Development Of Addictive Behavior Research Articles

Serum brain-derived neurotrophic factor in relation to craving and duration of abstinence in patients with heroin dependence-A case-control study.

Addiction is a chronic disorder that comes with emotional and financial burdens. Several neurobiological factors were correlated to opiate-use disorder which is brain-derived neurotrophic factor (BDNF). BDNF has been found to be involved in long-term potentiation of synaptic strength, a mechanism that is thought to motivate both natural adaption mechanisms as well as the development of addictive behavior. In this study, we aimed to address the relation between BDNF serum level and heroin craving and the effect of duration of abstinence on them. A case study was conducted on 80 subjects from Kasr Al-Ainy Psychiatry and Addiction Treatment Hospital with a history of heroin dependence and were divided into two groups: Group A had 40 active heroin-dependent subjects while in Group B, 40 subjects with 1-year heroin abstinence. Severity of addiction was assessed by the addiction severity index, heroin craving was measured by Brief Substance Craving Scale and serum BDNF level was investigated using an enzyme-linked immunosorbent assay. The findings show that active heroin users had significantly higher serum BDNF which is associated with high heroin craving in comparison to the abstinent group. This study revealed a significant positive correlation between serum BDNF levels and craving in active heroin users versus 1-year abstinent subjects. It is the first study to address the relationship between craving and serum BDNF level in a 1-year abstinent participants. These findings help to determine the brain alterations associated with illness and recovery in heroin dependence.

A novel role for astrocytic fragmented mitochondria in regulating morphine addiction

Chronic morphine exposure causes the development of addictive behaviors, accompanied by an increase in neuroinflammation in the central nervous system. While previous researches have shown that astrocytes contribute to brain diseases, the role of astrocyte in morphine addiction through induced neuroinflammation remain unexplored. Here we show that morphine-induced inflammation requires the crosstalk among neuron, astrocyte, and microglia. Specifically, astrocytes respond to morphine-induced neuronal activation by increasing glycolytic metabolism. The dysregulation of glycolysis leads to an increased in the generation of mitochondrial reactive oxygen species and causes excessive mitochondrial fragmentation in astrocytes. These fragmented, dysfunctional mitochondria are consequently released into extracellular environment, leading to activation of microglia and release of inflammatory cytokines. We also found that blocking the nicotinamide adenine dinucleotide salvage pathway with FK866 could inhibit astrocytic glycolysis and restore the mitochondrial homeostasis and effectively attenuate neuroinflammatory responses. Importantly, FK866 reversed morphine-induced addictive behaviors in mice. In summary, our findings illustrate an essential role of astrocytic immunometabolism in morphine induced neural and behavioral plasticity, providing a novel insight into the interactions between neurons, astrocytes, and microglia in the brain affected by chronic morphine exposure.

Associations between adverse childhood experiences and early adolescent problematic screen use in the United States

BackgroundProblematic screen use, defined as an inability to control use despite private, social, and professional life consequences, is increasingly common among adolescents and can have significant mental and physical health consequences. Adverse Childhood Experiences (ACEs) are important risk factors in the development of addictive behaviors and may play an important role in the development of problematic screen use.MethodsProspective data from the Adolescent Brain Cognitive Development Study (Baseline and Year 2; 2018–2020; N = 9,673, participants who did not use screens were excluded) were analyzed in 2023. Generalized logistic mixed effects models were used to determine associations with ACEs and the presence of problematic use among adolescents who used screens based on cutoff scores. Secondary analyses used generalized linear mixed effects models to determine associations between ACEs and adolescent-reported problematic use scores of video games (Video Game Addiction Questionnaire), social media (Social Media Addiction Questionnaire), and mobile phones (Mobile Phone Involvement Questionnaire). Analyses were adjusted for potential confounders including age, sex, race/ethnicity, highest parent education, household income, adolescent anxiety, depression, and attention-deficit symptoms, study site, and participants who were twins.ResultsThe 9,673 screen-using adolescents ages 11–12 years old (mean age 12.0) were racially and ethnically diverse (52.9% White, 17.4% Latino/Hispanic, 19.4% Black, 5.8% Asian, 3.7% Native American, 0.9% Other). Problematic screen use rates among adolescents were identified to be 7.0% (video game), 3.5% (social media), and 21.8% (mobile phone). ACEs were associated with higher problematic video game and mobile phone use in both unadjusted and adjusted models, though problematic social media use was associated with mobile screen use in the unadjusted model only. Adolescents exposed to 4 or more ACEs experienced 3.1 times higher odds of reported problematic video game use and 1.6 times higher odds of problematic mobile phone use compared to peers with no ACEs.ConclusionsGiven the significant associations between adolescent ACE exposure and rates of problematic video and mobile phone screen use among adolescents who use screens, public health programming for trauma-exposed youth should explore video game, social media, and mobile phone use among this population and implement interventions focused on supporting healthy digital habits.

Opioid withdrawal: role in addiction and neural mechanisms.

Withdrawal from opioids involves a negative affective state that promotes maintenance of drug-seeking behavior and relapse. As such, understanding the neurobiological mechanisms underlying withdrawal from opioid drugs is critical as scientists and clinicians seek to develop new treatments and therapies. In this review, we focus on the neural systems known to mediate the affective and somatic signs and symptoms of opioid withdrawal, including the mesolimbic dopaminergic system, basolateral amygdala, extended amygdala, and brain and hormonal stress systems. Evidence from preclinical studies suggests that these systems are altered following opioid exposure and that these changes mediate behavioral signs of negative affect such as aversion and anxiety during withdrawal. Adaptations in these systems also parallel the behavioral and psychological features of opioid use disorder (OUD), highlighting the important role of withdrawal in the development of addictive behavior. Implications for relapse and treatment are discussed as well as promising avenues for future research, with the hope of promoting continued progress toward characterizing neural contributors to opioid withdrawal and compulsive opioid use.

Goal-directed and habitual decision making under stress in gambling disorder: An fMRI study

The development of addictive behaviors has been suggested to be related to a transition from goal-directed to habitual decision making. Stress is a factor known to prompt habitual behavior and to increase the risk for addiction and relapse. In the current study, we therefore used functional MRI to investigate the balance between goal-directed ‘model-based’ and habitual ‘model-free’ control systems and whether acute stress would differentially shift this balance in gambling disorder (GD) patients compared to healthy controls (HCs). Using a within-subject design, 22 patients with GD and 20 HCs underwent stress induction or a control condition before performing a multistep decision-making task during fMRI. Salivary cortisol levels showed that the stress induction was successful. Contrary to our hypothesis, GD patients did not show impaired goal-directed ‘model-based’ decision making, which remained similar to HCs after stress induction. Bayes factors provided three times more evidence against a difference between the groups or a group-by-stress interaction on the balance between model-based and model-free decision making. Similarly, no differences were found between groups and conditions on the neural estimates of model-based or model-free decision making. These results challenge the notion that GD is related to an increased reliance on habitual (or decreased goal-directed) control, even during stress.

Correlation between NARX Score and Food Addictive Behavioral Patterns in Chronic Pain Patients

The purpose of this research study is to show a relationship between food addiction patterns to different types of food in chronic pain patients and the effectiveness of NARX score (overdose risk score) in predicting high risk factors in such patients. We implemented a cross sectional study design and used an eight-question survey that addressed addictive behavior and food choice relative to chocolate, cheese, meat and other foods. For the 110 respondents, the average NARX score was 383.5 and the median was 380; the high was 740 and the low was 80. The results of the 818 answers received (some of the respondents did not answer all eight questions) showed a strong correlation between food addictive behavioral patterns in chronic pain patients and high risk factors in chronic pain patients as manifested and measured by the NARX score. The three foods that were reported most frequently were chocolate, cheese and meat (this result correlates with previous research findings). Interestingly, meat was associated with the highest NARX score (the highest risk) chronic pain patients. Other foods reported with high frequency were coffee, sodas and sweets, underscoring the role of sugar in chronic pain syndromes. The objective of this study is to show possible role of dietary factors and food addiction in the development of addictive behaviors and possibly in the development of the opioid epidemic.We advocate further clinical studies.

Approach-Avoidance pattern of attentional bias in individuals with high tendencies toward problematic Internet pornography use.

Attentional bias plays a vital role in the occurrence and development of addictive behaviors. However, little is known about attentional processes in problematic Internet pornography use (PIPU), and previous studies have reported mixed results. The current study examined the components of attentional processing to sexual stimuli using an exogenous cueing task designed to differentiate between attentional engagement and disengagement. Two different stimulus presentation times (100 and 500 ms) were used to present the pornographic and neutral images to differentiate the early and late stages of attentional bias. Individuals with high (n = 40) and low (n = 40) PIPU tendencies were compared. The results demonstrated that individuals with high tendencies toward PIPU showed enhanced attentional engagement with pornographic stimuli in the early stage of attentional processing (100 ms), followed by attentional avoidance in the late stages of attentional processing (500 ms). Moreover, the severity of PIPU symptoms was positively correlated with attentional engagement scores in the short picture-time trials (100 ms) and weakly negatively correlated with attentional disengagement scores in the long picture-time trials (500 ms). This approach–avoidance pattern of attentional biases is in line with a recent theoretical model that emphasizes that appetitive and aversive motivational processes jointly determine attentional bias.

For citation: Minyurova S. A., Kruzhkova O. V., Vorobyeva I. V., Matveeva A. I. Addictive behaviour of adolescents and young men in the education system: Review of psychological and pedagogical research

Introduction. Addictive behaviour of students today is one of the most acute problems of the education system. Not only chemical addiction leads to serious problems, but also social networks, smartphones, gaming addictions lead to a significant decrease in the level of physical and mental health of adolescents and young men, socio-psychological maladaptation in society, violation of their psychological well-being and in critical cases – the development of suicidal risks. Nevertheless, a comprehensive study of the experience in psychological and pedagogical research in the field of addictive behaviour with the generalisation of methodological approaches and empirical results has not been conducted yet (although such review studies are present in relation to general and specific issues of addictive behaviour, its spread in individual countries or geographical regions, the role of the family, etc.). At the same time, such studies are necessary to ensure a complete understanding of the problem from the perspective of the educational organisation and the possibilities of the educational environment in the prevention of the spread of addictive behaviour among students.Aim. The aim of the study was to review and systematise international research in the field of psychological and pedagogical study of addictive behaviour of students.Methodology and research methods. The selection of scientific publications in the international scientometric database Scopus was carried out for inclusion in the review with search depth from 2011 to the present. The authors used the following keywords complexes for the search: “addiction&school”, “addictive behaviour&school”, “drug&school”, “alcohol&school”, “tobacco&school”, “internet addiction&school”, “gambling&school”. The specified word complexes such as “article title, short description, keywords” were included in the search section. Additional search restrictions were the type of articles (reviews, article); the chosen field of science was “Psychology” and an additional keyword was “adolescent”. After analysis the final list of selected publications amounted to 246 works.Results. The results of the study made it possible to systematise scientific publications and identify trends in the consideration of addictive behaviour in psychological and pedagogical research in the education system. Thus, it was revealed that the definition of addictive behaviour has a specific interpretation in relation to the concept of dependent behaviour. Behavioural manifestations of addictive behaviour in chemical and behavioural addictions have similar characteristics, whereas personal predictors, which determine the propensity of students to choose this deviation, may have ambivalent characteristics depending on the chosen form of addictive behaviour. At the same time, the forms of addictive behaviour of students in the educational environment are diverse and include both chemical addictions (smoking, alcohol and drug addiction) and behavioural variants of addictive behaviour (Internet addiction and dependence on video and computer games). At the same time, any of the listed addictions individually, or taking into account their combined nature, leads to a decrease in the success of training and unsatisfactory academic performance of students. In addition, difficulties in learning and interacting with other subjects of the educational environment may (among other things) be a factor stimulating the emergence of addictive behaviour as a form of care or compensation. Prevention of addictive behaviour, as a rule, is based on informing about the negative consequences of addictions, but it can take into account both the peculiarities of social behaviour and learning of adolescents and young men, as well as their personal characteristics, which act as zones of vulnerability for the development of addiction.Scientific novelty. The scientific novelty lies in the fact that the authors systematised scientific research in the field of psychological and pedagogical study of addictive behaviour of students, taking into account current trends in the spread of both chemical and non-chemical addictions, as well as their combined nature of distribution among adolescents and young men.Practical significance. The practical significance is due to the potential possibilities of using the data obtained to organise effective prophylactic work for preventing the development of addictive behaviour among students within the framework of the educational process in an educational organisation, taking into account international experience and psychological and pedagogical basis.

Hypocretin/Orexin Interactions with Norepinephrine Contribute to the Opiate Withdrawal Syndrome.

We previously found that human heroin addicts and mice chronically exposed to morphine exhibit a significant increase in the number of detected hypocretin/orexin (Hcrt)-producing neurons. However, it remains unknown how this increase affects target areas of the hypocretin system involved in opioid withdrawal, including norepinephrine containing structures locus coeruleus (LC) and A1/A2 medullary regions. Using a combination of immunohistochemical, biochemical, imaging, and behavioral techniques, we now show that the increase in detected hypocretin cell number translates into a significant increase in hypocretin innervation and tyrosine hydroxylase (TH) levels in the LC without affecting norepinephrine-containing neuronal cell number. We show that the increase in TH is completely dependent on Hcrt innervation. The A1/A2 regions were unaffected by morphine treatment. Manipulation of the Hcrt system may affect opioid addiction and withdrawal.SIGNIFICANCE STATEMENT Previously, we have shown that the hypothalamic hypocretin system undergoes profound anatomic changes in human heroin addicts and in mice exposed to morphine, suggesting a role of this system in the development of addictive behaviors. The locus coeruleus plays a key role in opioid addiction. Here we report that the hypothalamic hypocretin innervation of the locus coeruleus increases dramatically with morphine administration to mice. This increase is correlated with a massive increase in tyrosine hydroxylase expression in locus coeruleus. Elimination of hypocretin neurons prevents the tyrosine hydroxylase increase in locus coeruleus and dampens the somatic and affective components of opioid withdrawal.

THE PHENOMENON OF INTERNET ADDICTION AS THE MAIN DETERMINANT OF PATHOLOGICAL CULTURE IN THE GLOBALIZATION ENVIRONMENT

The purpose of the article: to find out the consequences of globalization processes that provoked a cultural crisis with the help of Internet networks, distorting the worldview and value orientations of the population . Applied research methods: the method of abstraction is used. Abstraction exists in organic unity with the method of generalization, theoretical-problem method and system-structural analysis. Such behavioural manifestations as neglect of established norms, isolation, anxiety, depressive states, deviant and addictive behaviour are characteristic of a marginal personality. These social factors provoke intra-personal conflicts and deep anxiety caused by the feeling of helplessness in the face of the hostile surrounding world. Besides, these crises encompass «the problem of the absurdity of one’s life, as well as doubts about the entire previous value system». Nowadays, there is a rapid development of addictive behaviour around the world, as evidenced by the constant increase in national and international research on this phenomenon. There emerge new types of addictive behaviour caused by the complexity of the social environment (the emergence of consumer culture and the technical development of communication links), namely, informatization and consumerism. New types of addictive behaviour are beginning to compete with new types, such as gaming and computer addiction. Researchers around the world are sounding the alarm about the deepening problem of Internet addiction among young people since the main danger is that a pathological addiction to the Internet can lead to serious consequences and depression. Concerning new types of addictive behaviour, traditional forms and means of social control have become helpless and ineffective.

NMDA Receptors in Accumbal D1 Neurons Influence Chronic Sugar Consumption and Relapse

Glutamatergic input via NMDA and AMPA receptors within the mesolimbic dopamine (DA) pathway plays a critical role in the development of addictive behavior and relapse toward drugs of abuse. Although well-established for drugs of abuse, it is not clear whether glutamate receptors within the mesolimbic system are involved in mediating chronic consumption and relapse following abstinence from a non-drug reward. Here, we evaluated the contribution of mesolimbic glutamate receptors in mediating chronic sugar consumption and the sugar-deprivation effect (SDE), which is used as a measure of relapse-like behavior following abstinence. We studied four inducible mutant mouse lines lacking the GluA1 or GluN1 subunit in either DA transporter (DAT) or D1R-expressing neurons in an automated monitoring system for free-choice sugar drinking in the home cage. Mice lacking either GluA1 or GluN1 in D1R-expressing neurons (GluA1D1CreERT2 or GluN1D1CreERT2mice) have altered sugar consumption in both sexes, whereas GluA1DATCreERT2 and GluN1DATCreERT2do not differ from their respective littermate controls. In terms of relapse-like behavior, female GluN1D1CreERT2mice show a more pronounced SDE. Given that glutamate receptors within the mesolimbic system play a critical role in mediating relapse behavior of alcohol and other drugs of abuse, it is surprising that these receptors do not mediate the SDE, or in the case of female GluN1D1CreERT2 mice, show an opposing effect. We conclude that a relapse-like phenotype of sugar consumption differs from that of drugs of abuse on the molecular level, at least with respect to the contribution of mesolimbic glutamate receptors.

"Photo-Rimonabant": Synthesis and Biological Evaluation of Novel Photoswitchable Molecules Derived from Rimonabant Lead to a Highly Selective and Nanomolar "Cis-On" CB1R Antagonist.

Human cannabinoid receptor type 1 (hCB1R) plays important roles in the regulation of appetite and development of addictive behaviors. Herein, we describe the design, synthesis, photocharacterization, molecular docking, and in vitro characterization of "photo-rimonabant", i.e., azo-derivatives of the selective hCB1R antagonist SR1411716A (rimonabant). By applying azo-extension strategies, we yielded compound 16a, which shows marked affinity for CB1R (Ki(cisform) = 29 nM), whose potency increases by illumination with ultraviolet light (CB1R Kitrans/cis ratio = 15.3). Through radioligand binding, calcium mobilization, and cell luminescence assays, we established that 16a is highly selective for hCB1R over hCB2R. These selective antagonists can be valuable molecular tools for optical modulation of CBRs and better understanding of disorders associated with the endocannabinoid system.

Features of personal identity of drug addicts

The problem of personal identity in the modern world is becoming increasingly important due to the increasing number of statuses and roles of the individual, which in recent decades have completely changed and are no longer fixed. One of the potential risks of personal identity disorders is drug addiction, which is one of the most acute problems of our time, the problem of which has reached catastrophic proportions. The peculiarities of the personal identity of persons addicted to psychoactive substances are now increasingly in the focus of researchers. The use of psychoactive substances forms an addictive identity, because of which a person relates himself only to his own role-playing, often illusory characteristics, losing a deep understanding of his own “Self”. Violation of the formation of identity, in turn, acts as a factor in the development of addictive behaviour. The article presents the results of a study of personal identity in people with drug addiction (opium addiction). The theoretical and methodological basis of the study was the concept of ego-identity E. Erickson and J. Marcia's concept of the statuses of his identity. We used techniques to diagnose personal identity "Who am I?" M. Kuna, T. McPartland in the modification of T.V. Rumyantseva and the method "Diagnosis of interpersonal relationships" (T. Leary). The study sample consisted of 102 male patients with drug addiction (opium addiction) aged 18-26 years, and 54 healthy males aged 18-27 years without signs of somatic, mental pathology and drug addiction. Research and analysis of personal identification characteristics of drug addicts shows that personal identity is characterized by internal consistency, blurring and inconsistency of the image of "Self", formed due to superficial and weak differentiation awareness of one's own "Self"; personal identity is characterized by blurring and unformed boundaries of one's own "Self", namely the adhesion of aspects of "Self" - Real and "Self" - ideal, which determines the deformation of personal identity and value-motivational sphere of the drug addict; characterized by polymorphic structure of "Self", the difficulty of self-identification and the inability to distinguish "ideal" aspects of personality from the real, which contributes to the formation of diffuse status of personal identity, supporting the process of negative transformation into addictive identity and characterized by awareness of drug addiction.

Cannabinoids and the endocannabinoid system in reward processing and addiction: from mechanisms to interventions .

The last decades have seen a major gain in understanding the action of cannabinoids and the endocannabinoid system in reward processing and the development of addictive behavior. Cannabis-derived psychoactive compounds such as Δ9-tetrahydrocannabinol and synthetic cannabinoids directly interact with the reward system and thereby have addictive properties. Cannabinoids induce their reinforcing properties by an increase in tonic dopamine levels through a cannabinoid type 1 (CB1) receptor–dependent mechanism within the ventral tegmental area. Cues that are conditioned to cannabis smoking can induce drug-seeking responses (ie, craving) by eliciting phasic dopamine events. A dopamine-independent mechanism involved in drug-seeking responses involves an endocannabinoid/glutamate interaction within the corticostriatal part of the reward system. In conclusion, pharmacological blockade of endocannabinoid signaling should lead to a reduction in drug craving and subsequently should reduce relapse behavior in addicted individuals. Indeed, there is increasing preclinical evidence that targeting the endocannabinoid system reduces craving and relapse, and allosteric modulators at CB1 receptors and fatty acid amide hydrolase inhibitors are in clinical development for cannabis use disorder. Cannabidiol, which mainly acts on CB1 and CB2 receptors, is currently being tested in patients with alcohol use disorder and opioid use disorder.

Long-Term Opioid Therapy in Spine Center Outpatients: Protocol for the Spinal Pain Opioid Cohort (SPOC) Study.

BackgroundSpinal pain is the leading cause of patient-years lived with chronic pain and disability worldwide. Although opioids are well documented as an effective short-term pain-relieving medication, more than a few weeks of treatment may result in a diminishing clinical effect as well as the development of addictive behavior. Despite recognition of opioid addiction in pain patients as a major problem commonly experienced in the clinic, no reference material exists on the scope of long-term problems in novel opioid users and the link to clinical outcomes.ObjectiveThe main aims of this study are to describe baseline and follow-up characteristics of the Spinal Pain Opioid Cohort (SPOC), to evaluate the general use of opioids in spinal pain when an acute pain episode occurs, and to demonstrate the prevalence of long-term opioid therapy (LTOT).MethodsProspective clinical registry data were collected from an outpatient spine center setting during 2012-2013 including patients with a new spinal pain episode lasting for more than 2 months, aged between 18 and 65 years who had their first outpatient visit in the center. Variables include demographics, clinical data collected in SpineData, the Danish National Patient Register, and The Danish National Prescription Registry. The primary outcome parameter is long-term prescription opioid use registered from 4 years before the first spine center visit to 5 years after.ResultsThis is an ongoing survey. It is estimated that more than 8000 patients fulfill the SPOC inclusion criteria. In 2019, we began the intellectual process of identifying the most relevant supplementary data available from the wide range of existing national registries available in Denmark. We have now begun merging SpineData with relevant opioid data from Danish national registers and will continue to extract data up to 2021-2022. We will also be looking at data regarding somatic or psychiatric hospitalization patterns, patient usage of health care resources, as well as their working status and disability pensions.ConclusionsTo our knowledge, this survey will be the first to document the scope of long-term problems regarding LTOT and opioid addiction following new spinal pain episodes and comparing descriptive follow-up data between substance users and nonusers.Trial RegistrationISRCTN Registry ISRCTN69685117; http://www.isrctn.com/ISRCTN69685117International Registered Report Identifier (IRRID)DERR1-10.2196/21380

Pregabalin Addiction: Case Report of a Young Adult

Pregabalin has been used widely for the treatment of neuropathic pain, generalized anxiety disorders and epilepsy. Data is scarce and much is not known about the addictive potential of pregabalin. Herein, we report details of a young adult who got addicted to pregabalin and approached for a smooth withdrawal. The subject had a successful outcome. Literature suggests a growing concern for the abuse of pregabalin. Risk factors associated with the development of addictive behavior with pregabalin need to be assessed.

Impact of Problematic Smartphone Use and Instagram Use Intensity on Self-Esteem with University Students from Physical Education.

Mobile devices are a revolutionary element that offer many possibilities, although they can also cause problems for users. This is the case with the development of addictive behaviors that can affect personal well-being. The purpose of this paper has been to analyze the influence of smartphone addiction and Instagram use intensity on the self-esteem of Physical Education students. A cross-sectional research design was adopted by applying an online survey to a sample of undergraduate students (n = 385). The results showed that gender and age were factors that influenced the problematic use of the smartphone. In turn, there was a significant positive correlation between smartphone addiction and Instagram use intensity. The influence of smartphone addiction on students’ self-esteem was also highlighted. In contrast, Instagram use intensity did not affect self-esteem. Finally, the findings are discussed, and the main implications of the study are established, where physical education students take on a special role in order to avoid the improper use of smartphones and Instagram through sport.

Life Adversities and Trauma as Factors of Addictive Behaviors

Within this study 117 drug and alcohol addicts (97 males and 20 females) were compared with a matching group of healthy controls. All respondents were questioned regarding negative life events (NLE) that have happened to them during different periods of their life, in particular when they were 0-6, 7-14, 15-18 and 19 and more years old. The questionnaire consisted of 69 questions which covered such issues as “assault”, “divorce/separation”, “major financial problems”, “serious illness or injury”, “legal problems”, “loss of confidant”, “serious marital problems”, “being robbed”, “serious difficulties at work”, “serious housing problems” and “job loss”, etc. Events related to the personal network and early life period included death of a parent, loss of an individual in the network, alcohol and drug addiction of a parent, problems in relations with parents, separation from parents, being brought up by persons other than parents, housing problems, having very bad relations with a parent, etc. It was found that the life course of NLE accumulation in addicts is 3 times higher than in controls, the differences were statistically significant (p<0,001) in all life periods. In the hierarchical regression model which was used, accumulation of NLEs in the early childhood and young adulthood (after 19) have a bigger impact than periods of school years and ad-olescence. Analysis of NLEs in the earliest life period (0-6 years) in addicts showed that alcohol problems in parents and perceived feelings that parents do not love them and even torture them emotionally were much more frequent than in controls. Other strong associations were with being brought up by people other than parents and father’s addiction. Physical and sexual violence were not among the priorities and were not so strongly associated with addiction. The results are discussed in terms of possible cultural peculiarities than may influence prioritization of childhood adversities and their relevance for further development of addictive behavior. The results obtained may be helpful while building rehabilitation measures for addicts, especially during family therapy

Orexins and the brain reinforcing systems

The purpose of the review was to analyze the neurochemical and neurophysiological mechanisms of the orexin system and the role of orexin in body functions and behavior. The focus is on the participation of orexin in the mechanisms of reinforcement and the formation of addictive behavior. At the beginning of the review a history of the first works on the field of orexin and its receptors are described. Hypothalamic orexin-producing cells and effects on brain functions are described. The effects of orexins and their receptors on eating behavior, wakefulness and positive reinforcement are described. Then, the effects of orexins on narcolepsy was analyzed. The participation of orexins in the mechanisms of reinforcement and dependence and the key role of orexins in the development of addictive behaviors is described. The special role of orexin in the formation of ethanol dependence is shown. Next, the issue of the action of orexins under stress was considered. Orexins have been shown to play an important role in the regulation of the nervous and humoral mechanisms mediating the formation of emotional memory associated with negative experience. It is concluded that orexin can modulate the estimation of stress and probability for reaching stimulus. In this regard, orexin antagonists can be considered as possible promising means of preventing and treating disorders of the anxiety-phobic spectrum, as well as disorders associated with the use of addictive drugs caused by stress and environmental stimuli.

Abstract P1-20-08: Breast surgery ERAS program: Trends since implementation on post-operative pain and discharge narcotic prescribing at our institution

Abstract Introduction: Recently, enhanced recovery after surgery (ERAS) pathways have been gaining popularity within surgical sub-specialties. Key ERAS concepts include the standardization of perioperative care such as pre-operative counseling, protocolization of analgesia and anesthesia regimens as well as early mobilization, among others. This approach aims to achieve cost savings through decreased length of stay, reduced opioid complications, and overall improved outcomes. In concordance with this trend, many institutions are now implementing ERAS protocols for breast surgery, especially with cases of mastectomy followed by immediate reconstruction. Our institution implemented a Breast Surgery ERAS program in February of 2018, consisting of standardized peri-operative analgesia/anesthesia, most significantly including a pre-operative pectoral block performed by anesthesia. We hypothesize that the use of the pre-operative pectoral block in the ERAS cohort will result in improved post-operative pain scores from the Non-ERAS cohort; additionally, we expect that the percentage of patients requiring opioid prescriptions at discharge for pain control will be decreased in the ERAS cohort. Methods: The EMR was queried for patients who underwent breast surgery with immediate reconstruction. The experimental group consisted of ERAS patients from February 6, 2018 to February 1, 2019 with an n = 107. The control group consisted of non-ERAS patients from April 19, 2016 to January 30, 2018 with an n=117. Chart review was performed for discharge medications, as well as pain scores recorded from time immediately post-operative, to just prior to discharge. Statistical analysis of the data was performed with a comparison of difference in means and Fischer exact test. Results: The ERAS cohort was noted to have a statistically significant decrease in the mean immediate post-operative pain scores (ERAS 2.04, Non-ERAS 4.04; p-value < 0.0001). There was no difference with comparison of the means of last pain scores recorded prior to discharge between the ERAS and Non-ERAS groups (ERAS 3.36, Non-ERAS 3.63, p-value 0.34). There was a statistically significant decrease in the percentage of patients discharged with opioid prescriptions in the ERAS group compared to the Non-ERAS group (ERAS 58.9% v 87.2% Non-ERAS; p-value <0.0001). The ERAS cohort LOS was also statistically significantly less than the Non-ERAS (ERAS 1.28 days, Non-ERAS 1.61 days; p-value = 0.0002). Discussion: Our ERAS protocol utilizes multi-modal pain control methods beginning pre-operatively, including the addition of a pectoral block placed by anesthesia, which we expect contributed highly to the lower mean immediate post-operative pain scores expressed by the ERAS cohort. This is important in the context of our nation’s current opioid epidemic, where decreasing discharge opioid prescriptions is imperative for reducing the risk for development of addictive behaviors, as well as the risk for opioid side effects such as nausea, constipation, and altered mental status. With the implementation of our Breast Surgery ERAS program, we have demonstrated clear progress towards this goal with the hope for continued improvement. Citation Format: Ashley A Woodfin, Emily Ramirez, Alison Coogan, Nehl Mehta, Anuja K Antony, Deana Shenaq, Keith C Hood, Cristina O'Donoghue, Claudia Perez, Rosalinda Alvarado, Andrea Madrigrano. Breast surgery ERAS program: Trends since implementation on post-operative pain and discharge narcotic prescribing at our institution [abstract]. In: Proceedings of the 2019 San Antonio Breast Cancer Symposium; 2019 Dec 10-14; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2020;80(4 Suppl):Abstract nr P1-20-08.