Substance use disorder

物质使用障碍
  • 文章类型: Journal Article
    丙型肝炎病毒(HCV)感染率的增加归因于物质使用流行。目前关于并行HCV流行率的数据有限。
    评估西弗吉尼亚州(WV)孕妇HCV感染的患病率并确定影响因素。
    对2020年01月至2024年01月30日期间在WV分娩的所有孕妇进行的基于人群的回顾性队列研究(N=69,925)。使用多个对数二项回归模型来估计调整风险比(ARR)和95%置信区间(CI)。
    母体HCV感染率为每1000分娩38例。患有HCV的怀孕个体的平均年龄为29.99(SD4.95)。HCV的风险在白人和白人中明显更高。少数族裔群体[ARR1.93(1.50,2.49)],低于[ARR1.57(1.37,1.79)]或至少高中[ARR1.31(1.17,1.47)]的人不仅仅是高中教育,医疗补助[ARR2.32(1.99,2.71)]vs.私人医疗保险,居住在小型地铁[ARR1.32(1.17,1.48)]和中型地铁[ARR1.41(1.24,1.61)]的人,vs.农村地区,和吸烟的人[ARR3.51(3.10,3.97)]。使用阿片类药物的患者的HCV风险最高[ARR4.43(3.95,4.96)];其次是兴奋剂使用[ARR=1.79(1.57,2.04)]。
    我们的研究结果强调,产妇年龄,种族,教育,和健康保险类型与孕产妇HCV感染有关。在WV怀孕期间吸烟和使用阿片类药物和兴奋剂的怀孕个体的关联程度最高。
    UNASSIGNED: The increasing rate of Hepatitis C virus (HCV) infection has been attributed to the substance use epidemic. There is limited data on the current rates of the paralleling HCV epidemic.
    UNASSIGNED: To estimate the prevalence of maternal HCV infection in West Virginia (WV) and identify contributing factors.
    UNASSIGNED: Population-based retrospective cohort study of all pregnant individual(s) who gave birth in WV between 01/01/2020 to 01/30/2024 (N = 69,925). Multiple log-binomial regression models were used to estimate the adjusted risk ratio (ARR) and the 95% confidence intervals (CI).
    UNASSIGNED: The rate of maternal HCV infection was 38 per 1,000 deliveries. The mean age of pregnant individual(s) with HCV was 29.99 (SD 4.95). The risk of HCV was significantly higher in White vs. minority racial groups [ARR 1.93 (1.50, 2.49)], those with less than [ARR 1.57 (1.37, 1.79)] or at least high school [ARR 1.31 (1.17, 1.47)] vs. more than high school education, those on Medicaid [ARR 2.32 (1.99, 2.71)] vs. private health insurance, those residing in small-metro [ARR 1.32 (1.17, 1.48)] and medium-metro [ARR 1.41 (1.24, 1.61)], vs. rural areas, and those who smoked [ARR 3.51 (3.10, 3.97)]. HCV risk was highest for those using opioids [ARR 4.43 (3.95, 4.96)]; followed by stimulant use [ARR = 1.79 (1.57, 2.04)].
    UNASSIGNED: Our findings highlight that maternal age, race, education, and type of health insurance are associated with maternal HCV infection. The magnitude of association was highest for pregnant individual(s) who smoked and used opioids and stimulants during pregnancy in WV.
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  • 文章类型: Journal Article
    阿片类药物使用障碍(MOUD)包括阿片类药物激动剂疗法(OAT)(丁丙诺啡和美沙酮),和阿片类拮抗剂(缓释纳曲酮)。所有形式的MOUD都可以改善阿片类药物使用障碍(OUD)和HIV结局。然而,艾滋病毒和OUD服务的整合仍然不足。获得MOUD的持续障碍强调了在艾滋病毒感染者(PWH)的OUD治疗中解决药物公平性的迫切需要。
    在这篇评论文章中,我们特别关注PWH中的OAT,因为它是最常用的MOUD形式。具体来说,我们描绘了HIV和OUD服务的交叉点,通过提供全面的筛查,强调他们融入美国结束艾滋病毒流行(EHE)计划,测试,以及对HIV和OUD的治疗。我们确定了OAT与抗逆转录病毒疗法(ART)的潜在药物相互作用,解决OAT访问中的差异,并展示了丁丙诺啡长效制剂的实际好处,ART,和暴露前预防,以改善艾滋病毒的预防和治疗,和OUD管理。
    优化PWH中的OUD结果需要仔细注意诊断OUD,开始OUD治疗,并确保药物保留。提供医疗保健的创新方法,例如移动药房,可以整合OUD和艾滋病毒,并覆盖服务不足的人群。
    UNASSIGNED: Medications for opioid use disorder (MOUD) include opioid agonist therapies (OAT) (buprenorphine and methadone), and opioid antagonists (extended-release naltrexone). All forms of MOUD improve opioid use disorder (OUD) and HIV outcomes. However, the integration of services for HIV and OUD remains inadequate. Persistent barriers to accessing MOUD underscore the immediate necessity of addressing pharmacoequity in the treatment of OUD in persons with HIV (PWH).
    UNASSIGNED: In this review article, we specifically focus on OAT among PWH as it is the most commonly utilized form of MOUD. Specifically, we delineate the intersection of HIV and OUD services, emphasizing their integration into the United States Ending the HIV Epidemic (EHE) plan by offering comprehensive screening, testing, and treatment for both HIV and OUD. We identify potential drug interactions of OAT with antiretroviral therapy (ART), address disparities in OAT access, and present the practical benefits of long-acting formulations of buprenorphine, ART, and pre-exposure prophylaxis for improving HIV prevention and treatment, and OUD management.
    UNASSIGNED: Optimizing OUD outcomes in PWH necessitates careful attention to diagnosing OUD, initiating OUD treatment, and ensuring medication retention. Innovative approaches to healthcare delivery, such as mobile pharmacies, can integrate both OUD and HIV and reach underserved populations.
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  • 文章类型: Letter
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  • 文章类型: Journal Article
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  • 文章类型: Editorial
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  • 文章类型: Journal Article
    在研究中使用了当前的研究概念,以清楚地识别照顾者-儿童二元的情感和认知能力,目的是通过心理心理治疗策略来补偿双方的缺陷。
    这个探索性的目标,纵向干预研究旨在深入了解30名6-12岁儿童的心理社会背景,这些儿童生活在以机构或家庭为中心的寄养中。数据将在三个时间点收集:在参与新开发的团体干预后和12个月后,旨在解决在潜伏期生活在寄养机构中的药物滥用父母的儿童的特殊需求。该研究是在维也纳大学心理学系与协会“对话”(VereinDialog)合作进行的。治疗持续时间为5个月,在此期间,两名受过专门培训的心理治疗师为儿童进行了10次小组会议,为寄养者进行了3次小组会议。所有统计分析都将考虑可用数据的类型。因此,由于序数因变量是重复测量的单向方差分析的非参数替代方法,因此本研究的主要结局将通过Friedman检验进行评估.此外,Mann-WhitneyU检验用于比较两个独立组之间的差异(住在寄养机构的儿童与家庭寄养)。为了评估关于儿童和照顾者的潜在相关性,进行斯皮尔曼相关(ρ)。为了检查次要结果,除了前面概述的方法,我们还将利用定性主题分析。
    本研究使用当前的研究概念来识别照顾者-儿童二元的情感和认知能力,目的是通过心理心理治疗策略来补偿双方的缺陷。该研究有一些局限性:小样本量不允许推广结果。由于缺乏对照组,未进行随机对照研究(RCT).作者意识到了这些局限性。然而,研究发现,将有助于推断进一步研究的研究问题。
    UNASSIGNED: The current research concept of mentalization is used in the study to clearly identify affective and cognitive abilities of the caregiver-child dyad with the aim of compensating deficits on both sides with psychological-psychotherapeutic strategies.
    UNASSIGNED: The objective of this explorative, longitudinal intervention study is to provide an in-depth understanding of the psycho-social background of 30 children aged 6-12 years living in institutional or family-centered foster care. Data will be collected at three time points: before, after and 12 months after participating in the newly developed group intervention, which intends to address the particular needs of children of drug abusing parents living in foster care in the latency period. The study is conducted at the Faculty of Psychology of the University of Vienna in collaboration with the Association \"Dialogue\" (Verein Dialog). The treatment duration spans 5 months, during which two specifically trained psychotherapists conduct 10 group sessions for children and three group sessions for foster caregivers. All statistical analyses will consider the type of data available. Therefore, the primary outcome of the study will be assessed via the Friedman test due to the ordinal dependent variable as it is the non-parametric alternative to the one-way ANOVA for repeated measures. In addition, the Mann-Whitney U test is used to compare differences between two independent groups (children living in institutional foster care vs. family foster care). To assess potential correlations regarding the child and caregivers\' capacity to mentalize, Spearman correlations (ρ) are conducted. To examine the secondary outcome, apart from the methods previously outlined, we will also utilize qualitative thematic analysis.
    UNASSIGNED: The present study uses the current research concept of mentalization to identify affective and cognitive abilities of the caregiver-child dyad with the aim of compensating deficits on both sides with psychological-psychotherapeutic strategies. There are some limitations of the study to mention: the small sample size does not allow to generalize the results. Due to the lack of a comparison group, a randomized control study (RCT) was not conducted. The authors are aware of these limitations. However, the studies\' findings, will help to deduce research questions for further studies.
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  • 文章类型: Journal Article
    对干预措施的满意度会影响行为变化的摄取和干预措施的长期疗效。因此,在为少数群体创建和调整行为干预措施时,通过参与者概况评估满意度至关重要。通过对54名女性的自我报告调查,收集了有关参与者创伤症状严重程度和干预满意度的定性和定量数据。样本是59.3%的西班牙裔,平均年龄为33.21岁(SD=10.42),他们正在接受物质使用障碍(SUD)的住院治疗,并参加了为期12次的基于正念的干预。定性响应使用主题分析进行编码,在第2节和第11节,使用综合混合方法方法比较了高创伤(N=28)和低创伤(N=26)组之间的定性主题频率。高创伤组和低创伤组由四分位数范围确定(底部25%=低;顶部75%=高)。在第2阶段,低创伤组报告的满意度(M=4.20,SD=0.55)明显高于高创伤组(M=3.77,SD=0.89);t(43)=1.90,p=0.03。在第11节,组间没有显著差异。混合方法分析表明,在第2阶段,高创伤组比低创伤组更频繁地出现“麻烦聚焦”,但在第11阶段,这两个组中都没有出现主题,这表明这可能会对高创伤个体构成最初的障碍,但随着干预的进行而消退。这说明了为患有SUD和高创伤的参与者量身定制的保留策略的重要性,同时他们适应干预。评估初始挑战的满意度可能有助于促进者进行干预以提高参与者的满意度。
    Satisfaction with an intervention influences the uptake of behavior changes and the long-term efficacy of the intervention. Therefore, it is crucial to assess satisfaction by participant profile when creating and adapting behavior interventions for minoritized populations. Qualitative and quantitative data on participant trauma symptom severity and intervention satisfaction were collected through self-report surveys from 54 women. The sample was 59.3% Hispanic, with an average age of 33.21 (SD = 10.42), who were in residential treatment for substance use disorders (SUDs) and participated in a 12-session mindfulness-based intervention. Qualitative responses were coded using thematic analysis, and an integrative mixed-methods approach was used to compare qualitative theme frequency between high-trauma (N = 28) and low-trauma (N = 26) groups at session 2 and session 11. High- and low-trauma groups were determined by interquartile ranges (bottom 25% = low; top 75% = high). In session 2, the low-trauma group reported significantly higher satisfaction (M = 4.20, SD = 0.55) than the high-trauma group (M = 3.77, SD = 0.89); t(43) = 1.90, p = 0.03. In session 11, there was no significant difference between groups. The mixed-methods analysis revealed that \"trouble focusing\" appeared more frequently in the high-trauma group than in the low-trauma group during session 2, but the theme was not present in either group at session 11, suggesting that this might pose an initial barrier for individuals with high trauma but subsides as the intervention progresses. This speaks to the importance of retention strategies tailored for participants with SUDs and high trauma while they adjust to the intervention. Assessing initial challenges with satisfaction may help facilitators intervene to increase participant satisfaction.
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  • 文章类型: Journal Article
    有效的数据收集和流行病学趋势监测对于应对与药物使用(SU)相关的日益增长的挑战至关重要。特别是考虑到新出现的趋势和案件的漏报。然而,关于韩国SU和物质使用障碍(SUD)的研究和数据很少。
    我们进行了范围审查,以确定截至2023年12月韩国SU研究中使用的数据源和监视方法。与韩国这一领域的专家进行的半结构化磋商补充了这一审查,其反馈导致对先前确定的数据来源和评估的修订。
    我们的审查确定了32种出版物对现有数据进行二次分析,以检查韩国SU和SUD的流行病学。其中,14项研究利用临床数据库探索成瘾性物质的处方模式,尤其是阿片类药物。11个数据来源显示出推进SU研究的前景;然而,他们面临着巨大的限制,包括缺乏可用数据,缺少数据,缺少关键变量,排除未在临床系统中捕获的边缘化人群,以及跨时间点和数据集匹配个人级别数据的复杂性。
    韩国SU的当前监视方法在可访问性方面面临相当大的挑战,可用性,和标准化。此外,现有的数据存储库可能无法捕获临床或司法系统未提供服务的人群信息。为了系统地改进监测方法,有必要开展强有力的、具有全国代表性的调查,完善现有临床数据的使用,并确保治疗设施数据的可用性。
    UNASSIGNED: Effective data collection and surveillance of epidemiological trends are essential in confronting the growing challenges associated with substance use (SU), especially in light of emerging trends and underreporting of cases. However, research and data are scarce regarding SU and substance use disorder (SUD) in Korea.
    UNASSIGNED: We conducted a scoping review to identify data sources and surveillance methods used in SU research in Korea up to December 2023. This review was complemented by semi-structured consultations with experts in this area in Korea, whose feedback led to revisions of previously identified data sources and assessments.
    UNASSIGNED: Our review identified 32 publications conducting secondary analyses on existing data to examine the epidemiology of SU and SUD in Korea. Of these, 14 studies utilized clinical databases to explore the prescription patterns of addictive substances, particularly opioids. Eleven data sources showed promise for advancing SU research; however, they face substantial limitations, including a lack of available data, missing data, the absence of key variables, the exclusion of marginalized populations not captured within the clinical system, and complexities in matching individual-level data across time points and datasets.
    UNASSIGNED: Current surveillance methods for SU in Korea face considerable challenges in accessibility, usability, and standardization. Moreover, existing data repositories may fail to capture information on populations not served by clinical or judicial systems. To systematically improve surveillance approaches, it is necessary to develop a robust and nationally representative survey, refine the use of existing clinical data, and ensure the availability of data on treatment facilities.
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  • 文章类型: Journal Article
    我们的目的是分析吸毒成瘾个体的犯罪行为与冲动性之间的关联,并调查冲动性是否介导了吸毒严重程度与法律问题之间的关系。
    这项横断面研究包括773名被诊断患有成瘾的男性(295名酒精使用者和478名可卡因/多物质使用者),同时接受成瘾治疗。BIS-11和ASI-6用于评估冲动,犯罪行为,和药物使用。
    在酒精使用者中,犯罪行为的患病率为41.7%(n=123),在裂纹/多物质使用者中,犯罪行为的患病率为64.9%(n=310)。在有犯罪史的个体中观察到较早使用不同物质和较高的冲动得分。调解分析表明,冲动是物质使用和犯罪行为之间的中介因素,提高法律问题的严重性。
    我们的研究结果可以帮助决定量身定制的治疗策略,不仅关注物质的使用,而且在预防社会问题上,犯罪,和冲动。
    UNASSIGNED: Our aim was to analyze the association between criminal behavior and impulsivity in individuals with drug addiction and investigate whether impulsiveness mediates the relationship between drug use severity and legal problems.
    UNASSIGNED: This cross-sectional study included 773 men diagnosed with addiction (295 alcohol users and 478 users of crack/polysubstance) while undergoing addiction treatment. The BIS-11 and ASI-6 were applied to assess impulsivity, criminal behavior, and drug use.
    UNASSIGNED: The prevalence of criminal behavior was 41.7% (n = 123) in alcohol users and 64.9% (n = 310) in users of crack/polysubstance. Earlier use of different substances and higher impulsivity scores were observed in individuals with criminal history. Mediation analyses revealed that impulsiveness acts as a mediator factor between substance use and criminal behavior, enhancing the severity of legal problems.
    UNASSIGNED: Our findings can help in deciding on tailored treatment strategies, focusing not only on substance use, but also on the prevention of social problems, criminality, and impulsivity.
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  • 文章类型: Journal Article
    物质使用障碍(SUD)的家族史(FH)是后代SUD的既定危险因素。后代心理特征或家庭环境的程度,每个都可能与SUD风险的家族性传播有关,在社会经济弱势群体中,FH+的变化不太清楚。我们比较了73名FH+和69名FH-12-16岁青年的家庭/社会环境和心理特征,这是一项关于父母刑事司法系统参与主要低收入人群的研究,少数民族城市人口。潜在轮廓分析(LPA)根据经验确定了具有相似心理特征的受试者群体,然后用FH+进行比较。发现FH+青年的平均家庭规模更大,更大的父母心理攻击,和更高的平均数量的不良童年经历,即使不考虑父母SUD。根据父母的报告,FH个体的报告卡等级较低,并且比FH个体更可能有外化障碍病史。然而,FH与许多心理特征或LPA的类成员没有显着相关。总之,在低收入人群中,少数民族城市青年,FH与家庭环境的差异有关,仅与个体心理特征的细微差别有关。
    Family history (FH+) of substance use disorder (SUD) is an established risk factor for offspring SUD. The extent to which offspring psychological traits or the family environment, each of which may be relevant to familial transmission of SUD risk, vary by FH+ in socioeconomically disadvantaged populations is less clear. We compared the family/social environmental and psychological characteristics of 73 FH+ and 69 FH- youth ages 12-16, from a study of parental criminal justice system involvement in a primarily low-income, minority urban population. A latent profile analysis (LPA) empirically identified groups of subjects with similar psychological characteristics, which were then compared by FH+. FH+ youths were found to have greater mean household size, greater parental psychological aggression, and a higher mean number of adverse childhood experiences, even without considering parental SUD. FH+ individuals had lower report card grades according to parental report and were more likely to have a history of externalizing disorders than FH- individuals. However, FH+ was not significantly associated with many psychological characteristics or with the class membership from the LPA. In conclusion, among a population of low-income, minority urban youth, FH+ was associated with differences in the family environment and only subtle differences in individual psychological characteristics.
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