Journal of substance use and addiction treatment最新文献

{"title":"State-level actions targeting unethical substance use disorder treatment practices: A qualitative study.","authors":"Melissa Davoust, PhiYen Nguyen, Michael Adelberg, Austin Frakt, Melissa M Garrido","doi":"10.1016/j.josat.2024.209609","DOIUrl":"10.1016/j.josat.2024.209609","url":null,"abstract":"<p><strong>Introduction: </strong>There has been increasing recognition of unethical practices occurring in substance use disorder (SUD) treatment, such as patient brokering and deceptive marketing. We conducted a qualitative study with key informants to characterize state actions that have been undertaken to target unethical practices and the context surrounding state-level actions, including barriers and facilitators to their implementation.</p><p><strong>Methods: </strong>We recruited key informants at the state-level, as well as those from national organizations engaged in improving SUD treatment quality, who could provide perspectives on the scope of unethical practices in the field and ways in which states have sought to prevent unethical practices and improve the quality of SUD treatment. We conducted semi-structured interviews via videoconference with 15 key informants from 11 organizations, including four national advocacy organizations, four state-level advocacy organizations, one local advocacy organization, and two SUD task forces, with both civilian and law enforcement perspectives represented.</p><p><strong>Results: </strong>Key informants described the scope of unethical substance use disorder treatment practices as encompassing patient brokering, deceptive marketing, unethical billing and insurance fraud, and harmful practices in recovery housing. They discussed state-level legislative and non-legislative activities (e.g., licensing and certification efforts, task forces) that have been undertaken to target unethical practices, but they emphasized the need for improved regulation and enforcement. Adequate funding and clear authority were seen as key to success, but without the ability to coordinate across state boundaries, key informants also felt state-level actions alone would be insufficient in combatting unethical actors and practices in substance use disorder treatment and recovery housing spaces.</p><p><strong>Conclusions: </strong>Lessons from states that have enacted legislation and other activities targeting unethical SUD treatment practices may help other states decide which policy approaches are most appropriate for their circumstances. However, our results also suggest that without additional resources or the ability to coordinate across state boundaries, state-level actions intended to combat unethical SUD treatment practices may be unlikely to have the desired effect.</p>","PeriodicalId":73960,"journal":{"name":"Journal of substance use and addiction treatment","volume":" ","pages":"209609"},"PeriodicalIF":0.0,"publicationDate":"2024-12-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142883686","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":"Trends, characteristics, and circumstances surrounding stimulant toxicity deaths in Ontario, Canada from 2018 to 2021.","authors":"Shaleesa Ledlie, Pamela Leece, Joanna Yang, Anita Iacono, Gillian Kolla, Rob Boyd, Nikki Bozinoff, Mike Franklyn, Dana Shearer, Ashley Smoke, Fangyun Wu, Tara Gomes","doi":"10.1016/j.josat.2024.209614","DOIUrl":"https://doi.org/10.1016/j.josat.2024.209614","url":null,"abstract":"<p><strong>Introduction: </strong>As the drug toxicity crisis continues to evolve globally, harms related to non-opioid substances, including stimulants, have risen in parallel. Our study aims were to describe trends in accidental stimulant toxicity deaths and to characterize demographic characteristics of decedents and the circumstances surrounding death.</p><p><strong>Methods: </strong>We conducted a population-based repeated cross-sectional study, of all accidental stimulant toxicity deaths between January 1, 2018, and December 31, 2021, in Ontario, Canada. We reported monthly rates of stimulant toxicity deaths per 100,000 people residing in Ontario and the circumstances surrounding death. All analyses were stratified by the type of stimulant(s) involved in death.</p><p><strong>Results: </strong>Between 2018 and 2021, we identified 5210 stimulant toxicity deaths with the monthly rate rising from 0.4 to 1.0 per 100,000. Both cocaine and methamphetamine were involved in 16.2 % of deaths, and 56.2 % and 27.7 % involved cocaine or methamphetamine (without other stimulants), respectively. Over 80 % of deaths also involved an opioid. Among all deaths, 75.2 % of decedents were male, 53.1 % were aged 25-44, and over half of all deaths occurred in private residences (64.7 %).</p><p><strong>Conclusions: </strong>The rate of stimulant toxicity deaths has continued to grow, more than doubling over a three-year period. As stimulant-related deaths continue to rise, comprehensive social supports and mental health services, including harm reduction and treatment programs adapted to the unique needs of people who use stimulants alone or in combination with other substances, are urgently required to meet the changing needs of people who use drugs.</p>","PeriodicalId":73960,"journal":{"name":"Journal of substance use and addiction treatment","volume":" ","pages":"209614"},"PeriodicalIF":0.0,"publicationDate":"2024-12-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142883688","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":"Preliminary evidence that self-incentives uniquely promote smoking cessation in incarcerated populations: A pilot randomized controlled trial.","authors":"Emma M Brown, Debbie M Smith, Christopher J Armitage","doi":"10.1016/j.josat.2024.209610","DOIUrl":"10.1016/j.josat.2024.209610","url":null,"abstract":"<p><strong>Introduction: </strong>Smoking prevalence rates in prison are typically four times higher than the rates found within community-based settings, increasing premature mortality. Encouraging smokers to self-administer incentives contingent on abstinence (i.e., self-incentivize) are effective in community-based settings and have the potential to work in an incarcerated population. The present study aims to: gauge the feasibility of- and assess possible effects associated with- encouraging smokers to self-incentivize to increase smoking abstinence.</p><p><strong>Methods: </strong>The study recruited 25 smokers from a UK prison who were attending the prison-based stop smoking service. Participants were randomized to one of three conditions, either: (a) an active control, asked to form a plan to quit smoking (n=5); or to self-incentivize if they had not smoked at all by the end of (b) the week (n=7); or (c) the month (n=13). The study gave no specific options to participants in choosing a self-incentive for a number of reasons (e.g., to enable choice of a self-incentive of sufficient rewarding value within a restrictive setting). Participant eligibility included: (a) aged 18 years or over, (b) able to understand written English, (c) competent to provide informed consent, and (d) were tobacco smokers, smoking on a daily basis. Acceptance and completion assessed feasibility. Chi-square analysis assessed possible effect of the intervention.</p><p><strong>Results: </strong>Twenty five out of 27 smokers who were approached, welcomed the opportunity of further support and completed the baseline questionnaire. At 3-month follow-up, no participants (0/5) in the control condition abstained from smoking. In contrast, three (out of seven, d=1.12) participants who self-incentivized on a weekly basis abstained, and five (out of 13, d=0.83) participants who self-incentivized on a monthly basis abstained at the 3-month follow-up time point. Abstaining is defined as no cigarette smoked within at least the last 28-days via self-report and supported by biochemical verification from a sub-sample of participants (68%; 17/25).</p><p><strong>Conclusions: </strong>Use of self-incentives alongside behavioral support and cessation medication is feasible and can be delivered at low-cost. Furthermore, the promise seen in this trial suggests a fully powered randomized controlled trial has the potential to increase smoking abstinence in an incarcerated population.</p>","PeriodicalId":73960,"journal":{"name":"Journal of substance use and addiction treatment","volume":" ","pages":"209610"},"PeriodicalIF":0.0,"publicationDate":"2024-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142878822","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":"Screening, treatment, and referral for substance use disorder in Medicaid health homes: Results of a national pilot study.","authors":"Olivia M Hinds, Melissa A Westlake, Sophia N D Negaro, Christina M Andrews","doi":"10.1016/j.josat.2024.209608","DOIUrl":"10.1016/j.josat.2024.209608","url":null,"abstract":"<p><strong>Introduction: </strong>Established under the Affordable Care Act, Medicaid health homes are designed to provide comprehensive health care for enrollees with chronic health conditions. Given high rates of substance use disorder (SUD) in Medicaid, health homes have the potential to enhance SUD identification and treatment. Yet little is known about the extent to which they engage in these activities. In this study, we assessed the proportion of health homes that screen, treat, and refer for SUD; health homes compliance with state plan requirements for SUD screening and treatment; and the extent to which these trends differ among health homes focusing on physical versus mental health and SUD.</p><p><strong>Methods: </strong>We administered a pilot survey in 2022 to all health care providers participating in active Medicaid health home models. Health home models were categorized as physical-, mental health-, or SUD-focused. We estimated the percentage of health homes engaged in SUD screening, treatment, and referral, and the percentage of health homes that complied with state requirements in each domain.</p><p><strong>Results: </strong>Our sample included 113 Medicaid health homes in 15 states and the District of Columbia. Physical health-focused health homes were more likely to screen for SUD than mental health-focused and SUD-focused health homes (81.0 % versus 63.4 % and 55.0 % respectively). Most health homes referred out at least some SUD treatment (84.1 %). Among those that did refer, fewer than 20 % had a formal contractual agreement with an SUD treatment program. The majority of health homes complied with state requirements for referral. However, among health homes required by their state to offer SUD screening, 38.5 % of physical health-, 10.0 % of mental health-, and 25.0 % of SUD-focused health homes failed to do so. Similarly, 5.9 % of physical health-, 67.9 % of mental health- and 45.0 % of SUD-focused health homes did not offer onsite SUD treatment, even when required to do so.</p><p><strong>Conclusions: </strong>While Medicaid health home plans were established to promote care coordination and integration, relatively few health homes in this study reported doing so in the case of SUD. A concerning number of health homes did not comply with state plan requirements for SUD screening and treatment.</p>","PeriodicalId":73960,"journal":{"name":"Journal of substance use and addiction treatment","volume":" ","pages":"209608"},"PeriodicalIF":0.0,"publicationDate":"2024-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142878831","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":"Advancing peer support workforce research: Insights and recommendations through the lens of professionalization.","authors":"Justin S Bell, Angela Hagaman, Justin Beattey, Gina Fears, William L White, Dennis P Watson","doi":"10.1016/j.josat.2024.209612","DOIUrl":"10.1016/j.josat.2024.209612","url":null,"abstract":"<p><p>Over the past two decades, peer support providers have increasingly formalized their roles in the addiction treatment workforce through credentialing and professionalization efforts. Despite these advancements, misconceptions regarding their professional identity persist and contribute to challenges such as burnout and high turnover. This commentary underscores the importance of viewing the peer workforce as an emerging profession using a lens that has previously been applied to other healthcare service roles. We outline key milestones in the peer workforce's professional development and ongoing labor advocacy efforts by state and national organizations. We call for a comprehensive research agenda that addresses workforce outcomes, workplace dynamics, and role competencies. Such efforts are crucial for advancing the recognition and support of peers as an integral component of the behavioral healthcare workforce.</p>","PeriodicalId":73960,"journal":{"name":"Journal of substance use and addiction treatment","volume":" ","pages":"209612"},"PeriodicalIF":0.0,"publicationDate":"2024-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142878819","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":"Early implementation of an electronic measurement-based care tool in substance use disorder treatment clinics.","authors":"Megan A O'Grady, Patricia Lincourt, Sueun Hong, Shazia Hussain, Charles J Neighbors","doi":"10.1016/j.josat.2024.209605","DOIUrl":"10.1016/j.josat.2024.209605","url":null,"abstract":"<p><strong>Background: </strong>Measurement-based care (MBC), routinely measuring and reviewing treatment progress with a standardized tool, can inform clinical decision making and improve patient outcomes. Despite potential benefits, implementation of MBC in SUD treatment settings has been limited and little is known about its implementation in SUD settings. The goal of this convergent parallel mixed methods study was to understand staff experiences during early implementation of MBC in SUD treatment clinics.</p><p><strong>Methods: </strong>The Treatment Progress Assessment-8 (TPA8) is an 8-item measure that supports MBC with an electronic system (eTPA8) allowing client completion on electronic devices and providing staff reports. The study introduced the eTPA8 into 13 clinics using external practice facilitation and implementation teams. Quantitative data examining implementation included eTPA8 system data (1672 administrations) and staff surveys (n = 70) using feasibility, acceptability, and appropriateness measures. Semi-structured interviews (n = 34) were conducted with clinic staff. To analyze data, we classified clinics into adopters, non-adopters, and sustainers using eTPA8 system data. One-way ANOVA compared these classifications on the three implementation outcome measures. Rapid qualitative analysis was used for the interviews.</p><p><strong>Results: </strong>There were significant differences between staff in sustainer (M = 3.90) and non-adopter (M = 3.21) clinics on the feasibility measure (F(2, 68) = [4.28], p = 0.018). SUD program staff found the eTPA8 to be user-friendly, appropriate, and acceptable. There was some variation in perceived feasibility of regular use of the eTPA8, especially given competing demands and time constraints. Staff found the eTPA8 useful to support clinical interactions but varied in embracing new technology and the overall MBC concept. The inner and outer contexts influenced implementation and required attention by clinic champions and implementation teams. External practice facilitators were key to addressing barriers in an ongoing and flexible manner.</p><p><strong>Conclusions: </strong>Implementing MBC using the eTPA8 showed promise. Staff felt the TPA8 was generally clinically useful, appropriate, and acceptable; yet feasibility was variable. Adoption of MBC faced barriers (e.g., competing demands). Implementation required relatively intensive implementation supports that were dynamic, proactive, and responsive. Findings have implications for guiding development and refinement of responsive, theory-driven implementation strategies to support MBC in SUD treatment settings, with a particular focus on addressing feasibility.</p>","PeriodicalId":73960,"journal":{"name":"Journal of substance use and addiction treatment","volume":" ","pages":"209605"},"PeriodicalIF":0.0,"publicationDate":"2024-12-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142822581","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":"\"There was no services that I could access so I just stayed on the street…using until I went into labour.\": A qualitative study of accessibility and cultural safety of services for perinatal substance use in British Columbia, Canada.","authors":"S Joyce, M Piske, C Norris, B Barker, R David, U Malhotra, B Nosyk","doi":"10.1016/j.josat.2024.209604","DOIUrl":"10.1016/j.josat.2024.209604","url":null,"abstract":"<p><strong>Background: </strong>Perinatal substance use is a critical public health challenge, impacting both mother and fetus. Its prevalence has increased in British Columbia, Canada, disproportionately impacting First Nations people. For specialized perinatal substance use services to be effective, they must be accessible and safe. This study aimed to explore the accessibility and cultural safety of health services for perinatal substance use from the perspective of service users.</p><p><strong>Methods: </strong>We conducted a qualitative study from six focus group discussions, consisting of five in-person sharing circles for people with lived/living experience of pregnancy and substance use and one virtual focus group with inreach workers, for a total of 55 participants including 48 people with lived experience and seven inreach workers across the five health delivery regions in British Columbia. We interpreted results using thematic analysis and narrative inquiry to explore inductively and deductively derived themes.</p><p><strong>Results: </strong>Participants identified a lack of perinatal substance use specific services, particularly supportive housing facilities and wrap-around community centres in the province but highlighted that community-based services they were able to access made participants feel safe and respected. Thematic analysis identified six themes related to accessibility and cultural safety: geographic disparities in access to care, importance of Indigenous culture for Indigenous client's healing, transitions as critical moments in service accessibility, safe services protect the mother-infant dyad, inconsistent access to opioid agonist treatment, and relationality as a crucial element of safe service delivery.</p><p><strong>Conclusion: </strong>This study suggests that services that preserve the mother-infant dyad, incorporate wholistic care including Indigenous culture, and are relationship-based are experienced as accessible and safe, and those that do not are often mistrusted and avoided. This study highlights needed improvements, particularly of acute care services, through supporting instead of reporting birthing parents with substance use, ensuring continuous access to opioid agonist treatment for pregnant people with opioid use disorder, and suffusing the client-provider relationship with empathy, respect, and connection.</p>","PeriodicalId":73960,"journal":{"name":"Journal of substance use and addiction treatment","volume":" ","pages":"209604"},"PeriodicalIF":0.0,"publicationDate":"2024-12-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142823042","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":"Barriers and facilitators to the implementation of screening and intervention for co-use of opioid medications and alcohol among community pharmacy patients.","authors":"Grace Broussard, Kenneth C Hohmeier, Craig Field, Adam J Gordon, Kristi Carlston, Alina Cernasev, Melissa Tyszko, Ashley M Snyder, Gerald Cochran","doi":"10.1016/j.josat.2024.209606","DOIUrl":"10.1016/j.josat.2024.209606","url":null,"abstract":"<p><strong>Introduction: </strong>A significant risk for overdose among patients prescribed opioid medications is co-use of alcohol. Community pharmacies are underutilized as a resource to prevent and address co-use. The barriers and facilitators that promote or impede the adoption of universal alcohol screening and intervention at point of opioid medication dispensing are unknown. We assessed community pharmacy leaders, pharmacists, and technician's perceptions towards the implementation of a pharmacy-based screening/intervention for the co-use of opioids and alcohol among patients.</p><p><strong>Methods: </strong>We conducted a multi-method study that included one-time key informant interviews combined with a close-ended survey to inform our understanding of pharmacy system/practice-level barriers and facilitators for universal screening and intervention. Participants were recruited from Utah and Tennessee and were required to have active employment as pharmacy leaders, pharmacists, or technicians, be English-speaking, and believe they could provide feedback regarding co-use screening and intervention within community pharmacies. Interviews used the Consolidated Framework for Implementation Research and the Organizational Readiness for Implementing Change assessment. Qualitative analysis included both inductive and deductive coding. Themes followed a cycle of open, initial coding whereby codes were derived inductively from the data.</p><p><strong>Results: </strong>Themes from interviews (N = 68) included a) emphasizing a need to overcome the stigma associated with patients who engage in co-use and a mindset shift to treat the challenges and risks associated, b) need for corporate-level support, management buy-in, and c) appropriate technology to support the workflow including system-wide changes to support the integration of medication therapy management services within community pharmacies. However, barriers were offset by pharmacists eager to understand their role in screening patients and reiterated a focus on patient-centered care to achieve this goal. From the ORIC assessment, 75 % (n = 51) of respondents reported that community pharmacy staff wanted to implement the screening and intervention, and 69.1 % (n = 47) reported motivation to implement the screening and intervention. Finally, 67.6 % (n = 46) felt that community pharmacies are committed to implementing the screening and intervention, but only 10.3 % (n = 7) expressed strong support to do \"whatever it takes\" to implement the screening and intervention.</p><p><strong>Conclusion: </strong>These results provide critical insights into implementation strategies for the adoption of brief intervention by community pharmacists. These data are foundational to developing strategies for a powered trial and possible future system/practice-level implementation of universal alcohol screening and intervention for co-use.</p>","PeriodicalId":73960,"journal":{"name":"Journal of substance use and addiction treatment","volume":" ","pages":"209606"},"PeriodicalIF":0.0,"publicationDate":"2024-12-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142822574","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":"Pharmacological treatments for co-occurring PTSD and substance use disorders: A systematic review.","authors":"Megan Swannell, Richard C J Bradlow, Daniel Pham, Jessica Gabriel, Yasmin Manahan, Shalini Arunogiri","doi":"10.1016/j.josat.2024.209601","DOIUrl":"10.1016/j.josat.2024.209601","url":null,"abstract":"<p><strong>Introduction: </strong>Post-traumatic stress disorder and substance use disorders commonly co-occur and are associated with worse health outcomes. Currently, only psychosocial therapies are specifically recommended for use in the co-occurring population, but these come with numerous barriers to access and engagement. This study aims to identify potential pharmacological treatments to enhance treatment options and outcomes for this population.</p><p><strong>Methods: </strong>This systematic review identified studies on pharmacological treatment of co-occurring PTSD and SUD in humans, using validated outcome measurements, with study design of RCT, observational study, case control study or cohort study.</p><p><strong>Results: </strong>29 studies were identified for inclusion, looking at a range of 16 pharmacotherapies. A majority concentrated on alcohol use disorders and males, with many focused on the veteran population.</p><p><strong>Conclusions: </strong>This is an area for further research, inclusive of more SUDs, genders and civilians. Future studies utilizing consistent dosing, populations and measurement outcomes will allow for future meta-analysis.</p>","PeriodicalId":73960,"journal":{"name":"Journal of substance use and addiction treatment","volume":" ","pages":"209601"},"PeriodicalIF":0.0,"publicationDate":"2024-12-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142822763","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":"Vortioxetine improves illness severity for cannabis users with anxiety and depressive symptoms in a 6-month randomized controlled study.","authors":"Albert Kar Kin Chung, Cheuk Yin Tse, Gladys Kwan Yin Yeung, Sau Wan Tang, Wing-Man Chan, Johnson Kai Chun Law","doi":"10.1016/j.josat.2024.209607","DOIUrl":"10.1016/j.josat.2024.209607","url":null,"abstract":"<p><strong>Introduction: </strong>Cannabis use and misuse have mental health implications, particularly affecting mood and anxiety symptoms. Vortioxetine, a potent serotonin partial agonist/antagonist reuptake inhibitor antidepressant, has well-established effects in treating depressive and anxiety disorders and may serve as a potential treatment for individuals with cannabis use disorder and comorbid mood symptoms. In the current study, we aimed to investigate the efficacy of vortioxetine for cannabis users with anxiety and depressive symptoms alongside their cannabis dependence.</p><p><strong>Methods: </strong>This 6-month prospective, randomized controlled interventional pilot study investigated if vortioxetine could improve cannabis dependence, comorbid anxiety and/or depressive symptoms, and cognitive and functional outcomes in individuals using cannabis. Participants were randomized to receive either vortioxetine (N = 11) or standard treatment (N = 19).</p><p><strong>Results: </strong>Participants taking vortioxetine (mean dose 10 mg/day) showed significant improvement on clinician-observed overall mood states over time (p < .05) but not on their self-reported anxiety or depressive symptoms. Cannabis users receiving standard treatment did not exhibit similar improvement. No significant differences were found on cannabis dependence, cognition and functional outcomes between the two groups otherwise.</p><p><strong>Conclusions: </strong>The results suggest that the multimodal antidepressant vortioxetine may benefit cannabis users with depressive and anxiety symptoms in ameliorating their overall mood state.</p>","PeriodicalId":73960,"journal":{"name":"Journal of substance use and addiction treatment","volume":" ","pages":"209607"},"PeriodicalIF":0.0,"publicationDate":"2024-12-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142822767","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}