Drug and alcohol dependence
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Drug Alcohol Depend · Apr 2019
Identifying opioid prescribing patterns for high-volume prescribers via cluster analysis.
Despite recent decreases in opioid prescribing rates, evidence suggests there is substantial variation in the way opioids are prescribed by providers. This study aims to identify patterns in high-volume opioid prescribing. ⋯ These results provide a clearer picture of current patterns among high-volume prescribers, who accounted for almost two-thirds of all opioid prescriptions. In light of the ongoing opioid overdose epidemic, this knowledge is critical for prevention activities.
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Drug Alcohol Depend · Apr 2019
Randomized Controlled TrialVery-low-nicotine-content cigarettes and dependence among non-daily smokers.
The US Food and Drug Administration is considering reductions in the nicotine content of cigarettes to reduce smoking and tobacco dependence. A randomized study showed that even non-daily, intermittent smokers (ITS) reduced their cigarette consumption when switched to very-low-nicotine-content cigarettes (VLNCCs). This paper assesses whether switching ITS to VLNCCs results in decreased dependence and whether subsequent cigarette consumption is mediated by decreased dependence. ⋯ Among ITS, switching to VLNCCs results in reduced tobacco dependence. However, the reductions in dependence appear to be secondary to effects on cigarette consumption, and do not appear to be an independent predictor or cause of reduced cigarette consumption.
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Drug Alcohol Depend · Apr 2019
Association between polygenic risk for tobacco or alcohol consumption and liability to licit and illicit substance use in young Australian adults.
Co-morbid substance use is very common. Despite a historical focus using genetic epidemiology to investigate comorbid substance use and misuse, few studies have examined substance-substance associations using polygenic risk score (PRS) methods. ⋯ To our knowledge, this is the first study to report significant genetic overlap between the polygenic risks for smoking initiation and alcohol consumption and the risk of initiating major classes of illicit substances. PRSs constructed from large discovery GWASs allows the detection of novel genetic associations.
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Drug Alcohol Depend · Apr 2019
Co-occurring substance use and mental disorders among adults with opioid use disorder.
Co-occurring substance use and mental disorders among people with opioid use disorder (OUD) increase risk for morbidity and mortality. Addressing these co-occurring conditions is critical for improving treatment and health outcomes. There is limited recent research on the prevalence of co-occurring disorders, demographic characteristics associated with co-occurring disorders, and receipt of mental health and substance use treatment services among those with OUD. This limits the development of targeted and resourced policies and clinical interventions. ⋯ Co-occurring substance use and mental disorders are common among adults with OUD. Expanding access to comprehensive service delivery models that address the substance use and mental health co-morbidities of this population is urgently needed.
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Drug Alcohol Depend · Apr 2019
Randomized Controlled TrialIntegrated cognitive behavioral therapy for ADHD in adult substance use disorder patients: Results of a randomized clinical trial.
Attention Deficit Hyperactivity Disorder (ADHD) frequently co-occurs with Substance Use Disorders (SUDs). Standard ADHD pharmacotherapies are not effective in patients with this comorbidity and cognitive behavioral therapy (CBT) has not been tested in this population. This RCT aimed to compare the efficacy of Integrated CBT (CBT/Integrated) directed at adult ADHD and SUD with CBT directed at SUD only (CBT/SUD) in patients with SUD and ADHD (SUD + ADHD). ⋯ Compared to regular SUD cognitive behavioral therapy, integrated cognitive behavioral therapy resulted in a significant extra improvement in ADHD symptoms in SUD + ADHD patients.