ORCID Profile
0000-0002-5388-7376
Current Organisation
University of St Andrews
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Publisher: Royal College of Psychiatrists
Date: 24-02-2022
DOI: 10.1192/BJI.2022.1
Abstract: The COVID-19 pandemic has significantly affected treatment services for people with substance use disorders (SUDs). Based on the perspectives of service providers from eight countries, we discuss the impact of the pandemic on SUD treatment services. Although many countries quickly adapted in provision of harm reduction services by changes in policy and service delivery, some went into a forced abstinence-based strategy. Similarly, disruption of abstinence-based approaches such as therapeutic communities has been reported. Global awareness is crucial for responsible management of SUDs during the pandemic, and the development of international health policy guidelines is an urgent need in this area.
Publisher: BMJ
Date: 02-2022
DOI: 10.1136/BMJOPEN-2021-054376
Abstract: Develop a novel algorithm to categorise alcohol consumption using primary care electronic health records (EHRs) and asses its reliability by comparing this classification with self-reported alcohol consumption data obtained from the UK Biobank (UKB) cohort. Cross-sectional study. The UKB, a population-based cohort with participants aged between 40 and 69 years recruited across the UK between 2006 and 2010. UKB participants from Scotland with linked primary care data. Create a rule-based multiclass algorithm to classify alcohol consumption reported by Scottish UKB participants and compare it with their classification using data present in primary care EHRs based on Read Codes. We evaluated agreement metrics (simple agreement and kappa statistic). Among the Scottish UKB participants, 18 838 (69%) had at least one Read Code related to alcohol consumption and were used in the classification. The agreement of alcohol consumption categories between UKB and primary care data, including assessments within 5 years was 59.6%, and kappa was 0.23 (95% CI 0.21 to 0.24). Differences in classification between the two sources were statistically significant (p .001) More in iduals were classified as ‘sensible drinkers’ and in lower alcohol consumption levels in primary care records compared with the UKB. Agreement improved slightly when using only numerical values (k=0.29 95% CI 0.27 to 0.31) and decreased when using qualitative descriptors only (k=0.18 % CI 0.16 to 0.20). Our algorithm classifies alcohol consumption recorded in Primary Care EHRs into discrete meaningful categories. These results suggest that alcohol consumption may be underestimated in primary care EHRs. Using numerical values (alcohol units) may improve classification when compared with qualitative descriptors.
Publisher: Cold Spring Harbor Laboratory
Date: 20-10-2020
DOI: 10.1101/2020.10.17.20214304
Abstract: Cue reactivity is one of the most frequently used paradigms in functional magnetic resonance imaging (fMRI) studies of substance use disorders (SUDs). While there have been promising results elucidating the neurocognitive mechanisms of SUDs and SUD treatments, the interpretability and reproducibility of these studies is limited by incomplete reporting of participant characteristics, task design, craving assessment, scanning preparation and analysis decisions in fMRI drug cue reactivity (FDCR) experiments. This h ers clinical translation, not least because systematic review and meta-analysis of published work is difficult. This consensus paper and Delphi study aims to outline the important methodological aspects of FDCR research, present structured recommendations for more comprehensive methods reporting, and review the FDCR literature to assess the reporting of items that are deemed important. Fifty-five FDCR scientists from around the world participated in this study. First, an initial checklist of items deemed important in FDCR studies was developed by several members of the Enhanced NeuroImaging Genetics through Meta-Analyses (ENIGMA) Addiction working group based on a systematic review. Using a modified Delphi consensus method, all experts were asked to comment on, revise or add items to the initial checklist, and then to rate the importance of each item in subsequent rounds. The reporting status of items in the final checklist was investigated in 108 recently published FDCR studies identified through a systematic review. By the final round, 38 items reached the consensus threshold and were classified under 7 major categories: “Participant Characteristics”, “General fMRI Information”, “General Task Information”, “Cue Information”, “Craving Assessment Inside Scanner”, “Craving Assessment Outside Scanner” and “Pre- and Post- Scanning Considerations”. The review of the 108 FDCR papers revealed significant gaps in the reporting of the items considered important by the experts. For instance, while items in the “general fMRI reporting” category were reported in 90.5% of the reviewed papers, items in the “pre- and post-scanning considerations” category were reported by only 44.7% of reviewed FDCR studies. Considering the notable and sometimes unexpected gaps in the reporting of items deemed to be important by experts in any FDCR study, the protocols could benefit from the adoption of reporting standards. This checklist, a living document to be updated as the field and its methods advance, can help improve experimental design, reporting, and the widespread understanding of the FDCR protocols. This checklist can also provide a s le for developing consensus statements for protocols in other areas of task-based fMRI.
Publisher: Cold Spring Harbor Laboratory
Date: 21-07-2020
DOI: 10.1101/2020.07.16.20155341
Abstract: COVID-19 has infected more than 13 million people worldwide and impacted the lives of many more, with a particularly devastating impact on vulnerable populations, including people with substance use disorders (SUDs). Quarantines, travel bans, regulatory changes, social distancing and ‘lockdown’ measures have affected drug and alcohol supply chains and subsequently their availability, price and use patterns, with possible downstream effects on presentations of SUDs and demand for treatment. Given the lack of multicentric epidemiologic studies, we conducted a rapid global survey within the International Society of Addiction Medicine (ISAM) network in order to understand the status of substance-use patterns during the current pandemic. Cross-sectional survey. Worldwide. Starting on April 4 th , 2020 during a 5-week period, the survey received 185 responses from 77 countries. To assess addiction medicine professionals’ perceived changes in drug and alcohol supply, price, use pattern and related complications during the COVID-19 pandemic. Participants reported (among who answered “decreased” or “increased”, percentage of those who were in majority is reported in the parenthesis) a decrease in drug supply (69.0%), and at the same time an increase in price (95.3%) globally. With respect to changes in use patterns, an increase in alcohol (71.7%), cannabis (63.0%), prescription opioids (70.9%), and sedative/hypnotics (84.6%) use was reported while the use of hetamines (59.7%), cocaine (67.5%), and opiates (58.2%) was reported to decrease overall. The global report on changes in the availability, use patterns and complications of alcohol and drugs during the COVID-19 pandemic should be considered in making new policies and in developing mitigating measures and guidelines during the current pandemic (and probable future ones) in order to minimize risks to SUDs. Authors claimed no competing interest
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 2006
Publisher: Elsevier BV
Date: 10-2019
DOI: 10.1016/J.NEUBIOREV.2019.07.006
Abstract: Many studies have reported that heavy substance use is associated with impaired response inhibition. Studies typically focused on associations with a single substance, while polysubstance use is common. Further, most studies compared heavy users with light/non-users, though substance use occurs along a continuum. The current mega-analysis accounted for these issues by aggregating in idual data from 43 studies (3610 adult participants) that used the Go/No-Go (GNG) or Stop-signal task (SST) to assess inhibition among mostly "recreational" substance users (i.e., the rate of substance use disorders was low). Main and interaction effects of substance use, demographics, and task-characteristics were entered in a linear mixed model. Contrary to many studies and reviews in the field, we found that only lifetime cannabis use was associated with impaired response inhibition in the SST. An interaction effect was also observed: the relationship between tobacco use and response inhibition (in the SST) differed between cannabis users and non-users, with a negative association between tobacco use and inhibition in the cannabis non-users. In addition, participants' age, education level, and some task characteristics influenced inhibition outcomes. Overall, we found limited support for impaired inhibition among substance users when controlling for demographics and task-characteristics.
Publisher: Springer Science and Business Media LLC
Date: 25-06-2015
Publisher: Frontiers Media SA
Date: 29-04-2021
DOI: 10.3389/FPSYT.2021.639393
Abstract: Background: The coronavirus disease 2019 (COVID-19) pandemic has impacted people with substance use disorders (SUDs) worldwide, and healthcare systems have reorganized their services in response to the pandemic. Methods: One week after the announcement of the COVID-19 as a pandemic, in a global survey, 177 addiction medicine professionals described COVID-19-related health responses in their own 77 countries in terms of SUD treatment and harm reduction services. The health responses were categorized around ( 1 ) managerial measures and systems, ( 2 ) logistics, ( 3 ) service providers, and ( 4 ) vulnerable groups. Results: Respondents from over 88% of countries reported that core medical and psychiatric care for SUDs had continued however, only 56% of countries reported having had any business continuity plan, and 37.5% of countries reported shortages of methadone or buprenorphine supplies. Participants of 41% of countries reported partial discontinuation of harm-reduction services such as needle and syringe programs and condom distribution. Fifty-seven percent of overdose prevention interventions and 81% of outreach services were also negatively impacted. Conclusions: Participants reported that SUD treatment and harm-reduction services had been significantly impacted globally early during the COVID-19 pandemic. Based on our findings, we highlight several issues and complications resulting from the pandemic concerning people with SUDs that should be tackled more efficiently during the future waves or similar pandemics. The issues and potential strategies comprise the following: (1) helping policymakers to generate business continuity plans, (2) maintaining the use of evidence-based interventions for people with SUDs, (3) being prepared for adequate medication supplies, (4) integrating harm reduction programs with other treatment modalities, and (5) having specific considerations for vulnerable groups such as immigrants and refugees.
Publisher: Springer Science and Business Media LLC
Date: 08-04-2014
Publisher: Springer Science and Business Media LLC
Date: 04-02-2022
Location: United Kingdom of Great Britain and Northern Ireland
No related grants have been discovered for Alex Baldacchino.