Alcohol Rehabilitation Research Articles

Mindfulness-based relapse prevention targeting psychological craving and trait mindfulness in young Chinese women with methamphetamine dependence: a randomized controlled trial.

We recruited 58 MA-dependent young adult females from a compulsory isolation drug rehabilitation center in Sichuan Province and randomly divided them into an MBRP group (n = 29) and a control group (n = 29) according to their degree of psychological craving. The MBRP group received 2 hours of MBRP training twice a week for 4 weeks, alongside routine treatment at the drug rehabilitation center. Meanwhile, the control group solely received routine treatment at the drug rehabilitation center without any additional interventions. The assessment was conducted before and immediately after the intervention, with the Compulsive Drug Use Scale (OCDUS) used to assess craving and the Five-Factor Mindfulness Scale (FFMQ) used to assess trait mindfulness. Also, a "mental feedback monitoring balance" instrument was used to assess concentration and relaxation during some training sessions. This randomized trial was conducted to evaluate the effectiveness of decreasing psychological craving and increasing trait mindfulness. At baseline, there were no significant differences in total or dimension scores for FFMQ or OCDUS between the two groups (all P > 0.05). After the intervention, the repeated measures ANOVA showed a significant time main effect on changes in observing, non-judging, and non-reacting scores (all P < 0.05), and a significant interaction effect between time and group on both FFMQ total score and OCDUS score (P < 0.01 or P < 0.05). Mental feedback monitoring indicated significant improvement in concentration and relaxation after breath meditation exercises (P < 0.05 or P < 0.001). Additionally, the MBRP group showed improved relaxation during the body scan exercise (P < 0.01). MBRP training can improve the trait mindfulness of MA addicts and reduce psychological cravings effectively.

Effect of Severity of Depression and Perceived Social Support on Suicidal Ideation among Patients Hospitalized with Substance Use Disorder

Objective: The aim of this study was to investigate the effects of perceived social support and depression on suicidal ideation in inpatients receiving substance abuse disorder treatment.&#x0D; Method: A total of 110 inpatients in an Alcohol and Drug Treatment Center were included in the study. A sociodemographic and clinical information form, Beck Depression Inventory, Suicidal Ideation Scale, and Multidimensional Perceived Social Support Scale were administered to all patients.&#x0D; Results: No significant correlation was identified between total social support score and suicidal ideation, whereas a weak negative but statistically significant correlation was found between social support from family and suicidal ideation scores (r=-0.231; p=0.016). The mean value of suicidal ideation was 2.22 in the non-depressed groupand 10.13 in the severely depressed group. We also found thatpatients whowere exempted from military service and those who had attempted suicide before had statistically significantly higher scores on the suicidal ideation scale.&#x0D; Conclusion: In patients diagnosed with substance use disorder, various factors may increase the risk of suicidal behavior. In particular, patients with insufficient social support, depressive symptoms, unable to carry out their military service and those who have attempted suicide before should be closely followed for suicidal ideation.

Impaction-Based Exhaled Breath Sampling for Substance Monitoring: A Prospective Pilot Study (DrugXhale).

For decades, intake monitoring of drugs using urine as the matrix of choice is the gold standard in drug treatment centers. A properly conducted urine drug test can identify recent use of prescribed, non-prescribed and illicit drugs. However, issues like adulteration, substitution and privacy issues have driven the search for alternative matrices. This prospective pilot study evaluates the use of an impaction-based breath sampling device, Breath Explor®, as an alternative to traditional urine-based drug monitoring. Breath samples were analyzed using a validated 32-component liquid chromatography-tandem mass spectrometry (LC-MSMS) method. Recovery data represent the efficiency of extracting the analytes from the breath devices. Both automated and manual processing of the Breath Explor® devices showed mean recovery rates ranging from 39.5% to 55.4% for the 32 analytes. Despite the small number of subjects, breath analysis proved to be a convenient and easy-to-use methodology. An overall kappa-values of 0.5 indicated a moderate level of agreement with urine analysis, underscoring its potential as a complementary diagnostic tool. All participants tested positive in their breath sample for methadone (70% methadone and 100% EDDP), while a significant portion (90%) tested positive for 6-monoacetylmorphine (6-MAM). This innovative approach offers several advantages, including non-invasiveness, reduced risk of adulteration, and the ability to perfom repeated automated sampling and confirmation testing. These findings suggest that breath-based substance monitoring could complement or even replace traditional urine-based methods in clinical practice.

Psychosocial well-being needs of alcohol/drug sufferers and therapeutic architectural solutions in rehabilitation centre, Nigeria: a cross-sectional study

Background In a rehabilitation centre designed for drug and alcohol recovery, the therapeutic environment may enhance the psychosocial well-being of sufferers and facilitate a speedy recovery. This study aims to investigate the psychosocial well-being needs (PWNs) of users in an alcohol and drug rehabilitation centre (ADRC) and how therapeutic architectural solutions (TASs) can promote a healing environment through design. Methods The study employed a mixed research method (qualitative and quantitative). The research strategy was a case study of four rehabilitation centres in Nigeria’s busiest cities; Lagos, Abuja, Port Harcourt, and Enugu. Data were collected via survey questionnaires, an in-depth interview guide, an observation guide, and a checklist of TACs in a healthcare facility. We first investigated what the PWNs of alcohol and drug sufferers (ADSs) are, then identified the therapeutic architectural components (TACs) of an ADRC, before determining what effect TACs have on the recovery process of substance abuse patients. Results The findings identify eight PWNs and nine TACs essential in an ADRC. The result indicates that TACs have a significant effect on the recovery process of ADSs. However, based on the study results, a framework (framework here refers to using an intelligent and sensitive conceptual design structure as a standard guide for the building archetype rehabilitation facility, which supports mental health service delivery) may be recommended for rehabilitation facilities with TASs for Substance Abuse Disorder (SUD). Conclusion The study result presents a correlation between ADSs’ recovery rates and a well-designed therapeutic environment. So, there is a need for evidence-based design (EBD) of rehabilitation centres with full compliments of a therapeutic architectural environment and integration of mental health services into routine care in sub-Saharan Africa. Limitations include that analyses were cross-sectional and thus may not deduce causal directions, and the authors based the result on self-report.

Diversion or death? The moral framework shaping bifurcated punishments for drug offences in Indonesia

Background As the UN urges states to move from harsh punishments for drug offences towards treatment programmes, Indonesia has adopted a bifurcated penal policy. Most of those convicted are sentenced to imprisonment or death, but some ‘minor’ offenders are diverted to drug treatment centres. We explore the moralities that shape drug policy, justice professionals’ interpretation and application of laws and policies, and judgements about who is deserving of diversion. Methods We draw on experiences and perceptions of 136 Indonesian criminal justice professionals, through in-depth qualitative interviewing and focus groups, to reveal the moral landscapes shaping policy and practice. Results Justice narratives blur penal concerns with moral judgments about drug offending, with normative responses shaping punishments in law and practice. While there is some compassion for ‘minor’ drug offenders, driving rationales for diversion, drug traffickers are regarded as morally deserving of prison and capital punishment, with traditionalist perceptions of harm amplified by a purgative rationale. Conclusion This article highlights the analytical potential of moralities such as ‘compassion’ and ‘traditionalism’ in criminal justice research and policy in Southeast Asia. Understanding the formation and navigation of these normative values may assist in challenging harsh penal policy in Indonesia and the wider region.

Pilot model of hepatitis C virus micro-elimination in high-risk populations in Hong Kong: Barriers and facilitators

BackgroundAlthough the general seroprevalence of hepatitis C virus (HCV) infection in Hong Kong is <0.5 %, Hong Kong is still striving for HCV elimination owing to barriers in care cascade encompassing linkage-to-care (LTC), treatment initiation and adherence. We aimed to evaluate the feasibility of a pilot model of micro-elimination to strengthen the HCV care cascade for high-risk groups in Hong Kong. MethodsWe initiated the pilot Conquering Hepatitis vIa Micro-Elimination (CHIME) program which adopts an integrated care approach involving outreach visits to halfway house or drug rehabilitation centers run by non-governmental organizations. Participants with history of injection drug use (PWID), recreational drug use, or imprisonment were included. We performed point-of-care test for anti-HCV with reflex HCV RNA testing. LTC with government-subsidized direct acting antiviral was provided to viremic participants. We compared the impact on the care cascade with a cohort of HCV patients (17.8 % PWID) under usual care. Results396 participants (62.9 % PWID) were screened and 187 (47.2 %) were viremic, of which 29.8 % had cirrhosis. Proportion with LTC, treatment initiation and adherence were 76.5 % and 63.7 %, 90.9 % and 85.8 %, and 90.0 % and 92.2 %, for the CHIME program and usual care, respectively. The CHIME program was significantly associated with higher odds of LTC (OR 1.797, 95 % CI 1.221–2.644). Non-engagement in care (affecting 37.9 % participants with HCV viremia) was associated with unemployment (OR 2.165, 95 % CI 1.118–4.190). ConclusionThe pilot CHIME program demonstrated feasibility of an integrated approach to consolidate the HCV care cascade in high-risk populations in Hong Kong.

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

Serological and molecular survey of rat hepatitis E virus (Rocahepevirus ratti) in drug users

ABSTRACT Rat hepatitis E virus (ratHEV) is an emerging cause of acute hepatitis of zoonotic origin. Since seroprevalence studies are scarce, at-risk groups are almost unknown. Because blood-borne infections frequently occur in people with drug use, who are particularly vulnerable to infection due to lack of housing and homelessness, this population constitutes a priority in which ratHEV infection should be evaluated. Therefore, the aim of this study was to evaluate the ratHEV seroprevalence and RNA detection rate in drug users as a potential at-risk population. We designed a retrospective study involving individuals that attended drug rehabilitation centres. Exposure to ratHEV was assessed by specific antibody detection using ELISA and dot blot (DB) assay and the presence of active infection by ratHEV RNA detection using RT-qPCR. Three-hundred and forty-one individuals were included, the most of them being men (67.7%) with an average age of 45 years. A total of 17 individuals showed specific IgG antibodies against ratHEV (4.6%; 95% CI; 3.1%–7.9%). One case of active ratHEV infection was identified (0.3%; 95% CI: 0.1%–1.8%). This was a 57-year-old homeless woman with limited financial resources, who had active cocaine and heroin use via parenteral route. In conclusion, we identified a potential exposure to ratHEV among drug users. Targeted studies in drug users with proper control groups are necessary to evaluate high-risk populations and transmission routes more accurately.

The Dark Triad and aggression among drug abstainers: a moderated mediation model of self-control and physical exercise

BackgroundDrug addiction is a significant public health concern, and aggression is common among people with drug addiction. Despite mounting evidence showing that the Dark Triad is a risk factor for aggression, the mediating and moderating mechanisms underlying this relationship are less known. This study tested the mediation effect of self-control in the association between the Dark Triad and aggression and whether this mediation was moderated by physical exercise.MethodsA cross-sectional study was conducted in two compulsory drug rehabilitation centers in Nanning, China. A convenience sample of 564 drug abstainers completed a questionnaire to assess their Dark Triad, self-control, aggression, and physical exercise levels. Mediation and moderation analyses were carried out in SPSS macro-PROCESS.ResultsSelf-control partially mediated the positive association between the Dark Triad and aggression. Physical exercise moderated the indirect effect of the Dark Triad on aggression via self-control, with the effect decreasing with the increase in physical exercise levels.ConclusionsThis study offers fresh insights into the underlying mediating and moderating mechanisms between the Dark Triad and aggression. The findings provide important practical implications for future intervention and prevention programs to address aggression among drug abstainers, which may be realized through strengthening self-control and physical exercise.

Sensitivity and specificity of Aboriginal-developed items to supplement the adapted PHQ-9 screening measure for depression: results from the Getting it Right study.

To determine the psychometric properties of an Aboriginal and Torres Strait Islander-developed depressive symptom screening scale. Prospective diagnostic accuracy study. Ten primary health care services or residential alcohol and other drug rehabilitation services in Australia that predominantly serve Aboriginal and Torres Strait Islander peoples. 500 adults (18 years or older) who identified as Aboriginal and/or Torres Strait Islander and were able to communicate sufficiently to respond to questionnaire and interview questions. Recruitment occurred between 25 March 2015 and 2 November 2016. Criterion validity of seven Aboriginal and Torres Strait Islander-developed items, using the adapted Patient Health Questionnaire 9 (aPHQ-9) and depression module of the Mini International Neuropsychiatric Interview (MINI) 6.0.0 as the criterion standards. The seven-item scale had good internal consistency (α=0.83) and correlated highly with the aPHQ-9 (ρ=0.76). All items were significantly associated with diagnosis of a current major depressive episode. Discriminant function and decision tree analysis identified three items forming a summed scale that classified 85% of participants correctly. These three items showed equivalent sensitivity and specificity to the aPHQ-9 when compared with the MINI-identified diagnosis of a current major depressive episode. Three items developed by and for Aboriginal and Torres Strait Islander people may provide effective, efficient and culturally appropriate screening for depression in Aboriginal and Torres Strait Islander health care contexts.

Exploring the interplay of abstinence self-efficacy, locus of control, and perceived social support in substance use disorder recovery

Introduction Substance use disorder (SUD) poses a significant public health challenge globally, with substantial impacts on physical and social well-being. This study investigates the interplay between abstinence self-efficacy (ASE), locus of control (LOC), perceived social support (PSS), and various socio-demographic and psychosocial factors among individuals undergoing SUD rehabilitation. Methods Researchers obtained permission from drug rehabilitation centers in Assam, India, and conducted orientation programs for prospective participants. A total of 144 participants, aged 18–65 years, predominantly from rural areas participated in the study. Data was collected through one-to-one interviews, covering socio-demographic history, drug abuse, and administering scales for ASE, LOC and PSS. Collected data underwent digitization and subsequent descriptive and inferential statistical analyses. Results Significant associations were found between ASE and socio-demographic variables, family dynamics, and drug use history, highlighting the importance of considering these factors in SUD rehabilitation. Disturbed family relationships were linked to diminished ASE and higher risk of relapse, emphasizing the role of family support in recovery. Additionally, a negative correlation was observed between ASE and LOC, suggesting that individuals with higher ASE tend to have a more internal locus of control, which positively influences recovery outcomes. Moreover, positive correlations were found between ASE and PSS, particularly from family members, underscoring the importance of social support in fostering recovery. Regression analysis further elucidated the relationships between ASE, LOC, and PSS, emphasizing the predictive value of LOC and the impact of family support on ASE. Conclusion Findings of this study have several implications for developing targeted interventions aimed at strengthening ASE, promoting internal locus of control, and enhancing social support systems.

Alcohol Rehabilitation Within 3 Months After Alcohol Hepatitis and Survival - A National Analysis

Background and aimsThere is limited understanding of the benefits of alcohol rehabilitation after alcohol hepatitis (AH). MethodsWe conducted a 2012-2021 national longitudinal study involving adult inpatients diagnosed with AH in France. We assessed the primary outcome of liver transplantation or death within one year after AH, including in its complicated form (CAH) defined as ≥ 2 hepatic or extrahepatic complications within 4 weeks after AH. The primary exposure was in-hospital alcohol rehabilitation within 3 months following AH. Patients who died (6.5%, n=5,282) or were censored (12.5%, n=10,180) ≤ 4 weeks after AH were excluded. We measured adjusted hazard ratios (aHR) and odds ratios (aOR) within the full cohort and propensity-matched samples. ResultsAmong 65,737 patients (median age 52; IQR 44–60; 76% male), 12% died or underwent liver transplantation. In-hospital alcohol rehabilitation was noted for 25% of patients (15.2% among CAH patients) and was the primary discharge diagnosis for 13.3%. The one-year transplant-free survival rates were 94% (95% CI: 94% to 95%) for rehabilitated patients, compared to 85% (85% to 86%) for those without [aHR 0.62 (0.57 to 0.69) p < 0.001]. Among CAH patients, transplant-free survival was 78% (76% to 81%) with rehabilitation versus 70% (69% to 71%) without [aHR 0.82 (0.68 to 0.98) p = 0.025]. In propensity-matched samples, rehabilitation was linked to an aOR of 0.54 (0.49 to 0.55, p < 0.001) overall, and 0.73 (0.60 to 0.89, p = 0.002) among matched CAH patients. ConclusionsIn-hospital alcohol rehabilitation within 3-months after AH and CAH improve transplant-free survival rate but remain underutilized. FundingNo external funding

Penal-welfare systems in a (post)colonial world: The rise and disregard of alcohol and drug rehabilitation centers in South Africa

Apartheid South Africa developed a notoriously punitive and racist approach to alcohol and drug use. Less reported is that the state gave significant attention to rehabilitation, first for the minority white population and later for black South Africans. This paper asks why in the post-apartheid era—despite a huge influx of cheap heroin, methamphetamines, and other drugs—the government showed a relative disregard for rehabilitation. Addressing this question, the paper points to the configuration of forces driving public rehabilitation in the colonial era included the upliftment of “poor whites,” the need to maintain black workers’ productivity, and the ascendancy of the disease concept of addiction. In the post-1994 period these forces waned as a multiracial middle class came to purchase treatment in private rehabilitation facilities, the disease concept fell into retreat, and mass unemployment helped to position poor black drug users as an “undeserving poor.” The paper contributes to comparative studies on penal-welfare systems and the recent attention to drug histories from the global South.

Self-Reported Methamphetamine Use Versus Biological Testing Among Treatment-Seeking Patients

Background: The validity of self-reported methamphetamine use among treatment-seeking patients has been reported as inconsistent and therefore inconclusive. Objectives: To evaluate the validity of self-reported methamphetamine use versus urinalysis in patients with methamphetamine use disorder at a drug treatment center. Methods: In this cross-sectional study, we enrolled 71 individuals with methamphetamine use disorder who were referred to the Iranian National Center for Addiction Studies (INCAS) clinic. Self-reported methamphetamine use in the last 72 hours was compared to urinalysis, conducted using the immunoassay technique. Sensitivity, negative predictive value (NPV), Cohen's kappa statistics, percent agreement, and positive percent agreement were estimated. Results: Only 24.6% of participants reported methamphetamine use during treatment. Self-reported methamphetamine use had a sensitivity of 50.0% and a NPV of 86.0%. The percent agreement, positive percent agreement, and Cohen's kappa statistic between self-reported use and the urine test were 86.0%, 42.8%, and 52.4%, respectively. No significant factors were found to be associated with the agreement between self-reported use and the urine test. Conclusions: The validity of self-reported methamphetamine use appears to be relatively acceptable and can be used with caution for monitoring treatment.

Comparison of a novel expanded social network recruitment intervention with risk network recruitment to HIV testing: locating undiagnosed cases in South Africa.

To ascertain whether a novel expanded social network recruitment to HIV testing (E-SNRHT) intervention recruits men and individuals with previously undiagnosed HIV at higher rates than risk network recruitment. Initial "seed" participants were prospectively randomly assigned to the E-SNRHT intervention or to risk network recruitment. Their network members were included in the study arm of their recruiter. Three Department of Health clinics and two drug treatment centers (DTCs) in the Msunduzi municipality of KwaZulu-Natal, South Africa. Clinics and DTCs referred 110 newly HIV-diagnosed adult "seeds" to the study from June 2022 to February 2023. E-SNRHT seeds were asked to recruit network members as described below; risk network recruitment arm seeds were asked to recruit recent sex and/or injection partners. Presenting a recruitment coupon (from clinic/DTC staff or another participant) was required for eligibility. E-SNRHT seeds were shown educational material about HIV transmission risks and then asked to recruit anyone they know (e.g., friends, family) whom they thought could benefit from HIV testing. Rates of recruiting men to HIV testing and locating individuals with previously undiagnosed HIV. E-SNRHT recruited significantly higher proportions of men to HIV testing (70.3 vs. 40.4%; χ2 = 16.33; P < 0.0005) and located significantly more previously undiagnosed cases of HIV per seed than risk network recruitment (rate ratio = 9.40; P < 0.0001). E-SNRHT also recruited significantly higher proportions of women with previously undiagnosed HIV (29.0 vs. 10.7%; χ2 = 3.87; P = 0.049). E-SNRHT is an important strategy to expand the reach of HIV testing among men and undiagnosed cases of HIV in KwaZulu-Natal.

Eysenck's Personality Questionnaire Scores of Heroin Addicts in Pakistan.

Objective The main objective of the study was to find Eysenck's Personality Questionnaire scores of heroin addicts in Pakistan and to compare the EPQ scores with demographic variables such as age, gender, and duration of addiction. Methodology of the study This cross-sectional study was conducted in Islamabad, Pakistan. Data was collected from 300 participants. The participants were recruited from various drug rehabilitation centers and clinics across Pakistan. Patients diagnosed with heroin addiction by a qualified medical professional and currently undergoing treatment or rehabilitation for heroin addiction were included in the study. Data was collected through a purposive sampling technique. Results Data was collected from 300 participants, including both males and females. The age range included subjects from 18 years to 60 years. Heroin addicts in Pakistan have a mean extraversion score of 12.4 (SD=4.8), with scores ranging from 5 to 20, indicating average levels of sociability. Neuroticism had a mean score of 17.6 (SD=5.2), with a range from 7 to 25, suggesting high emotional instability and anxiety. Psychoticism had a mean score of 8.3 (SD=3.9), with scores between 2 and 15, indicating moderate levels of aggressive and antisocial behavior. Conclusion It is concluded that heroin addicts in Pakistan exhibit high levels of neuroticism, moderate levels of extraversion, and psychoticism. Younger addicts and those with a shorter duration of addiction display higher levels of these traits, indicating a need for personalized and targeted intervention strategies.

The influence of trauma history on opiate use disorder in an urban treatment facility in Pennsylvania

BackgroundOpioid use disorder is one of the most severe forms of substance use disorder and is associated with high morbidity and mortality. Opiate overdose deaths in the US are increasing every year, claiming over 100,000 lives in 2022. Psychological trauma exposure and post-traumatic stress disorder are major health problems in the United States and may contribute to the development of an opiate use disorder. The purpose of this study was to examine the association of psychological trauma exposure and post-traumatic stress disorder with opiate use disorder. MethodsThis study used a retrospective design with a convenience sample size of n = 150 participants diagnosed with opiate use disorder or substance use disorder from a drug treatment center in urban Pennsylvania. Retrospective data was collected on demographic characteristics, trauma exposures, diagnoses of post-traumatic stress disorder, opiate use disorder, and substance use disorder. Demographic data was gathered using a demographic survey, psychological trauma exposure was documented using the self-reported Life Events Checklist, and a diagnosis of post-traumatic stress disorder, opiate use disorder, and substance use disorder was confirmed as documented in the medical record by mental health providers. ResultsPersons with psychological trauma exposure >5 are more likely to develop opiate use disorder, Chi-Square (χ2 = 5.17, df = 1, p = 0.023). ConclusionOur study showed that psychological trauma exposure may lead to opiate use disorder, emphasizing the importance of identification of psychological trauma exposure and post-traumatic stress disorder diagnosis as part of trauma-informed strategies during the treatment of persons with opiate use disorder to help prevent disability and death.

Alcohol rehabilitation and cancer risk: a nationwide hospital cohort study in France

Even though alcohol consumption is an established risk factor for cancer, evidence regarding the effect of a reduction or cessation of alcohol consumption on cancer incidence is scarce. Our main study aim was to assess the effect of alcohol rehabilitation and abstinence on cancer incidence in people with alcohol dependence. We conducted a nationwide hospital retrospective cohort study which included all adults residing in mainland France and discharged in 2018-21. Multivariable Cox proportional hazards models were used to estimate the effect of rehabilitation treatment at hospital or a history of abstinence versus alcohol dependence without rehabilitation or abstinence on the risk for incident alcohol-associated cancers by sex, controlled for potential confounding risk factors. 10 260 056 men and 13 739 369 women were discharged from French hospitals in 2018-21. Alcohol dependence was identified in 645 720 (6·3%) men and 219 323 (1·6%) women. Alcohol dependence was strongly related to alcohol-associated cancer sites in both sexes (hepatocellular carcinoma and oral, pharyngeal, laryngeal, oesophageal, and colorectal cancers), except for breast cancer. Rehabilitation treatment or abstinence was associated with significantly lower risks compared with alcohol dependence without rehabilitation or abstinence (adjusted hazard ratios: 0·58, 99·89% CI 0·56-0·60 in men and 0·62, 0·57-0·66 in women). Relative risk reductions were significant for each alcohol-associated cancer site in both sexes and supported by all subgroup and sensitivity analyses. Our study results support the clear benefits of alcohol rehabilitation and abstinence in reducing the risk for alcohol-associated cancers. As only two in five patients with alcohol dependence were recorded with a history of rehabilitation treatment or abstinence, a large untapped potential exists for reducing cancer incidence. European Union's EU4Health programme.

Brain regulation training improves emotional competences in patients with alcohol use disorder.

Alcohol use disorder (AUD) is defined as the impaired ability to stop or control alcohol use despite adverse social, occupational, or health consequences and still represents one of the biggest challenges for society regarding health conditions, social consequences, and financial costs, including the high relapse rates after traditional alcohol rehabilitation treatment. Especially, the deficient emotional competence in AUD is said to play a key role in the development of AUD and hinders the interruption of substance compulsion, often leading to a viscous circle of relapse. Although the empirical evidence of a neurophysiological basis of AUD is solid and increases even further, clinical interventions based on neurophysiology are still rare for individuals with AUD. This randomized controlled trial investigates changes in emotional competences, alcohol-related cognitions, and drinking behavior before and after an established alcohol rehabilitation treatment (control group: nCG = 29) compared to before and after an optimized, add-on neurofeedback (NF) training (experimental group: nEG = 27). Improvements on the clinical-psychological level, i.e. increases in emotional competences as well as life satisfaction, were found after the experimental electroencephalography (EEG) NF training. Neurophysiological measurements via resting-state EEG indicate decreases in low beta frequency band, while alpha and theta bands remained unaffected.

A phase 3 randomised double-blind placebo-controlled trial of mirtazapine as a pharmacotherapy for methamphetamine use disorder: a study protocol for the Tina Trial

BackgroundThere are no approved pharmacotherapies for methamphetamine use disorder. Two preliminary phase 2 randomised controlled trials have found mirtazapine, a tetracyclic antidepressant, to be effective in reducing methamphetamine use. The proposed Tina Trial is the first phase 3 placebo-controlled randomised trial to examine the effectiveness and safety of mirtazapine as an outpatient pharmacotherapy for methamphetamine use disorder.MethodsThis is a multi-site phase 3 randomised, double-blind, placebo-controlled parallel trial. Participants are randomly allocated (1:1) to receive either mirtazapine (30 mg/day for 12 weeks) or matched placebo, delivered as a take-home medication. The target population is 340 people aged 18–65 years who have moderate to severe methamphetamine use disorder. The trial is being conducted through outpatient alcohol and other drug treatment clinics in Australia. The primary outcome is measured as self-reported days of methamphetamine use in the past 4 weeks at week 12. Secondary outcomes are methamphetamine-negative oral fluid samples, depressive symptoms, sleep quality, HIV risk behaviour and quality of life. Other outcomes include safety (adverse events), tolerability, and health service use. Medication adherence is being monitored using MEMS® Smart Caps fitted to medication bottles.DiscussionThis trial will provide information on the safety and effectiveness of mirtazapine as a pharmacotherapy for methamphetamine use disorder when delivered as an outpatient medication in routine clinical practice. If found to be safe and effective, this trial will support an application for methamphetamine use disorder to be included as a therapeutic indication for the prescription of mirtazapine.Trial registrationAustralian and New Zealand Clinical Trials Registry ACTRN12622000235707. Registered on February 9, 2022.