The opioid crisis remains a major public health concern, causing significant morbidity and mortality worldwide. Pain is frequently observed among individuals with opioid use disorder (OUD), and the current opioid agonist therapies (OAT) have limited efficacy in addressing the pain needs of this population. We reviewed the most promising non-opioid analgesic therapies for opioid-dependent individuals synthesising data from randomised controlled trials in the Medline database from December 2022 to March 2023. Ketamine, gabapentin, serotoninergic antidepressants, and GABAergic drugs were found to be the most extensively studied non-opioid analgesics with positive results. Additionally, we explored the potential of cannabinoids, glial activation inhibitors, psychedelics, cholecystokinin antagonists, alpha-2 adrenergic agonists, and cholinergic drugs. Methodological improvements are required to advance the development of novel analgesic strategies and establish their safety profile for opioid-dependent populations. We highlight the need for greater integration of experimental pain methods and abuse liability assessments, more granular assessments of prior opioid exposure, greater uniformity of pain types within study samples, and a particular focus on individuals with OUD receiving OAT. Finally, future research should investigate pharmacokinetic interactions between OAT and various non-opioid analgesics and perform reverse translation basic experiments, particularly with methadone and buprenorphine, which remain the standard OUD treatment.
Background: Through new publications on the subject, the main goal of this article is to seek a change in the pattern of alcohol use before and after bariatric surgery.
Methods: We searched the National Library of Medicine, CINAHL, and PsycINFO databases. We included original articles regarding alcohol consumption before and after bariatric surgery to conduct the systematic review.
Results: Our systematic review, which included 18 articles, yielded mixed results. Meta-analysis of six articles did not reveal statistically significant differences in alcohol use behaviours before and one year after bariatric surgery. However, throughout the perspective of follow-up after bariatric surgery, nine out of the twelve articles showed improvement in the pattern of alcohol consumption when evaluated up to two years after the end of the surgical period, and four out of the five articles with monitoring beyond two years showed worsening in consumption, compared to pre-surgery alcohol use behaviours.
Conclusions: Conclusions about the relationship between alcohol consumption and bariatric surgery are challenging primarily because of the variety of the methods used and the alcohol consumption measures. Despite that, our research pointed to an increased risk of alcohol use disorders two years after bariatric surgery.
Online racism is a digital social determinant to health inequity and an acute and widespread public health problem. To explore the heterogeneity of online racism exposure within and across race, we latent class modelled this construct among Asian (n = 310), Black (n = 306), and Latinx (n = 163) emerging adults in the United States and analysed key demographic and psychosocial health correlates. We observed Low and Mediated Exposure classes across all racial groups, whereas High Exposure classes appeared among Asian and Black people and the Systemic Exposure classes emerged uniquely in Asian and Latinx people. Generally, the High Exposure classes reported the greatest psychological distress and unjust views of society compared to all other classes. The Mediated and Systemic Exposure classes reported greater mental health costs than the Low Exposure classes. Asian women were more likely to be in the Mediated Exposure class compared to the Low Exposure class, whereas Black women were more likely to be in the Mediated Exposure class compared to both High and Low Exposure classes. About a third of each racial group belonged to the Low Exposure classes. Our findings highlight the multidimensionality of online racism exposure and identify hidden yet divergently risky subgroups. Research implications include examination of class membership chronicity and change over time, online exposure to intersecting oppressions, and additional antecedents and health consequences of diverse forms of online racism exposure.
Asylum seekers and refugees (ASR) experience many short-term and long-term post-migration stressors, e.g. discrimination after resettlement, leading to increased psychiatric morbidity in this population. Using data from the state-funded stepped-care project refuKey based in Lower Saxony, Germany, that aims to provide better mental health care access for ASR, we investigated the relationship between post-migration stressors and mental health in treatment-seeking ASR. In our naturalistic multi-centric study we assessed mental health (e.g. symptoms of depression, anxiety, traumatization, etc.), post-migration living difficulties, and perceived discrimination in ASR before and after treatment using questionnaires in eight languages consisting of internationally validated scales. Participants displayed poor mental health before, and significantly improved mental health parameters after treatment (p < 0.001). Post-migration living difficulties and perceived discrimination significantly predicted all mental health outcomes before treatment (p < 0.001) but not the treatment effects. However, perceived discrimination only contributed significantly to the prediction of quality-of-life and traumatization. Our findings suggest that refuKey-treatment helps despite the presence of post-migration living difficulties. Asylum policies should aim at reducing and overcoming post-migration living difficulties due to the strong association to mental health levels in treatment-seeking ASR.