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Archives of Women's Mental Health Oct 2023The co-occurrence of substance use disorders (SUD) and other mental disorders (OMD) is assumed to be high, but the details are uncertain in Spain. The objective of the... (Randomized Controlled Trial)
Randomized Controlled Trial
The co-occurrence of substance use disorders (SUD) and other mental disorders (OMD) is assumed to be high, but the details are uncertain in Spain. The objective of the present study was to know the prevalence of this comorbidity, as well as the pharmacological treatment, both in specific addiction treatment networks and in mental health networks, with a gender perspective. Observational, multicenter study, with a randomized sample, of patients under treatment for SUD or OMD in Spain (N = 1783). A specific questionnaire, collecting sociodemographic and clinical variables, diagnosed SUD and OMD, and prescribed psychotropic drugs, was completed by treating clinicians. Differences between females and males were searched. A high prevalence of OMD was found in those patients treated for their SUD (71%), and also of diagnoses of SUD (59%) in people treated for OMD. Significant relationships between addiction to certain substances and specific mental disorders were found (with no main differences between women and men). The treatments for OMD were very common in the addiction treatment networks, but that of SUDs in those patients treated in the mental health networks was less than expected. A high prescription of benzodiazepines was found. Women were less frequently diagnosed with cannabis, opioid, and especially cocaine use disorders, and they had fewer psychotic disorders and more affective, anxiety, sleep, and eating disorders, with the rest being the same, including personality disorders. Women had fewer treatments with agonists and more with antagonists, and more prescriptions of anxiolytics and antidepressants. This study provides preliminary information on the coexistence in routine clinical practice of addictive disorders and other mental disorders in Spain, and on the treatment provided, and shows differences in prevalence and clinical characteristics, and especially in treatment approaches between women and men. Thus, should be useful to adapt the treatment response with greater precision, and with a gender perspective.
Topics: Male; Humans; Female; Mental Disorders; Substance-Related Disorders; Comorbidity; Personality Disorders; Psychotic Disorders
PubMed: 37540344
DOI: 10.1007/s00737-023-01353-w -
Revista Colombiana de Psiquiatria... 2024The co-occurrence of substance use disorder with at least one other mental disorder is called dual pathology, which in turn is characterised by heterogeneous symptoms... (Review)
Review
INTRODUCTION
The co-occurrence of substance use disorder with at least one other mental disorder is called dual pathology, which in turn is characterised by heterogeneous symptoms that are difficult to diagnose and have a poor response to treatment. For this reason, the identification and validation of biomarkers is necessary. Within this group, possible electroencephalographic biomarkers have been reported to be useful in diagnosis, treatment and follow-up, both in neuropsychiatric conditions and in substance use disorders. This article aims to review the existing literature on electroencephalographic biomarkers in dual pathology.
METHODS
A narrative review of the literature. A bibliographic search was performed on the PubMed, Science Direct, OVID, BIREME and Scielo databases, with the keywords: electrophysiological biomarker and substance use disorder, electrophysiological biomarker and mental disorders, biomarker and dual pathology, biomarker and substance use disorder, electroencephalography, and substance use disorder or comorbid mental disorder.
RESULTS
Given the greater amount of literature found in relation to electroencephalography as a biomarker of mental illness and substance use disorders, and the few articles found on dual pathology, the evidence is organised as a biomarker in psychiatry for the diagnosis and prediction of risk and as a biomarker for dual pathology.
CONCLUSIONS
Although the evidence is not conclusive, it suggests the existence of a subset of sites and mechanisms where the effects of psychoactive substances and the neurobiology of some mental disorders could overlap or interact.
Topics: Humans; Electroencephalography; Biomarkers; Mental Disorders; Substance-Related Disorders; Diagnosis, Dual (Psychiatry)
PubMed: 38677941
DOI: 10.1016/j.rcpeng.2024.04.003 -
Current Opinion in Psychiatry Jul 2024The worldwide spread of novel psychoactive substances (NPS) in the illicit drug market and their continuous increase in number and type, for the purpose of bypassing... (Review)
Review
PURPOSE OF REVIEW
The worldwide spread of novel psychoactive substances (NPS) in the illicit drug market and their continuous increase in number and type, for the purpose of bypassing controlled substance legislation, represents a continuing challenge for forensic scientists, clinicians and enforcement authorities. We aim to provide information regarding the most urgent harms related to NPS consumption in different world regions and the current state of the art for NPS analysis.
RECENT FINDINGS
Unfortunately, the identification of NPS in biological samples is controversial, especially when samples are limited, or the drug is promptly and extensively metabolized. This causes a lack of information on their real diffusion in different parts of the world and in different populations. New technologies and instrumental detection of NPS in alternative samples are offering comprehensive information about NPS use.
SUMMARY
The lack of detection and underreporting of NPS in biological samples makes it difficult to obtain complete qualitative and quantitative information about NPS prevalence. The most innovative strategies that have been proposed in the last 2 years to assist NPS analysis and possibly facilitate the understanding of the NPS diffusion around the world are presented.
Topics: Humans; Psychotropic Drugs; Illicit Drugs; Substance Abuse Detection; Substance-Related Disorders
PubMed: 38818825
DOI: 10.1097/YCO.0000000000000939 -
Brazilian Journal of Anesthesiology... 2023Diversion of substances from the care of the intended patient is a significant problem in healthcare. Patients are harmed by the undertreatment of pain and suffering,... (Review)
Review
Diversion of substances from the care of the intended patient is a significant problem in healthcare. Patients are harmed by the undertreatment of pain and suffering, transmission of disease, as well as the risk associated with impaired vigilance. Healthcare providers may be harmed by the physical and mental impact of their addictions. Healthcare systems are placed in jeopardy by the legal impact associated with illegal routes of drug release including sanction and financial liability and loss of public trust. Healthcare institutions have implemented many measures to reduce diversion from the perioperative area. These efforts include education, medical record surveillance, automated medication dispensing systems, urine drug testing, substance waste management systems, and drug diversion prevention teams. This narrative review evaluates strengths, weaknesses, and effectiveness of these systems and provides recommendations for leaders and care providers.
Topics: Humans; Anesthesiologists; Prescription Drug Diversion; Substance-Related Disorders; Health Personnel; Pain
PubMed: 37517585
DOI: 10.1016/j.bjane.2023.07.008 -
The Psychiatric Clinics of North America Dec 2023Research has led to the development of hundreds of evidence-based prevention interventions, most of which are school-based prevention programs. Most primary care... (Review)
Review
Research has led to the development of hundreds of evidence-based prevention interventions, most of which are school-based prevention programs. Most primary care clinicians and child/adolescent behavioral health clinicians are unfamiliar with and/or lack training in evidence-based prevention interventions. However, most clinicians in these settings routinely screen children for developmental delays and skills deficits that increase the risk of developing substance abuse and a broad range of mental health and behavior problems by adolescence. It is hoped that the broader use of these practical evidence-based prevention tools may expand the prevention workforce to address the current youth mental health crisis.
Topics: Child; Adolescent; Humans; Substance-Related Disorders; Mental Health
PubMed: 37879835
DOI: 10.1016/j.psc.2023.03.002 -
Alternative Therapies in Health and... Sep 2023Drug addiction, or substance abuse disorder, has a long history. The use of a drug that causes dependence has been used in various religious and tribal initiation... (Review)
Review
BACKGROUND
Drug addiction, or substance abuse disorder, has a long history. The use of a drug that causes dependence has been used in various religious and tribal initiation ceremonies. Currently, recreational use or peer modelling leads an individual to substance abuse. The magnitude of the problem of addiction increases multifold in the presence of stressors like broken families, joblessness, occupational stress, etc.
OBJECTIVES
The de-addiction process is used to relieve an individual's craving for the drug. It is a painful process, as several effects of withdrawal compel a person to return to the drugs again and again. Our aim is to explore the available literature on the use of Unani medicine for de-addiction.
METHODOLOGY
We surveyed various classical books from the available literature for drug de-addiction in Unani medicine. Indexed journals were also surveyed for the available related material using various keywords like "opium addiction" and "Unani medicine and de-addiction " and the information was filtered for this review.
RESULTS
We observed that there was an elaborate scheme for de-addiction in opium addiction and the process is so general that it could serve as a framework for the de-addiction process for other similar drugs.
CONCLUSION
Unani medicine is significant in the literature as being among the the available de-addiction addiction processes and may furnish several leads for various herbal drugs that may be used for de-addiction in the future.
Topics: Humans; Medicine, Unani; Substance-Related Disorders
PubMed: 35452418
DOI: No ID Found -
International Journal of Environmental... Jul 2023This study aimed to assess the ability of community pharmacists to recognize cases of loperamide abuse at the point of sale, their perspective of and experience toward...
UNLABELLED
This study aimed to assess the ability of community pharmacists to recognize cases of loperamide abuse at the point of sale, their perspective of and experience toward potential abuse cases.
METHODS
A cross-sectional study was conducted in Jordan, using a self-administered online questionnaire. The questionnaire consisted of three main parts: demographics, the experience of pharmacists with abusers' behavior, as well as their perspectives toward loperamide abuse.
RESULTS
A total of 250 community pharmacists completed the survey, 54% (135) of which were female. Almost one-third (33.2%; 83) of the participants reported exposure to suspected cases of loperamide abuse during the last six months. Pharmacists declared that most of the suspected loperamide abusers were male (60.2%), of middle-low socioeconomic status (69.9%), and between 20 and 30 years of age (57.8%). The largest quantity (packs) of loperamide requested by a single patient was around 33.2 ± 14.9 at once. As reported by pharmacists, the suspected reasons behind loperamide abuse included 50% seeking euphoria, 17% relieving anxiety, and 33% controlling addiction (weaning off other opioids). The multivariate logistic regression analysis demonstrated a significant correlation between the male sex (OR = 1.2, 95% CI 0.12-1.59), pharmacy location in the center of Jordan (OR = 21.2, 95% CI 2.45-183.59), late-night working shift (Shift C, OR = 1.29, 95% CI 0.12-2.08), and abuse to loperamide during the last six months.
CONCLUSIONS
This study sheds light on loperamide abuse potentials, which could be influenced by different sociodemographic characteristics. Accordingly, close monitoring and thorough tackling of the abuse practices are mandated through an increase in educational and awareness campaigns about proper medication use.
Topics: Humans; Male; Female; Loperamide; Antidiarrheals; Pharmacists; Cross-Sectional Studies; Substance-Related Disorders
PubMed: 37510632
DOI: 10.3390/ijerph20146400 -
The Psychiatric Clinics of North America Dec 2023The wide and effective dissemination of research findings is crucial to the mission of the National Institute on Drug Abuse (NIDA). This article describes NIDA... (Review)
Review
The wide and effective dissemination of research findings is crucial to the mission of the National Institute on Drug Abuse (NIDA). This article describes NIDA dissemination efforts and resources that are available to inform clinicians, teens, families, and educators about youth and substance use. Resources that are available include content addressing facts about youth drug use, trends in use, and stigma, in addition to substance use disorder (SUD) prevention and treatment. Information is provided about resources such as infographics, research-based practice guides, training, educational events, and online videos. How input is solicited to inform dissemination efforts is described and future directions for NIDA's dissemination efforts are outlined.
Topics: Adolescent; United States; Humans; National Institute on Drug Abuse (U.S.); Adolescent Health; Substance-Related Disorders
PubMed: 37879839
DOI: 10.1016/j.psc.2023.03.009 -
Medicina Clinica May 2024Substance use is a common health problem, and substance use disorder, which is its most severe presentation, is associated with multiple medical consequences and a... (Review)
Review
Substance use is a common health problem, and substance use disorder, which is its most severe presentation, is associated with multiple medical consequences and a negative impact on individual and on population health. Substance use disorder needs to be addressed as any chronic medical condition; therefore, it has to be detected at the early stages and has to be properly treated to prevent drug-related harm. Internists should be able to recognize and treat intoxication and abstinence. Internists should also be able to refer the patient to state of the art long term treatment, aimed to detoxification and treatment induction to promote abstinence and prevent relapse. In this narrative review we will discuss substance use epidemiology, its main medical consequences and its treatment, with a focus on alcohol, opiates, cocaine and other stimulants, cannabis and benzodiazepines.
Topics: Humans; Substance-Related Disorders
PubMed: 38218656
DOI: 10.1016/j.medcli.2023.11.016 -
Journal of Psychopharmacology (Oxford,... Dec 2023Drugs that act on the central nervous system (CNS) and have sedative effects can lead to abuse in humans. New CNS-active drugs often require evaluation of their abuse...
BACKGROUND
Drugs that act on the central nervous system (CNS) and have sedative effects can lead to abuse in humans. New CNS-active drugs often require evaluation of their abuse potential in dedicated animal models before marketing approval. Daridorexant is a new dual orexin receptor antagonist (DORA) with sleep-promoting properties in animals and humans. It was approved in 2022 in the United States and Europe for the treatment of insomnia disorder.
AIMS
Nonclinical evaluation of abuse potential of daridorexant using three specific rat models assessing reinforcement, interoception, and withdrawal.
METHODS
Reinforcing effects of daridorexant were assessed in an operant rat model of intravenous drug self-administration. Similarity of interoceptive effects to those of the commonly used sleep medication zolpidem was tested in an operant drug discrimination task. Withdrawal signs indicative of physical dependence were evaluated upon sudden termination of chronic daridorexant treatment. Rat experiments were conducted at a dose range resulting in daridorexant plasma concentrations equaling or exceeding those achieved at the clinically recommended dose of 50 mg in humans.
RESULTS
Daridorexant had no reinforcing effects, was dissimilar to zolpidem in the drug discrimination task, and did not induce any withdrawal-related signs upon treatment discontinuation that would be indicative of physical dependence.
OUTCOMES
Daridorexant showed no signs of abuse or dependence potential in rats. Our data indicate that daridorexant, like other DORAs, has a low potential for abuse in humans.
Topics: Humans; Rats; Animals; Orexin Receptor Antagonists; Zolpidem; Imidazoles; Pyrrolidines; Sleep Initiation and Maintenance Disorders; Substance-Related Disorders
PubMed: 38059356
DOI: 10.1177/02698811231215415