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Concealable stigmatized identities (CSIs) are identities that can be kept hidden and carry negative stereotypes. To understand the potential influence instructors have as role models, we must first explore the identities instructors have and whether they disclose those identities to undergraduates. We surveyed national samples of science instructors (n = 1248) and undergraduates (n = 2428) at research institutions to assess the extent to which instructors hold CSIs, whether they reveal those identities to undergraduates, how the prevalence of CSIs among instructors compares to their prevalence among undergraduates, and the reasons instructors reveal or conceal their CSIs. The most common CSIs instructors reported were having anxiety (35%) and being a first-generation college student (29%). Relatively few instructors revealed CSIs to students. The largest mismatches of CSI prevalence were for struggling academically in college (-30%) and having anxiety (-25%); all mismatches grew when accounting for instructor CSI disclosure, highlighting that students perceive fewer role models of scientists with CSIs than actually exist.

This paper considers the ethical and practical issues of recruiting for, and administering a quantitative survey with marginalised populations. These issues were identified through a focus group discussion, which consolidated and expanded upon informal conversations held previously by five researchers about their experiences of conducting a face-to-face survey (using predominantly quantitative questions) with people who used amphetamine type substances in North East England, UK. Inductive and deductive thematic analysis of the focus group discussion led to the generation of three key themes: researcher positionality, emotions, and role dilemmas; study design; and ethics in practice. This paper therefore aims to extend literature which explores ethical and practical issues involved in studies with marginalised populations. It makes methodological suggestions for how work across a range of disciplines could make face-to-face survey research, and future studies with marginalised populations, more inclusive for both participants and researchers.

The COVID-19 pandemic resulted in increased parenting stress and substance use. At the same time that mental health and social service needs increased, access to services, including among those receiving treatment, decreased due to stay-at-home orders. Few programs were equipped or prepared to translate their interventions to a virtual format at the start of the pandemic. There is a critical need to identify effective adaptations to substance use and family-focused treatment during the COVID-19 pandemic. Effective program adaptations have continued relevance for the expansion of access to family-focused addiction services beyond the pandemic itself, particularly for rural or other hard to reach populations. Seventy-three semi-structured interviews were conducted with the five agencies participating in the implementation of the In-Home Recovery Program (IHRP), an in-home, substance use disorder (SUD) treatment program. Using a rapid analysis approach two coders analyzed interviews for recurring concepts and themes. Facilitators for adapting services included: (1) the introduction of virtual toxicology screens, (2) helping parents access technology, (3) assisting parents with non-identified children to decrease their stress, and (4) anticipating reoccurrences of substances during the pandemic. Barriers to adapting services included: (1) engaging young children in virtual treatment, (2) privacy, and (3) engaging in telehealth with parents experiencing domestic violence or reoccurrence of substances. Findings reveal virtual substance use treatment is possible. Facilitators to adaptation such as providing access to technology and virtual toxicology screens demonstrate the feasibility and acceptability of utilizing telehealth interventions for substance use. Barriers to adaptations were primarily related to the infant mental health component. Telehealth is likely not appropriate for children below the age of five. Individual sessions focusing on caregiving, rather than dyadic treatment may be more suitable to virtual formats.

This paper draws on findings from the From Adversity to University project, a unique widening participation initiative developed by one university to support a diverse range of people into Higher Education through engagement with a 12-week bridging module. This small-scale case study presents an in-depth exploration of how learning space shaped students' experience of a bridging module during the COVID-19 pandemic. Space is conceptualised through a theory of embodied cognition which recognises the complexity of social, cultural, and cognitive inter-relations between space and students' learning experience. An interpretative narrative methodological approach was taken, drawing on the Listening Guide [LG]. Semi-structured interviews were carried out with five students who completed the bridging module during the start of the COVID-19 pandemic. All had been affected by homelessness and most were in recovery from alcohol and/or drug addiction. For all participants, there was a complex and dynamic interconnectivity between learning spaces and their experience of the bridging module. The findings demonstrate for the five students how learning spaces (including the flexibility of the space) contributed to participants' sense of belonging, recovery from drugs and alcohol addiction, mental health and well-being. Implications of the study point towards the need for further research into the connection between learning space and the creation of a sense of belonging particularly for students from marginalised groups.

Counselor trainees in recovery from substance use often have a foundational recovery identity; they also develop a professional counselor identity through their training. This study utilized narrative inquiry to explore the integration of professional identity and recovery identity. Resonant threads and narrative tensions emerged from the storied experiences of participants.

Objective: The current study examined the mediating role of distress tolerance on the association between pain-related disability and addiction to opioids, past-month opioid use, and risky opioid use among an ethno-racially diverse sample of young adults with current pain. Methods: Participants were 141 undergraduate college students (78.7% female, M age = 22.50, SD = 5.41) who reported experiencing current pain. Results: Results indicated that distress tolerance statistically significantly explained the relationship between pain-related disability and addiction to opioids, past-month opioid use, and risky opioid use after controlling for the variance accounted for by pain intensity, negative affectivity, gender, and other substance misuses. Conclusions: Clinical implications are discussed in terms of targeting distress tolerance in the context of pain-related disability among young adults with pain who are at risk for opioid misuse.

The Alternative DSM-5 Model for Personality Disorders (AMPD) consists of level of personality functioning (Criterion A) and maladaptive personality traits (Criterion B). The brief scale versions of these are understudied, while often being used by clinicians and researchers. In this study, we wanted to investigate the overlap and predictive validity of Criterion A and B. Participants (N = 253) were measured on level of personality functioning (LPFS-BF) and maladaptive personality traits (PID-5-BF), as well as internalizing outcomes such existential meaninglessness (EMS) and externalizing outcomes such as substance and behavioral addictions (SSAB). Data analysis was conducted with principal component analysis (PCA) and regression analyses. The results showed over 50% overlap between the brief versions of Criterion A and B, while Criterion B slightly outperformed Criterion A in outcomes of EMS and SSAB. We discuss the potential redundancy and usefulness of personality functioning and maladaptive personality traits.

Objective: This study assessed undergraduate unhealthy substance use, levels of knowledge about opioid pharmacology, unhealthy use and safety, and students' perceptions about their level of knowledge. Participants: Participants were undergraduate students at a large, private university in the Northeast. Methods: This study employed a cross-sectional study design using an online survey. A convenience sample of undergraduate students (N = 317) described their actual and perceived levels of opioid knowledge and their self-reported substance use. Results: Objective answers to quiz-style questions about opioids showed knowledge deficits. Participants rated themselves as slightly less knowledgeable than the "average student." Ten percent of students surveyed had used opioids unhealthily at some point in their lifetime. Those reporting unhealthy opioid use had higher subjective and objective opioid knowledge scores. Conclusions: University students' subjective and objective knowledge of opioids warrants more effective and engaging substance use education on college campuses.

Background: E-cigarette prevention education aims to mitigate adolescent e-cigarette use. Such education is increasingly delivered through virtual/video-based teaching platforms (e.g. Zoom, Google Classrooms). However, there is little evidence about the effectiveness of virtual e-cigarette education compared to in-person education on adolescents' knowledge about e-cigarettes, perceived addictiveness and intent to try e-cigarettes, cigarettes, and marijuana. Objective: To evaluate the effectiveness of virtual e-cigarette education compared to in-person education on student knowledge and perceived addictiveness of e-cigarettes and intent to try e-cigarettes. Design, Setting and Method: We conducted a pre- and post-education evaluation among 10 middle and high school students in the Greater Birmingham area, Alabama, who were non-randomly assigned to receive either virtual (n = 745) or in-person e-cigarette education (n = 286) (mean age: 14.36 years). The study used a 25-minute educational presentation about the health effects of e-cigarettes, the risks of second- and third-hand smoke, the addictive nature of nicotine, and marketing strategies of e-cigarette companies. Participants completed a 10-minute self-administered survey immediately before and after the presentation. Results and conclusion: Except for certain e-cigarette knowledge-related items, our study shows that both virtual and in-person education had similar effects on improving knowledge about e-cigarettes, increasing perceived addictiveness and reducing intent to try e-cigarettes, cigarettes and marijuana among participants. Virtual education may be applied where in-person education is not feasible (e.g. in rural communities).

Background: Exercise has been recognized as a promising and emerging treatment for individuals recovering from addiction. The purpose of this article was to systematically review scientific studies using exercise as a means to improve, sustain, or treat addictions, and to provide suggestions for the future use of exercise as a treatment method for addiction. Methods: Using PRISMA guidelines, a database search was conducted for articles that tested the impact of exercise interventions on addiction-related outcomes. To be included, peer-reviewed experimental design studies had to use human subjects to investigate the relationship between exercise and the treatment of or recovery from addiction. Garrard's Matrix Method was used to extract data from reviewed articles (n = 53). Results: Nearly three quarters of the studies reviewed documented a significant change in addiction-related outcomes (e.g., more days abstinent, reduced cravings) in response to exercise exposure, particularly while someone was receiving treatment at an in or outpatient clinic. Many studies investigated the effect of acute bouts of exercise on nicotine dependence, and many studies had small sample sizes, leaving room for future research on how exercise might benefit people recovering from substance and process addictions. Conclusion: Results affirm that exercise can be a helpful aspect of addiction treatment. Future researchers should investigate different exercise settings (e.g., group-based exercise vs individual) and explore exercise maintenance and the long-term outcomes following discharge from treatment facilities.

Introduction: Opioid use disorder (OUD) is a critical health issue in the USA. Pennsylvania has the third highest number of drug overdose deaths per year, with the COVID-19 pandemic worsening these trends. Stigmatising beliefs towards OUD are associated with negative health outcomes, and there is a need for a larger evidence base on OUD stigma reduction strategies. This study reports on the creation and implementation of "Life Unites Us," a digital media campaign which uses a collective impact framework to address OUD stigma reduction across Pennsylvania. Method: "Life Unites Us" consists of various components, including a general public media campaign which uses education and contact-based strategies; engagement with stakeholders and advocates in community-based organisations across the state; and a data sharing website to inform the public of previously unavailable OUD stigma statistics. Each campaign component contributes to the overall collective impact framework. Results: Digital metrics showed 755 followers across the "Life Unites Us" social media pages, and 2,826 total website users with an average of 565 users per month. The campaign has partnered with 60 community based organisations, 921 individuals receive the monthly email and 11 influencers have posted 23 times and achieved over 13,000 engagements and a reach of 661,000. The campaign hosted 5 webinars with 520 attendees and an overall 64.1% attendance rate. Conclusion: This study fills a gap in the need for evidence-based digital interventions to address OUD-related stigma. The positive process metrics from the first 6 months suggest that this model may be an important addition to research on approaches to reduce OUD stigma.

This article presents a modified version of the bridge drawing assessment administered to a substance use disorder population at admission and discharge from a residential addiction treatment center. Following an overview of the bridge drawing assessment and method, the authors present two case descriptions that illustrate how the modified task enabled clients to visualize and understand their transition process, as well obstacles they were less consciously aware of, such as fears and de-motivators. Equally, clients' strengths, aptitudes, and hopes were brought into more conscious awareness.

An autobiographical, narrative art therapy approach to treat drug addiction was co-developed at the Methadone Clinic of Muhimbili National Hospital, Dar-es-Salaam, Tanzania. The 10-session art therapy intervention included a group of 7 men. The protocol, as illustrated with a case example, suggests that it could help resolve deep-seated pain, decrease shame, and increase self-esteem.

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]

Peer recovery coaches (PRCs) are increasingly playing a role in helping patients with substance use disorders engage with treatment. PRCs can support and motivate patients in meeting their self-defined recovery goals, engaging in addiction treatment, navigating the health care system, and overcoming barriers to recovery. This support increases patient engagement and is cost-effective. Little has been written about integrating PRCs in health care settings. In this column, the authors describe the implementation of a PRC program with 23 coaches serving 5,662 participants in diverse clinical settings. The authors discuss key facilitators and barriers and opportunities for further research. [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: In 2008, the European Association of Neuroscience Nursing (EANN) initiated the NeuroBlend™ project, which aimed to delineate the roles and competencies of neuroscience nurses across Europe. This project resulted in the development of the European Competence Profile (ECP), intended to standardize educational pathways and professional recognition for this specialized field. Aim: This study examines the relevance of neuroscience nursing practices to the competencies outlined in NeuroBlend™ across different Italian care settings, including multiple sclerosis, pediatric neurosurgery, pediatric neurology, Alzheimer's disease, and substance addiction. Methods: A phenomenological approach was employed, utilizing focus groups to gather the perspectives of nurses on the competencies defined by the NeuroBlend™ model. The focus groups were conducted from May 2022 to September 2022. The data collected from the focus groups were analyzed using thematic analysis. Results: Thirty nurses participated in the focus groups. Thematic analysis revealed the core competencies, such as communication, empathy, flexibility, and reflective skills, as critical in all care settings. The main themes that emerged were relationships with patients and families, personalized care, and continuity of care. Conclusions: The competencies outlined in the NeuroBlend™ framework are vital to the role of neuroscience nurses in the settings studied and remain highly relevant in the context of Italian healthcare. [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]