Alcohol Treatment Research Articles

Receipt of Medications for Alcohol and Opioid Use Disorders: The Importance of Service Utilization Patterns.

Medications for alcohol use disorder (MAUD) and opioid use disorder (MOUD) are underutilized evidence-based treatments. While patients often receive treatment in multiple medical treatment settings, it is unknown whether certain treatment settings or combinations of settings are associated with increased receipt of MAUD or MOUD. Data from the cross-sectional 2019 National Survey on Drug Use and Health were used to identify treatment settings where adult respondents received any past year alcohol treatment (n = 476, 33% female) or, separately, opioid treatment (n = 337, 38% female). Three-stage latent class analysis assessed the patterns of treatment settings utilization and their associations with receipt of MAUD or MOUD, adjusting for potential confounders. Only 10.9% of those in alcohol treatment received MAUD while 40.9% of those in opioid treatment received MOUD. Analyzing different treatment settings visited by respondents, a four-class model best fit the MAUD sample while a three-class model best fit the MOUD sample. There were significant differences in receipt of MAUD by treatment setting classes in unadjusted models (p < 0.05). There were no significant differences in receipt of MOUD across treatment utilization classes, but MOUD receipt was associated with severity of opioid use in all treatment setting classes. People in treatment for alcohol or opioid use were more likely to receive medication if their use was more severe, and were more likely to receive MAUD if they accessed care in many settings. As MOUD and especially MAUD are underutilized, these findings highlight opportunities to increase access to evidence-based care for alcohol and opioid use disorders.

Treatment completion among Australians attending publicly-funded specialist alcohol and other drug treatment services.

Completion of alcohol and other drug (AOD) treatment is associated with improved health and social outcomes. Previous research has largely focused on individual (e.g. demographic) or service-level (e.g. treatment modality/setting) factors related to treatment completion in isolation. This study investigates the relationship between treatment completion and service-level and substance related factors, after controlling for demographics. Retrospective cohort of 53,430 people engaging in government funded specialist AOD treatment across New South Wales, Australia, between 1 January 2015-31 December 2018. Generalised linear mixed models were used to analyse factors associated with treatment completion, accounting for repeated measures across treatment episodes. Approximately two-thirds (69.8 %, n = 37,330) of the cohort completed treatment at least once during the study period, 42.3 % (22,605) on a single, and 27.5 % (14,725) on multiple occasions. After controlling for demographics, treatment episodes for amphetamines were least likely to be recorded as complete (52.5 %), while those for MDMA were 1.9 (95 % CI: 1.49, 2.45) times more likely (67 %) than amphetamine episodes to be completed. Treatment episodes mandated through criminal justice/child protection agencies were 1.25 (95 % CI: 1.20, 1.30) times more likely to be completed compared to those originating from self-referral. There were no differences in treatment completion between self or health professional referrals (aOR: 0.98, 95 % CI: 0.95, 1.02). Episodes involving involuntary AOD treatment modalities and residential withdrawal were 6.67 times (95% CI: 4.53, 9.81) and 5.02 times (95 % CI: 4.46, 5.64) more likely respectively to be completed compared to those for community rehabilitation. Case management episodes were also more likely (aOR: 2.43, 95 % CI: 2.16, 2.73) to be completed. Episodes of longer treatment duration (≥90 days) were 1.89 times (95 % CI: 1.82, 1.97) more likely to be completed compared to shorter (≤30 days) treatment episodes. Treatment completion was moderated by a range of factors including drug type, treatment modality and duration, and referral source. Low rates of amphetamine treatment completion across treatment modalities confirms the urgent need for further research investigating more effective treatment options for amphetamine use disorders.

Comparison of the Effects of Brief Intervention (BI) on Relapse Prevention and Withdrawal Permanency in Opioid Addicts and Stimulant Users: A Quasi-Experimental Study

Background: Addiction to narcotics and stimulants is a major social and health challenge worldwide. Objectives: Considering the importance of non-medical treatments in addiction rehabilitation and the necessity of psychotherapy programs in substance abuse rehabilitation centers, the present study aimed to compare the effects of Brief Intervention (BI) on relapse prevention and sustained abstinence in opioid addicts and stimulant abusers seeking help from drop-in-centers (DICs) dedicated to harm reduction in Ahvaz, a city in southwestern Iran. Methods: This applied, quasi-experimental study employed a pre-test, post-test, and follow-up design. The statistical population included 120 male substance abusers and opioid addicts aged 18 to 59, systematically selected from 467 individuals with active files in Iran’s Drug and Alcohol Treatment Information System (IDATIS) under the Ministry of Health in 2023. Participants were selected based on inclusion and exclusion criteria and randomized into four groups: Two experimental groups and two control groups, each with 30 participants. Brief Intervention was provided only to the two experimental groups in four 60-minute sessions, while no intervention was offered to the control groups. Testing tools included specific kits for screening morphine and amphetamines in the urine of participants. Data were analyzed using analysis of variance (ANOVA) with repeated measures and descriptive statistical methods, utilizing SPSS version 24. Results: The study demonstrated that BI was significantly effective in relapse prevention and promoting sustained abstinence in opioid addicts attending harm reduction centers in Ahvaz (P &lt; 0.001). However, BI was not effective in preventing relapse or promoting abstinence in stimulant abusers (P = 0.235). Conclusions: The findings suggest that BI is an effective intervention for preventing relapse and promoting abstinence in opioid abusers. It is recommended that executive managers of addiction harm reduction centers guide their experienced social workers to implement this method as a selective psychotherapy approach complementary to medical treatment for opioid addicts.

Design of INSPIRE: Evaluation of the effectiveness of practice facilitation on implementation of screening, brief interventions, referral to treatment and medication for unhealthy alcohol use identification and treatment in primary care

Design of INSPIRE: Evaluation of the effectiveness of practice facilitation on implementation of screening, brief interventions, referral to treatment and medication for unhealthy alcohol use identification and treatment in primary care

From alcohol detoxification to treatment: A qualitative interview study on perceived barriers and assessed potential of mHealth among individuals postdetoxification.

Most individuals attending detoxification clinics do not pursue subsequent treatment. Earlier research has suggested that emerging technologies like mHealth interventions could address the postdetoxification treatment gap, yet it remains unclear whether patients themselves endorse such approaches. Our study aimed to qualitatively explore perceived treatment barriers and assessed potential of mHealth among individuals who have undergone alcohol detoxification. We conducted a single-interview-per-participant qualitative study, sampling participants (n = 23) that had visited the Stockholm substance use disorder emergency department for alcohol-related reasons, of whom n = 8 were purposively included due to having missed their scheduled follow-up outpatient appointment. Semistructured telephone interviews were conducted (2021-2022) and then systematically analyzed using reflexive thematic analysis. Across both areas of analysis, we identified six themes in total. We clustered barriers to postdetoxification treatment into three themes (10 subthemes) that may offer a nuancing perspective on previous research: "Misalignment between the treatment system and the individual," "Practical hurdles" and "Between reaching out and retreating." We identified three themes in participants' perspectives on mHealth as aftercare support, revealing expectations that such an approach may promote "self-awareness on own terms," assist in "navigating from solitary substance use struggles to supportive connections," and "offer a lifeline when needed most," thereby potentially resolving several barriers to treatment. This first qualitative study on barriers to alcohol treatment and mHealth potential postdetoxification offered various insights that may be translated into effective, real-world solutions to bridge the postdetoxification treatment gap. A natural next step for future research is to evaluate the impact of mHealth postdetoxification. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Edible electrospun materials for scalable cultivated beef production

Cultivated meats are a direct response to an ever-increasing global demand for meat, that will alleviate the negative impacts of animal farming on the environment and food security. Despite recent advances, however, challenges regarding scalability and costs remain, impeding the availability and affordability of these novel foods. Consequently, this study aims to design novel edible and biocompatible scaffolds for the expansion of bovine mesenchymal stem cells, using silk fibroin from degummed Bombyx mori cocoons. The scaffolds were created from 12 % (w/w) silk fibroin in formic acid via two different methods of electrospinning, a needle-based laboratory set-up and a needleless configuration with the ability to produce non-woven fabrics at industrial scale. The supports were further treated with methanol or ethanol, which induced β-sheet crystallisation and preserved their fibrous nature in an aqueous environment for at least 2 weeks, with <10 % total weight loss. Although the highly porous nanofibrous morphology was maintained in all cases (98–166 nm fibre diameters), the alcohol treatments increased the stiffness, strength and brittleness of the materials by 6-fold, 5-fold and 3-fold, respectively. When different seeding densities (1500, 3000 and 5000 cells/cm2) of bovine mesenchymal stem cells were investigated, there were no signs of cytotoxicity, and the best growth was achieved at the lowest cell density, yielding a 9-fold expansion, with a 0.018 h−1 specific growth rate and 44 h doubling time over 7 days. These findings provide novel insights into electrospun materials and may support future developments in cultivated meats.

A Novel Scale of Lifestyle Physical Activity: Measure Description and Intervention Responsiveness.

Lifestyle physical activity (LPA) interventions emphasize small bouts of movement that can be flexibly integrated into one's everyday routine. Despite research illustrating benefits for LPA on health outcomes, few LPA interventions and measurement tools have been developed and tested. The purpose of this study was to present a novel LPA self-report scale, including its content, scoring, and internal consistency reliability, and summarize its intervention responsiveness. The LPA scale was administered in a pilot randomized controlled trial that tested a 12-week LPA + Fitbit intervention against a health education (HE) control (matched to LPA + Fitbit on contact time) in a sample of 50 women with depression in alcohol treatment. The LPA scale includes 22 items covering five domains relevant to LPA. Results demonstrated good internal consistency reliability for the total score (ω = 0.84) but poor-to-acceptable internal consistency reliability for the domain scores (ω range: 0.43-0.80). Participants randomized to the LPA + Fitbit intervention had significantly greater improvements in the LPA total score and two domain scores compared to HE participants. Overall, results demonstrate good internal consistency reliability and intervention responsiveness of the LPA scale total score. A larger, more comprehensive psychometric evaluation is needed for validation of this scale.

Effects of Kalimeris indica on alcohol-induced liver injury through storing Nrf2/HO-1 pathway and gut microbiota.

Kalimeris indica (L.) Sch. Bip., (K. indica) is a plant classified under the genus Kalimeris within the Asteraceae family. The herb of K. indica has been historically utilized as a traditional medicine. The consumption of excessive amounts of alcohol represents a lifestyle choice that can induce tissue damage and contribute to the development of various health conditions. The HPLC-MS method was used to reveal the chemical composition of K. indica extract. HepG2 cells were used to test the in vitro oxidative stress. C57BL/6 mice were used to construct the in vivo alcohol-induced liver injury. H/E staining and serum ALT and AST levels were tested to assess the in vivo protective effect of ML (50 and 200mg/kg). GSH, SOD, and CAT levels along with byproduct MDA levels were used to evaluate the in vivo oxidative stress. Immunohistochemical experiments were used to examine the in vivo Nrf2 and HO-1 levels. 16S rRNA gene-based profiling method was used to test the alteration in gut microbiota. 16 compounds were identified from K. indica extract. K. indica treatment reduced oxidative stress in HepG2 cells treated with 5% alcohol. H/E staining results showed that K. indica (50 and 200mg/kg) alleviated liver injury caused by alcohol administration, eliciting a similar protective effect to the positive drug silymarin. Serum ALT and AST examination gave a consistent result, showing that ML could restore serum ALT and AST levels in mice treated with alcohol. Furthermore, K. indica could also restore GSH, SOD, CAT, and MDA levels in alcohol-treated mice, showing a potent effect on oxidative stress alleviation. Immunohistochemical experiments indicated that K. indica showed the liver protective effect through Nrf2/HO-1 pathway. 16S rRNA gene-based profiling revealed that alcohol treatment caused the alteration in gut microbiota, while K. indica treatment could result in a significantly richer variety of microbial communities compared to the alcohol group. K. indica (ML) has a protective effect on liver injury caused by alcohol administration. The Nrf2/HO-1 pathway and gut microbiota regulation were involved in the ML-induced liver protection. All the results indicate that K. indica has a potential in the treatment of alcohol-induced liver injury.

Next-generation biomarkers for alcohol consumption and alcohol use disorder diagnosis, prognosis, and treatment: Acritical review.

This critical review summarizes the current state of omics-based biomarkers in the alcohol research field. We first provide definitions and background information on alcohol and alcohol use disorder (AUD), biomarkers, and "omic" technologies. We next summarize using (1) genetic information as risk/prognostic biomarkers for the onset of alcohol-related problems and the progression from regular drinking to problematic drinking (including AUD), (2) epigenetic information as diagnostic biomarkers for AUD and risk biomarkers for alcohol consumption, (3) transcriptomic information as diagnostic biomarkers for AUD, risk biomarkers for alcohol consumption, and (4) metabolomic information as diagnostic biomarkers for AUD, risk biomarkers for alcohol consumption, and predictive biomarkers for response to acamprosate in subjects with AUD. In the final section, the clinical implications of the findings are discussed, and recommendations are made for future research.

Improving screening, brief intervention and referral to treatment for unhealthy alcohol use in diverse, low-resourced primary care clinics

BackgroundImplementation of screening brief intervention and referral to treatment (SBIRT) and medication-assisted treatment for alcohol use disorder (MAUD) remains low in primary care. ANTECEDENT (Partnerships to Enhance Alcohol Screening, Treatment, and Intervention) was a practice-facilitator led implementation study to increase SBIRT and MAUD use in diverse primary care clinics.MethodsFrom November 2019 – April 2023, we conducted a convergent parallel mixed methods evaluation. Participants were small and medium-sized primary care clinics in the Northwestern U.S. Clinics received foundational support (i.e., baseline/exit assessment, access to SBIRT Oregon website) and the option for supplemental implementation support (e.g., practice facilitation, expert consultation) over the 15-month intervention to improve SBIRT and MAUD. Qualitative and quantitative data regarding clinic characteristics, implementation strategies, and SBIRT/MAUD outcomes were collected through practice facilitator interviews, periodic reflections and clinic contact logs, interviews, pre-post surveys, and electronic health record (EHR) queries. Quantitative analyses included descriptive statistics, logistic regression, and the Wilcoxon sign-ranked test. Qualitative analysis took an immersion crystallization approach. Data were reviewed in a matrix to evaluate intervention adoption, implementation, and effectiveness.ResultsWe recruited 75 unique clinics; 66 participated and 48 (73%) completed the study. Eight participating clinics chose to receive foundational support only (12%) while 58 chose to engage in supplemental support (88%) activities. Clinics that received supplemental support and completed the intervention (n = 42) engaged in practice facilitation (Mean: 293 min, range: 75–550 min); data review (38%), HIT support (31%), expert consultation (19%), and peer-to-peer learning (5%). Pre- and post-intervention assessments showed significant improvement in self-reported SBIRT process outcomes. Performance data improved among the subset of completing clinics able to produce data (n = 17). Clinics described positive experiences with ANTECEDENT support and highlighted remaining barriers to SBIRT and MAUD implementation.ConclusionsParticipating clinics engaged in a diverse range of supportive activities. A flexible approach using practice facilitation and implementation support could be helpful for low-resourced primary care clinics in improving SBIRT and MAUD for unhealthy alcohol use.

Factors Associated With Motivation to Reduce Alcohol Use Among Patients With Chronic Liver Disease.

Alcohol use is prevalent among hepatology clinic patients with chronic liver disease (CLD). We explored factors associated with the importance and confidence dimensions of motivation to reduce drinking. Participants (N = 121) with unhealthy alcohol use (i.e., over NIH guidelines) receiving care in hepatology clinics from a safety-net hospital (SN, N = 54) and two Veterans Affairs Healthcare Systems (VA, N = 67) were enrolled in an alcohol intervention trial from March 2022 through October 2023. Baseline assessments included Generalised Anxiety Disorder (GAD-7), Patient Health Questionnaire (PHQ-8), Alcohol Use Disorders Identification Test (AUDIT), COVID-19 stress; and measures of importance and confidence to decrease alcohol use (readiness rulers, scales of 1-10). Liver disease aetiology and severity were extracted from electronic health records. We performed multivariable linear regression models with forward selection to assess pre-specified variables' associations with importance and confidence. The sample was 84% male, 40% Latino, 31% White, 18% Black and 11% other races; median age was 61 years. Median (Q1-Q3) AUDIT score was 16 (12-24), importance was 9 (6-10) and confidence was 8 (5-9). On multivariable analysis, VA site (vs. SN) participants had a 0.97-point lower importance score (p = 0.02); higher symptoms of depression (PHQ-8 score ≥ 10 vs. < 10) and AUDIT scores (for each point increase) were associated with higher importance score (estimates 1.2 and 0.08, p < 0.05, respectively). Liver disease aetiology and severity were not significantly associated with outcomes. Depression, alcohol problem severity and treatment site may influence motivation to reduce alcohol use and could inform future hepatology-based interventions.

Exploring the feasibility of Recovery Management Checkups for Primary Care in a Federally Qualified Health Center.

Primary care settings present an opportunity for alcohol and substance use disorder (A/SUD) screening and treatment referral. However, there are recognized deficiencies in widely used treatment referral approaches, including acute care connections, vs. those that can support longer-term recovery. Recovery Management Checkups for Primary Care (RMC-PC) is an intervention with an evidence base for improving treatment referral and subsequent recovery for primary care patients; however, the intervention has never been fully implemented outside of a research context. We conducted a feasibility study to inform a future hybrid study of RMC-PC that will test the implementation and effectiveness of the intervention in primary care practice. We used a convergent mixed method design. The study's setting was a Federally Qualified Health Center (FQHC) located in a large midwestern city. RMC-PC linkage services were administered by one of two treatment linkage managers: an FQHC linkage manager (F-LM) and a research staff linkage manager (R-LM). Quantitative data included (a) rates of positive A/SUD screening among a group of FQHC patients and (b) linkage manager service data (e.g., rate of successful meeting completion and days to completing of key events). Qualitative data included (c) an assessment of linkage manager's motivational interviewing performance and (d) a focus group with FQHC staff focused on their perspectives on RMC-PC implementation determinants. Quantitative data were summarized using descriptive statistics, and linkage manager performance was compared. Qualitative data were analyzed using a hybrid deductive-inductive process. Fifty percent of patients screened met moderate-high A/SUD risk. Eleven of 16 recruited patients completed at least one linkage manager meeting, with 63% completing both meetings. The F-LM delivered RMC-PC services alongside other duties successfully; however, three primary barriers to FQHC implementation were identified (difficulties applying motivational interviewing, incompatibilities of screening with FQHC technology and workflow, and lack of billing mechanism to support services). RMC-PC is feasible for FQHC staff to deliver, though issues identified must be considered to ensure successful and sustainable implementation. Knowledge gained will inform a packaged implementation strategy that will be used in a future hybrid trial.

Perspectives on limiting tobacco access and supporting access to nicotine vaping products among clients of residential drug and alcohol treatment services in Australia

IntroductionTobacco endgame strategies aim to drive down population smoking rates, the success of which can be improved with public buy-in, including from populations with high smoking rates such as alcohol...

Anticancer Effects of New Disulfiram Analogs.

Disulfiram (DSF), an irreversible aldehyde dehydrogenase 2 (ALDH2) inhibitor, is an U.S. Food and Drug Administration (FDA)-approved drug for the treatment of chronic alcoholism. Recent studies have reported an interesting antitumor activity of DSF against a wide range of human malignancies, while a growing number of ongoing and completed clinical trials have provided evidence supporting the repurposing of DSF as an anticancer treatment. Nevertheless, despite its current clinical indications and potential future therapeutic applications for treating various diseases, DSF is associated with serious side effects attributed to the inhibition of ALDH2. We have recently synthesized DSF analogs (2a-v) with limited inhibition of ALDH2. Here, we report the anticancer activity of these molecules by highlighting their effects on cell signaling in Jurkat cells. DSF and two DSF analogs, 2g and 2r, all stimulated apoptotic signaling pathways, although the 2g analog activated more apoptosis-related genes and induced higher levels of apoptosis in vitro. Differential gene expression data suggested that compounds 2g and 2r specifically reprogram target cells to downregulate pathways related to cell growth and division, while upregulating pathways related to apoptosis or differentiation. Interestingly, both compounds 2g and 2r had more differentially expressed genes related to DNA damage pathways (including those related to apoptosis) when compared to DSF, which may offer insights into their mechanisms of action.

Long-term effectiveness of SBIRT by outreach visits on subsequent alcohol treatment utilization among inpatients from general hospital: a 36-months follow-up

Aim To investigate the long-term effect of Screening, Brief Intervention, and Referral to Treatment (SBIRT) on alcohol treatment utilization among general hospital inpatients. Methods This 36-month follow-up of a randomized controlled trial included general hospital inpatients who were screened using the Alcohol Use Disorder Identification Test (AUDIT). Patients with an AUDIT score of 8+ were included. Patients were randomized to either SBIRT (Relay) or treatment as-usual (TAU). Outcome was attendance at a specialized outpatient treatment institution or prescription of pharmacological alcohol treatment in general practice. Using the Danish Civil Registration System, patients were followed in the Danish National Patient Registry, Danish National Alcohol Treatment Register, and the Danish National Prescription Registry. Data was collected up to 36 months after discharge. Results The study population consisted of 258 patients in the Relay group and 303 patients in the TAU group. In the Relay group, 36 (14.0%) patients received treatment versus 23 (7.6%) in the TAU group. Patients in the Relay group had higher odds for receiving treatment compared to the TAU group (OR: 1.97, 95% CI: 1.1–3.4, p = 0.01). Significantly more patients in the Relay group scored 16+ on the AUDIT and had already tried to change their alcohol consumption (both p < 0.01). Adjusted for potential confounders, the effect of the Relay intervention was reduced (OR: 1.37, 95%CI: 0.7–2.5, p = 0.31). Conclusions This study did not find evidence that SBIRT is better than TAU at sustaining significant long-term alcohol treatment utilization after discharge among inpatients from general hospital.

Daily cigarette smoking among inpatients for substance use disorders in France, 2010-2020: Commonalities and specificities across substances.

This study aims to estimate the prevalence and factors associated with cigarette smoking among patients in treatment for substance use disorders (SUD) in France. We analyze a nation-wide dataset retrieving information on patients entering treatment for alcohol, opioid and stimulant use disorders between 2010 and 2020. We conduct multilevel Poisson regressions to determine the main factors associated with daily cigarette smoking among all patients who entered treatment for alcohol (n=607122), opioid (n=283381) or stimulant (n=57189) use disorders, and zero-truncated negative-binomial regressions to predict the average number of cigarettes per day. Daily cigarette smoking remains a widespread behavior among patients with SUD (overall prevalence: 72.2%, 95% CI: 72.1-72.3), with lower prevalence of daily cigarette smoking among patients treated for alcohol use disorders (69.9%, 95% CI: 69.8-70.0), and higher for patients treated for opioid (78.8%, 95% CI: 78.6-79.0) or stimulant use disorders (75.8%, 95% CI: 75.4-76.2). There was an overall increase in daily cigarette smoking over time (69.9%, 95% CI: 69.8-70.0 in 2010 vs 76.8%, 95% CI: 76.5-76.9 in 2020); however, the average number of cigarettes per day decreased (17.8 per day, 95% CI: 17.7-17.9 in 2010 vs 16.3 per day, 95% CI: 16.2-16.4 in 2020). The higher the education level, the fewer number of cigarettes per day; conversely, the higher the occupational status, the higher the number of cigarettes. The high prevalence of smoking among patients treated for SUD in France departs from the decreasing trend observed in the general population and remains a source of concern. It is necessary to implement tailored prevention strategies that target specific patient subgroups and increase staff awareness.

Curcumol ameliorates alcohol and high-fat diet-induced fatty liver disease via modulation of the Ceruloplasmin/iron overload/mtDNA signaling pathway.

Fatty liver disease (FLD), a chronic liver disease characterized by excessive lipid deposition, is affecting more and more people worldwide owing to the increasing global incidence of obesity and heavy alcohol consumption. However, there is still no effective strategy for prevention or treatment of alcohol and high-fat diet (HFD)-induced FLD. The purpose of this study was to investigate the effect of curcumol on alcohol and HFD-induced FLD and the underlying molecular mechanisms. The results showed that curcumol ameliorated alcohol and HFD-induced hepatocyte injury in vivo and in vitro, and the mechanism might be related to its up-regulation of ceruloplasmin and subsequent alleviation of iron overload. Moreover, curcumol inhibited alcohol and HFD-induced mitochondrial damage and mtDNA release in hepatocytes by modulating iron overload. Furthermore, curcumol's inhibition of mtDNA release could suppress the activation of cGAS-STING and subsequent inflammation, and this phenomenon could be reversed by cGAS overexpression. Notably, alcohol and HFD-induced mtDNA release from hepatocytes contributed to HSC activation and this effect could be weakened by curcumol. In conclusion, these findings elucidated that curcumol ameliorated alcohol and HFD-induced FLD via modulating ceruloplasmin/iron overload/mtDNA signaling pathway, which lead to the inhibition of inflammation and HSCs activation.

Screening and Following Up Harmful Alcohol Use "… is Not Necessarily Your Primary Focus": A Qualitative Study Exploring Health Professionals' Experiences Addressing Harmful Alcohol Use in a Norwegian Hospital.

Alcohol use remains a leading cause of excess mortality and morbidity worldwide, and identifying and following up harmful alcohol use represents a key component of alcohol harm reduction policies. This article explores health professionals' experiences implementing these policies in a Norwegian hospital. To explore health professionals' views and experiences of systematic screening and tailored follow-up of harmful and hazardous alcohol use in a Norwegian hospital. We conducted semi-structured interviews with 13 specialty registrars and nurses working in the emergency department and observation ward of a hospital in Oslo, Norway. Interviews were carried out between May and December 2022, coded using NVivo v.14 and analyzed thematically. We identified three themes: (i) standardized and clinical assessment, referring to tensions between standardized and clinical alcohol risk assessment; (ii) formal and informal treatment guidelines, encompassing the informal patient care practices enacted in the emergency department and on the wards, and; (iii) training delivery and barriers to implementation, referring to the training penetration rate and identified need for "clear and simple" alcohol treatment guidelines. This study highlights tensions between alcohol-related harm and alcohol-related norms as these pertain to screening and following up harmful and hazardous alcohol use in a Norwegian hospital. Results suggest training should focus on zero alcohol recommendations, the use of assessment tools, the acceptability of screening to patients and "clear and simple" patient follow-up procedures.

미술치료 전공 학부생의 임상실습, 수퍼비전, 학부과정 경험에 대한 질적 연구

Objectives The purpose of this study is to explore through qualitative research the experiences of undergraduate students majoring in art therapy in clinical practice, supervision, and undergraduate courses, and to analyze the intrinsic meaning of these experiences. Methods Data were collected through two in-depth interviews with six undergraduate students majoring in alco-hol treatment. The interviews used a semi-structured questionnaire to encourage undergraduate students to talk freely about their experiences in clinical practice, supervision, and undergraduate courses. The collected data were analyzed using open coding according to qualitative research methodology, and themes were derived inductively. Through this, the main themes and subcategories experienced by the participants were identified and the research results were derived. Results As a result of the analysis, 6 main areas, 14 categories, and 37 subcategories were derived. In clinical practice, external factors such as conditions of the practice institution, workload, communication between thera-pists, and changes in clients, and internal factors such as self-criticism, tension while performing roles, and sense of accomplishment after practice were identified. The supervision experience consisted of process aspects such as close supervision and shared experiences with colleagues, as well as academic and emotional support from the supervisor. During the bachelor's course, self-exploration, anxiety and burden about art work, and interaction with classmates served as factors that promoted improved future vision and psychological growth. Conclusions These findings provide significant implications for establishing criteria for selecting clinical practice institutions, improving supervision education, and enhancing the role of school education in undergraduate pro-grams aimed at training art therapists.

Interest in the Use of Herbal Supplements to Close the Treatment Gap for Hazardous Alcohol Use Among Men Who Have Sex With Men: Secondary Analysis of a Cross-Sectional Study.

Hazardous alcohol consumption is highly prevalent for men who have sex with men (MSM). The 4 treatments currently approved by the Food and Drug Administration for alcohol use are reaching an alarmingly low percentage of people who would benefit from a reduction in their alcohol use. There is increasing interest in alternative methods of treatment, such as herbal supplements, to address hazardous drinking. However, research on the acceptability of alternative pharmacotherapies among MSM remains limited. We examined the prevalence and correlates of expressing interest in using herbal supplements for alcohol treatment among MSM with hazardous alcohol consumption. We conducted a secondary data analysis from a cross-sectional study of MSM who use alcohol, conducted from March 2015 to July 2017 in San Francisco, California, to assess the overall prevalence of interest in using herbal supplements to help reduce alcohol consumption. Associations between expressing interest in herbal supplements and demographic, social, and clinical characteristics were examined using bivariate and multivariable logistic regression models. One-third (66/200, 33%) of the participants expressed interest in an herbal supplement for reducing alcohol consumption. In the multivariable analyses, weekly binge drinking (adjusted odds ratio [aOR] 2.85, 95% CI 1.17-6.93), interest in abstaining from alcohol use (aOR 5.04, 95% CI 1.46-17.40), higher severity of alcohol dependence score (aOR 1.22, 95% CI 1.04-1.41), and interest in naltrexone (aOR 3.22, 95% CI 2.12-4.91) were independently associated with higher odds of being interested in using an herbal supplement to reduce alcohol consumption, adjusting for age, race or ethnicity, and education. We found that MSM who have hazardous drinking habits, more severe alcohol dependence, and interest in pharmacotherapy were more likely to express interest in using an herbal supplement for reducing alcohol consumption. To our knowledge, this is the first study that has evaluated correlates of interest in herbal supplements for alcohol use among MSM. As researchers implement novel alcohol treatment studies, they should focus on recruitment efforts among MSM with a motivation to reduce their alcohol use patterns.