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Cocaine and Acute Vascular Diseases
A. De Giorgi, F. Fabbian, M. Pala, F. Bonetti, I. Babini, I. Bagnaresi, F. Manfredini,
F. Portaluppi, D.P. Mikhailidis and R. Manfredini
[Abstract] [FULL-TEXT INQUIRY] [BSP/CDAR/E-Pub/00037]


Romantic Relationships and Alcohol Use
Judith L. Fischer and Jacquelyn D. Wiersma
[Abstract] [FULL-TEXT INQUIRY] [BSP/CDAR/E-Pub/00038]


Efficacy of Group Treatments for Alcohol Use Disorders: A Review
Lindsay M. Orchowski and Jennifer E. Johnson
[Abstract] [FULL-TEXT INQUIRY] [BSP/CDAR/E-Pub/00039]


Alcohol and Cognition – Consideration of Age of Initiation, Usage Patterns and Gender: A Brief Review
Paige C. Bartley and Amir H. Rezvani
[Abstract] [FULL-TEXT INQUIRY] [BSP/CDAR/E-Pub/00040]


The Association Between Alcohol Use and Sexual Risk Behaviors Among African American Women Across Three Developmental Periods: A Review
Jessica M. Sales, Jennifer L. Brown, Aaron T. Vissman and Ralph J. DiClemente
[Abstract] [FULL-TEXT INQUIRY] [BSP/CDAR/E-Pub/00041]


Understanding the Diverse Needs of Children whose Parents Abuse Substances
Jessica M. Solis, Julia M. Shadur, Alison R. Burns and Andrea M. Hussong
[Abstract] [FULL-TEXT INQUIRY] [BSP/CDAR/E-Pub/00042]


Synthetic Cannabinoids as Drugs of Abuse
John C. Ashton
[Abstract] [FULL-TEXT INQUIRY] [BSP/CDAR/E-Pub/00043]


Editorial: Alcohol, Drugs, and Diving: Implications for Health and Fitness to Dive
Joris C. Verster, Elisabeth A.M. Kienhorst and Rob A. van Hulst
[BSP/CDAR/E-Pub/00044]


Current Trends in Using Interact & Mobile Technology to Support the Treatment of Substances Use Disorders
Michael A. Cucciare, Kenneth R. Weingardt, Carolyn Greene and Julia Hoffman
[Abstract] [FULL-TEXT INQUIRY] [BSP/CDAR/E-Pub/00045]


Reward-Seeking Behavior and Addiction: Cause or Cog?
Oscar Arias-Carrión and Mohamed Salama
[Abstract] [FULL-TEXT INQUIRY] [BSP/CDAR/E-Pub/00046]


Comorbid Attention Deficit/Hyperactivity Disorder and Substance Use Disorder: Treatment Considerations
Larry J. Klassen, Timothy S. Bilkey, Martin Katzman and Pratap Chokka
[Abstract] [FULL-TEXT INQUIRY] [BSP/CDAR/E-Pub/00047]



Abstracts


Cocaine and Acute Vascular Diseases
A. De Giorgi, F. Fabbian, M. Pala, F. Bonetti, I. Babini, I. Bagnaresi, F. Manfredini,
F. Portaluppi, D.P. Mikhailidis and R. Manfredini
[FULL-TEXT INQUIRY] [BSP/CDAR/E-Pub/00037]

Cocaine is one of the most widely used drugs of abuse. Chest pain is the most common side effect requiring emergency visits after cocaine use. Vasoconstriction and platelet activation are the main effects of cocaine in the vasculature. In this brief review, we consider the most important clinical effects of cocaine abuse on the heart, brain and kidney. Symptoms related to cocaine toxicity such as myocardial infarction, congestive heart failure, arrhythmias, aortic dissection, stroke, renal failure, are similar to the clinical picture of atherosclerotic vascular damage, even if the age of cocaine abusers is usually in the second and third decades. Clinicians (especially emergency department physicians) should consider substance abuse among the differential diagnosis of chest pain in young people.
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Romantic Relationships and Alcohol Use
Judith L. Fischer and Jacquelyn D. Wiersma
[FULL-TEXT INQUIRY] [BSP/CDAR/E-Pub/00038]

The focus of this review is on the associations of alcohol use and aspects of romantic relationships. The review covers concepts and methods, partner drinking associations, effects of relationships on drinking, and drinking effects on relationships. Several conclusions were reached. People are attracted to similarly drinking others. With greater relationship commitment there is greater desistance from drinking. Across time and relationship commitment levels, socialization influences vary by gender. A thread throughout the review was the identification of congruent and discrepant drinking among relationship partners. Congruent drinking, even at higher levels, was associated with more positive outcomes whereas discrepant drinking was associated with more negative outcomes. Needed for the future are greater theory development and longitudinal and laboratory studies that include diverse samples and both parties to the relationship.
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Efficacy of Group Treatments for Alcohol Use Disorders: A Review
Lindsay M. Orchowski and Jennifer E. Johnson
[FULL-TEXT INQUIRY] [BSP/CDAR/E-Pub/00039]

This paper reviews the efficacy and processes of change within group treatments for alcohol use disorders (AUD). Methodologically rigorous studies examining group treatment for interviewer-diagnosed AUD include evaluations of cognitive-behavioral group treatments that focus on skills for relapse prevention (i.e., coping skills training, coping and social skills training), interactional group therapy, combined pharmacological and group interventions, and group cue exposure treatment. Given the depth of research examining the efficacy of individual treatments for AUD there is a need for further development and evaluation of group treatments that include rigorous clinician-administered diagnostic assessment, implement a control group or active treatment comparison, randomly assign participants to condition, report the racial and ethnic composition of the sample, explore mediators and moderators of intervention efficacy, and implement a manualized treatment protocol. Evaluation of process variables within group treatments for AUD and well designed treatment development studies are also needed to better understand how well established individual treatments for alcohol use disorders can be adapted to function effectively in a group format.
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Alcohol and Cognition – Consideration of Age of Initiation, Usage Patterns and Gender: A Brief Review
Paige C. Bartley and Amir H. Rezvani
[FULL-TEXT INQUIRY] [BSP/CDAR/E-Pub/00040]

Heavy alcohol use has numerous negative impacts on cognition. In many cases, it appears that excess drinking influences working memory, problem solving, attention, patterns of regional brain activation, and even gray and white matter volume. Due to these effects, most significant conclusions related to cognitive decline are limited to the assumption that “more is worse.” However, heavy alcohol use is a very complex psychosocial behavior and is subject to a problematic number of variables. As a result, it is very difficult to extend generalizations about drinking-related consequences to the overall population since many environmental and biological differences come into play for every individual. Three of these variables shown to have significant impact on cognitive sensitivity to alcohol are age of first alcohol use (age of drinking initiation), specific pattern of alcohol consumption and gender. Potential insight can be gained into how individual drinking scenarios differ in risk for cognitive decline by assessing how each of these important factors influences cognition independently. Although some overlap exists between categories, each still appears to contribute unique influence on likelihood and presentation of cognition-related effects. Based on existing and current research, age and gender tend to augment baseline sensitivity to alcohol, with patterns of alcohol intake also influencing how changes appear. Given these categorical differences, it is important to consider personal alcohol drinking history rather than just aggregate alcohol intake as risk factors in the cognitive impacts of drinking. The objective of this brief review is to examine the role of these factors on the effect of alcohol on cognition.
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The Association Between Alcohol Use and Sexual Risk Behaviors Among African American Women Across Three Developmental Periods: A Review
Jessica M. Sales, Jennifer L. Brown, Aaron T. Vissman and Ralph J. DiClemente
[FULL-TEXT INQUIRY] [BSP/CDAR/E-Pub/00041]

Background: African American women experience increased rates of sexually transmitted diseases and HIV. The use of alcohol may increase sexual risk behaviors among this population.
Purpose: This paper provides a review and critique of the literature examining the association between alcohol use andsexual risk behaviors among African American females including a: (a) synthesis of research findings from adolescent, college-aged/early adulthood, and adult samples; (b) methodological critique of the literature; and (c) guidance for future research.

Methods: We reviewed 32 studies examining the association between alcohol use and sexual risk behaviors among African American females across developmental periods.

Results: Similar to previous association studies, results suggest that increased use of alcohol is associated with increased sexual risk practices among African American females. Further, even non-abuse levels of drinking among African American females, at all ages, were related to increased sexual risk-taking.

Conclusions: Future studies should seek to recruit samples that more fully reflect the diversity of African American women’s experiences across the lifespan. Given the association between alcohol use and/or abuse and the prevalence of STI/HIV-associated risk behaviors and adverse biological outcomes (i.e., STIs, including HIV) among African American females across the lifespan, there is a clear need to develop and evaluate prevention research efforts tailored for this subgroup.
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Understanding the Diverse Needs of Children whose Parents Abuse Substances
Jessica M. Solis, Julia M. Shadur, Alison R. Burns and Andrea M. Hussong
[FULL-TEXT INQUIRY] [BSP/CDAR/E-Pub/00042]

In this review, we consider the potential service needs of children of substance abusing parents based on what we know about the risk outcomes faced by these children and the parenting deficits often present in these families. Importantly, our review does not address the etiological role of parental substance abuse in children’s negative outcomes but instead we discuss the complex inter-related risk factors that often co-occur with and exacerbate risk associated with parental alcohol and drug use. We first review studies showing the elevated risk that children of substance abusing parents face in general for poorer academic functioning; emotional, behavioral, and social problems; and an earlier onset ofsubstance use, faster acceleration in substance use patterns, and higher rates of alcohol and drug use disorders. We then review studies showing contextual risk factors for children of substance abusing parents, including parenting deficits (less warmth, responsiveness, and physical and verbal engagement as well as harsher and more over-involved interaction styles), greater risk for child maltreatment, and less secure attachment patterns. We conclude with a discussion of future directions for research and guidelines for professionals working with children and their families where parental substance abuse is present.
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Synthetic Cannabinoids as Drugs of Abuse
John C. Ashton
[FULL-TEXT INQUIRY] [BSP/CDAR/E-Pub/00043]

In the last decade a number of products have appeared in various countries that contain synthetic cannabinoids. This article reviews the history of the sale of these drugs, and the evidence that they contain synthetic cannabinoids. The biochemistry of the synthetic cannabinoids identified thus far is discussed, including a discussion of chemical structures and biochemical targets. The cannabinoid receptor targets for these drugs are discussed, as well as other possible targets such as serotonin receptors. Evidence for the abuse potential of these drugs is reviewed. The toxicity of synthetic cannabinoids and cannabinoid products is reviewed and compared to that of the phytocannabinoid Δ9-tetrahydrocannabinol (THC). As cannabinoids are a structurally diverse class of drugs, it is concluded that synthetic cannabinoids should be classified by biological activity rather than by structure, and that if this isn’t done, novel synthetic cannabinoids will continue to emerge that fall outside of current regulatory classification models.
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Current Trends in Using Interact & Mobile Technology to Support the Treatment of Substances Use Disorders
Michael A. Cucciare, Kenneth R. Weingardt, Carolyn Greene and Julia Hoffman
[FULL-TEXT INQUIRY] [BSP/CDAR/E-Pub/00045]

Issues: By allowing for the efficient delivery of instructional content and the secure collection of self-report data regarding substance use and related problems, the Internet has tremendous potential to improve the effectiveness and accessibility of Substance Use Disorder (SUD) treatment and recovery-oriented services.

Approach: This article discusses some of the ways in which Internet and mobile technology can facilitate, complement and support the process of traditional clinician-delivered treatment for individuals with SUDs.

Key Findings: Internet applications are being used to support a range of activities including (a) the assessment and feedback process that constitutes a key feature of brief motivational interventions; and (b) the concurrent monitoring of patients who are receiving treatment for SUDs, to support continuing care, and the ongoing recovery of SUD patients who have completed face-to-face treatment. Internet technology is also being used to (c) support efficient delivery of clinical training in evidence-based practices for treating individuals who may have SUDs.

Implications: This emerging body of literature suggests that SUD treatment providers and program administrators can enhance the quality of clinician-delivered treatment by incorporating internet applications into existing processes of care and recovery oriented services.

Conclusion: Internet applications provide an unparalleled opportunity to engage patients in the treatment process, incorporate real-time data into treatment planning, prevent relapse, and promote evidence-based treatment approaches.
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Reward-Seeking Behavior and Addiction: Cause or Cog?
Oscar Arias-Carrión and Mohamed Salama
[FULL-TEXT INQUIRY] [BSP/CDAR/E-Pub/00046]

Although dopaminergic system represents the cornerstone in rewarding, other neurotransmitters can modulate both the reward system and the psychomotor effects of addictive drugs. Many hypotheses have been proposed for a better understanding of the reward system and its role in drug addiction. However, after many years of investigation, no single theory can completely explain the neural basis of drug addiction. Recent reports introduce novel neurotransmitters into the game e.g. dynorphins, orexins, histamine, gheralin and galanin. The interacting functions of these neurotransmitters have shown that the reward system and its role in drug dependence, is far more complicated than was thought before. Individual variations exist regarding response to drug exposure, vulnerability for addiction and the effects of different cues on reward systems. Consequently, genetic variations of neurotransmission are thought to influence reward processing that in turn may affect distinctive social behavior and susceptibility to addiction. However, the individual variations can not be based mainly on genetics; environmental factors seem to play a role too. Here we discuss the current knowledge about the orquestic regulation of different neurotransmitters on reward-seeking behavior and their potential effect on drug addiction.
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Comorbid Attention Deficit/Hyperactivity Disorder and Substance Use Disorder: Treatment Considerations
Larry J. Klassen, Timothy S. Bilkey, Martin Katzman and Pratap Chokka
[FULL-TEXT INQUIRY] [BSP/CDAR/E-Pub/00047]

Background: Attention-deficit hyperactivity disorder (ADHD) is predominantly a diagnosis of childhood and adolescence but has also been recognized in adults. It is associated with high rates of comorbid psychiatric conditions, particularly substance use disorders (SUD).

Methods: A review of the literature was conducted with a focus on ADHD, SUD, their comorbidity, and treatment considerations.

Results: Literature suggests that the use of methylphenidate (MPH) in children does not increase SUD later in life, and may in fact reduce substance use and abuse in adolescence and adulthood. Concurrent treatment of ADHD-SUD, which may be supported theoretically, has yielded inconsistent data on clinical trials. While MPH use in adults with ADHD-SUD may be effective in alleviating ADHD symptoms, the benefits on SUD are not clear and remain controversial. Studies suggest that adults with comorbid ADHD-SUD do not misuse or divert their medication, but MPH does not consistently improve substance use. However, data are lacking for substances other than cocaine and stimulants other than MPH. While the risk of stimulant abuse should not be ignored, it may be minimized by selecting medications that are not readily crushed and solubilized for parenteral administration, or by utilizing non-stimulant medications and/or psychotherapy.

Conclusion: While there are a lack of evidence-based guidelines for the concurrent treatment of ADHD and SUD, evidence to date suggests that stimulant medications should not necessarily be avoided for patients with comorbid ADHD-SUD and that concurrent treatment may be a successful approach to improve ADHD outcomes without worsening SUD symptoms.
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