Journal of Addictive Diseases最新文献

According to the Centers for Disease Control and Prevention (CDC), 100,306 drug overdose deaths occurred in the US during a 12-month period ending in April 2021. Opioids were involved in 75% of these related deaths. Opioid Use Disorder (OUD) is a constantly evolving public health crisis with potentially lethal consequences. In 2017, 900 adolescents began to misuse opioids every day. Nearly 10% of high school seniors reported using opioids nonmedically. Additionally, the incidence for hospitalizations for adolescents among children 1-19 years of age increased nearly 2-fold from 1997 to 2012. This data emphasizes the dangers associated with the increasing accessibility of pharmaceutical and non-pharmaceutical opioids, particularly for adolescents. All three of the currently FDA approved medications for OUD have shown clear efficacy in decreasing all-cause mortality in adults. It is proposed that the same effects should be seen in adolescents but limited data is present. A recent study analyzed buprenorphine and naltrexone treatment amongst OUD in adolescents between 2001-2014; only 1 in 4 youth received any medication therapy within six months of diagnosis. Adolescents under 16 were the most likely to receive medications. However, even adolescents aged 17, for whom buprenorphine is FDA approved for, were less likely to receive therapy than adults over 18 years of age. The following case report aims to demonstrate how subcutaneous extended release buprenorphine treatment can be initiated effectively as an outpatient in an adolescent with OUD. It is critical that clinicians work to expand access to pharmacotherapy for adolescents struggling with OUD to ensure proper management and reduction of opioid-related overdoses.

Introduction: Buprenorphine is used to treat opioid use disorder (OUD). However, therapy is often disrupted during acute pain episodes, and re-initiation is often deferred due to intolerable interruption in opioid analgesics. This case report describes a unique strategy for inducing buprenorphine without stopping opioid analgesics.

Case: One patient with OUD and acute pain was initiated on buprenorphine using intravenous microdosing without precipitated withdrawal or pain exacerbation. Full agonist opioids were successfully weaned after discharge and the patient was linked with a community-based treatment program.

Conclusion: This case describes use of intravenous buprenorphine to treat OUD and acute pain without adverse consequences.

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: Alternative tobacco products like midwakh are gaining popularity as potential substitutes for traditional cigarettes despite a misconception among smokers that they may be less harmful.

Objectives: To determine the prevalence, knowledge, beliefs, and predictors of midwakh smoking among adult smokers in Qatar during 2022.

Method: An analytic cross-sectional study was conducted from January 2022 to July 2022. A simple random sample (N = 1036) was employed to include participants from the list of adults 18 years and above obtained from Qatar's National Health Information System who were invited to participate in a telephone survey.

Results: Among the 806 participants (response rate 77.8%), 9.3% were current midwakh smokers, and 5.2% had ever smoked midwakh. The majority were male (97.2%), non-Qatari (70.9%), and aged over 24 years. Additionally, 66.7% of midwakh smokers reported having at least one family member or friend who smoked any tobacco product. Reasons for midwakh use included enjoyment, experimentation, cessation of other tobacco products, affordability, and lack of odor. Moreover, 70.9% believed midwakh smoking could lead to addiction, while 66.7% perceived it as more dangerous than other tobacco products, potentially causing severe health conditions like lung cancer. Multivariable logistic regression indicated a significant association between midwakh use and nationality, with Qataris being 0.21 times less likely to smoke midwakh than non-Qataris (adjusted odds ratio of 0.214, 95% confidence interval: 1.58-4.225, p value of 0.0001).

Conclusion: Midwakh smoking poses health risks comparable to other tobacco products, with peer influence being significant. Urgent action is needed to heighten awareness and allocate resources for effective intervention.

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.

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.

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.

Background: Synthetic cannabinoids (SCs) dependence is increasingly prevalent among young individuals globally, with limited understanding of their potential detrimental effects. Therefore, we conducted this comparative study to assess impulsivity and non-suicidal self-harm behavior in patients with SCs dependence.

Subjects and method: We conducted this comparative, case-control study in the outpatient clinics of (Beni-suef University Hospital). We recruited 30 patients with SCs dependence and the 30 healthy subjects as a control group. Psychometric scales, including Addiction Severity Index (ASI), Barratt Impulsivity Scale-11 (BIS-11), Deliberate Self-harm Inventory-Short Version (DSHI), SCID I, SCID II, and drug urine screen, were applied to compare the two study arms.

Results: DSHI-s scores were significantly higher between the two study arms (3.23 ± 4.97 vs. 0.0 ± 0.0, p < 0.001, for cases and controls, respectively). Similarly, the mean ± SD score of the BIS scale was significantly higher in cases 68.13 ± 9.75 compared to the control group (45.67 ± 5.12) with a statistically significant difference (p < 0.001). Using the regression analysis, we observed a significant positive linkage between age, duration of substance use, DSHI-s, and the Barratt scale.

Conclusion: Patients with synthetic cannabis addiction exhibited more impulsivity and self-harm behaviors compared to healthy controls. The adverse effects of substance use disorder escalated, notably in individuals classified as having severe addiction based on the Addiction Severity Index. Age and length of substance use were found to be potential factors influencing the level of impulsivity and self-harm actions.