Psychiatric and obstetric outcomes among peripartum patients with bipolar disorder: A single-institution study.

Introduction: Substance use disorders represent a critical global challenge, characterized by multifaceted etiologies often studied in isolation. Epigenetics provides a mechanism linking environmental exposures to biological susceptibility. This review synthesizes the most recent evidence (2023-2025) to analyze substance use disorders complexity through a holistic lens integrating epigenetic, psychological, socio-biological, spiritual, and legal perspectives. Material and Methods: Following PRISMA guidelines, a comprehensive search of databases (PubMed, Scopus, Web of Science, PsycINFO, EMBASE, Cochrane) was conducted. Ninety-four studies meeting inclusion criteria were analyzed. Data were extracted, and random-effects meta-analyses were performed where feasible. Results: Quantitative synthesis revealed significant effect sizes across all domains. Key findings include a strong association between trauma and substance use disorder severity (OR 2.45) and a novel meta-analytic link between trauma and specific epigenetic aberrations (standardized mean differences 0.75). Social support (OR 2.90), religiosity (hazzard ratio 0.65), decriminalization (RR 0.71), and improved access to Medication for opioid use disorder (OR 2.10) emerged as protective factors. Epigenetic studies demonstrated how adversity becomes biologically embedded. Significant cross-domain interactions were identified, with epigenetics acting as a central mediator between environmental experiences and biological outcomes. Conclusion: Evidence supports a holistic, integrated model of substance use disorders where epigenetic processes mediate the biological embedding of risk and resilience. Effective intervention requires breaking down disciplinary silos to simultaneously address psychological trauma, socio-environmental stressors, and their epigenetic influences. Future research must employ longitudinal designs to investigate the reversibility of epigenetic markers and evaluate multilevel interventions incorporating this biological perspective.

Using the actor-partner interdependence model to understand the relationship between parent-adolescent dyads' health literacy and substance use.

Sexual minority (SM) youth are more likely than heterosexual youth to engage in substance use. Injunctive norms, or perceptions of others' substance use attitudes, contribute to youth substance use initiation and progression. Among substance-naïve youth (ages 12-17; N=7628) in the 2023 National Survey on Drug Use and Health, we examined differences in perceived parental, close friend, and personal disapproval of cigarette smoking, marijuana experimentation, monthly marijuana use, and near-daily alcohol use across five sexual identity groups (heterosexual, gay, bisexual, different term, unsure) and sex assigned at birth. Across groups and substances, youth perceived the highest substance use disapproval from parents (range=72.4% - 97.4%), followed by personal disapproval (range=52.1% - 87.7%) and disapproval by close friends (range=48.6% - 81.6%). In multivariable models, bisexual, different term, and unsure youth reported lower close friend (IRR range=0.89-0.97) and personal (IRR range=0.89-0.92) disapproval, compared to heterosexual youth. SM females reported lower close friend and personal disapproval than heterosexual females. SM youth perceive more permissive norms towards substance use. Prevention strategies addressing peer norms and personal permissiveness may be critical for addressing SM youth substance use inequities.

Potentially traumatic events and substance use do not predict changes in resting state functional connectivity in early adolescence.

Mothers and children experiencing substance use and interpersonal violence: A qualitative study addressing the lived experiences of mothers in an attachment-based parenting intervention.

Stimulant misuse is associated with greater incidence of HIV, Hepatitis C virus (HCV), and sexually transmitted infections (STIs). Substance use treatment facilities are an important site of care for people with stimulant use disorder (StUD). Accessible testing for HIV, HCV, and STIs, and HIV treatment, pre-exposure prophylaxis (PrEP), and HCV treatment are essential for controlling these syndemics. We conducted a cross-sectional analysis of the 2024 National Substance Use and Mental Health Services Survey (N-SUMHSS) to describe availability of HIV, HCV, and STI testing, and HIV treatment, PrEP, and HCV treatment at substance use treatment facilities treating StUD. In addition, we compared the percentage of facilities with each service available between 2021 and 2024. Of included facilities (N = 12,118), HIV testing was available at 36.2%, HCV testing at 35.1%, STI testing at 31.0%. HIV treatment was available at 15.9%, PrEP at 11.2%, and HCV treatment at 17.9% of facilities. Of facilities that did not offer HIV or HCV testing, 9.50% and 8.60% had the capacity to collect blood samples, respectively. Of facilities without available STI testing, 87.2% had the capacity to collect urine samples. There were 759 facilities with HIV and 1063 with HCV treatment without PrEP availability. Between 2021 and 2024, the percentage with each service increased, however, the gaps between service availability also remained constant. Few substance use treatment facilities provided HIV, HCV, and STI testing, PrEP, and treatment. Yet, many collect biospecimens required for testing or management of PrEP. Expansion of these services and colocation with treatment facilities are crucial strategies for prevention, early diagnosis, and timely treatment of HIV, HCV, and STI in individuals with StUD.

Artificial intelligence innovations in substance use prevention on social media: A scoping review.

Patient-reported substance use in heart failure.

To investigate whether behavioral factors and substance use influence the oral disease burden at 40 years of age in a population-based birth cohort. This longitudinal study drew data from the 1982 Pelotas Birth Cohort, Brazil. At age 40, 453 participants were examined. Oral disease burden was modeled as a latent construct including decayed teeth, periodontal probing depth ≥4 mm, clinical attachment level ≥3 mm, and bleeding on probing. Family income at birth and sex were specified as distal exposures. Behavioral factors, substance use, and common mental disorders across adulthood were modeled as mediators influencing oral disease burden at age 40. Associations were estimated using structural equation modeling. Higher sugar intake (SC = 0.269, 95% CI: 0.168-0.370) and tobacco use (SC = 0.432, 95% CI: 0.336-0.527) were associated with an increased oral disease burden at age 40. Dental flossing (SC = -0.450, 95% CI: -0.605 to -0.294) and regular dental visits (SC = -0.311, 95% CI: -0.426 to -0.197) were protective. Cannabis use showed an apparent protective effect (SC = -0.259, 95% CI: -0.389 to -0.129), likely due to correlation with tobacco. Alcohol use was not associated with the outcome. Behavioral factors and substance use at age 30 significantly influenced oral disease burden at age 40. The long-term impact of behavioral trajectories on oral health is underscored by these findings. Clinical and policy interventions prioritizing the stabilization of healthy habits during early adulthood are essential to mitigate the cumulative burden of chronic oral diseases later in life.

Relationship of Ethanol, Cannabinoids, Benzodiazepines, and Opioids to Serious Injuries from Falls in Adults Aged 55 and Older.

Comorbid attention deficit/hyperactivity disorder (ADHD) and substance use disorder (SUD) is associated with poor treatment outcomes. This international multi-center observational prospective cohort study aimed to gain knowledge about predictors of treatment outcomes in adult SUD+ADHD patients. Data was collected from June 2017 to May 2021 at baseline, four weeks, three months, and nine months at twelve treatment services in nine countries. Main outcomes were: Treatment retention, ≥30% reduction from baseline to follow-up according to the adult ADHD self-report scale (ASRS-18), and self-reported substance use at three-month follow-up. A total of 137 adult females (24 %) and 441 adult males (76 %) were enrolled. Receiving stimulant treatment for ADHD was significantly associated with better treatment retention (OR: 2·4, 95% CI: 1·4-4·2), ≥30% reduction in ASRS total score (OR: 2·6, 95% CI: 1·2-6·1), and fewer heavy drinking days (IRR: 0·24, 95% CI: 0·13-0·42) at three months. Psychosocial treatment for ADHD was independently and significantly associated with fewer heavy drinking days at three months (IRR: 0·27, 95% CI: 0·14-0·51). In summary, treatment of ADHD in SUD+ADHD patients was related to improvements in ADHD-symptoms, treatment retention and fewer heavy drinking days at follow-up. These findings highlight the importance of ADHD treatment provision in this population. Future RCTs are warranted to confirm these results and should assess combinations of ADHD treatments and SUD treatments using different doses of stimulants. Trial Registration: ISRCTN (https://doi.org/10.1186/ISRCTN15998989).

Tobacco use is highly prevalent among individuals with schizophrenia and exacerbates craving, a key METHODS: Data were collected from 1769 patients within the FondaMental Expert Centers for Schizophrenia network. Sociodemographic, clinical, addictive, suicidal, and treatment-related variables were analyzed using both univariate and multivariate logistic regression models. Mediation analyses were performed to ensure robust statistical inference. The prevalence of tobacco smoking was 52.8% (n = 878). Higher tobacco craving scores were significantly correlated with increased suicidal ideation (p = 0.004), more frequent suicide attempts (p < 0.001), and higher suicide scores (p < 0.001). In the multivariable analysis, no significant associations were found between craving scores and all suicide outcomes. Regression models confirmed a strong association between tobacco craving and lifetime alcohol use disorder (AUD) (p < 0.001). Mediation analyses showed that AUD does not mediate the craving-suicide relationship (indirect effects p > 0.05). These findings highlight the complex interplay between clinical severity, substance use, and suicidality in shaping craving levels among patients with schizophrenia. Mediation analyses showed that AUD does not explain the craving-suicide relationship, indicating that these represent separate, parallel risk pathways. Assessment of tobacco craving and comorbid substance use, particularly AUD, is essential when assessing suicide risk. These findings have important implications for suicide prevention and treatment strategies in individuals with schizophrenia and co-occurring substance use disorders.

Problematic substance use among trans and non-binary people in Spain: An overlooked reality.

Limited research has examined the longitudinal interplay of depression, substance use, and immune dysregulation among men with HIV. We analyzed longitudinal data from 100 men who have sex with men (MSM) living with HIV enrolled in the HPTN 063 cohort (2011-2013) in Brazil. Depressive symptom severity, alcohol use severity, and recent illicit stimulant use were assessed quarterly over 12months. Soluble markers of immune activation (sCD14) and inflammation (IL-6) were measured at baseline and at a 12-month visit. Depressive symptom severity and alcohol use severity showed substantial within-person variability across time, whereas stimulant use remained relatively stable. These psychosocial factors were weakly intercorrelated. Controlling for baseline IL-6, the odds of having detectable IL-6 at 12months increased by 2% for each point increase in the proportion of visits with elevated depression, 7% for each point increase in mean depressive severity across visits, 5% for each point increase in depressive severity at nine months, and 6% for each point increase in depressive severity at 12months. Effects persisted after controlling for baseline HIV viral load. Controlling for baseline sCD14, estimated 12-month sCD14 increased 8ng/mL for each point increase in 12-month depressive severity and 20ng/mL for each point increase in 12-month alcohol use severity. The alcohol-sCD14 association was attenuated when adjusting for HIV viral load. Neither baseline IL-6 nor sCD14 strongly predicted future depressive symptoms or substance use. Depressive symptoms predicted future inflammation and current immune activation. Research should examine if interventions to treat depression can improve immune functioning.

Neurocognitive functioning in gambling: A systematic review of comparisons with other psychiatric and comorbid conditions.

Functional magnetic resonance imaging (fMRI) aims to identify biomarkers of neuropsychiatric illnesses, including substance use disorders; however, fMRI's clinical utility remains limited. One underexplored aspect of the fMRI signal is the systemic low-frequency oscillation (sLFO), a global physiological signal historically treated as noise but linked to vascular and autonomic function. Across 4 independent datasets, we used Regressor Interpolation at Progressive Time Delays analyses to extract the sLFO from resting-state and task-based fMRI data. We evaluated relationships between sLFO amplitude and acute and chronic indices of nicotine use. We further assessed the effects of nicotine and methylphenidate on the sLFO and related task performance. In individuals who smoked tobacco, higher average sLFO amplitude during cigarette cue exposure was negatively associated with nicotine dependence (n = 64; r = -0.32, p = .009), whereas a rise in the sLFO across the task was negatively associated with greater cue-induced craving (r = -0.31, p = .014). sLFO amplitude was reduced during chronic nicotine use versus abstinence (n = 65; p < .001). Relative to placebo, acute single-dose methylphenidate administration also reduced the sLFO in healthy control participants (n = 58; p = .001). Both acute methylphenidate- and nicotine-induced reductions in sLFO amplitude were associated with improved cognitive task performance. These findings demonstrate that the sLFO encodes biologically meaningful information related to substance use, consistent with its role as an index of physiological arousal. Importantly, because the sLFO can be extracted directly from existing fMRI datasets, it offers a powerful and complementary approach to enhance the clinical relevance of fMRI research beyond substance use.

Understanding health literacy and perceptions of substance use disorder among racial and ethnic minority communities: Insights from the health belief model.

The stigma attached to substance use disorder (SUD) can prevent entry into, and engagement with, treatment services. This paper provides an initial exploration into what could be an emerging trend using a case study approach. Semi-structured interviews were conducted with 15 women who have used, or were currently using, residential or community-based addiction services in Cork (Ireland). Some participants reported the well documented stigma attached to SUD as a barrier for entry into, and engaging with, the recovery process. Two participants reported feeling ashamed of being unable to identify specific traumas that could account for their substance use. They felt the stereotype of 'the addict' having had a traumatic life did not map onto their experiences, and felt stigmatised by others within recovery for this. Consequently, they questioned whether they had a SUD and should access treatment, and this initially prevented them from engaging in therapy. This paper does not refute the association between trauma and SUD. Rather it argues that common misunderstandings of trauma and substance use, and increased use of trauma talk, may have contributed to a new form of stereotype that some with SUDs must navigate.

Experiences with recovery from substance use in a Northern Midwest Indigenous Reservation setting.