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Venkatesh SK, Stangl BL, Yan J, Quijano Cardé NA, Stein EA, Diazgranados N, Schwandt ML, Sun H, Momenan R, Goldman D, De Biasi M, Ramchandani VA. Smoking-Related Increases in Alcohol Outcomes and Preliminary Evidence for the Protective Effect of a Functional Nicotine Receptor Gene (CHRNA5) Variant on Alcohol Consumption in Individuals Without Alcohol Use Disorder. Int J Neuropsychopharmacol 2024; 27:pyae035. [PMID: 39208422 PMCID: PMC11450629 DOI: 10.1093/ijnp/pyae035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/09/2024] [Accepted: 08/28/2024] [Indexed: 09/04/2024] Open
Abstract
BACKGROUND Alcohol and nicotine interact with the nicotinic acetylcholine receptor system to alter reward-related responses, thereby contributing to the co-use and misuse of these drugs. A missense polymorphism rs16969968 (G>A) in the CHRNA5 gene has shown a strong association with nicotine-related phenotypes. However, less is known about the impact of this variant on alcohol-related phenotypes. METHODS We assessed the main and interactive effect of smoking and rs16969968 polymorphism on alcohol consumption using the Alcohol Use Disorders Identification Test (AUDIT), Timeline Follow Back (TLFB), and Lifetime Drinking History (LDH) in 980 healthy adults without alcohol use disorder. We further examined the effect of the rs16969968 polymorphism on acute alcohol consumption using a free-access i.v. alcohol self-administration (IV-ASA) human laboratory paradigm in a subset of 153 nonsmoking participants. Subjective alcohol responses, alcohol sensitivity, and expectancy measures were compared between genotype groups (GG; AA/AG). RESULTS We observed a significant association of smoking with AUDIT, TLFB, and LDH measures across genotype groups, with smokers showing higher scores compared with nonsmokers. Additionally, we found an association between genotype and TLFB-total drinks in the IV-ASA subset, with the GG group showing higher scores than AA/AG group. Relatedly, the alcohol negative expectancy score was significantly lower in the GG group than the AA/AG group. CONCLUSIONS Our findings underscore the association of smoking with alcohol measures. We found preliminary evidence for the protective effect of the functional CHRNA5 polymorphism on alcohol consumption and its association with increased negative alcohol expectancies, which highlights the substantial heterogeneity in alcohol responses.
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Affiliation(s)
- Shyamala K Venkatesh
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
- Human Psychopharmacology Laboratory, National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health, Bethesda, Maryland, USA
| | - Bethany L Stangl
- Human Psychopharmacology Laboratory, National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health, Bethesda, Maryland, USA
| | - Jia Yan
- Human Psychopharmacology Laboratory, National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health, Bethesda, Maryland, USA
| | - Natalia A Quijano Cardé
- Pharmacology Graduate Group, Biomedical Graduate Studies, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Elliot A Stein
- Intramural Research Program, National Institute on Drug Abuse, National Institutes of Health, Baltimore, Maryland, USA
| | - Nancy Diazgranados
- Office of the Clinical Director, National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health, Bethesda, Maryland, USA
| | - Melanie L Schwandt
- Office of the Clinical Director, National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health, Bethesda, Maryland, USA
| | - Hui Sun
- Laboratory of Neurogenetics, National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health, Bethesda, Maryland, USA
| | - Reza Momenan
- Clinical Neuroimaging Research Core, National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health, Bethesda, Maryland, USA
| | - David Goldman
- Laboratory of Neurogenetics, National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health, Bethesda, Maryland, USA
- Office of the Clinical Director, National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health, Bethesda, Maryland, USA
| | - Mariella De Biasi
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Vijay A Ramchandani
- Human Psychopharmacology Laboratory, National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health, Bethesda, Maryland, USA
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Pengpid S, Peltzer K. Tobacco use and heavy episodic drinking among persons aged 18-69 years in Bolivia in 2019. Public Health 2024; 233:8-14. [PMID: 38810508 DOI: 10.1016/j.puhe.2024.04.037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2024] [Revised: 04/01/2024] [Accepted: 04/29/2024] [Indexed: 05/31/2024]
Abstract
OBJECTIVES The aim of this study was to estimate the prevalence and sociodemographic factors associated with tobacco use and heavy episodic drinking (TUHED), current tobacco use only (TU), and current heavy episodic drinking only (HED) among people 18-69 years in Bolivia in 2019. STUDY DESIGN Cross-sectional study. METHODS The analysis used cross-sectional data from Bolivia's STEPS 2019 survey; 4472 individuals answered questions about substance use and socio-demographic information. RESULTS The sample included 50.2% women and 49.8% men, 52.1% had secondary or higher education, 48.6% were Mestizo and 28.0% Quechua. The prevalence of TUHD was 6.0% (10.5% for men, 1.6% for women), TU 12.2% (20.0% for men, 4.4% for women), and HED 11.2% (13.4% for men and 9.1% for women). Male sex increased the risk of TU, HED and TUHED and belonging to the Amara ethnic group decreased the risk of TU and TUHED. Higher education was increased the odds of HED and among women of TUHED. Urban residence increased the risk of TUHED and among women of HED. For women, unemployment was associated with TU and marriage or cohabitation was inversely associated with TU, and for men, belonging to another ethnic group (such as Castellano or Tacana) increased the risk of TU and TUHED. CONCLUSION More than 10% of the general adult population in Bolivia participated in TU and HED, and among men in TUHED. Various factors associated with the different categories of substance use were identified.
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Affiliation(s)
- Supa Pengpid
- Department of Health Education and Behavioral Sciences, Faculty of Public Health, Mahidol University, Bangkok, Thailand; Department of Public Health, Sefako Makgatho Health Sciences University, Pretoria, South Africa; Department of Healthcare Administration, College of Medical and Health Science, Asia University, Taichung, Taiwan
| | - Karl Peltzer
- Department of Health Education and Behavioral Sciences, Faculty of Public Health, Mahidol University, Bangkok, Thailand; Department of Psychology, University of the Free State, Bloemfontein, South Africa; Department of Psychology, College of Medical and Health Science, Asia University, Taichung, Taiwan.
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Li H, Zhu L, Zhang J, Xue J. Prevalence, sociodemographic, and clinical correlates of underweight in a sample of Chinese male alcohol-dependent patients. Alcohol Alcohol 2024; 59:agae033. [PMID: 38773873 DOI: 10.1093/alcalc/agae033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2023] [Revised: 03/22/2024] [Accepted: 05/09/2024] [Indexed: 05/24/2024] Open
Abstract
BACKGROUND Underweight is a significant symptom in alcohol-dependent patients, yet few studies have examined underweight in Chinese male patients. The current study aimed to identify the prevalence, sociodemographic, and clinical correlates of underweight in Chinese male patients with alcohol dependency. METHODS In this cross-sectional study, 405 male inpatients with alcohol dependence and 383 healthy male controls were recruited. Participants' demographic and clinical data, including anthropometric data, were collected. We first conducted univariate analysis to identify seven variables with significant differences between groups: smoking behavior, hospitalization, alcohol consumption, cerebral infarction, hypertension, Hamilton Depression Scale (HAMD) score, and Scale for Assessment of Negative Symptom (SANS) score. Then, binary logistic regression was used to assess their relationship with underweight, with a significance level of .05. RESULTS The prevalence of underweight was significantly higher in the study population than in the control group (2.99% vs. 2.87%; P < .001). Patients with underweight had significantly higher rates of smoking behavior and cerebral infarction, as well as higher scores of SANS and HAMD than non-underweight patients. The non-underweight patients had higher daily alcohol consumption and times of hospitalization. Furthermore, logistic regression analysis showed that smoking behavior [odds ratio (OR) = 2.84, 95% confidence interval (CI) = 1.03-7.80, P = .043)], cerebral infarction (OR = 5.20, 95% CI = 1.13-23.85, P = .036), SANS score (OR = 1.22, 95% CI = 1.16-1.28, P < .001), and HAMD score (OR = 1.06, 95% CI = 1.02-1.11, P = .005) were associated with underweight. CONCLUSIONS More than 20% of male alcohol-dependent patients in a Chinese sample were underweight. Some demographic and clinical variables independent correlates for underweight in alcohol-dependent patients. We need to focus on alcohol-dependent patients with smoking, cerebral infarction, depression, and more prominent negative symptoms.
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Affiliation(s)
- Huanfen Li
- Department of Pharmacy, The Second Affiliated Hospital of Xinxiang Medical University, 207 Qianjin Road, Xinxiang MI453002, Henan, China
| | - Lifang Zhu
- Department of Pharmacy, The Second Affiliated Hospital of Xinxiang Medical University, 207 Qianjin Road, Xinxiang MI453002, Henan, China
| | - Jie Zhang
- Department of Addiction, The Second Affiliated Hospital of Xinxiang Medical University, 207 Qianjin Road, Xinxiang MI453002, Henan, China
| | - Jun Xue
- Department of Social Affairs, Henan Normal University, 46 Jianshe Road E, Xinxiang MI453007, Henan, China
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Vanlerberghe BTK, van Malenstein H, Sainz-Barriga M, Jochmans I, Cassiman D, Monbaliu D, van der Merwe S, Pirenne J, Nevens F, Verbeek J. Tacrolimus Drug Exposure Level and Smoking Are Modifiable Risk Factors for Early De Novo Malignancy After Liver Transplantation for Alcohol-Related Liver Disease. Transpl Int 2024; 37:12055. [PMID: 38440132 PMCID: PMC10909820 DOI: 10.3389/ti.2024.12055] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2023] [Accepted: 02/07/2024] [Indexed: 03/06/2024]
Abstract
De novo malignancy (DNM) is the primary cause of mortality after liver transplantation (LT) for alcohol-related liver disease (ALD). However, data on risk factors for DNM development after LT are limited, specifically in patients with ALD. Therefore, we retrospectively analyzed all patients transplanted for ALD at our center before October 2016. Patients with a post-LT follow-up of <12 months, DNM within 12 months after LT, patients not on tacrolimus in the 1st year post-LT, and unknown smoking habits were excluded. Tacrolimus drug exposure level (TDEL) was calculated by area under the curve of trough levels in the 1st year post-LT. 174 patients received tacrolimus of which 19 (10.9%) patients developed a DNM between 12 and 60 months post-LT. Multivariate cox regression analysis identified TDEL [HR: 1.710 (1.211-2.414); p = 0.002], age [1.158 (1.076-1.246); p < 0.001], number of pack years pre-LT [HR: 1.021 (1.004-1.038); p = 0.014] and active smoking at LT [HR: 3.056 (1.072-8.715); p = 0.037] as independent risk factors for DNM. Tacrolimus dose minimization in the 1st year after LT and smoking cessation before LT might lower DNM risk in patients transplanted for ALD.
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Affiliation(s)
- Benedict T. K. Vanlerberghe
- Department of Gastroenterology and Hepatology, University Hospitals Leuven, Leuven, Belgium
- Laboratory of Hepatology, Department of Chronic Diseases and Metabolism (CHROMETA), KU Leuven, Leuven, Belgium
- Department of Internal Medicine, Division of Gastroenterology and Hepatology, Maastricht University Medical Centre, Maastricht, Netherlands
- School of Nutrition and Translational Research in Metabolism (NUTRIM), University Maastricht, Maastricht, Netherlands
| | - Hannah van Malenstein
- Department of Gastroenterology and Hepatology, University Hospitals Leuven, Leuven, Belgium
- Laboratory of Hepatology, Department of Chronic Diseases and Metabolism (CHROMETA), KU Leuven, Leuven, Belgium
| | - Mauricio Sainz-Barriga
- Transplantation Research Group, Department of Microbiology, and Transplantation, Laboratory of Abdominal Transplantation, KU Leuven, University of Leuven, Leuven, Belgium
- Department of Abdominal Transplant Surgery, University Hospitals Leuven, Leuven, Belgium
| | - Ina Jochmans
- Transplantation Research Group, Department of Microbiology, and Transplantation, Laboratory of Abdominal Transplantation, KU Leuven, University of Leuven, Leuven, Belgium
- Department of Abdominal Transplant Surgery, University Hospitals Leuven, Leuven, Belgium
| | - David Cassiman
- Department of Gastroenterology and Hepatology, University Hospitals Leuven, Leuven, Belgium
- Laboratory of Hepatology, Department of Chronic Diseases and Metabolism (CHROMETA), KU Leuven, Leuven, Belgium
| | - Diethard Monbaliu
- Transplantation Research Group, Department of Microbiology, and Transplantation, Laboratory of Abdominal Transplantation, KU Leuven, University of Leuven, Leuven, Belgium
- Department of Abdominal Transplant Surgery, University Hospitals Leuven, Leuven, Belgium
| | - Schalk van der Merwe
- Department of Gastroenterology and Hepatology, University Hospitals Leuven, Leuven, Belgium
- Laboratory of Hepatology, Department of Chronic Diseases and Metabolism (CHROMETA), KU Leuven, Leuven, Belgium
| | - Jacques Pirenne
- Transplantation Research Group, Department of Microbiology, and Transplantation, Laboratory of Abdominal Transplantation, KU Leuven, University of Leuven, Leuven, Belgium
- Department of Abdominal Transplant Surgery, University Hospitals Leuven, Leuven, Belgium
| | - Frederik Nevens
- Department of Gastroenterology and Hepatology, University Hospitals Leuven, Leuven, Belgium
- Laboratory of Hepatology, Department of Chronic Diseases and Metabolism (CHROMETA), KU Leuven, Leuven, Belgium
| | - Jef Verbeek
- Department of Gastroenterology and Hepatology, University Hospitals Leuven, Leuven, Belgium
- Laboratory of Hepatology, Department of Chronic Diseases and Metabolism (CHROMETA), KU Leuven, Leuven, Belgium
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Cano MT, Reavis JV, Pennington DL. Perceived discrimination enhances the association between distress and impact related to the murder of George Floyd and unhealthy alcohol use in a survey sample of U.S. Veterans who report drinking. Addict Behav Rep 2023; 17:100481. [PMID: 36713472 PMCID: PMC9876779 DOI: 10.1016/j.abrep.2023.100481] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2022] [Revised: 12/16/2022] [Accepted: 01/14/2023] [Indexed: 01/18/2023] Open
Abstract
Introduction On May 25, 2020, George Floyd was murdered by a Minneapolis police officer leading to increased social justice and antiracism movements (SJARM) across the United States. Vicarious exposure to racism and perceived discrimination are salient sources of distress which may lead to increased alcohol use as means of coping. The primary aim of the current study was to examine how perceived discrimination and the subjective impact and personal distress related to the SJARM following the George Floyd murder interact and relate to unhealthy alcohol use among U.S. Veterans. Methods 286 Veterans were assessed for unhealthy alcohol use (AUDIT-10), perceived discrimination (EDS), and subjective impact and personal distress related to the SJARM. Two moderation analyses were performed to examine whether subjective impact and personal distress moderated relations between perceived discrimination and alcohol use. In-depth follow-up analyses were conducted to examine differences and relationships among variables. Results In two different moderation models, perceived discrimination moderated the association between both subjective impact (p <.001) and personal distress (p <.001) felt by the SJARM and unhealthy alcohol use. In planned exploratory analyses, Veterans who reported perceived discrimination reported higher levels of unhealthy alcohol use (M = 14.71, SD = 9.39) than those who did not t(2 8 4) = 5.61, p <.001. In post-hoc analyses, racial/ethnic minorities were significantly more likely to report perceived racial discrimination (p <.001) while non-Hispanic Whites were more likely to report perceived discrimination based on education or income level (p <.01). Conclusions In the context of a socially unjust event amidst a global pandemic, perceived discrimination contributes to unhealthy alcohol use and subjective impact and personal distress associated with the SJARM following the murder of George Floyd. Results highlight the importance of addressing discrimination experiences in Veterans who seek alcohol treatment, particularly as rates of unhealthy alcohol use are on the rise.
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Affiliation(s)
- Monique T. Cano
- Department of Psychiatry and Behavioral Sciences, University of California, San Francisco, San Francisco, CA 94143, United States
- San Francisco VA Health Care System, San Francisco, CA 94121, United States
| | - Jill V. Reavis
- Department of Psychiatry and Behavioral Sciences, University of California, San Francisco, San Francisco, CA 94143, United States
- San Francisco VA Health Care System, San Francisco, CA 94121, United States
- Palo Alto University, Palo Alto, CA 94304, United States
| | - David L. Pennington
- Department of Psychiatry and Behavioral Sciences, University of California, San Francisco, San Francisco, CA 94143, United States
- San Francisco VA Health Care System, San Francisco, CA 94121, United States
- Northern California Institute for Research and Education (NCIRE), San Francisco, CA 94121, United States
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Siegel SD, Tindle HA, Bergen AW, Tyndale RF, Schnoll R. The Use of Biomarkers to Guide Precision Treatment for Tobacco Use. ADDICTION NEUROSCIENCE 2023; 6. [PMID: 37089247 PMCID: PMC10121195 DOI: 10.1016/j.addicn.2023.100076] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/18/2023]
Abstract
This review summarizes the evidence to date on the development of biomarkers for personalizing the pharmacological treatment of combustible tobacco use. First, the latest evidence on FDA-approved medications is considered, demonstrating that, while these medications offer real benefits, they do not contribute to smoking cessation in approximately two-thirds of cases. Second, the case for using biomarkers to guide tobacco treatment is made based on the potential to increase medication effectiveness and uptake and reduce side effects. Next, the FDA framework of biomarker development is presented along with the state of science on biomarkers for tobacco treatment, including a review of the nicotine metabolite ratio, electroencephalographic event-related potentials, and other biomarkers utilized for risk feedback. We conclude with a discussion of the challenges and opportunities for the translation of biomarkers to guide tobacco treatment and propose priorities for future research.
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Yokoyama A, Kimura M, Yoshimura A, Matsushita S, Yoneda J, Maesato H, Komoto Y, Nakayama H, Sakuma H, Yumoto Y, Takimura T, Toyama T, Iwahara C, Mizukami T, Yokoyama T, Higuchi S. Nonsmoking after simultaneous alcohol abstinence and smoking cessation program was associated with better drinking status outcome in Japanese alcohol-dependent men: A prospective follow-up study. PLoS One 2023; 18:e0282992. [PMID: 36989266 PMCID: PMC10057780 DOI: 10.1371/journal.pone.0282992] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2022] [Accepted: 03/01/2023] [Indexed: 03/30/2023] Open
Abstract
BACKGROUND Growing evidence suggests that intervention for smoking cessation enhances alcohol abstinence in treatment settings for alcohol dependence. However, research in this field is rare in Asians. METHOD We prospectively investigated the association of smoking status with drinking status using 9 surveys mailed during a 12-month period in 198 Japanese alcohol-dependent men (70 never/ex-smokers and 128 smokers) who admitted for the first time and completed a 3-month inpatient program for simultaneous alcohol abstinence and smoking cessation. RESULTS Nonsmoking during the first month after discharge and at the end of follow-up was reported in 28.9% and 25.0% of the baseline smokers, respectively. Kaplan-Meier estimates showed that a 12-month alcohol abstinence and heavy-drinking-free status were more frequent among never/ex-smokers (45.1% and 59.8%, respectively) and baseline smokers who quit smoking during the first month after discharge (59.0% and 60.8%, respectively), compared with sustained smokers (30.0% and 41.2%, respectively). Among the baseline smokers, the multivariate odds ratio (95% confidence interval) for smoking cessation during the first month were 2.77 (1.01-7.61) for alcohol abstinence during the period and 2.50 (1.00-6.25) for use of varenicline, a smoking cessation agent, during the inpatient program. After adjusting for age, drinking profile, lifestyle, family history of heavy or problem drinking, lifetime episodes of other major psychiatric disorders, and medications at discharge, the multivariate hazard ratios (HRs) for drinking lapse were 0.57 (0.37-0.89) for the never/ex-smoking and 0.41 (0.23-0.75) for new smoking cessation groups, respectively, compared with sustained smoking, while the corresponding HRs for heavy-drinking lapse were 0.55 (0.33-0.90) and 0.47 (0.25-0.88), respectively. The HR for drinking lapse was 0.63 (0.42-0.95) for the nonsmoking group (vs. smoking) during the observation period, while the HR for heavy-drinking lapse was 0.58 (0.37-0.91) for the nonsmoking group (vs. smoking) during the observation period. Other significant variables that worsened drinking outcomes were higher daily alcohol intake prior to hospitalization, family history of heavy or problem drinking and psychiatric medications at discharge. CONCLUSION Nonsmoking was associated with better outcomes on the drinking status of Japanese alcohol-dependent men, and a smoking cessation program may be recommended to be integrated into alcohol abstinence programs.
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Affiliation(s)
- Akira Yokoyama
- National Hospital Organization Kurihama Medical and Addiction Center, Yokosuka, Kanagawa, Japan
| | - Mitsuru Kimura
- National Hospital Organization Kurihama Medical and Addiction Center, Yokosuka, Kanagawa, Japan
| | - Atsushi Yoshimura
- Division of Psychiatry, Tohoku Medical and Pharmaceutical University, Sendai, Miyagi, Japan
| | - Sachio Matsushita
- National Hospital Organization Kurihama Medical and Addiction Center, Yokosuka, Kanagawa, Japan
| | - Junichi Yoneda
- National Hospital Organization Kurihama Medical and Addiction Center, Yokosuka, Kanagawa, Japan
| | - Hitoshi Maesato
- National Hospital Organization Kurihama Medical and Addiction Center, Yokosuka, Kanagawa, Japan
| | - Yasunobu Komoto
- Department of Psychiatry, Yoshino Hospital, Machida, Tokyo, Japan
| | - Hideki Nakayama
- Department of Psychiatry, Asahiyama Hospital, Sapporo, Hokkaido, Japan
| | - Hiroshi Sakuma
- Department of Psychiatry, National Hospital Organization Saigata Medical Center, Joetsu, Niigata, Japan
| | - Yosuke Yumoto
- National Hospital Organization Kurihama Medical and Addiction Center, Yokosuka, Kanagawa, Japan
| | - Tsuyoshi Takimura
- National Hospital Organization Kurihama Medical and Addiction Center, Yokosuka, Kanagawa, Japan
| | - Tomomi Toyama
- National Hospital Organization Kurihama Medical and Addiction Center, Yokosuka, Kanagawa, Japan
| | - Chie Iwahara
- Department of Psychiatry, Hakuhou Clinic, Saitama, Saitama, Japan
| | - Takeshi Mizukami
- National Hospital Organization Kurihama Medical and Addiction Center, Yokosuka, Kanagawa, Japan
| | - Tetsuji Yokoyama
- Department of Health Promotion, National Institute of Public Health, Wako, Saitama, Japan
| | - Susumu Higuchi
- National Hospital Organization Kurihama Medical and Addiction Center, Yokosuka, Kanagawa, Japan
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Barbería-Latasa M, Bes-Rastrollo M, Pérez-Araluce R, Martínez-González MÁ, Gea A. Mediterranean Alcohol-Drinking Patterns and All-Cause Mortality in Women More Than 55 Years Old and Men More Than 50 Years Old in the "Seguimiento Universidad de Navarra" (SUN) Cohort. Nutrients 2022; 14:nu14245310. [PMID: 36558468 PMCID: PMC9788476 DOI: 10.3390/nu14245310] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2022] [Revised: 12/11/2022] [Accepted: 12/12/2022] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND Most of the available epidemiological evidence on alcohol and chronic disease agrees on recommending alcohol abstention to young people, but some controversy exists about the most appropriate recommendation for alcohol abstention for people of older ages. A growing body of evidence suggests that the pattern of alcohol consumption is likely to be a strong effect modifier. The Mediterranean Alcohol Drinking Pattern (MADP) represents a score integrating several dimensions of drinking patterns (moderation, preference for red wine, drinking with meals, and avoiding binge drinking). Our aim was to clarify this issue and provide more precise recommendations on alcohol consumption. METHODS We prospectively followed-up 2226 participants (men older than 50 years and women older than 55 years at baseline) in the Seguimiento Universidad de Navarra (SUN) cohort. We classified participants into three categories of adherence to the MADP score (low, moderate, and high), and we added a fourth category for abstainers. Cox regression models estimated multivariable-adjusted hazard ratios (HR) of all-cause death and 95% confidence intervals (CI) using low MADP adherence as the reference category. RESULTS The strongest reduction in risk of mortality was observed for those with high adherence to the MADP, with an HR of 0.54 (95% CI: 0.37-0.80). The moderate adherence group (HR = 0.65, 95% CI: 0.44-0.96) and the abstention group (HR = 0.60, 95% CI: 0.36-0.98) also exhibited lower risks of mortality than the low MADP adherence group. CONCLUSIONS based on the available evidence, a public health message can be provided to people older than 50 years as follows: among those who drink alcohol, high adherence to the MADP score could substantially reduce their risk of all-cause mortality.
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Affiliation(s)
- María Barbería-Latasa
- Department of Preventive Medicine and Public Health, University of Navarra, 31008 Pamplona, Spain
- Instituto de Investigación Sanitaria de Navarra (IdiSNA), Navarra Institute for Health Research, 31008 Pamplona, Spain
| | - Maira Bes-Rastrollo
- Department of Preventive Medicine and Public Health, University of Navarra, 31008 Pamplona, Spain
- Instituto de Investigación Sanitaria de Navarra (IdiSNA), Navarra Institute for Health Research, 31008 Pamplona, Spain
- Biomedical Research Network Center for Pathophysiology of Obesity and Nutrition (CIBEROBN), Carlos III Health Institute, 28029 Madrid, Spain
| | - Rafael Pérez-Araluce
- Department of Preventive Medicine and Public Health, University of Navarra, 31008 Pamplona, Spain
- Instituto de Investigación Sanitaria de Navarra (IdiSNA), Navarra Institute for Health Research, 31008 Pamplona, Spain
| | - Miguel Ángel Martínez-González
- Department of Preventive Medicine and Public Health, University of Navarra, 31008 Pamplona, Spain
- Instituto de Investigación Sanitaria de Navarra (IdiSNA), Navarra Institute for Health Research, 31008 Pamplona, Spain
- Biomedical Research Network Center for Pathophysiology of Obesity and Nutrition (CIBEROBN), Carlos III Health Institute, 28029 Madrid, Spain
- Correspondence:
| | - Alfredo Gea
- Department of Preventive Medicine and Public Health, University of Navarra, 31008 Pamplona, Spain
- Instituto de Investigación Sanitaria de Navarra (IdiSNA), Navarra Institute for Health Research, 31008 Pamplona, Spain
- Biomedical Research Network Center for Pathophysiology of Obesity and Nutrition (CIBEROBN), Carlos III Health Institute, 28029 Madrid, Spain
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Caira-Chuquineyra B, Fernandez-Guzman D, Quispe-Vicuña C, Gutierrez-Rodriguez R, Valencia PD. Factors associated with alcohol abuse in the Peruvian population: analysis of a national health survey 2019. J Public Health (Oxf) 2022:6782834. [DOI: 10.1093/pubmed/fdac116] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2022] [Revised: 06/21/2022] [Indexed: 11/05/2022] Open
Abstract
Abstract
Aim
To evaluate the factors associated with alcohol abuse in the Peruvian population.
Methods
A secondary analysis was performed using data from the Demographic and Family Health Survey of Peru, 2019. We included 24 264 Peruvians between 18 and 59 years. For the analysis of association, the Poisson regression model with robust standard errors was used. Adjusted Prevalence Ratios (aPR) with their respective 95% confidence intervals (95% CI) were calculated.
Results
The prevalence of alcohol abuse was 5.2%. Having higher education (aPR:1.61; 95%CI:1.04–2.48), being widowed, separated or divorced (aPR:1.73; 95%CI:1.18–2.54), belonging to the third (aPR:1.70; 95%CI:1.12–2.60), fourth (aPR:2.08; 95%CI:1.33–3.23) or fifth socioeconomic quintile (aPR:2.16; 95%CI:1.33–3.50), being from the Sierra (aPR:1.45; 95%CI:1.12–1.87) or Selva (aPR:1.48; 95%CI:1.13–1.94), not having health insurance (aPR:1.25; 95%CI:1.04–1.50), being a current smoker (aPR:2.43; 95%CI:2.02–2.93) and having major depression (aPR:1.77; 95%CI:1.32–2.36) were associated with a higher prevalence of alcohol abuse. On the other hand being a middle-aged adult (aPR:0.73; 95%CI:0.60–0.88), female (aPR:0.16; 95%CI:0.12–0.22) and having started drinking alcohol after the age of 18 years (aPR:0.57; 95%CI:0.47–0.69) were associated with a lower prevalence.
Conclusions
One in 20 Peruvians between 18 and 59 years had alcohol abuse. Age, gender, education level, marital status, socioeconomic level, region, age of first drink, smoking and depression were associated with alcohol abuse.
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Affiliation(s)
- Brenda Caira-Chuquineyra
- Grupo Peruano de Investigación Epidemiológica, Unidad para la Generación y Síntesis de Evidencias en Salud, Universidad San Ignacio de Loyola , 15074 Lima , Peru
- Facultad de Medicina, Universidad Nacional de San Agustín de Arequipa , 04000 Arequipa , Peru
| | - Daniel Fernandez-Guzman
- Grupo Peruano de Investigación Epidemiológica, Unidad para la Generación y Síntesis de Evidencias en Salud, Universidad San Ignacio de Loyola , 15074 Lima , Peru
- Escuela Profesional de Medicina Humana, Universidad Nacional de San Antonio Abad del Cusco , 08000 Cusco , Peru
| | - Carlos Quispe-Vicuña
- Grupo Peruano de Investigación Epidemiológica, Unidad para la Generación y Síntesis de Evidencias en Salud, Universidad San Ignacio de Loyola , 15074 Lima , Peru
- Sociedad Científica San Fernando, Universidad Nacional Mayor de San Marcos , 15081 Lima , Peru
| | - Raysa Gutierrez-Rodriguez
- Escuela Profesional de Medicina Humana, Universidad Nacional de San Antonio Abad del Cusco , 08000 Cusco , Peru
| | - Pablo D Valencia
- Facultad de Estudios Superiores Iztacala, Universidad Nacional Autónoma de México , 04510 Mexico , Mexico
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10
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Castro-de-Araujo LFS, Cortes F, de Siqueira Filha NT, Rodrigues EDS, Machado DB, de Araujo JAP, Lewis G, Denaxas S, Barreto ML. Patterns of multimorbidity and some psychiatric disorders: A systematic review of the literature. Front Psychol 2022; 13:940978. [PMID: 36186392 PMCID: PMC9524392 DOI: 10.3389/fpsyg.2022.940978] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2022] [Accepted: 07/26/2022] [Indexed: 11/25/2022] Open
Abstract
Objective The presence of two or more chronic diseases results in worse clinical outcomes than expected by a simple combination of diseases. This synergistic effect is expected to be higher when combined with some conditions, depending on the number and severity of diseases. Multimorbidity is a relatively new term, with the first fundamental definitions appearing in 2015. Studies usually define it as the presence of at least two chronic medical illnesses. However, little is known regarding the relationship between mental disorders and other non-psychiatric chronic diseases. This review aims at investigating the association between some mental disorders and non-psychiatric diseases, and their pattern of association. Methods We performed a systematic approach to selecting papers that studied relationships between chronic conditions that included one mental disorder from 2015 to 2021. These were processed using Covidence, including quality assessment. Results This resulted in the inclusion of 26 papers in this study. It was found that there are strong associations between depression, psychosis, and multimorbidity, but recent studies that evaluated patterns of association of diseases (usually using clustering methods) had heterogeneous results. Quality assessment of the papers generally revealed low quality among the included studies. Conclusions There is evidence of an association between depressive disorders, anxiety disorders, and psychosis with multimorbidity. Studies that tried to examine the patterns of association between diseases did not find stable results. Systematic review registration https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42021216101, identifier: CRD42021216101.
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Affiliation(s)
- Luis Fernando Silva Castro-de-Araujo
- Center of Data and Knowledge Integration for Health (CIDACS), Fiocruz, Bahia, Brazil
- Department of Psychiatry, Austin Health, The University of Melbourne, Parkville, VIC, Australia
| | - Fanny Cortes
- Center of Data and Knowledge Integration for Health (CIDACS), Fiocruz, Bahia, Brazil
| | - Noêmia Teixeira de Siqueira Filha
- Center of Data and Knowledge Integration for Health (CIDACS), Fiocruz, Bahia, Brazil
- Department of Health Sciences, University of York, York, United Kingdom
| | - Elisângela da Silva Rodrigues
- Center of Data and Knowledge Integration for Health (CIDACS), Fiocruz, Bahia, Brazil
- Federal University of Ceará, Ceará, Brazil
| | - Daiane Borges Machado
- Center of Data and Knowledge Integration for Health (CIDACS), Fiocruz, Bahia, Brazil
- Department of Global Health and Social Medicine, Harvard Medical School, Boston, MA, United States
| | - Jacyra Azevedo Paiva de Araujo
- Center of Data and Knowledge Integration for Health (CIDACS), Fiocruz, Bahia, Brazil
- *Correspondence: Jacyra Azevedo Paiva de Araujo
| | - Glyn Lewis
- Division of Psychiatry, University College London, London, United Kingdom
| | - Spiros Denaxas
- Institute of Health Informatics, University College London, London, United Kingdom
| | - Mauricio L. Barreto
- Center of Data and Knowledge Integration for Health (CIDACS), Fiocruz, Bahia, Brazil
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11
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Caballero FF, Lana A, Struijk EA, Arias-Fernández L, Yévenes-Briones H, Cárdenas-Valladolid J, Salinero-Fort MÁ, Banegas JR, Rodríguez-Artalejo F, Lopez-Garcia E. Prospective Association Between Plasma Amino Acids And Multimorbidity In Older Adults. J Gerontol A Biol Sci Med Sci 2022; 78:637-644. [PMID: 35876753 DOI: 10.1093/gerona/glac144] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2022] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Some amino acids have been associated with aging-related disorders and risk of physical impairment. The aim of this study was to assess the association between plasma concentrations of nine amino acids, including branched-chain and aromatic amino acids, and multimorbidity. METHODS This research uses longitudinal data from the Seniors-ENRICA 2 study, a population-based cohort from Spain which comprises non-institutionalized adults older than 65. Blood samples were extracted at baseline and after a follow-up period of two years for a total of 1488 subjects. Participants' information was linked with electronic health records. Chronic diseases were grouped into a list of 60 mutually exclusive conditions. A quantitative measure of multimorbidity, weighting morbidities by their regression coefficients on physical functioning, was employed and ranged from 0 to 100. Generalized estimating equation models were used to explore the relationship between plasma amino acids and multimorbidity, adjusting for sociodemographics, socioeconomic status and lifestyle behaviors. RESULTS The mean age of participants at baseline was 73.6 (SD = 4.2) years, 49.6% were women. Higher concentrations of glutamine [coef. per mmol/l (95% confidence interval = 10.1 (3.7, 16.6)], isoleucine [50.3 (21.7, 78.9)] and valine [15.5 (3.1, 28.0)] were significantly associated with higher multimorbidity scores, after adjusting for potential confounders. Body mass index could have influenced the relationship between isoleucine and multimorbidity (p = 0.016). CONCLUSIONS Amino acids could play a role in regulating aging-related diseases. Glutamine and branched-chain amino acids as isoleucine and valine are prospectively associated and could serve as risk markers for multimorbidity in older adults.
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Affiliation(s)
- Francisco Félix Caballero
- Department of Preventive Medicine and Public Health. Universidad Autónoma de Madrid and CIBER of Epidemiology and Public Health, Madrid
| | - Alberto Lana
- Department of Medicine. Universidad de Oviedo/ISPA, Oviedo
| | - Ellen A Struijk
- Department of Preventive Medicine and Public Health. Universidad Autónoma de Madrid and CIBER of Epidemiology and Public Health, Madrid
| | | | - Humberto Yévenes-Briones
- Department of Preventive Medicine and Public Health. Universidad Autónoma de Madrid and CIBER of Epidemiology and Public Health, Madrid
| | - Juan Cárdenas-Valladolid
- Dirección Técnica de Sistemas de Información. Gerencia Asistencial de Atención Primaria, Servicio Madrileño de Salud, Madrid.,Fundación de Investigación e Innovación Biosanitaria de Atención Primaria, Madrid.,Enfermería. Universidad Alfonso X El Sabio, Villanueva de la Cañada
| | - Miguel Ángel Salinero-Fort
- Fundación de Investigación e Innovación Biosanitaria de Atención Primaria, Madrid.,Subdirección General de Investigación Sanitaria. Consejería de Sanidad, Madrid.,Red de Investigación en Servicios de Salud en Enfermedades Crónicas.,Grupo de Envejecimiento y Fragilidad de las personas mayores. IdIPAZ, Madrid
| | - José R Banegas
- Department of Preventive Medicine and Public Health. Universidad Autónoma de Madrid and CIBER of Epidemiology and Public Health, Madrid
| | - Fernando Rodríguez-Artalejo
- Department of Preventive Medicine and Public Health. Universidad Autónoma de Madrid and CIBER of Epidemiology and Public Health, Madrid.,IMDEA-Food Institute. CEI UAM+CSIC, Madrid
| | - Esther Lopez-Garcia
- Department of Preventive Medicine and Public Health. Universidad Autónoma de Madrid and CIBER of Epidemiology and Public Health, Madrid.,IMDEA-Food Institute. CEI UAM+CSIC, Madrid
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12
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King CP, Meyer PJ. The incentive amplifying effects of nicotine: Roles in alcohol seeking and consumption. ADVANCES IN PHARMACOLOGY (SAN DIEGO, CALIF.) 2022; 93:171-218. [PMID: 35341566 DOI: 10.1016/bs.apha.2021.10.008] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Nicotine has a unique profile among drugs of abuse. To the noninitiated user, nicotine has powerful aversive effects and its relatively weak euphorigenic effects undergo rapid tolerance. Despite this, nicotine is commonly abused despite negative heath consequences, and nicotine users have enormous difficulty quitting. Further, nicotine is one of the most commonly co-abused substances, in that it is often taken in combination with other drugs. One explanation of this polydrug use is that nicotine has multiple appetitive and consummatory conditioning effects. For example, nicotine is a reinforcement enhancer in that it can potently increase the incentive value of other stimuli, including those surrounding drugs of abuse such as alcohol. In addition, nicotine also has a unique profile of neurobiological effects that alter regulation of alcohol intake and interoception. This review discusses the psychological and biological mechanisms surrounding nicotine's appetitive conditioning and consummatory effects, particularly its interactions with alcohol.
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Affiliation(s)
- Christopher P King
- Department of Psychology, State University of New York at Buffalo, Buffalo, NY, United States; Clinical and Research Institute on Addictions, State University of New York at Buffalo, Buffalo, NY, United States
| | - Paul J Meyer
- Department of Psychology, State University of New York at Buffalo, Buffalo, NY, United States.
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13
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AshaRani PV, Karuvetil MZ, Brian TYW, Satghare P, Roystonn K, Peizhi W, Cetty L, Zainuldin NA, Subramaniam M. Prevalence and Correlates of Physical Comorbidities in Alcohol Use Disorder (AUD): a Pilot Study in Treatment-Seeking Population. Int J Ment Health Addict 2022; 21:1-18. [PMID: 35095353 PMCID: PMC8783789 DOI: 10.1007/s11469-021-00734-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 12/07/2021] [Indexed: 12/17/2022] Open
Abstract
This study aimed to understand the prevalence of physical comorbidities, undiagnosed and inadequately controlled chronic physical conditions and correlates of high cholesterol, hypertension and liver enzyme abnormalities in those with alcohol use disorder (AUD). Participants (n = 101) with AUD were recruited from a tertiary care centre through convenient sampling. The prevalence of physical and psychiatric comorbidities in the sample was 83.17% and 51.49%, respectively. Around 53.47% had two or more chronic physical conditions (multimorbidity). Hypertension (44.55%), asthma (23.76%), high cholesterol (22.77%) and liver enzyme abnormalities (21.78%) were the top four physical comorbidities. The prevalence of undiagnosed and inadequately controlled chronic physical conditions was 61.4% and 32.7%, respectively. Gender, education and body mass index (BMI) were associated with hyperlipidaemia while age and education were associated with hypertension. Higher waist-hip ratio was associated with liver enzyme abnormalities. Routine clinical care must include regular screening and follow-up of the risk groups to monitor their physical and mental health.
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Affiliation(s)
- P. V. AshaRani
- Research Division, Institute of Mental Health, 10 Buangkok View, Singapore, 539747 Singapore
| | - Mohamed Zakir Karuvetil
- National Addictions Management Service, Institute of Mental Health, 10 Buangkok View, Singapore, 539747 Singapore
| | - Tan Yeow Wee Brian
- Research Division, Institute of Mental Health, 10 Buangkok View, Singapore, 539747 Singapore
| | - Pratika Satghare
- Research Division, Institute of Mental Health, 10 Buangkok View, Singapore, 539747 Singapore
| | - Kumarasan Roystonn
- Research Division, Institute of Mental Health, 10 Buangkok View, Singapore, 539747 Singapore
| | - Wang Peizhi
- Research Division, Institute of Mental Health, 10 Buangkok View, Singapore, 539747 Singapore
| | - Laxman Cetty
- Research Division, Institute of Mental Health, 10 Buangkok View, Singapore, 539747 Singapore
| | - Noor Azizah Zainuldin
- National Addictions Management Service, Institute of Mental Health, 10 Buangkok View, Singapore, 539747 Singapore
| | - Mythily Subramaniam
- Research Division, Institute of Mental Health, 10 Buangkok View, Singapore, 539747 Singapore
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore, 117549 Singapore
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14
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Mishra VK, Srivastava S, T. M, Murthy PV. Population attributable risk for multimorbidity among adult women in India: Do smoking tobacco, chewing tobacco and consuming alcohol make a difference? PLoS One 2021; 16:e0259578. [PMID: 34731220 PMCID: PMC8565748 DOI: 10.1371/journal.pone.0259578] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2021] [Accepted: 10/21/2021] [Indexed: 01/28/2023] Open
Abstract
BACKGROUND The present study aims to estimate the prevalence and correlates of multimorbidity among women aged 15-49 years in India. Additionally, the population attributable risk for multi-morbidity in reference to those women who smoke tobacco, chew tobacco, and consume alcohol is estimated. METHODS The data was derived from the National Family Health Survey which was conducted in 2015-16. The effective sample size for the present paper 699,686 women aged 15-49 years in India. Descriptive statistics along with bivariate analysis were used to do the preliminary analysis. Additionally, binary logistic regression analysis was used to fulfil the objectives. RESULTS About 1.6% of women had multimorbidity in India. The prevalence of multimorbidity was high among women from southern region of India. Women who smoke tobacco, chew tobacco and consume alcohol had 87% [AOR: 1.87CI: 1.65, 2.10], 18% [AOR: 1.18; CI: 1.10, 1.26] and 18% [AOR: 1.18; CI: 1.04, 1.33] significantly higher likelihood to suffer from multi-morbidity than their counterparts respectively. Population Attributable Risk for women who smoke tobacco was 1.2% (p<0.001), chew tobacco was 0.2% (p<0.001) and it was 0.2% (p<0.001) among women who consumed alcohol. CONCLUSION The findings indicate the important role of lifestyle and behavioural factors such as smoking and chewing tobacco and consuming alcohol in the prevalence of multimorbidity among adult Indian women. The subgroups identified as at increased risk in the present study can be targeted while making policies and health decisions and appropriate comorbidity management can be implemented.
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Affiliation(s)
- Vivek K. Mishra
- Department of Population Studies, Sri Venkateswara University, Tirupati, Andhra Pradesh, India
| | - Shobhit Srivastava
- International Institute for Population Sciences, Mumbai, Maharashtra, India
| | - Muhammad T.
- International Institute for Population Sciences, Mumbai, Maharashtra, India
| | - P. V. Murthy
- Department of Population Studies and Social Work, College of Arts, Sri Venkateswara University, Tirupati, Andhra Pradesh, India
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15
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Borges TL, da Cruz de Sousa LP, Reisdorfer E, Vedana KGG, Pillon SC, Miasso AI. Factors associated with alcohol use and abuse in Brazilian primary health care settings. Arch Psychiatr Nurs 2021; 35:486-490. [PMID: 34561063 DOI: 10.1016/j.apnu.2021.06.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/18/2021] [Accepted: 06/12/2021] [Indexed: 11/29/2022]
Abstract
The main goal of this study was to identify the prevalence of alcohol use and associations with selected variables among clients in a primary healthcare setting. A quantitative, cross-sectional study was carried out using structured questionnaires to measure the pattern of alcohol consumption, quality of life and common mental disorders. The results showed that men, people between 18 and 40 years old, with income between $300.00 and 1200.00 and smokers were at a higher risk of problematic alcohol use. Healthcare professionals should include alcohol screening questions to identify the hazardous consumption of alcohol at an early stage and prevent negative consequences.
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Affiliation(s)
- Tatiana Longo Borges
- Centro Universitário Estácio de Ribeirão Preto, Rua Abrahão Issa Halach, 980 - Bairro Ribeirânia, Ribeirão Preto 14096-160, SP, Brazil.
| | - Ligiane Paula da Cruz de Sousa
- Escola de Enfermagem de Ribeirão Preto da Universidade de São Paulo, Avenida dos Bandeirantes, 3900, Campus Universitário - Bairro Monte Alegre, Ribeirão Preto 14040-902, SP, Brazil
| | | | - Kelly Graziani Giacchero Vedana
- Escola de Enfermagem de Ribeirão Preto da Universidade de São Paulo, Avenida dos Bandeirantes, 3900, Campus Universitário - Bairro Monte Alegre, Ribeirão Preto 14040-902, SP, Brazil.
| | - Sandra Cristina Pillon
- Escola de Enfermagem de Ribeirão Preto da Universidade de São Paulo, Avenida dos Bandeirantes, 3900, Campus Universitário - Bairro Monte Alegre, Ribeirão Preto 14040-902, SP, Brazil.
| | - Adriana Inocenti Miasso
- Escola de Enfermagem de Ribeirão Preto da Universidade de São Paulo, Avenida dos Bandeirantes, 3900, Campus Universitário - Bairro Monte Alegre, Ribeirão Preto 14040-902, SP, Brazil.
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16
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King A, Fucito L. Cigarette Smoking and Heavy Alcohol Drinking: The Challenges and Opportunities for Combination Treatments. Am J Psychiatry 2021; 178:783-785. [PMID: 34516230 DOI: 10.1176/appi.ajp.2021.21070692] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Affiliation(s)
- Andrea King
- Department of Psychiatry and Behavioral Neuroscience, University of Chicago, Chicago (King); Department of Psychiatry, Yale University, Yale Cancer Center, and Smilow Cancer Hospital at Yale-New Haven, New Haven, Conn. (Fucito)
| | - Lisa Fucito
- Department of Psychiatry and Behavioral Neuroscience, University of Chicago, Chicago (King); Department of Psychiatry, Yale University, Yale Cancer Center, and Smilow Cancer Hospital at Yale-New Haven, New Haven, Conn. (Fucito)
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17
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Fitzke RE, Davis JP, Pedersen ER. Co-use of Tobacco Products and Cannabis among Veterans: A Preliminary Investigation of Prevalence and Associations with Mental Health Outcomes. J Psychoactive Drugs 2021; 54:250-257. [PMID: 34334112 DOI: 10.1080/02791072.2021.1956026] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
While tobacco product (such as combustible cigarettes and nicotine vaping products) and cannabis use rates remain high in the general United States (U.S.) population, veterans from the conflicts in Iraq and Afghanistan (i.e., OEF/OIF veterans) are at high risk of high rates of cannabis and tobacco use. Co-use of tobacco and cannabis (i.e., using both substances within a specified period of time or combining the drugs within the same device for use) is of growing prevalence in the U.S. However, little is understood about the prevalence rates of tobacco and cannabis co-use among U.S. veterans and its associations with mental health symptomatology. The current study conducted a preliminary analysis of co-use patterns of tobacco and cannabis and associated mental health outcomes among a sample of OEF/OIF veterans (N = 1,230). Results indicated high rates of lifetime and past 30-day use of both substances. Past 30-day co-users endorsed significantly higher levels of stress, PTSD, depression, and anxiety compared to singular product users. Results suggest that the addition of cannabis use in conjunction with tobacco use may be associated with greater mental health symptoms among veterans. Findings indicate veteran tobacco and cannabis co-users may benefit from mental health care to help mitigate poor mental health symptoms.
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Affiliation(s)
- Reagan E Fitzke
- Department of Psychiatry and Behavioral Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Jordan P Davis
- Suzanne Dworak-Peck School of Social Work, USC Center for Artificial Intelligence in Society, USC Center for Mindfulness Science, University of Southern California, Los Angeles, CA, USA
| | - Eric R Pedersen
- Department of Psychiatry and Behavioral Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
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18
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Siegel SD, Brooks M, Ragozine-Bush HE, Schnoll RA, Curriero FC. The co-occurrence of smoking and alcohol use disorder in a hospital-based population: Applying a multimorbidity framework using geographic information system methods. Addict Behav 2021; 118:106883. [PMID: 33714034 DOI: 10.1016/j.addbeh.2021.106883] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2020] [Revised: 02/08/2021] [Accepted: 02/15/2021] [Indexed: 11/27/2022]
Abstract
Tobacco and alcohol use are leading causes of premature mortality in the US and concurrent use is associated with even greater health risks. A cross-sectional study of 20,310 patients admitted to a Mid-Atlantic acute health care system between July 1, 2018 and June 30, 2019 were categorized according to smoking and alcohol use disorder (AUD) status. Of the total admissions, 1464 (7.2%) were current smokers with an AUD. These patients were younger (52.4 vs. 63.9), more likely to be male (64.1% vs. 38.0%) and covered by Medicaid (46.9% vs. 11.6%), and resided in proximity to higher counts of tobacco (10.3 vs. 4.72) and alcohol (2.24 vs. 1.14) retailers than never smokers without an AUD. Clinically, these patients had higher rates of other substance use disorders (60.4% vs. 6.1%), depression (64.6% vs. 34.8%), HIV/AIDS (3.3% vs. 0.6%), and liver disease (40.7% vs. 13.2%) than never smokers without an AUD. Patients who concurrently smoke and have an AUD face unique and serious health risks. A multimorbidity framework can guide clinical and community-based interventions for individuals with concurrent psychiatric and chronic medical conditions, complex social needs, and adverse environmental exposures.
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Affiliation(s)
- Scott D Siegel
- Value Institute, Christiana Care Health System, USA; Helen F. Graham Cancer Center & Research Institute, Christiana Care Health System, USA.
| | | | | | - Robert A Schnoll
- Department of Psychiatry and Abramson Cancer Center, University of Pennsylvania, USA
| | - Frank C Curriero
- Johns Hopkins Spatial Science for Public Health Center, Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, USA
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19
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Peltier MR, Sofuoglu M, Petrakis IL, Stefanovics E, Rosenheck RA. Sex Differences in Opioid Use Disorder Prevalence and Multimorbidity Nationally in the Veterans Health Administration. J Dual Diagn 2021; 17:124-134. [PMID: 33982642 PMCID: PMC8887838 DOI: 10.1080/15504263.2021.1904162] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/09/2023]
Abstract
Opioid use disorder (OUD) is a significant problem among US veterans with increasing rates of OUD and overdose, and thus has substantial importance for service delivery within the Veterans Health Administration (VHA). Among individuals with OUD, several sex- specific differences have begun to emerge regarding co-occurring medical, psychiatric and pain-related diagnoses. The rates of such multimorbidities are likely to vary between men and women with OUD and may have important implications for treatment within the VHA but have not yet been studied. Methods: The present study utilized a data set that included all veterans receiving VHA health care during Fiscal Year (FY) 2012 (October 1, 2011 through September 30, 2012), who were diagnosed during the year with opioid dependence or abuse. VHA patients diagnosed with OUD nationwide in FY 2012 were compared by sex on proportions with OUD, and among those with OUD, on sociodemographic characteristics, medical, psychiatric and pain-related diagnoses, as well as on service use, and psychotropic and opioid agonist prescription fills. Results: During FY 2012, 48,408 veterans were diagnosed with OUD, 5.77% of whom were women. Among those veterans with OUD, few sociodemographic differences were observed between sexes. Female veterans had a higher rate of psychiatric diagnoses, notably mood, anxiety and personality disorders, as well as higher rates of pain-related diagnoses, such as headaches and fibromyalgia, while male veterans were more likely to have concurrent, severe medical co-morbidities, including hepatic disease, HIV, cancers, peripheral vascular disease, diabetes and related complications, and renal disease. There were few differences in health service utilization, with women reporting greater receipt of prescriptions for anxiolytic/sedative/hypnotics, stimulants and lithium. Men and women did not differ in receipt of opioid agonist medications or mental health/substance use treatments. Conclusions: There are substantial sex-specific differences in patterns of multimorbidity among veterans with OUD, spanning medical, psychiatric and pain-related diagnoses. These results illustrate the need to view OUD as a multimorbid condition and design interventions to target such multimorbidities. The present study highlights the potential benefits of sex-specific treatment and prevention efforts among female veterans with OUD and related co-occurring disorders.
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Affiliation(s)
- MacKenzie R Peltier
- Department of Psychiatry, Yale School of Medicine, New Haven, Connecticut, USA
| | - Mehmet Sofuoglu
- Department of Psychiatry, Yale School of Medicine, New Haven, Connecticut, USA.,VA New England Mental Illness, Research, Education and Clinical Center (MIRECC), VA Connecticut Healthcare System, West Haven, Connecticut, USA
| | - Ismene L Petrakis
- Department of Psychiatry, Yale School of Medicine, New Haven, Connecticut, USA.,VA New England Mental Illness, Research, Education and Clinical Center (MIRECC), VA Connecticut Healthcare System, West Haven, Connecticut, USA
| | - Elina Stefanovics
- Department of Psychiatry, Yale School of Medicine, New Haven, Connecticut, USA.,VA New England Mental Illness, Research, Education and Clinical Center (MIRECC), VA Connecticut Healthcare System, West Haven, Connecticut, USA
| | - Robert A Rosenheck
- Department of Psychiatry, Yale School of Medicine, New Haven, Connecticut, USA.,VA New England Mental Illness, Research, Education and Clinical Center (MIRECC), VA Connecticut Healthcare System, West Haven, Connecticut, USA
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Dartois M, Haudiquet N, Albuisson E, Angioi-Duprez K, Schwan R, Laprévote V, Schwitzer T. Retinal dysfunctions in regular tobacco users: The retina as a window to the reward circuit in addictive disorders. J Psychiatr Res 2021; 136:351-357. [PMID: 33636691 DOI: 10.1016/j.jpsychires.2021.02.023] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/12/2020] [Revised: 01/20/2021] [Accepted: 02/08/2021] [Indexed: 02/07/2023]
Abstract
The nicotine contained in tobacco is a neuromodulator which affects neurotransmission within the brain. The retina is an easy way to study central synaptic transmission dysfunctions in neuropsychiatric disorders. The purpose of this study is to assess the impact of regular tobacco use on retinal function using pattern (PERG), flash (fERG) and multifocal (mfERG) electroretinogram (ERG). We recorded PERG, fERG and mfERG for 24 regular tobacco users and 30 healthy non-smoking subjects. The protocol was compliant with International Society for Clinical Electrophysiology of Vision standards. The amplitudes and peak times (PT) of P50, N95 waves (PERG), a-, b- and oscillatory potentials (fERG), and N1, P1, N2 (mfERG) were evaluated. Compared to non-smokers, the results (Mann-Whitney U test, Bonferroni correction) for tobacco users suggested a significant increase of ~ 1 ms in the PT of light-adapted 3.0 fERG b-wave (p = 0.002). Using mfERG, we observed the following increases in tobacco users: in ring 3 for P1 PT of ~1,5 ms and in ring 5 for P1 PT of ~ 1 ms and for N2 PT of ~ 1 ms (p = 0.002, p = 0.002 and p = 0.006). It is our hypothesis that these results reflect the consequences of regular tobacco use on retinal synaptic transmission, and more specifically on dopaminergic and cholinergic transmission. We deduce that the retina may provide a crucial site of investigation for neurotransmission modulation of the reward circuit in regular tobacco users.
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Affiliation(s)
- Mathilde Dartois
- Pôle Hospitalo-Universitaire de Psychiatrie d'Adultes et d'Addictologie du Grand Nancy, Centre Psychothérapique de Nancy, Laxou, France.
| | - Nicolas Haudiquet
- Pôle Hospitalo-Universitaire de Psychiatrie d'Adultes et d'Addictologie du Grand Nancy, Centre Psychothérapique de Nancy, Laxou, France.
| | - Eliane Albuisson
- CHRU-Nancy, DRCI, Département MPI, Unité de Méthodologie, Data management et Statistique UMDS, F-54000, Nancy, France; Université de Lorraine, Faculté de Médecine, InSciDenS, F-54000, Nancy, France; Université de Lorraine, CNRS, IECL, F-54000, Nancy, France; Faculté de Médecine, Université de Lorraine, Vandœuvre-lès-Nancy, France.
| | - Karine Angioi-Duprez
- Service d'Ophtalmologie, CHRU Nancy, Nancy, France; Faculté de Médecine, Université de Lorraine, Vandœuvre-lès-Nancy, France.
| | - Raymund Schwan
- Pôle Hospitalo-Universitaire de Psychiatrie d'Adultes et d'Addictologie du Grand Nancy, Centre Psychothérapique de Nancy, Laxou, France; INSERM U1114, Fédération de Médecine Translationnelle de Strasbourg, Département de Psychiatrie, Centre Hospitalier Régional Universitaire de Strasbourg, Strasbourg, France; Faculté de Médecine, Université de Lorraine, Vandœuvre-lès-Nancy, France.
| | - Vincent Laprévote
- Pôle Hospitalo-Universitaire de Psychiatrie d'Adultes et d'Addictologie du Grand Nancy, Centre Psychothérapique de Nancy, Laxou, France; INSERM U1114, Fédération de Médecine Translationnelle de Strasbourg, Département de Psychiatrie, Centre Hospitalier Régional Universitaire de Strasbourg, Strasbourg, France; Faculté de Médecine, Université de Lorraine, Vandœuvre-lès-Nancy, France.
| | - Thomas Schwitzer
- Pôle Hospitalo-Universitaire de Psychiatrie d'Adultes et d'Addictologie du Grand Nancy, Centre Psychothérapique de Nancy, Laxou, France; INSERM U1114, Fédération de Médecine Translationnelle de Strasbourg, Département de Psychiatrie, Centre Hospitalier Régional Universitaire de Strasbourg, Strasbourg, France; Faculté de Médecine, Université de Lorraine, Vandœuvre-lès-Nancy, France.
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21
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Domi A, Barbier E, Adermark L, Domi E. Targeting the Opioid Receptors: A Promising Therapeutic Avenue for Treatment in “Heavy Drinking Smokers”. Alcohol Alcohol 2021; 56:127-138. [DOI: 10.1093/alcalc/agaa139] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2020] [Revised: 12/02/2020] [Accepted: 12/03/2020] [Indexed: 01/12/2023] Open
Abstract
Abstract
Aims
Despite a general decline in tobacco use in the last decades, the prevalence of tobacco smoking in individuals with alcohol use disorder (AUD) remains substantial (45–50%). Importantly, the co-use of both substances potentiates the adverse effects, making it a significant public health problem. Substantial evidence suggests that AUD and Tobacco use disorder (TUD) may share common mechanisms. Targeting these mechanisms may therefore provide more effective therapy. Numerous studies describe a potential role of the endogenous opioid system in both AUD and TUD. Reviewing this literature, we aim to evaluate the efficacy of molecules that target the opioid system as promising therapeutic interventions for treating alcohol and tobacco co-use disorders.
Methods
We provide a synthesis of the current epidemiological knowledge of alcohol and tobacco co-use disorders. We evaluate clinical and preclinical research that focuses on the regulation of the endogenous opioid system in alcohol, nicotine, and their interactions.
Results
The epidemiological data confirm that smoking stimulates heavy drinking and facilitates alcohol craving. Pharmacological findings suggest that treatments that are efficacious in the dual addiction provide a beneficial treatment outcome in comorbid AUD and TUD. In this regard, MOP, DOP and NOP-receptor antagonists show promising results, while the findings prompt caution when considering KOP-receptor antagonists as a treatment option in alcohol and tobacco co-use disorders.
Conclusions
Existing literature suggests a role of the opioid system in sustaining the high comorbidity rates of AUD and TUD. Molecules targeting opioid receptors may therefore represent promising therapeutic interventions in ‘heavy drinking smokers.’
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Affiliation(s)
- Ana Domi
- Addiction Biology Unit, Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, Sahlgrenska Academy University of Gothenburg, Box 410, Gothenburg 405 30, Sweden
| | - Estelle Barbier
- Center for Social and Affective Neuroscience, Linköping University, Campus US, Entrance 65, Linköping 581 85, Sweden
| | - Louise Adermark
- Addiction Biology Unit, Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, Sahlgrenska Academy University of Gothenburg, Box 410, Gothenburg 405 30, Sweden
| | - Esi Domi
- Center for Social and Affective Neuroscience, Linköping University, Campus US, Entrance 65, Linköping 581 85, Sweden
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Rhee TG, Peltier MR, Sofuoglu M, Rosenheck RA. Do Sex Differences Among Adults With Opioid Use Disorder Reflect Sex-specific Vulnerabilities? A Study of Behavioral Health Comorbidities, Pain, and Quality of Life. J Addict Med 2020; 14:502-509. [PMID: 32371659 PMCID: PMC8962823 DOI: 10.1097/adm.0000000000000662] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
OBJECTIVES Studies suggest that men and women have different vulnerabilities to a number of substance use disorders (SUDs). We examined whether differences between women and men with opioid use disorder (OUD) are significantly different from those without OUD for selected sociodemographic and health outcomes. METHODS We used a cross-sectional survey design using data from 2012 to 2013 National Epidemiological Survey on Alcohol and Related Conditions Wave III, which surveyed nationally representative samples of non-institutionalized adults (n = 36,309 unweighted). Past-year OUD and other behavioral co-morbidities were defined using DSM-5 criteria. In bivariate analyses, we investigated sex differences in socio-demographic factors, behavioral co-morbidities, pain, and health-related quality of life (HRQOL) between women and men with past-year OUD, and then those without past-year OUD. We further used logistic regression analyses to evaluate interactions between effect of sex and past-year OUD status on behavioral co-morbidities, pain, and HRQOL. RESULTS When extrapolated, about 2.1 million US adults met diagnostic criteria for past-year OUD. Women with OUD had a higher likelihood of having several past-year psychiatric disorders, and a lower likelihood of having any past-year SUDs compared to male counterparts. However, similar relationships were observed among those without OUD and significant interaction effects were not found on behavioral co-morbidities, pain, and HRQOL, indicating that general sex differences are not specific to OUD. CONCLUSIONS Although sex differences are not specific to OUD, concurrent disorders are not uncommon among women, as well as men, with OUD. There is a need to treat concurrent behavioral health conditions from a multimorbidity perspective in the treatment of OUD in both sexes.
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Affiliation(s)
- Taeho Greg Rhee
- VA New England Mental Illness, Research, Education and Clinical Center (MIRECC), VA Connecticut Healthcare System, West Haven, CT (TGR, MKRP, MS, RAR); Department of Psychiatry, School of Medicine, Yale University, New Haven, CT (TGR, MKRP, MS, RAR); Department of Public Health Sciences, School of Medicine, University of Connecticut Health Care, Farmington, CT (TGR); Psychology Service, VA Connecticut Healthcare System, West Haven, CT (MKRP)
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23
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Stefanovics EA, Rosenheck RA. Gender Difference in Substance Use and Psychiatric Outcomes Among Dually Diagnosed Veterans Treated in Specialized Intensive PTSD Programs. J Dual Diagn 2020; 16:382-391. [PMID: 33002376 DOI: 10.1080/15504263.2020.1822569] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
OBJECTIVES Posttraumatic stress disorder (PTSD) is a problem of growing importance among female veterans, which is especially challenging when accompanied by comorbid substance use disorder (SUD). Since women are still a small minority of Veterans Health Administration (VHA) patients, there is concern that outcomes among dually diagnosed women may be worse than among men. METHOD National program evaluation data were collected at admission and 4 months after discharge from 7,074 dually diagnosed veterans including 203 women (2.9%) treated at 57 specialized intensive VHA PTSD treatment programs between 1993 and 2011. Multiple regression was used to compare clinical change in women and men adjusting for baseline differences. RESULTS Women showed no significant differences from men in measures of substance use or total PTSD symptoms at admission although they were more likely to have experienced sexual trauma and less likely to report combat exposure. With adjustment for these differences, there were no significant gender differences in length of stay, satisfaction with treatment, or measures of change in substance use or total PTSD symptoms 4 months after discharge. Reductions in an index of days of substance use was associated with reduction in total PTSD symptoms among both women (R = 0.33; p = .01) and men (R = 0.44, p < .0001) with no significant gender difference. CONCLUSION No significant gender differences were observed in substance use or PTSD outcomes, despite the extreme minority status of women in VHA programs. Highly vulnerable women can benefit as much as men, even when treatment is not formally tailored to address gender-specific needs.
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Affiliation(s)
- Elina A Stefanovics
- Department of Psychiatry, School of Medicine, Yale University, New Haven, Connecticut, USA.,Department of Veterans Affairs Connecticut Healthcare System, New England Mental Illness, Research, Education, and Clinical Center (MIRECC), West Haven, Connecticut, USA
| | - Robert A Rosenheck
- Department of Psychiatry, School of Medicine, Yale University, New Haven, Connecticut, USA.,Department of Veterans Affairs Connecticut Healthcare System, New England Mental Illness, Research, Education, and Clinical Center (MIRECC), West Haven, Connecticut, USA
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24
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Roberts W, Rosenheck RA. Correlates of Concurrent Morbid Obesity and Tobacco Use Disorder Nationally in the Veterans Health Administration. J Dual Diagn 2020; 16:373-381. [PMID: 32866073 PMCID: PMC7717576 DOI: 10.1080/15504263.2020.1808749] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
The aim of this study was to examine health, demographic, and service utilization characteristics of veterans with multimorbid tobacco use disorder (TUD) and morbid obesity compared to those with either condition alone. Methods: Health record data were extracted from the computerized patient record system of the Veterans Health Administration (VHA; October 1, 2011 to September 30, 2012). Bivariate and multivariate logistic regression models were used to compare veterans with both TUD and morbid obesity (body mass index [BMI] ≥ 40 kg/m2) to veterans with each condition alone on a range of demographic, health, and service utilization outcome variables that also were extracted from the VHA administrative record. Results: Veterans with both morbid obesity and TUD showed higher rates of medical and psychiatric comorbidity than did veterans with either condition alone. However, while veterans with TUD and morbid obesity showed higher rates of comorbid substance use disorders than veterans with morbid obesity alone, veterans with both conditions showed substantially lower rates of substance use disorders than those with TUD alone. Conclusions: Veterans with co-occurring morbid obesity and TUD appear to be at greater risk for medical disease and psychiatric conditions. The unexpected finding that veterans with TUD alone had more concurrent substance use disorders than veterans with both TUD and morbid obesity suggest the possibility that overeating may be a substitute for substance use in the context of TUD. The multimorbidity profile described here may suggest unique treatment needs for individuals with both TUD and morbid obesity. Highlights Medical multimorbidities predict additional health conditions and poorer outcomes. Obesity and tobacco use may share common underlying vulnerabilities. Veterans with both conditions showed higher rates of certain multimorbidities. Obesity may protect against substance use in tobacco users.
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Affiliation(s)
- Walter Roberts
- Department of Psychiatry, Yale School of Medicine, New Haven, Connecticut, USA.,VA Connecticut Health System, West Haven, Connecticut, USA
| | - Robert A Rosenheck
- Department of Psychiatry, Yale School of Medicine, New Haven, Connecticut, USA.,VA Connecticut Health System, West Haven, Connecticut, USA
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25
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Chandler CM, Maggio SE, Peng H, Nixon K, Bardo MT. Effects of ethanol, naltrexone, nicotine and varenicline in an ethanol and nicotine co-use model in Sprague-Dawley rats. Drug Alcohol Depend 2020; 212:107988. [PMID: 32387915 PMCID: PMC7293937 DOI: 10.1016/j.drugalcdep.2020.107988] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/14/2019] [Revised: 03/18/2020] [Accepted: 03/18/2020] [Indexed: 01/02/2023]
Abstract
BACKGROUND As alcohol and nicotine use disorders are entwined, it may be possible to develop a single medication to treat both. We previously developed a model for ethanol (EtOH) and nicotine co-use in female selectively bred alcohol-preferring (P) rats. To model co-use in a genetically diverse population, we adapted the model to outbred Sprague-Dawley rats of both sexes and assessed the effect of drug pretreatments. METHODS In phase 1, rats were trained in a 2-bottle choice between water and a sweetened or unsweetened EtOH solution in operant chambers. In phase 2, rats were trained in nicotine self-administration under an increasing fixed ratio (FR) schedule with 2 bottles containing water or saccharin-sweetened EtOH also available. In phase 3, rats were pretreated with EtOH (0.5, 1.5 g/kg), naltrexone (0.3 mg/kg), nicotine (0.2, 0.6 mg/kg), varenicline (3.0 mg/kg) or vehicle before the session. RESULTS Sweetening the EtOH solution was required to obtain pharmacologically relevant levels of consumption in Phase 1, with males showing increased sweetened EtOH preference compared to females. In Phase 2, increasing the FR requirement for nicotine decreased nicotine infusions, but increased EtOH consumption. In Phase 3, EtOH, naltrexone, and nicotine failed to alter EtOH consumption; however, varenicline decreased both EtOH and nicotine intake. CONCLUSIONS The co-use model was successfully adapted to Sprague-Dawley rats by adding saccharin to the EtOH solution. In contrast to previous results in P rats, varenicline reduced both EtOH and nicotine intake, indicating it may be a useful monotherapy for co-use in a genetically diverse population.
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Affiliation(s)
- Cassie M Chandler
- Department of Psychology, University of Kentucky, 106 B, Kastle Hall, Lexington, KY 40536, USA
| | - Sarah E Maggio
- Department of Psychology, University of Kentucky, 106 B, Kastle Hall, Lexington, KY 40536, USA
| | - Hui Peng
- Department of Pharmaceutical Sciences, University of Kentucky, Lexington, KY 40536, USA
| | - Kimberly Nixon
- Division of Pharmacology and Toxicology, College of Pharmacy, The University of Texas at Austin, Austin, TX, USA
| | - Michael T Bardo
- Department of Psychology, University of Kentucky, 106 B, Kastle Hall, Lexington, KY 40536, USA.
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26
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Marmet S, Studer J, Wicki M, Bertholet N, Khazaal Y, Gmel G. Unique versus shared associations between self-reported behavioral addictions and substance use disorders and mental health problems: A commonality analysis in a large sample of young Swiss men. J Behav Addict 2019; 8:664-677. [PMID: 31891314 PMCID: PMC7044575 DOI: 10.1556/2006.8.2019.70] [Citation(s) in RCA: 31] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND AND AIMS Behavioral addictions (BAs) and substance use disorders (SUDs) tend to co-occur; both are associated with mental health problems (MHPs). This study aimed to estimate the proportion of variance in the severity of MHPs explained by BAs and SUDs, individually and shared between addictions. METHODS A sample of 5,516 young Swiss men (mean = 25.47 years old; SD = 1.26) completed a self-reporting questionnaire assessing alcohol, cannabis, and tobacco use disorders, illicit drug use other than cannabis, six BAs (Internet, gaming, smartphone, Internet sex, gambling, and work) and four MHPs (major depression, attention-deficit hyperactivity disorder, social anxiety disorder, and borderline personality disorder). Commonality analysis was used to decompose the variance in the severity of MHPs explained (R2) by BAs and SUDs into independent commonality coefficients. These were calculated for unique BA and SUD contributions and for all types of shared contributions. RESULTS BAs and SUDs explained between a fifth and a quarter of the variance in severity of MHPs, but individual addictions explained only about half of this explained variance uniquely; the other half was shared between addictions. A greater proportion of variance was explained uniquely or shared within BAs compared to SUDs, especially for social anxiety disorder. CONCLUSIONS The interactions of a broad range of addictions should be considered when investigating their associations with MHPs. BAs explain a larger part of the variance in MHPs than do SUDs and therefore play an important role in their interaction with MHPs.
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Affiliation(s)
- Simon Marmet
- Addiction Medicine, Department of Psychiatry, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland,Corresponding author: Simon Marmet; Addiction Medicine, Department of Psychiatry, Lausanne University Hospital and University of Lausanne, Rue du Bugnon 23, CH-1011 Lausanne, Switzerland; Phone: +41 21 314 18 97; Fax: +41 21 314 05 62; E-mail:
| | - Joseph Studer
- Addiction Medicine, Department of Psychiatry, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Matthias Wicki
- Addiction Medicine, Department of Psychiatry, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Nicolas Bertholet
- Addiction Medicine, Department of Psychiatry, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Yasser Khazaal
- Addiction Medicine, Department of Psychiatry, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland,Research Centre, University Institute of Mental Health at Montréal, Québec, Canada
| | - Gerhard Gmel
- Addiction Medicine, Department of Psychiatry, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland,Research Department, Addiction Switzerland, Lausanne, Switzerland,Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, Toronto, ON, Canada,Department of Health and Social Sciences, University of the West of England, Bristol, UK
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27
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Marmet S, Studer J, Lemoine M, Grazioli VS, Bertholet N, Gmel G. Reconsidering the associations between self-reported alcohol use disorder and mental health problems in the light of co-occurring addictions in young Swiss men. PLoS One 2019; 14:e0222806. [PMID: 31568530 PMCID: PMC6768466 DOI: 10.1371/journal.pone.0222806] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2019] [Accepted: 09/07/2019] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Alcohol use disorder (AUD) is known to co-occur with other addictions, as well as with mental health problems. However, the effects of other addictions co-occurring with AUD on mental health problems were rarely studied and not considering them may bias estimates of the association between AUD and mental health problems. This study investigated which role co-occurring addictions play for the cross-sectional associations between self-reported AUD and mental health problems. METHOD Participants were 5516 young Swiss men (73.0% of those that gave written informed consent) who completed a self-report questionnaire. Using short screening questionnaires, we assessed three substance use disorders (alcohol, cannabis and tobacco), seven behavioural addictions (internet, gaming, smartphone, internet sex, gambling, work, exercise) and four mental health problems (major depression, bipolar disorder, attention deficit hyperactivity disorder (ADHD) and social anxiety disorder). Differences in the proportions of mental health problems were tested using logistic regressions between (1) participants with no AUD and AUD, (2) participants with no AUD and AUD alone and (3) participants with no AUD and AUD plus at least one co-occurring addiction. RESULTS Overall, (1) participants with AUD had higher proportions of major depression (Odds ratio (OR [95% confidence interval]) = 3.51 [2.73, 4.52]; ADHD (OR = 3.12 [2.41, 4.03]); bipolar disorder (OR = 4.94 [3.38, 7.21]) and social anxiety (OR = 2.21 [1.79, 2.73])) compared to participants with no AUD. Considering only participants with AUD alone compared to participants with no AUD (2), differences in proportions were no longer significant for major depression (OR = 0.83 [0.42, 1.64]), bipolar disorder (OR = 1.69 [0.67, 4.22]), social anxiety (OR = 1.15 [0.77, 1.73]) and ADHD (OR = 1.65 [1.00, 2.72]) compared to participants with no AUD. In contrast, (3) proportions of mental health problems were considerably higher for participants with AUD plus at least one other addiction when compared to participants with no AUD, with OR's ranging from 2.90 [2.27, 3.70] for social anxiety, 4.03 [3.02, 5.38] for ADHD, 5.29 [4.02, 6.97] for major depression to 6.64 [4.44, 9.94] for bipolar disorder. CONCLUSIONS AUD was associated with all four measured mental health problems. However, these associations were mainly due to the high proportions of these mental health problems in participants with AUD plus at least one co-occurring addiction and only to a lesser degree due to participants with AUD alone (i.e. without any other co-occurring addictions). Hence, estimates of the association between AUD and mental health problems that do not consider other addictions may be biased (i.e. overestimated). These findings imply that considering addictions co-occurring with AUD, including behavioural addictions, is important when investigating associations between AUD and mental health problems, and for the treatment of AUD and co-morbid disorders.
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Affiliation(s)
- Simon Marmet
- Addiction Medicine, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Joseph Studer
- Addiction Medicine, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Mélissa Lemoine
- Addiction Medicine, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Véronique S. Grazioli
- Addiction Medicine, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Nicolas Bertholet
- Addiction Medicine, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Gerhard Gmel
- Addiction Medicine, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
- Addiction Switzerland, Lausanne, Switzerland
- Centre for Addiction and Mental Health, Toronto, Canada
- University of the West of England, Frenchay Campus, Bristol, United Kingdom
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28
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Firth J, Siddiqi N, Koyanagi A, Siskind D, Rosenbaum S, Galletly C, Allan S, Caneo C, Carney R, Carvalho AF, Chatterton ML, Correll CU, Curtis J, Gaughran F, Heald A, Hoare E, Jackson SE, Kisely S, Lovell K, Maj M, McGorry PD, Mihalopoulos C, Myles H, O'Donoghue B, Pillinger T, Sarris J, Schuch FB, Shiers D, Smith L, Solmi M, Suetani S, Taylor J, Teasdale SB, Thornicroft G, Torous J, Usherwood T, Vancampfort D, Veronese N, Ward PB, Yung AR, Killackey E, Stubbs B. The Lancet Psychiatry Commission: a blueprint for protecting physical health in people with mental illness. Lancet Psychiatry 2019; 6:675-712. [PMID: 31324560 DOI: 10.1016/s2215-0366(19)30132-4] [Citation(s) in RCA: 750] [Impact Index Per Article: 150.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/29/2019] [Accepted: 04/01/2019] [Indexed: 12/20/2022]
Affiliation(s)
- Joseph Firth
- NICM Health Research Institute, Western Sydney University, Westmead, NSW, Australia; Division of Psychology and Mental Health, School of Health Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK; Centre for Youth Mental Health, University of Melbourne, Melbourne, VIC, Australia.
| | - Najma Siddiqi
- Department of Health Sciences, University of York, Hull York Medical School, Bradford, UK; Bradford District Care NHS Foundation Trust, Bradford, UK
| | - Ai Koyanagi
- Research and Development Unit, Parc Sanitari Sant Joan de Déu, Universitat de Barcelona, Fundació Sant Joan de Déu, Barcelona, Spain; Instituto de Salud Carlos III, Centro de Investigación Biomédica en Red de Salud Mental, Madrid, Spain; Institució Catalana de Recerca i Estudis Avançats, Barcelona, Spain
| | - Dan Siskind
- Metro South Addiction and Mental Health Service, Brisbane, QLD, Australia; School of Medicine, University of Queensland, Brisbane, QLD, Australia
| | - Simon Rosenbaum
- School of Psychiatry, Faculty of Medicine, University of New South Wales, Sydney, NSW, Australia
| | - Cherrie Galletly
- Ramsay Health Care Mental Health, Adelaide, SA, Australia; Northern Adelaide Local Health Network, Adelaide, SA, Australia; Discipline of Psychiatry, University of Adelaide, Adelaide, SA, Australia
| | - Stephanie Allan
- Institute of Health and Wellbeing, University of Glasgow, Glasgow, UK
| | - Constanza Caneo
- Departamento de Psiquiatría, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Rebekah Carney
- Division of Psychology and Mental Health, School of Health Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK; Youth Mental Health Research Unit, Greater Manchester Mental Health NHS Foundation Trust, Manchester, UK
| | - Andre F Carvalho
- Centre for Addiction and Mental Health, Toronto, ON, Canada; Department of Psychiatry, University of Toronto, Toronto, ON, Canada
| | - Mary Lou Chatterton
- Deakin Health Economics, Institute for Health Transformation, Faculty of Health, Deakin University, Melbourne, VIC, Australia
| | - Christoph U Correll
- Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY, USA; Department of Psychiatry, Zucker Hillside Hospital, Glen Oaks, NY, USA; Department of Child and Adolescent Psychiatry, Charité Universitätsmedizin, Berlin, Germany
| | - Jackie Curtis
- School of Psychiatry, Faculty of Medicine, University of New South Wales, Sydney, NSW, Australia; Keeping the Body in Mind Program, South Eastern Sydney Local Health District, Sydney, NSW, Australia
| | - Fiona Gaughran
- South London and Maudsley NHS Foundation Trust, London, UK; Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Adrian Heald
- Division of Diabetes, Endocrinology and Gastroenterology, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK; Manchester Academic Health Science Centre, University of Manchester, Manchester, UK; Department of Diabetes and Endocrinology, Salford Royal Hospital, Salford, UK
| | - Erin Hoare
- Food and Mood Centre, Deakin University, Melbourne, VIC, Australia
| | - Sarah E Jackson
- Department of Behavioural Science and Health, University College London, London, UK
| | - Steve Kisely
- School of Medicine, University of Queensland, Brisbane, QLD, Australia; Department of Psychiatry, Dalhousie University, Halifax, NS, Canada
| | - Karina Lovell
- Division of Nursing, Midwifery and Social Work, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK; Greater Manchester Mental Health NHS Foundation Trust, Manchester, UK
| | - Mario Maj
- Department of Psychiatry, University of Campania Luigi Vanvitelli, Naples, Italy
| | - Patrick D McGorry
- Centre for Youth Mental Health, University of Melbourne, Melbourne, VIC, Australia; Orygen, The National Centre of Excellence in Youth Mental Health, University of Melbourne, Melbourne, VIC, Australia
| | - Cathrine Mihalopoulos
- Deakin Health Economics, Institute for Health Transformation, Faculty of Health, Deakin University, Melbourne, VIC, Australia
| | - Hannah Myles
- Discipline of Psychiatry, University of Adelaide, Adelaide, SA, Australia
| | - Brian O'Donoghue
- Centre for Youth Mental Health, University of Melbourne, Melbourne, VIC, Australia; Orygen, The National Centre of Excellence in Youth Mental Health, University of Melbourne, Melbourne, VIC, Australia
| | - Toby Pillinger
- South London and Maudsley NHS Foundation Trust, London, UK; Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK; Medical Research Council London Institute of Medical Sciences, London, UK; Institute of Clinical Sciences, Faculty of Medicine, Imperial College London, London, UK
| | - Jerome Sarris
- NICM Health Research Institute, Western Sydney University, Westmead, NSW, Australia; Department of Psychiatry, University of Melbourne, Melbourne, VIC, Australia; The Melbourne Clinic, Melbourne, VIC, Australia
| | - Felipe B Schuch
- Department of Sports Methods and Techniques, Federal University of Santa Maria, Santa Maria, Brazil
| | - David Shiers
- Division of Psychology and Mental Health, School of Health Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK; Psychosis Research Unit, Greater Manchester Mental Health NHS Foundation Trust, Manchester, UK
| | - Lee Smith
- Cambridge Centre for Sport and Exercise Sciences, Anglia Ruskin University, Cambridge, UK
| | - Marco Solmi
- Neurosciences Department and Padua Neuroscience Centre, University of Padua, Padua, Italy
| | - Shuichi Suetani
- Metro South Addiction and Mental Health Service, Brisbane, QLD, Australia; Queensland Brain Institute, University of Queensland, Brisbane, QLD, Australia; Queensland Centre for Mental Health Research, The Park Centre for Mental Health, Wacol, QLD, Australia
| | - Johanna Taylor
- Department of Health Sciences, University of York, Hull York Medical School, Bradford, UK
| | - Scott B Teasdale
- School of Psychiatry, Faculty of Medicine, University of New South Wales, Sydney, NSW, Australia; Keeping the Body in Mind Program, South Eastern Sydney Local Health District, Sydney, NSW, Australia
| | - Graham Thornicroft
- Centre for Global Mental Health, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - John Torous
- Department of Psychiatry, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
| | - Tim Usherwood
- The George Institute for Global Health, University of New South Wales, Sydney, NSW, Australia; Department of General Practice, Westmead Clinical School, University of Sydney, Westmead, NSW, Australia
| | - Davy Vancampfort
- Department of Rehabilitation Sciences, Katholieke Universiteit Leuven, Leuven, Belgium; University Psychiatric Centre, Katholieke Universiteit Leuven, Kortenberg, Belgium
| | - Nicola Veronese
- National Research Council, Neuroscience Institute, Aging Branch, Padova, Italy
| | - Philip B Ward
- School of Psychiatry, Faculty of Medicine, University of New South Wales, Sydney, NSW, Australia; Schizophrenia Research Unit, Ingham Institute of Applied Medical Research, Liverpool, NSW, Australia
| | - Alison R Yung
- Division of Psychology and Mental Health, School of Health Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK; Centre for Youth Mental Health, University of Melbourne, Melbourne, VIC, Australia; Orygen, The National Centre of Excellence in Youth Mental Health, University of Melbourne, Melbourne, VIC, Australia
| | - Eoin Killackey
- Centre for Youth Mental Health, University of Melbourne, Melbourne, VIC, Australia; Orygen, The National Centre of Excellence in Youth Mental Health, University of Melbourne, Melbourne, VIC, Australia
| | - Brendon Stubbs
- South London and Maudsley NHS Foundation Trust, London, UK; Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
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Kladney M, Joudrey P, Cunningham CO, Bachhuber MA. Pharmacotherapy Prescribing to Patients with Concurrent Tobacco and Alcohol Use Disorder in a Large, Urban, Integrated Health System. J Gen Intern Med 2019; 34:804-805. [PMID: 30604121 PMCID: PMC6544704 DOI: 10.1007/s11606-018-4806-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Affiliation(s)
- Mat Kladney
- Division of General Internal Medicine, Montefiore Medical Center/Albert Einstein College of Medicine, Bronx, NY, USA. .,Division of General Internal Medicine and Clinical Innovation, New York University - Bellevue Hospital, New York, NY, USA.
| | - Paul Joudrey
- VA Connecticut Healthcare System, West Haven Campus, West Haven, CT, USA.,National Clinician Scholars Program, Yale School of Medicine, New Haven, CT, USA
| | - Chinazo O Cunningham
- Division of General Internal Medicine, Montefiore Medical Center/Albert Einstein College of Medicine, Bronx, NY, USA
| | - Marcus A Bachhuber
- Division of General Internal Medicine, Montefiore Medical Center/Albert Einstein College of Medicine, Bronx, NY, USA
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De Aquino JP, Sofuoglu M, Stefanovics E, Rosenheck R. Adverse Consequences of Co-Occurring Opioid Use Disorder and Cannabis Use Disorder Compared to Opioid Use Disorder Only. THE AMERICAN JOURNAL OF DRUG AND ALCOHOL ABUSE 2019; 45:527-537. [PMID: 31112429 DOI: 10.1080/00952990.2019.1607363] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Background: While there is growing interest in the possibility that cannabis may be a partial substitute for opioids, studies have yet to examine whether individuals with co-occurring opioid and cannabis use disorders (OUD and CUD) have less risk of negative outcomes than those with OUD only. Objective: This study sought to compare the sociodemographic and clinical characteristics of patients diagnosed with co-occurring OUD and CUD to patients with OUD only, CUD only, and patients with any other drug use disorders. We hypothesized that co-occurring OUD and CUD would be associated with lower risk of inpatient admissions and emergency department (ED) visits, lower rates of homelessness, and fewer opioid prescriptions. Methods: Comparisons were based on bivariate analyses, logistic and linear multiple regression models of National Veterans Health Administration (VHA) data from Fiscal Year 2012. Results: Of the 234,181 (94% male) patients diagnosed with drug use disorders, 8.6% were diagnosed with co-occurring OUD and CUD; 33.3% with OUD only; 26.5% with CUD only; and 31.6% with other drug use disorders. Compared to the OUD only group (Mean = 4.8 (SD = 8.84)), the group with co-occurring OUD and CUD was associated with a lower number of opioid prescriptions (Mean = 3.79 (SD = 8.22)) (d = -0.16), but higher likelihood of inpatient psychiatric admission (RR = 1.95) and homelessness (RR = 1.52), and no significant difference in ED visits. Conclusions: These data highlight the need to further investigate whether the complex effects of cannabis use on patients with OUD are counterbalanced by potential benefits of reduced in opioid prescribing.
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Affiliation(s)
- Joao P De Aquino
- a Department of Psychiatry, Yale University School of Medicine , New Haven , CT , USA
| | - Mehmet Sofuoglu
- a Department of Psychiatry, Yale University School of Medicine , New Haven , CT , USA.,b U.S. Department of Veterans Affairs, New England Mental Illness, Research, Education and Clinical Center (MIRECC), VA Connecticut Healthcare System , West Haven , CT , USA
| | - Elina Stefanovics
- a Department of Psychiatry, Yale University School of Medicine , New Haven , CT , USA.,b U.S. Department of Veterans Affairs, New England Mental Illness, Research, Education and Clinical Center (MIRECC), VA Connecticut Healthcare System , West Haven , CT , USA
| | - Robert Rosenheck
- a Department of Psychiatry, Yale University School of Medicine , New Haven , CT , USA.,b U.S. Department of Veterans Affairs, New England Mental Illness, Research, Education and Clinical Center (MIRECC), VA Connecticut Healthcare System , West Haven , CT , USA
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MacLean RR, Sofuoglu M. Stimulants and Mood Disorders. CURRENT ADDICTION REPORTS 2018. [DOI: 10.1007/s40429-018-0212-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/16/2022]
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Ho P, Rosenheck R. Substance Use Disorder Among Current Cancer Patients: Rates and Correlates Nationally in the Department of Veterans Affairs. PSYCHOSOMATICS 2018; 59:267-276. [DOI: 10.1016/j.psym.2018.01.003] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/09/2017] [Revised: 01/07/2018] [Accepted: 01/08/2018] [Indexed: 11/29/2022]
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