Problematic Substance Use Research Articles

One-year predictions of delayed reward discounting in the adolescent brain cognitive development study.

Delayed reward discounting (DRD) refers to the extent to which an individual devalues a reward based on a temporal delay and is known to be elevated in individuals with substance use disorders and many mental illnesses. DRD has been linked previously with both features of brain structure and function, as well as various behavioral, psychological, and life-history factors. However, there has been little work on the neurobiological and behavioral antecedents of DRD in childhood. This is an important question, as understanding the antecedents of DRD can provide signs of mechanisms in the development of psychopathology. The present study used baseline data from the Adolescent Brain Cognitive Development Study (N = 4,042) to build machine learning models to predict DRD at the first follow-up visit, 1 year later. In separate machine learning models, we tested elastic net regression, random forest regression, light gradient boosting regression, and support vector regression. In five-fold cross-validation on the training set, models using an array of questionnaire/task variables were able to predict DRD, with these findings generalizing to a held-out (i.e., "lockbox") test set of 20% of the sample. Key predictive variables were neuropsychological test performance at baseline, socioeconomic status, screen media activity, psychopathology, parenting, and personality. However, models using magnetic resonance imaging (MRI)-derived brain variables did not reliably predict DRD in either the cross-validation or held-out test set. These results suggest a combination of questionnaire/task variables as antecedents of excessive DRD in late childhood, which may presage the development of problematic substance use in adolescence. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Co-Occurrence of Gaming Disorder and Other Potentially Addictive Behaviours between Australia, New Zealand, and the United Kingdom

Background: Evidence suggests that gamers can have varying experiences of disordered gaming behaviours due to coping mechanisms and how they can act as risk or protective factor in the development and/or maintenance of disordered behaviours. A particular area of interest is how this may manifest across different countries. Understanding the interplay of these potential risk and protective factors within different countries will aid identifying and preventing disordered behaviours. Methods: Three cohorts were recruited from Australia, New Zealand, and the United Kingdom. Each cohort was required to complete a battery of psychometric scales exploring problematic behaviours, problematic substance use, co-occurrence, coping styles, and personality. A latent profile analysis was conducted to examine the differences between cohorts and further investigated with additional analyses. Results: The findings suggested that a minority of gamers were affected by gaming disorder, and there appeared an at-risk cohort who utilise gaming as a maladaptive coping strategy. Other accompanying potentially addictive behaviour or substance use may be exacerbated as a result, the manifestation of which can be influenced by cultural elements. Conclusions: When considering gamers from countries which hold similar views, it is important to be cognisant of the variations found in the manifestations of disordered gaming and accompanying potentially addictive behaviours. This will allow for a more precise identification of at-risk behaviours, which will result in more favourable treatment outcomes for those who are considered at-risk or high-risk individuals.

Real-time momentary mood as a predictor of college students' prescription drug misuse in daily life: Direct links and the moderating role of background mental health.

The present study addressed calls for research to identify real-time predictors of prescription drug misuse (Schepis et al., 2020) by testing young adults' momentary reports of their negative mood and positive mood as predictors of event-level misuse in daily life. We implemented a 28-day ecological momentary assessment (EMA) procedure that collected individuals' mood and other contextual experiences in moments preceding prescription drug misuse. Consistent with models of problematic substance use as a means to reduce negativity (Khantzian, 1997), results from hierarchical generalized linear modeling (HGLM) indicated within-person links between higher than usual negative mood and greater likelihood of prescription misuse in daily life. Contrary to the hypothesis, misuse was also more likely when preceded by elevated positive mood. We found consistent support for the hypothesized between-person effects, with prescription misuse in daily life associated with higher average levels of negative mood, and lower average levels of positive mood, across the reporting period. We further predicted that individuals reporting greater levels of social anxiety, depression, and externalizing symptoms would evidence stronger links between their momentary negative mood and prescription misuse. Partial support for this moderation hypothesis was found, with the positive within-person link between negative mood and prescription misuse significantly stronger among individuals higher (vs. lower) on social anxiety and depression. Results provide support for intricate connections between young adults' momentary mood, mental health symptoms, and prescription drug misuse. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

PROTOCOL: The effectiveness of psychosocial interventions for reducing problematic substance use, improving mental health, and improving housing stability for adults experiencing homelessness: A systematic review and meta-analysis.

This systematic review is part of a broader evidence synthesis which aims to produce two systematic reviews to address a significant gap in the evidence base identified by Luchenski et al. (2018) and by (White, 2018). The first review (which is the subject of this protocol) will use meta-analysis to examine the effectiveness of different psychosocial interventions in (1) reducing problematic substance use; (2) improving mental health; and (3) improving housing stability for adults experiencing homelessness. The second review (which is covered by a separate title registration and protocol) will be of the experiences of adults experiencing homelessness when accessing or using psychosocial interventions, and will be a qualitative evidence synthesis using thematic synthesis (Thomas & Harden, 2008).

The Adolescent Problem Gambling Prevalence Associated with Leisure-Time Activities and Risky Behaviors in Southern Spain

Gambling addiction is increasing and is becoming a public health concern due to the rise of gambling-related harms affecting the youth. Previous studies suggest a strong link between problem gambling (PG) and substance use and psychosocial and familial factors. Our main objective was to analyze the association between PG and factors like sport, leisure-time activities, and risk-taking behaviors in adolescents. A survey on substance use and addictive behaviors was performed in 2019 on a representative sample of 2240 subjects (14–18 years) from the Southern Spain Region. Data variables like socio-demographic characteristics, sport, leisure and free time activities, family environment, PG (Lie-Bet Scale), compulsive internet use (CIUS Scale), and consumption of alcohol and cannabis were collected using a standardized questionnaire. Weighted PG prevalence was estimated in either sex, as well as the differences between various levels of PG using chi-square tests. Crude and adjusted weighted logistic regression models were used to identify predictors associated with PG. The prevalence of PG was associated with shopping frequency, compulsive internet use, cannabis use in the previous month, higher family economic status, and having a homemaker father which increased the likelihood of PG. On the contrary, cultural hobbies such as playing an instrument, painting, singing, and writing, and having a working mother were inversely associated with PG. Our results suggest that encouraging participation in creative activities along with supervised shopping and monitoring compulsive internet use and cannabis consumption may contribute some protection against adolescent PG.

Associations of adolescent psychosocial factors to later benzodiazepine use: a population-based follow-up study of adolescent psychiatric inpatients in Northern Finland.

We investigated factors associated with benzodiazepine (BZD) use during late adolescence and early adulthood. The study population consisted of 508 adolescents admitted to psychiatric inpatient care between April 2001 and March 2006. Information on adolescents' family- and school-related factors, suicidality and psychiatric disorders were obtained by semistructured interviews. Data on BZD prescriptions from 1999 to 2012 were collected from the Social Insurance Institution of Finland. In males heavy BZD use associated with adolescent substance-use disorder (OR, 3.5; P < 0.004) and parents' psychiatric problems (OR, 3.5; P = 0.029). Among females, conduct disorder (OR, 3.3; P = 0.016), being a bully/bully-victim (OR, 3.3; P = 0.019) and parental substance-use problems (OR, 2.6; P = 0.024) were related to heavy BZD use. The mean (±SD) age of first BZD prescription was significantly lower in heavy, compared with mild users (men: 19.3 ± 2.5 vs. 21.0 ± 2.5 years, P = 0.027; women: 19.7 ± 2.6 vs. 21.5 ± 3.4 years, P = 0.027). Heavy, compared with mild, BZD use is associated with female suicide attempts (OR, 5.0; P = 0.049). Physicians should be cautious when prescribing BZDs to young adults and must allocate treatment to those with carefully evaluated clinical indications.

O060 The relationship between sleep and appetitive conditioning: A systematic review and meta-analysis

Abstract Appetitive conditioning involves learning to associate previously neutral stimuli with pleasant or rewarding cues. Elements of appetitive conditioning underpin various maladaptive consummatory behaviours, including regular consumption of unhealthy foods, recreational substance use, and clinical symptoms of certain mental disorders (e.g., binge-eating disorder, substance use disorder). One modifiable mechanism underlying appetitive conditioning appears to be sleep, due to its critical role in new learning. This systematic review and meta-analysis (PROSPERO registration: CRD42021234793) examined the relationship between sleep and appetitive conditioning. Inclusion criteria included: a) appetitive conditioning paradigm; b) measure of conditioning; c) sleep measurement and/or sleep loss; and d) written in English. Searches of seven databases returned 3343 publications as of March 2022. The final sample consisted of 40 studies using animal models. No human studies were identified. We found: a) sleep loss interfered with appetitive conditioning tasks involving natural reinforcers (i.e., food; p &amp;lt; 0.001); b) tasks involving drug reinforcers showed potentiating effects of sleep loss (p &amp;lt; 0.001); c) extinction learning was negatively impacted by sleep loss, irrespective of reinforcer; and d) post-learning sleep was associated with increases in REM sleep (p = 0.02). Findings suggest sleep loss potentiates the impact of psychoactive substances to produce an increased risk of problematic substance use. This indicates sleep may be an important target in treating substance use disorders. In obese/overweight populations sleep loss may be associated with deficits in the conditioning and extinction of reward behaviours. Further research is needed to assess the relationship between sleep and appetitive conditioning in humans.

Systematic review of the efficacy, effectiveness, and cost-effectiveness of stepped-care interventions for the prevention and treatment of problematic substance use

BackgroundStepped-care is a commonly recommended and implemented care model across health care domains, including substance use. Despite their presumed efficient allocation of treatment resources, a current and robust evidence synthesis is needed on the efficacy, effectiveness and cost-effectiveness of stepped-care for substance use. MethodsThis systematic review analyzed articles describing evaluations of stepped-care models that measured the use of acutely psychoactive substances (i.e., alcohol, cannabis, hallucinogens, inhalants, opioids, sedatives, hypnotics, anxiolytics, and stimulants) as a primary or secondary outcome, in participants over 18 years old. The analysis investigated model and participant characteristics associated with treatment outcomes. ResultsThe study team conducted a search of five databases of literature (PsychINFO, MEDLINE, Embase, Cochrane Library and Scopus) published between January 1, 2010, and November 1, 2020. The search yielded 1051 unique articles, 19 of which were included in the analysis. The studies had considerable variability in sample sizes (n = 18–2310), time to follow-up (4.5 months to 3 years), and retention rates (35.1–100 %). Studies examined outcomes for either alcohol alone (n = 9), alcohol and other drug use (n = 9), or drug use alone (n = 1). Most studies (n = 13;) were rated as good quality. Three (15.8 %) were rated as fair and three (15.8 %) were rated as poor quality. The evidence regarding the efficacy, effectiveness and cost-effectiveness of stepped-care approaches is limited, but four of seven studies found that adaptive-care interventions delivered in the context of other systemic interventions produced greater benefit than control conditions in relation to at least one alcohol-related outcome. We have insufficient evidence to determine whether the modes or intensity of interventions included in the models, or decision rules used to step people up or down to differing levels of care, have an impact on outcome. ConclusionHeterogeneity between studies with regard to model and evaluation design limited the degree to which the analysis could draw robust conclusions. Sample recruitment and statistical power are particular challenges, and the field needs more innovative evaluation designs to assess the efficacy, effectiveness, and cost-effectiveness of stepped-care models.

Investigating recovery from problem substance use using digital photovoice.

This study investigates the complex process of recovery from problem substance use using a visual research method known as 'Photovoice'. Seven service users from a harm reduction drug service were given digital cameras and asked to photograph 'people, places, and things' meaningful to them in their recovery. These photographs were then used as a catalyst for discussion during two in-depth interviews. This study demonstrates the nuanced experiences of recovery as some participants expressed feeling isolated while others reflected upon their access to various forms of social capital. These findings recognise the link between social capital and recovery outcomes, while also reflecting upon how services might imbed the need for relationship quality within artificial recovery networks. The use of photographs is a novel way of providing voice to the lived experience of service users and adds to the discussion and debate concerning how recovery services may develop.

Field still grapples with standard by which to evaluate harm reduction

It would be difficult today to look at the body of evidence and not acknowledge that the most widely used harm reduction strategies do exactly that: reduce harms associated with problematic substance use. The question that generates a much less confident response in the research and treatment communities involves whether embracing harm reduction will offer a clearer path to more lives free of dangerous drugs, representing a wiser investment of resources than alternatives, such as expanding treatment.

Longitudinal associations between adolescent out-of-school time and adult substance use.

Based on Bronfenbrenner's bioecological theory and Bornstein's specificity principle, the purpose of this study was to examine adolescents' time in out-of-school settings as a precursor of three types of problematic substance use in adulthood (i.e., binge drinking, regular marijuana use, and use of illicit drugs). Adolescents (N = 978) reported the time they spent in four common out-of-school settings at ages 15 and 18: unsupervised time with peers, organized sports, other organized activities, and paid employment. At age 26, participants reported binge drinking, marijuana use, and illicit drug use. Adolescents' time in out-of-school settings during high school predicted age 26 substance use over and above family and adolescent factors, including adolescents' substance use during high school. Adolescents' unsupervised time with peers increased the odds and frequency of binge drinking and regular marijuana use at age 26. Time in high school organized sports increased the odds of binge drinking at age 26, but not marijuana or illicit drug use. Time spent in other organized activities, such as community service and the arts, lowered the odds of illicit drug use whereas paid employment in high school was not related to age 26 substance use. Aligned with Bornstein's specificity principle, time spent in specific out-of-school settings during adolescence were differentially related to substance use problems in early adulthood, with some activities serving as a risk factor and other activities serving as a protective factor for young adults.

“Watch out for the boogieman”: stigma and substance use recovery among migrants and ethnic minorities

AbstractPeople with a migration background and ethnic minorities (MEM) with substance use problems are confronted with stigma due to their ethnicity and substance use. This study explores how living with multiple stigmatized identities impacts substance use recovery among MEM. We conducted 34 in‐depth interviews with a diverse sample of MEM with substance use problems in Flanders, Belgium. A Qualitative Content Analysis using Earnshaw's stigma framework revealed that their recovery processes are challenged by accumulated stigma based on different intersectional statuses, namely ethnicity, substance use, psychological problems, criminal histories, poverty, unemployment and gender. These stigmas can negatively influence their well‐being, increase problem substance use and act as a barrier to recovery capital. While stigma moderators, which determine how stigma unfolds within society, were spread across the micro‐to‐macro continuum (from personal to social, community and macro‐cultural features), mediators that influence the role of stigma in recovery were mainly psychosocial. Hence, prevention and intervention strategies should be aimed at reducing stigma on the macro, meso and micro level, while individuals and communities can limit the impact of public stigma on recovery through constructive personal and collective coping and action mechanisms.

Problem gambling severity, gambling behavior, substance use, and mental health in gamblers who do and do not use cannabis: Evidence from a Canadian national sample

IntroductionCannabis use frequently co-occurs with gambling, and evidence indicates that both acute and chronic cannabis use may influence gambling behavior. The primary aim of the present study was to further contribute to the literature on this relationship by examining data collected from a Canadian national study of gambling. MethodsRespondents consisted of 10,054 Canadian gamblers recruited from Leger Opinion’s (LEO) online panel. In this study, gamblers who used cannabis were compared with non-users across a number of gambling as well as demographic and mental health variables. ResultsOf the total sample, 25.4 % reported past 12-month cannabis use. Among the 2,553 cannabis-users, 21.3 % reported daily use, and 69.9 % reported using once a month or more. A total of 56.2 % indicated they had used cannabis while gambling in the past 12 months. Bivariate analysis found significant differences between cannabis use and non-use on numerous demographic, mental health, and gambling-related variables. Individuals with greater problem gambling severity scores, more hours gambling, and a larger range of gambling activities were more likely to endorse using cannabis. Hierarchical logistic regression revealed that tobacco use, and having experienced significant child abuse were predictors of cannabis use. Non-use of cannabis was associated with older age, less engagement in online gambling, and being less likely to consume alcohol. ConclusionThe present findings both corroborate previous studies and expand upon the relationship between cannabis and gambling.

Pain Management and Substance Use Disorders

The American Society for Pain Management Nursing and the International Nurses Society on Addictions hold the position that persons with co-occurring pain and substance use disorder have the right to be treated with dignity and respect, and receive evidence-based, high-quality assessment and management for both conditions using an integrated, holistic, multidimensional approach. Non-opioid and nonpharmacological approaches to pain management are recommended. Opioids should not be withheld from anyone if necessary to treat pain, and a team-based approach, including pain and addiction specialists, should be utilized when possible. Pain management should include interventions aimed at minimizing the risk for relapse or escalation of problematic substance use, and actively involve the person and their support persons in the plan of care. Institutions should establish policies and procedures that support this position statement.

The effects of loneliness and psychological flexibility on veterans’ substance use and physical and mental health functioning during the COVID-19 pandemic

During the COVID-19 pandemic, social isolation was a common experience as people were trying to keep themselves and others safe from infection. Veterans with problematic substance use are at particular risk of the consequences of social isolation. This study evaluated the nature of social interactions during the COVID-19 pandemic and the effects of loneliness and psychological flexibility on self-reported substance use and physical and mental health functioning among U.S. veterans who reported problematic substance use. Data from 409 veterans with self-reported substance use concerns were obtained via a cross-sectional online survey. Results showed that many veterans who engaged in problematic substance use during the COVID-19 pandemic reported a number of social supports during this period and frequent communication with others, but still felt lonelier during the pandemic. In regression analyses, higher levels of loneliness were associated with more negative impacts of the pandemic, greater substance use, and poorer physical and mental health functioning. Psychological flexibility demonstrated significant unique variance in explaining mental health functioning during the pandemic after accounting for loneliness, but not for substance use or physical functioning. For veterans with high levels of loneliness, high levels of psychological flexibility were associated with a lower negative impact on quality of life due to the pandemic, but for veterans with low levels of loneliness, differing levels of psychological flexibility were not significantly associated with the negative impact of COVID-19. Overall, loneliness and psychological flexibility appear to be highly associated with the negative impact of COVID-19 on veterans with problematic substance use.

Construct validity of DSM-5 cannabis use disorder diagnosis and severity levels in adults with problematic substance use

The DSM-5 definition of cannabis use disorder (CUD) differs from DSM-IV by combining abuse and dependence criteria (without the legal criterion) and including withdrawal and craving criteria. Information on construct validity of the DSM-5 CUD diagnosis and severity levels is lacking. This study examines the associations between DSM-5 CUD and severity classification and a set of concurrent validators. Adults with problematic substance use were recruited from two settings: a research setting in an urban medical center and a suburban inpatient addiction treatment program. Participants who reported past-year cannabis use (n = 392) were included in this study and completed a semi-structured, clinician-administered diagnostic interview. Regression models estimated the associations between binary DSM-5 CUD and severity levels with a set of validators, including cannabis use variables, psychopathology, and functional impairment. DSM-5 CUD and all severity levels were associated with cannabis use validators, including number of days used, self-reporting that cannabis use was a major problem, and greater cannabis craving. DSM-5 CUD and severe CUD were associated with other psychiatric disorders and social impairment. Findings add information about the validity of DSM-5 CUD diagnosis and severity levels, with severe CUD receiving the strongest support from its association with validators across all domains, as distinct from the mild and moderate CUD measures that were associated with cannabis-specific validators alone. Severe CUD is likely to require more intensive treatment to bolster physical, psychiatric, and social functioning, whereas the mild and moderate severity thresholds provide useful information for identifying less severe disorders for prevention and brief intervention.

Research trends in college students' sleep from 2012 to 2021: A bibliometric analysis.

BackgroundA great proportion of college students experience various sleep problems, which damage their health and study performance. College students' sleep problems, which are caused by several factors, have been easily ignored before. In the past decade, more research has been published to expand our understanding of undergraduates' sleep. The purpose of the study is to explore the research hotspots and frontiers regarding college students' sleep using CiteSpace5.8.R3 and offer guidance for future study.MethodsWe retrieved relevant literature from the Web of Science Core Collection Database and imputed the downloaded files into CiteSpace5.8.R3 for visualization analysis. We generated network maps of the collaborations between authors, countries, institutions, the cited journals, and co-occurrence keywords. The analysis of keywords clusters, timeline views, and keywords citation bursts help us identify the hotspots and research trends.ResultsA total of 1,841 articles related to college students' sleep, published from 2012 to 2021, were selected. The number of publications gradually increased. Karl Peltzer was the most prolific authors with 15 publications. The United States and Harvard University separately contributed 680 and 40 articles and had the greatest impact in this field. SLEEP ranked first in the frequency of cited journals. The article published by Lund HG was the most influential publication. Based on the analysis of keywords, we summarized research hotspots as follows: current status, affecting factors, and adverse outcomes of college students' sleep. The frontiers were the further understanding of the relationships between sleep and mental and physical health, and various interventions for sleep disorders.ConclusionOur study illustrates the research hotspots and trends and calls for more research to expand the findings. In the future, the cooperation between institutions and authors needs to be strengthened. The complex relationships between sleep and mental and physical health and problematic substance use disorders are necessary to be explored. Longitudinal studies or randomized controlled trials should be constructed to verify the current findings or assumptions.

Kindness, connection, and science

The story told in this article is representative of the experiences of many parents dealing with the problematic substance use of their son or daughter. Professional help is difficult to find. Experienced professionals often send parents to nonprofessional self-help groups to receive care and themselves apply the approaches developed by these groups when providing services to family members.

Gender differences in the stress-buffering effects of mindfulness facets on substance use among low-income adolescents

Problematic substance use during adolescence predicts numerous adverse outcomes, including increased risk of substance use disorders in adulthood. Adolescents often use substances to cope with stress, particularly adolescents who have experienced environmental stress in childhood (e.g., low-income environments), but research indicates stress-related substance use disorders may develop differently across gender. This highlights a need to identify coping resources for stress-related substance use and understand whether these coping resources are differentially effective across gender. Mindfulness has garnered evidence as a coping resource for stress-related problematic substance use; however, there is limited research on how specific mindfulness facets (e.g., nonjudgment) may buffer against stress-related substance use among adolescents. This study examined whether overall mindfulness and specific facets buffered the association between stress and substance use differentially across gender in a predominantly low-income, racially-diverse (42 % Black, 24 % White, 15 % Hispanic/Latinx, 13 % Asian, 3 % American Indian/Alaskan Native, and 3 % multiracial) sample of adolescents (n = 212) using moderated moderation models. Girls with lower levels of two mindfulness facets (i.e., acceptance/nonjudgement, decentering/nonreactivity), relative to girls with higher levels, demonstrated a greater probability of substance use with increased stress. Conversely, boys with higher levels of acceptance/nonjudgement and decentering/nonreactivity, relative to boys with lower levels, reported a greater probability of substance use with increased stress. Results suggest that acceptance/nonjudgment and decentering/nonreactivity may be protective against stress-related substance use for girls and potentially contraindicated for boys, indicating that adolescent substance use prevention and intervention efforts may need to be tailored by gender.

Reducing Problematic Substance Use under Exceptional Circumstances-Effects of the COVID-19 Restrictions on Inpatient Substance Use Disorder Treatment in Finland.

The COVID-19 pandemic has affected people’s daily lives on multiple levels. At highest risk are the most vulnerable members of the society, whose lives were already affected by various risks even before the pandemic. This study investigates how clients in inpatient substance use disorder treatment experienced the COVID-19 restrictions and their influence on recovery. The research data consists of six focus group interviews conducted remotely using a semi-structured thematic interview method. The focus group clients (N = 19) were currently in inpatient substance abuse treatment during the pandemic and the ensuring restrictions. The data were analyzed using qualitative content analysis. The results show that the COVID-19 restrictions have influenced the clients’ desistance processes throughout the pandemic. The restrictions seemed to exacerbate substance abuse problems before treatment initiation and highlight the importance of peer support during treatment. Moreover, the restrictions seemed to change the function and hamper the management of social capital, raise concerns about returning home, as well as intensifying the inter-municipal segregation of services. To conclude, attention should be paid to facilitating and ensuring informal support and managing social capital. In light of this study, it seems necessary to explore the social conditions among clients in inpatient substance abuse treatment during the pandemic.