Drug Dependence Research Articles

Health-related issues of people experiencing homelessness in Thailand: a scoping review.

Homelessness is a significant global challenge affecting people worldwide. In Thailand, the health-related issues of people experiencing homelessness have not been a major research focus. This scoping review aims to explore the scope of research on health-related issues among people experiencing homelessness in Thailand. Eight databases (ACI, AMED, Embase, PsycINFO, PubMed, Scopus, TCI, and Web of Science) were searched from inception of each database to August 2022. The search terms consisted of terms related to people experiencing homelessness in Thailand. Research articles published in Thai or English were included. Of 186 articles, 167 were excluded during duplicate removal (n = 45), title and abstract screening (n = 106), seeking for full-text articles (n = 2), and full-text screening (n = 14). Nineteen articles were included for extraction and synthesis. Three topics (health status, causes of homelessness and effects of homelessness on health, healthcare and social services) were summarised. The included studies described mental health (e.g., depression, suicide, alcohol and drug dependence), physical health (e.g., poor self-hygiene, injuries, accidents), and health behaviours (e.g., alcohol drinking, substance use, unsafe sex). Social behaviours and health problems linked to homelessness, and several factors related to health and living conditions (e.g., stigma, discrimination) were reported. People experiencing homelessness had some barriers to access to healthcare and social services (e.g., health insurance, social welfare, financial difficulties). The majority of studies on health-related issues in people experiencing homelessness in Thailand are descriptive studies. Future studies should focus on the interactions and mechanisms between homelessness and health.

SOME FEATURES OF CONSTRUCTING DISPLACEMENT CHARACTERISTICS AND WATERING DYNAMICS

The term «displacement characteristic» (DCh) was first proposed by D. A. Efros in 1959 to indicate the dependence of the accumulated oil withdrawal on the accumulated liquid withdrawal. Subsequently, DChfound wide application in the analysis of oil field development. Many authors proposed various modifications of the DCh coordinates, but directactual measurements of development parameters were always used - annual, accumulated measurements of oil, liquid, water production, water cut, liquid, oil, and water flow rates. Characteristics of oil displacement are called graphical dependences of accumulated oil production on accumulated or current values of liquid or water production, constructed based on actual data. With the help of cold water, three tasks were solved: assessment of recoverable oil reserves, calculation of the technological effect of geological and technical measures, and calculation of technological development indicators. But the main condition for application was the immutability of the development system.Recently, dependences that use parameters such as selection from geological or recoverable oil reserves have come to be classified as chemical dependencies. These dependencies have nothing to do with DCh. Justification of geological and recoverable oil reserves is an independent task; moreover, with the help of chemical recovery, recoverable reserves are found under the existing development system. Against the background of such a confusion of concepts, the definition of the concept of «standard» chemicals is introduced, which has no real meaning for an oil development facility.The dynamics of water cut refers to the change in water cut over time, for example, depending on the time of development of reserves, geological or recoverable. The dynamics of watering in this case has nothing to do with the cold water.The dry period is of great importance when developing an oil field. With the same finaloil recovery, the longer the water-free period, the better the economic indicators.Using the Buckley-Leverett function todetermine water cut is only possible when the flow is two-phase, oil and water. It is impossible to determine the anhydrous period using the Buckley-Leverett function, since it does not exist, therefore, constructing the dynamics of water supply only based on this function is incorrect.When conducting laboratory experiments on core material, in which the heterogeneity compared to the formation is minimal and can be identified with a one-dimensional flow, the anhydrous period is significant and reaches from 0.74 to 0.94 units. of the total volume of displaced oil.For a single-layer field, where there is only one homogeneous layer, the heterogeneity is greater than for the core, but less than for a heterogeneous development object. We can talk about an analogue of a two-dimensional flow with some degree of convention.Considering that these are not laboratory studies, where measurements are carried out more accurately, but production ones, the low-water-cut period (up to 10 %) is 0.4 of the total oil production from wells with simultaneous commissioning of wells. If the wells were commissioned at different periods of time, as is always the case in fields, then the dynamics of water supply are completely different, and water supply begins earlier than when all wells are commissioned simultaneously.

Tuning electronic and thermoelectric properties of armchair graphene nanoribbon in the presence of electron phonon coupling

Electronic and thermoelectric properties of armchair graphene nanoribbon taking into account the effects of interaction between electrons and Einstein phonons have been addressed. Specially we study the temperature dependence of thermal conductivity, density of states and specific heat of the structure. The effects of electron phonon coupling strength on thermal conductivity and thermoelectric electronic of the system have been studied. Green’s function method has been implemented to obtain electronic properties of the system in the context of Holstein Hamiltonian. One loop electronic self-energy of the Hamiltonian has been obtained in order to find interacting electronic Green’s function. The transport and thermoelectric properties of armchair graphene nanoribbon in the presence of electron phonon coupling can be readily found using interacting Green’s function based on Kubo formula. We find numerical results for chemical potential dependence of thermal conductivity and thermoelectric properties in the presence of Holstein phonons. Specially the behaviors of Seebeck coefficient, power factor function, figure of merit and Lorenz number of the system have been analyzed. Our results show turning on electron phonon coupling leads to reduction of band gap in density of states of the armchair nanoribbon.

Comparison of the Intestinal Microbiota Composition and Function of Red Claw Crayfish (Cherax quadricarinatus) Cultured in Ponds and Rice Fields

The growth environment significantly influences the intestinal microbiota of aquatic organisms. We investigated the composition and functional differences in the intestinal microbiota of red claw crayfish (Cherax quadricarinatus) in rice fields (RB) and ponds (PB) by 16S rDNA high-throughput sequencing technology. The results indicate that the Shannon, Simpson, Sobs, Chao1, and ACE indices of PB are all higher than those of RB, demonstrating greater diversity and richness of intestinal microbiota. The dominant phyla in the intestinal microbiota of the Cherax quadricarinatus were Proteobacteria, Tenericutes, and Firmicutes. Tenericutes and Proteobacteria were significantly more abundant in the RB than in the PB, while Planctomycetes and Firmicutes were significantly more abundant in the PB than in the RB. The results of network correlation analysis indicate that Proteobacteria and Firmicutes exhibit strong connectivity with other microbial groups in the gut microbiota of Cherax quadricarinatus, showing significant centrality. They play an important role in the interactions within the gut microbiota community. The dominant bacterial genera in the Cherax quadricarinatus’s gut were Citrobacter, Candidatus_Bacilloplasma, and Clostridium_sensu_stricto_1. The abundance of the genus Clostridium was significantly higher in the PB than in the RB, whereas the abundance of Candidatus_Hepatoplasma and Vibrio was significantly lower in the PB than in the RB. The prediction function of KEGG enrichment showed that the abundance of Amino acid metabolism, Biosynthesis of Other Secondary Metabolites, Transport and Catabolism, Cancers, and Nervous System, Substance Dependence were significantly higher in the PB, while the infectious diseases pathway was enriched in the RB. In summary, our results revealed significant differences in the composition and diversity of intestinal microbiota in the Cherax quadricarinatus between rice paddy and pond farming environments. The intestinal microbiota of the Cherax quadricarinatus grown in pond environments exhibit higher diversity and stability, manifested by an increase in beneficial bacteria abundance and a decrease in opportunistic pathogens. These findings significantly improve understanding of the complex relationship among Cherax quadricarinatus, intestinal microbiota, and the environment.

CONCEPT OF SOCIAL ANXIETY DISORDER IN AYURVEDA: A REVIEW

Social Anxiety Disorder (SAD) is a minor mental illness characterized by substantial degree of fear in one or more social situations. The condition becomes clinically relevant when the fear is persistent for a period of six months or more. A few outcomes of Social Anxiety Disorder are depression and substance abuse. It can be seen more in teenagers than in young adults. In common populaces, women are having more rates of Social Anxiety Disorder than in men. The contemporary management of Social Anxiety Disorder are with the usage of anxiolytic drugs and their practice is limited owing to the risk of drug abuse and dependency. As per Ayurveda, Social Anxiety Disorder can be considered under the Shareerika - Manasika Vikara (psychosomatic disorder). This involves Udvega avastha of Manas (hesitant state of mind) along with the predominance of Vata and Pitta dosa. As the references are scattered, the paper is an attempt to understand the concept of Social Anxiety Disorder. This article is an endeavor to bring light to understanding the concept and find out suitable solutions for Social Anxiety Disorder through an Ayurvedic perspective.

Immunohistochemistry analyses of the abomasal mucosa show differences in cellular-mediated immune responses to Haemonchus contortus infection in resistant and susceptible young lambs

Haemonchus contortus is known for its high pathogenicity in sheep, and the uncontrolled use of anthelmintics resulted in the emergence of multiple drug-resistant populations. Breeding sheep for gastrointestinal nematode resistance is a sustainable alternative to reduce dependence of anthelmintic drugs, and differences in the degree of resistance between breeds have been reported. Here we compare two sheep breeds (Santa Ines and Ile de France), concerning the differences in innate and adaptive immune response involved in the resistance against H. contortus infection. Immunohistochemical analyses of the abomasum were conducted in naïve Santa Ines (n = 14) and Ile de France (n = 12) lambs randomized into four groups: infected Santa Ines (n = 8), non-infected control Santa Ines (n = 6), infected Ile de France (n = 8), and non-infected control Ile de France (n = 4). The infected lambs were initially infected with H. contortus infective larvae at 14 days of age, and multiple infections were conducted every second day until they reached 66 days of age. There was a significant effect (P < 0.001) of the infection with increase in numbers of CD3+ T; CD79α+ B; GATA3+ Th2/ILC2; POU2F3+ tuft cells; FOXP3+ T reg; and IgE + cells in the fundus of the abomasal mucosa in both Santa Ines and Ile de France lambs. Nevertheless, the infected Santa Ines lambs presented the highest averages for CD79α+ B; GATA3+ Th2/ILC; IgE + cells; and POU2F3+ tuft cells and there was a significant association of the breed and infection status with regards to POU2F3+ tuft cells, with the highest mean in the infected Santa Ines group. The infected Santa Ines group had three lambs with high degree of resistance and five lambs that showed a moderate infection. Our results suggest a mechanism of synergistic coordination between different immune-cell types in promoting resistance of suckling lambs under H. contortus infection.

Implementing management of the physical fitness education program for the drug rehabilitation patients in drug addict therapy centre

Abstract. This research analyses the urgency of Implementation of Physical Fitness Education Program Management for Drug Rehabilitation Patients at the Bidayatussalikin Islamic Boarding School (BIBS) Drug Addict Therapy House in Indonesia. This research was a mixed-method research. The quantitative sample consisted of 65 BIBS drug rehabilitation students. The qualitative sample included 6 expert informants. The conclusion is the implementation of physical fitness education programme management as a means of accelerating non-medical rehabilitation for students as former drug addicts needs to be implemented. This programme can be used as a means of accelerating the non-medical healing process through; strengthening physical fitness components, repairing the body's nerve cells, encouraging the release of the hormones dopamine and endorphins that trigger happiness, reducing stress, managing emotions, stabilising mood, channeling positive energy, avoiding empty thoughts, helping restore damaged memory, and entertaining the students as former drug addicts. The conclusion of this study emphasizes the importance of implementing a structured physical fitness education pro-gram in drug rehabilitation centers. The findings confirm that such programs not only provide significant physical health benefits, but also support psychological recovery and encourage positive routines for patients. Physical fitness programs, integrated in drug rehabilitation strategies, should be considered a crucial and indispensable component, due to their contribution to physical and mental well-being during the recovery process. Research has also shown the integral role of rehabilitation in helping individuals suffering from substance use disorders to achieve recovery and pre-vent relapse. By incorporating approaches that cover physical, psychological, social, and spiritual aspects, rehabilitation programs can effectively support the holistic well-being and successful recovery of individuals undergoing rehabili-tation from substance dependence. Keywords: Urgency; Management of Physical Fitness Education Programs; The Drug Rehabilitation Patients

Identifying and Exploring Jean Watson's Theory of Human Caring in Nursing Approaches for Patients with Psychoactive Substance Dependence in Medical and Surgical Acute Wards.

Patients with substance use disorders may view healthcare professionals as capable of supporting them through their suffering and experience. Although numerous studies have focused on the roles, approaches, and attitudes of healthcare professionals, there is a lack of information on the nursing perspective. This study aims to explore the experiences and nursing approaches towards patients with psychoactive substance dependence admitted to an Italian acute hospital ward. A qualitative phenomenological study was conducted. Data were collected using semi-structured face-to-face interviews. The interviews were transcribed, read thoroughly, and analysed. Fifteen nurses were interviewed. Six main themes were extracted: (1) origin context, (2) participants' personal thoughts, (3) type of approach provided, (4) school education received on the topic, (5) effectiveness of rehabilitative therapy, and (6) methods that can improve nursing care. The findings suggest that most respondents experience stigma and discrimination when providing care to these patients. In response to the results obtained, models have been suggested, such as Jean Watson's Human Caring Theory, which shows how practising a holistic approach based on empathy and active listening can improve the relationship between nurses and patients. Furthermore, to eliminate stereotypes, it would be appropriate to act on the university education of nurses. This study was not registered.

Self-control as mediator and social support as moderator in stress-relapse dynamics of substance dependency

Substance Use Disorders (SUDs) present a significant challenge to global public health, with prolonged drug use not only impairing individual health but also hindering social development. Despite various interventions aimed at addressing drug abuse and dependence, a high relapse rate remains a prominent issue. In light of this, this study aims to explore the impact of perceived stress on the relapse of individuals with SUDs, as well as the mediating role of self-control and the moderating role of social support, in hopes of providing new perspectives for interventions to reduce the risk of relapse among individuals with SUDs. By utilizing a convenience sampling method, 420 male individuals with SUDs were recruited from detoxification centers in Guangxi, China. They completed questionnaires on perceived stress, self-control, social support, and tendencies towards relapse. A total of 401 valid datasets were obtained and analyzed using the SPSS Process plugin to conduct a moderated mediation model analysis. Results: (1) Perceived stress had a positive impact on the relapse of individuals with SUDs, (2) Self-control played a partial mediating role between perceived stress and the relapse, (3) The direct effect of perceived stress on the relapse and its first half of the indirect effect were moderated by social support. The research emphasize the critical importance of learning stress management strategies, enhancing self-control, and receiving comprehensive social support in the prevention and treatment of substance dependence. By strengthening self-control and social support as both internal and external resources, the likelihood of relapse among individuals with SUDs can be reduced, contributing to more effective and comprehensive drug rehabilitation strategies.

Associations Between Gut Microbiota and Alcohol Abuse: A Mendelian Randomisation and Bioinformatics Study.

Alcohol abuse, also known as Alcohol Use Disorder (AUD), is a substance dependency psychiatric disorder. We aimed to establish a causal relationship between specific gut microbiota and alcohol abuse using Mendelian Randomisation (MR) and bioinformatics methods. We acquired summary data of genome-wide association studies (GWAS) for gut microbiota and alcohol abuse from the Mibiogen and Finngen databases, respectively. We conducted MR analyses using various methodologies and mapped the single nucleotide polymorphisms (SNPs) to genes via the FUMA GWAS platform. We further performed multiple enrichment analyses and a Multi-variable Mendelian Randomisation (MVMR) approach to examine whether gut microbiota influences alcohol abuse by modulating neurotransmitter-related amino acids. The MR analysis revealed an inverse relationship between the genus Eubacterium ventriosum group and the Porphyromonadaceae family with alcohol abuse. Gene enrichment analysis showed that these genes are expressed in brain tissue and are involved in addictive disorders, psychiatric conditions, immunological processes, neurotransmitter synthesis and synaptic regulation. MVMR analysis suggested that the Porphyromonadaceae family as well as genus Eubacterium ventriosum group may suppress alcohol abuse through the metabolism of neurotransmitter-related amino acids, especially Tryptophan. The MR analysis and bioinformatics investigations indicate that the genus Eubacterium ventriosum group and Porphyromonadaceae family confer a protective effect against alcohol abuse, potentially through the modulation of synaptic function.

Characteristics of women on opioid substitution therapy in primary healthcare in Tshwane (South Africa): a retrospective observational study.

Women who use drugs face specific challenges compared to men, such as higher rates of HIV infection, unsafe injecting practices and intimate partner violence. However, this population's access to drug dependence treatment and gender-sensitive interventions remains limited, leading to unmet needs and increased vulnerability. To investigate the characteristics of and associations with retention in care among women on opioid substitution therapy (OST) in a community based primary care setting. A descriptive observational study within the Community Orientated Substance Use Programme in Tshwane, South Africa. Data from 199 women (>18 years) on OST was extracted from an electronic database and paper-based files. Data was analysed descriptively, and inferential analysis looked for association of variables with retention on OST for≥6 months. Majority of participants were unemployed, with 44.3% falling within the 20-29 years age range. During the initiation and course of OST, 39.2% of women experienced intimate partner violence, and 19.0% were pregnant. Retention on OST was significantly associated with increasing age at initiation (p=0.047), knowledge of HIV status (p=0.029), an increase in the ASSIST score (p=0.023), and methadone dose (p<0.001). Factors such as race, employment status, health system level, pregnancy, intimate partner using substances, intimate partner violence, route of administering opioids, and having tuberculosis and/or hepatitis C exposure did not show a significant relationship with retention on OST (p>0.05). This study reveals specific vulnerabilities in women receiving OST, emphasising the need for the integration of interventions to address reproductive health, violence mitigation, infectious disease and polydrug use into care.

Patterns of childhood maltreatment and maternal substance use disorder on the development of emerging adult offspring substance use.

Exposure to child maltreatment and maternal substance use disorder represent two highly consequential and co-occurring experiences of family-level adversity for the development of concerning substance use behaviors among offspring. The present study uses latent class analysis to identify how characteristics of childhood maltreatment and maternal substance use disorder naturally cluster. Further, this study investigates how distinct patterns of maltreatment and maternal substance use differentially predict emerging adult substance use in offspring. Participants (N = 405) were drawn from a longitudinal follow-up study of emerging adults who participated in a research summer camp program as children. Wave 1 of the study included 674 school-aged children with and without maltreatment histories, all of whom experienced low socioeconomic status. Patterns of child maltreatment experiences, based on coded Child Protective Services record data, and maternal substance use behaviors, per a diagnostic interview, were used to predict Wave 2 (emerging adulthood) substance use. Results indicated that children who were exposed to a pattern of multitype maltreatment and multitype maternal substance dependence, relative to those exposed to multitype maltreatment alone, reported greater alcohol dependence symptoms during emerging adulthood. Additionally, these same individuals reported greater past-year hard liquor consumption relative to those who experienced chronic, multitype maltreatment and maternal alcohol dependence. These findings highlight how a pattern of maternal polysubstance use and multitype maltreatment is particularly consequential for the intergenerational transmission of substance use behaviors. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Relapses in Alcohol and Cocaine Dependence in Spousal Relationships: A Behavioral Assessment with Couple

Contingency analysis is a central concept and method in behavior analysis for understanding how the environment influences human behavior. In the treatment of chemical dependency, this analysis makes it possible to examine the functional relationships between antecedent stimuli, behaviors, and consequences (antecedent-behavior-consequence model) in order to understand and modify behavior. Through contingency analysis, professionals can personalize and adapt interventions according to the individual needs of substance-dependence patients, making it a fundamental tool in the multidisciplinary approach to relapse prevention. The purpose of this article is to conduct analyses of contingencies described in reports of relapse episodes of psychoactive substance use by individuals diagnosed with alcohol dependence and cocaine dependence, formally married, throughout their spousal behavioral histories. Based on detailed and systematic information about more than one case in comparison, contingency analyses of relapse episodes were conducted. The study sample consisted of four heterosexual couples (total N = 8), with one individual in the couple diagnosed with alcohol or cocaine dependence. The selection was made through the Rehabilitation Program of a Military Police Hospital located in Vitória/ES, Brazil. The analyses revealed common contingencies, including social pressure (from the friends' group with their invitations), negative emotional states (elicited by plans gone wrong, adverse conditions), and physiological dependence (craving, withdrawal syndrome, tolerance, and salience of use). The specificity of the spousal relationship provided the nuance for these contingencies, emphasizing the importance of therapeutic interventions with couples to assist in preventing relapses, including stress management skills, craving coping, conflict resolution, frustration tolerance, and communication.

Influence of Microstructure on Defect Chemistry - Transport - Chemical Strain Coupling of (Pr,Ce)O2-δ Nanoparticles

Solid oxide fuel/electrolysis cells (SOFC/SOECs) are promising and environmentally-friendly technologies for meeting ever-increasing electricity and energy storage demands. Nanostructuring of SOFC/SOEC electrodes can enable improvement of the reaction kinetics and reduction of the operating temperature, owing to factors including the enlarged surface area, short diffusion lengths, and unique surface & interface properties. While the kinetic benefit is apparent, the effect of nanostructuring on other device-relevant physico-chemical properties cannot be neglected. Especially, the coefficients of chemical expansion (CCEs) are an important metric for mixed ionic-electronic conductors that can undergo changes in oxygen stoichiometry with variations in the surrounding atmosphere, temperature, and voltages during processing/operation. Chemical strains can cause cracking of monolithic parts during fabrication and delamination of electrodes from electrolytes in operation. CCEs are typically measured on bulk, polycrystalline materials with large particle or grain sizes. Therefore, it is important to understand the coupled transport and chemical expansion behavior in nano-ionic materials with large interface/surface density. This work aims to uncover the role of microstructure and nanoscale effects on the chemical strain and transport properties, through the lens of defect chemistry, with the goal of ultimately developing design principles for zero-strain materials with improved device lifetime and performance.Pr0.2Ce0.8O2- δ (PCO20) was selected as a model system and prepared as nanoparticles by a surfactant-free, low temperature co-precipitation method. (Pr,Ce)O2-δ compositions are valuable model oxide ion conductors to study, since both Pr and Ce can undergo changes of valence states under different temperature and pO2 regimes to accommodate oxygen stoichiometry excursions. Prepared nanoparticle samples were first in-situ sintered in the dilatometer at three different temperatures (600 ⁰C, 725 ⁰C, 850 ⁰C) to induce and evaluate microstructure evolution. The chemical strain and electronic/ionic conductivity were then studied on stable microstructures with different average particle sizes at lower temperatures by simultaneous in-situ dilatometry and electrochemical impedance measurement (EIS) upon changing pO2 at different isotherms (550 to 400 ⁰C). At each isotherm, all the samples expand as pO2 decreases. From the conductivity vs. pO2 measurements, the maxima at certain pO2 indicate the dominant polaron mechanism of the electronic transport, consistent with the measured conductivity activation energy. However, samples with lower sintering temperatures exhibit less pO2 dependence of the conductivity, which implies a transition in the mixed ionic/electronic conduction behavior toward higher ionic transference numbers as particle size decreases. Correspondingly, the chemical strains associated with losing oxygen monotonically decrease with the decrease of the sintering temperature, and hence the particle size. The chemical strain vs. oxygen stoichiometry dependence and corresponding CCEs were quantified as function of particle size and temperature by combining thermogravimetric analysis (TGA) with the dilatometry results and in-situ X-ray diffraction. The particle size, chemical composition, valence states, and morphology of samples after CCEs measurements were also compared using XRD, SEM, and S/TEM-EELS, with the latter indicating the expected differences between bulk and surface defect chemistry. Implications of the results for size-dependent defect chemistry and its influence on chemical strains and redox CCEs will be further discussed. Keywords: redox, chemical expansion, defect chemistry, mixed ionic electronic conduction, ceria, chemo-mechanics, nanoparticle, thermogravimetric analysis, dilatometry, impedance

Combined nefopam-fentanyl use in PCA for postoperative analgesia in spinal surgery patients: a randomized, controlled, single-blind trial

Background &amp; objective: The use of fentanyl to manage postoperative pain in spinal surgery patients is common, although there have been concerns about potential of drug abuse and dependence. We investigated the effects of the combined administration of nefopam and fentanyl through intravenous (IV) patient-controlled analgesia (PCA) on early postoperative pain and possible side effects in patients undergoing spinal surgeries. Methodology: In this randomized, controlled study, 70 patients were allocated to receive either fentanyl 10 µg/mL (Group F) or fentanyl 10 µg/mL with nefopam 1.2 mg/mL (Group FN), with a total PCA volume of 100 mL per infusion bag. Patients received a background dose of 0.25 µg/kg/h and bolus dose of 0.5 mL SOS (fentanyl 5 µg). The lockout interval was set at 10 min and upper limit was set at 15 mL/4 h. The PCA parameters were set according to the body weight of each patient. Results: The cumulative postoperative fentanyl consumptions after 48 h for Group F and Group NF were reported as 744.6 ± 94.2 µg and 631 ± 62.5 µg (P &lt; 0.05) respectively. The average number of bolus doses requested by the patients in Group F and FN were 20.8 ± 11.0, and NF 11.4± 7.6). The A/D ratio of both groups for the bolus doses were 70%. Group NF consistently scored a lower VAS and VAS-D score during the 48-hour postoperative period. However, the VAS scores significantly differ statistically between groups at 1, 6, 9, and 12 hours. Within group differences, the VAS score differed significantly statistically during the 0-1, 1-2, and 2-3 hours for Group F, while 24-36 hours for Group NF. Conclusion: The inclusion of nefopam in patient-controlled analgesia for spine surgery patients significantly reduced total use of fentanyl within the 48 hours postoperatively after the surgery. Patients receiving fentanyl with nefopam consistently had lower VAS scores at different time points. Abbreviations: PCA - patient-controlled analgesia; VAS - Visual Analogue Scale Keywords: postoperative pain, fentanyl, nefopam, patient-controlled analgesia Citation: Le XD, Nguyen ML, Nguyen DT, Do TH, Nguyen HG. Combined nefopam-fentanyl use in PCA for postoperative analgesia in spinal surgery patients: a randomized, controlled, single-blind trial. Anaesth. pain intensive care 2024;28(4):687−691; DOI: 10.35975/apic.v28i4.2370 Received: January 06, 2024; Reviewed: April 14, 2024; Accepted: April 14, 2024

AI be used in medicine? Not in MI, SUDs, CPDD panelists suggest

While artificial intelligence (AI) may have utility in some medical practices such as reading X‐rays, it is not going to be useful in diagnosing or treating conditions with nuances — notably, substance use disorders (SUDs) or mental illness — experts suggested in a panel on the topic at the June College on Problems of Drug Dependence (CPDD) annual conference in Montreal.

Pattern of substance abuse among patients in a rehabilitation center

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

An In-Home Withdrawal Service for individuals with low-to-moderate substance dependence: implementation and program evaluation.

Background Sonder's In-Home Withdrawal Service (IHWS) has been providing a unique home-based, multidisciplinary, wraparound withdrawal option for people with low-to-moderate levels of substance dependence since September 2019. This paper provides an evaluation of the service's overall impact on reducing substance use among clients through the delivery of this innovative service model. The evaluation explores the acceptability and feasibility of the service via client, stakeholder, and staff perspectives. Methods A mixed-method design was used to evaluate the IHWS. Descriptive analysis of quantitative data was conducted using clinical assessments from client records and online feedback surveys. Qualitative data from client, staff, and stakeholder feedback surveys were analysed thematically. Results Overall, 1166 referrals were received over the lifespan of the service, and a data set of 96 clients was included in the analysis. Self-reported measures showed that most clients decreased their substance use (89%), improved their psychological health status (75%), improved their physical health (65%), improved their quality of life (69%), and improved their understanding and ability to manage their alcohol and other drugs (AOD) use (84%). Client feedback suggests the service is providing a unique option for AOD withdrawal. Stakeholders commend the service's home-based setting, multidisciplinary and person-centred approach to care, and recommended expansion of the service to increase access for clients and reduce demand on inpatient settings. Conclusions The IHWS is having a significant impact in reducing substance use and highlights the need for increased access to holistic approaches to withdrawal. This includes pre- and post-withdrawal support and the inclusion of multidisciplinary teams, and engaging lived experience practitioners. A focus on funding primary-based services is required to meet the rising costs of tertiary-based care and to better meet the needs of consumers.

Predicting the Hallucinogenic Potential of Molecules Using Artificial Intelligence.

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

Understanding pregabalin misuse and dependence: Insights from a North Indian addiction treatment center

Background: Pregabalin, approved for various medical conditions, has shown increasing misuse potential globally. However, limited research exists on pregabalin dependence in India. This study aimed to investigate the prevalence and characteristics of pregabalin dependence among individuals seeking substance use disorder (SUD) treatment in North India. Methods: A cross-sectional, analytical study was conducted on patients enrolled between August 2022 and July 2023 at an academic institution-based addiction treatment center. Case records of patients with pregabalin dependence were retrieved and compared with controls with opioid dependence but no history of pregabalin use. Results: Among 3766 registered patients, 135 had pregabalin dependence (prevalence: 3.58 per 100 registered patients). Pregabalin-dependent patients were male, with a median usage duration of eight months and a median daily dose of 1200 mg. Most had concurrent opioid dependence, primarily heroin, used via the injection route. The odds of pregabalin dependence among those with opioid dependence were significantly higher than those with other substance dependence (OR 1.44, 95% CI 1.13–1.85). Reasons for pregabalin use included opioid craving reduction, sedation, and euphoria. Patients with pregabalin dependence were more likely to have lower socioeconomic status (P &lt; 0.0001) and urban residence (P = 0.032), an earlier age of substance use initiation (P = 0.02) and treatment seeking (P &lt; 0.0001), and a higher co-occurrence of psychiatric disorders (P = 0.007) and less occurrence of alcohol dependence (P = 0.03). Conclusion: Findings underscore the need for heightened awareness, screening, and intervention efforts targeting pregabalin misuse within SUD treatment. Further research should focus on longitudinal studies to elucidate pregabalin dependence’s trajectory.