Food Addiction and Tobacco Use Disorder: Common Liability and Shared Mechanisms.

As food addiction is being more commonly recognized within the scientific community, parallels can be drawn between it and other addictive substance use disorders, including tobacco use disorder. Given that both unhealthy diets and smoking are leading risk factors for disability and death, a greater understanding of how food addiction and tobacco use disorder overlap with one another is necessary. This narrative review aimed to highlight literature that investigated prevalence, biology, psychology, and treatment options of food addiction and tobacco use disorder. Published studies up to August 2020 and written in English were included. Using a biopsychosocial lens, each disorder was assessed together and separately, as there is emerging evidence that the two disorders can develop concurrently or sequentially within individuals. Commonalities include but are not limited to the dopaminergic neurocircuitry, gut microbiota, childhood adversity, and attachment insecurity. In addition, the authors conducted a feasibility study with the purpose of examining the association between food addiction symptoms and tobacco use disorder among individuals seeking tobacco use disorder treatment. To inform future treatment approaches, more research is necessary to identify and understand the overlap between the two disorders.

Levels and predictors of participation in integrated treatment programs for pregnant and parenting women with problematic substance use.

BACKGROUND: Women who are seeking services for problematic substance use are often also balancing responsibilities of motherhood. Integrated treatment programs were developed to address the diverse needs of women, by offering a holistic and comprehensive mix of services that are trauma- and violence-informed, and focus on maternal and child health promotion and the development of healthy relationships. METHODS: Using system-level administrative data from a suite of outpatient integrated programs in Ontario, Canada, we described the clients and rates and predictors of treatment participation over a 7-year period (2008-2014; N = 5162). RESULTS: All participants were either pregnant or parenting children under 6 years old at admission to treatment. Retention (length of time between the first and last visit) averaged 124.9 days (SD = 185.6), with episodes consisting of 14.6 visits (SD = 28.6). The vast majority of women attended more than one visit (87.2%), typically returning within 2 weeks (mean 12.3 days, SD = 11.1). In addition to being pregnant or new mothers experiencing problematic substance use, most were unemployed, on social assistance, and single. CONCLUSIONS: Programs appeared to be able to successfully engage most women in treatment once they accessed the programs. Although rates of treatment participation did vary across subgroups defined by sociodemographic and admission characteristics, effect sizes tended to be small on average, providing little evidence in general of sociodemographic inequities in participation. Further work is needed to study the influence of program-level factors on participation, and how these link to maternal and child outcomes.

Integrated treatment programs for pregnant and parenting women with problematic substance use: Service descriptions and client perceptions of care.

Integrated treatment programs comprehensively address the unique and varied needs of pregnant and parenting women with problematic substance use. Despite the growth of these programs and evidence supporting their effectiveness, a clear picture of services that comprise integrated treatment is lacking. To address this gap in knowledge, we explored the services provided by 12 integrated treatment programs in one Canadian province. We found that integrated programs routinely provided substance use and mental health services, yet there was marked variability in other supportive services that address other central needs of women, such as prenatal and primary care, therapeutic childcare, housing and transportation support. Using survey data, we further examined client perceptions of care within integrated treatment programs (N = 106) compared to standard treatment programs (N = 207), and thematically analyzed qualitative feedback provided by integrated program clients to gain insight into how services may or may not be promoting positive perceptions of care. We found that integrated treatment program clients perceive their care more positively than clients in standard treatment programs and services provided impact on these perceptions. Implications for treatment development and research are discussed.