Drug and alcohol dependence最新文献

{"title":"Population perinatal substance use and an environmental scan of health services in British Columbia, Canada","authors":"Micah Piske ,&nbsp;Shannon Joyce ,&nbsp;Youwei Yan ,&nbsp;Noah Katsuno ,&nbsp;Fahmida Homayra ,&nbsp;Michelle J. Zanette ,&nbsp;Brittany Barker ,&nbsp;Louise Meilleur ,&nbsp;Bronwyn McBride ,&nbsp;Pamela Joshi ,&nbsp;Eva Sullivan ,&nbsp;Bohdan Nosyk","doi":"10.1016/j.drugalcdep.2024.112457","DOIUrl":"10.1016/j.drugalcdep.2024.112457","url":null,"abstract":"<div><h3>Background</h3><div>Substance use during pregnancy is underreported globally and there is limited data on its prevalence and the availability of supportive services. This study determined population perinatal substance use in British Columbia (BC) by region and examined the availability of clinical and community-based programs.</div></div><div><h3>Methods</h3><div>Using linked provincial health administrative data, we conducted a population-based retrospective cohort study including all BC residents accessing care for substance use (alcohol, opioids, stimulants, sedatives, and cannabis) within 12 months of first perinatal care record to delivery during 2016–2021. We also conducted an environmental scan to identify all programs offering perinatal care and substance use treatment/support in BC as of December 2022 and described program components by region.</div></div><div><h3>Results</h3><div>The population included 12,439 people with perinatal substance use with 13,814 linked livebirths during the study period. The incidence rate of perinatal substance use was nearly eight times higher in rural/remote Northern BC compared to the metropolitan Vancouver Coastal region (1044.2 vs. 131.3 per 100,000 population, respectively). We identified 29 related services (19 wrap-around programs, 8 supportive housing, and only 2 acute care programs). Residents outside of Metro Vancouver accounted for 60 % (N=1745) of people with perinatal substance use; however, these regions represented only 35 % of BC’s specialized acute care and supportive housing beds (N=140).</div></div><div><h3>Conclusions</h3><div>Expanding supports for perinatal substance use - particularly acute care and supportive housing within more rural/remote regions in BC - will be critical to address geographic inequities in access to perinatal care and improve health outcomes for pregnant people who use substances and their infants.</div></div>","PeriodicalId":11322,"journal":{"name":"Drug and alcohol dependence","volume":"264 ","pages":"Article 112457"},"PeriodicalIF":3.9,"publicationDate":"2024-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142383040","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Buprenorphine use among non-hospital residential programs","authors":"Cynthia Nichols ,&nbsp;Daniel Baslock ,&nbsp;Margaret Lloyd Sieger","doi":"10.1016/j.drugalcdep.2024.112456","DOIUrl":"10.1016/j.drugalcdep.2024.112456","url":null,"abstract":"<div><h3>Background</h3><div>The purpose of this study is to investigate the use of buprenorphine within non-hospital residential programs. We hypothesize that programs offering long-term treatment will be less likely to accept or prescribe buprenorphine, but those that accept public insurance will demonstrate relative increased likelihood of buprenorphine availability.</div></div><div><h3>Method</h3><div>This study analyzed data from the 2021 National Substance Use and Mental Health Services Survey. The analytic sample (n=3654) included a subset of facilities that reported providing only substance use treatment, including three non-mutually exclusive service types: detox, short-term, and long-term. A logistic regression examined the association between buprenorphine availability and residential service type, holding constant characteristics associated with the outcome of interest. We then tested an interaction between public insurance and long-term service type on the outcome of interest.</div></div><div><h3>Results</h3><div>While long-term service type was associated with reduced odds of buprenorphine availability (OR=.288, p &lt;.05), programs that both offered long-term residential programs <em>and</em> accepted public health insurance had 3.5 higher odds of accepting or prescribing buprenorphine (OR=4.586, p&lt;.01) compared to long-term programs without public insurance.</div></div><div><h3>Implications</h3><div>Patients who require treatment of longer duration may face barriers to buprenorphine availability; however, public insurance acceptance may increase odds of availability of buprenorphine among long-term programs.</div></div>","PeriodicalId":11322,"journal":{"name":"Drug and alcohol dependence","volume":"264 ","pages":"Article 112456"},"PeriodicalIF":3.9,"publicationDate":"2024-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142383039","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":"Effects of in vivo NRT sampling on smoking abstinence and NRT adherence: A randomized clinical trial","authors":"Karen L. Cropsey ,&nbsp;William P. Wagner ,&nbsp;Andrew Bontemps ,&nbsp;Elizabeth Hawes ,&nbsp;Bailey Pridgen ,&nbsp;Adrienne C. Lahti ,&nbsp;Peter S. Hendricks ,&nbsp;Andres Azuero ,&nbsp;Matthew J. Carpenter","doi":"10.1016/j.drugalcdep.2024.112458","DOIUrl":"10.1016/j.drugalcdep.2024.112458","url":null,"abstract":"<div><h3>Background</h3><div>Nicotine replacement therapy (NRT) is an effective treatment but is associated with poor adherence during smoking cessation attempts. This study aimed to determine if In Vivo Sampling, an experiential intervention that includes sampling of NRT in-session, increases NRT adherence and smoking abstinence compared to standard smoking cessation behavioral counseling.</div></div><div><h3>Methods</h3><div>Eligible participants were under community corrections supervision and smoked five or more cigarettes per day for the past year. Participants were randomly assigned to receive either In Vivo Sampling or standard smoking cessation behavioral counseling. Both interventions involved four 30-minute sessions and received 12 weeks of combination NRT. Self-reported NRT adherence, quit attempts, and carbon monoxide (CO)-verified smoking cessation were measured at one, three-, and six-months post-intervention.</div></div><div><h3>Results</h3><div>From 2017–2022, 515 participants were enrolled and randomized. The In Vivo Sampling group had significantly greater mean adherence to patch and lozenge NRT regimens (71 % vs. 60 %, OR: 1.63, 95 % CI: 1.36–1.96, p&lt;.001). The In Vivo group had a significantly higher likelihood of quit attempts across time (61 % vs. 53 %, OR: 1.4, 95 % CI: 1.05–1.87, p=.021). Groups did not significantly differ on the percent of participants who had quit smoking at 6 months post-intervention (17 % In Vivo Sampling vs. 13 % standard counseling, OR: 1.43, p=.24).</div></div><div><h3>Conclusion</h3><div>In Vivo Sampling demonstrated better NRT adherence and quit attempts but similar cessation rates to standard behavioral counseling. The In Vivo Sampling intervention represents a novel approach that increased behaviors typically associated with successful cessation over standard behavioral counseling.</div></div>","PeriodicalId":11322,"journal":{"name":"Drug and alcohol dependence","volume":"264 ","pages":"Article 112458"},"PeriodicalIF":3.9,"publicationDate":"2024-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142368006","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":"Trends in injectable buprenorphine prescribing in Canada: A descriptive analysis in five Canadian Provinces","authors":"Philippe Boilard ,&nbsp;Tianru Wang ,&nbsp;Anita Iacono ,&nbsp;S Monty Ghosh ,&nbsp;Tara Gomes","doi":"10.1016/j.drugalcdep.2024.112451","DOIUrl":"10.1016/j.drugalcdep.2024.112451","url":null,"abstract":"<div><h3>Background</h3><div>Injectable extended-release buprenorphine (BUP-ER) (Sublocade®) is a newer form of opioid agonist therapy (OAT) administered monthly. It was listed on formularies across Canada in February 2020, expanding the options for OAT across the country. This study describes rates of injectable BUP-ER uptake in five provinces to compare access to this novel medication across Canada.</div></div><div><h3>Methods</h3><div>We conducted a retrospective time-series analysis among individuals who received injectable BUP-ER in British Columbia, Alberta, Saskatchewan, Manitoba, and Ontario from February 1, 2020, to March 31, 2022. The primary outcome was the population-adjusted rate of injectable BUP-ER in each province, with secondary analyses exploring rates by urban/rural location, and the number of prescribers of injectable BUP-ER per 100,000 population.</div></div><div><h3>Results</h3><div>In total, 6528 individuals were treated with injectable BUP-ER, with the majority in British Columbia (29.0 %) and Ontario (47.0 %). By March 2022, the rate of BUP-ER use was highest in British Columbia (16.6 per 100,000), and lowest in Ontario (9.1 per 100,000). The rate of BUP-ER use was higher in rural areas (15.5 per 100,000) compared to urban centres (10.6 per 100,000), and British Columbia had the highest rate of prescribers per 100,000 population (5.9) compared to Ontario (2.2), Alberta (2.3), Saskatchewan (3.4) and Manitoba (3.5) by the end of Q1–2022.</div></div><div><h3>Conclusion</h3><div>Uptake of BUP-ER varied geographically since being approved by Health Canada. More rapid uptake in rural areas is reassuring and suggests that this form of OAT may be supporting treatment access to those with barriers to more traditional treatment formulations.</div></div>","PeriodicalId":11322,"journal":{"name":"Drug and alcohol dependence","volume":"264 ","pages":"Article 112451"},"PeriodicalIF":3.9,"publicationDate":"2024-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142328116","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Understanding the motivational mechanisms for smoking and vaping among dual users and exclusive smokers","authors":"Jennifer M. Betts ,&nbsp;Jessica W. Cook ,&nbsp;Kate H. Kobinsky ,&nbsp;Timothy B. Baker ,&nbsp;Douglas E. Jorenby ,&nbsp;Megan E. Piper","doi":"10.1016/j.drugalcdep.2024.112436","DOIUrl":"10.1016/j.drugalcdep.2024.112436","url":null,"abstract":"<div><h3>Background</h3><div>Understanding the motivational processes that influence e-cigarette use in a laboratory setting may help elucidate mechanisms that support long-term ecigarette use, which could have significant clinical and public health consequences.</div></div><div><h3>Methods</h3><div>Secondary analyses were conducted on data from exclusive smokers (<em>N</em>=47) and dual users (<em>N</em>=88) who underwent a laboratory <em>ad lib</em> use session. Participants were given 10<!--> <!-->minutes to smoke (exclusive smokers) or vape (dual users) as much as they wanted. Withdrawal was assessed pre- and post-use. Smoking and vaping behavior was coded from session videos. Person-level predictors included cigarette/ecigarette craving-relief expectancies, demographics, and cigarette/e-cigarette use and dependence. Smoking and vaping status was assessed at Year 1 using self-reported 30-day point prevalence. Data were analyzed using general linear models and logistic regressions.</div></div><div><h3>Results</h3><div>Both groups reported reductions in withdrawal after product use, including cigarette craving. Baseline e-cigarette craving-relief expectancies, pre-session ecigarette craving, heaviness of e-cigarette use, and relative e-cigarette dependence were significant univariate predictors of continued vaping in dual users at Year 1 (<em>OR</em>s&gt;1.04, <em>p</em>s&lt;.05). Dual users and exclusive smokers did not differ on use behavior (i.e., average number of puffs, <em>p</em>s&gt;.16).</div></div><div><h3>Conclusions</h3><div>E-cigarette use alleviated withdrawal, including cigarette and e-cigarette craving, in dual users. Laboratory use behavior did not differ between dual users using e-cigarettes and exclusive smokers using cigarettes. Greater e-cigarette craving-relief expectancies, e-cigarette craving, heaviness of e-cigarette use, and morning product use pattern (‘relative dependence’) may reflect mechanisms that sustain e-cigarette use.</div></div>","PeriodicalId":11322,"journal":{"name":"Drug and alcohol dependence","volume":"264 ","pages":"Article 112436"},"PeriodicalIF":3.9,"publicationDate":"2024-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142328117","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":"Criminal legal system engagement among people who use drugs in Oregon following decriminalization of drug possession","authors":"Hope M. Smiley-McDonald ,&nbsp;Esther Chung ,&nbsp;Lynn D. Wenger ,&nbsp;Morgan Godvin ,&nbsp;Danielle Good ,&nbsp;Gillian Leichtling ,&nbsp;Erica N. Browne ,&nbsp;Barrot H. Lambdin ,&nbsp;Alex H. Kral","doi":"10.1016/j.drugalcdep.2024.112449","DOIUrl":"10.1016/j.drugalcdep.2024.112449","url":null,"abstract":"<div><h3>Background</h3><div>In February 2021, Measure 110 (M110) in Oregon decriminalized noncommercial possession of drugs. We examined criminal legal system (CLS) involvement of people who use drugs (PWUD) 2 years after decriminalization.</div></div><div><h3>Methods</h3><div>We conducted a quantitative survey of PWUD (N=468) in eight Oregon counties between March and November 2023. We ran multivariable models to examine predictors of CLS involvement and law enforcement stops.</div></div><div><h3>Results</h3><div>The majority of PWUD (74 %) reported any past year CLS involvement; 67 % had at least one law enforcement stop (mean of 11.4 and median of 3 law enforcement stops) and 33 % had at least one jail incarceration. Among PWUD whom law enforcement had found to possess drugs (n=101), 77 % had their drugs seized at least once, and 63 % (n=56) were taken into custody for charges that did not include drug use or possession at least once. Younger age, cisgender male identity, unstable housing, and nonurban county location were associated with a higher prevalence of any CLS involvement. PWUD who were unstably housed had 6.80 more law enforcement stops than housed PWUD (95 % CI: 4.03–9.57). PWUD in nonurban counties experienced 9.73 more law enforcement stops than those in urban areas (95 % CI: 4.90–14.56). No significant differences were found by race or ethnicity and CLS involvement. Only 13 % of PWUD were aware that all drugs had been decriminalized.</div></div><div><h3>Conclusions</h3><div>Despite drug decriminalization, the majority of PWUD in our study reported significant CLS engagement and limited M110 knowledge.</div></div>","PeriodicalId":11322,"journal":{"name":"Drug and alcohol dependence","volume":"264 ","pages":"Article 112449"},"PeriodicalIF":3.9,"publicationDate":"2024-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142319529","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":"Community-based medical education in addiction and harm reduction: Perspectives on addiction medicine training","authors":"Sara Beeler ,&nbsp;Elisabeth A. Poorman ,&nbsp;Sarah E. Messmer ,&nbsp;Geoffrey V. Stetson ,&nbsp;Madelyn Perez","doi":"10.1016/j.drugalcdep.2024.112448","DOIUrl":"10.1016/j.drugalcdep.2024.112448","url":null,"abstract":"","PeriodicalId":11322,"journal":{"name":"Drug and alcohol dependence","volume":"264 ","pages":"Article 112448"},"PeriodicalIF":3.9,"publicationDate":"2024-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142538807","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":"Effects of xylazine on naloxone-precipitated fentanyl withdrawal in male and female rats","authors":"Hannah N. Carlson ,&nbsp;Anthony G. Spera ,&nbsp;Mark A. Smith","doi":"10.1016/j.drugalcdep.2024.112450","DOIUrl":"10.1016/j.drugalcdep.2024.112450","url":null,"abstract":"<div><h3>Purpose</h3><p>The combination of fentanyl and xylazine (i.e., “tranq-dope”) was recently declared an emerging national health threat in the United States. Given the recency of this development, very little is known regarding the behavioral pharmacology of fentanyl-xylazine combinations. The purpose of this study was to characterize the somatic and affective withdrawal symptoms of this drug combination.</p></div><div><h3>Methods</h3><p>Male and female Long Evans rats were given twice daily (08:00 and 20:00) subcutaneous injections of fentanyl, xylazine, or combined fentanyl-xylazine for five days. On the sixth (testing) day, rats were given a final injection at 08:00. Four hours later, rats were injected intraperitoneally with either saline or a naloxone challenge before behavioral observation. Somatic withdrawal was examined using the Gellert-Holtzman scale and anxiety-like behavior was examined using the elevated plus maze.</p></div><div><h3>Results</h3><p>Naloxone administration did not induce somatic or affective symptoms in rats treated with fentanyl alone, a low dose of xylazine alone, or a high dose of xylazine alone. Naloxone induced somatic but not affective withdrawal symptoms in rats treated with both fentanyl and xylazine.</p></div><div><h3>Conclusion</h3><p>Chronic co-exposure to fentanyl and xylazine produces an opioid-like somatic withdrawal syndrome at doses that are not apparent with either drug alone<strong>.</strong> These results corroborate clinical reports that xylazine worsens fentanyl withdrawal and suggest that novel interventions may be required to treat withdrawal from fentanyl-xylazine combinations in humans.</p></div>","PeriodicalId":11322,"journal":{"name":"Drug and alcohol dependence","volume":"264 ","pages":"Article 112450"},"PeriodicalIF":3.9,"publicationDate":"2024-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142238902","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":"Estimating the societal cost of heroin dependence in an Australian population engaged in treatment or harm reduction services","authors":"Natasha Hall ,&nbsp;Long Le ,&nbsp;Julie Abimanyi-Ochom ,&nbsp;Christina Marel ,&nbsp;Katherine Mills ,&nbsp;Maree Teesson ,&nbsp;Cathrine Mihalopoulos","doi":"10.1016/j.drugalcdep.2024.112447","DOIUrl":"10.1016/j.drugalcdep.2024.112447","url":null,"abstract":"<div><h3>Introduction</h3><div>Heroin dependence is a public health concern in Australia. High mortality rates, increased risk of physical/mental health comorbidities and increased risk of social issues contribute to a high personal and societal cost. The aim of this paper is to understand the societal cost of heroin dependence in an Australian population.</div></div><div><h3>Methods</h3><div>A longitudinal cohort study of 600 people with heroin dependence were interviewed at five timepoints. Resource use was determined from interviews and was multiplied by unit costs to estimate the annual healthcare, productivity, crime and other costs (homelessness, heroin drug and prison costs). The monetary value of premature mortality was calculated using the value of a statistical life year method.</div></div><div><h3>Results</h3><div>The annual mean societal cost of heroin dependence in Australia was A$120,599/person. This included healthcare costs (A$10,055), lost productivity costs (A$63,158), crime costs (A$7204) and other costs (A$40,182). Healthcare costs, lost productivity costs, crime costs and other costs trended downwards over the five waves. Lost productivity was the highest cost contributor (52 %), followed by heroin drug (25 %). The estimated number of life years lost due to heroin over the 11-year study period was 2703 years, which approximates to a monetary value of premature death of $213 million.</div></div><div><h3>Discussion and conclusions</h3><div>The significant societal cost emphasises the importance of providing resources to heroin dependence. The cost of lost productivity, crime and heroin contributed to over 80 % of the total costs, which highlights the illicit nature and reduced capacity to work contributes to the high costs to society.</div></div>","PeriodicalId":11322,"journal":{"name":"Drug and alcohol dependence","volume":"264 ","pages":"Article 112447"},"PeriodicalIF":3.9,"publicationDate":"2024-09-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0376871624013723/pdfft?md5=b817daea5f3121e835c69936bb1d138d&pid=1-s2.0-S0376871624013723-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142313024","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Is severe alcohol use disorder really associated with increased utilitarian moral judgment? Exploration using the CNI model","authors":"Mado Gautier ,&nbsp;Jessica Mange ,&nbsp;Xavier De Longueville ,&nbsp;Pierre Maurage","doi":"10.1016/j.drugalcdep.2024.112435","DOIUrl":"10.1016/j.drugalcdep.2024.112435","url":null,"abstract":"<div><h3>Objectives</h3><p>The psychology of moral decision-making classically contrasts utilitarianism (based on consequences) and deontology (based on moral norms). Previous studies capitalizing on this dichotomy have suggested the presence of a utilitarian bias among patients with severe alcohol use disorder (SAUD). We aimed to further disentangle the processes involved in such bias through a more validated approach, the CNI model of moral decision-making. This model allows to go further than the classical approach by distinguishing sensitivity to consequences (C), to moral norms (N), and general preference for inaction over action (I) in response to moral dilemmas.</p></div><div><h3>Methods</h3><p>Thirty-four recently detoxified patients with SAUD and 34 matched control participants completed a battery of 48 dilemmas derived from the CNI model, as well as social cognition tasks.</p></div><div><h3>Results</h3><p>In contrast with the utilitarian bias suggested in previous studies based on the classical approach, patients with SAUD did not show an increased sensitivity to consequences in comparison with control participants. However, they showed a reduced sensitivity to moral norms, as well as a greater action tendency. These biases were not related to social cognition deficits.</p></div><div><h3>Conclusions</h3><p>Patients with SAUD are not more utilitarian than healthy controls, this previously reported bias being artificially generated by the methodological limits of the classical approach. Instead, they present a reduced sensitivity to moral norms and an action bias, which might impact their interpersonal relations and contribute to the social isolation frequently reported in this population, thus identifying moral decision-making as a new therapeutic lever in SAUD.</p></div>","PeriodicalId":11322,"journal":{"name":"Drug and alcohol dependence","volume":"264 ","pages":"Article 112435"},"PeriodicalIF":3.9,"publicationDate":"2024-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142238901","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}