Substance Abuse and Rehabilitation最新文献

{"title":"Could the link between drug addiction in adulthood and substance use in adolescence result from a blurring of the boundaries between incentive and hedonic processes?","authors":"F. Kehinde, Opeoluwa Oduyeye, Raihan Mohammed","doi":"10.2147/SAR.S202996","DOIUrl":"https://doi.org/10.2147/SAR.S202996","url":null,"abstract":"Abstract There is a broad consensus that the development of drug addiction in adulthood is closely linked to the onset of drug use in adolescence. However, the relationship between drug exposure during adolescence and subsequent vulnerability to addiction is yet to be fully understood. This review will first use evidence from adult studies on reward and addiction to give an up-to-date reference point of normal reward-circuitry and the maladaptive changes that later occur in addiction. This will then be compared with current evidence from adolescent studies on reward-circuitry. Similarities between the reward processes governing characteristic behavioral traits in adolescence and the reward profile in adult addiction could help to explain why the risk of later developing addiction is increased when substance use is initiated in adolescence. We argue that the age of onset is a major risk factor in the development of substance use disorder due to a blurring of the boundaries between incentive and hedonic processes, which occurs during adolescence. A deeper understanding of the processes that mediate this blurring could open new avenues for the prevention and treatment of adult drug addiction.","PeriodicalId":22060,"journal":{"name":"Substance Abuse and Rehabilitation","volume":"10 1","pages":"33 - 46"},"PeriodicalIF":1.8,"publicationDate":"2019-07-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.2147/SAR.S202996","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46798986","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Current perspectives on the impact of Kratom use","authors":"Charles A. Veltri, O. Grundmann","doi":"10.2147/SAR.S164261","DOIUrl":"https://doi.org/10.2147/SAR.S164261","url":null,"abstract":"Abstract The leaves from the tree Mitragyna speciosa, commonly known as Kratom, in the coffee plant family (Rubiaceae) are commonly used in their native habitat of Southeast Asia as a stimulant to sustain energy during hard day labor and as an opioid-like analgesic and sedative. Traditional and modern uses overlap based on the effects of the leaf extract which has also gained popularity in the United States and Europe in the last two decades. Kratom has and is being used for the mitigation of opioid withdrawal symptoms and as a harm reduction agent with a minority of users subsequently developing a dependence on the extract. The respective demographic use patterns of Kratom differ between Southeast Asia and the Western world. While pure Kratom is primarily used by day laborers and misused in conjunction with cough medicine by youth in Southeast Asia, a majority of users in the United States is middle-aged, has at least middle income, private health insurance, and completed some college. Deaths attributed to the use of Kratom have been reported in Europe and the United States but not in Southeast Asia. Although Kratom was detected as the alkaloid mitragynine in the blood of the decedents, causality could not be established in almost all cases because of poly-drug exposures. It is notable that Kratom can cause herb–drug interactions, especially with other central nervous system -active substances. Given the mostly unregulated market for Kratom products in Western countries, consumers may be exposed to adulterated or contaminated products, especially if purchased through websites or the darknet. A number of countries have scheduled Kratom because of its stimulant- and opioid-like effects and the established interaction of the alkaloid mitragynine with opioid receptors.","PeriodicalId":22060,"journal":{"name":"Substance Abuse and Rehabilitation","volume":"10 1","pages":"23 - 31"},"PeriodicalIF":1.8,"publicationDate":"2019-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.2147/SAR.S164261","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44499396","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Measuring recovery in opioid use disorder: clinical utility and psychometric properties of the Treatment Effectiveness Assessment.","authors":"Walter Ling,&nbsp;Vijay R Nadipelli,&nbsp;Caitlyn T Solem,&nbsp;David Farabee,&nbsp;Naoko A Ronquest,&nbsp;Brian Perrochet,&nbsp;Susan M Learned,&nbsp;Chinmay G Deshpande,&nbsp;Christian Heidbreder","doi":"10.2147/SAR.S198361","DOIUrl":"https://doi.org/10.2147/SAR.S198361","url":null,"abstract":"<p><p><b>Purpose:</b> The Treatment Effectiveness Assessment (TEA) is a patient-centered instrument for evaluating treatment progress and recovery from substance use disorders, including opioid use disorder (OUD). We assessed the TEA's reliability and validity and determined minimal clinically important differences (MIDs) in participants with moderate to severe OUD. <b>Patients and methods:</b> The TEA measures change in four single-item domains (substance use, health, lifestyle, community involvement) from treatment initiation across the duration of a treatment program. Self-reported responses range from 1 (\"none or not much\") to 10 (\"much better\") with items summed to a total score ranging from 4-40. We assessed floor and ceiling effects, internal consistency, test-retest reliability, known-groups validity (ANOVA stratified by current health status [36-Item Short Form Health Survey item 1]), convergent/divergent validity, and MIDs using data from a phase 3, open-label clinical trial of buprenorphine extended-release monthly injection for subcutaneous use (BUP-XR). Participants with OUD completed the TEA at screening and before monthly injections for up to 12 months. <b>Results:</b> Among 410 participants (mean age 38 years; 64% male), the mean baseline (pre-injection 1) TEA total score was 25.4 (SD 9.7), with <10% of participants at the measure floor and 10%-20% at the ceiling across domains. Internal consistency was high (Cronbach's α=0.90), with marginal test-retest reliability (intraclass correlation coefficient =0.69). Mean TEA total score consistently increased from baseline (n=410; mean 25.4 [SD 9.7]) to end of study (n=337; 35.0 [6.7]) and differentiated between current health status groups (<i>P</i><0.001); it was weakly correlated with other measures of health-related quality of life/severity. MIDs ranged from 5-8 for the TEA total score across anchor- and distribution-based approaches. <b>Conclusion:</b> The TEA exhibited acceptable reliability and validity in a cohort of participants with moderate to severe OUD treated with BUP-XR. Given its brevity and psychometric properties, the TEA is a promising tool for use in clinical practice and research.</p>","PeriodicalId":22060,"journal":{"name":"Substance Abuse and Rehabilitation","volume":"10 ","pages":"13-21"},"PeriodicalIF":1.8,"publicationDate":"2019-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.2147/SAR.S198361","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37362428","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The association between perceived stigma and substance use disorder treatment outcomes: a review.","authors":"Kathleen A Crapanzano,&nbsp;Rebecca Hammarlund,&nbsp;Bilal Ahmad,&nbsp;Natalie Hunsinger,&nbsp;Rumneet Kullar","doi":"10.2147/SAR.S183252","DOIUrl":"https://doi.org/10.2147/SAR.S183252","url":null,"abstract":"<p><p>Substance use disorders (SUDs) take a heavy toll on those who have them and on society more broadly. These disorders are often difficult to treat, and relapse is common. Perhaps, because of these factors, these disorders are highly stigmatized worldwide. The purpose of this study is to examine empirical work intended to determine the impact of perceived social stigma and self-stigma on the process of recovering from SUDs with the assistance of formal treatment services. Qualitative studies confirmed that stigma experiences are common among those with these disorders and that these experiences can negatively impact feelings and beliefs about treatment. One quantitative study provided good statistical support for a direct effect of stigma on outcomes, but this was contradicted by other longitudinal data. In general, quantitative articles suggested an indirect effect of stigma on treatment outcomes, via negative emotions and cognitive mechanisms such as feelings of self-efficacy. However, it was notable that there was little consistency in the literature as to definitions and measurement of the constructs of recovery, perceived social stigma, and self-stigma. Future work should focus on bringing clarity, and validated measures, to this problem in order to better determine the nature of these relationships.</p>","PeriodicalId":22060,"journal":{"name":"Substance Abuse and Rehabilitation","volume":"10 ","pages":"1-12"},"PeriodicalIF":1.8,"publicationDate":"2018-12-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.2147/SAR.S183252","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36854061","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Adapting substance use brief interventions for adolescents: perspectives of adolescents living with adults in substance use disorder treatment.","authors":"Howard Padwa,&nbsp;Erick G Guerrero,&nbsp;Veronica Serret,&nbsp;Melvin Rico,&nbsp;Lillian Gelberg","doi":"10.2147/SAR.S177865","DOIUrl":"https://doi.org/10.2147/SAR.S177865","url":null,"abstract":"<p><strong>Background: </strong>Brief interventions (BIs) have shown potential to reduce both alcohol and drug use. Although BIs for adults have been studied extensively, little is known about how to adapt them to meet the needs and preferences of adolescents. This article examines adolescents' preferences to consider when adapting BIs for use with adolescents.</p><p><strong>Methods: </strong>Eighteen adolescents (age 9-17 years) living in Los Angeles County with adults receiving substance use disorder treatment were interviewed and asked about their perspectives on how to adapt a BI originally developed for adults for use with adolescents. Questions focused on adolescents' preferences for who should deliver BIs, how BIs should be delivered, and what content they would want to be included in BIs. Interviews were recorded, transcribed, and coded using summative content analysis.</p><p><strong>Results: </strong>Adolescents did not express any discernable opinions concerning who delivers BIs or what content they would want to be included, but they did share perspectives on how BIs should be delivered. Most adolescents did not endorse incorporating text messaging or social media into BIs. Instead they preferred having BIs delivered face-to-face or over the telephone. They reported that they did not want BIs to incorporate text messaging or social media due to concerns about trust, the quality of information they would receive, and challenges communicating in writing instead of speaking.</p><p><strong>Conclusion: </strong>Although the study has limitations because of its small sample size, findings indicate that adolescents may not want text messaging or social media to be incorporated into BIs for substance use. These findings warrant further research and consideration, particularly as work to enhance BIs for adolescents continues.</p>","PeriodicalId":22060,"journal":{"name":"Substance Abuse and Rehabilitation","volume":"9 ","pages":"137-142"},"PeriodicalIF":1.8,"publicationDate":"2018-12-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.2147/SAR.S177865","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36813508","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Review of the effects of self-stigma and perceived social stigma on the treatment-seeking decisions of individuals with drug- and alcohol-use disorders.","authors":"R Hammarlund,&nbsp;K A Crapanzano,&nbsp;L Luce,&nbsp;L Mulligan,&nbsp;K M Ward","doi":"10.2147/SAR.S183256","DOIUrl":"https://doi.org/10.2147/SAR.S183256","url":null,"abstract":"<p><p>Substance-use disorders are a public health crisis globally and carry with them significant morbidity and mortality. Stigma toward people who abuse these substances, as well as the internalization of that stigma by substance users, is widespread. In this review, we synthesized the available evidence for the role of perceived social stigma and self-stigma in people's willingness to seek treatment. While stigma may be frequently cited as a barrier to treatment in some samples, the degree of its impact on decision-making regarding treatment varied widely. More research needs to be done to standardize the definition and measurement of self- and perceived social stigma to fully determine the magnitude of their effect on treatment-seeking decisions.</p>","PeriodicalId":22060,"journal":{"name":"Substance Abuse and Rehabilitation","volume":"9 ","pages":"115-136"},"PeriodicalIF":1.8,"publicationDate":"2018-11-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.2147/SAR.S183256","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36772603","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mindfulness meditation in the treatment of substance use disorders and preventing future relapse: neurocognitive mechanisms and clinical implications.","authors":"Sarah E Priddy,&nbsp;Matthew O Howard,&nbsp;Adam W Hanley,&nbsp;Michael R Riquino,&nbsp;Katarina Friberg-Felsted,&nbsp;Eric L Garland","doi":"10.2147/SAR.S145201","DOIUrl":"10.2147/SAR.S145201","url":null,"abstract":"<p><p>Substance use disorders (SUDs) are a pervasive public health problem with deleterious consequences for individuals, families, and society. Furthermore, SUD intervention is complicated by the continuous possibility of relapse. Despite decades of research, SUD relapse rates remain high, underscoring the need for more effective treatments. Scientific findings indicate that SUDs are driven by dysregulation of neural processes underlying reward learning and executive functioning. Emerging evidence suggests that mindfulness training can target these neurocognitive mechanisms to produce significant therapeutic effects on SUDs and prevent relapse. The purpose of this manuscript is to review the cognitive, affective, and neural mechanisms underlying the effects of mindfulness-based interventions (MBIs) on SUDs. We discuss the etiology of addiction and neurocognitive processes related to the development and maintenance of SUDs. We then explore evidence supporting use of MBIs for intervening in SUDs and preventing relapse. Finally, we provide clinical recommendations about how these therapeutic mechanisms might be applied to intervening in SUDs and preventing relapse.</p>","PeriodicalId":22060,"journal":{"name":"Substance Abuse and Rehabilitation","volume":"9 ","pages":"103-114"},"PeriodicalIF":1.8,"publicationDate":"2018-11-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.2147/SAR.S145201","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36810778","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Butane hash oil and dabbing: insights into use, amateur production techniques, and potential harm mitigation.","authors":"Ihsan Al-Zouabi,&nbsp;John M Stogner,&nbsp;Bryan Lee Miller,&nbsp;Elizabeth S Lane","doi":"10.2147/SAR.S135252","DOIUrl":"https://doi.org/10.2147/SAR.S135252","url":null,"abstract":"<p><p>The use of marijuana concentrates has escalated in recent years with butane extracts appearing particularly popular. The administration of butane hash oil, colloquially referred to as \"dabbing,\" is distinct from traditional flower cannabis usage due to the THC content of samples and the presence of impurities such as unpurged butane. While this may confer heightened risk to the user, additional significant concerns are tied to fires and explosions. Using butane as a solvent in amateur \"blasting\" methods may result in a flammable vapor pooling in enclosed spaces and igniting when exposed to a spark. As research on butane extract users, amateur production techniques, health risks, and legality is in its infancy, we explored existing studies on the topic to create a review of substantiated knowledge related to THC extracted using butane. The resulting assessment centers on three areas: 1) dab users including both recreational users and medical marijuana patients; 2) butane extraction techniques including illicit amateur open methods and the safer closed-loop system employed in medicinal/recreational states; and 3) risks, both related to fires and legality. We follow the presentation of this material with a summary of the (mis)information reaching the public in print and online sources so that public educational campaigns can focus on dispelling the inaccuracies and false notions of safety that may be tied to amateur production.</p>","PeriodicalId":22060,"journal":{"name":"Substance Abuse and Rehabilitation","volume":"9 ","pages":"91-101"},"PeriodicalIF":1.8,"publicationDate":"2018-11-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.2147/SAR.S135252","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36707643","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Analysis of psychotropic drug-related deaths in south Osaka.","authors":"Naoto Tani,&nbsp;Tomoya Ikeda,&nbsp;Tomomi Michiue,&nbsp;Shigeki Oritani,&nbsp;Fumiya Morioka,&nbsp;Takaki Ishikawa","doi":"10.2147/SAR.S163491","DOIUrl":"https://doi.org/10.2147/SAR.S163491","url":null,"abstract":"<p><strong>Objective: </strong>The aim of this study was to investigate the occurrence of deaths due to psychotropic drugs in south Osaka during a 10-year period and discuss societal factors from a medical viewpoint.</p><p><strong>Methods: </strong>Psychotropic drug-related deaths were retrospectively investigated based on the forensic postmortem data of 1,746 decedents in 2005-2014, and we excluded cases in which stimulant drugs were detected. Of these, 133 cases (7.6%) were found to be psychotropic drug-related deaths and were analyzed.</p><p><strong>Results: </strong>Psychotropic drug-related deaths occurred in 78 males (59%; age range, 14-95 years) and 55 females (41%; 20-84 years). The direct cause of death was acute drug intoxication in many cases, and of these, acute combined drug intoxication due to the use of multiple drugs accounted for 76% of the deaths. Most of these victims were found to have gastrointestinal and cardiovascular diseases. Cases of psychotropic drug-related deaths had especially poor medical conditions. In addition, tests were positive for blood alcohol in 23% of the cases.</p><p><strong>Conclusion: </strong>The descriptive results revealed several factors that may be related to psychotropic drug-related deaths. To prevent drug abuse, several factors were deemed to be important, including improvements in the medical state of an individual, the avoidance of social isolation, and from a medical standpoint, the management of prescription drugs by medical personnel.</p>","PeriodicalId":22060,"journal":{"name":"Substance Abuse and Rehabilitation","volume":"9 ","pages":"79-90"},"PeriodicalIF":1.8,"publicationDate":"2018-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.2147/SAR.S163491","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36577539","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Relationship between buprenorphine adherence and relapse, health care utilization and costs in privately and publicly insured patients with opioid use disorder.","authors":"Naoko A Ronquest,&nbsp;Tina M Willson,&nbsp;Leslie B Montejano,&nbsp;Vijay R Nadipelli,&nbsp;Bernd A Wollschlaeger","doi":"10.2147/SAR.S150253","DOIUrl":"https://doi.org/10.2147/SAR.S150253","url":null,"abstract":"<p><strong>Background: </strong>Treatment for opioid use disorder is important because of the negative health, societal and economic consequences of illicit opioid use, but treatment adherence can be a challenge. This study assessed the association between buprenorphine medication-assisted treatment (MAT) adherence and relapse, health care utilization and costs.</p><p><strong>Patients and methods: </strong>Patients with opioid use disorder who were newly initiating a buprenorphine MAT regimen were identified in the 2008-2014 MarketScan^® Commercial and Medicaid Databases and followed for 12 months after their earliest outpatient pharmacy claim for buprenorphine. Adherence was categorized using proportion of days covered (PDC) with buprenorphine, and patients with PDC≥0.80 were classified as adherent. Descriptive and adjusted analyses compared relapse prevalence, utilization and costs, all measured in the 12 months following buprenorphine MAT initiation, of adherent patients to patients in non-adherent PDC categories (PDC<0.20, 0.20≤PDC<0.40, 0.40≤PDC<0.60, 0.60≤PDC<0.80).</p><p><strong>Results: </strong>Adherent patients were 37.1% of the Commercial sample (N=16,085) and 41.3% of the Medicaid sample (N=5,688). In both samples, non-adherent patients were significantly more likely than adherent patients to relapse and to have hospitalizations and emergency department visits. As a result, as buprenorphine MAT adherence increased, pharmacy costs increased, but medical costs decreased. Total costs (pharmacy plus medical costs) in the 12 months following buprenorphine MAT initiation decreased with adherence in Commercial patients ($28,525 for PDC<0.20 to $17,844 for PDC≥0.80). A slight decrease in total costs in the 12 months following buprenorphine MAT initiation was also observed in Medicaid patients ($21,292 for PDC<0.20 to $18,621 for PDC≥0.80). After adjustment, total costs of adherent patients in the Commercial sample ($17,519) were significantly lower compared with those of non-adherent patients (range $20,294-$24,431). In the Medicaid sample, adjusted total costs were not significantly different between adherence groups.</p><p><strong>Conclusion: </strong>Buprenorphine MAT adherence in the 12 months following treatment was associated with reduced odds of relapse and reduced unadjusted medical costs. For Commercial patients who were adherent to treatment, the adjusted total costs were predicted to be 30% lower than those for patients with PDC<0.20.</p>","PeriodicalId":22060,"journal":{"name":"Substance Abuse and Rehabilitation","volume":"9 ","pages":"59-78"},"PeriodicalIF":1.8,"publicationDate":"2018-09-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.2147/SAR.S150253","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36577538","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}