Heavy cannabis use has been frequently associated with increased rates of mental illness and cognitive impairment, particularly amongst adolescent users. However, the neurobiological processes that ...underlie these associations are still not well understood. In this review, we discuss the findings of studies examining the acute and chronic effects of cannabis use on the brain, with a particular focus on the impact of commencing use during adolescence. Accumulating evidence from both animal and human studies suggests that regular heavy use during this period is associated with more severe and persistent negative outcomes than use during adulthood, suggesting that the adolescent brain may be particularly vulnerable to the effects of cannabis exposure. As the endocannabinoid system plays an important role in brain development, it is plausible that prolonged use during adolescence results in a disruption in the normative neuromaturational processes that occur during this period. We identify synaptic pruning and white matter development as two processes that may be adversely impacted by cannabis exposure during adolescence. Potentially, alterations in these processes may underlie the cognitive and emotional deficits that have been associated with regular use commencing during adolescence.
Although affective and substance use disorders frequently co-occur, the role of affective dysregulation in addiction is often overlooked. This paper reviews the role of affective dysregulation in the ...initiation and maintenance of substance use disorders (SUDs), presenting evidence for a relationship between SUD and three biologically-based dimensions of affective temperament and behaviour: negative affect (NA), positive affect (PA), and effortful control (EC). High NA, low EC, and both high and low PA were each found to play a role in conferring risk and maintaining substance use behaviours, although the strength of their influence differed depending on stage of illness (i.e., early onset use through to addiction). Given these findings, we argue that future research should explicitly consider how changes within affective systems may underlie the development of SUDs. A better understanding of the role of affective dysregulation in addiction will aid in clarifying how risk is conferred, as well as how addictive behaviours are maintained, thereby informing the development of preventative strategies and novel treatments. Future studies should continue to examine the role of high NA in SUDs, and further examine the respective roles of high PA, low PA, and low EC, as well as identifying the affective characteristics that predispose high-risk individuals to later substance use problems.
Objective: To identify parenting strategies associated with adolescent
alcohol consumption that parents can use to implement new national guidelines regarding
alcohol consumption by people under the ...age of 18.
Methods: A systematic search of academic literature employing the PRISMA
method identified 77 relevant articles. Inclusion criteria for the review were (i)
longitudinal cohort studies; (ii) measurement of one or more parenting factors during
adolescence or pre-adolescence (between the ages of 8 and 17) as a predictor (iii) outcome
measurement of any alcohol use and/or alcohol related problems during adolescence at least
one time point after the initial parenting factor was measured, and/or problem drinking in
adulthood. Studies were excluded if alcohol use was combined with other substance use or
problem behaviour as an outcome variable, or if different parenting factors were combined
as a single predictor variable for analysis. Stouffer's method of combining p values was
used to determine whether associations between variables were reliable.
Results: Twelve parenting variables were investigated in these studies:
parental modelling, provision of alcohol, alcohol-specific communication, disapproval of
adolescent drinking, general discipline, rules about alcohol, parental monitoring,
parent–child relationship quality, family conflict, parental support, parental
involvement, and general communication. We found that delayed alcohol initiation was
predicted by: parental modelling, limiting availability of alcohol to the child, parental
monitoring, parent–child relationship quality, parental involvement and general
communication. Reduced levels of later drinking by adolescents were predicted by: parental
modelling, limiting availability of alcohol to the child, disapproval of adolescent
drinking, general discipline, parental monitoring, parent–child relationship quality,
parental support and general communication.
Conclusions: A number of parenting strategies were identified that parents
can use to reduce their adolescent's alcohol consumption. These could be promoted to
parents to help them implement new national guidelines on alcohol use.
A principal feature of drug addiction is a reduced ability to regulate control over the desire to procure drugs regardless of the risks involved. Traditional models implicated the neural ‘reward’ ...system in providing a neurobiological model of addiction. Newer models however, have expanded on this circuitry to include two separate, but interconnecting systems, the limbic system in the incentive sensitization of drugs, and the prefrontal cortex (PFC) in regulating inhibitory control over drug use. Until the recent developments in neuroimaging and brain stimulation techniques, it has been extremely difficult to assess the involvement of the PFC in addiction. In the current review, we explore the involvement of the frontostriatal circuitry in regulating inhibitory control, and suggest how dysregulation of these circuits could be involved in an increased difficulty in ceasing drug use. Following this, we investigate the recent neuropsychological, neuroimaging and brain stimulation studies that explore the presence of these inhibitory deficits, and frontostriatal dysfunctions, across various different substance groups. Further insight into these deficits could contribute to the development of treatment strategies which target these cognitive impairments, and frontostriatal dysfunction, in reducing drug-seeking behaviors.
Objective:
Chronic methamphetamine use is commonly associated with the development of psychotic symptoms. The predictors and correlates of methamphetamine-associated psychosis are poorly understood. ...We sought to systematically review factors associated with psychotic symptoms in adults using illicit amphetamine or methamphetamine.
Methods:
A systematic literature search was performed on MEDLINE (OVID), PsycINFO and EMBASE databases from inception to 8 December 2016. The search strategy combined three concept areas: methamphetamine or amphetamine, psychosis and risk factors. Included studies needed to compare adults using illicit methamphetamine or amphetamine, using a validated measure of psychosis, on a range of risk factors. Of 402 identified articles, we removed 45 duplicates, 320 articles based on abstract/title and 17 ineligible full-text articles, leaving 20 included studies that were conducted in 13 populations. Two co-authors independently extracted the following data from each study: country, setting and design; participant demographic and clinical details; sample size; measure/s used and measures of association between psychosis outcomes and risk factors. Individual study quality was assessed using a modified Newcastle-Ottawa Scale, and strength of evidence was assessed using GRADE criteria.
Results:
Frequency of methamphetamine use and severity of methamphetamine dependence were consistently found to be associated with psychosis, and sociodemographic factors were not. There was inconsistent evidence available for all other risk factors. Individual study quality was low–moderate for the majority of studies. Heterogeneity in study outcomes precluded quantitative synthesis of outcomes across studies.
Conclusion:
The most consistent correlates of psychotic symptoms were increased frequency of methamphetamine use and dependence on methamphetamine. The findings of this review highlight the need for targeted assessment and treatment of methamphetamine use in individuals presenting with psychosis.
•Interviews (n = 30) explored Australian patients’ experiences of depot buprenorphine.•Often, depot buprenorphine afforded more time to engage in travel, work and study.•For a few participants, depot ...buprenorphine disrupted important clinical supports.•Depot buprenorphine is experienced in varying ways for different patients.•Clinical teams should closely monitor new patients receiving depot buprenorphine.
Long-acting injectable depot buprenorphine is an important new treatment option for the management of opioid dependence, delivering therapeutic doses in weekly or monthly formulations. Depot buprenorphine aims to overcome challenges associated with traditional opioid agonist therapy (OAT), including: poor patient adherence; inconvenience of regular attendance for dosing; and, risk of non-medical use of takeaway doses. However, little is known about patients’ experiences of depot buprenorphine. This qualitative study aimed to explore patients’ experiences of the practical and social affordances of depot buprenorphine.
Participants were recruited from sites in Sydney, regional New South Wales, and Melbourne, Victoria, Australia. Thirty participants (16 men, 14 women; mean age 47.3 years) participated in semi-structured interviews. Participants had histories of both heroin and prescription opioid use, and previous OAT including daily dosing of buprenorphine and methadone.
Depot buprenorphine afforded positive benefits for many participants, including: opportunities to avoid stigma experienced at pharmacies/clinics; time to engage in activities (e.g., travel, work) by releasing participants from previous OAT treatment regimens; and, cost savings by not having to pay pharmacy fees associated with daily dosing. However, for some participants, moving to depot buprenorphine: disrupted engagements with important social/practical supports available at pharmacies/clinics; constrained their control over dosing; and, constrained their ability to generate income via the sale of takeaway doses.
While generally experienced as affording benefits, depot buprenorphine can have differing social and practical impacts. Clinicians should monitor patients receiving depot buprenorphine to reduce the risk of unintended consequences including disruption to clinical supports.
Truck driving is one of the most common male occupations worldwide. Drivers endure long working hours, isolation, separation from family, compromised sleep, and face rigid regulatory requirements. ...Studies have documented the work factors contributing to poor health outcomes, however these have not been explored in the Australian context. The aim of this grounded theory study was to explore the impact of work and coping factors on mental health of Australian truck drivers from their perspective.
Recruitment used a purposive snowball sampling, through social media campaigns and direct email invites. Interview data were collected via phone/teleconference, audio recorded and typed verbatim. Inductive coding and thematic analysis were completed with triangulation of themes.
Seventeen interviews were completed (94% male). Six themes arose, two supporting (Connections; Coping methods), and four disrupting mental health (Compromised supports; Unrealistic demands; Financial pressures; Lack of respect). Drivers had concerns regarding the many things beyond their control and the interactions of themes impacting their health even further.
This study explored the impact of work and coping factors affecting truck driver mental health in Australia. Themes described the importance of connections and coping methods drivers had to support their health. Many factors that compromised their health were often outside their control. These results highlight the need for a multi-faceted collaboration between stakeholders; the driver, employing companies, policy makers/regulators and the public to address the negative impact of truck driving on mental health.
This study explored the role of social network and social identity factors in recovery from addiction. The sample consisted of 537 individuals who completed a survey about their experiences of ...recovery. Results indicated that the transition from addiction to recovery was characterized by an increase in social connectedness and changes in social network composition coupled with the emergence of a “recovery” identity. These factors accounted for 14% of the variance in quality of life when controlling for known predictors, accounting for a greater proportion of variance than substance use variables. Results suggest that recovery from addiction can be understood as a socially mediated transition characterized by social network and social identity change, which drive broader improvements in quality of life.
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