Journal of Addictive Diseases最新文献

Amphetamine-type stimulants (ATS), such as methamphetamine, amphetamine, and MDMA, are highly risky substances linked to neurochemical disruptions, metabolic disturbances, and systemic toxicity. Despite substantial research on their neurotoxic effects, the metabolic pathways involved in ATS dependence remain poorly understood. This study aimed to characterize the metabolic signatures associated with ATS dependence using NMR-based metabolomics to identify systemic metabolic disruptions related to chronic ATS use. A cross-sectional study was conducted involving 583 participants, comprising ATS-dependent individuals from Malaysian drug detention centers and healthy controls. Plasma samples were analyzed using 1H-NMR, CPMG, and HSQC spectroscopy to obtain comprehensive metabolomic profiles. Multivariate analyses, including PCA-X, OPLS-DA, and logistic regression, were employed to identify metabolites that differentiated ATS patients from controls. Metabolites were cross-referenced with BMRB and HMDB databases for validation. ATS-dependent individuals showed significant alterations in metabolic pathways, with reductions in cholic acid, L-valine, L-alanine, lactic acid, creatinine, histidine, taurine, and homovanillic acid (all p < .005), indicating disruptions in energy metabolism, neurotransmitter biosynthesis, and oxidative stress defenses. Elevated L-arginine levels (p < .001) suggested nitrogen metabolism dysregulation. OPLS-DA analysis demonstrated robust group separation (R²Y = 0.762, Q²Y = 0.756, AUROC = 0.987), with sensitivity, specificity, and classification accuracy of 86.9%, 97.4%, and 91.5%, respectively. This study presents the first NMR-based metabolomic profile of ATS misuse in Malaysia, identifying critical metabolic disruptions linked to chronic ATS use. Key biomarkers, including cholic acid, L-valine, and homovanillic acid, highlight potential targets for biomarker development and precision medicine strategies to improve the diagnosis, treatment, and understanding of ATS use disorder.

This systematic review synthesizes current evidence on non-prescribed ketamine use, emphasizing its neurobiological impacts and psychotherapeutic interventions. Patterns of misuse demonstrate the complex interplay of neurobiological, socio-economic, demographic and psychological factors with adolescents, women and polysubstance users identified as high-risk groups. Neurobiological findings highlight prefrontal-limbic dysconnectivity, maladaptive neuroplasticity alongside hypothalamic-pituitary-adrenal (HPA) axis dysregulation as central mechanisms underlying this addiction. The review evaluates the comparative efficacy of psychotherapies whilst proposing an innovative framework that aligns therapeutic timing with neuroplastic recovery phases. Emerging evidence identifies biomarkers, e.g., brain-derived neurotrophic factor (BDNF) and heart rate variability (HRV), as promising tools for guiding personalized and phase-specific interventions. Gaps in research include the limited representation of low-resource settings and insufficient longitudinal data on biomarker integration and therapy sequencing. Recommendations propose a comprehensive neurobiologically informed model which carefully integrates digital platforms, culturally tailored strategies and biomarkers to enhance treatment outcomes.

Background: The current study uses geographic information system (GIS) methods to better understand structural risks significantly associated with substance misuse and how those risks may be driven by urbanicity versus rurality.

Methods: Using Alabama Medicaid administrative claims data from January 1, 2015, to December 31, 2020, we identified Medicaid recipients with claims for methamphetamine use. Our dataset included 100% of claims for the 2015-2020 study period. County-level geocodes were also obtained for each Medicaid recipient aged > 18 years (n = 9,861). We added a rural-urban designation variable for each county by utilizing the rural-urban continuum codes from the United States Department of Agriculture.

Results: Fifty-one counties (76.12%), specifically, had changes in methamphetamine use rates > 0% during the study period, with 10 (14.93%) counties exhibiting >100% increases in methamphetamine use rates. Findings suggest that Alabamians residing in rural portions of the state engaged in greater usage as compared with those in urban locations.

Conclusion: Findings point to the need for intervention in rural Alabama targeting methamphetamine use. The development of prevention and intervention approaches that target risks stemming from geographical differences may bolster current efforts to reduce methamphetamine and other forms of substance misuse.

Methods: This descriptive-analytical study included a self-report questionnaire based on the TPB model, and was distributed to a sample of 115 people recovering from SUD, aged 18-69, 62% of whom were men.

Results: Attitude, Subjective Norms (SN), and Perceived Behavioral Control (PBC) toward online addiction treatment was significantly positive in relation to intention and past behavior of participants in online addiction treatment. Attitude and PBC were found to be significant predictors, and the TPB model was found to be significant {F (3,111) = 47.29, p < 0.01}, explaining 56% of the variance of intention for participants in online addiction treatment.

Conclusion: As online treatment is a relatively new tool in addiction treatment, professionals and treatment providers should encourage beliefs, attitudes, moral norms, and perceived behavior control to increase intentions among future participants in online addiction treatment.

Background: Consuming opioid agonists is a risk factor for cardiovascular disease particularly in intravenous heroin users. The monthly injectable extended-release opioid antagonist, naltrexone (XR-NTX) is an effective treatment for opioid use disorder. The impact of opioid receptor blockade through XR-NTX on blood pressure, a critical risk factor for cardiovascular morbidity, has not yet been characterized.

Methods: The study evaluated the change in blood pressure during XR-NTX treatment among 14 patients who predominately used intravenous heroin and 24 patients who used prescription oral opioids, all with opioid use disorder. Blood pressure was measured in each patient immediately before the first XR-NTX injection and ∼two weeks after the first injection. The change in diastolic and systolic pressure was compared between the heroin users and the prescription opioids users using analysis of variance.

Results: XR-NTX treatment was associated with significant decreases in diastolic blood pressure in the heroin group, but not in the prescription opioids group. Systolic blood pressure values in the heroin users showed a decline at trend level only.

Conclusions: Further research is warranted to replicate our findings and to determine whether XR-NTX effect is relatively specific to blood pressure or generalizes to other components of metabolic syndrome. Distinguishing between heroin and prescription opioid users could shed light on the unique clinical and pharmacological profiles of opioid drugs, particularly regarding their cardiovascular safety. This information can be useful in developing personalized therapeutic strategies based on the route of opioid administration.

Background: Most studies on Food Addiction (FA) used the strict classical diagnosis approach without quantifying sub-threshold symptoms (i.e. uncontrolled/excessive food intake, negative affect, craving, tolerance, withdrawal, and continued use despite harm) nor indicating where they stand on the "three-stage addiction cycle" modeling the transition from substance use to addiction.

Objectives: (1) to estimate the proportion of clinically significant episodes of distress/impairment in severely obese patients without FA, and (2) to assess their associations with FA symptoms at the subthreshold level.

Methods: The modified Yale Food Addiction Scale 2.0 (mYFAS 2.0) assesses 11 symptoms (diagnostic criteria) plus clinically significant impairment and distress (clinical significance criterion). We used this tool to diagnose FA (≥ 2 criteria plus clinical significance) in adult patients with severe obesity, but included only those below the threshold in the analyses. Demographics, clinical features, and obesity complications were collected.

Results: Only 18% of the 192 participants (women n = 148, 77.1%; mean age: 43.0 ± 13.2) reported a total absence of FA symptoms, while one in four reported recurrent episodes of clinically significant distress (24%) or impairment (25%) in social, occupational, or other important areas of functioning. The most common recurrent symptoms were first-stage symptoms (binge/intoxication), while second- (withdrawal/negative affect) and third-stage (preoccupation/anticipation) symptoms affected nearly one patient in five for tolerance and craving, and one in ten for withdrawal. In multivariate analysis, impairment was positively related to withdrawal and tolerance, while distress was positively related to failure in role obligations.

Conclusion: Many patients with severe obesity experience recurrent episodes of FA symptoms at the subthreshold level. Prospective studies will examine whether these symptoms may play a causal role in symptoms progression toward a full-blown FA and obesity outcomes.

Neuroimaging has continually advanced, playing a crucial role in the accurate diagnosis of various brain pathologies and disorders. This integrative review aimed to identify the main changes in brain connections found in fMRI scans of individuals with Internet Gaming Disorder (IGD). The data collection method involved searching for the terms "Magnetic Resonance Imaging", "Psychological Dependence" and "Internet Addiction Disorder" in the PubMed and Embase databases. Studies published between 2020 and January 2023 were included and manually analyzed through the virtual environment created in the "Rayyan" software, compiling a total of 18 scientific studies. The main findings reveal changes such as significant increases or decreases in functional connectivity in certain regions of the brain. Some potential negative impacts on the uncontrolled use of technologies among the young population were evaluated, such as the loss of inhibitory control in decision-making, transforming leisure into dependence, and although the IGD understands the associated risks and harms, it faces difficulties in resisting the desire to stop playing. This situation emphasizes the need for more long-term studies that can be comparative between different age groups. Conclusion, the brain regions with the most significant changes in functional connectivity in individuals with IGD symptoms are the prefrontal cortex, fronto-parietal regions, frontal gyrus, insula lobe, cingulate cortex and striatum. The lack of comprehensive knowledge about the effects of video game addiction across different age groups is a significant concern. Therefore, it is essential to carry out research that evaluates the impact of these technologies on different stages of human development.

Background: There has been extensive research demonstrating the effectiveness of medications for opioid use disorder (MOUD) but limited investigation into its long-term retention rate.

Objective: Assess the long-term treatment retention of a buprenorphine-based MOUD clinic with additional stratifications by age and gender.

Methods: This retrospective study analyzed 10-years of data from a MOUD clinic in West Virginia that served 3,255 unique patients during the study period (2009-2019). Retention was measured by summation of total treatment days with a new episode of care defined as re-initiating buprenorphine treatment after 60+ consecutive days of nonattendance. Kaplan-Meier survival analysis, with the log-rank test, was used to compare retention by gender and age.

Results: The mean age was 38 (SD = 10.6) and 95% were non-Hispanic white. Irrespective of treatment episode, 56.8% of patients were retained ≥ 90 days, and the overall median time in treatment was 112 days. Considering only the first treatment episode, 48.4% of 3,255 patients were retained at least 90 days and the overall median was 77 days. Female patients had a ≥ 90 day retention rate of 52.2% for the first admission and 60.1% for multiple admissions, both significantly higher than those of male subjects (44.1% and 53.0%). Additionally, patients ≤ 24 years old had the lowest rate of treatment retention, while patients aged ≥ 35 had the highest.

Conclusions: This study adds to the limited data regarding long-term retention in MOUD. Our findings indicate gender and age were highly correlated with retention in MOUD treatment.

Background: Central sensitization is an important mechanism underlying many chronic pain conditions. Chronic pain and alcohol use disorder (AUD) are highly comorbid. Despite great scientific interest in brain mechanisms linking chronic pain and AUD, progress has been impeded by difficulty assessing central sensitization in AUD.

Objective: The present study is the first to employ a validated surrogate measure to describe central sensitization in a clinical sample with AUD.

Methods: Participants with AUD (n = 99) were recruited from an academic addiction treatment center. A well-established surrogate measure of central sensitization, The American College of Rheumatology Fibromyalgia Survey Criteria (ACRFMS) was administered. Participants also responded to questions about quality of life (RAND-36), and AUD. Descriptive analyses and Spearman's rho correlations were performed.

Results: Chronic pain and evidence of central sensitization were prevalent. Greater central sensitization was associated with worse health-related quality of life. Participants higher in central sensitization expressed greater endorsement of pain as a reason for AUD onset, maintenance, escalation, treatment delay, and relapse.

Conclusion: The present study bolsters prior assertions that AUD and chronic pain might compound one another via progressive sensitization of shared brain circuitry. These results may inform future mechanistic research and precision AUD treatment.