Addiction Science & Clinical Practice最新文献

{"title":"Spatial accessibility of substance use disorder treatment programs, compared with other health care facilities, in New York State, 2024.","authors":"Marcus A Bachhuber, Chinazo O Cunningham, Pat Lincourt, Ashly E Jordan","doi":"10.1186/s13722-025-00592-9","DOIUrl":"https://doi.org/10.1186/s13722-025-00592-9","url":null,"abstract":"<p><strong>Background: </strong>Spatial accessibility of substance use disorder (SUD) treatment is a crucial component of access and a comprehensive analysis can help to identify if and where a lack of spatial accessibility is a barrier to treatment.</p><p><strong>Methods: </strong>We conducted a cross-sectional analysis of spatial accessibility of SUD treatment (outpatient, opioid treatment program, and residential) in New York State (NYS). We estimated two measures of spatial accessibility: one-way travel time (i.e., drive time for NYS outside of New York City [NYC] and public transit time for NYC) and robustness (i.e., the difference in travel time between the closest and fifth closest facility). Comparison facilities included Federally Qualified Health Centers, dialysis facilities, and hospitals. We compared travel time and robustness by urbanicity (NYC, urban non-NYC, rural) and NYS economic development region using population-weighted paired t-tests.</p><p><strong>Results: </strong>The percentage of NYS residents within 30 min travel time was 97.2% for outpatient SUD treatment programs and 82.3% for opioid treatment programs. Mean statewide travel time to outpatient SUD treatment programs was comparable to travel time to Federally Qualified Health Centers (difference: 1.0 min [95%CI 0.9 to 1.1; P < 0.001]) and dialysis facilities (difference: 0.1 min [95%CI 0.03 to 0.2; P = 0.01]), and significantly shorter than to hospitals (difference: 5.6 min [95%CI 5.4 to 5.7; P < 0.001]). Travel time to opioid treatment programs was significantly longer than to Federally Qualified Health Centers (difference: -7.4 min [95%CI - 7.6 to - 7.2; P < 0.001]), dialysis facilities (difference: -8.2 min [95%CI - 8.4 to - 8.1; P < 0.001]), and hospitals (difference: - 2.8 min [95%CI - 3.0 to - 2.6; P < 0.001]). Compared with NYC, mean travel time to each type of SUD treatment program was significantly shorter in urban non-NYC areas and longer in rural areas. For robustness, compared with NYC, there was no significant difference in urban non-NYC areas for outpatient and residential SUD treatment programs, but more limited robustness for opioid treatment programs in urban non-NYC areas and all types of SUD treatment programs in rural areas.</p><p><strong>Conclusion: </strong>We identified widespread spatial accessibility of SUD treatment facilities across NYS. Recent opportunities such as revised federal regulations on opioid treatment program mobile medication units, increased flexibility in using telehealth in opioid treatment programs and other settings, and opioid settlement funding can be leveraged to increase access in rural areas.</p>","PeriodicalId":54223,"journal":{"name":"Addiction Science & Clinical Practice","volume":"20 1","pages":"60"},"PeriodicalIF":3.2,"publicationDate":"2025-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144762335","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Rapid intravenous symptom-inhibiting fentanyl induction (SIFI) to optimize rotation onto oral opioid agonist therapy among individuals who use unregulated fentanyl: protocol for an open-label, single arm clinical trial.","authors":"Pouya Azar, Martha J Ignaszewski, Marianne Harris, Zoran Barazanci, Ruth Davison, James S H Wong, Anil Maharaj, Nickie Mathew, David Hall, Silvia A Guillemi, Julie Foreman, Rolando Barrios, Julio S G Montaner","doi":"10.1186/s13722-025-00586-7","DOIUrl":"10.1186/s13722-025-00586-7","url":null,"abstract":"<p><strong>Background: </strong>Most opioid use disorder (OUD) treatment guidelines target community medical settings, and the subsequent recommendations were established to prioritize safety and reduce diversion prior to the fentanyl era. For people with OUD who use unregulated fentanyl, slow induction onto opioid agonist therapy (OAT) with gradual dose titration is often ineffective or insufficient for reducing withdrawal symptoms and cravings, thereby hampering engagement and retention in treatment. Given the severe risks associated with continued use of the increasingly toxic unregulated drug supply, new and innovative approaches to the management of OUD are urgently needed. We have developed an alternative induction protocol, using a rapid intravenous symptom-inhibiting fentanyl induction (SIFI) to optimize rotation onto oral OAT.</p><p><strong>Methods: </strong>An open-label, single arm, prospective pilot clinical trial is being conducted in an outpatient setting to assess the safety, feasibility, and efficacy of a rapid symptom-inhibiting intravenous fentanyl induction protocol to establish starting doses of methadone or sustained-release oral morphine (SROM) based on individual opioid requirements, as a treatment strategy for individuals with OUD who use unregulated fentanyl. The primary outcome is safety, as defined by occurrence of study drug-related adverse events (including but not limited to opioid toxicity and QT interval prolongation) that require intervention during induction and the first 7 days on OAT. Secondary objectives are to determine whether the SIFI protocol will result in use of higher-than-standard starting doses of methadone and SROM, and to determine whether implementation of this protocol will be acceptable to participants and will result in reduced withdrawal symptoms, improved retention, and better long-term outcomes on OAT.</p><p><strong>Discussion: </strong>This is the first study to rapidly and objectively estimate opioid tolerance and use it to calculate individualized starting doses of oral OAT in an outpatient setting among people who use unregulated fentanyl. We predict that starting methadone or SROM with individually-tailored doses will lead to therapeutic target concentrations being achieved quickly, safely, and with good patient satisfaction. This approach has the potential to more effectively and safely initiate OAT, to minimize opioid withdrawal and cravings, and in turn to decrease unregulated fentanyl use and increase retention on life-saving OAT.</p><p><strong>Trial registration: </strong>ClinicalTrials.gov, NCT05905367; date of registration: June 15, 2023; latest update posted July 18, 2024. https://clinicaltrials.gov/study/NCT05905367 Protocol version: 4.0, April 22, 2024.</p>","PeriodicalId":54223,"journal":{"name":"Addiction Science & Clinical Practice","volume":"20 1","pages":"58"},"PeriodicalIF":3.2,"publicationDate":"2025-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12306136/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144745962","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Participant experiences with a text message and contingency management intervention for alcohol use during pregnancy and lactation in Cape Town, South Africa.","authors":"Lesley-Ann Erasmus-Claassen, Noluthando Mpisane, Petal Petersen Williams, Felicia A Browne, Bronwyn Myers, Wendee M Wechsberg, Charles D H Parry, Shantae N Taylor, Yukiko Washio","doi":"10.1186/s13722-025-00594-7","DOIUrl":"10.1186/s13722-025-00594-7","url":null,"abstract":"<p><strong>Background: </strong>The Western Cape region of South Africa has one of the highest global rates of Fetal Alcohol Spectrum Disorder (FASD), underscoring the urgent need for effective interventions. This qualitative study, designed as a process evaluation, explores pregnant and lactating participants' perceptions and experiences of a text message and contingency management (CM) intervention.</p><p><strong>Methods: </strong>The study involved post-intervention interviews with 10 pregnant participants and 10 post-partum lactating participants. Coding and a thematic analysis approach were applied to the collected data using NVivo 12.</p><p><strong>Results: </strong>Participants identified key factors influencing their engagement in the intervention. Participants faced logistical barriers, but supportive social networks and flexible program components encouraged participation. Increased self-efficacy and external accountability also facilitated behavior change. Furthermore, participants suggested improvements for accessibility and tailored support, highlighting important considerations for future interventions.</p><p><strong>Conclusion: </strong>The findings highlighted the potential benefits of the intervention in improving individuals' health behaviors. However, logistical barriers and the need for expanded support services were identified, emphasizing the importance of refining intervention strategies in resource-limited settings.</p><p><strong>Clinical trial registration: </strong>NCT05319977.</p>","PeriodicalId":54223,"journal":{"name":"Addiction Science & Clinical Practice","volume":"20 1","pages":"59"},"PeriodicalIF":3.2,"publicationDate":"2025-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12309210/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144745961","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"An investigation of fentanyl and methamphetamine use among first-time arrestees from 25 county jails across the U.S. in 2023.","authors":"Joseph E Schumacher, Abdullah Ahsan, Amber H Simpler, Adam P Natoli, Bradley J Cain, Peter S Chindavong, Aren Yarcan","doi":"10.1186/s13722-025-00588-5","DOIUrl":"10.1186/s13722-025-00588-5","url":null,"abstract":"<p><p>Widespread use of fentanyl in combination with methamphetamine in carceral settings presents unique health risks and public health challenges. To contribute to continued efforts to understand drug use among first-time arrestees, this study characterizes the nature and extent of urine drug screenings (UDS) positive for fentanyl and/or methamphetamine among first-time arrestees receiving healthcare in 25 jails across the U.S. This study used the same data source, data extraction, sample selection, and UDS variables as those reported by Schumacher et al. (2025) and a similar data analytic strategy which included 81,842 arrestees with a UDS or 28.8% of total arrestees (283,884). Among first-time arrestees with complete results (43,553), 32,561 or 74.8% of arrestees tested positive for any drug and among those, 14,426 (44.3%) were positive for fentanyl and/or methamphetamine. Of those, 59.8% and 11.5% were only positive for methamphetamine or fentanyl, respectively, while 28.7% were positive for both. Demographically, individuals testing positive for both fentanyl and methamphetamine were predominantly white young adults (aged 20-39), with similar co-occurrence patterns in males and females. Fentanyl alone was more common in southern and midwestern jails and mega-sized jails, methamphetamine was more common in medium-large and southern jails, and their co-occurrence was most common in western and large jails. Approximately 97.5% of first-time arrestees tested positive for two or more drugs, with individuals testing positive for five or more drugs significantly more likely to test positive for both fentanyl and methamphetamine. This study highlights the significant prevalence of methamphetamine and/or fentanyl use among first-time arrestees, underscoring the urgent need for targeted interventions, improved in-jail substance use treatment, and post-release support to mitigate overdose risks and enhance public health outcomes.</p>","PeriodicalId":54223,"journal":{"name":"Addiction Science & Clinical Practice","volume":"20 1","pages":"57"},"PeriodicalIF":3.2,"publicationDate":"2025-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12288351/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144709927","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"\"I've learned that I'm open-minded to this possibility\": A qualitative study to evaluate the acceptability of a psilocybin-aided smoking cessation treatment for people with HIV who smoke.","authors":"Patricia A Cioe, Garrett S Stang, Danish Azam, Sarah Dugal","doi":"10.1186/s13722-025-00563-0","DOIUrl":"10.1186/s13722-025-00563-0","url":null,"abstract":"<p><strong>Background: </strong>People with HIV (PWH) are disproportionately affected by cigarette use, with a 40 - 70% prevalence rate. Although many express a strong interest in quitting, many PWH who smoke experience lower cessation rates with traditional treatments, in part due to their comorbid anxiety and depressive symptoms. Psilocybin, a classic psychedelic referred to as \"breakthrough therapy\" by the U.S. Food & Drug Administration (FDA), has been shown to have potential as a therapeutic treatment for psychiatric symptoms, (e.g., anxiety and depression) and substance use disorders, including tobacco dependence. Preliminary evidence has shown that administering psilocybin to people who smoke and have been previously unable to quit with traditional treatments resulted in impressive smoking abstinence rates (80%) at 6-months in a smoking cessation pilot study.</p><p><strong>Objective: </strong>Explore, using qualitative methods, the perceptions and acceptability of a psilocybin-assisted treatment for smoking cessation among PWH who smoke.</p><p><strong>Methods: </strong>Semi-structured, in-depth qualitative interviews were conducted with PWH who smoke. Interviews were audio-recorded, transcribed verbatim, and analyzed using rapid thematic analysis.</p><p><strong>Results: </strong>Twenty-five participants were enrolled: 15 cis male, 9 cis female, and 1 transgender female. Five main themes emerged: varying previous experiences with psilocybin; uncertainty about psilocybin's effects and concern over potential side effects; need for trusted sources of information and testimonials; ultimately willing to try psilocybin-aided therapy for tobacco treatment; and, set and setting of psilocybin use matters.</p><p><strong>Conclusions: </strong>Psilocybin-assisted smoking cessation treatment appears to be acceptable among PWH who smoke. Participants highlighted the importance of addressing key concerns related to an emerging therapy to increase acceptability and willingness to try it. Further research is needed to evaluate the safety and effectiveness of psilocybin prior to incorporating this emerging therapy for smoking cessation into tobacco treatment clinical services for PWH.</p>","PeriodicalId":54223,"journal":{"name":"Addiction Science & Clinical Practice","volume":"20 1","pages":"56"},"PeriodicalIF":3.7,"publicationDate":"2025-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12278509/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144683546","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Alcohol reduction strategies among persons with hiv: past attempts, self-reported effectiveness, and future strategies of interest.","authors":"Nanyangwe Siuluta, Christina E Parisi, Shantrel S Candidate, Jacqueline Sherbuk, Yan Wang, Maya Widmeyer, Charurut Somboonwit, Jessy G Dévieux, Robert L Cook, Natalie E Chichetto","doi":"10.1186/s13722-025-00581-y","DOIUrl":"10.1186/s13722-025-00581-y","url":null,"abstract":"<p><strong>Background: </strong>Alcohol consumption is associated with poor health outcomes in people with HIV (PWH). Although various alcohol reduction strategies exist, little is known about PWH's past experiences or future preferences. This study describes the previous strategies PWH had used, their perceived effectiveness, among people who ever drank, and the strategies PWH who endorsed heavy drinking would consider trying in the future. It also examines how these experiences and preferences vary by sociodemographic factors and past 12 month drug use.</p><p><strong>Methods: </strong>A cross-sectional analysis was conducted on data from 453 PWH enrolled in the Florida Cohort Wave III study (2020-2023; mean age 50 years, 60% men). Participants who attempted to reduce or quit drinking (n = 321) were asked about their use of eight alcohol reduction strategies and rated the effectiveness of each on a 4-point Likert scale. Participants reporting heavy drinking (n = 170) were asked about their willingness to try seven strategies in the future. Chi-square and Fisher's exact tests analyzed differences by sex, age, race/ethnicity, and past 12 month drug use.</p><p><strong>Results: </strong>Among the 321 who had ever tried to reduce or quit drinking, endorsed strategies including \"on my own\"/ complete cessation (80%), prayer (61%), Alcoholics Anonymous (AA) (38%), counseling/therapy (31%), inpatient/outpatient detox (23%), self-monitoring (11%), and medication (7%). The strategies with the highest self-reported effectiveness were for prayer (59%), \"on my own\"/ complete cessation (58%), and in-patient detox (50%). Prayer was significantly more common among females and non-Hispanic Black or Hispanic participants. Those with past 12 month drug use were significantly more likely to have tried most strategies, except medications or prayer. Among 170 who reported heavy drinking, \"on my own\"/ complete cessation (43%), AA (24%), and counseling/therapy (21%) were the most endorsed strategies they would try in the future. No significant differences in future preferences were found by demographics, but those with past 12 month drug use showed more interest in formal treatment approaches.</p><p><strong>Conclusion: </strong>Commonly used alcohol reduction strategies among PWH were non-medical, easily accessible, and perceived as very effective. Incorporating safe and effective patient-driven methods into treatment guidelines may improve strategy uptake.</p>","PeriodicalId":54223,"journal":{"name":"Addiction Science & Clinical Practice","volume":"20 1","pages":"54"},"PeriodicalIF":3.7,"publicationDate":"2025-07-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12276704/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144669000","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Usability and cultural adaptation of a text message-based tobacco cessation intervention for people living with HIV in Uganda and Zambia.","authors":"Heather Wipfli, Jim Arinaitwe, Fastone Goma, Lynn Atuyambe, David Guwatudde, Masauso Moses Phiri, Elizeus Rutebemberwa, Fred Wabwire-Mangen, Richard Zulu, Cosmas Zyambo, Kyra Guy, Ronald Kusolo, Musawa Mukupa, Ezekiel Musasizi, Joan S Tucker","doi":"10.1186/s13722-025-00580-z","DOIUrl":"10.1186/s13722-025-00580-z","url":null,"abstract":"<p><strong>Background: </strong>Text messaging-based interventions (TMIs) have demonstrated effectiveness in reducing tobacco use in many populations. However, such interventions have not been tailored to meet the complex medical and psychosocial factors confronting people living with HIV (PLWH) in sub-Saharan Africa (SSA). We describe the process of adapting the SmokefreeTXT message library so that it is applicable to all forms of tobacco use, addresses issues specifically facing PLWH who use tobacco, and is culturally appropriate for use in Uganda and Zambia.</p><p><strong>Methods/design: </strong>Participants were PLWH who currently used tobacco and health services workers recruited from HIV clinics in two regions of Uganda and two regions of Zambia. Eight focus groups (N = 48) were conducted with PLWH tobacco users and four focus groups (N = 28) were conducted with healthcare providers to adapt the TMI content for the cultural context and HIV status. A subsample of PLWH focus group participants (N = 14) provided feedback on the adapted TMI after using it for three weeks on their own phone. Focus group transcripts were analyzed for key themes based on the moderator guides using Dedoose software™. Means and percentages were calculated for survey data to assess the TMI's acceptability and feasibility.</p><p><strong>Results: </strong>Focus group feedback on facilitators and barriers to quitting tobacco, as well as strengths and limitations of the TMI-based intervention approach, were used to finalize the adapted TMI's content and delivery for usability testing. PLWH identified multiple barriers to quitting tobacco including addiction, lack of support and education, and community perceptions. Health service workers highlighted the need for community-level interventions, improved provider knowledge on tobacco cessation, and tailored support strategies. Usability testing participants rated the TMI as helpful and relevant, emphasizing the interactive features as supportive and beneficial. Further, they reported few problems using it over three weeks, except for difficulty keeping their phone charged.</p><p><strong>Conclusions: </strong>Results suggest that an adapted version of SmokefreeTXT is a feasible and acceptable option for PLWH in Uganda and Zambia who are interested in quitting tobacco use.</p><p><strong>Trial registration: </strong>ClinicalTrials.gov Identifier NCT05487807. Registered August 4, 2022, https://clinicaltrials.gov/ct2/show/record/NCT05487807.</p>","PeriodicalId":54223,"journal":{"name":"Addiction Science & Clinical Practice","volume":"20 1","pages":"55"},"PeriodicalIF":3.7,"publicationDate":"2025-07-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12276659/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144669001","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Potential predictors affecting outcomes in a randomized controlled trial of support programs for parents of young adults with hazardous substance use.","authors":"Ola Siljeholm, Anders Hammarberg","doi":"10.1186/s13722-025-00582-x","DOIUrl":"10.1186/s13722-025-00582-x","url":null,"abstract":"<p><strong>Background: </strong>There is a lack of research on which specific factors that predict positive outcomes in support programs for concerned significant others (CSOs) to individuals with substance use disorders (SUDs). The aim of the study was to investigate predictors of positive outcomes among young adults in the areas of: treatment seeking, decreased substance use, and improved parent-young adult relationships. Outcomes were assessed at 24-weeks following a randomized controlled trial (RCT) comparing Community Reinforcement and Family Training (CRAFT) and manualized counselling for parents of young adults (18-24 years) with hazardous substance use.</p><p><strong>Methods: </strong>A secondary analysis from an RCT including 113 parents (92% female) of young adults (87% male) recruited from two outpatient clinics for young adults in Stockholm, Sweden, subsequently nationwide. Clinical and sociodemographic predictors of treatment entry, substance use, and relationship happiness at 24 weeks follow-up were assessed using linear and logistic mixed-effects models.</p><p><strong>Results: </strong>Previous young adult treatment engagement and higher parental self-efficacy were significant predictors of treatment entry, explaining 16% of the variance. Baseline alcohol and substance use consistently predicted higher use over time across measures. Parental stress showed complex associations: higher stress predicted reduced substance use in some models but increased use in others. For the measure of relationship happiness, baseline scores were the strongest predictor.</p><p><strong>Conclusions: </strong>Taken together, the findings suggest promising targets for tailored support programs for parents of young adults with SUD, such as components designed to enhance parental self-efficacy.</p><p><strong>Trial registration: </strong>ISRCTN12212515 https://www.isrctn.com/ISRCTN12212515 . Submitted November 7th, 2018, registered March 4th, 2019.</p>","PeriodicalId":54223,"journal":{"name":"Addiction Science & Clinical Practice","volume":"20 1","pages":"53"},"PeriodicalIF":3.7,"publicationDate":"2025-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12243382/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144602199","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Integrating an exercise program into opioid agonist therapy: a pilot study on feasibility, fitness improvements, and participation challenges.","authors":"Einar Furulund, Siv-Elin Leirvåg Carlsen, Silvia Eiken Alpers, Jørn Henrik Vold, Karl Trygve Druckrey-Fiskaaen, Tesfaye Madebo, Sindre M Dyrstad, Torgeir Gilje Lid, Lars Thore Fadnes","doi":"10.1186/s13722-025-00583-w","DOIUrl":"10.1186/s13722-025-00583-w","url":null,"abstract":"<p><strong>Background: </strong>People receiving opioid agonist therapy (OAT) face high risk of comorbidities, including cardiovascular and mental health disorders. Integrating exercise programs with OAT may reduce health disparities and improve well-being. This study explored the feasibility and preliminary effects of an integrated exercise program.</p><p><strong>Method: </strong>This multicentre, mixed-methods pilot study was conducted in Western Norway, recruiting 22 participants receiving OAT from three outpatient clinics. The six-week, group-based exercise program focused on high-intensity endurance and strength training. Changes in aerobic fitness (4-minut step test), psychological distress (10-item Hopkins Symptom Checklist, SCL-10), fatigue (3-items Fatigue Severity Scale, FSS-3), lung function (spirometry), and respiratory symptoms (modified Medical Research Council Dyspnea Scale, mMRC) were assessed, while qualitative interviews provided insights into intervention feasibility.</p><p><strong>Results: </strong>Pre- and post-test assessments indicated improvements in aerobic fitness, as measured by the 4-minute step test, with a pre-test mean of 89.4 (SD: 24.7) and a post-test mean of 103.1 (SD: 31.3) step-cycles, despite a modest attendance rate of 28%. Psychological distress, evaluated using the SCL-10, increased in score from 1.85 (SD: 0.66) to 2.03 (SD: 0.59). Fatigue also increased slightly Fss-3: 4.44 (SD:2.38) to 5.07 (SD:2.01), while respiratory symptoms using mMRC, lung capacity with FVC, and expiratory volume FEV1 remained stable. Qualitative findings were categorized into three main themes: (1) The clinic as an arena for physical activity, (2) a modest move with a substantial benefit for participants, (3) challenges and adjustments to the intervention. Participants reported that exercising in connection with the OAT clinic promoted a sense of care and support from clinicians. Many experienced increased self-confidence and social engagement, though attendance was affected by health issues, fluctuating motivation, and logistical challenges.</p><p><strong>Conclusion: </strong>This pilot study suggests that integrating structured exercise into OAT can be feasible and improve aerobic fitness. However, increased psychological distress and fatigue might indicate the need for additional support. The low attendance rate highlights engagement challenges, emphasizing the need for tailored strategies to enhance participation. Future research should focus on optimizing intervention design to improve attendance and enhance physical and psychological outcomes for individuals in OAT.</p>","PeriodicalId":54223,"journal":{"name":"Addiction Science & Clinical Practice","volume":"20 1","pages":"52"},"PeriodicalIF":3.2,"publicationDate":"2025-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12235965/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144592926","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pharmacotherapy of psychiatric inpatients with mental and behavioral disorders caused by sedatives or hypnotics (F13): Results from an observational pharmacovigilance program between 2000 and 2017.","authors":"Philipp Pauwels, Beatrice Haack, Sermin Toto, Johanna Seifert, Renate Grohmann, Martin Heinze, Oliver Zolk, Phileas Johannes Proskynitopoulos, Michael Schneider, Timo Greiner","doi":"10.1186/s13722-025-00579-6","DOIUrl":"10.1186/s13722-025-00579-6","url":null,"abstract":"<p><strong>Background: </strong>The treatment of choice for substance use disorder (SUD) caused by sedatives, hypnotics, and anxiolytics (SHA) is to slowly taper the dose of the implicated substance to the point of abstinence, thereby minimizing withdrawal symptoms. Concomitant pharmacotherapy may be indicated to manage excessive withdrawal or rebound symptoms. This study investigated the use of psychotropic drugs for the treatment of SHA-dependent SUD patients in Germany.</p><p><strong>Methods: </strong>Data were obtained from the German Drug Safety Program in Psychiatry (\"Arzneimittelsicherheit in der Psychiatrie\"; AMSP) from 2000 to 2017. SHA SUD was classified using the 10th Edition of the International Classification of Disease (ICD-10).</p><p><strong>Results: </strong>The present study included 1,015 patients with a primary diagnosis of mental and behavioral disorders due to use of sedatives or hypnotics (F13.1-F13.9). The most common comorbid psychiatric diagnoses were additional SUDs (F1, n = 279), especially alcohol use disorder (F10; n = 124), and mood disorders (F3; n = 201). A total of 95.6% of patients received one or more psychotropic drugs, most commonly antidepressant drugs (63.1% of patients), tranquillizing drugs (55.5%), and antipsychotic drugs (46.7%). The most common combination was an antidepressant drug and a tranquillizing drug (33.0%). Overall, psychotropic drugs with sedating properties (e.g., mirtazapine, quetiapine, doxepin, and trimipramine) were preferred. An increase in use over the 17-year observation period was observed for tranquillizing drugs and, most pronounced, for antipsychotic drugs.</p><p><strong>Conclusion: </strong>We found high rates of non-SHA drugs among patients treated for SHA-SUD. The prevalent use of psychotropic drugs with strong sedating properties indicates a symptom-oriented treatment approach, which is often \"off-label\" but may be clinically necessary. Main limitation is the cross-sectional design of the AMSP databank. Therefore, we cannot provide any follow up data on the patient collective especially regarding outcome.</p>","PeriodicalId":54223,"journal":{"name":"Addiction Science & Clinical Practice","volume":"20 1","pages":"51"},"PeriodicalIF":3.7,"publicationDate":"2025-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12180187/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144334421","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}