Drug and alcohol dependence最新文献_第5页

Drinking on empty: Daily associations between food and alcohol disturbance, subjective alcohol intoxication, and negative consequences 空饮：食物与酒精干扰、主观酒精中毒和负面后果之间的日常联系。

IF 3.6 2区医学 Q1 PSYCHIATRY

Drug and alcohol dependence

Pub Date : 2025-12-05 DOI: 10.1016/j.drugalcdep.2025.112994

Luke Herchenroeder , Ellen W. Yeung

Background

Food and alcohol disturbance (FAD) refers to restricting caloric intake prior to, or during a drinking episode to increase/quicken alcohol’s effects (FAD-intoxication) or to offset calories consumed from alcohol (FAD-calories). FAD is common among college students and is associated with alcohol-related harms cross-sectionally. However, to date there is limited research examining FAD’s association with negative alcohol-related consequences, as well as mechanisms linking FAD and negative consequences, at the event level.

Basic procedure

The present study utilized a within-person, day-level design to assess whether individuals reported higher levels of subjective alcohol intoxication on days when they engaged in FAD compared to drinking days absent of FAD. In turn, we examined whether increased subjective alcohol intoxication positively associated with same-day negative consequences. The sample included 72 college students (73.8 % female; 51.4 % White non-Hispanic; M_age=19.64) who completed up to two surveys daily (Wednesday-Sunday) for five weeks.

Main findings

For FAD-intoxication analyses, we found a significant mediation effect such that on days when students engaged in FAD-intoxication they reported higher subjective alcohol intoxication than on days when they consumed alcohol absent of FAD-intoxication. In turn, on days when students reported higher subjective alcohol intoxication they also reported more negative alcohol-related consequences. In contrast, the mediation effect for the FAD-calories model was not significant.

Conclusions

These findings further highlight the risk associated with engaging in FAD-intoxication and provides preliminary evidence that FAD-intoxication should be considered in interventions aiming to reduce event-level alcohol-related harms among college students.

背景：食物和酒精干扰（FAD）是指在饮酒前或期间限制热量摄入，以增加/加速酒精的作用（FAD中毒）或抵消酒精消耗的卡路里（FAD卡路里）。FAD在大学生中很常见，并且与酒精相关的危害横断面相关。然而，迄今为止，在事件层面审查FAD与酒精相关负面后果的关联以及将FAD与负面后果联系起来的机制的研究有限。基本程序：本研究采用人内、日水平设计来评估个体是否报告在FAD发生时主观酒精中毒水平高于不发生FAD的饮酒日。反过来，我们研究了主观酒精中毒的增加是否与当天的负面后果呈正相关。样本包括72名大学生（73.8%为女性；51.4%为非西班牙裔白人；年龄=19.64），他们每天（周三至周日）完成两次调查，持续五周。主要发现：对于fad中毒分析，我们发现了显著的中介效应，例如，在学生从事fad中毒的日子里，他们报告的主观酒精中毒程度高于没有fad中毒的日子。反过来，在学生主观酒精中毒程度较高的日子里，他们也报告了更多与酒精有关的负面后果。相反，fad -卡路里模型的中介作用不显著。结论：这些发现进一步强调了fad中毒的风险，并提供了初步证据，表明应该在旨在减少大学生事件级酒精相关危害的干预措施中考虑fad中毒。

{"title":"Drinking on empty: Daily associations between food and alcohol disturbance, subjective alcohol intoxication, and negative consequences","authors":"Luke Herchenroeder , Ellen W. Yeung","doi":"10.1016/j.drugalcdep.2025.112994","DOIUrl":"10.1016/j.drugalcdep.2025.112994","url":null,"abstract":"<div><h3>Background</h3><div>Food and alcohol disturbance (FAD) refers to restricting caloric intake prior to, or during a drinking episode to increase/quicken alcohol’s effects (FAD-intoxication) or to offset calories consumed from alcohol (FAD-calories). FAD is common among college students and is associated with alcohol-related harms cross-sectionally. However, to date there is limited research examining FAD’s association with negative alcohol-related consequences, as well as mechanisms linking FAD and negative consequences, at the event level.</div></div><div><h3>Basic procedure</h3><div>The present study utilized a within-person, day-level design to assess whether individuals reported higher levels of subjective alcohol intoxication on days when they engaged in FAD compared to drinking days absent of FAD. In turn, we examined whether increased subjective alcohol intoxication positively associated with same-day negative consequences. The sample included 72 college students (73.8 % female; 51.4 % White non-Hispanic; M<sub>age</sub>=19.64) who completed up to two surveys daily (Wednesday-Sunday) for five weeks.</div></div><div><h3>Main findings</h3><div>For FAD-intoxication analyses, we found a significant mediation effect such that on days when students engaged in FAD-intoxication they reported higher subjective alcohol intoxication than on days when they consumed alcohol absent of FAD-intoxication. In turn, on days when students reported higher subjective alcohol intoxication they also reported more negative alcohol-related consequences. In contrast, the mediation effect for the FAD-calories model was not significant.</div></div><div><h3>Conclusions</h3><div>These findings further highlight the risk associated with engaging in FAD-intoxication and provides preliminary evidence that FAD-intoxication should be considered in interventions aiming to reduce event-level alcohol-related harms among college students.</div></div>","PeriodicalId":11322,"journal":{"name":"Drug and alcohol dependence","volume":"278 ","pages":"Article 112994"},"PeriodicalIF":3.6,"publicationDate":"2025-12-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145746408","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

Willingness to receive medication for opioid use disorder (MOUD): A longitudinal analysis of social network support 阿片类药物使用障碍患者接受药物治疗意愿：社会网络支持的纵向分析。

IF 3.6 2区医学 Q1 PSYCHIATRY

Drug and alcohol dependence

Pub Date : 2025-12-01 DOI: 10.1016/j.drugalcdep.2025.112966

Hannah K. Knudsen , Maria Rockett , Carrie B. Oser

Background

Medications for opioid use disorder (MOUD, i.e., buprenorphine, methadone, naltrexone) save lives, but many individuals are unwilling to receive MOUD treatment. Few longitudinal studies have examined whether social network support for MOUD is related to willingness to receive MOUD.

Methods

Egocentric network data were collected from 393 adults with OUD who were incarcerated in 14 Kentucky prisons; follow-up data were collected about six months post-release. For each named alter, participants (egos) reported on perceived alters’ support for buprenorphine, methadone, and naltrexone at baseline and follow-up; baseline network scores were averaged into a network support for MOUD score and a change score from baseline to follow-up was calculated. Multiple imputation by chained equations addressed missing data. A multivariate linear regression model of willingness to receive MOUD at follow-up was estimated that included baseline network support for MOUD, change in network support, baseline willingness to receive MOUD, lifetime history of MOUD, and demographics.

Results

Baseline network support for MOUD was positively associated with willingness to receive MOUD at follow-up (b=0.190, 95 % CI: 0.072–0.308, p < .01). Increase in network support for MOUD over time was also positively associated with willingness to receive MOUD at follow-up (b=0.210, 95 % CI: 0.102–0.319, p < .001).

Conclusion

Social network support for MOUD, both the initial level and change over time, was associated with participants’ willingness to receive MOUD. These findings suggest that intervention development focused on increasing social network support may have utility in increasing uptake of MOUD.

背景：阿片类药物使用障碍（mod，即丁丙诺啡，美沙酮，纳曲酮）的药物可以挽救生命，但许多人不愿意接受mod治疗。很少有纵向研究考察社交网络对mod的支持是否与接受mod的意愿有关。方法：收集肯塔基州14所监狱关押的393名成年OUD患者的自我中心网络数据；随访数据在释放后约6个月收集。对于每个指定的改变，参与者（自我）在基线和随访时报告了感知到的改变者对丁丙诺啡、美沙酮和纳曲酮的支持；将基线网络得分平均为网络支持mod得分，并计算从基线到随访的变化得分。用链式方程进行多次插补，解决了数据缺失问题。评估随访时接受mod意愿的多元线性回归模型，包括基线网络对mod的支持、网络支持的变化、基线接受mod的意愿、终生mod病史和人口统计学。结果：基线网络支持与随访时接受mod的意愿呈正相关（b=0.190, 95% CI: 0.072-0.308, p）。结论：社交网络支持mod，无论是初始水平还是随时间变化，都与参与者接受mod的意愿相关。这些发现表明，以增加社会网络支持为重点的干预开发可能对增加mod的摄取有效用。

{"title":"Willingness to receive medication for opioid use disorder (MOUD): A longitudinal analysis of social network support","authors":"Hannah K. Knudsen , Maria Rockett , Carrie B. Oser","doi":"10.1016/j.drugalcdep.2025.112966","DOIUrl":"10.1016/j.drugalcdep.2025.112966","url":null,"abstract":"<div><h3>Background</h3><div>Medications for opioid use disorder (MOUD, i.e., buprenorphine, methadone, naltrexone) save lives, but many individuals are unwilling to receive MOUD treatment. Few longitudinal studies have examined whether social network support for MOUD is related to willingness to receive MOUD.</div></div><div><h3>Methods</h3><div>Egocentric network data were collected from 393 adults with OUD who were incarcerated in 14 Kentucky prisons; follow-up data were collected about six months post-release. For each named alter, participants (egos) reported on perceived alters’ support for buprenorphine, methadone, and naltrexone at baseline and follow-up; baseline network scores were averaged into a network support for MOUD score and a change score from baseline to follow-up was calculated. Multiple imputation by chained equations addressed missing data. A multivariate linear regression model of willingness to receive MOUD at follow-up was estimated that included baseline network support for MOUD, change in network support, baseline willingness to receive MOUD, lifetime history of MOUD, and demographics.</div></div><div><h3>Results</h3><div>Baseline network support for MOUD was positively associated with willingness to receive MOUD at follow-up (b=0.190, 95 % CI: 0.072–0.308, p < .01). Increase in network support for MOUD over time was also positively associated with willingness to receive MOUD at follow-up (b=0.210, 95 % CI: 0.102–0.319, p < .001).</div></div><div><h3>Conclusion</h3><div>Social network support for MOUD, both the initial level and change over time, was associated with participants’ willingness to receive MOUD. These findings suggest that intervention development focused on increasing social network support may have utility in increasing uptake of MOUD.</div></div>","PeriodicalId":11322,"journal":{"name":"Drug and alcohol dependence","volume":"277 ","pages":"Article 112966"},"PeriodicalIF":3.6,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145590519","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

Effectiveness of online mutual-help group attendance for adults with alcohol use disorders in the pooled, longitudinal, U.S. National PAL Study cohorts 在线互助组参加酒精使用障碍成人的有效性：美国国家纵向PAL研究队列。

IF 3.6 2区医学 Q1 PSYCHIATRY

Drug and alcohol dependence

Pub Date : 2025-12-01 DOI: 10.1016/j.drugalcdep.2025.112919

S.E. Zemore , L. Li , C.K. Lui , C. Timko , P. Martinez , A. Mericle

Purpose

Online mutual-help group (MHG) meetings have exploded, yet it remains unclear whether online attendance is effective. We examined how MHG attendance mode (online only, in-person only, or both) related to alcohol outcomes, hypothesizing poorer outcomes for online-only (vs. in-person only) attendance via lower MHG involvement. We also explored whether MHG attendance mode moderated associations between involvement and outcomes.

Methods

Data were from the U.S. Peer ALternatives for Addiction (PAL) Study, with baselines in 2015 and 2021 (N = 1152) and 6- and 12-month follow-ups. Participants reported lifetime AUD and attending a 12-step and/or second-wave MHG for an alcohol problem of their own in the prior 30 days at baseline. Surveys assessed past-30-day MHG attendance mode and involvement (5-item scale); outcomes included alcohol abstinence, alcohol problems, and heavy drinking (dichotomized). Analyses were lagged causal mediation models testing the natural indirect effects (NIEs) of MHG attendance mode on subsequent outcomes via MHG involvement, also examining exposure-mediator interactions.

Results

Across outcomes and as hypothesized, significant NIEs emerged between online-only (vs. in-person only) attendance and worse alcohol outcomes via lower involvement (ps<.01). Results showed equivalent outcomes for those attending via both modes (vs. in-person only), and effects of MHG involvement on outcomes were comparable across MHG attendance mode.

Conclusions

People attending MHG meetings for an AUD exclusively online may experience diminished benefits due to their lower overall involvement. While online-only attendees who are highly involved may fare well, high involvement may be difficult to achieve in online contexts. Thus, incorporating in-person attendance is probably optimal.

目的：在线互助组（MHG）会议爆炸式增长，但在线出席是否有效仍不清楚。我们研究了MHG出席模式（仅在线、仅面对面或两者都有）与饮酒结果的关系，并假设仅在线（与仅面对面）出席的MHG参与程度较低，结果较差。我们还探讨了MHG出席模式是否调节了参与与结果之间的关联。方法：数据来自美国同伴替代成瘾（PAL）研究，基线为2015年和2021年（N = 1152），随访6个月和12个月。参与者报告了终生AUD，并在基线前30天内因自己的酒精问题参加了12步和/或第二波MHG。调查评估了过去30天MHG的出席模式和参与（5项量表）；结果包括戒酒、酒精问题和重度饮酒（二分类）。分析采用滞后的因果中介模型，通过MHG参与检验MHG参与模式对后续结果的自然间接效应（NIEs），并检验暴露-中介的相互作用。结果：正如假设的那样，在所有结果中，仅在线（与仅面对面）出席之间出现了显著的nie，并且由于较低的参与而导致较差的酒精结果（结论：仅在线参加AUD的MHG会议的人可能会由于较低的总体参与度而减少收益）。虽然高度参与的在线参与者可能会过得很好，但在在线环境中，高度参与可能很难实现。因此，结合亲自出席可能是最理想的。

{"title":"Effectiveness of online mutual-help group attendance for adults with alcohol use disorders in the pooled, longitudinal, U.S. National PAL Study cohorts","authors":"S.E. Zemore , L. Li , C.K. Lui , C. Timko , P. Martinez , A. Mericle","doi":"10.1016/j.drugalcdep.2025.112919","DOIUrl":"10.1016/j.drugalcdep.2025.112919","url":null,"abstract":"<div><h3>Purpose</h3><div>Online mutual-help group (MHG) meetings have exploded, yet it remains unclear whether online attendance is effective. We examined how MHG attendance mode (online only, in-person only, or both) related to alcohol outcomes, hypothesizing poorer outcomes for online-only (vs. in-person only) attendance via lower MHG involvement. We also explored whether MHG attendance mode moderated associations between involvement and outcomes.</div></div><div><h3>Methods</h3><div>Data were from the U.S. Peer ALternatives for Addiction (PAL) Study, with baselines in 2015 and 2021 (N = 1152) and 6- and 12-month follow-ups. Participants reported lifetime AUD and attending a 12-step and/or second-wave MHG for an alcohol problem of their own in the prior 30 days at baseline. Surveys assessed past-30-day MHG attendance mode and involvement (5-item scale); outcomes included alcohol abstinence, alcohol problems, and heavy drinking (dichotomized). Analyses were lagged causal mediation models testing the natural indirect effects (NIEs) of MHG attendance mode on subsequent outcomes via MHG involvement, also examining exposure-mediator interactions.</div></div><div><h3>Results</h3><div>Across outcomes and as hypothesized, significant NIEs emerged between online-only (vs. in-person only) attendance and worse alcohol outcomes via lower involvement (ps<.01). Results showed equivalent outcomes for those attending via both modes (vs. in-person only), and effects of MHG involvement on outcomes were comparable across MHG attendance mode.</div></div><div><h3>Conclusions</h3><div>People attending MHG meetings for an AUD exclusively online may experience diminished benefits due to their lower overall involvement. While online-only attendees who are highly involved may fare well, high involvement may be difficult to achieve in online contexts. Thus, incorporating in-person attendance is probably optimal.</div></div>","PeriodicalId":11322,"journal":{"name":"Drug and alcohol dependence","volume":"277 ","pages":"Article 112919"},"PeriodicalIF":3.6,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145411237","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

Impact of morphine dependence and withdrawal on economic demand for fentanyl, cocaine, and methamphetamine in rats 吗啡依赖和戒断对大鼠芬太尼、可卡因和甲基苯丙胺经济需求的影响

IF 3.6 2区医学 Q1 PSYCHIATRY

Drug and alcohol dependence

Pub Date : 2025-11-28 DOI: 10.1016/j.drugalcdep.2025.112992

Robert W. Seaman Jr. , Nima Shariatzadeh , Kelly A. Salinas , Christina M. George , Yong-Gong Shi , Gregory T. Collins

Background

Stimulant-opioid co-use has surged in the United States, with methamphetamine use among people who use opioids increasing 82.6 % from 2015 to 2017. This trend contributes to rising overdose deaths, marking a "fourth wave" of the opioid epidemic. This study examined how opioid dependence and withdrawal affect the reinforcing effects of opioids and stimulants.

Methods & results

Male Sprague-Dawley rats (8–12 per group) were trained to self-administer fentanyl (3.2 µg/kg/inf), cocaine (0.32 mg/kg/inf), or methamphetamine (0.1 mg/kg/inf) under fixed ratio (FR) schedules. Opioid dependence was established through escalating twice-daily morphine injections (10–40 mg/kg) over four days, then maintained with daily doses of 40 mg/kg morphine. Rats exhibited stable signs of withdrawal (somatic signs, weight loss, hyperalgesia) following 20 h but not 12 h of morphine deprivation. Demand curves were generated by progressively increasing work requirements (FR 3, 5, 10, 18, 32, 56, 100, etc.) across sessions conducted 12 (morphine dependent) or 20 (morphine withdrawn) hours after morphine or saline (non-dependent controls). Morphine withdrawal (20-hour deprived group) increased demand for fentanyl but decreased demand for cocaine and methamphetamine. Morphine dependence (12-hour deprived group) had minimal effects, but did reliably decrease demand for cocaine. Morphine dependence increased demand intensity (Q₀) only for the small dose of fentanyl; all other conditions were unaffected.

Conclusions

These results demonstrate that opioid withdrawal increases motivation for opioid use while reducing motivation for stimulants, particularly at higher costs. Understanding these dynamics is crucial for developing effective polysubstance treatments addressing both opioid dependence and stimulant co-use.

在美国，兴奋剂和阿片类药物的共同使用激增，从2015年到2017年，阿片类药物使用者中甲基苯丙胺的使用量增加了82.6%。这一趋势导致过量死亡人数上升，标志着阿片类药物流行的“第四波”。本研究探讨了阿片类药物依赖和戒断如何影响阿片类药物和兴奋剂的强化作用。方法和结果雄性Sprague-Dawley大鼠（每组8-12只）在固定比例（FR）计划下自我给药芬太尼（3.2µg/kg/inf）、可卡因（0.32 mg/kg/inf）或甲基苯丙胺（0.1 mg/kg/inf）。阿片类药物依赖是通过在4天内逐步增加每日两次吗啡注射（10-40 mg/kg），然后维持每日剂量40 mg/kg吗啡来建立的。大鼠在吗啡剥夺20小时后表现出稳定的戒断症状（躯体症状、体重减轻、痛觉过敏），而在12小时后则没有。需求曲线是通过在吗啡或生理盐水（非依赖对照）后12小时（吗啡依赖）或20小时（吗啡戒断）期间逐渐增加的工作需求（FR 3、5、10、18、32、56、100等）而产生的。吗啡戒断（剥夺20小时组）增加了对芬太尼的需求，但减少了对可卡因和甲基苯丙胺的需求。吗啡依赖（12小时剥夺组）影响最小，但确实减少了对可卡因的需求。吗啡依赖仅对小剂量芬太尼增加需求强度（Q0）；其他条件均未受影响。这些结果表明，阿片类药物戒断增加了阿片类药物使用的动机，同时减少了兴奋剂的动机，特别是在成本较高的情况下。了解这些动态对于开发有效的多物质治疗解决阿片类药物依赖和兴奋剂共同使用至关重要。

{"title":"Impact of morphine dependence and withdrawal on economic demand for fentanyl, cocaine, and methamphetamine in rats","authors":"Robert W. Seaman Jr. , Nima Shariatzadeh , Kelly A. Salinas , Christina M. George , Yong-Gong Shi , Gregory T. Collins","doi":"10.1016/j.drugalcdep.2025.112992","DOIUrl":"10.1016/j.drugalcdep.2025.112992","url":null,"abstract":"<div><h3>Background</h3><div>Stimulant-opioid co-use has surged in the United States, with methamphetamine use among people who use opioids increasing 82.6 % from 2015 to 2017. This trend contributes to rising overdose deaths, marking a \"fourth wave\" of the opioid epidemic. This study examined how opioid dependence and withdrawal affect the reinforcing effects of opioids and stimulants.</div></div><div><h3>Methods & results</h3><div>Male Sprague-Dawley rats (8–12 per group) were trained to self-administer fentanyl (3.2µg/kg/inf), cocaine (0.32mg/kg/inf), or methamphetamine (0.1mg/kg/inf) under fixed ratio (FR) schedules. Opioid dependence was established through escalating twice-daily morphine injections (10–40mg/kg) over four days, then maintained with daily doses of 40mg/kg morphine. Rats exhibited stable signs of withdrawal (somatic signs, weight loss, hyperalgesia) following 20h but not 12h of morphine deprivation. Demand curves were generated by progressively increasing work requirements (FR 3, 5, 10, 18, 32, 56, 100, etc.) across sessions conducted 12 (morphine dependent) or 20 (morphine withdrawn) hours after morphine or saline (non-dependent controls). Morphine withdrawal (20-hour deprived group) increased demand for fentanyl but decreased demand for cocaine and methamphetamine. Morphine dependence (12-hour deprived group) had minimal effects, but did reliably decrease demand for cocaine. Morphine dependence increased demand intensity (Q<sub>0</sub>) only for the small dose of fentanyl; all other conditions were unaffected.</div></div><div><h3>Conclusions</h3><div>These results demonstrate that opioid withdrawal increases motivation for opioid use while reducing motivation for stimulants, particularly at higher costs. Understanding these dynamics is crucial for developing effective polysubstance treatments addressing both opioid dependence and stimulant co-use.</div></div>","PeriodicalId":11322,"journal":{"name":"Drug and alcohol dependence","volume":"278 ","pages":"Article 112992"},"PeriodicalIF":3.6,"publicationDate":"2025-11-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145692349","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

Quality of life and treatment effectiveness direct and indirect effects on cocaine abstinence outcomes during cocaine use disorder treatment 生活质量和治疗效果对可卡因使用障碍治疗期间可卡因戒断结果的直接和间接影响

IF 3.6 2区医学 Q1 PSYCHIATRY

Drug and alcohol dependence

Pub Date : 2025-11-28 DOI: 10.1016/j.drugalcdep.2025.112993

Crystal L. Smith , Sterling M. McPherson , Nicole Rodin , Sean E. Hovland , Nicole Akana , Andre QC Miguel , John Marsden , Andrew J. Saxon

Background

Patient-perceived Quality-of-Life (QOL) and treatment effectiveness (TEA) have previously been shown to be positively associated with better substance use treatment outcomes.

Objectives

This study examined potentially causal relationships amongst QOL, TEA, and cocaine abstinence.

Methods

Secondary data analyses (CTN-0148) were conducted on the NIDA Clinical Trial Network study, Cocaine Use Reduction with Buprenorphine (CTN-0048). N = 301 participants with DSM-IV cocaine dependence and opioid use history were administered injectable naltrexone and randomized to one of three buprenorphine/naloxone doses, 4 mg/1 mg, 16 mg/4 mg or placebo. Mediation models estimated direct and indirect effects amongst QOL, TEA, and cocaine abstinence.

Results

The QOL Environment domain exerted a significant indirect effect (B=0.01, SE=0.01, 95 % CI=[0.00, 0.02]) on cocaine abstinence and a direct effect on TEA (B=0.57, SE=0.22, 95 % CI=[0.16, 1.01]). Other QOL domains and individual QOL items exerted no statistically significant direct effects on cocaine abstinence. Overall QOL exerted a significant direct effect on TEA (95 % CI=[0.32, 2.45]) along with a significant indirect effect on cocaine abstinence (95 % CI=[0.01, 0.05]). TEA had a significant positive direct effect on cocaine abstinence (95 % CI=[0.01, 0.02]).

Conclusion

Overall QOL and environmental QOL are related to treatment response through their relationship with patients’ perception of treatment effectiveness. TEA is directly related to cocaine abstinence at the end of treatment. QOL and TEA measures may serve as indicators of a need for additional support within care plans. These findings highlight the impact of a patient’s sense of well-being and their perceived treatment effectiveness on biochemically validated cocaine abstinence.

患者感知的生活质量（QOL）和治疗有效性（TEA）先前已被证明与更好的药物使用治疗结果呈正相关。目的本研究探讨了生活质量、TEA和可卡因戒断之间的潜在因果关系。方法对NIDA临床试验网络研究丁丙诺啡减少可卡因使用（CTN-0048）进行二次数据分析（CTN-0148）。301名具有DSM-IV可卡因依赖和阿片类药物使用史的参与者给予注射纳曲酮，并随机分为三种丁丙诺啡/纳洛酮剂量，4mg / 1mg， 16mg / 4mg或安慰剂。中介模型估计了生活质量、茶和可卡因戒断之间的直接和间接影响。结果QOL环境域对可卡因戒断有显著的间接影响（B=0.01， SE=0.01, 95% CI=[0.00, 0.02]），对TEA有显著的直接影响（B=0.57， SE=0.22, 95% CI=[0.16, 1.01]）。其他生活质量领域和个别生活质量项目对可卡因戒断没有显著的直接影响。总体生活质量对TEA有显著的直接影响（95% CI=[0.32, 2.45]），对可卡因戒断有显著的间接影响（95% CI=[0.01, 0.05]）。TEA对可卡因戒断有显著的正向直接影响（95% CI=[0.01, 0.02]）。结论总体生活质量和环境生活质量通过与患者对治疗效果的感知关系与治疗反应相关。TEA与治疗结束时的可卡因戒断有直接关系。生活质量和TEA测量可以作为护理计划中需要额外支持的指标。这些发现强调了患者的幸福感和他们感知到的治疗效果对生物化学验证的可卡因戒断的影响。

{"title":"Quality of life and treatment effectiveness direct and indirect effects on cocaine abstinence outcomes during cocaine use disorder treatment","authors":"Crystal L. Smith , Sterling M. McPherson , Nicole Rodin , Sean E. Hovland , Nicole Akana , Andre QC Miguel , John Marsden , Andrew J. Saxon","doi":"10.1016/j.drugalcdep.2025.112993","DOIUrl":"10.1016/j.drugalcdep.2025.112993","url":null,"abstract":"<div><h3>Background</h3><div>Patient-perceived Quality-of-Life (QOL) and treatment effectiveness (TEA) have previously been shown to be positively associated with better substance use treatment outcomes.</div></div><div><h3>Objectives</h3><div>This study examined potentially causal relationships amongst QOL, TEA, and cocaine abstinence.</div></div><div><h3>Methods</h3><div>Secondary data analyses (CTN-0148) were conducted on the NIDA Clinical Trial Network study, <em>Cocaine Use Reduction with Buprenorphine</em> (CTN-0048). N = 301 participants with DSM-IV cocaine dependence and opioid use history were administered injectable naltrexone and randomized to one of three buprenorphine/naloxone doses, 4mg/1mg, 16mg/4mg or placebo. Mediation models estimated direct and indirect effects amongst QOL, TEA, and cocaine abstinence.</div></div><div><h3>Results</h3><div>The QOL Environment domain exerted a significant indirect effect (<em>B</em>=0.01, <em>SE</em>=0.01, 95 % CI=[0.00, 0.02]) on cocaine abstinence and a direct effect on TEA (<em>B</em>=0.57, <em>SE</em>=0.22, 95 % CI=[0.16, 1.01]). Other QOL domains and individual QOL items exerted no statistically significant direct effects on cocaine abstinence. Overall QOL exerted a significant direct effect on TEA (95 % CI=[0.32, 2.45]) along with a significant indirect effect on cocaine abstinence (95 % CI=[0.01, 0.05]). TEA had a significant positive direct effect on cocaine abstinence (95 % CI=[0.01, 0.02]).</div></div><div><h3>Conclusion</h3><div>Overall QOL and environmental QOL are related to treatment response through their relationship with patients’ perception of treatment effectiveness. TEA is directly related to cocaine abstinence at the end of treatment. QOL and TEA measures may serve as indicators of a need for additional support within care plans. These findings highlight the impact of a patient’s sense of well-being and their perceived treatment effectiveness on biochemically validated cocaine abstinence.</div></div>","PeriodicalId":11322,"journal":{"name":"Drug and alcohol dependence","volume":"278 ","pages":"Article 112993"},"PeriodicalIF":3.6,"publicationDate":"2025-11-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145692345","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

Comparison of remote to hybrid methods on recruitment and retention rates in a smoking cessation trial 远程方法与混合方法在戒烟试验中招募率和保留率的比较

IF 3.6 2区医学 Q1 PSYCHIATRY

Drug and alcohol dependence

Pub Date : 2025-11-27 DOI: 10.1016/j.drugalcdep.2025.112976

Elizabeth S. Hawes , Andrew P. Bontemps , William P. Wagner , Peter S. Hendricks , Adrienne C. Lahti , Andres Azuero , Karen L. Cropsey

Objectives

Due to the COVD-19 pandemic, many ongoing clinical trials had to rapidly shift to using remote trials, including our smoking cessation trial within a criminal legal population. The objective of this study was to compare recruitment rate, study adherence, retention, nicotine replacement therapy adherence, and quit attempts between participants who completed the study as planned (In-Person; N = 236), after implementation of a voucher system and additional check-in appointments (Incentivized; N = 126), and after the pandemic began (Hybrid; N = 153).

Methods

515 participants were recruited with criminal legal involvement from Birmingham, AL, and randomized to an In Vivo nicotine replacement therapy (NRT) sampling group or a standard smoking cessation counseling group, with both groups receiving 12 weeks of NRT.

Results

There were no significant differences in any of the study outcomes between the methodology groups, suggesting that hybrid methods of research do not result in a slower recruitment pace, less visits attended, or a higher likelihood of drop-out. Completing the study remotely did not appear to impact study outcomes such as likelihood of making a quit attempt or using NRT.

Conclusions

This study suggests that remote methods may be as effective as in-person methods in a clinical trial, although a randomized trial of these methods is needed.

由于covid -19大流行，许多正在进行的临床试验不得不迅速转向使用远程试验，包括我们在刑事合法人群中进行的戒烟试验。本研究的目的是比较按计划完成研究的参与者（面对面，N = 236）、实施代金券制度和额外登记预约后（N = 126）和大流行开始后（N = 153）的招募率、研究依从性、保留性、尼古丁替代疗法依从性和戒烟尝试。方法从美国伯明翰招募了515名涉及刑事法律的参与者，随机分为体内尼古丁替代疗法（NRT）采样组和标准戒烟咨询组，两组均接受12周的NRT治疗。结果两组研究结果均无显著差异，表明混合研究方法不会导致招募速度减慢、就诊人数减少或退出的可能性增加。远程完成研究似乎不会影响研究结果，如戒烟尝试或使用NRT的可能性。结论：本研究表明，在临床试验中，远程方法可能与现场方法一样有效，尽管需要对这些方法进行随机试验。

{"title":"Comparison of remote to hybrid methods on recruitment and retention rates in a smoking cessation trial","authors":"Elizabeth S. Hawes , Andrew P. Bontemps , William P. Wagner , Peter S. Hendricks , Adrienne C. Lahti , Andres Azuero , Karen L. Cropsey","doi":"10.1016/j.drugalcdep.2025.112976","DOIUrl":"10.1016/j.drugalcdep.2025.112976","url":null,"abstract":"<div><h3>Objectives</h3><div>Due to the COVD-19 pandemic, many ongoing clinical trials had to rapidly shift to using remote trials, including our smoking cessation trial within a criminal legal population. The objective of this study was to compare recruitment rate, study adherence, retention, nicotine replacement therapy adherence, and quit attempts between participants who completed the study as planned (In-Person; N = 236), after implementation of a voucher system and additional check-in appointments (Incentivized; N = 126), and after the pandemic began (Hybrid; N = 153).</div></div><div><h3>Methods</h3><div>515 participants were recruited with criminal legal involvement from Birmingham, AL, and randomized to an In Vivo nicotine replacement therapy (NRT) sampling group or a standard smoking cessation counseling group, with both groups receiving 12 weeks of NRT.</div></div><div><h3>Results</h3><div>There were no significant differences in any of the study outcomes between the methodology groups, suggesting that hybrid methods of research do not result in a slower recruitment pace, less visits attended, or a higher likelihood of drop-out. Completing the study remotely did not appear to impact study outcomes such as likelihood of making a quit attempt or using NRT.</div></div><div><h3>Conclusions</h3><div>This study suggests that remote methods may be as effective as in-person methods in a clinical trial, although a randomized trial of these methods is needed.</div></div>","PeriodicalId":11322,"journal":{"name":"Drug and alcohol dependence","volume":"278 ","pages":"Article 112976"},"PeriodicalIF":3.6,"publicationDate":"2025-11-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145692347","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

Composition of gut microbiota and alcohol-related liver disease: A systematic review and meta-analysis 肠道菌群组成与酒精相关性肝病：一项系统综述和荟萃分析

IF 3.6 2区医学 Q1 PSYCHIATRY

Drug and alcohol dependence

Pub Date : 2025-11-27 DOI: 10.1016/j.drugalcdep.2025.112988

Xuanxuan Niu , Lei Ma , Zhewen Zhou , Yan Li , Anyi Shi , Lihan Weng , Huichun Xing

Background and objectives

The intestinal microbiome has been identified as a key factor influencing the development and prognosis of alcohol-related liver disease (ARLD). This article aims to systematically review and meta-analyze the alterations in the gut microbiome associated with ARLD, providing a comprehensive overview of these changes.

Methods

PubMed, Embase, and Web of Science databases were systematically searched from January 1, 2015, to September 1, 2024, with the search limited to studies published in English and Chinese. Articles meeting the inclusion criteria—providing gut microbiota analysis and reporting changes in diversity and abundance—were selected through a two-stage screening process. Data extraction was conducted independently by two reviewers to ensure accuracy and reliability.

Results

We compared gut microbiota differences between ARLD patients and healthy individuals, focusing on α-diversity, β-diversity, and microbial abundance. Among 17 studies, α-diversity indices showed a significant decrease in Shannon index (SMD=-0.63, 95 % CI= [-1.40, −0.14]), p < 0.001), Chao1 (SMD=-1.20, 95 % CI= [-1.67, −0.74], p = 0.022), and OTUs (SMD=-1.14, 95 % CI= [-1.55, −0.73], p = 0.010), with no significant differences observed in Simpson index, ACE, inverse Simpson, or Pielou evenness. Of 21 studies on β-diversity, 16 reported significant differences between ARLD and healthy controls. Most findings indicate a reduction in anti-inflammatory microorganisms and an enrichment of pro-inflammatory microorganisms in ARLD patients.

Conclusion

The study revealed that intestinal microbiome changes in ARLD patients are characterized by decreased microbial diversity, a reduction in anti-inflammatory microbiota, and an enrichment of pro-inflammatory bacteria. These findings highlight the intestinal microbiome as a promising target for potential ARLD treatment strategies.

背景与目的：肠道微生物群已被确定为影响酒精相关性肝病（ARLD）发展和预后的关键因素。本文旨在系统回顾和荟萃分析与ARLD相关的肠道微生物组变化，提供这些变化的全面概述。方法：系统检索PubMed、Embase和Web of Science数据库，检索时间为2015年1月1日至2024年9月1日，检索限于已发表的中英文研究。符合纳入标准的文章-提供肠道微生物群分析并报告多样性和丰度的变化-通过两阶段筛选过程进行选择。数据提取由两名评审人员独立进行，以确保准确性和可靠性。结果：我们比较了ARLD患者与健康个体肠道菌群的差异，重点关注α-多样性、β-多样性和微生物丰度。17项研究中，α-多样性指数Shannon指数明显下降（SMD=-0.63, 95% CI= [-1.40, -0.14]）， p结论：ARLD患者肠道菌群变化表现为微生物多样性下降，抗炎菌群减少，促炎菌群丰富。这些发现强调肠道微生物组是潜在的ARLD治疗策略的一个有希望的目标。

{"title":"Composition of gut microbiota and alcohol-related liver disease: A systematic review and meta-analysis","authors":"Xuanxuan Niu , Lei Ma , Zhewen Zhou , Yan Li , Anyi Shi , Lihan Weng , Huichun Xing","doi":"10.1016/j.drugalcdep.2025.112988","DOIUrl":"10.1016/j.drugalcdep.2025.112988","url":null,"abstract":"<div><h3>Background and objectives</h3><div>The intestinal microbiome has been identified as a key factor influencing the development and prognosis of alcohol-related liver disease (ARLD). This article aims to systematically review and meta-analyze the alterations in the gut microbiome associated with ARLD, providing a comprehensive overview of these changes.</div></div><div><h3>Methods</h3><div>PubMed, Embase, and Web of Science databases were systematically searched from January 1, 2015, to September 1, 2024, with the search limited to studies published in English and Chinese. Articles meeting the inclusion criteria—providing gut microbiota analysis and reporting changes in diversity and abundance—were selected through a two-stage screening process. Data extraction was conducted independently by two reviewers to ensure accuracy and reliability.</div></div><div><h3>Results</h3><div>We compared gut microbiota differences between ARLD patients and healthy individuals, focusing on α-diversity, β-diversity, and microbial abundance. Among 17 studies, α-diversity indices showed a significant decrease in Shannon index (SMD=-0.63, 95 % CI= [-1.40, −0.14]), <em>p</em> < 0.001), Chao1 (SMD=-1.20, 95 % CI= [-1.67, −0.74], <em>p</em> = 0.022), and OTUs (SMD=-1.14, 95 % CI= [-1.55, −0.73], <em>p</em> = 0.010), with no significant differences observed in Simpson index, ACE, inverse Simpson, or Pielou evenness. Of 21 studies on β-diversity, 16 reported significant differences between ARLD and healthy controls. Most findings indicate a reduction in anti-inflammatory microorganisms and an enrichment of pro-inflammatory microorganisms in ARLD patients.</div></div><div><h3>Conclusion</h3><div>The study revealed that intestinal microbiome changes in ARLD patients are characterized by decreased microbial diversity, a reduction in anti-inflammatory microbiota, and an enrichment of pro-inflammatory bacteria. These findings highlight the intestinal microbiome as a promising target for potential ARLD treatment strategies.</div></div>","PeriodicalId":11322,"journal":{"name":"Drug and alcohol dependence","volume":"278 ","pages":"Article 112988"},"PeriodicalIF":3.6,"publicationDate":"2025-11-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145673061","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

Micro-costing analysis of harm reduction services in office-based addiction treatment 办公室成瘾治疗中减少伤害服务的微观成本分析。

IF 3.6 2区医学 Q1 PSYCHIATRY

Drug and alcohol dependence

Pub Date : 2025-11-27 DOI: 10.1016/j.drugalcdep.2025.112990

Austen Markus , Margaret Shang , Olivia Studnicki , Ariana Freund , Jessica Merlin , Jane M. Liebschutz , Vikram K. Raghu , Raagini Jawa

Objectives

The U.S. opioid crisis, driven by rising polysubstance use and limited access to treatment, continues to strain healthcare systems with nearly 87 % of people with substance use disorders (SUD) lacking addiction treatment and SUD-related hospitalizations increasing. Integration of harm reduction services (HRS) into office-based addiction treatment (OBAT) can reduce high-risk drug use, overdose, infection, and healthcare utilization. However, stigma and reimbursement barriers have hindered adoption. To inform future implementation, we conducted a micro-costing analysis of HRS integration in OBAT settings.

Methods

Using a retrospective, ingredients-based, micro-costing approach from the health system perspective, we estimated the upfront and operational costs associated with distributing pre-packaged harm reduction kits in three OBAT clinics in Pittsburgh, PA, and assessed the absolute costs of the program to determine affordability.

Results

Between February 2024 and June 2024, a total of 784 kits were distributed, averaging 261 kits per site. The most popular kits distributed included fentanyl test strips (n = 155), wound care (n = 146), and xylazine test strips (n = 122). Total upfront costs were $1962.03, and 5-month operational costs were $5480.68 across all three sites. Thus, we estimated that HRS integration into OBAT settings would cost one site $654.01 upfront and $365.38 and $4384.54 to operate monthly and annually, respectively.

Conclusions

We found that the estimated costs of HRS integration into OBAT sites was affordable and on par with other medical supplies kept in clinic spaces. More research needs to be done to assess HRS cost-effectiveness in reducing healthcare utilization and patient morbidity.

目的：美国的阿片类药物危机，由越来越多的多物质使用和有限的治疗机会驱动，继续使医疗保健系统紧张，近87%的物质使用障碍（SUD）患者缺乏成瘾治疗，与SUD相关的住院治疗增加。将减少伤害服务（HRS）纳入办公室成瘾治疗（OBAT）可以减少高风险药物使用、过量使用、感染和医疗保健利用。然而，耻辱感和报销障碍阻碍了采用。为了为未来的实施提供信息，我们对OBAT环境下的HRS集成进行了微观成本分析。方法：从卫生系统的角度，采用回顾性的、基于成分的微观成本计算方法，我们估计了宾夕法尼亚州匹兹堡市三家OBAT诊所分发预包装的减少伤害工具包的前期和运营成本，并评估了该计划的绝对成本，以确定可负担性。结果：2024年2月至2024年6月，共发放试剂盒784套，平均每个站点261套。分发最多的试剂盒包括芬太尼试纸条（n = 155）、伤口护理试纸条（n = 146）和噻嗪试纸条（n = 122）。前期总成本为1962.03美元，5个月的运营成本为5480.68美元。因此，我们估计，将HRS集成到OBAT设置中，一个站点的前期费用为654.01美元，每月和每年的运营费用分别为365.38美元和4384.54美元。结论：我们发现，将HRS整合到OBAT站点的估计成本是可以承受的，并且与保留在诊所空间的其他医疗用品相当。需要做更多的研究来评估HRS在降低医疗保健利用率和患者发病率方面的成本效益。

{"title":"Micro-costing analysis of harm reduction services in office-based addiction treatment","authors":"Austen Markus , Margaret Shang , Olivia Studnicki , Ariana Freund , Jessica Merlin , Jane M. Liebschutz , Vikram K. Raghu , Raagini Jawa","doi":"10.1016/j.drugalcdep.2025.112990","DOIUrl":"10.1016/j.drugalcdep.2025.112990","url":null,"abstract":"<div><h3>Objectives</h3><div>The U.S. opioid crisis, driven by rising polysubstance use and limited access to treatment, continues to strain healthcare systems with nearly 87 % of people with substance use disorders (SUD) lacking addiction treatment and SUD-related hospitalizations increasing. Integration of harm reduction services (HRS) into office-based addiction treatment (OBAT) can reduce high-risk drug use, overdose, infection, and healthcare utilization. However, stigma and reimbursement barriers have hindered adoption. To inform future implementation, we conducted a micro-costing analysis of HRS integration in OBAT settings.</div></div><div><h3>Methods</h3><div>Using a retrospective, ingredients-based, micro-costing approach from the health system perspective, we estimated the upfront and operational costs associated with distributing pre-packaged harm reduction kits in three OBAT clinics in Pittsburgh, PA, and assessed the absolute costs of the program to determine affordability.</div></div><div><h3>Results</h3><div>Between February 2024 and June 2024, a total of 784 kits were distributed, averaging 261 kits per site. The most popular kits distributed included fentanyl test strips (n = 155), wound care (n = 146), and xylazine test strips (n = 122). Total upfront costs were $1962.03, and 5-month operational costs were $5480.68 across all three sites. Thus, we estimated that HRS integration into OBAT settings would cost one site $654.01 upfront and $365.38 and $4384.54 to operate monthly and annually, respectively.</div></div><div><h3>Conclusions</h3><div>We found that the estimated costs of HRS integration into OBAT sites was affordable and on par with other medical supplies kept in clinic spaces. More research needs to be done to assess HRS cost-effectiveness in reducing healthcare utilization and patient morbidity.</div></div>","PeriodicalId":11322,"journal":{"name":"Drug and alcohol dependence","volume":"278 ","pages":"Article 112990"},"PeriodicalIF":3.6,"publicationDate":"2025-11-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145746354","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

Higher levels of naloxone protection are associated with lower risk-taking: A longitudinal analysis of New York City residents using unprescribed opioids 更高水平的纳洛酮保护与更低的风险相关：对使用非处方阿片类药物的纽约市居民的纵向分析

IF 3.6 2区医学 Q1 PSYCHIATRY

Drug and alcohol dependence

Pub Date : 2025-11-27 DOI: 10.1016/j.drugalcdep.2025.112989

Luther Elliott , Adrian Harris , Dev Crasta , Melody S. Goodman , Yuyu Chen , Saba Rouhani , David Frank , Jemar R. Bather , Alex S. Bennett

Objective

To apply risk compensation theory to naloxone peer access and evaluate whether reported naloxone protection—having naloxone and someone to administer it present when using unprescribed opioids—correlated with greater opioid overdose risk behaviors.

Methods

Longitudinal cohort of 422 NYC residents using unprescribed opioids who completed at least three monthly surveys over 24 months. Mixed-effects models estimated unadjusted and adjusted associations between naloxone protection and both opioid risk and overdose events and were used to test whether race/ethnicity and gender modified the relationship between naloxone protection and risk behaviors.

Results

Being protected 75 % of the time or more was identified as a meaningful cutoff in the sample and was associated with fewer opioid risk behaviors and overdose events. Race/ethnicity, but not gender, was found to be a significant effect modifier of naloxone protection.

Conclusions

Findings indicate no support for the risk compensation-derived hypothesis that people who use opioids while protected by naloxone pursue more overdose-associated risk behaviors than those unprotected.

Policy implications

Concerns about how naloxone may disinhibit people who use opioids, leading to greater risk-taking, appear unfounded, reaffirming the importance of universal naloxone access.

目的将风险补偿理论应用于纳洛酮的同行获取，并评估报告的纳洛酮保护（非处方阿片类药物使用时存在纳洛酮和给药者）是否与阿片类药物过量风险行为增加相关。方法对422名使用非处方阿片类药物的纽约市居民进行纵向队列研究，这些居民在24个月内完成了至少三个月的调查。混合效应模型估计了纳洛酮保护与阿片类药物风险和过量事件之间未经调整和调整的关联，并用于测试种族/民族和性别是否改变了纳洛酮保护与风险行为之间的关系。结果在样本中，75%或更多的时间受到保护被确定为有意义的临界值，并与较少的阿片类药物风险行为和过量事件相关。种族/民族，而非性别，被发现是纳洛酮保护的显著影响因素。结论：研究结果不支持风险补偿衍生的假设，即使用阿片类药物并接受纳洛酮保护的人比未接受纳洛酮保护的人有更多的过量相关风险行为。政策影响对纳洛酮如何使阿片类药物使用者失去抑制，从而导致更大风险的担忧似乎是没有根据的，这重申了普遍获得纳洛酮的重要性。

{"title":"Higher levels of naloxone protection are associated with lower risk-taking: A longitudinal analysis of New York City residents using unprescribed opioids","authors":"Luther Elliott , Adrian Harris , Dev Crasta , Melody S. Goodman , Yuyu Chen , Saba Rouhani , David Frank , Jemar R. Bather , Alex S. Bennett","doi":"10.1016/j.drugalcdep.2025.112989","DOIUrl":"10.1016/j.drugalcdep.2025.112989","url":null,"abstract":"<div><h3>Objective</h3><div>To apply risk compensation theory to naloxone peer access and evaluate whether reported naloxone <em>protection</em>—having naloxone and someone to administer it present when using unprescribed opioids—correlated with greater opioid overdose risk behaviors.</div></div><div><h3>Methods</h3><div>Longitudinal cohort of 422 NYC residents using unprescribed opioids who completed at least three monthly surveys over 24 months. Mixed-effects models estimated unadjusted and adjusted associations between naloxone protection and both opioid risk and overdose events and were used to test whether race/ethnicity and gender modified the relationship between naloxone protection and risk behaviors.</div></div><div><h3>Results</h3><div>Being protected 75 % of the time or more was identified as a meaningful cutoff in the sample and was associated with fewer opioid risk behaviors and overdose events. Race/ethnicity, but not gender, was found to be a significant effect modifier of naloxone protection.</div></div><div><h3>Conclusions</h3><div>Findings indicate no support for the risk compensation-derived hypothesis that people who use opioids while protected by naloxone pursue more overdose-associated risk behaviors than those unprotected.</div></div><div><h3>Policy implications</h3><div>Concerns about how naloxone may disinhibit people who use opioids, leading to greater risk-taking, appear unfounded, reaffirming the importance of universal naloxone access.</div></div>","PeriodicalId":11322,"journal":{"name":"Drug and alcohol dependence","volume":"278 ","pages":"Article 112989"},"PeriodicalIF":3.6,"publicationDate":"2025-11-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145692346","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

Childhood trauma, family functioning, and the BDNF gene may affect the development of alcohol use disorder 童年创伤、家庭功能和BDNF基因可能影响酒精使用障碍的发展

IF 3.6 2区医学 Q1 PSYCHIATRY

Drug and alcohol dependence

Pub Date : 2025-11-26 DOI: 10.1016/j.drugalcdep.2025.112987

Yi-Wei Yeh , Catherine Shin Huey Chen , Shin-Chang Kuo , Chun-Yen Chen , Yu-Chieh Huang , Jyun-Teng Huang , You-Ping Yang , Jhih-Syuan Huang , Kuo-Hsing Ma , San-Yuan Huang

Background

Childhood trauma and family dysfunction substantially increase the risk of alcohol use disorder (AUD) among individuals with genetic susceptibility. Brain-Derived Neurotrophic Factor (BDNF) plays a crucial role in neuronal neuroplasticity.

Methods

The cross-sectional case-control study examines the associations between the BDNF gene, childhood trauma, and family functioning in relation to vulnerability to AUD. A total of 1085 participants were recruited from the Han Chinese population. The final analysis included data from 518 patients with AUD and 548 healthy controls, and 19 were excluded due to DNA issues. Three psychometric instruments—the childhood trauma questionnaire (CTQ), the adverse childhood experiences questionnaire (ACEs), and the family APGAR questionnaires were used to assess environmental risk factors contributing to AUD. An independent t-test was used to examine differences between controls, AUD, and its subgroups for each psychometric score. ANCOVA was performed to assess the effects of BDNF variants on CTQ, ACE, and APGAR scores in patients with AUD after adjusting for age and gender.

Results

The CTG haplotype in the rs6265-rs6484320-rs7934165 block of the BDNF gene was associated with the late-onset AUD (p = 9.9 ×10⁻⁵). Higher CTQ and ACEs scores were observed in AUD patients, particularly in those with early-onset AUD. Total CTQ score and ACEs score were negatively correlated with the onset age of AUD, although these scores were not influenced by BDNF genotype.

Conclusion

Childhood trauma and impaired family functioning may serve as predictive factors in the development of AUD. BDNF gene variants, childhood trauma, and family functioning appear to influence AUD risk.

背景：童年创伤和家庭功能障碍在遗传易感性个体中显著增加酒精使用障碍（AUD）的风险。脑源性神经营养因子（BDNF）在神经元可塑性中起着至关重要的作用。方法横断面病例对照研究探讨了BDNF基因、儿童创伤和家庭功能与AUD易感性之间的关系。总共从汉族人群中招募了1085名参与者。最终分析包括518名AUD患者和548名健康对照者的数据，其中19名因DNA问题而被排除在外。采用童年创伤问卷（CTQ）、童年不良经历问卷（ace）和家庭APGAR问卷三种心理测量工具评估环境风险因素对AUD的影响。使用独立t检验来检查每个心理测量分数在对照组、AUD及其亚组之间的差异。在调整年龄和性别后，采用ANCOVA评估BDNF变异对AUD患者CTQ、ACE和APGAR评分的影响。结果BDNF基因rs6265-rs6484320-rs7934165片段的CTG单倍型与晚发型AUD相关（p = 9.9 ×10−5）。在AUD患者中观察到较高的CTQ和ace评分，特别是在早发性AUD患者中。CTQ总分和ace评分与AUD发病年龄呈负相关，但不受BDNF基因型的影响。结论童年创伤和家庭功能障碍可能是AUD发生的预测因素。BDNF基因变异、童年创伤和家庭功能似乎影响AUD的风险。

{"title":"Childhood trauma, family functioning, and the BDNF gene may affect the development of alcohol use disorder","authors":"Yi-Wei Yeh , Catherine Shin Huey Chen , Shin-Chang Kuo , Chun-Yen Chen , Yu-Chieh Huang , Jyun-Teng Huang , You-Ping Yang , Jhih-Syuan Huang , Kuo-Hsing Ma , San-Yuan Huang","doi":"10.1016/j.drugalcdep.2025.112987","DOIUrl":"10.1016/j.drugalcdep.2025.112987","url":null,"abstract":"<div><h3>Background</h3><div>Childhood trauma and family dysfunction substantially increase the risk of alcohol use disorder (AUD) among individuals with genetic susceptibility. Brain-Derived Neurotrophic Factor (BDNF) plays a crucial role in neuronal neuroplasticity.</div></div><div><h3>Methods</h3><div>The cross-sectional case-control study examines the associations between the <em>BDNF</em> gene, childhood trauma, and family functioning in relation to vulnerability to AUD. A total of 1085 participants were recruited from the Han Chinese population. The final analysis included data from 518 patients with AUD and 548 healthy controls, and 19 were excluded due to DNA issues. Three psychometric instruments—the childhood trauma questionnaire (CTQ), the adverse childhood experiences questionnaire (ACEs), and the family APGAR questionnaires were used to assess environmental risk factors contributing to AUD. An independent <em>t</em>-test was used to examine differences between controls, AUD, and its subgroups for each psychometric score. ANCOVA was performed to assess the effects of BDNF variants on CTQ, ACE, and APGAR scores in patients with AUD after adjusting for age and gender.</div></div><div><h3>Results</h3><div>The CTG haplotype in the <em>rs6265-rs6484320-rs7934165</em> block of the <em>BDNF</em> gene was associated with the late-onset AUD (<em>p</em> = 9.9 ×10<sup>−5</sup>). Higher CTQ and ACEs scores were observed in AUD patients, particularly in those with early-onset AUD. Total CTQ score and ACEs score were negatively correlated with the onset age of AUD, although these scores were not influenced by <em>BDNF</em> genotype.</div></div><div><h3>Conclusion</h3><div>Childhood trauma and impaired family functioning may serve as predictive factors in the development of AUD. <em>BDNF</em> gene variants, childhood trauma, and family functioning appear to influence AUD risk.</div></div>","PeriodicalId":11322,"journal":{"name":"Drug and alcohol dependence","volume":"278 ","pages":"Article 112987"},"PeriodicalIF":3.6,"publicationDate":"2025-11-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145692348","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