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At least 271 records · Page 15Linked to original sources
PubMed1979

[Acupuncture as a part of a program of detoxification and weaning from opiates: 25 cases].

Presents results of a detoxification and habit loosing program carried out in 25 morphine-like substances addicts (mainly heroine) aged 19-26. The therapeutic treatment based on gabaergic drugs (l-glutamine, sodium valproate and piridoxine), low doses psychodrugs (tricyclics and benzodiacepines) and acupuncture, began in 13 subjects at the hospital and continued at the outpatients' service, while 12 subjects were treated only at the outpatients' service. Follow up: 6 subjects of the hospitalized group free from the addiction (5 subjects from more than 1 year after their discharge); 3 subjects of the outpatients' group abstinent from no more than 4 months after discharge. Biochemical mechanisms involved in this therapeutic program are extensively discussed.

Acupuncture Therapy↗
PubMed1981

[Recognizing and treating drug addicts. Part 2. Differential diagnosis, therapy].

Persons addicted to opiates often have fresh injection scars on the skin directly above the veins in the arms and legs. These appear as well as scars from abscesses and burns, tattoos, advanced tooth decay and signs of chronic hepatitis. An intensive consumption of hallucinogens is often connected to an inclination toward apathy and a loss of contact to reality (amotivational syndrome). It is necessary to have a sufficiently wide spectrum of therapeutic and rehabilitation measures being offered, due to the wide range of variants one can expect in the personality structure and the primary disturbance. The slogan of "therapy instead of punishment" leads nowhere. Long-term in-patient programmes, still presently favoured in our country, are not sufficient and are being increasingly more frequently rejected by the addicts themselves. Out-patient therapy trends, which are both extremely necessary and promising, are to be found in the close co-operation between physicians and specialists in social therapy while utilizing community resources. Two examples for such a programme are discussed (Hesse, Marx). A more concentrated improvement of out-patient therapy and rehabilitation of drug addicts is only possible when the chemical-toxicological diagnosis of addicting substances in urine becomes a routine process in the medical laboratory, e.g. by enzyme immunological methods.

Adult↗
PubMed1995

Smokeless tobacco: epidemiology, health effects and cessation strategies.

Smokeless tobacco is an extremely addictive substance with a high rate of use in certain demographic groups, such as adolescents and Native Americans. In the past 20 years, the use of smokeless tobacco has almost tripled. Health risks include leukoplakia (a premalignant oral lesion), oral cancer and systemic nicotine effects such as elevated blood pressure and serum cholesterol levels. To avoid or control these effects, family physicians should identify patients who use smokeless tobacco and encourage and support cessation efforts. Patients who are unsure about quitting need the risks of their habit personalized, and those who are actively trying to stop using smokeless tobacco need emotional and, in some cases, therapeutic support (e.g., nicotine replacement therapy). The family physician should encourage patients who appear motivated to stop using smokeless tobacco to set a quit date in the very near future. However, all smokeless tobacco users--regardless of their motivation to quit--need to be followed to ensure compliance with cessation advice or to detect medical complications from use of this form of tobacco.

Algorithms↗
PubMed1995

Effects of dopamine depletion on the morphology of medium spiny neurons in the shell and core of the rat nucleus accumbens.

Nucleus accumbens receives a dense dopaminergic innervation which is important in regulating motivated states of behavior such as goal-directed actions, stimulus-reward associations and reinforcement of addictive substances. The shell and core territories of this nucleus each receive functionally and morphologically distinct dopaminergic inputs and lesions of the ascending pathways totally deprive the core but not the shell of dopaminergic fibers. Medium spiny neurons are the principal targets of dopaminergic terminals. The present study explored whether the loss of dopamine inputs can affect these neurons and whether cells in the shell and core would be equally susceptible to such a loss. Intracellular injection in fixed slices and neuronal reconstruction were used to analyze the dendritic trees of 62 neurons in the shell and core of animals that received a unilateral, chronic 6-hydroxydopamine lesion of the medial forebrain bundle. In the dopamine-depleted core, dendrites are significantly shorter (16% decrease) than in the intact core and in both the dopamine-depleted core and lateral shell, dendrites are less spiny than in respective control regions. Dopamine loss in the medial shell is associated with significantly more tortuous dendrites that are lower in spine density. However, the number of spines is not reduced which may mean that the increase recorded for segment length, although insignificant in tests, could be responsible for the change in spine density. These data suggest that the loss of dopamine can affect accumbal neuronal morphology and, moreover, can affect neuronal structures differentially in the shell and core.

Animals↗
PubMed1995

Risk factors for inhalant abuse in juvenile offenders: the case of Mexico.

During the last two decades the abuse of inhalants and other addictive substances has received considerable attention in Mexico. Although substance abuse seems to affect everyone, adolescents seem to be at higher risk, and although researchers have identified the links between substance abuse and delinquency, there is not enough scientific information to explain the reason. A cross-sectional study was designed to examine the relationship between known risk factors and inhalant abuse among a group of Mexican juvenile offenders. Of the 626 subjects studied, 58% reported use of different drugs, and of them 23% abused inhalants. Gender, low socio-economic level and labor status were the principal risk factors associated with inhalant abuse. According to attributable risks calculated, and taking into account the methodological limitations of the study, the authors suggest some preventive actions to decrease inhalant abuse in the population studied.

Adolescent↗
PubMed1993

[Criminal prosecution of drunk driving in the former Czechoslovakia and in the Czech Republic and Slovakia].

In the successor states of former Czechoslovakia, the law enforces the principle of 0.0% alcohol content in blood while operating a motorized vehicle. Those persons who break this law can be punished according to either section 201 StGB "Jeopardizing others while under the influence of addictive substances" or section 201 a StGB which regulates "drunk driving" instances. Various sanctions can also be imposed: 1) imprisonment; 2) confiscation of driver's license; 3) monetary fine. Within the judicial framework, driving while intoxicated, 0.1% alcohol content in blood, is absolutely forbidden, and in some cases, an alcohol content of 0.08% is sufficient to place the suspect under the same laws regulating 0.1% category. The alcohol content in the blood is usually determined by means of a blood or urine test.

Accidents, Traffic↗
PubMed1993

A family physician-counselor program for medical students.

BACKGROUND: Impairment among medical students has increased over the past decade, thus requiring programs to identify and manage student needs. METHODS: At Eastern Virginia Medical School, first-year medical students are assigned personal physician-counselors from the Department of Family and Community Medicine. These physicians provide health care and assist students in identifying and managing new or preexisting medical and psychosocial problems. Students meet with their physician-counselors during the first week of school to develop rapport and to complete a screening history and genogram. Subsequent small group meetings help students adjust to life in medical school. RESULTS: Psychosocial problems such as alcoholism, mental illness, substance addiction, and sexual abuse have been identified among students and/or their families, and management strategies have been initiated. This program has been evaluated highly by both faculty and students. CONCLUSIONS: This program has been helpful in identifying problems and implementing treatment strategies for medical students.

Counseling↗
PubMedDate not supplied

[The reinforcing properties of psychostimulating preparations on models of conditioned-reflex place preference in mice].

Secondary reinforcing properties of cocaine, amphetamine, methylcathinone, ephedrine, apomorphine, and bromocriptine were studied with the aid of conditioned place preference technique in mice. All explored drugs, except apomorphine, induced dose-related conditioned place preference in mice. Technique of comparative analysis of addictive potentialities of drugs is proposed. Procedure and analysis aspects of described technique as well as the possibilities of its implementation for screening of addictive substances are discussed.

Animals↗
PubMed1996

[Alcohol].

Alcohol is one of the most widely used addictive substances. It can be assumed that everybody encounters alcohol--ethanol in various forms and concentrations in the course of their lives. A global and social problem of our civilization is alcohol consumption which has a rising trend. Since 1989 the consumption of alcoholic beverages is rising and the mean annual consumption of concentrated ethanol per head is cea 10 litres. In ethanol abuse the organism is damaged not only by ethanol alone but in particular by substances formed during its metabolism. Its detailed knowledge is essential for the knowledge and investigations of the metabolic and toxic effect of ethanol on the organism. Ingested alcohol is in 90-98% eliminated from the organism by three known metabolic pathways: 1-alcohol dehydrogenase, 2-the microsomal ethanol oxidizing system and 3-catalase. Alcohol is a frequent important risk factor of serious "diseases of civilization" such as IHD, hypertension, osteoporosis, neoplastic diseases. Cirrhosis of the liver and chronic pancreatitis are the well known diseases associated with alcohol ingestion and also their most frequent cause. It is impossible to list all organs and diseases which develop as a result of alcohol consumption. It is important to realize that regular and "relatively" small amounts in the long run damage the organism and may be even fatal.

Alcoholism↗
PubMed1998

[Smoking initiation in students: cross-sectional and longitudinal study of predictive factors].

BACKGROUND: This study examines the evolution of tobacco use among schoolchildren in sixth and seventh grades in Barcelona (11-13 years) and identifies smoking risk factors through cross-sectional and follow-up analysis. POBLATION AND METHODS: The cohort consists of 1,003 students attending 13 schools who served as control units for a study assessing the effects of a school-based addictive substances prevention program. Participants answered the same questionnaire in 1990 and 1991. Risk factors for the experimentation and for regular smoking are studied through cross-sectional and prospective studies. RESULT: In a year, smokers increase from 9.7% to 18.9% and regular smokers rise from 1.1% to 5.5%. The initial cross-sectional analysis finds stronger associations than the follow-up one. Some variables loose their significance in the longitudinal analysis. Among non-smokers, the strongest predictors to emerge are intention to smoke, the belief that smoking is fun, peers, siblings and mother consumption, and being male; however girls appear to consolidate the consumption more than boys among the cohort of triers. CONCLUSIONS: Tobacco use prevalences are consistent with other studies developed in our city. Social environment emerges as an important predictor; friends, siblings and mothers tobacco use and gender are the main risk factors.

Adolescent↗
PubMed1998

Medication development of ibogaine as a pharmacotherapy for drug dependence.

The potential for deriving new psychotherapeutic medications from natural sources has led to renewal interest in rain forest plants as a source of lead compounds for the development of antiaddiction medications. Ibogaine is an indole alkaloid found in the roots of Tabernanthe iboga (Apocynaceae family), a rain forest shrub that is native to equatorial Africa. Ibogaine is used by indigenous peoples in low doses to combat fatigue, hunger and in higher doses as a sacrament in religious rituals. Members of American and European addict self-help groups have claimed that ibogaine promotes long-term drug abstinence from addictive substances, including psychostimulants and cocaine. Anecdotal reports attest that a single dose of ibogaine eliminates withdrawal symptoms and reduces drug cravings for extended periods of time. The purported antiaddictive properties of ibogaine require rigorous validation in humans. We have initiated a rising tolerance study using single administration to assess the safety of ibogaine for treatment of cocaine dependency. The primary objectives of the study are to determine safety, pharmacokinetics and dose effects, and to identify relevant parameters of efficacy in cocaine-dependent patients. Pharmacokinetic and pharmacodynamic characteristics of ibogaine in humans are assessed by analyzing the concentration-time data of ibogaine and its desmethyl metabolite (noribogaine) from the Phase I trial, and by conducting in vitro experiments to elucidate the specific disposition processes involved in the metabolism of both parent drug and metabolite. The development of clinical safety studies of ibogaine in humans will help to determine whether there is a rationale for conducting efficacy trials in the future.

Animals↗
PubMedDate not supplied

Patient-treatment matching in substance abuse. Drug addiction severity.

In this study, a mixed group of 60 substance-dependent patients were randomly assigned to 12 weeks of treatment in either a high-structure, behaviorally oriented (HSB) or a low-structure, facilitative (LSF) individual counseling style. We tested the hypothesis that patients with a more severe pretreatment drug problem will realize greater treatment benefit in HSB counseling, while those with a less severe problem will benefit more in the LSF approach. Six counselors provided the treatments in a counterbalanced design that controlled for possible differences in counselor effectiveness. Treatment benefit comparisons with respect to the counselors' posttreatment ratings, the number of counseling sessions attended, reduction in problem severity, and substance use during treatment were consistently in the hypothesized direction. These findings provide at least partial support for the notion that treatment benefit for substance abuse patients can be improved through appropriate patient-treatment matching on the basis of addiction severity.

Adult↗
PubMedDate not supplied

Use of the Addiction Severity Index with homeless substance abusers.

The Addiction Severity Index (ASI) is a widely adopted assessment instrument that provides severity ratings of the multiple problems exhibited by alcohol and drug dependent persons and allows for quantitative assessment (composite scores) of client status in these problems areas over time. ASI change scores of homeless and near homeless substance abusers, generated by contrasting ASI composite scores at two points in time, show a high level of agreement to objective relapse data from the Massachusetts Bureau of Substance Abuse Services Management Information System. Clients readmitted to a publicly funded detoxification facility exhibited significantly lower mean change scores on five of the seven problems areas measured by the ASI. These data illustrate the applicability of the ASI to homeless men and women and the utility of the ASI in measuring client improvement.

Adult↗
PubMed2003

Chronic pain, substance abuse and addiction.

Health care professionals face numerous challenges in assessing and treating chronic pain patients with a substance abuse history. Societal perspectives on morality and criminality, imprecise addiction terminology, litigation fears, and genuine concern for a patient's relapse into or escalation of substance abuse result in unrelieved and under-relieved pain in precisely the population that--as increasing evidence indicates--is generally intolerant of pain. Before adequate pain relief can occur in chronic pain patients with current or past substance abuse issues, it is imperative that the clinician recognize addiction as a disease with known symptoms and treatments. Further, the clinician must realize the difference between true addiction and similar conditions, so the patient's condition can be monitored and regulated properly. Although clinicians are often reluctant to medicate with opioids, it is always best to err on the side of adequate pain relief. Withholding opioids from chronic pain patients in order to avoid the onset or relapse of addiction is contrary to the growing body of evidence and results only in unnecessary pain for the patient. Chronic pain in patients with a history of addictive disease can be treated successfully with opiate analgesia; it just requires caution and careful monitoring of medication use. If addiction is treated as a known risk when providing opioid analgesia to a recovering addict, its development can be minimized while pain relief is provided.

Analgesics, Opioid↗
PubMed1993

Adolescent Substance Use and Addictions: Epidemiology, Current Trends, and Public Policy.

Although the proportion of high school seniors who use illicit drugs has declined from 54% in 1979 to 29% in 1991, substance use and addiction are still major problems among adolescents. The authors examine epidemiologic and demographic data for each of the major illicit drugs, focusing on relevant factors such as age, gender, educational plans, socioeconomic status, geographic region, population density, race, and ethnicity. This analysis leads to a discussion of policies that may further decrease the use of illicit drugs.

Journal Article↗
PubMed2006

Toward a unitary perspective on the bipolar spectrum and substance abuse: opiate addiction as a paradigm.

Bipolar spectrum disorders and addiction often co-occur and constitute reciprocal risk factors that the authors believe are best considered under a unitary perspective. In particular, we submit that patients whose disorders fall under the bipolar spectrum - and its hyperthymic and cyclothymic temperamental substrates are at increased risk for substance use, possibly moving towards addiction through exposure to intrinsically dependence-producing substances. In our experience, the contribution of bipolar spectrum disorders to the addictive process is often clinically missed, because attenuated and subclinical expressions of such mood disorders as bipolar II and cyclothymia are not adequately appreciated by our current formal diagnostic system (e.g. DSM-IV, as well as research and clinical practice based on it). The use of agonist treatment in dual diagnosis heroin addicts has allowed us to gather valuable knowledge about the intrinsic, and historically and clinically documented mood-regulating effects of opiates. From the therapeutic point of view, the challenge of double diagnosis requires double competence from clinicians. The combination of opiate agonists and mood stabilizers often produces results difficult to obtain with the use of the two types of drugs separately. We therefore submit that the present conceptualization of the link between bipolar spectrum and addictive disorders has not only heuristic and scientific values, but also an important message for the clinician.

Alcoholism↗
PubMed1993

Office Assessment of Substance Abuse and Addiction.

Various factors prevent the primary care physician from implementing effective diagnosis, evaluation, and treatment of substance abuse among adolescents, including time constraints, practice styles, inadequate reimbursement, and physician discomfort. The author examines the positive outcomes of physician involvement as well as the negative consequences of noninvolvement and recommends strategies and resources to aid the primary care physician in coping with adolescents suspected of substance abuse.

Journal Article↗