Addiction and Health最新文献

Substance abuse significantly impacts pulmonary health, with diverse complications arising from the use of tobacco, alcohol, opioids, and other illicit drugs. These substances can directly damage lung tissue and exacerbate chronic respiratory diseases through mechanisms like oxidative stress, inflammation, and immune dysfunction. This study reviewed current evidence on the prevalence, pathophysiology, and clinical manifestations of pulmonary complications associated with substance abuse. Key findings include the high prevalence of chronic obstructive pulmonary disease among heroin users, the association of cocaine with acute and chronic pulmonary conditions, and the role of alcohol in exacerbating respiratory infections and acute respiratory distress syndrome. The review highlights diagnostic challenges, emphasizing the need for comprehensive clinical assessments, advanced imaging, and biomarker utilization. Additionally, it outlines treatment strategies, including pharmacological interventions, smoking cessation programs, and pulmonary rehabilitation. Recognizing the public health implications, the review advocates preventive measures, harm reduction strategies, and integrated care models to mitigate the burden of substance-related pulmonary diseases.

Background: Opioid use disorder (OUD) is a global health crisis, contributing to significant public health challenges and economic loss. Although existing treatments are available, there is a critical need for novel therapeutic strategies. This review examined the potential of glucagon-like peptide-1 (GLP-1) receptor agonists, primarily used in diabetes management, as a repurposed treatment for OUD.

Methods: We explored preclinical studies that demonstrate how GLP-1 receptor agonists can modulate neurobiological pathways involved in opioid addiction, particularly dopaminergic signaling. We also reviewed initial human clinical trials examining the impact of GLP-1 receptor agonists on opioid self-administration, relapse behavior, and cravings.

Findings: Preclinical data suggest that GLP-1 receptor agonists can reduce opioid self-administration and relapse behavior in animal models. Early human clinical trials indicate promising results, showing a potential role for GLP-1 receptor agonists in reducing opioid cravings and improving treatment outcomes.

Conclusion: Although early findings are encouraging, further research is needed to confirm these results, optimize dosing regimens, and clarify the underlying mechanisms of action. Given the interplay between metabolic and neuropsychiatric factors in OUD, GLP-1 receptor agonists offer a unique therapeutic advantage. Large-scale clinical trials are essential to determine their long-term efficacy, safety, and integration into comprehensive OUD treatment plans.

Background: Inhalants are volatile organic compounds (VOCs) abused to achieve psychostimulant effects. VOCs are found in substances such as paint thinners, glues, and adhesives.

Case presentation: This case illustrates a 27-year-old unmarried, unemployed man from rural Andhra Pradesh with a three-year history of volatile inhalant use, specifically Fevicol. His inhalant use began during college and escalated from occasional use to daily consumption of up to 1 Liter per day through huffing and bagging. He reported a feeling of euphoria and occasional drowsiness accompanied by redness of the eyes. Parallel to the increase in his inhalant use, noticeable behavioral changes, including decreased social interaction, self-talking, irritability, frequent disputes with family members, and multiple job changes, were observed. Upon interview, psychotic symptoms including auditory hallucinations and persecutory delusions, started around one year ago, prompting inpatient psychiatric admission. A diagnosis of volatile inhalant-induced psychotic disorder (ICD-11) was made. Management relied on antipsychotics (risperidone) as the cornerstone, along with cognitive behavioral therapy, motivational enhancement therapy and relapse prevention for sustained recovery.

Discussion: This case highlights distinctive aspects, including prolonged duration of psychotic symptoms following chronic inhalant exposure, as well as the aggravation of psychotic symptoms (mainly auditory hallucination) occurring 15-20 minutes after acute inhalant use. The nicotine self-medication hypothesis has been proposed to explain this phenomenon, suggesting that nicotine may alleviate distress during acute use.

Conclusion: The focus was not only to explain the psychiatric sequelae of inhalant abuse but also to underscore the importance of comprehensive management strategies for adequate recovery and to unveil the roles of gamma-aminobutyric acid (GABA) disinhibition, glutamate, and dopamine dysregulation. Ultimately, the combination of pharmacotherapy and behavioral interventions is essential. To decrease experimentation with inhalants, regulation alone is insufficient without education and awareness-raising. A specific combination of strategies at three different levels, the government (consistent stringent rules at state and national levels, restriction of sales to minors, and community and school-based interventions), producers (adding deterrents and replacing harmful chemicals with safer alternatives), and consumers (education on health consequences and legal implications), can be implemented in India.

Background: This study assessed the Persian version of the Functioning Assessment Short Test (FAST) in bipolar disorder patients to determine its reliability and validity, as currently no specialized tools are available to evaluate functional impairment in this population.

Methods: A cross-sectional study was conducted with 240 bipolar disorder patients at Shafa Hospital in Rasht in 2023. The Persian version of the FAST was translated and reviewed for content validity, reliability, and factor analysis. Data analysis was done using IBM SPSS version 26, and confirmatory factor analysis (CFA) was performed with LISREL version 8.8.

Findings: The results indicated a content validity ratio (CVR) above 0.62. To assess convergent validity, the Short Form Health Survey (SF-36) was used, yielding a direct and significant correlation (P<0.001, r=0.675). The FAST exhibited a Cronbach's alpha of 0.953, indicating robust internal consistency. The intraclass correlation coefficient (ICC) ranged from 0.74 to 0.98, signifying excellent reliability. The correlation coefficient between scores from repeated tests demonstrated strong reliability. CFA was employed to confirm the dimensions of the FAST, and the construct validity was considered satisfactory.

Conclusion: The Persian version of the FAST demonstrated strong psychometric properties in the study, making it useful for evaluating rehabilitation interventions, assessing medication effects, and supporting research efforts.

Background: This study explored the gender-specific effects of methadone, a synthetic opioid receptor agonist commonly used in opioid addiction treatment, on renal tissue and function. We aimed to elucidate the underlying mechanisms involving inflammatory pathways and redox system activity.

Methods: Forty-two Wistar rats (200-250 g) were allocated into six groups: three males and three females, each comprised of control, and methadone-treated 5 mg/kg and 20 mg/kg. Over eight weeks, animals received either saline or methadone syrup orally. Blood urea nitrogen (BUN) and serum creatinine (sCr) were measured in serum. The inflammatory cytokines and antioxidant enzyme activity were assessed in left kidneys, which were preserved at -80 °C, while histopathological analysis via H&E staining was done on the formalin-fixed right kidneys.

Findings: Methadone administration resulted in renal tissue injury characterized by enhanced glomerular and interstitial inflammation. Notable increases in malondialdehyde (MDA), BUN, sCr, transforming growth factor beta (TGF-β), tumor necrosis factor alpha (TNF-α), and interleukin 17 (IL-17) were observed in methadone-treated groups, indicating impaired renal function associated with oxidative stress and inflammation, with male rats exhibiting more severe alterations. Conversely, methadone treatment elevated glutathione peroxidase (GPx), and catalase (Cat) activities, predominantly in females.

Conclusion: Prolonged methadone therapy exerts a nephrotoxic effect through the activation of oxidative stress and inflammatory pathways, with male rats displaying greater renal pathology and dysfunction, potentially attributed to diminished antioxidant defenses.

Background: Many studies have examined the association between smokeless tobacco and the risk of oral cancer. In South and Southeastern Asia, the use of smokeless tobacco, which increases the risk of oral cancer, is very common. The aim of this study is to provide a comprehensive review of studies conducted and published in a period of ten years to provide a more accurate assessment of the association between smokeless tobacco and oral cancer.

Methods: An electronic search in six databases (PubMed, Scopus, Embase, Web of Science, ProQuest, and Cochrane Library) was conducted using keywords equivalent to oral cancer and smokeless tobacco. After selecting the articles according to the inclusion and exclusion criteria, a total of 30 prospective cohort and case-control studies from 2010 to 2020, which investigated the association of smokeless tobacco with oral cancer, were examined. The articles were qualitatively assessed using the Newcastle Ottawa Quality Assessment scale checklist. Then, study design (study type, setting, and duration of data collection), sample population (number, gender, and age), cancer type, smokeless tobacco type, effect size, and confounder adjustment were extracted from the studies.

Findings: Five studies examined smokeless tobacco and chewing tobacco, and 25 studies reported and evaluated the type of smokeless tobacco, most of which were related to betel quid and supari. While the results of 21 studies revealed a positive and significant relationship between oral cancer and smokeless tobacco use (OR: 0.67-149.5), seven studies did not find a significant correlation.

Conclusion: This systematic review confirms the positive and significant association between non-smoking tobacco use and the risk of oral cancer.

Background: Methamphetamine is a common addictive industrial substance. Medicinal plants such as Artemisia absinthium L. with anti-inflammatory, antioxidant, analgesic, neuroprotective, antidepressant, and antipyretic properties may help patients reduce withdrawal syndrome symptoms.

Methods: Five treatment groups received intraperitoneal (i.p.) injections of 3,4-methylenedioxymethamphetamine (MDMA) and an ethanolic extract of A. absinthium diluted in 0.9% normal saline for 7 days. The animals were assigned to five groups: Group I (Control): NaCl 0.9%+Naloxone (SN), administered daily via intraperitoneal (i.p.) injection; Group II: MDMA+NaCl 0.9%+Naloxone (MSN), administered daily via i.p. injection; Groups III, IV, and V: MDMA+NaCl 0.9%+Naloxone+ethanolic Artemisia absinthium extract at concentrations of 5%, 10%, and 25% (MSNA), respectively, administered daily via i.p. injection. To induce withdrawal syndrome, two hours after the last injection of MDMA on the 7th day, naloxone was injected (i.p.) at a dose of 1 mg/kg, and rats were quickly transferred to glass cylinders, and the symptoms of MDMA withdrawal syndrome based on stomach cramp, diarrhea, bruxism, body dragging, and wet dog shakes were recorded within 30 minutes.

Findings: The MSN and MSNA 5% interventions may not be well-tolerated and could require reevaluation to minimize adverse effects; however, MSNA 10% and MSNA 25% showed reduced severity, suggesting potential for better tolerability and effectiveness in managing symptoms like writhing, body dragging, teeth chattering, and diarrhea.

Conclusion: It appears that 10% and 25% ethanolic extracts of A. absinthium can lessen certain behavioral signs associated with animal addiction withdrawal. We need more research to optimize dosages for better results.

Background: The issue of street children and adolescents represents a significant global challenge, often interconnected with issues such as substance abuse. The present research aims to ascertain the prevalence of substance abuse and its associated determinants within the population of street children and adolescents in Zahedan, Iran.

Methods: This cross-sectional study, conducted between December 2021 and May 2022, focused on street children and adolescents. A validated questionnaire was administered through face-to-face interviews to evaluate the prevalence of substance abuse and associated factors within this population. The collected data were analyzed using bivariable and multivariable logistic regression models. Additionally, penalized logistic regression techniques were employed in the statistical analysis.

Findings: A cohort of 200 street children, with a mean age of 13.6 years, was examined. The majority of the sample comprised male individuals (n=156, 98.15%). The study revealed that 27% of the participants (95% confidence interval [CI]: 0.21-0.33) reported a history of substance abuse (n=54). Key risk factors identified encompassed increasing age (odds ratio [OR]=1.32, 95% CI: 1.12-1.55), prior detention (OR=5.45, 95% CI: 1.92-15.42), and a family history of substance abuse (OR=7.53, 95% CI: 3.02-18.77), indicating a heightened likelihood of substance abuse with each of these factors. The logistic regression model exhibited satisfactory predictive accuracy (area under the curve [AUC]=0.78, 95% CI: 0.72-0.86).

Conclusion: This study identified age, a familial history of substance use, and prior incarceration as significant predictors of substance abuse among street children and adolescents. Consequently, there is a demonstrated need for focused interventions that address familial, social, and psychological determinants to mitigate substance abuse within this at-risk demographic.

Background: Pregabalin (PGB), a gabapantinoid drug, which is commonly prescribed by physicians and some patients abuse it, can lead to seizure. Pregabalin-induced seizures (PGBIS) and their risk factors were systematically reviewed.

Methods: The databases were searched from January 1, 2011, to August 1, 2022. Studies that reported PGBIS were included. The records were assessed according to the PRISMA-P protocol.

Findings: From a total of 224 records, 11 studies were included, comprising four cross-sectional studies and seven case reports. The data from the cross-sectional studies were notably limited. Seven studies documented nine cases (five females and four males), with a median age of 51 years (ranging from 16 to 65). PGB was used for therapeutic purposes, abuse, and suicide attempts. One case had kidney dysfunction. A significant number of cases used PGB with other drugs. There was no difference between the ingested dose of PGB in men (2700 and 4200 mg) and women (3000, 1200, 3825, and 1200 mg). All cases had normal renal function, except for one case.

Conclusion: PGBIS is not common. However, it was reported for all purposes of PGB consumption. No specific risk factor for PGBIS was found. It was more commonly reported in females, patients who consumed high doses of PGB (>1200 mg), patients who ingested multiple drugs, and patients with renal insufficiency. The dosages used for therapeutic purposes were much lower than in the other two groups.