[Therapeutic experiences and prognosis in heroin dependence].
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Biomedical subjects
Publications and source records attributed to D Ladewig.
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The effects of 0.8 g alcohol kg-1 on CNS processes as reflected in EEG changes were studied in controlled experiments in 14 subjects in relation to BAC levels. A Two Period Change-Over Design with repeated trials over time allowed us to ascertain the time course and to isolate alcohol-induced changes from diurnal variations and effects of sequence and period. Based on spectral analysis of analog EEG recordings, the study has shown differential patterns of bi-phasic or tri-phasic alcohol-induced EEG changes over time in a number of parameters in background and in stimulus-elicited EEG responses varying with the BAC level and the metabolic phase of alcohol biotransformation. An increase in alpha activity during the absorption phase, a shift in the median of the total spectral power to the right (upwards), a decrease in slow activity in the delta and theta bands, and a decrease in variability of the background EEG on one hand and a reduction in stimulus-elicited EEg responses in total spectral alpha, theta and delta bands on the other are all interpreted as a stimulating excitatory effect during the absorption phase, parallel to the increase in BAC. The reverse pattern in the first part of the elimination phase infers a decrease in cerebral activation reflecting the sedative, depressant action of alcohol in this phase. The effects observed in the last trial, to a certain extent interpreted as stimulating, were simultaneous with the beginning of the post-alcohol hangover phase.
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In the treatment of alcoholism, the medical profession takes an important position which until now has not gained the necessary appreciation. The prognosis of alcoholism is more favourable than generally assumed, especially if it is possible to early recognize patients with alcohol problems. Besides pharmaco-therapeutic possibilities it is important that doctors also consider psychotherapeutic methods, especially psychotherapeutical procedures according to ROGERS and TAUSCH, as well as various methods of behavioural modification.
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The definition of abuse and dependence of non-narcotic analgesics should take into consideration the interaction of drug and personality. Usually, definitions are based on qualitative aspects of the risk-benefit ratio in the use of psychotropic drugs. By means of modern research methods in epidemiology and clinical psychology, quantitative aspects might be integrated in the process of defining persons and drugs when evaluating their risk of abuse or dependence. In a prospective field study with working housewives of northwestern Switzerland who showed objective evidence of intake of non-narcotic analgesics and a control group, the interaction of drug use and personality features has been investigated. There was significant evidence that heavy use of non-narcotic analgesics was paralleled with a high risk of depression, emotional liability and disturbance in sexual identity. Using urine analysis, the study group was divided into two subgroups showing low or high intake of drugs, respectively. Special attention was focused on persons shifting from the study group into the control group and vice versa.
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This experiment was conducted in order to examine different alcohol-induced states of activation as indicated by the acoustic evoked heart rate response (HRR). Twelve healthy male subjects received 0.7 g/kg alcohol in one session of a cross-over designed experiment. In the control session no alcohol was given. The measurements of three parameters of the heart rate response as well as the self-assessments of mood were repeated five times along the course of the venous blood alcohol concentration. Significant depressant alcohol effects were reflected in a decrease in the HRR acceleration as well as in a decrease in vitality, vigilance, and self-estimated startle reaction. Stimulating effects could be observed in an increase of the mean heart rate and the second HRR deceleration. We conclude that different alcohol-induced states of activiation represent different patterns of inhibitory and facilitatory processes, each manifesting itself in different parameters. The results suggest three major components of alcohol action: 1) an inhibition release with immediate onset,2) a slower processing inhitition,3) attention focussing as a compensatory response to inhibition.