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Addiction Psychiatry Advanced Psychotherapy Curriculum 成瘾精神病学高级心理治疗课程
IF 2.5 4区 医学 Q2 SUBSTANCE ABUSE Pub Date : 2025-04-28 DOI: 10.1111/ajad.70042

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引用次数: 0
2025 AAAP Annual Meeting Abstract Submissions Open! 2025年AAAP年会开放摘要投稿!
IF 2.5 4区 医学 Q2 SUBSTANCE ABUSE Pub Date : 2025-04-28 DOI: 10.1111/ajad.70043

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引用次数: 0
Pain intensity in patients using extended-release naltrexone or opioid agonists and its effect on extended-release naltrexone treatment outcomes 使用缓释纳曲酮或阿片类激动剂患者的疼痛强度及其对缓释纳曲酮治疗结果的影响。
IF 1.9 4区 医学 Q2 SUBSTANCE ABUSE Pub Date : 2025-04-28 DOI: 10.1111/ajad.70035
Farid Juya MD, Kristin K. Solli MSc, PhD, Line Holtan BSN, Ann-Christin Sannes MSc, PhD, Bente Weimand MSc, PhD, Anne G. Sagen MSc, Jūratė Š. Benth PhD, Johannes Gjerstad PhD, Lars Tanum MD, DMSci, Jon Mordal MD, PhD

Background and Objectives

Extended-release naltrexone (XR-NTX) is an opioid antagonist effective for treating opioid use disorder (OUD). However, concerns about inadequate pain management may limit its use. This study will examine changes in pain intensity in OUD patients choosing XR-NTX compared to opioid agonist treatment (OAT), identify subgroups with distinct pain intensity trajectories, and assess the effect of pain intensity on XR-NTX treatment outcomes (retention, relapse, opioid use, and cravings).

Methods

This 24-week study included OUD patients aged 18–65 years opting for XR-NTX (n = 160). Patients receiving OAT (n = 151) served as controls. Pain intensity was measured every 4 weeks for XR-NTX and at baseline and Week 24 for OAT using the numerical pain rating scale-11 (NPRS-11). Data were analyzed with linear mixed models and group-based trajectory modeling.

Results

Between baseline and Week 24, XR-NTX participants with low to moderate pain showed a significant reduction in pain intensity, while those with high pain did not. In the OAT group, no significant reduction in pain intensity was observed (from baseline to Week 24). Pain intensity was not associated with XR-NTX treatment outcomes.

Discussion and Conclusions

Contrary to perception, XR-NTX does not worsen pain intensity, nor did pain intensity affect XR-NTX treatment outcomes.

Scientific Significance

This study is the first to explore the association between changes in pain intensity and XR-NTX treatment outcomes in OUD patients over a 24-week period. The findings challenge the perception that XR-NTX is less suitable for treating OUD patients with pain.

背景和目的:缓释纳曲酮(XR-NTX)是一种治疗阿片类药物使用障碍(OUD)有效的阿片类拮抗剂。然而,对疼痛管理不足的担忧可能会限制其使用。本研究将检查选择XR-NTX的OUD患者与阿片类激动剂治疗(OAT)相比疼痛强度的变化,确定具有不同疼痛强度轨迹的亚组,并评估疼痛强度对XR-NTX治疗结果(保留,复发,阿片类药物使用和渴望)的影响。方法:这项为期24周的研究纳入了选择XR-NTX治疗的18-65岁OUD患者(n = 160)。接受OAT治疗的患者(n = 151)作为对照组。XR-NTX每4周测量一次疼痛强度,在基线和OAT第24周使用数值疼痛评定量表-11 (NPRS-11)。采用线性混合模型和基于组的轨迹模型对数据进行分析。结果:在基线和第24周之间,低至中度疼痛的XR-NTX参与者的疼痛强度显着降低,而高度疼痛的参与者则没有。在OAT组中,疼痛强度没有明显降低(从基线到第24周)。疼痛强度与XR-NTX治疗结果无关。讨论与结论:与认知相反,XR-NTX不会加重疼痛强度,疼痛强度也不会影响XR-NTX的治疗结果。科学意义:本研究首次探讨了24周内OUD患者疼痛强度变化与XR-NTX治疗结果之间的关系。研究结果挑战了XR-NTX不适合治疗有疼痛的OUD患者的看法。
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引用次数: 0
Monthly buprenorphine depot injection (SUBLOCADE®) for opioid use disorder during pregnancy 每月丁丙诺啡储存注射(SUBLOCADE®)用于妊娠期间阿片类药物使用障碍。
IF 1.9 4区 医学 Q2 SUBSTANCE ABUSE Pub Date : 2025-04-28 DOI: 10.1111/ajad.70034
Melinda Ramage FNP-BC, CARN-AP, LCAS, Becky Bishop RN, BSN, Vikki Mangano RN, Baher Mankabady MD

Background and Objectives

Untreated opioid use disorder (OUD) in pregnancy is associated with adverse obstetrical outcomes, maternal morbidity, and maternal mortality. This article will inform clinicians about the use of monthly extended-release buprenorphine (BUP-XR, SUBLOCADE®) to treat OUD during pregnancy and postpartum.

Methods

We examined the use of monthly BUP-XR during pregnancy in patients with OUD, summarizing case studies (N = 4) from clinical practice, reviewing >5 years of pregnancy and postpartum surveillance data (quantitative [N = 322] and qualitative) and relevant literature in PubMed (N = 4).

Results

The clinical practice case studies highlight the experience from four pregnant patients with OUD who received monthly BUP-XR. All four neonates were delivered full-term with normal birthweight, no fetal anomalies, and no medication required for neonatal opioid withdrawal syndrome. Additionally, over 300 pregnancies have been reported through postmarketing surveillance, of which 68 have known outcomes consistent with information described in the product label. Findings from literature, postmarketing surveillance, and clinical practice case studies were consistent with the established safety profile of buprenorphine.

Conclusion and Scientific Significance

This study addresses a lack of knowledge of treatment of pregnant individuals with OUD and draws on relevant experience from prescribers treating patients with monthly BUP-XR during pregnancy and postpartum. These data support consideration of implementing BUP-XR as part of evidence-based practice that prioritizes OUD treatment access, patient stability, and patient choice during the perinatal period. Three sources of data illustrate that the use of monthly BUP-XR during pregnancy has demonstrated no increased risk and is consistent with the established buprenorphine safety profile.

背景和目的:妊娠期未经治疗的阿片类药物使用障碍(OUD)与不良的产科结局、孕产妇发病率和孕产妇死亡率相关。本文将告知临床医生使用每月缓释丁丙诺啡(BUP-XR, SUBLOCADE®)治疗孕期和产后OUD。方法:我们研究了妊娠期每月BUP-XR在OUD患者中的使用情况,总结了临床案例研究(N = 4),回顾了50年妊娠和产后监测数据(定量[N = 322]和定性)以及PubMed的相关文献(N = 4)。结果:临床实践案例研究突出了4例妊娠OUD患者每月接受BUP-XR的经验。所有四名新生儿均足月分娩,出生体重正常,无胎儿异常,无需新生儿阿片类戒断综合征药物治疗。此外,通过上市后监测报告了300多例怀孕,其中68例的已知结果与产品标签上描述的信息一致。来自文献、上市后监测和临床实践案例研究的结果与丁丙诺啡已建立的安全性一致。结论及科学意义:本研究解决了妊娠期OUD患者治疗知识不足的问题,借鉴了妊娠期及产后每月BUP-XR患者的相关经验。这些数据支持考虑实施BUP-XR作为循证实践的一部分,优先考虑围产期OUD治疗的可及性、患者稳定性和患者选择。三个来源的数据表明,在怀孕期间每月使用BUP-XR没有增加风险,并且与既定的丁丙诺啡安全性一致。
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引用次数: 0
Call for Review Papers 2025 2025年征稿
IF 2.5 4区 医学 Q2 SUBSTANCE ABUSE Pub Date : 2025-04-28 DOI: 10.1111/ajad.70037

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引用次数: 0
Call for Special Issue Papers 2025 征集2025年特刊论文
IF 2.5 4区 医学 Q2 SUBSTANCE ABUSE Pub Date : 2025-04-28 DOI: 10.1111/ajad.70038

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引用次数: 0
AAAP 36th Annual Meeting & Scientific Symposium - Save the Date AAAP第36届年会暨科学研讨会-保存日期
IF 2.5 4区 医学 Q2 SUBSTANCE ABUSE Pub Date : 2025-04-28 DOI: 10.1111/ajad.70039

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引用次数: 0
AAAP Performance and Practice (PIP) Resources AAAP性能和实践(PIP)资源
IF 2.5 4区 医学 Q2 SUBSTANCE ABUSE Pub Date : 2025-04-28 DOI: 10.1111/ajad.70040

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引用次数: 0
Exploring cannabis as a treatment for chronic pain in a rural Appalachian population 探索大麻作为阿巴拉契亚农村人口慢性疼痛的治疗方法。
IF 1.9 4区 医学 Q2 SUBSTANCE ABUSE Pub Date : 2025-04-19 DOI: 10.1111/ajad.70033
Treah Haggerty MD, MS, Toni M. Rudisill PhD, Patricia Dekeseredy RN, MScN, Abigail Cowher BA, Cara L. Sedney MD, MA

Background and Objectives

Many cannabis laws include medical use with pain as an indication. However, it is not known the extent of cannabis use for pain, the types of pain treated, and the perceived effectiveness of cannabis for chronic pain in this region. The purpose of this study was to understand cannabis use for pain in West Virginia patients.

Methods

Ten thousand chronic pain patients were surveyed, and users and non-users of cannabis were compared.

Results

One thousand three hundred fifty-one people responded, with 24% using cannabis. They were in pain for longer, most >10 years. They often used other medications for pain and more often had a previous opioid prescription for pain.

Discussions and Conclusions

Patients who use cannabis have higher levels of reported pain for longer durations of time than those who do not use cannabis. More information is needed to understand the implications for cannabis use in this population.

Scientific Significance

Patients with chronic pain who use cannabis have tried multiple treatment modalities, had more types of pain, and often received an opioid prescription.

背景和目的:许多大麻法律将医疗用途与疼痛作为适应症。然而,目前尚不清楚大麻用于治疗疼痛的程度、治疗的疼痛类型以及大麻在该地区治疗慢性疼痛的有效性。这项研究的目的是了解西弗吉尼亚州患者使用大麻治疗疼痛的情况。方法:对1万例慢性疼痛患者进行调查,对大麻使用者和非大麻使用者进行比较。结果:一千三百五十一人回应,其中24%使用大麻。他们的痛苦持续的时间更长,大多数人在10年左右。他们经常使用其他药物治疗疼痛,更经常的是以前有阿片类药物治疗疼痛的处方。讨论和结论:与不使用大麻的患者相比,使用大麻的患者报告的疼痛程度更高,持续时间更长。需要更多的信息来了解这一人群使用大麻的影响。科学意义:使用大麻的慢性疼痛患者尝试了多种治疗方式,疼痛类型更多,并且经常接受阿片类药物处方。
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引用次数: 0
Tobacco use and impulsivity in people with mental illness: A systematic review 精神疾病患者的烟草使用和冲动:一项系统综述。
IF 2.5 4区 医学 Q2 SUBSTANCE ABUSE Pub Date : 2025-04-16 DOI: 10.1111/ajad.70032
Angela Praecht PhD, Shivahn Garvie BSc, Maryam Sorkhou PhD, James MacKillop PhD, Tony P. George MD

Background and Objectives

Impulsivity is a risk factor for the development and maintenance of tobacco use, especially among individuals with comorbid mental illness, but the nature of this relationship is poorly understood. We systematically examined evidence for the relationship between impulsivity and tobacco use in people with psychiatric disorders.

Methods

Following PRISMA guidelines, original peer-reviewed articles published from database inception to July 2024 were searched for using PubMed, Google Scholar, ProQuest, Ovid, and PsycINFO.

Results

Of 1192 articles identified, 16 met the inclusion criteria. There was consistent evidence of a positive relationship between tobacco use and impulsivity in schizophrenia (SZ), major depressive disorder (MDD) and bipolar disorder (BD). However, the majority of studies were cross-sectional studies, preventing causal inferences.

Discussion and Conclusions

Tobacco smoking is robustly associated with impulsivity in people with SZ, MDD, and BD, although causal conclusions cannot be drawn due to methodological limitations of the current literature. Future prospective and experimental studies are needed to ascertain whether impulsivity is a risk factor for smoking, how tobacco use affects impulsivity, and whether impulsivity may be a treatment target for smoking cessation.

Scientific Significance

To our knowledge, this article is the first comprehensive review of literature, specifically examining the relationship of tobacco smoking and impulsivity among individuals with psychiatric disorders. By highlighting this understudied intersection, our findings provide novel insights into the relationship between smoking behaviors and impulsivity in individuals with mental illness, contributing to more effective treatment strategies and emphasizing the need for tailored interventions to address these co-morbidities.

背景和目的:冲动是发展和维持烟草使用的一个危险因素,特别是在患有精神疾病的个体中,但这种关系的性质尚不清楚。我们系统地研究了精神疾病患者冲动和吸烟之间关系的证据。方法:按照PRISMA指南,检索PubMed、b谷歌Scholar、ProQuest、Ovid和PsycINFO数据库中从数据库建立到2024年7月发表的同行评议的原创文章。结果:1192篇文献中,16篇符合纳入标准。有一致的证据表明,在精神分裂症(SZ)、重度抑郁症(MDD)和双相情感障碍(BD)中,烟草使用与冲动性之间存在正相关。然而,大多数研究是横断面研究,防止因果推论。讨论和结论:吸烟与SZ、MDD和BD患者的冲动密切相关,尽管由于当前文献的方法学限制,无法得出因果结论。未来的前瞻性和实验性研究需要确定冲动性是否是吸烟的危险因素,烟草使用如何影响冲动性,以及冲动性是否可能成为戒烟的治疗目标。科学意义:据我们所知,这篇文章是第一篇全面的文献综述,专门研究了精神疾病患者吸烟和冲动之间的关系。通过强调这一尚未充分研究的交叉点,我们的研究结果为精神疾病患者吸烟行为和冲动之间的关系提供了新的见解,有助于制定更有效的治疗策略,并强调需要量身定制的干预措施来解决这些合并症。
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期刊
American Journal on Addictions
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