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Recovery Capital Gains May Precede Craving Reduction in Opioid Use Disorder. 恢复资本收益可能先于阿片类药物使用障碍的迫切减少。
IF 1.8 Pub Date : 2023-10-05 eCollection Date: 2023-01-01 DOI: 10.2147/SAR.S433350
Nicholas L Bormann, Andrea N Weber, Benjamin Miskle, Stephan Arndt, Alison C Lynch

Purpose: Cravings for drugs and alcohol have been significantly associated with worse treatment outcomes. We investigated if improvements in recovery capital (RC) (eg, a measure of social capital/network, financial resources, education, and cultural factors) over time were associated with decreased reported cravings.

Patients and methods: The original cohort consisted of 133 participants (63 females) with opioid use disorder seeking outpatient treatment, who completed the Assessment of Recovery Capital (ARC) (range 0 to 50) and the Brief Addiction Monitor (BAM) thrice over the 6-month study. Intervention was medication and case management. Analysis included one-way mixed models testing change over time for ARC total scores and single question craving rating (5-point Likert scale). Cross-lagged panel estimates used structural equation models with variables z-scored, allowing for path coefficient evaluation as standard deviations (sd).

Results: Total ARC significantly increased over the study (χ2 = 33.77, df = 2, p < 0.0001), with baseline of 36.6 (n = 114, sd = 11.1) and 6-month of 41.2 (n = 107, sd = 9.5). Craving also changed significantly (χ2 = 8.51, df = 2, p < 0.015), with baseline of 1.1 (n = 101, sd = 1.2) and 6-month of 0.9 (n = 107, sd = 1.1). The cross-lag from baseline RC to 3-month craving was significant (β = -0.28, SE = 0.11, z = -2.53, p < 0.011). The converse was not true; baseline craving did not affect later RC. Results were similarly significant when comparing 3-month to 6-month. The majority of sample was on buprenorphine.

Conclusion: As RC improves, the reported cravings at both 3- and 6-month study time points are significantly reduced. When evaluated inversely, there was not a significant association with baseline cravings and follow-up RC. Significant path coefficients provide an estimation of a directional effect from increased RC towards craving reduction.

目的:渴望药物和酒精与较差的治疗结果显著相关。我们调查了随着时间的推移,恢复资本(RC)(如社会资本/网络、财政资源、教育和文化因素的衡量标准)的改善是否与报告的渴望减少有关。患者和方法:最初的队列由133名患有阿片类药物使用障碍寻求门诊治疗的参与者(63名女性)组成,他们在6个月的研究中三次完成了恢复资本评估(ARC)(范围为0-50)和短暂成瘾监测(BAM)。干预是药物治疗和病例管理。分析包括单向混合模型,测试ARC总分和单题渴望评级(5分Likert量表)随时间的变化。交叉滞后面板估计使用了变量为z的结构方程模型,允许将路径系数评估为标准差(sd)。结果:总ARC在研究期间显著增加(χ2=33.77,df=2,p<0.01),基线为36.6(n=114,sd=11.1),6个月为41.2(n=107,sd=9.5),基线为1.1(n=101,sd=1.2),6个月为0.9(n=107,sd=1.1)。从基线RC到3个月渴望的交叉滞后显著(β=0.28,SE=0.11,z=2.53,p<0.01)。相反;基线渴求不影响后期RC。当比较3个月和6个月时,结果同样显著。大部分样本是丁丙诺啡。结论:随着RC的改善,报告的3个月和6个月研究时间点的食欲都显著降低。当反向评估时,与基线食欲和随访RC没有显著关联。显著路径系数提供了从增加的RC到减少渴望的方向效应的估计。
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引用次数: 0
Interventions to Support Engagement in Addiction Care Postpartum: Principles and Pitfalls. 支持产后参与戒毒护理的干预措施:原则与陷阱。
IF 5.1 Q1 SUBSTANCE ABUSE Pub Date : 2023-07-03 eCollection Date: 2023-01-01 DOI: 10.2147/SAR.S375652
Shayna Mazel, Karen Alexander, Camille Cioffi, Mishka Terplan

There is a fundamental disconnect between the optimal management of addiction in general and care delivery in pregnancy and postpartum. Addiction is a chronic condition requiring some degree of management across the life course. Yet, in the US, reproductive care is episodic and centers more on pregnancy than at other stages of the reproductive life course. Pregnancy is prioritized in access to insurance as almost all pregnant people are Medicaid eligible but access ends at varying points postpartum. This results in a structural mismatch: the episodic management of the chronic condition of addiction only within gestational periods. Though people with substance use disorder (SUD) may access care in pregnancy, treatment attrition is common postpartum. Postpartum is a time of increased vulnerabilities where insurance churn and newborn caretaking responsibilities collide in a context of care withdrawal from the health system and health providers. In part in consequence, return to use, SUD recurrence, overdose, and overdose death are more common postpartum than in pregnancy, and drug deaths have become a leading cause of maternal deaths in the US. This review addresses interventions to support engagement in addiction care postpartum. We begin with a scoping review of model programs and evidence-informed interventions that have been shown to increase continuation of care postpartum. We then explore the realities of contemporary care through a review of clinical and ethical principles, with particular attention to harm reduction. We conclude with suggestions of strategies (clinical, research, and policy) to improve care postpartum and highlight potential pitfalls in the uptake of evidence-based and person-centered services.

对一般成瘾的最佳管理与孕期和产后护理之间存在根本性的脱节。成瘾是一种慢性疾病,需要在整个生命过程中进行一定程度的管理。然而,在美国,生育护理是偶发性的,并且更多集中在妊娠期,而不是生育期的其他阶段。由于几乎所有的孕妇都有资格享受医疗补助,因此在获得保险方面优先考虑怀孕期,但在产后的不同阶段,获得保险的机会就会终止。这就造成了结构上的不匹配:只在妊娠期对成瘾这一慢性病进行偶发性管理。虽然药物使用障碍(SUD)患者可以在孕期获得治疗,但产后治疗的流失很常见。产后是一个脆弱性增加的时期,保险的变化和照顾新生儿的责任在医疗系统和医疗服务提供者撤出护理的背景下发生碰撞。因此,产后复吸、吸毒成瘾复发、用药过量和用药过量死亡比孕期更为常见,而吸毒死亡已成为美国孕产妇死亡的主要原因。本综述探讨了支持产后参与成瘾护理的干预措施。首先,我们将对示范项目和有实证依据的干预措施进行范围界定,这些干预措施已被证明可提高产后护理的持续性。然后,我们通过回顾临床和伦理原则来探讨当代护理的现实情况,尤其关注减少伤害。最后,我们就改善产后护理的策略(临床、研究和政策)提出建议,并强调在采用循证和以人为本的服务时可能存在的隐患。
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引用次数: 0
Prevalence and Factors Associated with Alcohol Consumption Among Secondary School Students in Nekemte, Ethiopia: A Cross-Sectional Study. 埃塞俄比亚内格姆特中学生饮酒的患病率和相关因素:一项横断面研究。
IF 1.8 Pub Date : 2023-05-12 eCollection Date: 2023-01-01 DOI: 10.2147/SAR.S408736
Tesfaye Shibiru, Anthonisamy Arulandhu, Ashenafi Belete, Jiregna Etana, Wakjira Amanu

Background: Alcohol consumption is a major public health concern among adolescents and young adults. Adolescence is an important period of human growth. Alcohol consumption during this age will lead to a variety of problems: health, social, economic, etc. Further, research studies have shown that alcohol consumption, both at normal and above normal levels, will lead to a wide range of health problems. The purpose of this study is to evaluate the prevalence and associated factors for alcohol consumption among secondary school students in Nekemte town, East Wollega Zone, Ethiopia, in 2022.

Methods: A school-based cross-sectional research design approach is used. The data is collected using a structured and self-administered questionnaire. Through systematic random sampling, 291 out of 15,798 students ranging from 9 through 12 grades are chosen. The students selected from each school are proportional to their total strength.

Results: The study is conducted on 291 participants with a mean age of 17.5 ± 1.5 years. Of them, 49.8% are males, and the remaining 50.2% are females. It revealed that 27.84% of participants consume alcohol: 30.3% males and 25.3% females. Age (AOR: 2.755, 95% CI: 1.307-5.809), Urban location (AOR: 1.674, 95% CI: 0.962-2.914), Smoking (AOR: 0.426, 95% CI: 0.104-1.740), Chewing Khat (AOR: 2.185, 95% CI: 0.539-8.855), Having friends who drink (AOR: 1.740, 95% CI: 0.918-3.300), and having a family member who drinks alcohol. All these categories are significantly (p<0.05) associated with alcohol use.

Conclusion: The effects of alcohol consumption and its risks of mental illness, chronic illness, and social problems in adulthood are not completely understood by school students. Alcoholism can be eradicated using educational, preventive, and motivating measures. Special attention should be given to young people and their coping mechanisms against alcohol use.

背景:饮酒是青少年的主要公共健康问题。青春期是人类成长的重要时期。这个年龄段的饮酒会导致各种问题:健康、社会、经济等。此外,研究表明,正常和高于正常水平的饮酒都会导致广泛的健康问题。本研究的目的是评估2022年埃塞俄比亚东Wollega区Nekemte镇中学生饮酒的流行率和相关因素。方法:采用基于学校的横断面研究设计方法。数据是使用结构化和自行管理的问卷收集的。通过系统随机抽样,从15798名9至12年级的学生中选出291名。从每个学校选出的学生与他们的综合实力成正比。结果:该研究共有291名参与者,平均年龄17.5±1.5岁。其中男性占49.8%,女性占50.2%。调查显示,27.84%的参与者饮酒:30.3%的男性和25.3%的女性。年龄(AOR:2.755,95%CI:1.307-5.809),城市位置(AOR:1.674,95%CI:0.962-2.914),吸烟(AOR:0.426,95%CI:0.104-1.740),嚼卡塔(AOR=2.185,95%CI:0.539-8.855),有朋友喝酒(AOR:0.740,95%CI:0.918-3300),有家人喝酒。所有这些类别(结论:在校学生还没有完全了解饮酒的影响及其成年后患精神疾病、慢性病和社会问题的风险。可以通过教育、预防和激励措施根除酗酒。应该特别关注年轻人及其应对酗酒的机制。
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引用次数: 0
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 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。
{"title":"Impact of Smoking Status and Nicotine Dependence on Academic Performance of Health Sciences Students.","authors":"Jaber S Alqahtani,&nbsp;Abdulelah M Aldhahir,&nbsp;Zaid Alanazi,&nbsp;Emad Zahi Alsulami,&nbsp;Mujahid A Alsulaimani,&nbsp;Abdullah A Alqarni,&nbsp;Abdullah S Alqahtani,&nbsp;Ayadh Yahya AlAyadi,&nbsp;Musallam Alnasser,&nbsp;Ibrahim A AlDraiwiesh,&nbsp;Saeed M Alghamdi,&nbsp;Hussam M Almarkhan,&nbsp;Abdullah S Alsulayyim,&nbsp;Saad M AlRabeeah,&nbsp;Mohammed D AlAhmari","doi":"10.2147/SAR.S393062","DOIUrl":"https://doi.org/10.2147/SAR.S393062","url":null,"abstract":"<p><strong>Background: </strong>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.</p><p><strong>Methods: </strong>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.</p><p><strong>Results: </strong>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 (<i>p</i><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).</p><p><strong>Conclusion: </strong>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.</p>","PeriodicalId":22060,"journal":{"name":"Substance Abuse and Rehabilitation","volume":null,"pages":null},"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/f1/f0/sar-14-13.PMC9970882.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10826697","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
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 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 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 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。
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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 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。
{"title":"Bio-Psycho-Social Profile of People with Substance Use Disorders Treated in Locally Assigned Treatment Facilities in Kandahar, Afghanistan.","authors":"Muhammad Haroon Stanikzai,&nbsp;Mohammad Wahid Wahidi","doi":"10.2147/SAR.S412821","DOIUrl":"https://doi.org/10.2147/SAR.S412821","url":null,"abstract":"<p><strong>Background: </strong>Substance use and its associated bio-psycho-social problems are public health concerns with harmful individual and social consequences.</p><p><strong>Objective: </strong>This study assessed the bio-psycho-social profile of people with substance use disorders (SUD) treated at locally assigned treatment facilities in Kandahar, Afghanistan.</p><p><strong>Methods: </strong>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.</p><p><strong>Results: </strong>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.</p><p><strong>Conclusion: </strong>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.</p>","PeriodicalId":22060,"journal":{"name":"Substance Abuse and Rehabilitation","volume":null,"pages":null},"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/9c/a7/sar-14-89.PMC10417592.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10352043","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: 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 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 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
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Substance Abuse and Rehabilitation
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