Substance Use Disorders

2020 ◽  
pp. 372-386
Author(s):  
Shirshendu Sinha ◽  
Bhanu Prakash Kolla ◽  
Meghna P. Mansukhani
Keyword(s):  
Substance Use ◽  
Substance Use Disorders ◽  
Sleep Disturbances ◽  
Time Course ◽  
Drugs Of Abuse ◽  
Treatment Options ◽  
Treatment Strategies ◽  
Specific Treatment ◽  
Early Recovery ◽  
Individual Substance

Sleep disturbances although highly prevalent conditions in patients with substance use disorders, they are underreported, underrecognized, underdiagnosed, and often untreated. Alcohol and various drugs of abuse interfere with the initiation and maintenance of sleep. The sleep disturbances can be experienced during active substance use including intoxication as well as during early recovery. Literature also indicates insomnia is a risk factor for substance abuse. Thus sleep disturbances can play a major role in initiating and maintaining substance use and increase the risk of relapse. This review describes the existing literature on the bidirectional relationships between sleep disturbances and substance use disorders in the context of alcohol, cannabis, opioid, and cocaine use disorders. Evidence with regards the type and severity of the sleep disruption, its time course, relationship to relapse, and treatment options when available are discussed. Specific treatment strategies focused on individual substance-related sleep disturbances will improve global outcome in substance use disorders and sleep and enhance the quality of life of the patients.

scholarly journals Interactions of neuroimmune signaling and glutamate plasticity in addiction

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.

scholarly journals Common and separable neural alterations in substance use disorders: evidence from coordinate-based meta-analyses of functional neuroimaging studies in human

2020 ◽  
Author(s):  
Benjamin Klugah-Brown ◽  
Xin Di ◽  
Jana Zweerings ◽  
Klaus Mathiak ◽  
Benjamin Becker ◽  
...  
Keyword(s):  
Substance Use ◽  
Substance Use Disorders ◽  
Cognitive Processes ◽  
Functional Neuroimaging ◽  
Meta Analysis ◽  
Treatment Strategies ◽  
Specific Treatment ◽  
Behavioral Alterations ◽  
Meta Analyses

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.

scholarly journals Molecular Subtypes and Precision Oncology in Intrahepatic Cholangiocarcinoma

2021 ◽  
Vol 10 (13) ◽  
pp. 2803
Author(s):  
Carolin Czauderna ◽  
Martha M. Kirstein ◽  
Hauke C. Tews ◽  
Arndt Vogel ◽  
Jens U. Marquardt
Keyword(s):  
Clinical Care ◽  
Treatment Options ◽  
Treatment Strategies ◽  
Specific Treatment ◽  
Growth Factor Receptor ◽  
Treatment Modalities ◽  
Precision Oncology ◽  
Recurrence Rates ◽  
Isocitrate Dehydrogenase 1 ◽  
Liver Cancers

Cholangiocarcinomas (CCAs) are the second-most common primary liver cancers. CCAs represent a group of highly heterogeneous tumors classified based on anatomical localization into intra- (iCCA) and extrahepatic CCA (eCCA). In contrast to eCCA, the incidence of iCCA is increasing worldwide. Curative treatment strategies for all CCAs involve oncological resection followed by adjuvant chemotherapy in early stages, whereas chemotherapy is administered at advanced stages of disease. Due to late diagnosis, high recurrence rates, and limited treatment options, the prognosis of patients remains poor. Comprehensive molecular characterization has further revealed considerable heterogeneity and distinct prognostic and therapeutic traits for iCCA and eCCA, indicating that specific treatment modalities are required for different subclasses. Several druggable alterations and oncogenic drivers such as fibroblast growth factor receptor 2 gene fusions and hotspot mutations in isocitrate dehydrogenase 1 and 2 mutations have been identified. Specific inhibitors have demonstrated striking antitumor activity in affected subgroups of patients in phase II and III clinical trials. Thus, improved understanding of the molecular complexity has paved the way for precision oncological approaches. Here, we outline current advances in targeted treatments and immunotherapeutic approaches. In addition, we delineate future perspectives for different molecular subclasses that will improve the clinical care of iCCA patients.

Sleep Disturbances and Substance Use Disorders: A Bi-Directional Relationship

2016 ◽  
Vol 46 (7) ◽  
pp. 408-412 ◽  
Author(s):  
Anjum Ara ◽  
William Jacobs ◽  
Ishrat Ali Bhat ◽  
W. Vaughn McCall
Keyword(s):  
Substance Use ◽  
Substance Use Disorders ◽  
Sleep Disturbances

Characteristics of sleep disturbances related to substance use disorders

2020 ◽  
Vol 120 (5) ◽  
pp. 153
Author(s):  
M.V. Vetrova ◽  
K.V. Rybakova ◽  
O.V. Goncharov ◽  
D.N. Kuchmenko ◽  
I.N. Genina ◽  
...  
Keyword(s):  
Substance Use ◽  
Substance Use Disorders ◽  
Sleep Disturbances

Introduction and Overview

2016 ◽  
Author(s):  
Kenneth J. Sher ◽  
Alvaro Vergés
Keyword(s):  
Substance Use ◽  
Genetic Variation ◽  
Substance Use Disorders ◽  
Drugs Of Abuse ◽  
Psychological Processes ◽  
Cultural Contexts ◽  
Fundamental Nature ◽  
Chronic Effects ◽  
Multidisciplinary Perspective ◽  
Acute And Chronic Effects

Substance use and substance use disorders (SUDs) have been documented in a number of cultures since the beginnings of recorded time and represent major societal concerns in the present day. The chapters in this Handbook review a number of different areas of inquiry into the fundamental nature of substance use and SUDs, their features, their causes, their consequences, their course, their treatment, and their prevention. It is clear that understanding these various aspects of substance use and SUDs requires a multidisciplinary perspective that considers the pharmacology of drugs of abuse, genetic variation in these acute and chronic effects, and psychological processes in the context of the interpersonal and cultural contexts. This chapter provides a general overview of most (but not all) of the topics covered in the Handbook, guiding the reader to the relevant chapters that address each topic in more detail.

Differences in prevalence and patterns of substance use in schizophrenia and bipolar disorder

2007 ◽  
Vol 38 (9) ◽  
pp. 1241-1249 ◽  
Author(s):  
P. A. Ringen ◽  
T. V. Lagerberg ◽  
A. B. Birkenæs ◽  
J. Engn ◽  
A. Færden ◽  
...  
Keyword(s):  
Bipolar Disorder ◽  
Substance Use ◽  
Drug Use ◽  
Treatment Strategies ◽  
Specific Treatment ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Use Patterns ◽  
Bipolar Spectrum Disorder ◽  
Frequent Use

BackgroundSchizophrenia and bipolar disorder have partly overlapping clinical profiles, which include an over-representation of substance-use behaviour. There are few previous studies directly comparing substance-use patterns in the two disorders. The objective of the present study was to compare the prevalence of substance use in schizophrenia and bipolar disorder, and investigate possible differences in pattern and frequency of use.MethodA total of 336 patients with schizophrenia or bipolar spectrum disorder from a catchment area-based hospital service were included in a cross-sectional study. In addition to thorough clinical assessments, patients were interviewed about drug-use history, habits and patterns of use. The prevalence and drug-use patterns were compared between groups.ResultsPatients with bipolar disorder had higher rates of alcohol consumption, while schizophrenia patients more often used centrally stimulating substances, had more frequent use of non-alcoholic drugs and more often used more than one non-alcoholic drug. Single use of cannabis was more frequent in bipolar disorder.ConclusionThe present study showed diagnosis-specific patterns of substance use in severe mental disorder. This suggests a need for more disease-specific treatment strategies, and indicates that substance use may be an important factor in studies of overlapping disease mechanisms.

Spirituality, Religiosity and Addiction Recovery: Current Perspectives

2019 ◽  
Vol 11 (1) ◽  
pp. 26-32 ◽  
Author(s):  
Livia Beraldo ◽  
Felipe Gil ◽  
Antonio Ventriglio ◽  
Arthur G. de Andrade ◽  
Antonio Geraldo da Silva ◽  
...  
Keyword(s):  
Substance Use ◽  
Substance Use Disorders ◽  
Prospective Studies ◽  
Therapeutic Option ◽  
Treatment Options ◽  
Public Health Problem ◽  
Mediation Effect ◽  
Opioid Use ◽  
Important Public Health Problem ◽  
Positive Effects

Substance use disorders are an important public health problem with a multifactorial etiology and limited effective treatment options. Within this context, spirituality-based approaches may provide interesting and useful options in managing substance use disorders. This kind of intervention can have positive effects in alleviating some core symptoms associated with substance use, such as aggressiveness. Improvement in cessation rates for alcohol, cocaine and opioid use disorders have also been described in some clinical studies. However, spirituality may not play a beneficial role in some subgroups, such as among individuals with crack cocaine and cannabis use disorders. A widely available intervention for alcohol use disorders is Alcoholics Anonymous (AA), which can be seen as a spirituality-based intervention. Spirituality also seems to be especially beneficial for minorities such as Latinos, African-Americans and Native-Americans. Moreover, spiritual-based interventions are also helpful alternatives in many rural environments where conventional healthcare for substance use disorders may not be easily available. However, spiritual-based interventions may be considered as a possible adjunctive therapeutic option to conventional treatments. There is a need for prospective studies outside U.S., especially where spiritual-based approaches are available. It may be difficult to carry out randomized controlled trials because of the nature of the spiritual/ religious dimensions. However, prospective studies that evaluate mediation effect of spirituality and religiosity on recovery would be helpful. Qualitative studies combined with quantitative design offer excellent options to evaluate the recovery process, especially among special populations.

Turn the Next Page

2020 ◽  
pp. 327-356
Author(s):  
Kathryn A. Cunningham ◽  
Amanda E. Price ◽  
F. Gerard Moeller ◽  
Noelle C. Anastasio
Keyword(s):  
Substance Use ◽  
Eating Disorder ◽  
Substance Use Disorders ◽  
Binge Eating Disorder ◽  
Treatment Strategies ◽  
Cognitive Restructuring ◽  
Neural Systems ◽  
Addictive Disorders ◽  
Brain Circuitry ◽  
Optimal Window

Contemporary research has enriched our knowledge of mechanisms involved in the generation and persistence of the debilitating disorders characterized by an “addictive dimensionality,” such as substance use disorders and binge eating disorder. Personalized treatment strategies for addictive disorders might include one or a combination of medications at important stages in detoxification and recovery to reduce craving, assist in establishing a substance-free state, and open the optimal window to allow cognitive restructuring and enhanced inhibitory control of substance-seeking. The overlapping neural systems and brain circuitry involved across addictive disorders have elevated interest in the metabolic and neural regulators serotonin (5-hydroxytryptamine; 5-HT) and ghrelin. This chapter focuses on these systems as examples of how we can broaden our horizons for advancing future therapeutic and biomarker initiatives.

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