Current Addiction Reports最新文献

Purpose of review: Glucagon-like peptide-1 receptor agonists (GLP-1RAs) have emerged as a potential therapeutic class for substance use disorders (SUD). This narrative review focuses primarily on clinical and epidemiological studies to synthesize existing evidence on GLP-1RAs in the context of SUD. The overall objective is to clarify current understanding, summarize ongoing and forthcoming trials, and provide directions for future clinical research on the potential utility of GLP-1RAs in treating SUD.

Recent findings: Among addictive substances, alcohol has received the most attention in GLP-1RA research. Nicotine, opioids, and psychostimulants have also been investigated. Large-scale retrospective cohort studies provide evidence supporting improvements in substance use-related outcomes with GLP-1RA treatment. Evidence from randomized controlled trials (RCTs) of GLP-1RAs for SUD is beginning to accumulate, with some variability in findings, potentially due to heterogeneity in GLP-1RAs and study populations. Additional data from RCTs will be essential to determine the efficacy, safety, and tolerability of GLP-1RAs for treating SUD.

Summary: Converging evidence suggests that GLP-1RAs hold promise for addiction treatment, highlighting the need for RCTs to establish whether GLP-1RAs can expand the range of treatment options for SUD.

Purpose of review: In this article, we systematically review the research on peer recovery support services (PRSS) for substance use disorder (SUD).

Recent findings: We update our 2019 review on PRSS for SUD, with a focus on quantitative, multi-group studies (K = 28; N = 12,601). We searched four databases (December 2024), identifying 17 new studies reviewed here in addition to 11 studies included in our previous review. Though challenges with synthesis of this diverse literature remain, evidence has coalesced to indicate the capacity of PRSS to improve SUD treatment engagement and retention, with some preliminary but inconclusive evidence suggesting PRSS may also support better substance use outcomes.

Summary: PRSS can play an important role in the SUD care continuum, particularly in helping individuals initiate and stay engaged with treatment. More work is needed, however, to determine when, where, and over what duration PRSS are most impactful, as well as for whom, and under what conditions PRSS are most beneficial.

Purpose of review: Drug addiction is characterized by compulsive drug seeking and use, accompanied by negative emotional states (hyperkatifeia) and heightened pain sensitivity (hyperalgesia) during withdrawal. Both hyperalgesia and hyperkatifeia are integral components of substance use disorders, negatively impacting treatment and recovery. The underlying neurobiological mechanisms of hyperalgesia and hyperkatifeia involve alterations of brain reward and stress circuits, including the dynorphin/κ-opioid receptor (KOR) system. The dynorphin/KOR system modulates pain perception, negative affect, and addictive behaviors. Here, we review the preclinical evidence of dynorphin/KOR signaling in opioid withdrawal-induced hyperalgesia and hyperkatifeia.

Recent findings: In opioid dependence models, pharmacological and genetic interventions of the dynorphin/KOR system attenuate somatic and motivational signs of withdrawal and addictive-like behaviors, highlighting its therapeutic potential. Understanding the intricate interplay between dynorphin/KOR signaling, hyperalgesia, hyperkatifeia, and addiction offers novel insights into treatment strategies for opioid use disorder and other substance use disorders.

Summary: Further research is needed to elucidate precise mechanisms of the sexual dimorphism of dynorphin/KOR signaling and identify targeted interventions to mitigate hyperalgesia and hyperkatifeia and facilitate recovery from addiction.

Purpose of review: Nicotine addiction is the result of repeated tobacco use and subsequently promotes continued consumption, potentially acting as both cause and consequence of tobacco use. This scoping review aims to describe the literature and catalogue existing measures regarding perceptions of nicotine addiction with special attention to scales that recognize its multidimensionality.

Recent findings: Following a comprehensive review of 923 empirical articles, we found 252 articles that assessed perceptions of nicotine addiction, five of which utilized a validated measure. Single item assessments were categorized into affective concern, knowledge that tobacco is addictive, personal perceptions of addiction, other people's addiction, and comparative addictiveness. Scaled measures of perceptions of nicotine addiction largely assessed perceived susceptibility and severity.

Summary: Despite decades of research demonstrating the importance of perceptions of risk and expectancies in risk-behavior decision-making, tools and items assessing perceptions of nicotine addiction are highly varied and do not account for the multidimensionality of nicotine addiction. We, as a field, lack a comprehensive assessment of perceptions of nicotine addiction that integrates the complexity of addiction into an individual's appraisal of risk, which is a critical component of prevention and intervention-based research.

Supplementary information: The online version contains supplementary material available at 10.1007/s40429-025-00673-4.

Purpose of review: Evaluate literature examining whether mutual help groups (MHGs) for illicit drug use disorders benefit participants.

Recent findings: Recent studies consistently show that MHG attendance and involvement predict reductions in drug use and addiction severity. More rigorous methodologies offer stronger evidence of effectiveness, but additional controlled trials are needed. Drug-focused MHG challenges include lower success rates of professionally-delivered interventions to facilitate participation compared to alcohol-focused MHGs, and stigma towards opioid agonist medications. Culturally-tailored MHG formats may benefit specific populations (e.g., racial/ethnic minorities). Non-12 step MHGs like SMART Recovery show promise, but research is limited. Online delivery formats positively affect retention.

Summary: Evidence on the benefits of MHGs for drug use disorders is encouraging but incomplete. MHG engagement may be enhanced by cultural adaptations and reduced stigma towards medications. Future research should focus on non-12 step MHGs, treatment integration, optimizing online formats, and understudied groups (e.g. Indigenous populations). Selection bias remains a challenge in evaluations of MHG effectiveness.

Purpose of the review: Women experience worse alcohol-related health consequences compared to men, including greater risk and susceptibility to the neurotoxic effects of alcohol. There is a critical need to identify underlying neurobiological mechanisms underlying sex differences in alcohol use disorder (AUD) phenotypes to better inform individualized treatment options. This report aimed to systematically review existing original literature that examined sex differences in white matter tract integrity in individuals with heavy drinking/AUD using diffusion magnetic resonance imaging (dMRI) and provide recommendations for future research. A systematic review was conducted using Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines and PubMed and Google Scholar databases from inception until January 1, 2024.

Recent findings: Of 565 studies from the database search, 12 met study criteria. Nine (75%) showed evidence of sex-related differences in white matter tract integrity. Five studies showed greater vulnerability of white matter tract degradation in women with heavy drinking/AUD and four showed greater vulnerability in men with heavy drinking/AUD.

Summary: This is the first study to systematically assess the existing literature on sex differences in AUD-related white matter tract integrity. The findings from this systematic review were equivocal. Future research should address the mixed literature by systematically examining sex differences in white matter tract integrity in larger, well-characterized samples to account for confounding factors such as alcohol use history, age, other substance use, and psychiatric comorbidities.

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: There are disproportionately elevated rates of cannabis use and cannabis use disorder (CUD) among sexual and gender minoritized (SGM) individuals. Minority stressors (e.g., victimization, internalized stigma) are a robust predictor of SGM cannabis and related outcomes. The psychological mediation framework posits that changes in coping and emotion regulation, social/interpersonal, cognitive, and SGM group-specific functioning explain associations between minority stress and cannabis outcomes. This systematic review covers the extant literature evaluating the putative mechanisms that link minority stress to cannabis use and related outcomes.

Recent findings: Searches were conducted on MEDLINE, Embase, PsycInfo, CINAHL, and Web of Science through November 2023. We identified 12 articles. We sorted mechanisms using categories from the psychological mediation framework. Several studies evaluated coping and emotion regulation mechanisms, with strongest support for cannabis coping motives and preliminary support for depressive symptoms and emotion dysregulation. Few studies evaluated social/interpersonal and cognitive mechanisms, and none found support for these mechanisms. Lastly, there was preliminary support for internalized hetero/cissexism as a group-specific mechanism.

Summary: The findings of this review provide some support for the psychological mediation framework, highlight future directions for research testing this framework, and underscore some targets of intervention related to cannabis use and CUD among SGM individuals.

Purpose of review: The Hispanosphere is a vast region of the world that has received little attention in the digital health literature. No study to date has examined the availability and quality of publicly available mobile applications (apps) for cigarette smoking cessation in this region. Three coders utilized the American Psychiatry Association (APA)'s Brief App Evaluation Model Screener (Brief-AEM Screener) to evaluate the quality of the label and public-facing screens of smoking cessation apps in Spanish. Availability of apps in the Hispanosphere was compared to availability of apps in the Anglosphere.

Recent findings: We identified and reviewed 19 apps in Spanish in Google Play. The median score using the Brief-AEM Screener was 63 out of 100 suggesting generally acceptable app quality and features according to the quality standards for digital health tools proposed by the APA. However, we found (1) notable inaccurate and misleading labelling claims, (2) poor grammar or incomplete translations, and (3) a lack of cultural and linguistic adaptation to countries in the Hispanosphere. Our comparison of smoking cessation apps between the Hispanosphere and the Anglosphere suggested that there is a large digital equity gap between these two regions, with a four to sevenfold gap in app availability.

Summary: There is a relative shortage of quality and quantity of digital health apps for smoking cessation in the Hispanosphere. To ensure the cultural appropriateness of those digital interventions, it is essential that developers of digital health tools establish community partners in the region prior to developing apps for smoking cessation.

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.