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Biomedical subjects

N S Miller

Publications and source records attributed to N S Miller.

At least 73 records · Page 4Linked to original sources
PubMed1990

The contemporary alcoholic.

Multiple drug use occurs in alcoholics in an age-dependent relationship. The younger the onset of alcoholism, the more likely is additional drug use. Drugs used by alcoholics, in decreasing order of frequency, are marijuana, cocaine, and other stimulants, phencyclidine, benzodiazepines, barbiturates, and hallucinogens. Evaluation of intoxication and treatment or detoxification in alcoholics should always include consideration of other drugs. Multiple drug use in alcoholics does not preclude the short- or long-term treatment that traditionally is available for alcoholics, such as programmatic treatment and AA and NA and psychotherapy. The existence of poly-drug addiction in alcoholics and of alcohol dependence in families of drug addicts and alcoholics suggest a common genetic vulnerability to alcoholism and drug addiction.

Adolescent↗
PubMed1990

The prevalence of marijuana (cannabis) use and dependence in cocaine dependence.

In a retrospective and prospective study using DSM-III-R criteria for substance dependence in 232 inpatients and 51 outpatients, the clinical suspicion that cocaine addicts use other drugs including marijuana was confirmed. As many as 53% of cocaine addicts diagnosed by DSM-III-R criteria for cocaine dependence qualified for a diagnosis of cannabis dependence. The reports regarding marijuana and other drug dependence among cocaine addicts have been few and inconclusive. The diagnosis of other drug use and dependence in cocaine dependence has importance with regard to prognosis and treatment. This study found a high prevalence of marijuana (cannabis) dependence in patients with cocaine dependence.

Adult↗
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

Comparison of the bladder response to indole and sodium saccharin ingestion by male rats.

To ascertain whether the bladder mass increase and epithelial hyperplasia induced by 5% dietary sodium saccharin (NaS) in short-term experiments with rats are caused by increased urinary excretion of indican associated with this treatment, the responses of the urine and bladder induced by 1.5% indole (Id) ingestion were compared with those induced by 5% NaS and 1.5% Id + 5% NaS. Id and NaS, when fed alone, produced equivalent increases in bladder mass and both compounds induced epithelial hyperplasia, but Id ingestion was associated with much greater urinary indican excretion (5 mg/g diet ingested) than was NaS (0.3 mg/g diet ingested). When Id and NaS were ingested together, the bladder mass increase was additive, but the epithelial hyperplasia was not exacerbated over that observed with each alone, and the urinary indican was equivalent to that produced by Id alone. These findings suggest that a high level of urinary indican excretion is associated with an increase in bladder mass and epithelial hyperplasia (Id treatment) but indicate that the relatively low urinary indican level obtained by NaS feeding alone is unlikely to be responsible for the bladder responses noted with this compound.

Animals↗
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

The diagnosis of alcohol, cocaine, and other drug dependence in an inpatient treatment population.

The diagnosis of alcohol, cocaine, and other drug dependence in inpatient treatment populations is important to identify for clinical prognosis, treatment, and genetic research. The use of alcohol by cocaine addicts is a common cause for relapse to cocaine. The treatment of cocaine addiction is simplified if alcohol dependence is also present because the same methods can be used for both. In this study, 94% of those patients who qualified for the diagnosis of cocaine dependence were also diagnosed as having alcohol and other drug dependence. The demographic characteristics of these cocaine addicts (n = 413) compared to those patients with the diagnosis of alcohol dependence only (n = 677) and alcohol dependence and drug dependence other than cocaine (n = 453).

Adolescent↗
PubMed1989

A common cause of alcoholism.

A common cause of alcoholism is the nonalcoholic. At least half of the nonalcoholics have a family member who is not alcoholic. The classic "enabler" is the caretaker of the alcoholic. Without the enabler, alcoholism would dwindle. The so-called innocent bystanders are not consciously intending to harm the alcoholic. Most of the time there is no conscious intention to help the alcoholic continue drinking and inflicting self-destruction. The innocent bystander must become guilty. The guilty must confront the alcoholic with the consequences of alcoholism. The concerned must refuse to make excuses for the alcoholic's failure and resentment. The innocent bystander may lack willpower more than the alcoholic by refusing to look alcoholism in the eye.

Adult↗
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

Drug abuse: a biopsychiatric model.

The effects of drug abuse are caused by the stimulation or inhibition of different neurotransmitters, chiefly gamma-aminobutyric acid, acetylcholine, norepinephrine, dopamine, serotonin and beta-endorphin. The biopsychiatric model focuses on neurotransmitter activity to diagnose and treat overdose and addiction. This model explains how different drugs exert their effects and provides a rationale for specific pharmacologic intervention in the drug-abusing patient.

Amphetamines↗
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↗