Assessment of rTMS treatment effects for methamphetamine use disorder based on EEG microstates.

Microstates have been proposed as topographical maps representing large-scale resting-state networks and have recently been suggested as markers for methamphetamine use disorder (MUD). However, it is unknown whether and how they change after repetitive transcranial magnetic stimulation (rTMS) intervention. This study included a comprehensive subject population to investigate the effect of rTMS on MUD microstates. 34 patients with MUD underwent a 4-week randomized, double-blind rTMS intervention (active=17, sham=17). Two resting-state EEG recordings and VAS evaluations were conducted before and after the intervention period. Additionally, 17 healthy individuals were included as baseline controls. The modified k-means clustering method was used to calculate four microstates (MS-A∼MS-D) of EEG, and the FC network was also analyzed. The differences in microstate indicators between groups and within groups were compared. The durations of MS-A and MS-B microstates in patients with MUD were significantly lower than that in HC but showed significant improvements after rTMS intervention. Changes in microstate indicators were found to be significantly correlated with changes in craving level. Furthermore, selective modulation of the resting-state network by rTMS was observed in the FC network. The findings indicate that changes in microstates in patients with MUD are associated with craving level improvement following rTMS, suggesting they may serve as valuable evaluation markers.

Mindfulness and clinical correlates in methamphetamine use disorder.

BACKGROUND: Mindfulness-based interventions are increasingly used for the treatment of substance use disorders, including methamphetamine use disorder (MUD). Literature indicates that trait mindfulness may play a key role in the effectiveness of these treatments on therapeutic outcome, yet no prior studies have tested for differences in trait mindfulness between individuals with MUD and healthy control participants. Such differences are important for treatment implementation. OBJECTIVES: The goals of this study were to evaluate trait mindfulness and to determine its clinical correlates in individuals with MUD. METHODS: A group of participants with MUD at varying lengths of abstinence from methamphetamine (< 1h to 90 days; mean 5.4 ± 12.5 days; N=95, 53 female, 42 male) and a healthy control group (N=65, 30 female, 35 male) completed the Mindfulness Attention Awareness Scale (MAAS). Group differences and relationships between trait mindfulness and several measures of drug use and psychiatric symptoms were evaluated. RESULTS: In participants with MUD, trait mindfulness was 10% lower than in healthy controls (p < 0.001), but it was not significantly correlated with measures of drug use or craving. Across both groups, trait mindfulness was negatively correlated with state anxiety, depression, emotional dysregulation, impulsivity, and a history of childhood trauma, while it was positively correlated with self-compassion (ps < 0.001). CONCLUSION: The deficit in trait mindfulness in MUD presents a capacity that can be targeted for improved treatment outcome with mindfulness-based therapies. Trait mindfulness is inversely related to mood dysregulation.

Effects of heart rate variability biofeedback (HRVBFB) on sleep quality and depression among methamphetamine users.

Methamphetamine is garnering concern due to its increasing use worldwide. Depression and sleep quality are major mental health issues in substance users. Heart rate variability biofeedback (HRVBFB) has shown promising results in terms of reducing depression and increasing sleep quality. The present study aimed to explore the effects of HRVBFB on these two issues in methamphetamine users. Sixty-one methamphetamine users were enrolled and allocated randomly into a treatment as usual (TAU) group and a HRVBFB plus TAU group. The levels of depressive symptoms and sleep quality were assessed at intake, end of the intervention, and end of follow-up. Compared with baseline, the levels of depressive symptoms and poor sleep quality were decreased at the end of the intervention and follow-up in the HRVBFB group. The HRVBFB group exhibited a greater decrease in depressive symptoms and a better improvement in sleep quality than the TAU group. The associations of HRV indices with levels of depressive symptoms and poor sleep quality were different in the two groups. Our results showed that HRVBFB is a promising intervention for reducing depressive symptoms and improving sleep quality in methamphetamine users. The benefits with respect to depressive symptoms and poor sleep quality can extend beyond the end of HRVBFB intervention.

Methamphetamine: Mechanism of Action and Chinese Herbal Medicine Treatment for Its Addiction.

With the proliferation of synthetic drugs, research on the mechanism of action of addictive drugs and treatment methods is of great significance. Among them, methamphetamine (METH) is the most representative amphetamine synthetic drug, and the treatment of METH addiction has become an urgent medical and social problem. In recent years, the therapeutic effects of Chinese herbal medicines on METH addiction have gained widespread attention because of their non-addictiveness, multiple targets, low side effects, low cost, and other characteristics. Previous studies have identified a variety of Chinese herbal medicines with effects on METH addiction. Based on the research on METH in recent years, this article summarizes the mechanism of action of METH as the starting point and briefly reviews the Chinese herbal medicine-based treatment of METH.

Methamphetamine: Mechanism of Action and Chinese Herbal Medicine Treatment for Its Addiction / 中国结合医学杂志

With the proliferation of synthetic drugs, research on the mechanism of action of addictive drugs and treatment methods is of great significance. Among them, methamphetamine (METH) is the most representative amphetamine synthetic drug, and the treatment of METH addiction has become an urgent medical and social problem. In recent years, the therapeutic effects of Chinese herbal medicines on METH addiction have gained widespread attention because of their non-addictiveness, multiple targets, low side effects, low cost, and other characteristics. Previous studies have identified a variety of Chinese herbal medicines with effects on METH addiction. Based on the research on METH in recent years, this article summarizes the mechanism of action of METH as the starting point and briefly reviews the Chinese herbal medicine-based treatment of METH.

Characterizing Help-Seeking Searches for Substance Use Treatment From Google Trends and Assessing Their Use for Infoveillance: Longitudinal Descriptive and Validation Statistical Analysis.

BACKGROUND: There is no recognized gold standard method for estimating the number of individuals with substance use disorders (SUDs) seeking help within a given geographical area. This presents a challenge to policy makers in the effective deployment of resources for the treatment of SUDs. Internet search queries related to help seeking for SUDs using Google Trends may represent a low-cost, real-time, and data-driven infoveillance tool to address this shortfall in information. OBJECTIVE: This paper assesses the feasibility of using search query data related to help seeking for SUDs as an indicator of unmet treatment needs, demand for treatment, and predictor of the health harms related to unmet treatment needs. We explore a continuum of hypotheses to account for different outcomes that might be expected to occur depending on the demand for treatment relative to the system capacity and the timing of help seeking in relation to trajectories of substance use and behavior change. METHODS: We used negative binomial regression models to examine temporal trends in the annual SUD help-seeking internet search queries from Google Trends by US state for cocaine, methamphetamine, opioids, cannabis, and alcohol from 2010 to 2020. To validate the value of these data for surveillance purposes, we then used negative binomial regression models to investigate the relationship between SUD help-seeking searches and state-level outcomes across the continuum of care (including lack of care). We started by looking at associations with self-reported treatment need using data from the National Survey on Drug Use and Health, a national survey of the US general population. Next, we explored associations with treatment admission rates from the Treatment Episode Data Set, a national data system on SUD treatment facilities. Finally, we studied associations with state-level rates of people experiencing and dying from an opioid overdose, using data from the Agency for Healthcare Research and Quality and the CDC WONDER database. RESULTS: Statistically significant differences in help-seeking searches were observed over time between 2010 and 2020 (based on P<.05 for the corresponding Wald tests). We were able to identify outlier states for each drug over time (eg, West Virginia for both opioids and methamphetamine), indicating significantly higher help-seeking behaviors compared to national trends. Results from our validation analyses across different outcomes showed positive, statistically significant associations for the models relating to treatment need for alcohol use, treatment admissions for opioid and methamphetamine use, emergency department visits related to opioid use, and opioid overdose mortality data (based on regression coefficients having P≤.05). CONCLUSIONS: This study demonstrates the clear potential for using internet search queries from Google Trends as an infoveillance tool to predict the demand for substance use treatment spatially and temporally, especially for opioid use disorders.

'Even though you hate everything that's going on, you know they are safer at home': The role of Aboriginal and Torres Strait Islander families in methamphetamine use harm reduction and their own support needs.

INTRODUCTION: First Nations people who use methamphetamine are overrepresented in regional and remote Australia and more likely to turn to family for support. This can place strain on families. The support needs of family members of individuals using methamphetamine are poorly understood. METHODS: We conducted 19 focus groups and seven interviews with mostly First Nations community, family members and service providers. In total, 147 participants across six sites participated as part of a larger study investigating First Nations perspectives of how to address methamphetamine use and associated harms. We applied a social and emotional wellbeing framework to examine support needs and role of family in mitigating methamphetamine harms. RESULTS: Findings highlighted the importance of families in providing support to people using methamphetamine and in reducing associated harms, often without external support. The support provided encompassed practical, social, emotional, financial, access to services and maintaining cultural connection. Providing support took a toll on family and negatively impacted their own social and emotional wellbeing. DISCUSSION AND CONCLUSIONS: First Nations families play an important and under-recognised role in reducing methamphetamine-related harms and greater efforts are required to support them. Professional resources are needed to deal with impacts of methamphetamine on families; these should be pragmatic, accessible, targeted and culturally appropriate. Support for families and communities should be developed using the social and emotional wellbeing framework that recognises wellbeing and healing as intrinsically connected to holistic health, kinship, community, culture and ancestry, and socioeconomic and historical influences on peoples' lives.

[Effect of Tiaoshen acupuncture on anxiety after methamphetamine withdrawal].

OBJECTIVE: To compare the therapeutic effect between Tiaoshen acupuncture combined with psychotherapy and simple psychotherapy on anxiety after methamphetamine withdrawal. METHODS: A total of 78 patients were randomized into an observation group (39 cases, 2 cases dropped off) and a control group (39 cases, 1 case dropped off). Psychotherapy was given in the control group. On the basis of the treatment in the control group, Tiaoshen acupuncture was applied at Baihui (GV 20), Shenting (GV 24), Benshen (GB 13), Neiguan (PC 6) and Shenmen (HT 7) in the observation group. The treatment was given once a day, 6 days were as one course and totally 4 courses were required in both groups. The scores of Hamilton anxiety scale (HAMA), quality of life for drug addicts (QOL-DA) and Pittsburgh sleep quality index (PSQI) before and after treatment were observed in both groups. RESULTS: After treatment, the various scores and the total scores of HAMA, QOL-DA and PSQI were decreased compared before treatment in both groups (P<0.05), and the scores of somatic anxiety factor, the psychic anxiety factor and the total score of HAMA, each various score and the total score of QOL-DA as well as the scores of sleep quality, time to fall asleep, sleep time, daytime dysfunction and the total score of PSQI in the observation group were lower than those in the control group (P<0.05). CONCLUSION: Tiaoshen acupuncture combined with psychotherapy can relieve the anxiety in patients with anxiety after methamphetamine withdrawal, improve the quality of life and sleep, the therapeutic effect is superior to the simple psychotherapy.

The associations of cannabis and methamphetamine use with cognitive performance over the first 2 years of treatment in schizophrenia spectrum disorders.

AIM: Cognitive deficits are a core feature of schizophrenia, and comorbid substance use may be a contributory factor. Methamphetamine use has been associated with cognitive impairment in schizophrenia, while associations with cannabis use are less clear-cut. This study aimed to investigate the associations of cannabis and methamphetamine use with cognitive performance in first-episode schizophrenia spectrum disorders over the first 2 years of treatment. METHODS: This was a longitudinal cohort study in 81 patients treated with flupenthixol decanoate according to a standardized protocol over 24 months. Cognitive performance was assessed with the Measurement and Treatment Research to Improve Cognition in Schizophrenia Cognitive Consensus Battery at four time points, and urine testing for cannabis and methamphetamine was conducted at six time points. We used linear mixed-effect models for repeated measures to assess visit-wise changes in composite cognitive scores in patients (n = 91) compared to matched controls without psychiatric or medical disorders (n = 100). Linear regression models were constructed to examine pre-treatment and end-point effects in patients. RESULTS: Compared to controls, patients exhibited greater cognitive impairments at baseline, which improved with treatment, but remained significantly lower throughout. The number of positive methamphetamine, but not cannabis, tests predicted less cognitive improvement in patients. CONCLUSIONS: Our findings suggest a negative association between methamphetamine and cognition, but not cannabis.

[SUN's abdominal acupuncture for depression after methamphetamine withdrawal: a randomized controlled trial].

OBJECTIVE: To compare the clinical effect of SUN 's abdominal acupuncture and conventional acupuncture in the treatment of depression after methamphetamine withdrawal. METHODS: A total of 80 female patients with depression after methamphetamine withdrawal were randomly divided into an observation group (40 cases, 1 case dropped off) and a control group (40 cases, 2 cases dropped off). The control group was treated with conventional acupuncture at Baihui (GV 20), Yintang (GV 29), Taichong (LR 3), Shenmen (HT 7), Neiguan (PC 6), Danzhong (GV 17), and the observation group was treated with SUN 's abdominal acupuncture at area 1 of the abdomen and area 8 of the abdomen. Both groups were treated once a day, 30 min each time, 6 days as a course of treatment, 1 day rest between treatment courses, a total of 4 courses of treatment. The scores of withdrawal symptoms, Hamilton depression scale (HAMD), Pittsburgh sleep quality index (PSQI) scale and serum serotonin (5-HT) level were compared between the two groups before and after treatment. RESULTS: After treatment, the scores of withdrawal symptoms, HAMD and the various scores and total score of PSQI scale in the two groups were all lower than before treatment (P<0.01), and the scores of withdrawal symptoms, HAMD and the sleep quality, time to fall asleep, sleep time scores and total score of PSQI in the observation group were lower than the control group (P<0.05, P<0.01). After treatment, the serum 5-HT level of the two groups was increased (P<0.01), and that in the observation group was higher than the control group (P<0.05). CONCLUSION: SUN 's abdominal acupuncture can improve withdrawal symptom, depression and sleep quality, increase serum 5-HT content in treatment of depression after methamphetamine withdrawal, and has better effect than conventional acupuncture.

Case Series: Cariprazine for treatment of methamphetamine use disorder.

BACKGROUND AND OBJECTIVES: Methamphetamine use is a major source of morbidity and mortality but has no reliably effective interventions. We identified cariprazine as an option for treatment of methamphetamine use disorder (MUD) and present two cases. METHODS: Two patients with MUD and psychotic disorders were treated with cariprazine. Abstinence and cravings were assessed using urine drug screens and the Brief Substance Craving Scale, respectively. RESULTS: Both patients reported global functional improvement, reduction in methamphetamine cravings and use with cariprazine, confirmed with negative urine drug screens. CONCLUSIONS AND SCIENTIFIC SIGNIFICANCE: Cariprazine's unique pharmacodynamic profile conveys potential efficacy for MUD. It would be a novel treatment that targets multiple psychiatric symptoms seen in MUD.

The Use of Kratom (Mitragyna speciosa Korth.) Among People Who Co-use Heroin and Methamphetamine in Malaysia.

OBJECTIVES: Kratom (Mitragyna speciosa Korth.), an indigenous medicinal plant, has been widely used as a traditional remedy in Southeast Asia. However, its combined consumption with other substances has received scarce attention. This study investigates the use of kratom among adults with a history of using heroin and methamphetamine in Malaysia. METHODS: A total of 332 patients who were mandated to undergo drug rehabilitation participated in this cross-sectional study. The study data were collected through face-to-face interviews using a semi-structured questionnaire. RESULTS: The majority were males (95%, n = 314/332) and Malays (98%, n = 325/332) with a mean age of 32.3 years (SD = 9.16). Over two thirds of the respondents used kratom to alleviate heroin withdrawal symptoms and to reduce methamphetamine intake; 59% used it as a substitute for heroin and methamphetamine. A similar proportion used kratom to reduce heroin intake (58%), while only 15% used it for its euphoric effects. Multivariate analysis showed that previous attendees of government rehabilitation programs had lower odds of using kratom as a heroin substitute. CONCLUSIONS: The potential of kratom to alleviate heroin withdrawal symptoms, and to reduce methamphetamine and heroin intake, among people who co-use heroin and methamphetamine warrants further research.

Ameliorative effects of alkaloid extract from Mitragyna speciosa (Korth.) Havil. Leaves on methamphetamine conditioned place preference in mice.

ETHNOPHARMACOLOGICAL RELEVANCE: Mitragyna speciosa (Korth.) Havil., popularly known as Kratom (KT), is a medicinal plant used for pain suppression in Southeast Asia. It has been claimed to assist drug users withdraw from methamphetamine (METH) dependence. However, its use was controversial and not approved yet. AIM OF THE STUDY: This study was conducted to characterize local field potential (LFP) patterns in the nucleus accumbens (NAc) and the hippocampus (HP) in mice with METH conditioned place preference (CPP) that were treated with KT alkaloid extract. MATERIALS AND METHODS: Male Swiss albino ICR mice were implanted with intracraneal electrodes into the NAc and HP. To induce METH CPP, animals were injected intraperitoneally once a day with METH (1 mg/kg) and saline (0.9% w/v) alternately and put into METH/saline compartments to experience the associations between drug/saline injection and the unique environmental contexts for 10 sessions. Control group received saline injection paired with both saline/saline compartments. On post-conditioning day, effects of 40 (KT40), 80 (KT80) mg/kg KT alkaloid extract and 20 mg/kg bupropion (BP) on CPP scores and LFP powers and NAc-HP coherence were tested. RESULTS: Two-way ANOVA revealed significant induction of CPP by METH sessions (P < 0.01). Multiple comparisons indicated that METH CPP was completely abolished by KT80 (P < 0.001). NAc gamma I (30.0-44.9 Hz) and HP delta (1.0-3.9 Hz) powers were significantly increased in mice with METH CPP (P < 0.01). The elevated NAc gamma I was significantly suppressed by KT80 (P < 0.05) and the increased HP delta was significantly reversed by KT40 (P < 0.01) and KT80 (P < 0.001). In addition, NAc-HP coherence was also significantly increased in gamma I (30.0-44.9 Hz) frequency range (P < 0.05) but it was reversed by KT80 (P < 0.05). Treatment with BP did not produce significant effect on these parameters. CONCLUSIONS: These findings demonstrated that KT alkaloid extract significantly reversed CPP scores and LFP patterns induced by METH administration. The ameliorative effects of the extract might be beneficial for treatment of METH craving and addiction.

Effect of Tiaoshen acupuncture on anxiety after methamphetamine withdrawal / 中国针灸

OBJECTIVE@#To compare the therapeutic effect between Tiaoshen acupuncture combined with psychotherapy and simple psychotherapy on anxiety after methamphetamine withdrawal.@*METHODS@#A total of 78 patients were randomized into an observation group (39 cases, 2 cases dropped off) and a control group (39 cases, 1 case dropped off). Psychotherapy was given in the control group. On the basis of the treatment in the control group, Tiaoshen acupuncture was applied at Baihui (GV 20), Shenting (GV 24), Benshen (GB 13), Neiguan (PC 6) and Shenmen (HT 7) in the observation group. The treatment was given once a day, 6 days were as one course and totally 4 courses were required in both groups. The scores of Hamilton anxiety scale (HAMA), quality of life for drug addicts (QOL-DA) and Pittsburgh sleep quality index (PSQI) before and after treatment were observed in both groups.@*RESULTS@#After treatment, the various scores and the total scores of HAMA, QOL-DA and PSQI were decreased compared before treatment in both groups (P<0.05), and the scores of somatic anxiety factor, the psychic anxiety factor and the total score of HAMA, each various score and the total score of QOL-DA as well as the scores of sleep quality, time to fall asleep, sleep time, daytime dysfunction and the total score of PSQI in the observation group were lower than those in the control group (P<0.05).@*CONCLUSION@#Tiaoshen acupuncture combined with psychotherapy can relieve the anxiety in patients with anxiety after methamphetamine withdrawal, improve the quality of life and sleep, the therapeutic effect is superior to the simple psychotherapy.

SUN's abdominal acupuncture for depression after methamphetamine withdrawal: a randomized controlled trial / 中国针灸

OBJECTIVE@#To compare the clinical effect of SUN 's abdominal acupuncture and conventional acupuncture in the treatment of depression after methamphetamine withdrawal.@*METHODS@#A total of 80 female patients with depression after methamphetamine withdrawal were randomly divided into an observation group (40 cases, 1 case dropped off) and a control group (40 cases, 2 cases dropped off). The control group was treated with conventional acupuncture at Baihui (GV 20), Yintang (GV 29), Taichong (LR 3), Shenmen (HT 7), Neiguan (PC 6), Danzhong (GV 17), and the observation group was treated with SUN 's abdominal acupuncture at area 1 of the abdomen and area 8 of the abdomen. Both groups were treated once a day, 30 min each time, 6 days as a course of treatment, 1 day rest between treatment courses, a total of 4 courses of treatment. The scores of withdrawal symptoms, Hamilton depression scale (HAMD), Pittsburgh sleep quality index (PSQI) scale and serum serotonin (5-HT) level were compared between the two groups before and after treatment.@*RESULTS@#After treatment, the scores of withdrawal symptoms, HAMD and the various scores and total score of PSQI scale in the two groups were all lower than before treatment (P<0.01), and the scores of withdrawal symptoms, HAMD and the sleep quality, time to fall asleep, sleep time scores and total score of PSQI in the observation group were lower than the control group (P<0.05, P<0.01). After treatment, the serum 5-HT level of the two groups was increased (P<0.01), and that in the observation group was higher than the control group (P<0.05).@*CONCLUSION@#SUN 's abdominal acupuncture can improve withdrawal symptom, depression and sleep quality, increase serum 5-HT content in treatment of depression after methamphetamine withdrawal, and has better effect than conventional acupuncture.

Metoprine, a histamine N-methyltransferase inhibitor, attenuates methamphetamine-induced hyperlocomotion via activation of histaminergic neurotransmission in mice.

Metoprine increases the content of histamine in brain by inhibiting histamine N-methyltransferase (HMT), a centrally acting histamine degrading enzyme. We present data demonstrating that pretreatment with metoprine attenuates the hyperlocomotive effects of METH in mice using a multi-configuration behavior apparatus designed to monitor four behavioral outcomes [horizontal locomotion, appetitive behavior (food access), and food and water intake]. Metoprine pretreatment itself induced hyperlocomotion in mice challenged with saline during the large part of light phase. The trend was also observed during the following dark phase. This is the first report that metoprine has a long-lasting locomotor stimulating property. Similarly, in a tail suspension test, a single injection of metoprine significantly reduced total time of immobility in mice, consistent with the idea that metoprine possesses motor stimulating properties. Metoprine pretreatment did not affect other aspects of behavior. Metoprine did not affect the appetitive and drinking behavior while exerted an effect on stereotypy. No stereotyped behavior was observed in mice pretreated with vehicle followed by METH, while stereotyped sniffing was observed in mice pretreated with metoprine followed by METH. The metoprine pretreatment attenuated METH-induced hyperlocomotion during the first 2 h of light phase, suggesting that metoprine-induced locomotor stimulating property might be different from that of METH. The hypothalamic content of histamine (but not its brain metabolite) was increased after metoprine or METH administration. Both METH and metoprine reduced dopamine and histamine turnover in the striatum and the nucleus accumbens and the hypothalamus, respectively, and there is a significant metoprine pretreatment x METH challenge interaction in the histamine turnover. It is likely that metoprine may attenuate METH-induced hyperlocomotion via activation of histaminergic neurotransmission. Metoprine also might induce a long-lasting locomotor stimulating effect via a putative mechanism different from that whereby METH induces the locomotor stimulating effect.

Lack of longitudinal changes in cognition in individuals with methamphetamine use disorder during the first 6 weeks after commencing treatment.

Background: Methamphetamine use disorder (MUD) associates with cognitive impulsivity deficits. However, few studies have examined longitudinal changes in cognition, and it remains unclear if deficits resolve during early recovery.Objectives: To compare: (1) cognitive function of individuals with MUD at treatment onset and six-weeks later with controls tested over the same period; (2) cognitive changes in MUD-individuals who remained abstinent versus relapsed.Method: We recruited 108 participants meeting DSM-IV-TR criteria for methamphetamine dependence (81 males) and 50 demographically matched controls (38 males); 77 methamphetamine- dependent participants (59 males) and 48 controls (36 males) were retained at follow-up. We administered response inhibition, delay discounting and uncertainty-based decision-making tests at both endpoints. Relapse was defined as methamphetamine concentrations >0.4 ng/mg at follow-up in hair toxicology.Results: We found a significant time-by-group interaction on uncertainty-based decision-making (effect size: η2 = .05), although post-hoc tests to disentangle this interaction yielded inconclusive results (p-range = .14-.40; BF10-range = 0.43-1.67). There were no significant time-by-group interactions on response inhibition or delay discounting, with the former likely a null effect (η2-interaction = .003 and .02; BFincl = 0.23 and 0.71). There were no significant differences in cognitive recovery between individuals who maintained abstinence (n = 12) versus relapsed (n = 65) (η2-range = .003-.04), although evidence was inconclusive toward whether findings reflected true null effects (BFincl-range = 0.33-0.75).Conclusion: We did not find evidence that MUD-related cognitive impulsivity deficits improve beyond practice effects over 6 weeks. Findings do not support previous, albeit conflicting, evidence of early recovery of cognitive deficits in MUD.

6,7,4[Formula: see text]-Trihydroxyflavanone Prevents Methamphetamine-Induced T Cell Deactivation by Protecting the Activated T Cells from Apoptosis.

Methamphetamine (METH) is an extremely addictive drug that has raised serious public health concerns recently. METH addiction not only results in neuronal cytotoxicity, but it also affects immune cell activity, including T lymphocytes. 6,4,7[Formula: see text]-trihydroxyflavanone (THF), isolated from Dalbergia odorifera, has been studied for its antibacterial activity, but evidence for whether THF has an anti-cytotoxic and protective effect on T cell activation exposed to METH is lacking. In this study, results showed that treatment with THF was not cytotoxic to Jurkat T cells but dose-dependently mitigated the cytotoxicity induced by exposure to METH. The Western blot results demonstrating pre-treatment with THF maintained the expression of anti-apoptotic proteins and phosphorylation of PI3K/Akt/mTOR downregulated by treatment with METH. Furthermore, we found that decreased expression of IL-2 and CD69 by METH exposure was partially restored, and viability was significantly prevented by pre-treatment with THF in activated T cells. These findings were involved in re-elevated expression of anti-apoptotic proteins as well as recovered pathways including MAPK/PI3K/Akt/mTOR in activated T cells pre-exposed to METH. Our results suggest beneficial effects of THF against the cytotoxic and immune-modulating effect of METH on T cells and therapeutic potential of THF for patients with immunodeficiency caused by METH addiction.

The experiences of pregnant women attending a specialist service and using methamphetamine.

BACKGROUND: Pregnant women attending the Specialist Drug and Alcohol Service in Perth use methamphetamine as their primary drug of choice. This is the only tertiary service for pregnant and postnatal women with complex Alcohol and Other Drug Use in Western Australia. It is a midwifery-led multidisciplinary team. Many of the women struggle with addiction, polysubstance use, co-occurring mental health, family and domestic violence, complex trauma and fear of Child Protection and infant removal. Therefore, the aim of this study was to understand the impact of methamphetamine use of pregnant women attending the service and explore and highlight the potential barriers to engagement and follow-up. METHODS: A qualitative study informed by phenomenological methods was undertaken using semi-structured interviews with 20 women with methamphetamine use attending the service in order to explore and understand the experience of using methamphetamine in pregnancy and the postpartum period. A thematic analysis was undertaken with data from the women in the study (n=20) to identify key themes. RESULTS: Key themes that emerged from the women's experiences detail their resilience and experience with methamphetamine and the impact that methamphetamine has on their life. A key concern for women regarding methamphetamine use and engagement with specialist services was the welfare of their child(ren). Agencies charged with child protection was a barrier to treatment because women feared disclosure of methamphetamine use would result in loss of child custody. Themes highlighted the multiple layers of adversities, and trauma from childhood to adulthood including, co-occurring drug use, mental health and life histories of trauma (abuse, violence, and neglect; intergenerational trauma; intergenerational drug and alcohol use, and child removal), the omnipresence of methamphetamine, and the impact on pregnancy and mothering. CONCLUSION: We conclude that understanding the experiences of women and the impact methamphetamine use has on their life is paramount to providing effective and appropriate care to support pregnant women in a trauma-informed and woman-centred approach. Poor engagement in pregnancy care for women with methamphetamine use has significant impacts on mother and infant.

Correlates of trichomoniasis among female sex workers who inject drugs in two Mexico-US border cities.

This paper evaluates correlates of trichomoniasis among female sex workers who inject drugs (FSWIDs) in two Mexico-US border cities. HIV-negative FSWIDs aged 18 years or older were enrolled in a study between 2008 and 2010 in Tijuana and Ciudad Juarez (Cd.), Mexico. All participants underwent a baseline interviewer-administered survey and did a rapid test for trichomoniasis. Using regression to estimate prevalence ratios, we examined sociodemographics, sex work characteristics, sexual health and behavior, substance use, and police and violence exposures as potential correlates of trichomoniasis. Of 584 women (284 in Tijuana, 300 in Cd. Juarez), prevalence of trichomoniasis was 33.6%. Factors associated with trichomoniasis in multivariable analysis were having money stolen by police in the past six months (adjusted prevalence ratio [aPR] =1.448, 95% confidence interval [CI] = 1.152-1.821), recent methamphetamine use (aPR = 1.432, CI = 1.055-1.944), lifetime syphilis infection (aPR = 1.360, CI = 1.061-1.743), ever use of a home remedy to treat vaginal symptoms (aPR = 1.301, CI = 1.027-1.649), and number of regular clients in the past month (aPR = 1.006 per client, CI = 1.004-1.009), while controlling for age and city of interview. Alongside the need for trichomoniasis surveillance and treatment programs, findings indicate that both structural and behavioral factors serve as primary correlates of trichomoniasis among FSWIDs in these cities.