<![CDATA[High-potency cannabis surges; psychiatry confronts psychosis risk, dependence, and data gaps—why clinicians must guide safer use now.]]>
Effect of low-intensity focused ultrasound on hippocampus of alcohol addicted mice: a preliminary study
Alcohol addiction is a chronic relapsing brain disorder characterized by significant neurobiological changes, particularly within the hippocampus, which mediates emotional regulation and reward-seeking behavior. Previous studies have shown that alcohol-induced neuronal injury contributes to withdrawal-associated anxiety and persistent alcohol preference. This study investigated the therapeutic effects of low-intensity focused ultrasound (LIFU) on the hippocampus in a mouse model of alcohol addiction. Twenty-six male C57BL/6 mice were allocated to an alcohol-exposed group (n = 20) and a control group (n = 6). Following a 28-day modeling period, the alcohol group was randomly subdivided into a therapy group and a sham group. The therapy group received LIFU treatment, while the sham group underwent an identical procedure with the ultrasound transducer powered off. After seven days of treatment, the therapy group exhibited less severe anxiety symptoms upon alcohol withdrawal and a reduced preference for alcohol compared to the sham group. The brain-derived neurotrophic factor (BDNF) concentration was significantly lower in the therapy group than in the sham group, but did not differ significantly from the control group. Hippocampal HE staining revealed more pronounced degeneration and apoptosis of granule cells in the dentate gyrus (DG) region in the sham group relative to the therapy group. These preliminary findings suggest that LIFU may modulate alcohol addiction by mitigating hippocampal neuronal injury.
The patterns of relapse and abstinence: using machine learning to identify a multidimensional signature of long-term outcome after inpatient alcohol withdrawal treatment
AimsA machine learning approach to identify a multidimensional signature associated with relapse and long-term outcome in alcohol dependence treatment.DesignIn this observational naturalistic study, inpatients with alcohol dependence received qualified detoxification plus CBT (Cognitive Behavioral Therapy) and were followed up 6-months after discharge to assess abstinence and drinking behavior. Cross-validated multivariate sparse partial least squares analysis (SPLS) was used to investigate the relationship between clinical features and four long-term outcome variables.SettingGermany.Participants152 patients (on average 47.8 years old, 72% male) with alcohol dependence, who received inpatient qualified detoxification plus CBT.Measurements35 clinical features were used to cover all three phases of inpatient treatment (pre-, within-, post-treatment). Among these, sociodemographic characteristics, ICD-10 psychiatric diagnoses, previous detoxification treatments, and somatic measurements as well as inpatient treatment setting such as withdrawal medication, liver ultrasound, further information about the patients´ stay, and post-inpatient care were assessed. The four outcome dimensions included: continuous abstinence, abstinence at follow up, daily alcohol consumption, and days of abstinence after discharge.FindingsSix months after withdrawal treatment 46% of the patients achieved continuous abstinence. Socioeconomic, clinical and somatic features across the treatment timeline were analyzed and summarized into a multivariate signature associated with long-term treatment outcome. Thereby, the SPLS algorithm identified regular completion of withdrawal treatment, higher education, and employment status to be most strongly associated with a positive outcome. Alcohol-related hepatic and hematopoietic damage, number of previous withdrawal treatments and living in a shelter were most profoundly associated with a negative outcome.ConclusionConceiving treatment outcome as a multidimensional signature and moving beyond simple binary classifications of relapse versus abstinence may improve the understanding of relapse pathways and support more individualized treatment strategies.
Brain Circuits Underlying Placebo Pain Relief Identified in Mice
Though the placebo effect is a well documented phenomenon, the neurological mechanisms that underlie the process are still not fully understood. Now scientists from multiple institutions led by a team at the University of California San Diego (UCSD) have pinpointed the brain circuitry in mice that they believe is responsible for placebo pain relief. Details of their findings are published in a new paper in the journal Neuron. In it, they describe brain regions that support placebo effects and highlight sites where endogenous opioid neuropeptides send signals that are important for placebo pain relief.
The paper is titled “Top-down control of the descending pain modulatory system drives multimodal placebo analgesia.” According to the team, theirs is the first study to establish placebo mechanisms by adapting a protocol used for humans to work in mice. Working alongside labs at the University of Pennsylvania, University of California Irvine, and elsewhere, the UCSD team detected activity in parts of the mouse brain that correspond to those previously implicated in human studies. Furthermore, by precisely mapping neural pathways and brain activity in the mice, the team identified essential roles for neural circuits that link the cortex to the brainstem and spinal cord during placebo pain relief.
They also found that training mice to exhibit a placebo effect with one type of pain results in relief from several different types of pain including pain from injuries. That is particularly notable because it has “direct implications for how placebo training in humans might be used to produce resilience to future pain that results from injury,” explained Matthew Banghart, PhD, an associate professor in UCSD’s neurobiology department and lead author on the study. The findings also open a door to “expectancy-driven” placebo effects as a substitute for addictive painkillers, he noted, meaning that it might be possible to use placebo conditioning to train patients to build preemptive resilience to pain.
Full details of the findings and methods used are provided in the paper. In it, the teams explain that they used sensor technology and a light-activated drug developed in the Banghart lab to study the role of naturally-occurring opioid peptides in the brain. Specifically, they used the sensors to detect opioid peptide signaling in the ventrolateral periaqueductal gray (vlPAG) region, a known hub for pain signaling, during placebo trials. They then used the light-activated drug called photoactivatable naloxone, or PhNX, to establish that these opioid peptides actually drive pain relief in a manner similar to drugs like morphine. The light allowed the scientists control and timing of the opioid signaling interference. Using PhNX, they confirmed that both morphine-induced pain relief and placebo pain relief use the same opioid signaling pathway in the vlPAG region of the brain.
Essentially, “we trained a mouse brain to create its own broad-spectrum painkillers on demand, precisely where they are needed to treat pain, without the off-target effects of opioid-based painkillers,” said Janie Chang-Weinberg, a PhD student in the biological sciences graduate program at UCSD and one of the first authors on the study.
Future studies planned by the team will dig more deeply into how placebo learning unfolds in the brain and evaluate different placebo training strategies in mice with an eye towards developing protocols that readily translate to produce placebo pain resilience in people living with chronic pain.
The post Brain Circuits Underlying Placebo Pain Relief Identified in Mice appeared first on GEN – Genetic Engineering and Biotechnology News.
<![CDATA[High-potency cannabis surges; psychiatry confronts psychosis risk, dependence, and data gaps—why clinicians must guide safer use now.]]>
Editorial: Assessment and management of addictive disorders in sexual and racial minorities
AACR Warns Congress of Cancer Care Setbacks from Proposed NIH Cuts, Again
Cancer researchers in the United States are once again bracing for a high-stakes funding battle in Washington, as a proposed $6 billion cut to the National Institutes of Health (NIH) for fiscal year 2027 threatens to derail years of scientific progress.
For advocates like Jon Retzlaff, Chief Policy Officer and Vice President for Science Policy and Government Affairs at the American Association for Cancer Research (AACR), the situation feels strikingly familiar and deeply consequential. That sense of déjà vu is shaping the response from the cancer research community, which is now urging Congress to once again reject the administration’s proposal just as it did last year.
To understand the urgency of the current moment, Retzlaff points back to the turmoil of the previous budget cycle. “A year ago, the president had proposed a 40% cut to NIH,” Retzlaff told Inside Precision Medicine. “Things looked pretty bleak.” The consequences were immediate and unsettling: grants were stuck and there were cutbacks on committees and staff.
But Congress ultimately intervened decisively. “We engaged with Congress, who has the power of the purse,” Retzlaff said. “They summarily rejected the president’s proposal for the 40% cuts and instead provided a $450 million increase for NIH.” Lawmakers also delivered a significant boost to the National Cancer Institute (NCI), reinforcing what Retzlaff described as a clear signal of bipartisan support for biomedical research. “What we saw for the current fiscal year… is they summarily rejected the president’s proposal,” Retzlaff said. “So now we are going through the exercise all over again.”
Despite the renewed threat, Retzlaff sees reasons for hope rooted in last year’s outcome. “People asked, ‘How can you be so optimistic?’” He recalled the earlier funding fight. “At least this year, I’m going to be able to tell them why I can be optimistic,” he said. “Because it was Congress that stood up.”
Still, he cautioned against complacency. “We can’t rest on our laurels. We can’t take it for granted,” Retzlaff said. “We will be continuing to press the issue.”
Holding down the precision oncology fort
For AACR, the renewed funding fight underscores a central truth: cancer research depends on long-term, uninterrupted investment. “You need this sustained funding over time,” Retzlaff said. “You go where the science is showing opportunities and also where there might not be opportunities right now.”
He emphasized that scientific progress is rarely linear or predictable. “Even though people can’t necessarily say it’s clear-cut that if we do research in this, we’re going to make some progress,” he said, “for some of the cancers, we just need to do research to try to have that knowledge discovery going on.”
Retzlaff added, “Basic biology is so important,” stressing that foundational science underpins every future breakthrough and the continued growth of precision medicine as the new standard of healthcare. “It’s about identifying the biomarkers that are important,” Retzlaff explained.
Meanwhile, emerging areas such as cancer vaccines are generating both excitement and urgency. “Cancer vaccines are now a big issue,” he said. “AACR is very interested in pushing that kind of research forward.”
Yet all of this progress depends on stable funding. Without it, Retzlaff warned, research priorities could narrow dangerously. “If you start cutting back, the next thing you know, we’re just funding breast cancer and lung cancer,” he said, “whereas the rare cancers need to be investigated. We need to give those people hope.”
Sustained national commitment to health
Funding cuts would also ripple through the clinical research pipeline. Retzlaff, who has become more involved in clinical trials in recent years, noted their complexity and cost.
While pharmaceutical companies often support later-stage development, early and exploratory studies depend heavily on NIH funding. “We rely on pharmaceutical companies… once you get into the translational part,” he explained, but without federal investment at the front end, fewer discoveries will ever reach that stage.
For AACR, protecting NIH funding is about more than preserving scientific momentum; it’s about sustaining a national commitment to health. “We’ve got 50,000 members,” Retzlaff said. “Two-thirds of them are from the U.S., and probably two-thirds of them are completely reliant in many ways on NIH funding.” That dependence drives the organization’s advocacy efforts. “Our number one priority is inspiring excitement on Capitol Hill and from lawmakers for robust, sustained and predictable funding for the NIH,” he said.
AACR’s outreach spans everything from congressional briefings to large-scale advocacy events. “It’s working with the entire community,” Retzlaff said, noting collaborations with hundreds of organizations and initiatives, such as Medical Research Hill Day. “We’re constantly looking at drum[ming] up conversations with the media,” he added. “It’s things like that—briefings, reports, letters—you name it.”
At the same time, AACR is navigating broader policy and public health challenges. Retzlaff highlighted ongoing engagement with the Food and Drug Administration (FDA) on issues ranging from clinical trial efficiency to tobacco regulation.
Backing cancer vaccines
Prevention, too, remains a critical priority. “HPV prevention is very important,” he said, though he acknowledged that misinformation has slowed progress. “The anti-vaccine movement is a huge concern.”
Retzlaff said that the cancer vaccine issue is rooted in communication and not the regulators. According to Retzlaff, the director of the National Cancer Institute has had some meetings with Secretary Kennedy, who was supportive of moving cancer vaccines forward. “We have to figure out what it is that people will accept about cancer vaccines that they’re not accepting about vaccines overall,” Retzlaff said. “That’s a communication issue… trying to combat the misinformation out there.”
AACR has even debated trying new names for the modality. Retzlaff elaborated, “There was some discussion about whether we can change the name of this from ‘cancer vaccines’ to something else.”
As Congress weighs the proposed cuts, AACR is calling on researchers, patients, and advocates to speak out once again. The message, Retzlaff said, is simple but urgent: “We definitely want to get the information out… about the importance of NIH medical research… and inspire people to take action.”
The outcome will determine not only the trajectory of cancer research but also the pace at which new discoveries can translate into treatments and, ultimately, save lives.
The post AACR Warns Congress of Cancer Care Setbacks from Proposed NIH Cuts, Again appeared first on Inside Precision Medicine.
Prediction of Relapse Using Digital Technology in People in Recovery From Substance Use Disorders: Early Economic Evaluation With a Case Study of the Subreal App
Background: Many people relapse after achieving abstinence in substance use disorders. Health care providers may scan the horizon for new technologies to predict response that allow interventions to be targeted rather than routine. Currently, no such predictive technologies are available in the United Kingdom. The Subreal app is available for use in research contexts, but no clinical data specific to the app are yet available. Early health economic modeling can use data from the literature to explore characteristics essential for the new technology to be cost-effective. This information can guide developers in setting performance targets and pricing and estimating potential cost savings and/or cost-effectiveness for health care providers. Objective: This study was supported by a UK industry funding body to explore the potential of digital technologies such as the Subreal app to offer cost savings or cost-effectiveness for health care providers. We explored the threshold price and clinical effectiveness required to deliver cost savings and cost-effectiveness in 2 subpopulations with substance use disorders in a UK setting. Methods: Deterministic models were used to estimate costs per relapse and quality-adjusted life years over 1-, 5-, and 20-year time horizons for people who have achieved abstinence after treatment for alcohol or opioid misuse. The intervention was a digital technology predicting relapse, provided—in addition to standard care—for 1 year post achievement of abstinence. In Subreal, biomarker data are collected daily through the app, and artificial intelligence–enhanced risk assessment flags patients who require additional support. The comparator was event-driven, reactive response to relapse. Costs and quality-of-life estimates were calculated using Markov models with data from existing published sources. The base-case estimate of 15% reduction in first-year relapse rates was based on a previous study on a similar but simpler digital technology. Results: Digital technologies such as the Subreal app have the potential to be cost-saving from a UK health and social care perspective, especially when used over a longer time horizon. Assuming a reduction of 15% in first-year relapse rates, digital technologies have the potential to be cost-saving, provided that they do not cost more than £300 (US $400.09) and £460 (US $613.47) per patient per annum for alcohol and opioid use disorders, respectively. No cost was included for postalert care, as it was assumed that this could be met within existing resources. Cost savings would be achieved predominantly through a reduction in treatment requirements as fewer people relapse. Price thresholds would reduce correspondingly if a <15% reduction in relapse rates were achieved. Conclusions: Developers of digital technologies that aim to reduce relapse need to focus on the generation of evidence of clinical effectiveness and develop a commercially sustainable pricing model that allows health care providers to benefit from cost savings.
<![CDATA[New ASAM youth criteria redefine SUD care with brain-stage levels, chronic monitoring, detox safety, and family-centered support.]]>
Therapeutic Potential of GLP-1 Receptor Agonists for Smoking Cessation
Glucagon-like peptide-1 (GLP-1) therapies are under investigation for a growing number of neuropsychiatric conditions, including substance use disorders. Cigarette smoking accounts for the largest proportion of substance use-related morbidity and mortality, in part reflecting increased risk for cardiometabolic disease among people who smoke. Given modest quit rates with approved smoking cessation therapies, medications with novel mechanisms of action are needed to expand the available monotherapy and combination treatment options.