Category: From Newswise – Addiction

Newswise — For years, even as opioid overdose deaths dramatically increased, doctors and other prescribers in the United States needed special permission from the federal government if they wanted to prescribe buprenorphine, a medication that helps patients overcome opioid addiction and prevents fatal overdoses.

That requirement, called an “X waiver”, was eliminated on January 12, 2023 due to an item in a major federal budget bill. This meant that suddenly, any clinician who had a license to prescribe controlled substances could prescribe buprenorphine.

Now, a new study by University of Michigan researchers looks at what happened in the year after that federal policy change.

Published in the New England Journal of Medicine, the study finds that the number of buprenorphine prescribers increased rapidly after the policy change. By December 2023, more than 53,600 clinicians prescribed buprenorphine, an increase of 11,500 over December 2022. 

But the rise in available treatment providers didn’t spark meaningful increases in patients getting care in 2023, the new findings show. In any given month of 2022, about 810,000 to 830,000 Americans were prescribed buprenorphine, but these numbers changed little after January 2023. 

“Our findings suggest that elimination of the federal waiver requirement reduced barriers to buprenorphine prescribing but unfortunately was insufficient to increase overall use,” said Kao-Ping Chua, M.D., Ph.D., the study’s first author.

“The fact that this policy failed to increase the number of patients with buprenorphine prescriptions through the first year of implementation highlights the many other barriers to buprenorphine prescribing that must be overcome,” added Thuy Nguyen, Ph.D., the senior author of the manuscript.

The study found a small jump in January 2023 in the number of patients starting buprenorphine for the first time. And in December 2023, more than 48,200 patients started taking the medication – up from the 46,500 patients who started in December 2022. These numbers include any patient who hadn’t received buprenorphine in at least six months.

People with opioid addiction often need to take buprenorphine daily for months to years to overcome addiction to the opioid they are trying to quit – whether it’s heroin, prescription painkillers such as hydrocodone and oxycodone, or synthetic opioids like fentanyl.

The government’s decision to eliminate the waiver was designed to decrease barriers to buprenorphine prescribing and promote access to this lifesaving drug.

The January 2023 change came after the federal government tried other tactics during the COVID-19 era, including allowing telehealth-based prescribing of buprenorphine and allowing prescribers to obtain an X waiver to prescribe buprenorphine to 30 or fewer patients without undergoing 8 hours of training.

Chua and colleagues previously showed that even with these earlier changes, the number of new patients using buprenorphine for the first time was flat between 2019 and 2022. 

The stigma against treating people with opioid addiction, and the challenge of adding new types of care and support in primary care clinics and pain clinics that are already overburdened by other patient demands may be affecting the number of patients seeking or getting care.

Chua is co-director of the Research and Data Domain at the U-M Opioid Research Institute (ORI), as well as being an assistant professor of pediatrics in the Medical School with a joint appointment in the School of Public Health, and a member of the Susan B. Meister Child Health Evaluation and Research Center and the Institute for Healthcare Policy and Innovation (IHPI).

Nguyen is a health economist at the U-M School of Public Health and member of ORI and IHPI. Co-authors include ORI co-director Amy Bohnert, Ph.D., and ORI/IHPI members Mark Bicket, M.D., Ph.D., and Pooja Lagisetty, Ph.D., as well as Rena Conti, Ph.D. of Boston University.

Several of the authors have been involved in the Michigan Opioid Collaborative, which since 2017 has helped primary care providers, hospitals and others increase the availability of buprenorphine to patients in Michigan through free consultations, training events and more.

Recently, the MOC team, including Bohnert, published findings from the effort’s first years in JAMA Network Open.

Because the MOC effort rolled out gradually across Michigan’s 83 counties, they were able to track how the number of prescribers offering buprenorphine, and the number of patients receiving it, changed in counties where MOC had a presence, compared with those where it wasn’t yet available.

The study showed a clear, sharp rise in both prescribers offering the treatment, and people receiving it, starting soon after MOC became available to support prescribers in a county. Meanwhile, no such rises happened in counties that had not yet become part of the MOC coverage area. MOC now covers all areas of the state, though the study covers a time period through 2020 when there were still more than 20 counties not yet participating.

MOC recently merged with another U-M opioid effort to become the Overdose Prevention Engagement Network, and continues to offer consultation, on-demand online training to comply with the current federal requirement, and more as well as screening tools for opioid use disorders and opioid-sparing surgical prescribing tools.  Visit https://michigan-open.org/ for more information or to seek a consultation about prescribing buprenorphine.

The study was funded by the National Institute on Drug Abuse, part of the National Institutes of Health (R01DA056438). This content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.

Buprenorphine Dispensing after Elimination of the Waiver Requirement, New England Journal of Medicine, DOI:10.1056/NEJMc2312906, https://www.nejm.org/doi/full/10.1056/NEJMc2312906

Newswise — Dara Ghahremani and Edythe London, faculty in the UCLA Health Department of Psychiatry and Biobehavioral Sciences, have been selected to join a coalition of experts from international universities to research new methods to diagnose, treat and prevent addiction disorders.  

Ghahremani and London, who are also a part of The Jane and Terry Semel Institute for Neuroscience and Human Behavior at UCLA, will be co-principal investigators in the Untangling Addiction program launched this year by the nonprofit health research organization Wellcome Leap. The three-year, $50 million project includes 13 other partnering universities and organizations and is aimed at developing new ways to quantify addiction risk and progression through biomarkers. 

The UCLA team will conduct the first large-scale probe of a nucleus in the brain known as the habenula — a region associated with the negative states experienced during withdrawal. The habenula has had strong links to addiction in animal studies but has not been adequately studied in humans. The team will assess MRI data from thousands of individuals with problematic alcohol use to determine if similar relationships are observed in humans. 

“If we do find those links, the habenula could be an important therapeutic neural target,” Ghahremani said. “For example, a relatively novel noninvasive brain stimulation technique, called low-intensity focused ultrasound, may be used to temporarily alter habenula function during periods of alcohol withdrawal to reduce symptoms and thereby reduce vulnerability to continued drug use.” 

Newswise — Opioid dependence in Scotland remains high but largely stable, according to a new University of Bristol-led analysis published in Addiction today [18 April] and by Public Health Scotland. The study is the first to estimate the number of people dependent on opioid drugs (such as heroin), and who are in or could benefit from drug treatment, among Scotland’s population since 2015/2016 estimates were published. 

Scotland has one of the highest rates of drug-related deaths in Europe, with the number of these more than doubling between 2011 and 2020. At 250-300 per million population in 2021-22, Scotland’s rate of drug-related deaths was sixteen times higher than the average in the European Union and on par with rates in North America. As part of the response to the public health emergency in drug-related deaths, the Scottish Government-commissioned study sought to understand whether the number of people with opioid dependence among its general publication is also increasing. 

To predict how many people aged 15 to 64 years old are opioid dependent, researchers from Bristol’s National Institute for Health and Care Research Health Protection Research Unit (NIHR HPRU) in Behavioural Science and Evaluation applied a statistical modelling technique using data from Public Health Scotland’s Scottish Public Health Drug Linkage Programme, including information on people in drug treatment called opioid agonist treatment (OAT – primarily methadone and buprenorphine) and data on opioid-related mortality and hospital admissions. 

In these new estimates, researchers found the prevalence of opioid dependence in Scotland to have been relatively stable between 2014/15 to 2019/20, with 47,100 people estimated to be opioid-dependent in 2019/20 – which is 1.3 per cent of the adult population aged 15-64. 

While there was weak evidence of a small reduction in the total number of people with opioid dependence since 2014/15, the extent of any change was estimated to be small (-0.07 per cent or -2,000 people). There was evidence that the population of people with opioid dependence were ageing, with estimates of the number of people aged 15 to 34 years old reducing by 5,100 and the number aged 50 to 64 years old increasing by 2,800 between 2014/15 and 2019/20. 

The research team also estimated that over 60 per cent of the population of people who were opioid-dependent received OAT at least once during 2019/20 and nearly 75 per cent had been in drug treatment in the last five years. 

Dr Hayley Jones, Associate Professor in Medical Statistics in the Bristol Medical School: Population Health Sciences (PHS), lead author and developer of the method (Multi-Parameter Estimation of Prevalence) used in Scotland, said: “This is the first time that trends in the prevalence of people with opioid dependence have been produced in Scotland, showing the value of and making the most of the high-quality linked data sets that are available there. 

“The method can be used to update the estimates in future, and can be applied in other countries that create comprehensive records of people in drug treatment and link these to data on drug-related harms.” 

Professor Matt Hickman, co-first author and director of the NIHR HPRU at the University of Bristol, added: “Importantly, our estimates suggest the substantial increase in drug-related deaths in Scotland is not due to increases in the underlying population of people with opioid dependence but because of increases in the risk of death experienced by people with opioid dependence in Scotland.” 

Professors Sharon Hutchinson and Andrew McAuley, co-authors and lead researchers at Glasgow Caledonian University, explained: “We showed that exposure to drug treatment in Scotland is high compared to many countries worldwide.  The challenge in Scotland and rest of UK, however, is to retain people in drug treatment for longer and to determine what other interventions are required to effect change at the population level – and bring down the number of drug-related deaths.” 

The public health surveillance study, commissioned by the Scottish Government, is a collaboration between Public Health Scotland, the University of Bristol, and Glasgow Caledonian University.

Paper 

‘Prevalence of opioid dependence in Scotland 2015-2020: a Multi-Parameter Estimation of Prevalence (MPEP) Study’ by A Markoulidakis, M Hickman et al. in Addiction

Newswise — Worldwide, someone dies from drug or alcohol addiction every four minutes. Now, researchers at Huntsman Mental Health Institute at the University of Utah have been selected by Wellcome Leap to research a new treatment for substance use disorder as part of a $50 million commitment to develop innovative treatments.

Brian J. Mickey, MD, PhD, professor of psychiatry at Huntsman Mental Health Institute, will lead the team of investigators with expertise in psychiatry, biomedical engineering, neuroscience, radiology, and social work to research a new, noninvasive treatment for addiction. Co-principal investigators include Jan Kubanek, PhD and Taylor Webb, PhD; co-investigators include Eric Garland, PhD, LCSW; Rana Jawish, MD; Vincent Koppelmans, PhD; and Tom Riis, PhD.

The research will be funded by the Untangling Addiction program, which is a $50 million program founded by Wellcome Leap to develop scalable measures to assess addiction susceptibility, quantify the risks stemming from addiction, and develop innovative treatments.  

“Substance use disorder is a significant global health problem, and yet the treatment options are limited,” Mickey said.  “We’re developing a non-invasive intervention for preventing and treating addiction, chronic pain, and depression. This funding will help us validate and generate the data to support the next critical step: an efficacy trial to determine the effectiveness of the intervention.”

Mickey’s team will use a novel ultrasound-based device to modulate deep brain regions and behaviors associated with opioid addiction. The goal will be to ultimately develop this approach into an individually targeted therapeutic intervention for a range of addictions.

“Addictions are brain illnesses that have enormous negative impact on individuals, families, and society,” Mickey said. “A major reason that addictions have been difficult to prevent—and treat—is that they are driven by dysfunction of deep brain regions that are challenging to access. Many psychiatric problems such as depression, anxiety, and addiction are caused by malfunction of brain circuits. This project is an example of our mission to understand how these neural circuits are dysregulated and to develop novel, circuit-targeted interventions that return the brain to a healthy state.”

“We are proud to bring Wellcome Leap’s innovative problem-solving and funding approach to our research enterprise at the University of Utah,” said Taylor Randall, President, University of Utah. “To have our mental health researchers contributing to pioneering work on addiction treatment reaffirms our commitment to improving lives through discovery.”

“What makes research like this so impactful is that it brings together a variety of disciplines to help solve complex problems in mental health,” said Mark Hyman Rapaport, MD, CEO of Huntsman Mental Health Institute. “This is particularly timely news given the groundbreaking of a new translational research building on campus focused on mental health and the brain. Our nation is in a mental health crisis, but there is hope if we can think differently and work together to change this trajectory.”

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About Huntsman Mental Health Institute

Huntsman Mental Health Institute at University of Utah Health brings together 75 years of patient care, research, and education into one of the nation’s leading academic medical centers focused on mental health. Nestled in the campus of University of Utah, Huntsman Mental Health Institute serves the community with 1,600 faculty and staff in 20 locations providing inpatient and outpatient services for youth, teens, and adults as well as a comprehensive crisis care model which includes the nationally recognized SafeUT app and the 988 Crisis hotline for Utah. Our mission is to advance mental health knowledge, hope, and healing for all. Learn more at: HMHI.utah.edu and join the conversation on Instagram, Facebook, TikTok, X and LinkedIn.

Newswise — Using data from a top video game streaming service, Puneet Manchanda, Isadore and Leon Winkelman Professor of Marketing, and PhD student Bruno Castelo Branco challenge preconceived notions of high addiction rates in the video game-playing community. 

Building off Manchanda’s previous research on addiction, the research explores a video game addiction using data on actual gaming behavior in the real world. Previous research on the addiction rate of video games has focused on individual representations of addiction through surveys and questionnaires. Rather than looking at just time played as a key indicator for addiction, Manchanda and Branco explored the rates of consumption  – whether playing video games makes you play even more. 

In their exploration of the data from the computer game streaming platform Steam, Manchanda and Branco were able to look at consumption and addictive behavior objectively.

“To consider a person addicted, our definition is that playing video games makes you want to play video games even more,” shared Branco. “Our methodological approach allows us to test each individual’s behavior separately and come up with a share of people with addiction within the gamer population.” 

Using this definition, they found that depending on the type of video game, only 14.6-18.3% of their sample of 13,400 video gamers on Steam show signs of addictive consumption. As Manchanda and Branco noted, this may be a surprising statistic depending on an individual’s relationship to the video game industry.

“If I share this with some parents, they think, ‘It’s way too low, right?’ But if I share this with gamers, they think, ‘Oh, it’s ridiculously high. Your definition of addiction must be wrong,’” shared Manchanda. “I found a similar situation when I started researching gambling. First, [advocates] have to agree with the number. The problem, then, is the valence around the number. Is it a positive or a negative? And that depends on your worldview, experience, who you are, and whether you are a video game player.”

One particularly impactful finding was the negligible differences in the rates of addiction between types of video games. There are many critics of the new style of ‘battle royale’ games, such as Fortnite, Apex Legends, and Valorant. Casual observers believe that the games are intentionally designed to increase addiction with bright animation and increased free access.

Manchanda and Branco shared that despite claims that some video games are purposefully designed to be addictive, they found that game characteristics are not strong predictors of addiction status.

“We look at the nuances of all the different types of games and try to correlate them with the addiction parameter, and we find that there isn’t a lot of correlation,” said Manchanda. “Based on our discussions with game designers, they all design games to be engaging. So perhaps one explanation is that all these games on Steam are meant to make you come back. So there’s no differential advantage one game has over the other.” 

A better predictor of addiction is an individual’s predisposition to addictive consumption. In other words, video games are not inherently addictive because of certain design elements or genres. Rather, an individual’s specific needs are being met by video games in an addictive manner.

“While playing video games related to survival, RPG, single-player, and shooter are more correlated with addiction, game type explains very little of the addictive behavior,” shared Branco. “This suggests that addiction is mostly determined by person-specific traits.”

Additionally, the study found that the addictive subgroup of the gaming population had some unique features that separated them from the total population of gamers. For example, people classified as being addicted to video games, on average, own more games, have more friends on the platform, play longer sessions, and are more likely to purchase new games.

The questions of addictive consumption of video games, which Manchanda and Branco elucidate in their research, are ongoing. In their future research, Manchanda and Branco hope to explore avenues such as video games’ impact on rational versus irrational behavior, the ethics of video game marketing and advertising, the particular design traits of specific video games, and more.

The paper, Is Video Gaming Addictive?: An Empirical Analysis has been submitted for publication.

BYLINE: Joseph McClain

Newswise — A research group centered at the University of California San Diego School of Medicine has drilled deep into a dataset of over 3 million individuals compiled by the direct-to-consumer genetics company 23andMe, Inc., and found intriguing connections between genetic factors influencing alcohol consumption and their relationship with other disorders.

The study was recently published in the Lancet eBioMedicine.

Sandra Sanchez-Roige, Ph.D., corresponding author and associate professor at UC San Diego School of Medicine Department of Psychiatry, explained that the study used genetic data to broadly classify individuals as being European, Latin American and African American. Such classifications “are needed to avoid a statistical genetics pitfall called population stratification,” noted co-author Abraham A. Palmer, Ph.D., professor and vice chair for basic research in the psychiatry department.

The researchers analyzed genetic data from the 3 million 23andMe research participants, focusing on three specific little snippets of DNA known as single-nucleotide polymorphisms, or SNPs. Sanchez-Roige explained that variants, or alleles, of these particular SNPs are “protective” against a variety of alcohol behaviors, from excessive alcohol drinking to alcohol use disorder.

One of the alcohol-protective variants they considered is very rare: the most prevalent among the three alleles found in the study showed up in 232 individuals of the 2,619,939 European cohort, 29 of the 446,646 Latin American cohort and in 7 of the 146,776 African American cohort; others are much more common. These variants affect how the body metabolizes ethanol — the intoxicating chemical in alcoholic beverages.

“The people who have the minor allele variant of the SNP convert ethanol to acetaldehyde very rapidly. And that causes a lot of negative effects,” said Sanchez-Roige. She went on to say that the resulting nausea eclipses any pleasurable effects of alcohol — think of a bad hangover that sets in almost immediately.

“These variants are primarily associated with how much someone may consume alcohol,” she said. “And they also tend to prevent alcohol use disorder, because these variants are primarily associated with the quantity of alcohol someone may drink.”

Sanchez-Roige explained that the SNP variants’ influence on alcohol consumption are well researched, but her group took a “hypothesis-free” approach to the 23andMe dataset, which contains survey data on thousands of traits and behaviors. The researchers wanted to find out if the three SNP variants might have any other effects beyond alcohol consumption.

Sanchez-Roige and Palmer noted that their group has developed a 10-year partnership with 23andMe that has focused on numerous traits, especially those with relevance for addiction. This work is the basis of an academic collaboration through the 23andMe Research Program.

They data-mined the analyses of DNA from saliva samples submitted by consenting 23andMe research participants, as well as the responses to the surveys of health and behavior available from the 23andMe database, and found a constellation of associations, not necessarily connected with alcohol. Individuals with the alcohol-protecting alleles had generally better health, including less chronic fatigue and needing less daily assistance with daily tasks.

But the paper notes individuals with the alcohol-protective alleles also had worse health outcomes in certain areas: more lifetime tobacco use, more emotional eating, more Graves’ disease and hyperthyroidism. Individuals with the alcohol-protective alleles also reported totally unexpected differences, such as more malaria, more myopia and several cancers, particularly more skin cancer and lung cancer, and more migraine with aura.

Sanchez-Roige acknowledged that there is a chicken-and-egg aspect to their findings. For example: Cardiovascular disease is just one of a number of maladies known to be associated with alcohol consumption. “So is alcohol consumption leading to these conditions?” she asks. Palmer finishes the thought: “Or do these genetic differences influence traits like malaria and skin cancer in a manner that is independent of alcohol consumption?”

Sanchez-Roige said that such broad, hypothesis-free studies are only possible if researchers have access to very large sets of data. Many datasets, including the one used in the study, rely heavily on individuals with European ancestry.

“It is important to include individuals from different ancestral backgrounds in genetic studies because it provides a more complete understanding of the genetic basis of alcohol behaviors and other conditions, all of which contributes to a more inclusive and accurate understanding of human health,” she said. “The study of only one group of genetically similar individuals (for example, individuals of shared European ancestry) could worsen health disparities by aiding discoveries that will disproportionately benefit only that population.”

She said their study opens numerous doors for future research, chasing down possible connections between the alcohol-protective alleles and conditions that have no apparent connection with alcohol consumption.

“Understanding the underlying mechanisms of these effects could have implications for treatments and preventative medicine,” Sanchez-Roige noted.

Co-authors on the paper from the University of California San Diego School of Medicine Department of Psychiatry are Mariela V. Jennings, Natasia S. Courchesne-Krak, Renata B. Cupertino and Sevim B. Bianchi. Sandra Sanchez-Roige is also associated with the Department of Medicine, Division of Genetic Medicine, Vanderbilt University.

Other co-authors are: José Jaime Martínez-Magaña, Department of Psychiatry, Division of Human Genetics, Yale University School of Medicine; Laura Vilar-Ribó, Psychiatric Genetics Unit, Group of Psychiatry, Mental Health and Addiction, Vall d’Hebron Research Institute, Universitat Autònoma de Barcelona, Barcelona, Spain; Alexander S. Hatoum, Department of Psychology & Brain Sciences, Washington University in St. Louis; Elizabeth G. Atkinson, Department of Molecular and Human Genetics, Baylor College of Medicine; Paola Giusti-Rodriguez, Department of Psychiatry, University of Florida College of Medicine; Janitza L. Montalvo-Ortiz, Department of Psychiatry, Division of Human Genetics, Yale University School of Medicine, National Center of Posttraumatic Stress Disorder, VA CT Healthcare Center; Joel Gelernter, VA CT Healthcare Center, Department of Psychiatry, West Haven CT; and Departments of Psychiatry, Genetics & Neuroscience, Yale Univ. School of Medicine; María Soler Artigas, Psychiatric Genetics Unit, Group of Psychiatry, Mental Health and Addiction, Vall d’Hebron Research Institute, Universitat Autònoma de Barcelona, Barcelona, Spain; Department of Mental Health, Hospital Universitari Vall d’Hebron, Barcelona; Biomedical Network Research Centre on Mental Health (CIBERSAM), Madrid; and Department of Genetics, Microbiology, and Statistics, Faculty of Biology, Universitat de Barcelona; Howard J. Edenberg, Department of Biochemistry and Molecular Biology, Indiana University School of Medicine; and the 23andMe Inc. Research Team, including Sarah L. Elson and Pierre Fontanillas.

The study was funded, in part, by Tobacco-Related Disease Research Program grants T32IR5226 and 28IR-0070, National Institute of Health (NIH) National Institute of Drug Abuse (NIDA) DP1DA054394, and NIH National Institute of Mental Health (NIMH) R25MH081482.

Newswise — MONTCLAIR, New Jersey (April 1, 2024) – Mountainside Medical Center proudly announces the successful acquisition of behavioral health providers from Envision Healthcare to the hospital’s employed physician enterprise, Mountainside Medical Group.  This marks a significant milestone in the hospital’s commitment to meeting the evolving needs of patients and the community.

“The decision to employ behavioral health providers comes at a crucial time, as the demand for mental health and behavioral health services continues to rise locally in New Jersey and across the country,” said Tim O’Brien, Mountainside Medical Center CEO.  “Recent studies have highlighted the growing need for accessible and comprehensive mental health care, and we are proud to take proactive steps to address this pressing issue. This acquisition not only strengthens our organization’s ability to provide holistic care but also underscores our dedication to remaining at the forefront of healthcare innovation.”

Jonathan Hertz, M.D., will continue to serve as the medical director of Behavioral Health Services. Dr. Hertz’s expertise will play a pivotal role to support the hospital’s commitment to supporting the behavioral health needs of our patients and community.

The experienced behavioral health team at Mountainside Medical Center provides a wide range of comprehensive services, including inpatient and outpatient care, counseling, psychiatry, and treatments for various conditions such as eating disorders, bipolar disorder, addiction, and more. Additionally, the hospital offers 24/7 access to emergency psychiatric services and specialized care for geriatric patients.

For more information about our Behavioral Health Services, please visit https://mountainsidehosp.com/services/behavioral-health-services.

About Mountainside Medical Center

Mountainside Medical Center has been serving Montclair and its surrounding New Jersey communities since 1891. The hospital provides patients immediate access to innovative and effective treatment alternatives at specialized centers within the hospital that focus on imaging, women’s health, cancer care, surgery, obesity, stroke and chronic kidney disease. Mountainside Medical Center is designated as a Primary Stroke Center by the NJ State Department of Health and Senior Services and is one of only a few community hospitals licensed by the State to perform emergency and elective cardiac angioplasty. To learn more about Mountainside Medical Center visit www.mountainsidehosp.com .

About Hackensack Meridian Mountainside Medical Group

The Mountainside Medical Group is a network of physicians specializing in primary care, OB/GYN, endocrinology, pulmonology, gastroenterology, otolaryngology, plastic surgery, colorectal surgery, and rheumatology created by Mountainside Medical Center. We believe people who establish a personal relationship with their doctors experience better health and quality of life. Start well and stay well with Mountainside Medical Group. Offices are located in Montclair, Bloomfield, Caldwell, Glen Ridge, Montville, Nutley, Clifton, Verona, West Caldwell, and Woodland Park. For more information, visit www.mountainsidemedicalgroup.com

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Newswise — A newly discovered feedback loop involving estrogen may explain why women might become dependent on nicotine more quickly and with less nicotine exposure than men. The research could lead to new treatments for women who are having trouble quitting nicotine-containing products such as cigarettes.

Sally Pauss is a doctoral student at the University of Kentucky College of Medicine in Lexington. She led the project.

“Studies show that women have a higher propensity to develop addiction to nicotine than men and are less successful at quitting,” said Pauss, who is working under the supervision of Terry D. Hinds Jr., an associate professor. “Our work aims to understand what makes women more susceptible to nicotine use disorder to reduce the gender disparity in treating nicotine addiction.”

The researchers found that the sex hormone estrogen induces the expression of olfactomedins, proteins that are suppressed by nicotine in key areas of the brain involved in reward and addiction. The findings suggest that estrogen–nicotine–olfactomedin interactions could be targeted with therapies to help control nicotine consumption.

Pauss will present the research at Discover BMB, the annual meeting of the American Society for Biochemistry and Molecular Biology, which will be held March 23–26 in San Antonio.

“Our research has the potential to better the lives and health of women struggling with substance use,” she said. “If we can confirm that estrogen drives nicotine seeking and consumption through olfactomedins, we can design drugs that might block that effect by targeting the altered pathways. These drugs would hopefully make it easier for women to quit nicotine.”

For the new study, the researchers used large sequencing datasets of estrogen-induced genes to identify genes that are expressed in the brain and exhibit a hormone function. They found just one class of genes that met these criteria: those coding for olfactomedins. They then performed a series of studies with human uterine cells and rats to better understand the interactions between olfactomedins, estrogen and nicotine. The results suggested that estrogen activation of olfactomedins — which is suppressed when nicotine is present — might serve as a feedback loop for driving nicotine addiction processes by activating areas of the brain’s reward circuitry such as the nucleus accumbens.

The researchers are now working to replicate their findings and definitively determine the role of estrogen. This knowledge could be useful for those taking estrogen in the form of oral contraceptives or hormone replacement therapy, which might increase the risk of developing a nicotine use disorder.

The investigators also want to determine the exact olfactomedin-regulated signaling pathways that drive nicotine consumption and plan to conduct behavioral animal studies to find out how manipulation of the feedback loop affects nicotine consumption.

Sally Pauss will present this research during a poster session from 4:30–6:30 p.m. CDT on Monday, March 25, in the exhibit hall of the Henry B. González Convention Center (Poster Board No. 152) (abstract). Contact the media team for more information or to obtain a free press pass to attend the meeting.

Image available.

 

About the American Society for Biochemistry and Molecular Biology (ASBMB)

The ASBMB is a nonprofit scientific and educational organization with more than 12,000 members worldwide. Founded in 1906 to advance the science of biochemistry and molecular biology, the society publishes three peer-reviewed journals, advocates for funding of basic research and education, supports science education at all levels, and promotes the diversity of individuals entering the scientific workforce. www.asbmb.org

Find more news briefs at: https://discoverbmb.asbmb.org/newsroom.

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BYLINE: Patti Zielinski

Newswise — People who identify as lesbian, gay and bisexual – particularly women – respond more positively to tobacco marketing, are more inclined to smoke cigarettes daily and may have a more difficult time quitting, according to two studies by a Rutgers Health researcher.

The studies, published in the Annals of LGBTQ Public and Population Health and Preventive Medicine Reports, investigated how some among the LGBTQ population respond to tobacco marketing, how they use tobacco and their history of quitting using two large national datasets, including the Population Assessment of Tobacco and Health Study and the National Survey on Drug Use and Health.

Ollie Ganz, a faculty member at the Rutgers Institute for Nicotine and Tobacco Studies and an assistant professor at the Rutgers School of Public Health who is lead author of the studies, discussed the significance of the findings to future policy.

Why is specifically studying how sexual minority populations receive tobacco marketing important?

From previous studies, we know that sexual minority individuals are more likely to use tobacco products than heterosexual individuals. This may be because tobacco companies have targeted this population with advertising and promotions, but the impact of this has not been studied extensively. The main thing we wanted to understand in this study is, given that sexual minority individuals are exposed to more tobacco advertising than heterosexual individuals, are there also differences in terms of how receptive they are to the ads, such as having a positive response to the ads.

What did your study find regarding tobacco marketing among sexual minority individuals?

What was unique about our study is that we were able to look at subsets of the LGB population – gay men, bisexual men, lesbian/gay women and bisexual women – rather than looking at them as one group. By looking at these subgroups we discovered that lesbian/gay and bisexual women were more likely to be receptive to marketing for tobacco products overall, and that bisexual women – but not lesbian/gay women – were more likely to be receptive to marketing for cigarettes, cigars, e-cigarettes and smokeless tobacco, compared with heterosexual women.  

Among men, we discovered that gay men, but not bisexual men, were more likely to be receptive to cigar advertising compared with heterosexual men. We also found that gay and bisexual men were more likely to be receptive to e-cigarette advertising compared with heterosexual men.

In the Preventive Medicine Reports study, you also looked at subsets of the LGB population, but focused on cigarette use behaviors. What were your findings?

We discovered that sexual minority women – particularly bisexual women – are smoking at higher rates and are having a harder time quitting compared with heterosexual women. We also found that the differences in prevalence of cigarette smoking between lesbian/gay and bisexual women and heterosexual women was much greater than between the prevalence between sexual minority men and heterosexual men.

These findings show that we need more support to specifically help sexual minority women quit smoking –particularly bisexual women. This population presents unique challenges, such as greater mental health problems, and there is a need for more resources and tailored interventions to support them in quitting smoking.

How can these findings inform future policy?

In order for tobacco control policies and regulations and public education campaigns to be effective, they need to be able to identify the populations that are at greatest risk for tobacco use. They also need a body of evidence that identifies the factors that are driving elevated use among those populations so effective messages and policies can be developed that directly address those factors.

Newswise — (SACRAMENTO, Calif.) — More and more states in the U.S. are legalizing recreational cannabis, leading to concerns that teen use will increase. Tobacco consumption among high school students, including vaping and e-cigarettes, is a concerning 12.6%, although trending downward.

Researchers at UC Davis were interested in learning how the combined use of these two products — cannabis and tobacco — might impact high school students in California.

In a new study published in The Journal of Pediatrics, they found high school students who use both tobacco and cannabis products miss more school and have lower grades compared to students who don’t use either product or who use the products individually (tobacco or cannabis) but don’t combine them.

“Substance use is a main predictor of educational outcomes, including absenteeism,” said Melanie Dove, an assistant adjunct professor in the Department of Public Health Sciences and first author of the paper. “These results highlight the need for comprehensive efforts to prevent and reduce substance use from both cannabis and tobacco products among youth.”

California survey reveals students’ tobacco and cannabis use

The researchers analyzed data from the 2021-22 California Healthy Kids Survey. The anonymous, confidential survey administered by the California Department of Education asks questions about wellness, resiliency, school climate and safety. The study reviewed responses from 287,653 high school students in ninth and 11th grade.

The researchers found that among high school students in California:

• 3.7% use tobacco and cannabis
• 3.7% use cannabis only
• 1.7% use tobacco only

Students who used both tobacco and cannabis reported the highest percentage of absenteeism. On average, they missed three days of school in the past month — almost one and a half more days of absenteeism than teens who didn’t use both products.

Students who co-used tobacco and cannabis were also more likely to have lower grades than students who did not use either product.

Using an 8-point scale with an 8 representing mostly A’s and 1 representing F’s, they found the average grade for students who did not use cannabis or tobacco was 6.24, or mostly B’s.

By comparison, average grades for students who used both cannabis and tobacco were about half a grade lower, at 5.08 or mostly B- and C’s.

Students who used either cannabis or tobacco, but not both, also had slightly lower grades than nonusers: students who only used tobacco had an average grade of 5.61 (mostly B’s), and students who only used cannabis had an average grade of 5.54 (mostly B’s).

Harmful effects on student health

The U.S. Surgeon General released a report describing the health risks of e-cigarettes on youth and young adults. It explains how habits formed in youth, when the brain is still developing and learning, can result in teens getting addicted more easily.

“We know that using tobacco and cannabis puts young people at risk for longer-term addiction, behavioral issues and respiratory health problems,” said Elisa Tong, a co-author of the study. Tong is a physician at UC Davis Health and director of the Tobacco Cessation Policy Research Center. “For young people who are not current users but are exposed to use by others, the aerosol from these products is not harmless, and contains potentially harmful chemicals, heavy metals and fine particulates,” Tong said.

Schools and parents can help prevent tobacco use

The researchers noted some limitations of their study. The survey is not representative of all high school students in California. Students who were absent on the day of the survey were not included. Another limitation is that the data is based on students’ self-reported responses; even though the survey was anonymous, students may feel uncomfortable sharing their actual substance use or absence patterns and may have underreported them.

Another consideration is that the percentage of California high school students who report using any tobacco product is 6.6%, according to the 2022 California Youth Tobacco Survey. This percentage is well below the national average (12.6%) and may reflect California’s rigorous anti-smoking campaigns and the adoption of non-smoking public spaces dating back to the mid-1990s.

“While certain school factors — like peer pressure — can contribute to teen tobacco and cannabis use, schools also play a critical role in prevention, especially in partnership with families,” said Kevin Gee, a professor at the UC Davis School of Education and senior author of the paper. “One important tool available to California’s schools is the Tobacco Use Prevention Education program that, when strategically invested in intervention and cessation activities, has shown promise in reducing tobacco use among teens.”

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