Global statistics on alcohol, tobacco and illicit drug use: 2017 status report

Patterns of substance use on a given day in a national sample of U.S. young adults

INTRODUCTION

Young adulthood constitutes a period of substance use risk and many young adults engage in use of more than one substance. While existing work has examined young adult co-use of substances at the day-level, there has not been a comprehensive investigation of day-level substance use that considers mode and intensity of use in a national sample of U.S. young adults.

METHODS

Individuals were eligible through participation in the nationally-representative Monitoring the Future study in 12th grade in 2018 and reporting past 30-day drinking in 12th-grade. Respondents completed a 14-day daily study in 2019 (n = 911 individuals; modal age 19). Days on which individuals reported alcohol, cannabis, and/or nicotine/tobacco use (n = 3,086 days and 590 individuals) were examined. Latent class analysis was used to identify patterns of substance use at the day-level with stress, boredom, loneliness, and type of day as covariates.

RESULTS

Six patterns of substance use days were identified: Vaping Nicotine (33.69 %), Cannabis Smoking (23.49 %), Alcohol Only (17.10 %), Cannabis Vaping (11.72 %), Multiple Combustibles (7.28 %), and Multimodal Cannabis (6.72 %) days. Stress and boredom were greater on Multimodal Cannabis days compared to most other substance use days. Alcohol Only days were characterized by lower levels of stress, boredom, and loneliness and a greater probability of being a special occasion or a weekend compared to other substance use days.

DISCUSSION

This study identified heterogeneous patterns of substance use behaviors among U.S. young adults. Understanding these patterns is important for developing intervention strategies that are responsive to specific substance use on a given day.

Cannabis and tobacco use in bipolar disorder: Associations with early onset, psychotic symptoms, and relapse risk (2015-2019)

BACKGROUND

Substance use disorders (SUD) frequently occur alongside bipolar disorder (BD), with some studies indicating a 29 % comorbidity rate in Western populations [1]. The relationship between BD and SUD is intricate and bidirectional - drug misuse can increase the risk of developing BD, and individuals with BD have a higher risk of developing SUD. This complex interplay often leads to earlier BD onset, more hospitalizations, and reduced effectiveness of pharmacological treatments, particularly mood stabilizers. This work aims to describe the impact of drugs in the risk of relapse in BD and to approach the differences in the evolution in substance users compared to non-users.

METHODS

We conducted a prospective cohort study including the patients admitted to Hospital Clínic of Barcelona acute psychiatric unit with the diagnosis of manic or mixed episode during the period between 2015 and 2019. We established a follow-up of 3 years from the date of admission in which hospital readmissions are examined.

RESULTS

The study, which included 279 patients, concluded that only tobacco users showed significantly higher rates of emergency room (ER) visits and hospital readmissions in the period study, while cannabis was only associated with earlier onset of illness, current manic polarity, the presence of psychotic symptoms and a higher likelihood of discontinuing treatment. Alcohol, cocaine and stimulants did not appear to have an association with the variables studied.

LIMITATIONS

Lack of follow-up information from people leaving the region or changing to private sector services, lack of detailed information around the pattern and history of consumption.

CONCLUSIONS

Tobacco seemed to have a clear negative association with the course of the illness. Cannabis, while its use was not associated with the relapse rate, was indirectly associated with variables suggesting a more severe symptomatology and a possible qualitatively different course of illness. More evidence is needed to define the mechanisms and patterns related to these effects.

Ethical aspects and user preferences in applying machine learning to adjust eHealth addressing substance use: A mixed-methods study

BACKGROUND

Digital health interventions targeting substance use disorders are being increasingly implemented. Data science methodology has the potential to enhance involvement and efficacy of these interventions, though application may raise ethical considerations. This study aimed to explore possible ethical aspects and preferences among users of an online digital intervention for substance use and gambling disorder regarding the application of supervised machine learning (ML) methodology.

METHODS

We recruited participants from a widely used, evidence-based online substance use and gambling intervention from the Netherlands (Jellinek Digital Self-help). Initially, we conducted two online focus groups (n = 5 each) to explore topics related to ethical considerations and user preferences regarding the application of ML for adapting unguided digital interventions. Subsequently, the findings from these focus groups informed the development of an online, quantitative, self-reported questionnaire study regarding this topic (n = 157). Data collection and analyses were guided by the principles of biomedical ethics by Beauchamp and Childress.

RESULTS

Our qualitative and quantitative results revealed that digital intervention users found the application of machine learning analyses to be ethically acceptable, although they had difficulties conceptualizing ML applications. Participants believed that it could benefit the intervention and subsequently their well-being. Both qualitative and quantitative results emphasized the importance of preserving user autonomy in applying supervised ML to adjust digital interventions. In addition, based on both data sources we found that digital intervention users trusted Jellinek's integrity to apply ML. Ethical concerns identified in the qualitative data (e.g., data security, human control), were not confirmed in our quantitative findings.

CONCLUSIONS

This mixed-methods study revealed that users of digital intervention demonstrated limited concern for ethical aspects regarding applying ML to adapt digital interventions. Ethical aspects were primarily pertained to their needs for autonomy and privacy.

Attributable risk factors and trends in global burden of falls from 1990 to 2021: A comprehensive analysis based on Global Burden Of Disease Study 2021

BACKGROUND

Falls are a leading cause of disability-adjusted life years (DALYs) and mobility difficulties. Previous estimates have relied on restricted regional scope and lack a thorough global study. This study, for the first time, examines the evolving trends in the global burden of falls from 1990 to 2021, focusing on geographic variation in disease burden and risk factors, predicting the development of burden of falls. Our aim was to provide information for allocating medical resources, taking health policies into action, and making patient management systems operate better.

METHOD

Data on incident cases, deaths, and DALYs were collected for countries, regions, ages, and sexes worldwide from the Global Burden Disease (GBD) 2021 database. Using R (version 4.3.2), we calculated estimated annual percent changes (EAPCs) for assessing trends in age-standardized rates, visualized risk factors, and predicted the global burden of falls. Joinpoint regression (version 4.9.1.0) was used to identify significant temporal trends and change points.

RESULTS

In 2021, 548.8 million people were affected by falls. There were 215 million incidence, 43.8 million DALYs, and 800,000 deaths caused by falls. The incidence rate of falls increases with age, and sex inequalities exist. Compared with 1990, the age-standardized incidence rate (ASIR), death rate (ASDR), and DALY rate (ASDALYsR) declined despite an increase in absolute numbers. The ASDR and ASDALYsR of falls are expected to decline in the future, whereas the ASIR is expected to rise. The fall burden varied significantly according to region and its sociodemographic index (SDI). Both ASIR (R = 0.510, p < 0.001) and ASDALYsR (R = 0.2762, p < 0.001) were positively correlated with SDI. In contrast, ASDR (R=-0.536, p < 0.001) showed a consistently negative association with SDI. Low bone mineral density, occupational injuries, alcohol use, and smoking emerged as the top factors associated with fall-related DALYs and deaths.

CONCLUSIONS

The overall burden of falls declined between 1990 and 2021, but the future incidence is expected to increase. The global burden of falls remains unchanged and shows significant regional and sex-based differences. Effective prevention and strategies against risk factors are imperative for reducing the future burden.

Efficacy and safety of psilocybin for the treatment of substance use disorders: A systematic review

Psilocybin, a serotonergic psychedelic, may have therapeutic benefits for Substance Use Disorders (SUDs), but its overall efficacy and safety remain uncertain. This systematic review assessed the safety and efficacy of psilocybin for SUDs through a systematic database search conducted via OVID on May 22, 2024, and summarized 26 ongoing clinical trials registered on clinicaltrials.gov. Among 16 published included studies, 7 (43.75 %) focused on Alcohol Use Disorder (AUD), 5 (31.25 %) on Tobacco Use Disorder (TUD), and the remainder on Cocaine Use Disorder (CUD) (1, 6.25 %), Opioid Use Disorder (1, 6.25 %), Nicotine Use Disorder (1, 6.25 %), and multiple SUDs (1, 6.25 %). Study designs included open-label trials (5, 31.25 %), cross-sectional observational studies (6, 37.5 %), qualitative analyses (2, 12.5 %), one double-blind RCT (6.25 %), one pilot fMRI study (6.25 %), and one long-term follow-up (6.25 %). Psilocybin-assisted psychotherapy (PAP) was used in 10 studies (62.5 %), with doses ranging from microdosing to 20-40 mg/70 kg. PAP was associated with significant reductions in alcohol consumption, smoking cessation, and related psychological improvements. AUD studies reported fewer heavy drinking days, increased abstinence rates, and neuroimaging data indicating normalization of brain activity. TUD studies demonstrated high smoking abstinence rates, with mystical experiences predicting long-term outcomes. Findings for other SUDs were mixed, though psilocybin showed potential in reducing opioid dependence and nicotine use. Preliminary evidence supports psilocybin's efficacy and safety for AUD and TUD, particularly with psychotherapy, but larger clinical trials are needed to confirm these findings.

The use of baclofen to reduce alcohol-attributable hospitalizations and emergency department admissions

AIMS

The potential benefit of baclofen in reducing hospitalizations and emergency department (ED) admissions attributed to alcohol-related diagnoses has not been conclusively established. This study aimed to examine the relationship between baclofen use and the incidence of alcohol-attributable hospitalizations and ED admissions in the general population.

METHODS

We conducted a self-controlled case series study (SCCS) using data from the Taiwan National Health Insurance Research Database. 2904 patients who had at least one alcohol-attributable hospitalization or emergency department admission and were prescribed 28 or more days of baclofen unrelated to alcohol were included. Conditional Poisson regression was used to estimate the incidence rate ratio (IRR) and 95% confidence interval (CI) for the risk of alcohol-attributable hospitalizations and ED admissions during exposure to baclofen, as well as the pre- and post-exposure periods, relative to the baseline period. The contribution of concomitant psychotropic medication use was also assessed.

RESULTS

Baclofen was associated with a reduced incidence of alcohol-attributable hospitalizations (IRR = 0.64; 95% CI: 0.53∼0.77) and ED admissions (IRR = 0.56; 95% CI: 0.49∼0.65) in multivariate models. No statistically significant reduction was observed in any admission method in either the pre- or post-exposure period. A dose-dependent response in ED admissions was observed with baclofen, i.e. >60 mg/day associated with a greater decrease in the IRR (0.25, 95% CI: 0.10∼0.62) relative to doses of <30 (0.63, 95% CI: 0.53∼0.75) and 30-60 mg/day (IRR = 0.50, 95% CI: 0.40∼0.63).

CONCLUSIONS

These findings suggest a possible beneficial effect of baclofen in reducing the incidence of alcohol-attributable hospitalizations and ED admissions.

Repeated Alcohol Drinking in Mice is Associated with Bidirectional Alterations in Corticostriatal Coherence

Decreased functional connectivity between the striatum and frontal cortex is observed in individuals with alcohol use disorder (AUD), and predicts the probability of relapse in abstinent individuals with AUD. To further our understanding of how repeated alcohol consumption impacts the corticostriatal circuit, extracellular electrophysiological recordings (local field potentials; LFPs) were gathered from the nucleus accumbens (NAc) and prefrontal cortex (PFC) of C57BL/6J mice voluntarily consuming alcohol or water using the 2-hour access 'drinking-in-the-dark' (DID) procedure. Following a three-day acclimation period wherein only water access was provided during DID, mice were given 14 consecutive days of access to alcohol. Electrophysiology data was collected throughout the entirety of the final day of acclimation (i.e. water baseline) and the first and final days of alcohol access. We evaluated power and coherence at five frequency bands during bouts of drinking. Surprisingly, we only detected significant changes in power in the NAc; no differences were observed in power in the PFC. Increases in NAc power were detected at the Theta, Beta, and Gamma frequencies. At each of these frequencies, increases were identified on the final alcohol session compared to water baseline. Only at the Theta frequency were increases also detected compared to the first alcohol session. Furthermore, significant increases in Delta coherence were observed on the final alcohol session compared to water baseline, whereas significant decreases in Theta and Beta coherence were identified on both alcohol sessions compared to water baseline. These results provide additional support for alterations in the functional coupling of corticostriatal circuits associated with alcohol consumption and suggest the Theta frequency may be uniquely susceptible to these alterations.

Association between sociodemographic factors and alcohol consumption among adults aged 18-69 years in Kazakhstan: a cross-sectional study

OBJECTIVE

The aim of this study is to analyse the prevalence and characteristics of alcohol consumption including the patterns of heavy episodic drinking, among the adult population of Kazakhstan (18-69 years old) and identify key socio-demographic and regional factors influencing alcohol use.

DESIGN/METHODS

A cross-sectional, population-based study was conducted from October 2021 to May 2022. Data were collected via face-to-face interviews using the standardised WHO STEPwise approach.

SETTING AND PARTICIPANTS

The sample included 6720 adults aged 18-69 years from all 17 regions of Kazakhstan.

RESULTS

Among participants, 54.1% had ever consumed alcohol, 42.5% in the past 12 months and 23.7% in the past month. Men had higher adjusted odds of alcohol consumption in the past 30 days (adjusted OR 1.57; 95% CI: 1.37 to 1.81) and heavy episodic drinking (adjusted OR 1.80; 95% CI: 1.44 to 2.24) compared with women. Younger adults (18-24 years) had lower odds of alcohol consumption (adjusted OR 0.61; 95% CI: 0.45 to 0.83) and heavy episodic drinking (adjusted OR 0.59; 95% CI: 0.37 to 0.94). Russians and Ukrainians had significantly higher adjusted odds of alcohol consumption (adjusted OR 1.48; 95% CI: 1.11 to 1.98 and OR 1.85; 95% CI: 1.14 to 3.01, respectively). Significant regional differences were found, with higher alcohol use in the northern regions and major cities. Smoking was strongly associated with alcohol consumption (adjusted OR 3.08; 95% CI: 2.65 to 3.57) and heavy episodic drinking (adjusted OR 3.72; 95% CI: 3.05 to 4.54). Education, occupation and marital status were not significant determinants.

CONCLUSIONS

The findings highlight the complexity of alcohol consumption patterns in Kazakhstan and the need for targeted public health interventions tailored to gender, age, ethnicity and region.

Artificial intelligence approaches for anti-addiction drug discovery

Drug addiction remains a complex global public health challenge, with traditional anti-addiction drug discovery hindered by limited efficacy and slow progress in targeting intricate neurochemical systems. Advanced algorithms within artificial intelligence (AI) present a transformative solution that boosts both speed and precision in therapeutic development. This review examines how artificial intelligence serves as a crucial element in developing anti-addiction medications by targeting the opioid system along with dopaminergic and GABAergic systems, which are essential in addiction pathology. It identifies upcoming trends promising in studying less-researched addiction-linked systems through innovative general-purpose drug discovery techniques. AI holds the potential to transform anti-addiction research by breaking down conventional limitations, which will enable the development of superior treatment methods.

University Students' Knowledge and Attitudes Toward Substance Abuse: A Cross-Sectional Study from Saudi Arabia

BACKGROUND

Substance abuse is a major public health issue, particularly among university students. Understanding students' knowledge and attitudes toward substance abuse is important for designing educational and preventive strategies, helping early intervention efforts, supporting mental health services, and ensuring culturally suitable programming.

OBJECTIVE

This study aimed to assess university students' knowledge and attitudes regarding substance abuse and to identify demographic and educational factors associated with these variables.

METHODS

A cross-sectional study was conducted among 745 university students from various academic disciplines. Data were collected using a structured questionnaire assessing knowledge and attitudes related to substance abuse. Statistical analyses included descriptive statistics, reliability analysis, correlation, and regression tests.

RESULTS

The sample included 50.5% males and 49.5% females, with the majority aged 18-21 years (58.0%). Most participants had heard of substance abuse (91.7%) and recognized its association with chronic disease (97.3%). Knowledge scores varied significantly on the basis of academic background and prior exposure to awareness programs. Attitudes toward substance abuse were mixed, with a notable proportion of students perceiving potential benefits in certain contexts. A weak, non-significant correlation was found between knowledge and attitudes (r = 0.068, p = 0.064).

CONCLUSION

Although students showed generally good knowledge about substance abuse, variations in understanding and attitudes were obvious across demographic and educational subgroups. These findings emphasize the need for targeted, context-specific educational interventions to address misconceptions and improve preventive awareness. Future research should evaluate the long-term impact of such interventions on students' attitudes and behaviors.

Clinicians' Perspectives on Cannabis Use and Cannabis Treatment in Clients Undertaking Opioid Dependence Treatment

INTRODUCTION

There are no prior studies investigating the perspectives of Opioid Treatment Program (OTP) clinicians on clients' cannabis use. This study examines the perspectives of OTP clinicians on patterns of cannabis use; harms and benefits; current and potential interventions and their confidence in implementing them.

METHODS

Clinicians from six public OTP services in New South Wales completed the survey. Participants included nurses, doctors, pharmacists, allied health and consumer workers. Single-level regression models were used to estimate participants' sex, role and experience effect.

RESULTS

A total of 162 participants responded to the survey (estimated response rate 56%). Participants estimated 56.1% (±23.9) of OTP clients had used cannabis in the past month, and 44.9% (±6.5) had cannabis dependence. Clinicians indicated (15.3% ± 17.2%) clients identified problematic cannabis use and (10.7% ± 16.9) sought treatment in the past year. The harms most frequently identified by staff were cannabis dependence (46.5% ± 27.9%), financial issues (37.5% ± 29.2%) and increased tobacco use (33.1% ± 28.2%). The benefits most frequently identified were management of sleep problems (49.7% ± 27.8%), chronic pain symptoms (35.6% ± 24.3%) and improvements in mental health (48.3% ± 25.6%). Sixty-five participants (63.7%) advocated for enhancing efforts to address cannabis use, with none supporting scaling down services. Clinicians prioritised withdrawal services (81%), harm reduction (77.4%), counselling (74%) and medicinal cannabis (59.8%), although the majority had low confidence in delivering most of these interventions.

DISCUSSION AND CONCLUSIONS

Despite awareness about cannabis use patterns and identification of both harms and benefits, clinicians identified low rates of cannabis interventions and low levels of confidence in delivering interventions.

Role of ketamine in the treatment of substance use disorders: A systematic review

BACKGROUND AND AIMS

Substance Use Disorders (SUDs) involve diminished control, risky use, impaired social interactions, and physical dependence. Despite their global prevalence and burden, treatment options remain limited. Ketamine (KET), an NMDA receptor antagonist, may aid SUD treatment by modulating glutamatergic neurotransmission. This systematic review evaluates KET's role in SUD treatment.

METHODS

This review surveyed three databases until June 2024, including 14 studies with 551 participants.

RESULTS

Among the 14 studies, 6 focused on alcohol, 3 on cocaine, 4 on opioids, and 1 on cannabis. Seven studies (50 %) combined KET with psychotherapy, while seven (50 %) focused solely on KET's pharmacological effects. KET dose ranges varied from 0.11 mg/kg to 2.0 mg/kg and study primary endpoints ranged from less than a day to two years. The results of the included studies demonstrated KET's efficacy across various SUDs. In Alcohol Use Disorder (AUD), KET reduced withdrawal symptoms and benzodiazepine requirements. In Cocaine Use Disorder (CUD), KET decreased craving and increased abstinence rates. In Opioid Use Disorder (OUD), high-dose KET psychotherapy (KPT) improved abstinence and reduced craving. In Cannabis Use Disorder (CNUD), KET reduced weekly use and increased abstinence confidence.

CONCLUSIONS

Conclusion: While preliminary studies suggest that KET may have short-term benefits in treating SUDs, the evidence remains limited by small sample sizes and a lack of randomized trials. Further research with larger, well-controlled studies is needed to determine optimal dosing, clarify mechanisms of action, and assess long-term efficacy and potential risks, including abuse liability, before broader clinical implementation can be recommended.

Impulsivity behaviors and white matter mediate the relationship between genetic risk for cannabis use disorder and early cannabis use in adolescents

BACKGROUND AND AIM

Cannabis use disorder (CUD) is strongly influenced by genetic factors; however the mechanisms underpinning this association are not well understood. This study investigated whether a polygenic risk score (PRS) based on a genome-wide association study for CUD in adults predicts cannabis use in adolescents and whether the association can be explained by inter-individual variation in structural properties of brain white matter or risk-taking behaviors.

DESIGN AND SETTING

Longitudinal and cross-sectional analyses using data from the IMAGEN cohort, a European longitudinal study integrating genetic, neuroimaging and behavioral measures. We measured associations between PRS for CUD, novelty and sensation seeking traits and fractional anisotropy (FA) of white matter tracts. Mediation modeling explored whether novelty seeking and FA mediated the association between the PRS and cannabis use.

PARTICIPANTS

Participants were assessed at 14 (n = 1762), 19 (n = 1175) and 23 (n = 1139) years old.

MEASUREMENTS

European School Survey Project on Alcohol and Other Drugs, substance use risk profile scale, Fagerstrom Test for Nicotine Dependence, temperament and character inventory, Kirby Monetary Questionnaire, diffusor tensor imaging and CUD-PRS.

FINDINGS

CUD-PRS was associated with adolescent total cannabis exposure [P < 0.001, beta = 0.098 (95% confidence interval = 0.059, 0.137)] as well as with other substance use measures [alcohol P = 0.002, beta = 0.058 (0.020, 0.096); cigarettes smoked P < 0.001, beta = 0.086 (0.044, 0.128); fargestrom score P < 0.001, beta = 0.062 (0.028, 0.096); drug score P < 0.001, beta = 0.106 (0.065, 0.147)]. CUD-PRS was also associated with impulsivity, risk-taking behaviors [impulsivity P < 0.001, beta = 0.106 (0.060, 0.142); sensation seeking P < 0.001, beta = 0.094 (0.0523, 0.1357); novelty seeking P < 0.001, beta = 0.105 (0.064, 0.146); discounting task P < 0.001, beta = 0.051 (0.013, 0.089)] and average FA [P < 0.001, beta = -0.010 (-0.015, -0.005)]. Longitudinal mediation models showed that these behaviors and brain measures could mediate the association of PRS with cannabis use [overall indirect effect for novelty seeking P < 0.001, beta = 0.048 (0.028, 0.068); impulsivity P = 0.016, beta = 0.019 (0.004, 0.035); sensation seeking P < 0.001, beta = 0.034 (0.017, 0.05)].

CONCLUSIONS

The genetic risk of adult cannabis use disorder appears to be associated with substance use behavior and white matter structure as early as age 14. The observed mediation effect is consistent with the notion that genetic risk increases novelty seeking in a way that leads to more cannabis use in adolescents.

Betel-quid addictive use disorders and Oral potentially malignant disorders and Oral cancer in south, southeast, and East Asia: A systematic review and meta-analysis

OBJECTIVE

This study aimed to provide a comprehensive assessment of the measurement and prevalence of betel-quid (BQ) abuse, dependence, and BQ use disorder (BUD), as well as to evaluate the impact of BQ addiction on oral malignant diseases.

METHODS

We used the PRISMA guidelines to perform a systematic review and meta-analysis. We searched for relevant publications up to April 2024 in PubMed, Web of Science, and Embase. The articles were evaluated for BQ addiction and its relationship with oral potentially malignant disorders (OPMD) and oral cancer.

RESULTS

The prevalence of BQ abuse, dependence, and BUD in South, Southeast, and East Asia varied between 0.8%-46.3%, 0.4%-43.5%, and 4.7%-39.2%, respectively. Among BQ chewers, the corresponding proportions of these disorders ranged from 40.5%-99.6%, 20.9%-99.6%, and 55.2%-99.3%. The pooled risks of OPMD associated with BQ abuse, dependence, and BUD were 16.3, 18.7, and 9.6-35.5, respectively. The risk of oral cancer for mild, moderate, and severe BUD was 8.5, 8.2, and 42.3, respectively.

CONCLUSIONS

BUD mediates the link between BQ use and an increased risk of oral malignant disorders. Addressing and treating BQ addiction is an important component of comprehensive OPMD and oral cancer preventive and intervention programs that go beyond simple cessation efforts.

Recurrent and De Novo Liver Disease After Liver Transplantation

Disease recurrence after liver transplantation (LT) is common. Certain liver diseases such as autoimmune hepatitis and steatotic liver disease may appear de novo after LT. This review discusses post LT alcohol-associated liver disease, metabolic dysfunction-associated liver disease, autoimmune hepatitis, primary biliary cholangitis, and primary sclerosing cholangitis. Both recurrent and de novo diseases are important causes of allograft failure.

Psychoactive drug use and prognosis in patients with cancer presenting with acute cardiovascular disease

BACKGROUND

The psychoactive drug consumption and the short- and long-term cardiovascular prognosis of patients with cancer admitted for acute cardiovascular events are not well established.

AIMS

To assess the prevalence of psychoactive drug use, in-hospital outcomes and 1-year prognosis in patients with cancer hospitalized for acute cardiovascular events.

METHODS

In a prospective multicentre study of all consecutive patients admitted to intensive cardiac care units, a history of cancer was recorded systematically. The primary outcome was the prevalence of psychoactive drugs detected by urine drug assay. The secondary outcomes were: the rate of in-hospital major adverse events, defined as all-cause death, cardiogenic shock and cardiac arrest; and the 1-year rate of major adverse cardiovascular and cerebrovascular events, defined as cardiovascular death, myocardial infarction and stroke.

RESULTS

Among 1499 patients recruited, 151 had a history of cancer (10%), including 61 (40%) with active cancer and 90 (60%) with cancer in remission. Among patients with a history of cancer, 39 (25.8%) tested positive for at least one psychoactive drug. Using a matching approach based on the likelihood of having a cancer, a history of cancer was not associated with an increased risk of in-hospital major adverse events (odds ratio: 1.54, 95% confidence interval: 0.68-3.45; P=0.3). However, a history of cancer was associated with a higher incidence of 1-year major adverse cardiovascular and cerebrovascular events (hazard ratio: 3.04, 95% confidence interval: 1.63-5.67; P<0.001).

CONCLUSIONS

The prevalence of psychoactive drug use among patients with a history of cancer hospitalized for acute cardiovascular events was 25.8%. A history of cancer was an independent predictor of 1-year major adverse cardiovascular and cerebrovascular events.

Infralimbic deep brain stimulation: The impact of frequency and timing on extinction and reinstatement of morphine-seeking behaviors in male rats

Opioid use disorder poses a substantial public health burden. While existing treatments have limitations in achieving long-term abstinence, deep brain stimulation (DBS) emerges as a promising alternative for patients with treatment-refractory addiction. The infralimbic (IL) region has been increasingly recognized by recent studies as a critical brain area involved in addiction, making it a potential target for novel treatments. This study investigates the efficacy of high- and low-frequency DBS within the IL in modulating extinction and reinstatement of morphine-induced conditioned place preference (CPP). After the morphine CPP was established (5 mg/kg; sc), 30-min HFS or LFS session (130 or 10 Hz, 200 μA, 60 μs, respectively) was applied in the IL during two experimental paradigms: daily sessions during the extinction period or a single session prior to the reinstatement test. Following extinction, drug-seeking behavior was reinstated by a morphine priming dose (1 mg/kg; sc). The results indicated that both HFS and LFS during extinction days significantly shortened the extinction duration and prevented the reinstatement of drug-seeking behavior. Furthermore, a single session of DBS prior to priming-dose administration showed that HFS significantly inhibited the reoccurrence of morphine-seeking behavior, while LFS failed to prevent the morphine-primed reinstatement. The results also demonstrated that receiving HFS during the extinction period is more effective in reducing the reinstatement of morphine-seeking behavior compared to that when used in a single session. In conclusion, this research indicates that DBS of the IL can influence addiction-related behaviors across a spectrum of frequencies. Additionally, the therapeutic effectiveness of DBS may vary depending on the timing of its application.

Raising to conformity without strictness: is it achievable?

Background

The prevailing belief that parental strictness is optimal for children is not uniformly supported by recent research. Contrary to the traditional notion that strictness is necessary to ensure children's conformity to social norms, contemporary studies question its necessity. This study aims to analyze how two main parenting dimensions, warmth and strictness, are related to the psychosocial adjustment of children.

Method

A sample of 1,224 Spanish adolescents and young adults was examined, divided into two groups: adolescents aged 12-18 years (51.14%) and young adults aged 19-35 years (48.86%). Adolescent participants were recruited from high schools while young adults were recruited from university courses. Children (i.e., adolescent and young adult offspring) responded to an online questionnaire that included all measures: parenting dimensions (warmth and strictness) and children's psychosocial adjustment criteria (emotional self-concept, self-esteem, social competence, and conformity). Power analyses (a priori and sensitivity analyses) were applied to ensure sufficient sample sizes to achieve adequate power. Cohen's d values from correlation analyses and multiple linear regression analyses were performed. Beta confidence intervals were analyzed to relate parenting dimensions, sex and age to self-concept, self-esteem, social competence, and conformity.

Results

The statistical analysis plainly indicated that parental warmth was positively associated with criteria for child psychosocial adjustment, including self-esteem, social competence, and conformity. This relationship was consistent across both adolescents and young adults. Conversely, parental strictness was either negatively related to or not significantly associated with these criteria.

Conclusion

This study clearly suggests that, completely contrary to expectations that strict parenting might be a need component to achieving psychosocial adjustment, parental warmth, rather than strictness, is more effective in promoting children's psychosocial adjustment.

Evaluating the dissemination of evidence-based practices in substance use treatment: A cluster-randomized clinical trial of Colombo Plan's Innovative professional training model

The training of professionals who work in the treatment of substance use disorders is a fundamental aspect for the dissemination of evidence-based practices that ensure the quality of the treatment delivered to patients. Colombo Plan has developed a training model that allows effective, rapid, and scalable dissemination. However, this model does not have an empirical evaluation of its results to date. This project seeks to evaluate the dissemination model through a cluster-randomized clinical trial with a parallel superiority design, in which 27 treatment centers will be randomly assigned to training + action plan and technical advice, training only, or control without training, action plan or advice. The results of this study will inform public policy regarding substance use treatment at the national level and will help improve efforts by Colombo Plan at dissemination of evidence-based practices.

A superior colliculus-originating circuit prevents cocaine reinstatement via VR-based eye movement desensitization treatment

While Virtual Reality (VR) technology shows promise in the management of substance use disorders, the development of an effective VR-based extinction procedure remains lacking. In this study, we developed a VR-based eye movement desensitization and reprocessing extinction training program tailored for mice. We found that this VR treatment during cocaine extinction prevents reinstatement by suppressing the hyperactivation of glutamatergic excitatory neurons in the intermediate layers of the superior colliculus (SCiCaMKIIα) during exposure to environmental cues. Additionally, SCiCaMKIIα neurons innervate tyrosine hydroxylase-positive neurons in the locus coeruleus (LCTH). Environmental cues trigger stronger phasic activation of LCTH neurons through this SCiCaMKIIα→LCTH projection, leading to increased dopamine release onto the dorsal CA3 (dCA3) region, thereby facilitating reinstatement. Furthermore, we demonstrate that VR treatment effectively inhibits the neural circuitry involving SCiCaMKIIα→LCTH→dCA3 in response to environmental cues, thus preventing cocaine reinstatement. Our findings suggest that VR treatment may represent a promising strategy for achieving drug abstinence.

Abnormal ventromedial-to-dorsolateral hierarchical topography of striatal circuits in cocaine use disorder and its modulations by brain stimulation

Cocaine use disorder (CUD) has been linked to cortico-striatal dysfunctions, particularly within the prefrontal-striatal circuitry. However, previous studies have typically focused on discrete parcellations of the striatum, overlooking its continuous variations of neural organization. Moreover, while repetitive transcranial magnetic stimulation (rTMS) has shown benefits in CUD treatment, the neural effects of rTMS on striatal dysfunction in CUD remain poorly understood. Using connectome gradient-mapping techniques on three resting-state functional magnetic resonance imaging datasets, we derived the ventromedial-to-dorsolateral striatal functional topography. We identified specific alterations in this topography in the discovery cohort (41 CUD patients and 44 controls), validated findings in an independent cohort (53 CUD patients and 45 controls), and examined whether rTMS targeting the left dorsolateral prefrontal cortex (dlPFC) could normalize abnormalities in the rTMS-treatment cohort (44 patients). Across all datasets, we found a positive correlation between gradient variation and drug dependence severity in CUD. Compared to controls, CUD in both the discovery and replication cohorts exhibited elevated gradient values in the ventral striatum, while decreased values in the dorsal striatum were observed only in the discovery cohort. Furthermore, in the rTMS-treatment cohort, 5-Hz rTMS targeting the left dlPFC significantly normalized the aberrant gradient values in the ventral striatum, and these changes also related to cocaine craving changes. Overall, our study provides novel evidence of specific alterations in the ventromedial-to-dorsolateral functional topography of the striatum in CUD patients and highlights the impact of rTMS on striatal circuits through prefrontal modulation.

Unseen dualities: underdiagnosis of substance use disorders in borderline personality disorder

Introduction

Borderline personality disorder (BPD) patients exhibit high rates of co-occurring mental disorders. Though literature reports varying prevalence of substance use disorders (SUD) in BPD, they are frequent with prevalence rates of approximately 45%. This study examines the 12-month prevalence of SUDs in a German sample of BPD patients by semi-structured interviews and compared to medical records.

Methods

N=126 BPD patients were included. Twelve-month SUD prevalence was obtained by semi-structured clinical interview (SCID) and compared to reported prevalence in the general population and to diagnoses from medical records.

Results

Mean age of the sample was 37.5 (SD ± 11.5) years and N=61 (48%) patients were female. Compared to the general population, increased 12-month prevalence based on SCID was found for alcohol abuse (22.2%, +7.9-times), alcohol dependence (17.5%, +5.6-times), cannabis abuse (15.1%, +30.2-times), cannabis dependence (19.0%, +31.7-times), sedative abuse (3.2%, +4.6-times) and sedative dependence (3.2% +4.6-times). N=43 (34.1%) patients presented at least one diagnosis of substance abuse and N=43 (34.1%) presented at least one diagnosis of substance dependence. N=51 (40.1%) patients were diagnosed with at least one substance use or dependence disorder. On average, prevalence based on SCID exceeded prevalence obtained from medical records. Particularly, alcohol abuse (3.5-times), cannabis abuse (2.4-times) and dependence (2.2-times), and sedative- and stimulant abuse (both no diagnosis in medical record vs. 3.2% in SCID) were underrecognized. Furthermore, concordance rates between diagnoses based on medical record and SCID were below 30% for all substances.

Conclusion

Our data confirm high prevalence of SUDs in BPD patients. Of note, medical records underrecognized alcohol abuse and cannabis abuse and dependence. Substance abuse and dependence are primary risk factors of suicidal behaviors and completed suicide. SUDs have been shown to be amenable to psychotherapeutic interventions. Therefore, careful diagnosis of SUD by e.g. expert structured interviews and integration of SUDs in a multimodal treatment plan is recommended.

Understanding the Interplay of Interpersonal Violence, Smoking, and Alcohol Consumption in Brazilian Adults: Evidence from a National Health Survey

Interpersonal violence (IV) in adulthood seems to be related to alcoholism and smoking. However, whether it reflects differently by gender and the frequency of exposure to these outcomes remains largely unexplored, particularly in developing countries. This study aimed to evaluate associations of acute and chronic IV exposure (physical, psychological, and sexual) with binge drinking and smoking, separately for men and women adults. Cross-sectional study, enrolled 72.597 participants, aged 18 to 64, from the Brazilian National Health Survey (NHS). The explanatory variables of interest were physical, sexual, and psychological exposure to IV in the last 12 months, whether once or some/many times. The dependent variables were binge drinking and smoking. The magnitudes of associations and their confidence Interval of 95% between each exposure and outcome were estimated using Poisson regression with robust variance. Sequential adjustments were made for age, race/skin color, marital status and sexual orientation, education, and income. After adjustment for all covariates, men exposed to physical, psychological (both once or some/many times), and sexual violence (only once) were associated with binge drinking and smoking (p < .05). Further, women exposed to any form of violence, whether once or some/many times, were associated with binge drinking (p < .05). However, remained related to smoking women exposed to physical (both once or some/many times) and psychological violence (only some/many times) (p < .05). Interestingly, any frequency of sexual violence remained not associated with smoking. Women's higher exposure to violence is strongly linked to binge drinking, particularly in cases of physical and psychological violence. Men exposed to violence also exhibit significant associations with binge drinking and smoking. These findings emphasize the complex interplay of gender, violence, and public health challenges in Brazil.

Psychometric assessment of the Moroccan version of the car, relax, alone, forget, friends, trouble (CRAFFT) scale among adolescent and young adults with a substance use disorder

BACKGROUND

The Car, Relax, Alone, Forget, Friends, Trouble (CRAFFT) scale is a widely used screening tool for early identification of alcohol and other drug use, and assessing the risk of substance use disorders in adolescents and young adults. Despite its broad use, translation into several languages, and validation in various settings, no study has yet confirmed the psychometric properties of a Moroccan version. The present research aims to adapt and validate the Moroccan Arabic dialect version of the CRAFFT scale among adolescents and young adults with alcohol and drug use disorder.

METHODS

A total of 302 adolescents and young adults (mean age = 18.36 ± 2.36), including 161 males and 41 females, were recruited from a substance use treatment center in Fez City. Confirmatory Factor Analysis (CFA) was used to assess the factorial structure and model fit, while internal consistency was evaluated using the Kuder-Richardson Formula 20 (KR-20). Convergent validity was examined using gold standard measures, including the International Neuropsychiatric Interview (MINI) and the Hooked-on Nicotine Checklist (HONC). All statistical analyses were performed using JASP software (version 0.17).

RESULTS

CFA revealed a one-factor structure with a good overall fit (χ²/df = 1.91, Root Mean Square Error of Approximation (RMSEA) = 0.06, Standardized Root Mean Square Residual (SRMR) = 0.03, Comparative Fit Index (CFI) = 0.98, Normed Fit Index (NFI) = 0.97. The model had strong reliability with a KR-20 coefficient of 0.80. Convergent validity was confirmed by a high and significant correlation with the MINI gold standard (r = 0.82, p < 0.001), while a low correlation with the HONC gold standard (r = 0.20, p < 0.001) confirmed the scale's convergent validity. A cutoff score of 4 or higher on the CRAFFT was identified as optimal for balancing sensitivity (78.35%) and specificity (91.67%), achieving a Youden index of 0.70.

CONCLUSION

The psychometric properties of the Moroccan version of the CRAFFT confirm that it is a valid tool for screening the early detection of alcohol and drug use and for assessing the risk of substance use disorders in adolescents and young adults.

Emergency admission, previous delirium tremens and increased liver stiffness as risk factors for severe alcohol withdrawal - A prospective study

OBJECTIVE

To determine if increased liver stiffness (ILS) is a risk factor for patients with alcohol withdrawal to develop severe alcohol withdrawal symptoms (SAWS) like delirium tremens (DT) or withdrawal seizures (WS).

METHOD

Prospective inclusion of 394 patients undergoing withdrawal treatment between 2013-2021. Laboratory exams, history, physical examination, abdominal sonography with elastography and FibroScan® measurements were performed. Primary endpoint was SAWS defined as DT and/or WS. Patients with >  12.5 kPa stiffness in FibroScan® and >  1.75 m/s in Acoustic Radiation Force Impulse Imaging were considered ILS, patients with both measurements below the respective cut-off were ILS negative. Univariate analysis with receiver operating characteristic curve analysis and multivariate analysis were performed.

RESULTS

78 patients (19.8%) had ILS. Of these, 28 patients developed complications despite treatment. SAWS correlated significantly with patients with ILS. Further significant correlations were emergency hospital admission, Alcohol Withdrawal Scale ≥  5, lower potassium, elevated bilirubin, increased Gamma-GT, thrombocytopenia, previous WS, and previous DT. In multivariate binary regression analysis, odds ratio for SAWS was 5.4 for emergency admission, 3.5 for previous DT and 2.2 for ILS, even if the significance level for the last parameter was missed.

CONCLUSIONS

Patients with ILS have an increased risk of developing SAWS, as well as patients with emergency admission and previous DT among other markers. Treatment in an appropriately equipped facility is recommended for patients with this risk profile which can be measured easily by a general practitioner or in an emergency department.

Hydroxycotinine exhibits a stronger association with chronic kidney disease in smokers when compared to cotinine: Evidence from NHANES 2013-2018

INTRODUCTION

Smoking is a recognized risk factor for chronic kidney disease (CKD), and cotinine and hydroxycotinine are tobacco metabolites that can be used to quantify smoking. This study evaluated their relationship with CKD in smokers.

METHODS

This secondary dataset analysis is based on National Health and Nutrition Examination Survey (NHANES) data from 2013 to 2018. A cross-sectional examination of a subsample of 2930 adult smokers aged ≥20 years was conducted to investigate the relationship between serum cotinine and its metabolite, hydroxycotinine, and CKD. Linear regression, multivariable-adjusted logistic regression, restrictive cubic splines, and subgroup analysis were utilized.

RESULTS

Serum cotinine and hydroxycotinine levels were significantly elevated in CKD patients compared to the non-CKD population (230.00 vs 212.00 ng/mL, p=0.02 for cotinine; 97.30 vs 74.70 ng/mL, p<0.001 for hydroxycotinine). In multivariable-adjusted logistic regression models, cotinine (≥316 ng/mL) showed a positive association solely with renal insufficiency (adjusted odds ratio, AOR=1.53; 95% CI: 1.07-2.17). In contrast, hydroxycotinine (≥124 ng/mL) was independently associated with three CKD indices: CKD diagnosis (AOR=1.61; 95% CI: 1.06-2.43), renal insufficiency (AOR=2.07; 95% CI: 1.33-3.23), and albuminuria (or proteinuria) (AOR=1.61; 95% CI: 1.06-2.43). Restricted cubic spline analyses revealed nonlinear dose-response relationships: hydroxycotinine exhibited broader negative associations with both eGFR and uACR (p<0.001), while cotinine showed threshold-dependent correlations with CKD risk (positive <180 ng/mL, attenuated above). Subgroup analyses further indicated that hydroxycotinine consistently correlated with CKD across demographics (e.g. males, age <60 years, obesity), whereas cotinine's associations were more limited, with no significant interaction effects observed (p for interaction >0.05).

CONCLUSIONS

Elevated serum concentrations of cotinine and hydroxycotinine are positively associated with low glomerular filtration rate, albuminuria, and CKD in smokers, with hydroxycotinine demonstrating a stronger correlation. Smoking is established as a heightened risk factor for CKD, thus avoidance or reduction of smoking is strongly recommended.

Validation of screening instruments for alcohol and substance use disorders among men and women in Eastern Cape, South Africa

INTRODUCTION

Valid Alcohol Use Disorder (AUD) and Substance Use Disorder (SUD) screeners are needed to identify and link people to services. We evaluated the performance of several AUD and SUD screeners in South Africa using the Mini International Neuropsychiatric Interview (MINI)-5 diagnostic gold standard.

METHODS

Adults at primary and tertiary care facilities in Buffalo City Metro, South Africa, were screened by research assistants using the AUDIT and AUDIT-C (AUD), DAST-10 (SUD) and NIDA Quick Screen (AUD and SUD). Nurses administered the MINI-5 to identify AUD and SUD. We assessed the internal consistency, criterion validity, sensitivity and specificity of these tools, stratified by gender.

RESULTS

Among 1885 participants, the prevalence of AUD and SUD were 9.5 % and 1.6 %, respectively. All tools demonstrated adequate internal consistency and criterion validity. A positive AUDIT screen (men: ≥8; women: ≥7) yielded sensitivity/specificity of 70.6/87.3 % (men: 78.7/82.6 %; women: 64.8/89.8 %). A positive AUDIT-C screen (men: ≥4; women: ≥3) yielded sensitivity/specificity of 66.1/82.0 % (men: 64.0/78.8 %; women: 67.6/81.3 %). Endorsing the NIDA alcohol use question yielded sensitivity/specificity of 71.1/68.1 % (men: 74.7/59.7 %; women: 68.6/72.5 %). Endorsing either NIDA substance use questions yielded sensitivity/specificity of 80.6/91.7 % (men: 80.8/89.0 %; women: 80.0/93.1 %). A DAST-10 cut-off of ≥ 3 yielded sensitivity/specificity of 71.0/96.0 % (men: 73.1/83.7 %; women 60.0/97.4 %).

CONCLUSIONS

The AUDIT and AUDIT-C performed similarly among men and women, although lower cut-offs may optimize performance among women. The low number of SUD cases hampered our ability to draw conclusions about the SUD screeners' performance.

Cannabis use and cannabis use disorders and their treatment in the Europe

This paper introduces the special issue on cannabis use in Europe. It describes data on the prevalence of cannabis use in Europe and the more limited data on the prevalence of cannabis use disorders, one of the most common forms of drug problem treated in many countries in Europe. It summarises what research has indicated about the adverse effects of acute and chronic cannabis use and discusses potential health system responses that may reduce some of these harms. These include public education about the risks of cannabis use; screening and brief interventions in primary medical settings; and specialist treatment for cannabis use disorders. It briefly indicates the special issues that may need to be addressed in dealing with the high rates of comorbidity between cannabis use disorders, other types of drug use disorders, and common mental disorders.

Maternal Cannabis Use Disorder and Neonatal Health Outcomes: A Data Linkage Study

OBJECTIVE

We tested for the potential associations between maternal antenatal cannabis use disorders (CUD) and neonatal health outcomes using large linked administrative data.

DESIGN

Population-based retrospective cohort study.

SETTING

The study was conducted in New South Wales, Australia.

POPULATION OR SAMPLE

A total of 215 879 singleton live births.

METHODS

Generalised linear models (GLMs) fitted using log-binomial regression to estimate risk ratios (RRs) with the corresponding 95% confidence intervals (95% CI). Additionally, we conducted a propensity score matching (PSM) analysis.

MAIN OUTCOME MEASURES

The outcomes include preterm births (PTB), low birth weight (LBW), small for gestational age (SGA), 5-min lower Apgar scores and admission to the neonatal intensive care unit (NICU).

RESULTS

In unmatched analyses, antenatal CUD was associated with increased risks for all adverse neonatal outcomes (adjusted risk ratio [RR] ranging from 1.47 [95% CI: 1.01, 2.14] for 5-min lower APGAR scores to 2.58 [95% CI 2.28, 2.91] for PTB). In PSM analyses, we observed slightly attenuated risks of PTB (RR = 1.98 [1.70, 2.31]), LBW (RR = 2.46 [2.13, 2.84]), SGA (RR = 1.84 [1.44, 2.35]) and admission to NICU (RR = 1.91 [1.49, 2.45]) after matching by covariates. However, we found no significant association between antenatal CUD and 5-min low APGAR scores (RR = 1.47 [0.94, 2.30]).

CONCLUSION

We found that maternal antenatal exposure to CUD is associated with a range of adverse neonatal outcomes. This study highlights that targeted interventions focusing on antenatal counselling are recommended to mitigate risks associated with maternal cannabis use.

Association Between Dietary Alcohol Intake and Migraine or Severe Headache Miscellaneous Pain: The NHANES 1999-2004

BACKGROUND

The relationship between alcohol consumption and migraine or severe headache remains controversial in the existing literature. Given that alcohol is a widely consumed beverage, clarifying the relationship between alcohol and migraine or severe headaches can help manage the patient's condition.

AIM

This study aimed to investigate the potential relationship between alcohol consumption and migraine or severe headache.

METHODS

Employing National Health and Nutrition Examination Survey (NHANES) database records spanning March 1999 to December 2004, our analysis encompassed threshold effects, smoothed curve fitting, and multivariate logistic regression to elucidate the relationship between alcohol consumption level and migraine or severe headaches. We utilized subgroup analyses and interaction tests to explore the stability of this relationship across different stratified populations.

RESULTS

A total of 13,083 subjects were enrolled. The odds of migraine or severe headache decreased with increasing dietary alcohol intake. This was more pronounced in the older and male subgroups.

CONCLUSIONS

There was a significant negative association between dietary alcohol intake and the odds of having migraine or severe headache.

Exploring hazardous alcohol use and its determinants among health professionals in Bahir Dar, Northwest Ethiopia

Introduction

Alcohol consumption among health professionals can have serious and multifaceted impacts, affecting both the individual and their professional responsibilities. Despite its critical importance, there is limited research on the burden and contributing factors of hazardous alcohol use among health professionals in Ethiopia. This study aimed to evaluate the magnitude and determinants of hazardous alcohol use among health professionals in Bahir Dar City, Northwest Ethiopia.

Method

An institution-based cross-sectional study was conducted from June 1-30, 2020, involving 384 health professionals. Participants were selected through a simple random sampling method, stratified by profession. Data were collected using a structured and semi-structured self-administered questionnaire, and hazardous alcohol use was assessed using the 10-item Alcohol Use Disorder Identification Test (AUDIT). Data entry was done using EpiData Version 4.6, and analysis was carried out with SPSS Version 23. Bivariable and multivariable logistic regression analyses were employed to estimate crude and adjusted odds ratios, respectively, with a 95% confidence interval. A p-value of less than 0.05 was considered statistically significant.

Results

The burden of hazardous alcohol use among health professionals was 16.4% (95% CI: 13%-20.3%). Significant factors associated with hazardous alcohol use included having a family history of alcohol consumption (AOR=2.68, 95% CI: 1.27-5.66), mild psychological distress (AOR=2.7, 95% CI: 1.12-6.50), moderate/severe psychological distress (AOR=5.84, 95% CI: 2.08-16.37), lifetime Khat use (AOR=10.44, 95% CI: 3.96-27.53), and possessing a diploma-level education (AOR=3.56, 95% CI: 1.28-9.87).

Conclusion

The high prevalence of hazardous alcohol use among health professionals in Bahir Dar City underscores an urgent need for targeted intervention and prevention strategies. Significant risk factors, including family history of alcohol use, psychological distress, Khat use, and educational level. To reduce hazardous alcohol use, the study recommends mental health programs, workplace policies promoting well-being, and integrated prevention and treatment strategies for alcohol and khat use.

Changes in alcohol consumption among Belgian adults participating in the internet-based one-month-abstinence campaign 'Tournée Minérale'

BACKGROUND AND OBJECTIVE

Temporary abstinence campaigns (TAC) are a promising approach to reduce alcohol consumption. This study examined changes in (at-risk) alcohol consumption and determinants of alcohol consumption among Belgian adults participating in the Tournée Minérale Campaign (TMC, Belgian TAC). In addition, moderating effects of age, sex, education level, successfully refraining from alcohol during TMC, risk drinking, drinking levels and binge drinking were investigated.

METHODS

TMC is a fully automated mass media prevention campaign challenging Belgian adults to refrain from alcohol during the month February. This study includes a baseline, post- (four weeks after TMC) and follow-up (six months after TMC) test using online recruitment and an online questionnaire. Participants were self-selected by signing up on the TMC website. Repeated measures ANCOVAs were used to examine changes over time in alcohol consumption (log transformed due to skewness) and determinants among TMC participants (n = 8,730, 48.4 ± 12.9 years old, 37.4% males) who filled in all three measurements. Moderation effects were assessed for age, sex, education level, successfully refraining from alcohol during TMC, risk drinking, drinking levels and binge drinking at baseline. McNemar tests were used to examine the change in prevalence of risk drinking and binge drinking.

RESULTS

TMC participants showed a significant decrease in weekly alcohol consumption (mean exp(x)-1) and CI) from baseline (6.2 [6.4,6.7]) to post (4.2 [4.1,4.3], F = 22.0, p < .001 d = -2.4 [-2.4,-2.3]) and from baseline to follow-up (5.1 [4.9,5.2], F = 24.2, p < .001, d = -1.5 [-1.5,-1.4]), and an increase from post to follow-up (F = 21.1, p < .001). In the short term (from baseline to post), the decreases were stronger among older, male and lower educated TMC participants, those successfully refraining during TMC, higher risk drinkers and binge drinkers. In the medium term (from baseline to follow-up), changes in alcohol consumption were moderated by education (stronger among lower educated) and risk drinking (increase in lower risk drinkers and decrease in higher risk drinkers). Participants' baseline drinking level moderated changes in alcohol consumption. Both short and medium term increases in alcohol consumption were observed among those with a low drinking level (those who drank 0 to < 4 glasses at baseline), while short and medium term decreases were observed among those with higher drinking levels, i.e. those with moderate (≥ 4 to ≤ 10 glasses), high (> 10 to ≤ 17 glasses) and highest (> 17 glasses) drinking level at baseline. A reduction in the proportion of risk drinkers and binge drinkers and changes in determinants of alcohol consumption (e.g. attitudes towards drinking less alcohol and habit of drinking alcohol) were observed among TMC participants.

CONCLUSIONS

TMC participants reported favourable changes in (the underlying determinants of) alcohol consumption in the short and medium term. Higher level drinkers appear to be especially attracted to participate in TMC and to experience the strongest decreases in alcohol consumption. However, without comparison with a control group of non-participants or comparison points, we cannot simply attribute the changes over time to participation in TMC. Future research with a stronger study design is needed to rule out possible bias (e.g., selection bias, seasonal effects or regression to the mean) and to examine mechanisms and longer term effects of TACs.

Hard-To-Reach and Hidden Groups in Health-Related Research-A Scoping Review

AIMS

The aim of this scoping review was to identify hard-to-reach and hidden groups in health-related research and to understand the recruitment methods used with these groups.

DESIGN

The presented scoping review has an exploratory perspectiveand was conducted in accordance with Arksey and O'Malley's framework and the PRISMA-ScR guidelines.

DATA SOURCES

A comprehensive search of CINAHL and MEDLINE databases was performed for studies published up to November 2022. The searches were updated in December 2024.

REVIEW METHODS

Relevant papers were identified via specific search terms and inclusion and exclusion criteria. Two authors independently assessed eligible literature and extracted relevant data, which was analysed and synthesised to answer the research questions. The analysis method used was descriptive analysis with quantification.

RESULTS

Overall, 1024 studies were screened. The included studies were published between 2001 and 2022. A total of 41 studies were included in the review. In this data, groups were defined mostly as hard-to-reach and hidden. The groups were divided into eight categories: LGBTQ+ community, intoxicant users, sex workers and their clients, marginalised groups, mental health care seekers and users, impaired persons, people living outside their original home country and victims of abuse or neglect. Recruitment methods were varied, with snowball sampling, respondent-based sampling and websites being the most used.

CONCLUSION

This review provides insight into the current knowledge on hard-to-reach and hidden study groups. In studies targeting hard-to-reach and hidden groups, the use of concepts is variable and inconsistent.

IMPACT

In clinical nursing practice, it is important to identify hidden and hard-to-reach groups, as the goal of equality is to improve the health and well-being of all individuals, including marginalised groups.

REPORTING METHOD

Reporting was guided by Preferred Reporting Items for Systematic Reviews and Meta-Analysis ex-tension for Scoping Reviews (PRISMA-ScR).

PATIENT OR PUBLIC CONTRIBUTION

No patient or public contribution.

General dental practitioners' knowledge, attitudes and practice towards psychoactive substance use screening: A systematic review

ISSUES

Dentists can play a key role in screening for psychoactive substances use. This systematic review aimed to identify the knowledge, attitudes and practices of dentists related to screening for use of psychoactive substances and the facilitating factors and barriers.

APPROACH

According to Preferred Reporting Items for Systematic reviews and Meta-Analyses, four databases were searched until July 2024 to identify reports relating to screening for substance use by dentists. Search terms used key words relating to knowledge, attitudes or practices concerning the screening of tobacco, alcohol or any other substance use.

KEY FINDINGS

Twenty reports met the inclusion criteria for this review. In practice, dentists were more likely to identify tobacco use than alcohol or other substance use. Although the screening for tobacco was widely performed by dentists, the proposal of interventions was less frequent. Despite the opinion of many dentists that screening is part of their professional role, particularly tobacco, their knowledge of how to identify and intervene seemed low. Lack of knowledge or training were identified as barriers.

IMPLICATIONS

Identification of these factors should encourage greater diffusion of recommended tools for screening and development of initial and continuing training for dentists. These factors should convince decision-makers to help dentists to identify referral solutions, in particular coordinated care pathways, and to consider the acceptability and feasibility of the screening tools available to dentists.

CONCLUSION

Tobacco use was more frequently identified than was other substances, screening was always more frequent than interventions, and lack of training proved to be the main barriers to screening. Education and training in the screening of psychoactive substance use is a key factor in encouraging improved practices, particularly on intervention following detection and on substances other than tobacco.

Investigating the determinants of perceived shame in young adults with paternal substance use disorder in Pakistan: A phenomenological study

BACKGROUND

Substance use disorder profoundly affects not only the individuals with the condition but also their family members, particularly children. The impact on children can be long-lasting, influencing their development and well-being throughout their lives. The study explored the determinants of perceived shame in young adults with paternal substance use disorder in Pakistan.

METHOD

Eight young adults aged 20-30 with paternal substance use disorder were selected through a purposive sampling technique for this study. A phenomenological research design, with interpretative phenomenological analysis, was used to gain an in-depth and comprehensive perspective. Semi-structured interviews were conducted with the participants.

RESULT

Two master themes with respective two sub-themes along with 40 codes were identified i.e., personal distress (psychological problems and existential crises) and social and relational issues (social problems and interpersonal turmoil).

CONCLUSION

Shame is the dominant factor that young adults with paternal substance use face. The study highlighted that these young adults face many personal, social, and relational issues that intensify their feelings of shame. This study may assist mental health professionals in developing effective strategies to decrease the feeling of shame in young adults affected by paternal substance use disorder.

The safety and efficacy of cannabinoids for the treatment of mental health and substance use disorders: protocol for a systematic review and meta-analysis

There has been a global increase in the use of cannabinoids as a treatment for mental health (MH) and substance use disorders (SUD). In 2016, an Australian government-funded review found that although medicinal cannabinoids accounted for a small reduction in MH symptoms, the results varied according to study design. There has since been a rise in randomised controlled trials (RCTs) aiming to examine the efficacy of cannabinoids for the treatment of MH and SUD. Therefore, the current systematic review will (a) identify all RCTs examining the efficacy of cannabinoids in treating MH and SUD, (b) provide a quantitative or narrative synthesis of the evidence examining efficacy, and (c) synthesise adverse event data to examine evidence of harm. Electronic databases (Ovid MEDLINE, PsychINFO, Cochrane Central Register of Controlled Clinical Trials, Cochrane Database of Systematic Reviews, and Embase) were searched from 1980 to 24 May 2023. The study adheres to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis Guidelines. Articles will be screened to capture peer-reviewed RCTs evaluating the efficacy of plant-based and pharmaceutical cannabinoids in reducing or treating MH and SUD among people of any age. The Cochrane risk of bias tool 2.0 will be used to assess bias, while the Grades of Recommendation, Assessment, Development and Evaluation (GRADE) tool will be used to assess the quality of evidence for each outcome. Study findings will be disseminated through published manuscripts, conferences, and health policy guidelines.Systematic review registration PROSPERO CRD42023392718.

Factors related to cough strength before tracheal extubation in post-cardiac surgery patients: A cross-sectional study

BACKGROUND

Tracheal extubation failure after cardiac surgery is associated with diminished cough strength, albeit the information on cough strength in post-cardiac surgery patients is limited.

AIM

To investigate the cough strength in patients after cardiac surgery before tracheal extubation and the related influencing factors.

STUDY DESIGN

A cross-sectional study was designed, with adherence to the STROBE guidelines. The participants were 528 patients undergoing open-heart cardiac surgery who were admitted to the Cardio Surgical Centre in a tertiary hospital in Nanjing, China, from August 2022 to September 2023. Cough peak flow (CPF) ≤60 L/min set as the cut-off value for evaluating diminished cough strength before tracheal extubation. Univariate analysis and multiple linear regression analysis were used to analyse the related influencing factors.

RESULTS

The mean CPF was 130.70 ± 50.58 L/min. A total of 76 (14.4%) patients exhibited a CPF of ≤60 L/min. Multiple linear regression analysis revealed that gender (B = 14.266, t = 2.456, p = .014), inspiratory capacity (IC) (B = 0.013, t = 3.755, p < .001), preoperative CPF (B = 0.086, t = 3.903, p < .001), muscle strength (B = 12.423, t = 4.242, p < .001), preoperative exercise regimen (B = 16.716, t = 4.236, p < .001) and pain levels (B = -8.115, t = -5.794, p < .001) significantly contributed to cough strength.

CONCLUSIONS

Female gender, lower upper limb muscle strength, higher pain levels, lower preoperative CPF and IC, and the absence of systematic exercise were found to be associated with diminished cough strength.

RELEVANCE TO CLINICAL PRACTICE

Cough strength provides important auxiliary data in extubation decision-making. In addition, understanding its relevant factors can help identify the high-risk group of tracheal extubation failure and can help provide a strong theoretical basis for the development of personalized interventions.

Drug delivery strategies for the treatment of relapse behavior in substance use disorder- A systematic review

Substance use disorders (SUDs) pose a significant global health challenge, with relapse being a major obstacle in achieving successful treatment outcomes. In recent years, drug delivery strategies have emerged as promising tools to improve treatment efficacy and patient compliance in the context of SUD. Here we explore a diverse range of drug delivery strategies that have been investigated for addressing relapse behavior in SUD. By examining a wide array of clinical and preclinical studies, this review highlights the advances made in drug delivery technologies in the hopes of aiding future research to further establish novel systems. The present systematic review has been created after gathering data from multiple databases including Google Scholar, PubMed and Cochrane, taking into account both review and research (preclinical and clinical) studies along with other systematic reviews and meta-analyses. Relevant articles have been categorized into those pertaining to opioid use disorder, alcohol use disorder and tobacco use disorder. Substance use disorders are a global health problem, with tobacco use associated with the highest mortality, followed by alcohol and opioids. Conventional drug delivery options, such as oral medication have a number of disadvantages, such as low compliance. To tackle these challenges, multiple novel strategies such as sustained release implants, transdermal patches and liquid crystal-based injections have been developed. This systematic review presents a concise view of the strategies already available, as well as those currently undergoing trials. By doing so, the authors hope to stimulate further research to help overcome the challenges in treating SUDs.

Prospects of elafibranor in treating alcohol-associated liver diseases

Alcohol-related liver disease (ALD), which is induced by excessive alcohol consumption, is a leading cause of liver-related morbidity and mortality. ALD patients exhibit a spectrum of liver injuries, including hepatic steatosis, inflammation, and fibrosis, similar to symptoms of nonalcohol-associated liver diseases such as primary biliary cholangitis, metabolic dysfunction-associated steatotic liver disease, and nonalcoholic steatohepatitis. Elafibranor has been approved for the treatment of primary biliary cholangitis and has been shown to improve symptoms in both animal models and in vitro cell models of metabolic dysfunction-associated steatotic liver disease and nonalcoholic steatohepatitis. However, the efficacy of elafibranor in treating ALD remains unclear. In this article, we comment on the recent publication by Koizumi et al that evaluated the effects of elafibranor on liver fibrosis and gut barrier function in an ALD mouse model. Their findings indicate the potential of elafibranor for ALD treatment, but further experimental investigations and clinical trials are warranted.

Brain structural differences in cocaine use disorder: Insights from multivariate and neurotransmitter analyses

Cocaine use disorder (CUD) is a chronic and relapsing neuropsychiatric disorder characterized by structural and functional brain lesions, posing a significant public health challenge. While the disruptive effects of cocaine on neurotransmitter systems (receptors/transporters) have been well established, the patterns of brain structural abnormalities in CUD and its interaction with other factors remain an ongoing topic of investigation. We employed source-based morphometry (SBM), a multivariate approach on 50 CUD participants and 50 matched healthy controls from the public SUDMEX CONN dataset. This method allowed us to identify co-varying patterns of brain tissue volume differences, and further explore the effect of average cocaine dosage through moderation analysis. Spatial correlation analysis was also performed to examine micro-macro structural consistency between tissue volume variations and chemoarchitectural distribution of dopamine and serotonin. Our SBM analysis findings were consistent with reward-related neuroadaptations in the striato-thalamo-cortical and limbic pathways and also exhibited co-localization with the distribution of dopamine and serotonin systems. The moderation analysis suggested that the average dosage positively strengthens cocaine consumption years' effect on brain structures. By integrating our findings of gray and white matter volume differences and corresponding neurotransmitter profiles, this comprehensive view not only strengthens our understanding of the brain's structural abnormalities in CUD, but also reveals potential mechanisms underlying its development and progression.

Understanding sex and populational differences in spatio-temporal exploration patterns and homebase dynamics of zebrafish following repeated ethanol exposure

Ethanol (EtOH) is one of the most widely consumed substance, affecting neurobehavioral functions depending on multiple environmental and biological factors. Although EtOH modulates zebrafish (Danio rerio) anxiety-like behaviors in novelty-based paradigms, the potential role of biological sex and populational variability in the exploratory dynamics in the open field test (OFT) is unknown. Here, we explored whether a repeated EtOH exposure protocol modulates the spatio-temporal exploration and homebase-related parameters in a population- and sex-dependent manner. Male and female fish from the short-fin (SF) and leopard (LEO) phenotypes were exposed to EtOH for 7 days (1 % v/v, 20 min per day). On the 8th day, the OFT was performed to assess locomotor and exploratory behaviors. We verified significant populational differences in the baseline spatio-temporal exploration patterns, supporting a pronounced anxiety in LEO with a higher homebase index compared to SF. We also found sex-dependent differences in EtOH sensitivity, where SF was more sensitive to EtOH, especially in females, which showed marked alterations in thigmotaxis and homebase occupancy. Conversely, only LEO female subjects showed increased center occupancy following EtOH. Principal component analysis (PCA) showed the main components that explained data variability, which were sex- and population-dependent. Overall, our novel findings support the utility of zebrafish-based models to assess how EtOH influences the exploratory profile in the OFT, as well as to elucidate potential differences of sex and population in the neurobehavioral responses of alcohol exposure in a translational perspective.

Spatial variation and determinant factors of alcohol consumption in Ethiopia: Spatial and multilevel analysis of Ethiopian demographic and health survey

BACKGROUND

Alcohol consumption continues to be a public health problem in Ethiopia. Previous investigations have been conducted on alcohol consumption in Ethiopia; however, these investigations were limited to specific localities, which could not represent the existing alcohol consumption in different parts of Ethiopia. Besides, the spatial variation of alcohol consumption was not well investigated in the previous studies, which could hinder the implementation of effective intervention towards alcohol consumption. Hence, this study aimed to determine the spatial distribution and determinant factors of alcohol consumption in Ethiopia.

METHODS

Secondary data from the 2016 Ethiopian demographic health survey was used in this study. A total of 44,023 weight samples were included using a stratified two-stage cluster sampling technique. The spatial variation of alcohol consumption was analyzed using ArcGIS version 10.7.1. The statistical significance of alcohol consumption clusters were identified using Kuldorff's SaTScan version 10.2. A multi-level analysis was also conducted to identify factors associated with alcohol consumption using STATA version 14.

RESULTS

In this study, 33.15% (95%CI: 32.5-33.8) of the study participants consumed alcohol with statistically significant spatial variation across regions of the country. Traditional religion (AOR = 13.7; 95%CI: 2.68-70.3), Regional variations (Amhara region-AOR = 3.56; 95%CI: 1.85-6.8, living in a low proportion of community literacy (AOR = 1.84; 95%CI: 1.1-3.18), cigarette smoking habit (AOR = 15.82; 95%CI: 4.31-58.1), and chewing Khat (AOR = 2.98; 95%CI: 1.22-7.27) were positively linked with alcohol consumption. Hot spot areas of alcohol consumption were found in Tigray, Amhara, and some parts of Oromia regions. The statistical significance of the primary clusters was also observed in Tigray and Amhara regions.

CONCLUSIONS

We found that one-third of Ethiopia's population is consuming alcohol. Having a cigarette smoking habit, chewing khat, high proportion of community literacy, and traditional religion were associated factors for alcohol consumption. Therefore, the federal government of Ethiopia, and ministry of health, and other concerned bodies should work in collaboration to decrease the proportion of people consuming alcohol.

Correlates of Tobacco Use Among People with Mental Illness Within Asia: A Scoping Review

Tobacco use among people with mental illness is one of the contributing risk factors for premature morbidity and mortality. Two in three people with mental illness are current smokers with deteriorating physical health and quality of life. This review outlines the prevalence and predictors of tobacco use among people with mental illness in Asia. Twenty-five cross-sectional studies were selected from the exhaustive search of databases. Ten countries emerged based on the number of studies conducted within Asia among people diagnosed with mental illness and tobacco use, namely, India (8), China (7), Pakistan (2), Singapore (2), Sri Lanka (01), Japan (01), Jordan (01), Malaysia (01), Korea (01), and Taiwan (01). The prevalence of tobacco use was in the range of 3.6% to 89.4%, with the measure of precision at 95% confidence. The highest and lowest prevalence was reported in China, followed by India. Being male, separated, lower education, unemployed, lack of family support, a psychotic diagnosis, lack of knowledge, motivation, and a coping mechanism were predictors of tobacco use. This review emphasized the extent and predictors of tobacco use among this vulnerable group that need to be reflected while initiating and implementing cessation strategies by healthcare providers.

Major Depression in Comorbidity with Substance use Disorders: Patients' Features and Clinical-Neurobiological Rationale of Antidepressant Treatments

The frequent co-occurrence of major depressive disorder (MDD) and substance use disorders (SUDs) entails significant clinical challenges. Compared to patients with MDD alone, patients with MDD and SUD often show increased anhedonia, emotional blunting, and impaired cognitive function. These symptoms lead to an inability to control cravings, more substance use, increased relapse rates, and poor adherence to the treatment. This fosters a detrimental cycle leading to more severe depressive symptoms, functional impairment, and chronicity, culminating in heightened morbidity, mortality, and healthcare resource utilization. Data on antidepressant treatment of MDD-SUD patients are inconclusive and often conflicting because of a number of confounding factors in clinical trials or difficulty in dissecting the specific contributions of pharmacological versus psychological interventions in real-world studies. The patient's unique clinical features and specific SUD and MDD subtypes must be considered when choosing treatments. Ideally, drug treatment for MDD-SUD should act on both conditions and address core symptoms such as anhedonia, craving, and cognitive dysfunction while ensuring minimal emotional blunting, absence of drug interactions, and no addictive potential. This approach aims to address unmet needs and optimize the outcomes in a clinical population often underrepresented in treatment paradigms.

Health disparities and injection drug use behaviors among adults with and without disabilities in the National Survey on drug use and health, 2015-2019

BACKGROUND

Little is known about the prevalence of injection drug use in people with disabilities (PWD) when compared by disability type and to other adults without disabilities.

OBJECTIVE OR HYPOTHESIS

The prevalence of past-year injection drug use will be higher in adults with a reported disability than adults without any reported disability.

METHODS

This study consisted of secondary analyses of data from the 2015-2019 National Survey of Drug Use and Health. The analytic sample comprised 214,505 US adults. Self-reported past-year injection drug use represented the outcome of interest. Disability status and socioeconomic characteristics were conceptualized as predictors, and sex and age were used as controls.

RESULTS

Past-year prevalence of self-reported injection drug use was 0.24 % (95 % CI, 0.22-0.27) in adults without a disability but 0.66 % (95 % CI, 0.59-0.73) in adults with a disability. All disability types examined were associated with increased odds of reporting past-year injection drug use, but the strongest association was observed for disability related to difficulty concentrating (AOR, 4.90; 95 % CI, 3.92-6.14). Adjusted odds of past-year methamphetamine injection were more than three times as high in adults with a disability, compared to those without a disability (AOR, 3.21; 95 % CI, 2.37-4.33) and more than two times as high in adults with a disability for cocaine injection (AOR, 2.77; 95 % CI, 1.84-4.15).

CONCLUSION

Disability status is associated with injection of various types of drugs, and a variety of disability types are associated with higher odds of injection drug use.

How Dangerous? Substance Use Risk Perceptions in Chilean Preadolescents

Early substance use initiation among children represents a significant risk to public health. Research suggests that early positive perceptions and cognitions of elementary students toward substance use may predict later use during adolescence. Studies among adolescent populations have shown an inverse relationship between substance use and risk perceptions. To gain insight into alcohol, tobacco, and marijuana risk perceptions prior to adolescence, we analyzed data from the Chilean Early Childhood Longitudinal Survey (ELPI). In a sample of 5,278 families (mean age of preadolescents 10.63 years, SD = .64; 50.5% males), our findings showed that an important proportion of Chilean 10 years old did not perceive occasional tobacco, alcohol, or marijuana use to be high-risk activities. However, the majority of respondents did consider daily substance use to be a high-risk activity, with some variation across substances. Overall, older preadolescents were more likely to consider substance use to be less risky compared to their slightly younger counterparts. Our analysis also demonstrated that past month substances use by caregivers were all found to be predictive of low-medium risk perceptions among preadolescents surveyed, while conversely, caregivers' negative reactions to finding out their child had used a substance decreased the likelihood of holding low-medium risk perceptions. Individuals from single-parent households were less likely to consider substance use as being high-risk compared to their peers. Preadolescents with caregivers reporting higher average incomes were also more likely to hold lower risk perceptions of occasional substance use. Implications for public policies to prevent substance use in the pre-adolescent population are discussed.

A global review of the impact on women from men's alcohol drinking: the need for responding with a gendered lens

BACKGROUND

Global evidence shows that men's harmful alcohol use contributes to intimate partner violence (IPV) and other harms. Yet, interventions that target alcohol-related harms to women are scarce. Quantitative analyses demonstrate links with physical and verbal aggression; however, the specific harms to women from men's drinking have not been well articulated, particularly from an international perspective.

AIM

To document the breadth and nature of harms and impact of men's drinking on women.

METHODS

A narrative review, using inductive analysis, was conducted of peer-reviewed qualitative studies that: (a) focused on alcohol (men's drinking), (b) featured women as primary victims, (c) encompassed direct/indirect harms, and (d) explicitly featured alcohol in the qualitative results. Papers were selected following a non-time-limited systematic search of key scholarly databases.

RESULTS

Thirty papers were included in this review. The majority of studies were conducted in low- to middle-income countries. The harms in the studies were collated and organised under three main themes: (i) harmful alcohol-related actions by men (e.g. violence, sexual coercion, economic abuse), (ii) impact on women (e.g. physical and mental health harm, relationship functioning, social harm), and (iii) how partner alcohol use was framed by women in the studies.

CONCLUSION

Men's drinking results in a multitude of direct, indirect and hidden harms to women that are cumulative, intersecting and entrench women's disempowerment. An explicit gendered lens is needed in prevention efforts to target men's drinking and the impact on women, to improve health and social outcomes for women worldwide.

Effectiveness of Machine Learning-Based Adjustments to an eHealth Intervention Targeting Mild Alcohol Use

INTRODUCTION

This study aimed to evaluate effects of three machine learning based adjustments made to an eHealth intervention for mild alcohol use disorder, regarding (a) early dropout, (b) participation duration, and (c) success in reaching personal alcohol use goals. Additionally, we aimed to replicate earlier machine learning analyses.

METHODS

We used three cohorts of observational log data from the Jellinek Digital Self-help intervention. First, a cohort before implementation of adjustments (T0; n = 320); second, a cohort after implementing two adjustments (i.e., sending daily emails in the first week and nudging participants towards a "no alcohol use" goal; T1; n = 146); third, a cohort comprising the prior adjustments complemented with eliminated time constraints to reaching further in the intervention (T2; n = 236).

RESULTS

We found an increase in participants reaching further in the intervention, yet an increase in early dropout after implementing all adjustments. Moreover, we found that more participants aimed for a quit goal, whilst participation duration declined at T2. Intervention success increased, yet not significantly. Lastly, machine learning demonstrated reliability for outcome prediction in smaller datasets of an eHealth intervention.

CONCLUSION

Strong correlates as indicated by machine learning analyses were found to affect goal setting and use of an eHealth program for alcohol use problems.

Effects of psychedelics on neurogenesis and broader neuroplasticity: a systematic review

In the mammalian brain, new neurons continue to be generated throughout life in a process known as adult neurogenesis. The role of adult-generated neurons has been broadly studied across laboratories, and mounting evidence suggests a strong link to the HPA axis and concomitant dysregulations in patients diagnosed with mood disorders. Psychedelic compounds, such as phenethylamines, tryptamines, cannabinoids, and a variety of ever-growing chemical categories, have emerged as therapeutic options for neuropsychiatric disorders, while numerous reports link their effects to increased adult neurogenesis. In this systematic review, we examine studies assessing neurogenesis or other neurogenesis-associated brain plasticity after psychedelic interventions and aim to provide a comprehensive picture of how this vast category of compounds regulates the generation of new neurons. We conducted a literature search on PubMed and Science Direct databases, considering all articles published until January 31, 2023, and selected articles containing both the words "neurogenesis" and "psychedelics". We analyzed experimental studies using either in vivo or in vitro models, employing classical or atypical psychedelics at all ontogenetic windows, as well as human studies referring to neurogenesis-associated plasticity. Our findings were divided into five main categories of psychedelics: CB1 agonists, NMDA antagonists, harmala alkaloids, tryptamines, and entactogens. We described the outcomes of neurogenesis assessments and investigated related results on the effects of psychedelics on brain plasticity and behavior within our sample. In summary, this review presents an extensive study into how different psychedelics may affect the birth of new neurons and other brain-related processes. Such knowledge may be valuable for future research on novel therapeutic strategies for neuropsychiatric disorders.

Age- and sex-standardized prevalence of alcohol consumption and its determinants in the western region of Iran, Ilam: a cross-sectional study

BACKGROUND AND OBJECTIVE

In recent years, alcohol consumption in different parts of Iran has increased. However, this growth was dramatic in deprived regions. The percent study aimed to determine the age-sex standardized prevalence of alcohol consumption and related factors in the general population of Ilam city during 2021-2022.

METHOD

This population-based cross-sectional study was conducted in the general population of Ilam city located in western Iran. A total of 1,431 individuals over the age of 15 were included in the study using multi-stage cluster sampling. Alcohol consumption was assessed using a Persian version of high-risk behavior questionnaire (Cronbach's alpha > 73%). Analysis was done by Stata version 11 and R Software. Logistic regression analysis was used for data analysis and calculating odds ratio (OR), and a significance level of 0.05 was considered.

RESULTS

In total 1,431 individuals completed the questionnaire. The mean ± standard deviation (SD) age of the study participants was 43.40 ± 15.51 years. The age-sex standardized prevalence with 95% confidence interval (CI) of alcohol consumption was 4.05% (95% CI: 3.09 to 5.20). Based on multiple logistic model, having a bachelor's degree (OR: 7.13; 95% CI: 1.89 to 26.76), cigarette smoking (OR: 6.92; 95% CI: 2.94 to 16.29), hookah smoking (OR: 7.34; 95% CI: 3.09 to 17.47) and drug abuse (OR: 2.88; 95% CI: 1.38 to 5.99) had a positive association with alcohol consumption. Furthermore, having a high economic status 0.62 (OR: 0.62; 95% CI: 0.26 to 1.48) had a negative association with alcohol consumption. The most powerful determinants (according to standardized coefficient) for alcohol consumption were hookah smoking (standardized coefficient: 0.588) and high education level (0.743).

CONCLUSION

Considering the prevalence of alcohol consumption in the population over 15 years old, it is necessary to take preventive and intervention measures, with more attention from health policymakers and other sectors.