Showing papers in "American Journal of Drug and Alcohol Abuse in 2017"
TL;DR: The results suggest that in the context of a structured treatment program, psilocybin holds considerable promise in promoting long-term smoking abstinence, adding to recent and historical evidence suggesting high success rates when using classic psychedelics in the treatment of addiction.
Abstract: Background: A recent open-label pilot study (N = 15) found that two to three moderate to high doses (20 and 30 mg/70 kg) of the serotonin 2A receptor agonist, psilocybin, in combination with cognitive behavioral therapy (CBT) for smoking cessation, resulted in substantially higher 6-month smoking abstinence rates than are typically observed with other medications or CBT alone. Objectives: To assess long-term effects of a psilocybin-facilitated smoking cessation program at ≥12 months after psilocybin administration. Methods: The present report describes biologically verified smoking abstinence outcomes of the previous pilot study at ≥12 months, and related data on subjective effects of psilocybin. Results: All 15 participants completed a 12-month follow-up, and 12 (80%) returned for a long-term (≥16 months) follow-up, with a mean interval of 30 months (range = 16–57 months) between target-quit date (i.e., first psilocybin session) and long-term follow-up. At 12-month follow-up, 10 participants (67%...
377 citations
TL;DR: In this paper, the authors reviewed existing epidemiologic research on the smoking behaviors of persons with depressive symptoms and disorders and identified gaps in the literature that warrant further study, and concluded that persons with depression, compared to those without depression, are more like...
Abstract: Background: Smoking and depression are both leading causes of disability, mortality and morbidity around the world. Using epidemiologic data to study the association between depression and the severity, course, and persistence of smoking in the general population is important for understanding the scope of the problem of smoking among people with depression. Objectives: The current paper aims to critically review existing epidemiologic research on the smoking behaviors of persons with depressive symptoms and disorders and to identify gaps in the literature that warrant further study. Methods: Literature searches of Medline and EMBASE were used to identify articles that analyzed epidemiologic data and examined an aspect of smoking behavior in persons with depressive symptoms or disorders. Six hundred ninety-three abstracts were reviewed and 45 studies met all of the inclusion criteria to be included in the review. Results: Persons with depression, compared to those without depression, are more like...
165 citations
TL;DR: Future studies should continue to focus on alcohol and tobacco/nicotine interactions in individuals with a wide scope of drinking and smoking histories, different states of alcohol and nicotine deprivation, and influences of either drug on craving, subjective responses, and consumption over the course of the blood alcohol curve.
Abstract: Background: Alcohol use disorders and tobacco use contribute significant risk to the global burden of disease, and each are major public health concerns. Together, alcohol and tobacco use are highly comorbid and have multiplicative health risks when used concurrently, underscoring the importance of examining alcohol-tobacco interactions in the human laboratory. Objective: The aims of this review were to summarize the state of research examining alcohol-tobacco interactions in the human laboratory. Methods: We reviewed human laboratory evidence for alcohol and tobacco/nicotine interactions, including 1) craving in drinkers and smokers exposed to smoking or drinking cues, 2) fixed-dosing of alcohol or nicotine in smokers and drinkers, and 3) smoking and alcohol influences on self-administration behaviors. The interactive effects of tobacco/nicotine with other drugs of abuse are also briefly discussed. Results: Overall, results identified that alcohol and tobacco have reciprocal influences on potenti...
95 citations
TL;DR: Cognitive remediation targeting these deficits might increase the related functions that mediate the ability to moderate or abstain from alcohol, and so lead to improved treatment results.
Abstract: Background: Promising models for cognitive rehabilitation in alcohol treatment rest on a more nuanced understanding of the associated impairments in the multifaceted domains of executive functioning (EF) and impulsivity. Objectives: This meta-analysis examined the effects of alcohol on the individual subcomponents of EF and impulsivity in recently detoxified participants, including 1) Inhibition & Self-Regulation, 2) Flexibility & Set Shifting, 3) Planning & Problem Solving, 4) Reasoning & Abstraction, and 5) Verbal Fluency. Impulsivity was further examined through an analysis of motor, cognitive, and decisional subcategories. Method: Investigators searched, coded, and calculated effect sizes of impairments demonstrated in a broad range of neuropsychological tests for EF. A total of 77 studies were selected covering 48 years of research with a sample size of 5140. Results: Findings ranged from a Hedges’ g effect size of 0.803 for Inhibition to a Hedges’ g of 0.359 for Verbal Fluency. Results also ...
91 citations
TL;DR: It is suggested that substance self-concept is a promising, but understudied, construct that could clarify its potential as an important risk factor for hazardous use and addiction as well as its utility as a prevention and treatment target.
Abstract: Background: This paper provides an overview of the self-concept as it relates to substance use. Self-concept has a long history in psychological theory and research; however, substance self-concept (e.g., viewing one’s self as a drinker or smoker) is an understudied area of research with the potential to expand existing conceptualizations of substance use, addiction, and prevention and treatment efforts, and should receive greater research attention. Objectives: First, we review and provide a theoretical framework of substance self-concept that draws from dual process models and distinguishes between implicit and explicit self-concept. Next, we summarize key findings related to substance use in the extant literature, focusing on alcohol and tobacco (smoking). Results: Across both substances, there is converging evidence that substance self-concept is associated with substance use outcomes, including quantity and frequency of use and problems associated with use, and that change in substance self-c...
87 citations
TL;DR: Drug use is prevalent among college students, and drug use persists among young adults, even after many have graduated college, according to a longitudinal study of first-time, first-year students at a university in the mid-Atlantic US.
Abstract: Background: Drug use among college students is associated with adverse academic and health outcomes and risks to personal safety. Objectives: This study utilized data from a longitudinal study to estimate annual prevalence, cumulative lifetime prevalence, and incidence of ten types of drug use during the eight years after college entry and the average age of onset of each drug used. Methods: Participants (N = 1,253; 52% female) were young adults who were originally enrolled as first-time, first-year students at a university in the mid-Atlantic US. Annual personal interviews gathered data about the use of seven illicit drugs and three prescription drugs used nonmedically. Annual follow-up rates ranged from 76 to 91%. Results: Marijuana was the most commonly used drug in every year of the study, with the highest annual prevalence estimates in Year 3 (47%wt). In Year 8, when the modal age of participants was 25, 29%wt used marijuana during the past year. Nonmedical use of prescription drugs was more ...
78 citations
TL;DR: Recent clinical and preclinical data examining the genetic factors and mechanisms underlying co-use of nicotine and alcohol or cocaine and amphetamines are discussed, including the critical role of nicotinic acetylcholine receptors throughout, and the dearth of preclinical studies assessing concurrent drug exposure are emphasized.
Abstract: Concurrent use of tobacco and alcohol or psychostimulants represents a major public health concern, with use of one substance influencing consumption of the other. Co-abuse of these drugs leads to substantial negative health outcomes, reduced cessation, and high economic costs, but the underlying mechanisms are poorly understood. Epidemiological data suggest that tobacco use during adolescence plays a particularly significant role. Adolescence is a sensitive period of development marked by major neurobiological maturation of brain regions critical for reward processing, learning and memory, and executive function. Nicotine exposure during this time produces a unique and long-lasting vulnerability to subsequent substance use, likely via actions at cholinergic, dopaminergic, and serotonergic systems. In this review, we discuss recent clinical and preclinical data examining the genetic factors and mechanisms underlying co-use of nicotine and alcohol or cocaine and amphetamines. We evaluate the critical role of nicotinic acetylcholine receptors throughout, and emphasize the dearth of preclinical studies assessing concurrent drug exposure. We stress important age and sex differences in drug responses, and highlight a brief, low-dose nicotine exposure paradigm that may better model early use of tobacco products. The escalating use of e-cigarettes among youth necessitates a closer look at the consequences of early adolescent nicotine exposure on subsequent alcohol and drug abuse.
73 citations
TL;DR: Analysis of patterns of youth tobacco use and associations with sociodemographic characteristics and tobacco dependence in the National Youth Tobacco Survey shows shifts in adolescent tobacco product usage towards non-cigarette tobacco products.
Abstract: Background: Despite significant declines in youth cigarette smoking, overall tobacco usage remains over 20% as non-cigarette tobacco product usage is increasingly common and polytobacco use (using 1+ tobacco product) remains steady. Objectives: The present study was designed to identify patterns of youth tobacco use and examine associations with sociodemographic characteristics and tobacco dependence. Methods: The current analysis uses Latent Class Analysis (LCA) to examine the 6,958 tobacco users (n = 2,738 female) in the National Youth Tobacco Survey (2012 and 2013). We used as indicators past month use of tobacco products (cigarettes, cigars, smokeless tobacco, e-cigarettes, hookah, snus, pipes, bidis, and kreteks) and regressed resulting classes on sociodemographic characteristics and tobacco dependence. Results: Nine classes emerged: cigarette smokers (33.4% of sample, also included small probabilities for use of cigars and e-cigarettes), cigar smokers (16.8%, nearly exclusive), smokeless tob...
66 citations
TL;DR: Evidence is provided that opioid dependence may result in the breakdown of two distinct yet highly overlapping structural and functional systems that might account more for the cognitive and decision-making impairments.
Abstract: Background: Prior research utilizing whole-brain neuroimaging techniques has identified structural differences in gray matter in opioid-dependent individuals. However, the results have been inconsistent. Objectives: The current study meta-analytically examines the neuroimaging findings of studies published before 2016 comparing opioid-dependent individuals to drug-naive controls. Method: Exhaustive search of five databases yielded 12 studies that met inclusion criteria. Anisotropic Effect-Size Seed-Based d Mapping (AES-SDM) was used to analyze the data extracted by three independent researchers. Voxel-based AES-SDM distinguishes increases and decreases in brain matter significant at the whole-brain level. Results: AES-SDM identified the fronto-temporal region, bilaterally, as being the primary site of gray matter deficits associated with opioid use. Moderator analysis revealed that length of opioid use was negatively associated with gray matter in the left cerebellar vermis and the right Rolandic ...
65 citations
TL;DR: Key findings from the research on the implementation of smoking cessation in SUD treatment are summarized and research is needed to determine how to accelerate the diffusion of evidence-based practices to the Sud treatment field.
Abstract: Background: The high prevalence of smoking among individuals receiving treatment for substance use disorder (SUD) has led to repeated calls for integrating smoking cessation treatment into these settings. Objectives: This review summarizes key findings from the research on the implementation of smoking cessation in SUD treatment. Methods: PubMed searches of articles published from 2000 to 2015 yielded 48 empirical studies that focused on the delivery of smoking cessation in the US specialty SUD treatment settings in which organizations and counselors were the unit of analysis. Most studies used observational designs to gather data from organizations and counselors. Organizational studies show that few SUD treatment programs offer cessation counseling or pharmacotherapy. Organizational barriers include limited training, inadequate resources, and cultural norms that do not recognize smoking cessation as part of the organization’s mission. Smoking cessation services are more likely to be available in...
64 citations
TL;DR: There is substantial evidence of cannabis use leading to other illicit drug use and of an association between cannabis use and psychosis and a few reports suggest an association with bipolar disorder while the association with depression and anxiety disorders is mixed.
Abstract: Background: The use of cannabis has garnered more attention recently with ongoing efforts at marijuana legalization. The consequences of cannabis use are not clearly understood and remain a concern. Objectives: To review the acute and persistent effects of cannabis use and associations with psychiatric disorders. Methods: Using Pubmed and PsychInfo, we conducted a narrative review of the literature on cannabis and psychiatric comorbidity using the keywords cannab*, marijuana, schizo*, psychosis, mood, depression, mania, bipolar, and anxiety. Results: There is substantial evidence of cannabis use leading to other illicit drug use and of an association between cannabis use and psychosis. A few reports suggest an association with bipolar disorder while the association with depression and anxiety disorders is mixed. Conclusions: Whenever an association is observed between cannabis use and psychiatric disorders, the relationship is generally an adverse one. Age at the time of cannabis use appears to be...
TL;DR: There is a very limited number of pharmacotherapy and an even smaller number of psychosocial interventions in bipolar disorder, and the need for larger, multisite studies with generalizable samples to provide more definite guidance for clinical practice is highlighted.
Abstract: Background: The comorbidity of substance use disorders (SUDs) in bipolar disorder is among the highest in psychiatric disorders. Evidence-based controlled psychosocial or pharmacological interventi...
TL;DR: This review focuses on the preclinical literature regarding nicotine’s interaction with alcohol, stimulants, opioids, and Δ9-tetrahydrocannabinol (THC) and the current understanding of how these various classes of abused drugs may interact with nicotine is understood.
Abstract: Polysubstance abuse is common among substance-use disorder patients, and nicotine is one of the most commonly co-used substances. Epidemiological and clinical laboratory studies suggest that nicotine, when combined with other drugs of abuse, increases intake of one or both substances. This review focuses on the preclinical literature regarding nicotine’s interaction with alcohol, stimulants (i.e., cocaine, amphetamines), opioids (i.e., morphine, heroin), and Δ9-tetrahydrocannabinol (THC). The current understanding of how these various classes of abused drugs may interact with nicotine on behavioral, physiological, and pharmacological indices that may be important in maintaining co-use of one or both substances in human populations are highlighted. Suggestions as to future areas of research and gaps in knowledge are offered.
TL;DR: Examination of sociodemographic characteristics associated with self-reported synthetic cannabinoid use among a clinical psychiatric population within a public hospital in New York City found homelessness/residing in a shelter during time of treatment was the most prominent correlate.
Abstract: Background: Growing evidence of adverse outcomes following synthetic cannabinoid use has engendered interest into populations at risk The existing literature reports that synthetic cannabinoid use is predominant among young, white males However, reports from local Departments of Health have found contrary evidence, showing that synthetic cannabinoid use is prevalent in populations other than those of young, white men Objectives: This study sought to examine sociodemographic characteristics associated with self-reported synthetic cannabinoid use among a clinical psychiatric population within a public hospital in New York City Methods: A cross-sectional medical record review was conducted on synthetic cannabinoid users and non-users in an emergency psychiatric setting A total of 948 patients who presented at the emergency psychiatric setting in 2014 were included in this sample, 110 (116%) of whom were synthetic cannabinoid users Logistic regressions were used to determine the sociodemographi
TL;DR: By targeting shared cognitive-affective processes underlying SUD-depression, transdiagnostic treatment models have the potential to offer a novel clinical approach to treating this difficult-to-treat comorbidity and relevant, co-occurring psychiatric disturbances, such as posttraumatic stress.
Abstract: Background: The co-occurrence of depression and substance use disorders (SUD) is highly prevalent and associated with poor treatment outcomes for both disorders. As compared to individuals sufferin...
TL;DR: A host of clinical and demographic factors that differ between non-treatment-seeking and treatment-seeking research participants and the clinical significance of these variables are highlighted.
Abstract: Background: Medication development for alcoholism typically includes experimental pharmacology studies with non-treatment-seeking individuals with alcohol use disorder (AUD) paving the way for rand...
TL;DR: Research findings suggest the timing of marijuana use prevention was no later than middle school, and future interventions should be developed for both parents and adolescents, and delivered to the right target population at the right time.
Abstract: Background: More recent data are required for effective measures to prevent marijuana use among youth in the United States. Objective: To investigate the risk of marijuana use onset by age using the most recent data from a national sample. Methods: Data for participants (n = 26,659) aged 12–21 years from the 2013 National Survey on Drug Use and Health (NSDUH) (50.4% male, 55.6% White) were analyzed. Patterns of the risk of marijuana use initiation from birth to age of 20 years by single year of age were characterized using hazards survival models. Results: The estimated hazards of marijuana use showed unique age patterns for the overall sample and by gender and racial/ethnic groups. Up to age of 11 years, the hazards of marijuana use initiation were below 0.0500; the hazards after age of 11 years increased rapidly with two peaks at age 16 (0.1291) and 18 years (0.1496), separated by a reduction at age 17 years (0.1112). The age pattern differed significantly by gender (hazards from high to low: ma...
TL;DR: The findings suggest that organized drug disposal efforts may have a minimal impact on reducing the availability of unused controlled medications at a community level.
Abstract: Background: Organized disposal of controlled medications, such as take-back events and permanent drug donation boxes, is a prevention strategy that has been widely used to reduce the availability of controlled medications for diversion or abuse However, little is known as to whether this strategy actually reduces the overall availability of these medications for the purposes of diversion or abuse Objectives: The objective of this study was to compare the number and types of controlled medications that were disposed through organized efforts to the number dispensed in local communities Methods: The quantity and type of controlled medication collected from three take-back events and permanent drug donation boxes over 4-week-long periods in five counties in south-central Kentucky was measured and compared to the number of controlled medications dispensed, as reported by Kentucky All Schedule Prescription Electronic Reporting system Results: In 2013, 21,121,658 controlled medications units were di
TL;DR: There was no statistically significant association between marijuana use and viral suppression among persons living with HIV in this sample of PLWH receiving medical care in Florida, and there is a need for additional evidence from other samples and settings that include more marijuana users.
Abstract: Background: Marijuana use is common among persons living with HIV (PLWH), but studies on its effect on HIV clinical outcomes are limited. Objectives: We determined the association between marijuana use and HIV viral suppression among PLWH. Methods: Data came from five repeated cross-sections (2009–2013) of the Florida Medical Monitoring Project, a population-based sample of PLWH in Florida. Data were obtained via interview and medical record abstraction (MRA). Weighted logistic regression models were used to determine the association between marijuana use (past 12 months) and durable viral suppression (HIV-1 RNA value of ≤ 200 copies/milliliter in all measurements within the past 12 months). Results: Of the 1,902 PLWH receiving antiretroviral therapy, completed an interview, and had a linked MRA, 20% reported marijuana use (13% less than daily and 7% daily use) and 73% achieved durable viral suppression. In multivariable analysis, marijuana use was not significantly associated with durable viral s...
TL;DR: Heavy adolescent marijuana use seems to set Black, urban youth on a long-term trajectory of disadvantage that persists into midlife, and it is critical to interrupt this long- term disadvantage through the prevention of heavy adolescentarijuana use, long- Term marijuana and other drug use, and school dropout.
Abstract: Background: In the United States, perceptions of marijuana’s acceptability are at an all-time high, risk perceptions among youth are low, and rates are rising among Black youth. Thus, it is...
TL;DR: Individuals of all ages who reported using nicotine products of any kind were significantly more likely than nonusers to report alcohol, marijuana, other drug, and poly-substance use and to meet diagnostic criteria for a substance-use disorder.
Abstract: Background: The increasing popularity of non-cigarette nicotine products, especially among youth, highlights the need for greater attention to their potential risks, including nicotine addiction and other substance use and addiction. Objectives: To examine the extent to which nicotine product use co-occurs with other substance use and addiction among youth and adults, describe the demographic groups and types of nicotine products associated with an increased risk of such co-occurrence, and discuss implications for research, prevention, clinical practice, and policy. Methods: Analyzing 2014 data from two nationally representative US surveys, the National Survey on Drug Use and Health (NSDUH) and the Monitoring the Future (MTF) study, we examined the co-occurrence between nicotine product use and alcohol and other drug use and addiction. Results: Individuals of all ages who reported using nicotine products of any kind were significantly more likely than nonusers to report alcohol, marijuana, other d...
TL;DR: Regression analyses indicated that young age, black race/ethnicity, greater intensity of use, current tobacco/nicotine use, and alcohol and other drug use disorders were associated with increased odds of a marijuana use disorder.
Abstract: Background: The changing political and social climate surrounding marijuana use, coupled with the fact that available estimates of marijuana use disorder prevalence are outdated and do not adequately represent adolescents, underscore the need for up-to-date and comprehensive prevalence estimates of marijuana use disorder Objectives: To provide recent national estimates of marijuana use disorder as a function of usage patterns, age, and other sociodemographic, substance use, and mental health variables Methods: Analyses of data from the 2014 National Survey on Drug Use and Health examined the prevalence of marijuana use disorder among respondents (N = 55,271) with various sociodemographic, substance use, and mental health characteristics Logistic and multinomial regression analyses examined the correlates of marijuana use disorder as a function of these variables, with a special focus on age Results: In 2014, 349% of lifetime, 1162% of past-year, and 1532% of past-30-day marijuana users met
TL;DR: Among minority youth, e-cigarette initiation was associated with perceptions of harm and addiction potential, as well as exposure to e- cigarette advertising, which may benefit prevention efforts targeting minority youth who are at risk of becoming e-cigarettes initiators.
Abstract: Background: Electronic cigarettes (e-cigarette) use among youth is a pressing public health issue, with prevalence of use surpassing that of tobacco cigarettes. While research concerning e-cigarett...
TL;DR: Despite the availability of multiple evidence-based interventions that have been implemented across diverse justice system settings, these services are not sufficiently used to address the scope of treatment and supervision needs among offenders with CODs.
Abstract: Background: Over seven million persons in the United States are supervised by the criminal justice system, including many who have co-occurring mental and substance use disorders (CODs). This popul...
TL;DR: Although it initially appeared that there was substantial agreement as to which psychoactive substances should be regarded as “hard” and “soft,” closer inspection shows that the dividing line is blurred without clear criteria for categorization.
Abstract: Background: Precise terminology and definitions are important components of scientific language. Although the terms “hard drugs” and “soft drugs” are used widely by professionals, neither the International Classification of Diseases nor the Diagnostic and Statistical Manual classify psychoactive substances into the categories “hard” and “soft.”Objectives: To analyze the occurrence of the terms “hard drugs” and “soft drugs” in recent scientific literature and to establish the degree of consensus in labeling psychoactive substances as “hard” or “soft.”Methods: A critical review of scientific papers listed in PubMed and Scopus between 2011 and 2015. Three hundred thirty-four articles were initially identified as potentially relevant for review, 132 of which were included in the final analysis.Results: One hundred twenty-four articles used the term “hard drugs” and 84.7% provided examples of substances considered “hard.” Forty-four articles used the term “soft drugs” and 90.9% provided examples of sub...
TL;DR: Appropriate regulation of ketamine is important for international efforts to control ketamine’s cross-border trafficking and its nonmedical use and there is a clear trend toward tighter regulations.
Abstract: Background: Ketamine is an anesthetic commonly used in low-income countries and has recently been shown to be effective for treatment-resistant depression. However, the illicit manufacturing, trafficking, and nonmedical use of ketamine are increasing globally, and its illicit use poses major public health challenges in many countries. Objectives: To review the nonmedical use of ketamine in selected countries and its regulatory control. Methods: We conducted a review of literature identified from searches of the China National Knowledge Infrastructure (CNKI) (1979–2016) and PubMed databases, supplemented by additional references identified by the authors. Special attention was given to the regulation of ketamine. Results: Illicit manufacturing, trafficking, and use of ketamine appear to have begun on a large scale in several Asian nations, and it has subsequently spread to other regions. Regulations governing availability of ketamine vary across countries, but there is a clear trend toward tighter ...
TL;DR: The results of the present study suggest that online and offline gaming can be assessed using the same psychometric instrument and identify important structural features about how online andOffline gaming might contribute differently to problematic use.
Abstract: Background: Despite the increasing popularity of video game playing, little is known about the similarities and differences between online and offline video game players. Objectives: The aims of this study were (i) to test the applicability and the measurement invariance of the previously developed Problematic Online Gaming Questionnaire (POGQ) in both online and offline gamers and to (ii) examine the differences in these groups. Methods: Video game use habits and POGQ were assessed in a sample of 1,964 (71% male) adolescent videogame players. Those gamers who played at least sometimes in an online context were considered “online gamers,” while those who played videogames exclusively offline were considered “offline gamers.” Results: Confirmatory factor analysis supported the measurement invariance across online and offline videogame players. According to the multiple indicators multiple causes (MIMIC) model, online gamers were more likely to score higher on overuse, interpersonal conflict, and so...
TL;DR: Clinical and preclinical evidence supports overlapping mechanistic actions of HIV and alcohol use on peripheral and neural immune systems, and suggests potential for a feed-forward cycle in which heavy drinking induces innate immune signaling, which in turn stimulates subsequent alcohol use behavior.
Abstract: Background: Emerging research points to innate immune mechanisms in the neuropathological and behavioral consequences of heavy alcohol use. Alcohol use is common among people living with HIV infection (PLWH), a chronic condition that carries its own set of long-term effects on brain and behavior. Notably, neurobiological and cognitive profiles associated with heavy alcohol use and HIV infection share several prominent features. This observation raises questions about interacting biological mechanisms as well as compounded impairment when HIV infection and heavy drinking co-occur. Objective and Method: This narrative overview discusses peer-reviewed research on specific immune mechanisms of alcohol that exhibit apparent potential to compound the neurobiological and psychiatric sequelae of HIV infection. These include microbial translocation, systemic immune activation, blood-brain barrier compromise, microglial activation, and neuroinflammation. Results: Clinical and preclinical evidence supports o...
TL;DR: Cannabis smoking could be a potential risk factor for the development of cardiac ischemia in low-risk, young males with acute myocardial infarction.
Abstract: Background: Cannabis is one of the most widely used illicit substances worldwide, and it has the highest prevalence among drugs used in Egypt. Objectives: The aims were to evaluate whether the use of cannabis is a risk factor of acute coronary heart disease in low-risk, young males and to compare the cardiac pathological changes between cannabis exposed and non-exposed ischemic patients. Methods: This was a cross-sectional study that was performed on 138 male patients, aged ≤ 40 years, with acute myocardial infarction who were admitted to the Cardiac Care Unit at the University Hospital. Urine samples were submitted for toxicological analysis using a homogenous enzyme immunoassay technique to determine the substance of use. The patients were divided into three groups: group 1 (n = 23), cannabis-positive only patients; group 2 (n = 28), patients positive for any other substance of use; and group 3 (n = 34), patients negative for any substance of use. Results: Smoking was prominent, whereas group 1 ...
TL;DR: PET investigations from the last ten years that explore the dopaminergic system in tobacco, alcohol, stimulant, opiates, and cannabis addiction are summarized and the potential interactive effects of acute and chronic tobacco and substance co-use on the dopamine system are explored.
Abstract: With the evolving sensitivity of positron emission tomography (PET) and the emergence of novel radiotracers, greater insight has been gained into the dopaminergic system as it relates to substance use. In this review, we summarize PET investigations from the last ten years that explore the dopaminergic system in tobacco, alcohol, stimulant, opiates, and cannabis addiction. In light of the prevalence of substance co-use, this review will also explore the effect of tobacco and other substance abuse co-morbidity on the dopaminergic system across study samples in the reviewed literature. In non-dependence, increased DA transmission following acute stimulant administration is a robust and consistent observation but is less detectable following acute alcohol and tobacco, where it likely represents a conditioned effect mediating reward expectation. Chronic drug exposure is generally associated with a hypo-functioning pre-synaptic dopamine system and lower D2/D3 receptor availability relative to healthy controls. Emerging evidence also shows that stimulant use disorders in particular may also be associated with greater D3 receptor availability relative to controls. A defined role for the dopaminergic system in cannabis and opiate use is yet to be elucidated. Future work is also needed to delineate the potential interactive effects of acute and chronic tobacco and substance co-use on the dopaminergic system.