Substance Use Disorder Patients Research Articles

Decoding substance use disorder severity from clinical notes using a large language model

Substance use disorder (SUD) poses a major concern due to its detrimental effects on health and society. SUD identification and treatment depend on a variety of factors such as severity, co-determinants (e.g., withdrawal symptoms), and social determinants of health. Existing diagnostic coding systems used by insurance providers, like the International Classification of Diseases (ICD-10), lack granularity for certain diagnoses, but American clinicians will add this granularity (as that found within the Diagnostic and Statistical Manual of Mental Disorders classification or DSM-5) as supplemental unstructured text in clinical notes. Traditional natural language processing (NLP) methods face limitations in accurately parsing such diverse clinical language. Large language models (LLMs) offer promise in overcoming these challenges by adapting to diverse language patterns. This study investigates the application of LLMs for extracting severity-related information for various SUD diagnoses from clinical notes. We propose a workflow employing zero-shot learning of LLMs with carefully crafted prompts and post-processing techniques. Through experimentation with Flan-T5, an open-source LLM, we demonstrate its superior recall compared to the rule-based approach. Focusing on 11 categories of SUD diagnoses, we show the effectiveness of LLMs in extracting severity information, contributing to improved risk assessment and treatment planning for SUD patients.

The complex relationships among self-acceptance, perceived social support, drug use stereotype threat, and subthreshold depression in people with substance use disorder: exploring the mediating and buffering effects

IntroductionDepression levels are significantly higher among people with substance use disorder (SUD) than in the general population; however, studies on the level of subthreshold depression in this population are scarce. Research shows a significant correlation between self-acceptance and depression, with social support playing a key role in the process of recovery and social reintegration for people with SUD. This study aimed to explore the effects of self-acceptance, perceived social support, and stereotype threat of people with SUD on their subthreshold depression, as well as potential mediating and buffering effects.MethodsThis study was conducted from January-March 2024. 1068 drug addicts (548 males and 520 females) were recruited in Chengdu, Sichuan Province. After signing informed consent, their psychometric data were obtained using the Self-acceptance Questionnaire (SAQ), Perceived Social Support Scale (PSSS), Drug Use Stereotype Threat Scale (DSTS) and Center for Epidemiologic Studies Depression Scale(CES-D). Gender and group differences in relevant scale dimensions were explored. Linear regression models were used to assess the relationships between PSSS, SAQ, and DSTS scores and subthreshold depression in male and female participants. Bootstrap mediation effect tests were used to further test the mediation effect of drug use stereotype threat and perceived social support between self-acceptance and subthreshold depression. Line graphs were used to show the buffering effect of perceived social support on the relationship between self-acceptance and subthreshold depression in different groups.ResultsThe results showed that,gender, HIV-positive or not, education and monthly income level affect subthreshold depression in patients with SUD. Negative correlation between self-acceptance and subthreshold depression among SUD patients. Furthermore, perceived social support and substance use stereotypes threatmediated the relationship between self-acceptance and subthreshold depression, respectively, forming a parallel mediating relationship. Results exploring the buffering effect of perceived social support by subgroup showed that the buffering effect of perceived social support on subthreshold depression was most pronounced in the HIV-negative and and female groups. Social support, group stereotypes discrimination affect the mental health of sud patients.DiscussionOur study provides theoretical support for the alleviation of subthreshold depression among people with SUD, realizing that self-acceptance, perceived social support and reduction of drug use stereotype threat can be a psychoprotective factor for people with SUD.

Resilience and its relationship with quality of life and comorbid substance use disorder in patients with type I bipolar disorder

BackgroundBipolar disorders (BD) are common psychiatric disorders. Stressful life events as well as comorbid Substance use disorders contribute to functional impairment in patients with BD. This study aimed to assess resilience and its relation to quality of life and severity of comorbid substance use disorders in patients with type I bipolar disorder.Sixty six type I bipolar disorder patients—currently in remission—were categorized into two groups: a group including 33 patients were compared to a sociodemographically matched group of 33 patients of similar disease related clinical variables with comorbid substance use disorder. Resilience, quality of life and severity of addiction were assessed for both groups.ResultsResilience level was found to be significantly lower in bipolar with comorbid substance use group compared to bipolar group. Quality of life of bipolar patients with comorbid substance use was not only significantly impaired but also positively correlated to resilience level. There was a strong negative correlation between resilience level and all aspects of addiction severity in patients with type I bipolar disorder.ConclusionLevel of resilience was found to be positively correlated to quality of life and negatively correlated to severity of comorbid substance use in patients with type I bipolar disorder.

Insomnia in Patients With Substance Use Disorders: Assessment and Management.

Insomnia, characterized by difficulty initiating or maintaining sleep, or poor sleep quality, is highly prevalent among individuals with substance use disorders (SUDs). The relationship between the 2 conditions is often bidirectional. We reviewed the impact of various substances (alcohol, stimulants, opioids, and cannabis) on sleep architecture and their potential to contribute to insomnia. The role of insomnia as a risk factor for different SUDs is also explored. Assessment strategies for co-occurring insomnia and SUDs are discussed, emphasizing the importance of reassessment throughout various phases of substance use treatment. Evidence-based nonpharmacologic and pharmacologic interventions for managing insomnia in SUD patients are presented, highlighting the importance of tailoring treatment approaches to individual needs and substance-specific considerations. Assessment and management of comorbid insomnia and SUDs is crucial but can be difficult; however, studies have shown some benefits using nonpharmacologic and pharmacologic approaches.

Personalized cue-reactive delta-theta oscillations guide deep brain stimulation for opioid use disorder.

Substance use disorders (SUDs) are a significant public health concern, with over 30% failing available treatment. Severe SUD is characterized by drug-cue reactivity that predicts treatment-failure. We leveraged this pathophysiological feature to personalize deep brain stimulation (DBS) of the nucleus accumbens region (NAc) in an SUD patient. While this DBS lead was externalized for clinical purposes, we administered a personalized drug cue-reactivity task while recording NAc electrophysiology. We identified a cue-evoked signal in the ventral NAc associated with intensification of opioid-related cravings, which attenuated with therapeutic stimulation delivered to this same area. DBS was then programmed to engage this subregion within NAc to account for the biomarker location, heralding the potential for personalized strategies to optimize DBS for SUD.

Effect of serotonin receptor gene variants on substance use disorders

Background Substance use disorders are multifaceted conditions influenced by both genetic and environmental factors. Serotonergic pathways are known to be involved in substance use disorder susceptibility, with genetic markers within serotonin receptor genes identified as potential risk factors. Methods To further explore this relationship, we conducted a study to investigate the association between several polymorphisms in five serotonin receptor genes (HTR1B, HTR2A/B, HTR3A/B) and substance use disorders (SUD) in Jordanian males by sequencing genotypes in 496 SUD patients and 496 healthy controls. Results Our findings revealed an allelic association between rs9567735 in the HTR2A gene and rs17586428 in the HTR2B gene with SUD. Haplotype analysis also showed that one haplotype of the HTR2A gene and four haplotypes of the five included genes were significantly associated with SUD risk. Moreover, we found that motives for substance use were correlated with single nucleotide polymorphisms SNPs rs1923882 and rs1150226, with the latter SNP also being associated with smoking. Conclusion These findings suggest that genetic variants of human 5-HT receptor genes may affect individual susceptibility to SUD in Jordan. However, further studies with larger sample sizes and additional variants in the same or different genes must confirm these findings.

Comparing mental health and substance use disorders in patients receiving durable VADs versus transplants: A TriNetX database analysis.

Ventricular assist device (VAD) and cardiac transplant patients experience significant strain on their physical and mental wellbeing postoperatively. Mental health and substance use disorders (MHDs and SUDs) have substantial effects on the quality of life and compliance of transplant and VAD patients. In this study, we compare and characterize MHDs and SUDs between VAD and cardiac allograft patients and transplant list patients with and without VADs. This study compares the incidence of MHDs and SUDs between VAD and cardiac transplant patients. Cohorts were defined using ICD-10 codes in TriNetX, a large public database. Patient characteristics were matched by using propensity score matching. Incidence was analyzed using the log-rank test. Statistical significance was set at p < 0.05. Survival analysis showed a statistically significant impact of adjustment disorder, nicotine dependence, and mood disorder in VAD patients as compared to cardiac allograft recipients. Depression and opioid use disorder had a significantly higher incidence in post-transplant patients compared to their VAD counterparts. Survival analysis showed that PTSD and mood disorder had a statistically significant effect on the patients waiting on transplant wait list without VADs as compared to those with VADs. MHDs and SUDs have profound implications on quality of life, survival, and medication compliance. The incidence of MHDs and SUDs differed between VAD versus cardiac transplant patients as well as the patients on the transplant waitlist with and without VADs. Mental health resources should be tailored to address risk factors that may be unique to each group of patients.

Factors Influencing the Attitudes of Substance Use Disorders: A Review from Patients and Health Care Providers Perspectives

Substance use disorder (SUD) is a long-term uncontrolled use of harmful substances such as illegal drugs, prescription drugs, alcohol and tobacco. Despite growing treatment options, SUD remains a public health challenge. This review explores factors of attitudes and cognition that affect both the SUD patient and therapist perspectives. The review mainly focuses on the role of cognition, stigma, implicit cognitive attitude and general explicit attitude. From patients’ perspective, the perception and awareness of having the disorder as well as the self-stigma to SUD significantly shape their attitude and willingness to seek help and treatments. Implicit attitudes unconsciously influence patients' overall attitudes toward substance use behaviors and substance use behavior treatment, as well as subsequent behaviors. For health care providers, stigma, lack of expertise and training in SUD can lead to negative attitudes and inadequate treatment of SUD patients. This may reduce the effectiveness of patient treatment and the likelihood of recovery. This review emphasizes to recognize the limitations of different studies and encourage next steps for improvement. Limitations of different studies including over-reliance on self-reporting, and lack of long-term studies can be improved by adding more follow-up studies on different aspects to update the data and further validate the research on the impact of different attitudes. This review also encourages to increase and popularize the knowledge of SUD, to increase the training of healthcare professionals on SUD to change and influence the attitudes of patients and healthcare professionals.

Substance Use Disorders Among Human Trafficking Victims: Evidence from the 2019 to 2021 Nationwide Emergency Department Sample

Background Human trafficking (HT) survivors are at risk for substance use disorder (SUD), although assessing the SUD epidemiology of HT survivors is difficult. This study used data from the 2019 to 2021 Nationwide Emergency Department Sample to estimate the prevalence of SUD for HT survivors utilizing emergency departments (ED) in the United States of America (US). Methods We included visits for patients aged 12–64 years with any International Classification of Diseases 10th Revision, Clinical Modification (ICD-10-CM) codes documenting HT as a cause of morbidity (N = 1,688, SE = 141) or history of HT (N = 2,524, SE = 218). We estimated the prevalence of HT-related visits with SUD, associations between SUD and trafficking type, and demographic variation by SUD. Results Any non-nicotine SUD was frequently documented among patients with HT as a cause of morbidity (37.64%, n = 635) and for patients with any history of HT (42.42%, n = 1,071). SUD was more frequently documented in cases of sex trafficking (43.47%, n = 579) relative to labor trafficking (15.79%, n = 56) (p < 0.001). Having any non-nicotine SUD was associated with higher rates of hospitalization for ED visits with HT as a cause of morbidity (53.31% [n = 339] vs. 12.39% [n = 130]; p < 0.001) and for those with a history of HT (76.78% [n = 822] vs 50.43% [n = 733]; p < 0.001). Conclusions HT patients presenting to the ED have high rates of SUD and HT patients with SUD having a greater likelihood of hospitalization. ED clinicians can play an important role in supporting SUD recovery among HT survivors.

Serum Levels of Lead and Selected Acute Phase Proteins in Patients with Substance Use Disorders

Background: Chronic inflammation, immune system dysfunction and elevation in the levels of toxic metals such as lead (Pb) are common observations in patients with substance use disorders (SUD). However, there is little information on the acute phase profile of SUD patients with different serum levels of Pb. Therefore, serum levels of selected acute phase proteins in SUD patients with different serum levels of Pb were determined in this study. Methods: A total of 84 adults consisting of 45 patients with SUDs and 39 controls were enrolled into this case-control study. Serum levels of Pb, albumin and C-reactive protein (CRP) were determined using Atomic Absorption Spectrophotometer, bromocresol green (BCG) colorimetric method, and ELISA, respectively. Thereafter, CRP-albumin ratio (CAR) was calculated as appropriate. Results: Serum levels of Pb and albumin were significantly higher in patients with SUDs compared with the controls. Considering variation in acute phase proteins based on Pb level, the serum level of albumin was significantly lower, while the serum CRP level and CAR were slightly higher in patients with SUDs whose Pb level was higher than 5 µg/dL compared with patients whose Pb level was ≤5 µg/dL. No significant differences were observed in the levels of Pb, albumin, CRP, CAR in patients with SUDs who abuse single substance compared with those who abuse multiple substances. Conclusion: SUD is associated with increased serum levels of Pb and albumin, and alteration in the serum levels of acute phase proteins appears to be influenced by the serum Pb level. Therefore, there is the need for routine measurement of Pb level in patients with SUDs as they could benefit from therapeutic interventions involving chelation of Pb which could prevent disordered acute phase responses in the patients and facilitate optimal response to antipsychotics.

SHADOWS OF BIRTH ORDER: AFFECTIVE TEMPERAMENT, PERCEIVED PARENTAL ATTITUDES, AND SUBSTANCE USE DISORDERS

Aim: In personality development temperamental traits, along with parental attitudes and birth order play a crucial role. These factors—temperamental traits, birth order, perceived parental attitudes—can influence substance use and its continuation. This study aims to explore the relationship between Adler's birth order theory, temperamental traits and perceived parental attitudes in the context of substance use disorders (SUDs). Material and method: The study included 37 SUD patients from XXX Hospital's Alcohol and Drug Treatment Center and 37 siblings without substance use. Participants temperamental traits and parental attitudes were assessed using the Temperament Evaluation of Memphis, Pisa, Paris, San Diego Autoquestionnaire (TEMPS-A) and the Short Form of the Perceived Parental Attitudes Scale-Child Form (s-EMBU). Independent samples t-test, one-way analysis of variance, Spearman correlation coefficient, and binary logistic regression analysis were used in data analysis. Results: Individuals with SUD had significantly higher depressive, cyclothymic, irritable, and anxious temperaments than their siblings (p &lt; 0.05), and these traits were linked to perceived rejecting parental attitudes. Birth order analysis showed higher cyclothymic temperament in the first and last children. However, contrary to our hypotheses, no relationship was observed between birth order and perceived parental attitudes in any groups. According to regression analysis, individuals who were last-born had a 5.34 times higher likelihood of developing SUD compared to others. Conclusion: Assessing challenges based on birth order can aid in providing effective addiction treatment services. Our study found a link between perceived parental attitudes and temperamental traits, but not with birth order. This suggests temperamental traits may moderate the effect of birth order on perceived parental attitudes. Given the strong link between affective temperamental traits and rejecting parental attitudes, we recommend implementing behavioral parent training programs to reduce parental anger and hostility.

Transdiagnostic features of inflammatory markers and executive function across psychiatric disorders

Executive dysfunction and dysregulated inflammation are found in patients with different psychiatric disorders. However, whether there are different associations between inflammatory markers and executive performance in patients with different psychiatric diagnoses is unknown. Our study aims were (1) to compare peripheral cytokine expression and executive function in patients with bipolar disorder (BD), substance use disorder (SUD), and schizophrenia (SCZ), and in healthy controls (HC) and (2) to explore the potential association between inflammatory cytokines and executive function in different patient groups and HC. Participants with BD (n = 816), SUD (opioid use disorder and/or methamphetamine use disorder, n = 518), SCZ (n = 146), and HC (n = 186) were recruited. Plasma cytokine levels [tumor necrosis factor (TNF)-α, interleukin (IL)-8 (only measured in 8 SCZ patients), transforming growth factor (TGF)-β1 (not measured in SCZ patients)], C-reactive protein (CRP), brain-derived neurotrophic factor (BDNF) levels, and executive function [Wisconsin Card Sorting Test (WCST) and Continuous Performance Test (CPT)] were assessed. We found that all patient groups had worse executive performance and higher inflammatory cytokine levels than the HC group. SCZ patients had the worst executive performance, while SUD patients had the highest inflammatory cytokine levels. Increased plasma IL-8, CRP, and TNF-α levels were specifically associated with worse executive function in BD, SUD, and SCZ patients (P = 0.009, 0.04, and 0.03, respectively). We concluded that dysregulated inflammation might be a transdiagnostic feature among different psychiatric disorders and associated with executive dysfunction. Further studies to investigate the causal relationship and mechanisms between inflammation and executive dysfunction may be needed.

Psychometric Evaluation of the Dutch Version of the Substance Use Recovery Evaluator (SURE-NL)

Introduction: Patient-reported outcome measures (PROMs) are an important source of information that allow for a patient-centered assessment. Outcome measurement of substance use disorder (SUD) treatment traditionally focuses on drug use and deficits in functioning, overlooking other aspects of the personal and dynamic process of recovery. The substance use recovery evaluator (SURE) is a PROM developed with service user input to monitor the recovery journey and assess treatment outcomes in people with SUD. The objective of this study was to examine the validity and reliability of the Dutch translation of the SURE, the SURE-NL, for measuring indicators of recovery in Dutch-speaking patients with SUD. Methods: The original SURE questionnaire was translated from English to Dutch using forward-backward translation. A total of N = 171 participants were recruited as part of a naturalistic multicenter study in inpatient (N = 149) and outpatient (N = 22) SUD treatment centers. We examined the factorial structure, reliability, and concurrent and discriminant validity of the SURE-NL. Results: The original 5-factor structure of the SURE showed acceptable fit for the SURE-NL, and internal consistencies of the subscales ranged from 0.61 to 0.76; internal consistency of the total score was 0.83. Concurrent validity was confirmed through positive correlations of the SURE-NL total and subscale scores with the WHOQoL-BREF subscales, but correlations varied depending on subscale and treatment setting, with higher correlations for the outpatient compared to the inpatient subgroup. Discriminant validity was confirmed through low, mostly non-significant correlations between the SURE-NL and the DASS-21. Conclusions: Although the SURE was originally designed for outpatient settings, our findings in a predominantly inpatient sample indicate that the SURE-NL is suitable for assessing personal recovery and recovery capital in Dutch-speaking Belgian patients with SUD. However, subscales should be used and interpreted with caution. Further research is needed with larger Dutch-speaking outpatient samples and the development of a tailored SURE for inpatient settings should be considered.

Abstract 224: Clinical Outcomes of Non‐Traumatic Subarachnoid Hemorrhage in Patients with Substance Use Disorder: A TriNetX Analysis

Introduction/Purpose Subarachnoid hemorrhage (SAH), an accumulation of blood between the pia and arachnoid mater, is most often caused by non‐traumatic rupture of a cerebral aneurysm. Common risk factors that contribute to the development of SAH include hypertension, smoking, and substance use. There is a well‐documented association between the use of sympathomimetic agents and the development of SAH. However, there is a gap in understanding regarding the clinical outcomes of SAH patients with current and/or past use of other substances, which this study aims to address. Methods This retrospective cohort study used the TriNetX Research Network to analyze data from patients with a history of non‐traumatic SAH when at least 18 years of age. Substance use disorders were determined by the ICD‐10 codes F10 to F19, and included a total of 13 substances. Patients with each substance use disorder were compared to patients with no substance use disorders with Cox proportional hazard models. The outcomes of interest that were analyzed included mortality, vasospasm, hydrocephalus, and epilepsy. Results A total of 209,970 patients with non‐traumatic SAH were included in the study. In patients with non‐traumatic SAH, substance use disorders were associated with a significantly increased hazard of mortality for alcohol (HR=1.08, [1.04, 1.13]), opiates (HR=1.23, [1.14, 1.32]), stimulants (HR=1.17, [1.05, 1.30]), nicotine (HR=1.04, [1.01, 1.07]), inhalants (HR=1.19, [1.05, 1.36]), and other psychoactive substances (HR=1.221, [1.135, 1.313]). While nicotine dependence (HR=1.273, [1.210, 1.340]) and cannabis dependence (HR=1.255, [1.072, 1.399]) increased the hazard of vasospasm, alcohol (HR=0.916, [0.841, 0.997]) and sedatives (HR=0.705, [0.504, 0.987]) offered significant protection. Similarly, although nicotine dependence (HR=1.08, [1.043, 1.119]) increased the hazard of hydrocephalus, several substance use disorders – including alcohol (HR=0.816, [0.772, 0.863]), opioids (HR=0.830, [0.745, 0.924]), cannabis (HR=0.799, [0.723, 0.882]), sedatives (HR=0.673, [0.545, 0.830]), hallucinogens (HR=0.445, [0.277, 0.717]), and other psychoactive substances (HR=0.730, [0.661, 0.807]) – decreased the hazard of hydrocephalus. Conclusions Our study found that substance use disorders in patients with non‐traumatic SAH are associated with a significant increase in the hazard of mortality in alcohol, opioids, stimulants, nicotine, inhalants, and other psychoactive substances. While nicotine and cannabis dependence increased the hazard of vasospasm, alcohol and sedatives offered protection for these patients. Furthermore, while nicotine dependence increased the hazard of hydrocephalus, other substances, including alcohol, opioids, cannabis, sedatives, hallucinogens, and other psychoactive substances, decreased the hazard of hydrocephalus. The findings of our study illuminate the long‐term neurological impact of substance use disorders in patients with non‐traumatic SAH, and can help guide clinical decision‐making and public health education measures to target substance use disorders in the general population.

Examining the Potential Impact of Recreational Cannabis Legalization on Individuals Receiving Treatment for Substance Use Disorder: An Interrupted Time Series Study in Guelph, Ontario, Canada.

The present research evaluated the impact of legalizing recreational cannabis among individuals with substance use disorders (SUDs) who may already use cannabis at high rates. Using an interrupted time series study design, we evaluated the potential impact of legalizing recreational cannabis among individuals seeking treatment for SUD within a hospital-based treatment setting in Guelph, Ontario. We examined 2,925 individuals who entered an inpatient SUD treatment program between April 2017 and December 2021. We performed segmented regression analyses using both the date of cannabis legalization and the date of edibles legalization as the interruption time point. We also performed stratified analyses to examine potential sex differences. We found no significant changes in the frequency of cannabis use using either of the interruption time points. However, among the subsample who had used cannabis, there was evidence of increasing CUD severity post-legalization of edibles, as well as an overall decreasing trend in readiness to quit over time. Stratified analyses also suggested possible sex differences in frequency of cannabis use, CUD severity, and readiness to quit. Results point to some small but potentially important impacts of recreational cannabis legalization that may only continue with time. Nevertheless, there is a need to continue to monitor cannabis use trends over time to understand any potential lagged effects.

Dyspnea, respiratory muscle strength, cough capacity, and sleep quality in individuals with substance use disorder

There is evidence that substance use and smoking cause some adverse effects on the respiratory system. The aim of this study was to assess dyspnea severity, respiratory muscle strength, cough capacity, and sleep quality in people with substance use disorder (SUD). Forty eight individuals with SUD and 28 active cigarette smokers participated in the study. Participants’ dyspnea severity was assessed using the Modified Medical Research Council Scale, respiratory muscle strength was measured with a portable electronic mouth pressure device, peak cough flow was assessed with a Peak Flow Meter, and sleep quality was determined using the Pittsburgh Sleep Quality Index (PSQI). The amount of daily cigarette smoking and dyspnea severity were significantly higher in individuals with SUD (p < .001). Peak cough flow values, maximum inspiratory pressure (MIP), maximum expiratory pressure (MEP), MIP (%predicted), and MEP (%predicted) were not significantly different between the SUD patients and the active cigarette smokers (p > .05). However, PSQI sub-parameters such as subjective sleep quality, sleep latency, habitual sleep efficiency, use of sleeping medication, and total scores showed significant differences between the SUD patients and the active cigarette smokers (p < .05, p < .001, p = .03, p < .001, p < .001, respectively). Individuals with SUD were found to have higher dyspnea and poorer sleep quality than active smokers. However, respiratory muscle strength and cough capacities were similar.

The family and substance abuser in the mental health institution environment.

South African drug usage demographics are rare. Substance abuse disorder patients and their families have complex interactions. This study examines family members living with drug addict. The study seeks to investigate the experiences of family members living with a substance use disorder (SUD) individual. The research took place in a Gqeberha psychiatric facility. Low-income households were interviewed. This research is qualitative, exploratory, and descriptive study. Recorded and transcribed in-depth patient family interviews were collected. Qualitative thematic analysis was used to analyse data. The data themes were interpreted using family systems theory. Each of the three main themes has subthemes. The first theme concerns family members' inadequate comprehension of addiction. The subtheme explores family members' denial and failure to recognize substance use disease symptoms. The second theme concerns variations in behaviour that challenge cultural norms. This subtheme addresses hallucinations, delusions, and fury in SUD patients. The third theme addresses the negative effects of drug use on families, potentially leading to divorce. This subtheme focuses on the family's lack of awareness of resources that may have supported them and the SUD individual. Immediate family members are crucial to patient recovery. The family seemed to be struggling living with an SUD relative. Experts should help the family to manage the addict's treatment. Healthcare education can help families cope with substance abusers. This study will assist the nursing administration in discovering ways to help families manage a loved one with an SUD.

The Impact of Family Relations on a Sample of Egyptian Patients with Substance Use Disorder

Abstract Background Substance use disorders (SUD) present a complex condition characterized by uncontrolled substance use despite adverse consequences, often intertwined with social and family problems. Dysfunctional family relationships, including violence, stress, parental drug use, and poor communication, have been linked to adolescent drug use. The current study investigates the association between family relation dysfunction and substance use, aiming to understand the quality of this connection. Aim of the Work This case - control study aims to examine the relationship between family relations and substance use, assessing the impact on the type and severity of substance abuse. Specific objectives include exploring the association between family dysfunction and SUD, comparing family interaction in SUD patients and normal individuals, and evaluating variations in family interaction based on sociodemographic factors. Patients and Methods Seventy participants, comprising 35 SUD patients and 35 healthy controls, were recruited from EL-Abbsia Mental Health Hospital. Participants were assessed using socio- demographic data sheets, Structured Clinical Interview for DSM-IV Axis I Disorders (SCID-I), Quality of Family Relationships Scale (KOBI), and Addiction Severity Index. Urine tests were conducted for psychoactive substances. Statistical analysis involved various tests, including t-tests, Mann-Whitney, chi-square, and correlation analyses. Results The study revealed a significant prevalence of smoking among SUD patients compared to controls, along with longer smoking duration and higher daily cigarette consumption. SUD patients exhibited increased medical issues and higher incidences of substance use, particularly cannabis and heroin. Family rejection and non-acceptance were significantly higher in SUD cases, correlating with the severity and duration of substance abuse. Conclusion The findings underscore the significant connection between family relationship dysfunction and substance use. Rejection and non-acceptance within the family environment emerge as crucial predictors of addiction. The study highlights the need for comprehensive interventions addressing family dynamics in substance abuse treatment.

Effect of Mindfulness on Treatment Motivation in Patients with Substance Use Disorder

Objective: This research aimed to assess the mindfulness levels among individuals with substance use disorder (SUD) and investigate its influence on treatment motivation.&#x0D; Method: A descriptive and cross-sectional study was carried out involving 184 SUD patients. Data collection utilized a Personal Information Form, The Mindful Attention Awareness Scale (MAAS), and the Treatment Motivation Questionnaire (TMQ).&#x0D; Results: A strong positive correlation was identified between MAAS and TMQ levels (r: 0.796, p

Histone deacetylase 5 in prelimbic prefrontal cortex limits context-associated cocaine seeking.

Repeated cocaine use produces neuroadaptations that support drug craving and relapse in substance use disorders (SUDs). Powerful associations formed with drug-use environments can promote a return to active drug use in SUD patients, but the molecular mechanisms that control the formation of these prepotent drug-context associations remain unclear. In the rat intravenous cocaine self-administration (SA) model, we examined the role and regulation of histone deacetylase 5 (HDAC5) in the prelimbic (PrL) and infralimbic (IL) cortices in context-associated drug seeking. To this end, we employed viral molecular tools, chemogenetics, RNA-sequencing, electrophysiology, and immunohistochemistry. In the PrL, reduction of endogenous HDAC5 augmented context-associated, but not cue-or drug prime-reinstated cocaine seeking, whereas overexpression of HDAC5 in PrL, but not IL, reduced context-associated cocaine seeking, but it had no effects on sucrose seeking. In contrast, PrL HDAC5 overexpression following acquisition of cocaine SA had no effects on future cocaine seeking. We found that HDAC5 and cocaine SA altered the expression of numerous PrL genes, including many synapse-associated genes. HDAC5 significantly increased inhibitory synaptic transmission onto PrL deep-layer pyramidal neurons, and it reduced the induction of FOS-positive neurons in the cocaine SA environment. Our findings reveal an essential and selective role for PrL HDAC5 to limit associations formed in cocaine, but not sucrose, SA environments, and that it alters the PrL excitatory/inhibitory balance, possibly through epigenetic regulation of synaptic genes. These results further position HDAC5 as a key factor regulating reward-circuit neuroadaptations that underlie common relapse triggers in SUD.