Current Addiction Reports最新文献

Purpose of review: We present current evidence on the associations among sleep, pain, and medications for opioid use disorder (MOUD) among individuals with opioid use disorder (OUD).

Recent findings: We searched MEDLINE, Embase, PsycInfo, Web of Science, and Cochrane Library from inception until September 2023 for original research studies examining sleep, pain, and MOUD. We identified 19 manuscripts (14 were cross-sectional studies, four were prospective cohort studies, and one was a randomized controlled trial). Measures of sleep and pain varied. Sleep disturbance and pain were highly prevalent and associated. However, the associations between MOUD treatment characteristics (e.g., initiation, type, dose, and prior MOUD) and a) sleep and b) pain were mixed or unclear. Limited sample sizes and covariates such as opioid use disorder severity sometimes complicated the examination or interpretation of these associations. Few studies examined possible mediators underlying these associations.

Summary: While sleep and pain were consistently associated, it is unclear whether sleep and pain are associated with MOUD treatment characteristics or other covariates such as opioid use disorder severity. Future research on the associations among sleep, pain, and MOUD among individuals with OUD should consider a) comparing different MOUD treatments including formulations and dose schedules, b) qualitative and mixed methods studies to assess patient and provider preferences for the treatment of sleep and pain in OUD treatment settings, c) longitudinal studies that employ reliable and valid measures with sufficiently powered sample sizes to examine mediation and moderation, and d) testing whether interventions addressing pain or sleep among patients receiving MOUD improve pain, sleep, and MOUD outcomes.

Purpose of review: The purpose of this review is to investigate the use of digital health technologies and/or digital therapeutics (DTx) products in the treatment of substance use disorders (SUDs) in the general population and among criminal justice-involved individuals.

Recent findings: Despite an expanding evidence base, only three SUD DTxs have received federal regulatory approval. Across studies, DTx products have proven successful in engaging patients in SUD treatment and reducing healthcare costs and resource utilizations. Findings for emerging SUD DTx products show similar results. Still, there is a paucity of evidence regarding the use of digital health technologies and/or DTx among criminal justice populations.

Summary: DTxs have proven effective for treating multiple SUD types (e.g., nicotine and opioids) among the general population. DTx shows similar promise among justice-involved populations, but additional efficacy and implementation research is needed to address barriers such as cost, cultural resistance, and infrastructure.

Purpose of review: The incorporation of digital technologies and their use in youth's everyday lives has been increasing rapidly over the past several decades with possible impacts on youth development and mental health. This narrative review aimed to consider how the use of digital technologies may be influencing brain development underlying adaptive and maladaptive screen-related behaviors.

Recent findings: To explore and provide direction for further scientific inquiry, an international group of experts considered what is known, important gaps in knowledge, and how a research agenda might be pursued regarding relationships between screen media activity and neurodevelopment from infancy through childhood and adolescence. While an understanding of brain-behavior relationships involving screen media activity has been emerging, significant gaps exist that have important implications for the health of developing youth.

Summary: Specific considerations regarding brain-behavior relationships involving screen media activity exist for infancy, toddlerhood, and early childhood; middle childhood; and adolescence. Transdiagnostic frameworks may provide a foundation for guiding future research efforts. Translating knowledge gained into better interventions and policy to promote healthy development is important in a rapidly changing digital technology environment.

Purpose of review: The brain's salience network (SN), primarily comprising the anterior insula and anterior cingulate cortex, plays a key role in detecting salient stimuli and processing physical and socioemotional pain (e.g., social rejection). Mounting evidence underscores an altered SN in the etiology and maintenance of substance use disorders (SUDs). This paper aims to synthesize recent functional neuroimaging research emphasizing the SN's involvement in SUDs and physical/socioemotional pain and explore the therapeutic prospects of targeting the SN for SUD treatment.

Recent findings: The SN is repeatedly activated during the experience of both physical and socioemotional pain. Altered activation within the SN is associated with both SUDs and chronic pain conditions, characterized by aberrant activity and connectivity patterns as well as structural changes. Among individuals with SUDs, functional and structural alterations in the SN have been linked to abnormal salience attribution (e.g., heightened responsiveness to drug-related cues), impaired cognitive control (e.g., impulsivity), and compromised decision-making processes. The high prevalence of physical and socioemotional pain in the SUD population may further exacerbate SN alterations, thus contributing to hindered recovery progress and treatment failure. Interventions targeting the restoration of SN functioning, such as real-time functional MRI feedback, neuromodulation, and psychotherapeutic approaches, hold promise as innovative SUD treatments.

Summary: The review highlights the significance of alterations in the structure and function of the SN as potential mechanisms underlying the co-occurrence of SUDs and physical/socioemotional pain. Future work that integrates neuroimaging with other research methodologies will provide novel insights into the mechanistic role of the SN in SUDs and inform the development of next-generation treatment modalities.

Purpose of review: The purpose of the review was to examine findings on sleep characteristics among children with a parental history of alcohol use disorder (CPHAUDs) in different age groups. We identified unanswered questions and discussed directions for future research. We also discussed the implications of these current findings on alcohol prevention and intervention programs.

Recent findings: Parental ratings and youth report of sleep difficulties have been longitudinally associated with the emergence of alcohol use and alcohol-related problems among both CPHAUDsand non-CPHAUDs. There were inconsistent findings comparing sleep characteristics in these two groups. Studies that used self-report and parental ratings reported no or minimal differences while studies that used actigraphy and polysomnography found significant, albeit moderate but meaningful differences.

Summary: Current research shows that CPHAUDs and non-CPHAUDs are similar on most objective and subjective sleep measures. There are a few significant differences between the two groups that may have implications for the development of behavioral problems, substance use and other risk behaviors.