FACTORS ASSOCIATED WITH THE OUTCOME OF DRUG ADDICTION TREATMENT

Despite different treatment approaches many patients with drug addiction continue to use drugs during and after treatment. Approximately 50 percent of the patients in substance abuse treatment do not complete the first month of treatment ,and this is associated with poor outcome. Attempts have been made to improve outcomes of addiction treatment by addressing patient characteristics that predict continued drug use. Appropriate instruments have been developed in order to facilitate assessment and outcome research. It could be concluded that different psychosocial factors could serve as a predictor of drug addiction treatment outcome. However the interplay of these factors is still poorly understood and further research is neede

Closing the gap between training needs and training provision in addiction medicine

Substance use disorders pose a significant global social and economic burden. Although effective interventions exist, treatment coverage remains limited. The lack of an adequately trained workforce is one of the prominent reasons. Recent initiatives have been taken worldwide to improve training, but further efforts are required to build curricula that are internationally applicable. We believe that the training needs of professionals in the area have not yet been explored in sufficient detail. We propose that a peer-led survey to assess those needs, using a standardised structured tool, would help to overcome this deficiency. The findings from such a survey could be used to develop a core set of competencies which is sufficiently flexible in its implementation to address the specific needs of the wide range of professionals working in addiction medicine worldwide.J.K. is supported by funding from the European Union's Horizon 2020 research and innovation programme under the Marie Skłodowska-Curie grant agreement No 701698.S

Clinical decision-making style preferences of European psychiatrists : Results from the Ambassadors survey in 38 countries

Background While shared clinical decision-making (SDM) is the preferred approach to decision-making in mental health care, its implementation in everyday clinical practice is still insufficient. The European Psychiatric Association undertook a study aiming to gather data on the clinical decision-making style preferences of psychiatrists working in Europe. Methods We conducted a cross-sectional online survey involving a sample of 751 psychiatrists and psychiatry specialist trainees from 38 European countries in 2021, using the Clinical Decision-Making Style - Staff questionnaire and a set of questions regarding clinicians' expertise, training, and practice. Results SDM was the preferred decision-making style across all European regions ([central and eastern Europe, CEE], northern and western Europe [NWE], and southern Europe [SE]), with an average of 73% of clinical decisions being rated as SDM. However, we found significant differences in non-SDM decision-making styles: participants working in NWE countries more often prefer shared and active decision-making styles rather than passive styles when compared to other European regions, especially to the CEE. Additionally, psychiatry specialist trainees (compared to psychiatrists), those working mainly with outpatients (compared to those working mainly with inpatients) and those working in community mental health services/public services (compared to mixed and private settings) have a significantly lower preference for passive decision-making style. Conclusions The preferences for SDM styles among European psychiatrists are generally similar. However, the identified differences in the preferences for non-SDM styles across the regions call for more dialogue and educational efforts to harmonize practice across Europe.Peer reviewe

Responding to COVID-19 : emerging practices in addiction medicine in 17 countries

Following the classification of the Coronavirus disease (COVID-19) as a pandemic by the World Health Organization (WHO), countries were encouraged to implement urgent and aggressive actions to change the course of the disease spread while also protecting the physical and mental health and well-being of all people. The challenges and solutions of providing prevention, treatment, and care for those affected with issues related to substance use and addictive behaviors are still being discussed by the global community. Several international documents have been developed for service providers and public health professionals working in the field of addiction medicine in the context of the pandemic (1–3), however, less is known about country-level responses. In the current paper we, as individual members of the Network of Early Career Professionals working in Addiction Medicine (NECPAM), discuss emerging country-level guidelines developed in the 6 months following the outbreak.The South African Medical Research Councilhttp://www.frontiersin.org/Psychiatryam2022Family Medicin

INPATIENT MANAGEMENT OF GHB/GBL WITHDRAWAL

Background: Gamma-hydroxybutyrate (GHB) and its precursor gamma-butyrolactone (GBL) are popular drugs of abuse used for their euphoric, (potential) anabolic, sedative, and amnestic properties. Daily use of GHB/GBL can lead to addiction and the possibility of withdrawal syndrome on cessation which results in tremor, tachycardia, insomnia, anxiety, hypertension, delirium, coma. Aim: To describe the baseline characteristics, treatment and retention in patients admitted for GHB/GBL withdrawal management. Methods: A retrospective review of 4 consecutive cases of patients reporting GHB/GBL addiction who were admitted for inpatient management of withdrawal syndrome. Results: All patients were using GHB/GBL daily, 1-1.5 ml per hour. One of them was using cannabis additionally, others were using alcohol, cocaine and amphetamine type stimulants. Psychiatric comorbidities as personality disorders, depression, anxiety and bigorexia were recognized. Patients were treated with benzodiazepines and/or clomethiazole, atypical and typical antipsychotics and beta-blockers. Delirium was developed in two patients. One patient completed detoxification and finished the treatment program. One patient completed detoxification but stopped his treatment earlier, two patients did not completed detoxification and left the program. Conclusion: GHB/GBL withdrawal can be severe and retention in program is poor. Polysubstance use, psychiatric comorbidities and heavier GHB/GBL use as possible predictors of poor treatment outcome need consideration in treatment planning

Closing the gap between needs and supply of training in addiction medicine

Substance use disorders pose a significant global social and economic burden. Although effective interventions exist, treatment coverage remains limited. The lack of an adequately trained workforce is one of the prominent reasons. Recent initiatives have been taken worldwide to improve training, but further efforts are required to build curricula that are internationally applicable. We believe that the training needs of professionals in the area have not yet been explored in sufficient detail. We propose that a peer-led survey to assess those needs, using a standardised structured tool, would help to overcome this deficiency. The findings from such a survey could be used to develop a core set of competencies which is sufficiently flexible in its implementation to address the specific needs of the wide range of professionals working in addiction medicine worldwide.European Commission Horizon 202

Дослідження методами інфрачервоної спектроскопії валентних і деформаційних коливань хімічних зв'язків у функціональних групах органічних сполук, що містяться в зернах інбредних ліній кукурудзи

The infrared spectroscopy was applied on kernels of the following maize inbred lines with significant traits: ZPPL 186, ZPPL 225 and M1-3-3 Sdms, with the aim to determine structural properties of organic compounds and their unstable state. The set hypothesis was that it was necessary to observe the existence of numerous and different spectral bands, not studied so far, occurring in various patterns (bands of low intensity, single or grouped) and to explain the nature and the dynamics of their formation. Such spectral bands were observed in the wave number range of 400—2925 cm—1 and are caused by the different types of vibration movements (valence and deformation vibrations) of organic compounds: alkenes, aromatic compounds, alcohols, ethers, carboxylic acids, esters, amines, amides, alkanes, nitro compounds, ketones, aldehydes, alkynes, nitriles and phenols. In this way, it is possible to establish not only the structure of organic compounds of kernels of observed maize inbred lines, but also it is possible to point out to their unstable, conformational and functional properties. The importance of intensity, shape and kinetics of spectral bands, expressing unstable processes in biological systems and bioactive organic molecules, has been studied and emphasised for the first time.В работе рассмотрено применение метода инфракрасной спектроскопии зерен элитных инбредных линий кукурузы ZPPL 186, ZPPL 225 и M1-3-3 Sdms с целью определения структурных характеристик органических соединений и их неустойчивого состояния. Выдвинута гипотеза о необходимости изучения различных многочисленных спектральных полос, неисследованных до сих пор, появляющихся в различных формах (полосы низкой интенсивности, одиночные или сгруппированные), объяснения природы и динамики их образования. Такие спектральные полосы наблюдались в диапазоне волн 400—2925 см—1, они вызваны различными типами колебаний (валентных и деформационных) органических соединений: алкенов, ароматических соединений, спиртов, простых эфиров, карбоновых кислот, сложных эфиров, аминов, амидов, алканов, нитросоединений, кетонов, альдегидов, алкинов, нитрилов и фенолов. Таким образом, можно установить не только структуру органических соединений зерен наблюдаемых инбредных линий кукурузы, но также указать их неустойчивые, конформационные и функциональные свойства. В работе впервые акцентирована важность изучения формы, кинетики и интенсивности спектральных полос, выражающих неустойчивые процессы в биологических системах и биоактивных органических молекулах.У роботі розглянуто застосування методу інфрачервоної спектроскопії зерен елітних інбредних ліній кукурудзи ZPPL 186, ZPPL 225 і M1-3-3 Sdms з метою визначення структурних характеристик органічних сполук та їх нестійкого стану. Висунуто гіпотезу про необхідність вивчення різних численних спектральних смуг, недосліджених досі, що з'являються в різних формах (смуги низької інтенсивності, поодинокі або згруповані), пояснення природи і динаміки їх утворення. Такі спектральні смуги спостерігали в діапазоні хвиль 400—2925 см-1, вони спричинені різними типами коливань (валентних і деформаційних) органічних сполук: алкенів,ароматичних сполук, спиртів, простих ефірів, карбонових кислот, складних ефірів, амінів, амідів, алканів, нітросполук, кетонів, альдегідів, алкінів, нітрилів і фенолів. Отже, можна встановити не тільки структуру органічних сполук зерен досліджуваних інбредних ліній кукурудзи, а й вказати їх нестійкі, конформаційні та функціональні властивості. У роботі вперше акцентована важливість вивчення форми, кінетики та інтенсивності спектральних смуг, що виражають нестійкі процеси в біологічних системах і біоактивних органічних молекулах