Abstinence Symptoms Research Articles

Assessment of human abuse potential of an unflavored, sucralose-sweetened electronic cigarette in combustible cigarette smokers.

Despite the popularity of electronic cigarettes (ECIGs), limited research has examined the role of sweeteners, independent of other flavors, in shaping ECIG human abuse potential (HAP). This study examined the effects of sucralose and nicotine in unflavored ECIG liquid solutions to provide a basic understanding of the effects of sweeteners on ECIG HAP compared to combustible cigarettes. Individuals who smoked cigarettes daily (N = 14) completed five within-subject, Latin-square ordered study sessions that differed by product used: (a) own-brand combustible cigarettes (OB), (b) 0 mg/mL nicotine, unsweetened liquid, (c) 0 mg/mL nicotine, sucralose-sweetened liquid, (d) 15 mg/mL nicotine, unsweetened liquid, and (e) 15 mg/mL nicotine, sucralose-sweetened liquid. Participants completed subjective questionnaires and behavioral tasks following a 10-puff directed use bout during which puff topography was measured, and blood was sampled for later measurement of plasma nicotine concentration. On average, the OB condition had a greater increase in plasma nicotine concentration and produced more pronounced subjective effects compared to the ECIG conditions. The 15 mg/mL nicotine ECIGs delivered significantly more nicotine and produced greater drug effects and reductions in tobacco abstinence symptoms than the 0 mg/mL nicotine ECIGs. Sucralose-containing solutions increased ECIG product appeal, puff duration, and puff volume during the 10-puff directed bout. Findings revealed greater HAP for OB cigarettes relative to all ECIGs tested and suggest that adding sucralose and nicotine elevates ECIG HAP via different mechanisms; sucralose appears to influence HAP through product appeal, while nicotine influences HAP through drug effects and tobacco/nicotine abstinence symptom suppression. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Effect of Ramadan fasting on changes in smoking and vaping behaviors and withdrawal symptoms severity: a cross-sectional study

Background Ramadan fasting, an obligatory duty for adult Muslims, entails refraining from eating, drinking, smoking, and vaping from dawn until sunset. Throughout Ramadan, people accept major changes to daily routines. Consequently, Ramadan is associated with abstinence symptoms and changes in smoking or vaping behavior. Aim The study aims to assess the presence of withdrawal symptoms and its severity, as well as smoking or vaping behavior change and its determinants during Ramadan fasting. Methods A cross-sectional study was conducted during Ramadan in 2023. Data were collected online using a Google form, including questionnaires assessing socio-demographic data, nicotine dependence using Fagerstrom Test for Nicotine Dependence, vaping and shisha smoking, presence and severity of physiological and psychological withdrawal symptoms and its coping strategies. Smoking and vaping behavioral change during Ramadan and its contributing factors were also evaluated. Results A total of 251 participants (96% males), mean age ± standard deviation (33 ± 12.1) were surveyed. Withdrawal symptoms were reported among 70.5%, however, their severity was generally low both physiologically and psychologically. Education, nationality, smoking duration, nicotine dependence, and the amount of consumed E-liquid per day were the independent predictors of withdrawal symptoms presence. Attempts to quit smoking and vaping were reported by 54.6% of the participants; young age and higher educational levels were the factors associated with more quitting attempts. Conclusions The withdrawal symptoms severity linked to Ramadan fasting is minimal. Many smokers and vapers made attempts to quit during Ramadan. Ramadan presents a chance for smoking and vaping cessation with some behavioral support.

The abstinence from smartphone scale (ABSS-10): Psychometric properties and practical utility

In order to frame excessive smartphone use as an addiction, it is important to understand whether this behavior determines abstinence symptoms and which damaging effect it has on emotions and cognition. However, an appropriate tool to assess the presence of smartphone abstinence symptoms is still lacking. In the present study, we propose a scale that is specifically developed to assess the psychological state deriving from smartphone abstinence: The Abstinence from Smartphone Scale (ABSS-10). The aim of this work is to validate ABSS-10 and to investigate its relevance in the context of smartphone addiction. Two studies were conducted to explore ABSS-10 psychometric properties, focusing on discriminant validity, and its relationship with smartphone dependence and emotional attachment. In Study 1, university students were administered the ABSS-10 two times during a two and a half-hour long smartphone restriction period. In Study 2, the scale was administered three times during a five-hour long smartphone restriction period. General state anxiety and smartphone dependence scales were also administered. The findings reveal that ABSS-10 effectively differentiates smartphone abstinence symptoms from general state anxiety and dependence. Moreover, results show that the scale detects changes in abstinence symptoms scores during a five-hour restriction period. The scale's utility in both research and practical settings is discussed, highlighting its potential contributions to understanding the psychological dynamics of smartphone use and abstinence. The present work suggests that ABSS-10 is a robust tool for research on the psychological effects of smartphone usage.

Exploring treatment specifics of addictive disorder in a young adult living in a post-war middle income country with rapid social and cultural transition: a qualitative case report

IntroductionAddictive disorder, characterized by the tendency to abuse an illicit substance or manifest a repeated risky behavior, is a fairly common phenomenon occurring in the last 50 years, predominantly in middle and high income countries. While psychotherapy has an evident positive impact in the treatment of the disorder, data has shown that it is often not sufficient to achieve full remission and have optimal positive impact in the quality of life compared to simultaneous use of psychotherapy, pharmacotherapy and psychosocial rehabilitation.ObjectivesThe aim of the study is to highlight different specifics of the inpatient treatment of “Mr. E”, living in a post-war middle-income country with rapid social and cultural transition.MethodsSubject of this case study is “Mr. E” a 17 year old student with a history of family trauma with a long history of abuse and ambulatory psychiatric treatment. Data has been analyzed from the medical history of the patient treated in 2023, in the substance abuse unit of the Department of Psychiatry, University Clinical Center of Kosova. Semi structured interviews, daily abstinence symptoms evaluation and self - report measures were used to gather qualitative data throughout the treatment process. Treatment protocol consisted on: detoxification, pharmacotherapy and simultaneous supportive individual and group psychotherapy, with the goal to evaluate, treat and reintegrate “Mr. E” into the society free of illicit substance abuse. Comorbidities are correlated with underlying causes, while a healthy lifestyles are promoted through the work on behavior changes that will support optimal social reintegration in a rapid changing social and cultural environment.ResultsThe findings revealed several significant therapeutic objectives such as: Enhanced self – awareness; Reduced ruminations and increased self-control; Enhanced quality of life; and Decreased substance abuse. Detoxification protocol in the treatment of addictive disorder in inpatient psychiatric treatment was essential for abstinence symptom management during crisis. Strengthening the body parallel to healing the mind was found as an important stepping stone.ConclusionsCombined, detoxification, psychopharmacological, and psychotherapeutic approach was essential for successful treatment of a young adult in a post-war middle income country with rapid social and cultural transition.Disclosure of InterestNone Declared

Initial evidence of the acute effect of electronic nicotine delivery system use on energy intake.

Previous work has aimed to disentangle the acute effects of nicotine and smoking on appetite with mixed findings. Electronic nicotine delivery systems (ENDS) have yet to be examined in this regard despite evidence of use for weight control. The present study tested the influence of an ENDS on acute energy intake and associated subjective effects. Participants (n = 34; 18-65 years) with current ENDS use completed two randomly ordered clinical lab sessions after overnight abstinence from tobacco/nicotine/food/drinks (other than water). Sessions differed by the product administered over 20 min: active (20 puffs of a JUUL ENDS device; 5% nicotine tobacco-flavored pod) or control (access to an uncharged JUUL with an empty pod). About 40 min after product administration, participants were provided an ad lib buffet-style meal with 21 food/drink items. Subjective ratings were assessed at baseline, after product use, and before/after the meal. Energy intake (kcal) was calculated using pre-post buffet item weights. Repeated measures analyses of variance and pairwise comparisons were used to detect differences by condition and time (α < .05). Mean ± standard error of the mean energy intake did not differ significantly between active (1011.9 ± 98.8 kcal) and control (939.8 ± 88.4 kcal; p = .108) conditions. Nicotine abstinence symptoms significantly decreased after the active condition, while satiety significantly increased. Following the control condition, satiety remained constant while hunger significantly increased relative to baseline. Findings indicate that acute ENDS use did not significantly impact energy intake, but there was an ENDS-associated subjective increase in satiety and relative decrease in hunger. Results support further investigation of ENDS on appetite. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Expanding Treatment, Recovery, and Reentry Services for Female Offenders: Improving Outcomes through Client-Centered Interventions.

This study investigated the impact of a specialized program aimed at improving substance use disorder and trauma treatment, recovery, and reentry services for adult female offenders. Trained recovery coaches delivered pretreatment interventions such as prescreening, motivational interviewing, and support-building to facilitate treatment entry and improve outcomes. Of 113 participants, 40% identified as racial/ethnic minorities, and 72% fell within the 25-45 age range. A notable 44.5% reduction in self-reported psychiatric symptoms was observed, alongside significant improvements in abstinence and trauma symptoms. Recovery capital and psychosocial functioning showed marked improvement including significant changes in employment status and housing stability and a decrease in criminal justice involvement. The results suggest that targeted, client-centered approaches can effectively improve recovery and psychosocial functioning among female offenders while reducing re-incarceration rates. These findings underscore the importance of addressing the unique needs of this population in both pre-and post-release settings to ensure equitable access to reentry services.

Impact of menstrual cycle on smoking cessation: A review

Background. Information on the way menstrual cycle phases can influence the achievement of tobacco abstinence is contradictory. Objective. A scope review was conducted to determine the effect of the menstrual cycle on tobacco abstinence, considering the phases of the cycle, hormone levels, and premenstrual syndrome. Method. A literature search was conducted in Scopus, PubMed, MEDLINE, and PsycINFO databases. Ten articles comparing the phases of the menstrual cycle or analyzing the association between premenstrual syndrome and a withdrawal condition (length of abstinence or withdrawal symptoms) were included. Results. Two main results were identified: 1) there is no difference in withdrawal symptoms and craving between menstrual cycle phases and 2) abstinence rates in the studies were higher during the luteal phase. Discussion and conclusion. The advisability of suggesting that women wishing to quit smoking should begin to do so at the start of the luteal phrase is discussed. However, smoking cessation interventions must consider all the symptoms experienced during the luteal phase.

Acute effects of flavored Black and mild cigars among young adult cigarette smokers.

The U.S. Food and Drug Administration proposed new product standards that would ban characterizing flavors (other than tobacco) in cigars. To inform this regulatory action, we compared physiological effects, use behavior, and subjective effects of four popular cigar flavors in cigar-naïve young adult cigarette smokers. Across five laboratory visits, participants (n = 25) used and evaluated own brand (OB) cigarettes or Black & Mild cigars (original, wine, apple, and cream flavors). Linear mixed models tested differences in saliva nicotine, exhaled carbon monoxide (CO), heart rate (HR), blood pressure (BP), puff topography, and subjective effects (p < .05). Compared to all cigars, OB resulted in higher nicotine boost (953 vs. < 300 ng/ml) and lower CO boost (4 vs. 8-9 ppm). Nicotine boost for original cigars (283 ng/ml) was significantly higher than wine (190 ng/ml). All products significantly increased HR/BP relative to baseline, but across time wine and apple cigars were associated with significantly lower HR than OB and BP effects varied. Relative to OB, participants took approximately 0.5 s longer puffs for all cigars and took significantly larger puffs (+ 21%-24%) of original, wine, and apple cigars. OB was rated more positively than all cigars, which had similar subjective effects. Wine cigars were disliked most and were less effective in reducing tobacco abstinence symptoms than OB; cream cigars were harsher and had stronger flavor intensity than original. The consistency in toxicant exposure, use behavior, and subjective effects across cigar flavors, including original, highlights the need for product standards to interpret characterizing flavors subject to prohibition broadly. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Multilevel Effects of Environmental and Neighborhood Factors on Sober Living House Resident 12-Month Outcomes.

Sober living houses (SLHs) are abstinence-based environments designed for individuals in recovery to live with others in recovery. Research shows that SLHs help some individuals maintain recovery and that certain SLH-related factors may be particularly protective. Here we assess how SLH housing and neighborhood characteristics are related to abstinence and psychiatric symptoms over time. Baseline, 6-month, and 12-month data were collected from 557 SLH residents. Multilevel mixed models tested associations between house and neighborhood characteristics and individual-level percent days abstinent (PDA) and the number of psychiatric symptoms (measured with the Psychiatric Diagnostic Screening Questionnaire [PDSQ]) as outcomes. Final models adjusted for sex, age, and race/ethnicity; ratings of house characteristics; and objective measurements of neighborhood-level exposures. Both PDA and PDSQ improved significantly (ps ≤ .05) over time in both unadjusted and adjusted models. More self-help groups and fewer alcohol outlets within one mile were significantly protective for PDA, whereas walkability was significantly related to worse PDA and PDSQ (ps ≤ .05). For house-level factors, better ratings of house maintenance were related to significantly fewer psychiatric symptoms, whereas higher scores on SLH's safety measures and personal or residence identity were related to more psychiatric symptoms (ps ≤ .05). No house-level factor was significantly related to PDA. Neighborhood-level factors such as increased availability of self-help groups and fewer nearby alcohol outlets may increase abstinence among individuals living in SLHs. House-level factors related to better maintenance may also facilitate improved mental health.

The therapeutic potential of glucagon-like peptide-1 for persons with addictions based on findings from preclinical and clinical studies.

Although the multifaceted mechanisms underlying alcohol use disorder (AUD) have been partially defined, the neurobiological complexity of this disorder is yet to be unraveled. One of the systems that have gained attention in recent times is the gut-brain axis. Although numerous peptides participate in this axis, glucagon-like peptide-1 (GLP-1) plays a central role. GLP-1 is a crucial anorexigenic peptide, with potent abilities to reduce food intake and body weight. The physiological complexity of GLP-1 entails glucose homeostasis, gastrointestinal motility, and the release of insulin and glucagon. As reviewed in this study, acute or repeated treatment with GLP-1 receptor (GLP-1R) agonists decreases alcohol consumption in rodents. Moreover, the abilities of alcohol to promote hyperlocomotion, dopamine release in the nucleus accumbens, and reward in the conditioned place preference paradigm are all suppressed by GLP-1R ligands. Moreover, activation of GLP-1R suppresses the motivation to consume alcohol, alcohol-seeking behaviors, and relapse drinking in male rodents. Similarly, abstinence symptoms experienced during alcohol withdrawal are attenuated by activation of the GLP-1 pathway. On a similar note, the activation of GLP-1 receptors within areas of the brain that are processing reward modulates these alcohol-related responses. Another area that is crucial for this ability is the nucleus of the solitary tract, which is where GLP-1 is produced and from which GLP-1-containing neurons project to areas of reward. These findings may have clinical relevance as AUD is associated with polymorphisms in GLP-1-related genes. Although a GLP-1R agonist does not alter alcohol intake in AUD patients, it reduces this consumption in a sub-population of obese AUD individuals. Given the uncertainty of this outcome, additional clinical studies of obese AUD patients should explore the effects of the GLP-1R agonists on alcohol intake and body weight. Furthermore, GLP-1 receptors modulate the behavioral and neurochemical responses to addictive drugs. Taken together, these preclinical and clinical findings imply that the GLP-1 pathway plays a role in the complex mechanisms regulating alcohol and drug consumption patterns, unveiling a novel aspect of addiction medicine.

Characterization of cannabis withdrawal symptoms and serum levels of neurotransmitters among cannabis-dependent smokers during sustained abstinence within a controlled residential environment

Introduction Cannabis (aka marijuana) is the most frequently consumed illicit substance worldwide, and a subset of frequent cannabis smokers (up to 30%) develop dependence. A less well-known consequence of cannabis dependence is withdrawal syndrome, characterized by a time-dependent constellation of symptoms (Lafaye et al. Dialogues Clin Neurosci 2017;19(3), 309-316). Objectives This study aims to prospectively assess the course of cannabis withdrawal symptoms within a controlled inpatient detoxification setting and to correlate the severity of withdrawal symptoms with the serum levels of neurotransmitters (NT). Methods N=45 treatment-seeking chronic cannabis dependents (assessed by ICD-10) were enrolled, and their withdrawal symptoms were assessed prospectively from admission (Day-0) to 28 days using Marijuana withdrawal checklist (MWC). Sociodemographic characteristics and self-reported drug use histories were reported. Serum levels of dopamine, serotonin, norepinephrine, epinephrine, and cortisol were measured. Cannabis abstinence symptoms were assessed daily using MWC for 4 weeks, and serum neurotransmitter levels were analyzed at admission (Day 0), 7, 14, 21, and 28. Comparison between groups was done using Friedman’s test. Correlation between NT level and MWC scores was performed using linear regression spearman correlation analysis Results The follow-up NT levels from Day 0 to 28 showed a significant (p&lt;0.05) decrease in serotonin and dopamine, whereas epinephrine levels showed a significant increase (Fig 1) with the course of withdrawal. Withdrawal symptoms like decreased appetite, sweating, and craving were significantly and positively correlated with serotonin, dopamine, and epinephrine NT levels (Fig 2). Image: Image 2: Conclusions Findings support the presence of clinically significant cannabis withdrawal symptoms with NT levels in subjects with cannabis dependence seeking substance abuse treatment. The data of this study determine the relationship between observed withdrawal symptoms and changes in brain chemistry and evaluate its possible utility as a predictor of relapse. Disclosure of Interest None Declared

ADHD symptoms and smoking outcomes in a randomized controlled trial of varenicline for adolescent and young adult tobacco cessation

BackgroundMost adult daily smokers try their first cigarette during adolescence. Attention-Deficit Hyperactivity Disorder (ADHD) in adolescents is associated with increased risk for cigarette smoking. The impact of ADHD symptoms on smoking cessation among adolescents has been less well-studied. The present secondary data analysis from a clinical trial of varenicline examined ADHD symptoms as a moderator of smoking cessation in adolescents and young adults. MethodsThe double-blind, placebo-controlled trial included treatment-seeking daily cigarette smokers ages 14 – 21 (N = 157) randomized to receive a 12-week course of varenicline or placebo, added to weekly smoking cessation counseling. At pre-treatment assessment, participants were administered a self-report measure of ADHD symptoms, the ADHD – Rating Scale (ADHD-RS). High (≥5) versus low (<5) and continuous ADHD-RS symptom counts in both hyperactive/impulsive (HI) and inattention (IA) domains were examined as predictors of smoking outcomes. ResultsParticipants with high IA symptoms at baseline were less likely to achieve 7-day point prevalence abstinence (PPA) at weekly visits (p = .001) during active treatment and end-of-treatment (p = .002) compared to those with low IA symptoms. In contrast, high HI symptoms did not predict differences in 7-day PPA or end-of-treatment abstinence versus low symptoms (p’s ≥ .07). These findings were not modified by varenicline versus placebo treatment assignment. ConclusionsADHD IA symptoms were associated with poorer cessation outcomes among adolescent smokers. These findings warrant additional investigation into how ADHD symptoms may be accounted for in smoking cessation interventions for adolescents and young adults.

Development and pilot testing of PROACTIVE: A pediatric onco-critical care capacity and quality assessment tool for resource-limited settings.

Nearly 90% children with cancer reside in low- and middle-income countries, which face multiple challenges delivering high-quality pediatric onco-critical care (POCC). We recently identified POCC quality and capacity indicators for PROACTIVE (PediatRic Oncology cApaCity assessment Tool for IntensiVe carE), a tool that evaluates strengths and limitations in POCC services. This study describes pilot testing of PROACTIVE, development of center-specific reports, and identification of common POCC challenges. The original 119 consensus-derived PROACTIVE indicators were converted into 182 questions divided between 2 electronic surveys for intensivists and oncologists managing critically ill pediatric cancer patients. Alpha-testing was conducted to confirm face-validity with four pediatric intensivists. Eleven centers representing diverse geographic regions, income levels, and POCC services conducted beta-testing to evaluate usability, feasibility, and applicability of PROACTIVE. Centers' responses were scored and indicators with mean scores ≤75% in availability/performance were classified as common POCC challenges. Alpha-testing ensured face-validity and beta-testing demonstrated feasibility and usability of PROACTIVE (October 2020-June 2021). Twenty-two surveys (response rate 99.4%) were used to develop center-specific reports. Adjustments to PROACTIVE were made based on focus group feedback and surveys, resulting in 200 questions. Aggregated data across centers identified common POCC challenges: (1) lack of pediatric intensivists, (2) absence of abstinence and withdrawal symptoms monitoring, (3) shortage of supportive care resources, and (4) limited POCC training for physicians and nurses. PROACTIVE is a feasible and contextually appropriate tool to help clinicians and organizations identify challenges in POCC services across a wide range of resource-levels. Widespread use of PROACTIVE can help prioritize and develop tailored interventions to strengthen POCC services and outcomes globally.

Psychostimulants by academics of the pharmacy course at the Federal University: instrument validation and consumption analysis

Objective: The purpose of this study was to analyze the consumption profile with the possible stimulants effects on the central nervous system (CNS) in academics of the Pharmacy course at the Universidade Federal do Amapá, through a validated questionnaire. Method: this pharmacoepidemiologic research has a cross-sectional and descriptive study. The procedure consisted of a three-domain questionnaire’s elaboration: 1. Sociodemographic; 2. Beck Depression Inventory (BDI); and 3. Dundee Ready Education Environment Measure (DREEM) questionnaire, with a probability sampling of 166 students. The questionnaire/ sociodemographic domain was validated through specialists and the application was conducted in three different period steps for ten academics (protocol number 3.753.673). Result: The validation process resulted in predominantly poor/weak concordances, and 60,8% of the interviewed academics confirmed consuming psychostimulants, of these about 51% consumes two or more substances considered CNS stimulants. As shown, the proposed instrument was validated, despite the week’s concordance in the Kappa index. Conclusion: The collected data from the instrument showed that the CNS stimulants consumption affects more than 50% of the students and that these substances bring risk to life, being observed abstinence symptoms by its users.

Cortical thickness and related depressive symptoms in early abstinence from chronic methamphetamine use.

Methamphetamine use is surging globally as a cause of morbidity and mortality. Treatment is typically sought in early abstinence, when craving and depressive symptoms are intense, contributing to relapse and poor outcomes. To advance an understanding of this problem and identify therapeutic targets, we conducted a retrospective analysis of brain structure in 89 adults with Methamphetamine Use Disorder who were in early abstinence and 89 healthy controls. Unlike most prior research, the participants did not significantly differ in age, sex and recent use of alcohol and tobacco (p-values ≥ 0.400). We analysed thickness across the entire cerebral cortex by fitting a general linear model to identify differences between groups. Follow-up regressions were performed to determine whether cortical thickness in regions showing group differences was related to craving, measured on a visual analogue scale, or to the Beck Depression Inventory score. Participants in early methamphetamine abstinence (M ± SD = 22.1 ± 25.6 days) exhibited thinner cortex in clusters within bilateral frontal, parietal, temporal, insular, and right cingulate cortices relative to controls (p-values < 0.001, corrected for multiple comparisons). Unlike craving (β =0.007, p= 0.947), depressive symptoms were positively correlated with cortical thickness across clusters (β =0.239, p = 0.030) and with thickness in the anterior cingulate cluster (β =0.246, p = 0.027) in the methamphetamine-dependent group. Inasmuch as anterior cingulate pathology predicts response to antidepressants for Major Depressive Disorder, cingulate structure may also identify patients with Methamphetamine Use Disorder who can benefit from antidepressant medication.

Overnight Abstinence Is Associated With Smaller Secondary Somatosensory Cortical Volumes and Higher Somatosensory-Motor Cortical Functional Connectivity in Cigarette Smokers.

Abstinence symptoms present challenges to successful cessation of cigarette smoking. Chronic exposure to nicotine and long-term nicotine abstinence are associated with alterations in cortical and subcortical gray matter volumes (GMVs). We aimed at examining changes in regional GMVs following overnight abstinence and how these regional functions relate to abstinence symptoms. Here, in a sample of 31 regular smokers scanned both in a satiety state and after overnight abstinence, we employed voxel-wise morphometry and resting-state functional connectivity (rsFC) to investigate these issues. We processed imaging data with published routines and evaluated the results with a corrected threshold. Smokers showed smaller GMVs of the left ventral hippocampus and right secondary somatosensory cortex (SII) after overnight abstinence as compared to satiety. The GMV alterations in right SII were positively correlated with changes in withdrawal symptom severity between states. Furthermore, right SII rsFC with the precentral gyrus was stronger in abstinence as compared to satiety. The inter-regional rsFC was positively correlated with motor impulsivity and withdrawal symptom severity during abstinence and negatively with craving to smoke during satiety. These findings highlight for the first time the effects of overnight abstinence on cerebral volumetrics and changes in functional connectivity of a higher-order sensory cortex. These changes may dispose smokers to impulsive behaviors and aggravate the urge to smoke at the earliest stage of withdrawal from nicotine. Overnight abstinence leads to changes in gray matter volumes and functional connectivity of the second somatosensory cortex in cigarette smokers. Higher somatosensory and motor cortical connectivity in abstinence is significantly correlated with trait motor impulsivity and withdrawal symptom severity. The findings add to the literature of neural markers of nicotine addiction.

Abstinence Rate, Adverse Events and Withdrawal Symptoms after Varenicline Use and Predicting Factors of Smoking Abstinence: A Multicentre Single-State Study in Malaysia.

(1) Background: Varenicline is a widely prescribed agent in smoking cessation. However, the abstinence rate, the incidence of adverse events and withdrawal symptoms, have not been widely studied locally. This study aimed to determine the prevalence of smoking abstinence, adverse events and withdrawal symptoms associated with varenicline use, as well as possible factors contributing to successful smoking abstinence. (2) Methods: This was a retrospective, cohort study conducted in twenty-two government-operated smoking cessation clinics across the state of Perak, Malaysia. The medical records of adult smokers (age ≥ 18 years old) who were prescribed with varenicline between January 2017 and June 2018 were traced. The medical records of smokers who used pharmacotherapy other than varenicline, those who received less than four weeks of varenicline treatment, and with missing data were excluded. (3) Results: Sixty-eight out of 114 subjects (59.6%) successfully achieved smoking abstinence. Probable varenicline-induced chest pain was documented in three subjects. Altered behaviour (n = 2) and auditory hallucinations (n = 1) were also reported. Varenicline treatment duration is a significant predictive factor for successful smoking abstinence (odds ratio (OR) = 2.45; 95% confidence interval (CI) 1.74–3.45; p < 0.001), followed by age (OR = 1.25; 95% CI 1.005–1.564; p = 0.045), the presence of adverse events (OR = 0.096; 95% CI 0.014–0.644; p = 0.016) and withdrawal symptoms (OR = 0.032; 95% CI 0.016–0.835; p = 0.032). (4) Conclusion: Almost two-thirds of the subjects achieved smoking abstinence with varenicline. The duration of the treatment, as well as the patients’ ages had a significant influence on successful smoking abstinence. Rare cases of cardiovascular and neuropsychiatric-related adverse events were reported, warranting continuous surveillance and adverse drug reaction reporting.

A Prospective Cohort Study to Assess Neonatal Adaptation in Neonates Exposed to Psychotropic Medications in Utero

AimsWe aimed to compare the NAS in neonatal exposed to antidepressants to unexposed neonates.MethodsA prospective cohort study was carried out comprising of women in 3rd trimester of pregnancy, data were collected on women exposed and unexposed to antidepressants. Approval from the Rotunda Hospital REC was obtained.Hospital records were used to collect pre-, peri- and postnatal information which was relevant to the study Aim. Neonatal Abstinence Score was completed within 0–48 hours of the birth, Moderate-Severe abstinence was defined as eight points or higher (on a scale with maximum 40 points), mild abstinence as 4 points or higher. Paediatric records were reviewed where the baby required NICU admission. Women were recruited between 2019–2021Results221 women in total were recruited,138 pregnant women were on no psychotropic medication (Control group) and 83 pregnant women were on antidepressant medication (exposed group).In the exposed group, 46% (38/83) were on Sertraline,19% (16/83) fluoxetine, 17% (14/83) Escitalopram and 17% (14/83) on other SSRI/SNRI.Six infants (3%) expressed signs of severe abstinence and 38 (28%) had mild abstinence symptoms in exposed group whereas in control group 10 (7%) of infants were observed to have mild abstinence which was seen in infants with low birth weight, poor feeding and poor sleep after feed. Neonatal hypoglycaemia in infants prenatally exposed to antidepressant was seen in 10% compared to 1% of control group.ConclusionSevere abstinence in infants prenatally exposed to antidepressants was found to be (3%) and mild abstinence in 28% this is in keeping with international findings. Low one minute APGAR sores and greater rates of hypoglycaemia were also noted.While neonatal withdrawal with all antidepressants are usually mild and self-limiting it is important to make the obstretric and neonatal teams aware of the mothers medication and mothers should be advised that their baby may need a review by neonatology after delivery.

The Attitude of Youth to Alcohol: the Risk of Alcohol Dependence

he purpose of this article is: to reveal the psychological aspects of some diseases, as a result of alcohol consumption; to describe the peculiarities of phy­sical dependence in a way of alcoholic state; to make a scheme how alcoholism is developed; to describe the characteristic complications of binge drinking, such as white fever, alcoholic delirium; to model the degrees of intoxication; to pro-vide the pilot research and to find out the attitude of youth to alcohol.methods of the research. The following theoretical methods of the research were used to solve the tasks formulated in the article: a categorical method, structural and functional methods, the methods of the analysis, sys-tematization, modeling, generalization. The empirical method is a pilot research. The research was organized in Kyiv, Lviv, and Rivne. While researching the socio­demographic characteristics (age of respondents, their gender) were taken into account.the results of the research. A clear correlation was found: the practice of alcohol consumption was spread according to the age of respondents. Drinks such as beer, wine, vodka, cognac, whiskey, liqueur, moonshine, etc. have ever been consumed by one of three 10­year­old respondents (36%), one in two 11­ and 12­year­olds (49% and 54%), 73% – 13­year­olds, 78% – 14­year­olds, 85% – among boys and girls who were 15 years old. The share of young people at the age from 16 to 22 who drank alcohol is extremely high, ranging from 93% to 98%. Data on the age of the first case of alcohol consumption are indicative. For example, the largest share of respondents said that they had tasted beer for the first time at the age of 10 – this group is 28%, and at the age of 16 and older – 9% of respondents. The group of people who never drank alcohol is 24%. “The acquaintance” with wine and spirits occurs mainly in adolescents aged 13­16 years old and older (in particular, in the group of respondents in the age of 10­14 years old, the experience of the first drinking, at least a glass of wine have 43% of respondents). Among all respondents, 31% and 43% of ones, respectively, never drank wine or spirits. Almost half (43%) of the younger group (10­14 years old) did not answer the question about the age of the first beer. Another 75% of respondents of the same age ignored the question about the first use of spirits. Such a distribution may indicate a tendency of children and adolescents to secrecy, their bias against the confidentiality of individual answers to questionnaires.conclusions. Chronic alcoholism or alcohol addiction is a disease in which a person develops an incredible craving for alcohol, symptoms of asthenia and abstinence and other alcoholic disorders. The alcoholic is very depressed, he/she is insecure, sometimes repents, scared. The character deteriorates sharply, sleep is short and superficial, he/she sees terrible dreams. At the same time, the body’s resistance to alcohol poisoning increases. At the stage of domestic drunkenness the usual doses of alcoholism are no longer enough. Another sign of alcoholism is weakening of protective reflexes, such as vomiting, nausea, salivation. Hal-lucinations, acute psychosis and memory loss are observed with large doses of alcohol. There is an unstable motive for the person’s behavior, the patient per-forms acts that are not the main characteristics of him/her before. In the past, a sincere, merciful, a kind man becomes indifferent, immoral, angry. The alcoholic lacks focus. He/she never brings the case to the end.

Sex differences in brain regional homogeneity during acute abstinence in cocaine use disorder.

There are significant sex differences in the clinical characteristics of cocaine use disorder (CUD). As this is a brain disorder that involves changes in functional connectivity, we investigated the existence of sex differences among people with CUD and controls. We used a data‐driven method comparing males (n = 20, CK‐M) and females with CUD (n = 20, CK‐F) and healthy controls (20 males, HC‐M and 20 females, HC‐F). The participants undertook a resting‐state functional magnetic resonance imaging exam. Regional homogeneity (ReHo) was performed to identify group and sex differences. Persons with CUD of both sexes presented lower ReHo parameters than controls, especially within the parietal lobule. Males with CUD showed higher ReHo than females in three right‐side brain areas: postcentral gyrus, putamen and fusiform gyrus. It was found that abstinence symptoms severity was associated with lower ReHo values in the right postcentral gyrus and the right fusiform gyrus. Participants with CUD exhibited altered ReHo parameters compared to controls, similar to what is found in ageing‐related disorders. Our data also indicate that cocaine has sex‐specific effects on brain functioning when analysing ReHo.