , McKenzie R. Cox , David Haines , James Hays , Mayande K. Mlungwana , Andrea Avena-Koenigsberger , Marian L. Logrip , Joaquin Goni , Jaroslaw Harezlak , Ann E.K. Kosobud , David A. Kareken , Sean O’Connor , Martin H. Plawecki , Melissa A. Cyders

Background

Prolonged alcohol use is associated with neuroadaptations that may contribute to continued alcohol consumption, even in the presence of adverse consequences. Although well studied in preclinical models, the neural mechanisms of aversion-resistant alcohol-seeking in humans are understudied.

Purpose

The goal of this study was to examine whether altered amygdala resting state functional connectivity (rsFC) is a mechanism for how lifetime drinking history and alcohol use disorder symptoms relate with objectively measured neutral and aversion-resistant alcohol-seeking in the human laboratory.

Methods

A sample of 55 adults (age 21–55, mean=32.18 years, 56.4 % female, 60.0 % White) completed two counterbalanced intravenous alcohol progressive-ratio self-administration sessions (pairing alcohol-seeking with aversive or neutral stimuli) and a resting state fMRI scan. Two bilateral a priori amygdala seed regions were selected.

Results

rsFC strength of the left basolateral amygdala and dorsal anterior cingulate cortex mediated the relationships between both lifetime alcohol use and alcohol use disorder symptom severity with alcohol-seeking in the aversive session. rsFC between the right centromedial amygdala and occipital regions was associated with, but not specific to, alcohol-seeking during the neutral session; this connectivity mediated the association with alcohol use disorder symptom severity, but not the association with lifetime alcohol use.

Conclusions

This study provides evidence linking the basolateral amygdala to human aversion-resistant alcohol-seeking. Identification of brain mechanisms underlying aversion-resistant alcohol-seeking can facilitate translational research and identify physiological mechanisms of alcohol use disorder progression.

背景：长期饮酒与神经适应有关，这可能导致持续饮酒，即使存在不良后果。尽管在临床前模型中得到了很好的研究，但对人类厌恶抵抗酒精寻求的神经机制研究不足。目的：本研究的目的是研究改变的杏仁核静息状态功能连接（rsFC）是否是终身饮酒史和酒精使用障碍症状与人类实验室客观测量的中性和厌恶抵抗性酒精寻求相关的机制。方法：55名成年人（年龄21-55岁，平均32.18岁，56.4%女性，60.0%白人）完成了两次平衡静脉酒精渐进比例自我给药（将酒精寻求与厌恶或中性刺激配对）和静息状态fMRI扫描。选择两个双侧先验杏仁核种子区。结果：左侧基底外侧杏仁核和前扣带回背侧皮质的rsFC强度介导了终生酒精使用和酒精使用障碍症状严重程度与厌恶期酒精寻求的关系。在中性时段，右侧杏仁核中央内侧和枕部区域之间的rsFC与酒精寻求有关，但并非特定于此；这种连通性介导了与酒精使用障碍症状严重程度的关联，但与终生酒精使用无关。结论：本研究提供的证据表明，基底外侧杏仁核与人类抵抗性酒精寻求有关。确定厌恶抵抗性酒精寻求的大脑机制可以促进转化研究，并确定酒精使用障碍进展的生理机制。

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引用次数: 0

Exploring drug checking services for people who use drugs: Pre-implementation study 探索为吸毒者提供药物检查服务：实施前研究。

IF 3.6 2区医学 Q1 PSYCHIATRY

Drug and alcohol dependence

Pub Date : 2025-12-06 DOI: 10.1016/j.drugalcdep.2025.112986

Whitney Ludwig , Kaitlyn Jaffe , Steve Alsum , Mary Dwan , Robert Ploutz-Snyder , Clayton Shuman , Chin Hwa (Gina) Dahlem

Background

The growing proportion of adulterants in the street drug supply has increased overdose risk and other negative health outcomes for people who used drugs (PWUD). Though useful, single-item test strips (ie fentanyl), are limited in their ability to identify multiple drugs in one drug sample. Thus, community-based drug checking services (DCS) using fourier transform infrared spectroscopy (FTIR) are being adopted as an overdose prevention strategy. To inform the pre-implementation of Michigan’s first DCS using FTIR, we sought to understand facilitators and barriers to FTIR among potential participants at a local harm reduction agency.

Methods

Potential DCS participants were recruited (n = 25) into three focus groups (n = 8–9) and one individual interview. Semi-structured interview guides informed by the Consolidated Framework for Implementation Research (CFIR) were used. Focus groups were audio-recorded, transcribed and rapid thematic qualitative analysis was conducted. Themes were developed to inform DCS implementation within CFIR domains with relevant constructs displayed in summary matrices.

Results

Participants’ main concern was being targeted by police when utilizing FTIR. Additional barriers included concerns about confidentiality, testing wait time, and negative community perceptions. Key facilitators were trusted staff, sharing FTIR information via PWUD social networks, and efforts to increase participant service access with extended hours. Participants felt FTIR would be a valuable resource to support safer drug use, increase autonomy, and help prevent overdose by providing information about drug contents.

Conclusions

DCS can inform PWUD and the public of dangerous analogues in the drug supply, increase autonomy to make informed decisions, and reduce overdose risk.

背景：街头毒品供应中掺假成分的比例不断增加，增加了吸毒过量的风险和对吸毒者（PWUD）的其他负面健康后果。虽然单项试纸（如芬太尼）很有用，但在一种药物样本中识别多种药物的能力有限。因此，使用傅里叶变换红外光谱（FTIR）的社区药物检查服务（DCS）正在被采用作为过量预防策略。为了为密歇根州首个使用FTIR的DCS的预实施提供信息，我们试图了解当地一家减少危害机构的潜在参与者中FTIR的促进因素和障碍。方法：招募潜在的DCS参与者（n = 25），分为三个焦点组（n = 8-9）和一个单独访谈。采用了由实施研究综合框架（CFIR）提供的半结构化访谈指南。对焦点小组进行录音、转录，并进行快速专题定性分析。开发主题是为了通知CFIR域中的DCS实现，并在摘要矩阵中显示相关结构。结果：参与者在使用FTIR时主要担心被警察盯上。其他障碍包括对保密性、测试等待时间和社区负面看法的担忧。关键的推动者是值得信赖的工作人员，通过PWUD社交网络分享FTIR信息，并努力通过延长工作时间来增加参与者的服务访问。与会者认为，FTIR将是一种宝贵的资源，可以支持更安全的药物使用，增加自主权，并通过提供有关药物成分的信息来帮助防止过量使用。结论：DCS可以向PWUD和公众通报药品供应中的危险类似物，增加做出知情决策的自主权，降低用药过量风险。

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引用次数: 0

Rethinking acute nicotine self-administration in inhaled tobacco products: A randomized clinical trial with ENDS in young adults 重新思考吸入烟草制品中尼古丁的急性自我给药：一项针对年轻人的随机临床试验。

IF 3.6 2区医学 Q1 PSYCHIATRY

Drug and alcohol dependence

Pub Date : 2025-12-05 DOI: 10.1016/j.drugalcdep.2025.112998

Mario El Hourani, Soha Talih, Rola Salman, Nareg Karaoghlanian, Eliana Hanna, Rachel El Hage, Alan Shihadeh

Background

Puffing behavior is often interpreted through a nicotine titration model, which posits that individuals adjust puffing to achieve the central nervous system effects of nicotine. This model has been invoked frequently to explain the phenomenon of “compensation,” in which people increase puffing intensity when using reduced-nicotine products. However, puffing patterns may also be governed by sensory feedback in the upper airways. This study tests that hypothesis using electronic nicotine delivery systems (ENDS) as a model.

Design

Within-subject, double-blind clinical study using a puff-by-puff switching protocol.

Setting

Clinical Aerosol Technology Lab, American University of Beirut; December 2024.

Interventions

Ten adults who consume both ENDS and cigarettes completed three randomized directed puffing bouts during a single clinical lab visit. In each bout, they alternated puffs between two identical ENDS devices differing by one design factor: (1) power (20 W vs 40 W, 0 mg/ml nicotine); (2) power (20 W vs 40 W, matched nicotine flux); (3) PG:VG ratio (30:70 vs 70:30).

Outcomes

Puff topography and sensory feedback (mouthful, draw effort, throat hit) measured on a puff-by-puff basis.

Results

Puff duration responded immediately and reversibly to changes in sensory feedback. At higher power, participants reported stronger mouthful, easier draw, and took shorter puffs regardless of nicotine content (p < .05). At matched flux, computed nicotine dose was lower at 40 W than 20 W (p < .01). PG:VG effects were also significant.

Conclusions

Puffing behavior appears to be driven by sensory cues, not delayed nicotine effects—highlighting an underused regulatory pathway: targeting product design features that shape perception.

背景：吸烟行为通常通过尼古丁滴定模型来解释，该模型假设个体通过调节吸烟来达到尼古丁对中枢神经系统的影响。这个模型经常被用来解释“补偿”现象，即人们在使用尼古丁含量降低的产品时增加了吸烟的强度。然而，充气模式也可能由上呼吸道的感觉反馈控制。本研究以电子尼古丁传递系统（ENDS）为模型验证了这一假设。设计：受试者内，双盲临床研究，采用逐泡切换方案。单位：贝鲁特美国大学临床气溶胶技术实验室；2024年12月。干预措施：在一次临床实验室访问中，10名既使用ENDS又吸烟的成年人完成了三次随机定向雾化试验。在每一回合中，他们在两个相同的ENDS设备之间交替抽烟，这两个设备的设计因素不同：(1)功率（20瓦vs 40瓦，0毫克/毫升尼古丁）；(2)功率（20W vs 40W，匹配烟碱通量）；PG:VG比率（30:70 vs 70:30）。结果：在每一口的基础上测量呼吸地形和感觉反馈（一口，用力，喉咙撞击）。结果：呼吸持续时间对感觉反馈的变化有立即可逆的反应。在更高的功率下，参与者报告说，不管尼古丁含量如何，他们的一口更强，更容易抽，吸的时间更短(p结论：吸烟行为似乎是由感官线索驱动的，而不是延迟的尼古丁效应——强调了一个未被充分利用的调节途径：针对塑造感知的产品设计特征。

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引用次数: 0