Ida Halvorsen Brenna, Karin Merethe Waleur, Jūratė Šaltytė Benth, Kristin K Solli, Jon Mordal, Else-Marie Løberg, Bente Weimand, Lars Tanum
{"title":"Patients with Opioid Use Disorder Choosing Treatment with Extended-Release Naltrexone: A 6-Month Naturalistic Study.","authors":"Ida Halvorsen Brenna, Karin Merethe Waleur, Jūratė Šaltytė Benth, Kristin K Solli, Jon Mordal, Else-Marie Løberg, Bente Weimand, Lars Tanum","doi":"10.1159/000541431","DOIUrl":"10.1159/000541431","url":null,"abstract":"<p><strong>Introduction: </strong>The treatment efficacy of extended-release naltrexone (XR-NTX) for opioid use disorder (OUD) has been demonstrated in several studies, but not in naturalistic settings where opioid agonist treatment (OAT) is freely accessible. This study aimed to examine the different treatment outcomes of XR-NTX in a setting where the participants freely chose XR-NTX as a treatment option instead of OAT.</p><p><strong>Methods: </strong>This was a 24-week open-label clinical prospective cohort study conducted in an outpatient setting at five hospitals in Norway. The study included 161 participants aged 18-65 years with OUD. Intramuscular injections of XR-NTX were administered every 4 weeks for 24 weeks. Measurements included retention in treatment, reasons for treatment discontinuation, days of use of opioids, other illicit substances and alcohol, level of heroin craving, treatment satisfaction, and adverse events (AEs).</p><p><strong>Results: </strong>Of 161 included participants, the mean age was 38 years, and 24% were women; 138 received at least one dose of the study medication (modified intention-to-treat [MITT] population), and mean time in treatment was 18.1 weeks (95% CI: 16.8-19.4). The majority of the MITT population (84; 60.9%) completed 24 weeks of treatment in the study. There was a significant decrease in the overall use of opioids (p < 0.001) and the use of alcohol, and other illicit substances were low. The participants generally reported high treatment satisfaction and low heroin cravings. Those who completed the 24 weeks of treatment reported significantly fewer days of opioid use (p < 0.001) and higher treatment satisfaction (p < 0.001) than those who discontinued treatment before 24 weeks. No serious AEs were directly related to XR-NTX use.</p><p><strong>Conclusion: </strong>This study demonstrated high retention rates, decreased opioid use, and low use of other illicit substances and alcohol. Participants also reported low cravings for heroin and high treatment satisfaction. Completion of the full 24-week treatment resulted in lower opioid use and increased treatment satisfaction compared to those who discontinued treatment before 24 weeks. The observed higher retention and reduced opioid use, compared to other studies, may be attributed to participants' strong motivation for opioid abstinence facilitated by XR-NTX treatment.</p>","PeriodicalId":11902,"journal":{"name":"European Addiction Research","volume":" ","pages":"1-12"},"PeriodicalIF":2.8,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142575065","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Cornelis A J DeJong, Gabrielle Welle-Strand, Enjeline Hanafi, Lucas Pinxten, Roshan Bhad, Shalini Arunogiri
{"title":"Global Assessment of Training Needs in Addiction Medicine.","authors":"Cornelis A J DeJong, Gabrielle Welle-Strand, Enjeline Hanafi, Lucas Pinxten, Roshan Bhad, Shalini Arunogiri","doi":"10.1159/000542182","DOIUrl":"10.1159/000542182","url":null,"abstract":"<p><strong>Introduction: </strong>A minority of addiction patients receive appropriate treatment directly from trained professionals in addiction medicine. Most countries have not recognized addiction medicine (AM) as a specialty in its own right or within psychiatry/other specialties. Therefore, the effectiveness and organization of AM training around the world need to be improved. Unfortunately, standard instruments are rarely used in most studies to assess training needs. This study aimed to determine international competencies in AM among professionals in as many countries as possible using a standard instrument such as the AM Training Needs Assessment (AM-TNA).</p><p><strong>Method: </strong>We examined competencies in AM with the AM-TNA using an online survey. A General Competency Level in Addiction Medicine (GLOCIAM30) was calculated by dividing the total score by the number of 30 items. This GLOCIAM30 was used to measure the general level of competency in AM and to compare individual competencies.</p><p><strong>Results: </strong>One hundred ninety-nine respondents from 45 countries completed the survey. Ninety-five of the 199 respondents (49.0%) had a GLOCIAM30 higher or equal to 4 (fairly competent). The highest skill level was found for the competency \"Assessing substance use problems by taking the patient's history.\" Nine of the 45 countries had 8 or more respondents (n = 129). After post hoc analysis, there was no difference between these countries. Respondents could reasonably estimate whether the competency level in their country was higher or lower than the world average.</p><p><strong>Conclusions: </strong>This study is the first international attempt to examine competencies in AM. Although a much larger study population is needed to establish an overall goal for competencies in AM, our study provided an initial direction for such a gold standard in benchmarking procedures.</p>","PeriodicalId":11902,"journal":{"name":"European Addiction Research","volume":" ","pages":"75-86"},"PeriodicalIF":2.8,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142686392","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Esther Pars, Joanneke E L VanDerNagel, Boukje A G Dijkstra, Arnt F A Schellekens
{"title":"Exploring Recovery Priorities in Inpatient Addiction Treatment: A Q-Methodological Study.","authors":"Esther Pars, Joanneke E L VanDerNagel, Boukje A G Dijkstra, Arnt F A Schellekens","doi":"10.1159/000542371","DOIUrl":"10.1159/000542371","url":null,"abstract":"<p><strong>Introduction: </strong>Recovery from substance use disorder (SUD) is increasingly recognized as a personal journey, necessitating an approach that considers individual goals and priorities. Research on recovery priorities in inpatient settings is limited. Our study employs Q-methodology to explore recovery priorities among clients with multimorbid SUD, aiming to guide targeted, recovery-oriented care.</p><p><strong>Methods: </strong>This cross-sectional study employed Q-methodology to explore recovery priorities among 129 individuals entering inpatient addiction treatment. A collaboratively developed Q-set of 42 statements covered clinical, functional, and personal recovery goals. Participants ranked statements by importance, and rotated factor analysis was used to identify clusters of recovery priorities. Qualitative interview data were then analyzed for further interpretation.</p><p><strong>Results: </strong>We found 12 consensus statements and two distinct factors. Factor 1 (n = 60) emphasized personal growth and coping, while factor 2 (n = 51) highlighted practical aspects such as securing income and housing. Qualitative data supported these findings.</p><p><strong>Conclusions: </strong>Despite the individual nature of recovery and the diversity within the addiction treatment population, our study identified shared goals and two distinct factors. This insight can inform tailored interventions, with factor 1 individuals potentially favoring psychological approaches and factor 2 individuals focusing on practical goals.</p>","PeriodicalId":11902,"journal":{"name":"European Addiction Research","volume":" ","pages":"23-34"},"PeriodicalIF":2.8,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142767075","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Clarissa Janousch, Lukas Eggenberger, Annekatrin Steinhoff, Lydia Johnson-Ferguson, Laura Bechtiger, Michelle Loher, Denis Ribeaud, Manuel Eisner, Markus R Baumgartner, Tina M Binz, Lilly Shanahan, Boris B Quednow
{"title":"Words versus Strands: Reliability and Stability of Concordance Rates of Self-Reported and Hair-Analyzed Substance Use of Young Adults over Time.","authors":"Clarissa Janousch, Lukas Eggenberger, Annekatrin Steinhoff, Lydia Johnson-Ferguson, Laura Bechtiger, Michelle Loher, Denis Ribeaud, Manuel Eisner, Markus R Baumgartner, Tina M Binz, Lilly Shanahan, Boris B Quednow","doi":"10.1159/000541713","DOIUrl":"10.1159/000541713","url":null,"abstract":"<p><strong>Introduction: </strong>Population-level substance use research primarily relies on self-reports, which often underestimate actual use. Hair analyses offer a more objective estimate; however, longitudinal studies examining concordance are lacking. Previous studies showed that specific psychological and behavioral characteristics are associated with a higher likelihood of underreporting substance use, but the longitudinal stability of these associations remains unclear. We compared the prevalence of illegal and non-medical prescription substance use assessed with self-reports and hair analyses and predicted underreporting across two time points.</p><p><strong>Methods: </strong>Data were drawn from a community cohort study. At the first time point, the sample with self-report and hair analysis comprised 1,002 participants (Mage = 20.6 [SD = 0.38] years, 50.2% female), of which 761 (Mage = 24.5 [SD = 0.38] years, 48.3% female) also provided hair at the second time point. We compared substance use 3-month prevalence rates assessed by self-reports and hair analyses for the most frequent substances cannabis/tetrahydrocannabinol (THC), amphetamines, Ecstasy/3,4-methylenedioxymethamphetamine (MDMA), cocaine, ketamine, codeine, and opioid painkillers. Binary logistic regressions were conducted to test behavioral and psychological predictors of underreporting.</p><p><strong>Results: </strong>Self-reported past-year prevalence rates of non-medical substance use were high, specifically for cannabis (56% prevalence rate at age 20/49% at age 24), Ecstasy (13%/14%), codeine (13%/11%), cocaine (12%/13%), and opioid painkillers (4%/11%). Comparing self-report and hair-analysis 3-month prevalence rates over time, consistent underreporting (similar underreporting rates between time points and investigation of false negatives) was observed for daily cannabis (22%/23%), Ecstasy/MDMA (41%/52%), cocaine (30%/60%), ketamine (61%/72%), and codeine use (48%/51%). Underreporting of Ecstasy/MDMA, cocaine, ketamine, and opioid painkillers significantly increased. Contrarily, weekly to daily cannabis (31%/18%), amphetamine (95%/11%), and opioid painkiller use (12%/66%) were overreported. Hair analysis-derived 3-month prevalence rates of cocaine (9%/23%) and ketamine (2%/6%) strongly increased over time, while decreasing for codeine (11%/8%). Balanced accuracies were higher for hair analysis compared to self-reports for daily cannabis, Ecstasy/MDMA, cocaine, ketamine, and codeine but lower for weekly to daily cannabis and amphetamines, while fairly similar for opioid painkillers. Accuracy metrics were largely stable for cannabis measures but partially varied over time for other substances, which was likely driven by the large changes in underreporting. False negative reports were associated across both time points, indicating an intra-individual consistency of underreporting. At both time points, delinquency and attention-deficit hyperactivity disorder symptoms were ","PeriodicalId":11902,"journal":{"name":"European Addiction Research","volume":" ","pages":"60-74"},"PeriodicalIF":2.8,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142675474","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Mismatch of Biological and Social Time in Cocaine-Addicted Men.","authors":"Jeevan Fernando, Karen D Ersche","doi":"10.1159/000535219","DOIUrl":"10.1159/000535219","url":null,"abstract":"<p><strong>Introduction: </strong>Chronotype describes a person's preferential activity pattern during a 24-hour period, which may not be in line with their social lifestyle. A mismatch between biological and social time is known as \"social jetlag,\" which has negative effects on wellbeing. Cocaine influences a person's activity levels, but very little is known about possible changes in chronotype of patients with cocaine use disorder (CUD). Here, we aimed to shed light on self-reported changes in chronotype in patients with CUD and the clinical implications.</p><p><strong>Methods: </strong>A total of 90 men from the local community were recruited; about half of the sample met the criteria for CUD, while the other half were healthy without a personal history of substance use disorder. Participants completed the Munich Chronotype Questionnaire along with questionnaires about mental health, daily fatigue, and drug/alcohol use.</p><p><strong>Results: </strong>Half of the CUD patients fell into the category of late chronotype - a significantly larger proportion than their healthy peers. Late \"night owls\" tended to have started using cocaine at an earlier age than other chronotypes; a finding that was not observed with tobacco, cannabis, or alcohol. Drug use severity in CUD patients did not differ across chronotypes. CUD patients (52%) did not have a preferred time of day to use cocaine. The mismatch between social and biological time was significantly greater in CUD patients and unrelated to drug use or mental health status.</p><p><strong>Conclusion: </strong>CUD appears to be associated with disruptions in chronotype which are, contrary to a widely held view, not reflected by using patterns or addiction severity.</p>","PeriodicalId":11902,"journal":{"name":"European Addiction Research","volume":" ","pages":"23-31"},"PeriodicalIF":3.9,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138798041","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Commentary on Bramness et al.: A Finnish Perspective on Addiction Training.","authors":"Jonna Levola, Margareeta Häkkinen","doi":"10.1159/000537726","DOIUrl":"10.1159/000537726","url":null,"abstract":"","PeriodicalId":11902,"journal":{"name":"European Addiction Research","volume":" ","pages":"140-141"},"PeriodicalIF":2.8,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140038978","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Andre Bedendo, Jacques Gaume, Joseph Studer, Gillian Tober, Duncan Raistrick, Nick Heather, Maria Lucia Oliveira Souza-Formigoni, Jim McCambridge
{"title":"Mediational Analyses of the Effects of Social Behaviour and Network Therapy on Alcohol Use.","authors":"Andre Bedendo, Jacques Gaume, Joseph Studer, Gillian Tober, Duncan Raistrick, Nick Heather, Maria Lucia Oliveira Souza-Formigoni, Jim McCambridge","doi":"10.1159/000535200","DOIUrl":"10.1159/000535200","url":null,"abstract":"<p><strong>Introduction: </strong>Social behaviour and network therapy involves an active participation of the practitioner in recruiting a supportive network to change the client's alcohol use. Despite achieving beneficial effects on alcohol consumption, its possible mechanisms of change are a relatively under-studied topic compared to those of other alcohol treatment interventions. This study aimed to explore therapist skills through which social behaviour and network therapy may achieve effects on alcohol consumption in comparison with motivational enhancement therapy.</p><p><strong>Methods: </strong>This study was secondary analysis of data from the UK Alcohol Treatment Trial, a multicentre, pragmatic, randomized controlled trial. The sample comprised 376 participants randomized to motivational enhancement therapy or social behaviour and network therapy. We used the UK Alcohol Treatment Trial Process Rating Scale to assess therapist skills. Outcomes drinks per drinking day and percentage of days abstinent were assessed 12 months after treatment initiation. Analyses were conducted in a simple mediation framework.</p><p><strong>Results: </strong>Therapist skills score (combining frequency and quality) for involving others in behaviour change mediated social behaviour and network therapy effects on percentage of days abstinent (b = 0.06, 95% CI: 0.02; 0.10, p = 0.01). The frequency with which therapists acted as an active agent for change also mediated the effects of social behaviour and network therapy on percentage of days abstinent (b = 0.03, 95% CI: 0.003; 0.05, p = 0.03). The frequency with which the therapist stressed social support as a key factor in achieving change unexpectedly mediated an increase in drinks per drinking day (b = 0.10, 95% CI: 0.01; 0.18, p = 0.02). The two latter mediation effects were not sustained when quality was considered. All other indirect effects tested were non-significant.</p><p><strong>Discussion/conclusions: </strong>How social behaviour and network therapy exerts effects on alcohol outcomes is not yet well understood and in this study was not attributable to observed ratings of therapist treatment-specific skills. Therapist skill in planning the involvement of others during treatment, however, warrants further study. We suggest that the present findings should be regarded as hypothesis generating as it identifies specific targets for further investigation in alcohol treatment process studies.</p>","PeriodicalId":11902,"journal":{"name":"European Addiction Research","volume":" ","pages":"14-22"},"PeriodicalIF":3.9,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138482217","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Addiction Training and Research: Striking Differences between France and Germany.","authors":"George Brousse, Francois Paille, Karl Mann","doi":"10.1159/000537974","DOIUrl":"10.1159/000537974","url":null,"abstract":"","PeriodicalId":11902,"journal":{"name":"European Addiction Research","volume":" ","pages":"149-152"},"PeriodicalIF":2.8,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140916363","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Addiction Physician Specialty Training: How Does the USA Compare with Europe?","authors":"Honora Englander","doi":"10.1159/000539191","DOIUrl":"10.1159/000539191","url":null,"abstract":"","PeriodicalId":11902,"journal":{"name":"European Addiction Research","volume":" ","pages":"153-155"},"PeriodicalIF":2.8,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141330560","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}