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Engeln M, Ahmed SH. The multiple faces of footshock punishment in animal research on addiction. Neurobiol Learn Mem 2024; 213:107955. [PMID: 38944108 DOI: 10.1016/j.nlm.2024.107955] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2024] [Revised: 06/05/2024] [Accepted: 06/20/2024] [Indexed: 07/01/2024]
Abstract
Continued drug use despite negative consequences is a hallmark of addiction commonly modelled in rodents using punished drug intake. Over the years, addiction research highlighted two subpopulations of punishment sensitive and resistant animals. While helpful to interrogate the neurobiology of drug-related behaviors, these procedures carry some weaknesses that need to be recognized and eventually defused. Mainly focusing on footshock-related work, we will first discuss the criteria used to define punishment-resistant animals and how their relative arbitrariness may impact our findings. With the overarching goal of improving our interpretation of the punishment-resistant phenotype, we will evaluate how tailored punishment protocols may better apprehend resistance to punishment, and how testing the robustness of punishment resistance could yield new results and strengthen interpretations. Second, we will question whether and to what extent punishment sensitivity, as currently defined, is reflective of abstinence and suggest that punishment resistance is, in fact, a prerequisite to model abstinence from addiction. Again, we will examine how challenging the robustness of the punishment-sensitive phenotype may help to better characterize it. Finally, we will evaluate whether diminished relapse-like behavior after repeated punishment-induced abstinence could not only contribute to better understand the mechanisms of abstinence, but also uniquely model progressive recovery (i.e., after repeated failed attempts at recovery) which is the norm in people with addiction. Altogether, by questioning the strengths and weaknesses of our models, we would like to open discussions on the different ways we interpret punishment sensitivity and resistance and the aspects that remain to be explored.
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Affiliation(s)
- Michel Engeln
- Univ. Bordeaux, CNRS, INCIA, UMR 5287, F-33000 Bordeaux, France.
| | - Serge H Ahmed
- Univ. Bordeaux, CNRS, INCIA, UMR 5287, F-33000 Bordeaux, France.
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Acuff SF, Strickland JC, Smith K, Field M. Heterogeneity in choice models of addiction: the role of context. Psychopharmacology (Berl) 2024; 241:1757-1769. [PMID: 38990313 DOI: 10.1007/s00213-024-06646-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/18/2024] [Accepted: 07/01/2024] [Indexed: 07/12/2024]
Abstract
RATIONALE Theories of addiction guide scientific progress, funding priorities, and policy development and ultimately shape how people experiencing or recovering from addiction are perceived and treated. Choice theories of addiction are heterogenous, and different models have divergent implications. This breeds confusion among laypeople, scientists, practitioners, and policymakers and reduces the utility of robust findings that have the potential to reduce the global burden of addiction-associated harms. OBJECTIVE Here we differentiate classes of choice models and articulate a novel framing for a class of addiction models, called contextual models, which share as a first principle the influence of the environment and other contextual factors on behavior within discrete choice contexts. RESULTS These models do not assume that all choice behaviors are voluntary, but instead that both proximal and distal characteristics of the choice environment-and particularly the benefits and costs of both drug use and non-drug alternatives-can influence behavior in ways that are outside of the awareness of the individual. From this perspective, addiction is neither the individual's moral failing nor an internal uncontrollable urge but rather is the result of environmental contingencies that reinforce the behavior. CONCLUSIONS Contextual models have implications for guiding research, practice, and policy, including identification of novel target mechanisms while also improving existing interventions.
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Affiliation(s)
- Samuel F Acuff
- Recovery Research Institute, Center for Addiction Medicine, Massachusetts General Hospital and Harvard Medical School, 151 Merrimac Street, Boston, MA, 02114, USA.
| | - Justin C Strickland
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, 5510 Nathan Shock Drive, Baltimore, MD, 21224, USA
| | - Kirsten Smith
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, 5510 Nathan Shock Drive, Baltimore, MD, 21224, USA
| | - Matt Field
- Department of Psychology, University of Sheffield, Sheffield, S1 2LT, UK
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Ahmed SH. The importance of choice and agency in animal models of addiction. J Neural Transm (Vienna) 2024; 131:487-489. [PMID: 37906290 DOI: 10.1007/s00702-023-02712-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2023] [Accepted: 10/15/2023] [Indexed: 11/02/2023]
Abstract
The aim of this short commentary is twofold. First, it uncovers and outlines in broad strokes a historical, albeit oft-overlooked, trend toward a growing place for choice and agency in the design of animal models of addiction. Next, it tries to draw from this historical trend some perspectives and implications for future research.
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Affiliation(s)
- Serge H Ahmed
- Univ. Bordeaux, CNRS, INCIA, UMR 5287, 33000, Bordeaux, France.
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Bergeria CL, Gipson CD, Smith KE, Stoops WW, Strickland JC. Opioid craving does not incubate over time in inpatient or outpatient treatment studies: Is the preclinical incubation of craving model lost in translation? Neurosci Biobehav Rev 2024; 160:105618. [PMID: 38492446 PMCID: PMC11046527 DOI: 10.1016/j.neubiorev.2024.105618] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2023] [Revised: 02/29/2024] [Accepted: 03/05/2024] [Indexed: 03/18/2024]
Abstract
Within addiction science, incubation of craving is an operational label used to describe time-dependent increases in drug seeking during periods of drug deprivation. The purpose of this systematic review was to describe the preclinical literature on incubation of craving and the clinical literature on craving measured over extended periods of abstinence to document this translational homology and factors impacting correspondence. Across the 44 preclinical studies that met inclusion criteria, 31 reported evidence of greater lever pressing, nose pokes, spout licks, or time spent in drug-paired compartments (i.e., drug seeking) relative to neutral compartments after longer periods of abstinence relative to shorter periods of abstinence, labelled as "incubation of craving." In contrast, no clinical studies (n = 20) identified an increase in opioid craving during longer abstinence periods. The lack of clinical evidence for increases in craving in clinical populations weakens the translational utility of operationalizing the time-dependent increase in drug-seeking behavior observed in preclinical models as models of incubation of "craving".
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Affiliation(s)
- Cecilia L Bergeria
- Johns Hopkins University School of Medicine, Department of Psychiatry and Behavioral Sciences, Baltimore, MD, United States.
| | - Cassandra D Gipson
- University of Kentucky College of Medicine, Department of Pharmacology and Nutritional Sciences, Lexington, KY, United States
| | - Kirsten E Smith
- Johns Hopkins University School of Medicine, Department of Psychiatry and Behavioral Sciences, Baltimore, MD, United States
| | - William W Stoops
- University of Kentucky College of Medicine, Department of Behavioral Science, Lexington, KY, United States
| | - Justin C Strickland
- Johns Hopkins University School of Medicine, Department of Psychiatry and Behavioral Sciences, Baltimore, MD, United States
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Millan EZ, McNally GP. Reprioritizing motivations in addiction. Science 2024; 384:271. [PMID: 38669580 DOI: 10.1126/science.ado9989] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/28/2024]
Abstract
Drugs of abuse alter neuronal signaling.
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Affiliation(s)
- E Zayra Millan
- School of Psychology, University of New South Wales, Sydney, NSW, Australia
| | - Gavan P McNally
- School of Psychology, University of New South Wales, Sydney, NSW, Australia
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Panlilio LV, Burgess-Hull AJ, Feldman JD, Rogers JM, Tyburski M, Smith KE, Epstein DH. Activity space during treatment with medication for opioid use disorder: Relationships with personality, mood, and drug use. JOURNAL OF SUBSTANCE USE AND ADDICTION TREATMENT 2024; 157:209219. [PMID: 37981240 PMCID: PMC10922786 DOI: 10.1016/j.josat.2023.209219] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/24/2023] [Revised: 09/15/2023] [Accepted: 11/13/2023] [Indexed: 11/21/2023]
Abstract
INTRODUCTION Activity space in people with substance use disorders (SUDs) has been assessed for theoretical reasons and for detection/prevention of relapse. In this observational study, we relate passively obtained activity space measures to mental states and behaviors relevant to the success of treatment for opioid use disorder. Our long-term goal is to use such data to assess risk in real time and to recognize when SUD patients might benefit from a just-in-time intervention. METHODS We used GPS data from 238 urban residents in the first 16 weeks of stabilization on medication for opioid use disorder to test preregistered hypotheses about activity space (distance traveled, number of locations, time spent moving, and psychosocial-hazard levels of neighborhoods where participants spent time) in relation to certain static variables (personality, mood propensities) and time-varying treatment-relevant behaviors such as craving and use of opioids and cocaine. RESULTS The most consistent findings were that 1) mobility decreased over the course of the study; 2) neuroticism was associated with overall lower mobility; 3) trait-like positive mood (averaged from momentary ratings) was associated with higher mobility; 4) participants who used cocaine more frequently had lower mobility; 5) early in treatment, participants spent less time moving (i.e., were more sedentary) on days when they were craving. Some of these findings were in the expected direction (i.e., the ones involving neuroticism and positive mood), and some were opposite to the expected direction (i.e., we expected cocaine use to be associated with higher mobility); others (e.g., changes in mobility over time or in relation to craving) involved nondirectional hypotheses. CONCLUSIONS Real-time information that patients actively provide is valuable for assessing their current state, but providing this information can be burdensome. The current results indicate that certain static or passively obtained data (personality variables and GPS-derived mobility information) are relevant to time-varying, treatment-relevant mental states and drug-related behavior, and therefore might be useful when incorporated into algorithms for detecting need for intervention in real time. Further research should assess how population-specific these relationships are, and how these passive measures can best be combined with low temporal-density, actively-provided data to obtain valid, reliable assessments with minimal burden.
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Affiliation(s)
- Leigh V Panlilio
- Real-world Assessment, Prediction, and Treatment (RAPT) Unit, National Institute on Drug Abuse Intramural Research Program (NIDA IRP), 251 Bayview Blvd, Baltimore, MD 21224, USA.
| | - Albert J Burgess-Hull
- Real-world Assessment, Prediction, and Treatment (RAPT) Unit, National Institute on Drug Abuse Intramural Research Program (NIDA IRP), 251 Bayview Blvd, Baltimore, MD 21224, USA.
| | - Jeffrey D Feldman
- Real-world Assessment, Prediction, and Treatment (RAPT) Unit, National Institute on Drug Abuse Intramural Research Program (NIDA IRP), 251 Bayview Blvd, Baltimore, MD 21224, USA.
| | - Jeffrey M Rogers
- Real-world Assessment, Prediction, and Treatment (RAPT) Unit, National Institute on Drug Abuse Intramural Research Program (NIDA IRP), 251 Bayview Blvd, Baltimore, MD 21224, USA; SDSU/UCSD Joint Doctoral Program (in Clinical Psychology), 6363 Alvarado Ct, San Diego, CA 92120, USA.
| | - Matthew Tyburski
- Real-world Assessment, Prediction, and Treatment (RAPT) Unit, National Institute on Drug Abuse Intramural Research Program (NIDA IRP), 251 Bayview Blvd, Baltimore, MD 21224, USA
| | - Kirsten E Smith
- Real-world Assessment, Prediction, and Treatment (RAPT) Unit, National Institute on Drug Abuse Intramural Research Program (NIDA IRP), 251 Bayview Blvd, Baltimore, MD 21224, USA.
| | - David H Epstein
- Real-world Assessment, Prediction, and Treatment (RAPT) Unit, National Institute on Drug Abuse Intramural Research Program (NIDA IRP), 251 Bayview Blvd, Baltimore, MD 21224, USA.
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Jemberie WB, Snellman F, Eriksson M, Hammarberg A. 'Ageing with an alcohol problem is not what I envision': reclaiming agency in shaping personal ageing trajectory and recovery from alcohol problems. BMC Geriatr 2023; 23:866. [PMID: 38104085 PMCID: PMC10724916 DOI: 10.1186/s12877-023-04573-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2023] [Accepted: 12/05/2023] [Indexed: 12/19/2023] Open
Abstract
BACKGROUND Eliciting and understanding older persons' descriptions of their resources for healthy ageing and the interaction of these resources with alcohol use and alcohol problems can facilitate health promotion. It can also inform clinicians when identifying areas of recovery capital that present risks and strength for older people seeking alcohol treatment. The objective of this study was to illuminate the experiences and perspectives of older persons on ageing, alcohol use, treatment, and recovery from alcohol problems, as well as their understanding of healthy ageing. METHODS Eight men and two women, aged 61 to 73 years, with moderate drinking as a treatment goal and treated at an outpatient alcohol clinic in Sweden, participated in semi-structured audio-recorded virtual interviews. A qualitative content analysis examined the transcribed interviews. RESULTS Three themes were identified: "Tipping the balance", "Staying behind a veil" and "Lifting the vail". First, participants understood healthy ageing as a personal and multidimensional process that involved actively expanding, maintaining or adjusting to the resources needed to lead an active and meaningful life while preserving autonomy, dignity and independence for as long as possible. Second, most participants viewed moderate alcohol use as a contributor to healthy ageing. They sought treatment when their drinking became unsustainable and an immediate threat to their healthy ageing resources. Stigma, ambivalence and a lack of treatment options, however, contributed to delayed treatment. Third, the participants responded to treatment approaches that elicited their concern, incorporated their expertise and treatment and life goals, appreciated their autonomy and agency, and considered them partners in goal setting and decision making. Reduced drinking helped participants regain their agency and improved their healthy ageing capital which in turn catalyzed continuing recovery. CONCLUSIONS Older persons in non-abstinent recovery perceive healthy ageing and alcohol recovery as personal and interacting multidimensional processes involving their agency to improve biopsychosocial functioning. Treatment approaches that recognize older persons' desire for healthy ageing, incorporate their treatment goals and respect their autonomy are likely to be acceptable and effective.
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Affiliation(s)
- Wossenseged Birhane Jemberie
- Department of Social Work, Umeå University, 901 87, Umeå, Sweden.
- Centre for Demography and Aging Research (CEDAR), Umeå University, Umeå, Sweden.
- The Swedish National Graduate School for Competitive Science On Aging and Health (SWEAH), Faculty of Medicine, Lund University, Lund, Sweden.
| | - Fredrik Snellman
- Department of Social Work, Umeå University, 901 87, Umeå, Sweden
| | - Malin Eriksson
- Department of Social Work, Umeå University, 901 87, Umeå, Sweden
| | - Anders Hammarberg
- Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet and Stockholm Health Care Services, Region Stockholm, Stockholm, Sweden
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McNally GP, Jean-Richard-Dit-Bressel P, Millan EZ, Lawrence AJ. Pathways to the persistence of drug use despite its adverse consequences. Mol Psychiatry 2023; 28:2228-2237. [PMID: 36997610 PMCID: PMC10611585 DOI: 10.1038/s41380-023-02040-z] [Citation(s) in RCA: 10] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/20/2022] [Revised: 03/10/2023] [Accepted: 03/15/2023] [Indexed: 04/01/2023]
Abstract
The persistence of drug taking despite its adverse consequences plays a central role in the presentation, diagnosis, and impacts of addiction. Eventual recognition and appraisal of these adverse consequences is central to decisions to reduce or cease use. However, the most appropriate ways of conceptualizing persistence in the face of adverse consequences remain unclear. Here we review evidence that there are at least three pathways to persistent use despite the negative consequences of that use. A cognitive pathway for recognition of adverse consequences, a motivational pathway for valuation of these consequences, and a behavioral pathway for responding to these adverse consequences. These pathways are dynamic, not linear, with multiple possible trajectories between them, and each is sufficient to produce persistence. We describe these pathways, their characteristics, brain cellular and circuit substrates, and we highlight their relevance to different pathways to self- and treatment-guided behavior change.
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Affiliation(s)
- Gavan P McNally
- School of Psychology, UNSW Sydney, Sydney, NSW, 2052, Australia.
| | | | - E Zayra Millan
- School of Psychology, UNSW Sydney, Sydney, NSW, 2052, Australia
| | - Andrew J Lawrence
- Florey Institute of Neuroscience and Mental Health, Parkville, VIC, 3010, Australia
- Florey Department of Neuroscience and Mental Health, University of Melbourne, Melbourne, VIC, 3010, Australia
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Shover CL, Spoliansky JG, Godvin M. Polysubstance use and lived experience: new insights into what is needed. Curr Opin Psychiatry 2023:00001504-990000000-00070. [PMID: 37191654 DOI: 10.1097/yco.0000000000000876] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/17/2023]
Abstract
PURPOSE OF REVIEW During the current overdose crisis in the United States and Canada, both polysubstance use and interventions involving people with lived experience of substance use disorder have grown. This review investigates the intersection of these topics to recommend best practices. RECENT FINDINGS We identified four themes from the recent literature. These are ambivalence about the term lived experience and the practice of using private disclosure to gain rapport or credibility; efficacy of peer participation; promoting equitable participation by fairly compensating staff hired for their lived experience; challenges unique to the current polysubstance-dominated era of the overdose crisis. People with lived experience make important contributions to research and treatment, especially given the additional challenges that polysubstance use creates above and beyond single substance use disorder. The same lived experience that can make someone an excellent peer support worker also often comes with both trauma related to working with people struggling with substance use and lack of opportunities for career advancement. SUMMARY Policy priorities for clinicians, researchers and organizations should include steps to foster equitable participation, such as recognizing expertise by experience with fair compensation; offering career advancement opportunities; and promoting self-determination in how people describe themselves.
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Affiliation(s)
- Chelsea L Shover
- Division of General Internal Medicine and Health Services Research
| | - Jordan G Spoliansky
- Department of Family Medicine, University of California, Los Angeles, Los Angeles, California
| | - Morgan Godvin
- The Action Lab, Center for Health Policy and Law, Northeastern University, Boston, Massachusetts, USA
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