Substance Use Disorders Research Articles

Factors associated with delayed admission to the burn unit: A major burn center’s experience

BackgroundTimely admission to the burn unit is crucial. Ideal burn care requires prompt interventions such as wound and body temperature management, infection control, and fluid resuscitation to prevent complications like burn progression and infection. In this study, we identify specific factors and outcomes associated with delayed admission to a regional burn center. MethodsPatients admitted to a large urban burn center from January 2015 to December 2023 were retrospectively queried, with subsequent collection of demographic and outcome variables from chart review. Descriptive statistics, Welch’s t-tests of unequal variances, and Chi-square analysis were performed. Multiple logistic regression was performed to explore the association between delayed admission and ICU stay, ventilator requirements, and mortality. ResultsA total of 3137 patients were included in the study. Approximately 63.4 % of patients were admitted within 24 h, while 36.6 % had a significant delay in care of over 24 h after injury. Male patients were likely to experience delayed admission (39.0 vs. 31.8 %, p < 0.001). There was no significant difference in age between the two cohorts (38.6 vs. 39.7 years, p = 0.199). There was no significant difference in time to admission by racial background (p = 0.061). Total body surface area burned (TBSA) varied between the delayed and control cohorts (15.5±18.7 % vs. 8.2±12.9 %, p < 0.001). Patients who were single (p < 0.001) and lived alone (p = 0.011) were more likely to experience a delay in burn unit admission. Homelessness (p < 0.001), substance abuse disorder (p < 0.001), and uninsured status (p < 0.001) were also associated with delayed admission. In regression analysis when controlling for TBSA, delay in care was significantly associated with a greater requirement for ICU stay (p < 0.001) and mechanical ventilation (p = 0.021) but was not associated with increased mortality (p = 0.232). ConclusionSociodemographic variables such as homelessness, lack of social support, and substance abuse are associated with delayed burn unit admission. Knowledge of these factors can inform future interventions to improve outcomes for vulnerable patients, promoting better recovery and long-term outcomes after burn injury.

Bible reading and human flourishing among U.S. military families

Bible reading and human flourishing among U.S. military families Sung Joon Jang and Byron R. Johnson, inspire us with their research on Bible reading and human flourishing among U.S. military families. Military service can create unique challenges for active and retired members and their families, such as frequent deployments or relocations and family separation. It also brings into their home lives the mental and physical consequences of war after tours of duty and post-combat experiences. Prior research shows that these stressors tend to have lasting, detrimental effects on the well-being of military personnel, veterans, and their families, including mental illness, poor health, post-traumatic stress disorder (PTSD), substance abuse, marital and family problems, suicide, and domestic violence.

Differences in the Rates of Diagnoses of Mental and Behavioral Disorders Due to Psychoactive Substance Use by Sex and Age during Pre-Pandemic and COVID-19 Pandemic Periods in Kazakhstan.

The COVID-19 pandemic had profound impacts worldwide on individuals with mental and behavioral disorders, including disorders due to psychoactive substance use. We investigated how the COVID-19 pandemic affected the trends in these disorders in the Republic of Kazakhstan. We researched and compared ICD-10 data on mental and behavioral disorders due to substance use in Kazakhstan that were diagnosed in 2018-2019 (pre-pandemic) versus 2020-2021 (the pandemic period). The data for the pandemic period were significantly different from those of the pre-pandemic in that (i) 'other stimulant-related disorders (F15)' and 'other psychoactive substance-related disorders (F19)' were increased in the younger age groups, (ii) the risk of 'opioid-related disorders (F11)' was decreased in the 30-year-old group in both males and females, and (iii) the risk of 'alcohol-related disorders (F10)' was increased in the 30-year-old group and decreased in the 20- and 50-year-old groups. In only the males, (iv) the risk of 'other psychoactive substance-related disorders (F19)' was increased in almost all of the age groups, and (v) the risk of 'cannabis-related disorders (F12)' was increased in the ≥50-year-olds. The pre-pandemic and pandemic periods thus involved changes due to COVID-19 in both males and females that were especially notable in males. These results indicate that further measures designed to prevent mental and behavioral disorders due to psychoactive substances are necessary at the primary, secondary, and tertiary levels, and personnel in medicine/nursing, the government, private organizations, and the public need to collaborate to devise such measures.

The role of the human-canine bond in recovery from substance use disorder: A scoping review and narrative synthesis

Abstract Recovery from substance use disorder (SUD) is a personal journey that includes connection with self and others, including animals – known as the human-animal bond (HAB). Research shows that canines are the most common type of animal integrated into animal-assisted interventions to support people with SUD. Yet, to our knowledge, there has been no review of the evidence on the role of canines in SUD recovery. The scoping review’s objective was to examine the literature on the human-canine bond’s role in recovery from SUD among adolescents and adults, including how the bond may help or hinder recovery. The review considered records that described the human-canine bond with respect to recovery in any recovery- or therapy-related setting globally. Eleven databases were searched, and 32 sources met inclusion criteria that involved companion dogs, therapy dogs, service/assistance, dogs and others. The thematic analysis across records identified three key benefits of the human-canine bond in SUD recovery: (1) a source of social connection and a conduit for human-to-human social connection, (2) a calming and comforting effect on individuals with SUD that can reduce stress and anxiety, and (3) the human-canine bond as a motivating factor for positive change. Through these themes, the bond may help divert substance use-related thoughts and reduce cravings, bolster engagement in treatment and recovery, and help to decrease and prevent substance use. However, a few articles found no role or a limited role of the human-canine bond in recovery, and challenges and considerations were reported, particularly for marginalized populations (e.g., related to obtaining and maintaining housing, employment, and SUD treatment). Most of the records discussed canine welfare in some capacity. Calls were also made for improved policy, public awareness, and animal welfare.

The Neurocircuitry of Substance Use Disorder, Treatment, and Change: A Resource for Clinical Psychiatrists.

Substance use disorder (SUD) is common in psychiatric patients and has a negative impact on health and well-being. However, SUD often goes untreated, and there is a need for psychiatrists, of all specialties, to address this pervasive clinical problem. In this review, the authors' goal is to provide a resource that describes treatments for SUD, using neuroscience as a framework. They discuss the effect of pharmacotherapy on craving, intoxication, and withdrawal and its ability to interrupt the cycle of substance use in SUD. The neuroscience of stress is reviewed, including medications targeting neurotransmitter systems activated by alarm and fear. Neuroplasticity and promising treatments that use this mechanism, including ketamine, psilocybin, and transcranial magnetic stimulation (TMS), are discussed. The authors conclude by listing resources and practice guidelines for physicians interested in learning more about treatments for SUD.

Trends in racial/ethnic and geographic disparities in substance use disorders mortality in the United States, 2000-2019.

Substance use disorders (SUD) are a major public health concern in the United States. This study examined racial/ethnic and state-level disparities in SUD mortality in the United States from 2000 to 2019. Age-standardized mortality rates for SUD were obtained for 5 racial/ethnic groups (White respondents, Black respondents, Latino, Asian-Pacific Islander [API], American Indian/Alaska Native [AIAN]) by state and sex from 2000 to 2019. Joinpoint regression analysis was used to model temporal trends overall and by demographic factors. From 2000 to 2019, the overall mortality rate increased from 8.0 to 28.8 deaths per 100,000 population across all groups. AIANs had the highest mortality in 2019 (57.8 per 100,000), followed by Black respondents, White respondents, Latinos, and APIs. Significant increases occurred across all racial/ethnic groups, with the greatest average annual percentage change (AAPC2000-2019) among White respondents (6.7%; 95% confidence interval [CI]: 6.2%-7.3%), APIs (6.0%, 95% CI: 5.6%-6.2%), and AIANs (5.9%, 95% CI: 5.6%-6.2%). Mortality rates increased more rapidly for females than males among White respondents, AIANs, Black respondents, and Latinos. Substantial state-level variation emerged, with the highest mortality rates in 2019 seen in West Virginia, the District of Columbia, Delaware, Ohio, and Pennsylvania. Racial/ethnic and geographic disparities in SUD mortality have widened significantly from 2000 to 2019, highlighting priority areas for prevention efforts. This study provides detailed insights into long-term trends in racial, ethnic, and geographic disparities in SUD mortality across the United States, informing targeted prevention and intervention strategies.

Doing transdisciplinary research in Guyana's prisons

AbstractThis article reflects on the research process that underpinned the ESRC GCRF project ‘Mental Health, Neurological and Substance Abuse Disorders in Guyana's Jails: 1825 to the present day’. Introducing readers to a transdisciplinary team comprised of academics and practitioners, in what follows we think through how the methods of the research underpinned the production of the data used in this special issue. The article highlights the emotional labour and ethics of care among the team, and the benefits of transdisciplinary research and the mutual recipriocity and learning that took place between academics and prison staff. The goal of the project was to create equitable and ethical partnerships, and this contributed to the success of this research in terms of findings, data, and real‐world impact.

Discovery of a novel piperazine derivative, cmp2: a selective TRPC6 activator suitable for treatment of synaptic deficiency in Alzheimer’s disease hippocampal neurons

Alzheimer disease (AD) is characterized by progressive loss of memory. Synaptic loss is now the best correlate of cognitive dysfunction in patients with Alzheimer’s disease. Thus, restoration or limitation of synapse loss is a promising strategy for pharmacotherapy of AD. N–N substituted piperazines are widely used chemical compounds for drug interventions to treat different illnesses including CNS diseases such as drug abuse, mental and anxiety disorders. Piperazine derivatives are small molecules that are usually well tolerated and cross blood brain barrier (BBB). Thus, disubstituted piperazines are good tools for searching and developing novel disease-modifying drugs. Previously, we have determined the piperazine derivative, 51164, as an activator of TRPC6 in dendritic spines. We have demonstrated synaptoprotective properties of 51164 in AD mouse models. However, 51164 was not able to cross BBB. Within the current study, we identified a novel piperazine derivative, cmp2, that is structurally similar to 51164 but is able to cross BBB. Cmp2 binds central part of monomeric TRPC6 in similar way as hypeforin does. Cmp2 selectively activates TRPC6 but not structurally related TRPC3 and TRPC7. Novel piperazine derivative exhibits synaptoprotective properties in culture and slices and penetrates the BBB. In vivo study indicated cmp2 (10 mg/kg I.P.) reversed deficits in synaptic plasticity in the 5xFAD mice. Thus, we suggest that cmp2 is a novel lead compound for drug development. The mechanism of cmp2 action is based on selective TRPC6 stimulation and it is expected to treat synaptic deficiency in hippocampal neurons.

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.

Meta-correlation of the effect of ketamine and psilocybin induced subjective effects on therapeutic outcome

There is some evidence that the subjective effects of ketamine and other psychedelics like psilocybin are crucial for their therapeutic outcomes, such as treatment of depression or substance use disorder (SUD). We performed a meta-analysis and systematic review on the correlation of subjective symptoms and dissociation versus ketamine-induced therapeutic outcomes in patients with depression or SUD. A similar analysis was conducted for psilocybin-induced therapeutic improvement. We retrieved 23 papers studying ketamine (21 on depression, 2 on SUD) in 471 patients and 8 papers studying psilocybin (6 on depression, 2 on SUD) in 183 patients. Our study demonstrated a modest role for subjective effects mediating therapeutic outcomes, with R2-values ranging from 5–10% for ketamine and for psilocybine the R2 was 24%. A greater mediating effect for psilocybin compared to ketamine was detected, particularly when restricting the analysis to depression. Additionally there is a greater mediating effect in SUD than depression, irrespective of treatment.

Associations between intraindividual reaction time variability, baseline respiratory sinus arrhythmia, and trait impulsivity in males with substance use disorders

Trait impulsivity, characterized by the tendency to act without adequate consideration of potential consequences in pursuit of immediate rewards, is a recognized vulnerability marker for substance use disorders (SUDs). Cognitive control deficits are implicated in the manifestation of high trait impulsivity, and intraindividual reaction time variability (IIRTV), an indicator of cognitive control, may influence trait impulsivity. Baseline respiratory sinus arrhythmia (RSA) reflects vagal tone, serves as an index of physiological self-regulation, which has been demonstrated to be related to trait impulsivity. However, it is unclear whether IIRTV is associated with trait impulsivity and whether it interacts with baseline RSA to influence trait impulsivity. A total of 113 males with SUDs participated (Mage = 46.04 years, SD = 11.53) in this study. Trait impulsivity was assessed using a self-report questionnaire, IIRTV was measured through a two-choice oddball task, and baseline RSA was obtained through the collection of electrocardiogram (ECG) data. The results indicated that IIRTV interacted with baseline RSA to influence trait impulsivity. These findings suggested that cognitive control indexed by IIRTV, might represent a central nervous correlate of trait impulsivity, and that it interacted with vagal tone indexed by baseline RSA, to influence trait impulsivity.

8256 Early Life Stress and Pubertal Predictors of Youth Substance Use Initiation: Does Sex Moderate the Relationship Between ELS, Puberty, and Substance Use Initiation?

Abstract Disclosure: A. Donovan: None. S. Assari: None. M. Shaheen: None. C. Grella: None. L. Richter: None. T.C. Friedman: None. Background: Early life stress (ELS) is a construct composed of children’s experiences of abuse, neglect, and conflict. Approximately 20% of adolescents in the United States have experienced ELS at some point, and these experiences influence adolescent and adult health behavior outcomes. Adults with a history of ELS display higher rates of substance use disorders (SUD) and report earlier initiation of substance use. Additionally, ELS has been associated with early puberty, which in turn is linked to earlier substance use initiation. Our study examines the roles of pubertal status, sex hormones (estradiol, testosterone, and DHEA) and ELS as predictors of the initiation of substance use among a nationally representative sample of male and female adolescents in NIDA’s Adolescent Brain Cognitive Development (ABCD) database. Methods: Baseline measures from the ABCD database release 5.0 were used to generate an ELS score (0-60), puberty assessed via parental report on the Pubertal Development Scale (PDS, 1-4), and sex hormones (estradiol, testosterone, and DHEA) were analyzed via salivary samples. The relationship between these scores and time to first use of alcohol, nicotine, and marijuana was determined via survival analysis utilizing a cox regression. Age was tested as a covariate in the interaction of ELS and time to first use of alcohol, nicotine, and marijuana. Data were analyzed overall and for biological boys and girls separately (N=11,866, 52%M 48%F. ages 9-11 at baseline). Results: We observed additive effects of PDS score, estradiol measure, age, and ELS on time to first use of any substance (alcohol, nicotine, or marijuana) and found age (Exp β= 1.029, p&amp;lt;0.001) and ELS (Exp β= 1.017, p&amp;lt;0.05) to be significant predictors of time to first use. After separating by sex, ELS was no longer a significant predictor for males (Exp β= 1.014, p=0.054), but remained a predictor for females (Exp β= 1.019, p&amp;lt;0.05) indicating the overall effect was driven by females. Additionally, salivary estradiol was a significant predictor of first use for females (Exp β= 1.208, p&amp;lt;0.05), while salivary DHEA and testosterone were not predictors for males or females. Conclusions: Our results indicate sex does moderate the relationship between ELS and substance use initiation within our population, with females showing increased risk of initiation with increases in estradiol. Further findings from our study will help to describe sex differences among the factors that increase the risk of substance use initiation among ELS-exposed youth and explore how these vary by substance. ABCD provides an unprecedented opportunity to explore the mechanisms behind complex effects of ELS by sex on risk factors for adolescent substance use initiation. Presentation: 6/1/2024

8769 A Case of Metastatic and Catecholamine Producing Bilateral Pheochromocytoma in a Patient with RET Gene Mutation

Abstract Disclosure: R.A. Mayers: None. A. Szafran-Swietlik: None. RET mutation, observed in multiple endocrine neoplasia type 2 syndromes, is implicated in the development of pheochromocytomas of the kinase signaling cluster. Such tumors have lower metastatic risk and adrenergic production compared to the ones from the other clusters. We present a case of a metastatic, bilateral, small and biochemically active pheochromocytoma .This is the case of a 27-year-old man diagnosed with MEN 2A. He underwent total thyroidectomy due to medullary thyroid carcinoma at 2 years old. He was deemed cured and started on levothyroxine replacement. Since then, his plasma metanephrines by liquid chromatography-mass spectrometry and urine metanephrines done in a yearly basis as screening, were always within range of normality. Over the years, he developed substance abuse disorder with use of Kratom and methamphetamines and was admitted in a rehabilitation center multiple times in the last three years. During this time, the patient was reported to be slightly tachycardiac which was initially attributed to the use of substances. On the last year, an echocardiogram done as evaluation of his tachycardia showed an ejection fraction of 35%. Later, his annual metanephrine levels were markedly elevated (free metanephrine: 137 pg/mL and free normetanephrine : 157 pg/mL, normal ranges reported as less than 57 pg/mL and less than 148 pg/mL respectively). Abdominal tomography showed a right adrenal nodule of 1.2 cm and a left adrenal nodule of 1.6 cm, both with more than 10 Hounsfield Units. A Metaiodobenzylguanidine scan revealed a left adrenal nodule of 1.8 cm with diffuse radiotracer uptake, a right adrenal nodule of 1.2 cm with radiotracer activity and 3 subtle areas of focally increased radiotracer activity in the liver, two in left hepatic lobe and other in posterior right upper lobe. He underwent bilateral adrenalectomy with cortical sparring. Pathology results evidenced a left adrenal with a unifocal mass of 1.8 cm and a right adrenal with a mass of 1.2 cm , both without lymphovascular, capsular, local invasion or necrosis, a mitotic rate of 1-2 without atypical mitosis, not encapsulated with clean margins and positive for synaptophysin , chromogranin and S100 stains. An additional mass of 0.7 cm on the right adrenal gland was described with similar characteristics to the described before except for the involvement of the surgical margins. Currently on the literature there are different opinions regarding screening approach for pheochromocytomas in the presence of RET mutations. There are not strong recommendations regarding the use of imaging as a screening tool in this group of patients. It is important to consider that there are cases, as the one described in this report, that might present metastatic disease even with the presence of small pheochromocytomas that belong to the cluster of kinase signaling. Presentation: 6/3/2024

Differences in Mental Health Between Female Sexual Minority and Heterosexual Youth with a Substance Use Disorder Who Are Experiencing Homelessness.

Purpose: The purpose of this study was to examine differences in mental health outcomes of two groups within youth experiencing homelessness (YEH) and who have a substance use disorder (SUD): sexual minority (SM) and heterosexual females. Methods: This study used baseline data from four randomized clinical trials of substance use interventions for YEH with a SUD to examine differences in depression and suicidality between SM and heterosexual female youth. Participants were between 12 and 24 years of age. Meta-analytic methods were used to aggregate data across studies to estimate differences in mental health. Results: Results indicated that female SM-YEH had higher depression symptoms (Hedge's g [g]=0.20; 95% confidence interval [CI] 0.01-0.39), higher risk of a history of suicide behavior (risk ratio = 1.63; 95% CI: 1.17-2.27), and a greater number of suicide behaviors (g = 0.31; 95% CI: 0.09-0.54) compared to their heterosexual peers. These effect sizes were not moderated by age. Conclusion: Female SM-YEH had elevated levels of depression and suicidality compared to their heterosexual peers. The findings of this study align with research on mental health disparities between SM and heterosexual youth generally, which underscores the unique struggles and risks associated with identifying as a female SM-YEH with a SUD.

A novel rural hospital/clinic-system practice-based research network: the Rural Addiction Implementation Network (RAIN) initiative and its goals, implementation, and early results

ABSTRACT Background: Rural and frontier communities face high rates of opioid use disorders (OUDs). In 2021, the Rural Addiction Implementation Network (RAIN) sought to establish a rural hospital/clinic-system practice-based research network (RH-PBRN) to facilitate implementation of evidence-based addiction-related prevention, treatment, and recovery (PTR) services to reduce the morbidity of OUD and substance use disorder (SUD) in rural communities. Objective: To describe the goals and implementation of PTR activities of RAIN, a novel RH-PBRN. Methods: RAIN identified teams of external/internal facilitators at four rural hospitals/clinic-networks to achieve at least 15 PTR activities involving OUD and other SUDs. RAIN utilized an implementation-facilitation approach: facilitators assessed the implementation environment and promoted interventions to overcome barriers to PTR implementation. Other interventions included site visits, community of learning calls, and e-communication. RAIN assessed and recorded facilitators and barriers to implementation, milestone attainment, and outcomes of PTR activities. At 18 months, we queried facilitators about the fidelity and implementation of RAIN activities. Results: RAIN established an HP-PBRN in four sites (Idaho, Montana, Utah, and Wyoming). Within the HP-PBRN, 20 PTR activities were established (p = 7, T = 10, R = 3; range 3–7 per site). Barriers to implementation of PTR activities included competing clinical demands, especially due to COVID-19, lack of dedicated effort for staff at sites, and stigma of addiction and its treatment. Facilitators of implementation included the use of trained expert facilitators and communication between the sites. Conclusions: RAIN implemented 20 addiction-related PTR activities in four rural hospitals/clinic-networks. RAIN’s intervention model could be replicated to address addiction-related harms in other rural communities.

Paternal perinatal depression: underestimation of the disorder, its clinical and classificatory entanglements, and therapeutic alternatives

In the perinatal period, fathers may also suffer from depression, referred to as paternal perinatal depression. Studies have shown that the prevalence of paternal perinatal depression is considerably higher than in the general adult population. For example, a meta-analysis showed that the prevalence of depression among fathers was 9.76% during the prenatal period and 8.75% during the postpartum year.1 Paternal perinatal depression can deteriorate the marital relationship and generate psychosocial and behavioral problems in the offspring (Ramchandani et al., 2021).2 However, paternal perinatal depression has received comparatively little clinical attention. A review of the literature on this subject will list the biological, psychological and social risk factors for this condition, which include a history of depression or anxiety disorders, lack of social support, conflicts in the couple's relationship, economic and labor problems. The clinical characteristics of depression share similarities with depressions in other periods of life, and there are differential clinical features, such as anger, aggressiveness, somatic symptoms and greater comorbidity with substance abuse disorder. Early detection with scales such as the Edinburgh, Gotland and PAPA and the appropriate approach are fundamental to mitigate the effects of paternal perinatal depression. Psychotherapeutic support, psychoeducation of the disorder, and self-care tools can be part of a comprehensive approach to help parents experiencing this condition. In conclusion, the proposal to include this disorder within the parental perinatal affective disorders, as proposed by the author Baldoni,3 given the level of overlap that it usually has with other comorbid conditions (anxiety, alcohol abuse, impulse control disorders) and high frequency of masked symptoms, goes in the direction to give the attention it deserves for early detection and provide adequate support and treatment.

“I feel like I'm always on edge”: Perceptions of parole supervision by parolees with substance use disorders

IntroductionWhile extant research has looked at parole and its various actors as an institution, few studies recount the parole experience from the perspective of parolees. Additionally, despite the prevalence of substance use disorders (SUDs) within the criminal justice system, research that assesses the additional challenges this population faces throughout parole supervision is even scarcer. MethodsTo address this gap, we analyze in-depth qualitative interviews (n = 51) conducted with reentering men with SUDs as they navigate parole in Pennsylvania. Three independent coders identified all narratives relating to a broad theme of “parole and probation experiences.” The authors then completed iterative rounds of more fine-grained independent coding within that theme. ResultsOur results emphasize that SUDs present a significant barrier to reentry success, and the tension of surveillance and revocation is amplified for those enduring simultaneous reentry and recovery. Importantly, our respondents regard parole officers more positively than they view parole as an institution, yet this perception of officers does not equate to provision of reintegration and recovery support. Respondents perceive that parole presents unnecessary additional hurdles to their reentry success, and their perceived risk level impacts their surveillance intensity. ConclusionsThe information gleaned through inclusion of perspectives from those enduring parole supervision calls for a critical assessment of current parole practices. Further, the current approach to SUDs within community supervision criminalizes relapse without provision of treatment resources or support.

Molecular Mechanisms of Methamphetamine-Induced Addiction via TAAR1 Activation.

Trace amine-associated receptor 1 (TAAR1), a member of the trace amine receptor family, recognizes various trace amines in the brain, including endogenous β-phenylethylamine (PEA) and methamphetamine (METH). TAAR1 is a novel target for several neurological disorders, including schizophrenia, depression, and substance abuse. Herein, we report the structure of the human TAAR1-Gs protein complex bound to METH. Using functional studies, we reveal the molecular basis of METH recognition by TAAR1, and potential mechanisms underlying the selectivity of TAAR1 for different ligands. Molecular dynamics simulations further elucidated possible mechanisms for the binding of chiral amphetamine (AMPH)-like psychoactive drugs to TAAR1. Additionally, we discovered a hydrophobic core on the transmembrane helices (TM), TM5 and TM6, explaining the unique mechanism of TAAR1 activation. These findings reveal the ligand recognition pattern and activation mechanism of TAAR1, which has important implications for the development of next-generation treatments for substance abuse and various neurological disorders.

Telehealth adoption for substance use and mental health disorders in Minnesota and North Dakota: a quasi-experimental study.

The coronavirus disease 2019 (COVID-19) pandemic necessitated rapid adoption of telehealth services to maintain healthcare access for treating substance use disorders (SUDs) and mental health care (MHC). However, the impacts of telehealth expansion policies adopted in 2020 on access to addiction treatment in North Dakota (ND) and Minnesota (MN) remain unclear. This study examines the impact of the COVID-19 pandemic on utilization of telehealth services for SUDs and MHC in ND and MN. We conducted a quasi-experimental study design using Medicaid telehealth claims data from 2018 to 2022. Segmented regression analysis of interrupted time series (ITS) data was employed to assess the impact of the COVID-19 pandemic (March 2020) on telehealth service utilization. From 2018 to 2022, there were 580,186 telehealth claims for SUDs (MN: 545,676; ND: 34,510) and 3.4 million claims for MHC (MN: 3.3 million; ND: 85,391). The mean telehealth utilization rate for SUDs was 5.2 vs. 7.3 per 1,000 beneficiaries and for MHC was 12.6 vs. 45.2 per 1,000 beneficiaries in ND and MN, respectively. The pandemic led to significant increases in telehealth use: ND (SUDs: +22.7/1,000; MHC: +59.8/1,000) and MN (SUDs: +30/1,000; MHC: +185.5/1,000). ND saw smaller initial increases but more gradual declines over time (SUDs: -0.42/1,000/month; MHC: -1.03/1,000/month) compared to MN (SUDs: -0.43/1,000/month; MHC: -2.78/1,000/month). The COVID-19 pandemic significantly increased Medicaid telehealth utilization for SUDs and MHC in both states. MN experienced larger initial increases with steeper declines, while ND showed more sustainable utilization trends, indicating potential for sustained improvements in access to behavioral health services.

Nursing Students' Attitudes Toward Women With Maternal Substance Use Disorders.

Maternal substance use disorders (SUD) have challenged relationships between women with SUD and their nurses. Nurses have reported biased attitudes toward women with SUD, which can interfere with their care. However, it is not well known how nursing students perceive women with SUD and their infants. This article describes nursing students' attitudes toward women with SUD, which can be used to inform educational strategies. An inductive content analysis was used to analyze 76 reflection papers written by nursing students at a midwestern university. Three main themes were identified: (1) stigma toward women with SUD; (2) concerns for infants with neonatal abstinence syndrome; and (3) influence of clinical experiences on attitudes toward women with SUD. Nursing students need more evidence-based guidance on managing their biases as well as the biases of nurses who work in maternity settings. [J Nurs Educ. 2024;63(10):659-664.].