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Biomedical subjects

M S Gold

Publications and source records attributed to M S Gold.

At least 91 records · Page 5Linked to original sources
PubMed1989

Urinary basal body temperature in anorexia nervosa.

Measurements of basal body temperature obtained from first-morning voided urine were followed longitudinally in 23 individuals with anorexia nervosa. In each of 10 hypothermic individuals, we found that basal body temperature was significantly correlated with weight gain, whereas in most normothermic individuals, no relationship was found. This suggests that measurement of basal body temperature may provide a convenient means of assessing clinical improvement and nutritional rehabilitation in some patients with anorexia nervosa. Differences in neuroendocrine measures and weight gain were also studied. Thyroid functions did not differ significantly between groups, and no differences were found in dexamethasone suppression or in the thyrotropin-releasing hormone (TRH) stimulation test. Hypothermic individuals, however, were significantly younger and significantly more likely to gain weight in response to treatment.

Anorexia Nervosa↗
PubMed1989

Family history and diagnosis of alcohol dependence in cocaine dependence.

Genetic research in alcoholism has made major advances in recent decades. Twin, adoption, high-risk, and familial studies have demonstrated an inheritance factor in alcoholism. No studies have demonstrated a genetic or familial disposition to cocaine and marijuana dependence. Two hundred sixty-three inpatients were given a structured psychiatric interview retrospectively (150) and prospectively (113) to obtain a DSM-III-R diagnosis of substance dependence disorders in the probands and of alcohol dependence in family members. Our study reveals a large number of probands with cocaine dependence with a positive family history for alcohol dependence. Approximately 50% of probands with cocaine dependence had at least a first or second degree relative with a diagnosis of alcohol dependence when studied by the family history and study methods. As many as 89% of probands who met DSM-III-R criteria for cocaine dependence qualified for other substance dependence diagnoses. Our study finds a high prevalence of alcohol (68% and 89%) and cannabis dependence (53% and 46%) in patients with cocaine dependence. Furthermore, the age of onset of alcohol and other drug dependence is early for those with cocaine dependence and precedes the onset of cocaine dependence. The diagnoses of other alcohol and drug dependence in cocaine dependence and in family members of probands with cocaine dependence have important implications for etiology, prognosis, and treatment.

Adult↗
PubMed1989

The diagnosis of marijuana (cannabis) dependence.

The definition of marijuana (Cannabis) dependence (addiction) contains three critical elements. These are (a) preoccupation with the acquisition of marijuana, (b) compulsive use of marijuana, (c) relapse to or recurrent use of the marijuana. The manifestations of abnormal marijuana use may assume many forms. Medical, psychiatric, neurological, traumatic, and sociological sequelae occur commonly in acute and chronic marijuana use. Marijuana dependence must be diagnosed primarily as the etiological or precipitating agent to adequately prevent and treat these conditions. The central role of marijuana addiction can be identified. The consequences of the marijuana addiction should be separated from the marijuana addict's actual motivation or craving to use marijuana. Marijuana addicts use abnormally because of what marijuana does to them and not for them. Marijuana reinforces its own use. Psychosocial stressors are not required to produce a marijuana addiction in biologically susceptible individuals. Consequences that result from an addiction to marijuana do not produce the abnormal use. A presumptive diagnosis of marijuana dependence (addiction) can be established by detecting significant consequences associated with marijuana use. A definitive diagnosis entails confirming the presence of addictive behavior by identifying a preoccupation, compulsivity and relapse relative to the drug, marijuana.

Cannabis↗
PubMed1989

A 12-step treatment approach for marijuana (Cannabis) dependence.

Marijuana (Cannabis) dependence (addiction) is a disorder for which treatment is essential and relatively sophisticated. A basic assumption in the treatment model is that marijuana addiction involves pathological processes in the physical, mental (cognitive), and emotional (mood) states of the addicted individual. These pathological processes constitute a disease entity that is diagnosable, treatable, and has a predictable course. One approach for the treatment of marijuana addiction involves physicians, psychologists, counselors, and social workers who treat the disease of marijuana addiction. We present this approach to treatment of marijuana addiction as representative of a popular method but not as the only modality available.

Alcoholics Anonymous↗
PubMed1989

The diagnosis of alcohol and cannabis dependence in cocaine dependents and alcohol dependence in their families.

Genetic research in alcoholism has made major advances in recent decades. Twin, adoption, high-risk and familial studies have demonstrated an inheritance factor in alcoholism. Few studies have demonstrated a genetic predisposition to cocaine and cannabis dependence. Two hundred and sixty-three inpatients were given a structured psychiatric interview retrospectively (150) and prospectively (113) to obtain DSM-III-R diagnosis of cocaine, alcohol and cannabis dependence disorders in the inpatients and of alcohol dependence in family members. Our study reveals a large number of cocaine dependents with a positive family history for alcohol dependence. Approximately 50% of cocaine addicts had at least a first or second degree relative with a diagnosis of alcohol dependence when studied by the family history and study methods. As many as 89% of cocaine dependents diagnosed by DSM-III-R criteria for cocaine dependence qualified for other alcohol and drug dependence diagnoses. Our study finds a high prevalence of alcohol (67% and 89%) and cannabis dependence (51% and 46%) in patients with cocaine dependence. Previous reports regarding alcohol and other drug dependence among cocaine dependents and their families are few and inconclusive. The diagnosis of other drug and alcohol dependence in cocaine dependence and in family members of cocaine dependents has important impact on etiology, prognosis and treatment.

Adult↗
PubMed1989

Amphetamines: pharmacology, abuse and addiction.

Amphetamine (beta-phenylisopropylamine) is a potent sympathomimetic amine of a simple structure with a multiplicity of biological effects that include hyperthermic, anorectic, cardiovascular and central nervous system stimulant actions. Since the 1930s a large number of drugs have been developed from systematic, chemical modifications of the basic amphetamine molecule to emphasize some of the properties of amphetamines and to eliminate or diminish others. These chemical manipulations have resulted in the synthesis of a variety of more selectively acting sympathomimetics. These altered molecules include CNS stimulants, potent psychomimetics (hallucinogens), anorectic agents, and vasoconstrictors that all have the basic beta-phenylisopropylamine skeleton. Reports of the consequences of abuse and addiction followed rather closely the development of these agents: manufacture, distribution and use continue to the present day. Both legitimate and illicit production account for a significant level of use of CNS stimulants. CNS stimulants are perhaps the most reinforcing drugs known to man. For this reason alone they will persist as drugs of choice among a variety of personalities.

Amphetamines↗
PubMed1989

Suggestions for changes in DSM-III-R criteria for substance use disorders.

The revisions for the diagnosis of Substance Use Disorders in DSM-III-R provide significant improvements toward a more valid and reliable categorization of substance use disorders. However, additional considerations may be indicated to further enhance the utility of the DSM-III-R as a diagnostic instrument.

Denial, Psychological↗
PubMed1989

Cocaine.

The smoking of freebase cocaine produces faster and higher peak blood and brain levels. Cocaine intoxication can produce virtually any psychiatric symptom. Significant medical complications include seizures, cardiac arrhythmias and respiratory arrest. An understanding of the neuropharmacology of cocaine enhances the identification of cocaine use and addiction.

Acute Disease↗
PubMed1989

Identification and treatment of benzodiazepine abuse.

Although often used in the medical management of anxiety, insomnia, seizures and muscle spasm, benzodiazepines lead to significant complications after continuous use. These complications include tolerance, addiction, dependence and abuse. Knowledge of the diagnostic criteria and treatment of side effects improves the physician's use of these commonly prescribed drugs.

Benzodiazepines↗
PubMed1989

Sedative-hypnotics: pharmacology and use.

The quest for an ideal sedative-hypnotic drug has been fraught with failure. The goals of the perfect sedative-hypnotic drug are to: (1) produce a transient reduction in the level of consciousness for the purpose of sedation, calmness, and tranquility without lingering aftereffects; (2) produce sleep without the potential to arrest respirations and without aftereffects on sensorium and mood; and (3) produce no abuse, addiction, tolerance, or dependence. Nonetheless, clinical conditions have required the use of sedative-hypnotic drugs in spite of the inherent difficulties with them. The history of sedative-hypnotic drugs is replete with attempts to produce a safe and effective drug. The introduction of one sedative-hypnotic drug for another has been heralded by unguarded optimism and misguided claims. History has repeated itself with each new drug. Toxicities, abuse, addiction, and development of tolerance and dependence have remained in force for each drug that has appeared on the market. Only minor variations on a theme have differentiated one drug from another as the essential features have remained in force.

Drug Interactions↗
PubMed1988

The use of opiate antagonists in treating bulimia: a study of low-dose versus high-dose naltrexone.

Sixteen individuals with bulimia consented to a 6-week trial of naltrexone, receiving either standard dosages of 50-100 mg each day or high dosages of 200-300 mg each day. At the end of 6 weeks, individuals in the low-dose group had no significant change in their frequency of binge eating or purging, while individuals in the high-dose group had significant reductions in both behaviors. Four individuals in the low-dose group who were crossed over to high-dose naltrexone at the end of the study went on to experience significant reductions in binge eating and purging. These findings support the potential utility of opiate blockade in treating bulimia, but suggest that dosages of naltrexone greater than those needed to block exogenous opiates may be required for therapeutic efficacy in reducing binge eating and purging.

Bulimia↗
PubMed1988

The human sexual response and alcohol and drugs.

The effects of alcohol and drugs on sexual function are important to consider in clinical histories and medication prescribing practices. Virtually all aspects of the human sexual response are affected by alcohol and drugs: 1. Desire (libido) is reduced. 2. Performance. Impotency as defined by lack of erection and ejaculation occurs. 3. Dissatisfaction ensues. These effects of alcohol and drugs can be understood and illustrated by examining the phases of excitement, plateau, orgasm, and resolution in the human sexual response. The important first step in the treatment of sexual dysfunction is to identify the alcohol/drug/medication use. The next is to recognize the profound effect it can have on the human sexual response. Furthermore, knowledge of the mechanism of action of the drugs and a basic conception of the physiology and psychology of sexual performance are necessary to predict the course of the sexual dysfunction. In many instances, the sexual dysfunction is reversible even after chronic alcohol/drug/medication use.

Autonomic Nervous System↗