Postpartum and addiction recovery of women in opioid use disorder treatment: A qualitative study.

Postpartum is a highly vulnerable time for women with opioid use disorder (OUD). Our primary objective was to identify patient and provider reported aspects of the pregnancy to postpartum transition that impact recovery progress for postpartum women receiving medication for opioid use disorder (MOUD). This qualitative study consisted of semi-structured interviews with postpartum women in OUD treatment ( = 12) and providers ( = 9) at an outpatient addiction clinic.

Effects of Psychopathy on Neurocognitive Domains of Impulsivity in Abstinent Opiate and Stimulant Users.

Psychopathy and substance use disorders (SUDs) are both characterized by neurocognitive impairments reflecting higher levels of impulsivity such as reward-driven decision-making and deficient inhibitory control. Previous studies suggest that psychopathy may exacerbate decision-making deficits, but it may be unrelated to other neurocognitive impairments among substance dependent individuals (SDIs). The aim of the present study was to examine the role of psychopathy and its interpersonal-affective and impulsive-antisocial dimensions in moderating the relationships between dependence on different classes of drugs and neurocognitive domains of impulsivity.

HIV-1 Tat and morphine decrease murine inter-male social interactions and associated oxytocin levels in the prefrontal cortex, amygdala, and hypothalamic paraventricular nucleus.

Many persons infected with HIV-1 (PWH) and opioid-dependent individuals experience deficits in sociability that interfere with daily living. Sociability is regulated by the prefrontal cortico-hippocampal-amygdalar circuit. Within this circuit HIV-1 trans-activator of transcription (HIV-1 Tat) and opioids can increase dendritic pathology and alter neuronal firing.

Social Information Processing in Substance Use Disorders: Insights From an Emotional Go-Nogo Task.

Positive social connections are crucial for recovery from Substance Use Disorder (SUD). Of interest is understanding potential social information processing (SIP) mediators of this effect. To explore whether persons with different SUD show idiosyncratic biases toward social signals, we administered an emotional go-nogo task (EGNG) to 31 individuals with Cocaine Use Disorder (CoUD), 31 with Cannabis Use Disorder (CaUD), 79 with Opioid Use Disorder (OUD), and 58 controls.

Altered effective connectivity of the reward network during an incentive-processing task in adults with alcohol use disorder.

Background: Abnormalities of reward sensitivity and impulsivity are known to be correlated with each other and alcohol use disorder (AUD) risk, but the underlying aberrant neural circuitry involved is not clearly defined. We sought to extend the current knowledge of AUD pathophysiology by studying incentive processing in persons with AUD using functional neuroimaging data.

Methods: We utilized functional MRI data from the Human Connectome Project Database obtained during performance of a number-guessing incentive-processing task with win, loss, and neutral feedback conditions in 78 participants with either DSM-IV alcohol abuse or dependence (combined as the AUD group) and 78 age- and sex-matched control (CON) participants.

Pre-exposure prophylaxis (PrEP) indication and uptake among people receiving buprenorphine for the treatment of opioid use disorder.

Background: People with opioid use disorder (OUD) are disproportionately burdened by HIV. The United States' Centers for Disease Control and Prevention (CDC) has issued guidelines for pre-exposure prophylaxis (PrEP) indication. We know little about PrEP for people receiving medication for OUD.

Development and Feasibility Study of an Addiction-Focused Phenotyping Assessment Battery.

Background And Objectives: Current methods of classifying individuals with substance use disorder (SUD) result in vast heterogeneity among persons within a given diagnosis. These approaches, while clinically allowing for distinctions between patient groups, are less than ideal when attempting to recruit a neurobehaviorally defined subset of subjects into clinical trials. To address this gap, alternative strategies have been proposed, including behavioral phenotyping.

HIV-1 Tat and Morphine Differentially Disrupt Pyramidal Cell Structure and Function and Spatial Learning in Hippocampal Area CA1: Continuous versus Interrupted Morphine Exposure.

About half the people infected with human immunodeficiency virus (HIV) have neurocognitive deficits that often include memory impairment and hippocampal deficits, which can be exacerbated by opioid abuse. To explore the effects of opioids and HIV on hippocampal CA1 pyramidal neuron structure and function, we induced HIV-1 transactivator of transcription (Tat) expression in transgenic mice for 14 d and co-administered time-release morphine or vehicle subcutaneous implants during the final 5 d (days 9-14) to establish steady-state morphine levels. Morphine was withheld from some slices during recordings to begin to assess the initial pharmacokinetic consequences of opioid withdrawal.

Buprenorphine dosing for the treatment of opioid use disorder through pregnancy and postpartum.

Purpose Of Review: Opioid-related deaths are a leading cause of mortality during pregnancy through 12 months postpartum. Buprenorphine use during pregnancy is increasing, yet expert opinion on its dosing through the perinatal period is limited. We provide a review of the current clinical literature on buprenorphine dosing during pregnancy through 12 months postpartum.

The ups and downs of relating nondrug reward activation to substance use risk in adolescents.

Purpose Of Review: A wealth of epidemiological and cohort research, together with a healthy dose of anecdote, has characterized late-adolescence and emerging adulthood as a time of increased substance use and other risky behaviors. This review will address whether differences between adolescents or between adolescents and other age groups in dopaminergic mesolimbic recruitment by (non-drug) rewards inferred from functional magnetic resonance imaging (fMRI) could partially explain morbidity and mortality from risky-behavior-related causes in adolescents.

Recent Findings: Recent findings do not suggest a definitive directionality with regard to whether increased vs decreased mesolimbic responsiveness to nondrug rewards correlates with real-world risk-taking.

Resting-State Directional Connectivity and Anxiety and Depression Symptoms in Adult Cannabis Users.

Background: Anxiety and depression symptoms are common among cannabis users and could be a risk factor for cannabis use (CU) disorder. Thus, it is critical to understand the neuronal circuits underlying the associations between CU and these symptoms. Alterations in resting-state functional connectivity within and/or between the default mode network and salience network have been reported in CU, anxiety, and depressive disorders and thus could be a mechanism underlying the associations between CU disorder and anxiety/depression symptoms.

Methylnaltrexone crosses the blood-brain barrier and attenuates centrally-mediated behavioral effects of morphine and oxycodone in mice.

Background: Antagonism of peripheral opioid receptors by methylnaltrexone (MNTX) was recently proposed as a potential mechanism to attenuate the development of opioid analgesic tolerance based on experiments conducted in mice. However, reports indicate that MNTX is demethylated to naltrexone (NTX) in mice, and NTX may subsequently cross the blood-brain barrier to antagonize centrally-mediated opioid effects. The goal of this study was to determine whether MNTX alters centrally-mediated behaviors elicited by the opioid analgesics, morphine and oxycodone, and to quantify concentrations of MNTX and NTX in blood and brain following their administration in mice.

Evaluation of a new departmental policy to decrease routine opioid prescribing after vaginal delivery.

Background: In line with a nationwide commitment to decrease opioid prescribing, in October 2017, our department implemented a new departmental policy to cease routine provision of opioid prescriptions at the time of discharge following vaginal delivery.

Objective: This study aimed to evaluate the effect of this policy on the number of discharge opioid prescriptions provided and outpatient encounters observed postpartum.

Study Design: This was a retrospective cohort study of patients who underwent vaginal delivery at our institution from November 2016 to January 2018.

Caring for women with substance use disorders through pregnancy and postpartum during the COVID-19 pandemic: Lessons learned from psychology trainees in an integrated OBGYN/substance use disorder outpatient treatment program.

Objective: This article presents a brief overview of the challenges and facilitators to the provision of substance use disorder (SUD) treatment for pregnant and parenting women during the COVID-19 pandemic. Specifically, we highlight the deployment of telepsychology services during the pandemic by an integrated, trainee-based women & addictions program that provides care via a multidisciplinary team, including an obstetrician, addiction medicine fellow, nurse, behavioral health trainees, violence prevention advocates, and pediatric provider.

Methods: We outline unique adaptations that the program made to shift from in-person psychology trainee services to telepsychology.

Sex-specific risk profiles for substance use among college students.

Introduction: Growing evidence indicates sex and gender differences exist in substance use. Framed by a lifecourse perspective, we explored prospectively by sex the effects of distal and proximal factors on the initiation of drug use in college.

Methods: College students without prior drug use (n = 5,120 females; n = 2,951 males) were followed longitudinally across 4 years.

Chronic HIV-1 Tat exposure alters anterior cingulate cortico-basal ganglia-thalamocortical synaptic circuitry, associated behavioral control, and immune regulation in male mice.

HIV-1 selectively disrupts neuronal integrity within specific brain regions, reflecting differences in viral tropism and/or the regional differences in the vulnerability of distinct neuronal subpopulations within the CNS. Deficits in prefrontal cortex (PFC)-mediated executive function and the resultant loss of behavioral control are a particularly debilitating consequence of neuroHIV. To explore how HIV-1 disrupts executive function, we investigated the effects of 48 h, 2 and/or 8 weeks of HIV-1 Tat exposure on behavioral control, synaptic connectivity, and neuroimmune function in the anterior cingulate cortex (ACC) and associated cortico-basal ganglia (BG)-thalamocortical circuitry in adult, Tat transgenic male mice.

Menstrual Hygiene Needs Among Women Undergoing Substance Use Disorder Treatment.

Unmet menstrual hygiene needs are common among women receiving substance use disorder treatment, despite having regular interactions with health care professionals.

Opioid and neuroHIV Comorbidity - Current and Future Perspectives.

With the current national opioid crisis, it is critical to examine the mechanisms underlying pathophysiologic interactions between human immunodeficiency virus (HIV) and opioids in the central nervous system (CNS). Recent advances in experimental models, methodology, and our understanding of disease processes at the molecular and cellular levels reveal opioid-HIV interactions with increasing clarity. However, despite the substantial new insight, the unique impact of opioids on the severity, progression, and prognosis of neuroHIV and HIV-associated neurocognitive disorders (HAND) are not fully understood.

Feasibility of bystander-administered naloxone delivered by drone to opioid overdose victims.

Background: Currently, ≤5% of bystanders witnessing an opioid overdose (OD) in the US administer antidote to the victim. A possible model to mitigate this crisis would be a system that enables 9-1-1 dispatchers to both rapidly deliver naloxone by drone to bystanders at a suspected opioid OD and direct them to administer it while awaiting EMS arrival.

Methods: A simulated 9-1-1 dispatcher directed thirty subjects via 2-way radio to retrieve naloxone nasal spray from atop a drone located outside the simulation building and then administer it using scripted instructions.

Examination of preliminary behavioral and effective connectivity findings from treatment response to citalopram in cocaine use disorder: A dynamic causal modeling study.

We sought effective (directional) connectivity parameters associated with response to citalopram in cocaine use disorder (CUD) by conducting a functional magnetic resonance imaging (fMRI) experiment with participants diagnosed with CUD (n = 13) and matched healthy controls (HC; n = 17). CUD participants showed a positive correlation between bilateral DLPFC-to-putamen effective connectivity and treatment effectiveness score. These preliminary results support further investigation of prefrontal-striatal interactions in response to treatment in CUD.

Methylation Patterns of the Associate With Relapse-Related Behaviors in Cocaine-Dependent Participants.

Relapse during abstinence in cocaine use disorder (CUD) is often hastened by high impulsivity (predisposition toward rapid unplanned reactions to stimuli without regard to negative consequences) and high cue reactivity (e.g., attentional bias towards drug reward stimuli).

Validation of the Levenson Self-Report Psychopathy Scale in Bulgarian Substance-Dependent Individuals.

The co-occurrence of psychopathy and substance use disorders (SUDs) is associated with higher relapse rates and increased risk of violent offending. Studies on the validity of psychopathy measures in community samples and substance-dependent individuals (SDIs) are scarce. The aim of the current study was to examine the psychometric properties of the Levenson Self-Report Psychopathy Scale (LSRP) in a sample of Bulgarian SDIs and non-dependent controls.

Conditional expression of HIV-1 tat in the mouse alters the onset and progression of tonic, inflammatory and neuropathic hypersensitivity in a sex-dependent manner.

Background: At least one-third of HIV-1-afflicted individuals experience peripheral neuropathy. Although the underlying mechanisms are not known, they may involve neurotoxic HIV-1 proteins.

Methods: We assessed the influence of the neurotoxic HIV-1 regulatory protein, Tat, on inflammatory and neuropathic nociceptive behaviours using transgenic male and female mice that conditionally expressed (or did not express) HIV-1 Tat in fibrillary acidic protein-expressing glia in the central and peripheral nervous systems.