麻豆传媒在线

This Week in the 麻豆传媒在线 Weekly

Society and substance use have long influenced each other, and this relationship, in a way, reflects on a society’s sense of modernity. Take pregnancy, for example— it’s alarming but a reality that much of our society today still treats substance use during pregnancy as a crime. This punitive approach is so pervasive that advocating for model legislation is actually a necessity (). In the same society, moms with postpartum depression are turning their hopes toward low-dose psilocybin and self-treating for an illness that has long been underserved ().

This all touches upon another effect of modernization—societies are better recognizing how substance use and mental health are closely related. For example, it used to be that wildfire fighters related “work hard” to “play hard,” but time is revealing that this relationship is often about loneliness, trauma, and binge drinking (). Even the “food noise” of obesity exemplifies a shift in our understanding of how stigmatized behaviors are often diseases of the brain ().

And even though modern science has shown us how these brain diseases can “impact the entire community,” culture still drives how (and why) societies respond differently (). For example, the beer gardens of modern-day Bulawayo “embody the moral and practical contradictions of late colonial development” in Zimbabwe (), while in America, racial disparities still persist for Black patients seeking OUD care at emergency departments ().

All of this illustrates how modern societies are not all the same and neither are their relationships with substance use. When the World Health Organization (WHO) published its first on the tobacco epidemic in 2008, knowledge and wealth seemed to drive a sense of modernity toward substance use. Contrast that with the WHO’s most recent report and it seems that modernity has now become a matter of choice (). 

Thanks for reading,

Nicholas Athanasiou, MD, MBA, DFASAM
Editor in Chief

with Co-Editors: Brandon Aden, MD, MPH, FASAM; John A. Fromson, MD; Jack Woodside, MD

Lead Story 

 馃敁

JAMA Network Open

This cohort study of 1,683 patients assessed if there are racial and ethnic disparities in treatment referral rates among patients in the emergency department (ED) with opioid overdose. Researchers found a statistically significant difference in the proportion of Black patients who received an outpatient treatment referral (5.7%) compared with White patients (9.6%). These findings suggest that Black patients presenting to the ED with opioid overdose may be less likely to receive outpatient treatment referrals, underscoring the need for targeted intervention and enhanced referral processes.

Research and Science 

 馃敁&苍产蝉辫;

Addiction

Prescribing and dispensing of stimulants such as Adderall and Ritalin have increased significantly in the last several years, which may raise concerns about increased non-prescribed use. The study examined trends in non-prescribed use using the Population Assessment of Tobacco and Health (PATH) Study, an ongoing annual survey of a nationally representational cohort, from 2013 to 2022. Overall, there was no significant change in prevalence of past 12-month non-prescribed stimulant use. The authors examined different age cohorts, and young adults aged 18-24 had much higher prevalence of non-prescribed use than other age groups. Of note, prevalence of use had declined in this age cohort in recent survey waves. 

Drug and Alcohol Dependence

Pregnenolone (PREG) is a precursor to neuroactive steroids (NAS) that activate the GABA receptor. Chronic cocaine use decreases levels of these NAS and GABA receptor activity, and enhances stress response. This study examined the effect of PREG on cocaine craving and cocaine use. Individuals with cocaine use disorder (CUD) seeking treatment were randomly assigned to receive 300 mg PREG/day (n=18), 500 mg PREG/day (n=16), or placebo (n=18) for 8 weeks. Stress provoking imagery and cocaine cue imagery increased cocaine craving in the placebo group (p<.001) but not in the 300 mg and 500 mg PREG groups. The amount of cocaine use during the study was significantly less in the 300 mg PREG group compared to both the placebo group (p=.047) and the 500 mg PREG group (p=.001). These results suggest PREG reduces cocaine craving and cocaine use in CUD.

Drug and Alcohol Dependence

The FitForChange study found that exercise helps reduce alcohol consumption, depression, and anxiety. This is a secondary analysis of that study examining the effect of exercise on health-related quality of life (HR-QoL). Participants were randomly assigned to aerobic exercise (n=49), yoga (n=46), or usual treatment (n=45). The aerobic exercise and yoga groups were asked to attend 3 one-hour supervised sessions a week for 12 weeks. The mental health component of HR-Qol improved from baseline to follow-up for both the aerobic exercise and yoga groups (both 40 to 48) significantly more than for the usual treatment group (40 to 43). These effects were greatest for people with severe AUD.

 馃敁

PLOS One

The main constituents of the liquids used in electronic nicotine delivery systems (ENDS) are generally propylene glycol (PG) and vegetable glycerin (VG). PG is known to increase nicotine bioavailability but also produces more carcinogenic byproducts and thus some manufacturers have shifted to lower concentrations. In this study, researchers used a mouse model to examine impact on in utero development of exposure to 2 formulations: 1) 30% PG/70% VG (30/70) and 2) 50% PG/50% VG (50/50). When compared to controls, there was a significant reduction in growth for the 30/70 group, but no difference in the 50/50 group. These findings suggest that VG may not be safer than PG. Further, as these formulations did not contain nicotine, the results suggest that nicotine-free e-cigarettes are not benign. The authors emphasize that more research is needed on the individual components and mixtures used in ENDS.

Learn More 

 馃敁&苍产蝉辫;

Nutrition and Diabetes

Food noise refers to persistent thoughts about food that are perceived by the individual as being unwanted and/or dysphoric and may cause harm to the individual, including social, mental, or physical problems. Food noise is distinguished from routine food-related thoughts by its intensity and intrusiveness, resembling rumination. This article describes initial research developing the Ro Allison Indiana Dhurandhar- Food Noise Inventory (RAID-FN Inventory) to measure food noise. It also outlines future areas of research, including exploring the prevalence and physiological underpinnings of food noise and the role of cultural and sociodemographic factors. Topics discussed include the effects of glucagon-like peptide 1 (GLP-1) receptor agonists on food noise, the potential role of food noise in weight management and metabolic health, understanding food noise’s impact on health outcomes and quality of life, the stigma associated with food noise, and the potential influence of food noise on public health policies.

 馃敁&苍产蝉辫;

The American Journal of Psychiatry

This editorial points to an article in the same issue reporting that the Monitoring the Future Study of 12th graders shows significant declines in the use of opioids, benzodiazepines, and stimulants between 2009 and 2022. The editorial authors also note that illicit drug use among 12th graders is at the lowest level during the 50 years of the study. However, the 2023 National Survey on Drug Use and Health shows over 2 million adolescents between the ages of 12 and 17 have an SUD, primarily cannabis use disorder. The authors also highlight a study in the May issue of the journal which discussed a 5-year follow-up of a school-based intervention in the 7th grade that delays experimentation and reduces the rates of SUD. School-based programs and public health messaging can improve the well-being of adolescents.

PNAS

The authors of this commentary discuss research findings that elucidate the relationship between alcohol consumption and rapid production and secretion of fibroblast growth factor 21 (FGF21). FGF21 signaling is involved in multiple physiological effects but has been shown to suppress alcohol intake and increase water intake. The induction of FGF21 was found to occur due to effects of ethanol metabolism. First, ethanol is converted to acetyl-CoA during metabolism and promotes acetylation of histones in the promoter region of FGF21. Second, alcohol promotes production of glycerol-3-phosphate (G3P), which activates the transcription factor carbohydrate response element binding protein (ChREBP). Understanding these mechanisms could potentially lead to better understanding of alcohol use disorder (AUD). 

In the News 

 馃敁

World Health Organization

 馃敁

WWNO

 馃敁

Montana Free Press

 馃敁

The Conversation

 馃敁

Reason Foundation

 馃敁

Women’s Health