Global Assessment of Training Needs in Addiction Medicine.

Introduction: A minority of addiction patients receive appropriate treatment directly from trained professionals in addiction medicine. Most countries have not recognized addiction medicine (AM) as a specialty in its own right or within psychiatry/other specialties. Therefore, the effectiveness and organization of AM training around the world need to be improved.

Self-Assessment of Addiction Medicine Core Competencies in Four Year Groups of Psychiatrists in Training: Efficacy of the Addiction Medicine Training Needs Assessment Scale in a Local Training Context.

Background: In addiction medicine training, self-assessment is increasingly used to support self-regulation learning by identifying standards of excellence, competence gaps, and training needs. To ensure psychiatrists in Lithuania also develop specific addiction competencies, the Lithuanian Health Sciences University faculty in Kaunas developed an addiction psychiatry curriculum.

Objectives: The aim of this research is to explore the efficacy of the AM-TNA scale to measure individual and group differences in proficiency in the core competencies of addiction medicine.

Cognitive Impairments in Patients with GHB Use Disorder Predict Relapse in GHB Use.

Background: The recreational use of gamma hydroxybutyrate (GHB) is associated with frequent overdoses, coma and the risk of developing GHB use disorder (GUD). Several studies suggest negative effects of GHB use or related comas on cognition. Since relapse rates are high in GUD and cognitive impairment has been associated with relapse in other substance use disorders, we aimed to (1) investigate the prevalence of cognitive impairment before and after detoxification, (2) analyse the relationship between GHB use, comas, and cognitive impairment, and (3) explore the association between cognitive impairment and relapse after detoxification in GUD patients.

Premenstrual syndrome predicts alcohol craving in women with substance use disorders.

Premenstrual Syndrome (PMS) comprises psychological, somatic, and behavioral symptoms during the luteal phase of almost every menstrual cycle. PMS and premenstrual dysphoric disorder (PMDD) may be associated with substance use. Between 2018 and 2020 we studied the relationship between PMS and substance use within a prospective case-control design comparing a consecutive series of women having a substance use disorder and being treated in an addiction treatment center (ATC group, n = 151)) and one with community dwelling women attending their general practitioner (GP group, n = 101).

A Global Survey on Changes in the Supply, Price, and Use of Illicit Drugs and Alcohol, and Related Complications During the 2020 COVID-19 Pandemic.

COVID-19 has infected more than 77 million people worldwide and impacted the lives of many more, with a particularly devastating impact on vulnerable populations, including people with substance use disorders (SUDs). Quarantines, travel bans, regulatory changes, social distancing, and "lockdown" measures have affected drug and alcohol supply chains and subsequently their availability, price, and use patterns, with possible downstream effects on presentations of SUDs and demand for treatment. Given the lack of multicentric epidemiologic studies, we conducted a rapid global survey within the International Society of Addiction Medicine (ISAM) network in order to understand the status of substance-use patterns during the current pandemic.

Clinical judgement versus self-rating of demoralization in outpatients with a substance-use disorder: A cross-sectional study.

Purpose: To investigate the ability of case managers, working in ambulatory treatment settings specialized in addiction care, to clinically judge demoralization in substance-dependent patients.

Design And Methods: In a cross-sectional study, clinical judgments of case managers were compared with the patients' scores on the Demoralization Scale, by calculating the sensitivity and specificity scores.

Findings: Case managers identified demoralization in 85% of the cases (sensitivity), the specificity of 62% suggests that demoralization was overestimated by case managers.

Barriers and Facilitators to Seek Help for Substance Use Disorder among Dutch Physicians: A Qualitative Study.

Introduction: Substance use disorders (SUDs) among physicians affect their health, quality of life, but potentially also their quality of care. Despite the availability of effective specific Physician Health Programs (PHPs), physicians with SUD often experience barriers when seeking professional help. Therefore, we studied barriers and facilitators when seeking help for SUD among physicians from a multiple perspective approach.

Reorganization of Substance Use Treatment and Harm Reduction Services During the COVID-19 Pandemic: A Global Survey.

The coronavirus disease 2019 (COVID-19) pandemic has impacted people with substance use disorders (SUDs) worldwide, and healthcare systems have reorganized their services in response to the pandemic. One week after the announcement of the COVID-19 as a pandemic, in a global survey, 177 addiction medicine professionals described COVID-19-related health responses in their own 77 countries in terms of SUD treatment and harm reduction services. The health responses were categorized around (1) managerial measures and systems, (2) logistics, (3) service providers, and (4) vulnerable groups.

An international consultation on case reports in addiction medicine.

A Case Report (CR) is a scientific documentation of a single clinical observation which serves to inform but also to educate the reader. Case reports help to compliment clinical critical thinking in Addiction Medicine (AM) when there is limited evidence base. This study aims to analyze how international clinical and research leaders in Addiction Medicine view Case Reports and their relevance to bridge the gap between evidence and practice.

Success Rates of Monitoring for Healthcare Professionals with a Substance Use Disorder: A Meta-Analysis.

In the past decades, monitoring programs have been developed for healthcare professionals with substance use disorders. We aimed to explore estimates of abstinence and work retention rates after participation in such monitoring programs. A literature search was performed using PubMed, Embase, PsycINFO, and CINAHL.

Prolonged Ketamine and Norketamine Excretion Profiles in Urine After Chronic Use: A Case Series.

Purpose/background: Ketamine (K) is used as a party drug with hallucinogenic properties with a half-life of about 2.5 hours. Data are available with respect to the detection window (ie, when a person is still tested positive for the drug and/or metabolite after use) of K after single use.

Psychometric Properties of the Externalizing Spectrum Inventory: Replication and Extension across Clinical and Non-Clinical Samples.

The Externalizing Spectrum Inventory aims at assessing personality features that underlie externalizing disorders such as substance abuse and antisocial behaviors. The objective was to replicate the psychometric properties of the 160-item Externalizing Spectrum Inventory in Dutch clinical and non-clinical samples. First, Cronbach's alpha, test-retest reliability and the factor structure were analyzed on a mixed sample of inpatients (n = 149), undergraduates (n = 227), and community participants (n = 178).

Addiction-Focused Eye Movement Desensitization and Reprocessing Therapy as an Adjunct to Regular Outpatient Treatment for Alcohol Use Disorder: Results From a Randomized Clinical Trial.

Background: This study examined the feasibility, safety, and efficacy of addiction-focused eye movement desensitization and reprocessing (AF-EMDR) treatment, as an add-on intervention to treatment as usual (TAU).

Methods: Adult outpatients with alcohol use disorder (AUD) (N = 109) who already received or had just started with TAU (Community Reinforcement Approach) were recruited at 6 outpatient addiction care facilities. They were randomly assigned to either TAU + 7 weekly 90-minute sessions of AF-EMDR (N = 55) or TAU-only (N = 54).

Prevalence of cognitive impairment in patients with substance use disorder.

Introduction And Aims: Cognitive impairments in substance use disorder predict treatment outcome and are assumed to differ between substances. They often go undetected, thus the current study focuses on the prevalence of and differences in cognitive functioning across substances by means of a cognitive screen at the early stage of addiction treatment.

Design And Methods: The Montreal Cognitive Assessment was administered to outpatients seeking treatment for substance use disorder.

Changes over time in Lithuanian schoolchildren's attitudes toward addictive behaviors: Promoting and preventing factors.

Background: Concern is growing about the high prevalence of traditional and new forms of addictive behaviors among young people due to the health risks and a better understanding of the factors causing these behaviors is needed.

Aim: To evaluate tendencies in the attitudes of Lithuanian schoolchildren toward addictive behaviors over a three year period and to ascertain the promoting and preventing factors of such behaviors.

Methods: The researchers developed a survey which was conducted twice over a three year period.

Using the Pictorial Representation of Illness and Self Measure (PRISM) to Quantify and Compare Suffering From Trauma and Addiction.

Objective: In a sample of people with substance use disorder who had experienced psychological trauma, this study aimed to quantify differences in perceived suffering due to addiction-related problems and to trauma-related problems.

Methods: The sample comprised 146 inpatients with substance use disorder: 25% had posttraumatic stress disorder (PTSD), 21% had subthreshold PTSD; and the remainder constituted the trauma-only group. PTSD, substance use disorder, and suffering were assessed using validated instruments.

Demoralization in Patients With Substance Use and Co-Occurring Psychiatric Disorders.

Objective: In recent years, treatment of substance use disorder has rekindled emphasis on recovery which, being a gradual process, starts with remoralization. In this study, we examine the level of demoralization throughout the treatment process for patients with comorbid substance dependence and psychiatric disorders.

Methods: 217 patients with co-occurring disorders and 179 community-based individuals participated in this study.

Substance Misuse Education for Physicians: Why Older People are Important.

This perspective article focuses on the need for training and education for undergraduate medical students on substance-related disorders, and describes initiatives undertaken in the United Kingdom (UK), Netherlands, United States (US), and Norway to develop the skills, knowledge, and attitudes needed by future doctors to treat patients adequately. In addition, we stress that in postgraduate training, further steps should be taken to develop Addiction Medicine as a specialized and transverse medical domain. Alcohol use disorder is a growing public health problem in the geriatric population, and one that is likely to continue to increase as the baby boomer generation ages.

Psychiatric comorbidity, psychological distress, and quality of life in gamma-hydroxybutyrate-dependent patients.

Understanding the psychiatric state and psychological distress level of patients with gamma-hydroxybutyrate dependence is important to develop effective detoxification and relapse management methods. The aim of the current study was to assess the prevalence among gamma-hydroxybutyrate-dependent individuals of psychiatric comorbidity and psychological distress levels and their association with the individuals' pattern of misuse and quality of life. There were 98 patients tested with the Mini International Neuropsychiatric Interview-plus, the Brief Symptom Inventory, the Depression Anxiety Stress scale, and the EuroQoL-5D as a part of the Dutch gamma-hydroxybutyrate detoxification monitor in 7 addiction treatment centers.

The Effect of Co-occurring Substance Use on Gamma-hydroxybutyric Acid Withdrawal Syndrome.

Objectives: Gamma-hydroxybutyric acid (GHB) withdrawal is a complex syndrome which can be potentially life-threatening. Additionally, GHB-dependent patients frequently report co-occurring substance use of other psychoactive drugs. We assessed the add-on effect of co-use on GHB withdrawal symptoms.

Are addiction-related memories malleable by working memory competition? Transient effects on memory vividness and nicotine craving in a randomized lab experiment.

Background And Objectives: Experimental research suggests that working memory (WM) taxation reduces craving momentarily. Using a modified Eye Movement Desensitization and Reprocessing (EMDR) procedure, prolonged reductions in craving and relapse rates in alcohol dependence have been demonstrated. Modified EMDR-procedures may also hold promise in smoking cessation attempts.

Web-Based Cognitive Behavioral Therapy for Female Patients With Eating Disorders: Randomized Controlled Trial.

Background: Many patients with eating disorders do not receive help for their symptoms, even though these disorders have severe morbidity. The Internet may offer alternative low-threshold treatment interventions.

Objective: This study evaluated the effects of a Web-based cognitive behavioral therapy (CBT) intervention using intensive asynchronous therapeutic support to improve eating disorder psychopathology, and to reduce body dissatisfaction and related health problems among patients with eating disorders.

Baclofen as relapse prevention in the treatment of Gamma- Hydroxybutyrate (GHB) dependence: an open label study.

Background: GHB dependence is a growing health problem in several western countries, especially the Netherlands. Attempts to stop using GHB are often followed by relapse shortly after successful detoxification. Craving for GHB use and co-morbid psychiatric symptom levels are thought to be the major factors contributing to the high relapse rates.

Baclofen as relapse prevention in the treatment of gamma-hydroxybutyrate dependence: a case series.

In the last decade, gamma-hydroxybutyrate (GHB) abuse and dependence have increased. It has been reported that GHB dependence has a high rate of relapse, serious complications of intoxication, and a potentially life-threatening withdrawal syndrome. Nevertheless, in clinical practice, there is no known medical treatment to support GHB relapse prevention.

Baclofen and γ-hydroxybutyrate (GHB), a dangerous combination.

Baclofen is a γ-aminobutyric acid (GABA)-β receptor agonist with a muscle relaxant effect. It increases GABA activity and reduces the production of glutamate and dopamine. The GABA precursor γ-hydroxybutyrate (GHB) has gained popularity as a drug of abuse.