Substance-Related and Addictive Disorders

2014 ◽  
Author(s):  
Benjamin R. Bryan ◽  
Frances R. Levin
Keyword(s):  
Substance Use ◽  
Drug Use ◽  
Substance Use Disorders ◽  
Alcohol Use Disorder ◽  
Behavioral Therapy ◽  
Evidence Based ◽  
Addictive Behaviors ◽  
Addictive Disorders ◽  
Psychotherapeutic Interventions ◽  
Drug Use Pattern

Alcohol use disorder tends to have a progressive course with varying outcomes. The rate of onset of a drug’s effects and the rate at which the effects diminish or are lost affect the evolution of a drug use pattern into a substance use disorder. Depression, psychosis, anxiety, and delirium are all common symptoms associated with drug use. Many patients underestimate the amount of alcohol or drugs they use when asked by a physician. Patients with addictive behaviors demonstrate varying degrees of denial. Evidence-based psychotherapeutic interventions for the treatment of substance use disorders include motivational interviewing and cognitive-behavioral therapy. A number of medications are available for treatment of substance use disorders: acamprosate, buprenorphine, bupropion, disulfiram, methadone, naloxone, naltrexone, and varenicline.

Evidence-Based Behavioral Therapies for Substance Use Disorders

2020 ◽  
pp. 267-282
Author(s):  
Kathryn Polak ◽  
Sydney Kelpin ◽  
Jarrod Reisweber ◽  
Dace S. Svikis
Keyword(s):  
Gender Differences ◽  
Substance Use ◽  
Substance Use Disorders ◽  
Brief Intervention ◽  
Behavioral Therapy ◽  
Contingency Management ◽  
Psychosocial Interventions ◽  
Evidence Based ◽  
Behavioral Therapies ◽  
Selection Of

A variety of pharmacological and psychosocial interventions have demonstrated efficacy in the treatment of substance use disorders (SUDs). This chapter focuses on evidence-based behavioral and psychosocial interventions for the treatment of alcohol use disorder and other SUDs. Among the interventions discussed are screening, brief intervention, and referral to treatment (SBIRT); motivational interviewing (MI); cognitive behavioral therapy (CBT); and contingency management (CM). Additionally, one promising intervention for SUD, Transcending Self Therapy (TST), is spotlighted. The importance of comprehensive care is noted by the authors, as is the importance of recognizing gender differences in the selection of therapies and the need to address barriers to care for specific populations.

scholarly journals Inventory and Analysis of Controlled Trials of Mobile Phone Applications Targeting Substance Use Disorders: A Systematic Review

2021 ◽  
Vol 12 ◽  
Author(s):  
Rubaab Bahadoor ◽  
Jean-Marc Alexandre ◽  
Lucie Fournet ◽  
Thibaut Gellé ◽  
Fuschia Serre ◽  
...  
Keyword(s):  
Systematic Review ◽  
Substance Use ◽  
Substance Use Disorders ◽  
Mobile Health ◽  
Addiction Treatment ◽  
Controlled Trials ◽  
Addictive Behaviors ◽  
Double Blind ◽  
Adequate Treatment ◽  
Addictive Disorders

Background: Less than 20% of people with addictions have access to adequate treatment. Mobile health could improve access to care. No systematic review evaluates effectiveness of mobile health applications for addiction.Objectives: First aim was to describe controlled trials evaluating the effectiveness of smartphone applications targeting substance use disorders and addictive behaviors. Secondly, we aimed to understand how the application produced changes in behavior and craving management.Method: A systematic review based on PRISMA recommendations was conducted on MEDLINE, CENTRAL, and PsycINFO. Studies had to be controlled trials concerning addictive disorders (substance/behavior), mobile application-based interventions, assessing effectiveness or impact of those applications upon use, published after 2008. Relevant information was systematically screened for synthesis. Quality and risk of bias were evaluated with JADAD score.Results: Search strategy retrieved 22 articles (2014-2019) corresponding to 22 applications targeting tobacco, alcohol, other substances and binge eating disorder. Control groups had access to usual treatments or a placebo-application or no treatment. Eight applications showed reduced use. Most of the applications informed about risks of use and suggestions for monitoring use. Twelve applications managed craving.Discussion: Heterogeneity limited study comparisons. Duration of studies was too short to predict sustainable results. A reduction of craving seemed related to a reduction in use.Conclusion: There is a lack of robust and comparable studies on mHealth applications for addiction treatment. Such applications could become significant contributors in clinical practice in the future so longer-termed double-blind studies are needed. Targeting craving to prevent relapse should be systematic.

scholarly journals Assessment of Sexual Functions among Male with Substance Use Disorders

2021 ◽  
pp. 64-74
Author(s):  
Ahmed Osama Tolba ◽  
Mohammad Abd El Hakim Selem ◽  
Maged Mostafa Ragab ◽  
Ahmed Abd El Rahman Mubarak ◽  
Adel Abd El Kerem Badawy
Keyword(s):  
Substance Abuse ◽  
Substance Use ◽  
Drug Use ◽  
Substance Use Disorders ◽  
Life Assessment ◽  
Psychiatric Evaluation ◽  
Control Group ◽  
Sexual Dysfunctions ◽  
Psychiatric Interview ◽  
Addictive Disorders

Background: Recent epidemiological and clinical studies confirmed the presence of a strong association between substance use disorders and sexual dysfunctions. Studies have demonstrated that prevalence of sexual dysfunctions among addict was about 30 %the most common problem among male substance abuse patients were Erectile Dysfunction (ED) and delayed ejaculation Methods: This cohort comparative study was conducted on of 376 males aged between 18 – 50 years who were substance abusers including tramadol, cannabis and poly substance related and addictive disorders. All participants were subjected to psychiatric interview which was done using SCID-5-CV structured clinical interview for DSM-5 disorders. Psychometric, biochemical, medical and drug history evaluations were also performed. Results: Our results show comparison between four groups (opiates-cannabis-poly substance abuse and control group according to severity of drug abuse, psychiatric evaluation and according to sexual functions. There were statistically significant differences between groups in sociodemographic data mainly in occupational and educational history. There also were statistically significant differences between groups in terms of drug use, psychiatric assessment, assessment of sexual activity, hormonal assessment of the studied population and quality of life assessment. Conclusions: Long term drug use has a statistically significant negative effect on all domains of male sexual functions. Also average daily dose and severity of addiction are significantly correlated to sexual dysfunctions in patients with tramadol abuse. This is done through an alteration in sex hormone and alters feedback regulations of the pituitary on the hypothalamus.

The Holy Trinity

2021 ◽  
pp. 33-44
Author(s):  
David A. Patterson Silver Wolf
Keyword(s):  
Substance Use ◽  
Cognitive Behavioral Therapy ◽  
Motivational Interviewing ◽  
Substance Use Disorders ◽  
Behavioral Therapy ◽  
National Level ◽  
Cognitive Behavioral ◽  
Twelve Step ◽  
Evidence Based ◽  
Holy Trinity

Decades of research have identified three effective treatments for substance use disorders. This chapter explores the three most studied and proven evidence-based interventions: Motivational Interviewing, Cognitive Behavioral Therapy, and Twelve-Step Facilitation. The inconsistency or infrequency with which evidence-based interventions are used in the treatment of addictions is finally getting some attention at the national level, and there are new recommendations regarding the deployment of treatment approaches. It is important for the reader to understand the roots of these three interventions and why, despite being easy to learn and likely to work, they are not regularly being deployed inside of treatment centers.

scholarly journals The Profound Heterogeneity of Substance Use Disorders: Implications for Treatment Development

2021 ◽  
pp. 096372142110269
Author(s):  
Kathleen M. Carroll
Keyword(s):  
Substance Use ◽  
Substance Use Disorders ◽  
Behavioral Therapy ◽  
Full Range ◽  
Treatment Development ◽  
Computer Based Training ◽  
Tailored Interventions ◽  
Effective Interventions ◽  
Computer Based ◽  
Disorder Type

A single treatment approach will never be sufficient to address the diversity of individuals with substance use disorders (SUDs). SUDs have historically defied definition through simple characterizations or models, and no single characterization has led to the development of broadly effective interventions. The range of dimensions of heterogeneity among individuals with SUDs, including severity of the disorder, type of substance, and issues that frequently co-occur, underscores the need for highly tailored approaches. Personalized medicine for individuals with SUDs will require two major developments. First, given the diversity of individuals with SUDs, multivariate phenotyping is needed to identify the particular features driving addictive processes in a given individual. Second, a wider range of interventions that directly target core mechanisms of addiction and the problems that co-occur with them is needed. As clinicians cannot be expected to master the full range of interventions that may target these core processes, developing interventions that can be delivered easily, flexibly, and systematically via technology will facilitate the ability to truly tailor them to this highly complex and challenging population. One such technology-delivered intervention, Computer-Based Training for Cognitive Behavioral Therapy (CBT4CBT), is used as an example to illustrate a vision for the future of highly tailored interventions for individuals with SUDs.

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 Evidence-Based Guidelines for Mental, Neurological, and Substance Use Disorders in Low- and Middle-Income Countries: Summary of WHO Recommendations

PLoS Medicine ◽  
2011 ◽  
Vol 8 (11) ◽  
pp. e1001122 ◽  
Author(s):  
Tarun Dua ◽  
Corrado Barbui ◽  
Nicolas Clark ◽  
Alexandra Fleischmann ◽  
Vladimir Poznyak ◽  
...  
Keyword(s):  
Substance Use ◽  
Substance Use Disorders ◽  
Evidence Based ◽  
Middle Income ◽  
Middle Income Countries ◽  
Evidence Based Guidelines ◽  
Low And Middle Income

Abstract 228: National Prevalence of Substance Use Disorders Among Hospitalized Heart Failure Patients

2018 ◽  
Vol 11 (suppl_1) ◽  
Author(s):  
Sarah C Snow ◽  
Gregg C Fonarow ◽  
Joseph A Ladapo ◽  
Donna L Washington ◽  
Katherine Hoggatt ◽  
...  
Keyword(s):  
Heart Failure ◽  
Substance Use ◽  
Native American ◽  
Drug Use ◽  
Substance Use Disorders ◽  
Age Groups ◽  
Opioid Use ◽  
Drug Use Disorders ◽  
Increased Risk ◽  
Drug Use Disorder

Background: Several cardiotoxic substances contribute to the development of heart failure (HF). The burden of comorbid substance use disorders (SUD) among patients with HF is under-characterized. Objectives: To describe the national burden of comorbid SUD (tobacco, alcohol, or drug use disorders) among hospitalized HF patients in the U.S. Methods: We used data from the 2014 National Inpatient Sample to calculate the proportion of hospitalizations for a primary HF admission with tobacco, alcohol, or drug use disorder diagnoses, accounting for demographic factors. Drug use disorder analysis was further sub-divided into specific illicit substance categories. Results: There were a total of 989,080 HF hospitalizations of which 35.3% (n=348,995) had a documented SUD. Tobacco use disorder (TUD) was most common (n= 327,220, 33.1%) followed by drug use disorder (DUD) (n=34,600, 3.5%) and alcohol use disorder (AUD) (n=34,285, 3.5%). Female sex was associated with less TUD (OR 0.59; 95% CI, 0.58-0.60), AUD (OR 0.23; 95% CI, 0.22-0.25) or DUD (OR 0.58; 95% CI 0.55-0.62). Tobacco, alcohol, cocaine, and opioid use disorders were highest among HF patients age 45 to 55, while cannabis and amphetamine use was highest in those <45 years. Native American race (versus White) was associated with increased risk of AUD (OR 1.67; 95% CI 1.27-2.20). Black race was associated with increased risk of AUD (OR 1.09; 95% CI 1.02-1.16) or DUD (OR 1.63; 95% CI 1.53-1.74). Medicaid insurance (versus Medicare) was associated with greater TUD (OR 1.27; 95% CI 1.23-1.32), AUD (OR 1.74; 95% CI 1.62-1.87), and DUD (OR 2.15; 95% CI 2.01-2.30). Decreasing quartiles of median household income were associated with increasing SUD. Conclusions: Comorbid SUD disproportionately affects certain HF populations, including men, younger age groups, lower SES patients, and race/ethnic minorities. Further research on interventions to improve prevention and treatment of SUD among hospitalized HF patients are needed given the high rates of SUD in this population. Systematically screening hospitalized HF patients for SUD may reveal opportunities for treatment and secondary prevention.

scholarly journals “Turning the tide” in Treatment of substance use: A nursing response

2017 ◽  
Vol 8 (2) ◽  
pp. 116 ◽  
Author(s):  
Julie Worley ◽  
Kathleen R. Delaney
Keyword(s):  
Substance Use ◽  
Healthcare Provider ◽  
Substance Use Disorders ◽  
Evidence Based ◽  
Review Of Literature ◽  
Evidence Based Treatment ◽  
The Impact

Objective: To analyze science and practice surrounding nursing approaches to substance use disorders (SUDs) and make recommendations for the future.Methods: A review of literature and topics related to healthcare provider stigma, science surrounding SUDs, nursing approaches to SUDs in education and practice and evidence based treatment was conducted, analyzed and synthesized.Results: Stigma is embedded in nursing approach to SUDs, up to date information regarding SUDs is not widely disseminated or practiced in nursing.Conclusions: To reduce the impact of stigma and to bring nurses into the “turning the Tide” movement requires an understanding of how beliefs root stigma, building knowledge related to SUDs as an illness, and expansion of nurses' skill when intervening with individuals dealing with SUDs.

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