Opioid use in the United States has steadily risen since the 1990s, along with staggering increases in addiction and overdose fatalities. With this surge in prescription and illicit opioid abuse, it is paramount to understand the genetic risk factors and neuropsychological effects of opioid use disorder (OUD). Polymorphisms disrupting the opioid and dopamine systems have been associated with increased risk for developing substance use disorders. Molecular imaging studies have revealed how these polymorphisms impact the brain and contribute to cognitive and behavioral differences across individuals. Here, we review the current molecular imaging literature to assess how genetic variations in the opioid and dopamine systems affect function in the brain's reward, cognition, and stress pathways, potentially resulting in vulnerabilities to OUD. Continued research of the functional consequences of genetic variants and corresponding alterations in neural mechanisms will inform prevention and treatment of OUD.

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Molecular Imaging of Opioid and Dopamine Systems: Insights Into the Pharmacogenetics of Opioid Use Disorders.

Risk taking, sensation seeking and personality as related to changes in substance use from adolescence to young adulthood.

Personality traits are related with risk of hazardous alcohol use and alcohol dependence. The Substance Use Risk Profile Scale (SURPS) measures personality traits associated with addictive substance abuse. We examined psychometric properties of the SURPS in Lithuanian population. Two hundred forty-seven participants (mean age 37.22 ± 0.78 years), were recruited from the local community and from an inpatient addiction treatment centre. Internal consistency, stability, factor structure, content validity, and external validity of the SURPS were examined. Hazardous alcohol use was evaluated by Alcohol Use Disorder Identification Test (AUDIT). Alcohol dependence diagnosis was established by International Classification of Diseases - 10 (ICD - 10). We also performed gender analyses for associations of personality traits with alcohol dependence and hazardous use of alcohol. The SURPS scale demonstrated appropriate internal validity, good temporal stability, and adequate criterion validity and construct validity. The SURPS scores of hopelessness, anxiety sensitivity and impulsivity were higher in the alcohol dependence group than in the control group for both males and females. Impulsivity and sensation seeking were associated with hazardous alcohol use and these associations were more prevalent in females. Lithuanian translation of the SURPS scale was appropriate. The SURPS demonstrated good sensitivity for discriminating on alcohol dependence and was more sensitive for discriminating on hazardous alcohol use for females.

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Validation of the Substance Use Risk Profile Scale in Lithuanian population

Clinical symptoms and personality traits predict subpopulations of treatment-seeking substance users.

Problematic alcohol use is a major contributor to the global burden of death and disabilities, and it represents a public health concern that has grown substantially following the COVID-19 pandemic. The available treatment options remain limited and to develop better pharmacotherapies for alcohol misuse we need to identify suitable biological targets. Previous research has implicated the brain's endocannabinoid system (ECS) in psychiatric and stress-related outcomes, including substance use and habituation to repeated stress. Moreover, genetic variants in the cannabinoid-1 receptor gene (CNR1; CB1R) have been associated with personality traits, which are in turn predictors of substance use disorders. To date, however, no human genome-wide association study has provided evidence for an involvement of the ECS in substance use outcomes. One reason for this ECS-related "missing heritability" may be unexamined gene-environment interactions. To explore this possibility, we conducted cross-sectional analyses using DNA samples and stress-exposure data from a longitudinal Swedish population-based study (N = 2,915). Specifically, we genotyped rs2023239, a functional C/T single nucleotide polymorphism in CNR1, previously reported to be associated with CNR1 binding in the brain, subjective reward following alcohol intake, and alcohol cue-elicited brain activation. Our two outcomes of interest were (i) problematic alcohol use based on the Alcohol Use Disorders Identification Test (AUDIT), and (ii) personality trait scores based on the Five Factor Model. We found no baseline association between rs2023239 and problematic alcohol use or personality traits. However, there was a clear trend for interaction between rs2023239's risk allele (C) and stressful life events (SLEs) in both childhood and adulthood, which predicted problematic alcohol use. Although not significant, there was also some indication that the risk allele interacted with child SLEs to increase scores on neuroticism. Our study supports the notion that the ECS can affect alcohol intake behaviors by interacting with life adversities and is-to the best of our knowledge-the first to focus on the interaction between CNR1 and stressors in both childhood and adulthood in humans. Further studies are warranted to confirm these findings. 

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The cannabinoid receptor-1 gene interacts with stressful life events to increase the risk for problematic alcohol use

Background The prevalence of female alcohol and substance abusers has markedly increased. The main objective of this research was to explore personality profiles among females who had alcohol and opiate dependence. Aim The aim of the study is to analyse if there is differences in personality profiles of females addicted to alcohol and opiates. We hypothesized that there might be significant differences in personality profiles among subgroups of women who present with alcohol and opiate use disorders. Subjects and methods Of 157 consecutive women with diagnosis of alcohol/opiate addiction, 62 fulfilled following inclusion criteria: age 19-45 years, abstinence from alcohol and opiates for at least 10 days prior to enrollment. Alcohol-dependent group consisted of 30 females, while opiate-dependent group consisted of 32 females. The control group involved 30 age-matched randomly chosen healthy women. The data were collected using the Revised NEO Personality Inventory (NEO-PI-R). The multiple stepwise discriminant analysis was used to determine relations between personality traits and the probability of belonging to one of the study groups. Results Significant differences in the NEO-PI-R scores were observed between groups for all main personality traits except for Openness to Experience. Compared with controls, substance-dependent women scored significantly higher on Neuroticism and lower on Conscientiousness. Opiate-dependent females scored the highest on Neuroticism and on Extraversion and lowest on Agreeableness and on Conscientiousness. Alcohol-dependent females scored higher on Conscientiousness and lower on Neuroticism compared to opiate-dependent women. Conclusions The results of our study confirmed significant characteristics in personality profiles among females with alcohol and opiate dependence, as well as the difference between these two groups of substance abusers and their healthy controls. The distinct personality characteristics among different groups of substance addicted women should be taken into account when creating the most effective program of prevention and therapeutic approaches in this specific cohort.

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Five-Factor Model Personality Profiles: The Differences between Alcohol and Opiate Addiction among Females.

Hospital pharmacy is a specialized field within pharmacy and an integral part of healthcare provided to hospitalized patients in a healthcare institution, striving to maintain and continuously improve medication management and pharmaceutical care for patients in line with the highest standards in a hospital environment. Purpose of the study was to monitor pharmaceutical healthcare quality indicators for in-hospital pharmacies, to explain the concept of quality and provide recommendations for the provision of pharmaceutical healthcare in secondary and tertiary healthcare institutions through pharmaceutical healthcare quality indicators. We used the case study method as an in-depth, intense and precisely focused method of descriptive research to present our three-case series. To analyse case studies, we selected hospital pharmacies in three healthcare institutions, the Clinical-Hospital Center (CHC) Zvezdara, University Clinical Center (UCC) Kragujevac and Special Hospital for Addiction Diseases (SHAD). Reference framework was established according to pharmaceutical healthcare quality indicators taken from a pilot project on quality indicators in hospital pharmacies entitled "Indicators of quality and patient safety in pharmaceutical healthcare - hospital pharmacy" from 2012. Data was collected from questionnaires that were filled in directly by pharmacists from pharmacy databases and records from regular everyday work activities. For the purposes of achieving second and third objectives of this study, we performed a literature search for the quality of pharmaceutical healthcare and quality indicators. Comparison of the calculated indicators from the 3 health care institutions presented in our case series provided insight into indicators that are monitored in all three healthcare institutions (6 indicators) as well as in the distribution of indicators by institutions encompassed by our research. Comparative analysis of the calculated indicators by healthcare institutions indicates that I1 is monitoring 12 indicators, I2 9 indicators and I3 8 indicators. Only 1 indicator from the pilot project is being monitored in line with the new "Rule-book on healthcare quality indicators and on the evaluation of the quality of professional work" in the observed institutions (adverse reactions to the medicines/medical devices). The same Rule-book imposes monitoring of another 4 indicators, pointing to improvement of the healthcare system and modernization of pharmaceutical healthcare. It can hence be concluded that the implementation of new indicators requires recommendations and that further research is necessary to determine how to assess pharmaceutical healthcare efficiency and quality that are to be improved through indicators introduced in the pharmaceutical healthcare practice.

Diana Raketic

Papers

Five-Factor Model Personality Profiles: The Differences between Alcohol and Opiate Addiction among Females.

Analysis of quality indicators of pharmaceutical healthcare provided in in-patient healthcare institutions: Case study