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PubMed2003

Development of vaccines to help treat drug dependence.

The social and economic consequences of drug addiction are immense. Although many methods are adopted to treat addiction, including therapeutic intervention and counseling, the long-term success rate has been limited and there continues to be a need for more effective treatments. A novel approach that has sparked a significant degree of interest recently is the use of vaccines designed to raise specific antibodies against drugs of abuse. Antibodies that prevent addictive substances crossing the blood-brain barrier may prove to be an effective mechanism that will help prevent relapse during efforts to abstain from the drug. Proof-of-principle for this approach has been established in numerous animal models. Currently a cocaine vaccine is in phase II clinical trials and, more recently, two vaccines to nicotine have entered phase I trials. Key efficacy trials are required to establish the true potential of these therapeutic vaccines.

Animals↗
PubMed2003

[Profile of smokers who seek treatment at a smoking cessation clinic].

OBJECTIVES: The variety of smoking cessation therapies that have proven effective ranges from simple counseling to intensive interventions. The objective of our study was to identify the characteristics of smokers who currently seek treatment at a smoking cessation clinic. METHODS: Descriptive observational study. The target population consisted of smokers who sought treatment at a smoking cessation clinic. The following variables were studied: sex; age; referral source; marital status; educational level; age at which smoking began, age at which it became a regular habit and the time elapsed between the two moments; level of nicotine dependence (Fagerström Test for Nicotine Dependence); number of cigarettes per day; number of years smoking; use of other potentially-addictive substances (alcohol, caffeine, psychotropic medications and other drugs); presence of concomitant disease; previous attempts to quit smoking; current reasons for smoking cessation; and concentration of expired air carbon monoxide (CO). An initial medical history was taken from each smoker on the waiting list for treatment at the clinic in order to gather data on the study variables; these individuals were then enrolled in a 3-month group smoking cessation program that utilized both medication and cognitive-behavioral therapy. The results are presented in percentages and means with standard deviations (SD) and 95% confidence intervals (CI). RESULTS: 385 smokers were studied--239 (62%) men and 146 (38%) women--the average age being 43.05 years (SD: 9.07). Mean nicotine-dependence (Fagerström Test score) was 6.05 (SD: 2.19); mean number of cigarettes per day: 25.9 (SD: 12.11); mean number of years as a smoker: 25.3 (SD: 9.04); and mean expired air CO: 39.30 (SD: 25.18). Associated disease was present as chronic bronchitis for 27.5% and cardiovascular risk factors for 15%. Previous attempts to quit smoking were reported by 72%; the reasons for the present attempt to quit smoking were the prevention of disease (38%), awareness of dependence (20%) and parental desire to serve as a positive role model for children (10%). CONCLUSIONS: At present, the smokers who attend a smoking cessation clinic are young, severely-dependent adults in the initial stage of preparing to quit. The prevalence of symptoms in this population is low. The profile of the population seeking specialized smoking cessation treatment is expected to change in the future as those with smoking-related diseases and other specific populations of smokers become included.

Adult↗
PubMedDate not supplied

[Warning signs of eating, depressive, learning disorders and violent behavior among teenagers in Cantabria, Spain].

BACKGROUND: Teenagers relatively frequently suffer from eating, depressive learning and violent behavior disorders which are often detected late. This study was aimed at investigating the presence of warning signs among teenagers in view of these disorders and to relate them to the social and family environment and living habits. METHODS: A descriptive, cross-sectional study by means of a survey of 2,178 teenagers in the 12-16 age range, representative of the teenagers of Cantabria. The warning signs were defined based on the American Medical Association and American Psychiatric Association criteria. RESULTS: Warning signs of learning disorders related to the male gender, attending public schools and repeating a year were found among 4.2% of the teenagers. Warning signs of eating disorders and depressive disorders, both related to the female gender, were found respectively among 4.3% and 10.2% of the teenagers. A total of 8.4% showed warning signs of violent behavior, more often among males. The signs investigated are spread homogeneously, increasing with age, and are significantly related to a higher degree of smoking, drinking and illegal drugs, episodes of drunkenness and a certain use of free time on the part of the teenagers, with a higher degree of consumption of addictive substances among friends and family members. CONCLUSIONS: The routine assessment during the teen years of warning signs of having the disorders studied would make their early detection possible.

Adolescent↗
PubMedDate not supplied

[Conditioned-reflex activation of electrical self-stimulation of the brain: a model of a situational craving for narcotics].

Rats with electrodes implanted into lateral hypothalamus were trained to press a lever to obtain electrical stimulation of the brain. After elaboration of self-stimulation (SS) conditioning of morphine-induced activation of SS-response was carried out. Five pairings were performed of morphine (3 mg/kg, i.p.) administration and SS in the box with distinct environmental cues (brightness, color, floor texture, background noise). After morphine withdrawal activation of SS was reproduced after simple placing of the animal in "conditioned" chamber. This effect was naloxone-sensitive. The observed effect is considered to be the adequate model of addictive substances craving.

Animals↗
PubMedDate not supplied

[The intravenous self-administration of narcotics in mice].

Four commonly and largely abused drugs morphine, cocaine, amphetamine, cathinone and sympathomimetic ephedrine were investigated, using intravenous self-administration by naive mice, with special regard to methodological aspects of these techniques. All drugs showed a similar bell-shaped concentration response curves, which are typical of compounds with high addictive potential. A new method of analysis of the reinforcing properties allowing to disregard motor side effects of drugs nas been proposed. Procedure and analysis aspects of described techniques as well as the possibilities of its application for screening of addictive substances are discussed.

Animals↗
PubMed2004

[New trends in the treatment and prevention of addictive disorders].

Some trends in the treatment and prevention of diseases related to alcohol, drugs and gambling are reviewed. Brief intervention is crucially important, considering high prevalence of addictive diseases. Motivation enhancement according to the stage of motivation is used in brief intervention and also during more comprehensive therapy. Psychological and pharmacological management of craving is used more than before. Close and systematic co-operation between professional services and Alcoholics Anonymous and/or other self-helping groups is common and useful. Prevention of addictive diseases includes measures such as taxation, restriction of availability, age limits, restrictions of advertisements, and prevention of drinking under the influence of alcohol and other drugs. Effective school based prevention utilises interactive programmes and training of relevant skills (e.g. refusal skills, relaxation and decision making). Prevention on family level includes appropriate family monitoring and rules, moderate and consistent family discipline and family conflict resolution. Special attention should be paid to the children whose parents are alcohol or drug dependent. These children should, even as adults, abstain from alcohol and other addictive substances.

Humans↗
PubMed2004

Inhalant abuse by adolescents: a new challenge for Indian physicians.

Inhalant abuse has been commonly reported especially in the young during the last decades globally. The reason for the relative paucity of literature from India may be attributed to a lack of knowledge about this growing problem among health professionals. A series of five cases of inhalant abuse is described in order to understand this growing public health concern. Most of the cases started inhalant abuse during adolescence. All patients except one abused typewriter erasing fluid and thinner which contains toluene. All the patients reported using inhalants as addictive substance because of their easy accessibility, cheap price, their faster onset of action and the regular 'high' that it provided. Whereas several features of inhalant dependence were fulfilled, no physical withdrawal signs were observed. The diagnosis of inhalant abuse can be difficult and relies almost entirely on clinical judgment. Treatment is generally supportive.

Administration, Inhalation↗
PubMed2005

The possible contribution of neuronal nicotinic acetylcholine receptors in depression.

Although tobacco use and smoking were introduced long ago, it was only recently that the nicotine contained in the tobacco leaves was recognized as an addictive substance acting on the central nervous system (CNS). However, even prior to this recognition, several studies have reported an association between smoking and psychiatric disorders. One of the many observations was that smoking cessation is accompanied by a marked increase in the probability of major depression. In parallel with the discovery of the neuronal nicotinic acetylcholine receptors and their extensive expression in the CNS, this association sheds new light on the influence of cholinergic transmission in depression. In this article, we examine the various modes of action of nicotine in the CNS and discuss the mechanisms by which this alkaloid can prevent or precipitate mood disorders, and the possibility of discovering new therapeutic avenues for the treatment of depression.

Animals↗
PubMed2005

[Social factors associated with the daily cigarette smoking among middle-school student adolescents in Bucaramanga, Colombia].

INTRODUCTION: Daily cigarette smoking is associated with high morbidity and mortality in adults. This pattern of tobacco use is established during the early adolescence. Among adolescents, daily cigarette smoking is a strong predictor of illegal, addictive substance use. The prevalence of daily cigarette smoking is not known in Colombian adolescent middle-school students. OBJECTIVE: To assess smoking prevalence, daily cigarette smoking and associated factors among middle school-students in Bucaramanga, northeast Colombia. MATERIALS AND METHODS: An anonymous questionnaire concerning illegal and legal substance use was administered to a random sample of 2,586 students. RESULTS: The group mean age was 13.0 years; 54.9% was male; 32.0% was in sixth grade, 31.7% in seventh, 25.2% in eighth and 11.1% in ninth grade, with 67.1% enrolled in public schools. The prevalence of daily cigarette smoking lasting the month prior to the questionnaire was 3.8% (95% CI 2.7-4.9). Logistic regression showed a significant association between being the best friend of a smoker or a drinker of alcohol (OR=3.71; 95% CI 1.71-8.04), having low academic performance perception (OR=3.83; 95% CI 1.0-14.2), and being older age (OR=1.4; 95% CI 1.2-1.8). CONCLUSIONS: These data demonstrated that one in 26 middle-school student adolescents from Bucaramanga is an everyday smoker. The most important associated factor was being the best friend of a smoker or a drinker of alcohol.

Adolescent↗
PubMed2006

Diet, nutritional status and food related traditions of Oraon tribes of New Mal (West Bengal), India.

INTRODUCTION: According to the 2001 census conducted by the Government of India, India has more than 84 million tribals who constitute 8.2% of India's population. The Oraons are an agricultural tribe found mainly in Orissa, Bihar, Jharkhand and West Bengal. The present study was undertaken on a group of Oraon tribals working in a tea gardens of New Mal in Jalpaiguri district of West Bengal. The children attended the local primary school. The Oraons are covered by the Integrated Child Development Scheme (ICDS) of the Government of India, which is concerned with the health, nutrition and development of children and their mothers. To evaluate the effect of ICDS, the practices of adults towards hygiene, medication, addictive substances and diet were also recorded. METHODS: 500 Oraon tribals, including 200 men and 150 women aged 20-45 years, and 150 children aged 6-12 years, were surveyed for their dietary intake by 24-hour recall and semi-quantitative food frequency questionnaire methodology and anthropometry, and a description of food-related traditions. RESULTS: The diet of all Oraon groups was deficient in all food groups. Cereal intake was least deficient, while the intake of milk and fruit was almost negligible. Their diet was supplemented by a locally grown green leafy vegetable dheki saag, and fermented leftover rice. The energy available from the diet for all age groups was only 52-53% of the recommended dietary allowances of the Indian Council of Medical Research. Children were enrolled in a midday meal program at the local primary school; however, their energy intake was severely deficient, and of the same order as their parents. The mean basal mass index (BMI) of adult Oraons was not low, but children were severely undernourished. Men were less undernourished than were women. Some potentially useful traditions practiced included wiping washed utensils with leaves of a local plant mirchaiya, preparing herbal tablets called ranoodava to make an alcoholic and a medicinal drink called hadiya. The Oraons' knowledge of contraception, vaccinations, proper diet and supplements needed for successful pregnancy was severely deficient. CONCLUSIONS: A remarkable finding of this study on the Oraon tribals is that the BMI of children was substantially below that of adult men and women. This deficiency cannot be attributed to energy intake because energy intake of children, as percentage of recommended dietary allowance, was about the same as adults. The study shows that the midday meal program provided only approximately 25% of the energy requirements of the children; moreover, it was qualitatively deficient. It also seems that the midday meal replaced rather than supplemented home meals. Despite ICDS coverage, knowledge with regard to contraception, vaccinations, proper diet and supplements needed for successful pregnancy was very low. Interesting traditional practices concerned with methods of preparing food and use of local plants as medicines were observed and documented. Rural health professionals should ensure adequate quantity and quality of food supplementation. They should strive to disseminate health related knowledge. Traditional tribal practices should be studied for their nutritional and medicinal value. They could be responsible for the adequate BMI of adult Oraon, despite severe deficiency in energy intake.

Adult↗
PubMed2006

Smoking habits of adolescents and the role of dentists.

Tobacco smoking has a devastating effect on the health and well-being of the public and remains the nation's leading avoidable cause of premature mortality and disability. On an average, each smoker who dies would have lived another 15 years if he/she was a non-smoker. Though adult smoking has decreased markedly, there is an alarming rise in the use of tobacco among adolescents. One unique aspect of dentistry is some of the adverse health effects of tobacco uses are clinically apparent in the oral cavity at a relatively early stage of use. More than one-half of the adult population and nearly three-quarters of the student population see a dentist each year, and yet 80% of dentists do not routinely ask about tobacco use and advise tobacco users to quit. Nicotine is a highly addictive substance, and the urge to continue smoking is powerful. As doctors our motto in advising patients should be, "If you smoke, quit. If you don't, then don't try it." The second part of the message is especially important for adolescents, since most adult smokers started their habit as adolescents. The authors have highlighted the harmful effects of smoking and the role dentists have to impart as responsible citizens in educating their patients, especially in the younger generation to help them lead a healthier and more meaningful tomorrow.

Adolescent↗
PubMed2006

[Epidemiology, treatment and prevention of attention deficit/hyperactivity disorder: a review].

Attention deficit/hyperactivity disorder (ADHD) is characterized by inattentiveness and/or impulsiveness and hyperactivity, which are unsuited for the developmental stage or age. Although mechanisms leading to the onset of the disease are unclear, this condition seriously hinders childrens' social or learning functions, and recently it was selected as a target disease for a special supporting education program by the Minitry of Education, Culture, Sports, Science and Technology, together with learning disorders and high-functioning pervasive developmental disorders in Japan. In spite of the increasing social interest in ADHD, the epidemiological evidence including data for incidence, prevalence, gender differences, and etiology remain insufficient. In Western countries, as represented by the United States, operational diagnostic criteria such as DSM-IV are widely used and several diagnostic processes using structured interviews have been established. However, the diagnostic criteria have not been consistent even within DSM as shown by DSM-IV and DSM-III-R, and therefore basic epidemiological evidence was not consistent in the previous studies. Regarding the etiology of ADHD, exposure to addictive substances during the pregnancy period caused by maternal smoking or drinking, and familial socioeconomic status are considered important environmental factors. In addition, a family history of mental disorders and polymorphisms of dopamine-related genes such as DRD4 or SLC6A3 have been noted as genetic factors concerning the development of ADHD. However, in Japan, no studies of these subjects or gene-environment interactions have so far been performed. Thus, epidemiological assessment of other than Western populations is needed. In the clinical situation, it is important to grasp the timing of treatment and target problems on the basis of changes of children's ability to control their attention or behavior, and environmental factors associated with growth processes. Especially, comorbidity such as conduct disorder or oppositional defiant disorder is a critical problem. Thus, considering that ADHD is a multifactorial disease, a comprehensive therapic strategy involving medication, education, judicature, and administration should be established for primary and secondary prevention.

Adolescent↗
PubMedDate not supplied

[Ultima ratio of the applied security measures in placing perpetrators in a psychiatric hospital].

The meaning of articles on the main security measures concerned with placing the convict in a closed psychiatric unit is studied. Articles 93 & 94 section 1 of the penal code limit their application only as final measures--the ultima ratio. Art. 93 of the penal code pertains to the perpetrator of illegal actions in connection to their psychiatric illness, mental retardation, alcohol or other related substance addiction, along with a risk of the crime being committed once again, only when it will prevent the person from repeating the crime. The issues that need be considered are the following: psychic state of the perpetrator along with prediction of the risk of him repeating the act, but the liability evaluation and the degree of probability do not play any vital role. This is probably due to the fact that the measure described in art. 96 of the penal code has a limited time span (it cannot be any shorter than 3 months and longer than 2 years) and what is more; it can be applied instead of the punishment. Art. 94 section 1 of the penal code requires very precise evaluation of the risk of repetition in each case of a non-liable perpetrator guilty of conducting crime of serious social damage. This measure is not limited in time span, because it depends on the psychic state of the person under its influence. Henceforth it is considered as more restrictive.

Commitment of Persons with Psychiatric Disorders↗
PubMed1991

[Problem drinkers among high school students in Japan].

In Japan, an increase in the consumption of alcohol by young people has been noted. This survey on drinking problems was performed on 1062 students of second year high school in 1990 using the Adolescent Alcohol Involvement Scale (AAIS). The results revealed that among all of the survey subjects of both sexes, 21.4% were abstainers, 4.2% normal adolescents, 60.9% non-problem drinkers, 12.6% alcohol misusers and 0.9% alcoholic-like drinkers. A high alcohol consumption rate and high percentages of those with drinking problems were observed among high school students. Students who used other addictive substances (i.e., smoking or thinner inhalation) reported significantly higher AAIS scores than those who didn't. Similarly high mean AAIS scores were found among students with family problems such as drinking parents or broken homes than those without this problem. Alcohol misusers and alcoholic-like drinkers accounted for 14.2% of males and 12.7% of females. In a survey performed 10 years previously on high school students, no alcoholic-like drinkers were found and only 1% were alcohol misusers. These results indicated that problem drinkers have dramatically increased among Japanese high school students in the last 10 years.

Adolescent↗
PubMedDate not supplied

[The national addictions survey of Mexico].

A probabilistic household survey was made with the following objectives: to estimate the prevalence of consumption of tobacco, alcohol and legal and illegal drugs; to identify attitudes and values, risk factors and problems associated with the consumption of addictive substances in a population from 12 to 65 years old, which resides in the urban areas of Mexico. This survey forms part of the National Health Surveys System, and its sample design is based on the Master Sample Framework of the National Health Surveys System, which gathered information representative of the national population and for seven regions. In the elaboration of the questionnaire indicators proposed by the World Health Organization (WHO), validated for Mexico, were used as well as previous knowledge about the topic. Thirteen thousand and five interviews were made, of which 96.7 per cent were complete and 2.6 per cent were rejected. In the group from 12 to 17 years old, 32 per cent of the men and 23 per cent of the women already consumed alcoholic drinks. The age group with the largest proportion of men who were frequent drinkers is from 30 to 39 years of age, with 36.3 per cent. For women 34.0 per cent of the frequent drinkers were found in the 40 to 49 year age group. It was found that six per cent of the population from 18 to 65 years of age is alcohol dependent, 12.5 per cent of men and less than one per cent of women. The population which smokes reaches 26 per cent of the total, with 38.3 per cent of men and 14.4 per cent of women. Forty two and four per cent of smokers are from 18 to 29 years of age. Among the daily smokers, 17 per cent were considered dependent on cigarettes. Only 4.8 per cent of the population admits having consumed some type of drug on at least one occasion, with the men from 12 to 34 years old being the age group which is most affected by the use of drugs (8.5%). Active users in the last year made up 2.1 per cent and in the last month the proportion of active users was less than one per cent. The most frequently used drug was marihuana (1%), the second used were tranquilizers (0.4%), and the third most frequently used were inhalants (glue, thinner) (0.26%). The most commonly consumed drug by male users was marihuana and by female users the most commonly used drug was stimulants.(ABSTRACT TRUNCATED AT 250 WORDS)

Age Factors↗
PubMed1989

Massive caffeine ingestion resulting in death.

Caffeine has long been recognized as an addictive substance with numerous toxic effects. Death due to caffeine overdose is rare, due in part to its marked gastric irritation resulting in spontaneous emesis. Caffeine can be found in food, beverages, analgesics, and over-the-counter weight loss products. We report a fatality resulting from the ingestion of mail order diet pills containing caffeine as their only active ingredient. A 22-year-old female arrived in the emergency department in cardiac arrest after ingesting these diet pills. Resuscitation efforts were unsuccessful. A serum toxicology screen revealed the presence of caffeine with a level of 1,560 micrograms/ml (lethal greater than 100 micrograms/ml). To our knowledge this is the highest reported fatal caffeine level. No other drugs were identified on the screen. Based on the absence of pathology on autopsy and the high caffeine level, death was attributed to acute caffeine toxicity. This case illustrates that deaths resulting from caffeine, although rare, continue to occur.

Adult↗
PubMedDate not supplied

Health beliefs and practices of runners versus nonrunners.

Returns of mailed questionnaires from 77 runner and 63 nonrunner respondents showed that runners placed a statistically higher value on health and performed greater numbers of health-related behaviors. Major differences were found in nutrition, exercise, and medical awareness and self-care. No major differences were found in addictive substance use, stress management, or safety practices. A number of concerns regarding runners' health practices were identified, including running while ill or in pain, incidence of injuries, negative feelings when unable to run, neglect of a conscious cool-down period, low weight levels, and a tendency to increase workouts following perceived dietary indiscretions.

Adult↗