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Donato S, Meredith LR, Nieto SJ, Bujarski S, Ray LA. Medication development for AUD: A systematic review of clinical trial methodology. Alcohol 2024; 120:194-203. [PMID: 38972367 DOI: 10.1016/j.alcohol.2024.06.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2024] [Revised: 05/24/2024] [Accepted: 06/21/2024] [Indexed: 07/09/2024]
Abstract
Refining clinical trial methodology has become increasingly important as study design is shown to influence treatment efficacy. To maximize the efficiency of randomized clinical trials (RCTs), researchers aim to establish standardized practices. The goal of this systematic review is to describe methodological practices of clinical trials for alcohol use disorder (AUD) over the past 40 years. To achieve this goal, a PubMed search was conducted in April 2023 for RCTs on AUD medications published between July 2018 through April 2023. Resulting studies were combined with a previous search from 1985 through 2018. Inclusion criteria for the RCT studies were: (1) a randomized controlled trial, (2) double or single blinded, (3) placebo or active control condition, (4) alcohol use as the primary endpoint, (5) 4 or more weeks of treatment, and (6) 12 or more weeks of follow-up. In total, methodological data from 139 RCTs representing 19 medications and spanning the past four decades were summarized. Results indicated that the most common medications tested were naltrexone (k = 42), acamprosate (k = 24), and baclofen (k = 11). On average, participants were 74% male and consumed 226 drinks per month pre-randomization. The median length of treatment was 12 weeks (IQR = 12-16; min = 4 max = 52) and the median follow-up duration was 12.5 weeks (IQR: 12-26; min = 7 max = 104). There were two broad domains of outcomes (i.e., abstinence and heavy drinking), with most studies featuring outcomes from both domains (k = 87; 63%). Reporting practices were summarized by decade, revealing an increased enrollment of females, better reporting of race and ethnicity data, and less studies requiring pre-trial abstinence. This review summarizes the current state of the literature on randomized clinical trials for AUD including effect sizes for individual studies and summaries of key methodological features across this representative set of clinical trials.
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Affiliation(s)
- S Donato
- Department of Psychology, University of California, Los Angeles, Los Angeles, CA, USA
| | - L R Meredith
- Department of Psychology, University of California, Los Angeles, Los Angeles, CA, USA
| | - S J Nieto
- Department of Psychology, University of California, Los Angeles, Los Angeles, CA, USA
| | - S Bujarski
- Department of Psychology, University of California, Los Angeles, Los Angeles, CA, USA
| | - L A Ray
- Department of Psychology, University of California, Los Angeles, Los Angeles, CA, USA; Brain Research Institute, University of California, Los Angeles, Los Angeles, CA, USA; Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, Los Angeles, CA, USA.
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Friske MM, Torrico EC, Haas MJW, Borruto AM, Giannone F, Hade AC, Yu Y, Gao L, Sutherland GT, Hitzemann R, Philips MA, Fei SS, Sommer WH, Mayfield RD, Spanagel R. A systematic review and meta-analysis on the transcriptomic signatures in alcohol use disorder. Mol Psychiatry 2024:10.1038/s41380-024-02719-x. [PMID: 39242950 DOI: 10.1038/s41380-024-02719-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/19/2024] [Revised: 08/20/2024] [Accepted: 08/22/2024] [Indexed: 09/09/2024]
Abstract
Currently available clinical treatments on alcohol use disorder (AUD) exhibit limited efficacy and new druggable targets are required. One promising approach to discover new molecular treatment targets involves the transcriptomic profiling of brain regions within the addiction neurocircuitry, utilizing animal models and postmortem brain tissue from deceased patients with AUD. Unfortunately, such studies suffer from large heterogeneity and small sample sizes. To address these limitations, we conducted a cross-species meta-analysis on transcriptome-wide data obtained from brain tissue of patients with AUD and animal models. We integrated 36 cross-species transcriptome-wide RNA-expression datasets with an alcohol-dependent phenotype vs. controls, following the PRISMA guidelines. In total, we meta-analyzed 964 samples - 502 samples from the prefrontal cortex (PFC), 282 nucleus accumbens (NAc) samples, and 180 from amygdala (AMY). The PFC had the highest number of differentially expressed genes (DEGs) across rodents, monkeys, and humans. Commonly dysregulated DEGs suggest conserved cross-species mechanisms for chronic alcohol consumption/AUD comprising MAPKs as well as STAT, IRF7, and TNF. Furthermore, we identified numerous unique gene sets that might contribute individually to these conserved mechanisms and also suggest novel molecular aspects of AUD. Validation of the transcriptomic alterations on the protein level revealed interesting targets for further investigation. Finally, we identified a combination of DEGs that are commonly regulated across different brain tissues as potential biomarkers for AUD. In summary, we provide a compendium of genes that are assessable via a shiny app, and describe signaling pathways, and physiological and cellular processes that are altered in AUD that require future studies for functional validation.
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Affiliation(s)
- Marion M Friske
- Institute of Psychopharmacology, Central Institute of Mental Health, Mannheim, University of Heidelberg, Heidelberg, Germany.
- Waggoner Center for Alcohol and Addiction Research and the Department of Neuroscience, The University of Texas at Austin, Austin, TX, USA.
| | - Eva C Torrico
- Institute of Psychopharmacology, Central Institute of Mental Health, Mannheim, University of Heidelberg, Heidelberg, Germany
| | - Maximilian J W Haas
- Institute of Psychopharmacology, Central Institute of Mental Health, Mannheim, University of Heidelberg, Heidelberg, Germany
| | - Anna M Borruto
- Institute of Psychopharmacology, Central Institute of Mental Health, Mannheim, University of Heidelberg, Heidelberg, Germany
| | - Francesco Giannone
- Institute of Psychopharmacology, Central Institute of Mental Health, Mannheim, University of Heidelberg, Heidelberg, Germany
| | - Andreas-Christian Hade
- Department of Pathological Anatomy and Forensic Medicine, University of Tartu, Tartu, Estonia
- Forensic Medical Examination Department, Estonian Forensic Science Institute, Tallinn, Estonia
| | - Yun Yu
- Bioinformatics & Biostatistics Core, Oregon National Primate Research Center, Oregon Health & Science University West Campus, Portland, OR, USA
| | - Lina Gao
- Bioinformatics & Biostatistics Core, Oregon National Primate Research Center, Oregon Health & Science University West Campus, Portland, OR, USA
| | - Greg T Sutherland
- New South Wales Tissue Resource Center, University of Sydney, Camperdown, NSW, Australia
| | - Robert Hitzemann
- Department of Behavioral Neuroscience, Oregon Health & Science University, Portland, OR, USA
| | - Mari-Anne Philips
- Department of Physiology, Institute of Biomedicine and Translational Medicine, University of Tartu, Tartu, Estonia
| | - Suzanne S Fei
- Bioinformatics & Biostatistics Core, Oregon National Primate Research Center, Oregon Health & Science University West Campus, Portland, OR, USA
| | - Wolfgang H Sommer
- Bethania Hospital for Psychiatry, Psychosomatics and Psychotherapy, Greifswald, Germany
- German Center for Mental Health (DZPG), Partner Site Mannheim-Heidelberg-Ulm, Mannheim, Germany
| | - R Dayne Mayfield
- Waggoner Center for Alcohol and Addiction Research and the Department of Neuroscience, The University of Texas at Austin, Austin, TX, USA
| | - Rainer Spanagel
- Institute of Psychopharmacology, Central Institute of Mental Health, Mannheim, University of Heidelberg, Heidelberg, Germany.
- German Center for Mental Health (DZPG), Partner Site Mannheim-Heidelberg-Ulm, Mannheim, Germany.
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Mereish EH. Oppression-Based Stress and Alcohol Inequities Among Sexual and Gender Minority People: An Intersectional Multilevel Framework. Alcohol Res 2024; 44:05. [PMID: 39246430 PMCID: PMC11379061 DOI: 10.35946/arcr.v44.1.05] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/10/2024] Open
Abstract
PURPOSE Sexual and gender minority (SGM) people are at heightened risk for alcohol use, hazardous drinking, and alcohol use disorder compared to heterosexual and cisgender individuals. This paper: (a) presents an oppression framework that integrates intersectionality, stress, stigma, and addiction-based theories to examine the complex and nuanced ways oppression-based stress (e.g., minority stress) leads to sexual orientation and gender identity inequities in alcohol use; (b) conducts a narrative review that summarizes recent and novel advancements in the literature on the impact of oppression-based stressors on alcohol use outcomes across structural, interpersonal, and intrapersonal domains among SGM people; and (c) provides future research and intervention directions for the alcohol field. SEARCH METHODS A select review of the literature was conducted on July 10, 2023, using multiple electronic databases (i.e., PsycInfo, PubMed, Web of Science) and focusing on studies that had examined the associations between oppression-based stressors and alcohol use outcomes across structural, interpersonal, and intrapersonal levels. Search terms focused on alcohol consumption; SGM people, particularly SGM people of color; and oppression-based stress. Cross-sectional studies that focused on heterosexism-based and anti-bisexual oppression-based stressors at the interpersonal or intrapersonal levels and alcohol use outcomes were excluded as they have been included in prior reviews of the literature. SEARCH RESULTS The initial and combined search across the databases resulted in 3,205 articles. Of those, the narrative review included 50 peer-reviewed articles that focused on the following four areas of the literature on the associations between oppression-based stressors and alcohol use outcomes: (1) experimental, longitudinal, and experience sampling studies of heterosexism- and anti-bisexual oppression-based stressors (22 articles); (2) any studies of cissexism-based stressors (12 articles); (3) any studies of intersectional oppression among SGM people of color (seven articles, one article overlapped with the first category and another overlapped with the fourth category); and (4) any studies of structural oppression (11 articles). DISCUSSION AND CONCLUSIONS Results of this narrative review indicate that mounting evidence implicates oppression-based stress in inequities in alcohol use, hazardous drinking, and alcohol use disorder in SGM populations. This reflects SGM people's embodiment of oppression and injustice at the structural, interpersonal, and intrapersonal levels. Given some inconsistent and mixed patterns of findings, future research needs greater specificity in drinking inclusion criteria, robust and well-validated measures, more attention to culturally and developmentally relevant moderating and mediating mechanisms across the lifespan, application of sophisticated methodologies, and integration of intersectional and addiction frameworks.
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Affiliation(s)
- Ethan H Mereish
- Lavender Lab, Department of Psychology, University of Maryland, College Park, Maryland
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Wang Y, Liu F, Wu X, Zhou F, Chen X, Xi Z. Intracerebral hemorrhage complicated by alcohol use disorder in young males in Chongqing China: Characteristics and long-term outcome. J Stroke Cerebrovasc Dis 2024; 33:107995. [PMID: 39241845 DOI: 10.1016/j.jstrokecerebrovasdis.2024.107995] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2024] [Revised: 08/31/2024] [Accepted: 09/03/2024] [Indexed: 09/09/2024] Open
Abstract
BACKGROUND The characteristics of patients with intracerebral hemorrhage (ICH) complicated by alcohol use disorders (AUD) are not well understood. Investigating the clinical characteristics and prognosis of this subgroup (AUD-ICH) is necessary. METHODS This study involved young males with ICH who were admitted to our hospital between January 2013 and March 2022. Based on drinking patterns, the included cases were divided into three groups: AUD, occasional drinking, and non-drinking. We compared the clinical characteristics and prognosis of patients in the three groups. The effect of AUD on hematoma expansion and long-term dysfunction was explored by developing regression models. The potential mediating role of hematoma density heterogeneity within the relationship between AUD and hematoma expansion was examined through mediation analysis. RESULTS This study included 222 cases of male patients with ICH, with a mean age of 54.16. AUD patients had a higher risk of hematoma expansion and dysfunction compared to occasional drinkers (odds ratio [OR] 2.966, p=0.028 for hematoma expansion; hazard ratio [HR] 2.620, p=0.006 for dysfunction) and non-drinkers (OR 3.505, p=0.011 for hematoma expansion; HR 2.795, P=0.003 for dysfunction). The mediation analysis showed that the indirect effect through hematoma density heterogeneity on the relationship between AUD and hematoma expansion was significant, with a mediated proportion of 19.3%. CONCLUSIONS AUD was an independent risk factor for hematoma expansion and long-term dysfunction in young male patients with ICH. Hematoma density heterogeneity partially mediated the relationship between AUD and hematoma expansion.
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Affiliation(s)
- Yuzhu Wang
- Department of Neurology, the First Affiliated Hospital of Chongqing Medical University, Chongqing 400016, China.
| | - Fei Liu
- Department of Neurology, the First Affiliated Hospital of Chongqing Medical University, Chongqing 400016, China.
| | - Xiaohui Wu
- Department of Neurology, the First Affiliated Hospital of Chongqing Medical University, Chongqing 400016, China.
| | - Fu Zhou
- Department of Neurology, the First Affiliated Hospital of Chongqing Medical University, Chongqing 400016, China.
| | - Xuan Chen
- Department of Neurology, the First Affiliated Hospital of Chongqing Medical University, Chongqing 400016, China.
| | - Zhiqin Xi
- Department of Neurology, the First Affiliated Hospital of Chongqing Medical University, Chongqing 400016, China.
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Ekhtiari H, Sangchooli A, Carmichael O, Moeller FG, O'Donnell P, Oquendo M, Paulus MP, Pizzagalli DA, Ramey T, Schacht J, Zare-Bidoky M, Childress AR, Brady K. Neuroimaging Biomarkers in Addiction. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2024:2024.09.02.24312084. [PMID: 39281741 PMCID: PMC11398440 DOI: 10.1101/2024.09.02.24312084] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 09/18/2024]
Abstract
As a neurobiological process, addiction involves pathological patterns of engagement with substances and a range of behaviors with a chronic and relapsing course. Neuroimaging technologies assess brain activity, structure, physiology, and metabolism at scales ranging from neurotransmitter receptors to large-scale brain networks, providing unique windows into the core neural processes implicated in substance use disorders. Identified aberrations in the neural substrates of reward and salience processing, response inhibition, interoception, and executive functions with neuroimaging can inform the development of pharmacological, neuromodulatory, and psychotherapeutic interventions to modulate the disordered neurobiology. Based on our systematic search, 409 protocols registered on ClinicalTrials.gov include the use of one or more neuroimaging paradigms as an outcome measure in addiction, with the majority (N=268) employing functional magnetic resonance imaging (fMRI), followed by positron emission tomography (PET) (N=71), electroencephalography (EEG) (N=50), structural magnetic resonance imaging (MRI) (N=35) and magnetic resonance spectroscopy (MRS) (N=35). Furthermore, in a PubMed systematic review, we identified 61 meta-analyses including 30 fMRI, 22 structural MRI, 8 EEG, 7 PET, and 3 MRS meta-analyses suggesting potential biomarkers in addictions. These studies can facilitate the development of a range of biomarkers that may prove useful in the arsenal of addiction treatments in the coming years. There is evidence that these markers of large-scale brain structure and activity may indicate vulnerability or separate disease subtypes, predict response to treatment, or provide objective measures of treatment response or recovery. Neuroimaging biomarkers can also suggest novel targets for interventions. Closed or open loop interventions can integrate these biomarkers with neuromodulation in real-time or offline to personalize stimulation parameters and deliver the precise intervention. This review provides an overview of neuroimaging modalities in addiction, potential neuroimaging biomarkers, and their physiologic and clinical relevance. Future directions and challenges in bringing these putative biomarkers from the bench to the bedside are also discussed.
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Affiliation(s)
- Hamed Ekhtiari
- Department of Psychiatry, University of Minnesota Medical School, Minneapolis, MN, USA (Ekhtiari); Laureate Institute for Brain Research (LIBR), Tulsa, OK, USA (Ekhtiari, Paulus); School of Psychological Sciences, Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Melbourne, Australia (Sangchooli); Pennington Biomedical Research Center, Baton Rouge, Louisiana, USA (Carmichael); Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA (Oquendo, Childress); Institute for Drug and Alcohol Studies, Virginia Commonwealth University, Richmond, VA, USA (Moeller); Translational Medicine, Sage Therapeutics, Cambridge, MA, USA and McLean Hospital, Department of Psychiatry, Harvard Medical School, Belmont, MA, USA (O'Donnell); Division of Depression and Anxiety, McLean Hospital, Belmont, MA, USA (Pizzaggali); National Institute on Drug Abuse, Bethesda, MD, USA (Ramey); Department of Psychiatry, University of Colorado Anschutz Medical Campus, Aurora, CO, USA (Schacht); Iranian National Center for Addiction Studies (INCAS), Tehran University of Medical Sciences, Tehran, Iran (Zare-Bidoky); Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, SC, USA (Brady)
| | - Arshiya Sangchooli
- Department of Psychiatry, University of Minnesota Medical School, Minneapolis, MN, USA (Ekhtiari); Laureate Institute for Brain Research (LIBR), Tulsa, OK, USA (Ekhtiari, Paulus); School of Psychological Sciences, Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Melbourne, Australia (Sangchooli); Pennington Biomedical Research Center, Baton Rouge, Louisiana, USA (Carmichael); Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA (Oquendo, Childress); Institute for Drug and Alcohol Studies, Virginia Commonwealth University, Richmond, VA, USA (Moeller); Translational Medicine, Sage Therapeutics, Cambridge, MA, USA and McLean Hospital, Department of Psychiatry, Harvard Medical School, Belmont, MA, USA (O'Donnell); Division of Depression and Anxiety, McLean Hospital, Belmont, MA, USA (Pizzaggali); National Institute on Drug Abuse, Bethesda, MD, USA (Ramey); Department of Psychiatry, University of Colorado Anschutz Medical Campus, Aurora, CO, USA (Schacht); Iranian National Center for Addiction Studies (INCAS), Tehran University of Medical Sciences, Tehran, Iran (Zare-Bidoky); Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, SC, USA (Brady)
| | - Owen Carmichael
- Department of Psychiatry, University of Minnesota Medical School, Minneapolis, MN, USA (Ekhtiari); Laureate Institute for Brain Research (LIBR), Tulsa, OK, USA (Ekhtiari, Paulus); School of Psychological Sciences, Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Melbourne, Australia (Sangchooli); Pennington Biomedical Research Center, Baton Rouge, Louisiana, USA (Carmichael); Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA (Oquendo, Childress); Institute for Drug and Alcohol Studies, Virginia Commonwealth University, Richmond, VA, USA (Moeller); Translational Medicine, Sage Therapeutics, Cambridge, MA, USA and McLean Hospital, Department of Psychiatry, Harvard Medical School, Belmont, MA, USA (O'Donnell); Division of Depression and Anxiety, McLean Hospital, Belmont, MA, USA (Pizzaggali); National Institute on Drug Abuse, Bethesda, MD, USA (Ramey); Department of Psychiatry, University of Colorado Anschutz Medical Campus, Aurora, CO, USA (Schacht); Iranian National Center for Addiction Studies (INCAS), Tehran University of Medical Sciences, Tehran, Iran (Zare-Bidoky); Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, SC, USA (Brady)
| | - F Gerard Moeller
- Department of Psychiatry, University of Minnesota Medical School, Minneapolis, MN, USA (Ekhtiari); Laureate Institute for Brain Research (LIBR), Tulsa, OK, USA (Ekhtiari, Paulus); School of Psychological Sciences, Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Melbourne, Australia (Sangchooli); Pennington Biomedical Research Center, Baton Rouge, Louisiana, USA (Carmichael); Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA (Oquendo, Childress); Institute for Drug and Alcohol Studies, Virginia Commonwealth University, Richmond, VA, USA (Moeller); Translational Medicine, Sage Therapeutics, Cambridge, MA, USA and McLean Hospital, Department of Psychiatry, Harvard Medical School, Belmont, MA, USA (O'Donnell); Division of Depression and Anxiety, McLean Hospital, Belmont, MA, USA (Pizzaggali); National Institute on Drug Abuse, Bethesda, MD, USA (Ramey); Department of Psychiatry, University of Colorado Anschutz Medical Campus, Aurora, CO, USA (Schacht); Iranian National Center for Addiction Studies (INCAS), Tehran University of Medical Sciences, Tehran, Iran (Zare-Bidoky); Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, SC, USA (Brady)
| | - Patricio O'Donnell
- Department of Psychiatry, University of Minnesota Medical School, Minneapolis, MN, USA (Ekhtiari); Laureate Institute for Brain Research (LIBR), Tulsa, OK, USA (Ekhtiari, Paulus); School of Psychological Sciences, Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Melbourne, Australia (Sangchooli); Pennington Biomedical Research Center, Baton Rouge, Louisiana, USA (Carmichael); Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA (Oquendo, Childress); Institute for Drug and Alcohol Studies, Virginia Commonwealth University, Richmond, VA, USA (Moeller); Translational Medicine, Sage Therapeutics, Cambridge, MA, USA and McLean Hospital, Department of Psychiatry, Harvard Medical School, Belmont, MA, USA (O'Donnell); Division of Depression and Anxiety, McLean Hospital, Belmont, MA, USA (Pizzaggali); National Institute on Drug Abuse, Bethesda, MD, USA (Ramey); Department of Psychiatry, University of Colorado Anschutz Medical Campus, Aurora, CO, USA (Schacht); Iranian National Center for Addiction Studies (INCAS), Tehran University of Medical Sciences, Tehran, Iran (Zare-Bidoky); Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, SC, USA (Brady)
| | - Maria Oquendo
- Department of Psychiatry, University of Minnesota Medical School, Minneapolis, MN, USA (Ekhtiari); Laureate Institute for Brain Research (LIBR), Tulsa, OK, USA (Ekhtiari, Paulus); School of Psychological Sciences, Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Melbourne, Australia (Sangchooli); Pennington Biomedical Research Center, Baton Rouge, Louisiana, USA (Carmichael); Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA (Oquendo, Childress); Institute for Drug and Alcohol Studies, Virginia Commonwealth University, Richmond, VA, USA (Moeller); Translational Medicine, Sage Therapeutics, Cambridge, MA, USA and McLean Hospital, Department of Psychiatry, Harvard Medical School, Belmont, MA, USA (O'Donnell); Division of Depression and Anxiety, McLean Hospital, Belmont, MA, USA (Pizzaggali); National Institute on Drug Abuse, Bethesda, MD, USA (Ramey); Department of Psychiatry, University of Colorado Anschutz Medical Campus, Aurora, CO, USA (Schacht); Iranian National Center for Addiction Studies (INCAS), Tehran University of Medical Sciences, Tehran, Iran (Zare-Bidoky); Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, SC, USA (Brady)
| | - Martin P Paulus
- Department of Psychiatry, University of Minnesota Medical School, Minneapolis, MN, USA (Ekhtiari); Laureate Institute for Brain Research (LIBR), Tulsa, OK, USA (Ekhtiari, Paulus); School of Psychological Sciences, Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Melbourne, Australia (Sangchooli); Pennington Biomedical Research Center, Baton Rouge, Louisiana, USA (Carmichael); Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA (Oquendo, Childress); Institute for Drug and Alcohol Studies, Virginia Commonwealth University, Richmond, VA, USA (Moeller); Translational Medicine, Sage Therapeutics, Cambridge, MA, USA and McLean Hospital, Department of Psychiatry, Harvard Medical School, Belmont, MA, USA (O'Donnell); Division of Depression and Anxiety, McLean Hospital, Belmont, MA, USA (Pizzaggali); National Institute on Drug Abuse, Bethesda, MD, USA (Ramey); Department of Psychiatry, University of Colorado Anschutz Medical Campus, Aurora, CO, USA (Schacht); Iranian National Center for Addiction Studies (INCAS), Tehran University of Medical Sciences, Tehran, Iran (Zare-Bidoky); Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, SC, USA (Brady)
| | - Diego A Pizzagalli
- Department of Psychiatry, University of Minnesota Medical School, Minneapolis, MN, USA (Ekhtiari); Laureate Institute for Brain Research (LIBR), Tulsa, OK, USA (Ekhtiari, Paulus); School of Psychological Sciences, Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Melbourne, Australia (Sangchooli); Pennington Biomedical Research Center, Baton Rouge, Louisiana, USA (Carmichael); Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA (Oquendo, Childress); Institute for Drug and Alcohol Studies, Virginia Commonwealth University, Richmond, VA, USA (Moeller); Translational Medicine, Sage Therapeutics, Cambridge, MA, USA and McLean Hospital, Department of Psychiatry, Harvard Medical School, Belmont, MA, USA (O'Donnell); Division of Depression and Anxiety, McLean Hospital, Belmont, MA, USA (Pizzaggali); National Institute on Drug Abuse, Bethesda, MD, USA (Ramey); Department of Psychiatry, University of Colorado Anschutz Medical Campus, Aurora, CO, USA (Schacht); Iranian National Center for Addiction Studies (INCAS), Tehran University of Medical Sciences, Tehran, Iran (Zare-Bidoky); Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, SC, USA (Brady)
| | - Tatiana Ramey
- Department of Psychiatry, University of Minnesota Medical School, Minneapolis, MN, USA (Ekhtiari); Laureate Institute for Brain Research (LIBR), Tulsa, OK, USA (Ekhtiari, Paulus); School of Psychological Sciences, Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Melbourne, Australia (Sangchooli); Pennington Biomedical Research Center, Baton Rouge, Louisiana, USA (Carmichael); Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA (Oquendo, Childress); Institute for Drug and Alcohol Studies, Virginia Commonwealth University, Richmond, VA, USA (Moeller); Translational Medicine, Sage Therapeutics, Cambridge, MA, USA and McLean Hospital, Department of Psychiatry, Harvard Medical School, Belmont, MA, USA (O'Donnell); Division of Depression and Anxiety, McLean Hospital, Belmont, MA, USA (Pizzaggali); National Institute on Drug Abuse, Bethesda, MD, USA (Ramey); Department of Psychiatry, University of Colorado Anschutz Medical Campus, Aurora, CO, USA (Schacht); Iranian National Center for Addiction Studies (INCAS), Tehran University of Medical Sciences, Tehran, Iran (Zare-Bidoky); Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, SC, USA (Brady)
| | - Joseph Schacht
- Department of Psychiatry, University of Minnesota Medical School, Minneapolis, MN, USA (Ekhtiari); Laureate Institute for Brain Research (LIBR), Tulsa, OK, USA (Ekhtiari, Paulus); School of Psychological Sciences, Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Melbourne, Australia (Sangchooli); Pennington Biomedical Research Center, Baton Rouge, Louisiana, USA (Carmichael); Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA (Oquendo, Childress); Institute for Drug and Alcohol Studies, Virginia Commonwealth University, Richmond, VA, USA (Moeller); Translational Medicine, Sage Therapeutics, Cambridge, MA, USA and McLean Hospital, Department of Psychiatry, Harvard Medical School, Belmont, MA, USA (O'Donnell); Division of Depression and Anxiety, McLean Hospital, Belmont, MA, USA (Pizzaggali); National Institute on Drug Abuse, Bethesda, MD, USA (Ramey); Department of Psychiatry, University of Colorado Anschutz Medical Campus, Aurora, CO, USA (Schacht); Iranian National Center for Addiction Studies (INCAS), Tehran University of Medical Sciences, Tehran, Iran (Zare-Bidoky); Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, SC, USA (Brady)
| | - Mehran Zare-Bidoky
- Department of Psychiatry, University of Minnesota Medical School, Minneapolis, MN, USA (Ekhtiari); Laureate Institute for Brain Research (LIBR), Tulsa, OK, USA (Ekhtiari, Paulus); School of Psychological Sciences, Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Melbourne, Australia (Sangchooli); Pennington Biomedical Research Center, Baton Rouge, Louisiana, USA (Carmichael); Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA (Oquendo, Childress); Institute for Drug and Alcohol Studies, Virginia Commonwealth University, Richmond, VA, USA (Moeller); Translational Medicine, Sage Therapeutics, Cambridge, MA, USA and McLean Hospital, Department of Psychiatry, Harvard Medical School, Belmont, MA, USA (O'Donnell); Division of Depression and Anxiety, McLean Hospital, Belmont, MA, USA (Pizzaggali); National Institute on Drug Abuse, Bethesda, MD, USA (Ramey); Department of Psychiatry, University of Colorado Anschutz Medical Campus, Aurora, CO, USA (Schacht); Iranian National Center for Addiction Studies (INCAS), Tehran University of Medical Sciences, Tehran, Iran (Zare-Bidoky); Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, SC, USA (Brady)
| | - Anna Rose Childress
- Department of Psychiatry, University of Minnesota Medical School, Minneapolis, MN, USA (Ekhtiari); Laureate Institute for Brain Research (LIBR), Tulsa, OK, USA (Ekhtiari, Paulus); School of Psychological Sciences, Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Melbourne, Australia (Sangchooli); Pennington Biomedical Research Center, Baton Rouge, Louisiana, USA (Carmichael); Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA (Oquendo, Childress); Institute for Drug and Alcohol Studies, Virginia Commonwealth University, Richmond, VA, USA (Moeller); Translational Medicine, Sage Therapeutics, Cambridge, MA, USA and McLean Hospital, Department of Psychiatry, Harvard Medical School, Belmont, MA, USA (O'Donnell); Division of Depression and Anxiety, McLean Hospital, Belmont, MA, USA (Pizzaggali); National Institute on Drug Abuse, Bethesda, MD, USA (Ramey); Department of Psychiatry, University of Colorado Anschutz Medical Campus, Aurora, CO, USA (Schacht); Iranian National Center for Addiction Studies (INCAS), Tehran University of Medical Sciences, Tehran, Iran (Zare-Bidoky); Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, SC, USA (Brady)
| | - Kathleen Brady
- Department of Psychiatry, University of Minnesota Medical School, Minneapolis, MN, USA (Ekhtiari); Laureate Institute for Brain Research (LIBR), Tulsa, OK, USA (Ekhtiari, Paulus); School of Psychological Sciences, Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Melbourne, Australia (Sangchooli); Pennington Biomedical Research Center, Baton Rouge, Louisiana, USA (Carmichael); Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA (Oquendo, Childress); Institute for Drug and Alcohol Studies, Virginia Commonwealth University, Richmond, VA, USA (Moeller); Translational Medicine, Sage Therapeutics, Cambridge, MA, USA and McLean Hospital, Department of Psychiatry, Harvard Medical School, Belmont, MA, USA (O'Donnell); Division of Depression and Anxiety, McLean Hospital, Belmont, MA, USA (Pizzaggali); National Institute on Drug Abuse, Bethesda, MD, USA (Ramey); Department of Psychiatry, University of Colorado Anschutz Medical Campus, Aurora, CO, USA (Schacht); Iranian National Center for Addiction Studies (INCAS), Tehran University of Medical Sciences, Tehran, Iran (Zare-Bidoky); Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, SC, USA (Brady)
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6
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Seager MJ, Bolton SL, Bolton JM, Mota NP, Afifi TO, Sareen J, Enns MW. Coping style as a risk factor for future alcohol use disorder: A 16-year longitudinal study in a Canadian military sample. Drug Alcohol Depend 2024; 262:111408. [PMID: 39106609 DOI: 10.1016/j.drugalcdep.2024.111408] [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: 03/20/2024] [Revised: 07/05/2024] [Accepted: 07/24/2024] [Indexed: 08/09/2024]
Abstract
BACKGROUND Coping strategies used in response to stress have the potential to influence the development of mental health disorders, including alcohol use disorders. The current study investigated whether coping strategies placed an individual at greater likelihood for developing a future alcohol use disorder. METHODS This study used data from the Canadian Armed Forces Members and Veterans Mental Health Follow-up Survey; a nationally representative 16-year follow-up survey, with initial data collected in the 2002 Canadian Community Health Survey - Canadian Forces Supplement. The total sample from the two datasets included 2941 individuals who were Regular Force members in 2002. Coping styles included problem-focused, avoidant, and self-medication. Adjusted logistic regression analyses examined relationships between coping style (in 2002) and alcohol use disorders (developed between 2002 and 2018). RESULTS Self-medication coping in 2002 was associated with any alcohol disorder since last interview (i.e., 2002-2018) (AOR 1.26; 95 % CI, 1.02-1.57) and during the past year (adjusted odds ratios [AOR 1.26; 95 % CI, 1.08-1.47]), as well as past-year binge drinking (AOR 1.19; 95 % CI, 1.09-1.29). Problem-focused coping was protective against past-year alcohol abuse (AOR 0.84; 95 % CI, 0.71-1.00) and any alcohol use disorder (AOR 0.87; 95 % CI 0.76-1.00). CONCLUSION Coping styles were strongly associated with future alcohol use disorders. Notably, results show the risk extended over a 16-year period. Findings suggest the use of self-medicating coping strategies places an individual at increased risk of developing alcohol use disorders, while problem-focused coping may decrease future risk of alcohol use disorders.
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Affiliation(s)
- Meredith J Seager
- Department of Psychiatry, Max Rady College of Medicine, Rady Faculty of Health Sciences University of Manitoba, Winnipeg, MB, Canada; Department of Community Health Sciences, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB, Canada.
| | - Shay-Lee Bolton
- Department of Psychiatry, Max Rady College of Medicine, Rady Faculty of Health Sciences University of Manitoba, Winnipeg, MB, Canada; Department of Community Health Sciences, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB, Canada
| | - James M Bolton
- Department of Psychiatry, Max Rady College of Medicine, Rady Faculty of Health Sciences University of Manitoba, Winnipeg, MB, Canada; Department of Community Health Sciences, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB, Canada
| | - Natalie P Mota
- Department of Psychiatry, Max Rady College of Medicine, Rady Faculty of Health Sciences University of Manitoba, Winnipeg, MB, Canada; Department of Clinical Health Psychology, University of Manitoba, Winnipeg, MB, Canada
| | - Tracie O Afifi
- Department of Psychiatry, Max Rady College of Medicine, Rady Faculty of Health Sciences University of Manitoba, Winnipeg, MB, Canada; Department of Community Health Sciences, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB, Canada
| | - Jitender Sareen
- Department of Psychiatry, Max Rady College of Medicine, Rady Faculty of Health Sciences University of Manitoba, Winnipeg, MB, Canada
| | - Murray W Enns
- Department of Psychiatry, Max Rady College of Medicine, Rady Faculty of Health Sciences University of Manitoba, Winnipeg, MB, Canada
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7
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Qiu L, Liang C, Kochunov P, Hutchison KE, Sui J, Jiang R, Zhi D, Vergara VM, Yang X, Zhang D, Fu Z, Bustillo JR, Qi S, Calhoun VD. Associations of alcohol and tobacco use with psychotic, depressive and developmental disorders revealed via multimodal neuroimaging. Transl Psychiatry 2024; 14:326. [PMID: 39112461 PMCID: PMC11306356 DOI: 10.1038/s41398-024-03035-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/18/2023] [Revised: 07/18/2024] [Accepted: 07/23/2024] [Indexed: 08/10/2024] Open
Abstract
People affected by psychotic, depressive and developmental disorders are at a higher risk for alcohol and tobacco use. However, the further associations between alcohol/tobacco use and symptoms/cognition in these disorders remain unexplored. We identified multimodal brain networks involving alcohol use (n = 707) and tobacco use (n = 281) via supervised multimodal fusion and evaluated if these networks affected symptoms and cognition in people with psychotic (schizophrenia/schizoaffective disorder/bipolar, n = 178/134/143), depressive (major depressive disorder, n = 260) and developmental (autism spectrum disorder/attention deficit hyperactivity disorder, n = 421/346) disorders. Alcohol and tobacco use scores were used as references to guide functional and structural imaging fusion to identify alcohol/tobacco use associated multimodal patterns. Correlation analyses between the extracted brain features and symptoms or cognition were performed to evaluate the relationships between alcohol/tobacco use with symptoms/cognition in 6 psychiatric disorders. Results showed that (1) the default mode network (DMN) and salience network (SN) were associated with alcohol use, whereas the DMN and fronto-limbic network (FLN) were associated with tobacco use; (2) the DMN and fronto-basal ganglia (FBG) related to alcohol/tobacco use were correlated with symptom and cognition in psychosis; (3) the middle temporal cortex related to alcohol/tobacco use was associated with cognition in depression; (4) the DMN related to alcohol/tobacco use was related to symptom, whereas the SN and limbic system (LB) were related to cognition in developmental disorders. In summary, alcohol and tobacco use were associated with structural and functional abnormalities in DMN, SN and FLN and had significant associations with cognition and symptoms in psychotic, depressive and developmental disorders likely via different brain networks. Further understanding of these relationships may assist clinicians in the development of future approaches to improve symptoms and cognition among psychotic, depressive and developmental disorders.
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Affiliation(s)
- Ling Qiu
- College of Computer Science and Technology, Nanjing University of Aeronautics and Astronautics, Nanjing, China
- Key Laboratory of Brain-Machine Intelligence Technology, Ministry of Education, Nanjing University of Aeronautics and Astronautics, Nanjing, China
| | - Chuang Liang
- College of Computer Science and Technology, Nanjing University of Aeronautics and Astronautics, Nanjing, China
- Key Laboratory of Brain-Machine Intelligence Technology, Ministry of Education, Nanjing University of Aeronautics and Astronautics, Nanjing, China
| | - Peter Kochunov
- Department of Psychiatry, University of Maryland School of Medicine, Baltimore, MD, USA
| | - Kent E Hutchison
- Department of Psychology and Neuroscience, University of Colorado Boulder, Boulder, CO, USA
| | - Jing Sui
- State Key Laboratory of Cognitive Neuroscience and Learning, Beijing Normal University, Beijing, China
| | - Rongtao Jiang
- Department of Radiology and Biomedical Imaging, Yale University, New Haven, CT, USA
| | - Dongmei Zhi
- State Key Laboratory of Cognitive Neuroscience and Learning, Beijing Normal University, Beijing, China
| | - Victor M Vergara
- Tri-institutional Center for Translational Research in Neuroimaging and Data Science (TReNDS) Georgia State University, Georgia Institute of Technology, Emory University, Atlanta, GA, USA
| | - Xiao Yang
- Huaxi Brain Research Center, West China Hospital of Sichuan University, Chengdu, China
| | - Daoqiang Zhang
- College of Computer Science and Technology, Nanjing University of Aeronautics and Astronautics, Nanjing, China
- Key Laboratory of Brain-Machine Intelligence Technology, Ministry of Education, Nanjing University of Aeronautics and Astronautics, Nanjing, China
| | - Zening Fu
- Tri-institutional Center for Translational Research in Neuroimaging and Data Science (TReNDS) Georgia State University, Georgia Institute of Technology, Emory University, Atlanta, GA, USA
| | - Juan R Bustillo
- Departments of Neurosciences and Psychiatry and Behavioral Sciences, University of New Mexico, Albuquerque, NM, USA.
| | - Shile Qi
- College of Computer Science and Technology, Nanjing University of Aeronautics and Astronautics, Nanjing, China.
- Key Laboratory of Brain-Machine Intelligence Technology, Ministry of Education, Nanjing University of Aeronautics and Astronautics, Nanjing, China.
| | - Vince D Calhoun
- Tri-institutional Center for Translational Research in Neuroimaging and Data Science (TReNDS) Georgia State University, Georgia Institute of Technology, Emory University, Atlanta, GA, USA
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8
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Maddern XJ, Ursich LT, Bailey G, Pearl A, Anversa RG, Lawrence AJ, Walker LC. Sex Differences in Alcohol Use: Is It All About Hormones? Endocrinology 2024; 165:bqae088. [PMID: 39018449 DOI: 10.1210/endocr/bqae088] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/02/2024] [Revised: 07/10/2024] [Accepted: 07/15/2024] [Indexed: 07/19/2024]
Abstract
Risky alcohol use and alcohol use disorders (AUD) are a rising problem in women, yet a major disparity in our understanding of what drives alcohol consumption in women remains. Historically biomedical research has focused on male subjects; however, recent increases in reporting of females, have highlighted major differences between the sexes. Here we review the current literature of the effect of gonadal steroid hormones (estrogens, androgens, and progestins), neurosteriods, and neurobiological factors on alcohol use in clinical and preclinical studies of both sexes. Further, we briefly discuss how fundamental sex differences in genetics, metabolism, neuroimmune, and stress responses may influence sex differences in alcohol intake. Comparing the sexes could aid in the discovery of novel therapeutics to treat AUD, and implementation of current treatment options in women.
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Affiliation(s)
- Xavier J Maddern
- Florey Institute of Neuroscience and Mental Health, Melbourne, VIC 3052, Australia
- Florey Department of Neuroscience and Mental Health, University of Melbourne, Melbourne, VIC 3052, Australia
| | - Lauren T Ursich
- Florey Institute of Neuroscience and Mental Health, Melbourne, VIC 3052, Australia
- Florey Department of Neuroscience and Mental Health, University of Melbourne, Melbourne, VIC 3052, Australia
| | - Grace Bailey
- Florey Institute of Neuroscience and Mental Health, Melbourne, VIC 3052, Australia
- Florey Department of Neuroscience and Mental Health, University of Melbourne, Melbourne, VIC 3052, Australia
| | - Amy Pearl
- Florey Institute of Neuroscience and Mental Health, Melbourne, VIC 3052, Australia
| | - Roberta G Anversa
- Florey Institute of Neuroscience and Mental Health, Melbourne, VIC 3052, Australia
- Florey Department of Neuroscience and Mental Health, University of Melbourne, Melbourne, VIC 3052, Australia
| | - Andrew J Lawrence
- Florey Institute of Neuroscience and Mental Health, Melbourne, VIC 3052, Australia
- Florey Department of Neuroscience and Mental Health, University of Melbourne, Melbourne, VIC 3052, Australia
| | - Leigh C Walker
- Florey Institute of Neuroscience and Mental Health, Melbourne, VIC 3052, Australia
- Florey Department of Neuroscience and Mental Health, University of Melbourne, Melbourne, VIC 3052, Australia
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9
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Quintrell E, Page A, Wyrwoll C, Larcombe A, Preen DB, Almeida O, Etherton-Beer C, Kelty E. Alcohol pharmacotherapy dispensing trends in Australia between 2006 and 2023. Alcohol Alcohol 2024; 59:agae063. [PMID: 39242103 PMCID: PMC11379491 DOI: 10.1093/alcalc/agae063] [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: 05/14/2024] [Revised: 08/08/2024] [Accepted: 08/23/2024] [Indexed: 09/09/2024] Open
Abstract
AIMS This study aimed to investigate acamprosate and naltrexone dispensing patterns in Australia. METHODS A 10% representative sample of medications subsidized by the Australian Pharmaceutical Benefits Scheme (PBS) was used to identify individuals who were dispensed naltrexone or acamprosate between January 2006 and December 2023. Data were used to examine concurrent dispensing, medication switching and treatment episode length, as well as changes in prevalence and incidence over time. RESULTS During the study, we identified 22 745 individuals with a total of 117 548 dispensed prescriptions (45.3% naltrexone, 43.0% acamprosate, and 11.7% concurrent dispensing). Alcohol pharmacotherapy dispensing occurred in 1354 per 100 000 individuals. It is estimated that 2.9% of individuals with an alcohol use disorder in Australia are receiving a PBS-listed pharmacological treatment. For both pharmacotherapies, individuals were most likely to be male (60.0%) and 35-54 years of age (56.0%). Individuals were more likely to switch from acamprosate to naltrexone rather than the reverse. From 2006 and 2023, the number of prevalent individuals treated with an alcohol pharmacotherapy significantly increased, driven mainly the use of naltrexone, which more than doubled over the study period. Incident naltrexone-treated individuals were more likely to remain on treatment for the recommended minimum 3-month period compared to acamprosate treated individuals, although overall dispensing for at least 3 months was low (5.1%). CONCLUSIONS In Australia between 2006 and 2023, rates of naltrexone dispensing have substantially increased, while acamprosate dispensing showed minimal changes. However, the use of alcohol pharmacotherapies remains low compared with the likely prevalence of alcohol use disorders.
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Affiliation(s)
- Ebony Quintrell
- School of Population and Global Health, University of Western Australia, Nedlands 6009, Western Australia, Australia
- Respiratory Environmental Health, Wal-Yan Respiratory Research Centre, The Kids Research Institute Australia, Nedlands 6009, Western Australia, Australia
| | - Amy Page
- School of Allied Health, University of Western Australia, Crawley 6009, Western Australia, Australia
| | - Caitlin Wyrwoll
- The Kids Research Institute Australia, Nedlands 6009, Western Australia, Australia
- School of Human Sciences, University of Western Australia, Crawley 6009, Western Australia, Australia
| | - Alexander Larcombe
- Respiratory Environmental Health, Wal-Yan Respiratory Research Centre, The Kids Research Institute Australia, Nedlands 6009, Western Australia, Australia
- Occupation, Environment and Safety, School of Population Health, Curtin University, Bentley 6102, Western Australia, Australia
| | - David B Preen
- School of Population and Global Health, University of Western Australia, Nedlands 6009, Western Australia, Australia
| | - Osvaldo Almeida
- Medical School, University of Western Australia, Nedlands 6009, Western Australia, Australia
| | | | - Erin Kelty
- School of Population and Global Health, University of Western Australia, Nedlands 6009, Western Australia, Australia
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10
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Vignoli T, Staccioli MC, Salaris M, Sanchini S, Martino E, Rigoli L, Salis F, Caputo F, Fattore L, Agabio R. Needs of female outpatients with alcohol use disorder: data from an Italian study. Alcohol Alcohol 2024; 59:agae054. [PMID: 39118403 DOI: 10.1093/alcalc/agae054] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2024] [Revised: 07/11/2024] [Accepted: 07/29/2024] [Indexed: 08/10/2024] Open
Abstract
AIMS Alcohol use disorder (AUD) is a common mental disorder characterized by sex-gender differences (SGDs). The present study was aimed at evaluating attitudes displayed by Italian AUD treatment services towards investigating the presence of SGDs in their patients and implementing gender-specific treatments for female AUD patients. METHODS Potential SGDs were initially investigated in a sample of AUD outpatients, subsequently followed by a national survey on the adoption of specific interventions for female AUD outpatients. RESULTS The presence of SGDs was confirmed in a sample of 525 (332 men; 193 women) AUD outpatients, including a higher prevalence of anxiety and mood disorders, and episodes of violence and trauma among female AUD outpatients compared to males. Despite the presence of these SGDs, only <20% of a total of 217 Italian AUD treatment services reported the implementation of specific strategies for female AUD outpatients. The majority of services (94%) reported investigating episodes of violence and/or trauma, largely resorting to specific procedures only when these issues were detected. CONCLUSIONS Our findings confirm the presence of SGDs among AUD outpatients, including a higher prevalence of anxiety and mood disorders and episodes of violence and trauma among females compared with males. However, only a small number of services have adopted a gender medicine approach in AUD treatment. These results underline the urgency of investigating the specific needs of female, male, and non-binary AUD patients in order to personalize and enhance the effectiveness and appeal of AUD treatment.
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Affiliation(s)
- Teo Vignoli
- Rimini Addiction Unit, Addiction and Mental Health Department, Romagna Local Health Unit, Viale Luigi Settembrini 2, 47923 Rimini, Italy
| | | | - Maristella Salaris
- Rimini Addiction Unit, Addiction and Mental Health Department, Romagna Local Health Unit, Viale Luigi Settembrini 2, 47923 Rimini, Italy
| | - Samantha Sanchini
- Pesaro Addiction Unit, Addiction Department, Pesaro Urbino Local Health Unit, Via Cesare Lombroso 49, 61122 Pesaro, Italy
| | - Elisa Martino
- Ravenna Addiction Unit, Addiction and Mental Health Department, Romagna Local Health Unit, Via Alberto Missiroli 16, 48121 Ravenna, Italy
| | - Lorena Rigoli
- Cento Fiori social cooperative, Via Portogallo 10, 47922 Rimini, Italy
| | - Francesco Salis
- Department of Medical Sciences, and Public Health, University of Cagliari, SS 554, km 4.5, 09042 Monserrato (CA), Italy
- Department of Biomedical Sciences, Section of Neuroscience and Clinical Pharmacology, University of Cagliari, SS 554, km 4.5, 09042 Monserrato (CA), Italy
| | - Fabio Caputo
- Centre for the Study and Treatment of Alcohol-Related Diseases, Department of Translational Medicine, University of Ferrara, Via Luigi Borsari 46, 44121 Ferrara, Italy
- Department of Internal Medicine, SS Annunziata Hospital, University of Ferrara, Via Vicini 2, 44042 Cento (Ferrara), Italy
| | - Liana Fattore
- CNR Institute Neuroscience-Cagliari, National Research Council, SS 554, km 4.5, 09042 Monserrato (CA) Cagliari, Italy
| | - Roberta Agabio
- Department of Biomedical Sciences, Section of Neuroscience and Clinical Pharmacology, University of Cagliari, SS 554, km 4.5, 09042 Monserrato (CA), Italy
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Giannone F, Ebrahimi C, Endrass T, Hansson AC, Schlagenhauf F, Sommer WH. Bad habits-good goals? Meta-analysis and translation of the habit construct to alcoholism. Transl Psychiatry 2024; 14:298. [PMID: 39030169 PMCID: PMC11271507 DOI: 10.1038/s41398-024-02965-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/08/2023] [Revised: 05/19/2024] [Accepted: 05/24/2024] [Indexed: 07/21/2024] Open
Abstract
Excessive alcohol consumption remains a global public health crisis, with millions suffering from alcohol use disorder (AUD, or simply "alcoholism"), leading to significantly reduced life expectancy. This review examines the interplay between habitual and goal-directed behaviors and the associated neurobiological changes induced by chronic alcohol exposure. Contrary to a strict habit-goal dichotomy, our meta-analysis of the published animal experiments combined with a review of human studies reveals a nuanced transition between these behavioral control systems, emphasizing the need for refined terminology to capture the probabilistic nature of decision biases in individuals with a history of chronic alcohol exposure. Furthermore, we distinguish habitual responding from compulsivity, viewing them as separate entities with diverse roles throughout the stages of the addiction cycle. By addressing species-specific differences and translational challenges in habit research, we provide insights to enhance future investigations and inform strategies for combatting AUD.
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Affiliation(s)
- F Giannone
- Institute of Psychopharmacology, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, 68159, Mannheim, Germany
| | - C Ebrahimi
- Faculty of Psychology, Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, 01062, Dresden, Germany
| | - T Endrass
- Faculty of Psychology, Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, 01062, Dresden, Germany
| | - A C Hansson
- Institute of Psychopharmacology, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, 68159, Mannheim, Germany
| | - F Schlagenhauf
- Department of Psychotherapy, Campus Charité Mitte, Charité Universitätsmedizin Berlin & St. Hedwig Hospital, 10117, Berlin, Germany
| | - W H Sommer
- Institute of Psychopharmacology, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, 68159, Mannheim, Germany.
- Bethania Hospital for Psychiatry, Psychosomatics and Psychotherapy, Greifswald, Germany.
- German Center for Mental Health (DZPG), Partner Site Mannheim-Heidelberg-Ulm, 68159, Mannheim, Germany.
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12
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Chen Y, Zhong Y, Wang M, Su X, Li Q, Wang J, Sun L. Global trends and differences in the burden of alcohol use disorders attributable to childhood sexual abuse by sex, age, and socio-demographic index: Findings from the Global Burden of Disease Study 2019. CHILD ABUSE & NEGLECT 2024; 153:106818. [PMID: 38696952 DOI: 10.1016/j.chiabu.2024.106818] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/08/2023] [Revised: 03/13/2024] [Accepted: 04/24/2024] [Indexed: 05/04/2024]
Abstract
BACKGROUND Childhood sexual abuse (CSA) is a severe global problem associated with alcohol use disorder (AUD). Previous studies have confirmed this relationship; however, there is a lack of research on the disease burden of AUD attributable to CSA. OBJECTIVE To analyze global spatiotemporal trends and differences in the disease burden of AUD attributable to CSA and its relationship with age, sex, and the sociodemographic index (SDI). PARTICIPANTS AND SETTING Data from the Global Burden of Disease 2019 Public Database. METHODS Summary exposure value (SEV) was used to evaluate CSA. Disability-adjusted life year (DALY), years lived with disability (YLD), years of life lost (YLL), and their annual rates of change were used to evaluate disease burden. Cluster analysis based on Ward's method was used to examine the global burden associated with age, sex, and SDI. A 95 % uncertainty intervals (UI), excluding 0, was considered statistically significant. RESULTS In 2019, 1.63 million (95 % UI 0.23-3.90 million) DALYs of AUD were caused by CSA and the age-standardized rates (ASRs) of DALY was 19.77 (95 % UI 2.78-47.46) globally. Annual rates of change in DALY of people over 65 years of age increased from 1990 to 2019 in all regions except the High-middle SDI regions. The ASRs of DALY of females in High SDI regions, were always at a much higher level than other SDI regions, and showed an upward trend from 1990 to 2019 (DALY 1990: 20.38 [95 % UI 2.87-47.77], 2019: 23.61 [95 % UI 3.55-54.94]). CONCLUSIONS Substantial geographical differences were observed in the burden of AUD attributable to CSA. The level of CSA exposure was inconsistent with the related burden of AUD in different regions according to the sociodemographic index. The burden of disease increased in the elderly population and in females in high sociodemographic index regions.
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Affiliation(s)
- Yifan Chen
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan 250012, China; National Health Commission of China (NHC) Key Laboratory of Health Economics and Policy Research (Shandong University), Jinan 250012, China
| | - Yunxi Zhong
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan 250012, China; National Health Commission of China (NHC) Key Laboratory of Health Economics and Policy Research (Shandong University), Jinan 250012, China
| | - Meiqi Wang
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan 250012, China; National Health Commission of China (NHC) Key Laboratory of Health Economics and Policy Research (Shandong University), Jinan 250012, China
| | - Xiaoying Su
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan 250012, China; National Health Commission of China (NHC) Key Laboratory of Health Economics and Policy Research (Shandong University), Jinan 250012, China
| | - Qixiu Li
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan 250012, China; National Health Commission of China (NHC) Key Laboratory of Health Economics and Policy Research (Shandong University), Jinan 250012, China
| | - Jie Wang
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan 250012, China; National Health Commission of China (NHC) Key Laboratory of Health Economics and Policy Research (Shandong University), Jinan 250012, China
| | - Long Sun
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan 250012, China; National Health Commission of China (NHC) Key Laboratory of Health Economics and Policy Research (Shandong University), Jinan 250012, China.
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13
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Lebeaut A, Zegel M, Healy NA, McGrew SJ, Viana AG, Vujanovic AA. Posttraumatic Stress and Alcohol Use Among Hispanic/Latinx University Students: A Moderated Indirect Effect Model of Coping-Related Drinking and Anxiety Sensitivity. J Dual Diagn 2024; 20:236-250. [PMID: 38569201 PMCID: PMC11211699 DOI: 10.1080/15504263.2024.2335177] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/05/2024]
Abstract
OBJECTIVE Posttraumatic stress symptoms (PTSS) and anxiety sensitivity (AS) are associated with increased alcohol use and coping-motivated drinking among university students. This study among trauma-exposed Hispanic/Latinx university students sought to examine the indirect effect of PTSS on alcohol use severity through coping-motivated drinking and test the moderating role of AS and AS subfacets. METHODS University students who identified as Hispanic/Latinx (N = 830) were recruited from a large, urban, southern university and completed online, self-report questionnaires. RESULTS A significant interactive effect of PTSS and AS on coping-motivated drinking emerged. PTSS exerted a significant indirect effect on alcohol use severity, through coping-motivated drinking. Simple slope analyses revealed that PTSS was associated with coping-motivated drinking across all levels of AS. Post hoc results revealed unique biological sex differences in probable diagnosis odds ratios. CONCLUSIONS These findings indicate that PTSS and AS are associated with coping-motivated drinking and alcohol use severity in trauma-exposed, Hispanic/Latinx university students.
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Affiliation(s)
- Antoine Lebeaut
- Department of Psychology, University of Houston, Houston,
Texas
| | - Maya Zegel
- Department of Psychology, University of Houston, Houston,
Texas
| | | | - Shelby J. McGrew
- Department of Psychological and Brain Sciences, Texas
A&M University, College Station, Texas
| | - Andres G. Viana
- Department of Psychiatry and Behavioral Sciences, Texas
A&M School of Medicine, Bryan, Texas
| | - Anka A. Vujanovic
- Department of Psychology, University of Houston, Houston,
Texas
- Department of Psychological and Brain Sciences, Texas
A&M University, College Station, Texas
- Department of Psychiatry and Behavioral Sciences, Texas
A&M School of Medicine, Bryan, Texas
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14
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Burnett DP, Trikalinos TA, Kiluk BD, Ray L, Misquith C, Magill M. A Descriptive Review and Meta-Regression Study of Demographic and Study Context Factors in US Clinical Trials of Cognitive Behavioral Interventions for Alcohol or Other Drug Use. Subst Use Misuse 2024:1-11. [PMID: 38946162 DOI: 10.1080/10826084.2024.2369167] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 07/02/2024]
Abstract
Objectives. Cognitive-Behaviorally Based Interventions (CBIs) are evidence-based treatments for alcohol and other drug (AOD) use with potential variable effectiveness by population sub-groups. This study used evidence synthesis to examine treatment effect by demographic and study context factors in clinical trials of CBI for AOD. Methods. Studies were systematically identified, and their characteristics and outcome data were extracted and summarized. Standardized mean differences were calculated for within- and between-condition effects on substance use outcomes. Demographic and study context moderators were identified during data acquisition and several sensitivity analyses were conducted. Results. The sample included K = 29 trials and a total of 15 study-level moderators were examined. Information on participants' age, biological sex, and race were reported in at least 26 trials, but information on gender identity, sexual orientation, and ethnicity were reported infrequently or in non-inclusive ways. The mean between-condition effect size was small and moderately heterogenous (d = 0.158, 95% CI = 0.079, 0.238, I2 = 46%) and the mean within-condition effect size was large and showed high heterogeneity (dz = 1.147, 95% CI = 0.811, 1.482, - I2 = 96%). The specific drug targeted in the study and whether biological assay-based outcomes were used moderated between-condition CBI efficacy and the inclusion of co-occurring mental health conditions and study publication date moderated within-condition CBI effects. Conclusions. Results provide preliminary data on study context factors associated with effect estimates in United States based clinical trials of CBI for AOD.
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Affiliation(s)
- Don-Pierre Burnett
- School of Public Health, Brown University, Providence, Rhode Island, USA
| | | | - Brian D Kiluk
- Department of Psychiatry, Yale School of Medicine, New Haven, Connecticut, USA
| | - Lara Ray
- Department of Psychology, University of California at Los Angeles, Los Angeles, California, USA
| | - Chelsea Misquith
- School of Public Health, Brown University, Providence, Rhode Island, USA
- University Library, Brown University, Providence RI
| | - Molly Magill
- School of Public Health, Brown University, Providence, Rhode Island, USA
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15
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Haque LY, Leggio L. Integrated and collaborative care across the spectrum of alcohol-associated liver disease and alcohol use disorder. Hepatology 2024:01515467-990000000-00939. [PMID: 38935926 DOI: 10.1097/hep.0000000000000996] [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] [Received: 04/06/2024] [Accepted: 06/08/2024] [Indexed: 06/29/2024]
Abstract
The public health impact of alcohol-associated liver disease (ALD), a serious consequence of problematic alcohol use, and alcohol use disorder (AUD) is growing, with ALD becoming a major cause of alcohol-associated death overall and the leading indication for liver transplantation in the United States. Comprehensive care for ALD often requires treatment of AUD. Although there is a growing body of evidence showing that AUD treatment is associated with reductions in liver-related morbidity and mortality, only a minority of patients with ALD and AUD receive this care. Integrated and collaborative models that streamline both ALD and AUD care for patients with ALD and AUD are promising approaches to bridge this treatment gap and rely on multidisciplinary and interprofessional teams and partnerships. Here, we review the role of AUD care in ALD treatment, the effects of AUD treatment on liver-related outcomes, the impact of comorbid conditions such as other substance use disorders, obesity, and metabolic syndrome, and the current landscape of integrated and collaborative care for ALD and AUD in various treatment settings. We further review knowledge gaps and unmet needs that remain, including the role of precision medicine, the application of harm reduction approaches, the impact of health disparities, and the need for additional AUD treatment options, as well as further efforts to support implementation and dissemination.
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Affiliation(s)
- Lamia Y Haque
- Department of Internal Medicine, Yale School of Medicine, New Haven, Connecticut, USA
- Yale Program in Addiction Medicine, Yale School of Medicine, New Haven, Connecticut, USA
| | - Lorenzo Leggio
- Clinical Psychoneuroendocrinology and Neuropsychopharmacology Section, Translational Addiction Medicine Branch, National Institute on Drug Abuse and National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health, Baltimore and Bethesda, Maryland, USA
- Department of Behavioral and Social Sciences, Center for Alcohol and Addiction Studies, School of Public Health, Brown University, Providence, Rhode Island, USA
- Division of Addiction Medicine, Department of Medicine, School of Medicine, Johns Hopkins University, Baltimore, Maryland, USA
- Department of Neuroscience, Georgetown University Medical Center, Washington, District of Columbia, USA
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16
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Leger BS, Meredith JJ, Ideker T, Sanchez-Roige S, Palmer AA. Rare and common variants associated with alcohol consumption identify a conserved molecular network. ALCOHOL, CLINICAL & EXPERIMENTAL RESEARCH 2024; 48:1704-1715. [PMID: 39031522 DOI: 10.1111/acer.15399] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/23/2024] [Revised: 06/05/2024] [Accepted: 06/07/2024] [Indexed: 07/22/2024]
Abstract
BACKGROUND Genome-wide association studies (GWAS) have identified hundreds of common variants associated with alcohol consumption. In contrast, genetic studies of alcohol consumption that use rare variants are still in their early stages. No prior studies of alcohol consumption have examined whether common and rare variants implicate the same genes and molecular networks, leaving open the possibility that the two approaches might identify distinct biology. METHODS To address this knowledge gap, we used publicly available alcohol consumption GWAS summary statistics (GSCAN, N = 666,978) and whole exome sequencing data (Genebass, N = 393,099) to identify a set of common and rare variants for alcohol consumption. We used gene-based analysis to implicate genes from common and rare variant analyses, which we then propagated onto a shared molecular network using a network colocalization procedure. RESULTS Gene-based analysis of each dataset implicated 294 (common variants) and 35 (rare variants) genes, including ethanol metabolizing genes ADH1B and ADH1C, which were identified by both analyses, and ANKRD12, GIGYF1, KIF21B, and STK31, which were identified in only the rare variant analysis, but have been associated with other neuropsychiatric traits. Network colocalization revealed significant network overlap between the genes identified via common and rare variants. The shared network identified gene families that function in alcohol metabolism, including ADH, ALDH, CYP, and UGT. Seventy-one of the genes in the shared network were previously implicated in neuropsychiatric or substance use disorders but not alcohol-related behaviors (e.g. EXOC2, EPM2A, and CACNG4). Differential gene expression analysis showed enrichment in the liver and several brain regions. CONCLUSIONS Genes implicated by network colocalization identify shared biology relevant to alcohol consumption, which also underlie neuropsychiatric traits and substance use disorders that are comorbid with alcohol use, providing a more holistic understanding of two disparate sources of genetic information.
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Affiliation(s)
- Brittany S Leger
- Program in Biomedical Sciences, University of California San Diego, La Jolla, California, USA
- Department of Psychiatry, University of California San Diego, La Jolla, California, USA
| | - John J Meredith
- Department of Psychiatry, University of California San Diego, La Jolla, California, USA
| | - Trey Ideker
- Department of Medicine, University of California San Diego, La Jolla, California, USA
- Institute for Genomic Medicine, University of California San Diego, La Jolla, California, USA
| | - Sandra Sanchez-Roige
- Department of Psychiatry, University of California San Diego, La Jolla, California, USA
- Institute for Genomic Medicine, University of California San Diego, La Jolla, California, USA
- Division of Genetic Medicine, Department of Medicine, Vanderbilt University, Nashville, Tennessee, USA
| | - Abraham A Palmer
- Department of Psychiatry, University of California San Diego, La Jolla, California, USA
- Institute for Genomic Medicine, University of California San Diego, La Jolla, California, USA
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17
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Aftab M, Javed F, Haider S, Khan R, Khan SU, Alam K, Amir A, Ullah F, Shah NA. Design and Characterization of Chitosan-Based Smart Injectable Hydrogel for Improved Sustained Release of Antinarcotics. Pharmaceuticals (Basel) 2024; 17:749. [PMID: 38931416 PMCID: PMC11206616 DOI: 10.3390/ph17060749] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2024] [Revised: 05/30/2024] [Accepted: 06/03/2024] [Indexed: 06/28/2024] Open
Abstract
The treatment adherence of narcotics-addicted individuals with reduced incidences of relapse can be enhanced by a sustained drug release formulation of antinarcotics. So far, different drug formulations have been reported with sustained drug release periods of 28 and 35 days. To further enhance this duration, different formulations of injectable hydrogels (IHs) have been developed by combining low molecular weight (LMW) and high molecular weight (HMW) chitosan (CS) with guar gum (GG) and crosslinking them by sodium bi phosphate dibasic. The structural, morphological, and physicochemical properties of LMW-CS IH, and HMW-CS IH were evaluated using Fourier transform infrared spectroscopy (FT-IR), thermo-gravimetric analysis (TGA), scanning electron microscopy (SEM), and rheological, swelling, and biodegradation analysis. The HMW-CS IH showed high crosslinking, increased thermal stability, high mechanical strength, elevated swelling, and low biodegradation. The antinarcotic drugs naltrexone (NTX) and disulfiram (DSF) were loaded separately into the HMW-CS IH and LMW-CS IH. The release of NTX and DSF was investigated in phosphate buffer saline (PBS) and ethanol (0.3%, 0.4%, and 0.5%) over a 56-day period using an UV spectrophotometer. The drug release data were tested in zero-order, first-order, and Korsemeyer-Peppas mathematical models. In PBS, all prepared formulations followed non-Fickian drug release, while in ethanol, only NTX HMW-CS IH followed non-Fickian release in all three different concentrations of ethanol.
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Affiliation(s)
- Maryam Aftab
- Department of Biosciences, COMSATS University, Park Road, Islamabad 45520, Pakistan
| | - Fatima Javed
- Department of Chemistry, Shaheed Benazir Bhutto Women University, Peshawar 25000, Pakistan;
| | - Sajjad Haider
- Department of Chemical Engineering, King Saud University, Riyadh 11545, Saudi Arabia;
| | - Rawaiz Khan
- Restorative Dental Sciences Department, College of Dentistry, King Saud University, Riyadh 11545, Saudi Arabia;
| | - Salah Uddin Khan
- College of Engineering, King Saud University, P.O. Box 800, Riyadh 11421, Saudi Arabia;
| | - Kamran Alam
- Separation and Conversation Technology, Flemish Institute for Technological Research (VITO), 2400 Mol, Belgium;
| | - Afreenish Amir
- Department of Microbiology, National Institute of Health, Islamabad 45500, Pakistan;
| | - Faheem Ullah
- Department of Biological Sciences, National University of Medical Sciences (NUMS), Rawalpindi 46000, Pakistan
- School of Materials and Mineral Resources Engineering, Engineering Campus, University Sains Malaysia, Nibong Tebal 14300, Malaysia
| | - Naseer Ali Shah
- Department of Biosciences, COMSATS University, Park Road, Islamabad 45520, Pakistan
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18
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Johnson MC, Zweig JA, Zhang Y, Ryabinin AE. Effects of social housing on alcohol intake in mice depend on the non-social environment. Front Behav Neurosci 2024; 18:1380031. [PMID: 38817806 PMCID: PMC11137225 DOI: 10.3389/fnbeh.2024.1380031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2024] [Accepted: 05/01/2024] [Indexed: 06/01/2024] Open
Abstract
Background Excessive alcohol consumption leads to serious health problems. Mechanisms regulating the consumption of alcohol are insufficiently understood. Previous preclinical studies suggested that non-social environmental and social environmental complexities can regulate alcohol consumption in opposite directions. However, previous studies did not include all conditions and/or did not include female rodents. Therefore, in this study, we examined the effects of social versus single housing in standard versus non-standard housing conditions in male and female mice. Methods Adult C57BL/6 J mice were housed in either standard shoebox cages or in automated Herdsman 2 (HM2) cages and exposed to a two-bottle choice procedure with 3% or 6% ethanol versus water for 5 days. The HM2 cages use radiotracking devices to measure the fluid consumption of individual mice in an undisturbed and automated manner. In both housing conditions, mice were housed either at one or at four per cage. Results In standard cages, group housing of animals decreased alcohol consumption and water consumption. In HM2 cages, group housing significantly increased ethanol preference and decreased water intake. There were no significant differences in these effects between male and female animals. These observations were similar for 3 and 6% ethanol solutions but were more pronounced for the latter. The effects of social environment on ethanol preference in HM2 cages were accompanied by an increase in the number of approaches to the ethanol solution and a decrease in the number of approaches to water. The differences in ethanol intake could not be explained by differences in locomotor or exploratory activity as socially housed mice showed fewer non-consummatory visits to the ethanol solutions than single-housed animals. In addition, we observed that significant changes in behaviors measuring the approach to the fluid were not always accompanied by significant changes in fluid consumption, and vice versa, suggesting that it is important to assess both measures of motivation to consume alcohol. Conclusion Our results indicate that the direction of the effects of social environment on alcohol intake in mice depends on the non-social housing environment. Understanding mechanisms by which social and non-social housing conditions modulate alcohol intake could suggest approaches to counteract environmental factors enhancing hazardous alcohol consumption.
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Affiliation(s)
| | | | | | - Andrey E. Ryabinin
- Department of Behavioral Neuroscience, School of Medicine, Oregon Health and Science University, Portland, OR, United States
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19
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Long B, Keim SM, Gottlieb M, Rathlev N. Is Phenobarbital an Effective Treatment for Alcohol Withdrawal Syndrome? J Emerg Med 2024:S0736-4679(24)00153-7. [PMID: 39227241 DOI: 10.1016/j.jemermed.2024.05.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2024] [Revised: 05/04/2024] [Accepted: 05/05/2024] [Indexed: 09/05/2024]
Abstract
BACKGROUND Alcohol use disorder is associated with a variety of complications, including alcohol withdrawal syndrome (AWS), which may occur in those who decrease or stop alcohol consumption suddenly. AWS is associated with a range of signs and symptoms, which are most commonly treated with GABAergic medications. CLINICAL QUESTION Is phenobarbital an effective treatment for AWS? EVIDENCE REVIEW Studies retrieved included two prospective, randomized, double-blind studies and three systematic reviews. These studies provided estimates of the effectiveness and safety of phenobarbital for treatment of AWS. CONCLUSIONS Based on the available literature, phenobarbital is reasonable to consider for treatment of AWS. Clinicians must consider the individual patient, clinical situation, and comorbidities when selecting a medication for treatment of AWS.
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Affiliation(s)
- Brit Long
- Department of Emergency Medicine, Brooke Army Medical Center, Fort Sam Houston, Texas
| | - Samuel M Keim
- Department of Emergency Medicine, University of Arizona, Tucson, Arizona.
| | - Michael Gottlieb
- Department of Emergency Medicine, Rush University Medical Center, Chicago, Illinois
| | - Niels Rathlev
- Department of Emergency Medicine, University of Massachusetts Chan Medical School-Baystate, Springfield, Massachusetts
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20
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Bhagavathula AS, Aldhaleei WA. Alcohol and Substance Use Among the Working Age Population: A Nationwide Study of Fall-Related Emergency Department Visits. J Stud Alcohol Drugs 2024; 85:330-338. [PMID: 38270911 PMCID: PMC11218450 DOI: 10.15288/jsad.23-00330] [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: 10/13/2023] [Accepted: 01/13/2024] [Indexed: 01/26/2024] Open
Abstract
OBJECTIVE Prior studies have linked fall-related emergency department (ED) visits among older adults to alcohol use. Characteristics related to falls in the working age population (WAP; 15-64 years) may vary with alcohol and substance use. This study aimed to identify factors associated with fall-related ED visits related to alcohol and substance use in the WAP. METHOD Using nationally representative 2019-2020 National Hospital Ambulatory Medical Care Survey data, fall-related ED visits within 72 hours were stratified by indication of alcohol use, substance use, and concurrent alcohol and substance use. Descriptive statistics accounting for the survey's complex design were used along with multivariable logistic regression to identify associated factors. RESULTS Between 2019 and 2020, an estimated 10,800,000 fall-related ED visits occurred among the WAP, with 51.7% related to alcohol use, substance use, or both. Multivariable logistic regression analysis revealed that the WAP with fall-injury ED visits were associated with alcohol use (adjusted odds ratio [AOR] = 2.3, 95% CI [1.0, 5.9]) or concurrent alcohol and substance use (AOR = 8.5, 95% CI [1.6, 43.0]), and individuals with alcohol and substance use with a depression diagnosis are twice as likely to visit EDs with fall injuries. CONCLUSIONS Individuals with alcohol and substance use with depression were twice as likely to visit EDs for fall injuries. Higher fall-related ED visits in the WAP were attributed to alcohol and substance use. Identified factors could improve injury prevention and timely intervention among the WAP in the United States.
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Affiliation(s)
- Akshaya Srikanth Bhagavathula
- Department of Public Health, College of Health and Human Services, North Dakota State University, Fargo, North Dakota
| | - Wafa A. Aldhaleei
- Division of Gastroenterology and Hepatology, Mayo Clinic, Jacksonville, Florida
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21
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Punia K, Scott W, Manuja K, Sabbineni M, Campbell K, Balodis IM, MacKillop J. SAEM GRACE: Anti-craving medications for alcohol use disorder treatment in the emergency department: A systematic review of direct evidence. Acad Emerg Med 2024; 31:504-514. [PMID: 37735346 DOI: 10.1111/acem.14806] [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: 04/14/2023] [Revised: 08/11/2023] [Accepted: 08/14/2023] [Indexed: 09/23/2023]
Abstract
OBJECTIVES Alcohol-related concerns commonly present to the emergency department (ED), with a subset of individuals experiencing the symptoms of an alcohol use disorder (AUD). As such, examining the efficacy of pharmacological anti-craving treatment for AUD in the ED is of increasing interest. The objective of this systematic review was to evaluate the direct evidence assessing the efficacy of providing anti-craving medications for AUD treatment in the ED. METHODS A systematic search was conducted according to the patient-intervention-control-outcome question: (P) adults (≥18 years old) presenting to the ED with an AUD (including suspected AUD); (I) anti-craving medications (i.e., naltrexone, acamprosate, gabapentin); (C) no prescription or placebo; (O) reduction of repeat ED visits, engagement in addiction services, reductions in heavy drinking days, reductions in any drinking and amount consumed (or abstinence), and in relapse. Two reviewers independently assessed articles for inclusion and conducted risk of bias assessments for included studies. RESULTS From 143 potentially relevant articles, 6 met inclusion criteria: 3 clinical trials, and 3 case studies. The clinical trials identified evaluated oral versus extended-release naltrexone, monthly extended-release naltrexone injections, and disulfiram. Both oral and extended-release naltrexone resulted in decreased alcohol consumption. Monthly extended-release naltrexone injections resulted in significant improvements in drinking and quality of life. Although out of scope, the disulfiram studies identified did not result in an improvement in drinking in comparison to no medication. CONCLUSIONS Overall, there are few studies directly examining the efficacy of anti-craving medications for AUD in the ED, although the limited evidence that exists is supportive of naltrexone pharmacotherapy, particularly extended-release injection formulation. Additional randomized controlled trials are necessary for substantive direct evidence on anti-craving medication initiation in the ED.
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Affiliation(s)
- Kiran Punia
- Department of Psychology, Neuroscience, and Behaviour, McMaster University, Hamilton, Ontario, Canada
- Peter Boris Centre for Addictions Research, St. Joseph's Healthcare, Hamilton/McMaster University, Hamilton, Ontario, Canada
| | - William Scott
- Michael G. DeGroote School of Medicine, McMaster University, Hamilton, Ontario, Canada
| | - Kriti Manuja
- Peter Boris Centre for Addictions Research, St. Joseph's Healthcare, Hamilton/McMaster University, Hamilton, Ontario, Canada
| | - Monica Sabbineni
- Michael G. DeGroote School of Medicine, McMaster University, Hamilton, Ontario, Canada
| | | | - Iris M Balodis
- Peter Boris Centre for Addictions Research, St. Joseph's Healthcare, Hamilton/McMaster University, Hamilton, Ontario, Canada
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario, Canada
- Michael G. DeGroote Centre for Medicinal Cannabis Research, McMaster University/St. Joseph's Healthcare Hamilton, Hamilton, Ontario, Canada
| | - James MacKillop
- Peter Boris Centre for Addictions Research, St. Joseph's Healthcare, Hamilton/McMaster University, Hamilton, Ontario, Canada
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario, Canada
- Michael G. DeGroote Centre for Medicinal Cannabis Research, McMaster University/St. Joseph's Healthcare Hamilton, Hamilton, Ontario, Canada
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22
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Grodin EN, Kirsch D, Belnap M, Ray LA. Sex differences in neural response to an acute stressor in individuals with an alcohol use disorder. ALCOHOL, CLINICAL & EXPERIMENTAL RESEARCH 2024; 48:843-854. [PMID: 38652235 DOI: 10.1111/acer.15301] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/25/2023] [Revised: 01/29/2024] [Accepted: 02/29/2024] [Indexed: 04/25/2024]
Abstract
BACKGROUND Alcohol use disorder (AUD) and stress influence overlapping neural circuits in the brain. The literature is mixed regarding the presence of sex differences in the neural response to acute stressors, and this issue has not been examined in individuals with AUD. We validated a stress functional magnetic resonance imaging (fMRI) paradigm in individuals with AUD and tested for sex differences. METHODS Twenty-five treatment-seeking individuals with AUD (15M/10F) were recruited to participate in the neuroimaging study linked to a clinical trial of ibudilast (NCT03594435). To assess social-evaluative stress, participants completed the Montreal Imaging Stress Task (MIST). Whole brain and amygdala region-of-interest analyses were conducted. Subjective ratings of anxiety and distress were collected. Repeated measures ANCOVAs were performed to evaluate the effect of stress on anxiety and distress and to evaluate sex differences. RESULTS There were trend-level effects of stress on anxiety ratings and amygdala activation (p's = 0.06). There was a significant effect of stress in the bilateral thalamus, ventral tegmental area, and paracingulate (Z's > 4.09, p's < 0.03). There was a trend-level effect of sex on subjective ratings of stress (p's = 0.07). Females had higher amygdala activation in response to stress (p = 0.02). Females also had greater activation than males in the precuneus, posterior cingulate cortex, and right inferior frontal gyrus during acute stress (Z's > 3.56, p's < 0.03). CONCLUSIONS This study provides an initial validation of the MIST in a sample of individuals with AUD. It also provides preliminary evidence of sex differences in the response to social-evaluative stress, which is important, given the relevance of stress and negative emotionality as motivators for alcohol use in females.
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Affiliation(s)
- Erica N Grodin
- Department of Psychology, University of California at Los Angeles, Los Angeles, California, USA
- Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine, University of California at Los Angeles, Los Angeles, California, USA
- Brain Research Institute, University of California at Los Angeles, Los Angeles, California, USA
| | - Dylan Kirsch
- Department of Psychology, University of California at Los Angeles, Los Angeles, California, USA
| | - Malia Belnap
- Neuroscience Interdepartmental Program, University of California at Los Angeles, Los Angeles, California, USA
| | - Lara A Ray
- Department of Psychology, University of California at Los Angeles, Los Angeles, California, USA
- Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine, University of California at Los Angeles, Los Angeles, California, USA
- Brain Research Institute, University of California at Los Angeles, Los Angeles, California, USA
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23
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Punia K, Scott W, Manuja K, Campbell K, Balodis IM, MacKillop J. SAEM GRACE: Phenobarbital for alcohol withdrawal management in the emergency department: A systematic review of direct evidence. Acad Emerg Med 2024; 31:481-492. [PMID: 37589203 DOI: 10.1111/acem.14788] [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: 01/23/2023] [Revised: 06/19/2023] [Accepted: 07/02/2023] [Indexed: 08/18/2023]
Abstract
OBJECTIVES Alcohol withdrawal syndrome (AWS) is a commonly presenting condition in the emergency department (ED) and can have severe complications, including mortality. Benzodiazepines are first-line medications for treating AWS but may be unavailable or insufficient. This systematic review evaluates the direct evidence assessing the utility of phenobarbital for treating AWS in the ED. METHODS A systematic search was conducted and designed according to the patient-intervention-comparator-outcome (PICO) question: (P) adults (≥18 years old) presenting to the ED with alcohol withdrawal; (I) phenobarbital (including adjunctive); (C) benzodiazepines or no intervention; and (O) AWS complications, admission to a monitored setting, control of symptoms, adverse effects, and adjunctive medications. Two reviewers independently assessed articles for inclusion and conducted risk of bias assessments for included studies. RESULTS From 70 potentially relevant articles, seven studies met inclusion criteria: three retrospective cohort studies, two retrospective chart reviews, and two randomized controlled trials (RCTs), one examining phenobarbital monotherapy and one examining adjunctive phenobarbital. Across the retrospective cohort studies, treatment of AWS with phenobarbital resulted in lower odds of a subsequent ED visit. The retrospective chart reviews indicated that phenobarbital was associated with higher discharge rate compared to benzodiazepine-only treatments. For the two RCTs, phenobarbital did not differ significantly from benzodiazepine for most outcomes, although concomitant treatment with phenobarbital was associated with lower benzodiazepine use and intensive care unit admission. The heterogeneous designs and small number of studies prevented quantitative synthesis. CONCLUSIONS Relatively few studies provide direct evidence on the utility of phenobarbital for AWS in the ED, but the evidence that exists generally suggests that it is a reasonable and appropriate approach. Additional RCTs and other methodologically rigorous investigations are needed for more definitive direct evidence.
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Affiliation(s)
- Kiran Punia
- Department of Psychology, Neuroscience, and Behaviour, McMaster University, Ontario, Hamilton, Canada
- Peter Boris Centre for Addictions Research, St. Joseph's Healthcare Hamilton/McMaster University, Hamilton, Ontario, Canada
| | - William Scott
- Michael G. DeGroote School of Medicine, McMaster University, Hamilton, Ontario, Canada
| | - Kriti Manuja
- Peter Boris Centre for Addictions Research, St. Joseph's Healthcare Hamilton/McMaster University, Hamilton, Ontario, Canada
| | | | - Iris M Balodis
- Peter Boris Centre for Addictions Research, St. Joseph's Healthcare Hamilton/McMaster University, Hamilton, Ontario, Canada
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario, Canada
- Michael G. DeGroote Centre for Medicinal Cannabis Research (CMCR), McMaster University, Hamilton, Ontario, Canada
| | - James MacKillop
- Peter Boris Centre for Addictions Research, St. Joseph's Healthcare Hamilton/McMaster University, Hamilton, Ontario, Canada
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario, Canada
- Michael G. DeGroote Centre for Medicinal Cannabis Research (CMCR), McMaster University, Hamilton, Ontario, Canada
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24
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Minozzi S, Ambrosi L, Saulle R, Uhm SS, Terplan M, Sinclair JM, Agabio R. Psychosocial and medication interventions to stop or reduce alcohol consumption during pregnancy. Cochrane Database Syst Rev 2024; 4:CD015042. [PMID: 38682758 PMCID: PMC11057221 DOI: 10.1002/14651858.cd015042.pub2] [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] [Indexed: 05/01/2024]
Abstract
BACKGROUND Despite the known harms, alcohol consumption is common in pregnancy. Rates vary between countries, and are estimated to be 10% globally, with up to 25% in Europe. OBJECTIVES To assess the efficacy of psychosocial interventions and medications to reduce or stop alcohol consumption during pregnancy. SEARCH METHODS We searched the Cochrane Drugs and Alcohol Group Specialised Register (via CRSLive), Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, Embase, CINAHL, Web of Science, and PsycINFO, from inception to 8 January 2024. We also searched for ongoing and unpublished studies via ClinicalTrials.gov and the World Health Organization (WHO) International Clinical Trials Registry Platform (ICTRP). All searches included non-English language literature. We handsearched references of topic-related systematic reviews and included studies. SELECTION CRITERIA We included randomised controlled trials that compared medications or psychosocial interventions, or both, to placebo, no intervention, usual care, or other medications or psychosocial interventions used to reduce or stop alcohol use during pregnancy. Our primary outcomes of interest were abstinence from alcohol, reduction in alcohol consumption, retention in treatment, and women with any adverse event. DATA COLLECTION AND ANALYSIS We used standard Cochrane methodological procedures. MAIN RESULTS We included eight studies (1369 participants) in which pregnant women received an intervention to stop or reduce alcohol use during pregnancy. In one study, almost half of participants had a current diagnosis of alcohol use disorder (AUD); in another study, 40% of participants had a lifetime diagnosis of AUD. Six studies took place in the USA, one in Spain, and one in the Netherlands. All included studies evaluated the efficacy of psychosocial interventions; we did not find any study that evaluated the efficacy of medications for the treatment of AUD during pregnancy. Psychosocial interventions were mainly brief interventions ranging from a single session of 10 to 60 minutes to five sessions of 10 minutes each. Pregnant women received the psychosocial intervention approximately at the end of the first trimester of pregnancy, and the outcome of alcohol use was reassessed 8 to 24 weeks after the psychosocial intervention. Women in the control group received treatment as usual (TAU) or similar treatments such as comprehensive assessment of alcohol use and advice to stop drinking during pregnancy. Globally, we found that, compared to TAU, psychosocial interventions may increase the rate of continuously abstinent participants (risk ratio (RR) 1.34, 95% confidence interval (CI) 1.14 to 1.57; I2 =0%; 3 studies; 378 women; low certainty evidence). Psychosocial interventions may have little to no effect on the number of drinks per day, but the evidence is very uncertain (mean difference -0.42, 95% CI -1.13 to 0.28; I2 = 86%; 2 studies; 157 women; very low certainty evidence). Psychosocial interventions probably have little to no effect on the number of women who completed treatment (RR 0.98, 95% CI 0.94 to 1.02; I2 = 0%; 7 studies; 1283 women; moderate certainty evidence). None of the included studies assessed adverse events of treatments. We downgraded the certainty of the evidence due to risk of bias and imprecision of the estimates. AUTHORS' CONCLUSIONS Brief psychosocial interventions may increase the rate of continuous abstinence among pregnant women who report alcohol use during pregnancy. Further studies should be conducted to investigate the efficacy and safety of psychosocial interventions and other treatments (e.g. medications) for women with AUD. These studies should provide detailed information on alcohol use before and during pregnancy using consistent measures such as the number of drinks per drinking day. When heterogeneous populations are recruited, more detailed information on alcohol use during pregnancy should be provided to allow future systematic reviews to be conducted. Other important information that would enhance the usefulness of these studies would be the presence of other comorbid conditions such as anxiety, mood disorders, and the use of other psychoactive substances.
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Affiliation(s)
- Silvia Minozzi
- Department of Epidemiology, Lazio Regional Health Service, Rome, Italy
| | - Ludovico Ambrosi
- Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, University of Pavia, Pavia, Italy
| | - Rosella Saulle
- Department of Epidemiology, Lazio Regional Health Service, Rome, Italy
| | - Seilin S Uhm
- School of Medicine, University of Southampton, Southampton, UK
| | - Mishka Terplan
- Friends Research Institute, Baltimore, USA
- Family and Community Medicine, University of California, San Francisco, San Francisco, USA
| | | | - Roberta Agabio
- Department of Biomedical Sciences, Section of Neuroscience and Clinical Pharmacology, University of Cagliari, Cagliari, Italy
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Lauckner C, Takenaka BP, Sesenu F, Brown JS, Kirklewski SJ, Nicholson E, Haney K, Adatorwovor R, Boyd DT, Fallin-Bennett K, Restar AJ, Kershaw T. Combined Motivational Interviewing and Ecological Momentary Intervention to Reduce Hazardous Alcohol Use Among Sexual Minority Cisgender Men and Transgender Individuals: Protocol for a Randomized Controlled Trial. JMIR Res Protoc 2024; 13:e55166. [PMID: 38578673 PMCID: PMC11031694 DOI: 10.2196/55166] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2023] [Revised: 02/14/2024] [Accepted: 02/20/2024] [Indexed: 04/06/2024] Open
Abstract
BACKGROUND Sexual minority cisgender men and transgender (SMMT) individuals, particularly emerging adults (aged 18-34 years), often report hazardous drinking. Given that alcohol use increases the likelihood of HIV risk behaviors, and HIV disproportionately affects SMMT individuals, there is a need to test interventions that reduce hazardous alcohol use and subsequent HIV risk behaviors among this population. Ecological momentary interventions (EMIs), which use mobile phones to deliver risk reduction messages based on current location and behaviors, can help to address triggers that lead to drinking in real time. OBJECTIVE This study will test an EMI that uses motivational interviewing (MI), smartphone surveys, mobile breathalyzers, and location tracking to provide real-time messaging that addresses triggers for drinking when SMMT individuals visit locations associated with hazardous alcohol use. In addition, the intervention will deliver harm reduction messaging if individuals report engaging in alcohol use. METHODS We will conduct a 3-arm randomized controlled trial (N=405 HIV-negative SMMT individuals; n=135, 33% per arm) comparing the following conditions: (1) Tracking and Reducing Alcohol Consumption (a smartphone-delivered 4-session MI intervention), (2) Tracking and Reducing Alcohol Consumption and Environmental Risk (an EMI combining MI with real-time messaging based on geographic locations that are triggers to drinking), and (3) a smartphone-based alcohol monitoring-only control group. Breathalyzer results and daily self-reports will be used to assess the primary and secondary outcomes of drinking days, drinks per drinking day, binge drinking episodes, and HIV risk behaviors. Additional assessments at baseline, 3 months, 6 months, and 9 months will evaluate exploratory long-term outcomes. RESULTS The study is part of a 5-year research project funded in August 2022 by the National Institute on Alcohol Abuse and Alcoholism. The first 1.5 years of the study will be dedicated to planning and development activities, including formative research, app design and testing, and message design and testing. The subsequent 3.5 years will see the study complete participant recruitment, data collection, analyses, report writing, and dissemination. We expect to complete all study data collection in or before January 2027. CONCLUSIONS This study will provide novel evidence about the relative efficacy of using a smartphone-delivered MI intervention and real-time messaging to address triggers for hazardous alcohol use and sexual risk behaviors. The EMI approach, which incorporates location-based preventive messaging and behavior surveys, may help to better understand the complexity of daily stressors among SMMT individuals and their impact on hazardous alcohol use and HIV risk behaviors. The tailoring of this intervention toward SMMT individuals helps to address their underrepresentation in existing alcohol use research and will be promising for informing where structural alcohol use prevention and treatment interventions are needed to support SMMT individuals. TRIAL REGISTRATION ClinicalTrials.gov NCT05576350; https://www.clinicaltrials.gov/study/NCT05576350. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) PRR1-10.2196/55166.
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Affiliation(s)
- Carolyn Lauckner
- Center for Health Equity Transformation, University of Kentucky, Lexington, KY, United States
| | - Bryce Puesta Takenaka
- Department of Social and Behavioral Sciences, Yale School of Public Health, New Haven, CT, United States
| | - Fidelis Sesenu
- Center for Health Equity Transformation, University of Kentucky, Lexington, KY, United States
| | - Jaime S Brown
- Center for Health Equity Transformation, University of Kentucky, Lexington, KY, United States
| | - Sally J Kirklewski
- Department of Social and Behavioral Sciences, Yale School of Public Health, New Haven, CT, United States
| | - Erin Nicholson
- Department of Social and Behavioral Sciences, Yale School of Public Health, New Haven, CT, United States
| | - Kimberly Haney
- Center for Health Equity Transformation, University of Kentucky, Lexington, KY, United States
| | - Reuben Adatorwovor
- Department of Biostatistics, University of Kentucky, Lexington, KY, United States
| | - Donte T Boyd
- College of Social Work, The Ohio State University, Columbus, OH, United States
- Center for Interdisciplinary Research on AIDS, Yale University, New Haven, CT, United States
| | - Keisa Fallin-Bennett
- Department of Family and Community Medicine, University of Kentucky, Lexington, KY, United States
| | - Arjee Javellana Restar
- Department of Social and Behavioral Sciences, Yale School of Public Health, New Haven, CT, United States
- Department of Epidemiology, Department of Health Systems and Population Health, University of Washington, Seattle, WA, United States
| | - Trace Kershaw
- Department of Social and Behavioral Sciences, Yale School of Public Health, New Haven, CT, United States
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Agabio R, Domenicali M, Zavan V, Addolorato G. Education and Training in Alcohology in Italy. Eur Addict Res 2024; 30:145-148. [PMID: 38498982 DOI: 10.1159/000537799] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/07/2023] [Accepted: 02/08/2024] [Indexed: 03/20/2024]
Affiliation(s)
- Roberta Agabio
- Department of Biomedical Sciences, University of Cagliari, Cagliari, Italy
| | - Marco Domenicali
- Department of Medical and Surgical Sciences, Alma Mater Studiorum-University of Bologna, Bologna, Italy
- Department of Primary Health Care, Internal Medicine Unit Addressed to Frailty and Aging, "S. Maria delle Croci" Ravenna Hospital, AUSL Romagna, Ravenna, Italy
| | - Valeria Zavan
- Addiction Unit, Local Health Agency To4, Torino, Italy
| | - Giovanni Addolorato
- Department of Medical and Surgical Sciences, Catholic University of Rome, Rome, Italy
- Internal Medicine and Alcohol Related Disease Unit, Columbus-Gemelli Hospital, Fondazione Policlinico Universitario A. Gemelli IRCCS, Roma, Italy
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Grodin EN, Baskerville WA, Meredith LR, Nieto S, Ray LA. Reward, relief, and habit drinking profiles in treatment seeking individuals with an AUD. Alcohol Alcohol 2024; 59:agae032. [PMID: 38725398 PMCID: PMC11082523 DOI: 10.1093/alcalc/agae032] [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: 02/20/2024] [Revised: 04/18/2024] [Accepted: 04/20/2024] [Indexed: 05/13/2024] Open
Abstract
AIMS This study aimed to compare reward, relief, and habit treatment-seeking individuals on recent drinking, alcohol use disorder (AUD) phenomenology, and mood. The second aim of the study was to evaluate the predictive validity of reward, relief, and habit profiles. METHOD Treatment-seeking individuals with an AUD (n = 169) were recruited to participate in a medication trial for AUD (NCT03594435). Reward, relief, and habit drinking groups were assessed using the UCLA Reward Relief Habit Drinking Scale. Group differences at baseline were evaluated using univariate analyses of variance. A subset of participants were enrolled in a 12-week, double-blind, placebo-controlled medication trial (n = 102), and provided longitudinal drinking and phenomenology data. The predictive validity of group membership was assessed using linear regression analyses. RESULTS At baseline, individuals who drink primarily for relief had higher craving and negative mood than those who drink for reward and habit. Prospectively, membership in the relief drinking group predicted greater alcohol use, greater heavy drinking, and fewer days abstinent compared to those in the reward drinking group. Membership in the relief drinking group also predicted greater alcohol craving, more alcohol-related consequences, and more anxiety symptoms over 12 weeks compared to those in the reward drinking group. CONCLUSIONS This study provides support for reward and relief drinking motive profiles in treatment-seeking individuals with an AUD. Membership in the relief drinking motive group was predictive of poorer drinking outcomes and more negative symptomology over 12 weeks, indicating that individuals who drink for relief may be a particularly vulnerable sub-population of individuals with AUD.
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Affiliation(s)
- Erica N Grodin
- Department of Psychology, University of California, Los Angeles, Los Angeles, California 90095, United States
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, Los Angeles, California 90095, United States
- Brain Research Institute, University of California, Los Angeles, Los Angeles, California 90095, United States
| | - Wave-Ananda Baskerville
- Department of Psychology, University of California, Los Angeles, Los Angeles, California 90095, United States
| | - Lindsay R Meredith
- Department of Psychology, University of California, Los Angeles, Los Angeles, California 90095, United States
| | - Steven Nieto
- Department of Psychology, University of California, Los Angeles, Los Angeles, California 90095, United States
| | - Lara A Ray
- Department of Psychology, University of California, Los Angeles, Los Angeles, California 90095, United States
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, Los Angeles, California 90095, United States
- Brain Research Institute, University of California, Los Angeles, Los Angeles, California 90095, United States
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Leger BS, Meredith JJ, Ideker T, Sanchez-Roige S, Palmer AA. Rare and Common Variants Associated with Alcohol Consumption Identify a Conserved Molecular Network. BIORXIV : THE PREPRINT SERVER FOR BIOLOGY 2024:2024.02.26.582195. [PMID: 38464225 PMCID: PMC10925118 DOI: 10.1101/2024.02.26.582195] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/12/2024]
Abstract
Genome-wide association studies (GWAS) have identified hundreds of common variants associated with alcohol consumption. In contrast, rare variants have only begun to be studied for their role in alcohol consumption. No studies have examined whether common and rare variants implicate the same genes and molecular networks. To address this knowledge gap, we used publicly available alcohol consumption GWAS summary statistics (GSCAN, N=666,978) and whole exome sequencing data (Genebass, N=393,099) to identify a set of common and rare variants for alcohol consumption. Gene-based analysis of each dataset have implicated 294 (common variants) and 35 (rare variants) genes, including ethanol metabolizing genes ADH1B and ADH1C, which were identified by both analyses, and ANKRD12, GIGYF1, KIF21B, and STK31, which were identified only by rare variant analysis, but have been associated with related psychiatric traits. We then used a network colocalization procedure to propagate the common and rare gene sets onto a shared molecular network, revealing significant overlap. The shared network identified gene families that function in alcohol metabolism, including ADH, ALDH, CYP, and UGT. 74 of the genes in the network were previously implicated in comorbid psychiatric or substance use disorders, but had not previously been identified for alcohol-related behaviors, including EXOC2, EPM2A, CACNB3, and CACNG4. Differential gene expression analysis showed enrichment in the liver and several brain regions supporting the role of network genes in alcohol consumption. Thus, genes implicated by common and rare variants identify shared functions relevant to alcohol consumption, which also underlie psychiatric traits and substance use disorders that are comorbid with alcohol use.
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Affiliation(s)
- Brittany S Leger
- Program in Biomedical Sciences, University of California San Diego, La Jolla, CA, USA
- Department of Psychiatry, University of California San Diego, La Jolla, CA, USA
| | - John J Meredith
- Department of Psychiatry, University of California San Diego, La Jolla, CA, USA
| | - Trey Ideker
- Department of Medicine, University of California San Diego, La Jolla, CA 92093, USA
- Institute for Genomic Medicine, University of California San Diego, La Jolla, CA 92093, USA
| | - Sandra Sanchez-Roige
- Department of Psychiatry, University of California San Diego, La Jolla, CA, USA
- Institute for Genomic Medicine, University of California San Diego, La Jolla, CA 92093, USA
- Department of Medicine, Division of Genetic Medicine, Vanderbilt University, Nashville, TN, USA
| | - Abraham A Palmer
- Department of Psychiatry, University of California San Diego, La Jolla, CA, USA
- Institute for Genomic Medicine, University of California San Diego, La Jolla, CA 92093, USA
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Ray LA, Baskerville WA, Nieto SJ, Grodin E, Enders C, Kady A, Meredith L, Gillis A, Leventhal A, Ho D, Miotto K. A practice quit model to test early efficacy of medications for alcohol use disorder in a randomized clinical trial. Psychopharmacology (Berl) 2024; 241:543-553. [PMID: 38012333 DOI: 10.1007/s00213-023-06504-6] [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: 07/12/2023] [Accepted: 11/07/2023] [Indexed: 11/29/2023]
Abstract
RATIONALE Screening novel medications for alcohol use disorder (AUD) requires models that are both efficient and ecologically-valid. Ideally, such models would be associated with the outcomes of a given medication in clinical trials. OBJECTIVES To test a novel human laboratory model in which individuals with intrinsic motivation to change their drinking engage in a "practice quit" attempt consisting of 6 days of complete abstinence from alcohol. METHOD Individuals with current AUD completed a randomized, double-blind, placebo-controlled study of naltrexone (50 mg), varenicline (2 mg bid), or matched placebo. Participants were titrated onto the study medication for 1 week prior to starting the 6-day practice quit attempt. During the practice quit attempt, participants completed daily interviews with research staff. All participants completed an alcohol cue-exposure paradigm before starting the study medication and after 2 weeks of study medication. RESULTS There were no significant medication effect on drinks per drinking day (F(2,49) = 0.66, p = 0.52) or percent days abstinent (F(2,49) = 0.14, p = 0.87) during the 6-day practice quit period. There were no medication effects on alcohol cue-reactivity (F(2,44) = 0.80, p = 0.46). Notably, participants sharply reduced their drinking during the entire 13-day medication treatment period, as compared to reducing only during the 6-day practice quit period. During the total medication period, higher levels of motivation to change was associated with higher percent days abstinent (F(1,49) = 8.12, p < 0.01). CONCLUSIONS This study reports mostly null findings, which challenges us to decompose its nuanced design to consider model refinements. Possible changes to the model include considering the requirement for intrinsic motivation for change, including a longer practice quit period, encompassing the medication administration timeframe in the practice quit period, increasing the required sample size for signal detection, and examining a post COVID-19 pandemic cohort.
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Affiliation(s)
- Lara A Ray
- Department of Psychology, University of California at Los Angeles, 1285 Franz Hall, Box 951563, Los Angeles, CA, 90095-1563, USA.
- Department of Psychiatry and Biobehavioral Sciences, University of California at Los Angeles, Los Angeles, CA, USA.
- Brain Research Institute, University of California at Los Angeles, Los Angeles, CA, USA.
| | - Wave-Ananda Baskerville
- Department of Psychology, University of California at Los Angeles, 1285 Franz Hall, Box 951563, Los Angeles, CA, 90095-1563, USA
| | - Steven J Nieto
- Department of Psychology, University of California at Los Angeles, 1285 Franz Hall, Box 951563, Los Angeles, CA, 90095-1563, USA
| | - Erica Grodin
- Department of Psychiatry and Biobehavioral Sciences, University of California at Los Angeles, Los Angeles, CA, USA
| | - Craig Enders
- Department of Psychology, University of California at Los Angeles, 1285 Franz Hall, Box 951563, Los Angeles, CA, 90095-1563, USA
| | - Annabel Kady
- Department of Psychology, University of California at Los Angeles, 1285 Franz Hall, Box 951563, Los Angeles, CA, 90095-1563, USA
| | - Lindsay Meredith
- Department of Psychology, University of California at Los Angeles, 1285 Franz Hall, Box 951563, Los Angeles, CA, 90095-1563, USA
| | - Artha Gillis
- Department of Psychiatry and Biobehavioral Sciences, University of California at Los Angeles, Los Angeles, CA, USA
| | - Adam Leventhal
- Department of Population and Public Health Sciences, University of Southern California, Los Angeles, CA, USA
| | - Diana Ho
- Department of Psychology, University of California at Los Angeles, 1285 Franz Hall, Box 951563, Los Angeles, CA, 90095-1563, USA
| | - Karen Miotto
- Department of Psychiatry and Biobehavioral Sciences, University of California at Los Angeles, Los Angeles, CA, USA
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Qiu J, Dong F, Zhuge H, Han Q, Li J, Guo R, Dou X, Li J, Li S. Preventive effect of low-carbohydrate high-fat dietary pattern on liver disease caused by alcohol consumption via a 6pgd-involved mechanism in mice. Food Funct 2024; 15:732-746. [PMID: 38117162 DOI: 10.1039/d3fo04335e] [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: 12/21/2023]
Abstract
A low-carbohydrate high-fat (LCHF) dietary pattern has been reported to improve chronic metabolic diseases. However, whether and how the LCHF diet affects the pathological progression in patients with alcohol-related liver diseases (ALD) is largely unknown. This study was conducted to evaluate the effect of the LCHF diet on ALD and clarify its potential mechanism(s). The ALD model was established by feeding C57BL/6N mice with a Lieber-DeCarli liquid alcohol diet with a modified carbohydrate/fat ratio under an isoenergetic pattern. After an eight-week intervention, we observed that the LCHF diet significantly reduced alcohol-induced hepatic steatosis and liver injury, along with improved lipid metabolic-related gene disorders and redox imbalance. The alcohol-stimulated increase in pro-inflammatory cytokine cytokines expression, including TNF-α, IL-1β, and IL-6, was markedly reversed by the LCHF diet. Liver transcriptome sequencing and qPCR validation showed that twenty-four alcohol-disturbed genes were significantly reversed by LCHF-diet intervention. The top differentially expressed genes were selected for further investigation. Among them, 6-phosphogluconate dehydrogenase (6PGD) was significantly up-regulated by alcohol treatment in both the liver and cultured hepatocytes. Spearman correlation analysis revealed that 6PGD was positively associated with hepatic steatosis, liver injury, and oxidative stress indexes. In vitro, the 6PGD knockdown ameliorated alcohol-induced hepatotoxicity and intracellular lipid accumulation, as well as lipid metabolic-related gene disorders, implying the involvement of 6PGD in LCHF-protected ALD. In conclusion, LCHF diet intervention alleviated chronic alcohol consumption-induced liver dysfunction in mice. 6PGD is a potential novel target for ALD prevention that contributes to LCHF-improved ALD. A LCHF diet might be a promising choice for ALD management.
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Affiliation(s)
- Jiannan Qiu
- School of Public Health, Zhejiang Chinese Medical University, Hangzhou, Zhejiang, PR. China.
- School of Life Science, Zhejiang Chinese Medical University, Hangzhou, Zhejiang, PR. China
| | - Fan Dong
- School of Public Health, Zhejiang Chinese Medical University, Hangzhou, Zhejiang, PR. China.
| | - Hui Zhuge
- School of Life Science, Zhejiang Chinese Medical University, Hangzhou, Zhejiang, PR. China
| | - Qiang Han
- School of Public Health, Zhejiang Chinese Medical University, Hangzhou, Zhejiang, PR. China.
| | - Jiaomei Li
- School of Public Health, Zhejiang Chinese Medical University, Hangzhou, Zhejiang, PR. China.
| | - Rui Guo
- School of Public Health, Zhejiang Chinese Medical University, Hangzhou, Zhejiang, PR. China.
| | - Xiaobing Dou
- School of Life Science, Zhejiang Chinese Medical University, Hangzhou, Zhejiang, PR. China
| | - Jiayu Li
- School of Public Health, Zhejiang Chinese Medical University, Hangzhou, Zhejiang, PR. China.
| | - Songtao Li
- School of Public Health, Zhejiang Chinese Medical University, Hangzhou, Zhejiang, PR. China.
- Department of Clinical Nutrition, Affiliated Zhejiang Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, PR. China
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Deng WQ, Belisario K, Gray JC, Levitt EE, MacKillop J. A high-resolution PheWAS approach to alcohol-related polygenic risk scores reveals mechanistic influences of alcohol reinforcing value and drinking motives. Alcohol Alcohol 2024; 59:agad093. [PMID: 38261344 DOI: 10.1093/alcalc/agad093] [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: 08/11/2023] [Revised: 11/08/2023] [Accepted: 12/16/2023] [Indexed: 01/24/2024] Open
Abstract
AIMS This study uses a high-resolution phenome-wide approach to evaluate the motivational mechanisms of polygenic risk scores (PRSs) that have been robustly associated with coarse alcohol phenotypes in large-scale studies. METHODS In a community-based sample of 1534 Europeans, we examined genome-wide PRSs for the Alcohol Use Disorders Identification Test (AUDIT), drinks per week, alcohol use disorder (AUD), problematic alcohol use (PAU), and general addiction, in relation to 42 curated phenotypes. The curated phenotypes were in seven categories: alcohol consumption, alcohol reinforcing value, drinking motives, other addictive behaviors, commonly comorbid psychiatric syndromes, impulsivity, and personality traits. RESULTS The PRS for each alcohol phenotype was validated via its within-sample association with the corresponding phenotype (adjusted R2s = 0.35-1.68%, Ps = 0.012-3.6 × 10-7) with the exception of AUD. All PRSs were positively associated with alcohol reinforcing value and drinking motives, with the strongest effects from AUDIT-consumption (adjusted R2s = 0.45-1.33%, Ps = 0.006-3.6 × 10-5) and drinks per week PRSs (adjusted R2s = 0.52-2.28%, Ps = 0.004-6.6 × 10-9). Furthermore, the PAU and drinks per week PRSs were positively associated with adverse childhood experiences (adjusted R2s = 0.6-0.7%, Ps = 0.0001-4.8 × 10-4). CONCLUSIONS These results implicate alcohol reinforcing value and drinking motives as genetically-influenced mechanisms using PRSs for the first time. The findings also highlight the value of dissecting genetic influence on alcohol involvement through diverse phenotypic risk pathways but also the need for future studies with both phenotypic richness and larger samples.
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Affiliation(s)
- Wei Q Deng
- Peter Boris Centre for Addictions Research, St. Joseph's Healthcare Hamilton, Hamilton, Ontario L8N 3K7, Canada
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario L8N 3K7, Canada
| | - Kyla Belisario
- Peter Boris Centre for Addictions Research, St. Joseph's Healthcare Hamilton, Hamilton, Ontario L8N 3K7, Canada
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario L8N 3K7, Canada
| | - Joshua C Gray
- Department of Medical and Clinical Psychology, Uniformed Services University, Bethesda, MD 20814, United States
| | - Emily E Levitt
- Peter Boris Centre for Addictions Research, St. Joseph's Healthcare Hamilton, Hamilton, Ontario L8N 3K7, Canada
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario L8N 3K7, Canada
| | - James MacKillop
- Peter Boris Centre for Addictions Research, St. Joseph's Healthcare Hamilton, Hamilton, Ontario L8N 3K7, Canada
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario L8N 3K7, Canada
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Meng Y, Sun J, Zhang G. Pick fecal microbiota transplantation to enhance therapy for major depressive disorder. Prog Neuropsychopharmacol Biol Psychiatry 2024; 128:110860. [PMID: 37678703 DOI: 10.1016/j.pnpbp.2023.110860] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/17/2023] [Revised: 08/23/2023] [Accepted: 09/04/2023] [Indexed: 09/09/2023]
Abstract
In recent years, fecal microbiota transplantation (FMT) has emerged as a promising therapy for major depressive disorder (MDD). The goal of the operation is to restore a healthy gut microbiota by introducing feces from a healthy donor into the recipient's digestive system. The brain-gut axis is thought to have a significant role in regulating mood, behavior, and cognition, which supports the use of FMT in the treatment of MDD. Numerous studies have shown a correlation between abnormalities of the gut microbiota and MDD, whereas FMT has demonstrated the potential to restore microbial equilibrium. While FMT has shown encouraging results, it is crucial to highlight the potential hazards and limits inherent to this therapeutic approach. Stool donor-to-recipient disease transfer is a concern of FMT. Furthermore, it still needs to be determined what effect FMT has on the gut microbiota and the brain in the long run. This literature review provides an overview of the possible efficacy of FMT as a therapeutic modality for MDD. There is hope for patients who have not reacted well to typical antidepressant therapy since FMT may become an invaluable tool in the treatment of MDD as researchers continue to examine the relationship between gut microbiota and MDD.
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Affiliation(s)
- Yiming Meng
- Department of Central Laboratory, Cancer Hospital of Dalian University of Technology, Liaoning Cancer Hospital & Institute, No. 44, Xiaoheyan Road, Dadong District, Shenyang 110042, China.
| | - Jing Sun
- Department of Biobank, Cancer Hospital of Dalian University of Technology, Liaoning Cancer Hospital & Institute, No. 44, Xiaoheyan Road, Dadong District, Shenyang 110042, China
| | - Guirong Zhang
- Department of Central Laboratory, Cancer Hospital of Dalian University of Technology, Liaoning Cancer Hospital & Institute, No. 44, Xiaoheyan Road, Dadong District, Shenyang 110042, China
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Traccis F, Minozzi S, Trogu E, Vacca R, Vecchi S, Pani PP, Agabio R. Disulfiram for the treatment of cocaine dependence. Cochrane Database Syst Rev 2024; 1:CD007024. [PMID: 38180268 PMCID: PMC10767770 DOI: 10.1002/14651858.cd007024.pub3] [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] [Indexed: 01/06/2024]
Abstract
BACKGROUND Cocaine is a psychostimulant used by approximately 0.4% of the general population worldwide. Cocaine dependence is a chronic mental disorder characterised by the inability to control cocaine use and a host of severe medical and psychosocial complications. There is current no approved pharmacological treatment for cocaine dependence. Some researchers have proposed disulfiram, a medication approved to treat alcohol use disorder. This is an update of a Cochrane review first published in 2010. OBJECTIVES To evaluate the efficacy and safety of disulfiram for the treatment of cocaine dependence. SEARCH METHODS We updated our searches of the following databases to August 2022: the Cochrane Drugs and Alcohol Group Specialised Register, CENTRAL, MEDLINE, Embase, CINAHL, and PsycINFO. We also searched for ongoing and unpublished studies via two trials registries. We handsearched the references of topic-related systematic reviews and included studies. The searches had no language restrictions. SELECTION CRITERIA We included randomised controlled trials that evaluated disulfiram alone or associated with psychosocial interventions versus placebo, no intervention, other pharmacological interventions, or any psychosocial intervention for the treatment of cocaine dependence. DATA COLLECTION AND ANALYSIS We used standard methodological procedures expected by Cochrane. MAIN RESULTS Thirteen studies (1191 participants) met our inclusion criteria. Disulfiram versus placebo or no treatment Disulfiram compared to placebo may increase the number of people who are abstinent at the end of treatment (point abstinence; risk ratio (RR) 1.58, 95% confidence interval (CI) 1.05 to 2.36; 3 datasets, 142 participants; low-certainty evidence). However, compared to placebo or no pharmacological treatment, disulfiram may have little or no effect on frequency of cocaine use (standardised mean difference (SMD) -0.11 standard deviations (SDs), 95% CI -0.39 to 0.17; 13 datasets, 818 participants), amount of cocaine use (SMD -0.00 SDs, 95% CI -0.30 to 0.30; 7 datasets, 376 participants), continuous abstinence (RR 1.23, 95% CI 0.80 to 1.91; 6 datasets, 386 participants), and dropout for any reason (RR 1.20, 95% CI 0.92 to 1.55; 14 datasets, 841 participants). The certainty of the evidence was low for all these outcomes. We are unsure about the effects of disulfiram versus placebo on dropout due to adverse events (RR 12.97, 95% CI 0.77 to 218.37; 1 study, 67 participants) and on the occurrence of adverse events (RR 3.00, 95% CI 0.35 to 25.98), because the certainty of the evidence was very low for these outcomes. Disulfiram versus naltrexone Disulfiram compared with naltrexone may reduce the frequency of cocaine use (mean difference (MD) -1.90 days, 95% CI -3.37 to -0.43; 2 datasets, 123 participants; low-certainty evidence) and may have little or no effect on amount of cocaine use (SMD 0.12 SDs, 95% CI -0.27 to 0.51, 2 datasets, 123 participants; low-certainty evidence). We are unsure about the effect of disulfiram versus naltrexone on dropout for any reason (RR 0.86, 95% CI 0.56 to 1.32, 3 datasets, 131 participants) and dropout due to adverse events (RR 0.50, 95% CI 0.07 to 3.55; 1 dataset, 8 participants), because the certainty of the evidence was very low for these outcomes. AUTHORS' CONCLUSIONS Our results show that disulfiram compared to placebo may increase point abstinence. However, disulfiram compared to placebo or no pharmacological treatment may have little or no effect on frequency of cocaine use, amount of cocaine use, continued abstinence, and dropout for any reason. We are unsure if disulfiram has any adverse effects in this population. Caution is required when transferring our results to clinical practice.
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Affiliation(s)
- Francesco Traccis
- Department of Biomedical Sciences, Section of Neurosciences and Clinical Pharmacology, University of Cagliari, Cagliari, Italy
| | - Silvia Minozzi
- Department of Epidemiology, Lazio Regional Health Service, Rome, Italy
| | - Emanuela Trogu
- Department of Mental Health, Psychiatric Diagnosis and Treatment Service, Local Social Health Agency, Cagliari, Italy
| | - Rosangela Vacca
- SC Clinical Governance and PDTA, ARES Sardegna, Sassari, Italy
| | - Simona Vecchi
- Department of Epidemiology, Lazio Regional Health Service, Rome, Italy
| | - Pier Paolo Pani
- Social Health Services, Sardinia Protection Health Trust, Cagliari, Italy
| | - Roberta Agabio
- Department of Biomedical Sciences, Section of Neurosciences and Clinical Pharmacology, University of Cagliari, Cagliari, Italy
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Smith WP. Negative Lifestyle Factors Specific to Aging Persons Living with HIV and Multimorbidity. J Int Assoc Provid AIDS Care 2024; 23:23259582241245228. [PMID: 39051608 PMCID: PMC11273731 DOI: 10.1177/23259582241245228] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2023] [Revised: 02/28/2024] [Accepted: 03/18/2024] [Indexed: 07/27/2024] Open
Abstract
The primary goal of medical care during the pre-antiretroviral therapy (ART) era was to keep persons living with human immunodeficiency virus (HIV) alive, whereas since the advent of ART, the treatment objective has shifted to decreasing viral loads and infectiousness while increasing CD4+ T-cell counts and longevity. The health crisis, however, is in preventing and managing multimorbidity (ie, type 2 diabetes), which develops at a more accelerated or accentuated pace among aging persons living with HIV. Relative to the general population and age-matched uninfected adults, it may be more difficult for aging HIV-positive persons who also suffer from multimorbidity to improve negative lifestyle factors to the extent that their behaviors could support the prevention and management of diseases. With recommendations and a viable solution, this article explores the impact of negative lifestyle factors (ie, poor mental health, suboptimal nutrition, physical inactivity, alcohol use) on the health of aging individuals living with HIV.
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Chung T, Suffoletto B, Ewing SWF, Bhurosy T, Jiang Y, Valera P. Prediction Rules Identify Which Young Adults Have Higher Rates of Heavy Episodic Drinking After Exposure to 12-Week Text Message Interventions. SUBSTANCE USE & ADDICTION JOURNAL 2024; 45:144-149. [PMID: 38258850 PMCID: PMC10924270 DOI: 10.1177/29767342231206653] [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] [Indexed: 01/24/2024]
Abstract
BACKGROUND An alcohol text message intervention recently demonstrated effects in reducing heavy episodic drinking (HED) days at the three month follow-up in young adults with a history of hazardous drinking. An important next step in understanding intervention effects involves identifying baseline participant characteristics that predict who will benefit from intervention exposure to support clinical decision-making and guide further intervention development. To identify baseline characteristics that predict HED, this exploratory study used a prediction rule ensemble (PRE). Compared to more complex decision-tree methods (e.g., random forest), PREs have comparable performance, while generating simpler rules that can directly identify subgroups that do or do not respond to intervention. METHODS This secondary analysis examined data from 916 young adults who reported HED (68.5% female, mean age = 22.1, SD = 2.1), were enrolled in an alcohol text message randomized clinical trial and who completed baseline assessment and the three month follow-up. A PRE with ten fold cross-validation, which included 21 baseline variables representing sociodemographic characteristics (e.g., sex, age, race, ethnicity, college enrollment), alcohol consumption (frequency of alcohol consumption, quantity consumed on a typical drinking day, frequency of HED), impulsivity subscales (i.e., negative urgency, positive urgency, lack of premeditation, lack of perseverance, sensation seeking), readiness to change, perceived peer drinking and HED-related consequences, and intervention status were used to predict HED at the three month follow-up. RESULTS The PRE identified 12 rules that predicted HED at three months (R2 = 0.23) using 7 baseline features. Only two cases (0.2%) were not classified by the 12 rules. The most important features for predicting three month HED included baseline alcohol consumption, negative urgency score, and perceived peer drinking. CONCLUSIONS The rules provide interpretable decision-making tools that predict who has higher alcohol consumption following exposure to alcohol text message interventions using baseline participant characteristics (prior to intervention), which highlight the importance of interventions related to negative urgency and peer alcohol use.
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Affiliation(s)
- Tammy Chung
- Department of Psychiatry, Rutgers, The State University of New Jersey, New Brunswick, NJ, USA
- Institute for Health, Health Care Policy and Aging Research, Rutgers, The State University of New Jersey, New Brunswick, NJ, USA
| | - Brian Suffoletto
- Department of Emergency Medicine, Stanford University, Stanford, CA, USA
| | | | - Trishnee Bhurosy
- Department of Population Health, School of Health Professions and Human Services, Hofstra University, Hempstead, NY, USA
| | - Yanping Jiang
- Institute for Health, Health Care Policy and Aging Research, Rutgers, The State University of New Jersey, New Brunswick, NJ, USA
- Department of Family Medicine and Community Health, Rutgers, The State University of New Jersey, New Brunswick, NJ, USA
| | - Pamela Valera
- Department of Urban-Global Public Health, School of Public Health, Rutgers, The State University of New Jersey, New Brunswick, NJ, USA
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Tsermpini EE, Goričar K, Kores Plesničar B, Plemenitaš Ilješ A, Dolžan V. The Disease Model of Addiction: The Impact of Genetic Variability in the Oxidative Stress and Inflammation Pathways on Alcohol Dependance and Comorbid Psychosymptomatology. Antioxidants (Basel) 2023; 13:20. [PMID: 38275640 PMCID: PMC10812813 DOI: 10.3390/antiox13010020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2023] [Revised: 12/15/2023] [Accepted: 12/19/2023] [Indexed: 01/27/2024] Open
Abstract
Oxidative stress and neuroinflammation are involved in the pathogenesis of alcohol addiction. However, little is known regarding the effect of genetic, behavioral, psychological, and environmental sources of origin on the inflammation and oxidative stress pathways of patients with alcohol addiction. Our study aimed to evaluate the impact of selected common functional single-nucleotide polymorphisms in inflammation and oxidative stress genes on alcohol addiction, and common comorbid psychosymptomatology. Our study included 89 hospitalized alcohol-addicted patients and 93 healthy individuals, all Slovenian males. Their DNA was isolated from peripheral blood and patients were genotyped for PON1 rs705379, rs705381, rs854560, and rs662, SOD2 rs4880, GPX1 rs1050450, IL1B rs1143623, rs16944, and rs1071676, IL6 rs1800795, IL6R rs2228145, and miR146a rs2910164. Kruskal-Wallis and Mann-Whitney tests were used for the additive and dominant genetic models, respectively. Our findings suggested the involvement of IL6 rs1800795 in alcohol addiction. Moreover, our data indicated that the genetic variability of SOD2 and PON1, as well as IL1B and IL6R, may be related to comorbid psychosymptomatology, revealing a potential indirect means of association of both the oxidative stress and inflammation pathways.
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Affiliation(s)
- Evangelia Eirini Tsermpini
- Pharmacogenetics Laboratory, Institute of Biochemistry and Molecular Genetics, Faculty of Medicine, University of Ljubljana, 1000 Ljubljana, Slovenia; (E.E.T.); (K.G.)
| | - Katja Goričar
- Pharmacogenetics Laboratory, Institute of Biochemistry and Molecular Genetics, Faculty of Medicine, University of Ljubljana, 1000 Ljubljana, Slovenia; (E.E.T.); (K.G.)
| | - Blanka Kores Plesničar
- University Psychiatric Clinic, 1000 Ljubljana, Slovenia;
- Faculty of Medicine, University of Ljubljana, 1000 Ljubljana, Slovenia
| | - Anja Plemenitaš Ilješ
- Department of Psychiatry, University Clinical Centre Maribor, 2000 Maribor, Slovenia
| | - Vita Dolžan
- Pharmacogenetics Laboratory, Institute of Biochemistry and Molecular Genetics, Faculty of Medicine, University of Ljubljana, 1000 Ljubljana, Slovenia; (E.E.T.); (K.G.)
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Aguas-Ayesa M, Yárnoz-Esquiroz P, Olazarán L, Perdomo CM, García-Goñi M, Andrada P, Escalada J, Silva C, Marcos A, Frühbeck G. Evaluation of Dietary and Alcohol Drinking Patterns in Patients with Excess Body Weight in a Spanish Cohort: Impact on Cardiometabolic Risk Factors. Nutrients 2023; 15:4824. [PMID: 38004218 PMCID: PMC10675718 DOI: 10.3390/nu15224824] [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: 10/06/2023] [Revised: 11/14/2023] [Accepted: 11/16/2023] [Indexed: 11/26/2023] Open
Abstract
Unhealthy dietary habits and sedentarism coexist with a rising incidence of excess weight and associated comorbidities. We aimed to analyze the dietary and drinking patterns of patients with excess weight, their main characteristics, plausible gender differences and impact on cardiometabolic risk factors, with a particular focus on the potential contribution of beer consumption. Data from 200 consecutive volunteers (38 ± 12 years; 72% females) living with overweight or class I obesity attending the obesity unit to lose weight were studied. Food frequency questionnaires and 24 h recalls were used. Reduced-rank regression (RRR) analysis was applied to identify dietary patterns (DPs). Anthropometry, total and visceral fat, indirect calorimetry, physical activity level, comorbidities and circulating cardiometabolic risk factors were assessed. Study participants showed high waist circumference, adiposity, insulin resistance, dyslipidemia, pro-inflammatory adipokines and low anti-inflammatory factors like adiponectin and interleukin-4. A low-fiber, high-fat, energy-dense DP was observed. BMI showed a statistically significant (p < 0.05) correlation with energy density (r = 0.80) as well as percentage of energy derived from fat (r = 0.61). Excess weight was associated with a DP low in vegetables, legumes and whole grains at the same time as being high in sweets, sugar-sweetened beverages, fat spreads, and processed meats. RRR analysis identified a DP characterized by high energy density and saturated fat exhibiting negative loadings (>-0.30) for green leafy vegetables, legumes, and fruits at the same time as showing positive factor loadings (>0.30) for processed foods, fat spreads, sugar-sweetened beverages, and sweets. Interestingly, for both women and men, wine represented globally the main source of total alcohol intake (p < 0.05) as compared to beer and distillates. Beer consumption cannot be blamed as the main culprit of excess weight. Capturing the DP provides more clinically relevant and useful information. The focus on consumption of single nutrients does not resemble real-world intake behaviors.
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Affiliation(s)
- Maite Aguas-Ayesa
- Department of Endocrinology & Nutrition, Clínica Universidad de Navarra, 31008 Pamplona, Spain
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, 31008 Pamplona, Spain
| | - Patricia Yárnoz-Esquiroz
- Department of Endocrinology & Nutrition, Clínica Universidad de Navarra, 31008 Pamplona, Spain
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, 31008 Pamplona, Spain
- Obesity and Adipobiology Group, Instituto de Investigación Sanitaria de Navarra (IdiSNA), 31008 Pamplona, Spain
| | - Laura Olazarán
- Department of Endocrinology & Nutrition, Clínica Universidad de Navarra, 31008 Pamplona, Spain
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, 31008 Pamplona, Spain
- Obesity and Adipobiology Group, Instituto de Investigación Sanitaria de Navarra (IdiSNA), 31008 Pamplona, Spain
| | - Carolina M. Perdomo
- Department of Endocrinology & Nutrition, Clínica Universidad de Navarra, 31008 Pamplona, Spain
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, 31008 Pamplona, Spain
| | - Marta García-Goñi
- Department of Endocrinology & Nutrition, Clínica Universidad de Navarra, 31008 Pamplona, Spain
| | - Patricia Andrada
- Department of Endocrinology & Nutrition, Clínica Universidad de Navarra, 31008 Pamplona, Spain
| | - Javier Escalada
- Department of Endocrinology & Nutrition, Clínica Universidad de Navarra, 31008 Pamplona, Spain
| | - Camilo Silva
- Department of Endocrinology & Nutrition, Clínica Universidad de Navarra, 31008 Pamplona, Spain
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, 31008 Pamplona, Spain
- Obesity and Adipobiology Group, Instituto de Investigación Sanitaria de Navarra (IdiSNA), 31008 Pamplona, Spain
| | - Ascensión Marcos
- Immunonutrition Research Group, Department of Metabolism and Nutrition, Institute of Food Science and Technology and Nutrition (ICTAN)—CSIC, 28040 Madrid, Spain
| | - Gema Frühbeck
- Department of Endocrinology & Nutrition, Clínica Universidad de Navarra, 31008 Pamplona, Spain
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, 31008 Pamplona, Spain
- Obesity and Adipobiology Group, Instituto de Investigación Sanitaria de Navarra (IdiSNA), 31008 Pamplona, Spain
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Barré T, Di Beo V, Roux P, Mourad A, Verger P, Fressard L, Herault T, Buyck JF, Beck F, Carrieri P. Screening for alcohol use in primary care: assessing French general practitioner practices. Alcohol Alcohol 2023; 58:672-682. [PMID: 37818974 DOI: 10.1093/alcalc/agad067] [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: 06/06/2023] [Revised: 09/19/2023] [Accepted: 09/20/2023] [Indexed: 10/13/2023] Open
Abstract
Alcohol use is a leading risk factor for premature death and disability. To tackle this issue, more systematic and accurate screening for at-risk consumption is needed in healthcare systems, especially by general practitioners (GPs). We assessed the frequency of at-risk consumption screening by GPs in France. We also identified characteristics associated with more frequent screening and greater use of validated screening tools by these healthcare providers. A cross-sectional survey was conducted among a representative sample of French GPs. Multinomial logistic regressions were used to identify factors associated with more frequent screening and greater use of validated screening tools. Response rate was of 73%. Of the 2412 participants, 42.8% screened all their patients systematically and repeatedly, while 48.0% never used standardized tools to screen potentially at-risk patients. Among other characteristics, being aware of and using the "early identification and brief intervention" screening strategy, and feeling absolutely comfortable talking with patients about reducing or stopping their alcohol use, were both associated with more frequent screening and use of standardized tools. Our results on at-risk alcohol use screening highlight an improvement over data from previous studies. Nevertheless, better training of French GPs in good alcohol screening practices-specifically, increased screening frequency and greater use of standardized tools-may improve identification of at-risk patients.
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Affiliation(s)
- Tangui Barré
- Aix Marseille Univ, Inserm, IRD, SESSTIM, Sciences Economiques & Sociales de la Santé & Traitement de l'Information Médicale, ISSPAM, Faculté de Médecine, 27 Bd Jean Moulin, 13385 Marseille Cedex 5, France
| | - Vincent Di Beo
- Aix Marseille Univ, Inserm, IRD, SESSTIM, Sciences Economiques & Sociales de la Santé & Traitement de l'Information Médicale, ISSPAM, Faculté de Médecine, 27 Bd Jean Moulin, 13385 Marseille Cedex 5, France
| | - Perrine Roux
- Aix Marseille Univ, Inserm, IRD, SESSTIM, Sciences Economiques & Sociales de la Santé & Traitement de l'Information Médicale, ISSPAM, Faculté de Médecine, 27 Bd Jean Moulin, 13385 Marseille Cedex 5, France
| | - Abbas Mourad
- Aix Marseille Univ, Inserm, IRD, SESSTIM, Sciences Economiques & Sociales de la Santé & Traitement de l'Information Médicale, ISSPAM, Faculté de Médecine, 27 Bd Jean Moulin, 13385 Marseille Cedex 5, France
| | - Pierre Verger
- ORS PACA, Southeastern Health Regional Observatory, Faculté des Sciences Médicales et Paramédicales, 27 Boulevard Jean Moulin, 13385 Marseille Cedex 5, France
| | - Lisa Fressard
- ORS PACA, Southeastern Health Regional Observatory, Faculté des Sciences Médicales et Paramédicales, 27 Boulevard Jean Moulin, 13385 Marseille Cedex 5, France
| | - Thomas Herault
- Union Régionale des Médecins Libéraux des Pays de La Loire, 13 rue de la Loire, Bâtiment C2, 44230 Saint Sébastien-sur-Loire, Nantes, France
| | - Jean-François Buyck
- Observatoire Régional de La Santé Des Pays de La Loire, 2 Rue de la Loire, 44200 Nantes, France
| | - François Beck
- Santé Publique France, 12, rue du Val d'Osne 94 415 Saint-Maurice cedex, France
- Centre de Recherche en Épidémiologie et Santé des Populations (CESP), Inserm U1018, Université Paris-Saclay, Université Paris-Sud, Université Versailles Saint-Quentin (UVSQ), 16 Av. Paul Vaillant Couturier, 94800 Villejuif, France
| | - Patrizia Carrieri
- Aix Marseille Univ, Inserm, IRD, SESSTIM, Sciences Economiques & Sociales de la Santé & Traitement de l'Information Médicale, ISSPAM, Faculté de Médecine, 27 Bd Jean Moulin, 13385 Marseille Cedex 5, France
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Cucciare MA, Marchant K, Benton C, Hildebrand D, Ghaus S, Han X, Thompson RG, Timko C. Connect To Care (C2C): protocol for two-site randomized controlled pilot trial to improve outcomes for patients with hazardous drinking and PTSD and/or depression symptoms. Addict Sci Clin Pract 2023; 18:50. [PMID: 37592359 PMCID: PMC10433540 DOI: 10.1186/s13722-023-00403-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2022] [Accepted: 07/31/2023] [Indexed: 08/19/2023] Open
Abstract
BACKGROUND In studies of the general population and of military veterans, many primary care patients with hazardous drinking and PTSD and/or depression (abbreviated here as HD +) do not initiate or engage with alcohol-related care. To address this gap in care, we identified and will pilot test a promising evidence-based intervention, Connect To Care (C2C). C2C is a strengths-based approach, delivered by a Care Coach by telephone and/or video, with four components: (1) identifying and leveraging patient strengths to facilitate care initiation, (2) collaborative decision-making around a menu of care options, (3) identifying and resolving barriers to care, and (4) monitoring and facilitating progress toward care initiation by, for example, checking on barriers, identifying solutions, and revisiting care options. METHODS/DESIGN Aim 1 will involve adapting C2C for use in Veterans Affairs' (VA) primary care. We will use an iterative process that includes focus groups and semi-structured interviews with key stakeholders (patients, primary care providers, and VA national policy leaders). In Aim 2, we will conduct a two-site, pilot randomized controlled trial to determine the feasibility of conducting a larger scale trial to test C2C's effectiveness, ascertain the acceptability of C2C among primary care patients with HD + , and explore the efficacy of C2C to improve veteran patients' initiation of and engagement in alcohol care, and their alcohol and mental health (PTSD, depression) outcomes, at 3-month follow-up. We will explore explanatory mechanisms by which C2C is effective. DISCUSSION Study findings are likely to have implications for clinical practice to enhance current approaches to linking patients with HD + to alcohol care by applying a practical intervention such as C2C. The results may improve treatment outcomes for people with HD + by drawing on patients' strengths to problem-solve barriers to care following a process of shared decision-making with a coach. In addition to possibly accelerating the translation of C2C into practice, study findings will also support additional research in terms of a planned effectiveness-implementation hybrid trial, adding to this study's potential for high impact. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT05023317.
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Affiliation(s)
- Michael A Cucciare
- Center for Mental Healthcare and Outcomes Research, Central Arkansas Veterans Affairs Healthcare System, North Little Rock, AR, 72205, USA
- Education and Clinical Center, Veterans Affairs South Central Mental Illness Research, Central Arkansas Veterans Healthcare System, North Little Rock, AR, 72205, USA
- Department of Psychiatry, University of Arkansas for Medical Sciences, Little Rock, AR, 72205, USA
| | - Kathy Marchant
- Center for Mental Healthcare and Outcomes Research, Central Arkansas Veterans Affairs Healthcare System, North Little Rock, AR, 72205, USA
| | - Cristy Benton
- Center for Mental Healthcare and Outcomes Research, Central Arkansas Veterans Affairs Healthcare System, North Little Rock, AR, 72205, USA
| | - Deanna Hildebrand
- Center for Mental Healthcare and Outcomes Research, Central Arkansas Veterans Affairs Healthcare System, North Little Rock, AR, 72205, USA
| | - Sharfun Ghaus
- Center for Innovation to Implementation, Department of Veterans Affairs Health Care System, Palo Alto, CA, 94304, USA
| | - Xiaotong Han
- Center for Mental Healthcare and Outcomes Research, Central Arkansas Veterans Affairs Healthcare System, North Little Rock, AR, 72205, USA
- Education and Clinical Center, Veterans Affairs South Central Mental Illness Research, Central Arkansas Veterans Healthcare System, North Little Rock, AR, 72205, USA
- Department of Psychiatry, University of Arkansas for Medical Sciences, Little Rock, AR, 72205, USA
| | - Ronald G Thompson
- Center for Mental Healthcare and Outcomes Research, Central Arkansas Veterans Affairs Healthcare System, North Little Rock, AR, 72205, USA
- Department of Psychiatry, University of Arkansas for Medical Sciences, Little Rock, AR, 72205, USA
| | - Christine Timko
- Center for Innovation to Implementation, Department of Veterans Affairs Health Care System, Palo Alto, CA, 94304, USA.
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA, 94305, USA.
- Center for Innovation to Implementation, 795 Willow Road (152-MPD), Menlo Park, CA, 94025, USA.
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Syan SK, McIntyre-Wood C, Vandehei E, Vidal ML, Hargreaves T, Levitt EE, Scarfe M, Marsden E, MacKillop E, Sarles-Whittlesey H, Amlung M, Sweet L, MacKillop J. Resting state functional connectivity as a predictor of brief intervention response in adults with alcohol use disorder: A preliminary study. ALCOHOL, CLINICAL & EXPERIMENTAL RESEARCH 2023; 47:1590-1602. [PMID: 37572293 DOI: 10.1111/acer.15123] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/19/2022] [Revised: 05/17/2023] [Accepted: 05/24/2023] [Indexed: 08/14/2023]
Abstract
BACKGROUND Brief interventions for alcohol use disorder (AUD) are generally efficacious, albeit with variability in response. Resting state functional connectivity (rsFC) may characterize neurobiological indicators that predict the response to brief interventions and is the focus of the current investigation. MATERIALS AND METHODS Forty-six individuals with AUD (65.2% female) completed a resting state functional magnetic resonance imaging (fMRI) scan immediately followed by a brief intervention aimed at reducing alcohol consumption. Positive clinical response was defined as a reduction in alcohol consumption by at least one World Health Organization (WHO) risk drinking level at 3-month follow-up. rsFC was analyzed using seed-to-voxel analysis with seed regions from four networks: salience network, reward network, frontoparietal network, and default mode network. RESULTS At baseline, responders had greater rsFC between the following seed regions in relation to voxel-based clusters than non-responders: (i) anterior cingulate cortex (ACC) in relation to left postcentral gyrus and right supramarginal gyrus (salience network); (ii) right posterior parietal cortex in relation to right ventral ACC (salience network); (iii) right interior frontal gyrus (IFG) pars opercularis in relation to right cerebellum and right occipital fusiform gyrus (frontoparietal); and (iv) right primary motor cortex in relation to left thalamus (default mode). Lower rsFC in responders vs. nonresponders was seen between the (i) right rostral prefrontal cortex in relation to left IFG pars triangularis (frontoparietal); (ii) right IFG pars triangularis in relation to right cerebellum (frontoparietal); (iii) right IFG pars triangularis in relation to right frontal eye fields and right angular gyrus (frontoparietal); and (iv) right nucleus accumbens in relation to right orbital frontal cortex and right insula (reward). CONCLUSIONS Resting state functional connectivity in the frontoparietal, salience, and reward networks predicts the response to a brief intervention in individuals with AUD and could reflect greater receptivity or motivation for behavior change.
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Affiliation(s)
- Sabrina K Syan
- Department of Psychology, Neuroscience and Behaviour, McMaster University, Hamilton, Ontario, Canada
- Peter Boris Centre for Addictions Research, St. Joseph's Healthcare Hamilton, Hamilton, Ontario, Canada
| | - Carly McIntyre-Wood
- Peter Boris Centre for Addictions Research, St. Joseph's Healthcare Hamilton, Hamilton, Ontario, Canada
| | - Emily Vandehei
- Peter Boris Centre for Addictions Research, St. Joseph's Healthcare Hamilton, Hamilton, Ontario, Canada
| | - Mae Linda Vidal
- Peter Boris Centre for Addictions Research, St. Joseph's Healthcare Hamilton, Hamilton, Ontario, Canada
| | - Tegan Hargreaves
- Peter Boris Centre for Addictions Research, St. Joseph's Healthcare Hamilton, Hamilton, Ontario, Canada
| | - Emily E Levitt
- Peter Boris Centre for Addictions Research, St. Joseph's Healthcare Hamilton, Hamilton, Ontario, Canada
| | - Molly Scarfe
- Peter Boris Centre for Addictions Research, St. Joseph's Healthcare Hamilton, Hamilton, Ontario, Canada
| | - Emma Marsden
- Peter Boris Centre for Addictions Research, St. Joseph's Healthcare Hamilton, Hamilton, Ontario, Canada
| | - Emily MacKillop
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario, Canada
| | | | - Michael Amlung
- Cofrin Logan Center for Addiction Research and Treatment, University of Kansas, Lawrence, Kansas, USA
- Department of Applied Behavioral Science, University of Kansas, Lawrence, Kansas, USA
| | - Lawrence Sweet
- Department of Psychology, University of Georgia, Athens, Georgia, USA
| | - James MacKillop
- Peter Boris Centre for Addictions Research, St. Joseph's Healthcare Hamilton, Hamilton, Ontario, Canada
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario, Canada
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Halladay J, Slade T, Chapman C, Mewton L, O'Dean S, Visontay R, Baillie A, Teesson M, Sunderland M. Is the association between psychological distress and risky alcohol consumption shifting over time? An age-period-cohort analysis of the Australian population. Psychiatry Res 2023; 326:115356. [PMID: 37494878 DOI: 10.1016/j.psychres.2023.115356] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/04/2023] [Revised: 06/02/2023] [Accepted: 07/20/2023] [Indexed: 07/28/2023]
Abstract
This study explored age, period, and cohort effects associated with trends in psychological distress and risky alcohol consumption. Data came from 108,536 Australians aged 14-79 years old from birth cohorts between 1925-2005, endorsing past year alcohol use in the 2004-2019 Australian National Drug Strategy Household Surveys. Risky alcohol consumption was split into exceeding weekly national drinking limits (>10 drinks per week) or daily limits (>4 drinks per day). An extended hierarchical age-period-cohort model was used to investigate differential effects on trends in psychological distress. Psychological distress showed an inverse U-shape throughout the lifespan with a peak in distress at age 60. Exceeding weekly alcohol limits was positively related to psychological distress prior to age 40 while exceeding daily alcohol limits remained positively related across the lifespan. There were relatively flat period effects, with no alcohol-related changes in psychological distress across years. Lastly, psychological distress gradually increased across birth cohorts until a notable spike among Australians born from 1980-2005 alongside weakening alcohol-related cohort effects. Overall, the recent increases in psychological distress did not appear to be meaningfully explained by risky alcohol consumption though risky alcohol consumption remained an important factor to consider alongside psychological distress.
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Affiliation(s)
- Jillian Halladay
- The Matilda Centre for Research in Mental Health and Substance Use, University of Sydney, NSW, Australia
| | - Tim Slade
- The Matilda Centre for Research in Mental Health and Substance Use, University of Sydney, NSW, Australia
| | - Cath Chapman
- The Matilda Centre for Research in Mental Health and Substance Use, University of Sydney, NSW, Australia
| | - Louise Mewton
- The Matilda Centre for Research in Mental Health and Substance Use, University of Sydney, NSW, Australia
| | - Siobhan O'Dean
- The Matilda Centre for Research in Mental Health and Substance Use, University of Sydney, NSW, Australia
| | - Rachel Visontay
- The Matilda Centre for Research in Mental Health and Substance Use, University of Sydney, NSW, Australia
| | - Andrew Baillie
- The Matilda Centre for Research in Mental Health and Substance Use, University of Sydney, NSW, Australia
| | - Maree Teesson
- The Matilda Centre for Research in Mental Health and Substance Use, University of Sydney, NSW, Australia
| | - Matthew Sunderland
- The Matilda Centre for Research in Mental Health and Substance Use, University of Sydney, NSW, Australia.
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Meads C, Zeeman L, Sherriff N, Aranda K. Prevalence of alcohol use amongst sexual and gender minority (LGBTQ+) communities in the UK: a systematic scoping review. Alcohol Alcohol 2023:7145918. [PMID: 37114766 DOI: 10.1093/alcalc/agad029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2022] [Revised: 03/20/2023] [Accepted: 04/06/2023] [Indexed: 04/29/2023] Open
Abstract
BACKGROUND globally, alcohol use rates vary by sexual orientation and gender identity (SOGI), but UK government statistics on alcohol use in the LGBTQ+ population are missing. AIM this systematic scoping review determined the prevalence of alcohol use amongst gender and sexual minority people in the UK. METHODS empirical UK studies from 2010 onwards reporting the prevalence of alcohol use in SOGI compared with heterosexual/cisgender people were included. Searches in MEDLINE, Embase, Web of Science, PsycINFO, CINAHL, Cochrane Library, Google Scholar, Google, charity websites and systematic reviews were conducted in October 2021, using SOGI, alcohol and prevalence terms. Citation checking was done by two authors, with disagreements resolved through discussion. Data extraction was done by one author (CM) and checked by another (LZ). Quality assessment was performed by study design, sample type and statistical analysis of results. A narrative synthesis was qualitatively combined with a tabular presentation of results. RESULTS database and website searches found 6607 potentially relevant citations, and 505 full texts were reviewed with 20 studies included, found in 21 publications and grey literature reports. Most were on sexual orientation, including 12 from large cohort studies. Harmful alcohol use is higher in LGBTQ+ people than heterosexual people in the UK, a result similar to that found in other countries. Qualitative data reflected alcohol's role as emotional support. Fewer asexual people drank alcohol compared with allosexual people, and there were no data available regarding intersex people. CONCLUSION funded cohort studies and service providers should routinely collect SOGI data. Standardized reporting of SOGI and alcohol use would improve comparability across studies.
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Affiliation(s)
- Catherine Meads
- Faculty of Health, Education, Medicine and Social Care, Anglia Ruskin University, Cambridge, CB1 2LZ, UK
- Centre for Transforming Sexuality and Gender, University of Brighton, BN2 0JG, Brighton, UK
| | - Laetitia Zeeman
- Centre for Transforming Sexuality and Gender, University of Brighton, BN2 0JG, Brighton, UK
- School of Sport and Health Sciences, University of Brighton, Brighton, BN1 9PH, UK
| | - Nigel Sherriff
- Centre for Transforming Sexuality and Gender, University of Brighton, BN2 0JG, Brighton, UK
- School of Sport and Health Sciences, University of Brighton, Brighton, BN1 9PH, UK
| | - Kay Aranda
- Centre for Transforming Sexuality and Gender, University of Brighton, BN2 0JG, Brighton, UK
- School of Sport and Health Sciences, University of Brighton, Brighton, BN1 9PH, UK
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Llamosas-Falcón L, Rehm J. Alcohol consumption in Spain. Med Clin (Barc) 2023; 160:302-304. [PMID: 36774288 DOI: 10.1016/j.medcli.2023.01.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2022] [Revised: 01/05/2023] [Accepted: 01/08/2023] [Indexed: 02/11/2023]
Affiliation(s)
- Laura Llamosas-Falcón
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, Toronto, Ontario, Canadá.
| | - Jürgen Rehm
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, Toronto, Ontario, Canadá; Campbell Family Mental Health Research Institute, CAMH, Toronto, Ontario, Canadá; Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canadá; Department of Psychiatry, University of Toronto, Toronto, Ontario, Canadá; Institute of Medical Science, University of Toronto, Toronto, Ontario, Canadá; Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Alemania; Center for Interdisciplinary Addiction Research (ZIS), Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf (UKE), Hamburgo, Alemania; Program on Substance Abuse, Public Health Agency of Catalonia, Program on Substance Abuse & designated WHO CC, Public Health Agency of Catalonia, Barcelona, España
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Abstract
BACKGROUND Alcohol use disorder (AUD) is one of the most widespread psychiatric disorders leading to detrimental consequences to people with this disorder and others. Worldwide, the prevalence of heavy episodic drinking (30-day prevalence of at least one occasion of 60 g of pure alcohol intake among current drinkers) is estimated at 20% and the prevalence of AUD at 5% of the adult general population, with highest prevalence in Europe and North America. Therapeutic approaches, including pharmacotherapy, play an important role in treating people with AUD. This is an update of a Cochrane Review first published in 2018. OBJECTIVES To evaluate the benefits and harms of baclofen on achieving and maintaining abstinence or reducing alcohol consumption in people with AUD compared to placebo, no treatment or any other pharmacological relapse prevention treatment. SEARCH METHODS We used standard, extensive Cochrane search methods. The latest search was 22 November 2021. SELECTION CRITERIA Randomised controlled trials (RCTs) of at least four weeks' treatment duration and 12 weeks' overall study duration comparing baclofen for AUD treatment with placebo, no treatment or other treatments. DATA COLLECTION AND ANALYSIS We used standard Cochrane methods. Our primary outcomes were 1. relapse, 2. frequency of use, 3. amount of use, 4. adverse events, 5. dropouts from treatment and 6. dropouts from treatment due to adverse events. Our secondary outcomes were 7. craving, 8. anxiety, 9. depression and 10. frequency of most relevant adverse events. MAIN RESULTS We included 17 RCTs (1818 participants) with a diagnosis of alcohol dependence according to the Diagnostic and Statistical Manual of Mental Disorders, 4th edition or International Classification of Diseases 10th edition criteria. Mean age was 46.5 years and 70% were men. Ten studies compared baclofen to placebo or another medication; seven compared two baclofen doses to placebo or another medication. Globally, 15 studies compared baclofen to placebo, two baclofen to acamprosate and two baclofen to naltrexone. In 16 studies, participants received psychosocial treatments. We judged most studies at low risk of selection, performance, detection (subjective outcome), attrition and reporting bias. Ten studies detoxified participants before treatment; in seven studies, participants were still drinking at the beginning of treatment. Treatment duration was 12 weeks for 15 RCTs and longer in two studies. Baclofen daily dose was 30 mg to 300 mg: 10 RCTs used low doses (30 mg or less); eight RCTs medium doses (above 30 and 100 mg or less) and four RCTs high doses (above 100 mg). Compared to placebo, moderate-certainty evidence found that baclofen probably decreases the risk to relapse (risk ratio (RR) 0.87, 95% confidence interval (CI) 0.77 to 0.99; 12 studies, 1057 participants). This result was confirmed among detoxified participants but not among other subgroups of participants. High-certainty evidence found that baclofen increases the percentage of days abstinent (mean difference (MD) 9.07, 95% CI 3.30 to 14.85; 16 studies, 1273 participants). This result was confirmed among all subgroups of participants except non-detoxified or those who received medium doses. There was no difference between baclofen and placebo in the other primary outcomes: heavy drinking days (standardised mean difference (SMD) -0.18, 95% CI -0.48 to 0.11; 13 studies, 840 participants; moderate-certainty evidence); number of drinks per drinking days (MD -0.45, 95% CI -1.20 to 0.30; 9 studies, 392 participants; moderate-certainty evidence); number of participants with at least one adverse event (RR 1.05, 95% CI 0.99 to 1.11; 10 studies, 738 participants; high-certainty evidence); dropouts (RR 0.88, 95% CI 0.74 to 1.03; 17 studies, 1563 participants; high-certainty evidence); dropouts due to adverse events (RR 1.39, 95% CI 0.89 to 2.18; 16 studies, 1499 participants; high-certainty evidence). These results were confirmed by subgroup analyses except than for the dropouts that resulted lower among participants who received high doses of baclofen and studies longer than 12 weeks. Compared to placebo, there was no difference in craving (SMD -0.16, 95% CI -0.37 to 0.04; 17 studies, 1275 participants), anxiety (MD -0.01, 95% CI -0.14 to 0.11; 15 studies, 1123 participants) and depression (SMD 0.07, 95% CI -0.12 to 0.27; 11 studies, 1029 participants). Concerning the specific adverse events, baclofen increases fatigue, dizziness, somnolence/sedation, dry mouth, paraesthesia and muscle spasms/rigidity. There was no difference in the other adverse events. Compared to acamprosate, one study (60 participants) found no differences in any outcomes but the evidence was very uncertain: relapse (RR 1.25, 95% CI 0.71 to 2.20; very low-certainty evidence); number of participants with at least one adverse event (RR 0.63, 95% CI 0.23 to 1.69; very low-certainty evidence); dropouts (RR 0.56, 95% CI 0.21 to 1.46; very low-certainty evidence); dropouts due to adverse events (RR 0.33, 95% CI 0.01 to 7.87; very low-certainty evidence) and craving (MD 5.80, 95% CI -11.84 to 23.44); and all the adverse events evaluated. Compared to naltrexone, baclofen may increase the risk of relapse (RR 2.50, 95% CI 1.12 to 5.56; 1 study, 60 participants; very low-certainty evidence) and decrease the number of participants with at least one adverse event (RR 0.35, 95% CI 0.15 to 0.80; 2 studies, 80 participants; very low-certainty evidence) but the evidence is very uncertain. One study (60 participants) found no difference between baclofen and naltrexone in the dropouts at the end of treatment (RR 1.00, 95% CI 0.32 to 3.10; very low-certainty evidence), craving (MD 2.08, 95% CI -3.71 to 7.87), and all the adverse events evaluated. AUTHORS' CONCLUSIONS Baclofen likely reduces the risk of relapse to any drinking and increases the percentage of abstinent days, mainly among detoxified participants. It does not increase the number of participants with at least one adverse event, those who dropout for any reason or due to adverse events. It probably does not reduce number of heavy drinking days and the number of drinks per drinking days. Current evidence suggests that baclofen may help people with AUD in maintaining abstinence. The results of comparisons of baclofen with acamprosate and naltrexone were mainly based on only one study.
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Affiliation(s)
- Roberta Agabio
- Biomedical Sciences, Section of Neuroscience and Clinical Pharmacology, University of Cagliari, Monserrato (CA), Italy
| | - Rosella Saulle
- Department of Epidemiology, Lazio Regional Health Service, Rome, Italy
| | | | - Silvia Minozzi
- Department of Epidemiology, Lazio Regional Health Service, Rome, Italy
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