Background: Although Alcohol Use Disorder (AUD) is highly prevalent worldwide, treating this condition remains challenging. Further, potential treatments for AUD do not fully address alcohol-induced neuroadaptive changes. Understanding the effects of pharmacotherapies for AUD on the human brain may lead to tailored, more effective treatments, and improved individual clinical outcomes. Objectives: We systematically reviewed the literature for studies investigating pharmacotherapies for AUD that included neuroimaging-based treatment outcomes. We searched the PubMed, Scielo, and PsycINFO databases up to January 2021. Study eligibility criteria, participants, and interventions: Eligible studies included those investigating pharmacotherapies for AUD and employing functional magnetic resonance imaging (fMRI), positron emission tomography (PET), single-photon emission computed tomography (SPECT), and/or proton magnetic resonance spectroscopy (H-MRS). Study appraisal and synthesis methods: Two independent reviewers screened studies’ titles and abstracts for inclusion. Data extraction forms were shared among all the authors to standardize data collection. We gathered information on the following variables: sample size; mean age; sociodemographic and clinical characteristics; alcohol use status; study design and methodology; main neuroimaging findings and brain-regions of interest (i.e., brain areas activated by alcohol use and possible pharmacological interactions); and limitations of each study. Results: Out of 177 studies selected, 20 studies provided relevant data for the research topic. Findings indicate that: (1) Acamprosate and gabapentin may selectively modulate limbic regions and the anterior cingulate cortex; (2) Naltrexone and disulfiram effects may involve prefrontal, premotor, and cerebellar regions; (3) Pharmacotherapies acting on glutamate and GABA neurotransmission involve primarily areas underpinning reward and negative affective states, and; (4) Pharmacotherapies acting on opioid and dopamine systems may affect areas responsible for the cognitive and motor factors of AUD. Limitations: Most of the studies were focused on naltrexone. A small number of studies investigated the action of disulfiram and gabapentin, and no neuroimaging studies investigated topiramate. In addition, the time between medication and neuroimaging scans varied widely across studies. Conclusions: We identified key-brain regions modulated by treatments available for AUD. Some of the regions modulated by naltrexone are not specific to the brain reward system, such as the parahippocampal gyrus (temporal lobe), parietal and occipital lobes. Other treatments also modulate not specific regions of the reward system, but play a role in the addictive behaviors, including the insula and dorsolateral prefrontal cortex. The role of these brain regions in mediating the AUD pharmacotherapy response warrants investigation in future research studies.

Craving is one of the most important symptoms of cocaine use disorder (CUD) since it contributes to the relapse and persistence of such disorder. This systematic review aimed to investigate which brain regions are modulated during cocaine craving. The articles were obtained through searches in the Google Scholar, Regional BVS Portal, PubMed, and Scielo databases. Overall, there was a selection of 36 studies with 1574 individuals, the majority being participants with CUD, whereby about 61.56% were individuals with CUD and 38.44% were controls (mean age = 40.4 years). Besides the methodological points, the neurobiological investigations comprised fMRI (58.34%) and PET (38.89%). The induction of cocaine craving was studied using different methods: exposure to cocaine cues (69.45%), stressful stimuli, food cues, and methylphenidate. Brain activations demonstrated widespread activity across the frontal, parietal, temporal, and occipital lobes, basal ganglia, diencephalon, brainstem, and the limbic system. In addition to abnormalities in prefrontal cortex activity, abnormalities in various other brain regions’ activity contribute to the elucidation of the neurobiology of cocaine craving. Abnormalities in brain activity are justified not only by the dysfunction of dopaminergic pathways but also of the glutamatergic and noradrenergic pathways, and distinct ways of inducing craving demonstrated the involvement of distinct brain circuits and regions.

Background: E-cigarettes, initially designed for nicotine consumption, are now increasingly being used to smoke cannabis, resulting in a growing trend known as “dual vaping”. This term describes individuals, referred to as “dual users”, who use e-cigarettes for both substances. This study aims to review and analyze existing research on dual vaping, with a focus on the associated health risks and behavioral patterns. Methods: A narrative review of the literature was conducted using PubMed. Studies focusing on individuals who use electronic cigarettes for vaping tobacco and cannabis, either chronically or episodically, were examined. Relevant articles were identified and thematically synthesized to provide a comprehensive overview of the topic. Results: Dual vaping was found to be prevalent among younger men, White and Hispanic populations, and individuals with higher economic status and educational level. The use of one substance was shown to predispose individuals to the use of the other, often leading to concurrent use of both substances. Peer influence and positive expectations regarding e-cigarettes were identified as significant predictors of dual use. Dual vapers exhibited a higher susceptibility to respiratory and systemic symptoms compared to those who exclusively vaped nicotine or cannabis. Moreover, a notable prevalence of psychiatric disorders, such as substance use disorders, anxiety, and depression, was observed in this group. Fruit-flavored e-cigarettes were the most preferred option among dual vapers when using both nicotine and cannabis. Conclusions: Current evidence is insufficient to fully elucidate the long-term impacts of dual vaping on physical and mental health, particularly when compared to individuals who have never vaped. Further studies are needed to gain a more comprehensive understanding of this behavior.

Background: E-cigarettes, initially designed for nicotine consumption, are now increasingly being used to smoke cannabis, resulting in a growing trend known as "dual vaping." This term describes individuals, referred to as "dual users," who use e-cigarettes for both substances. This study aims to review and analyse existing research on dual vaping, with a focus on the associated health risks and behavioral patterns. Methods: A systematic search on PubMed was performed up to August 2023. Studies investigating individuals who use electronic cigarettes for vaping tobacco and cannabis, either chronically or episodically, were included. Articles that met the inclusion criteria were thoroughly reviewed and analysed. Results: A total of 1,778 studies were screened, of which 53 articles were reviewed, and 25 met the inclusion criteria. Four main characteristics emerged: the demographic variables of users, their health risks, behaviours, and predisposing factors to smoking. Dual Vaping was found to be prevalent among younger men, White and Hispanic populations, and individuals with higher economic status and educational level. The use of one substance was shown to predispose individuals to the use of the other, often leading to concurrent use of both substances. Peer influence and positive expectations regarding e-cigarettes were identified as significant predictors of dual use. Dual Vapers exhibited a higher susceptibility to respiratory and systemic symptoms compared to those who exclusively vaped nicotine or cannabis. Moreover, a notable prevalence of psychiatric disorders, such as substance use disorders, anxiety, and depression, was observed in this group. Fruit-flavored e-cigarettes were the most preferred option among Dual Vapers when using both nicotine and cannabis. Conclusion: Current evidence is insufficient to fully elucidate the long-term impacts of dual vaping on physical and mental health, particularly when compared to individuals who have never vaped. Further studies are needed to gain a more comprehensive understanding of this behaviour.