European Addiction Research最新文献

{"title":"Sweet Flavors and the Addictive Potential of E-Cigarettes: A Systematic Narrative Review.","authors":"Jan van Amsterdam, Wim van den Brink","doi":"10.1159/000553008","DOIUrl":"10.1159/000553008","url":null,"abstract":"<p><strong>Introduction: </strong>Population-based surveys indicate that sweet and fruity flavors in the e-liquids are key drivers of attractiveness of e-cigarettes (ECIGs). However, their role in the addictive potential of ECIGs is less well established. This systematic review aimed to synthetize the available evidence on the impact of sweet and fruity flavors on indicators of nicotine dependence.</p><p><strong>Methods: </strong>A systematic review was conducted in PubMed, Embase, and Google Scholar in accordance with PRISMA guidelines. Studies were eligible if they reported the effects of sweet/fruity flavors in ECIGs on (1) consumption rate, (2) vaping topography and nicotine intake, (3) reward and reinforcement, and (4) indicators of nicotine dependence. Studies limited to qualitative assessments of flavor properties were excluded. Initially, 454 studies were identified and screened independently by two reviewers, resulting in 23 eligible studies. Risk of bias and study quality were evaluated using the Johanna Briggs Institute Critical Appraisal Tools.</p><p><strong>Results: </strong>Sweet/fruity flavors were consistently associated with increased consumption rates and a higher puff number and volume, leading to more nicotine exposure. Several studies also demonstrated that sweet flavors enhanced the reward and reinforcement of ECIG use. However, findings regarding their effects on craving and withdrawal were inconsistent.</p><p><strong>Conclusion: </strong>Sweet/fruity flavors appear to increase the abuse liability of ECIGs, but the evidence remains inconclusive. Additional high-quality studies that adequately control for known covariates are required to clarify their contribution and the independent role of flavors in nicotine dependence. These findings, together with emerging toxicological data on ECIGs, should be carefully considered in regulatory decisions regarding flavor bans in ECIGs.</p>","PeriodicalId":11902,"journal":{"name":"European Addiction Research","volume":" ","pages":"1-19"},"PeriodicalIF":1.8,"publicationDate":"2026-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13544901/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148224137","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"FDA Approves Reduced Drinking Endpoints for Alcohol Trials: A New Road for Alcohol Treatment?","authors":"Jørgen G Bramness, Geert Dom","doi":"10.1159/000552370","DOIUrl":"10.1159/000552370","url":null,"abstract":"","PeriodicalId":11902,"journal":{"name":"European Addiction Research","volume":" ","pages":"69-71"},"PeriodicalIF":1.8,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13225787/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148143087","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Variations in Regulated Cannabis Sales Conditions and Their Effect on Purchase Behaviour: Findings from an Observational Study.","authors":"Nadine Heckel, Maximilian Buschner, Etna J E Engeli, Patricia Dürler, Eva Maria Havelka, Maximilian Haas, Marcus Herdener, Carlos Nordt","doi":"10.1159/000551031","DOIUrl":"10.1159/000551031","url":null,"abstract":"<p><p><p>Introduction: Many countries are exploring regulations for non-medical cannabis markets to mitigate cannabis-related health risks. Regulations such as restricting opening hours or product variability may be useful tools, yet their effects on cannabis purchases remain understudied due to a lack of comprehensive sales data.</p><p><strong>Methods: </strong>The Züri Can study implements a framework for strictly regulated cannabis sales, with a fixed product portfolio and a maximum purchase volume. The dataset contains all tracked purchases of 2,507 participants from August 22, 2023, to January 17, 2025, across ten Cannabis Social Clubs (CSCs), ten pharmacies, and the municipal Drug Information Centre Zurich (DIZ). It captures detailed information on sales conditions (opening hours, product variety, customers per hour) and purchase behaviour (purchase frequency, number of packages per purchase, THC volume, and expenditure per package). Generalised estimating equations provided means and confidence intervals by type of point of sale (POS). Multilevel survival analysis and random coefficient models examined how sales conditions influenced purchase behaviour, and how purchase behaviour evolved over time.</p><p><strong>Results: </strong>Pharmacies had notably more weekly operating days (5.66), longer daily opening hours (6.16), and fewer customers per hour (1.08) than CSCs (3.81 days; 3.76 h; 4.62 customers per hour) and the DIZ (2.85 days; 3.28 h, 3.37 customers per hour). However, compared to the POS average, longer opening hours and more customers per hour only slightly increased purchase frequency; their impact on purchase amount was negligible. Variations in the number of available products only marginally affected purchasing behaviour. Purchase frequency was higher in the 30 days following the first purchase and declined over 12 months (CSCs, pharmacies) or remained stable (DIZ) while amount obtained per purchase remained stable.</p><p><strong>Conclusion: </strong>These findings suggest that in a strictly regulated non-medical cannabis market similar to the framework of the Züri Can study, variations in sales conditions only have a small impact on purchase behaviour. Legal access to cannabis does not inherently lead to increased purchasing and may even contribute to a decline in purchase frequency. </p>.</p>","PeriodicalId":11902,"journal":{"name":"European Addiction Research","volume":" ","pages":"46-55"},"PeriodicalIF":1.8,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13035307/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147580833","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Toward Inclusivity: Validation of a Gender-Sensitive Tool to Measure Barriers to Alcohol Use Disorder Treatment among Cis- and Transgender People.","authors":"Sissi Viiri, Laia Alonso-Marmelstein, Emese Kroon, Anne Marije Kaag","doi":"10.1159/000551484","DOIUrl":"10.1159/000551484","url":null,"abstract":"<p><p><p>Introduction: Individuals with alcohol use disorder (AUD) encounter significant barriers to seeking treatment, with these obstacles often greater for cisgender women and transgender individuals. Negative consequences of AUD are particularly severe in these groups, yet research on their specific treatment barriers is lacking. This study aimed to develop and evaluate the Barriers to AUD Treatment Questionnaire (BAT-Q) and to explore differences in reported barriers among cisgender men, cisgender women, and transgender individuals who had considered AUD treatment in the past 5 years.</p><p><strong>Methods: </strong>Participants were recruited through online platforms in the Netherlands and in-person flyers in the greater Amsterdam area. In total, 112 cisgender men, 154 cisgender women, and 98 transgender individuals completed an online survey that included the BAT-Q questionnaire.</p><p><strong>Results: </strong>Exploratory factor analysis identified seven reliable domains of barriers: social stigma, comorbid problems and negative care experiences, limited care accessibility, fear of limited inclusivity and discrimination, limited social support, socioeconomic constraints, and negative expectations of care. While comparisons among groups yielded preliminary insights these findings should be interpreted with caution, as confirmatory factor analysis have not yet been conducted. However, transgender individuals reported higher barriers than both cisgender men and women across all domains except socioeconomic constraints. Both cisgender women and transgender individuals experienced greater stigma-related barriers than cisgender men. Higher alcohol and drug use severity predicted greater overall treatment barriers in all groups. Notably, poorer perceived socioeconomic status and low social support were more strongly associated with barriers among women than among cisgender men or transgender individuals.</p><p><strong>Conclusion: </strong>These findings underscore the need for gender-affirming and accessible AUD services. The BAT-Q provides a promising new tool for identifying and addressing specific barriers to treatment, although further validation of its structure is warranted to strengthen the interpretation of group differences. </p>.</p>","PeriodicalId":11902,"journal":{"name":"European Addiction Research","volume":" ","pages":"72-85"},"PeriodicalIF":1.8,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13171085/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147467322","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Factors Contributing to Criminal Behavior in the Context of Buying-Shopping Behavior.","authors":"Nora M Laskowski, Astrid Müller, Beate Muschalla, Georgios Paslakis, Ekaterini Georgiadou","doi":"10.1159/000550136","DOIUrl":"10.1159/000550136","url":null,"abstract":"<p><p><p>Introduction: Individuals with compulsive buying-shopping disorder (CBSD) often engage in criminal behaviors like fraud and theft, influenced by materialistic values, impaired moral judgment, and low self-control. Psychological mechanisms linking CBSD and criminality are yet not well understood. This study examines psychological/personality factors contributing to criminal tendencies in individuals with CBSD.</p><p><strong>Methods: </strong>An online survey recruited participants through social media, Websites, and academic institutions. Eligible participants were ≥18 years with German language skills. Ethical approval was granted by Hannover Medical School. Measures included the Pathological Buying Screener (PBS), Materialistic Value Scale, Big Five Inventory, Rosenberg Self-Esteem Scale, the Dirty Dozen for Dark Triad traits, and a self-developed questionnaire on criminal behavior.</p><p><strong>Results: </strong>Forty-three participants scored above (CBSD+) and 166 participants below (CBSD-) the PBS cutoff for CBSD. The CBSD+ group showed higher materialism, lower self-esteem, elevated Dark Triad traits, and more criminal behaviors compared to the CBSD- group. Nearly 70% of the CBSD+ group reported at least one criminal behavior. A multiple linear regression (enter method) identified higher PBS scores, younger age, and lower extraversion as predictors of more criminal buying-shopping-related behaviors.</p><p><strong>Conclusion: </strong>The findings reveal the intricate factors contributing to criminal behavior in CBSD. The lack of significant association between neuroticism, dark personality features, and the amount of criminal behaviors needs further investigation. The explained variance of 39% indicates that additional influences on criminal behavior remain to be explored. Future research should aim for more diverse samples and longitudinal designs to enhance generalizability and understanding of these complex relationships. </p>.</p>","PeriodicalId":11902,"journal":{"name":"European Addiction Research","volume":" ","pages":"1-14"},"PeriodicalIF":1.8,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12904648/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145911053","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Recovery Outcomes and Treatment Dropout in Patients with Complex Problems Undergoing Inpatient Addiction Treatment: A Naturalistic Prospective Cohort Study.","authors":"Esther Pars, Boukje A G Dijkstra, Joanneke E L VanDerNagel, Arnt F A Schellekens","doi":"10.1159/000550485","DOIUrl":"10.1159/000550485","url":null,"abstract":"<p><p><p>Introduction: Recovery from substance use disorder (SUD) spans clinical, functional, and personal dimensions. However, research covering these domains, particularly in populations with complex problems such as those with mild to borderline intellectual disabilities (MBIDs), remains limited. This study explored different recovery outcomes and their relationship with treatment dropout during the first 12 weeks of inpatient treatment, while also examining whether the presence of MBID affected the outcomes.</p><p><strong>Methods: </strong>A naturalistic, prospective cohort study was conducted with patients undergoing inpatient SUD treatment at a Salvation Army Clinic in The Netherlands. Recovery outcomes (clinical, functional, personal) and predictors of dropout were assessed over 12 weeks. MBID (yes/no) was determined using the SCIL screening tool. Data were analyzed using repeated measures (M)ANCOVA to evaluate recovery trajectories and logistic regression to explore associations between recovery levels and dropout.</p><p><strong>Results: </strong>Of the 157 participants, 66% screened positive for potential MBID, and 40% dropped out within 12 weeks. For completers, significant improvements were observed across all recovery domains over time (all p < 0.001). Psychological problems decreased by a mean of 9.6 points (95% CI: 7.5-11.8), physical problems by a mean of 3.7 points (95% CI: 2.0-5.4), and craving by a mean of 7.5 points (95% CI: 6.4-8.6). Functional recovery increased by a mean of 5.1 points (95% CI: -1.4 to 11.7), and personal recovery by a mean of 5.7 points (95% CI: 3.5-7.9). Lower baseline recovery levels were associated with greater relative improvements but lower endpoint scores. Lower baseline functional recovery was a small but significant predictor of dropout. MBID status did not affect recovery trajectories.</p><p><strong>Conclusions: </strong>The findings suggest a multidimensional recovery process during early phases of inpatient treatment, irrespective of MBID status. Baseline recovery levels play a crucial role in shaping outcomes, underscoring the importance of early assessments. Importantly, these findings indicate that those worst off at baseline profit most from treatment. </p>.</p>","PeriodicalId":11902,"journal":{"name":"European Addiction Research","volume":" ","pages":"56-68"},"PeriodicalIF":1.8,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12908947/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145965813","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison of the Treatments in Crack Use Disorder: A Systematic Review.","authors":"Jonathan Marc Flory Samartino, Tatiana Aboulafia-Brakha, Louise Penzenstadler, Gabriel Thorens, Daniele Zullino","doi":"10.1159/000551660","DOIUrl":"10.1159/000551660","url":null,"abstract":"<p><p><p>Background: Many studies address the different treatments for crack cocaine use disorder without distinguishing between crack use and cocaine use disorder. Furthermore, they highlight various approaches, such as psychotherapeutic methods, medications, and social interventions, whose effectiveness remains contentious for crack use disorder. Our aim was to evaluate the relative effectiveness of these various treatments, specifically for crack use disorder.</p><p><strong>Methods: </strong>This systematic review followed PRISMA guidelines; we searched PubMed, Embase, and Web of Science for studies between 2014 and July 2024.</p><p><strong>Eligibility criteria: </strong>Due to the limited number of available studies, we included all studies worldwide with full text available in English or French, published between 2014 and 2024, reflecting the recent increase in interest in crack use. Studies included adults aged 18 years or older with a clinical diagnosis of crack cocaine addiction based on a validated clinical scale. We excluded studies that did not distinguish between crack and cocaine use in their assessment of crack cocaine (or crack/cocaine) use disorder. We reported the randomized controlled trials (RCTs) results based on the type of interventions, including various outcomes: reduction of health (within the biopsychosocial model), increased accessibility and retention in healthcare, and reduction in drug use. The reliability of the evidence was assessed using Cochrane's tool for evaluating the risk of bias.</p><p><strong>Results: </strong>We identified 3,313 records, of which 46 were eligible, and 33 were finally included. Among the 33 studies, 15 were RCTs. Among the RCTs, the majority had a moderate risk of bias (8/15), followed by high risk (6/15), and only one had a low risk of overall bias. Contingency management was associated with higher abstinence, better treatment retention, and improvements in mental health, although the interpretability of these findings is limited by their generalizability. Pharmacological trials with dexamfetamine showed a reduction in drug use and an increase in abstinence, but only in a specific population receiving heroin-assisted treatment. Adjunct trials such as transcranial direct current stimulation yielded mixed findings, with some studies suggesting improvements in abstinence and quality of life, while others reported no significant effects. The findings highlight that tailored interventions supported by a contingency management approach may enhance engagement and treatment effectiveness. </p>.</p>","PeriodicalId":11902,"journal":{"name":"European Addiction Research","volume":" ","pages":"120-132"},"PeriodicalIF":1.8,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13233060/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147503349","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Lessons Learned from Implementing a Centrally Organized, Cross-Sectoral, Patient-Centered Treatment Coordination System for Hazardous Substance Use and Substance Use Disorders: The Randomized Controlled ASSIST Study.","authors":"Jeanette Röhrig, Lorenz Sutter, Elke Prestin, Vanessa-Emily Müller-Schoch, Anna Debler-Ognjenovic, Gerard Schippers, Theo G Broekman, Lena Rademacher, Michael Krausz, Fiona Choi, Annabel S Mueller-Stierlin, Maurice Cabanis","doi":"10.1159/000552302","DOIUrl":"10.1159/000552302","url":null,"abstract":"<p><p><p>Introduction: Although effective treatments for substance use disorders (SUDs) are available in Germany, only a fraction of individuals use them. Barriers include the complexity of the addiction support system, implementation challenges, limited coordination and communication between the different sectors and services, and stigma-related factors such as shame and guilt. Innovative, accessible, and patient-centered care models are rarely effectively implemented. The ASSIST study aimed to evaluate the effectiveness of a sector-independent, individualized treatment coordination model compared to standard care. The new intervention was based on a standardized online assessment, a regional competence center, and an individual treatment assistant. Participants were assigned to levels of care and treatment options tailored to their individual goals and substance use profiles.</p><p><strong>Methods: </strong>A randomized controlled trial with a waiting control group (WCG) was conducted in participants with SUDs or at risk for SUDs. The intervention group (ASSIST) received access to the ASSIST intervention; the WCG received treatment as usual. Assessments were performed at four time points (t0 to t3) over a 6-month period. The primary outcome was change in patient satisfaction (ZUF-8) over 6 months, and the secondary outcomes included change in empowerment, change in quality of life, treatment allocation and retention. Outcomes were analyzed using mixed-effects models (primary: over 6 months [t0 to t3]; secondary: over 2 months [t0 to t1]). Fidelity was assessed descriptively.</p><p><strong>Results: </strong>Between November 2021 and November 2022, 304 participants (mean age 41 years; 78% male) were enrolled and randomized (ASSIST n = 149, WCG n = 155). No significant time*group interaction effects were found for the primary outcome ZUF-8 (b = 0.16; p = 0.503) or for secondary outcomes. However, ASSIST participants were significantly more likely to start accessing services from the addiction support system compared to the WCG. Fidelity analysis showed low adherence among staff of support services, indicating substantial deviations from the intended implementation.</p><p><strong>Conclusion: </strong>Study success was severely impeded by challenging pandemic conditions and limited support from local stakeholders. The corresponding recruitment barriers restrict the generalizability of our findings, as mainly participants already engaged in specialized treatment settings were included in the study. Nonetheless, the project provides valuable insights for future health interventions in addiction care, highlighting the critical importance of stakeholder commitment, flexibility in implementation, and contingency planning to manage external disruptions. </p>.</p>","PeriodicalId":11902,"journal":{"name":"European Addiction Research","volume":" ","pages":"160-174"},"PeriodicalIF":1.8,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13341083/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147811893","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Confidence in Managing Use and Minimising Harm as Mediators of Quality of Life among Anabolic-Androgenic Steroid Consumers in Alcohol and Other Drug Treatment Settings.","authors":"Benjamin Bonenti, Nicholas Leigh Kerswell, Grace Shuttleworth, Carmen Lim, Thomas O'Connor, Jason Ferris, Kylie Lee, Timothy Piatkowski","doi":"10.1159/000550427","DOIUrl":"10.1159/000550427","url":null,"abstract":"<p><p><p>Introduction: Anabolic-androgenic steroid (AAS) consumers frequently experience elevated physical and psychological risks, yet the psychological mechanisms linking risk exposure to health outcomes remain poorly understood. This study examined whether general confidence in managing substance use and minimising harm mediates the relationship between clinical risk and quality of life among AAS consumers engaged with community-based alcohol and other drug (AOD) services.</p><p><strong>Methods: </strong>Intake data from 517 adults (93.4% male) reporting lifetime AAS use were analysed, drawn from a broader cohort of 18,786 clients at Lives Lived Well services between 2020 and 2024. Mediation analyses tested whether two confidence variables: (1) substance use management and (2) harm minimisation, explained associations between clinical risk (defined by World Health Organisation - Alcohol, Smoking and Substance Involvement Screening Test steroid risk score), and three quality of life domains: physical, psychological, and overall wellbeing.</p><p><strong>Results: </strong>Higher clinical steroid risk scores were significantly associated with poorer quality of life across domains; however, these effects were fully mediated by lower general confidence in managing substance use and minimising harm among clients who reported AAS use. Confidence in consumption practices buffered against physical undesired effects, while confidence in harm reduction was strongly linked to psychological wellbeing.</p><p><strong>Conclusions: </strong>Among AAS consumers in AOD treatment, broader substance use confidence appears meaningfully related to quality of life. While the confidence measures are general rather than AAS-specific, these findings provide a preliminary insight into confidence-related processes in a clinically underexamined group. Interventions that promote these strategies may offer a critical mechanism for ensuring this cohort physical and psychological wellbeing. </p>.</p>","PeriodicalId":11902,"journal":{"name":"European Addiction Research","volume":" ","pages":"34-45"},"PeriodicalIF":1.8,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12912760/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145988819","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Factors Influencing Treatment Outcomes in a Randomized Clinical Trial for Gambling Disorder: A Secondary Analysis.","authors":"Niklas Mäkelä, Jarkko Isotalo, Hannu Alho, Sari Castrén","doi":"10.1159/000550527","DOIUrl":"10.1159/000550527","url":null,"abstract":"<p><p><p>Introduction: Sociodemographic background factors, gambling game type, depressive symptoms, and comorbid substance use have been associated with gambling disorder, but the associations of these factors with treatment outcomes remain unclear. This study examined background factors in participants of a clinical trial, identifying factors which were associated with treatment outcomes such as gambling urge and quality of life.</p><p><strong>Methods: </strong>This was a secondary analysis of a single-center 12-week randomized placebo-controlled clinical trial investigating the effects of as-needed intranasal naloxone combined with psychosocial support in the treatment of gambling disorder. Independent variables were analyzed with linear mixed models, with analyses both including and excluding treatment allocation.</p><p><strong>Results: </strong>Sociodemographic factors or game types were not associated with treatment outcomes. Adherence to trial medication and high self-perceived readiness to change gambling behavior were associated with greater reduction in gambling urge and severity, and greater increase in gambling self-efficacy and quality of life. Higher scores for depressive symptoms were associated with more severe gambling and a slightly greater decrease in gambling urge, as well as a greater increase in quality of life. When included as a nuisance factor, treatment allocation abolished most statistically significant results.</p><p><strong>Conclusion: </strong>Participants with high medication adherence had improved treatment outcomes compared to participants with low medication adherence, possibly representing greater motivation and commitment to treatment. More severe depressive symptoms were associated with a greater reduction in gambling urge but not gambling severity. </p>.</p>","PeriodicalId":11902,"journal":{"name":"European Addiction Research","volume":" ","pages":"15-27"},"PeriodicalIF":1.8,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12978809/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146003089","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}