A Behavioral Economic Examination of Sexual Behaviors in the Era of Pre-exposure Prophylaxis via Explanatory Sequential Mixed Methods.

Pre-exposure prophylaxis (PrEP) use may be associated with condom use decisions. The current investigation examined sexual decision-making in the context of PrEP among young adult men who have sex with men (MSM) between 18 and 30 years old, using an explanatory sequential mixed methods design. For the quantitative aim, 99 MSM currently taking PrEP (i.e., PrEP-experienced) and 140 MSM not currently taking PrEP (i.e., PrEP-naive) completed an online survey, including the Sexual Delay Discounting Task (SDDT), which captures likelihood of condom use. For the qualitative aim, 15 people from each group were interviewed about their (1) conceptualizations of risky sex and (2) ways they manage their sexual risk. Participants were, on average, 25.69 years old (SD = 3.07) and 64% White. Results from the quantitative aim revealed, controlling for covariates, PrEP-experienced participants exhibited significantly lower likelihood of (1) using an immediately available condom and (2) waiting for a delayed condom (i.e., sexual delay discounting) compared to PrEP-naive participants. Qualitative themes explaining what young adult MSM consider to be risky sex included: (1) any sex as risky sex, (2) risky sex as "sex without a conversation," and (3) risky sex as sex with risk for physical harm. Themes on ways young adult MSM manage sexual risk were classified as proactive, reactive, and passive. Results suggest that PrEP use is related to condom use decisions. Taken together, quantitative differences in sexual delay discounting, but qualitatively similar conceptualizations and management of risky sex, suggest that the SDDT may be a useful tool in sex research to capture processes (i.e., delay discounting) underlying sexual decision-making that may be missed by traditional self-reports. Implications of results, including potentially providing (good quality) condoms with every PrEP prescription, and future research topics are discussed.

Measuring Sexual Risk-Taking: A Systematic Review of the Sexual Delay Discounting Task.

The Sexual Delay Discounting Task (SDDT; Johnson & Bruner, 2012) is a behavioral economic task that assesses sexual risk-taking by measuring likelihood of immediate and delayed condom use. The SDDT is ecologically valid and has been used to test effects of various substances on sexual risk-taking. However, considerable variety in implementation, analysis, and reporting of the SDDT may limit rigor and reproducibility of findings. The current review synthesized studies that used the SDDT to evaluate these possible variabilities systematically. A two-step search (citation-tracking and keyword-based search) was conducted to identify studies that met inclusion criteria (i.e., used the SDDT). Eighteen peer-reviewed articles met inclusion criteria. The SDDT has been implemented primarily in three populations: individuals who use cocaine, men who have sex with men, and college students. Comparable results across diverse populations support the SDDT's validity. A few studies administered substances before the SDDT. Evidence suggests that while cocaine and alcohol increased sexual risk-taking under some conditions, buspirone decreased preference for immediate condomless sex. There was also heterogeneity in the determination of data orderliness (i.e., outliers) and inconsistent reporting of task design and analysis. Considerable differences present in methodologic approaches could influence results. Reducing variation in the administration, analysis, and reporting of the SDDT will enhance rigor and reproducibility and maximize the task's tremendous potential.

Using Crowdsourcing for Alcohol and Nicotine Use Research: Prevalence, Data Quality, and Attrition on Amazon Mechanical Turk.

BackgroundGauging the feasibility of using Amazon Mechanical Turk ® (MTurk) for various types of substance use research is precluded by a lack of information pertaining to the recruitment process in published studies utilizing it and concurrent information on data quality. ObjectiveThe present report addressed this gap by documenting the prevalence of alcohol and nicotine use, self-reported major health conditions, and information on data quality and retention on MTurk. Individuals 21 to 90 years old (N = 1101, Mdn age = 30) with United States-based MTurk accounts completed a stand-alone screening survey. The screening consisted of basic demographic, substance use, and physical/mental health questions, as well as items to gauge language proficiency/attention (i.e., data quality). ResultsPoor quality data was infrequent (6.5% of participants) and associated with self-reported non-United States residence, affirmative responding (e.g., currently pregnant, using both alcohol and nicotine), and other response characteristics (e.g., not disclosing health conditions). Among those passing quality checks, alcohol and nicotine use were relatively common (71.5% and 24.8%). Major physical (6.3%) and mental health conditions (14.8%) were less common. Despite not sending direct invitations, most eligible participants returned to and completed the main study (81.7%). Conclusions/Importance: Alcohol and nicotine use were relatively common among MTurk workers and retention rates were high. Together with the low prevalence of poor quality data, MTurk appears to remain a fruitful platform for substance use research; although researchers must be diligent in using appropriate screening tools, as substance use was sometimes associated with poor data quality and MTurk account information may not be reliable.

Attention-Deficit/Hyperactivity Disorder Symptoms Are Associated with Greater Delay Discounting of Condom-Protected Sex and Money.

Attention-deficit/hyperactivity disorder (ADHD) is associated with increased risk of detrimental life outcomes. Recent research also indicates that ADHD is associated with sexual risk behavior, such as unprotected sex. Some risky sexual behaviors may be driven, in part, by preference for immediate rewards, referred to as delay discounting, which is prominent in etiological models of ADHD. Therefore, the present study examined the effect of delay on preference for both monetary and sexual outcomes in adults with many ADHD symptoms (both on and off medication) and with fewer ADHD symptoms. Online participants (N = 275; n = 161 males, n = 114 females) completed a monetary delay discounting task, assessing preference for smaller sooner versus larger delayed hypothetical money, and the Sexual Delay Discounting Task, assessing preference for condom use in hypothetical casual sex scenarios based on delay until condom availability. Those with greater ADHD symptoms discounted delayed monetary outcomes as well as delayed condom-protected sex (i.e., preferred sooner money rewards and immediate unprotected sex) significantly more than those with fewer symptoms; however, no effect of current medication use was found across monetary or sexual delay discounting among those with greater ADHD symptoms. This study is the first to demonstrate the relation between ADHD symptoms and reduced condom-use likelihood. Increased discounting of delayed condom-protected sex might constitute one mechanism of risky sexual behavior among individuals with ADHD symptoms. Interventions geared toward increasing condom use in situations in which condoms may otherwise be unavailable, may mitigate risky sexual behaviors and their associated harms in this population.

Sexual Probability Discounting: A Mechanism for Sexually Transmitted Infection Among Undergraduate Students.

Lack of condom use among youth is a major contributor to the spread of sexually transmitted infections (STIs) including HIV/AIDS, which has lifelong deleterious health consequences. College students (N = 262) completed the Sexual Probability Discounting Task in which participants reported their likelihood of condom use under various probabilities of contracting an STI. Each participant completed the task in regard to different STIs including HIV/AIDS and different partners. Results showed that the likelihood of condom-protected sex generally decreased as HIV/AIDS and other STI contraction became less probable. Moreover, condom-protected sex likelihood was related to STI type (e.g., decreased condom-protected sex in chlamydia relative to HIV/AIDS condition) and partner desirability (decreased condom-protected sex with more desirable partners). Results are the first to show that compared to other STIs, HIV/AIDS had the most influence on condom-protected sex. Results showed probability discounting contributed to lack of condom-protected sex and offers a novel framework for examining determinants of within-subject variability in condom use.

Review: Sex-Based Differences in Treatment Outcomes for Persons With Opioid Use Disorder.

BACKGROUND AND OBJECTIVES: In order to address the current opioid crisis, research on treatment outcomes for persons with opioid use disorder (OUD) should account for biological factors that could influence individual treatment response. Women and men might have clinically meaningful differences in their experience in OUD treatment and might also have unique challenges in achieving successful, long-term recovery. This review summarizes and synthesizes the current literature on sex-based differences in OUD treatment outcomes. METHODS: Relevant literature was identified via automated and manual searches using the terms "opioid treatment outcome sex [or gender] differences" and "opiate treatment outcome sex [or gender] differences." Search methodology was consistent with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA), and were conducted within the PubMed electronic database during March and April of 2018. RESULTS: The initial PubMed search yielded 241 manuscripts and 31 original research articles that met inclusion/exclusion criteria were synthesized in this review. Several important trends emerged, including findings that women are more likely than men to present to treatment with co-occurring mental health conditions such as depression, and that women might respond particularly well to buprenorphine maintenance. DISCUSSION AND CONCLUSIONS: While much of the literature on this topic is subject to potential cohort effects, interventions that address co-occurring mental health conditions and psychosocial stress might improve treatment outcomes for women with OUD. SCIENTIFIC SIGNIFICANCE: Funding agencies and researchers should focus attention toward human laboratory studies and clinical trials that are prospectively designed to assess sex-based differences in OUD recovery. (Am J Addict 2019;28:246-261).

Systematic review of sex-based differences in opioid-based effects.

There are several biological factors that might play a role in physiological response to opioids and/or the onset of problematic opioid use; however, sex-based differences in non-analgesic opioid-based effects are poorly understood. The goal of this review is to provide a current analysis of the pre-clinical literature on sex-based differences in response to endogenous and exogenous opioids, including the interplay between sex hormones and opioid receptor-mediated neuronal activity and associated behaviours. A systematic search was performed on the following terms within PubMed between March and April 2018: 'opioid oestrogen', 'opioid progesterone', 'opioid oestradiol', and 'opioid testosterone'. Pre-clinical research on the non-analgesic, sex-based effects of opioids is disparate, both in terms of methodology and outcomes, which prohibits a cohesive summary of the results. Themes from the pre-clinical literature suggest that opioid receptor binding, coupling, and density vary as a function of hormone exposure. Findings also suggest that interactions between endogenous opioid and stress systems may differ between males and females as a function of ovarian hormones. Given the current opioid-related public health crisis, there is a pressing need to increase systematic pre-clinical and clinical research on sex-based differences in opioid-effects and opioid use disorder.

The Value of Clean Air: Comparing Discounting of Delayed Air Quality and Money Across Magnitudes.

The detrimental health effects of exposure to air pollution are well established. Fostering behavioral change concerning air quality may be challenging because the detrimental health effects of exposure to air pollution are delayed. Delay discounting, a measure of impulsive choice, encapsulates this process of choosing between the immediate conveniences of behaviors that increase pollution and the delayed consequences of prolonged exposure to poor air quality. In Experiment 1, participants completed a series of delay-discounting tasks for air quality and money. We found that participants discounted delayed air quality more than money. In Experiment 2, we investigated whether the common finding that large amounts of money are discounted less steeply than small amounts of money generalized to larger and smaller improvements in air quality. Participants discounted larger improvements in air quality less steeply than smaller improvements, indicating that the discounting of air quality shares a similar process as the discounting of money. Our results indicate that the discounting of delayed money is strongly related to the discounting of delayed air quality and that similar mechanisms may be involved in the discounting of these qualitatively different outcomes. These data are also the first to demonstrate the malleability of delay discounting of air quality, and provide important public health implications for decreasing delay discounting of air quality.

Using Spatial, Economic, and Ecological Opinion Data to Inform Gray Wolf Conservation.

Public opinion can be an influential factor in wildlife management decisions. Evaluating public opinions can help legitimize, or delegitimize, management and facilitate long-term conservation goals. This is especially true for the controversial issues surrounding the management of predators. We surveyed Montana, USA, residents during summer of 2013 to measure public opinion regarding economic and ecological impacts of the gray wolf (Canis lupus), and current management of this species. Although opinions were polarized in some areas, a greater percentage of Montanans think that wolves negatively affect the economy, but impact tourism (which contributes to the economy) positively. These differences may reflect the belief that rancher economic losses from wolf predation of cattle is greater than overall tourism gains related to wolves (e.g., wolf-watching), in addition to the perception of wolves negatively affecting big game (e.g., elk [Cervus canadensis]). Results also show that a slightly greater percentage of Montanans feel that wolves positively rather than negatively affect the ecosystem. Regarding specific practices, more Montanans than not have a positive opinion of maintaining wolves on the landscape and also support hunting of wolves. More Montanans hold negative rather than positive opinions, however, regarding wolf trapping. This result was most evident in western Montana as assessed by a spatial distribution of opinions by county and has implications for current wolf management and nontarget species. Results of ordinal regression analyses revealed that big game hunters, males, and those who held negative opinions of the effect of wolves on the Montana ecosystem and economy were significantly more likely to support both hunting and trapping practices. Living in western Montana predicted positive opinions of hunting, but alternatively, negative opinions of trapping. These results provide an understanding of public opinion of wolf management by county as well as statistical inferences that can be useful for informing more regionally oriented management practices.

Pain and withdrawal are common among patients receiving medications for opioid use disorder and associated with pain catastrophizing, negative affect, and poor sleep.

Substantial percentages of persons receiving medications for opioid use disorder (MOUD) continue to experience clinically significant levels of pain and opioid withdrawal, which may pose barriers to reducing opioid use. Continued pain, in particular, may increase the risk for psychiatric problems and poorer treatment retention, especially with a lack of adequate care for pain. The goals of these analyses were to characterize the prevalence of, and patient-level variables associated with, pain and opioid withdrawal, as well as utilization of related coping strategies and treatments. Participants were 18 years of age or older and received methadone or buprenorphine for opioid use disorder (n = 179). Participants completed this survey in person, within their MOUD clinic. Participants completed patient-level and demographic questions as well as measures of pain, withdrawal, utilization of related coping strategies, and pain treatment. Numerous participants endorsed chronic pain (41.9%) or opioid withdrawal (89.4%) and indicated reliance upon over-the-counter medications and prayer for pain management. Multiple linear regression models showed greater pain catastrophizing and negative affect accounted for variability in pain severity and pain interference, as well as opioid withdrawal. Persons who slept less and endorsed chronic pain also reported greater pain severity and interference, and pain interference was higher with increased age. These and previous findings combine to further highlight the detrimental role that pain catastrophizing and negative affect can play in pain perception and withdrawal, but also represent promising treatment targets to facilitate pain and withdrawal management and improved quality of life. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Case report: Adult with bipolar disorder and autism treated with ketamine assisted psychotherapy.

Background: Evidence has increased in recent years regarding the potential for ketamine to serve as a novel treatment option for a range of conditions, particularly depression (unipolar and bipolar). However, research regarding ketamine as a potential therapeutic for Autism Spectrum Disorder (ASD) is lacking, despite high overlap with bipolar depression and theoretical foundations for its use. Case presentation: A 29-year-old man with bipolar disorder and Autism Spectrum Disorder, type 2 diabetes, presented with mood swings and suicidal thoughts, and anger outbursts occurring daily. The patient was referred by a psychiatrist due to irritability and outbursts during the previous 5 months. These outbursts were unable to be controlled by the medications prescribed, included yelling and screaming, and the patient was unable to speak with the psychiatrist. The patient underwent ketamine assisted psychotherapy with 6 initial IV infusions of ketamine over a 1 month period followed by 2 booster IV ketamine infusions. Following ketamine treatment, dramatic reductions in outbursts were observed as well as reductions in anxiety, suicidality, and depression scores. Conclusion: This case study adds to the scant literature regarding ketamine treatment for individuals with bipolar disorder and ASD. We did not find ASD to be a contraindication for IV ketamine and ketamine assisted psychotherapy. Reductions in anger outbursts, anxiety, suicidality, and depression suggest ketamine treatment might be tailored to individuals with bipolar disorder and ASD, and additional systematized research is warranted. Although potential mechanisms of action are not clear, these data add to the discussion regarding clinical practice considerations and the potential for ketamine to improve quality of life and associated metrics.

The Blinded-Dose Purchase Task: assessing hypothetical demand based on cocaine, methamphetamine, and alcohol administration.

RATIONALE: Behavioral economic drug purchase tasks quantify the reinforcing value of a drug (i.e., demand). Although widely used to assess demand, drug expectancies are rarely accounted for and may introduce variability across participants given diverse drug experiences. OBJECTIVES: Three experiments validated and extended previous hypothetical purchase tasks by using blinded drug dose as a reinforcing stimulus, and determined hypothetical demand for experienced effects while controlling for drug expectancies. METHODS: Across three double-blind, placebo-controlled, within-subject experiments, cocaine (0, 125, 250 mg/70 kg; n=12), methamphetamine (0, 20, 40 mg; n=19), and alcohol (0, 1 g/kg alcohol; n=25) were administered and demand was assessed using the Blinded-Dose Purchase Task. Participants answered questions regarding simulated purchasing of the blinded drug dose across increasing prices. Demand metrics, subjective effects, and self-reported real-world monetary spending on drugs were evaluated. RESULTS: Data were well modeled by the demand curve function, with significantly higher intensity (purchasing at low prices) for active drug doses compared to placebo for all experiments. Unit-price analyses revealed more persistent consumption across prices (lower α) in the higher compared to lower active dose condition for methamphetamine (a similar non-significant finding emerged for cocaine). Significant associations between demand metrics, peak subjective effects, and real-world spending on drugs also emerged across all experiments. CONCLUSIONS: Orderly demand curve data revealed differences across drug and placebo conditions, and relations to real-world measures of drug spending, and subjective effects. Unit-price analyses enabled parsimonious comparisons across doses. Results lend credence to the validity of the Blinded-Dose Purchase Task, which allows for control of drug expectancies.

Are the attention checks embedded in delay discounting tasks a valid marker for data quality?

To ensure good quality delay discounting (DD) data in research recruiting via crowdsourcing platforms, including attention checks within DD tasks have become common. These attention checks are typically identical in format to the task questions but have one sensical answer (e.g., "Would you prefer $0 now or $100 in a month?"). However, the validity of these attention checks as a marker for DD or overall survey data quality has not been directly examined. To address this gap, using data from two studies (total N = 700), the validity of these DD attention checks was tested by assessing performance on other non-DD attention checks and data quality measures both specific to DD and overall survey data (e.g., providing nonsystematic DD data, responding inconsistently in questionnaires). We also tested whether failing the attention checks was associated with degree of discounting or other participant characteristics to screen for potential bias. While failing the DD attention checks was associated with a greater likelihood of nonsystematic DD data, their discriminability was inadequate, and failure was sometimes associated with individual differences (suggesting that data exclusion might introduce bias). Failing the DD attention checks was also not associated with failing other attention checks or data quality indicators. Overall, the DD attention checks do not appear to be an adequate indicator of data quality on their own, for either the DD task or surveys overall. Strategies to enhance the validity of DD attention checks and data cleaning procedures are suggested, which should be evaluated in future research. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

The Effects of the Opioid Crisis on Agricultural Industries.

Opioid use remains a significant public health crisis. However, few quantitative or qualitative data exist on the prevalence of opioid use and associated mental health conditions in agricultural industries and how it affects the industries themselves. Data on opioid use and associated consequences were collected among agricultural business owners and workers using both quantitative (n = 129) and qualitative assessment (n = 7). The prevalence of opioid use, pain, stress, and depressive symptoms as well as associated hazards were characterized among individuals who work in horticulture (nursery and landscape) and those who work in food production (livestock and crops). Qualitative interviews were also conducted to better understand individual experiences with opioid use. Opioid use was significantly higher among horticultural industries compared to food production. Pain and depressive scores were higher among those who had used opioids although stress did not differ. Importantly, substantial percentages of participants who reported opioid use also reported consequences associated with their use, including missing work, being injured at work while using, and having difficulty in completing daily tasks. These results provide initial evidence that opioid use is substantially affecting agricultural industries in terms of mental health, personal health, labor availability, and productivity.

Independent and concurrent cannabis use with alcohol, cigarettes, and other substances among college students: Rates and consequences.

Objective: The purpose of this study was to examine patterns of concurrent cannabis and other substance use and their differential associations with cannabis-related problems and academic outcomes in college students. Participants: Participants were undergraduate students (N = 263; M age = 19.1 years; 61.2% female) who were eligible if they used cannabis at least 3 days in the past month (M = 10.1 days). Method: Substance use, academic-related outcomes, and measures of Cannabis Use Disorder (CUD) severity and problems were obtained in an online survey. Results: The five groups evaluated were cannabis-only users (5.3%), cannabis and alcohol (47.1%), cannabis, alcohol and cigarettes (16.7%), cannabis, alcohol and other substances (14.8%), or all-substances (16%). Cannabis-only and all-substance users reported using cannabis most frequently (ps ≤ .034), but only the latter reported greater CUD severity, problems, and poorer academic outcomes. Discussion: College student polysubstance users may be at increased risk for poorer outcomes compared to cannabis-only users and other groups.

Methamphetamine administration dose effects on sexual desire, sexual decision making, and delay discounting.

Correlational evidence has linked methamphetamine use and HIV sexual risk behavior, but the direct effects of methamphetamine on sexual desire and sexual decision making in humans have not been tested. This study was designed to test the effect of methamphetamine administration on sexual desire and hypothetical condom-use decisions as measured by the Sexual Delay Discounting Task. Recreational stimulant users (n = 19) participated in this within-subject, placebo-controlled study comparing the effects of 0 mg, 20 mg, and 40 mg of oral methamphetamine. Compared to placebo, methamphetamine caused dose-related and time-related increases in a single-item sexual desire rating and some standard stimulant abuse liability ratings, as well as dose-related increases in the Sexual Arousal and Desire Inventory (SADI; a multidimensional scale capturing positive and negative aspects of desire/arousal). However, methamphetamine caused no significant mean differences in likelihood of condom use within the Sexual Delay Discounting Task or the Monetary Discounting Task. SADI scores were negatively correlated with change from placebo in condom use likelihood in the Sexual Delay Discounting Task for some partner conditions (i.e., decreased reported likelihood of condom use in participants who experienced increased desire/arousal and vice versa). These mixed results may be consistent with methamphetamine's role as both a treatment for attention-deficit/hyperactivity disorder and as a drug of abuse associated with increased delay discounting, and they suggest that methamphetamine's effects on discounting may be modulated by the reinforcing properties of what is being discounted. Delay discounting may be an understudied element of risky sexual decision making, particularly among individuals who use methamphetamine. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

At-risk drinking, operant demand, and cross-commodity discounting as predictors of drunk driving in underage college women.

Behavioral economics offers unique tools for assessing value and motivation associated with college drinking. Tasks that model changes in consumption as a function of price (operant demand) or the decline in an outcome's subjective value as a function of time-to-occurrence (delay discounting) provide valuable information that may efficiently supplement clinical screening instruments when characterizing alcohol use severity. The first aim of this investigation was to examine the extent to which at-risk drinking, operant demand for alcohol, and single- and cross-commodity discounting of money and alcohol predict adverse consequences of past-month drinking in underage college women (N = 72). The second aim was to determine whether these clinical and behavioral economic measures could significantly predict the odds of past-month drunk driving, a serious public health concern due to the increasing prevalence of heavy episodic drinking among women in their first 1 - 2 years of college. Results showed that higher scores on the consumption factor of the Alcohol Use Disorder Identification Test (AUDIT-C), higher Persistence (consumption amidst constraint) and Amplitude (maximum consumption) of demand, as well as lower rates of discounting for choices between alcohol now or double the amount after a delay (choosing the larger amount of alcohol even when it is delayed) significantly predicted adverse consequences of past-month drinking. Moreover, higher scores on the AUDIT-C, higher Amplitude of demand, and greater discounting for choices between alcohol now and money later (choosing immediately available alcohol at the expense of double the equivalent in delayed money) significantly predicted past-month drunk driving. We contend that operant demand along with single- and cross-commodity discounting can be viewed as intersecting measures of reinforcer value with clinical relevance to college women.

Spending Time in Nature Serves as a Protective Factor against Problematic Alcohol Use: A Structural Equation Modeling Approach.

Alcohol use in the U.S. continues to be a prevalent behavior with the potential for far-reaching personal and public health consequences. Risk factors for problematic drinking include negative affect and impulsive decision-making. Research suggests exposure to nature reduces negative affect, increases positive affect, and reduces impulsive choice. The purpose of the current study was to explore the relationships between exposure to nature (actively going out to nature and the level of greenness around the participant's daily life), affect, impulsive decision-making, and alcohol use, using structural equation modeling. Cross-sectional data (N = 340) collected online on Amazon MTurk were used to test the hypothesized relationships separately for alcohol consumption and alcohol-related problems. Actively spending time in nature was associated with lower negative affect and higher positive affect, while passive exposure to nature was only associated with higher positive affect. In turn, negative affect was positively related to both alcohol measures, while positive affect was related to increased alcohol consumption, but not alcohol-related problems. Impulsive decision-making was not related to nature or alcohol measures. Findings suggest that intentionally spending time in nature may protect against problematic alcohol use by reducing negative affect. These results warrant further research on nature as an adjunct treatment for reducing alcohol and substance-related harms and carry implications for public education and increasing accessibility to natural spaces.

Associations between alcohol use and peripheral, genetic, and epigenetic markers of oxytocin in a general sample of young and older adults.

INTRODUCTION: Human and nonhuman animal research suggests that greater oxytocin (OT) activity is protective against harmful substance use. Most research on this topic is preclinical, with few studies evaluating the association between substance use and individual differences in the human OT system. The present study sought to fill this gap by evaluating the relationship between alcohol use and multiple biological measures of OT activity in an overall low to moderate-drinking sample. METHOD: As part of a larger study, generally healthy young (n = 51) and older (n = 53) adults self-reported whether they regularly used alcohol and how much alcohol they consumed per week. Participants also provided blood samples from which peripheral OT, and in an age-heterogeneous subset of participants (n = 56) variation in the oxytocin receptor gene (the OXTR rs53576 polymorphism) and OXTR DNA methylation levels (at cytosine-guanine dinucleotide sites -860, -924, -934), were obtained. RESULTS: A-allele carriers of the OXTR rs53579 polymorphism were less likely to regularly consume alcohol. Among regular alcohol consumers, number of alcoholic drinks per week was positively associated with peripheral OT in regression models excluding observations of high influence (postdiagnostic models). Number of alcoholic drinks per week was consistently negatively associated with OXTR DNA methylation at site -860; and with OXTR DNA methylation at site -924 in postdiagnostic models. CONCLUSIONS: The significant associations between alcohol use and individual differences in OT activity support the involvement of the OT system in alcohol use, which most likely reflect the role of OT when alcohol use is under control of its rewarding properties and/or the acute impacts of alcohol on the OT system. Additional research with markers of OT activity and alcohol use, particularly longitudinal, is needed to clarify the bidirectional effects of OT and alcohol use in moderate to harmful drinking and dependence.

Using greenspace and nature exposure as an adjunctive treatment for opioid and substance use disorders: Preliminary evidence and potential mechanisms.

The demand for opioid medication to effectively treat pain has contributed to the surging opioid crisis, which is a major source of morbidity and mortality in the U.S. More than 100,000 people begin opioid maintenance treatment (OMT) annually, the standard pharmacotherapy for opioid use disorder (OUD). Although OMT is the standard care for OUD, patients often experience or develop a heightened sensitivity to pain (hyperalgesia) as a result of the opioid medication, and also have high rates of stress, affective, and anxiety-related conditions. These conditions are interactive with other behavioral and environmental correlates of opioid and other substance use disorders including impulsive decision-making (e.g., harmful opioid use associated with increased delay discounting), and a lack of alternative (i.e., substance-free) and social reinforcement. Collectively these complex and multifaceted factors constitute significant predictors of lack of adherence to OMT (and other pharmacotherapies) and relapse. There is an urgent need, therefore, to develop novel adjunctive treatments that preserve the benefits of OMT and various pharmacotherapies, and simultaneously diminish continued pain and hyperalgesia, reduce stress and anxiety-related conditions, target relevant behavioral mechanism such as impulsive choice, and also serve to enhance the value of alternative and substance free activities. Here, we discuss evidence that an environmental manipulation - access to greenspace and nature - could serve as a potential adjunctive treatment to standard pharmacotherapies by targeting multiple biological and behavioral mechanisms that standard pharmacotherapies do not address.