Journal of Addictive Diseases最新文献

Background: Persons with substance use disorders (SUDs) have a greater risk of suicide compared with the general population. Adjustment Disorder (AD) has been under-researched in SUD populations.

Objective(s): To characterize rates, and associated features, of AD among persons with SUD for whom lethality concerns arise in a general hospital setting.

Methods: Retrospective analysis of electronic medical record data from psychiatric consultations during a consecutive six-month period.

Results: Compared with persons with SUD classified as non-attempters, suicide attempters were significantly more likely to be diagnosed with AD. Multiple logistic regression models revealed patients with SUD referred for suicide-related concerns have an increased risk of suicide attempt if also diagnosed with AD or if they have a history of prior suicide attempt.

Conclusions: These data are in line with the contention that SUD, with comorbid AD, portend significant risk for suicide. AD represents an important disorder to recognize and target in suicide prevention strategies.

Background and objectives: There has been little research in an urban population regarding knowledge of harm reduction measures and treatment options. The objective of our study was to evaluate knowledge and perceptions of harm reduction measures and types of treatment available for opioid use disorder among patients and family in an urban emergency department (ED) waiting room.

Methods: We conducted a single center, cross-sectional survey study that occurred between September 2021 and August 2022. A convenience sample of patients and family members that were above 18 and English speaking were recruited by research assistants. Participants were assessed on knowledge and preferences around drug treatment options and harm reduction. Data were summarized using descriptive statistics and compared using the Freeman-Halton/Kruskall-Wallis/Mann-Whitney U tests. p-Values were reported at the 0.05 significance level.

Results: We collected 200 responses. Of these, 104 people had a connection to someone with a substance use disorder (SUD) and 50 had an SUD. Of those who had a connection to someone with SUD, 63 had heard of naloxone (60.6%, CI: [50.5, 69.9]). Fewer than 60% of respondents in each group had heard of Medications for Opioid Use Disorder (MOUD) (p = 0.46) and fewer than 50% thought that among people who use drugs that they knew would be interested in receiving treatment (p = 0.10).

Discussion and conclusions: Our study found that among people who came to an urban emergency department, there was a lack of awareness of harm reduction and MOUD. Interventions should be put into place to educate on the importance of MOUD and harm reduction.

Background: Ramadan fasting, an obligatory duty for adult Muslims, entails refraining from eating, drinking, smoking, and vaping from dawn until sunset. Throughout Ramadan, people accept major changes to daily routines. Consequently, Ramadan is associated with abstinence symptoms and changes in smoking or vaping behavior.

Aim: The study aims to assess the presence of withdrawal symptoms and its severity, as well as smoking or vaping behavior change and its determinants during Ramadan fasting.

Methods: A cross-sectional study was conducted during Ramadan in 2023. Data were collected online using a Google form, including questionnaires assessing socio-demographic data, nicotine dependence using Fagerstrom Test for Nicotine Dependence, vaping and shisha smoking, presence and severity of physiological and psychological withdrawal symptoms and its coping strategies. Smoking and vaping behavioral change during Ramadan and its contributing factors were also evaluated.

Results: A total of 251 participants (96% males), mean age ± standard deviation (33 ± 12.1) were surveyed. Withdrawal symptoms were reported among 70.5%, however, their severity was generally low both physiologically and psychologically. Education, nationality, smoking duration, nicotine dependence, and the amount of consumed E-liquid per day were the independent predictors of withdrawal symptoms presence. Attempts to quit smoking and vaping were reported by 54.6% of the participants; young age and higher educational levels were the factors associated with more quitting attempts.

Conclusions: The withdrawal symptoms severity linked to Ramadan fasting is minimal. Many smokers and vapers made attempts to quit during Ramadan. Ramadan presents a chance for smoking and vaping cessation with some behavioral support.

Background: Perinatal women treated for substance use disorder (SUD) face considerable barriers to recovery that might be ameliorated through activation of community support.

Objectives: This descriptive study evaluated the presence of drug-free family and friends in the social networks of perinatal women treated for SUD. It also assessed the interest of these women to partner with network members to mobilize support across several recovery needs.

Methods: Social network interviews were conducted with 40 pre- and post-partum women treated at the Center for Addiction and Pregnancy (CAP) in Baltimore, Maryland. These interviews also prompted participants to consider which network members to invite to the program to support recovery efforts.

Results: Study participants reported that their personal social networks included 4.4 drug-free adults. An overwhelming majority (80%) of participants reported a willingness to invite at least one person to the CAP program. Participants also endorsed several opportunities for collaboration between the program and community support.

Conclusions: These findings suggest that treatment program guided activation of network support offers a testable strategy to help perinatal women reduce barriers to recovery and improve treatment outcomes.

Objectives: Recent research has focused on the effects of legalization on cannabis-related emergency department visits, but the considerable healthcare costs of cannabis-related hospitalizations merit attention. We will examine the association between recreational cannabis legalization and cannabis-related hospitalizations.

Methods: A cohort of 3,493,864 adults from Alberta was examined (October 2015-May 2021) over three periods: pre-legalization, post-legalization of flowers and herbs (phase one), and post-legalization of edibles, extracts, and topicals (phase two). Interrupted time series analyses were used to detect changes.

Results: The study found an increase in hospitalization rates among younger adults (18-24) before legalization, yet no increased risk was associated with cannabis legalization, for either younger (18-24) or older adults (25+).

Conclusions: Clinicians should be aware of the increased risk in younger groups and may benefit from early identification and intervention strategies, including screening and brief interventions in primary care settings.

Rationale: The opioid crisis in North America has recently seen a fourth wave, which is dominated by drug-related deaths due to the combined use of illicitly manufactured fentanyl [IMF] and stimulants such as cocaine and methamphetamine.

Objectives: A systematic review addressing the question why drug users combine opioids and stimulants and why the combination results in such a high overdose mortality: from specific and dangerous pharmacokinetic or pharmacodynamic interactions or from accidental poisoning?

Results: Motives for the combined use include a more intensive high or rush when used at the same time, and some users have the unfounded and dangerous belief that co-use of stimulants will counteract opioid-induced respiratory depression. Overdose deaths due to combined (intravenous) use of opioids and stimulants are not likely to be caused by specific pharmacokinetic or pharmacodynamic interactions between the two drugs and it is unlikely that the main cause of overdose deaths is due to accidental poisoning.

Conclusion: The unexpectedly high overdose rates in this population could not be attributed to accidental overdosing or pharmacokinetic/pharmacodynamic interactions. The most likely explanation for the high rate of drug-related deaths in opioid-cocaine co-users is careless overdosing with either cocaine, opioid(s) or both, probably facilitated by the high level of preexisting impulsivity in these co-users and a further acute increase in impulsivity following cocaine use. The primary corollary is that cocaine users should avoid IMF use in the same time window. In addition, IMF users should refrain from cocaine use to avoid impulsive IMF overdosing.

Background: This study pilot tested Moving On In My Recovery (MOIMR), a 12-session, acceptance-based, cognitive-behavioral, manual-guided group program for individuals in recovery from substance use. MOIMR aims to bridge the gap between formal treatment and sustained recovery. Method: Participants were 61 people in recovery from substance use and in the catchment area of the Betsi Cadwaladr Health Board, North Wales, United Kingdom. Using a variety of questionnaires, participants' psychological flexibility and wellbeing were assessed at baseline, post-treatment, and a three-month follow-up. Participants who dropped out were contacted at the follow-up and interviewed about their experience. Results: The study successfully recruited participants from real-world treatment services. During the study, significant improvements were observed in participants' social functioning, experiential avoidance, recovery capital, low mood, and anxiety. The proportion of participants who achieved abstinence also improved. Qualitative feedback confirmed the benefits that participants derived from attending the MOIMR groups. Conclusion: The program offered significant benefits for the participants despite many of them having apprehensions about undertaking a group-based approach. The gains established by quantitative analysis appeared to be supported by the qualitative findings. These findings suggest that a full randomized controlled trial of MOIMR would be feasible.

Background: Long-term complications of alcohol use disorder (AUD) include severe neurological diseases like Wernicke-Korsakoff syndrome and alcohol-related dementia. Furthermore, acute alcohol intoxication and acute withdrawal syndrome can mimic neurological symptoms. Clinicians may overlook underlying comorbidities by focusing excessively on AUD in these patients. We report two cases wherein AUD was a significant confounding factor in the diagnosis of underlying neurological conditions.

Case presentations: A 46-year-old male with AUD developed delirium tremens due to severe AAI. Despite initiating treatment for acute withdrawal syndrome which resolved delirium tremens, space-time disorientation persisted for a week. A brain MRI showed signal abnormalities in the centra semiovalia. A rachicentesis and repeat brain and spine MRI later revealed oligoclonal bands in cerebrospinal fluid and bone marrow signal abnormalities, indicating multiple sclerosis. A 61-year-old female with AUD presented with disorientation and memory deficits following a car accident. One month after discharge, the patient developed left hemidysesthesia, walking instability, strength deficits and hallucinations. Biohumoral tests confirmed that she was still in recovery. An electroencephalogram and brain CT scan and MRI raised the suspicion of Creutzfeldt-Jakob disease; elevated tau protein levels confirmed the diagnosis. The patient's condition deteriorated rapidly, leading to death.

Conclusions: Persistent neurological symptoms in AUD patients even after receiving treatment for acute alcohol intoxication or withdrawal syndrome, may indicate the presence of underlying neurodegenerative conditions such as multiple sclerosis and Creutzfeldt-Jakob disease.

TikTok's rapid rise has spurred concerns about its potential to cause problematic use behaviors, which some consider akin to addiction. This systematic review seeks to understand the diagnostic and therapeutic implications of TikTok use within the scope of clinical psychology. From September 15, 2023 to March 30, 2024 a systematic review was conducted to investigate whether this new pathological condition can be recognized as a behavioral addiction. We searched the following databases for relevant studies: PubMed, National Center for Biotechnology Information (NCBI), PsycINFO, MDPI, Frontiers in Psychology, ScienceDirect, and ReserchGate. We identified a total of 294 unique articles. 45 full-text articles were assessed for eligibility and only 21 of these met the eligibility criteria and were included in the final systematic review. We identified factors like salience, craving, and abstinence related to problematic TikTok use, confirming its potential risk as a behavioral addiction. Currently, there are neither established guidelines, nor an acceptable number of clinical cases, to determine the inclusion of TikTok addiction within an official classification. Additional considerations include the assessed target population, geographical differences, and the lack of specific treatments or interventions. Our study confirms that problematic TikTok use must be considered an addiction both for the considerable risk it entails and for its developmental trajectory. Through the analysis of the included studies, we confirmed elevated levels of salience, abstinence, tolerance, craving, excessive use, desire to control consumption, and alterations in daily life habits associated with problematic TikTok use.