Migration and time to first tobacco cigarette after waking

Drug and Alcohol Dependence 156 (2015) e183–e245 e241 currently a major public health problem. This study examined whether pre-treatment drug reinforcement value predicted opioid use during outpatient treatment of prescription opioid addiction. Methods: Secondary analyses of a multi-site clinical trial (NIDA CTN-0030) for adults with prescription opioid dependence who received 12 weeks of buprenorphine-naloxone and counseling (N=353). Analyses covaried for opioid dependence severity and opioid source. Predictors were naturalistic indices of drug reinforcement value including the total amount and proportion of income spent on drugs. Outcome was opioid use during treatment assessed by weekly urine drug screens. Results: Obtaining opioids from doctors was associated with lower pre-treatment drug spending, while obtaining opioids from dealers/patients was associated with greater spending. Controlling for demographics, opioid dependence severity, and opioid source frequency, patients who spent a greater total amount (OR=1.30, p< .001) and a greater proportion of their income on drugs (OR=1.31, p< .001) were more likely to use opioids during treatment. Conclusions: As indicated by pre-treatment allocation of economic resources to drugs, individual differences in drug reinforcement value reflect propensity for continued opioid use during treatment among individuals with prescription opioid addiction. Future studies should examine disrupted decision-making and reward-processing in prescription opioid users more directly and test whether reinforcer pathology can be remediated in this increasingly prevalent population. Financial support: NIDA 5T32DA026400 and the NIDA Clinical Trials Network. http://dx.doi.org/10.1016/j.drugalcdep.2015.07.648 Migration and time to first tobacco cigarette after waking Wei Xue1,∗, James C. Anthony2 1 Michigan State University, East Lansing, MI, United States 2 Epidemiology and Biostatistics, Michigan State University, East Lansing, MI, United States Aims: At CPDD2014, we reported on suspected effects ofmigration on tobacco smoking. Here, studying 12–24 year old active smokers, we aim to estimate possible migration effects on time to first cigarette (TTFC) after waking up, which is one of the most robust indicators of tobacco dependence. For many immigrants, migration into theUnitedStates (US) includesmajor environmental shifts. Accordingly,with increasing elapsed time since in-migration (ETSI), onemight expect convergence of immigrant TTFC estimates with TTFC estimates for the US-born. Methods: Data are from active tobacco smokers (n∼98,357, 12–24 year olds) identified via the United States National Surveys on Drug Use and Health Restricted-use Data Analysis System (NSDUH, R-DAS) 2002–2011, which use stratified multistage area probability sampling and IRB-approved computer-assisted standardized assessments. Estimates are based on analysis weights and Taylor series variances. Results: Just over one in three of 12–24 year old US-born active smokers have short TTFC (36.1%; 95% CI =35.7, 36.3). The corresponding estimate for the most recent immigrants (ETSI < 5 years) is just under one in five (17.2%; 95% CI =15.0, 19.7), and is just over one infive for immigrantswithETSI≥10years (21.8%; 95%CI =19.7, 24.0). In an exploratory subset analysis focused on newly incident smokers, the TTFC estimates are 15.9% for the US-born and 4.7% for long-residence immigrants (ETSI≥10 years). Conclusions: Our expectations are contradicted by these novel epidemiological estimates. By the time of presentation at CPDD2015, we will have some additional evidence on protection against TTFC apparently enjoyed by immigrant smokers relative to US-born smokers (e.g., greater presence of smoke-free home rules; constraints on disposable income). Financial support: Supported by NIDA T32DA021129 (WX); K05DA015799 (JCA). http://dx.doi.org/10.1016/j.drugalcdep.2015.07.649 Influence of dorsolateral prefrontal cortex and ventral striatum on risk avoidance in addiction: A mediation analysis Dorothy Yamamoto1,∗, Choong-Wan Woo2, Tor Wager2, Jody Tanabe1 1 Radiology, University of Colorado Denver, Aurora, CO, United States 2 Psychology and Neuroscience, University of Colorado Boulder, Boulder, CO, United States Aims: Alterations in frontal and striatal function are hypothesized tounderlie riskydecision-making indrugusers, buthowthese regions interact to affect behavior is incompletely understood. We used mediation analysis to model the contributions of prefrontal cortex and ventral striatal activity to risk avoidance in drug users. Methods:Thirty-sevenabstinent substance-dependent individuals (SDI) and 43 controls underwent fMRI while performing a decision-making task involving riskandreward.Wetestedwhether activity in dorsolateral prefrontal cortex (DLPFC) and ventral striatum (VST) explained group differences in risk avoidance behavior. Next, we conducted a whole-brain mediation analysis to explore other brain regions that may influence the relationship between VST activity and risk avoidance. Results:RightDLPFC (RDLPFC)positivelymediatedgroupdifferences in risk avoidance (p<0.05). RDLPFC activitywas higher in SDI and predicted greater risk avoidance across groups, controlling for SDI vs. controls. Conversely, VST activity negatively influenced risk avoidance (p<0.05). VST activity was higher in SDI and predicted lower risk avoidance. Whole-brain analysis revealed that RDLPFC and left temporal-parietal junction positively (p<0.001), while right thalamus and left middle frontal gyrus negatively (p<0.005), mediated the VST activity-risk avoidance relationship. Conclusions: RDLPFC activity mediated less risky decisionmaking while VST activity mediated greater risky decision-making across SDI and controls. These results suggest that an imbalance in prefrontal and striatal function may adversely influence choices involving risk in drug users.Modeling the contributions ofmultiple brain systems to behavior through mediation analysis could lead to a better understanding of mechanisms of behavior and suggest future targets for addiction treatment. Financial support: National Institute of Drug Abuse DA024104 and DA027748. http://dx.doi.org/10.1016/j.drugalcdep.2015.07.650