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Impact of Smoking Status and Nicotine Dependence on Academic Performance of Health Sciences Students. 吸烟状况和尼古丁依赖对健康科学专业学生学习成绩的影响
IF 1.8 Q1 SUBSTANCE ABUSE Pub Date : 2023-01-01 DOI: 10.2147/SAR.S393062
Jaber S Alqahtani, Abdulelah M Aldhahir, Zaid Alanazi, Emad Zahi Alsulami, Mujahid A Alsulaimani, Abdullah A Alqarni, Abdullah S Alqahtani, Ayadh Yahya AlAyadi, Musallam Alnasser, Ibrahim A AlDraiwiesh, Saeed M Alghamdi, Hussam M Almarkhan, Abdullah S Alsulayyim, Saad M AlRabeeah, Mohammed D AlAhmari

Background: Smoking behavior has been associated with poor academic performance among adult students worldwide. However, the detrimental effect of nicotine dependence on several students' academic achievement indicators is still unclear. This study aims to assess the impact of smoking status and nicotine dependence on grade point average (GPA), absenteeism rate and academic warnings among undergraduate health sciences students in Saudi Arabia.

Methods: A validated cross-sectional survey was conducted, in which, participants responded to questions evaluated cigarette consumption, urge to consume and dependency, learning performance, days of absentees, and academic warnings.

Results: A total of 501 students from different health specialties have completed the survey. Of whom, 66% were male, 95% ranging between the age of 18-30 years old, and 81% reported no health issues or chronic diseases. Current smokers estimated to be 30% of the respondents, of which 36% revealed smoking history of 2-3 years. The prevalence of nicotine dependency (high to extremely high) was 50%. Overall, smokers had significantly lower GPA, higher absenteeism rate, and higher number of academic warnings when compared to nonsmokers (p<0.001). Heavy smokers demonstrated significantly less GPA (p=0.036), higher days of absences (p=0.017), and more academic warnings (p=0.021) compared to light smokers. The linear regression model indicated a significant association between smoking history (increased pack-per-year) and poor GPA (p=0.01) and increased number of academic warning last semester (p=0.01), while increased cigarette consumption was substantially linked with higher academic warnings (p=0.002), lower GPA (p=0.01), and higher absenteeism rate for last semester (p=0.01).

Conclusion: Smoking status and nicotine dependence were predictive of worsening academic performance, including lower GPA, higher absenteeism rate and academic warnings. In addition, there is a substantial and unfavorable dose-response association between smoking history and cigarette consumption with impaired academic performance indicators.

背景:在世界范围内,吸烟行为与成人学生的学习成绩差有关。然而,尼古丁依赖对一些学生学业成绩指标的不利影响尚不清楚。本研究旨在评估吸烟状况和尼古丁依赖对沙特阿拉伯健康科学本科学生平均绩点(GPA)、缺勤率和学术警告的影响。方法:进行了一项有效的横断面调查,其中参与者回答了评估卷烟消费量、消费冲动和依赖性、学习表现、缺课天数和学术警告的问题。结果:共有501名卫生专业学生完成调查。其中66%为男性,95%的年龄在18-30岁之间,81%的人报告没有健康问题或慢性病。目前吸烟者估计占应答者的30%,其中36%的人有2-3年的吸烟史。尼古丁依赖的患病率(高至极高)为50%。总体而言,与不吸烟者相比,吸烟者的平均绩点更低,缺勤率更高,学术警告次数更多。结论:吸烟状况和尼古丁依赖可预测学习成绩恶化,包括GPA更低,缺勤率更高,学术警告次数更多。此外,吸烟史和香烟消费与学业成绩指标受损之间存在实质性的不利剂量反应关联。
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引用次数: 0
Nearly One-Fourth of Eastern Ethiopian Adolescents are Current Psychoactive Substance Users: A School-Based Cross-Sectional Study. 近四分之一的埃塞俄比亚东部青少年目前是精神活性物质使用者:一项基于学校的横断面研究。
IF 1.8 Q1 SUBSTANCE ABUSE Pub Date : 2023-01-01 DOI: 10.2147/SAR.S401843
Abdi Birhanu, Tilahun Bete, Addis Eyeberu, Tamirat Getachew, Elias Yadeta, Abraham Negash, Magarsa Lami, Tegenu Balcha, Addisu Sertsu, Adera Deballa

Introduction: Psychoactive substance use is a growing health problem in both developing and developed countries. Despite adolescents being at high risk of practicing risky behaviors including substance use, there is no adequate information on the problem in the Harari Region, in the Eastern part of Ethiopia. Hence, the present study aimed to identify the burden of current substance use in high school adolescent students of Harari Region, Ethiopia, from 10th April to 10th May 2022.

Methods: A school-based cross-sectional study was employed on a total of 1498 randomly selected adolescent students. Poisson regression was used for the assessment of substance use over the last three months among adolescent students. The substance use burden was reported by IRR (incidence rate ratio) at a 95% Confidence interval. The final model fitness was checked using Akaike information criterion (AIC) and Bayesian information criterion (BIC) reports. The variables that had less than 0.05 P-value were declared to be statistically significant.

Results: The overall psychoactive substance use was 373 (24.9%, 95% Confidence Interval (CI); 22.8-27.1%). The substances included khat (21.6%, 95% CI; 18.6-23.6%), alcohol drinking (1.8%; 95% CI; 1.3-2.6%), and smoking (1.2%, 95% CI; 0.75-1.9%). Being male (IRR (Incidence Rate ratio) = 1.21, 95% CI; 1.11-1.38), availability of the substance (IRR (Incidence Rate ratio) = 2.02, 95%; 1.53-2.66), having substance user friends (IRR=1.60: 95% CI: 1.30-2.01), and being at a younger age (IRR = 1.21; 95% CI: 1.02-1.44) increased the psychoactive substance use rate in the adolescents.

Conclusion and recommendation: One out of four adolescents was a current psychoactive substance user. Being male, substance availability, having substance-user friends, and being at younger age increased the psychoactive substance use rate in school adolescents in Eastern Ethiopia. The intervention that involves the schools' community, students' families, and executive bodies should be strengthened to overcome the substance use-related burdens among high school adolescent students.

精神活性物质的使用在发展中国家和发达国家都是一个日益严重的健康问题。尽管青少年有很高的危险行为,包括使用药物,但在埃塞俄比亚东部的哈拉里地区,没有关于这一问题的充分信息。因此,本研究旨在确定2022年4月10日至5月10日埃塞俄比亚哈拉里地区高中青少年学生当前物质使用的负担。方法:采用校本横断面研究,随机抽取1498名青少年学生进行调查。泊松回归用于评估青少年学生在过去三个月内的物质使用情况。物质使用负担以IRR(发病率比)报告,可信区间为95%。最后采用赤池信息准则(AIC)和贝叶斯信息准则(BIC)报告检验模型的适应度。p值小于0.05的变量被认为具有统计学意义。结果:总体精神活性物质使用为373例(24.9%,95%可信区间(CI));22.8 - -27.1%)。这些物质包括阿拉伯茶(21.6%,95% CI);18.6-23.6%),饮酒(1.8%;95%可信区间;1.3-2.6%)和吸烟(1.2%,95% CI;0.75 - -1.9%)。男性(IRR(发病率比)= 1.21,95% CI;1.11-1.38),物质可得性(IRR(发生率比)= 2.02,95%;1.53-2.66),有物质使用者朋友(IRR=1.60: 95% CI: 1.30-2.01),年龄较小(IRR= 1.21;95% CI: 1.02-1.44)增加了青少年的精神活性物质使用率。结论和建议:四分之一的青少年目前是精神活性物质使用者。在埃塞俄比亚东部,男性、物质可得性、有使用物质的朋友以及年龄较低增加了在校青少年使用精神活性物质的比率。应该加强学校社区、学生家庭、行政机关的介入,以克服高中生的药物使用负担。
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引用次数: 0
Efficacy of Cognitive Behavioral Therapy for Alcohol and Other Drug Use Disorders: Is a One-Size-Fits-All Approach Appropriate? 认知行为治疗酒精和其他药物使用障碍的疗效:一刀切的方法是否合适?
IF 1.8 Q1 SUBSTANCE ABUSE Pub Date : 2023-01-01 DOI: 10.2147/SAR.S362864
Molly Magill, Brian D Kiluk, Lara A Ray

Purpose: We provide an overview of Cognitive Behavioral Therapy (CBT) efficacy for adult alcohol or other drug use disorders (AOD) and consider some key variations in application as well as contextual (ie, moderators) or mechanistic (ie, mediators) factors related to intervention outcomes.

Methods: This work is a narrative overview of the review literature on CBT for AOD.

Results: Robust evidence suggests the efficacy of classical/traditional CBT compared to minimal and usual care control conditions. CBT combined with another evidence-based treatment such as Motivational Interviewing, Contingency Management, or pharmacotherapy is also efficacious compared to minimal and usual care control conditions, but no form of CBT consistently demonstrates efficacy compared to other empirically-supported modalities. CBT and integrative forms of CBT have potential for flexible application such as use in a digital format. Data on mechanisms of action, however, are quite limited and this is despite preliminary evidence that shows that CBT effect sizes on mechanistic outcomes (ie, secondary measures of psychosocial adjustment) are moderate and typically larger than those for AOD use.

Conclusion: CBT for AOD is a well-established intervention with demonstrated efficacy, effect sizes are in the small-to-moderate range, and there is potential for tailoring given the modular format of the intervention. Future work should consider mechanisms of CBT efficacy and key conditions for dissemination and implementation with fidelity.

目的:我们概述了认知行为疗法(CBT)对成人酒精或其他药物使用障碍(AOD)的疗效,并考虑了应用中的一些关键变化以及与干预结果相关的情境(即调节因子)或机制(即中介因子)因素。方法:对CBT治疗AOD的文献综述进行综述。结果:强有力的证据表明,与最低限度和常规护理对照条件相比,经典/传统CBT的有效性。CBT与其他循证治疗相结合,如动机性访谈、应急管理或药物治疗,与最低限度和常规护理控制条件相比也有效,但与其他经验支持的方式相比,没有一种形式的CBT始终表现出疗效。CBT和CBT的综合形式具有灵活应用的潜力,例如以数字格式使用。然而,关于作用机制的数据相当有限,尽管有初步证据表明,CBT对机制结果(即心理社会适应的次要测量)的效应大小是中等的,通常比使用AOD的效应大。结论:CBT治疗AOD是一种行之有效的干预措施,具有明显的疗效,效应量在小到中等范围内,并且由于干预的模块化格式,有可能进行调整。未来的工作应考虑CBT的有效性机制和传播和实施的关键条件。
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引用次数: 3
A Prospective Biopsychosocial Repeated Measures Study of Stress and Dropout from Substance Addiction Treatment. 药物成瘾治疗中压力与退出的前瞻性生物-心理-社会重复测量研究。
IF 1.8 Q1 SUBSTANCE ABUSE Pub Date : 2023-01-01 DOI: 10.2147/SAR.S376389
Kari Bøhle, Eli Otterholt, Stål Kapstø Bjørkly

Introduction: This prospective, repeated-measures observational study tested biopsychosocial variables as risk factors for dropping out of inpatient substance addiction treatment. Substance use disorder (SUD) is viewed as a chronic relapsing disease caused by an interaction between biological, psychological, and social factors. However, there is a lack of prospective studies that combine biopsychosocial variables when assessing dropout. The aims of this study were to investigate whether there was 1) An association between biopsychosocial factors and dropping out of inpatient substance addiction treatment, 2) An interaction with SUD diagnosis and cortisol, and 3) Different dropout rates between short-term and long-term institutions.

Materials and methods: Patients (n = 173) were recruited from two inpatient treatment centers in Norway between 2018 and 2021. The following biopsychosocial variables were measured at four timepoints: ward atmosphere (Ward Atmosphere Scale, WAS), psychological distress (Hopkins Symptom Checklist 10, HSCL-10), motivation (M-scale of the Circumstances, Motivation, Readiness, and Suitability questionnaire), and concentration of salivary cortisol (CORT- nmol/L). Cortisol levels were measured for two consecutive days at each timepoint and calculated by two cortisol indices, daytime cortisol slope (DCS) and area under the curve with respect to the ground (AUCG). A multivariate logistic regression analysis was performed to find an association between dropout rates and the biopsychosocial variables.

Results: The results suggest a lower dropout odds for patients with high motivation (OR = 0.76, p = 0.022) and patients admitted to short-term treatment (OR = 0.06, p = 0.005). An interaction with stimulant SUD and DCS (OR = 13.74, p = 0.024) also revealed higher dropout odds. No statistical significance was found for psychological distress, WAS, and cortisol AUCG.

Conclusion: The results support monitoring motivation during treatment and further investigating biopsychosocial variables when assessing dropout risk together with SUD diagnosis.

引言:这项前瞻性、重复测量的观察性研究测试了生物心理社会变量作为住院患者物质成瘾治疗退出的危险因素。物质使用障碍(SUD)被认为是一种由生物、心理和社会因素相互作用引起的慢性复发性疾病。然而,在评估辍学时,缺乏结合生物心理社会变量的前瞻性研究。本研究旨在探讨生物社会心理因素与住院物质成瘾患者退出治疗之间是否存在关联,与SUD诊断和皮质醇之间是否存在相互作用,以及短期和长期机构的辍学率是否存在差异。材料和方法:2018年至2021年间,从挪威的两个住院治疗中心招募患者(n = 173)。在四个时间点测量以下生物心理社会变量:病房气氛(病房气氛量表,WAS)、心理困扰(霍普金斯症状检查表10,HSCL-10)、动机(环境、动机、准备和适宜性问卷的m量表)和唾液皮质醇浓度(CORT- nmol/L)。在每个时间点连续两天测量皮质醇水平,并通过两个皮质醇指数,白天皮质醇斜率(DCS)和相对于地面的曲线下面积(AUCG)计算皮质醇水平。进行多变量逻辑回归分析以发现辍学率与生物心理社会变量之间的关联。结果:结果表明,高动机患者(OR = 0.76, p = 0.022)和接受短期治疗的患者(OR = 0.06, p = 0.005)的退出几率较低。与兴奋剂SUD和DCS的相互作用(OR = 13.74, p = 0.024)也显示出更高的退学几率。心理困扰、was和皮质醇AUCG均无统计学意义。结论:该结果支持在治疗过程中监测动机,并在评估退学风险时进一步研究生物心理社会变量,并结合SUD诊断。
{"title":"A Prospective Biopsychosocial Repeated Measures Study of Stress and Dropout from Substance Addiction Treatment.","authors":"Kari Bøhle,&nbsp;Eli Otterholt,&nbsp;Stål Kapstø Bjørkly","doi":"10.2147/SAR.S376389","DOIUrl":"https://doi.org/10.2147/SAR.S376389","url":null,"abstract":"<p><strong>Introduction: </strong>This prospective, repeated-measures observational study tested biopsychosocial variables as risk factors for dropping out of inpatient substance addiction treatment. Substance use disorder (SUD) is viewed as a chronic relapsing disease caused by an interaction between biological, psychological, and social factors. However, there is a lack of prospective studies that combine biopsychosocial variables when assessing dropout. The aims of this study were to investigate whether there was 1) An association between biopsychosocial factors and dropping out of inpatient substance addiction treatment, 2) An interaction with SUD diagnosis and cortisol, and 3) Different dropout rates between short-term and long-term institutions.</p><p><strong>Materials and methods: </strong>Patients (n = 173) were recruited from two inpatient treatment centers in Norway between 2018 and 2021. The following biopsychosocial variables were measured at four timepoints: ward atmosphere (Ward Atmosphere Scale, WAS), psychological distress (Hopkins Symptom Checklist 10, HSCL-10), motivation (M-scale of the Circumstances, Motivation, Readiness, and Suitability questionnaire), and concentration of salivary cortisol (CORT- nmol/L). Cortisol levels were measured for two consecutive days at each timepoint and calculated by two cortisol indices, daytime cortisol slope (DCS) and area under the curve with respect to the ground (AUC<sub>G</sub>). A multivariate logistic regression analysis was performed to find an association between dropout rates and the biopsychosocial variables.</p><p><strong>Results: </strong>The results suggest a lower dropout odds for patients with high motivation (OR = 0.76, p = 0.022) and patients admitted to short-term treatment (OR = 0.06, p = 0.005). An interaction with stimulant SUD and DCS (OR = 13.74, p = 0.024) also revealed higher dropout odds. No statistical significance was found for psychological distress, WAS, and cortisol AUC<sub>G</sub>.</p><p><strong>Conclusion: </strong>The results support monitoring motivation during treatment and further investigating biopsychosocial variables when assessing dropout risk together with SUD diagnosis.</p>","PeriodicalId":22060,"journal":{"name":"Substance Abuse and Rehabilitation","volume":"14 ","pages":"61-75"},"PeriodicalIF":1.8,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/cb/14/sar-14-61.PMC10351681.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9836331","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Bio-Psycho-Social Profile of People with Substance Use Disorders Treated in Locally Assigned Treatment Facilities in Kandahar, Afghanistan. 在阿富汗坎大哈当地指定的治疗机构治疗的物质使用障碍患者的生物心理社会概况。
IF 1.8 Q1 SUBSTANCE ABUSE Pub Date : 2023-01-01 DOI: 10.2147/SAR.S412821
Muhammad Haroon Stanikzai, Mohammad Wahid Wahidi

Background: Substance use and its associated bio-psycho-social problems are public health concerns with harmful individual and social consequences.

Objective: This study assessed the bio-psycho-social profile of people with substance use disorders (SUD) treated at locally assigned treatment facilities in Kandahar, Afghanistan.

Methods: We conducted this facility-based cross-sectional study among 621 substance users receiving care at three locally assigned treatment facilities in November-December 2022. We performed multiple linear regression to determine factors associated with psychological symptoms.

Results: The mean age of the participants was 34.41 (± 10.10 SD) years. The majority of our subjects (81.2%) perceived their physical health as very good or fair. More than two-thirds (73.4%) rated their social support as high. Of all participants, 541 (87.1%) had symptoms of depression, 569 (91.6%) of anxiety, and 442 (71.2%) of stress. The prevalence of severe depression, anxiety, and stress was 34.8%, 65.8%, and 27.3%, respectively. The multiple linear regression showed that several attributes of people with substance use disorders [ie, having a low level of education (β=0.12, p=<0.001), being unemployed (β=0.31, p=<0.001), having a low level of social support (β=-0.35, p=<0.001), had a pre-existing medical condition (β=-0.28, p=<0.001), and having lived abroad in the past ten years (β=0.10, p=0.001)] were significantly associated with higher DASS-21 total scores.

Conclusion: This study highlights the importance of providing bio-psycho-social support programs and implementing therapeutic interventions to help people with substance use disorders, particularly those who are most susceptible to higher levels of bio-psycho-social problems.

背景:物质使用及其相关的生物-心理-社会问题是具有有害个人和社会后果的公共卫生问题。目的:本研究评估了在阿富汗坎大哈当地指定的治疗机构治疗的物质使用障碍(SUD)患者的生物心理社会特征。方法:我们在2022年11月至12月在三家当地指定的治疗机构接受治疗的621名药物使用者中进行了这项基于设施的横断面研究。我们采用多元线性回归来确定与心理症状相关的因素。结果:参与者的平均年龄为34.41(±10.10 SD)岁。我们的大多数受试者(81.2%)认为他们的身体健康状况非常好或一般。超过三分之二(73.4%)的人认为自己的社会支持度很高。在所有参与者中,541人(87.1%)有抑郁症状,569人(91.6%)有焦虑症状,442人(71.2%)有压力症状。重度抑郁、焦虑和压力的患病率分别为34.8%、65.8%和27.3%。多元线性回归显示物质使用障碍患者的几个属性[即教育水平低](β=0.12, p=)结论:本研究强调了提供生物心理社会支持计划和实施治疗干预措施对物质使用障碍患者的重要性,特别是那些最容易出现较高水平的生物心理社会问题的人。
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引用次数: 1
Features of Addiction in Binge-Eating Disorder: Considerations for Screening and Treatment. 暴饮暴食症的成瘾特征:筛选和治疗的考虑。
IF 1.8 Q1 SUBSTANCE ABUSE Pub Date : 2023-01-01 DOI: 10.2147/SAR.S391636
Alexandra Paul, Aleena Ghanta, Ariana M Chao

Similarities have been reported between the diagnostic and associated characteristics of binge-eating disorder (BED) and substance-related and non-substance-related disorders. This has resulted in interest in using addiction models to inform clinical care for people with BED. The purpose of this paper was to review features of addiction in BED with a focus on clinical implications. First, we briefly summarize similarities and differences in diagnostic and mechanistic features and symptoms for BED and food addiction, substance-related disorders, and non-substance-related disorders. Then we review aspects of addiction in BED that have clinical implications for screening and treatment of this condition. Similarities in diagnostic criteria between BED and substance-related and non-substance-related disorders include loss of control, greater use than intended, continued use despite adverse consequences, and marked distress. Addiction models may help inform aspects of clinical care of BED, particularly for shared antecedents and mechanisms underlying both disorders and to enhance engagement in treatment. Yet, there are large gaps in evidence regarding the effects of many aspects of addiction models to BED. More research is needed to examine the safety and efficacy of using addiction theories and frameworks for clinical strategies for BED.

据报道,暴饮暴食症(BED)的诊断和相关特征与物质相关和非物质相关疾病相似。这引起了人们对使用成瘾模型为BED患者提供临床护理的兴趣。本文的目的是回顾BED成瘾的特点,重点是临床意义。首先,我们简要总结了BED与食物成瘾、物质相关障碍和非物质相关障碍的诊断和机制特征和症状的异同。然后,我们回顾了BED成瘾的各个方面,这些方面对筛查和治疗这种疾病具有临床意义。BED与药物相关疾病和非药物相关疾病的诊断标准的相似之处包括失去控制、使用过量、不顾不良后果继续使用和明显的痛苦。成瘾模型可能有助于为BED的临床护理提供信息,特别是对于两种疾病的共同前因和机制,以及提高治疗参与度。然而,关于成瘾模型对BED的许多方面的影响,证据存在很大差距。需要更多的研究来检验使用成瘾理论和框架作为BED的临床策略的安全性和有效性。
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引用次数: 0
Updated Perspectives on the Neurobiology of Substance Use Disorders Using Neuroimaging. 利用神经影像学研究物质使用障碍神经生物学的最新观点。
IF 1.8 Q1 SUBSTANCE ABUSE Pub Date : 2023-01-01 DOI: 10.2147/SAR.S362861
Kevin S Murnane, Amber N Edinoff, Elyse M Cornett, Alan D Kaye

Substance use problems impair social functioning, academic achievement, and employability. Psychological, biological, social, and environmental factors can contribute to substance use disorders. In recent years, neuroimaging breakthroughs have helped elucidate the mechanisms of substance misuse and its effects on the brain. Functional magnetic resonance imaging (MRI), positron emission tomography (PET), single-photon emission computed tomography (SPECT), and magnetic resonance spectroscopy (MRS) are all examples. Neuroimaging studies suggest substance misuse affects executive function, reward, memory, and stress systems. Recent neuroimaging research attempts have provided clinicians with improved tools to diagnose patients who misuse substances, comprehend the complicated neuroanatomy and neurobiology involved, and devise individually tailored and monitorable treatment regimens for individuals with substance use disorders. This review describes the most recent developments in drug misuse neuroimaging, including the neurobiology of substance use disorders, neuroimaging, and substance use disorders, established neuroimaging techniques, recent developments with established neuroimaging techniques and substance use disorders, and emerging clinical neuroimaging technology.

物质使用问题损害社会功能、学业成就和就业能力。心理、生物、社会和环境因素可导致物质使用障碍。近年来,神经影像学的突破有助于阐明药物滥用的机制及其对大脑的影响。功能性磁共振成像(MRI)、正电子发射断层扫描(PET)、单光子发射计算机断层扫描(SPECT)和磁共振波谱(MRS)都是例子。神经影像学研究表明,药物滥用会影响执行功能、奖励、记忆和压力系统。最近的神经影像学研究尝试为临床医生提供了改进的工具,以诊断滥用药物的患者,理解涉及的复杂神经解剖学和神经生物学,并为物质使用障碍患者设计个性化定制和可监测的治疗方案。这篇综述描述了药物滥用神经影像学的最新发展,包括物质使用障碍的神经生物学、神经影像学和物质使用障碍、已建立的神经影像学技术、已建立的神经影像学技术和物质使用障碍的最新发展,以及新兴的临床神经影像学技术。
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引用次数: 0
Harmful Alcohol Use Among Patients with Tuberculosis in Gedeo Zone, Southern Ethiopia. 埃塞俄比亚南部Gedeo地区结核病患者有害酒精使用情况
IF 1.8 Q1 SUBSTANCE ABUSE Pub Date : 2022-01-01 DOI: 10.2147/SAR.S384921
Kalkidan Yohannes, Getinet Ayano, Kusse Koirita Toitole, Henok Mulatu Teferi, Hirbaye Mokona

Introduction: Alcohol consumption among patients with tuberculosis is on the rise. There is evidence that alcohol consumption negatively affects treatment outcomes for these populations. Due to this, a substantial number of people relapse, withdraw from treatment, or even die as a result of their alcohol addiction. Despite this, little research has been conducted on the factors associated with the harmful use of alcohol by this group of people in Ethiopia. The purpose of this study was to determine the prevalence and associated factors of harmful alcohol use among patients with tuberculosis in the Gedeo Zone, southern Ethiopia.

Methods: A cross-sectional study was conducted at healthcare facilities. Four hundred and fifteen participants aged 18 and older were recruited using a systematic random sampling method. Data on sociodemographic factors, clinical factors, social support, perceptions of the stigma associated with tuberculosis, and depression were collected using structured and validated instruments. Measurement of harmful alcohol consumption was conducted using the AUDIT.

Results:  The prevalence of harmful alcohol use among tuberculosis patients was 20% (95% CI; 16.1-24.2%). There is a significant correlation between medical comorbidity (AOR = 2.44, 95% CI: 1.29-4.62), disease duration (≥12 months) (AOR = 2.88, 95% CI: 1.03-3.04), and being male (AOR = 2.10, 95% CI: 1.17-3.77) with harmful alcohol consumption.

Conclusion: Our study revealed that alcohol consumption was high among tuberculosis patients. The presence of comorbidities, being male, and having a long-term illness were significant predictors of harmful alcohol consumption. It is imperative to screen patients who have suffered from chronic tuberculosis for an extended period of time. It is also pertinent to screen patients with comorbid medical conditions for alcohol abuse. Screening for alcohol abuse at an early stage can prevent poor treatment outcomes as well as the effects of comorbid medical conditions and harmful use of alcohol.

前言:结核病患者的饮酒量呈上升趋势。有证据表明,饮酒对这些人群的治疗结果有负面影响。因此,相当数量的人复发,退出治疗,甚至死于他们的酒精成瘾。尽管如此,很少对埃塞俄比亚这一群体有害使用酒精的相关因素进行研究。本研究的目的是确定埃塞俄比亚南部Gedeo区结核病患者有害酒精使用的患病率及其相关因素。方法:在医疗机构进行横断面研究。采用系统随机抽样方法招募了415名18岁及以上的参与者。使用结构化和经过验证的工具收集有关社会人口因素、临床因素、社会支持、与结核病相关的耻辱感和抑郁症的数据。使用审计对有害酒精消费进行了测量。结果:结核病患者有害酒精使用的患病率为20% (95% CI;16.1 - -24.2%)。医学共病(AOR = 2.44, 95% CI: 1.29-4.62)、病程(≥12个月)(AOR = 2.88, 95% CI: 1.03-3.04)和男性(AOR = 2.10, 95% CI: 1.17-3.77)与有害饮酒有显著相关。结论:我们的研究表明,结核病患者的饮酒量很高。存在合并症、男性和长期患病是有害酒精消费的重要预测因素。对长期患有慢性结核病的患者进行筛查是非常必要的。这也与筛查有酒精滥用合并症的患者有关。在早期阶段对酒精滥用进行筛查可以预防不良治疗结果以及合并症和有害使用酒精的影响。
{"title":"Harmful Alcohol Use Among Patients with Tuberculosis in Gedeo Zone, Southern Ethiopia.","authors":"Kalkidan Yohannes,&nbsp;Getinet Ayano,&nbsp;Kusse Koirita Toitole,&nbsp;Henok Mulatu Teferi,&nbsp;Hirbaye Mokona","doi":"10.2147/SAR.S384921","DOIUrl":"https://doi.org/10.2147/SAR.S384921","url":null,"abstract":"<p><strong>Introduction: </strong>Alcohol consumption among patients with tuberculosis is on the rise. There is evidence that alcohol consumption negatively affects treatment outcomes for these populations. Due to this, a substantial number of people relapse, withdraw from treatment, or even die as a result of their alcohol addiction. Despite this, little research has been conducted on the factors associated with the harmful use of alcohol by this group of people in Ethiopia. The purpose of this study was to determine the prevalence and associated factors of harmful alcohol use among patients with tuberculosis in the Gedeo Zone, southern Ethiopia.</p><p><strong>Methods: </strong>A cross-sectional study was conducted at healthcare facilities. Four hundred and fifteen participants aged 18 and older were recruited using a systematic random sampling method. Data on sociodemographic factors, clinical factors, social support, perceptions of the stigma associated with tuberculosis, and depression were collected using structured and validated instruments. Measurement of harmful alcohol consumption was conducted using the AUDIT.</p><p><strong>Results: </strong> The prevalence of harmful alcohol use among tuberculosis patients was 20% (95% CI; 16.1-24.2%). There is a significant correlation between medical comorbidity (AOR = 2.44, 95% CI: 1.29-4.62), disease duration (≥12 months) (AOR = 2.88, 95% CI: 1.03-3.04), and being male (AOR = 2.10, 95% CI: 1.17-3.77) with harmful alcohol consumption.</p><p><strong>Conclusion: </strong>Our study revealed that alcohol consumption was high among tuberculosis patients. The presence of comorbidities, being male, and having a long-term illness were significant predictors of harmful alcohol consumption. It is imperative to screen patients who have suffered from chronic tuberculosis for an extended period of time. It is also pertinent to screen patients with comorbid medical conditions for alcohol abuse. Screening for alcohol abuse at an early stage can prevent poor treatment outcomes as well as the effects of comorbid medical conditions and harmful use of alcohol.</p>","PeriodicalId":22060,"journal":{"name":"Substance Abuse and Rehabilitation","volume":"13 ","pages":"117-125"},"PeriodicalIF":1.8,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/c5/d7/sar-13-117.PMC9760035.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10763181","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
The Role of the Pharmacist in Combating the Opioid Crisis: An Update. 药剂师在对抗阿片类药物危机中的作用:更新。
IF 1.8 Q1 SUBSTANCE ABUSE Pub Date : 2022-01-01 DOI: 10.2147/SAR.S351096
Lucas Kosobuski, Carolyn O'Donnell, Cynthia P Koh-Knox Sharp, Nathaniel Chen, Laura Palombi

Introduction: The opioid overdose crisis has claimed hundreds of thousands of lives in the United States in the last decade, with overdose numbers continuing to climb. At the same time, the role of the pharmacist in combating the opioid crisis continues to evolve.

Methods: A literature search was conducted in Ovid MEDLINE that incorporated both MeSH terms and keywords to describe two concepts: the opioid epidemic and pharmacists/pharmacies. The search was limited to articles published after 2010 through the end of 2021 and returned 196 articles that were analyzed thematically.

Results: Thematic analysis revealed the following themes: prevention, interventions, public health role of the pharmacist, pharmacists in multiple roles, barriers, pharmacist and healthcare provider attitudes, educational initiatives for pharmacists and student pharmacists, and future research.

Discussion: While a great deal of progress has been made in the role of the pharmacist in supporting individuals with opioid use disorder (OUD) in the last two decades, pharmacists must seek to invest time and resources into practices with a strong evidence base to better mitigate the growing, devastating impact of the opioid crisis. Pharmacists must be willing to embrace new and non-traditional roles in patient care, service and research, and seek to advance evidence-based knowledge and practice.

Conclusion: Pharmacy practice has expanded greatly in the past decade with pharmacists taking on new and creative approaches to addressing the opioid crisis. Collaborative and interdisciplinary approaches to addressing the root causes of opioid misuse and opioid overdose are still desperately needed. These include attention to the critical roles of social determinants of health, stigma elimination, legislative advocacy for patients with OUD, and focused education for providers, pharmacists, and the community. Recognition and support of the value of collaboration to both improve public health and individual patient care, continued investments in pharmacy practice advancement in OUD treatment and harm reduction, and the creation of workflows and prescribing algorithms to assist in dosing medications to prevent withdrawal symptoms and achieve improved pain control are desperately needed.

导读:在过去的十年里,阿片类药物过量危机已经夺去了美国数十万人的生命,而且过量服用的人数还在继续攀升。与此同时,药剂师在对抗阿片类药物危机中的作用也在不断发展。方法:在Ovid MEDLINE中检索文献,纳入MeSH术语和关键词,描述阿片类药物流行和药剂师/药房两个概念。搜索仅限于2010年至2021年底发表的文章,并返回了196篇进行主题分析的文章。结果:专题分析揭示了以下主题:预防、干预措施、药剂师的公共卫生角色、药剂师多重角色、障碍、药剂师和卫生保健提供者的态度、药剂师和学生药剂师的教育举措以及未来的研究方向。讨论:虽然在过去二十年中,药剂师在支持阿片类药物使用障碍(OUD)患者方面的作用取得了很大进展,但药剂师必须寻求将时间和资源投入到具有强大证据基础的实践中,以更好地减轻阿片类药物危机日益严重的破坏性影响。药剂师必须愿意在病人护理,服务和研究中接受新的和非传统的角色,并寻求推进循证知识和实践。结论:在过去的十年中,药学实践已经大大扩大,药剂师采取了新的和创造性的方法来解决阿片类药物危机。仍然迫切需要采取合作和跨学科的方法来解决阿片类药物滥用和阿片类药物过量的根本原因。这些措施包括关注健康的社会决定因素的关键作用,消除耻辱感,对OUD患者进行立法宣传,以及对提供者、药剂师和社区进行重点教育。迫切需要承认和支持合作的价值,以改善公共卫生和个人病人护理,继续投资于药房实践,改进OUD治疗和减少伤害,以及创建工作流程和处方算法,以协助给药,防止戒断症状和改善疼痛控制。
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引用次数: 1
Substance Use in Pregnancy: Identifying Stigma and Improving Care. 妊娠期物质使用:识别污名并改善护理。
IF 1.8 Q1 SUBSTANCE ABUSE Pub Date : 2021-11-23 eCollection Date: 2021-01-01 DOI: 10.2147/SAR.S319180
Andrea Weber, Benjamin Miskle, Alison Lynch, Stephan Arndt, Laura Acion

This review examines the impact of stigma on pregnant people who use substances. Stigma towards people who use drugs is pervasive and negatively impacts the care of substance-using people by characterizing addiction as a weakness and fostering beliefs that undermine the personal resources needed to access treatment and recover from addiction, including self-efficacy, help seeking and belief that they deserve care. Stigma acts on multiple levels by blaming people for having a problem and then making it difficult for them to get help, but in spite of this, most pregnant people who use substances reduce or stop using when they learn they are pregnant. Language, beliefs about gender roles, and attitudes regarding fitness for parenting are social factors that can express and perpetuate stigma while facilitating punitive rather than therapeutic approaches. Because of stigmatizing attitudes that a person who uses substances is unfit to parent, pregnant people who use substances are at heightened risk of being screened for substance use, referred to child welfare services, and having their parental rights taken away; these outcomes are even more likely for people of color. Various treatment options can successfully support recovery in substance-using pregnant populations, but treatment is underutilized in all populations including pregnant people, and more knowledge is needed on how to sustain engagement in treatment and recovery activities. To combat stigma when working with substance-using pregnant people throughout the peripartum period, caregivers should utilize a trauma-informed approach that incorporates harm reduction and motivational interviewing with a focus on building trust, enhancing self-efficacy, and strengthening the personal skills and resources needed to optimize health of the parent-baby dyad.

这篇综述探讨了污名对使用药物的孕妇的影响。对吸毒者的污名化是普遍存在的,并通过将成瘾定性为一种弱点,培养破坏获得治疗和戒除成瘾所需的个人资源的信念,包括自我效能感、寻求帮助和他们应该得到治疗的信念,对药物使用者的护理产生负面影响。耻辱感在多个层面上起作用,指责人们有问题,然后使他们难以获得帮助,但尽管如此,大多数使用药物的孕妇在得知自己怀孕后减少或停止使用药物。语言、关于性别角色的信念以及关于是否适合养育子女的态度是表达和延续耻辱的社会因素,同时促进惩罚而不是治疗方法。由于使用药物的人不适合为人父母的污名化态度,使用药物的孕妇更有可能被筛查是否使用药物,转到儿童福利服务机构,并被剥夺父母的权利;有色人种更有可能出现这些结果。各种治疗方案可以成功地支持吸毒孕妇人群的康复,但包括孕妇在内的所有人群的治疗都没有得到充分利用,需要更多的知识来了解如何持续参与治疗和康复活动。在整个围产期与使用药物的孕妇一起工作时,为了消除耻辱感,护理人员应该利用创伤知情的方法,将减少伤害和动机性访谈结合起来,重点是建立信任,增强自我效能,加强个人技能和资源,以优化父母-婴儿的健康。
{"title":"Substance Use in Pregnancy: Identifying Stigma and Improving Care.","authors":"Andrea Weber,&nbsp;Benjamin Miskle,&nbsp;Alison Lynch,&nbsp;Stephan Arndt,&nbsp;Laura Acion","doi":"10.2147/SAR.S319180","DOIUrl":"https://doi.org/10.2147/SAR.S319180","url":null,"abstract":"<p><p>This review examines the impact of stigma on pregnant people who use substances. Stigma towards people who use drugs is pervasive and negatively impacts the care of substance-using people by characterizing addiction as a weakness and fostering beliefs that undermine the personal resources needed to access treatment and recover from addiction, including self-efficacy, help seeking and belief that they deserve care. Stigma acts on multiple levels by blaming people for having a problem and then making it difficult for them to get help, but in spite of this, most pregnant people who use substances reduce or stop using when they learn they are pregnant. Language, beliefs about gender roles, and attitudes regarding fitness for parenting are social factors that can express and perpetuate stigma while facilitating punitive rather than therapeutic approaches. Because of stigmatizing attitudes that a person who uses substances is unfit to parent, pregnant people who use substances are at heightened risk of being screened for substance use, referred to child welfare services, and having their parental rights taken away; these outcomes are even more likely for people of color. Various treatment options can successfully support recovery in substance-using pregnant populations, but treatment is underutilized in all populations including pregnant people, and more knowledge is needed on how to sustain engagement in treatment and recovery activities. To combat stigma when working with substance-using pregnant people throughout the peripartum period, caregivers should utilize a trauma-informed approach that incorporates harm reduction and motivational interviewing with a focus on building trust, enhancing self-efficacy, and strengthening the personal skills and resources needed to optimize health of the parent-baby dyad.</p>","PeriodicalId":22060,"journal":{"name":"Substance Abuse and Rehabilitation","volume":"12 ","pages":"105-121"},"PeriodicalIF":1.8,"publicationDate":"2021-11-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/dc/a0/sar-12-105.PMC8627324.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39769052","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 30
期刊
Substance Abuse and Rehabilitation
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