American Journal on Addictions最新文献

Background and objectives: Problematic video game use is a source of concern. In addictions, difficulties with emotional regulation have become an important variable of interest. However, their study in relation to problematic video game use remains insufficient.

Methods: A systematic review was conducted following PRISMA 2020 guidelines; 322 studies were screened, resulting in a final sample of k = 18 studies. The methodological quality of these studies was rated as moderate according to the McMaster Critical Review Form for Quantitative studies (CRF-Q).

Results: There is evidence of relationship between different facets of emotional regulation and the presence of problematic video game use. Particularly, video games serve as escape strategy for suppressing emotional expression. There is no consensus regarding the nature of the relationship between emotional regulation, psychopathology, and problematic video game use, with various proposals suggesting moderation and mediation. There is also no consensus regarding the mediation of gender in the relationship between emotional dysregulation and problematic video game use. The level of certainty regarding the validity of the results was moderate.

Discussion and conclusions: Emotional dysregulation plays a role in problematic video game use, especially through strategies as emotional suppression, and lack of abilities to understand and control emotions. It is important to consider emotional regulation as a potential target for research and intervention in clinical populations.

Scientific significance: We review the largest sample of papers on problem gaming and emotion regulation to date. Our results highlight the importance of emotion regulation and, specially, emotional suppression, or negative escapism, on problematic video game use.

Background and objectives: Although concurrent stimulant use is common among people with opioid use disorder (OUD), there is little evidence on its impacts on opioid agonist therapy (OAT) outcomes. This study sought to determine the impact of baseline methamphetamine/amphetamine use on discontinuation of OAT among individuals with prescription-type OUD (POUD) initiating methadone or buprenorphine/naloxone as part of a pragmatic randomized trial in Canada.

Methods: Secondary analysis of a pan-Canadian pragmatic trial conducted between 2017 and 2020 comparing supervised methadone versus flexible take-home dosing buprenorphine/naloxone models of care. Cox proportional hazard models were used to evaluate the effect of baseline methamphetamine/amphetamine use (measured by urine drug test [UDT]) on two discontinuation outcomes (i.e., assigned OAT discontinuation, any OAT discontinuation).

Results: Two hundred nine (n = 209) participants initiated OAT, of which 96 (45.9%) had positive baseline methamphetamine/amphetamine UDT. Baseline methamphetamine/amphetamine use was associated with shorter median times in assigned OAT (21 vs. 168 days, hazard ratio [aHR] = 2.45, 95% confidence interval [CI] = 1.60-3.76) and any OAT (25 days vs. 168 days, aHR = 2.06, CI = 1.32-3.24). No interaction between methamphetamine/amphetamine and assigned OAT was observed for either outcome (p > .05).

Conclusion and scientific significance: This study offers novel insights on the impact of methamphetamine/amphetamine use on OAT outcomes among people with POUD. Methamphetamine/amphetamine use was common and was associated with increased risk of OAT discontinuation. Supplementary interventions, including treatment for stimulant use, are needed to improve retention in OAT and optimize treatment outcomes in this population.

Background and objectives: Risky substance use (RSU) is common among people with chronic pain and is associated with worse pain treatment outcomes. Nonopioid treatment is recommended, but it is unknown whether people with RSU use different or fewer pain treatment modalities. This study describes use of different pain treatments by veterans with and without RSU and those receiving versus not receiving opioid medication.

Methods: Veterans (N = 924) who filed service-connected disability claims related to musculoskeletal conditions and rated their pain four or higher on the Numeric Rating Scale, reported on 25 different pain services in the preceding 90 days. Recent RSU was identified via Alcohol, Smoking, and Substance Involvement Test (ASSIST) cutoffs and/or nail sample toxicology.

Results: Overall, RSU was not associated with number of provider-delivered or self-delivered pain modalities. Over-the-counter medications (71%), self-structured exercise (69%), and nonopioid prescription medications (38%) were the most used modalities. Veterans receiving prescribed opioids (8.4%) were more likely to see primary care, receive injections, and attend exercise and/or meditation classes, compared to those without opioid prescriptions.

Discussion and conclusions: Opioid and nonopioid pain treatment utilization did not differ based on RSU, and those prescribed opioids were more likely to engage in other nonopioid pain treatments. Regardless of RSU, veterans appear willing to try provider-delivered (58%) and self-delivered (79%) pain treatment.

Scientific significance: In this first-ever evaluation of 25 different pain treatment modalities among veterans with and without RSU, people with RSU did not use less treatment modalities.

Background and objectives: Legalization of medical marijuana has increased unintentional exposure to marijuana in young children. We aim to explore the sociodemographic disadvantage profile, prevalence, and clinical presentation of children diagnosed with unintentional exposure to marijuana.

Methods: We conducted a retrospective chart abstraction of 121 children (aged 0-6) seen at the Emergency Department (ED) at a single tertiary hospital center in Dayton, Ohio between January 01, 2010 and January 09, 2022.

Results: Majority were female (62.8%), white (50.4%), and with Medicaid as their primary insurance (84.3%). The median age at exposure was 1.8 years. There was a 14-fold increase in unintentional marijuana cases pre-2017 (7 cases) versus post-2017 (114 cases), the year of legalization of medical marijuana in the state of Ohio. Majority of the patients were using public assistance (66.4%). 26.7% of the cases had a prior social work consultation and 38.1% had a prior children services consultation. 51.3% of the children had a social disadvantage index score of 3 or greater (range 0-5) with higher scores indicating greater disadvantage.

Discussion and conclusions: The number of patients presenting to the ED at the hospital has increased 14-fold since the legalization of medical marijuana in Ohio. Half of the children displayed a higher sociodemographic disadvantage index score.

Scientific significance: Our study is the first study investigating the sociodemographic profile of children exposed to marijuana. The findings of this study may be utilized to inform policy for safely dispensing recreational and medicinal marijuana products and focus the efforts on families with sociodemographic disadvantage.

Background and objectives: Experiencing sexism is related to more alcohol-related problems, presumably via drinking to cope with negative affect associated with experiencing sexism. Yet no known studies have directly tested whether the relation of sexism to alcohol problems occurs via relevant negative emotions and drinking to cope with negative emotions. Given that sexism is a type of negative evaluation, social anxiety may be one type of negative affect that plays a role in sexism's relation with drinking behaviors.

Method: This study tested whether sexism was related to alcohol-related problems via the serial effects of social anxiety and coping-motivated alcohol use among 836 cis-female undergraduates who endorsed past-month alcohol use.

Results: Past-year experiences with sexism were positively correlated with coping and conformity-motivated alcohol use, alcohol problems (but not peak estimated blood alcohol content, eBAC), social anxiety, and depression. After statistically controlling for depression and peak eBAC, sexism was indirectly related to alcohol problems via the serial effects of social anxiety and drinking motives (coping, conformity).

Discussion and conclusions: Results highlight the important role of social anxiety and drinking to cope with negative emotions and to fit in with peers who drink in relation of sexism with alcohol-related problems.

Scientific significance: This is the first known study to find that experiences of sexism are related to alcohol problems via the serial effects of social anxiety and coping and conformity-motivated drinking. This is also the first known study to find that sexism is related to more conformity-motivated drinking.

Background and objectives: Although some studies have related social media use and depressive symptoms, little is known about the role of psychoactive substance use in this relationship. Therefore, this study aimed to estimate the association between time spent on social media (TSSM) and depressive symptoms and to examine whether this relationship is mediated by psychoactive substances in students.

Methods: Our cross-sectional analysis included a sample of students from a university in a large city in southern Brazil. The TSSM and tobacco frequency of consumption were self-reported. Depressive symptoms were assessed with the Patient Health Questionnaire. Alcohol and illicit drug-related risks were assessed with the Alcohol, Smoking and Substance Involvement Screening Test. Hayes's PROCESS macro was used for mediation analyses, adjusted for age, sex, body mass index and physical activity.

Results: A total of 3161 students were included, of which, 69.0% reported moderate to severe depressive symptoms. The association between TSSM and depressive symptoms was statistically significant and partially mediated by tobacco consumption (indirect effect [IE] = 0.05; 95% CI: 0.02-0.08), alcohol-related risk (IE = 0.19; 95% CI: 0.14-0.25), and illicit drug-related risk (IE = 0.08; 95% CI: 0.05-0.12).

Conclusion and scientific significance: Our data suggest a direct relationship between TSSM and depressive symptoms, with a partial mediation effect of psychoactive substance use. This study highlights the importance that public health initiatives aimed at preventing depressive problems in young adults should focus not only on TSSM, but also on controlling and reducing psychoactive substance use.