Addicted Patients Research Articles

Global Assessment of Training Needs in Addiction Medicine

Introduction: A minority of addiction patients receive appropriate treatment directly from trained professionals in addiction medicine. Most countries have not recognized addiction medicine (AM) as a specialty in its own right or within psychiatry/other specialties. Therefore, the effectiveness and organization of AM training around the world need to be improved. Unfortunately, standard instruments are rarely used in most studies to assess training needs. This study aimed to determine international competencies in AM among professionals in as many countries as possible using a standard instrument such as the AM Training Needs Assessment (AM-TNA). Method: We examined competencies in AM with the AM-TNA using an online survey. A General Competency Level in Addiction Medicine (GLOCIAM30) was calculated by dividing the total score by the number of 30 items. This GLOCIAM30 was used to measure the general level of competency in AM and to compare individual competencies. Results: One hundred ninety-nine respondents from 45 countries completed the survey. Ninety-five of the 199 respondents (49.0%) had a GLOCIAM30 higher or equal to 4 (fairly competent). The highest skill level was found for the competency “Assessing substance use problems by taking the patient’s history.” Nine of the 45 countries had 8 or more respondents (n = 129). After post hoc analysis, there was no difference between these countries. Respondents could reasonably estimate whether the competency level in their country was higher or lower than the world average. Conclusions: This study is the first international attempt to examine competencies in AM. Although a much larger study population is needed to establish an overall goal for competencies in AM, our study provided an initial direction for such a gold standard in benchmarking procedures.

A randomized controlled trial on the effect of cranial electrotherapy stimulation on depression, anxiety, and craving in addicted male patients undergoing methadone maintenance treatment.

Addicted patients undergoing methadone maintenance treatment are prone to several complications and the risk of relapse. The present study aims to investigate the effect of cranial electrotherapy stimulation on depression, anxiety, and craving in addicted male people undergoing methadone maintenance treatment. This randomized controlled trial study was conducted on 60 male patients referred to Persia addiction treatment center between 2021 and 2022. Patients were randomly divided into two equal treatment and placebo groups. The treatment group received cranial electrotherapy stimulation intervention for 48 sessions of 30min. Depression and anxiety were evaluated using the Hamilton questionnaire before and after the intervention, and the level of craving was also evaluated with the Federdi 2008 questionnaire. Comparing the level of depression and anxiety before and after the intervention in both treatment and placebo groups did not show any significant difference (p < 0.05). Craving after the intervention was significantly different in both groups and was lower in the treatment group compared to the placebo group (33.43 versus 42.17, p = 0.004). In the placebo group, the level of anxiety and depression, and in the treatment group, the level of depression, anxiety and craving for consumption decreased significantly after the intervention compared to before the intervention (p < 0.05). Cranial electrotherapy stimulation did not have a significant effect on reducing the level of depression and anxiety of patients, but it is effective in the reduction of craving in addicted people undergoing methadone maintenance treatment. This randomized clinical trial was registered on 2022/5/13 with clinical trial code of IRCT20210523051367N1.

Molecular and Environmental Determinants of Addictive Substances.

Knowledge about determinants of addiction in people taking addictive substances is poor and needs to be supplemented. The novelty of this paper consists in the analysis of innovative aspects of current research about relationships between determinants of addiction in Polish patients taking addictive substances and rare available data regarding the relationships between these factors from studies from recent years from other environments, mainly in Europe, and on the development of genetic determinants of physiological responses. We try to explain the role of the microelements Mn, Fe, Cu, Co, Zn, Cr, Ni, Tl, Se, Al, B, Mo, V, Sn, Sb, Ag, Sr, and Ba, the toxic metals Cd, Hg, As, and Pb, and the rare earth elements Sc, La, Ce, Pr, Eu, Gd, and Nd as factors that may shape the development of addiction to addictive substances or drugs. The interactions between factors (gene polymorphism, especially ANKK1 (TaqI A), ANKK1 (Taq1 A-CT), DRD2 (TaqI B, DRD2 Taq1 B-GA, DRD2 Taq1 B-AA, DRD2-141C Ins/Del), and OPRM1 (A118G)) in patients addicted to addictive substances and consumption of vegetables, consumption of dairy products, exposure to harmful factors, and their relationships with physiological responses, which confirm the importance of internal factors as determinants of addiction, are analyzed, taking into account gender and region. The innovation of this review is to show that the homozygous TT mutant of the ANKK1 TaqI A polymorphism rs 1800497 may be a factor in increased risk of opioid dependence. We identify a variation in the functioning of the immune system in addicted patients from different environments as a result of the interaction of polymorphisms.

Drug Addiction Clinical Study Among Patients Admitted to the Alqana Center for Social Rehabilitation

Background: Drug addiction is a worldwide issue; 5.6% of the world's population aged 15 to 64 took drugs at least once in 2016. For the majority of medicines, younger individuals use them more than older people do. Drug abuse seems to be on the increase in several ASEAN (Association of Southeast Asian Nations) countries, particularly among young men aged 15 to 30. Illicit drug abuse account for around 14% of the overall health burden among young males. Younger individuals are also more prone to die from drug abuse issues. Aims of study is to assess the severity of problems related to drug addiction. in Baghdad city and to study epidemiological features of drug addiction among Patients Admitted to the Alqana Center for Social Rehabilitation. Patients and methods: An analytical cross-sectional study of 300 individuals diagnosed as a drug addiction patient according to the criteria established by the "Diagnostic and Statistical Manual of Mental Disorders", Fifth Edition, text revision, often called the DSM-V-TR or DSM-5-TR. From the medical department at Alqana Center for Social Rehabilitation in Baghdad. The research was carried out from 25/December/2023 to 30/June/2024. Results: the demographic characteristics of the study sample. In with a mean and a standard deviation (SD) of age of 29.33±18.68. Individuals aged 20-29 year had the highest proportion to addiction, with a rate of 42.7%. Conversely, 89.3% of the participants were male. The majority,86.7%, live in urban regions. The majority of patients had 51.7% unmarried, with only 36.0% being married and 12.3% was divorced. The main rate among drug addiction patients was 38.7% primary education ,33.0% secondary education, and 16.0% was illiterate patient, while lowest patient 12.3% at collage. According to the statistics in the table,76.3% of the participants were free business. 95.0% cigarette smoker. presented the result of psychological symptoms as show 93.0% of study addictive patient have mood swings, and in the same table the behavioral and social symptoms showed as 97.0% of study patient had poor performance and/or attendance at work or school. Also, physical symptoms of addiction showed as 74.7% of patient suffering from disrupted sleep patterns, including insomnia Regarding to the withdrawal symptoms of drug addiction presented in Table (3), results showed as 95.7% fatigue, 85.3% muscle pain or aches, 81.0% irritability and agitation, 76.0% trembling and tremors, 69.3% hunger, 50.7% anxiety, 36.7% sweating, 30.7% insomnia, 25.3% loss of appetite, 22.7% depression, 20.7% confusion, 22.3% nausea, 9.3% seizures, 8.0% dilated pupils, 3.3% vomiting, and 2.3% paranoia. Conclusion: the majority of addicted patient was male. the main symptoms were Poor performance and/or attendance at work or school and mood swing. The highly complication was fatigue. Regarding the way of addiction, the tablets is vast majority and enjoyment is the most common cause of addiction. Recommendations: It's possible that other important differences between the factors seen in this study would become clearer if multicenter study, the sample size was larger and the duration of the addiction study had been longer.

Cardiac Profile Assessment of Acute Opioid Intoxicated Addicted Patients Admitted to General Hospitals of Port Said and Damietta Governorates

Cardiac Profile Assessment of Acute Opioid Intoxicated Addicted Patients Admitted to General Hospitals of Port Said and Damietta Governorates

The relationship between sleep profiles and anxiety and depression in addicted patients: A latent profile analysis

The relationship between sleep profiles and anxiety and depression in addicted patients: A latent profile analysis

Investigation of the Demographic Characteristics of Patients Addicted to Opioids Undergoing Drug Maintenance Treatment in Addiction Treatment Centers in Bojnurd City

Introduction: Opium addiction is one of the most significant problems in Iran. This study investigates demographic information of opium-addicted patients undergoing maintenance treatment in Bojnurd addiction treatment centers. This study aims to identify high-risk groups and those who need therapeutic and psychosocial interventions to maintain treatments. Method: This cross-sectional study was conducted from 2016 to 2021 on 300 addicted patients referring to Bojnurd addiction treatment centers. These patients participated in the opioid maintenance treatment program for at least six months. The investigation utilized a checklist of demographic information and examined the files of addicted people undergoing maintenance treatment in eight addiction treatment centers in the city. The data were analyzed in SPSS23 software using the Chi-square statistical test. Results: The mean age (standard deviation) of the participants was 52.17±14.13 years. Besides, 76.6% of the participants were male, 70.0% resided in the city, and 73.6% were married. The majority of the participants had a primary education level and were self-employed. Opium juice was the most consumed substance, and smoking was the most common method of use. Conclusion: It appears that married and middle-aged individuals constitute the largest population undergoing maintenance treatment in Bojnurd city. The high frequency of individuals with low or no literacy in the studied population underscores the importance of education.

Evaluation of the Hepatotoxicity of Buprenorphine in Rat Pups Born to an Exposed Mother During Lactation.

This study aimed to evaluate the hepatotoxicity of buprenorphine in lactating rat pups of buprenorphine-injected mothers. Buprenorphine (BUP), a semisynthetic opioid, is increasingly administrated as a first-line standard maintenance treatment for opioid dependence due to its high safety and efficacy compared to other opioids. Numerous studies have confirmed the safety of BUP maintenance treatment in addicted patients. This study was designed to assess the effects of BUP on the activities of liver enzymes, oxidative parameters, and liver histopathological changes in pups born to a mother exposed to this drug during lactation. BUP at a dose of 0.5 or 0.1 mg/kg was subcutaneously administrated to lactating rats for 28 days. At the end of the experiment, the pups were anesthetized, and blood samples were obtained from their hearts for measuring liver enzymes. Then the livers of the animals were dissected to measure oxidative stress parameters. In addition, the liver samples were fixed for histopathological evaluation. The findings indicated a decrease in the activities of serum liver enzymes (ALT and AST) of the pups born to mothers exposed to 0.5 and 1 mg/kg of BUP during lactation. BUP could not change malondialdehyde (MDA), glutathione (GSH), nitric oxide (NO) levels, nor superoxide dismutase (SOD) activity in the liver tissue of animals. Some vacuolated hepatocytes with dark, eccentric nuclei, necrosis with karyolytic nuclei, mitotic figures, and multiple binucleated cells were seen in the pups which received 1 mg/kg of BUP. In conclusion, BUP may induce liver dysfunction in pups born to mothers exposed to this drug during lactation.

The impact of methamphetamine on psychosocial variables in patients from Iraq.

The current work reviews the psychosocial factors associated with different urinary methamphetamine concentration levels. From April to November 2023, 243 participants from Baghdad's Al-Ataa Hospital were the subjects of a cross-sectional descriptive analysis study. We included 73 patients in this study. The urinary methamphetamine concentration levels were from 3 to 92,274 ng/ml, with a mean ± SD of 10,873.6 ± 18,641. Patients diagnosed with major depression disorder exhibited higher scores on GHQ-30, UCLA, MOAS, and BDI-II with a significant P-value of 0.0001, 0.001, 0.0001, and 0.0001, consequently with an effect size of 0.015, 0.001, 1.05, and 3.24, respectively. The multi-screening test can produce a false positive. It frequently interferes with other drugs, especially antidepressants. This will result in patients being stigmatized and accused. On the other hand, those who accidentally come into contact with crystal smoke will experience the same withdrawal symptoms as the addicted patients. Their urinary methamphetamine level (titer) could have negative results. Urinary methamphetamine levels should be zero in healthy patients. In this situation, screening tests, expert opinion, and urine methamphetamine testing are strongly recommended.

Research on the Willingness Model for Community Drug Rehabilitation Participation Based on Mixed Research

Objective: With the continuous improvement of community management functions, community drug rehabilitation management in China has also received increasing attention. Currently, research mainly focuses on the policy and measure reforms of management departments. According to relevant data, the willingness of drug users to actively participate in community drug rehabilitation management is still low. Theoretical Framework: Through a search for quantitative data, it was discovered that two independent factors impact this variable: Program outcomes and small teamwork competence. Furthermore, there exists an additional mediating variable: Client-centered management practices have a correlation with program outcomes and have an impact on the willingness of clients. Client-centered management practice correlates with the proficiency of small workgroups and impacts clients' receptiveness. Method: The researcher used qualitative and quantitative sequential exploratory mixed methods to achieve this. In the qualitative stage, the study focused on key stakeholders from five Correction Institutes using interviews, focus groups, and lessons learned as tools for data collection. A purposive sample of 27 individuals was selected. The researcher used content and topic analysis to develop a conceptual framework and a questionnaire. In the quantitative stage, the study included drug addicts in correction institutes. A sample of 356 respondents was sampled using a systematic sampling method. Results and Discussion: Through literature research and field interviews, our project team found that customer centered management practices, small team cooperation ability, and the achievements of community management projects have an impact on the willingness of drug addiction patients to participate in community drug rehabilitation. Therefore, a structural equation model that affects the willingness to participate in community drug rehabilitation is proposed. We hope to explore the optimal structural relationship through a mixed qualitative and quantitative research method, and provide reference for relevant academic research. Research Implications: As recommendations, managers should analyze project role links and emphasize cross-role communication and collaboration. For future studies, it is recommended to use qualitative data such as work process observations and examine the long-term consequences of participants' Willingness.

Guidelines for Reasonable and Appropriate Care in the Emergency Department (GRACE-4): Alcohol use disorder and cannabinoid hyperemesis syndrome management in the emergency department.

The fourth Society for Academic Emergency Medicine (SAEM) Guidelines for Reasonable and Appropriate Care in the Emergency Department (GRACE-4) is on the topic of the emergency department (ED) management of nonopioid use disorders and focuses on alcohol withdrawal syndrome (AWS), alcohol use disorder (AUD), and cannabinoid hyperemesis syndrome (CHS). The SAEM GRACE-4 Writing Team, composed of emergency physicians and experts in addiction medicine and patients with lived experience, applied the Grading of Recommendations Assessment Development and Evaluation (GRADE) approach to assess the certainty of evidence and strength of recommendations regarding six priority questions for adult ED patients with AWS, AUD, and CHS. The SAEM GRACE-4 Writing Team reached the following recommendations: (1) in adult ED patients (over the age of 18) with moderate to severe AWS who are being admitted to hospital, we suggest using phenobarbital in addition to benzodiazepines compared to using benzodiazepines alone [low to very low certainty of evidence]; (2) in adult ED patients (over the age of 18) with AUD who desire alcohol cessation, we suggest a prescription for one anticraving medication [very low certainty of evidence]; (2a) in adult ED patients (over the age of 18) with AUD, we suggest naltrexone (compared to no prescription) to prevent return to heavy drinking [low certainty of evidence]; (2b) in adult ED patients (over the age of 18) with AUD and contraindications to naltrexone, we suggest acamprosate (compared to no prescription) to prevent return to heavy drinking and/or to reduce heavy drinking [low certainty of evidence]; (2c) in adult ED patients (over the age of 18) with AUD, we suggest gabapentin (compared to no prescription) for the management of AUD to reduce heavy drinking days and improve alcohol withdrawal symptoms [very low certainty of evidence]; (3a) in adult ED patients (over the age of 18) presenting to the ED with CHS we suggest the use of haloperidol or droperidol (in addition to usual care/serotonin antagonists, e.g., ondansetron) to help with symptom management [very low certainty of evidence]; and (3b) in adult ED patients (over the age of 18) presenting to the ED with CHS, we also suggest offering the use of topical capsaicin (in addition to usual care/serotonin antagonists, e.g., ondansetron) to help with symptom management [very low certainty of evidence].

Interrelation between subjective assessment of mental state and perception of family relations by relatives caring for patients with addiction

The addictive disorder often becomes a difficult experience for the all family. Studying the factors influencing the level of psychological distress of addicted patients’ relatives is necessary to create an effective system of psychological assistance for them.Purpose: to reveal the interrelations between the subjective assessment of the mental state and the perception of family relationships among relatives of patients with pathological gambling (PG) and relatives of patients with stimulant use disorder (SUD).Materials and methods. In a cross-sectional study 100 and 41 patients’ relatives were included in the PG and SUD groups respectively. The Symptom Checklist-90-Revised (SCL-90-R) and the Family Environment Scale (FES) was used as an assessment tools. Socio-demographic and clinical data were also collected.Results. The analysis of interrelations between the severity of psychopathological symptoms and the perception of family relationships in the studied groups determined both general and specific correlations. In both groups there are multiple negative correlations between the majority of SCL-90-R scales and the “Cohesion” scale (FES). The specific interrelations included, for example, multidirectional correlations between the “Expressiveness” scale (FES) and psychopathological symptoms scales of the SCL-90-R. Increased expressiveness in the PG group was associated with less severity of psychopathological symptoms and level of distress, and, on the contrary, a greater severity of psychological distress in respondents of the SUD group. Analysis of the correlations in PG compared to SUD showed greater predictability of the connections between psychopathological symptoms and perception of family relationships in the PG group. Thus, the indicators of psychopathological symptoms and psychological distress are negatively associated with parameters reflecting the perception of family cohesion, trust in intrafamily relations, social activity and family organization and, at the same time, have positive interrelations with the indicator of conflict in family relationships.Conclusion. The perception of the family cohesion function as the intrapsychic protection that facilitate the relatives’ adaptation in the emerging life situation, regardless of the form of patients’ addiction.

CD137+ and regulatory T cells as independent prognostic factors of survival in advanced non-oncogene addicted NSCLC patients treated with immunotherapy as first-line

BackgroundImmune checkpoint inhibitors (ICIs), administered alone or combined with chemotherapy, are the standard of care in advanced non-oncogene addicted Non-Small Cell Lung Cancer (NSCLC). Despite these treatments' success, most long-term survival benefit is restricted to approximately 20% of patients, highlighting the need to identify novel biomarkers to optimize treatment strategies. In several solid tumors, immune soluble factors, the activatory CD137+ Tcells, and the immunosuppressive cell subsets Tregs and MDSCs (PMN(Lox1+)-MDSC and M-MDSCs) correlated with responses to ICIs and clinical outcomes thus becoming appealing predictive and prognostic factors. This study investigated the role of distinct CD137+ Tcell subsets, Tregs, MDSCs, and immune-soluble factors in NSCLC patients as possible biomarkers.MethodsThe levels of T cells, MDSCs and soluble factors were evaluated in 89 metastatic NSCLC patients who underwent ICIs as first- or second-line treatment. T cell analysis was performed by cytoflurimetry evaluating Tregs and different CD137+ Tcell subsets also combined with CD3+, CD8+, PD1+, and Ki67+ markers. Circulating cytokines and immune checkpoints were also evaluated by Luminex analysis. All these parameters were correlated with several clinical factors (age, sex, smoking status, PS and TPS), response to therapy, PFS , and OS . The analyses were conducted in the overall population and in patients treated with ICIs as first-line (naïve patients).ResultsIn both groups of patients, high levels of circulating CD137+ and CD137+PD1+ T cells (total, CD4 and CD8) and the soluble factor LAG3 positively correlated with response to therapy. In naïve patients, PMN(Lox1+)-MDSCs negatively correlated with clinical response, and a high percentage of Tregs was associated with favorable survival. Moreover, the balance between Treg/CD137+ Tcells or PMN(Lox1+)-MDSC/CD137+ Tcells was higher in non-responding patients and was associated with poor survival. CD137+ Tcells and Tregs resulted as two positive independent prognostic factors.ConclusionHigh levels of CD137+, CD137+PD1+ Tcells and sLAG3 could predict the response to ICIs in NSCLC patients independently by previous therapy. Combining the evaluation of CD137+ Tcells and Tregs also as Treg/CD137+ T cells ratio it is possible to identify naive patients with longer survival.

Correlations between Clinic Preferences and Alcohol Use Disorder: an Alcohol Cohort Study in Northern Taiwan in 2022

IntroductionChronic alcoholism can result in severe liver conditions such as fatty liver disease and cirrhosis, potentially leading to life-threatening complications and premature death.ObjectivesThis study investigated the age-sex distribution of patients with alcohol addiction and aimed to identify differences in clinic department preferences based on their principal and additional diagnoses in Taiwan, in 2022.MethodsWe conducted a comprehensive analysis of the diagnostic patterns of 334 patients with alcohol addiction from the Taoyuan General Hospital, Ministry of Health and Welfare.ResultsFigure 1 depicts patient demographics, highlighting 297 male and 37 female patients with alcohol-related disorders. Males aged 41-60 years were particularly dominant, as shown in Figure 2. Principal diagnoses, including alcoholic liver disease and acute pancreatitis, are detailed in Table 1. Additional diagnoses, such as chronic pancreatitis and esophageal varices, are presented in Table 2. For departmental preferences, Table 3 reveals the Gastrointestinal (GI) department as the top choice, followed by Kidney, Neurological, and Cardiovascular/Chest.Table 1.Top 5 Principal Diagnoses of Alcohol Addiction Patients.ICD-10-CMPrinciple diagnosisTimesRankK70Alcoholic liver disease431K85Acute pancreatitis272F10Alcohol related disorders183A41Other sepsis144K86Other chronic pancreatits115Table 2.Top 5 Additional Diagnoses of Alcohol Addiction Patients. ICD-10-CMAdditional diagnosisTimesRankF10Alcohol related disorders401K86Other chronic pancreatits182I85Esophageal varices163K70Other sepsis16E87Other disorders of fluid, electrolyte and acid-base balance154R65Symptoms and signs specifically associated with systemic inflammation and infection105Table 3.Top 5 Departments for Alcoholism Patient Presentation.DepartmentTimesRankGastrointestinal1621Kidney392Neurological253Cardiovascular Chest154Image:Image 2:Conclusions The study revealed that patients with alcohol addiction often delay seeking psychiatric help instead of presenting for medical care only after liver or gastrointestinal complications occur. This underscores the crucial need for better health education regarding the relationship between alcohol addiction and liver disease. Prompt recognition and early intervention for substance addiction can significantly reduce these risks and improve patient outcomes.Disclosure of InterestNone Declared

Rs822336 binding to C/EBPβ and NFIC modulates induction of PD-L1 expression and predicts anti-PD-1/PD-L1 therapy in advanced NSCLC

Efficient predictive biomarkers are needed for immune checkpoint inhibitor (ICI)-based immunotherapy in non-small cell lung cancer (NSCLC). Testing the predictive value of single nucleotide polymorphisms (SNPs) in programmed cell death 1 (PD-1) or its ligand 1 (PD-L1) has shown contrasting results. Here, we aim to validate the predictive value of PD-L1 SNPs in advanced NSCLC patients treated with ICIs as well as to define the molecular mechanisms underlying the role of the identified SNP candidate. rs822336 efficiently predicted response to anti-PD-1/PD-L1 immunotherapy in advanced non-oncogene addicted NSCLC patients as compared to rs2282055 and rs4143815. rs822336 mapped to the promoter/enhancer region of PD-L1, differentially affecting the induction of PD-L1 expression in human NSCLC cell lines as well as their susceptibility to HLA class I antigen matched PBMCs incubated with anti-PD-1 monoclonal antibody nivolumab. The induction of PD-L1 expression by rs822336 was mediated by a competitive allele-specificity binding of two identified transcription factors: C/EBPβ and NFIC. As a result, silencing of C/EBPβ and NFIC differentially regulated the induction of PD-L1 expression in human NSCLC cell lines carrying different rs822336 genotypes. Analysis by binding microarray further validated the competitive allele-specificity binding of C/EBPβ and NFIC to PD-L1 promoter/enhancer region based on rs822336 genotype in human NSCLC cell lines. These findings have high clinical relevance since identify rs822336 and induction of PD-L1 expression as novel biomarkers for predicting anti-PD-1/PD-L1-based immunotherapy in advanced NSCLC patients.

Like cheese and chalk or cross-fertilization? A qualitative exploration of how addiction patients perceive treatment in a general psychiatry ward

Background Addiction has historically been conceptualized and treated differently to other conditions. Studies suggest that healthcare staff perceive patients with substance use disorders (SUD) as a specific subgroup with distinct and challenging needs yet SUD patients frequently receive treatment in general psychiatry settings. Notwithstanding, knowledge of how SUD patients view themselves compared to other psychiatric patients and how they experience treatment in general psychiatry settings is lacking. Methods We conducted semi-structured interviews with 22 SUD patients voluntarily hospitalized in the acute psychiatric unit of a general hospital to explore the lived experiences of SUD patients receiving detoxification in an acute psychiatry ward. Data were analyzed using Thematic Content Analysis. Results Two primary themes and five subthemes emerged: (A) Patient perceptions of the problem and its consequences’, which includes the subcategories (i) Patient views of addiction, (ii) Staff perception of the patients; and (B) Lived experiences within the specific setting with subthemes (i) Interaction with the specific setting, (ii) Interaction with fellow patients, and (iii) Perception of staff by patients. Conclusions Overall, SUD patients had mixed perceptions; while many appreciated aspects of their hospitalization, others faced challenges in having all their needs met. Implementing policy-level interventions, like integrating SUD patient needs into psychiatry ward design and ensuring adequate resource allocation and staff training, could improve care quality for addiction patients in general psychiatry settings.

The attitudes of Polish nurses towards patients with alcohol-related problems and the subsequent impact on care delivery

Abstract Aim. To analyse the attitudes of nursing staff towards patients with co-occurring alcohol problems. Material and methods. The study was conducted among 120 nurses working in a tertiary hospital in the Podbeskidzie region (Poland). A diagnostic survey was used with self-administered questionnaire as the research tool. Results. The number of 93.3% of the respondents confirmed that they had addicts among their patients. The respondents believe that the education and social status of addicted patients (41.8%) and their gender (54%) are important in the way they are treated by medical staff and affect the quality of service provided. The attitudes and feelings of the respondents, when caring for patients with co-occurring alcohol problems, are most often negative or indifferent. Conclusions. In clinical reality, there is stigmatization and a rather unfavourable or indifferent attitude towards patients with an accompanying alcohol problem. Nursing staff find working with an alcoholic challenging and do not treat patients with co-existing alcohol use disorder on an equal footing with patients suffering from other disease entities.

The Effectiveness of Behavior Modification Therapy on Level Of Anxiety Among Substance Addicted Patients in Selected De-Addiction Center Meerut

Statement of the Problem: A study to assess the effectiveness of behavior modification therapy on level of anxiety among substance addicted patients in selected de-addiction center Meerut, U.P. Objectives: 1. To assess the level of anxiety among substance addiction patients in experimental and control group. 2. To deliver the behavioral modification therapy in experimental group. 3. To evaluate the effectiveness of behavioral modification therapy on level of anxiety among substance addiction patients in experimental group. 4. To compare the level of anxiety among substance addiction patients in experimental and control group. 5. To associate the level of anxiety and their selected variables among the substance addiction patients in experimental and control group . Methods: A quasi experimental study was conducted on 60 substance addicted patients, 30 in experimental group and 30 in control group selected by purposive sampling technique having kept the inclusion and exclusion criteria. The tools used for this study was Standardized Hamilton Anxiety scale for assessing the level of anxiety among substance addicted patients and its demographic variables. Results: Major findings of the study: Findings of the study reveals that the effectiveness of behavioural modification therapy is help to decrease the level of anxiety Among Experimental Group Pre-test scores shows that that majority of samples 16(53%) had mild to moderate anxiety, 08 (27%) had mild anxiety and 04 (13%) had moderate to severe anxiety and post-test data represented that majority of samples 20(66%) had mild anxiety, 06 (20%) had mild to moderate anxiety, and 02 (7%) had severe anxiety. Conclusion: The results and findings of this study shows that Behavior modification therapy is very effective and significant to decrease the level of anxiety among substance use patients from selected rehabilitation center, Meerut.

Reality check. The issue of social plausibility in Virtual reality therapy with addiction patients

In France, virtual reality has been experimented since 2016 to address addictive behaviors. The existing literature insists on the “immersive” dimension of the technology as a significant factor in the efficacy of exposure. An ethnographic approach, however, suggests that the realism criterion should be reassessed. Based on a fieldwork conducted in the addictology department of a French hospital that made use of Virtual reality therapy (VRT), the article shows that it is a form of technical reiteration designed to develop reflexivity about one's actions, provoking the craving so that it can be domesticated. The patient's engagement in “as if” mode is facilitated by the therapist's work in mapping the patient's addictive practices, personalizing the exposure situations, and elaborating the simulation as being part of a practical experiment. While the question of graphic realism does not seem especially problematic, the question of social plausibility can put the simulation operation under strain.

Addiction Patient’s Relationship to Self and Predictions on the Estimated Hospitalization Duration

Addictions are physical and/or psychological dependency disorders characterized by repetitive and compulsive behaviours in which the individual has difficulty controlling impulses. In this study, behaviours are defined as chronic alcohol or substance use. Thus, compulsions will generate negative consequences on a person's quality of life. Among the causes of addiction are genetic and biological factors, environmental factors, trauma, abuse, lack of emotional support, stress, social pressures, poor coping mechanisms, social and cultural factors.&#x0D; Material and method&#x0D; In this study, part of a larger study, 81 patients diagnosed with toxic-nutritional liver cirrhosis, chronic alcohol users, aged between 32 and 68 years were included. The study period was of two years, and anamnestic data (number of hospitalization days, hospitalization frequency) were collected for the period 2015-2022. In order to carry out the linear research, SPSS statistical software was used. Patients, after obtaining consent, were administered a psychological questionnaire designed to assess unconditional self-acceptance, based on the hypothesis that low self-tolerance generates self-destructive behaviours, i.e. addictions.&#x0D; &#x0D; Results &#x0D; The necessary statistical steps were followed in order to check the database and it was possible to obtain correlations between the number of hospitalization days, the hospitalization frequency and the scores obtained in the questionnaire. Finally, it was possible to generate a simple linear regression prediction with the number of hospitalisation days /inpatient frequency as the dependent variable and the test score as the independent variable.&#x0D; The results showed that as unconditional self-acceptance decreases (decreasing score), the hospitalization duration or the number of patient presentations to the doctor increases.&#x0D; Conclusions &#x0D; Unconditional self-acceptance, environmental tolerance, coping mechanisms have a major impact on the patient's well-being and compliance with treatment. Psychosomatic disorders accompany the addiction patient to a much greater extent than the diagnosis made by clinicians. This demonstrates the need for a diagnostic tool, the lack of collaboration with the psychiatrist, ultimately generating costs on the health system and reducing the quality of the patient’s life.&#x0D; In order to optimise the diagnosis, a tool within the clinician's reach (internal medicine doctor, gastroenterologist, etc.) and a real collaboration with the psychiatrist or clinical psychologist is necessary.