Tag: SUD: Substance Use Disorder

College Students & Substance Use: Do They Require different Strategies for Prevention & Intervention?

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Research Paper Title

Cumulative Risk of Substance Use in Community College Students.

Background

Substance use in community college students has been explored in only a handful of studies.

Differences in population characteristics and substance use between 2- and 4-year students suggest that different factors may promote and thwart this behaviour.

Cumulative risk is a parsimonious methodology that provides better model stability and more statistical power, yet it has only been recently used in substance use research.

The aim of this study is to investigate multiple aspects of substance use risk in a population in need of substance use prevention and intervention services.

Methods

The researchers conducted a cross-sectional study of community college students (N = 288; 75% female) examining the relative contributions of different domains of cumulative risk (eg, life stressors, academic stressors, and mental health diagnoses) to develop different profiles of risk across substance use classes (ie, alcohol, cigarette, marijuana, and hard drug use).

Results

Cumulative risk analyses indicated that alcohol and tobacco use were associated with the domains of life stressors and peer/family substance use, marijuana use with peer/family substance use and stressful childhood experiences, and hard drug use with peer/family substance use, lack of social support, low access to care, and stressful childhood experiences.

Conclusions

Different strategies for prevention and intervention may be necessary to effectively address different forms of substance use in this population.

Scientific Significance

The risk domain profiles related to specific drugs may lead to targeted interventions to reduce substance use in community college students.

Reference

Salgado García, F., Bursac, Z. & Derefinko, K.J. (2020) Cumulative Risk of Substance Use in Community College Students. The American Journal on Addictions. 29(2), pp.97-104. doi: 10.1111/ajad.12983. Epub 2020 Jan 3.

Considering Drug-Associated Contexts in Substance Use Disorders and Treatment Development.

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Research Paper Title

Considering Drug-Associated Contexts in Substance Use Disorders and Treatment Development.

Background

Environmental contexts that are reliably associated with the use of pharmacologically active substances are hypothesized to contribute to substance use disorders.

In this review, the researchers provide an updated summary of parallel pre-clinical and human studies that support this hypothesis.

Methods

Research conducted in rats shows that environmental contexts that are reliably paired with drug use can renew extinguished drug-seeking behaviour and amplify responding elicited by discrete, drug-predictive cues.

Akin to drug-associated contexts, interoceptive drug stimuli produced by the psychopharmacological effects of drugs can also influence learning and memory processes that play a role in substance use disorders.

Results

Findings from human laboratory studies show that drug-associated contexts, including social stimuli, can have profound effects on cue reactivity, drug use, and drug-related cognitive expectancies.

This translationally relevant research supports the idea that treatments for substance use disorders could be improved by considering drug-associated contexts as a factor in treatment interventions.

The researchers conclude this review with ideas for how to integrate drug-associated contexts into treatment-oriented research based on 4 approaches:

  • Pharmacology;
  • Brain stimulation;
  • Mindfulness-based relapse prevention; and
  • Cognitive behavioural group therapy.

Throughout, the researchers focus on alcohol- and tobacco-related research, which are two of the most prevalent and commonly misused drugs worldwide for which there are known treatments.

Reference

LeCocq, M.R., Randall, P.A., Besheer, J. & Chaudhri, N. (2020) Considering Drug-Associated Contexts in Substance Use Disorders and Treatment Development. Neurotherapeutics. 17(1), pp.43-54. doi: 10.1007/s13311-019-00824-2.

Can CBD Capsules Treat Cannabis Addiction?

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For individuals who are addicted to cannabis, one treatment option may be, paradoxically, to take pills that contain an extract of the drug.

The first test of the idea has found that indiviudals taking capsules of this extract, known as cannabidiol (CBD), nearly halved the amount of cannabis they smoked, according to recent research.

Cannabis is often seen as a soft drug, but according to one estimate about one in 10 people can become addicted, getting withdrawal symptoms such as anxiety when they try to stop using it.

The number of individuals seeking treatment because they can not quit smoking cannabis has been rising in the past decade, linked with use of the more potent form known as skunk.

There are two main psychoactive substances in cannabis:

  • The first is CBD; and
  • The second is the compound is tetrahydrocannabinol (THC).

THC is responsible for the drug’s high and, while THC tends to increase anxiety, CBD calms – it gets rid of eh toxic effects of THC.

In a recent study, Val Curran and her colleagues at the University College London, ran a trial in which participants took CBD for four weeks to alleviate withdrawal symptoms to help them quit smoking cannabis.

The trial involved 82 individuals classed as severely addicted to the drug, who were given one of three different doses of CBD in capsule form or a placebo (they all, also, had psychological support).

  • The middle dose of 400 milligrams worked best – after six months, it halved the amount of cannabis each individual used compared with placebo, as shown by tests for THC in their urine.
    • The 400 milligram dose also more than doubled the number of days when individuals had no THC in their urine.
  • The highest dose of 800 milligrams was slightly less effective than the middle one.
  • The lowest dose did not work.

A previous study has shown that individuals can also be helped to quit smoking cannabis by treatment with Sativex, a cannabis extract with both CBD and THC, deployed in a similar way to nicotine replacement therapy for tobacco users.

Academics suggest there could be advantages to using CBD alone. CBD has a variety of anti-addictive properties.

Researchers are also investigating CBD as a treatment for alcohol addiction. Two of the main features during alcohol detoxification are:

  • Severe anxiety; and
  • Risk of seizures.

It is believed that CBD has very strong anxiety-reducing properties, but this is still being researched.

Curran’s study also found preliminary evidence that CBD may help individuals to give up smoking tobacco.

CBD supplements are increasingly sold in pharmacies and health food shops as remedies for a range of illnesses, but at much lower doses than those used in Curran’s trial.

Many of the health claims made for them are not (currently) based on evidence. Therefore the current advice is that anyone who cannot stop smoking cannabis should seek medical assistance.

Reference

New Scientist. (2019) CBD Capsules May Treat Cannabis Addiction. New Scientist. 19 October 2019, pp.9.

Feeling the Pain: Substance Misuse & Generalised Anxiety Disorder

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Research Paper Title

An Examination of Comorbid Generalized Anxiety Disorder and Chronic Pain on Substance Misuse in a Canadian Population-Based Survey.

Background

Chronic pain and generalized anxiety disorder (GAD) are co-occurring, and both conditions are independently associated with substance misuse.

However, limited research has examined the impact of comorbid GAD and chronic pain on substance misuse.

The aim of this article was to examine the associations between comorbid GAD and chronic pain conditions compared to GAD only with non-medical opioid use, drug abuse/dependence, and alcohol abuse/dependence in a Canadian, population-based sample.

Methods

Data came from the 2012 Canadian Community Health Survey-Mental Health (N = 25,113). Multiple logistic regressions assessed the associations between comorbid GAD and chronic pain conditions (migraine, back pain, and arthritis) on substance misuse.

Results

Comorbid GAD + back pain and GAD + migraine were associated with increased odds of non-medical opioid use compared to GAD only.

However, the relationship was no longer significant after controlling for additional chronic pain conditions.

No significant relationship was found between GAD + chronic pain conditions with drug or alcohol abuse/dependence.

Conclusions

Comorbid GAD + back pain and GAD + migraine have a unique association with non-medical opioid use in Canadians compared to GAD only, and chronic pain multi-morbidity may be driving this relationship.

Results emphasise the need for screening for substance misuse and prescription access in the context of GAD and comorbid chronic pain.

Reference

Bilevicius, E., Sommer, J.L., Keough, M.T. & El-Gabalawy, R. (2020) An Examination of Comorbid Generalized Anxiety Disorder and Chronic Pain on Substance Misuse in a Canadian Population-Based Survey. Canadian Journal of Psychiatry. doi: 10.1177/0706743719895340. [Epub ahead of print].

What are the Factors Associated with Anxiety Disorders among Patients with Substance Use Disorders

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Research Paper Title

Factors associated with anxiety disorders among patients with substance use disorders in Lebanon: Results of a cross-sectional study.

Background

Estimate the rate of anxiety disorders (AD) and associated factors among patients with substance use disorder (SUD) in Lebanon.

Methods

A cross-sectional study, conducted between April and September 2017, enrolled 57 inpatients with SUD.

Results

The rate of AD in patients with SUD was 61.4%. The university level of education compared to the primary level of education (ORa = 0.221) was significantly associated with lower anxiety among patients with SUD. Being sexually abused and having a family history of depression tended to significance.

Conclusions

AD is widespread in Lebanon and high rates of anxiety in patients with SUD were found, warranting the implementation of strategic interventions and establishing national policies and legislation for mental health services to provide optimal care.

Reference

Haddad, C., Darwich, M.J., Obeid, S., Sacre, H., Zakhour, M., Kazour, F., Nabout, R., Hallit, S. & Tahan, F.E. (2019) Factors associated with anxiety disorders among patients with substance use disorders in Lebanon: Results of a cross-sectional study. Perspectives in Psychiatric Care. doi: 10.1111/ppc.12462. [Epub ahead of print].

Do Pregnant & Postpartum Women in OUD Treatment have the Potential to Benefit from Access to PSS throughout their Perinatal Period?

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Research Paper Title

Peer support specialists and perinatal opioid use disorder: Someone that’s been there, lived it, seen it.

Background

Perinatal opioid use disorder (OUD) has increased drastically since 2000 and is associated with myriad adverse outcomes.

The Substance Abuse and Mental Health Services Administration (SAMHSA) recommends using peer support services to promote sustained remission from substance use disorders (SUDs).

Integrating peer support specialists into perinatal OUD treatment has the potential to improve maternal and child health.

However, there is limited published research on the experiences of pregnant and parenting women with peer support specialists during SUD treatment.

The purpose of this study was to:

  1. Describe experiences of perinatal women undergoing OUD treatment with peer support specialists; and
  2. Describe recommendations for improving or enhancing peer support services.

Methods

For this qualitative descriptive study, the researchers conducted two focus groups in a private location in a clinic that serves postpartum women with OUD (N = 9) who were parenting a child under the age of 5.

The focus groups were voice recorded, professionally transcribed, and analyzed in MAXQDA using content analysis.

Results

Four themes emerged from the data:

  1. Feeling Supported by Peer Support Specialists;
  2. Qualities of an ‘Ideal’ Peer Support Specialist;
  3. Strategies to Improve Interactions with Peer Support Specialists; and
  4. Importance of Communication Across the Perinatal Period.

Participants reported that PSSs had a strong, positive impact on their recovery.

Postpartum women report overall positive experiences receiving peer support services during their pregnancy and postpartum period.

However, participants offered suggestions to improve their interactions with PSSs, such as clarifying the boundaries between peer supporters and clients.

Conclusions

Pregnant and postpartum women in OUD treatment have the potential to benefit from access to PSS throughout their perinatal period.

Future research is needed to determine the impact of PSS on sustained recovery for perinatal women with OUD.

Reference

Fallin-Bennett, A., Elswick, A. & Ashford, K. (2019) Peer support specialists and perinatal opioid use disorder: Someone that’s been there, lived it, seen it. Addictive Behaviors. 102:106204. doi: 10.1016/j.addbeh.2019.106204. [Epub ahead of print].