Conditioned stimuli (CS) associated with alcohol ingestion are thought to play a role in relapse by producing a craving that in turn increases motivation to drink which increases ethanol-seeking and ...disrupts other ongoing behavior. Alternatively, such CS may provide information indicating a likely increase in the density of the paired unconditioned stimulus and simultaneously elicit behavior that may be incompatible with other ongoing behavior, i.e., approach toward the CS. To explore these possibilities, rats were trained to respond for ethanol or food in two different components of the same session after which a light above the ethanol-lever was lighted twice during each component and each light presentation was followed by ethanol delivery. The duration of this CS was 10 s initially and then increased to 30 s, then to 100 s, and finally returned to 30 s. The change in responding for ethanol or food was compared to a matched period immediately preceding CS presentation. The CS presentation increased responding to ethanol, and this effect
increases
with longer CS presentations. In contrast, the CS presentation decreased responding to food, and this effect
decreases
with longer CS presentations. These results appear to support the informational account of CS action rather than simply a change in the motivation to seek and consume ethanol. This suggests that craving as it is commonly understood likely represents multiple behavioral processes, not simply increased desire for alcohol and that reports of craving likely reflect labeling based upon past experiences rather than a cause of future drug-taking.
Background
Phosphatidylethanol 16:0/18:1 (PEth), found in whole blood, is a biomarker for alcohol consumption with high sensitivity, specificity, and a long detection window. The TASSO‐M20 device is ...used to self‐collect capillary blood from the upper arm and has advantages over finger stick methods. The purpose of this study was to (1) validate PEth measurement using the TASSO‐M20 device, (2) describe the TASSO‐M20 for blood self‐collection during a virtual intervention, and (3) characterize PEth, urinary ethyl glucuronide (uEtG) and self‐reported alcohol in a single participant over time.
Methods
PEth levels in blood samples dried on TASSO‐M20 plugs were compared to those in (1) liquid whole blood (N = 14) and (2) dried blood spot cards (DBS; N = 23). Additionally, the self‐reported drinking, positive or negative uEtG results (dip card cutoff ≥300 ng/mL), and observed self‐collection of blood with TASSO‐M20 devices for PEth levels were obtained over time during virtual interviews of a single contingency management participant. High‐performance liquid chromatography with tandem mass spectrometry detection was used to measure PEth levels for both preparations.
Results
PEth concentrations from dried blood on TASSO‐M20 plugs and liquid whole blood were correlated (0 to 1700 ng/mL; N = 14; r2 = 0.988; slope = 0.951) and in a subgroup of samples with lower concentrations (N = 7; 0 to 200 ng/mL; r2 = 0.944, slope = 0.816). PEth concentrations from dried blood on TASSO‐M20 plugs and DBS were correlated (0 to 2200 ng/mL; N = 23; r2 = 0.927; slope = 0.667) and in a subgroup of samples with lower concentrations (N = 16; 0 to 180 ng/mL; r2 = 0.978, slope = 0.749). Results of the contingency management participant indicate that changes in PEth levels (TASSO‐M20) and uEtG concentrations were consistent with each other and with changes in self‐reported alcohol use.
Conclusions
Our data support the utility, accuracy, and feasibility of using the TASSO‐M20 device for blood self‐collection during a virtual study. The TASSO‐M20 device had multiple advantages over the typical finger stick method, including consistent blood collection, participant acceptability, and less discomfort as indicated by acceptability interviews.
This study validated methods for assessing phosphatidylethanol 16:0/18:1 (PEth) levels following blood collection with the TASSO‐M20 device. PEth levels on TASSO‐M20 plugs were compared to the standard methods of liquid whole blood or dried blood spot (DBS). PEth concentrations on TASSO‐M20 plugs were highly correlated with liquid whole blood (0–200 ng/mL; r2 = 0.944, slope = 0.816) and DBS (0–180 ng/mL; r2 = 0.978, slope = 0.749). The TASSO‐M20 device is an accurate blood collection method for PEth quantification.
Background: Recent cannabis use is associated with an approximate two-fold increase in automobile crash risk, but detecting cannabis-impaired driving remains a challenge.
Objectives and Methods: In ...this perspective, the pros and cons of two types of assessments arising from those used to detect alcohol-impaired driving are discussed in the context of cannabis-impaired driving.
Results: Some laws rely on tests to detect whether blood or breath levels exceed a legally defined (per se) threshold. These laws rely on clear and consistent relationships across individuals between detectable drug concentrations and the amount consumed, crash risk, or degree of driver impairment. However, unlike alcohol, there is poor correspondence between detected levels of the primary active constituent of cannabis or its metabolites and the amount consumed or its behavioral effects. Field sobriety tests assess impairment on functional tests calibrated to reflect actual driving-impairment and validated to predict traffic safety risk. However, functional tests for cannabis-impaired driving have not been developed or validated, and the degree of impairment resulting from recent cannabis use is difficult to distinguish from other conditions such as advancing age or use of certain medications.
Conclusions: Although standard field sobriety tests have advantages over per se tests for cannabis-impaired driving, limitations of both leave cannabis users and law enforcement officials little guidance in assessing an individual's driving fitness after recent cannabis use. General strategies for detecting and preventing impaired driving regardless of the cause would be preferable to establishing specific methods for every situation or substance that could impair driving.
Since the United States Supreme Court’s 1994 adoption of “transformative use” as a criterion for evaluating the first statutory fair use factor, “transformative use” analysis has engulfed all of fair ...use, becoming transformed, and perhaps deformed, in the process. A finding of “transformativeness” often foreordained the ultimate outcome, as the remaining factors, especially the fourth, withered into restatements of the first.
Lately, however, courts are expressing greater scepticism concerning what uses actually “transform” the original content. As a result, courts may be reforming “transformative use” to reinvigorate the other statutory factors, particularly the inquiry into the impact of the use on the potential markets for or value of the copied work. The article concludes with some suggestions for rebalancing the factors.
Background and Purpose
Drugs that more potently or effectively reduce ethanol‐maintained behaviour versus an alternative are considered selective and are considered promising pharmacotherapies for ...alcoholism. Such results are often obtained using separate groups or multiple schedules where ethanol and the alternative are available alone or sequentially. Recently, we observed that when ethanol and food were available sequentially under a multiple schedule, fluvoxamine and varenicline were selective; yet this selectivity disappeared when ethanol and food were concurrently available.
Experimental Approach
We examined the generality of these findings by comparing doses of several drugs required to decrease ethanol‐ and food‐maintained responding under a multiple schedule and under a concurrent schedule. Effects were determined for chlordiazepoxide, 2,5‐dimethoxy‐4‐iodoamphetamine (DOI), meta‐chlorophenylpiperazine (mCPP), morphine, naltrexone and d‐amphetamine.
Key Results
Under the multiple schedule, ED50 values for decreases in ethanol‐maintained responding were significantly different and lower than ED50s for decreases in food‐maintained responding (demonstrating selectivity) for each drug except for chlordiazepoxide (which was equipotent) and naltrexone (which did not affect responding). However, this selectivity vanished or even inverted under the concurrent schedule, such that ED50 values for decreasing ethanol‐ and food‐maintained responding were not different (or, following DOI, the ED50 for food‐maintained responding was lower than for ethanol‐maintained responding).
Conclusions and Implications
Results are consistent with those seen following fluvoxamine and varenicline administration, and suggest that selectivity is assay‐dependent. These results indicate the need for careful interpretation of selective drug effects, especially when obtained in situations where ethanol or the alternative is the only programmed reinforcement available.
Abstract Objective To determine the influence of Supplemental Nutrition Assistance Program (SNAP) and participant demographics on nutrition education outcomes. Methods At program enrollment (pre) and ...1 month later (post), a statewide convenience sample of adults, who participated in the Plan, Shop, Save, and Cook program, completed a 7-item questionnaire to evaluate change in resource management skills (RMS) and running out of food before the end of the month. Results Percent of participants (n = 3,744) who reported behavioral improvements in RMS ranged from 38.8% in comparing prices to 54% in reading labels. Female gender and Hispanic ethnicity were positively related to pre–post RMS change ( P = .001). Participants who received SNAP food assistance and made greater pre–post improvement in RMS reported the greatest decrease in running out of food ( P = .001). Conclusions and Implications Both food assistance and education on nutrition and resource management are needed to reduce food insecurity in SNAP-eligible audiences.
The impact of posttraumatic stress disorder (PTSD) is substantial and often results in pervasive functional impairments. Although evidence-based treatments for PTSD are established, there remains ...room for improvement as many individuals continue to meet diagnostic criteria even after successful treatment completion. Cannabidiol (CBD) has attracted considerable attention based on its potential to treat a myriad of health conditions. CBD may decrease anxiety and facilitate extinction learning processes, two critical targets of trauma-focused psychotherapies. We present the design and methods for a pilot randomized clinical trial to examine the combination of CBD and prolonged exposure for PTSD.
Participants (n = 24) will be randomized to CBD or placebo for 18 days delivered in combination with ten daily prolonged exposure sessions over two weeks. The study medication will be Epidiolex® (250 mg BID). The PTSD Checklist for DSM-5 will be the primary outcome to assess PTSD severity at baseline, during treatment, and at 1-month follow-up. Blood, saliva, and heart rate will be collected during treatment to assess intervention effects on biological outcomes related to PTSD and the endocannabinoid system.
Consistent with the purpose of a pilot, our goals are to evaluate the feasibility of study procedures, safety of the intervention, and the preliminary effect of CBD to inform a larger trial. Descriptive and inferential statistics will be used to address study aims.
Findings will inform decision making on combining CBD with behavioral interventions for PTSD to enhance outcomes and mitigate the morbidity of this debilitating condition.
•Novel treatments for PTSD are critical given that many do not achieve remission after treatment.•CBD may decrease hyperarousal and enhance extinction learning.•The design and methods for a pilot RCT to examine a novel combination intervention are presented.•Findings will inform planning for a larger RCT and an alternative treatment option for PTSD.
Periods of engaging in an alternative behavior diminishes behavioral control by stimuli occasioning alcohol use. This increase in relapse resistance with increasing recovery suggests that changing ...stimulus control over substance use may be a mechanism responsible for decreased relapse rates with longer recovery. However, the generality of this phenomenon to other drugs of abuse, including opioid self-administration, remains unclear. This study tests the generality of these findings with etonitazene to determine whether the shift in attention represents a behavioral process that generalizes from conditions we previously reported.
Five adult male Lewis rats were trained to respond on levers under two stimulus conditions; high-cost food (food FR150 and etonitazene FR5) and low-cost food (both food and etonitazene FR 5). Next, only the high-cost food stimulus (occasioning etonitazene responding) was presented for 20 sessions (Use Phase) followed by 9 sessions in which only the low-cost food stimulus (occasioning food responding) was presented (Recovery Phase). During the Recovery Phase, testing occurred during the first component of sessions 0, 1, 2, 4, and 8 when rats were re-exposed to the high-cost food stimulus. The number of food responses prior to completing the etonitazene response requirement during this stimulus exposure was the primary measure.
Food responses during stimulus re-exposure increased significantly as a function of recovery sessions completed with a slope 95 % CI of 2.49 responses/recovery session 0.16, 4.81. The average number of etonitazene deliveries per use session was 32 ± 6.6 or an average daily dose of 48.8 ± 10.1 μg/kg. During Recovery Phase, etonitazene deliveries decreased to 2.4 ± 1 or 3.6 ± 1.5 μg/kg.
The decrease in stimulus control observed for ethanol self-administration appears to generalize to opioid self-administration, indicating this change in stimulus control may play a general role in recovery.
Addiction is continued drug use despite its harm. As one always has alternatives, addiction can be construed as a decision to allocate behavior to drug use. While decision making is commonly ...discussed and studied as if it resulted from deliberative, evaluative processes, such processes are actually only rarely involved in behavior allocation. These deliberative processes are too slow, effortful and inefficient to guide behavior other than when necessary. Rather, most actions are guided by faster, more automatic processes, often labeled habits. Habits are mostly adaptive, and result from repeated reinforcement leading to over-learned behavior. Habitual behavior occurs rapidly in response to particular contexts, and the behavior occurring first is that which occurs, i.e., the behavior that is decided upon. Thus, as drug use becomes habitual, drug use is likely to be chosen over other available activities in that particular context. However, while drug use becoming habitual is necessary for addiction to develop, it is not sufficient. Typically, constraints limit even habitual drug use to safer levels. These constraints might include limiting occasions for use; and, almost always, constraints on amount consumed. However, in a minority of individuals, drug use is not sufficiently constrained and addiction develops. This review discusses the nature of these constraints, and how they might fail. These failures do not result from abnormal learning processes, but rather unfortunate interactions between a person and their environment over time. These accumulate in the maladaptive allocation of behavior to drug use. This Behavior Allocation Disorder (BAD) can be reversed; occasionally easily when the environment significantly changes, but more often by the arduous application of deliberative processes generally absent from decision making. These deliberative processes must continue until new more adaptive habits become the most probable behavior in the contexts encountered. As alternatives to drug use become the most probable behavior, relapse risk diminishes.
•Addiction is a Behavioral Allocation Disorder, a BAD.•BADs result from learning, the cumulative experiences of a person with an environment.•Of the behaviors that could occur, the most probable, the fastest one occurs.•Habitual behavior is rapid; thus as drug use becomes habitual, it becomes more likely.•Habits are naturally constrained, when habits escape constraints a BAD may occur.
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