Drugs and alcohol, dependence and recovery.
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76 to 100 of 1,310Neurobiology of cue-reactivity, craving, and inhibitory control in non-substance addictive behaviors.
Non-substance addictive behaviors may involve repetitive rewarding behaviors including gambling, gaming, sexual activities, internet-use, and buying-shopping. In addictions, there exists diminished control over participation in the behaviors and continuation of the behaviors despite experiencing negative consequences. Addictive participation in behaviors typically results in distress and functional impairment in personal, relational, occupational, educational, or other life domains. Increases in cue-reactivity and craving and decreases in inhibitory control may represent pivotal mechanisms in addictions, especially when behavior-specific cues are present. Similar to substance-use disorders, alterations in brain networks related to reward processing, executive functioning, salience attribution, and habit formation and in neurochemical pathways that may include dopamine, serotonin, opioids…
matched on Substance-Related Disorders (mesh), Behavior, Addictive (mesh), substance use disorder (text), craving (text)
Lee JD, Nunes EV, Mpa PN, Bailey GL, Brigham GS, Cohen AJ, Fishman M, Ling W, Lindblad R, Shmueli-Blumberg D, Stablein D, May J, Salazar D, Liu D, Rotrosen J (2016)randomised controlled trialMEDLINE-indexed journal, not yet read by usContemporary clinical trials53 citations NIDA Clinical Trials Network CTN-0051, Extended-Release Naltrexone vs. Buprenorphine for Opioid Treatment (X:BOT): Study design and rationale.
Introduction: For opioid-dependent patients in the US and elsewhere, detoxification and counseling-only aftercare are treatment mainstays. Long-term abstinence is rarely achieved; many patients relapse and overdose after detoxification. Methadone, buprenorphine-naloxone (BUP-NX) and extended-release naltrexone (XR-NTX) can prevent opioid relapse but are underutilized. This study is intended to develop an evidence-base to help patients and providers make informed choices and to foster wider adoption of relapse-prevention pharmacotherapies.
Methods: The National Institute on Drug Abuse's Clinical Trials Network (CTN) study CTN-0051, X:BOT, is a comparative effectiveness study of treatment for 24weeks with XR-NTX, an opioid antagonist, versus BUP-NX, a high affinity partial opioid agonist, for opioid dependent patients initiating treatment at 8 short-term residential (detoxification) units …
matched on Opioid-Related Disorders (mesh), craving (text), relapse (text)
Blum K, Liu Y, Wang W, Wang Y, Zhang Y, Oscar-Berman M, Smolen A, Febo M, Han D, Simpatico T, Cronjé FJ, Demetrovics Z, Gold MS (2015)randomised controlled trialMEDLINE-indexed journal, not yet read by usPostgraduate medicine87 citations rsfMRI effects of KB220Z™ on neural pathways in reward circuitry of abstinent genotyped heroin addicts.
Recently, Willuhn et al. reported that cocaine use and even non-substance-related addictive behavior increases as dopaminergic function is reduced. Chronic cocaine exposure has been associated with decreases in D2/D3 receptors and was also associated with lower activation of cues in occipital cortex and cerebellum, in a recent PET study by Volkow's et al. Therefore, treatment strategies, like dopamine agonist therapy, that might conserve dopamine function may be an interesting approach to relapse prevention in psychoactive drug and behavioral addictions. To this aim, we evaluated the effect of KB220Z™ on reward circuitry of 10 heroin addicts undergoing protracted abstinence (average 16.9 months). In a randomized placebo-controlled crossover study of KB220Z, five subjects completed a triple-blinded experiment in which the subject, the person administering the treatment, and the person eva…
matched on Substance Withdrawal Syndrome (mesh), craving (text), relapse (text)
Treating Opioid Dependence With Injectable Extended-Release Naltrexone (XR-NTX): Who Will Respond?
Objectives: Once-monthly intramuscular extended-release naltrexone (XR-NTX) has demonstrated efficacy for the prevention of relapse in opioid dependence, providing an alternative to agonist or partial agonist maintenance (ie, methadone and buprenorphine). The question remains, for whom is this unique treatment most efficacious and can patient-treatment matching factors be identified?
Methods: A moderator analysis was conducted on a previously reported 24-week, placebo-controlled, multisite, randomized controlled trial of XR-NTX (n = 126) versus placebo (n = 124) among recently detoxified opioid-dependent adults in Russia, which showed XR-NTX superior to placebo in proportion of opioid abstinent weeks. The moderator analysis examined a dichotomous indicator of good clinical response-achieving at least 90% of weeks abstinent over the 24-week trial. A series of logistic regression models we…
matched on Opioid-Related Disorders (mesh), craving (text), relapse (text)
Gabapentin treatment for alcohol dependence: a randomized clinical trial.
Importance: Approved medications for alcohol dependence are prescribed for less than 9% of US alcoholics.
Objective: To determine if gabapentin, a widely prescribed generic calcium channel/γ-aminobutyric acid-modulating medication, increases rates of sustained abstinence and no heavy drinking and decreases alcohol-related insomnia, dysphoria, and craving, in a dose-dependent manner.
Design, participants and setting: A 12-week, double-blind, placebo-controlled, randomized dose-ranging trial of 150 men and women older than 18 years with current alcohol dependence, conducted from 2004 through 2010 at a single-site, outpatient clinical research facility adjoining a general medical hospital.
Interventions: Oral gabapentin (dosages of 0 [placebo], 900 mg, or 1800 mg/d) and concomitant manual-guided counseling.
Main outcomes and measures: Rates of complete abstinence and no heavy drinking (copr…
matched on Substance Withdrawal Syndrome (mesh), craving (text), relapse (text)
Cue exposure therapy for the treatment of opiate addiction: results of a randomized controlled clinical trial.
Background: Persistent cue reactivity to drug-related stimuli is a well-known phenomenon among abstinent drug users and has been found to be a predictor of relapse. Cue exposure therapy (CET) aims to reduce this cue reactivity by exposing abstinent drug users to conditioned drug-related stimuli while preventing their habitual response, i.e. drug use.
Methods: 127 abstinent heroin-dependent Dutch inpatients were randomized to CET (n = 65; 55 completers) and placebo psychotherapy treatment (PPT) (n = 62; 59 completers). It was examined whether CET would lead to a decrease in drug-related cue reactivity (using mixed-design ANOVA) and subsequently to lower dropout and relapse rates (using logistic regression) compared to PPT.
Results: Both groups responded with a similar decrease in self-reported cue reactivity (craving, mood). The CET group did show a significant decrease in physiological r…
matched on Substance Withdrawal Syndrome (mesh), craving (text), relapse (text)
Nicotine receptor partial agonists for smoking cessation.
Background: Nicotine receptor partial agonists may help people to stop smoking by a combination of maintaining moderate levels of dopamine to counteract withdrawal symptoms (acting as an agonist) and reducing smoking satisfaction (acting as an antagonist).
Objectives: To review the efficacy of nicotine receptor partial agonists, including varenicline and cytisine, for smoking cessation.
Search methods: We searched the Cochrane Tobacco Addiction Group's specialised register for trials, using the terms ('cytisine' or 'Tabex' or 'dianicline' or 'varenicline' or 'nicotine receptor partial agonist') in the title or abstract, or as keywords. The register is compiled from searches of MEDLINE, EMBASE, and PsycINFO using MeSH terms and free text to identify controlled trials of interventions for smoking cessation and prevention. We contacted authors of trial reports for additional information whe…
matched on Substance Withdrawal Syndrome (mesh), relapse (text)
Preoperative alcohol cessation prior to elective surgery.
Background: Hazardous drinking has been associated with an increased postoperative complication rate after surgery. Common complications include postoperative infections, cardiopulmonary complications, and bleeding episodes. Preoperative abstinence may to some degree reverse alcohol-induced pathophysiological processes and thus prevent postoperative complications.
Objectives: To assess the effect of preoperative alcohol cessation interventions on the rate of postoperative complications including mortality in hazardous drinkers. To assess the effect of preoperative alcohol cessation interventions for hazardous drinkers on alcohol use in the postoperative period and in the long term.
Search methods: We searched the Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library 2011, Issue 9); Ovid MEDLINE (1966 to September 2011); Ovid EMBASE (1966 to September 2011); CINAH…
matched on Substance Withdrawal Syndrome (mesh), relapse (text)
Van den Brink W, Haasen C (2006)meta-analysisMEDLINE-indexed journal, not yet read by usCanadian journal of psychiatry. Revue canadienne de psychiatrie86 citations Evidenced-based treatment of opioid-dependent patients.
Objective: To provide an overview of treatment options for opioid-dependent patients.
Method: We screened all published studies on the treatment of opioid dependence, with a special focus on systematic literature reviews, formal metaanalyses, and recent trials.
Results: Both clinical experience and neurobiological evidence indicate that opioid dependence is a chronic relapsing disorder. Treatment objectives depend on the pursued goals: crisis intervention, abstinence-oriented treatment (detoxification and relapse prevention), or agonist maintenance treatment. The high quality of solid evidence in the literature demonstrates that there are numerous effective interventions available for the treatment of opioid dependence. Crisis intervention, frequently necessary owing to the high overdose rate, can be effectively handled with naloxone. Abstinence-oriented interventions are effective for o…
matched on Opioid-Related Disorders (mesh), relapse (text)
Oral naltrexone maintenance treatment for opioid dependence.
Background: Research on the clinical application of oral naltrexone agrees on several things. From a pharmacological perspective, naltrexone works. From an applied perspective, however, this medication is not used since the medication compliance and the retention rates are very poor.
Objectives: To evaluate the effects of naltrexone maintenance treatment versus placebo or other treatments in preventing relapse in opioid addicts after detoxification.
Search strategy: We searched the Cochrane Drugs and Alcohol Group Register of Trials (January 2005), Cochrane Central Register of Controlled Trials (CENTRAL - The Cochrane Library Issue 1, 2005), MEDLINE (1973-first year of naltrexone use in humans- January 2005), EMBASE (1974- January 2005), PsycINFO (OVID-January 1985 to January 2004). We inspected reference lists of relevant articles and we contacted pharmaceutical producers of naltrexone,…
matched on Opioid-Related Disorders (mesh), relapse (text)
Central and Peripheral Biomarkers of Stress Response for Addiction Risk and Relapse Vulnerability.
Substance use disorders (SUDs) are marked by heterogeneity in clinical symptomatology and high relapse rates following treatment. Here, we describe specific peripheral and central stress responses associated with the pathophysiology of SUDs. We outline potential stress response measures, including hypothalamus-pituitary-adrenal axis markers, autonomic responses, and central structural and functional brain alterations that could be exploited as putative biomarkers in SUDs. We posit that stress responses can be predictive of both the development of SUDs and their high relapsing nature. We examine their potential as candidate biomarkers, as well as the remaining challenges in developing and implementing their application for the prevention and treatment of SUDs.
matched on Substance-Related Disorders (mesh), Behavior, Addictive (mesh), substance use disorder (text), relapse (text)
Shaping vulnerability to addiction - the contribution of behavior, neural circuits and molecular mechanisms.
Substance use disorders continue to impose increasing medical, financial and emotional burdens on society in the form of morbidity and overdose, family disintegration, loss of employment and crime, while advances in prevention and treatment options remain limited. Importantly, not all individuals exposed to abused substances effectively develop the disease. Genetic factors play a significant role in determining addiction vulnerability and interactions between innate predisposition, environmental factors and personal experiences are also critical. Thus, understanding individual differences that contribute to the initiation of substance use as well as on long-term maladaptations driving compulsive drug use and relapse propensity is of critical importance to reduce this devastating disorder. In this paper, we discuss current topics in the field of addiction regarding individual vulnerabilit…
matched on Substance-Related Disorders (mesh), Behavior, Addictive (mesh), substance use disorder (text), relapse (text)
Cadet JL (2016)reviewMEDLINE-indexed journal, not yet read by usMolecular neurobiology100 citations Epigenetics of Stress, Addiction, and Resilience: Therapeutic Implications.
Substance use disorders (SUDs) are highly prevalent. SUDs involve vicious cycles of binges followed by occasional periods of abstinence with recurrent relapses despite treatment and adverse medical and psychosocial consequences. There is convincing evidence that early and adult stressful life events are risks factors for the development of addiction and serve as cues that trigger relapses. Nevertheless, the fact that not all individuals who face traumatic events develop addiction to licit or illicit drugs suggests the existence of individual and/or familial resilient factors that protect these mentally healthy individuals. Here, I give a brief overview of the epigenetic bases of responses to stressful events and of epigenetic changes associated with the administration of drugs of abuse. I also discuss the psychobiology of resilience and alterations in epigenetic markers that have been ob…
matched on Substance-Related Disorders (mesh), Behavior, Addictive (mesh), substance use disorder (text), relapse (text)
Oxytocin for the treatment of drug and alcohol use disorders.
There is growing interest in the use of oxytocin (OT) as a potential treatment for alcohol and other substance-use disorders. OT is a neuropeptide that modulates adaptive processes associated with addiction including reward, tolerance, associative learning, memory, and stress responses. OT exerts its effects through interactions with the hypothalamic-pituitary-adrenal axis and multiple neurotransmitter systems including the dopamine mesolimbic reward and corticotrophin-releasing factor stress systems. The effects of OT on stress systems are of high interest, given the strong link between stress, drug use and relapse, and known dysregulation of hypothalamic-pituitary-adrenal-axis activity associated with substance-use disorders. At the same time, the OT system is itself altered by acute or chronic drug exposure. This review summarizes the preclinical and clinical literature on the OT syst…
matched on Substance-Related Disorders (mesh), Substance Withdrawal Syndrome (mesh), substance use disorder (text), relapse (text)
Potential role of N-acetylcysteine in the management of substance use disorders.
There is a clear and pressing need to expand pharmacotherapy options for substance use disorders (SUDs) in order to improve sustained abstinence outcomes. Preclinical literature has demonstrated the role of glutamate in addiction, suggesting that new targets for pharmacotherapy should focus on the restoration of glutamatergic function. Glutamatergic agents for SUDs may span multiple addictive behaviors and help demonstrate potentially overlapping mechanisms in addiction. The current review will focus specifically on N-acetylcysteine (NAC), a safe and well-tolerated glutamatergic agent, as a promising potential pharmacotherapy for the treatment of SUDs across several substances of abuse. Building on recently published reviews of the clinical efficacy of NAC across a broad range of conditions, this review will more specifically discuss NAC as a pharmacotherapy for SUDs, devoting particular…
matched on Substance-Related Disorders (mesh), Substance Withdrawal Syndrome (mesh), substance use disorder (text), relapse (text)
Mindfulness-based treatment to prevent addictive behavior relapse: theoretical models and hypothesized mechanisms of change.
Mindfulness-based treatments are growing in popularity among addiction treatment providers, and several studies suggest the efficacy of incorporating mindfulness practices into the treatment of addiction, including the treatment of substance use disorders and behavioral addictions (i.e., gambling). The current paper provides a review of theoretical models of mindfulness in the treatment of addiction and several hypothesized mechanisms of change. We provide an overview of mindfulness-based relapse prevention (MBRP), including session content, treatment targets, and client feedback from participants who have received MBRP in the context of empirical studies. Future research directions regarding operationalization and measurement, identifying factors that moderate treatment effects, and protocol adaptations for specific populations are discussed.
matched on Substance-Related Disorders (mesh), Behavior, Addictive (mesh), substance use disorder (text), relapse (text)
Pharmacotherapy of addictive disorders.
Substance use disorders are highly prevalent in the United States and cause considerable damage to our society. They are underrecognized and undertreated despite a vast body of literature demonstrating the efficacy of treatment using both psychosocial and psychopharmacological modalities. For the last decade, research and progress into the biological basis of the addictive process has led to a rapidly growing number of pharmacological agents used to interrupt the addictive process at its various stages such as the initiation of substance abuse, the transition from abuse to dependence, and the prevention of drug reinstatement or relapse. Food and Drug Administration-approved medications exist for nicotine, alcohol, and opioid use disorders, and progress is being made to develop agents for stimulant use disorders. Regarding nicotine use disorders, nicotine replacement therapies,bupropion a…
matched on Substance-Related Disorders (mesh), Behavior, Addictive (mesh), substance use disorder (text), relapse (text)
The global burden of perinatal common mental health disorders and substance use among migrant women: a systematic review and meta-analysis.
Background: There are one billion migrants globally, of whom 82 million are forced migrants. Pregnant migrants face pre-migration stressors such as conflict, transit stressors including poverty, and post-migration stressors including navigating the immigration system; these stressors can make them vulnerable to mental illness. We aimed to assess the global prevalence of and risk factors for perinatal mental health disorders or substance use among women who are migrants.
Methods: In this systematic review and meta-analysis, we searched OVID MEDLINE, Embase, PsycINFO, CENTRAL, Global Health, Scopus, and Web of Science for studies published from database inception until July 8, 2022. Cohort, cross-sectional, and interventional studies with prevalence data for any mental illness in pregnancy or the postnatal period (ie, up to a year after delivery) or substance use in pregnancy were included…
matched on Substance-Related Disorders (mesh)
Sexual orientation concealment and mental health: A conceptual and meta-analytic review.
Identity concealment affects all sexual minority individuals, with potentially complex mental health implications. Concealing a sexual minority identity can simultaneously generate the stress of hiding, protect against the stress of discrimination, and keep one apart from sexual minority communities and their norms and supports. Not surprisingly, existing studies of the association between sexual orientation concealment and mental health problems show contradictory associations-from positive to negative to null. This meta-analysis attempts to resolve these contradictions. Across 193 studies (n = 92,236) we find a small positive association between sexual orientation concealment and internalizing mental health problems (i.e., depression, anxiety, distress, problematic eating; ESr = 0.126; 95% CI [0.102, 0.151]) and a small negative association between concealment and substance use problem…
matched on Substance-Related Disorders (mesh)
Self-regulation in childhood as a predictor of future outcomes: A meta-analytic review.
This meta-analysis explores whether self-regulation in childhood relates to concurrent and subsequent levels of achievement, interpersonal behaviors, mental health, and healthy living. A comprehensive literature search identified 150 studies that met inclusion criteria (745 effect sizes; total n = 215,212). Data were analyzed using inverse-variance weighted random effects meta-analysis. Mean effect sizes from 55 meta-analyses provided evidence that self-regulation relates to 25 discrete outcomes. Results showed that self-regulation in preschool (∼age 4) was positively associated with social competency, school engagement, and academic performance, and negatively associated with internalizing problems, peer victimization, and externalizing problems, in early school years (∼age 8). Self-regulation in early school years was positively related to academic achievement (math and literacy), and …
matched on Substance-Related Disorders (mesh)
Effectiveness of digital psychological interventions for mental health problems in low-income and middle-income countries: a systematic review and meta-analysis.
Background: The effectiveness of digital psychological interventions in low-income and middle-income countries (LMICs) remains unclear. We aimed to systematically investigate the available evidence for digital psychological interventions in reducing mental health problems in LMICs.
Methods: In this systematic review and meta-analysis, we searched PubMed, PsycINFO, Embase, and Cochrane databases for articles published in English from database inception to March 9, 2020. We included randomised controlled trials investigating digital psychological interventions in individuals with mental health problems in LMICs. We extracted data on demographics, inclusion and exclusion criteria, details of the intervention, including the setting, digital delivery method, control group conditions, number of sessions, therapeutic orientation (eg, cognitive therapy or behaviour therapy), presence or absence …
matched on Substance-Related Disorders (mesh)
Intimate Partner Violence in Transgender Populations: Systematic Review and Meta-analysis of Prevalence and Correlates.
Background: Transgender individuals experience unique vulnerabilities to intimate partner violence (IPV) and may experience a disproportionate IPV burden compared with cisgender (nontransgender) individuals. Objectives: To systematically review the quantitative literature on prevalence and correlates of IPV in transgender populations. Search Methods: Authors searched research databases (PubMed, CINAHL), gray literature (Google), journal tables of contents, and conference abstracts, and consulted experts in the field. Authors were contacted with data requests in cases in which transgender participants were enrolled in a study, but no disaggregated statistics were provided for this population. Selection Criteria: We included all quantitative literature published before July 2019 on prevalence and correlates of IPV victimization, perpetration, or service utilization in transgender populatio…
matched on Substance-Related Disorders (mesh)
Social network interventions for health behaviours and outcomes: A systematic review and meta-analysis.
Background: There has been a growing interest in understanding the effects of social networks on health-related behaviour, with a particular backdrop being the emerging prominence of complexity or systems science in public health. Social network interventions specifically use or alter the characteristics of social networks to generate, accelerate, or maintain health behaviours. We conducted a systematic review and meta-analysis to investigate health behaviour outcomes of social network interventions.
Methods and findings: We searched eight databases and two trial registries from 1990 to May 28, 2019, for English-language reports of randomised controlled trials (RCTs) and before-and-after studies investigating social network interventions for health behaviours and outcomes. Trials that did not specifically use social networks or that did not include a comparator group were excluded. We sc…
matched on Substance-Related Disorders (mesh)
Broken (windows) theory: A meta-analysis of the evidence for the pathways from neighborhood disorder to resident health outcomes and behaviors.
The criminological "broken windows" theory (BWT) has inspired public health researchers to test the impact of neighborhood disorder on an array of resident health behaviors and outcomes. This paper identifies and meta-analyzes the evidence for three mechanisms (pathways) by which neighborhood disorder is argued to impact health, accounting for methodological inconsistencies across studies. A search identified 198 studies (152 with sufficient data for meta-analysis) testing any of the three pathways or downstream, general health outcomes. The meta-analysis found that perceived disorder was consistently associated with mental health outcomes, as well as substance abuse, and measures of overall health. This supported the psychosocial model of disadvantage, in which stressful contexts impact mental health and related sequelae. There was no consistent evidence for disorder's impact on physica…
matched on Substance-Related Disorders (mesh)
Fellmeth G, Rose-Clarke K, Zhao C, Busert LK, Zheng Y, Massazza A, Sonmez H, Eder B, Blewitt A, Lertgrai W, Orcutt M, Ricci K, Mohamed-Ahmed O, Burns R, Knipe D, Hargreaves S, Hesketh T, Opondo C, Devakumar D (2018)meta-analysisMEDLINE-indexed journal, not yet read by usLancet (London, England)330 citations Health impacts of parental migration on left-behind children and adolescents: a systematic review and meta-analysis.
Background: Globally, a growing number of children and adolescents are left behind when parents migrate. We investigated the effect of parental migration on the health of left behind-children and adolescents in low-income and middle-income countries (LMICs).
Methods: For this systematic review and meta-analysis we searched MEDLINE, Embase, CINAHL, the Cochrane Library, Web of Science, PsychINFO, Global Index Medicus, Scopus, and Popline from inception to April 27, 2017, without language restrictions, for observational studies investigating the effects of parental migration on nutrition, mental health, unintentional injuries, infectious disease, substance use, unprotected sex, early pregnancy, and abuse in left-behind children (aged 0-19 years) in LMICs. We excluded studies in which less than 50% of participants were aged 0-19 years, the mean or median age of participants was more than 19…
matched on Substance-Related Disorders (mesh)