Journal of Addictive Diseases最新文献

Background: No FDA-approved medications for methamphetamine (MA) use disorder (MUD) are available. Suvorexant (SUVO), a dual orexin receptor antagonist that is FDA approved for insomnia treatment, reduces MA self-administration and MA-induced reinstatement responding in preclinical studies. SUVO may also reduce MA use by targeting substance use risk factors, including insomnia, stress, cue reactivity, and craving. This case series study assessed the (1) feasibility and safety of administering suvorexant in a sample of individuals with MUD; and (2) preliminary effects of suvorexant on objective and subjective measures of sleep, stress, and cue reactivity/craving. Method: Participants (n = 3) were randomized to receive 1 week of SUVO or placebo using a within-subject, crossover design with a 1-week washout period between doses. Participants completed self-report (sleep quality, stress), behavioral (cold pressor task), and physiological measures (heart rate, electroencephalogram) during all three weeks. Participants wore a Fitbit to monitor sleep throughout the study. Results: Participants completed all study visits and tasks. One report of severe drowsiness and of severe headache were made; no other severe side effects were associated with SUVO. SUVO improved total sleep time and resulted in lower resting-state alpha power, but was mixed for subjective sleep quality. SUVO administration was associated with increased overall brain reactivity to cues that was not specific to MA cues and also reduced stress, though self-reported stress demonstrated mixed results. Conclusion: Suvorexant was safe and tolerable in a MUD sample. Future research may benefit from investigating SUVO in a well-controlled study with a larger sample.

Introduction: Stigma within communities is pervasive and a barrier to substance use disorder (SUD) treatment. The current proof-of-concept study evaluated enCompass, a community-based SUD knowledge and stigma intervention.

Methods: In 2021, 22 enCompass trainings were offered to community members in partnership with the Ohio Governor's RecoveryOhio initiative to 22 Ohio counties with high numbers of overdose deaths. Participants of the current study included 492 individuals who completed surveys measuring knowledge of SUD treatment and medication, and SUD stigma (i.e., stereotypes, prejudice, discrimination), before and after the intervention. Implementation-related outcomes (i.e., acceptability, appropriateness, feasibility) were also measured after the intervention.

Results: Participants' knowledge increased, and their SUD stigma decreased, from before to after the intervention. Participants strongly agreed that the intervention was acceptable, appropriate, and feasible.

Discussion: Although more testing with longitudinal, randomized designs is needed, preliminary results suggest that enCompass is a promising community-based SUD knowledge and stigma intervention.

Objectives: To examine whether various quit strategies and relapse triggers are associated with maintenance period in a sample of people who quit vaping.

Method: Young Canadians who used to vape (N = 772) completed an online survey on maintenance period, quit strategies, and relapse triggers. Logistic regression was employed to variables associated with maintenance period.

Results: People with past vaping history who quit unassisted or through eliminating social influences were more likely to achieve long-term maintenance. Those who quit through thinking about health improvements, distraction techniques, or self-restriction were less likely to achieve long-term maintenance. Other substance use or sensory vaping cues as relapse triggers were less likely to be experienced for those in long-term maintenance. Using very high concentrations of nicotine prior to quitting, and being unemployed were associated with lower likelihood for long-term maintenance.

Conclusions: It is important to consider quit strategies, relapse triggers, and nicotine use prior to quitting in vaping cessation programing as they are related to maintenance period.

Substance use disorders (SUDs) represent a major challenge in psychiatric treatment, with significant relapse rates despite various psychotherapeutic interventions. This systematic review explores the neurobiological underpinnings of addiction and examines the efficacy of psychotherapies, such as Cognitive Behavioral Therapy (CBT), Eye Movement Desensitization and Reprocessing (EMDR), Mindfulness-Based Relapse Prevention (MBRP), and emerging therapies in treating SUDs. Additionally, the study assesses how emerging biomarkers and neuroimaging data could enhance therapeutic outcomes by guiding personalized treatments. Neurobiological markers, such as prefrontal-limbic connectivity, mesolimbic dopaminergic dysregulation, and glutamate transmission deficits, are shown to significantly influence treatment efficacy. For example, prefrontal cortex hypoactivity and amygdala hyperactivity correlate with poor impulse control and emotional regulation, making these individuals more responsive to CBT and EMDR. Similarly, dopaminergic dysfunction in the mesolimbic pathway is closely tied to reward-seeking behavior where Transcranial Magnetic Stimulation (TMS) may offer therapeutic benefits. Epigenetic modifications, primarily those affecting the glucocorticoid receptor (GR), highlight the role of stress in relapse suggesting that trauma-focused therapies can be effective for individuals with high stress vulnerability. This review finds that integrating neurobiological insights with clinically validated psychometric assessments could significantly improve treatment stratification. Future research should focus on aligning diagnostic systems, such as the DSM-5, with neurobiological markers and psychological tells to facilitate more precise and personalized interventions, potentially transforming addiction treatment outcomes.

Adolescent gambling, internet gambling among college students, and the impact of school bullying collectively form a complex web of challenges that significantly influence the well-being of today's youth. As technology continues to evolve, the accessibility of online platforms has heightened concerns regarding the occurrence and impact of online gambling among college students. This quantitative research investigates the interconnected dynamics of adolescent gambling prevention strategies, internet gambling among high school and college students, and the role of school bullying. Utilizing a purposive sampling technique, 800 valid responses were collected from a total distribution of 850 questionnaires (500 high school, and 300 college students). The data, analyzed using SPSS statistical software, yielded significant findings. The study validates a negative correlation between effective adolescent gambling prevention strategies and problematic gambling prevalence. It also reveals higher psychological distress and a negative correlation between academic performance and internet gambling frequency among college students engaged in internet gambling. Furthermore, a positive association exists between school bullying experience and adolescents' engagement in both offline and online gambling behaviors. Demographic factors such as socioeconomic status and ethnicity were found to moderate the relationship between adolescent gambling prevention strategies and gambling prevalence. A research novelty is introduced, demonstrating a positive correlation between exposure to pro-gambling advertisements on digital platforms and the frequency and severity of internet gambling among college students. This study offers insightful perspectives on the complex dynamics of adolescent behaviors, guiding the creation of specific prevention strategies and emphasizing the influence of digital advertising on internet gambling.

Background: This study investigates the effects of open and closed exercise interventions on the physical and mental health of individuals undergoing substance use disorder (SUD). We examined changes in tendency of recurrence of use, vital capacity (VC), resting heart rate (RHR), sleep quality, and choice reaction time.

Methods: Conducted over six months at the drug rehabilitation center, 95 participants were randomly assigned to closed exercise, open exercise, or control group. Outcome measures were taken at baseline, three months, and six months.

Results: Both exercise groups showed significant improvements in reduction of return-to-use risk and VC compared to baseline. Open exercise groups showed earlier significant improvements in risk of return to use at three months. No significant changes were observed in RHR. Both exercise groups showed significant improvements in sleep quality, with the open exercise group also showing significant improvements in choice reaction time. At six months, both exercise groups showed significant improvements over the control group in tendency of recurrence of use, VC, and sleep quality, with no significant differences between the exercise groups.

Conclusions: Both exercise interventions led to significant improvements in reducing the risk of return to substance use, VC, sleep quality, and choice reaction time, with the open exercise group showing the most pronounced effects in choice reaction time.

Background: Individuals who use both cigarettes and e-cigarettes may have multiple nicotine product use self-identities, each of which may be associated with patterns of use, including cessation.

Objectives: This study examined changes in "smoker" and "vaper" identities and product use behaviors over one year among adults who used both cigarettes and e-cigarettes. We hypothesized that stronger baseline vaping identities would be associated with higher odds of smoking cessation, and stronger baseline smoking identities would be associated with continued cigarette use.

Methods: Participants (N = 364), who were recruited for an observational study of cigarette and e-cigarette use, completed measures of "smoker" and "vaper" identity, nicotine dependence, and product use at baseline and 12 months. We examined associations between smoking and vaping identities and tobacco product use. Logistic regression evaluated the effects of age, gender, and baseline smoking and vaping identities on continued smoking or abstinence at 12 months.

Results: Smoking and vaping identities were independent at baseline (p = .51) but associated at 12 months (p = .0001). At 12 months, "ex-smokers" had higher e-cigarette use than "smokers" and "social/occasional smokers" (p <.0001). Those who identified as "vapers" at baseline had lower odds of smoking at 12 months (OR = 2.27, "non-/ex-vaper" vs "vaper"; OR = 2.05, "social/occasional vaper" vs "vaper").

Smoking and vaping identities are associated with changes in tobacco product use over time.

Background: Cannabis use has increased in prevalence over the past several decades, and novel forms of cannabis (e.g., concentrates and edibles) have become readily available.

Objective: The purpose of this narrative review was to compare the prevalence of use, methods of consumption, and risk for cannabis use disorder outcomes across cannabis forms to better understand the diversifying landscape of cannabis products and practices.

Methods: The electronic database PubMed was used to find relevant articles with keyword searches related to the prevalence of use, methods of consumption, and risk for cannabis use disorder for three major forms of cannabis (flower, concentrates, and edibles).

Results: Use of all three major forms is prevalent among many cannabis users, but there are differences in user demographics and methods of consumption. Use of cannabis concentrates may be associated with a greater risk for cannabis use disorder. Given the historical predominance of cannabis flower use, many outcomes have not been compared with concentrates or edibles. Furthermore, form-specific longitudinal data is lacking.

Conclusions: Given the more recent emergence of novel cannabis products, comparisons of the long-term outcomes of use for each form are needed to advance the development of more informed harm reduction practices that are common to and specific to each form of cannabis.

Background: E-cigarette use has risen rapidly, especially among young people. TikTok is one of the most commonly used social media platforms among young people. The representation of vaping cessation messages in TikTok content remains unexplored. We aimed to address this gap by analyzing the vaping cessation content prevalent on TikTok.

Methods: This cross-sectional mixed methods study analyzed the top 100 TikTok videos-determined based on view-counts-related to vaping cessation. Our quantitative analysis examined video characteristics, while our qualitative analysis identified key thematic representations.

Results: The final sample included 87 videos, with a combined total of over 100 billion views. Most videos were created by regular users (general TikTok content creators) rather than those identifying as health experts or professionals such as doctors, acupuncturists or dental hygienists. Very few posts mentioned evidence-based cessation aids or support. Videos scored high on understandability but low on actionability based on standardized criteria. Qualitative analysis identified nine key themes: motivations for quitting, barriers to quitting, use of aids and strategies, relapse experiences, identity and self-image, celebrating cessation success, emotional journey of quitting vaping, seeking social support, and limited mentions of healthcare providers.

Conclusions: TikTok appears to be a useful influential forum for studying quitting behavior through the sharing of personal experiences and perspectives on vaping cessation. Opportunities exist to integrate evidence-based messaging and support into this platform. Findings can inform social media interventions designed to counter pro-vaping content and promote quitting e-cigarette use.

Implications: Partnerships among health professionals, public health experts, and social media influencers may be leveraged to disseminate proven vaping cessation techniques on leading social media platforms such as TikTok.

Background: Persons with opioid use disorder (OUD) urgently need improved access to medications for opioid use disorder (MOUD) and long-term treatment. Promising options include initiating buprenorphine in the emergency department (ED), telemedicine, and proactive treatment referrals before overdose events.

Objective(s): We describe the process and outcomes of a novel referral path utilizing preemptive outreach and telemedicine to facilitate rapid access to MOUD and long-term treatment.

Methods: Participants were referred to telemedicine appointments with ED providers for buprenorphine initiation and to treatment agencies via an electronic referral network. Administrative data tracked participation at each stage of the process. Independent samples t-tests and chi-square tests assessed differences in process completion based on demographics.

Results: 163 persons with OUD or recent opioid overdose were referred, with high rates of participant follow-through, resulting in 126 new buprenorphine prescriptions and 114 linkages to long-term treatment. Of the 163 patients referred, 114 (69.9%) completed all steps. Participant demographics were not associated with significantly different completion rates.

Conclusions: This model serves as a viable pathway to link people to treatment resources and MOUD, and novelly combines prospective client outreach with telemedicine to reach persons before they arrive in the ED following an overdose. Future studies should examine the impact of similar programs on subsequent opioid use rates and treatment retention.