The interplay of genes and adolescent development in substance use disorders: leveraging findings from GWAS meta-analyses to test developmental hypotheses about nicotine consumption

AbstractDelineating common and separable neural alterations in substance use disorders (SUD) is imperative to understand the neurobiological basis of the addictive process and to inform substance-specific treatment strategies. Given numerous functional MRI (fMRI) studies in different SUDs, meta-analysis could provide an opportunity to determine robust shared and substance-specific alterations. The present study employed a coordinate-based meta-analysis covering fMRI studies in individuals with addictive cocaine, cannabis, alcohol, and nicotine use. The primary meta-analysis demonstrated common alterations in primary dorsal striatal, and frontal circuits engaged in reward/salience processing, habit formation, and executive control across different substances and task-paradigms. Subsequent sub-analyses revealed substance-specific alterations in frontal and limbic regions, with marked frontal and insula-thalamic alterations in alcohol and nicotine use disorders respectively. Finally, examining task-specific alterations across substances revealed pronounced frontal alterations during cognitive processes yet stronger striatal alterations during reward-related processes. Together the findings emphasize the role of dysregulations in striato-frontal circuits and dissociable contributions of these systems in the domains of reward-related and cognitive processes which may contribute to substance-specific behavioral alterations.

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The prevalence of substance use disorders and substance use in anorexia nervosa: a systematic review and meta-analysis

Journal of Eating Disorders ◽

10.1186/s40337-021-00516-3 ◽

2021 ◽

Vol 9 (1) ◽

Author(s):

Daniel J. Devoe ◽

Gina Dimitropoulos ◽

Alida Anderson ◽

Anees Bahji ◽

Jordyn Flanagan ◽

...

Keyword(s):

Systematic Review ◽

Substance Use ◽

Anorexia Nervosa ◽

Drug Abuse ◽

Binge Eating ◽

Substance Use Disorders ◽

Meta Analysis ◽

English Summary ◽

High Prevalence ◽

Meta Analyses

Abstract Aim Individuals with anorexia nervosa (AN) often present with substance use and substance use disorders (SUDs). However, the prevalence of substance use and SUDs in AN has not been studied in-depth, especially the differences in the prevalence of SUDs between AN types [e.g., AN-R (restrictive type) and AN-BP (binge-eating/purge type]. Therefore, this systematic review and meta-analysis aimed to assess the prevalence of SUDs and substance use in AN samples. Method Systematic database searches of the peer-reviewed literature were conducted in the following online databases: MEDLINE, PsycINFO, Embase, and CINAHL from inception to January 2021. We restricted review eligibility to peer-reviewed research studies reporting the prevalence for either SUDs or substance use in individuals with AN. Random-effects meta-analyses using Freeman–Tukey double arcsine transformations were performed on eligible studies to estimate pooled proportions and 95% confidence intervals (CIs). Results Fifty-two studies met the inclusion criteria, including 14,695 individuals identified as having AN (mean age: 22.82 years). Random pooled estimates showed that substance use disorders had a 16% prevalence in those with AN (AN-BP = 18% vs. AN-R = 7%). Drug abuse/dependence disorders had a prevalence of 7% in AN (AN-BP = 9% vs. AN-R = 5%). In studies that looked at specific abuse/dependence disorders, there was a 10% prevalence of alcohol abuse/dependence in AN (AN-BP = 15% vs. AN-R = 3%) and a 6% prevalence of cannabis abuse/dependence (AN-BP = 4% vs. AN-R = 0%). In addition, in terms of substance use, there was a 37% prevalence for caffeine use, 29% prevalence for alcohol use, 25% for tobacco use, and 14% for cannabis use in individuals with AN. Conclusion This is the most comprehensive meta-analysis on the comorbid prevalence of SUDs and substance use in persons with AN, with an overall pooled prevalence of 16%. Comorbid SUDs, including drugs, alcohol, and cannabis, were all more common in AN-BP compared to AN-R throughout. Therefore, clinicians should be aware of the high prevalence of SUD comorbidity and substance use in individuals with AN. Finally, clinicians should consider screening for SUDs and integrating treatments that target SUDs in individuals with AN. Plain English Summary Individuals with anorexia nervosa (AN) may also present with substance use or have a substance use disorder (SUDs). Thus, we conducted a systematic review and meta-analysis to determine the prevalence of substance use and substance use disorders in individuals with AN. We examined published studies that reported the prevalence of either substance use or SUDs in individuals with AN. We found that substance use disorders had a 16% prevalence and that drug abuse/dependence disorders had a prevalence of 7% in those with AN. These rates were much higher in individuals with binge-eating/purging type compared to the restrictive AN. However, many specific substance use disorders and substance use types were low in individuals with AN. Nonetheless, clinicians should be aware of the high prevalence of SUD comorbidity and substance use in individuals with AN.

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Digital Mental Health for Alcohol and Substance Use Disorders

Current Treatment Options in Psychiatry ◽

10.1007/s40501-019-00190-y ◽

2019 ◽

Vol 6 (4) ◽

pp. 352-366 ◽

Cited By ~ 2

Author(s):

Nikolaos Boumparis ◽

Mieke H. J. Schulte ◽

Heleen Riper

Keyword(s):

Substance Use ◽

Alcohol Use ◽

Active Control ◽

Substance Use Disorders ◽

Control Groups ◽

Digital Interventions ◽

Other Substances ◽

Meta Analyses ◽

Active Controls

Abstract Purpose Only about 20% of people suffering from substance use disorders access available treatments due to various obstacles; digital interventions could potentially overcome some of these. Meta-analyses suggest the strongest evidence for interventions targeting alcohol use reduction, followed by cannabis and illicit substances. However, most randomized controlled trials (RCTs) used unguided standalone interventions compared to non-active controls, with limited follow-up periods and disregarded comorbidity. This review examines the literature published over the last three years (2016–2019), with a focus on recent RCTs and whether they addressed some of these gaps. Recent findings Except for digital interventions targeting alcohol use, the number of RCTs in the last three years is limited. Although there is considerable heterogeneity between the studies, most of them applied unguided add-on interventions compared to active control groups, and a limited number investigated guided interventions. In addition, there is a need for longer follow-up periods, active rather than non-active control groups, outcome standardization, and increased focus on comorbidity. Summary Although the number of studies using guided add-on or blended interventions compared to active controls has increased, future studies should consider our identified gaps and suggestions to further strengthen the evidence of digital interventions for reducing the use of alcohol and other substances.

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Does Early Exposure to Stimulants Lead to Substance Use Disorders Later on?

Ethical Human Psychology and Psychiatry ◽

10.1891/1559-4343.17.1.22 ◽

2015 ◽

Vol 17 (1) ◽

pp. 22-32 ◽

Cited By ~ 1

Author(s):

Jonathan E. Prousky

Keyword(s):

Substance Use ◽

Substance Use Disorders ◽

Stimulant Medication ◽

Behavioral Changes ◽

Childhood And Adolescence ◽

Early Exposure ◽

Hyperactivity Disorder ◽

Childhood Problems ◽

The Central Nervous System ◽

Meta Analyses

Attention deficit/hyperactivity disorder (ADHD) denotes childhood problems of hyperactivity, inattention, and impulsivity, leading to impairments in daily functioning, scholastic performance, and relationships with peers. Although the rationale for stimulant medication is to reduce the morbidity associated with having ADHD, critics have argued that methylphenidate and other prescribed stimulant drugs (PSDs) are overly prescribed and inherently dangerous. Researchers have also raised concerns that PSDs might prime the central nervous system, thus rendering individuals more susceptible to substance use disorders (SUDs) later in life. There is also a strong comorbidity between ADHD and SUDs in adulthood. If many adults with SUDs were prescribed stimulants for ADHD as children or during adolescence, this could suggest that taking these drugs during these critical developmental periods increase the risks for SUDs later on. Research articles (i.e., both animal and human data) were reviewed to ascertain if any associations exist between PSDs and brain and behavioral changes. Review articles, meta-analyses, clinical trials, and clinical data were examined to assess associations between PSDs during childhood and adolescence and the development of SUDs in adolescence and adulthood. Contentious evidence does suggest that PSDs are not likely responsible for substance use and SUDs in adolescence, although it remains equivocal if PSDs offer any protection against substance use and abuse in adolescence. Although PSDs do reduce symptoms of ADHD that may interfere with learning in childhood, the evidence raises the possibility that these drugs might be responsible for substance use and SUDS in some adults.

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