Addicted Individuals Research Articles

Immuno-epidemiological co-affection model of HIV infection and opioid addiction.

In this paper, we present a multi-scale co-affection model of HIV infection and opioid addiction. The population scale epidemiological model is linked to the within-host model which describes the HIV and opioid dynamics in a co-affected individual. CD4 cells and viral load data obtained from morphine addicted SIV-infected monkeys are used to validate the within-host model. AIDS diagnoses, HIV death and opioid mortality data are used to fit the between-host model. When the rates of viral clearance and morphine uptake are fixed, the within-host model is structurally identifiable. If in addition the morphine saturation and clearance rates are also fixed the model becomes practical identifiable. Analytical results of the multi-scale model suggest that in addition to the disease-addiction-free equilibrium, there is a unique HIV-only and opioid-only equilibrium. Each of the boundary equilibria is stable if the invasion number of the other epidemic is below one. Elasticity analysis suggests that the most sensitive number is the invasion number of opioid epidemic with respect to the parameter of enhancement of HIV infection of opioid-affected individual. We conclude that the most effective control strategy is to prevent opioid addicted individuals from getting HIV, and to treat the opioid addiction directly and independently from HIV.

Pharmacogenetics of Addiction Therapy.

Drug addiction is a serious relapsing disease that has high costs to society and to the individual addicts. Treatment of these addictions is still in its nascency, with only a few examples of successful therapies. Therapeutic response depends upon genetic, biological, social, and environmental components. A role for genetic makeup in the response to treatment has been shown for several addiction pharmacotherapies with response to treatment based on individual genetic makeup. In this chapter, we will discuss the role of genetics in pharmacotherapies, specifically for cocaine, alcohol, and opioid dependences. The continued elucidation of the role of genetics should aid in the development of new treatments and increase the efficacy of existing treatments.

Mediating role of metacognitions in the relationship between cognitive avoidance and smoking addiction: a structural equation modeling

Purpose: Cognitive processes have an important place in starting or quitting smoking, which is an important public health problem all over the world. The present study was conducted to determine the mediator role of metacognition about smoking in the relation between cognitive avoidance and nicotine addiction in individuals who want to quit smoking.
 Materials and Methods: The study was completed with a total of 294 people who volunteered to participate in the study and who filled the data collection forms. In the evaluation of the data, descriptive statistics and the Spearman Correlation Test was used for correlation analysis. The effects of cognitive avoidance, nicotine addiction, and metacognition about smoking on each other was examined with structural equality modelling.
 Results: A total of 61.9% of the volunteers who participated in our study were male, and the mean age was 33.17±10.62. The data were found to support the model, and the goodness of fit indices were acceptable (CMIN/DF=2.02, GFI=0.93, AGFI=0.90, CFI=0.96, RMSEA=0.059). Cognitive avoidance and metacognitive beliefs affect nicotine addiction in individuals who want to quit smoking, and metacognitive processes about smoking played mediator roles in the interaction between cognitive avoidance and nicotine addiction.
 Conclusion: It will be useful to include cognitive processes as well as metacognitive processes about smoking in smoking cessation programs.

Exercise Addiction and Self-Esteem in Individuals Exercising

Amaç: Bu çalışmada egzersiz yapan bireylerin egzersiz bağımlılık düzeyini, benlik saygılarını belirlemek, farklı değişkenlerle ilişkileri ve farkları ortaya koymak amaçlanmıştır. 
 Yöntem: Çalışmaya Çanakkale İl merkezinde bulunan spor merkezlerinde egzersiz yapan 202 kişi katılmıştır. Araştırmanın veri toplama araçları olarak Egzersiz Bağımlılığı Ölçeği ve Rosenberg Benlik Saygısı Ölçeği kullanılmıştır.
 Bulgular: Elde edilen bulgulara göre cinsiyet değişkenin egzersiz bağımlılığı ve benlik saygısı üzerinde etkisi olmadığı belirlenmiştir. Medeni durum değişkenine göre katılımcıların bireysel-sosyal ihtiyaçlarını erteleme ve çatışma puanlarında anlamlı fark olduğu belirlenmiştir. Yaş değişkeni ve benlik saygısı puanı arasında anlamlı ilişki olduğu tespit edilmiştir. Egzersize katılan bireylerin egzersiz sıklığı ve egzersiz yaşlarının egzersiz bağımlılığıyla pozitif yönde anlamlı ilişkisi olduğu belirlenmiştir. 
 Sonuç: Egzersiz yapan bireylerin egzersiz bağımlılığı açısından bağımlı grup oldukları ve benlik saygı puanlarının yüksek olduğu, haftalık egzersiz süresi ve egzersize katılım aylarının artmasıyla birlikte egzersiz bağımlılık düzeylerinin arttığı belirlenmiştir. Bununla birlikte egzersiz yapan bireyler arasında bekar olan bireylerin egzersize katılım için bireysel ve sosyal ihtiyaçlarını erteleyebildikleri sonucuna varılmıştır

Changes in temporal discounting, hedonic hunger, and food addiction during recovery from substance misuse

Substance use disorders (SUDs) and obesity are both chronic, relapsing, remitting disorders that arise from a heightened preference for immediate-focused rewards (i.e., steep temporal discounting). During recovery from SUDs, overweight and obese outcomes are common as individuals may replace drug rewards for food rewards. However, little has been done to investigate the neuropsychological processes underlying food reward and addiction in individuals recovering from SUDs. Using data collected from the International Quit and Recovery Registry and Amazon Mechanical Turk, we aimed to elucidate the factors that influence the attraction to palatable foods in a population in recovery from substance misuse (n = 114) as well as a population with no history of substance misuse (n = 97). We hypothesized that individuals in recovery from substance misuse would have steeper temporal discounting, an increased drive for palatable foods (i.e., hedonic hunger), and greater food addiction symptoms than non-substance users. Contrary to our hypotheses, we found that individuals in recovery from SUDs show improved outcomes in temporal discounting, hedonic hunger, and food addiction symptoms. Moreover, recovery status and temporal discounting significantly predicted these outcomes. Our findings suggest that the enhanced executive control processes needed for successful SUD recovery may transfer to other reward-related processes such as food reward and consumption. Interventions targeted at improving executive function including episodic future thinking, meditation, or exercise, may be excellent ways to support a successful recovery and improve other reward-related processes, including food consumption, to decrease the risk of overweight or obese outcomes during recovery.

Indirect Relationship between Alcoholics Anonymous Spirituality and Their Hopelessness: The Role of Meaning in Life, Hope, and Abstinence Duration

Spiritual growth is a significant factor in Alcoholics Anonymous treatment process. In the literature, there is an observable lack of research regarding spiritual mechanisms of recovery in alcohol addicted individuals who are participants of self-help groups. The study purpose was to examine the potential mechanisms indirectly influencing participants of Alcoholics Anonymous (AA) and to determine the effects of spiritual experiences on their feelings of hopelessness through finding meaning in life, improving hope, and longer abstinence duration. The study was conducted using a cross-sectional design. Participants were AA meeting attenders from Poland. According to the obtained results, the relationship between spiritual experiences and feelings of hopelessness was indirect through meaning in life, hope, and abstinence duration. Additionally, the moderated mediation effect was positively verified. Meaning in life moderated the relationship between hope and feelings of hopelessness. In a group of AA participants with less-than-average and average levels of meaning in life, hope protected against feelings of hopelessness. Among AA participants with higher-than-average meaning in life, hope was not related to their depression symptoms. The spiritual mechanisms, which led to reduced feelings of hopelessness among AA participants, and the role of meaning in life, hope, and duration of abstinence were confirmed.

When Does a Lot Become Too Much? A Q Methodological Investigation of UK Student Perceptions of Digital Addiction.

Despite the benefits of the internet and other digital technology, the online world has been associated with a negative impact on university student wellbeing. Many university students report symptoms of pathological internet use. Internationally, further research is needed to understand what student users of technology perceive to be problematic internet and/or digital use. The current study explores the range of perceptions that university students hold about ‘digital addiction’. We recruited 33 participants from a UK university into a Q-methodology study. Participants sorted, ranked, and commented on fifty-two statements representing the concourse of ‘things written or said about digital addiction’. The statements were identified from a comprehensive search of a wide variety of sources (e.g., newspapers, academic articles, blogs, and YouTube). Principal Component Analysis was used to identify four distinct viewpoints of ‘digital addiction’: (I) digital addiction is differentiated by the negative consequences experienced by addicted individuals; (II) digital addiction comes from our fascination with the online world; (III) digital addiction is an attempt to escape real world problems and impacts on mental health and relationships; (IV) digital addiction is defined by the amount of time we spend online. All four viewpoints share the perception that people do not realize they are digitally addicted because using and having digital devices on you at all times has become the social norm. There was also overall agreement that that those with ‘addictive personalities’ were more likely to be ‘digitally addicted’. Despite these similarities, complexity and contradictions within the viewpoints surrounding what digital addiction is and how it might be defined are apparent. The information found in this study provides important suggestions of how we might frame prevention and early intervention messages to engage students and ensure they develop the skills necessary to successfully manage their digital lives.

How are the causes of gambling harm conceptualised by people who gamble?

Abstract Background Messages to prevent gambling harm traditionally focused on individualised responsibility which stigmatise those who experience harm. Shifts have occurred among researchers, advocates, and some governments towards public health approaches which recognise broader determinants of harm. This includes the social practices of gambling and the tactics used by the industry to increase profits. This exploratory study aimed to identify how people who gamble conceptualise the causes of gambling harm. Methods A qualitatively led online panel survey was conducted via Qualtrics. A sample of 427 adults in two Australian states who gamble using electronic gambling machines or sports betting in a typical month provided text responses to the question “What do you think causes gambling harm?”. A reflexive thematic analysis was conducted. Results The vast majority of participants viewed gambling harm as being an issue of personal responsibility or addiction, with some making moral judgements about those who experience harm. Only a small portion of participants recognised the broader determinants beyond the individual that produce harm. Conclusions Gambling is still viewed by people who gamble as an issue of individual behaviour and addiction among a stigmatised sub-group of gamblers. The broader determinants of harm were generally not identified as causes of harm. This suggests the shift towards public health understandings of harm has not extended to the public. There are discrepancies between how the general public understands gambling harm and how it has been conceptualised by experts. Public health messages need to be reconsidered so they are relevant to and understood by the general community. Strategies to shift public understandings of harm also need to be identified. Key messages People who gamble understand gambling harm differently to how it has been conceptualised by experts. This has implications for how harm should be communicated in public health strategies. This study demonstrates the benefits of collecting qualitative data through online surveys.

How Does Food Addiction Relate to Obesity? Patterns of Psychological Distress, Eating Behaviors and Physical Activity in a Sample of Lebanese Adults: The MATEO Study.

Food addiction is currently not an official diagnosis (as a standalone disorder substance-related and addictive disorder) in the Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM-5). To best of our knowledge, there is no previous research on differences between addictive-like eating behavior regarding its associations with psychological distress, eating behaviors and physical activity among individuals with obesity. The objective of the present study was to distinguish psychological and behavioral patterns of individuals with obesity concerning food addiction using a cluster analysis. We determined the profiles of the participants in terms of psychological distress, eating behaviors and physical activity and evaluated their association with food addiction. A cross-sectional study was conducted between September and November 2020, during the lockdown period imposed by the government for the COVID-19 pandemic. A sample of 507 individuals with obesity aged between 18 and 65 years participated in the present study by filling in the online questionnaire, including the validated Arabic version of the modified version of the Yale Food Addiction Scale, the Arabic version of the Depression, Anxiety and Stress Scale, the Three-Factor Eating Questionnaire, and the short version of the International Physical Activity Questionnaire. A cluster analysis was performed using the K-mean method to identify and group participants according to their patterns/profiles. A stepwise linear regression was conducted, taking the food addiction score as the dependent variable. Higher levels of uncontrolled eating, emotional eating and stress were significantly associated with higher food addiction score. Belonging to cluster 2 (psychological well-being and cognitive restraint) (B = 14.49) or cluster 3 (moderate psychological distress and cognitive restraint) (B = 6.67) compared to cluster 1 (psychological well-being, appropriate physical activity levels and eating behaviors) was significantly associated with higher food addiction score. The present research revealed that food addiction is significantly associated with higher psychological distress and maladaptive eating behaviors. Higher levels of uncontrolled eating, emotional eating and stress as well as belonging to clusters 2 and 3 were found to be predictors of food addiction in individuals with obesity in the present study. This knowledge could be useful in regard to psychological treatment of obesity and addictive-like eating behavior.

Relationship Between Caregivers' Care Burden and Their Social Functioning Perceptions Toward Addicted Patients: A Cross-Sectional Survey.

AimThe aim of this study is to examine the relationship between social functioning perceptions of the caregivers toward their patients, and their perceived care burden. MethodThe descriptive, cross-sectional and correlational study was carried out between September 2017-September 2019 using two measurement tools, in addition to an introductory information form: the Burden Interview and Social Functioning Scale The study was conducted with caregivers of the 76 addict outpatients and inpatients of the Alcohol and Substance Addiction Treatment Center of a university hospital in Turkey. The study data were evaluated using descriptive statistical analysis and correlation analysis.ResultsOf the caregivers, 69.7% were female and had a mean age of 43.32 ± 13.35 years; 52.6% and 47.4% of the all caregivers provided care to substance abusers and alcohol abusers, respectively. Of the addicted individuals receiving care, 78.9% were male, 60.5% were single, and 56.6% were unemployed. The mean age of patients was found to be 35.94 ± 11.75 years, and patients had been given treatment for an average of 7.56 ± 7.26 years. It was found that as caregivers’ total mean Social Functioning Scale scores and mean subscale scores increased, their mean Burden Interview scores decreased (p > .05), though this value was not found to be statistically significant. ConclusionThese results are important to support not only the addicted individual but also their caregiver, and to conduct the related treatment and care holistically.

Modulatory effect of opioid administration on the activity of cholinesterase enzyme: a systematic review of mice/rat models

We aimed to review the literature to find the specific effect of opioids on the activity of cholinesterase (ChE) enzyme which plays a substantial role in the functioning of cholinergic system. Literature search was performed by two independent reviewers in order to find relevant articles about the changes in the activity of ChE in mice or rat following opioid administration. Based on findings from literature review, opioid administration is able to induce cholinergic modulation via decreasing or increasing the activity of ChE enzyme. However, the degree of variation of ChE in various brain regions is different. No gender differences was reported in the effect of opioids on ChE activity. Although chronic opioid administration may decrease enzyme function, ChE activity might be unchanged following opioid withdrawal using naloxone or the development of tolerance. Opioid type affects whether or not naloxone can reverse the changes of ChE. Direct inhibitory action of morphine and the other opioid ligands believed responsible for the decrease in the ChE activity. Moreover, the potency of codeine to induce allosteric enhancement of acetylcholine receptor signaling might be involved in the cholinergic modulation of codeine and other opioids. Animal studies on rat and mice showed that opioids may change the activity of ChE. These changes can pertain an increase or decrease in enzyme activity; as there might be no change. The type of opioid used may have an effect on the cholinergic modulation. It is beneficial to conduct cross-sectional and cohort studies on addicted individuals, especially opium abusers, to find the precise association of opioids with alterations in human acetyl cholinesterase or butyrylcholinesterase. Simulation studies can also examine the structure-function relationships and provide important details to better understand the mechanism of action of opioid compounds on ChE activity. In addition, understanding how opioids impact ChE activity may help perform proper interventions for drug abstinence.

Mediating Role of Satisfaction with Life in the Effect of Self-Esteem and Education on Social Media Addiction in Turkey

The increasing use of social media due to various individual and social reasons may trigger some psycho-social issues. What can be effective in reducing social media addiction, which causes social and economic problems, is an important issue today. This study aimed to investigate the mediation effect of satisfaction with life in the impact of self-esteem and education level on social media addiction in individuals. The study was designed as cross-sectional, and the sample consists of 952 volunteers over the age of 15 using social media in Turkey. A personal information form, the Bergen Social Media Addiction Scale, the Rosenberg Self-Esteem Scale, and the Satisfaction with Life Scale were used as data collection tools in the study. The data were analyzed with SPSS 23.0 Program and PROCESS macro plug-in. Demographic questions such as age, gender, and marriage were used as control variables. As a result of the research, it was determined that satisfaction with life had a mediation role in the effect of self-esteem and education level on social media addiction. Self-esteem and education level improved satisfaction with life, and increased satisfaction with life resulted in less social media addiction. These results demonstrate the importance of implementing specific practices based on self-esteem and education, especially for vulnerable groups, to minimize the problems that may arise with the excessive use of digital apps and social media.

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.

Substance abuse and weight control: Do they really have opposing effects?

Addiction to alcohol and cigarettes has been associated with being overweight and obese. Considering the compulsion for food and drugs may share the same neuronal pathway in the brain, this relationship is expected, but the empirical literature is mixed regarding directionality of the relationship between substance abuse and weight control, and it has never been studied directly. In order to address this gap, a systematic was conducted (quantitative) and resulted in a narrative report to summarize the effects of substance abuse treatment on body mass and the effect of weight control on substance abuse (due to the heterogenity of the studies designs, no meta-analysis was performed). Searches of PubMed, Web of Science, and CINHAL databases led to the inclusion of 9 studies out of 48 results. Three of these studies dealt with effects of substance abuse treatment on body weight, three dealt with effects of weight management treatment on substance use, and three studies dealt with both. Among the six studies testing drug interventions on smoking cessation only one increased body mass, while two of them reported a reduction in body weight and BMI of the abstinent subjects being treated, and three of them did not show any change at the intervention follow-up. The six studies testing interventions for weight reduction did not increase addiction to cigarettes or alcohol; and evidence from two of them these studies pointed to a higher number of smoke-abstinent individuals and reduced number of cigarettes per day with the intervention. The evidence collected from interventional studies showed that weight management and drug abuse treatment can be complementary to each other and may be a good combination to treat addiction in overweight and obese individuals. Considering none of the interventions designed for weight control led to increased addiction for substances, despite some risk of weight gain, the interventions did not lead to risk of increased substance abuse. • Most drug interventions for cigarette cessation did not increase body mass. • The RCTs showed reduction in body weight and BMI in abstinent subjects under drug treatment. • None of the diverse interventions aiming weight reduction, increase the addiction for cigarette or alcohol.

Distinct motivations to seek out information in healthy individuals and problem gamblers

As massive amounts of information are becoming available to people, understanding the mechanisms underlying information-seeking is more pertinent today than ever. In this study, we investigate the underlying motivations to seek out information in healthy and addicted individuals. We developed a novel decision-making task and a novel computational model which allows dissociating the relative contribution of two motivating factors to seek out information: a desire for novelty and a general desire for knowledge. To investigate whether/how the motivations to seek out information vary between healthy and addicted individuals, in addition to healthy controls we included a sample of individuals with gambling disorder—a form of addiction without the confound of substance consumption and characterized by compulsive gambling. Our results indicate that healthy subjects and problem gamblers adopt distinct information-seeking “modes”. Healthy information-seeking behavior was mostly motivated by a desire for novelty. Problem gamblers, on the contrary, displayed reduced novelty-seeking and an increased desire for accumulating knowledge compared to healthy controls. Our findings not only shed new light on the motivations driving healthy and addicted individuals to seek out information, but they also have important implications for the treatment and diagnosis of behavioral addiction.

Behavioral addiction and autism spectrum disorder: A systematic review

BackgroundAccording to DSM-5 criteria, Autism spectrum disorder (ASD) is a neurodevelopmental condition characterized by deficiencies in social communication and interaction along with the presence of restrictive and repetitive patterns of behavior. Few studies have explored the prevalence of behavioral addiction in individuals with ASD. Since addiction and ASD share common characteristics, individuals with ASD may be more vulnerable to addictive behaviors. Some typical behavioral addictions include internet, gaming, and gambling addiction. While most previous studies on ASD and addiction have looked at chemical addiction, behavioral addiction has not been thoroughly studied to date. AimsThe objective of this study was to investigate the presence of behavioral addiction among individuals diagnosed with autism spectrum disorder. Methods and proceduresA systematic literature search of five databases was conducted in accordance with the PRISMA guidelines. Search results were reviewed for the predetermined inclusion criteria independently by two authors. Outcomes and resultsThe search yielded 539 publications after the removal of duplicates. 61 met the inclusion criteria for title and abstract review. Full texts were reviewed resulting in an additional 31 being removed. The remaining 30 included 4 case reports and 26 original studies. Results included 27 studies that found a positive correlation (15 of significance, 12 of unknown significance) between a behavioral addiction and either ASD or Autistic traits, 1 found a significant negative correlation, 3 did not find a correlation. Conclusions and implicationsThis review is inconclusive about links between ASD and behavioral addictions. While a vast majority of studies show a positive correlation, many do not provide the statistical analysis to show if the correlations are significant. In addition, a positive correlation between ASD and behavioral addiction is observed in the presence of comorbid mental health conditions in many of the studies. Further research with proper controls and statistical analysis is needed to determine whether the development of behavioral addiction is directly influenced by ASD or if the presence of a comorbid mental health condition is the true cause.

S-Equol mitigates motivational deficits and dysregulation associated with HIV-1

Motivational deficits (e.g., apathy) and dysregulation (e.g., addiction) in HIV-1 seropositive individuals, despite treatment with combination antiretroviral therapy, necessitates the development of innovative adjunctive therapeutics. S-Equol (SE), a selective estrogen receptor β agonist, has been implicated as a neuroprotective and/or neurorestorative therapeutic for HIV-1 associated neurocognitive disorders (HAND); its therapeutic utility for motivational alterations, however, has yet to be systematically evaluated. Thus, HIV-1 transgenic (Tg) and control animals were treated with either a daily oral dose of SE (0.2 mg) or vehicle and assessed in a series of tasks to evaluate goal-directed and drug-seeking behavior. First, at the genotypic level, motivational deficits in HIV-1 Tg rats treated with vehicle were characterized by a diminished reinforcing efficacy of, and sensitivity to, sucrose. Motivational dysregulation was evidenced by enhanced drug-seeking for cocaine relative to control animals treated with vehicle. Second, treatment with SE ameliorated both motivational deficits and dysregulation in HIV-1 Tg rats. Following a history of cocaine self-administration, HIV-1 Tg animals treated with vehicle exhibited lower levels of dendritic branching and a shift towards longer dendritic spines with decreased head diameter. Treatment with SE, however, led to long-term enhancements in dendritic spine morphology in HIV-1 Tg animals supporting a potential underlying basis by which SE exerts its therapeutic effects. Taken together, SE restored motivated behavior in the HIV-1 Tg rat, expanding the potential clinical utility of SE to include both neurocognitive and affective alterations.

Comparison of Emotional Intelligence, Attachment Style, and Mental Health in Addicted and Nonaddicted People

Background: Nowadays, because of the increasing prevalence of addiction in society, there are many costs involved in treating addicts and returning them to normal lives. This will not be possible except in new and effective ways. Objectives: This study aimed to compare emotional intelligence, attachment style, and mental health in addicted and healthy individuals. Methods: On the basis of inclusion criteria, available sampling method, and semistructured interview based on Diagnostic and Statistical Manual of Mental Disorders-5, 100 addicted men were selected and after matching with 100 nonaddicted men by, Extracurricular Vein Scale (TMMS), light questionnaire Adult Attachment Style (AAS), and the Goldenberg General Health Questionnaire (GHQ) were assessed. Results: The results showed that in all 3 components of attention, differentiation, and mood reconstruction of emotional intelligence, addicted people scored lower than the nonaddicted group. The results showed that in the secure attachment style, the mean scores of the nonaddicted group are higher than the addicted group, while in the avoidant insecure style and ambivalent anxiety style, addicted men are significantly higher than nonaddicted men. Also, in all components of mental health, the nonaddicted group obtained higher scores compared with addicted people. Conclusions: Psychological correlations of emotional intelligence, adult attachment style, and mental health are important risk factors for the phenomenon of drug addiction and have many practical implications for preventive interventions and treatment of abusive behaviors.

Effectiveness of Policies for Addressing the US Opioid Epidemic: A Model-Based Analysis from the Stanford-Lancet Commission on the North American Opioid Crisis

Background: The opioid epidemic causes significant morbidity and mortality in the United States, and has been exacerbated by COVID-19.Methods: We extend and update a previously developed model to assess the effectiveness of the following interventions, alone and combined, for controlling the U.S. opioid epidemic: reduced prescribing, drug rescheduling, prescription monitoring programs, tamper-resistant drug reformulation, excess opioid disposal, naloxone availability, needle exchange, pharmacotherapy, and psychosocial treatment. We measure life years, quality-adjusted life years (QALYs), and opioid-related deaths over five and ten years.Findings: Under the status quo, our model predicts that approximately 522,000 opioid-related deaths will occur from 2020 to 2024 (range 424,000 - 575,000), rising to 1,172,000 (range 956,000 - 1,308,000) by 2029. Expansion of naloxone availability had the largest effect: with 30% expansion, approximately 25% of opioid deaths would be averted. Pharmacotherapy, needle exchange, and psychosocial treatment are uniformly beneficial, reducing opioid-related deaths while leading to gains in life years and QALYs. Reduced prescribing for acute and transitioning pain (at the end of the first month of acute pain) would reduce lives lost over five and ten years. Reducing chronic pain prescribing, rescheduling drugs, and increasing excess opioid disposal programs would increase total deaths over five years as some opioid users escalate to heroin, but decrease deaths over ten years. Combined interventions would lead to greater increases in life years, QALYs, and deaths averted, although in many cases the results are subadditive.Interpretation: A combination of expanded health services for addicted individuals and reduced opioid prescribing would moderately lessen the severity of the opioid crisis over the next decade. Tragically, even with improved public policies, significant morbidity and mortality is inevitable.Funding: Grant R37-DA15612 from the National Institute on Drug Abuse and a grant from Stanford University School of Medicine to support the Stanford-Lancet Commission on the North American Opioid Crisis.Declaration of Interests: The authors have no conflict of interest to report.

Prevalence of Drug Relapse among Clients in Rehabilitation Centres in North Central Nigeria: Implications for School Counsellors

Despite sufficient research studies in the field of drug abuse, drug relapse remains one of the salient aspects that has received less attention among research experts. This study thus investigated the prevalence of drug relapse among clients in NDLEA (National Drug Law Enforcement Agency) rehabilitation centres in North Central, Nigeria. A descriptive survey design was adopted for this study. Censors sampling method, that is, only the available clients or respondents (during the conduct of the study) at the rehabilitation centres in the North Central region participated in the study. A researcher-designed questionnaire on "Prevalence of Drug Relapse" was used to collect the relevant data. The instrument had a reliability co-efficient of 0.69 using the test re-test method. All hypotheses were tested using t-test and Analysis of Variance (ANOVA) statistics at a 0.05 level of significance. The main findings of the study revealed that drug relapse is moderately prevalent among clients in NDLEA rehabilitation centres in North Central, Nigeria. In view of this, it was recommended that NDLEA and other stakeholders should intensify efforts in identifying more addicted individuals so that they can go through the rehabilitation process and adjust effectively to their environment and avoid returning to drug/substance use after treatment.