Systematic Review of Obstetric and Child Outcomes of Prenatal Exposure to Inhalants in the Context of a Use Disorder
Published: March/April 2025 Journal Article
Overview
This one-hour, on-demand, journal article-based activity discusses non-invasive neuromodulation techniques for alcohol use disorder (AUD). Repetitive transcranial magnetic stimulation (rTMS) has shown promise to have a long-lasting effect on drug craving.
The target audience for this intermediate continuing education activity includes: physicians, nurse practitioners, physician associates, pharmacists and other clinicians, researchers, students, and policymakers.
This activity addresses the following ACGME Core Competencies: Patient Care, Medical Knowledge, Systems-Based Practice
Abstract
Aims We aimed to evaluate the immediate and up to three-months effect of multiple session repetitive Transcranial Magnetic Stimulation (rTMS) on alcohol craving in AUD.
Methods We performed a systematic review and random effects meta-analysis. We included randomized controlled trials with at least ten sessions of rTMS and postintervention alcohol craving assessment. We evaluated the immediate and up to three months effects of active rTMS vs. sham stimulation.
Results Twelve studies met inclusion criteria, including 475 participants across both treatment and control groups. rTMS reduced alcohol craving over sham stimulation immediately post-treatment (SMD = −0.79, 95% CI: −1.53 to −0.04, p = .04, I2 = 93%). Concerning a maintenance effect, our meta-analysis revealed a medium effect for active rTMS in reduction of alcohol craving at three-month follow-up (SMD = −0.44, 95% CI: −0.77 to 0.11, p < .01, I2 = 38%). Our subgroup analysis revealed that rTMS targeting the medial prefrontal cortex (SMD = −2.12, 95% CI: −4.34 to 0.09, p = .06, I2 = 94%) may be more effective than stimulating the right dorsolateral prefrontal cortex (SMD = −1.04, 95% CI: −2.56 to 0.48, p = .18, I2 = 96%) or left dorsolateral prefrontal cortex (SMD = −0.27, 95% CI: −0.60 to 0.05, p = .10, I2 = 0%) immediately after treatment.
Conclusion A minimum of ten sessions rTMS reduced alcohol craving immediately after treatment, this effect seems to sustain over a three-months period. We provide limited evidence of superiority for rTMS targeting the medial prefrontal cortex.
Learning Objectives
Upon completion of this activity, learners will be able to:
Investigate the use of non-invasive neuromodulation techniques to treat the cravings associated with alcohol use disorder
Evaluate the effectiveness of repetitive transcranial magnetic stimulation (rTMS) in reducing alcohol cravings, including the optimal stimulation site, number of sessions, and duration of effects.
Registration Rates
Rate Description
Rate
ASAM Member
$0
Non-Member
$39
Associate Member
$0
Resident Member*
$0
Student Member*
$0
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Open Registration: 02/03/2025 - 02/03/2028
Close Access Date: 03/03/2028
Course Instructions
Click on the Contents tab to begin this activity.
Click View Journal Article and read the journal article in its entirety.
Click Complete Post Test to answer multiple choice questions. Participants will have 10 attempts to pass and must answer 2 out of 3 questions correctly.
Click Complete Evaluation to provide valuable activity feedback. Scroll down on all questions as there may be answer options that expand past the size of the window.
Click the button Claim Medical Credits in the box titled Claim Credits & Certificate. Choose the type of credit and click submit. Click the button View/Print Certificate to save or print your certificate. You can view/print your certificate at any time by visiting the ASAM eLearning Center, clicking Dashboard, and clicking Transcript/Achievements.
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In support of improving patient care, the American Society of Addiction Medicine is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team.
Certified Counselors: NBCC Contact Hours Not OfferedAmerican Society of Addiction Medicine has been approved by NBCC as an Approved Continuing Education Provider, ACEP No. 7062. Programs that do not qualify for NBCC credit are clearly identified. American Society of Addiction Medicine is solely responsible for all aspects of the programs.
Maintenance of Certification (MOC)/Continuing Certification Program (CCP)
This activity is designed to meet the requirements for MOC/CCP for several primary physician boards and for state licensing CME requirements. MOC Credit is only reported and designated for ABA, ABP, ABIM, and ABS. By completing the online credit application and evaluation, the learner permits ASAM to report credits to the appropriate Board. Learn more.
ABIM MOC Points: 1.00 Medical Knowledge
ABP MOC: 1.00 Lifelong Learning & Self-Assessment
ABS Continuing Certification: 1.00 Accredited CME
ABA MOCA 2.0®*: 1.00 Lifelong Learning
MOCA 2.0® is a trademark of the American Board of Anesthesiology®.
This activity contributes to the CME requirement for Part II: Lifelong Learning and Self-Assessment of the American Board of Anesthesiology's (ABA) redesigned Maintenance of Certification in Anesthesiology Program® (MOCA®), known as MOCA 2.0®. Please consult the ABA website, https://www.theaba.org/, for a list of all MOCA 2.0 requirements.
Additionally, this activity has been designed to satisfy the requirements of the following primary physician board certification requirements. Please confirm with your individual Board.
American Board of Addiction Medicine (ABAM)
American Board of Preventive Medicine (ABPM)
American Board of Psychiatry and Neurology (ABPN)
Royal College of Physicians and Surgeons of Canada (RCPSC)
Certificates for other professions
All participants may request a certificate of participation upon completion of the activity and an online evaluation confirming their participation. Learners are strongly advised to contact their professional licensing board or professional association to confirm this certificate will be accepted as evidence supporting continuing education requirements.
California Association for Drug/Alcohol Educators (CAADE)
This educational program is approved by CAADE: #CP40 999 1225.
California Association of DUI Treatment Centers (CADTP)
This educational program is approved by CADTP: #205.
California Consortium of Addiction Programs and Professionals (CCAPP)
This educational program is approved by CCAPP: #OS-20-330-0227.
Disclosure Information
In accordance with the disclosure policies of ASAM and Joint Accreditation, the effort is made to ensure balance, independence, objectivity, and scientific rigor in all accredited continuing education activities. These policies include identifying and mitigating all relevant financial relationships with ineligible companies for those involved in the creation and dissemination of accredited continuing education.
See the attached article and pdf for a list of disclosures
3 Questions | 10 attempts | 2/3 points to pass
To complete and receive credit for this CE activity, you must answer at least two out of the following three questions correctly.
Up to 1.00 medical credits available | Certificate available
Up to 1.00 medical credits available | Certificate available
Participants should claim only the credit commensurate with the extent of their participation in the activity.
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