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Age of cigarette smoking onset is associated with P300 smoking cue reactivity: Preliminary EEG findings
Abstracts / Drug and Alcohol Dependence 146 (2015) e118–e201
Trends in racial/ethnic differences in heroin use and heroin risk behaviors among nonmedical users of prescription opioids from 2002 to 2011 Silvia S. Martins 1 , Julian Santaella 1 , Brandon D. Marshall 2 , Adriana Maldonado 1 , Magdalena Cerdá 1 1 Epidemiology, Columbia University, New York, NY, United States 2 Epidemiology, Brown University, Providence, RI, United States
Aims: To examine changes in the patterns of past-year heroin use and heroin risk behaviors (injection drug use and abuse/dependence) among Whites, Blacks, and Hispanics who were nonmedical users of prescription opioids (POs). Methods: Secondary analysis of the US National Survey of Drug Use and Health (NSDUH) 2002–2005 and 2008–2011 data using weighted logistic regression models, stratified by race/ethnicity and adjusted for other socio-demographics, frequency past-year of PO use (1–29 days, 30–99 days, 100+ days) and other past-year drug use. Results: Among PO users, there was a significant increase in past-year heroin use across time, from 18.53 per 1000 in 2002–2005 to 35.57 per 1000 in 2008–2011 (p < 0.01). This increase was mainly due to an increase in past-year heroin use among White (from 21.30 per 1000 in 2002–2005 to 38.73 per 1000 in 2008–2011, p < 0.01) and Hispanic (from 11.56 per 1000 in 2002–2005 to 26.04 per 1000 in 2008–2011, p = 0.05) nonmedical PO users. There was a significant increase in heroin use among Blacks, but only among those that used PO at least 30 days in the past-year. White past-year PO users who used PO at least 30 days in the past-year were more likely to have ever injected heroin and POs, to meet criteria for heroin and PO abuse/dependence, and think heroin was fairly easy to obtain, compared to those who used POs less than 30 days a year. Black and Hispanic past-year PO users who used POs 100 or more days a year were more likely than those that used PO less than 30 days in the past-year to be injection heroin users, have heroin abuse/dependence and report that heroin was fairly easy to obtain. Conclusions: Changes in the patterns of heroin use and heroin risk behaviors across time among nonmedical users of PO vary by race/ethnicity. Across all racial groups, frequent PO users are at greatest risk of heroin use and related harms and should be the focus of harm reduction and substance abuse treatment interventions. Financial support: RO1HD060072 (Martins), KO1DA030449 (Cerdá), R21AA021909 (Cerdá). http://dx.doi.org/10.1016/j.drugalcdep.2014.09.445 Evaluation of sex differences in cannabinoid withdrawal in rats Julie A. Marusich 1 , Timothy Lefever 1 , Rebecca Craft 2 , J.L. Wiley 1 1 RTI International, Research Triangle Park, NC, United States 2 Washington State University, Pullman, WA, United States
Aims: Although epidemiological studies indicate that cannabis using women attempting to quit report more withdrawal and relapse compared to men, only a handful of empirical studies have examined sex differences in cannabinoid dependence. The purpose of the study was to examine sex differences in withdrawal from 9-tetrahydrocannabinol (THC) in a rat model.
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Methods: Forty male and forty female Sprague-Dawley rats were administered THC or vehicle twice daily for 6.5 days. Locomotor activity, temperature, and warm water tail withdrawal were assessed on days 1 and 6. On the afternoon of day 7, rats were administered a vehicle or rimonabant challenge, counterbalanced across subchronic dosing groups, followed by assessments of locomotor activity, temperature, tail withdrawal, acoustic startle, and observation of withdrawal related behaviors. Results: Male rats, but not females, showed THC-induced locomotor decreases on day 1, and developed tolerance to this effect across days. Female rats administered THC and challenged with rimonabant showed increased retropulsion compared to male and female rats in other treatment groups. Subchronic treatment with THC followed by rimonabant challenge increased paw tremors and head twitches, decreased prepulse inhibition, and led to a lack of locomotor habituation in rats of both sexes. Rats in all groups treated with THC exhibited increased startle amplitude and weight loss. Conclusions: This study represents the first systematic examination of THC dependence in gonadally intact adult rats of both sexes, extends findings reported previously only in male rodents to females, and revealed some sex differences. The results suggest that the changes that occur during antagonist-precipitated withdrawal from THC extend beyond the typically reported somatic signs to more nuanced disruptions of cognitive and affective functioning. The breadth of withdrawal signs observed in rodents mirrors those that have been observed in humans. Financial support: NIDA Grant DA-016644. http://dx.doi.org/10.1016/j.drugalcdep.2014.09.446 Age of cigarette smoking onset is associated with P300 smoking cue reactivity: Preliminary EEG findings Yasmin Mashhoon, Stacey L. Farmer, George H. Trksak, Scott E. Lukas McLean Imaging Center, McLean Hospital | Harvard Medical School, Belmont, MA, United States Aims: The typical age range for initiating smoking and developing long-term nicotine dependence, ages 15–18, coincides with critical neuromaturation. Thus, early onset (age <16 yrs), relative to late onset (age >16 yrs), smoking may be particularly noxious for developmentally immature systems that regulate neural signaling efficiency and reactivity. The current study investigates effects of age of smoking onset on alterations in neurophysiological measures of smoking cue reactivity and subjective craving in adult smokers. Methods: Adult early onset smokers (EOS; n = 4) and late onset smokers (LOS; n = 7) in acute withdrawal, as well as adult nonsmokers (NS; n = 6) took part in an ongoing electroencephalography (EEG) smoking cue reactivity study. Participants handled neutral objects as well as smoking-related objects, and also viewed two computerized presentations of smoking, neutral, or arousing stimuli in an oddball paradigm. P300 event-related potentials were measured during picture presentations, and craving/mood assessments and physiologic recordings also were collected. Results: Preliminary findings indicate significantly higher P300 amplitudes in the central midline (Cz) channel in EOS, LOS and NS in response to drug images (p < 0.02), but not neutral or arousing images, after handling smoking objects. Furthermore, P300 amplitudes trended towards being higher in LOS in response to drug images (p = 0.06) compared to EOS and NS groups. EOS and LOS reported greater craving (p = 0.05) after handling smoking objects relative to after handling neutral objects.
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Abstracts / Drug and Alcohol Dependence 146 (2015) e118–e201
Conclusions: Greater P300 reactivity was associated with smoking cues, particularly in LOS. Differential P300 reactivity profiles between LOS and EOS may be related to differences in compensatory signaling neuroadaptations resulting from smoking during early maturation. Preliminary findings suggest that late onset smoking may alter neurophysiological signaling systems involved in responding to smoking-related pictures, which could have important implications for designing smoking cessation interventions. Financial support: NIDA K01 grant DA034028 (YM). http://dx.doi.org/10.1016/j.drugalcdep.2014.09.447 Understanding the service needs of assault-injured, drug-using youth presenting for care in an urban emergency department Lynn S. Massey 2 , K. Bohnert 2 , M.A. Walton 2 , M. Ranney 4 , Erin E. Bonar 2 , F.C. Blow 2 , M. Zimmerman 1 , Brenda M. Booth 3 , R.M. Cunningham 1 1 Injury Center, University of Michigan, Ann Arbor, MI, United States 2 Department of Psychiatry, University of Michigan, Ann Arbor, MI, United States 3 University of Arkansas, Little Rock, AR, United States 4 Brown University, Providence, RI, United States
Aims: To inform optimal content/location of violence interventions, it is critical to understand the baseline characteristics, and intent to retaliate, of drug using assault-injured youth Methods: At an urban ED, assault-injured (AI) youth (ages 14–24) endorsing past 6 month substance use (n = 350), and a proportionally-sampled substance using comparison group (CG) presenting for non-assault-related care (n = 250) were recruited, completed a baseline assessment (participation rate 82%). Medical chart review was conducted. Conditional regression analysis was conducted to examine correlates associated with seeking ED care for an assault injury Results: Over half (57%) of all youth (58.8% male, mean age 20.1, 58.2% African American) met criteria for drug/alcohol use disorder (9% receiving prior treatment). Among the AI group, 1/4 intended to retaliate (of which 49% had firearm access). The AI youth report poorer mental health (PTSD), more substance use, and were more likely to report prior ED visits for assault or psychiatric evaluation. Regression analysis found AI youth were more likely to be on probation/parole (AOR = 2.26; CI = 1.28, 3.90), and have PTSD (AOR = 1.88; CI = 1.01, 3.50) than the CG Conclusions: AI youth have substantial unmet needs for substance use and mental health treatment including PTSD. These characteristics along with increased risk of retaliation, increased ED service utilization, and firearm access highlight the need for interventions that start at time of ED visit Financial support: NIDA RO1 024646 & CDC U01 CE001957. http://dx.doi.org/10.1016/j.drugalcdep.2014.09.448
Development and pilot testing of an online training to raise awareness among criminal justice professionals of medications used to treat opioid addiction Jason Matejkowski 1,2 , Karen L. Dugosh 2 , Nicolle Clements 3,2 , David S. Festinger 2,4 1
University of Kansas, Lawrence, KS, United States Treatment Research Institute, Philadelphia, PA, United States 3 St. Joseph’s University, Philadelphia, PA, United States 4 University of Pennsylvania, Philadelphia, PA, United States 2
Aims: We developed and tested an online training for criminal justice professionals to raise their awareness of the potential benefits that medication assisted treatment of opioid addiction (MAT) has for the people they serve. Methods: Through two pilot studies, we examined to what extent the training increased criminal justice system treatment referrers’ and decision makers’ (1) knowledge of MAT, (2) positive attitudes toward MAT, and (3) willingness to refer criminal justice clients to MAT services. In study one, 45 treatment referrers participated in a randomized trial of the training. In study two, 25 decision makers participated in a pre/post-trial of the training. Paired t-tests and repeated measures mixed effects models were used to test hypotheses that participation in the training would increase knowledge, positive attitudes, and willingness to refer to MAT. Results: (Study 1) At post-training, the experimental group had significantly higher scores than those in the control group on knowledge items and on all measures assessing attitudes towards MAT and willingness to refer to MAT. Effects sizes (d) ranged from .66 to 1.03. Mixed effects models indicated significant group effects for items assessing whether medications should be used more often and items assessing general attitudes towards MAT. (Study 2) Significant increases at posttest, in the desired direction, were observed on four of the five dependent variables. Effect sizes (d) at posttest ranged from 0.53 to 1.16. Conclusions: Results from these studies provide preliminary support for the efficacy of our online MAT training in improving treatment referrers’ and decision makers’ perceptions of MAT. Financial support: This study was supported by a grant from the Pennsylvania Department of Health (SAP 4100054873). http://dx.doi.org/10.1016/j.drugalcdep.2014.09.449 Initiation of nonmedical prescription opioid use and development of opioid dependence among young adults Pedro Mateu-Gelabert, Honoria Guarino Institute for Infectious Disease Research, NDRI, Inc., New York, NY, United States Aims: To elucidate the social contexts in which youth initiate nonmedical prescription opioid (PO) use, their motivations for initiation, and the processes leading to opioid dependence and associated negative health consequences. Methods: Forty-four New York City young adults (ages 18–32) who reported nonmedical PO use in the past 30 days were recruited for digitally audiotaped, 1.5-hour-long, semi-structured interviews. Interviews focused on motivations for and contexts surrounding initial PO use, drug use trajectories and practices, and
Trends in racial/ethnic differences in heroin use and heroin risk behaviors among nonmedical users of prescription opioids from 2002 to 2011 Silvia S. Martins 1 , Julian Santaella 1 , Brandon D. Marshall 2 , Adriana Maldonado 1 , Magdalena Cerdá 1 1 Epidemiology, Columbia University, New York, NY, United States 2 Epidemiology, Brown University, Providence, RI, United States
Aims: To examine changes in the patterns of past-year heroin use and heroin risk behaviors (injection drug use and abuse/dependence) among Whites, Blacks, and Hispanics who were nonmedical users of prescription opioids (POs). Methods: Secondary analysis of the US National Survey of Drug Use and Health (NSDUH) 2002–2005 and 2008–2011 data using weighted logistic regression models, stratified by race/ethnicity and adjusted for other socio-demographics, frequency past-year of PO use (1–29 days, 30–99 days, 100+ days) and other past-year drug use. Results: Among PO users, there was a significant increase in past-year heroin use across time, from 18.53 per 1000 in 2002–2005 to 35.57 per 1000 in 2008–2011 (p < 0.01). This increase was mainly due to an increase in past-year heroin use among White (from 21.30 per 1000 in 2002–2005 to 38.73 per 1000 in 2008–2011, p < 0.01) and Hispanic (from 11.56 per 1000 in 2002–2005 to 26.04 per 1000 in 2008–2011, p = 0.05) nonmedical PO users. There was a significant increase in heroin use among Blacks, but only among those that used PO at least 30 days in the past-year. White past-year PO users who used PO at least 30 days in the past-year were more likely to have ever injected heroin and POs, to meet criteria for heroin and PO abuse/dependence, and think heroin was fairly easy to obtain, compared to those who used POs less than 30 days a year. Black and Hispanic past-year PO users who used POs 100 or more days a year were more likely than those that used PO less than 30 days in the past-year to be injection heroin users, have heroin abuse/dependence and report that heroin was fairly easy to obtain. Conclusions: Changes in the patterns of heroin use and heroin risk behaviors across time among nonmedical users of PO vary by race/ethnicity. Across all racial groups, frequent PO users are at greatest risk of heroin use and related harms and should be the focus of harm reduction and substance abuse treatment interventions. Financial support: RO1HD060072 (Martins), KO1DA030449 (Cerdá), R21AA021909 (Cerdá). http://dx.doi.org/10.1016/j.drugalcdep.2014.09.445 Evaluation of sex differences in cannabinoid withdrawal in rats Julie A. Marusich 1 , Timothy Lefever 1 , Rebecca Craft 2 , J.L. Wiley 1 1 RTI International, Research Triangle Park, NC, United States 2 Washington State University, Pullman, WA, United States
Aims: Although epidemiological studies indicate that cannabis using women attempting to quit report more withdrawal and relapse compared to men, only a handful of empirical studies have examined sex differences in cannabinoid dependence. The purpose of the study was to examine sex differences in withdrawal from 9-tetrahydrocannabinol (THC) in a rat model.
e195
Methods: Forty male and forty female Sprague-Dawley rats were administered THC or vehicle twice daily for 6.5 days. Locomotor activity, temperature, and warm water tail withdrawal were assessed on days 1 and 6. On the afternoon of day 7, rats were administered a vehicle or rimonabant challenge, counterbalanced across subchronic dosing groups, followed by assessments of locomotor activity, temperature, tail withdrawal, acoustic startle, and observation of withdrawal related behaviors. Results: Male rats, but not females, showed THC-induced locomotor decreases on day 1, and developed tolerance to this effect across days. Female rats administered THC and challenged with rimonabant showed increased retropulsion compared to male and female rats in other treatment groups. Subchronic treatment with THC followed by rimonabant challenge increased paw tremors and head twitches, decreased prepulse inhibition, and led to a lack of locomotor habituation in rats of both sexes. Rats in all groups treated with THC exhibited increased startle amplitude and weight loss. Conclusions: This study represents the first systematic examination of THC dependence in gonadally intact adult rats of both sexes, extends findings reported previously only in male rodents to females, and revealed some sex differences. The results suggest that the changes that occur during antagonist-precipitated withdrawal from THC extend beyond the typically reported somatic signs to more nuanced disruptions of cognitive and affective functioning. The breadth of withdrawal signs observed in rodents mirrors those that have been observed in humans. Financial support: NIDA Grant DA-016644. http://dx.doi.org/10.1016/j.drugalcdep.2014.09.446 Age of cigarette smoking onset is associated with P300 smoking cue reactivity: Preliminary EEG findings Yasmin Mashhoon, Stacey L. Farmer, George H. Trksak, Scott E. Lukas McLean Imaging Center, McLean Hospital | Harvard Medical School, Belmont, MA, United States Aims: The typical age range for initiating smoking and developing long-term nicotine dependence, ages 15–18, coincides with critical neuromaturation. Thus, early onset (age <16 yrs), relative to late onset (age >16 yrs), smoking may be particularly noxious for developmentally immature systems that regulate neural signaling efficiency and reactivity. The current study investigates effects of age of smoking onset on alterations in neurophysiological measures of smoking cue reactivity and subjective craving in adult smokers. Methods: Adult early onset smokers (EOS; n = 4) and late onset smokers (LOS; n = 7) in acute withdrawal, as well as adult nonsmokers (NS; n = 6) took part in an ongoing electroencephalography (EEG) smoking cue reactivity study. Participants handled neutral objects as well as smoking-related objects, and also viewed two computerized presentations of smoking, neutral, or arousing stimuli in an oddball paradigm. P300 event-related potentials were measured during picture presentations, and craving/mood assessments and physiologic recordings also were collected. Results: Preliminary findings indicate significantly higher P300 amplitudes in the central midline (Cz) channel in EOS, LOS and NS in response to drug images (p < 0.02), but not neutral or arousing images, after handling smoking objects. Furthermore, P300 amplitudes trended towards being higher in LOS in response to drug images (p = 0.06) compared to EOS and NS groups. EOS and LOS reported greater craving (p = 0.05) after handling smoking objects relative to after handling neutral objects.
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Abstracts / Drug and Alcohol Dependence 146 (2015) e118–e201
Conclusions: Greater P300 reactivity was associated with smoking cues, particularly in LOS. Differential P300 reactivity profiles between LOS and EOS may be related to differences in compensatory signaling neuroadaptations resulting from smoking during early maturation. Preliminary findings suggest that late onset smoking may alter neurophysiological signaling systems involved in responding to smoking-related pictures, which could have important implications for designing smoking cessation interventions. Financial support: NIDA K01 grant DA034028 (YM). http://dx.doi.org/10.1016/j.drugalcdep.2014.09.447 Understanding the service needs of assault-injured, drug-using youth presenting for care in an urban emergency department Lynn S. Massey 2 , K. Bohnert 2 , M.A. Walton 2 , M. Ranney 4 , Erin E. Bonar 2 , F.C. Blow 2 , M. Zimmerman 1 , Brenda M. Booth 3 , R.M. Cunningham 1 1 Injury Center, University of Michigan, Ann Arbor, MI, United States 2 Department of Psychiatry, University of Michigan, Ann Arbor, MI, United States 3 University of Arkansas, Little Rock, AR, United States 4 Brown University, Providence, RI, United States
Aims: To inform optimal content/location of violence interventions, it is critical to understand the baseline characteristics, and intent to retaliate, of drug using assault-injured youth Methods: At an urban ED, assault-injured (AI) youth (ages 14–24) endorsing past 6 month substance use (n = 350), and a proportionally-sampled substance using comparison group (CG) presenting for non-assault-related care (n = 250) were recruited, completed a baseline assessment (participation rate 82%). Medical chart review was conducted. Conditional regression analysis was conducted to examine correlates associated with seeking ED care for an assault injury Results: Over half (57%) of all youth (58.8% male, mean age 20.1, 58.2% African American) met criteria for drug/alcohol use disorder (9% receiving prior treatment). Among the AI group, 1/4 intended to retaliate (of which 49% had firearm access). The AI youth report poorer mental health (PTSD), more substance use, and were more likely to report prior ED visits for assault or psychiatric evaluation. Regression analysis found AI youth were more likely to be on probation/parole (AOR = 2.26; CI = 1.28, 3.90), and have PTSD (AOR = 1.88; CI = 1.01, 3.50) than the CG Conclusions: AI youth have substantial unmet needs for substance use and mental health treatment including PTSD. These characteristics along with increased risk of retaliation, increased ED service utilization, and firearm access highlight the need for interventions that start at time of ED visit Financial support: NIDA RO1 024646 & CDC U01 CE001957. http://dx.doi.org/10.1016/j.drugalcdep.2014.09.448
Development and pilot testing of an online training to raise awareness among criminal justice professionals of medications used to treat opioid addiction Jason Matejkowski 1,2 , Karen L. Dugosh 2 , Nicolle Clements 3,2 , David S. Festinger 2,4 1
University of Kansas, Lawrence, KS, United States Treatment Research Institute, Philadelphia, PA, United States 3 St. Joseph’s University, Philadelphia, PA, United States 4 University of Pennsylvania, Philadelphia, PA, United States 2
Aims: We developed and tested an online training for criminal justice professionals to raise their awareness of the potential benefits that medication assisted treatment of opioid addiction (MAT) has for the people they serve. Methods: Through two pilot studies, we examined to what extent the training increased criminal justice system treatment referrers’ and decision makers’ (1) knowledge of MAT, (2) positive attitudes toward MAT, and (3) willingness to refer criminal justice clients to MAT services. In study one, 45 treatment referrers participated in a randomized trial of the training. In study two, 25 decision makers participated in a pre/post-trial of the training. Paired t-tests and repeated measures mixed effects models were used to test hypotheses that participation in the training would increase knowledge, positive attitudes, and willingness to refer to MAT. Results: (Study 1) At post-training, the experimental group had significantly higher scores than those in the control group on knowledge items and on all measures assessing attitudes towards MAT and willingness to refer to MAT. Effects sizes (d) ranged from .66 to 1.03. Mixed effects models indicated significant group effects for items assessing whether medications should be used more often and items assessing general attitudes towards MAT. (Study 2) Significant increases at posttest, in the desired direction, were observed on four of the five dependent variables. Effect sizes (d) at posttest ranged from 0.53 to 1.16. Conclusions: Results from these studies provide preliminary support for the efficacy of our online MAT training in improving treatment referrers’ and decision makers’ perceptions of MAT. Financial support: This study was supported by a grant from the Pennsylvania Department of Health (SAP 4100054873). http://dx.doi.org/10.1016/j.drugalcdep.2014.09.449 Initiation of nonmedical prescription opioid use and development of opioid dependence among young adults Pedro Mateu-Gelabert, Honoria Guarino Institute for Infectious Disease Research, NDRI, Inc., New York, NY, United States Aims: To elucidate the social contexts in which youth initiate nonmedical prescription opioid (PO) use, their motivations for initiation, and the processes leading to opioid dependence and associated negative health consequences. Methods: Forty-four New York City young adults (ages 18–32) who reported nonmedical PO use in the past 30 days were recruited for digitally audiotaped, 1.5-hour-long, semi-structured interviews. Interviews focused on motivations for and contexts surrounding initial PO use, drug use trajectories and practices, and