Addiction Research Articles

Public health prevention programmes for mental illness in school-age children and adolescents

Abstract Background Psychiatrists, psychotherapists and other mental health professionals have long stated the importance of adequate social groups and early intervention for the prevention of severe mental diseases. With psychiatric illness incidence increasing most in the adolescent and young adult populations, we propose the use of school-age directed public mental health initiatives to combat remaining social stigma and promote mental wellbeing, as well as educate children and adolescents in how to recognise symptoms and ask for help. Methods We conducted a systematic review on PubMed as well as government and NGO websites to identify public health initiatives in the prevention and early identification of mental illness among young individuals. Results Preliminary results show that, while certain countries have delineated guidelines on how to support students’ mental health, very few have implemented nation-wide, or even region-wide programmes that directly target prevention and education. A particular note should be made regarding substance abuse and addiction, one of the few illnesses for which many countries have already enacted in-school programmes, that however often overlook the medical aspect of such diseases. Of further note are certain local programmes aimed at offering quality and accessible care to adolescents struggling with mental diseases. Conclusions With psychiatric diseases projected to become one of the greatest contributors to the global burden of disease by 2030, and the importance of early intervention in preventing severe psychiatric illness, we advocated for European public health initiatives implemented in schools, which could be crucial in curbing the spread of mental illness. Key messages • Adolescent and young adults are those most affected by the rising prevalence of mental illness. Consequently, we advocate for in-school programmes to aid in early identification and intervention. • Early identification of mental diseases is crucial in the prevention of severe psychiatric illness, but little has been done so far in terms of public health interventions to tackle such problems.

Proportion and distribution of neurotransmitter-defined cell types in the ventral tegmental area and substantia nigra pars compacta

Most studies on the ventral tegmental area (VTA) and substantia nigra pars compacta (SNc) have focused on dopamine neurons and their role in processes such as motivation, learning, movement, and associated disorders such as addiction and Parkinson's disease. However there has been increasing attention on other VTA and SNc cell types that release GABA, glutamate, or a combination of neurotransmitters. Yet the relative distributions and proportions of neurotransmitter-defined cell types across VTA and SNc has remained unclear. Here, we used fluorescent in situ hybridization in male and female mice to label VTA and SNc neurons that expressed mRNA encoding the canonical vesicular transporters for dopamine, GABA, or glutamate: vesicular monoamine transporter (VMAT2), vesicular GABA transporter (VGAT), and vesicular glutamate transporter (VGLUT2). Within VTA, we found that no one type was particularly more abundant, instead we observed similar numbers of VMAT2+ (44 %), VGAT+ (37 %) and VGLUT2+ (41 %) neurons. In SNc we found that a slight majority of neurons expressed VMAT2 (54 %), fewer were VGAT+ (42 %), and VGLUT2+ neurons were least abundant (16 %). Moreover, 20 % of VTA neurons and 10 % of SNc neurons expressed more than one vesicular transporter, including 45 % of VGLUT2+ neurons. We also assessed within VTA and SNc subregions and found remarkable heterogeneity in cell-type composition. And by quantifying density across both anterior-posterior and medial-lateral axes we generated heatmaps to visualize the distribution of each cell type. Our data complement recent single-cell RNAseq studies and support a more diverse landscape of neurotransmitter-defined cell types in VTA and SNc than is typically appreciated.

The impact of voluntary wheel-running exercise on hippocampal neurogenesis and behaviours in response to nicotine cessation in rats.

The literature indicates that nicotine exposure or its discontinuation impair adult hippocampal neurogenesis in rats, though the impact of exercise on this process remains unclear. We have previously shown that disturbances in the number of doublecortin (DCX, a marker of immature neurons)-positive (DCX+) cells in the dentate gyrus (DG) of the hippocampus during nicotine deprivation may contribute to a depression-like state in rats. This study aimed to investigate the effect of running on hippocampal neurogenesis, depression-like symptoms, and drug-seeking behaviour during nicotine deprivation. The rats were subjected to nicotine (0.03mg/kg/inf) self-administration via an increasing schedule of reinforcement. After 21 sessions, the animals entered a 14-day abstinence phase during which they were housed in either standard home cages without wheels, cages equipped with running wheels, or cages with locked wheels. Wheel running increased the number of Ki-67+ and DCX+ cells in the DG of both nicotine-deprived and nicotine-naive rats. Wheel-running exercise evoked an antidepressant effect on abstinence Day 14 but had no effect on nicotine-seeking behaviour on abstinence Day 15 compared to rats with locked-wheel access. In summary, long-term wheel running positively affected the number of immature neurons in the hippocampus, which corresponded with an antidepressant response in nicotine-weaned rats. One possible mechanism underlying the positive effect of running on the affective state during nicotine cessation may be the reduction in deficits in DCX+ cells in the hippocampus.

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Focal Adhesion Kinase Inhibition Ameliorates Burn Injury-Induced Chronic Pain in Rats.

Burn injury-induced pain (BIP) is a significant global health concern, affecting diverse populations including children, military veterans, and accident victims. Current pharmacotherapeutics for the management of BIP are associated with severe side effects including drug addiction, respiratory depression, sedation, and constipation posing significant barrier to their clinical utility. In the present study, we have investigated the potential role of focal adhesion kinase (p-FAK) for the very first time in BIP and elucidated the associated underlying mechanisms. Defactinib (DFT), a potent p-FAK inhibitor, administered at doses of 5, 10, and 20mg/kg via intraperitoneal injection, demonstrates significant efficacy in reducing both evoked and spontaneous pain without causing addiction or other central nervous system toxicities. Burn injury triggers p-FAK-mediated phosphorylation of Erk1/2 and NR2B signaling in the DRG, resulting in heightened hypersensitivity through microglial activation, neuropeptide release, and elevated proinflammatory cytokines. Defactinib (DFT) counteracts these effects by reducing NR2B upregulation, lowering substance P levels, inhibiting microglial activation, and restoring IL-10 levels while leaving CGRP levels unchanged. These findings provide valuable insights into the pivotal role of p-FAK in regulating BIP and highlight the potential for developing novel therapeutics for burn injury-induced pain with minimal side effects.

“More stress, more addiction?” The relationship between stress and relapse of male individuals with drug addiction: A chain mediation model

This study aims to investigate the mechanism of relapse tendency in male drug abusers and provide empirical evidence for reducing relapse tendency of drug abusers. A survey was conducted on 310 male individuals with drug addiction using Chinese Perceived Stress Scale (CPSS), Simple Coping Style Questionnaire (SCSQ), the Regulatory Emotional Self-Efficacy Scale, and the Relapse Tendency Scale (RTS). (1) Stress is significantly positively correlated with the relapse tendency of individuals with drug addiction; (2) Stress indirectly affects relapse tendency through regulatory emotional self-efficacy; (3) Regulatory emotional self-efficacy can directly and negatively predict relapse tendency, and can also indirectly and negatively predict relapse tendency through coping style. Stress coping theory, tension elimination theory, and the self-administration hypothesis are applicable to explain the tendency to relapse due to stress among compulsory isolated drug abusers in China; Regulatory emotional self-efficacy and coping style play a chain mediating role between stress and relapse tendency of male individuals with drug addiction.

Specific anti-toxic immunotherapy: use in medical practice and perspectives

The results of use of approaches and means of antitoxic immunotherapy in medical practice are summarized: passive transfer of various variants of antibodies specific to toxic compounds, vaccination – specific active immunization with vaccines carrying determinants of the immunochemical specificity of target toxic compounds. The practical effectiveness of the known approaches of passive transfer and vaccination is associated with the ability of specific antibodies, by binding target bioactive compounds with pronounced toxicity, to change the availability of corresponding structures in the body-targets and, in the presence of a sufficient number of specific antibodies with high binding ability to the target compounds, neutralize their toxicity. In medical practice, polyspecific heterologous antisera or the gamma globulin fraction of antisera (extremely rare monoclonal antibodies of narrow specificity) are widely used for passive transfer as antidotes in the treatment of victims in order to prevent deaths and extensive necrosis of soft tissues at the site of the bite of poisonous snakes and insects. Active immunization – vaccination with appropriate antigenic drugs should create in immunized individuals a state of humoral immunity with the corresponding characteristics of antibody formation specific to the target compound. When a target toxic compound enters an immunized organism, it is also possible to neutralize its toxicity. The most successful experience in using the principles of active immunization as a technology for specific antitoxic therapy is associated with the practice of using toxoids for toxinemic infections. Specific practical techniques used to achieve the effectiveness of possible approaches to specific antitoxic immunotherapy in the form of passive transfer of specific antibodies or their fragments are considered: to combat lethal infections in the pathogenesis of which the toxic effects of bacterial exotoxins are significant; when treating victims of snake and insect bites, exposure to poisons of marine organisms, algae and plant toxins; in the treatment of severe intoxication with certain low molecular weight toxic substances: digoxin, colchicine, tricyclic antidepressants. The most successful experiences of using the principles of active immunization as a technology for specific antitoxic therapy, based on the use of toxoids with specificity for diphtheria, tetanus, botulism, cholera, typhoid fever, dysentery, gas gangrene and other toxinemic infections, are also considered. The fairly high immunogenicity of toxoids with the possibility of activating both constitutional and adaptive immunity has become the basis for their use as macromolecular carriers of hapten analogues of narcotic substances – a promising direction in drug addiction, in the implementation of which a number of experimental molecular and combined vaccines of opiates, methamphetamine, cocaine, and nicotine. This variant of practical efforts in medicine can be regarded as a new direction of specific antitoxic immunotherapy – an option to combat drug addiction by vaccinating drug addicts.

Psychometric Properties of the Credibility/Expectancy Questionnaire in Individuals with Opioid Use Disorder

ABSTRACT Credibility and expectancy are important aspects of therapy/treatment processes. We aimed to perform cross-cultural validation and examine the psychometric properties of the Credibility/Expectancy Questionnaire (CEQ). Ninety-one patients with opioid use disorder from Tobacco, Alcohol, and Drug Addiction Treatment Program were included in the study. Sociodemographic data form, CEQ, Beck Depression Inventory (BDI), State and Trait Anxiety Inventory (STAI), and Attitudes Toward Seeking Psychological Professional Help Scale-Short Form (ATSPPHS-SF) were filled out by participants. Confirmatory factor analyses showed that CEQ has two factors in our sample, similar to the original version. Reliability analyses showed that CEQ has a high internal consistency and test-retest reliability. Regarding convergent validity results, CEQ was correlated with ATSPPHS-SF. No significant correlation was found between CEQ and BDI and STAI regarding discriminant validity results. In conclusion, the Turkish version of CEQ is a valid, reliable scale and could be used in patients with opioid use disorder. In patients with opioid use disorder, we contributed to the addiction literature by adapting a short and effective survey that measures trust and expectation.

Methamphetamine-induced cardiotoxicity: in search of protective transcriptional mechanisms.

Crystalline methamphetamine hydrochloride is an illegal drug with ahigh addictive potential, better known by its colloquial name "ice" or "crystal meth". The abuse of this drug has led to significant health problems worldwide. Like other amphetamine-type stimulants, chronic consumption of methamphetamine leads to direct toxic effects on the central nervous system, causing cognitive impairment, depressive behavior, and other severe neurological or psychiatric symptoms. Besides its neurotoxicity, the drug exhibits numerous deleterious effects on the cardiovascular system, including hypertension, accelerated atherosclerosis, vasospasm-induced acute coronary syndromes, sudden cardiac death, and dilated cardiomyopathy with congestive heart failure and left ventricular dysfunction. The excessive release of catecholamines upon methamphetamine exposure causes vasoconstriction and vasospasm, which ultimately lead to hypertension, tachycardia, endothelial dysfunction, and cardiotoxicity. While numerous studies have focused on transcription factors expressed in the brain that cause the neurotoxic effects of the drug, much less is known about transcription factors involved in the development of methamphetamine-induced heart failure. In this article, we provide an overview of the Janus kinase-signal transducer and activator of transcription3 (JAK-STAT3) pathway involved in ischemia/reperfusion injury in the myocardium, which may be activated by the vasospasm-inducing action of the drug. However, much more work is needed to decipher the precise role of STAT protein family members, including the potentially cardioprotective STAT3, in the pathogenesis of methamphetamine-induced cardiotoxicity.

Basal cortisol level modulates stress-induced opioid-seeking behavior

In preclinical studies and our human laboratory, the α2-noradrenergic autoreceptor antagonist yohimbine was found to promote drug-seeking behavior. This study evaluated effects of dose-combinations of yohimbine and the glucocorticoid receptor agonist hydrocortisone to model intensity-dependent effects of stimulating each neurochemical system, alone and together, on stress-reactivity and opioid-seeking. Twelve regular heroin-using participants diagnosed with opioid use disorder (OUD) were stabilized on sublingual buprenorphine (8-mg/day), then passed a hydromorphone 18-mg vs. placebo intramuscular reinforcement screen. Across 9 experimental conditions (3 × 3 within-subject, randomized crossover, placebo-controlled, double-blind design) during inpatient buprenorphine maintenance, combinations of oral pretreatment doses of yohimbine (0, 27, 54-mg; t = 0 min) then hydrocortisone (0, 20, 40-mg; t = 45 min) were administered. In each condition, subjective drug and mood effects, cardiovascular responses, and saliva cortisol and α-amylase levels were assessed to evaluate stress-reactivity, and participants completed a 12-trial choice progressive ratio task during which they could earn units of hydromorphone (1.5-mg intramuscular) and/or money ($2.00). Yohimbine dose-dependently increased blood pressure, α-amylase, and anxiety scores, and decreased opioid agonist symptoms; hydrocortisone dose-dependently increased cortisol levels. Yohimbine/hydrocortisone dose-combinations significantly shifted within-session responding from money to opioid-seeking among participants with lower basal cortisol levels. These findings replicate yohimbine effects on stress biomarkers and demonstrate that noradrenergic/glucocorticoid-potentiated opioid-seeking is modulated by basal cortisol level. In persons with OUD stabilized on buprenorphine, basal HPA-axis activity and acute stressors can enhance opioid relative reinforcing efficacy. These factors may limit OUD treatment efficacy and highlight the need for novel interventions that prevent stress-induced opioid-seeking.

Maternal childhood trauma, caregiving behavior, and child cognitive development in the context of drug addiction.

Exposure to childhood trauma confers intergenerational risk on child development. However, the mechanism linking a mother's childhood trauma with her child's cognitive development remains poorly understood. This study recruited 71 mother-child dyads affected by substance use disorder from local, community-based, outpatient substance use treatment programs. Maternal exposure to childhood trauma, caregiving behavior, and child cognitive development were assessed in each mother-child dyad. These were measured through a comprehensive biopsychosocial interview, an observed dyadic interaction coded using the Coding Interactive Behavior system, and the Bayley Scales of Infant and Toddler Development, Screening Test, respectively. We hypothesized that compromised caregiving behavior would mediate a negative relationship between maternal childhood trauma and child cognitive development. Analyses did not support this hypothesis. Specifically, maternal childhood trauma was not significantly associated with child cognitive development nor the four dimensions of maternal caregiving behavior. However, caregiving behavior (specifically maternal sensitivity and limit setting) was associated with child cognitive development, when controlling for maternal childhood trauma and child age. The lack of associations observed suggests that protective factors may buffer the intergenerational impact of childhood trauma. Furthermore, the relationship between quality of caregiving and child cognitive development highlights the importance of interventions which foster sensitive caregiving behaviors that may bolster child cognitive development in the context of maternal substance use disorder and maternal childhood trauma. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Loss to follow-up of patients after antiviral treatment as an additional barrier to HCV elimination

BackgroundEliminating hepatitis C virus (HCV) infections is a goal set by the World Health Organization. This has become possible with the introduction of highly effective and safe direct-acting antivirals (DAA) but limitations remain due to undiagnosed HCV infections and loss of patients from the cascade of care at various stages, including those lost to follow-up (LTFU) before the assessment of the effectiveness of the therapy. The aim of our study was to determine the extent of this loss and to establish the characteristics of patients experiencing it.MethodsPatients with chronic HCV infection from the Polish retrospective multicenter EpiTer-2 database who were treated with DAA therapies between 2015 and 2023 were included in the study.ResultsIn the study population of 18,968 patients, 106 had died by the end of the 12-week post-treatment follow-up period, and 509 patients did not report for evaluation of therapy effectiveness while alive and were considered LTFU. Among patients with available assessment of sustained virological response (SVR), the effectiveness of therapy was 97.5%. A significantly higher percentage of men (p<0.0001) and a lower median age (p=0.0001) were documented in LTFU compared to the group with available SVR assessment. In LTFU patients, comorbidities such as alcohol (p<0.0001) and drug addiction (p=0.0005), depression (p=0.0449) or other mental disorders (p<0.0001), and co-infection with human immunodeficiency virus (HIV) (p<0.0001) were significantly more common as compared to those with SVR assessment. They were also significantly more often infected with genotype (GT) 3, less likely to be treatment-experienced and more likely to discontinue DAA therapy.ConclusionsIn a real-world population of nearly 19,000 HCV-infected patients, we documented a 2.7% loss to follow-up rate. Independent predictors of this phenomenon were male gender, GT3 infection, HIV co-infection, alcohol addiction, mental illnesses, lack of prior antiviral treatment and discontinuation of DAA therapy.

Musical Mirroring of Social Predicaments in Aristotle “GLOC-9” Pollisco Song Compositions through Stylistic Lens

This study was a stylistic analysis aimed at delineating the different social predicaments embedded in the ten (10) song compositions of GLOC-9. Particularly, it sought to: (1) identify the linguistic levels used in cascading the message and style of the songs along with semantics, lexicogrammar, phonology, and acoustic phonetics; (2) determine the stylistic devices under figures of speech used in the songs; (3) define the thematic levels presented in the songs along with the thematic concept and thematic statement; (4) specify the values or morals conveyed in the songs; and (5) discuss the social predicaments embedded in the songs. To further strategize the data gathering, the researchers used the Hallidayan Systemic-Functional Linguistic Theory in order to extract the different linguistic levels in the songs. Thus, the researchers found out that the social predicaments embedded in the song compositions that depicted social realities were: (1) social injustice; (2) violence; (3) prostitution; (4) drug addiction; (5) corruption; (6) gender discrimination; (7) killing; (8) poverty; and (9) brain drain mentality. Ergo, the results being demarcated in this study may help cultivate social awareness and provide positive implications in terms of transcending the minds of every Filipino, which is a crucial determinant in society and more especially in that of the nation.

The Effectiveness of Acceptance and Commitment Therapy Method on the Life Expectancy of Patients with Various Diseases in Iran: A Literature Review Study

Context: Acceptance and commitment therapy (ACT) is a cognitive-behavioral psychotherapy method focusing on acceptance and commitment to life values. Objectives: This study aimed to evaluate the effectiveness of the ACT method on the life expectancy (LE) of patients with different diseases. Evidence Acquisition: The present study is a literature review that collects findings from past related studies in the last two decades. For this purpose, the essential and common Medical Subject Headings (MeSH) terms were first identified. Then, the desired MeSH terms were searched in the most reliable and essential international databases, including Google Scholar, Scopus, PubMed, Web of Science, and national databases, including Magiran, SID, Iran doc, etc. First, 265 articles were identified, and then 18 were selected as final studies considering the inclusion and exclusion criteria. Results: The findings of 18 studies were extracted for the present study. Some different types of patients, including those with rheumatoid arthritis, depression, multiple sclerosis, asthma, diabetes, liver transplants, chronic pain, cancer, physical-motor disabilities, drug addiction, and others, were shown to increase LE through the use of the ACT method. The main finding of the present study was that using the ACT method to increase LE in patients with various diseases has a significant effect, which was clearly highlighted in all the selected studies. Conclusions: Based on the findings, ACT is an effective and high-efficiency method in increasing patients' LE. Acceptance and commitment therapy can improve LE, resilience, quality of life, compliance with treatment, and other patient benefits, thus improving the speed of recovery for patients. Therefore, the ACT method, which is a non-pharmacological method, can be used by specialists and clinical psychology experts for different patients.

Preclinical evaluation of abuse potential of the peripherally-restricted kappa opioid receptor agonist HSK21542

HSK21542 is a peripherally-restricted kappa opioid receptor (KOR) agonist developed for pain treatment. Because of the CNS pharmacological concern of opioid receptor activation, such as physical dependence and addiction potential, an assessment of abuse potential of HSK21542 was required prior to marketing approval. The preclinical abuse potential assessments for HSK21542 included the following studies: 1) intravenous self-administration study to explore the relative reinforcing efficacy in rats self-administering remifentanil; 2) rat drug discrimination study to examine the pharmacological similarity of the interoceptive or subjective effects of HSK21542 in rats discriminating pentazocine; 3) rat conditioned place preference (CPP) paradigm to test the rewarding effects; 4) rat natural physical dependence-spontaneous withdrawal study in rats chronically treated with HSK21542; 5) naloxone-precipitated withdrawal assay following chronic HSK21542 exposure to evaluate its physical dependence potential. The results showed that HSK21542 was devoid of behavioral evidence of positive reinforcing effect and did not share similar discriminative stimulus effects with pentazocine. HSK21542 also did not produce CPP in rats. In addition, HSK21542 did not produce spontaneous withdrawal or naloxone-precipitated withdrawal in rats with chronic treatments. Collectively, these preclinical findings suggest that HSK21542 has no abuse potential in animals, which demonstrate low abuse potential in humans.

Research on Online Games and Social Interaction

This paper delves into the central position of online games in contemporary society and their close relationship with social interaction. With the popularity of the Internet, online games have become one of the most important ways of leisure and social communication. The study outlines the development of MMOs, from their origins to their diverse classifications, and in particular how their unique social characteristics facilitate interactions between players. Through theoretical analysis combined with social exchange theory and symbolic interaction theory, this paper reveals the mechanisms of social interactions in MMOs, including inter-player exchanges, cooperation and competition, and explores how these interactions profoundly affect players' gaming experience and behavioural decisions. Further, this paper analyses the trend of convergence between online games and social networks, and how this convergence enhances the social attributes and player engagement of games. At the same time, the paper also focuses on the social problems that online games may bring, such as Internet addiction and social disorders, cyberbullying, etc., and looks forward to the impact of technological advances on future social interaction patterns. Finally, the paper summarises the potential and challenges faced by online games in promoting healthy social interactions, and puts forward suggestions for future research with a view to promoting the healthy development of the field of online games and social interactions.

The Role of Fathers' Involvement in Parenting and Adolescent Social Harms: A Narrative Review

Background: In today's society, the issue of fatherhood and involvement in the upbringing of children has been emphasized. The study aimed to investigate the impact of fathers' involvement in parenting on the social victimization of adolescents. Methods: The present research utilized a narrative review methodology, with technical terms being explained at the beginning. Relevant sources were identified by conducting searches on reputable academic databases, including ISI Web of Knowledge, PubMed, Google Scholar, ProQuest, Ovid, Elsevier, SID, and Magiran, covering the period from 2000 to 2023. The search keywords encompassed various related themes, such as fatherhood, absent fathers, childrearing, adolescents, father involvement, engagement, social problems, and Boolean operators (AND, OR, NOT). Compilation procedures were conducted according to the SANRA checklist. In the initial search, 162 articles were obtained. After removing duplicates and evaluating their titles and abstracts, 9 articles were selected for the review. Results: Based on the findings of this literature review, paternal involvement in child-rearing is shown to positively affect the intellectual, moral, and social development of adolescents. Conversely, the absence of a father figure has been linked to negative outcomes such as drug addiction, decreased academic performance in both school and university, anti-social attitudes, separation anxiety, aggression, feelings of insecurity, and negative thoughts in teenagers. Conclusion: The involvement of fathers in upbringing of their children fosters critical thinking and reinforces children's empowerment in making pivotal decisions, while simultaneously acting as a safeguard against social risks.

Delay discounting of rewards and losses, alcohol use, and the influence of socioeconomic factors: A cross-sectional online study in frequent drinkers.

Delay discounting describes the devaluation of future outcomes over time and is a popular behavioral construct in addiction research. Prior studies show modest yet consistent associations between problematic alcohol use and delayed reward discounting (DRD). However, the potential confounding influence of socioeconomic status (SES, e.g., income and education) is rarely addressed. In this study, we aimed to investigate the robustness of DRD as a predictor of alcohol use after controlling for socioeconomic and demographic variables. Additionally, we aimed to test the association between delayed loss discounting (DLD) and alcohol use in a sufficiently large sample. We collected data from 341 moderate-to-heavy-drinking participants (27.92 ± 21.12 g alcohol/day, 43.48 ± 11.90 years old, 49.9% female, UK residents) in a cross-sectional online study. DRD and DLD were measured using an intertemporal choice task. Questionnaires encompassed alcohol use (AUDIT, weekly alcohol consumption), education and income, subjective measures of past and present socioeconomic status, and impulsivity. DRD, but not DLD, was significantly associated with AUDIT scores (r = 0.15) and weekly alcohol consumption (r = 0.12). DRD remained a significant yet weak predictor of AUDIT scores when controlling for education and income, but not when controlling for education and age. We replicated a small but robust association between alcohol use and DRD, but not DLD. This association appeared to be confounded by education and age, but not by income. We conclude that socioeconomic and demographic variables should systematically be accounted for in future studies investigating DRD and alcohol use.

Development and Validation of the Emergency Medical Technicians Occupational Stress Scale

Introduction. The population of interested workers for this study included Emergency Medical Technicians (EMTs) in the United States. This group of workers was chosen because of the nature of their work, which requires their presence at the scenes of life and death situations. Certainly, their work conditions can have an effect on their psychological well-being. Yet, the work of these workers, with all of its stressors, has not been adequately studied through the use of appropriate measuring instruments. Emergency Medical Technicians are not unknown in occupational stress research. This report discusses previous studies on EMT workers and occupational stressors and explains the curative process through the development and validation of an EMT Occupational Stress Scale. The report also highlights the psychometric investigation of this scale. Paramedics/EMTs face increased risk of physical and psychological stress due to the nature of their work. It is crucial to understand the stressors affecting their well-being in order to develop appropriate management strategies. Research suggests that EMTs may lack preparation for their roles, requiring additional training in empathy and emotional intelligence. The relationship between stressors experienced and clinical service provided needs further investigation. Standardized measures of stress for paramedics/EMTs are lacking and more comprehensive instruments are needed. This report aims to develop a comprehensive stress scale specifically for EMTs/paramedics, addressing validation concerns and incorporating environmental stress within a larger theoretical framework. Methods. This study was This study was conducted using a mixed-methods approach to develop and validate the Emergency Medical Technicians Occupational Stress Scale. The scale was pilot tested with a sample of EMTs to ensure reliability and validity. by the ethics committee and is based on a literature review. The Canadian EMT Job Satisfaction Questionnaire was used to measure organizational stress levels of EMTs. The questionnaire was reviewed by professionals and academics, resulting in the inclusion of five new items. The final item list consisted of 58 questions. Permission was obtained. Results. The outcomes and findings obtained from the comprehensive study conducted on the Development and Validation of the Emergency Medical Technicians Occupational Stress Scale have shed light on significant discoveries pertaining to the intricate realm of stress levels experienced by our dedicated EMT professionals. Conclusion. The rapidly evolving scope of Emergency Medical Services (EMS) practice has placed increasing demands on the relatively small professional community that consists of EMTs and paramedics. An Occupational Stress model was developed to examine interpersonal work stressors unique to the EMT role, and a measure was developed to assess the construct. Initial results suggest that the OSM is an accurate, reliable, and potentially valuable assessment tool. High levels of interpersonal stress may influence the EMTs to cope with their daily activities by seeking outlets for tension and depression through increased use of alcohol, legal drugs, and caffeine. Alcohol is used more frequently than other legal drugs are to modify interpersonal stress symptoms. The EMTs are in a prime position to help each other identify these symptoms when arising and offer assistance. Staff stress management programs are essential in solving and preventing occupational stress. A move toward prevention rather than reaction to such stress, which for many results in alcoholism, drug addiction, or job related emotional illness, will serve to preserve the health of the EMTs. The medical community has a vested interest in the health of these dedicated professionals. Not only does such prevention attempt to manage the human tragedy of alcoholism, legal drug addiction, and job related emotional illness, but it also prevents the more tangible, but no less important cost factors to the EMT.

Morphine-induced hyperalgesia impacts small extracellular vesicle miRNA composition and function.

Morphine and other synthetic opioids are widely prescribed to treat pain. Prolonged morphine exposure can paradoxically enhance pain sensitivity in humans and nociceptive behavior in rodents. To better understand the molecular mechanisms underlying opioid-induced hyperalgesia, we investigated changes in miRNA composition of small extracellular vesicles (sEVs) from the serum of mice after a morphine treatment paradigm that induces hyperalgesia. We observed significant differential expression of 18 miRNAs in sEVs from morphine-treated mice of both sexes compared to controls. Several of these miRNAs were bioinformatically predicted to regulate cyclic AMP response element binding protein (CREB), a well-characterized transcription factor implicated in pain and drug addiction. We confirmed the binding and repression of Creb mRNA by miR-155 and miR-10a. We tested if serum-derived sEVs from morphine-treated mice could elicit nociceptive behavior in naïve recipient mice. Intrathecal injection of 1 μg sEVs did not significantly impact basal mechanical and thermal threshold in naïve recipient mice. However, prophylactic 1 μg sEV administration in recipient mice resulted in faster resolution of complete Freund's adjuvant-induced mechanical and thermal inflammatory hypersensitivity. Other behaviors assayed following administration of these sEVs were not impacted including sEV conditioned place preference and locomotor sensitization. These results indicate that morphine regulation of serum sEV composition can contribute to analgesia and suggest a potential for sEVs to be a non-opioid therapeutic intervention strategy to treat pain.