Over the past decade, psychedelic compounds have emerged as potentially transformative therapeutics for a variety of intractable neuropsychiatric conditions. However, historically most of the basic science has utilized these compounds as probes to interrogate various endogenous neurotransmitter systems—mainly the serotonin 5-HT2A receptor. With the renewed interest in utilizing these compounds as therapeutics and the explosion in clinical trials, psychedelics have been purported to treat many neuropsychiatric disorders, including depression, cluster headaches, migraines, anxiety, and obsessive-compulsive disorder. It is therefore imperative to understand the biology and pharmacology behind their therapeutic mechanisms as well as expose any potential pitfalls in their widespread use as treatments. This review covers the latest advances in understanding the biological mechanisms, the newest efforts in drug discovery, and potential pitfalls when it comes to utilizing this class of compounds as emerging therapeutics. To read the full article, choose Open Athens “Institutional Login” and search for “Midlands Partnership”.
Given the high rates of mental health comorbidity among opioid users, and increasing rates of opioid prescription for chronic pain, psychiatrists and mental health clinicians are likely to treat patients who are dependent on opioids. Among such patients, many will have histories of opioid overdose or suicide attempts. It is tempting to assume that these are related behaviours and that ‘accidental’ overdoses are actually suicide attempts. We provide evidence here to demonstrate that while some overdoses are intentional, most are not. To read the full article, choose Open Athens “Institutional Login” and search for “Midlands Partnership”.
Overdose risk during a course of treatment with medication for opioid use disorder (MOUD) has not been clearly delineated. The authors sought to address this gap by leveraging a new data set from three large pragmatic clinical trials of MOUD. To read the full article, choose Open Athens “Institutional Login” and search for “Midlands Partnership”.
Alcohol use typically begins in adolescence, and the risk of later alcohol use disorders increases with earlier age of onset. Emotion dysregulation in adolescence has been linked to alcohol use. The present study seeks to extend previous findings by examining whether gender moderates the association between emotion regulation strategies (suppression and cognitive reappraisal) and alcohol-related problems in a longitudinal sample of adolescents. To read the full article, choose Open Athens “Institutional Login” and search for “Midlands Partnership”.
Alcohol-related cirrhosis is a frequent and difficult-to-treat disease. Despite the low hepatic metabolism of baclofen, data on its use in this subgroup are scarce. The French multicenter Observatory of patients treated with Baclofen for Alcohol DEpendence real-life cohort assessed: (a) prescription modalities of baclofen in liver units; (b) safety profile of baclofen; and (c) declared alcohol intake, biological markers of excessive alcohol intake and hepatic function at 12 months. To read the full article, choose Open Athens “Institutional Login” and search for “Midlands Partnership”.
The amount and pattern of cigarette and alcohol consumption are highly associated with cardiovascular risk. The aim of the present study was the assessment of changes in arterial stiffness and classical risk factors for cardiovascular disease after alcohol withdrawal and detoxification in persons with alcohol use disorder. To read the full article, choose Open Athens “Institutional Login” and search for “Midlands Partnership”.
To identify the distinguishing characteristics of alcohol dependent patients who confuse alcohol cravings with pre-meal hunger. To read the full article, choose Open Athens “Institutional Login” and search for “Midlands Partnership”.
Substance use disorders co-occurring with other mental health disorders are common and harmful. Clinical guidelines often recommend substance use screening and brief intervention though evidence about screening practice in mental health services is limited. This systematic review of routine clinical practice in adult mental health services aims to identify (a) proportions of screening and brief intervention, (b) how they are practised and (c) their outcomes. To read the full article, choose Open Athens “Institutional Login” and search for “Midlands Partnership”.
Concurrent Treatment of Posttraumatic Stress Disorder (PTSD) and Substance Use Disorders Using Prolonged Exposure (i.e., COPE) is an efficacious, integrated, psychotherapy that attends to PTSD and substance use disorders simultaneously. No study has examined how therapeutic alliance functions during the provision of COPE and how this compares to non-integrated treatments, such as Relapse Prevention (RP) for substance use disorders. Understanding the role of alliance in COPE versus RP could inform treatment refinement and ways to enhance treatment outcomes. To read the full article, choose Open Athens “Institutional Login” and search for “Midlands Partnership”.
Treatment efficacy for co-occurring posttraumatic stress disorder (PTSD) and substance use disorders is well established, yet direct evidence for comparative effectiveness across treatments is lacking. The present study compared the effectiveness of several behavioral and pharmacological therapies for adults with co-occurring PTSD and alcohol or other drug use disorders. To read the full article, choose Open Athens “Institutional Login” and search for “Midlands Partnership”.
This study tested the effectiveness of schema therapy (ST) for borderline personality disorder (BPD) and comorbid alcohol dependence (AD). Twenty patients participated in a case series study with multiple baselines. The baseline phase consisted of treatment as usual. It was followed by a case conceptualization phase, an experiential techniques phase and a behavioural change phase. Patients showed a significant decrease in BPD and AD symptoms; change was mainly accomplished in the experiential techniques phase, with medium to large effect sizes.
The findings of the study suggest that most heavy drinkers who experience negative life events in late mid-life tend to continue with this pattern of alcohol consumption whilst going through these events. Therefore, mental health practitioners may wish to consider asking about and/or assessing alcohol consumption in individuals reporting mid-life events such as divorce and severe illness or death of a family member. This is especially pertinent given that the “constant heavy drinking” group in the study was also shown to be more vulnerable to depression, suggesting a co-morbidity between alcohol use and mental health problems in this group.
The objective of this research was to explore how gay men use drugs in their sex lives, colloquially called “chemsex”. This paper reports on a sub-theme within the research about support, care and peer support. To read the full article, choose Open Athens “Institutional Login” and search for “Midlands Partnership”.
Federally certified opioid treatment programs (OTPs) provide psychosocial counselling in addition to medications for opioid use disorder (MOUDs) using a patient-centered approach in providing substance use disorder treatment. This study explored factors associated with patients' adherence to counselling while receiving MOUD at an OTP. To read the full article, choose Open Athens “Institutional Login” and search for “Midlands Partnership”.
There is some limited evidence of an association between technology addictions and emergence of pre-psychotic symptoms, high psychoticism, psychotic like experiences and high schizotypy among young non-clinical adults. These addictions and their subsequent distress are likely to contribute to transition to psychosis in individuals at risk. We aimed to compare smartphone, Internet and Facebook addictions between low and high schizotypal individuals; and to explore the association between these addictions and distress in the high schizotypy group. To read the full article, choose Open Athens “Institutional Login” and search for “Midlands Partnership”.
Substance use is highly prevalent among people with mood disorders. Effective treatment for these people requires a better understanding of the relationship between both mood and substance use from the perspectives of those with lived experience.
The Royal Australian and New Zealand College of Psychiatrists’ (RANZCP) 2018 position statement supports increased, regulated availability of e-cigarettes (ECs) as a harm-reduction measure and recommends further research into their use. Aligned with this recommendation, we aimed to critically evaluate the RANZCP’s stance on this issue through a literature review focused on the areas identified in the position statement as requiring further investigation: (1) the adverse health effects attributable to ECs; (2) use of ECs for smoking cessation (particularly for people living with severe mental illness); and (3) EC-associated risks for nicotine naïve young people. To read the full article, choose Open Athens “Institutional Login” and search for “Midlands Partnership”.
This issue of the Journal is primarily focused on new advances in the diagnosis and treatment of opioid use disorder. The issue begins with an overview by Drs. Cecilia Bergeria and Eric Strain from Johns Hopkins University (1) that discusses the prevalence of opiate use disorder and associated lethal overdoses as well as current pharmacologic and nonpharmacologic treatment approaches. Elsewhere in the issue, making the diagnosis of prescription-related opiate use disorder (POUD) can be challenging and in this regard a paper explores the impacts of modifying current criteria for POUD on prevalence rates. Another paper assesses the efficacy of buprenorphine/naloxone, primarily taken at home, for treating POUD. Also related to treatment, another paper characterizes the effects of COVID-19 telehealth policy changes related to buprenorphine treatment on VA patients with opiate use disorder. We also present papers in this issue that address the prevalence of cannabis use disorder in the VA population and the possibility of using a mindfulness-based intervention as a nonpharmacologic treatment for pain. To read the full article, choose Open Athens “Institutional Login” and search for “Midlands Partnership”.