Hugo Lopez

Hospital Clínic de Barcelona · Servicio de Psiquiatría

Background: the role of medications for alcohol use disorder (MAUD) in patients with cirrhosis is not well established. Evidence on the efficacy and safety of these drugs in these patients is scarce. Approach & results: we performed a systematic review and meta-analysis according to PRISMA guidelines on the efficacy of MAUD in patients with cirrho...

Background: Alcohol use can cause harm not only to the person who consumes it but also to others. Prior research has found that these alcohol-attributable harms to others differ across socioeconomic groups, though several findings have been contradictory. The aim of this contribution was to study the role of individual-level and population-level i...

Background: Using data from 33 European countries (including all EU member states), this study aimed to 1) estimate the prevalence of unrecorded alcohol use among past-week alcohol users, 2) describe how unrecorded alcohol use is associated with drinking patterns, and 3) estimate the contribution of unrecorded alcohol to the total amount of alcoho...

Background. For alcohol, regulating availability is an effective way to reduce consumption and harm. Similarly, the higher availability of medical cannabis dispensaries has been linked to increased cannabis consumption and harm. For recreational cannabis markets, such a link is suspected but still poorly understood. Methods: A systematic literature...

Background: Alcohol’s detrimental health effects do not affect everyone equally but accumulate in people with low socioeconomic status (SES). Using data from the 2021 Standard European Alcohol Survey, we explore gender- and SES-specific consumption patterns, and COVID-19 related changes in consumption across Europe. Methods: Cross-sectional populat...

Objectives: Cannabis use quantities are relevant for determining cannabis-related harms. This research aims to provide an overview of the available methods to assess quantities through self-report. Methods: A rapid review of various strategies to collect information on cannabis use quantities through self-report. Two independent literature searc...

Lifetime prevalence of cannabis use is estimated 192 million adults worldwide (2017) and has increased by 16% in the last decade. However, data on quantity and frequency of use that can lead to harm is lacking. We have developed a survey to assess patterns of cannabis use and related harms in a sample of cannabis users. This paper focuses on evalua...

BACKGROUND The lockdown measures introduced during the COVID-19 pandemic were a catalyst for rapid digitalisation of services in the field of substance use and substance use disorders. This highlights a need to backcast and co-create a future where digital tools for addressing substance use are optimally developed and used. OBJECTIVE This paper re...

Background: A significant proportion of people attending Primary Care (PC) have anxiety-depressive symptoms and work-related burnout compounded by a lack of resources to meet their needs. The COVID-19 pandemic has exacerbated this problem and digital tools have been proposed as a solution. Objective: We present the development, feasibility, and...

The aim of the current study is to assess if the patterns of use, socio-demographic characteristics, and use of other drugs differ among people who only use cannabis and those that use synthetic cannabinoids. Data from the second wave of the European Web Survey on Drugs, a web-based cross-sectional survey from 10 different European countries includ...

No- and low-alcohol drinks (NoLo) have been proposed as a potential way forward for the reduction in the alcohol burden of disease. So far, there is scarce synthesized evidence on the effects of these products on people with alcohol use disorder (AUD), or with a heavy or high-risk drinking pattern. The aim of the present study is to systematically...

Background: Effective interventions exist for heavy drinking and depression but to date there has been limited translation into routine practice in global health systems. This evidence-to-practice gap is particularly evident in low- and middle-income countries. The international SCALA project (Scale-up of Prevention and Management of Alcohol Use Di...

Background Initial results from the SCALA study demonstrated that training primary health care providers is an effective implementation strategy to increase alcohol screening in Colombia, Mexico and Peru, but did not show evidence of superior performance for the standard compared to the shorter training arm. This paper elaborates on those outcomes...

Purpose of review: The purpose of this update is to provide an overview of recent research publications (January 2020-January 2022) on real-time telemedicine solutions for the management of addictions (alcohol, tobacco, opioids, and other drugs). Recent findings: Motivational interviewing by real-time telemedicine showed effectiveness in youth a...

The crisis caused by prescribed opioids and their related side effects are a public health problem worldwide. Most of these are prescribed for coping with chronic pain. The coexistence of opioid use disorder (OUD) in patients with chronic pain represents a complex challenge due to the need for managing both pain and OUD. The aim of this systematic...

Background: During the COVID-19 pandemic, an increase of heavy alcohol use has been reported in several high-income countries. We examined changes in alcohol use during the pandemic among primary health care (PHC) patients in two middle income countries, Colombia and Mexico. Methods: Data were collected during routine consultations in 34 PHC cen...

Issues: Numerous studies have examined the impact of the COVID-19 pandemic on alcohol use changes in Europe, with concerns raised regarding increased use and related harms. Approach: We synthesised observational studies published between 1 January 2020 and 31 September 2021 on self-reported changes in alcohol use associated with COVID-19. Electr...

A heart transplantation (HT) is performed when a patient’s heart health has been severely compromised. However, the health care needs of a patient throughout the transplantation process are also significant. In order to investigate these postoperative heart transplant challenges, this study has two objectives: to find which psychosocial and psychia...

Background: Cannabis is one of the most used drugs worldwide. There is no gold standard treatment for cannabis use disorder (CUD). Motivational interviewing (MI) has shown efficacy in some substance use disorders. Therefore, a systematic review was conducted to assess the effectiveness of MI in CUD. Methods: Randomized controlled trials or open-...

Evidence suggests that changes in alcohol consumption during the first months of the COVID-19 pandemic were unevenly distributed over consumer groups. We investigated possible inter-country differences in how changes in alcohol consumption are contingent on initial consumption (before or at the start of the pandemic), and how changes in consumption...

Background The lack of an agreed international minimum approach to measuring cannabis use hinders the integration of multidisciplinary evidence on the psychosocial, neurocognitive, clinical and public health consequences of cannabis use. Methods A group of 25 international expert cannabis researchers convened to discuss a multidisciplinary framewo...

The Coronavirus Disease 2019 (COVID-19) can affect mental health in different ways. There is little research about psychiatric complications in hospitalized patients with COVID-19. The aim of the study was to describe the psychiatric clinical profile and pharmacological interactions in COVID-19 inpatients referred to a Consultation-Liaison Psychiat...

Background Cannabis is one of the most widely used substances worldwide. Heavy use is associated with an increased risk of cannabis use disorders, psychotic disorders, acute cognitive impairment, traffic injuries, respiratory problems, worse pregnancy outcomes, and there are indications for genotoxic and epigenotoxic adverse effects. International...

Background: Cannabis is the third most consumed drug worldwide. Thus, healthcare providers should be able to identify users who are in need for an intervention. This study aims to explore the relationship of acute, chronic, and early exposure (AE, CE, and EE) to cannabis with cognitive and behavioral harms (CBH), as a first step toward defining ris...

Background Brief interventions (BI) for risky drinkers in primary healthcare have been demonstrated to be cost-effective but they are still poorly implemented. Digital BI seems to be a complementary strategy to overcome some barriers to implementation but there is a scarcity of studies in clinical environments. We present the results of a randomize...

Aims: Cognitive impairment in patients with alcohol use disorder (AUD) is highly prevalent, and it negatively impacts treatment outcome. However, this condition is neither systematically assessed nor treated. Thus, we aimed to explore the usability of a virtual reality-based protocol ('Rehabilitation Gaming System', RGS) for patients with AUD. Me...

Background-Aims New psychoactive substances (NPS) are new narcotic or psychotropic drugs that are not controlled by the drug conventions of the United Nations. In the last 10 years, numerous NPS have been identified in Europe but there is no comprehensive overview of mortality related to them. This study aims to estimate the mortality related to NP...

The standardization of cannabis doses is a priority for research, policy-making, clinical and harm-reduction interventions and consumer security. Scientists have called for standard units of dosing for cannabis, similar to those used for alcohol. A Standard Joint Unit (SJU) would facilitate preventive and intervention models in ways similar to the...

Introduction The Coronavirus Disease 2019 (COVID-19) can affect mental health in different ways. There is little research about psychiatric complications in hospitalized patients with COVID-19. Objectives The aim of the study was to describe the psychiatric clinical profile and pharmacological interactions in COVID-19 inpatients referred to a Cons...

Background and importance: SBIRT programs (Screening Brief Intervention and Referral to Treatment) for at-risk drinkers in emergency departments (ED) have shown to be effective, particularly at short term. In this article, we report mid and long-term follow-up results of a specialized SBIRT program. A short-term follow-up after 1.5 months showed e...

Background Providing alcohol screening and brief advice (SBA) in primary health care (PHC) can be an effective measure to reduce alcohol consumption. To aid successful implementation in an upper middle-income country context, this study investigates the perceived appropriateness of the programme and the perceived barriers to its implementation in P...

Purpose We aimed to test the effects of providing municipal support and training to primary health care providers compared to both training alone and to care as usual on the proportion of adult patients having their alcohol consumption measured. Methods We undertook a quasi-experimental study reporting on a 5-month implementation period in 58 prim...

Alcohol-related cognitive impairment (ARCI) is highly prevalent among patients with alcohol dependence. Although it negatively influences treatment outcome, this condition is underdiagnosed and undertreated. The aim of this systematic review is to investigate the existing evidence regarding both cognitive and pharmacological interventions for ARCI....

Tobacco use is more prevalent among alcohol liver disease (ALD) transplant patients and exerts harmful effects to the patient and to the graft. The aims of this study were to examine the impact of smoking status (nonsmoker, ex-smoker, active smoker) on patient survival and clinical outcomes, and to assess risk factors for active smoking before and...

There is great potential for scaling up the delivery of brief interventions for alcohol and illicit drug use, given the increasing coverage of mobile devices and technologies for digital interventions, including apps for smartphones and tablets. However, while the number of digital interventions is increasing rapidly, the involvement of brief-inter...

Background: Citizens affected by substance use disorders are high-risk populations for both SARS-CoV-2 infection and COVID-19-related mortality. Relevant vulnerabilities to COVID-19 in people who suffer substance use disorders are described in previous communications. The COVID-19 pandemic offers a unique opportunity to reshape and update addictio...

Background : The management of coronavirus disease 2019 (COVID-19) in patients with comorbid psychiatric disorders poses several challenges, especially regarding drug interactions. Methods : We report three representative case-scenarios on patients with psychiatric disorders and COVID-19 to provide a practical approach based on the existing litera...

UNSTRUCTURED There is great potential for scaling up the delivery of brief interventions for alcohol and illicit drug use, given the increasing coverage of mobile devices and technologies for digital interventions, including apps for smartphones and tablets. However, while the number of digital interventions is increasing rapidly, the involvement o...

Background: There is huge potential for scaling up the delivery of brief interventions for alcohol and illicit drug use, given the increasing coverage and technologies of e-digital interventions, including applications for smartphones and tablets. However, while the quantity of digital interventions is increasing rapidly, the involvement of brief-i...

Objective To evaluate if cannabis dose recorded as standard joint unit (SJU) consumed before admission and other related factors have an influence on psychiatric inpatient's symptom severity and clinical outcomes. Methods Cross-sectional study in an acute psychiatric inpatient unit including 106 individuals. Quantity of cannabis was measured as SJ...

Cannabis is the third most used psychoactive substance worldwide. The legal status of cannabis is changing in many Western countries, while we have very limited knowledge of the public health impact of cannabis-related harms. There is a need for a summary of the evidence of harms and risks attributed to cannabis use, in order to inform the definiti...

Monitoring mental health outcomes has traditionally been based on heuristic decisions often based on scarce, subjective evidence, making the clinical decisions made by professionals, as well as the monitoring of these diseases, subject to flaws. However, the "digital phenotype", which refers to the analysis of data collected by measuring human beha...

Monitoring mental health outcomes has traditionally been based on heuristic decisions often based on scarce, subjective evidence, making the clinical decisions made by professionals, as well as the monitoring of these diseases, subject to flaws. However, the "digital phenotype", which refers to the analysis of data collected by measuring human beha...

Background : While primary health care-based prevention and management of heavy drinking is clinically effective and cost-effective, it remains poorly implemented in routine practice. Systematic reviews and multi-country studies have demonstrated the ability of training and support programmes for healthcare professionals to increase primary health...

Introduction: Reduced drinking has been debated as a treatment goal for heavy drinking alcohol dependent patients, in whom treatment based on abstinence is not always an option. Nalmefene was the first drug approved by the European Medicines Agency (2013) with the indication of reduced drinking in high drinking risk level alcohol dependent patients...

BACKGROUND In the EU, approximately 165 million people suffer from mental health disorders, namely anxiety, mood disorders, and substance abuse. These mental health disorders have resulted in both direct and indirect global economic costs estimated at US $2.5 trillion in 2010, with the indirect costs (USD $ 1.7 trillion) being significantly higher...

Background: Monitoring mental health outcomes has traditionally been based on heuristic decisions, often based on scarce, subjective evidence, making the clinical decisions made by professionals, as well as the monitoring of these diseases, subject to flaws. However, the digital phenotype, which refers to the analysis of data collected by measurin...

Objective: Benzodiazepines have a good safety profile. Nevertheless, off-label use of these drugs may increase the risk of falls, dependence, and memory loss. Off-label prescription use is not highly prevalent. Studies have not researched the factors that influence off-label prescription use. We aim to identify the prevalence of off-label use of b...

Background: Psychosocial risk factors influence the course of transplantation. Psychosocial evaluation is an important part of pre-transplantation evaluation processes, yet there are no standardised instruments in Spanish. Objective: To translate, adapt, and test the reliability of the Stanford Integrated Psychosocial Assessment for Transplantat...

Digital brief interventions have emerged as an instrument to improve the implementation of Screening, Brief Intervention and Referral to Treatment programs for risky drinkers. However, trials in Catalonia have been unsuccessful. This study was aimed at researching professionals’ perceptions regarding the usefulness of digital brief interventions in...

Objective: Understanding the impact of Level of Information and Communication Technology Use, computer self-efficacy and perceived product usability of healthcare professionals regarding an alcohol consumption reduction website on facilitated access defined as referring patients to the webpage. Methods: 52 nurses and 41 general practitioners wer...

The selection of liver transplant (LT) candidates with alcohol use disorder is influenced by the risk of alcohol relapse (AR) after LT. We aimed to investigate the risk factors of AR after LT and its impact on graft and recipient outcomes. Retrospective study including all consecutive patients with alcohol use disorder undergoing LT from January 20...

Aims: Alcoholic hepatitis (AH) is a life-threatening complication of alcohol use disorder (AUD). Alcohol abstinence is the main predictor of the long-term prognosis of AH. It is unknown whether AUD treatment retention (TR) after an AH episode impacts alcohol relapse and mortality or what baseline factors influence TR. Methods: Design: case-contr...

Alcohol Liver Disease (ALD) is one of the most prevalent conditions leading to liver transplantation for end-stage liver disease. There is lacking evidence of regular urine screening testing (RUST) impact on survival or liver transplantation of ALD patients. The aims of this study were to compare the sensitivity of RUST, to assess its impact on sur...

Introduction: The Standard Joint Unit (1 SJU = 7 mg of 9-Tetrahydrocannabinol) simplifies the exploration of risky patterns of cannabis use. This study proposes a preliminary quantitative cutoff criterion to screen for cannabis use disorder (CUD). Methodology: Socio-demographical data and information on cannabis quantities, frequency of use, and...

Background: Screening, Brief Intervention, and Referral to Treatment (SBIRT) programs have been developed, evaluated, and shown to be effective, particularly in primary care and general practice. Nevertheless, effectiveness of SBIRT in emergency departments (EDs) has not been clearly established. Objective: We aimed to evaluate the feasibility a...

Cocaine is the second most used illicit drug worldwide. Identification of cocaine use disorders (CUD) and related aspects such as craving and CUD severity are relevant for clinical practice, public health programs, and research. There are a wide variety of instruments available for assessing CUD, showing different reliability, validity, and applica...

Background: Alcohol intake and hypertension (HT) are interrelated public health problems with cost-effective interventions at the primary care level that, to date, are poorly implemented. Objective: This study aims to explore the barriers to implementing alcohol interventions for people with HT in primary care. Methods: As part of the project...