N-acetylcysteine in substance use disorder: a lesson from preclinical and clinical research

Pharmacological Reports ◽

10.1007/s43440-021-00283-7 ◽

2021 ◽

Author(s):

Irena Smaga ◽

Małgorzata Frankowska ◽

Małgorzata Filip

Keyword(s):

Substance Use ◽

Substance Use Disorder ◽

Drugs Of Abuse ◽

Current Knowledge ◽

Drug Seeking ◽

New Strategy ◽

Seeking Behavior ◽

Mucolytic Agent ◽

Brain Condition

AbstractSubstance use disorder (SUD) is a chronic brain condition, with compulsive and uncontrollable drug-seeking that leads to long-lasting and harmful consequences. The factors contributing to the development of SUD, as well as its treatment settings, are not fully understood. Alterations in brain glutamate homeostasis in humans and animals implicate a key role of this neurotransmitter in SUD, while the modulation of glutamate transporters has been pointed as a new strategy to diminish the excitatory glutamatergic transmission observed after drugs of abuse. N-acetylcysteine (NAC), known as a safe mucolytic agent, is involved in the regulation of this system and may be taken into account as a novel pharmacotherapy for SUD. In this paper, we summarize the current knowledge on the ability of NAC to reduce drug-seeking behavior induced by psychostimulants, opioids, cannabinoids, nicotine, and alcohol in animals and humans. Preclinical studies showed a beneficial effect in animal models of SUD, while the clinical efficacy of NAC has not been fully established. In summary, NAC will be a small add-on to usual treatment and/or psychotherapy for SUD, however, further studies are required.

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Role of Neurocognition in the Etiology of Substance Use Disorder

PsycEXTRA Dataset ◽

10.1037/e535332007-001 ◽

2006 ◽

Author(s):

Ralph E. Tarter

Keyword(s):

Substance Use ◽

Substance Use Disorder

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Interactions of neuroimmune signaling and glutamate plasticity in addiction

Journal of Neuroinflammation ◽

10.1186/s12974-021-02072-8 ◽

2021 ◽

Vol 18 (1) ◽

Author(s):

Cassandra D. Gipson ◽

Scott Rawls ◽

Michael D. Scofield ◽

Benjamin M. Siemsen ◽

Emma O. Bondy ◽

...

Keyword(s):

Substance Use ◽

Drug Use ◽

Substance Use Disorders ◽

Drugs Of Abuse ◽

Treatment Strategies ◽

Glutamate Signaling ◽

Open Questions ◽

Seeking Behavior ◽

Glutamate System ◽

Chronic Use

AbstractChronic use of drugs of abuse affects neuroimmune signaling; however, there are still many open questions regarding the interactions between neuroimmune mechanisms and substance use disorders (SUDs). Further, chronic use of drugs of abuse can induce glutamatergic changes in the brain, but the relationship between the glutamate system and neuroimmune signaling in addiction is not well understood. Therefore, the purpose of this review is to bring into focus the role of neuroimmune signaling and its interactions with the glutamate system following chronic drug use, and how this may guide pharmacotherapeutic treatment strategies for SUDs. In this review, we first describe neuroimmune mechanisms that may be linked to aberrant glutamate signaling in addiction. We focus specifically on the nuclear factor-kappa B (NF-κB) pathway, a potentially important neuroimmune mechanism that may be a key player in driving drug-seeking behavior. We highlight the importance of astroglial-microglial crosstalk, and how this interacts with known glutamatergic dysregulations in addiction. Then, we describe the importance of studying non-neuronal cells with unprecedented precision because understanding structure-function relationships in these cells is critical in understanding their role in addiction neurobiology. Here we propose a working model of neuroimmune-glutamate interactions that underlie drug use motivation, which we argue may aid strategies for small molecule drug development to treat substance use disorders. Together, the synthesis of this review shows that interactions between glutamate and neuroimmune signaling may play an important and understudied role in addiction processes and may be critical in developing more efficacious pharmacotherapies to treat SUDs.

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Recovery-informed Theory: Situating the Subjective in the Science of Substance Use Disorder Recovery

Journal of Recovery Science ◽

10.31886/jors.13.2019.38 ◽

2019 ◽

Vol 1 (3) ◽

pp. 1-15 ◽

Cited By ~ 5

Author(s):

Austin M Brown ◽

Robert D Ashford

Keyword(s):

Substance Use ◽

Substance Use Disorders ◽

Substance Use Disorder ◽

Systems Of Care ◽

Grand Theory ◽

Recovery Strategies ◽

Recovery Capital ◽

New Ideas

As recovery from substance use disorder becomes more than a mere quantifiable outcome, there exists a need to discuss and propose the underlying theoretical constructs that ultimately describe and identify the science of recovery. In this abstract undertaking, we propose an initial formulation of a grand theory of recovery science, built upon the seminal theories of recovery capital, recovery-oriented systems of care, and socioecological theory. This grand theory - labeled recovery-informed theory (RIT) - states that successful long-term recovery is self-evident and is a fundamentally emancipatory set of processes. This paper will discuss, analyze, and explore this theory as it is situated within the larger substance use, misuse, and disorder contexts. The uses, implications, and benefits of RIT as an organizing point of inquiry for recovery science are also discussed. By promoting the role of subjective recovery experience in the formulation of the study of recovery, it may be possible to summon new ideas, metrics, and strategies that can directly address substance use disorders in society. Adopting a recovery-informed understanding as follows from this grand theory may allow individual recovery and wellness trajectories to be explored, adapted, and modified to exemplify person-centered and individualized recovery strategies.

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Outline of This Treatment Program

Concurrent Treatment of PTSD and Substance Use Disorders Using Prolonged Exposure (COPE) ◽

10.1093/med:psych/9780199334537.003.0002 ◽

2014 ◽

pp. 25-42

Author(s):

Sudie E. Back ◽

Edna B. Foa ◽

Therese K. Killeen ◽

Katherine L. Mills ◽

Maree Teesson ◽

...

Keyword(s):

Substance Use ◽

Substance Use Disorders ◽

Substance Use Disorder ◽

Treatment Program ◽

Post Traumatic Stress Disorder ◽

Traumatic Stress ◽

Post Traumatic Stress ◽

Post Traumatic ◽

Focus Questions

This chapter provides the therapist with an outline of the COPE treatment and components of each session (e.g. check-in, review homework, post-traumatic stress disorder [PTSD] focus, substance use disorder focus). Questions regarding who can deliver the therapy are addressed, as well as questions regarding the role of medications. Finally, special considerations for delivering treatment to patients with PTSD and comorbid substance use disorders are reviewed for the therapist.

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Impulsivity and Drug-Seeking Behavior in Substance Misuse

Substance Use Disorders ◽

10.1093/med/9780190920197.003.0004 ◽

2020 ◽

pp. 65-86

Author(s):

Noelle C. Anastasio ◽

Dennis J. Sholler ◽

Brionna D. Davis-Reyes ◽

Amanda E. Price ◽

Michelle A. Land ◽

...

Keyword(s):

Substance Use ◽

Cue Reactivity ◽

Complex Nature ◽

Psychoactive Drugs ◽

Negative Consequences ◽

Drug Seeking ◽

Drug Cues ◽

Seeking Behavior ◽

The Impact ◽

Substances Of Abuse

Vulnerability to initiate use of psychoactive drugs as well as relapse to drug-seeking in patients with established substance use disorders are precipitated by behavioral disinhibition or impulsivity (a predisposition toward rapid unplanned reactions to stimuli without regard to negative consequences) and attentional bias toward drug cues (cue reactivity). These behavioral phenotypes are not independent mechanistically nor neurobiologically, and preclinical analyses have demonstrated the complex nature of the interactions between these interlocked phenotypic behaviors, including aspects of their shared neurobiology and circuitry. This chapter focuses on impulsivity and drug-seeking behaviors from a preclinical perspective and summarizes studies exploring the impact of substances of abuse in the context of the neurobiology of impulsivity and drug-seeking behaviors in rodents.

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Boredom Proneness and Aggression Among People With Substance Use Disorder: The Mediating Role of Trait Anger and Impulsivity

Journal of Drug Issues ◽

10.1177/0022042619886822 ◽

2019 ◽

Vol 50 (1) ◽

pp. 77-88

Author(s):

Qilong Cao ◽

Jing An

Keyword(s):

Substance Use ◽

Substance Use Disorder ◽

Positive Relationship ◽

Trait Anger ◽

Mediating Role ◽

Boredom Proneness ◽

Using Data ◽

Multiple Mediator Model ◽

The Relationship

Boredom proneness has been linked to aggressive behaviors; however, the relationship between them is not well understood. To better understand the mechanism underlying the relationship between boredom proneness and aggression, a serial multiple mediator model was built, where boredom proneness impacted aggression simultaneously through (a) impulsivity, (b) trait anger, and (c) impulsivity to trait anger. Using data collected among Chinese substance users, a battery of interview questionnaires was completed. Results from this study indicate a positive relationship between boredom proneness, impulsivity, trait anger, and aggression. Moreover, the mediating role of impulsivity, trait anger, and both impulsivity and trait anger in serial were found. This study reflects that the link from boredom proneness to aggression among substances users could be partially explained via impulsivity and anger.

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