Abstinence Research Articles

Post-occlusive reactive hyperemia in habituated caffeine users: Effects of abstaining versus consuming typical doses.

Post-occlusive reactive hyperemia (PORH) typically requires caffeine abstinence. For habitual users, it is unknown if abstinence affects PORH. Compare PORH after habitual users consume or abstain from caffeine. On separate visits (within-subject), PORH was measured in 30 participants without abstinence from typical caffeine doses (CAFF) and with abstinence (ABS). Measurements included baseline and peak hyperemic velocity, tissue saturation index slopes during ischemia (Slope 1) and following cuff deflation (Slope 2), resting arterial occlusion pressure (AOP), heart rate (HR), systolic (SBP), and diastolic (DBP) blood pressure. All variables were compared using Bayesian paired t-tests. BF10 = likelihood of alternative vs null. Results are mean±SD. Comparing baseline velocity (cm/s) between CAFF (9.3±4.8) and ABS (7.5±4.9) yielded anecdotal evidence (BF10 = 1.0). Peak hyperemic velocity (cm/s) was similar (CAFF = 77.3±16.7; ABS = 77.6±19.0, BF10 = 0.20). For slopes (TSI% /s), CAFF Slope 1 = -0.11±0.04 and Slope 2 = 1.9±0.46 were similar (both BF10≤0.20) to ABS Slope 1 = -0.12±0.03 and Slope 2 = 1.8±0.42. SBP and DBP (mmHg) were both similar (CAFF SBP = 116.0±9.8, DBP = 69.6±5.8; ABS SBP = 115.5±10.7, DBP = 69.5±5.4; both BF10≤0.22). Comparing AOP (mmHg) (CAFF = 146.6±15.0; ABS = 143.0±16.4) yielded anecdotal evidence (BF10 = 0.46). HR (bpm) was similar (CAFF = 66.5±12.3; ABS = 66.9±13.0; BF10 = 0.20). In habitual users, consuming or abstaining from typical caffeine doses does not appear to affect post-occlusive reactive hyperemia.

Effects Of Caffeine Abstinence On The Acute Response To Low-load Blood Flow Restriction Exercise

Caffeine (CAFF) enhances muscular responses to exercise. Blood flow restriction (BFR) studies typically require CAFF abstinence (ABS) prior to BFR exercise (BFR-ex). The effect of ABS has not been tested in habituated CAFF users. PURPOSE: Compare acute muscular response to BFR-ex after habitual CAFF intake and acute ABS. METHODS: 15 participants completed a 3 visit (2-14d apart) within-subject study. Visit 1 involved familiarization, CAFF intake form, and maximum strength test (1RM). Visits 2-3 consisted of dominant arm BFR-ex (3 sets of armcurls to failure, 30% 1RM, 40% arterial occlusion pressure, 30s inter-set rest). One visit was with CAFF and the other ABS (counterbalanced, 1 hr after typical intake). Maximal voluntary contractions (MVC, N) were taken pre- and post-BFR-ex. Biceps electromyography amplitude (EMGa) was measured during MVC and BFR-ex, and normalized to preMVC (%Pre). EMGa during BFR-ex was averaged over the first and last 3 repetitions for each set. Bayesian RMANOVA were conducted to find the most probable model vs. the null (BF10) for all variables except EMGa and force during MVC (Bayes paired t-test). Data are mean ± SD. RESULTS: A time main effect (BF10 = 6.5e+7) suggestsforce decreased from pre (237.7 ± 61.5) to post (154.9 ± 47.2). Weak evidence suggests no difference in EMGa (BF10 = .39) between CAFF (130.3 ± 74.7) and ABS (160.7 ± 99.9) during MVC. A time main effect (BF10 = 1.7e+37) indicates more completed repetitions in set 1 (33.0 ± 8.5) vs. 2 (10.8 ± 3.3, BF10 = 1.3e+14) and 3 (9.0 ± 2.8, BF10 = 2.2e+15); and set 2 vs. 3 (BF10 = 240.1). A time main effect (BF10 = 128.5) indicates EMGa increased from beginning (133.5 ± 97.7) to end of set 1 (227.3 ± 123.1), BF10 = 972.1), and from beginning (176.4 ± 73.0) to end of set 2 (219.2 ± 116.3, BF10 = 58.4) during BFR-ex. Moderate evidence suggests a difference from beginning (186.5 ± 81.9) to end of set 3 (212.3 ± 122.4, BF10 = 3.5). Moderate to strong evidence suggests a difference in EMGa (all BF10 ≥ 4.9) at the beginning of each set during BFR-ex. A condition main effect (BF10 = 74.3) indicates strong evidence for higher EMGa in CAFF (216.0 ± 125.6) vs. ABS (169.1 ± 80.2, BF10 = 15.2) during BFR-ex. CONCLUSION: Muscular responses to BFR-ex appear to not differ between conditions, except EMGa during BFR-ex. ABS from CAFF may not be required prior to BFR-ex in future studies.

Compulsivity and impulsivity in opioid dependence

ObjectiveChronic exposure to illicit opioid drugs can cause serious health and social problems. However, less is known about the differential effect of various opioid treatments, such as methadone and buprenorphine, on neurocognitive domains such as compulsivity and impulsivity, despite their relevance to the treatment of opioid dependence. MethodsA total of 186 participants were recruited with a cross-sectional design: i) illicit heroin users (n = 27), ii) former heroin users stabilized on methadone MMT (n = 48), iii) a buprenorphine maintenance treatment (BMT) group (n = 18), iv) an abstinent (ABS) group with a history of opioid dependence who were previously stabilized on MMT or BMT (n = 29) and v) healthy controls (HC) (n = 64). We used the Intra-Extra Dimensional Shift (IED) and Cambridge Gambling Task (CGT) paradigms for measuring compulsivity and impulsivity constructs respectively. ResultsHeightened compulsivity persisted in the heroin, buprenorphine and abstinent groups. Heroin, methadone and buprenorphine groups exhibited impaired behavioral responses to feedback, consisting of increased deliberation time and poorer risk adjustment. Higher compulsivity measures were negatively associated with opioid dose which may reflect sedation effects. ConclusionsOur results suggest that compulsivity and impulsivity are core neurocognitive dimensions for opioid dependence which differ in their presentation according to the stage of treatment. Participants taking higher morphine equivalent doses performed better in compulsivity measures. These findings have implications for the treatment of opioid dependence and longitudinal studies are warranted.

Chronic Fentanyl Self-Administration Generates a Shift toward Negative Affect in Rats during Drug Use.

Drug addiction is thought to be driven by negative reinforcement, and it is thought that a shift from positive affect upon initial exposure to negative affect after chronic exposure to a drug is responsible for maintaining self-administration (SA) in addicted individuals. This can be modeled in rats by analyzing ultrasonic vocalizations (USVs), a type of intraspecies communication indicative of affective state based on the frequency of the emission: calls in the 22 kHz range indicate negative affect, whereas calls in the 50 kHz range indicate positive affect. We employed a voluntary chronic, long-access model of fentanyl SA to analyze affective changes in the response to chronic fentanyl exposure. Male Sprague-Dawley rats self-administered either fentanyl (N = 7) or saline (N = 6) for 30 consecutive days and USVs were recorded at four different time points: the day before the first SA session (PRE), the first day of SA (T01), the last day of SA (T30), and the first day of abstinence (ABS). At T01, the ratio of 50 to 22 kHz calls was similar between the fentanyl and saline groups, but at T30, the ratio differed between groups, with the fentanyl group showing significantly fewer 50 kHz calls and more 22 kHz calls relative to saline animals. These results indicate a shift toward a negative affect during drug use after chronic exposure to fentanyl and support negative reinforcement as a main driving factor of opioid addiction.

Comparison of the effect of Morphine and Buprenorphine on full-term and near-term neonates with neonatal abstinence syndrome admitted to Valiasr Hospital, Birjand, Iran; A Randomized Clinical Trial Study

Background: Because there are insufficient data to compare the relative efficacy of commonly prescribed opioids (morphine and buprenorphine), the present study aimed to compare the effect of morphine and buprenorphine on term and near-term neonates with neonatal abstinence syndrome. Materials and Methods: This double-blind randomized clinical trial was performed on 60 neonates admitted to Valiasr Hospital in Birjand in two groups whose mothers were addicted to drugs (opium and its derivatives) and the neonate had symptoms of withdrawal syndrome. Neonatal assessment was based on Finnegan score. The neonates were randomly assigned to buprenorphine (n = 30) and morphine (n = 30). The Chi square test, Fisher exact test, student t.test and Mann-Whitney U test were used for comparing background characteristics and treatment outcome between two groups. Results: In the present study, a total of 53.3% of the patients in both groups were boys and the rest were girls. The mean length of hospital stay in the buprenorphine and morphine groups was 5.97 ± 3.38 and 7.53 ± 4.83 days, respectively (p=0.15). Also, apnea was observed in 33.3% of the total neonates in the buprenorphine group and 43.3% of the neonates in the morphine group (p=0.43). The two groups were homogenous in regards of apnea complications, oral intolerance, hypotension and blood culture result (p>0.05). Conclusion: The results of the present study showed no significant difference between the results of treatment and reduction of treatment complications between buprenorphine and morphine-treated neonates.

Systematic review of sexuality education intervention in the 21st century

This study carried out a systematic review of research on sexuality education interventions in China by using CNKI, Web of Science, and other Chinese and English databases.A total of 82 articles and reports were included for analysis. With regard to the intervention modes and content, this systematic review found that comprehensive sexuality education has not been fully implemented in China, and school-based sex education primarily focuses on adolescents. The content of sex education mainly included puberty, abstinence, and HIV/STI prevention. In terms of intervention effectiveness, the results showed that sexuality education intervention is more effective in enhancing an awareness of sexuality issues and in changing the attitudes of children and adolescents, while it is less effective in sexual behavioral changes. Several suggestions are provided for sexuality education and future intervention. 【摘 要】本文从中国知网、Web of Science等中英文数据库中系统收集了 2000—2019 年以来发表的中国性教育干预研究 文献 82 篇,从干预方式、干预内容和干预效果对相关文献进行系统综述。从干预方式与内容来看,全面性教育在中国还没 有得到广泛开展,学校性教育最为关注青少年群体,内容以青春期、生殖健康和预防艾滋病为主,大多数干预内容单一,缺 乏全面性、系统性和社会性别视角。从干预效果来看,性教育干预对于儿童青少年性与生殖健康知识的改变最为有效,态 度改变较为明显,行为改善结果不甚理想。本文为应如何开展更加科学系统的性教育干预研究指明了方向。

Does Reducing Alcohol Use Reduce Harm

Since total abstinence from alcohol use often is not achieved, countries have recommended specific drinking levels to diminish the related harms. To

Do Social Factors Play a Role in the Rate of Developmental Follow-up Visits Among Patients with Neonatal Abstinence Syndrome?

Purpose: Newborns exposed to opioids prenatally are at risk of developing Neonatal Abstinence Syndrome (NAS). Developmental follow-up is crucial and enables assessment of gross-motor, fine-motor, social development, language, and learning ability at specific life stages to determine if all the milestones are being achieved. Social factors may play a role in the rate compliance with developmental follow-up visits among infants with NAS. We hypothesized that neonates with NAS, who have multiple social confounders, are …

Accuracy of the Finnegan Scoring Based on Nursing Experience

Background: Neonatal Abstinence Syndrome (NAS) often follows the abrupt discontinuation of drugs at time of delivery. The Modified Finnegan Scoring System (MFSS), commonly used to assess infants with NAS, quantifies the severity of the symptoms and guides treatment. Previous studies showed that the FSS has a high inter-observer reliability of 0.996 and has convergent validity. Goal: To determine MFSS inter-rater reliability among NICU nurses and examine the impact of nursing experience. Methodology: A standardized video of infant exhibiting …

Introducing the Eating, Sleeping, Consoling Care Tool at The University of Vermont Children's Hospital (UVMCH)

Introduction: Given wide variation in care practices for infants with Neonatal Abstinence Syndrome (NAS) many clinicians aim to improve care through standardization. The Eating, Sleeping, Consoling (ESC) Care Tool standardizes both non-pharmacologic and pharmacologic care based on assessment of functional symptoms of opioid withdrawal and has been associated with a decrease in length of stay and pharmacologic treatment. Goal: Decrease the median percent of newborns who receive methadone postnatally for NAS by 30% between July, 2018 and January, 2019 by implementing the ESC Care Tool. Setting: At UVMCH, opioid exposed infants are routinely monitored on Labor and Delivery and the Newborn Nursery …

Introduction of a Neonatal Abstinence Syndrome Non-Pharmacologic Interventions Bundle to Improve Care of At-Risk Newborns

The United States opioid crisis takes root in the 1990s and has amplified over the last 20 years. It continues to involve increasing opiate use and growing prevalence of opiate use disorder both in and out of pregnancy(1). From 1999 to 2014, the frequency of opioid use disorder among women admitted to the hospital for delivery more than quadrupled(2). As a result, more babies are exposed to opiates prenatally and at risk for neonatal abstinence syndrome (NAS). In 2014, approximately 32,000 babies had NAS. As this number increases, so do …

Does pharmacological treatment of withdrawal symptoms improve the sleep patterns in infants with neonatal abstinence syndrome (NAS)

Background: Infants with NAS may have disturbed sleep, and increased movement reflecting central nervous system irritability. However, sleep pattern in such infants following control of withdrawal symptoms with methadone hasn’t been quantitatively analyzed. We hypothesized that successful treatment of withdrawal symptoms with methadone would also improve the sleep patterns in infants with NAS. Persistent disordered sleep in the neonatal period if persists even after pharmacological control of withdrawal symptoms may potentially lead to adverse childhood neurodevelopmental outcome. Objective: To characterize sleep-wake states using Actigraphy (activity-based sleep-wake …

Multiple self-care behaviors and associated factors in community-dwelling patients with hypertension in Myanmar.

ABSTRACTThis study aimed to identify the prevalence of self-care behaviors and the associated factors among hypertensive patients in primary care in Myanmar. This cross-sectional study was conducted from April to May 2019 among 410 hypertensive patients in Myitkyina Township, Kachin State, Myanmar. Hypertensive patients aged 30–70 years old and being registered at the community health centers in Myitkyina Township were selected using multi-stage cluster random sampling. Self-care behaviors were measured by Hypertensive Self-Care Activity Level Effect (H-SCALE). Chi-square test and multiple logistic regression analysis were used to explore the associated factors. Prevalence of adherence to multiple self-care behaviors were low: avoidance of tobacco use at 50.2%, followed by physical activity at 24.9%, medication at 24.1%, weight management at 9.5%, and healthy diet at 2.7%, while abstinence from harmful alcohol drinking was high at 97.8%. Multiple logistic regression analysis indicated that younger patients, low family income, inadequate knowledge, and no comorbidity were associated with non-adherence to medication. Living in rural area and having poor self-efficacy were associated with non-adherence to weight management, while being younger, female and having poor self-efficacy were also associated with non-adherence to physical activity. Compared with Kachin, other ethnics were more likely to be non-adherent to avoidance of tobacco use. Although a majority of respondents were not harmful drinkers, adherence to medication, healthy diet, physical activity, weight management and avoidance of tobacco use were very low. Health practitioners should provide education programs for hypertensive patients to direct them towards practical techniques in managing their blood pressure.

Lack of Authoritative Measures to Support Abstinence From Nicotine.

Lack of Authoritative Measures to Support Abstinence From Nicotine.

Patrones de consumo de alcohol en adolescentes ecuatorianos: ¿Estilo mediterráneo o anglosajón?

Introducción: Se conoce una práctica del consumo generalizada de alcohol en adolescentes, aunque no el patrón o tipo de consumo más representativo. Objetivo: Identificar por sexo los niveles y los patrones de consumo de alcohol en una muestra de adolescentes ecuatorianos. Metodología: Estudio descriptivo, categórico y comparativo a través del uso de la prueba AUDIT. Participantes: 1260 adolescentes (55,3% hombres), de 12 a 19 años (M = 15; DE = 1,56), estudiantes de 11 centros (86% públicos), en ciclo de Educación Básica General (30.2%) y Bachillerato (69.8%) de las provincias de Cotopaxi y Tungurahua. Resultados: El consumo de alcohol se encuentra extendido en la muestra, la abstinencia es del 43% y el 49% en hombres y mujeres, el tipo de consumo no presenta riesgos significativos. El patrón de consumo de alcohol es mayoritariamente moderado; la prevalencia del estilo intenso es del 15.7 y el 22.2% en hombres y mujeres. El sexo es invariante. Conclusiones: Hay una práctica generalizada de consumo de alcohol moderado y un patrón de consumo del tipo mediterráneo

Adolescentes Filhos de Dependentes Químicos Abstinentes: Como se Relacionam com Álcool?

O objetivo deste estudo foi compreender a percepção de adolescentes sobre o consumo de álcool em suas famílias, nas quais pelo menos um dos pais fosse dependente químico em abstinência. Foi realizada uma pesquisa qualitativa exploratória, com base no paradigma sistêmico. Foram entrevistados quatro adolescentes utilizando-se questionário de dados sociodemográficos, entrevista semiestruturada, entrevista de dilemas e AUDIT-C. Na análise de conteúdo foram identificadas quatro categorias temáticas: (1) história e contexto familiar de abuso de substâncias e abstinência (2) fatores de proteção para o não uso de álcool por adolescentes, (3) fatores de risco para o uso de álcool por adolescentes e (4) contradições e ambivalências dos adolescentes quanto ao uso de álcool. Todos os adolescentes entrevistados tinham conhecimento da história dos pais quanto à dependência química e abstinência, o que os levou a evitar o uso de álcool. Porém, em um dos casos, o grupo de pares e as questões transgeracionais se apresentaram como fatores de risco. Na entrevista de dilemas, os participantes demonstraram ambivalência quanto ao uso de álcool. Destaca-se a necessidade de atenção aos fatores transgeracionais envolvidos no abuso e dependência do álcool.

MR structural and functional changes in patients with long-term abstinence of methamphetamine

Objective To investigate the changes of brain gray matter volume (GMV) and brain activity in patients with long-term methamphetamine (MA) abstinence compared with healthy controls. Methods This study included 44 abstinent MA patients and 40 demographically equivalent healthy controls. Structural magnetic resonance imaging (MRI) and resting-state functional MRI (rs-fMRI) were obtained on Siemens 3.0 T MR. Differences in GMV between abstinent MA group and control group were assessed using voxel-based morphometry (VBM) method. Within each region showed significant differences between two groups, the value of the fractional amplitude of low frequency fluctuation (fALFF) was calculated using the rs-fMRI data. Differences of fALFF between groups were also evaluated. Furthermore, partial correlation coefficients adjusted for age, years of education, smoking and drinking were calculated in the abstinent MA group to assess associations between the mean GMV and fALFF values in significant clusters and variables of MA use and abstinence. Results Compared with controls, abstinent MA group showed increased GMV in the right cerebellum crus and decreased GMV in the right calcarine. While fALFF values within bilateral cerebellum crus in abstinent MA patients were significantly increased. Moreover, GMV of the left cerebellar crus was positively correlated with the withdrawal time among abstinent MA patients. Conclusions Both structural and functional abnormalities were found in abstinent MA patients even after long-term abstinence. The positive correlation between GMV of left cerebellum crus and abstinent duration suggested that prolonged abstinence may be beneficial to brain recovery. The fALFF of the right calcarine was increased even with decreased GVM in the abstinent MA group. It indicates that the brain activity of this area is increased, which may imply that drug cue-induced craving is significant among methamphetamine patients even after long-term abstinence. Key words: Methamphetamine; Magnetic resonance imaging; Voxel-based morphometry; Fractional amplitude of low frequency fluctuation

Correlationship between hunman spermatozoa spontaneous acrosome reaction rate and sperm survival rate and total motility and abnormal rate

Objective To study the exploring of correlationship between hunman spermatozoa spontaneous acrosome reaction rate and sperm survival rate and total motility and abnormal rate and to evaluate the effect of hunman spermatozoa spontaneous acrosome reaction rate on male fertility. Methods A total of 223 semen samples in our hospital from December 2017 to May 2018 were selected.The patient was abstinent for 2-7 days, and all semen was collected in a disposable sterile and non-toxic container.All the standards were from WHO laboratory manual for the examination and processing of human sperm(fifth edition). Routine analysis of semen was performed using the CASA system.Sperm survival rate and total motility were calculated.The sperm abnormality rate after papanicolaou staining was observed.The spermatozoa spontaneous acrosome reaction rate was tested by PSA-FITC staining.According to the positive rate of acrosome reaction (AR) than 10 was abnormal, two groups were divided into AR>10 and AR no more than 10. Correlationship between hunman spermatozoa spontaneous acrosome reaction rate and sperm survival rate and total motility and abnormal rate were explored by SPSS 22.0 statistical software. Results There were significant differences in sperm survival rate and total motility between normal and abnormal groups(P<0.05). The hunman spermatozoa spontaneous acrosome reaction rate was negatively correlated with sperm survival rate and total motility(r=-0.249, P<0.05; r=-0.256, P<0.05). There was no significant correlation between hunman spermatozoa spontaneous acrosome reaction rate and sperm abnormal rate. Conclusions The hunman spermatozoa spontaneous acrosome reaction rate is related the sperm survival rate and total motility, and it can be used as one of the indicator of male reproductive function. Key words: Semen; Acrosome Reaction; Survival Rate; Teratozoospermia

Exploring the Social Structure of a Health-Related Online Community for Tobacco Cessation: A Two-Mode Network Approach.

Unhealthy behaviors, such as tobacco use, increase individual health risk while also creating a global economic burden on the healthcare system. Social ties have been seen as an important, yet complex factor, to sustain abstinence from these modifiable risk behaviors. However, the underlying social mechanisms are still opaque and poorly understood. Digital health communities provide opportunities to understand social dependencies of behavior change because peer interactions in these platforms are digitized. In this paper, we present a novel approach that integrates theories of behavior change and Exponential Random Graph Models (ERGMs) to understand structural dependencies between users of an online community and the behavior change techniques that are manifested in their communication using an affiliation network. Results indicate population specific traits in terms of individuals’ engagement in peer communication embed behavior change techniques in online social settings. Implications for personalized health promotion technologies are discussed.

Maternal Methadone Use and White Race are Associated with Increased Risk of Neonatal Abstinence Syndrome

Purpose: Neonatal Abstinence Syndrome (NAS) is a drug withdrawal syndrome experienced after birth by infants who were exposed to opioids in utero. Opioid use during pregnancy is increasing, resulting in an increase in NAS. Between 2000 and 2013, the prevalence of NAS increased from 0.9 to 3.9 per 1000 births in South Carolina. We aimed to identify factors that predict an opioid-exposed infant’s need for NAS treatment at a regional perinatal center in South Carolina. We hypothesized that the degree of maternal polysubstance drug …