Drug and alcohol dependence最新文献_第6页

Reciprocal effects between illicit drug use and mental health conditions among healthcare workers in Sweden: A one-year follow-up study 瑞典卫生保健工作者非法药物使用与精神健康状况之间的相互影响：一项为期一年的随访研究。

IF 3.6 2区医学 Q1 PSYCHIATRY

Drug and alcohol dependence

Pub Date : 2025-12-05 DOI: 10.1016/j.drugalcdep.2025.112997

Josefina Peláez Zuberbuhler , Emelie Thern , Siw Tone Innstrand , Marit Christensen , Bodil J. Landstad , Malin Sjöström , Devy L. Elling , Emma Brulin

Background

Research suggests a comorbidity between illicit drug use and mental health conditions. However, it remains unclear whether illicit drug use serves as a risk factor for, or a consequence of, mental health conditions in healthcare workers (HCWs). This study aimed to 1) examine the prevalence of illicit drug use among HCWs in Sweden and 2) investigate the bidirectional relationship between illicit drug use and mental health conditions(i.e., depression and burnout).

Methods

Data from the 2022 and 2023 Longitudinal Occupational Health Survey in Healthcare Sweden (LOHHCS) were used. The data included 3280 HCWs (50.3 % physicians and 49.7 % nurses). Questionnaires assessed illicit drug use frequency, burnout complaints (BAT-12), and depression (SCL-CD6). Cross-lagged panel models (CLPMs) were used to examine the reciprocal relationships over the two studied time-points between illicit drug use and mental health conditions.

Results

The prevalence of illicit drug use in 2022 was 1.3 %, which increased slightly to 1.6 % one and a half years later, in 2023. Using two-wave panel data, results revealed a bidirectional effect between illicit drug use and burnout. However, while depression was associated with subsequent illicit drug use, the reversed association was not observed.

Conclusions

These findings suggest that illicit drug use plays different roles in relation to burnout and depression among healthcare workers. This highlights the importance of integrated treatment strategies and preventive measures that address both illicit drug use and mental health conditions—especially burnout—simultaneously.

背景：研究表明，非法药物使用与精神健康状况之间存在共病。然而，目前尚不清楚非法药物使用是卫生保健工作者精神健康状况的风险因素还是后果。本研究旨在1)检查瑞典卫生保健工作者中非法药物使用的流行程度；2)调查非法药物使用与精神健康状况（即精神健康状况）之间的双向关系。抑郁和倦怠)。方法：使用2022年和2023年瑞典卫生保健纵向职业健康调查（LOHHCS）的数据。数据包括3280名医护人员（50.3%为医生，49.7%为护士）。问卷评估了非法药物使用频率、倦怠投诉（BAT-12）和抑郁（SCL-CD6）。交叉滞后面板模型（clpm）用于检查在两个研究时间点上非法药物使用与精神健康状况之间的相互关系。结果：2022年的非法药物使用率为1.3%，一年半后的2023年略有上升至1.6%。使用双波面板数据，结果揭示了非法药物使用与倦怠之间的双向效应。然而，虽然抑郁症与随后的非法药物使用有关，但没有观察到相反的关联。结论：这些研究结果表明，非法药物使用在医护人员的职业倦怠和抑郁中起着不同的作用。这突出了综合治疗战略和预防措施的重要性，既要处理非法药物使用问题，又要同时处理精神健康状况，特别是精神衰竭问题。

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引用次数: 0

Characteristics of family, friends, and significant others affected by another’s alcohol or other drug use in Australia and correlates of help-seeking 在澳大利亚，受他人酒精或其他药物使用影响的家人、朋友和重要他人的特征以及寻求帮助的相关性

IF 3.6 2区医学 Q1 PSYCHIATRY

Drug and alcohol dependence

Pub Date : 2025-12-05 DOI: 10.1016/j.drugalcdep.2025.112996

Clare M. Rushton, Alison K. Beck, Peter J. Kelly, Philippa Coleman, Briony Larance

Background

Supporting families, friends, and significant others (hereafter ‘families’) affected by a loved one’s (hereafter ‘Person’s’) alcohol and drug (AOD) use can improve family wellbeing. However, little is known about families’ help-seeking patterns. This study aimed to describe characteristics and explore correlates of accessing support among affected families.

Methods

An online cross-sectional survey conducted between September-2023 and August-2024 of N = 1756 English-speaking Australian residents, aged > 18, identifying as affected by a loved one’s AOD use. Data collected included sociodemographics, psychological wellbeing indicators, and help-seeking, analysed using summary statistics and logistic regressions.

Results

Participants (1433/1569; 91.3 % female), were mostly partners (621/1756; 35.4 %). Seventy-one percent (1159/1633) were concerned about their Person’s alcohol use, followed by methamphetamines (n = 210; 12.9 %). Participants reported being concerned about their Person’s AOD use for a median of 9.5 years (SD=10.1). Fifty-four percent (816/1510) of participants (affected families) reported high-very high psychological distress, 22.7 % (345/1521) reported recent suicidal ideation, 14.8 % (192/1299) reported risky alcohol use and 19.7 % (257/1305) recently used illicit drugs. Participants who accessed specialised family-AOD support (419/1228; 34.1 %) were more likely older (65 +; Adj.OR=1.47; 95 %CI[1.03, 2.10]), less likely to reside with their Person (Adj.OR=0.72; 95 %CI[0.55, 0.96]) and to report their own risky drinking (Adj.OR=0.53; 95 %CI[0.35, 0.80]), and more likely to report their Person accessed AOD treatment (Adj.OR=1.85; 95 %CI[1.33, 2.56]).

Conclusions

The results highlight elevated distress, suicidality and substance use among affected families and their delayed access to predominantly non-specialised support. Greater investment in community-health campaigns and specialised services is required to ensure provision of timely and tailored support.

支持受亲人（个人）酒精和药物（AOD）使用影响的家庭、朋友和重要的其他人（以下简称“家庭”）可以改善家庭幸福。然而，人们对家庭的求助模式知之甚少。本研究旨在描述受影响家庭获得支持的特征并探讨相关关系。方法在2023年9月至2024年8月期间，对1756名年龄在18岁、说英语的澳大利亚居民进行了一项在线横断面调查，他们认为自己受到亲人使用AOD的影响。收集的数据包括社会人口统计、心理健康指标和求助情况，并使用汇总统计和逻辑回归进行分析。结果参与者（1433/1569人，女性91.3%）以伴侣为主（621/1756人，35.4%）。71%（1159/1633）的人担心自己的酒精使用，其次是甲基苯丙胺（n = 210; 12.9%）。参与者报告说，他们对自己的AOD使用的担忧中位数为9.5年（SD=10.1）。54%（816/1510）的参与者（受影响家庭）报告高-非常高的心理困扰，22.7%（345/1521）报告最近有自杀意念，14.8%（192/1299）报告危险饮酒，19.7%（257/1305）报告最近使用非法药物。获得专门的家庭AOD支持的参与者（419/1228;34.1%）更可能是老年人（65岁以上；adjj . or =1.47; 95% CI[1.03, 2.10]），更不可能与他们的个人一起生活（adjj . or =0.72; 95% CI[0.55, 0.96]），更不可能报告他们自己的危险饮酒（adjj . or =0.53; 95% CI[0.35, 0.80]），更可能报告他们的个人获得AOD治疗（adjj . or =1.85; 95% CI[1.33, 2.56]）。结论：研究结果表明，受影响家庭的痛苦程度、自杀倾向和药物使用增加，以及他们获得非专业支持的时间延迟。需要加大对社区卫生运动和专门服务的投资，以确保提供及时和有针对性的支持。

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引用次数: 0

Access to medications for opioid use disorder among primary care patients with homeless experience in the Department of Veterans Affairs 在退伍军人事务部无家可归的初级保健患者中获得阿片类药物使用障碍的药物。

IF 3.6 2区医学 Q1 PSYCHIATRY

Drug and alcohol dependence

Pub Date : 2025-12-05 DOI: 10.1016/j.drugalcdep.2025.112995

Audrey L. Jones , Haojia Li , Jacob D. Baylis , Sophia Huebler , Ying Suo , Yue Zhang , Lillian Gelberg , Susan Zickmund , Tom H. Greene , Stefan G. Kertesz , Adam J. Gordon

Background

Primary care settings tailored for persons with experience of homelessness (PEH) could enhance opioid use disorder treatment delivery, but evidence is lacking.

Objective

To examine medication treatment for opioid use disorder (MOUD) among PEH who received homeless-tailored primary care in the Department of Veterans Affairs (VA).

Methods

Receipt of MOUD was assessed from electronic health records among VA primary care patients with experience of homelessness and OUD in 2016–2020. We estimated the proportion who received MOUD over time and applied mixed effect Poisson models with entropy balance weighting to estimate differences in MOUD by primary care type (homeless-tailored vs. mainstream). Secondary analyses examined the consistency of findings across 18 VA service regions.

Findings

The percentage of eligible PEH (n = 45,864) receiving any MOUD rose from 42.1 % to 51.0 % over time. Half (51.3 %) of those initiating MOUD received > 30 days MOUD over one year. In unadjusted models, the proportion receiving MOUD was slightly higher in homeless-tailored primary care, compared to mainstream primary care (48.8 % vs 46.4 %, Unadjusted Incidence Rate Ratio=1.09, 95 % CI=1.03–1.16). After covariate adjustment, there was no statistical difference between groups (Adjusted IRR=0.97, CI=0.92–1.02). This proved broadly consistent across VA service regions.

Conclusions

Concomitant with a national VA initiative to tailor primary care services for PEH, half of diagnosed patients received MOUD. Yet evidence of durable treatment was low, and the homeless-tailored clinics did not outperform mainstream clinics. Efforts to tailor primary care for PEH may require specialized addiction staffing and implementation support to improve MOUD care in these settings.

背景：为无家可归者量身定制的初级保健环境可以加强阿片类药物使用障碍治疗的提供，但缺乏证据。目的：探讨在退伍军人事务部（VA）接受无家可归者量身定制初级保健的PEH中阿片类药物使用障碍（mod）的药物治疗情况。方法：从2016-2020年经历过无家可归和OUD的VA初级保健患者的电子健康记录中评估mod的接收情况。我们估计了随时间推移接受mod的比例，并应用熵平衡加权的混合效应泊松模型来估计初级保健类型（无家可归者定制与主流）mod的差异。二次分析检查了18VA服务区域调查结果的一致性。结果：随着时间的推移，符合条件的PEH （n = 45,864）接受任何mod的百分比从42.1%上升到51.0%。一半（51.3%）的患者在一年内接受了30天的mod治疗。在未调整的模型中，与主流初级保健相比，无家可归者量身定制的初级保健中接受mod的比例略高（48.8% vs 46.4%，未调整的发病率比=1.09,95% CI=1.03-1.16）。协变量校正后，两组间差异无统计学意义（校正IRR=0.97， CI=0.92-1.02）。事实证明，这在各个退伍军人服务地区是普遍一致的。结论：随着国家VA倡议为PEH量身定制初级保健服务，一半确诊患者接受了mod。然而，持久治疗的证据很低，为无家可归者量身定制的诊所也没有超过主流诊所。为PEH量身定制初级保健的努力可能需要专门的成瘾人员配备和实施支持，以改善这些环境中的mod护理。

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引用次数: 0

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。

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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。

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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。

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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。

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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。

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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。

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引用次数: 0