Biomedical subjects
Publications and source records attributed to R E Garey.
Methods for determination of PCP in body fluids are presented and a rapid screening method is suggested. The demographics, psychiatric profiles, forensic aspects, and diagnostic problems of PCP abuse are discussed.
In a public hospital emergency room, 580 urines were screened for phencyclidine (PCP) with the routine EMIT-DAU PCP screen, the extended EMIT-DAU PCP screen, and a gas chromatograph/mass spectrometer/computer (GC/MS/COMP) in selected ion mode, which was chosen as the reference method. The extended method produced a 38.5% increase in positives detected over the routine EMIT-DAU PCP screen and allowed 66.4% of the specimens to be signed out as negative without confirmation by GC/MS/COMP. This ability to provide a rapid, relatively inexpensive screen for PCP in urine and, in particular, to eliminate those patients whose specimens are negative, is important in a psychiatric population that contains many acutely psychotic individuals with grossly abnormal behavior.
Thirty-one samples of street heroin were analyzed bacteriologically and chemically as to their microbial burden and chemical adulterants (fillers). Sixty-one percent of the samples were positive for microbial growth. Many species were isolated from the positive samples with Bacillus sp (79%) and Aspergillus sp (10%) predominating. The level of contamination ranged from 1.6 X 10(2) to 3.7 X 10(4) organisms per gram. We obtained cultures from 16 addicts from the Chicago area and 21 from the New Orleans area who had soft-tissue infections related to their habit. Infections in this group of patients were usually polymicrobial; however, there was no correlation between the organisms recovered from street heroin and the addicts' infections. Most drug-related infections appear to be related to the addicts' own oral and dermal microflora. No correlation was observed between the chemical fillers and the bacteria recovered from the heroin.
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The purpose of this paper is to examine one variable in the treatment of heroin addiction, ther therapist-client relationship. Eighty-six individuals who were discharged from the Tulane NARA Drug Abuse Program were examined on 20 social and personality variables. The variable of the counselor--patient relationship was found important in the final outcome of treatment. Clients who had a single counselor throughout the entire course of treatment did significantly better (p less than .002) than their peers who were transferred from one counselor to another, suggesting that a stable client--therapist relationship greatly enhances the chances of the patient reaching drug abstinence and being rehabilitated.
Two studies, designed to control for as many variables as possible, were conducted in 21 rhesus monkeys, some with brain electrodes and some unoperated, to determine the effects of marijuana on brain function and ultrastructure. Some monkeys were exposed to smoke of active marijuana (using different dose schedules), some were administered delta-9-THC (0.69 mg/kg iv), and others were exposed to smoke of inactive marijuana (from which all cannabinols had been removed). To deliver smoke to the monkeys, two different apparatuses were used. Dose schedules comparable to those of human marijuana smokers were established, as determined by plasma levels of delta-9-THC. After 2- to 3-months' exposure, the monkeys that were heavy- and moderate-smokers of active marijuana, and those administered delta-9-THC iv, developed chronic recording changes at deep brain sites, most marked in the septal region, hippocampus, and amygdala. These changes persisted throughout the exposure period (6 or 8 months) and during the postexposure observation period (1 to 8 months). Brains of these electrode-implanted monkeys, as well as those without electrodes that were exposed to delta-9-THC, showed ultrastructural alterations characterized by changes at the synapse, destruction of rough endoplasmic reticulum, and development of nuclear inclusion bodies. In contrast, brains of monkeys exposed to smoke of inactive marijuana and of unexposed controls showed no ultrastructural changes. The findings indicate that exposure to delta-9-THC, the psychoactive ingredient of marijuana, at doses commensurate with those used by human marijuana smokers can produce permanent alterations in brain function and structure of monkeys.
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A one year study of phencyclidine abuse in New Orleans showed that 90% of the cases cannot be detected by routine laboratory methods. Fifty percent of all cases showed evidence of police intervention. Initial impressions covered a wide range of psychiatric and clinical diagnoses. Recurring psychiatric problems due to the presence of the drug would indicate observation for a period of at least 72 hours. Patterns of PCP abuse cross racial and ethnic boundaries and are found uniformly in all population groups.
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The temporal sequence of changes in norepinephrine (NE) levels in various regions of brains of control and 6-hydroxydopa (6-OHDOPA)-treated rats was determined. It was found that 6-OHDOPA (60 mug/g i.p., three doses, 48-hour intervals), when administered from birth, markedly altered the NE content of various brain regions during the following 8-week period. In telencephalic regions, such as the neocortex and hippocampus, NE levels (micrograms per tissue) increased dramatically from birth in saline-treated rats, while NE was depressed by 55 to 85% in 6-OHDOPA animals. Studies for measuring the uptake of 3H-NE (2 X 10(-7) M) by synaptosomes isolated from the neocortex showed that uptake, was reduced by approximately 40% at 2, 5 and 52 weeks of age. Therefore, it appears that 6-OHDOPA is able to permanently impair the ontogenetic development of noradrenergic neurons in regions supplied by the dorsal noradrenergic bundle. In contrast to these effects, NE levels in the cerebellum were elevated 2-fold in 6-OHDOPA-treated rats of 8 weeks, postnatal age. Uptake was not similarly increased, indicating that the elevation in NE was not due to an increase in the number of nerve endings, but rather to an increase in the intraneuronal storage depots of NE. In the hypothalamus NE levels were not dramatically altered, while uptake was reduced by about 40% up to 1 year of age. Application of Michaelis-Menten kinetics indicated a decrease in the Vmax for 3H-NE uptake in the hypothalamus of 6-OHDOPA (60 mug/g i.p., two doses, 48-hour intervals from birth)-treated rats, sacrificed at 6 months of age. The pons-medulla and midbrain regions showed moderate increases in NE levels at 5 and 8 weeks. Uptake 1 was not increased in the pons-medulla at any time, and the Vmax remained unchanged when measured in rats at 6 months of age. It is apparent that 6-OHDOPA is capable of altering the ontogenesis of noradrenergic neurons and that the effects on development are different in different areas of the brain.
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