1
|
Lehoux T, Capobianco A, Lacoste J, Rollier S, Mopsus Y, Melgire M, Lecuyer F, Gervilla M, Weiner L. Virtual reality cue-exposure therapy in reducing cocaine craving: the Promoting Innovative COgnitive behavioral therapy for Cocaine use disorder (PICOC) study protocol for a randomized controlled trial. Trials 2024; 25:421. [PMID: 38937824 PMCID: PMC11212420 DOI: 10.1186/s13063-024-08275-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2024] [Accepted: 06/19/2024] [Indexed: 06/29/2024] Open
Abstract
BACKGROUND Cocaine craving is a central symptom of cocaine use disorders (CUD). Virtual reality cue-exposure therapy for craving (VRCET) allows more immersive, realistic, and controllable exposure than traditional non-VR cue-exposure therapy (CET), whose efficacy is limited in treating substance use disorders. The purpose of this study is to evaluate the efficacy and acceptability of VRCET, as a stand-alone and add-on intervention (i.e., combined with cognitive therapy), compared to a picture-based CET (PCET), in reducing self-reported cocaine craving in inpatients hospitalized for CUD. METHODS Fifty-four inpatients hospitalized for CUD will be randomized in one of two intensive 3-week treatment arms: 10 meetings/2-week treatment of VRCET plus 5 meetings/1-week treatment of memory-focused cognitive therapy (MFCT; experimental arm), or 15 meetings/3-week treatment of PCET (active control arm). The Craving Experience Questionnaire (CEQ - F & S) will be used to assess the primary outcome, i.e., the post-treatment decrease of self-reported cocaine craving frequency (within the past 2 weeks) and intensity scores (in VR exposure to cocaine cues). Secondary endpoints include urinary, physiological, and self-reported cocaine use-related measures. Assessments are scheduled at pretreatment, after 2 weeks of treatment (i.e., VRCET vs. PCET), post-treatment (3 weeks, i.e., VRCET + MFCT vs. PCET), and at 1-month follow-up. Acceptability will be evaluated via (i) the Spatial Presence for Immersive Environments - Cybersickness along VRCET and (ii) the Client Satisfaction Questionnaires after 2 weeks of treatment and post-treatment. DISCUSSION This study will be the first to evaluate the acceptability and efficacy of VRCET for CUD, as a psychotherapeutic add-on, to reduce both cocaine craving frequency and intensity. Additionally, this study will provide evidence about the specific interest of VRCET, compared to a non-VR-based CET, as a cue reactivity and exposure paradigm for treating substance use disorders. TRIAL REGISTRATION NCT05833529 [clinicaltrials.gov]. Prospectively registered on April 17, 2023.
Collapse
Affiliation(s)
- T Lehoux
- Laboratoire de Psychologie Des Cognitions, University of Strasbourg, 4 Rue Blaise Pascal, 67081, Strasbourg, France.
- Laboratoire ICube - Equipe IGG, University of Strasbourg, 300 Boulevard Sébastien Brant, 67412, Illkirch, France.
| | - Antonio Capobianco
- Laboratoire ICube - Equipe IGG, University of Strasbourg, 300 Boulevard Sébastien Brant, 67412, Illkirch, France
| | - Jérôme Lacoste
- Service d'Addictologie, University Hospital of Martinique - Hôpital Pierre Zobda-Quitman (CHU de Martinique), CS 90632 - 97261, Fort-de-France Martinique, France
| | - Sloane Rollier
- Research Methodological Support (USMR), Délégation à La Recherche Clinique et à L'Innovation, University Hospital of Martinique - Hôpital Pierre Zobda-Quitman (CHU de Martinique), CS 90632 - 97261, Fort-de-France, Martinique, France
| | - Yann Mopsus
- Research Methodological Support (USMR), Délégation à La Recherche Clinique et à L'Innovation, University Hospital of Martinique - Hôpital Pierre Zobda-Quitman (CHU de Martinique), CS 90632 - 97261, Fort-de-France, Martinique, France
| | - Manuela Melgire
- Department of Addictology, CSAPA Saint-Esprit, Saint-Esprit Hospital (CH de Saint-Esprit), BP 176 Route du Petit-Bourg, 97270, Saint-Esprit, Martinique, France
| | - Flavien Lecuyer
- Laboratoire ICube - Equipe IGG, University of Strasbourg, 300 Boulevard Sébastien Brant, 67412, Illkirch, France
| | - Miguel Gervilla
- Laboratoire ICube - Equipe IGG, University of Strasbourg, 300 Boulevard Sébastien Brant, 67412, Illkirch, France
| | - Luisa Weiner
- Laboratoire de Psychologie Des Cognitions, University of Strasbourg, 4 Rue Blaise Pascal, 67081, Strasbourg, France
| |
Collapse
|
2
|
Lehoux T, Porche CN, Capobianco A, Gervilla M, Lecuyer F, Anthouard J, Weiner L. Towards virtual reality exposure therapy for cocaine use disorder: A feasibility study of inducing cocaine craving through virtual reality. Addict Behav Rep 2024; 19:100549. [PMID: 38725607 PMCID: PMC11081783 DOI: 10.1016/j.abrep.2024.100549] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2023] [Revised: 03/12/2024] [Accepted: 04/29/2024] [Indexed: 05/12/2024] Open
Abstract
Background Craving is a core symptom of cocaine use disorders (CUD). Inducing craving in exposure to substance cues is of relevant interest for numerous clinical applications. Virtual reality exposure (VRE) might be a promising candidate for improving cue-exposure paradigms but remains almost not studied for cocaine. This feasibility study's main aim is to assess whether VRE to cocaine cues is capable to induce cocaine craving compared with VRE to neutral cues. Methods We conducted a within-subjects controlled trial in which cocaine users performed 3 consecutive 10 mins-tasks: VRE to neutral and cocaine cues, and a relaxation-based resting procedure. The primary outcome was the change in Cocaine Craving Questionnaire-Brief (CCQ-Brief) scores between VRE to neutral and cocaine cues. Secondary outcomes included between-tasks changes in scores of cocaine craving, pleasant/unpleasant emotions as well as self-efficacy to cope with craving. Results We recruited 11 chronic cocaine users including mostly crack smokers (45 %), cocaine snorters (36 %) and injectors (18 %), with 73 % of participants meeting DSM-IV criteria for cocaine dependence and/or abuse. Non-parametrical sign tests indicated significant large increases of CCQ-Brief scores from neutral to cocaine cue-VRE (S(11) = 11, p < 0.01, Cliff's Δ = 0.65, 95 % CI: 0.17-0.88). Exploratory comparative analyses indicated significant changes after our post-cues VRE relaxation procedure, with cocaine craving and emotions restored to baseline. Conclusions VRE to cocaine cues was feasible and capable to induce cocaine craving in cocaine users. This second VRE-based cue-reactivity study in cocaine paves the way for unexplored research on VRE clinical applications for CUD.
Collapse
Affiliation(s)
- Thomas Lehoux
- Laboratoire de Psychologie des Cognitions, University of Strasbourg, 4 Rue Blaise Pascal, 67081 Strasbourg, France
- Laboratoire ICube, University of Strasbourg, 300 Boulevard Sébastien Brant, 67412 Illkirch, France
- Association Ithaque, 12 Rue Kuhn, 67000 Strasbourg, France
| | - Christelle Nithart Porche
- Psychiatry, Mental Health, and Addictology Department, Strasbourg University Hospital, 1 Place de l’Hôpital, 67091 Strasbourg, France
- Institut National de la Santé et de la Recherche Médicale, Unité de Recherche 1114, Cognitive Neuropsychology, and Pathophysiology of Schizophrenia, 67000 Strasbourg, France
| | - Antonio Capobianco
- Laboratoire ICube, University of Strasbourg, 300 Boulevard Sébastien Brant, 67412 Illkirch, France
| | - Miguel Gervilla
- Laboratoire ICube, University of Strasbourg, 300 Boulevard Sébastien Brant, 67412 Illkirch, France
| | - Flavien Lecuyer
- Laboratoire ICube, University of Strasbourg, 300 Boulevard Sébastien Brant, 67412 Illkirch, France
| | | | - Luisa Weiner
- Laboratoire de Psychologie des Cognitions, University of Strasbourg, 4 Rue Blaise Pascal, 67081 Strasbourg, France
- Psychiatry, Mental Health, and Addictology Department, Strasbourg University Hospital, 1 Place de l’Hôpital, 67091 Strasbourg, France
| |
Collapse
|
3
|
Kiiroja L, Stewart SH, Gadbois S. Can scent-detection dogs detect the stress associated with trauma cue exposure in people with trauma histories? A proof-of-concept study. FRONTIERS IN ALLERGY 2024; 5:1352840. [PMID: 38606088 PMCID: PMC11006987 DOI: 10.3389/falgy.2024.1352840] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2023] [Accepted: 02/02/2024] [Indexed: 04/13/2024] Open
Abstract
Introduction Post-traumatic stress disorder (PTSD) is an impairing mental health condition with high prevalence among military and general populations alike. PTSD service dogs are a complementary and alternative intervention needing scientific validation. We investigated whether dogs can detect putative stress-related volatile organic compounds (VOCs) in the breath of people with trauma histories (54% with PTSD) exposed to personalized trauma cues. Methods Breath samples were collected from 26 humans over 40 experimental sessions during a calm (control breath sample) and stressed state induced by trauma cue exposure (target breath sample). Two scent detection canines were presented with the samples in a two alternative forced choice (2AFC) discrimination and yes/no detection task. The 2AFC task assessed the dogs' ability to discriminate between the two states within the breath samples of one individual. The detection task determined their ability to generalize the target odour across different individuals and different stressful events of one individual. Signal Detection Theory was applied to assess dogs' sensitivity, specificity, precision, and response bias. Results The dogs performed at ∼90% accuracy across all sample sets in the discrimination experiment, and at 74% and 81% accuracy, respectively, in the detection experiment. Further analysis of dog olfactory performance in relation to human donor self-reported emotional responses to trauma cue exposure suggested the dogs may have been detecting distinct endocrine stress markers. One dog's performance correlated with the human donors' self-reported fear responses and the other dog's performance correlated with the human donors' self-reported shame responses. Based on these correlations between dog performance and donor self-report measures, we speculate that the VOCs each dog was detecting likely originated from the sympathetico-adreno-medullary axis (SAM; adrenaline, noradrenaline) in the case of the first dog and the hypothalamo-pituitary-adrenal axis (HPA; glucocorticoids) in the case of the second dog. Conclusion Our proof-of-concept study is the first to demonstrate that some dogs can detect putative VOCs emitted by people with trauma histories when experiencing distress theoretically associated with the intrusion and arousal/reactivity symptoms of PTSD. Results have potential to improve the effectiveness and training protocol of PTSD service dogs with a focus on enhancing their alert function.
Collapse
Affiliation(s)
- Laura Kiiroja
- Canine Olfaction Lab, Department of Psychology and Neuroscience, Dalhousie University, Halifax, NS, Canada
| | - Sherry H. Stewart
- Canine Olfaction Lab, Department of Psychology and Neuroscience, Dalhousie University, Halifax, NS, Canada
- Mood, Anxiety, and Addictions Comorbidity (MAAC) Lab, Department of Psychiatry, Dalhousie University, Halifax, NS, Canada
| | - Simon Gadbois
- Canine Olfaction Lab, Department of Psychology and Neuroscience, Dalhousie University, Halifax, NS, Canada
| |
Collapse
|
4
|
Porche S, Gardner B. Reflective and non-reflective influences on cannabis use among undergraduate students: A qualitative study. JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2024; 72:328-334. [PMID: 35157557 DOI: 10.1080/07448481.2022.2034835] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/30/2021] [Revised: 10/19/2021] [Accepted: 11/28/2021] [Indexed: 06/14/2023]
Abstract
OBJECTIVE Around 40% of US university students use cannabis, 25% of whom present with cannabis use disorder, which endangers health. We investigated the concurrent contribution of reflective processes, which generate action via conscious deliberation, and non-reflective processes, which prompt behavior automatically, to undergraduates' cannabis consumption. PARTICIPANTS Eighteen UK undergraduates who regularly consume cannabis (11 female, 7 male; mean age 20 y). METHODS Semi-structured interviews explored cannabis motives, routines, cues, and decision points. Thematic analysis identified themes, in each of which reflective and non-reflective dimensions were coded. RESULTS Four themes were identified: cannabis use for relaxation, social bonding, and symbolic-affective significance, and contexts and triggers. Some influences guided cannabis use reflectively in some settings, and non-reflectively in others. Even when cannabis use was consciously driven, non-reflective processes were deployed to execute subservient acts, such as rolling joints. CONCLUSIONS Findings highlight specific processes and pathways that might be targeted to reduce cannabis-related harm.
Collapse
Affiliation(s)
- Samuele Porche
- Department of Psychology, King's College London Institute of Psychiatry Psychology and Neuroscience, London, UK
| | - Benjamin Gardner
- Department of Psychology, King's College London Institute of Psychiatry Psychology and Neuroscience, London, UK
| |
Collapse
|
5
|
Gray BA, Bolts OL, Fitzke RE, Douglass MA, Pedersen ER, Prince MA. Using Latent Profile Analysis to Examine Cannabis Use Contexts: Associations with Use, Consequences, and Protective Behaviors. Subst Use Misuse 2023; 59:208-217. [PMID: 37846065 DOI: 10.1080/10826084.2023.2267112] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2023]
Abstract
OBJECTIVE College students represent a large portion of the population, and report high rates of cannabis use and related negative outcomes, including interpersonal problems, risky behaviors, or physical dependency. The contexts in which students use cannabis (e.g., at a party, when feeling down or depressed, after a fight with a loved one) likely affect their risk of experiencing consequences. We aimed to discern profiles of cannabis use contexts and compare profiles on use frequency, consequences, and the use of cannabis protective behavioral strategies (PBS). METHOD College students were surveyed regarding their cannabis use contexts, frequency, consequences, and PBS use (n = 265; female = 72.8%). We used Latent Profile Analysis to identify patterns of cannabis use contexts and auxiliary testing to compare profiles on use frequency, consequences, and PBS use. RESULTS Our examination revealed three latent profiles of cannabis use. The Social Use Profile was associated with use in predominantly social/uplifting contexts. The Physical & Emotional Pain Profile was also associated with use in these contexts but was defined by additional use in response to pain. The All Contexts Profile was associated with frequent use in all contexts, including those that were least endorsed by the other profiles. Profiles differed in cannabis use frequency, PBS use, and the number of consequences experienced, such that profiles were more likely to be associated with more frequent cannabis use, higher risk of experiencing use-consequences, and using fewer PBS as the number of use contexts increased across the profiles. CONCLUSIONS The contexts in which people use cannabis are associated with cannabis risk and protection. Prevention and intervention efforts may benefit from considering contexts of cannabis use.
Collapse
Affiliation(s)
- Bethany A Gray
- Department of Psychology, Colorado State University, Fort Collins, Colorado, USA
| | - Olivia L Bolts
- Department of Psychology, Colorado State University, Fort Collins, Colorado, USA
| | - Reagan E Fitzke
- Department of Psychiatry and Behavioral Sciences, University of Southern California; Keck School of Medicine, Los Angeles, California, USA
| | - Morgan A Douglass
- Department of Psychology, Colorado State University, Fort Collins, Colorado, USA
| | - Eric R Pedersen
- Department of Psychiatry and Behavioral Sciences, University of Southern California; Keck School of Medicine, Los Angeles, California, USA
| | - Mark A Prince
- Department of Psychology, Colorado State University, Fort Collins, Colorado, USA
| |
Collapse
|
6
|
Sainz-Cort A, Martín-Islas M, Oña G, Jimenez-Garrido D, López-Navarro M, Muñoz-Marron E, Viejo-Sobera R, Bouso JC. Spanish versions and validation of a series of rating scales and visual analogue scales to assess the subjective effects of cannabis. Int Clin Psychopharmacol 2023:00004850-990000000-00108. [PMID: 37982285 DOI: 10.1097/yic.0000000000000498] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/21/2023]
Abstract
Cannabis is being legalized for medical and recreational purposes all around the world. However, the understanding of the psychological effects of cannabis is still limited, and it has been previously linked to mental disorders such as schizophrenia. Lately, new scales have been created and adapted to measure its psychological effects. The aim of this study is to create Spanish versions of some of these scales and test their psychometric characteristics. One hundred sixteen participants were recruited from Cannabis Social Clubs (CSC) in Barcelona, Spain. Participants under the effects of their own cannabis completed the Cannabis Experience Questionnaire-modified version (CEQ-mv), Addiction Research Centre Inventory-18 (ARCI-18), Psychotomimetic States Inventory (PSI) and Visual Analogue Scales (VAS). Questionnaires were completed in the CSC, providing a naturalistic setting for the study. Exploratory factor analysis and internal consistency were analyzed. PSI was reduced from a 6-factor to a 4-factor model with adequate to low reliability, ARCI-18 was reduced from a 3-factor to a 2-factor model with good reliability, and VAS were reduced from a 4-factor to a 3-factor model, also with good reliability. These questionnaires showed adequate reliability and can be used in future studies to test the subjective effects of cannabis in clinical and naturalistic settings.
Collapse
Affiliation(s)
- Alberto Sainz-Cort
- Faculty of Health Sciences. Universitat Oberta de Catalunya (UOC)
- International Center for Ethnobotanical Education, Research and Service (ICEERS), Barcelona
| | - Marta Martín-Islas
- International Center for Ethnobotanical Education, Research and Service (ICEERS), Barcelona
| | - Genís Oña
- International Center for Ethnobotanical Education, Research and Service (ICEERS), Barcelona
- Universitat Rovira i Virgili, Medical Anthropology Research Center (MARC), Tarragona, Spain
| | - Daniel Jimenez-Garrido
- International Center for Ethnobotanical Education, Research and Service (ICEERS), Barcelona
| | - Miriam López-Navarro
- Neurobiology Research Unit, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark
| | | | | | - Jose Carlos Bouso
- International Center for Ethnobotanical Education, Research and Service (ICEERS), Barcelona
- Universitat Rovira i Virgili, Medical Anthropology Research Center (MARC), Tarragona, Spain
| |
Collapse
|
7
|
Wang Y, Zuo J, Wang L, Wang Q, Wang X, Yang Q, Wu HE, Goodman CB, Wang D, Liu T, Zhang X. The Association of Drug-Use Characteristics and Active Coping Styles With Positive Affect in Patients With Heroin-Use Disorder and Methamphetamine-Use Disorder During the COVID-19 Pandemic. Front Public Health 2021; 9:739068. [PMID: 34926370 PMCID: PMC8677928 DOI: 10.3389/fpubh.2021.739068] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2021] [Accepted: 10/25/2021] [Indexed: 11/26/2022] Open
Abstract
Background: Positive affect (PA) is crucial for individuals to cope with the current pandemic and buffer the lingering fears after it, especially for patients with substance-use disorders (SUDs). The current study aimed to explore PA and its related factors during the COVID-19 pandemic in male patients with the heroin-use disorder (HUD) and patients with the methamphetamine-use disorder (MAUD), respectively. Methods: A total of 325 male patients with SUDs (106 with HUD and 219 with MAUD, all were single-substance users) in a compulsory rehabilitation center underwent semi-structured interviews during the pandemic. The demographic information, drug-use characteristics, active coping styles (ACSs, by Simple Coping Style Questionnaire), and PA (by the Positive and Negative Affect Scale) of participants were collected and recorded. Results: There were significant differences between the two groups in age, the proportion of full-time workers before the epidemic, duration of drug use, the proportion of patients with long-term withdrawal during the epidemic, cravings, ACS, and PA. Correlation and multiple linear regression analysis showed that duration of drug use, ACS, and stable jobs were significant predictive factors for PA in patients with HUD, while long-term withdrawal, ACS, and stable jobs during the epidemic were significant predictive factors for PA in patients with MAUD. Conclusions: Our study demonstrated the factors for PA in patients with HUD and MAUD during the pandemic. The results provided a basis for the comprehensive understanding of the PA of patients with SUDs and the development of targeted treatments.
Collapse
Affiliation(s)
- Yingying Wang
- Department of Psychiatry, The Second Xiangya Hospital of Central South University, Changsha, China.,National Clinical Research Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, China
| | - Jinsong Zuo
- School of Life Science and Chemistry, Hunan University of Technology, Zhuzhou, China
| | - Long Wang
- Sanming Taijiang Hospital, Sanming, China
| | - Qianjin Wang
- Department of Psychiatry, The Second Xiangya Hospital of Central South University, Changsha, China.,National Clinical Research Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, China
| | - Xin Wang
- Department of Psychiatry, The Second Xiangya Hospital of Central South University, Changsha, China.,National Clinical Research Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, China
| | - Qian Yang
- Department of Psychiatry, The Second Xiangya Hospital of Central South University, Changsha, China.,National Clinical Research Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, China
| | - Hanjing Emily Wu
- Department of Psychiatry and Behavioral Sciences, The University of Texas Health Science Center at Houston, Houston, TX, United States
| | - Colin B Goodman
- Department of Psychiatry and Behavioral Sciences, The University of Texas Health Science Center at Houston, Houston, TX, United States
| | - Dongmei Wang
- CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, China
| | - Tieqiao Liu
- Department of Psychiatry, The Second Xiangya Hospital of Central South University, Changsha, China.,National Clinical Research Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, China
| | - Xiangyang Zhang
- CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, China
| |
Collapse
|
8
|
Borodovsky JT, Sofis MJ, Grucza RA, Budney AJ. The importance of psychology for shaping legal cannabis regulation. Exp Clin Psychopharmacol 2021; 29:99-115. [PMID: 32437193 PMCID: PMC7679279 DOI: 10.1037/pha0000362] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Different patterns of cannabis use can be traced directly back to different interactions between 2 types of variables: pharmacological and environmental. As legal cannabis expands in the U.S. and around the world, state and national regulatory agencies are gaining control over these variables. Specifically, regulatory agencies are increasingly capable of altering (a) the pharmacological properties of cannabis products and (b) the way these products are distributed to the population. Consequently, cannabis regulatory agencies are in a unique position to use evidence from psychological science to alter cannabis consumption patterns in ways that mitigate potential harm to public health. However, most state-level legal cannabis regulatory systems in the U.S. are not yet evidence-based or public health-oriented. This applied review and commentary draws on evidence from the psychological science literature to help regulators better understand the types of behaviors they must address and guide empirically supported regulation of THC-laden cannabis, whether used putatively for medical or recreational reasons. This review is organized into 3 parts that correspond to the 3 primary agents within the cannabis regulation ecosystem: (a) the cannabis consumer, (b) the cannabis industry, and (c) the cannabis regulatory agency. Within this structure, the review addresses critical psychological variables that drive cannabis consumer and industry behaviors and discusses how regulatory agencies can use this information to protect public health. (PsycInfo Database Record (c) 2021 APA, all rights reserved).
Collapse
Affiliation(s)
- Jacob T Borodovsky
- Department of Psychiatry, Washington University School of Medicine in St. Louis
| | - Michael J Sofis
- Center for Technology and Behavioral Health, Dartmouth Geisel School of Medicine
| | - Richard A Grucza
- Department of Psychiatry, Washington University School of Medicine in St. Louis
| | - Alan J Budney
- Center for Technology and Behavioral Health, Dartmouth Geisel School of Medicine
| |
Collapse
|
9
|
Wilson SD, Collins RL, Prince MA, Vincent PC. Effects of exercise on experimentally manipulated craving for cannabis: A preliminary study. Exp Clin Psychopharmacol 2018; 26:456-466. [PMID: 29792472 PMCID: PMC6162100 DOI: 10.1037/pha0000200] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Cannabis is the most commonly used illicit drug in the United States, and craving for cannabis is related to cannabis use. Exercise has been demonstrated to reduce craving for substances. To examine the effects of exercise on cannabis craving, we conducted a 3-week within-subject crossover experiment. Young-adult men (n = 35) and women (n = 11), age 18-25 years (M = 20.76, SD = 1.68), who regularly (≥3 times per week) used cannabis participated in a cue exposure paradigm to stimulate craving. After each of three separate craving inductions, they completed a 10-min bout of exercise that varied in intensity (rest, moderate, vigorous). Craving was assessed before and after the induction, immediately following the exercise, and at three 10-min intervals (total of 30 min). Results of condition-specific, repeated measures analyses of variance showed nonsignificant reductions in immediate postexercise craving for the moderate and vigorous conditions. We used latent growth modeling to examine the trajectory of craving rebound during the 30 min following exercise and explored the effect of baseline weekly cannabis use in predicting craving rebound. Within 30 min postexercise, craving rebounded for both the moderate, F(3, 135) = 9.10, p < .01, and vigorous, F(3, 135) = 3.48, p < .05, conditions. We found that among cannabis users reporting larger quantities of typical weekly cannabis use, craving rebounded more quickly following vigorous than moderate exercise, b = 0.02, SE = 0.02, 95% confidence interval [0.00, 0.06]. The findings suggest that moderate exercise may be useful for reducing craving, particularly among those who use larger quantities of cannabis. (PsycINFO Database Record (c) 2018 APA, all rights reserved).
Collapse
Affiliation(s)
- Sandy D. Wilson
- Doctoral Candidate, Department of Community Health and Health Behavior, University at Buffalo, State University of New York, 3435 Main Street, 825 Kimball Tower, Buffalo, New York 14214-8028, Direct phone: 716-829-5623, Fax: 716-829-6040
| | - R. Lorraine Collins
- Professor, Department of Community Health and Health Behavior, University at Buffalo, State University of New York
| | - Mark A. Prince
- Assistant Professor, Department of Psychology, Colorado State University
| | - Paula C. Vincent
- Research Assistant Professor, Department of Community Health and Health Behavior, University at Buffalo, State University of New York
| |
Collapse
|
10
|
Sherman BJ, Baker NL, Squeglia LM, McRae-Clark AL. Approach bias modification for cannabis use disorder: A proof-of-principle study. J Subst Abuse Treat 2018; 87:16-22. [PMID: 29471922 PMCID: PMC5826579 DOI: 10.1016/j.jsat.2018.01.012] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2017] [Revised: 01/12/2018] [Accepted: 01/12/2018] [Indexed: 11/21/2022]
Abstract
BACKGROUND More effective treatments for cannabis use disorder (CUD) are needed. Evidence suggests that biases in cognitive processing of drug-related stimuli are central to the development and maintenance of addiction. The current study examined the feasibility and effect of a novel intervention - approach bias modification (ApBM) - on cannabis approach bias and cue-reactivity. METHODS A randomized, double-blind, sham-controlled proof-of-principle laboratory experiment investigated the effect of a four-session computerized ApBM training protocol on cannabis approach bias and cue-reactivity in non-treatment seeking adults age 18-65 with CUD (N = 33). ApBM procedures involved responding to cannabis or neutral stimuli using a computer joystick to model approach or avoidance behavior. Reactivity to tactile, olfactory, and auditory cue sets was assessed with physiological (blood pressure and heart rate) and subjective (cannabis craving) measures. Cannabis use was assessed via self-report. RESULTS Participants receiving ApBM showed blunted cannabis cue-induced craving at the end of training compared to those in the sham-ApBM condition (p = .05). A preliminary gender effect on cannabis use was also found; men receiving ApBM reported fewer cannabis use sessions per day at the end of training compared to women (p = .02), while there were no differences between men and women in the sham condition. ApBM did not attenuate cannabis approach bias following training. CONCLUSION Preliminary results indicate that ApBM may be efficacious in reducing cannabis cue-reactivity and improving cannabis use outcomes. While encouraging, the results should be interpreted with caution. Investigation of ApBM as an adjunct to psychosocial treatments for treatment-seeking adults with CUD is warranted.
Collapse
Affiliation(s)
- Brian J Sherman
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, 67 President Street, Charleston, SC 29425, USA.
| | - Nathaniel L Baker
- Department of Public Health Sciences, Medical University of South Carolina, 135 Cannon Street, Charleston, SC, 29425, USA
| | - Lindsay M Squeglia
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, 67 President Street, Charleston, SC 29425, USA
| | - Aimee L McRae-Clark
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, 67 President Street, Charleston, SC 29425, USA
| |
Collapse
|
11
|
Sauvaget A, Bulteau S, Guilleux A, Leboucher J, Pichot A, Valrivière P, Vanelle JM, Sébille-Rivain V, Grall-Bronnec M. Both active and sham low-frequency rTMS single sessions over the right DLPFC decrease cue-induced cravings among pathological gamblers seeking treatment: A randomized, double-blind, sham-controlled crossover trial. J Behav Addict 2018; 7:126-136. [PMID: 29463098 PMCID: PMC6035030 DOI: 10.1556/2006.7.2018.14] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/07/2017] [Revised: 11/27/2017] [Accepted: 01/25/2018] [Indexed: 12/11/2022] Open
Abstract
Background Craving is a core symptom of addictive disorders, such as pathological gambling for example. Over the last decade, several studies have assessed the efficacy of repetitive transcranial magnetic stimulation (rTMS) in the addiction field, which triggers the dorsolateral prefrontal cortex (DLPFC) to decrease craving. The STIMJEU study investigated whether a single session of low-frequency (LF, i.e., 1 Hz) rTMS applied to the right DLPFC reduced cue-induced gambling craving in a sample of treatment-seeking pathological gamblers. Methods Thirty patients received both active and sham rTMS in random order and were blinded to the condition in a within-subject crossover design. Outcome measures included self-reported gambling craving (Visual Analog Scale and Gambling Craving Scale) and physiological measures (heart rate and blood pressure). Results The rTMS sessions were associated with a significant decrease in the gambling urge, regardless of whether the session was active or sham. When controlling cue-induced craving levels, no effects were observed on craving for active rTMS. Overall, rTMS was well-tolerated, and the credibility of the sham procedure was assessed and appeared to be appropriate. Conclusions We failed to demonstrate the specific efficacy of one session of LF rTMS to decrease cue-induced craving in pathological gamblers. A strong placebo-effect and rTMS parameters may partly explain these results. Yet, we are convinced that rTMS remains a promising therapeutic method. Further studies are required to examine its potential effect.
Collapse
Affiliation(s)
- Anne Sauvaget
- Psychiatry Neuromodulation Unit, Addictology and Liaison Psychiatry Department, CHU Nantes, Nantes, France
- Faculty of Sport Sciences, Laboratory “Movement, Interactions, Performance” (E.A. 4334), University of Nantes, Nantes, France
| | - Samuel Bulteau
- Psychiatry Neuromodulation Unit, Addictology and Liaison Psychiatry Department, CHU Nantes, Nantes, France
- SPHERE MethodS in Patients-centered outcomes and HEalth ResEarch, Université de Nantes, Université de Tours, Nantes, France
| | - Alice Guilleux
- SPHERE MethodS in Patients-centered outcomes and HEalth ResEarch, Université de Nantes, Université de Tours, Nantes, France
| | - Juliette Leboucher
- Pathological Gambling Treatment Unit, Addictology and Liaison Psychiatry Department, CHU Nantes, Nantes, France
| | - Anne Pichot
- Psychiatry Neuromodulation Unit, Addictology and Liaison Psychiatry Department, CHU Nantes, Nantes, France
| | - Pierre Valrivière
- Psychiatry Neuromodulation Unit, Addictology and Liaison Psychiatry Department, CHU Nantes, Nantes, France
| | - Jean-Marie Vanelle
- Psychiatry Neuromodulation Unit, Addictology and Liaison Psychiatry Department, CHU Nantes, Nantes, France
| | - Véronique Sébille-Rivain
- SPHERE MethodS in Patients-centered outcomes and HEalth ResEarch, Université de Nantes, Université de Tours, Nantes, France
| | - Marie Grall-Bronnec
- SPHERE MethodS in Patients-centered outcomes and HEalth ResEarch, Université de Nantes, Université de Tours, Nantes, France
- Pathological Gambling Treatment Unit, Addictology and Liaison Psychiatry Department, CHU Nantes, Nantes, France
| |
Collapse
|
12
|
Metrik J, Aston ER, Kahler CW, Rohsenow DJ, McGeary JE, Knopik VS, MacKillop J. Cue-elicited increases in incentive salience for marijuana: Craving, demand, and attentional bias. Drug Alcohol Depend 2016; 167:82-8. [PMID: 27515723 PMCID: PMC5037029 DOI: 10.1016/j.drugalcdep.2016.07.027] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/27/2016] [Revised: 07/26/2016] [Accepted: 07/26/2016] [Indexed: 01/04/2023]
Abstract
BACKGROUND Incentive salience is a multidimensional construct that includes craving, drug value relative to other reinforcers, and implicit motivation such as attentional bias to drug cues. Laboratory cue reactivity (CR) paradigms have been used to evaluate marijuana incentive salience with measures of craving, but not with behavioral economic measures of marijuana demand or implicit attentional processing tasks. METHODS This within-subjects study used a new CR paradigm to examine multiple dimensions of marijuana's incentive salience and to compare CR-induced increases in craving and demand. Frequent marijuana users (N=93, 34% female) underwent exposure to neutral cues then to lit marijuana cigarettes. Craving, marijuana demand via a marijuana purchase task, and heart rate were assessed after each cue set. A modified Stroop task with cannabis and control words was completed after the marijuana cues as a measure of attentional bias. RESULTS Relative to neutral cues, marijuana cues significantly increased subjective craving and demand indices of intensity (i.e., drug consumed at $0) and Omax (i.e., peak drug expenditure). Elasticity significantly decreased following marijuana cues, reflecting sustained purchase despite price increases. Craving was correlated with demand indices (r's: 0.23-0.30). Marijuana users displayed significant attentional bias for cannabis-related words after marijuana cues. Cue-elicited increases in intensity were associated with greater attentional bias for marijuana words. CONCLUSIONS Greater incentive salience indexed by subjective, behavioral economic, and implicit measures was observed after marijuana versus neutral cues, supporting multidimensional assessment. The study highlights the utility of a behavioral economic approach in detecting cue-elicited changes in marijuana incentive salience.
Collapse
Affiliation(s)
- Jane Metrik
- Center for Alcohol and Addiction Studies, Brown University School of Public Health, Providence, RI, 02903, USA; Providence Veterans Affairs Medical Center, Providence, RI, 02908, USA.
| | - Elizabeth R. Aston
- Center for Alcohol and Addiction Studies, Brown University School of Public Health, Providence, RI, 02903
| | - Christopher W. Kahler
- Center for Alcohol and Addiction Studies, Brown University School of Public Health, Providence, RI, 02903
| | - Damaris J. Rohsenow
- Center for Alcohol and Addiction Studies, Brown University School of Public Health, Providence, RI, 02903,Providence Veterans Affairs Medical Center, Providence, RI, 02908
| | - John E. McGeary
- Providence Veterans Affairs Medical Center, Providence, RI, 02908,Rhode Island Hospital, Alpert Medical School of Brown University, Providence, RI, 02903
| | - Valerie S. Knopik
- Rhode Island Hospital, Alpert Medical School of Brown University, Providence, RI, 02903
| | - James MacKillop
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario, L8N 3K7 Canada
| |
Collapse
|