Drug and alcohol dependence最新文献

{"title":"The association of opioid prescribing continuity and the risk of opioid use disorder among older adults","authors":"Prachi Prajapati ,&nbsp;Shadi Bazzazzadehgan ,&nbsp;Yi Yang ,&nbsp;Kaustuv Bhattacharya ,&nbsp;Shishir Maharjan ,&nbsp;John P. Bentley ,&nbsp;Sujith Ramachandran","doi":"10.1016/j.drugalcdep.2025.112899","DOIUrl":"10.1016/j.drugalcdep.2025.112899","url":null,"abstract":"<div><h3>Background</h3><div>Lower opioid prescribing continuity is associated with a higher risk of opioid-related adverse events. This study aimed to evaluate the association between opioid prescribing continuity and risk of opioid use disorder (OUD).</div></div><div><h3>Methods</h3><div>Older adults (≥ 65 years) on long-term opioid therapy (LTOT) were identified from 2012 to 2020 5 % Medicare claims data. The study outcome was OUD. Opioid prescribing continuity, measured using the continuity of care index (COCI), was treated as a time-varying predictor measured monthly from LTOT initiation until outcome/censoring. The association between COCI and risk of OUD was evaluated using an extended Cox regression model.</div></div><div><h3>Results</h3><div>Of 153,570 patients, 7.61 % (n = 11,697) developed OUD after LTOT initiation. The mean (SD) age was 75.74 (8.42) years and 70.16 % (n = 107,743) were female. After adjusting for covariates, patients with medium COCI (adjusted hazard ratio [aHR] = 1.76, 95 % CI 1.58 – 1.96; p &lt; .001) and high COCI (aHR = 1.32, 95 % CI 1.22 – 1.44; p &lt; .001) had higher OUD risk compared to those with low COCI. Patients with high COCI (aHR = 0.75, 95 % CI 0.69 – 0.82; p &lt; .001) had significantly lower hazard of OUD than those with medium COCI.</div></div><div><h3>Conclusion</h3><div>Greater opioid prescribing continuity may promote OUD detection, highlighting the importance of consistent care for better management of opioid-related conditions. Alternatively, highly fragmented care among patients with LTOT may lead to lower detection of OUD, despite patients potentially being at higher risk for OUD. Thus, it is important to build trustful patient-prescriber relationships for early OUD detection and management.</div></div>","PeriodicalId":11322,"journal":{"name":"Drug and alcohol dependence","volume":"276 ","pages":"Article 112899"},"PeriodicalIF":3.6,"publicationDate":"2025-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145119201","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pilot randomized controlled trial of a cognitive-behavioral treatment combined with a physical activity tracker for smoking cessation","authors":"Roberto Secades-Villa ,&nbsp;Ignacio Cuesta-López ,&nbsp;Alba González-Roz","doi":"10.1016/j.drugalcdep.2025.112893","DOIUrl":"10.1016/j.drugalcdep.2025.112893","url":null,"abstract":"<div><h3>Introduction</h3><div>Wearable physical activity trackers are increasingly being used in health interventions and are a promising approach for addressing substance use disorders. This study aimed to examine the feasibility, acceptability, and preliminary effectiveness of cognitive-behavioral therapy (CBT) combined with the use of a physical activity tracker for smoking cessation.</div></div><div><h3>Method</h3><div>Seventy-four people who smoke were randomly assigned to one of two treatment conditions: CBT (n = 33) or CBT + physical activity tracker (PAT) (n = 41). The CBT intervention involved one group-based session per week for six weeks. Participants in the CBT+PAT condition received the device and were required to use it throughout the treatment. The International Physical Activity Questionnaire was used to assess physical activity in both groups.</div></div><div><h3>Results</h3><div>78.7 % of participants finished the treatment in the CBT group and 87.8 % in the CBT+PAT group (<em>p</em> = 0.939). The mean percentage of adherence to the physical activity tracker (days of use) was 84.87 %, and the mean patient satisfaction rating with the device was 38.8/50. There was a statistically significant increase in physical activity (number of steps per day) in the CBT+PAT group (<em>p</em> &lt; 0.002) but not in the CBT group. There was an average reduction of 9.3 cigarettes per day in the CBT+PAT group and 13.2 in the CBT group, with no statistically significant differences between groups.</div></div><div><h3>Conclusion</h3><div>Using a PAT within a behavioral intervention for smoking cessation is feasible. CBT+PAT seems effective in promoting physical activity in treatment-seeking people who smoke smokers. More powerful randomized controlled trials in the future should examine their potential effects on smoking outcomes.</div></div>","PeriodicalId":11322,"journal":{"name":"Drug and alcohol dependence","volume":"276 ","pages":"Article 112893"},"PeriodicalIF":3.6,"publicationDate":"2025-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145155306","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Opioid withdrawal as a barrier to harm reduction: Examining how overdose prevention behaviors are affected by withdrawal","authors":"Grace Yi ,&nbsp;Lauren Dayton ,&nbsp;Anya Scott-Wallace ,&nbsp;Melissa Davey-Rothwell ,&nbsp;Seun Falade-Nwulia ,&nbsp;Carl Latkin","doi":"10.1016/j.drugalcdep.2025.112895","DOIUrl":"10.1016/j.drugalcdep.2025.112895","url":null,"abstract":"<div><h3>Background and objectives</h3><div>In the past decade, the increasing availability and prevalence of fentanyl in the drug supply have heightened the risk of fatal overdose and increased the frequency and severity of opioid withdrawal symptoms. We aimed to examine how opioid withdrawal impacts engagement in harm reduction behaviors among people who use drugs.</div></div><div><h3>Methods</h3><div>Data came from a community-based research study in Baltimore, Maryland, conducted from 2022 to 2024. Participants were adults who used heroin, fentanyl, or prescription opiates to get high in the past month (N = 676). Structured surveys assessed withdrawal as a barrier to testing drugs for potency and overdose prevention. Logistic regression models were used to identify correlates of engagement in harm reduction during periods of withdrawal.</div></div><div><h3>Results</h3><div>Half the sample (46.6 %) reported that withdrawal “always” or “often” prevented them from testing drugs, and 66.6 % agreed that withdrawal was a barrier to overdose prevention. Depression symptoms (adjusted odds ratio (aOR): 1.56, 95 % CI 1.09–2.25), increased opioid use per week (aOR: 1.12, 95 % CI 1.03–1.22), and White race (aOR: 1.75, 95 % CI 1.16–2.62) were independently associated with lower engagement in drug testing and overdose prevention during withdrawal.</div></div><div><h3>Conclusions</h3><div>Withdrawal significantly impacts engagement in harm reduction behaviors, even among those with high awareness and receptivity to drug testing and overdose prevention strategies. Withdrawal management and mental health support are emergent and critical components for harm reduction interventions to prevent overdose morbidity and mortality among people who use drugs.</div></div>","PeriodicalId":11322,"journal":{"name":"Drug and alcohol dependence","volume":"276 ","pages":"Article 112895"},"PeriodicalIF":3.6,"publicationDate":"2025-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145119202","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The socioeconomic, health, and family situation of parents of patients with substance use diagnosis: A descriptive registry study","authors":"Solveig Glestad Christiansen ,&nbsp;Torleif Halkjelsvik ,&nbsp;Inger Synnøve Moan ,&nbsp;Øystein Kravdal","doi":"10.1016/j.drugalcdep.2025.112892","DOIUrl":"10.1016/j.drugalcdep.2025.112892","url":null,"abstract":"<div><h3>Background</h3><div>The characteristics of parents of patients with substance use diagnoses (PPSUD) have received limited attention in public health. Previous studies, mainly based on convenience samples, report challenges in health, work, and family life. Using register data, this study provides a broad descriptive overview of their characteristics.</div></div><div><h3>Methods</h3><div>Based on patient records from 2008 to 2018, we identified 111,075 PPSUD residing in Norway in 2018. A subgroup excluding parents with substance use diagnoses themselves (PPSUD_Excl; n = 98,507) was matched by age and gender to parents without substance use diagnoses from the general population (Comparison; n = 98,507). We compared proportions and means.</div></div><div><h3>Results</h3><div>Parents of patients with substance use diagnosis were more often divorced (PPSUD_Excl: 28.7 %; Comparison: 17.9 %; p-values &lt;.001 for this and subsequent comparisons), less likely to work full-time (57.9 % vs. 68.5 %), and more likely to receive disability pension (23.4 % vs. 13.7 %) and have sickness absence (27.7 % vs. 20.8 %). General practitioner consultations were more common among PPSUD_Excl (82.5 %) than Comparison (80.7 %), especially for mental health (15.4 % vs. 10.7 %) and musculoskeletal issues (35.8 % vs. 33.0 %), but physiotherapy use was lower (16.6 % vs. 18.5 %). Hospital admission rates were higher for PPSUD_Excl (15.1 %) than Comparison (12.9 %).</div></div><div><h3>Conclusions</h3><div>Parents of patients with substance use diagnosis face more challenges than other parents across life domains, including weaker labour market attachment, greater dependence on benefits, more mental health-related consultations, and higher overall healthcare use. Large discrepancies in disability pension and sickness absence, but modest in overall healthcare utilisation, suggest potential underutilisation of healthcare services.</div></div>","PeriodicalId":11322,"journal":{"name":"Drug and alcohol dependence","volume":"276 ","pages":"Article 112892"},"PeriodicalIF":3.6,"publicationDate":"2025-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145119139","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prior restraint stress counteracts memory deficits associated with adolescent alcohol exposure by targeting both the hippocampal endocannabinoid and glutamatergic systems","authors":"Julia Verheul-Campos ,&nbsp;Laura Sanchez-Marín ,&nbsp;Yolanda López ,&nbsp;Ana L. Gavito ,&nbsp;Pedro Grandes ,&nbsp;Pedro Serrano ,&nbsp;Inmaculada Guerricagoitia ,&nbsp;Guillermo Estivill-Torrús ,&nbsp;Marta Rodríguez-Arias ,&nbsp;Jose Miñarro ,&nbsp;Francisco J. Pavón-Morón ,&nbsp;Juan Suárez ,&nbsp;Antonia Serrano ,&nbsp;Fernando Rodríguez de Fonseca","doi":"10.1016/j.drugalcdep.2025.112891","DOIUrl":"10.1016/j.drugalcdep.2025.112891","url":null,"abstract":"<div><div>Recent studies link intensive adolescent alcohol exposure to adult memory deficits and glutamatergic dysfunction, as shown in preclinical models of binge drinking. Adolescent stress exposure has also been associated with changes in emotional behavior and memory, varying with stress timing and intensity. This study demonstrates that repeated exposure to restraint stress (five sessions of 1.5<!--> <!-->h from postnatal days 32–36) can prevent memory deficits, but not anxiety, caused by intensive alcohol exposure (four weekly cycles of 3<!--> <!-->g/kg ethanol doses followed by three washout days) when assessed in adult animals (postnatal day 77). PCR analysis of hippocampal mRNA showed alcohol consumption reduced expression of growth factors (BDNF), glutamate receptor subunits (AMPA: GluR1, GluR2; NMDA: NR1, NR2A), and endocannabinoid signaling genes (CB2, PPARα; DAGLα, DAGLβ; FAAH, MAGL). Restraint stress largely reversed these biochemical changes, suggesting it protects against alcohol’s long-term impact on the hippocampus by partially restoring glutamatergic synaptic function and normalizing glutamate receptor and endocannabinoid system expression. Proteomic studies in the dorsal hippocampus further reveal that early stress exposure modifies how adolescent alcohol affects dorsal hippocampal protein expression. These findings imply that early stress habituation could counteract neurodevelopmental changes affecting memory when induced by adolescent alcohol exposure. However, disruption of emotional behavior is still present in animals exposed to alcohol, independently of the stress delivered.</div></div>","PeriodicalId":11322,"journal":{"name":"Drug and alcohol dependence","volume":"276 ","pages":"Article 112891"},"PeriodicalIF":3.6,"publicationDate":"2025-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145099485","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association of substance use with stroke in heart failure by community socioeconomic distress","authors":"Brian Witrick ,&nbsp;Frank Annie ,&nbsp;Timothy Dotson ,&nbsp;Wes Kimble ,&nbsp;George Sokos ,&nbsp;Christopher Bianco ,&nbsp;Sarah Rinehart ,&nbsp;Megan Pate ,&nbsp;Evonne Richards ,&nbsp;Brian Hendricks","doi":"10.1016/j.drugalcdep.2025.112890","DOIUrl":"10.1016/j.drugalcdep.2025.112890","url":null,"abstract":"<div><h3>Introduction</h3><div>Substance use is common among individuals with heart failure (HF) and is linked to cardiotoxic effects and adverse outcomes. Given the increased vulnerability of HF patients to ischemic stroke, understanding how substance use and community distress contribute to this risk is vital for optimizing clinical prevention strategies. This study examined whether substance use increases stroke risk among HF patients and whether this association differs by community distress level.</div></div><div><h3>Methods</h3><div>We conducted a multicenter study using data from HF patients treated at WVU Medicine and Charleston Area Medical Center (CAMC) in West Virginia between 2017 and 2023. Multivariable logistic regression assessed the association between substance use and ischemic stroke, stratified by community distress level and adjusted for demographics and comorbidities.</div></div><div><h3>Results</h3><div>Among 33,663 individuals with HF in the WVU Medicine cohort, 2651 (7.88 %) experienced a stroke. Among 8050 in the CAMC cohort, 900 (11.18 %) experienced a stroke. Overall, among both cohorts, patients with substance use disorder diagnoses had greater odds of stroke. WVU (aOR, 1.36; 95 % CI, 1.14–1.63) and CAMC (aOR, 3.50; 95 % CI, 2.85–4.55). In distressed communities, the association was stronger: WVU (aOR, 1.68; 95 % CI, 1.34–2.09) and CAMC (aOR, 3.70; 95 % CI, 3.03–4.52). In non-distressed communities, only the CAMC cohort showed a significant association (aOR, 1.80; 95 % CI, 1.63–2.09).</div></div><div><h3>Conclusions and relevance</h3><div>Substance use is linked to higher stroke risk among HF patients, especially in socioeconomically distressed communities. Addressing both clinical and structural factors is essential for effective stroke prevention in this population.</div></div>","PeriodicalId":11322,"journal":{"name":"Drug and alcohol dependence","volume":"276 ","pages":"Article 112890"},"PeriodicalIF":3.6,"publicationDate":"2025-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145119073","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prevalence and predictors of staff burnout and shortages among syringe services programs in the United States, 2023","authors":"Barrot H. Lambdin ,&nbsp;Chris Akiba ,&nbsp;Jamie Humphrey ,&nbsp;Lynn Wenger ,&nbsp;Sarah Philbrick ,&nbsp;Paul LaKosky ,&nbsp;Stephanie Prohaska ,&nbsp;Laura Guzman ,&nbsp;Alex H. Kral ,&nbsp;Sheila V. Patel","doi":"10.1016/j.drugalcdep.2025.112889","DOIUrl":"10.1016/j.drugalcdep.2025.112889","url":null,"abstract":"<div><div>High levels of burnout have been a persistent experience of healthcare workers, which can have cascading impacts of staff turnover and shortages. We estimate the prevalence and predictors with staff burnout and staff shortages among syringe services programs throughout the United States. For this cross-sectional study, we utilized data from National Survey of Syringe Services Programs (NSSSP). Study outcomes included staff burnout and staff shortages, and predictors included organizational type, number of participant visits, full-time staff, annual budget, urbanicity, lagged drug overdose mortality rates, law enforcement harassment, and community harassment. Our analysis included negative binomial generalized estimating equations for continuous outcomes and logit generalized estimating equations for binary outcomes. In 2022, the prevalence of SSPs reporting staff burnout and shortages as an internal challenge was 58 % and 43 %, respectively. We found that SSPs experiencing law enforcement harassment and urban SSPs reported significantly higher risk of reporting staff burnout, while SSPs operated by a Department of Public Health DPHs reported significantly lower risk of staff burnout. We also found that SSPs experiencing law enforcement harassment and community harassment reported significantly higher risk of staff shortages; while SSPs operated by a Department of Public Health DPHs and SSPs with budgets ≥ $500,000 had significantly lower risk of staff shortages. In conclusion, levels of staff burnout and shortages are alarmingly high among SSPs in the United States. Further understanding approaches that use a systems level approach to address staff burnout and shortages are urgently needed.</div></div>","PeriodicalId":11322,"journal":{"name":"Drug and alcohol dependence","volume":"276 ","pages":"Article 112889"},"PeriodicalIF":3.6,"publicationDate":"2025-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145155304","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Predictive performance for alcohol use disorder of polygenic scores based on the general addiction risk factor and problematic alcohol use","authors":"Ana M. Pérez-Gutiérrez ,&nbsp;Gerardo Flórez ,&nbsp;Vanessa Blanco ,&nbsp;Fernando L. Vázquez ,&nbsp;Enric Abellí-Deulofeu ,&nbsp;Lluisa Ortega ,&nbsp;Antonia Serrano ,&nbsp;Francisco Arias ,&nbsp;Francisco Navarrete ,&nbsp;Francina Fonseca ,&nbsp;Valentín Estévez ,&nbsp;Jesús Gómez Trigo ,&nbsp;Fernando Facal ,&nbsp;Manuel Arrojo ,&nbsp;Jorge Manzanares ,&nbsp;Roberto Muga ,&nbsp;Laia Miquel ,&nbsp;Fernando Rodríguez de Fonseca ,&nbsp;Marta Torrens ,&nbsp;Gabriel Rubio ,&nbsp;Javier Costas","doi":"10.1016/j.drugalcdep.2025.112877","DOIUrl":"10.1016/j.drugalcdep.2025.112877","url":null,"abstract":"<div><h3>Background</h3><div>Polygenic scores (PGSs) may play a role in targeted prevention of alcohol use disorder (AUD) by risk stratification. A latent genetic factor representing common liability to different substance use disorders (SUDs), known as the addiction risk factor (AdRF), was recently characterized. Our aim was to analyze the predictive performance for AUD of the AdRF PGS, comparing it with PGSs of problematic alcohol use (PAU) and of a common liability factor to substance use involvement.</div></div><div><h3>Methods</h3><div>PGSs were estimated across two datasets, comprising 1637 treatment-seeking AUD patients and 4178 controls. Logistic regression was used to evaluate performance of ancestry-normalized PGSs. Subgroup sensitivity analyses were tested based on clinical data. Sex-dependent effects were assessed by comparing PGSs between sexes.</div></div><div><h3>Results</h3><div>Tail-based measures revealed a better performance of the AdRF PGS than the other PGSs. Compared with the remaining subjects, those at the top decile of PGS presented a 3.3-fold greater odds of AUD. Other analyses revealed similar performance of the AdRF and PAU PGSs. The effect estimates were larger in subgroups with addictive and psychiatric comorbidities, higher severity, and earlier age of onset. Women patients presented higher PAU and AdRF PGSs than men patients.</div></div><div><h3>Conclusions</h3><div>This new generation of PGSs is one step closer to precision public health for AUD prevention. Alcohol-specific genetic factors are not determinant for predicting AUD risk, which may benefit from shared genetic susceptibility among different SUDs. Our data suggest sex differences in genetic susceptibility, probably as a result of complex interplay between genes and social environment.</div></div>","PeriodicalId":11322,"journal":{"name":"Drug and alcohol dependence","volume":"276 ","pages":"Article 112877"},"PeriodicalIF":3.6,"publicationDate":"2025-09-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145099484","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Co-creating a gamified tool for cannabis and tobacco use monitoring: Participant-driven development","authors":"Cristina Martínez ,&nbsp;Judith Saura ,&nbsp;Marta Enríquez ,&nbsp;Ariadna Feliu ,&nbsp;Marcela Fu ,&nbsp;Montse Ballbè ,&nbsp;Xavier Roca ,&nbsp;Magalí Andreu ,&nbsp;Margarida Pla ,&nbsp;Elena Maestre-González ,&nbsp;Sílvia Mondon ,&nbsp;Pablo Barrio ,&nbsp;Antònia Raich ,&nbsp;Victoria Porthé ,&nbsp;Oscar Garcia-Pañella ,&nbsp;Joan Colom ,&nbsp;Lidia Segura ,&nbsp;Esteve Fernández ,&nbsp;Nathalia Rosa","doi":"10.1016/j.drugalcdep.2025.112880","DOIUrl":"10.1016/j.drugalcdep.2025.112880","url":null,"abstract":"<div><h3>Introduction</h3><div>The growing use of cannabis, often alongside tobacco, presents challenges for substance use treatment programs (SUTPs), as it intensifies withdrawal symptoms. To address dual dependencies and improve engagement, we developed a gamified web app for individuals in SUTP who use cannabis to monitor their use. This paper describes the tool’s co-creation process and and, findings that guided alignment with target needs.</div></div><div><h3>Methods</h3><div>Seventeen adults with current or past cannabis use were recruited from SUTPs in Catalonia (2021–2023). Using a qualitative, participatory design, the study involved reflexive thematic analysis and co-creation with researchers, clinicians, and gamification experts. Development followed four phases: (1) Discovering, expectations and motivations through interviews; (2) Deepening in Co-design, exploring needs and profiles; (3) Narrative Development, basing stories on real experiences; and (4) Technical Development, adapting features to goals.</div></div><div><h3>Results</h3><div>In Phase 1, two archetypes were identified: “socializers” and “explorers”, along with core values, such as acceptance, social connection, and life control. Phase 2 revealed expectations for content on autonomy, stigma reduction, empathy, self-confidence, tranquility, and curiosity as key motivators. Phase 3 created three stories. Phase 4 produced a customized tracking app, integrating questionnaires.</div></div><div><h3>Conclusion</h3><div>This study highlights the value of co-creation in designing interventions for SUTPs and demonstrates usefulness of participatory approaches to create mHealth tools. These approaches informed the app’s design to align with individuals' motivations and preferences, grounded in lived experiences. The resulting web app provides personalized support for substance use treatment. Future research should explore clinical and behavioral impacts.</div></div>","PeriodicalId":11322,"journal":{"name":"Drug and alcohol dependence","volume":"276 ","pages":"Article 112880"},"PeriodicalIF":3.6,"publicationDate":"2025-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145099471","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Three-day blues after ecstasy/MDMA use: Evidence from a longitudinal and daily analysis in the European nightlife scene","authors":"Matthijs Blankers ,&nbsp;Ruben van Beek ,&nbsp;Desirée Spronk ,&nbsp;Wouter den Hollander ,&nbsp;Rosa Andree ,&nbsp;Tom P. Freeman ,&nbsp;Meryem Grabski ,&nbsp;H. Valerie Curran ,&nbsp;Jon Waldron ,&nbsp;Margriet W. van Laar","doi":"10.1016/j.drugalcdep.2025.112881","DOIUrl":"10.1016/j.drugalcdep.2025.112881","url":null,"abstract":"<div><h3>Background</h3><div>There is a lack of understanding of the nature of the post-acute affective response in the days after ecstasy/3,4-Methylenedioxymethamphetamine (MDMA) use and whether this is associated with ecstasy/MDMA use or circumstantial factors. In the three days following ecstasy/MDMA use, we evaluated whether a drop in mental well-being is observed and can be related to ecstasy use.</div></div><div><h3>Methods</h3><div>Data for this study were obtained from a longitudinal and momentary analysis in the European nightlife scene (ALAMA study). Using ecological daily assessment, participants were asked to complete a daily 3-minute questionnaire for 35 days. Young adults (age 18–34) from the United Kingdom (n = 120) and the Netherlands (n = 124) who use ecstasy/MDMA were recruited in the nightlife scene and using social media campaigns. Substance use, psychological well-being and pathology, sleep quality, harm reduction behaviours, and socio-demographics data were collected digitally through a smartphone app.</div></div><div><h3>Results</h3><div>Participants reported on average a significant drop in mental well-being in the three days following ecstasy/MDMA use (B=-0.14, SE=0.04, p &lt; .001) even when accounting for other substance use, socio-demographics, applied harm reduction strategies, measures of depression, anxiety and sleep quality. For commonly used substances other than ecstasy/MDMA and cocaine, no significant associations with mental well-being in the three days following their use were found.</div></div><div><h3>Conclusions</h3><div>A drop in mental well-being in the three days following ecstasy/MDMA use was associated with ecstasy/MDMA use, in addition to other factors such as (co-)use of other substances, especially cocaine, sleep duration and quality in the days following use, and baseline levels of depression and anxiety.</div></div>","PeriodicalId":11322,"journal":{"name":"Drug and alcohol dependence","volume":"276 ","pages":"Article 112881"},"PeriodicalIF":3.6,"publicationDate":"2025-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145119074","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}