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Khorrami M, Khorrami F, Haghani K, Fathy Karkaragh F, Khodashenas A, Souri S. Gender differences in sleep quality among Iranian traditional and industrial drug users. Neurobiol Sleep Circadian Rhythms 2024; 17:100104. [PMID: 39070941 PMCID: PMC11283124 DOI: 10.1016/j.nbscr.2024.100104] [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: 04/29/2024] [Revised: 06/20/2024] [Accepted: 06/28/2024] [Indexed: 07/30/2024] Open
Abstract
•The findings emphasize gender differences in sleep quality among different cultures, races, and ethnicities.•There are gender differences in sleep quality in Iranian traditional and industrial drug users.•Industrial drug users have a lower quality of sleep than traditional drug users.•The sleep quality of drug users (traditional and industrial) is lower than that of healthy people.
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Affiliation(s)
- Mohammad Khorrami
- Islamic Azad University, Tehran Science & Research Branch (Isfahan), Isfahan, Iran
| | - Fatemeh Khorrami
- Faculty of Paramedicine, Golestan University of Medical Sciences, Gorgan, Iran
| | - Kosar Haghani
- Department of Social Sciences University of Mazandaran Babolsar, Iran
| | | | - Ayda Khodashenas
- Clinical Psychology, Department of Psychology, Ferdowsi University of Mashhad, Mashhad, Iran
| | - Sara Souri
- General Psychology in Payam Nour University, Branch Amol, Amol, Iran
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Mackay A, Downey LA, Arunogiri S, Ogeil RP, Hayley AC. Trait anger as a predictor of dangerous driving behaviour amongst people who use methamphetamine. ACCIDENT; ANALYSIS AND PREVENTION 2024; 204:107634. [PMID: 38795421 DOI: 10.1016/j.aap.2024.107634] [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: 07/06/2023] [Revised: 05/09/2024] [Accepted: 05/09/2024] [Indexed: 05/28/2024]
Abstract
INTRODUCTION Despite increased prevalence of methamphetamine in road trauma, it remains unclear how its use translates to an increased risk of traffic-related harm. Exploration of psychosocial factors may thus help identify relevant predictors of dangerous driving behaviour among people who regularly consume methamphetamine. METHODS Licenced individuals who report predominant and sustained methamphetamine use (at least 1-time/month for 6 months at heaviest use) were recruited from the Australian community and via targeted campaign (Eastern Health). Psychosocial, substance use and driving behaviour data (Dula Dangerous Driving Index, DDDI) were collected via a secure anonymous online forced-entry survey platform (Qualtrics). RESULTS Seventy-seven individuals (65.5 % male) aged between 20-50 years [mean = 29.7, ± Standard Deviation (SD) 6.1] were included. Most (90 %) respondents met criteria for problematic methamphetamine use [Severity of Dependency Scale (SDS) score ≥ 5], and 75 % were high-risk alcohol consumers [Alcohol Use Disorders Identification Test (AUDIT-C) score ≥ 4 for men and ≥ 3 for women]. On average, age of first methamphetamine use occurred at 23.3 years (±5.2). A best-possible subset's regression selection method with dangerous driving behaviour as the dependent variable determined the model with three predictors (alcohol use, substance dependence severity and trait anger) as most parsimonious. After controlling for substance use, trait anger strongly and positively predicted dangerous driving behaviour as measured by the DDDI ([F(3,74) = 26.06, p < .001, adjusted R2 = 0.50, Cohens f2 = 0.42). DISCUSSION AND CONCLUSIONS Trait anger is a strong predictor of risky driving among road users who use methamphetamine. Interactions between stable negative-emotional and situational traffic and driving-related factors may increase risk of harm through greater engagement in risk-taking behaviour.
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Affiliation(s)
- Aaron Mackay
- Centre for Mental Health and Brain Sciences, Swinburne University of Technology, Hawthorn, Australia
| | - Luke A Downey
- Centre for Mental Health and Brain Sciences, Swinburne University of Technology, Hawthorn, Australia; Institute for Breathing and Sleep, Austin Health Hospital, Melbourne, Australia
| | - Shalini Arunogiri
- Monash Addiction Research Centre, Eastern Health Clinical School, Faculty of Medicine, Nursing and Health Sciences, Monash University, Australia; Turning Point, Eastern Health, Richmond, Victoria, 3121, Australia
| | - Rowan P Ogeil
- Monash Addiction Research Centre, Eastern Health Clinical School, Faculty of Medicine, Nursing and Health Sciences, Monash University, Australia; Turning Point, Eastern Health, Richmond, Victoria, 3121, Australia
| | - Amie C Hayley
- Centre for Mental Health and Brain Sciences, Swinburne University of Technology, Hawthorn, Australia; Institute for Breathing and Sleep, Austin Health Hospital, Melbourne, Australia; International Council for Alcohol, Drugs and Traffic Safety (ICADTS), Australia.
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Praeger VC, Frei MY, Pham D, Praeger AJ, Lubman DI, Arunogiri S. Rotation from methadone to buprenorphine using a micro-dosing regime in patients with opioid use disorder and serious mental illness: A case series. Drug Alcohol Rev 2024. [PMID: 38894653 DOI: 10.1111/dar.13885] [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: 09/17/2023] [Revised: 04/07/2024] [Accepted: 05/14/2024] [Indexed: 06/21/2024]
Abstract
INTRODUCTION Inducting buprenorphine from methadone has traditionally involved initial opioid withdrawal, with risk of mental state deterioration in patients with serious mental illness (SMI). Micro-dosing of buprenorphine, with small incremental doses, is a novel off-label approach to transitioning from methadone and does not require a period of methadone abstinence. Given the limited literature about buprenorphine microdosing, we aimed to evaluate the feasibility and safety of inducting buprenorphine in a series of patients on methadone with SMI. METHODS For this retrospective case series, we reviewed the records of 16 patients with SMI at a Melbourne addiction treatment centre, from January 2021 to July 2022, who transitioned via micro-dosing, from high-dose methadone (>30 mg) to buprenorphine and depot-buprenorphine. Psychiatric diagnoses, mental state, other substance withdrawal, transfer success, transition time, opioid withdrawal symptoms and overall patient experience were collected via objective and subjective reporting. RESULTS Methadone to buprenorphine transfer was completed by 88% of patients. Mental health measures remained stable with the exception of mildly increased anxiety. Median transfer time was 6.5 days for inpatients, 9 days for mixed setting and 10 days for outpatients. Most patients (93%) rated their experience 'manageable' reporting mild withdrawal symptoms. One patient met study criteria for precipitated withdrawal. DISCUSSION AND CONCLUSIONS This retrospective case series provides evidence that the use of a micro-dosing buprenorphine induction for methadone to buprenorphine transitions, including to depot-buprenorphine, has negligible risk, is tolerated by patients with SMI and is unlikely to precipitate an exacerbation of their mental illness.
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Affiliation(s)
| | - Matthew Y Frei
- Turning Point, Eastern Health, Melbourne, Victoria, Australia
| | - Dan Pham
- Turning Point, Eastern Health, Melbourne, Victoria, Australia
| | - Adrian J Praeger
- Department of Neurosurgery, Monash Hospital, Melbourne, Victoria, Australia
- Department of Surgery, School of Clinical Sciences, Monash University, Melbourne, Victoria, Australia
| | - Dan I Lubman
- Turning Point, Eastern Health, Melbourne, Victoria, Australia
- Monash Addiction Research Centre, Eastern Health Clinical School, Faculty of Medicine, Nursing & Health Sciences, Monash University, Melbourne, Victoria, Australia
| | - Shalini Arunogiri
- Turning Point, Eastern Health, Melbourne, Victoria, Australia
- Monash Addiction Research Centre, Eastern Health Clinical School, Faculty of Medicine, Nursing & Health Sciences, Monash University, Melbourne, Victoria, Australia
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Åhman A, Karlsson A, Berge J, Håkansson A. Mortality, morbidity, and predictors of death among amphetamine-type stimulant users - a longitudinal, nationwide register study. Addict Behav Rep 2024; 19:100553. [PMID: 38800761 PMCID: PMC11127464 DOI: 10.1016/j.abrep.2024.100553] [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: 01/24/2024] [Revised: 05/10/2024] [Accepted: 05/13/2024] [Indexed: 05/29/2024] Open
Abstract
Introduction Use of amphetamine-type stimulants (ATS) contributes substantially to the global burden of disease. Large-scale follow-up studies of morbidity and mortality in ATS users are few. This study analysed morbidity, mortality, and potential predictors of all-cause mortality in a nationwide cohort of patients with ATS use disorder. Methods Data was acquired from national Swedish registers. All Swedish residents 18 years or older, with a registered ATS use diagnosis in 2013-2014 were included (N = 5,018) and followed until December 31, 2017. Comorbid diagnoses and causes of death were assessed and potential predictors of all-cause mortality were examined through Cox regression. Results Median age at inclusion was 36.6 years (interquartile range 27.4---48.1) and 70.5 % were men. The crude mortality rate was 24.6 per 1,000 person-years. The adjusted all-cause standardized mortality ratio was 12.4 (95 % CI [11.34-13.55]). The most common cause of death was overdose (28.9 %). Multiple drug use (hazard ratio 1.39, 95 % CI [1.14-1.70], p = 0.004), anxiety (hazard ratio 1.39, 95 % CI [1.11-1.72], p = 0.014), viral hepatitis (hazard ratio 1.85, 95 % CI [1.50-2.29], p = 0.004), and liver disease (hazard ratio 2.41, 95 % CI [1.55-3.74], p = 0.004) were predictors of all-cause mortality. Conclusions Multiple drug use, anxiety disorders, viral hepatitis and liver diseases were identified as risk factors for death. Our findings call for better screening, prevention, and treatment of somatic and psychiatric comorbidity among ATS users to reduce mortality.
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Affiliation(s)
- A. Åhman
- Lund University, Faculty of Medicine, Department of Clinical Sciences Lund, Psychiatry, Lund, Sweden
- Faculty of Medicine, Department of Clinical Sciences Lund, BMC F12, Sölvegatan 19, 221 84 Lund, Sweden
| | - A. Karlsson
- Lund University, Faculty of Medicine, Department of Clinical Sciences Lund, Psychiatry, Lund, Sweden
- Faculty of Medicine, Department of Clinical Sciences Lund, BMC F12, Sölvegatan 19, 221 84 Lund, Sweden
| | - J. Berge
- Lund University, Faculty of Medicine, Department of Clinical Sciences Lund, Psychiatry, Lund, Sweden
- Faculty of Medicine, Department of Clinical Sciences Lund, BMC F12, Sölvegatan 19, 221 84 Lund, Sweden
| | - A. Håkansson
- Lund University, Faculty of Medicine, Department of Clinical Sciences Lund, Psychiatry, Lund, Sweden
- Faculty of Medicine, Department of Clinical Sciences Lund, BMC F12, Sölvegatan 19, 221 84 Lund, Sweden
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Borgatti DA, Rowlett JK, Berro LF. Effects of methamphetamine on actigraphy-based sleep parameters in female rhesus monkeys: Orexin receptor mechanisms. Drug Alcohol Depend 2024; 259:111285. [PMID: 38636173 PMCID: PMC11111337 DOI: 10.1016/j.drugalcdep.2024.111285] [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: 12/12/2023] [Revised: 03/05/2024] [Accepted: 04/01/2024] [Indexed: 04/20/2024]
Abstract
BACKGROUND The orexin system has been implicated as a mechanism underlying insomnia and methamphetamine-induced sleep disruptions, with a potential role for OX2 receptors in the sleep-modulating effects of orexin. The aim of the present study was to investigate the extent to which orexin receptors mediate the effects of acute methamphetamine administration on actigraphy-based sleep in female rhesus monkeys. METHODS Actigraphy-based sleep measures were obtained in female rhesus monkeys (n=5) under baseline and acute test conditions. First, morning (10h) i.m. injections of methamphetamine (0.03 - 0.56mg/kg) were administered to determine the effects of methamphetamine alone. Then, saline or methamphetamine (0.3mg/kg) were administered at 10h, and evening (17h30) oral treatments with vehicle, the non-selective orexin receptor antagonist suvorexant (1 - 10mg/kg, p.o.), or the OX2-selective orexin receptor antagonist MK-1064 (1 - 10mg/kg, p.o.) were given. The ability of suvorexant and MK-1064 (10mg/kg, p.o.) to improve actigraphy-based sleep was also assessed in a group of female monkeys quantitatively identified with "short-duration sleep" (n=4). RESULTS Methamphetamine dose-dependently disrupted actigraphy-based sleep parameters. Treatment with either suvorexant or MK-1064 dose-dependently improved actigraphy-based sleep in monkeys treated with methamphetamine. Additionally, both suvorexant and MK-1064 promoted actigraphy-based sleep in a group of monkeys with baseline short actigraphy-based sleep. CONCLUSIONS These findings suggest that orexin-mediated mechanisms play a role in the effects of methamphetamine on actigraphy-based sleep in female monkeys. Targeting the orexin system, in particular OX2 receptors, could be an effective option for treating sleep disruptions observed in individuals with methamphetamine use disorder.
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Affiliation(s)
- Daniel A Borgatti
- Department of Psychiatry and Human Behavior, University of Mississippi Medical Center, Jackson, MS 39216, USA; Graduate Program in Neuroscience, University of Mississippi Medical Center, Jackson, MS 39216, USA
| | - James K Rowlett
- Department of Psychiatry and Human Behavior, University of Mississippi Medical Center, Jackson, MS 39216, USA; Graduate Program in Neuroscience, University of Mississippi Medical Center, Jackson, MS 39216, USA; Center for Innovation and Discovery in Addictions, University of Mississippi Medical Center, Jackson, MS 39216, USA
| | - Lais F Berro
- Department of Psychiatry and Human Behavior, University of Mississippi Medical Center, Jackson, MS 39216, USA; Graduate Program in Neuroscience, University of Mississippi Medical Center, Jackson, MS 39216, USA; Center for Innovation and Discovery in Addictions, University of Mississippi Medical Center, Jackson, MS 39216, USA.
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Liu X, Tai Q, Meng F, Tian Y, Wang D, Fan F, Yang Y, Fu F, Wei D, Tang S, Chen J, Du Y, Zhu R, Wang W, Liu S, Wan J, Zhang W, Liang Q, Li Y, Wang L, Zhou H, Zhang X. The Association Between Rumination and Craving in Chinese Methamphetamine-Dependent Patients: The Masking Effect of Depression. Subst Use Misuse 2024; 59:1455-1463. [PMID: 38789408 DOI: 10.1080/10826084.2024.2352617] [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: 05/26/2024]
Abstract
BACKGROUND Craving is a core feature of addiction. Rumination and depression play a crucial role in the process of methamphetamine addiction. The aim of this study was to examine the relationship between rumination, depression and craving in methamphetamine patients, which has not been explored yet. METHODS A total of 778 patients with methamphetamine user disorder (MUD) at the Xinhua Drug Rehabilitation Center, located in Mianyang City, Sichuan Province, China. We used a set of self-administered questionnaires that included socio-demographic, detailed drug use history, rumination, depression and craving information. The Rumination Response Scale (RRS) was used to measure rumination, the Beck Depression Inventory (BDI) to measure depression and the Visual Analogue Scale (VAS) to measure craving. RESULTS There was a significant positive correlation between rumination and craving, or depression, and between depression and craving. Furthermore, depression mediated between rumination and craving, with a mediation effect of 160%. CONCLUSIONS Our findings suggest that there is a close interrelationship between rumination, craving and depression in MUD patients, and that depression may play a mediating role between rumination and craving.
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Affiliation(s)
- Xiuli Liu
- CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, China
- Department of Psychology, University of Chinese Academy of Sciences, Beijing, China
| | - Qingjie Tai
- CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, China
- Department of Psychology, University of Chinese Academy of Sciences, Beijing, China
| | - Feifei Meng
- CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, China
- Department of Psychology, University of Chinese Academy of Sciences, Beijing, China
| | - Yang Tian
- CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, China
- Department of Psychology, University of Chinese Academy of Sciences, Beijing, China
| | - Dongmei Wang
- CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, China
- Department of Psychology, University of Chinese Academy of Sciences, Beijing, China
| | - Fusheng Fan
- Xin Hua Drug Rehabilitation Center, Sichuan, China
| | - Yin Yang
- CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, China
- Department of Psychology, University of Chinese Academy of Sciences, Beijing, China
| | - Fabing Fu
- Xin Hua Drug Rehabilitation Center, Sichuan, China
| | - Dejun Wei
- Xin Hua Drug Rehabilitation Center, Sichuan, China
| | | | - Jiajing Chen
- CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, China
- Department of Psychology, University of Chinese Academy of Sciences, Beijing, China
| | - Yuxuan Du
- CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, China
- Department of Psychology, University of Chinese Academy of Sciences, Beijing, China
| | - Rongrong Zhu
- CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, China
- Department of Psychology, University of Chinese Academy of Sciences, Beijing, China
| | - Wenjia Wang
- CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, China
- Department of Psychology, University of Chinese Academy of Sciences, Beijing, China
| | - Siying Liu
- School of Psychology, Capital Normal University, Beijing, China
| | - Jiaxue Wan
- School of Psychology, Capital Normal University, Beijing, China
| | - Wanni Zhang
- School of Psychology, Capital Normal University, Beijing, China
| | - Qilin Liang
- School of Psychology, Capital Normal University, Beijing, China
| | - Yuqing Li
- CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, China
- Department of Psychology, University of Chinese Academy of Sciences, Beijing, China
| | - Li Wang
- CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, China
- Department of Psychology, University of Chinese Academy of Sciences, Beijing, China
| | - Huixia Zhou
- CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, China
- Department of Psychology, University of Chinese Academy of Sciences, Beijing, China
| | - Xiangyang Zhang
- CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, China
- Department of Psychology, University of Chinese Academy of Sciences, Beijing, China
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Acheson LS, Clay S, McKetin R, Lintzeris N, Dunlop A, Brett J, Christmass M, Rodgers C, Shoptaw S, Farrell M, Ezard N, Siefried KJ. Participant experiences in a pilot study for methamphetamine withdrawal treatment: Implications for retention. THE INTERNATIONAL JOURNAL OF DRUG POLICY 2024; 126:104383. [PMID: 38479162 DOI: 10.1016/j.drugpo.2024.104383] [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: 11/11/2023] [Revised: 02/21/2024] [Accepted: 03/03/2024] [Indexed: 04/29/2024]
Abstract
INTRODUCTION There is little knowledge of the perspectives of people who use methamphetamine and have participated in clinical trials, and none for interventions not intended to address abstinence. A better understanding of these experiences could lead to more patient centred clinical trial design. This study seeks to understand the experiences of people who completed a clinical trial of lisdexamfetamine for the treatment of acute methamphetamine withdrawal. METHODS Thematic analysis of open-ended, semi-structured interviews with eight people who participated in an inpatient clinical trial of lisdexamfetamine for acute methamphetamine withdrawal. Interviews were conducted between days 3 and 6 of admission to an inner-city Sydney hospital. RESULTS Participants described how research procedures, the research setting, and the investigational product affected their experiences while enrolled in a clinical trial. Of particular importance to participants were transparent and low burden trial procedures, a welcoming trial environment, trusting relationships and effective communication, which were linked with the participants' subsequent decision to remain enrolled in the trial. DISCUSSION The experiences of participants in this clinical trial can be distilled into four meta-themes: agency, caring-trust, safety, and communication. Participants spontaneously linked these experiences with a capacity to remain enrolled in the study. By considering the experiences of trial participants in clinical trial design, researchers can improve the experiences of future trial participants and facilitate their choice to remain enrolled in clinical trials.
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Affiliation(s)
- Liam S Acheson
- The National Drug and Alcohol Research Centre (NDARC), University of New South Wales, 22-32 King St, Randwick, NSW 2031, Australia; Alcohol and Drug Service, St Vincent's Hospital Sydney, 390 Victoria St Darlinghurst, NSW 2010, Australia; The National Centre for Clinical Research on Emerging Drugs (NCCRED), c/o University of New South Wales, 22-32 King St, Randwick, NSW 2031, Australia.
| | - Simon Clay
- The National Drug and Alcohol Research Centre (NDARC), University of New South Wales, 22-32 King St, Randwick, NSW 2031, Australia
| | - Rebecca McKetin
- The National Drug and Alcohol Research Centre (NDARC), University of New South Wales, 22-32 King St, Randwick, NSW 2031, Australia
| | - Nicholas Lintzeris
- New South Wales Drug and Alcohol Clinical Research and Improvement Network (DACRIN), Sydney, Australia; Drug and Alcohol Services, South East Sydney Local Health District, 591 S Dowling St, Surry Hills, NSW 2010, Australia; Specialty of Addiction Medicine, The University of Sydney, Camperdown, NSW 2050, Australia
| | - Adrian Dunlop
- New South Wales Drug and Alcohol Clinical Research and Improvement Network (DACRIN), Sydney, Australia; Drug and Alcohol Clinical Services, Hunter New England Local Health District, Lookout Rd, New Lambton Heights, NSW 2305, Australia; School of Medicine and Public Health, University of Newcastle, University Dr, Callaghan, NSW 2308, Australia
| | - Jonathan Brett
- Clinical Pharmacology and Toxicology, St Vincent's Hospital Sydney, 390 Victoria St Darlinghurst, NSW 2010, Australia; St. Vincent's Clinical School, The University of New South Wales, 390 Victoria St Darlinghurst, NSW 2010, Australia
| | - Michael Christmass
- Next Step Drug and Alcohol Services, 32 Moore St, East Perth, WA, 6004, United States; National Drug Research Institute, Curtin University, Kent St, Bentley WA 6102, United States
| | - Craig Rodgers
- Alcohol and Drug Service, St Vincent's Hospital Sydney, 390 Victoria St Darlinghurst, NSW 2010, Australia
| | - Steve Shoptaw
- Department of Family Medicine, University of California Los Angeles, Los Angeles, CA 90095, United States
| | - Michael Farrell
- The National Drug and Alcohol Research Centre (NDARC), University of New South Wales, 22-32 King St, Randwick, NSW 2031, Australia
| | - Nadine Ezard
- Alcohol and Drug Service, St Vincent's Hospital Sydney, 390 Victoria St Darlinghurst, NSW 2010, Australia; The National Centre for Clinical Research on Emerging Drugs (NCCRED), c/o University of New South Wales, 22-32 King St, Randwick, NSW 2031, Australia; New South Wales Drug and Alcohol Clinical Research and Improvement Network (DACRIN), Sydney, Australia
| | - Krista J Siefried
- The National Drug and Alcohol Research Centre (NDARC), University of New South Wales, 22-32 King St, Randwick, NSW 2031, Australia; Alcohol and Drug Service, St Vincent's Hospital Sydney, 390 Victoria St Darlinghurst, NSW 2010, Australia; The National Centre for Clinical Research on Emerging Drugs (NCCRED), c/o University of New South Wales, 22-32 King St, Randwick, NSW 2031, Australia
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Acheson LS, Gordon C, McKetin R, Brett J, Christmass M, Rodgers C, Lintzeris N, Dunlop A, Farrell M, Shoptaw S, Ezard N, Siefried KJ. Measuring Objective and Subjective Sleep during Lisdexamfetamine Treatment of Acute Methamphetamine Withdrawal: A Feasibility Study. Eur Addict Res 2024; 30:121-125. [PMID: 38498995 DOI: 10.1159/000536328] [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] [Received: 09/27/2023] [Accepted: 12/21/2023] [Indexed: 03/20/2024]
Abstract
INTRODUCTION Sleep disturbance is common during methamphetamine (MA) use and withdrawal; however, the feasibility of combined subjective-objective measurement of sleep-wake has not been shown in this population. Actigraphy is a well-established, non-invasive measure of sleep-wake cycles with good concordance with polysomnography. This study aimed to investigate the feasibility and utility of using actigraphy and sleep diaries to investigate sleep during MA withdrawal. METHODS We conducted a feasibility and utility study of actigraphy and sleep diaries during a clinical trial of lisdexamfetamine for MA withdrawal. Participants were inpatients for 7 days, wore an actigraph (Philips Actiwatch 2) and completed a modified Consensus Sleep Diary each morning. Participants were interviewed between days 3-5. RESULTS Ten participants (mean age 37 years, 90% male) were enrolled. No participant removed the device prematurely. Participants interviewed (n = 8) reported that the actigraph was not difficult or distracting to wear or completion of daily sleep diary onerous. Actigraphic average daily sleep duration over 7 days was 568 min, sleep onset latency 22.4 min, wake after sleep onset (WASO) 75.2 min, and sleep efficiency 83.6%. Sleep diaries underreported daily sleep compared with actigraphy (sleep duration was 56 min (p = 0.008) and WASO 47 min (p < 0.001) less). Overall sleep quality was 4.4 on a nine-point Likert scale within the diary. CONCLUSIONS Continuous actigraphy is feasible to measure sleep-wake in people withdrawing from MA, with low participant burden. We found important differences in self-reported and actigraphic sleep, which need to be explored in more detail.
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Affiliation(s)
- Liam S Acheson
- The National Drug and Alcohol Research Centre (NDARC), The University of New South Wales, Sydney, New South Wales, Australia
- Alcohol and Drug Service, St Vincent's Hospital Sydney, Sydney, New South Wales, Australia
- The National Centre for Clinical Research on Emerging Drugs (NCCRED), c/o the University of New South Wales, Sydney, New South Wales, Australia
| | - Christopher Gordon
- Susan Wakil School of Nursing and Midwifery, The University of Sydney, Sydney, New South Wales, Australia
- CIRUS Centre for Sleep and Chronobiology, Woolcock Institute of Medical Research, University of Sydney, Sydney, New South Wales, Australia
| | - Rebecca McKetin
- The National Drug and Alcohol Research Centre (NDARC), The University of New South Wales, Sydney, New South Wales, Australia
| | - Jonathan Brett
- Clinical Pharmacology and Toxicology, St Vincent's Hospital Sydney, Sydney, New South Wales, Australia
- St. Vincent's Clinical School, The University of New South Wales, Sydney, New South Wales, Australia
| | - Michael Christmass
- Next Step Drug and Alcohol Services, Perth, Washington, Australia
- National Drug Research Institute, Curtin University, Perth, Washington, Australia
| | - Craig Rodgers
- Alcohol and Drug Service, St Vincent's Hospital Sydney, Sydney, New South Wales, Australia
| | - Nicholas Lintzeris
- New South Wales Drug and Alcohol Clinical Research and Improvement Network (DACRIN), Sydney, New South Wales, Australia
- Drug and Alcohol Services, Sydney, New South Wales, Australia
- Specialty of Addiction Medicine, The University of Sydney, Sydney, New South Wales, Australia
| | - Adrian Dunlop
- New South Wales Drug and Alcohol Clinical Research and Improvement Network (DACRIN), Sydney, New South Wales, Australia
- Drug and Alcohol Clinical Services, Newcastle, New South Wales, Australia
- School of Medicine and Public Health, The University of Newcastle, Newcastle, New South Wales, Australia
| | - Michael Farrell
- The National Drug and Alcohol Research Centre (NDARC), The University of New South Wales, Sydney, New South Wales, Australia
| | - Steven Shoptaw
- Department of Family Medicine, The University of California Los Angeles, Los Angeles, California, USA
| | - Nadine Ezard
- Alcohol and Drug Service, St Vincent's Hospital Sydney, Sydney, New South Wales, Australia
- The National Centre for Clinical Research on Emerging Drugs (NCCRED), c/o the University of New South Wales, Sydney, New South Wales, Australia
- New South Wales Drug and Alcohol Clinical Research and Improvement Network (DACRIN), Sydney, New South Wales, Australia
| | - Krista J Siefried
- The National Drug and Alcohol Research Centre (NDARC), The University of New South Wales, Sydney, New South Wales, Australia
- Alcohol and Drug Service, St Vincent's Hospital Sydney, Sydney, New South Wales, Australia
- The National Centre for Clinical Research on Emerging Drugs (NCCRED), c/o the University of New South Wales, Sydney, New South Wales, Australia
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Wilens TE, Wilson RLH, Beltrame L, Taylor A, O'Connell J. An Inpatient Protocol for the Treatment of Methamphetamine Withdrawal in Patients With and Without Opioid Use Disorder. J Addict Med 2024; 18:180-184. [PMID: 38227855 DOI: 10.1097/adm.0000000000001269] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2024]
Abstract
OBJECTIVE Increasing rates of methamphetamine (METH) use, use disorders, and related overdoses are a growing public health problem. There are a lack of protocols addressing METH intoxication and withdrawal symptoms that manifest during acute withdrawal treatment resulting in inpatient management difficulties and premature discharges. This report presents a novel treatment protocol comprised of behavior-targeted and pharmacological components that aims to reduce the intensity and duration of METH intoxication and withdrawal related symptoms during early treatment, improve retention, and provide clinicians with a tool to meet this growing problem. METHODS The protocol was developed by a team of addiction physicians and other clinical staff. Clinical and administrative staff at a community acute stabilization unit were trained and the protocol was implemented with patients presenting with METH use. Pharmacological interventions, including ascorbic acid, antipsychotics, and other sedatives are discussed, as are behavior-based orders. A retrospective quality assurance examination was conducted on patient characteristics and outcomes as well as focus groups with nursing staff. RESULTS A total of 23 patients consecutively admitted to the unit used the protocol (100% male). Most patients (67%) displayed symptoms of METH use or withdrawal. Behavior-related interventions were used in 52% of patients, while 48% received behavior-related and pharmacological measures. Patient completion of the protocol was 83%, and the protocol's utility was supported by nursing staff. CONCLUSIONS This retrospective evaluation of a novel METH withdrawal treatment protocol suggests feasibility, tolerability, and preliminary evidence of effectiveness, providing clinicians with a new tool that requires further study.
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Affiliation(s)
- Timothy E Wilens
- From the Department of Psychiatry, Massachusetts General Hospital, Boston, MA (TEW, RLHW); Harvard Medical School, Boston, MA (TEW); Bay Cove Human Services, Boston, MA (LB, AT, JO)
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10
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Denning CJE, Madory LE, Herbert JN, Cabrera RA, Szumlinski KK. Neuropharmacological Evidence Implicating Drug-Induced Glutamate Receptor Dysfunction in Affective and Cognitive Sequelae of Subchronic Methamphetamine Self-Administration in Mice. Int J Mol Sci 2024; 25:1928. [PMID: 38339206 PMCID: PMC10856401 DOI: 10.3390/ijms25031928] [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: 01/01/2024] [Revised: 01/28/2024] [Accepted: 02/01/2024] [Indexed: 02/12/2024] Open
Abstract
Methamphetamine (MA) is a highly addictive drug, and MA use disorder is often comorbid with anxiety and cognitive impairment. These comorbid conditions are theorized to reflect glutamate-related neurotoxicity within the frontal cortical regions. However, our prior studies of MA-sensitized mice indicate that subchronic, behaviorally non-contingent MA treatment is sufficient to dysregulate glutamate transmission in mouse brain. Here, we extend this prior work to a mouse model of high-dose oral MA self-administration (0.8, 1.6, or 3.2 g/L; 1 h sessions × 7 days) and show that while female C57BL/6J mice consumed more MA than males, MA-experienced mice of both sexes exhibited some signs of anxiety-like behavior in a behavioral test battery, although not all effects were concentration-dependent. No MA effects were detected for our measures of visually cued spatial navigation, spatial learning, or memory in the Morris water maze; however, females with a history of 3.2 g/L MA exhibited reversal-learning deficits in this task, and mice with a history of 1.6 g/L MA committed more working-memory incorrect errors and relied upon a non-spatial navigation strategy during the radial-arm maze testing. Relative to naïve controls, MA-experienced mice exhibited several changes in the expression of certain glutamate receptor-related proteins and their downstream effectors within the ventral and dorsal areas of the prefrontal cortex, the hippocampus, and the amygdala, many of which were sex-selective. Systemic pretreatment with the mGlu1-negative allosteric modulator JNJ 162596858 reversed the anxiety-like behavior expressed by MA-experienced mice in the marble-burying test, while systemic pretreatment with NMDA or the NMDA antagonist MK-801 bi-directionally affected the MA-induced reversal-learning deficit. Taken together, these data indicate that a relatively brief history of oral MA is sufficient to induce some signs of anxiety-like behavior and cognitive dysfunction during early withdrawal that reflect, at least in part, MA-induced changes in the corticolimbic expression of certain glutamate receptor subtypes of potential relevance to treating symptoms of MA use disorder.
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Affiliation(s)
- Christopher J. E. Denning
- Department of Psychological and Brain Sciences, University of California Santa Barbara, Santa Barbara, CA 93106, USA; (C.J.E.D.); (L.E.M.); (J.N.H.); (R.A.C.)
| | - Lauren E. Madory
- Department of Psychological and Brain Sciences, University of California Santa Barbara, Santa Barbara, CA 93106, USA; (C.J.E.D.); (L.E.M.); (J.N.H.); (R.A.C.)
| | - Jessica N. Herbert
- Department of Psychological and Brain Sciences, University of California Santa Barbara, Santa Barbara, CA 93106, USA; (C.J.E.D.); (L.E.M.); (J.N.H.); (R.A.C.)
| | - Ryan A. Cabrera
- Department of Psychological and Brain Sciences, University of California Santa Barbara, Santa Barbara, CA 93106, USA; (C.J.E.D.); (L.E.M.); (J.N.H.); (R.A.C.)
| | - Karen K. Szumlinski
- Department of Psychological and Brain Sciences, University of California Santa Barbara, Santa Barbara, CA 93106, USA; (C.J.E.D.); (L.E.M.); (J.N.H.); (R.A.C.)
- Department of Molecular, Cellular and Developmental Biology, University of California Santa Barbara, Santa Barbara, CA 93106, USA
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11
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Sharafi H, Bakouni H, McAnulty C, Drouin S, Coronado-Montoya S, Bahremand A, Bach P, Ezard N, Le Foll B, Schütz CG, Siefried KJ, Tardelli VS, Ziegler D, Jutras-Aswad D. Prescription psychostimulants for the treatment of amphetamine-type stimulant use disorder: A systematic review and meta-analysis of randomized placebo-controlled trials. Addiction 2024; 119:211-224. [PMID: 37880829 DOI: 10.1111/add.16347] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/29/2023] [Accepted: 08/10/2023] [Indexed: 10/27/2023]
Abstract
BACKGROUND AND AIMS There is currently no standard of care for pharmacological treatment of amphetamine-type stimulant (ATS) use disorder (ATSUD). This systematic review with meta-analysis (PROSPERO CRD42022354492) aimed to pool results from randomized placebo-controlled trials (RCTs) to evaluate efficacy and safety of prescription psychostimulants (PPs) for ATSUD. METHODS Major indexing sources and trial registries were searched to include records published before 29 August 2022. Eligible studies were RCTs evaluating efficacy and safety of PPs for ATSUD. Risk of bias (RoB) was assessed using the Cochrane RoB 2 tool. Risk ratio (RR) and risk difference were calculated for random-effect meta-analysis of dichotomous variables. Mean difference and standardized mean difference (SMD) were calculated for random-effect meta-analysis of continuous variables. RESULTS Ten RCTs (n = 561 participants) were included in the meta-analysis. Trials studied methylphenidate (n = 7), with daily doses of 54-180 mg, and dextroamphetamine (n = 3), with daily doses of 60-110 mg, for 2-24 weeks. PPs significantly decreased end-point craving [SMD -0.29; 95% confidence interval (CI) = -0.55, -0.03], while such a decrease did not reach statistical significance for ATS use, as evaluated by urine analysis (UA) (RR = 0.93; 95% CI = 0.85-1.01). No effect was observed for self-reported ATS use, retention in treatment, dropout following adverse events, early-stage craving, withdrawal and depressive symptoms. In a sensitivity analysis, treatment was associated with a significant reduction in UA positive for ATS (RR = 0.89; 95% CI = 0.79-0.99) after removing studies with a high risk of bias. In subgroup analyses, methylphenidate and high doses of PPs were negatively associated with ATS use by UA, while higher doses of PPs and treatment duration (≥ 20 weeks) were positively associated with longer retention. CONCLUSIONS Among individuals with amphetamine-type stimulant use disorder, treatment with prescription psychostimulants may decrease ATS use and craving. While effect size is limited, it may increase with a higher dosage of medications.
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Affiliation(s)
- Heidar Sharafi
- Research Centre, Centre Hospitalier de l'Université de Montréal (CRCHUM), Montreal, Canada
- Department of Psychiatry and Addictology, Faculty of Medicine, Université de Montréal, Montreal, Canada
| | - Hamzah Bakouni
- Research Centre, Centre Hospitalier de l'Université de Montréal (CRCHUM), Montreal, Canada
- Department of Psychiatry and Addictology, Faculty of Medicine, Université de Montréal, Montreal, Canada
| | - Christina McAnulty
- Research Centre, Centre Hospitalier de l'Université de Montréal (CRCHUM), Montreal, Canada
- Department of Psychiatry and Addictology, Faculty of Medicine, Université de Montréal, Montreal, Canada
| | - Sarah Drouin
- Research Centre, Centre Hospitalier de l'Université de Montréal (CRCHUM), Montreal, Canada
| | - Stephanie Coronado-Montoya
- Research Centre, Centre Hospitalier de l'Université de Montréal (CRCHUM), Montreal, Canada
- Department of Psychiatry and Addictology, Faculty of Medicine, Université de Montréal, Montreal, Canada
| | - Arash Bahremand
- Research Centre, Centre Hospitalier de l'Université de Montréal (CRCHUM), Montreal, Canada
- Department of Psychiatry and Addictology, Faculty of Medicine, Université de Montréal, Montreal, Canada
| | - Paxton Bach
- Department of Medicine, University of British Columbia, Vancouver, Canada
- British Columbia Centre on Substance Use, St Paul's Hospital, Vancouver, Canada
| | - Nadine Ezard
- National Centre for Clinical Research on Emerging Drugs (NCCRED), University of New South Wales, Sydney, Australia
- St Vincent's Hospital Sydney Alcohol and Drug Service, Darlinghurst, Australia
- National Drug and Alcohol Research Centre (NDARC), University of New South Wales, Randwick, Australia
| | - Bernard Le Foll
- Department of Pharmacology and Toxicology, Faculty of Medicine, University of Toronto, Toronto, Canada
- Department of Family and Community Medicine, Faculty of Medicine, University of Toronto, Toronto, Canada
- Department of Psychiatry, University of Toronto, Toronto, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
- Translational Addiction Research Laboratory, Campbell Family Mental Health Research Institute, Center for Addiction and Mental Health, Toronto, Canada
- Waypoint Research Institute, Waypoint Centre for Mental Health Care, Penetanguishene, Canada
| | - Christian G Schütz
- Department of Psychiatry, University of British Columbia, Vancouver, Canada
| | - Krista J Siefried
- National Centre for Clinical Research on Emerging Drugs (NCCRED), University of New South Wales, Sydney, Australia
- St Vincent's Hospital Sydney Alcohol and Drug Service, Darlinghurst, Australia
- National Drug and Alcohol Research Centre (NDARC), University of New South Wales, Randwick, Australia
| | - Vitor S Tardelli
- Departamento de Psiquiatria, Universidade Federal de São Paulo, São Paulo, Brazil
| | - Daniela Ziegler
- Centre Hospitalier de l'Université de Montréal (CHUM), Montreal, Canada
| | - Didier Jutras-Aswad
- Research Centre, Centre Hospitalier de l'Université de Montréal (CRCHUM), Montreal, Canada
- Department of Psychiatry and Addictology, Faculty of Medicine, Université de Montréal, Montreal, Canada
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12
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Zhu R, Wang D, Fan F, Fu F, Wei D, Tang S, Tian Y, Chen J, Li Y, Zhou H, Wang L, Zhang X. Differences in the prevalence and clinical correlates of depressive symptoms in male patients with methamphetamine and heroin use disorder in a Chinese Han population. Am J Addict 2024; 33:48-57. [PMID: 37644677 DOI: 10.1111/ajad.13476] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2023] [Revised: 08/02/2023] [Accepted: 08/17/2023] [Indexed: 08/31/2023] Open
Abstract
BACKGROUND AND OBJECTIVES Comorbidity of substance use disorders and depression is a common phenomenon. It is well known that opioid addiction is neurobiologically distinct from psychostimulant addiction. However, direct comparisons of comorbid depressive symptoms in patients with methamphetamine (METH) use disorder (MAUD) and heroin use disorders (HUD) have been lacking until now. METHODS A total of 353 patients with methamphetamine use disorder, 76 patients with HUD, and 203 healthy controls were recruited. The Beck Depression Inventory (BDI-SF), the Desires for Drug Questionnaire (DDQ) and the short form of the Childhood Trauma Questionnaire (CTQ-SF) were used to measure participants' depressive symptoms, drug craving, and childhood abuse or neglect, respectively. RESULTS The prevalence of depressive symptoms was 35.41% (125/353) in MAUD and 56.57% (43/76) in MAUD, significantly higher than the 22.66% (46/203) in healthy controls. Furthermore, there was a significant difference in the total BDI score between the MAUD and HUD groups (F = 5.02, df = 1, 372, p = .026). Among MAUD, years of education, history of incarceration, month of abstinence and negative reinforcement scores were associated with depressive symptoms (all p < .05). Among HUD, duration of drug use, childhood emotional abuse and sexual abuse were associated with depressive symptoms (all p < .05). CONCLUSIONS AND SCIENTIFIC SIGNIFICANCE The prevalence and correlates of depressive symptoms differ between MAUD and HUD, adding to the existing literature. Therefore, treatment and intervention programs should be designed to address these unique correlates in HUD and MAUD patients.
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Affiliation(s)
- Rongrong Zhu
- CAS Key Laboratory of Mental Health, Chinese Academy of Sciences, Beijing, China
- Department of Psychology, University of Chinese Academy of Sciences, Beijing, China
| | - Dongmei Wang
- CAS Key Laboratory of Mental Health, Chinese Academy of Sciences, Beijing, China
- Department of Psychology, University of Chinese Academy of Sciences, Beijing, China
| | - Fusheng Fan
- Psychological Health Center, Xin Hua Drug Rehabilitation Center, Sichuan, China
| | - Fabing Fu
- Psychological Health Center, Xin Hua Drug Rehabilitation Center, Sichuan, China
| | - Dejun Wei
- Psychological Health Center, Xin Hua Drug Rehabilitation Center, Sichuan, China
| | - Shanshan Tang
- Psychological Health Center, Xin Hua Drug Rehabilitation Center, Sichuan, China
| | - Yang Tian
- CAS Key Laboratory of Mental Health, Chinese Academy of Sciences, Beijing, China
- Department of Psychology, University of Chinese Academy of Sciences, Beijing, China
| | - Jiajing Chen
- CAS Key Laboratory of Mental Health, Chinese Academy of Sciences, Beijing, China
- Department of Psychology, University of Chinese Academy of Sciences, Beijing, China
| | - Yuqing Li
- CAS Key Laboratory of Mental Health, Chinese Academy of Sciences, Beijing, China
- Department of Psychology, University of Chinese Academy of Sciences, Beijing, China
| | - Huixia Zhou
- CAS Key Laboratory of Mental Health, Chinese Academy of Sciences, Beijing, China
- Department of Psychology, University of Chinese Academy of Sciences, Beijing, China
| | - Li Wang
- CAS Key Laboratory of Mental Health, Chinese Academy of Sciences, Beijing, China
- Department of Psychology, University of Chinese Academy of Sciences, Beijing, China
| | - Xiangyang Zhang
- CAS Key Laboratory of Mental Health, Chinese Academy of Sciences, Beijing, China
- Department of Psychology, University of Chinese Academy of Sciences, Beijing, China
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13
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Guerin AA, Bridson T, Plapp HM, Bedi G. A systematic review and meta-analysis of health, functional, and cognitive outcomes in young people who use methamphetamine. Neurosci Biobehav Rev 2023; 153:105380. [PMID: 37678571 DOI: 10.1016/j.neubiorev.2023.105380] [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: 05/22/2023] [Revised: 08/30/2023] [Accepted: 09/01/2023] [Indexed: 09/09/2023]
Abstract
Methamphetamine use typically starts in adolescence, and early onset is associated with worse outcomes. Yet, health, functional, and cognitive outcomes associated with methamphetamine use in young people are not well understood. The aim of this study was to comprehensively assess the evidence on health, functional, and cognitive outcomes in young people (10-25 years-old) who use methamphetamine. Sixty-six studies were included. The strongest association observed was with conduct disorder, with young people who use methamphetamine some 13 times more likely to meet conduct disorder criteria than controls. They were also more likely to have justice system involvement and to perpetrate violence against others. Educational problems were consistently associated with youth methamphetamine use. The cognitive domain most reliably implicated was inhibitory control. Key limitations in the literature were identified, including heterogenous measurement of exposure and outcomes, lack of adequate controls, and limited longitudinal evidence. Outcomes identified in the present review - suggesting complex and clinically significant behavioural issues in this population - are informative for the development of future research and targeted treatments.
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Affiliation(s)
- Alexandre A Guerin
- Centre for Youth Mental Health, University of Melbourne, Melbourne, Australia; Orygen, Melbourne, Australia.
| | - Tahnee Bridson
- Centre for Youth Mental Health, University of Melbourne, Melbourne, Australia; Orygen, Melbourne, Australia
| | - Helena M Plapp
- Orygen, Melbourne, Australia; Royal Melbourne Hospital, Melbourne, Australia
| | - Gillinder Bedi
- Centre for Youth Mental Health, University of Melbourne, Melbourne, Australia; Orygen, Melbourne, Australia
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14
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Forchuk C, Serrato J, Scott L, Rudnick A, Dickey C, Silverman M. "No Good Choice": What are the Issues of Having no Harm Reduction Strategies in Hospitals? Subst Abuse 2023; 17:11782218231186065. [PMID: 37476501 PMCID: PMC10354823 DOI: 10.1177/11782218231186065] [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: 03/06/2023] [Accepted: 06/16/2023] [Indexed: 07/22/2023]
Abstract
Background Despite an increase in methamphetamine use and subsequent hospitalizations, the majority of Canadian hospitals currently lack harm reduction strategies for substance use. This can mean that people with lived experience of methamphetamine use are faced with a number of difficult decisions to make when admitted to hospital. Caring for people with lived experience of methamphetamine use can also be problematic with zero tolerance policies requiring abstinence to be maintained. This analysis set out to understand potential health care issues due to a lack of harm reduction strategies from the prospective of people with lived experience of methamphetamine use as well as health care/service professionals. Methods Based on a larger study, this secondary analysis explored issues discussed by people with lived experience of methamphetamine use and health care/service professionals regarding the challenges of providing harm reduction approaches in the hospital setting. A total of 108 individuals with lived experience of methamphetamine use completed a qualitative component of a mixed-method interview. In addition, 31 health care/service professionals participated in virtual focus groups and one-to-one interviews. Responses were analyzed using an ethnographic thematic approach. Results People with lived experience of methamphetamine use reported 3 choices upon admission: leave or avoid the hospital, stay but experience unsupported withdrawal, or stay but hide their substance usage from health care professionals. Health care/service professionals described 2 options: uphold zero tolerance that can lead to stigma and a lack of knowledge regarding addiction, or accept harm reduction but be unable to implement such strategies. This could lead to health being compromised due to policy and practice that requires abstinence. Neither group of participants described a good choice for them. Conclusion Current policy and education related to substance use needs to be revised.
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Affiliation(s)
- Cheryl Forchuk
- Arthur Labatt Family School of Nursing, Western University, London, ON, Canada
- Lawson Health Research Institute, London, ON, Canada
| | | | - Leanne Scott
- Lawson Health Research Institute, London, ON, Canada
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15
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Scott R. Methamphetamine dependence in Australia-why is 'ice' (crystal meth) so addictive? PSYCHIATRY, PSYCHOLOGY, AND LAW : AN INTERDISCIPLINARY JOURNAL OF THE AUSTRALIAN AND NEW ZEALAND ASSOCIATION OF PSYCHIATRY, PSYCHOLOGY AND LAW 2023; 31:671-704. [PMID: 39118784 PMCID: PMC11305059 DOI: 10.1080/13218719.2023.2206870] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/12/2022] [Accepted: 04/13/2023] [Indexed: 08/10/2024]
Abstract
Australia has one of the highest rates in the world of the use of the crystalline form of methamphetamine, a highly addictive stimulant that is often associated with a chronic, relapsing dependency. Methamphetamine use is associated with both acquisitive and violent offending, which cause substantial personal and societal costs. Whilst the short-term euphoria and stimulation provide a positive reinforcement to methamphetamine use, the aversive states of withdrawing from methamphetamine and the associated craving, which may last up to five weeks into abstinence, underlie the negative reinforcement to continued methamphetamine use. Although many methamphetamine-dependent users experience high levels of psychological distress, it is likely that less than half engage with treatment or support services, and current intervention and treatment programmes have high discontinuation rates. Stigma and discrimination, even from paramedics and health clinicians, are prominent barriers to methamphetamine-dependent users accessing treatment in Australia.
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Affiliation(s)
- Russ Scott
- West Moreton Prison Mental Health Service, Brisbane, QLD, Australia
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16
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Priest KC, Balasanova AA, Levander XA, Chan B, Blazes CK, Mahan J, Brown J, Mahoney S, Peng L, Mahoney S, Lundy T, Englander H. Caring for Hospitalized Adults with Methamphetamine Use Disorder: A Proposed Clinical Roadmap. Am J Med 2023; 136:507-509. [PMID: 36739062 PMCID: PMC10947159 DOI: 10.1016/j.amjmed.2023.01.012] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/03/2023] [Accepted: 01/04/2023] [Indexed: 02/05/2023]
Affiliation(s)
- Kelsey C Priest
- School of Medicine, MD/PhD Program, Oregon Health & Science University, Portland, OR; Department of Psychiatry, Stanford University School of Medicine, Stanford, CA; Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA.
| | - Alëna A Balasanova
- Department of Psychiatry, University of Nebraska Medical Center, Omaha, NE
| | - Ximena A Levander
- Department of Medicine, Division of General Internal Medicine and Geriatrics, Section of Addiction Medicine, Oregon Health & Science University, Portland, OR; IMPACT Team, Oregon Health & Science University, Portland, OR
| | - Brian Chan
- Department of Medicine, Division of General Internal Medicine and Geriatrics, Section of Addiction Medicine, Oregon Health & Science University, Portland, OR; IMPACT Team, Oregon Health & Science University, Portland, OR
| | | | - John Mahan
- Jackson County Health and Human Services, Medford, OR
| | - Jessica Brown
- IMPACT Team, Oregon Health & Science University, Portland, OR
| | - Stacey Mahoney
- IMPACT Team, Oregon Health & Science University, Portland, OR; Harmony Academy Recovery High School, Lake Oswego, OR
| | - Linda Peng
- Department of Medicine, Division of General Internal Medicine and Geriatrics, Section of Addiction Medicine, Oregon Health & Science University, Portland, OR; IMPACT Team, Oregon Health & Science University, Portland, OR
| | - Sean Mahoney
- IMPACT Team, Oregon Health & Science University, Portland, OR; Mental Health & Addiction Association of Oregon, Portland, OR
| | - Traci Lundy
- IMPACT Team, Oregon Health & Science University, Portland, OR; Mental Health & Addiction Association of Oregon, Portland, OR
| | - Honora Englander
- Department of Medicine, Division of General Internal Medicine and Geriatrics, Section of Addiction Medicine, Oregon Health & Science University, Portland, OR; IMPACT Team, Oregon Health & Science University, Portland, OR
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Fernandez DP, Kuss DJ, Justice LV, Fernandez EF, Griffiths MD. Effects of a 7-Day Pornography Abstinence Period on Withdrawal-Related Symptoms in Regular Pornography Users: A Randomized Controlled Study. ARCHIVES OF SEXUAL BEHAVIOR 2023; 52:1819-1840. [PMID: 36652136 PMCID: PMC9847461 DOI: 10.1007/s10508-022-02519-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/09/2022] [Revised: 11/14/2022] [Accepted: 12/20/2022] [Indexed: 06/17/2023]
Abstract
Little is known about whether withdrawal-like symptoms manifest when regular pornography users attempt to abstain from pornography. The present study used a randomized controlled design to examine whether (1) negative abstinence effects that may be potentially reflective of withdrawal-related symptoms manifest when a non-clinical sample of regular pornography users attempt to abstain from pornography for a 7-day period and (2) these negative abstinence effects would only manifest (or manifest more strongly) for those with higher levels of problematic pornography use (PPU). A total of 176 undergraduate students (64.2% female) who were regular pornography users (defined as having used pornography ≥ three times a week in the past 4 weeks) were randomly assigned to an abstinence group (instructed to attempt abstinence from pornography for 7 days, n = 86) or a control group (free to watch pornography as usual, n = 90). Participants completed measures of craving, positive and negative affect, and withdrawal symptoms at baseline and each night of the 7-day period. Contrary to the confirmatory hypotheses, there were no significant main effects of group (abstinence vs. control) or group × PPU interaction effects on any of the outcome measures, controlling for baseline scores. These findings indicate that no evidence of withdrawal-related symptoms was found for abstaining participants, and this was not dependent on level of PPU. However, exploratory analyses showed a significant three-way interaction (group × PPU × past 4-week frequency of pornography use [FPU]) on craving, where an abstinence effect on craving was found at high levels of PPU only once past 4-week FPU reached the threshold of daily use. While these exploratory findings should be interpreted with caution, they suggest that abstinence effects could potentially manifest when there is a combination of high PPU and high FPU-a hypothesis that warrants investigation in future prospective abstinence studies.
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Affiliation(s)
- David P Fernandez
- Psychology Department, Nottingham Trent University, 50 Shakespeare Street, Nottingham, NG1 4FQ, UK.
| | - Daria J Kuss
- Psychology Department, Nottingham Trent University, 50 Shakespeare Street, Nottingham, NG1 4FQ, UK
| | - Lucy V Justice
- Psychology Department, Nottingham Trent University, 50 Shakespeare Street, Nottingham, NG1 4FQ, UK
| | | | - Mark D Griffiths
- Psychology Department, Nottingham Trent University, 50 Shakespeare Street, Nottingham, NG1 4FQ, UK
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18
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Zhang S, Luo J, Zeng Y, Ren H, Chen Z, Ren Y. Acupuncture for protracted amphetamine abstinence syndrome: study protocol for a systematic review and meta-analysis. BMJ Open 2023; 13:e062491. [PMID: 37085314 PMCID: PMC10124197 DOI: 10.1136/bmjopen-2022-062491] [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] [Indexed: 04/23/2023] Open
Abstract
INTRODUCTION Amphetamine-type stimulants (ATSs) are presenting a great challenge to global public health along with its worldwide abuse in recent years. Protracted amphetamine abstinence syndrome (PAAS) is one of the primary causes of relapse for ATS abusers during withdrawal. However, different conclusions are reached by previous trials. This study is designed to evaluate the efficacy and safety of acupuncture in treating PAAS. METHODS AND ANALYSIS Cochrane Central Register of Controlled Trials, PubMed, Embase, Web of Science, Cumulative Index to Nursing and Allied Health Literature (CINAHL), PsycINFO, ProQuest Dissertation and Theses, Allied and Complementary Medicine Database (AMED), ClinicalTrials.gov and who.int/trialsearch will be searched from the inception to February 2023 and language will be restricted to English and Chinese. Eligible randomised controlled trials will be included. The primary outcome is the intensity of withdrawal syndrome. The secondary outcomes include: (1) intensity of pain, anxiety, depression and other associated symptoms; (2) number of participants with relapse; (3) retention of treatment and (4) nature and rate of adverse effects. Data synthesis will be performed by using RevMan (V.5.4). The quality of evidence will be evaluated by the Grading of Recommendations, Assessment, Development and Evaluation approach. This study will strictly adhere to the Preferred Reporting Items for Systematic Review and Meta-Analysis guidelines. ETHICS AND DISSEMINATION Ethical approval is not required as this is a systematic review and meta-analysis based on previously published studies that do not involve patients' privacy. The results of this study will be disseminated in a peer-reviewed journal. PROSPERO REGISTRATION NUMBER CRD42022297761.
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Affiliation(s)
- Su Zhang
- School of Acupuncture and Tuina, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, China
| | - Jun Luo
- School of Chinese Classics, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - YiWei Zeng
- School of Acupuncture and Tuina, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, China
| | - Huan Ren
- School of Acupuncture and Tuina, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, China
| | - Zhihan Chen
- School of Acupuncture and Tuina, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, China
| | - Yulan Ren
- School of Chinese Classics, Chengdu University of Traditional Chinese Medicine, Chengdu, China
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Li MJ, Shoptaw SJ. Clinical management of psychostimulant withdrawal: review of the evidence. Addiction 2023; 118:750-762. [PMID: 36401591 PMCID: PMC10069411 DOI: 10.1111/add.16093] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/01/2022] [Accepted: 11/02/2022] [Indexed: 11/21/2022]
Abstract
It is estimated that a majority of people who use psychostimulants, particularly methamphetamine (MA) and cocaine, experience withdrawal upon abstinence from sustained use. This review of clinical research reports the evidence regarding biomedical and behavioral treatments for psychostimulant withdrawal symptoms. It provides a framework for clinicians and scientists to increase impact on attenuating MA and cocaine withdrawal during initial and sustained abstinence. Articles reviewed included reports of controlled clinical trials (randomized or non-randomized) reporting at least one withdrawal symptom among the outcomes or specifically studying patients in withdrawal. Potential efficacy for MA withdrawal is noted for a few medications (mirtazapine, naltrexone, bupropion) and repetitive transcranial magnetic stimulation during acute (first week), early protracted (weeks 2-4) and late protracted (> 4 weeks) withdrawal phases. Topiramate shows mixed evidence of efficacy for cocaine withdrawal. In general, there is inconsistent signal for biomedical and behavioral treatments on MA and cocaine withdrawal.
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Affiliation(s)
- Michael J. Li
- Department of Family Medicine, University of California, Los Angeles, CA, USA
| | - Steven J. Shoptaw
- Department of Family Medicine, University of California, Los Angeles, CA, USA
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, CA, USA
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20
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Transcranial Stimulation for the Treatment of Stimulant Use Disorder. Neurol Int 2023; 15:325-338. [PMID: 36976664 PMCID: PMC10051697 DOI: 10.3390/neurolint15010021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2023] [Revised: 02/14/2023] [Accepted: 02/23/2023] [Indexed: 03/05/2023] Open
Abstract
The increasing prevalence of stimulant use disorder (StUD) involving methamphetamine and cocaine has been a growing healthcare concern in the United States. Cocaine usage is associated with atherosclerosis, systolic and diastolic dysfunction, and arrhythmias. Furthermore, approximately one of every four MIs is cocaine-induced among patients aged 18 to 45. Methamphetamine use has been associated with nerve terminal damage in the dopaminergic system resulting in impaired motor function, cognitive decline, and co-morbid psychiatric disorders. Current treatment options for StUD are extremely limited, and there are currently no FDA-approved pharmacotherapies. Behavioral interventions are considered first-line treatment; however, in a recent meta-analysis comparing behavioral treatment options for cocaine, contingency management programs provided the only significant reduction in use. Current evidence points to the potential of various neuromodulation techniques as the next best modality in treating StUD. The most promising evidence thus far has been transcranial magnetic stimulation which several studies have shown to reduce risk factors associated with relapse. Another more invasive neuromodulation technique being studied is deep-brain stimulation, which has shown promising results in its ability to modulate reward circuits to treat addiction. Results showing the impact of transcranial magnetic stimulation (TMS) in the treatment of StUD are limited by the lack of studies conducted and the limited understanding of the neurological involvement driving addiction-based diseases such as StUD. Future studies should seek to provide data on consumption-reducing effects rather than craving evaluations.
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Acheson LS, Williams BH, Farrell M, McKetin R, Ezard N, Siefried KJ. Pharmacological treatment for methamphetamine withdrawal: A systematic review and meta-analysis of randomised controlled trials. Drug Alcohol Rev 2023; 42:7-19. [PMID: 35862266 PMCID: PMC10083934 DOI: 10.1111/dar.13511] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2022] [Revised: 04/08/2022] [Accepted: 06/21/2022] [Indexed: 01/10/2023]
Abstract
ISSUES Cessation of methamphetamine use may result in a characteristic withdrawal syndrome, no medication has been approved for this indication. This systematic review aims to assess the efficacy of pharmacotherapy for methamphetamine withdrawal, the first comprehensive meta-analysis since 2008. APPROACH MEDLINE (1966-2020), CINAHL (1982-2020), PsychINFO (1806-2020) and EMBASE (1947-2020) were systematically searched. Studies were included if they were randomised controlled trials (RCT) investigating pharmacological treatments for methamphetamine withdrawal, reviewing outcomes of treatment discontinuation, mental health outcomes, withdrawal symptoms (including craving) and patient safety. The relative risk (RR) and weighted mean difference (MD) were used to meta-analyse dichotomous and continuous data respectively, with 95% confidence intervals. Risk of bias and Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) assessments were conducted. KEY FINDINGS Nine RCTs of six medications (n = 242 participants) met inclusion criteria, however, only six trials of four medications (n = 186) could be meta-analysed. Mean sample size across studies was 27 participants, and 88% of participants were male. The quality of evidence in this review varies from low to very low on GRADE assessments. Amineptine may reduce discontinuation rates (RR 0.22, 95% confidence interval [CI] 0.07, 0.72, p = 0.01), and improve global state (MD -0.49, 95% CI -0.80, -0.17), compared with placebo, however, this medication is no longer approved. No other medications improved any domain when compared with placebo. Due to lack of reporting safety profiles could not be established. CONCLUSIONS There is insufficient evidence to indicate any medication is effective for the treatment of methamphetamine withdrawal. The poor quality of the evidence indicates a need for better powered, high-quality trials.
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Affiliation(s)
- Liam S Acheson
- The National Drug and Alcohol Research Centre, UNSW Sydney, Sydney, Australia.,Alcohol and Drug Service, St Vincent's Hospital Sydney, Sydney, Australia.,The National Centre for Clinical Research on Emerging Drugs, c/o UNSW Sydney, Sydney, Australia
| | - Benjamin H Williams
- Department of Psychiatry, Royal Prince Alfred Hospital, Sydney Local Health District, Sydney, Australia
| | - Michael Farrell
- The National Drug and Alcohol Research Centre, UNSW Sydney, Sydney, Australia
| | - Rebecca McKetin
- The National Drug and Alcohol Research Centre, UNSW Sydney, Sydney, Australia
| | - Nadine Ezard
- The National Drug and Alcohol Research Centre, UNSW Sydney, Sydney, Australia.,Alcohol and Drug Service, St Vincent's Hospital Sydney, Sydney, Australia.,The National Centre for Clinical Research on Emerging Drugs, c/o UNSW Sydney, Sydney, Australia.,New South Wales Drug and Alcohol Clinical Research and Improvement Network, Sydney, Australia
| | - Krista J Siefried
- The National Drug and Alcohol Research Centre, UNSW Sydney, Sydney, Australia.,Alcohol and Drug Service, St Vincent's Hospital Sydney, Sydney, Australia.,The National Centre for Clinical Research on Emerging Drugs, c/o UNSW Sydney, Sydney, Australia
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22
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Ottonelli I, Sharma A, Ruozi B, Tosi G, Duskey JT, Vandelli MA, Lafuente JV, Nozari A, Muresanu DF, Buzoianu AD, Tian ZR, Zhang Z, Li C, Feng L, Wiklund L, Sharma HS. Nanowired Delivery of Curcumin Attenuates Methamphetamine Neurotoxicity and Elevates Levels of Dopamine and Brain-Derived Neurotrophic Factor. ADVANCES IN NEUROBIOLOGY 2023; 32:385-416. [PMID: 37480467 DOI: 10.1007/978-3-031-32997-5_10] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/24/2023]
Abstract
Curcumin is a well-known antioxidant used as traditional medicine in China and India since ages to treat variety of inflammatory ailments as a food supplement. Curcumin has antitumor properties with neuroprotective effects in Alzheimer's disease. Curcumin elevates brain-derived neurotrophic factor (BDNF) and dopamine (DA) levels in the brain indicating its role in substance abuse. Methamphetamine (METH) is one of the most abused substances in the world that induces profound neurotoxicity by inducing breakdown of the blood-brain barrier (BBB), vasogenic edema and cellular injuries. However, influence of curcumin on METH-induced neurotoxicity is still not well investigated. In this investigation, METH neurotoxicity and neuroprotective effects of curcumin nanodelivery were examined in a rat model. METH (20 mg/kg, i.p.) neurotoxicity is evident 4 h after its administration exhibiting breakdown of BBB to Evans blue albumin in the cerebral cortex, hippocampus, cerebellum, thalamus and hypothalamus associated with vasogenic brain edema as seen measured using water content in all these regions. Nissl attaining exhibited profound neuronal injuries in the regions of BBB damage. Normal curcumin (50 mg/kg, i.v.) 30 min after METH administration was able to reduce BBB breakdown and brain edema partially in some of the above brain regions. However, TiO2 nanowired delivery of curcumin (25 mg/kg, i.v.) significantly attenuated brain edema, neuronal injuries and the BBB leakage in all the brain areas. BDNF level showed a significant higher level in METH-treated rats as compared to saline-treated METH group. Significantly enhanced DA levels in METH-treated rats were also observed with nanowired delivery of curcumin. Normal curcumin was able to slightly elevate DA and BDNF levels in the selected brain regions. Taken together, our observations are the first to show that nanodelivery of curcumin induces superior neuroprotection in METH neurotoxicity probable by enhancing BDNF and DA levels in the brain, not reported earlier.
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Affiliation(s)
- Ilaria Ottonelli
- Te.far.t.I, Dept of Life Sciences, University of Modena and Reggio Emilia, Modena, Italy
| | - Aruna Sharma
- International Experimental Central Nervous System Injury & Repair (IECNSIR), Surgical Sciences, Anesthesiology & Intensive Care Med., Uppsala University Hospital, Uppsala University, Uppsala, Sweden
| | - Barbara Ruozi
- Te.far.t.I, Dept of Life Sciences, University of Modena and Reggio Emilia, Modena, Italy
| | - Giovanni Tosi
- Te.far.t.I, Dept of Life Sciences, University of Modena and Reggio Emilia, Modena, Italy
| | - Jason Thomas Duskey
- Te.far.t.I, Dept of Life Sciences, University of Modena and Reggio Emilia, Modena, Italy
| | - Maria Angela Vandelli
- Te.far.t.I, Dept of Life Sciences, University of Modena and Reggio Emilia, Modena, Italy
| | - José Vicente Lafuente
- LaNCE, Department Neuroscience, University of the Basque Country (UPV/EHU), Leioa, Bizkaia, Spain
| | - Ala Nozari
- Anesthesia and Critical Care, Chobanian & Avedisian School of Medicine, Boston University, Boston, MA, USA
| | - Dafin Fior Muresanu
- "RoNeuro" Institute for Neurological Research and Diagnosis, Cluj-Napoca, Romania
- Clinical Neurosciences, University of Medicine & Pharmacy, Cluj-Napoca, Romania
| | - Anca Dana Buzoianu
- Department of Clinical Pharmacology and Toxicology, "Iuliu Hatieganu" University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Z Ryan Tian
- Dept. Chemistry & Biochemistry, University of Arkansas, Fayetteville, AR, USA
| | - Zhiqiang Zhang
- Department of Neurosurgery, Chinese Medicine Hospital of Guangdong Province; The Second Affiliated Hospital, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Cong Li
- Department of Neurosurgery, Chinese Medicine Hospital of Guangdong Province; The Second Affiliated Hospital, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Lianyuan Feng
- Department of Neurology, Bethune International Peace Hospital, Zhongshan Road (West), Shijiazhuang, Hebei Province, China
| | - Lars Wiklund
- International Experimental Central Nervous System Injury & Repair (IECNSIR), Surgical Sciences, Anesthesiology & Intensive Care Med., Uppsala University Hospital, Uppsala University, Uppsala, Sweden
| | - Hari Shanker Sharma
- International Experimental Central Nervous System Injury & Repair (IECNSIR), Surgical Sciences, Anesthesiology & Intensive Care Med., Uppsala University Hospital, Uppsala University, Uppsala, Sweden.
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23
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Noninvasive Vagus Nerve Stimulation in the Treatment of Methamphetamine Use Disorder: A Review Article. IRANIAN JOURNAL OF PSYCHIATRY AND BEHAVIORAL SCIENCES 2022. [DOI: 10.5812/ijpbs-123423] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
: Methamphetamine (MA) use and the mortality it causes are increasing worldwide. The neurobiological mechanisms underlying the destructive effects of MA use are complex; however, there is much evidence that MA induces the dysfunction of monoaminergic transmission and causes oxidative stress, neuroinflammation, gliosis, and apoptosis. These toxic effects are associated with cardiotoxicity and neurotoxicity and with an imbalance in the autonomic nervous system, which altogether manifest themselves in clinical symptoms, such as neuropsychiatric disorders and cardiovascular diseases. There is no approved treatment for methamphetamine use disorder (MUD) despite all efforts made to date. The behavioral and pharmacological approaches currently used for the treatment of MUD are not completely effective. In this study, it is hypothesized that the stimulation of the vagus nerve and biological pathways underlying the processes of this stimulation might be effective as adjunctive therapy. Despite the potential effects of vagus nerve stimulation (VNS) to improve MUD, no study has yet examined the clinical potential effects of VNS in patients with the disorder. Therefore, further studies, including experimental and clinical trials, are needed to examine the effects of VNS on MUD.
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Acheson LS, Ezard N, Lintzeris N, Dunlop A, Brett J, Rodgers C, Gill A, Christmass M, McKetin R, Farrell M, Shoptaw S, Siefried KJ. Lisdexamfetamine for the treatment of acute methamphetamine withdrawal: A pilot feasibility and safety trial. Drug Alcohol Depend 2022; 241:109692. [PMID: 36399936 DOI: 10.1016/j.drugalcdep.2022.109692] [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: 09/08/2022] [Revised: 10/28/2022] [Accepted: 10/28/2022] [Indexed: 11/09/2022]
Abstract
BACKGROUND There is no effective treatment for methamphetamine withdrawal. This study aimed to determine the feasibility and safety of a tapering dose of lisdexamfetamine for the treatment of acute methamphetamine (MA) withdrawal. METHODS Open-label, single-arm pilot study, in an inpatient drug and alcohol withdrawal unit assessing a tapering dose of oral lisdexamfetamine dimesylate commencing at 250 mg once daily, reducing by 50 mg per day to 50 mg on Day 5. Measures were assessed daily (days 0-7) with 21-day telephone follow-up. Feasibility was measured by the time taken to enrol the sample. Safety was the number of adverse events (AEs) by system organ class. Retention was the proportion to complete treatment. Other measures included the Treatment Satisfaction Questionnaire for Medication (TSQM), the Amphetamine Withdrawal Questionnaire and craving (Visual Analogue Scale). RESULTS Ten adults seeking inpatient treatment for MA withdrawal (9 male, median age 37.1 years [IQR 31.7-41.9]), diagnosed with MA use disorder were recruited. The trial was open for 126 days; enroling one participant every 12.6 days. Eight of ten participants completed treatment (Day 5). Two participants left treatment early. There were no treatment-related serious adverse events (SAEs). Forty-seven AEs were recorded, 17 (36%) of which were potentially causally related, all graded as mild severity. Acceptability of the study drug by TSQM was rated at 100% at treatment completion. Withdrawal severity and craving reduced through the admission. CONCLUSION A tapering dose regimen of lisdexamfetamine was safe and feasible for the treatment of acute methamphetamine withdrawal in an inpatient setting.
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Affiliation(s)
- Liam S Acheson
- The National Drug and Alcohol Research Centre (NDARC), the University of New South Wales, Sydney, Australia; Alcohol and Drug Service, St Vincent's Hospital Sydney, Sydney, Australia; The National Centre for Clinical Research on Emerging Drugs (NCCRED), c/o the University of New South Wales, Sydney, Australia.
| | - Nadine Ezard
- The National Drug and Alcohol Research Centre (NDARC), the University of New South Wales, Sydney, Australia; Alcohol and Drug Service, St Vincent's Hospital Sydney, Sydney, Australia; The National Centre for Clinical Research on Emerging Drugs (NCCRED), c/o the University of New South Wales, Sydney, Australia; New South Wales Drug and Alcohol Clinical Research and Improvement Network (DACRIN), NSW, Australia
| | - Nicholas Lintzeris
- New South Wales Drug and Alcohol Clinical Research and Improvement Network (DACRIN), NSW, Australia; The Langton Centre, South East Sydney Local Health District, Sydney, Australia; Discipline of Addiction Medicine, the University of Sydney, Sydney, Australia
| | - Adrian Dunlop
- New South Wales Drug and Alcohol Clinical Research and Improvement Network (DACRIN), NSW, Australia; Drug and Alcohol Clinical Services, Hunter New England Local Health District, Newcastle, Australia; School of Medicine and Public Health, the University of Newcastle, Newcastle, Australia
| | - Jonathan Brett
- Clinical Pharmacology and Toxicology, St Vincent's Hospital Sydney, Sydney, Australia; St. Vincent's Clinical School, the University of New South Wales, Sydney, Australia
| | - Craig Rodgers
- Alcohol and Drug Service, St Vincent's Hospital Sydney, Sydney, Australia
| | - Anthony Gill
- Alcohol and Drug Service, St Vincent's Hospital Sydney, Sydney, Australia
| | - Michael Christmass
- Next Step Drug and Alcohol Services, Perth, Australia; National Drug Research Institute, Curtin University, Perth, Australia
| | - Rebecca McKetin
- The National Drug and Alcohol Research Centre (NDARC), the University of New South Wales, Sydney, Australia
| | - Michael Farrell
- The National Drug and Alcohol Research Centre (NDARC), the University of New South Wales, Sydney, Australia
| | - Steve Shoptaw
- Department of Family Medicine, The University of California Los Angeles, Los Angeles, USA
| | - Krista J Siefried
- The National Drug and Alcohol Research Centre (NDARC), the University of New South Wales, Sydney, Australia; Alcohol and Drug Service, St Vincent's Hospital Sydney, Sydney, Australia; The National Centre for Clinical Research on Emerging Drugs (NCCRED), c/o the University of New South Wales, Sydney, Australia
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25
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Tatari F, Farnia V, Lalehgni F, Moradi A, Radmehr F, Davarinejad O, Hookari S, Salemi S, Golmohammadi F, Alikhani M. The efficacy of venlafaxine in the treatment of depression, withdrawal symptoms, and craving in individuals with methamphetamine dependence. JOURNAL OF SUBSTANCE USE 2022. [DOI: 10.1080/14659891.2022.2144508] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Affiliation(s)
- Faezeh Tatari
- Department of Psychiatry, Substance abuse Prevention Research Center, Health institute, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Vahid Farnia
- Department of Psychiatry, Substance abuse Prevention Research Center, Health institute, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Fatemeh Lalehgni
- Department of Psychiatry, Substance abuse Prevention Research Center, Health institute, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Asieh Moradi
- Department of Psychology, Faculty of Social Sciences, Razi University, Kermanshah, Iran
| | - Farnaz Radmehr
- Clinical Research Development Center, Imam Khomeini and Mohammad Kermanshahi and Farabi Hospitals, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Omran Davarinejad
- Clinical Research Development Center, Imam Khomeini and Mohammad Kermanshahi and Farabi Hospitals, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Sara Hookari
- Clinical Research Development Center, Imam Khomeini and Mohammad Kermanshahi and Farabi Hospitals, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Safora Salemi
- Department of Psychiatry, Substance abuse Prevention Research Center, Health institute, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Farzaneh Golmohammadi
- Clinical Research Development Center, Imam Khomeini and Mohammad Kermanshahi and Farabi Hospitals, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Mostafa Alikhani
- Clinical Research Development Center, Imam Khomeini and Mohammad Kermanshahi and Farabi Hospitals, Kermanshah University of Medical Sciences, Kermanshah, Iran
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26
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Acheson LS, Ezard N, Lintzeris N, Dunlop A, Brett J, Rodgers C, Gill A, Christmass M, McKetin R, Farrell M, Shoptaw S, Siefried KJ. Trial protocol of an open label pilot study of lisdexamfetamine for the treatment of acute methamphetamine withdrawal. PLoS One 2022; 17:e0275371. [PMID: 36190973 PMCID: PMC9529099 DOI: 10.1371/journal.pone.0275371] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2022] [Accepted: 09/13/2022] [Indexed: 11/09/2022] Open
Abstract
Introduction Methamphetamine (MA) use disorder is an important public health concern. MA withdrawal is often the first step in ceasing or reducing use. There are no evidence-based withdrawal treatments, and no medication is approved for the treatment of MA withdrawal. Lisdexamfetamine (LDX) dimesilate, used in the treatment of attention deficit hyperactivity disorder and binge eating disorder has the potential as an agonist therapy to ameliorate withdrawal symptoms, and improve outcomes for patients. Methods A single arm, open-label pilot study to test the safety and feasibility of LDX for the treatment of MA withdrawal. Participants will be inpatients in a drug and alcohol withdrawal unit, and will receive a tapering dose of LDX over five days: 250mg LDX on Day 1, reducing by 50mg per day to 50mg on Day 5. Optional inpatient Days 6 and 7 will allow for participants to transition to ongoing treatment. Participants will be followed-up on Days 14, 21 and 28. All participants will also receive standard inpatient withdrawal care. The primary outcomes are safety (measured by adverse events, changes in vital signs, changes in suicidality and psychosis) and feasibility (the time taken to enrol the sample, proportion of screen / pre-screen failures). Secondary outcomes are acceptability (treatment satisfaction questionnaire, medication adherence, concomitant medications, qualitative interviews), retention to protocol (proportion retained to primary and secondary endpoints), changes in withdrawal symptoms (Amphetamine Withdrawal Questionnaire) and craving for MA (visual analogue scale), and sleep outcomes (continuous actigraphy and daily sleep diary). Discussion This is the first study to assess lisdexamfetamine for the treatment of acute MA withdrawal. If safe and feasible results will go to informing the development of multi-centre randomised controlled trials to determine the efficacy of the intervention.
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Affiliation(s)
- Liam S. Acheson
- The National Drug and Alcohol Research Centre (NDARC), the University of New South Wales, Sydney, Australia
- Alcohol and Drug Service, St Vincent’s Hospital Sydney, Sydney, Australia
- The National Centre for Clinical Research on Emerging Drugs (NCCRED), c/o the University of New South Wales, Sydney, Australia
- * E-mail:
| | - Nadine Ezard
- Alcohol and Drug Service, St Vincent’s Hospital Sydney, Sydney, Australia
- The National Centre for Clinical Research on Emerging Drugs (NCCRED), c/o the University of New South Wales, Sydney, Australia
- New South Wales Drug and Alcohol Clinical Research and Improvement Network (DACRIN), Sydney, Australia
| | - Nicholas Lintzeris
- New South Wales Drug and Alcohol Clinical Research and Improvement Network (DACRIN), Sydney, Australia
- The Langton Centre, South East Sydney Local Health District, Sydney, Australia
- Discipline of Addiction Medicine, the University of Sydney, Sydney, Australia
| | - Adrian Dunlop
- New South Wales Drug and Alcohol Clinical Research and Improvement Network (DACRIN), Sydney, Australia
- Drug and Alcohol Clinical Services, Hunter New England Local Health District, Newcastle, Australia
- School of Medicine and Public Health, the University of Newcastle, Newcastle, Australia
| | - Jonathan Brett
- Clinical Pharmacology and Toxicology, St Vincent’s Hospital Sydney, Sydney, Australia
- St. Vincent’s Clinical School, the University of New South Wales, Sydney, Australia
| | - Craig Rodgers
- Alcohol and Drug Service, St Vincent’s Hospital Sydney, Sydney, Australia
| | - Anthony Gill
- Alcohol and Drug Service, St Vincent’s Hospital Sydney, Sydney, Australia
| | - Michael Christmass
- Next Step Drug and Alcohol Services, Perth, Australia
- National Drug Research Institute, Curtin University, Perth, Australia
| | - Rebecca McKetin
- The National Drug and Alcohol Research Centre (NDARC), the University of New South Wales, Sydney, Australia
| | - Michael Farrell
- The National Drug and Alcohol Research Centre (NDARC), the University of New South Wales, Sydney, Australia
| | - Steve Shoptaw
- Department of Family Medicine, The University of California Los Angeles, Los Angeles, California, United States of America
| | - Krista J. Siefried
- The National Drug and Alcohol Research Centre (NDARC), the University of New South Wales, Sydney, Australia
- Alcohol and Drug Service, St Vincent’s Hospital Sydney, Sydney, Australia
- The National Centre for Clinical Research on Emerging Drugs (NCCRED), c/o the University of New South Wales, Sydney, Australia
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27
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Rungnirundorn T, Krusong K, Kalayasiri R, Maes M. Leukocyte telomere length is not shortened in methamphetamine dependence or methamphetamine-induced psychosis but is increased following traumatic events. World J Biol Psychiatry 2022; 23:613-621. [PMID: 34895035 PMCID: PMC9991870 DOI: 10.1080/15622975.2021.2016957] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/23/2021] [Revised: 12/06/2021] [Accepted: 12/07/2021] [Indexed: 01/25/2023]
Abstract
OBJECTIVE This study aims to examine the effects of methamphetamine (MA) use and dependence and MA withdrawal symptoms on the telomere length and whether shortening of the latter is associated with MA-induced psychosis (MIP). METHODS This study included 185 MA-abuse, 118 MA-dependent, and 67 MIP patients, diagnosed using DSM-IV criteria. The Semi-structured Assessment for Drug Dependence and Alcoholism (SSADDA) questionnaire was employed to collect MA-related data. MIP was confirmed using the Methamphetamine Experience Questionnaire (MEQ). The leukocyte telomere length was measured using real-time polymerase chain reaction measuring the Telomere/Single gene ratio (T/S ratio). Data were analysed using multivariate statistical analyses. RESULTS There were no significant associations between the T/S ratio and severity of MA-use, MIP, and MA withdrawal symptoms. MIP was significantly predicted by alcohol dependence, antisocial personality disorder, and MA-use severity. There were significantly positive associations between the T/S ratio and previous traumatic and life-threatening events. The T/S ratio was not affected by alcohol and nicotine dependence. Alcohol and nicotine dependence, antisocial personality disorder, and severity of MA use increased risk of MA withdrawal symptoms. CONCLUSION MIP and MA-use severity are not associated with leukocyte telomere length, but previous traumatic and life-threatening events are associated with increased telomere length.
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Affiliation(s)
| | - Kuakarun Krusong
- Structural and Computational Biology Research Unit, Department of Biochemistry, Faculty of Science, Chulalongkorn University, Bangkok, Thailand
| | - Rasmon Kalayasiri
- Department of Psychiatry, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
| | - Michael Maes
- Department of Psychiatry, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
- Department of Psychiatry, Medical University of Plovdiv, Plovdiv, Bulgaria
- IMPACT Strategic Research Centre, Deakin University, PO Box 281, Geelong, VIC, 3220, Australia
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28
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Wang M, Chen Y, Xu Y, Zhang X, Sun T, Li H, Yuan C, Li J, Ding ZH, Ma Z, Sun Y. A Randomized Controlled Trial Evaluating the Effect of Tai Chi on the Drug Craving in Women. Int J Ment Health Addict 2022:1-13. [PMID: 36119946 PMCID: PMC9469824 DOI: 10.1007/s11469-022-00917-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/30/2022] [Indexed: 10/27/2022] Open
Abstract
This study was conducted in the purpose of investigating the effect of Tai Chi on drug craving for women with drug disorders. One hundred and twelve women were recruited from a drug rehabilitation center in China, and 47 and 48 were finally analyzed in the control group and exercise group, respectively. The exercise group underwent a 3-month Tai Chi training, whereas the control group experienced no exercise intervention during the same time period. The drug craving was measured by the visual analog scale. In data analysis, repeated-measures were utilized to test the differences between the control and exercise group over the course of the experiment time. The mean of the craving score significantly dropped from pre-test (control: mean = 5.38, SD = 3.04; exercise: mean = 4.68, SD = 2.93) to post-test (control: mean = 4.03, SD = 2.73; exercise: mean = 1.91, SD = 1.90) in both groups (control group: t = 3.84, df = 46, p < 0.001; exercise group: t = 5.941, df = 47, p < 0.001), with more decrease witnessed in the exercise group. Repeated-measures analysis with a Huynh-Feldt correction showed the significant effect of time (F = 27.383, p < 0.001) as well as the study group by time interaction (F = 3.52, p = 0.024). Tai Chi can ameliorate the drug craving in women and it could be a supportive treatment for drug addiction.
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Affiliation(s)
- Mu Wang
- Institute of Intelligent Machines, Hefei Institute of Physical Science, Chinese Academy of Sciences, Hubin Building, Science Island, Shushan, Hefei, 230031 Anhui People’s Republic of China
- University of Science and Technology of China, Hefei, 230026 People’s Republic of China
| | - Yanyan Chen
- Institute of Intelligent Machines, Hefei Institute of Physical Science, Chinese Academy of Sciences, Hubin Building, Science Island, Shushan, Hefei, 230031 Anhui People’s Republic of China
| | - Yubing Xu
- Institute of Intelligent Machines, Hefei Institute of Physical Science, Chinese Academy of Sciences, Hubin Building, Science Island, Shushan, Hefei, 230031 Anhui People’s Republic of China
| | - Xiaoyu Zhang
- Institute of Intelligent Machines, Hefei Institute of Physical Science, Chinese Academy of Sciences, Hubin Building, Science Island, Shushan, Hefei, 230031 Anhui People’s Republic of China
- University of Science and Technology of China, Hefei, 230026 People’s Republic of China
| | - Ting Sun
- Institute of Intelligent Machines, Hefei Institute of Physical Science, Chinese Academy of Sciences, Hubin Building, Science Island, Shushan, Hefei, 230031 Anhui People’s Republic of China
| | - Huazhi Li
- Women Specific Drug Rehabilitation Center, Hefei, Anhui People’s Republic of China
| | - Cunfeng Yuan
- Drug Rehabilitation Administration of the Ministry of Justice of the People’s Republic of China, Beijing, People’s Republic of China
| | - Jin Li
- Women Specific Drug Rehabilitation Center, Hefei, Anhui People’s Republic of China
| | - Zeng-Hui Ding
- Institute of Intelligent Machines, Hefei Institute of Physical Science, Chinese Academy of Sciences, Hubin Building, Science Island, Shushan, Hefei, 230031 Anhui People’s Republic of China
| | - Zuchang Ma
- Institute of Intelligent Machines, Hefei Institute of Physical Science, Chinese Academy of Sciences, Hubin Building, Science Island, Shushan, Hefei, 230031 Anhui People’s Republic of China
| | - Yining Sun
- Institute of Intelligent Machines, Hefei Institute of Physical Science, Chinese Academy of Sciences, Hubin Building, Science Island, Shushan, Hefei, 230031 Anhui People’s Republic of China
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29
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Time-dependent affective disturbances in abstinent patients with methylphenidate use disorder. BMC Psychiatry 2022; 22:564. [PMID: 35996130 PMCID: PMC9394023 DOI: 10.1186/s12888-022-04187-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/12/2022] [Accepted: 07/31/2022] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND Methylphenidate (MPH), also called Ritalin, is used to treat attention-deficit hyperactivity disorder (ADHD) patients. With occasional reports of subjects suffering from Methylphenidate use disorder (MPHUD), few studies analyzed the neuropsychological changes in this population. PURPOSE This study aims to evaluate the clinical outcomes of individuals with MPHUD. METHODS We retrospectively analyzed 61 MPH patients (aged 16-27 years) admitted to the Beijing Gaoxin Hospital drug rehabilitation program from Jan 2017 to Mar 2019. The drug use history and drug abuse motivation scale were collected at admission. Clinicians rated the Hamilton Depression Rating Scale, Hamilton Anxiety Rating Scale, and DSM-5 Stimulant use disorder criteria each week during the 4 weeks rehabilitation program. Correlation analyses were conducted between drug use history and affective disturbances. RESULTS The results showed that the adolescent period is the peak for MPH exposure, and 1/3 of patients got their first exposure to MPH from their parents. MPH abstinence accompanies severe anxiety and depression symptoms, significantly alleviating after four weeks of treatment. CONCLUSIONS MPHUD is associated with substantial affective disturbances, which warrants a more considerable sample investigation.
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30
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Yang J, Zhang Z, Xie Z, Bai L, Xiong P, Chen F, Zhu T, Peng Q, Wu H, Zhou Y, Ma Y, Zhang Y, Chen M, Gao J, Tian W, Shi K, Du Y, Duan Y, Wang H, Xu Y, Kuang YQ, Zhu M, Yu J, Wang K. Metformin modulates microbiota-derived inosine and ameliorates methamphetamine-induced anxiety and depression-like withdrawal symptoms in mice. Biomed Pharmacother 2022; 149:112837. [PMID: 35339829 DOI: 10.1016/j.biopha.2022.112837] [Citation(s) in RCA: 23] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2022] [Revised: 03/16/2022] [Accepted: 03/16/2022] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND Metformin exhibits therapeutic potential in behavioural deficits induced by methamphetamine (METH) in rats. Emerging studies suggest gut microbiota may impact psychiatric symptoms, but there is no direct evidence supporting metformin's participation in the pathophysiology of withdrawal symptoms via modulation of gut microbiota. METHODS In order to define the functional impacts of gut microbiota and metformin to the behavioural deficits during METH withdrawal, we utilized a combination of fecal microbiota transplantation (FMT), high-throughput sequencing, and untargeted metabolomics technologies. RESULTS First, METH addicts exhibited higher α diversity and distinct microbial structures compared to healthy controls. In particular, the relative abundance of Rikenellaceae was positively correlated with the severity of anxiety and depression. Second, both human-to-mouse and mouse-to-mouse FMTs confirmed that METH-altered-microbiota transplantation is sufficient to promote anxiety and depression-like behaviours in recipient germ-free mice, and these behavioural disturbances could be ameliorated by metformin. In-depth analysis revealed that METH significantly altered the bacterial composition and structure as well as relative abundance of several bacterial taxa and metabolites, including Rikenellaceae and inosine, respectively, whereas add-on metformin could remodel these alterations. Finally, the inosine complementation successfully restored METH-induced anxiety and depression-like behaviours in mice. CONCLUSION This study demonstrates that METH withdrawal-induced anxiety and depression-like behaviours are reversible and transmissible via gut microbiota in a mouse model. The therapeutic effects of metformin on psychiatric manifestations are associated with microbiota-derived metabolites, highlighting the role of the gut microbiota in substance use disorders and the pathophysiology of withdrawal symptoms.
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Affiliation(s)
- Jiqing Yang
- NHC Key Laboratory of Drug Addiction Medicine, First Affiliated Hospital of Kunming Medical University, Kunming 650032, China; Department of Clinical Laboratory, The First Affiliated Hospital of Kunming Medical University, Kunming 650032, China; Faculty of Life science and Technology, Kunming University of Science and Technology, Kunming 650500, China; Centre for Experimental Studies and Research, First Affiliated Hospital of Kunming Medical University, Kunming 650032, China
| | - Zunyue Zhang
- NHC Key Laboratory of Drug Addiction Medicine, First Affiliated Hospital of Kunming Medical University, Kunming 650032, China; School of Medicine, Yunnan University, Kunming 650091, China
| | - Zhenrong Xie
- NHC Key Laboratory of Drug Addiction Medicine, First Affiliated Hospital of Kunming Medical University, Kunming 650032, China; Centre for Experimental Studies and Research, First Affiliated Hospital of Kunming Medical University, Kunming 650032, China
| | - Ling Bai
- Faculty of Life science and Technology, Kunming University of Science and Technology, Kunming 650500, China
| | - Pu Xiong
- NHC Key Laboratory of Drug Addiction Medicine, First Affiliated Hospital of Kunming Medical University, Kunming 650032, China; Centre for Experimental Studies and Research, First Affiliated Hospital of Kunming Medical University, Kunming 650032, China
| | - Fengrong Chen
- NHC Key Laboratory of Drug Addiction Medicine, First Affiliated Hospital of Kunming Medical University, Kunming 650032, China; Centre for Experimental Studies and Research, First Affiliated Hospital of Kunming Medical University, Kunming 650032, China
| | - Tailin Zhu
- Ministry of Education-Shanghai Key Laboratory for Children's Environmental Health, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai 200092, China
| | - Qingyan Peng
- NHC Key Laboratory of Drug Addiction Medicine, First Affiliated Hospital of Kunming Medical University, Kunming 650032, China; Centre for Experimental Studies and Research, First Affiliated Hospital of Kunming Medical University, Kunming 650032, China
| | - Hongjin Wu
- NHC Key Laboratory of Drug Addiction Medicine, First Affiliated Hospital of Kunming Medical University, Kunming 650032, China; Centre for Experimental Studies and Research, First Affiliated Hospital of Kunming Medical University, Kunming 650032, China
| | - Yong Zhou
- NHC Key Laboratory of Drug Addiction Medicine, First Affiliated Hospital of Kunming Medical University, Kunming 650032, China; Centre for Experimental Studies and Research, First Affiliated Hospital of Kunming Medical University, Kunming 650032, China
| | - Yuru Ma
- NHC Key Laboratory of Drug Addiction Medicine, First Affiliated Hospital of Kunming Medical University, Kunming 650032, China; Centre for Experimental Studies and Research, First Affiliated Hospital of Kunming Medical University, Kunming 650032, China
| | - Yongjin Zhang
- NHC Key Laboratory of Drug Addiction Medicine, First Affiliated Hospital of Kunming Medical University, Kunming 650032, China; Centre for Experimental Studies and Research, First Affiliated Hospital of Kunming Medical University, Kunming 650032, China
| | - Minghui Chen
- NHC Key Laboratory of Drug Addiction Medicine, First Affiliated Hospital of Kunming Medical University, Kunming 650032, China; Centre for Experimental Studies and Research, First Affiliated Hospital of Kunming Medical University, Kunming 650032, China
| | - Jianyuan Gao
- NHC Key Laboratory of Drug Addiction Medicine, First Affiliated Hospital of Kunming Medical University, Kunming 650032, China; Centre for Experimental Studies and Research, First Affiliated Hospital of Kunming Medical University, Kunming 650032, China
| | - Weiwei Tian
- NHC Key Laboratory of Drug Addiction Medicine, First Affiliated Hospital of Kunming Medical University, Kunming 650032, China
| | - Kai Shi
- College of Science, Guilin University of Technology, Guilin 541004, China
| | - Yan Du
- Department of Clinical Laboratory, The First Affiliated Hospital of Kunming Medical University, Kunming 650032, China
| | - Yong Duan
- Department of Clinical Laboratory, The First Affiliated Hospital of Kunming Medical University, Kunming 650032, China
| | - Huawei Wang
- NHC Key Laboratory of Drug Addiction Medicine, First Affiliated Hospital of Kunming Medical University, Kunming 650032, China
| | - Yu Xu
- NHC Key Laboratory of Drug Addiction Medicine, First Affiliated Hospital of Kunming Medical University, Kunming 650032, China; Department of Gastrointestinal Surgery, The First Affiliated Hospital of Kunming Medical University, Kunming 650032, China
| | - Yi-Qun Kuang
- NHC Key Laboratory of Drug Addiction Medicine, First Affiliated Hospital of Kunming Medical University, Kunming 650032, China; Centre for Experimental Studies and Research, First Affiliated Hospital of Kunming Medical University, Kunming 650032, China
| | - Mei Zhu
- NHC Key Laboratory of Drug Addiction Medicine, First Affiliated Hospital of Kunming Medical University, Kunming 650032, China; Centre for Experimental Studies and Research, First Affiliated Hospital of Kunming Medical University, Kunming 650032, China
| | - Juehua Yu
- NHC Key Laboratory of Drug Addiction Medicine, First Affiliated Hospital of Kunming Medical University, Kunming 650032, China; Centre for Experimental Studies and Research, First Affiliated Hospital of Kunming Medical University, Kunming 650032, China.
| | - Kunhua Wang
- NHC Key Laboratory of Drug Addiction Medicine, First Affiliated Hospital of Kunming Medical University, Kunming 650032, China; Faculty of Life science and Technology, Kunming University of Science and Technology, Kunming 650500, China; School of Medicine, Yunnan University, Kunming 650091, China.
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31
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Ren H, Zeng Y, Zhang M, Zhang S, Chen Z, Wu B, Liu J, Ren Y. Electro-acupuncture for protracted amphetamine abstinence syndrome: study protocol for a pragmatic randomized controlled trial. Trials 2022; 23:216. [PMID: 35292088 PMCID: PMC8922742 DOI: 10.1186/s13063-022-06154-7] [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: 06/10/2021] [Accepted: 03/06/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Protracted amphetamine abstinence syndrome is one of the primary causes of relapse for amphetamine-type drug abusers during withdrawal. However, the importance of the management of protracted amphetamine abstinence syndrome is underestimated. Electro-acupuncture may be a safe and effective alternative therapy for protracted amphetamine abstinence syndrome, but the evidence is limited. METHODS The study is a prospective, two-center, randomized, waitlist controlled, open-label pragmatic trial. A total of 300 patients with protracted amphetamine abstinence syndrome will be recruited. All participants will be randomly assigned to an electro-acupuncture group or a waitlist group in a 1:1 ratio. Participants in the electro-acupuncture group will receive the electrical-acupuncture treatment. Waitlist group participants will not receive electro-acupuncture treatment but will be assessed at each visit. Treatments will be administered twice a week for a total of 4 consecutive weeks. The primary outcome in this study is the change in the ACSA between baseline (week 0) and the completion of treatment (week 4), and the secondary outcomes are changes in the Hamilton Depression Scale (HAMD), the visual analog scale (VAS), the Hamilton Anxiety Scale (HAMA), the Pittsburgh Sleep Quality Index (PSQI), the Montreal Cognitive Assessment (MoCA), and the Medical Outcomes Study 36-item Short-Form Health Survey (SF-36). DISCUSSION This study will assess the effectiveness of acupuncture in PAAS in real-world settings to provide support for clinical decisions and a basis for subsequent trials comparing acupuncture with other positive regimens. TRIAL REGISTRATION ClinicalTrials.gov ChiCTR2000040619 . Registered on 3 December 2020.
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Affiliation(s)
- Huan Ren
- School of Acupuncture-Moxibustion and Tuina, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, 610075, China
| | - Yiwei Zeng
- School of Acupuncture-Moxibustion and Tuina, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, 610075, China
| | - Min Zhang
- School of Acupuncture-Moxibustion and Tuina, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, 610075, China
| | - Su Zhang
- School of Acupuncture-Moxibustion and Tuina, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, 610075, China
| | - Zhihan Chen
- School of Acupuncture-Moxibustion and Tuina, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, 610075, China
| | - Binbin Wu
- Coercive Rehabilitation Center for Addicts Affiliated to the Public Security Bureau of Deyang, Deyang, Sichuan, 618007, China
| | - Jun Liu
- Medical Rehabilitation Department, Drug Rehabilitation Administration of Sichuan Province, Chengdu, Sichuan, 610036, China
| | - Yulan Ren
- School of Chinese Classics, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, 610075, China.
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32
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Kim B, Tag SH, Nam E, Ham S, Ahn S, Kim J, Cho DW, Lee S, Yang YS, Lee SE, Kim YS, Cho IJ, Kim KP, Han SC, Im HI. SYNCRIP controls miR-137 and striatal learning in animal models of methamphetamine abstinence. Acta Pharm Sin B 2022; 12:3281-3297. [PMID: 35967275 PMCID: PMC9366222 DOI: 10.1016/j.apsb.2022.02.030] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2021] [Revised: 01/24/2022] [Accepted: 01/28/2022] [Indexed: 12/18/2022] Open
Abstract
Abstinence from prolonged psychostimulant use prompts stimulant withdrawal syndrome. Molecular adaptations within the dorsal striatum have been considered the main hallmark of stimulant abstinence. Here we explored striatal miRNA–target interaction and its impact on circulating miRNA marker as well as behavioral dysfunctions in methamphetamine (MA) abstinence. We conducted miRNA sequencing and profiling in the nonhuman primate model of MA abstinence, followed by miRNA qPCR, LC–MS/MS proteomics, immunoassays, and behavior tests in mice. In nonhuman primates, MA abstinence triggered a lasting upregulation of miR-137 in the dorsal striatum but a simultaneous downregulation of circulating miR-137. In mice, aberrant increase in striatal miR-137-dependent inhibition of SYNCRIP essentially mediated the MA abstinence-induced reduction of circulating miR-137. Pathway modeling through experimental deduction illustrated that the MA abstinence-mediated downregulation of circulating miR-137 was caused by reduction of SYNCRIP-dependent miRNA sorting into the exosomes in the dorsal striatum. Furthermore, diminished SYNCRIP in the dorsal striatum was necessary for MA abstinence-induced behavioral bias towards egocentric spatial learning. Taken together, our data revealed circulating miR-137 as a potential blood-based marker that could reflect MA abstinence-dependent changes in striatal miR-137/SYNCRIP axis, and striatal SYNCRIP as a potential therapeutic target for striatum-associated cognitive dysfunction by MA withdrawal syndrome.
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Levent A, Davelaar EJ. Recreational drug use and prospective memory. Psychopharmacology (Berl) 2022; 239:909-922. [PMID: 35129670 DOI: 10.1007/s00213-022-06081-0] [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: 03/10/2021] [Accepted: 02/01/2022] [Indexed: 11/28/2022]
Abstract
Prospective memory (PM) impairment in recreational drug users has been documented in recent years. However, most studies on the effects of drugs on PM contain several methodological challenges, such as small sample size (< 100 participants), unrepresentative sample type (e.g., student or patient), short abstinence period (< 7 days), and lack of control of potential confounds (e.g., sleep and IQ). The present study investigated the possible consequences of recreational drug use on prospective memory, using self-report and lab-based prospective memory measures while overcoming the methodological challenges. The sample was composed of 47 non-users (27 females, age range from 18 to 50 +) and 53 drug users (21 females, age range from 18 to 50 +). Recreational drug users reported significantly more deficits in the long-term episodic, short-term habitual, and internally cued PM failures subscales of the Prospective Memory Questionnaire. However, these deficits were eliminated after controlling for covariates (e.g., age, sleep quality, general health, alcohol usage). Recreational drug users also performed worse than non-users in the short-term, long-term, event-based, and time-based PM subscales of the Royal Prince Alfred Prospective Memory Test. These results remained significant after controlling for the covariates. Drug users demonstrated greater impairments on time-based and long-term PM tasks thought to be linked with executive functioning. Taken together, the present study provides further support for recreational drug-related deficits in PM and highlights a dissociation between self-report and lab-based PM measures.
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Affiliation(s)
- Adnan Levent
- Department of Psychological Sciences, Birkbeck, University of London, Male Street, London, WC1E 7HX, UK.
| | - Eddy J Davelaar
- Department of Psychological Sciences, Birkbeck, University of London, Male Street, London, WC1E 7HX, UK
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34
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Giang LM, Li MJ, Okafor CN, Diep NB, Shoptaw SJ. Correlates of methamphetamine use severity among patients receiving methadone maintenance treatment for opioid use disorder in Vietnam. J Subst Abuse Treat 2022; 132:108461. [PMID: 34098204 PMCID: PMC8572314 DOI: 10.1016/j.jsat.2021.108461] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2020] [Revised: 02/16/2021] [Accepted: 05/04/2021] [Indexed: 01/03/2023]
Abstract
OBJECTIVES To assess the severity of methamphetamine use among methadone maintenance treatment (MMT) patients in Vietnam with opioid use disorder and concurrent methamphetamine use, and to identify risk factors associated with higher severity of methamphetamine use. METHODS We used survey data and medical record abstractions from 428 people with opioid use disorder who also use methamphetamine while partaking in methadone treatment in five clinics in Hanoi, Vietnam. We used multinomial logistic regression to assess other risk factors and problems associated with high methamphetamine use severity. RESULTS Those who reported injecting heroin in the past 3 months (AOR = 4.05, 95% CI [1.30, 12.55], p = 0.02), having a longer history of lifetime heroin use (AOR = 1.13, 95% CI [1.03, 1.24], p < 0.01), and having higher cravings (AOR = 1.97, 95% CI [1.31, 2.98], p < 0.01) and fatigue (AOR = 1.25, 95% CI [0.96, 1.61], p = 0.09) related to methamphetamine withdrawal had greater odds of high methamphetamine use severity. One of five clinics had a significantly higher percentage of methamphetamine use severity than others. CONCLUSION Successful MMT in patients with opioid use disorder in Vietnam may additionally require methamphetamine-focused screening and intervention.
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Affiliation(s)
- Le Minh Giang
- Center for Training and Research on Substance Abuse-HIV, Hanoi Medical University, Hanoi, Vietnam
| | - Michael J. Li
- Center for Behavioral and Addiction Medicine, Department of Family Medicine, University of California, Los Angeles
| | - Chukwuemeka N. Okafor
- Department of Public Health, Robbins College of Health and Human Sciences, Baylor University, Waco Texas
| | - Nguyen Bich Diep
- Center for Training and Research on Substance Abuse-HIV, Hanoi Medical University, Hanoi, Vietnam
| | - Steven J. Shoptaw
- Center for Behavioral and Addiction Medicine, Department of Family Medicine, University of California, Los Angeles
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35
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Hu X, Jiang P, Gao Y, Sun J, Zhou X, Zhang L, Qiu H, Li H, Cao L, Liu J, Gong Q, Huang X. Brain morphometric abnormalities and their associations with affective symptoms in males with methamphetamine use disorder during abstinence. Front Psychiatry 2022; 13:1003889. [PMID: 36299549 PMCID: PMC9588977 DOI: 10.3389/fpsyt.2022.1003889] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/26/2022] [Accepted: 09/16/2022] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Methamphetamine (METH) use induces neurotoxic effects in brain structures and affective symptoms that persist during abstinence. However, the brain morphometry of individuals with METH use disorder (MUD) remains unclear, as well as their associations with affective symptoms during abstinence. METHODS Forty-eight abstinent males with MUD and 66 age-, sex-, and education-matched healthy controls (HCs) underwent high-resolution T1-weighted magnetic resonance imaging. Cortical thickness, surface area, volume, local gyrification index (LGI), and subcortical volume were obtained with FreeSurfer software. Brain morphometry differences between groups and their associations with affective symptoms and drug abuse history within the males with MUD were examined, with intracranial volume, age, and years of education as covariates. RESULTS Compared with the HCs, the individuals with MUD showed a significantly higher LGI in the right cuneus gyrus, left lingual gyrus, bilateral supramarginal gyrus, right inferior parietal gyrus (IPG), and right dorsal anterior cingulate cortex (clusterwise p < 0.05, Monte Carlo-corrected), as well as a smaller volume of the left nucleus accumbens (NAcc) (p < 0.05, FDR-corrected). However, there were no significant group differences in cortical thickness, area or volume. In addition, the LGI in the right IPG was positively associatedwith the severity of depression and anxiety symptoms in MUDs (p < 0.05, FDR-corrected). CONCLUSION Brain morphometric abnormalities in abstinent males with MUD were characterized by hypergyrification across multiple mid-posterior brain regions anda smaller volume of the left NAcc.Gyrification of the right IPG may be a potential neural substrate underlying the affective symptoms experienced by MUDs during abstinence.
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Affiliation(s)
- Xinyue Hu
- Functional and Molecular Imaging Key Laboratory of Sichuan Province, Department of Radiology, Huaxi Magnetic Resonance Research Center (HMRRC), West China Hospital, Sichuan University, Chengdu, China.,Psychoradiology Research Unit of the Chinese Academy of Medical Sciences, West China Hospital of Sichuan University, Chengdu, China
| | - Ping Jiang
- Functional and Molecular Imaging Key Laboratory of Sichuan Province, Department of Radiology, Huaxi Magnetic Resonance Research Center (HMRRC), West China Hospital, Sichuan University, Chengdu, China.,Psychoradiology Research Unit of the Chinese Academy of Medical Sciences, West China Hospital of Sichuan University, Chengdu, China.,West China Medical Publishers, West China Hospital of Sichuan University, Chengdu, China
| | - Yingxue Gao
- Functional and Molecular Imaging Key Laboratory of Sichuan Province, Department of Radiology, Huaxi Magnetic Resonance Research Center (HMRRC), West China Hospital, Sichuan University, Chengdu, China.,Psychoradiology Research Unit of the Chinese Academy of Medical Sciences, West China Hospital of Sichuan University, Chengdu, China
| | - Jiayu Sun
- Department of Radiology, West China Hospital of Sichuan University, Chengdu, China
| | - Xiaobo Zhou
- Department of Psychosomatics, Academy of Medical Sciences and Sichuan Provincial People's Hospital, Chengdu, China
| | - Lianqing Zhang
- Functional and Molecular Imaging Key Laboratory of Sichuan Province, Department of Radiology, Huaxi Magnetic Resonance Research Center (HMRRC), West China Hospital, Sichuan University, Chengdu, China.,Psychoradiology Research Unit of the Chinese Academy of Medical Sciences, West China Hospital of Sichuan University, Chengdu, China
| | - Hui Qiu
- Functional and Molecular Imaging Key Laboratory of Sichuan Province, Department of Radiology, Huaxi Magnetic Resonance Research Center (HMRRC), West China Hospital, Sichuan University, Chengdu, China.,Psychoradiology Research Unit of the Chinese Academy of Medical Sciences, West China Hospital of Sichuan University, Chengdu, China
| | - Hailong Li
- Functional and Molecular Imaging Key Laboratory of Sichuan Province, Department of Radiology, Huaxi Magnetic Resonance Research Center (HMRRC), West China Hospital, Sichuan University, Chengdu, China.,Psychoradiology Research Unit of the Chinese Academy of Medical Sciences, West China Hospital of Sichuan University, Chengdu, China
| | - Lingxiao Cao
- Functional and Molecular Imaging Key Laboratory of Sichuan Province, Department of Radiology, Huaxi Magnetic Resonance Research Center (HMRRC), West China Hospital, Sichuan University, Chengdu, China.,Psychoradiology Research Unit of the Chinese Academy of Medical Sciences, West China Hospital of Sichuan University, Chengdu, China
| | - Jing Liu
- Functional and Molecular Imaging Key Laboratory of Sichuan Province, Department of Radiology, Huaxi Magnetic Resonance Research Center (HMRRC), West China Hospital, Sichuan University, Chengdu, China.,Psychoradiology Research Unit of the Chinese Academy of Medical Sciences, West China Hospital of Sichuan University, Chengdu, China
| | - Qiyong Gong
- Functional and Molecular Imaging Key Laboratory of Sichuan Province, Department of Radiology, Huaxi Magnetic Resonance Research Center (HMRRC), West China Hospital, Sichuan University, Chengdu, China.,Psychoradiology Research Unit of the Chinese Academy of Medical Sciences, West China Hospital of Sichuan University, Chengdu, China
| | - Xiaoqi Huang
- Functional and Molecular Imaging Key Laboratory of Sichuan Province, Department of Radiology, Huaxi Magnetic Resonance Research Center (HMRRC), West China Hospital, Sichuan University, Chengdu, China.,Psychoradiology Research Unit of the Chinese Academy of Medical Sciences, West China Hospital of Sichuan University, Chengdu, China
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Gallagher JP, Twohig PA, Crnic A, Rochling FA. Illicit Drug Use and Endoscopy: When Do We Say No? Dig Dis Sci 2022; 67:5371-5381. [PMID: 35867192 PMCID: PMC9306238 DOI: 10.1007/s10620-022-07619-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/29/2021] [Accepted: 05/11/2022] [Indexed: 01/05/2023]
Abstract
BACKGROUND Illicit drug use (IDU) is often encountered in patients undergoing elective ambulatory surgical procedures such as endoscopy. Given the variety of systemic effects of these drugs, sedation and anesthetics are believed to increase the risk of cardiopulmonary complications during procedures. Procedural cancelations are common, regardless of the drug type, recency of use, and total dosage consumed. There is a lack of institutional and society recommendations regarding the optimal approach to performing outpatient endoscopy on patients with IDU. AIM To review the literature for current recommendations regarding the optimal management of outpatient elective endoscopic procedures in patients with IDU. Secondary aim is to provide guidance for clinicians who encounter IDU in endoscopic practice. METHODS Systematic review of PubMed, CINAHL, Embase, and Google Scholar for articles presenting data on outcomes of elective procedures in patients using illicit drugs. RESULTS There are no clinically relevant differences in periprocedural complications or mortality in cannabis users compared to non-users. Endoscopy in patients with remote cocaine use was also found to have similar outcomes to recent use. CONCLUSIONS Canceling endoscopic procedures in patients with recent IDU without consideration of the type of drug, dosage, and chronicity may lead to unnecessary delays in care and increased patient morbidity. Healthcare systems would benefit from additional guidelines for evaluating the patient with recent illicit drug use for acute intoxication and consider proceeding with procedures in the non-toxic population.
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Affiliation(s)
- John P. Gallagher
- Department of Internal Medicine, University of Nebraska Medical Center, 982000 Medical Center Drive, Omaha, NE 68198 USA
| | - Patrick A. Twohig
- Division of Gastroenterology & Hepatology, University of Nebraska Medical Center, 982000 Medical Center Drive, Omaha, NE 68198 USA
| | - Agnes Crnic
- Department of Anesthesiology and Pain Medicine, The Ottawa Hospital, University of Ottawa, Room B307, 1053 Carling Ave, Mail Stop 249, Ottawa, ON K1Y 4E9 Canada
| | - Fedja A. Rochling
- Division of Gastroenterology & Hepatology, University of Nebraska Medical Center, 982000 Medical Center Drive, Omaha, NE 68198 USA
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Perez FA, Blythe S, Wouldes T, McNamara K, Black KI, Oei JL. Prenatal methamphetamine-impact on the mother and child-a review. Addiction 2022; 117:250-260. [PMID: 33830539 DOI: 10.1111/add.15509] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/10/2021] [Revised: 02/02/2021] [Accepted: 03/24/2021] [Indexed: 11/29/2022]
Abstract
Methamphetamine (MA) is the second most commonly used illicit drug in the world, after cannabis. There are limited data on the outcomes of pregnant MA users but there is rapidly emerging evidence to suggest that they are more vulnerable, marginalized and impoverished compared with other drug-using mothers. MA use during pregnancy is associated with worse pregnancy outcomes and significantly higher rates of co-existing health and psychosocial problems. Newborn infants exposed to MA are at increased risk of perinatal complications, present differently at birth to infants exposed to other drugs of dependency such as opioids and have poorer neurological adaptation and feeding difficulties. Sparse literature from neuroimaging and cohort studies suggests that the neurocognitive deficits in MA exposed children persist, even into adulthood. Current clinical practice guidelines for the care of substance exposed pregnant women are opioid-centric with little attention paid to the consequences of prenatal MA exposure.
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Affiliation(s)
- Fatima Anne Perez
- Department of Newborn Care, The Royal Hospital for Women, Randwick, Australia.,School of Women's and Children's Health, Faculty of Medicine, University of New South Wales, Kensington, Australia
| | - Stacy Blythe
- School of Nursing and Midwifery, Western Sydney University.,Ingham Institute, Liverpool, Australia
| | - Trecia Wouldes
- School of Medicine, Department of Psychological Medicine, University of Auckland, Auckland, New Zealand
| | - Kelly McNamara
- Faculty of Medicine and Health, University of Sydney, Sidney, Australia.,School of Women's and Children's Health, University of New SouthWales, Sidney, Australia
| | - Kirsten I Black
- Faculty of Medicine and Health, University of Sydney, Sidney, Australia
| | - Ju Lee Oei
- Department of Newborn Care, The Royal Hospital for Women, Randwick, Australia.,School of Women's and Children's Health, Faculty of Medicine, University of New South Wales, Kensington, Australia
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Circulating microRNA miR-137 as a stable biomarker for methamphetamine abstinence. Psychopharmacology (Berl) 2022; 239:831-840. [PMID: 35138425 PMCID: PMC8891205 DOI: 10.1007/s00213-022-06074-z] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/11/2021] [Accepted: 01/24/2022] [Indexed: 12/01/2022]
Abstract
OBJECTIVE Stimulant use instigates abstinence syndrome in humans. miRNAs are a critical component for the pathophysiology of stimulant abstinence. Here we sought to identify a miRNA marker of methamphetamine abstinence in the circulating extracellular vesicles (cEVs). METHODS miR-137 in the cEVs was quantified by qPCR in thirty-seven patients under methamphetamine abstinence and thirty-five age-matched healthy controls recruited from 2014 to 2016 from the general adult population in a hospital setting, Seoul, South Korea. Diagnostic power was evaluated by area under curve in the receiver-operating characteristics curve and other multiple statistical parameters. RESULTS Patients under methamphetamine abstinence exhibited a significant reduction in cEV miR-137. Overall, cEV miR-137 had high potential as a blood-based marker of methamphetamine abstinence. cEV miR-137 retained the diagnostic power irrespective of the duration of methamphetamine abstinence or methamphetamine use. Interestingly, cEV miR-137 interacted with age: Control participants displayed an aging-dependent reduction of cEV miR-137, while methamphetamine-abstinent patients showed an aging-dependent increase in cEV miR-137. Accordingly, cEV miR-137 had variable diagnostic power depending on age, in which cEV miR-137 more effectively discriminated methamphetamine abstinence in the younger population. Duration of methamphetamine use or abstinence, cigarette smoking status, depressive disorder, or antidepressant treatment did not interact with the methamphetamine abstinence-induced reduction of cEV miR-137. CONCLUSION Our data collectively demonstrated that miR-137 in the circulating extracellular vesicles held high potential as a stable and accurate diagnostic marker of methamphetamine abstinence syndrome.
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Hubená P, Horký P, Grabic R, Grabicová K, Douda K, Slavík O, Randák T. Prescribed aggression of fishes: Pharmaceuticals modify aggression in environmentally relevant concentrations. ECOTOXICOLOGY AND ENVIRONMENTAL SAFETY 2021; 227:112944. [PMID: 34715502 DOI: 10.1016/j.ecoenv.2021.112944] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/16/2021] [Revised: 10/20/2021] [Accepted: 10/21/2021] [Indexed: 06/13/2023]
Abstract
Traces of psychoactive substances have been found in freshwaters globally. Fish are chronically exposed to pollution at low concentrations. The changes of aggressive behaviour of chub (Squalius cephalus) were determined under the exposure to four psychoactive compounds (sertraline, citalopram, tramadol, methamphetamine) at environmentally relevant concentrations of 1 μg/L for 42 days. We tested whether (A) the behavioural effect of compounds varies within a single species; (B) there is a correlation between the individual brain concentration of the tested pollutants and fish aggression using the novel analysis of pollutants in brain; and (C) there is detectable threshold to effective pollutant concentration in brain. Behaviour and pollutant concentrations in brain were determined repeatedly (1st, 7th, 21st, 42nd and 56th days), including a two-week-long depuration period. The effect of particular compounds varied. Citalopram and methamphetamine generally increased the fish aggression, while no such effect was found after exposure to tramadol or sertraline. The longitudinal analysis showed an aggression increase after depuration, indicating the presence of withdrawal effects in methamphetamine- and tramadol-exposed fish. The analysis of pollutant concentration in brain revealed a positive linear relationship of citalopram concentration and aggression, while no such effect was detected for other compounds and/or their metabolites. Structural break analyses detected concentration thresholds of citalopram (1 and 3 ng/g) and sertraline (1000 ng/g) in brain tissue, from which a significant effect on behaviour was manifested. While the effect of sertraline was not detected using traditional approaches, there was a reduction in aggression after considering its threshold concentration in the brain. Our results suggest that pursuing the concentration threshold of psychoactive compounds can help to reduce false negative results and provide more realistic predictions on behavioural outcomes in freshwater environments, especially in the case of compounds with bioaccumulation potential such as sertraline.
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Affiliation(s)
- Pavla Hubená
- Czech University of Life Sciences Prague, Department of Zoology and Fisheries, Kamýcká 129, 165 00 Praha 6 - Suchdol, Czech Republic.
| | - Pavel Horký
- Czech University of Life Sciences Prague, Department of Zoology and Fisheries, Kamýcká 129, 165 00 Praha 6 - Suchdol, Czech Republic
| | - Roman Grabic
- University of South Bohemia in České Budějovice, Faculty of Fisheries and Protection of Waters, South Bohemian Research Center of Aquaculture and Biodiversity of Hydrocenoses, Zátiší 728/II, 398 25 Vodňany, Czech Republic
| | - Kateřina Grabicová
- University of South Bohemia in České Budějovice, Faculty of Fisheries and Protection of Waters, South Bohemian Research Center of Aquaculture and Biodiversity of Hydrocenoses, Zátiší 728/II, 398 25 Vodňany, Czech Republic
| | - Karel Douda
- Czech University of Life Sciences Prague, Department of Zoology and Fisheries, Kamýcká 129, 165 00 Praha 6 - Suchdol, Czech Republic
| | - Ondřej Slavík
- Czech University of Life Sciences Prague, Department of Zoology and Fisheries, Kamýcká 129, 165 00 Praha 6 - Suchdol, Czech Republic
| | - Tomáš Randák
- University of South Bohemia in České Budějovice, Faculty of Fisheries and Protection of Waters, South Bohemian Research Center of Aquaculture and Biodiversity of Hydrocenoses, Zátiší 728/II, 398 25 Vodňany, Czech Republic
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Thompson RG, Oliveto A, Thostenson JD, Wilson MP, McGaugh J, Mancino MJ. Utility of a controlled amphetamine withdrawal paradigm among adults who use methamphetamine: A pilot clinical trial. J Psychopharmacol 2021; 35:1420-1430. [PMID: 34697965 PMCID: PMC10110391 DOI: 10.1177/02698811211050563] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND The continued increase in prevalence of methamphetamine use in the United States has resulted in a significant increase in the number of patients entering treatment for methamphetamine use. However, no robustly efficacious pharmacologic treatment for methamphetamine use or withdrawal has been identified to date after stopping methamphetamine use. AIMS Given the association between methamphetamine withdrawal and relapse during early treatment, this study tested a controlled d-amphetamine withdrawal paradigm among methamphetamine-using individuals. METHODS Treatment-seeking adults who used methamphetamine (N = 34; 47% female; 100% white) were enrolled in a 4-week, randomized, double-blind, placebo-controlled trial in a residential setting, in which all participants were maintained on d-amphetamine (30 mg BID) during week 1, then half were switched to placebo during weeks 2-3. All participants received placebo during week 4. Outcomes included vital signs, withdrawal, cravings for methamphetamine, mood, and cognition. Bivariate analyses tested treatment group differences on baseline demographic and outcome variables. Repeated measures models examined main and interaction effects of treatment over time. RESULTS/OUTCOMES Participants were successfully randomized and safely stabilized on d-amphetamine. Craving for methamphetamine increased during weeks 2-3 in the placebo group relative to those on d-amphetamine. Interactions with age and heart rate were noted. CONCLUSIONS/INTERPRETATION To our knowledge, this is the first double-blind, placebo-controlled trial measuring pharmacologic effects of abruptly stopping controlled d-amphetamine administration in adults who use methamphetamine. Results support the potential of this withdrawal paradigm to further examine the efficacy of pharmacologic agents in ameliorating methamphetamine withdrawal symptoms.
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Affiliation(s)
- Ronald G Thompson
- Center for Health Services Research, Department of Psychiatry, College of Medicine, University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | - Alison Oliveto
- College of Medicine, University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | - Jeff D Thostenson
- College of Medicine, University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | - Michael P Wilson
- College of Medicine, University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | - Janette McGaugh
- Ouachita Behavioral Health and Wellness, Hot Springs, AR, USA
| | - Michael J Mancino
- College of Medicine, University of Arkansas for Medical Sciences, Little Rock, AR, USA
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Rubenis AJ, Baker AL, Arunogiri S. Methamphetamine use and technology-mediated psychosocial interventions: A mini-review. Addict Behav 2021; 121:106881. [PMID: 33896672 DOI: 10.1016/j.addbeh.2021.106881] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2020] [Revised: 02/04/2021] [Accepted: 02/13/2021] [Indexed: 02/06/2023]
Abstract
Engagement with face-to-face psychosocial interventions is often compromised in people using methamphetamine (MA), in the context of high rates of polysubstance use, mental health disorders, cognitive impairment and geographic isolation. Technology-mediated interventions offer flexible ways of engaging with treatment and are readily accessible. This mini-review evaluates evidence from eight studies for the effectiveness of telephone, mHealth (text-messaging and apps) and computer-based interventions for MA use. Two papers from one telephone counselling study showed a small improvement in MA-related outcomes, particularly for individuals in active use. However, a directive counselling style was associated with a higher likelihood of MA use during recovery for those higher in resistance to authority. Text-messaging interventions generally showed small but significant reductions in MA use in non-treatment seekers. When compared, there was no significant difference in level of MA use reduction between interactive, automated and self-monitoring text messages. Studies in other modalities (smartphone app, one trial; computer-based interventions, two trials) did not confer statistically significant reductions in MA use, though were likely impacted by app design and participant characteristics. Preliminary findings hint at the potential effectiveness of telephone counselling in aftercare and the capacity for text-messaging to reach those who are not in treatment. Given the small amount of existing literature, this review discusses the potential value of emerging interventions, the importance of adapting interventions to the characteristics of people who use MA and suggests specific directions for research in each technology modality.
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Affiliation(s)
- Adam J Rubenis
- Turning Point, Eastern Health, 110 Church St., Richmond, VIC 3121, Australia; National Drug and Alcohol Research Centre, Faculty of Medicine, University of New South Wales, Sydney, NSW 2052, Australia; The National Centre for Clinical Research on Emerging Drugs (NCCRED), University of New South Wales, Sydney, NSW 2052, Australia.
| | - Amanda L Baker
- School of Medicine and Public Health, University of Newcastle, NSW 2300, Australia.
| | - Shalini Arunogiri
- Turning Point, Eastern Health, 110 Church St., Richmond, VIC 3121, Australia; Monash Alfred Psychiatry Research Centre, Central Clinical School, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, VIC 3004, Australia.
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42
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Wongtongkam N. Impact of comorbid substance use and infectious and non-communicable diseases in a cross-sectional study, Thailand. JOURNAL OF SUBSTANCE USE 2021. [DOI: 10.1080/14659891.2021.1967481] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- Nualnong Wongtongkam
- Centre for Rural and Remote Health, James Cook University, Mount Isa, Queensland, Australia
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43
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Liu L, Liu M, Zhao W, Zhao YL, Wang Y. Tetrahydropalmatine Regulates BDNF through TrkB/CAM Interaction to Alleviate the Neurotoxicity Induced by Methamphetamine. ACS Chem Neurosci 2021; 12:3373-3386. [PMID: 34448569 DOI: 10.1021/acschemneuro.1c00373] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
Abstract
Tetrahydropalmatine (THP) has analgesic, hypnotic, sedative, and other pharmacological effects. Brain-derived neurotrophic factor (BDNF) plays an important role in neuronal plasticity, growth, and development. However, their mechanism of action in methamphetamine (MA)-induced neurotoxicity remains unclear. This study aims to explore the important role of BDNF in MA neurotoxicity and whether THP can regulate BDNF through the interaction between tyrosine kinase receptor B (TrkB)/calmodulin (CAM) to alleviate the neurotoxicity induced by MA. SD rats were randomly divided into control, MA, and MA + THP groups. Stereotyped behavior test, captive rejection test, open field test (OFT), and Morris water maze (MWM) were used to evaluate the anxiety, aggression, cognition, learning, and memory. Extracted hippocampus and mesencephalon tissue were detected by Western blot, HE staining, and immunohistochemistry. TUNEL staining was used to detect apoptosis. MOE was used for bioinformatics prediction, and coimmunoprecipitation was used to confirm protein interactions. Long-term abuse of MA resulted in lower weight gain ratio and nerve cell damage and caused various neurotoxicity-related behavioral abnormalities: anxiety, aggression, cognitive motor disorders, and learning and memory disorders. MA-induced neurotoxicity is related to the down-regulation of BDNF and apoptosis. THP attenuated the MA-induced neurotoxicity by decreasing CAM, increasing TrkB, phosphorylating Akt, up-regulating NF-κB and BDNF, and inhibiting cell apoptosis. MA can induce neurotoxicity in rats. BDNF may play a vital role in MA-induced neurotoxicity. THP regulates BDNF through TrkB/CAM interaction to alleviate the neurotoxicity induced by MA. THP may be a potential therapeutic drug for the neurotoxic and neurodegenerative diseases related to MA.
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Affiliation(s)
- Lian Liu
- Department of Clinical Pharmacology, School of Pharmacy, China Medical University, Shenyang, Liaoning 110122, P. R. China
| | - Ming Liu
- Department of Drug Control, Criminal Investigation Police University of China, Shenyang, Liaoning 110854, P. R. China
| | - Wei Zhao
- Department of Drug Control, Criminal Investigation Police University of China, Shenyang, Liaoning 110854, P. R. China
| | - Yuan-Ling Zhao
- Department of Clinical Pharmacology, School of Pharmacy, China Medical University, Shenyang, Liaoning 110122, P. R. China
| | - Yun Wang
- Department of Clinical Pharmacology, School of Pharmacy, China Medical University, Shenyang, Liaoning 110122, P. R. China
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Li Z, Qi Y, Liu K, Cao Y, Zhang H, Song C, Deng H. Effect of Chaihu-jia-Longgu-Muli decoction on withdrawal symptoms in rats with methamphetamine-induced conditioned place preference. Biosci Rep 2021; 41:BSR20211376. [PMID: 34355745 PMCID: PMC8380915 DOI: 10.1042/bsr20211376] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2021] [Revised: 07/18/2021] [Accepted: 08/04/2021] [Indexed: 11/17/2022] Open
Abstract
Traditional Chinese medicine detoxification prescription Chaihu-jia-Longgu-Muli decoction (CLMD) relieves depressive symptoms in patients withdrawing from methamphetamine. In the present study, we assessed the effects of CLMD on methamphetamine withdrawal in rats. A methamphetamine-intoxicated rat model was established. Rats were randomly divided into the control, model, high-dosage, medium-dosage, and low-dosage groups, receiving high, medium, and low doses of CLMD, respectively. Weekly body weight measurements revealed that rats treated with methamphetamine had the lowest body weight. The conditioned place preference (CPP) experiment revealed that methamphetamine-intoxicated rats stayed significantly longer in the drug-paired chamber than the control rats. However, after administering high-dosage CLMD, the amount of time the rats spent in the drug-paired chamber was significantly less than that of the model rats. Our open-field test revealed that the model group had lower crossing and rearing scores than the control group. Additionally, rats that received CLMD treatment exhibited higher crossing and rearing scores than the model rats. Striatal dopamine (DA), 5-hydroxytryptamine (5-HT), and endorphins (β-EP) and serum interleukin (IL)-1α and IL-2 concentrations were estimated. Rats in the model group had lower striatal DA, 5-HT, and β-EP and higher serum IL-1α and IL-2 concentrations than those in the control group. High-dosage CLMD administration significantly changed the concentrations of these molecules, such that they approached normal concentrations. In general, CLMD could prevent the development of methamphetamine-induced withdrawal symptoms in rats by increasing the DA, 5-HT, and β-EP and lowering the IL-1α and IL-2 concentrations.
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Affiliation(s)
- Zifa Li
- Behavioural Phenotyping Core Facility, Shandong University of Traditional Chinese Medicine, Jinan 250355, China
- Chinese Medicine Neuro-Psycho Pharmacology Laboratory (CMNPPL), Shandong University of Traditional Chinese Medicine, Jinan 250355, China
| | - Yuchen Qi
- No. 2 Department of Encephalopathy, Affiliated Hospital of Shandong University of Traditional Chinese Medicine, Jinan 250011, China
| | - Kun Liu
- Behavioural Phenotyping Core Facility, Shandong University of Traditional Chinese Medicine, Jinan 250355, China
- Chinese Medicine Neuro-Psycho Pharmacology Laboratory (CMNPPL), Shandong University of Traditional Chinese Medicine, Jinan 250355, China
| | - Yiming Cao
- School of Traditional Chinese Medicine, Shandong University of Traditional Chinese Medicine, Jinan 250355, China
| | - Hao Zhang
- Behavioural Phenotyping Core Facility, Shandong University of Traditional Chinese Medicine, Jinan 250355, China
- Chinese Medicine Neuro-Psycho Pharmacology Laboratory (CMNPPL), Shandong University of Traditional Chinese Medicine, Jinan 250355, China
| | - Chunhong Song
- Behavioural Phenotyping Core Facility, Shandong University of Traditional Chinese Medicine, Jinan 250355, China
- Chinese Medicine Neuro-Psycho Pharmacology Laboratory (CMNPPL), Shandong University of Traditional Chinese Medicine, Jinan 250355, China
| | - Hualiang Deng
- School of Traditional Chinese Medicine, Shandong University of Traditional Chinese Medicine, Jinan 250355, China
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Liu L, Liu M, Zhao W, Zhao YL, Wang Y. Levo-tetrahydropalmatine: A new potential medication for methamphetamine addiction and neurotoxicity. Exp Neurol 2021; 344:113809. [PMID: 34256045 DOI: 10.1016/j.expneurol.2021.113809] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2021] [Revised: 06/23/2021] [Accepted: 07/08/2021] [Indexed: 10/20/2022]
Abstract
Levo-tetrahydropalmatine (l-THP) is mainly derived from the dried tuber of the Papaveraceae plant Corydalis, also called Corydalis B, which is a drug with analgesic, hypnotic, sedative and other effects. Methamphetamine (METH) belongs to the central nervous stimulant and is a highly addictive drug. It is an urgent problem to study the mechanism of methamphetamine neurotoxicity and to search for the therapeutic targets of the METH addiction. This review is aimed to discuss the pharmacological mechanism and the protective effects of l-THP on METH-induced neurotoxicity, and to explore the therapeutic prospects of l-THP for METH addiction to provide an innovative application of l-THP in clinic. It was found that exposure to METH leads to the compulsive drug-seeking and drug-taking behavior, which is ultimately resulted in METH addiction and neurotoxicity. L-THP has the inhibitory effects on the incidence, maintenance and relapse of METH addiction. L-THP can effectively enhance the plasticity of nerve cells and improve the function of nerve cells where brain-derived neurotrophic factor (BDNF) and its pathways play a protective role. Therefore, l-THP has the potential to become an important therapeutic drug for METH addiction and neurotoxicity.
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Affiliation(s)
- Lian Liu
- Department of Clinical Pharmacology, School of Pharmacy, China Medical University, Shenyang, Liaoning 110122, PR China
| | - Ming Liu
- Department of Drug Control, Criminal Investigation Police University of China, Shenyang, Liaoning 110854, PR China
| | - Wei Zhao
- Department of Drug Control, Criminal Investigation Police University of China, Shenyang, Liaoning 110854, PR China
| | - Yuan-Ling Zhao
- Department of Clinical Pharmacology, School of Pharmacy, China Medical University, Shenyang, Liaoning 110122, PR China
| | - Yun Wang
- Department of Clinical Pharmacology, School of Pharmacy, China Medical University, Shenyang, Liaoning 110122, PR China.
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Horký P, Grabic R, Grabicová K, Brooks BW, Douda K, Slavík O, Hubená P, Sancho Santos EM, Randák T. Methamphetamine pollution elicits addiction in wild fish. J Exp Biol 2021; 224:270755. [PMID: 34229347 DOI: 10.1242/jeb.242145] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2020] [Accepted: 05/26/2021] [Indexed: 12/24/2022]
Abstract
Illicit drug abuse presents pervasive adverse consequences for human societies around the world. Illicit drug consumption also plays an unexpected role in contamination of aquatic ecosystems that receive wastewater discharges. Here, we show that methamphetamine, considered as one of the most important global health threats, causes addiction and behavior alteration of brown trout Salmo trutta at environmentally relevant concentrations (1 µg l-1). Altered movement behavior and preference for methamphetamine during withdrawal were linked to drug residues in fish brain tissues and accompanied by brain metabolome changes. Our results suggest that emission of illicit drugs into freshwater ecosystems causes addiction in fish and modifies habitat preferences with unexpected adverse consequences of relevance at the individual and population levels. As such, our study identifies transmission of human societal problems to aquatic ecosystems.
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Affiliation(s)
- Pavel Horký
- Czech University of Life Sciences Prague, Faculty of Agrobiology, Food and Natural Resources, Department of Zoology and Fisheries, Kamýcká 129, 165 00 Prague 6, Czech Republic
| | - Roman Grabic
- University of South Bohemia in České Budějovice, Faculty of Fisheries and Protection of Waters, South Bohemian Research Center of Aquaculture and Biodiversity of Hydrocenoses, Zátiší 728/II, 389 25 Vodňany, Czech Republic
| | - Kateřina Grabicová
- University of South Bohemia in České Budějovice, Faculty of Fisheries and Protection of Waters, South Bohemian Research Center of Aquaculture and Biodiversity of Hydrocenoses, Zátiší 728/II, 389 25 Vodňany, Czech Republic
| | - Bryan W Brooks
- University of South Bohemia in České Budějovice, Faculty of Fisheries and Protection of Waters, South Bohemian Research Center of Aquaculture and Biodiversity of Hydrocenoses, Zátiší 728/II, 389 25 Vodňany, Czech Republic.,Department of Environmental Science, Institute of Biomedical Studies, Center for Reservoir and Aquatic Systems Research, Baylor University, Waco, TX 76798, USA
| | - Karel Douda
- Czech University of Life Sciences Prague, Faculty of Agrobiology, Food and Natural Resources, Department of Zoology and Fisheries, Kamýcká 129, 165 00 Prague 6, Czech Republic
| | - Ondřej Slavík
- Czech University of Life Sciences Prague, Faculty of Agrobiology, Food and Natural Resources, Department of Zoology and Fisheries, Kamýcká 129, 165 00 Prague 6, Czech Republic
| | - Pavla Hubená
- Czech University of Life Sciences Prague, Faculty of Agrobiology, Food and Natural Resources, Department of Zoology and Fisheries, Kamýcká 129, 165 00 Prague 6, Czech Republic
| | - Eugenia M Sancho Santos
- University of South Bohemia in České Budějovice, Faculty of Fisheries and Protection of Waters, South Bohemian Research Center of Aquaculture and Biodiversity of Hydrocenoses, Zátiší 728/II, 389 25 Vodňany, Czech Republic
| | - Tomáš Randák
- University of South Bohemia in České Budějovice, Faculty of Fisheries and Protection of Waters, South Bohemian Research Center of Aquaculture and Biodiversity of Hydrocenoses, Zátiší 728/II, 389 25 Vodňany, Czech Republic
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Vrajová M, Šlamberová R, Hoschl C, Ovsepian SV. Methamphetamine and sleep impairments: neurobehavioral correlates and molecular mechanisms. Sleep 2021; 44:6066541. [PMID: 33406259 DOI: 10.1093/sleep/zsab001] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2020] [Revised: 11/01/2020] [Indexed: 12/12/2022] Open
Abstract
Methamphetamine is a potent and highly addictive psychostimulant, and one of the most widely used illicit drugs. Over recent years, its global usage and seizure have been on a rapid rise, with growing detrimental effects on mental and physical health, and devastating psychosocial impact pressing for intervention. Among the unwanted effects of methamphetamine, acute and long-term sleep impairments are of major concern, posing a significant therapeutic challenge, and a cause of addiction relapse. Unraveling mechanisms and functional correlates of methamphetamine-related sleep and circadian disruption are, therefore, of key relevance to translational and clinical psychiatry. In this article, we review the mounting evidence for the acute and long-term impairements of sleep-wake behavior and circadian activity caused by single or recurring methamphetamine usage and withdrawal. Factors contributing to the severity of sleep loss and related cognitive deficit, with risks of relapse are discussed. Key molecular players mediating methamphetamine-induced dopamine release and neuromodulation are considered, with wake-promoting effects in mesolimbic circuits. The effects on various sleep phases and related changes in dopamine levels in selected subcortical structures are reviewed and compared to other psychostimulants with similar action mechanisms. A critical appraisal is presented of the therapeutic use of modafinil, countering sleep, and circadian rhythm impairments. Finally, emerging knowledge gaps and methodical limitations are highlighted along with the areas for future research and therapeutic translation.
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Affiliation(s)
- Monika Vrajová
- Department of Experimental Neurobiology, National Institute of Mental Health, Klecany, Czech Republic
| | - Romana Šlamberová
- Department of Physiology, Third Faculty of Medicine, Charles University, Prague, Czech Republic
| | - Cyril Hoschl
- Department of Experimental Neurobiology, National Institute of Mental Health, Klecany, Czech Republic.,Department of Psychiatry and Medical Psychology, Third Faculty of Medicine, Charles University, Klecany, Czech Republic
| | - Saak V Ovsepian
- Department of Experimental Neurobiology, National Institute of Mental Health, Klecany, Czech Republic.,Department of Psychiatry and Medical Psychology, Third Faculty of Medicine, Charles University, Klecany, Czech Republic
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Zhao J, Kral AH, Simpson KA, Ceasar RC, Wenger LD, Kirkpatrick M, Bluthenthal RN. Factors associated with methamphetamine withdrawal symptoms among people who inject drugs. Drug Alcohol Depend 2021; 223:108702. [PMID: 33894459 DOI: 10.1016/j.drugalcdep.2021.108702] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/10/2021] [Revised: 02/23/2021] [Accepted: 02/28/2021] [Indexed: 12/17/2022]
Abstract
BACKGROUND Regular methamphetamine (MA) use can result in withdrawal syndrome characterized by fatigue, agitation, depression, and anxiety. No studies that we are aware of have examined the prevalence and predictors of MA withdrawal symptoms among people who inject drugs (PWID). METHODS PWID were recruited using targeted sampling methods in Los Angeles and San Francisco, California from 2016 to 2017. Survey questions included demographics, drug use, and MA withdrawal symptoms, frequency, and symptom severity. Participants who reported regular MA use (> 12 times in the last 30 days) were included in this analysis (N = 595). Multivariable regression models were developed to examine factors associated with any MA withdrawal, withdrawal frequency, symptom severity, and receptive syringe sharing. RESULTS MA withdrawal symptoms in the past 6 months were reported by 53 % of PWID, with 25 % reporting weekly withdrawal symptoms, and 20 % reporting very or extremely painful symptoms. In multivariable logistic regression, presence of any MA withdrawal symptoms was positively associated with more frequent MA use and non-injection tranquilizer use and inversely associated with crack cocaine use. Among those reporting any withdrawal, female sex was associated with more frequent withdrawal symptoms. Very or extremely painful withdrawal symptoms were associated with being in residential treatment. Receptive syringe sharing was associated with any MA withdrawal symptoms and weekly frequency of symptoms. CONCLUSION MA withdrawal symptoms are common among PWID and are associated with receptive syringe sharing. Strategies for implementing MA use treatment, safe supply programs, and syringe services programs targeting people who inject MA are indicated.
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Affiliation(s)
- Johnathan Zhao
- Keck School of Medicine, University of Southern California, 1975 Zonal Ave, Los Angeles, CA, 90033, United States
| | - Alex H Kral
- RTI International, 2150 Shattuck Avenue, Suite 800, Berkeley, CA, 94704, United States
| | - Kelsey A Simpson
- Department of Preventive Medicine, Institute for Prevention Research, Keck School of Medicine, University of Southern California, 2001 N Soto St, 3rd Floor, Los Angeles, CA, 90033, United States
| | - Rachel Carmen Ceasar
- Department of Preventive Medicine, Institute for Prevention Research, Keck School of Medicine, University of Southern California, 2001 N Soto St, 3rd Floor, Los Angeles, CA, 90033, United States
| | - Lynn D Wenger
- RTI International, 2150 Shattuck Avenue, Suite 800, Berkeley, CA, 94704, United States
| | - Matt Kirkpatrick
- Department of Preventive Medicine, Institute for Prevention Research, Keck School of Medicine, University of Southern California, 2001 N Soto St, 3rd Floor, Los Angeles, CA, 90033, United States
| | - Ricky N Bluthenthal
- Department of Preventive Medicine, Institute for Prevention Research, Keck School of Medicine, University of Southern California, 2001 N Soto St, 3rd Floor, Los Angeles, CA, 90033, United States.
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49
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Qi L, Yin Y, Bu L, Tang Z, Tang L, Dong G. Acute VR competitive cycling exercise enhanced cortical activations and brain functional network efficiency in MA-dependent individuals. Neurosci Lett 2021; 757:135969. [PMID: 34023411 DOI: 10.1016/j.neulet.2021.135969] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2021] [Revised: 05/14/2021] [Accepted: 05/17/2021] [Indexed: 12/23/2022]
Abstract
BACKGROUND Methamphetamine (MA) dependence is associated with elevated rates cognitive impairment in MA users. The objective of the present study was to investigate the effects of virtual reality (VR) competitive cycling excise on the neurocognitive functions and on negative affectivity of MA-dependent individuals. METHODS Thirty MA-dependent individuals performed a colour-word Stroop task and underwent a profile of mood states (POMS) scale assessment both before and after a 10 min VR competitive cycling exercise. Functional near-infrared spectroscopy (fNIRS) were recorded during the pre-and post-exercise Stroop tasks and during rest. RESULTS After acute exercise, neural activity, along with improved Stroop performance, was enhanced significantly in the dorsolateral prefrontal cortex. Also observed during post-exercise Stroop tasks was a more efficient network architecture in the topological organization of brain networks than during the pre-exercise Stroop tasks. As for resting states before versus after exercisethe, we detected an increased functional connectivity between the prefrontal cortex and the motor cortex after exercise. CONCLUSIONS These results suggest that an acute bout of VR competitive cycling exercise facilitates executive information processing by enhancing task-related cortical activations and brain functional network efficiency in MA-dependent individuals.
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Affiliation(s)
- Liping Qi
- School of Biomedical Engineering, Dalian University of Technology, Dalian, 116024, China.
| | - Yue Yin
- School of Biomedical Engineering, Dalian University of Technology, Dalian, 116024, China
| | - Lingguo Bu
- Joint SDU-NTU Centre for Artificial Intelligence Research (C-FAIR), Shandong University, Jinan, 250101, China
| | - Zekun Tang
- Shandong Sport University, Jinan, 250102, China
| | - Lei Tang
- Compulsory Isolation Drug Rehabilitation Center of Shandong Province, Zibo, 255311, China
| | - Guijun Dong
- Shandong Sport University, Jinan, 250102, China.
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50
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Caffino L, Mottarlini F, Zita G, Gawliński D, Gawlińska K, Wydra K, Przegaliński E, Fumagalli F. The effects of cocaine exposure in adolescence: Behavioural effects and neuroplastic mechanisms in experimental models. Br J Pharmacol 2021; 179:4233-4253. [PMID: 33963539 PMCID: PMC9545182 DOI: 10.1111/bph.15523] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2021] [Revised: 04/15/2021] [Accepted: 05/04/2021] [Indexed: 01/23/2023] Open
Abstract
Drug addiction is a devastating disorder with a huge economic and social burden for modern society. Although an individual may slip into drug abuse throughout his/her life, adolescents are at higher risk, but, so far, only a few studies have attempted to elucidate the underlying cellular and molecular bases of such vulnerability. Indeed, preclinical evidence indicates that psychostimulants and adolescence interact and contribute to promoting a dysfunctional brain. In this review, we have focused our attention primarily on changes in neuroplasticity brought about by cocaine, taking into account that there is much less evidence from exposure to cocaine in adolescence, compared with that from adults. This review clearly shows that exposure to cocaine during adolescence, acute or chronic, as well as contingent or non‐contingent, confers a vulnerable endophenotype, primarily, by causing changes in neuroplasticity. Given the close relationship between drug abuse and psychiatric disorders, we also discuss the translational implications providing an interpretative framework for clinical studies involving addictive as well as affective or psychotic behaviours.
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Affiliation(s)
- Lucia Caffino
- Department of Pharmacological and Biomolecular Sciences, Università degli Studi di Milano, Milan, Italy
| | - Francesca Mottarlini
- Department of Pharmacological and Biomolecular Sciences, Università degli Studi di Milano, Milan, Italy
| | - Gianmaria Zita
- Dipartimento di Salute Mentale e Dipendenze, ASST Fatebenefratelli-Sacco, Milan, Italy
| | - Dawid Gawliński
- Department of Drug Addiction Pharmacology, Maj Institute of Pharmacology Polish Academy of Sciences, Kraków, Poland
| | - Kinga Gawlińska
- Department of Drug Addiction Pharmacology, Maj Institute of Pharmacology Polish Academy of Sciences, Kraków, Poland
| | - Karolina Wydra
- Department of Drug Addiction Pharmacology, Maj Institute of Pharmacology Polish Academy of Sciences, Kraków, Poland
| | - Edmund Przegaliński
- Department of Drug Addiction Pharmacology, Maj Institute of Pharmacology Polish Academy of Sciences, Kraków, Poland
| | - Fabio Fumagalli
- Department of Pharmacological and Biomolecular Sciences, Università degli Studi di Milano, Milan, Italy
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