Journal of Addictive Diseases最新文献

The rise in pregnancy-related overdose deaths has been driven by the use of high-potency illicitly-manufactured synthetic opioids including fentanyl. Xylazine, a veterinary sedative, is increasingly noted as a common adulterant in the United States illicit opioid supply. Exposure to the xylazine-fentanyl combination has been associated with severe harms including sedation, necrotic wounds, and symptoms of xylazine withdrawal. Due to limited data that directly addresses the risks of xylazine exposure during human pregnancy, we conducted a narrative review to summarize the available evidence about the clinical implications of xylazine exposure in pregnancy drawing from evidence from animal models, the general adult population, and the authors' clinical experiences. Because xylazine exposure presents unique risks to pregnant persons, management of xylazine exposure and related clinical sequelae in pregnant persons warrants nuanced clinical management. Further, additional research is critically needed to develop best practice guidelines related to the management of co-occurring xylazine-opioid exposure during pregnancy including harm reduction strategies to reduce exposure risk during pregnancy.

Objectives: Determine if long-acting injectable buprenorphine (LAIB) can be successfully and safely administered in the hospital with minimal sublingual buprenorphine lead-in and potentially improve follow-up engagement in care.

Methods: We performed a retrospective case series of 46 patients who received LAIB while hospitalized at a safety-net community hospital. We abstracted demographic information, details about substance use disorder treatment history, in-hospital buprenorphine initiation methods and follow-up data from inpatient and outpatient electronic medical records.

Results: In total, 46 hospitalized patients received LAIB during the study period. The majority of our patients were older Black adults with Medicaid who self-reported intranasal heroin use. A low-dose buprenorphine initiation protocol was used most commonly, either in sublingual or intravenous form, with only two cases of precipitated withdrawal occurring during the buprenorphine initiation process and no cases of precipitated withdrawal after the administration of LAIB. 87% (40) of the patients received LAIB after receiving either sublingual or IV buprenorphine for fewer than the recommended seven days. Of the 46 hospitalized patients who received LAIB, 23 (50%) attended a follow-up addiction medicine appointment within 30 days of discharge.

Conclusions: Hospital administration of LAIB could play an important role in retention in care after hospital discharge.

Objective: Dissatisfaction with an inividual's sex life is underlying factor that can lead to pornography addiction. The current research aims to understand the relationship between pornography use and sexual satisfaction.

Methods: The pooled correlation coefficient with 95% confidence interval was calculated using random effects. The meta-regression method was used to examine factors affecting heterogeneity between studies and Egger's test was used to evaluate of publication bias.

Results: 41 studies with a total sample size of 70541 participants were included in the meta-analysis. The pooled estimate for the correlation coefficient in total, in male and in female -0.06 (95% CI: -0.09 to -0.02), -0.07 (95% CI: -0.16 to 0.02) and -0.04 (95% CI: -0.08 to -0.01). The pooled estimate of correlation coefficient was -0.04 (95% CI: -0.07 to -0.02) in cross-sectional, -0.12 (95% CI: -0.19 to -0.05) in cohort, 0.00 (95% CI: -0.15 to 0.15) in studies that used self-report questionnaire and -0.06 (95% CI: -0.08 to -0.03) in studies that used online survey. Based on the results of the meta-regression, the publication year was found to have a significant effect on heterogeneity among studies (B = 0.013, p = 0.018). However, study design, age, data collection method, quality score and sample size did not have a significant effect.

Conclusions: There was a significant negative correlation between pornography and sexual satisfaction and the disaggregation of results by gender also indicated this negative correlation among women. However, the relationship between pornography and sexual satisfaction was not significant in men.

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.

Background: Tobacco use is one of the leading causes of preventable mortality and morbidity. Although Cyprus is considered a developed country, the tobacco prevalence and related issues have not been explored sufficiently in the general population of North Cyprus.

Objective: The objective of this study is to determine the rate of tobacco product consumption and related factors among the visitors of a community health center and a university hospital in Northern Cyprus.

Methods: The study was designed as a cross-sectional study The data were collected using a questionnaire developed in compliance with WHO guidelines. The data were analyzed using IBM-SPSS18.0 with p < 0.05 evaluated as significant.

Results: Out of a total of 635 individuals approached, 615 provided responses. The participation rate was 96%. The frequency of male smokers was 47.2%, while the frequency of female smokers was 34.0%, with a total smoking rate of 40.7%, much higher than world averages. The survey identified friendship influence as the primary reason for starting tobacco use, accounting for 42%, followed by being stressed at 34.6%. Male gender, being single, having no children, Turkish nationality were predictors of smoking, while financial status was not. The participants indicated a high frequency regarding exposure to passive smoke (51.1%). More than half of the respondents thought tobacco control in Northern Cyprus is not satisfactory.

Conclusion: More research needs to be done to determine the exact overall prevalence of tobacco consumption in the population, which was found high in this study. Moreover, implementation of comprehensive tobacco control strategies is essential to control the prevalent tobacco dependence.

Objectives: Management of opioid withdrawal in the inpatient setting can vary widely depending on the patient, the physician, and the institution. Although buprenorphine and methadone are first-line therapy for withdrawal management, some patients experience barriers to those medications. In this case series, we explore high dose opioid agonist therapy (HDOAT) as a novel and effective option to bridge to recovery in this particular setting.

Methods: This retrospective case series includes- five patients with opioid use disorder (OUD) who were treated with HDOAT while hospitalized and reports on their outcomes.

Results: All five patients completed lifesaving medical therapy, engaged with community health workers for resources, and successfully transitioned to medications for opioid use disorder (MOUD). More importantly, none of the patients had patient directed discharges (PDDs). Furthermore, there were no inpatient drug uses or overdoses requiring naloxone administration, even with very high doses of oxycodone. None of the five patients were readmitted within thirty days.

Conclusions: Although more rigorous research is needed, HDOAT may be a viable strategy for OUD when patients continued to decline buprenorphine or methadone on admission. This case series demonstrated the successful use of this strategy toward preventing PDDs, promoting treatment completion, and allowing substance recovery and rehabilitation, in patients who elected to defer MOUD on arrival.

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.

In recent years, various traumatic events such as pandemics, earthquakes, wars, and migration have occurred worldwide. Negative news and content related to these events can be easily accessed on social media, leading to the concept of doomscrolling. Doomscrolling is a recent phenomenon in mental health research and has not yet been sufficiently studied. Therefore, in this study, the longitudinal relationship between social media addiction and doomscrolling was examined. In this study, data were collected at two time points, time 1 (T1) and time 2 (T2), separated by a two-month interval. The study sample comprised 301 adolescents (48.5% female; 51.5% male) from 20 cities in Turkey. Participants were aged 12 to 19 (M_age = 15.55, SD = 1.09). The study employed a Cross-lagged path analytic model for the analysis. The analyses revealed positive and significant relationships between social media addiction and doomscrolling. It was concluded that at T1, addiction to social media had a positive correlation with doomscrolling at T2. Furthermore, the analysis revealed that social media addiction at T1 had a positive correlation with social media addiction at T2. However, the study found that engaging in doomscrolling at T1 did not significantly predict the development of social media addiction at T2. In conclusion, adolescents' social media addiction levels increase the risk of doomscrolling. These results demonstrate the importance of interventions that include social media addiction in the prevention and treatment of doomscrolling. Mental health professionals can provide interventions that include healthy social media use skills in adolescents to prevent doomscrolling.