Substance Abuse Research Articles

Exploring the interplay of abstinence self-efficacy, locus of control, and perceived social support in substance use disorder recovery.

Substance use disorder (SUD) poses a significant public health challenge globally, with substantial impacts on physical and social well-being. This study investigates the interplay between abstinence self-efficacy (ASE), locus of control (LOC), perceived social support (PSS), and various socio-demographic and psychosocial factors among individuals undergoing SUD rehabilitation. Researchers obtained permission from drug rehabilitation centers in Assam, India, and conducted orientation programs for prospective participants. A total of 144 participants, aged 18-65 years, predominantly from rural areas participated in the study. Data was collected through one-to-one interviews, covering socio-demographic history, drug abuse, and administering scales for ASE, LOC and PSS. Collected data underwent digitization and subsequent descriptive and inferential statistical analyses. Significant associations were found between ASE and socio-demographic variables, family dynamics, and drug use history, highlighting the importance of considering these factors in SUD rehabilitation. Disturbed family relationships were linked to diminished ASE and higher risk of relapse, emphasizing the role of family support in recovery. Additionally, a negative correlation was observed between ASE and LOC, suggesting that individuals with higher ASE tend to have a more internal locus of control, which positively influences recovery outcomes. Moreover, positive correlations were found between ASE and PSS, particularly from family members, underscoring the importance of social support in fostering recovery. Regression analysis further elucidated the relationships between ASE, LOC, and PSS, emphasizing the predictive value of LOC and the impact of family support on ASE. Findings of this study have several implications for developing targeted interventions aimed at strengthening ASE, promoting internal locus of control, and enhancing social support systems.

Analyzing quality of life among people with opioid use disorder from the National Institute on Drug Abuse Data Share initiative: implications for decision making.

We aimed to estimate health state utility values (HSUVs) for the key health states found in opioid use disorder (OUD) cost-effectiveness models in the published literature. Data obtained from six trials representing 1,777 individuals with OUD. We implemented mapping algorithms to harmonize data from different measures of quality of life (the SF-12 Versions 1 and 2 and the EQ-5D-3L). We performed a regression analysis to quantify the relationship between HSUVs and the following variables: days of extra-medical opioid use in the past 30 days, injecting behaviors, treatment with medications for OUD, HIV status, and age. A secondary analysis explored the impact of opioid withdrawal symptoms. There were statistically significant reductions in HSUVs associated with extra-medical opioid use (-0.002 (95% CI [-0.003,-0.0001]) to -0.003 (95% CI [-0.005,-0.002]) per additional day of heroin or other opiate use, respectively), drug injecting compared to not injecting (-0.043 (95% CI [-0.079,-0.006])), HIV-positive diagnosis compared to no diagnosis (-0.074 (95% CI [-0.143,-0.005])), and age (-0.001 per year (95% CI [-0.003,-0.0002])). Parameters associated with medications for OUD treatment were not statistically significant after controlling for extra-medical opioid use (0.0131 (95% CI [-0.0479,0.0769])), in line with prior studies. The secondary analysis revealed that withdrawal symptoms are a fundamental driver of HSUVs, with predictions of 0.817 (95% CI [0.768, 0.858]), 0.705 (95% CI [0.607, 0.786]), and 0.367 (95% CI [0.180, 0.575]) for moderate, severe, and worst level of symptoms, respectively. We observed HSUVs for OUD that were higher than those from previous studies that had been conducted without input from people living with the condition.

Isobutyryl-carfentanyl has strong acute toxicity and analgesic effects with high addiction potential.

Isobutyryl-carfentanyl is the most recently discovered fentanyl analogue with a chemical structure that is similar to that of carfentanyl. Its analogue, carfentanyl, is regarded as one of the most lethal drugs in the world, with a potency of 10,000 times that of morphine. Therefore, isobutyryl-carfentanyl may possess a comparably high potency and its harmful effects cannot be ignored. This study was designed to assess the analgesic effect of isobutyryl-carfentanyl and the potential risks associated with its misuse. In this study, we assessed the acute toxicity of isobutyryl-carfentanyl by up-and-down-procedure, the analgesic efficacy by hot-plate test, the abuse potential by conditioned place preference (CPP), drug self-administration, and drug discrimination tests, and compared it with fentanyl and carfentanyl. The estimated median lethal dose (LD50) of isobutyryl-carfentanyl administered were 175mg/kg (intragastric administration, IG), 15.84mg/kg (intraperitoneal injection, IP), 15.84mg/kg (subcutaneous injection, SC), and 1.6mg/kg (intravenous injection, IV), respectively. The 50% maximal analgesic effect (ED50) of isobutyryl-carfentanyl was determined to be 0.00319mg/kg, with an analgesic potency 14 times that of fentanyl and 0.82 times that of carfentanyl. Isobutyryl-carfentanyl exhibited a significant positional preference at a minimum dose of 0.1mg/kg, while fentanyl exhibited a significant positional preference at a minimum dose of 0.3mg/kg. In the heroin (0.05mg/kg/infusion) self-administration substitution experiment, isobutyryl-carfentanyl showed significant self-administration behaviour at doses of 0.0005-0.001mg/kg/infusion, with the maximum number of infusions observed at a dose of 0.001mg/kg. In the heroin (1mg/kg) drug discrimination experiment, fentanyl (0.005-0.02mg/kg), carfentanyl (0.0005-0.002mg/kg), and isobutyryl-carfentanyl (0.001-0.005mg/kg) were tested in the dose-effect curves. The results showed that all three drugs exhibit dose-dependent increase in the number of drug-associated nose pokes responses and reduction in the rate of nose pokes. The subjective effect potency of isobutyryl-carfentanyl was found to be 4.4 times that of fentanyl and 0.5 times that of carfentanyl. In summary, isobutyryl-carfentanyl has high acute toxicity and analgesic effect, with strong psychological dependence approximately 5 times that of fentanyl and 0.5 times that of carfentanyl, and has extremely high abuse potency.

Comparison of psychopathology, purpose in life and moral courage between nursing home and hospital healthcare workers during the COVID-19 pandemic

The COVID-19 pandemic deeply affected healthcare workers, although the impact may have differed according to different workplace contexts. The aim of this current research was to compare the psychopathology presented by hospital versus nursing home healthcare workers during the COVID-19 pandemic and to analyse the predictive role of purpose in life and moral courage in the appearance of psychopathology. This was an observational, cross-sectional study carried out on a sample of 108 healthcare workers, 54 each from a hospital or nursing homes, who were recruited during the 5 and 6th waves of the COVID-19 pandemic in Spain. Various self-reported scales were used to assess anxiety, depression, acute/post-traumatic stress disorder, drug and alcohol abuse, burnout, purpose in life, and moral courage. Compared to the hospital healthcare workers, nursing home healthcare workers had higher scores and a higher prevalence of anxiety (74.1% vs. 42%), depression (40.7% vs. 14.8%), and post-traumatic stress disorder (55.6% vs. 25.9). In the overall sample, purpose in life was a protective factor against psychopathology (OR = 0.54) and burnout (OR = 0.48); moral courage was a protective factor against depression (OR = 0.47) and acute stress (OR = 0.45); and exposure of family/friends to SARS-CoV-2 was a risk factor for acute stress (OR = 2.24), post-traumatic stress disorder (OR = 1.33), and higher burnout depersonalisation subscale scores (OR = 1.84). In conclusion, the increased presence of psychopathology in nursing home healthcare workers may be influenced by workplace and occupational contexts, personal factors such as exposure of family/friends to SARS-CoV-2, or internal dimensions such as purpose in life and moral courage. This knowledge could be useful for understanding how a future epidemic or pandemic might affect the mental health of healthcare workers in different labour contexts.

A study on substance abuse awareness and usage trends within the construction sector

Purpose To address safety risks, worker well-being concerns and productivity losses in construction due to substance misuse, this study aims to explore awareness and usage levels of various substances among Nigerian construction professionals. The findings aim to inform targeted interventions and policy development to tackle these industry-specific challenges. Design/methodology/approach A comprehensive literature review identified several substances and intoxicants commonly used in construction, which informed the development of a well-structured questionnaire. This questionnaire was distributed to both construction professionals and nonprofessionals. The Shapiro-Wilk test assessed the normality of awareness and utilization scores for each substance, while the Kruskal-Wallis H-test explored significant differences in awareness and usage scores among different respondent groups. Findings Despite reporting low awareness of substances commonly used in construction, a significant proportion (over 60%) of respondents admitted to using several of these substances in their construction activities. This highlights a concerning disconnect, with more than half (62.5%) exceeding a predefined threshold (3.5) for significant substance use. Ten out of the 16 substances surveyed fell into this category, indicating a widespread issue within the industry. Practical implications The findings of this study highlight the need for increased education and awareness programs about the dangers of substance misuse in the construction industry. Construction companies should implement regular training sessions and workshops to educate workers on the risks associated with substance use. Additionally, there should be stricter enforcement of substance use policies and routine substance testing to deter misuse. These measures can enhance safety, improve worker well-being and boost overall productivity in the construction industry. Originality/value The insights from this study can inform the development of international policies and best practices for substance use prevention and worker well-being in the construction industry. Sharing these findings with international organizations, policymakers and industry stakeholders can help create broader guidelines and frameworks adaptable for implementation in various countries.

Benzodiazepine-receptor agonist prescription in a population of hospitalised patients in four psychogeriatric units in Switzerland.

The aim of this study is to describe the patterns of prescription of benzodiazepine-receptor agonists in hospitalised patients in four psychogeriatric units in Switzerland. This is a retrospective cross-sectional study that included patients aged 65 years or more hospitalised in one of the four psychogeriatric units of a university hospital in Switzerland during 2019. The presence, type and dose of benzodiazepine-receptor agonists was assessed at admission and at discharge. Three-hundred and eighty-six patients (214 women, 78.2 ± 8.1 years) were included in the study; 33.4% of patients had at least one benzodiazepine-receptor agonist at admission and 22.5% at discharge. The relative reduction of benzodiazepine-receptor agonists prescription in standardised dose was 78%. Age was found to be a protective factor against benzodiazepine-receptor agonists prescription at admission (adjusted odds ratio 0.94, confidence interval 0.91-0.98), and diagnosis of substance abuse was found to be a risk factor (adjusted odds ratio 4.43, confidence interval 1.42-17.02). Longer hospital stays (> 14 days) were associated with higher reduction of benzodiazepine-receptor agonists. The prevalence of a prescription of benzodiazepine-receptor agonists at admission was high, but during the psychogeriatric hospitalisation benzodiazepine-receptor agonists prescription decreased both in absolute and relative terms.

Dopamine reuptake and inhibitory mechanisms in human dopamine transporter.

The dopamine transporter has a crucial role in regulation of dopaminergic neurotransmission by uptake of dopamine into neurons and contributes to the abuse potential of psychomotor stimulants1-3. Despite decades of study, the structure, substrate binding, conformational transitions and drug-binding poses of human dopamine transporter remain unknown. Here we report structures of the human dopamine transporter in its apo state, and in complex with the substrate dopamine, the attention deficit hyperactivity disorder drug methylphenidate, and the dopamine-uptake inhibitors GBR12909 and benztropine. The dopamine-bound structure in the occluded state precisely illustrates the binding position of dopamine and associated ions. The structures bound to drugs are captured in outward-facing or inward-facing states, illuminating distinct binding modes and conformational transitions during substrate transport. Unlike the outward-facing state, which is stabilized by cocaine, GBR12909 and benztropine stabilize the dopamine transporter in the inward-facing state, revealing previously unseen drug-binding poses and providing insights into how they counteract the effects of cocaine. This study establishes a framework for understanding the functioning of the human dopamine transporter and developing therapeutic interventions for dopamine transporter-related disorders and cocaine addiction.

Development of a GC-MS Method for the Analysis of Selected Opioids in Human Hair Samples

Background: Hair samples are recognized as alternative biological specimens in forensic and clinical toxicology for detecting drug abuse and poisoning. Forensic testing for opioids in hair has become a useful diagnostic measure for assessing chronic drug usage through segmental analysis. However, accurate, sensitive and specific analytical methods are needed. The aim of this study was to introduce a simple, sensitive and specific GC-MS method for the identification and quantitation of selected and commonly abused opioids (tramadol, methadone, morphine, and codeine) in hair samples. Methods: After external decontamination, a 50 mg portion of powdered hair sample was combined with hydrochloric acid (0.1 M) and incubated on a magnetic stirrer at 56°C for 16 hours. Then, 1 mL of sodium hydroxide (0.1 M) and 2 mL of phosphate buffer (1 M, pH=8.4) were added. Chloroform-isopropanol (ratio: 80:20 V/V) was utilized as the extracting solvent and the sample was homogenized and centrifuged for 5 minutes (at 3500 rpm). After centrifugation, the organic phase was dried using dry nitrogen gas. The sample was derivatized with N-methyl-N-(trimethylsilyl) trifluoroacetamide (MSTFA). The blank, standards, and real samples were subsequently analyzed by GC-MS.Results: The limits of detection in the linearity experiments ranged from 0.12 to 0.21 ng/mg. According to the validation results, the method exhibited linearity in the concentration range of 0.1-2.5 ng/mg for all analytes, with calibration curve slopes ranging from R2=0.98 to 0.99. Good inter and intra-day precision relative standard deviations (RSDs) were observed to be <3.5% for all compounds. Extraction efficiency varied from 91.8 to 102.4%. Conclusion: The validation and analysis of actual samples indicate that this method is straightforward, sensitive, and specific for the analysis of opioids in routine hair analysis.

Role of Family Cohesion as Moderator between Job Stress and Drug Abuse among Employees of Business Process Outsourcing / Information Technology Sector

Role of Family Cohesion as Moderator between Job Stress and Drug Abuse among Employees of Business Process Outsourcing / Information Technology Sector

Long term mortality in burn injury survivors: A matched cohort study

BackgroundSurvivors of burn injuries may be at risk of early death. This study describes the mortality of burn survivors in comparison with two matched cohorts. MethodsThis retrospective cohort study compared adults admitted with a burn injury from 2009 to 2019 with two matched cohorts; one from the general population and one with a diagnosis of acute pancreatitis. Patients were excluded from analysis if they died during hospital admission or within 90 days of hospital discharge. Cox proportional hazards models were used to explore differences between cohorts and variables associated with mortality. Results7,147 burns patients were matched with 6,810 pancreatitis patients and 28,184 individuals from the general population. Patients with a burn injury had an increased risk of death when compared to the general population (HR 2.46, 95 % CI 2.28,2.66, p < 0.001) and those with acute pancreatitis (HR 1.28, 95 % CI 1.17,1.40, p < 0.001). Socioeconomic deprivation, increasing comorbidity and specific comorbidities such as alcohol, drug abuse and depression were also associated with increased mortality. ConclusionSurvivors of burn injury are at increased risk of mortality compared to individuals matched on sex, age and socioeconomic deprivation in both the general population and with a hospital admission due to acute pancreatitis.

Rapid nanomolar detection of cocaine in biofluids by electrochemical aptamer-based sensor with low-temperature effect for drugged driving screening.

Cocaine is one of the most abused illicit drugs, and its abuse damages the central nervous system and can even lead directly to death. Therefore, the development of simple, rapid and highly sensitive detection methods is crucial for the prevention and control of drug abuse, traffic accidents and crime. In this work, an electrochemical aptamer-based(EAB) sensor based on the low-temperature enhancement effect was developed for the direct determination of cocaine in bio-samples. The signal gain of the sensor at 10°C was greatly improved compared to room temperature, owing to the improved affinity between the aptamer and the target. Additionally, the electroactive area of the gold electrode used to fabricate the EAB sensor was increased 20 times by a simple electrochemical roughening method. The porous electrode possesses more efficient electron transfer and better antifouling properties after roughening. These improvements enabled the sensor to achieve rapid detection of cocaine in complex bio-samples. The low detection limits (LOD) of cocaine in undiluted urine, 50% serum and 50% saliva were 70nM, 30nM and 10nM, respectively, which are below the concentration threshold in drugged driving screening. The aptasensor was simple to construct and reusable, which offers potential fordrugged driving screening in the real world.

The Principal’s Problem: Anchoring Equity in an Exclusionary System

This paper, titled "The Principal’s Problem: Anchoring Equity in an Exclusionary System," offers a critical examination of the multifaceted challenges faced by school administrators in navigating an educational landscape marked by growing equity issues, safety concerns, and the mental health crisis among students. Drawing from the author's 35-year experience in various educational roles in Massachusetts, the critical situational analysis delves into the complexities of fostering a safe, inclusive, and equitable school environment amid a youth mental healthcrisis, reactionary legislative demands, and a hostile, binary, social landscape. The first section of the paper emphasizes the evolving role of educators in addressing the emotional well-being and safety of students. It illustrates how external tragedies, such as student suicides and drug overdoses, directly impact school policies and practices. The author highlights systemic inequities, such as disparities in recognition and funding between male and female sports teams and the controversy over gender-specific graduation gown colors, illustrating the difficulties in upholding Title IX and fostering gender equality. The paper further explores the escalation ofgun violence and its profound impact on school safety protocols and legislation. It addresses the administrative burden of complying with a myriad of regulations aimed at ensuring student safety and emotional well-being, from bullying and gender identity to mental health and substance abuse. The first-person narrative critiques the overwhelming expectations placed on school administrators to act as both educational leaders and first responders in a socioeconomically diverse and politically charged environment. It argues for a more holistic approach to educational leadership, one that balances legal and moral obligations to protect free expression with the imperative to create a nurturing and inclusive school culture. The author posits that the real challenge lies in the practical implementation of these ideals.

The Principal’s Problem: Anchoring Equity in an Exclusionary System

This paper, titled "The Principal’s Problem: Anchoring Equity in an Exclusionary System," offers a critical examination of the multifaceted challenges faced by school administrators in navigating an educational landscape marked by growing equity issues, safety concerns, and the mental health crisis among students. Drawing from the author's 35-year experience in various educational roles in Massachusetts, the critical situational analysis delves into the complexities of fostering a safe, inclusive, and equitable school environment amid a youth mental healthcrisis, reactionary legislative demands, and a hostile, binary, social landscape. The first section of the paper emphasizes the evolving role of educators in addressing the emotional well-being and safety of students. It illustrates how external tragedies, such as student suicides and drug overdoses, directly impact school policies and practices. The author highlights systemic inequities, such as disparities in recognition and funding between male and female sports teams and the controversy over gender-specific graduation gown colors, illustrating the difficulties in upholding Title IX and fostering gender equality. The paper further explores the escalation ofgun violence and its profound impact on school safety protocols and legislation. It addresses the administrative burden of complying with a myriad of regulations aimed at ensuring student safety and emotional well-being, from bullying and gender identity to mental health and substance abuse. The first-person narrative critiques the overwhelming expectations placed on school administrators to act as both educational leaders and first responders in a socioeconomically diverse and politically charged environment. It argues for a more holistic approach to educational leadership, one that balances legal and moral obligations to protect free expression with the imperative to create a nurturing and inclusive school culture. The author posits that the real challenge lies in the practical implementation of these ideals.

Imbuing Spirituality to Enhance the Effectiveness of Employee Assistance Programs (EAPs)

Conventional approaches of management researchers are based on economic rationality and human emotions, which are deficient in the spiritual aspects of humanity. Spirituality is an element of practical wisdom. Rationalist ethics and knowledge do not alone ensure virtues. The concept of spirituality places an ultimate or an apparent immaterial truth. It enables a person to discover the essence of their being. Spiritual practices, including prayer, meditation, and contemplation, are anticipated to enhance an individual’s inner space. They facilitate non-judgmental awareness, the ability to recover quickly from negative stimuli like stress or calmness, empathy, and increased flexibility in response. An Employee Assistance Program (EAP) is an arrangement between a corporation, academic institution, or government agency and its employees that provides a variety of support programs for employees mainly dealing with work-related difficulties. The concept of the EAP originated in the 1970s to reduce substance abuse and intoxication in the workplace. Since then, EAPs have evolved to deal with various issues such as depression, marital problems, anger, anxiety, physical illness, etc. EAPs can provide daycare for employees' children and elder care for employees' parents. The relevance of spiritual wisdom in management is a widely accepted fact. This paper examines how Employee Assistance Programs can be made more effective by imbuing spiritual practices

Law Enforcement Against Drug Abusers Through Medical Rehabilitation and Social Rehabilitation

Drug abuse is a global threat that damages society. Although various efforts have been made, there is still a lot of confusion and misunderstanding in the community about the dangers of narcotics. Patterns of drug use have pathological features, causing physical and psychological dependence. Law enforcement against drug abuse involves medical and social rehabilitation to help individuals recover and return to functioning in society. A holistic and collaborative approach from various parties as well as the use of new disciplines and technologies are needed to effectively address this problem. NThis research uses a normative legal analysis approach that focuses on law enforcement against drug abuse. The normative approach is used by analysing the synchronisation of vertical and horizontal legal norms and related legal systematics. The implementation of medical and social rehabilitation emphasises the importance of a holistic approach in helping individuals affected by drug abuse. This approach includes medical, social, and spiritual dimensions, such as Ruqyah, Dhikr, and spiritual contemplation methods, to design a more comprehensive and effective rehabilitation strategy. Recommendations for enforcement for people who misuse drugs should promote a holistic approach that includes medical, social, and spiritual aspects, such as Ruqyah and Dhikr, to support comprehensive recovery. Law enforcement should focus on treatment and recovery rather than punishment, and be supported by communities and based on social and humanitarian understanding.

State inequities: Gaps in planned treatment for criminal legal referrals with opioid use disorder across two decades of US treatment admissions.

Criminal-legal (CL) referrals to addiction treatment have historically had low utilization of medications for opioid use disorder (MOUD). While state differences have been reported, an in-depth longitudinal analysis of state-by-state differences is lacking. The Substance Abuse and Mental Health Services Administration Treatment Episode Dataset-Admissions 2000-2020 provided data for individuals entering their initial treatment with an opioid as their primary substance. Outcome was planned use of MOUD, assessing odds ratio (OR) of CL referrals relative to non-CL referrals cumulatively over the 21-year period and as incremental change (change in relative disparity) using effect sizes, stratified by each state. 2,187,447 cases met the criteria. Planned MOUD occurred in 37.7% of non-CL clients versus 6.5% of CL clients (OR = 0.11, 95% confidence interval = 0.11-0.12). For all clients, planned MOUD increased from 2000 (33.9%) to 2020 (44.8%). This increase was blunted within CL clients, increasing from 2000 (6.4%) to 2020 (13.3%). Rhode Island saw the greatest improvements in equity. While rates of planned MOUD increased over the 21 years, a significant disparity persisted among CL clients in most states. As opioid use disorders and opioid-related overdoses are more prevalent among those involved with the CL system, improving this has high impact. Provides the most comprehensive analysis of state-by-state inequities in MOUD access for CL relative to non-CL referrals over a 21-year period through use of a national data set. Positive outliers are used as case examples for others to follow in pursuit of more equitable care.

Pattern of substance abuse among patients in a rehabilitation center

Background: Substance use disorders have profound implications for individuals, their families, and society as a whole. At present, drug trafficking and addiction have ensnared every corner of the globe, impacting millions of individuals worldwide. This pressing issue of drug abuse is concerning due to the underlying conditions fueling it, including shifting cultural values, increasing economic stress, and weakened social support networks. Aims and Objectives: This study aimed to identify the trends in drug abuse and its influencing factors among patients undergoing treatment for addiction in rehabilitation centers in Telangana. Materials and Methods: The study, a descriptive cross-sectional analysis, involved 222 individuals grappling with drug addiction at the primary rehabilitation center for drug addiction treatment in Telangana. Information was gathered using a pre-tested, structured questionnaire between September and December 2022 under the Department of Pharmacology. Results: Among the respondents, 95% were male and 5% were female, with a majority falling in the 21–30 age brackets. The religious breakdown comprised 151 Hindus, 32 Muslims, and 30 Christians, while 41% hailed from tribal regions. Injection emerged as the most prevalent method of substance abuse among 194 participants. The onset of drug abuse mostly occurred between ages 11 and 20, primarily driven by self or peer pressure. Notably, 89% of participants reported being compelled to consume substances. Conclusion: The study found a significant correlation between male gender and drug consumption (P&lt;0.05), as well as between the 21 and 30 age group and drug intake (P&lt;0.05). Additionally, the research highlighted a high prevalence of drug dependence among educated individuals, with familial conflicts and peer pressure being cited as common triggers for various forms of substance abuse.

ADHD - Treatment Options and Consequences of Neglect

Purpose of Research: Attention Deficit Hyperactivity Disorder (ADHD) is one of the most frequently diagnosed neurodevelopmental disorders. It is estimated to occur in approximately 5-10% of children and adolescents. This paper aims to highlight the challenges faced by individuals suffering from ADHD, present risk factors, summarize current treatment methods, and outline the consequences of neglecting treatment. Methods: Databases such as PubMed, Medline, and ResearchGate were used. Basic Results: The goal of ADHD treatment is to reduce the severity of symptoms and improve the social, academic, and emotional functioning of children and adolescents. The choice of treatment and the selection of a specific medication depend on the patient's age and coexisting disorders. Conclusions: ADHD often coexists with other mental disorders, complicating diagnosis and treatment. Lack of or ineffective treatment has consequences such as learning difficulties, disruptions in peer and family relationships. It correlates with higher rates of traffic accidents, accidental injuries, earlier onset, and higher rates of substance abuse.

Predicting the Hallucinogenic Potential of Molecules Using Artificial Intelligence.

The development of new drugs addressing serious mental health and other disorders should avoid the psychedelic experience. Analogs of psychedelic drugs can have clinical utility and are termed "psychoplastogens". These represent promising candidates for treating opioid use disorder to reduce drug dependence, with rarely reported serious adverse effects. This drug abuse cessation is linked to the induction of neuritogenesis and increased neuroplasticity, a hallmark of psychedelic molecules, such as lysergic acid diethylamine. Some, but not all psychoplastogens may act through the G-protein coupled receptor (GPCR) 5HT2A whereas others may display very different polypharmacology making prediction of hallucinogenic potential challenging. In the process of developing tools to help design new psychoplastogens, we have used artificial intelligence in the form of machine learning classification models for predicting psychedelic effects using a published in vitro data set from PsychLight (support vector classification (SVC), area under the curve (AUC) 0.74) and in vivo human data derived from books from Shulgin and Shulgin (SVC, AUC, 0.72) with nested five-fold cross validation. We have also explored conformal predictors with ECFP6 and electrostatic descriptors in an effort to optimize them. These models have been used to predict known 5HT2A agonists to assess their potential to act as psychedelics and induce hallucinations for PsychLight (SVC, AUC 0.97) and Shulgin and Shulgin (random forest, AUC 0.71). We have tested these models with head twitch data from the mouse. This predictive capability is desirable to reliably design new psychoplastogens that lack in vivo hallucinogenic potential and help assess existing and future molecules for this potential. These efforts also provide useful insights into understanding the psychedelic structure activity relationship.

Implementation of Cognitive Behavioral Therapy for psychosis via telehealth: An expert consultation and clinical service model.

Individuals living with psychosis are often underserved in the United States, partly due to the dearth of providers trained in evidence-based practices for this population. One such practice is Cognitive Behavioral Therapy for psychosis, which the Substance Abuse and Mental Health Services Administration has identified as a standard of care for this population. The explosion of telehealth, in large part due to the COVID-19 pandemic, has led to increased opportunities for virtual psychotherapy. Telehealth offers a number of benefits, such as the ability to address service inequities, including lack of access to a local provider well-trained in the modality of therapy needed. The current article describes the National Psychosis Telehealth Program within the National Expert Consultation and Specialized Services (formerly VA National Telemental Health Center) program, U.S. Department of Veterans Affairs. The goal of this telehealth program is to utilize an expert consultation model and offer a remote individual, time-limited Cognitive Behavioral Therapy for psychosis protocol to Veterans across the nation in order to decrease access disparities to this relatively scarce service. We share our initiation activities and lessons learned as we developed this program in hopes of encouraging others to consider similar efforts at their sites. We also include a typical, complex case that serves to illustrate the challenges and benefits of this approach. (PsycInfo Database Record (c) 2024 APA, all rights reserved).