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Liao C, He ZW, Yu R, Yu YJ, Liu XR, Kong DL, Wang Y. CircRNA: a rising therapeutic strategy for lung injury induced by pulmonary toxicants. Arch Toxicol 2024; 98:1297-1310. [PMID: 38498160 DOI: 10.1007/s00204-024-03706-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2023] [Accepted: 02/14/2024] [Indexed: 03/20/2024]
Abstract
Lung injury has been a serious medical problem that requires new therapeutic approaches and biomarkers. Circular RNAs (circRNAs) are non-coding RNAs (ncRNAs) that exist widely in eukaryotes. CircRNAs are single-stranded RNAs that form covalently closed loops. CircRNAs are significant gene regulators that have a role in the development, progression, and therapy of lung injury by controlling transcription, translating into protein, and sponging microRNAs (miRNAs) and proteins. Although the study of circRNAs in lung injury caused by pulmonary toxicants is just beginning, several studies have revealed their expression patterns. The function that circRNAs perform in relation to pulmonary toxicants (severe acute respiratory distress syndrome coronavirus-2 (SARS-CoV-2), drug abuse, PM2.5, and cigarette smoke) is the main topic of this review. A variety of circRNAs can serve as potential biomarkers of lung injury. In this review, the biogenesis, properties, and biological functions of circRNAs were concluded, and the relationship between circRNAs and pulmonary toxicants was discussed. It is expected that the new ideas and potential treatment targets that circRNAs provide would be beneficial to research into the molecular mechanisms behind lung injury.
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Affiliation(s)
- Cai Liao
- Department of Clinical Pharmacology, School of Pharmacy, China Medical University, No. 77 Puhe Road, Shenyang North New Area, Shenyang, 110122, Liaoning, China
| | - Zhen-Wei He
- Department of Neurology, The Fourth Affiliated Hospital of China Medical University, Shenyang, Liaoning, China
| | - Rui Yu
- Department of Clinical Pharmacology, School of Pharmacy, China Medical University, No. 77 Puhe Road, Shenyang North New Area, Shenyang, 110122, Liaoning, China
| | - Ya-Jie Yu
- Department of Clinical Pharmacology, School of Pharmacy, China Medical University, No. 77 Puhe Road, Shenyang North New Area, Shenyang, 110122, Liaoning, China
| | - Xiao-Ru Liu
- Department of Clinical Pharmacology, School of Pharmacy, China Medical University, No. 77 Puhe Road, Shenyang North New Area, Shenyang, 110122, Liaoning, China
| | - De-Lei Kong
- Department of Respiratory and Critical Care Medicine, The First Hospital of China Medical University, No. 155, Nanjing Street, Heping District, Shenyang, 110000, Liaoning, China.
| | - Yun Wang
- Department of Clinical Pharmacology, School of Pharmacy, China Medical University, No. 77 Puhe Road, Shenyang North New Area, Shenyang, 110122, Liaoning, China.
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Arakelian M, Barnett B, Weleff J. The Zero Suicide Model in Addiction Treatment Settings: Recognizing the Need for Feasibility and Implementation Data. Psychiatr Serv 2024; 75:378-380. [PMID: 37933133 DOI: 10.1176/appi.ps.20230175] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2023]
Abstract
The Zero Suicide (ZS) model is a promising approach for preventing all suicides across health care settings. ZS provides guidelines for health care systems to implement best practices in suicide prevention. Patients with substance use disorders are at increased risk for suicide, but no known research has investigated how to integrate the ZS model into addiction treatment settings. This Open Forum encourages clinicians and researchers to integrate ZS into such settings and to study its feasibility and effectiveness. ZS integration into addiction treatment may improve both suicide and addiction outcomes, but additional research is needed.
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Affiliation(s)
- Miranda Arakelian
- Cleveland Clinic Lerner College of Medicine at Case Western Reserve University, Cleveland Clinic, Cleveland (Arakelian, Barnett); Department of Psychiatry and Psychology, Neurological Institute, Cleveland Clinic, Cleveland (Barnett); Department of Psychiatry, Yale University School of Medicine, New Haven (Weleff)
| | - Brian Barnett
- Cleveland Clinic Lerner College of Medicine at Case Western Reserve University, Cleveland Clinic, Cleveland (Arakelian, Barnett); Department of Psychiatry and Psychology, Neurological Institute, Cleveland Clinic, Cleveland (Barnett); Department of Psychiatry, Yale University School of Medicine, New Haven (Weleff)
| | - Jeremy Weleff
- Cleveland Clinic Lerner College of Medicine at Case Western Reserve University, Cleveland Clinic, Cleveland (Arakelian, Barnett); Department of Psychiatry and Psychology, Neurological Institute, Cleveland Clinic, Cleveland (Barnett); Department of Psychiatry, Yale University School of Medicine, New Haven (Weleff)
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3
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Galust H, Seltzer JA, Hardin JR, Friedman NA, Salamat J, Clark RF, Harmon J. Adulterants present in the San Diego county fentanyl supply: a laboratory analysis of seized law enforcement samples. BMC Public Health 2024; 24:923. [PMID: 38553721 PMCID: PMC10981322 DOI: 10.1186/s12889-024-18459-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2023] [Accepted: 03/26/2024] [Indexed: 04/01/2024] Open
Abstract
BACKGROUND The opioid overdose crisis is one of the worst public health crises ever to face the US and emerging evidence suggests its effects are compounded by the presence of drug adulterants. Here we report our efforts to characterize the adulterants present within the local fentanyl supply of San Diego County, obtained from undifferentiated drug samples seized by local law enforcement over the calendar year 2021. METHODS Thirty-two participating local law enforcement agencies across San Diego submitted 4838 unknown individual illicit drug samples (total of 312 kg) to the San Diego County Sheriff's Department Regional Crime Laboratory for identification. RESULTS Qualitative analysis of these samples via FTIR and GC-MS identified methamphetamine (38.7%), fentanyl (20.8%), diacetylmorphine (heroin) (10.2%), codeine (5.8%) and alprazolam (4.3%) as the most common illicit substances and the presence of 52 unique adulterants. The most common adulterants included 4-methylaminoantipyrine (4-MAAP) (10.9%), mannitol (9%), acetaminophen (8.5%), methamphetamine (4.2%), diacetylmorphine (heroin) (3.6%), tramadol (1.9%), and xylazine (1.7%). Several additional pharmacologically active adulterants and contaminants of interest were also identified. CONCLUSION This analysis is vital for public health use and harm reduction efforts at the level of the individual consumer. Continued direct surveillance of the drug supply is necessary for the detection of potentially harmful adulterants that may pose serious threats to the public.
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Affiliation(s)
- Henrik Galust
- Division of Medical Toxicology, Department of Emergency Medicine, UC San Diego Health, 200 W. Arbor Dr. #8676, 92103, San Diego, CA, USA.
- VA San Diego Healthcare System, San Diego, CA, USA.
- California Poison Control System, San Diego, CA, USA.
| | - Justin A Seltzer
- Division of Medical Toxicology, Department of Emergency Medicine, UC San Diego Health, 200 W. Arbor Dr. #8676, 92103, San Diego, CA, USA
- VA San Diego Healthcare System, San Diego, CA, USA
- California Poison Control System, San Diego, CA, USA
| | - Jeremy R Hardin
- Division of Medical Toxicology, Department of Emergency Medicine, UC San Diego Health, 200 W. Arbor Dr. #8676, 92103, San Diego, CA, USA
- VA San Diego Healthcare System, San Diego, CA, USA
- California Poison Control System, San Diego, CA, USA
| | - Nathan A Friedman
- Division of Medical Toxicology, Department of Emergency Medicine, UC San Diego Health, 200 W. Arbor Dr. #8676, 92103, San Diego, CA, USA
- VA San Diego Healthcare System, San Diego, CA, USA
- California Poison Control System, San Diego, CA, USA
| | - Jeff Salamat
- San Diego County Sheriff's Crime Laboratory. John F. Duffy Administrative Center, 9621. Ridgehaven Ct, 92123, San Diego, CA, USA
| | - Richard F Clark
- Division of Medical Toxicology, Department of Emergency Medicine, UC San Diego Health, 200 W. Arbor Dr. #8676, 92103, San Diego, CA, USA
- VA San Diego Healthcare System, San Diego, CA, USA
- California Poison Control System, San Diego, CA, USA
| | - Jennifer Harmon
- San Diego County Sheriff's Crime Laboratory. John F. Duffy Administrative Center, 9621. Ridgehaven Ct, 92123, San Diego, CA, USA
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Hirschel J, Barcos-Munoz F, Chalard F, Chiodini F, Epiney M, Fluss J, Rougemont AL. Perinatal arterial ischemic stroke: how informative is the placenta? Virchows Arch 2024:10.1007/s00428-024-03780-1. [PMID: 38502326 DOI: 10.1007/s00428-024-03780-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2023] [Revised: 01/31/2024] [Accepted: 03/05/2024] [Indexed: 03/21/2024]
Abstract
Neuroplacentology is an expanding field of interest that addresses the placental influence on fetal and neonatal brain lesions and on further neurodevelopment. The objective of this study was to clarify the link between placental pathology and perinatal arterial ischemic stroke (PAIS). Prior publications have reported different types of perinatal stroke with diverse methodologies precluding firm conclusions. We report here the histological placental findings in a series of 16 neonates with radiologically confirmed PAIS. Findings were grouped into 3 categories of lesions: (1) inflammation, (2) placental and fetal hypoxic lesions, and (3) placentas with a high birthweight/placenta weight ratio. Matched control placentas were compared to the pathological placentas when feasible. The eight term singleton placentas were compared to a series of 20 placentas from a highly controlled amniotic membrane donation program; in three twin pregnancies, the placental portions from the affected twin and unaffected co-twin were compared. Slightly more than half (9/16, 56%) had histopathological features belonging to more than one category, a feature shared by the singleton control placentas (13/20, 65%). More severe and extensive lesions were however observed in the pathological placentas. One case occurring in the context of SARS-CoV-2 placentitis further expands the spectrum of COVID-related perinatal disease. Our study supports the assumption that PAIS can result from various combinations and interplay of maternal and fetal factors and confirms the value of placenta examination. Yet, placental findings must be interpreted with caution given their prevalence in well-designed controls.
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Affiliation(s)
- Jessica Hirschel
- Division of Neonatal and Intensive Care, Department of Pediatrics, Gynecology and Obstetrics, University Hospitals of Geneva, Geneva, Switzerland
| | - Francisca Barcos-Munoz
- Division of Neonatal and Intensive Care, Department of Pediatrics, Gynecology and Obstetrics, University Hospitals of Geneva, Geneva, Switzerland
| | - François Chalard
- Unit of Pediatric Radiology, Department of Radiology, University Hospitals of Geneva and Faculty of Medicine, University of Geneva, Geneva, Switzerland
| | - Florence Chiodini
- Therapeutic Tissue Biobank, University Hospitals of Geneva, Geneva, Switzerland
| | - Manuella Epiney
- Obstetrics Unit Department of Obstetrics and Gynecology, University Hospitals of Geneva and Faculty of Medicine, University of Geneva, Geneva, Switzerland
| | - Joel Fluss
- Pediatric Neurology Unit, University Hospitals of Geneva and Faculty of Medicine, University of Geneva, Geneva, Switzerland
| | - Anne-Laure Rougemont
- Division of Clinical Pathology, Diagnostic Department, Geneva University Hospitals and Faculty of Medicine, University of Geneva, Geneva, Switzerland.
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Mlunde LB, Saalim K, Mbwambo JK, Kiwia P, Fitch E, Manyama W, Rugemalila I, Clay S, Lambdin BH, Stelmach RD, Bann C, Nyblade L. Adapting a health facility HIV stigma-reduction participatory training intervention to address drug use stigma in HIV care and treatment clinics in Dar es Salaam, Tanzania. Harm Reduct J 2024; 21:65. [PMID: 38491349 PMCID: PMC10941424 DOI: 10.1186/s12954-024-00965-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2023] [Accepted: 02/20/2024] [Indexed: 03/18/2024] Open
Abstract
BACKGROUND HIV prevalence among people who use drugs (PWUD) in Tanzania is 4-7 times higher than in the general population, underscoring an urgent need to increase HIV testing and treatment among PWUD. Drug use stigma within HIV clinics is a barrier to HIV treatment for PWUD, yet few interventions to address HIV-clinic drug use stigma exist. Guided by the ADAPT-ITT model, we adapted the participatory training curriculum of the evidence-based Health Policy Plus Total Facility Approach to HIV stigma reduction, to address drug use stigma in HIV care and treatment clinics (CTCs). METHODS The first step in the training curriculum adaptation process was formative research. We conducted 32 in-depth interviews in Dar es Salaam, Tanzania: 18 (11 men and 7 women) with PWUD living with HIV, and 14 with a mix of clinical [7] and non-clinical [7] CTC staff (5 men and 9 women). Data were analyzed through rapid qualitative analysis to inform initial curriculum adaptation. This initial draft curriculum was then further adapted and refined through multiple iterative steps of review, feedback and revision including a 2-day stakeholder workshop and external expert review. RESULTS Four CTC drug use stigma drivers emerged as key to address in the curriculum adaptation: (1) Lack of awareness of the manifestations and consequences of drug use stigma in CTCs (e.g., name calling, ignoring PWUD and denial of care); (2) Negative stereotypes (e.g., all PWUD are thieves, dangerous); (3) Fear of providing services to PWUD, and; (4) Lack of knowledge about drug use as a medical condition and absence of skills to care for PWUD. Five, 2.5-hour participatory training sessions were developed with topics focused on creating awareness of stigma and its consequences, understanding and addressing stereotypes and fears of interacting with PWUD; understanding drug use, addiction, and co-occurring conditions; deepening understanding of drug use stigma and creating empathy, including a panel session with people who had used drugs; and working to create actionable change. CONCLUSION Understanding context specific drivers and manifestations of drug use stigma from the perspective of PWUD and health workers allowed for ready adaptation of an existing evidence-based HIV-stigma reduction intervention to address drug use stigma in HIV care and treatment clinics. Future steps include a pilot test of the adapted intervention.
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Affiliation(s)
- Linda B Mlunde
- Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania.
| | | | - Jessie K Mbwambo
- Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania
- Muhimbili National Hospital, Dar es Salaam, Tanzania
| | - Pfiriael Kiwia
- Kimara Peer Educators and Health Promoters, Dar es Salaam, Tanzania
| | | | | | | | - Sue Clay
- 3C Regional Consultants, Lusaka, Zambia
| | | | | | - Carla Bann
- RTI International, Research Triangle Park, NC, USA
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6
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Zhou X, Thompson LK, Pagano A, Rahman N, Patel S, Gibson D, Ibrahim A, Casanova B, Schwartz RP, Vocci FJ, Clarke DE. Patient Engagement in and Adaptations to Delivery of Outpatient Care for Opioid Use Disorder During the COVID-19 Pandemic. Psychiatr Serv 2024; 75:258-267. [PMID: 37855101 DOI: 10.1176/appi.ps.202100507] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2023]
Abstract
OBJECTIVE The authors investigated adaptations to outpatient care delivery and changes in treatment demand and engagement among patients receiving medications for opioid use disorder (MOUD) in the months after the declaration of the COVID-19 public health emergency in 2020. METHODS Data were collected through an online survey (June-November 2020) of outpatient MOUD prescribers. The survey obtained information on outpatient practices' adaptations to MOUD treatment and urine drug screening (UDS) and elicited provider views on the effects of the COVID-19 pandemic on patient demand for, and engagement in, treatment. Multivariable regression analyses were used to examine associations among practice characteristics, patient engagement, and service adaptations. RESULTS Of 516 respondents, 74% reported adaptations to MOUD delivery during the pandemic. Most respondents implemented virtual visits for initial (67%) and follow-up (77%) contacts. Prescribers of buprenorphine were more likely than those who did not prescribe the medication to report MOUD adaptations. Among respondents reporting any MOUD adaptation, 77% made adaptations to their UDS practices. Among 513 respondents who answered COVID-19-related questions, 89% reported that the pandemic had affected the treatment and engagement of their patients. Of these respondents, 30% reported increased difficulty with patient engagement, and 45% reported that their patients preferred virtual visits during this period, whereas 18% endorsed patient preference for in-person visits. CONCLUSIONS Telehealth and federal regulatory easements in response to the COVID-19 pandemic enabled providers to continue treating patients for opioid use disorder in 2020. The results suggest that care adaptations and changes in patient demand and engagement were common in the practices surveyed.
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Affiliation(s)
- Xinzhe Zhou
- Division of Research, American Psychiatric Association, Washington, D.C. (Zhou, Thompson, Rahman, Patel, Gibson, Casanova, Clarke); Quality and Science Department, American Society of Addiction Medicine, Rockville, Maryland (Pagano); Friends Research Institute, Baltimore (Ibrahim, Schwartz, Vocci); Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore (Clarke)
| | - Laura K Thompson
- Division of Research, American Psychiatric Association, Washington, D.C. (Zhou, Thompson, Rahman, Patel, Gibson, Casanova, Clarke); Quality and Science Department, American Society of Addiction Medicine, Rockville, Maryland (Pagano); Friends Research Institute, Baltimore (Ibrahim, Schwartz, Vocci); Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore (Clarke)
| | - Anna Pagano
- Division of Research, American Psychiatric Association, Washington, D.C. (Zhou, Thompson, Rahman, Patel, Gibson, Casanova, Clarke); Quality and Science Department, American Society of Addiction Medicine, Rockville, Maryland (Pagano); Friends Research Institute, Baltimore (Ibrahim, Schwartz, Vocci); Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore (Clarke)
| | - Nusrat Rahman
- Division of Research, American Psychiatric Association, Washington, D.C. (Zhou, Thompson, Rahman, Patel, Gibson, Casanova, Clarke); Quality and Science Department, American Society of Addiction Medicine, Rockville, Maryland (Pagano); Friends Research Institute, Baltimore (Ibrahim, Schwartz, Vocci); Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore (Clarke)
| | - Sejal Patel
- Division of Research, American Psychiatric Association, Washington, D.C. (Zhou, Thompson, Rahman, Patel, Gibson, Casanova, Clarke); Quality and Science Department, American Society of Addiction Medicine, Rockville, Maryland (Pagano); Friends Research Institute, Baltimore (Ibrahim, Schwartz, Vocci); Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore (Clarke)
| | - Debbie Gibson
- Division of Research, American Psychiatric Association, Washington, D.C. (Zhou, Thompson, Rahman, Patel, Gibson, Casanova, Clarke); Quality and Science Department, American Society of Addiction Medicine, Rockville, Maryland (Pagano); Friends Research Institute, Baltimore (Ibrahim, Schwartz, Vocci); Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore (Clarke)
| | - Adila Ibrahim
- Division of Research, American Psychiatric Association, Washington, D.C. (Zhou, Thompson, Rahman, Patel, Gibson, Casanova, Clarke); Quality and Science Department, American Society of Addiction Medicine, Rockville, Maryland (Pagano); Friends Research Institute, Baltimore (Ibrahim, Schwartz, Vocci); Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore (Clarke)
| | - Barbara Casanova
- Division of Research, American Psychiatric Association, Washington, D.C. (Zhou, Thompson, Rahman, Patel, Gibson, Casanova, Clarke); Quality and Science Department, American Society of Addiction Medicine, Rockville, Maryland (Pagano); Friends Research Institute, Baltimore (Ibrahim, Schwartz, Vocci); Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore (Clarke)
| | - Robert P Schwartz
- Division of Research, American Psychiatric Association, Washington, D.C. (Zhou, Thompson, Rahman, Patel, Gibson, Casanova, Clarke); Quality and Science Department, American Society of Addiction Medicine, Rockville, Maryland (Pagano); Friends Research Institute, Baltimore (Ibrahim, Schwartz, Vocci); Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore (Clarke)
| | - Frank J Vocci
- Division of Research, American Psychiatric Association, Washington, D.C. (Zhou, Thompson, Rahman, Patel, Gibson, Casanova, Clarke); Quality and Science Department, American Society of Addiction Medicine, Rockville, Maryland (Pagano); Friends Research Institute, Baltimore (Ibrahim, Schwartz, Vocci); Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore (Clarke)
| | - Diana E Clarke
- Division of Research, American Psychiatric Association, Washington, D.C. (Zhou, Thompson, Rahman, Patel, Gibson, Casanova, Clarke); Quality and Science Department, American Society of Addiction Medicine, Rockville, Maryland (Pagano); Friends Research Institute, Baltimore (Ibrahim, Schwartz, Vocci); Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore (Clarke)
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Uhm J, Hong S, Han E. The need to monitor emerging issues in etomidate usage: the misuse or abuse potential. Forensic Sci Med Pathol 2024; 20:249-260. [PMID: 36853502 DOI: 10.1007/s12024-023-00596-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/13/2023] [Indexed: 03/01/2023]
Abstract
Since 2011, the misuse or abuse of etomidate has gradually increased when propofol was designated a controlled drug under the Narcotics Control Act in Korea. Accordingly, the Ministry of Food and Drug Safety announced that etomidate would be under the 'Regulation on the designation of drugs that may cause concerns of misuse or abuse' rule in June 2020, which is less stringent than the Narcotics Control Act. Therefore, this review investigates potential misuse or abuse cases of etomidate to consider strengthening its management. A literature search was conducted to compare etomidate with other sedatives in their efficacy and side effects, as well as identify the adverse health outcomes, abuse cases, and analytical methods of etomidate. Etomidate has an equal or higher sedative efficacy and lower risk of adverse cardiopulmonary events than propofol. However, major adverse effects of etomidate include adrenocortical suppression and unproven associated deaths, as well as myoclonus requiring pre-treatment. Although the issue of abuse and misuse of etomidate is emerging in recent years, there are few academic reports on these issues and analytical methods in the forensic field. In order to effectively manage the misuse or abuse of etomidate, it is necessary to continuously monitor related cases with great interest and to be more intensively studied on its abuse potential.
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Affiliation(s)
- Jiyeong Uhm
- College of Pharmacy, Duksung Women's University, Seoul, South Korea
| | - Songhee Hong
- College of Pharmacy, Duksung Women's University, Seoul, South Korea
| | - Eunyoung Han
- College of Pharmacy, Duksung Women's University, Seoul, South Korea.
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Unar A, Sahito OM, Alsawalha L, Afridi HI, Ataya FS, Bashir MS, Fouad D, Talpur FN, Ali N. Determination of Toxic Elements in Cannabinoid and Opioid Drugs and Their Impact on Addicts' Health: A Comparative Study. Biol Trace Elem Res 2024:10.1007/s12011-024-04096-6. [PMID: 38383917 DOI: 10.1007/s12011-024-04096-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/16/2023] [Accepted: 02/05/2024] [Indexed: 02/23/2024]
Abstract
Drug addiction is associated with significant health risks, including cardiovascular complications, cancer, and mental disorders. Illicit drugs, such as cannabinoids and opioids, including prescription medications, are widely consumed and have profound health consequences. Understanding the health effects of the toxic elements in these substances is critical for overdose prevention and effective recovery strategies. This study aimed to determine toxic elements, including arsenic (As), cadmium (Cd), mercury (Hg), and nickel (Ni), in cannabinoid and opioid drugs and in biological samples (whole blood, scalp hair, and serum) from 311 male drug abuse patients aged 15-60 years with a history of drug abuse. The participants were categorized into three age groups. The comparative analysis involved 113 reference subjects of the same age groups. The sample preparation employed microwave-assisted acid digestion, and the toxic elements were quantified using atomic absorption spectrophotometry. Accuracy was ensured using certified reference materials for hair, whole blood, and serum samples. Drug-addicted subjects had significantly higher concentrations of toxic elements (arsenic, cadmium, mercury, and nickel) in biological samples than referent subjects (p > 0.001). Elevated levels of these toxic elements may increase susceptibility to infections, possibly due to malnutrition, drug-related effects, and additional contaminants. These findings necessitate further studies to explore the long-term health outcomes, potential treatment options, and broader socioeconomic impacts of substance abuse. This study serves as a baseline for future research in this critical public health field.
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Affiliation(s)
- Ahsanullah Unar
- Department of Precision Medicine, University of Campania 'L. Vanvitelli', 80138, Naples, Italy.
| | - Oan Muhammad Sahito
- National Centre of Excellence in Analytical Chemistry, University of Sindh, Jamshoro, 76080, Pakistan
| | | | - Hassan Imran Afridi
- National Centre of Excellence in Analytical Chemistry, University of Sindh, Jamshoro, 76080, Pakistan.
| | - Farid Shokry Ataya
- Department of Biochemistry, College of Science, King Saud University, P.O. Box 2455, 11451, Riyadh, Saudi Arabia
| | - Muhammad Sohail Bashir
- Institutes of Physical Science and Information Technology, Key Laboratory of Structure and Functional Regulation of Hybrid Materials of Ministry of Education, Anhui University, Hefei, 230601, China
- CAS Key Laboratory of Soft Matter Chemistry, Department of Polymer Science and Engineering, University of Science and Technology of China, 230026, Hefei, China
| | - Dalia Fouad
- Department of Zoology, College of Science, King Saud University, PO Box 22452, 11495, Riyadh, Saudi Arabia
| | - Farah Naz Talpur
- National Centre of Excellence in Analytical Chemistry, University of Sindh, Jamshoro, 76080, Pakistan
| | - Naveed Ali
- Department of Political Science, University of Campania 'L. Vanvitelli', 81100, Caserta, Italy
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Plank PM, Hinze CA, Abu Isneineh R, Suhling H. ["Crack lung" - atypical bilateral pneumonia]. Inn Med (Heidelb) 2024:10.1007/s00108-024-01668-5. [PMID: 38366210 DOI: 10.1007/s00108-024-01668-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 01/16/2024] [Indexed: 02/18/2024]
Abstract
Inhalation of crack and freebase results in alveolar hemorrhage. In severe courses of the disease, progressive respiratory insufficiency may lead to respiratory failure and acute respiratory distress syndrome (ARDS). Computed tomography of the thorax reveals bilateral consolidation and ground-glass pattern leaving a subpleural gap. This case report of a 48-year-old male patient highlights the importance of a thorough medical history while ruling out infectious causes.
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Affiliation(s)
- Pia Maria Plank
- Klinik für Kardiologie und Angiologie, Medizinische Hochschule Hannover, Carl-Neuberg-Straße 1, 30625, Hannover, Deutschland.
| | | | - René Abu Isneineh
- Klinik für Gastroenterologie, Medizinische Hochschule Hannover, Hannover, Deutschland
| | - Hendrik Suhling
- Klinik für Pneumologie und Infektiologie, Medizinische Hochschule Hannover, Hannover, Deutschland
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McCabe SE, Schulenberg JE, Wilens TE, Schepis TS, Werner KS, McCabe VV, Veliz PT. Attention-Deficit Hyperactivity Disorder Stimulant Therapy and Prescription Drug Misuse During Transition to Young Adulthood. Psychiatr Serv 2024:appips20230418. [PMID: 38321920 DOI: 10.1176/appi.ps.20230418] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/08/2024]
Abstract
OBJECTIVE Limited prospective data exist about the impact of stimulant therapy for attention-deficit hyperactivity disorder (ADHD) during adolescence on the risk for later prescription drug misuse (PDM; i.e., of benzodiazepines, opioids, and stimulants). METHODS National longitudinal multicohort panels (baseline cohort years 2005-2017) of U.S. 12th grade students (N=11,066; ages 17 and 18 years) from the Monitoring the Future study were surveyed via self-administered questionnaires and followed up biennially during young adulthood (ages 19-24). A multivariable analysis was used to assess whether adolescents' lifetime history of stimulant therapy for ADHD was associated with subsequent PDM. RESULTS Overall, 9.9% of adolescents reported lifetime stimulant therapy for ADHD at ages 17 and 18. No significant differences were found in the adjusted odds of later incidence or prevalence of past-year PDM during young adulthood between adolescents with lifetime stimulant therapy and adolescents with no stimulant therapy. Over the 5-year follow-up, past-year PDM during young adulthood was most prevalent among adolescents who reported both stimulant therapy and prescription stimulant misuse (53.1%) and those who reported prescription stimulant misuse only (51.5%). Compared with adolescents in a control group without lifetime stimulant therapy or misuse, adolescents reporting prescription stimulant misuse had significantly higher adjusted odds of later incidence and prevalence of PDM during young adulthood. CONCLUSIONS Adolescents' stimulant therapy for ADHD was not significantly associated with increased risk for later PDM during young adulthood. In contrast, adolescents' misuse of prescription stimulants strongly predicted later PDM. Monitoring adolescents for prescription stimulant misuse may help identify and mitigate the risk for future PDM.
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Affiliation(s)
- Sean Esteban McCabe
- Center for the Study of Drugs, Alcohol, Smoking and Health, School of Nursing (S. E. McCabe, Wilens, Schepis, Werner, V. V. McCabe, Veliz), Institute for Social Research (S. E. McCabe, Schulenberg, Veliz), Department of Psychology (Schulenberg), and Department of Psychiatry (Werner, V. V. McCabe), University of Michigan, Ann Arbor; Department of Psychiatry, Massachusetts General Hospital and Harvard Medical School, Harvard University, Boston (Wilens); Department of Psychology, Texas State University, San Marcos (Schepis)
| | - John E Schulenberg
- Center for the Study of Drugs, Alcohol, Smoking and Health, School of Nursing (S. E. McCabe, Wilens, Schepis, Werner, V. V. McCabe, Veliz), Institute for Social Research (S. E. McCabe, Schulenberg, Veliz), Department of Psychology (Schulenberg), and Department of Psychiatry (Werner, V. V. McCabe), University of Michigan, Ann Arbor; Department of Psychiatry, Massachusetts General Hospital and Harvard Medical School, Harvard University, Boston (Wilens); Department of Psychology, Texas State University, San Marcos (Schepis)
| | - Timothy E Wilens
- Center for the Study of Drugs, Alcohol, Smoking and Health, School of Nursing (S. E. McCabe, Wilens, Schepis, Werner, V. V. McCabe, Veliz), Institute for Social Research (S. E. McCabe, Schulenberg, Veliz), Department of Psychology (Schulenberg), and Department of Psychiatry (Werner, V. V. McCabe), University of Michigan, Ann Arbor; Department of Psychiatry, Massachusetts General Hospital and Harvard Medical School, Harvard University, Boston (Wilens); Department of Psychology, Texas State University, San Marcos (Schepis)
| | - Ty S Schepis
- Center for the Study of Drugs, Alcohol, Smoking and Health, School of Nursing (S. E. McCabe, Wilens, Schepis, Werner, V. V. McCabe, Veliz), Institute for Social Research (S. E. McCabe, Schulenberg, Veliz), Department of Psychology (Schulenberg), and Department of Psychiatry (Werner, V. V. McCabe), University of Michigan, Ann Arbor; Department of Psychiatry, Massachusetts General Hospital and Harvard Medical School, Harvard University, Boston (Wilens); Department of Psychology, Texas State University, San Marcos (Schepis)
| | - Kennedy S Werner
- Center for the Study of Drugs, Alcohol, Smoking and Health, School of Nursing (S. E. McCabe, Wilens, Schepis, Werner, V. V. McCabe, Veliz), Institute for Social Research (S. E. McCabe, Schulenberg, Veliz), Department of Psychology (Schulenberg), and Department of Psychiatry (Werner, V. V. McCabe), University of Michigan, Ann Arbor; Department of Psychiatry, Massachusetts General Hospital and Harvard Medical School, Harvard University, Boston (Wilens); Department of Psychology, Texas State University, San Marcos (Schepis)
| | - Vita V McCabe
- Center for the Study of Drugs, Alcohol, Smoking and Health, School of Nursing (S. E. McCabe, Wilens, Schepis, Werner, V. V. McCabe, Veliz), Institute for Social Research (S. E. McCabe, Schulenberg, Veliz), Department of Psychology (Schulenberg), and Department of Psychiatry (Werner, V. V. McCabe), University of Michigan, Ann Arbor; Department of Psychiatry, Massachusetts General Hospital and Harvard Medical School, Harvard University, Boston (Wilens); Department of Psychology, Texas State University, San Marcos (Schepis)
| | - Philip T Veliz
- Center for the Study of Drugs, Alcohol, Smoking and Health, School of Nursing (S. E. McCabe, Wilens, Schepis, Werner, V. V. McCabe, Veliz), Institute for Social Research (S. E. McCabe, Schulenberg, Veliz), Department of Psychology (Schulenberg), and Department of Psychiatry (Werner, V. V. McCabe), University of Michigan, Ann Arbor; Department of Psychiatry, Massachusetts General Hospital and Harvard Medical School, Harvard University, Boston (Wilens); Department of Psychology, Texas State University, San Marcos (Schepis)
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11
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Tsai J, Kinney RL, Elbogen EB, Gluff J. Systematic Review of Financial Interventions for Adults Experiencing Behavioral Health Conditions. Psychiatr Serv 2024:appips20230271. [PMID: 38321921 DOI: 10.1176/appi.ps.20230271] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/08/2024]
Abstract
OBJECTIVE The authors reviewed the literature on finance-based interventions used to improve clinical and psychosocial outcomes among adults experiencing mental disorders, substance use disorders, or both. METHODS A systematic review of the peer-reviewed literature, published from 1900 to 2022, was conducted. Only studies with participants with a mental disorder or a substance use disorder, a structured finance-based intervention or program, a quantitative dependent variable in a behavioral health outcomes domain, and a defined research design were included. Studies were rated with a quality assessment tool, and overall evidence (levels I-VII) for the outcomes was rated. RESULTS In total, 544 articles were identified, screened for eligibility, and reduced to 55 articles. These articles were rated by two independent raters, and 18 articles were ultimately included. Of these 18 articles, four reported findings of randomized controlled trials (RCTs), one conducted a secondary analysis of an RCT, and the remaining articles were observational studies. The most studied intervention was representative payeeship, which reduced substance use and enhanced money management, showing the strongest evidence for improving outcomes among adults with behavioral health conditions. Weaker evidence suggested that financial education and assistance interventions could improve health care utilization and other psychosocial outcomes among individuals with mental or substance use disorders. CONCLUSIONS Level II-V evidence indicates that finance-based interventions can improve outcomes among adults experiencing behavioral health conditions. Further research is needed to assess the impact of interventions beyond representative payee programs on objectively measured outcomes.
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Affiliation(s)
- Jack Tsai
- National Center on Homelessness Among Veterans, Homeless Programs Office, U.S. Department of Veterans Affairs (VA), Washington, D.C. (Tsai, Kinney, Gluff); School of Public Health, University of Texas Health Science Center at Houston, Houston (Tsai); National Veterans Financial Resource Center, Rocky Mountain Mental Illness Research, Education, and Clinical Center for Suicide Prevention, VA, Denver (Elbogen); Department of Psychiatry, Duke University School of Medicine, Durham, North Carolina (Elbogen)
| | - Rebecca L Kinney
- National Center on Homelessness Among Veterans, Homeless Programs Office, U.S. Department of Veterans Affairs (VA), Washington, D.C. (Tsai, Kinney, Gluff); School of Public Health, University of Texas Health Science Center at Houston, Houston (Tsai); National Veterans Financial Resource Center, Rocky Mountain Mental Illness Research, Education, and Clinical Center for Suicide Prevention, VA, Denver (Elbogen); Department of Psychiatry, Duke University School of Medicine, Durham, North Carolina (Elbogen)
| | - Eric B Elbogen
- National Center on Homelessness Among Veterans, Homeless Programs Office, U.S. Department of Veterans Affairs (VA), Washington, D.C. (Tsai, Kinney, Gluff); School of Public Health, University of Texas Health Science Center at Houston, Houston (Tsai); National Veterans Financial Resource Center, Rocky Mountain Mental Illness Research, Education, and Clinical Center for Suicide Prevention, VA, Denver (Elbogen); Department of Psychiatry, Duke University School of Medicine, Durham, North Carolina (Elbogen)
| | - Jeffrey Gluff
- National Center on Homelessness Among Veterans, Homeless Programs Office, U.S. Department of Veterans Affairs (VA), Washington, D.C. (Tsai, Kinney, Gluff); School of Public Health, University of Texas Health Science Center at Houston, Houston (Tsai); National Veterans Financial Resource Center, Rocky Mountain Mental Illness Research, Education, and Clinical Center for Suicide Prevention, VA, Denver (Elbogen); Department of Psychiatry, Duke University School of Medicine, Durham, North Carolina (Elbogen)
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Shabani M, Jamali Z, Naserian A, Khezri S, Salimi A. Maintenance of mitochondrial function by sinapic acid protects against tramadol-induced toxicity in isolated mitochondria obtained from rat brain. Naunyn Schmiedebergs Arch Pharmacol 2024; 397:889-897. [PMID: 37526689 DOI: 10.1007/s00210-023-02648-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/14/2023] [Accepted: 07/26/2023] [Indexed: 08/02/2023]
Abstract
It is reported that tramadol can induce neurotoxic effects with the production of DNA damage, mitochondrial dysfunction, and oxidative stress. The current study aimed to evaluate the potential role of mitochondrial impairment in the pathogenesis of tramadol-induced neurotoxicity, and protective effect of sinapic acid (SA) against it in isolated mitochondria from rat brain. Mitochondria were isolated and were incubated with toxic concentrations (100 μM) of tramadol and then cotreated with tramadol + SA (10, 50, and 100 μM). Biomarkers of mitochondrial toxicity including succinate dehydrogenases (SDH) activity, reactive oxygen species (ROS), lipid peroxidation (LPO), mitochondrial membrane potential (MMP), GSH depletion, and mitochondrial swelling were assessed. Our results showed a significant decrease in SDH activity, and a significant increase in ROS, LPO, GSH depletion, MMP collapse, and mitochondrial swelling was detected in tramadol group. We observed that 50 and 100 μM SA cotreatment for 1 h efficiently ameliorated tramadol-caused damage in mitochondrial dysfunction, accumulation of ROS, LPO, GSH depletion, depolarization of mitochondrial membrane potential, and mitochondrial swelling. These data suggest that mitochondrial impairment and oxidative stress are mechanisms involved in the pathogenesis of tramadol-induced neurotoxicity. Also, results indicate that SA antagonizes against tramadol-induced mitochondrial toxicity and suggest SA may be a preventive/therapeutic agent for tramadol-induced neurotoxicity complications.
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Affiliation(s)
- Mohammad Shabani
- Traditional Medicine and Hydrotherapy Research Center, Ardabil University of Medical Sciences, Ardabil, Iran
- Department of Pharmacology and Toxicology, School of Pharmacy, Ardabil University of Medical Sciences, Ardabil, Iran
| | - Zhaleh Jamali
- Department of Addiction Studies, School of Medicine, Shahroud University of Medical Sciences, Shahroud, Iran
- Student Research Committee, School of Medicine, Shahroud University of Medical Sciences, Shahroud, Iran
| | - Aida Naserian
- Students Research Committee, Faculty of Pharmacy, Ardabil University of Medical Sciences, Ardabil, Iran
| | - Saleh Khezri
- Traditional Medicine and Hydrotherapy Research Center, Ardabil University of Medical Sciences, Ardabil, Iran
- Department of Pharmacology and Toxicology, School of Pharmacy, Ardabil University of Medical Sciences, Ardabil, Iran
| | - Ahmad Salimi
- Traditional Medicine and Hydrotherapy Research Center, Ardabil University of Medical Sciences, Ardabil, Iran.
- Department of Pharmacology and Toxicology, School of Pharmacy, Ardabil University of Medical Sciences, Ardabil, Iran.
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Taha SA, Westra JR, Tacker DH, Raji MA, Kuo YF. Trends in co-prescribed opioids and benzodiazepines, non-prescribed opioids and benzodiazepines, and schedule-I drugs in the United States, 2013 to 2019. Prev Med Rep 2024; 38:102584. [PMID: 38292029 PMCID: PMC10827545 DOI: 10.1016/j.pmedr.2023.102584] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2022] [Revised: 08/22/2023] [Accepted: 12/27/2023] [Indexed: 02/01/2024] Open
Abstract
Concurrent opioid and benzodiazepine users are at increased risk of overdose death, compared to opioid-only users. The objective of this study was to understand recent time trends in opioid and benzodiazepine concurrent use, misuse, and schedule-I drug use, and how these differ by age, sex and geographic region. Commercial, United States medical insurance claims data and urine drug test results from 2013 to 2019 were used to study the outcomes of concurrent use (n = 756,258), schedule-I drug use (n = 746,672) and prescription misuse (n = 452,523). Drug use outcomes were studied at quarterly time points for each year. Data analysis included joinpoint regression models to estimate quarterly drug use rates, determined by positive urine tests for corresponding drug categories, and was conducted from November 2021 through January 2022. Concurrent use decreased from 19.3% to 9.8%, misuse generally decreased from 75.6% to 55.1%, and schedule-I use increased from 8.9% to 13.8%, from 2013 to 2019. Concurrent use decreased at greater rates after 2016, after the Centers for Disease Control and Food and Drug Administration guidelines against concurrent use were released, while schedule-I use increased, notably after the 2014 hydrocodone reschedule. This indicates a potential shift from prescription use to non-prescribed drug use, where most affected groups included males, younger individuals, and those residing in Northeastern regions. Study results support public health initiatives focused on policy that increases access to multimodal pain management and substance use disorder management programs-critical steps in preventing patients from seeking non-prescribed drugs for self- medicating due to pain or addiction.
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Affiliation(s)
- Shaden A. Taha
- Center for Metabolic Health, University of Texas Medical Branch, Galveston, TX, USA
- Department of Preventive Medicine and Population Health, University of Texas Medical Branch, Galveston, TX, USA
| | - Jordan R. Westra
- Department of Preventive Medicine and Population Health, University of Texas Medical Branch, Galveston, TX, USA
- Office of Biostatistics, University of Texas Medical Branch, Galveston, TX, USA
| | - Danyel H. Tacker
- Department of Pathology, Anatomy, and Laboratory Medicine, West Virginia University, WV, USA
| | - Mukaila A. Raji
- Department of Internal Medicine, University of Texas Medical Branch, Galveston, TX, USA
- Sealy Center on Aging, University of Texas Medical Branch, Galveston, TX, USA
| | - Yong-Fang Kuo
- Department of Preventive Medicine and Population Health, University of Texas Medical Branch, Galveston, TX, USA
- Office of Biostatistics, University of Texas Medical Branch, Galveston, TX, USA
- Department of Internal Medicine, University of Texas Medical Branch, Galveston, TX, USA
- Sealy Center on Aging, University of Texas Medical Branch, Galveston, TX, USA
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14
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Newton H, Miller-Rosales C, Crawford M, Cai A, Brunette M, Meara E. Availability of Medication for Opioid Use Disorder Among Accountable Care Organizations: Evidence From a National Survey. Psychiatr Serv 2024; 75:182-185. [PMID: 37614155 PMCID: PMC10895446 DOI: 10.1176/appi.ps.20230087] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 08/25/2023]
Abstract
OBJECTIVE This report aimed to assess how accountable care organizations (ACOs) addressed ongoing opioid use disorder treatment needs over time. METHODS Responses from the 2018 (N=308 organizations) and 2022 (N=276) National Survey of Accountable Care Organizations (response rate=55% in both years) were used to examine changes in availability of medication for opioid use disorder (MOUD) among ACOs with Medicare and Medicaid contracts. RESULTS The percentage of respondents offering at least one MOUD grew from 39% in 2018 to 52% in 2022 (p<0.01). MOUDs were more likely to be available in 2022 among ACOs with (vs. without) in-network substance use treatment facilities (80% vs. 33%, p<0.001). The percentage of 2022 respondents who reported offering MOUD was similar in states with high versus low opioid overdose mortality rates. CONCLUSIONS Despite growing availability of MOUD among ACOs, nearly half reported not offering any MOUD in 2022, and the availability of MOUD did not increase with treatment need.
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Affiliation(s)
- Helen Newton
- Department of Family Medicine, University of North Carolina School of Medicine, Chapel Hill (Newton); Department of Health Care Policy, Harvard Medical School, Boston (Miller-Rosales); Dartmouth Institute for Health Policy & Clinical Practice, Dartmouth Geisel School of Medicine, Lebanon, New Hampshire (Crawford); Department of Health Policy and Management, Harvard T. H. Chan School of Public Health, Boston (Cai, Meara); Department of Psychiatry, Dartmouth Geisel School of Medicine, Hanover, New Hampshire (Brunette)
| | - Chris Miller-Rosales
- Department of Family Medicine, University of North Carolina School of Medicine, Chapel Hill (Newton); Department of Health Care Policy, Harvard Medical School, Boston (Miller-Rosales); Dartmouth Institute for Health Policy & Clinical Practice, Dartmouth Geisel School of Medicine, Lebanon, New Hampshire (Crawford); Department of Health Policy and Management, Harvard T. H. Chan School of Public Health, Boston (Cai, Meara); Department of Psychiatry, Dartmouth Geisel School of Medicine, Hanover, New Hampshire (Brunette)
| | - Maia Crawford
- Department of Family Medicine, University of North Carolina School of Medicine, Chapel Hill (Newton); Department of Health Care Policy, Harvard Medical School, Boston (Miller-Rosales); Dartmouth Institute for Health Policy & Clinical Practice, Dartmouth Geisel School of Medicine, Lebanon, New Hampshire (Crawford); Department of Health Policy and Management, Harvard T. H. Chan School of Public Health, Boston (Cai, Meara); Department of Psychiatry, Dartmouth Geisel School of Medicine, Hanover, New Hampshire (Brunette)
| | - Arno Cai
- Department of Family Medicine, University of North Carolina School of Medicine, Chapel Hill (Newton); Department of Health Care Policy, Harvard Medical School, Boston (Miller-Rosales); Dartmouth Institute for Health Policy & Clinical Practice, Dartmouth Geisel School of Medicine, Lebanon, New Hampshire (Crawford); Department of Health Policy and Management, Harvard T. H. Chan School of Public Health, Boston (Cai, Meara); Department of Psychiatry, Dartmouth Geisel School of Medicine, Hanover, New Hampshire (Brunette)
| | - Mary Brunette
- Department of Family Medicine, University of North Carolina School of Medicine, Chapel Hill (Newton); Department of Health Care Policy, Harvard Medical School, Boston (Miller-Rosales); Dartmouth Institute for Health Policy & Clinical Practice, Dartmouth Geisel School of Medicine, Lebanon, New Hampshire (Crawford); Department of Health Policy and Management, Harvard T. H. Chan School of Public Health, Boston (Cai, Meara); Department of Psychiatry, Dartmouth Geisel School of Medicine, Hanover, New Hampshire (Brunette)
| | - Ellen Meara
- Department of Family Medicine, University of North Carolina School of Medicine, Chapel Hill (Newton); Department of Health Care Policy, Harvard Medical School, Boston (Miller-Rosales); Dartmouth Institute for Health Policy & Clinical Practice, Dartmouth Geisel School of Medicine, Lebanon, New Hampshire (Crawford); Department of Health Policy and Management, Harvard T. H. Chan School of Public Health, Boston (Cai, Meara); Department of Psychiatry, Dartmouth Geisel School of Medicine, Hanover, New Hampshire (Brunette)
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15
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Khiyali Z, Rashedi V, Tavacol Z, Dehghan A, Bijani M. Smoking, alcohol consumption, drug abuse, and osteoporosis among older adults: a cross-sectional study on PERSIAN cohort study in Fasa. BMC Geriatr 2024; 24:80. [PMID: 38254032 PMCID: PMC10802063 DOI: 10.1186/s12877-024-04678-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2023] [Accepted: 01/05/2024] [Indexed: 01/24/2024] Open
Abstract
BACKGROUND With increasing life expectancy and a growing population of older adults, the prevalence of osteoporosis has risen, resulting in a higher incidence of bone fractures, which necessitate extended treatment and specialized medical care. This study investigates the relationship between smoking, alcohol consumption, drug abuse, and osteoporosis among older adults in southern Iran, utilizing cohort data. METHODS This cross-sectional study is derived from the Fasa Adult Cohort Study (FACS), which included 10,133 individuals. From this cohort, we selected 1,631 older adults using census sampling methods. Our study aimed to explore the correlation between smoking, alcohol consumption, and drug abuse among older adults and the incidence of osteoporosis. We collected demographic information, nutritional indexes, medical history, glucocorticoid usage, and self-reported data on smoking, alcohol consumption, drug abuse, and osteoporosis through questionnaires. To investigate the relationship between smoking, alcohol, and drug use with osteoporosis while accounting for confounding factors, we employed logistic regression analysis. RESULTS The average age of the study participants was 64.09 ± 3.8 years, with a majority (898 (55.1%)) being female. Osteoporosis prevalence among the subjects was 25.20%. The results did not reveal a significant correlation between smoking, alcohol consumption, drug abuse, and osteoporosis (p > 0.05). Regression analysis identified gender, recent history of fractures within the past five years, history of using glucocorticoids, and physical activity as significant predictive risk factors for osteoporosis within the study population (p < 0.05). CONCLUSION The study underscores the significance of addressing osteoporosis risk factors in older adults. Healthcare policymakers and administrators can use these findings to identify and mitigate influential factors contributing to osteoporosis in this demographic.
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Affiliation(s)
- Zahra Khiyali
- Iranian Research Center on Aging, Department of Aging, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | - Vahid Rashedi
- Iranian Research Center on Aging, Department of Aging, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | - Ziba Tavacol
- Department of Medical-Surgical Nursing, School of Nursing, Fasa University of Medical Sciences, Fasa, Iran
| | - Azizallah Dehghan
- Noncommunicable Diseases Research Center (NCDRC), Fasa University of Medical Sciences, Fasa, Iran
| | - Mostafa Bijani
- Department of Medical-Surgical Nursing, School of Nursing, Fasa University of Medical Sciences, Fasa, Iran.
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Gonçalves PFR, Nunes LED, Andrade BDS, Silva MOLD, Souza INDO, Assunção-Miranda I, Castro NG, Neves GA. Age-dependent memory impairment induced by co-exposure to nicotine and a synthetic cannabinoid in mice. Prog Neuropsychopharmacol Biol Psychiatry 2023; 127:110821. [PMID: 37442332 DOI: 10.1016/j.pnpbp.2023.110821] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/23/2023] [Revised: 06/24/2023] [Accepted: 07/06/2023] [Indexed: 07/15/2023]
Abstract
Co-use of marijuana and tobacco products is the second most common drug combination among adolescents. Nicotine (NIC) and cannabinoid use during adolescence induce similar detrimental changes, raising the hypothesis that simultaneous exposure could result in even more severe outcomes. Thus, we investigated whether the co-exposure to NIC and the synthetic cannabinoid WIN 55,212-2 (WIN) in adolescent mice causes behavioral outcomes different from those observed after exposure to a single drug. Male Swiss mice were exposed twice daily to NIC, WIN, or NIC + WIN during adolescence (PND28-47) or adulthood (PND70-89). Drug combination led to a greater reduction in weight gain in adolescent mice, while NIC-induced weight loss was observed in adults. During administration, NIC provoked hypothermia, and WIN produced hyperlocomotion in adolescent and adult mice. Animals exposed to NIC + WIN presented a profile of changes similar to those exposed to NIC. After drug exposure, changes in locomotion, thigmotaxis, social preference, prepulse inhibition, and working and recognition memory were evaluated. Adolescent but not adult mice exposed to NIC showed withdrawal-related hyperlocomotion unaffected by WIN co-administration. An age-specific impairment in object recognition memory was induced only by drug co-exposure during adolescence, which resolved spontaneously before reaching early adulthood. A transient decrease in hippocampal α7 nAChR subunit and CB1 receptor mRNA levels was induced by NIC exposure, which may be involved but is not enough to explain the memory impairment. Our work confirms the potential of NIC and cannabinoids association to aggravate some of the individual drug effects during critical neurodevelopmental periods.
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Affiliation(s)
- Patricia Felix Rolo Gonçalves
- Laboratório de Farmacologia Molecular, Instituto de Ciências Biomédicas, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
| | - Luis Eduardo Duarte Nunes
- Laboratório de Farmacologia Molecular, Instituto de Ciências Biomédicas, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
| | - Brenda da Silva Andrade
- Laboratório de Farmacologia Molecular, Instituto de Ciências Biomédicas, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
| | | | - Isis Nem de Oliveira Souza
- Laboratório de Farmacologia Molecular, Instituto de Ciências Biomédicas, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
| | - Iranaia Assunção-Miranda
- Instituto de Microbiologia Paulo de Goes, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
| | - Newton Gonçalves Castro
- Laboratório de Farmacologia Molecular, Instituto de Ciências Biomédicas, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
| | - Gilda Angela Neves
- Laboratório de Farmacologia Molecular, Instituto de Ciências Biomédicas, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil.
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Lee K, Lam SKK, Hung SL, Fung HW. Substance abuse among mothers in Taiwan: Investigating its prevalence and testing the trauma model. Asian J Psychiatr 2023; 90:103805. [PMID: 37924745 DOI: 10.1016/j.ajp.2023.103805] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/27/2023] [Revised: 10/10/2023] [Accepted: 10/16/2023] [Indexed: 11/06/2023]
Abstract
Substance abuse is a serious problem in our society. In particular, household or parental substance abuse could lead to adverse childhood experiences for the affected children. However, little is known about the prevalence of substance abuse among parents, especially in Asian societies. Moreover, although the trauma model of addiction has significant implications for the prevention and treatment of substance abuse, most evidence comes from Western samples. To address these knowledge gaps, we examined the prevalence of substance abuse in a sample of mothers in Taiwan and tested the trauma model of substance abuse. A total of 867 Taiwanese mothers completed standardized self-report assessments in 2023. The screening results indicated that the 12-month prevalence of drug abuse and alcohol abuse was 12.3% and 7.3%, respectively; 15.5% had either or both drug and alcohol abuse. Most types of trauma exposure were associated with drug abuse severity, while interpersonal stress and dissociative symptoms were associated with alcohol abuse severity, even after controlling for a variety of demographic and health variables as well as general psychopathology (i.e., depressive symptoms). The relatively high prevalence of substance abuse among Taiwanese mothers in our sample is concerning, particularly when compared to the rates reported in other Asian samples. We also provide preliminary cross-cultural evidence supporting the self-medication theory and the trauma model of substance abuse in the Asian context. We discuss the potential importance of addressing trauma and stress to prevent substance abuse and call for follow-up studies.
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Affiliation(s)
- Kunhua Lee
- Department of Educational Psychology and Counseling, National Tsing Hua University, Hsinchu City, Taiwan.
| | - Stanley Kam Ki Lam
- Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, Hong Kong.
| | - Suet Lin Hung
- Department of Social Work, Hong Kong Baptist University, Hong Kong.
| | - Hong Wang Fung
- Department of Social Work, Hong Kong Baptist University, Hong Kong.
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Poruban T, Hunavy M, Farkas D, Carnoky S, Jakubova M. A rare Serratia marcescens-associated acute endocarditis of a tricuspid valve in an intravenous drug user : A case report and literature review. Wien Klin Wochenschr 2023; 135:631-636. [PMID: 37256420 DOI: 10.1007/s00508-023-02217-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2023] [Accepted: 04/20/2023] [Indexed: 06/01/2023]
Abstract
Serratia marcescens is a gram-negative bacillus that is an opportunistic agent in respiratory tract infections, urinary tract infections, and septicemia. It is rarely also a cause of infective endocarditis which follows a rapid and devastating course, typically in persons with history of intravenous drug use (IDU). This article reports a fatal case of a 27-year-old patient with a known history of IDU, who presented with clinical symptoms concerning right-sided endocarditis as well as signs of acute respiratory distress syndrome. Finally, a detailed review of the literature is provided concerning the acute endocarditis of a tricuspid valve, especially associated with Serratia marcescens infection.
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Affiliation(s)
- Tibor Poruban
- 1st Cardiological Clinic, East Slovak Institute of Cardiovascular Diseases, Pavol Jozef Safarik University, Ondavska 8, 040 11, Kosice, Slovakia.
| | - Mikulas Hunavy
- 1st Cardiological Clinic, East Slovak Institute of Cardiovascular Diseases, Pavol Jozef Safarik University, Ondavska 8, 040 11, Kosice, Slovakia
| | | | - Stanislav Carnoky
- 1st Cardiological Clinic, East Slovak Institute of Cardiovascular Diseases, Pavol Jozef Safarik University, Ondavska 8, 040 11, Kosice, Slovakia
| | - Marta Jakubova
- 1st Cardiological Clinic, East Slovak Institute of Cardiovascular Diseases, Pavol Jozef Safarik University, Ondavska 8, 040 11, Kosice, Slovakia
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19
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Chang SH, Pai PY, Hsu CH, Marthandam Asokan S, Tsai BCK, Weng WT, Kuo WW, Shih TC, Kao HC, Chen WST, Huang CY. Estimating the impact of drug addiction causes heart damage. Drug Chem Toxicol 2023; 46:1044-1050. [PMID: 36216784 DOI: 10.1080/01480545.2022.2122984] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2022] [Revised: 07/26/2022] [Accepted: 09/01/2022] [Indexed: 11/03/2022]
Abstract
To date, few studies have investigated the toxicological effects of the combined use of amphetamine and heroin in the heart. Hence, the aim of this study was to identify indicators for clinical evaluation and prevention of cardiac injury induced by the combined use of amphetamine and heroin. Four different groups were analyzed: (1) normal group (n=25;average age=35 ± 6.8); (2) heart disease group (n=25;average age=58 ± 17.2); (3) drug abusers (n = 27; average age = 37 ± 7.7); (4) drug abstainers (previous amphetamine-heroin users who had been drug-free for more than two weeks; n = 22; average age = 35 ± 5.6). The activity of MMPs, and levels of TNF-α, IL-6, GH, IGF-I, and several serum biomarkers were examined to evaluate the impact of drug abuse on the heart. The selected plasma biomarkers and classic cardiac biomarkers were significantly increased compared to the normal group. The zymography data showed the changes in cardiac-remodeling enzymes MMP-9 and MMP-2 among combined users of amphetamine and heroin. The levels of TNF-α and IL-6 only increased in the heart disease group. Growth hormone was increased; however, IGF-I level decreased with drug abuse and the level was not restored by abstinence. We speculated that the amphetamine-heroin users might pose risk to initiate heart disease even though the users abstained for more than two weeks. The activity change of MMP-9 and MMP-2 can be a direct reason affecting heart function. The indirect reason may be related to liver damage by drug abuse reduce IGF-1 production to protect heart function.
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Affiliation(s)
- Sheng-Huang Chang
- Department of Health, Executive Yuan, Tsao-Tun Psychiatric Center, Nantou, Taiwan
| | - Pei-Ying Pai
- Division of Cardiology, China Medical University Hospital, Taichung, Taiwan
| | - Chiung-Hung Hsu
- Cardiovascular and Mitochondrial Related Disease Research Center, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Hualien, Taiwan
| | - Shibu Marthandam Asokan
- Cardiovascular and Mitochondrial Related Disease Research Center, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Hualien, Taiwan
- Department of Biotechnology, Bharathiar University, Coimbatore, Tamil Nadu, India
| | - Bruce Chi-Kang Tsai
- Cardiovascular and Mitochondrial Related Disease Research Center, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Hualien, Taiwan
| | - Wen-Tsan Weng
- Cardiovascular and Mitochondrial Related Disease Research Center, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Hualien, Taiwan
| | - Wei-Wen Kuo
- Department of Biological Science and Technology, China Medical University, Taichung, Taiwan
- Ph.D. Program for Biotechnology Industry, China Medical University, Taichung, Taiwan
| | - Tzu-Ching Shih
- Department of Biomedical Imaging and Radiological Science College of Medicine, China Medical University, Taichung, Taiwan
| | - Hui-Chuan Kao
- Department of Public Health, Tzu Chi University, Hualien, Taiwan
| | - William Shao-Tsu Chen
- Department of Psychiatry, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Hualien, Taiwan
- Department of Human Development and Psychology, Tzu Chi University, Buddhist Tzu Chi Medical Foundation, Hualien, Taiwan
| | - Chih-Yang Huang
- Cardiovascular and Mitochondrial Related Disease Research Center, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Hualien, Taiwan
- Graduate Institute of Biomedical Sciences, China Medical University, Taichung, Taiwan
- Department of Medical Laboratory Science and Biotechnology, Asia University, Taichung, Taiwan
- Center of General Education, Tzu Chi University of Science and Technology, Hualien, Taiwan
- Department of Medical Research, China Medical University Hospital, China Medical University, Taichung, Taiwan
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20
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McCabe SE, Schulenberg JE, Wilens TE, Schepis TS, McCabe VV, Veliz P. Transitions in Prescription Benzodiazepine Use and Misuse and in Substance Use Disorder Symptoms Through Age 50. Psychiatr Serv 2023; 74:1154-1162. [PMID: 37143335 PMCID: PMC10867819 DOI: 10.1176/appi.ps.20220247] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/06/2023]
Abstract
OBJECTIVE Prescription benzodiazepines are among the most commonly used and misused controlled medications. The authors aimed to examine transitions from medical use of prescription benzodiazepines to prescription benzodiazepine misuse, prescription opioid misuse, and substance use disorder symptoms during adulthood. METHODS Eleven national cohorts of U.S. 12th graders (N=26,575) were followed up from ages 18 (1976-1986) to 50 (2008-2018). Prescription benzodiazepine misuse, prescription opioid misuse, and substance use disorder symptoms were examined with prevalence estimates and multivariable logistic regression. RESULTS By age 35, 70.9% of respondents had not used or misused prescription benzodiazepines, 11.3% reported medical use only, 9.8% indicated both medical use and misuse, and 14.1% reported misuse only. In analyses adjusted for demographic and other characteristics, adults reporting only medical use of prescription benzodiazepines by age 35 had higher odds of later prescription benzodiazepine misuse (adjusted OR [AOR]=2.17, 95% CI=1.72-2.75) and prescription opioid misuse (AOR=1.40, 95% CI=1.05-1.86) than respondents ages 35-50 who never used prescription benzodiazepines. More frequent medical use of prescription benzodiazepines by age 35 was associated with increased risk for substance use disorder symptoms at ages 40-50. Any history of prescription benzodiazepine misuse by age 35 was associated with higher odds of later prescription benzodiazepine misuse, prescription opioid misuse, and substance use disorder symptoms, compared with no misuse. CONCLUSIONS Prescription benzodiazepine use or misuse may signal later prescription drug misuse or substance use disorders. Medical use of prescription benzodiazepines by age 35 requires monitoring for prescription drug misuse, and any prescription benzodiazepine misuse warrants an assessment for substance use disorder.
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Affiliation(s)
- Sean Esteban McCabe
- Center for the Study of Drugs, Alcohol, Smoking and Health, University of Michigan School of Nursing, Ann Arbor (all authors); Institute for Social Research (S. E. McCabe, Schulenberg, Veliz) and Department of Psychiatry (V. V. McCabe), University of Michigan, Ann Arbor; Department of Psychiatry, Massachusetts General Hospital, Boston (Wilens); Department of Psychology, Texas State University, San Marcos (Schepis)
| | - John E Schulenberg
- Center for the Study of Drugs, Alcohol, Smoking and Health, University of Michigan School of Nursing, Ann Arbor (all authors); Institute for Social Research (S. E. McCabe, Schulenberg, Veliz) and Department of Psychiatry (V. V. McCabe), University of Michigan, Ann Arbor; Department of Psychiatry, Massachusetts General Hospital, Boston (Wilens); Department of Psychology, Texas State University, San Marcos (Schepis)
| | - Timothy E Wilens
- Center for the Study of Drugs, Alcohol, Smoking and Health, University of Michigan School of Nursing, Ann Arbor (all authors); Institute for Social Research (S. E. McCabe, Schulenberg, Veliz) and Department of Psychiatry (V. V. McCabe), University of Michigan, Ann Arbor; Department of Psychiatry, Massachusetts General Hospital, Boston (Wilens); Department of Psychology, Texas State University, San Marcos (Schepis)
| | - Ty S Schepis
- Center for the Study of Drugs, Alcohol, Smoking and Health, University of Michigan School of Nursing, Ann Arbor (all authors); Institute for Social Research (S. E. McCabe, Schulenberg, Veliz) and Department of Psychiatry (V. V. McCabe), University of Michigan, Ann Arbor; Department of Psychiatry, Massachusetts General Hospital, Boston (Wilens); Department of Psychology, Texas State University, San Marcos (Schepis)
| | - Vita V McCabe
- Center for the Study of Drugs, Alcohol, Smoking and Health, University of Michigan School of Nursing, Ann Arbor (all authors); Institute for Social Research (S. E. McCabe, Schulenberg, Veliz) and Department of Psychiatry (V. V. McCabe), University of Michigan, Ann Arbor; Department of Psychiatry, Massachusetts General Hospital, Boston (Wilens); Department of Psychology, Texas State University, San Marcos (Schepis)
| | - Philip Veliz
- Center for the Study of Drugs, Alcohol, Smoking and Health, University of Michigan School of Nursing, Ann Arbor (all authors); Institute for Social Research (S. E. McCabe, Schulenberg, Veliz) and Department of Psychiatry (V. V. McCabe), University of Michigan, Ann Arbor; Department of Psychiatry, Massachusetts General Hospital, Boston (Wilens); Department of Psychology, Texas State University, San Marcos (Schepis)
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21
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Falgas-Bague I, Zhen-Duan J, Ferreira C, Tahanasab SA, Cuervo-Torello F, Fukuda M, Markle SL, Alegría M. Uncovering Barriers to Engagement in Substance Use Disorder Care for Medicaid Enrollees. Psychiatr Serv 2023; 74:1116-1122. [PMID: 37070259 DOI: 10.1176/appi.ps.20220193] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/19/2023]
Abstract
OBJECTIVE The authors aimed to uncover factors that affect engagement in substance use disorder treatment among Medicaid beneficiaries in New York State. METHODS The authors conducted 40 semistructured interviews with clients, plan administrators, health care providers, and policy leaders directly involved with substance use care in New York State. Data were analyzed with thematic analysis. RESULTS Main themes resulting from analysis of the 40 interviews showed that most stakeholders agreed that a need exists to better integrate psychosocial services into behavioral health care systems; that systemic stigma, stigma from providers, and lack of cultural responsiveness in the substance use care system hinder engagement in and provision of high-quality care; and that rural health care networks with coordinated models benefit clients' engagement in care. CONCLUSIONS Stakeholders involved in care for substance use disorder perceived a lack of integration of resources to meet clients' social needs, the presence of stigma, and low levels of cultural and linguistic capacity as key factors contributing to low engagement in and low quality of care for substance use disorder. Future interventions should address social needs within the therapeutic regimen and modify curricula in clinical training to reduce stigma and increase cultural competence.
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Affiliation(s)
- Irene Falgas-Bague
- Disparities Research Unit, Massachusetts General Hospital, Boston (all authors); Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Basel, Switzerland (Falgas-Bague); Department of Psychiatry, Harvard Medical School, Boston (Zhen-Duan, Alegría)
| | - Jenny Zhen-Duan
- Disparities Research Unit, Massachusetts General Hospital, Boston (all authors); Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Basel, Switzerland (Falgas-Bague); Department of Psychiatry, Harvard Medical School, Boston (Zhen-Duan, Alegría)
| | - Caroline Ferreira
- Disparities Research Unit, Massachusetts General Hospital, Boston (all authors); Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Basel, Switzerland (Falgas-Bague); Department of Psychiatry, Harvard Medical School, Boston (Zhen-Duan, Alegría)
| | - Sara A Tahanasab
- Disparities Research Unit, Massachusetts General Hospital, Boston (all authors); Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Basel, Switzerland (Falgas-Bague); Department of Psychiatry, Harvard Medical School, Boston (Zhen-Duan, Alegría)
| | - Fernando Cuervo-Torello
- Disparities Research Unit, Massachusetts General Hospital, Boston (all authors); Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Basel, Switzerland (Falgas-Bague); Department of Psychiatry, Harvard Medical School, Boston (Zhen-Duan, Alegría)
| | - Marie Fukuda
- Disparities Research Unit, Massachusetts General Hospital, Boston (all authors); Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Basel, Switzerland (Falgas-Bague); Department of Psychiatry, Harvard Medical School, Boston (Zhen-Duan, Alegría)
| | - Sheri L Markle
- Disparities Research Unit, Massachusetts General Hospital, Boston (all authors); Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Basel, Switzerland (Falgas-Bague); Department of Psychiatry, Harvard Medical School, Boston (Zhen-Duan, Alegría)
| | - Margarita Alegría
- Disparities Research Unit, Massachusetts General Hospital, Boston (all authors); Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Basel, Switzerland (Falgas-Bague); Department of Psychiatry, Harvard Medical School, Boston (Zhen-Duan, Alegría)
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22
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Arslan Z, Kartufan FF, Kuloglu Genc M, Battal D, Yayla M, Turkmen Z. An analytical approach to determining pethidine: An investigation of 18 patients' urine. J Pharm Biomed Anal 2023; 235:115670. [PMID: 37647794 DOI: 10.1016/j.jpba.2023.115670] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2023] [Revised: 07/12/2023] [Accepted: 08/17/2023] [Indexed: 09/01/2023]
Abstract
Pethidine (PET) is an opioid pain-relief medicine with high addiction potential, especially among health professionals. Pethidine is commonly prescribed in Turkey as a pain-relieving medication for operative purposes. Due to its accessibility, low cost, user-friendliness, and effectiveness, PET is often misused by both healthcare professionals and patients. For this reason, analytical determination methods for PET abuse are essential in terms of forensic toxicology. In this study, a fast, reliable, and accurate gas chromatography-mass spectrometry method was developed for the first time in Turkey for the simultaneous detection of PET and its main urinary metabolite norpethidine (NPET). The method was validated in terms of selectivity, linearity, the limit of detection (LOD), the limit of quantification (LOQ), trueness, and precision according to the Scientific Working Group for Forensic Toxicology guidelines. The linear range was between 0.125-25.00 μg/mL for PET and 1.00-20.00 μg/mL for NPET. The LOD values for PET and NPET were 0.05 µg/mL and 0.49 µg/mL, while the LOQ values were 0.125 µg/mL and 1.00 µg/mL, respectively. Extraction efficiencies were calculated as 113% for PET and 104% for NPET. The intra-assay and inter-assay precision results were within acceptable limits. In the presented study, the validated method was applied to the urine of 18 patients collected at the 1st and 3rd hours after receiving PET. All samples in the study were collected under patients' consent and in line with ethical guidelines.
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Affiliation(s)
- Zeynep Arslan
- Istanbul University-Cerrahpaşa, The Institute of Forensic Sciences and Legal Medicine, Department of Science, Istanbul, Turkey
| | | | - Merve Kuloglu Genc
- Istanbul University-Cerrahpaşa, The Institute of Forensic Sciences and Legal Medicine, Department of Science, Istanbul, Turkey
| | - Dilek Battal
- Mersin University, Department of Toxicology, Faculty of Pharmacy, Mersin, Turkey
| | - Murat Yayla
- Istanbul University-Cerrahpaşa, The Institute of Forensic Sciences and Legal Medicine, Department of Science, Istanbul, Turkey
| | - Zeynep Turkmen
- Istanbul University-Cerrahpaşa, The Institute of Forensic Sciences and Legal Medicine, Department of Science, Istanbul, Turkey.
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23
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Chauhan V, Sharma M. Development and validation of presumptive spot test for the identification of z-drugs used in drug-facilitated crimes. Forensic Sci Med Pathol 2023:10.1007/s12024-023-00739-7. [PMID: 37878164 DOI: 10.1007/s12024-023-00739-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/16/2023] [Indexed: 10/26/2023]
Abstract
The significance and desire for preliminary testing approaches that are straightforward, quick, selective, affordable, and practical for use in the field are highlighted by the increasing enormous amounts of potentially illegal samples being seized worldwide. The "z-drugs," which include zolpidem, zopiclone, and eszopiclone, are non-benzodiazepine medications used to treat insomnia. z-drugs are short-term solutions for sleeplessness and anxiety but have a long history of abuse and misuse. The extensive list is primarily utilized for drug-facilitated crimes and drug dependence. The presumptive color spot test for z-drugs, such as zolpidem, zopiclone, and eszopiclone, has been created and validated in this study. In the preliminary identification of zolpidem, zopiclone, and eszopiclone, no color spot test has been documented as per the literature. The color spot test is the most essential and routinely used technique for identifying any unknown sample substance. The color test method was proven to provide high-quality, dependable presumptive test findings and satisfy standards for preliminary screening usage. Validation experiments demonstrate that, at room temperature, the color change is specific to the zolpidem, zopiclone, and eszopiclone classes and unaffected by the common cutting agent's presence. It was discovered that 5, 10, and 6 ppm were the operational limit of detection of the sample present against the reagents 0.1% diphenyl carbazone, aqueous potassium iodoplatinate, and modified cobalt thiocyanate reagent, respectively. The color test is immediate and validated with other substances of a similar category and 10 ppm was the operational limit of detection.
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Affiliation(s)
- Varsha Chauhan
- National Forensic Science University, Delhi Campus, Ministry of Home Affairs, Sec-3, Rohini, Delhi, 110085, India
| | - Manu Sharma
- National Forensic Science University, Delhi Campus, Ministry of Home Affairs, Sec-3, Rohini, Delhi, 110085, India.
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24
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Rezayof A, Ghasemzadeh Z, Sahafi OH. Addictive drugs modify neurogenesis, synaptogenesis and synaptic plasticity to impair memory formation through neurotransmitter imbalances and signaling dysfunction. Neurochem Int 2023; 169:105572. [PMID: 37423274 DOI: 10.1016/j.neuint.2023.105572] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2023] [Revised: 07/01/2023] [Accepted: 07/05/2023] [Indexed: 07/11/2023]
Abstract
Drug abuse changes neurophysiological functions at multiple cellular and molecular levels in the addicted brain. Well-supported scientific evidence suggests that drugs negatively affect memory formation, decision-making and inhibition, and emotional and cognitive behaviors. The mesocorticolimbic brain regions are involved in reward-related learning and habitual drug-seeking/taking behaviors to develop physiological and psychological dependence on the drugs. This review highlights the importance of specific drug-induced chemical imbalances resulting in memory impairment through various neurotransmitter receptor-mediated signaling pathways. The mesocorticolimbic modifications in the expression levels of brain-derived neurotrophic factor (BDNF) and the cAMP-response element binding protein (CREB) impair reward-related memory formation following drug abuse. The contributions of protein kinases and microRNAs (miRNAs), along with the transcriptional and epigenetic regulation have also been considered in memory impairment underlying drug addiction. Overall, we integrate the research on various types of drug-induced memory impairment in distinguished brain regions and provide a comprehensive review with clinical implications addressing the upcoming studies.
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Affiliation(s)
- Ameneh Rezayof
- Department of Animal Biology, School of Biology, College of Science, University of Tehran, Tehran, Iran.
| | - Zahra Ghasemzadeh
- Department of Animal Biology, School of Biology, College of Science, University of Tehran, Tehran, Iran
| | - Oveis Hosseinzadeh Sahafi
- Department of Neurophysiology, Graduate School of Medicine, The University of Tokyo, Tokyo, 113-0033, Japan
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25
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Gancarz AM, Hagarty DP, Cobb MM, Kausch MA, Krieg B, Alammari N, Gilbert K, Russo J, Dietz DM. Operant novelty seeking predicts cue-induced reinstatement following cocaine but not water reinforcement in male rats. Psychopharmacology (Berl) 2023; 240:2201-2215. [PMID: 37552291 PMCID: PMC10506955 DOI: 10.1007/s00213-023-06441-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/11/2023] [Accepted: 07/25/2023] [Indexed: 08/09/2023]
Abstract
RATIONALE An important facet of cocaine addiction is a high propensity to relapse, with increasing research investigating factors that predispose individuals toward uncontrolled drug use and relapse. A personality trait linked to drug addiction is high sensation seeking, i.e., a preference for novel sensations/experiences. In an animal model of sensation seeking, operant novelty seeking predicts the acquisition of drug self-administration. OBJECTIVE The primary goal of this research was to evaluate the hypothesis that sensitivity to the reinforcing effects of novel sensory stimuli predicts more intensive aspects of drug-taking behaviors, such as relapse. METHODS Rats were first tested for Operant Novelty Seeking, during which responses resulted in complex visual/auditory stimuli. Next, rats were trained to respond to water/cocaine reinforcers signaled by a cue light. Finally, rats were exposed to extinction in the absence of discrete cues and subsequently tested in a single session of cue-induced reinstatement, during which active responses resulted in cues previously paired with water/cocaine delivery. RESULTS The present study showed operant responses to produce novel sensory stimuli positively correlate with responding for cocaine during self-administration and during discrete cue-induced reinstatement, but no association with performance during extinction. A different pattern of associations was observed for a natural reward, in this case, water reinforcement. Here, the degree of novelty seeking also correlated with responding to water reinforcement and extinction responding; however, operant novelty seeking did not correlate with responding to water cues during testing of cue-induced reinstatement. Taken together, the incongruence of relationships indicates an underlying difference between natural and drug reinforcers. CONCLUSION In summary, we found a reinforcer-dependent relationship between operant novelty seeking (i.e., sensation seeking) and responsivity to extinction and discrete cues signaling availability for cocaine (i.e., craving), demonstrating the validity of the operant novelty seeking model to investigate drug seeking and relapse.
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Affiliation(s)
- Amy M Gancarz
- Department of Psychology, California State University, Bakersfield, Dorothy Donahoe Hall (DDH) H106, 9001 Stockdale Highway, Bakersfield, CA, 93311, USA.
| | - Devin P Hagarty
- Department of Psychology, California State University, Bakersfield, Dorothy Donahoe Hall (DDH) H106, 9001 Stockdale Highway, Bakersfield, CA, 93311, USA
| | - Moriah M Cobb
- Department of Psychology, California State University, Bakersfield, Dorothy Donahoe Hall (DDH) H106, 9001 Stockdale Highway, Bakersfield, CA, 93311, USA
| | - Michael A Kausch
- Department of Psychology, California State University, Bakersfield, Dorothy Donahoe Hall (DDH) H106, 9001 Stockdale Highway, Bakersfield, CA, 93311, USA
| | - Brandon Krieg
- Department of Psychology, California State University, Bakersfield, Dorothy Donahoe Hall (DDH) H106, 9001 Stockdale Highway, Bakersfield, CA, 93311, USA
| | - Nora Alammari
- Department of Psychology, California State University, Bakersfield, Dorothy Donahoe Hall (DDH) H106, 9001 Stockdale Highway, Bakersfield, CA, 93311, USA
| | - Kameron Gilbert
- Department of Psychology, California State University, Bakersfield, Dorothy Donahoe Hall (DDH) H106, 9001 Stockdale Highway, Bakersfield, CA, 93311, USA
| | - Jacqueline Russo
- Department of Psychology, California State University, Bakersfield, Dorothy Donahoe Hall (DDH) H106, 9001 Stockdale Highway, Bakersfield, CA, 93311, USA
| | - David M Dietz
- Clinical and Research Institute On Addictions, University at Buffalo, Buffalo, NY, USA
- Department of Pharmacology and Toxicology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, NY, USA
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26
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Allen C, Arredondo C, Dunham R, Fishman M, Lev L, Mace S, Parks J, Rosa D, Shoyinka S, White D, Williams A. Guidance for Handling the Increasing Prevalence of Drugs Adulterated or Laced With Fentanyl. Psychiatr Serv 2023; 74:1059-1062. [PMID: 37042103 DOI: 10.1176/appi.ps.202100660] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/13/2023]
Abstract
The use of fentanyl and its analogs is the primary driver of deaths related to the opioid overdose crisis. In fall 2021, the U.S. Drug Enforcement Administration issued its first public safety alert in 6 years to raise awareness of the escalating prevalence of fentanyl in counterfeit pills and in other opioids, such as heroin, and nonopioids, such as methamphetamine. In addition to increased public awareness, specific actions are needed to remediate the risk for fentanyl overdose. The authors endorse four principles to address the opioid overdose crisis and provide guidance for remediating its impacts: an incremental approach to behavior change or harm reduction; engagement strategies for individuals with substance use disorder; an integrated care approach to ensure better access to treatment programs and effective interventions; and vigilance among clinicians, program staff, and patients to the threat of fentanyl-adulterated drugs. The authors offer specific recommendations on how to apply these principles effectively within health care systems, communities, and law enforcement agencies across the United States.
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Affiliation(s)
- Craig Allen
- Addiction Services, Hartford HealthCare, Meriden, Connecticut (Allen); El Rio Community Health Center, Tucson (Arredondo); Metropolitan Human Services District, New Orleans (Dunham); Maryland Treatment Centers, Johns Hopkins University, Baltimore (Fishman); Beebe Healthcare, Lewes, Delaware (Lev); National Council for Mental Wellbeing, Washington, D.C. (Mace, Parks, Williams); Emergency Medicine, Acacia Network, New York City (Rosa); Department of Behavioral Health and Intellectual Disability Services, Philadelphia (Shoyinka); Psychiatric Emergency Services, Grady Health System, Emory University School of Medicine, Atlanta (White)
| | - Christina Arredondo
- Addiction Services, Hartford HealthCare, Meriden, Connecticut (Allen); El Rio Community Health Center, Tucson (Arredondo); Metropolitan Human Services District, New Orleans (Dunham); Maryland Treatment Centers, Johns Hopkins University, Baltimore (Fishman); Beebe Healthcare, Lewes, Delaware (Lev); National Council for Mental Wellbeing, Washington, D.C. (Mace, Parks, Williams); Emergency Medicine, Acacia Network, New York City (Rosa); Department of Behavioral Health and Intellectual Disability Services, Philadelphia (Shoyinka); Psychiatric Emergency Services, Grady Health System, Emory University School of Medicine, Atlanta (White)
| | - Rochelle Dunham
- Addiction Services, Hartford HealthCare, Meriden, Connecticut (Allen); El Rio Community Health Center, Tucson (Arredondo); Metropolitan Human Services District, New Orleans (Dunham); Maryland Treatment Centers, Johns Hopkins University, Baltimore (Fishman); Beebe Healthcare, Lewes, Delaware (Lev); National Council for Mental Wellbeing, Washington, D.C. (Mace, Parks, Williams); Emergency Medicine, Acacia Network, New York City (Rosa); Department of Behavioral Health and Intellectual Disability Services, Philadelphia (Shoyinka); Psychiatric Emergency Services, Grady Health System, Emory University School of Medicine, Atlanta (White)
| | - Marc Fishman
- Addiction Services, Hartford HealthCare, Meriden, Connecticut (Allen); El Rio Community Health Center, Tucson (Arredondo); Metropolitan Human Services District, New Orleans (Dunham); Maryland Treatment Centers, Johns Hopkins University, Baltimore (Fishman); Beebe Healthcare, Lewes, Delaware (Lev); National Council for Mental Wellbeing, Washington, D.C. (Mace, Parks, Williams); Emergency Medicine, Acacia Network, New York City (Rosa); Department of Behavioral Health and Intellectual Disability Services, Philadelphia (Shoyinka); Psychiatric Emergency Services, Grady Health System, Emory University School of Medicine, Atlanta (White)
| | - Leonard Lev
- Addiction Services, Hartford HealthCare, Meriden, Connecticut (Allen); El Rio Community Health Center, Tucson (Arredondo); Metropolitan Human Services District, New Orleans (Dunham); Maryland Treatment Centers, Johns Hopkins University, Baltimore (Fishman); Beebe Healthcare, Lewes, Delaware (Lev); National Council for Mental Wellbeing, Washington, D.C. (Mace, Parks, Williams); Emergency Medicine, Acacia Network, New York City (Rosa); Department of Behavioral Health and Intellectual Disability Services, Philadelphia (Shoyinka); Psychiatric Emergency Services, Grady Health System, Emory University School of Medicine, Atlanta (White)
| | - Shannon Mace
- Addiction Services, Hartford HealthCare, Meriden, Connecticut (Allen); El Rio Community Health Center, Tucson (Arredondo); Metropolitan Human Services District, New Orleans (Dunham); Maryland Treatment Centers, Johns Hopkins University, Baltimore (Fishman); Beebe Healthcare, Lewes, Delaware (Lev); National Council for Mental Wellbeing, Washington, D.C. (Mace, Parks, Williams); Emergency Medicine, Acacia Network, New York City (Rosa); Department of Behavioral Health and Intellectual Disability Services, Philadelphia (Shoyinka); Psychiatric Emergency Services, Grady Health System, Emory University School of Medicine, Atlanta (White)
| | - Joseph Parks
- Addiction Services, Hartford HealthCare, Meriden, Connecticut (Allen); El Rio Community Health Center, Tucson (Arredondo); Metropolitan Human Services District, New Orleans (Dunham); Maryland Treatment Centers, Johns Hopkins University, Baltimore (Fishman); Beebe Healthcare, Lewes, Delaware (Lev); National Council for Mental Wellbeing, Washington, D.C. (Mace, Parks, Williams); Emergency Medicine, Acacia Network, New York City (Rosa); Department of Behavioral Health and Intellectual Disability Services, Philadelphia (Shoyinka); Psychiatric Emergency Services, Grady Health System, Emory University School of Medicine, Atlanta (White)
| | - Daniel Rosa
- Addiction Services, Hartford HealthCare, Meriden, Connecticut (Allen); El Rio Community Health Center, Tucson (Arredondo); Metropolitan Human Services District, New Orleans (Dunham); Maryland Treatment Centers, Johns Hopkins University, Baltimore (Fishman); Beebe Healthcare, Lewes, Delaware (Lev); National Council for Mental Wellbeing, Washington, D.C. (Mace, Parks, Williams); Emergency Medicine, Acacia Network, New York City (Rosa); Department of Behavioral Health and Intellectual Disability Services, Philadelphia (Shoyinka); Psychiatric Emergency Services, Grady Health System, Emory University School of Medicine, Atlanta (White)
| | - Sosunmolu Shoyinka
- Addiction Services, Hartford HealthCare, Meriden, Connecticut (Allen); El Rio Community Health Center, Tucson (Arredondo); Metropolitan Human Services District, New Orleans (Dunham); Maryland Treatment Centers, Johns Hopkins University, Baltimore (Fishman); Beebe Healthcare, Lewes, Delaware (Lev); National Council for Mental Wellbeing, Washington, D.C. (Mace, Parks, Williams); Emergency Medicine, Acacia Network, New York City (Rosa); Department of Behavioral Health and Intellectual Disability Services, Philadelphia (Shoyinka); Psychiatric Emergency Services, Grady Health System, Emory University School of Medicine, Atlanta (White)
| | - DeJuan White
- Addiction Services, Hartford HealthCare, Meriden, Connecticut (Allen); El Rio Community Health Center, Tucson (Arredondo); Metropolitan Human Services District, New Orleans (Dunham); Maryland Treatment Centers, Johns Hopkins University, Baltimore (Fishman); Beebe Healthcare, Lewes, Delaware (Lev); National Council for Mental Wellbeing, Washington, D.C. (Mace, Parks, Williams); Emergency Medicine, Acacia Network, New York City (Rosa); Department of Behavioral Health and Intellectual Disability Services, Philadelphia (Shoyinka); Psychiatric Emergency Services, Grady Health System, Emory University School of Medicine, Atlanta (White)
| | - Aaron Williams
- Addiction Services, Hartford HealthCare, Meriden, Connecticut (Allen); El Rio Community Health Center, Tucson (Arredondo); Metropolitan Human Services District, New Orleans (Dunham); Maryland Treatment Centers, Johns Hopkins University, Baltimore (Fishman); Beebe Healthcare, Lewes, Delaware (Lev); National Council for Mental Wellbeing, Washington, D.C. (Mace, Parks, Williams); Emergency Medicine, Acacia Network, New York City (Rosa); Department of Behavioral Health and Intellectual Disability Services, Philadelphia (Shoyinka); Psychiatric Emergency Services, Grady Health System, Emory University School of Medicine, Atlanta (White)
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Snoubar M, Kasim S, Badawi M, Shaban Q, AbuAlrub I, Hunjul M, Khelfeh N, Abuhassan A, Hanani A, Bilbeisi S, Damiri B. High-risk drug use among Palestinian adolescent refugees in the North West Bank Palestine. J Ethn Subst Abuse 2023:1-20. [PMID: 37698173 DOI: 10.1080/15332640.2023.2255850] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/13/2023]
Abstract
Palestinian adolescent refugees are at increased risk for behaviors that can lead to poor health outcomes, such as high-risk substance use. This research focuses on the prevalence of substance use and its relationship with depression among adolescent male refugees in Palestine's North-West Bank. A cross-sectional study was conducted in five of seven refugee camps to gather data using a proportional stratified sampling technique. A structured questionnaire-based interview was conducted to gather sociodemographic data, self-reported substance use, and depression scale information. Additionally, urine screening tests were used to detect the presence of different drugs in participants' urine samples. The final sample size was 386 refugee males; 24.0% were workers, and 13.7% worked previously. For self-reported substance use, 26.9%;12.4%; 28.0%; 37.0%; and 60.4%, 2.6% of adolescents reported current users of cigarettes, e-cigarettes, waterpipe, coffee, energy drinks (ED), and alcohol, respectively. Moreover, 3.4% tested positive for at least one drug. The drugs that tested positive were as follows: PCP (5%), MDMA (1.8%), THC (1.6%), BZO (0.5%), and MET (0.5%). The adjusted logistic regression showed an increased risk of depression among workers (OR = 3.777; p-value = 0.008), cigarette smokers (OR = 2.948; p-value = 0.04), waterpipe smokers (OR = 4.458; p-value = 0.041), and coffee users (OR = 2.883, p-value = 0.046). In conclusion, Palestinian adolescent refugees are at increased risk for behaviors that can lead to poor health outcomes, such as high-risk substance use, including illicit drugs, alcohol use, tobacco smoking, and ED intake. The results of this study reveal alarming figures on drug use associated with depression in refugee camps which demand controlling interventions.
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Affiliation(s)
| | - Salih Kasim
- An-Najah National University, Nablus, Palestine
| | | | | | | | | | | | | | | | - Saed Bilbeisi
- Opioid Substitution Therapy Unit, Ramallah, Palestine
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Metcalfe JD, Drake RE. Assessing Substance Use Disorder Among Social Security Administration Disability Applicants. Psychiatr Serv 2023; 74:830-837. [PMID: 36789609 DOI: 10.1176/appi.ps.20220343] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/16/2023]
Abstract
OBJECTIVE Co-occurrence of substance use disorder and mental illness complicates treatment and is associated with increased disability. However, identification of substance use disorder in populations recently engaged in treatment can be challenging. This study aimed to examine traditional screening tools for substance use disorder and proxy characteristics (i.e., demographic characteristics, behaviors, and diagnoses) as predictors of clinician-observed substance use disorder. METHODS The Supported Employment Demonstration, funded by the Social Security Administration, studied 2,960 adults whose applications for disability benefits because of mental illness were recently denied. In a subsample (N=1,354) for whom substance use disorder was determined by community-based teams during follow-up, the authors used logistic regression to identify baseline predictors of observed substance use disorder and compared the sensitivity and specificity of detection by using standardized screening tools (Alcohol Use Disorder Identification Test [AUDIT], 10-item Drug Abuse Screening Test [DAST-10]) with detection via decision trees based on proxy characteristics. RESULTS Using decision trees based on a combination of personal characteristics (sensitivity=0.47, specificity=0.83, area under the curve [AUC]=0.71) or personal characteristics including diagnostic data (sensitivity=0.54, specificity=0.81, AUC=0.72) provided more accurate identification of substance use disorder than using a combination of the AUDIT and DAST-10 (sensitivity=0.34, specificity=0.88, AUC=0.61). Adding the combined AUDIT and DAST-10 substance use disorder indicator to either tree negligibly improved accuracy. CONCLUSIONS In populations recently engaged in treatment, for whom standardized substance use disorder screening tools are less accurate than expected, consideration of personal characteristics could improve the detection of substance use disorder essential for treatment planning.
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Hamed MA, Ekundina VO, Akhigbe RE. Psychoactive drugs and male fertility: impacts and mechanisms. Reprod Biol Endocrinol 2023; 21:69. [PMID: 37507788 PMCID: PMC10375764 DOI: 10.1186/s12958-023-01098-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/13/2022] [Accepted: 05/03/2023] [Indexed: 07/30/2023] Open
Abstract
Although psychoactive drugs have their therapeutic values, they have been implicated in the pathogenesis of male infertility. This study highlights psychoactive drugs reported to impair male fertility, their impacts, and associated mechanisms. Published data from scholarly peer-reviewed journals were used for the present study. Papers were assessed through AJOL, DOAJ, Google Scholar, PubMed/PubMed Central, and Scopus using Medical Subjects Heading (MeSH) indexes and relevant keywords. Psychoactive drugs negatively affect male reproductive functions, including sexual urge, androgen synthesis, spermatogenesis, and sperm quality. These drugs directly induce testicular toxicity by promoting ROS-dependent testicular and sperm oxidative damage, inflammation, and apoptosis, and they also suppress the hypothalamic-pituitary-testicular axis. This results in the suppression of circulating androgen, impaired spermatogenesis, and reduced sperm quality. In conclusion, psychoactive drug abuse not only harms male sexual and erectile function as well as testicular functions, viz., testosterone concentration, spermatogenesis, and sperm quality, but it also alters testicular histoarchitecture through a cascade of events via multiple pathways. Therefore, offering adequate and effective measures against psychoactive drug-induced male infertility remains pertinent.
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Affiliation(s)
- Moses Agbomhere Hamed
- Department of Medical Laboratory Science, Afe Babalola University, Ado-Ekiti, Ekiti State, Nigeria.
- The Brainwill Laboratory, Osogbo, Osun State, Nigeria.
- Reproductive Biology and Toxicology Research Laboratories, Oasis of Grace Hospital, Osogbo, Osun State, Nigeria.
| | | | - Roland Eghoghosoa Akhigbe
- Reproductive Biology and Toxicology Research Laboratories, Oasis of Grace Hospital, Osogbo, Osun State, Nigeria
- Department of Physiology, Ladoke Akintola University of Technology, Ogbomoso, Oyo State, Nigeria
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Coelho A, Lima-Bastos S, Gobira P, Lisboa S. Endocannabinoid signaling and epigenetics modifications in the neurobiology of stress-related disorders. Neuronal Signal 2023; 7:NS20220034. [PMID: 37520658 PMCID: PMC10372471 DOI: 10.1042/ns20220034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2023] [Revised: 06/30/2023] [Accepted: 07/07/2023] [Indexed: 08/01/2023] Open
Abstract
Stress exposure is associated with psychiatric conditions, such as depression, anxiety, and post-traumatic stress disorder (PTSD). It is also a vulnerability factor to developing or reinstating substance use disorder. Stress causes several changes in the neuro-immune-endocrine axis, potentially resulting in prolonged dysfunction and diseases. Changes in several transmitters, including serotonin, dopamine, glutamate, gamma-aminobutyric acid (GABA), glucocorticoids, and cytokines, are associated with psychiatric disorders or behavioral alterations in preclinical studies. Complex and interacting mechanisms make it very difficult to understand the physiopathology of psychiatry conditions; therefore, studying regulatory mechanisms that impact these alterations is a good approach. In the last decades, the impact of stress on biology through epigenetic markers, which directly impact gene expression, is under intense investigation; these mechanisms are associated with behavioral alterations in animal models after stress or drug exposure, for example. The endocannabinoid (eCB) system modulates stress response, reward circuits, and other physiological functions, including hypothalamus-pituitary-adrenal axis activation and immune response. eCBs, for example, act retrogradely at presynaptic neurons, limiting the release of neurotransmitters, a mechanism implicated in the antidepressant and anxiolytic effects after stress. Epigenetic mechanisms can impact the expression of eCB system molecules, which in turn can regulate epigenetic mechanisms. This review will present evidence of how the eCB system and epigenetic mechanisms interact and the consequences of this interaction in modulating behavioral changes after stress exposure in preclinical studies or psychiatric conditions. Moreover, evidence that correlates the involvement of the eCB system and epigenetic mechanisms in drug abuse contexts will be discussed.
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Affiliation(s)
- Arthur A. Coelho
- Department of Pharmacology, Ribeirão Preto Medical School, University of São Paulo, Brazil
- Department of BioMolecular Sciences, School of Pharmaceutical Sciences of Ribeirão Preto, University of São Paulo, Brazil
| | - Sávio Lima-Bastos
- Department of Pharmacology, Ribeirão Preto Medical School, University of São Paulo, Brazil
- Department of BioMolecular Sciences, School of Pharmaceutical Sciences of Ribeirão Preto, University of São Paulo, Brazil
| | - Pedro H. Gobira
- Department of BioMolecular Sciences, School of Pharmaceutical Sciences of Ribeirão Preto, University of São Paulo, Brazil
| | - Sabrina F. Lisboa
- Department of BioMolecular Sciences, School of Pharmaceutical Sciences of Ribeirão Preto, University of São Paulo, Brazil
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Zarghami M, Kharazmi O, Alipour A, Babakhanian M, Khosravi A, Mirtorabi SD. Time Series Modeling and Forecasting of Drug-Related Deaths in Iran (2014-2016). Addict Health 2023; 15:149-155. [PMID: 38026723 PMCID: PMC10658097 DOI: 10.34172/ahj.2023.1277] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/20/2021] [Accepted: 09/08/2021] [Indexed: 12/01/2023]
Abstract
Background Investigating the temporal variations and forecasting the trends in drug-related deaths can help prevent health problems and develop intervention programs. The recent policy in Iran is strongly focused on deterring drug use and replacing illicit drugs with legal ones. This study aimed to investigate drug-related deaths in Iran in 2014-2016 and forecast the death toll by 2019. Methods In this longitudinal study, Box-Jenkins time series analysis was used to forecast drug-related deaths. To this end, monthly counts of drug-related deaths were obtained from March 2014 to March 2017. After data processing, to obtain stationary time series and examine the stability assumption with the Dickey-Fuller test, the parameters of the Autoregressive Integrated Moving Averages (ARIMA) model were determined using autocorrelation function (ACF) and partial autocorrelation function (PACF) graphs. Based on Akaike statistics, ARIMA (0, 1, 1) was selected as the best-fit model. Moreover, the Dickey-Fuller test was used to confirm the stationarity of the time series of transformed observations. The forecasts were made for the next 36 months using the ARIMA (0,1,2) model and the same confidence intervals were applied to all months. The final extracted data were analyzed using R software, Minitab, and SPSS-23. Findings According to the Iranian Ministry of Health and the Legal Medicine Organization, there were 8883 drug-related deaths in Iran from March 2014 to March 2017. According to the time series findings, this count had an upward trend and did not show any seasonal pattern. It was forecasted that the mean drug-related mortality rate in Iran would be 245.8 cases per month until 2019. Conclusion This study showed a rising trend in drug-related mortality rates during the study period, and the modeling process for forecasting suggested this trend would continue until 2019 if proper interventions were not instituted.
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Affiliation(s)
- Mehran Zarghami
- Psychiatry and Behavioral Sciences Research Center, Addiction Institute, Mazandaran University of Medical Sciences, Sari, Iran
- Department of Psychiatry, Faculty of Medicine, Mazandaran University of Medical Sciences, Sari, Iran
| | - Omid Kharazmi
- Department of Statistics, Faculty of Mathematical Sciences, Vali-e-Asr University of Rafsanjan, Rafsanjan, Iran
| | - Abbas Alipour
- Community Medicine Department, Medical Faculty, Mazandaran University of Medical Sciences, Sari, Iran
| | - Masoudeh Babakhanian
- Psychiatry and Behavioral Sciences Research Center, Addiction Institute, Mazandaran University of Medical Sciences, Sari, Iran
- Social Determinants of Health Research Center, Semnan University of Medical Sciences, Semnan, Iran
| | - Ardeshr Khosravi
- Deputy for Public Health, Ministry of Health and Medical Education, Tehran, Iran
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Jang KW, Lee HK, Park BJ, Kang HC, Lee SK, Kim CH, Nam SK, Roh D. Social Stigma and Discrimination Toward People With Drug Addiction: A National Survey in Korea. Psychiatry Investig 2023; 20:671-680. [PMID: 37525617 PMCID: PMC10397776 DOI: 10.30773/pi.2023.0065] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/27/2023] [Accepted: 05/24/2023] [Indexed: 08/02/2023] Open
Abstract
OBJECTIVE This study aims to understand the attitudes, stigma, and discrimination of the general adult population toward drug addiction. METHODS We conducted a cross-sectional nationwide survey with 1,020 Korean adults using an Internet web-based panel. Self-reported data were collected on demographics, experience with substance abuse, perceptions of narcotic analgesic use, beliefs about the legalization of cannabis use, coping with substance abuse and addiction, and perceptions of drug risks. All statistical analysis in this study utilized the IBM SPSS Statistics 26 program. RESULTS In this study, 1.6% of the participants reported abuse of opioid analgesics, 88.0% reported negative perceptions of drug addiction, and 76.9% reported agreeing to unfair treatment of drug addicts. Logistic regression analysis found that perceived stigma was more prevalent among women (odd ratio [OR]=2.087, p<0.01), old adults (OR=1.939, p<0.01), those with no personal experience of opioid misuse (OR=8.172, p<0.05), and those who were non-smoking (OR=2.011, p<0.01). In addition, the discriminatory attitude was more prevalent among participants with higher income (OR=1.989, p<0.001) and those who are non-smoking (OR=1.608, p<0.05). CONCLUSION This study provides information and guidelines for public intervention in drug addiction by identifying factors influencing social stigma and discriminatory behaviors toward drug addiction. The findings suggest that education on drug addiction prevention for the general adult population is necessary, and this education should include knowledge on coping with drug addiction and reducing stigma and discrimination toward drug addicts.
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Affiliation(s)
- Ki Won Jang
- Mind-Neuromodulation Laboratory, Hallym University College of Medicine, Chuncheon, Republic of Korea
| | - Hae Kook Lee
- Department of Psychiatry, Catholic University College of Medicine, Seoul, Republic of Korea
| | - Byung Joo Park
- Department of Preventive Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Hoon-Chul Kang
- Division of Pediatric Neurology, Department of Pediatrics, Severance Children's Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Sang-Kyu Lee
- Mind-Neuromodulation Laboratory, Hallym University College of Medicine, Chuncheon, Republic of Korea
- Department of Psychiatry, Chuncheon Sacred Heart Hospital, Hallym University College of Medicine, Chuncheon, Republic of Korea
| | - Chan-Hyung Kim
- Department of Psychiatry and Institute of Behavioural Science in Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Sang Kyu Nam
- Mind-Neuromodulation Laboratory, Hallym University College of Medicine, Chuncheon, Republic of Korea
| | - Daeyoung Roh
- Mind-Neuromodulation Laboratory, Hallym University College of Medicine, Chuncheon, Republic of Korea
- Department of Psychiatry, Chuncheon Sacred Heart Hospital, Hallym University College of Medicine, Chuncheon, Republic of Korea
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Saini H, Mann H, Saini I, Bhanot N, Kelly K, Rana S. Isolated cerebral mucormycosis: A case discussion. IDCases 2023; 33:e01821. [PMID: 37415782 PMCID: PMC10320071 DOI: 10.1016/j.idcr.2023.e01821] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2023] [Revised: 06/11/2023] [Accepted: 06/15/2023] [Indexed: 07/08/2023] Open
Abstract
We report a case of a 32-year-old male with a history of type 1 diabetes, inhaled drug use, and alcohol use disorder, who presented with encephalopathy, holocranial headaches, neck pain, confusion, and generalized tonic-clonic seizures. The patient initially presented at a rural community hospital with a fever and was found to be in diabetic ketoacidosis (DKA). He was also hemodynamically stable but stuporous, prompting intubation to protect his airway. Despite initial treatment measures, his neurological condition worsened and he remained ventilator-dependent. Key findings include a high glucose level, presence of ketones, and evidence of drug use. Blood cultures showed no growth, but his febrile state persisted. Cerebrospinal fluid (CSF) analysis revealed mild pleocytosis, hyperglycorrhachia but normal protein, with no growth. Neuroimaging showed right hemispheric slowing on EEG and diffusion restriction in the right frontal lobe on MRI. The patient's neurological status worsened on the second day of admission, manifesting as sluggish pupillary reflexes, right third nerve palsy, and decerebrate posturing. Emergent MRI suggested cerebral edema, leading to initiation of hypertonic saline. This case highlights the diagnostic challenges and critical management considerations in a patient with multiple comorbidities presenting with unexplained neurological deterioration, emphasizing the importance of a comprehensive and timely approach to diagnosis and treatment.
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Affiliation(s)
- Harneel Saini
- Allegheny General Hospital, 320 E North Ave, Pittsburgh, PA 15212, United States
| | - Harinoor Mann
- Allegheny General Hospital, 320 E North Ave, Pittsburgh, PA 15212, United States
| | - Ishveen Saini
- Lake Erie College of Osteopathic Medicine, 1858 W Grandview Blvd, Erie, PA 16509, United States
| | - Nitin Bhanot
- Allegheny General Hospital, 320 E North Ave, Pittsburgh, PA 15212, United States
| | - Kevin Kelly
- Allegheny General Hospital, 320 E North Ave, Pittsburgh, PA 15212, United States
| | - Sandeep Rana
- Allegheny General Hospital, 320 E North Ave, Pittsburgh, PA 15212, United States
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Kim M, Oh S, Kim S, Ji M, Choi B, Bae JW, Lee YS, Paik MJ, Lee S. Alcohol perturbed locomotor behavior, metabolism, and pharmacokinetics of gamma-hydroxybutyric acid in rats. Biomed Pharmacother 2023; 164:114992. [PMID: 37301134 DOI: 10.1016/j.biopha.2023.114992] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2023] [Revised: 05/30/2023] [Accepted: 06/06/2023] [Indexed: 06/12/2023] Open
Abstract
Gamma-hydroxybutyric acid (GHB), both a metabolic precursor and product of gamma-aminobutyric acid (GABA), is a central nervous system depressant used for the treatment of narcolepsy-associated cataplexy and alcohol withdrawal. However, administration of GHB with alcohol (ethanol) is a major cause of hospitalizations related to GHB intoxication. In this study, we investigated locomotor behavior as well as metabolic and pharmacokinetic interactions following co-administration of GHB and ethanol in rats. The locomotor behavior of rats was evaluated following the intraperitoneal administration of GHB (sodium salt, 500 mg/kg) and/or ethanol (2 g/kg). Further, time-course urinary metabolic profiling of GHB and its biomarker metabolites glutamic acid, GABA, succinic acid, 2,4-dihydroxybutyric acid (OH-BA), 3,4-OH-BA, and glycolic acid as well as pharmacokinetic analysis were performed. GHB/ethanol co-administration significantly reduced locomotor activity, compared to the individual administration of GHB or ethanol. The urinary and plasma concentrations of GHB and other target compounds, except for 2,4-OH-BA, were significantly higher in the GHB/ethanol co-administration group than the group administered only GHB. The pharmacokinetic analysis results showed that the co-administration of GHB and ethanol significantly increased the half-life of GHB while the total clearance decreased. Moreover, a comparison of the metabolite-to-parent drug area under the curve ratios demonstrated that the metabolic pathways of GHB, such α- and β-oxidation, were inhibited by ethanol. Consequently, the co-administration of GHB and ethanol aggravated the metabolism and elimination of GHB and enhanced its sedative effect. These findings will contribute to clinical interpretation of GHB intoxication.
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Affiliation(s)
- Mingyu Kim
- College of Pharmacy, Keimyung University, 1095 Dalgubeol-daero, Dalseo-gu, Daegu 42601, the Republic of Korea
| | - Songjin Oh
- College of Pharmacy, Sunchon National University, 25 Jungang-ro, Suncheon 57922, the Republic of Korea
| | - Suji Kim
- College of Pharmacy, Keimyung University, 1095 Dalgubeol-daero, Dalseo-gu, Daegu 42601, the Republic of Korea
| | - Moongi Ji
- College of Pharmacy, Sunchon National University, 25 Jungang-ro, Suncheon 57922, the Republic of Korea
| | - Byeongchan Choi
- College of Pharmacy, Sunchon National University, 25 Jungang-ro, Suncheon 57922, the Republic of Korea
| | - Jung-Woo Bae
- College of Pharmacy, Keimyung University, 1095 Dalgubeol-daero, Dalseo-gu, Daegu 42601, the Republic of Korea
| | - Yong Sup Lee
- College of Pharmacy, Kyung Hee University, 26 Kyungheedae-ro, Dongdaemun-gu, Seoul 02447, the Republic of Korea
| | - Man-Jeong Paik
- College of Pharmacy, Sunchon National University, 25 Jungang-ro, Suncheon 57922, the Republic of Korea.
| | - Sooyeun Lee
- College of Pharmacy, Keimyung University, 1095 Dalgubeol-daero, Dalseo-gu, Daegu 42601, the Republic of Korea.
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Jones SK, Korte JE, Wilson D. Hazard of substance abuse onset among adults diagnosed with epilepsy or migraine. Epilepsy Behav 2023; 144:109258. [PMID: 37209553 DOI: 10.1016/j.yebeh.2023.109258] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/16/2023] [Revised: 04/26/2023] [Accepted: 05/07/2023] [Indexed: 05/22/2023]
Abstract
OBJECTIVE We investigated adult-onset epilepsy as a risk factor for the development of substance use disorder (SUD) by comparing the rate of SUD diagnosis among adults diagnosed with epilepsy with presumably healthy controls with lower extremity fractures (LEF). For additional comparison, we investigated the risk for adults with migraine only. Epilepsy and migraine are both episodic neurological disorders and migraine is frequently comorbid with epilepsy. METHODS We conducted a time-to-event analysis using a subset of surveillance data of hospital admissions, emergency department visits, and outpatient visits in South Carolina, USA from January 1, 2000, through December 31, 2011. Individuals aged 18 years or older were identified using the International Classification of Disease, 9thRevision Clinical Modification (ICD-9) with a diagnosis of epilepsy (n = 78,547; 52.7% female, mean age 51.3 years), migraine (n = 121,155; 81.5% female, mean age 40.0 years), or LEF (n = 73,911; 55.4% female, mean age 48.7 years). Individuals with SUD diagnosis following epilepsy, migraine, or LEF were identified with ICD-9 codes. We used Cox proportional hazards regression to model the time to SUD diagnosis comparing adults diagnosed with epilepsy, migraine, and LEF, adjusting for insurance payer, age, sex, race/ethnicity, and prior mental health comorbidities. RESULTS Compared to LEF controls, adults with epilepsy were diagnosed with SUD at 2.5 times the rate [HR 2.48 (2.37, 2.60)] and adults with migraine only were diagnosed with SUD at 1.12 times the rate [HR 1.12 (1.06, 1.18)]. We found an interaction between disease diagnosis and insurance payer, with hazard ratios comparing epilepsy to LEF of 4.59, 3.48, 1.97, and 1.44 within the commercial payer, uninsured, Medicaid, and Medicare strata, respectively. SIGNIFICANCE Compared to presumably healthy controls, adults with epilepsy had a substantially higher hazard of SUD, while adults with migraine only showed a small, but significant, increased hazard of SUD.
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Affiliation(s)
- Stephanie K Jones
- Department of Public Health, Baylor University, Waco, TX 76798, USA.
| | - Jeffrey E Korte
- Department of Public Health Sciences, Medical University of South Carolina, Charleston. SC 29425, USA.
| | - Dulaney Wilson
- Department of Public Health Sciences, Medical University of South Carolina, Charleston. SC 29425, USA.
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Delaveridou E, Simichanidou A, Galanis S, Nikolaidou O. Life threatening, subclavian artery mycotic aneurysm rupture into a gigantic supraclavicular abscess in an intravenous drug user. Clin Med (Lond) 2023; 23:267-269. [PMID: 38614783 DOI: 10.7861/clinmed.2023-0127] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
Subclavian artery injuries are sporadic, and the most common aetiology is trauma. Self-injury of the vessel in those misusing intravenous drugs is a rare complication, as most reports describe injury to the femoral artery. Thus, erosion and potential rupture of the arterial wall is possible due infection and phlegmon or abscess formation. We present a case of a young, female, hemodynamically unstable intravenous drug user admitted to the emergency department with a life-threatening, purulent haemorrhagic mass located at her right lateral cervical region. The patient admitted an inadvertent arterial puncture 10 days prior and an effort to self-manage the bleeding with the application of self-pressure and antibiotics. Computed tomography arteriogram of the neck revealed a gigantic, multicompartment, thick-walled collection with hyperdense fluid in her right supraclavicular region while active extravasation derived from the right subclavian artery was evident in late arterial phase. The patient was treated with endovascular graft stenting, despite the given presence of infection, as a salvage operation due to time limitation in open surgical repair.
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Affiliation(s)
| | - Anna Simichanidou
- 'George Papanikolaou' General Hospital of Thessaloniki, Thessaloniki, Greece
| | - Stavros Galanis
- 'George Papanikolaou' General Hospital of Thessaloniki, Thessaloniki, Greece
| | - Olga Nikolaidou
- 'George Papanikolaou' General Hospital of Thessaloniki, Thessaloniki, Greece.
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Roma K, Mohammed S, Sieck B, Naik K, Wahid S. Kratom Induced Acute Liver Injury: A Case Study and the Importance of Herbal Supplement Regulation. J Hepatol 2023:S0168-8278(23)00311-2. [PMID: 37121435 DOI: 10.1016/j.jhep.2023.04.026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/27/2022] [Revised: 04/16/2023] [Accepted: 04/17/2023] [Indexed: 05/02/2023]
Affiliation(s)
- Katerina Roma
- Internal Medicine, Kirk Kerkorian School of Medicine at UNLV, Las Vegas, Nevada.
| | - Salman Mohammed
- Kirk Kerkorian School of Medicine at UNLV, Las Vegas, Nevada
| | - Blake Sieck
- Kirk Kerkorian School of Medicine at UNLV, Las Vegas, Nevada
| | - Katrina Naik
- Division of Gastroenterology, Kirk Kerkorian School of Medicine at UNLV, Las Vegas, Nevada
| | - Shahid Wahid
- Division of Gastroenterology, Kirk Kerkorian School of Medicine at UNLV, Las Vegas, Nevada
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Goldstein AB, Oudekerk BA, Blanco C. From Prevention Science to Services: Identifying Paths to Sustainable Evidence-Based Preventive Interventions. Psychiatr Serv 2023:appips20220641. [PMID: 37042106 DOI: 10.1176/appi.ps.20220641] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/13/2023]
Affiliation(s)
- Amy B Goldstein
- Division of Epidemiology, Services and Prevention Research, National Institute on Drug Abuse, Bethesda
| | - Barbara A Oudekerk
- Division of Epidemiology, Services and Prevention Research, National Institute on Drug Abuse, Bethesda
| | - Carlos Blanco
- Division of Epidemiology, Services and Prevention Research, National Institute on Drug Abuse, Bethesda
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Wang X, Xiang P, Zhang S, Wang J, Zhang J, Wu H, Wang X. Retrospective analysis of forensic toxicology data from 2021 to identify patterns of various forensic cases. Forensic Sci Int 2023; 347:111683. [PMID: 37068373 DOI: 10.1016/j.forsciint.2023.111683] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2022] [Revised: 04/03/2023] [Accepted: 04/07/2023] [Indexed: 04/19/2023]
Abstract
PURPOSE Knowing and analyzing the characteristics and trends of forensic toxicology cases in a certain area is particularly important for a local government to establish an effective prevention and control system. The purpose of this work was to summarize data from forensic toxicology cases received by the Academy of Forensic Sciences (AFS) in 2021. METHODS As requested by the police or according to the details of cases, samples were systematically screened or analyzed by various methods. Liquid chromatography-tandem mass spectrometry and gas chromatography-mass spectrometry were used to identify medicinal drugs, drugs of abuse, pesticides, poison gases, etc. RESULTS: AFS received a total of 17,758 cases in 2021, of which 314 cases underwent autopsy. The main cause of death was sudden death, and the manner of death was mainly accident. Among 13,744 drug abuse cases, the number of positive cases was 1721, with a positive rate of 12.5%, and synthetic cannabinoids were the most frequently detected substances. In 3640 traffic cases, 85.3% of drivers were suspected of drunk driving. In 103 poisoning cases, hydrogen sulfide poisoning and pesticide suicide account for a large proportion. In drug-facilitated crimes, zolpidem was the most frequently tested component. In 55 case of dog poisonings, the main poisons were cyanides and succinylcholine, and the main poisoning tools were poisonous baits and poisonous syringe darts. CONCLUSIONS This study profiles the toxicological characteristics of forensic toxicological cases conducted at the AFS in 2021 and provides a scientific basis for poisoning cases and drug abuse prevention.
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Affiliation(s)
- Xinying Wang
- Department of Forensic Toxicology, Shanghai Key Laboratory of Forensic Medicine, Shanghai Forensic Science Platform, Academy of Forensic Science, Shanghai, China; School of Pharmacy, Shenyang Pharmaceutical University, Shenyang, China
| | - Ping Xiang
- Department of Forensic Toxicology, Shanghai Key Laboratory of Forensic Medicine, Shanghai Forensic Science Platform, Academy of Forensic Science, Shanghai, China
| | - Sujing Zhang
- Department of Forensic Toxicology, Shanghai Key Laboratory of Forensic Medicine, Shanghai Forensic Science Platform, Academy of Forensic Science, Shanghai, China
| | - Jinming Wang
- Department of Forensic Pathology, Shanghai Key Laboratory of Forensic Medicine, Shanghai Forensic Science Platform, Academy of Forensic Science, Shanghai, China
| | - Jianhua Zhang
- Department of Forensic Pathology, Shanghai Key Laboratory of Forensic Medicine, Shanghai Forensic Science Platform, Academy of Forensic Science, Shanghai, China
| | - Hejian Wu
- Department of Forensic Toxicology, Shanghai Key Laboratory of Forensic Medicine, Shanghai Forensic Science Platform, Academy of Forensic Science, Shanghai, China.
| | - Xin Wang
- Department of Forensic Toxicology, Shanghai Key Laboratory of Forensic Medicine, Shanghai Forensic Science Platform, Academy of Forensic Science, Shanghai, China.
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Ciccirillo F, Abrignani MG, Temporelli PL, Binaghi G, Cappelletto C, Lopriore V, Cesaro A, Maloberti A, Cozzoli D, Riccio C, Caldarola P, Oliva F, Gabrielli D, Colivicchi F. The Key Role of a Psychoactive Substance Use History in Comprehensive Cardiovascular Risk Assessment, Diagnosis, Treatment, and Prevention. Cardiology 2023; 148:257-268. [PMID: 37040728 DOI: 10.1159/000530246] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/27/2022] [Accepted: 03/11/2023] [Indexed: 04/13/2023]
Abstract
BACKGROUND Psychoactive substances have toxic effects resulting different cardiovascular and non-cardiovascular organ damage. Through a variety of mechanisms, they can trigger the onset of various forms of cardiovascular disease: acute or chronic, transient or permanent, subclinical or symptomatic. Hence, a thorough knowledge of the patient's drug habits is essential for a more complete clinical-etiopathogenetic diagnosis and consequent therapeutic, preventive, and rehabilitative management. SUMMARY The prime reason for taking a psychoactive substance use history in the cardiovascular context is to identify those people who use substances (whether habitual or occasional users, symptomatic or not) and adequately assess their overall cardiovascular risk profile in terms of "user status" and type of substance(s) used. A psychoactive substance history could also alert the physician to suspect, and eventually diagnose, cardiovascular disease related to the intake of psychoactive substances, so optimizing the medical management of users. This anamnesis could finally assess the likelihood of patients persisting in the habit as a user or relapse, while maintaining high their cardiovascular risk profile. Taking such a history should be mandatory when a causal connection is suspected between intake of psychoactive substances and the observed symptoms or pathology, regardless of whether the individual is a declared user or not. KEY MESSAGES The purpose of this article was to provide practical information on when, how, and why to perform a psychoactive substance use history.
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Affiliation(s)
| | | | - Pier Luigi Temporelli
- Division of Cardiac Rehabilitation, ICS Maugeri, IRCCS Gattico-Veruno, Gattico-Veruno, Italy
| | | | | | | | - Arturo Cesaro
- Cardiology Division, AORN Sant'Anna and San Sebastiano, Caserta, Italy
- Campania University "L. Vanvitelli,", Napoli, Italy
| | | | | | - Carmine Riccio
- Post-Acute Patient Follow-Up UOSD, Cardiovascular Department, AORN, Sant'Anna and San Sebastiano, Caserta, Italy
| | | | - Fabrizio Oliva
- Cardiology- Heart Failure and Transplants, Cardiotoracovascular Department "A. De Gasperis,", Milan, Italy
| | - Domenico Gabrielli
- Cardiology-UTIC Unit, AO San Camillo Forlanini, Rome, Italy
- Heart Care Foundation, Florence, Italy
| | - Furio Colivicchi
- Clinical and Rehabilitative Cardiology, San Filippo Neri Hospital, ASL Rome 1, Rome, Italy
- ANMCO, Florence, Italy
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Brondeel KC, Malone KT, Ditmars FR, Vories BA, Ahmadzadeh S, Tirumala S, Fox CJ, Shekoohi S, Cornett EM, Kaye AD. Algorithms to Identify Nonmedical Opioid Use. Curr Pain Headache Rep 2023; 27:81-88. [PMID: 37022564 DOI: 10.1007/s11916-023-01104-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/21/2023] [Indexed: 04/07/2023]
Abstract
The rise in nonmedical opioid overdoses over the last two decades necessitates improved detection technologies. Manual opioid screening exams can exhibit excellent sensitivity for identifying the risk of opioid misuse but can be time-consuming. Algorithms can help doctors identify at-risk people. In the past, electronic health record (EHR)-based neural networks outperformed Drug Abuse Manual Screenings in sparse studies; however, recent data shows that it may perform as well or less than manual screenings. Herein, a discussion of several different manual screenings and recommendations is contained, along with suggestions for practice. A multi-algorithm approach using EHR yielded strong predictive values of opioid use disorder (OUD) over a large sample size. A POR (Proove Opiate Risk) algorithm provided a high sensitivity for categorizing the risk of opioid abuse within a small sample size. All established screening methods and algorithms reflected high sensitivity and positive predictive values. Neural networks based on EHR also showed significant effectiveness when corroborated with Drug Abuse Manual Screenings. This review highlights the potential of algorithms for reducing provider costs and improving the quality of care by identifying nonmedical opioid use (NMOU) and OUD. These tools can be combined with traditional clinical interviewing, and neural networks can be further refined while expanding EHR.
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Affiliation(s)
- Kimberley C Brondeel
- University of Texas Medical Branch, University of Texas, 301 University Blvd, 77555, Galveston, TX, USA
| | - Kevin T Malone
- School of Medicine, Louisiana State University Health Sciences Center at Shreveport, LA, 71103, Shreveport, USA
| | - Frederick R Ditmars
- University of Texas Medical Branch, University of Texas, 301 University Blvd, 77555, Galveston, TX, USA
| | - Bridget A Vories
- University of Texas Medical Branch, University of Texas, 301 University Blvd, 77555, Galveston, TX, USA
| | - Shahab Ahmadzadeh
- Department of Anesthesiology, Louisiana State University Health Sciences Center at Shreveport, Shreveport, LA, 71103, USA
| | - Sridhar Tirumala
- Department of Anesthesiology, Louisiana State University Health Sciences Center at Shreveport, Shreveport, LA, 71103, USA
| | - Charles J Fox
- Department of Anesthesiology, Louisiana State University Health Sciences Center at Shreveport, Shreveport, LA, 71103, USA
| | - Sahar Shekoohi
- Department of Anesthesiology, Louisiana State University Health Sciences Center at Shreveport, Shreveport, LA, 71103, USA.
| | - Elyse M Cornett
- Department of Anesthesiology, Louisiana State University Health Sciences Center at Shreveport, Shreveport, LA, 71103, USA
| | - Alan D Kaye
- Department of Anesthesiology, Louisiana State University Health Sciences Center at Shreveport, Shreveport, LA, 71103, USA
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Cameron-Burr KT, Bola RA, Kiyatkin EA. Dantrolene sodium fails to reverse robust brain hyperthermia induced by MDMA and methamphetamine in rats. Psychopharmacology (Berl) 2023; 240:785-795. [PMID: 36700960 DOI: 10.1007/s00213-023-06321-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/26/2022] [Accepted: 01/19/2023] [Indexed: 01/27/2023]
Abstract
RATIONALE Hyperthermia induced by psychomotor stimulants may cause leakage of the blood-brain barrier, vasogenic edema, and lethality in extreme cases. Current treatments such as whole-body cooling are only symptomatic and a clear need to develop pharmacological interventions exists. Dantrolene sodium, a peripheral muscle relaxant used in the treatment of malignant hyperthermia, has been proposed as potentially effective to treat MDMA-hyperthermia in emergency rooms. However, debate around its efficacy for this indication persists. OBJECTIVES To investigate dantrolene as a treatment for illicit hyperthermia induced by psychomotor stimulant drugs, we examined how Ryanodex®, a concentrated formulation of dantrolene sodium produced by Eagle Pharmaceuticals, influences 3,4-methylenedioxymethamphetamine (MDMA)- and methamphetamine (METH)-induced hyperthermia in awake freely moving rats. We injected rats with moderate doses of MDMA (9 mg/kg) and METH (9 mg/kg) and administered Ryanodex® intravenously (6 mg/kg) after the development of robust hyperthermia (>2.5 °C) mimicking clinical acute intoxication. We conducted simultaneous temperature recordings in the brain, temporal muscle, and skin to determine the basic mechanisms underlying temperature responses. To assess the efficacy of dantrolene in attenuating severe hyperthermia, we administered MDMA to rats maintained in a warm ambient environment (29 °C), conditions which produce robust brain and body hyperthermia (>40 °C) and lethality. RESULTS Dantrolene failed to attenuate MDMA- and METH-induced hyperthermia, though locomotor activity was significantly reduced. All animals maintained at warm ambient temperatures that received dantrolene during severe drug-induced hyperthermia died within or soon after the recording session. CONCLUSIONS Our results suggest that dantrolene sodium formulations are not mechanistically suited to treat MDMA- and METH-induced hyperthermia.
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Affiliation(s)
- Keaton T Cameron-Burr
- Behavioral Neuroscience Branch, National Institute on Drug Abuse - Intramural Research Program, National Institutes of Health, DHHS, 251 Bayview Blvd, Baltimore, MD, 21224, USA
| | - R Aaron Bola
- Behavioral Neuroscience Branch, National Institute on Drug Abuse - Intramural Research Program, National Institutes of Health, DHHS, 251 Bayview Blvd, Baltimore, MD, 21224, USA
| | - Eugene A Kiyatkin
- Behavioral Neuroscience Branch, National Institute on Drug Abuse - Intramural Research Program, National Institutes of Health, DHHS, 251 Bayview Blvd, Baltimore, MD, 21224, USA.
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Moline M, Asakura S, Beuckman C, Landry I, Setnik B, Ashworth J, Henningfield JE. The abuse potential of lemborexant, a dual orexin receptor antagonist, according to the 8 factors of the Controlled Substances Act. Psychopharmacology (Berl) 2023; 240:699-711. [PMID: 36749354 PMCID: PMC10006052 DOI: 10.1007/s00213-023-06320-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/27/2022] [Accepted: 01/17/2023] [Indexed: 02/08/2023]
Abstract
RATIONALE Lemborexant (LEM) is a dual orexin receptor antagonist (DORA) approved in multiple countries including the USA, Japan, Canada, Australia, and several Asian countries for the treatment of insomnia in adults. As a compound with central nervous system activity, it is important to understand the abuse potential of LEM with respect to public health. OBJECTIVES This review discusses data for LEM relevant to each of the 8 factors of the United States Controlled Substances Act. RESULTS LEM did not demonstrate abuse potential in nonclinical testing and was associated with a low incidence of abuse-related adverse events in clinical study participants with insomnia disorder. Similar to other DORAs that have been evaluated (eg., almorexant, suvorexant (SUV), and daridorexant), LEM and the positive controls (zolpidem and SUV) also showed drug liking in a phase 1 abuse potential study that enrolled subjects who used sedatives recreationally. However, internet surveillance of SUV and the FDA Adverse Events Reporting System suggests that drugs in the DORA class display very low abuse-related risks in the community. Additionally, as described in FDA-approved labeling, it does not carry physical dependence and withdrawal risks. CONCLUSIONS LEM, similar to most other prescription insomnia medications, was placed into Schedule IV. However, LEM and other drugs in the DORA class may have a lower potential for abuse as suggested by real-world postmarketing data from federal surveys and internet surveillance, and thus may have lower risks to public health than Schedule IV benzodiazepines and nonbenzodiazepine hypnotics that potentiate GABA signaling.
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Affiliation(s)
- Margaret Moline
- Eisai Inc., 200 Metro Boulevard, Nutley, Jersey, NJ, 07110, USA.
| | | | | | | | - Beatrice Setnik
- Altasciences, Laval, Quebec, Canada and the Department of Pharmacology and Toxicology, University of Toronto, Toronto, Ontario, Canada
| | | | - Jack E Henningfield
- Pinney Associates, Inc., Bethesda, MD, USA.,The Johns Hopkins University School of Medicine, Baltimore, MD, USA
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Nikbakhtzadeh M, Ranjbar H, Moradbeygi K, Zahedi E, Bayat M, Soti M, Shabani M. Cross-talk between the HPA axis and addiction-related regions in stressful situations. Heliyon 2023; 9:e15525. [PMID: 37151697 PMCID: PMC10161713 DOI: 10.1016/j.heliyon.2023.e15525] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2022] [Revised: 04/04/2023] [Accepted: 04/12/2023] [Indexed: 05/09/2023] Open
Abstract
Addiction is a worldwide problem that has a negative impact on society by imposing significant costs on health care, public security, and the deactivation of the community economic cycle. Stress is an important risk factor in the development of addiction and relapse vulnerability. Here we review studies that have demonstrated the diverse roles of stress in addiction. Term searches were conducted manually in important reference journals as well as in the Google Scholar and PubMed databases, between 2010 and 2022. In each section of this narrative review, an effort has been made to use pertinent sources. First, we will provide an overview of changes in the Hypothalamus-Pituitary-Adrenal (HPA) axis component following stress, which impact reward-related regions including the ventral tegmental area (VTA) and nucleus accumbens (NAc). Then we will focus on internal factors altered by stress and their effects on drug addiction vulnerability. We conclude that alterations in neuro-inflammatory, neurotrophic, and neurotransmitter factors following stress pathways can impact related mechanisms on craving and relapse susceptibility.
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Affiliation(s)
- Marjan Nikbakhtzadeh
- Department of Physiology, School of Medicine, Tehran University of Medical Science, Tehran, Iran
| | - Hoda Ranjbar
- Neuroscience Research Center of Kerman, Institute of Neuropharmacology, Kerman University of Medical Science, Kerman, Iran
| | | | - Elham Zahedi
- Department of Physiology, School of Medicine, Tehran University of Medical Science, Tehran, Iran
| | - Mahnaz Bayat
- Clinical Neurology Research Centre, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Monavareh Soti
- Neuroscience Research Center of Kerman, Institute of Neuropharmacology, Kerman University of Medical Science, Kerman, Iran
- Corresponding author. Neuroscience Research Center, Neuropharmacology institute, Kerman University of Medical Sciences, Kerman, Postal Code: 76198-13159, Iran.
| | - Mohammad Shabani
- Neuroscience Research Center of Kerman, Institute of Neuropharmacology, Kerman University of Medical Science, Kerman, Iran
- Corresponding author. Neuroscience Research Center, Neuropharmacology institute, Kerman University of Medical Sciences, Kerman, Postal Code: 76198-13159, Iran.
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Bodnar RJ. Endogenous opiates and behavior: 2021. Peptides 2023; 164:171004. [PMID: 36990387 DOI: 10.1016/j.peptides.2023.171004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/26/2023] [Revised: 03/23/2023] [Accepted: 03/23/2023] [Indexed: 03/29/2023]
Abstract
This paper is the forty-fourth consecutive installment of the annual anthological review of research concerning the endogenous opioid system, summarizing articles published during 2021 that studied the behavioral effects of molecular, pharmacological and genetic manipulation of opioid peptides and receptors as well as effects of opioid/opiate agonizts and antagonists. The review is subdivided into the following specific topics: molecular-biochemical effects and neurochemical localization studies of endogenous opioids and their receptors (1), the roles of these opioid peptides and receptors in pain and analgesia in animals (2) and humans (3), opioid-sensitive and opioid-insensitive effects of nonopioid analgesics (4), opioid peptide and receptor involvement in tolerance and dependence (5), stress and social status (6), learning and memory (7), eating and drinking (8), drug abuse and alcohol (9), sexual activity and hormones, pregnancy, development and endocrinology (10), mental illness and mood (11), seizures and neurologic disorders (12), electrical-related activity and neurophysiology (13), general activity and locomotion (14), gastrointestinal, renal and hepatic functions (15), cardiovascular responses (16), respiration and thermoregulation (17), and immunological responses (18).
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Affiliation(s)
- Richard J Bodnar
- Department of Psychology and Neuropsychology Doctoral Sub-Program, Queens College, City University of New York, CUNY, 65-30 Kissena Blvd., Flushing, NY 11367, USA.
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Moorman DE, Aston-Jones G. Prelimbic and infralimbic medial prefrontal cortex neuron activity signals cocaine seeking variables across multiple timescales. Psychopharmacology (Berl) 2023; 240:575-594. [PMID: 36464693 PMCID: PMC10406502 DOI: 10.1007/s00213-022-06287-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/20/2022] [Accepted: 11/23/2022] [Indexed: 12/12/2022]
Abstract
RATIONALE AND OBJECTIVES The prefrontal cortex is critical for execution and inhibition of reward seeking. Neural manipulation of rodent medial prefrontal cortex (mPFC) subregions differentially impacts execution and inhibition of cocaine seeking. Dorsal, or prelimbic (PL), and ventral, or infralimbic (IL) mPFC are implicated in cocaine seeking or extinction of cocaine seeking, respectively. This differentiation is not seen across all studies, indicating that further research is needed to understand specific mPFC contributions to drug seeking. METHODS We recorded neuronal activity in mPFC subregions during cocaine self-administration, extinction, and cue- and cocaine-induced reinstatement of cocaine seeking. RESULTS Both PL and IL neurons were phasically responsive around lever presses during cocaine self-administration, and activity in both areas was reduced during extinction. During both cue- and, to a greater extent, cocaine-induced reinstatement, PL neurons exhibited significantly elevated responses, in line with previous studies demonstrating a role for the region in relapse. The enhanced PL signaling in cocaine-induced reinstatement was driven by strong excitation and inhibition in different groups of neurons. Both of these response types were stronger in PL vs. IL neurons. Finally, we observed tonic changes in activity in all tasks phases, reflecting both session-long contextual modulation as well as minute-to-minute activity changes that were highly correlated with brain cocaine levels and motivation associated with cocaine seeking. CONCLUSIONS Although some differences were observed between PL and IL neuron activity across sessions, we found no evidence of a go/stop dichotomy in PL/IL function. Instead, our results demonstrate temporally heterogeneous prefrontal signaling during cocaine seeking and extinction in both PL and IL, revealing novel and complex functions for both regions during these behaviors. This combination of findings argues that mPFC neurons, in both PL and IL, provide multifaceted contributions to the regulation of drug seeking and addiction.
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Affiliation(s)
- David E Moorman
- Department of Psychological and Brain Sciences & Neuroscience and Behavior Graduate Program, University of Massachusetts Amherst, Amherst, MA, 01003, USA.
| | - Gary Aston-Jones
- Brain Health Institute, Rutgers University and Rutgers Biomedical and Health Sciences, Piscataway, NJ, 08854, USA
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Lapeyre-Mestre M. Addictovigilance in women, the hidden part of the iceberg? Therapie 2023; 78:157-164. [PMID: 36280399 DOI: 10.1016/j.therap.2022.10.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2022] [Accepted: 08/28/2022] [Indexed: 11/07/2022]
Abstract
Epidemiology of substance use disorders and their complications is driven by a male predominance, and women, even if they are more and more prevalent, are never specifically represented in studies in the field. Apart from the time of pregnancy, which in itself requires specific prevention, treatment and follow-up, the importance of the sex of women in the complications of substance abuse is neglected. To illustrate, we described some characteristics of women identified in the addictovigilance information system in France and Europe, related to drug use disorders (both for illicit substances and medications). Even if the exposure to some psychoactive substances remains more prevalent in men, women, and particularly young women, seem to be more vulnerable to the adverse effects of these substances, as observed for opioid analgesics, benzodiazepines, cannabis and even nitrous oxide. It is now imperative that the female sex/gender be taken into consideration in addictovigilance expertise and in drug safety in general, even for substances for which use is predominantly male. In addition, the adequate management of the women requires the development of specific prevention and care strategies.
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Affiliation(s)
- Maryse Lapeyre-Mestre
- Service de pharmacologie médicale et clinique, centre d'addictovigilance (CEIP-A), CHU de Toulouse-UFR santé, université de Toulouse, 31000 Toulouse, France.
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Abstract
Ulcerated and inflammatory lesions of the oral mucosa are not rare. A detailed patient medical and social history including habits and abuses, as well as the duration, location, focality and presence, or lack of local and/or systemic symptoms is critical in establishing a proper diagnosis. This article discusses the clinical presentation, management, and histopathologic characteristics of a variety of ulcerative and inflammatory lesions seen in the oral cavity.
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Affiliation(s)
- Elizabeth M Philipone
- Division of Oral and Maxillofacial Pathology, Columbia University Irving Medical Center, New York, NY 10032, USA.
| | - Scott M Peters
- Division of Oral and Maxillofacial Pathology, Columbia University Irving Medical Center, New York, NY 10032, USA
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Zisman-Ilani Y, Smith WR, Morris NP. Addressing Substance Use in Psychiatric Care: An Old Problem With Renewed Urgency. Psychiatr Serv 2023; 74:201-203. [PMID: 35833255 DOI: 10.1176/appi.ps.202100724] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
Patients, clinicians, researchers, and policy makers have long called for greater integration of services for people with co-occurring mental and substance use disorders. Decades later, these services remain fragmented in psychiatry across much of the United States. Mounting deaths from drug-related overdoses call for renewed focus on bringing substance use into the center of psychiatric services. This Open Forum explores factors within the field of psychiatry, including insufficient training related to substance use, prevalent stigma surrounding substance use, and limited availability of co-occurring disorder specialists, that reinforce this divide and offers solutions for better addressing substance use disorders in psychiatric care.
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Affiliation(s)
- Yaara Zisman-Ilani
- Department of Social and Behavioral Sciences, College of Public Health, Temple University, Philadelphia (Zisman-Ilani); Department of Clinical, Educational and Health Psychology, Division of Psychology and Language Sciences, University College London, London (Zisman-Ilani); Department of Psychiatry, University of Pennsylvania, Philadelphia (Smith); Department of Psychiatry and Behavioral Sciences, University of California, San Francisco, San Francisco (Morris)
| | - William R Smith
- Department of Social and Behavioral Sciences, College of Public Health, Temple University, Philadelphia (Zisman-Ilani); Department of Clinical, Educational and Health Psychology, Division of Psychology and Language Sciences, University College London, London (Zisman-Ilani); Department of Psychiatry, University of Pennsylvania, Philadelphia (Smith); Department of Psychiatry and Behavioral Sciences, University of California, San Francisco, San Francisco (Morris)
| | - Nathaniel P Morris
- Department of Social and Behavioral Sciences, College of Public Health, Temple University, Philadelphia (Zisman-Ilani); Department of Clinical, Educational and Health Psychology, Division of Psychology and Language Sciences, University College London, London (Zisman-Ilani); Department of Psychiatry, University of Pennsylvania, Philadelphia (Smith); Department of Psychiatry and Behavioral Sciences, University of California, San Francisco, San Francisco (Morris)
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Dunham CM, Huang GS, Chance EA, Hileman BM, Han JS. Trauma activation patient preinjury toxicology-positive proportions and associated risk conditions: A retrospective study. Injury 2023; 54:1334-1341. [PMID: 36737270 DOI: 10.1016/j.injury.2023.01.048] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/05/2022] [Revised: 12/13/2022] [Accepted: 01/26/2023] [Indexed: 01/30/2023]
Abstract
BACKGROUND Unlike prior guidelines for a positive toxicology screen, the 2022 national trauma data bank dictionary requires the exclusion of postinjury drugs. We aimed to (1) investigate the proportion of drugs in the toxicology screen that were given postinjury; (2) determine preinjury toxicology-positive associations with smoking, psychiatric, and drug abuse histories in an activation patient (ACT-Pt) cohort; and (3) explore whether ACT-Pt varied toxicology testing rates would produce similar preinjury toxicology-positive results. METHODS In this retrospective study, the historic parent database included consecutive trauma center admissions where toxicology testing was discretionary. A supplementary electronic medical record audit of ACT-Pts age 18-60 years assessed smoking, psychiatric, and drug abuse histories. Subsequently, ACT-Pt age 18-100 years testing was encouraged by attending surgeons and, later routine testing was implemented. RESULTS Of 2,076 patients in the historic parent database, discretionary toxicology testing occurred in 23.9% (n = 496) and the positive proportion was 58.9% (n = 292). However, 23.6% (n = 69) of the positive screens had the drug given postinjury. The preinjury positive-toxicology proportion was 45.0% (223/496). Preinjury toxicology positivity was greater in ACT-Pts age 18-60 years (52.3%) than in other patients (activations >60 years of age or consultations) (33.7%; p < 0.0001; odds ratio [OR] = 2.2). Smoking, psychiatric, and drug abuse histories were more common in ACT-Pts age 18-60 years preinjury toxicology-positive patients (74.4%, 51.3%, and 98.7%) than in negative patients (36.6%, 25.2%, and 25.2%; p < 0.0001). In ACT-Pts age 18-100 years, when compared to historic discretionary testing (32.7%), testing was increased with encouraged testing (62.1%; p < 0.0001; OR = 3.4) and routine testing (73.1%; p < 0.0001; OR = 5.6). ACT-Pt preinjury toxicology positivity was similar for historic discretionary (47.9%), encouraged (57.6%), and routine (51.3%) (p = 0.3670) testing. The meta-analytic toxicology-positive proportion for the three testing strategies was 49.8%. CONCLUSIONS Substantial toxicology-positive findings are due to postinjury drug administration. Toxicology positivity is associated with ACT-Pts age 18-60 years and smoking, psychiatric, and drug abuse histories. ACT-Pt age 18-100 years preinjury toxicology positivity is 50% and does not vary with different testing proportions and strategies.
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Affiliation(s)
- C Michael Dunham
- Trauma, Critical Care, and General Surgery Services, St. Elizabeth Youngstown Hospital, 1044 Belmont Ave., St. Elizabeth Youngstown Hospital, Youngstown, OH 44501, United States.
| | - Gregory S Huang
- Trauma, Critical Care, and General Surgery Services, St. Elizabeth Youngstown Hospital, 1044 Belmont Ave., St. Elizabeth Youngstown Hospital, Youngstown, OH 44501, United States
| | - Elisha A Chance
- Trauma and Neuroscience Research Department, St. Elizabeth Youngstown Hospital, 1044 Belmont Ave., Youngstown, OH 44501, United States
| | - Barbara M Hileman
- Trauma and Neuroscience Research Department, St. Elizabeth Youngstown Hospital, 1044 Belmont Ave., Youngstown, OH 44501, United States
| | - Jane S Han
- Department of Surgery, St Elizabeth Youngstown Hospital, 1044 Belmont Ave., Youngstown, OH 44501, United States
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