Long-Acting Buprenorphine Formulations as a New Strategy for the Treatment of Opioid Use Disorder.

Long-acting buprenorphine formulations have been recently marketed for the Opioid Agonist Treatment (OAT) of opioid use disorder (OUD) associated with medical, social, and psychological support. Their duration of action ranges from one week up to 6 months. The non-medical use of opioids is increasing with a parallel rise in lethal overdoses. Methadone and buprenorphine are the standard treatment for opioid dependence. Methadone Maintenance Treatment (MMT) is widely recognized as one of the most effective ways of reducing the risks of overdose, crime, and transmission of HIV (Human Immunodeficiency Virus) in people who use opioids; however, its effectiveness has been hindered by low rates of uptake and retention in treatment. Furthermore, both methadone and buprenorphine are widely diverted and misused. Thus, a crucial aspect of treating OUD is facilitating patients' access to treatment while minimizing substance-related harm and improving quality of life. The newly developed long-acting buprenorphine formulations represent a significant change in the paradigm of OUD treatment, allowing an approach individualized to patients' needs. Strengths of this individualized approach are improved adherence (lack of peaks and troughs in blood concentrations) and a reduced stigma since the patient doesn't need to attend their clinic daily or nearly daily, thus facilitating social and occupational integrations as the quality of life. However, less frequent attendance at the clinic should not affect the patient-physician relationship. Therefore, teleconsulting or digital therapeutic services should be developed in parallel. In addition, diversion and intravenous misuse of buprenorphine are unlikely due to the characteristics of these formulations. These features make this approach of interest for treating OUD in particular settings, such as subjects staying or when released from prison or those receiving long-term residential treatment for OUD in the therapeutic communities. The long-lasting formulations of buprenorphine can positively impact the OUD treatment and suggest future medical and logistic developments to maximize their personalized management and impact.

Evaluation of Risk Behavior in Gambling Addicted and Opioid Addicted Individuals.

Evidence suggests that both opioid addicted and gambling addicted individuals are characterized by higher levels of risky behavior in comparison to healthy people. It has been shown that the administration of substitution drugs can reduce cravings for opioids and the risky decisions made by individuals addicted to opioids. Although it is suggested that the neurobiological foundations of addiction are similar, it is possible that risk behaviors in opioid addicts may differ in detail from those addicted to gambling. The aim of this work was to compare the level of risk behavior in individuals addicted to opioid, with that of individuals addicted to gambling, using the Iowa Gambling Task (IGT). The score and response time during the task were measured. It was also observed, in the basis of the whole IGT test, that individuals addicted to gambling make riskier decisions in comparison to healthy individuals from the control group but less riskier decisions in comparison to individuals addicted to opioids, before administration of methadone and without any statistically significant difference after administration of methadone-as there has been growing evidence that methadone administration is strongly associated with a significant decrease in risky behavior.

Pitch Syntax Violations Are Linked to Greater Skin Conductance Changes, Relative to Timbral Violations - The Predictive Role of the Reward System in Perspective of Cortico-subcortical Loops.

According to contemporary opinion emotional reactions to syntactic violations are due to surprise as a result of the general mechanism of prediction. The classic view is that, the processing of musical syntax can be explained by activity of the cerebral cortex. However, some recent studies have indicated that subcortical brain structures, including those related to the processing of emotions, are also important during the processing of syntax. In order to check whether emotional reactions play a role in the processing of pitch syntax or are only the result of the general mechanism of prediction, the comparison of skin conductance levels reacting to three types of melodies were recorded. In this study, 28 subjects listened to three types of short melodies prepared in Musical Instrument Digital Interface Standard files (MIDI) - tonally correct, tonally violated (with one out-of-key - i.e., of high information content), and tonally correct but with one note played in a different timbre. The BioSemi ActiveTwo with two passive Nihon Kohden electrodes was used. Skin conductance levels were positively correlated with the presented stimuli (timbral changes and tonal violations). Although changes in skin conductance levels were also observed in response to the change in timbre, the reactions to tonal violations were significantly stronger. Therefore, despite the fact that timbral change is at least as equally unexpected as an out-of-key note, the processing of pitch syntax mainly generates increased activation of the sympathetic part of the autonomic nervous system. These results suggest that the cortico-subcortical loops (especially the anterior cingulate - limbic loop) may play an important role in the processing of musical syntax.