Current Addiction Reports最新文献

Purpose of review: To examine cannabis-induced effects on driving performance. Prior systematic reviews consistently reveal that Δ⁹-tetrahydrocannabinol (THC) impairs driving performance. The present narrative review summarized evidence on the acute and residual effects of cannabis on driving performance from controlled experimental research completed in the past five years. Expanding on prior research, recent studies examine individual and combined effects of THC and cannabidiol (CBD), combined effects of cannabis and alcohol, and a variety of cannabis administration modes.

Recent findings: Cannabis with THC acutely impairs driving without significant residual deficits. CBD does not acutely impair driving performance, although relatively low doses (< 300 mg) were used in most studies. The combination of alcohol and THC results in additive effects that amplifies impairment. In line with prior research findings, cannabis-induced driving impairment is consistently observed within the first hour after use and impairment remains detectable for ~ 4-5 h post-inhalation; studies testing oral and sublingual cannabis administrations were sparse. Participants were willing and ready to drive shortly after using cannabis while their driving skills were objectively impaired.

Summary: Despite clear evidence of cannabis-induced driving impairment, a consistent impairment standard that can be used outside the laboratory is lacking. More research focused on sensitive biomarkers combined with technologically-advanced behavioral methods is needed to improve the precision and accuracy in determining cannabis-induced driving impairment. Future studies should focus on novel oral and oromucosal formulations emerging on the legal cannabis market.

Purpose of review: This paper proposes a stress-response framework for understanding substance use in the context of adversity, integrating fight (resistance), flight (adaptive coping), freeze (maladaptive coping), and fawn (strategic assimilation/appeasement) responses, with resilience as a moderating factor.

Recent findings: Evidence indicates that adaptive resistance and coping can protect against substance use, while maladaptive resistance, maladaptive coping, and fawning may increase long-term risk despite short-term relief. Resilience, both individual and collective, can buffer adversity's effects and enhance positive stress responses, though measurement and conceptual inconsistencies limit cross-study synthesis.

Summary: Advancing research on adversity and substance use requires the use of validated measures, the simultaneous assessment of multiple stress responses to capture their interactions, and greater theorization of resistance and fawning/strategic assimilation, which remain underdeveloped and understudied in substance use research.

Purpose of review: Personality disorders (PDs) and substance use disorders (SUDs) co-occur at high rates. Transdiagnostic mechanisms such as affective processes could improve our understanding of etiology, maintenance, and treatment of co-occurring disorders. We review the role that affective factors play in the overlap between PDs and SUDs and focus on current directions in assessment and evaluation of affective processes.

Recent findings: Recent affect-related work informing PD and SUD co-occurrence has focused on conceptualizing PDs dimensionally, testing affective processes as transdiagnostic constructs, issues in affect measurement, using ecological momentary assessment to identify proximal risk pathways, and debate on the role of affect in SUD.

Summary: Affective changes can be reliably measured in daily life, and evidence supports using dimensional models of PDs compared to categorical diagnoses. Future work should build on these strengths and focus on careful translations of SUD theories to research.

Purpose of review: 'Habit theory' is a pervasive framework that describes addiction as a transition from goal-directed use (e.g. of drugs) to habitual response, accompanied by a neurobiological shift in fronto-striatal brain circuitry. As a theory that has been explored in the context of substance addictions, this article evaluates the conceptual fit of habit theory to gambling behavior and gambling disorder, and summarizes recent empirical evidence.

Recent findings: Relevant research falls into two main themes. First, studies have compared behavioral markers of habit (e.g. the two-step task, Pavlovian-to-Instrumental Transfer effects) in groups with and without gambling problems. These studies find limited direct support for the hypothesis. Second, psychological research has begun to examine habit-like behaviors in naturalistic gambling. These studies find behavioral expressions consistent with habit formation, primarily during engagement with slot machines, but are yet to test key tenets of habit theory such as insensitivity to outcome devaluation.

Summary: Modern gambling products (e.g. slot machines, in-play sports betting) create rich learning environments that may be highly amenable to habit formation. Further research is needed to develop and validate new tools for testing habit formation and habit strength / persistence in the context of gambling.

Purpose of review: This paper aimed to estimate pooled bi-directional associations between multidimensional sleep health and substance use among youth and investigate whether these associations differed as a function of race/ethnicity.

Recent findings: Empirical observational studies providing quantitative data on the association of sleep health (duration [sleep obtained per 24 hours], satisfaction [subjective assessment of sleep], alertness [ability to maintain attentive wakefulness], and timing [placement of sleep]) and substance use (i.e., alcohol and cannabis), and racial/ethnic demographic information among U.S. youth (10-25) were identified through a systematic literature search. Random effects meta-analyses were conducted using 95 effect sizes extracted from 38 studies.

Summary: We found evidence for a bi-directional relationship between total sleep duration and substance use. Sleep satisfaction predicted substance use, but findings were inconclusive whether substance use predicted sleep satisfaction. Sleep alertness predicted alcohol (but not cannabis) use, whereas sleep timing predicted cannabis (but not alcohol) use. Nuanced racial/ethnic differences were also found in these sleep-substance use relationships, which differed across sleep domains and types of substance.

Purpose of review: As the overdose crisis evolves, it is important to monitor fentanyl consumption patterns. This review provides an overview of recent findings regarding illegally manufactured fentanyl (IMF) availability, use, and associated harms in the US.

Recent findings: Availability of IMF has increased, especially in pill form, and the increasing adulteration of IMF with veterinary tranquilizers such as xylazine complicates overdose response. Prevalence in the general population based on self-reported IMF use is rare, and likely underestimated. Transitions from injection to smoking have been documented in recent years, particularly in the western US. Fentanyl-stimulant polysubstance use has also been observed increasingly among IMF-related overdose deaths.

Summary: Shifts in routes of administration, availability of counterfeit pills containing fentanyl, and common adulterants add complexity to the landscape of IMF use and related harms. Additional data is needed for monitoring changes in consumption patterns to inform prevention and harm reduction efforts.

Purpose of review: Both substance use disorders (SUD) and chronic pain are highly prevalent, require new effective interventions, and share similar underlying neurocircuitry. A promising intervention for both is repetitive transcranial magnetic stimulation (rTMS) which is a tool to modulate brain circuits. In this narrative review, we surveyed the current state of rTMS used to address SUDs and chronic pain by focusing on 132 reports published since 2010.

Recent findings: The field agrees that rTMS application in these clinical samples is safe and potentially effective, even in co-occurring disease or with recent substance use. Overall, the pain field has come to a stronger consensus about how best to apply rTMS to reduce diverse chronic pain conditions compared to the SUD field. We argue for standardization of methods within fields to rapidly address each clinical group. Such a standardization will require a concerted effort to test applications head-to-head to evaluate relative efficacy across applications. A coordinated effort in this regard is needed between research groups and funding agencies to accomplish this goal.

Summary: One of the most effective steps the field can take toward this goal is to measure the neuromechanisms that underlie SUD and pain before and after an rTMS intervention. Only 18% of reviewed reports included any brain measurement such as functional magnetic resonance imaging, electroencephalography, and event-related potentials. We argue that such measurements are essential for optimizing rTMS as an intervention for clinical populations. If rTMS is ostensibly applied to modulate neurocircuits, measurement of those circuits to verify, iterate, and optimize application is fundamental for developing effective treatments.

Purpose of review: This review examines self-efficacy and traces the construct from theory and operationalization to clinical practice and intervention design in addiction science.

Recent findings: Self-efficacy is a construct with a strong theoretical and methodological foundation. While evidence for self-efficacy as a statistical mediator in the context of clinical trials of addictions treatments is mixed, it is most conclusive in within-condition, non-experimental designs. Consistency in empirical support across research methods, populations, and outcomes strengthens support for self-efficacy as a mechanism of alcohol or other substance consumption outcomes.

Summary: The current review provides evidence for self-efficacy as a mechanism worthy of direct attention in clinical care for alcohol or other substance use disorders. It is likely a common mechanism of human behavior change that can be harnessed in a range of treatment modalities and client-identified goals. Future work should target self-efficacy directly in intervention development, implementation, and dissemination.

Purpose of review: Behavioural addictions involve loss of control over initially rewarding behaviours, which continue despite adverse consequences. Theoretical models suggest that these patterns of behaviour evolve over time, with compulsive and habitual behaviours held to reflect a loss of behavioural control. Compulsivity can be broadly described as a propensity for (or engagement in) repetitive behaviours that are not aligned with overall goals. Here, we consider whether compulsivity is associated with behavioural addictions at different stages of their development, based on self-report and neurocognitive measures.

Recent findings: This review found that there is initial evidence that compulsive traits might predispose individuals to engage in problematic behaviours, and that self-report and neurocognitive measures of compulsivity are associated with severity of problematic behaviours even in the early stages of behavioural addictions. In the later stages of behavioural addiction, there is strong evidence for an association of gambling disorder with cognitive inflexibility, but less evidence for an association between compulsivity and other types of behavioural addiction.

Summary: Moving forwards, well-powered longitudinal studies, including studies using ecological momentary assessment (EMA), will be important in robustly developing our understanding of how compulsivity is related to behavioural addictions over their timecourse.

Purpose of review: In the U.S., cannabis products containing at least 0.3% tetrahydrocannabinol (THC), are legal for adult use in 22 states (including the District of Columbia) and in 16 additional states for medicinal use. There is a growing body of literature to understand how these products are marketed. The objective of this narrative review is to summarize recent research examining cannabis advertising. We characterized the research reviewed across three primary domains: (1) content of cannabis advertising; (2) prevalence of cannabis advertising exposure; and (3) effects of cannabis advertising on user perceptions.

Recent findings: Research indicates that cannabis is marketed in a variety of ways, including via tactics (e.g., price promotions) found to be effective in increasing use of other commercial products (e.g., tobacco). Moreover, cannabis marketing tactics may be appealing to youth or mislead consumers via unsubstantiated health claims. Exposure to cannabis advertising is common among both youth and adults, occurring through a variety of pathways including storefront signage, social media and billboards. Finally, several studies have found associations between exposure to cannabis marketing and cannabis use; however, studies designed to estimate causal effects of exposure were limited, warranting additional research in this area.

Summary: Understanding the prevalence and effects of exposure to cannabis advertising, along with the content of this advertising, can inform the operationalization and implementation of regulations and interventions designed to mitigate harms associated with advertising exposure.