Treatment Of Alcohol Dependence Research Articles

A smartphone app-based intervention combined with face-to-face sessions for alcohol dependence at internal medicine clinics: A randomized controlled trial

BackgroundAddressing the limited access to treatments for alcohol dependence, we developed ALM-002, a therapeutic application to be “prescribed” for non-abstinence-oriented treatment in internal medicine settings. Our objective was to preliminarily assess the efficacy and safety of ALM-002. MethodsIn a multicenter, open-label randomized controlled trial, participants aged ≥20 with alcohol dependence and daily alcohol consumption exceeding 60 g for men and 40 g for women, without severe complications, were randomly assigned to either the intervention group using ALM-002 or the treatment-as-usual control group. Participant in both groups received individual face-to-face sessions by physicians at weeks 0, 4, 8, and 12. The primary endpoint was the change in heavy drinking days (HDDs) from week 0 to week 12. A mixed model for repeated measures was employed. ResultsWe enrolled 43 participants: 22 in the intervention group and 21 in the control group. A significant reduction in HDDs every 4 weeks from week 0 to week 12 was observed, with a between-group difference of −6.99 days (95% CI: −12.4 to −1.6 days, standardized mean difference: −0.80). ConclusionsThese results indicate the potential of ALM-002 as a viable treatment for alcohol dependence. Further studies are needed to evaluate the clinical potential of ALM-002.

Pharmacological treatments for alcohol dependence: Evidence on uptake, inequalities and comparative effectiveness from a UK population-based cohort.

We assessed the prevalence of prescribing of certain medications for alcohol dependence and the extent of any inequalities in receiving prescriptions for individuals with such a diagnosis. Further, we compared the effectiveness of two of the most prescribed medications (acamprosate and disulfiram) for alcohol dependence and assessed whether there is inequality in prescribing either of them. We used a nationwide dataset on prescriptions and hospitalisations in Scotland, UK (N = 19,748). We calculated the percentage of patients receiving alcohol dependence prescriptions after discharge, both overall and by socio-economic groups. Binary logistic regressions were used to assess the odds of receiving any alcohol-dependence prescription and the comparative odds of receiving acamprosate or disulfiram. Comparative effectiveness in avoiding future alcohol-related hospitalisations (N = 11,239) was assessed using Cox modelling with statistical adjustment for potential confounding. Upto 7% of hospitalised individuals for alcohol use disorder received prescriptions for alcohol dependence after being discharged. Least deprived socio-economic groups had relatively more individuals receiving prescriptions. Inequalities in prescribing for alcohol dependence existed, especially across sex and comorbidities: males had 12% (odds ratio [OR] 0.88, 95% confidence interval [CI] 0.81-0.96) and those with a history of mental health hospitalisations had 10% (OR 0.90, 95% CI 0.82-0.98) lower odds of receiving prescriptions after an alcohol-related hospitalisation. Prescribing disulfiram was superior to prescribing acamprosate in preventing alcohol-related hospitalisations (hazard ratio ranged between 0.60 and 0.81 across analyses). Disulfiram was relatively less likely prescribed to those from more deprived areas. Inequalities in prescribing for alcohol dependence exists in Scotland with lower prescribing to men and disulfiram prescribed more to those from least deprived areas.

A retrospective study of unexpected deaths with alcohol use disorder from Japanese forensic autopsy cases

BackgroundAlcohol use disorder (AUD) is an important target for prevention of alcohol-related problems. In this study, we analyzed forensic autopsy cases to reveal the characteristics of the living conditions and death situations of individuals with AUD. MethodsWe retrospectively investigated 486 cases with a history of alcohol consumption for which a forensic autopsy was performed from 2012 to 2021 in Yamaguchi prefecture. Judgement of AUD was made using DSM-5. Various factors were compared statistically between AUD and non-AUD cases. ResultsOf the 486 cases, 225 (46.2%) were judged to be AUD, including 89 (18.3%) with advanced AUD, 33 (6.8%) were judged not to be AUD, and a judgement could not be made in the remaining cases. AUD was associated with alcohol consumption prior to death. Only 14.3% of the advanced-AUD cases was in treatment for alcohol dependence. The rates of interpersonal, health, financial and legal problems, receipt of public assistance and an extremely cluttered or hoarding house status were higher in all AUD and advanced AUD cases. Living alone, smoking and BMI were also associated with AUD. ConclusionsMany cases of alcohol-related deaths may have AUD, and persons with AUD who undergo a forensic autopsy commonly have multiple socioeconomic factors that may be associated with isolation that is involved in exacerbation of AUD. Further studies of these associations are needed because early diagnosis and treatment of AUD and support for the patient may lead to reduction of alcohol-related deaths.

Associations of ADH1B and ALDH2 genotypes and alcohol flushing with drinking history, withdrawal symptoms, and ICD-10 criteria in Japanese alcohol-dependent men.

Given the high prevalence of fast-metabolizing alcohol dehydrogenase-1B*2 (ADH1B*2 ) and inactive aldehyde dehydrogenase-2*2 (ALDH2*2 ) alleles in East Asians, we evaluated how the ADH1B / ALDH2 genotypes and alcohol flushing might affect the development of alcohol dependence (AD). We evaluated how the ADH1B / ALDH2 genotypes and self-reported alcohol flushing affected history of drinking events and withdrawal symptoms and ICD-10 criteria in 4116 Japanese AD men. The ADH1B*1/*1 group and ALDH2*1/*1 group were 1-5 years younger than the ADH1B*2 (+) and ALDH2*1/*2 groups, respectively, for all of the ages at onset of habitual drinking, blackouts, daytime drinking, uncontrolled drinking, withdrawal symptoms, and first treatment for AD, and the current age. Blackouts were more common in the ADH1B*1/*1 group and ALDH2*1/*1 group. Daytime drinking, uncontrolled drinking, and withdrawal symptoms, such as hand tremor, sweating, convulsions, and delirium tremens/hallucinations were more common in the ADH1B*1/*1 group. The ADH1B*1/*1 was positively associated with the ICD-10 criteria for 'tolerance' and 'withdrawal symptoms'. The ADH1B*1/*1 group and ALDH2*1/*2 group had a larger ICD-10 score. Never flushing was reported by 91.7% and 35.2% of the ALDH2*1/*1 and ALDH2*1/*2 carriers, respectively. After a 1-2-year delay in the onset of habitual drinking in the former-/current-flushing group, no differences in the ages of the aforementioned drinking milestones were found according to the flushing status. The ADH1B*1/*1 and ALDH2*1/*1 accelerated the development of drinking events and withdrawal symptoms in Japanese AD patients. ICD-10 score was larger in the ADH1B*1/*1 group and ALDH2*1/*2 group. The effects of alcohol flushing on drinking events were limited.

Bioactive potentialities of Grewia flavescens root extract in the treatment of alcohol dependence: Preliminary phytochemical study

Although the use of plants for medicinal purposes is an ancient practice, there is a perception that in the field of chemical dependency, its role has been and is little studied. With regard to alcohol dependence, the third leading cause of hospitalization in psychiatric hospitals in Mozambique, an ethnobotanical work was carried out in 2018 in the Municipality of Massinga, province of Inhambane, with the aim of identifying with practitioners of traditional medicine, the plants they use in their treatment, having resulted, among other plants, in the identification of Grewia flavescens, from which the need arose, based on phytochemical prospecting and literary framework support, to carry out a study of a preliminary nature on the bioactive potential of the root extract (part indicated in the survey) of Grewia flavescens in the treatment of alcohol dependence. The results showed the presence of Flavonoids, Tannins, Alkaloids, Triterpenoids and Saponins. About this group of bioactives, there is bibliographical evidence that points to the anxiolytic and anti-depressant action of Flavonoids, Saponins and Alkaloids, allowing to infer that these can act as mood stabilizers in patients in the phase of alcohol withdrawal syndrome and craving during treatment, not despite deepening from preclinical studies.

ATPase Copper Transporting Beta (ATP7B) Is a Novel Target for Improving the Therapeutic Efficacy of Docetaxel by Disulfiram/Copper in Human Prostate Cancer.

Docetaxel has been the standard first-line chemotherapy for lethal metastatic prostate cancer (mPCa) since 2004, but resistance to docetaxel treatment is common. The molecular mechanisms of docetaxel resistance remain largely unknown and could be amenable to interventions that mitigate resistance. We have recently discovered that several docetaxel-resistant mPCa cell lines exhibit lower uptake of cellular copper and uniquely express higher levels of a copper exporter protein ATP7B. Knockdown of ATP7B by silencing RNAs (siRNA) sensitized docetaxel-resistant mPCa cells to the growth-inhibitory and apoptotic effects of docetaxel. Importantly, deletions of ATP7B in human mPCa tissues predict significantly better survival of patients after their first chemotherapy than those with wild-type ATP7B (P = 0.0006). In addition, disulfiram (DSF), an FDA-approved drug for the treatment of alcohol dependence, in combination with copper, significantly enhanced the in vivo antitumor effects of docetaxel in a docetaxel-resistant xenograft tumor model. Our analyses also revealed that DSF and copper engaged with ATP7B to decrease protein levels of COMM domain-containing protein 1 (COMMD1), S-phase kinase-associated protein 2 (Skp2), and clusterin and markedly increase protein expression of cyclin-dependent kinase inhibitor 1 (p21/WAF1). Taken together, our results indicate a copper-dependent nutrient vulnerability through ATP7B exporter in docetaxel-resistant prostate cancer for improving the therapeutic efficacy of docetaxel.

Disulfiraminės psichozės atvejis

Introduction. Disulfiram is one of three medications approved by the Federal Drug Administration (FDA) to treat alcohol dependence. Patients tend to abstain from alcohol to avoid the unpleasant effects of alcohol toxicity. There may be some side effects, the most common of which are drowsiness, unusual tiredness, headache, metallic taste in mouth, skin rashes, decreased libido. Disulfiram induced psychosis is a psychiatric side effect that occurs very rarely.
 Case report. We report the case of a 33-year-old patient with nearly 15 years history of psychiatric personality disorder and alcohol dependence. Approximately 4 days of alcohol abstinence, as an inpatient he was administered disulfiram. After two weeks, the patient began to feel some side effects. He was admitted to hospital and was diagnosed with disulfiram induced psychosis.
 Discussion. The effect of disulfiram on alcohol metabolism was noticed in the 1940s. It should be used only by motivated patients who must be fully informed about the alcohol-disulfiram reaction. Disulfiram should only be started after about 10 days of sobriety, and the recommended dosage is 500 mg/day. The drug should be used with caution in people with a history of heart disease, diabetes mellitus, hypothyroidism, cerebral damage, nephritis, liver cirrhosis, epilepsy. Caution is recommended for patients who use benzodiazepines, some antibiotics, anticoagulants, tricyclic antidepressants. There may be some adverse effects, more serious ones include changes in vision, numbness, pain or weakness in the limbs, liver cell damage, peripheral neuropathy, seizures – but these are considered to be very rare. Psychiatric side effects may include mood changes, psychotic reactions, memory impairment. Reliable data is lacking, but cases of disulfiram induced psychosis are considered to be rare. Patients taking disulfiram should be monitored carefully.

Comparative pharmacogenetic study of disulfiram or cyanamide efficacy for alcohol dependence: the key role of dopamine neurotransmission gene polymorphisms

The actual direction of increasing the efficacy of alcohol dependence (AD) treatment is the search for opportunities for individualization of therapy using pharmacogenetic markers to stratify patients in order to select the most optimal therapeutic tactics.Aims. To test an associations of possible pharmacogenetic markers with indicators of the efficacy of disulfiram and cyanamide to stabilize remission in patients with AD.Materials and methods. A pharmacogenetic study was conducted on the basis of a double-blind, randomized, comparative, placebo-controlled clinical study of the efficacy and tolerability of disulfiram and cyanamide in the treatment of alcohol dependence syndrome. The main outcome: the duration of retention of patients in the treatment program (in remission), and withdrawal from the treatment program for any reason was considered a negative outcome. Secondary outcomes: time to relapse to alcohol use and time to recurrence to AD. 150 patients with AD (ICD-10 criteria) (av. age - 40.65±1.09 y.o., 19.3% females) were randomly assigned to one of three treatment groups (50 subjects in each): Disulfiram, Cyanamid and Placebo. All patients had weekly (12 weeks) visits to research clinic for brief counselling session. The genetic panel of the study consisted of 15 polymorphic loci in 9 genes: dopamine receptors 2 (DRD2) and 4 (DRD4) types, transmembrane dopamine transporter (DAT), enzymes dopamine-beta-hydroxylase (DBH) and catechol-ortho-methyl-transferase, as well as a two polymorphisms in the genes of the endogenous opioid system and the aldehyde dehydrogenase enzyme gene cluster.Results. For disulfiram, the DBH rs1108580 is associated with a longer remission (p=0.053, trend), and DRD4 VNTR 48 bp is associated with a shorter remission (p=0.006). For cyanamide, DAT VNTR 40 bp was associated with shorter remission (p=0.006) and rapid recurrence to AD (p=0.045). DAT rs27072 has an effect simultaneously in two treatment groups, while the direction of the effect is opposite. For cyanamide, the marker is slightly associated with a longer remission (p = 0.082, trend), a longer time to relapse (p = 0.063, trend) and a longer time to recurrence to AD (p = 0.083, trend). For placebo, DAT rs27072, on the contrary, is associated with a shorter time to to recurrence to AD (p = 0.066, trend). For placebo, DRD2 rs1799732 was associated with a shorter remission (p = 0.001), a shorter time to relapse (p = 0.018), and a shorter time to recurrence to AD (p = 0.001).Conclusion. Preliminary pharmacogenetic markers of the efficacy of alcohol dependence treatment have been identified in genes that control dopaminergic neurotransmission. After independent validation, the obtained genetic markers may be used for pharmacogenetic stratification of patients in order to select the optimal treatment options for alcohol dependence.

Fecal microbiota transplantation repairs intestinal permeability and regulates the expression of 5-HT to influence alcohol-induced depression-like behaviors in C57BL/6J mice.

The epidemic of alcohol abuse affects millions of people worldwide. Relevant evidence supports the notion that the gut microbiota (GM) plays a crucial role in central nervous system (CNS) function, and its composition undergoes changes following alcohol consumption. Therefore, the purpose of this study was to investigate the effect of reconstructing the gut microbiota by fecal microbiota transplantation (FMT) on alcohol dependence. Here, we established an alcohol dependence model with C57BL/6J mice and proved that FMT treatment improved anxiety-like behavior and alcohol-seeking behavior in alcohol-dependent mice. Additionally, we found that the expression of the intestinal intercellular tight junction structure proteins ZO-1 and occludin was significantly increased after FMT. FMT repaired intestinal permeability in alcohol-dependent mice and decreased the levels of lipopolysaccharide (LPS) and proinflammatory factors. Moreover, the serotonin (5-hydroxytryptamine, 5-HT) content was significantly increased in alcohol-dependent mouse intestinal and brain tissues after receiving the fecal microbiome from healthy mice. 16S rRNA sequencing demonstrated that FMT markedly reshaped the composition of the gut microbiota and elicited changes in the intestinal barrier and 5-HT levels. Collectively, our results revealed that FMT has a palliative effect on alcohol dependence and explored the underlying mechanisms, which provides new strategies for the treatment of alcohol dependence.

Substitution therapy for patients with alcohol dependence: Mechanisms of action and efficacy.

New approaches for the treatment of alcohol dependence (AD) may improve patient outcomes. Substitution maintenance therapy is one of the most effective treatment options for opioid and nicotine use disorders. So far, there has been little attention to substitution therapy for the treatment of AD. Here, we explain the mechanistic foundations of alcohol substitution maintenance therapy. Alcohol has many primary targets in the brain (and other organs) and the physical interaction of ethanol molecules with these specific ethanol-sensitive sites on a variety of ionotropic receptors (e.g. GABA-A, NMDA, and nicotinic acetylcholine (nACh) receptors) and ion channels provides the rationale for substitution. As such, a variety of compounds can interact with those ethanol-sensitive sites and can thus substitute for some of the effects of alcohol. For some of these compounds, alcohol discrimination studies have shown their substitution potential. Accordingly, potential substitution treatments include agonists acting at GABA receptors such as sodium oxybate, baclofen and benzodiazepines, NMDA receptor antagonists such as ketamine and memantine, or nAChRs agonists such as varenicline. All these compounds are already approved for other indications and we present clinical evidence for these drugs in the treatment of alcohol withdrawal syndrome (AWS) and in the long-term treatment of AD, and outline future steps for their acceptance as substitution treatment in AD. Finally, we discuss the substitution approach of managed alcohol programs for the most severely affected homeless populations. Results showed that sodium oxybate is probably the closest to a substitution therapy for AD and is already approved for the treatment of AWS and in the long-term treatment of AD in some countries. In conclusion, we argue that better AD treatment can be provided if substitution maintenance treatments for alcohol are implemented at a similar scale as for opioid and nicotine use disorder.

Current treatments of alcohol use disorder.

Emerging treatments for alcohol dependence reveal an intricate interplay of neurobiological, psychological, and circumstantial factors that contribute to Alcohol Use Disorder (AUD). The approved strategies balancing these factors involve extensive manipulations of neurotransmitter systems such as GABA, Glutamate, Dopamine, Serotonin, and Acetylcholine. Innovative developments are engaging mechanisms such as GABA reuptake inhibition and allosteric modulation. Closer scrutiny is placed on the role of Glutamate in chronic alcohol consumption, with treatments like NMDA receptor antagonists and antiglutamatergic medications showing significant promise. Complementing these neurobiological approaches is the progressive shift towards Personalized Medicine. This strategy emphasizes unique genetic, epigenetic and physiological factors, employing pharmacogenomic principles to optimize treatment response. Concurrently, psychological therapies have become an integral part of the treatment landscape, tackling the cognitive-behavioral dimension of addiction. In instances of AUD comorbidity with other psychiatric disorders, Personalized Medicine becomes pivotal, ensuring treatment and prognosis are closely defined by individual characteristics, as exemplified by Lesch Typology models. Given the high global prevalence and wide distribution of AUD, a persistent necessity exists for development and improvement of treatments. Current research efforts are steadily paving paths towards more sophisticated, effective typology-based treatments: a testament to the recognized imperative for enhanced treatment strategies. The potential encapsulated within the ongoing research suggests a promising future where the clinical relevance of current strategies is not just maintained but significantly improved to effectively counter alcohol dependence.

Lived Experiences of Intimate Partner Violence and Help-seeking among Wives of Persons with Alcohol Dependence: A Thematic Analysis.

Worldwide, intimate partner violence (IPV) is a significant public health problem. Most of the wives of persons with alcohol dependence (PwAD) experience IPV in their lifetime. The study examined lived experiences of IPV among wives of PwAD. Qualitative research study design was used. Twenty participants were recruited using the consecutive sampling method. The researcher used an in-depth interview guide to collect the data. ATLAS.ti.9 software was used to analyse the qualitative data. Thematic analysis was used for coding and emerging themes. The thematic analysis yielded four themes generated from the in-depth interview: (1) reasons for the IPV, (2) help-seeking, (3) barriers in help-seeking and (4) coping with IPV. Survivors of IPV do not seek help due to self-stigma, unavailable resources, and lack of awareness about treatment for alcohol dependence. Clinicians should routinely screen for IPV among female spouses of persons with alcohol-dependent syndrome and provide psychosocial interventions for the survivors of IPV.

Alcohol Use Disorders: The Role of Employment Status and the Effectiveness of Occupational Therapy

Alcoholism is an addiction that has a high prevalence in Central and Eastern Europe, alongside tobacco use and obesity, being recognized as one of the major factors contributing to disability and premature death. The economic pressure caused by alcohol consumption is significant, and national economies suffer major deficits due to this widely propagated phenomenon. Understanding the consumption behavior, from its origins to the development of the behavior itself, and the treatment of alcohol dependence, falls within the purview of psychiatric and psychological practice. The multitude of facets of alcohol consumption makes it both attractive to a wide range of individuals and difficult to define in terms of its influence on the person as a whole: physiologically, temperamentally, characterologically, and psychosocially. The effects of alcohol on consumers are specific to a versatile substance: disinhibition, reduction of anxiety, alteration of somatic sensations, speech rate and fluency, motor skills, and other cognitive-behavioral dimensions. The addictiveness of alcohol is closely related to its impact on consumers, especially in terms of the relationship that develops between the individual and the behavior of consumption. As the literature shows, the development of alcohol addiction is linked to deep emotional aspects specific to humans, giving it a psychosocial and cultural component that transforms it into a characteristic human construct.

Effects of virtual reality-based cue exposure therapy on craving and physiological responses in alcohol-dependent patients-a randomised controlled trial

BackgroundCue exposure therapy is used to treat alcohol dependence. However, its effectiveness is controversial due to the limitations of the clinical treatment setting. Virtual reality technology may improve the therapeutic effect. The aim of this study is to explore whether virtual reality-based cue exposure therapy can reduce the psychological craving and physiological responses of patients with alcohol dependence.MethodsForty-four male alcohol-dependent patients were recruited and divided into the study group (n = 23) and the control group (n = 21) according to a random number table. The control group received only conventional clinical treatment for alcohol dependence. The study group received conventional clinical treatment with the addition of VR cue exposure (treatment). The primary outcome was to assess psychological craving and physiological responses to cues of patients before and after treatment.ResultsAfter virtual reality-based cue exposure therapy, the changes in VAS and heart rate before and after cue exposure in the study group were significantly lower than those in the control group (P < 0.05), while the changes in skin conductance and respiration between the study group and the control group were not significantly different (P > 0.05). The changes in VAS and heart rate before and after cue exposure in the study group were significantly lower than those before treatment (P < 0.05), while the changes in skin conductance and respiration were not significantly different from those before treatment (P > 0.05). The changes in VAS, heart rate, skin conductance and respiration before and after cue exposure in the control group were not significantly different from those before treatment (P > 0.05).ConclusionVirtual reality-based cue exposure therapy can reduce the psychological craving and part of the physiological responses of alcohol-dependent patients during cue exposure in the short term and may be helpful in the treatment of alcohol dependence.Trial registrationThe study protocol was registered at the China Clinical Trial Registry on 26/02/2021 (www.chictr.org.cn; ChiCTR ID: ChiCTR2100043680).

Aversive agents: Think twice. A case report on disulfiram-induced mania.

We present a case of disulfiram-induced mania in a patient with both alcohol use disorder (AUD) and psychostimulant use disorder (PUD), without a history of psychosis or mania. This acute presentation may be linked to the increased dopamine levels caused by disulfiram metabolism. Our patient developed manic symptoms 10 days after starting disulfiram, prescribed to treat the AUD. It should be noted that the symptoms resolved rapidly after disulfiram cessation during hospitalization. Disulfiram use is an effective treatment for alcohol dependence. However, there are safety concerns associated with it and it requires close monitoring, particularly in patients with a history of mania, psychosis, or psychostimulant use.

Mediating role of anxiety and impulsivity in the association between child maltreatment and lifetime non-suicidal self-injury with and without suicidal self-injury

BackgroundChild maltreatment can increase the risk of lifetime non-suicidal self-injury (NSSI) and suicidal self-injury (SSI), but there is limited knowledge regarding the differences of potentially psychological mechanisms between NSSI with and without SSI. MethodsParticipants, 3918 community-based Chinese young men aged 18–34 years in Chengdu, were included in this study. We investigated the association between depression, anxiety, psychosis, child maltreatment, adulthood traumatic events, impulsivity, alcohol dependence, drug abuse, and lifetime of NSSI among participants with and without SSI. Parallel mediation analysis was utilized to explore the mediators for the relation between child maltreatment and NSSI. ResultsThe prevalence of lifetime NSSI was 6.1 % (95 % CI: 5.4 %–6.9 %) among young men. Anxiety and impulsivity partially mediated the effect of child maltreatment on NSSI either with (indirect effect: 51.2 %) or without SSI (indirect effect: 34.3 %). Depression was independently and significantly associated with only NSSI but not with NSSI+SSI. Alcohol dependence and psychosis were independently and significantly associated with NSSI+SSI and mediated the effect of child maltreatment on NSSI+SSI. LimitationsThe cross-sectional survey data limits the robustness of the proof to the causal relationships. ConclusionsAnxiety and impulsivity are associated with NSSI either with or without SSI and partially mediate the effect of child maltreatment on NSSI. Depression is associated with only NSSI, while alcohol dependence and psychosis are only associated with NSSI+SSI. It could be crucial to improve treatment and recovery of alcohol dependence and psychosis for preventing young men engaged in NSSI from attempting SSI.

The Therapeutic Role of Olea europaea in Alcohol Dependence Base in Network Pharmacology Analysis

Alcohol dependence is a state of alcohol becoming a vital part of the life of a person who consumes it; when discontinued, it can lead to a wide range of physical and mental health disorders as well as a decrease in life productivity in people with alcohol dependence. Olea Europaea (OE) is a plant capable of treating alcohol dependence. The method used in silico-based pharmacological grid analysis to determine the ability of the OE compound to treat alcohol dependence. EO compound data is obtained from the KnapSack database, absorption, distribution, metabolism, and excretion (ADME) screening using SwissADME, target protein prediction using SwissTargetPrediction, Gene cards, venny, pharmacological grid analysis with String-DB, visualization with Cytoscape 3.10.0. Results are obtained from 63 OE compounds, and 17 have ADME criteria matching the drug compounder (Drug Likeness/DL). The pathways that correlate with therapy are dopamine receptors, dopamine transporter, serotonin receptor, gamma-aminobutyric acid receptor, and toll-like receptors for known therapeutic target proteins: OPRM1, DRD2, ALDH2, ADH1B, ADH1A, ADH1C, ADH4, ADH7, SLC6A3, CNR1, POMC, ARRB2, and NCS1. Compounds associated with alcohol dependency therapy include Hexanal, Nonadienal, Octanal, 3-Hexenal, 3-Methyl-butanal, Methyl nominate, Cinchonidine, cinchonine, (9S)-10,11-Dihydrocinchonan-9-ol, Oleuropeic acid, Butyl acetate, cis-3-hexenyl acetate, and (S)-2,3-Epoxysqualene. Based on the findings, OE is a potential drug candidate for alcohol dependence.

Feasibility of a remotely monitored blood alcohol concentration device to facilitate treatment motivation

BackgroundConsistent monitoring of blood alcohol concentration through breathalyzers is critical for identifying reoccurrence. Little research has effectively utilized convenient wireless enabled breathalyzers that can measure blood alcohol concentration while enhancing treatment motivation for outpatient care. The current study attempted to understand the impact of wireless breathalyzers on treatment motivation and self-efficacy in remaining sober for individuals diagnosed with alcohol use disorder in an outpatient treatment facility. MethodsParticipants were assigned to one of two conditions: the experimental breathalyzer and the treatment as usual group. The groups were assessed by the University of Rhode Island Change Assessment (URICA), and on self-efficacy, measured by the Alcohol Abstinence Self-Efficacy Scale (AASE). The evaluation period took place over three months with a six-week follow-up evaluation. During the entirety of the evaluation period and post-study follow up, interviews occurred. ResultsAs a secondary analysis, the URICA's motivational scores were higher for participants receiving the experimental intervention at a two-month evaluation and at the six-week follow-up. The AASE's temptation to reoccurrence scores significantly reduced over time for both groups. The confidence to resist temptation was not significant. Three major themes emerged from the interviews, including the benefit of the breathalyzer facilitating their treatment, ease of device use, and technical issues. ConclusionsThe insights gained from this study will be important to develop cost-effective ancillary interventions for comprehensive alcohol dependence treatment. On-going monitoring enabled by new technology allows treatment providers to take an individualized disease-management approach as well as facilitating timely interventions by the treatment provider.

Alcohol and Loneliness: Their Entanglement and Social Constitution

I develop an externalist perspective and analysis of the relatedness of loneliness and (harmful) alcohol use and the concept of loneliness. I depart from twenty qualitative interviews with people undergoing inpatient treatment for alcohol dependence. Both, loneliness and its relatedness to alocohol dependence turn out to be complex relational and interactional phenomena whose occurrence and dynamics depend on the social and situational conditions under which they arise. Despite huge variations in interviewees’ experiences of loneliness, they share a common phenomenological and analytical structure. Loneliness arises when instances of social interaction fail to arrive at mutual understanding within a certain social context. Loneliness is neither reducible to individual experiences nor to distinctive characteristics of a person. Rather, it presents an evaluative and interactional phenomenon, a person’s awareness of his/her failure to establish mutual understanding with others in social interaction. The relatedness of alcohol dependence and loneliness is neither conceptual nor causal nor explainable by facts about the individuals concerned, but depends on the kind of loneliness involved and the function habitual ways of drinking alcohol have in a person’s everyday life and social environment.

Improving access to treatment for alcohol dependence in primary care: A qualitative investigation of factors that facilitate and impede treatment access and completion.

Timely intervention for people with alcohol dependence in primary care is needed. Primary care services have a key role in supporting adults with alcohol dependence and require appropriate provision of services. To examine the perceptions of both primary care practitioners and adults with alcohol dependence regarding service provision and to describe help seeking behaviours for adults with alcohol dependence. Qualitative study consisting of semi-structured interviews with adults with alcohol dependence, healthcare professionals and staff members of specialist alcohol services who had previous or current experience in the management, treatment, or referral of adults with alcohol dependence in Northwest England. Interviews were conducted with ten adults with alcohol dependence and 15 staff. Data were analysed thematically, applying principles of constant comparison. Three themes were identified following inductive thematic analysis. The first theme, point of access relates to current service provision being reactive rather than preventative, the stigma associated with alcohol dependence and a person's preparedness to change. The second theme identified was treatment process and pathways that highlights difficulties of engagement, mental health support, direct access and person-centred support. The third theme was follow-up care and discusses the opportunities and threats of transitional support or aftercare for alcohol dependence, signposting and peer support. There are clear opportunities to support adults with alcohol dependence in primary care and the need to increase provision for timely intervention for alcohol related issues in primary care.