Am J Drug Alcohol Abuse 2017 Sep 18:1-4. Epub 2017 Sep 18.
b UT Southwestern Medical Center , Department of Psychiatry , Dallas , TX , USA.
The gap between treatment utilization and treatment need for substance use disorders (SUDs) remains a significant concern in our field. While the growing call to bridge this gap often takes the form of more treatment services and/or better integration of existing services, this perspective proposes that more effective labels for and transparent descriptions of existing services would also have a meaningful impact. Adopting the perspective of a consumer-based health-care model (wherein treatments and services are products and patients are consumers) allows us to consider how labels like Addiction-focused Medical Management, Medication-Assisted Treatment, Medication-Assisted Therapy, and others may actually be contributing to the underutilization problem rather than alleviating it. Read More
Background: Readiness to change alcohol use has been associated with a number of predictors including emotional distress, drinking severity, and consequence severity, as well as with static demographic factors such as gender and race/ethnicity.
Objective: To examine the relationships among these variables and readiness to change alcohol use in young adults.
Methods: Structural equation modeling was used to test pathways of readiness to change in 1,256 young adult patients (78% male/22% female) ages 18-29 who were provided screening, brief intervention and referral to treatment (SBIRT) as part of a Substance Abuse and Mental Health Services Administration (SAMHSA) Treatment Capacity Expansion Project. Read More
Background: Opioid use disorder during pregnancy is a growing health concern. Methadone maintenance is the treatment of choice but emerging data indicate buprenorphine is a viable alternative. Due to costs and limited accessibility of methadone, pregnant women may require transition from methadone to buprenorphine for maintenance treatment. Read More
Background: Previous meta-analytical research examining cocaine and methamphetamine separately suggests potentially different neuropsychological profiles associated with each drug. In addition, neuroimaging studies point to distinct structural changes that might underlie differences in neuropsychological functioning.
Objectives: This meta-analysis compared the effect sizes identified in cocaine versus methamphetamine studies across 15 neuropsychological domains. Read More
Background: Cannabis use disorder (CUD) is a common condition with few treatments. Several studies in other substance use disorders have found that applying repetitive transcranial magnetic stimulation (rTMS) to the dorsolateral prefrontal cortex (DLPFC) decreases cue-elicited craving and possibly decreases use. To date, there have been no studies attempting to use rTMS in CUD. Read More
Background: Problem drinking carries significant health burdens, including an increased risk of hypertension. The effect of chronic alcohol intake on blood pressure (BP) in women is understudied and poorly understood.
Objectives: We sought to examine the relationships between drinking habits and BP in hypertensive women. Read More
Background: Homeless women are at high risk for substance use disorder (SUD), and are a growing proportion of the homeless population. However, homeless women experience barriers to engaging in substance use services.
Objectives: Among homeless women with SUD, to explore service use, motivation to change, service barriers, and willingness to have substance use and mental health problems addressed in primary health care. Read More
Background: The clinical feasibility of a novel non-opioid and benzodiazepine-free protocol was assessed for the treatment of medically supervised opioid withdrawal and transition to subsequent relapse prevention strategies.
Methods: A retrospective chart review of DSM-IV diagnosed opioid-dependent patients admitted for inpatient medically supervised withdrawal examined 84 subjects (52 males, 32 females) treated with a 4-day protocol of scheduled tizanidine, hydroxyzine, and gabapentin. Subjects also received ancillary medications as needed, and routine counseling. Read More
Background: Recovery high schools (RHSs) provide post-treatment education and recovery support for young people with substance use disorders (SUDs). This is the first quasi-experimental outcome study to determine RHS effectiveness relative to students in non-RHSs.
Objectives: To examine effects of RHS attendance on academic and substance use outcomes among adolescents treated for SUDs 6 months after recruitment to the study. Read More
Background: Drug-induced conditioned place preference (CPP) is linked to the addictive properties of the drug used. The number of studies that have investigated the effects of propofol on CPP is limited. Research findings suggest that nitric oxide (NO) might play an important role in substance use disorders. Read More
Background: Evidence suggests that for young adults, intimate partners influence each other's drinking patterns. Therefore, exploration of variables related to intimate partner relationships (such as attachment style) could broaden the current understanding of risk factors for alcohol problems in this demographic.
Objectives: The current study examined the role of drinking context in the relationships among insecure attachment, alcohol problems, and relationship satisfaction. Read More
Background: Brief addiction treatments including motivational interviewing (MI) have shown promise with adolescents, but the factors that influence treatment efficacy in this population remain unknown. One candidate is working memory, the ability to hold a fact or thought in mind. This is relevant, as in therapy, a client must maintain and manipulate ideas while working with a clinician. Read More
Background: With approximately 20% of Americans residing in rural communities, substance use differences is an important topic for appropriate use of resources, policy decisions, and the development of prevention and intervention programs.
Objectives: The current study examined differences in alcohol, tobacco, and marijuana use among students from rural and urban backgrounds across the transition to college.
Methods: Participants were 431 (48% male) undergraduate students from a large, public southeastern university who provided yearly alcohol, tobacco, and marijuana use data during freshman, sophomore, and junior years. Read More
Background: Reactive oxygen species (ROS) are thought to play a role in the adverse physical and mental consequences of methamphetamine usage. The oxidative DNA adduct 8-hydroxy-2'-deoxyguanosine (8-OHdG) is a well-known biomarker of ROS-induced DNA damage. Currently, there is insufficient clinical information about methamphetamine-induced oxidative DNA damage. Read More
Background: Recent but largely separate literatures have examined neurocognitive alterations related to both depression and binge drinking, suggesting similar patterns of impairments in attention control and decisional processes. However, depression and problematic alcohol use tend to co-occur, and few studies have examined whether cognitive processing effects of depression and binge drinking are independent or interacting.
Objective: The current study examined joint effects of depressive symptoms and past-year binge drinking on cognitive processing (measured via EEG assessment). Read More
Background: Recent legislation in Pennsylvania allows police officers to administer naloxone to individuals in an opioid overdose. Pressure has subsequently been placed on police departments to adopt naloxone programs.
Objective: To survey Pennsylvania Chiefs of Police regarding potential obstacles to officer-administered naloxone, and their overall opinion toward such programs. Read More
Background: Black young adults have lower rates of alcohol use than other racial groups. Genetic factors may protect against drinking. Specifically, the ADH1B*3 allele is present almost exclusively in Black populations and has been protective against alcohol use and alcohol use disorder. Read More
Background: Negative views toward substance use treatment among some rural substance users and limited treatment resources in rural areas likely affect substance use utilization. It is therefore important to determine whether accessing healthcare options other than substance use treatment, specifically outpatient medical care (OMC), is associated with reductions in substance use.
Objectives: We examined whether use of OMC was associated with reductions in substance use among rural substance users over a three-year period. Read More
Background: γ-hydroxybutyrate (GHB) has a high potential for illicit use; overdose of this compound results in sedation, respiratory depression and death. Tolerance to the hypnotic/sedative and electroencephalogram effects of GHB occurs with chronic GHB administration; however, tolerance to respiratory depression has not been evaluated. GHB toxicodynamic effects are mediated predominantly by GABAB receptors. Read More
Background: Precise terminology and definitions are important components of scientific language. Although the terms "hard drugs" and "soft drugs" are used widely by professionals, neither the International Classification of Diseases nor the Diagnostic and Statistical Manual classify psychoactive substances into the categories "hard" and "soft."
Objectives: To analyze the occurrence of the terms "hard drugs" and "soft drugs" in recent scientific literature and to establish the degree of consensus in labeling psychoactive substances as "hard" or "soft. Read More
Background: Alcohol use disorders adversely affect individual and societal health. These disorders are a chronic brain disease, and protective factors against relapse should be studied. Prefrontal cortex (PFC) dysfunction is evident in alcohol use disorders, and research that explores recovery of the PFC in alcohol use disorders is needed, specifically in regard to how psychological and behavioral factors can augment medicalized treatments and protect against relapse. Read More
Am J Drug Alcohol Abuse 2017 Sep 13;43(5):495-504. Epub 2017 Feb 13.
a Mental Health Institute of the Second Xiangya Hospital, Central South University, The China National Clinical Research Center for Mental Health Disorders, National Technology Institute of Psychiatry, Key Laboratory of Psychiatry and Mental Health of Hunan Province , Changsha , Hunan , China.
Background: Ketamine is an anesthetic commonly used in low-income countries and has recently been shown to be effective for treatment-resistant depression. However, the illicit manufacturing, trafficking, and nonmedical use of ketamine are increasing globally, and its illicit use poses major public health challenges in many countries.
Objectives: To review the nonmedical use of ketamine in selected countries and its regulatory control. Read More
Background: Chronic heroin use can cause a deficit of inhibitory function, leading to a loss of control over drug use. Exposure to drug-related cues is considered as one of the contributing factors. However, it is unclear whether there are dynamic changes on the effect of drug-related cues on response inhibition following prolonged abstinence. Read More
Background: Avatar-assisted therapy (AAT) is a novel and emerging technology that uses the Internet to enable clinicians and clients in substance abuse treatment to participate in group counseling sessions from separate and remote locations in real time through the use of avatars and virtual environments.
Objectives: The current study is a pilot proof-of-concept feasibility study involving individuals in outpatient substance abuse treatment. This report addresses two questions: (1) are individuals who present for substance abuse treatment interested in receiving AAT and (2) what factors are associated with better treatment success. Read More
Overview: Though not an official diagnosis, psychopathy has become an important area of research due to the litany of deleterious outcomes associated with this aspect of temperament. Psychopathy is composed of primary and secondary traits. Research consistently links psychopathy to alcohol pathology, though often only via secondary traits which are comprised of intractable aspects of behavior (e. Read More
Background: The associations between cannabis use and psychosis are well documented in numerous studies. There is a need to evaluate the impact of cannabis use on inpatient psychiatric utilization and outcomes.
Objectives: To evaluate the impact of cannabis use on psychiatric hospital outcomes. Read More
Background: Producers of supersized alcopops have ignored requests from a number of state attorneys general to reduce the alcohol concentration in these products. To the contrary, new flavor options have since been released that contain even greater alcohol content so that some alcopop products now contain 5.5 standard alcoholic drinks in a single-serving can. Read More
Smoking remains one of the most preventable causes of morbidity and mortality in the United States (1). A number of factors contribute to the initiation and maintenance of smoking behavior, including psychosocial influences (2,3), neurobehavioral traits (4), and genetic susceptibility (5-7). Prevalence rates of tobacco dependence among individuals with mental health issues are strikingly high when compared to the general population, particularly among individuals with depression and anxiety disorders (8). Read More
Background: Illicit substance use remains highly prevalent in the US, and epidemiological surveillance surveys estimate that in 2015, over 27 million individuals (10.1% of the US population) 12 years of age or older used illicit drugs in the past 30 days.(1) Outpatient treatment delivered in community-based settings is the dominant modality for addiction treatment, typically involving weekly psychosocial counseling sessions in an individual and/or group format. Read More
Background: Patients adherent to their recommended treatment regimen demonstrate favorable outcomes. However, it is unclear whether there are specific short-term continuing care performance variables indicative of better long-term prognosis.
Objective: This study determined the impact of attendance at an outpatient appointment within 7 days post-discharge from residential treatment on 12-month outcomes. Read More
Background: Ibogaine is a monoterpene indole alkaloid used in medical and nonmedical settings for the treatment of opioid use disorder. Its mechanism of action is apparently novel. There are no published prospective studies of drug use outcomes with ibogaine. Read More
Background: Response disinhibition plays an important role in addictive behaviors. However, results of studies on the performance on response inhibition tasks of individuals evidencing potentially problematic levels of alcohol drinking are mixed.
Objectives: We assessed conditions under which persons with a relatively high risk of alcohol dependence show inhibition deficits in such tasks and investigated the nature of those deficits. Read More
Background: Cannabis is the most used illicit drug worldwide. The long-standing consequences for the central nervous system associated with frequent cannabis use have not been well delineated and should be determined.
Objective: To review recent studies on the effects of regular cannabis use regarding its effects on cognition, brain structure, and function in adults. Read More
Background: New psychoactive substances (NPS) continue to emerge; however, few surveys of substance use ask about NPS use. Research is needed to determine how to most effectively query use of NPS and other uncommon drugs.
Objective: To determine whether prevalence of self-reported lifetime and past-year use differs depending on whether or not queries about NPS use are preceded by "gate questions. Read More
Background: High alcohol intake on weekends (binge drinking) is more frequent in young adults, who could undergo early liver damage. Alcohol-induced liver damage is characterized by polymorphonuclear cell (PMN) infiltration, which can be represented in the peripheral blood by altered trafficking and activation profiles.
Objective: To evaluate the PMN trafficking and activation immunophenotypic profiles in people with a binge drinking pattern. Read More
Background: Despite increasing marijuana use among older adults, little research has been done on marijuana's effects on their healthcare use.
Objectives: To examine whether (1) marijuana use is associated with the likelihood of emergency department (ED) visits through increased injury risk, and (2) marijuana use patterns are associated with injury risk and ED visits among older adults.
Methods: Using the 2012-2013 National Epidemiologic Survey on Alcohol and Related Problems (N = 14,715 aged 50+; 6,379 men and 8,336 women), descriptive statistics were used to compare past-year marijuana users to nonusers on sociodemographic and physical/mental health characteristics. Read More
Alcohol is the most common substance of addiction and a threat not only to health but also to sustainable human development. Consequently, at least a 10% relative reduction in the harmful use of alcohol has been advocated by the World Health Organization (WHO). This perspective describes alcohol use in Africa, strategies to reduce harmful alcohol use, and the ability of African countries to meet this target. Read More
Background: The ALDH2*2 allele (A-allele) at rs671 is more commonly carried by Asians and is associated with alcohol-related flushing, a strong adverse reaction to alcohol that is protective against drinking. Social factors, such as having friends who binge drink, also contribute to drinking in Asian youth.
Objectives: This study examined the interplay between ALDH2*2, peer drinking, and alcohol consumption in college students. Read More
Background: Maternal cannabis use in pregnancy is linked with long-term adverse behavioral outcomes in offspring. Epigenetic processes established in utero that affect dopaminergic (reward) signaling may mediate risks. Associations between cannabis use and offspring DNA methylation have not been investigated; however, maternal tobacco smoking in pregnancy is associated with distinct patterns of DNA methylation at birth and beyond. Read More
Background: US FDA guidance recommends measuring the degree of effort needed to manipulate abuse-deterrent (AD) opioids. The ALERRT(®) instrument (PinneyAssociates; Bethesda, MD) uses visual analog scales to assess the labor, effort, and resources necessary to physically compromise AD product candidates in standardized settings.
Objective: Use the ALERRT(®) instrument for testing morphine abuse-deterrent, extended-release, injection-molded tablets (ADER-IMT) 60 and 100 mg and the comparators immediate-release (IR) morphine sulfate 30 mg and extended-release (ER) morphine sulfate 60 mg. Read More
Background: Medication development for alcoholism typically includes experimental pharmacology studies with non-treatment-seeking individuals with alcohol use disorder (AUD) paving the way for randomized controlled trials in treatment-seekers with AUD.
Objectives: The goal of this study is to provide a direct comparison between AUD treatment-seeking research participants and non-treatment-seeking participants on demographic and clinical variables and to test whether variables that differentiate the two groups are associated with clinical outcomes.
Method: Non-treatment-seeking AUD participants (n = 213; 76. Read More