Publications

@article{pmid36912195,

title = {Cannabidiol-associated hepatotoxicity: A systematic review and meta-analysis},

author = {Lindsay A Lo and April Christiansen and Lauren Eadie and Justin C Strickland and David D Kim and Michael Boivin and Alasdair M Barr and Caroline A MacCallum},

doi = {10.1111/joim.13627},

issn = {1365-2796},

year  = {2023},

date = {2023-06-01},

journal = {J Intern Med},

volume = {293},

number = {6},

pages = {724--752},

abstract = {BACKGROUND: Findings of liver enzyme elevations in recent cannabidiol studies have raised concerns over liver safety. This study aimed to determine the association between cannabidiol use, liver enzyme elevation, and drug-induced liver injury (DILI).nnMETHODS: In this systematic review and meta-analysis, a search of EMBASE, CENTRAL, CINAHL, Clinicaltrials.gov, Medline, medRxiv, and Web of Science of records up to February 2022 was conducted. Clinical trials initiating daily cannabidiol treatment with serial liver enzyme measures were included. The proportion of liver enzyme elevations and DILI were independently extracted from published reports. Pooled proportions and probability meta-analyses were conducted.nnRESULTS: Cannabidiol use was associated with an increased probability of liver enzyme elevation (N = 12 trials, n = 1229; OR = 5.85 95% CI = 3.84-8.92, p < 0.001) and DILI (N = 12 trials, n = 1229; OR = 4.82 95% CI = 2.46-9.45, p < 0.001) compared to placebo controls. In participants taking cannabidiol (N = 28 trials, n = 1533), the pooled proportion of liver enzyme elevations was 0.074 (95% CI 0.0448-0.1212), and DILI was 0.0296 (95% CI 0.0136-0.0631). High-dose CBD (≥1000 mg/day or ≥20 mg/kg/day) and concomitant antiepileptic drug use were identified as risk factors. No cases were reported in adults using cannabidiol doses <300 mg/day. No cases of severe DILI were reported.nnCONCLUSIONS: Cannabidiol-associated liver enzyme elevations and DILI meet the criteria of common adverse drug events. Clinicians are encouraged to screen for cannabidiol use and monitor liver function in patients at increased risk.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{pmid36621047,

title = {Exploring potential moderators of depressive symptoms and treatment outcomes among patients with opioid use disorder},

author = {Jennifer D Ellis and Jamey J Lister and Michael J A Wohl and Mark K Greenwald and David M Ledgerwood},

doi = {10.1016/j.addbeh.2022.107604},

issn = {1873-6327},

year  = {2023},

date = {2023-05-01},

journal = {Addict Behav},

volume = {140},

pages = {107604},

abstract = {BACKGROUND: Depressive symptoms are common in patients seeking medication treatment for opioid use disorder (MOUD treatment) and decrease quality of life but have been inconsistently related to opioid treatment outcomes. Here, we explore whether depressive symptoms may only be related to adverse treatment outcomes among individuals reporting high opioid use-related coping motives (i.e., use of opioids to change affective states) and high trait impulsivity, two common treatment targets.nnMETHODS: Patients seeking MOUD treatment (N = 118) completed several questionnaires within two weeks of their treatment intake. Treatment outcomes (opioid-positive urine screens and days retained in treatment) were extracted from treatment records. Moderation analyses controlling for demographic characteristics and main effects were conducted to explore interaction effects between depressive symptoms and two distinct moderators.nnRESULTS: Depressive symptoms were only related to opioid use during early treatment among patients reporting high opioid use-related coping motives (B = 2.67, p =.004) and patients reporting high trait impulsivity (B = 2.01, p =.039). Further, depressive symptoms were only inversely related to days retained among individuals with high opioid use-related coping motives (B = -10.12, p =.003).nnCONCLUSIONS: Individuals presenting to treatment with opioid-related coping motives and/or impulsivity in the context of depressive symptoms may confer unique risk for adverse treatment outcomes. Clinicians may wish to consider these additive risk factors when developing their treatment plan.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{pmid37166910b,

title = {Clinically meaningful individual differences in opioid withdrawal expression},

author = {Orrin D Ware and Kelly E Dunn},

doi = {10.1037/pha0000654},

issn = {1936-2293},

year  = {2023},

date = {2023-05-01},

journal = {Exp Clin Psychopharmacol},

abstract = {Opioid use disorder (OUD) is a significant public health concern. An individual with an OUD may experience withdrawal after stopping opioid use. There has been limited exploration of the individual differences in withdrawal expression. This study expands understanding of this issue by examining the presence and frequency at which persons who have ever had opioid withdrawal have experienced different opioid withdrawal symptoms. Using cross-sectional data captured online from Amazon Mechanical Turk, 124 adults with a lifetime experience of opioid withdrawal were included. Respondents were able to indicate ever experiencing 31 individual opioid withdrawal symptoms. If a symptom was ever experienced, respondents would indicate if it was common and whether it bothered them. A cluster analysis was used to explore variability between the withdrawal symptoms. The sample was primarily men ( = 76, 61.3%) with an average age of 34.7 ( = 11.6). The typical withdrawal syndrome lasted 6.5 days ( = 4.9) and was most severe at 5.7 ( = 4.9) days. Lifetime endorsement of individual symptoms ranged from a high of 73.4% (anxious) to a low of 43.5% (nausea). The cluster analysis was significant, (1, 122) = 215.6,  < .001, with good Bayesian information criteria (0.7). The two clusters are conceptualized here as HIGH ( = 73; 59%) and LOW ( = 51; 41%) endorsing, with a mean of 21.9 and 8.5 items endorsed. These data add to prior studies by suggesting high variability in the individual expression of opioid withdrawal symptoms. It may be time for the field to develop a consensus regarding opioid withdrawal symptom expression and measurement to enhance clinical care. (PsycInfo Database Record (c) 2023 APA, all rights reserved).},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{pmid36473635b,

title = {Correlates and consequences of anxiety and depressive symptom trajectories during early treatment for alcohol use},

author = {Jill A Rabinowitz and Jennifer D Ellis and Jonathan Wells and Justin C Strickland and Brion S Maher and Joseph G Hobelmann and Andrew Huhn},

doi = {10.1016/j.alcohol.2022.11.005},

issn = {1873-6823},

year  = {2023},

date = {2023-05-01},

journal = {Alcohol},

volume = {108},

pages = {44--54},

abstract = {We investigated whether latent trajectories of anxiety and depressive symptoms were associated with clinically relevant variables including treatment attrition among individuals seeking treatment for alcohol use. Participants were drawn from 78 addiction treatment centers and included individuals in treatment for alcohol use, had in-treatment data, and screened positive for anxiety (n = 6147) or depressive symptoms (n = 6197) at intake. Anxiety and depressive symptoms were measured weekly during the first month of treatment. Three trajectories of anxiety symptoms (i.e., Persistent Moderate Anxiety Symptoms, Remitting Moderate Anxiety Symptoms, and Remitting Mild Anxiety Symptoms) and depressive symptoms (i.e., Increasing Moderate Depressive Symptoms, Persistent Moderate Depressive Symptoms, and Remitting Mild Depressive Symptoms) were identified. Women, younger individuals, and individuals who endorsed greater past month benzodiazepine use and depressive symptoms at intake were more likely to be in the Persistent Moderate Anxiety Symptoms trajectory relative to the Remitting Mild Anxiety Symptoms subgroup. Women, individuals who screened positive for anxiety at intake, and individuals reporting past month heroin use were more likely to be in the Increasing Moderate Depressive Symptoms trajectory relative to the Remitting Mild Depressive Symptom trajectory. Trajectories characterized by persistent moderate anxiety and depressive symptoms during the first month of treatment were more likely to drop out of treatment compared to individuals who reported low symptom levels. Findings indicate heterogeneity in the clinical course of anxiety and depressive symptoms among individuals in treatment for alcohol use and highlight that persistently high anxiety and depressive symptoms may pose an impediment to successful treatment completion. Results also demonstrate the importance of considering demographic and clinical characteristics at treatment intake as they may have significant implications for the unfolding of anxiety and depressive symptoms during treatment and subsequent outcomes.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{pmid36508168,

title = {Cognitive training and remediation interventions for substance use disorders: a Delphi consensus study},

author = {Antonio Verdejo-Garcia and Tara Rezapour and Emily Giddens and Arash Khojasteh Zonoozi and Parnian Rafei and Jamie Berry and Alfonso Caracuel and Marc L Copersino and Matt Field and Eric L Garland and Valentina Lorenzetti and Leandro Malloy-Diniz and Victoria Manning and Ely M Marceau and David L Pennington and Justin C Strickland and Reinout Wiers and Rahia Fairhead and Alexandra Anderson and Morris Bell and Wouter J Boendermaker and Samantha Brooks and Raimondo Bruno and Salvatore Campanella and Janna Cousijn and W Miles Cox and Andrew C Dean and Karen D Ersche and Ingmar Franken and Brett Froeliger and Pedro Gamito and Thomas E Gladwin and Priscila D Goncalves and Katrijn Houben and Joanna Jacobus and Andrew Jones and Anne M Kaag and Johannes Lindenmeyer and Elly McGrath and Talia Nardo and Jorge Oliveira and Charlotte R Pennington and Kelsey Perrykkad and Hugh Piercy and Claudia I Rupp and Mieke H J Schulte and Lindsay M Squeglia and Petra Staiger and Dan J Stein and Jeff Stein and Maria Stein and William W Stoops and Mary Sweeney and Katie Witkiewitz and Steven P Woods and Richard Yi and Min Zhao and Hamed Ekhtiari},

doi = {10.1111/add.16109},

issn = {1360-0443},

year  = {2023},

date = {2023-05-01},

journal = {Addiction},

volume = {118},

number = {5},

pages = {935--951},

abstract = {AIMS: Substance use disorders (SUD) are associated with cognitive deficits that are not always addressed in current treatments, and this hampers recovery. Cognitive training and remediation interventions are well suited to fill the gap for managing cognitive deficits in SUD. We aimed to reach consensus on recommendations for developing and applying these interventions.nnDESIGN, SETTING AND PARTICIPANTS: We used a Delphi approach with two sequential phases: survey development and iterative surveying of experts. This was an on-line study. During survey development, we engaged a group of 15 experts from a working group of the International Society of Addiction Medicine (Steering Committee). During the surveying process, we engaged a larger pool of experts (n = 54) identified via recommendations from the Steering Committee and a systematic review.nnMEASUREMENTS: Survey with 67 items covering four key areas of intervention development: targets, intervention approaches, active ingredients and modes of delivery.nnFINDINGS: Across two iterative rounds (98% retention rate), the experts reached a consensus on 50 items including: (i) implicit biases, positive affect, arousal, executive functions and social processing as key targets of interventions; (ii) cognitive bias modification, contingency management, emotion regulation training and cognitive remediation as preferred approaches; (iii) practice, feedback, difficulty-titration, bias modification, goal-setting, strategy learning and meta-awareness as active ingredients; and (iv) both addiction treatment work-force and specialized neuropsychologists facilitating delivery, together with novel digital-based delivery modalities.nnCONCLUSIONS: Expert recommendations on cognitive training and remediation for substance use disorders highlight the relevance of targeting implicit biases, reward, emotion regulation and higher-order cognitive skills via well-validated intervention approaches qualified with mechanistic techniques and flexible delivery options.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{pmid36473635,

title = {Correlates and consequences of anxiety and depressive symptom trajectories during early treatment for alcohol use},

author = {Jill A Rabinowitz and Jennifer D Ellis and Jonathan Wells and Justin C Strickland and Brion S Maher and Joseph G Hobelmann and Andrew Huhn},

doi = {10.1016/j.alcohol.2022.11.005},

issn = {1873-6823},

year  = {2023},

date = {2023-05-01},

journal = {Alcohol},

volume = {108},

pages = {44--54},

abstract = {We investigated whether latent trajectories of anxiety and depressive symptoms were associated with clinically relevant variables including treatment attrition among individuals seeking treatment for alcohol use. Participants were drawn from 78 addiction treatment centers and included individuals in treatment for alcohol use, had in-treatment data, and screened positive for anxiety (n = 6147) or depressive symptoms (n = 6197) at intake. Anxiety and depressive symptoms were measured weekly during the first month of treatment. Three trajectories of anxiety symptoms (i.e., Persistent Moderate Anxiety Symptoms, Remitting Moderate Anxiety Symptoms, and Remitting Mild Anxiety Symptoms) and depressive symptoms (i.e., Increasing Moderate Depressive Symptoms, Persistent Moderate Depressive Symptoms, and Remitting Mild Depressive Symptoms) were identified. Women, younger individuals, and individuals who endorsed greater past month benzodiazepine use and depressive symptoms at intake were more likely to be in the Persistent Moderate Anxiety Symptoms trajectory relative to the Remitting Mild Anxiety Symptoms subgroup. Women, individuals who screened positive for anxiety at intake, and individuals reporting past month heroin use were more likely to be in the Increasing Moderate Depressive Symptoms trajectory relative to the Remitting Mild Depressive Symptom trajectory. Trajectories characterized by persistent moderate anxiety and depressive symptoms during the first month of treatment were more likely to drop out of treatment compared to individuals who reported low symptom levels. Findings indicate heterogeneity in the clinical course of anxiety and depressive symptoms among individuals in treatment for alcohol use and highlight that persistently high anxiety and depressive symptoms may pose an impediment to successful treatment completion. Results also demonstrate the importance of considering demographic and clinical characteristics at treatment intake as they may have significant implications for the unfolding of anxiety and depressive symptoms during treatment and subsequent outcomes.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{pmid37195789b,

title = {Fentanyl Absorption, Distribution, Metabolism, and Excretion: Narrative Review and Clinical Significance Related to Illicitly Manufactured Fentanyl},

author = {H Elizabeth Bird and Andrew S Huhn and Kelly E Dunn},

doi = {10.1097/ADM.0000000000001185},

issn = {1935-3227},

year  = {2023},

date = {2023-05-01},

journal = {J Addict Med},

abstract = {OBJECTIVES: This narrative review summarizes literature on pharmaceutical fentanyl's absorption, distribution, metabolism, and excretion patterns to inform research on illicitly manufactured fentanyl (IMF).nnRESULTS: Fentanyl is highly lipophilic, lending itself to rapid absorption by highly perfused tissues (including the brain) before redistributing from these tissues to muscle and fat. Fentanyl is eliminated primarily by metabolism and urinary excretion of metabolites (norfentanyl and other minor metabolites). Fentanyl has a long terminal elimination, with a documented secondary peaking phenomenon that can manifest as "fentanyl rebound." Clinical implications in overdose (respiratory depression, muscle rigidity, and "wooden chest syndrome") and opioid use disorder treatment (subjective effects, withdrawal, and buprenorphine-precipitated withdrawal) are discussed. The authors highlight research gaps derived from differences in medicinal fentanyl studies and IMF use patterns, including that medicinal fentanyl studies are largely conducted with persons who were opioid-naive, anesthetized, or had severe chronic pain and that IMF use is characterized by supratherapeutic doses and frequent and sustained administration patterns, as well as adulteration with other substances and/or fentanyl analogs.nnCONCLUSIONS: This review reexamines information yielded from decades of medicinal fentanyl research and applies elements of the pharmacokinetic profile to persons with IMF exposure. In persons who use drugs, peripheral accumulation of fentanyl may be leading to prolonged exposure. More focused research on the pharmacology of fentanyl in persons using IMF is warranted.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{pmid37166910,

title = {Clinically meaningful individual differences in opioid withdrawal expression},

author = {Orrin D Ware and Kelly E Dunn},

doi = {10.1037/pha0000654},

issn = {1936-2293},

year  = {2023},

date = {2023-05-01},

journal = {Exp Clin Psychopharmacol},

abstract = {Opioid use disorder (OUD) is a significant public health concern. An individual with an OUD may experience withdrawal after stopping opioid use. There has been limited exploration of the individual differences in withdrawal expression. This study expands understanding of this issue by examining the presence and frequency at which persons who have ever had opioid withdrawal have experienced different opioid withdrawal symptoms. Using cross-sectional data captured online from Amazon Mechanical Turk, 124 adults with a lifetime experience of opioid withdrawal were included. Respondents were able to indicate ever experiencing 31 individual opioid withdrawal symptoms. If a symptom was ever experienced, respondents would indicate if it was common and whether it bothered them. A cluster analysis was used to explore variability between the withdrawal symptoms. The sample was primarily men ( = 76, 61.3%) with an average age of 34.7 ( = 11.6). The typical withdrawal syndrome lasted 6.5 days ( = 4.9) and was most severe at 5.7 ( = 4.9) days. Lifetime endorsement of individual symptoms ranged from a high of 73.4% (anxious) to a low of 43.5% (nausea). The cluster analysis was significant, (1, 122) = 215.6,  < .001, with good Bayesian information criteria (0.7). The two clusters are conceptualized here as HIGH ( = 73; 59%) and LOW ( = 51; 41%) endorsing, with a mean of 21.9 and 8.5 items endorsed. These data add to prior studies by suggesting high variability in the individual expression of opioid withdrawal symptoms. It may be time for the field to develop a consensus regarding opioid withdrawal symptom expression and measurement to enhance clinical care. (PsycInfo Database Record (c) 2023 APA, all rights reserved).},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{pmid37195789,

title = {Fentanyl Absorption, Distribution, Metabolism, and Excretion: Narrative Review and Clinical Significance Related to Illicitly Manufactured Fentanyl},

author = {H Elizabeth Bird and Andrew S Huhn and Kelly E Dunn},

doi = {10.1097/ADM.0000000000001185},

issn = {1935-3227},

year  = {2023},

date = {2023-05-01},

journal = {J Addict Med},

abstract = {OBJECTIVES: This narrative review summarizes literature on pharmaceutical fentanyl's absorption, distribution, metabolism, and excretion patterns to inform research on illicitly manufactured fentanyl (IMF).nnRESULTS: Fentanyl is highly lipophilic, lending itself to rapid absorption by highly perfused tissues (including the brain) before redistributing from these tissues to muscle and fat. Fentanyl is eliminated primarily by metabolism and urinary excretion of metabolites (norfentanyl and other minor metabolites). Fentanyl has a long terminal elimination, with a documented secondary peaking phenomenon that can manifest as "fentanyl rebound." Clinical implications in overdose (respiratory depression, muscle rigidity, and "wooden chest syndrome") and opioid use disorder treatment (subjective effects, withdrawal, and buprenorphine-precipitated withdrawal) are discussed. The authors highlight research gaps derived from differences in medicinal fentanyl studies and IMF use patterns, including that medicinal fentanyl studies are largely conducted with persons who were opioid-naive, anesthetized, or had severe chronic pain and that IMF use is characterized by supratherapeutic doses and frequent and sustained administration patterns, as well as adulteration with other substances and/or fentanyl analogs.nnCONCLUSIONS: This review reexamines information yielded from decades of medicinal fentanyl research and applies elements of the pharmacokinetic profile to persons with IMF exposure. In persons who use drugs, peripheral accumulation of fentanyl may be leading to prolonged exposure. More focused research on the pharmacology of fentanyl in persons using IMF is warranted.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{Rabinowitz2023b,

title = {Correlates and consequences of anxiety and depressive symptom trajectories during early treatment for alcohol use},

author = {Jill A. Rabinowitz and Jennifer D. Ellis and Jonathan Wells and Justin C. Strickland and Brion S. Maher and Joseph G. Hobelmann and Andrew Huhn},

doi = {10.1016/j.alcohol.2022.11.005},

issn = {0741-8329},

year  = {2023},

date = {2023-05-00},

journal = {Alcohol},

volume = {108},

pages = {44--54},

publisher = {Elsevier BV},

keywords = {Behavioral Neuroscience, Biochemistry, General Medicine, Health (social science), Neurology, Toxicology},

pubstate = {published},

tppubtype = {article}

}

@article{Ellis2023d,

title = {Exploring potential moderators of depressive symptoms and treatment outcomes among patients with opioid use disorder},

author = {Jennifer D. Ellis and Jamey J. Lister and Michael J.A. Wohl and Mark K. Greenwald and David M. Ledgerwood},

doi = {10.1016/j.addbeh.2022.107604},

issn = {0306-4603},

year  = {2023},

date = {2023-05-00},

journal = {Addictive Behaviors},

volume = {140},

publisher = {Elsevier BV},

keywords = {Clinical Psychology, Medicine (miscellaneous), Psychiatry and Mental health, Toxicology},

pubstate = {published},

tppubtype = {article}

}

@article{pmid36871377,

title = {Oral Cannabidiol does not alter Alcohol Seeking and Self-Administration in Baboons},

author = {Catherine F Moore and C Austin Zamarripa and Elise M Weerts},

doi = {10.1016/j.drugalcdep.2023.109829},

issn = {1879-0046},

year  = {2023},

date = {2023-04-01},

journal = {Drug Alcohol Depend},

volume = {245},

pages = {109829},

abstract = {BACKGROUND: The cannabinoid cannabidiol (CBD) is currently under investigation as a pharmacotherapy for alcohol use disorder. The aim of the present study was to examine whether acute and chronic treatment with pure CBD would decrease alcohol seeking and consumption behaviors or alter drinking patterns in male baboons with extensive histories of daily alcohol intake (1 g/kg/day).nnMETHODS: Seven male baboons self-administered oral alcohol (4% w/v) in a validated chained schedule of reinforcement (CSR) procedure that modeled periods of anticipation, seeking, and consumption. In Experiment 1, CBD (5-40 mg/kg) or vehicle (peanut oil, USP) was administered orally 15- or 90-minutes prior to the start of the session. In Experiment 2, oral doses of CBD (10-40 mg/kg) or vehicle were administered for 5 consecutive days during ongoing alcohol access under the CSR. In addition, behavioral observations were conducted to assess potential drug side effects (e.g., sedation, motor incoordination) following chronic CBD treatment immediately after the session and 24-hours after drug administration.nnRESULTS: Across both experiments, baboons self-administered an average of 1 g/kg/day of alcohol under baseline conditions. Administration of acute or chronic CBD (150-1200 mg total CBD dose/day) that encompassed the purported therapeutic dose range did not significantly reduce alcohol seeking, self-administration or intake (g/kg). Drinking patterns (i.e., number of drinks/bouts, bout duration, nor interdrink interval) also were not altered. There were no observable behavioral disruptions following CBD treatment.nnCONCLUSIONS: In sum, the current data do not support use of pure CBD as an effective pharmacotherapy to reduce ongoing excessive drinking.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{pmid36871378b,

title = {A cross-sectional survey on cannabis: Characterizing motives, opinions, and subjective experiences associated with the use of various oral cannabis products},

author = {Ashley N Dowd and C Austin Zamarripa and Dennis J Sholler and Justin C Strickland and Elia Goffi and Jacob T Borodovsky and Elise M Weerts and Ryan Vandrey and Tory R Spindle},

doi = {10.1016/j.drugalcdep.2023.109826},

issn = {1879-0046},

year  = {2023},

date = {2023-04-01},

journal = {Drug Alcohol Depend},

volume = {245},

pages = {109826},

abstract = {BACKGROUND: Cannabis-infused products available for oral consumption include food and drink items (i.e., edibles) (e.g., baked goods, gummy-, chocolate-, and hard-candies, beverages/drinks) as well as non-food formulations (e.g., oils/tinctures, pills/capsules). This study characterized the motives, opinions, and subjective experiences associated with the use of these seven subtypes of oral cannabis products.nnMETHODS: This web-based survey collected cross-sectional, self-report data from a convenience sample of 370 adults regarding various use-motives, self-reported cannabinoid content, subjective experiences, and opinions related to ingesting oral cannabis products with alcohol and/or food. Advice participants had received about modifying oral cannabis product effects, in general, was also collected.nnRESULTS: Participants reported consuming cannabis baked goods and gummy candies most frequently over the past year (68% and 63%, respectively). Participants were less likely to use oils/tinctures for enjoyment/desire relative to other product types and more likely to use oils/tinctures for therapeutic purposes (e.g., medication-replacement). Self-reported cannabinoid content was highly variable across participants and within product subtype. Participants reported feeling stronger and longer-lasting effects when consuming oral cannabis products on an empty stomach and 43% received advice to "eat a snack or meal" to mitigate effects that are too strong, which contrasts with controlled studies. Finally, 43% of participants reported modifying their experiences with alcohol at least some of time.nnCONCLUSIONS: These findings underscore the need to further evaluate use-motives as well as the interaction between dietary factors, cannabinoid pharmacokinetics, and subjective drug effects and the interactive effects of oral cannabis products and alcohol in a controlled laboratory setting.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{pmid37041624,

title = {Evaluating health information provided to kratom consumers by good manufacturing practice-qualified vendors},

author = {Katherine Hill and Stephen Gibson and Oliver Grundmann and Kirsten E Smith and Jonathan Ballard and Corneliu N Stanciu},

doi = {10.1186/s13011-023-00531-4},

issn = {1747-597X},

year  = {2023},

date = {2023-04-01},

journal = {Subst Abuse Treat Prev Policy},

volume = {18},

number = {1},

pages = {21},

abstract = {BACKGROUND: "Kratom" commonly refers to the botanical Mitragyna speciosa, native to Southeast Asia, which is increasingly used globally for its unique pharmacological effects. Motives for using the whole plant material or kratom-derived products include self-management of pain, mental health disorders, symptoms related to substance use disorders, and/or to increase energy. In the United States, kratom products have varying alkaloid content, potencies, and marketing profiles. There is little regulatory oversight over kratom, as it is currently not approved as a dietary supplement by the Food and Drug Administration. This results in substantial variability in labeling of kratom products and the product information provided to consumers.nnMETHODS: In January 2023, we evaluated the American Kratom Association's Good Manufacturing Practices (GMP) qualified vendors' websites (n = 42) using the well-established and validated DISCERN instrument to examine the quality of health information provided to consumers. DISCERN contains 15 five-point Likert-scale questions on specific criteria, with the highest possible score being 75, indicating that all the DISCERN criteria have been fulfilled by the website (i.e., the highest quality information is provided to consumers).nnRESULTS: The mean DISCERN score for all evaluated online kratom vendors was 32.72 (SD = 6.69; score range 18.00-43.76). Overall, vendors scored higher on DISCERN questions assessing the website's reliability, as vendors typically provided clear information for consumers about product availability, purchasing, shipping, etc. On average, vendors scored poorly on the DISCERN section pertaining to the quality of the health information provided. Information on kratom's potential risks and benefits was particularly insufficient.nnCONCLUSIONS: Consumers require high quality information in order to make informed decisions concerning use, which entails disclosure of known risks and potential benefits. The online kratom vendors evaluated in this study should consider enhancing the quality of health information provided, especially information regarding kratom's risks and benefits. Further, consumers should be made aware of current knowledge gaps related to kratom's effects. Clinicians must also be aware of the lack of evidence-based information available to their patients who use kratom or are interested in using kratom products, in order to facilitate educational discussions with them.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{pmid36871378,

title = {A cross-sectional survey on cannabis: Characterizing motives, opinions, and subjective experiences associated with the use of various oral cannabis products},

author = {Ashley N Dowd and C Austin Zamarripa and Dennis J Sholler and Justin C Strickland and Elia Goffi and Jacob T Borodovsky and Elise M Weerts and Ryan Vandrey and Tory R Spindle},

doi = {10.1016/j.drugalcdep.2023.109826},

issn = {1879-0046},

year  = {2023},

date = {2023-04-01},

journal = {Drug Alcohol Depend},

volume = {245},

pages = {109826},

abstract = {BACKGROUND: Cannabis-infused products available for oral consumption include food and drink items (i.e., edibles) (e.g., baked goods, gummy-, chocolate-, and hard-candies, beverages/drinks) as well as non-food formulations (e.g., oils/tinctures, pills/capsules). This study characterized the motives, opinions, and subjective experiences associated with the use of these seven subtypes of oral cannabis products.nnMETHODS: This web-based survey collected cross-sectional, self-report data from a convenience sample of 370 adults regarding various use-motives, self-reported cannabinoid content, subjective experiences, and opinions related to ingesting oral cannabis products with alcohol and/or food. Advice participants had received about modifying oral cannabis product effects, in general, was also collected.nnRESULTS: Participants reported consuming cannabis baked goods and gummy candies most frequently over the past year (68% and 63%, respectively). Participants were less likely to use oils/tinctures for enjoyment/desire relative to other product types and more likely to use oils/tinctures for therapeutic purposes (e.g., medication-replacement). Self-reported cannabinoid content was highly variable across participants and within product subtype. Participants reported feeling stronger and longer-lasting effects when consuming oral cannabis products on an empty stomach and 43% received advice to "eat a snack or meal" to mitigate effects that are too strong, which contrasts with controlled studies. Finally, 43% of participants reported modifying their experiences with alcohol at least some of time.nnCONCLUSIONS: These findings underscore the need to further evaluate use-motives as well as the interaction between dietary factors, cannabinoid pharmacokinetics, and subjective drug effects and the interactive effects of oral cannabis products and alcohol in a controlled laboratory setting.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{pmid35467921b,

title = {A crowdsourcing survey study on the subjective effects of delta-8-tetrahydrocannabinol relative to delta-9-tetrahydrocannabinol and cannabidiol},

author = {Cecilia L Bergeria and Justin C Strickland and Tory R Spindle and Maja Kalaba and Prem Umang Satyavolu and Matthew Feldner and Ryan Vandrey and Marcel Bonn-Miller and Erica N Peters and Elise Weerts},

doi = {10.1037/pha0000565},

issn = {1936-2293},

year  = {2023},

date = {2023-04-01},

journal = {Exp Clin Psychopharmacol},

volume = {31},

number = {2},

pages = {312--317},

abstract = {Delta-8-tetrahydrocannabinol (Δ8-THC) has emerged as a new retail cannabinoid product in the U.S. This study queried Δ8-THC users about product use characteristics and self-reported drug effects. Participants were recruited via a large online crowdsourcing platform (Amazon Mechanical Turk). Adults ( = 252) with past year Δ8-THC use (35% with at least weekly use) completed surveys and open-ended questions related to their reasons for using and past experiences with Δ8-THC-containing retail products. Participants with past year use of Δ9-tetrahydrocannabinol (Δ9-THC) and/or cannabidiol (CBD; 81% and 63%) compared the effects of Δ8-THC to those of Δ9-THC and/or CBD by rating drug effects on a visual analog scale from -50 to + 50 where negative scores indicated Δ8-THC effects are weaker, positive scores indicated Δ8-THC effects are stronger, and a score of 0 indicated equal effects to Δ9-THC or CBD. Compared to Δ9-THC, self-reported ratings for "Drug effect," "Bad effect," "Sick," "Anxiety," "Paranoia," "Irritability," "Restlessness," "Memory Problems," and "Trouble Performing Routine Tasks" were lower for Δ8-THC ( = -0.21 to -0.44). Compared to CBD, ratings for Δ8-THC effects were higher for "Drug effect," "Good effect," "High," "Relaxed," "Sleepy," "Hunger/Have the Munchies," "Memory Problems," "Trouble Performing Routine Tasks," and "Paranoia" ( = 0.27-1.02). Qualitative responses indicated that participants used Δ8-THC because it is perceived as (a) legal, (b) a substitute or similar to Δ9-THC, and/or (c) less intense than Δ9-THC. Δ8-THC is an understudied psychoactive component of cannabis that shares more characteristics with Δ9-THC than CBD and should be characterized further with human laboratory studies. (PsycInfo Database Record (c) 2023 APA, all rights reserved).},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{pmid35467921,

title = {A crowdsourcing survey study on the subjective effects of delta-8-tetrahydrocannabinol relative to delta-9-tetrahydrocannabinol and cannabidiol},

author = {Cecilia L Bergeria and Justin C Strickland and Tory R Spindle and Maja Kalaba and Prem Umang Satyavolu and Matthew Feldner and Ryan Vandrey and Marcel Bonn-Miller and Erica N Peters and Elise Weerts},

doi = {10.1037/pha0000565},

issn = {1936-2293},

year  = {2023},

date = {2023-04-01},

journal = {Exp Clin Psychopharmacol},

volume = {31},

number = {2},

pages = {312--317},

abstract = {Delta-8-tetrahydrocannabinol (Δ8-THC) has emerged as a new retail cannabinoid product in the U.S. This study queried Δ8-THC users about product use characteristics and self-reported drug effects. Participants were recruited via a large online crowdsourcing platform (Amazon Mechanical Turk). Adults ( = 252) with past year Δ8-THC use (35% with at least weekly use) completed surveys and open-ended questions related to their reasons for using and past experiences with Δ8-THC-containing retail products. Participants with past year use of Δ9-tetrahydrocannabinol (Δ9-THC) and/or cannabidiol (CBD; 81% and 63%) compared the effects of Δ8-THC to those of Δ9-THC and/or CBD by rating drug effects on a visual analog scale from -50 to + 50 where negative scores indicated Δ8-THC effects are weaker, positive scores indicated Δ8-THC effects are stronger, and a score of 0 indicated equal effects to Δ9-THC or CBD. Compared to Δ9-THC, self-reported ratings for "Drug effect," "Bad effect," "Sick," "Anxiety," "Paranoia," "Irritability," "Restlessness," "Memory Problems," and "Trouble Performing Routine Tasks" were lower for Δ8-THC ( = -0.21 to -0.44). Compared to CBD, ratings for Δ8-THC effects were higher for "Drug effect," "Good effect," "High," "Relaxed," "Sleepy," "Hunger/Have the Munchies," "Memory Problems," "Trouble Performing Routine Tasks," and "Paranoia" ( = 0.27-1.02). Qualitative responses indicated that participants used Δ8-THC because it is perceived as (a) legal, (b) a substitute or similar to Δ9-THC, and/or (c) less intense than Δ9-THC. Δ8-THC is an understudied psychoactive component of cannabis that shares more characteristics with Δ9-THC than CBD and should be characterized further with human laboratory studies. (PsycInfo Database Record (c) 2023 APA, all rights reserved).},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{pmid36977804,

title = {Correlates of illness uncertainty in cancer survivors and family caregivers: a systematic review and meta-analysis},

author = {Ting Guan and Mimi V Chapman and Lisa de Saxe Zerden and Anjalee Sharma and Ding-Geng Chen and Lixin Song},

doi = {10.1007/s00520-023-07705-7},

issn = {1433-7339},

year  = {2023},

date = {2023-03-01},

journal = {Support Care Cancer},

volume = {31},

number = {4},

pages = {242},

abstract = {PURPOSE: Illness uncertainty is widely recognized as a psychosocial stressor for cancer survivors and their family caregivers. This systematic review and meta-analysis aimed to identify the sociodemographic, physical, and psychosocial correlates that are associated with illness uncertainty in adult cancer survivors and their family caregivers.nnMETHODS: Six scholarly databases were searched. Data synthesis was based on Mishel's Uncertainty in Illness Theory. Person's r was used as the effect size metric in the meta-analysis. Risk of bias was assessed using the Quality Assessment Tool for Observational Cohort and Cross-Sectional Studies.nnRESULTS: Of 1116 articles, 21 articles met the inclusion criteria. Of 21 reviewed studies, 18 focused on cancer survivors, one focused on family caregivers, and 2 included survivors and family caregivers. Findings identified distinct correlates for illness uncertainty in cancer survivors, including sociodemographic factors (e.g., age, gender, race), stimuli frame (e.g., symptom, family history of cancer), structure providers (e.g., education), coping, and adaptation. Notable effect sizes were observed in the correlations between illness uncertainty and social support, quality of life, depression, and anxiety. Caregivers' illness uncertainty was associated with their race, general health, perception of influence, social support, quality of life, and survivors' prostate-specific antigen levels. Insufficient data precluded examining effect size of correlates of illness uncertainty among family caregivers.nnCONCLUSION: This is the first systematic review and meta-analysis to summarize the literature on illness uncertainty among adult cancer survivors and family caregivers. Findings contribute to the growing literature on managing illness uncertainty among cancer survivors and family caregivers.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{pmid36880895c,

title = {Patterns of polysubstance use and clinical comorbidity among persons seeking substance use treatment: An observational study},

author = {Jennifer D Ellis and Jill A Rabinowitz and Orrin D Ware and Jonathan Wells and Kelly E Dunn and Andrew S Huhn},

doi = {10.1016/j.josat.2022.208932},

issn = {2949-8759},

year  = {2023},

date = {2023-03-01},

journal = {J Subst Use Addict Treat},

volume = {146},

pages = {208932},

abstract = {INTRODUCTION: Polysubstance use is common among individuals seeking treatment for substance use disorders (SUD). However, we know less about patterns and correlates of polysubstance use among treatment-seeking populations. The current study aimed to identify latent patterns of polysubstance use and associated risk factors in persons entering SUD treatment.nnMETHODS: Patients (N = 28,526) being admitted for substance use treatment reported on their use of thirteen substances (e.g., alcohol, cannabis, cocaine, amphetamines, methamphetamines, other stimulants, heroin, other opioids, benzodiazepines, inhalants, synthetics, hallucinogens, and club drugs) in the month before treatment and prior to the month before treatment. Latent class analysis (LCA) determined the relationship between class membership and gender, age, employment status, unstable housing, self-harm, overdose, past treatment, depression, generalized anxiety disorder, and/or post-traumatic stress disorder (PTSD).nnRESULTS: Identified classes included: 1) Alcohol primary, 2) Moderate probability of past-month alcohol, cannabis, and/or opioid use; 3) Alcohol primary, Lifetime cannabis and cocaine use; 4) Opioid primary, Lifetime use of alcohol, cannabis, hallucinogens, club drugs, amphetamines, and cocaine; 5) Moderate probability of past-month alcohol, cannabis, and/or opioid use, Lifetime use of various substances; 6) Alcohol and cannabis primary, Lifetime use of various substances; and 7) High past-month polysubstance use. Individuals who engaged in past-month polysubstance use attended to face elevated risk of screening positive for recent unstable housing, unemployment, depression, anxiety, PTSD, self-harm, and overdose.nnCONCLUSIONS: Current polysubstance use is associated with significant clinical complexity. Tailored treatments that reduce harms resulting from polysubstance use and related psychiatric comorbidity may improve treatment outcomes in this population.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{pmid36480398,

title = {The effects of social context and opportunity cost on the behavioral economic value of cannabis},

author = {Samuel F Acuff and Justin C Strickland and Elizabeth R Aston and Kathryn S Gex and James G Murphy},

doi = {10.1037/adb0000902},

issn = {1939-1501},

year  = {2023},

date = {2023-02-01},

journal = {Psychol Addict Behav},

volume = {37},

number = {1},

pages = {156--165},

abstract = {OBJECTIVE: Behavioral economics suggest that cannabis reinforcing value (cannabis demand) may be influenced by external, contextual factors such as the social reward that might accompany cannabis use and the presence of opportunity costs (e.g., a next-day responsibility that cannabis use might adversely impact). The present study examined the effect of social context and opportunity cost on cannabis demand and explored whether relations were moderated by cannabis use severity.nnMETHOD: Adults with past-week cannabis use recruited from Amazon's Mechanical Turk ( = 310; 53.5% female, 79.4% White) completed four purchase tasks, in which participants reported how much cannabis they would purchase across escalating prices, to index cannabis demand under varying contexts: (a) solitary, typical responsibilities; (b) social, typical responsibilities; (c) solitary, substantial responsibilities; and (d) social, substantial responsibilities.nnRESULTS: The presence of peers significantly increased demand intensity (consumption at zero price) and  (maximum expenditure) relative to the solitary conditions. Substantial responsibilities significantly decreased intensity, breakpoint (price at which consumption is fully suppressed), and  (price at which maximum expenditure occurs) and increased elasticity (greater price sensitivity). Demand was most inelastic in the social, typical responsibilities condition relative to other conditions. Cannabis use severity was associated with less elastic demand in the solitary, typical responsibilities condition. Those with higher cannabis use severity reported larger differences in demand intensity and  between solitary and social conditions, and in demand elasticity between typical and substantial responsibility conditions.nnCONCLUSIONS: Results are consistent with previous research illustrating social and opportunity costs as determinants of cannabis use behavior. (PsycInfo Database Record (c) 2023 APA, all rights reserved).},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{pmid36592650,

title = {Extra-experimental scarcity impacts hypothetical operant demand: A natural SARS-CoV-2 eperiment},

author = {Derek D Reed and Brent A Kaplan and Fernanda S Oda and Justin C Strickland},

doi = {10.1016/j.beproc.2022.104817},

issn = {1872-8308},

year  = {2023},

date = {2023-02-01},

journal = {Behav Processes},

volume = {205},

pages = {104817},

abstract = {Behavioral economic demand models quantify the extent to which an organism defends its consumption of a commodity. Commodity purchase tasks permit humans a quick yet psychometrically sound approach to assessing commodity demand for various retail products. Operant behavioral economic literature suggests economy type (open vs closed) can significantly alter demand, yet this effect is largely undocumented in the commodity purchase task literature. In this study, we leveraged the market pressures for retail goods (hand lotion and sanitizer; paper towels and toilet paper; soda and water) resulting from SARS-CoV-2 into a natural experiment comparing within-subject demand across two time-points during the pandemic using a crowdsourced approach. Results suggest that hypothetical commodity purchase tasks are sensitive to extra-experimental market pressures (e.g., scarcity due to the closing of economies), adding additional confidence to the self-report nature of purchase task responding and providing further construct validity to these approaches.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{pmid35266779c,

title = {A double-blind, randomized, placebo-controlled, pilot clinical trial examining buspirone as an adjunctive medication during buprenorphine-assisted supervised opioid withdrawal},

author = {Cecilia L Bergeria and Hongjun Tan and Denis Antoine and Elise M Weerts and Andrew S Huhn and J Gregory Hobelmann and Kelly E Dunn},

doi = {10.1037/pha0000550},

issn = {1936-2293},

year  = {2023},

date = {2023-02-01},

journal = {Exp Clin Psychopharmacol},

volume = {31},

number = {1},

pages = {194--203},

abstract = {Successful management of opioid withdrawal improves long-term treatment outcomes and reduces opioid use-related morbidity and mortality. Mechanistically supported pharmacotherapeutic approaches are needed to effectively manage acute and protracted opioid withdrawal. Buspirone is a D2 antagonist and 5-HT1a agonist that may decrease opioid withdrawal. Individuals ( = 15) admitted to a residential treatment center for opioid use disorder (OUD) were enrolled into a double-blind randomized clinical trial to assess the efficacy and acceptability of buspirone (45 mg/day) as an adjunctive medication to buprenorphine-assisted, supervised opioid withdrawal. Participants completed daily questionnaires which consisted of the Subjective Opiate Withdrawal Scale (SOWS) and a consensus sleep diary, which assessed total sleep time, time to sleep onset, and sleep quality. Total SOWS scores, individual opioid withdrawal symptoms and sleep outcomes were assessed between treatment groups (Placebo and Buspirone) and over time in a repeated measures linear mixed model. Total SOWS scores significantly decreased across study phases for both groups but decreased to a greater extent among individuals assigned to buspirone during both the first and second week of stable buspirone. Greater decreases in withdrawal were observed during Week 2 of stable buspirone relative to Week 1 of stable buspirone. Participants also reported significant increases in sleep duration and significant decreases in latency to sleep onset. This study provides further support that buspirone can help mitigate opioid withdrawal during a supervised opioid taper. Buspirone may confer unique benefits during protracted withdrawal periods. (PsycInfo Database Record (c) 2023 APA, all rights reserved).},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{pmid35266780c,

title = {Can initial experiences with drugs predict future drug abuse risks?},

author = {Neil B Varshneya and Kelly E Dunn and Caitlyn J Grubb and Sandra I Okobi and Andrew S Huhn and Cecilia L Bergeria},

doi = {10.1037/pha0000559},

issn = {1936-2293},

year  = {2023},

date = {2023-02-01},

journal = {Exp Clin Psychopharmacol},

volume = {31},

number = {1},

pages = {186--193},

abstract = {Initial experiences with drugs may influence an individual's motivations for continued use. This study evaluated the relationship between subjective effects elicited by an individual's first use of alcohol or cannabis, Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) alcohol use disorder (AUD) or cannabis use disorder (CUD) severity, and behavioral economic demand for alcohol or cannabis. Self-reports of initial subjective effects associated with drugs were analyzed for  = 463 participants whose first substance use was either alcohol or cannabis. The likelihood that a particular subjective effect at the time of first use was associated with current AUD/CUD was assessed using ordinal logistic regression with subjective effects as predictors of DSM-5 severity. Behavioral economic demand was assessed using a hypothetical purchase task in which participants indicated their hypothetical consumption of alcohol or cannabis as a function of price. Significant associations were observed for initial subjective effects elicited by alcohol or cannabis and increased DSM-5 severity: (alcohol) relief (OR = 2.52 [95% CI 1.51-4.25],  = .0005) and (cannabis) energetic (OR = 2.31 [95% CI 3.27-55.5],  = .0004). The mean (± SEM)  value for the alcohol subgroup endorsing relief ($96.22 ± $26.48) was significantly greater than the  value for the alcohol subgroup not endorsing relief ($33.81 ± $12.93), (237) = 2.276,  = .0237. These results suggest that the initial subjective effects associated with a given substance may predict the development and/or severity of substance misuse and substance use disorders (SUDs). These findings are consistent with anecdotal reports that persons with SUD feel energized by the use of substances whereas persons without SUD do not report experiencing such subjective effects upon first use. (PsycInfo Database Record (c) 2023 APA, all rights reserved).},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{pmid35266779b,

title = {A double-blind, randomized, placebo-controlled, pilot clinical trial examining buspirone as an adjunctive medication during buprenorphine-assisted supervised opioid withdrawal},

author = {Cecilia L Bergeria and Hongjun Tan and Denis Antoine and Elise M Weerts and Andrew S Huhn and J Gregory Hobelmann and Kelly E Dunn},

doi = {10.1037/pha0000550},

issn = {1936-2293},

year  = {2023},

date = {2023-02-01},

journal = {Exp Clin Psychopharmacol},

volume = {31},

number = {1},

pages = {194--203},

abstract = {Successful management of opioid withdrawal improves long-term treatment outcomes and reduces opioid use-related morbidity and mortality. Mechanistically supported pharmacotherapeutic approaches are needed to effectively manage acute and protracted opioid withdrawal. Buspirone is a D2 antagonist and 5-HT1a agonist that may decrease opioid withdrawal. Individuals ( = 15) admitted to a residential treatment center for opioid use disorder (OUD) were enrolled into a double-blind randomized clinical trial to assess the efficacy and acceptability of buspirone (45 mg/day) as an adjunctive medication to buprenorphine-assisted, supervised opioid withdrawal. Participants completed daily questionnaires which consisted of the Subjective Opiate Withdrawal Scale (SOWS) and a consensus sleep diary, which assessed total sleep time, time to sleep onset, and sleep quality. Total SOWS scores, individual opioid withdrawal symptoms and sleep outcomes were assessed between treatment groups (Placebo and Buspirone) and over time in a repeated measures linear mixed model. Total SOWS scores significantly decreased across study phases for both groups but decreased to a greater extent among individuals assigned to buspirone during both the first and second week of stable buspirone. Greater decreases in withdrawal were observed during Week 2 of stable buspirone relative to Week 1 of stable buspirone. Participants also reported significant increases in sleep duration and significant decreases in latency to sleep onset. This study provides further support that buspirone can help mitigate opioid withdrawal during a supervised opioid taper. Buspirone may confer unique benefits during protracted withdrawal periods. (PsycInfo Database Record (c) 2023 APA, all rights reserved).},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{pmid35266780b,

title = {Can initial experiences with drugs predict future drug abuse risks?},

author = {Neil B Varshneya and Kelly E Dunn and Caitlyn J Grubb and Sandra I Okobi and Andrew S Huhn and Cecilia L Bergeria},

doi = {10.1037/pha0000559},

issn = {1936-2293},

year  = {2023},

date = {2023-02-01},

journal = {Exp Clin Psychopharmacol},

volume = {31},

number = {1},

pages = {186--193},

abstract = {Initial experiences with drugs may influence an individual's motivations for continued use. This study evaluated the relationship between subjective effects elicited by an individual's first use of alcohol or cannabis, Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) alcohol use disorder (AUD) or cannabis use disorder (CUD) severity, and behavioral economic demand for alcohol or cannabis. Self-reports of initial subjective effects associated with drugs were analyzed for  = 463 participants whose first substance use was either alcohol or cannabis. The likelihood that a particular subjective effect at the time of first use was associated with current AUD/CUD was assessed using ordinal logistic regression with subjective effects as predictors of DSM-5 severity. Behavioral economic demand was assessed using a hypothetical purchase task in which participants indicated their hypothetical consumption of alcohol or cannabis as a function of price. Significant associations were observed for initial subjective effects elicited by alcohol or cannabis and increased DSM-5 severity: (alcohol) relief (OR = 2.52 [95% CI 1.51-4.25],  = .0005) and (cannabis) energetic (OR = 2.31 [95% CI 3.27-55.5],  = .0004). The mean (± SEM)  value for the alcohol subgroup endorsing relief ($96.22 ± $26.48) was significantly greater than the  value for the alcohol subgroup not endorsing relief ($33.81 ± $12.93), (237) = 2.276,  = .0237. These results suggest that the initial subjective effects associated with a given substance may predict the development and/or severity of substance misuse and substance use disorders (SUDs). These findings are consistent with anecdotal reports that persons with SUD feel energized by the use of substances whereas persons without SUD do not report experiencing such subjective effects upon first use. (PsycInfo Database Record (c) 2023 APA, all rights reserved).},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{pmid35266780,

title = {Can initial experiences with drugs predict future drug abuse risks?},

author = {Neil B Varshneya and Kelly E Dunn and Caitlyn J Grubb and Sandra I Okobi and Andrew S Huhn and Cecilia L Bergeria},

doi = {10.1037/pha0000559},

issn = {1936-2293},

year  = {2023},

date = {2023-02-01},

journal = {Exp Clin Psychopharmacol},

volume = {31},

number = {1},

pages = {186--193},

abstract = {Initial experiences with drugs may influence an individual's motivations for continued use. This study evaluated the relationship between subjective effects elicited by an individual's first use of alcohol or cannabis, Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) alcohol use disorder (AUD) or cannabis use disorder (CUD) severity, and behavioral economic demand for alcohol or cannabis. Self-reports of initial subjective effects associated with drugs were analyzed for  = 463 participants whose first substance use was either alcohol or cannabis. The likelihood that a particular subjective effect at the time of first use was associated with current AUD/CUD was assessed using ordinal logistic regression with subjective effects as predictors of DSM-5 severity. Behavioral economic demand was assessed using a hypothetical purchase task in which participants indicated their hypothetical consumption of alcohol or cannabis as a function of price. Significant associations were observed for initial subjective effects elicited by alcohol or cannabis and increased DSM-5 severity: (alcohol) relief (OR = 2.52 [95% CI 1.51-4.25],  = .0005) and (cannabis) energetic (OR = 2.31 [95% CI 3.27-55.5],  = .0004). The mean (± SEM)  value for the alcohol subgroup endorsing relief ($96.22 ± $26.48) was significantly greater than the  value for the alcohol subgroup not endorsing relief ($33.81 ± $12.93), (237) = 2.276,  = .0237. These results suggest that the initial subjective effects associated with a given substance may predict the development and/or severity of substance misuse and substance use disorders (SUDs). These findings are consistent with anecdotal reports that persons with SUD feel energized by the use of substances whereas persons without SUD do not report experiencing such subjective effects upon first use. (PsycInfo Database Record (c) 2023 APA, all rights reserved).},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{pmid35266779,

title = {A double-blind, randomized, placebo-controlled, pilot clinical trial examining buspirone as an adjunctive medication during buprenorphine-assisted supervised opioid withdrawal},

author = {Cecilia L Bergeria and Hongjun Tan and Denis Antoine and Elise M Weerts and Andrew S Huhn and J Gregory Hobelmann and Kelly E Dunn},

doi = {10.1037/pha0000550},

issn = {1936-2293},

year  = {2023},

date = {2023-02-01},

journal = {Exp Clin Psychopharmacol},

volume = {31},

number = {1},

pages = {194--203},

abstract = {Successful management of opioid withdrawal improves long-term treatment outcomes and reduces opioid use-related morbidity and mortality. Mechanistically supported pharmacotherapeutic approaches are needed to effectively manage acute and protracted opioid withdrawal. Buspirone is a D2 antagonist and 5-HT1a agonist that may decrease opioid withdrawal. Individuals ( = 15) admitted to a residential treatment center for opioid use disorder (OUD) were enrolled into a double-blind randomized clinical trial to assess the efficacy and acceptability of buspirone (45 mg/day) as an adjunctive medication to buprenorphine-assisted, supervised opioid withdrawal. Participants completed daily questionnaires which consisted of the Subjective Opiate Withdrawal Scale (SOWS) and a consensus sleep diary, which assessed total sleep time, time to sleep onset, and sleep quality. Total SOWS scores, individual opioid withdrawal symptoms and sleep outcomes were assessed between treatment groups (Placebo and Buspirone) and over time in a repeated measures linear mixed model. Total SOWS scores significantly decreased across study phases for both groups but decreased to a greater extent among individuals assigned to buspirone during both the first and second week of stable buspirone. Greater decreases in withdrawal were observed during Week 2 of stable buspirone relative to Week 1 of stable buspirone. Participants also reported significant increases in sleep duration and significant decreases in latency to sleep onset. This study provides further support that buspirone can help mitigate opioid withdrawal during a supervised opioid taper. Buspirone may confer unique benefits during protracted withdrawal periods. (PsycInfo Database Record (c) 2023 APA, all rights reserved).},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{pmid36410029,

title = {Kava () in the United States: the quiet rise of a substance with often subtle effects},

author = {Salma Pont-Fernandez and Marina Kheyfets and Jeffrey M Rogers and Kirsten E Smith and David H Epstein},

doi = {10.1080/00952990.2022.2140292},

issn = {1097-9891},

year  = {2023},

date = {2023-01-01},

journal = {Am J Drug Alcohol Abuse},

volume = {49},

number = {1},

pages = {85--96},

abstract = { Piper methysticum, commonly called kava, has long been consumed in beverage form in the Pacific Islands. Kava use in the US has slowly increased since the 1990s, but is not assessed in major epidemiological surveys. To analyze social-media posts about kava from current, past, and prospective users, for motivations, patterns of co-use, and effects. Text from Reddit posts, and accompanying metadata, were collected and thematically coded by two independent raters. 423 posts were collected, spanning January 2006 through December 2021. Of the 1,211 thematic codes applied, 1,098 (90. 7%) were concordant. Motivations for use bifurcated into self-treatment (for psychiatric or physical health conditions) and recreation; these were not mutually exclusive. Kava was rarely considered strongly euphoriant, but was valued as an anxiolytic. Kava was frequently used with other substances, most commonly kratom. Kava was used at lower doses for self-treatment than for other purposes (pseudo-R = 0.11). Undesirable effects (gastrointestinal upset, fatigue) were mentioned, though less often than benefits. Hepatotoxicity, reported elsewhere as a rare, non-dose-related risk, was disputed on the basis of its not having been experienced by those posting. Kava appears to be conceptualized among Reddit posters as an anxiolytic with few risks or adverse effects. As it grows in popularity, especially among people who use other drugs that are more liable to misuse or addiction, it should be assessed in probability samples (i.e. in the major national drug surveys) and clinical practice for its risks, potential benefits, and possible drug-drug interactions.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{pmid36594896,

title = {Kratom Alkaloids: A Blueprint?},

author = {Kirsten Elin Smith and Abhisheak Sharma and Oliver Grundmann and Christopher R McCurdy},

doi = {10.1021/acschemneuro.2c00704},

issn = {1948-7193},

year  = {2023},

date = {2023-01-01},

journal = {ACS Chem Neurosci},

volume = {14},

number = {2},

pages = {195--197},

abstract = {Alkaloids from the botanical  (commonly referred to as "kratom") interact with opioid, adrenergic, serotonergic, and other receptors to provide myriad reported effects, including analgesia, energy, improved mood, and relaxation, among others. These alkaloids are complex and unique and may serve as a blueprint for the development of novel molecules to treat various substance use disorders.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{pmid37214465,

title = {Examining the paradoxical effects of kratom: a narrative inquiry},

author = {Kirsten E Smith and Jeffrey D Feldman and Kelly E Dunn and Christopher R McCurdy and Stephanie T Weiss and Oliver Grundmann and Albert Garcia-Romeu and Janeen Nichels and David H Epstein},

doi = {10.3389/fphar.2023.1174139},

issn = {1663-9812},

year  = {2023},

date = {2023-01-01},

journal = {Front Pharmacol},

volume = {14},

pages = {1174139},

abstract = { Surveys and case reports have documented kratom use in the United States (US) for over a decade. However, those reports have generally not examined in depth the role kratom plays in the lives of those who use it regularly for sustained periods. Until there are controlled studies of the pharmacology and subjective effects of kratom alkaloids in humans, one of the best sources of insight on kratom-product use remains qualitative data with nuanced descriptions of kratom effects from those who use it regularly.  We conducted semistructured qualitative interviews with adults who regularly use kratom products, as part of a laboratory study of kratom-product self-administration. This qualitative component of the study was conducted as a narrative case-report series ( = 10).  Despite some differences among participants, all experienced acute combination effects that were largely, even simultaneously, analgesic and stimulatory. Most participants had decreased their dosages over time, and one planned to quit. Five of the 10 participants met DSM-5-based criteria for kratom-use disorder (3 mild, 1 moderate, 1 severe, by symptoms counts). When kratom was inadvertently taken in larger than intended doses, participants described a constellation of symptoms that they called "the wobbles" (a jittery feeling accompanied by what seemed to be nystagmus); this was rare, but could be of scientific and clinical interest as a possible manifestation of serotonin syndrome. Most participants described tolerance but considered kratom generally safe at low-moderate doses, providing perceived benefits with less potential risk for adverse effects compared to pharmaceuticals or illicit drugs.  In-depth interview data like these help confirm and clarify findings from larger survey studies and clinician-driven case reports. They are needed to inform the policy practice regarding kratom and may also help inform future experimental designs.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{pmid36572113,

title = {Demand and cross-price elasticity of cocaine and social contact in a free-operant procedure of nonexclusive choice},

author = {Mark A Smith and Hannah S H Cha and Jessica L Sharp and Justin C Strickland},

doi = {10.1016/j.pbb.2022.173511},

issn = {1873-5177},

year  = {2023},

date = {2023-01-01},

journal = {Pharmacol Biochem Behav},

volume = {222},

pages = {173511},

abstract = {Research examining the social determinants of addiction has advanced significantly with the recent development of preclinical models of drug use and the social environment. These models reveal that drug use and social contact compete with one another for behavioral expression in discrete-trial choice procedures using concurrent schedules of reinforcement. The purpose of this study was to determine how concurrent access to cocaine and a social partner influences the demand for each alternative under free-operant conditions in which responding maintained by each reinforcer is independent and nonexclusive of the other. To this end, male rats were trained under a free-operant, concurrent schedule of reinforcement in which responding maintained by cocaine and access to a social partner operated independently of one another. Measures of economic demand (e.g., intensity, O, cross-price elasticity) were determined by manipulating the response requirement (i.e., fixed ratio value) across sessions. Tests were conducted in which the social partner was either treated or not treated with cocaine to determine whether the intoxication state of the partner influenced demand. The principal findings of this study are (1) demand for a cocaine-treated partner is greater than demand for a cocaine-free partner, (2) demand for cocaine is greater in the presence of a cocaine-treated partner than a cocaine-free partner, and (3) concurrent access to cocaine decreases demand for social contact. Notably, measures of cross-price elasticity indicated that social contact is a robust economic substitute for cocaine.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{pmid36449315c,

title = {Clinical Trial Design Challenges and Opportunities for Emerging Treatments for Opioid Use Disorder: A Review},

author = {Brian D Kiluk and Bethea A Kleykamp and Sandra D Comer and Roland R Griffiths and Andrew S Huhn and Matthew W Johnson and Kyle M Kampman and Marco Pravetoni and Kenzie L Preston and Ryan Vandrey and Cecilia L Bergeria and Michael P Bogenschutz and Randall T Brown and Kelly E Dunn and Robert H Dworkin and Patrick H Finan and Peter S Hendricks and Elisabeth J Houtsmuller and Thomas R Kosten and Dustin C Lee and Frances R Levin and Aimee McRae-Clark and Charles L Raison and Kurt Rasmussen and Dennis C Turk and Roger D Weiss and Eric C Strain},

doi = {10.1001/jamapsychiatry.2022.4020},

issn = {2168-6238},

year  = {2023},

date = {2023-01-01},

journal = {JAMA Psychiatry},

volume = {80},

number = {1},

pages = {84--92},

abstract = {IMPORTANCE: Novel treatments for opioid use disorder (OUD) are needed to address both the ongoing opioid epidemic and long-standing barriers to existing OUD treatments that target the endogenous μ-opioid receptor (MOR) system. The goal of this review is to highlight unique clinical trial design considerations for the study of emerging treatments for OUD that address targets beyond the MOR system. In November 2019, the Analgesic, Anesthetic, and Addiction Clinical Trial Translations, Innovations, Opportunities, and Networks (ACTTION) public-private partnership with the US Food and Drug Administration sponsored a meeting to discuss the current evidence regarding potential treatments for OUD, including cannabinoids, psychedelics, sedative-hypnotics, and immunotherapeutics, such as vaccines.nnOBSERVATIONS: Consensus recommendations are presented regarding the most critical elements of trial design for the evaluation of novel OUD treatments, such as: (1) stage of treatment that will be targeted (eg, seeking treatment, early abstinence/detoxification, long-term recovery); (2) role of treatment (adjunctive with or independent of existing OUD treatments); (3) primary outcomes informed by patient preferences that assess opioid use (including changes in patterns of use), treatment retention, and/or global functioning and quality of life; and (4) adverse events, including the potential for opioid-related relapse or overdose, especially if the patient is not simultaneously taking maintenance MOR agonist or antagonist medications.nnCONCLUSIONS AND RELEVANCE: Applying the recommendations provided here as well as considering input from people with lived experience in the design phase will accelerate the development, translation, and uptake of effective and safe therapeutics for individuals struggling with OUD.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{pmid36449315b,

title = {Clinical Trial Design Challenges and Opportunities for Emerging Treatments for Opioid Use Disorder: A Review},

author = {Brian D Kiluk and Bethea A Kleykamp and Sandra D Comer and Roland R Griffiths and Andrew S Huhn and Matthew W Johnson and Kyle M Kampman and Marco Pravetoni and Kenzie L Preston and Ryan Vandrey and Cecilia L Bergeria and Michael P Bogenschutz and Randall T Brown and Kelly E Dunn and Robert H Dworkin and Patrick H Finan and Peter S Hendricks and Elisabeth J Houtsmuller and Thomas R Kosten and Dustin C Lee and Frances R Levin and Aimee McRae-Clark and Charles L Raison and Kurt Rasmussen and Dennis C Turk and Roger D Weiss and Eric C Strain},

doi = {10.1001/jamapsychiatry.2022.4020},

issn = {2168-6238},

year  = {2023},

date = {2023-01-01},

journal = {JAMA Psychiatry},

volume = {80},

number = {1},

pages = {84--92},

abstract = {IMPORTANCE: Novel treatments for opioid use disorder (OUD) are needed to address both the ongoing opioid epidemic and long-standing barriers to existing OUD treatments that target the endogenous μ-opioid receptor (MOR) system. The goal of this review is to highlight unique clinical trial design considerations for the study of emerging treatments for OUD that address targets beyond the MOR system. In November 2019, the Analgesic, Anesthetic, and Addiction Clinical Trial Translations, Innovations, Opportunities, and Networks (ACTTION) public-private partnership with the US Food and Drug Administration sponsored a meeting to discuss the current evidence regarding potential treatments for OUD, including cannabinoids, psychedelics, sedative-hypnotics, and immunotherapeutics, such as vaccines.nnOBSERVATIONS: Consensus recommendations are presented regarding the most critical elements of trial design for the evaluation of novel OUD treatments, such as: (1) stage of treatment that will be targeted (eg, seeking treatment, early abstinence/detoxification, long-term recovery); (2) role of treatment (adjunctive with or independent of existing OUD treatments); (3) primary outcomes informed by patient preferences that assess opioid use (including changes in patterns of use), treatment retention, and/or global functioning and quality of life; and (4) adverse events, including the potential for opioid-related relapse or overdose, especially if the patient is not simultaneously taking maintenance MOR agonist or antagonist medications.nnCONCLUSIONS AND RELEVANCE: Applying the recommendations provided here as well as considering input from people with lived experience in the design phase will accelerate the development, translation, and uptake of effective and safe therapeutics for individuals struggling with OUD.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{doi:10.1177/10443894221145759,

title = {“Do Not Carry the Load by Yourself”: Advice for Families Affected by Non-Medical Opioid Use},

author = {Florentine S. Friedrich and Emily Pasman and Lena Boraginna-Ballard and Sydney O’Shay and Kathryn A. Szechy and Jennifer D. Ellis and Stella M. Resko and Suzanne Brown},

url = {https://doi.org/10.1177/10443894221145759},

doi = {10.1177/10443894221145759},

year  = {2023},

date = {2023-01-01},

journal = {Families in Society},

volume = {104},

number = {3},

pages = {262-277},

abstract = {Non-medical opioid use (NMOU) has had a devastating effect on families. Affected families may experience interpersonal and financial problems and self-stigma that can impede help-seeking and self-care. This study aimed to identify recommendations for families affected by opioids given by those with lived experience. Adults with a family member with NMOU (N = 299) completed a survey that included an open-ended question asking for advice for other families similarly affected by opioids. Data were coded independently by research team members using an iterative approach to thematic analysis. Themes included seeking support, seeking education, and managing relationships with the loved one and others. Results highlight avenues for helping families cope while supporting a loved one who uses opioids, including contact with others with shared experience and access to educational resources. Families affected by opioids can provide valuable insights that should be considered when designing supports for families.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{REID2023108,

title = {Sleep-EEG Spectral Power Predicts Next-Day Pain In Long-Term Opioid Users With Chronic Low-Back Pain},

author = {Matthew J. Reid and Julia Camacho Wejbrandt and Alexandros Giagtzis and Liza Abraham and Jennifer D. Ellis and Patrick H. Finan and Michael T. Smith},

url = {https://www.sciencedirect.com/science/article/pii/S1526590023003449},

doi = {https://doi.org/10.1016/j.jpain.2023.02.305},

issn = {1526-5900},

year  = {2023},

date = {2023-01-01},

journal = {The Journal of Pain},

volume = {24},

number = {4, Supplement},

pages = {108},

abstract = {Previous research has focused on differences in spectral characteristics between participants with chronic low back pain and healthy controls. However, there has been little examination of how differences in such spectral parameters contribute to day-to-day variability in pain symptoms. We conducted a naturalistic experiment in participants with chronic low back pain utilizing wireless sleep-EEG to examine how activity in spectral bands is associated with next morning and daytime pain. We analyzed data from 28 participants using linear regression modelling to test the relationship between absolute and relative power in the delta (1-3.5Hz), theta (4-6.5Hz), alpha (8-12Hz), sigma (12-16Hz) and beta (18-28Hz) bands and reports of average (across nighttime and daytime periods) and current (at morning and evening) pain. When examining absolute power, morning reports demonstrated that higher power in the alpha, sigma and theta bands were significantly associated with lower reports of current morning pain and average pain the previous night. Evening reports demonstrated that only higher power in the alpha band was significantly associated with lower current evening pain, and average daytime pain. When examining relative power, morning reports demonstrated no significant associations between power bands and morning pain reports. Evening reports demonstrated that higher power in the beta power range was significantly associated with higher current evening pain. There were no significant relationships amongst other bands. These findings indicate that spectral sleep-EEG markers may provide translational marker of next-day pain liability. Future work should attempt to resolve the differences in findings observed between relative and absolute values. NCT03680287.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{ELLIS2023110,

title = {Concurrent And Lagged Associations With Cannabis And Opioid Craving Among Patients With Chronic Pain},

author = {Jennifer D. Ellis and Rachel Brenowitz and Liza Abraham and Siny Tsang and Chung Jung Mun and Johannes Thrul and Patrick H. Finan},

url = {https://www.sciencedirect.com/science/article/pii/S1526590023003516},

doi = {https://doi.org/10.1016/j.jpain.2023.02.312},

issn = {1526-5900},

year  = {2023},

date = {2023-01-01},

journal = {The Journal of Pain},

volume = {24},

number = {4, Supplement},

pages = {110-111},

abstract = {In 2020, 43.3 opioid prescriptions per 100 individuals were dispensed in the United States, and an increasing number of states have legalized cannabis for medical use. Craving is a risk factor for nonmedical use of both cannabis and opioids. Elucidating correlates of craving among patients with chronic pain may identify modifiable risk factors for substance-related problems and misuse. Adults with chronic pain (N=46), who reported prescription opioid and cannabis use for pain management, completed repeated smartphone-based surveys assessing momentary cannabis and/or opioid use, pain, pain catastrophizing, affect, anxiety, and stress over 30 days. Using mixed models, we examined concurrent and lagged associations between pain, pain catastrophizing, affect, anxiety, stress, substance use, and craving within each day. Individuals reported greater craving of opioids (B=0.14},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{BRENOWITZ202310,

title = {Pain Catastrophizing And Affect Mediate The Associations Between Opioid/Cannabis Co-Use And Pain Relief},

author = {Rachel Brenowitz and Liza Abraham and Jennifer D. Ellis and Siny Tsang and Chung Jung Mun and Johannes Thrul and Patrick Hamilton Finan},

url = {https://www.sciencedirect.com/science/article/pii/S1526590023000846},

doi = {https://doi.org/10.1016/j.jpain.2023.02.045},

issn = {1526-5900},

year  = {2023},

date = {2023-01-01},

journal = {The Journal of Pain},

volume = {24},

number = {4, Supplement},

pages = {10-11},

abstract = {Previously, we reported that opioid/cannabis co-use contributed to greater pain relief than use of either substance alone among patients with chronic pain. Here, we extend upon those findings by examining if affect and pain catastrophizing mediate the relationship between co-use and pain relief. Ecological momentary assessment (EMA) was used to assess daily pain relief, use of cannabis and opioids, affect, and pain catastrophizing in adults with chronic pain who were using opioids and cannabis for pain (N=46). Mediation analysis was performed using the "mediation” package in R. Analyses examined whether 1) momentary affect and/or 2) momentary pain catastrophizing mediated the relationship between opioid/cannabis co-use (relative to opioid or cannabis alone) and momentary pain relief. Affect mediated the associations between opioid/cannabis co-use and pain relief, such that better affective functioning (more positive affect and less negative affect) explained a significant portion of variance in the association between cannabis/opioid co-use and pain relief, relative to opioids (ACME=-0.018},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{10.3389/frsle.2023.1111669,

title = {Pain catastrophizing moderates the relationship between chronic pain and insomnia severity in persons with opioid use disorder},

author = {Melanie A. Baime and Prem Umang Satyavolu and Andrew S. Huhn and Jennifer D. Ellis},

url = {https://www.frontiersin.org/articles/10.3389/frsle.2023.1111669},

doi = {10.3389/frsle.2023.1111669},

issn = {2813-2890},

year  = {2023},

date = {2023-01-01},

journal = {Frontiers in Sleep},

volume = {2},

abstract = {<sec>Study objectivesChronic pain and insomnia commonly co-occur among individuals with opioid use disorder (OUD) and are associated with adverse treatment outcomes and reduced quality of life. Exploring factors that influence these relationships may help identify relevant treatment targets. The present study investigated whether pain catastrophizing moderates the presence of chronic pain and insomnia severity in individuals with OUD.</sec><sec>MethodsParticipants with OUD symptoms (N = 154) were recruited from Amazon's Mechanical Turk, and completed screening measures for chronic pain, insomnia, and pain catastrophizing. Moderation analyses were used to explore whether pain catastrophizing moderated the relationship between chronic pain and insomnia severity.</sec><sec>ResultsResults suggested that chronic pain was only associated with insomnia severity symptoms among individuals with higher levels of pain catastrophizing but was unrelated at lower levels of pain catastrophizing.</sec><sec>ConclusionsThese results suggest that pain catastrophizing may represent a modifiable risk factor among individuals with co-occurring OUD, insomnia, and chronic pain. Future longitudinal and experimental research that examines changes in insomnia, pain severity, and pain catastrophizing over time in OUD may be beneficial.</sec>},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{HOCHHEIMER202315,

title = {The impact of opioid-stimulant co-use on tonic and cue-induced craving},

author = {Martin Hochheimer and Justin C. Strickland and Jill A. Rabinowitz and Jennifer D. Ellis and Cecilia L. Bergeria and J. Gregory Hobelmann and Andrew S. Huhn},

url = {https://www.sciencedirect.com/science/article/pii/S0022395623002054},

doi = {https://doi.org/10.1016/j.jpsychires.2023.05.018},

issn = {0022-3956},

year  = {2023},

date = {2023-01-01},

journal = {Journal of Psychiatric Research},

volume = {164},

pages = {15-22},

abstract = {The twin opioid-stimulant epidemics have led to increased overdose deaths and present unique challenges for individuals entering treatment with opioid-stimulant polysubstance use. This study examined tonic and cue-induced craving as a primary outcome among persons in substance use treatment who reported primary substances of opioids, methamphetamine, or cocaine. The sample consisted of 1974 individuals in 55 residential substance-use treatment centers in the United States in 2021. Weekly surveys were delivered via a third-party outcomes tracking system, including measures of tonic and cue-induced craving. Initial comparisons on tonic and cue-induced craving were made among those who primarily used opioids, cocaine, or methamphetamine. Further, the effect of opioid/stimulant polysubstance use on tonic and cue-induced craving was evaluated using marginal effect regression models. Primary methamphetamine use was associated with decreased tonic craving compared to primary opioid use (β = −5.63, p < 0.001) and primary cocaine use was also associate with decreased tonic craving compared to primary opioid use (β = −6.14, p < 0.001). Primary cocaine use was also associated with lower cue-induced cravings compared to primary opioid use (β = −0.53},

keywords = {Cocaine use, Cue-induced craving, Episodic craving, Methamphetamine use, Opioid use, Polysubstance use, Tonic craving},

pubstate = {published},

tppubtype = {article}

}

@article{pmid36449315,

title = {Clinical Trial Design Challenges and Opportunities for Emerging Treatments for Opioid Use Disorder: A Review},

author = {Brian D Kiluk and Bethea A Kleykamp and Sandra D Comer and Roland R Griffiths and Andrew S Huhn and Matthew W Johnson and Kyle M Kampman and Marco Pravetoni and Kenzie L Preston and Ryan Vandrey and Cecilia L Bergeria and Michael P Bogenschutz and Randall T Brown and Kelly E Dunn and Robert H Dworkin and Patrick H Finan and Peter S Hendricks and Elisabeth J Houtsmuller and Thomas R Kosten and Dustin C Lee and Frances R Levin and Aimee McRae-Clark and Charles L Raison and Kurt Rasmussen and Dennis C Turk and Roger D Weiss and Eric C Strain},

doi = {10.1001/jamapsychiatry.2022.4020},

issn = {2168-6238},

year  = {2023},

date = {2023-01-01},

journal = {JAMA Psychiatry},

volume = {80},

number = {1},

pages = {84--92},

abstract = {IMPORTANCE: Novel treatments for opioid use disorder (OUD) are needed to address both the ongoing opioid epidemic and long-standing barriers to existing OUD treatments that target the endogenous μ-opioid receptor (MOR) system. The goal of this review is to highlight unique clinical trial design considerations for the study of emerging treatments for OUD that address targets beyond the MOR system. In November 2019, the Analgesic, Anesthetic, and Addiction Clinical Trial Translations, Innovations, Opportunities, and Networks (ACTTION) public-private partnership with the US Food and Drug Administration sponsored a meeting to discuss the current evidence regarding potential treatments for OUD, including cannabinoids, psychedelics, sedative-hypnotics, and immunotherapeutics, such as vaccines.nnOBSERVATIONS: Consensus recommendations are presented regarding the most critical elements of trial design for the evaluation of novel OUD treatments, such as: (1) stage of treatment that will be targeted (eg, seeking treatment, early abstinence/detoxification, long-term recovery); (2) role of treatment (adjunctive with or independent of existing OUD treatments); (3) primary outcomes informed by patient preferences that assess opioid use (including changes in patterns of use), treatment retention, and/or global functioning and quality of life; and (4) adverse events, including the potential for opioid-related relapse or overdose, especially if the patient is not simultaneously taking maintenance MOR agonist or antagonist medications.nnCONCLUSIONS AND RELEVANCE: Applying the recommendations provided here as well as considering input from people with lived experience in the design phase will accelerate the development, translation, and uptake of effective and safe therapeutics for individuals struggling with OUD.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{pmid36968973,

title = {Prior Periods of Abstinence Among Adults With an Alcohol Use Disorder: A Qualitative Template Analysis},

author = {Orrin D Ware and Breanna Labos and Daniella Hudgins and Nathan A Irvin and Megan E Buresh and Cecilia L Bergeria and Mary M Sweeney},

doi = {10.1177/11782218231162468},

issn = {1178-2218},

year  = {2023},

date = {2023-01-01},

journal = {Subst Abuse},

volume = {17},

pages = {11782218231162468},

abstract = {Abstaining from substance use is a goal of many people with alcohol use disorder (AUD). Understanding patient perspectives of a period of abstinence may assist persons with AUD in achieving this goal. We accessed the electronic health records of adults with AUD entering an emergency department in Baltimore, Maryland, who received a brief peer support intervention for substance use. Data contained open-ended text entered by staff after a patient indicated ever having a sustained period of substance abstinence. Using qualitative template analysis methodology, we identified codes and themes from these open-ended responses from N = 153 adults with AUD. The sample was primarily male (n = 109, 71.2%) and White (n = 98, 64.1%) with an average age of 43.8 years (SD = 11.2). Themes identified included the abstinence length, abstinence reason, relapse, triggers, time of relapse, and treatment. The most common code for abstinence length was "between 1 and 5 years" (n = 55, 35.9%). Other abstinence length codes included "less than 1 year" and "more than 5 years." Relapse triggers included "family (non-death)," "death of a loved one," "social," "economic," and "treatment-related" reasons. Findings from this study could be used to inform strategies for peer support interventions to assist patients with substance abstinence.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{pmid37151972,

title = {Operational definition of precipitated opioid withdrawal},

author = {Kelly E Dunn and H Elizabeth Bird and Cecilia L Bergeria and Orrin D Ware and Eric C Strain and Andrew S Huhn},

doi = {10.3389/fpsyt.2023.1141980},

issn = {1664-0640},

year  = {2023},

date = {2023-01-01},

journal = {Front Psychiatry},

volume = {14},

pages = {1141980},

abstract = {BACKGROUND: Opioid withdrawal can be expressed as both a spontaneous and precipitated syndrome. Although spontaneous withdrawal is well-characterized, there is no operational definition of precipitated opioid withdrawal.nnMETHODS: People ( = 106) with opioid use disorder maintained on morphine received 0.4 mg intramuscular naloxone and completed self-report (Subjective Opiate Withdrawal Scale, SOWS), visual analog scale (VAS), Bad Effects and Sick, and observer ratings (Clinical Opiate Withdrawal Scale, COWS). Time to peak severity and minimal clinically important difference (MCID) in withdrawal severity were calculated. Principal component analysis (PCA) during peak severity were conducted and analyzed with repeated measures analyses of variance (ANOVA).nnRESULTS: Within 60 min, 89% of people reported peak SOWS ratings and 90% of people had peak COWS scores as made by raters. Self-reported signs of eyes tearing, yawning, nose running, perspiring, hot flashes, and observed changes in pupil diameter and rhinorrhea/lacrimation were uniquely associated with precipitated withdrawal. VAS ratings of Bad Effect and Sick served as statistically significant severity categories (0, 1-40, 41-80, and 81-100) for MCID evaluations and revealed participants' identification with an increase of 10 [SOWS; 15% maximum percent effect (MPE)] and 6 (COWS; 12% MPE) points as meaningful shifts in withdrawal severity indicative of precipitated withdrawal.nnCONCLUSION: Data suggested that a change of 10 (15% MPE) and 6 (12% MPE) points on the SOWS and COWS, respectively, that occurred within 60 min of antagonist administration was identified by participants as a clinically meaningful increase in symptom severity. These data provide a method to begin examining precipitated opioid withdrawal.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{Carr2022,

title = {Childhood Adversity, Addiction Severity, and Comorbidity Among Patients Receiving Opioid Use Disorder Treatment},

author = {Meagan M. Carr and Jennifer D. Ellis and Karen K. Saules and David M. Ledgerwood},

doi = {10.1097/nmd.0000000000001581},

issn = {1539-736X},

year  = {2023},

date = {2023-00-00},

journal = {J Nerv Ment Dis},

volume = {211},

number = {2},

pages = {150--156},

publisher = {Ovid Technologies (Wolters Kluwer Health)},

abstract = {Abstract

          Patients in opioid use disorder (OUD) treatment report high rates of childhood adversity, and women experience greater exposure to certain types of childhood adversity (e.g., sexual abuse). Childhood adversity is associated with clinical severity, but the mechanisms explaining this association are not well understood. Participants (N = 171) in opioid agonist treatment completed measures of childhood adversity, emotion regulation, and clinical severity (i.e., addictive behaviors, depression, and anxiety). Women endorsed greater childhood adversity and higher current psychopathology than men. The association between childhood adversity and clinical severity varied as a function of symptom type, although emotion regulation was a strong predictor in all models. Women reported higher levels of anxiety after controlling for covariates, childhood adversity, and emotion dysregulation. Future research should investigate treatment strategies to address emotion dysregulation among patients in OUD treatment, particularly women who may present with greater childhood adversity exposure and anxiety.},

keywords = {Psychiatry and Mental health},

pubstate = {published},

tppubtype = {article}

}

@article{pmid36644224,

title = {Factors related to substance use treatment attendance after peer recovery coach intervention in the emergency department},

author = {Orrin D Ware and Megan E Buresh and Nathan A Irvin and Maxine L Stitzer and Mary M Sweeney},

doi = {10.1016/j.dadr.2022.100093},

issn = {2772-7246},

year  = {2022},

date = {2022-12-01},

journal = {Drug Alcohol Depend Rep},

volume = {5},

abstract = {INTRODUCTION: Brief intervention with peer recovery coach support has been used to generate referrals to substance use disorder treatment from the emergency department (ED). This retrospective study evaluated factors associated with successful linkage to treatment following brief intervention in the ED.nnMETHODS: Data were extracted from the electronic health record for patients who were referred to substance use treatment from the ED and for whom follow-up data regarding treatment attendance was available (=666). We examined associations between demographic and insurance variables, substance use, mental health diagnosis, prior abstinence, and stage of change with successful linkage to substance use treatment after ED referral.nnRESULTS: The sample was majority male (68%), White (62%), and had a mean age of 43 years (SD=12). Medicaid was the most common insurance (49%) followed by employer/private (34%). Multivariable logistic regression determined patients with Medicaid (OR=2.94, 95% CI:2.09-4.13, p=<.001), those who had a documented alcohol use disorder diagnosis (OR=1.59, 95% CI:1.074-2.342, p=.02), and those in the "Action" stage of change (OR=2.33, 95% CI:1.47-3.69, p=<.001) had greater odds of being successfully linked to treatment.nnCONCLUSIONS: These results identify characteristics of patients available in the health record to determine who is more likely or less likely to attend substance use treatment following ED referral. Given appropriate screening, this information could be used to direct standard care resources to those with high likelihood of treatment attendance and strengthen follow-up interventions with peer recovery coaches for those with lower likelihood of treatment attendance.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{pmid34096756d,

title = {Wireless electroencephalography (EEG) to monitor sleep among patients being withdrawn from opioids: Evidence of feasibility and utility},

author = {Kelly E Dunn and Patrick H Finan and Andrew S Huhn and Charlene Gamaldo and Cecilia L Bergeria and Eric C Strain},

doi = {10.1037/pha0000483},

issn = {1936-2293},

year  = {2022},

date = {2022-12-01},

journal = {Exp Clin Psychopharmacol},

volume = {30},

number = {6},

pages = {1016--1023},

abstract = {Sleep impairment is a common comorbid and debilitating symptom for persons with opioid use disorder (OUD). Research into underlying mechanisms and efficacious treatment interventions for OUD-related sleep problems requires both precise and physiologic measurements of sleep-related outcomes and impairment. This pilot examined the feasibility of a wireless sleep electroencephalography (EEG) monitor (Sleep Profiler™) to measure sleep outcomes and architecture among participants undergoing supervised opioid withdrawal. Sleep outcomes were compared to a self-reported sleep diary and opioid withdrawal ratings. Participants (n = 8, 100% male) wore the wireless EEG 85.6% of scheduled nights. Wireless EEG detected measures of sleep architecture including changes in total, NREM and REM sleep time during study phases, whereas the diary detected changes in wakefulness only. Direct comparisons of five overlapping outcomes revealed lower sleep efficiency and sleep onset latency and higher awakenings and time spent awake from the wireless EEG versus sleep diary. Associations were evident between wireless EEG and increased withdrawal severity, lower sleep efficiency, less time in REM and non-REM stages 1 and 2, and more hydroxyzine treatment; sleep diary was associated with total sleep time and withdrawal only. Data provide initial evidence that a wireless EEG is a feasible and useful tool for objective monitoring of sleep in persons experiencing acute opioid withdrawal. Data are limited by the small and exclusively male sample, but provide a foundation for using wireless EEG sleep monitors for objective evaluation of sleep-related impairment in persons with OUD in support of mechanistic and treatment intervention research. (PsycInfo Database Record (c) 2022 APA, all rights reserved).},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{pmid34735202b,

title = {Social, psychological, and substance use characteristics of U.S. adults who use kratom: Initial findings from an online, crowdsourced study},

author = {Kirsten E Smith and Kelly E Dunn and Oliver Grundmann and Albert Garcia-Romeu and Jeffrey M Rogers and Marc T Swogger and David H Epstein},

doi = {10.1037/pha0000518},

issn = {1936-2293},

year  = {2022},

date = {2022-12-01},

journal = {Exp Clin Psychopharmacol},

volume = {30},

number = {6},

pages = {983--996},

abstract = {Kratom, a plant that produces opioid-like effects, has gained popularity in the U.S. for self-treating symptoms of chronic pain, mood disorders, and substance-use disorders (SUDs). Most data on kratom are from surveys into which current kratom-using adults could self-select; such surveys may underrepresent people who have used kratom and chosen to stop. Available data also do not adequately assess important psychosocial factors surrounding kratom use. In this study, U.S. adults who reported past 6-month alcohol, opioid, and/or stimulant use ( = 1,670) were recruited via Amazon Mechanical Turk between September and December 2020. Of the 1,510 evaluable respondents, 202 (13.4%) reported lifetime kratom use. Kratom-using adults, relative to others, were typically younger, male, unpartnered, without children, and had lower income. They had higher rates of chronic pain (31.7% vs. 21.9%,  = .003), childhood adversity, anxiety, and depression ( < .001), and lower perceived social rank ( = .19, .02-.22) and socioeconomic status ( = .37 .16-.26). They also reported higher use rates for most substances (except alcohol); this included medically supervised and unsupervised use of prescription opioids and diverted opioid agonist therapy (OAT) medications. Most (83.2%) met diagnostic criteria for any past-year SUD. Those reporting kratom use were less likely to reside in an urban/suburban area. The strongest predictors of kratom use were use of other drugs: cannabidiol ( = 3.73), psychedelics ( = 3.39), and nonmedical prescription opioids ( = 1.72). Another strong predictor was lifetime OAT utilization ( = 2.31). Despite seemingly poorer psychosocial functioning and health among respondents reporting lifetime kratom use, use of other substances may be the strongest indicators of kratom use. (PsycInfo Database Record (c) 2022 APA, all rights reserved).},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{pmid34110889,

title = {Sleep disturbance as a therapeutic target to improve opioid use disorder treatment},

author = {Andrew S Huhn and Patrick H Finan},

doi = {10.1037/pha0000477},

issn = {1936-2293},

year  = {2022},

date = {2022-12-01},

journal = {Exp Clin Psychopharmacol},

volume = {30},

number = {6},

pages = {1024--1035},

abstract = {Sleep health is an important factor across several physical and mental health disorders, and a growing scientific consensus has identified sleep as a critical component of opioid use disorder (OUD), both in the active disease state and during OUD recovery. The goal of this narrative review is to collate the literature on sleep, opioid use, and OUD as a means of identifying therapeutic targets to improve OUD treatment outcomes. Sleep disturbance is common and often severe in persons with OUD, especially during opioid withdrawal, but also in persons on opioid maintenance therapies. There is ample evidence that sleep disturbances including reduced total sleep time, disrupted sleep continuity, and poor sleep quality often accompany negative OUD treatment outcomes. Sleep disturbances are bidirectionally associated with several other factors related to negative treatment outcomes, including chronic stress, stress reactivity, low positive affect, high negative affect, chronic pain, and drug craving. This constellation of outcome variables represents a more comprehensive appraisal of the quality of life and quality of recovery than is typically assessed in OUD clinical trials. To date, there are very few clinical trials or experimental studies aimed at improving sleep health in OUD patients, either as a means of improving stress, affect, and craving outcomes, or as a potential mechanistic target to reduce opioid withdrawal and drug use behaviors. As such, the direct impact of sleep improvement in OUD patients is largely unknown, yet mechanistic and clinical research suggests that therapeutic interventions that target sleep are a promising avenue to improve OUD treatment. (PsycInfo Database Record (c) 2022 APA, all rights reserved).},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{pmid34096756c,

title = {Wireless electroencephalography (EEG) to monitor sleep among patients being withdrawn from opioids: Evidence of feasibility and utility},

author = {Kelly E Dunn and Patrick H Finan and Andrew S Huhn and Charlene Gamaldo and Cecilia L Bergeria and Eric C Strain},

doi = {10.1037/pha0000483},

issn = {1936-2293},

year  = {2022},

date = {2022-12-01},

journal = {Exp Clin Psychopharmacol},

volume = {30},

number = {6},

pages = {1016--1023},

abstract = {Sleep impairment is a common comorbid and debilitating symptom for persons with opioid use disorder (OUD). Research into underlying mechanisms and efficacious treatment interventions for OUD-related sleep problems requires both precise and physiologic measurements of sleep-related outcomes and impairment. This pilot examined the feasibility of a wireless sleep electroencephalography (EEG) monitor (Sleep Profiler™) to measure sleep outcomes and architecture among participants undergoing supervised opioid withdrawal. Sleep outcomes were compared to a self-reported sleep diary and opioid withdrawal ratings. Participants (n = 8, 100% male) wore the wireless EEG 85.6% of scheduled nights. Wireless EEG detected measures of sleep architecture including changes in total, NREM and REM sleep time during study phases, whereas the diary detected changes in wakefulness only. Direct comparisons of five overlapping outcomes revealed lower sleep efficiency and sleep onset latency and higher awakenings and time spent awake from the wireless EEG versus sleep diary. Associations were evident between wireless EEG and increased withdrawal severity, lower sleep efficiency, less time in REM and non-REM stages 1 and 2, and more hydroxyzine treatment; sleep diary was associated with total sleep time and withdrawal only. Data provide initial evidence that a wireless EEG is a feasible and useful tool for objective monitoring of sleep in persons experiencing acute opioid withdrawal. Data are limited by the small and exclusively male sample, but provide a foundation for using wireless EEG sleep monitors for objective evaluation of sleep-related impairment in persons with OUD in support of mechanistic and treatment intervention research. (PsycInfo Database Record (c) 2022 APA, all rights reserved).},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{pmid34735202,

title = {Social, psychological, and substance use characteristics of U.S. adults who use kratom: Initial findings from an online, crowdsourced study},

author = {Kirsten E Smith and Kelly E Dunn and Oliver Grundmann and Albert Garcia-Romeu and Jeffrey M Rogers and Marc T Swogger and David H Epstein},

doi = {10.1037/pha0000518},

issn = {1936-2293},

year  = {2022},

date = {2022-12-01},

journal = {Exp Clin Psychopharmacol},

volume = {30},

number = {6},

pages = {983--996},

abstract = {Kratom, a plant that produces opioid-like effects, has gained popularity in the U.S. for self-treating symptoms of chronic pain, mood disorders, and substance-use disorders (SUDs). Most data on kratom are from surveys into which current kratom-using adults could self-select; such surveys may underrepresent people who have used kratom and chosen to stop. Available data also do not adequately assess important psychosocial factors surrounding kratom use. In this study, U.S. adults who reported past 6-month alcohol, opioid, and/or stimulant use ( = 1,670) were recruited via Amazon Mechanical Turk between September and December 2020. Of the 1,510 evaluable respondents, 202 (13.4%) reported lifetime kratom use. Kratom-using adults, relative to others, were typically younger, male, unpartnered, without children, and had lower income. They had higher rates of chronic pain (31.7% vs. 21.9%,  = .003), childhood adversity, anxiety, and depression ( < .001), and lower perceived social rank ( = .19, .02-.22) and socioeconomic status ( = .37 .16-.26). They also reported higher use rates for most substances (except alcohol); this included medically supervised and unsupervised use of prescription opioids and diverted opioid agonist therapy (OAT) medications. Most (83.2%) met diagnostic criteria for any past-year SUD. Those reporting kratom use were less likely to reside in an urban/suburban area. The strongest predictors of kratom use were use of other drugs: cannabidiol ( = 3.73), psychedelics ( = 3.39), and nonmedical prescription opioids ( = 1.72). Another strong predictor was lifetime OAT utilization ( = 2.31). Despite seemingly poorer psychosocial functioning and health among respondents reporting lifetime kratom use, use of other substances may be the strongest indicators of kratom use. (PsycInfo Database Record (c) 2022 APA, all rights reserved).},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{pmid34096756b,

title = {Wireless electroencephalography (EEG) to monitor sleep among patients being withdrawn from opioids: Evidence of feasibility and utility},

author = {Kelly E Dunn and Patrick H Finan and Andrew S Huhn and Charlene Gamaldo and Cecilia L Bergeria and Eric C Strain},

doi = {10.1037/pha0000483},

issn = {1936-2293},

year  = {2022},

date = {2022-12-01},

journal = {Exp Clin Psychopharmacol},

volume = {30},

number = {6},

pages = {1016--1023},

abstract = {Sleep impairment is a common comorbid and debilitating symptom for persons with opioid use disorder (OUD). Research into underlying mechanisms and efficacious treatment interventions for OUD-related sleep problems requires both precise and physiologic measurements of sleep-related outcomes and impairment. This pilot examined the feasibility of a wireless sleep electroencephalography (EEG) monitor (Sleep Profiler™) to measure sleep outcomes and architecture among participants undergoing supervised opioid withdrawal. Sleep outcomes were compared to a self-reported sleep diary and opioid withdrawal ratings. Participants (n = 8, 100% male) wore the wireless EEG 85.6% of scheduled nights. Wireless EEG detected measures of sleep architecture including changes in total, NREM and REM sleep time during study phases, whereas the diary detected changes in wakefulness only. Direct comparisons of five overlapping outcomes revealed lower sleep efficiency and sleep onset latency and higher awakenings and time spent awake from the wireless EEG versus sleep diary. Associations were evident between wireless EEG and increased withdrawal severity, lower sleep efficiency, less time in REM and non-REM stages 1 and 2, and more hydroxyzine treatment; sleep diary was associated with total sleep time and withdrawal only. Data provide initial evidence that a wireless EEG is a feasible and useful tool for objective monitoring of sleep in persons experiencing acute opioid withdrawal. Data are limited by the small and exclusively male sample, but provide a foundation for using wireless EEG sleep monitors for objective evaluation of sleep-related impairment in persons with OUD in support of mechanistic and treatment intervention research. (PsycInfo Database Record (c) 2022 APA, all rights reserved).},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{pmid36272516,

title = {Relating individual differences in the reinforcing value of smoking and dependence severity to nicotine exposure levels in vulnerable populations},

author = {Kaitlyn O Browning and Michael J DeSarno and Danielle R Davis and Joanna M Streck and Cecilia L Bergeria and Roxanne F Harfmann and Maria A Parker and Sarah H Heil and Stacey C Sigmon and Diann E Gaalema and Jennifer W Tidey and Dustin C Lee and Haley J Tetreault and Stephen T Higgins},

doi = {10.1016/j.ypmed.2022.107312},

issn = {1096-0260},

year  = {2022},

date = {2022-12-01},

journal = {Prev Med},

volume = {165},

number = {Pt B},

pages = {107312},

abstract = {Cigarette smoking is overrepresented in populations with psychiatric conditions and socioeconomic disadvantage. Greater understanding of the role of reinforcement and nicotine dependence in smoking among vulnerable populations may facilitate development of better targeted interventions to reduce smoking. Prior research demonstrated that individual differences in the reinforcing value of smoking and nicotine-dependence severity predicted total nicotine-exposure in vulnerable populations. The present study uses multivariate regression to address two aims: (1) Quantify the degree to which the reinforcing value of smoking, assessed using the Cigarette Purchase Task (CPT), and dependence severity assessed using the Fagerström Test of Nicotine Dependence and Brief Wisconsin Inventory of Smoking Dependence Motives (B-WISDM) each account for individual differences in cotinine-plus-3'-hydroxycotinine (COT+3HC) levels. (2) Explore whether there is overlap in the variance accounted for by the CTP, FTND, and B-WISDM. Participants were 628 adults with co-morbid psychiatric conditions or socioeconomic disadvantage who smoked daily. The CPT, FTND, and B-WISDM models accounted for 23.76%, 32.45%, and 29.61% of the variance in COT+3HC levels, respectively. Adding CPT to the FTND model failed to increase the variance accounted for and adding it to the B-WISDM model did so by only 1.2% demonstrating considerable overlap in the variance in nicotine exposure levels accounted for by these three instruments. These results provide new knowledge on the relationship between individual differences in the reinforcing value of smoking and nicotine-exposure levels and suggest differences in reinforcing value may underpin a considerable portion of the variance in nicotine exposure accounted for by dependence severity.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{pmid34096756,

title = {Wireless electroencephalography (EEG) to monitor sleep among patients being withdrawn from opioids: Evidence of feasibility and utility},

author = {Kelly E Dunn and Patrick H Finan and Andrew S Huhn and Charlene Gamaldo and Cecilia L Bergeria and Eric C Strain},

doi = {10.1037/pha0000483},

issn = {1936-2293},

year  = {2022},

date = {2022-12-01},

journal = {Exp Clin Psychopharmacol},

volume = {30},

number = {6},

pages = {1016--1023},

abstract = {Sleep impairment is a common comorbid and debilitating symptom for persons with opioid use disorder (OUD). Research into underlying mechanisms and efficacious treatment interventions for OUD-related sleep problems requires both precise and physiologic measurements of sleep-related outcomes and impairment. This pilot examined the feasibility of a wireless sleep electroencephalography (EEG) monitor (Sleep Profiler™) to measure sleep outcomes and architecture among participants undergoing supervised opioid withdrawal. Sleep outcomes were compared to a self-reported sleep diary and opioid withdrawal ratings. Participants (n = 8, 100% male) wore the wireless EEG 85.6% of scheduled nights. Wireless EEG detected measures of sleep architecture including changes in total, NREM and REM sleep time during study phases, whereas the diary detected changes in wakefulness only. Direct comparisons of five overlapping outcomes revealed lower sleep efficiency and sleep onset latency and higher awakenings and time spent awake from the wireless EEG versus sleep diary. Associations were evident between wireless EEG and increased withdrawal severity, lower sleep efficiency, less time in REM and non-REM stages 1 and 2, and more hydroxyzine treatment; sleep diary was associated with total sleep time and withdrawal only. Data provide initial evidence that a wireless EEG is a feasible and useful tool for objective monitoring of sleep in persons experiencing acute opioid withdrawal. Data are limited by the small and exclusively male sample, but provide a foundation for using wireless EEG sleep monitors for objective evaluation of sleep-related impairment in persons with OUD in support of mechanistic and treatment intervention research. (PsycInfo Database Record (c) 2022 APA, all rights reserved).},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{pmid36108442,

title = {Disease and decision},

author = {Kirsten E Smith},

doi = {10.1016/j.jsat.2022.108874},

issn = {1873-6483},

year  = {2022},

date = {2022-11-01},

journal = {J Subst Abuse Treat},

volume = {142},

pages = {108874},

abstract = {At age 16, I injected morphine for the first time, and then started injecting heroin. By most standards, I was highly functioning, although I eventually became addicted. I was and remain socioeconomically privileged, but my relationship to heroin resulted in behaviors and consequences that I never could have conceived of, and which I sometimes strain to remember occurred. My life now is stable and conventional. Some aspects of my past addiction are unerasable, but the most salient of those are the social and legal consequences of having a criminal record-not any hallmarks of a chronic brain disease or disorder. I do not consider myself "in recovery." Rather, I am recovered, by standards both my own and derived from clinical nosology. I have been in sustained remission for over a decade. Yet feelings are not facts, as is often said. I still use alcohol, and occasionally (though not recently) I have used other drugs, so there remains the possibility that my brain is indeed "diseased" and I am not objectively recovered, my self-assessment notwithstanding. My aim in writing about my lived experience of drug use, addiction, and recovery is to highlight the heterogeneity of people's experiences and the insight that personal narratives can provide. Debates about the brain disease model of addiction are often confined to academia, with the real-world, unintended consequences of the "disease" label seldom considered. Stigmatization of people with addiction comes from moralizing about drug use but may also originate from well-intended labels. I posit that we should not need labels to care about addicted people and make scientifically informed treatment accessible. Addicted people deserve help because they either need or want it, regardless of labels that presume to describe the etiology or likely trajectory of their problems. I conclude that some labels, even those needed for clinical classification of human behavior, may be pernicious. Clinicians and researchers have an obligation to reflect more deeply on the implications of the disease conceptualization of complex human behaviors such as addiction.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{pmid35767669b,

title = {Kratom use as more than a "self-treatment"},

author = {Kirsten E Smith and Kelly E Dunn and Jeffrey M Rogers and Oliver Grundmann and Christopher R McCurdy and Albert Garcia-Romeu and Destiny Schriefer and Marc T Swogger and David H Epstein},

doi = {10.1080/00952990.2022.2083967},

issn = {1097-9891},

year  = {2022},

date = {2022-11-01},

journal = {Am J Drug Alcohol Abuse},

volume = {48},

number = {6},

pages = {684--694},

abstract = {  (kratom) is increasingly used in the United States for its pharmacological effects. Kratom's relative novelty makes for a dynamic situation, such that use motivations are not firmly established and may be changing. Investigators and clinicians require frequent updates on kratom trends. To assess the current state of kratom-use initiation, sourcing, motivations, preference, conceptualizations, and perceived stigma, using survey responses from current and former users. Between April-May 2021 we recontacted 289 respondents who reported lifetime kratom use (on an unrelated survey) to answer kratom-specific questions. The sample (N=129) was majority female (51.9%) and white (71.9%). Most (69.0%) reported first trying kratom after 2015. Mean age of use initiation (29.9 years) was older than for other substances, including opioids. Kratom ranked as a preferred substance by 48.5%. The strongest drug association with past-year kratom use was vaped nicotine (3.31,95% CI 1.23-8.88). Use was less likely among those prescribed buprenorphine in the past year (0.03, CI 0.01-0.28). Past-month cannabis use (4.18,CI 1.80-9.72) had the strongest association with past-month kratom use. Over 40 use motivations were endorsed, many (but not all) supporting the "self-treatment" narrative of kratom use, including use as an opioid, alcohol, or stimulant substitute. Treatment shortfalls were associated with decisions to try kratom. Kratom use motivations are diversifying, with multiple factors driving use. As sales continue to increase, the public-health, clinical, and policy responses to kratom should be grounded in rigorous bench-to-bedside scientific research. Comprehensive study of kratom is currently lacking.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{pmid36182746,

title = {A longitudinal study of COVID-19 disclosure stigma and COVID-19 testing hesitancy in the United States},

author = {L Dayton and W Song and I Kaloustian and E L Eschliman and J C Strickland and C Latkin},

doi = {10.1016/j.puhe.2022.08.003},

issn = {1476-5616},

year  = {2022},

date = {2022-11-01},

journal = {Public Health},

volume = {212},

pages = {14--21},

abstract = {OBJECTIVES: This study examines the relationship between COVID-19 disclosure stigma and COVID-19 testing hesitancy and assesses their changes between November 2020 and 2021.nnSTUDY DESIGN: This was a longitudinal cohort.nnMETHODS: A total of 355 participants completed four study waves between November 2020 and November 2021. Factor analyses and Cronbach's alpha assessed the factor structure and internal consistency of the COVID-19 Disclosure Stigma scale. Paired t-tests and McNemar's Chi-squared test assessed change between the study waves. Multivariable logistic regression models examined the relationship between COVID-19 disclosure stigma and testing hesitancy at four study waves.nnRESULTS: COVID-19 disclosure stigma declined significantly between the last study waves (P = 0.030). The greatest disclosure concern was reporting a positive test to close contacts (range: 19%-21%) followed by disclosure to friends (range: 10%-15%) and family (range: 4%-10%). Over the course of the four study waves, COVID-19 testing hesitancy when symptomatic ranged from 23% to 30%. Older age, female gender, and having received a COVID-19 vaccine were associated with decreased odds of testing hesitancy. Greater COVID-19 disclosure stigma and more conservative political ideology showed a consistent relationship with increased odds of COVID-19 testing hesitancy.nnCONCLUSIONS: Study findings suggest that many people anticipate feeling stigmatized when disclosing positive test results, especially to close contacts. A substantial percentage of study participants reported hesitancy to be tested when symptomatic. This study identifies a need for interventions that normalize COVID-19 testing (e.g. engaging leaders with conservative followings), provide strategies for disclosing positive results, and allow anonymous notification of potential COVID-19 exposure.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{pmid36005849,

title = {Behavioral economic methods predict future COVID-19 vaccination},

author = {Justin C Strickland and Derek D Reed and Lauren Dayton and Matthew W Johnson and Carl Latkin and Lindsay P Schwartz and Steven R Hursh},

doi = {10.1093/tbm/ibac057},

issn = {1613-9860},

year  = {2022},

date = {2022-11-01},

journal = {Transl Behav Med},

volume = {12},

number = {10},

pages = {1004--1008},

abstract = {Increasing vaccine utilization is critical for numerous diseases, including COVID-19, necessitating novel methods to forecast uptake. Behavioral economic methods have been developed as rapid, scalable means of identifying mechanisms of health behavior engagement. However, most research using these procedures is cross-sectional and evaluates prediction of behaviors with already well-established repertories. Evaluation of the validity of hypothetical tasks that measure behaviors not yet experienced is important for the use of these procedures in behavioral health. We use vaccination during the COVID-19 pandemic to test whether responses regarding a novel, hypothetical behavior (COVID-19 vaccination) are predictive of later real-world response. Participants (N = 333) completed a behavioral economic hypothetical purchase task to evaluate willingness to receive a hypothetical COVID-19 vaccine based on efficacy. This was completed in August 2020, before clinical trial data on COVID-19 vaccines. Participants completed follow-up assessments approximately 1 year later when the COVID-19 vaccines were widely available in June 2021 and November 2021 with vaccination status measured. Prediction of vaccination was made based on data collected in August 2020. Vaccine demand was a significant predictor of vaccination after controlling for other significant predictors including political orientation, delay discounting, history of flu vaccination, and a single-item intent to vaccinate. These findings show predictive validity of a behavioral economic procedure explicitly designed to measure a behavior for which a participant has limited-to-no direct prior experience or exposure. Positive correspondence supports the validity of these hypothetical arrangements for predicting vaccination utilization and advances behavioral economic methods.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{pmid36126611b,

title = {The association of chronic pain and opioid withdrawal in men and women with opioid use disorder},

author = {Orrin D Ware and Jennifer D Ellis and Kelly E Dunn and J Gregory Hobelmann and Patrick Finan and Andrew S Huhn},

doi = {10.1016/j.drugalcdep.2022.109631},

issn = {1879-0046},

year  = {2022},

date = {2022-11-01},

journal = {Drug Alcohol Depend},

volume = {240},

pages = {109631},

abstract = {BACKGROUND: Approximately 2.7 million individuals in the United States had an opioid use disorder (OUD) in 2020. Chronic pain may exacerbate opioid withdrawal severity, yet most research on opioid withdrawal has not collected data on chronic pain status. Moreover, there is limited evidence that women tend to experience greater opioid withdrawal severity than men, but large, confirmatory studies on this topic have not been published. The goal of this study was to examine the roles of chronic pain and gender on opioid withdrawal severity using a large, multi-site database.nnMETHODS: Data were collected from N = 1252 individuals with OUD entering eight residential addiction treatment facilities. Demographic, drug use behaviors, and chronic pain status were collected at treatment intake, and self-reported opioid withdrawal and craving were measured at intake and 1-3 days, 4-6 days, and 7-9 days after intake. Regression analyses were used to predict withdrawal and craving severity at intake and across the four timepoints.nnRESULTS: At intake, withdrawal was higher in persons who were older, had greater SUD severity, women, had chronic pain, and used > 1 substance (p-values ≤.007) and craving was higher in persons with greater SUD severity (p < .001) and women (p = .033). Withdrawal remained higher in women and persons with chronic pain across timepoints but decreased at a similar rate relative to comparators.nnCONCLUSIONS: Women and persons with chronic pain would benefit from earlier engagement in treatment and may require a more intensive strategy to mitigate opioid withdrawal in early treatment.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{pmid35817255,

title = {Real-Time Monitoring of Cannabis and Prescription Opioid Co-Use Patterns, Analgesic Effectiveness, and the Opioid-Sparing Effect of Cannabis in Individuals With Chronic Pain},

author = {Chung Jung Mun and Courtney Nordeck and Erin M Anderson Goodell and Ryan Vandrey and Vadim Zipunnikov and Kelly E Dunn and Patrick H Finan and Johannes Thrul},

doi = {10.1016/j.jpain.2022.06.009},

issn = {1528-8447},

year  = {2022},

date = {2022-11-01},

journal = {J Pain},

volume = {23},

number = {11},

pages = {1799--1810},

abstract = {Despite a rapid expansion of cannabis use for pain management, how cannabis and prescription opioids are co-used and whether co-use improves analgesia and promotes reduction of opioid use in the daily lives of individuals with chronic pain is poorly understood. Based upon ecological momentary assessment (EMA), the present study examined 1) how pain and use of opioids and/or cannabis in the previous moment is associated with individuals' choice of opioids and/or cannabis in the next moment, 2) the effects of co-use on pain severity and pain relief, and 3) whether daily total opioid consumption differs on days when people only used opioids versus co-used. Adults with chronic pain (N = 46) using both opioids and cannabis who were recruited online completed a 30-day EMA. Elevated pain did not increase the likelihood of co-use in subsequent momentary assessments. Switching from sole use of either opioids and cannabis to co-use was common. Neither co-use nor sole use of either cannabis or opioids were associated with reductions in pain in the next moment. However, participants reported the highest daily perceived pain relief from co-use compared to cannabis and opioid use only. Post hoc analysis suggested recall bias as a potential source of this discrepant findings between momentary versus retrospective assessment. Lastly, there was no evidence of an opioid-sparing effect of cannabis in this sample. The present study shows preliminary evidence on cannabis and opioid co-use patterns, as well as the effects of co-use on pain and opoid dose in the real-world setting. PERSPECTIVE: This article presents the overall patterns and effects of co-using cannabis and prescription opioids among individuals with chronic pain employing ecological momentary assessment. There were conflicting findings on the association between co-use and analgesia. Co-use was not associated with a reduction in daily opioid consumption in this sample.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{pmid36126611,

title = {The association of chronic pain and opioid withdrawal in men and women with opioid use disorder},

author = {Orrin D Ware and Jennifer D Ellis and Kelly E Dunn and J Gregory Hobelmann and Patrick Finan and Andrew S Huhn},

doi = {10.1016/j.drugalcdep.2022.109631},

issn = {1879-0046},

year  = {2022},

date = {2022-11-01},

journal = {Drug Alcohol Depend},

volume = {240},

pages = {109631},

abstract = {BACKGROUND: Approximately 2.7 million individuals in the United States had an opioid use disorder (OUD) in 2020. Chronic pain may exacerbate opioid withdrawal severity, yet most research on opioid withdrawal has not collected data on chronic pain status. Moreover, there is limited evidence that women tend to experience greater opioid withdrawal severity than men, but large, confirmatory studies on this topic have not been published. The goal of this study was to examine the roles of chronic pain and gender on opioid withdrawal severity using a large, multi-site database.nnMETHODS: Data were collected from N = 1252 individuals with OUD entering eight residential addiction treatment facilities. Demographic, drug use behaviors, and chronic pain status were collected at treatment intake, and self-reported opioid withdrawal and craving were measured at intake and 1-3 days, 4-6 days, and 7-9 days after intake. Regression analyses were used to predict withdrawal and craving severity at intake and across the four timepoints.nnRESULTS: At intake, withdrawal was higher in persons who were older, had greater SUD severity, women, had chronic pain, and used > 1 substance (p-values ≤.007) and craving was higher in persons with greater SUD severity (p < .001) and women (p = .033). Withdrawal remained higher in women and persons with chronic pain across timepoints but decreased at a similar rate relative to comparators.nnCONCLUSIONS: Women and persons with chronic pain would benefit from earlier engagement in treatment and may require a more intensive strategy to mitigate opioid withdrawal in early treatment.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{pmid35767669,

title = {Kratom use as more than a "self-treatment"},

author = {Kirsten E Smith and Kelly E Dunn and Jeffrey M Rogers and Oliver Grundmann and Christopher R McCurdy and Albert Garcia-Romeu and Destiny Schriefer and Marc T Swogger and David H Epstein},

doi = {10.1080/00952990.2022.2083967},

issn = {1097-9891},

year  = {2022},

date = {2022-11-01},

journal = {Am J Drug Alcohol Abuse},

volume = {48},

number = {6},

pages = {684--694},

abstract = {  (kratom) is increasingly used in the United States for its pharmacological effects. Kratom's relative novelty makes for a dynamic situation, such that use motivations are not firmly established and may be changing. Investigators and clinicians require frequent updates on kratom trends. To assess the current state of kratom-use initiation, sourcing, motivations, preference, conceptualizations, and perceived stigma, using survey responses from current and former users. Between April-May 2021 we recontacted 289 respondents who reported lifetime kratom use (on an unrelated survey) to answer kratom-specific questions. The sample (N=129) was majority female (51.9%) and white (71.9%). Most (69.0%) reported first trying kratom after 2015. Mean age of use initiation (29.9 years) was older than for other substances, including opioids. Kratom ranked as a preferred substance by 48.5%. The strongest drug association with past-year kratom use was vaped nicotine (3.31,95% CI 1.23-8.88). Use was less likely among those prescribed buprenorphine in the past year (0.03, CI 0.01-0.28). Past-month cannabis use (4.18,CI 1.80-9.72) had the strongest association with past-month kratom use. Over 40 use motivations were endorsed, many (but not all) supporting the "self-treatment" narrative of kratom use, including use as an opioid, alcohol, or stimulant substitute. Treatment shortfalls were associated with decisions to try kratom. Kratom use motivations are diversifying, with multiple factors driving use. As sales continue to increase, the public-health, clinical, and policy responses to kratom should be grounded in rigorous bench-to-bedside scientific research. Comprehensive study of kratom is currently lacking.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{pmid34081511b,

title = {Delay discounting and neurocognitive performance in young adults with differential patterns of substance use: Findings from the Human Connectome Project},

author = {Gideon P Naudé and Justin C Strickland and Derek D Reed and Michael Amlung},

doi = {10.1037/pha0000469},

issn = {1936-2293},

year  = {2022},

date = {2022-10-01},

journal = {Exp Clin Psychopharmacol},

volume = {30},

number = {5},

pages = {682--691},

abstract = {A large proportion of individuals who use psychoactive substances regularly use more than one substance. This pattern of behavior, termed polysubstance use, is associated with greater risks than when consuming only a single substance. The present study examined delay discounting, neurocognitive functioning, and demographic indicators among a large, racially and socioeconomically diverse sample of young adults drawn from the Human Connectome Project who reported either non, mono, or dual use of alcohol, tobacco, and/or cannabis. Univariate and multivariate tests suggested individuals who reported using multiple substances were more likely to be male, experienced higher rates of alcohol use disorder, and, when reporting both alcohol use and cannabis involvement, scored lower on a measure of inhibitory control relative to those who reported mono or dual use of alcohol and/or cigarettes. Individuals who reported currently smoking cigarettes exhibited the steepest discounting irrespective of other substances used; however, we observed additive effects for alcohol use and, to a lesser extent, cannabis involvement. Specifically, steeper discounting occurred when individuals who reported either regular alcohol use or > 100 lifetime instances of cannabis use also reported smoking cigarettes. We discuss several hypotheses for this finding related to the diversity of the sample and substances assessed as well as directions for future programmatic lines of research. (PsycInfo Database Record (c) 2022 APA, all rights reserved).},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{pmid33856822,

title = {Use patterns, beliefs, experiences, and behavioral economic demand of indica and sativa cannabis: A cross-sectional survey of cannabis users},

author = {Dennis J Sholler and Meghan B Moran and Sean B Dolan and Jacob T Borodovsky and Fernanda Alonso and Ryan Vandrey and Tory R Spindle},

doi = {10.1037/pha0000462},

issn = {1936-2293},

year  = {2022},

date = {2022-10-01},

journal = {Exp Clin Psychopharmacol},

volume = {30},

number = {5},

pages = {575--583},

abstract = {Cannabis products available for retail purchase are often marketed based on purported plant species (e.g., "indica" or "sativa"). The cannabis industry frequently claims that indica versus sativa cannabis elicits unique effects and/or is useful for different therapeutic indications. Few studies have evaluated use patterns, beliefs, subjective experiences, and situations in which individuals use indica versus sativa. A convenience sample of cannabis users ( = 179) was surveyed via Amazon Mechanical Turk (mTurk). Participants were asked about their prior use of, subjective experiences with, and opinions on indica versus sativa cannabis and completed hypothetical purchasing tasks for both cannabis subtypes. Participants reported a greater preference to use indica in the evening and sativa in the morning and afternoon. Participants were more likely to perceive feeling "sleepy/tired" or "relaxed" after using indica and "alert," "energized," and "motivated" after using sativa. Respondents were more likely to endorse wanting to use indica if they were going to sleep soon but more likely to use sativa at a party. Hypothetical purchasing patterns (i.e., grams of cannabis purchased as a function of escalating price) did not differ between indica and sativa, suggesting that demand was similar. Taken together, cannabis users retrospectively report feeling different effects from indica and sativa; however, demand generally did not differ between cannabis subtypes, suggesting situational factors could influence whether someone uses indica or sativa. Placebo-controlled, blinded studies are needed to characterize the pharmacodynamics and chemical composition of indica and sativa cannabis and to determine whether user expectancies contribute to differences in perceived indica/sativa effects. (PsycInfo Database Record (c) 2022 APA, all rights reserved).},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{pmid35770374,

title = {Urinary Excretion Profile of Cannabinoid Analytes Following Acute Administration of Oral and Vaporized Cannabis in Infrequent Cannabis Users},

author = {Dennis J Sholler and C Austin Zamarripa and Tory R Spindle and Erin L Martin and David Kuntz and Ryan Vandrey and Megan Grabenauer},

doi = {10.1093/jat/bkac042},

issn = {1945-2403},

year  = {2022},

date = {2022-10-01},

journal = {J Anal Toxicol},

volume = {46},

number = {8},

pages = {882--890},

abstract = {Traditionally, smoking has been the predominant method for administering cannabis, but alternative routes of administration have become more prevalent. Additionally, research examining urinary cannabinoid excretion profiles has primarily focused on 11-nor-9-carboxy-∆9-tetrahydrocannabinol (∆9-THC-COOH), a metabolite of ∆9-tetrahydrocannabinol (∆9-THC), as the primary analyte. The aim of the current study was to characterize the urinary excretion profile of ∆9-THC-COOH, ∆9-THC, ∆8-tetrahydrocannabinol (∆8-THC), 11-hydroxy-∆9-tetrahydrocannabinol (11-OH-∆9-THC), ∆9-tetrahydrocannabivarin (THCV), 11-nor-∆9-tetrahydrocannabivarin-9-carboxlic acid (THCV-COOH), cannabidiol (CBD), cannabinol (CBN) and 8,11-dihydroxytetrahydrocannabinol (8,11-diOH-∆9-THC) following controlled administration of both oral and vaporized cannabis. Participants (n = 21, 11 men/10 women) who were infrequent cannabis users ingested cannabis-containing brownies (0, 10 and 25 mg ∆9-THC) and inhaled vaporized cannabis (0, 5 and 20 mg ∆9-THC) across six double-blind outpatient sessions. Urinary concentrations of ∆9-THC analytes were measured at baseline and for 8 h after cannabis administration. Sensitivity, specificity and agreement between the three immunoassays (IAs) for ∆9-THC-COOH (cutoffs of 20, 50 and 100 ng/mL) and liquid chromatography-tandem mass spectrometry (LC-MS-MS) analyses (confirmatory cutoff concentrations of 15 ng/mL) were assessed. Urinary concentrations for ∆9-THC-COOH, ∆9-THC, 11-OH-∆9-THC, THCV, CBN and 8,11-diOH-∆9-THC all peaked at 5-6 h and 4 h following oral and vaporized cannabis administration, respectively. At each active dose, median maximum concentrations (Cmax) for detected analytes were quantitatively higher after oral cannabis administration compared to vaporized. Using current recommended federal workplace drug-testing criteria (screening via IA with a cutoff of ≥50 ng/mL and confirmation via LC-MS-MS at a cutoff of ≥15 ng/mL), urine specimens tested positive for ∆9-THC-COOH in 97.6% of oral sessions and 59.5% of vaporized sessions with active ∆9-THC doses. These data indicate that while ∆9-THC-COOH may serve as the most consistent confirmatory analyte under the current drug-testing guidelines, future work examining 11-OH-∆9-THC under similar parameters could yield an alternative analyte that may be helpful in distinguishing between licit and illicit cannabis products.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{pmid36152876,

title = {Suvorexant maintenance enhances the reinforcing but not subjective and physiological effects of intravenous cocaine in humans},

author = {William W Stoops and Justin C Strickland and Kevin W Hatton and Lon R Hays and Abner O Rayapati and Joshua A Lile and Craig R Rush},

doi = {10.1016/j.pbb.2022.173466},

issn = {1873-5177},

year  = {2022},

date = {2022-10-01},

journal = {Pharmacol Biochem Behav},

volume = {220},

pages = {173466},

abstract = {Preclinical research has sought to understand the role of the orexin system in cocaine addiction given the connection between orexin producing cells in the lateral hypothalamus and brain limbic areas. Exogenous administration of orexin peptides increased cocaine self-administration whereas selective orexin-1 receptor antagonists reduced cocaine self-administration in non-human animals. The first clinically available orexin antagonist, suvorexant (a dual orexin-1 and orexin-2 receptor antagonist), attenuated motivation for cocaine and cocaine conditioned place preference, as well as cocaine-associated impulsive responding, in rodents. This study aimed to translate those preclinical findings and determine whether suvorexant maintenance altered the pharmacodynamic effects of cocaine in humans. Seven non-treatment seeking subjects with cocaine use disorder completed this within-subject human laboratory study, and a partial data set was obtained from one additional subject. Subjects were maintained for at least three days on 0, 5, 10 and 20 mg oral suvorexant administered at 2230 h daily in random order. Subjects completed experimental sessions in which cocaine self-administration of 0, 10 and 30 mg/70 kg of intravenous cocaine was evaluated on a concurrent progressive ratio drug versus money choice task. Subjective and physiological effects of cocaine were also determined. Cocaine functioned as a reinforcer and produced prototypic dose-related subjective and physiological effects (e.g., increased ratings of "Stimulated" and heart rate). Suvorexant (10, 20 mg) increased self-administration of 10 mg/70 kg cocaine and decreased oral temperature but did not significantly alter any other effects of cocaine. Future research may seek to evaluate the effects of orexin-1 selective antagonists in combination with cocaine.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{pmid34081511,

title = {Delay discounting and neurocognitive performance in young adults with differential patterns of substance use: Findings from the Human Connectome Project},

author = {Gideon P Naudé and Justin C Strickland and Derek D Reed and Michael Amlung},

doi = {10.1037/pha0000469},

issn = {1936-2293},

year  = {2022},

date = {2022-10-01},

journal = {Exp Clin Psychopharmacol},

volume = {30},

number = {5},

pages = {682--691},

abstract = {A large proportion of individuals who use psychoactive substances regularly use more than one substance. This pattern of behavior, termed polysubstance use, is associated with greater risks than when consuming only a single substance. The present study examined delay discounting, neurocognitive functioning, and demographic indicators among a large, racially and socioeconomically diverse sample of young adults drawn from the Human Connectome Project who reported either non, mono, or dual use of alcohol, tobacco, and/or cannabis. Univariate and multivariate tests suggested individuals who reported using multiple substances were more likely to be male, experienced higher rates of alcohol use disorder, and, when reporting both alcohol use and cannabis involvement, scored lower on a measure of inhibitory control relative to those who reported mono or dual use of alcohol and/or cigarettes. Individuals who reported currently smoking cigarettes exhibited the steepest discounting irrespective of other substances used; however, we observed additive effects for alcohol use and, to a lesser extent, cannabis involvement. Specifically, steeper discounting occurred when individuals who reported either regular alcohol use or > 100 lifetime instances of cannabis use also reported smoking cigarettes. We discuss several hypotheses for this finding related to the diversity of the sample and substances assessed as well as directions for future programmatic lines of research. (PsycInfo Database Record (c) 2022 APA, all rights reserved).},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{pmid36181330,

title = {Opioid Use Disorder: Pernicious and Persistent},

author = {Cecilia L Bergeria and Eric C Strain},

doi = {10.1176/appi.ajp.20220699},

issn = {1535-7228},

year  = {2022},

date = {2022-10-01},

journal = {Am J Psychiatry},

volume = {179},

number = {10},

pages = {708--714},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{Ellis2022c,

title = {Intra-individual variability and stability of affect and craving among individuals receiving medication treatment for opioid use disorder},

author = {Jennifer D. Ellis and Chung Jung Mun and David H. Epstein and Karran A. Phillips and Patrick H. Finan and Kenzie L. Preston},

doi = {10.1038/s41386-022-01352-y},

issn = {1740-634X},

year  = {2022},

date = {2022-09-00},

journal = {Neuropsychopharmacol.},

volume = {47},

number = {10},

pages = {1836--1843},

publisher = {Springer Science and Business Media LLC},

keywords = {Pharmacology, Psychiatry and Mental health},

pubstate = {published},

tppubtype = {article}

}