AddictionPub Date : 2025-02-09DOI: 10.1111/add.70000
Maximilian Meyer, Eriks Strazdins, Adrian Guessoum, Jean N Westenberg, Christian Appenzeller-Herzog, Marco E G V Cattaneo, R Michael Krausz, Kenneth M Dürsteler, Undine E Lang, Lars G Hemkens, Marc Vogel
{"title":"Relative risks of adverse effects across different opioid agonist treatments-A systematic review and meta-analysis.","authors":"Maximilian Meyer, Eriks Strazdins, Adrian Guessoum, Jean N Westenberg, Christian Appenzeller-Herzog, Marco E G V Cattaneo, R Michael Krausz, Kenneth M Dürsteler, Undine E Lang, Lars G Hemkens, Marc Vogel","doi":"10.1111/add.70000","DOIUrl":"https://doi.org/10.1111/add.70000","url":null,"abstract":"<p><strong>Background and aims: </strong>Opioid agonist treatment (OAT) is established for opioid use disorder, but limited data on adverse effects exist. We aimed to review relative risks of adverse effects across opioid agonists.</p><p><strong>Methods: </strong>Systematic review with pair-wise meta-analysis of randomized clinical trials. A search in Embase, Medline, PsycInfo, CENTRAL and the Web of Science Core Collection was performed from inception to 11 April 2024 (PROSPERO: CRD42022322722). Two reviewers independently extracted data and used the Cochrane Risk of Bias Assessment Tool. Certainty of evidence was assessed using GRADE (Grading of Recommendations Assessment, Development and Evaluation). Primary outcomes were constipation, sedation, pruritus, sweating, nausea and vomiting, headache and any non-headache pain.</p><p><strong>Results: </strong>We identified 25 eligible trials, including 4892 participants. Reported agonists were methadone, levomethadone, methadyl acetate, buprenorphine, buprenorphine/naloxone, slow-release oral morphine (SROM), diacetylmorphine, hydromorphone and opium tincture. Buprenorphine (all formulations combined) was associated with a lower risk of sedation than methadone [risk ratio (RR) = 0.68 (95% confidence interval = 0.56-0.82)]; 1558 participants, 9 studies]. Methadone had a lower risk of sedation compared with SROM [RR = 0.63 (0.58-0.69); 356 participants, 2 studies] and a lower risk of nausea than methadyl acetate [RR = 0.56 (0.37-0.85); 913 participants, 3 studies]. There was high overall risk of bias in 92% of included trials due to limited and non-systematic outcome assessment. Certainty of evidence was low or very low for all but one comparison with moderate certainty.</p><p><strong>Conclusions: </strong>There is currently insufficient data to determine whether the rates of adverse effects differ across opioid agonist treatments for most outcomes, with several exceptions. Moreover, the certainty of evidence is currently low or very low due to a lack of rigorous outcome assessment.</p>","PeriodicalId":109,"journal":{"name":"Addiction","volume":" ","pages":""},"PeriodicalIF":5.2,"publicationDate":"2025-02-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143381341","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
AddictionPub Date : 2025-02-06DOI: 10.1111/add.16772
Samantha Johnstone, Robert K Cooper, Jennifer M Wray, Sarah S Tonkin, Kyler S Knapp, Craig R Colder, Eugene Maguin, Martin C Mahoney, Stephen T Tiffany, Thomas H Brandon, Rebecca L Ashare, Rachel F Tyndale, Larry W Hawk
{"title":"Evaluating mediators of the effect of varenicline preloading on smoking abstinence in a randomized controlled trial.","authors":"Samantha Johnstone, Robert K Cooper, Jennifer M Wray, Sarah S Tonkin, Kyler S Knapp, Craig R Colder, Eugene Maguin, Martin C Mahoney, Stephen T Tiffany, Thomas H Brandon, Rebecca L Ashare, Rachel F Tyndale, Larry W Hawk","doi":"10.1111/add.16772","DOIUrl":"https://doi.org/10.1111/add.16772","url":null,"abstract":"<p><strong>Background and aims: </strong>Mechanisms of varenicline preloading in promoting smoking abstinence have not been evaluated. Based on an extinction of reinforcement framework, we tested the hypothesis that pre-quit reductions in smoking rate mediate the effect of extended preloading on abstinence. We also tested alternative indicators of change in smoking reinforcement, as well as smoking aversion, nausea and abstinence self-efficacy as candidate mediators.</p><p><strong>Design, participants and intervention: </strong>Randomized, double-blind, placebo-controlled trial (NCT03262662) comparing extended (4-week varenicline) to standard (3 weeks of placebo, 1-week varenicline) preloading, preceding 11 weeks of open-label varenicline, in 320 adults (56% female). The primary outcome was self-reported continuous smoking abstinence during the last 4 weeks of treatment, with cotinine bio-verification at end of treatment (EOT).</p><p><strong>Setting: </strong>University at Buffalo, State University of New York, USA (part of the trial was conducted at participants' homes due to the COVID-19 pandemic).</p><p><strong>Measurements: </strong>Candidate mediators, including smoking rate and subjective effects of smoking (reward, satisfaction, aversion), self-reported craving, withdrawal, nausea and abstinence self-efficacy, were assessed daily during the pre-quit period with ecological momentary assessment. At two laboratory visits participants completed a choice task to assess smoking reinforcement.</p><p><strong>Findings: </strong>There was a statistically significant indirect effect of extended preloading on greater EOT abstinence rates through pre-quit declines in smoking rate [a*b = 0.284, 95% confidence interval (0.072,0.616)] and percent reduction in smoking across the pre-quit period [a*b = 0.225, (0.080,0.437)]. There were also statistically significant indirect effects through reductions in pre-quit craving [a*b = 0.150, (0.01,0.420)] and increases in pre-quit self-efficacy [a*b = 0.157, (0.038,0.375)]. Sex-specific analyses suggested these mediated effects were consistently limited to females. No other candidate mediators yielded statistically significant indirect effects.</p><p><strong>Conclusions: </strong>Extended varenicline preloading mediated smoking abstinence through reduced pre-quit smoking and craving among female smokers seeking to quit; increased pre-quit abstinence self-efficacy was also a significant mediator.</p>","PeriodicalId":109,"journal":{"name":"Addiction","volume":" ","pages":""},"PeriodicalIF":5.2,"publicationDate":"2025-02-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143363179","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
AddictionPub Date : 2025-02-06DOI: 10.1111/add.70012
Johan Duflou
{"title":"Rare but relevant: The injection of tablet preparations and pulmonary hypertension.","authors":"Johan Duflou","doi":"10.1111/add.70012","DOIUrl":"https://doi.org/10.1111/add.70012","url":null,"abstract":"<p><p>Intravascular injection of dissolved medicinal preparations such as crushed tablets is associated with a risk of injecting particulate material into the vasculature. This particulate material will naturally pass to the lungs where it will be largely filtered out in the pulmonary vascular bed, and in turn, it can result in a range of pathological processes in the lungs including pulmonary arterial hypertension, granulomatous lung disease, and pulmonary fibrosis. On rare occasions, a rapid increase in pulmonary vascular resistance can result in sudden death of the injecting drug user.</p>","PeriodicalId":109,"journal":{"name":"Addiction","volume":" ","pages":""},"PeriodicalIF":5.2,"publicationDate":"2025-02-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143254383","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
AddictionPub Date : 2025-02-06DOI: 10.1111/add.70010
Truc Thanh Thai, Diep Bich Nguyen, Trang Thu Nguyen, Hai-Van Thi Hoang, Michael Li, Li Li, Tuong-Vi Thi Vu, Lan-Phuong Thi Tran, Dung Van Do, Steve Shoptaw, Giang Minh Le
{"title":"Validation of the alcohol, smoking and substance involvement screening test (ASSIST) for identifying methamphetamine use among people on methadone maintenance treatment in Vietnam.","authors":"Truc Thanh Thai, Diep Bich Nguyen, Trang Thu Nguyen, Hai-Van Thi Hoang, Michael Li, Li Li, Tuong-Vi Thi Vu, Lan-Phuong Thi Tran, Dung Van Do, Steve Shoptaw, Giang Minh Le","doi":"10.1111/add.70010","DOIUrl":"10.1111/add.70010","url":null,"abstract":"<p><strong>Background and aims: </strong>Identifying those who use methamphetamine or are at high risk of using methamphetamine is essential so that early, appropriate intervention can be made. This study evaluated the use of the Alcohol, Smoking and Substance Involvement Screening Test (ASSIST) for identifying methamphetamine use among people on methadone maintenance treatment (MMT) in Vietnam.</p><p><strong>Methods: </strong>From June 2021 to May 2023, all people on MMT at 15 methadone clinics in Hanoi and Ho Chi Minh City, Vietnam, were invited to participate in this study. Participants underwent a face-to-face interview to complete the 8-item ASSIST. Participants also had a urine drug test (UDT) for methamphetamine use. Discriminant properties of the ASSIST were evaluated using UDT as the reference.</p><p><strong>Results: </strong>Among 6709 participants, 10.7% (n = 717) tested positive for methamphetamine use via UDT. The ASSIST demonstrated robust discriminant abilities to identify those who used methamphetamine [area under the curve (AUC) = 0.872; 95% confidence interval (CI) = 0.856-0.887]. At the commonly used cutoff of 4, the ASSIST had a sensitivity of 83.8% and a specificity of 82.0%. At this cutoff, 82.2% of the ASSIST results aligned with UDT outcomes (kappa coefficient = 0.41, P < 0.001) and the ASSIST identified a prevalence of 25.0%. At higher cutoffs, the sensitivity of the ASSIST decreased but both the specificity and the agreement with the UDT results increased.</p><p><strong>Conclusions: </strong>The Alcohol, Smoking and Substance Involvement Screening Test (ASSIST) appears to be reliable and valid in identifying methamphetamine use among people on methadone treatment in Vietnam. Cutoff adjustments may help to reduce false positive rates.</p>","PeriodicalId":109,"journal":{"name":"Addiction","volume":" ","pages":""},"PeriodicalIF":5.2,"publicationDate":"2025-02-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143254386","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
AddictionPub Date : 2025-02-06DOI: 10.1111/add.70009
Timothy Piatkowski, Ross Coomber, Cameron Francis, Emma Kill, Geoff Davey, Sarah Cresswell, Alan White, Madeline Harding, Karen Blakey, Steph Reeve, Brooke Walters, Cheneal Puljevic, Jason Ferris, Monica Barratt
{"title":"The world's first anabolic-androgenic steroid testing trial: A two-phase pilot combining chemical analysis, results dissemination and community feedback.","authors":"Timothy Piatkowski, Ross Coomber, Cameron Francis, Emma Kill, Geoff Davey, Sarah Cresswell, Alan White, Madeline Harding, Karen Blakey, Steph Reeve, Brooke Walters, Cheneal Puljevic, Jason Ferris, Monica Barratt","doi":"10.1111/add.70009","DOIUrl":"https://doi.org/10.1111/add.70009","url":null,"abstract":"<p><strong>Background and aims: </strong>The clandestine production and distribution of anabolic-androgenic steroids (AAS) poses health risks due to the uncertainty of their contents. This study aimed to test the chemical content of AAS samples and provide aggregate results back to the community, exploring how these results influenced usage decisions and risk management.</p><p><strong>Design: </strong>A mixed-methods approach was used, combining chemical analysis of AAS samples with qualitative interviews. Participants submitted samples for testing, and the results were later shared with them. Semi-structured interviews explored participants' perceptions of AAS risks and the impact of testing results on their behaviour.</p><p><strong>Setting: </strong>The study was conducted at CheQpoint drug checking service in Brisbane, Australia.</p><p><strong>Participants: </strong>Thirty-two samples were submitted for testing between 19 April and 7 June 2024, with 23 samples analysed. A total of 25 active AAS users participated in interviews.</p><p><strong>Measurements: </strong>Chemical analyses identified substances present and assessed active ingredient concentrations. Qualitative interviews gathered participants' perceptions, and these data were analysed through iterative categorisation, guided by the Health Belief Model.</p><p><strong>Findings: </strong>Chemical analysis identified that 13% of samples contained substances different from what was expected. Concentrations of active ingredients were close to expected levels [e.g. testosterone propionate at 96.2 mg/mL (range = 91.39-101.01 mg/mL)]. Interviews identified four key theme categories. Participants sought testing primarily for substance verification, expressing concerns about contamination and dosage. Barriers to testing included limited access and fear of disclosure. While testing was seen as a valuable harm reduction tool, gaps in health guidance and follow-up support were identified as areas for improvement.</p><p><strong>Conclusions: </strong>Thirteen percent of 23 anabolic-androgenic steroid (AAS) samples analysed contained substances different from what was expected. Interviews with active AAS users highlighted the need for reliable information, accessible testing services and tailored health approaches for AAS use.</p>","PeriodicalId":109,"journal":{"name":"Addiction","volume":" ","pages":""},"PeriodicalIF":5.2,"publicationDate":"2025-02-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143254385","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
AddictionPub Date : 2025-02-06DOI: 10.1111/add.70004
Megan L Hammersley, Gustaaf A Dekker, Lyle C Gurrin, Elizabeth A Hoon, Stefanie Schurer, John W Lynch, Marnie Aldred, Julia Dalton, Cherise J Fletcher, Lisa G Smithers
{"title":"The use of financial incentives for smoking cessation in pregnant women: A parallel-group randomised controlled trial protocol.","authors":"Megan L Hammersley, Gustaaf A Dekker, Lyle C Gurrin, Elizabeth A Hoon, Stefanie Schurer, John W Lynch, Marnie Aldred, Julia Dalton, Cherise J Fletcher, Lisa G Smithers","doi":"10.1111/add.70004","DOIUrl":"https://doi.org/10.1111/add.70004","url":null,"abstract":"<p><strong>Background and aims: </strong>Smoking cessation during pregnancy results in short- and long-term health benefits for the mother and infant. Despite public health policies and initiatives to reduce smoking, smoking in pregnancy remains unacceptably high in Australia, particularly among populations of high disadvantage. Internationally, the use of financial incentives has shown some promise in assisting pregnant women to quit smoking, but more research is needed in different contexts. This study aims to determine the efficacy, cost-effectiveness and acceptability of the use of financial incentives in Australia.</p><p><strong>Design: </strong>2-arm parallel-group randomised controlled trial.</p><p><strong>Setting: </strong>Australian antenatal care setting.</p><p><strong>Participants: </strong>Pregnant women who smoke.</p><p><strong>Intervention: </strong>Women randomised to the intervention group will receive financial incentives of increasing value at three time points throughout their pregnancy (4 and 12 weeks from the first antenatal visit and 37 weeks gestation) upon confirmation of smoking abstinence.</p><p><strong>Measurements: </strong>The primary comparison outcome is a composite binary measure of abstinence at three time points during pregnancy (4, 12 and 37 weeks). Smoking abstinence will be determined by a carbon monoxide breath analysis reading of ≤3 ppm. The primary statistical analysis is estimation of the absolute difference in the prevalence of abstinence at all three time points based on the intention-to-treat groups. A cost-effectiveness analysis will be undertaken to quantify the social returns of the intervention. A qualitative process evaluation will also be conducted to determine fidelity, contextual factors and the acceptability of the intervention to pregnant women and healthcare workers.</p><p><strong>Comments: </strong>This study will be the first Australian trial of financial incentives in reducing smoking in pregnancy. The findings will provide evidence on the acceptability, effectiveness and cost-effectiveness of financial incentives to reduce smoking in pregnancy in Australia.</p>","PeriodicalId":109,"journal":{"name":"Addiction","volume":" ","pages":""},"PeriodicalIF":5.2,"publicationDate":"2025-02-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143363185","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
AddictionPub Date : 2025-02-05DOI: 10.1111/add.16775
Cara Platts, Jennifer Lacy-Nichols
{"title":"Mapping corporate sponsorship of alcohol and gambling associations: An Australian pilot study.","authors":"Cara Platts, Jennifer Lacy-Nichols","doi":"10.1111/add.16775","DOIUrl":"https://doi.org/10.1111/add.16775","url":null,"abstract":"<p><strong>Background and aims: </strong>Alcohol and gambling industries use a range of strategies to oppose and undermine public health policies targeting their industries. Industry associations often play a visible role in advancing alcohol and gambling industry interests, yet there are few studies analysing who their members or partners are and the relationships between them. Our study developed an approach to map the landscape of Australian alcohol and gambling associations, their members and partners and the connections between commercial actors.</p><p><strong>Methods: </strong>We conducted our study in four phases: first, we systematically searched for alcohol and gambling industry associations; second, we identified and classified association members and/or partners; third, we mapped three types of relationships between associations and members/partners (umbrella associations, co-location and joint membership/partnerships); lastly, we analysed the disclosures of the members and partners of the Australian Hotels Associations and Clubs Associations.</p><p><strong>Results: </strong>We identified 126 industry associations and 1486 unique companies/organisations from multiple industry sectors that were members/partners. Only 75 (59.5%) associations provided a list of members/partners. Most companies/organisations were partners of only one association (n = 1218), while five companies were partners of more than 20 associations. Concerning relationships, we identified five national clusters, 27 instances of co-location and an extensive network linking associations through shared partnerships. Finally, we assessed 658 relationships between Hotels and Clubs Associations and their partners, of which only 91 (13.8%) were transparently disclosed.</p><p><strong>Conclusions: </strong>In Australia, many alcohol and gambling industry associations do not disclose their members or corporate partners and provide limited funding information. Members and corporate partners of Australian alcohol and gambling industry associations rarely disclose their support and are diverse in focus, size, members, partners, purpose and activities.</p>","PeriodicalId":109,"journal":{"name":"Addiction","volume":" ","pages":""},"PeriodicalIF":5.2,"publicationDate":"2025-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143187573","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
AddictionPub Date : 2025-02-03DOI: 10.1111/add.70011
Fares Qeadan, Ashlie McCunn, Benjamin Tingey
{"title":"Response to Wang and Winterstein: Robustness of GIP/GLP-1 RA findings in substance use disorders","authors":"Fares Qeadan, Ashlie McCunn, Benjamin Tingey","doi":"10.1111/add.70011","DOIUrl":"10.1111/add.70011","url":null,"abstract":"<p>We appreciate the thoughtful commentary by Wang and Winterstein [<span>1</span>] on our study [<span>2</span>], which provides an opportunity to address their concerns and further elucidate the robustness of our findings.</p><p>Regarding the concern about the comparator group lacking a defined clinical context, this issue was carefully considered. To minimize biases from misaligned trajectories, we assigned index dates for the comparator group randomly within the observational window, per Hernan and Robins [<span>3</span>]. In response to Wang and Winterstein [<span>1</span>], we conducted an additional analysis aligning the time intervals between initial opioid use disordert (OUD)/alcohol use disorder (AUD) diagnosis and study entry for both groups. The adjusted incidence rate ratio (aIRR) and 95% CI for opioid overdose among those prescribed GIP/GLP-1 receptor agonists (RAs) compared to those not prescribed was 0.52 (0.29–0.92) for the OUD cohort. Similarly, for alcohol intoxication, the aIRR (95% CI) was 0.53 (0.33–0.87) for the AUD cohort. These findings align closely with the original results of 0.60 (0.43–0.83) and 0.50 (0.40–0.63), underscoring the robustness of our conclusions.</p><p>Regarding residual confounding because of healthcare engagement, treatment-seeking behaviors and comorbidities, we used comprehensive strategies to address these challenges. Our regression models adjusted for baseline demographic, clinical and healthcare utilization variables [<span>4</span>]. Additionally, we used inverse probability of treatment weighting (IPTW) to balance measured confounders and minimize bias [<span>5</span>]. Sensitivity analyses excluding patients with prior overdose or intoxication histories demonstrated that the protective associations remained stable, rather than being driven by differential substance use histories between prescribed and non-prescribed patients. Adjustment of healthcare utilization and severity markers confirmed robustness beyond confounding by indication [<span>6</span>]. Stratified analyses revealed no substantial differences in effect estimates for subgroups with Type 2 diabetes or obesity, confirming consistency across populations. We respectfully refute the statement by Wang and Winterstein that our results ‘shifted toward the null’ or demonstrated a ‘weakened protective effect’ when restricted to patients with Type 2 diabetes or obesity. The observed aIRRs were nearly identical, and the overlapping CIs across subgroups confirm consistent findings [<span>7</span>], reminding the commentators of the distinction between absolute and statistical differences. Furthermore, our study focused on a general OUD/AUD population and was not limited to patients with diabetes or comparing different diabetic medications. Assertions about active versus non-active comparators are, therefore, beyond the scope of our analysis.</p><p>We also addressed concerns about unmeasured confounders, including proxies for disease severity,","PeriodicalId":109,"journal":{"name":"Addiction","volume":"120 5","pages":"1062-1063"},"PeriodicalIF":5.2,"publicationDate":"2025-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/add.70011","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143078004","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
AddictionPub Date : 2025-01-30DOI: 10.1111/add.16766
Amelia Woods, Catherine Foley, Katherine M. Conigrave, Winifred Asare-Doku, Anthony Shakeshaft, Stella Settumba-Stolk, Michael Farrell, Michael Doyle
{"title":"Extended-release pharmacotherapies for substance use disorders in incarcerated populations: A systematic review","authors":"Amelia Woods, Catherine Foley, Katherine M. Conigrave, Winifred Asare-Doku, Anthony Shakeshaft, Stella Settumba-Stolk, Michael Farrell, Michael Doyle","doi":"10.1111/add.16766","DOIUrl":"10.1111/add.16766","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background and aims</h3>\u0000 \u0000 <p>Substance use (SU) is prevalent among individuals in the criminal justice system (CJS). However, there is often poor access to treatment. We aimed to assess the effectiveness of two medications, extended-release naltrexone (XR-NTX) and extended-release buprenorphine (XR-BUP) for the prison population.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We searched Scopus, OVID/Embase, PubMed/Medline, ProQuest, EBSCO, Cochrane Library and Australian Criminology Database for original articles published from 1 January 2002 to 31 December 2022. Inclusion criteria: 18+, substance use disorder; XR treatment; recent incarceration. We extracted study, participants, treatment characteristics and outcome variables. We conducted risk of bias assessments using the RoB-2, ROBINS-I, JBI tools and Evers et al.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>We identified 25 papers (16 studies) examining 3403 participants. Sixteen papers (9 studies) focused on XR-NTX, eight (7 studies) on XR-BUP and one on both. Eighteen papers (11 studies) were from the US, with the remainder from Norway, Australia, UK, Canada and Germany. There were eight RCTs (10 papers), four secondary observational analyses, four cohort studies, four economic analyses, two case series and one qualitative paper. Most studies had small–moderate samples, with varying retention and follow-up periods. Among RCTs, two XR-NTX studies for opioid use found no difference in retention vs treatment as usual and placebo, while one reported improved retention for XR-NTX implant vs methadone. One RCT showed mixed retention results for XR-NTX vs placebo in alcohol use. One XR-BUP study showed improved or equivalent treatment retention (depending on measures) vs sublingual buprenorphine. There was no difference in overdoses. SU for XR-NTX was challenging to assess due to differing definitions, measures and comparators. XR-BUP yielded mixed SU results, with one indicating a greater effect and another no difference from comparators.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>There is no clear evidence for the effectiveness of extended release naltrexone and buprenorphine among individuals in the criminal justice system compared with shorter acting formulations. But there is growing evidence for the effectiveness of extended release buprenorphine in reducing opioid use and improving treatment retention in that population, with potential cost offsets from initial medication expenses.</p>\u0000 </section>\u0000 </div>","PeriodicalId":109,"journal":{"name":"Addiction","volume":"120 5","pages":"835-859"},"PeriodicalIF":5.2,"publicationDate":"2025-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/add.16766","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143062192","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
AddictionPub Date : 2025-01-30DOI: 10.1111/add.16773
Rachna Begh, Monserrat Conde, Thomas R Fanshawe, Dylan Kneale, Lion Shahab, Sufen Zhu, Michael Pesko, Jonathan Livingstone-Banks, Nicola Lindson, Nancy A Rigotti, Kate Tudor, Dimitra Kale, Sarah E Jackson, Karen Rees, Jamie Hartmann-Boyce
{"title":"Electronic cigarettes and subsequent cigarette smoking in young people: A systematic review.","authors":"Rachna Begh, Monserrat Conde, Thomas R Fanshawe, Dylan Kneale, Lion Shahab, Sufen Zhu, Michael Pesko, Jonathan Livingstone-Banks, Nicola Lindson, Nancy A Rigotti, Kate Tudor, Dimitra Kale, Sarah E Jackson, Karen Rees, Jamie Hartmann-Boyce","doi":"10.1111/add.16773","DOIUrl":"https://doi.org/10.1111/add.16773","url":null,"abstract":"<p><strong>Aims: </strong>To assess the evidence for a relationship between the use of e-cigarettes and subsequent smoking in young people (≤29 years), and whether this differs by demographic characteristics.</p><p><strong>Methods: </strong>Systematic review with association direction plots (searches to April 2023). Screening, data extraction and critical appraisal followed Cochrane methods. Our primary outcome was the association between e-cigarette use, availability or both, and change in population rate of smoking in young people. The secondary outcomes were initiation, progression and cessation of smoking at individual level. We assessed certainty using Grading of Recommendations, Assessment, Development and Evaluations (GRADE).</p><p><strong>Results: </strong>We included 126 studies. For our primary outcome, there was very low certainty evidence (limited by risk of bias and inconsistency) suggesting that e-cigarette use and availability were inversely associated with smoking in young people (i.e. as e-cigarettes became more available and/or used more widely, youth smoking rates went down or, conversely, as e-cigarettes were restricted, youth smoking rates went up). All secondary outcomes were judged to be very low certainty due to very serious risk of bias. Data consistently showed direct associations between vaping at baseline and smoking initiation (28 studies) and smoking progression (5 studies). The four studies contributing data on smoking cessation had mixed results, precluding drawing any conclusion on the direction of association. There was limited information to determine whether relationships varied by sociodemographic characteristics.</p><p><strong>Conclusion: </strong>At an individual level, people who vape appear to be more likely to go on to smoke than people who do not vape; however, it is unclear if these behaviours are causally linked. Very low certainty evidence suggests that youth vaping and smoking could be inversely related.</p>","PeriodicalId":109,"journal":{"name":"Addiction","volume":" ","pages":""},"PeriodicalIF":5.2,"publicationDate":"2025-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143062191","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}