Opioid substitution treatment, relapse and addiction-related outcomes in prison setting and after release: A longitudinal study.

Opioid addiction is a common problem among prisoners. The aim of this study was to examine differences between people who are incarcerated receiving opioid substitution treatment (OST) and those not receiving OST on addiction-related outcome variables during incarceration and after release from prison. Variables covered illicit use of opioids, non-prescribed substitution medication and other substances, opioid withdrawal symptoms, opioid craving, non-fatal overdoses and post-release substitution treatment.

[First Aid Training for Drug Overdose in Opioid Addicts and Provision of Take-Home Naloxone on Release from Prison: Feasibility Study from the Bavarian Model Project].

Introduction: Between 22 and 30% of prisoners in Germany are reported to be intravenous drug users. There is a 12-fold increase in mortality, mostly as a result of opioid overdose in the first weeks after release from prison. We evaluated the feasibility of first aid training for drug overdose, including take-home naloxone in incarcerated opioid addicts.

German Guidelines on Screening, Diagnosis, and Treatment of Alcohol Use Disorders: Update 2021.

Introduction: Alcohol consumption in Germany is associated with considerable health and economic consequences. In addition to prevention, the early detection and differential treatment of those affected play an important role. The guideline "Screening, Diagnosis, and Treatment of Alcohol Use Disorders" forms the basis of this care for people suffering from alcohol use disorders.

Colocalization analysis of pancreas eQTLs with risk loci from alcoholic and novel non-alcoholic chronic pancreatitis GWAS suggests potential disease causing mechanisms.

Background: Previous genome-wide association studies (GWAS) identified genome-wide significant risk loci in chronic pancreatitis and investigated underlying disease causing mechanisms by simple overlaps with expression quantitative trait loci (eQTLs), a procedure which may often result in false positive conclusions.

Methods: We conducted a GWAS in 584 non-alcoholic chronic pancreatitis (NACP) patients and 6040 healthy controls. Next, we applied Bayesian colocalization analysis of identified genome-wide significant risk loci from both, our recently published alcoholic chronic pancreatitis (ACP) and the novel NACP dataset, with pancreas eQTLs from the GTEx V8 European cohort to prioritize candidate causal genes and extracted credible sets of shared causal variants.

[Kratom - a short review for pain medicine].

Background: Consumption of the psychotropic plant kratom (botanical name: Mitragyna speciosa) is sometimes used for the self-medication of chronic or acute pain. An increase in the use is possible in Germany in the future.

Objective: This review provides an overview on kratom for pain specialists.

[Treatment of Opioid-dependent Inmates - Attitudes and Treatment Practice of medical Staff in Bavarian Prisons].

Background: The present study examines the treatment practice and attitudes of medical staff towards opioid-dependent inmates in Bavarian prisons.

Method: We interviewed medical staff (n=20) from 18 Bavarian prisons about substitution practice and attitudes by semi-structured interviews.

Results: With regard to the treatment routines and the attitudes of the medical staff, we found mixed results.

[Weighing the benefits and harms of psychotropic and analgesic substances - A perspective of German addiction medicine experts].

Background: In Europe, there have been several addiction-expert rankings of harms related to the use of psychotropic substances in the last 15 years. Among them, only one expert ranking took into account the potential benefits of these drugs. Non-Opioidergic Analgesics (NOAs), such as gabapentinoids and NSAIDs, which have been increasingly the subject of abuse / misuse reports, have not been considered in such expert rankings.

Ranking the Harm of Psychoactive Drugs Including Prescription Analgesics to Users and Others-A Perspective of German Addiction Medicine Experts.

Over the past 15 years, comparative assessments of psychoactive substance harms to both users and others have been compiled by addiction experts. None of these rankings however have included synthetic cannabinoids or non-opioid prescription analgesics (NOAs, e.g.

[Scientific Rationale for the Directive on Opioid Substitution Treatment of the German Medical Association: A Summary].

Background: According to the Narcotic Drugs Prescription Ordinance (BtMVV), the German Medical Association was commissioned to issue a directive on opioid substitution treatment (OST) based on the current state of scientific medical knowledge.

Method: For the publication of the initial version of the German Medical Association's directive in 2002, an extensive literature research had been conducted, categorizing the results by levels of evidence. Subsequent revisions in 2010 and 2017 included recent systematic reviews, studies of evidence levels I-III and international guidelines.

Transancestral GWAS of alcohol dependence reveals common genetic underpinnings with psychiatric disorders.

Liability to alcohol dependence (AD) is heritable, but little is known about its complex polygenic architecture or its genetic relationship with other disorders. To discover loci associated with AD and characterize the relationship between AD and other psychiatric and behavioral outcomes, we carried out the largest genome-wide association study to date of DSM-IV-diagnosed AD. Genome-wide data on 14,904 individuals with AD and 37,944 controls from 28 case-control and family-based studies were meta-analyzed, stratified by genetic ancestry (European, n = 46,568; African, n = 6,280).

Heterozygous carriage of the alpha1-antitrypsin Pi*Z variant increases the risk to develop liver cirrhosis.

Objective: Homozygous alpha1-antitrypsin (AAT) deficiency increases the risk for developing cirrhosis, whereas the relevance of heterozygous carriage remains unclear. Hence, we evaluated the impact of the two most relevant AAT variants ('Pi*Z' and 'Pi*S'), present in up to 10% of Caucasians, on subjects with non-alcoholic fatty liver disease (NAFLD) or alcohol misuse.

Design: We analysed multicentric case-control cohorts consisting of 1184 people with biopsy-proven NAFLD and of 2462 people with chronic alcohol misuse, both cohorts comprising cases with cirrhosis and controls without cirrhosis.

Shared genetic etiology between alcohol dependence and major depressive disorder.

The clinical comorbidity of alcohol dependence (AD) and major depressive disorder (MDD) is well established, whereas genetic factors influencing co-occurrence remain unclear. A recent study using polygenic risk scores (PRS) calculated based on the first-wave Psychiatric Genomics Consortium MDD meta-analysis (PGC-MDD1) suggests a modest shared genetic contribution to MDD and AD. Using a (~10 fold) larger discovery sample, we calculated PRS based on the second wave (PGC-MDD2) of results, in a severe AD case–control target sample.

Genome-wide association study identifies inversion in the locus to modify risk for alcoholic and non-alcoholic chronic pancreatitis.

Objective: Alcohol-related pancreatitis is associated with a disproportionately large number of hospitalisations among GI disorders. Despite its clinical importance, genetic susceptibility to alcoholic chronic pancreatitis (CP) is poorly characterised. To identify risk genes for alcoholic CP and to evaluate their relevance in non-alcoholic CP, we performed a genome-wide association study and functional characterisation of a new pancreatitis locus.

Genetic Contribution to Alcohol Dependence: Investigation of a Heterogeneous German Sample of Individuals with Alcohol Dependence, Chronic Alcoholic Pancreatitis, and Alcohol-Related Cirrhosis.

The present study investigated the genetic contribution to alcohol dependence (AD) using genome-wide association data from three German samples. These comprised patients with: (i) AD; (ii) chronic alcoholic pancreatitis (ACP); and (iii) alcohol-related liver cirrhosis (ALC). Single marker, gene-based, and pathway analyses were conducted.

Methamphetamine-Related Disorders.

Background: Methamphetamine is considered more dangerous than other stimulants because of its acute complications, long-term neurotoxicity, and potential for drug dependence. Until now, there have been no evidence-based guidelines for the treatment of methamphetamine-related disorders, either in Germany or abroad.

Methods: A systematic literature search was performed on the treatment of methamphetamine-related disorders.

Recovery from alcohol dependence: Do smoking indicators predict abstinence?

Background And Objectives: There is inconsistent evidence about the potential influence of smoking on recovery from alcohol dependence. Our study aimed at assessing the impact of smoking-behavior on relapse during a 12 months follow-up period following a detoxification in patients with Alcohol Use Disorder (AUD).

Methods: Three hundred Patients with AUD (74.

[Psychometric Evaluation of the German Version of the Short Questionnaire for Family Members-Affected by Addiction SQFM-AA (Gambling)].

Introduction: Affected others of disordered gamblers are often heavily impacted because of the illness. Up till now, there is no standardized German instrument to assess this impact. Internationally, the Short Questionnaire for Family Members-affected by addiction (SQFM-AA) is often used which is based on the Stress-Strain-Coping-Support-Modell.

[Guideline-oriented treatment of alcohol-related disorders].

Alcohol use disorders (e.g. abuse and dependence) account for a plethora of consequences for affected individuals and for a substantial proportion of the overall burden of disease for the community.

A genome-wide association study confirms PNPLA3 and identifies TM6SF2 and MBOAT7 as risk loci for alcohol-related cirrhosis.

Alcohol misuse is the leading cause of cirrhosis and the second most common indication for liver transplantation in the Western world. We performed a genome-wide association study for alcohol-related cirrhosis in individuals of European descent (712 cases and 1,426 controls) with subsequent validation in two independent European cohorts (1,148 cases and 922 controls). We identified variants in the MBOAT7 (P = 1.

Association of the OPRM1 Variant rs1799971 (A118G) with Non-Specific Liability to Substance Dependence in a Collaborative de novo Meta-Analysis of European-Ancestry Cohorts.

The mu1 opioid receptor gene, OPRM1, has long been a high-priority candidate for human genetic studies of addiction. Because of its potential functional significance, the non-synonymous variant rs1799971 (A118G, Asn40Asp) in OPRM1 has been extensively studied, yet its role in addiction has remained unclear, with conflicting association findings. To resolve the question of what effect, if any, rs1799971 has on substance dependence risk, we conducted collaborative meta-analyses of 25 datasets with over 28,000 European-ancestry subjects.

XRCC5 as a risk gene for alcohol dependence: evidence from a genome-wide gene-set-based analysis and follow-up studies in Drosophila and humans.

Genetic factors have as large role as environmental factors in the etiology of alcohol dependence (AD). Although genome-wide association studies (GWAS) enable systematic searches for loci not hitherto implicated in the etiology of AD, many true findings may be missed owing to correction for multiple testing. The aim of the present study was to circumvent this limitation by searching for biological system-level differences, and then following up these findings in humans and animals.

Genetic risk prediction and neurobiological understanding of alcoholism.

We have used a translational Convergent Functional Genomics (CFG) approach to discover genes involved in alcoholism, by gene-level integration of genome-wide association study (GWAS) data from a German alcohol dependence cohort with other genetic and gene expression data, from human and animal model studies, similar to our previous work in bipolar disorder and schizophrenia. A panel of all the nominally significant P-value SNPs in the top candidate genes discovered by CFG  (n=135 genes, 713 SNPs) was used to generate a genetic  risk prediction score (GRPS), which showed a trend towards significance (P=0.053) in separating  alcohol dependent individuals from controls in an independent German test cohort.