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Background: Addicted patients undergoing methadone maintenance treatment are prone to several complications and the risk of relapse. Objective: The present study aims to investigate the effect of cranial electrotherapy stimulation on depression, anxiety, and craving in addicted male people undergoing methadone maintenance treatment. Methods: This randomized controlled trial study was conducted on 60 male patients referred to Persia addiction treatment center between 2021 and 2022. Patients were randomly divided into two equal treatment and placebo groups. The treatment group received cranial electrotherapy stimulation intervention for 48 sessions of 30 min. Depression and anxiety were evaluated using the Hamilton questionnaire before and after the intervention, and the level of craving was also evaluated with the Federdi 2008 questionnaire. Results: Comparing the level of depression and anxiety before and after the intervention in both treatment and placebo groups did not show any significant difference (p < 0.05). Craving after the intervention was significantly different in both groups and was lower in the treatment group compared to the placebo group (33.43 versus 42.17, p = 0.004). In the placebo group, the level of anxiety and depression, and in the treatment group, the level of depression, anxiety and craving for consumption decreased significantly after the intervention compared to before the intervention (p < 0.05). Conclusion: Cranial electrotherapy stimulation did not have a significant effect on reducing the level of depression and anxiety of patients, but it is effective in the reduction of craving in addicted people undergoing methadone maintenance treatment. Trial registration: This randomized clinical trial was registered on 2022/5/13 with clinical trial code of IRCT20210523051367N1. [ABSTRACT FROM AUTHOR]

The consumption of performance and image-enhancing drugs (PIEDs) is commonly pathologised in public health discourse as stemming from an unhealthy relationship to masculinity, and is often framed as intrinsically 'risky' and fundamentally at odds with 'good health'. This article examines Australian health promotion materials on PIEDs to analyse their role in shaping notions of good health, normal gender and appropriate self-improvement. To do so, it draws on the work of Butler, Law and Latour to consider how these materials co-constitute men and their health, often in problematic ways. First, we examine the ways in which PIEDs are constituted via a politics of the 'natural', then consider how the health promotion materials on PIEDs participate in the regulation of appropriate, healthy masculinity, and conclude by examining how adolescent masculinity is co-constituted with PIEDs. We observe a key tension between health promotion's avowed interest in improvement and optimisation and its treatment of PIED consumers as aberrant, vulnerable and insecure subjects whose drive to enhance and optimise is characterised by pathology and addiction. We conclude by arguing that health promotion materials on PIEDs fail to acknowledge the exceedingly normative character of enhancement practices in contemporary society. [ABSTRACT FROM AUTHOR]

The image of craving as a desire of unimaginable and irresistible force is poised to solve the puzzle of addiction: persistent drug use despite severe negative consequences. But the image is flawed. Drawing on science, philosophy, and first‐person testimony, I argue against irresistibility and develop a more nuanced, heterogeneous account of craving for drugs. Craving comes in three varieties, each corresponding to a kind of answer to the question why people crave drugs: cue‐induced, goal‐focused, and attachment‐based. This in turn grounds an approach to addressing addiction that is humane and heterogeneous, moving beyond strategies that are fundamentally controlling. [ABSTRACT FROM AUTHOR]

This is the first clinical practice guideline (CPG) from the American Academy of Pediatrics outlining evidence-based approaches to safely prescribing opioids for acute pain in outpatient settings. The central goal is to aid clinicians in understanding when opioids may be indicated to treat acute pain in children and adolescents and how to minimize risks (including opioid use disorder, poisoning, and overdose). The document also seeks to alleviate disparate pain treatment of Black, Hispanic, and American Indian/Alaska Native children and adolescents, who receive pain management that is less adequate and less timely than that provided to white individuals. There may also be disparities in pain treatment based on language, socioeconomic status, geographic location, and other factors, which are discussed. The document recommends that clinicians treat acute pain using a multimodal approach that includes the appropriate use of nonpharmacologic therapies, nonopioid medications, and, when needed, opioid medications. Opioids should not be prescribed as monotherapy for children or adolescents who have acute pain. When using opioids for acute pain management, clinicians should prescribe immediate-release opioid formulations, start with the lowest age- and weight-appropriate doses, and provide an initial supply of 5 or fewer days, unless the pain is related to trauma or surgery with expected duration of pain longer than 5 days. Clinicians should not prescribe codeine or tramadol for patients younger than 12 years; adolescents 12 to 18 years of age who have obesity, obstructive sleep apnea, or severe lung disease; to treat postsurgical pain after tonsillectomy or adenoidectomy in patients younger than 18 years; or for any breastfeeding patient. [ABSTRACT FROM AUTHOR]

Background: Integrating molecular-targeted agents into combination chemotherapy is transformative for enhancing treatment outcomes in cancer. However, realizing the full potential of this approach requires a clear comprehension of the genetic dependencies underlying drug synergy. While the interactions between conventional chemotherapeutics are well-explored, the interplay of molecular-targeted agents with conventional chemotherapeutics remains a frontier in cancer treatment. Hence, we leveraged a powerful functional genomics approach to decode genomic dependencies that drive synergy in molecular-targeted agent/chemotherapeutic combinations in gastric adenocarcinoma, addressing a critical need in gastric cancer therapy. Methods: We screened pharmacological interactions between fifteen molecular-targeted agent/conventional chemotherapeutic pairs in gastric adenocarcinoma cells, and examined the genome-scale genetic dependencies of synergy integrating genome-wide CRISPR screening with the shRNA-based signature assay. We validated the synergy in cell death using fluorescence-based and lysis-dependent inference of cell death kinetics assay, and validated the genetic dependencies by single-gene knockout experiments. Results: Our combination screen identified SN-38/erlotinib as the drug pair with the strongest synergism. Functional genomics assays unveiled a genetic dependency signature of SN-38/erlotinib identical to SN-38. Remarkably, the enhanced cell death with improved kinetics induced by SN-38/erlotinib was attributed to erlotinib's off-target effect, inhibiting ABCG2, rather than its on-target effect on EGFR. Conclusion: In the era of precision medicine, where emphasis on primary drug targets prevails, our research challenges this paradigm by showcasing a robust synergy underpinned by an off-target dependency. Further dissection of the intricate genetic dependencies that underlie synergy can pave the way to developing more effective combination strategies in gastric cancer therapy. [ABSTRACT FROM AUTHOR]

Rationale: Cocaine use disorder (CUD) is a brain disorder for which there is no Food and Drug Administration-approved pharmacological treatment. Evidence suggests that glutamate and metabotropic glutamate receptor subtype 5 (mGlu5) play critical roles in synaptic plasticity, neuronal development, and psychiatric disorders. Objective: In the present study, we tested the hypothesis that the mGlu5 receptor is functionally involved in intravenous cocaine self-administration and assessed the effects of sex and cocaine exposure history. Methods: We used a preclinical model of CUD in rats that were allowed long access (LgA; 6 h/day) or short access (ShA; 1 h/day) to intravenous cocaine (750 µg/kg/infusion [0.1 ml]) self-administration. Rats received acute intraperitoneal or oral administration of the mGlu5 receptor negative allosteric modulator mavoglurant (1, 3, and 10 mg/kg) or vehicle. Results: Both intraperitoneal and oral mavoglurant administration dose-dependently reduced intravenous cocaine self-administration in the first hour and in the entire 6 h session in rats in the LgA group, with no effect on locomotion. In the ShA group, mavoglurant decreased locomotion but had no effects on cocaine self-administration. We did not observe significant sex × treatment interactions. Conclusions: These findings suggest that the mGlu5 receptor is involved in escalated cocaine self-administration. These findings support the development of clinical trials of mavoglurant to evaluate its potential therapeutic benefits for CUD. [ABSTRACT FROM AUTHOR]

Tobacco pictorial warnings could employ a variety of emotional appeals to enhance effectiveness; however, little research exists to guide the selection of discrete emotional appeals. Further, it remains unclear how contextual pro-smoking norms might influence the persuasive impacts of discrete emotional appeals within pictorial warnings, especially in China, where the overall smoking rate and social acceptance remain high. To fill these gaps, this study leveraged the largest set of pictorial warnings (K = 510) tested to date. Using a randomized large-K multiple-message design, we evaluated the impacts of disgust, fear, self-anger, contempt, shame, and hope appeals among Chinese adult male smokers (N = 2,306) on perceived message effectiveness (PME). Results showed that fear, self-anger, shame, and hope appeals significantly increased PME, while disgust and contempt appeals appeared less effective. Importantly, the PME of nearly all emotional appeals – except hope appeals – was weakened for Chinese adult male smokers with higher pro-smoking normative perceptions, highlighting the importance of considering local contextual influences when implementing pictorial warnings. [ABSTRACT FROM AUTHOR]

Recent shifts in UK policy have seen certain populations, who were predominantly viewed as offenders due to their involvement in drug offences, increasingly recognized as victims of exploitation. Drawing on qualitative data from three studies, this article interrogates how this trend is playing out within contemporary drugs policing, focussing on officers' responses to people affected by: drug addiction, child criminal exploitation and 'cuckooing'. It examines the tensions that arise as these three categories of emergent drug victims conflict with officers' normative expectations of victimhood, perceptions of their role as police and existing operational strategies. It also reveals officers' attempts to (re)gain ontological security by policing the boundaries of victimhood and re-focussing on new categories of offender. [ABSTRACT FROM AUTHOR]

Background and aims: Tobacco product excise taxes are a cost‐effective method for reducing tobacco consumption, but industry pricing and marketing strategies encourage consumers to engage in price‐minimizing behaviours (PMBs). We investigated the relationship between tobacco tax increases and PMBs, measuring whether PMBs intensify following tax increases, whether low‐income consumers with higher nicotine dependence are more likely to engage in PMBs and whether PMBs are negatively related to smoking cessation. Method: This was a systematic review with meta‐analysis of cross‐sectional and longitudinal studies from seven databases up to March 2023, using studies that reported any product‐ and purchasing‐related smoking behaviours post‐tobacco tax increase in a general representative population. Sixty‐eight studies were quality‐assessed using the Newcastle–Ottawa scale. All studies were narratively synthesized, with five studies involving 13 068–26 575 participants providing data for pooled analyses on PMBs [purchasing lower‐priced brands, roll‐your‐own (RYO) tobacco and cartons] pre‐ and post‐tax increases using a random effects meta‐analytical model. Results: Fifty‐seven studies reported on legal PMBs, and 17 studies reported illicit cigarette purchasing. Meta‐analysis showed that consecutive tax increases were positively associated with purchasing RYO [odds ratio (OR) = 1.60, 95% confidence interval (CI) = 1.04–2.46], especially in higher tobacco taxing environments, with substantial heterogeneity (I2 = 96%). Lower income and higher nicotine dependence were associated with purchasing lower‐priced brands and RYO, whereas higher income and nicotine dependence were associated with purchasing cartons, large‐sized packs and cross‐border sales. Less evidence associated illicit tobacco purchases with tax increases or PMBs with smoking cessation. Conclusions: Tobacco purchasers' PMBs vary widely by state, country and time‐period within countries. Both legal and illegal PMBs, potentially influenced by industry pricing tactics, may exacerbate health inequalities and dilute the public health benefits of tobacco tax increases. [ABSTRACT FROM AUTHOR]

Aims: Research has associated lack of parental care, physical abuse, and parental substance abuse to homelessness, with the presence of two or more such factors dramatically increasing one's chances of becoming homeless as an adult. Less clear is which (cumulation of) factors may mediate the difference between transitional and recurrent homelessness. Methods: Quantitative analysis of four risk factors—addiction, weak social network, criminal activity, psychopathology—among 69 transitionally and recurrently homeless (RH) adults, followed by in‐depth qualitative analysis of adverse childhood experiences (ACEs) among 30 selected participants. Results: RH participants had higher cumulative risk and a higher prevalence and broader range of ACEs than transitionally homeless participants, with the prevalence of childhood physical abuse marking the greatest difference between the two groups. Recurrent homelessness was also correlated with addiction to hard drugs, criminal activity, and weak social networks. Conclusion: Longitudinal and intervention studies in larger groups are needed to assess causality. [ABSTRACT FROM AUTHOR]

Although numerous predictors of sexual violence (SV) have been identified, there is a need to further explore protective factors and examine the nature and strength of associations between predictors and SV outcomes using a hierarchical predictive model. Cross-sectional data from the My World Survey Post-Second Level (2019) in Ireland were used. The sample contained 8, 288 post-secondary students, 69% female, aged 18 to 25 years (M = 20.25, SD = 1.85). Univariate and multivariate binary logistic regression analyses were conducted to identify correlates of two SV outcomes (i.e., forced/pressured to have sex and being touched in a sexual manner without consent) across societal, community, relationship, and individual levels. Approximately 25% of females and 10% of males reported being forced/pressured to have sex, whereas 55% of females and 23% of males reported being touched in a sexual manner without consent. Key predictors of SV in multivariate analyses included being female and experiencing violence in a romantic relationship, whereas discrimination, living on campus or in rented accommodation (compared with living at home) were also significant predictors of both SV outcomes. Parental conflict, sexual initiation, depressive symptoms, older age, and an avoidant coping style significantly predicted being forced/pressured to have sex, whereas being bullied and engaging in problem drinking were unique predictors of being touched sexually without consent. Findings highlight the importance of considering salient risk and protective factors at the individual, relationship, community and societal level to predict SV and effectively guide the delivery of interventions and support services for post-secondary students affected by SV. [ABSTRACT FROM AUTHOR]

AbstractIntroduction: Substance use disorder (SUD) stigma undermines the implementation of effective harm reduction and treatment strategies in the U.S. and can impede individuals from seeking treatment. One research question guided this study: How do personal beliefs regarding SUD, familiarity with SUDs, and culture (religion, political ideology, and urbanicity), shape perceived societal SUD stigma? Methods: An online survey was sent to affiliates of a Michigan-based organization, Families Against Narcotics and administrators of Michigan Prepaid Inpatient Health Plan regional entities (N = 1,559). Results: On average respondents viewed society as moderately stigmatizing. The beliefs that drug users can stop whenever they want and that drug users have weak character were significantly associated with greater perceived levels of societal SUD stigma. The effects of religion on perceived stigma may be affected by beliefs of the immorality of drug use, while the effects of political ideology on perceived stigma may differ based on beliefs of the controllability of drug use. The effect of urbanicity may rely on perceived accessibility of treatment. Conclusion: Our findings reflect the intersection of personal beliefs and cultural contexts as they shape perceived societal SUD stigmatization. [ABSTRACT FROM AUTHOR]

AbstractThis study aims to investigate the mechanism of relapse tendency in male drug abusers and provide empirical evidence for reducing relapse tendency of drug abusers. A survey was conducted on 310 male individuals with drug addiction using Chinese Perceived Stress Scale (CPSS), Simple Coping Style Questionnaire (SCSQ), the Regulatory Emotional Self-Efficacy Scale, and the Relapse Tendency Scale (RTS). (1) Stress is significantly positively correlated with the relapse tendency of individuals with drug addiction; (2) Stress indirectly affects relapse tendency through regulatory emotional self-efficacy; (3) Regulatory emotional self-efficacy can directly and negatively predict relapse tendency, and can also indirectly and negatively predict relapse tendency through coping style. Stress coping theory, tension elimination theory, and the self-administration hypothesis are applicable to explain the tendency to relapse due to stress among compulsory isolated drug abusers in China; Regulatory emotional self-efficacy and coping style play a chain mediating role between stress and relapse tendency of male individuals with drug addiction. [ABSTRACT FROM AUTHOR]

Background: Coffee and tea consumption account for most caffeine intake and 2–3 billion cups are taken daily around the world. Caffeine dependence is a widespread but under recognized problem. Objectives: To conduct a systematic review on the genetic susceptibility factors affecting caffeine metabolism and caffeine reward and their association with caffeine intake. Methodology: We conducted PubMed and Embase searches using the terms "caffeine", "reward", "gene", "polymorphism", "addiction", "dependence" and "habit" from inception till 2024. The demographics, genetic and clinical data from included studies were extracted and analyzed. Only case-control studies on habitual caffeine drinkers with at least 100 in each arm were included. Results: A total of 2552 studies were screened and 26 studies involving 1,851,428 individuals were included. Several genes that were involved with caffeine metabolism such as CYP1A2, ADORA2A, AHR, POR, ABCG2, CYP2A6, PDSS2 and HECTD4 rs2074356 (A allele specific to East Asians and monomorphic in Europeans, Africans and Americans) were associated with habitual caffeine consumption with effect size difference of 3% to 32% in number of cups of caffeinated drink per day per effect allele. In addition, ALDH2 was linked to the Japanese population. Genes associated with caffeine reward included BDNF, SLC6A4, GCKR, MLXIPL and dopaminergic genes such as DRD2 and DAT1 which had around 2–5% effect size difference in number of cups of caffeinated drink for each allele per day. Conclusion: Several genes that were involved in caffeine metabolism and reward were associated with up to 30% effect size difference in number of cups of caffeinated drink per day, and some associations were specific to certain ethnicities. Identification of at-risk caffeine dependence individuals can lead to early diagnosis and stratification of at-risk vulnerable individuals such as pregnant women and children, and can potentially lead to development of drug targets for dependence to caffeine. [ABSTRACT FROM AUTHOR]

As many countries are hit by the social economic impact of heroin addiction, there is an urgent need to have an effective awareness program that focuses on educating the population on the danger of heroin addiction and helping the heroin‐users quit. This paper aims to study the effect of the awareness program on the spread of heroin dependence using a mathematical model with distributed delay. First, we show the existence threshold parameter R0$$ {\mathfrak{R}}_0 $$, which we call the basic reproduction number of the spread of heroin use. We prove, via the Lyapunov direct method, that the drug‐free equilibrium is globally asymptotically stable if R0<1$$ {\mathfrak{R}}_0<1 $$. If R0>1$$ {\mathfrak{R}}_0>1 $$, the drug dependence persists, and the drug equilibrium is globally asymptotically stable. We give three possible scenarios to find the optimal awareness program strategy that puts the heroin epidemic under control. These scenarios take into consideration the reachability of the population, the immunity against heroin addiction, and the effectiveness of the program to contain the use of heroin in the population and bring R0$$ {\mathfrak{R}}_0 $$ below one. [ABSTRACT FROM AUTHOR]

Ketamine and esketamine are increasingly prescribed in the treatment of resistant mood disorders and persons at risk of suicide. Ketamine is a drug of misuse with increasing non-therapeutic use in the general population. Herein, our aim was to determine whether ketamine and/or esketamine are disproportionately associated with reports of substance and/or alcohol misuse. Replicating a similar analysis recently conducted using the Food and Drug Administration Adverse Event Reporting System (FAERS) database, we identified cases of "alcohol problem, alcoholism, alcohol abuse, substance dependence, substance use disorder (SUD), substance abuse, drug dependence, drug use disorder and drug abuse" in association with ketamine and esketamine reported to the World Health Organization Pharmacovigilance Database (WHO VigiBase). We searched the database from inception to January 2024. The reporting odds ratio (ROR) of each of the aforementioned parameters was calculated; acetaminophen was used as the control. The numerator of the equation represents the number of cases (n) and the denominator represents the total cases of psychiatric disorders (N). Significance was obtained when the lower limit of the 95 % confidence (CI) > 1.0. The RORs for ketamine was increased for most parameters (i.e., alcohol abuse (3.24), substance dependence (12.48), substance use disorder (170.44), substance abuse (2.94), drug dependence (2.88), drug use disorder (11.54) and drug abuse (2.85), respectively). With respect to esketamine, the RORs were observed to be different from ketamine insofar as we observed a reduction in the RORs for three parameters (i.e., substance abuse (0.41), drug dependence (0.083) and drug abuse (0.052), respectively). The IC025 values were significant for ketamine in cases of alcohol abuse (0.35), substance dependence (0.50), substance use disorder (2.77), substance abuse (0.83), drug dependence (0.97), drug use disorder (1.95) and drug abuse (0.94). Additionally, oxycontin showed significant IC025 values for substance use disorder (0.0014), substance abuse (0.042), and drug dependence (0.17). Esketamine was not associated with an increased ROR for any parameter of alcohol and/or substance use disorder. Mixed results were observed with ketamine with some RORs increased and others decreased. Estimating RORs using a pharmacovigilance database does not establish causation in the case of elevated RORs and cannot be assumed to be a therapeutic effect when lower RORs were observed. • Esketamine was not associated with an increased ROR for alcohol and/or substance use disorder (SUD) • Mixed results were observed with ketamine, where some RORs were increased while others decreased • Causation cannot be established in the case of elevated RORs derived from a pharmacovigilance database • A therapeutic effect cannot be assumed when lower RORs were observed. [ABSTRACT FROM AUTHOR]

Background: Alcohol and drug dependence are major health and economic burdens to society. One of the major challenges to reducing this burden will be to develop more effective and better tolerated medications that target alternative mechanisms in the brain. While the dopamine system has been well characterized for mediating the reward value of drugs, there is evidence that the endocrine system also conveys signals to the same neural systems using gut hormones. Summary: These gut hormones, produced in the stomach and intestine and that regulate food intake, have also been shown to control the use of other substances, such as alcohol and drugs of abuse. Examples of such hormones are ghrelin and glucagon-like peptide-1, which exert their effects on dopamine transmission in parts of the brain known to be involved in some of the core features of addiction, such as reward sensitivity. Key Messages: This raises the possibility that gut hormone systems may play a pivotal role in addictive disorders. This review will briefly outline emerging evidence that the ghrelin and glucagon-like peptide-1 hormones are contrasting mediators of alcohol and drug use and may present a promising alternative target for treatment intervention in addictive disorders. [ABSTRACT FROM AUTHOR]

Background: Medicinal plants that are abundant in physiologically active phytochemicals have long been used in traditional medicine. Due to their anti-inflammatory and antioxidant qualities, several of these can lower the chance of developing certain illnesses. Coccidiosis is a disease that affects many animals and results in large financial losses. Eimeria spp. strains that are resistant to drugs have emerged as a result of drug addiction and overuse. Therefore, Teucrium polium leaves ethanolic extract (TPLE) was assessed on behavioral performance for the animals injected with Eimeria papillata. Methods: T. polium leaves ethanolic extract (TPLE) was prepared. Also, the behavior of mice infected with the E. papillata parasite and treated with the plant extract was evaluated. In addition, eosin and hematoxylin-stained tissue sections of mice brains were made. Result: There was an improvement in the number of vertical and horizontal movements in the plant-treated group. In addition, there was an improvement in learning and memory through increased total latency time the number of crossings during the shock. Also declined the number of inertial crossings and several reinforced crossings during the shock. There were no changes in oxidative stress or brain histopathology. Our results showed that TPLE has improved the behavioral performance of mice, which promotes the conduct of numerous researches on the compounds found in plants and their effect on animal behavior and also in investigating the behavior of animals in response to infection and treatment. [ABSTRACT FROM AUTHOR]

We present findings from the Our Voice in Barú project, examining adolescent engagement in citizen science to address environmental and social factors affecting well-being in a semi-rural Afro-descendant community in Latin America. The project aimed to identify barriers and enablers of well-being, informing adolescent-led actions for sustainable environmental changes relevant to adolescent health. Utilizing the Our Voice citizen science method, which involved technology-enabled walks, participatory cartography workshops and community meetings, we engaged adolescents and other community members. Complex systems framework was employed to analyze results and assess the promotion of collective action and local change. Local enablers of well-being included availability of quality sports and recreational venues as safe spaces, educational settings and cultural aspects, fostering safety, community pride, and personal growth. Conversely, barriers included environmental contamination, deteriorated sports venues and drug addiction, indicating the community's limited access to services and exposure to harmful substances. Adolescent citizen scientists, in partnership with the research team and relevant community decision-makers, successfully achieved changes aimed at identified barriers, including infrastructural enhancements like the repair of pumps to remove stagnant water, improvements in the quality and safety of recreational venues, and the implementation of community-led initiatives to address substance abuse and promote healthier behaviors. The Our Voice in Barú project empowered adolescents to advocate for change and promoted collective action to tackle barriers identified as significant to their well-being. [ABSTRACT FROM AUTHOR]

A self-administered questionnaire for screening cigarette dependence was developed based on a set of 6335 Chinese adult smokers (termed the China Cigarette Dependence Test, CCDT). Both a 20-item version (CCDT-20) and a 7-item of the questionnaire (CCDT-7) were developed following 2-round of tests on their construct validity, test-retest reliability and internal consistency, covering seven dimensions (cigarettes per day, tolerance, withdrawal symptoms, craving, loss of control, regularity, and stereotypy). The results showed that the CCDT-20 and CCDT-7 scores were higher in daily smokers than in occasional smokers, and both were associated with self-rated nicotine dependence, exhaled carbon monoxide (CO), saliva cotinine, and DSM-V. The CCDT-20 and CCDT-7 scales were found to be easier to use by smokers in China and provided a more reliable measure of their cigarette dependence. [ABSTRACT FROM AUTHOR]

Aim: Contrary to expectations, studies of racial-ethnic disparities in substance use disorder (SUD) treatment frequently uncover minority-majority parity in access and utilization of services. What accounts for the anomaly? To answer the question, this study explores racial-ethnic differences in the odds of utilization of SUD treatment in varied settings (e.g., the criminal justice system, private doctor's office, etc.), adjusting for sources of treatment insurance, socioeconomic correlates of treatment (e.g., employment, income, education), as well as clients' clinical features (e.g., type of substance abuse/dependence, co-morbidities, health status). Methods: Data were compiled from the National Survey of Drug Use and Health (NSDUH) dataset, 2002-2014. The sample consisted of respondents with a past year diagnosis of a substance use disorder, who also reported having received treatment (n = 6,207). Data were pooled to maximize subgroup analyses. Weight- and design- adjusted logistic regressions were use to analyze factors predicting SUD treatment source. Results: Blacks were more likely than Whites to receive treatment through the criminal justice system and Whites more likely than Blacks and Latinx to receive treatment at a doctor's office. Blacks were also more likely than Whites to receive treatment through inpatient/outpatient rehabilitation, before adjustments but not afterwards. Discussion: In this study we show that even after adjusting for mechanisms expected to shape pathways from race-ethnicity to SUD treatment sites, significant racial-ethnic disparities persist. This fills an important gap in the literature in that disparities research has not explicitly modeled racial-ethnic variation across the full range of SUD treatment sites. [ABSTRACT FROM AUTHOR]

Background: Depression is frequently associated with unsuccessful smoking cessation. Objective: In this study, we investigated the impact of depression history on smoking cessation success in a clinical setting. Methods: This retrospective study included 726 patients who visited our smoking cessation clinic between January 1, 2001, and December 31, 2018. Kaplan–Meier analyses and Cox proportional hazards regression models were used to perform univariate and multivariate analyses of smoking cessation success factors. Results: Among the 726 patients, 76 had a history of depression and demonstrated significantly lower 12-week quit rate compared to those without (33.6% vs. 69.6%, p <.001). Multivariate Cox analysis revealed a significant association between abstinence rate and history of depression (hazard ratio 2.251, 95% CI 1.505–3.315, p <.001), history of schizophrenia (hazard ratio 2.716, 95% CI 1.427–4.840, p =.003), and Fagerström Nicotine Dependence Test scores (hazard ratio 1.519, 95% CI 1.053–2.197, p =.025). Conclusions: Our findings suggested that a history of depression is a significant prognostic factor for smoking cessation, underscoring the need for targeted interventions for patients with a history of depression. The findings of this study are subject to potential selection bias due to recruitment from a single hospital, which may limit the generalizability of our results. This study highlights the necessity for novel, specialized smoking cessation therapies to support patients with a history of depression in their cessation journey. [ABSTRACT FROM AUTHOR]

According to the Centers for Disease Control and Prevention (CDC), 100,306 drug overdose deaths occurred in the US during a 12-month period ending in April 2021. Opioids were involved in 75% of these related deaths. Opioid Use Disorder (OUD) is a constantly evolving public health crisis with potentially lethal consequences. In 2017, 900 adolescents began to misuse opioids every day. Nearly 10% of high school seniors reported using opioids nonmedically. Additionally, the incidence for hospitalizations for adolescents among children 1-19 years of age increased nearly 2-fold from 1997 to 2012. This data emphasizes the dangers associated with the increasing accessibility of pharmaceutical and non-pharmaceutical opioids, particularly for adolescents. All three of the currently FDA approved medications for OUD have shown clear efficacy in decreasing all-cause mortality in adults. It is proposed that the same effects should be seen in adolescents but limited data is present. A recent study analyzed buprenorphine and naltrexone treatment amongst OUD in adolescents between 2001-2014; only 1 in 4 youth received any medication therapy within six months of diagnosis. Adolescents under 16 were the most likely to receive medications. However, even adolescents aged 17, for whom buprenorphine is FDA approved for, were less likely to receive therapy than adults over 18 years of age. The following case report aims to demonstrate how subcutaneous extended release buprenorphine treatment can be initiated effectively as an outpatient in an adolescent with OUD. It is critical that clinicians work to expand access to pharmacotherapy for adolescents struggling with OUD to ensure proper management and reduction of opioid-related overdoses. [ABSTRACT FROM AUTHOR]

Objective: Pediatric loss‐of‐control (LOC) eating is associated with high BMI and predicts binge‐eating disorder and obesity onset with age. Research on the etiology of this common comorbidity has not explored the potential for shared genetic risk. This study examined genetic and environmental influences on LOC eating and its shared influence with BMI. Method: Participants were 499 monozygotic and 398 same‐sex dizygotic twins (age = 17.38 years ± 0.67, BMIz = 0.03 ± 1.03, 54% female) from the Colorado Center for Antisocial Drug Dependence Study. LOC eating was assessed dichotomously. Self‐reported height and weight were converted to BMIz. Univariate and bivariate twin models estimated genetic and environmental influences on LOC eating and BMIz. Results: More girls (21%) than boys (9%, p < 0.001) reported LOC eating. The phenotypic correlation with BMIz was 0.03 in girls and 0.18 in boys. Due to the nonsignificant phenotypic correlation in girls, bivariate twin models were fit in boys only. Across all models, the best‐fitting model included genetic and unique environmental effects. Genetic factors accounted for 0.51 (95% CI: 0.23, 0.73) of the variance of LOC eating in girls and 0.54 (0.18, 0.90) in boys. The genetic correlation between LOC eating and BMIz in boys was 0.45 (0.15, 0.75). Discussion: Findings indicate moderate heritability of LOC eating in adolescence, while emphasizing the role of unique environmental factors. In boys, LOC eating and BMIz share a proportion of their genetic influences. [ABSTRACT FROM AUTHOR]

Addiction is known to occur through the consumption of substances such as pharmaceuticals, illicit drugs, food, alcohol and tobacco. These addictions can be viewed as drug addiction, resulting from the ingestion of chemical substances contained in them. Multiple neural networks, including the reward system, anti‐reward/stress system and central immune system in the brain, are believed to be involved in the onset of drug addiction. Although various compound evaluations using microelectrode array (MEA) as an in vitro testing methods to evaluate neural activities have been conducted, methods for assessing addiction have not been established. In this study, we aimed to develop an in vitro method for assessing the addiction of compounds, as an alternative to animal experiments, using human iPS cell‐derived dopaminergic neurons with MEA measurements. MEA data before and after chronic exposure revealed specific changes in addictive compounds compared to non‐addictive compounds, demonstrating the ability to estimate addiction of compound. Additionally, conducting gene expression analysis on cultured samples after the tests revealed changes in the expression levels of various receptors (nicotine, dopamine and GABA) due to chronic administration of addictive compounds, suggesting the potential interpretation of these expression changes as addiction‐like responses in MEA measurements. The addiction assessment method using MEA measurements in human iPS cell‐derived dopaminergic neurons conducted in this study proves effective in evaluating addiction of compounds on human neural networks. [ABSTRACT FROM AUTHOR]

Increased allocation of behaviour to substance abuse at the expense of personal and social rewards is a hallmark of addiction that is reflected in several of DSM‐5 criteria for diagnosis of substance use disorder. Previous studies focused on refining the self‐administration (SA) model to better emulate an addictive state in laboratory animals. Here, we employed concurrent SA of sucrose pellets and morphine as two competing natural and drug rewards, respectively, to validate the feasibility of capturing pathological behavioural allocation in rats. A custom‐made three‐lever operant chamber was used. With one active and one inactive lever presented, rats were trained to self‐administer morphine (0.5 mg/kg/infusion; 2 h/day) under a fixed‐ratio 1 (FR‐1) schedule until a stable response was achieved. Next, they were trained to self‐administer morphine in the presence of a third lever dispensing sucrose pellets (20 mg) under FR‐1. Concurrent morphine‐sucrose SA sessions (2 h/day) were continued until stable morphine taking behaviour was re‐established. In another experiment, rats first established stable sucrose pellet SA (2 h/day, FR‐1) and then were trained to take morphine (0.5 mg/kg/infusion; 2 h/day). Subsequently, all rats underwent extinction training, in which morphine was replaced with saline while sucrose pellets were still available upon lever pressing, followed by cue‐induced reinstatement of morphine seeking behaviour. Results showed that rats retained morphine SA when sucrose pellets were also available, but they showed binge‐like sucrose intake when morphine was removed during the extinction sessions. However, morphine SA did not develop in rats that had previously established sucrose pellet SA. In conclusion, morphine SA developed even in the presence of a potent competing nondrug reward in rats. Adding an effort‐based contingent delivery of a natural reward to the standard SA model, this protocol may provide an improved model of drug addiction in laboratory animals. [ABSTRACT FROM AUTHOR]

Global drug policy is currently dominated by great enthusiasm about human rights, including the idea that rights can generate less punitive approaches to drugs. But if human rights were an effective framework for the prevention of punitive approaches towards drugs, why haven't they prevented them previously? One possibility is that rights are less reliable for those society considers 'less than human'. In Western liberal contexts that valorise voluntarity, rationality, authenticity, and order, people who use drugs figure as compulsive, irrational, duplicitous and chaotic. Rights can reproduce these logics of abjection, including through the repetition of ideas about drugs and proper ways of being. A body of critical drug scholarship seeks to intervene in these constructions. This work mobilises 'habit' as an otherwise to 'addiction' and argues that habit is the foundation of realities. Habits, and thus realities, can be changed. This paper draws on these approaches to explore whether insights from critical drug scholarship can help to generate something after rights, made possible by new habits and modes of connection. To make this argument, we consider habits as a site of both repetition and rupture. We ask whether habits can help us rethink or disrupt rights, and the 'human' therein. [ABSTRACT FROM AUTHOR]

Background: Individuals with opioid dependence often experience poor oral health, including dental decay, periodontal disease and mucosal infection, frequently exacerbated by factors such as smoking, alcohol consumption, inadequate oral hygiene and low utilisation of oral health services. This study aimed to assess oral health status and oral health-related quality of life (OHRQoL) among opioid-dependent individuals and explore their potential associations. Methods: Participants enrolled in an opioid treatment program (OTP) at three Australian urban clinics were assessed using the validated Oral Health Assessment Tool (OHAT) and Oral Health Impact Profile (OHIP-14). Results: The average age of the 75 participants was 44.7 years, with 45% receiving opioid treatment for over 5 years. Dental decay and inadequate oral hygiene were prevalent. Mean OHAT and OHIP-14 scores were 6.93 and 20.95 respectively, indicating moderate oral health severity and poor OHRQoL. Physical pain and psychological discomfort significantly impacted participants' quality of life, with the effects being particularly pronounced for those aged 30 and above. An exploratory analysis revealed a strong correlation between OHAT and OHIP-14 severity scores, with a one-point increase in OHAT associated with 1.85 times higher odds of a lower OHRQoL (odds ratio = 1.85, 95% confidence interval: 1.38–2.49, P = <0.001). Conclusions: These findings underscore the multifaceted impact of oral health on the well-being of OTP clients. Routine dental check-ups, education on oral hygiene practices and timely treatment for oral health problems are crucial recommendations based on this study. Such measures hold the potential to enhance the quality of life for individuals attending OTPs. Opioid-dependent individuals face substantial oral health challenges influenced by both opioid effects and lifestyle factors. This study investigated the oral health status and quality of life among opioid treatment program (OTP) clients, revealing prevalent dental caries and inadequate oral cleanliness, resulting in physical pain and psychological discomfort that impacted their quality of life. This identified correlation between oral health status and quality of life highlights the critical need for timely intervention to enhance the health and well-being of clients attending OTPs. [ABSTRACT FROM AUTHOR]

Objective: To explore the presence of drug dependence and Epilepsy in patients with PTC (Post Truamatic Contusions) balanced cautiously. Study Design: Proposed Reviewed Research study. Setting: Hayatabad Medical Complex, Peshawar. Period: July 2020 to December 2020. Methods: About 90% of patients aged between fifteen to sixtyfive years old identified with cerebral lesion and balanced cautiously were applied. Follow up sessions was provided to patients for 12to 18 months. Results: Among the enrolled patients, 23% established early PTS (Post Traumatic Seizures) and approximately established late PTS (Post Traumatic Seizures) from mild to moderate level of cerebral lesion. Patients having early signs of Post traumatic Seizure, about 6% utilized AEDs (Anti-epileptic Drugs) for about 3 months throughout the treatment period and about 7% of patients along with late Post Traumatic Seizures utilized AEDs. Moreover, approximately 8 percent patients established late post traumatic Seizure without considering any early signs of condition. Research findings indicated that only 3% of patients with early and late PTS actually required AEDs for at least 6 months. Although, about 44 percent of patients were utilizing Anti-epileptic drugs to control seizures. Sensible usage of Anti-epileptic drugs is familiar in our region, contributing to enhanced danger of medicine opposition and acquiring financial pressure on low-paid people in well-established state. Additionally, extreme usage of anti-epileptic and prophylactic drugs doesn't impact the occurrence of PTE (Post Traumatic Epilepsy). Conclusion: The presence of late and early post-traumatic epilepsy observed within our study is contrast to that explored in another research. Sensible production of AEDs is occured in our state, that increases the danger of medicine opposition and attain financial issues for economically destruct people in well-established states. Extreme usage of AEDs and prophylactic drugs doesn't have an important influence on stopping PTE. [ABSTRACT FROM AUTHOR]

Background: Alcohol use disorder (AUD) is thought to bias the neurocircuitry underlying reward processing and motivation to preferentially attend to conditioned alcohol cues over natural rewards. The present case–control pilot study evaluated this hypothesis using novel natural reward paradigms. Methods: Twenty‐eight participants (AUD, n = 14, light drinkers, n = 14) were recruited—AUD participants reported 44.0% heavy drinking days (%HDD) and 4.67 drinks/day over the preceding 90 days. Functional magnetic resonance imaging (fMRI) data were acquired during the administration of three separate picture‐viewing paradigms of alcohol cues, food scenes, and social reward, respectively. Independent samples t‐tests were performed to compare groups' fMRI data and exploratory correlation analyses were performed to examine associations with clinical characteristics of AUD. Results: Food scenes elicited abnormally low reward‐related activation, within the superior frontal gyrus and caudate bilaterally, among AUD participants. Lower activation to food scenes within the superior frontal gyrus was, in turn, associated with higher levels of past‐month %HDD among AUD participants, specifically, along with craving and alcohol dependence severity when examined across the full sample. Contrasting reward types (e.g., alcohol cues vs. food scenes) did not reveal "preferential" activation to differentiate groups. Conclusions: Heavy drinking appears associated with reduced responsivity to natural rewards, specifically food rather than social cues. Neural mechanisms underlying the high prevalence of malnutrition among individuals with AUD may involve some combination of blunted approach‐related affect and reduced craving‐related motivation to eat when food is present, resulting in limited engagement of cortico‐striato‐thalamic motor circuitry supporting food acquisition. However, given the preliminary nature of this pilot study, such formulations remain tentative until larger follow‐up studies can be conducted. From a potential translational standpoint, the ability of promising therapeutics to demonstrate increased responsivity to natural rewards, specifically nutritive reward may serve as a valuable complementary efficacy indicator for future clinical neuroimaging trials in AUD. [ABSTRACT FROM AUTHOR]

Background and aims: Opioid use disorder (OUD) and opioid dependence lead to significant morbidity and mortality, yet treatment retention, crucial for the effectiveness of medications like buprenorphine‐naloxone, remains unpredictable. Our objective was to determine the predictability of 6‐month retention in buprenorphine‐naloxone treatment using electronic health record (EHR) data from diverse clinical settings and to identify key predictors. Design: This retrospective observational study developed and validated machine learning‐based clinical risk prediction models using EHR data. Setting and cases: Data were sourced from Stanford University's healthcare system and Holmusk's NeuroBlu database, reflecting a wide range of healthcare settings. The study analyzed 1800 Stanford and 7957 NeuroBlu treatment encounters from 2008 to 2023 and from 2003 to 2023, respectively. Measurements Predict continuous prescription of buprenorphine‐naloxone for at least 6 months, without a gap of more than 30 days. The performance of machine learning prediction models was assessed by area under receiver operating characteristic (ROC‐AUC) analysis as well as precision, recall and calibration. To further validate our approach's clinical applicability, we conducted two secondary analyses: a time‐to‐event analysis on a single site to estimate the duration of buprenorphine‐naloxone treatment continuity evaluated by the C‐index and a comparative evaluation against predictions made by three human clinical experts. Findings Attrition rates at 6 months were 58% (NeuroBlu) and 61% (Stanford). Prediction models trained and internally validated on NeuroBlu data achieved ROC‐AUCs up to 75.8 (95% confidence interval [CI] = 73.6–78.0). Addiction medicine specialists' predictions show a ROC‐AUC of 67.8 (95% CI = 50.4–85.2). Time‐to‐event analysis on Stanford data indicated a median treatment retention time of 65 days, with random survival forest model achieving an average C‐index of 65.9. The top predictor of treatment retention identified included the diagnosis of opioid dependence. Conclusions: US patients with opioid use disorder or opioid dependence treated with buprenorphine‐naloxone prescriptions appear to have a high (∼60%) treatment attrition by 6 months. Machine learning models trained on diverse electronic health record datasets appear to be able to predict treatment continuity with accuracy comparable to that of clinical experts. [ABSTRACT FROM AUTHOR]

Between 30 and 40% of 18-year olds in England, Wales and Northern Ireland enter tertiary education (university) each year. Young adulthood (ages 15 to 25) is the usual period in which problems with alcohol, drugs or other behaviors begin to emerge, and yet these issues have received limited study in the UK. Government policy dictates that a full continuum of treatment and recovery services should be available in each area of the country, but uptake of these services by university students appears to be limited. In this discussion paper we describe the background to, and components of, the Collegiate Recovery Program (CRP), an initiative that has grown rapidly in the USA in the past decade. We then describe how the first UK University-led CRP was set up, before outlining what has been learnt so far and the potential challenges facing this approach. [ABSTRACT FROM AUTHOR]

Background: Chronic pain and opioid misuse are a prevalent comorbidity with deleterious health outcomes. Growing work indicates that posttraumatic stress disorder (PTSD) can increase the risk for chronic pain and opioid misuse and dependence. However, there is little understanding of social determinants of health (SDoH) that may account for interrelations of PTSD with chronic pain and opioid misuse and dependence. Health literacy is one relevant SDoH construct, reflecting the ability to gather, process, and comprehend health-related information required to engage in a healthcare setting. Objective: The purpose of the present cross-sectional study was to examine the indirect effect of health literacy in the association between PTSD and opioid misuse, opioid dependence, pain intensity, and pain disability. Method: The sample included 142 adults (Mage = 35.2, SD = 9.9; 67.4% female; 70.1% White/Caucasian) with self-reported chronic pain and probable PTSD who were using opioid medication. Results: Results demonstrated that PTSD symptom severity had a small indirect effect on opioid misuse and opioid dependence via health literacy; no indirect effects were evident for pain intensity and disability. Conclusion: The present investigation provides evidence that health literacy may serve as an important explanatory factor in associations between PTSD symptom severity and opioid misuse and dependence among adults with co-occurring probable PTSD and chronic pain. [ABSTRACT FROM AUTHOR]

Background: Rhinitis medicomentosa (RM) is a form of non-allergic rhinitis caused by the use of nasal decongestants for longer than the recommended duration. Because of this problem of use, addiction to the drug occurs in individuals. In our study, we aimed to evaluate the susceptibility of RM patients to substance addiction. Methods: The study was planned as a prospective, multicentric study between September 2022 and September 2023. Patients diagnosed with RM were included in the study. Beck depression scale, Drug use disorders identification test, Substance Abuse Proclivity Scale were applied to the patients participating in the study. The research data were analyzed electronically with SPSS program version 25. Results: The study included 86 patients with an average age of 31 years. The average duration of medication use was 22 months. Age, gender, duration of nasal congestion, duration of drug use and smoking were not independent predictors for depression and substance use tendency. Conclusion: The relationship between RM and addictive substances is not clear. The tendency to use drugs did not increase in RM patients. In the light of these data, we think that there is no need for a practice other than routine functioning in the use of drugs and similar substances that are likely to cause addiction in RM patients. [ABSTRACT FROM AUTHOR]

The concept of recovery has emerged as a prominent paradigm to understand processes of change in individuals with substance use problems. To date, most studies have focused on personal recovery as the key driving force of recovery journeys, generally individualizing the often-disabling social realities that persons in recovery face. To counterbalance this bias, this paper focuses on the contextual dynamics at stake during recovery processes, based on the lived experiences of 30 persons in drug addiction recovery in Flanders (Belgium). A Lifeline Interview Method was applied to elicit recovery narratives, which were thematically analysed. We found that interpersonal relationships, enabling and disabling places, and socio-economic factors facilitate or impede recovery in meaningful ways. The findings also show how these diverse contextual dimensions are interrelated and ambiguous. Researchers, policymakers, and treatment providers should acknowledge the relational nature of recovery and the invalidating impact of stigma across the three identified contextual levels. [ABSTRACT FROM AUTHOR]

Persistent neurochemical and biological disturbances resulting from repeated cycles of drug reward, withdrawal, and relapse contribute to drug dependence. Methamphetamine (MA) is a psychostimulant with substantial abuse potential and neurotoxic effects, primarily affecting monoamine neurotransmitter systems in the brain. In this study, we aimed to explore the progression of drug dependence in rat models of MA self-administration, extinction, and reinstatement through targeted and non-targeted metabolomics analyses. Metabolic profiles were examined in rat plasma during the following phases: after 16 days of MA self-administration (Group M); after 16 days of self-administration followed by 14 days of extinction (Group MS); and after self-administration and extinction followed by a reinstatement injection of MA (Group MSM). Each group of MA self-administration, extinction, and reinstatement induces distinct changes in the metabolic pathways, particularly those related to the TCA cycle, arginine and proline metabolism, and arginine biosynthesis. Additionally, the downregulation of glycerophospholipids and sphingomyelins in Group MSM suggests their potential role in MA reinstatement. These alterations may signify the progressive deterioration of these metabolic pathways, possibly contributing to drug dependence following repeated cycles of drug reward, withdrawal, and relapse. These results provide valuable insights into the metabolic changes associated with MA use at various stages, potentially facilitating the discovery of early diagnostic biomarkers and therapeutic targets for MA use disorders. [ABSTRACT FROM AUTHOR]

A Brain-Computer Interface (BCI) is a system that allows a person to control external devices using only their brain activity. It works by translating brain signals into commands that can be understood by a computer. Several lines of evidence demonstrated the deleterious effect of methamphetamine (MA) on neurological and psychological functions. The use of amphetamines, such as MA, is associated with cerebrovascular complications such as cerebrovascular accidents (CVA), hemorrhage, hypoxic damage and vasculitis. Interestingly, while changes to cerebral blood flow (CBF) in response to acute amphetamine exposure have been reported. Transcranial Color Doppler (TCCD) is a non-invasive medical imaging technique that uses ultrasound waves to measure blood flow velocity in the major arteries of the brain, specifically within the circle of Willis. The research paper you referenced explores the use of TCCD as a potential measurement modality for BCIs. Quantitative electroencephalogram (qEEG) is a powerful tool for understanding brain function qEEG can reveal specific brain wave patterns associated with drug addiction, potentially providing insights into the neurobiological mechanisms underlying cravings, withdrawal symptoms, and relapse risk in Methamphetamine User Disorder (MUD). There is growing research interest in using Transcranial dopller as a measurement modality for BCIs.Here are some of the key considerations for using Transcranial doppler in BCIs: Mental Tasks, signal processing and classification, accuracy and reliability. Transcranial doppler provides information about blood flow in specific arteries but lacks detailed spatial information about brain activity. These patterns could vary depending on the type of drug, the severity of addiction, and individual differences. Transcranial doppler in measuring middle cerebral artery (MCA) blood flow velocity parameters (peak systolic velocity (PSV) and mean flow velocity (MFV)). qEEG can help researchers investigate the complex interplay between addiction and other brain disorders, like depression or anxiety. Characteristic qEEG in drugs addiction Increased Theta (4-8 Hz) and delta (1-4 Hz) brain waves are often associated with sleep and relaxation. However, research has shown that individuals with drug addiction may have increased theta and delta activity, particularly in the frontal and temporal regions of the brain. Altered Beta (13-30 Hz) brain waves are generally associated with wakefulness, alertness, and cognitive processing. Studies have observed both increases and decreases in beta activity in individuals with drug addiction, depending on the type of drug, the stage of addiction, and the specific brain regions being examined. The results of this research have important practical implications for building an diagnostic and functional assement with a better understanding of an using technology. [ABSTRACT FROM AUTHOR]

Background: Addiction to smartphone is defined as the disability to cease using the device despite the physical, psychological, or social consequences. The diagnosis of this disorder is increasing exponentially among teenagers, even more so after Corona Virus Disease 2019 (COVID-19) pandemic. This study aims to analyze the risk of mobile phone addiction among teenagers in Italy and its relationship with other risk behaviors, such as drug consumption and emotional well-being, following the COVID-19 pandemic. Methods: A cross-sectional observational study was conducted in Catania, Sicily, during 2022. The study sample comprised 342 students from a secondary education center that answered to a validated Italian version of the Smartphone Addiction Scale Short Version (SAS-SV) accessing through computers and mobile devices. Subjective Wellbeing was measured with the Personal Wellbeing Index-School Children (PWI-SC). Also, they completed the NIAAA Brief Alcohol Use Screener. Results: Our results showed that 30.1% of students who participated in the survey were classified with a smartphone addiction. Besides, most of the participants used the Smartphone for social networks (86.0%). Regarding the other aspects measured, the mean self-perceived well-being score measured with the PWI-SC was 55.5, and 36.2% of participants were categorized as "high risk" for depression. Finally, four out of ten participants were at "moderate or high risk" of an alcohol use disorder. Conclusions: Our results suggest that the use of mobile phones is increasing in adolescents, an age group also exposed to social and health problems. [ABSTRACT FROM AUTHOR]

Introduction: Overdose deaths from high-potency synthetic opioids, including fentanyl and its analogs, continue to rise along with emergency department (ED) visits for complications of opioid use disorder (OUD). Fentanyl accumulates in adipose tissue; although rare, this increases the risk of precipitated withdrawal in patients upon buprenorphine initiation. Many EDs have implemented medication for opioid use disorder (MOUD) programs using buprenorphine. However, few offer methadone, a proven therapy without the risk of precipitated withdrawal associated with buprenorphine initiation. We describe the addition of an ED-initiated methadone treatment pathway and compared its 72-hour follow-up outpatient treatment engagement rates to our existing ED-initiated buprenorphine MOUD program. Methods: We expanded our ED MOUD program with a methadone treatment pathway. From February 20–September 19, 2023, we screened 20,504 ED arrivals; 5.1% had signs of OUD. We enrolled 61 patients: 28 in the methadone; and 33 in the buprenorphine pathways. For patients who screened positive for opioid use, shared decision-making was employed to determine whether buprenorphine or methadone therapy was more appropriate. Patients in the methadone pathway received their first dose of up to 30 milligrams (mg) of methadone in the ED. Two additional methadone doses of up to 40 mg were dispensed at the time of the ED visit and held in the department, allowing patients to return each day for observed dosing until intake at an opioid treatment program (OTP). We compared 72-hour rates of outpatient follow-up treatment engagement at the OTP (for those on methadone) or at the addiction treatment center (ATC) (for those on buprenorphine) for the two treatment pathways. Results: Of the 28 patients enrolled in the methadone pathway, 12 (43%) successfully engaged in follow-up treatment at the OTP. Of the 33 patients enrolled in the buprenorphine pathway, 15 (45%) successfully engaged in follow-up treatment at the ATC (relative risk 1.06; 95% confidence interval 0.60–1.87). Conclusion: Methadone initiation in the ED to treat patients with OUD resulted in similar 72-hour followup outpatient treatment engagement rates compared to ED-buprenorphine initiation, providing another viable option for MOUD. [ABSTRACT FROM AUTHOR]

Simple Summary: This review delves into the differences between two important groups of dopamine-producing brain cells, found in regions called the ventral tegmental area and the substantia nigra. While these cells are located close to each other, they play different roles in the brain and are affected differently by diseases like Parkinson's. Understanding these differences is key to developing better treatments and more selective, without causing unwanted effects on other brain functions. This review discusses how these cells are structured, how they connect to other parts of the brain, how they function, and the differences during development. The goal is to provide insights that could lead to more precise therapies, targeting specific groups of cells without harming others. This research is important for advancing treatments for brain disorders and improving our understanding of the brain's complex wiring. Dopaminergic neurons in the ventral tegmental area (VTA) and the substantia nigra pars compacta (SNpc) comprise around 75% of all dopaminergic neurons in the human brain. While both groups of dopaminergic neurons are in close proximity in the midbrain and partially overlap, development, function, and impairments in these two classes of neurons are highly diverse. The molecular and cellular mechanisms underlying these differences are not yet fully understood, but research over the past decade has highlighted the need to differentiate between these two classes of dopaminergic neurons during their development and in the mature brain. This differentiation is crucial not only for understanding fundamental circuitry formation in the brain but also for developing therapies targeted to specific dopaminergic neuron classes without affecting others. In this review, we summarize the state of the art in our understanding of the differences between the dopaminergic neurons of the VTA and the SNpc, such as anatomy, structure, morphology, output and input, electrophysiology, development, and disorders, and discuss the current technologies and methods available for studying these two classes of dopaminergic neurons, highlighting their advantages, limitations, and the necessary improvements required to achieve more-precise therapeutic interventions. [ABSTRACT FROM AUTHOR]

Background: Drug addiction, characterized by compulsive drug use and high relapse rates, arises from complex interactions between reward and aversion systems in the brain. The paraventricular nucleus (PVN), located in the anterior hypothalamus, serves as a neuroendocrine center and is a key component of the hypothalamic–pituitary–adrenal axis. Objective: This review aimed to explore how the PVN impacts reward and aversion in drug addiction through stress responses and emotional regulation and to evaluate the potential of PVN as a therapeutic target for drug addiction. Methods: We review the current literature, focusing on three main neuron types in the PVN—corticotropin‐releasing factor, oxytocin, and arginine vasopressin neurons—as well as other related neurons, to understand their roles in modulating addiction. Results: Existing studies highlight the PVN as a key mediator in addiction, playing a dual role in reward and aversion systems. These findings are crucial for understanding addiction mechanisms and developing targeted therapies. Conclusion: The role of PVN in stress response and emotional regulation suggests its potential as a therapeutic target in drug addiction, offering new insights for addiction treatment. [ABSTRACT FROM AUTHOR]

Objectives: To investigate the effects of Toll-like receptor 4 (TLR4) -nuclear factor кВ (NFKB)-P38 and C-C chemokine receptor 5 (CCR5)- (inositol triphosphate) IP3 signaling pathways on the neuroimmunity of glial cells in propofol-dependent rats. Methods: In vitro experiments: the effect of propofol drug dependence on BV2 (mouse microglia) cell activity were detected and compared by cell counting kit-8 (CCK-8) kit. The effect of propofol drug dependence on the apoptosis rate of BV2 cells were compared by flow cytometry. The effects of different concentrations of propofol on BV2 cytokines [tumor necrosis factor-a (TNF-a), chemokine ligand 2 (CCL2) and CCL5] were compared. The expressions of TLR4, p65, phosphorylated-p65 (p-p65), extracellular regulated protein kinase (ERK) 1/2 and p-ERK1/2 were detected and compared by Western blot (WB). Animal experiments: 24 SD rats were used to establish a propofol drug dependence model and divided into three groups: blank group (injected with the same amount of normal saline, n=8), propofol drug dependence model group (injected with 40 mg/kg propofol and normal saline, n=8), isobuprost (IBU) pretreatment + propofol intervention group (injected with 7.5 mg/kg IBU, n = 8 ). The addictive effect of propofol were evaluated by conditioned place preference (CPP) and moving distance. The levels of serum cytokines (CCL2, CCL5 and TNF-a) and the expression of related proteins in prefrontal cortex of SD rat model were detected and compared. Results: Compared with blank group, the levels of CCL2, CCL5 and TNF-a in propofol 15 µM intervention group were increased (P < 0.05) The levels of CCL2, CCL5 and TNF-a in propofol 20 µ.M intervention group were increased (P < 0.05) Compared with blank group, the levels of CCL2, CCL5 and TNF-a in propofol intervention group were increased (P < 0.05) compared with propofol intervention group, the levels of CCL2, CCL5 and TNF-α in IBU pretreatment + propofol intervention group were significantly decreased (P < 0.05) . Compared with blank group, the expression of TLR4 protein in propofol intervention group and IBU pretreatment + propofol intervention group was significantly increased, and the expression of p-p65 and p-ERK1/2 protein was significantly up-regulated (P < 0.05) there was no significant difference in the expression of p65 and ERK1/2 protein (P > 0.05) Compared with propofol intervention group, the expression of TLR4, p-p65 and p-ERK1/2 protein in IBU pretreatment + propofol intervention group was significantly decreased (P < 0.05) Compared with blank group, the CPP value in propofol intervention group was significantly increased (P < 0.05) compared with propofol intervention group, the CPP value in IBU pretreatment + propofol intervention group was significantly decreased (P < 0.05) Compared with blank group, the difference in the moving distance between propofol intervention group and blank group was statistically significant (P < 0.05) Compared with propofol intervention group, the IBU pretreatment + propofol intervention group also showed a tendency to reduce the moving distance (P < 0.05) In the frontal cortex of rats, compared with blank group, the levels of CCL2, CCL5 and TNF-a in propofol intervention group were significantly increased (P < 0.05) Compared with propofol intervention group, the levels of CCL2, CCL5 and TNF-a in IBU pretreatment + propofol intervention group were significantly decreased (P < 0.05) Compared with blank group, the expression of TLR4 protein, p-p65 and p-ERK1/2 in prefrontal cortex of the propofol intervention group were significantly increased (P < 0.05) . Compared with propofol intervention group, the expression of TLR4 protein, p-p65 and p-ERK1/2 in prefrontal cortex of the IBU pretreatment + propofol intervention group were significantly decreased (P < 0.05) Conclusion: TLR4-NFKB-P38 and CCR5-IP3 signaling pathways may be involved in the role of neuroimmune regulation in propofol drug dependence. [ABSTRACT FROM AUTHOR]

This study aimed to explore disordered eating behaviors in gender-affirming treatment (GAT)-seeking transgender (TG) adults and cisgender people, in addition to analyzing the association between gender dysphoria intensity, body mass index, and disordered eating behaviors. Data were collected from 132 GAT-seeking TG people with gender dysphoria who had never received GAT (91 TG men, 41 TG women), and 153 cisgender (99 cisgender men, 54 cisgender women) participants from Turkey. The Utrecht Gender Dysphoria Scale was used to evaluate the intensity of gender dysphoria. Eating Disorder Examination Questionnaire and Questionnaire on Eating and Weight Patterns-5 were utilized to assess disordered eating. There was no difference between TG women and TG men in terms of ED psychopathology. The most prominent characteristic in all four groups was shape concern, which was significantly higher in TG men and TG women when compared to cisgender men and cisgender women. Binge eating was notably more frequent in TG men and TG women compared to cisgender men, with 11% of the TG men and 7.3% of the TG women meeting the criteria for possible binge eating disorder. Screening for disordered eating behaviors, particularly binge eating, may be recommended in routine care for TG people. [ABSTRACT FROM AUTHOR]

Self-immolation represents a relatively frequent cause of burn, especially in Tunisia after the revolution, with high costs at the individual and societal level. In this retrospective study, we report epidemiological, clinical and evolutionary characteristics of burns by immolation at the CTB of Tunis over a period of 10 years. The study involved 755 patients over the 10 years. The mean age was 33.38 years with a sex ratio of 4.5:1 (618 M/ 137F). Half of the patients (51%) were single, 2/3 (74.3%) had an unfavourable or medium socioeconomic level, 35.8% were unemployed. The educational level was secondary in 46% of cases and primary in 33.9%. Secondary transfer was noted in 53.6% of cases with agreement in 57.8%. The patients came from all regions of Tunisia with a predominance of those from the Tunis area (37.8%). One third of our patients had a psychiatric history, with the notion of a previous suicide attempt in 5.1% of cases. Alcoholism and/or drug addiction was reported in 17.7% of cases. The act of self-immolation was performed in a public place in 59.2% of cases. TBSA was 41.48%. Burns were deep in 66.2% of cases. Facial involvement was noted in 90% of patients. ABSI was 7.35 and Baux index 78 +/- 50. The average length of stay was 17.64 days. 2/3 of patients (72.1%) required intubation and mechanical ventilation. The mortality rate was 57.2%. [ABSTRACT FROM AUTHOR]

Background: The number of persons using opioids has increased worldwide in the last decade, particularly the use of opioid analgesics in North America and Africa. In Germany, the prevalence of heroin addiction has remained relatively stable. Method: Narrative review of the literature. Results: Opioid-assisted maintenance treatment (OMT) with the established substances methadone, levomethadone, slow-release morphine and buprenorphine is recommended as the first-line treatment for heroin dependence. The OMT reduces the use of heroin, mortality and individual suffering and improves the quality of life and physical health. A diamorphine and heroine-assisted treatment is an option for people who do not benefit from conventional OMT. An alternative to the use of diamorphine could be treatment with hydromorphone hydrochloride. The regulations on carrying out maintenance treatment in the Controlled Substances Prescription Act and the guidelines of the Federal Medical Association in Germany have been loosened based on the experiences of the COVID-19 pandemic, for example with respect to take-home prescriptions. There is an ongoing intensive discussion on how to deal with the decreasing number of outpatient clinics offering OMT. Conclusion: The first-line treatment for opioid addiction is opioid-assisted substitution treatment, including diamorphine and heroin-assisted treatment. Long-acting depot medications and implants still play a subordinate role. [ABSTRACT FROM AUTHOR]

Introduction: There is evidence that providers often overprescribe opiates in the postoperative period. Despite an ever-growing geriatric population, there is little research detailing current opiate usage in older patients after trauma. This population presents a unique set of challenges for pain management and prescription drug dependence due to sensitivity, a narrow therapeutic window, and high rates of pre-existing polypharmacy. Objective: Assess the use of narcotics in geriatric trauma patients with various injury patterns to establish a reference point for future intervention for reduction in narcotic dependence. Methods: We created a database of trauma patients' age ≥65 years admitted to a single level 1 trauma center in the Southeastern United States during the 2019 calendar year. Information gathered included patient factors, injury patterns, operative intervention, pain medications prescribed during hospitalization and at discharge, total and average daily morphine milligram equivalents (MME) inpatient and outpatient, and requests/prescriptions for narcotics at follow-up. Results: In 2019, there were 475 patients aged ≥65 admitted to our level 1 trauma center for acute traumatic injuries. 219 of those patients required operative intervention. Average total inpatient MME for this cohort was 169.0 with average daily MME of 22.89. The average total prescribed MME upon discharge was 79.27. There were 29 patients documented to request narcotic prescription refill at time of clinic follow-up, 27 of whom were prescribed a narcotic medication at follow-up. Conclusion: This dataset establishes a reference point for opiate use in geriatric trauma patients to facilitate further research for mitigation of risk in this population. [ABSTRACT FROM AUTHOR]

Ketamine and esketamine have been proven to be effective in treating adults with treatment resistant depression (TRD). Preliminary evidence indicates that, when combined with behavioral and psychological interventions, both agents may offer benefits for individuals with substance use disorder (SUD) and alcohol use disorder (AUD). Notwithstanding, concerns have been raised as to whether either or both agents are associated with abuse and/or gateway activity. Herein, we evaluate disproportionate reporting expressed as reporting odds ratios (ROR) for esketamine and ketamine. The outcomes of interest include alcohol problem, alcoholism, alcohol abuse, substance dependence, SUD, substance abuse, drug dependence, drug use disorder and drug abuse as codified by the Medical Dictionary for Regulatory Activities (MedDRA) within the FAERS. The IC025 values were significant for ketamine in cases of alcohol abuse (0.28), substance dependence (1.88), substance use disorder (0.996), substance abuse (0.61), drug dependence (0.56), drug use disorder (1.17) and drug abuse (1.22). Additionally, oxycontin showed significant IC025 values for substance dependence (0.067), substance use disorder (0.094), substance abuse (0.035), and drug dependence (0.27). We observed significant increases in the reporting odds ratios (RORs) for ketamine with respect to various outcomes: alcohol abuse (ROR 2.84, 95 % CI 1.53–5.28; p = 0.0010), substance dependence (ROR 18.72, 95 % CI 8.49–41.30; p ≤ 0.0001), SUD (ROR 11.40, 95 % CI 4.24–30.65; p ≤ 0.0001), substance abuse (ROR 2.29, 95 % CI 1.73–3.04; p ≤ 0.0001), drug dependence (ROR 1.99, 95 % CI 1.64–2.42; p ≤ 0.0001), drug use disorder (ROR 4.50, 2.94–6.88; p ≤ 0.0001) and drug abuse (ROR 3.72, 3.36–4.12; p ≤ 0.0001). For esketamine, we observed that the ROR was significantly reduced for substance abuse (ROR 0.37, 95 % CI 0.22–0.63; p = 0.0003), drug dependence (ROR 0.13, 95 % CI 0.076–0.23; p ≤ 0.0001) and drug abuse (ROR 0.048, 95 % CI 0.030–0.078; p ≤ 0.0001). To our knowledge, this is the first report of spontaneous adverse events related to these outcomes of interest in the FAERS. Mixed RORs were observed across aspects of SUD and AUD for both ketamine and esketamine. Due to limitations in the FAERS, establishing causal links between new onset alcohol and substance misuse with either agent remains inconclusive. Possible beneficial effects on measures of SUD and AUD were observed. It is currently unclear, but possible, whether both agents have differential ameliorative effects across dimensions of SUD and AUD, which is a focus of ongoing research. • Mixed RORs were observed across aspects of SUD and AUD for ketamine & esketamine • Due to limitations of FAERS, causal links between new onset alcohol and substance misuse with either agent is inconclusive • Possible beneficial effects on measures of SUD and AUD were observed • It is unclear if both agents have differential ameliorative effects across dimensions of SUD & AUD [ABSTRACT FROM AUTHOR]

Rationale: Methamphetamine addiction is a persistent and intractable pathological learning and memory, whereas no approved therapeutics is available. However, few attentions have been paid to how associative learning participates in the formation of intractable memory related to drug addiction Objectives and methods: To investigate the role of associative learning in methamphetamine addiction and the underlying neurobiological mechanism, methamphetamine self-administration, oral sucrose self-administration, chemogenetic neuromanipulation, and fiber photometry in mice were performed in this study. Results: We reported that associative learning increased methamphetamine-induced self-administration, but not oral sucrose self-administration. In addition, the enhancement of methamphetamine-induced self-administration was independent of more methamphetamine consumption, and remained with higher drug-taking and motivation in the absence of visual cues, suggesting the direct effects of the associative learning that enhanced methamphetamine-induced self-administration. Moreover, chemogenetic inactivation of the secondary visual cortex (V2) reduced the enhancement of the drug-taking induced by associative learning but did not alter sucrose-taking. Further fiber photometry of V2 neurons demonstrated that methamphetamine-associative learning elicits V2 neuron excitation, and sucrose-associative learning elicits V2 neuron inhibition. Conclusions: Therefore, this study reveals the neurobiological mechanism of V2 excitability underlying how associative learning participates in the formation of intractable memory related to drug addiction, and gives evidence to support V2 as a promising target for stimulation therapy for methamphetamine addiction. [ABSTRACT FROM AUTHOR]

Objective: Negative urgency (i.e., acting rashly when experiencing negative affect; NU), is a theorised maintenance factor in binge‐eating type eating disorders. This study examined the association between trait NU and eating disorder severity, momentary changes in state NU surrounding episodes of binge eating, and the momentary mechanistic link between affect, rash action, and binge‐eating risk. Methods: Participants were 112 individuals with binge‐eating disorder (BED). Baseline measures included the UPPS‐P Impulsive Behaviour Scale to assess trait NU and the Eating Disorders Examination to assess binge‐eating frequency and global eating disorder severity. Ecological momentary assessment captured real‐time data on binge eating, negative affect, and state NU. Results: Multiple regression analysis revealed a strong association between trait NU and eating disorder severity. Generalised estimating equations showed that state NU increased before and decreased after binge‐eating episodes, and that this pattern was not moderated by trait‐level NU. Finally, a multilevel structural equation model indicated that increases in rash action mediated the momentary relationship between states of high negative affect and episodes of binge eating. Conclusion: These findings underscore the importance of both trait and state NU in binge‐eating type eating disorders, and suggest NU as a potential key target for intervention. Highlights: Trait negative urgency (tNU) appears to be a marker of disorder severity, potentially above and beyond binge frequencyState urgency significantly increased prior to binge eating and decreased following binge eating, regardless of tNUMoments of high negative affect predict increases in subsequent rash action, and that this impulsivity is predictive of a greater likelihood of a binge‐eating episode [ABSTRACT FROM AUTHOR]