Institute for Health and Recovery

For decades knowledge about the etiology, epidemiology, neurobiology, typology, and treatment of addiction in various populations has been well documented and widely disseminated. In more recent years, there has been a growing interest in investigating the prevalence, multiple pathways, and mechanisms that facilitate sustained remission and long-term stable recovery. Such an endeavor is predicated on the belief that discovery of not just more effective short-term stabilization and addiction treatment protocols, but also how people achieve long-term recovery will help ameliorate current addiction crises. Such experiential knowledge could inspire and inform the testing of new service strategies to meet the dynamic recovery needs of diverse populations-services that could be coordinated with, or supplant, existing ones toward the goals of engaging affected individuals and families earlier and better supporting them across the long-term stages of recovery. The "why", "what" and "how", involved in creating and pursuing a recovery research agenda is described, with detailed attention given to twelve significant research dimensions that promise to enhance understanding of the multiple recovery pathways and mechanisms and thereby improve the precision, nature, timing, and scope of services. The article also describes how best to engage with recovery communities cross-culturally to obtain the most accurate, informative, and beneficial results. A new science of addiction recovery promises to reinvigorate and vitally inform clinical and public health efforts in ameliorating endemic harms related to addiction.

Monitoring the zoonotic potential of emerging SARS-CoV-2 variants in animals is a critical tool to protect public health. We conducted a longitudinal study in 47 households reporting people with COVID-19 in Texas in January-July 2022, during the first Omicron wave. We evaluated 105 people and 100 of their companion animals by RT-qPCR for SARS-CoV-2 at three sequential sampling events 1-2 weeks apart, starting 0-5 days after the first reported diagnosis of COVID-19 in the house. Of 47 households that reported people with COVID-19, SARS-CoV-2 was detected in 43, with 68% of people testing positive by RT-qPCR; 95.5% of people had antibodies to SARS-CoV-2. Dogs were the only animal species positive by RT-qPCR (5.4%; 3/55). Viral copies were consistently lower in dogs than household members, and no infectious virus was recovered in cell culture. Whole genome sequencing revealed household clusters of Omicron subvariants BA.1.1, BA.2.3.4 and BA.5.1.1 in people, dogs and a food bowl, confirming human-to-dog transmission within households, with no evidence of onward transmission from the infected dogs. Eleven dogs (n = 55) and two cats (n = 26) had neutralizing antibodies against SARS-CoV-2. Infection was not associated with clinical signs in pets; only two animals that tested negative for SARS-CoV-2 were reported to be sick. Nearly one-third (30.2%) of households with active COVID-19 had pets exposed to SARS-CoV-2, similar to our pre-Omicron studies, yet incidence of infection in cats was lower compared to pre-Omicron. These differences suggest that the zoonotic transmission dynamics in households may differ based on variant.

Abstract Background: Despite the widespread use of histidine-rich protein 2 (HRP2)-based rapid diagnostic tests (RDTs), purified native HRP2 antigen is not standardly used in research applications or assessment of RDTs used in the field.Methods: This report describes purification of native HRP2 (nHRP2) from the HB3 P. falciparum culture strain. As this culture strain lacks pfhrp3 from its genome, it is an excellent source of HRP2 protein only, and does not produce the closely-related HRP3. The nHRP2 protein was isolated from culture supernatant, infected red blood cells (iRBCs), and whole parasite lysate using nickel-metal chelate chromatography. Biochemical characterization of nHRP2 from HB3 culture was conducted by SDS-PAGE and western blotting, and nHRP2 was assayed by RDT, ELISA, and bead-based immunoassay.Results: Purified nHRP2 was identified by SDS-PAGE and western blot as a ~60 kDa protein that bound anti-HRP-2 monoclonal antibodies. Mouse anti-HRP2 monoclonal antibody was found to produce high optical density readings between dilutions of 1:100 and 1:3,200 by ELISA with assay signal observed up to a 1:200,000 dilution. nHRP2 yield from HB3 culture by bead-based immunoassay revealed that both culture supernatant and iRBC lysate were practical sources of large quantities of this antigen, producing a total yield of 292.4 µg of nHRP2 from two pooled culture preparations. Assessment of nHRP2 recognition by RDTs revealed that Carestart Pf HRP2 and HRP2/pLDH RDTs detected purified nHRP2 when applied at concentrations between 20.6 to 2060 ng/mL, performing within a log-fold dilution of commercially-available recombinant HRP2. The band intensity observed for the nHRP2 dilutions was equivalent to that observed for P. falciparum culture strain dilutions of 3D7 and US06 F Nigeria XII between 12.5 and 1,000 parasites/µl.Conclusions: Purified nHRP2 could be a valuable reagent for laboratory applications as well as assessment of new and existing RDTs prior to their use in clinical settings. These results establish that it is possible to extract microgram quantities of the native HRP2 antigen from HB3 culture and that this purified protein is well recognized by existing monoclonal antibody lines and RDTs.

Persistent host immune responses initiated by oral bacteria protect host against infection but may also elicit the process of sustained periodontal inflammation and subsequent alveolar bone loss. Interleukin-10 (IL-10), an anti-inflammatory cytokine, can downregulate pro-inflammatory cytokine and inhibit neutrophil migration in inflammation. IL-10-expressing regulatory B cells (B10) is termed by negatively regulating immune response through IL-10 and are mainly restricted in CD19+ CD1dhi CD5+ B cells in mice. Our current study was aimed to explore the effect of locally transferred CD19+ CD1dhi CD5+ B cells on inflammation and alveolar bone loss in an experimental periodontitis mouse model. Ligation plus P. gingivalis (Pg) infection was used to induce periodontitis in a mouse model. CD19+ CD1dhi CD5+ B cells were sorted by flow cytometry and transferred into the gingivae immediately on the fifth day after ligation. All the mice were sacrificed on day 14 after ligation. H&E staining showed that inflammatory cell infiltration was significantly reduced by the CD19+ CD1dhi CD5+ B cells. Toluidine blue staining showed that the CD19+ CD1dhi CD5+ B cells alleviated alveolar bone loss in the ligature/Pg-induced periodontitis in mice. Immunohistochemical staining showed Receptor Activator of NF-KappaB Ligand (RANKL), Interleukin-1β(IL-1β) and Interleukin-17 (IL-17) were decreased after the CD19+ CD1dhi CD5+ B cell transfer. Immunofluorescent staining showed that IL-10 was increased while the number of Ly6G+ neutrophil and its RANKL production were decreased in gingival tissue. These results indicated that locally transferred CD19+ CD1dhi CD5+ B cells may alleviate alveolar bone loss through inhibiting pro-inflammatory cytokine expression and RANKL-expressing neutrophils in the periodontitis mouse model.

Sober living houses (SLHs) are an increasingly common element of the recovery support services landscape, yet little is known about their neighborhood context. This study describes neighborhoods in which SLHs are located and examines differences by house characteristics. SLHs in Los Angeles County (N = 297) were geocoded and linked with U.S. Census, alcohol outlet, recovery resources, and accessibility data. Regression analyses tested differences by house characteristics. Co-ed houses were in neighborhoods that were less ethnically diverse and farther away from recovery resources. Larger house capacity was associated with increased density of off-premise alcohol outlets but also increased proximity to treatment. Higher fees were associated with lower neighborhood disadvantage and off-premise alcohol outlet density but the greater distance from treatment programs and other recovery resources. House characteristics are associated with neighborhood factors that both support recovery and place residents at risk.

Whereas a growing literature has sought to understand challenges involved in the dissemination and implementation of specific evidence-based practices (EBP), few studies have centered on the perspectives of front-line community providers regarding best practices, clinical ideals and barriers to quality improvement for clients with psychosis. The goal of this project was to lay a foundation for future work aimed at improving the overall quality and impact of the multifaceted services typically provided to adults with psychosis served by the public mental health system. The findings reported here draw on a series of in-depth interviews and focus groups with 34 clinicians based at multiple inner-city community mental health sites. The project was participatory and service user co-led. Analyses focus on participant's perspectives concerning optimal services for clients with psychosis and perceived barriers to improving services. Providers strongly underscored the centrality of relationship quality versus mastery of specialized techniques and of deeper experiential engagement with the subjective meaning of the experience of psychosis. Asked about barriers to quality improvement, they described both macrolevel social forces, including chronic underfunding and overreliance on manualized approaches to distress, as well as cross-cutting clinical challenges not typically captured in the literature on more specific, targeted interventions. Our discussion focuses on the implications of these findings with respect to research and quality improvement and concludes with a call to increase investment and attention to the perspectives of front-line providers and the issue of workforce and organizational capacity vis-à-vis psychosis. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

Research shows that digital social network sites (SNSs) may be valuable platforms to effect health behavior change. Little is known specifically about their ability to help address alcohol and other drug problems. This gap is noteworthy, given that individuals are already participating in existing, recovery-specific SNSs (hereafter referred to as recovery SNSs): online communities with the functionality of conventional SNSs (e.g., Facebook) that focus on substance use disorder (SUD) recovery. For example, InTheRooms.com (ITR) is a large, well-known recovery SNS that is available for free 24 hr/day via website and mobile smartphone applications. It offers recovery tools within a digital social milieu for over 430,000 registered users. To augment the knowledge base on recovery SNS platforms, we conducted an online survey of 123 ITR participants (M = 50.8 years old; 56.9% female; 93.5% White; M = 7.3 years of abstinence, range of 0-30 years; 65% cited alcohol as their primary substance). Respondents engaged with ITR, on average, for about 30 min/day several times each week. Daily meditation prompts and live online video meetings were the most commonly utilized resources. Participants generally endorsed ITR as a helpful platform, particularly with respect to increased abstinence/recovery motivation and self-efficacy. Compared to individuals abstinent for 1 or more years, those abstinent less than 1 year (including nonabstinent individuals) showed similar rates of engagement with ITR activities and similar levels of perceived benefit. Our findings suggest that longitudinal studies are warranted to examine the clinical utility of ITR and other recovery SNSs as SUD treatment adjuncts and/or recovery self-management tools. (PsycINFO Database Record

Abstract Using a quasi‐experimental design, this study examined the effectiveness of a standardized intervention model designed to build resiliency in children of women with co‐occurring mental health and substance use disorders and histories of interpersonal abuse. The children and mothers who participated in this study were a subset of the sample used for the Women, Co‐occurring Disorders and Violence Study (WCDVS). The children's intervention model consisted of three components: clinical assessment, service coordination and advocacy, and a psychoeducational skills‐building group. Children in the comparison group received individual, group, and family services. Six‐month and 12‐month outcomes were examined among 253 children. Children in the intervention group improved significantly more than children in the comparison group. © 2007 Wiley Periodicals, Inc. J Comm Psychol 35: 823–843, 2007.