The purpose of this paper is to look into how reliable and valid the Persian version of the Cannabis Use Disorder Identification Test-Revised (CUDIT-R-Pr) is. It will also compare the screening features of the CUDIT-R...The purpose of this paper is to look into how reliable and valid the Persian version of the Cannabis Use Disorder Identification Test-Revised (CUDIT-R-Pr) is. It will also compare the screening features of the CUDIT-R with those of the DSM-5 criteria for cannabis use disorder (CUD) based on the SCID-5-CT in a group of university students in Tehran, Iran. The study used the stratified random sampling technique to collect data from 541 students (19 to 24 years old) who used cannabis in Tehran universities in 2024. Confirmatory factor analysis confirmed the uni-dimensionality of the CUDIT-R-Pr. We checked the reliability of the CUDIT-R-Pr using Cronbach Alpha, split-half, inter-rater, test-retest stability over time, and parallel testing equivalence. The results indicated that CUDIT-R-Pr is reliable, reproducible, and responsive, with substantial agreement and adequate interpretability. The CUDIT-R shows that it can tell the difference between different levels of cannabis use severity, which is known as discriminant validity. Receiver operating characteristic analyses confirmed this, using an area under the receiver operating characteristics curve (AUC = 0.95) at a cutoff of ten or less. This allowed CUDIT-R-Pr to accurately predict any DSM-5 based on the highest correctly classified value (0.89), demonstrating high levels of sensitivity (0.96), specificity (0.69), and Youden value (0.65). The exact maximum Youden index (0.72) showed that CUDIT-R-Pr could also predict moderate DSM-5 with a cutoff of twelve or less. To validate and generalize the CUDIT-R-Pr for use among Iranian cannabis users, we need more research.展开更多
In this article,we comment on the article by Zhang et al,which explores the familiarity,awareness,and usage of smart medical care and its correlation with mental health and personality traits.The use of intelligent he...In this article,we comment on the article by Zhang et al,which explores the familiarity,awareness,and usage of smart medical care and its correlation with mental health and personality traits.The use of intelligent healthcare technologies in treating mental disorders and substance use disorders shows significant promise,but involves certain challenges,such as limited access,low technological literacy,and privacy concerns.These barriers disproportionately affect deprived populations and individuals with severe mental health conditions.We highlight the positive impact of smart healthcare solutions,such as telemedicine and wearable technologies,on patient engagement,remote monitoring,and treatment adherence.To overcome these challenges,we propose strategies,such as improving user-friendliness,ensuring equitable access to digital interventions,enhancing cybersecurity,and integrating smart healthcare into clinical workflows.Training healthcare providers and developing policies to ensure the ethical use of patient data are essential.When implemented thoughtfully,smart healthcare technologies can revolutionize mental health and substance use disorder treatment,improve patient outcomes,and reduce healthcare inequities.展开更多
Opioid use disorder(OUD)is a major public health problem affecting millions of people worldwide.Although OUD is a chronic and relapsing disorder,a variety of pharmacological and non-pharmacological interventions are a...Opioid use disorder(OUD)is a major public health problem affecting millions of people worldwide.Although OUD is a chronic and relapsing disorder,a variety of pharmacological and non-pharmacological interventions are available.Medication-assisted treatment of OUD generally relies on competition for opioid receptors against the addictive substance.The mechanisms of this competition are to block or inactivate the opioid receptor or activate the receptor with a substance that is intermittent or long acting.Methadone and buprenorphine are two United States Food and Drug Administration-approved medications that have long-term positive effects on the health of opioid-dependent individuals.Although clinical studies of drugs generally demonstrate efficacy in thousands of people and toxicity is excluded,it cannot be predicted whether the given drug will cause side effects in one of the patients at the treatment dose.Individual differences can be explained by many biological and environmental factors.Variations in genes encoding drug metabolism or cellular drug targets significantly explain the variability in drug response between individuals.Therefore,for the effects of candidate genes to be accepted and included in individual treatment protocols,it is important to repeat studies on individuals of different ethnic backgrounds and prove a similar effect.展开更多
BACKGROUND Recent data are inconclusive regarding the risk of arrhythmias among young cannabis users.Furthermore,many young adults use both cannabis and tobacco,which could add a residual confounding effect on outcome...BACKGROUND Recent data are inconclusive regarding the risk of arrhythmias among young cannabis users.Furthermore,many young adults use both cannabis and tobacco,which could add a residual confounding effect on outcomes.So,we studied young men who have cannabis use disorder(CUD)excluding tobacco use disorder(TUD)to understand their independent association with atrial fibrillation(AF)and related outcomes.AIM To study the association of CUD with AF and related outcomes.METHODS We used weighted discharge records from National Inpatient Sample(2019)to assess the baseline characteristics and mortality rates for AF-related hospitalizations in young(18-44 years)men in 1:1 propensity-matched CUD+vs CUD-cohorts without TUD.RESULTS Propensity matched CUD+and CUD-cohorts consisted of 108495 young men in each arm.Our analysis showed an increased incidence of AF in black population with CUD.In addition,the CUD+cohort had lower rates of hyperlipidemia(6.4%vs 6.9%),hypertension(5.3%vs 6.3%),obesity(9.1%vs 10.9%),alcohol abuse(15.5%vs 16.9%),but had higher rates of anxiety(24.3%vs 18.4%)and chronic obstructive pulmonary disease(COPD)(9.8%vs 9.4%)compared to CUD-cohort.After adjustment with covariates including other substance abuse,a non-significant association was found between CUD+cohort and AF related hospitalizations(odd ratio:1.27,95%confidence interval:0.91-1.78,P=0.15).CONCLUSION Among hospitalized young men,the CUD+cohort had a higher prevalence of anxiety and COPD,and slightly higher proportion of black patients.Although there were higher odds of AF hospitalizations in CUD+cohort without TUD,the association was statistically non-significant.The subgroup analysis showed higher rates of AF in black patients.Large-scale prospective studies are required to evaluate long-term effects of CUD on AF risk and prognosis without TUD and concomitant substance abuse.展开更多
Alcohol use disorder(AUD)represents a major public health issue which affects millions of people globally and consist a chronic relapsing condition associated with substantial morbidity and mortality.The gut microbiom...Alcohol use disorder(AUD)represents a major public health issue which affects millions of people globally and consist a chronic relapsing condition associated with substantial morbidity and mortality.The gut microbiome plays a crucial role in maintaining overall health and has emerged as a significant contributor to the pathophysiology of various psychiatric disorders.Recent evidence suggests that the gut microbiome is intimately linked to the development and progression of AUD,with alcohol consumption directly impacting its composition and function.This review article aims to explore the intricate relationship between the gut microbiome and AUD,focusing on the implications for mental health outcomes and potential therapeutic strategies.We discuss the bidirectional communication between the gut microbiome and the brain,highlighting the role of microbiotaderived metabolites in neuroinflammation,neurotransmission,and mood regulation.Furthermore,we examine the influence of AUD-related factors,such as alcohol-induced gut dysbiosis and increased intestinal permeability,on mental health outcomes.Finally,we explore emerging therapeutic avenues targeting the gut microbiome in the management of AUD,including prebiotics,probiotics,and fecal microbiota transplantation.Understanding the complex interplay between the gut microbiome and AUD holds promise for developing novel interventions that could improve mental health outcomes in individuals with AUD.展开更多
BACKGROUND High risk of alcohol and drug use disorders in people with attentiondeficit/hyperactivity disorder(ADHD)calls for exploratory research of relationships with clinical features of ADHD.AIM To estimate prevale...BACKGROUND High risk of alcohol and drug use disorders in people with attentiondeficit/hyperactivity disorder(ADHD)calls for exploratory research of relationships with clinical features of ADHD.AIM To estimate prevalence of alcohol/drug use disorders and associations with ADHD symptom severity and emotional dysregulation,in adults with ADHD.METHODS This observational cross-sectional clinical study consisted of patients admitted to a private psychiatric outpatient clinic in Oslo,Norway(2014-2018).Five-hundred and fifty-eight eligible patients diagnosed with ADHD(Diagnostic and Statistical Manual of Mental Disorders,Fifth Edition(DSM-5)criteria)agreed to participate.Alcohol and drug use disorders were diagnosed using the Mini International Neuropsychiatric Interview(MINI).Dependence and abuse were merged into“use”disorder as in MINI version 7.0/DSM-5.Questions were related both to lifetime and the past 12-mo.ADHD severity was assessed by the Adult ADHD Self Report Scale(ASRS).Subdivisions of the ASRS questionnaire as inattentive items and hyperactive/impulsivity items were recorded separately.Emotional dysregulation was assessed by the eight-item version of Barkley’s Current Behavior Scale-Self Report.RESULTS The 12-mo prevalence was 5.3%for alcohol use disorder and 13.7%for drug use disorder.The lifetime prevalence was 12.0%for alcohol use disorder and 27.7%for drug use disorder.Men had higher rates of both alcohol use disorder and drug use disorder compared to women.The prevalence of drug use disorder was more than twice that of alcohol use disorder for both sexes.The drugs most participants reported having used were(in descending order):Amphetamine(19.1%),cannabis(17.1%),cocaine or ecstasy(7.4%),benzodiazepines(7.4%),and heroin or other opioids(2.9%).Lifetime drug use disorder was significantly associated with both hyperactivity-impulsivity symptoms and emotional dysregulation symptom severity.Lifetime alcohol use disorder,on the other hand,was not significantly associated with ADHD symptoms or emotional dysregulation when adjusted for gender and age.CONCLUSION Patients with ADHD have a high lifetime prevalence of drug use disorder,which is associated with higher levels of hyperactivity-impulsivity symptoms and emotional dysregulation.展开更多
Alcohol use disorders represent a heterogeneous spectrum of clinical manifestations that have been defined by the Diagnostic and Statistical Manual of Mental Disorders-5. Excessive alcohol intake can lead to damage of...Alcohol use disorders represent a heterogeneous spectrum of clinical manifestations that have been defined by the Diagnostic and Statistical Manual of Mental Disorders-5. Excessive alcohol intake can lead to damage of various organs, including the liver. Alcoholic liver disease includes different injuries ranging from steatosis to cirrhosis and implicates a diagnostic assessment of the liver disease and of its possible complications. There is growing interest in the possible different tools for assessing previous alcohol consumption and for establishing the severity of liver injury, especially by noninvasive methods.展开更多
BACKGROUND Following the development of the coronavirus disease-2019(COVID-19)pandemic in Italy,a strict lockdown was imposed from March 9 to May 5,2020.The risks of self-medication through alcohol or psychoactive sub...BACKGROUND Following the development of the coronavirus disease-2019(COVID-19)pandemic in Italy,a strict lockdown was imposed from March 9 to May 5,2020.The risks of self-medication through alcohol or psychoactive substance abuse were increased,as well as the tendency to adopt pathological behaviors,such as gambling and internet addiction.AIM To evaluate the impact of the COVID-19 pandemic and associated containment measures on craving in a group of patients suffering from substance use disorder and/or gambling disorder who were in treatment in outpatient units or in residency programs as inpatients.METHODS One hundred and fifty-three patients completed a structured questionnaire evaluating craving and other behaviors using a visual analogue scale(VAS).Forty-one subjects completed a pencil and paper questionnaire during the interview.The clinician provided an online questionnaire to 112 patients who had virtual assessments due to lockdown restrictions.Statistical analyses were performed using Statistica version 8.0.Quantitative parameters are presented as the mean±SD and qualitative parameters as number and percentage per class.The Kolmogorov-Smirnov test was used to check for normality of distributions.Analysis of variance and Duncan post hoc test were employed to analyze differences among subgroup means.The associations between variables were measured using Pearson's correlation.A P value of<0.05 was considered significant.RESULTS The variation in craving between the present and the month before showed VASrelated reductions of craving in 57%,increases in 24%,and no significant change in 19%of the sample.The level of craving was significantly higher(F=4.36;P<0.05)in outpatients(n=97;mean=3.8±3.1)living in their own home during the quarantine compared with inpatients(n=56;mean=2.8±2.8)in residential programs.Craving for tetrahydrocannabinol was the greatest(4.94,P<0.001)among various preferred substances.CONCLUSION The unexpected result of this study may be explained by a perceived lack of availability of substances and gambling areas and/or decreased social pressure on a subject usually excluded and stigmatized,or the acquisition of a new social identity based on feelings of a shared common danger and fate that overshadowed the sense of exclusion and rejection in the abuser.展开更多
Drug overdose is the leading cause of death by injury in the United States.The incidence of substance use disorder(SUD)in the United States has increased steadily over the past two decades,becoming a major public heal...Drug overdose is the leading cause of death by injury in the United States.The incidence of substance use disorder(SUD)in the United States has increased steadily over the past two decades,becoming a major public health problem for the country.The drivers of the SUD epidemic in the United States have changed over time,characterized by an initial heroin outbreak between 1970 and 1999,followed by a painkiller outbreak,and finally by an ongoing synthetic opioid outbreak.The nature and sources of these abused substances reveal striking differences in the socioeconomic and behavioral factors that shape the drug epidemic.Moreover,the geospatial distribution of the SUD epidemic is not homogeneous.The United States has specific locations where vulnerable communities at high risk of SUD are concentrated,reaffirming the multifactorial socioeconomic nature of this epidemic.A better understanding of the SUD epidemic under a spatial epidemiology framework is necessary to determine the factors that have shaped its spread and how these patterns can be used to predict new outbreaks and create effective mitigation policies.This narrative minireview summarizes the current records of the spatial distribution of the SUD epidemic in the United States across different periods,revealing some spatiotemporal patterns that have preceded the occurrence of outbreaks.By analyzing the epidemic of SUD-related deaths,we also describe the epidemic behavior in areas with high incidence of cases.Finally,we describe public health interventions that can be effective for demographic groups,and we discuss future challenges in the study and control of the SUD epidemic in the country.展开更多
Alcohol use disorder is a complex and heterogeneous phenomenon that can be studied from several points of view by focusing on its different components.Alcohol is a hepatotoxin whose metabolism creates profound alterat...Alcohol use disorder is a complex and heterogeneous phenomenon that can be studied from several points of view by focusing on its different components.Alcohol is a hepatotoxin whose metabolism creates profound alterations within the hepatocyte.The liver is the central organ in the metabolism of alcohol,a process that also involves other organs and tissues such as the brain,heart and muscles,but the most relevant organ is the liver.The anatomopathological alterations in the liver associated with the prolonged use of alcohol range from the simple accumulation of neutral fats in the hepatocytes,to cirrhosis and hepatocellular carcinoma.Alcohol abuse frequently leads to liver disease such as steatosis,steatohepatitis,fibrosis,cirrhosis,and tumors.Following the spread of coronavirus disease 2019(COVID-19),there was an increase in alcohol consumption,probably linked to the months of lockdown and smart working.It is known that social isolation leads to a considerable increase in stress,and it is also recognized that high levels of stress can result in an increase in alcohol intake.Cirrhotic patients or subjects with liver cancer are immunocompromised,so they may be more exposed to COVID-19 infection with a worse prognosis.This review focuses on the fact that the COVID-19 pandemic has made the emergence of alcohol-induced liver damage a major medical and social problem.展开更多
Objective:We examined the effects of mindfulness-based interventions(MBIs)on depressive symptoms in patients with substance use disorders(SUDs)and explored the moderating effects of participant,method,and intervention...Objective:We examined the effects of mindfulness-based interventions(MBIs)on depressive symptoms in patients with substance use disorders(SUDs)and explored the moderating effects of participant,method,and intervention characteristics.Methods:We systematically searched 8 databases from their inception till November 2021.The inclusion criteria were primary studies evaluating MBIs in patients with SUDs with depression measured as an outcome,those including a control group,and those written in English.We used a random-effects model to compute effect sizes(ESs)using Hedges’g,a forest plot,and Q and I2 statistics as measures of heterogeneity;we also examined moderator analyses.Results:Nineteen studies included 1352 participants(age:38.6±7.0 years).Overall,MBIs showed significantly improved depression(g=0.67,95%confidence interval[CI]:0.29,1.05,I2=89%)compared to controls.With regard to moderators,providing MBIs as an individual plus group intervention had a greater effect(g=2.13)on reducing depressive symptoms than providing MBIs as a group intervention(g=0.64)or an individual intervention only(g=0.33,P=0.034).Using concealed allocation tended to reduce depressive symptoms(g=1.22)as compared to not using concealed allocation(g=0.48,P=0.086).No other quality indicators were demonstrated to have a moderating influence on the value of the ES.Conclusions:MBIs improved depressive symptoms in patients with SUDs.MBIs might be used as an adjunctive or alternative to conventional treatment for depressed patients with SUDs.展开更多
Theoretical models have predicted a positive association between anxiety and Internet use disorders.However,thefindings of previous studies are conflicting,with some reporting a positive association and others proposing...Theoretical models have predicted a positive association between anxiety and Internet use disorders.However,thefindings of previous studies are conflicting,with some reporting a positive association and others proposing no relationship between the two.To explore the true relationship between the two and analyze the reasons for the differences,100 primary studies involving 108,539 subjects were entered into a meta-analysis.The results showed that(1)there was a significant positive correlation between students’anxiety and Internet use disorder(r=0.330);(2)the moderating effect of anxiety type was significant.(3)The moderating effects of the measurement instrument for Internet use disorder,the measurement instrument for anxiety,the subject’s grade level,the subject’s region,and the type of publication were not significant.The question of how the different anxiety types of students and IUD have different mechanisms of action needs to be further explored.展开更多
<strong>Background:</strong> Alcohol Use Disorders (AUDs) in the elderly are associated with impairments in physical, psychological, social and cognitive functioning. Both the elderly men and women who dri...<strong>Background:</strong> Alcohol Use Disorders (AUDs) in the elderly are associated with impairments in physical, psychological, social and cognitive functioning. Both the elderly men and women who drink alcohol are at a greater risk of social isolation and economic deprivation and the women in particular are in the danger of rapid development of dependence a phenomenon termed “telescoping” dependence. This study seeks to determine the prevalence of alcohol use disorders as well as their associated factors among the elderly in Jos South LGA, Plateau State, Nigeria. <strong>Methods:</strong> A community-based cross-sectional study of elderly (≥60 years) men and women. A total of 400 out of a total of 422 elderly community dwellers identified were interviewed with the aid of a composite questionnaire incorporating the socio-demography, Alcohol Smoking and Substance Involvement Screening Test (ASSIST), Mini International Neuropsychiatric Interview (MINI) and the 12-item General Health Questionnaire (GHQ-12). <strong>Results:</strong> The lifetime and current prevalence of alcohol use were 69.8% and 45.5% respectively. The prevalence of AUDs was (n = 52, 13.0%). AUDs was significantly associated with being male (OR = 2.57, 95%CI: 1.35 - 3.77, p < 0.01). Participants with AUDs were more likely to report difficulty ambulating (<em>χ</em><sup>2</sup> = 0.34, 0.56), cardiovascular (<em>χ</em><sup>2</sup> = 0.42, p = 0.52), respiratory (<em>χ</em><sup>2</sup> = 0.55, p = 0.46), and digestive (<em>χ</em><sup>2</sup> = 0.17, p = 0.68) problems, though not statistically significant. Similarly, no significant associations were seen with probable psychiatric co-morbidity (<em>χ</em><sup>2</sup> = 2.35, p = 0.13) and chronic pain (<em>χ</em><sup>2</sup> = 0.52, p = 0.47). <strong>Conclusions:</strong> Alcohol use and use disorders were common in this elderly cohort. AUDs were associated with poorer health indices.展开更多
The medical profession is divided in its approach to treating patients with addiction issues, particularly in regards to the treatment of opioid use disorder with Suboxone (buprenorphine/naloxone). Here we present two...The medical profession is divided in its approach to treating patients with addiction issues, particularly in regards to the treatment of opioid use disorder with Suboxone (buprenorphine/naloxone). Here we present two cases of patients who have achieved over 11 years of sobriety with long-term Suboxone maintenance therapy. Their stories help to demonstrate that Suboxone is a viable long-term treatment option for severe opioid addiction. While life-long Suboxone use can lead to physical dependence on the drug, this is far from simply replacing one addiction with another. Some providers may feel that physical dependence on a medication does not represent appropriate or adequate treatment of opioid use disorder;however, when compared with the grave potential consequences of severe opioid use disorder, the potential benefits of achieving sobriety with Suboxone maintenance far outweigh the risks.展开更多
The COVID-19 pandemic has changed the way healthcare services are delivered. These changes will likely persist as countries recover from the economic crises following lockdowns. In developing countries, services for s...The COVID-19 pandemic has changed the way healthcare services are delivered. These changes will likely persist as countries recover from the economic crises following lockdowns. In developing countries, services for substance use disorders (SUDs) are inadequate and as countries prioritize infectious diseases, individuals with SUDs may suffer further neglect. This paper is a narrative review of peer-reviewed and grey literature on the current challenges with SUD treatment in Nigeria assesses how telehealth may positively affect access to evidence-based treatments and suggests strategies for implementation considering the unique challenges and opportunities in the country. If prioritized in her policy, telehealth has the potential to improve treatment outcomes for SUDs in Nigeria.展开更多
Nigeria has a very high number of sickle cell disease (SCD) population with addition of 150,000 babies born annually with the disease. Early infant diagnosis and good care make many of these babies survive to adulthoo...Nigeria has a very high number of sickle cell disease (SCD) population with addition of 150,000 babies born annually with the disease. Early infant diagnosis and good care make many of these babies survive to adulthood. Severe pain requiring moderately strong or very strong analgesics is a common presentation of patients with Sickle Cell Anaemia. Paediatricians find ready usefulness of Opioids which are very useful for the painful episodes among these patients. Therefore, the chances of abuse and addiction to these medications become very high and constitute additional burden on the deficient manpower in the health sector. Opioid Use Disorder among Sickle Cell Disease patients has subtle presentation, so a high index of suspicion is required to make both the diagnosis and referral to treatment centres. In this review, the epidemiology, pain pathophysiology, behavioural and pharmacologic therapy have been re-examined.展开更多
Problem gambling is over-represented in patients treated for substance use disorders, but substance-specific prevalence of problem gambling is rarely reported. In specialized addiction treatment facilities for opioid ...Problem gambling is over-represented in patients treated for substance use disorders, but substance-specific prevalence of problem gambling is rarely reported. In specialized addiction treatment facilities for opioid maintenance treatment and for alcohol and prescription drug dependence, respectively, 129 patients were screened for problem gambling using the NODS-CLiP. The lifetime prevalence of problem gambling was markedly higher in opioid maintenance treatment (61 percent) than in alcohol and prescription drug dependence treatment (11 percent, p < 0.001). When controlling for gender and age, problem gambling remained significantly associated with opioid maintenance treatment. The present study demonstrated a very high prevalence of lifetime problem gambling in opioid maintenance treatment patients. This calls for active screening for problem gambling in substance use disorder patients, and mainly in treatment for opioid dependence.展开更多
The opioid crisis has impacted the lives of millions of Americans.Digital technology has been applied in both research and clinical practice to mitigate this public health emergency.Blockchain technology has been impl...The opioid crisis has impacted the lives of millions of Americans.Digital technology has been applied in both research and clinical practice to mitigate this public health emergency.Blockchain technology has been implemented in healthcare and other industries outside of cryptocurrency,with few studies exploring its utility in dealing with the opioid crisis.This paper explores a novel application of blockchain technology and its features to increase uptake of medications for opioid use disorder.展开更多
Background:Alcohol use and traumatic events have a connecting relationship owing to the rising number of people adopting alcoholism as a coping strategy.Objectives:This study examined the cardiorenal protective effect...Background:Alcohol use and traumatic events have a connecting relationship owing to the rising number of people adopting alcoholism as a coping strategy.Objectives:This study examined the cardiorenal protective effect of morin,a bioflavonoid,in mice comorbidly exposed to alcohol use disorder(AUD)and posttraumatic stress disorder(PTSD).Methods:Mice exposed to single-prolong-stress(SPS)-induced PTSD were submitted to every-other-day ethanol(2 g/kg,oral gavage)for AUD induction,alongside treatments with morin(50 mg/kg and 100 mg/kg)or fluox-etine(10 mg/kg),from days 8-21 once daily.After that,mice were euthanized on day 22,markers of oxidative stress(glutathione,catalase,superoxide dismutase,malondialdehyde,nitrite)and inflammatory cytokines(tumor necrosis factor(TNF-α),interleukin-6(IL-6))in the kidney and heart were assayed.Results:Our result showed that mice exposed to SPS+EtOH-induced PTSD-AUD had reduced levels of glutathione,catalase,and superoxide dismutase,with increased malondialdehyde and nitrite concentrations in the heart and kidney relative to SPS+EtOH group.Also,the SPS+EtOH group showed increased concentrations of TNF-αand IL-6 in the heart and kidney tissues,suggesting inflammatory activity relative to normal control.Treatment with morin(50 mg/kg and 100 mg/kg)significantly reduced the SPS-EtOH-induced oxidative and nitrergic stress relative to the SPS+EtOH group.Additionally,the increased release of TNF-αand IL-6 following PTSD-AUD induction was profoundly inhibited by morin in a similar manner to fluoxetine.Conclusion:Our findings suggest that AUD-PTSD interaction-induced organ dysfunction,such as cardiorenal impairments,was reversed by morin via mechanisms associated with attenuation of oxidative/nitrergic stress and release of pro-inflammatory cytokines in mice.展开更多
BACKGROUND Patients and providers are often unaware of available treatment options for alcohol use disorder(AUD)and how to pursue them.AIM To improve AUD treatment rates using an educational video module(EVM).METHODS ...BACKGROUND Patients and providers are often unaware of available treatment options for alcohol use disorder(AUD)and how to pursue them.AIM To improve AUD treatment rates using an educational video module(EVM).METHODS Prospective single-center cohort study evaluating the impact of a novel interactive patient EVM in promoting AUD treatment among hospitalized patients with alcohol-associated liver disease.Treatment was defined as receiving medication or participating in psychosocial treatment within 30 days of discharge.Primary outcome was change in treatment rates after viewing the EVM compared to a retrospective control cohort.Secondary outcomes were predictors of receiving treatment,EVM feedback,30-day hospital readmission,outpatient follow-up,return to alcohol use,and mortality.RESULTS Forty-two patients were included.Mean age was 45 years,50%were female,and mean model for end-stage liver disease score 15.5.After viewing the EVM,treatment rates increased for pharmacologic(50%vs 22%,P=0.0008)and psychosocial treatment(73.8%vs 44%,P=0.01).Return to alcohol use was significantly lower(7.9%vs 35.6%,P=0.003).All 100%of patients would recommend the EVM.CONCLUSION EVM allows hospitalized patients to receive standardized education about AUD treatment.This may address patient and provider knowledge gaps and reduce the growing burden of alcohol-associated liver disease.Future studies should evaluate EVM in larger patient populations using a multi-center study design.展开更多
文摘The purpose of this paper is to look into how reliable and valid the Persian version of the Cannabis Use Disorder Identification Test-Revised (CUDIT-R-Pr) is. It will also compare the screening features of the CUDIT-R with those of the DSM-5 criteria for cannabis use disorder (CUD) based on the SCID-5-CT in a group of university students in Tehran, Iran. The study used the stratified random sampling technique to collect data from 541 students (19 to 24 years old) who used cannabis in Tehran universities in 2024. Confirmatory factor analysis confirmed the uni-dimensionality of the CUDIT-R-Pr. We checked the reliability of the CUDIT-R-Pr using Cronbach Alpha, split-half, inter-rater, test-retest stability over time, and parallel testing equivalence. The results indicated that CUDIT-R-Pr is reliable, reproducible, and responsive, with substantial agreement and adequate interpretability. The CUDIT-R shows that it can tell the difference between different levels of cannabis use severity, which is known as discriminant validity. Receiver operating characteristic analyses confirmed this, using an area under the receiver operating characteristics curve (AUC = 0.95) at a cutoff of ten or less. This allowed CUDIT-R-Pr to accurately predict any DSM-5 based on the highest correctly classified value (0.89), demonstrating high levels of sensitivity (0.96), specificity (0.69), and Youden value (0.65). The exact maximum Youden index (0.72) showed that CUDIT-R-Pr could also predict moderate DSM-5 with a cutoff of twelve or less. To validate and generalize the CUDIT-R-Pr for use among Iranian cannabis users, we need more research.
文摘In this article,we comment on the article by Zhang et al,which explores the familiarity,awareness,and usage of smart medical care and its correlation with mental health and personality traits.The use of intelligent healthcare technologies in treating mental disorders and substance use disorders shows significant promise,but involves certain challenges,such as limited access,low technological literacy,and privacy concerns.These barriers disproportionately affect deprived populations and individuals with severe mental health conditions.We highlight the positive impact of smart healthcare solutions,such as telemedicine and wearable technologies,on patient engagement,remote monitoring,and treatment adherence.To overcome these challenges,we propose strategies,such as improving user-friendliness,ensuring equitable access to digital interventions,enhancing cybersecurity,and integrating smart healthcare into clinical workflows.Training healthcare providers and developing policies to ensure the ethical use of patient data are essential.When implemented thoughtfully,smart healthcare technologies can revolutionize mental health and substance use disorder treatment,improve patient outcomes,and reduce healthcare inequities.
文摘Opioid use disorder(OUD)is a major public health problem affecting millions of people worldwide.Although OUD is a chronic and relapsing disorder,a variety of pharmacological and non-pharmacological interventions are available.Medication-assisted treatment of OUD generally relies on competition for opioid receptors against the addictive substance.The mechanisms of this competition are to block or inactivate the opioid receptor or activate the receptor with a substance that is intermittent or long acting.Methadone and buprenorphine are two United States Food and Drug Administration-approved medications that have long-term positive effects on the health of opioid-dependent individuals.Although clinical studies of drugs generally demonstrate efficacy in thousands of people and toxicity is excluded,it cannot be predicted whether the given drug will cause side effects in one of the patients at the treatment dose.Individual differences can be explained by many biological and environmental factors.Variations in genes encoding drug metabolism or cellular drug targets significantly explain the variability in drug response between individuals.Therefore,for the effects of candidate genes to be accepted and included in individual treatment protocols,it is important to repeat studies on individuals of different ethnic backgrounds and prove a similar effect.
文摘BACKGROUND Recent data are inconclusive regarding the risk of arrhythmias among young cannabis users.Furthermore,many young adults use both cannabis and tobacco,which could add a residual confounding effect on outcomes.So,we studied young men who have cannabis use disorder(CUD)excluding tobacco use disorder(TUD)to understand their independent association with atrial fibrillation(AF)and related outcomes.AIM To study the association of CUD with AF and related outcomes.METHODS We used weighted discharge records from National Inpatient Sample(2019)to assess the baseline characteristics and mortality rates for AF-related hospitalizations in young(18-44 years)men in 1:1 propensity-matched CUD+vs CUD-cohorts without TUD.RESULTS Propensity matched CUD+and CUD-cohorts consisted of 108495 young men in each arm.Our analysis showed an increased incidence of AF in black population with CUD.In addition,the CUD+cohort had lower rates of hyperlipidemia(6.4%vs 6.9%),hypertension(5.3%vs 6.3%),obesity(9.1%vs 10.9%),alcohol abuse(15.5%vs 16.9%),but had higher rates of anxiety(24.3%vs 18.4%)and chronic obstructive pulmonary disease(COPD)(9.8%vs 9.4%)compared to CUD-cohort.After adjustment with covariates including other substance abuse,a non-significant association was found between CUD+cohort and AF related hospitalizations(odd ratio:1.27,95%confidence interval:0.91-1.78,P=0.15).CONCLUSION Among hospitalized young men,the CUD+cohort had a higher prevalence of anxiety and COPD,and slightly higher proportion of black patients.Although there were higher odds of AF hospitalizations in CUD+cohort without TUD,the association was statistically non-significant.The subgroup analysis showed higher rates of AF in black patients.Large-scale prospective studies are required to evaluate long-term effects of CUD on AF risk and prognosis without TUD and concomitant substance abuse.
文摘Alcohol use disorder(AUD)represents a major public health issue which affects millions of people globally and consist a chronic relapsing condition associated with substantial morbidity and mortality.The gut microbiome plays a crucial role in maintaining overall health and has emerged as a significant contributor to the pathophysiology of various psychiatric disorders.Recent evidence suggests that the gut microbiome is intimately linked to the development and progression of AUD,with alcohol consumption directly impacting its composition and function.This review article aims to explore the intricate relationship between the gut microbiome and AUD,focusing on the implications for mental health outcomes and potential therapeutic strategies.We discuss the bidirectional communication between the gut microbiome and the brain,highlighting the role of microbiotaderived metabolites in neuroinflammation,neurotransmission,and mood regulation.Furthermore,we examine the influence of AUD-related factors,such as alcohol-induced gut dysbiosis and increased intestinal permeability,on mental health outcomes.Finally,we explore emerging therapeutic avenues targeting the gut microbiome in the management of AUD,including prebiotics,probiotics,and fecal microbiota transplantation.Understanding the complex interplay between the gut microbiome and AUD holds promise for developing novel interventions that could improve mental health outcomes in individuals with AUD.
文摘BACKGROUND High risk of alcohol and drug use disorders in people with attentiondeficit/hyperactivity disorder(ADHD)calls for exploratory research of relationships with clinical features of ADHD.AIM To estimate prevalence of alcohol/drug use disorders and associations with ADHD symptom severity and emotional dysregulation,in adults with ADHD.METHODS This observational cross-sectional clinical study consisted of patients admitted to a private psychiatric outpatient clinic in Oslo,Norway(2014-2018).Five-hundred and fifty-eight eligible patients diagnosed with ADHD(Diagnostic and Statistical Manual of Mental Disorders,Fifth Edition(DSM-5)criteria)agreed to participate.Alcohol and drug use disorders were diagnosed using the Mini International Neuropsychiatric Interview(MINI).Dependence and abuse were merged into“use”disorder as in MINI version 7.0/DSM-5.Questions were related both to lifetime and the past 12-mo.ADHD severity was assessed by the Adult ADHD Self Report Scale(ASRS).Subdivisions of the ASRS questionnaire as inattentive items and hyperactive/impulsivity items were recorded separately.Emotional dysregulation was assessed by the eight-item version of Barkley’s Current Behavior Scale-Self Report.RESULTS The 12-mo prevalence was 5.3%for alcohol use disorder and 13.7%for drug use disorder.The lifetime prevalence was 12.0%for alcohol use disorder and 27.7%for drug use disorder.Men had higher rates of both alcohol use disorder and drug use disorder compared to women.The prevalence of drug use disorder was more than twice that of alcohol use disorder for both sexes.The drugs most participants reported having used were(in descending order):Amphetamine(19.1%),cannabis(17.1%),cocaine or ecstasy(7.4%),benzodiazepines(7.4%),and heroin or other opioids(2.9%).Lifetime drug use disorder was significantly associated with both hyperactivity-impulsivity symptoms and emotional dysregulation symptom severity.Lifetime alcohol use disorder,on the other hand,was not significantly associated with ADHD symptoms or emotional dysregulation when adjusted for gender and age.CONCLUSION Patients with ADHD have a high lifetime prevalence of drug use disorder,which is associated with higher levels of hyperactivity-impulsivity symptoms and emotional dysregulation.
文摘Alcohol use disorders represent a heterogeneous spectrum of clinical manifestations that have been defined by the Diagnostic and Statistical Manual of Mental Disorders-5. Excessive alcohol intake can lead to damage of various organs, including the liver. Alcoholic liver disease includes different injuries ranging from steatosis to cirrhosis and implicates a diagnostic assessment of the liver disease and of its possible complications. There is growing interest in the possible different tools for assessing previous alcohol consumption and for establishing the severity of liver injury, especially by noninvasive methods.
文摘BACKGROUND Following the development of the coronavirus disease-2019(COVID-19)pandemic in Italy,a strict lockdown was imposed from March 9 to May 5,2020.The risks of self-medication through alcohol or psychoactive substance abuse were increased,as well as the tendency to adopt pathological behaviors,such as gambling and internet addiction.AIM To evaluate the impact of the COVID-19 pandemic and associated containment measures on craving in a group of patients suffering from substance use disorder and/or gambling disorder who were in treatment in outpatient units or in residency programs as inpatients.METHODS One hundred and fifty-three patients completed a structured questionnaire evaluating craving and other behaviors using a visual analogue scale(VAS).Forty-one subjects completed a pencil and paper questionnaire during the interview.The clinician provided an online questionnaire to 112 patients who had virtual assessments due to lockdown restrictions.Statistical analyses were performed using Statistica version 8.0.Quantitative parameters are presented as the mean±SD and qualitative parameters as number and percentage per class.The Kolmogorov-Smirnov test was used to check for normality of distributions.Analysis of variance and Duncan post hoc test were employed to analyze differences among subgroup means.The associations between variables were measured using Pearson's correlation.A P value of<0.05 was considered significant.RESULTS The variation in craving between the present and the month before showed VASrelated reductions of craving in 57%,increases in 24%,and no significant change in 19%of the sample.The level of craving was significantly higher(F=4.36;P<0.05)in outpatients(n=97;mean=3.8±3.1)living in their own home during the quarantine compared with inpatients(n=56;mean=2.8±2.8)in residential programs.Craving for tetrahydrocannabinol was the greatest(4.94,P<0.001)among various preferred substances.CONCLUSION The unexpected result of this study may be explained by a perceived lack of availability of substances and gambling areas and/or decreased social pressure on a subject usually excluded and stigmatized,or the acquisition of a new social identity based on feelings of a shared common danger and fate that overshadowed the sense of exclusion and rejection in the abuser.
文摘Drug overdose is the leading cause of death by injury in the United States.The incidence of substance use disorder(SUD)in the United States has increased steadily over the past two decades,becoming a major public health problem for the country.The drivers of the SUD epidemic in the United States have changed over time,characterized by an initial heroin outbreak between 1970 and 1999,followed by a painkiller outbreak,and finally by an ongoing synthetic opioid outbreak.The nature and sources of these abused substances reveal striking differences in the socioeconomic and behavioral factors that shape the drug epidemic.Moreover,the geospatial distribution of the SUD epidemic is not homogeneous.The United States has specific locations where vulnerable communities at high risk of SUD are concentrated,reaffirming the multifactorial socioeconomic nature of this epidemic.A better understanding of the SUD epidemic under a spatial epidemiology framework is necessary to determine the factors that have shaped its spread and how these patterns can be used to predict new outbreaks and create effective mitigation policies.This narrative minireview summarizes the current records of the spatial distribution of the SUD epidemic in the United States across different periods,revealing some spatiotemporal patterns that have preceded the occurrence of outbreaks.By analyzing the epidemic of SUD-related deaths,we also describe the epidemic behavior in areas with high incidence of cases.Finally,we describe public health interventions that can be effective for demographic groups,and we discuss future challenges in the study and control of the SUD epidemic in the country.
文摘Alcohol use disorder is a complex and heterogeneous phenomenon that can be studied from several points of view by focusing on its different components.Alcohol is a hepatotoxin whose metabolism creates profound alterations within the hepatocyte.The liver is the central organ in the metabolism of alcohol,a process that also involves other organs and tissues such as the brain,heart and muscles,but the most relevant organ is the liver.The anatomopathological alterations in the liver associated with the prolonged use of alcohol range from the simple accumulation of neutral fats in the hepatocytes,to cirrhosis and hepatocellular carcinoma.Alcohol abuse frequently leads to liver disease such as steatosis,steatohepatitis,fibrosis,cirrhosis,and tumors.Following the spread of coronavirus disease 2019(COVID-19),there was an increase in alcohol consumption,probably linked to the months of lockdown and smart working.It is known that social isolation leads to a considerable increase in stress,and it is also recognized that high levels of stress can result in an increase in alcohol intake.Cirrhotic patients or subjects with liver cancer are immunocompromised,so they may be more exposed to COVID-19 infection with a worse prognosis.This review focuses on the fact that the COVID-19 pandemic has made the emergence of alcohol-induced liver damage a major medical and social problem.
文摘Objective:We examined the effects of mindfulness-based interventions(MBIs)on depressive symptoms in patients with substance use disorders(SUDs)and explored the moderating effects of participant,method,and intervention characteristics.Methods:We systematically searched 8 databases from their inception till November 2021.The inclusion criteria were primary studies evaluating MBIs in patients with SUDs with depression measured as an outcome,those including a control group,and those written in English.We used a random-effects model to compute effect sizes(ESs)using Hedges’g,a forest plot,and Q and I2 statistics as measures of heterogeneity;we also examined moderator analyses.Results:Nineteen studies included 1352 participants(age:38.6±7.0 years).Overall,MBIs showed significantly improved depression(g=0.67,95%confidence interval[CI]:0.29,1.05,I2=89%)compared to controls.With regard to moderators,providing MBIs as an individual plus group intervention had a greater effect(g=2.13)on reducing depressive symptoms than providing MBIs as a group intervention(g=0.64)or an individual intervention only(g=0.33,P=0.034).Using concealed allocation tended to reduce depressive symptoms(g=1.22)as compared to not using concealed allocation(g=0.48,P=0.086).No other quality indicators were demonstrated to have a moderating influence on the value of the ES.Conclusions:MBIs improved depressive symptoms in patients with SUDs.MBIs might be used as an adjunctive or alternative to conventional treatment for depressed patients with SUDs.
基金supported by“An Empirical Study on the Relationship between Mobile Phone Dependence and Social Anxiety among Adolescents in the Post-COVID-19 Era”(LJKMR20221512)"LiaoNing Revitalization Talents Program"(grant no.XLYC2007134).
文摘Theoretical models have predicted a positive association between anxiety and Internet use disorders.However,thefindings of previous studies are conflicting,with some reporting a positive association and others proposing no relationship between the two.To explore the true relationship between the two and analyze the reasons for the differences,100 primary studies involving 108,539 subjects were entered into a meta-analysis.The results showed that(1)there was a significant positive correlation between students’anxiety and Internet use disorder(r=0.330);(2)the moderating effect of anxiety type was significant.(3)The moderating effects of the measurement instrument for Internet use disorder,the measurement instrument for anxiety,the subject’s grade level,the subject’s region,and the type of publication were not significant.The question of how the different anxiety types of students and IUD have different mechanisms of action needs to be further explored.
文摘<strong>Background:</strong> Alcohol Use Disorders (AUDs) in the elderly are associated with impairments in physical, psychological, social and cognitive functioning. Both the elderly men and women who drink alcohol are at a greater risk of social isolation and economic deprivation and the women in particular are in the danger of rapid development of dependence a phenomenon termed “telescoping” dependence. This study seeks to determine the prevalence of alcohol use disorders as well as their associated factors among the elderly in Jos South LGA, Plateau State, Nigeria. <strong>Methods:</strong> A community-based cross-sectional study of elderly (≥60 years) men and women. A total of 400 out of a total of 422 elderly community dwellers identified were interviewed with the aid of a composite questionnaire incorporating the socio-demography, Alcohol Smoking and Substance Involvement Screening Test (ASSIST), Mini International Neuropsychiatric Interview (MINI) and the 12-item General Health Questionnaire (GHQ-12). <strong>Results:</strong> The lifetime and current prevalence of alcohol use were 69.8% and 45.5% respectively. The prevalence of AUDs was (n = 52, 13.0%). AUDs was significantly associated with being male (OR = 2.57, 95%CI: 1.35 - 3.77, p < 0.01). Participants with AUDs were more likely to report difficulty ambulating (<em>χ</em><sup>2</sup> = 0.34, 0.56), cardiovascular (<em>χ</em><sup>2</sup> = 0.42, p = 0.52), respiratory (<em>χ</em><sup>2</sup> = 0.55, p = 0.46), and digestive (<em>χ</em><sup>2</sup> = 0.17, p = 0.68) problems, though not statistically significant. Similarly, no significant associations were seen with probable psychiatric co-morbidity (<em>χ</em><sup>2</sup> = 2.35, p = 0.13) and chronic pain (<em>χ</em><sup>2</sup> = 0.52, p = 0.47). <strong>Conclusions:</strong> Alcohol use and use disorders were common in this elderly cohort. AUDs were associated with poorer health indices.
文摘The medical profession is divided in its approach to treating patients with addiction issues, particularly in regards to the treatment of opioid use disorder with Suboxone (buprenorphine/naloxone). Here we present two cases of patients who have achieved over 11 years of sobriety with long-term Suboxone maintenance therapy. Their stories help to demonstrate that Suboxone is a viable long-term treatment option for severe opioid addiction. While life-long Suboxone use can lead to physical dependence on the drug, this is far from simply replacing one addiction with another. Some providers may feel that physical dependence on a medication does not represent appropriate or adequate treatment of opioid use disorder;however, when compared with the grave potential consequences of severe opioid use disorder, the potential benefits of achieving sobriety with Suboxone maintenance far outweigh the risks.
文摘The COVID-19 pandemic has changed the way healthcare services are delivered. These changes will likely persist as countries recover from the economic crises following lockdowns. In developing countries, services for substance use disorders (SUDs) are inadequate and as countries prioritize infectious diseases, individuals with SUDs may suffer further neglect. This paper is a narrative review of peer-reviewed and grey literature on the current challenges with SUD treatment in Nigeria assesses how telehealth may positively affect access to evidence-based treatments and suggests strategies for implementation considering the unique challenges and opportunities in the country. If prioritized in her policy, telehealth has the potential to improve treatment outcomes for SUDs in Nigeria.
文摘Nigeria has a very high number of sickle cell disease (SCD) population with addition of 150,000 babies born annually with the disease. Early infant diagnosis and good care make many of these babies survive to adulthood. Severe pain requiring moderately strong or very strong analgesics is a common presentation of patients with Sickle Cell Anaemia. Paediatricians find ready usefulness of Opioids which are very useful for the painful episodes among these patients. Therefore, the chances of abuse and addiction to these medications become very high and constitute additional burden on the deficient manpower in the health sector. Opioid Use Disorder among Sickle Cell Disease patients has subtle presentation, so a high index of suspicion is required to make both the diagnosis and referral to treatment centres. In this review, the epidemiology, pain pathophysiology, behavioural and pharmacologic therapy have been re-examined.
文摘Problem gambling is over-represented in patients treated for substance use disorders, but substance-specific prevalence of problem gambling is rarely reported. In specialized addiction treatment facilities for opioid maintenance treatment and for alcohol and prescription drug dependence, respectively, 129 patients were screened for problem gambling using the NODS-CLiP. The lifetime prevalence of problem gambling was markedly higher in opioid maintenance treatment (61 percent) than in alcohol and prescription drug dependence treatment (11 percent, p < 0.001). When controlling for gender and age, problem gambling remained significantly associated with opioid maintenance treatment. The present study demonstrated a very high prevalence of lifetime problem gambling in opioid maintenance treatment patients. This calls for active screening for problem gambling in substance use disorder patients, and mainly in treatment for opioid dependence.
基金This work was supported by the National Center for Complementary and Integrative Health under Grant 4R33AT010606-03 and National Institute on Drug Abuse.
文摘The opioid crisis has impacted the lives of millions of Americans.Digital technology has been applied in both research and clinical practice to mitigate this public health emergency.Blockchain technology has been implemented in healthcare and other industries outside of cryptocurrency,with few studies exploring its utility in dealing with the opioid crisis.This paper explores a novel application of blockchain technology and its features to increase uptake of medications for opioid use disorder.
文摘Background:Alcohol use and traumatic events have a connecting relationship owing to the rising number of people adopting alcoholism as a coping strategy.Objectives:This study examined the cardiorenal protective effect of morin,a bioflavonoid,in mice comorbidly exposed to alcohol use disorder(AUD)and posttraumatic stress disorder(PTSD).Methods:Mice exposed to single-prolong-stress(SPS)-induced PTSD were submitted to every-other-day ethanol(2 g/kg,oral gavage)for AUD induction,alongside treatments with morin(50 mg/kg and 100 mg/kg)or fluox-etine(10 mg/kg),from days 8-21 once daily.After that,mice were euthanized on day 22,markers of oxidative stress(glutathione,catalase,superoxide dismutase,malondialdehyde,nitrite)and inflammatory cytokines(tumor necrosis factor(TNF-α),interleukin-6(IL-6))in the kidney and heart were assayed.Results:Our result showed that mice exposed to SPS+EtOH-induced PTSD-AUD had reduced levels of glutathione,catalase,and superoxide dismutase,with increased malondialdehyde and nitrite concentrations in the heart and kidney relative to SPS+EtOH group.Also,the SPS+EtOH group showed increased concentrations of TNF-αand IL-6 in the heart and kidney tissues,suggesting inflammatory activity relative to normal control.Treatment with morin(50 mg/kg and 100 mg/kg)significantly reduced the SPS-EtOH-induced oxidative and nitrergic stress relative to the SPS+EtOH group.Additionally,the increased release of TNF-αand IL-6 following PTSD-AUD induction was profoundly inhibited by morin in a similar manner to fluoxetine.Conclusion:Our findings suggest that AUD-PTSD interaction-induced organ dysfunction,such as cardiorenal impairments,was reversed by morin via mechanisms associated with attenuation of oxidative/nitrergic stress and release of pro-inflammatory cytokines in mice.
文摘BACKGROUND Patients and providers are often unaware of available treatment options for alcohol use disorder(AUD)and how to pursue them.AIM To improve AUD treatment rates using an educational video module(EVM).METHODS Prospective single-center cohort study evaluating the impact of a novel interactive patient EVM in promoting AUD treatment among hospitalized patients with alcohol-associated liver disease.Treatment was defined as receiving medication or participating in psychosocial treatment within 30 days of discharge.Primary outcome was change in treatment rates after viewing the EVM compared to a retrospective control cohort.Secondary outcomes were predictors of receiving treatment,EVM feedback,30-day hospital readmission,outpatient follow-up,return to alcohol use,and mortality.RESULTS Forty-two patients were included.Mean age was 45 years,50%were female,and mean model for end-stage liver disease score 15.5.After viewing the EVM,treatment rates increased for pharmacologic(50%vs 22%,P=0.0008)and psychosocial treatment(73.8%vs 44%,P=0.01).Return to alcohol use was significantly lower(7.9%vs 35.6%,P=0.003).All 100%of patients would recommend the EVM.CONCLUSION EVM allows hospitalized patients to receive standardized education about AUD treatment.This may address patient and provider knowledge gaps and reduce the growing burden of alcohol-associated liver disease.Future studies should evaluate EVM in larger patient populations using a multi-center study design.
