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

Nature-based experience in Venetian lagoon: Effects on craving and wellbeing in addict residential inpatients.

Introduction: It is known that exposure to the natural environment may positively modulate mental processes and behaviors; in particular, it can reduce stress, anxiety, and depressive symptoms. This suggests a potential integration of "nature experience" into the treatment for substance use disorder (SUD) since various types of addiction are associated with anxiety and depression. Considering that only one study has been reported to date in patients with alcohol use disorder, the effect of nature experience in SUD patients' needs to be further investigated. This study aimed to test the effects of exposure to a natural lagoon environment on craving and measures of wellbeing in SUD patients in comparison to exposure to an urban environment. Methods: Twenty-four SUD patients were divided into three groups of eight participants and exposed to two walking sessions (interspersed with a 1-week …

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

Addiction Research Unit: Affective and cognitive mechanisms of specific Internet-use disorders.

In the eleventh International Classification of Diseases (ICD-11) of the World Health Organization, gambling disorder and gaming disorder are included in the category 'disorders due to addictive behaviours', which can be specified further as occurring either predominantly offline or predominantly online. Other specific problematic behaviours may be considered for the category 'other specified disorders due to addictive behaviours'. The Research Unit FOR 2974, funded by the German Research Foundation (Deutsche Forschungsgemeinschaft, DFG), focuses on the most prominent online addictive behaviours: gaming, pornography use, buying-shopping and social-networks use. The main goal of the Research Unit is to contribute to a better understanding of the common and differential psychological as well as neurobiological mechanisms involved in these specific types of Internet-use disorders. We aim to…

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Nabiximols for the Treatment of Cannabis Dependence: A Randomized Clinical Trial.

Importance: There are no effective medications for treating dependence on cannabis. Objective: To examine the safety and efficacy of nabiximols in the treatment of patients with cannabis dependence. Design, setting, and participants: This parallel double-blind randomized clinical trial comparing nabiximols with placebo in a 12-week, multisite outpatient study recruited participants from February 3, 2016, to June 14, 2017, at 4 outpatient specialist alcohol and drug treatment services in New South Wales, Australia. Participants had cannabis dependence (as defined by the International Statistical Classification of Diseases and Related Health Problems, Tenth Revision) and were seeking treatment, were nonresponsive to prior treatment attempts, were 18 to 64 years of age, had no other substance use disorder, had no severe medical or psychiatric conditions, were not pregnant, were not mandated…

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

Heart rate variability biofeedback: Theoretical basis, delivery, and its potential for the treatment of substance use disorders.

Heart rate variability biofeedback (HRV BFB) is a biobehavioural clinical intervention that is gaining growing empirical support for the treatment of a number of psychological disorders, several of which are highly comorbid with substance use disorders (SUDs). The present article reviews the autonomic nervous system bases of two key processes implicated in the formation and maintenance of addictive pathology-affect dysregulation and craving-and asks if HRV BFB may be an effective intervention to ameliorate autonomic nervous system dysregulation in these processes, and as such, prove to be an effective intervention for SUDs. A detailed description of HRV BFB and its delivery is provided. Preliminary evidence suggests HRV BFB may be an effective addendum to current first-line SUD treatments, though no firm conclusions can be drawn at this time; more research is needed.

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Cue Reactivity in the Ventral Striatum Characterizes Heavy Cannabis Use, Whereas Reactivity in the Dorsal Striatum Mediates Dependent Use.

Background: Animal models of addiction suggest that the transition from incentive-driven drug use to habitual and ultimately compulsive drug use is mediated by a shift from ventral to dorsal striatal cue control over drug seeking. Previous studies in human cannabis users reported elevated trait impulsivity and neural cue reactivity in striatal circuits; however, these studies were not able to separate addiction-related from exposure-related adaptations. Methods: To differentiate the adaptive changes, the current functional magnetic resonance imaging study examined behavioral and neural cue reactivity in dependent (n = 18) and nondependent (n = 20) heavy cannabis users and a nonusing reference group (n = 44). Results: Irrespective of dependence status, cannabis users demonstrated elevated trait impulsivity as well as increased ventral striatal reactivity and striatal frontal coupling in r…

matched on Marijuana Abuse (mesh), craving (text)

Acute glucagon-like peptide-1 receptor agonist liraglutide prevents cue-, stress-, and drug-induced heroin-seeking in rats.

Substance use disorder is challenging to treat due to its relapsing nature. In the last decade, opioid use disorder has been a threat to public health, being declared an epidemic by the Centers for Disease Control and Prevention. This is a tragic situation, considering there currently are only three effective, yet not ideal, treatments to prevent relapse to opioids. Recent research has shown that hormones that modulate hunger and satiety also can modulate motivated behavior for drugs of abuse. For example, the short-acting analog of glucagon-like peptide-1 (GLP-1), an incretin hormone that regulates homeostatic feeding, has been shown to reduce responding for rewarding stimuli such as food, cocaine, heroin, and nicotine when administered over several days or weeks. This may serve as an effective adjuvant during treatment; however, whether it would be effective when used acutely to bridge…

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Cognitive Behavioral Therapy for Depression

INTRODUCTION Depressive disorders are one of the most common psychiatric disorders that occur in people of all ages across all world regions. Although it may present at any age however adolescence to early adults is the most common age of onset, and females are affected two times more in comparison to the males. Depressive disorders can occur as heterogeneous conditions in clinical scenario ranging from transient minor symptoms to severe and debilitating clinical conditions, causing severe social and occupational impairments. Usually, it presents with constellations of cognitive, emotional, behavioral, physiological, interpersonal, social, and occupational symptoms. The illness can be of various severities, and a significant proportion of the patients can have recurrent illness. Depression is also highly comorbid with several psychiatric and medical illnesses such as anxiety disorders, s…

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Continuous High Frequency Deep Brain Stimulation of the Rat Anterior Insula Attenuates the Relapse Post Withdrawal and Strengthens the Extinction of Morphine Seeking.

Deep brain stimulation (DBS) modulates the neuronal activity in specific brain circuits and has been recently considered as a promising intervention for refractory addiction. The insula cortex is the hub of interoception and is known to be involved in different aspects of substance use disorder. In the present study, we investigate the effects of continuous high frequency DBS in the anterior insula (AI) on drug-seeking behaviors and examined the molecular mechanisms of DBS action in morphine-addicted rats. Sprague-Dawley rats were trained to the morphine-conditioned place preference (CPP, day 1-8) followed by bilaterally implanted with DBS electrodes in the AI (Day 10) and recovery (Day 10-15). Continuous high-frequency (HF) -DBS (130 Hz, 150 μA, 90 μs) was applied during withdrawal (Day 16-30) or extinction sessions. CPP tests were conducted on days 16, 30, 40 during withdrawal session …

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

Recovery schools for improving behavioral and academic outcomes among students in recovery from substance use disorders: a systematic review.

This Campbell systematic review examines the effects of recovery schools on student behavioral and academic outcomes, compared to the effects of non-recovery schools. The review summarizes evidence from one quasi-experimental study (with a total of 194 participants) that had potential serious risk of bias due to confounding. Sizable portions of youth are in recovery from substance use disorders, and many youth will return to use after receiving substance use treatment. Youth spend most of their waking hours at school, and thus schools are important social environments for youth in recovery from substance use disorders. Recovery schools have been identified as educational programs that may help support youth in recovery from substance use disorders. This review focused on two types of recovery schools: RHSs, which are schools that award secondary school diplomas and offer a range of thera…

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Sex-specific effects of cigarette smoking on caudate and amygdala volume and resting-state functional connectivity.

Recent studies have demonstrated sex-specific differences in etiology, course and brain dysfunction that are associated with cigarette smoking. However, little is known about sex-specific differences in subcortical structure and function. In this study, structural and resting-state functional magnetic resonance imaging (fMRI) data were collected from 60 cigarette smokers (25 females) and 67 nonsmokers (28 females). The structural MRI was applied to identify deficits in sex-specific subcortical volume. Using resting-state fMRI, sex-related alterations in resting-state functional connectivity (rsFC) were investigated in subcortical nuclei with volume deficits as seed regions. Compared to nonsmokers, male but not female smokers demonstrated a significantly smaller volume in the left caudate, while female but not male smokers showed a smaller volume in the right amygdala. Resting-state FC an…

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Incubation of neural alcohol cue reactivity after withdrawal and its blockade by naltrexone.

During the first weeks of abstinence, alcohol craving in patients may increase or "incubate." We hypothesize that Naltrexone (NTX) blocks this incubation effect. Here, we compared NTX effects on neural alcohol cue reactivity (CR) over the first weeks of abstinence and on long-term clinical outcomes to standard treatment. Male alcohol-dependent patients (n = 55) and healthy controls (n = 35) were enrolled. Participants underwent baseline psychometric testing and functional magnetic resonance imaging (fMRI) assessment of mesolimbic alcohol CR. Patients participated in a standard treatment program with the option of adjuvant NTX. They received another scan after 2 weeks of treatment. We found higher CR in several brain regions in patients versus healthy controls. CR significantly increased over 2 weeks in the standard treatment group (n = 13) but not in the NTX group (n = 22). NTX significa…

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Alcohol Craving Predicts Relapse After Residential Addiction Treatment.

Aims: Replicate the previously reported association of elevated alcohol craving, measured by Penn Alcohol Craving Scale (PACS) during residential treatment, with post-treatment relapse and explore whether elevated craving scores 3 months post-treatment are also associated with subsequent relapse. Methods: Alcohol craving was assessed with the PACS on admission and at several time points post-treatment in 190 subjects with DSM-IV diagnosis of alcohol dependence admitted to residential treatment. Data about relapse to any drinking (primary outcome measure) was collected at 3, 6, 9 and 12 months after treatment. Cox regression models were used to determine whether PACS scores were associated with relapse. Statistical models were adjusted for meaningful demographic and clinical covariates. Results: Follow-up data was available for 149/190 (78%) of subjects. Elevated PACS scores at discharge …

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Relationship between Craving and Early Relapse in Alcohol Dependence: A Short-Term Follow-up Study.

Background: The role of craving in alcohol dependence and its relationship with relapse has been studied widely in the past decade. The present study was undertaken to assess the role of craving in short-term relapse of patients seeking treatment for alcohol dependence and changes in craving score at the end of detoxification and at follow-up. Materials and methods: A total of 34 male individuals with alcohol dependence (excluding comorbid drug dependence, organic or psychiatric disorder), after detoxification and discharge, consented. No anticraving medicine, aversive or psychotherapy, was advised. They were diagnosed on the International Statistical Classification of Diseases-10 using Diagnostic Interview for Genetic Studies. Severity of Alcohol Dependence Questionnaire (SADQ) and Clinical Institute Withdrawal Assessment Scale-Alcohol-Revised (CIWA-AR) were administered at the time of …

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Using Virtual Reality in the Treatment of Gambling Disorder: The Development of a New Tool for Cognitive Behavior Therapy.

Virtual reality (VR) can be used in the treatment of gambling disorder to provide emotionally charged contexts (e.g., induce cravings) where patients can practice cognitive behavior therapy (CBT) techniques in the safety of the therapist's office. This raises practical questions, such as whether the cravings are sufficient to be clinically useful but also manageable enough to remain clinically safe. Pilot data are also needed to test the development of a treatment manual and prepare large randomized control trials. This paper reports on three studies describing (a) cravings induced in VR compared to real gambling and a control game of skill with no money involved (N = 28 frequent gamblers and 36 infrequent gamblers); (b) the usefulness of a treatment protocol with only two CBT sessions using VR (N = 34 pathological gamblers); and (c) the safety of a four-session treatment program of CBT …

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Effect of short-term heart rate variability biofeedback on long-term abstinence in alcohol dependent patients - a one-year follow-up.

Background: A randomized controlled study (RCT) recently showed that short-term heart rate variability (HRV) biofeedback in addition to standard rehabilitation care for alcohol dependence can reduce craving, anxiety and improve cardiovascular autonomic function. In this one-year follow-up study we aimed to explore whether completion of 2-week HRV-Biofeedback training is associated with long-term abstinence. Furthermore, we sought to identify potential predictors of post-treatment abstinence. Methods: We conducted a survey on abstinence in patients with alcohol dependence 1 year after completion of an RCT comparing HRV-biofeedback in addition to inpatient rehabilitation treatment alone (controls). Abstinence rates were compared and analysed for association with demographic data as well as psychometric and autonomic cardiac assessment before and after completion of the biofeedback training…

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Phosphoproteomic Analysis Reveals a Novel Mechanism of CaMKIIα Regulation Inversely Induced by Cocaine Memory Extinction versus Reconsolidation.

Unlabelled: Successful addiction treatment depends on maintaining long-term abstinence, making relapse prevention an essential therapeutic goal. However, exposure to environmental cues associated with drug use often thwarts abstinence efforts by triggering drug using memories that drive craving and relapse. We sought to develop a dual approach for weakening cocaine memories through phosphoproteomic identification of targets regulated in opposite directions by memory extinction compared with reconsolidation in male Sprague-Dawley rats that had been trained to self-administer cocaine paired with an audiovisual cue. We discovered a novel, inversely regulated, memory-dependent phosphorylation event on calcium-calmodulin-dependent kinase II α (CaMKIIα) at serine (S)331. Correspondingly, extinction-associated S331 phosphorylation inhibited CaMKIIα activity. Intra-basolateral amygdala inhibitio…

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Right anterior insula connectivity is important for cue-induced craving in nicotine-dependent smokers.

The insula has been implicated in cue-induced craving and relapse in nicotine-dependent tobacco cigarette smokers. The aims of the present study were to identify brain regions that exhibit greater functional connectivity with the right anterior insula in response to smoking cues than to neutral cues and the role of functional connectivity between these regions in mediating cue-induced craving in healthy (free of axis I psychiatric disorders) nicotine-dependent tobacco cigarette smokers. Functional magnetic resonance imaging data were collected from 63 healthy nicotine-dependent smokers viewing blocks of smoking and neutral cues. Craving ratings were obtained after each block. A psychophysiologic interaction approach was used to identify regions that exhibited significantly greater functional connectivity with the right anterior insula (seed) during the smoking cues than during the neutra…

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Neural correlates of adherence to extended-release naltrexone pharmacotherapy in heroin dependence.

Injectable extended-release naltrexone (XRNTX) presents an effective therapeutic strategy for opioid addiction, however its utility could be hampered by poor adherence. To gain a better insight into this phenomenon, we utilized blood oxygenation level-dependent functional magnetic resonance imaging (fMRI) in conjunction with a validated cue-induced craving procedure to examine neural correlates of XRNTX adherence. We operationalized treatment adherence as the number of monthly XRNTX injections (range: 0-3) administered to a group of fully detoxified heroin-dependent subjects (n=32). Additional outcomes included urine toxicology screening and self-reported tobacco use. The presented heroin-related visual cues reliably elicited heroin craving in all tested subjects. Nine, five, three and 15 of the participants, respectively, received zero, one, two and three XRNTX injections, predicted by …

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Intestinal permeability, gut-bacterial dysbiosis, and behavioral markers of alcohol-dependence severity.

Alcohol dependence has traditionally been considered a brain disorder. Alteration in the composition of the gut microbiota has recently been shown to be present in psychiatric disorders, which suggests the possibility of gut-to-brain interactions in the development of alcohol dependence. The aim of the present study was to explore whether changes in gut permeability are linked to gut-microbiota composition and activity in alcohol-dependent subjects. We also investigated whether gut dysfunction is associated with the psychological symptoms of alcohol dependence. Finally, we tested the reversibility of the biological and behavioral parameters after a short-term detoxification program. We found that some, but not all, alcohol-dependent subjects developed gut leakiness, which was associated with higher scores of depression, anxiety, and alcohol craving after 3 wk of abstinence, which may be …

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The hypocretins and the reward function: what have we learned so far?

A general consensus acknowledges that drug consumption (including alcohol, tobacco, and illicit drugs) constitutes the leading cause of preventable death worldwide. But the global burden of drug abuse extends the mortality statistics. Indeed, the comorbid long-term debilitating effects of the disease also significantly deteriorate the quality of life of individuals suffering from addiction disorders. Despite the large body of evidence delineating the cellular and molecular adaptations induced by chronic drug consumption, the brain mechanisms responsible for drug craving and relapse remain insufficiently understood, and even the most recent developments in the field have not brought significant improvement in the management of drug dependence. Though, recent preclinical evidence suggests that disrupting the hypocretin (orexin) system may serve as an anticraving medication therapy. Here, w…

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Discriminative inhibitory control of cocaine seeking involves the prelimbic prefrontal cortex.

Background: Recent neuroimaging studies have shown that people with cocaine addiction retain some degree of control over drug craving that correlates with neural activity in the lateral prefrontal cortex (PFC). Here, we report similar findings in a rat model of inhibitory control of cocaine seeking. Methods: Rats actively responding for cocaine were trained to stop responding when presented with a discriminative stimulus that signaled lack of reinforcement. Rats were then tested for inhibitory control of cocaine seeking in novel behavioral contexts and in circumstances when cocaine seeking is particularly intense (e.g., following drug priming). The role of neuronal activity in different subregions of the PFC was assessed using local pharmacologic inactivation and c-Fos immunohistochemistry. Results: Rats progressively acquired the ability to stop cocaine seeking, even during drug intoxic…

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Drug-related cues exacerbate decision making and increase craving in heroin addicts at different abstinence times.

Rationale: Relapse is a persistent problem in the management of addiction. Drug-related cues are powerful instigators of relapse. Impulsive decision making may contribute to relapse through a poorly considered assessment of the consequences of drug use. Drug cues robustly increase subjective craving, which is frequently associated with relapse. Objective: The present study explored the effects of drug-related cues on decision making and craving in heroin addicts at different abstinence times: 1, 3, 12, and 24 months. Methods: The 75 male participants were given 5 min exposure to neutral and drug-associated cues while decision making performance, craving, blood pressure, heart rate, and emotional state pre- and post-exposure were assessed. The Iowa Gambling Task was used to evaluate decision making ability in heroin addicts. Results: Drug-related cues exacerbated impulsive decision making…

matched on craving (text), relapse (text)

Craving in response to stress induction in a human laboratory paradigm predicts treatment outcome in alcohol-dependent individuals.

Rationale: Alcohol dependence is associated with high rates of recidivism. Stress has been shown to increase alcohol craving in alcohol-dependent individuals, but the association between stress-induced craving and alcoholism treatment outcome is not well understood. Objective: The aim of the present study was to examine the relationship between strength of stress-induced alcohol craving in the human laboratory and subsequent drinking in a cohort of treatment-seeking, alcohol-dependent adults. Materials and methods: This is a prospective study assessing stress-induced craving in the lab and subsequent treatment outcomes in alcohol-dependent subjects enrolled in a 12-week outpatient study. Stress was induced using a previously developed, individualized, audio recorded stress script and validated with objective (salivary cortisol) and subjective measures of distress. In vivo craving for alc…

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Reactivity to laboratory stress provocation predicts relapse to cocaine.

Background: Cocaine dependence is a chronic relapsing disorder characterized by periods of abstinence and high rates of return to drug using behavior. Elevated levels of stress have been associated with relapse to cocaine; however, the nature of this association is not well understood. Methods: The relationship between reactivity to three human laboratory provocations and relapse to cocaine was investigated. Participants were 53 cocaine-dependent individuals who were admitted for a 2-day inpatient stay during which a psychosocial provocation (i.e., the Trier Social Stress Task), a pharmacological provocation (i.e., administration of 1 microg/kg corticotrophin releasing hormone; CRH), and a drug cue exposure paradigm were completed. Adrenocortico-trophic hormone (ACTH), cortisol, heart rate, and subjective cocaine craving and stress were assessed at baseline and at multiple time points po…

matched on craving (text), relapse (text)

Difficulties in emotion regulation and impulse control in recently abstinent alcoholics compared with social drinkers.

Background: Early abstinence from chronic alcohol dependence is associated with increased emotional sensitivity to stress-related craving as well as changes in brain systems associated with stress and emotional processing. The aim of the current study was to examine potential difficulties in emotion regulation during early alcohol abstinence using the recently validated Difficulties of Emotion Regulation Scale (DERS). Method: Recently abstinent treatment-seeking alcohol abusers (n=50) completed the DERS during their first week of inpatient treatment and at discharge (5 weeks later). These responses were compared to a group of social drinkers (n=62). Results: Compared with social drinkers, alcohol-dependent patients reported significant differences in emotional awareness and impulse control during week 1 of treatment. Significant improvements in awareness and clarity of emotion were obser…

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