Addiction is a chronic relapsing disorder characterized by compulsive seeking and consumption of drugs, with this abnormal "Go" behavior resulting in significant negative consequences. Research has shown that the dorsal medial striatum (DMS) is associated with the pathophysiological mechanisms of addiction; however, drugs targeting the DMS to achieve therapeutic effects for addiction remain unavailable. Intracellular cAMP signaling, regulated by G protein-coupled receptors (GPCRs), critically modulates the excitability, plasticity and neurotransmission of GABAergic medium spiny neurons (MSNs). In this study we investigated how inhibition of PDE4 modulated cAMP levels with a specific focus on how these changes influenced the dopamine D1 receptor MSNs (D1-MSNs) and D2 receptor MSNs (D2-MSNs) in the DMS, thereby influencing abnormal "Go" behavior. We established alcohol-induced conditioned place preference (CPP) model and two-bottle choice drinking model in mice. PDE4 inhibitor rolipram (0.5 μg) were bilaterally microinjected into the DMS of mice 2 h prior to the combination of alcohol. The activation of D1-MSNs and D2-MSNs in the DMS was assayed using c-Fos immunofluorescence staining. We showed that rolipram microinjection significantly increased cAMP levels in MSNs of the DMS and restored the activation balance between D1-MSNs and D2-MSNs. This rebalancing of MSN activity attenuated abnormal "Go" behaviors including high-drinking behavior. We further identified the ERK signaling downstream of cAMP in D2-MSNs of the DMS, together with the PDE4 subtype PDE4B, as key mediators of the inhibitory effects of PDE4 inhibitors on high-drinking behavior. These results highlight a new strategy emphasizing the pivotal role of PDE4 as a key regulator of cAMP signaling in MSNs, maintaining the dynamic balance between D1-MSNs and D2-MSNs, and further identify D2-MSNs specific PDE4B/cAMP/ERK modulation as a promising target for addiction treatment.

ABSTRACT Many people enter addiction treatment through the criminal justice system, which has an important role in oversight, accountability, and adherence to addiction treatment. While urine drug tests (UDT) are valuable tools in addiction treatment, they are easily misinterpreted which can result in tragic legal and social consequences. Practical solutions are needed to enhance the integrity of UDT in the criminal justice system and to ensure that the twin goals of individual rehabilitation and community safety are achieved. Clinicians should remain within the scope of their training, involve the appropriate professionals, understand the limitations, and be aware of the most common areas of misinterpretation of UDT. Proper objective assessment of the data by a qualified professional is essential to avoid serious consequences to due process. Furthermore, there are no current statistics on the total numbers of people receiving UDT in the criminal justice system, resulting in a paucity of data and research on UDT and its effectiveness in addiction treatment. Due to the time needed to update and educate court professionals, practical solutions offer a bridge to solving the most common issues facing this vulnerable population. Updated guidance is needed to enhance the integrity of UDT in the criminal legal system.

ABSTRACT Introduction: A host of cross-sectional studies have identified problematic substance use and post-traumatic stress symptoms as risk factors for repeated interpersonal violence (revictimization) in college samples. However, it remains unclear which factors are associated with revictimization for patients who meet diagnostic criteria for both substance use disorder (SUD) and post-traumatic stress disorder (PTSD). The identification of factors associated with revictimization is an important step towards preventing violence against people with psychiatric disorders and can inform treatment. Method: Data were based on the Treatment of PTSD and Addiction (TOPA) study, a randomized controlled trial including N = 209 patients that received inpatient and outpatient treatment for SUD and PTSD. We selected participants who had experienced interpersonal victimization at baseline (N = 203) and assessed revictimization across the 9-month follow-up period. Revictimization included: physical violence, violence with a gun, sexual violence, and ‘other unwanted sexual experience’. The risk factors we investigated were severity of PTSD, severity of alcohol and drug use disorder, interpersonal difficulties, sex, and age. We analysed the data using logistic regression analyses with multiple imputation for missing data. Results: Physical violence was the most common type of revictimization during the study period (26.0%), closely followed by ‘other unwanted sexual experience’ (20.0%). The severity of PTSD and age were univariate predictors for revictimization; however, only age was robustly related to revictimization while accounting for other study variables. We conducted sensitivity analyses with complete cases and observed data. Discussion: Approximately two in five individuals experienced revictimization across the 9-month follow-up period, underscoring it as a clinically relevant issue. Since age emerged as the only risk factor for revictimization in our sample, future research should focus on identifying modifiable factors associated with age, e.g. impulsivity and novelty seeking. These factors may be addressed in interventions aimed at reducing the risk of revictimization.

This study conducted a validation of the piloted Positive Psychology Intervention (PPI) program, which was empirically designed based on the character strengths and virtues (CSV) of the Person Who Use Drugs (PWUDs) and aims to improve their life satisfaction, mental wellbeing, and overall psychological functioning. Forty male residents of the Mega Drug Abuse Treatment and Rehabilitation Center were randomly assigned in treatment or control group using a between-subject experimental pretest-posttest design. Results showed significant improvement in PWUDs' mental wellbeing (M = -0.63, SD = 0.25; t(20) = -2.5, P < .02921), overall psychological functioning (M = -1.25, SD = 0.22; t(20) = -5.71, P < .00013) but not in their life satisfaction (M = -1.55, SD = 0.4; t(20) = -1.55, P > .15033); this could be attributed to their habituated lifestyle brought by their prolonged stay in the center due to the series of nationwide restrictions. However, the vibrant documented accounts of the PWUDs about the perceived impact of the PPI program showed a very high rating coupled with substantial data supporting impactful effects on their overall personhood that are essential to their drug abuse treatment and rehabilitation efforts. Putting the data altogether, it is validated that the PPI program was practical, effective, and functionally responsive to the drug abuse treatment and rehabilitation of the PWUDs. Pertinent conclusions were drawn, and recommendations were provided accordingly.

Commentary on Wan et al.: Optimizing the neurofeedback protocol in addiction treatment.

Yeast based N-demethylation for the production of nororipavine in fed-batch or continuous cultivation.

Relationships of patient risk profiles and receipt of specialty treatment with early, sustained, and stable cessation of heavy alcohol use across populations.

Clinical outcomes of addictive disorders six months after ADHD Diagnosis: Insights from the START study.

Heart failure with preserved ejection fraction (HFpEF) has a high prevalence and a low quality of life, and there are limited medications for the treatment of this disease. In recent years, disulfiram (DSF), an FDA-approved drug for the treatment of chronic alcohol addiction, has been found to have anti-inflammatory properties. The present study was designed to investigate the cardioprotective effects of DSF on patients with HFpEF and its mechanism using a model of HFpEF induced in mice fed a high-fat diet (HFD, 60% of calories from fat) and Nω-nitro-L-arginine methyl ester (L-NAME, 0.5 g/L in drinking water). The results showed that DSF effectively reversed the HFD + L-NAME-induced increases in left ventricular end-diastolic diameter (LVEDD), left ventricular end-systolic diameter (LVESD), interventricular septal thickness, left ventricular mass, the ratio of peak early mitral diastolic velocity to peak late mitral diastolic velocity, the ratio of early mitral diastolic velocity to early diastolic velocity, as well as the reductions in the absolute value of global longitudinal strain (GLS), without affecting the left ventricular ejection fraction (LVEF). In addition, DSF notably attenuated the HFD + L-NAME-induced increase in blood pressure, exercise intolerance, cardiac hypertrophy, pulmonary edema, and elevated N-terminal pro-B-type natriuretic peptide (NT-proBNP) levels. Mechanistically, we found that DSF inhibited myocardial PANoptosis-like cell death, mainly by inhibiting the release of myocardial interleukin 1β (IL-1β), which inhibited transforming growth factor-β-activated kinase 1(TAK1)-mediated PANoptosis. Given the cardioprotective effects of DSF, its clinical use would be a novel strategy for the protection and treatment of cardiac injury in patients with HFpEF.

Tailoring of a chronic pain self-management intervention for individuals with opioid use disorder in office-based addiction treatment.

Background Personalized rehabilitation is gaining increasing importance, especially in sports-related activities where injury rates are high. Evidence-based and human-focused rehabilitation approaches emphasize health equity, individual rights, and creativity in care. Objective This study aimed to examine the psychological advantages of incorporating Tai Chi into mandatory drug rehabilitation programs for sports athletes. Methods A randomized controlled trial was conducted with 172 participants, equally divided into a Tai Chi intervention group and a control group. The intervention group performed Tai Chi three times per week for 16 weeks under uniform guidance, while the control group received conventional rehabilitation care. Results Pre- and post-intervention psychological assessments demonstrated that the Tai Chi group showed significant improvements in emotional well-being, self-regulation, and psychological resilience compared to the control group. Conclusion Tai Chi practice enhances mental and physical recovery in rehabilitation settings. Integrating culturally relevant and holistic practices into recovery programs supports sustainable, person-centered rehabilitation and confirms the value of incorporating conventional movement therapies into contemporary care.

Exploring Scottish addiction services: provider-based stigma, addiction aetiology beliefs, treatment bias, and burnout among addiction treatment providers.

Community health worker and family support for addiction treatment services.

The US opioid crisis has become a serious public health issue, causing tens of thousands of deaths and tremendous economic loss annually. Acupuncture, as a traditional non-pharmacological method of analgesia, has demonstrated extraordinary value in addressing this crisis. This paper systematically elucidates the causes and impacts of the US opioid crisis and deeply explores the neurobiological mechanisms of acupuncture analgesia, including the activation of the endogenous opioid system, neurotransmitter regulation, and anti-inflammatory and immune modulation via multiple pathways. By analyzing the clinical evidence for acupuncture in the management of acute and chronic pain, opioid dosage reduction, and addiction treatment, we demonstrate the feasibility and efficacy of acupuncture as an alternative to opioid therapy. Research shows that acupuncture can not only effectively relieve various types of pain but also reduce opioid consumption and treat opioid dependence and addiction. However, the promotion of acupuncture in the US still faces multi-faceted challenges, including issues of standardization, limited insurance coverage, and insufficient high-quality evidence. Future efforts should focus on strengthening multidisciplinary research collaboration, improving standardized treatment protocols, and integrating acupuncture into comprehensive pain management systems to provide a safer, more cost-effective, non-pharmacological alternative for resolving the opioid crisis.

Drug abuse is a serious global public health problem, with the prevalence in Indonesia reaching 1.73% or about 3.33 million people in 2023, mainly among those aged 15–24 years. Understanding the psychological determinants of this behavior is crucial to enhance prevention and rehabilitation efforts. Objective: To analyze determinants of drug abuse behavior based on the Health Belief Model (HBM) through a literature review of studies published between 2015 and 2025. Methods: A literature review of 8 academic articles from Google Scholar and PubMed, limited to open‑access Indonesian- and English‑language journals examining HBM constructs related to drug abuse and rehabilitation participation. Results: HBM variables were generally associated with drug abuse behavior and rehabilitation adherence, with self‑efficacy emerging as the most consistent determinant, followed by perceived susceptibility and perceived severity. Perceived barriers, especially complex administrative procedures, distance, costs, and stigma, were identified as major obstacles to engaging in rehabilitation. Conclusion: The HBM is useful for mapping determinants of drug abuse behavior and highlights the need to strengthen self‑efficacy, risk perceptions, and barrier reduction within health promotion and community‑based rehabilitation programs.

One of the things I am proudest of during my tenure at New York State Office of Addiction Services and Supports (NYS OASAS) was our successful efforts to change the insurance laws to make it easier to access addiction treatment. Among our accomplishments is that we created one publicly available level of care tool to make decisions about whether someone needed addiction treatment and where they should receive it. We ended the constant and almost immediate interference by the insurers about whether the person needed to still be in that level of addiction treatment. We ended the need for prior approval to access treatment, including medications.

This paper introduces an innovative framework for sex addiction treatment, integrating the Neuro-Linguistic Programming (NLP) Swish Pattern with the phenomenology of Maurice Merleau-Ponty. Departing from traditional cognitive-behavioural models, this approach conceptualises sexual compulsivity as a deeply embodied phenomenon. A qualitative multiple case study was conducted on eight men in Hong Kong, with data analysed using Interpretative Phenomenological Analysis (IPA). Findings demonstrate the Swish Pattern, when phenomenologically framed, functions not as a mere cognitive technique but a catalyst for profound shifts in the ‘lived body’, modifying motor intentionality and restructuring the perceptual field. The analysis yielded five superordinate themes on clients’ embodied, temporal, and intersubjective experiences of transformation. The discussion highlights the centrality of the body-subject and the self-other dynamic in recovery. The paper argues for a more embodied, holistic, and phenomenologically informed therapeutic approach that addresses the whole person within their socio-cultural context.

ABSTRACT The use of traditional medicinal plants in therapeutic settings has gained increasing attention for their potential in mental health and addiction treatment. This study explores the ethnomedical use of Brunfelsia grandiflora (chiric sanango) within the therapeutic framework of the Takiwasi Center in the Peruvian Amazon, where it is integrated into strict plant-based dietary regimens (“dietas”) to support addiction recovery and psychological well-being. The research combines data from semi-structured interviews with therapists, traditional healers, and other staff members, along with patient-reported experience data from the institution’s database. A total of 74 case reports were analyzed to assess both the physiological and psychological effects of chiric. Findings indicate that the plant induces notable physical effects, including numbness, tingling, dizziness, and cold sensations, while also facilitating deep psychological introspection, emotional processing, and enhanced social engagement. Participants frequently reported shifts from distressing emotions to states of clarity, acceptance, and resilience. These effects suggest that chiric sanango may serve as an important adjunct in psychotherapy and addiction treatment. This study highlights the intersection of Amazonian ethnomedicine and modern therapeutic practices, emphasizing the need for further pharmacological and clinical investigations into the psychoactive properties of B. grandiflora and its potential role in mental health interventions.

Nicotine is the main substance responsible for the development of tobacco addiction. The α3β4 nicotinic acetylcholine receptors (nAChRs) are a potential key target for mitigating nicotine reward. Preliminary studies in our laboratory suggest that α-conotoxin [S9K]TxID serves as a selective and potent antagonist targeting α3β4 nAChRs, which may be beneficial in addressing nicotine addiction. However, the mechanisms of [S9K]TxID treatment in nicotine addiction are still to be determined. This study aimed to identify the differential metabolic profiles of [S9K]TxID treatment in nicotine addiction using an untargeted metabolomic profiling method. As demonstrated by behavioral experiments, [S9K]TxID effectively attenuated nicotine-induced conditioned place preference (CPP) expression without exerting inhibitory effects on the central nervous system (CNS). The results of untargeted metabolomics revealed that eight metabolites were significantly altered after [S9K]TxID treatment, particularly phenylalanine. [S9K]TxID also attenuated nicotine-induced metabolic disorders by regulating phenylalanine, tyrosine and tryptophan biosynthesis. In conclusion, our findings suggest that [S9K]TxID could be a potential therapeutic compound for nicotine addiction.

BackgroundNicotine addiction is a major public health challenge, with existing pharmacological interventions often limited by suboptimal efficacy, adverse effects and withdrawal symptoms.ObjectivesThis study explores the effects of combining levo-tetrahydropalmatine (l-THP), a dopamine receptor antagonist, with low-dose naltrexone (LDN), an opioid receptor antagonist, on nicotine-induced conditioned place preference (CPP) in mice.MethodsThe combined therapeutic effects of l-THP and LDN on nicotine was evaluated using a mouse CPP paradigm. Male Kunming mice were subjected to nicotine-induced CPP, followed by treatment with l-THP, LDN, or their combination. Behavioral assessments were conducted, and plasma β-endorphin levels were measured using enzyme linked immunosorbent assay.ResultsA 10 mg/kg l-THP alone significantly attenuated CPP, while LDN alone showed no significant effect. The combination of 10 mg/kg l-THP and 0.3 mg/kg LDN produced a synergistic reduction in nicotine-seeking behavior, effectively reversing the CPP effect. The combination therapy was associated with an increased plasma β-endorphin levels, suggesting a modulation of the endogenous opioid system.ConclusionThese findings indicate that the combination therapy based on dual-action mechanism of l-THP and LDN, targeting both dopamine and opioid pathways, effectively attenuates nicotine-induced CPP in mice, which may offer a potential treatment for nicotine addiction. The combination enhances therapeutic efficacy within the nicotine-induced CPP paradigm and correlates with an elevation of β-endorphin levels.