National Drug Addiction Center

【目的】宮城県におけるグリーフケア，グリーフサポート情報に関する情報源，ひと目で把握できる情報源が存在しなかったため，県内の関連団体を可視化することを目的とした．【活動の概要】任意団体「東北グリーフサポート」を発足し，仙台・宮城グリーフサポートマップを作成した．また，市民公開講座およびグリーフ・フェスを開催し，一般市民を対象に認知度やニーズ調査を行った．【成果】市民公開講座参加者80名のうち20%がグリーフケア受療経験を有し，92%がマップを周囲に紹介したいと回答した．グリーフ・フェス参加者240名中，87.1%がグリーフへの理解が深まったと回答した．マップ作成とイベント開催を通し，県内における関連団体ネットワークが形成された．【結論】本活動により，県内のグリーフ関連資源を可視化でき，支援を必要とする市民が適切な支援へつながる可能性が示された．

Subthreshold depression (SD) is prevalent among Chinese undergraduates, often leading to impaired academic and social functioning, and elevated risk for major depressive disorder (MDD). Behavioral activation (BA) is an evidence-based treatment for depression, but its effectiveness and mechanisms for SD in this population remain relatively limited. This randomized controlled trial (RCT) aimed to evaluate the efficacy of a culturally adapted, group-based BA intervention for reducing SD symptoms, increasing environmental rewards (ERs), and promoting behavioral activation. Forty-one undergraduates with SD were randomly assigned to six 90-minute sessions of face-to-face BA group (n = 21) or a waitlist control (n = 20). Compared to the waitlist, the BA group showed significantly greater reductions in depressive symptoms (Beck Depression Inventory-II) from baseline to post intervention and this improvement was sustained in follow-up (Group × Time interaction, F(2,78) = 6.79, p < 0.05, partial η2 = 0.15), alongside significant increases in both BA (Behavioral Activation for Depression Scale) and ERs (Environmental Reward Observation Scale) level; whereas in the control group, no significant difference was observed in the level of BA, ERs and depressive symptoms between baseline and post intervention. However, ERs did not significantly mediate the effect on depressive symptoms (indirect effect = -0.3, 95% CI [-0.85, 0.13]). Findings support BA as a scalable, culturally relevant campus intervention and motivate larger trials to optimize mediator timing and test a more comprehensive model of change, incorporating mechanisms of both punishment attenuation (e.g., reduced avoidance) and motivational recalibration (e.g., social connectedness).

BackgroundGrowing evidence supports long-acting injectable (LAI) buprenorphine in opioid use disorder treatment. Implementation is limited due to concerns about costs as well as potential reduction of support, which could increase strain on health care services. This real-life study follows clinical patients one year prospectively and one year retrospectively from switching from daily sublingual or peroral opioid agonist treatment (OAT) to LAI buprenorphine exploring how this impacts days of inpatient care and emergency room (ER) visits.MethodsFrom electronic medical records, from four Swedish OAT clinics, we identified all patients (n=128) who had switched from sublingual or peroral OAT, to LAI buprenorphine during the first two years of implementation (2019-2021 in three clinics, 2021–2023 in the fourth). In this within-subject mirror study, patients served as their own controls. The number of days of inpatient care and ER visits were extracted from the electronic medical records using a standard operating procedure. Quasi-Poisson models were used to compare health care utilization before and after starting LAI buprenorphine.ResultsAmong the 128 patients, 28 (22%) were female and mean age was 37.8 (SD 9.0) years. Days of inpatient care were reduced by half, dropping from an average of 9.0 to 4.5 days (incidence rate ratio [IRR]: 0.5, 95% CI 0.41–0.61, p<.001), with a health care cost reduction of SEK 45,081 (~USD 4,090) per patient. The decline in days of inpatient care was even steeper among the 85 patients who remained on LAI buprenorphine treatment at 12 months (IRR 0.26, 95% CI 0.20–0.34, p<.001), with a decrease in health care costs of SEK 73,210 (~USD 6,642) per patient. ER visits showed no significant change (IRR: 0.93, 95%CI 0.79 - 1.09). One-year treatment retention to LAI buprenorphine was high (67%). Most patients who discontinued LAI buprenorphine transitioned to other sublingual/peroral forms of OAT, resulting in an overall OAT continuation rate of 89%.ConclusionsImplementation of LAI buprenorphine in OAT clinical settings was associated with a significant reduction in inpatient care and substantially reduced health care costs. These results challenge common economic hesitations and support wider integration of LAI options in opioid use disorder treatment.Clinical trial numberNot applicable.

Alzheimer's Disease is a growing health concern, with no available disease-modifying treatments. A previous report suggested that a Delta Opioid Receptor (DOR) antagonist could prevent Alzheimer's-like pathology; however, no DOR antagonists are clinically approved. We thus expanded on our previous structure-activity relationship work on morphinan scaffold DOR antagonists to generate and evaluate new DOR antagonist ligands. We identified a lead compound 12 (SRI-22136) with sub-nM DOR potency, high selectivity, and high inhibition of β-secretase activity. We further evaluated 12 in CD-1 mice, finding full antagonist efficacy at 1 mg/kg by the intraperitoneal route. We then tested the ability of 12 to prevent Alzheimer's-like pathology in a 5XFAD transgenic mouse model, with daily treatment from 2 to 5 months of age. This treatment completely prevented Alzheimer's-like pathology, including memory deficits, β-secretase activity, Aβ1-42 accumulation, and brain inflammatory markers. Together these results suggest 12 as a potential new lead compound to prevent Alzheimer's Disease.

This article analyses the diagnostic criteria for borderline personality disorder as defined in the 5th edition of Diagnostic and Statistical Manual of Mental Disorders and the 11th revision of International Classification of Diseases. The combination of categorical and dimensional diagnostic models improves its validity, which meets the needs of clinical practice. At the same time, the heterogeneity and persistent conceptual ambiguity of borderline personality disorder are emphasized. The phenomenology of comorbidity between borderline and addictive disorders is considered as overlapping symptoms that exacerbate overall clinical presentation. Challenges in diagnosing borderline personality disorder are noted when constitutional symptoms are masked by the consequences of psychoactive substance use. The article offers a brief overview of current approaches to the treatment of borderline personality disorder, highlighting the potential of ketamine therapy. The results of our own retrospective open study of 18 patients with dual (borderline personality disorder + alcohol/cocaine use disorder) and triple (borderline personality disorder + alcohol/cocaine use disorder + depression) diagnosis who received ketamine treatment are discussed. Patients received three ketamine infusions over one week (0.5–0.75 mg/kg over 40 minutes), followed by a booster session one month later. Preliminary results of treatment are discussed, which are quite comparable with the effectiveness of specialized psychotherapy. These findings suggest that ketamine therapy may offer a novel perspective on the traditionally pessimistic therapeutic outlook for borderline personality disorder.

Abstract Handwriting identification is widely accepted as scientific evidence. However, its authenticity is questioned because it depends on the appraiser's professional skills and susceptibility to deliberate false identification by expert witnesses. Consequently, there is an urgent need for an effective handwriting identification system (HWIS) that reduces reliance on the appraiser's skills and mitigates the risk of international false identification. Here, we report a HWIS that integrates a self‐powered handwriting signal data acquisition device with an advanced deep learning architecture possessing powerful feature extraction ability and one‐class classification function. The device successfully captures the characteristic differences in handwriting behavior between genuine writers and forgers, and the handwriting identification results demonstrate the excellent performance of our system, showcasing its powerful potential to solve the longstanding challenge of handwriting identification that has perplexed humans for a considerable period. Moreover, this work exhibits the system's capability for remote access and downloading the handwriting signal data through the data cloud, highlighting its practical value for fulfilling the requirements of handwriting recognition and identification applications, and it can effectively advance signature information security and ensure the protection of private information.image

Background: Substance use disorders are accompanied by a sense of shame or self- stigmatization, the degree of which may be different in men and women. Women who use substances suffer from more complications and poor treatment seeking Aim: To compare self-stigma among men and women seeking treatment for opioid dependence. Methodology: This is cross sectional observational study included 40 married(20 male, 20 female) patients of opioid dependence (ICD-10) seeking treatment for the first time in a tertiary care Addiction-treatment Center. Following informed consent, participants were interviewed using a semi-structured questionnaire (socio-demographic and substance use details), Addiction severity index (ASI) and Substance Abuse Self Stigma Scale (SASSS). Clearance from institutional ethics board obtained. Results: The primary opioid of use was Heroin (55%) in males, Injection Pentazocine (45%) in females. Mean duration of opioid use was higher in males (8.53vs5.75years). Scores on ASI did not differ significantly between the groups. Self-stigma scores were found to be significantly higher (p&lt;0.001) in females in all three subscales: self-devaluation (2.52 vs. 3.29), fear and enacted stigma (3.28 vs. 3.95), and stigma avoidance (2.79 vs. 3.63) Conclusion: Despite lower duration of drug use and similar level so f addiction severity, self- stigma was significantly higher among women with opioid dependence. These findings add to the scarce literature on female opioid dependence from India and improve the understanding of higher self-stigmatization in women with addiction and thus underscore the need for gender-sensitive clinical and public health measures.

The Attempted Suicide Short Intervention Program (ASSIP) is a brief therapy aimed at preventing repeat suicide attempts by addressing the underlying backgrounds and vulnerabilities associated with suicidal behaviour. In Switzerland, ASSIP demonstrated an 80% reduction in long-term risk of repeat suicide attempts, but a description of the implementation and effects in a Swedish context is lacking. This pilot study, as part of a larger feasibility study preparing for a future RCT, examines the clinical characteristics of individuals receiving ASSIP in Sweden, focusing on gender differences and initial outcomes. One hundred individuals who had attempted suicide were recruited from psychiatric facilities across Sweden. Demographic and clinical data were collected, including diagnostic information and details about suicide attempt methods. Suicidal intent at index suicide attempt was assessed by the Suicide Intent Scale (SIS). Attitude towards suicide, suicide ideation and behaviour and other suicide-related symptoms were measured using the Suicide Assessment Scale Self-rate (SUAS-S) at baseline and after three sessions of ASSIP, and changes in SUAS-S scores were used to assess initial outcomes. Almost half of the cohort had a mood disorder and 39% had an anxiety disorder. Men were more likely than women to use violent methods in their suicide attempts. The mean SIS score was 17.6. SUAS-S scores had decreased significantly by the third session. The findings of this pilot study showed reduced self-rated scores on SUAS among high-risk individuals after three sessions of ASSIP treatment, suggesting the potential relevance brief, targeted interventions in suicide prevention. Except for the attempt method, no gender differences were found.

In the United States, Black people face harsher health and social consequences of addiction compared to people who are not Black. These differential consequences are largely attributable to systemic racism. While addiction treatment may mitigate health disparities related to substance use, Black people also experience structural barriers and direct interpersonal racism which contribute to inequitable access and treatment outcomes. Improvements in addiction treatment for Black people are urgently needed, but there is little guidance or consensus on how to achieve this. Our interdisciplinary work group is comprised of 16 researchers and clinicians from one urban safety-net hospital in the Northeast US, and 9 community members with lived experience of substance use disorder (SUD) who came together from 2022 to 2024 for a community-engaged initiative to identify how to make addiction treatment more appealing, effective, and equitable for Black people. This paper's objective is two-fold. First, we provide a broad overview of the project, which included 6 scoping literature reviews, 7 focus groups, and 4 day-long convenings which included an additional 30 experts on addiction treatment for Black patients, drawn primarily from the Northeast U.S. Altogether, we engaged more than 70 people with expertise in substance use and treatment, the majority of whom identify as Black. Second, we present major findings from the convenings, where we identified actions that can be taken now to improve the care of Black people and challenge the racist features of our addiction treatment system. Making addiction treatment more appealing, effective, and equitable will help to achieve health equity for Black people who use substances.