SciBits

Stigma Surrounding People with Substance Use Disorder: A Scoping Review Examining Educational Programs

1. Stigma is a major social determinant affecting recovery in substance use disorders.
2. Educational programs targeting stigma are heterogeneous and poorly standardized.
3. Most programs include curriculum development, evaluation, and specific target audiences.
4. Only one program met criteria for a fully evidence-based and sustainable model.
5. Standardized stigma education could improve healthcare delivery and patient outcomes.

Stigma Against Patients With Substance Use Disorders Among Health Care Professionals and Trainees

1. Stigma toward patients with SUD is prevalent among healthcare professionals and trainees.
2. Most intervention studies show small but significant reductions in stigma.
3. Interventions often combine education and contact with affected individuals.
4. Measurement of stigma is highly heterogeneous across studies.
5. More rigorous and long-term studies are needed.

Stigma in substance-based and behavioural addictions: A systematic review

1. Addiction-related stigma is associated with shame, discrimination, and reduced help-seeking.
2. Substance addictions are more stigmatized than behavioral addictions.
3. Familiarity with addiction reduces public stigma.
4. Between 22–40% of affected individuals report stigma as a barrier to care.
5. Evidence on effective stigma reduction strategies remains limited.

Effectiveness of Interventions in Reducing Substance-Related Stigma

1. Interventions show small overall effects in reducing substance-related stigma.
2. No significant effects were found for self- or social stigma.
3. Structural stigma showed small but significant improvement.
4. Intervention characteristics did not significantly influence outcomes.
5. Stigma reduction interventions remain promising but limited.

Intersection of Gender and Drug Use-Related Stigma

1. Gender influences experiences of drug-related stigma.
2. Qualitative studies show women experience higher stigma levels.
3. Quantitative findings are mixed regarding gender differences.
4. Intersectionality shapes health risks and access to care.
5. Tailored stigma measures are needed.

Systematic review of stigma interventions for providers

1. Provider stigma is a major barrier to treatment engagement.
2. Interventions combining education and contact are most effective.
3. Contact with people in recovery produces lasting attitude change.
4. Studies show methodological limitations and heterogeneity.
5. Implementation outcomes need further evaluation.

Mass media interventions to reduce stigma

1. Mass media interventions aim to reduce stigma at population level.
2. Messaging approaches are highly heterogeneous.
3. Some interventions reinforce negative stereotypes unintentionally.
4. Measurement of stigma varies widely across studies.
5. More theory-driven interventions are needed.

Interventions to reduce self-stigma in people who use drugs

1. Self-stigma interventions show promising but mixed results.
2. Psychotherapeutic approaches (e.g., ACT) are most effective.
3. Most interventions are group-based and clinic-based.
4. Measurement heterogeneity limits comparability.
5. More scalable interventions are needed.

Opioid-related stigma typology

1. Opioid stigma occurs at multiple levels including self, interpersonal, and structural.
2. Context and type of opioid use influence stigma.
3. Stigma affects both pain treatment and addiction care.
4. Healthcare settings are key sites of stigma reproduction.
5. Multi-level interventions are required.

Diversity in opioid-related stigma interventions

1. Stigma interventions often lack diversity considerations.
2. Cultural and intersectional factors are underrepresented.
3. Most interventions target providers or the public.
4. Inclusion of lived experience improves interventions.
5. Future work should integrate intersectional frameworks.

Stigma and substance use disorders: an international phenomenon

1. Public stigma toward substance use disorders (SUD) is widespread and often stronger than stigma toward other psychiatric disorders.
2. Stigma manifests through stereotyping, negative emotional reactions, and discrimination at both interpersonal and institutional levels.
3. Stigma contributes to under-treatment by reducing help-seeking, provider engagement, and policy support.
4. Public attitudes toward individuals with SUD frequently include perceptions of dangerousness and moral failure.
5. Reducing stigma through education and policy change is essential to improve treatment access and outcomes.

The association between perceived stigma and substance use disorder treatment outcomes: a review

1. Perceived stigma and self-stigma are common among individuals with SUD and negatively affect recovery processes.
2. Stigma impacts treatment outcomes primarily through indirect pathways such as reduced self-efficacy and negative emotions.
3. Evidence for a direct causal effect of stigma on treatment outcomes is inconsistent across studies.
4. Internalized stigma reduces self-esteem and motivation for treatment engagement.
5. There is significant heterogeneity in how stigma and recovery are defined and measured across studies.

Communication strategies to counter stigma and improve mental health and substance use disorder policy

1. Public stigma is a major determinant of low support for policies targeting mental illness and SUD.
2. Communication strategies using personal narratives can increase policy support without increasing stigma.
3. Messages emphasizing structural barriers to treatment are more effective than those linking mental illness to violence.
4. Stigma is associated with reduced willingness to fund treatment and increased support for punitive policies.
5. Evidence-based communication strategies are essential to improve public attitudes and policy engagement.

A systematic literature review of patient perspectives of barriers and facilitators to access, adherence, stigma, and persistence to treatment for substance use disorder

1. Patients with opioid use disorder report stigma as a major barrier to treatment access and adherence.
2. Structural barriers such as treatment deserts and provider shortages compound stigma effects.
3. Stigma operates at both social and healthcare levels, affecting patient engagement.
4. Qualitative data highlight lived experiences of discrimination and marginalization in treatment pathways.
5. Addressing both structural and interpersonal stigma is essential for improving treatment uptake.

Mental Illness and Substance Use Disorder Stigma: Mapping Pathways Between Structures and Individuals to Accelerate Research and Intervention

1. Structural stigma plays a central role in shaping risk, treatment access, and recovery in SUD and mental illness.
2. Structural factors influence outcomes via interpersonal stigma and individual psychological processes.
3. Key mediators include reduced access to resources, social isolation, and maladaptive behavioral responses.
4. Intersectionality amplifies stigma effects and inequalities.
5. A multi-level framework is required to design effective interventions targeting stigma.

Stigma Toward Substance Dependence: Causes, Consequences, and Potential Interventions

1. Substance dependence is among the most stigmatized health conditions globally.
2. Stigma negatively impacts multiple domains including employment, housing, relationships, and health.
3. Public, self, and structural stigma interact to reinforce barriers to recovery.
4. Internalized stigma leads to withdrawal and reduced life aspirations.
5. Effective interventions require understanding both psychological and structural drivers of stigma.

Intervention Stigma toward Medications for Opioid Use Disorder: A Systematic Review

1. Medications for opioid use disorder (MOUD) are effective but highly stigmatized.
2. Healthcare providers may equate MOUD with continued drug use and limit access to care.
3. Patients and peers may stigmatize pharmacological treatments.
4. Policy-level regulation contributes to stigma.
5. Intervention stigma reduces uptake of evidence-based treatments.

Structural Stigma, Racism, and Sexism Studies on Substance Use and Mental Health: A Review of Measures and Designs

1. Structural stigma, racism, and sexism are key determinants of substance use and mental health outcomes.
2. Structural stigma includes policies and institutional practices.
3. Studies use diverse indicators such as laws and economic systems.
4. Most research is observational.
5. Structural determinants operate across populations.

Neurobiology and Symptomatology of Post-Acute Alcohol Withdrawal

1. Post-acute alcohol withdrawal syndrome (PAWS) includes persistent symptoms such as anxiety, dysphoria, sleep disturbance and cognitive impairment.
2. Symptoms typically emerge during early abstinence and may persist for months.
3. PAWS is associated with neurobiological alterations including changes in the nucleus accumbens and prefrontal cortex.
4. Neurochemical changes involve serotonin, cortisol, orexins and other neuroendocrine markers.
5. PAWS symptoms increase risk of relapse and require better diagnostic criteria and targeted treatments.

Promising strategies for prevention of alcohol-related brain damage through optimised management of acute alcohol withdrawal

1. Alcohol withdrawal syndrome reflects an imbalance between GABA inhibition and glutamate excitation.
2. Repeated withdrawal episodes increase neuronal excitability through the kindling phenomenon.
3. Suboptimal management of withdrawal may contribute to alcohol-related brain damage (ARBD).
4. Neuroprotective pharmacological strategies targeting glutamatergic mechanisms are being explored.
5. Improved withdrawal management may reduce long-term cognitive impairment.

Alcohol withdrawal syndrome: mechanisms, manifestations, and management

1. Chronic alcohol exposure leads to adaptive changes including downregulation of GABA receptors and upregulation of NMDA receptors.
2. Abrupt cessation produces glutamate-mediated CNS hyperexcitability.
3. Clinical manifestations include tremor, agitation, hallucinations, seizures and delirium tremens.
4. Dopaminergic and noradrenergic activation contribute to autonomic and psychiatric symptoms.
5. Treatment aims to restore inhibitory neurotransmission and reduce excitatory activity.

Identification and management of alcohol withdrawal syndrome

1. Alcohol withdrawal usually develops within 6–24 hours after abrupt reduction of heavy drinking.
2. Clinical severity ranges from mild autonomic symptoms to seizures and delirium tremens.
3. Pathophysiology involves imbalance between inhibitory GABA and excitatory glutamate systems.
4. Benzodiazepines represent the gold-standard treatment.
5. Adjunctive therapies include anticonvulsants, clonidine and beta-blockers.

Alcohol Withdrawal Syndrome: Benzodiazepines and Beyond

1. Alcohol withdrawal occurs when dependent individuals abruptly stop drinking.
2. Symptoms include tremor, anxiety, tachycardia, hypertension and hallucinations.
3. Severe withdrawal may progress to seizures or delirium tremens.
4. Benzodiazepines have the strongest evidence for treatment.
5. Other agents include anticonvulsants, adrenergic drugs and supportive vitamin therapy.

Alcohol withdrawal syndrome in medical patients

1. Alcohol withdrawal is common among hospitalized alcohol-dependent patients.
2. Symptoms range from insomnia and tremor to seizures and delirium tremens.
3. Early identification using tools such as CIWA-Ar is recommended.
4. Benzodiazepines are usually administered using symptom-triggered protocols.
5. Adjunctive therapies include fluids, electrolytes and medications for autonomic symptoms.

Alcohol withdrawal delirium – diagnosis, course and treatment

1. Delirium tremens is the most severe complication of alcohol withdrawal syndrome.
2. It combines autonomic hyperactivity with delirium and perceptual disturbances.
3. Without treatment, complications include arrhythmia, respiratory arrest and death.
4. Intensive monitoring and supportive care are essential.
5. High-dose benzodiazepines remain first-line pharmacological treatment.

Management of Alcohol Withdrawal in the Emergency Department

1. Alcohol withdrawal syndrome is a common emergency department presentation.
2. Diagnosis relies on symptoms following reduction of heavy alcohol use.
3. Benzodiazepines remain first-line treatment for acute withdrawal.
4. Alternatives such as phenobarbital or anticonvulsants may be used in selected patients.
5. Emergency management should include linkage to long-term AUD treatment.

Symptom-Triggered Therapy for Alcohol Withdrawal Syndrome

1. Benzodiazepines are the standard pharmacological treatment for alcohol withdrawal.
2. Symptom-triggered dosing guided by withdrawal scales is widely recommended.
3. Meta-analysis suggests symptom-triggered therapy reduces treatment duration.
4. It also reduces the total benzodiazepine dose required.
5. Evidence for effects on mortality or seizures remains limited.

Evaluation of the course and treatment of Alcohol Withdrawal Syndrome with the CIWA-Ar

1. The CIWA-Ar scale is widely used to monitor the severity of alcohol withdrawal syndrome.
2. Meta-analysis data show that CIWA-Ar scores significantly decrease during the course of treatment.
3. Both benzodiazepine and non‑benzodiazepine treatments reduce CIWA-Ar scores.
4. No significant difference in treatment effectiveness between these medication classes was observed.
5. The study supports the CIWA-Ar as a reliable tool for monitoring alcohol withdrawal progression.

Alcohol Use Disorder Treatment: Problems and Solutions

1. Alcohol use disorder is a major global health problem associated with high mortality and morbidity.
2. The addiction process can be conceptualized as a three‑stage cycle: binge/intoxication, withdrawal/negative affect, and preoccupation/anticipation.
3. Each stage involves dysfunction in specific neurobiological circuits related to reward, stress and executive control.
4. Effective behavioral and pharmacological treatments exist but remain underutilized.
5. Improving screening, reducing stigma and expanding treatment targets are key priorities for the field.

Comparative efficacy and safety of pharmacotherapies for alcohol withdrawal

1. Network meta‑analysis including more than 10,000 participants compared pharmacological treatments for alcohol withdrawal.
2. Benzodiazepines remain among the most effective treatments for preventing withdrawal seizures.
3. Diazepam shows evidence of reducing the risk of delirium tremens.
4. Several anticonvulsants and other agents reduce withdrawal severity scores.
5. High heterogeneity and risk of bias limit definitive comparisons across treatments.

Alcohol Withdrawal Is an Oxidative Stress Challenge for the Brain

1. Alcohol withdrawal induces oxidative stress and neuronal injury in the brain.
2. Repeated withdrawal episodes may contribute to long‑term alcohol‑related cognitive impairment.
3. Severe complications such as seizures and delirium tremens are linked to neurotoxic processes.
4. Thiamine deficiency may interact with withdrawal to increase the risk of Wernicke encephalopathy.
5. Neuroprotective strategies during withdrawal may reduce long‑term brain damage.

Sex difference in alcohol withdrawal syndrome

1. Alcohol withdrawal syndrome shows potential sex differences in clinical presentation.
2. Men appear more likely to develop severe complications such as seizures and delirium tremens.
3. Hospital length of stay and ICU admission rates do not consistently differ between sexes.
4. Men often receive higher doses of benzodiazepines in withdrawal treatment.
5. Further large‑scale studies are needed to clarify sex‑specific mechanisms and outcomes.

Management of Post‑Acute Alcohol Withdrawal

1. Post‑acute alcohol withdrawal syndrome includes symptoms such as anxiety, sleep disturbance and cognitive dysfunction.
2. These symptoms may persist for months after the acute withdrawal phase.
3. Evidence for pharmacological treatment is limited and often based on small studies.
4. Gabapentinoids and anticonvulsants show some benefit for negative affect and sleep symptoms.
5. More robust randomized trials are required to establish effective treatments for PAWS.

Prevention of alcohol withdrawal seizure recurrence and treatment in the emergency department

1. Emergency departments frequently manage patients presenting with alcohol withdrawal symptoms.
2. Benzodiazepines remain the most evidence‑based treatment for preventing withdrawal seizures.
3. Evidence does not clearly support one benzodiazepine over another.
4. Data on phenobarbital and other alternatives remain limited.
5. More research is needed to guide withdrawal management specifically in emergency settings.

Pharmacotherapy of alcohol dependence: update

1. Alcohol use disorder is associated with significant medical and psychiatric morbidity.
2. Pharmacological treatments complement psychosocial therapies in relapse prevention.
3. Acamprosate and naltrexone have the strongest evidence for reducing relapse risk.
4. Disulfiram may be effective in selected patients under supervision.
5. Advances in neurobiological research may lead to new pharmacological treatment targets.

Prégabaline sous la loupe carcérale

1. Increasing demand for pregabalin is observed in prison populations with high rates of substance use history.
2. Requests frequently display craving-like characteristics and drug-seeking behavior.
3. Psychiatric adverse effects include euphoria, disinhibition, and mood instability.
4. The authors advocate systematic refusal of prescription in detainees with addiction history.
5. The issue raises broader ethical and public health concerns regarding prescribing in correctional settings.

A Comparison of the Pharmacokinetics and Pharmacodynamics of Pregabalin and Gabapentin

1. Pregabalin demonstrates linear absorption with bioavailability ≥90% independent of dose.
2. Gabapentin exhibits saturable absorption with decreasing bioavailability at higher doses.
3. Pregabalin reaches peak plasma concentrations within approximately one hour, faster than gabapentin.
4. Both substances are renally excreted and not hepatically metabolized.
5. Pharmacokinetic differences may partly explain differences in clinical response patterns and abuse potential.

Pregabalin for generalized anxiety disorder: systematic review and meta-analysis

1. Meta-analysis of eight randomized controlled trials (n=2299) demonstrated pregabalin superiority over placebo for generalized anxiety disorder.
2. The pooled effect size was moderate (Hedges’ g=0.37) with no significant heterogeneity (I²=0%).
3. Clinical response occurs rapidly and is comparable to benzodiazepines.
4. Dropout rates did not differ significantly from placebo.
5. Pregabalin represents an effective and well-tolerated treatment option for GAD.

Pregabalin for the treatment of neuropathic pain: a narrative review

1. Pregabalin misuse is increasingly reported worldwide, particularly among individuals with substance use disorders.
2. Recreational doses frequently exceed therapeutic recommendations and are often combined with other psychoactive substances.
3. Desired effects include euphoria, disinhibition, anxiolysis, and altered perception.
4. Overdose cases and mortality associated with misuse have increased internationally.
5. Pharmacists and prescribers play a central preventive role in reducing diversion and misuse.

Détournement de la prégabaline à des fins toxicomaniaques

1. Pregabalin misuse is increasingly reported worldwide, particularly among individuals with substance use disorders.
2. Recreational doses frequently exceed therapeutic recommendations and are often combined with other psychoactive substances.
3. Desired effects include euphoria, disinhibition, anxiolysis, and altered perception.
4. Overdose cases and mortality associated with misuse have increased internationally.
5. Pharmacists and prescribers play a central preventive role in reducing diversion and misuse.

Abuse and Misuse of Pregabalin and Gabapentin: A Systematic Review Update

1. Evidence since 2016 confirms continued global growth in gabapentinoid misuse.
2. Gabapentinoids are frequently co-used with opioids and other central nervous system depressants.
3. Opioid use disorder remains the strongest predictor of gabapentinoid abuse.
4. High-dose use is associated with increased healthcare utilization and overdose risk.
5. Emerging US data complement earlier European pharmacovigilance findings.

Abuse and Misuse of Pregabalin and Gabapentin

1. Reports of gabapentinoid misuse have increased substantially since 2010.
2. Abuse prevalence is low in the general population but markedly elevated among opioid use disorder populations.
3. Misuse typically involves supratherapeutic dosing to induce euphoric or dissociative effects.
4. A history of substance use disorder represents the strongest risk factor for misuse.
5. Gabapentinoids are increasingly detected in overdose deaths, particularly in combination with opioids.

How addictive are gabapentin and pregabalin? A systematic review

1. Animal and human data show limited intrinsic rewarding properties of gabapentin and pregabalin.
2. Behavioral dependence without prior substance use disorder was extremely rare and documented in only four cases.
3. Pregabalin demonstrates somewhat higher abuse liability than gabapentin regarding self-administration durability.
4. The main risk population consists of individuals with current or past opioid or polysubstance use disorders.
5. Overdose toxicity is generally low in isolation but becomes clinically relevant when combined with opioids or sedatives.

Paliperidone palmitate vs paliperidone ER in acute schizophrenia: systematic review and network meta-analysis

1. both PP and oral paliperidone ER were superior to placebo for PANSS improvement at week 6.
2. all-cause discontinuation did not differ significantly between PP and paliperidone ER.
3. no meaningful differences were found for most efficacy or tolerability outcomes.
4. prolactin increased with both treatments, but more with oral paliperidone.
5. authors conclude that PP is a reasonable option for acute schizophrenia, but direct head‑to‑head RCTs are needed.

Efficacy and safety profile of paliperidone palmitate injections in schizophrenia: evidence-based review

1. nonadherence is a major driver of relapse and LAIs were developed to address this problem.
2. PP1M shows clear superiority to placebo in short-term RCTs for acute schizophrenia.
3. maintenance studies demonstrate significant relapse prevention versus placebo.
4. tolerability resembles risperidone with risks of prolactin elevation, weight gain, and EPS.
5. availability of 1‑, 3‑ (and emerging 6‑) monthly formulations offers flexible long-term options.

How loading dose strategies for depot paliperidone can go wrong

1. standard loading doses can produce very high early paliperidone exposure in vulnerable patients.
2. the case illustrates severe, prolonged Parkinsonism after guideline-based initiation.
3. clinicians should confirm prior tolerability before using loading strategies.
4. therapeutic drug monitoring (e.g., prolactin) may help assess excessive exposure.
5. depot formulations are powerful tools but require individualized dosing caution.

Cumulative clinical experience with paliperidone palmitate 3‑monthly (PP3M): critical appraisal

1. real‑world studies show higher treatment persistence with PP3M than with PP1M or oral agents.
2. PP3M is associated with fewer relapses, rehospitalizations, and bed days.
3. patients on PP3M tend to need fewer benzodiazepines and oral antipsychotics.
4. quality of life, stigma, and patient satisfaction often improve after switching to PP3M.
5. clinicians and caregivers generally report high satisfaction with PP3M.

Role of paliperidone palmitate 3‑monthly in clinical practice

1. >85% of patients relapse within one year after an acute episode without effective maintenance.
2. reduced dosing frequency generally improves adherence in chronic illness.
3. PP3M is the only LAI with a quarterly (12‑week) dosing interval.
4. evidence supports comparable efficacy and tolerability to PP1M for stable patients.
5. more comparative research is still needed versus other LAIs and oral agents.

Comparative pharmacology of risperidone and paliperidone

1. paliperidone differs chemically from risperidone by a single hydroxyl group.
2. this increases hydrophilicity and alters blood–brain barrier penetration.
3. risperidone and paliperidone have different 5‑HT2A/D2 binding ratios.
4. preclinical data show differential effects on mitochondrial proteins and movement.
5. these synaptic differences may influence neuronal firing and plasticity.

Paliperidone 3‑Month Injection for Treatment of Schizophrenia: A Narrative Review

1. poor adherence is a major driver of relapse and hospitalization in schizophrenia.
2. PP3M provides comparable efficacy to PP1M with a substantially longer dosing interval.
3. post‑hoc analyses show longer relapse‑free survival after PP3M than after oral paliperidone.
4. two pivotal RCTs established non‑inferiority of PP3M to PP1M for relapse prevention.
5. PP3M is generally safe and well tolerated while improving adherence.

Invega Hafyera (PP6M): Extended‑release injectable for schizophrenia

1. PP6M is the first paliperidone formulation administered every 6 months.
2. a phase III non‑inferiority trial showed comparable efficacy to PP3M.
3. pharmacokinetic exposure over 6 months is similar to PP3M with higher peak‑trough ratio.
4. lower injection frequency may improve access to care and adherence.
5. PP6M expands long‑term maintenance options for clinically stable patients.

Critical appraisal of 3‑monthly paliperidone depot injections

1. relapse prevention is a core target in schizophrenia management.
2. non‑adherence is common and strongly predicts relapse and hospitalization.
3. PP3M pharmacokinetics allow feasible 3‑monthly administration after PP1M stabilization.
4. randomized trials show significantly longer time to relapse versus placebo.
5. PP3M has a favorable safety profile and may serve as a first‑line LAI.

Clinical relevance of paliperidone palmitate 3‑monthly (PP3M)

1. PP3M significantly delays time to relapse compared with placebo.
2. PP3M is non‑inferior to PP1M for relapse‑free survival.
3. low NNT and high NNH indicate a favorable benefit–risk profile.
4. symptomatic and functional remission improve with PP3M.
5 reduced dosing frequency lowers caregiver burden and increases patient preference.

Paliperidone to Treat Psychotic Disorders

1. the review synthesizes evidence that dopamine dysregulation underlies positive psychotic symptoms.
2. paliperidone acts primarily via D2 and 5‑HT2A antagonism similar to other second‑generation antipsychotics.
3. clinical studies consistently show symptom reduction in schizophrenia and schizoaffective disorder.
4 cognitive and functional impairments remain substantial despite pharmacological improvement.
5. adherence to antipsychotic treatment is crucial for reducing relapse and suicide risk.

Paliperidone for the treatment of schizoaffective disorder

1. schizoaffective disorder requires treatment of both psychotic and mood symptoms.
2. oral paliperidone ER and monthly paliperidone palmitate were effective in acute trials.
3. benefits were observed for psychosis, mania, and depressive symptoms.
4. paliperidone worked as monotherapy and as adjunct to mood stabilizers or antidepressants.
5. long‑acting injectable formulation may improve adherence and reduce relapse risk.

Efficacy and tolerability of paliperidone in mania of bipolar disorder: a meta-analysis

1. the meta-analysis included three randomized placebo-controlled trials in acute mania.
2 paliperidone did NOT significantly improve manic symptoms versus placebo.
3 small improvements were seen in psychosocial functioning and global severity.
4 treatment was associated with more extrapyramidal medication use and weight gain.
5 serum prolactin increased significantly compared with placebo.

The current data on the 3‑month paliperidone palmitate formulation (PP3M)

1. PP3M was developed to further reduce nonadherence in stabilized patients.
2. pharmacokinetic studies show exposure comparable to monthly paliperidone.
3. peak levels occur about 3–4 weeks after injection with a long half-life.
4. pivotal RCTs demonstrated non‑inferiority to monthly paliperidone for relapse prevention.
5. real‑world data suggest fewer relapses and hospitalizations with long dosing intervals.

A Feasibility Study of Patients with Major Depression and Substance Use Disorders: Vortioxetine as Maintenance Treatment

1. vortioxetine significantly reduced depressive symptom severity over six months in patients with comorbid major depressive disorder and substance use disorders.
2. treatment was associated with improvements in global functioning and quality of life.
3. cognitive and executive functions improved during vortioxetine maintenance treatment.
4. a significant reduction in the use of several substances, particularly alcohol, cannabis, and cocaine, was observed.
5. the findings support the feasibility and potential utility of vortioxetine in dual-diagnosis populations in real-world settings.

Effect of vortioxetine in subjects with major depressive and alcohol use disorders: a 6-month retrospective analysis

1. vortioxetine significantly improved depressive symptoms in patients with comorbid major depressive disorder and alcohol use disorder.
2 remission rates were comparable between patients with and without alcohol use disorder.
3 anxiety, anhedonia, cognitive performance, and overall functioning improved during treatment.
4. vortioxetine was well tolerated and showed a favorable safety profile in this comorbid population.
5. the results suggest vortioxetine as a suitable pharmacological option within integrated treatment programs for MDD and AUD.

Effectiveness and Safety of Vortioxetine for the Treatment of Major Depressive Disorder in the Real World: A Systematic Review and Meta-Analysis

1. real-world studies show that vortioxetine produces large improvements in depressive symptom severity in patients with major depressive disorder.
2. significant benefits were also observed in cognitive functioning and functional disability.
3. pooled response and remission rates were high across observational studies.
4. vortioxetine demonstrated good tolerability with low dropout rates and nausea as the most common adverse event.
5. the findings support vortioxetine as an effective and safe antidepressant in routine clinical practice.

Vortioxetine in major depressive disorder: from mechanisms of action to clinical studies. An updated review

1. vortioxetine is a multimodal antidepressant combining serotonin reuptake inhibition with receptor modulation.
2. this pharmacological profile explains its antidepressant, anxiolytic, and procognitive effects.
3 clinical studies demonstrate favorable efficacy and tolerability compared with other antidepressants.
4 vortioxetine shows particular benefits for cognitive symptoms and functional recovery in depression.
5. the review supports vortioxetine as a promising option for patients with major depressive disorder and comorbid conditions.

Vortioxetine – pharmacological properties and use in mood disorders. The current state of knowledge

1. vortioxetine shows robust antidepressant efficacy across randomized trials, open studies, and meta-analyses.
2. the drug improves not only mood symptoms but also anhedonia and cognitive functioning.
3. its multimodal mechanism contributes to a favorable tolerability profile.
4. vortioxetine appears effective in elderly patients and in those with somatic or psychiatric comorbidities.
5. the review highlights vortioxetine as a well-tolerated option supporting functional recovery in mood disorders.

Vortioxetine for depression in adults: A systematic review and dose–response meta-analysis of randomized controlled trials

1. vortioxetine shows a clear dose–response relationship for antidepressant efficacy in major depressive disorder.
2. the estimated optimal efficacy range lies between approximately 5 and 20 mg per day.
3. higher doses are associated with increased efficacy but reduced tolerability.
4. acceptability and safety outcomes worsen modestly with increasing dosage.
5. the findings inform dose optimization and support further research beyond current licensed doses.

Negotiating the divide: Science, politics, and institutional boundaries in Swiss cannabis regulation

1. This qualitative study explores how Swiss stakeholders construct boundaries between medical and non-medical cannabis regulation.
2. Conceptual boundary work frames medical cannabis as scientific while positioning non-medical use as social or political.
3. Structural boundary work relies heavily on insurance reimbursement rules and pharmacy-based distribution.
4. Cannabis pilot trials using pharmacies challenge these boundaries and create regulatory tensions.
5. The authors argue that rigid boundary work may obscure the complex realities of cannabis use and policy.

Association of Recreational Cannabis Legalization with Frequency of Using Cannabis for Sleep

1. This population-based twin study examined associations between recreational cannabis legalization and cannabis use for sleep.
2. Legalization was associated with more frequent cannabis use for sleep, independent of mental health and sleep quality.
3. No association was observed with alcohol or prescription sleep medication use for sleep.
4. Co-use of cannabis with other sleep aids was not increased in legalization contexts.
5. Findings raise questions about self-medication for sleep in legalized environments.

The rise of psilocybin use in the United States

1. This multisource observational study documents rising psilocybin use in the United States since 2019.
2. Increases were observed across all age groups, particularly young and older adults.
3. Psilocybin use was more common among individuals with mental health conditions or chronic pain.
4. Poison center calls related to psilocybin increased substantially, especially among youth.
5. Findings underscore the need for public health surveillance alongside liberalization trends.

Molecular design of a therapeutic LSD analogue with reduced hallucinogenic potential

1. This preclinical study describes the development of a novel LSD analogue with reduced hallucinogenic effects.
2. Minor molecular modifications preserved neuroplasticity-promoting properties.
3. The compound improved behavioral measures relevant to schizophrenia in mice.
4. Hallucinogenic-like signaling and psychosis-related gene expression were minimized.
5. Results support development of non-hallucinogenic psychoplastogens for neuropsychiatric disorders.

Psychedelics for substance use disorders: are women being addressed?

1. This scoping review assessed how sex and gender are addressed in studies of psychedelics for substance use disorders.
2. Most studies underrepresented women or failed to report sex-disaggregated outcomes.
3. Few studies incorporated sex-based analyses despite known biological and social differences.
4. No studies meaningfully discussed gender implications in interpretation of results.
5. The authors call for systematic integration of sex and gender perspectives in future research.

The landscape of ketamine use disorder: Patient experiences and perspectives on current treatment options

1. This international mixed-methods survey documents a substantial burden of physical, psychological, and social harms among people with ketamine use disorder.
2. Urological symptoms, nasal damage, and gastrointestinal pain were highly prevalent, yet treatment-seeking remained low despite significant impairment.
3. Withdrawal symptoms such as craving, anxiety, and low mood were commonly reported, indicating a clinically relevant abstinence syndrome.
4. Participants who accessed care often described existing addiction services as poorly adapted to ketamine-specific harms and trajectories.
5. The findings reveal major service gaps and underline the need for ketamine-specific clinical pathways and professional training.

The impacts of policies controlling the spatial availability of take-away alcohol on consumption and harms

1. This narrative review synthesizes evidence from natural experiments evaluating policies that regulate off-premise alcohol availability.
2. Expanding alcohol sales to convenience stores was consistently associated with increased consumption and alcohol-related harms.
3. In contrast, expanding access through grocery stores showed little or no evidence of increased harm, highlighting outlet-specific effects.
4. Policies reducing allowable alcohol content were linked to fewer emergency department presentations.
5. Results support nuanced, context-sensitive alcohol availability policies integrated with pricing and marketing controls.

Effects of legal access versus illegal market cannabis on use and mental health

1. This randomized controlled trial compared regulated, pharmacy-based cannabis access with continued illegal market use.
2. Legal access was associated with a modest reduction in cannabis misuse severity over six months.
3. The reduction was most pronounced among participants with concurrent use of other substances.
4. No significant differences emerged for depressive, anxiety, or psychotic symptoms between groups.
5. Findings support regulated access models as harm-reduction tools rather than drivers of increased use or psychiatric harm.

Psilocybin-assisted psychotherapy for methamphetamine use disorder: A pilot open-label safety and feasibility study

1. This pilot open-label study evaluated the feasibility and short-term safety of psilocybin-assisted psychotherapy for methamphetamine use disorder.
2. Participants received structured preparation, a single psilocybin session, and integration therapy in an outpatient setting.
3. No serious adverse events occurred, and reported adverse effects were transient and manageable.
4. Reductions in self-reported methamphetamine use and craving were observed during follow-up.
5. Results support feasibility and justify larger randomized trials to evaluate efficacy and durability of effects.

Concomitant use of antidepressants and classic psychedelics: A scoping review

1. This scoping review examined clinical and experimental evidence on the combined use of antidepressants and classic psychedelics.
2. Across studies, concomitant use was generally safe and not associated with serotonin syndrome.
3. Some attenuation of acute psychedelic effects was reported, though findings were inconsistent.
4. Clinical improvements in depression were observed even when antidepressants were continued.
5. The review challenges routine antidepressant discontinuation and emphasizes patient safety and accessibility.

Single treatment with MM120 (lysergide) in generalized anxiety disorder

1. This phase 2b randomized clinical trial evaluated single-dose lysergide (MM120) in moderate to severe generalized anxiety disorder.
2. Doses of 100 μg and 200 μg produced clinically meaningful anxiety reductions at four weeks compared with placebo.
3. Lower doses failed to show significant effects, indicating a clear dose–response relationship.
4. Adverse effects were dose dependent and consistent with known psychedelic effects.
5. Findings support further phase 3 trials and position lysergide as a potential novel anxiolytic treatment.

The Index of Cannabis Equivalence (ICE): A user-centered approach to standardization of cannabis dose–response

1. This study proposes a user-derived standard unit to compare cannabis doses across routes of administration.
2. Survey data from over 1300 users informed equivalence estimates for smoking, vaping, and edibles.
3. The ICE prioritizes subjective intoxication and route of use rather than THC content alone.
4. Findings highlight limitations of THC-based standard units for cannabis.
5. A standardized framework could improve harm reduction messaging, research comparability, and regulatory design.

Residential treatment for individuals with substance use disorders: Assessing the evidence

1. This comprehensive review assessed the evidence base for residential treatment of substance use disorders.
2. Across reviews and individual studies, the overall level of evidence was rated as moderate.
3. Randomized trials showed mixed results when residential treatment was compared with other levels of care.
4. Methodological limitations, including sample selection and comparison groups, constrained conclusions.
5. Residential treatment remains a relevant option for individuals with high psychosocial needs, but better research is required.

5F-AKB48: A synthetic cannabinoid presenting an emerging public health concern in France

1. This retrospective analysis describes 304 cases of 5F-AKB48 exposure reported to French poison control centers.
2. Most cases involved adolescent males, with e-cigarette liquids as a common route of administration.
3. While most poisonings were mild to moderate, severe neurological symptoms occurred in a minority of cases.
4. Co-exposure with other substances increased the risk of severe outcomes.
5. Findings identify 5F-AKB48 as an emerging public health concern requiring targeted prevention and regulation.

Sip, savor, but don’t spill: mindfulness enhances alcohol enjoyment without boosting consumption

1. Two randomized controlled experiments examined whether a brief mindfulness induction alters alcohol enjoyment and consumption in low-risk drinkers.
2. Mindfulness significantly increased subjective enjoyment and positive affect during alcohol tasting while reducing negative emotions.
3. Despite enhanced enjoyment, actual alcohol consumption did not increase relative to control conditions.
4. Implicit attitudes toward alcohol remained unchanged, suggesting a dissociation between affective experience and behavioral impulse.
5. Findings highlight that mindfulness may intensify sensory reward without reinforcing use, depending on motivational and regulatory context.

How the brain decides which moments you’ll never forget

1. Experimental studies examined how emotionally salient events influence memory for temporally adjacent neutral experiences.
2. Emotionally charged moments retroactively and proactively enhanced memory for otherwise mundane details.
3. Neural prioritization mechanisms favored weak memory traces when they overlapped with salient experiences.
4. The findings help explain why contextual details surrounding major life events are often vividly remembered.
5. Results suggest potential applications for learning enhancement and treatment of memory disorders.

Patient involvement in undergraduate psychiatric education: an international survey

1. An international survey assessed the extent and forms of patient involvement in undergraduate psychiatric education.
2. Levels of involvement ranged from minimal participation to fully integrated and sustainable educational roles.
3. Patient involvement was associated with perceived improvements in empathy, communication skills, and realism of training.
4. Implementation varied widely across countries and institutions, reflecting structural and cultural barriers.
5. The authors highlight patient involvement as a valuable yet underutilized educational resource in psychiatry.

A qualitative study exploring motives for the transition from injecting to smoking drugs in Vancouver, British Columbia

1. Qualitative interviews explored why people who use unregulated drugs transition from injecting to smoking.
2. Participants described smoking as a strategy to reduce injection-related harms and manage overdose risk.
3. Drug smoking was framed as a form of resilience in the context of an unpredictable and toxic drug supply.
4. Social stigma, discretion, and control over dosing shaped consumption practices.
5. Findings support expanding harm reduction services for people who smoke drugs.

Opioid Withdrawal as a Barrier to Harm Reduction

1. Community-based survey data examined how opioid withdrawal affects engagement in harm reduction behaviors.
2. Nearly half of participants reported withdrawal as a frequent barrier to drug checking and overdose prevention.
3. Depression, higher opioid use, and demographic factors were associated with lower harm reduction engagement.
4. Withdrawal altered decision-making even among individuals knowledgeable about overdose prevention.
5. Results underscore withdrawal management as a critical component of harm reduction strategies.

A Scoping Review of Interventions Addressing Social Determinants of Health and their Influence on Opioid Use Disorder Outcomes

1. This scoping review synthesized evidence on interventions targeting social determinants of health in opioid use disorder.
2. Most interventions addressed healthcare access, community context, or economic stability.
3. Outcomes included improved treatment initiation, reduced opioid use, and lower overdose risk.
4. Methodological heterogeneity and inconsistent measurement limited comparability across studies.
5. The review highlights the need for broader and more rigorous SDOH-focused interventions.

Cannabis Use Among Individuals With Psychosis After State-Level Commercial Cannabis Legalization

1. The study assessed cannabis use changes among individuals with psychosis after legalization.
2. Recreational legalization was associated with increased 30-day cannabis use.
3. Increases were larger than those observed in the general population.
4. No significant changes were observed in high-frequency use.
5. Findings have implications for cannabis regulation in vulnerable populations.

Growing pains: Administrative burden and regulatory compliance in German Cannabis Cultivation Associations

1. The study examined early implementation challenges of Cannabis Cultivation Associations in Germany.
2. Administrative burden created significant barriers to association establishment.
3. Regulatory complexity limited harm reduction and market displacement goals.
4. Stigma and financial risks affected participation.
5. Policy adjustments are needed to support effective implementation.

Behavioural Effects and Naloxone Effectiveness With New Synthetic Opioids

1. The review synthesizes evidence on behavioural effects of novel synthetic opioids.
2. Nitazenes show wide variability in potency and overdose risk.
3. Naloxone remains effective but may require higher or repeated dosing.
4. Polysubstance use complicates overdose response.
5. Findings support expanded naloxone access and drug checking services.

Questions and Concerns About MDMA-Assisted Therapy in Veterans with PTSD Symptoms

1. The study explored veterans’ attitudes toward MDMA-assisted therapy.
2. Participants expressed both hope and concerns about safety and side effects.
3. Misunderstandings about MDMA and therapy were common.
4. Concerns about addiction potential were frequently mentioned.
5. Findings inform psychoeducation and survey development for MDMA-AT.

Naloxone dosing in the era of synthetic opioids: Applying the Goldilocks principle

1. The article discusses challenges in naloxone dosing with potent synthetic opioids.
2. Both under-dosing and over-antagonism pose clinical risks.
3. A titrated, patient-specific dosing approach is recommended.
4. High-dose formulations raise new training challenges.
5. Education and monitoring are essential for safe overdose response.

A Scoping Review of the Emergence of Novel Synthetic Opioids in Australian Drug Markets

1. Novel synthetic opioids have recently emerged in Australian drug markets.
2. Nitazenes and fentanyl analogues are responsible for most reported harms.
3. Surveillance systems have detected increasing nitazene-related poisonings since 2021.
4. Some harms occurred among opioid-naïve individuals due to contaminated stimulants.
5. Drug checking and naloxone distribution are key harm reduction responses.

Higher levels of naloxone protection are associated with lower risk-taking

1. The study examined risk compensation in relation to naloxone access among people using unprescribed opioids.
2. Higher levels of naloxone protection were associated with fewer overdose risk behaviors.
3. Naloxone protection was linked to lower overdose incidence over time.
4. No evidence supported the hypothesis of increased risk-taking due to naloxone access.
5. Findings support policies promoting universal naloxone availability.

Early evidence of the effects of xylazine-adulterated fentanyl in Ohio

1. Xylazine has increasingly been detected as an adulterant in fentanyl supplies in Ohio.
2. Higher xylazine prevalence was associated with increased overdose deaths.
3. Xylazine-adulterated fentanyl may contribute substantially to excess mortality.
4. Naloxone may be less effective in xylazine-related overdoses.
5. The findings highlight the urgency of monitoring emerging adulterants.

5-Methoxy-N,N-dimethyltryptamine for alcohol use disorder: a phase 2 trial

1. A single dose of 5-MeO-DMT was tested in people with moderate to severe alcohol use disorder.
2. The intervention showed acceptable safety and tolerability.
3. Reductions in alcohol consumption and craving were observed.
4. Half of participants achieved continuous abstinence during follow-up.
5. Results support further controlled clinical trials.

Recovering in place: what the concept of place can offer recovery science

1. Recovery science has focused mainly on individual-level change.
2. The article introduces a place-based framework for understanding recovery.
3. Physical and social environments shape recovery trajectories.
4. The model integrates recovery capital with spatial perspectives.
5. Place-based approaches have implications for policy and practice.

Defining a threshold for higher potency cannabis products in legal markets

1. Cannabis potency has increased substantially in legal markets, raising public health concerns.
2. Higher THC concentrations are associated with increased risks of cannabis use disorder and psychosis.
3. Evidence does not support a clear absolute THC threshold for defining high potency products.
4. Low regulatory thresholds may be undermined by access to illegal or alternative legal markets.
5. Policymakers must balance feasibility, consumer understanding, and harm reduction goals.

Freedom is (still today) therapeutic: centenary and continuing relevance of Franco Basaglia

1. Franco Basaglia combined psychiatric reform with social and political critique.
2. His work challenged institutional psychiatry and promoted deinstitutionalisation.
3. Basaglia’s ideas remain relevant in contemporary mental health services.
4. Freedom is framed as a therapeutic principle rather than a secondary outcome.
5. His legacy informs modern debates on human rights in psychiatry.

Could alcohol-free and low-alcohol beverages be used to extinguish alcohol cravings?

1. No- and low-alcohol beverages may influence alcohol craving through associative learning.
2. Repeated exposure without alcohol could theoretically extinguish conditioned craving.
3. The approach may only be suitable for individuals pursuing abstinence.
4. Combining no/low-alcohol beverages with pharmacotherapy may enhance effects.
5. Empirical evidence is currently limited and requires further study.

The Relationship between Attachment Types and Drug of Choice: A Cluster Analysis

1. Attachment styles are associated with different substance use patterns.
2. Disorganized attachment shows increased vulnerability to opioid and sedative use.
3. Secure attachment is linked to lower substance-related risk.
4. Findings align with neurobiological models of attachment and addiction.
5. Attachment-informed interventions may improve prevention and treatment.

A scoping review and concept analysis to inform Canada’s safe(r) opioid supply research agenda

1. Safe(r) opioid supply encompasses diverse clinical and community-based approaches.
2. The literature reveals conceptual ambiguity in current usage.
3. Two main paradigms are identified: prescribed and non-medicalized supply.
4. Clear definitions are needed to assess benefits and risks.
5. Conceptual clarification can guide research and policy development.

Supporting desistance from crime: The promise of psychedelic-assisted therapy

1. Psychedelic-assisted therapy is explored as a support for desistance from crime.
2. The approach emphasizes identity change and meaning-making.
3. Justice-involved populations may particularly benefit from such interventions.
4. Community-based settings are favored over prison environments.
5. Empirical evidence on recidivism outcomes is still lacking.

Are We Doing Enough? Drug-Related Deaths as a Pressing Social Issue

1. Drug-related deaths represent a major and growing public health and social problem, particularly affecting young people.
2. Northern European countries show especially high mortality rates despite advanced health systems.
3. Current prevention efforts are insufficient and unevenly implemented across countries.
4. Drug-related mortality must be understood beyond individual risk factors, including social and structural determinants.
5. Stronger political commitment and implementation of evidence-based interventions are urgently needed.