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Ketamine is a restricted and regulated medication in Australia and New Zealand, which has implications when considering treatment for patients with treatment-resistant depression and a history of illicit drug use, abuse or dependence. Regulations governing prescription of ketamine for treatment-resistant depression vary between jurisdictions in Australia and New Zealand, though most restrict use in those with drug dependence. There is substantial variation in definitions of drug dependence used in each jurisdiction, and between the legal and clinical definitions, with the latter specified in the current International Classification of Diseases, Eleventh Revision and Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition. This paper reviews the literature assessing the risk of ketamine misuse and dependence in patients with a history of illicit drug use, abuse or dependence and presents recommendations for psychiatrists who prescribe ketamine in such patients with treatment-resistant depression. [ABSTRACT FROM AUTHOR]

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

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

Abstract Aim To investigate changes in the clinical characteristics of patients who abused benzodiazepine receptor agonists (BZRA) or over‐the‐counter (OTC) drugs before and after COVID‐19 based on the 2018 and 2022 data of the “Nationwide Psychiatric Hospital (NPH) Survey on Drug‐related Psychiatric Disorders.” Method A total of 446 and 155 cases, and 435 and 273 cases, who mainly abused BZRAs or OTC drugs, respectively, were extracted from the database of the two NPH Surveys. Demographic variables, education, employment, criminal record, drug use during the previous year, psychiatric diagnosis, and types of abused drugs were compared between 2018 and 2022. Result A comparison of BZRA abusers revealed a decreased number of users during the previous year and an increase in the comorbidity rate of other disorders (F3 and F4 in ICD‐10) in 2022. Etizolam, flunitrazepam, triazolam, and zolpidem were used most in both years, with an increase in zolpidem and a decrease in triazolam in 2022. A comparison of OTC drug abusers revealed a higher proportion of women and young patients in 2022. An increase in the comorbidity rate of F3 and F9 and a significant increase in the use of dextromethorphan products were observed in 2022, although codeine products were in the majority in both years. Conclusion By comparing NPH Surveys before and after the COVID‐19 pandemic, both BZRA abusers and OTC drug abusers present complex pathologies, requiring tailor‐made treatment. The younger OTC drug abusers were particularly evident among women, and the abuse of dextromethorphan‐containing OTC drugs has increased alarmingly.

Introduction: Females of childbearing age with hepatitis C virus (HCV) face increased marginalisation with intersecting, sex‐specific barriers to direct acting antiviral (DAA) therapy. We assessed the factors associated with uptake of DAA therapy among females of childbearing age, including those with evidence of recent drug dependence. Methods: HCV notifications in New South Wales, Australia (1995–2017) were linked to opioid agonist therapy (OAT), hospitalisations, incarcerations, perinatal, HIV notifications, deaths and prescription databases. Recent drug dependence was defined as hospitalisation due to injectable drugs or receipt of OAT occurring in the DAA era (2016–2018). Logistic regression was used to analyse factors associated with DAA uptake among females of childbearing age (18–44), including those with recent drug dependence. Results: Among 57,467 people with evidence of chronic HCV in the DAA era (2016–2018), 20,161 (35%) were female, including 33% (n = 6563/20,161) of childbearing age (18–44). Among all females of childbearing age (n = 6563) and those with evidence of recent drug dependence (n = 2278/6563, 35%), DAA uptake was lower among those who had given birth in the DAA era (vs. no birth record, all females of childbearing age; aOR: 0.74, 95% CI 0.61, 0.89; those with recent drug dependence; aOR 0.69, 95% CI 0.51, 0.93) and Aboriginal and Torres Strait Islander peoples (all females of childbearing age; aOR 0.81, 95% CI 0.71, 0.93; those with recent drug dependence aOR 0.75, 95% CI 0.62, 0.90). Conclusion: Females of childbearing age should be considered a key population for DAA therapy. Enhancing antenatal and postnatal HCV care may be critical in the pursuit towards elimination. [ABSTRACT FROM AUTHOR]

• PET is applied to the diagnosis of PD, AD, and drug dependence. • PET imaging emerges as a crucial tool for detecting brain biomarkers. • This article also indicates the limitations that specificity and sensitivity of PET imaging agents need to be further improved. • The article provides a forward-looking perspective in the future development directions of PET imaging. Brain disorders are a series of conditions with damage or loss of neurons, such as Parkinson's disease (PD), Alzheimer's disease (AD), or drug dependence. These individuals have gradual deterioration of cognitive, motor, and other central nervous system functions affected. This degenerative trajectory is intricately associated with dysregulations in neurotransmitter systems. Positron Emission Tomography (PET) imaging, employing radiopharmaceuticals and molecular imaging techniques, emerges as a crucial tool for detecting brain biomarkers. It offers invaluable insights for early diagnosis and distinguishing brain disorders. This article comprehensively reviews the application and progress of conventional and novel PET imaging agents in diagnosing brain disorders. Furthermore, it conducts a thorough analysis on merits and limitations. The article also provides a forward-looking perspective in the future development directions of PET imaging agents for diagnosing brain disorders and proposes potential innovative strategies. It aims to furnish clinicians and researchers with an all-encompassing overview of the latest advancements and forthcoming trends in the utilization of PET imaging for diagnosing brain disorders. [ABSTRACT FROM AUTHOR]

Aim: To investigate changes in the clinical characteristics of patients who abused benzodiazepine receptor agonists (BZRA) or over‐the‐counter (OTC) drugs before and after COVID‐19 based on the 2018 and 2022 data of the "Nationwide Psychiatric Hospital (NPH) Survey on Drug‐related Psychiatric Disorders." Method: A total of 446 and 155 cases, and 435 and 273 cases, who mainly abused BZRAs or OTC drugs, respectively, were extracted from the database of the two NPH Surveys. Demographic variables, education, employment, criminal record, drug use during the previous year, psychiatric diagnosis, and types of abused drugs were compared between 2018 and 2022. Result: A comparison of BZRA abusers revealed a decreased number of users during the previous year and an increase in the comorbidity rate of other disorders (F3 and F4 in ICD‐10) in 2022. Etizolam, flunitrazepam, triazolam, and zolpidem were used most in both years, with an increase in zolpidem and a decrease in triazolam in 2022. A comparison of OTC drug abusers revealed a higher proportion of women and young patients in 2022. An increase in the comorbidity rate of F3 and F9 and a significant increase in the use of dextromethorphan products were observed in 2022, although codeine products were in the majority in both years. Conclusion: By comparing NPH Surveys before and after the COVID‐19 pandemic, both BZRA abusers and OTC drug abusers present complex pathologies, requiring tailor‐made treatment. The younger OTC drug abusers were particularly evident among women, and the abuse of dextromethorphan‐containing OTC drugs has increased alarmingly. [ABSTRACT FROM AUTHOR]

Maladaptive metacognitive thoughts about sleep often precede incidences of sleep disturbances. While the relationship between sleep disturbances and khat dependence is known, no research has examined the function of metacognition as a potential mediator between khat dependency and sleep problems in polysubstance users. This study used a brief structured questionnaire to measure the sleep problems, the severity of khat dependence (SDS-khat), and a metacognition score on khat-chewing polysubstance users (n = 374, age = 26.95 ± 3.80 years). The association was determined using Baron and Kenny's mediation effect model. The average SDS-khat score was 6.66 ± 1.41, and the metacognition score was 26.40 ± 4.09. Severity of khat dependence showed significant negative correlation with metacognition (b = −.53, standard error (SE) =.15, p <.001), and metacognition showed significant negative correlation with complaints of sleep disturbances, sleep deficit-related daytime problems, and sleep deficit-related socio-occupational disturbances (b = −.17, SE =.03, p <.001), (b = −.19, SE =.03, p <.001), (b = −.12, SE =.05, p <.05) respectively. Polysubstance users with khat dependence and comorbid sleep disturbances were more likely to have poor metacognition. [ABSTRACT FROM AUTHOR]

The escalating rates of morbidity and mortality associated with opioid use disorder (OUD) have spurred a critical need for improved treatment outcomes. This study aimed to investigate the impact of prolonged exposure to Fentanyl, a potent opioid, on behavior, biochemical markers, oxidative stress, and the composition of the gut microbiome. Additionally, we sought to explore the therapeutic potential of Anacyclus pyrethrum in mitigating the adverse effects of Fentanyl withdrawal. The study unveiled that chronic Fentanyl administration induced a withdrawal syndrome characterized by elevated cortisol levels (12.09 mg/mL, compared to 6.3 mg/mL for the control group). This was accompanied by heightened anxiety, indicated by a reduction in time spent and entries made into the open arm in the Elevated Plus Maze Test, as well as depressive-like behaviors, manifested through increased immobility time in the Forced Swim Test. Additionally, Fentanyl exposure correlated with decreased gut microbiome density and diversity, coupled with heightened oxidative stress levels, evidenced by elevated malondialdehyde (MDA) and reduced levels of catalase (CAT) and superoxide dismutase (SOD). However, both post- and co-administration of A. pyrethrum exhibited substantial improvements in these adverse effects, effectively alleviating symptoms associated with OUD withdrawal syndrome and eliciting positive influences on gut microbiota. In conclusion, this research underscores the therapeutic potential of A. pyrethrum in managing Fentanyl withdrawal symptoms. The findings indicate promising effects in alleviating behavioral impairments, reducing stress, restoring gut microbiota, and mitigating oxidative stress, offering valuable insights for addressing the challenges of OUD treatment. [ABSTRACT FROM AUTHOR]

Dian-Jeng Li,1,2,&ast; Joh-Jong Huang,3,&ast; Su-Ting Hsu,1 Hui-Ching Wu,4 Kuan-Ying Hsieh,1 Guei-Ging Lin,1 Pei-Jhen Wu,1 Chin-Lien Liu,1 Frank Huang-Chih Chou1 1Kaohsiung Municipal Kai-Syuan Psychiatric Hospital, Kaohsiung, Taiwan; 2Department of Nursing, Meiho University, Pingtung, Taiwan; 3Faculty of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung City, Taiwan; 4Department of Social Work, Taiwan Social Resilience Center, National Taiwan University, Taipei, Taiwan&ast;These authors contributed equally to this workCorrespondence: Frank Huang-Chih Chou, Kaohsiung Municipal Kai-Syuan, Psychiatric Hospital, No. 130, Kaisyuan 2nd Road, Lingya District, Kaohsiung, 802211, Taiwan, Tel +886 7-751-3171 Ext. 2302, Fax +886 7-771-2494, Email f50911.tw@yahoo.com.tw Hui-Ching Wu, Department of Social Work, National Taiwan University, No. 1, Section 4, Roosevelt Road, Taipei, 10617, Taiwan, Tel +886 2-3366-9483, Fax +886 2-2368-0532, Email hchingwu@ntu.edu.twIntroduction: The coronavirus disease 2019 (COVID-19) pandemic has had an impact on patients with substance use disorder (SUD). We aimed to investigate factors associated with confidence and adherence to governmental policies against COVID-19 (social desirability) among patients with SUD.Methods: This cross-sectional study was conducted during 2020 to 2021. Patients with SUD and healthy controls were recruited. The severity of sleep disturbance, social desirability, drug dependence, vaccine worries, other psychological burdens and demographic variables were collected through self-administrated questionnaires. Differences between the SUD and control groups were estimated. Hierarchical regression analysis was used to identify significant relationships between social desirability and other factors.Results: In total, 58 of patients with SUD and 47 healthy controls were recruited. The patients with SUD had a lower level of social desirability and more severe sleep disturbance than the control group. Older age, more severe sleep disturbance, lower level of drug dependence, and lower level of vaccine worries were significantly associated with a higher level of social desirability among the patients with SUD.Conclusion: Our results show the importance of timely interventions for drug dependence and to address vaccine worries in patients with SUD.Keywords: drug dependence, coping strategies, sleep disturbance, vaccine worries, COVID-19

Abstract Objective To examine the clinical characteristics of over‐the‐counter (OTC) drug abusers in psychiatric practice in Japan. Method We examined the attributes, ICD‐10 subcategory, and comorbid mental disorders of patients who mainly abuse OTC products and compared the clinical characteristics of single product and multiple products abusers, using the database of the “2022 Nationwide Mental Hospital Survey of Drug‐related Disorders.” Results Among the 2468 subjects included in this survey, 273 (11.1%) used OTC products as main drugs. Of these, 209 (78.3%) and 58 (21.7%) were classified into the single product group and the multiple products group, respectively. Six were excluded for unknown ingredients. By comparing these groups, we found that many of the multiple products group consisted of young women who were recently treated for drug problems. Many subjects in the group also had a short treatment period. No differences were observed between the groups regarding the ICD‐10 F1 subcategory, but many subjects in the multiple products group fulfilled the criteria of F6 “disorders of adult personality and behavior.” Conclusion OTC products are easily accessible drugs of abuse for young women in Japan. The results of this study indicate the necessity to reconsider the educational approach for preventing drug abuse, which has focused on illicit drugs. The study also indicates that some OTC products, which contain ingredients banned overseas due to their harmful effects, are still sold in Japan and that abusers for those products exist. Measures by the government are considered urgently needed.

• Electroacupuncture therapy (EAT) can effectively alleviate the effect of zolpidem on sleep quality in insomnia patients. • EAT and relaxation treatment intervention effectively promoted the recovery of deep sleep time in patients. • EAT can reduce nerve stress function and has a sedative effect, so it has a good effect on insomnia. To explore therapeutic interventions after drug withdrawal reduction for insomnia patients who used zolpidem excessively for a long time. A total of 86 patients with simple insomnia were randomly rolled into treatment (Tre) group (electroacupuncture therapy under low-dose zolpidem+relaxation treatment intervention, n=40) and control (Ctrl) group (low-dose zolpidem+relaxation treatment intervention, n=40), all of which received treatment and intervention for four weeks. As a result, after the dosage of zolpidem was gradually reduced, the deep sleep time of patients in the two groups was reduced in the first stage. However, with the prolongation of treatment time, the reduction trend of the two groups was gradually alleviated, but no great difference was found between groups (P >0.05). In the second stage of treatment, the deep sleep time of patients in the two groups gradually recovered and increased, and that in Tre group was greater than that in Ctrl group, and the upward trend was significant but differed slightly between groups (P >0.05). After treatment, the insomnia severity index (ISI) scores of the two groups gradually decreased, and that in Tre group was drastically inferior to those of Ctrl group on days 14 and 28 after treatment (both P s<0.05). In summary, electroacupuncture therapy can effectively alleviate the effect of zolpidem on sleep quality in patients with insomnia after drug discontinuation and promote the recovery of deep sleep time in patients, thereby alleviating the side effects and drug dependence of patients. [ABSTRACT FROM AUTHOR]

This article discusses the effects of opioid withdrawal on striatal dopamine levels. The study found that in laboratory rats exposed to morphine injections, extracellular dopamine concentrations decreased in the ventral striatum during withdrawal, but increased in the dorsal striatum during naloxone-triggered withdrawal. These findings suggest that withdrawal symptoms can become paired with opioid availability, enhancing the incentive salience of the drug and promoting conditioned approach. The article also explores the implications of these findings for addiction treatment, suggesting that a medication that offsets the aversive effects of withdrawal while diminishing dopamine surges could be beneficial. [Extracted from the article]

Background: In recent years, in Europe, there has been a growing concern about the use of sexualized drugs among men who have sex with men (MSM), due to its possible link to an increase in sexually transmitted infections. The aim of this review is to study the prevalence of chemsex, and the sexualized drug used in Europe, describing both different consumption patterns and other sexual behaviors considered risky and their possible relationship with positivity in diagnoses of sexually transmitted infections, including human immunodeficiency virus. Methods: We conducted a literature review in the main scientific databases (PubMed, Embase, Scopus, Cochrane Library, Web of Science), filtering for articles published between January 2018 and April 2023 that collect information on sexualized drug use and sexual practices conducted in European countries among men who have sex with men, including whether these behaviors can lead to diagnoses of sexually transmitted infections. Results: The definition of drugs included in chemsex is not clearly defined and shows heterogeneity between study publications; the three drugs presented in all manuscripts are mephedrone, GHB/GBL, and crystal methamphetamine. The prevalence of chemsex in Europe is 16% [11–21%] among MSM. The most frequent risky sexual behavior associated with chemsex practice was unprotected sex with a high number of partners. The log risk ratio of STIs was 0.86 (95% CI: 0.49 to 1.23). Conclusions: Adherence to definitions, stringent research methodologies, and focused interventions are needed to tackle the intricate relationship between substance use, sexual behavior, and the risk of HIV/STI transmission in MSM. [ABSTRACT FROM AUTHOR]

Objective: To examine the clinical characteristics of over‐the‐counter (OTC) drug abusers in psychiatric practice in Japan. Method: We examined the attributes, ICD‐10 subcategory, and comorbid mental disorders of patients who mainly abuse OTC products and compared the clinical characteristics of single product and multiple products abusers, using the database of the "2022 Nationwide Mental Hospital Survey of Drug‐related Disorders." Results: Among the 2468 subjects included in this survey, 273 (11.1%) used OTC products as main drugs. Of these, 209 (78.3%) and 58 (21.7%) were classified into the single product group and the multiple products group, respectively. Six were excluded for unknown ingredients. By comparing these groups, we found that many of the multiple products group consisted of young women who were recently treated for drug problems. Many subjects in the group also had a short treatment period. No differences were observed between the groups regarding the ICD‐10 F1 subcategory, but many subjects in the multiple products group fulfilled the criteria of F6 "disorders of adult personality and behavior." Conclusion: OTC products are easily accessible drugs of abuse for young women in Japan. The results of this study indicate the necessity to reconsider the educational approach for preventing drug abuse, which has focused on illicit drugs. The study also indicates that some OTC products, which contain ingredients banned overseas due to their harmful effects, are still sold in Japan and that abusers for those products exist. Measures by the government are considered urgently needed. [ABSTRACT FROM AUTHOR]

Chronic exposure to opioids can lead to downregulation of astrocytic glutamate transporter 1 (GLT-1), which regulates the majority of glutamate uptake. Studies from our lab revealed that beta-lactam antibiotic, ceftriaxone, attenuated hydrocodone-induced downregulation of GLT-1 as well as cystine/glutamate antiporter (xCT) expression in central reward brain regions. In this study, we investigated the effects of escalating doses of morphine and tested the efficacy of novel synthetic non-antibiotic drug, MC-100093, and ceftriaxone in attenuating the effects of morphine exposure in the expression of GLT-1, xCT, and neuroinflammatory factors (IL-6 and TGF-β) in the nucleus accumbens (NAc). This study also investigated the effects of morphine and beta-lactams in locomotor activity, spontaneous alternation percentage (SAP) and number of entries in Y maze since opioids have effects in locomotor sensitization. Mice were exposed to moderate dose of morphine (20 mg/kg, i.p.) on days 1, 3, 5, 7, and a higher dose of morphine (150 mg/kg, i.p.) on day 9, and these mice were then behaviorally tested and euthanized on Day 10. Western blot analysis showed that exposure to morphine downregulated GLT-1 and xCT expression in the NAc, and both MC-100093 and ceftriaxone attenuated these effects. In addition, morphine exposure increased IL-6 mRNA and TGF-β mRNA expression, and MC-100093 and ceftriaxone attenuated only the effect on IL-6 mRNA expression in the NAc. Furthermore, morphine exposure induced an increase in distance travelled, and MC-100093 and ceftriaxone attenuated this effect. In addition, morphine exposure decreased the SAP and increased the number of arm entries in Y maze, however, neither MC-100093 nor ceftriaxone showed any attenuating effect. Our findings demonstrated for the first time that MC-100093 and ceftriaxone attenuated morphine-induced downregulation of GLT-1 and xCT expression, and morphine-induced increase in neuroinflammatory factor, IL-6, as well as hyperactivity. These findings revealed the beneficial therapeutic effects of MC-100093 and ceftriaxone against the effects of exposure to escalated doses of morphine.

The likelihood of substance dependency in offspring is increased in cases when there is a family history of drug or alcohol use. Mothering is limited by maternal addiction because of the separation. Maternal separation (MS) leads to the development of behavioural and neuropsychiatric issues in the future. Despite the importance of this issue, empirical investigations of the influences of maternal substance use and separation on substance use problems in offspring are limited, and studies that consider both effects are rare. This study aims to review a few studies on the mechanisms, treatments, genetics, epigenetics, molecular and psychological alterations, and neuroanatomical regions involved in the dependence of offspring who underwent maternal addiction and separation. The PubMed database was used. A total of 95 articles were found, including the most related ones in the review. The brain's lateral paragigantocellularis (LPGi), nucleus accumbens (NAc), caudate-putamen (CPu), prefrontal cortex (PFC), and hippocampus, can be affected by MS. Dopamine receptor subtype genes, alcohol biomarker minor allele, and preproenkephalin mRNA may be affected by alcohol or substance use disorders. After early-life adversity, histone acetylation in the hippocampus may be linked to brain-derived neurotrophic factor (BDNF) gene epigenetics and glucocorticoid receptors (GRs). The adverse early-life experiences differ in offspring›s genders and rewire the brain›s dopamine and endocannabinoid circuits, making offspring more susceptible to dependence. Related psychological factors rooted in earlylife stress (ELS) and parental substance use disorder (SUD). Treatments include antidepressants, histone deacetylase inhibitors, lamotrigine, ketamine, choline, modafinil, methadone, dopamine, cannabinoid 1 receptor agonists/antagonists, vitamins, oxytocin, tetrahydrocannabinol, SR141716A, and dronabinol. Finally, the study emphasizes the need for multifaceted strategies to prevent these outcomes. [ABSTRACT FROM AUTHOR]

Despite various interventions available for substance use disorders, relapse rates remain substantial and, therefore, alternative strategies for attenuating dependence are needed. This study examined the associations between exercise frequency, illicit substance use, and dependence severity among a large sample of people who use drugs. The study utilized data from the Global Drug Survey 2018 (N = 57,110) to investigate the relationship between exercise frequency, illicit substance use, and substance dependence severity. Binomial regressions were employed to examine the relationship between exercise and SDS scores for 9 drugs. Greater exercise frequency correlated with reduced severity of substance dependence for specific drugs: cannabis (χ2 = 14.75, p < .001), MDMA (χ2 = 4.73, p = .029), cocaine (χ2 = 8.37, p = .015), amphetamine powder (χ2 = 6.39, p = .041), and methamphetamine (χ2 = 15.17, p < .001). These findings suggest a potential link between exercise and reduced substance use dependency. Further research is needed to understand the complex dynamics between exercise and substance use, considering potential bidirectional relationships and concurrent factors. [ABSTRACT FROM AUTHOR]

Trihexyphenidyl (THP)—a synthetic anticholinergic medication used to manage parkinsonism and extrapyramidal symptoms—has gained significant clinical recognition. However, there is a critical gap in understanding its withdrawal effects. This study investigates the intricate interplay between gut microbiota and oxidative stress during THP withdrawal. Furthermore, it explores the therapeutic potential of Anacyclus pyrethrum (AEAP) for alleviating the associated adverse effects. This comprehensive research combines behavioral tests, biochemical analysis, gut microbiome assessment utilizing matrix-assisted laser desorption ionization–time of flight mass spectrometry (MALDI-TOF MS), and oxidative stress measures. The results reveal that the chronic administration of THP leads to severe withdrawal syndrome, marked by heightened anxiety, depressive-like behaviors, increased cortisol levels, elevated oxidative stress, and gut dysbiosis. However, the administration of AEAP alongside THP shows a significant capacity to mitigate these deleterious effects. Co-treatment and post-treatment with AEAP increased bacterial density and diversity, promoting the proliferation of beneficial bacteria associated with improved gut health. Furthermore, AEAP administration reduced cortisol levels and exhibited potent antioxidant properties, effectively countering the THP-induced oxidative damage. This study highlights the withdrawal effects of THP and underscores the therapeutic potential of AEAP for managing these symptoms. The findings reveal its promising effects in alleviating behavioral and biochemical impairments, reducing oxidative stress, and restoring gut microbiota, which could significantly impact the clinical management of THP withdrawal and potentially extend to other substance withdrawal scenarios. [ABSTRACT FROM AUTHOR]

This editorial published in Frontiers in Pharmacology titled "Substance use disorder: above and beyond addiction" provides a comprehensive examination of substance use disorder (SUD) from a multi-dimensional perspective. The editorial discusses various factors that contribute to the development, maintenance, and relapse of SUD, and highlights several studies on alcohol use disorder, opioid use, cocaine use disorder, and the impact of the COVID-19 pandemic on substance use. The authors hope that this research will enhance our understanding of SUD and inform comprehensive approaches to its management. The article also includes information about the funding and conflict of interest declarations for the research, with the authors receiving support from various research programs and declaring no conflicts of interest. The publisher emphasizes that the opinions expressed in the article are solely those of the authors and do not necessarily represent the views of their affiliated organizations or the publisher. [Extracted from the article]

Aims: Drugs today are one of the urgent and complex problems. One of the interventions that can be done to motivate quitting drug addiction is counselling This study aims to map evidence related to the strategies of counselling in victims of drug abuse and strategies in conducting counselling. Methods: Search databases for this study were PubMed, CINAHL, Science Direct and Google Scholar. Article identification was carried out based on the criteria for the year of publication (2013-2022), RCT / A Cross Section Study/Cross-Sectional Study, English and Indonesian Language, Fulltext, Teenagers to the elderly. Using the PRISMA flowchart, data extraction and scoping with the keywords (English): “Drug Dependence OR Subtance Abuse AND Counselling AND Drug Abuser” and keywords in Indonesian language “Ketergantungan Narkoba OR Penyalahgunaan Zat AND Konseling AND Pengguna Narkoba”. Results: The results of the study found that of the 9 articles that met the criteria. The main findings reveal that there are strategies in counselling, namely by means of drug counselling (drug handling controlled and monitored by doctors and nurses as psychoeducation providers) and telephone. counselling that can be used in screening and planning action. Conclusion: The conclusion of this study is that in counselling drug users there are several types, methods, and approaches included in the provision of counselling that are more effective in increasing motivation to recover or drug dependence in patients who are prescribed drugs by doctors compared to those who do not have prescription drugs. It is expected to contribute to the field of nursing as a strategy in counselling victims of drug abuse or people with drug addiction.

This study sought to develop a structural relationship model for relapse prediction based on dysfunctional personality beliefs regarding the mediating role of inhibition control. The investigation involved the correlation of structural equations. In 2021, the statistical population comprised all drug addicts who sought treatment at Ardabil Addiction Treatment Camp. 200 male subjects were chosen using the available sampling method and the Relapse to the Prediction Questionnaire (RPS), the Dysfunctional Personality Beliefs Questionnaire (PBQ), and the Inhibition Control Test (go / nogo). Using clever pls3 software, the obtained data were analyzed using structural equation modeling. According to the results of structural equation modeling, dysfunctional personality beliefs have a direct and significant effect on relapse. In addition, inhibition control mediated the indirect impact of dysfunctional personality beliefs. The value of fit (GOF) criterion was utilized to evaluate the model’s overall fit, which governs both the measurement and structural model components. Consequently, the value of goodness of fit (GOF) is 0.41, which, when compared to acceptable values for GOF, demonstrates the model’s overall good fit. According to the findings of this study, it is necessary to provide regular training programs for substance abusers based on the principles of cognitive-behavioral therapy in order to determine the patient’s dysfunctional beliefs about addiction, assist the patient in developing more effective beliefs and behaviors, and assist the patient in developing more effective coping mechanisms.

BackgroundClinical trials reveal posttraumatic stress disorder (PTSD) improvement leads to decreased substance use among patients with comorbid substance use disorder (SUD). Using administrative medical record data, we determined whether clinically meaningful PTSD Checklist (PCL) (≥20 points) score decreases were positively associated with SUD treatment utilization.MethodsWe used a retrospective cohort of Veterans Health Affairs (VHA) medical record data (2008-2015). PTSD Checklist (PCL) scores were used to categorize patients into those with a clinically meaningful PTSD improvement (≥20 point decrease) or not (

The escalating rates of morbidity and mortality associated with opioid use disorder (OUD) have spurred a critical need for improved treatment outcomes. This study aimed to investigate the impact of prolonged exposure to Fentanyl, a potent opioid, on behavior, biochemical markers, oxidative stress, and the composition of the gut microbiome. Additionally, we sought to explore the therapeutic potential of Anacyclus pyrethrum in mitigating the adverse effects of Fentanyl withdrawal. The study unveiled that chronic Fentanyl administration induced a withdrawal syndrome characterized by elevated cortisol levels (12.09 mg/mL, compared to 6.3 mg/mL for the control group). This was accompanied by heightened anxiety, indicated by a reduction in time spent and entries made into the open arm in the Elevated Plus Maze Test, as well as depressive-like behaviors, manifested through increased immobility time in the Forced Swim Test. Additionally, Fentanyl exposure correlated with decreased gut microbiome density and diversity, coupled with heightened oxidative stress levels, evidenced by elevated malondialdehyde (MDA) and reduced levels of catalase (CAT) and superoxide dismutase (SOD). However, both post- and co-administration of A. pyrethrum exhibited substantial improvements in these adverse effects, effectively alleviating symptoms associated with OUD withdrawal syndrome and eliciting positive influences on gut microbiota. In conclusion, this research underscores the therapeutic potential of A. pyrethrum in managing Fentanyl withdrawal symptoms. The findings indicate promising effects in alleviating behavioral impairments, reducing stress, restoring gut microbiota, and mitigating oxidative stress, offering valuable insights for addressing the challenges of OUD treatment.

Introduction: The North-Eastern, North-Western, and North-Central cities in Nigeria comprise of 19 states, each with its own governor. With over 400 ethnicities in the country, Northern Nigeria is home to many ethnic groups nearly half of whom are the Hausa-Fulani whose main religion is Islam. Practices in Northern Nigeria has favoured polygamy, early child marriage, and a lack of desire for western education while encouraging the strictly Islamic studies especially among the Hausa/Fulanis. Northern Nigeria is also known for its gender inequality and poverty. Prescription drug abuse has become more common in recent years even among women in Northern Nigeria. Objectives: This study's objectives include finding out the predicting factors to entry into prescription drug use among women in Northern Nigeria. Highlighting the causes of growing numbers in prescription drug abuse as well as recommending solutions in form of preventative measures. Methods: Eight articles were selected after being critically appraised for this study following a set of inclusion and exclusion criteria. For this mixed method Systematic Review (SR), a thematic analysis was used for the results and findings. Results: This research shows that some of the factors in the rise of prescription drug abuse among women in Northern Nigeria include: unemployment, insurgency due to the activities of violent extremist organization—Boko Haram—in the Northern region, as well as family dynamics which involves family history of drug misuse, early marriage, and a lack of education. Conclusion: Understanding the factors influencing women into drug use in Northern Nigeria can help end the cycle. This study suggests recommendations to prompt a decline in the rising numbers of prescription drug use among women in Northern Nigeria.

Introduction: Negative affect and anxiety frequently precede the onset of drug use in those with substance use disorder (SUD). Low self-esteem may increase the risk of relapse. We examined the short-term effects of exercise on affect, anxiety, and self-esteem in inpatients with poly-SUD. Methods: This is a multicenter randomized control trial (RCT) with a crossover design. Thirty-eight inpatients (37.3 ± 6.4 years; 84% male) from three clinics participated in 45 min of soccer, circuit training, and control condition (psychoeducation) in a random order. Positive and negative affect (PANAS), state anxiety (single item), and self-esteem (Rosenberg SE-scale) were measured immediately before, immediately after, 1-h, 2-h, and 4-h post-exercise. Heart rate and ratings of perceived exertion were taken. Effects were assessed using linear mixed effects models. Results: Compared to the control condition, there were significant post-exercise improvements in positive affect (β = 2.99, CI = 0.39: 5.58), self-esteem (β = 1.84, CI = 0.49: 3.20), and anxiety (β = −0.69, CI = −1.34: −0.04) after circuit training (shown) and soccer. Effects persisted 4-h post-exercise. Reductions in negative affect were observed 2-h (circuit training: β = −3.39, CI = −6.35: −1.51) and 4-h (soccer: β = −3.71, CI = −6.03: −1.39) post-exercise, respectively. Conclusion: Moderately strenuous exercise undertaken in naturalistic settings may improve mental health symptoms in poly-SUD inpatients for up to 4-h post-exercise. [ABSTRACT FROM AUTHOR]

Introduction: Although the use of recreational drugs and pharmacological treatments have a strong impact on the sexuality of individuals with substance use disorders, sexuality is not usually included in the work plans of specialized residential services. Goals: The goals of this study were to analyze the users' sexual health in the context of residential care, as well as connecting the contents of the regulations regarding sexuality with the users' and professionals' sexual opinion. Results: The main results indicate that sexuality is not worked on in most centers. On the other hand, users presented a high level of sexual dysfunction. Finally, their sexual opinion was generally positive. Conclusion: In conclusion, despite the high level of sexual dysfunction among users, sexuality is not worked on in drug dependence residential centers; the sexual opinion of the people involved doesn't create an impediment. [ABSTRACT FROM AUTHOR]

This study aims to uncover the mechanism by which certain groups of women developed a methamphetamine addiction and ended up incarcerated. The subjects are 202 female inmates incarcerated for violating the Stimulant Drug Control Law shortly before their release from Japanese penal institutions between January and May 2016. Estimation by structural equation model indicates that higher self-esteem is less likely to be associated with developing depression, and depression is more likely to be correlated with drug addiction. However, we find that the influences of the victimization experiences during childhood or adulthood are not significant for this group of female inmates. These results align with the more recent finding by Carbone-Lopez & Miller (2012) and Smith (2017). We discuss the implication of the result. [ABSTRACT FROM AUTHOR]

Objectives: Social behavior, a set of motivating activities critical for survival, is disturbed in cholestasis conditions and many substance abusers as well as psychiatric disorders. The documented loss of social interest in cholestatic patients may be associated with depressive symptoms. Interestingly, the endogenous opioid system is involved in the modulation of depression. Methods in this research: , we assessed the effect of cholestasis and drug dependence on social and depression behaviors using the Three-Chamber Paradigm Test, Forced Swim Test (FST), and Tail Suspension Test (TST) as well as Open Field Test (OFT) in male NMRI mice. Results: The results indicated that alone administration of morphine and tramadol, as well as co-administration of them, increased social motivation and novelty but decreased depression in bile duct ligated mice. Whereas, alone administration of naloxone (a µ-opioid receptor antagonist) and co-administration of it along with morphine and tramadol decreased social motivation and novelty while enhanced depression in the sham-operated and bile duct ligated mice. These administrations of drugs did not change locomotor activity compared to the control group. Conclusion: In conclusion, it appears that (i) both cholestasis and drug dependence impaired social motivation behavior, as well as induced depression-like behavior in the bile duct, ligated mice, (ii) alone administration of morphine and tramadol as well as co-treatment of them may protect against cholestasis and drug dependence induced abnormal behaviors, (iii) µ-opioid receptors play an important role in modulation of social motivation and depression behaviors in mice. [ABSTRACT FROM AUTHOR]

Abstract Background Estimating the economic costs of self-injury mortality (SIM) can inform health planning and clinical and public health interventions, serve as a basis for their evaluation, and provide the foundation for broadly disseminating evidence-based policies and practices. SIM is operationalized as a composite of all registered suicides at any age, and 80% of drug overdose (intoxication) deaths medicolegally classified as ‘accidents,’ and 90% of corresponding undetermined (intent) deaths in the age group 15 years and older. It is the long-term practice of the United States (US) Centers for Disease Control and Prevention (CDC) to subsume poisoning (drug and nondrug) deaths under the injury rubric. This study aimed to estimate magnitude and change in SIM and suicide costs in 2019 dollars for the United States (US), including the 50 states and the District of Columbia. Methods Cost estimates were generated from underlying cause-of-death data for 1999/2000 and 2018/2019 from the US Centers for Disease Control and Prevention’s (CDC’s) Wide-ranging ONline Data for Epidemiologic Research (WONDER). Estimation utilized the updated version of Medical and Work Loss Cost Estimation Methods for CDC’s Web-based Injury Statistics Query and Reporting System (WISQARS). Exposures were medical expenditures, lost work productivity, and future quality of life loss. Main outcome measures were disaggregated, annual-averaged total and per capita costs of SIM and suicide for the nation and states in 1999/2000 and 2018/2019. Results 40,834 annual-averaged self-injury deaths in 1999/2000 and 101,325 in 2018/2019 were identified. Estimated national costs of SIM rose by 143% from $0.46 trillion to $1.12 trillion. Ratios of quality of life and work losses to medical spending in 2019 US dollars in 2018/2019 were 1,476 and 526, respectively, versus 1,419 and 526 in 1999/2000. Total national suicide costs increased 58%—from $318.6 billion to $502.7 billion. National per capita costs of SIM doubled from $1,638 to $3,413 over the observation period; costs of the suicide component rose from $1,137 to $1,534. States in the top quintile for per capita SIM, those whose cost increases exceeded 152%, concentrated in the Great Lakes, Southeast, Mideast and New England. States in the bottom quintile, those with per capita cost increases below 70%, were located in the Far West, Southwest, Plains, and Rocky Mountain regions. West Virginia exhibited the largest increase at 263% and Nevada the smallest at 22%. Percentage per capita cost increases for suicide were smaller than for SIM. Only the Far West, Southwest and Mideast were not represented in the top quintile, which comprised states with increases of 50% or greater. The bottom quintile comprised states with per capita suicide cost increases below 24%. Regions represented were the Far West, Southeast, Mideast and New England. North Dakota and Nevada occupied the extremes on the cost change continuum at 75% and − 1%, respectively. Conclusion The scale and surge in the economic costs of SIM to society are large. Federal and state prevention and intervention programs should be financed with a clear understanding of the total costs—fiscal, social, and personal—incurred by deaths due to self-injurious behaviors.

Abstract Introduction-A high consumption of benzodiazepines (BZDs) has been noticed sometimes outside the rules of prescription recommendations, which makes their consumption a major public health problem. The present study aimed to evaluate the prescription and use of BZDs in Sidi Bel-Abbès city. Methods-: This was a descriptive cross-sectional study carried out from February 01st, 2018 to June 30th, 2018 evaluating the prescription and use of BZDs in of Sidi Bel-Abbès by means of a questionnaire distributed to patients from the psychiatric hospital, the CHU psychiatry department and community pharmacists. The primary endpoint was the assessment of the prescription and use of BZDs in this city. Data entry and analysis were performed using SPSS software. Results-A total of 353 patients treated with at least one BZD were included, including 178 men. The prescription rate of BZDs was 1.10, young people (59.77%) and married people (60.34%) were the privileged consumers. The prescription was the prerogative of psychiatrists, in monotherapy (07.42%), the molecule most frequently prescribed was Bromazepam (31.07%) and night intake was the most important (49.01%). BZDs were used to combat insomnia (25.21%), anxiety (16.43%), for a period of more than a year (57.79%). Conclusion-The prescription and use of BZDs in Sidi Bel-Abbès has proven to be important. Insomnia and anxiety were the main reasons for their use, and Bromazepam was the most molecule frequently used. Résumé Introduction-Une forte consommation des benzodiazépines (BZDs) a été remarquée en dehors parfois des règles de recommandations de prescription, ce qui rend leur consommation un problème majeur de santé publique.La présente étude a eu pour objectif d’évaluer la prescription et l’usage des BZDs dans la ville de Sidi Bel-Abbès. Méthodes-Il s’agissait d’une étude descriptive transversale réalisée du 01 Février 2018 au 30 Juin 2018 évaluant la prescription et l’usage des BZDs dans la ville de Sidi Bel-Abbès au moyen d’un questionnaire distribué aux patients de l’hôpital psychiatrique, du service de psychiatrie du CHU et aux pharmaciens d’officine.Le critère de jugement principal était l’évaluation de la prescription et de l’utilisation des BZDs dans cette ville. La saisie et l'analyse des données ont été réalisées par le logiciel SPSS. Résultats-Au total, 353 patients traités au moins par une BZD ont été inclus dont 178 hommes. Le taux de prescription des BZDs était de 1.10, des jeunes (59,77 %) et des personnes mariées (60,34%) constituaient les consommateurs privilégiés. La prescription était l’apanage des psychiatres, en monothérapie (07,42%), la molécule la plus fréquemment prescrite était le Bromazépam (31,07%) et la prise nocturne était la plus importante (49,01%). Les BZDs étaient utilisées pour combattre l’insomnie (25,21%), l’anxiété (16,43%), pour une durée de plus d’une année (57,79 %). Conclusion-La prescription et l’utilisation des BZDs dans la ville de Sidi Bel-Abbès s’est avérée importante. L’insomnie et l’anxiété constituaient les principales raisons de leur utilisation, et le Bromazépam était la molécule la plus fréquemment utilisée .

Abstract Aim The effect of a web‐based relapse prevention program might vary depending on a specific population if the study participants included drug users with various characteristics. This secondary analysis explored subgroups among Japanese drug users that may benefit from a web‐based relapse prevention program. Methods Outpatients with drug use disorder (n = 48) were randomly assigned to an 8‐week, six‐session web‐based relapse prevention program (intervention group) or web‐based self‐monitoring only (control group). We tested the effects of the intervention on abstinence in different subgroups divided by a primary abused drug (methamphetamine vs other drugs), previous face‐to‐face relapse prevention (received vs not received), and outpatient treatment term (long‐term: ≥3 years vs short‐term:

Trihexyphenidyl (THP)—a synthetic anticholinergic medication used to manage parkinsonism and extrapyramidal symptoms—has gained significant clinical recognition. However, there is a critical gap in understanding its withdrawal effects. This study investigates the intricate interplay between gut microbiota and oxidative stress during THP withdrawal. Furthermore, it explores the therapeutic potential of Anacyclus pyrethrum (AEAP) for alleviating the associated adverse effects. This comprehensive research combines behavioral tests, biochemical analysis, gut microbiome assessment utilizing matrix-assisted laser desorption ionization–time of flight mass spectrometry (MALDI-TOF MS), and oxidative stress measures. The results reveal that the chronic administration of THP leads to severe withdrawal syndrome, marked by heightened anxiety, depressive-like behaviors, increased cortisol levels, elevated oxidative stress, and gut dysbiosis. However, the administration of AEAP alongside THP shows a significant capacity to mitigate these deleterious effects. Co-treatment and post-treatment with AEAP increased bacterial density and diversity, promoting the proliferation of beneficial bacteria associated with improved gut health. Furthermore, AEAP administration reduced cortisol levels and exhibited potent antioxidant properties, effectively countering the THP-induced oxidative damage. This study highlights the withdrawal effects of THP and underscores the therapeutic potential of AEAP for managing these symptoms. The findings reveal its promising effects in alleviating behavioral and biochemical impairments, reducing oxidative stress, and restoring gut microbiota, which could significantly impact the clinical management of THP withdrawal and potentially extend to other substance withdrawal scenarios.

Genetic influences on alcohol and drug dependence partially overlap, however, specific loci underlying this overlap remain unclear. We conducted a genome-wide association study (GWAS) of a phenotype representing alcohol or illicit drug dependence (ANYDEP) among 7291 European-Americans (EA; 2927 cases) and 3132 African-Americans (AA: 1315 cases) participating in the family-based Collaborative Study on the Genetics of Alcoholism. ANYDEP was heritable (h 2 in EA = 0.60, AA = 0.37). The AA GWAS identified three regions with genome-wide significant (GWS; P

Neuronal cholinergic circuits have been implicated in cognitive function and neurological disease, but the role of cholinergic signaling in other cellular populations within the brain has not been as fully defined. Here, we show that cholinergic signaling mechanisms are involved in mediating the function of the choroid plexus, the brain structure responsible for generating CSF and releasing various factors into the brain. The choroid plexus was found to express markers of endogenous cholinergic signaling, including multiple nicotinic acetylcholine receptor (nAChR) subtypes in a region-specific manner, and application of nicotine was found to induce cellular activation, as evidenced by calcium influx in primary tissue. During intravenous nicotine self-administration in male rats, nicotine increased expression of transthyretin, a protein selectively produced and released by the choroid plexus, and microRNA-204 (mir-204), a transcript found in high levels in the choroid plexus and CSF. Finally, human choroid plexus tissue from both sexes was found to exhibit similar nAChR, transthyretin and mir-204 expression profiles, supporting the translational relevance of the findings. Together, these studies demonstrate functionally active cholinergic signaling mechanisms in the choroid plexus, the resulting effects on transthyretin and mir-204 expression, and reveal the direct mechanism by which nicotine modulates function of this tissue.

Background: Estimating the economic costs of self-injury mortality (SIM) can inform health planning and clinical and public health interventions, serve as a basis for their evaluation, and provide the foundation for broadly disseminating evidence-based policies and practices. SIM is operationalized as a composite of all registered suicides at any age, and 80% of drug overdose (intoxication) deaths medicolegally classified as 'accidents,' and 90% of corresponding undetermined (intent) deaths in the age group 15 years and older. It is the long-term practice of the United States (US) Centers for Disease Control and Prevention (CDC) to subsume poisoning (drug and nondrug) deaths under the injury rubric. This study aimed to estimate magnitude and change in SIM and suicide costs in 2019 dollars for the United States (US), including the 50 states and the District of Columbia. Methods: Cost estimates were generated from underlying cause-of-death data for 1999/2000 and 2018/2019 from the US Centers for Disease Control and Prevention's (CDC's) Wide-ranging ONline Data for Epidemiologic Research (WONDER). Estimation utilized the updated version of Medical and Work Loss Cost Estimation Methods for CDC's Web-based Injury Statistics Query and Reporting System (WISQARS). Exposures were medical expenditures, lost work productivity, and future quality of life loss. Main outcome measures were disaggregated, annual-averaged total and per capita costs of SIM and suicide for the nation and states in 1999/2000 and 2018/2019. Results: 40,834 annual-averaged self-injury deaths in 1999/2000 and 101,325 in 2018/2019 were identified. Estimated national costs of SIM rose by 143% from $0.46 trillion to $1.12 trillion. Ratios of quality of life and work losses to medical spending in 2019 US dollars in 2018/2019 were 1,476 and 526, respectively, versus 1,419 and 526 in 1999/2000. Total national suicide costs increased 58%—from $318.6 billion to $502.7 billion. National per capita costs of SIM doubled from $1,638 to $3,413 over the observation period; costs of the suicide component rose from $1,137 to $1,534. States in the top quintile for per capita SIM, those whose cost increases exceeded 152%, concentrated in the Great Lakes, Southeast, Mideast and New England. States in the bottom quintile, those with per capita cost increases below 70%, were located in the Far West, Southwest, Plains, and Rocky Mountain regions. West Virginia exhibited the largest increase at 263% and Nevada the smallest at 22%. Percentage per capita cost increases for suicide were smaller than for SIM. Only the Far West, Southwest and Mideast were not represented in the top quintile, which comprised states with increases of 50% or greater. The bottom quintile comprised states with per capita suicide cost increases below 24%. Regions represented were the Far West, Southeast, Mideast and New England. North Dakota and Nevada occupied the extremes on the cost change continuum at 75% and − 1%, respectively. Conclusion: The scale and surge in the economic costs of SIM to society are large. Federal and state prevention and intervention programs should be financed with a clear understanding of the total costs—fiscal, social, and personal—incurred by deaths due to self-injurious behaviors. [ABSTRACT FROM AUTHOR]

Illicit substance use is dangerous in both acute and chronic forms, frequently resulting in lethal poisoning, addiction, and other negative consequences. Similar to research in other psychiatric conditions, whose ultimate goal is to enable effective prevention and treatment, studies in substance use are focused on factors elevating the risk for the disorder. The rapid growth of the substance use problem despite the effort invested in fighting it, however, suggests the need in changing the research approach. Instead of attempting to identify risk factors, whose neutralization is often infeasible if not impossible, it may be more promising to systematically reverse the perspective to the factors enhancing the aspect of liability to disorder that shares the same dimension but is opposite to risk, that is, resistance to substance use. Resistance factors, which enable the majority of the population to remain unaffected despite the ubiquity of psychoactive substances, may be more amenable to translation. While the resistance aspect of liability is symmetric to risk, the resistance approach requires substantial changes in sampling (high-resistance rather than high-risk) and using quantitative indices of liability. This article provides an overview and a practical approach to research in resistance to substance use/addiction, currently implemented in a NIH-funded project. The project benefits from unique opportunities afforded by the data originating from two longitudinal twin studies, the Virginia Twin Study of Adolescent and Behavioral Development and the Minnesota Twin Family Study. The methodology described is also applicable to other psychiatric disorders. [ABSTRACT FROM AUTHOR]

This paper proposes a stigma-vulnerability nexus as a critical incursion into understandings of and responses to drug-related social problems. Considering stigma and vulnerability as sites of ostensibly empathetic interventions that aim to mitigate the impact of illicit substances, it proposes that the two concepts are best deployed when located within the political economy of drug harms. Doing so foregrounds the material inequalities resulting from existing socio-economic arrangements and highlights the limitations of them being politically mobilised in purely cultural-interactional ways, which can serve to overlook structural conditions and justify harmful political choices. As a theoretical perspective, the stigma-vulnerability nexus is therefore concerned with the macro-structural factors that shape both concepts and how they intersect. To demonstrate its value as an analytic tool, it is first applied to the framing of 'County Lines' dealing, where senior gang members are stigmatised, but the wider drivers of vulnerability among the young people they exploit are overlooked. Secondly, the nexus is applied to the case of new psychoactive substances. Here, the perceived vulnerability of young people is used to justify responses that ultimately lead to amplified harms being displaced onto structurally disadvantaged populations such as the homeless and prison inmates, compounding their economic vulnerability and class stigma. [ABSTRACT FROM AUTHOR]

Research on recovery from drug dependence is largely focused on abstinence without consideration of other aspects of mental health. The present study seeks to identify among Canadians with a lifetime history of illicit drug dependence, the prevalence of, and factors associated with (1) remission, (2) absence of psychiatric disorders (APD), and (3) complete mental health (CMH). A sample of 20,305 respondents from the 2012 Canadian Community Health Survey-Mental Health was selected, including 460 with a history of drug dependence. Chi-square tests and logistic regression analyses were conducted. Among those with a history of drug dependence, 80.6% were in remission. Although 47.9% achieved APD and 37.9% were in CMH, these percentages were significantly lower than those without a history of drug dependence (90.3% and 74.1%, respectively). APD and CMH were more common among older respondents, those with higher levels of social support, and those without a history of depression or anxiety. The present study draws attention to the individuals who may be vulnerable to continued drug dependence, while also illuminating potential modifiable factors to support positive mental health outcomes among those with a history of illicit drug dependence. [ABSTRACT FROM AUTHOR]

People with comorbid alcohol/drug dependency and gambling disorder get worse results from treatment compared with patients with only one disorder. The treatment of individuals with comorbidities entails many difficulties because they receive the same treatment like everyone else despite studies showing that it is a heterogeneous group. This article identifies and discusses the unsatisfied treatment needs of people with comorbid alcohol/drug use and gambling disorder. A qualitative perspective (individual interviews) was applied. Our sample comprised 65 respondents and included people with comorbidity of substance use (alcohol/drugs) and gambling disorders, and professionals who were employed in the treatment sector. Particular categories of need were identified, relating to dependence therapy, family relationships, and financial, legal and housing issues. The study did not engage with needs connected to counseling for employment problems, such as difficulties with finding or keeping a job or getting along with coworkers, but did identify other needs related to financial issues. The unsatisfied treatment needs identified should be considered in designing therapeutic provision for people with comorbid alcohol/drug use and gambling disorder. This may trigger a greater acceptance of such provision and encourage individuals to seek treatment at earlier stage of dependence, as well as increase rates of retention in treatment. [ABSTRACT FROM AUTHOR]

Maintenance therapy with buprenorphine and methadone is the gold standard pharmacological treatment for opioid use disorder (OUD). Despite these compounds demonstrating substantial efficacy, a significant number of patients do not show optimal therapeutic responses. The abuse liability of these medications is also a concern. Here we used rats to explore the therapeutic potential of the new long-acting pan-opioid agonist Cebranopadol in OUD. We tested the effect of cebranopadol on heroin self-administration and yohimbine-induced reinstatement of heroin seeking. In addition, we evaluated the abuse liability potential of cebranopadol in comparison to that of heroin under fixed ratio 1 (FR1) and progressive ratio (PR) operant self-administration contingencies. Oral administration of cebranopadol (0, 25, 50 μg/kg) significantly attenuated drug self-administration independent of heroin dose (1, 7, 20, 60μg/inf). Cebranopadol also reduced the break point for heroin (20 μg/inf). Finally, pretreatment with cebranopadol significantly attenuated yohimbine-induced reinstatement of drug seeking. In abuse liability experiments under FR1 contingency, rats maintained responding for heroin (1, 7, 20, 60μg/inf) to a larger extent than cebranopadol (0.03, 0.1, 0.3, 1.0, 6.0μg/inf). Under PR contingency, heroin maintained responding at high levels at all except the lowest dose, while the break point (BP) for cebranopadol did not differ from that of saline. Together, these data indicate that cebranopadol is highly efficacious in attenuating opioid self-administration and stress-induced reinstatement, while having limited abuse liability properties. Overall, the data suggest clinical potential of this compound for OUD treatment. • Methadone and buprenorphine are the goldstandard therapies in OUD. Their abuse liability is a concern. • Cebranopadol, a first-in-class opioid agonist that also activates the NOP receptor, is in phase-III for pain. • Cebranopadol reduces the motivation for heroin self-administration and heroin seeking. • Results demonstrate a low abuse liability of cebranopadol in rat self-administration experiments. • Cebranopadol is candidate for immediate clinical investigation in OUD disorder patients. [ABSTRACT FROM AUTHOR]

Background: Hispanic/Latino (H/L) heritage civilians out-number all other non-White ethnic groups in the United States. When studied as one group, H/L diversity is ignored, including rates of drug misuse. This study's aim was to examine H/L diversity regarding drug dependence by disaggregating how the burdens of active alcohol or other drug dependence (AODD) might change if we were to address syndromes drug by drug. Method: Studying non-institutionalized H/L residents from the National Surveys on Drug Use and Health (NSDUH) 2002-2013 probability samples, we utilized online Restricted-use Data Analysis System variables to identify ethnic heritage subgroups and active AODD via computerized self-interviews. We estimated case counts of AODD with analysis-weighted cross-tabulations and variances from Taylor series. Radar plots disclose AODD variations when we simulate the reductions of drug-specific AODD one by one. Results: For all H/L heritage subgroups, the most substantial AODD decline might be achieved by reducing active alcohol dependence syndromes, followed by declines of cannabis dependence. The burdens due to active syndromes attributed to cocaine and pain relievers vary somewhat across subgroups. For the Puerto Rican subgroup, our estimates reveal potentially important burden reduction if active heroin dependence can be decreased. Conclusion: A sizeable reduction in the H/L population health burden attributable to AODD syndromes might be achieved via the effective decline of alcohol and cannabis dependence among all subgroups. Future research includes a systematic replication with recent NSDUH survey data, as well as various stratifications. If replicated, the need for targeted drug-specific interventions among H/L will become unequivocal.

Background: The COVID-19 pandemic affects the mental health and professional behavior of surgeons and anesthesiologists and seems to have an impact on substance dependence. Question: What are the reasons for the occurrence of substance dependence and burnout in surgeons and anesthesiologists timelessly and during the COVID-19 pandemic and what improvement measures could help in the clinical practice? Material and methods: A literature search was conducted in the form of a systematic review of studies and review articles relevant to the topic. Results: Over the years it has been shown that surgeons and anesthesiologists are prone to drug dependence due to their direct access to medications in the clinical field and work-related stress. In particular, surgeons and anesthesiologists appeared to have an increased propensity for addictive diseases and an increased risk of burnout in the pandemic. Conclusion: Preventive measures in favor of better working conditions in surgery and anesthesia and better drug control (not only for dispensing but also for correct drug testing), as well as more treatment and reintegration programs under psychiatric supervision and in collaboration with a multidisciplinary team are meaningful. [ABSTRACT FROM AUTHOR]

Aim: The effect of a web‐based relapse prevention program might vary depending on a specific population if the study participants included drug users with various characteristics. This secondary analysis explored subgroups among Japanese drug users that may benefit from a web‐based relapse prevention program. Methods: Outpatients with drug use disorder (n = 48) were randomly assigned to an 8‐week, six‐session web‐based relapse prevention program (intervention group) or web‐based self‐monitoring only (control group). We tested the effects of the intervention on abstinence in different subgroups divided by a primary abused drug (methamphetamine vs other drugs), previous face‐to‐face relapse prevention (received vs not received), and outpatient treatment term (long‐term: ≥3 years vs short‐term: <3 years). Consecutive abstinence duration from the primary abused drug was compared in the subgroups, and the interaction between the intervention condition and the subgroup condition was assessed. Results: In the subgroup with short‐term outpatient treatment, the intervention group maintained better abstinence than the control group. For those who used methamphetamine or those who had previously received a face‐to‐face relapse prevention program, the intervention group showed larger effect sizes than the results from all the participants. However, the interaction between the intervention condition and the subgroup condition was not significant for any subgroup. Conclusions: This study suggests that patients with short‐term treatment may benefit from a web‐based relapse prevention program as an alternative treatment. We need to recruit and allocate patients considering their treatment term in a future definitive trial. [ABSTRACT FROM AUTHOR]