51
|
Ashwal-Malka A, Tal-Kishner K, Feingold D. Moral injury and cannabis use disorder among Israeli combat veterans: The role of depression and perceived social support. Addict Behav 2022; 124:107114. [PMID: 34543870 DOI: 10.1016/j.addbeh.2021.107114] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2021] [Revised: 08/25/2021] [Accepted: 09/05/2021] [Indexed: 01/14/2023]
Abstract
INTRODUCTION Cannabis use is highly common among military combat veterans, who are also inclined toward developing Cannabis Use Disorder (CUD). The present study examined the association between Moral Injury (MI), which may occur following combat-related acts that violate one's deep moral beliefs, and CUD, as well as the mediating role of depression and the moderating role of perceived social support. METHODS Participants were 215 Israel Defense Forces male combat veterans discharged from military service within the past five years, who reported using cannabis regularly (≥3 days weekly) during the past six months. Participants completed a set of validated self-report questionnaires assessing MI, CUD, depression and perceived social support. RESULTS Results indicated that MI-perpetration by self and MI-betrayal were positively associated with CUD. Additionally, serial mediation analyses indicated that the associations between MI-self and betrayal and CUD were mediated by depression (direct effect: β = 0.13, p = 0.1, and β = 0.20, p = .04, respectively). Furthermore, moderation analyses indicated that the association between MI and CUD was significant only among participants with average or high levels of perceived social support (for support by a significant other: b = 0.13, p = .006 and b = 0.22, p < .001 for MI-self and betrayal, respectively; for support by family: b = 0.13, p = .009 for MI-betrayal; and for support by friends: b = 0.1, p = .044 for MI-self). CONCLUSIONS MI and its association with CUD should be addressed in clinical settings when working with combat veterans.
Collapse
Affiliation(s)
| | - Keren Tal-Kishner
- The Weinberg Child Development Center, The Edmond and Lili Safra Children's Hospital, Sheba Medical Center, Tel HaShomer, Israel
| | | |
Collapse
|
52
|
Lommer K, Schurr T, Frajo-Apor B, Plattner B, Chernova A, Conca A, Fronthaler M, Haring C, Holzner B, Macina C, Marksteiner J, Miller C, Pardeller S, Perwanger V, Pycha R, Schmidt M, Sperner-Unterweger B, Tutzer F, Hofer A. Addiction in the time of COVID-19: Longitudinal course of substance use, psychological distress, and loneliness among a transnational Tyrolean sample with substance use disorders. Front Psychiatry 2022; 13:918465. [PMID: 35982932 PMCID: PMC9380400 DOI: 10.3389/fpsyt.2022.918465] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/12/2022] [Accepted: 07/01/2022] [Indexed: 11/25/2022] Open
Abstract
INTRODUCTION Next to an increased use of alcohol, the current pandemic has been associated with increased psychological distress among the general population. Research on its effects on individuals suffering from substance use disorders (SUD) is scarce. This study aimed at expanding the existing literature on this topic with a focus on the impact of loneliness and perceived social support. METHODS Sixty-eight people diagnosed with SUD according to ICD-10 from the Austrian state of Tyrol and from the Italian Province of South Tyrol who had been treated in a psychiatric hospital in 2019 and one hundred and thirty-six matched reference subjects of the same regional background participated in an online survey. Sociodemographic variables and scores on the Brief Symptom Checklist, the Three-Item Loneliness Scale, and the Multidimensional Scale of Perceived Social Support were collected at baseline and 5 months thereafter. Baseline took place after the first wave, while follow-up largely coincided with the second wave of the pandemic. RESULTS Among both patients and the matched reference group, substance use as a means to feel better facing the pandemic rose and predicted higher levels of psychological distress. Patients were less likely to receive specific care at follow-up than at baseline and presented with a significantly higher prevalence of clinically relevant psychological distress and loneliness than the matched reference group at both assessment times. Among both groups, psychological burden remained unchanged over time. Perceived social support was generally significantly higher in the matched reference group than in patients. Loneliness and, to a lesser degree, low perceived social support predicted psychological distress. CONCLUSION These findings emphasize the need of preventive and educational measures regarding substance use behavior for both individuals suffering from SUD and those without mental health disorders.
Collapse
Affiliation(s)
- Kilian Lommer
- Division of Psychiatry I, Department of Psychiatry, Psychotherapy, Psychosomatics and Medical Psychology, Medical University Innsbruck, Innsbruck, Austria
| | - Timo Schurr
- Division of Psychiatry I, Department of Psychiatry, Psychotherapy, Psychosomatics and Medical Psychology, Medical University Innsbruck, Innsbruck, Austria
| | - Beatrice Frajo-Apor
- Division of Psychiatry I, Department of Psychiatry, Psychotherapy, Psychosomatics and Medical Psychology, Medical University Innsbruck, Innsbruck, Austria
| | - Barbara Plattner
- Department of Psychiatry, General Hospital of Bolzano, Sanitary Agency of South Tyrol, Bolzano, Italy
| | - Anna Chernova
- Division of Psychiatry I, Department of Psychiatry, Psychotherapy, Psychosomatics and Medical Psychology, Medical University Innsbruck, Innsbruck, Austria
| | - Andreas Conca
- Department of Psychiatry, General Hospital of Bolzano, Sanitary Agency of South Tyrol, Bolzano, Italy
| | - Martin Fronthaler
- Therapy Center Bad Bachgart, Sanitary Agency of South Tyrol, Rodengo, Italy
| | - Christian Haring
- Department of Psychiatry and Psychotherapy B, State Hospital Hall in Tyrol, Hall in Tyrol, Austria
| | - Bernhard Holzner
- Division of Psychiatry I, Department of Psychiatry, Psychotherapy, Psychosomatics and Medical Psychology, Medical University Innsbruck, Innsbruck, Austria
| | - Christian Macina
- Department of Psychiatry, General Hospital of Brunico, Sanitary Agency of South Tyrol, Brunico, Italy
| | - Josef Marksteiner
- Department of Psychiatry and Psychotherapy A, State Hospital Hall in Tyrol, Hall in Tyrol, Austria
| | - Carl Miller
- Department of Psychiatry, County Hospital Kufstein, Kufstein, Austria
| | - Silvia Pardeller
- Division of Psychiatry I, Department of Psychiatry, Psychotherapy, Psychosomatics and Medical Psychology, Medical University Innsbruck, Innsbruck, Austria
| | - Verena Perwanger
- Department of Psychiatry, General Hospital of Merano, Sanitary Agency of South Tyrol, Merano, Italy
| | - Roger Pycha
- Department of Psychiatry, General Hospital of Bressanone, Sanitary Agency of South Tyrol, Bressanone, Italy
| | - Martin Schmidt
- Department of Psychiatry, County Hospital Lienz, Lienz, Austria
| | - Barbara Sperner-Unterweger
- Division of Psychiatry II, Department of Psychiatry, Psychotherapy, Psychosomatics and Medical Psychology, Medical University Innsbruck, Innsbruck, Austria
| | - Franziska Tutzer
- Division of Psychiatry I, Department of Psychiatry, Psychotherapy, Psychosomatics and Medical Psychology, Medical University Innsbruck, Innsbruck, Austria
| | - Alex Hofer
- Division of Psychiatry I, Department of Psychiatry, Psychotherapy, Psychosomatics and Medical Psychology, Medical University Innsbruck, Innsbruck, Austria
| |
Collapse
|
53
|
Wilkerson JL, Alberti LB, Thakur GA, Makriyannis A, Milligan ED. Peripherally administered cannabinoid receptor 2 (CB 2R) agonists lose anti-allodynic effects in TRPV1 knockout mice, while intrathecal administration leads to anti-allodynia and reduced GFAP, CCL2 and TRPV1 expression in the dorsal spinal cord and DRG. Brain Res 2022; 1774:147721. [PMID: 34774500 PMCID: PMC10763621 DOI: 10.1016/j.brainres.2021.147721] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2021] [Revised: 11/02/2021] [Accepted: 11/05/2021] [Indexed: 12/18/2022]
Abstract
The transient receptor potential (TRP) superfamily of cation channels, of which the TRP vanilloid type 1 (TRPV1) receptor plays a critical role in inflammatory and neuropathic pain, is expressed on nociceptors and spinal cord dorsal horn neurons. TRPV1 is also expressed on spinal astrocytes and dorsal root ganglia (DRG) satellite cells. Agonists of the cannabinoid type 2 receptor (CB2R) suppress allodynia, with some that can bind TRPV1. The neuroimmune C-C class chemokine-2 (CCL2) expressed on injured DRG nociceptor cell bodies, Schwann cells and spinal astrocytes, stimulates immune cell accumulation in DRG and spinal cord, a known critical element in chronic allodynia. The current report examined whether two CB2R agonists, AM1710 and AM1241, previously shown to reverse light touch mechanical allodynia in rodent models of sciatic neuropathy, require TRPV1 activation that leads to receptor insensitivity resulting in reversal of allodynia. Global TRPV1 knockout (KO) mice with sciatic neuropathy given intrathecal or intraperitoneal AM1710 were examined for anti-allodynia followed by immunofluorescent microscopy analysis of lumbar spinal cord and DRG of astrocyte and CCL2 markers. Additionally, immunofluorescent analysis following intrathecal AM1710 and AM1241 in rat was performed. Data reveal that intrathecal AM1710 resulted in mouse anti-allodynia, reduced spinal astrocyte activation and CCL2 expression independent of TRPV1 gene deletion. Conversely, peripheral AM1710 in TRPV1-KO mice failed to reverse allodynia. In rat, intrathecal AM1710 and AM1241 reduced spinal and DRG TRPV1 expression, with CCL2-astrocyte and -microglial co-expression. These data support that CB2R agonists can impact spinal and DRG TRPV1 expression critical for anti-allodynia.
Collapse
Affiliation(s)
- Jenny L Wilkerson
- Department of Neurosciences, Health Sciences Center, School of Medicine, University of New Mexico, Albuquerque, NM 87131, USA; Department of Pharmacodynamics, College of Pharmacy, University of Florida, Gainesville, FL, USA
| | - Lauren B Alberti
- Department of Neurosciences, Health Sciences Center, School of Medicine, University of New Mexico, Albuquerque, NM 87131, USA
| | - Ganesh A Thakur
- Center for Drug Discovery, Northeastern University, Boston, MA 02115, USA
| | | | - Erin D Milligan
- Department of Neurosciences, Health Sciences Center, School of Medicine, University of New Mexico, Albuquerque, NM 87131, USA.
| |
Collapse
|
54
|
Michael A, Roska P. The difference between inpatient and outpatient programs regarding trait -anxiety, social support and state-anxiety in during the covid-19 pandemic in Israel. THERAPEUTIC COMMUNITIES 2021. [DOI: 10.1108/tc-03-2021-0008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Purpose
COVID-19 pandemic is affecting the well-being and the psychological resilience of different populations, particularly in the addiction field. This study aims to assess anxiety and its severity among patients and staff from different types of addiction services in Israel during this emergency.
Design/methodology/approach
The study was conducted during the period from March–July 2020. Participants included patients and staff (N = 282) from three different types of addiction services, were administered the State-Trait Anxiety Inventory, the multi-dimensional scale of perceived social support and demographic variables. In addition, a logistic regression model was applied to identify predictors of state anxiety by using statistical package for the social sciences software.
Findings
The results show that therapeutic communities clients reported more social support compared to other subjects. State anxiety has a positive strong correlation with trait anxiety both among patients and staff, and it was found as a crucial predictor of state anxiety in the regression equation. There is no statistically significant correlation between state anxiety and social support, gender or education among clients and staff as one. The state anxiety remains relatively stable and characterizes most people, staff and patients, men and women, medical staff members and other professionals.
Research limitations/implications
The current study has some contributions to the addiction field by understanding the psychological distress of a vulnerable population: substance users in treatment settings. The study population relied on convenient samples and future studies should be planned using a cross-sectional design and should take into account substance use measures. The findings are reinforcing the assumption that state anxiety was likely to increase during the coronavirus pandemic.
Practical implications
Adequate services should be planned to avoid relapse or mental deterioration of people who use drugs during health emergencies.
Originality/value
The research points out the unique and real difficulties of SUD clients, as well as the complexity and risks in their staff members’ works. The authors also saw that staff members need attention and maintenance; they are in the front line.
Collapse
|
55
|
O'Dell LE, Koob GF, Nazarian A. Vulnerability to substance abuse: A consideration of allostatic loading factors. Neuropharmacology 2021; 199:108767. [PMID: 34454910 DOI: 10.1016/j.neuropharm.2021.108767] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Affiliation(s)
- Laura E O'Dell
- Department of Psychology, The University of Texas at El Paso, El Paso, TX, USA.
| | - George F Koob
- National Institute on Alcohol Abuse and Alcoholism, Bethesda, MD, USA.
| | - Arbi Nazarian
- Department of Pharmaceutical Sciences, Western University of Health Sciences, Pomona, CA, USA.
| |
Collapse
|
56
|
Cakmak B, Calik A, Inkaya BV. Metaphoric Perceptions of Covid-19 Patients Related to the Disease. Clin Nurs Res 2021; 31:385-394. [PMID: 34615386 DOI: 10.1177/10547738211048312] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
This study aimed to explore metaphoric perceptions of patients with COVID-19 including treatment process, family relationships, and mental health via using metaphors. Purposive sampling was used to include participants. Totally 46 patients diagnosed with COVID-19 were included in the study. The metaphor-based data collection process was carried out with three open-ended questions. The metaphors compiled according to questions and grouped by 13 themes according to analysis. Patients explained to COVID-19 process by using 91 different metaphors. Most frequently used metaphors by patients; black hole/dark for the treatment process of COVID-19, steel for family relationships, sea metaphor for mental health. This study, it was determined that individuals are afraid of death, have a serious perception of uncertainty, and their family relationships and this process negatively affected their family relationships and mental states. Nurses have important responsibilities to increase the quality of patient care.
Collapse
|
57
|
Vera BDV, Carmona-Márquez J, Lozano-Rojas ÓM, Parrado-González A, Vidal-Giné C, Pautassi RM, Fernández-Calderón F. Changes in Alcohol Use during the COVID-19 Pandemic among Young Adults: The Prospective Effect of Anxiety and Depression. J Clin Med 2021; 10:4468. [PMID: 34640485 PMCID: PMC8509511 DOI: 10.3390/jcm10194468] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2021] [Revised: 09/20/2021] [Accepted: 09/24/2021] [Indexed: 01/06/2023] Open
Abstract
Health measures instantiated to reduce the spread of COVID-19 have imposed significant constraints for the population and impacted on drinking habits and mental health. This study longitudinally compared changes in alcohol consumption before and after the COVID-19 outbreak and the impact of sociodemographic and mental health variables on such changes among a community sample of young adults. Data were collected in the context of a larger, ongoing longitudinal study. The sample consisted of 305 young adults from Spain aged between 18 and 26 years (mean age = 21.27, (SD = 2.21), female = 53.4%; college students = 61.6%) who completed first (November-2019 and February-2020; i.e., before the outbreak of COVID-19) and second follow-up questionnaires (March 2021, a year after the COVID-19 outbreak). Alcohol use (quantity and drinking frequency), depression and anxiety symptoms were measured. Quantity and frequency of alcohol use decreased from the pre- to post-COVID-19 period. A decrease in drinking frequency was observed among college students, but not in noncollege peers. Although we found no effect of pre-COVID-19 anxiety on alcohol use changes, those with more depressive symptoms at the pre-COVID assessment were more resistant to decreasing their drinking quantity and frequency after the COVID-19 outbreak. This information will be of value when designing interventions aimed at reducing harmful alcohol use and highlights the role of mental health status when identifying high risk populations of young-adults during this, and future, public health crises.
Collapse
Affiliation(s)
- Belén del Valle Vera
- Faculty of Psychology, National University of Córdoba, Córdoba X5000HUA, Argentina; (B.d.V.V.); (R.M.P.)
- Institute of Psychological Research, IIPsi-CONICET-UNC, Córdoba X5000HUA, Argentina
| | - José Carmona-Márquez
- Department of Clinical and Experimental Psychology, University of Huelva, 21071 Huelva, Spain; (J.C.-M.); (Ó.M.L.-R.); (A.P.-G.)
- Research Center on Natural Resources, Health and the Environment, University of Huelva, 21071 Huelva, Spain
| | - Óscar Martín Lozano-Rojas
- Department of Clinical and Experimental Psychology, University of Huelva, 21071 Huelva, Spain; (J.C.-M.); (Ó.M.L.-R.); (A.P.-G.)
- Research Center on Natural Resources, Health and the Environment, University of Huelva, 21071 Huelva, Spain
| | - Alberto Parrado-González
- Department of Clinical and Experimental Psychology, University of Huelva, 21071 Huelva, Spain; (J.C.-M.); (Ó.M.L.-R.); (A.P.-G.)
| | - Claudio Vidal-Giné
- Non-Governmental Organization Welfare and Development, Energy Control, 29200 Antequera, Spain;
| | - Ricardo Marcos Pautassi
- Faculty of Psychology, National University of Córdoba, Córdoba X5000HUA, Argentina; (B.d.V.V.); (R.M.P.)
- Instituto de Investigación Médica M. y M. Ferreyra (INIMEC–CONICET-Universidad Nacional de Córdoba), Córdoba X5016NST, Argentina
| | - Fermín Fernández-Calderón
- Department of Clinical and Experimental Psychology, University of Huelva, 21071 Huelva, Spain; (J.C.-M.); (Ó.M.L.-R.); (A.P.-G.)
- Research Center on Natural Resources, Health and the Environment, University of Huelva, 21071 Huelva, Spain
| |
Collapse
|
58
|
Ballantyne JC, Koob GF. Allostasis theory in opioid tolerance. Pain 2021; 162:2315-2319. [PMID: 33769368 DOI: 10.1097/j.pain.0000000000002280] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2020] [Accepted: 03/17/2021] [Indexed: 01/29/2023]
Affiliation(s)
- Jane C Ballantyne
- Department of Anesthesiology and Pain Medicine, University of Washington School of Medicine, Seattle, WA, United States
| | - George F Koob
- National Institute of Alcohol Abuse and Alcoholism, National Institutes of Health, Bethesda, MD, United States
| |
Collapse
|
59
|
Votaw VR, Stein ER, Witkiewitz K. A Longitudinal Mediation Model of Negative Emotionality, Coping Motives and Drinking Intensity Among Individuals Receiving Community Treatment for Alcohol Use Disorder. Alcohol Alcohol 2021; 56:573-580. [PMID: 33778864 DOI: 10.1093/alcalc/agab012] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2020] [Revised: 01/19/2021] [Accepted: 02/04/2021] [Indexed: 11/13/2022] Open
Abstract
AIMS Negative emotionality is a key domain in frameworks measuring heterogeneity in alcohol use disorder (AUD), such as the Addictions Neuroclinical Assessment (ANA). Recent research has examined the construct validity of the ANA negative emotionality domain, but has not examined whether this domain demonstrates predictive validity for drinking outcomes. In this study, we examined the association between self-reported negative emotionality at baseline and drinking intensity 1 year following AUD treatment initiation. We also assessed whether coping motives for alcohol use at 6 months following treatment initiation and changes in coping motives mediated this association. METHODS This was a secondary data analysis of a multisite prospective study of individuals entering AUD treatment (n = 263; 61.6% male; mean age = 33.8). Measures of coping motives and drinking intensity captured those who experienced a lapse to drinking. The associations between the ANA negative emotionality domain, coping motives and drinking intensity over time were assessed using a latent growth curve mediation model. RESULTS The ANA negative emotionality domain at baseline was indirectly associated with greater 7-12-month drinking intensity through higher coping motives at 6 months. Negative emotionality was not related to change in coping motives over the assessment period and change in coping motives was not related to 7-12-month drinking intensity. CONCLUSIONS This analysis provides evidence for the predictive validity of the ANA negative emotionality domain for coping motives and drinking intensity among treatment seekers who experienced a lapse to drinking. Coping motives may be an important target in AUD treatment among those high in negative emotionality.
Collapse
Affiliation(s)
- Victoria R Votaw
- Department of Psychology, University of New Mexico, 1 University of New Mexico, Albuquerque, NM 87131, USA.,Center on Alcohol, Substance Use, and Addictions, University of New Mexico, 2650 Yale SE MSC11-6280, Albuquerque, NM 87106, USA
| | - Elena R Stein
- Department of Psychology, University of New Mexico, 1 University of New Mexico, Albuquerque, NM 87131, USA.,Center on Alcohol, Substance Use, and Addictions, University of New Mexico, 2650 Yale SE MSC11-6280, Albuquerque, NM 87106, USA
| | - Katie Witkiewitz
- Department of Psychology, University of New Mexico, 1 University of New Mexico, Albuquerque, NM 87131, USA.,Center on Alcohol, Substance Use, and Addictions, University of New Mexico, 2650 Yale SE MSC11-6280, Albuquerque, NM 87106, USA
| |
Collapse
|
60
|
Uc A, Andersen DK, Apkarian AV, Bellin MD, Colloca L, Drewes AM, Dunbar EK, Forsmark CE, Goodman MT, Kapural L, Koob GF, Palermo TM, Pandol SJ, Pasricha P, Phillips AE, Piomelli D, Saloman JL, Schwarzenberg SJ, Singh VK, Sowa G, Strouse T, Treisman GJ, Windsor JA, Yadav D. Pancreatic Pain-Knowledge Gaps and Research Opportunities in Children and Adults: Summary of a National Institute of Diabetes and Digestive and Kidney Diseases Workshop. Pancreas 2021; 50:906-915. [PMID: 34643606 PMCID: PMC10273134 DOI: 10.1097/mpa.0000000000001899] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
ABSTRACT A workshop was sponsored by the National Institute of Diabetes and Digestive and Kidney Diseases to focus on research gaps and opportunities in pancreatic pain. The event was held on July 21, 2021, and structured into 4 sessions: (1) pathophysiology; (2) biomarkers, mediators, and pharmacology of pain; (3) pain assessment; and (4) pain treatment challenges and opportunities. The current state of knowledge was reviewed; many knowledge gaps and research needs were identified that require further investigation. Common themes included the need to better understand the underlying mechanisms of pain in pancreatic diseases, the relationship of visceral neural pathways and central pain centers, the role of behavioral factors and disorders on the perception of pain, and differences in pain perception and processes in children when compared with adults. In addition, the role of genetic risk factors for pain and the mechanisms and role of placebos in pain treatment were discussed. Methods of pain assessment including quantitative sensory testing were examined, as well as the process of central sensitization of pain. Finally, newer approaches to pain management including cognitive behavioral therapy, nerve stimulation, experimental (nonopioid) drugs, and cannabinoid compounds were covered.
Collapse
Affiliation(s)
- Aliye Uc
- From the Division of Gastroenterology, Hepatology, Pancreatology and Nutrition, Stead Family Department of Pediatrics, The University of Iowa, Iowa City, IA
| | - Dana K Andersen
- Division of Digestive Diseases and Nutrition, National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Bethesda, MD
| | - A Vania Apkarian
- Departments of Physiology, Anesthesiology, Physical Medicine and Rehabilitation, and Center for Translational Pain Research, Northwestern University, Feinberg School of Medicine, Chicago, IL
| | - Melena D Bellin
- Departments of Pediatrics and Surgery, University of Minnesota Masonic Children's Hospital, Minneapolis, MN
| | | | - Asbjørn M Drewes
- Department of Gastroenterology and Hepatology, Aalborg University Hospital, Aalborg, Denmark
| | | | - Christopher E Forsmark
- Division of Gastroenterology, Hepatology and Nutrition, Department of Medicine, University of Florida, Gainesville, FL
| | - Marc T Goodman
- Cancer Prevention and Control Program, Samuel Oschin Cancer Center, Cedars-Sinai Medical Center, Los Angeles, CA
| | | | - George F Koob
- National Institute on Alcohol Abuse and Alcoholism and Intramural Research Program, National Institute on Drug, National Institutes of Health, Bethesda, MD
| | | | - Stephen J Pandol
- Division of Gastroenterology, Department of Medicine, Cedars Sinai Medical Center, Los Angeles, CA
| | - Pankaj Pasricha
- Division of Gastroenterology and Hepatology, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD
| | - Anna E Phillips
- Division of Gastroenterology, Hepatology and Nutrition, Department of Medicine
| | - Daniele Piomelli
- Departments of Anatomy and Neurobiology, Biological Chemistry, and Pharmacology, University of California, Irvine School of Medicine, Irvine, CA
| | - Jami L Saloman
- Division of Gastroenterology, Hepatology and Nutrition, Department of Medicine
| | - Sarah Jane Schwarzenberg
- Division of Pediatric Gastroenterology, Hepatology and Nutrition, University of Minnesota Masonic Children's Hospital, Minneapolis, MN
| | - Vikesh K Singh
- Division of Gastroenterology and Hepatology, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD
| | - Gwendolyn Sowa
- Department of Physical Medicine and Rehabilitation, University of Pittsburgh School of Medicine, Pittsburgh, PA
| | - Thomas Strouse
- Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine at UCLA, Los Angeles, CA
| | - Glenn J Treisman
- Department of Psychiatry and Behavioral Sciences, Department of Internal Medicine, The Johns Hopkins University School of Medicine, Baltimore, MD
| | - John A Windsor
- Surgical and Translational Research Centre, Faculty of Medical and Health Sciences, The University of Auckland, Auckland, New Zealand
| | - Dhiraj Yadav
- Division of Gastroenterology, Hepatology and Nutrition, Department of Medicine
| |
Collapse
|
61
|
Szelest I, Harries B, Motluk L, Harries J. How prescribing available pharmacotherapies for alcohol use disorder can impact the healthcare system: A retrospective quality improvement study. Healthc Manage Forum 2021; 34:283-290. [PMID: 34247530 DOI: 10.1177/08404704211027183] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Alcohol use disorder is a multifactorial undertreated chronic disorder influenced by genetic, psychological, and environmental factors. Numerous pharmacotherapies are available and effective but are underutilized in healthcare. The purpose of this retrospective quality improvement study is to determine the impact of education sessions on the availability and efficacy of medications (focusing on Naltrexone) to treat alcohol use disorder in the healthcare system. Control charts were implemented to monitor the system change in two comparable urban areas. Dispensing rates increased at three points after a series of presentations. The first increase from baseline was 2.47 times, the second 3.7, and the third 4.81. Coinciding with these, weekly visits to the emergency department also decreased by 35% and stabilized at a 15% reduction. It was also observed that alcohol use disorder hospital admission rates decreased by 21%, but bounced back once the education sessions ended. Combined with counselling, pharmacotherapies can be effective in combating alcohol use disorder, while potentially reducing demands on the healthcare system.
Collapse
Affiliation(s)
- Izabela Szelest
- The Canadian Alcohol Use Disorder Society, Penticton, British Columbia, Canada.,Care.Transformed Consulting, Vancouver, British Columbia, Canada
| | - Bruce Harries
- The Canadian Alcohol Use Disorder Society, Penticton, British Columbia, Canada.,Improvement Associates Ltd., Edmonton, Alberta, Canada
| | - Lori Motluk
- The Canadian Alcohol Use Disorder Society, Penticton, British Columbia, Canada
| | - Jeff Harries
- The Canadian Alcohol Use Disorder Society, Penticton, British Columbia, Canada.,Interior Health Authority, Penticton, British Columbia, Canada
| |
Collapse
|
62
|
Feingold D, Zerach G. Parental Reflectiveness, Posttraumatic Symptoms and Alcohol Use Disorder among Israeli Combat-Veteran Fathers. JOURNAL OF CHILD AND FAMILY STUDIES 2021; 30:2155-2164. [PMID: 34230797 PMCID: PMC8249432 DOI: 10.1007/s10826-021-02024-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Accepted: 06/16/2021] [Indexed: 06/13/2023]
Abstract
Combat veterans are highly prone to develop Alcohol Use Disorder (AUD) following their release from duty, presumably due to high prevalence of prolonged aversive emotional symptoms such as Posttraumatic Stress Symptoms (PTSS). Parental Reflective Functions (PRF) and Parental Sense of Competence (PSOC) have been identified as key protective factors in predicting maternal functioning and well-being, yet little is known of its role among fathers, let alone combat veteran fathers. In this study we explored whether PRF and PSOC moderated the association between PTSS and AUD among 189 Israel Defense Forces (IDF) male combat veterans. Participants filled out validated measures assessing PTSS, PRF, PSOC and AUD. Results indicated that PTSS, as well as PRF's "interest and curiosity regarding the child's mental states" subscale, were positively correlated to AUD. In addition, PRF's "certainty about child mental states" subscale moderated the association between PTSS and AUD, so that PTSS and AUD were significantly correlated for participants who reported average or high levels of certainty about their child's mental states. This finding may imply that intrusive mentalizing ("hypermentalizing") by veteran fathers may facilitate the association between PTSS and AUD, presumably by constituting a maladaptive mechanism for coping with the stressful uncertainty embedded in the parent-child relationship.
Collapse
Affiliation(s)
| | - Gadi Zerach
- Department of Psychology, Ariel University, Ariel, Israel
| |
Collapse
|
63
|
Abstract
PURPOSE OF REVIEW This review provides an update on recently published literature on the rise of illicit fentanyls, risks for overdose, combinations with other substances, e.g. stimulants, consequences, and treatment. RECENT FINDINGS Overdose due to illicit synthetic opioids (e.g. fentanyl and fentanyl analogs) continues to rise in the US both preceding and during the COVID-19 pandemic. Fentanyl-related overdose is rising in new geographic areas e.g. the western USA. Stimulant-related overdose is also increasing nationwide driven by methamphetamine and cocaine. Polysubstance use, e.g. the use of a stimulant along with an opioid is driving stimulant-related overdose. Other medical consequences of injection drug use are rising including HIV and hepatitis C infections. Medication approaches to treating opioid use disorder remain the standard of care and there are new promising pharmacological approaches to treating methamphetamine use disorder. SUMMARY A 'fourth wave' of high mortality involving methamphetamine and cocaine use has been gathering force in the USA. Availability and use of illicit fentanyls are still the major drivers of overdose deaths and the current rise in stimulant-related deaths appears entwined with the ongoing opioid epidemic.
Collapse
Affiliation(s)
- Daniel Ciccarone
- Department of Family and Community Medicine, University of California, San Francisco, California, USA
| |
Collapse
|
64
|
Affiliation(s)
- Ned H Kalin
- Department of Psychiatry, University of Wisconsin School of Medicine and Public Health, Madison
| |
Collapse
|
65
|
[Consequences of the COVID-19 pandemic for people with schizophrenia, dementia and substance use disorders]. DER NERVENARZT 2021; 92:571-578. [PMID: 33779773 PMCID: PMC8006113 DOI: 10.1007/s00115-021-01105-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Accepted: 02/23/2021] [Indexed: 01/10/2023]
Abstract
Die COVID-19(„coronavirus disease 2019“)-Pandemie stellt die Sozial- und Gesundheitssysteme weltweit vor unerwartete Herausforderungen. Die direkten und indirekten medizinischen Folgen einer Infektion mit dem neuartigen Coronavirus bringen die Versorgungssysteme vielerorts an die Grenze ihrer Leistungsfähigkeit. Die neurotropen Effekte von COVID-19 können nicht nur neurologische, sondern auch psychische Akut- und Langzeitfolgen nach sich ziehen. Im psychiatrischen Kontext sind zusätzlich die psychischen und psychosozialen Folgen von Kontaktbeschränkungen und Lockdowns sowie die Auswirkungen täglicher medialer Berichterstattung auf Menschen mit psychischen Störungen zu berücksichtigen. In diesem Beitrag werden die Konsequenzen der COVID-19-Pandemie für Menschen mit psychischen Erkrankungen, insbesondere mit Schizophrenie, Demenz und Abhängigkeitserkrankungen, erörtert.
Collapse
|
66
|
Bejda G, Kułak-Bejda A, Waszkiewicz N, Krajewska-Kułak E. Type D Personality, Stress Level, Life Satisfaction, and Alcohol Dependence in Older Men. Front Psychiatry 2021; 12:712508. [PMID: 34707518 PMCID: PMC8542794 DOI: 10.3389/fpsyt.2021.712508] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/20/2021] [Accepted: 09/06/2021] [Indexed: 11/13/2022] Open
Abstract
Alcohol consumption among older adults is becoming an increasing public health problem due to the rapidly growing elderly population. There is a theory that Type D personality is positively correlated with alcohol dependence. The study aimed to assess the style of coping with stress, emotions and anxiety in elder men addicted to alcohol and the relationship between the above. The study included 170 men aged 60 years and older (mean age - 63 ± 3.1 years) addicted to alcohol staying in the Department of Alcohol Addiction Therapy for Men. They were tested with the questionnaire sheet and the following scales: Perceived Family Wealth (PFW), Family Affluence Scale (FAS), Cantril's Ladder of Life Scale, Satisfaction with Life Scale, Type D Personality Scale-14 (DS14), and the 10-item Perceived Stress Scale (PSS-10). The respondents' wealth on a scale of 1-5 points was assessed on avg. 3.1 ± 0.2. The above was confirmed by the results of the FAS scale study, where the respondents obtained an average of 3.9 ± 1.9 (min. 1, max. 8), which proves their average level of affluence. The evaluation of the satisfaction with life using Cantril's Ladder showed that the respondents were also satisfied with life on average (on average 5.5 ± 1.9). The assessment of life satisfaction using the Satisfaction with Life Scale (SWLS) scale allowed for the conclusion that the respondents were very dissatisfied with their lives (mean 17.2 ± 4.9). The evaluation of the measurement of perceived stress (PSS-10 scale) showed that the respondents obtained an average of 23.5 ± 3.7, and on the sten scale, a mean of 7.7 ± 0.98, which proves a high level of perceived stress. The study using the DS14 scale showed that the respondents were in the negative emotionality (NE) subscale - 17.4 ± 4.5 points, and in the HS scale - 16.2 ± 3.2, which proves that they can be classified as a Type D personality. The participants were very dissatisfied with their lives, with a high perceived stress and Type D personality.
Collapse
Affiliation(s)
- Grzegorz Bejda
- The School of Medical Science in Białystok, Białystok, Poland
| | | | | | | |
Collapse
|
67
|
Serebro M, Sobol-Goldberg S, Feingold D. From Enchantment to Disillusion: A Narrative Exploration of Cannabis Use Disorder Among Young Israeli Combat Veterans. Front Psychiatry 2021; 12:643618. [PMID: 34220568 PMCID: PMC8249726 DOI: 10.3389/fpsyt.2021.643618] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/18/2020] [Accepted: 05/24/2021] [Indexed: 11/13/2022] Open
Abstract
Introduction: Substance use is common among military personnel and war veterans, especially combat veterans. Despite substantially high prevalence of cannabis use and Cannabis Use Disorder (CUD) consistently reported among veterans, little is known about psychological factors which may underlie CUD among this population. Methods: In this study, we used narrative analysis in order to interpret retrospective in-depth interviews of combat veterans (N = 12) who were released from mandatory military duty during the past 5 years and currently qualified for a diagnosis of CUD. Participants were recruited from a larger quantitative study were eligible for participation if they screened positive for a diagnosis of CUD according to the Cannabis Use Disorder Identification Test- Revised (CUDIT-R) questionnaire. CUD diagnosis was validated in-person using the cannabis section of the Alcohol Use Disorder and Associated Disabilities Interview Schedule-5 (AUDADIS-5) interview protocol. All interviews were transcribed and coded using the content analysis procedure. Findings: Five main themes were extracted: (a) Traumatic events (b) Attitudes toward cannabis use (c) Combatant identity (d) The role of authority/father figures, and (e) Moral crisis. A meta-theme has been identified, "from enchantment to disillusion," representing a gradual psychological shift from a hopeful, highly motivated stance into the current state of mental rupture and moral injury, which are unsuccessfully compensated by excessive use of cannabis. Conclusions: This study shed light on the etiology of CUD among young combat veterans, highlighting the role of supposed self-medication for trauma and sense of betrayal.
Collapse
Affiliation(s)
- Miri Serebro
- MA Program, Psychology Department, Ariel University, Ariel, Israel
| | | | | |
Collapse
|
68
|
Matzopoulos R, Morlock R, Morlock A, Lerer B, Lerer L. Psychedelic Mushrooms in the USA: Knowledge, Patterns of Use, and Association With Health Outcomes. Front Psychiatry 2021; 12:780696. [PMID: 35046855 PMCID: PMC8761614 DOI: 10.3389/fpsyt.2021.780696] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/21/2021] [Accepted: 11/30/2021] [Indexed: 12/20/2022] Open
Abstract
Introduction: Popular media coverage of psychedelics use, growing research into this class of compounds for psychiatry and decriminalization initiatives, are transforming the public perception of psychedelics. However, little is known about levels of knowledge and psychedelic mushroom (PM) use among American adults. Methods: We examined PM use and various measures of health status, quality of life, and self-reported mental health outcome measures obtained through a national on-line, cross-sectional survey of adults with a demographic composition representative of the US adult population by region, gender, age, and race (weighted N = 251,297,495) from November 2020-March 2021. Results: General mental health and well-being were popular reasons for PM use (63.6%), although use for medically-diagnosed (31.8%) and self-diagnosed (19.0%) conditions was also common. PM users reported more depression and anxiety as reflected in higher GAD-7 and PHQ-9 scores. Factors predictive of PM use included being male [OR 1.54 95%CI 1.09-2.15] and having higher Charlson Comorbidity Index scores [OR 1.42; 95%CI 1.22-1.65]. Self-reported PM use was less likely among participants with health insurance [OR = 0.50 (0.35-0.72)], increased age [OR = 0.92 (0.90-0.93)] and, relative to those living in the west US census region, living in the northeast [OR = 0.27 (0.15-0.50)], midwest [OR = 0.34 (0.20-0.56)], and south [OR = 0.38 (0.26-0.55)]. Discussion and Conclusions: A significant number of Americans are already "self-medicating" with PM and as growing positive media coverage of psychedelics drives public interest in the health benefits of PM, this number will increase. The association between PM use and poor mental health requires further research to inform policy.
Collapse
Affiliation(s)
- Richard Matzopoulos
- Burden of Disease Research Unit, South African Medical Research Council, Cape Town, South Africa.,School of Public Health and Family Medicine, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
| | | | - Amy Morlock
- Acumen Health Research Institute, Ann Arbor, MI, United States
| | - Bernard Lerer
- Biological Psychiatry Laboratory and Hadassah BrainLabs, Hadassah - Hebrew University Medical Center, Jerusalem, Israel
| | - Leonard Lerer
- Back of the Yards Algae Sciences - Parow Entheobiosciences, Chicago, IL, United States
| |
Collapse
|
69
|
Evens R, Reiche S, Marek RM, Moon DU, Groß RE, Romanello A, Jalilzadeh Masah D, Scicchitano Böckheler M, Gutwinski S, Montag C, Mick I, Majić T. Psychedelic Experiences During the Early COVID-19 Pandemic: Findings From an International Online Survey. Front Psychiatry 2021; 12:732028. [PMID: 34803757 PMCID: PMC8599818 DOI: 10.3389/fpsyt.2021.732028] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/28/2021] [Accepted: 09/27/2021] [Indexed: 11/13/2022] Open
Abstract
Introduction: The current corona virus disease (COVID-19) pandemic has caused a serious global health crisis that has affected large parts of the public and private life worldwide, including the use of psychoactive substances. In this study, we investigated the effect of the COVID-19 pandemic on the use of serotonergic psychedelics, i.e., the settings in which people use psychedelics, the motives of usage, and the subjective quality of psychedelic experiences. Methods: The study was part of an international, cross-sectional, internet-based survey (N = 5,049) available in five languages (English, German, Spanish, Italian, and Korean) carried out during the early phase of the pandemic from April to August 2020. Participants were asked to retrospectively rate settings and motives of psychedelic substance use before the pandemic and in the last 4 weeks during the pandemic, as well as changes in psychedelic experiences. Results: Of n = 1,375 participants that reported the use psychedelics in 2019 or 2020, n = 642 (46.6%) also took psychedelics during the pandemic. During the pandemic, participants used psychedelics significantly less often in settings that were outside their home. Top motives to use psychedelics were comparable before and during the pandemic, but participants consumed less out of curiosity, to celebrate, or because friends took it, and more out of boredom. An increase in positively connoted, often pro-social experiences was observed. Two thirds of participants who used psychedelics during the pandemic claimed that psychedelics had helped them to deal better with the corona pandemic at least slightly. Discussion: Changes in setting and motives were mostly in line with restrictions caused by control measures to contain the spread of the virus. The unexpected increase in positively connoted experiences possibly reflects a favorable interaction of environmental macro- and individual micro-contexts during the pandemic (e.g., by reducing the use in more uncontrolled recreational settings or by encouraging a strong self-selection of substance users due to the expectation of "bad trips"). Increased pro-social feelings under psychedelics might reflect a desire for social interactions in times of social distancing and pandemic-related stress and anxiety.
Collapse
Affiliation(s)
- Ricarda Evens
- Research Group Psychotropic Substances, Psychiatric University Clinic at Hospital St. Hedwig
- CCM, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany.,Department of Psychiatry and Neurosciences
- CCM, Berlin Institute of Health, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
| | - Simon Reiche
- Research Group Psychotropic Substances, Psychiatric University Clinic at Hospital St. Hedwig
- CCM, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
| | - Roman M Marek
- Research Group Psychotropic Substances, Psychiatric University Clinic at Hospital St. Hedwig
- CCM, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany.,Interdisciplinary Research Group "The Future of Medicine: Good Health for All," Berlin-Brandenburg Academy of Sciences and Humanities, Berlin, Germany.,German Rheumatism Research Centre Berlin (DRFZ), Berlin, Germany
| | - Daa Un Moon
- Department of Psychiatry and Neurosciences
- CCM, Berlin Institute of Health, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
| | - Rosa Elisa Groß
- Department of Psychiatry and Neurosciences
- CCM, Berlin Institute of Health, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
| | - Amy Romanello
- Research Group Psychotropic Substances, Psychiatric University Clinic at Hospital St. Hedwig
- CCM, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany.,Department of Psychiatry and Neurosciences
- CCM, Berlin Institute of Health, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany.,Berlin School of Mind and Brain, Humboldt-Universität zu Berlin, Berlin, Germany
| | - Dario Jalilzadeh Masah
- Department of Psychiatry and Neurosciences
- CCM, Berlin Institute of Health, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
| | - Matteo Scicchitano Böckheler
- Department of Psychiatry and Neurosciences
- CCM, Berlin Institute of Health, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
| | - Stefan Gutwinski
- Research Group Psychotropic Substances, Psychiatric University Clinic at Hospital St. Hedwig
- CCM, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany.,Department of Psychiatry and Neurosciences
- CCM, Berlin Institute of Health, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
| | - Christiane Montag
- Department of Psychiatry and Neurosciences
- CCM, Berlin Institute of Health, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
| | - Inge Mick
- Research Group Psychotropic Substances, Psychiatric University Clinic at Hospital St. Hedwig
- CCM, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany.,Department of Psychiatry and Neurosciences
- CCM, Berlin Institute of Health, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
| | - Tomislav Majić
- Research Group Psychotropic Substances, Psychiatric University Clinic at Hospital St. Hedwig
- CCM, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany.,Department of Psychiatry and Neurosciences
- CCM, Berlin Institute of Health, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
| |
Collapse
|
70
|
Xu S, Park M, Kang UG, Choi JS, Koo JW. Problematic Use of Alcohol and Online Gaming as Coping Strategies During the COVID-19 Pandemic: A Mini Review. Front Psychiatry 2021; 12:685964. [PMID: 34194349 PMCID: PMC8236582 DOI: 10.3389/fpsyt.2021.685964] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/26/2021] [Accepted: 05/17/2021] [Indexed: 12/14/2022] Open
Abstract
The COVID-19 (coronavirus disease 2019) pandemic has dramatically changed our daily lives and activities, including those originally intended to serve for leisure and pleasure. Drinking and online gaming became coping behaviors used to rescue ourselves from the stress and restricted lifestyle during the COVID-19 pandemic. However, frequent drinking and gaming can result in the pathological consequences of addiction. Those affected use the stimuli not to obtain pleasure, but rather to avoid the displeasure induced by stress and previous use, often unsuccessfully. This review aims to provide an overview of recent longitudinal cohort studies on alcohol and gaming use during the COVID-19 pandemic, as well as to analyze how the pandemic has affected alcohol and gaming use. There was a substantial risk of alcohol and online gaming overuse during the lockdown, which may depend on the pandemic's duration or overuse patterns. Previous studies have shown that increased alcohol consumption and online gaming are associated with heightened stress and anxiety levels caused by social isolation/quarantine. Over time, frequent or excessive alcohol consumption and gaming could lead to an increased risk of more serious mental health problems. Every effort should be made to mitigate mental health problems and ensure adequate adaptation to these exceptional circumstances. Therefore, it would be helpful to encourage physical activity, social interaction, and collaboration to facilitate psychological and physical health.
Collapse
Affiliation(s)
- Shijie Xu
- Medical Research Center, Hainan Cancer Hospital, Haikou, China.,Institute of Human Behavioral Medicine, Medical Research Center, Seoul National University, Seoul, South Korea.,Biomedical Research Institute, Seoul National University Hospital, Seoul, South Korea
| | - Minkyung Park
- Department of Psychiatry, SMG-SNU Boramae Medical Center, Seoul, South Korea
| | - Ung Gu Kang
- Institute of Human Behavioral Medicine, Medical Research Center, Seoul National University, Seoul, South Korea.,Department of Psychiatry and Behavioral Science, Seoul National University College of Medicine, Seoul, South Korea
| | - Jung-Seok Choi
- Department of Psychiatry, SMG-SNU Boramae Medical Center, Seoul, South Korea.,Department of Psychiatry and Behavioral Science, Seoul National University College of Medicine, Seoul, South Korea
| | - Ja Wook Koo
- Emotion, Cognition and Behavior Research Group, Korea Brain Research Institute, Daegu, South Korea.,Department of Brain and Cognitive Sciences, Daegu Gyeongbuk Institute of Science and Technology, Daegu, South Korea
| |
Collapse
|
71
|
Scherbaum N, Bonnet U, Hafermann H, Schifano F, Bender S, Grigoleit T, Kuhn J, Nyhuis P, Preuss UW, Reymann G, Schneider U, Shibata J, Specka M. Availability of Illegal Drugs During the COVID-19 Pandemic in Western Germany. Front Psychiatry 2021; 12:648273. [PMID: 33967857 PMCID: PMC8102785 DOI: 10.3389/fpsyt.2021.648273] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/31/2020] [Accepted: 03/04/2021] [Indexed: 12/11/2022] Open
Abstract
Background: In response to the COVID-19-pandemic, a lockdown was established in the middle of March 2020 by the German Federal Government resulting in drastic reduction of private and professional traveling in and out of Germany with a reduction of social contacts in public areas. Research Questions: We seek evidence on whether the lockdown has led to a reduced availability of illegal drugs and whether subjects with substance-related problems tried to cope with possible drug availability issues by increasingly obtaining drugs via the internet, replacing their preferred illegal drug with novel psychoactive substances, including new synthetic opioids (NSO), and/or by seeking drug treatment. Methods: A questionnaire was anonymously filled in by subjects with substance-related disorders, typically attending low-threshold settings, drug consumption facilities, and inpatient detoxification wards from a range of locations in the Western part of Germany. Participants had to both identify their main drug of abuse and to answer questions regarding its availability, price, quality, and routes of acquisition. Results: Data were obtained from 362 participants. The most frequent main substances of abuse were cannabis (n = 109), heroin (n = 103), and cocaine (n = 75). A minority of participants reported decreased availability (8.4%), increased price (14.4%), or decreased quality (28.3%) of their main drug. About 81% reported no change in their drug consumption due to the COVID-19 pandemic and the lockdown. A shift to the use of novel psychoactive substances including NSO were reported only by single subjects. Only 1-2% of the participants obtained their main drug via the web. Discussion: Present findings may suggest that recent pandemic-related imposed restrictions may have not been able to substantially influence either acquisition or consumption of drugs within the context of polydrug users (including opiates) attending a range of addiction services in Germany.
Collapse
Affiliation(s)
- Norbert Scherbaum
- Department of Psychiatry and Psychotherapy, Medical Faculty, LVR-Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Udo Bonnet
- Department of Psychiatry and Psychotherapy, Medical Faculty, LVR-Hospital Essen, University of Duisburg-Essen, Essen, Germany.,Klinik für Psychiatrie, Psychotherapie und Psychosomatische Medizin, Evangelisches Krankenhaus Castrop-Rauxel, Castrop-Rauxel, Germany
| | - Henning Hafermann
- Department of Psychiatry and Psychotherapy, Medical Faculty, LVR-Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Fabrizio Schifano
- Psychopharmacology, Substance Misuse and Novel Psychoactive Substances Research Unit, University of Hertfordshire, Hatfield, United Kingdom
| | - Stefan Bender
- Klinik für Psychiatrie und Psychotherapie, LWL-Klinik Marsberg, Marsberg, Germany
| | - Torsten Grigoleit
- Abteilung für Abhängigkeitserkrankungen, LVR-Klinik Langenfeld, Langenfeld, Germany
| | - Jens Kuhn
- Klinik für Psychiatrie, Psychotherapie und Psychosomatik, Johanniter Krankenhaus Oberhausen, Oberhausen, Germany.,Department of Psychiatry and Psychotherapy, University of Cologne, Cologne, Germany
| | - Peter Nyhuis
- Klinik für Psychiatrie, Psychotherapie und Psychosomatik, St. Marien Hospital Eickel, Herne, Germany
| | - Ulrich W Preuss
- Vitos-Klinik für Psychiatrie und Psychotherapie, Herborn, Germany
| | | | - Udo Schneider
- Medizinisches Zentrum für Seelische Gesundheit, Krankenhaus Lübbecke-Rahden, Lübbecke, Germany
| | - Jo Shibata
- Substitution Outpatient Clinic, Health Department of the City of Cologne, Cologne, Germany
| | - Michael Specka
- Department of Psychiatry and Psychotherapy, Medical Faculty, LVR-Hospital Essen, University of Duisburg-Essen, Essen, Germany
| |
Collapse
|
72
|
Alcohol. Alcohol 2021. [DOI: 10.1016/b978-0-12-816793-9.00001-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
|
73
|
Gonçalves PD, Moura HF, do Amaral RA, Castaldelli-Maia JM, Malbergier A. Alcohol Use and COVID-19: Can we Predict the Impact of the Pandemic on Alcohol Use Based on the Previous Crises in the 21st Century? A Brief Review. Front Psychiatry 2020; 11:581113. [PMID: 33391048 PMCID: PMC7775307 DOI: 10.3389/fpsyt.2020.581113] [Citation(s) in RCA: 46] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/07/2020] [Accepted: 11/23/2020] [Indexed: 01/23/2023] Open
Abstract
The enormous health and economic challenges precipitated by the 2019 coronavirus disease (COVID-19) pandemic are comparable or even greater than those associated with previous historical world crises. Alcohol use, especially drinking to cope with stress, is a concern, as an increase in its sales has been reported in some countries during the quarantine. This study aims to provide a better understanding of what to expect in terms of alcohol consumption, risk factors for excessive use, and its potential consequences during this pandemic based on previous experiences. We investigated how traumatic events related to alcohol consumption. Studies on mass traumatic events (i.e., terrorism as 9/11), epidemic outbreaks (i.e., severe acute respiratory syndrome [SARS] in 2003), economic crises (such as 2008's Great Recession), and COVID-19 were selected. The main keywords used to select the studies were alcohol use, drinking patterns, alcohol use disorders, and alcohol-related consequences. Previous studies reported increases in alcohol use associated with those events mediated, at least partially, by anxiety and depressive symptoms, and posttraumatic stress disorder (PTSD). Being male, young, and single also seems to be associated with a higher vulnerability to develop risky drinking behavior after those tragic events. The discussion of previous risk and protective factors can contribute to elaborate more specific public health policies to mitigate the impact of the current pandemic on people's mental health, especially alcohol-related problems.
Collapse
Affiliation(s)
- Priscila Dib Gonçalves
- Department of Psychiatry, Medical School of University of São Paulo (USP), São Paulo, Brazil
| | - Helena Ferreira Moura
- Department of Psychiatry, Universidade Federal do Rio Grande do Sul (UFRGS), Faculty of Medicine, Porto Alegre, Brazil
| | | | - João Maurício Castaldelli-Maia
- Department of Psychiatry, Medical School of University of São Paulo (USP), São Paulo, Brazil
- Department of Neuroscience, ABC Health University Center, Santo André, Brazil
| | - André Malbergier
- Department of Psychiatry, Medical School of University of São Paulo (USP), São Paulo, Brazil
| |
Collapse
|
74
|
Affiliation(s)
- Ned H Kalin
- Department of Psychiatry, University of Wisconsin School of Medicine and Public Health, Madison
| |
Collapse
|