American Journal of Drug and Alcohol Abuse最新文献

{"title":"Speed and accuracy of online searches by legislators and medical students using RefBin's opioid use disorder database.","authors":"Katelynn Giroux, David Krag, Richard Single, Shania Prytherch, Sydney White, Sarah Niknaum","doi":"10.1080/00952990.2025.2450431","DOIUrl":"10.1080/00952990.2025.2450431","url":null,"abstract":"<p><p><i>Background:</i> Literature regarding opioid use disorder (OUD) is often difficult for nonscientific communities to access. The OUD database on RefBin categorizes scientific findings and may facilitate access to information regarding OUD.<i>Objectives:</i> To evaluate if the RefBin OUD database improves access to information about OUD for policymakers and medical students.<i>Methods:</i> 31 medical students and 13 individual policymakers completed this study. Using a cross-over method, participants answered questions about OUD. Speed, accuracy, confidence, and satisfaction metrics were collected and compared between searches that used RefBin vs other resources chosen by participants.<i>Results:</i> At baseline, medical students reported being comfortable with scientific literature and familiar with OUD. Policymakers reported low comfort levels with scientific literature and variable familiarity with OUD. Within the medical student sample, the odds of answering correctly were 2.43 times higher for RefBin searches than for searches using resources other than RefBin (non-RefBin searches) (<i>p</i> = .005; 95% CI: (1.31, 4.51)). For policymakers, the odds of answering correctly were 3.65 times higher for RefBin vs non-RefBin searches (<i>p</i> = .0496; 95% CI: [1.002, 13.279]). Medical students reported feeling confident in their results 50.7% of the time when using RefBin, compared to 28.3% with non-RefBin searches (<i>p</i> = .006).<i>Conclusion:</i> When compared with searching using non-RefBin sources, searches performed using RefBin resulted in improved accuracy and efficiency for both medical students and policymakers. This demonstrates the potential utility of the RefBin OUD database in improving access to reliable information about OUD.</p>","PeriodicalId":48957,"journal":{"name":"American Journal of Drug and Alcohol Abuse","volume":" ","pages":"173-179"},"PeriodicalIF":2.7,"publicationDate":"2025-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143494384","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":"Adolescent binge drinking in male Wistar rats increases ethanol consumption and reduces intoxication sensitivity in early adulthood without affecting withdrawal.","authors":"Camila Ravasi, Agustín Salguero, Leonardo Marengo, Pedro Peñalver, Ricardo Marcos Pautassi","doi":"10.1080/00952990.2025.2464644","DOIUrl":"https://doi.org/10.1080/00952990.2025.2464644","url":null,"abstract":"<p><p><i>Background:</i> Early adolescent ethanol exposure increases the risk of developing an alcohol use disorder. The mechanisms underlying this relationship may involve early ethanol exposure influencing anxiety or altering ethanol sensitivity.<i>Objectives:</i> To examine how adolescent binge drinking impacts sensitivity to ethanol intoxication, withdrawal symptoms, anxiety, compulsive behaviors, and ethanol intake in adulthood.<i>Methods:</i> Thirty-seven male Wistar rats self-administered ethanol during adolescence [postnatal days (PD) 27-45] or were housed under control conditions. In adulthood, the rats received intragastric intubations to simulate heavy alcohol (PDs 61-65, 3 daily doses of 0.0 or 1.5 g/kg) exposure. Intoxication and withdrawal symptoms were assessed (PDs 61-70), along with compulsive behaviors (marble burying test, PD68) and anxiety-related behaviors (light-dark box and elevated plus maze tests, PDs 69-70). Two-bottle choice tests provided measures of ethanol intake (PDs 75-87).<i>Results:</i> Adolescent binge exposure increased ethanol consumption in adulthood (<i>p</i> < .001; η2 = 0.51), with binge-exposed rats drinking 4.5-6.5 g/kg/day vs. 2 g/kg/day in controls. Binge-exposed rats exhibited reduced sensitivity to ethanol intoxication (<i>p</i> < .05; η2 = 0.17). Withdrawal symptoms were significantly greater (<i>p</i> < .005; η2 = 0.36) in rats exposed to alcohol during adulthood compared to controls, regardless of binge ethanol exposure. Anxiety or compulsive behaviors were unaffected by binge ethanol.<i>Conclusions:</i> Adolescent binge drinking led, in male rats, to significant increases in ethanol intake and reduced sensitivity to intoxication in adulthood. These findings suggest that early ethanol exposure results in decreased ethanol sensitivity, potentially increasing the likelihood of ethanol use. Adolescent binge drinking is a key vulnerability factor, and interventions should target this behavior.</p>","PeriodicalId":48957,"journal":{"name":"American Journal of Drug and Alcohol Abuse","volume":" ","pages":"1-12"},"PeriodicalIF":2.7,"publicationDate":"2025-02-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143450631","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":"Associations between college enrollment and trends in substance use among young adults in the US from 2015 to 2019.","authors":"James Aluri, Himani Byregowda, Amelia Arria","doi":"10.1080/00952990.2024.2400923","DOIUrl":"10.1080/00952990.2024.2400923","url":null,"abstract":"<p><p><i>Background:</i> Substance use among college students has negative academic and health outcomes. Identifying substances that are more commonly used by students than non-students can reveal specific risks in the college environment.<i>Objectives:</i> To examine associations between college enrollment and prevalence and trends of use of a comprehensive list of substances.<i>Methods:</i> The sample included 2015-2019 participants in the National Survey on Drug Use and Health who were aged 18 to 22 and who were full-time enrolled or not enrolled in college. Prevalence of substance use was calculated for four subgroups: college males (<i>n</i> = 6,707), college females (<i>n</i> = 8,284), non-college males (<i>n</i> = 10,019), and non-college females (<i>n</i> = 9,266). Multivariate logistic regression was used to model the relationships between enrollment and substance use. Temporal trends in substance use prevalence were calculated for each subgroup.<i>Results:</i> College enrollment was associated with prescription stimulant misuse (aOR 1.50, 95% CI: 1.35-1.67), alcohol use (aOR 1.36, 95% CI: 1.27-1.47), and binge drinking (aOR 1.22, 95% CI: 1.15-1.30). From 2015 to 2019, the only substance whose use significantly increased among any subgroup was cannabis. The increase occurred among females only (+4.7% in college females and +5.6% in non-college females; both <i>p</i> < .01).<i>Conclusions:</i> College enrollment is most strongly associated with prescription stimulant misuse, suggesting that colleges should consider explicitly including stimulant misuse prevention in their health promotion strategies. The increasing use of cannabis among females warrants clinicians' attention to routine screening for use and provision of information about the mental health impacts of cannabis.</p>","PeriodicalId":48957,"journal":{"name":"American Journal of Drug and Alcohol Abuse","volume":" ","pages":"96-106"},"PeriodicalIF":2.7,"publicationDate":"2025-01-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142677589","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":"Withdrawal interference scale: a novel measure of withdrawal-related life disruption in opioid use disorder and alcohol use disorder.","authors":"Orman Trent Hall, Tommy Gunawan, Julie Teater, Craig Bryan, Stephanie Gorka, Vijay A Ramchandani","doi":"10.1080/00952990.2024.2350057","DOIUrl":"10.1080/00952990.2024.2350057","url":null,"abstract":"<p><p><i>Background:</i> <i>Hyperkatifeia</i> describes amplified emotional and motivational withdrawal due to addiction-related sensitization of brain-stress-systems. Hyperkatifeia has been proposed as a target for addiction treatment development. However, translation of basic research in this area will require new tools designed to measure <i>hyperkatifeia</i> and related phenomena outside of laboratory settings.<i>Objectives:</i> We define a novel concept, <i>withdrawal interference</i>, and introduce a new tool - the <i>Withdrawal Interference Scale</i> (WIS) - which measures the impact of withdrawal on daily life among individuals with OUD or AUD.<i>Methods:</i> Described are the combined results of three separate cross-sectional studies. The structural validity, convergent validity, construct validity, trans-diagnostic (AUD/OUD) configural, metric, and scalar invariance, internal consistency, and composite reliability of WIS was tested among three independent samples of 1) treatment-seeking adults with OUD (<i>n</i> = 132), 2) treatment-seeking adults with AUD (<i>n</i> = 123), and 3) non-treatment-seeking adults with OUD (<i>n</i> = 140). Males numbered 218 and females were 163.<i>Results:</i> WIS exhibited structural validity (1 factor), convergent validity (average variance extracted .670-.676), construct validity, trans-diagnostic configural (χ2/df = 2.10), metric (Δχ2 = 5.70, <i>p</i> = .681), and scalar invariance (Δχ2 = 12.34, <i>p</i> = .338), internal consistency (α .882-928), and composite reliability (.924-.925).<i>Conclusion:</i> These results suggest WIS is a valid and reliable instrument for measuring withdrawal-related life disruption in AUD and OUD. Further, given our findings of transdiagnostic measurement invariance, WIS scores of individuals with AUD and OUD can be meaningfully compared in future statistical analyses.</p>","PeriodicalId":48957,"journal":{"name":"American Journal of Drug and Alcohol Abuse","volume":" ","pages":"44-56"},"PeriodicalIF":2.7,"publicationDate":"2025-01-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141297019","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":"Withdrawal catastrophizing scale: initial psychometric properties and implications for the study of opioid use disorder and hyperkatifeia.","authors":"Orman Trent Hall, Michael Vilensky, Julie E Teater, Craig Bryan, Kara Rood, Julie Niedermier, Parker Entrup, Stephanie Gorka, Anthony King, David A Williams, K Luan Phan","doi":"10.1080/00952990.2023.2298257","DOIUrl":"10.1080/00952990.2023.2298257","url":null,"abstract":"<p><p><i>Background:</i> Discovery of modifiable factors influencing subjective withdrawal experience might advance opioid use disorder (OUD) research and precision treatment. This study explores one factor - withdrawal catastrophizing - a negative cognitive and emotional orientation toward withdrawal characterized by excessive fear, worry or inability to divert attention from withdrawal symptoms.<i>Objectives:</i> We define a novel concept - withdrawal catastrophizing - and present an initial evaluation of the Withdrawal Catastrophizing Scale (WCS).<i>Methods:</i> Prospective observational study (<i>n</i> = 122, 48.7% women). Factor structure (exploratory factor analysis) and internal consistency (Cronbach's α) were assessed. Predictive validity was tested via correlation between WCS and next-day subjective opiate withdrawal scale (SOWS) severity. The clinical salience of WCS was evaluated by correlation between WCS and withdrawal-motivated behaviors including risk taking, OUD maintenance, OUD treatment delay, history of leaving the hospital against medical advice and buprenorphine-precipitated withdrawal.<i>Results:</i> WCS was found to have a two-factor structure (distortion and despair), strong internal consistency (α = .901), and predictive validity - Greater withdrawal catastrophizing was associated with next-day SOWS (r_s (99) = 0.237, <i>p</i> = .017). Withdrawal catastrophizing was also correlated with risk-taking behavior to relieve withdrawal (r_s (119) = 0.357, <i>p</i> < .001); withdrawal-motivated OUD treatment avoidance (r_s (119) = 0.421, <i>p</i> < .001), history of leaving the hospital against medical advice (r_s (119) = 0.373, <i>p</i> < .001) and buprenorphine-precipitated withdrawal (r_s (119) = 0.369, <i>p</i> < .001).<i>Conclusion:</i> This study provides first evidence of <i>withdrawal catastrophizing</i> as a clinically important phenomenon with implications for the future study and treatment of OUD.</p>","PeriodicalId":48957,"journal":{"name":"American Journal of Drug and Alcohol Abuse","volume":" ","pages":"31-43"},"PeriodicalIF":2.7,"publicationDate":"2025-01-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140177358","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":"A case series examining the efficacy of gabapentin as a substitution therapy for the treatment of pregabalin use disorder.","authors":"Olivier Lejeune, Mathieu Chappuy, François Bailly, Benjamin Rolland","doi":"10.1080/00952990.2025.2467458","DOIUrl":"10.1080/00952990.2025.2467458","url":null,"abstract":"<p><p><i>Background:</i> Gabapentinoids are ligands of a brain calcium channel, which are approved for different indications, including epilepsy, neuropathic pain, or generalized anxiety disorder. Among gabapentinoids, pregabalin has been increasingly associated with a risk of pregabalin use disorder (PUD). To date, there is no recommended medical treatment for PUD. However, gabapentin, which has a lower abuse potential, could be used as a substitution therapy to reduce pregabalin withdrawal and craving.<i>Objectives:</i> To report on the experimental use of high dose of gabapentin among those with PUD.<i>Methods:</i> Case series of four patients (3 males and 1 female) with severe PUD (average daily doses ranging from 1,200 to 8,400 mg of pregabalin), in whom high dose of gabapentin was prescribed as a substitution treatment.<i>Results:</i> Upon gabapentin being administered as substitution therapy for pregabalin, all four patients experienced intense craving and distress. Despite receiving high doses of gabapentin, due to the observed levels of craving and distress, all four patients had to be rapidly switched back to pregabalin.<i>Conclusions:</i> Preliminary clinical findings suggest that gabapentin is unlikely to be a suitable, lower-risk alternative treatment for people with PUD. Additional examination of candidate medications, including other gabapentinoids, could be useful to identify an effective treatment for PUD.</p>","PeriodicalId":48957,"journal":{"name":"American Journal of Drug and Alcohol Abuse","volume":" ","pages":"68-72"},"PeriodicalIF":2.7,"publicationDate":"2025-01-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143494339","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":"A narrative review on alcohol use in women: insight into the telescoping hypothesis from a biopsychosocial perspective.","authors":"Dylan E Kirsch, Malia A Belnap, Annabel Kady, Lara A Ray","doi":"10.1080/00952990.2024.2419540","DOIUrl":"10.1080/00952990.2024.2419540","url":null,"abstract":"<p><p><i>Background:</i> There has been a dramatic rise in alcohol consumption and alcohol use disorder (AUD) among women. Recently, the field has made substantial progress toward better understanding sex and gender differences in AUD. This research has suggested accelerated progression to AUD and associated health consequences in women, a phenomenon referred to as \"telescoping.\"<i>Objective:</i> To examine evidence for the telescoping hypothesis from a biopsychosocial perspective.<i>Methods:</i> This narrative review examined and integrated research on biological, psychological, and socio-environmental factors that may contribute to the development and progression of AUD in women.<i>Results:</i> Biopsychosocial research has revealed sex- and gender-specific risk factors and pathways to AUD onset and progression. Biological sex differences render females more vulnerable to alcohol-related toxicity across various biological systems, including the brain. Notably, sex and gender differences are consistently observed in the neural circuitry underlying emotional and stress regulation, and are hypothesized to increase risk for an internalizing pathway to AUD in women. Psychological research indicates women experience greater negative emotionality and are more likely to use alcohol as a means to alleviate negative emotions compared with men. Socio-environmental factors, such as familial and peer isolation, appear to interact with biological and psychological processes in a way that increases risk for negative emotionality and associated alcohol use in women.<i>Conclusion:</i> There appears to be a complex interplay of biopsychosocial factors that increase risk for AUD onset and progression in women through an internalizing pathway. Developing targeted interventions for women with AUD that specifically target internalizing processes is critical.</p>","PeriodicalId":48957,"journal":{"name":"American Journal of Drug and Alcohol Abuse","volume":" ","pages":"14-30"},"PeriodicalIF":2.7,"publicationDate":"2025-01-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12206452/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143048428","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":"Assessment of liability to substance use disorder induced by two emerging stimulants, 4,4'-dimethylaminorex and escaline, in mice.","authors":"Sun Mi Gu, Yeung Bae Jin, Jin Mook Kim, Young-Hoon Kim, Jaesuk Yun, Hye Jin Cha","doi":"10.1080/00952990.2024.2439365","DOIUrl":"10.1080/00952990.2024.2439365","url":null,"abstract":"<p><p><i>Background:</i> The emergence of new psychoactive substances (NPSs) poses a serious global health threat. Although various groups of psychostimulants exist, this study specifically investigated two lesser-studied substances, 4,4'-dimethylaminorex (4,4'-DMAR) and escaline.<i>Objective:</i> To assess liability to substance use disorder (SUD), as evidenced via preclinical models, of the two psychostimulants.<i>Methods:</i> 4,4'-DMAR and escaline were evaluated, in mice, for their potential to exhibit rewarding and reinforcing effects, and for causing central dopaminergic activity. The climbing behavior test investigated whether the substances acted as dopaminergic agents and to determine the dose range for further evaluation. The rewarding and reinforcing effects of these substances were evaluated via the conditioned place preference (CPP) and self-administration (SA) tests.<i>Results:</i> The results showed that both test substances significantly increased climbing behavior at 1 mg/kg (<i>p</i> < .01). Mice treated with 0.1 and 1 mg/kg 4,4'-DMAR (<i>p</i> < .05) and with 1 mg/kg escaline (<i>p</i> < .01) exhibited increased duration of time spent in the substance-paired compartment in the CPP test compared to those treated with vehicle. Further, the frequency of infusions from the 5^th to 7^th sessions was significantly increased at 1 mg/kg/infusion of 4,4'-DMAR (<i>p</i> < .001) and at 0.01 and 0.1 mg/kg/infusion of escaline (<i>p</i> < .01) compared to controls.<i>Conclusion:</i> The findings suggest that 4,4'-DMAR and escaline have dopaminergic activity, exert reinforcing and rewarding effects, and may cause SUD. The findings can inform relevant authorities about the need to regulate these two new compounds.</p>","PeriodicalId":48957,"journal":{"name":"American Journal of Drug and Alcohol Abuse","volume":" ","pages":"57-67"},"PeriodicalIF":2.7,"publicationDate":"2025-01-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143383624","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":"Alcohol use and drinking motives across five countries: a post-COVID-19 pandemic update.","authors":"Joana Rupprecht, Bettina Spitzweck, Gabriele Oettingen, A Timur Sevincer","doi":"10.1080/00952990.2024.2442467","DOIUrl":"10.1080/00952990.2024.2442467","url":null,"abstract":"<p><p><i>Background:</i> It is necessary to understand drinking motives to inform tailored interventions counteracting high-risk alcohol use and alcohol use disorder. Research suggests that, during the COVID-19 pandemic, drinking to cope with the current situation (i.e. coping motive) increased. This was alarming since the coping motive is a predictor of alcohol use and alcohol-related problems.<i>Objective:</i> In the current study, we aimed to elucidate whether this COVID-19-induced increase in coping-motivated alcohol use outlasted the COVID-19 pandemic in the USA, Great Britain, Mexico, Spain, and Germany. We provide a 2023 post-COVID-19 update on alcohol use and drinking motives.<i>Methods:</i> In spring 2023, 1032 participants recruited via Prolific (48% female) across the five countries completed a cross-sectional online survey, including the Alcohol Use Disorder Identification Test (AUDIT) for alcohol use patterns and the Drinking Motives Questionnaire-Revised (DMQ-R) for drinking motives.<i>Results:</i> Across all five countries, 20-30% of the participants exceeded the AUDIT cutoff score for high-risk alcohol use. The ranking of all four motives for alcohol use was cross-nationally consistent: Social > Enhancement > Conformity > Coping.<i>Conclusion:</i> Compared to most research before the pandemic, with a Social > Enhancement > Coping > Conformity motive ranking, and research during COVID-19, with an Enhancement > Coping > Social > Conformity motive ranking, our data suggests that post-COVID drinking to socialize and to enhance one's own mood, are again the most important motives to drink alcohol. Furthermore, it seems like the increase in the coping motive found in research during the pandemic, did luckily not persist but conversely, post- compared to pre-COVID, the conformity motive seems more important than coping motive.</p>","PeriodicalId":48957,"journal":{"name":"American Journal of Drug and Alcohol Abuse","volume":" ","pages":"85-95"},"PeriodicalIF":2.7,"publicationDate":"2025-01-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143411327","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":"The role of Iowa gambling task performance in response to citalopram treatment for cocaine use disorder.","authors":"Constanza de Dios, Robert Suchting, Charles E Green, Heather E Webber, F Gerard Moeller, Scott D Lane, Joy Schmitz","doi":"10.1080/00952990.2024.2420773","DOIUrl":"10.1080/00952990.2024.2420773","url":null,"abstract":"<p><p><i>Background:</i> Cocaine use disorder (CUD) is associated with executive functioning impairments linked to serotonergic function. Previous studies reported efficacy with the selective serotonin reuptake inhibitor citalopram in reducing cocaine use.<i>Objectives:</i> The current study explored moderation and mediation of citalopram effects on cocaine use by performance across executive function domains.<i>Methods:</i> We conducted a secondary analysis of a double-blind, placebo-controlled, randomized Bayesian adaptive trial investigating citalopram efficacy in CUD treatment-seeking adults. At baseline and mid-treatment, participants completed assessments of decision-making (Iowa Gambling Task; IGT), attention, response inhibition, and cognitive flexibility. Outcomes were longest duration of abstinence (LDA; count of consecutive cocaine-negative urine tests) and Treatment Effectiveness Score (TES; count of cocaine-negative urine tests from study midpoint to endpoint). Bayesian models estimated independent moderation and mediation effects of cognitive ability on the association between treatment (citalopram 40 mg vs. placebo) and LDA/TES.<i>Results:</i> Of the four assessments, only the IGT demonstrated concurrent moderation and mediation in the sample (<i>N</i> = 80; 82% males). Treatment effects on LDA (IRR = 1.02) and TES (IRR = 1.03) were strongest in participants with higher baseline IGT scores, which indicate less risky decision-making (posterior probabilities >93%). Models supported a positive indirect effect of treatment on TES (IRR = 1.12, posterior probability = 81.6%), with 52.3% of the total effect mediated by changes in IGT scores from baseline to mid-treatment.<i>Conclusion:</i> We found evidence for IGT as a moderator and mediator of citalopram's effects on cocaine use. Decision-making ability may play a role in predicting who responds to citalopram and how.</p>","PeriodicalId":48957,"journal":{"name":"American Journal of Drug and Alcohol Abuse","volume":" ","pages":"73-84"},"PeriodicalIF":2.7,"publicationDate":"2025-01-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11899305/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143034688","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}