A specific cognitive behavioral group therapy program for stimulant use disorder.

Introduction: Stimulant use is an important health issue. In the US in 2018, 2.8% of males and 1.5% of females older than 18 had used cocaine in the preceding 12 months. Objective: To intervene in a specific targeted group of Stimulant Use Disorder (SUD) patients according to CBT and relapse prevention theories, and to determine the program's feasibility and attendance. Method: Stimulant Use Disorder patients in addiction care were evaluated for addictive, psychological and psychiatric dimensions at baseline and conclusion in a 9-session CBT group program with several themes: define SUD, enhance motivation, involve close companions, cope with craving, decline a proposal, solve problems, invite expert patients, invest time and money, and review content. Results: In total, 41 patients attended at least one session. They were mainly poly dependent, primarily cocaine users. Sixty percent of the population also suffered from another psychiatric comorbidity. Median attendance for participants was 7/9 sessions. Conclusion: A specific targeted CBT group for stimulant dependent highly comorbid patients is feasible. These findings suggest that peers should be included in addiction care services.

Network analysis of psychotic manifestations among cocaine users.

Psychotic experiences can be described along a continuum ranging from no psychotic experience at all, to clinical psychotic disorder. Any individual in the general population may encounter psychotic experiences under certain circumstances. Transient Cocaine Induced Psychotic Symptoms (TCIPS) are a well described model of such circumstances. Therefore, our aim was to use a network analysis to get a better knowledge on the architecture of previously described risk factors and how they contributed to two different measures of psychosis (psychosis proneness and transient cocaine induced psychotic symptoms) This study is a secondary analysis conducted among 180 cocaine users in addiction care centers in Paris and Paris suburb, who were evaluated with the PDI (Peters Delusion Inventory) and the SAPS-CIP (Scale for the Assessment of Psychotic Symptoms - Cocaine Induced Psychosis). Schizophrenia diagnosis was extracted from medical record. Relevant variables significantly associated with SAPS-CIP total score or PDI at the first step were included in a network analysis to better figurate their respective associations. The network centrality measures showed that the product preferentially used (crack vs cocaine) was related to TCIPS, psychosis proneness and, to a lesser extent, schizophrenia. Secondly, in this model TCIPS is a mediator between intensive cocaine use and psychosis proneness. Thirdly, this study refines the previous knowledge on heavy cannabis use being a risk factor for TCIPS. The observed link is not direct but mediated by psychosis proneness.

Relevance of treated cocaine users' retrospective memory of first cocaine use.

Little is known regarding between-subject variability in the subjective effects of first cocaine use. This study retrospectively assesses the subjective effects of first cocaine use in 160 current treatment-seeking cocaine use disorder patients. Subjective effects of first cocaine use were evaluated with an ad-hoc questionnaire used for cannabis effects. A principal component analysis (PCA) was performed, with resulting factors correlated with clinical variables (α = 0.05). Four factors emerged in the PCA, namely Anxiety (accounting for 21.5% of questionnaire variance), Disinhibition (17.3%), Tachypsychia (16%) and Calmness (13%). Male gender was associated with Disinhibition and Tachypsychia. Cocaine severity factors were associated with Disinhibition, Tachypsychia and Calmness. Opiate, sedative and poppers uses were associated with Anxiety, Tachypsychia and Calmness. The retrospective assessment of the subjective effects of first cocaine use shows significant variability. The different dimensions of subjective first effects are influenced by age, gender and previous substance use history, as well as characteristics of first cocaine use and cocaine-related outcomes.