Wei Hao

Purpose of Review: The rapid proliferation of synthetic opioids, particularly fentanyl and its analogues, has intensified the opioid crisis, highlighted the limitations of fragmented approaches to opioid use disorder (OUD), and heightened tensions between the United States and China. This narrative review compares public health policy responses in the United States and China across four key domains: demand reduction, harm reduction, supply control, and governance coordination, to evaluate how integrated governance can improve outcomes. Recent Findings: In the United States, there has been substantial progress in expanding opioid agonist treatment, naloxone distribution, and low-threshold services. However, persistent fragmentation across healthcare, public health, criminal justice, and social services continues to limit long-term recovery. In China, sustained declines in registered drug users over seven consecutive years and improvements in community-based rehabilitation reflect a more coordinated system linking treatment, rehabilitation, and social reintegration, although new challenges have emerged from the rising non-medical use of prescription medicines, veterinary anesthetics, and new psychoactive substances. Regulatory control of supply chains, upstream targeted interdiction,expanded treatment access, and harm reduction strategies may contribute collectively to recent reductions in drug overdose deaths in the United States. Summary: An effective response to synthetic opioids requires aligning demand reduction, harm reduction, and supply control strategies within a unified public health framework. Public health can serve as a practical bridge across differing policy systems and provide a foundation for sustained international cooperation in the synthetic opioid era.

Serum albumin, a reverse acute-phase protein, tends to decrease in response to acute clinical conditions. We hypothesized that albumin levels would exhibit state-dependent dynamics, with distinct patterns between acute episodes and remission states in schizophrenia. To test this, we conducted a retrospective longitudinal study to investigate the dynamic serum albumin levels in 148 schizophrenia patients, starting from their first episode through remission and subsequent relapse. A matched general population sample served as the control group. Classification models were developed using albumin levels (Albumin _current) and changes (ΔAlbumin₁ = Albumin _current−Albumin _{previous remission}, and ΔAlbumin₂ = Albumin _current−Albumin _{previous acute episode}) to distinguish clinical states. Model performance was evaluated using the area under the receiver operating characteristic (ROC) curve (AUC). Serum albumin levels were significantly lower during acute episodes (first episode: 45·6, standard deviation (SD) 4·0 g/L; relapse: 44·9, SD 4·0 g/L) compared to remission (48·6, SD 2·9 g/L) and matched controls (48·6, SD 3·4 g/L). Patients in remission showed albumin levels comparable to controls. These findings remained consistent after adjustment for potential confounders using mixed-effects model and in sex-stratified analyses. The classification model incorporating ΔAlbumin₁ and ΔAlbumin₂ achieved an AUC of 0·88 (95% CI: 0·84, 0·92) in distinguishing acute episodes from remission. These findings highlight serum albumin’s potential as a clinically useful biomarker of illness activity/state and mental stress in schizophrenia, with utility in differentiating between acute and remitted states.

Background: Cognitive bias modification (CBM) programs have shown promise in treating psychiatric conditions, but they can be perceived as boring and repetitive. Incorporating gamified designs and adaptive algorithms in CBM training may address this issue and enhance engagement and effectiveness. Objectives: This study aims to gather preliminary data and assess the preliminary efficacy of an adaptive approach bias modification (A-ApBM) paradigm in reducing cue-induced craving in individuals with methamphetamine use history. Methods: A randomized controlled trial with 3 arms was conducted. Individuals aged 18‐60 years with methamphetamine dependence and at least 1 year of methamphetamine use were recruited from 12 community-based rehabilitation centers in Sichuan, China. Individuals with the inability to fluently operate a smartphone and the presence of mental health conditions other than methamphetamine use disorder were excluded. The A-ApBM group engaged in ApBM training using a smartphone app for 4 weeks. The A-ApBM used an adaptive algorithm to dynamically adjust the difficulty level based on individual performance. Cue-induced craving scores and relapses were assessed using a visual analogue scale at baseline, postintervention, and at week-16 follow-up. Results: A total of 136 participants were recruited and randomized: 48 were randomized to the A-ApBM group, 48 were randomized to the static approach bias modification (S-ApBM) group, and 40 were randomized to the no-intervention control group. The A-ApBM group showed a significant reduction in cue-induced craving scores at postintervention compared with baseline (Cohen d=0.34; P<.01; 95% CI 0.03-0.54). The reduction remained significant at the week-16 follow-up (Cohen d=0.40; P=.01; 95% CI 0.18-0.57). No significant changes were observed in the S-ApBM and control groups. Conclusions: The A-ApBM paradigm with gamified designs and dynamic difficulty adjustments may be an effective intervention for reducing cue-induced craving in individuals with methamphetamine use history. This approach improves engagement and personalization, potentially enhancing the effectiveness of CBM programs. Further research is needed to validate these findings and explore the application of A-ApBM in other psychiatric conditions.

Background and aim: Alcohol consumption in China poses significant public health challenges. Between 2005 and 2010, alcohol production and by implication, consumption, surged, leading to increased alcohol‐related harms due to weak regulatory frameworks. This study examined recent patterns of alcohol consumption in China using public production data as a proxy. Method: Statistical analysis was conducted using data from the National Bureau of Statistics of China on the production of beer, wine, and liquor, from the years 2009 to 2023. Results: The production of liquor and wine in China increased from 7.1 and 0.96 million tons in 2009 to 13.6 and 1.14 million tons in 2016, respectively. Inferred alcohol per capita consumption (APC) rose from 4.38 L in 2009 to 6.45 L in 2016, representing a 47% increase. However, from 2016 onwards, alcohol production declined to 4.5 and 0.14 million tons for liquor and wine in 2023, respectively. Consequently, inferred APC decreased from 6.45 L to 2.85 L, an overall reduction of 55.8%. Conclusions: Alcohol production and inferred consumption in China appear to have substantially declined since 2016. Potential factors contributing to this decline include stricter government policies, stricter market regulation and tax enforcement, public health campaigns, and demographic and cultural shifts. However, many global measures such as higher taxes, price controls, advertising restrictions, and a legal drinking age, have not been (adequately) implemented in China.

Opioid dependence is a serious, life-threatening condition with severe social impacts. Naltrexone (NTX) can weaken the effect of opioids and effectively reduce opioid self-administration, discrimination, and opioid-induced subjective effects, and the oral dosage form has been approved for the treatment of opioid dependence. However, the effectiveness of oral naltrexone as an opioid antagonist has been limited due to poor patient adherence. A long-acting formulation in the form of naltrexone implant (NTX-IMP) with a five-month duration of action may address this issue and improve outcomes. This study (trial registration number: CTR20181954) aimed to evaluate the effect, safety, and pharmacokinetics of NTX-IMP in agonist effects via hydromorphone challenge test, and to determine optimal dosages for future research. Thirty-one former opioid-dependent individuals were randomized to the 0.9g or the 1.5g NTX-IMP group. All subjects exhibited significant antagonistic effects during hydromorphone challenge test. Calculation of slope between VAS score or pupil diameter and hydromorphone dose suggested a stronger antagonistic effect in the 1.5 g group. Pharmacokinetic data suggested that effective plasma naltrexone concentration (≥1ng/ml) was detected from the third day for over 148 days, with higher concentration and longer duration in the 1.5 g group. All subjects tolerated NTX-IMP well. The findings indicate that the NXT-IMP effectively blocks the agonistic effects of hydromorphone in a dose-dependent manner.

Background: Gaming disorder is a new disease, which is included in the disease unit of disorder caused by addiction in the 11th revision of the International Classification of Diseases. This study examined the symptom characteristics of gaming disorders in Chinese adolescents using the latent profile analysis. Methods: Totally, 5988 students (including 3285 boys and 2703 girls; aged 12–18 years) from junior high schools and senior high schools were enrolled. The Gaming Disorder Symptom Questionnaire-21 (GDSQ-21) was used to screen gaming disorder. A latent profile analysis was used for classifying the subgroups based on the extent of gaming usage. The relationship between adolescent gamers and demographic variables was analyzed by logistic regression. Results: The results of latent profile analysis supported the models of four latent profiles, which were defined as healthy gamers (Profile 1, 56.83%), impaired control gamers (Profile 2, 26.09%), impaired control-game priority gamers (Profile 3, 9.72%) and gamers with disorder (Profile 4, 7.36%), respectively. Logistic regression analysis found that, compared with girls, boys were more likely to be classified into the group dominated by the impaired gamers, the impaired control-game priority gamers, and the gamers with disorder. Conclusions: This study highlighted that the latent profile analysis identified four different groups of adolescent gamers, showing a clearer conceptualization of heterogeneous gamers. Gender and average weekly gaming time can predict the latent profile of adolescents. Our findings may facilitate the design of individualized assessment and early intervention programs for adolescent gamer users based on different gaming usage symptoms.

Background: Overwhelming evidence suggests that increasing alcohol taxes is an effective strategy for curbing alcohol consumption. However, research on the effects of such strategies in low- and middle-income nations is limited.Objective: The aim is to explore the temporal effect of alcohol tax policy in China.Methods: We employ interrupted time series analysis to investigate the temporal effects of tax policy changes on alcohol consumption and related consequences in Mainland China from 1961 to 2019. The study population, the total population of mainland region of China, aged more than 15 years.Results: The results show that the volume tax policy, which was announced in 2000 and implemented in 2001, led to an immediate reduction in the alcohol consumption (coefficient = -0.429, p < .001). Following the implementation of higher alcohol taxes in 1998 and 2001, the prevalence of alcohol use disorders (AUDs) and related years lived with disability (YLDs) gradually decreased. The relaxation of tax policy in 2006 led to a significant increase in alcohol consumption, both immediately (coefficient = 0.406, p < .001) and in the middle term (coefficient = 0.495, p < .001), as well as contribute to an immediate or medium term significant increase in the prevalence of AUDs (coefficient = 0.038, p = .010; coefficient = 0.032, p < .001) and YLDs (coefficient = 4.363, p = .001; coefficient = 4.226, p < .001).Conclusion: This study demonstrates that changes in alcohol consumption and related consequences (increase or decrease) have followed corresponding changes in alcohol tax policies (easing or tightening), indicating that increasing alcohol taxes can be an effective strategy in China for controlling alcohol consumption and related harms.

BACKGROUND: Cognitive bias modification (CBM) programs have shown promise in treating psychiatric conditions, but they can be perceived as boring and repetitive. Incorporating gamified designs and adaptive algorithms in CBM training may address this issue and enhance engagement and effectiveness. OBJECTIVE: To gather preliminary data and assess the preliminary efficacy of an adaptive approach bias modification (A-ApBM) paradigm in reducing cue-induced craving in individuals with methamphetamine use history. METHODS: A randomized controlled trial with three arms was conducted. Individuals aged 18-60 with methamphetamine dependence and at least one year of methamphetamine use were recruited from 12 community-based rehabilitation centers in Sichuan, China. Individuals with inability to fluently operate a smartphone and/or the presence of mental health conditions other than methamphetamine use disorder (MUD) were excluded. A-ApBM group engaged in ApBM training using a smartphone application for four weeks. A-ApBM used an adaptive algorithm to dynamically adjust the difficulty level based on individual performance. Cue-induced craving scores and relapse were assessed using a visual analog scale at baseline, post-intervention, and at week-16 follow-up. RESULTS: A total of 136 participants were recruited and randomized: 48 were randomized to the A-ApBM group, 48 were randomized to the S-ApBM group, and 40 were randomized to the no-intervention control group. The A-ApBM group showed a significant reduction in cue-induced craving scores at post-intervention compared to baseline (Cohen’s d = 0.34, p < 0.01, 95% CI = [0.03,0.54]). The reduction remained significant at the week-16 follow-up (Cohen’s d = 0.40, p= 0.01, 95% CI = [0.18,0.57]). No significant changes were observed in the S-ApBM and control groups. CONCLUSION: The adaptive ApBM paradigm with gamified designs and dynamic difficulty adjustments may be an effective intervention for reducing cue-induced craving in individuals with methamphetamine use history. This approach improves engagement and personalization, potentially enhancing the effectiveness of CBM programs. Further research is needed to validate these findings and explore the application of adaptive ApBM in other psychiatric conditions. TRIAL REGISTRATION: Registered at clinicaltrials.gov (ID NCT05794438 ).

The cognitive processing of drug‐related cues and the subsequent dysregulation of behaviour play a central role in the pathophysiology of substance use disorders. Prior studies are limited by small sample sizes and a lack of immersion in stimulus presentation. In the present study, we recruited patients with methamphetamine use disorder (MUD; N = 1099) from four compulsory isolated detoxification centres and healthy control participants (N = 305). With a 12‐min‐long virtual reality (VR) protocol stimulus, we discovered that patients showed a decrease in electroencephalogram (EEG) power across alpha to gamma bands in anterior scalp regions under methamphetamine‐related VR stimuli (e.g. a glass pipe and medical tubing) compared with the control stimuli (e.g. balls and cubes). Analysis of variance (ANOVA) showed that the interaction effects of stimuli type and group were significant in five EEG bands. Using generalised linear models, we classified the stimuli type (i.e. drug‐related vs. drug‐unrelated cues) in MUD patients with an f1 score of 90% on an out‐of‐sample testing set. The decreases of EEG between drug‐related cues and drug‐unrelated cues in delta, theta and alpha frequency bands are more frequently seen in patients than in healthy controls, perhaps reflecting general arousal and attenuated impulsive control. Our results suggest that EEG responses elicited by long‐duration methamphetamine‐related VR cues showed a specific signature, which may have future clinical implications.

Computerised cognitive remediation therapy (CCRT) and aerobic exercise are often used to rehabilitate social functioning in patients with schizophrenia. However, there is limited knowledge regarding the effects of CCRT combined with aerobic exercise on cognitive function and brain-derived neurotrophic factor (BDNF) levels in patients with schizophrenia and cognitive impairment. Ninety-six patients with schizophrenia and cognitive impairment were included in this study and randomly divided into control, aerobic exercise (AE), and CCRT combined with aerobic exercise (CAE) groups. Changes in processing speed and cognitive flexibility at week 8 were evaluated as primary and secondary cognitive outcomes using the Trail Making Test: Part A, the Brief Assessment of Cognition in Schizophrenia: Symbol Coding Test, and the Stroop Colour-Word Test. Positive and Negative Syndrome Scale (PANSS) scores and serum BDNF expression were determined as other secondary outcomes. The CAE group showed significantly better performance in terms of changes in processing speed and cognitive flexibility than the control and AE groups at week 8 (p < 0.05); however, no significant improvements in processing speed and cognitive flexibility were found between the control and AE groups. The CAE group showed significant improvements in the PANSS negative symptoms than the control group at week 8 (p < 0.05), but the AE group showed no significant difference in the changes of PANSS negative symptoms when compared with the other two groups. The CAE group and AE group showed a greater increase in serum BDNF levels than the control group (p < 0.01), but there was no significant difference in serum BDNF expression between the CAE group and AE group. In conclusion, 8-week CCRT combined with aerobic exercise may improve some cognitive performance and negative symptoms in patients with schizophrenia. Aerobic exercise may have an immediate effect on serum BDNF levels rather than cognitive function.