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

The D2/3 dopamine receptor in pathological gambling: a positron emission tomography study with [11C]-(+)-propyl-hexahydro-naphtho-oxazin and [11C]raclopride.

Aims: Pathological gambling (PG) shares diagnostic features with substance use disorder (SUD), but the neurochemical mechanisms underlying PG are poorly understood. Because dopamine (DA), a neurotransmitter implicated in reward and reinforcement, is probably involved, we used positron emission tomography (PET) to test whether PG is associated with abnormalities in D2 and D3 receptor levels, as observed in SUD. Design: Case-control study comparing PG to healthy control (HC) subjects. Setting: Academic research imaging centre. Participants: Thirteen non-treatment-seeking males meeting DSM-IV criteria for PG, and 12 matched HC (11 of whom completed PET). Measurements: Two PET scans (one with the D3 receptor preferring agonist [11C]-(+)-propyl-hexahydro-naphtho-oxazin (PHNO) and the other with [11C]raclopride) to assess D(2/3) DA receptor availability, and behavioural measures (self-report q…

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Problem gambling and intimate partner violence.

This study examined the prevalence and severity of intimate partner violence (IPV) among 248 problem gamblers (43 women, 205 men) recruited from newspaper advertisements. The main outcome measures used were the Canadian Problem Gambling Index, the Conflicts Tactics Scale-2, the State Trait Anger Expression Inventory-2, the drug and alcohol section of the Addiction Severity Index and the substance use section of the Structured Clinical Interview for the DSM-IV. In this sample, 62.9% of participants reported perpetrating and/or being the victims of IPV in the past year, with 25.4% reporting perpetrating severe IPV. The majority of the sample (64.5%) also had clinically significant anger problems, which was associated with an increased risk of being both the perpetrator and victim of IPV. The presence of a lifetime substance use disorder among participants who had clinically significant ang…

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Oral delta-9-tetrahydrocannabinol suppresses cannabis withdrawal symptoms.

Background: This study assessed whether oral administration of delta-9-tetrahydrocannbinol (THC) effectively suppressed cannabis withdrawal in an outpatient environment. The primary aims were to establish the pharmacological specificity of the withdrawal syndrome and to obtain information relevant to determining the potential use of THC to assist in the treatment of cannabis dependence. Method: Eight adult, daily cannabis users who were not seeking treatment participated in a 40-day, within-subject ABACAD study. Participants administered daily doses of placebo, 30 mg (10 mg/tid), or 90 mg (30 mg/tid) oral THC during three, 5-day periods of abstinence from cannabis use separated by 7-9 periods of smoking cannabis as usual. Results: Comparison of withdrawal symptoms across conditions indicated that (1) the lower dose of THC reduced withdrawal discomfort, and (2) the higher dose produced ad…

matched on Substance Withdrawal Syndrome (mesh), Marijuana Abuse (mesh)

Neuropsychological functioning in adolescent marijuana users: subtle deficits detectable after a month of abstinence.

In adults, studies examining the long-lasting cognitive effects of marijuana use demonstrate subtle deficits in attention, executive function, and memory. Because neuromaturation continues through adolescence, these results cannot necessarily generalize to adolescent marijuana users. The goal of this study was to examine neuropsychological functioning in abstinent marijuana using and demographically similar control adolescents. Data were collected from 65 adolescent marijuana users (n=31, 26% females) and controls (n=34, 26% females) 16-18 years of age. Extensive exclusionary criteria included independent psychiatric, medical, and neurologic disorders. Neuropsychological assessments were conducted after>23 days of monitored abstinence. After controlling for lifetime alcohol use and depressive symptoms, adolescent marijuana users demonstrated slower psychomotor speed (p<.05), and poorer c…

matched on Substance Withdrawal Syndrome (mesh), Marijuana Abuse (mesh)

Altered resting-state functional connectivity of the insula in young adults with Internet gaming disorder.

The insula has been implicated in salience processing, craving, and interoception, all of which are critical to the clinical manifestations of drug and behavioral addiction. In this functional magnetic resonance imaging (fMRI) study, we examined resting-state functional connectivity (rsFC) of the insula and its association with Internet gaming characteristics in 74 young adults with Internet gaming disorder (IGD) and 41 age- and gender-matched healthy control subjects (HCs). In comparison with HCs, IGD subjects (IGDs) exhibited enhanced rsFC between the anterior insula and a network of regions including anterior cingulate cortex (ACC), putamen, angular gyrus, and precuneous, which are involved in salience, craving, self-monitoring, and attention. IGDs also demonstrated significantly stronger rsFC between the posterior insula and postcentral gyrus, precentral gyrus, supplemental motor are…

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Spirituality-based recovery from drug addiction in the twelve-step fellowship of narcotics anonymous.

Background: Narcotics Anonymous is a worldwide fellowship that employs the Twelve-Step model for members dependent on drugs of abuse. The spiritual orientation of its program of abstinence has not been subjected to empirical study. Methods: Responses of 527 American Narcotics Anonymous meeting attendees to a structured questionnaire were evaluated for the roles of cognitive and psychosocial aspects of spirituality in their recovery. Results: Respondents had last used drugs or alcohol on average 6.1 years previously. They were found to be more oriented toward a spiritual than a formally religious orientation than probability samples of the general population. Aspects of membership such as affiliation toward other members and the experience of spiritual awakening were associated with lower rates of drug or alcohol craving, whereas scores on depression were associated with higher craving sc…

matched on Opioid-Related Disorders (mesh), craving (text)

Mindful attention reduces neural and self-reported cue-induced craving in smokers.

An emerging body of research suggests that mindfulness-based interventions may be beneficial for smoking cessation and the treatment of other addictive disorders. One way that mindfulness may facilitate smoking cessation is through the reduction of craving to smoking cues. The present work considers whether mindful attention can reduce self-reported and neural markers of cue-induced craving in treatment seeking smokers. Forty-seven (n = 47) meditation-naïve treatment-seeking smokers (12-h abstinent from smoking) viewed and made ratings of smoking and neutral images while undergoing functional magnetic resonance imaging (fMRI). Participants were trained and instructed to view these images passively or with mindful attention. Results indicated that mindful attention reduced self-reported craving to smoking images, and reduced neural activity in a craving-related region of subgenual anterio…

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Role of intestinal permeability and inflammation in the biological and behavioral control of alcohol-dependent subjects.

Background and aims: Mood and cognition alterations play a role in the motivation for alcohol-drinking. Lipopolysaccharides are known to stimulate inflammation that was shown to induce mood and cognitive changes in rodents and humans. Enhanced intestinal permeability and elevated blood LPS characterize alcohol-dependent mice. However, no data have been published in non-cirrhotic humans. Our first goal was to test whether intestinal permeability, blood LPS and cytokines are increased in non-cirrhotic alcohol-dependent subjects before withdrawal and if they recover after withdrawal. Our second goal was to test correlations between these biochemical and the behavioral variables to explore the possibility of a role for a gut-brain interaction in the development of alcohol-dependence. Methods: Forty alcohol-dependent-subjects hospitalized for a 3-week detoxification program were tested at ons…

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

Predicting dropout in the first 3 months of 12-step residential drug and alcohol treatment in an Australian sample.

Objective: Premature termination from treatment is a major factor associated with poorer drug and alcohol treatment outcomes. The present study investigated client-related baseline predictors of dropout at 3 months from a faith-based 12-step residential drug treatment program. Method: Data were collected over a period of 14 months from eight residential drug and alcohol treatment programs run by The Australian Salvation Army. The final sample consisted of 618 participants, including 524 men (84.8%) and 94 women (15.2%). Predictor variables of interest were age, gender, primary drug of concern, criminal involvement, psychological distress, drug cravings, self-efficacy to abstain, spirituality, forgiveness of self and others, and life purpose. At 3 months, 264 participants (42.7%) remained in the treatment program, and 354 participants (57.3%) had dropped out. Results: Binary logistic regr…

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Evidence that 'food addiction' is a valid phenotype of obesity.

There is growing evidence of 'food addiction' (FA) in sugar- and fat-bingeing animals. The purpose of this study was to investigate the legitimacy of this disorder in the human condition. It was also our intention to extend the validation of the Yale Food Addiction Scale (YFAS) - the first tool developed to identify individuals with addictive tendencies towards food. Using a sample of obese adults (aged 25-45 years), and a case-control methodology, we focused our assessments on three domains relevant to the characterization of conventional substance-dependence disorders: clinical co-morbidities, psychological risk factors, and abnormal motivation for the addictive substance. Results were strongly supportive of the FA construct and validation of the YFAS. Those who met the diagnostic criteria for FA had a significantly greater co-morbidity with Binge Eating Disorder, depression, and atten…

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Gambling disorder and problematic pornography use: Does co-occurrence influence treatment outcome?

Background and aims: Gambling disorder (GD) is a behavioral addiction often co-occurring with various mental health concerns, such as problematic pornography use (PPU). The specific impact of the co-occurrence of GD and PPU on treatment outcome remains underexplored. This study aimed to compare the treatment outcomes of individuals actively receiving treatment for GD (n = 172; 3.49% females), distinguishing between those without PPU (n = 146) and those with co-occurring GD and PPU (n = 26). Methods: Cognitive-behavioral therapy (CBT) was administered in 16 weekly sessions, with assessments of GD severity, impulsivity, emotion regulation, psychopathology, and personality. Dropout, relapses, number of sessions attended, number of relapses, and amount of money spent during relapses were assessed as the main treatment outcomes. Results: Patients with co-occurring GD and PPU showed greater GD…

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Estimated Reductions in Opioid Overdose Deaths With Sustainment of Public Health Interventions in 4 US States.

Importance: In 2021, more than 80 000 US residents died from an opioid overdose. Public health intervention initiatives, such as the Helping to End Addiction Long-term (HEALing) Communities Study (HCS), are being launched with the goal of reducing opioid-related overdose deaths (OODs). Objective: To estimate the change in the projected number of OODs under different scenarios of the duration of sustainment of interventions, compared with the status quo. Design, setting, and participants: This decision analytical model simulated the opioid epidemic in the 4 states participating in the HCS (ie, Kentucky, Massachusetts, New York, and Ohio) from 2020 to 2026. Participants were a simulated population transitioning from opioid misuse to opioid use disorder (OUD), overdose, treatment, and relapse. The model was calibrated using 2015 to 2020 data from the National Survey on Drug Use and Health, …

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

Needs affordance as a key factor in likelihood of problematic social media use: Validation, latent Profile analysis and comparison of TikTok and Facebook problematic use measures.

Despite increasing concerns of maladaptive cognitive responses associated with social media, estimates of its prevalence are lacking in the literature. Further, existing studies have disproportionately focused on Facebook, while ignoring the penetration of TikTok and concerns of associated maladaptive behaviors. This study aims to 1) validate scale measures for problematic Facebook and TikTok use (PFU and PTTU) 2) comparatively assess the underlying cognitive pathways of the PFU and PTTU among a sample of university students, 3) determine the cut-off score of the PTTU assessment scale using Latent Profile Analysis (LPA) and 4) evaluate the contribution of specific criteria in the diagnosis of PTTU. The scales used to assess PFU and PTTU were found to have appropriate psychometric properties. The scores between the PFU and PTTU scales were found to be strongly associated, however, the rel…

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Processing incomplete questionnaire data into continuous digital biomarkers for addiction monitoring.

Purpose: eHealth systems allow efficient daily smartphone-based collection of self-reported data on mood, wellbeing, routines, and motivation; however, missing data is frequent. Within addictive disorders, missing data may reflect lack of motivation to stay sober. We hypothesize that qualitative questionnaire data contains valuable information, which after proper handling of missing data becomes more useful for practitioners. Methods: Anonymized data from daily questionnaires containing 11 questions was collected with an eHealth system for 751 patients with alcohol use disorder (AUD). Two digital continuous biomarkers were composed from 9 wellbeing questions (WeBe-i) and from two questions representing motivation/self-confidence to remain sober (MotSC-i). To investigate possible loss of information in the process of composing the digital biomarkers, performance of neural networks to pred…

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The Anterior Insular Cortex→Central Amygdala Glutamatergic Pathway Is Critical to Relapse after Contingency Management.

Despite decades of research on neurobiological mechanisms of psychostimulant addiction, the only effective treatment for many addicts is contingency management, a behavioral treatment that uses alternative non-drug reward to maintain abstinence. However, when contingency management is discontinued, most addicts relapse to drug use. The brain mechanisms underlying relapse after cessation of contingency management are largely unknown, and, until recently, an animal model of this human condition did not exist. Here we used a novel rat model, in which the availability of a mutually exclusive palatable food maintains prolonged voluntary abstinence from intravenous methamphetamine self-administration, to demonstrate that the activation of monosynaptic glutamatergic projections from anterior insular cortex to central amygdala is critical to relapse after the cessation of contingency management.…

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Exercise during early, but not late abstinence, attenuates subsequent relapse vulnerability in a rat model.

Exercise has shown promise as a nonpharmacological intervention for addiction, with evidence suggesting a potential utility for relapse prevention. In humans, exercise as an intervention is typically introduced well after the initiation of abstinence, yet neurobiological data from preclinical studies suggest that it may be more effective if initiated during early abstinence. Here, using rat models, we determined whether the beneficial effects of exercise on relapse vulnerability depends on when exercise is first initiated, during early versus late abstinence. Once rats (n=47) acquired cocaine self-administration, they were given 24-h access to cocaine (1.5 mg/kg per infusion) under a discrete trial procedure (four infusions per hour) for 10 days. The rats then began a 14-day abstinence period in which they had access (2 h per day) to a locked wheel throughout abstinence (sedentary) or an…

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Psychological and physiological stress negatively impacts early engagement and retention of opioid-dependent individuals on methadone maintenance.

The present study investigated whether psychological and/or physiological measures of stress would impede induction onto methadone maintenance and predict early (<6 months) discontinuation. Compared with controls, opioid-dependent subjects displayed increased distress on the perceived stress scale (PSS) and post-traumatic stress disorder checklist (PCLC); 60% exhibited abnormal cortisol. Addiction severity index (ASI), drug-use, and stress indices explained between 17 and 37% of the variance in engagement including attendance, opioid abstinence, and methadone stabilization. Participants who discontinued treatment displayed poor engagement, abnormal cortisol, elevated withdrawal symptoms, higher distress, and increased ongoing opioid use versus compliant individuals. Discontinuation was initially related to drug-use severity; however, by 6 months, retention depended primarily upon cortiso…

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

Protective factors against relapse for practicing nurse anesthetists in recovery from anesthetic opiate dependency.

This qualitative inquiry explored factors that protect recovering anesthetic opioid-dependent nurse anesthetists from relapse after their return to anesthesia practice. Practicing nurse anesthetists in recovery from potent opioids were recruited through online advertising and individually interviewed over the telephone. The interview consisted of open-ended questions that aided description of personal experience of individual factors. Content analysis of the interviews revealed an overarching theme of a commitment to the recovery process, which provided the foundational protective element against relapse. Within this context, two major thematic factors emerged: personal factors and external factors. Personal factors came from within the individual and included such features as removing the obsession to use, self-realization, inner strength, and seeing the future. External factors were ex…

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

The oxytocin analogue carbetocin prevents emotional impairment and stress-induced reinstatement of opioid-seeking in morphine-abstinent mice.

The main challenge in treating opioid addicts is to maintain abstinence due to the affective consequences associated with withdrawal which may trigger relapse. Emerging evidence suggests a role of the neurohypophysial peptide oxytocin (OT) in the modulation of mood disorders as well as drug addiction. However, its involvement in the emotional consequences of drug abstinence remains unclear. We investigated the effect of 7-day opioid abstinence on the oxytocinergic system and assessed the effect of the OT analogue carbetocin (CBT) on the emotional consequences of opioid abstinence, as well as relapse. Male C57BL/6J mice were treated with a chronic escalating-dose morphine regimen (20-100 mg/kg/day, i.p.). Seven days withdrawal from this administration paradigm induced a decrease of hypothalamic OT levels and a concomitant increase of oxytocin receptor (OTR) binding in the lateral septum a…

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

Pharmacologically assisted treatment of opioid-dependent youth.

Opioid misuse, abuse, and dependence are global problems whose patterns vary across cultures. In the USA, the non-medical use of prescription opioids has become particularly serious because of its association with addiction and overdose death. Agonist and antagonist medications have been shown to be effective for opioid-dependent adults, and there is a growing body of data that they are also effective for youth. Here, we summarize evidence that detoxification alone results in high rates of treatment dropout and relapse but that the limited but growing data on the extended use of medication-assisted treatment for opioid-dependent youth have been positive. The implementation of medication-assisted treatment as a standard practice is feasible, easily integrated with counseling or psychotherapy, and has potential to greatly improve outcomes. Although concerns about safety and efficacy with y…

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

A systems medicine research approach for studying alcohol addiction.

According to the World Health Organization, about 2 billion people drink alcohol. Excessive alcohol consumption can result in alcohol addiction, which is one of the most prevalent neuropsychiatric diseases afflicting our society today. Prevention and intervention of alcohol binging in adolescents and treatment of alcoholism are major unmet challenges affecting our health-care system and society alike. Our newly formed German SysMedAlcoholism consortium is using a new systems medicine approach and intends (1) to define individual neurobehavioral risk profiles in adolescents that are predictive of alcohol use disorders later in life and (2) to identify new pharmacological targets and molecules for the treatment of alcoholism. To achieve these goals, we will use omics-information from epigenomics, genetics transcriptomics, neurodynamics, global neurochemical connectomes and neuroimaging (IM…

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The NK1 receptor antagonist L822429 reduces heroin reinforcement.

Genetic deletion of the neurokinin 1 receptor (NK1R) has been shown to decrease the reinforcing properties of opioids, but it is unknown whether pharmacological NK1R blockade has the same effect. Here, we examined the effect of L822429, a rat-specific NK1R antagonist, on the reinforcing properties of heroin in rats on short (1 h: ShA) or long (12 h: LgA) access to intravenous heroin self-administration. ShA produces heroin self-administration rates that are stable over time, whereas LgA leads to an escalation of heroin intake thought to model important dependence-related aspects of addiction. L822429 reduced heroin self-administration and the motivation to consume heroin, measured using a progressive-ratio schedule, in both ShA and LgA rats. L822429 also decreased anxiety-like behavior in both groups, measured on the elevated plus maze, but did not affect mechanical hypersensitivity obse…

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Premature ejaculation and other sexual dysfunctions in opiate dependent men receiving methadone substitution treatment.

Background: A significant number of men with opiate misuse have sexual problems. Premature ejaculation (PE) occurs predominantly on discontinuation of the opiate but seems to persist in some cases. The aims of this study were to determine the rates of PE and other sexual dysfunctions in patients maintained on methadone; to determine the time of onset of PE in relation to onset of opiate misuse; and to look at the patients' perception of the effect of heroin and methadone on PE. Methods: Sixty five men attending a tertiary referral clinic for methadone maintenance treatment were assessed cross-sectionally using a semi-structured questionnaire, clinical interview, review of clinical records and the International Index of Erectile Function (IIEF). Results: Thirty eight (58.5%) subjects reported a "lifetime" history of PE. Twenty (30.76%) of them reported "current" history of PE. Eleven (16.…

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

Identification of brain nuclei implicated in cocaine-primed reinstatement of conditioned place preference: a behaviour dissociable from sensitization.

Relapse prevention represents the primary therapeutic challenge in the treatment of drug addiction. As with humans, drug-seeking behaviour can be precipitated in laboratory animals by exposure to a small dose of the drug (prime). The aim of this study was to identify brain nuclei implicated in the cocaine-primed reinstatement of a conditioned place preference (CPP). Thus, a group of mice were conditioned to cocaine, had this place preference extinguished and were then tested for primed reinstatement of the original place preference. There was no correlation between the extent of drug-seeking upon reinstatement and the extent of behavioural sensitization, the extent of original CPP or the extinction profile of mice, suggesting a dissociation of these components of addictive behaviour with a drug-primed reinstatement. Expression of the protein product of the neuronal activity marker c-fos …

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Cue-induced alcohol-seeking behaviour is reduced by disrupting the reconsolidation of alcohol-related memories.

Rationale: In humans, the retrieval of memories associated with an alcohol-related experience frequently evokes alcohol-seeking behaviour. The reconsolidation hypothesis states that a consolidated memory could again become labile and susceptible to disruption after memory retrieval. Objectives: The aim of our study was to examine whether retrieval of alcohol-related memories undergoes a reconsolidation process. Methods: For this purpose, male Wistar rats were trained to self-administer ethanol in the presence of specific conditioned stimuli. Thereafter, animals were left undisturbed in their home cages for the following 21 days. Memory retrieval was performed in a single 5-min exposure to all alcohol-associated stimuli. The protein synthesis inhibitor anisomycin, the non-competitive N-methyl-D: -aspartate (NMDA) receptor antagonist MK-801 and acamprosate, a clinically used drug known to …

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