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Der Nervenarzt Nov 2020Homelessness is an expression of marked social exclusion phenomena and often particularly affects people with mental disorders. Mental disorders often precede the onset... (Review)
Review
Homelessness is an expression of marked social exclusion phenomena and often particularly affects people with mental disorders. Mental disorders often precede the onset of homelessness but can also be a result of homelessness. Different forms of therapeutic and social support interventions have been evaluated in various countries, predominantly with an outreach treatment approach. These interventions were often combined with low threshold availability of housing programs. These showed positive effects on housing stability and reduction of psychiatric symptoms but not in reduction of substance use disorders. Peer support strategies and the use of digital media are possible options for future therapeutic strategies.
Topics: Ill-Housed Persons; Housing; Humans; Internet; Mental Disorders; Substance-Related Disorders
PubMed: 32897391
DOI: 10.1007/s00115-020-00986-x -
Adicciones Nov 2020
Topics: Animals; Brain; Humans; Stress, Psychological; Substance-Related Disorders
PubMed: 32677686
DOI: 10.20882/adicciones.1470 -
Health and Human Rights Jun 2020The primary purpose of political, civil, socioeconomic, and cultural rights is to protect the dignity of all human beings. Good mental health and well-being is defined...
The primary purpose of political, civil, socioeconomic, and cultural rights is to protect the dignity of all human beings. Good mental health and well-being is defined by the "social, psychosocial, economic, and physical environment that enables individuals and populations to live a life of dignity, with full enjoyment of their rights and in the equitable pursuit of their potential." Stigmatization, discrimination, and negative stereotypes are barriers to mental health and well-being. Individuals with mental health problems, including those with drug dependence, suffer stigmatization, which is a direct affront to dignity and may have enduring health impacts. This paper discusses the implications of stigma for a human-rights based approach to improving mental health among those with drug dependence, with a focus on the opioid epidemic now ravaging the United States. It explores the public health burden of stigma related to substance misuse, including stigma in the context of treatment and health care. It also discusses the role of policy initiatives-including decriminalization-in addressing stigma related to substance misuse.
Topics: Human Rights; Humans; Public Health; Respect; Social Stigma; Substance-Related Disorders; United States
PubMed: 32669788
DOI: No ID Found -
Alcohol Research : Current Reviews 2020Alcohol, tobacco, and cannabis are the substances most frequently used during pregnancy, and opioid-exposed pregnancies have increased fourfold. The purpose of this... (Review)
Review
Alcohol, tobacco, and cannabis are the substances most frequently used during pregnancy, and opioid-exposed pregnancies have increased fourfold. The purpose of this review is to describe the prevalence and consequences of prenatal exposure to alcohol, tobacco, cannabis, and opioids. Currently available screening questionnaires for prenatal substance use are summarized and contrasted with the measures available for prenatal alcohol use. Because screening for prenatal alcohol and substance use is but the prelude to efforts to mitigate the potential adverse consequences, attempts for the modification of these consequences are briefly reviewed. In addition, areas of future research related to the criminalization of prenatal substance use, which may inhibit both inquiry and disclosure, are discussed. Indeed, the full potential of effective interventions has yet to be realized.
Topics: Alcohol Drinking; Female; Humans; Marijuana Use; Opioid-Related Disorders; Pregnancy; Prenatal Exposure Delayed Effects; Substance-Related Disorders; Tobacco Use
PubMed: 32612898
DOI: 10.35946/arcr.v40.2.06 -
Pain Management Nursing : Official... Dec 2022The American Society for Pain Management Nursing and the International Nurses Society on Addictions hold the position that persons with co-occurring pain and substance...
The American Society for Pain Management Nursing and the International Nurses Society on Addictions hold the position that persons with co-occurring pain and substance use disorder have the right to be treated with dignity and respect, and receive evidence-based, high-quality assessment and management for both conditions using an integrated, holistic, multidimensional approach. Non-opioid and nonpharmacological approaches to pain management are recommended. Opioids should not be withheld from anyone if necessary to treat pain, and a team-based approach, including pain and addiction specialists, should be utilized when possible. Pain management should include interventions aimed at minimizing the risk for relapse or escalation of problematic substance use, and actively involve the person and their support persons in the plan of care. Institutions should establish policies and procedures that support this position statement.
Topics: Humans; Pain Management; Analgesics, Opioid; Pain; Substance-Related Disorders; Opioid-Related Disorders
PubMed: 36202737
DOI: 10.1016/j.pmn.2022.08.015 -
Pharmacology, Biochemistry, and Behavior Jan 2020Addiction to drug and alcohol is regarded as a major health problem worldwide for which available treatments show limited effectiveness. The biggest challenge remains to... (Review)
Review
Addiction to drug and alcohol is regarded as a major health problem worldwide for which available treatments show limited effectiveness. The biggest challenge remains to enhance the capacities of interventions to reduce craving, prevent relapse and promote long-term recovery. New strategies to meet these challenges are being explored. Findings from preclinical work suggest that environmental enrichment (EE) holds therapeutic potential for the treatment of substance use disorders, as demonstrated in a number of animal models of drug abuse. The EE intervention introduced after drug exposure leads to attenuation of compulsive drug taking, attenuation of the rewarding (and reinforcing) effects of drugs, reductions in control of behavior by drug cues, and, very importantly, relapse prevention. Clinical work also suggests that multidimensional EE interventions (involving physical activity, social interaction, vocational training, recreational and community involvement) might produce similar therapeutic effects, if implemented continuously and rigorously. In this review we survey preclinical and clinical studies assessing the efficacy of EE as a behavioral intervention for substance use disorders and address related challenges. We also review work providing empirical evidence for EE-induced neuroplasticity within the mesocorticolimbic system that is believed to contribute to the seemingly therapeutic effects of EE on drug and alcohol-related behaviors.
Topics: Animals; Brain; Conditioning, Psychological; Environment; Exercise; Humans; Recurrence; Substance-Related Disorders; Treatment Outcome
PubMed: 31778722
DOI: 10.1016/j.pbb.2019.172829 -
The Journal of Headache and Pain Apr 2021Chronic headache is particularly prevalent in migraineurs and it can progress to a condition known as medication overuse headache (MOH). MOH is a secondary headache... (Review)
Review
Chronic headache is particularly prevalent in migraineurs and it can progress to a condition known as medication overuse headache (MOH). MOH is a secondary headache caused by overuse of analgesics or other medications such as triptans to abort acute migraine attacks. The worsening of headache symptoms associated with medication overuse (MO) generally ameliorates following interruption of regular medication use, although the primary headache symptoms remain unaffected. MO patients may also develop certain behaviors such as ritualized drug administration, psychological drug attachment, and withdrawal symptoms that have been suggested to correlate with drug addiction. Although several reviews have been performed on this topic, to the authors best knowledge none of them have examined this topic from the addiction point of view. Therefore, we aimed to identify features in MO and drug addiction that may correlate. We initiate the review by introducing the classes of analgesics and medications that can cause MOH and those with high risk to produce MO. We further compare differences between sensitization resulting from MO and from drug addiction, the neuronal pathways that may be involved, and the genetic susceptibility that may overlap between the two conditions. Finally, ICHD recommendations to treat MOH will be provided herein.
Topics: Analgesics; Headache Disorders, Secondary; Humans; Migraine Disorders; Prescription Drug Overuse; Substance-Related Disorders; Tryptamines
PubMed: 33910499
DOI: 10.1186/s10194-021-01224-8 -
Journal of Dual Diagnosis 2022This study evaluated the presence of drug-free family and friends in the social networks of patients treated in an inpatient setting for co-occurring psychiatric...
This study evaluated the presence of drug-free family and friends in the social networks of patients treated in an inpatient setting for co-occurring psychiatric disorders and substance use problems. Social network interviews were conducted with inpatients at the Johns Hopkins Bayview Acute Psychiatric Unit with co-occurring psychiatric disorders and substance use problems ( = 90). Participants reported about five social network members, of which four were drug-free. Most participants (> 70%) were willing to include a drug-free person in the current inpatient treatment plan to support recovery efforts ( = 1.8 network members) and identified several areas of recovery support. These results demonstrate that people treated in an inpatient psychiatric setting have local drug-free family or friends that they are willing to include in the treatment process. These findings support further study of methods to mobilize network members to enhance social support during and following hospitalization.
Topics: Humans; Inpatients; Community Support; Mental Disorders; Substance-Related Disorders; Social Support
PubMed: 36208467
DOI: 10.1080/15504263.2022.2125605 -
Neurotherapeutics : the Journal of the... Jan 2020Environmental contexts that are reliably associated with the use of pharmacologically active substances are hypothesized to contribute to substance use disorders. In... (Review)
Review
Environmental contexts that are reliably associated with the use of pharmacologically active substances are hypothesized to contribute to substance use disorders. In this review, we provide an updated summary of parallel preclinical and human studies that support this hypothesis. Research conducted in rats shows that environmental contexts that are reliably paired with drug use can renew extinguished drug-seeking behavior and amplify responding elicited by discrete, drug-predictive cues. Akin to drug-associated contexts, interoceptive drug stimuli produced by the psychopharmacological effects of drugs can also influence learning and memory processes that play a role in substance use disorders. Findings from human laboratory studies show that drug-associated contexts, including social stimuli, can have profound effects on cue reactivity, drug use, and drug-related cognitive expectancies. This translationally relevant research supports the idea that treatments for substance use disorders could be improved by considering drug-associated contexts as a factor in treatment interventions. We conclude this review with ideas for how to integrate drug-associated contexts into treatment-oriented research based on 4 approaches: pharmacology, brain stimulation, mindfulness-based relapse prevention, and cognitive behavioral group therapy. Throughout, we focus on alcohol- and tobacco-related research, which are two of the most prevalent and commonly misused drugs worldwide for which there are known treatments.
Topics: Animals; Brain; Conditioning, Psychological; Disease Models, Animal; Drug-Seeking Behavior; Humans; Substance-Related Disorders
PubMed: 31898285
DOI: 10.1007/s13311-019-00824-2 -
The International Journal on Drug Policy Aug 2021Over the past decades gamma-hydroxybutyrate (GHB) has emerged as a popular drug with high potential of (ab)use due to its euphoric and relaxing effects. An overview of... (Review)
Review
BACKGROUND
Over the past decades gamma-hydroxybutyrate (GHB) has emerged as a popular drug with high potential of (ab)use due to its euphoric and relaxing effects. An overview of different populations using GHB is urgently needed, since this would enable development of adequate prevention and treatment policies to diminish the risks associated with GHB use. We systematically reviewed literature on different GHB using populations, comparing demographic characteristics, GHB use patterns, psychosocial aspects and psychiatric comorbidity.
METHODS
We conducted a systematic review following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines using Rayyan software. Original studies published from January 1997 up to October 2019 on GHB use were included. Out of 80 full-text articles, 60 articles of 51 unique studies were included. Most studies included people using GHB 1) presenting at emergency departments (n = 22), 2) recruited from the general population (n = 11), or 3) presenting at addiction care (n = 8).
RESULTS
Three main sub-populations of people using GHB are described in the literature: people using GHB recreationally without adverse effects; people using GHB recreationally with adverse effects, and people with dependence on GHB. These groups show considerable overlap in gender, age range, and comorbid substance use, as well as amount of GHB use per occasion. Differences are related to frequency and function of GHB use, the number of comas experienced, as well as work status, and psychiatric comorbidity.
CONCLUSION
Policy interventions should aim at preventing the transition from recreational substance use to GHB use, as most users are experienced recreational substance users prior to starting GHB use. When people use GHB regularly, interventions should aim at reducing the level of GHB use and preventing GHB use-related harm. Longitudinal studies and population-based probability sampling are required for more insight in the dynamics of GHB use in different sub-populations, and the transition from one group to the other, ultimately leading to dependence on GHB.
Topics: Coma; Drug Users; Humans; Sodium Oxybate; Substance-Related Disorders
PubMed: 33892279
DOI: 10.1016/j.drugpo.2021.103230