Pub Date : 2020-10-09DOI: 10.1097/ADT.0000000000000228
Noha Shamseldin, Abdelrahman Asal, D. Enaba, Mohamed A. Khalil, Somaya H. Shaheen
Objectives: Gender differences in substance dependence across many domains including emotional dysregulation and deliberate self-harm (DSH) has not been studied widely. Tramadol dependence is themost one lacking empirical research and evidence regarding these differences; therefore, our aim is to detect gender differences in patients with tramadol dependence as regards emotional dysregulation and DSH. Materials and Methods: The study included 30 male and 30 female patients with tramadol dependence [diagnosis was made by Structured Clinical Interview for DSM-IV-TR Axis I Disorders (SCID-I)]. Assessment of emotional dysregulation and DSH was done by the Difficulties in Emotion Dysregulation Scale, the Deliberate SelfHarm Inventory—Short Version. Results: Female patients are higher in emotional dysregulation and induce DSH more evidently than male patients with tramadol dependence. There was a statistically significant positive correlation between overall emotional dysregulation and overall DSH in both groups. Conclusion: The results will be useful in clinical practice for the management of patients with tramadol dependence.
{"title":"Gender Differences in Emotional Dysregulation and Deliberate Self-harm in Patients With Tramadol Dependence","authors":"Noha Shamseldin, Abdelrahman Asal, D. Enaba, Mohamed A. Khalil, Somaya H. Shaheen","doi":"10.1097/ADT.0000000000000228","DOIUrl":"https://doi.org/10.1097/ADT.0000000000000228","url":null,"abstract":"Objectives: Gender differences in substance dependence across many domains including emotional dysregulation and deliberate self-harm (DSH) has not been studied widely. Tramadol dependence is themost one lacking empirical research and evidence regarding these differences; therefore, our aim is to detect gender differences in patients with tramadol dependence as regards emotional dysregulation and DSH. Materials and Methods: The study included 30 male and 30 female patients with tramadol dependence [diagnosis was made by Structured Clinical Interview for DSM-IV-TR Axis I Disorders (SCID-I)]. Assessment of emotional dysregulation and DSH was done by the Difficulties in Emotion Dysregulation Scale, the Deliberate SelfHarm Inventory—Short Version. Results: Female patients are higher in emotional dysregulation and induce DSH more evidently than male patients with tramadol dependence. There was a statistically significant positive correlation between overall emotional dysregulation and overall DSH in both groups. Conclusion: The results will be useful in clinical practice for the management of patients with tramadol dependence.","PeriodicalId":44600,"journal":{"name":"Addictive Disorders & Their Treatment","volume":null,"pages":null},"PeriodicalIF":1.1,"publicationDate":"2020-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46128608","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-10-09DOI: 10.1097/ADT.0000000000000226
F. Ghaffari, Sepideh Mohammadi, A. Shamsalinia, Tajmohammad Arazi
Objectives: Nurses play a key role in caring and assisting in the treatment of patients with substance abuse. However, providing quality nursing care for this particular patient group is affected by many barriers and challenges. These important challenges have not been considered to be a priority in Iranian studies. Thus, this study was conducted to assess the barriers faced by Iranian nurses in providing quality care for patients with substance abuse. Materials and Methods: A qualitative study using a content analysis approach was conducted. Semistructured interviews and focus groups were held with 38 nurses, who were working in general hospitals affiliated to Babol University of Medical Sciences. Purposive sampling was used to recruit participants. Results: Three main themes emerged from the data analysis: “negative and stereotypical attitudes,” feelings of unease and worry,” and “insufficient knowledge and lack of preparation.” Conclusions: This study highlights the need for more knowledge about patients with substance abuse among nurses, as well as promotional activities to improve the professional attitude, moral awareness, and human dignity in encounters with these patients regardless of their background. Also, there is a need for nurse administrators to enable nurses to provide better quality care for patients with substance abuse, through fostering a more resourceful and positive work atmosphere.
{"title":"Shedding Light on the Barriers to Providing Quality Nursing Care for Patients With Substance Abuse: A Qualitative Content Analysis","authors":"F. Ghaffari, Sepideh Mohammadi, A. Shamsalinia, Tajmohammad Arazi","doi":"10.1097/ADT.0000000000000226","DOIUrl":"https://doi.org/10.1097/ADT.0000000000000226","url":null,"abstract":"Objectives: Nurses play a key role in caring and assisting in the treatment of patients with substance abuse. However, providing quality nursing care for this particular patient group is affected by many barriers and challenges. These important challenges have not been considered to be a priority in Iranian studies. Thus, this study was conducted to assess the barriers faced by Iranian nurses in providing quality care for patients with substance abuse. Materials and Methods: A qualitative study using a content analysis approach was conducted. Semistructured interviews and focus groups were held with 38 nurses, who were working in general hospitals affiliated to Babol University of Medical Sciences. Purposive sampling was used to recruit participants. Results: Three main themes emerged from the data analysis: “negative and stereotypical attitudes,” feelings of unease and worry,” and “insufficient knowledge and lack of preparation.” Conclusions: This study highlights the need for more knowledge about patients with substance abuse among nurses, as well as promotional activities to improve the professional attitude, moral awareness, and human dignity in encounters with these patients regardless of their background. Also, there is a need for nurse administrators to enable nurses to provide better quality care for patients with substance abuse, through fostering a more resourceful and positive work atmosphere.","PeriodicalId":44600,"journal":{"name":"Addictive Disorders & Their Treatment","volume":null,"pages":null},"PeriodicalIF":1.1,"publicationDate":"2020-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43625224","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-09-30DOI: 10.1097/ADT.0000000000000225
Tassiane C S Paula, Camila Chagas, L. Martins, C. Ferri
Supplemental Digital Content is available in the text. Objective: Identify the standard drink and the differences in low-risk drinking guidelines for adults and older adults around the world according to sex and country-income level. Method: A search for standard drink definitions and low-risk drinking guidelines for adults and older people in current governmental documents was undertaken; items sought: (1) low-risk drinking guidelines for different age groups and sex; (2) definitions of a standard drink in grams of alcohol; (3) country-income level; (4) whether there was a national action plan for alcohol; (5) identification of particular vulnerable groups. Results: Of the 194 countries in the world, the authors were able to identify 58 that have low-risk drinking guidelines, 60.3% being high-income, 32.8% upper-middle-income, and 6.9% low-middle-income countries (no guidelines were found in low-income countries). Definitions of a standard drink ranged from 8 to 20 g. Low-risk drinking guidelines (grams/week) ranged substantiality: from 15 to 170 g for women and from 15 to 294 for men. For older adults, ranged from 70 to 204 for women and for men over 65 years of age. Discussion/Conclusion: Important differences among definitions of a standard drink and in low-risk drinking guidelines adopted by the countries were found. These differences can partially be explained by inherent aspects of each country; however, many guidelines do not seem to consider biological and social aspects or scientific evidence. In addition, it is important to highlight the lack of guidelines in low and low-middle income countries that would benefit from these measures.
{"title":"Low-risk Drinking Guidelines Around the World: An Overview of the Current Situation","authors":"Tassiane C S Paula, Camila Chagas, L. Martins, C. Ferri","doi":"10.1097/ADT.0000000000000225","DOIUrl":"https://doi.org/10.1097/ADT.0000000000000225","url":null,"abstract":"Supplemental Digital Content is available in the text. Objective: Identify the standard drink and the differences in low-risk drinking guidelines for adults and older adults around the world according to sex and country-income level. Method: A search for standard drink definitions and low-risk drinking guidelines for adults and older people in current governmental documents was undertaken; items sought: (1) low-risk drinking guidelines for different age groups and sex; (2) definitions of a standard drink in grams of alcohol; (3) country-income level; (4) whether there was a national action plan for alcohol; (5) identification of particular vulnerable groups. Results: Of the 194 countries in the world, the authors were able to identify 58 that have low-risk drinking guidelines, 60.3% being high-income, 32.8% upper-middle-income, and 6.9% low-middle-income countries (no guidelines were found in low-income countries). Definitions of a standard drink ranged from 8 to 20 g. Low-risk drinking guidelines (grams/week) ranged substantiality: from 15 to 170 g for women and from 15 to 294 for men. For older adults, ranged from 70 to 204 for women and for men over 65 years of age. Discussion/Conclusion: Important differences among definitions of a standard drink and in low-risk drinking guidelines adopted by the countries were found. These differences can partially be explained by inherent aspects of each country; however, many guidelines do not seem to consider biological and social aspects or scientific evidence. In addition, it is important to highlight the lack of guidelines in low and low-middle income countries that would benefit from these measures.","PeriodicalId":44600,"journal":{"name":"Addictive Disorders & Their Treatment","volume":null,"pages":null},"PeriodicalIF":1.1,"publicationDate":"2020-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44743179","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-09-29DOI: 10.1097/ADT.0000000000000230
D. Situmorang
To the Editor: Most women experience various stresses, such as emotional, physical, and social changes when they are pregnant, especially during this COVID-19 period. Many studies have shown that stressful life events and pregnancy experiences can lead to significant obstetric outcomes including spontaneous abortion, preterm delivery, growth retardation and decreased maternal-fetal attachment. In addition, if pregnant women experience increased stress, and pain, it may lead to delay and termination of medical procedures. Furthermore, to relieve and reduce stress and increase relaxation in pregnant women in this COVID-19 outbreak, various interventions such as pharmacological therapy, massage, aromatherapy, and reflexology have been carried out with fairly good procedures. In accordance with existing recommendations, that pharmacology should be carefully used for both mother and fetus. Therefore, there is one nonpharmacological nursing intervention that is safe enough to be applied to pregnant women, namely through the use of music as a therapeutic modality. In the last decade, there are quite a lot of research results and theories that explain that music has been shown to have a therapeutic effect on the body and mind. Music can neutralize negative emotions, increase stress thresholds, harmonize inner processes, help patients achieve a state of relaxation and reduce stress. Neuroscience, music can provide esthetic pleasure received by the right brain, which in turn can release endorphins from the suppituitary, thereby reducing physiological responses and relaxation. In addition, music can change the interaction of the thalamus and reticular activation system, as well as affect emotions, body muscles, and autonomic functions such as blood pressure, heart rate and respiratory rate. Therefore, through this article, I recommend that practitioners use music during the COVID-19 outbreak as an alternative to nonpharmacological nursing interventions, so that enough pregnant women will be helped and reduce their stress and anxiety.
{"title":"Music Therapy as a Nonpharmacological Intervention for Pregnant Women During COVID-19 Outbreak","authors":"D. Situmorang","doi":"10.1097/ADT.0000000000000230","DOIUrl":"https://doi.org/10.1097/ADT.0000000000000230","url":null,"abstract":"To the Editor: Most women experience various stresses, such as emotional, physical, and social changes when they are pregnant, especially during this COVID-19 period. Many studies have shown that stressful life events and pregnancy experiences can lead to significant obstetric outcomes including spontaneous abortion, preterm delivery, growth retardation and decreased maternal-fetal attachment. In addition, if pregnant women experience increased stress, and pain, it may lead to delay and termination of medical procedures. Furthermore, to relieve and reduce stress and increase relaxation in pregnant women in this COVID-19 outbreak, various interventions such as pharmacological therapy, massage, aromatherapy, and reflexology have been carried out with fairly good procedures. In accordance with existing recommendations, that pharmacology should be carefully used for both mother and fetus. Therefore, there is one nonpharmacological nursing intervention that is safe enough to be applied to pregnant women, namely through the use of music as a therapeutic modality. In the last decade, there are quite a lot of research results and theories that explain that music has been shown to have a therapeutic effect on the body and mind. Music can neutralize negative emotions, increase stress thresholds, harmonize inner processes, help patients achieve a state of relaxation and reduce stress. Neuroscience, music can provide esthetic pleasure received by the right brain, which in turn can release endorphins from the suppituitary, thereby reducing physiological responses and relaxation. In addition, music can change the interaction of the thalamus and reticular activation system, as well as affect emotions, body muscles, and autonomic functions such as blood pressure, heart rate and respiratory rate. Therefore, through this article, I recommend that practitioners use music during the COVID-19 outbreak as an alternative to nonpharmacological nursing interventions, so that enough pregnant women will be helped and reduce their stress and anxiety.","PeriodicalId":44600,"journal":{"name":"Addictive Disorders & Their Treatment","volume":null,"pages":null},"PeriodicalIF":1.1,"publicationDate":"2020-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45725805","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-09-16DOI: 10.1097/ADT.0000000000000220
P. L. Lua, Nor Afiqah Ahmad Nasrulddin, A. M. Mohamad, A. Hassan, M. Makhtar
Introduction: Inabah program is psychospiritual rehabilitative approach which holistically incorporates Islamic concepts and religious practices in its module encompassing of prayers, zikir, and hydrotherapy. Objectives: This study attempts to (1) determine the impact of Inabah on health-related quality of life (HRQoL) profiles and religiousness and (2) explore the relationships between HRQoL and religiousness pre-Inabah and post-Inabah. Methods: A prospective preintervention and postintervention study was conducted at 3 Inabah centers in Malaysia, recruiting new inmates aged 18 years and above who were cognitively stable and have undergone detoxification. The Malay WHOQOL-BREF (higher score=better HRQoL) and Psychological Measure of Islamic Religiousness (PMIR) (higher score=better profiles) were administered before and after Inabah intervention (minimum 2 mo). Results: One hundred fifteen all-male inmates of 144 eligible participants (79.9%) completed the program (age=30.5±7.8 y; intervention duration ≤2.5 mo=60.9%; The Sijil Pelajaran Malaysia qualification=47.0%). Significant positive changes in Overall HRQoL, General Health, Psychological, and Islamic Obligations and Implementation issues were detected after Inabah (P<0.05; effect size=0.27 to 0.39). Pre-Inabah, Life Satisfaction (in PMIR) correlated significantly with all HRQoL domains (P<0.001) while Islamic Obligations and Implementation only significantly correlated with Psychological domain (P<0.05). Majority of other PMIR versus HRQoL relationships were also significant. Post-Inabah however, dramatic increases were observed in Islamic Obligations and Implementation domain which linked significantly with all (except 1) HRQoL aspects. Conclusions: The positive impacts of the noninvasive Inabah program on HRQoL and religiousness among substance abusers were evident.
{"title":"Positive Impacts of Islamic Inabah Substance Abuse Rehabilitation Program on Health-related Quality-of-Life Profiles and Religiousness","authors":"P. L. Lua, Nor Afiqah Ahmad Nasrulddin, A. M. Mohamad, A. Hassan, M. Makhtar","doi":"10.1097/ADT.0000000000000220","DOIUrl":"https://doi.org/10.1097/ADT.0000000000000220","url":null,"abstract":"Introduction: Inabah program is psychospiritual rehabilitative approach which holistically incorporates Islamic concepts and religious practices in its module encompassing of prayers, zikir, and hydrotherapy. Objectives: This study attempts to (1) determine the impact of Inabah on health-related quality of life (HRQoL) profiles and religiousness and (2) explore the relationships between HRQoL and religiousness pre-Inabah and post-Inabah. Methods: A prospective preintervention and postintervention study was conducted at 3 Inabah centers in Malaysia, recruiting new inmates aged 18 years and above who were cognitively stable and have undergone detoxification. The Malay WHOQOL-BREF (higher score=better HRQoL) and Psychological Measure of Islamic Religiousness (PMIR) (higher score=better profiles) were administered before and after Inabah intervention (minimum 2 mo). Results: One hundred fifteen all-male inmates of 144 eligible participants (79.9%) completed the program (age=30.5±7.8 y; intervention duration ≤2.5 mo=60.9%; The Sijil Pelajaran Malaysia qualification=47.0%). Significant positive changes in Overall HRQoL, General Health, Psychological, and Islamic Obligations and Implementation issues were detected after Inabah (P<0.05; effect size=0.27 to 0.39). Pre-Inabah, Life Satisfaction (in PMIR) correlated significantly with all HRQoL domains (P<0.001) while Islamic Obligations and Implementation only significantly correlated with Psychological domain (P<0.05). Majority of other PMIR versus HRQoL relationships were also significant. Post-Inabah however, dramatic increases were observed in Islamic Obligations and Implementation domain which linked significantly with all (except 1) HRQoL aspects. Conclusions: The positive impacts of the noninvasive Inabah program on HRQoL and religiousness among substance abusers were evident.","PeriodicalId":44600,"journal":{"name":"Addictive Disorders & Their Treatment","volume":null,"pages":null},"PeriodicalIF":1.1,"publicationDate":"2020-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48971573","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-09-09DOI: 10.1097/ADT.0000000000000223
M. Abdelghani, A. Fouad, Ayat-Allah Mamdouh, Y. Raya
Objectives: Substance use disorder attributed to pregabalin (SUD-P) is a rising public health problem in Egypt. Cognitive impairment (CI) associated with SUD-P was underrated. This study aimed to identify and compare the CI and its correlates among patients with SUD-P and among control subjects. Materials and Methods: This study included 80 patients with SUD-P and 80 control subjects (matched for age, sex, and socioeconomic level) who were recruited from Heliopolis Psychiatric Hospital, Cairo, Egypt. The participants were interviewed using the Structured Clinical Interview for DSM-5 Axis I Disorders (SCID-5), Montreal Cognitive Assessment test, and urine screening for drugs. Results: Overall, 49% of patients with SUD-P used pregabalin alone, whereas the remaining used pregabalin with other substances, mainly cannabis (74%), heroin (59%), and tramadol (56%). About half of patients with SUD-P experienced CI. Compared with control subjects, patients with SUD-P were more likely to have impairments in delayed recall [odds ratio (OR): 3.1, 95% confidence interval (CI): 1.5-7.9], orientation (OR: 2.6, 95% CI: 1.2-4.9), and total Montreal Cognitive Assessment scores (OR: 2.6, 95% CI: 1.7-9.8). Pregabalin daily dose was correlated with impairments in naming, language, and abstraction domains in patients with SUD-P (P<0.047, P=0.006, and 0.006, respectively). Conclusions: CI was prevalent in patients with SUD-P. The domains of delayed recall and orientation were the most affected. The pregabalin daily dose was correlated with impaired naming, language, and abstraction functions.
{"title":"Association Between Cognitive Impairment and Substance Use Disorder Attributed to Pregabalin in Egypt: A Case-Control Study","authors":"M. Abdelghani, A. Fouad, Ayat-Allah Mamdouh, Y. Raya","doi":"10.1097/ADT.0000000000000223","DOIUrl":"https://doi.org/10.1097/ADT.0000000000000223","url":null,"abstract":"Objectives: Substance use disorder attributed to pregabalin (SUD-P) is a rising public health problem in Egypt. Cognitive impairment (CI) associated with SUD-P was underrated. This study aimed to identify and compare the CI and its correlates among patients with SUD-P and among control subjects. Materials and Methods: This study included 80 patients with SUD-P and 80 control subjects (matched for age, sex, and socioeconomic level) who were recruited from Heliopolis Psychiatric Hospital, Cairo, Egypt. The participants were interviewed using the Structured Clinical Interview for DSM-5 Axis I Disorders (SCID-5), Montreal Cognitive Assessment test, and urine screening for drugs. Results: Overall, 49% of patients with SUD-P used pregabalin alone, whereas the remaining used pregabalin with other substances, mainly cannabis (74%), heroin (59%), and tramadol (56%). About half of patients with SUD-P experienced CI. Compared with control subjects, patients with SUD-P were more likely to have impairments in delayed recall [odds ratio (OR): 3.1, 95% confidence interval (CI): 1.5-7.9], orientation (OR: 2.6, 95% CI: 1.2-4.9), and total Montreal Cognitive Assessment scores (OR: 2.6, 95% CI: 1.7-9.8). Pregabalin daily dose was correlated with impairments in naming, language, and abstraction domains in patients with SUD-P (P<0.047, P=0.006, and 0.006, respectively). Conclusions: CI was prevalent in patients with SUD-P. The domains of delayed recall and orientation were the most affected. The pregabalin daily dose was correlated with impaired naming, language, and abstraction functions.","PeriodicalId":44600,"journal":{"name":"Addictive Disorders & Their Treatment","volume":null,"pages":null},"PeriodicalIF":1.1,"publicationDate":"2020-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1097/ADT.0000000000000223","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42700780","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-09-02DOI: 10.1097/ADT.0000000000000222
A. S. Mohamed, Nesreen M. Ibrahim, A. Mazloum, Rehab Naguib, Lobna Azzam
Objectives: Tramadol addiction is one of the major addiction problems in growing countries, especially in Egypt. Moreover, there is a strong relation between suicidality and addiction even after exclusion of personality disorders; the burden of suicide adds to the burden of substance abuse in those individuals and their families. Materials and Methods: A cross-sectional descriptive study was conducted on 72 tramadol-dependent patients who were recruited randomly in this study from the addiction outpatient clinic of Okasha Institute of Psychiatry of Ain Shams University, after obtaining an informed consent. They are assessed by (1) Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders, 4th Edition Axis I Disorders for diagnosis of substance use disorder, (2) Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders, 4th Edition Axis II Disorders for exclusion of personality disorders, (3) suicide probability scale, and (4) Addiction Severity Index. Results: Regarding suicidal probability, 44.44% of the sample showed risk of suicide, which was severe among 19.44%, moderate among 11.11%, and mild among 13.89% of the sample. Regarding “Addiction Severity Index,” most patients had no real medical problem. In the employment domain, 38.89% had a slight problem. In the drug use domain, 80.56% had a moderate problem. There is a significant relation between the degree of medical, drug use, and legal problem and the severity of suicidal risk. Moreover, the longer duration of addiction and the advanced age of patients are risk factors for suicidal probability. Conclusions: There is a suicide probability among tramadol addicts. The duration of tramadol use could be considered a strong risk factor for suicide, as the longer the duration of tramadol, the higher the suicidal risk.
{"title":"Suicide Probability Among Tramadol Addicts","authors":"A. S. Mohamed, Nesreen M. Ibrahim, A. Mazloum, Rehab Naguib, Lobna Azzam","doi":"10.1097/ADT.0000000000000222","DOIUrl":"https://doi.org/10.1097/ADT.0000000000000222","url":null,"abstract":"Objectives: Tramadol addiction is one of the major addiction problems in growing countries, especially in Egypt. Moreover, there is a strong relation between suicidality and addiction even after exclusion of personality disorders; the burden of suicide adds to the burden of substance abuse in those individuals and their families. Materials and Methods: A cross-sectional descriptive study was conducted on 72 tramadol-dependent patients who were recruited randomly in this study from the addiction outpatient clinic of Okasha Institute of Psychiatry of Ain Shams University, after obtaining an informed consent. They are assessed by (1) Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders, 4th Edition Axis I Disorders for diagnosis of substance use disorder, (2) Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders, 4th Edition Axis II Disorders for exclusion of personality disorders, (3) suicide probability scale, and (4) Addiction Severity Index. Results: Regarding suicidal probability, 44.44% of the sample showed risk of suicide, which was severe among 19.44%, moderate among 11.11%, and mild among 13.89% of the sample. Regarding “Addiction Severity Index,” most patients had no real medical problem. In the employment domain, 38.89% had a slight problem. In the drug use domain, 80.56% had a moderate problem. There is a significant relation between the degree of medical, drug use, and legal problem and the severity of suicidal risk. Moreover, the longer duration of addiction and the advanced age of patients are risk factors for suicidal probability. Conclusions: There is a suicide probability among tramadol addicts. The duration of tramadol use could be considered a strong risk factor for suicide, as the longer the duration of tramadol, the higher the suicidal risk.","PeriodicalId":44600,"journal":{"name":"Addictive Disorders & Their Treatment","volume":null,"pages":null},"PeriodicalIF":1.1,"publicationDate":"2020-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47742480","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-09-01DOI: 10.1097/ADT.0000000000000194
H. Famitafreshi, M. Karimian
To the Editor: Addiction is a serious problem and despite many advances in the treatment of addiction, lots of addicts relapse to abusing drugs. The main problem in addiction is the lack of effective treatment based on the pathophysiology of the disease. Therefore, many studies have been done to understand the basic mechanisms that may be effective in controlling drug abuse. Recently, it has been well documented that the gut-brain axis plays an important role in brain diseases such as anxiety and depression. Since the addiction circuit mainly located in brain areas such as the reward circuit, it is not surprising that the gut-brain axis may cause changes in reward circuit functions. Recently, it has been well documented that dopamine secretion can be altered by changes in the microbiota. It is well known that changes in the colonization of human gut microbiota may result in neuropsychiatric and neurological diseases. Different mechanisms have been proposed based on anatomic pathways and hormone secretion but to date, no definite mechanism has been proposed. However, based on the studies in this regard the best treatment for addiction can have 2 ways. First, we can think of changing the existing present microbiota in addicts and the second is the administration of hormones that may be related to the gut-brain axis. Lactobacillus helveticus and Bifidobacterium longum have successfully been used in mood disorders and in addition, positive outcomes have achieved and more studies will reveal the best treatment. Administration of hormones should be taken with caution because someof themare useful and someof them have a negative outcome. So, hormones should be used with caution.
{"title":"Gut-Brain Axis–based Treatment in Addiction","authors":"H. Famitafreshi, M. Karimian","doi":"10.1097/ADT.0000000000000194","DOIUrl":"https://doi.org/10.1097/ADT.0000000000000194","url":null,"abstract":"To the Editor: Addiction is a serious problem and despite many advances in the treatment of addiction, lots of addicts relapse to abusing drugs. The main problem in addiction is the lack of effective treatment based on the pathophysiology of the disease. Therefore, many studies have been done to understand the basic mechanisms that may be effective in controlling drug abuse. Recently, it has been well documented that the gut-brain axis plays an important role in brain diseases such as anxiety and depression. Since the addiction circuit mainly located in brain areas such as the reward circuit, it is not surprising that the gut-brain axis may cause changes in reward circuit functions. Recently, it has been well documented that dopamine secretion can be altered by changes in the microbiota. It is well known that changes in the colonization of human gut microbiota may result in neuropsychiatric and neurological diseases. Different mechanisms have been proposed based on anatomic pathways and hormone secretion but to date, no definite mechanism has been proposed. However, based on the studies in this regard the best treatment for addiction can have 2 ways. First, we can think of changing the existing present microbiota in addicts and the second is the administration of hormones that may be related to the gut-brain axis. Lactobacillus helveticus and Bifidobacterium longum have successfully been used in mood disorders and in addition, positive outcomes have achieved and more studies will reveal the best treatment. Administration of hormones should be taken with caution because someof themare useful and someof them have a negative outcome. So, hormones should be used with caution.","PeriodicalId":44600,"journal":{"name":"Addictive Disorders & Their Treatment","volume":null,"pages":null},"PeriodicalIF":1.1,"publicationDate":"2020-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1097/ADT.0000000000000194","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47186422","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-08-14DOI: 10.1097/ADT.0000000000000221
J. Westermeyer, B. Soukup
Goal: The goal of this study was to alert clinicians to Korsakoff syndrome associatedwith comorbid neurological and neuropsychiatric conditions in patients aged 50 years and older. Methods: The study consists of 4 Korsakoff longitudinal case reports (mean age at onset=60.5 y), supplemented by relevant published reports. Findings: The findings include demographic characteristics, comorbid central nervous system conditions, and interventions. Conclusion: In older patients with Korsakoff syndrome and comorbid central nervous system conditions, the optimal functional outcome depends upon a neurophysiological understanding of all comorbidities plus treatment interventions that can alleviate >1 comorbid condition insofar as feasible.
{"title":"Late-onset Cases of Korsakoff Amnestic Syndrome With CNS Comorbidities: Suggestions for Long-term Management","authors":"J. Westermeyer, B. Soukup","doi":"10.1097/ADT.0000000000000221","DOIUrl":"https://doi.org/10.1097/ADT.0000000000000221","url":null,"abstract":"Goal: The goal of this study was to alert clinicians to Korsakoff syndrome associatedwith comorbid neurological and neuropsychiatric conditions in patients aged 50 years and older. Methods: The study consists of 4 Korsakoff longitudinal case reports (mean age at onset=60.5 y), supplemented by relevant published reports. Findings: The findings include demographic characteristics, comorbid central nervous system conditions, and interventions. Conclusion: In older patients with Korsakoff syndrome and comorbid central nervous system conditions, the optimal functional outcome depends upon a neurophysiological understanding of all comorbidities plus treatment interventions that can alleviate >1 comorbid condition insofar as feasible.","PeriodicalId":44600,"journal":{"name":"Addictive Disorders & Their Treatment","volume":null,"pages":null},"PeriodicalIF":1.1,"publicationDate":"2020-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48358157","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-08-07DOI: 10.1097/ADT.0000000000000218
A. Soliman, N. Zaki, Soheir H. El-Ghonemy, Reem El Ghamry, E. Shorub, M. Farag
Background: Recent evidence suggests that abusing drugs may alter the normal structure in brain regions and influence functions that induce cognitive deficits and promote continued drug use. Objective: The objective of this studywas to assess the pattern of cognitive dysfunctions in patients with chronic heroin use and to explore any relation to brain-derived neurotrophic factor (BDNF) plasma level. Method: This was a case-control naturalistic cross-sectional study of 50 patients (case group) with chronic heroin use according toDiagnostic and Statistical Manual of Mental Disorders, fourth edition (DSM-IV) who were recruited from the inpatient unit and outpatient clinics of Institute of Psychiatry, Ain Shams University, and were further compared with a control group that consisted of 38 frequency-matched healthy volunteers. The groups were subjected to the following: (1) clinical psychiatric examination, (2) Structured Clinical Interview for DSMIV (SCID-I), (3) Addiction Severity Index for the patients’ group, (4) Wechsler Adults Intelligence Scale, (5) Wechsler Memory Scale, (6) Wisconsin Card Sorting Test— computerized version was performed to assess cognitive functions, and (7) measuring BDNF plasma level. Results: Definite cognitive function impairment and poor cognitive domains were detected among the case group. Total intellectual functions, and visual, verbal, immediate memory, and executive functions were statistically significant (P<0.005). Although, there was no significance between BDNF plasma level and different neurocognitive functions, higher BDNF plasma level among the case group was detected. Limitation: Premorbid cognitive abilities could not be assessed, as the current study was a cross-sectional study. Conclusions: Those with chronic heroin use suffer from cognitive dysfunction of multiple domains that may contribute to their continued drug use. Psychotherapeutic programs should consider these findings in their approaches for better impact on patients’ quality of life and overall treatment outcome.
{"title":"Cognitive Functions and Impact of Plasma BDNF in Chronic Heroin Users","authors":"A. Soliman, N. Zaki, Soheir H. El-Ghonemy, Reem El Ghamry, E. Shorub, M. Farag","doi":"10.1097/ADT.0000000000000218","DOIUrl":"https://doi.org/10.1097/ADT.0000000000000218","url":null,"abstract":"Background: Recent evidence suggests that abusing drugs may alter the normal structure in brain regions and influence functions that induce cognitive deficits and promote continued drug use. Objective: The objective of this studywas to assess the pattern of cognitive dysfunctions in patients with chronic heroin use and to explore any relation to brain-derived neurotrophic factor (BDNF) plasma level. Method: This was a case-control naturalistic cross-sectional study of 50 patients (case group) with chronic heroin use according toDiagnostic and Statistical Manual of Mental Disorders, fourth edition (DSM-IV) who were recruited from the inpatient unit and outpatient clinics of Institute of Psychiatry, Ain Shams University, and were further compared with a control group that consisted of 38 frequency-matched healthy volunteers. The groups were subjected to the following: (1) clinical psychiatric examination, (2) Structured Clinical Interview for DSMIV (SCID-I), (3) Addiction Severity Index for the patients’ group, (4) Wechsler Adults Intelligence Scale, (5) Wechsler Memory Scale, (6) Wisconsin Card Sorting Test— computerized version was performed to assess cognitive functions, and (7) measuring BDNF plasma level. Results: Definite cognitive function impairment and poor cognitive domains were detected among the case group. Total intellectual functions, and visual, verbal, immediate memory, and executive functions were statistically significant (P<0.005). Although, there was no significance between BDNF plasma level and different neurocognitive functions, higher BDNF plasma level among the case group was detected. Limitation: Premorbid cognitive abilities could not be assessed, as the current study was a cross-sectional study. Conclusions: Those with chronic heroin use suffer from cognitive dysfunction of multiple domains that may contribute to their continued drug use. Psychotherapeutic programs should consider these findings in their approaches for better impact on patients’ quality of life and overall treatment outcome.","PeriodicalId":44600,"journal":{"name":"Addictive Disorders & Their Treatment","volume":null,"pages":null},"PeriodicalIF":1.1,"publicationDate":"2020-08-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42084436","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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