Study: Competitive People Have Higher Risk for Using Drugs

A new study from Spain suggests hostile and competitive people are more likely to abuse drugs and alcohol.

“There are still many questions to answer but what we discovered is very significant,” points out Dr. Rosario Ruiz Olivares, head researcher at the University of Cordoba (Spain). Nevertheless, Olivares said that what could be called an addictive personality “does not exist.”

However, the study does confirm that there is a very strong correlation between a personality characterized by hostility and competitiveness and consumption of illegal substances, such as cocaine, cannabis and hallucinogens.

Investigators believe that people who are patient, less hostile, and not competitive have a much lower likelihood of being drug users. “This kind of personality is a protective factor for drug consumption and is especially meaningful in the case of alcohol and tobacco,” Olivares said.

In the study, socio-demographic and personality questionnaires were completed by 3,816 young people in the province of Cordoba between the ages of 18 and 29. “In the future, we would like to broaden the sample to a national level and study behavior patterns according to the person’s gender,” states Rosario Ruiz.

These results represent an important step in the field of preventing drug consumption among young people, since it could focus specifically on people who demonstrate hostile and competitive traits.

Furthermore, it will not only help in prevention, but may also help clinicians given that individuals who have these characteristics can find it more difficult to overcome their addiction. Early detection of substance abuse can lead to specific psychological therapy designed to work on the personality traits that influence drug abuse.

Source: University of Cordoba

Mindfulness May Help Reduce Opioid Cravings in Chronic Pain Patients

People struggling with opioid addiction and chronic pain may experience fewer cravings and less pain if they use mindfulness techniques along with medication for opioid dependence, according to a new study published in the journal Drug and Alcohol Dependence.

Mindfulness is the meditative practice of focusing on the present moment and accepting one’s thoughts, feelings and bodily sensations, without judgment.

The study, led by researchers from Rutgers University in New Jersey, looked at the effects of mindfulness techniques and methadone therapy on 30 patients with opioid addiction and chronic pain.

The research team found that participants who received methadone and a mindfulness training-based intervention were 1.3 times better at controlling their cravings and had significantly greater improvements in pain, stress, and positive emotions, compared to participants who only received standard methadone treatment and counseling.

The findings held true even though the mindfulness participants were more aware of their cravings.

“Methadone maintenance therapy (MMT) has been an effective form of medication treatment for opioid use disorder,” said Associate Professor Nina Cooperman, a clinical psychologist in the Division of Addiction Psychiatry at Rutgers Robert Wood Johnson Medical School.

“However, nearly half of individuals on MMT continue to use opioids during treatment or relapse within six months.”

Cooperman said that people with opioid addictions often experience chronic pain, anxiety and depression while on methadone maintenance, which is why mindfulness-based, non-drug interventions are promising treatments.

The researchers said mindfulness-based interventions could help people dependent on opioids increase their self-awareness and self-control over cravings and be less reactive to emotional and physical pain.

Individuals with an opioid addiction could also be taught to change their negative thought patterns and savor pleasant events, which may help them to regulate their emotions and experience more enjoyment.

In 2017, more than 70,000 people died from a drug overdose, making it a leading cause of injury-related death in the United States. Of those deaths, almost 68% (47,600 overdose deaths) involved a prescription or illicit opioid, according to the Centers for Disease Control and Prevention (CDC). Overdose deaths involving prescription opioids were five times higher in 2017 than in 1999.

Source: Rutgers University

 

Smartphone Addiction in Late Adolescence May Increase Risk for Depression, Loneliness

A new study suggests young people who are hooked on their smartphones may be at an increased risk for depression and loneliness. University of Arizona investigators designed the study to explore whether reliance on smartphones precedes symptoms of depression and loneliness, or whether the reverse is true.

In a study of 346 older adolescents, ages 18-20, researchers found that smartphone dependency predicts higher reports of depressive symptoms and loneliness, rather than the other way around. Understanding the path of the relationship is important as mental health professionals work to design interventions to reduce dependency and subsequent mood disorders.

“The main takeaway is that smartphone dependency directly predicts later depressive symptoms,” said Matthew Lapierre, an assistant professor in the Department of Communication. “There’s an issue where people are entirely too reliant on the device, in terms of feeling anxious if they don’t have it accessible, and they’re using it to the detriment of their day-to-day life.”

In the study, Lapierre and his co-authors focus on smartphone dependency – a person’s psychological reliance on the device – rather than on general smartphone use, which can actually provide benefits.

“The research grows out of my concern that there is too much of a focus on general use of smartphones,” Lapierre said. “Smartphones can be useful. They help us connect with others. We’ve really been trying to focus on this idea of dependency and problematic use of smartphones being the driver for these psychological outcomes. ”

The study will appear in the Journal of Adolescent Health.

Acknowledging the direction of the relationship between smartphone dependency and poor psychological outcomes is critical for knowing how best to address the problem, said graduate student Pengfei Zhao, who co-authored the study with Lapierre and communication doctoral student Benjamin Custer.

“If depression and loneliness lead to smartphone dependency, we could reduce dependency by adjusting people’s mental health,” Zhao said. “But if smartphone dependency (precedes depression and loneliness), which is what we found, we can reduce smartphone dependency to maintain or improve wellbeing.”

The researchers measured smartphone dependency by asking study participants to use a four-point scale to rate a series of statements, such as “I panic when I cannot use my smartphone.”

Participants also answered questions designed to measure loneliness, depressive symptoms and their daily smartphone use. They responded to the questions at the start of the study and again three to four months later.

The study focused on older adolescents, a population researchers say is important for a couple of reasons: First, they largely grew up with smartphones. Second, they are at an age and transitional stage in life where they are vulnerable to poor mental health outcomes, such as depression.

“It might be easier for late adolescents to become dependent on smartphones, and smartphones may have a bigger negative influence on them because they are already very vulnerable to depression or loneliness,” Zhao said.

Given the potential negative effects of smartphone dependency, it may be worth it for people to evaluate their relationship with their devices and self-impose boundaries if necessary, the researchers said.

Looking for alternative ways to manage stress might be one helpful strategy, since other research has indicated that some people turn to their phones in an effort to relieve stress, Zhao said.

“When people feel stressed, they should use other healthy approaches to cope, like talking to a close friend to get support or doing some exercises or meditation,” Zhao said.

Smartphones are still a relatively new technology with research a global endeavor as a wide-variety of professionals investigate how the phones affect people’s lives.

Lapierre said now that researchers know that there is a link between smartphone dependency and depression and loneliness, future work should focus on better understanding why that relationship exists.

“The work we’re doing is answering some essential questions about the psychological effects of smartphone dependency,” he said. “Then we can start asking, ‘OK, why is this the case?’”

Source: University of Arizona

Anxiety, Depression Tied to Greater Opioid Use After Surgery

Pain is an unavoidable part of the healing process after surgery. Yet the current opioid crisis has made the standard prescribing practices for painkillers loaded with risk.

A new study from Michigan Medicine (U-M) could help clinicians navigate this risk by identifying which patients may be more likely to continue using opioids after their immediate recovery period.

“There is not much research on which surgical patients require more or less opioids, despite a push in the field for personalized medicine,” said first author Daniel Larach, M.D., M.T.R., M.A., a resident at U-M at the time of the study and now an assistant professor of clinical anesthesiology at the University of Southern California.

“Often with postoperative opioid prescribing, personalization falls by the wayside, with surgeons using the same amounts for every person receiving a certain procedure.”

The findings are published in the Annals of Surgery.

For the study, the research team evaluated the data of more than 1,000 people undergoing an elective hysterectomy, thoracic surgery, or a total knee or hip replacement. Before their operations, each patient provided demographic information and completed several screening questionnaires.

The patients were given scores measuring their degree of depression, anxiety, fatigue, sleep disturbance, physical function, as well as the severity of their overall and surgical site pain. The researchers also measured how many pills were prescribed to each patient.

The patients were then contacted one month following the surgery to assess how many opioid pills they had consumed.

“We found that anxiety is linked with more opioid use, which is disheartening to see but also heartening in the sense that this is something we could potentially target,” said Larach.

Other patient factors linked to increased opioid use included younger age, non-white race, no college degree, alcohol and tobacco use, and sleep disturbance.

Chad Brummett, M.D., associate professor of anesthesiology and director of anesthesia clinical research and pain research, said people may be knowingly or unknowingly medicating for other conditions.

“The only thing we’re giving them is opioids and we’re not giving them alternatives or other options,” he said. For example, patients with high anxiety around the time of surgery could be offered behavioral care or other non-opioid medications for anxiety and resulting pain.

Brummett also noted that the study found overprescription of opioids for all surgical procedures and a link between the prescription size and use.

“I think it is striking that you see once again that the more you prescribe, the more patients take, even after adjusting for all of these other risk factors,” Brummett said.

The team noted that right-sizing prescriptions through initiatives such as the Michigan Opioid Prescribing Engagement Network (OPEN), which provides recommendations for prescription amounts for various medical procedures, is a critical first step.

But, they say, this step should be followed by more research into specific patient factors that can be addressed in other ways.

“We are asking surgeons to learn about and think about pain and behavioral health in ways that we have not previously done. It will require an open mind,” said Brummett.

Source: Michigan Medicine- University of Michigan

 

Depression is the Strongest Predictor of Substance Use in Pregnancy

A new Canadian study finds that depression is the single largest driver of substance use during pregnancy, highlighting the need for greater support for the mental health of pregnant women.

According to the Centers for Disease Control and Prevention (CDC), the rate of pregnant women with a depression diagnosis at delivery increased by seven times from 2000 to 2015. And it is well known that drug and alcohol use during pregnancy is linked to poor birth outcomes, but some women continue to use these substances while pregnant.

For the study, a research team from Western University in Ontario and its affiliate, Brescia University College, investigated the potential predictors of cannabis, tobacco and alcohol use among pregnant women. They analyzed the health and geographical data of more than 25,000 pregnant women in Southwestern Ontario.

The research, published in the Journal of Neonatal-Perinatal Medicine, is the first Canadian study with a sample size this large to show that depression during pregnancy is the primary risk factor for cannabis, tobacco and alcohol use. In fact, depression was found to be a stronger predictor than education, income or age.

“Pregnant women who were depressed were 2.6 times more likely to use cannabis and twice as likely to smoke cigarettes and use alcohol while pregnant,” said Jamie Seabrook, PhD, an associate professor at Brescia and Western’s Schulich School of Medicine & Dentistry, and scientist at Children’s Health Research Institute, a Lawson program.

“We don’t know when the substance use first began, but we do know that it was continuing during pregnancy and that is a big risk factor for poor maternal and infant health outcomes.”

First author Rachel Brown says that the study really emphasizes the importance of focusing on pregnant women’s mental health. This might include better promotion of mental health strategies, psychotherapy and/or safe and proper mental health medication during pregnancy.

“The research shows that there is an effect later on in life as well with infants who are born preterm or low birth weight. To intervene or advocate for mental health programs for the mom, the idea is that it sets up the health of the infants later on in life,” said Brown, an MSc candidate.

The research team points out that this research is especially important in Canada with the recent legalization of recreational cannabis.

“Let’s help women with their mental health to improve their overall health and in doing so, improve the health of their baby,” said Seabrook.

Source: University of Western Ontario

Addiction Intervention in Hospital Can Be A ‘Reachable Moment’

Addiction patients who meet with an intervention team in the hospital are twice as likely to participate in treatment for substance use disorder after they are discharged, according to a new study published in the Journal of General Internal Medicine.

“This confirms that hospitalization is a reachable moment,” said lead author Honora Englander, M.D., an associate professor of medicine in the Oregon Health & Science University (OHSU) School of Medicine.

“We were able to sizably increase treatment engagement. That matters because treatment is associated with reduced health care costs, reduced mortality and a whole vast array of really important outcomes.”

Most hospitals do not treat substance use disorder (SUD) during hospitalization or connect people to treatment after discharge, and hospitalizations related to addiction are extremely costly. Hospitals may lack the staffing, financial resources, or interest in taking on addiction care.

However, people with substance use disorder often end up hospitalized, sometimes as a result of illness arising from their addiction. Examples include endocarditis caused by injection drug use, liver disease from overuse of alcohol, or various kinds of trauma.

Hospitals are well-equipped to handle the acute medical need, but not the underlying addiction.

“Stigma is a huge driver,” Englander said. “People don’t think of addiction as something that hospitals should be addressing. Our study pushes back at that.”

The study focused on the effectiveness of IMPACT, or Improving Addiction Care Team, an intervention program pioneered by OHSU in 2015. IMPACT brings together physicians, social workers, peer-recovery mentors and community addiction providers to address addiction when patients are admitted to the hospital. Englander is the project director.

The researchers compared 208 patients who received addiction medicine consultation at OHSU with a control group of Medicaid patients with similar conditions hospitalized in any Oregon hospital. The team compared the substance use treatment engagement in the month after they were released from the hospital.

The findings show that 38.9% of IMPACT patients engaged in substance use treatment, compared with 23.3% of similar patients who did not work with IMPACT.

OHSU’s program is one of only a handful in the nation, which remains beset by an opioid epidemic and a rising methamphetamine crisis that claimed more than 70,000 lives in 2017. The new study indicates the program makes a difference in engaging people in treatment.

“Hospital-based addiction medicine care can improve (substance use disorder) treatment engagement, which is associated with reduced substance use, mortality, and other important clinical outcomes,” the authors write.

“National expansion of such models represents an opportunity to address an enduring gap in the SUD treatment continuum.”

Source: Oregon Health & Science University