Substance use and addiction

۞يَسۡـَٔلُونَكَ عَنِ ٱلۡخَمۡرِ وَٱلۡمَيۡسِرِۖ قُلۡ فِيهِمَآ إِثۡمࣱ كَبِيرࣱ وَمَنَٰفِعُ لِلنَّاسِ وَإِثۡمُهُمَآ أَكۡبَرُ مِن نَّفۡعِهِمَاۗ وَيَسۡـَٔلُونَكَ مَاذَا يُنفِقُونَۖ قُلِ ٱلۡعَفۡوَۗ كَذَٰلِكَ يُبَيِّنُ ٱللَّهُ لَكُمُ ٱلۡأٓيَٰتِ لَعَلَّكُمۡ تَتَفَكَّرُونَ

They ask you [Prophet] about intoxicants and gambling: say, ‘There is great sin in both, and some benefit for people: the sin is greater than the benefit.’ They ask you what they should give: say, ‘Give what you can spare.’ In this way, God makes His messages clear to you, so that you may reflect

يَٰٓأَيُّهَا ٱلَّذِينَ ءَامَنُوٓاْ إِنَّمَا ٱلۡخَمۡرُ وَٱلۡمَيۡسِرُ وَٱلۡأَنصَابُ وَٱلۡأَزۡلَٰمُ رِجۡسࣱ مِّنۡ عَمَلِ ٱلشَّيۡطَٰنِ فَٱجۡتَنِبُوهُ لَعَلَّكُمۡ تُفۡلِحُونَ

You who believe, intoxicants and gambling, idolatrous practices, and [divining with] arrows are repugnant acts- Satan’s doing- shun them so that you may prosper

إِنَّمَا يُرِيدُ ٱلشَّيۡطَٰنُ أَن يُوقِعَ بَيۡنَكُمُ ٱلۡعَدَٰوَةَ وَٱلۡبَغۡضَآءَ فِي ٱلۡخَمۡرِ وَٱلۡمَيۡسِرِ وَيَصُدَّكُمۡ عَن ذِكۡرِ ٱللَّهِ وَعَنِ ٱلصَّلَوٰةِۖ فَهَلۡ أَنتُم مُّنتَهُونَ

With intoxicants and gambling, Satan seeks only to incite enmity and hatred among you, and to stop you remembering God and prayer. Will you not give them up

يَٰصَٰحِبَيِ ٱلسِّجۡنِ أَمَّآ أَحَدُكُمَا فَيَسۡقِي رَبَّهُۥ خَمۡرࣰ اۖ وَأَمَّا ٱلۡأٓخَرُ فَيُصۡلَبُ فَتَأۡكُلُ ٱلطَّيۡرُ مِن رَّأۡسِهِۦۚ قُضِيَ ٱلۡأَمۡرُ ٱلَّذِي فِيهِ تَسۡتَفۡتِيَانِ

Fellow prisoners, one of you will serve his master with wine; the other will be crucified and the birds will peck at his head. That is the end of the matter on which you asked my opinion.’

مَّثَلُ ٱلۡجَنَّةِ ٱلَّتِي وُعِدَ ٱلۡمُتَّقُونَۖ فِيهَآ أَنۡهَٰرࣱ مِّن مَّآءٍ غَيۡرِ ءَاسِنࣲ وَأَنۡهَٰرࣱ مِّن لَّبَنࣲ لَّمۡ يَتَغَيَّرۡ طَعۡمُهُۥ وَأَنۡهَٰرࣱ مِّنۡ خَمۡرࣲ لَّذَّةࣲ لِّلشَّٰرِبِينَ وَأَنۡهَٰرࣱ مِّنۡ عَسَلࣲ مُّصَفࣰّ ىۖ وَلَهُمۡ فِيهَا مِن كُلِّ ٱلثَّمَرَٰتِ وَمَغۡفِرَةࣱ مِّن رَّبِّهِمۡۖ كَمَنۡ هُوَ خَٰلِدࣱ فِي ٱلنَّارِ وَسُقُواْ مَآءً حَمِيمࣰ ا فَقَطَّعَ أَمۡعَآءَهُمۡ

Here is a picture of the Garden promised to the pious: rivers of water forever pure, rivers of milk forever fresh, rivers of wine, a delight for those who drink, rivers of honey clarified and pure, [all] flow in it; there they will find fruit of every kind; and they will find forgiveness from their Lord. How can this be compared to the fate of those stuck in the Fire, given boiling water to drink that tears their bowels

وَدَخَلَ مَعَهُ ٱلسِّجۡنَ فَتَيَانِۖ قَالَ أَحَدُهُمَآ إِنِّيٓ أَرَىٰنِيٓ أَعۡصِرُ خَمۡرࣰ اۖ وَقَالَ ٱلۡأٓخَرُ إِنِّيٓ أَرَىٰنِيٓ أَحۡمِلُ فَوۡقَ رَأۡسِي خُبۡزࣰ ا تَأۡكُلُ ٱلطَّيۡرُ مِنۡهُۖ نَبِّئۡنَا بِتَأۡوِيلِهِۦٓۖ إِنَّا نَرَىٰكَ مِنَ ٱلۡمُحۡسِنِينَ

Two young men went into prison alongside him. One of them said, ‘I dreamed that I was pressing grapes’; the other said, ‘I dreamed that I was carrying bread on my head and that the birds were eating it.’ [They said], ‘Tell us what this means- we can see that you are a knowledgeable man.’

They ask thee about wine and gambling.... And they ask thee what they should expend. God has servants on the earth who drink the wine of recognition and are drunk from the cup of love. There is no more than a whiff of this wine's reality in this world, and nothing but a show of that drunkenness, for this world is a prison, and what can a prison put up with? Today there is no more than that. Nonetheless, wait until tomorrow, the assembly of repose and ease [56:89], the arena of union with the Beloved, when the servants will be gazing on the Real. Hope for union with you has added to my life. What can union itself be, when hope does that!? A man in turmoil entered the shop of a wine merchant with one dirham. He said, “Give me wine for this dirham.” The merchant replied, “There's no wine left.” The man said, “I'm already in turmoil. I can't tolerate wine's reality. Show me a drop so I may s

O you who have faith! Wine, arrow-shuffling, idols, and divining arrows are a filth and of the deeds of Satan. The Prophet said, “Wine is the gatherer of sin and the mother of loathsome things”: Wine is the root of loathsome things and the key to great sins, the basis of misdeeds, the seed of misguided acts, and the source of discord. It dries up the springhead of obedience, holds back the water of remembrance, and opens the door to heedlessness. The soul becomes drunk from wine and is held back from the prayer. The heart becomes drunk from heedlessness and is held back from secret whispering. The Pir of the Tariqah spoke to these heedless people in the tongue of admonition: “O drunk- ards full of appetite! O sleepers in heedlessness! Have shame before that Lord who knows the treachery of the eyes and sees the inside of the hearts! He knows the treachery of the eyes and what the breasts

They ask you about wine and divinatory arrows gambling and what the ruling is regarding them. Say to them ‘In both that is in the partaking of both is great sin a variant reading for kabīr ‘great’ has kathīr ‘much’ because of the fighting cursing and swearing that ensue from it; and profit for men by way of delight and enjoyment in wine and acquiring money effortlessly from gambling; but the sin in them that is the degenerate behaviour in which they result is greater graver than the usefulness’. When this verse was revealed some gave up drinking while others persisted until the verse of sūrat al-Mā’ida Q. 590-91 finally made it illicit. And they will ask you what that is to say how much they should expend. Say expend ‘Comfortably’ al-‘afwa in the accusative is also read in the nominative al-‘afwu implying a preceding huwa that is the surplus of your need and do not expend what you need r

O you who believe verily wine that intoxicates and overcomes the mind and games of chance gambling and idols and divinatory arrows are an abomination an evil deemed vile of Satan’s work which he adorns; so avoid it this abomination consisting of the things mentioned do not do it; so that you might prosper.

Satan desires only to precipitate enmity and hatred between you through wine and games of chance when you partake of them because of the evil and discord that result therefrom; and to bar you by your being preoccupied with them from the remembrance of God and from prayer — He has specifically mentioned it prayer so as to magnify it. So will you then desist? from partaking of them? In other words Desist!

O you who believe! Khamr, Maysir, Ansab, and Azlam are a Rijs of Shaytan's handiwork. So avoid that in order that you may be successful (90)Shaytan wants only to excite enmity and hatred between you with Khamr and Maysir, and hinder you from the remembrance of Allah and from the Salah (the prayer). So, will you not then abstai (91)And obey Allah and obey the Messenger, and beware. Then if you turn away, you should know that it is Our Messenger's duty to convey in the clearest way (92)Those who believe and do righteous good deeds, there is no sin on them for what they ate, if they have Taqwa and believe and do righteous good deeds, and they (again) have Taqwa and believe, and then (once again) have Taqwa and perform good. And Allah loves the good-doers (93) Prohibiting Khamr (Intoxicants) and Maysir (Gambling) Allah forbids His believing servants from consuming Khamr and Maysir which is

حَدَّثَنَا أَبُو زَكَرِيَّا، يَحْيَى بْنُ دُرُسْتَ الْبَصْرِيُّ حَدَّثَنَا حَمَّادُ بْنُ زَيْدٍ، عَنْ أَيُّوبَ، عَنْ نَافِعٍ، عَنِ ابْنِ عُمَرَ، قَالَ قَالَ رَسُولُ اللَّهِ صلى الله عليه وسلم ‏ "‏ كُلُّ مُسْكِرٍ خَمْرٌ وَكُلُّ مُسْكِرٍ حَرَامٌ وَمَنْ شَرِبَ الْخَمْرَ فِي الدُّنْيَا فَمَاتَ وَهُوَ يُدْمِنُهَا لَمْ يَشْرَبْهَا فِي الآخِرَةِ ‏"‏ ‏.‏ قَالَ وَفِي الْبَابِ عَنْ أَبِي هُرَيْرَةَ وَأَبِي سَعِيدٍ وَعَبْدِ اللَّهِ بْنِ عَمْرٍو وَابْنِ عَبَّاسٍ وَعُبَادَةَ وَأَبِي مَالِكٍ الأَشْعَرِيِّ ‏.‏ قَالَ أَبُو عِيسَى حَدِيثُ ابْنِ عُمَرَ حَدِيثٌ حَسَنٌ صَحِيحٌ وَقَدْ رُوِيَ مِنْ غَيْرِ وَجْهٍ عَنْ نَافِعٍ عَنِ ابْنِ عُمَرَ عَنِ النَّبِيِّ صلى الله عليه وسلم ‏.‏ وَرَوَاهُ مَالِكُ بْنُ أَنَسٍ عَنْ نَافِعٍ عَنِ ابْنِ عُمَرَ مَوْقُوفًا فَلَمْ يَرْفَعْهُ ‏.‏

Narrated Ibn 'Umar: That the Messenger of Allah (ﷺ) said: "Every intoxicant is Khamr, and every intoxicant is unlawful. Whoever drinks Khamr in this world, and dies continuing it, he will not drink it in the Hereafter. He said: There are narrations on this topic from Abu Hurairah, Abu Sa'eed, 'Abdullah bin 'Amr, 'Ubadah, Abu Malik Al-Ash'ari, and Ibn 'Abbas. [Abu 'Eisa said:] The Hadith of Ibn 'Umar is a Hasan Sahih Hadith. It has been reported through other routes from Nafi', from Ibn 'Umar, from the Prophet (ﷺ). Malik bin Anas reported it from Nafi' from Ibn 'Umar in Mawquf - not Marfu' form

حَدَّثَنَا قُتَيْبَةُ، حَدَّثَنَا جَرِيرُ بْنُ عَبْدِ الْحَمِيدِ، عَنْ عَطَاءِ بْنِ السَّائِبِ، عَنْ عَبْدِ اللَّهِ بْنِ عُبَيْدِ بْنِ عُمَيْرٍ، عَنْ أَبِيهِ، قَالَ قَالَ عَبْدُ اللَّهِ بْنُ عُمَرَ قَالَ رَسُولُ اللَّهِ صلى الله عليه وسلم ‏ "‏ مَنْ شَرِبَ الْخَمْرَ لَمْ يَقْبَلِ اللَّهُ لَهُ صَلاَةً أَرْبَعِينَ صَبَاحًا فَإِنْ تَابَ تَابَ اللَّهُ عَلَيْهِ فَإِنْ عَادَ لَمْ يَقْبَلِ اللَّهُ لَهُ صَلاَةً أَرْبَعِينَ صَبَاحًا فَإِنْ تَابَ تَابَ اللَّهُ عَلَيْهِ فَإِنْ عَادَ لَمْ يَقْبَلِ اللَّهُ لَهُ صَلاَةً أَرْبَعِينَ صَبَاحًا فَإِنْ تَابَ تَابَ اللَّهُ عَلَيْهِ فَإِنْ عَادَ الرَّابِعَةَ لَمْ يَقْبَلِ اللَّهُ لَهُ صَلاَةً أَرْبَعِينَ صَبَاحًا فَإِنْ تَابَ لَمْ يَتُبِ اللَّهُ عَلَيْهِ وَسَقَاهُ مِنْ نَهْرِ الْخَبَالِ ‏"‏ ‏.‏ قِيلَ يَا أَبَا عَبْدِ الرَّحْمَنِ وَمَا نَهْرُ الْخَبَالِ قَالَ نَهْرٌ مِنْ صَدِيدِ أَهْلِ النَّارِ ‏.‏ قَالَ أَبُو عِيسَى هَذَا حَدِيثٌ حَسَنٌ وَقَدْ رُوِيَ نَحْوُ هَذَا عَنْ عَبْدِ اللَّهِ بْنِ عَمْرٍو وَابْنِ عَبَّاسٍ عَنِ النَّبِيِّ صلى الله عليه وسلم ‏.‏

Narrated 'Abdullah bin 'Umar: That the Messenger of Allah (ﷺ) said: "Whoever drinks Khamr, Salat is not accepted from him for forty days. If he repents, then Allah will accept his repentance. It he returns to it, then Allah will not accept his Salat for forty days. If he repents, then Allah will accept his repentance. If he returns to it, then Allah will not accepts his Salat for forty days. If he repents, then Allah will accept his repentance. If he returns to it a fourth time, Allah will not accept his Salat for forty days, and if he were to repent, Allah would not accept his repentance, and he will be given to drink from the river of Al-Khabal." They said: "O Aby 'Abdur-Rahman! What is the river of Al-Khabal?" He said: "A river of the pus from the inhabitants of the Fire." [Abu 'Eisa said:] This Hadith is Hasan. Similar to this has been reported from 'Abdullah bin 'Amr and Ibn 'Abbas from the Prophet (ﷺ)

حَدَّثَنَا أَحْمَدُ بْنُ حَنْبَلٍ، حَدَّثَنَا إِسْمَاعِيلُ بْنُ إِبْرَاهِيمَ، حَدَّثَنَا أَبُو حَيَّانَ، حَدَّثَنِي الشَّعْبِيُّ، عَنِ ابْنِ عُمَرَ، عَنْ عُمَرَ، قَالَ نَزَلَ تَحْرِيمُ الْخَمْرِ يَوْمَ نَزَلَ وَهِيَ مِنْ خَمْسَةِ أَشْيَاءَ مِنَ الْعِنَبِ وَالتَّمْرِ وَالْعَسَلِ وَالْحِنْطَةِ وَالشَّعِيرِ وَالْخَمْرُ مَا خَامَرَ الْعَقْلَ وَثَلاَثٌ وَدِدْتُ أَنَّ رَسُولَ اللَّهِ صلى الله عليه وسلم لَمْ يُفَارِقْنَا حَتَّى يَعْهَدَ إِلَيْنَا فِيهِنَّ عَهْدًا نَنْتَهِي إِلَيْهِ الْجَدُّ وَالْكَلاَلَةُ وَأَبْوَابٌ مِنْ أَبْوَابِ الرِّبَا ‏.‏

’Umar said :The prohibition of wine came down when (the Quranic verse ) came down. It was made from five thing namely, grapes, dates, honey, wheat ,barley. Wine is what infects (khamara) the mind. There are three things I wished that the prophet (ﷺ) would not leave us until he explained them fully to our satisfaction: (share of) grandfather, one who leaves no descendants or ascendants as hairs, and the details of usury

حَدَّثَنَا عَبَّادُ بْنُ مُوسَى الْخُتَّلِيُّ، أَخْبَرَنَا إِسْمَاعِيلُ، - يَعْنِي ابْنَ جَعْفَرٍ - عَنْ إِسْرَائِيلَ، عَنْ أَبِي إِسْحَاقَ، عَنْ عَمْرٍو، عَنْ عُمَرَ بْنِ الْخَطَّابِ، قَالَ لَمَّا نَزَلَ تَحْرِيمُ الْخَمْرِ قَالَ عُمَرُ اللَّهُمَّ بَيِّنْ لَنَا فِي الْخَمْرِ بَيَانًا شِفَاءً فَنَزَلَتِ الآيَةُ الَّتِي فِي الْبَقَرَةِ ‏{‏ يَسْأَلُونَكَ عَنِ الْخَمْرِ وَالْمَيْسِرِ قُلْ فِيهِمَا إِثْمٌ كَبِيرٌ ‏}‏ الآيَةَ قَالَ فَدُعِيَ عُمَرُ فَقُرِئَتْ عَلَيْهِ قَالَ اللَّهُمَّ بَيِّنْ لَنَا فِي الْخَمْرِ بَيَانًا شِفَاءً فَنَزَلَتِ الآيَةُ الَّتِي فِي النِّسَاءِ ‏{‏ يَا أَيُّهَا الَّذِينَ آمَنُوا لاَ تَقْرَبُوا الصَّلاَةَ وَأَنْتُمْ سُكَارَى ‏}‏ فَكَانَ مُنَادِي رَسُولِ اللَّهِ صلى الله عليه وسلم إِذَا أُقِيمَتِ الصَّلاَةُ يُنَادِي أَلاَ لاَ يَقْرَبَنَّ الصَّلاَةَ سَكْرَانُ فَدُعِيَ عُمَرُ فَقُرِئَتْ عَلَيْهِ فَقَالَ اللَّهُمَّ بَيِّنْ لَنَا فِي الْخَمْرِ بَيَانًا شِفَاءً فَنَزَلَتْ هَذِهِ الآيَةُ ‏{‏ فَهَلْ أَنْتُمْ مُنْتَهُونَ ‏}‏ قَالَ عُمَرُ انْتَهَيْنَا ‏.‏

Narrated Umar ibn al-Khattab: When the prohibition of wine (was yet to be) declared, Umar said: O Allah, give us a satisfactory explanation about wine. So the following verse of Surat al-Baqarah revealed; "They ask thee concerning wine and gambling. Say: In them is great sin...." Umar was then called and it was recited to him. He said: O Allah, give us a satisfactory explanation about wine. Then the following verse of Surat an-Nisa' was revealed: "O ye who believe! approach not prayers with a mind befogged...." Thereafter the herald of the Messenger of Allah (ﷺ) would call when the (congregational) prayer was performed: Beware, one who is drunk should not come to prayer. Umar was again called and it was recited to him). He said: O Allah, give us a satisfactory explanation about wine. This verse was revealed: "Will ye not then abstain?" Umar said: We abstained

وأما النبات فلا يحرم منه إلا ما يزيل العقل أو يزيل الحياة أو الصحة فمزيل العقل البنج و الخمر وسائر المسكرات ومزيل الحياة السموم ومزيل الصحة الأدوية في غير وقتها وكأن مجموع هذا يرجع إلى الضرر إلا الخمر و المسكرات فإن الذي لا يسكر منها أيضا حرام مع قلته لعينه ولصفته وهي الشدة المطربة

وقد يبيح هؤلاء شرب الخمر على وجه التداوي وحفظ الصحة إذا سلم من معرة السكر

وقال يزيد بن الوليد إياكم والغناء فإنه ينقص الحياء ويزيد الشهوة ويهدم المروءة وإنه لينوب عن الخمر ويفعل ما يفعله السكر فإن كنتم لا بد فاعلين فجنبوه النساء فإن الغناء داعية الزنا

وأما حديث عبدالله بن عمرو فروى أحمد في مسنده وأبو داود عنه أن النبيقال : إن الله تعالى حرم على أمتي الخمر والميسر والكوبة والغبيراء وكل مسكر حرام

أما الجمادات فطاهرة كلها إلا الخمر وكل منتبذ مسكر والحيوانات طاهرة كلها إلا الكلب والخنزير وما تولد منهما أو من أحدهما

وأما حديث ابن عباس ففي المسند أيضا : عنه أن رسول اللهقال : إن الله حرم الخمر والميسر والكوبة وكل مسكر حرام والكوبة الطبل قاله سفيان وقيل : البربط والقنين هو الطنبور بالحبشية والتقنين : الضرب به قاله ابن الأعرابي

Effects of lofexidine on stress-induced and cue-induced opioid craving and opioid abstinence rates: preliminary findings.: Objective: A preliminary study examined whether lofexidine decreases stress-induced and cue-induced opioid craving and improves opioid abstinence in naltrexone-treated opioid-dependent individuals. Materials and methods: Eighteen opioid-dependent patients were stabilized for 4 weeks with naltrexone (50 mg daily) and lofexidine (2.4 mg bid) before entering a 4-week randomized, double-blind placebo-controlled discontinuation study where one group continued on lofexidine for an additional 4 weeks,

A randomized controlled trial of a gender-focused addiction model versus 12-step facilitation for women veterans.: Background and objectives: Substance use disorder (SUD) has increased among women, including military veterans, yet SUD treatment was historically designed for males. This randomized controlled trial compared 12 individual sessions of a gender-focused SUD recovery model, A Woman's Path to Recovery (WPR) to an evidence-based, non-gender-focused SUD model, 12-Step Facilitation (TSF) for 66 women veterans with current severe SUD. Methods: The primary outcome was substance use; secondary outcomes we

Prevalence of comorbid disorders in problem and pathological gambling: systematic review and meta-analysis of population surveys.: Aims: This paper reviews evidence pertaining to the prevalence of common comorbid disorders, including alcohol use disorder, depression, substance use disorders, nicotine dependence, anxiety disorders and antisocial personality disorder, in population-representative samples of problem and pathological gamblers. Methods: A systematic search was conducted for peer-reviewed and unpublished articles reported between 1 January 1998 and 20 September 2010. Only studies which examined the prevalence of

Effortful Control - A Transdiagnostic Dimension Underlying Internalizing and Externalizing Psychopathology.: Effortful control (EC) or self-regulation refers to the ability to regulate behavior, emotion, and cognition. It has been identified as a contributor to both adaptive and adverse outcomes in children, adolescents, and adults and this across many domains. As such, it could be considered as a transdiagnostic dimension underlying internalizing (e.g., mood and anxiety disorders) and externalizing (e.g., substance use disorders, ADHD) psychopathology. We aimed to examine the role of EC throughout the

Randomized trial comparing mindfulness-based relapse prevention with relapse prevention for women offenders at a residential addiction treatment center.: Reincarceration rates are high among substance-involved criminal offenders. This study (conducted during 2010-2011 in an urban area and funded by a Washington State University-Vancouver mini-grant) used a randomized design to examine the effectiveness of mindfulness-based relapse prevention (MBRP) as compared to relapse prevention (RP), as part of a residential addictions treatment program for women referred by the criminal-justice system (N = 105). At 15-week follow up, regression analyses foun

Prevalence of substance use disorder comorbidity among individuals with eating disorders: A systematic review and meta-analysis.: Objective: Although prior meta-analyses have significantly enriched the available literature on the comorbidity of substance use disorders (SUD) among individuals with eating disorders (ED), there have been few, recent, comprehensive reviews, and limited meta-analyses that include a range of SUDs. Method: In accordance with the PRISMA guidelines, six electronic databases were searched, and a total of 1013 articles were identified using a combination of search terms to identify relevant prevalenc

Subtyping pathological gamblers based on impulsivity, depression, and anxiety.

This study examined putative subtypes of pathological gamblers (PGs) based on the Pathways model, and it also evaluated whether the subtypes would benefit differentially from treatment. Treatment-seeking PGs (N = 229) were categorized into Pathways subtypes based on scores from questionnaires assessing anxiety, depression, and impulsivity. The Addiction Severity Index-Gambling assessed severity of gambling problems at baseline, posttreatment, and 12-month follow-up. Compared with behaviorally conditioned (BC) gamblers, emotionally vulnerable (EV) gamblers had higher psychiatric and gambling severity, and were more likely to have a parent with a psychiatric history. Antisocial impulsive (AI) gamblers also had elevated gambling and psychiatric severity relative to BC gamblers. They were more likely to have antisocial personality disorder and had the highest legal and family/social severity…

matched on Behavior, Addictive (mesh)

Longer term effect of randomized, controlled group cognitive behavioural therapy for Internet addiction in adolescent students in Shanghai.

Objective: The aim of the present study was to evaluate the therapeutic effectiveness of group cognitive behavioural therapy (CBT) for Internet addiction in adolescents. Method: A total of 56 patients, who met Beard's diagnostic criteria for Internet addiction, aged 12-17 years, were divided randomly into an active treatment group (n = 32) and a clinical control group (n = 24). Participants in the active treatment group were treated with an eight-session multimodal school-based group CBT while participants in the clinical control group received no intervention. Internet use, time management, emotional, cognitive and behavioural measures were assessed for both groups at baseline, immediately after the intervention and at 6 month follow up by investigators blind to the participants' group status. Results: Internet use decreased in both groups while only the multimodal school-based group CB…

matched on Behavior, Addictive (mesh)

Nicotine replacement in abstinent smokers improves cognitive withdrawal symptoms with modulation of resting brain network dynamics.

Symptoms of cognitive impairment during smoking withdrawal can be ameliorated by nicotine replacement. To define brain mechanisms contributing to this therapeutic effect, we conducted a functional connectivity analysis of resting-state fMRI in 17 abstinent smokers following nicotine replacement in a double-blind, placebo-controlled, crossover design. We found that individual differences in cognitive withdrawal symptom improvements after nicotine replacement were associated with increased inverse coupling between executive control and default mode brain networks. Furthermore, improvements in withdrawal symptoms were negatively correlated with altered functional connectivity within the default mode network, and with connectivity between the executive control network and regions implicated in reward processing. These findings demonstrate that nicotine administration in abstinent smokers mod…

matched on Substance Withdrawal Syndrome (mesh)

OROS-methylphenidate or placebo for adult smokers with attention deficit hyperactivity disorder: racial/ethnic differences.

Objective: To explore racial/ethnic difference in OROS-methylphenidate (OMPH) efficacy when added to nicotine patch and counseling for treating nicotine dependence among smokers with attention deficit hyperactivity disorder (ADHD). Method: Participants were adult smokers with ADHD (202 whites and 51 non-whites) randomly assigned to OMPH or placebo in a multi-site, randomized controlled trial. Study outcomes were complete, prolonged, and point-prevalence abstinence at the end of treatment, and weekly ratings of ADHD symptoms, tobacco withdrawal symptoms, and desire to smoke. Results: The rate of four-week complete abstinence (no slips or lapses) was significantly higher with OMPH than placebo among non-white (OMPH=42.9%, placebo=13.3%, chi(2)(1)=5.20, p=0.02) but not white participants (OMPH=23.1%, placebo=23.5%, chi(2)(1)=0.00, p=0.95). Patterns of prolonged and point-prevalence abstinen…

matched on Substance Withdrawal Syndrome (mesh)

The cost-effectiveness of prize-based and voucher-based contingency management in a population of cocaine- or opioid-dependent outpatients.

Objective: To evaluate the cost-effectiveness of using prize-based and voucher-based contingency management (CM) as additions to standard treatment for cocaine- or heroin-dependent outpatients in community treatment centers. Methods: This cost-effectiveness analysis is based on a randomized clinical trial conducted at three community-based outpatient psychosocial substance abuse treatment clinics. A total of 142 cocaine- or heroin-dependent outpatients were randomly assigned to one of three treatment conditions: standard treatment (ST), ST with prizes (prize CM), or ST with vouchers (voucher CM) for 12 weeks. The primary patient outcome was the longest duration of confirmed abstinence (LDA) from cocaine, opioids and alcohol during treatment. Unit costs were collected from the three participating clinics. Resource utilizations and patient outcomes were obtained from the clinical trial. In…

matched on Opioid-Related Disorders (mesh)

Cognitive-behavioural, pharmacological and psychosocial predictors of outcome during tapered discontinuation of benzodiazepine.

Eighty-six participants wishing to stop benzodiazepine and who met DSM-IV (Diagnostic and Statistical Manual of Mental Disorders, 4th ed. American Psychological Association, 1994) criteria for anxiety disorder or insomnia were assessed pre- and post-taper on clinical, pharmacological and psychosocial measures. An initial cohort of 41 participants received treatment as usual (taper only) plus physician counselling in the same clinic setting. A second cohort of 45 participants were randomly allocated to group cognitive-behavioural therapy (CBT) plus taper, or group support (GS) plus taper. At 3 months follow-up, the outcomes in both the CBT and the GS subgroups were equivalent. Intention to treat analysis revealed a slight advantage to the CBT over the GS group and the CBT group showed higher self-efficacy post-taper. Over all 86 participants, a high-baseline level of psychological distres…

matched on Substance Withdrawal Syndrome (mesh)

Multicenter investigation of the opioid antagonist nalmefene in the treatment of pathological gambling.

Objective: Pathological gambling is a disabling disorder experienced by approximately 1%-2% of adults and for which there are few empirically validated treatments. The authors examined the efficacy and tolerability of the opioid antagonist nalmefene in the treatment of adults with pathological gambling. Method: A 16-week, randomized, dose-ranging, double-blind, placebo-controlled trial was conducted at 15 outpatient treatment centers across the United States between March 2002 and April 2003. Two hundred seven persons with DSM-IV pathological gambling were randomly assigned to receive nalmefene (25 mg/day, 50 mg/day, or 100 mg/day) or placebo. Scores on the primary outcome measure (Yale-Brown Obsessive Compulsive Scale Modified for Pathological Gambling) were analyzed by using a linear mixed-effects model. Results: Estimated regression coefficients showed that the 25 mg/day and 50 mg/day…

matched on Behavior, Addictive (mesh)

Controlled trial of prescribed heroin in the treatment of opioid addiction.

Aim: This study aimed to assess the efficacy of the prescription of intravenous diacetylmorphine (DAM) versus oral methadone with medical and psychosocial support, with a view of improving physical and mental health as well as social integration among socially excluded, opioid-dependent individuals for whom standard treatments have failed. Design: This study used an open, randomized controlled trial. Setting: This study took place in Granada, Spain. Participants: Sixty-two opioid-dependent participants were randomized, 31 in each treatment group, and 50 of them were analyzed. The participants were recruited directly from the streets, through peer outreach, in well-known meeting places for drug-addicted individuals. Interventions: Participants in the experimental group received injected DAM, twice a day, plus oral methadone, once a day, for 9 months. The control group received only oral m…

matched on Opioid-Related Disorders (mesh)

Virtual Reality (VR) in Assessment and Treatment of Addictive Disorders: A Systematic Review.

Background: Substance Use Disorder (SUD) and behavioral addictions are common and require a multidisciplinary approach. New technologies like Virtual Reality could have the potential to improve assessment and treatment of these disorders. Objective: In the present paper, we therefore present an overview of Virtual Reality (Head Mounted Devices) in the field of addiction medicine for craving assessment and treatment. Method: We conducted a systematic review by querying PubMed database for the titles of articles published up to March 2019 with the terms [virtual] AND [addictive] OR [addiction] OR [substance] OR [alcohol] OR [cocaine] OR [cannabis] OR [opioid] OR [tobacco] OR [nicotine] OR [methamphetamine] OR [gaming] OR [gambling]. Results: We screened 319 abstracts and analyzed 37 articles, dividing them into two categories, the first for assessment of cue reactivity (craving, psychophys…

matched on substance use disorder (text), craving (text)

Stress and substance use disorders: risk, relapse, and treatment outcomes.

Stress has long been associated with substance misuse and substance use disorders (SUDs). The past two decades have seen a surge in research aimed at understanding the underlying mechanisms driving this association. This Review introduces a multilevel "adaptive stress response" framework, encompassing a stress baseline, acute reaction, and recovery with return-to-homeostasis phase that occurs at varying response times and across domains of analysis. It also discusses evidence showing the disruption of this adaptive stress response in the context of chronic and repeated stressors, trauma, adverse social and drug-related environments, as well as with acute and chronic drug misuse and with drug withdrawal and abstinence sequelae. Subjective, cognitive, peripheral, and neurobiological disruptions in the adaptive stress response phases and their link to inflexible, maladaptive coping; increas…

matched on Substance-Related Disorders (mesh), substance use disorder (text), craving (text), relapse (text)

Therapeutic efficacy of environmental enrichment for substance use disorders.

Addiction to drug and alcohol is regarded as a major health problem worldwide for which available treatments show limited effectiveness. The biggest challenge remains to enhance the capacities of interventions to reduce craving, prevent relapse and promote long-term recovery. New strategies to meet these challenges are being explored. Findings from preclinical work suggest that environmental enrichment (EE) holds therapeutic potential for the treatment of substance use disorders, as demonstrated in a number of animal models of drug abuse. The EE intervention introduced after drug exposure leads to attenuation of compulsive drug taking, attenuation of the rewarding (and reinforcing) effects of drugs, reductions in control of behavior by drug cues, and, very importantly, relapse prevention. Clinical work also suggests that multidimensional EE interventions (involving physical activity, soc…

matched on Substance-Related Disorders (mesh), substance use disorder (text), craving (text), relapse (text)

Brain default-mode network dysfunction in addiction.

Aberrant patterns of brain functional connectivity in the default mode network (DMN) have been observed across different classes of substance use disorder (SUD) and are associated with craving and relapse. In addicted individuals resting functional connectivity (RSFC) of the anterior DMN, which participates in attribution of personal value and emotional regulation, tends to be decreased, whereas RSFC of the posterior DMN, which directs attention to the internal world, tends to be increased. Aberrant RSFC within the DMN is believed to contribute to impaired self-awareness, negative emotions and to ruminations in addiction. Additionally, the disrupted connectivity between DMN and cortical regions involved with executive function, memory and emotion could be critical to drug-taking regardless of negative consequences and to stress-triggered relapse. At the system level, the dynamics of DMN …

matched on Substance-Related Disorders (mesh), substance use disorder (text), craving (text), relapse (text)

Repeated electrical stimulation of reward-related brain regions affects cocaine but not "natural" reinforcement.

Drug addiction is associated with long-lasting neuronal adaptations including alterations in dopamine and glutamate receptors in the brain reward system. Treatment strategies for cocaine addiction and especially the prevention of craving and relapse are limited, and their effectiveness is still questionable. We hypothesized that repeated stimulation of the brain reward system can induce localized neuronal adaptations that may either potentiate or reduce addictive behaviors. The present study was designed to test how repeated interference with the brain reward system using localized electrical stimulation of the medial forebrain bundle at the lateral hypothalamus (LH) or the prefrontal cortex (PFC) affects cocaine addiction-associated behaviors and some of the neuronal adaptations induced by repeated exposure to cocaine. Repeated high-frequency stimulation in either site influenced cocain…

matched on Behavior, Addictive (mesh), craving (text), relapse (text)

Stress-induced cocaine craving and hypothalamic-pituitary-adrenal responses are predictive of cocaine relapse outcomes.

Background: Cocaine dependence is associated with high rates of relapse. Stress and drug cue exposure are known to increase cocaine craving and stress arousal, but the association between these responses and cocaine relapse has not been previously studied. Objective: To examine whether stress-induced and drug cue-induced cocaine craving and hypothalamic-pituitary-adrenal axis responses evoked in the laboratory are associated with subsequent cocaine relapse. Design: Prospective study design assessing cocaine relapse and drug use during a 90-day follow-up period after discharge from inpatient treatment and research. Data were analyzed by Cox proportional hazards regression and multiple regression. Setting: Inpatient treatment and research unit in a community mental health center. Patients: Forty-nine treatment-seeking cocaine-dependent individuals. Main outcome measures: Time to cocaine re…

matched on Behavior, Addictive (mesh), craving (text), relapse (text)

Psychosocial stress after reactivation of drug-related memory impairs later recall in abstinent heroin addicts.

Introduction: Stress and stress hormone are known to play important roles in modulating different stages of memory including reconsolidation. In a previous study, we found that treatment with stress or corticosterone after a single memory reactivation disrupted reconsolidation of a drug-related memory in rats. Here we presumed that stress after memory reactivation can effectively inhibit drug-related memory by disrupting its reconsolidation in abstinent heroin addicts. Materials and methods: In the present study, 21 abstinent heroin addicts learned a word list (containing ten neutral, ten heroin-related negative, and ten heroin-related positive words) on day 1; retrieval of a word list (learned 24 h earlier) was made on day 2; and immediately after retrieval, they were exposed to either a standardized psychosocial laboratory stressor (Trier Social Stress Test) or a control condition in a…

matched on Substance Withdrawal Syndrome (mesh), relapse (text)

What Is the Evidence for "Food Addiction?" A Systematic Review.

The diagnostic construct of "food addiction" is a highly controversial subject. The current systematic review is the first to evaluate empirical studies examining the construct of "food addiction" in humans and animals. Studies were included if they were quantitative, peer-reviewed, and in the English language. The 52 identified studies (35 articles) were qualitatively assessed to determine the extent to which their findings indicated the following addiction characteristics in relation to food: brain reward dysfunction, preoccupation, risky use, impaired control, tolerance/withdrawal, social impairment, chronicity, and relapse. Each pre-defined criterion was supported by at least one study. Brain reward dysfunction and impaired control were supported by the largest number of studies (n = 21 and n = 12, respectively); whereas risky use was supported by the fewest (n = 1). Overall, finding…

matched on substance use disorder (text), relapse (text)

The medial habenula and interpeduncular nucleus circuitry is critical in addiction, anxiety, and mood regulation.

Abstinence from chronic use of addictive drugs triggers an aversive withdrawal syndrome that compels relapse and deters abstinence. Many features of this syndrome are common across multiple drugs, involving both affective and physical symptoms. Some of the network signaling underlying withdrawal symptoms overlaps with activity that is associated with aversive mood states, including anxiety and depression. Given these shared features, it is not surprising that a particular circuit, the dorsal diencephalic conduction system, and the medial habenula (MHb) and interpeduncular nucleus (IPN), in particular, have been identified as critical to the emergence of aversive states that arise both as a result and, independently, of drug addiction. As the features of this circuit continue to be characterized, the MHb-IPN axis is emerging as a viable target for therapeutics to aid in the treatment of a…

matched on Behavior, Addictive (mesh), Substance Withdrawal Syndrome (mesh), relapse (text)

The pharmacological treatment of opioid addiction--a clinical perspective.

This article reviews the main pharmacotherapies that are currently being used to treat opioid addiction. Treatments include detoxification using tapered methadone, buprenorphine, adrenergic agonists such as clonidine and lofexidine, and forms of rapid detoxification. In opioid maintenance treatment (OMT), methadone is most widely used. OMT with buprenorphine, buprenorphine-naloxone combination, or other opioid agonists is also discussed. The use of the opioid antagonists naloxone (for the treatment of intoxication and overdose) and oral and sustained-release formulations of naltrexone (for relapse prevention) is also considered. Although recent advances in the neurobiology of addictions may lead to the development of new pharmacotherapies for the treatment of addictive disorders, a major challenge lies in delivering existing treatments more effectively. Pharmacotherapy of opioid addictio…

matched on Opioid-Related Disorders (mesh), Substance Withdrawal Syndrome (mesh), relapse (text)

An Automated Text Messaging Intervention to Reduce Substance Use Self-Stigma (Project RESTART): Protocol for a Feasibility and Acceptability Pilot Study.

Background: Stigma is a barrier to treatment and harm reduction seeking in people who use drugs. Most stigma reduction interventions offer psychotherapy or psychoeducation in group-based clinical settings, failing to reach people who are not in treatment. SMS text messaging is an effective and acceptable modality for delivering health information to people who use drugs and may be a suitable conduit for providing information and advice to understand and cope with stigma. Objective: This paper presents the protocol for a study that aims to determine the feasibility, acceptability, and preliminary effectiveness of a 4-week automated SMS text message intervention to increase stigma resistance and reduce self-stigma in people who use drugs. Methods: We designed a novel automated SMS text message intervention to address the four personal-level constructs of stigma resistance: (1) not believin…

matched on Substance-Related Disorders (mesh)

Effects of a trauma-informed curriculum on depression, self-efficacy, economic security, and substance use among TANF participants: Evidence from the Building Health and Wealth Network Phase II.

Rationale: Integrating trauma-informed peer support curriculum into the Temporary Assistance for Needy Families (TANF) program can help address caregiver trauma symptoms (e.g., depression, low self-efficacy, economic hardship) caused by exposures to violence and adversity that negatively impact one's ability to maintain employment and improve earnings; yet, it is unclear if trauma-informed peer support interventions designed for TANF impact co-occurring disorders, such as depression and substance use, that inhibit resiliency in the labor market. Objective: The aim of this study is to examine whether integrating trauma-informed peer support curriculum into the TANF program is associated with reductions in co-occurring depression and substance use, and improvements in self-efficacy and economic security. Method: From October 2015 to May 2018, 369 caregivers were enrolled in the 16-week Bui…

matched on Substance-Related Disorders (mesh)

Adapting an evidence-based HIV behavioral intervention for South African couples.

Background: In South Africa, heterosexual couples are at risk for HIV infection and transmission through substance use, gender-based violence and traditional gender roles, and sex risk behaviors such as having multiple partners and unsafe sex. Methods: To address these interconnected HIV risks among heterosexual couples, we used the ADAPT framework to modify an existing, efficacious women's HIV prevention intervention (the Western Cape Women's Health CoOp) to include components of an evidence-based couple's intervention from the United States (Project Connect) and components from the Men as Partners program that has been used successfully in South Africa. We conducted focus groups with men, women and couples, and obtained feedback from a long-standing Community Collaborative Board (CCB) to guide the synthesis of elements of these three interventions into a new intervention. We then pilot…

matched on Substance-Related Disorders (mesh)

Behavioural addiction-A rising tide?

The term 'addiction' was traditionally used in relation to centrally active substances, such as cocaine, alcohol, or nicotine. Addiction is not a unitary construct but rather incorporates a number of features, such as repetitive engagement in behaviours that are rewarding (at least initially), loss of control (spiralling engagement over time), persistence despite untoward functional consequences, and physical dependence (evidenced by withdrawal symptoms when intake of the substance diminishes). It has been suggested that certain psychiatric disorders characterized by maladaptive, repetitive behaviours share parallels with substance addiction and therefore represent 'behavioural addictions'. This perspective has influenced the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), which now has a category 'Substance Related and Addictive Disorders', including gambli…

matched on Substance-Related Disorders (mesh), Behavior, Addictive (mesh)

The forest and the trees: relational and specific factors in addiction treatment.

Aims: Increased expectations for the use of evidence-based methods in addiction treatment have fueled a debate regarding the relative importance of 'specific' versus 'common' factors in treatment outcome. This review explores the influence of these factors on addiction treatment outcome. Methods: The authors review and link findings from four decades of research on specific and general factors in addiction treatment outcome research. Findings: Although few would argue that what one does in addiction treatment is immaterial, outcome studies tend to find small to no difference when specific treatment methods are compared with each other or with treatment as usual. In contrast, there are usually substantial differences among therapists in client outcomes, and relational factors such as therapist empathy and therapeutic alliance can be significant determinants of addiction treatment outcome.…

matched on Substance-Related Disorders (mesh), Behavior, Addictive (mesh)

Therapeutic Potential of 5-HT2C Receptor Agonists for Addictive Disorders.

The neurotransmitter 5-hydroxytryptamine (5-HT; serotonin) has long been associated with the control of a variety of motivated behaviors, including feeding. Much of the evidence linking 5-HT and feeding behavior was obtained from studies of the effects of the 5-HT releaser (dex)fenfluramine in laboratory animals and humans. Recently, the selective 5-HT2C receptor agonist lorcaserin received FDA approval for the treatment of obesity. This review examines evidence to support the use of selective 5-HT2C receptor agonists as treatments for conditions beyond obesity, including substance abuse (particularly nicotine, psychostimulant, and alcohol dependence), obsessive compulsive, and excessive gambling disorder. Following a brief survey of the early literature supporting a role for 5-HT in modulating food and drug reinforcement, we propose that intrinsic differences between SSRI and serotonin …

matched on Substance-Related Disorders (mesh), Behavior, Addictive (mesh)

Reward processing in obesity, substance addiction and non-substance addiction.

Similarities and differences between obesity and addiction are a prominent topic of ongoing research. We conducted an activation likelihood estimation meta-analysis on 87 studies in order to map the functional magnetic resonance imaging (fMRI) response to reward in participants with obesity, substance addiction and non-substance (or behavioural) addiction, and to identify commonalities and differences between them. Our study confirms the existence of alterations during reward processing in obesity, non-substance addiction and substance addiction. Specifically, participants with obesity or with addictions differed from controls in several brain regions including prefrontal areas, subcortical structures and sensory areas. Additionally, participants with obesity and substance addictions exhibited similar blood-oxygen-level-dependent fMRI hyperactivity in the amygdala and striatum when proce…

matched on Substance-Related Disorders (mesh), Behavior, Addictive (mesh)