Journal of Addictive Diseases最新文献

Substance use disorders (SUDs) are chronic, relapsing conditions characterized by significant neurobiological and behavioral disruptions. Emerging evidence highlights the critical roles of oxidative stress, mitochondrial dysfunction, and neuroinflammation in the pathophysiology of drug misuse. Coenzyme Q10 (CoQ10), a mitochondrial cofactor with potent antioxidant and anti-inflammatory properties, has gained attention as a potential adjunctive therapy for managing substance-related neurotoxicity. This review explores the mechanistic role of CoQ10 in mitigating the oxidative damage and neuroinflammation induced by substances misuse, emphasizing its ability to restore mitochondrial function and support neuronal health. Preclinical studies demonstrate that CoQ10 supplementation reduces apoptosis, preserves neurotransmitter systems, and improves behavioral outcomes in models of cocaine, alcohol, nicotine, and opioid addiction. Clinical evidence, though limited, suggests CoQ10's safety and therapeutic potential in oxidative stress-related conditions, reinforcing its relevance to addiction. Despite these promising findings, challenges such as low bioavailability and the lack of SUD-specific clinical trials remain significant barriers. This review underscores the need for further research to optimize CoQ10's formulation, dosing strategies, and clinical applications in the treatment of SUDs. Integrating CoQ10 into multidisciplinary approaches could advance our ability to address the complex neurobiological challenges of SUDs and improve long-term recovery outcomes.

Introduction: The evolving landscape of laws and policies related to cannabis can inform patterns and trends in adolescent cannabis use. Today, a wide variety of cannabis products and alternatives are available in the legal and illicit markets. Harms associated with their use may vary depending on the amount and type of tetrahydrocannabinol (THC) they contain. Few studies have examined the awareness of and use of these different cannabis products among adolescents.

Methods: Our study examined patterns of cannabis use in adolescent patients of an urban pediatric addiction clinic.

Results: Most adolescents seen at the clinic use multiple cannabis products, and many adolescents use cannabinoid derivatives such as delta-8 and delta-10 THC.

Discussion: These results highlight the need for providers to explore in depth the various cannabis products used by adolescents, educate adolescents on the products, especially due to unknown risks associated with cannabinoid derivatives, and advocate for further regulation of alternative cannabis products.

Background: Cannabis Use Disorder (CUD) involves compulsive cannabis use, leading to significant impairment and distress. Previous research indicates lower physical activity and higher sedentary behavior among cannabis users, but the causal relationship remains unclear. This study aims to use Mendelian randomization (MR) to investigate the causal link between exercise, sedentariness, and CUD.

Methods: We analyzed genetic associations for (1) moderate-to-vigorous physical activity (MVPA), (2) leisure screen time (LST), (3) sedentary commuting behavior (SCB), and (4) sedentary behavior at work (SBW). Genetic instruments for smoking initiation were identified from the GSCAN study. Genetic associations for CUD were derived from the largest Genome-wide association studies (GWAS) of CUD. We selected significant genetic variants, harmonized data. We conducted MR analyses using IVW, assessing heterogeneity and pleiotropy with Cochran's Q test and MR-Egger regression, and performed leave-one-out analyses.

Results: SBW showed a protective causal relationship with CUD (OR = 0.61, 95% CI = 0.42-0.90, p = 0.012). LST increased the risk of CUD (OR = 1.43, 95% CI = 1.20-1.70, p < 0.001). LST also showed a significant causal relationship with smoking initiation (OR = 1.28, 95% CI = 1.21-1.36, p < 0.001), which was associated with increased CUD risk. Smoking initiation mediated 54.08% of the increased CUD risk associated with LST (95% CI = 53.72-54.44%).

Conclusions: A sedentary lifestyle may lead to CUD through smoking. Addressing sedentariness and promoting physical activity may reduce the risk of smoking initiation and subsequent cannabis-related problems.

An increasing number of new psychoactive substances (NPS), such as designer benzodiazepines, are becoming available on the recreational drug market. These are new unregistered substances and thereby an attempt to evade legislation. Often there is very limited clinical information available regarding these NPS, which could result in undesirable clinical outcomes in the management of intoxications, dependencies and withdrawals following NPS use. In this case report we describe a 23-year-old woman, who was admitted to our residential addiction care facility for the detoxification of the designer benzodiazepine bromazolam. Her daily use of 6 mg bromazolam was converted to 20 mg diazepam. Although we expected a higher dose would have been needed, 20 mg was sufficient and was tapered without complications. This case report demonstrates the safe conversion of 6 mg of bromazolam to 20 mg of diazepam by combining the use of fixed-dose and symptom-triggered-dose regimens. More clinical data is necessary to formulate advisory management for the detoxification of bromazolam and other designer benzodiazepines.

Introduction: Substance use disorder (SUD) is a common condition often associated with borderline personality disorder (BPD), and patients with both disorders (SUD + BPD) have more complex presentations and poorer outcomes in treatment. Thus, there is a need to identify more clearly the clinical differences between patients with SUD + BPD and those with SUD only to help clinicians in their diagnostic process.

Methods: Data from medical files of 92 patients with SUD (SUD only: n = 42; SUD + BPD: n = 50) treated in an outpatient psychiatry and addiction treatment center were extracted to compare the differences in terms of sociodemographic characteristics, substance used, psychopathological dimensions, comorbidity prevalence, and functional impairment.

Results: Compared to the SUD only group, patients in the SUD + BPD group were younger, more disabled, and less satisfied with their social life. Regarding substance used, the comorbid group had more frequently cannabis use disorder and poly nonalcoholic SUD. Regarding psychopathological dimensions, the comorbid group had higher levels of impulsivity, emotion regulation difficulties and alexithymia. Finally, regarding comorbidities, the comorbid group had a higher risk of comorbid anxiety, obsessive-compulsive, and post-traumatic stress disorders.

Conclusion: While being only exploratory, these results add evidence on the impact of the BPD comorbidity in patients with SUD and underline important dimensions that should be considered by clinicians working with this population.

While rates of opioid use disorder (OUD) continue to rise across the country, young adults with OUD are at particular risk as they have poorer treatment outcomes and lack developmentally appropriate treatment options. The introduction of mobile applications for OUD present a new avenue to improve treatment outcomes for young adults. One such app, reSET^® provides app users with weekly cognitive behavioral therapy lessons focusing on addiction with built in contingency management for completion of lessons and negative urine drug screens. This exploratory study aimed to identify the characteristics of patients who engaged with the application, reSET^®, as well as to describe potential differences in treatment outcomes between engagers and non-engagers. This observational cohort study analyzed clinical and other program data from 35 young adults between the ages of 20-28 that were involved in the care and prescribed medications for OUD in Baltimore, Maryland during the 12-week period of app prescription. Results indicated that young adults had dichotomous levels of engagement, with almost 30% engaging highly with the app, completing >90% of lessons, and approximately 70% having low engagement, completing <25% of lessons. There were no differences in mental health outcomes, but engagers were more likely to be retained in care at the end of the 12-week prescription as compared to non-engagers. Overall, results suggest that mHealth apps targeted for OUD treatment offer potential treatment benefits for young adults, especially regarding treatment retention. Future studies should investigate the treatment and mental health impacts of reSET^® and other mHealth apps within this population.