Treatment Strategies For Addiction Research Articles

The longitudinal relationships between short video addiction and depressive symptoms: A cross-lagged panel network analysis

Short video addiction, a specific type of internet addiction, has emerged as a significant problem among youth today. The high prevalence of co-occurring mood problems, such as depressive symptoms, in individuals with short video addiction poses additional challenges for treatment. However, the extent to which these symptoms interact, predict each other, and further maintain the problems remains unclear. Therefore, this study employed cross-lagged panel network analysis to reveal the directional network structure between the co-occurrence of short video addiction and depressive symptoms in a sample of 1163 Chinese youth. The findings indicate that specific symptoms of addiction, namely ‘Tolerance’, and depressive symptoms such as ‘Anhedonia’, predicted the subsequent development of symptoms for each mental health issue. Furthermore, both the addiction problem ‘Conflict’ and emotional feelings such as ‘Sad mood’ may serve as bridge symptoms linking the co-occurrence of these two mental health issues. These findings contribute to a profound comprehension of the interrelationships and evolution of these conditions over time, revealing the underlying mechanisms behind the high relapse rates observed in addiction treatment strategies. In other words, the key symptoms and bridge symptoms identified in this study can be prioritized as targets for preventing and treating short video addiction in this particular population. By disrupting any interconnectedness between short video addiction and depressive symptoms, we can avoid the progression or escalation of co-occurring issues, leading to more effective and comprehensive treatment outcomes.

The Technology Dilemma - Defining the Line Between Need and Addiction

It is possible that addiction is a subject that bears philosophical investigation due to the widespread nature of the problem and the degree to which it is intimately recognizable to us. The field of psychology, with its primary focus on clinical modes of discourse, has historically been the only one to undertake research in the area of addiction. Developing an effective treatment strategy for addiction is a very different challenge than merely comprehending the nature of addiction itself, especially if we add technology to the equation. However, if philosophy is able to contribute to such an understanding, then it may not be owing just to the insightful musings of philosophers, but rather to the increasingly provocative nature of the problem, issue, or even reality that is being investigated. It is possible that addiction is more of a forerunner of shifting cultural horizons and a symbol of an impending (human) crisis than it is merely a medical or clinical condition. If this is the case, then addiction is indicative of an impending crisis. By presenting a point of entrance to this historical fork in the road, it is possible that the subject of addiction can become debatable, or in other words, transform into a philosophical conundrum. This paper is trying to give in insight of the thin line between need and addiction in using technology.

Exploring the Relationship between Drug Addiction and Quality of Life in Herat, Afghanistan: A Cross-sectional Study.

Addiction is a global public health problem, with over 36 million people suffering from drug-use disorders. Afghanistan, the world's leading opium producer, has high rates of drug use owing to the easy access to drugs in this country. This study aimed to investigate drug users' quality of life in Herat, Afghanistan, and identify the factors affecting it. This cross-sectional study examined health-related quality of life at six rehabilitation camps in Herat, Afghanistan, from March to July 2019, using the short form-36 questionnaire (SF-36). Data collected through interviews were analyzed using SPSS software (version 25). A total of 240 participants from six rehabilitation camps in Herat, Afghanistan participated in this study. The majority of participants (80%) rated their overall health as "good" or "very good". Men had higher average scores for mental health and vitality than women and those aged 30-39 had the highest quality of life. Statistically significant differences were found in bodily pain (P=0.038), vitality (P=0.042), and social functioning (P=0.046) among users of different types of drugs. Opium abusers had the highest scores for the physical and mental components, followed by heroin, methamphetamine, hashish, and crack abusers. This study explored the relationship between drug addiction and quality of life in Herat, Afghanistan. The findings showed that young adults were more vulnerable to drug use and male addicts and opium users had the highest quality of life. This study can inform the development of effective rehabilitation programs but more research is needed for addiction treatment strategies.

Comparative Studies of Substance Use Disorder and Addiction Treatment Strategies in India and Developed Countries

Comparative Studies of Substance Use Disorder and Addiction Treatment Strategies in India and Developed Countries

56.3 “Would You Say My Child Is Addicted?”: Lending Principles of Addiction Treatment to Families and Adolescents Worried About Social Media

Social media use is nearly ubiquitous among adolescents and is increasingly a primary means of communication and information exchange among peers. Without current consensus, whether social media use can become an addiction has been debated and is at times warmly contested. A lack of clarity around terminology and criteria can leave providers uneasy about how to assess and address problematic or compulsive social media use. By the end of this presentation, attendees will: 1) understand current diagnostic categories (or lack thereof) around problematic internet and social media use; 2) increase comfort in screening for problematic social media use; 3) appreciate opportunities to utilize generalizable, core substance use and addiction treatment strategies for adolescents impacted by problematic social media use; and 4) recognize tools for guiding parents who feel that their children have problematic social media use.

Delivering Transcutaneous Auricular Neurostimulation (Tan) to Improve Symptoms Associated with Opioid Withdrawal: Results from a Randomized, Controlled Trial

Background: The development of practical strategies for treatment of addiction is a major priority for government agencies and health plans given the substantial impact on health, social, and economic welfare. Recently, neurostimulation approaches have demonstrated efficacy managing opioid withdrawal symptoms (OWS). This investigation determined whether transcutaneous auricular neurostimulation (tAN) is safe and effective in management of OWS. Methods: Participants were followed during residential detox treatment (Austin, Texas) at a single center in the US in this randomized, participant and assessor-blinded, parallel group trial. Adult (18–65) participants with a history of opioid withdrawal were randomized 1:1 with sealed opaque envelopes, using permuted blocks of four to active tAN or delayed tAN. tAN was delivered up to 23 hours per day for five days at the following settings: 5 Hz, 250 μs, 1·0 mA at cymba concha and 100 Hz, 250 μs, 1·4 mA adjacently anterior to tragus. The hypothesis-driven primary outcome was change in opioid withdrawal symptoms, measured by the Clinical Opiate Withdrawal Scale (COWS), from baseline to 60 minutes after start of tAN therapy in the intention-to-treat (ITT) population. This study is registered with ClinicalTrials.gov (NCT04075214). Outcomes: Thirty-five (35) participants were enrolled between December 2019 and December 2020 and 31 of those were assigned equally to treatment. The primary endpoint analysis included all randomized participants. Mean (SD) COWS scores were significantly reduced by 7·0 (4·7) points at 60 minutes after start of tAN (95% CI, −4·2 to 9·7; p<0·0001; Cohen’s d=2·0), meaning the observed percent reduction in COWS score for the primary endpoint was both significant and clinically meaningful at 45·9%. Two participants (7·7%) experienced a device-related adverse event which resolved without intervention. Interpretation: Results provide relevant and statistical evidence of safe and effective use of tAN in reducing OWS and supported FDA clearance. Trial Registration: This study is registered with ClinicalTrials.gov (NCT04075214). Funding: Trial was funded by the Sponsor, Spark Biomedical. Declaration of Interest: NK, SW, DP, CB, HV and AC are employees of Spark Biomedical. CT has private equity (stock options or other ownership interest) in and is a paid consultant of Spark Biomedical. Ethical Approval: This trial was conducted in accordance with ICH Good Clinical Practices Guidelines (E6) and FDA regulations and followed the Consolidated Standards of Reporting Trials (CONSORT) reporting guidelines. Institutional Review Board (IRB) approval from Western Copernicus Group (20191239; Puyallup, WA) was obtained prior to study conduct

Epidemiology, Microbiology, and Clinical Outcomes Among Patients With Intravenous Drug Use-Associated Infective Endocarditis in New Brunswick

BackgroundWithin the context of Canada’s opioid crisis, medical complications associated with intravenous drug use (IVDU) are increasing. Infective endocarditis (IE) is a serious complication of IVDU, and understanding the characteristics of these patients could aid health systems, clinicians, and patients in the optimization of treatment and prevention of IVDU-IE. MethodsAt a tertiary care hospital in southern New Brunswick, we conducted a retrospective chart review to identify patients with IVDU-IE admitted between January 1, 2013, and December 31, 2017. We collected data related to the epidemiology, microbiology, clinical manifestations, echocardiography, complications during hospital admission, and outcomes. ResultsForty-two cases of IVDU-IE met inclusion criteria. The rate of IVDU-IE increased from 2.28 per 100,000 population in 2014 to 4.00 in 2017, which, although not statistically significant, reflects patterns in other jurisdictions. Most patients (72.4%) were male, and the mean age was 38.3 (±11.5) years. Most patients (79.3%) injected opioids. The most common clinical sign was fever (90.5%), and Staphylococcus aureus (61.9%) was the most common microorganism. The tricuspid valve was most commonly infected (58.5%), 50% of cases had heart failure as a complication during admission, and 45.2% of cases required valve replacement or repair. The 2-year survival rate after admission for initial IVDU-IE episode was 62.0% (95% confidence interval: 36.5-79.7). ConclusionIVDU-IE is common in New Brunswick and may be increasing. Despite the relatively young age of this patient population, IVDU-IE is associated with significant morbidity and mortality. Expanding effective harm reduction and addiction treatment strategies for this cohort is recommended.

Dopaminergic Circuits in Reward and Aversion

The mesocorticolimbic dopamine (DA) system, which is composed of DA neurons in the ventral tegmental area (VTA) projecting to nucleus accumbens and medial prefrontal cortex, has been intensively studied because of its importance in reward processing, drug addiction and other neuropsychiatric diseases. Importantly, while VTA DA neurons were thought to form a homogeneous cell population, recent research has demonstrated a much greater diversity of VTA DA cell type and function. Accordingly, VTA DA neurons encode much more than reward and also contribute to negative affect such as aversion and social defeat stress. How VTA DA neurons could mediate both reward and aversion is currently unknown and an important goal of my research. In my presentation, I will discuss work from the lab that has elucidated the circuit architecture and function of the reciprocal connectivity in the mesolimbic DA system (Yang et al., 2018; Neuron). Moreover, I will discuss recent data that demonstrate the identification of a subcircuit within the mesolimbic DA system that contributes to the encoding of conditioned and unconditioned aversive stimuli (de Jong et al., Neuron, in press). Collectively, our work suggest that we need to develop a new perspective on the DA circuitry that will guide future treatment strategies for addiction and other neuropsychiatric disorders where dysfunction of the neural systems underlying motivated behaviors have been strongly implicated.This abstract is from the Experimental Biology 2019 Meeting. There is no full text article associated with this abstract published in The FASEB Journal.

The role of sphingolipids in psychoactive drug use and addiction.

Psychoactive drug use is a common behavior in many societies worldwide, frequently associated with drug instrumentalization. Regular use may develop into drug addiction, which is a severe psychiatric disorder with multiple pathological effects to virtually all organ systems. Treatment strategies for addiction are often insufficient with no broadly working pharmaco-treatment available. Recently, lipids, and particularly sphingolipids, have been considered as new mediators in the pathogenic pathways and as possible therapeutic targets for the treatment of addictive states. In our review, we discuss the contribution of sphingolipids in the development of addictive states including alcohol consumption, nicotine, amphetamine, morphine, and cocaine dependencies. Recent data show that the involvement of various classes of sphingolipids, such as sphingomyelins, ceramides, globosides, sulfatides, and cerebrosides, might explain the development of some specific features of addictive states, for example, apoptotic neurodegeneration induced by psychoactive substances. On the other hand, protective effects of sphingolipids are discussed. Sphingolipids might be a key mechanism in the development of beneficial effects of moderate alcohol consumption. Therefore, sphingolipid systems emerge as possible new pathways involved in the development of addiction and its pathophysiological consequences. However, further analysis is still needed to investigate the exact mechanisms of sphingolipid contribution and possibility of using of sphingolipids as new therapeutic targets.

Secure Attachment: An Antidote to Sex Addiction? A Thematic Analysis of Therapists' Experiences of Utilizing Attachment-Informed Treatment Strategies to Address Sexual Compulsivity

ABSTRACTResearch demonstrates a high correlation between insecure attachment and sex addiction. Insecure attachment prevents the formation of secure relationships and disrupts affect regulation. These can be key factors in the maintenance of sexual addiction. Sex addiction treatment strategies may therefore benefit from incorporating a focus upon developing the capacity for secure attachment, alongside treating sexual compulsivity.This study examines the lived experiences of 6 sex addiction therapists who incorporate an attachment-informed approach in their work. The study aims to elaborate key components of an attachment-based approach that could potentially be incorporated into sex addiction treatment strategies for therapists working across different modalities.

Altered orbitofrontal activity and dorsal striatal connectivity during emotion processing in dependent marijuana users after 28days of abstinence.

Intact cognitive and emotional functioning is vital for the long-term success of addiction treatment strategies. Accumulating evidence suggests an association between chronic marijuana use and lasting alterations in cognitive brain function. Despite initial evidence for altered emotion processing in dependent marijuana users after short abstinence periods, adaptations in the domain of emotion processing after longer abstinence remain to be determined. Using task-based and resting state fMRI, the present study investigated emotion processing in 19 dependent marijuana users and 18 matched non-using controls after an abstinence period of > 28days. Relative to the control subjects, negative emotional stimuli elicited increased medial orbitofrontal cortex (mOFC) activity and stronger mOFC-dorsal striatal and mOFC-amygdala functional coupling in dependent marijuana users (p < 0.022, FWE-corrected). Furthermore, mOFC-dorsal striatal functional connectivity was increased at rest in marijuana users (p < 0.03, FWE-corrected). Yet, processing of positive stimuli and subjective ratings of valence and arousal were comparable in both groups. Together, the present findings provide the first evidence for persisting emotion processing alterations in dependent marijuana users. Alterations might reflect long-term neural adaptations as a consequence of chronic marijuana use or predisposing risk factors for the development of marijuana dependence.

Sub-chronic Ghrelin Receptor Blockade Attenuates Alcohol- and Amphetamine-Induced Locomotor Stimulation in Mice.

Ghrelin initially emerged as a gut-brain hormone controlling food intake, meal initiation and appetite mainly via hypothalamic circuits in both rodents and humans. The findings that ghrelin receptors (GHS-R1A) are expressed in reward-related areas, including the nucleus accumbens (NAc) and ventral tegmental area (VTA), suggest that ghrelin is a novel reward regulator. Indeed, ghrelin signalling mediates the rewarding and motivational properties of addictive drugs. In addition, daily co-administration of a GHS-R1A antagonist and various addictive drugs prevents the drug-induced locomotor sensitization in rats. The present series of experiment were designed to evaluate the effect of repeated pharmacological GHS-R1A suppression on drug-induced locomotor stimulation in more detail. We showed that sub-chronic pre-treatment of the GHS-R1A antagonist, JMV2959, attenuated the ability of acute administration of alcohol as well as of amphetamine to stimulate locomotion. However, there was no effect of sub-chronic JMV2959 treatment on locomotor activity per se or on the expression of the GHS-R1A gene (Ghsr) in the VTA or the NAc compared with vehicle treatment. In addition, sub-chronic ghrelin treatment caused a locomotor sensitization. While previous research has pinpointed ghrelin as an appetite regulator the present study together with previous studies suggest that ghrelin signalling modulates various reward-mediated behaviours in rodents. Collectively, this suggests that the GHS-R1A could be a key target for novel treatment strategies for addiction.

Effect of co-morbidities on disease course in human immunodeficiency virus-infected illicit drug users in the era of highly active antiretroviral therapy.

Effect of co-morbidities on disease course in human immunodeficiency virus-infected illicit drug users in the era of highly active antiretroviral therapy.

Glutamatergic synaptic plasticity in the mesocorticolimbic system in addiction.

Addictive drugs remodel the brain’s reward circuitry, the mesocorticolimbic dopamine (DA) system, by inducing widespread adaptations of glutamatergic synapses. This drug-induced synaptic plasticity is thought to contribute to both the development and the persistence of addiction. This review highlights the synaptic modifications that are induced by in vivo exposure to addictive drugs and describes how these drug-induced synaptic changes may contribute to the different components of addictive behavior, such as compulsive drug use despite negative consequences and relapse. Initially, exposure to an addictive drug induces synaptic changes in the ventral tegmental area (VTA). This drug-induced synaptic potentiation in the VTA subsequently triggers synaptic changes in downstream areas of the mesocorticolimbic system, such as the nucleus accumbens (NAc) and the prefrontal cortex (PFC), with further drug exposure. These glutamatergic synaptic alterations are then thought to mediate many of the behavioral symptoms that characterize addiction. The later stages of glutamatergic synaptic plasticity in the NAc and in particular in the PFC play a role in maintaining addiction and drive relapse to drug-taking induced by drug-associated cues. Remodeling of PFC glutamatergic circuits can persist into adulthood, causing a lasting vulnerability to relapse. We will discuss how these neurobiological changes produced by drugs of abuse may provide novel targets for potential treatment strategies for addiction.

Memory impairment and alterations in prefrontal cortex gamma band activity following methamphetamine sensitization.

Repeated methamphetamine (MA) use leads to increases in the incentive motivational properties of the drug as well as cognitive impairments. These behavioral alterations persist for some time following abstinence, and neuroadaptations in the structure and function of the prefrontal cortex (PFC) are particularly important for their expression. However, there is a weak understanding of the changes in neural firing and oscillatory activity in the PFC evoked by repeated drug use, thus complicating the development of novel treatment strategies for addiction. The purpose of the current study was to assess changes in cognitive and brain function following MA sensitization. Sensitization was induced in rats, then temporal and recognition memory were assessed after 1 or 30days of abstinence. Electrophysiological recordings from the medial PFC were also acquired from rats whereupon simultaneous measures of oscillatory and spiking activity were examined. Impaired temporal memory was observed after 1 and 30days of abstinence. However, recognition memory was only impaired after 1day of abstinence. An injection of MA profoundly decreased neuronal firing rate and the anesthesia-induced slow oscillation (SO) in both sensitized (SENS) and control (CTRL) rats. Strong correlations were observed between the SO and gamma band power, which was altered in SENS animals. A decrease in the number of neurons phase-locked to the gamma oscillation was also observed in SENS animals. The changes observed in PFC function may play an integral role in the expression of the altered behavioral phenotype evoked by MA sensitization.

Repeated nicotine exposure in adolescent rats: Reduction of medial habenular activity and augmentation of nicotine preference

Adolescence is a critical period for the initiation of tobacco use. Nicotine not only stimulates brain reward circuits to establish and maintain the tobacco smoking habit, but also produces aversive reactions to nicotine after initial exposure, due to its noxious properties. Although new insights into the mechanisms that regulate nicotine avoidance could result in an advantageous treatment strategy for addiction, little is known about the mechanism of nicotine aversion in adolescence. Because growing evidences suggest that the habenula to interpeduncular nucleus circuitry plays a critical role in nicotine aversion, we investigated the effects of repeated nicotine exposure on the electrical activity of medial habenular neurons in adolescent rats, using extracellular recordings. Nicotine strongly increased the frequency of spontaneous spike activity in the medial habenula of naïve rats. In repeated nicotine-injected rats, we found a reduction in nicotine-induced spontaneous spike frequency, such that these neurons displayed a significantly lower basal activity and reduced spontaneous activity upon re-exposure to nicotine. Moreover, nicotine intake preference in repeated nicotine-injected rats is significantly more increased than that in saline-injected rats. These results demonstrate that repeated phases of nicotine exposure induce a functional switch in the activity of medial habenular neurons in adolescent rats and suggest that medial habenular activity is one of mediators for an inhibitory motivational signal that limits nicotine consumption.

The role of ghrelin in addiction: a review.

Ghrelin is a fast-acting hormone that is produced primarily by the stomach and by the brain although in smaller quantities. The regulation and the secretion of ghrelin are complex and not limited to aspects of feeding. Ghrelin exerts powerful effects on multiple processes, and it has been demonstrated that it mediates the rewarding properties of food as well as of drugs of abuse. The purpose of this review is to summarize the findings of preclinical and clinical studies related to ghrelin's possible role in addiction for each specific class of substances. Questions related to ghrelin's involvement in addiction are highlighted. Recurrent methodological issues that render the interpretation of the findings challenging are discussed. Also, the potential of targeting ghrelin as a pharmacologic treatment strategy for addiction is explored. Ghrelin signaling is implicated in the mediation of behavioral and biochemical effects of drugs of abuse that are cardinal for the development of addiction, especially for alcohol, nicotine, and stimulants. The available literature implicating ghrelin in opioid or cannabis use disorders is currently limited and inconclusive. There is intriguing, although not always consistent, evidence for the involvement of ghrelin signaling in aspects of addiction, especially in the cases of alcohol, nicotine, and stimulants. Further research, particularly in humans, is recommended to replicate and expand on the findings of the current literature. Improved and novel methodologies that take into account the volatile and complex nature of ghrelin are required to clarify the inconsistencies of the findings.

Binge drug use among street-involved youth in a Canadian setting

Background: Binge drug use has been associated with increased risk of human immunodeficiency virus (HIV) infection and other serious health-related harms among adult drug user populations. This study sought to determine the prevalence and correlates of binge drug use among street-involved youth in a Canadian setting. Methods: From September 2005 to May 2012, data were collected from the At-Risk Youth Study (ARYS), a prospective cohort of street-involved youth aged 14–26 years who use illicit drugs. Multivariate generalized estimating equation (GEE) logistic regression was used to identify factors associated with binge drug use. Results: Of the 987 participants included in this analysis, 41.5% reported binge drug use at baseline and another 59.1% reported binge drug use at some point during the study. In multivariate GEE analyses, older age (adjusted odds ratio [AOR] = 1.11), homelessness (AOR = 1.67), drug injecting (AOR = 1.63), non-fatal overdose (AOR = 1.98), public injecting (AOR = 1.42), being a victim of violence (AOR = 1.38), sex work (AOR = 2.51) and participation in drug dealing (AOR = 2.04) were independently associated with binge drug use in the previous six months (all p < 0.05). Discussion: The prevalence of reporting binge drug use among the youth was high in this setting and was independently associated with a range of high-risk activities and markers of vulnerability. Querying high-risk youth about binge drug use may help prioritize those in greatest need of addiction treatment strategies and public health interventions.

A systematic review of pediatric obesity and family communication through the lens of addiction literature.

Both treatment of addiction and treatment of pediatric obesity often integrate the family unit. Thus, addiction therapies may provide a model to guide treatment of pediatric obesity, particularly issues of family communication, weight, and weight-related behaviors. The aim of this systematic review is to assess what knowledge in the field of addiction treatment can be translated to pediatric weight management, particularly in relation to family-based approaches and communication. A systematic review of family communication and food addiction in obese children was conducted using MEDLINE and other databases, including all English-language studies published after 1990 meeting search criteria and related to family factors or family communication, and addiction treatment strategies used in obesity interventions. Three reviews, two survey studies, and two observational studies were included. Most focused on family communication; less-healthy communication patterns and parental restriction were related to maladaptive eating behaviors in children and attrition from weight management programs. A few studies suggested family communication interventions to improve unhealthy eating patterns in children, using therapies common in family treatment of addiction (e.g., motivational interviewing and cognitive behavioral therapy). No studies presented concrete suggestions to aid family communication around issues of food and weight management. Potential contributions of addiction therapies are discussed. Though the addictive properties of food have not been fully delineated and obesity is not classified as a disease of addiction, the field of addiction offers many approaches that may prove useful in the treatment of obesity.

2891 – Motivational approaches to addiction through movies within the context of treatment models

Introduction A comparison of addiction patterns and occurrence rates between European and United States Veterans will be the backdrop for introducing strategies for treatment and recovery models. Addiction therapists and Case Managers working within the context of the Department of Veterans Affairs in the United States have reported successful use of movies as motivational instruments and sources of heightened insight. Aims To introduce a catalog of movies that support motivational treatment strategies for addiction. To explore the experiences of therapists working with movies as treatment adjuncts To provide an analysis of the effect of the creative impact on therapy within current recovery models. To encourage therapists and increase confidence in utilizing movies within treatment contexts. Methods A compendium of relevant movies will be presented. Special attention will be paid to legal issues in Europe/US with regard to when permission is needed to use movie material within the context of treatment. Material from large group of addiction therapists will be made available and analyzed within addiction treatment models. Results The anonymous case examples and therapists’ experiences using movies as therapeutic adjuncts will increase awareness, confidence and ability to integrate this approach into approaches to addiction treatment. Conclusion Use of movies in addiction treatment increases awareness, creates insights and provides explicit emotional points of identification for patients and clients that facilitate understanding and engagement as treatment is introduced and progresses.