Search PubMed⌕ Search

Biomedical subjects

H D Kleber

Publications and source records attributed to H D Kleber.

At least 145 records · Page 8Linked to original sources
PubMed1979

Endorphin-locus coeruleus connection mediates opiate action and withdrawal.

Endorphins and exogenous opiates inhibit the activity of the noradrenergic nucleus locus coeruleus (LC). This discovery of endorphin transmitters and their interaction with the LC has supported our studies which have suggested that the majority of the signs and symptoms of opiate withdrawal are mimicked by electrical or chemical activation of the LC. We hypothesize that this endorphin-LC connection is critical to opiate action and the withdrawal syndrome. This hypothesis suggests that chronic opiate administration inhibits LC activity and that opiate abstinence after addiction results in a release from inhibition with resultant LC hyperactivity. This hypothesis is supported by recent data suggesting that clonidine as a drug which inhibits the LC and LC-mediated noradrenergic activation, is an efficacious non-opiate treatment for opiate withdrawal. This hypothesis can be tested in man by evaluating drugs which inhibit the LC and LC-mediated behaviors for anti-withdrawal efficacy.

Adrenergic Fibers↗
PubMed1978

Clonidine blocks acute opiate-withdrawal symptoms.

In a double-blind, placebo-controlled, cross-over trial, clonidine eliminated objective signs and subjective symptoms of opiate withdrawal for 240--360 min in eleven addicts in a hospital setting. In an open pilot study of the effects of clonidine on longer-term opiate abstinence and symptoms, the same patients did well while taking clonidine for one week. There was only one documented instance of heroin use, in a patient who did not take clonidine after hospital discharge. 6 weeks or more after the study, four patients were back on reduced doses of methadone, one was on tricyclic antidepressants, and seven were off of all opiates. All eleven patients were doing well. These data suggest that opiate withdrawal is due to increased neuronal activity in areas such as the locus coeruleus which are regulated by both alpha-2 adrenergic and opiate receptors.

Acute Disease↗
PubMed1978

Comparative validity of random-interval and fixed-interval urinalysis schedules.

Accurate detection of unprescribed drug use by addicts in treatment may facilitate their rehabilitation. Many clinics collect urine samples at random, using fixed-interval collection schedules, which are not free from sampling error. Random-interval schedules minimize sampling error and consequently increase detectability of drug use by eliminating safe periods during which drug use cannot be detected. We compared these two methods by observing rates of detected opiate- and quinine-positive samples preceding and following implementation of random-interval schedules. Detected drug use doubled initially. As detection and clinical sanctions became more certain, drug use declined to well below its former level. Programs that use fixed-interval schedules may underdetect drug use by more than 50%. If patients can reliably predict safe periods, the possibility of using drugs without fear of detection may impede their rehabilitation.

Appointments and Schedules↗
PubMed1977

Sequential patterns of multiple-drug use among high school students.

Only recently have multiple-drug use studies involving more than heroin and marijuana begun to be reported in the literature. Four of these studies have found evidence that multiple-drug use is a progressive phenomenon, although the particular pattern of multiple-drug use reported in different populations varies somewhat. This study examines the patterns of multiple-drug use reported by a random sample of 1,094 high school students living in greater New Haven, Conn in the 1972-1973 academic school year. Scalogram analysis reveals a progressive relationship for nine drugs: alcohol, marijuana, hashish, barbiturates, amphetamines, LSD, mescaline, cocaine, and heroin. Cigarettes and glue were not found to play a part in this pattern. The temporal order in which respondents reported that they had begun using each drug supports the results of scalogram analysis only in part.

Adolescent↗
PubMed1977

Detoxification from methadone maintenance: the state of the art.

The reasons for successful withdrawal from methadone maintenance remain to be clarified. The theories, methods, and outcome of methadone maintenance withdrawal are reviewed, and it is concluded that successful withdrawal is possible for at least a sizable minority.

Follow-Up Studies↗
PubMed1976

Successful detoxification from methadone maintenance. Follow-up study of 38 patients.

Thirty-eight patients were successfully detoxified from maintenance with methadone hydrochloride. Contrary to results of most previous studies, a substantial number of individuals were found to have remained drug-free, employed, and uninvolved with the criminal justice system since detoxification. Almost half of those who returned to drug use have become reinvolved in treatment. Escalated alcohol use occurred during and following methadone maintenance.

Alcoholism↗
PubMed1976

The relationship between drug education programs in the Greater New Haven schools and changes in drug use and drug-related beliefs and perceptions.

This study presents a broad epidemiological approach to evaluation of drug education. Data on adolescent drug use and on drug-related beliefs and perceptions, collected yearly over a three-year period in 33 schools in the Greater New Haven area, were analyzed in relation to information on drug education programs in these schools. Changes in the general prevalence rates for the study period (1970-1973) and with age were the background against which the effects of the independent variable--presence or absence of specific drug education activities in the various schools--were explored. While the overall evidence suggested that drug education does not have a strong, across-the-board influence on either drug use rates or beliefs and perceptions, more modest and specific effects were noted which have implications for drug education.

Adolescent↗
PubMed1975

Follow-up of participants in a drug dependence therapeutic community.

We interviewed by random sample 20 graduates and 20 dropouts from a drug dependence therapeutic community to identify any differences between groups. Although the two groups were from similar backgrounds at admission, the graduates seemed to do better after treatment. Throughout the follow-up period, the graduated spent proportionately less time addicted or in jail and proportionately more time employed or in school than those who dropped out of the treatment program. At follow-up, more graduates were available for voluntary abstinence and were abstaining from addicting drugs than were the dropouts. Also, at the follow-up interview, more graduates were employed or in school and fewer were legally involved than the dropouts. In the dropout group, abstinence in the follow-up period was correlated with longer length of treatment.

Adolescent↗