Effect of MAOA rs1465108 polymorphism on susceptibility to substance/alcohol use disorder: a novel PCR-RFLP assay for the detection of MAOA rs1465108.

BACKGROUND: The health and social consequences of substance/alcohol use disorders are harmful. Most of the individuals cannot stop using them due to more likely their genetic background. The current study aimed both to develop a novel PCR-RFLP method for genotyping of MAOA rs1465108 and to analyze the effect of MAOA rs1465108 on the risk of alcohol (AUD), opioid (OUD) or methamphetamine (MUD) use disorders and on the depressive and anxiety symptoms in a Turkish population. METHODS AND RESULTS: A total of 353 individual with AUD (n = 154), OUD (n = 160) or MUD (n = 39) and 109 healthy subjects were included. The intensity of anxiety and depressive symptoms and craving and opioid withdrawal were measured by appropriate scales. Logistic regression analysis revealed no association between MAOA rs1465108 polymorphism and substance/alcohol use disorder (p > 0.05). Healthy subjects (3.0) had significantly lower levels of depressive symptoms than individuals with OUD (27.0), AUD (21.0) and MUD (25.5) groups. The severity of depressive symptoms was significantly higher in OUD as compared to AUD. There was a statistically significant difference between individuals with AUD, OUD and MUD in view of the average ages of first use (17, 19 and 20 years, respectively) (p < 0.05). CONCLUSIONS: The results presented here do not support the hypothesis that MAOA rs1465108 is associated with substance/alcohol use disorders. The intensity of depressive symptoms could be changed according to the abused substance type. A novel PCR-RFLP was developed for genotyping of MAOA rs1465108 polymorphism, which could be a better option for laboratories without high technology equipment.

Could Telling Parents About Substance Use Decrease Involvement in Crime of Substance Users?

INTRODUCTION: Substance use disorder and criminal behaviors are increasing all over the world day by day. Factors that affect the involvement in crime among people with substance use disorders need to be examined more. This research aims to investigate the protective factors of substance users' involvement in crime and clarify the importance of telling parents about their substance use. METHOD: A total of 190 patients with substance use disorders were included. Patients were divided into two groups: those who told their families about their substance use (TP+) and those who did not tell (TP-). A sociodemographic data form, the short form of My Memories of Upbringing Scale for perceived parental attitudes, Experiences in Close Relationships Scale-Revised, and Emotional Autonomy Scale were used. RESULTS: Our study found that people in the TP+group were less involved in crime than TP-. Telling rates increased proportionally when individuals' anxious attachment and individuation levels rose. In the TP+group, criminal history was correlated positively with substance use duration. CONCLUSION: Telling their families that they are using substances can be a protective factor in itself against crime among drug users, especially in the early stages of addiction. Professionals in addiction psychiatry should encourage their patients to tell their substance use. Teaching and encouraging them to communicate with their relatives might play a key role for policymakers while dealing with substance use disorders and related outcomes.

Resilience and traumatic childhood experiences of patients with opioid use disorder.

We aim to explore childhood traumatic experiences and resilience of patients with OUD and compare these variables to healthy controls. Ninety-five patients and 83 healthy controls completed the Sociodemographic Data Form, Connor Davidson Psychological Resilience Scale (CDRS), and Childhood Trauma Questionnaire-33 (CTQ-33). We found that CTQ correlated negatively with CDRS in patients. T-test results showed significant differences between both groups regarding total and subscales' scores of CTQ-except overprotection-over control. Physical neglect predicted a decrease in resilience in patients with OUD. In conclusion, childhood traumas and resilience could be essential factors during patients' follow-up and treatment process with OUD.

Delirium Tremens and Central Pontine Myelinolysis in a Patient with Alcohol Use Disorder and Pneumonia: a Case Report and a Narrative Review.

INTRODUCTION: Delirium tremens (DT) is a serious condition occurring in alcohol withdrawal syndrome. Alcohol consumption may also cause additional health problems, such as respiratory infections or neuropsychiatric conditions such as central pontine myelinolysis. In this clinical scenario, managing DT can be expected to be more compelling and complex. Alcohol decreases coughing and mucociliary clearance and disrupts the immunity of the respiratory system. CASE: Here we report on a middle-aged man with alcohol use disorder who had developed DT due to alcohol withdrawal and comorbid pneumonia. DISCUSSION AND CONCLUSION: In this paper, DT, the relation between respiratory infections and alcohol intake, and the correlation of alcohol consumption and central pontine myelinolysis (CPM) are discussed. Also, the literature on alcohol consumption and the additional respiratory and neurologic problems resulting from it are presented.

OPRM1 rs2075572 has potential to affect plasma buprenorphine level in opioid users, but not OPRM1 rs562859.

OPRM1 gene encoding mu-opioid receptor (MOR) is the primary candidate gene for buprenorphine (BUP) pharmacogenetics. OPRM1 undergoes alternative splicing leading to multiple MOR subtypes. Thus, in the current study 2 SNPs (rs1799972 and rs562859) were selected due to evidence for their contribution to alternative splicing of OPRM1. The effects of 2 SNPs of OPRM1 gene on plasma buprenorphine and norbuprenorphine levels in a sample of 233 OUD patients receiving BUP/naloxone were examined. Polymorphisms were analyzed by PCR and RFLP. BUP and norbuprenorphine concentrations in plasma were measured by LC-MS/MS. OPRM1 rs2075572 GC + CC (0.12 ng/ml) had significantly higher plasma BUP level compared to GG (0.084 ng/ml) (p = 0.043). Although there was not a statistically significant difference between OPRM1 rs562859 genotypes (p = 0.46), patients with OPRM1 rs562859 CT + TT had higher plasma BUP and BUP-related values as compared to those with CC. In conclusion, the effect of OPRM1 rs2075572 on BUP levels in opioid users' plasma was shown in a Caucasian population for the first time. On the other hand, OPRM1 rs562859 seems not to influence the BUP pharmacology.

Substance use disorders after natural disasters: a narrative review.

Natural disasters significantly impact individuals and communities, including damage to infrastructure, injuries, loss of life, and psychological distress. Factors contributing to the development of substance use disorders (SUDs) during and after these events include trauma and stress, disruption of social support networks, availability of substances, and lack of access to mental health services. This paper aims to draw attention to the relationship between SUDs and natural disasters. Thus, we reviewed the literature by following SANRA guidelines. Prevention and intervention strategies to reduce the risk of SUDs during and after natural disasters are providing mental health services, strengthening social support networks, limiting access to substances, and providing education and training to healthcare providers, emergency responders, and community members. Considering the mental health needs of individuals affected by natural disasters is essential to mitigate the risk of SUDs and other mental health conditions.

A Hidden Pandemic? Abuse of Gabapentinoids: A Brief Review of Recent Studies.

BACKGROUND: Gabapentin and pregabalin were developed for epilepsy and neuropathic pain. They work via voltage-gated calcium channels and are used for broad-spectrum diagnoses, e.g., epilepsy, neuropathic pain, other chronic pain syndromes, anxiety disorders, alcohol-drug withdrawal syndromes, agitation, insomnia, etc. Especially in a world dealing with the opioid crisis, gabapentinoids were considered safer alternatives to opioid analgesics. METHODS: This review aims to comprehensively search and summarize recent studies concerning the abuse of gabapentinoids published between 2021 and 2022 from various regions around the world. RESULTS: Studies have highlighted that a history of substance use disorder is a significant risk factor for gabapentinoid abuse. Concurrent abuse of gabapentinoids with illicit drugs can exacerbate drug-related damages. Drug screening and postmortem toxicology tests have revealed an increase in gabapentinoid consumption. In response to the abuse potential, several countries have classified gabapentinoids as controlled substances. CONCLUSION: Gabapentinoids are highly abused molecules worldwide. Physicians should be aware of their abuse potential.

Emotion Dysregulation and Affective Temperaments in Opioid Use Disorder: the preliminary results of a prospective study.

BACKGROUND: Substance use disorder is a growing health problem all over the world. The coexistence of substance misuse, affective temperaments, and emotion dysregulation has not been studied sufficiently. OBJECTIVE: The present study aimed to evaluate the role of affective temperaments and emotion dysregulation on substance use disorder. The Emotion Dysregulation and Affective Temperaments in Opioid Use Disorder study was designed observational. This paper presents only the baseline assessments of the patient and control groups. One-year remission rates of the patients' group will be reported elsewhere after 1-year follow-up. METHODS: Sixty-seven patients with opioid use disorder and 68 healthy controls enrolled. All participants were administered to The Structured Clinical Interview for DSM-5, Temperament Evaluation of Memphis, Pisa, Paris, San Diego Autoquestionnaire, Difficulties in Emotion Regulation Scale, Beck Anxiety Inventory, and Beck Depression Inventory. RESULTS: Patients with opioid use disorder had higher scores from all temperamental scales and showed higher difficulties on emotion regulation than the control group. Even controlling the confounding effects of anxiety and depression levels, dysthymic and anxious temperament scores were found correlated with the emotion dysregulation score in the patient group. CONCLUSIONS: The emotional traits (i.e., affective temperaments) and emotion regulation abilities play a crucial role in substance use disorder. While managing substance use disorder, being aware of affective temperament characteristics and/or interventions to improve emotion regulation skills may be helpful.

OPRD1 rs569356 polymorphism has an effect on plasma norbuprenorphine levels and dose/kg-normalized norbuprenorphine values in individuals with opioid use disorder.

This study aimed to determine the effects of nine OPRM1, OPRD1 and OPRK1 polymorphisms on plasma BUP and norbuprenorphine (norBUP) concentrations and various treatment responses in a sample of 122 patients receiving BUP/naloxone. Plasma concentrations of BUP and norBUP were detected by LC-MS/MS. PCR-RFLP method was used to genotype polymorphisms. OPRD1 rs569356 GG had significantly lower plasma norBUP concentration (p = 0.018), dose- (p = 0.049) and dose/kg-normalized norBUP values (p = 0.036) compared with AA. Craving and withdrawal symptoms were significantly higher in OPRD1 rs569356 AG+GG relative to AA. There was a statistically significant difference between the OPRD1 rs678849 genotypes in the intensity of anxiety (13.5 for CT+TT and 7.5 for TT). OPRM1 rs648893 TT (18.8 ± 10.8) was significantly different to CC+CT (14.82 ± 11.3; p = 0.049) in view of the intensity of depression. This current study provides the first data on a prominent effect of the OPRD1 rs569356 variation on BUP pharmacology due to its metabolite norBUP.

Emotion dysregulation and affective temperaments in opioid use disorder: a 1-year follow-up study.

BACKGROUND: Opioid use disorder (OUD) remains a significant public health challenge with high recurrence rates and varied long-term outcomes. Affective temperament and emotion regulation have been identified as influencing addictive behaviors and treatment outcomes in OUD. However, limited research has explored their association with reversion over an extended period. OBJECTIVES: The EDATOUD (Emotion Dysregulation and Affective Temperaments in Opioid Use Disorder) study aimed to evaluate the effects of affective temperament and emotion regulation characteristics on recurrence over a 1-year follow-up period. The study aimed to compare the baseline characteristics of patients who achieved remission versus those who did not and identify potential predictors of recurrence risk. METHODS: The study included 63 patients with OUD who were assessed monthly for return-to-use through self-report, psychiatric examination, and urine analysis. Sociodemographic data, affective temperament, difficulties in emotion regulation, anxiety, and depression were measured at baseline. Statistical analyses were performed to compare the recurrent and remission groups and determine the predictive value of these clinical features on recurrence. RESULTS: Within the one-year, 77.8% of patients returned to use. Affective temperament characteristics did not differ between the groups. However, the recurrent group patients exhibited significantly more difficulties in emotion regulation. CONCLUSIONS: Difficulties in emotion regulation are associated with an increased risk of recurrence in patients with OUD. Understanding these factors can inform the development of tailored treatment strategies to improve long-term outcomes. Further research is needed to explore additional factors contributing to reversion and enhance intervention and support systems for sustained recovery in OUD.

Effects of UGT2B7 rs7662029 and rs7439366 polymorphisms on sublingual buprenorphine metabolism in heroin addicts: An improved PCR-RFLP assay for the detection of rs7662029 polymorphism.

This study aimed to determine the effects of UGT2B7 rs7662029 and rs7439366 polymorphisms on plasma buprenorphine (BUP) concentration and different treatment responses in a sample of 109 patients with opioid use disorder (OUD) treated with sublingual BUP/naloxone. Polymorphisms were analysed by PCR-RFLP. Plasma concentrations of BUP and its metabolite norbuprenorphine were detected by LC-MS/MS. Craving, withdrawal, depression and anxiety were measured by appropriate scales. OUD patients with rs7439366 CC or rs7662029 GG genotypes had significantly lower dose-normalized (BUP/D) and dose/kg-normalized BUP (BUP/D.kg-1) levels than those who were CT or AA carriers. Significant associations between UGT2B7 rs7662029 and increased craving (p = 0.037) and withdrawal symptoms (p = 0.029) were detected. Our findings were pointing to an important role of UGT2B7 in the metabolism of sublingual BUP/naloxone in the heroin addicts for the first time. A novel PCR-RFLP assay was developed for the determination of UGT2B7 rs7662029 polymorphism, based on utilizing novel restriction enzyme.

The reliability and validity of the Turkish version of the Neuropsychiatric Inventory-Clinician.

BACKGROUND/AIM: The Neuropsychiatric Inventory-Clinician (NPI-C) scale is one of the best-known scales for evaluating the behavioral and psychological symptoms of dementia. This study aimed to assess the reliability and validity of the Turkish version of the NPI-C scale in patients with Alzheimer disease (AD). MATERIALS AND METHODS: The NPI-C scale was administered to 125 patients with AD. For reliability, both Cronbach's α and interrater reliability were analyzed. The Behavioral Pathology in Alzheimer's Disease (BEHAVE-AD) scale was applied for validity and, in addition, the Mini Mental State Examination (MMSE), Instrumental Activities of Daily Living (IADL) scale, and Disability Assessment of Dementia (DAD) scale were completed. RESULTS: The Turkish version of the NPI-C scale showed high internal consistency (Cronbach's α = 0.75) and mostly good interrater reliability. Assessments of validity showed that the NPI-C and corresponding BEHAVE-AD domains were found to be significantly correlated, between 0.925 and 0.195. Moreover, the correlations between NPI-C and MMSE were significant for all domains except the dysphoria, anxiety, and elation/euphoria domains. When we conducted a correlation analysis of NPI-C with IADL, all domains were statistically significantly correlated except aggression, anxiety, elation/euphoria, and dysphoria. CONCLUSION: The Turkish version of the NPI-C scale was found to be a reliable and valid instrument to assess neuropsychiatric symptoms in Turkish elderly subjects with AD.