SA¹ú¼Ê´«Ã½

This Week in the SA¹ú¼Ê´«Ã½Weekly

As you may have noticed, we published several guest editorials recently and, over the next months, we intend to publish many more. Our goal is to provide readers with timely and accessible viewpoints from leaders in the field, covering a wide range of interesting topics. In addition to these efforts, we’ll continue to grow our podcast and search for new ways to bring you important addiction-related information.  

At The SA¹ú¼Ê´«Ã½Weekly, we remain committed to being your reliable weekly newsletter, offering summaries of the salient research in the field. We would also love to hear your thoughts on how we can make it even more engaging.

Please take a few minutes to fill out our survey below. You could win a $100 SA¹ú¼Ê´«Ã½eLearning Center gift card but most importantly, your input can help make the SA¹ú¼Ê´«Ã½Weekly even better. We always appreciate the feedback.  

One last thing -- we’re thinking about identifying more publications that come with CME opportunities. For example, there’s a thoroughly informative and concise commentary from the about the harms pregnant and postpartum people face because of structural and interpersonal bias. It’s not only a CME opportunity, but also an Editor’s Choice publication.

Thanks for reading,

Nicholas Athanasiou, MD, MBA, DFASAM
Editor in Chief

with Co-Editors: Brandon Aden, MD, MPH, FASAM, Jack Woodside, MD, John A. Fromson, MD

Lead Story 

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Addiction

It is not clear to what extent nicotine is responsible for adverse outcomes of smoking during pregnancy. This study examined outcomes of e-cigarette (EC) and nicotine replacement therapy (NRT) use in pregnancy. Pregnant smokers were randomly assigned to EC or NRT. ECs were more than twice as likely to be used regularly compared to NRT. Those abstaining from cigarettes had higher birth weights (3.3 Kg) than smokers (3.1 Kg), and the use of EC or NRT did not affect birth weight in abstainers. In the entire group (abstainers and smokers), use of EC and/or NRT was not associated with an increase in adverse events. Those using EC had less cough and phlegm than those using NRT. Other studies have confirmed the same, possibly resulting from antibacterial effects of additives to the EC liquid. The authors found no risks to pregnancy from EC or NRT use. 

Research and Science 

The American Journal of Psychiatry

This sex-separated multicenter longitudinal study analyzed 12-month data on real-life alcohol use (from 21,460 smartphone entries), menstrual cycle, and serum progesterone-to-estradiol ratios (from 667 blood samples at four individual study visits) in 74 naturally cycling females and 278 males with alcohol use disorder (AUD) between 2020 and 2022. Menstrual cycle phases were significantly associated with binge drinking and progesterone-to-estradiol ratio. In males, a higher progesterone-to-estradiol ratio was related to lower probabilities of binge drinking and any alcohol use.  Findings suggest that high progesterone-to-estradiol ratios can have a protective effect against problematic alcohol use in females and males with AUD, highlighting the progesterone-to-estradiol ratio as a promising treatment target. 

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Addiction Science & Clinical Practice

Health care practitioners (n=409) in Ohio completed an email survey of beliefs and attitudes about buprenorphine and OUD. The misinformation about buprenorphine most endorsed (25%) was that it substituted one drug for another. Second (21%) was that buprenorphine is not effective in reducing overdoses. The number of items of misinformation endorsed was associated with less willingness to work with patients with OUD. Almost half of the respondents believed they had been adequately trained to treat OUD, which was associated with increased willingness to work with patients with OUD. Negative bias towards patients with OUD was associated with less willingness to work with patients with OUD. They conclude that misinformation about buprenorphine is common and education to address it is essential to increasing utilization of MOUD. 

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Nature Medicine

This is a prospective observational study of the Magnesium–Ibogaine: the Stanford Traumatic Injury to the CNS protocol (MISTIC), provided together with complementary treatment modalities, in 30 male Special Operations Forces veterans (SOVs) with predominantly mild TBI. Ibogaine is a plant-derived compound known to interact with multiple neurotransmitter systems that has been studied primarily as a treatment for substance use disorders. It has been associated with instances of fatal cardiac arrhythmia, but coadministration of magnesium may mitigate this concern. MISTIC resulted in significant improvements in functioning both immediately and 1 month after treatment and in PTSD, depression, and anxiety at 1 month after treatment. There were no unexpected or serious adverse events.