scholarly journals Phasic Dopamine Release Magnitude Tracks Individual Differences in Sensitization of Locomotor Response following a History of Nicotine Exposure

2019 ◽  
Author(s):  
Ashley M. Fennell ◽  
Elizabeth G. Pitts ◽  
Lacey L. Sexton ◽  
Mark J. Ferris
Keyword(s):  
Substance Use ◽  
Individual Differences ◽  
Substance Use Disorder ◽  
Nicotinic Receptor ◽  
Dopamine Release ◽  
The United States ◽  
Locomotor Sensitization ◽  
Nicotine Exposure ◽  
Behavioral Models ◽  
Sprague Dawley

AbstractSmoking remains the primary cause of preventable death in the United States and smoking related illness costs more than $300 billion annually. Nicotine (the primary reinforcer in cigarettes) causes changes in behavior and neurochemistry that lead to increased probability of relapse. Given the role of mesolimbic dopamine projections in motivation, substance use disorder, and drug relapse, we examined the effect of repeated nicotine on rapid dopamine signals in the nucleus accumbens (NAc) of rats. Adult, male Sprague-Dawley rats were exposed to nicotine (0.2 or 0.4 mg/kg, subcutaneous) once daily for 7 days. On day 8, dopamine release and uptake dynamics, and their modulation by nicotinic receptor agonists and antagonists, were assessed using fast scan cyclic voltammetry in the NAc core. Nicotine exposure decreased electrically-stimulated dopamine release across a range of stimulation frequencies and decreased α6β2-containing nicotinic receptor control over dopamine release. Additionally, nicotine locomotor sensitization correlated with accumbal dopamine modulation by nicotine and mecamylamine. Taken together, our study suggests that repeated exposure to nicotine blunts dopamine release in the NAc core through changes in α6β2 modulation of dopamine release and individual differences in the sensitivity to this outcome may predict variation in behavioral models of vulnerability to substance use disorder.

scholarly journals Substance Use Disorder: A Model for Integration in Undergraduate Medical Education

2021 ◽  
Vol 8 ◽  
pp. 238212052110258
Author(s):  
Haritha Pavuluri ◽  
Nicolas Poupore ◽  
William Michael Schmidt ◽  
Samantha Gabrielle Boniface ◽  
Meenu Jindal ◽  
...  
Keyword(s):  
Medical Education ◽  
Substance Use ◽  
South Carolina ◽  
Substance Use Disorder ◽  
The United States ◽  
University Of South Carolina ◽  
Community Recovery ◽  
School Of Medicine ◽  
Treatment Gaps ◽  
The University

Substance Use Disorder (SUD) is a debilitating chronic illness with significant morbidity and mortality across the United States. The AAMC and LCME have supported the efforts for more effective medical education of SUD to address the existing stigma, knowledge, and treatment gaps. The Coronavirus 2019 (COVID-19) pandemic and associated social, economic, and behavioral impacts have added to this urgency. The University of South Carolina School of Medicine Greenville (USCSOMG), in collaboration with community organizations, has successfully implemented an integrated SUD education curriculum for medical students. Students learn about SUD in basic sciences, receive case-based education during clinical exercises, and are provided the opportunity to become a recovery coach and participate in the patient and family recovery meetings through this curriculum during preclinical years. During the clinical years, SUD education is enhanced with exposure to Medication for Addition Treatment (MAT). Students also partake in the care coordination of patients with SUD between the hospital and community recovery organizations. All students receive MAT waiver training in their final year and are prepared to prescribe treatment for SUD upon graduation. The experiences in this integrated curriculum integration can perhaps assist other organizations to implement similar components and empower the next generation of physicians to be competent and effective in treating patients with SUD.

Substance use disorder among older adults in the United States in 2020

Addiction ◽  
2009 ◽  
Vol 104 (1) ◽  
pp. 88-96 ◽  
Author(s):  
Beth Han ◽  
Joseph C. Gfroerer ◽  
James D. Colliver ◽  
Michael A. Penne
Keyword(s):  
United States ◽  
Older Adults ◽  
Substance Use ◽  
Substance Use Disorder ◽  
The United States

Substance Use Disorder Treatments

2017 ◽  
pp. 96-118 ◽  
Author(s):  
Liliane Cambraia Windsor ◽  
Douglas C. Smith ◽  
Kyle M. Bennett ◽  
Frederick X. Gibbons
Keyword(s):  
Substance Use ◽  
Emerging Adults ◽  
Substance Use Disorder ◽  
The United States ◽  
Drug Misuse ◽  
Future Research ◽  
Cultural Groups ◽  
Treatment Access ◽  
Effective Interventions ◽  
Diverse Groups

Today’s emerging adults belong to one of the most diverse generations in the United States and show the highest rates of alcohol and illicit drug misuse, facing significant health risks. Thus it is critical to develop effective interventions to reduce alcohol and illicit substance misuse and its related harms among this diverse group. This chapter examines the current literature on the development and effectiveness of existing culturally relevant substance use disorder treatments and makes recommendations for future research and best practices. We argue that given their unique needs, the severity of their substance use, and the low rates of treatment engagement among this population, it is critical that treatment efforts focus on increasing effective treatment access to all emerging adults. We further encourage substance use disorder treatment researchers and practitioners to move beyond addressing culture-bound intervention targets focused on specific cultural groups. The chapter advocates for the development, testing, and adoption of interventions that are responsive to cultural contexts and that (1) target social determinants of health, (2) are equally effective with privileged and marginalized emerging adults, and (3) prepare therapists to effectively deliver interventions to diverse groups and demonstrate cultural competence.

Representative Bureaucracy Through Staff With Lived Experience: Peer Coproduction in the Field of Substance Use Disorder Treatment

2020 ◽  
Vol 50 (8) ◽  
pp. 880-897
Author(s):  
Sunggeun (Ethan) Park
Keyword(s):  
Decision Making ◽  
Substance Use ◽  
Lived Experience ◽  
Substance Use Disorder ◽  
The United States ◽  
Descriptive Representation ◽  
Representative Bureaucracy ◽  
Organizational Decision Making ◽  
Substance Use Disorder Treatment ◽  
Disorder Treatment

This study extends the representative bureaucracy literature by theorizing and empirically testing how staff sharing lived experience with service users can serve as user representatives in service provision processes (i.e., the peer coproduction mechanism). Using survey data from a representative sample of substance use disorder treatment clinics in the United States, we explore factors associated with descriptive representation (the presence of staff with firsthand experience of a substance use disorder in both frontline treatment and senior positions) and directors’ perceptions of recovering staff’s potential to serve as user representatives in individual care and organizational decision-making processes. Recovering staff accounted for a third of the field’s workforce, but the majority of the clinics did not employ them in senior staff positions. Regression results suggest that organizational leaders’ recognition of recovering staff’s unique representation capacities may facilitate greater descriptive representation and grant meaningful organizational decision-making authority to recovering staff. Multiple research and practice implications are discussed.

Programming

2015 ◽  
Author(s):  
Patrece Hairston ◽  
Ingrid A. Binswanger
Keyword(s):  
Substance Use ◽  
Criminal Justice ◽  
Substance Use Disorders ◽  
Substance Use Disorder ◽  
Behavioral Interventions ◽  
The United States ◽  
Evidence Based ◽  
Mutual Aid ◽  
Criminal Justice Involvement ◽  
Federal Prisons

The nexus of substance use disorders and criminal justice involvement is considerable. This is particularly the case in the United States, where 48% of individuals in federal prisons were incarcerated for drug-related convictions in 2011. In the last year for which national data are available, approximately half of the individuals incarcerated in state and federal prisons met criteria for drug abuse or dependence. Tobacco and alcohol use are also more common in correctional populations than in the general, non-institutionalized population. Thus, criminal justice populations have a significant need for evidence-based treatment of addiction and interventions to reduce the medical complications of drug use. While many programs to address substance use disorder among correctional populations exist, many individuals fail to receive adequate care and continue to experience complications of substance use disorders. Thus, correctional clinicians and staff, researchers, and patients will need to continue to advocate for improved and enhanced dissemination of integrated, evidence-based behavioral and pharmacological treatment for substance use disorder across the continuum of criminal justice involvement. This chapter describes the evolution of addiction programming within correctional settings from the late 1700s to contemporary practices. Beginning with a discussion of mutual aid societies as one of the earliest providers of ‘treatment,’ this chapter outlines important aspects of early treatment. Additionally, current levels of care and specialized modalities for individuals involved in the criminal justice system are presented, such as cognitive-behavioral interventions, drug courts, therapeutic communities, pharmacologically supported therapy, and harm reduction approaches.

Abuse of reformulated OxyContin: Updated findings from a sentinel surveillance sample of individuals assessed for substance use disorder

2017 ◽  
Vol 13 (6) ◽  
pp. 425 ◽  
Author(s):  
Theresa A. Cassidy, MPH ◽  
Eileen Thorley, MPH ◽  
Ryan A. Black, PhD ◽  
Angela DeVeaugh-Geiss, PhD ◽  
Stephen F. Butler, PhD ◽  
...  
Keyword(s):  
Substance Use ◽  
Substance Use Disorder ◽  
The United States ◽  
Geographic Region ◽  
Addiction Severity Index ◽  
Prescription Opioid ◽  
Cross Sectional ◽  
Geographic Regions ◽  
Drug Problems ◽  
Treatment Settings

Objective: To examine abuse prevalence for OxyContin and comparator opioids over a 6-year period prior to and following market entry of reformulated OxyContin and assess consistency in abuse across treatment settings and geographic regions. Design: An observational study examining longitudinal changes using cross-sectional data from treatment centers for substance use disorder.Setting: A total of 874 facilities in 39 states in the United States within the National Addictions Vigilance Intervention and Prevention Program (NAVIPPRO®) surveillance system.Participants: Adults (72,060) assessed for drug problems using the Addiction Severity Index-Multimedia Version (ASI-MV®) from January 2009 through December 2015 who abused prescription opioids.Main outcome measure(s): Percent change in past 30-day abuse. Results: OxyContin had significantly lower abuse 5 years after reformulation compared to levels for original OxyContin. Consistency of magnitude in OxyContin abuse reductions across geographic regions, ranging from 41 to 52 percent with differences in abuse reductions in treatment setting categories occurred. Changes in geographic region and treatment settings across study years did not bias the estimate of lower OxyContin abuse through confounding.Conclusion: In the postmarket setting, limitations and methodologic challenges in abuse measurement exist and it is difficult to isolate singular impacts of any one intervention given the complexity of prescription opioid abuse. Expectations for a reasonable threshold of abuse for any one ADF product or ADF opioids as a class are still uncertain and undefined. A significant decline in abuse prevalence of reformulated OxyContin was observed 5 years after its reformulation among this treatment sample of individuals assessed for substance use disorder that was lower historically for the original formulation of this product.

scholarly journals Individual differences in the neuropsychopathology of addiction

2017 ◽  
Vol 19 (3) ◽  
pp. 217-229 ◽  
Keyword(s):  
Substance Use ◽  
Individual Differences ◽  
Substance Use Disorder ◽  
Negative Reinforcement ◽  
Incentive Salience ◽  
Cognitive Profiles ◽  
Pharmacological Treatments ◽  
Brain Reward ◽  
The Brain

Drug addiction or substance-use disorder is a chronically relapsing disorder that progresses through binge/intoxication, withdrawal/negative affect and preoccupation/anticipation stages. These stages represent diverse neurobiological mechanisms that are differentially involved in the transition from recreational to compulsive drug use and from positive to negative reinforcement. The progression from recreational to compulsive substance use is associated with downregulation of the brain reward systems and upregulation of the brain stress systems. Individual differences in the neurobiological systems that underlie the processing of reward, incentive salience, habits, stress, pain, and executive function may explain (i) the vulnerability to substance-use disorder; (ii) the diversity of emotional, motivational, and cognitive profiles of individuals with substance-use disorders; and (iii) heterogeneous responses to cognitive and pharmacological treatments. Characterization of the neuropsychological mechanisms that underlie individual differences in addiction-like behaviors is the key to understanding the mechanisms of addiction and development of personalized pharmacotherapy.

scholarly journals Substance Use Disorder in Physicians after Completion of Training in Anesthesiology in the United States from 1977 to 2013

2020 ◽  
Vol 133 (2) ◽  
pp. 342-349 ◽  
Author(s):  
David O. Warner ◽  
Keith Berge ◽  
Huaping Sun ◽  
Ann Harman ◽  
Ting Wang
Keyword(s):  
Substance Use ◽  
Substance Use Disorder ◽  
Significant Risk ◽  
The United States ◽  
Policy Formulation ◽  
Individual Treatment ◽  
Residency Programs ◽  
Kaplan Meier ◽  
Medical License

Background Substance use disorder among physicians can expose both physicians and their patients to significant risk. Data regarding the epidemiology and outcomes of physician substance use disorder are scarce but could guide policy formulation and individual treatment decisions. This article describes the incidence and outcomes of substance use disorder that resulted in either a report to a certifying body or death in physicians after the completion of anesthesiology training. Methods Physicians who completed training in U.S. anesthesiology residency programs from 1977 to 2013 and maintained at least one active medical license were included in this retrospective cohort study (n = 44,736). Substance use disorder cases were ascertained through records of the American Board of Anesthesiology and the National Death Index. Results Six hundred and one physicians had evidence of substance use disorder after completion of training, with an overall incidence of 0.75 per 1,000 physician-years (95% CI, 0.71 to 0.80; 0.84 [0.78 to 0.90] in men, 0.43 [0.35 to 0.52] in women). The highest incidence rate occurred in 1992 (1.79 per 1,000 physician-years [95% CI, 1.12 to 2.59]). The cumulative percentage expected to develop substance use disorder within 30 yr estimated by Kaplan–Meier analysis equaled 1.6% (95% CI, 1.4 to 1.7%). The most common substances used by 353 individuals for whom information was available were opioids (193 [55%]), alcohol (141 [40%]), and anesthetics/hypnotics (69 [20%]). Based on a median of 11.1 (interquartile range, 4.4 to 19.8) yr of follow-up, the cumulative proportion of survivors estimated to experience at least one relapse within 30 yr was 38% (95% CI, 31 to 43%). Of the 601 physicians with substance use disorder, 114 (19%) were dead from a substance use disorder–related cause at last follow-up. Conclusions A substantial proportion of anesthesiologists who develop substance use disorder after the completion of training die of this condition, and the risk of relapse is high in those who survive. Editor’s Perspective What We Already Know about This Topic What This Article Tells Us That Is New

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