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Coronavirus disease 2019 (COVID‐19) first emerged in China in November 2019. Most governments have responded to the COVID‐19 pandemic by imposing a lockdown. Some evidence suggests that a period of isolation might have led to a spike in alcohol misuse, and in the case of patients with alcohol use disorder (AUD), social isolation can favour lapse and relapse. The aim of our position paper is to provide specialists in the alcohol addiction field, in psychopharmacology, gastroenterology and in internal medicine, with appropriate tools to better manage patients with AUD and COVID‐19,considering some important topics: (a) the susceptibility of AUD patients to infection; (b) the pharmacological interaction between medications used to treat AUD and to treat COVID‐19; (c) the reorganization of the Centre for Alcohol Addiction Treatment for the management of AUD patients in the COVID‐19 era (group activities, telemedicine, outpatients treatment, alcohol‐related liver disease and liver transplantation, collecting samples); (d) AUD and SARS‐CoV‐2 vaccination. Telemedicine/telehealth will undoubtedly be useful/practical tools even though it remains at an elementary level; the contribution of the family and of caregivers in the management of AUD patients will play a significant role; the multidisciplinary intervention involving experts in the treatment of AUD with specialists in the treatment of COVID‐19 disease will need implementation. Thus, the COVID‐19 pandemic is rapidly leading addiction specialists towards a new governance scenario of AUD, which necessarily needs an in‐depth reconsideration, focusing attention on a safe approach in combination with the efficacy of treatment., All health care systems need to be reorganized during and after the COVID‐19 pandemic, and also the CAATs in order to combine operator safety with patient safety and care. The multi‐disciplinary intervention involving experts in the treatment of AUD and ALD with specialists in the treatment of COVID‐19 disease will need implementation and the contribution of the family and of care‐givers in the management of AUD and ALD patients will play a significant role.

The number of citations a peer-reviewed article receives is often used as a measure of its importance and scientific impact. This paper identifies, describes and categorizes the highly cited papers in addiction research on cannabis, heroin, cocaine and psychostimulants. Highly cited papers were identified in the Web of Science Core Collection database. Several bibliometric indicators were calculated. Social network analysis was applied to draw groups of authors and institutions with the greatest number of collaborations and co-words. The number of citations for the top 100 cited articles ranged from 649 to 4,672. The articles were published in 40 journals. The subject category Substance Abuse included 10 papers. The United States was the most productive country (79 papers), followed by the United Kingdom (9). The main funding institutions were the National Institutes of Health in the United States. The network of collaboration between authors distributes the 352 researchers into 53 groups. The three most cited works address the neural basis of drug craving as an incentive-sensitization theory of addiction, the clinical and research uses of the Addiction Severity Index, and the neurocircuitry of addiction. Scientific literature on addictions is widely dispersed both in multidisciplinary and specific journals of neurology, psychiatry and addictions, with relatively few publications providing most of the citations. An ongoing challenge for this field is the concentration of highly cited papers coming from a select number of countries, with the United States being the research hub of the world, with the highest volume of publications and total citations., This work have been funding by Servicio de Drogodependencias (PMD/UPCCA-València). Concejalía de Sanidad y Consumo. Ajuntament de València.

It is the position of the International Nurses Society on Addictions that all nurses, in all settings, should be prepared to provide care to patients with alcohol use problems, especially for women of childbearing age.

Two principal resources will be used to discuss Darren Haber’s paper Simulated Selfhood, Authentic Dialogue: An Intersubjective Systems Look at Treating Addiction. They are Intersubjective Self Psy...

The Science of Behavior Change project represents a major advance in the way we approach the study of behavior and behavior change; the protocols in this special issue reflect the innovative approach to intervention development. Digital technology is transforming the way we conduct science and can greatly assist with developing protocols, reporting studies, and evidence synthesis. The journal Addiction has developed an online Paper Authoring Tool (PAT) for reporting full-scale randomized controlled trials that could also be used for reporting protocols and early phase trials. PAT aims to help authors ensure that they include all the required information and present it in a way that is clear and consistent in terms of language and phrasing. It also generates a computer-readable record that should greatly facilitate automation of evidence synthesis. PAT is intended to represent the first step in creation of a supportive ecosystem for the conduct of science, linking grant applications, study protocols, study reports, measures, reviews and study data in a coordinated online knowledge base. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

Electronic nicotine delivery systems (ENDS) or e-cigarettes or vape pens/vaping devices are battery-powered devices used to smoke or ‘vape’, a flavoured solution containing varying concentrations of nicotine, an addictive chemical found in cigarettes and other forms of tobacco products. Amongst these various types of ENDS devices, e-cigarettes are the most common type. They produce an aerosolized mixture of the flavoured liquids and nicotine, which is inhaled by the user. Nicotine is considered as one of the most addictive substances. The rapidity at which it is introduced into the body, age of first exposure and the dosage administered all add to determine the potential risk of a person being addicted to it throughout life. Nicotine addiction is established more strongly when the exposure occurs in adolescence. The various flavours and attractive designs also add to the allure of these products to the young population. ENDS or e-cigarettes are manufactured in such a way to resemble conventional tobacco products such as cigarettes, pipes and cigars and common gadgets such as flash drives, flashlights or pens (Figs. ​(Figs.11 and ​and22)1. Structurally, most e-cigarettes contain four different components: a cartridge or reservoir, which holds a liquid solution containing varying amounts of nicotine with flavourings, and other chemicals (e-liquid or e-juice), namely a power source (usually a battery), a heating element (atomizer) and a mouthpiece that the person uses to inhale. They date back to 17th August 1965 when the first documented patent for this type of device was issued in Pennsylvania. Since then, it took several decades of additional propagation before mass production was initiated in 2003 in China and some other countries. Currently, there are more than 460 different e-cigarette brands with varied configuration of nicotine delivery available in the market, for example, cigar-likes (first generation), tank systems (second generation) and personal vaporizers (third generation) with over 7700 flavours2. This makes collation of data on health effects more difficult for generation of scientific evidence. Open in a separate window Fig. 1 Various types of electronic nicotine delivery systems devices. Source: Ref. 1

In 1996, when I was prescribed an antidepressant, there was already published research that showed selective serotonin reuptake inhibitors (SSRIs), commonly known as antidepressants, caused withdrawal effects.1 However, at that time, the Defeat Depression campaign had successfully created a narrative adopted by most prescribers, in which anxiety or depression were described to the patient as caused by a ‘chemical imbalance in the brain’ and that SSRIs were safe, effective, and non-addictive. Why would a doctor feel the need to do a full literature review? Today the word is out that my experience of attempting repeatedly to stop taking the drug and experiencing increasingly severe withdrawal effects is by no means uncommon. We now know a drug can cause dependence without causing addiction. Dependence is simply the physiological consequence of taking a drug that causes the body (especially the brain and central nervous system) to change its structure and functioning in response to the ongoing presence of the drug — for example, an antidepressant. The Public Health England (PHE) report Dependence and withdrawal associated with some prescribed medicines. An evidence review , published in 2019,2 established that 25% of adults in England were taking a dependence-forming drug. This led to the Royal College of Psychiatrists publishing a new position statement on antidepressant withdrawal, identifying it as potentially ‘severe and long-lasting’ , and something that patients should be made aware of during informed consent for these medications.3 As a busy GP, should you wish to learn more through reading current research, which papers give you the best insight into …

Aim: This study was aimed at investigating the availability and prescription of different medicinal variants of cannabis and their status in European countries. Methods: A ­web-based survey was sent to all member societies of the ­European Federation of Addiction Societies (EUFAS) in 2 waves during the summer of 2017. All 34 member societies in 19 different European countries were invited to participate. Results: We received 28 responses from 17 European countries. The cannabis extract nabiximol (Sativex®) is the most prevalent cannabis-based medicinal product marketed in Europe. Synthetic cannabinoids and standardized cannabis are less prevalent, and no country allows the growing of cannabis for personal medical use. The bringing of medical cannabis products from across borders to countries where the drug is not marketed is quite limited. The use of medical cannabis is restricted to some central medical conditions, but off-label use is prevalent in some countries. Conclusion: The use of medical cannabis in Europe seems to be restricted mostly to the use of the cannabis extract, nabiximol. There is only limited use of the cannabis plant as such for medical purposes, possibly indicating a different scenario in Europe as compared to the USA. Position Statement: EUFAS as an umbrella association of European addiction societies stresses the need for further studies on the efficacy of medical cannabis and warrants for possible dangers associated with the increasing popularity of medical cannabis. We need regulations at European level concerning registration and medical indications, development of uniform compounds and strength of products, and rules concerning sales and marketing.

Various epidemiological and biological evaluations and the recent publication of the DSM-V (diagnostic and statistical manual of mental disorders) has imposed on the scientific community a period of reflection on the diagnosis and treatment of what in the DSM-IV was defined as "addiction". To date, the term "addiction" has been replaced by the DSM-5, because there is no global scientific consensus that has unequivocally characterized its clinical characteristics. This, we will talk about substance/alcohol use disorders (SUDs/AUDs) and disorders related to behavioral alterations (DBA) that can generate organic diseases, mental disorders, and social problems. In the first psychotic episode 40-70% of subjects meet the criteria of a SUDs/AUDs, excluding tobacco dependence. Substances can not only be the cause of a psychotic onset, but they can also disrupt a psychotic picture or interfere with drug therapy. The pharmacodynamic profiles of many substances are able to provoke the phenomenology of the main psychotic symptoms in a way that can be superimposed onto those presented by psychotic subjects without a history of SUDs/AUDs. The Department of Addictions (DAs) must not be absorbed by or incorporated into the Departments of Mental Health (DMH), with which, however, precise operational cooperation protocols will have to be defined and maintained, but it will have to maintain its own autonomy and independent connotation. Addiction Medicine is a discipline that brings together elements of public health, prevention, internal medicine, clinical pharmacology, neurology, and even psychiatry. The inclusion of the DAs in those of DMH refers purely to a problem of pathology that has to do with lifestyle, choices, and behaviors. These, over time, show their dysfunctionality and only then do related problems emerge. Moreover, epidemiological, social, and clinical motivations impose the creation of alcohological teams dedicated to alcohol-related activities. The collaboration with self-help-groups (SHGs) is mandatory. The action of SHGs is accredited in numerous international recommendations both on the basis of consensus and evidence in the literature.

The Addiction Paper Authoring Tool (PAT) is an online application designed to improve the writing of research reports in the field of addiction. It is currently restricted to 2-arm randomised controlled trials but will be extended to cover other major types of study design. It prompts authors for information required, based on an underlying ontology of the field, and provides guidance and structure to ensure that the information provided is clear, consistent, comprehensive and coherent. It outputs a Word version of the paper that can then be edited for style. Equally importantly, it outputs a machine-readable record that can provide a basis for automated searching and evidence synthesis.

Worldwide, the prevalence of alcohol use disorder (AUD) is 20-30% in men and 10-15% in women, and cirrhosis due to alcohol-related liver disease (ALD) is responsible for 0.9% of global deaths and 47.9% of cirrhosis-related deaths. End-stage ALD (ESALD) is the final condition of alcohol-related cirrhosis, and severe acute alcohol-related hepatitis (SAAH) is a distinct clinical syndrome associated with the consumption of large amounts of alcohol. In some cases, ESALD, and SAAH may need liver transplantation (LT). Thus, the management of ESALD and SAAH in patients affected by AUD may be an essential part of the clinical skills for hepatologists. For these reasons, the national board of the Italian Society on Alcohol have reviewed the most recent data on the management of ESALD, SAAH and LT for ALD in patients with AUD, formulating a position paper with related recommendations regarding four issues of specific clinical interest in this field: (a) the management of hepatic encephalopathy in patients with AUD, and LT in patients with ESALD; (b) the management of SAAH; (c) the management of AUD in patients with ESALD and SAAH; (d) special populations: polydrug addicts.

The Patient Safety Subcommittee requested a review of the science and policy issues regarding the rapidly emerging public health epidemic of prescription opioid-related morbidity and mortality in the United States. Over 100,000 persons have died, directly or indirectly, from prescribed opioids in the United States since policies changed in the late 1990s. In the highest-risk group (age 35–54 years), these deaths have exceeded mortality from both firearms and motor vehicle accidents. Whereas there is evidence for significant short-term pain relief, there is no substantial evidence for maintenance of pain relief or improved function over long periods of time without incurring serious risk of overdose, dependence, or addiction. The objectives of the article are to review the following: (1) the key initiating causes of the epidemic; (2) the evidence for safety and effectiveness of opioids for chronic pain; (3) federal and state policy responses; and (4) recommendations for neurologists in practice to increase use of best practices/universal precautions most likely to improve effective and safe use of opioids and to reduce the likelihood of severe adverse and overdose events. Neurology® 2014;83:1277–1284

Before organizing mixed-mode data collection for the self-administered questionnaire of the Belgian Health Interview Survey, measurement effects between the paper-and-pencil and the web-based questionnaire were evaluated. A two-period cross-over study was organized with a sample of 149 employees of two Belgian research institutes (age range 22-62 years, 72% female). Measurement agreement was assessed for a diverse range of health indicators related to general health, mental and psychosocial health, health behaviors and prevention with kappa coefficients and intraclass correlation (ICC). The quality of the data collected by both modes was evaluated by quantifying the missing, 'don't know' and inconsistent values and data entry mistakes. Good to very good agreement was found for all categorical indicators with kappa coefficients superior to 0.60, except for two mental and psychosocial health indicators namely the presence of a sleeping disorder and of a depressive disorder (kappa≥0.50). For the continuous indicators high to acceptable agreement was observed with ICC superior to 0.70. Inconsistent answers and data-entry mistakes were only occurring in the paper-and-pencil mode. There were no less missing values in the web-based mode compared to the paper-and-pencil mode. The study supports the idea that web-based modes provide, in general, equal responses to paper-and-pencil modes. However, health indicators based upon factual and objective items tend to have higher measurement agreement than indicators requiring an assessment of personal subjective feelings. A web-based mode greatly facilitates the data-entry process and guides the completing of a questionnaire. However, item non-response was not positively affected. ispartof: PLOS ONE vol:13 issue:5 ispartof: location:United States status: published

The United States (U.S.) is facing a national opioid epidemic, and medical systems are in need of non-pharmacologic strategies that can be employed to decrease the public's opioid dependence. Acupuncture has emerged as a powerful, evidence-based, safe, cost-effective, and available treatment modality suitable to meeting this need. Acupuncture has been shown to be effective for the management of numerous types of pain conditions, and mechanisms of action for acupuncture have been described and are understandable from biomedical, physiologic perspectives. Further, acupuncture's cost-effectiveness can dramatically decrease health care expenditures, both from the standpoint of treating acute pain and through avoiding addiction to opioids that requires costly care, destroys quality of life, and can lead to fatal overdose. Numerous federal regulatory agencies have advised or mandated that healthcare systems and providers offer non-pharmacologic treatment options for pain. Acupuncture stands out as the most evidence-based, immediately available choice to fulfil these calls. Acupuncture can safely, easily, and cost-effectively be incorporated into hospital settings as diverse as the emergency department, labor and delivery suites, and neonatal intensive care units to treat a variety of commonly seen pain conditions. Acupuncture is already being successfully and meaningfully utilized by the Veterans Administration and various branches of the U.S. Military, in some studies demonstrably decreasing the volume of opioids prescribed when included in care.

International audience; There is growing interest in non-invasive brain stimulation (NIBS) as a novel treatment option for substance-use disorders (SUDs). Recent momentum stems from a foundation of preclinical neuroscience demonstrating links between neural circuits and drug consuming behavior, as well as recent FDA-approval of NIBS treatments for mental health disorders that share overlapping pathology with SUDs. As with any emerging field, enthusiasm must be tempered by reason; lessons learned from the past should be prudently applied to future therapies. Here, an international ensemble of experts provides an overview of the state of transcranial-electrical (tES) and transcranial-magnetic (TMS) stimulation applied in SUDs. This consensus paper provides a systematic literature review on published data - emphasizing the heterogeneity of methods and outcome measures while suggesting strategies to help bridge knowledge gaps. The goal of this effort is to provide the community with guidelines for best practices in tES/TMS SUD research. We hope this will accelerate the speed at which the community translates basic neuroscience into advanced neuromodulation tools for clinical practice in addiction medicine.

This study aimed to investigate the effects of the golf-addiction tendencies of golf betting participants on their self-management practices. About...

Chapter two investigates an overlooked archive of tobacco ephemera, the smoke-room booklets, cigarette cards, and periodicals meant to be consumed by men while smoking. Tobacco-related poems, pictures, and print forms produced a self-referential discourse that compared smoking to consuming print, through puns on “leaves,” “volumes,” and “puffs” of speech preserved in paper. Through the medium of smoke, mass print self-consciously began to mediate fantasy, mental relaxation, and reverie. The most famous nineteenth-century literary smoker, Arthur Conan Doyle’s fictional detective Sherlock Holmes, figures this addictive dependency on print in his iconic pipe. His media “addiction” – really a reliance on obscure information – reflects readers’ desire for encyclopedic knowledge. Such desires for cultural mastery drove the popularity of cigarette cards, which featured trivia, and became a staple of working- and middle-class life from their invention in the 1890s. Reframing Holmes as the first “information addict,” the chapter tells the back story of our current intensified appetite for information in a knowledge economy governed by mass media.

The articles highlighted this week focus on signaling events that control appetite and weight; the effects of Hippo signaling on cell function during cardiac repair; a mechanism that drives cancer drug addiction; inactivation of a kinase complex by structural rearrangement; and the mechanism by which a noncoding viral RNA inhibits host cell apoptosis.