Addiction最新文献

{"title":"Mega-analysis of the brain-age gap in substance use disorder: An ENIGMA Addiction working group study","authors":"Freda Scheffler,&nbsp;Jonathan Ipser,&nbsp;Devarshi Pancholi,&nbsp;Alistair Murphy,&nbsp;Zhipeng Cao,&nbsp;Jonatan Ottino-González,&nbsp;ENIGMA Addiction Working Group,&nbsp;Paul M. Thompson,&nbsp;Steve Shoptaw,&nbsp;Patricia Conrod,&nbsp;Scott Mackey,&nbsp;Hugh Garavan,&nbsp;Dan J. Stein","doi":"10.1111/add.16621","DOIUrl":"10.1111/add.16621","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background and Aims</h3>\u0000 \u0000 <p>The brain age gap (BAG), calculated as the difference between a machine learning model-based predicted brain age and chronological age, has been increasingly investigated in psychiatric disorders. Tobacco and alcohol use are associated with increased BAG; however, no studies have compared global and regional BAG across substances other than alcohol and tobacco. This study aimed to compare global and regional estimates of brain age in individuals with substance use disorders and healthy controls.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Design</h3>\u0000 \u0000 <p>This was a cross-sectional study.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Setting</h3>\u0000 \u0000 <p>This is an Enhancing Neuro Imaging through Meta-Analysis Consortium (ENIGMA) Addiction Working Group study including data from 38 global sites.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Participants</h3>\u0000 \u0000 <p>This study included 2606 participants, of whom 1725 were cases with a substance use disorder and 881 healthy controls.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Measurements</h3>\u0000 \u0000 <p>This study used the Kaufmann brain age prediction algorithms to generate global and regional brain age estimates using T1 weighted magnetic resonance imaging (MRI) scans. We used linear mixed effects models to compare global and regional (FreeSurfer lobestrict output) BAG (i.e. predicted minus chronological age) between individuals with one of five primary substance use disorders as well as healthy controls.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Findings</h3>\u0000 \u0000 <p>Alcohol use disorder (β = −5.49, <i>t</i> = −5.51, <i>p</i> &lt; 0.001) was associated with higher global BAG, whereas amphetamine-type stimulant use disorder (β = 3.44, <i>t</i> = 2.42, <i>p</i> = 0.02) was associated with lower global BAG in the separate substance-specific models.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>People with alcohol use disorder appear to have a higher brain-age gap than people without alcohol use disorder, which is consistent with other evidence of the negative impact of alcohol on the brain.</p>\u0000 </section>\u0000 </div>","PeriodicalId":109,"journal":{"name":"Addiction","volume":"119 11","pages":"1937-1946"},"PeriodicalIF":5.2,"publicationDate":"2024-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/add.16621","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142007885","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}

{"title":"Prescribing of extended release buprenorphine injection for Medicaid beneficiaries, 2018–2022","authors":"Rachael K. Ross,&nbsp;Kara E. Rudolph,&nbsp;Chelsea L. Shover","doi":"10.1111/add.16652","DOIUrl":"10.1111/add.16652","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background and aims</h3>\u0000 \u0000 <p>Extended release buprenorphine injection (INJ-BUP) has been available in the United States since 2018. INJ-BUP has the potential to positively impact opioid use disorder (OUD) treatment outcomes by providing additional treatment options. As one of the largest payers of OUD treatment in the US, Medicaid coverage is important for access and uptake of INJ-BUP. Uptake of INJ-BUP among Medicaid beneficiaries has not been described since 2019 and variation in uptake by state has not previously been explored. We aimed to measure prescribing of INJ-BUP for Medicaid beneficiaries since 2018, nationwide and by state.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We analyzed State Drug Utilization Data from 2017 to 2022 and calculated the number of prescription fills for INJ-BUP and oral buprenorphine paid by Medicaid. To compare across states, we calculated the number of prescription fills per 100 Medicaid beneficiaries treated for OUD using data from Transformed Medicaid Statistical Information System Substance Use Disorder (T-MSIS SUD) Data Books. Data sources are publicly available.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The number of prescription fills for INJ-BUP paid by Medicaid increased from 4322 (0.1% of all buprenorphine prescription fills) in 2018 to 186 861 (2.0%) in 2022. Each year the increase in fills exceeded the prior year change, indicating accelerating uptake. There was notable variability across states.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The number of extended release buprenorphine injection prescriptions among US Medicaid beneficiaries treated for opioid use disorder increased from over 4000 prescriptions in 2018 to over 185 000 in 2022 but uptake is much less than observed in other countries over shorter time periods.</p>\u0000 </section>\u0000 </div>","PeriodicalId":109,"journal":{"name":"Addiction","volume":"119 12","pages":"2211-2215"},"PeriodicalIF":5.2,"publicationDate":"2024-08-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141986853","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}

{"title":"ChatGPT-4: Alcohol use disorder responses","authors":"Alex M. Russell,&nbsp;Samuel F. Acuff,&nbsp;John F. Kelly,&nbsp;Jon-Patrick Allem,&nbsp;Brandon G. Bergman","doi":"10.1111/add.16650","DOIUrl":"10.1111/add.16650","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background and aims</h3>\u0000 \u0000 <p>Alcohol use disorder (AUD) is characterized by low levels of engagement with effective treatments. Enhancing awareness of AUD treatments and how to navigate the treatment system is crucial. Many individuals use online sources (e.g. search engines) for answers to health-related questions; web-based results include a mix of high- and low-quality information. Artificial intelligence may improve access to quality health information by providing concise, high-quality responses to complex health-related questions. This study evaluated the quality of ChatGPT-4 responses to AUD-related queries.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Method</h3>\u0000 \u0000 <p>A comprehensive list of 64 AUD-related questions was developed through a combination of Google Trends analysis and expert consultation. ChatGPT-4 was prompted with each question, followed by a request to provide 3–5 peer-reviewed scientific citations supporting each response. Responses were evaluated for whether they were evidence-based, provided a referral and provided supporting documentation.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>ChatGPT-4 responded to all AUD-related queries, with 92.2% (59/64) of responses being fully evidence-based. Although only 12.5% (8/64) of responses included referrals to external resources, all responses (100%; 5/5) to location-specific (‘near me’) queries directed individuals to appropriate resources like the NIAAA Treatment Navigator. Most (85.9%; 55/64) responses to the follow-up question provided supporting documentation.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>ChatGPT-4 responds to alcohol use disorder-related questions with evidence-based information and supporting documentation. ChatGPT-4 could be promoted as a reasonable resource for those looking online for alcohol use disorder-related information.</p>\u0000 </section>\u0000 </div>","PeriodicalId":109,"journal":{"name":"Addiction","volume":"119 12","pages":"2205-2210"},"PeriodicalIF":5.2,"publicationDate":"2024-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141981267","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}

{"title":"How psychedelics legalization debates could differ from cannabis.","authors":"Beau Kilmer","doi":"10.1111/add.16644","DOIUrl":"https://doi.org/10.1111/add.16644","url":null,"abstract":"","PeriodicalId":109,"journal":{"name":"Addiction","volume":" ","pages":""},"PeriodicalIF":5.2,"publicationDate":"2024-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141974531","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}

{"title":"Commentary on Conde et al.: Evidence and gap map offer an important opportunity for dialogue and refinement of the gateway hypothesis controversy","authors":"Arielle Selya,&nbsp;Joe G. Gitchell","doi":"10.1111/add.16645","DOIUrl":"10.1111/add.16645","url":null,"abstract":"<p>The question of whether e-cigarette use promotes subsequent cigarette smoking among youth (commonly known as the ‘gateway hypothesis’) is critical for understanding e-cigarettes' net impact on population health. Unfortunately, it is also a highly polarized topic. Not only is there no clear resolution (yet) embraced by both sides [<span>1, 2</span>], but the many studies published on the topic do not seem to have changed anyone's mind. This seems to be a real-life example of the epistemological network model described by O'Connor and Weatherall [<span>3</span>] (see the figures, particularly the polarization one) whereby levels of social trust and conformity are such that more research does not lead to a convergence on truth.</p><p>We hope that researchers willing to devote the effort and take the risks to work with ‘adversaries’ will draw motivation from peers in other fields taking the same risks and efforts.</p><p><b>Arielle Selya:</b> Conceptualization; project administration; writing—original draft; writing—review and editing. <b>Joe G. Gitchell:</b> Conceptualization; writing—review and editing.</p><p>Through Pinney Associates, A.S. and J.G.G. provide consulting services on tobacco harm reduction to Juul Labs (JLI). A.S. also individually provides consulting services on behavioural science to the Center of Excellence for the Acceleration of Harm Reduction (CoEHAR) through ECLAT Srl, which received funding from the Foundation for a Smoke-Free World (FSFW; now the Global Action to End Smoking [GA]). Neither JLI, CoEHAR, nor FSFW/GA had any role in, or oversight of, this commentary.</p>","PeriodicalId":109,"journal":{"name":"Addiction","volume":"119 10","pages":"1709-1710"},"PeriodicalIF":5.2,"publicationDate":"2024-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/add.16645","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141915530","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}

{"title":"A clinical research perspective on the regulation of medical and non-medical use of psychedelic drugs.","authors":"Michael P Bogenschutz","doi":"10.1111/add.16647","DOIUrl":"https://doi.org/10.1111/add.16647","url":null,"abstract":"","PeriodicalId":109,"journal":{"name":"Addiction","volume":" ","pages":""},"PeriodicalIF":5.2,"publicationDate":"2024-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141915529","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}

{"title":"The relationship between cannabis and nicotine use: A systematic review and meta-analysis","authors":"Tesfa Mekonen Yimer,&nbsp;Caitlin McClure-Thomas,&nbsp;Daniel Stjepanovic,&nbsp;Jack Wilson,&nbsp;Gary Chung Kai Chan,&nbsp;Wayne Denis Hall,&nbsp;Janni Leung","doi":"10.1111/add.16642","DOIUrl":"10.1111/add.16642","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background and aims</h3>\u0000 \u0000 <p>Cannabis and nicotine (tobacco or e-cigarettes) use commonly co-occurs and understanding their relationship can help to inform public health strategies to prevent their harms. We conducted a systematic review and meta-analysis to estimate the association of cannabis use given prior nicotine use and vice versa.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>PubMed, Embase, PsycINFO, Google Scholar and a hand-search were conducted in 2023 for longitudinal studies of the general population with no restrictions in settings (locations). Random-effects meta-analysis was conducted to estimate odds ratios between cannabis and nicotine use in both directions. The impact of unmeasured confounding was assessed using E-values.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>From 5387 identified records, we included 20 studies. Among cannabis-naïve youths, baseline use of any nicotine products was positively associated with initiation of any cannabis use at follow-up [odds ratio (OR) = 5.39, 95% confidence interval (CI) = 3.19, 9.11; adjusted OR (aOR) = 2.59, 95% CI = 2.01, 3.32]. In nicotine-naïve participants (youths + adults), baseline cannabis use was positively associated with the initiation of any nicotine use at follow-up (OR = 4.08, 95% CI = 2.05, 8.11; aOR = 2.94, 95% CI =1.54, 5.61). There were no significant associations between baseline cannabis use and subsequent initiation of any nicotine (aOR = 3.29, 95% CI = 0.85, 12.76) or daily nicotine use (aOR = 2.63, 95% CI = 0.41, 16.95) among youths. The median E-values were 5.5 for nicotine exposure and cannabis use initiation and 4.1 for cannabis exposure and nicotine use initiation, indicating that substantial unmeasured confounding would need to have a strong association with both outcomes to fully explain away the cannabis and nicotine relationship.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Although the evidence for associations between cannabis use and tobacco use is mixed, a majority of studies to date have found that cannabis use is associated with prior nicotine use and vice versa.</p>\u0000 </section>\u0000 </div>","PeriodicalId":109,"journal":{"name":"Addiction","volume":"119 12","pages":"2076-2087"},"PeriodicalIF":5.2,"publicationDate":"2024-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/add.16642","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141915560","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}

{"title":"What is the prevalence of anabolic-androgenic steroid use among women? A systematic review","authors":"Timothy Piatkowski,&nbsp;Bianca Whiteside,&nbsp;Jonathan Robertson,&nbsp;April Henning,&nbsp;Eric H. Y. Lau,&nbsp;Matthew Dunn","doi":"10.1111/add.16643","DOIUrl":"10.1111/add.16643","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background and aim</h3>\u0000 \u0000 <p>Evidence suggests there has been an increase in anabolic-androgenic steroid (AAS) use among women, driven by the evolving landscape of women's participation in sport. However, the extent of use is unknown. This systematic review aimed to estimate the prevalence of women's AAS use.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Method</h3>\u0000 \u0000 <p>We conducted a systematic review of peer-reviewed articles in English, focusing on AAS use among women aged 18 and above. We excluded grey literature and studies that measured doping through some form of analysis (e.g. urine or hair). Searched databases were MEDLINE, CINAHL, PsycINFO, SocINDEX, SPORTDiscus, Embase and Cochrane Library. Titles and abstracts for all articles were screened, followed by full-text assessment and data extraction of included articles by multiple authors for accuracy. The pooled prevalence of lifetime use was determined using a random effects model and the risk of bias was assessed using the Joanna Briggs Institute Prevalence Critical Appraisal Tool.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Based on 18 studies, participant numbers averaged 669 per study (median = 189; range = 16 to 7051). The overall pooled AAS use prevalence was 4% (95% confidence interval [CI] = 2–9%) with high heterogeneity overall (I² = 95%). In the subgroup analysis, AAS use prevalence was 16.8% (95% CI = 11.0–24.9%, I² = 44%) in the bodybuilder subgroup, 4.4% (95% CI = 1.2–15.1%, I² = 93%) in athletes/recreational gym user subgroup, and 1.4% (95% CI = 0.4–4.7%, I² = 96%) in the general population/other subgroup. Meta-regression demonstrated significantly higher AAS use in bodybuilders compared with the other subgroup (<i>P</i> = 0.011).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Anabolic-androgenic steroid use among women appears to be substantially higher among bodybuilders and athletes/recreational gym users than the general female population.</p>\u0000 </section>\u0000 </div>","PeriodicalId":109,"journal":{"name":"Addiction","volume":"119 12","pages":"2088-2100"},"PeriodicalIF":5.2,"publicationDate":"2024-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/add.16643","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141970092","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}

{"title":"Trends and adverse pregnancy and birth outcomes associated with stimulant-related disorder diagnosis","authors":"Nicole S. Pippard,&nbsp;Gretchen Bandoli,&nbsp;Rebecca J. Baer","doi":"10.1111/add.16636","DOIUrl":"10.1111/add.16636","url":null,"abstract":"&lt;div&gt;\u0000 \u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Background and aims&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Stimulant-related disorders (SRD), or the continued misuse of illicit or prescribed stimulants, during pregnancy can have adverse health effects for mothers and infants. This study aimed to measure prevalence and trends of SRD diagnosis in pregnancy, and associations between SRD diagnosis and adverse maternal and infant health outcomes, among pregnant individuals in California.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Design&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Retrospective cohort study.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Setting&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;California, USA.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Participants&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Pregnant individuals from the Study of Outcomes in Mothers and Infants (SOMI) with singleton live births between 2012 and 2020 (&lt;i&gt;n&lt;/i&gt; = 3 740 079).&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Measurements&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;SRD diagnosis (excluding cocaine) and maternal (gestational diabetes, gestational hypertension [gHTN], severe maternal morbidity [SMM]) and infant (very preterm birth [gestational age &lt;32 weeks], preterm birth [gestational age 32–37 weeks], neonatal intensive care unit [NICU] admission, small for gestational age [SGA]) outcomes were classified using International Classification of Disease (ICD) codes and vital statistics. Risk ratios were estimated with modified Poisson log linear regression that accounted for sibling pregnancies. Covariates included maternal sociodemographic characteristics, mental and physical health problems, nicotine use and co-occurrence of other diagnosed substance use disorders. Bias analyses were conducted to address unmeasured confounding and exposure misclassification.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Findings&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;SRD diagnosis among pregnant individuals increased from 2012 to 2020 (554 to 748 per 100 000 births). SRD diagnosis was associated with an increased risk of SMM (adjusted risk ratio [aRR] = 2.3; 95% confidence interval [CI] = 2.2–2.5), gHTN (aRR = 1.8; 95% CI = 1.7–1.9), very preterm birth (aRR = 2.2, 95% CI = 2.0–2.5), preterm birth (aRR = 2.1, 95% CI = 2.1–2.2) and NICU admission (aRR = 2.0, 95%CI = 1.9–2.0), and a decreased risk of gestational diabetes (aRR = 0.8; 95% CI = 0.8–0.9). SRD diagnosis was not associated with infants born SGA. Findings were generally robust to unmeasured confounding and misclassification of diagnosis.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Conclusions&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Stimulant-related disorder diagnosis during pregnancy appears to be a","PeriodicalId":109,"journal":{"name":"Addiction","volume":"119 11","pages":"2006-2014"},"PeriodicalIF":5.2,"publicationDate":"2024-08-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141905106","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}

{"title":"Prevalence of problematic pharmaceutical opioid use in patients with chronic non-cancer pain: A systematic review and meta-analysis","authors":"Kyla H. Thomas,&nbsp;Michael N. Dalili,&nbsp;Hung-Yuan Cheng,&nbsp;Sarah Dawson,&nbsp;Nick Donnelly,&nbsp;Julian P. T. Higgins,&nbsp;Matthew Hickman","doi":"10.1111/add.16616","DOIUrl":"10.1111/add.16616","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background and aims</h3>\u0000 \u0000 <p>Chronic non-cancer pain (CNCP) is one of the most common causes of disability globally. Opioid prescribing to treat CNCP remains widespread, despite limited evidence of long-term clinical benefit and evidence of harm such as problematic pharmaceutical opioid use (POU) and overdose. The study aimed to measure the prevalence of POU in CNCP patients treated with opioid analgesics.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Method</h3>\u0000 \u0000 <p>A comprehensive systematic literature review and meta-analysis was undertaken using MEDLINE, Embase and PsycINFO databases from inception to 27 January 2021. We included studies from all settings with participants aged ≥ 12 with non-cancer pain of ≥ 3 months duration, treated with opioid analgesics. We excluded case–control studies, as they cannot be used to generate prevalence estimates. POU was defined using four categories: dependence and opioid use disorder (D&amp;OUD), signs and symptoms of D&amp;OUD (S&amp;S), aberrant behaviour (AB) and at risk of D&amp;OUD. We used a random-effects multi-level meta-analytical model. We evaluated inconsistency using the <i>I</i>² statistic and explored heterogeneity using subgroup analyses and meta-regressions.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 148 studies were included with &gt; 4.3 million participants; 1% of studies were classified as high risk of bias. The pooled prevalence was 9.3% [95% confidence interval (CI) = 5.7–14.8%; <i>I</i>² = 99.9%] for D&amp;OUD, 29.6% (95% CI = 22.1–38.3%, <i>I</i>² = 99.3%) for S&amp;S and 22% (95% CI = 17.4–27.3%, <i>I</i>² = 99.8%) for AB. The prevalence of those at risk of D&amp;OUD was 12.4% (95% CI = 4.3–30.7%, <i>I</i>² = 99.6%). Prevalence was affected by study setting, study design and diagnostic tool. Due to the high heterogeneity, the findings should be interpreted with caution.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Problematic pharmaceutical opioid use appears to be common in chronic pain patients treated with opioid analgesics, with nearly one in 10 experiencing dependence and opioid use disorder, one in three showing signs and symptoms of dependence and opioid use disorder and one in five showing aberrant behaviour.</p>\u0000 </section>\u0000 </div>","PeriodicalId":109,"journal":{"name":"Addiction","volume":"119 11","pages":"1904-1922"},"PeriodicalIF":5.2,"publicationDate":"2024-08-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/add.16616","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141900169","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}