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Biomedical subjects

C P O'Brien

Publications and source records attributed to C P O'Brien.

At least 253 records · Page 14Linked to original sources
PubMed1975

Misuse and abuse of diazepam: an increasingly common medical problem.

Misuse and abuse of diazepam among addiction-prone individuals is reported. The most common pattern of abuse appears to be periodic ingestion of 30 to 80 mg of diazepam in one dose, either alone or in conjunction with methadone or other narcotics. Two cases of physical dependency to diazepam have been observed. Many addict patients using diazepam are buying it on "the streets". All physicians should know that diazepam abuse and misuse is occurring, and careful attention should be given to prescribing, transporting and storing this drug.

Adult↗
PubMedDate not supplied

Conditioning in human opiate addicts.

Eight volunteers maintained on daily methadone participated in a classical conditioning procedure to determine which if any of the elements of narcotic withdrawal could be conditioned; The unconditioned stimulus was the injection of a small dose of naloxone. The unconditioned response was a brief precipitated withdrawal syndrome. The conditioning stimulus was a tone, odor, and injection of saline. Conditioning was successful in the pilot study in 5 of 8 subjects. The conditioned response consisted of tearing, yawning, lacrimation, systolic blood pressure increase, respiratory irregularities and subjective feelings of narcotic withdrawal sickness (nausea, muscle aches, chills). A second group of 8 subjects showed, in addition to the above, evidence of conditioning of heart rate, respiratory rate, respiratory, rate and skin temperature decrease. These laboratory findings support the clinical reports of a conditioned withdrawal syndrome and suggest ways to improve treatment results by detecting and extinguishing or modifying conditioned responses.

Adult↗
PubMedDate not supplied

Using cue reactivity to screen medications for cocaine abuse: a test of amantadine hydrochloride.

The use of responding to drug-related stimuli as a dependent measure for studies of anticraving medications was assessed. Cocaine-dependent subjects receiving either amantadine hydrochloride, a putative anticraving agent, or placebo were exposed to drug-related cues prior to and 7 days after the initiation of the medication. Measurements of heart rate, skin resistance, skin temperature, and self-reported craving were taken during each stimulus session. Amantadine increased physiological reactivity to the drug-related cues compared to the placebo while having no effect on craving. Although the results discourage the use of amantadine as an anticraving medication, they do suggest that responses elicited by drug-related stimuli provide a valuable set of dependent measures for use in future medication trials of anticraving agents.

Adult↗
PubMedDate not supplied

Effect of smoking cues and cigarette availability on craving and smoking behavior.

This study examined whether smokers respond differently to smoking cues than to affectively neutral or unpleasant cues without smoking content, and whether reactivity is affected by expectations regarding the opportunity to smoke. Expectancy was manipulated by telling subjects in group SMOKE that they could smoke, and subjects in group NO SMOKE that they could not smoke following each cue-reactivity session. The dependent variables were subjective ratings of "desire to smoke", "high", "withdrawal", and mood, as well as latency to initiate smoking measured in group SMOKE. Statistical analyses demonstrated that only group SMOKE (a) reported greater "desire to smoke" and "withdrawal" to the smoking cues compared to the baseline, (b) reported greater "desire to smoke" to the smoking cues than to the unpleasant or to the neutral cues, and (c) smoked faster after the smoking cues than after the neutral cues. Both groups rated the unpleasant cues as affectively more negative than the neutral cues. The data suggest that the impact of drug-cues on craving and subsequent drug-use is due to their drug-related content, and not to negative affect. Furthermore, the impact of drug-related cues appears to be influenced by perceived drug-availability.

Adolescent↗
PubMedDate not supplied

Private substance abuse treatments: are some programs more effective than others?

There have been few studies of treatments for substance dependence among private programs. The present study compared the patient populations, treatment services provided and six-month outcomes of employed, insured patients referred by an employee assistance program to four private treatment programs (two inpatient and two outpatient). Subjects were alcohol and/or cocaine dependent males referred from a single employer. Ninety-four percent were successfully contacted at six-month follow-up, with confirmatory urinalysis and breathalyzer samples taken. Three results were obtained. First, there were significant and pervasive improvements shown in the total sample at follow-up. Fifty-nine percent were completely abstinent, 82% were working and only 8% required re-treatment. Second, there were significant differences among the programs in levels of improvement and six-month outcomes. Finally, the differences in efficacy were related to the differences in the nature and amount of treatment services provided.

Adult↗
PubMedDate not supplied

Can induced moods trigger drug-related responses in opiate abuse patients?

This study investigated the ability of four hypnotically induced mood states (euphoria, depression, anxiety, and anger) to trigger craving and other drug-related conditioned responses in detoxified opiate abuse patients. Hypnotically induced depression produced significant increases in drug craving for opiates. Depression also tended to increase global self-ratings of opiate withdrawal. Other trends included increases in self-rated craving by induced anxiety and increases in withdrawal symptoms by induced anger. These results suggest that negative mood states, perhaps in the context of repeated attempts at self-medication, may become conditioned stimuli capable of triggering craving and other drug-related conditioned responses. The ability of depression to produce reliable effects in this particular patient group may reflect the high lifetime prevalence of depression diagnoses for this sample. The implications of these findings for therapeutic strategies are discussed.

Adult↗
PubMedDate not supplied

Effects of an appointment reminder call on patient show rates.

A pilot study (N = 80) was conducted to determine if (1) prospective substance-dependent patients randomly selected to be reminded (TC) of their scheduled intake evaluation the day before their first appointment would have a higher show rate than those not contacted (NC); and (2) if TC subjects administered a satisfaction questionnaire 1-3 days after intake would exhibit higher treatment retention rates at one week and one month posttreatment entry than NC subjects not exposed to the questionnaire. The findings suggest that reminding prospective patients of their initial scheduled appointments and following up with phone calls to those who fail to show can improve the rate at which patients will initiate treatment, provided initial appointments are scheduled in a timely manner (7 days or less). Similarly, the combination of the reminder call and the satisfaction questionnaire were associated with higher treatment retention rates for those whose initial appointments were scheduled in a timely manner.

Adult↗
PubMedDate not supplied

Treatment of alcoholism as a chronic disorder.

Alcoholism is a common disorder that tends to be chronic and relapsing. Although there is clear evidence that treatment can be expected to induce a period of remission or at least decreased symptoms, treatment of alcoholism is generally regarded as unsuccessful. Alcoholism should be approached as a chronic medical disorder such as diabetes or arthritis. Complete abstinence is the preferred goal, but "cures" or permanent abstinence from alcohol are rare. In this model, treatment benefits may be measured by length of remission, reduction in alcohol use, improvement in health and enhancement of social functioning. Treatment continues over a period of years, mainly on an outpatient basis with increasing intensity if symptoms recur. Medications that reduce craving for alcohol or diminish the euphoric effects of alcohol would be very helpful in the management of this chronic disorder. Preclinical studies have produced evidence for involvement of the endogenous opioid system in the reinforcing effects of alcohol. Recent controlled clinical trials of the opiate receptor antagonist naltrexone suggest that medications of this type may improve the results of treatment for alcoholism.

Alcoholism↗
PubMedDate not supplied

Naltrexone in the treatment of alcoholism: a clinical review.

The pooled results from our Veterans Affairs studies are presented for 99 men. The naltrexone-treated subjects reported a reduction in alcohol craving and drinking, as well as less euphoria when they ingested alcohol. Relapse rates were significantly lower for the naltrexone-treated subjects than they were for placebo-treated subjects. Together with the consistent results from other double-blind trials of naltrexone, we conclude that naltrexone is a safe and useful adjunct in the rehabilitation of alcohol-dependent patients. Although administration of naltrexone was shown to improve treatment outcome, subjects who attended all 12 research visits demonstrated larger treatment effects. These data suggest that the use of naltrexone as a pharmacological adjunct to psychosocial intervention is an effective treatment for alcohol dependence. The effectiveness of naltrexone may be improved by designing a treatment program that enhances compliance with the medication.

Adult↗