- Email: [email protected]
Differences in delay discounting between heroin and prescription opioid users
Abstracts / Drug and Alcohol Dependence 171 (2017) e2–e226
Histories of alcohol dependence, perceived stress, and depression among people living with HIV Lauren Michelle Kaplan 1,∗ , Gail Ironson 2 1 School of Public Health, UC Berkeley, Alcohol Research Group, Emeryville, CA, United States 2 Psychology, University of Miami, Miami, FL, United States
Aims: To examine how histories of alcohol abuse and dependence are associated with stress and depression among people living with HIV. Methods: Participants were a paid HIV+ (n = 177) in the midrange of illness (CD4 number between 150 and 500; no previous acquired immunodeficiency syndrome [AIDS]-defining symptom) volunteer sample recruited through physician offices, specialty clinics, service organizations, and hospitals in Miami, Florida. Histories of alcohol dependence and abuse were assessed using DSM III criteria. Depression was measured using a cumulative average over two years of scores on the Beck Depression Inventory (BDI) and perceived stress was measured with the Perceived Stress Scale (PSS). OLS regression analysis was utilized. Results: History of alcohol dependence but not abuse was associated with more cumulative depression. When perceived stress was added to the model, history of alcohol dependence was no longer significantly associated with depression and perceived stress was significantly and positively associated with depression. History of alcohol dependence was also significantly associated with perceived stress. Conclusions: To our knowledge, this is the first study examining how histories of alcohol problems and perceived stress are associated with depression among people living with HIV. Findings suggest that perceived stress may mediate the associations between histories of alcohol dependence with depression. With the implementation of the Affordable Care Act, additional research is needed to understand how stress and mental health are involved in health outcomes and recovery from alcohol use disorders among people living with HIV. Such research can inform integrated approaches to specialist care. Interventions aimed at reducing stress and enhancing coping may reduce the risk of depression among patients with both HIV and alcohol use disorders, potentially reducing the risk of relapse. Financial support: Supported by R01MH53791, R01MH066697 (G. Ironson, P.I.), NIAAA Center grant P50 AA005595, and T32 AA007240. http://dx.doi.org/10.1016/j.drugalcdep.2016.08.277 Differences in delay discounting between heroin and prescription opioid users Sterling L. Karakula 1,∗ , Margaret L. Griffin 2 , Roger Weiss 2 , Kathryn McHugh 2 1
McLean Hospital, Belmont, MA, United States McLean Hospital/Harvard Medical School, Belmont, MA, United States 2
Aims: Among those with opioid use disorder (OUD), primary heroin use has been associated with greater substance use severity and poorer treatment outcomes compared to prescription opioid (PO) users. Differentiating heroin users from PO users is necessary to inform the treatment needs of these distinct populations. Delay discounting is a facet of impulsivity that reflects the degree to which future rewards are devalued based on their distance in time from
e99
the present. The present study compared delay discounting (DD) in those with OUD based on primary opioid of use. Methods: Adults with OUD (N = 147) on an inpatient detoxification unit completed self-report measures including the Monetary Choice Questionnaire, a measure of DD. Participants provided selfreported opioid use in the 30 days prior to admission and were categorized into three groups based on primary opioid of use: heroin, prescription, or combined (both PO and heroin). DD scores were calculated and compared among the three groups. Results: Results from a univariate ANOVA demonstrated a main effect of group on DD (F[2,144] = 4.92, p < .01). Specifically, the heroin group (p < .05) and the combined group (p < .05) demonstrated greater DD compared to the prescription group; however, DD did not differ between the heroin and combined groups (p = 1.00). The heroin and combined groups were therefore collapsed and compared to the prescription group, controlling for sociodemographic variables. A main effect of group on DD remained (F[1,125] = 7.43, p < .01). Conclusions: In a sample of inpatients with OUD, elevated DD was observed in those using heroin, either alone or in conjunction with POs, compared to those using only POs. This difference demonstrates a preference for immediate rewards in heroin users, which may contribute to their poorer treatment outcomes. Further, PO users with greater DD may be at an increased risk of transitioning to heroin use; longitudinal research should evaluate this possibility. Financial support: NIDA grants 2UG1DA015831, K24 DA022288, and K23 DA035297. http://dx.doi.org/10.1016/j.drugalcdep.2016.08.278 Fractional anisotropy increase in long-term anabolic-androgenic steroid users Marc J. Kaufman 2,∗ , Johanna Seitz 1 , Amanda E. Lyall 1 , Gen Kanayama 2 , Nikos Makris 1,2 , James I. Hudson 2 , Marek Kubicki 1 , Harrison G. Pope Jr. 2 1 Brigham & Women’s Hospital, Boston, MA, United States 2 McLean Hospital, Belmont, MA, United States
Aims: We recently reported increased amygdala volumes and reduced amygdala resting state functional connectivity in longterm anabolic-androgenic steroid (AAS) users versus non-users. We also acquired diffusion-weighted (DW) scans from these subjects to assess white matter structural connectivity. We hypothesized that we would detect fractional anisotropy (FA) abnormalities, reflecting white matter organization changes, in tracts associated with the amygdala network. Methods: Subjects in this study included 9 AAS users and 8 agematched non-using controls, whose 3-Tesla DW scans (B = 1000, 64 diffusion directions) satisfied quality controls. Images were processed with standard FSL tools, custom in-house scripts, and Tract-Based Spatial Statistics via the Enigma pipeline. We focused on integrity of the Inferior fronto-occipital fasciculus (IFOF), which connects inferior frontal and occipital lobes (major amygdala projections), and is involved in visuospatial memory, which we previously reported to be impaired in AAS users. Statistical analyses were conducted with Prism and SPSS. Results: We found a group FA difference in IFOF (ANOVA F1,15 = 9.4, P = 0.008), with AAS users exhibiting higher FA than non-users. Among AAS users, there was a positive association between FA and lifetime AAS use in IFOF (r = 0.82, P = 0.007). Posthoc FA laterality analysis revealed a significant group difference
Histories of alcohol dependence, perceived stress, and depression among people living with HIV Lauren Michelle Kaplan 1,∗ , Gail Ironson 2 1 School of Public Health, UC Berkeley, Alcohol Research Group, Emeryville, CA, United States 2 Psychology, University of Miami, Miami, FL, United States
Aims: To examine how histories of alcohol abuse and dependence are associated with stress and depression among people living with HIV. Methods: Participants were a paid HIV+ (n = 177) in the midrange of illness (CD4 number between 150 and 500; no previous acquired immunodeficiency syndrome [AIDS]-defining symptom) volunteer sample recruited through physician offices, specialty clinics, service organizations, and hospitals in Miami, Florida. Histories of alcohol dependence and abuse were assessed using DSM III criteria. Depression was measured using a cumulative average over two years of scores on the Beck Depression Inventory (BDI) and perceived stress was measured with the Perceived Stress Scale (PSS). OLS regression analysis was utilized. Results: History of alcohol dependence but not abuse was associated with more cumulative depression. When perceived stress was added to the model, history of alcohol dependence was no longer significantly associated with depression and perceived stress was significantly and positively associated with depression. History of alcohol dependence was also significantly associated with perceived stress. Conclusions: To our knowledge, this is the first study examining how histories of alcohol problems and perceived stress are associated with depression among people living with HIV. Findings suggest that perceived stress may mediate the associations between histories of alcohol dependence with depression. With the implementation of the Affordable Care Act, additional research is needed to understand how stress and mental health are involved in health outcomes and recovery from alcohol use disorders among people living with HIV. Such research can inform integrated approaches to specialist care. Interventions aimed at reducing stress and enhancing coping may reduce the risk of depression among patients with both HIV and alcohol use disorders, potentially reducing the risk of relapse. Financial support: Supported by R01MH53791, R01MH066697 (G. Ironson, P.I.), NIAAA Center grant P50 AA005595, and T32 AA007240. http://dx.doi.org/10.1016/j.drugalcdep.2016.08.277 Differences in delay discounting between heroin and prescription opioid users Sterling L. Karakula 1,∗ , Margaret L. Griffin 2 , Roger Weiss 2 , Kathryn McHugh 2 1
McLean Hospital, Belmont, MA, United States McLean Hospital/Harvard Medical School, Belmont, MA, United States 2
Aims: Among those with opioid use disorder (OUD), primary heroin use has been associated with greater substance use severity and poorer treatment outcomes compared to prescription opioid (PO) users. Differentiating heroin users from PO users is necessary to inform the treatment needs of these distinct populations. Delay discounting is a facet of impulsivity that reflects the degree to which future rewards are devalued based on their distance in time from
e99
the present. The present study compared delay discounting (DD) in those with OUD based on primary opioid of use. Methods: Adults with OUD (N = 147) on an inpatient detoxification unit completed self-report measures including the Monetary Choice Questionnaire, a measure of DD. Participants provided selfreported opioid use in the 30 days prior to admission and were categorized into three groups based on primary opioid of use: heroin, prescription, or combined (both PO and heroin). DD scores were calculated and compared among the three groups. Results: Results from a univariate ANOVA demonstrated a main effect of group on DD (F[2,144] = 4.92, p < .01). Specifically, the heroin group (p < .05) and the combined group (p < .05) demonstrated greater DD compared to the prescription group; however, DD did not differ between the heroin and combined groups (p = 1.00). The heroin and combined groups were therefore collapsed and compared to the prescription group, controlling for sociodemographic variables. A main effect of group on DD remained (F[1,125] = 7.43, p < .01). Conclusions: In a sample of inpatients with OUD, elevated DD was observed in those using heroin, either alone or in conjunction with POs, compared to those using only POs. This difference demonstrates a preference for immediate rewards in heroin users, which may contribute to their poorer treatment outcomes. Further, PO users with greater DD may be at an increased risk of transitioning to heroin use; longitudinal research should evaluate this possibility. Financial support: NIDA grants 2UG1DA015831, K24 DA022288, and K23 DA035297. http://dx.doi.org/10.1016/j.drugalcdep.2016.08.278 Fractional anisotropy increase in long-term anabolic-androgenic steroid users Marc J. Kaufman 2,∗ , Johanna Seitz 1 , Amanda E. Lyall 1 , Gen Kanayama 2 , Nikos Makris 1,2 , James I. Hudson 2 , Marek Kubicki 1 , Harrison G. Pope Jr. 2 1 Brigham & Women’s Hospital, Boston, MA, United States 2 McLean Hospital, Belmont, MA, United States
Aims: We recently reported increased amygdala volumes and reduced amygdala resting state functional connectivity in longterm anabolic-androgenic steroid (AAS) users versus non-users. We also acquired diffusion-weighted (DW) scans from these subjects to assess white matter structural connectivity. We hypothesized that we would detect fractional anisotropy (FA) abnormalities, reflecting white matter organization changes, in tracts associated with the amygdala network. Methods: Subjects in this study included 9 AAS users and 8 agematched non-using controls, whose 3-Tesla DW scans (B = 1000, 64 diffusion directions) satisfied quality controls. Images were processed with standard FSL tools, custom in-house scripts, and Tract-Based Spatial Statistics via the Enigma pipeline. We focused on integrity of the Inferior fronto-occipital fasciculus (IFOF), which connects inferior frontal and occipital lobes (major amygdala projections), and is involved in visuospatial memory, which we previously reported to be impaired in AAS users. Statistical analyses were conducted with Prism and SPSS. Results: We found a group FA difference in IFOF (ANOVA F1,15 = 9.4, P = 0.008), with AAS users exhibiting higher FA than non-users. Among AAS users, there was a positive association between FA and lifetime AAS use in IFOF (r = 0.82, P = 0.007). Posthoc FA laterality analysis revealed a significant group difference