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The field of addiction in its priority to save lives has emphasized harm reduction and medication therapies that have taken precedence over counseling and psychotherapy. The extensive mental health needs, traumatic histories and cognitive challenges of this population call for more availability of all treatments, but also in-depth treatment for the causes of the addiction. The prevalence of trauma is examined with regard to the challenge it presents in treatment for substance use disorder (SUD), and other comorbidities. Two case examples are offered that exemplify how art therapy expedites key information about underlying trauma. Art therapy is proposed as a treatment approach for SUD for its apparent activation of key neural networks that are also impacted by trauma, and its usefulness in engaging those who have cognitive challenges experientially. Quantitative research is cited that suggests art therapy's activation of the reward system, which may make art therapy useful in treating the stress and inhibition coefficients of addiction that map to neural networks of addiction. The need for additional empirical research is cited that may improve the efficiency and effectiveness of art therapy and mental health treatment. [ABSTRACT FROM AUTHOR]

Background and Objectives: Amidst increasing opioid‐related overdoses in the USA, opioid use disorder (OUD) treatment has seen few novel treatments emerge. High‐potency synthetic opioids (HPSOs) have altered clinical approaches, prompting evaluation of existing medications for opioid use disorder (MOUD) and interest in slow‐release oral morphine (SROM) as another therapeutic option. Here we survey addiction specialists on the influence of HPSOs on clinical practice, views on current MOUD regulations, and openness to novel therapies such as SROM. Methods: Anonymous, online survey conducted at a national conference of addiction specialists (N = 91). Pearson χ2 tests and Fisher's exact tests to compare respondent characteristics. Results: Approximately 89% of respondents (N = 91) acknowledge that HPSOs shifted addiction treatment in recent years, with 86% modifying their MOUD prescribing accordingly. Moreover, 84% report having patients who could benefit from other full opioid agonists beyond methadone for OUD management. Many report off‐label prescribing of full agonist opioids other than methadone for withdrawal symptoms or initiating MOUD. Eighty percent reported being in favor of incorporating SROM as a third‐line monotherapy for OUD. Discussion and Conclusion: This sample of addiction specialists supports innovative alternatives for MOUD in the USA to combat the challenges posed by fentanyl and related HPSOs. Future work should further addiction specialists' opinions on barriers to OUD treatment and exploration of these international strategies in the USA. Scientific Significance: This appears to be the first study exploring addiction specialists' perspectives on regulatory barriers to OUD treatment and their willingness to uptake internationally adopted strategies such as SROM. [ABSTRACT FROM AUTHOR]

Background and Objectives: Criminal‐legal (CL) referrals to addiction treatment have historically had low utilization of medications for opioid use disorder (MOUD). While state differences have been reported, an in‐depth longitudinal analysis of state‐by‐state differences is lacking. Methods: The Substance Abuse and Mental Health Services Administration Treatment Episode Dataset‐Admissions 2000–2020 provided data for individuals entering their initial treatment with an opioid as their primary substance. Outcome was planned use of MOUD, assessing odds ratio (OR) of CL referrals relative to non‐CL referrals cumulatively over the 21‐year period and as incremental change (change in relative disparity) using effect sizes, stratified by each state. Results: 2,187,447 cases met the criteria. Planned MOUD occurred in 37.7% of non‐CL clients versus 6.5% of CL clients (OR = 0.11, 95% confidence interval = 0.11–0.12). For all clients, planned MOUD increased from 2000 (33.9%) to 2020 (44.8%). This increase was blunted within CL clients, increasing from 2000 (6.4%) to 2020 (13.3%). Rhode Island saw the greatest improvements in equity. Discussion and Conclusions: While rates of planned MOUD increased over the 21 years, a significant disparity persisted among CL clients in most states. As opioid use disorders and opioid‐related overdoses are more prevalent among those involved with the CL system, improving this has high impact. Scientific Significance: Provides the most comprehensive analysis of state‐by‐state inequities in MOUD access for CL relative to non‐CL referrals over a 21‐year period through use of a national data set. Positive outliers are used as case examples for others to follow in pursuit of more equitable care. [ABSTRACT FROM AUTHOR]

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This Consensual Qualitative Research study investigated how Christian Alcoholics Anonymous (A.A.) members in the Southeastern United States with sustained sobriety conceptualize spirituality, and their beliefs about how spirituality aided their recovery. Emergent themes of pre-recovery periods were futile attempts to nurture a connection with the sacred, lack of connectedness, and spiritual struggles leading to sanctifying substances. Emergent themes during sobriety were spiritual experiences and shifts away from traditional religious organizations. Results highlight the importance of addressing spiritual struggles and facilitating the exploration of meaningful conservation practices in addiction treatment. [ABSTRACT FROM AUTHOR]

Approach bias modification (ApBM) has shown promise in addiction treatment, but effects are small and ecological validity suffers from completing trainings in the laboratory. Providing app-based trainings via mobile phones could increase training efficacy. One-hundred-and-thirty-one smokers seeking abstinence attended a smoking cessation intervention and were thereafter randomized to one of three conditions: (a) app-based ApBM-training; (b) app-based sham training; (c) no training. App trainings were performed on 14 consecutive days at home. Behavioral and self-report data was assessed at pretest, posttest, and a 6-week follow-up. App-based ApBM led to stronger reductions in cigarette smoking as compared to no training. However, both training variants led to stronger declines in nicotine dependence and the sham training was superior in reducing alcohol consumption. Although approach biases for positive cues increased following ApBM training, this effect did not mediate treatment outcome. Other smoking-related cognitive biases did not change after training. Our results can inform future research in the optimization and advancement of ApBM treatment for addiction. Trial registration: Registered with Current Controlled Trials: study ID ISRCTN15690771. Registered on 20 November 2018; http://www.isrctn.com/ISRCTN15690771. [ABSTRACT FROM AUTHOR]

The men-specific addiction treatment concept of casa fidelio in Niederbuchsiten, Switzerland, was established in 1993 and offers 25 therapy places for adult men. The goal is to provide men with an environment in which they can confront their masculinity without being influenced by women. The concept was developed to protect male clients from the challenges of mixed-gender facilities and to create a therapeutically supportive environment. [Extracted from the article]

Abstract: Aim: It was investigated, whether a lapse during an abstinence-oriented inpatient treatment of alcohol addiction is correlated to abstinence and employment one year after treatment. Afterwards, it was tested, how this correlation is influenced by further predictors of long-term abstinence. Furthermore, it was investigated which patient characteristics correlate with lapses during treatment. Methods: In a sample of 1.262 patients with a main diagnosis of alcohol dependence correlations between data collected at admission, during treatment and at one-year follow-up of inpatient treatment of addiction were analyzed by logistic regression. Modified Completers-only and Intention-to-treat analysis were conducted according to the DGSS1 and DGSS4 follow-up standards of the German Society of Addiction. Results: Both types of analysis showed a significant correlation between lapse during treatment and relapse during the follow-up period, even when adding further variables to the regression model. In contrast, no significant correlation was found between lapse during treatment and unemployment one year after treatment. Lapse during treatment occurred the more, the younger patients were and the more detoxification treatments they had. Conclusions: Patients with alcohol dependence who consumed alcohol already during inpatient treatment of alcohol addiction are, despite staying in treatment, more likely to experience relapse during a one-year follow-up period. In contrast the long-term status of employment appears to relate to other factors then to lapses during treatment. The results indicate that further research on alcohol consumption during inpatient treatment of alcohol addiction is needed. More detailed knowledge could contribute to enabling these patients to successfully cope with their substance-related disorder in the long run. [ABSTRACT FROM AUTHOR]

The role of dopamine in the pathophysiology of gambling disorder (GD) remains incompletely understood, with disparate research findings concerning presynaptic and postsynaptic structures and dopaminergic synthesis. The aim of this study was to investigate potential correlations between striatal dopamine transporter (DAT) lateralization and asymmetry index, as assessed by 123I-FP-CIT SPECT, and temperamental traits, as measured by Cloninger's Temperament and Character Inventory (TCI), in GD subjects. Significant associations were found between DAT binding asymmetries in the caudate and putamen and the temperamental dimensions of harm avoidance and novelty seeking. Specifically, high novelty seeking scores correlated with increased DAT binding in the left caudate relative to the right, whereas higher harm avoidance scores corresponded to increased DAT binding in the right putamen relative to the left. These observations potentially imply that the asymmetry in DAT expression in the basal ganglia could be an outcome of hemispheric asymmetry in emotional processing and behavioural guidance. In summary, our study provides evidence supporting the relationship between DAT asymmetries, temperamental dimensions and GD. Future investigations could be directed towards examining postsynaptic receptors to gain a more comprehensive understanding of dopamine's influence within the basal ganglia circuit in disordered gambling. If confirmed in larger cohorts, these findings could have substantial implications for the tailoring of individualized neuromodulation therapies in the treatment of behavioural addictions. [ABSTRACT FROM AUTHOR]

Introduction: Recovery from substance use disorder (SUD) is increasingly recognized as a personal journey, necessitating an approach that considers individual goals and priorities. Research on recovery priorities in inpatient settings is limited. Our study employs Q-methodology to explore recovery priorities among clients with multimorbid SUD, aiming to guide targeted, recovery-oriented care. Methods: This cross-sectional study employed Q-methodology to explore recovery priorities among 129 individuals entering inpatient addiction treatment. A collaboratively developed Q-set of 42 statements covered clinical, functional, and personal recovery goals. Participants ranked statements by importance, and rotated factor analysis was used to identify clusters of recovery priorities. Qualitative interview data were then analyzed for further interpretation. Results: We found 12 consensus statements and two distinct factors. Factor 1 (n = 60) emphasized personal growth and coping, while factor 2 (n = 51) highlighted practical aspects such as securing income and housing. Qualitative data supported these findings. Conclusions: Despite the individual nature of recovery and the diversity within the addiction treatment population, our study identified shared goals and two distinct factors. This insight can inform tailored interventions, with factor 1 individuals potentially favoring psychological approaches and factor 2 individuals focusing on practical goals. [ABSTRACT FROM AUTHOR]

Addiction is a complex neurobiological disorder characterized by compulsive drug-seeking and use despite harmful consequences. While abstinence-based approaches have long been the cornerstone of addiction treatment, recent years have seen legitimate challenges from harm reduction clinicians, and within the food addiction realm, the eating disorder treatment practitioners. This perspective emphasizes the role of abstinence in food addiction recovery using the Koob model and its concept of hyperkatifeia despite these reservations. However, further research is essential before abstinence can be recommended. We need to 1) identify what qualifies as abstinence in relation to ultra-processed food, 2) clarify suitable situations and disease progression for optimal implementation of this approach, 3) provide clear guidelines when it is harmful, and 4) conduct clinical studies to confirm the effectiveness of this strategy for long-term recovery from late-stage food addiction. [ABSTRACT FROM AUTHOR]

AbstractBackgroundMethodsResultsConclusionEmergency department (ED) visits are an opportunity to provide prevention services to people at high risk of overdose. Considering patients’ resources to initiate and sustain recovery ("recovery capital”) may be useful for tailoring ED services, although its relevance in this population is unknown.This secondary analysis used data from ED patients at high risk of opioid overdose enrolled in a randomized controlled trial in Rhode Island (2018–2021). We assessed baseline recovery capital using the Brief Assessment of Recovery Capital (BARC-10), dichotomized as a total score <47 versus ≥47. Post-discharge addiction treatment engagement within 30 days and non-fatal opioid overdose and fatal overdose within 18 months were assessed using statewide administrative data. We used modified Poisson regression and Cox proportional hazards models to estimate the association between recovery capital and (1) treatment engagement and (2) overdose risk, respectively, adjusting for potential confounders.Among 543 participants, 32.2% had a baseline BARC-10 total score of ≥47, 32.6% engaged in treatment within 30 days, and 25.6% had a non-fatal opioid overdose and 4.2% had a fatal overdose within 18 months. BARC-10 total score was not associated with treatment engagement within 30 days (adjusted relative risk = 0.79, 95% confidence interval [CI] = 0.60–1.05) or non-fatal opioid overdose (adjusted hazard ratio [aHR] = 0.83, 95%CI = 0.57–1.20) or fatal overdose (aHR = 0.45, 95%CI = 0.14–1.40) within 18 months.The majority of ED patients at high risk of opioid overdose had a BARC-10 total score of <47, suggesting low recovery capital. BARC-10 total score was not associated with post-discharge treatment engagement or overdose risk. [ABSTRACT FROM AUTHOR]

Background: There has been a growing interest in the use of psychedelics for therapeutic purposes. However, there is a lack of research on peer recovery coaches' attitudes toward the use of psychedelics for SUD treatment. Therefore, we conducted a survey of peer recovery coaches in Massachusetts to gain insight into their attitudes toward the use of psychedelics to treat SUDs. Methods: Peer recovery coaches in Massachusetts were invited to participate in an online survey between August and October 2023. The survey collected respondents' demographics, socioeconomic characteristics, personal substance use history, opinions on psychedelics for addiction treatment, and spiritual experiences. Results: 146 individuals completed the survey. The mean age was 48.7 years (SD 11.2), 61% identified as female, 74% were employed as peer recovery coaches, and 43% were Certified Addiction Recovery Coaches (CARC). 70.7% reported utilizing 12-step programs, and 76% reported having a personal history of using psychedelics. The majority of participants agreed that they would feel comfortable being a coach for someone using psychedelics to treat SUDs. However, a significant number of participants expressed concerns. Those who had utilized 12-steps were more likely to express concerns about the dangers of using psychedelics to treat SUD. Conversely, participants with a personal history of psychedelic use were more likely to support the use of psychedelics for the treatment of SUDs. Conclusions: While peer recovery coaches express support for using psychedelics to treat SUD, they also voice concerns about the potential risks. [ABSTRACT FROM AUTHOR]

Aims Methods Results Conclusions To offer insights into various salient substance use and addictive behaviours related aspects as applicable to India.We synthesised the published literature on addictive disorders from India. While not a systematic review of all available literature, the synthesis captures relevant themes including salient epidemiological findings, issues related to the prevention and management services targeted at addictive disorders, key observations in the context of the state of addiction science in the country, the policy status and its implications for the country.In general, the prevalence of substance use in India seems to be lower compared with global averages. For opioids, the prevalence rate is higher than the global average. Addiction prevention and treatment options for persons with addictive disorders in India can be best described as ‘diverse’: there is a wide range of services available, which vary across settings. Some models, services and products aimed at prevention and treatment of addictive disorders have been developed in the country. The policy, regulatory framework and programs targeted at addictions are not entirely in sync with the science. India has a substantial body of addiction science research.The addiction landscape in India is complex and evolving. There is a heterogeneity not only across the different themes related to addiction, but also within the themes across different parts of the country. [ABSTRACT FROM AUTHOR]

Mobile Phone Addiction represents an emergent addictive disorder that gravely jeopardizes the physical and mental health of adolescents worldwide, necessitating exhaustive research. Current reviews of MPA are in dire need of updates and enhancements. Therefore, this review aggregates the extant research spanning the past two decades on the prevalence, pathogenesis, comorbidities, assessment, and treatment of MPA, aiming to furnish a reference for future investigations into this condition. Pathogenesis, pathophysiology, assessment and treatment of MPA. [ABSTRACT FROM AUTHOR]

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

Background: Rural and frontier communities face high rates of opioid use disorders (OUDs). In 2021, the Rural Addiction Implementation Network (RAIN) sought to establish a rural hospital/clinic-system practice-based research network (RH-PBRN) to facilitate implementation of evidence-based addiction-related prevention, treatment, and recovery (PTR) services to reduce the morbidity of OUD and substance use disorder (SUD) in rural communities. Objective: To describe the goals and implementation of PTR activities of RAIN, a novel RH-PBRN. Methods: RAIN identified teams of external/internal facilitators at four rural hospitals/clinic-networks to achieve at least 15 PTR activities involving OUD and other SUDs. RAIN utilized an implementation-facilitation approach: facilitators assessed the implementation environment and promoted interventions to overcome barriers to PTR implementation. Other interventions included site visits, community of learning calls, and e-communication. RAIN assessed and recorded facilitators and barriers to implementation, milestone attainment, and outcomes of PTR activities. At 18 months, we queried facilitators about the fidelity and implementation of RAIN activities. Results: RAIN established an HP-PBRN in four sites (Idaho, Montana, Utah, and Wyoming). Within the HP-PBRN, 20 PTR activities were established (p = 7, T = 10, R = 3; range 3–7 per site). Barriers to implementation of PTR activities included competing clinical demands, especially due to COVID-19, lack of dedicated effort for staff at sites, and stigma of addiction and its treatment. Facilitators of implementation included the use of trained expert facilitators and communication between the sites. Conclusions: RAIN implemented 20 addiction-related PTR activities in four rural hospitals/clinic-networks. RAIN's intervention model could be replicated to address addiction-related harms in other rural communities. [ABSTRACT FROM AUTHOR]

Introduction: Patient‐centred care has become increasingly important in health care. Patient‐reported experience measures (PREM) are used to measure patient experiences in health care, but the availability of psychometrically validated PREMs is limited. The Patient Reported Experience Measure in Addiction Treatment (PREMAT) is a PREM developed with extensive service user input to assess the experiences of people in residential addiction treatment services. In this study we aimed to evaluate the psychometric properties of the Dutch translation of the PREMAT, the PREMAT‐NL. Methods: Ninety‐three participants completed the PREMAT‐NL approximately 45 days after starting addiction treatment as part of a naturalistic prospective multi‐centre study in Belgium. We examined the factorial structure using principal component analysis with Promax oblique rotation and assessed the internal consistencies of the subscales and total score using Cronbach's α. Additionally, we explored the relationship of PREMAT‐NL scores with demographic and clinical variables. Results: The PREMAT‐NL had a four‐factor structure, with good internal consistencies of the subscales (Cronbach's α >0.70) and excellent internal consistency of the total score (Cronbach's α = 0.94). The PREMAT‐NL total score was negatively skewed, and four score categories were proposed based on z‐scores. PREMAT‐NL scores correlated weakly with the type of treatment centre (r = 0.21, p < 0.05) and with previously received treatment for addiction (r = −0.25, p < 0.05). Discussion and Conclusions: Although the factor structure and thus the appropriate use of subscales need further investigation, the findings of this study support the use of the PREMAT‐NL total score as a valid and reliable PREM to evaluate residential addiction treatment services. [ABSTRACT FROM AUTHOR]

We studied opioid agonist treatment (OAT) status before buprenorphine-related death in Finland, where buprenorphine is the principal OAT medicine and also the most misused opioid, through a retrospective population-based study using medico-legal cause-of-death investigation and OAT patient records. The study included all death cases (N = 570) between 2018 and 2020 with a buprenorphine or norbuprenorphine finding in post-mortem toxicology and with known drug misuse history or concomitant findings of illicit drugs. Of the deceased, 10% had received OAT in the year before death. Less than 1% of individuals < 25 years had received OAT, whereas the proportion in individuals ≥ 25 years was 13% (p < 0.001). There were significantly more females and more fatal poisonings (p < 0.001) among those < 25 years than among those ≥ 25 years. OAT medication at the time of death was sublingual buprenorphine-naloxone in 74% and subcutaneous buprenorphine in 23%. Except for significantly fewer benzodiazepine findings among those receiving OAT, minimal differences were found in terms of age, gender, cause and manner of death, or concomitant substance use between the deceased in and outside of OAT. Concomitant misuse of benzodiazepines, psychostimulants, alcohol, and gabapentinoids was frequent both in and outside of OAT and likely contributed to the death. These results suggest that access to OAT especially for young people and treatment of multiple addictions should be improved. Comprehensive information from medico-legal cause-of-death investigation as a starting point, combined with subsequent ante-mortem patient records, proved to be a successful approach to shed light on the Finnish scene of buprenorphine mortality. [ABSTRACT FROM AUTHOR]

The purpose of this study was to attempt to verify the existence of a relationship between internal resources (self-esteem and self-efficacy) and motivation (decisional balance) to undergo treatment in prisoners with alcohol addiction participating in voluntary treatment as well as referred to obligatory addiction treatment based on a court decision. The study was carried out in penitentiary units in various parts of Poland in 2018–2019. Participants completed the Decision Balance Scale, Generalized Self–Efficacy Scale, and Multidimensional Self-Esteem Inventory twice – before and after addiction treatment. The study adopted the assumptions of the Transtheoretical Model developed by Prochaska and DiClemente (1984). There were no statistically significant differences between the group of prisoners referred for obligatory treatment and those undergoing voluntary therapy. At the end of the 3-month treatment, there was a significantly smaller number of arguments "for" drinking and less identity integration in both groups studied. The results obtained may indicate that after undergoing therapy, prisoners remain in a contemplation stage due to their inability to adapt therapeutic interactions to individual needs. It seems that changes in identity integration may be indicative of the crisis that is being experienced, which in effect may allow individuals with alcohol addiction to search for and achieve a potentially new, coherent image of themselves. • Addiction treatment, should focus on the resources of the convicted rather than their deficits. • Higher self-esteem increases the motivation to complete therapy and continue it after the end of incarceration. • Motivation plays a significant role in the completion of alcohol therapy, so it is important to diagnose patients in this regard before starting therapy, instead of mistakenly assuming the lack of motivation and the need to induce it. • People who undergo therapy with a court order only begin to realize the problem of alcohol dependence and begin to think about changing their behavior during the therapy. [ABSTRACT FROM AUTHOR]

Peer recovery coaches (PRCs) are increasingly playing a role in helping patients with substance use disorders engage with treatment. PRCs can support and motivate patients in meeting their self-defined recovery goals, engaging in addiction treatment, navigating the health care system, and overcoming barriers to recovery. This support increases patient engagement and is cost-effective. Little has been written about integrating PRCs in health care settings. In this column, the authors describe the implementation of a PRC program with 23 coaches serving 5,662 participants in diverse clinical settings. The authors discuss key facilitators and barriers and opportunities for further research. [ABSTRACT FROM AUTHOR]

Most overdose deaths in the United States involve opioids. Identification and management of opioid use disorder by primary care physicians is a critical need in health care. Substance use disorders share neurobiological dysregulation of the central motivation and reward pathway (powered by dopamine) that manifests as a cycle of addiction driven by impulse and compulsion. It is important that concern for opioid use disorder does not disrupt appropriate treatment of pain and that analgesic narcotic use is adequately monitored, especially in patients at risk of opioid use disorder. Most patients with opioid use disorder do not receive treatment. Those who do receive treatment will experience uncomfortable, but not life-threatening, symptoms of withdrawal. These symptoms can be managed with alpha2-adrenergic and opioid agonists that also reduce the reinforcement of drug use and help prolong recovery. The 2023 Mainstreaming Addiction Treatment Act removed the waiver requirement for buprenorphine prescribing, which closes the substantial gap in access to medication for opioid use disorder existing across gender, racial, and socioeconomic groups. Treatment plans that include medication for opioid use disorder have been shown to substantially reduce mortality. [ABSTRACT FROM AUTHOR]

Drug addiction is closely related to the dysregulation of complex neural circuits. However, the neural connections underlying the symptoms of methamphetamine (METH)-induced addiction have yet to be elucidated. We conducted ΔFosB (Delta FBJ murine osteosarcoma viral oncogene homolog B) associated immunofluorescence and electrophysiological recording experiments to measure the neural activity of paraventricular thalamus (PVT) neurons in METH treated mice. Then, the METH-mediated conditional place preference (CPP) behaviors were evaluated after chemogenetic manipulation of PVT neurons. Additionally, the neural projection from PVT to medial prefrontal cortex (mPFC) was verified through Adeno-associated virus (AAV) mediating neural tracing method, and its role on METH-mediated CPP behaviors was determined using chemogenetic and neural ablation strategies. We found that glutamatergic neurons in PVT were activated by METH. Activating the glutamatergic neurons in PVT promoted the METH-mediated CPP behaviors, while inhibiting these neurons attenuated the CPP behaviors. Moreover, we observed PVT neurons showed robust neuronal projections to mPFC, activation of the mPFC→projecting neurons in PVT or the afferent terminals in mPFC derived from PVT enhanced METH-mediated CPP performance, and ablating the mPFC neurons receipting neural projection from PVT impeded these increased METH-mediated CPP phenotypes. The underlying molecular mechanism of the dysfunctional PVT neurons after METH treatment and the PVT neurons regulating the activity of mPFC target neurons remains unclear. These results shed light on that PVT is a key METH addiction-controlling nucleus, and PVT → mPFC projection regulated METH-mediated CPP behaviors, which could serve as a vital pathway for morbidity and treatment for METH-mediated addiction. • PVT glutamatergic neurons are crucial in the pathology of METH-induced addiction. • PVT-mPFC projections regulated METH-induced CPP behaviors. • PVT-mPFC neural circuit is vital in treating METH-induced addiction. [ABSTRACT FROM AUTHOR]

The removal of the X-waiver in the Mainstreaming Addiction Treatment (MAT) Act of 2023 has substantial implications for buprenorphine prescribing as one of the options to treat opioid use disorder. The purpose of this commentary is to discuss the unanswered questions regarding buprenorphine in the intensive care unit (ICU) including how the passage of the MAT Act will affect ICU providers, which patients should receive buprenorphine, what is the most appropriate route of administration and dose of buprenorphine, what medications interact with buprenorphine, and how can transitions of care be optimized for these patients. [ABSTRACT FROM AUTHOR]

Background: Morbidity and mortality related to substance use have risen to catastrophic levels in North America, and treatment services are often difficult to access. In response, the province of British Columbia (BC), Canada, launched a province-wide addiction medicine support phone line that offers clinicians immediate access to phone consultation with an addictions medicine expert. The service operates 24/7 is accessible to any clinician in the province seeking assistance with an addiction-related question. We describe an evaluation of the reach and perceived impact of the service over its first two years. Methods: The 24/7 Addiction Medicine Clinician Support Line was evaluated prospectively from June 2020 to April 2022. All provider-to-provider encounters were included. Data was collected from two primary sources: health provider demographic information collected at the time of consultation, and optional clinician surveys conducted after the consultation was complete. Descriptive data are presented as numerical values and percentages. Results: Over the 22-month evaluation period, 1,279 consultations were requested by 631 distinct care providers across British Columbia. The service averaged 15 calls per week across the province, and 51.5% of calls were made outside of business hours. Physicians made the majority of calls to the service (n = 865, 67.6%), followed by nurse practitioners (n = 162, 12.7%). Among those who completed a follow-up survey (n = 258 calls, 20.2% total calls), 81.8% (n = 211) were "very" or "extremely" satisfied with the consultation. Of these respondents, 65.5% (n = 169) reported that the consultation led to the provision of better care for their patient, with 58.1% (n = 150) initiating a new prescription and 22.1% (n = 57) reporting expedited treatment for their patient. The consultation area of focus was most commonly opioid use (n = 417; 59.6%), followed by polysubstance use (n = 98; 14.0%). Conclusions: The impact of the 24/7 Addiction Clinician Support Line was widespread, and the service increased accessibility to evidence-based addictions treatment across a range of care settings. Clinicians expressed a high degree of satisfaction with the service. To our knowledge, this province-wide program is the first of its kind in North America, offering a scalable and adaptable model to support access to evidence-based addictions care in under-resourced settings. [ABSTRACT FROM AUTHOR]

Objective: Most patients with alcohol use disorder (AUD) regularly take medication. Alcohol interacts negatively with many commonly prescribed medications. Little is known about whether the risk of potential alcohol-medication and drug-drug interactions increases or decreases in patients with AUD during inpatient withdrawal treatment. The aim of our study was to determine the prevalence and characteristics of potential alcohol-medication and drug-drug interactions in patients with AUD before and after withdrawal treatment in an addiction unit. Design: Prospective monocentric quasi-experimental pre-post study. Methods: Medication records before and after withdrawal treatment were analyzed and screened for potential alcohol-medication (pAMI) and drug-drug interactions (pDDI) using the drugs.com classification and the AiDKlinik® electronic interaction program, respectively. Results: We enrolled 153 patients with AUD who were treated in an addiction unit of a university hospital in Germany. Of these, 67.3% experienced at least one pAMI before and 91.5% after withdrawal treatment. In total, there were 278 pAMIs classified as "mild," "moderate," or "severe" before and 370 pAMIs after withdrawal treatment. Additionally, there were 76 pDDIs classified as "moderate," "severe," or "contraindicated combinations" both before and after withdrawal treatment. Conclusion: The risk of exposure to pAMIs and pDDIs increases during inpatient withdrawal treatment in patients with AUD. Improvements in the quality of prescribing should particularly focus on the use of antihypertensives and opioids. [ABSTRACT FROM AUTHOR]

Mobile Phone Addiction represents an emergent addictive disorder that gravely jeopardizes the physical and mental health of adolescents worldwide, necessitating exhaustive research. Current reviews of MPA are in dire need of updates and enhancements. Therefore, this review aggregates the extant research spanning the past two decades on the prevalence, pathogenesis, comorbidities, assessment, and treatment of MPA, aiming to furnish a reference for future investigations into this condition. [ABSTRACT FROM AUTHOR]

Background: Congress 60 is an NGO that offers services to drug abusers, but its underlying theory has not been explored in previous studies. The purpose of this study is to examine the changes in the physical dimensions of the people treated in Congress 60. Methods: Grounded theory methodology was used to arrive at the underlying theory of Congress 60. The data were collected from 2021 to 2023 through interviews with 21 individuals, participant observation, and a review of available texts from Congress 60. Data were analyzed in MAXQDA 2020 following the constant comparison method recommended by Corbin and Strauss in 2014. Findings: The core concept included "Addiction-related transformations in body structures". Addiction-related transformations in body structures include addictive body structures (addiction and chronic substitution, and nervous system and external substances) and healthy body structure (opium tincture medicine, opium tincture dosage measurement, and taper-up-off of opium tincture in over time or Dezhakam Step Time). Conclusion: The theory of "Addiction-related transformations in body structures" derived from this study explains the process of entering and leaving addiction from the perspective of Congress 60. A person using drugs enters Congress 60 with addicted body structures. In Congress 60, using the right dose of opium tincture medicine and the Dezhakam Step Time (DST) method, the person's body structures return to normal. The findings of this study offer a novel perspective on addiction, suggesting potential avenues for further research through the exploration of various hypotheses. [ABSTRACT FROM AUTHOR]

Deferred Prosecution with Condition to Complete the Addiction Treatment (DPCCAT) is a judicial diversion program in Taiwan that shifts people who use drugs away from the label drug offender and toward the label patient. However, little is known about the effectiveness of completing a DPCCAT program on people who use drugs. Using a nationwide population-based retrospective panel data from 2008 to 2020, recidivism is defined as a person was caught urine positive and charged by a prosecutor after their completion of DPCCAT. After controlled gender, age, and region, comparisons of recidivism rates and time to relapse between Schedule I drug use only, Schedule I & II drug use, and heterogeneous group were examined. Of 24,248 participants with DPCCAT, 11,141 (46%) completed the one-year treatment program. Of completers, the five-year recidivism rates are significantly lower for the Schedule I drug use only (26%) than Schedule I & II drugs use (52%) and heterogeneous group (47%). Results from Cox regression indicated that the duration of recidivate to drug use is significantly longer for the Schedule I drug only than the other two groups after controlling for demographics. The main findings support that completion of a DPCCAT program only reduces the risk of recidivism for people who use Schedule I drug only and is less effective for polydrug users and heterogeneous group. We suggest that characteristics of people who use drugs and other criminal offenses should be taken into consideration for triage when DPCCAT is offered. [ABSTRACT FROM AUTHOR]

Copyright of De Familias y Terapias is the property of Instituto Chileno de Terapia Familiar and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of De Familias y Terapias is the property of Instituto Chileno de Terapia Familiar and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

ABSTRACT In addiction treatment, harm reduction is a philosophy that aims to reduce the harms from ongoing alcohol and other drug use. Although abstinence may be the ‘gold standard’ in reducing harm from ongoing alcohol and other drug use, harm reduction recognises that abstinence may not be achievable for certain individuals. Accordingly, harm reduction is used to enable medical or mental health treatment for individuals who continue to use alcohol and other drugs, providing a form of care which meets individuals where they present to healthcare facilities. Harm reduction accepts ongoing alcohol and other drug use, while providing a traditionally marginalised cohort of individuals access to healthcare services. In this perspective paper, we argue that the role of nurses in promoting and utilising harm reduction as part of their regular practice is essential to both reducing harm from alcohol and other drug use, engaging individuals who use alcohol and other drugs in healthcare services, and providing a means to accept individuals as they are to build trust and rapport for engagement in addiction treatment when they are ready, and at their own pace. Nurses, by virtue of their role and number in the healthcare landscape (approximately 28 million globally), are ideally placed to implement harm reduction in their practice to achieve better outcomes for individuals who use alcohol and other drugs. [ABSTRACT FROM AUTHOR]

Background: Psychedelic substance use in ritualistic and ceremonial settings dates back as early as 8,500 BCE. Only in recent years, from the mid-20th century, we have seen the re-emergence of psychedelics in a therapeutic setting and more specifically for the treatment of addiction. This article aims to review research over the past 40 years using classic (psilocybin, lysergic acid diethylamide [LSD], dimethyltryptamine [DMT], mescaline) and atypical (ketamine, ibogaine, 5-MeO-DMT, 3,4-methylenedioxymethamphetamine) psychedelics for the treatment of addiction. Summary: We will start with an overview of the pharmacology and physiological and psychological properties of psychedelic substances from pre-clinical and clinical research. We will then provide an overview of evidence gathered by studies conducted in controlled research environments and naturalistic and ceremonial settings, while we identify the proposed therapeutic mechanisms of each psychedelic substance. Key Messages: Classic and atypical psychedelics show promise as therapeutic alternatives for the treatment of addiction, through the improvement of psychological and physiological symptoms of dependence. A more comprehensive understanding of the ancient and present-day knowledge of the therapeutic potential of psychedelics can facilitate hope for psychedelic therapeutics in the treatment of addiction, especially for individuals who have failed other conventional treatment methods. [ABSTRACT FROM AUTHOR]

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

Background: Kratom/ketum is a psychoactive herbal preparation that has been used for a long time as a remedy and performance-enhancing substance in Southeast Asia. The advancement of globalization is making kratom increasingly more available in the western world, where it is becoming increasingly more used. Objective: The current research on kratom and its ingredients is presented. Material and methods: An overview of the use and effects of kratom is exemplary given on the basis of reports. The instrumentalization of the drug and its consequences up to the development of addiction are discussed. Results: Consumption is accompanied by several instrumentalizeable effects so that kratom is used as a therapeutic substance in the self-management of pain, anxiety and depression as well as other substance addictions. Another benefit comes from the performance-enhancing effects on physical work and in a social context. Consumption is usually well controlled, rarely escalates and has few and mostly mild aversive side effects. The danger arises from consumption particularly when there is an escalation of the dose and from mixed consumption with other psychoactive substances. The main alkaloid mitragynine and the more potent 7‑hydroxy-mitragynine are considered mainly responsible for the effect. Both have a complex pharmacology that involves partial µ‑opioid receptor agonism. Discussion: Epidemiological, clinical and neurochemical studies have shown that kratom only has a limited addictive drug profile, which might suggest a medical use as a remedy or substitute in addiction treatment. [ABSTRACT FROM AUTHOR]

Background: In Germany 1.5–2.75 million children live in families affected by substance use disorders. Substance abuse can impact on family interactions in many ways. If a dependent parental drug use continues over a longer period of time, this can have pronounced psychological and social consequences for the (co)affected children. Nevertheless, family-focused treatment approaches are not yet widely used in the context of addiction treatment. Aim: This review article aims to provide an overview of the prevalence of parenthood among dependent drug users in Germany, the impact of dependent drug use on families and family-focused treatment approaches. Methods and results: Recording parenthood is particularly difficult in the case of dependent drug users as they often do not openly discuss it with their therapists because of the fear of consequences from youth welfare services. In order to change this, a structured recording of parenthood by the treatment providers is required. This is the prerequisite for being able to offer family-focused treatment to those affected. In Germany, three evidence-based therapy programs are available for this purpose: SHIFT, SHIFT Plus and MAMADAM. Additionally, a number of programs developed in the Anglo-American region can also be used. In contrast, the evidence for web-based programs is much weaker. Discussion: In order to establish family-focused treatment approaches for drug-using parents across the board, long-term, secure funding is required. The necessary framework conditions must be created at a political level. [ABSTRACT FROM AUTHOR]

The variation in improvement among individuals with addiction after abstinence is a critical issue. Here, we aimed to identify robust multimodal markers associated with high response to 8-month abstinence in the individuals with heroin use disorder (HUD) and explore whether the identified markers could be generalized to the individuals with methamphetamine use disorder (MUD). According to the median of craving changes, 53 individuals with HUD with 8-month abstinence were divided into two groups: higher craving reduction and lower craving reduction. At baseline, clinical variables, cortical thickness and subcortical volume, fractional anisotropy (FA) of fibers and resting-state functional connectivity (RSFC) were extracted. Different strategies (single metric, multimodal neuroimaging fusion and multimodal neuroimaging-clinical data fusion) were used to identify reliable features for discriminating the individuals with HUD with higher craving reduction from those with lower reduction. The generalization ability of the identified features was validated in the 21 individuals with MUD. Multimodal neuroimaging-clinical fusion features with best performance was achieved an 87.1 ± 3.89% average accuracy in individuals with HUD, with a moderate accuracy of 66.7% when generalizing to individuals with MUD. The multimodal neuroimaging features, primarily converging in frontal regions (e.g., the left superior frontal (LSF) thickness, FA of the LSF-occipital tract, and RSFC of left middle frontal-right superior temporal lobe), collectively contributed to prediction alongside dosage and attention impulsiveness. In this study, we identified the validated multimodal frontal neuroimaging markers associated with higher response to long-term abstinence and revealed insights for the neural mechanisms of addiction abstinence, contributing to clinical strategies and treatment for addiction. [ABSTRACT FROM AUTHOR]

Background and objectives: The provider–patient relationship is integral to medical practice and health outcomes, particularly among vulnerable patient populations. This study compared the provider–patient relationship among pregnant patients with opioid‐use disorder (OUD), who did or did not have a history of moderate to severe trauma. Methods: This was an exploratory data analysis of 119 patients enrolled in the Support Models for Addiction Related Treatment trial. Probable posttraumatic stress disorder (PTSD) was determined by a score ≥ 31 on the PTSD Checklist for Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition. The provider–patient relationship was assessed at 26 ± 4 weeks of pregnancy using the Kim Alliance Scale (KAS). Multivariable regression was used to examine the association of KAS with probable PTSD among pregnant people with OUD. Results: The mean KAS score for pregnant participants without probable PTSD (N = 88) was 61.4 (SD ± 2.8) and for pregnant participants with probable PTSD (N = 31) was 59.6 (SD ± 3.7). Results demonstrated significant differences in KAS scores between those with and without probable PTSD after adjusting for demographic variables. Adjusted mean total KAS scores and scores on Empowerment and Communication subscales were significantly lower among those with probable PTSD compared to those without (p =.04 and 0.02, respectively) but did not differ significantly on Collaboration and Integration subscales. Conclusions and scientific significance: Analyses show an association between probable PTSD and provider–patient relationship among pregnant patients with OUD, with those with probable PTSD having a worse alliance with obstetric providers. This novel finding helps characterize the provider–patient relationship among a uniquely vulnerable population and can inform efforts to integrate trauma‐informed practices into prenatal care. [ABSTRACT FROM AUTHOR]

There are different treatments for food addiction (FA) symptomatology, but a comprehensive review with a meta-analysis to determine the most effective intervention is lacking. The aim of this review is to investigate the efficacy of pharmacological, behavioral, and bariatric-metabolic surgical interventions in reducing FA symptomatology. Meta-analyses including 15 studies in adults showed a significantly positive effect (std mean difference in FA symptoms before vs after intervention 0.72 (0.58–0.95)), with bariatric-metabolic surgical interventions showing the highest efficacy in improving FA symptoms (1.17 (0.58–1.76) before vs after intervention). The existing evidence suggests a beneficial effect of bariatric-metabolic surgical, pharmacological, and behavioral interventions, in that order, on FA symptomatology in people with overweight/obesity. Weight loss and behavioral and lifestyle changes after surgery may be determinants in improving FA symptomatology. [ABSTRACT FROM AUTHOR]

Copyright of Cyprus Turkish Journal of Psychiatry & Psychology (CTJPP) / Kıbrıs Türk Psikiyatri ve Psikoloji Dergisi is the property of Cyprus Turkish Journal of Psychiatry & Psychology (CTJPP) and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

The fight against substance use disorders, which have been on the rise in recent years, requires a multidisciplinary approach. The factors that cause addiction, environmental factors that enable substance access, and the resulting harm from substance use are intertwined. As per the 2021 data released by the Istanbul Morgue Specialization Department of the Council of Forensic Medicine, drug or stimulant use caused 1.7% of the 5458 autopsies conducted. In our research, deaths resulting from polysubstance use are the most prevalent, with amphetamine derivatives being the most frequently detected substance. The rise in fatalities associated with amphetamine derivatives and their easy accessibility pose a significant public health concern. Based on these findings, it is crucial to focus on the environmental and economic factors that support the use of these substances to control access to amphetamine derivatives. Additionally, people with substance abuse problems are isolated due to social isolation. This situation makes it difficult for them to access addiction treatment and prevents them from receiving emergency medical intervention in the event of an overdose. In this context, it is advisable to adopt a multidisciplinary approach and to develop a comprehensive intervention strategy in cooperation with the health, education, and security sectors. [ABSTRACT FROM AUTHOR]

Different care networks in Spain evaluate the co-occurrence of substance use disorders (SUD) and other mental disorders (OMDs). This study aimed to explore the differences in prevalence, sociodemographic and clinical profile, pharmacological treatment, and gender perspective of the co-occurrence of SUD and OMD between specific addiction treatment networks and mental health networks. This is an observational, cross-multicenter study with a randomized sample of patients under treatment for SUD or OMDs in different autonomous communities of Spain (N = 1783). Sixty-seven health professionals completed an ad hoc online questionnaire, collecting sociodemographic variables with patients diagnosed with SUD and OMDs, and their pharmacological treatments. The findings revealed a high prevalence of OMD in patients treated for SUD (71%) and those for OMD diagnosed with SUD (59%). Specific relationships between the SUDs and OMDs were identified. In networks treating SUDs, the increase in treatment for OMDs was widespread. However, the addition of SUD treatments in mental health networks was less frequent than expected. In addition, an elevated benzodiazepine prescription was detected in both settings. Some possible gender biases in treatments were found. This study provides preliminary information on the coexistence in routine clinical practice of addictive disorders and other mental disorders in Spain. The results revealed that the treatments provided are inefficient for SUDs in patients treated in mental health settings. Furthermore, a high prescription of anxiolytics and differences by sex are shown. These findings may contribute to adapting the treatment response with greater precision and effectiveness. [ABSTRACT FROM AUTHOR]

Introduction: The opioid crisis, a declared national health emergency, has prompted the exploration of innovative treatments to address the pervasive issues of opioid cravings and associated depression. Aims: This pilot cohort study investigated the efficacy of transcranial Photobiomodulation (tPBM) therapy using the SunPowerLED helmet to alleviate these symptoms in individuals undergoing treatment for opioid addiction at a rehabilitation center in West Virginia. Methods: Employing a quasi-experimental design, this study enrolled participants into two groups: one receiving tPBM therapy alongside standard care and a control group receiving standard care alone. The helmet features include the following: total wavelength = 810 nm, total irradiance = 0.06W/cm² (60 m W/cm²), and total fluence = 172.8J/cm². Results: The results of the Wilcoxon signed-rank tests for within-group analysis and Mann--Whitney U tests for between-group comparisons revealed statistically significant reductions in the intensity (W = 7.36, p = 0.012), time (W = 6.50, p = 0.015), frequency (W = 6.50, p = 0.010), and total scores of opioid cravings (W = 7.50, p = 0.009), as well as improvements in depression symptoms (W= 8.00, p = 0.005) within the PBM group compared to the non-PBM group. Discussion: These findings suggest that transcranial PBM therapy could be a promising noninvasive intervention for reducing opioid cravings and depressive symptoms in individuals with opioid use disorder, warranting further investigation through larger randomized controlled trials. [ABSTRACT FROM AUTHOR]

Driving the overdose epidemic, a significant proportion of adult and adolescent patients seen in neurology practice and hospital settings has substance use disorder. Fortunately, there are effective treatments available, in particular for opioid addiction. Some elements of treatment can be delivered directly in medical office-based settings, while others are best provided from within specialized addiction treatment facilities. In this article, we review the nature of substance use disorders, and the various treatment approaches that can be utilized to stabilize patients and facilitate their building a strong recovery foundation. Some interventions discussed may be directly provided by a physician identifying the disorder, while others involve collaboration with specialized addiction treatment centers and recovery support entities. [ABSTRACT FROM AUTHOR]

Abstract: Aim: Forensic addiction treatment in accordance with § 64 of the German Criminal Code (StGB) is carried out in the context of the legal order under given time and organizational conditions. How a contemporary forensic treatment practice for addicted offenders can nevertheless take place is described using the concept of two locations of a Bavarian clinic treating approximately 420 patients. Methods: The article first summarizes the framework conditions resulting from the penal code and state-specific enforcement law. The focus is on the presentation of the continuously developed and optimized treatment concept of the medbo clinics (Parsberg, Regensburg). In addition to clinical experience, scientific findings on the importance of substitution, aftercare and a more goal-oriented and patient-centered approach influenced the development of the concept. Discussion: Working in a correctional facility is caught between the two core missions of resocialization and protection of the general public. It is not only the comparatively long periods of detention that enable in-depth work on delinquency and disorder genesis and intensify the resocialization phases with extended real-life trials. Outpatient aftercare is now an integral part of forensic addiction therapy. However, limitations are also identified, such as the particular challenges posed by the nature of crime, the legal framework and the dual role of staff. [ABSTRACT FROM AUTHOR]

This research aims at studying the cognitive distortions and psychosis among the meth-amphetamine users. This study was exploratory in nature and qualitative research design was used. The sample size of this study was N=19 meth-amphetamine users who were residing in different rehabilitation centers of Islamabad/Rawalpindi and convenient sampling technique was used. Semi-structured interviews were conducted and then the thematic analysis was used to analyze the data. The results of the analysis indicates that there is a strong association between cognitive distortions and psychotic symptoms. The results also highlighted that the most common type of cognitive distortions includes all or nothing thinking, mental filtering, and catastrophizing. This study has shown that hallucinations and paranoid delusions can cause significant harm to their day-to-day functioning as well as to their quality of life. The research highlight the critical role that social and emotional support plays in mitigating the impact of cognitive distortions on mental illness. The results of this study highlights the need of comprehensive intervention techniques which will target both the cognitive and psychosocial levels in the treatment of addiction to prevent the relapse rate. [ABSTRACT FROM AUTHOR]

The nature and origins of addictions and of their adjunctive behaviors, as well as their chronicity, call for treatments that conceptualize and treat them as the long-term and complex processes that they are. Addictions are often comorbid with personality problems and with trauma histories. Patients suffering from these disorders often show poor engagement with treatment and high rates of relapse, possibly because available treatments have yet to address the patient suffering from addiction in a more integrated or holistic manner. In particular, comprehensive treatment models for addictive disorders - like treatments for personality disorders or trauma - are likely to require the integration of behavioral, cognitive, and emotion-focused interventions within a facilitative therapeutic relationship. However, most current treatment models, including ones which are highly effective in stabilization or behavioral change, lack one or more components of treatment that could sustain longer term recovery, wellness, and health for a higher percentage of patients. In this article, I propose approaching addictions and their treatment from the perspective of schema therapy, an integrative, developmental model with a strong track record of positive outcomes in addressing personality disorder symptoms and longstanding trauma histories, commonly comorbid with addictive disorders. In advancing this proposal, I begin by providing some background tying together addictions, attachment, and personality, suggesting they be treated simultaneously to achieve improved outcomes. Then, after briefly reviewing the leading approaches to the treatment of addictions, I introduce the idea that schema therapy is well-situated - both theoretically and practically - to address many of the shortcomings of existing treatment options. In particular, I note how addictive and co-occurring colluding behaviors are deeply intertwined with both early and continued frustration of core developmental needs. I illustrate how the addictive cycle is perpetuated through the process of schema reinforcement and through the operation of schema modes. I then demonstrate how these key terms (i.e., needs, schemas, and modes) inform the patient's assessment and case formulation, guiding treatment interventions from a strong therapeutic relationship that focuses on integrating recovery behavior change, healing dysfunctional schemas and modes, and preventing relapse. [ABSTRACT FROM AUTHOR]

While the construct of food addiction has been controversial, there is growing evidence that certain foods can activate biobehavioral and neurological mechanisms consistent with addiction to other substances. Despite increased evidence and acceptance of certain foods as addictive substances amongst the scientific community, there is a paucity of interventions available that are uniquely suited for the treatment of this condition. Further, many of the addiction and disordered eating treatment models currently utilized for food addiction are seemingly at odds, with the former often recommending complete abstinence from trigger foods and the latter promoting intake of all foods in moderation. The Food Addiction Clinical Treatment (FACT) manual was created as an alternative using an empirically supported harm-reduction model specifically targeted to treat the addiction and disordered eating features of food addiction. The purpose of the current article is to expose readers to the key tenets of the FACT manual, demonstrate the feasibility of this intervention with a sample of participants with severe food addiction, and discuss future directions for the treatment of food addiction. Positive outcomes from this intervention provide preliminary evidence for the efficacy of FACT for the treatment of food addiction with minimal negative adverse effects. Future research using randomized control trials and longer follow-up is needed to validate the FACT manual as an empirically supported treatment for food addiction. [ABSTRACT FROM AUTHOR]

In 2016, a new addiction treatment service, Allorfik, was introduced in Greenland. Allorfik has, throughout the implementation and after, used auditing of patient records with feedback to develop the quality of care in treatment. Audits and feedback are routinely done in each treatment center. This study wishes to investigate the development of the quality of treatment through the case notes from the journal audits. This study is based on case notes audits from 2019, 2020 and 2021. In the audits, the focus has been on the quality of documentation and content for ten specific areas in each patient record. Each area was scored on a Likert scale of 0–4 for both outcomes. Statistical analyses were done using Stata 17, and P-values < 0.05 were considered statistically significant. We present baseline characteristics for patients and illustrate the development of quality for both outcomes as time trends with scatter plots. The analysis was based on data from 454 patients and audits of their case notes. The mean number of weeks in treatment is 12.72, and the mean age for the people in the audited case notes is 39. Time had a positive effect on both outcomes, and so each month, documentation increased by 0.21 points (p-value = <0.001), and content increased by 0.27 points (p-value = <0.001). For documentation and content, the quality level has increased significantly with time, and the quality of case notes is at an excellent level at the final audits of all treatment centers. [ABSTRACT FROM AUTHOR]

The study examines the complex assessment of criminal culpability in individuals with ASPD, specifically regarding their ineligibility for conscription due to challenges obeying military regulations and endangering fellow soldiers. The research centers on 135 cases diagnosed with ASPD who sought exemption from conscription in Türkiye between 2018 and 2022, comparing their socio-demographic, clinical, and criminal characteristics. Significantly, individuals with severe ASPD demonstrate a correlation with increased rates of employment (p = .006), a greater frequency of planned offenses (p = .033), and a heightened frequency of criminal records (p < .001). Both groups with ASPD display self-harming tendencies, yet sASPD cases are more often subjected to exemption decisions prior to conscription (84.1%), in contrast to ASPD cases where disqualification arises primarily during conscription (59.1%) (p < .001). The rate of disqualification from conscription is greater among individuals with ASPD during service, particularly for severe cases earlier on. In both groups, younger individuals who live with their parents (p = .046) seek addiction treatment more frequently. sASPD individuals tend to have more criminal records, and exemption decisions often precede conscription. The study highlights differences between ASPD and sASPD, planned offenses, impulsivity, addiction treatment-seeking behavior, and frequency of criminal records as critical elements to consider when evaluating disqualifications for conscription in these groups. [ABSTRACT FROM AUTHOR]