Search Results (213)

The article examines the protective role of the family and youth formative communities against substance and behavioral addictions in adolescence. Its aim is to synthesize knowledge of risk and protective factors and to indicate how family and community environments can lower the likelihood of risky behaviors. The first part of the paper presents a multifactorial paradigm for explaining young people’s use of psychoactive substances, drawing on data about the situation in Poland. The second part explores the social significance of the family and participation in formative groups, especially religious ones, by referring to the concepts of social capital, normative socialization, and communal rootedness. The third part depicts Scouting and the Light-Life Movement as examples of educational settings that promote a lifestyle grounded in self-discipline, abstinence, and communal responsibility. Overall, the conducted analyses conclude that the protective potential of these environments is not automatic but depends on the quality of relationships, the presence of significant adults, the credibility of norms, and the communities’ capacity to respond to young people’s experiences amid ongoing secularization and cultural individualization. Full article

Background: As understanding of addiction extends beyond substance misuse, various behavioral disorders may emerge as recognized mental health conditions, including social media use disorder (SMUD). To date, however, empirical research supporting SMUD as a distinct disorder is limited and inconsistent. The present study set out to compare the relative prevalence of elevated symptoms suggestive of SMUD between those with no mental health history and affective disorders (both unipolar depression and bipolar disorder). Methods: Participants were recruited online and completed questionnaires measuring social media use (SMU), symptoms of SMUD, depression and various psychosocial factors associated with social media use (i.e., loneliness, social support). Among those with affective disorders, we set out to identify sociodemographic and clinical features that distinguish those with comorbid SMUD (i.e., above the cut-off on the SMUD screening measure). Results: Five main findings emerged from our analyses: (1) SMUD appears unrelated to known forms of SMU; (2) Among those with no mental health history, SMUD does not present independently of elevated depressive symptoms; (3), No sociodemographic or clinical features distinguish those with clinical depression reporting comorbid SMUD; (4), Among those with bipolar disorder (BD), symptoms of hypo/mania do not distinguish those also reporting elevated SMUD symptoms; (5) And SMUD symptoms no longer differ across clinical groups after adjusting for depressive symptoms. Conclusions: Our findings suggest that SMUD is unrelated to active or passive SMU. Symptoms suggestive of SMUD may instead be a contemporary manifestation of depressive symptomology. These findings do not support the existence of SMUD as a bona fide mental health condition. Full article

Glucagon-like peptide-1 (GLP-1) receptor agonists, originally developed for type 2 diabetes and obesity, have recently attracted interest as potential modulators of addictive behavior. This narrative review summarizes current knowledge on the neurobiological basis, randomized controlled trials, and psychiatric relevance of GLP-1 analogs in substance use disorders. English-language articles available at the time of the search were reviewed between February and April 2026, with emphasis on topics most relevant to psychiatric practice. The literature suggests that GLP-1 signaling influences reward processing, cue reactivity, stress responses, relapse vulnerability, and executive control through actions in the gut–brain axis and mesocorticolimbic circuitry. Early clinical findings are most encouraging in alcohol-related outcomes, including reductions in alcohol cue reactivity, craving, alcohol self-administration, and some measures of heavy drinking, whereas evidence in nicotine dependence is mixed and appears more consistent for limiting post-cessation weight gain than for improving abstinence itself. Evidence for other substance use disorders remains preliminary. Across randomized controlled trials, interpretation is limited by small sample sizes, short follow-up, heterogeneous endpoints, and selective populations. In addition, psychiatric and behavioral safety requires careful attention, particularly regarding rapid weight loss, excessive appetite suppression, restrictive eating, dehydration, and psychological destabilization in vulnerable individuals. At present, GLP-1 receptor agonists should be regarded as promising but unproven adjunctive candidates in addiction psychiatry, warranting further rigorous trials, structured monitoring, and interdisciplinary collaboration. Full article

Relapse in substance use disorders remains a persistent clinical challenge. Identity reconstruction, the psychological transition from an internalized “addict” identity to a recovery-oriented self, may be a core coping mechanism for abstinence maintenance. This exploratory pilot stratified randomized controlled trial examined the feasibility and preliminary effects of a Narrative Therapy (NT) group intervention, delivered within an evidence-based practice framework. Forty-five male residents of a closed rehabilitation facility were randomly assigned (n = 15 each) to an 8-week NT intervention, standard psychoeducation (TAU), or waitlist control (WLC). The Self-Identity Scale and an abbreviated four-item Stimulant Relapse Risk Scale served as outcomes. The Self-Concept Clarity Scale assessed a candidate process variable. A 3 (group) × 3 (time) repeated-measure ANOVA showed significant group × time interactions for self-identity (F = 64.215, p < 0.001, and η²p = 0.754) and relapse-risk indicators (F = 62.131, p < 0.001, and η²p = 0.747). For self-identity, only the NT group showed significant within-group gains. For relapse-risk indicators, NT scores were significantly lower than both control groups at post-test and follow-up (all pairwise p ≤ 0.008), with these reductions maintained at two-month follow-up. Within-group self-concept clarity gains emerged for NT, though between-group differences were nonsignificant. Because the study was conducted in a custodial setting, the relapse-risk findings reflect psychological vulnerability rather than observed behavior. Larger adequately powered trials are needed. Full article

Background/Objectives: Electronic cigarette (e-cigarette or vape) use is increasing, especially among young adults. Since there is no data on e-cigarette use among dental students in Costa Rica, this observational study aimed to evaluate the awareness and use of vapes in students at the Faculty of Dentistry, University of Costa Rica, and identify factors that influence their use. Methods: A cross-sectional online questionnaire was administered to a sample of dental students, and their responses were assessed. A total of 244 students, with a mean age of 21.38 ± 3.29 years, were recruited between October 2024 and May 2025. Multivariate binary logistic regression was employed to analyze factors influencing ever use of e-cigarettes. Results: Of the participants, 99.17% were aware of e-cigarettes, and 60.66% had used them at least once in their lifetime, with 8.61% being current users. Sixth-year students were more likely than first-year students to believe that e-cigarettes contain carcinogenic substances (p < 0.001). Participants that were unsure if vapes are more addictive than traditional tobacco cigarettes had lower odds of ever using them (OR = 0.092, 95% CI: 0.009–0.491, p = 0.004). Fourth-year dental students had higher odds of e-cigarette use compared to first-year students (AOR = 3.050, 95% CI: 1.102–8.804, p = 0.032). The survey showed that 23.84% of the participants learned about e-cigarettes from parents, friends, or classmates, and 19.94% learned about them from social media platforms like WhatsApp, Facebook, and Instagram. Conclusions: Most of the dental students demonstrated awareness of the health impacts of vaping. While more than half of the respondents had tried e-cigarettes, current use was low. Vaping behavior was influenced by academic level and perceptions of risk and addictiveness, with social networks and peers serving as primary information sources. These findings highlight the importance of integrating targeted educational interventions into dental curricula to strengthen awareness and promote evidence-based attitudes toward vaping. Full article

Background: Mega-events like the FIFA World Cup (FWC) present unique and substantial challenges for individuals in recovery from substance use disorders (SUDs), primarily by increasing the risk of relapse. We employed a qualitative design using reflexive thematic analysis to explore the behavior of patients with SUDs during the 2022 FWC and to evaluate institutional strategies for mitigating related risks. Methods: We purposively sampled 32 participants who were present at the Naufar Center during the 2022 FWC: (i) thirteen adult patients with SUDs who were receiving treatment, and (ii) nineteen healthcare practitioners. Semi-structured patient interviews were conducted, and focus group discussions were held with a multidisciplinary team, including psychologists, nurses, and physicians. Individuals’ experiences regarding patterns in substance use behavior, environmental triggers, and the effects of institutional interventions were examined. Thematic analysis was employed to identify patterns, risks, and effective strategies. Results: Most patients maintained abstinence and only had cravings for alcohol. Triggers included public celebrations, emotional excitement, and the increased availability of addictive substances. Psychologists and physicians reported signs of behavioral destabilization; nurses observed some behavioral changes and noted logistical challenges. The participants acknowledged the supportive measures provided by Naufar, including the accessibility of clinical services, individualized therapy, social and recreational programming, and protective fan zones, which enabled them to participate in various activities during the event. Conclusions: The 2022 FWC created considerable psychological and environmental triggers for high exposure to alcohol and other substances. The supportive structured activities and tailored interventions were helpful in mitigating the risk of relapse, maintaining treatment engagement and ensuring recovery. Further research is required to explore the implications for recovery-oriented practices during culturally and socially high-risk events. Full article

Substance abuse addictions and hepatitis B infections are two major public health problems facing humanity globally, especially in areas where the two problems co-exist. A mathematical model was used in this work to study the co-dynamics of substance abuse addictions and hepatitis B infections and investigate their possible control strategies. The mathematical features of the model, such as the disease-free equilibrium, endemic equilibrium, and basic reproduction number, were computed. The stability analysis of the disease-free equilibrium and endemic equilibrium was conducted analytically. The impact of multiple control measures, including public enlightenment, rehabilitation of individuals with substance abuse disorders, treatment of persons infected with hepatitis B, and vaccination of susceptible individuals, was examined numerically. The study reveals how co-existence fundamentally alters system behavior and control effectiveness and offers new insights for designing effective control management strategies. Full article

Substance use disorder (SUD) is a chronic neuropsychiatric condition characterized by persistent drug seeking and impaired behavioral control. Dopaminergic signaling has long been recognized as a central regulator of reinforcement learning, motivation, and habit formation. Addictive substances profoundly alter dopamine transmission through multiple mechanisms. These drug-induced changes contribute to the initiation, escalation, and persistence of addictive behaviors. In addition to dopamine, the cholinergic system has emerged as an important modulator of striatal circuit function. Acetylcholine and its receptors interact extensively with dopaminergic pathways, shaping striatal signaling dynamics and influencing learning and action selection, with particularly strong relevance for nicotine dependence. In this review, we discuss how striatal dopamine and acetylcholine contribute to learning, habit formation, and addiction-related behaviors, as well as how these systems interact at the circuit level. By integrating these findings, we propose a framework for understanding how dopamine–acetylcholine interactions may influence behavioral regulation relevant to substance use disorders. Full article

Substance use disorder (SUD) is a global problem with serious psychological, physiological, and social consequences. Seeking professional help is often delayed due to a lack of self-recognition of addiction, frequently sustained by self-deception. Although self-deception is a core feature of SUD, the mechanisms underlying it remain insufficiently studied. This research examines the role of impulsivity and self-efficacy in predicting self-deceptive behaviors—manipulation and mystification—in individuals undergoing addiction rehabilitation. The sample consisted of 122 Spanish participants from therapeutic communities (Mage = 44.99, SD = 10.58; 82.8% male) who completed the Self-Deception Questionnaire (SDQ-12), the Impulsive Control Scale Ramón y Cajal (ECIRyC), and the Drug Taking Confidence Questionnaire (DTCQ). Results showed that impulsivity significantly predicted both manipulation and mystification. Manipulation was also associated with self-efficacy in managing temptation and duration of addiction, highlighting its multifaceted nature. In contrast, mystification was predicted solely by impulsivity, suggesting a stronger dependence on internal psychological processes rather than contextual factors. These findings underscore the importance of targeting impulsivity and enhancing self-efficacy in addiction treatment. Interventions such as Cognitive Behavioral Therapy (CBT), Acceptance and Commitment Therapy (ACT), and mindfulness-based approaches may be particularly effective in reducing self-deceptive behaviors and supporting long-term recovery. Full article

Internet gaming disorder (IGD) and nonmedical prescription drug use (NMPDU) are prevalent, co-occurring concerns among young adults. Although prior research links problematic gaming and substance misuse, few studies have examined this relationship in non-college populations or whether student status modifies this association. This study examined the relationship between Gaming Addiction Scale (GAS) score and NMPDU among 1022 Rhode Island young adults aged 18 to 25. In the total sample, 44.6% identified as cisgender heterosexual female, 42.4% as sexual or gender minority (SGM), and 13.0% as cisgender heterosexual male. Multivariable logistic regression estimated the adjusted association between GAS scores and NMPDU, and an interaction term between GAS and student status was tested. Overall, 12.1% reported lifetime NMPDU. Higher GAS scores were associated with increased odds of NMPDU (adjusted odds ratio [AOR] = 1.05; 95% confidence interval [CI]: 1.01–1.09). Student status alone was not significantly associated with NMPDU; however, a significant interaction was observed between GAS and student status (AOR = 1.09, 95% CI: 1.01–1.18, p = 0.031). Higher GAS scores were positively associated with NMPDU, with student status strengthening this association. Findings support screening for problematic gaming, particularly among students, and integrated prevention strategies addressing both behavioral and substance-related risks. Full article

Background: Addictive disorders are characterized by the dysregulation of neural circuits involved in reward processing, salience attribution, emotional regulation, and cognitive control. Traditional neuroimaging paradigms based on static or two-dimensional stimuli show limited ecological validity and may fail to capture the contextual complexity of real-world addictive triggers. Immersive virtual reality (VR) offers a novel approach to simulate realistic, multisensory environments capable of eliciting craving and emotional responses. Although several reviews have examined VR in addictive disorders, most combined immersive and non-immersive tools and did not restrict inclusion to studies with brain-based outcomes. Methods: This systematic review with narrative synthesis was conducted in PubMed/MEDLINE and APA PsycINFO for studies published up to 30 December 2025. This systematic review followed PRISMA 2020 and was prospectively registered in PROSPERO; due to heterogeneity, findings were synthesized narratively. Eligible studies included human participants with substance-related or behavioral addictions and employed immersive VR paradigms (e.g., head-mounted display–based environments) combined with neuroimaging or neurophysiological measures (EEG, fMRI, fNIRS, PET, or DTI). Risk of bias was assessed using ROB-2 or ROBINS-I, and overall certainty of evidence was evaluated with the GRADE framework. Results: Ten studies met the inclusion criteria, encompassing over 1450 participants with alcohol, nicotine, methamphetamine, opioid use disorders, and internet gaming disorder. Immersive VR was associated with craving-related neural responses across modalities, involving prefrontal, insular, limbic, and striatal networks. EEG studies reported spectral power changes associated with craving and attentional salience, while fMRI, fNIRS, and PET studies demonstrated activation and modulation of executive control and reward-related circuits. Preliminary longitudinal and interventional studies indicate that repeated VR exposure may induce neurobiological changes consistent with therapeutic modulation. Conclusions: Immersive VR combined with neuroimaging supports the use of immersive VR as an ecologically grounded framework to probe addiction-related brain circuits; however, larger trials and standardized reporting are needed to strengthen clinical translation. Future studies should prioritize adequately powered randomized designs, harmonized VR cue-reactivity paradigms, and transparent neuroimaging reporting to enable reproducibility and cumulative inference. Full article

The neuronal cell adhesion molecule NrCAM is widely expressed in the nervous system across the lifespan and has important physiological functions in the development of neuronal circuits through axonal growth and guidance and formation and maintenance of synapses in the cortex. NrCAM gene polymorphisms are associated with vulnerability to neuropsychiatric disorders such as schizophrenia, as well as vulnerability to substance use disorders. We investigated the effects of acute and chronic stress and the effects of systemic administration of AMPAR antagonist CNQX and NMDAR antagonist MK-801 on delay discounting in male NrCAM knockout (KO) mice and their wild-type littermate controls (WT). Under the no-stress condition, no discounting differences were found. Acute stress increased discounting and impulsivity in WTs but not in NrCAM KO mice. Chronic stress increased discounting and impulsivity in both genotypes. CNQX increased impulsive choice in WT controls but not in NrCAM KOs; impulsive choice decreased in both genotypes after MK-801 administration. Relative to WTs, NrCAM KOs had more neuronal activation in the prelimbic and orbitofrontal cortices. In NrCAM KO mice, a low dose of MK-801 decreased neuronal activation in the ventral orbitofrontal cortex and increased activation in the accumbens shell and core. These results indicate differential effects of genotype, stress, and response to glutamatergic drugs and support a role for NrCAM in stress-induced behavioral alterations relevant to addiction and psychiatric disorders. Full article

Traumatic injuries represent a significant public health challenge, affecting millions worldwide annually and necessitating acute pain management that frequently involves the use of opioid analgesics to mitigate discomfort and facilitate recovery. Although opioids remain an integral part of post-traumatic injury pain management, their use exposes trauma survivors to the risk of developing persistent use, misuse, or opioid use disorder (OUD). Pre-injury health determinants, such as age, gender, psychiatric conditions, medical conditions, and substance use history, may interact with injury-related factors to acutely escalate the risk for misuse and addiction. Despite the growing recognition of these potential vulnerabilities, there remains a lack of evidence-based clinical decision support on modifiable and non-modifiable risk factors specific to post-traumatic injury opioid risk trajectories. This review summarizes the literature related to the multifactorial contributors to opioid misuse and addiction following traumatic injury such as patient-level (e.g., demographics, behavioral health), injury-related (e.g., severity, type), and system-level (e.g., prescribing patterns) characteristics. A comprehensive literature search, inclusive of the literature from 1995 to November 2025, was performed in PubMed/MEDLINE, Scopus, and Google Scholar using combinations of terms related to “opioids,” “misuse,” “addiction,” “trauma,” and “injury.” Search keywords and operators were developed in collaboration with a university librarian. Reference lists of articles were searched and synthesized. Case reports, case series, editorials, mini-reviews, letters to editor without original data, and qualitative studies were excluded. The findings of the review are expected to provide insight into clinical-decision making as it relates to the management of pain, pain-related distress and functional impact, and co-occurring conditions that may impact injury-related outcomes and the potential likelihood of substance misuse and addiction. Full article

Addiction poses a major global public health challenge. It is characterized by high prevalence, chronic relapse and limited efficacy of available pharmacotherapies across different substance use disorders. Increasing evidence demonstrates that incretin-based therapies directly modulate metabolic signaling pathways that intercross with central reward and motivational circuits, including hypothalamic-mesolimbic networks and dopaminergic neurotransmission. As a result, agents such as glucagon-like peptide 1 receptor agonists, originally developed for the treatment of type 2 diabetes and obesity, are now being actively investigated for their role in addiction treatment. This narrative review summarizes the current knowledge on the role of incretin-based therapies in the neurobiology of addiction. Evidence from preclinical models and human studies supports the potential therapeutic effect of glucagon-like peptide 1 receptor agonists in the treatment of alcohol use disorder, nicotine dependence, and the administration of other psychoactive substances, including psychostimulants, opioids, and cannabinoids. Preclinical studies consistently demonstrate that glucagon-like peptide 1 receptor agonists reduce substance intake, attenuate reward-related behaviors, and suppress relapse-like responding. So far, human evidence remains limited and is largely derived from observational studies. Preliminary research suggests potential reductions in substance use severity and overdose risk among individuals treated with incretin-based agents. While these findings highlight incretin signaling as a promising therapeutic option in addiction, the current evidence is insufficient to support their routine clinical use in the treatment of substance dependence. Therefore, further research is required to clarify underlying mechanisms and establish clinical efficacy. In particular, well-designed randomized controlled trials are needed to determine safety, tolerance and effectiveness of incretin-based therapies across different substance use disorders. Full article

Effective pain management is central to anesthesia, critical care, and perioperative medicine, and opioids remain essential agents for moderate-to-severe pain despite ongoing concerns regarding their safety and misuse. This narrative review synthesizes the current knowledge on opioid mechanisms, clinical indications, safety considerations, and evolving strategies aimed at optimizing their use. Opioids exert their analgesic effects primarily through μ-, δ-, and κ-opioid receptors, which modulate central and peripheral nociceptive pathways. They maintain a well-established role in acute postoperative and cancer-related pain, whereas their use in chronic non-cancer pain remains controversial. Contemporary evidence suggests that physiological dependence and addiction are less frequent in appropriately selected and monitored patients, although the risk increases in the presence of psychological comorbidity, prior substance use, or adverse social determinants of health. Unequal access, prescribing variability, and persistent disparities further complicate global opioid management strategies. Recent advances, including partial agonists such as buprenorphine, dual-mechanism agents such as tapentadol, individualized titration, opioid rotation, and the integration of multimodal analgesia, support safer and more tailored prescribing. Non-pharmacological interventions, including behavioral and physical therapies, increasingly complement pharmacological strategies to minimize opioid exposure and improve functional outcomes. Clinicians must balance analgesic efficacy with adverse effects, such as tolerance, opioid-induced hyperalgesia, sedation, and respiratory depression, particularly in perioperative and critically ill populations. Opioids remain indispensable for selected indications but should be incorporated into a comprehensive, patient-centered, multimodal analgesic approach that prioritizes safety, ongoing reassessment, and individualized risk mitigation. Full article