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Background: The COVID-19 pandemic impacted patients with substance use disorder (SUD) more than the general population and resulted in substantially increased emergency department admissions. Routine care of patients attending drug health services during the pandemic transitioned, with telehealth being important in delivering appropriate care. However, telehealth introduces unique risks such as privacy, confidentiality, and data safety. Providing health care through telehealth may fail if the legal impacts are not fully identified and acted on by health professionals. It also poses unintended risks for patients and can result in ineffectiveness, damages, medical negligence, and detracts from the best intentions of governments and health professionals. Understanding the legal framework ensures that medical professionals operate health care through telehealth within the law. Providing health care successfully through telehealth depends on the balance between innovation and legal compliance. By considering these aspects, clinicians and practitioners can provide effective and safe telehealth services during pandemics or any other natural disaster., Objective: We aimed to explore the legal impact of autonomy consent, confidentiality, privacy, data security, professional indemnity, and liability when delivering telehealth to patients with SUD. The scoping review also aimed to provide legal, ethical, and clinical considerations to minimize legal risks with using telehealth in drug health service outpatient settings., Methods: We performed a scoping review to provide an overview of existing research, statutes, and case laws for the incorporation of clinical, ethical, and legal considerations into telehealth use. Six databases for medical and 6 databases for legal publications were searched, as well as Australian national and selected international regulatory standards. Medical articles published up to June 2022 were included in this review. Our search yielded 1436 publications, 614 abstracts were reviewed, and 80 published studies met the inclusion criteria from 614 legal and medical search results. Current regulations related to technology use in drug health services, relevant cases, and international regulatory standards are discussed., Results: In total, 43 legal documents including 15 statutes, 4 case laws, and 37 medical publications were reviewed. The themes arising from the literature were consent and autonomy (20/80, 25%), confidentiality (8/80, 10%), privacy (8/80, 10%), data security (7/80, 9%), and professional indemnity issues (3/80, 4%) in telehealth use. Further, 24 studies identified legal issues associated with telehealth use in patients with SUD., Conclusions: Our review identified potential legal issues associated with telehealth use in patients with SUD. Several legal and medical research articles provide frameworks, codes of conduct, or suggestions for clinicians to consider, but there was little discussion or evidence of how legal considerations are being applied when providing telehealth consultations at drug health services. Clinicians should be aware of the medicolegal implications when providing health care via telehealth at drug health services., (©Meryem Jefferies, Robert Graham, Marguerite Tracy, Scott Read, Mohammed Eslam, Mark W Douglas, Jacob George. Originally published in the Journal of Medical Internet Research (https://www.jmir.org), 12.11.2024.)

Background: Drug addiction is a significant public health concern, and aggression is common among people with drug addiction. Despite mounting evidence showing that the Dark Triad is a risk factor for aggression, the mediating and moderating mechanisms underlying this relationship are less known. This study tested the mediation effect of self-control in the association between the Dark Triad and aggression and whether this mediation was moderated by physical exercise., Methods: A cross-sectional study was conducted in two compulsory drug rehabilitation centers in Nanning, China. A convenience sample of 564 drug abstainers completed a questionnaire to assess their Dark Triad, self-control, aggression, and physical exercise levels. Mediation and moderation analyses were carried out in SPSS macro-PROCESS., Results: Self-control partially mediated the positive association between the Dark Triad and aggression. Physical exercise moderated the indirect effect of the Dark Triad on aggression via self-control, with the effect decreasing with the increase in physical exercise levels., Conclusions: This study offers fresh insights into the underlying mediating and moderating mechanisms between the Dark Triad and aggression. The findings provide important practical implications for future intervention and prevention programs to address aggression among drug abstainers, which may be realized through strengthening self-control and physical exercise., (© 2024. The Author(s).)

The drug addiction is one of most serious deviant behavior seriously harming both addict person and one's relationship. The drug using is considered as deviant because means using substances from non-legal turn-over or applied in non-medical purposes. Then follows degradation of health of person and one's positioning into physical and mental dependence on them. With time, personal dependence on drugs becomes stronger. The addicted person looses possibility to experience joy from natural stimuli and more difficulties in controlling drug using appear. Persons using drugs frequently commit crimes to have money to maintain one's dependence. Therefore, issues of prevention narcotism and struggle with drug addiction are fundamental ones for whole system of prevention in Novorossiysk. The article presents analysis of implemented activities and adopted measures of struggle with drug addiction in population of Novorossiysk.

More than 60% of individuals recovering from substance use disorder relapse within one year. Some will resume drug consumption even after decades of abstinence. The cognitive and psychological mechanisms that lead to relapse are not completely understood, but stressful life experiences and external stimuli that are associated with past drug-taking are known to play a primary role. Stressors and cues elicit memories of drug-induced euphoria and the expectation of relief from current anxiety, igniting an intense craving to use again; positive experiences and supportive environments may mitigate relapse. We present a mathematical model of relapse in drug addiction that draws on known psychiatric concepts such as the "positive activation; negative activation" paradigm and the "peak-end" rule to construct a relapse rate that depends on external factors (intensity and timing of life events) and individual traits (mental responses to these events). We analyze which combinations and ordering of stressors, cues, and positive events lead to the largest relapse probability and propose interventions to minimize the likelihood of relapse. We find that the best protective factor is exposure to a mild, yet continuous, source of contentment, rather than large, episodic jolts of happiness., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 The Author(s). Published by Elsevier Inc. All rights reserved.)

Background: Prevalence of substance use disorders (SUD) is high among adolescents and young adults (AYAs) with complex medical needs. Little is known about risk factors for SUD in this population., Methods: This retrospective cohort study used electronic health record data from a large academic hospital system (2015-2019) to identify adolescents (aged 10-17) and young adults (aged 18-27) with intellectual/developmental disorders, psychiatric conditions, or complex medical conditions. Logistic regression was used to identify demographic, clinical, and neighborhood-level risk factors associated with SUD in this population., Results: A total of 149 adolescents and 536 young adults had a SUD diagnosis (6.7% and 20.6%, respectively). Among adolescents, notable risk factors for SUD included age (adjusted odds ratio [aOR] = 1.42, 95% confidence interval [CI] = [1.31, 1.54]), Hispanic ethnicity (aOR = 2.10, 95% CI = [1.10, 3.99]), additional psychoactive medication classes (aOR = 1.27, 95% CI = [1.11, 1.46]), and living in a "high" child opportunity index (COI) (aOR = 2.06, 95% CI [1.02, 4.14]) or a "very high" COI (aOR = 3.04, 95% CI [1.56,5.95]) area. Among young adults, notable risk factors included being male (aOR = 2.41, 95% CI [1.91, 3.05]), being Black (aOR = 1.64, 95% CI [1.28, 2.09]), and additional non-psychoactive (aOR = 1.07, 95% CI [1.03, 1.11]) or psychoactive medication classes (aOR = 1.17, 95% CI [1.07, 1.28])., Limitations: These descriptive analyses are limited to one large academic hospital system in North Carolina and may not be representative of all high-need AYAs in the state., Conclusions: Several demographic, clinical, and neighborhood risk factors are associated with SUD in high-need AYAs., Competing Interests: Funding: The funder/sponsor did not participate in the work. Declaration of interests: This research was partially supported by a National Research Service Award Pre-Doctoral/Post-Doctoral Traineeship from the Agency for Healthcare Research and Quality spon­sored by The Cecil G. Sheps Center for Health Services Research, The University of North Carolina at Chapel Hill, Grant No. T32-HS000032., (Copyright ©2024 by the North Carolina Institute of Medicine and The Duke Endowment. All rights reserved.)

Objectives: Recovery from drug addiction often poses challenges for the recovering person. The coping mechanisms employed by these individuals to resist temptations and manage stress play a key role in the healing process. This study was conducted to explore the coping strategies or techniques that individuals with addiction use to handle stress and temptation while undergoing treatment., Methods: A qualitative meta-synthesis approach was utilized to critically evaluate relevant qualitative research. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020 guidelines were used for article selection, with these standards applied to 4 academic databases: Scopus, PubMed, ProQuest, and CINAHL. The present review included studies published between 2014 and 2023, selected based on pre-established inclusion criteria. The quality of the studies was assessed using the Critical Appraisal Skills Programme Qualitative Studies Checklist. This review was registered with the International Prospective Register of Systematic Reviews (PROSPERO) under the registration number CRD42024497789., Results: The analysis of 13 qualifying qualitative articles revealed 5 major themes illustrating the coping mechanisms employed in the pursuit of recovery by individuals who use drugs. These themes include seeking social support, as well as psychological coping strategies, spiritual experiences, professional interventions, and the enhancement of awareness., Conclusions: Among individuals with drug addiction, coping mechanisms are crucial for resisting stress and temptations throughout the recovery process. Healthcare professionals, as medical specialists, can establish more thorough and effective plans to support these patients on their path to recovery.

Background: Drug addiction is a serious problem worldwide and is influenced by genetic factors. The present study aimed to investigate the association between genetics and drug addiction among Han Chinese., Methods: A total of 1000 Chinese users of illicit drugs and 9693 healthy controls were enrolled and underwent single nucleotide polymorphism (SNP)-based and haplotype-based association analyses via whole-genome genotyping., Results: Both single-SNP and haplotype tests revealed associations between illicit drug use and several immune-related genes in the major histocompatibility complex (MHC) region (SNP association: log 10 BF = 15.135, p = 1.054e-18; haplotype association: log 10 BF = 20.925, p = 2.065e-24). These genes may affect the risk of drug addiction via modulation of the neuroimmune system. The single-SNP test exclusively reported genome-wide significant associations between rs3782886 (SNP association: log 10 BF = 8.726, p = 4.842e-11) in BRAP and rs671 (SNP association: log 10 BF = 7.406, p = 9.333e-10) in ALDH2 and drug addiction. The haplotype test exclusively reported a genome-wide significant association (haplotype association: log 10 BF = 7.607, p = 3.342e-11) between a region with allelic heterogeneity on chromosome 22 and drug addiction, which may be involved in the pathway of vitamin B12 transport and metabolism, indicating a causal link between lower vitamin B12 levels and methamphetamine addiction., Conclusions: These findings provide new insights into risk-modeling and the prevention and treatment of methamphetamine and heroin dependence, which may further contribute to potential novel therapeutic approaches., (© 2024. The Author(s).)

The article presents an attempt to evaluate what factors could contribute into significant changes of both amount and structure of social cost of drug consumption in the region. The analysis, based on preserved basic principles of assessment, was applied to processes that occurred in both state and non-state spheres. The purpose of the study was to analyze main causes of dynamics of social cost of drug consumption during re-assessment., Materials and Methods: The social cost of drug consumption in the Samara Oblast was re-assessed in 2017-2020 (first assessment was implemented in 2007-2010). The main causes of increasing of social cost of drug consumption were analyzed on the basis of the study results., Results: In Samara Oblast, due to financial and structural changes in state and non-state spheres, occurred increasing of social cost of drug consumption from 18.0 billion to 25.4 billion rubles per year. At that, percentage of social cost of drug consumption in the gross domestic product decreased from 2.9% to 1.6%. In general structure of expenses greatest changes affected percentage of social aftermath of drug addiction (increase from 17.8% to 26.1%) and expenses of drug consumers (decrease from 69.7% to 62.3%)., Conclusions: The increase of absolute values of financial expenditures of the Oblast related to drug consumption conditioned by financial and structural changes in society, is accompanied by decreasing of percentage of ocial cost of drug consumption in value of gross domestic product. The main cause of its dynamics is significant increasing of gross regional product.

Background and Aims: Ketamine use as a recreational drug is becoming more popular nowadays. Ketamine-induced uropathy (KIU) is a late finding observed with long-term use of ketamine. A systematic review of Ketamine-Induced Uropathy was performed to emphasise its key clinical manifestations, mechanism of action and establish an effective treatment pathway., Methods and Results: A literature search was conducted in MEDLINE via Pubmed and Cochrane using the keywords ketamine and bladder, ketamine and uropathy, and ketamine and epidemiology. The search strategy was limited to articles published from 2000 to 2023. Both animal and human studies were included. A total of 101 papers were reviewed based on topic relevance from the title and abstracts available. While ketamine is a controlled drug in the United Kingdom (UK) and other countries, 283 ketamine-related deaths have been reported in the UK. There is no definite pathogenesis but multiple potential mechanisms that cause KIU and its related symptoms. KIU involves chronic inflammation of the bladder, ureteral wall thickening, hydronephrosis and finally, chronic renal failure. A multidisciplinary approach is paramount when managing these patients to break the vicious cycle. The mainstay of medical and surgical treatment pathways is continued abstinence to prevent symptom relapse. This review included the pathophysiology, novel medical treatments and surgical management of KIU., Conclusion: KIU is a rare but significantly disabling condition often seen among ketamine abusers. With the rising trend in drug addiction, KIU is expected to be more common. Unfortunately, it is a late complication in chronic ketamine abusers and is only partially reversible even with abstinence. This review discusses this rare entity's newer medical treatments and surgical options., Competing Interests: Declaration of conflicting interestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

The aim of this article is to revisit the multivariate causes of drug use. From the initial drive to experiment, to a progression towards dependence, this review endeavours to extrapolate the aetiology of causation. In doing so, prevalence of, and attitudes towards drug use are firstly examined. Influences on why people use illicit drugs are subsequently explored through the lens of established risk factors. Drug use and dependence are embedded within a complex interplay of invidual, genetic, cultural, and socio-economic components. By exploring the aetiology of drug use in a holistic sense, this will not only aid the therapeutic quality of intervention from clinicians, but enable the development of more comprehensive and tailored intervention plans in supporting recovery., (© 2023. The Author(s), under exclusive licence to Royal Academy of Medicine in Ireland.)

Building on the premises of Positive Psychology, this undertaking conducted a pilot study of the designed 14-session Positive Psychology Intervention (PPI) program established based on the character strengths and virtues (CSV) of persons who use drugs (PWUDs) to assess its usefulness, delivery details, and impacts. Conducted in one of the biggest Drug Abuse Treatment and Rehabilitation Center in the Philippines, 24 PWUDs were randomly selected by the program staff to participate in its pilot run while securing all necessary ethical guidelines and requirements. Via within-subjects pretest-posttest experimental design, the especially adapted and developed tools were used to assess the PWUDs' progress as they were facilitated by the said program. Results yielded significant improvements in the PWUDs' mental wellbeing ( M   =   1.29 , SD =  0.35; t (21) = 9.30, P  < .00001), life satisfaction ( M   =   1.82 , SD  =   0.24; t (21) = 9.89, P  < .00001), and psychological functioning ( M   =   1.65 , SD  =   0.19; t (21) = 8.58, P  < .00001). Moreover, the PWUDs regarded the designed PPI program very highly and experienced it with positive outcomes, especially for their CSVs. Further improvement of the said program centers around proper time allotment, number of participants in the program sessions, appropriate activities per session, including specific ice breaker games, activity materials needed, and the proper sequencing of each session. These data are used to improve the PPI program structures and components. Pertinent conclusions about the gathered data were drawn, and relevant recommendations were also thereby provided., Competing Interests: Declaration of Conflicting InterestsThe author declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Background: Substance use trends are complex; they often rapidly evolve and necessitate an intersectional approach in research, service, and policy making. Current and emerging digital tools related to substance use are promising but also create a range of challenges and opportunities., Objective: This paper reports on a backcasting exercise aimed at the development of a roadmap that identifies values, challenges, facilitators, and milestones to achieve optimal use of digital tools in the substance use field by 2030., Methods: A backcasting exercise method was adopted, wherein the core elements are identifying key values, challenges, facilitators, milestones, cornerstones and a current, desired, and future scenario. A structured approach was used by means of (1) an Open Science Framework page as a web-based collaborative working space and (2) key stakeholders' collaborative engagement during the 2022 Lisbon Addiction Conference., Results: The identified key values were digital rights, evidence-based tools, user-friendliness, accessibility and availability, and person-centeredness. The key challenges identified were ethical funding, regulations, commercialization, best practice models, digital literacy, and access or reach. The key facilitators identified were scientific research, interoperable infrastructure and a culture of innovation, expertise, ethical funding, user-friendly designs, and digital rights and regulations. A range of milestones were identified. The overarching identified cornerstones consisted of creating ethical frameworks, increasing access to digital tools, and continuous trend analysis., Conclusions: The use of digital tools in the field of substance use is linked to a range of risks and opportunities that need to be managed. The current trajectories of the use of such tools are heavily influenced by large multinational for-profit companies with relatively little involvement of key stakeholders such as people who use drugs, service providers, and researchers. The current funding models are problematic and lack the necessary flexibility associated with best practice business approaches such as lean and agile principles to design and execute customer discovery methods. Accessibility and availability, digital rights, user-friendly design, and person-focused approaches should be at the forefront in the further development of digital tools. Global legislative and technical infrastructures by means of a global action plan and strategy are necessary and should include ethical frameworks, accessibility of digital tools for substance use, and continuous trend analysis as cornerstones., (©Florian Scheibein, Elsa Caballeria, Md Abu Taher, Sidharth Arya, Angus Bancroft, Lisa Dannatt, Charlotte De Kock, Nazish Idrees Chaudhary, Roberto Perez Gayo, Abhishek Ghosh, Lillian Gelberg, Cees Goos, Rebecca Gordon, Antoni Gual, Penelope Hill, Iga Jeziorska, Eliza Kurcevič, Aleksey Lakhov, Ishwor Maharjan, Silvia Matrai, Nirvana Morgan, Ilias Paraskevopoulos, Zrinka Puharić, Goodman Sibeko, Jan Stola, Marcela Tiburcio, Joseph Tay Wee Teck, Zaza Tsereteli, Hugo López-Pelayo. Originally published in JMIR Human Factors (https://humanfactors.jmir.org), 12.12.2023.)

Drug abuse has a high prevalence worldwide and causes many health-related disorders. There are limited human exposure studies on establishing lead exposure levels and their propensity for drug addiction. In the present study, blood samples were tested for lead (Pb) concentrations in illicit drug users together with the related symptoms in comparison with control group of non-drug users. The study was performed on 250 volunteers divided equally in four drug groups, namely, opioids, hashish, methadone, and methamphetamine, and one control group of non-drug users. Participants were recruited from drug addiction clinics and camps in Kashan city, Iran, who were using drugs continuously for more than 1 year. Control group was recruited from companions of the patients with no drug use history. In the investigated groups of drug users, the highest blood-lead level (BLL) concentrations were observed in the opioid group (mean 37.57 µg/dL) with almost 3.7 times higher than in the control group (mean 3.39 µg/dL). In the methamphetamine group, type of occupation had the significant association with BLL concentrations. The positive correlation was revealed in the opioid and methadone groups for BLL concentrations and the duration of drug usage. In the opioid group, the highest BLL concentrations were observed among users who used both methods of drug use: smoking and eating. Also, several behavioral and life-style factors were identified which influence the blood-lead concentration in the drug users. The results of our study revealed that the BLL concentrations in investigated drug users' groups were significantly higher than in the control group (P < 0.001). That can be related with the Pb contents in illicitly used drugs. Apart other adverse health effects, long-term illicit drug use might cause to lead poisoning., (© 2023. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

Background: Violence occurs frequently in the life of forensic psychiatric patients, both as active aggression and in the form of victimization. Undoubtedly, these incidents shape personality, behavior, and affect the ability to interact adequately socially. Thus, such experiences may influence criminal recidivism and serve as forensic psychiatric/psychological predictors upon hospital discharge., Methods: Hence, this study aimed at characterizing two distinct female forensic psychiatric patient populations (nonsubstance use mental disorders [ n  = 110] versus substance use disorder [ n  = 415]) regarding their active and passive violent experiences as well as contextualizing these with their individual crime recidivism rates. The analysis followed a record-based, retrospective approach., Results: While both groups experienced aggression throughout childhood and youth equally often, substance use disorder patients were significantly more often exposed to violence during adulthood. On the other hand, severely mentally ill patients tended to react more often with violence during their hospital confinement. However, regarding their violent recidivism rate, no intergroup effects were observed. Finally, within the addicted group, a violent index crime as well as physical aggression during hospital confinement increased the odds for violent reoffending by approximately 2.4-fold (95% confidence interval 1.3-4.5) and 2.5-fold (95% confidence interval 1.1-5.9), respectively., Conclusion: In summary, these findings underline the importance of active aggression rather than victimization as an influencing factor on resocialization especially in a substance use disorder patient population.

Understandings of drug addiction recovery are still being debated. Research on perspectives from first-hand experiences with recovery is rare and often contains short-term experiences in the context of a treatment setting. We aim to gain further understanding of recovery by analyzing autobiographical data from persons in different stages of drug addiction recovery who are not linked to any specific treatment service. We conducted 30 in-depth qualitative interviews with participants from various parts of the Netherlands. Participants self-identified as being "in recovery" or "recovered" from drug addiction for at least 3 months. Men and women are equally represented, and the sample consists of an equal number of participants in early (<1 year, n = 10), sustained (1-5 years, n = 10), and stable (>5 years, n = 10) recovery. We undertook a data-driven thematic analysis. Participants described that recovery is a broad process of change because addiction is interwoven with everything (theme 1); that recovery is reconsidering identity, seeing things in a new light (theme 2); that recovery is a staged long-term process (theme 3); and that universal life processes are part of recovery (theme 4). Thus, Drug addiction recovery is experienced as an interwoven long-term process, including identity change and common or universal life processes. Policy and clinical practice should therefore be aimed at supporting long-term tailored recovery goals and disseminating first-hand recovery experiences to enhance long-term outcomes and reduce stigmatization.

Drug addiction is a leading cause of disability worldwide, with more than 70,000 Americans dying from drug overdose in 2019 alone. While only a small percentage of chronic drug users escalate to drug addiction, little is understood on the precise mechanisms of this susceptibility. Early life adversity is causally relevant to adult psychiatric disease and may contribute to the risk of addiction. Here we review recent pre-clinical evidence showing that early life exposure to stress and/or drugs regulates changes in behavior, gene expression, and the epigenome that persist into adulthood. We summarize the major findings and gaps in the preclinical literature, highlighting studies that demonstrate the often profound differences between female and male subjects., Competing Interests: Declaration of competing interest We declare no competing interests., (Copyright © 2023 The Authors. Published by Elsevier Inc. All rights reserved.)

Substance Use Disorder (SUD) is one of the major mental illnesses that is terrifically intensifying worldwide. It is becoming overwhelming due to limited options for treatment. The complexity of addiction disorders is the main impediment to understanding the pathophysiology of the illness. Hence, unveiling the complexity of the brain through basic research, identification of novel signaling pathways, the discovery of new drug targets, and advancement in cutting-edge technologies will help control this disorder. Additionally, there is a great hope of controlling the SUDs through immunotherapeutic measures like therapeutic antibodies and vaccines. Vaccines have played a cardinal role in eliminating many diseases like polio, measles, and smallpox. Further, vaccines have controlled many diseases like cholera, dengue, diphtheria, Haemophilus influenza type b (Hib), human papillomavirus, influenza, Japanese encephalitis, etc. Recently, COVID-19 was controlled in many countries by vaccination. Currently, continuous effort is done to develop vaccines against nicotine, cocaine, morphine, methamphetamine, and heroin. Antibody therapy against SUDs is another important area where serious attention is required. Antibodies have contributed substantially against many serious diseases like diphtheria, rabies, Crohn's disease, asthma, rheumatoid arthritis, and bladder cancer. Antibody therapy is gaining immense momentum due to its success rate in cancer treatment. Furthermore, enormous advancement has been made in antibody therapy due to the generation of high-efficiency humanized antibodies with a long half-life. The advantage of antibody therapy is its instant outcome. This article's main highlight is discussing the drug targets of SUDs and their associated mechanisms. Importantly, we have also discussed the scope of prophylactic measures to eliminate drug dependence., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2023 Elsevier B.V. All rights reserved.)

Background: The COVID-19 pandemic and measures have placed various burdens on societies and individuals. Emerging evidence suggests that people in drug addiction recovery were negatively affected. This study investigates whether risk and protective factors associated with return to problematic substance use differed between the periods before and during the pandemic for those in recovery., Methods: A convenience sample of persons in drug addiction recovery for at least three months completed an assessment at baseline before the pandemic (T0, N = 367) and at two consecutive follow-ups 12 months apart (T1, N = 311; T2, N = 246). The final follow-up took place during the pandemic (2020-2021). We analyzed rates and predictors of problematic substance use in both periods, and whether relations between predictors and problematic use differed between the periods., Results: Rates of problematic use did not differ significantly before and during the pandemic for those who were followed-up. However, the relationship between problematic use and commitment to sobriety differed between both periods (OR = 3.24, P = 0.010), as higher commitment was only associated with lower odds of problematic use during (OR = 0.27, P < 0.001), but not before, the pandemic (OR = 0.93, P = 0.762). In both periods, persons who were engaged in psychosocial support had lower odds of problematic use., Conclusions: The COVID-19 pandemic was not followed by significant return to problematic substance use in a cohort of people who were already in drug addiction recovery for some time before the pandemic. However, with restricted access to environmental resources, they may have been more dependent on internal motivations. Targeting personal recovery resources with interventions could therefore reduce the chances of return to problematic substance use during a pandemic., Competing Interests: Declaration of competing interest No conflict declared., (Copyright © 2023 The Authors. Published by Elsevier Inc. All rights reserved.)

α 3 β 4 Nicotinic acetylcholine receptor (nAChR) has been recognized as an emerging biomarker for the early detection of drug addiction. Herein, α 3 β 4 nAChR ligands were designed and synthesized to improve the binding affinity and selectivity of two lead compounds, ( S ) - QND8 and ( S ) - T2 , for the development of an α 3 β 4 nAChR tracer. The structural modification was achieved by retaining the key features and expanding the molecular structure with a benzyloxy group to increase the lipophilicity for blood-brain barrier penetration and to extend the ligand-receptor interaction. The preserved key features are a fluorine atom for radiotracer development and a p -hydroxyl motif for ligand-receptor binding affinity. Four ( R )- and ( S )-quinuclidine-triazole ( AK1 - AK4 ) were synthesized and the binding affinity, together with selectivity to α 3 β 4 nAChR subtype, were determined by competitive radioligand binding assay using [ 3 H]epibatidine as a radioligand. Among all modified compounds, AK3 showed the highest binding affinity and selectivity to α 3 β 4 nAChR with a K i value of 3.18 nM, comparable to ( S ) - QND8 and ( S ) - T2 and 3069-fold higher affinity to α 3 β 4 nAChR in comparison to α 7 nAChR. The α 3 β 4 nAChR selectivity of AK3 was considerably higher than those of ( S ) - QND8 (11.8-fold) and ( S ) - T2 (294-fold). AK3 was shown to be a promising α 3 β 4 nAChR tracer for further development as a radiotracer for drug addiction.

Drug abuse is a serious problem worldwide. Owing to intermittent intake of certain substances and the early inconspicuous clinical symptoms, this brings huge challenges for timely diagnosing addiction status and preventing substance use disorders (SUDs). As a non-invasive technique, neuroimaging can capture neurobiological signatures of abnormality in multiple brain regions caused by drug consumption in each clinical stage, like parenchymal morphology alteration as well as aberrant functional activity and connectivity of cerebral areas, making it realizable to diagnosis, prediction and even preemptive therapy of addiction. Machine learning (ML) algorithms primarily used for classification have been extensively applied in analysing medical imaging datasets. Significant neurobiological characteristics employed and revealed by classifiers were used to diagnose addictive states and predict initiation and vulnerability to drug usage, treatment abstinence, relapse and resilience of addicts and the risk of SUD. In this review, we summarize application of ML methods in neuroimaging focusing on addicts' diagnosis of clinical status and risk prediction and elucidate the discriminative neurobiological features from brain electrophysiological, morphological and functional perspectives that contribute most to the classifier, finally highlighting the auxiliary role of ML in addiction treatment., (© 2023 Society for the Study of Addiction.)

Extensive literature suggests that the brain reward system is crucial in understanding the neurobiology of substance use disorders. However, evidence of reliable deficits in functional connectivity across studies on substance use problems remains limited. Therefore, a voxel-wise seed-based meta-analysis using brain regions of the reward system as seeds of interest was conducted on 96 studies representing 5757 subjects with substance use problems. The ventromedial prefrontal cortex exhibited hyperconnectivity with the ventral striatum and hypoconnectivity with the amygdala and hippocampus. The executive striatum showed hyperconnectivity with the motor thalamus and dorsolateral prefrontal cortex and hypoconnectivity with the anterior cingulate cortex and anterior insula. Finally, the limbic striatum was found to be hyperconnected to the orbitofrontal cortex and hypoconnected to the precuneus compared with healthy subjects. The current study provided meta-analytical evidence of deficient functional connectivity between brain regions of the reward system and cortico-striato-thalamocortical loops in addiction. These results are consistent with deficits in motivation and habit formation occurring in addiction, and they highlight alterations in brain regions involved in socio-emotional processing and attention salience., (© 2022 Society for the Study of Addiction.)

As a chronic encephalopathy, drug addiction is responsible for millions of deaths per year around the world. The gut microbiome is a crucial component of the human microbiome. Through dynamic bidirectional communication along the 'gut-brain axis,' gut bacteria cooperate with their hosts to regulate the development and function of the immune, metabolic, and nervous systems. These processes may affect human health because some brain diseases are related to the composition of gut bacteria, and disruptions in microbial communities have been implicated in neurological disorders. We review the compositional and functional diversity of the gut microbiome in drug addiction. We discuss intricate and crucial connections between the gut microbiota and the brain involving multiple biological systems and possible contributions by the gut microbiota to neurological disorders. Finally, the treatment of probiotics and fecal transplantation was summarized. This was done to further understand the role of intestinal microecology in the pathogenesis of drug addiction and to explore new methods for the treatment of drug addiction., (Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.net.)

Introduction: High rates of early hospital discharge are often observed in crack cocaine users and are related to adverse outcomes and increased public spending. This study evaluated clinical and sociodemographic factors associated with early treatment discharge among crack users., Methods: The sample comprised 308 men diagnosed with crack cocaine use disorder (crack only), aged 18 to 65 years, admitted between 2013 and 2017 to a male-only hospital unit to treat substance use disorders. Sociodemographic and clinical data were obtained using the Addiction Severity Index, 6th version, and a Sociodemographic Questionnaire., Results: Early discharge (within 7 days) was significantly associated with lack of own income, insufficient family support, being single, and recent homelessness. Regarding drug use, lower treatment retention was related to younger age of crack use onset, recent alcohol use, and nicotine use. Factors such as age, skin color, and educational level showed no relation to the outcome., Conclusion: Our findings suggest that presence of characteristics verifiable at the time of admission may be related to crack users' treatment retention. Identification of these factors can contribute to target interventions in order to improve treatment adherence in crack cocaine users., Competing Interests: No conflicts of interest declared concerning the publication of this article.

Drug addiction is considered a chronic disorder affecting the individual's life, his/her family and society. Up till now the treatment of drug addiction is considered a problematic issue. Synthetic drugs available for the treatment of drug addiction are few, of limited efficacy and associated with serious side effects. Therefore, there is a continuous search for better therapeutic agents for drug addiction. Natural products represent a promising source for drug addiction treatment. This review summaries drug addiction definition, its mechanism of action, its types, its diagnosis, factors affecting its development and different available approaches for its treatment especially the use of natural products. Six plants were discussed thoroughly in this review, including, Tabernanthe iboga Baill., Mitragyna speciosa Korth., Pueraria montana var. lobata (Willd.) Sanjappa & Pradeep, Hypericum perforatum L., Panax ginseng C.A. Mey., and Withania somnifera (L.) Dunal., (© 2022 Wiley-VHCA AG, Zurich, Switzerland.)

Background: Women comprise around 15% of admissions to provincial correctional institutions in Canada. Women in custody are known to have a high prevalence of mental health concerns, but little is known about how those referred to mental health services compare with referred men at a similar stage of imprisonment., Aims: Our aim was to describe and compare clinical, social and demographic characteristics of a complete cohort of custodially remanded men and women who were referred to mental health services while under custodial remand in two correctional institutions., Methods: We carried out retrospective analysis of data obtained from 4040 men and 1734 provincially detained women referred to mental health services in two correctional centres holding mainly pre-trial prisoners and serving a large mixed urban-rural catchment area in Toronto, Canada over a nearly five-year period. Men and women were first screened using the Brief Jail Mental Health Screen. Those who screened positive were assessed using the Jail Screening Assessment Tool the Brief Psychopathology Rating Scale-Expanded (BPRS-E) and the Clinical Global Impression-Corrections (CGI-C)., Results: There were many similarities between men and women, but also some important differences. Women were more socioeconomically disadvantaged than men. More women than men reported having children, yet fewer reported having any form of employment or social supports, although men were more likely to report unstable housing. In addition, women were significantly more likely to have mood and anxiety problems and to be self-harming, but did not differ from men in current psychotic symptoms. We also found differences in patterns of substance use, with a higher proportion of women using heroin and methamphetamines but fewer women having accessed addiction services., Conclusions: Our findings have implications for clinicians and service planners. They underscore the value of systematic screening for identifying need. More specifically, they suggest need for increased availability of addiction services for women as well as ensuring support for those women who have dependent-age children. Improvement in supports for entry into employment is particularly needed for women, while men are particularly likely to need access to stable housing., (© 2022 John Wiley & Sons Ltd.)

Given the devastating social and health consequences of drug addiction and the limitations of current treatments, a new strategy is needed. Circadian system disruptions are frequently associated with drug addiction. Correcting abnormal circadian rhythms and improving sleep quality may thus be beneficial in the treatment of patients with drug addiction. Melatonin, an essential circadian hormone that modulates the biological clock, has anti-inflammatory, analgesic, anti-depressive, and neuroprotective effects via gut microbiota regulation and epigenetic modifications. It has attracted scientists' attention as a potential solution to drug abuse. This review summarized scientific evidence on the roles of melatonin in substance use disorders at the cellular, circuitry, and system levels, and discussed its potential applications as an intervention strategy for drug addiction., (Copyright © 2022. Published by Elsevier Ltd.)

Drug addiction is a chronic and relapsing brain disorder characterized by compulsive drug seeking and continued drug use despite adverse consequences. The high prevalence and social burden of addiction is indisputable; however, the available intervention is insufficient. Abnormal gene expression is observed in reward-related brain regions in animal models of addiction. The modulation of gene expression and aberrant adaptation of neural networks attribute to the changes in brain function under repeated exposure to addictive drugs. The emerging recognition of the role of microRNA (miRNA) provides new insights into many biological and pathological processes in the central nervous system. Considerable studies have demonstrated that miRNAs are strong modulators of posttranscriptional gene expression in drug addiction. Here, we provide an overview of miRNAs, followed by evidence for aberrant miRNA expression and regulatory roles of miRNAs in drug addiction as well as neuroadaptation. We concluded by providing our perspectives that miRNAs have the potential as novel therapeutic targets for drug addiction., (Copyright © 2022. Published by Elsevier Inc.)

Synaptic plasticity is the ability of synapses to weaken or strengthen over time, in response to changes in the activity of the neurons. It is orchestrated by a variety of genes, proteins, and external and internal factors, especially epigenetic factors. MicroRNAs (miRNAs) are well-acknowledged epigenetic modulators that regulate the translation and degradation of target genes in the nervous system. Increasing evidence has suggested that a number of miRNAs play important roles in modulating various aspects of synaptic plasticity. The deregulation of miRNAs could be associated with pathological alterations in synaptic plasticity, which could lead to different CNS-related diseases. Herein, we provide an update on the role of miRNAs in governing synaptic plasticity. In addition, we also summarize recent researches on the role of miRNAs in drug addiction, and their targets and mechanism of action. Understanding of the way in which miRNAs contribute to synaptic plasticity provides rational clues in establishing the novel biomarkers and new therapeutic strategies for the diagnosis and treatment of plasticity-related diseases and drug addiction., (© 2022. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)

Objective: This study aimed to evaluate whether progression from first drug use to crack-cocaine use differs according to gender, and whether the report of sexual or physical violence impacts the time of progression., Methods: We interviewed 896 crack-cocaine users (548 men; 348 women) from addiction treatment units. Cox regression models evaluated the time of progression from first drug use to crack use. We analyzed gender differences according to the absence or presence of sexual or physical violence, also considering whether violence, when present, had occurred before or after the onset of crack use., Results: Women presented a faster progression to crack use regardless of exposure to sexual or physical violence (p < 0.05). Compared to unexposed men, there was a similar progression for men exposed to sexual or physical violence before the first use of crack (p = 0.167 and p = 0.393, respectively). In both genders, we observed a faster progression among individuals exposed to these types of violence after the onset of crack use (p < 0.01)., Conclusions: We found a faster progression to crack use among women and among individuals exposed to sexual and physical violence after the onset of crack use. These results encourage differentiated treatment strategies, focused on gender and individual characteristics., Competing Interests: The authors report no conflicts of interest.

Background: Youth drug addiction is a significant social and health problem. Symptoms of the disease include a number of neurological, gastrointestinal and cardiovascular disorders. Possible hormonal disorders and dysregulation of the immune system could also occur., Case Presentation: We describe a case of a teenage patient with multiple diseases such as esophagitis, allergic disease, and numerous behavioral disorders leading to: self-injury of the body, suicide attempts by drugs overdosing, and experimentation with various psychoactive substances (morphine, amphetamine, methamphetamine, codeine). She was also diagnosed with bipolar disorder. A few hours before the admission to the ward, the patient had an intravenous injection of drugs. Toxicological tests confirmed the presence of amphetamine, ecstasy and opioids in the blood and urine. Laboratory tests revealed extremely increased inflammatory parameters, leucopenia, increased levels of IgG, IgA and IgE (total) immunoglobulins, low concentration of vitamin D. Bacteriological examinations were negative. General condition of the patient got better very quickly, antibiotic therapy was abandoned on the 4 th day. It was concluded that the cause of the elevated concentration of acute-phase proteins was most likely caused by intoxication with psychoactive drugs., Conclusions: The discussed case shows the difficulties of differential diagnosis in a teenage patient struggling with many diseases, who has been abusing drugs for several years. Increased inflammatory parameters in the form of an raised PCT, CRP, NLR, PLR values may be caused by many factors. In adolescents who frequently experiment with psychoactive substances, such cause of these disturbances should also be taken into account., (© 2022. The Author(s).)

The mechanisms underlying drug addiction remain nebulous. Furthermore, new psychoactive substances (NPS) are being developed to circumvent legal control; hence, rapid NPS identification is urgently needed. Here, we present the construction of the comprehensive database of controlled substances, AddictedChem. This database integrates the following information on controlled substances from the US Drug Enforcement Administration: physical and chemical characteristics; classified literature by Medical Subject Headings terms and target binding data; absorption, distribution, metabolism, excretion, and toxicity; and related genes, pathways, and bioassays. We created 29 predictive models for NPS identification using five machine learning algorithms and seven molecular descriptors. The best performing models achieved a balanced accuracy (BA) of 0.940 with an area under the curve (AUC) of 0.986 for the test set and a BA of 0.919 and an AUC of 0.968 for the external validation set, which were subsequently used to identify potential NPS with a consensus strategy. Concurrently, a chemical space that included the properties of vectorised addictive compounds was constructed and integrated with AddictedChem, illustrating the principle of diversely existing NPS from a macro perspective. Based on these potential applications, AddictedChem could be considered a highly promising tool for NPS identification and evaluation.

This study aimed to identify the relevant psychosocial factors that can predict the aggression in people with drug addiction. A total of 896 male participants ( Mean  = 38.30 years) completed the survey. Gradient boosting regression, a machine learning algorithm, was used to find the relevant psychosocial variables, such as psychological security, psychological capital, interpersonal trust and alexithymia, that may be significantly related to aggressive behavior. Results showed that the five most important factors in the prediction of aggression are interpersonal trust, psychological security, psychological capital, parental conflict and alexithymia. A high level of interpersonal trust, psychological security and psychological capital can predict a low level of aggression in people with drug addiction, while a high level of parental conflict and alexithymia can predict a high level of aggression. Overall, the findings highlight the need to focus interventions according to the relation between these psychosocial factors and aggression in order to decrease violence.age  = 38.30 years) completed the survey. Gradient boosting regression, a machine learning algorithm, was used to find the relevant psychosocial variables, such as psychological security, psychological capital, interpersonal trust and alexithymia, that may be significantly related to aggressive behavior. Results showed that the five most important factors in the prediction of aggression are interpersonal trust, psychological security, psychological capital, parental conflict and alexithymia. A high level of interpersonal trust, psychological security and psychological capital can predict a low level of aggression in people with drug addiction, while a high level of parental conflict and alexithymia can predict a high level of aggression. Overall, the findings highlight the need to focus interventions according to the relation between these psychosocial factors and aggression in order to decrease violence.

Drug treatment centres provide the highest level of rehab services for patients diagnosed with drug addictions. Most inpatient drug rehab programs focus on medical detox and mental health interventions. However, how to optimize the later remains a challenge. The aim of this study was to examine the psychophysiological and psychosocial profile of patients attending drug addiction centres in comparation with the general population. A total of 105 inpatient drug rehab patients and 50 participants from the general population were compared based on standardized psychophysiological and psychosocial measures. Results of this study suggest that patients attending drug addiction centers differ from general population in several different psychophysiological and psychosocial factors. Patients reported significantly lower levels of physical activity and increased sympathetic responsiveness, and significantly higher levels in loneliness, psychologically inflexibility and neuroticism. The results of this study highlight the importance of address healthy lifestyle behaviors such as sport practice and psychological variables such as loneliness, psychological (in)flexibility and neuroticism to improve current programs aim to prevent or reduce problematic drug consumptions., (© 2021. The Author(s).)

Objective: The aim: Analysis of the legal framework for the development of scientifically sound measures for the prevention and detection of drug addiction and substance abuse in the Armed Forces of Ukraine as an important element of the system of medical support for combat readiness of troops., Patients and Methods: Materials and methods: The normative documents on carrying out obligatory preventive narcological examinations in the Armed Forces of Ukraine and other power ministries and departments are considered., Conclusion: Conclusions: Today in Ukraine it is necessary to improve the legal framework and strengthen control over the work of military commissariats to study conscripts, collect the necessary information about alcohol and drug addiction of citizens who are called up to the Armed Forces of Ukraine.

Drug addiction is a chronic brain disease characterized by compulsive drug-seeking and drug-taking behaviors despite the major negative consequences. Current well-established neuronal underpinnings of drug addiction have promoted the substantial progress in understanding this disorder. However, non-neuronal mechanisms of drug addiction have long been underestimated. Fortunately, increased evidence indicates that neuroimmune system, especially Toll-like receptor 4 (TLR4) signaling, plays an important role in the different stages of drug addiction. Drugs like opioids, psychostimulants, and alcohol activate TLR4 signaling and enhance the proinflammatory response, which is associated with drug reward-related behaviors. While extensive studies have shown that inhibition of TLR4 attenuated drug-related responses, there are conflicting findings implicating that TLR4 signaling may not be essential to drug addiction. In this chapter, preclinical and clinical studies will be discussed to further evaluate whether TLR4-based neuroimmune pharmacotherapy can be used to treat drug addiction. Furthermore, the possible mechanisms underlying the effects of TLR4 inhibition in modulating drug-related behaviors will also be discussed., (© 2022. The Author(s), under exclusive license to Springer Nature Switzerland AG.)

It is known that in present time heroin addiction is the most widespread and difficult to treat. It includes two factors: physical and psychological addiction. The vast majority of patients remained mentally addicted to drugs after physical drug addiction has been eliminated and the organism has been completely detoxed. It is an indomitable desire to take drugs. Neurophysiological mechanisms are in base of psychological dependence. It is similar to those that implement obsessive states (obsessive-compulsive disorders). The central role in these neurophysiological mechanisms is played by limbic system of the brain that provides emotional and motivational behavior of humans (and animals). It was shown that the treatment of medical-resistant forms of obsessive-compulsive disorders requires stereotactic impacts on various structures of the limbic system, including cingulate gyrus. According to literature data, there was several hundred stereotactic effects on the cingulate gyrus in the world. About 1000 stereotactic operations have been performed in our country as a mental addiction of heroin dependent patients' treatment. The efficiency was of about 70%., (Copyright © 2022 Elsevier B.V. All rights reserved.)

This research uses structural equation modeling to determine the influence of uncertainty due to the COVID-19 pandemic as an independent variable in the negative emotional states and resilience (as mediating variables) vs. drug addiction, alcoholism, and suicide ideation as dependent variables in 5557 students from a public state university in Northern Mexico. The five variables are related through eight hypotheses and tested using partial least squares. We used an adapted questionnaire sent by email in May 2020. Findings show that uncertainty facing the COVID-19 pandemic had a direct and significant influence on negative emotional states and a significant inverse effect on resilience; in the trajectory, drug addiction and alcoholism, and suicide ideation are explained.

Poly-drug consumption contributes to fatal overdose in more than half of all poly-drug users. Analyzing decision-making networks may give insight into the motivations behind poly-drug use. We correlated average functional connectivity of the valuation system (VS), executive control system (ECS) and valuation-control complex (VCC) in a large population sample (n = 992) with drug use behaviour. VS connectivity is correlated with sedative use, ECS connectivity is separately correlated with hallucinogens and opiates. Network connectivity is also correlated with drug use via two-way interactions with other substances including alcohol and tobacco. These preliminary findings can contribute to our understanding of the common combinations of substance co-use and associated neural patterns., (Copyright © 2021 Elsevier B.V. and Japan Neuroscience Society. All rights reserved.)

Accurately identifying persons with addiction is critically important for effectively targeting treatment and harm reduction interventions. Misdiagnosis of addictive disorders can lead to a cascade of negative outcomes, including stigma, discontinuation of needed medications, undue scrutiny of both patients and physicians, and even criminal consequences. A recent study raises significant concerns about the accuracy of diagnosis code data, likely rooted in confusingly-worded International Classification of Diseases (ICD)-9 and ICD-10 codes and a general misunderstanding of the difference between addiction and physiologic dependence. It is hardly surprising that physicians frequently mislabel patients when the ICD terms used to code for addiction are themselves misleading. ICD codes have not been updated to reflect current understanding of addiction, unlike those in the DSM-5. To explore this issue further, this commentary briefly discusses new information regarding coding data inaccuracies, how coding inaccuracies can lead to misdiagnosis, and the dangers of conflating "addiction" with "dependence." The commentary concludes with a call for the ICD to update their codes to reflect current understanding of addiction.Key messagesIt is not surprising that physicians frequently conflate patients with "addiction" and "dependence" when the ICD terms used to code for addiction are themselves misleading.ICD codes have not been updated to reflect what we know about the nature of addiction, unlike those in the DSM-5.This commentary calls for the ICD to update their codes to reflect current understanding of addiction.

Most studies on drug addiction degree are made based on statistical scales, addicts' account, and subjective judgement of rehabilitation doctors. No objective, quantified evaluation has been made. This paper uses devises the synchronous bimodal signal collection and experimentation paradigm with electroencephalogram (EEG) and forehead high-density near-infrared spectroscopy (NIRS) device. The drug addicts are classified into mild, moderate and severe groups with reference to the suggestions of researchers and medical experts. Data of 45 drug addicts (mild: 15; moderate: 15; and severe: 15) is collected, and then used to design an addiction degree testing algorithm based on decision fusion. The algorithm is used to classify mild, moderate and severe addiction. This paper pioneers to use two types of Convolutional Neural Network (CNN) to abstract the EEG and NIR data of drug addicts, and introduces batch normalization to CNN, thus accelerating training process, reducing parameter sensitivity, and enhancing system robustness. The characteristics output by two CNNs are transformed into dimensions. Two new characteristics are assigned with a weight of 50% each. The data is used for decision fusion. In the networks, 27 subjects are used as training sets, 9 as validation sets, and 9 as testing sets. The 3-class accuracy remains to be 63.15%, preliminarily justifying this method as an effective approach to measure drug addiction degree. And the method is ready to use, objective, and offers results in real time.

Based on studies describing an increased prevalence of addictive behaviours in several rare sleep disorders and shift workers, a relationship between circadian rhythms and addiction has been hinted for more than a decade. Although circadian rhythm alterations and molecular mechanisms associated with neuropsychiatric conditions are an area of active investigation, success is limited so far, and further investigations are required. Thus, even though compelling evidence connects the circadian clock to addictive behaviour and vice-versa, yet the functional mechanism behind this interaction remains largely unknown. At the molecular level, multiple mechanisms have been proposed to link the circadian timing system to addiction. The molecular mechanism of the circadian clock consists of a transcriptional/translational feedback system, with several regulatory loops, that are also intricately regulated at the epigenetic level. Interestingly, the epigenetic landscape shows profound changes in the addictive brain, with significant alterations in histone modification, DNA methylation, and small regulatory RNAs. The combination of these two observations raises the possibility that epigenetic regulation is a common plot linking the circadian clocks with addiction, though very little evidence has been reported to date. This review provides an elaborate overview of the circadian system and its involvement in addiction, and we hypothesise a possible connection at the epigenetic level that could further link them. Therefore, we think this review may further improve our understanding of the etiology or/and pathology of psychiatric disorders related to drug addiction.

Background: The drug using crisis entails participation and justice issues making it a pressing health and social concern in the Philippines today., Aim: This study explored the lived experiences of Filipinos recovering from drug addiction and sought to understand the occupational justice determinants of drug addiction to better develop substance addiction rehabilitation programs in the Philippines., Method: Using a qualitative approach, we conducted in-depth interviews guided by the Occupational Justice Health Questionnaire to 24 participants. Data were analyzed using interpretative phenomenological analysis., Results: We found four emerging themes: living with drugs, living around rules, living for the future, and living amidst the war on drugs. Each theme represented a "period of participation" exposing occupational injustices that activated the first enablement skill "raise consciousness of occupational injustice" from the Participatory Occupational Justice Framework., Conclusion and Significance: Understanding the participants' lived experiences raised consciousness of the injustices that exist before and during rehabilitation which uncovered pointers to improve local substance addiction rehabilitation programs: use of occupation-based social participation interventions, limitation of occupational therapy services due to lack of human resources reinforcing interprofessional collaboration, a participatory approach is essential in discussing and addressing injustices, and deliberate use of political activities of daily living.

Aims and Objectives: To describe the substance use and mental health characteristics of nurses who complete suicide compared to non-nurses., Background: Nurses are at higher risk of suicide than the general population. The relationship between substance use, mental health and suicide in a large sample of nurses in the USA has not been previously described., Design: Retrospective observational quantitative analysis., Methods: Suicide data were retrospectively analysed in the Centers for Disease Control and Prevention National Violent Death Reporting System from 2003 to 2017. Data were compared between nurses who died by suicide (n = 2,306) and non-nurses who died by suicide (n = 185,620) using odds ratios calculations and chi-square test of proportions to detect independent risk factors of suicide completion in nurses. This study followed the STROBE guidelines., Results: Significant differences between nurses and non-nurses were found. Among decedents for whom substances were implicated as a cause of death, nurses were far more likely to be positive at the time of death for almost all substance classifications. Both male and female nurses were more likely than non-nurses to have a mental health problem reported. Among both female and male nurses, job problems were more prevalent compared to non-nurses (12.8% and 19.9% versus 7.2% and 11.9%, respectively). Female nurses were more likely to have a physical health problem compared to female non-nurses, male nurses and male non-nurses (26.2% versus 21.3%, 22% and 20.4%)., Conclusion: Unique relationships between substance use and mental health exist among nurses who complete suicide which may offer specific opportunities for interventions to reduce suicide., Relevance to Clinical Practice: Efforts to address workplace stress, facilitate self-referral for risky substance use, encourage mental health treatment and reduce the stigma associated with seeking help all offer potential interventions to reduce nurse suicide., (© 2021 John Wiley & Sons Ltd.)

Over the years, various models have been proposed to explain the psychology and biology of drug addiction, built primarily around the habit and compulsion models. Recent research indicates drug addiction may be goal-directed, motivated by excessive valuation of drugs. Drug consumption may initially occur for the sake of pleasure but may transition to a means of escaping withdrawal, stress and negative emotions. In this hypothetical paper, we propose a value-based neurobiological model for drug addiction. We posit that during dependency, the value-based decision-making system in the brain is not inactive but has instead prioritized drugs as the reward of choice. In support of this model, we consider the role of valuation in choice, its influence on pleasure and punishment, and how valuation is contrasted in impulsive and compulsive behaviours. We then discuss the neurobiology of value, beginning with the dopaminergic system and its relationship with incentive salience before moving to brain-wide networks involved in valuation, control and prospection. These value-based neurobiological components are then integrated into the cycle of addiction as we consider the development of drug dependency from a valuation perspective. We conclude with a discussion of cognitive interventions utilizing value-based decision-making, highlighting not just advances in recalibrating the valuation system to focus on non-drug rewards, but also areas for improvement in refining this approach., (Copyright © 2021 Elsevier Ltd. All rights reserved.)

Addiction is defined as the repeated exposure and compulsive seek of psychotropic drugs that, despite the harmful effects, generate relapse after the abstinence period. The psychophysiological processes associated with drug addiction (acquisition/expression, withdrawal, and relapse) imply important alterations in neurotransmission and changes in presynaptic and postsynaptic plasticity and cellular structure (neuroadaptations) in neurons of the reward circuits (dopaminergic neuronal activity) and other corticolimbic regions. These neuroadaptation mechanisms imply important changes in neuronal energy balance and protein synthesis machinery. Scientific literature links drug-induced stimulation of dopaminergic and glutamatergic pathways along with presence of neurotrophic factors with alterations in synaptic plasticity and membrane excitability driven by metabolic sensors. Here, we provide current knowledge of the role of molecular targets that constitute true metabolic/energy sensors such as AMPK, mTOR, ERK, or K ATP in the development of the different phases of addiction standing out the main brain regions (ventral tegmental area, nucleus accumbens, hippocampus, and amygdala) constituting the hubs in the development of addiction. Because the available treatments show very limited effectiveness, evaluating the drug efficacy of AMPK and mTOR specific modulators opens up the possibility of testing novel pharmacotherapies for an individualized approach in drug abuse., (© 2020 Society for the Study of Addiction.)

Drug addiction is a major worldwide medical and social problem.Cocaine,nicotine,methamphetamine,heroin and other psychoactive substances,with small molecular weight,can easily cross the blood-brain barrier and eventually lead to addiction and other serious neuropsychological damage.There is no effective cure for addiction currently.The drug-antibody complex formed on the basis of active or passive immunotherapy could not cross the blood-brain barrier,which reduces the concentration of the free active drug and prevents its distribution in the brain,thereby weakening the drug addiction-related reward effects.It provides a promising way for the treatment of drug addiction.This article reviews the progress of immunotherapy against psychoactive substances such as cocaine,nicotine,methamphetamine and heroin in the past 50 years from the aspects of active immunity,passive immunity,drug metabolism-related enzymes,adjuvants and so on.The goal is to provide some ideas for the development of agents for the treatment of psychoactive substance addiction.