Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “Narcotics”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 289 records · Page 16Linked to original sources

The criminality of narcotic addicts.

Recent research conducted by independent investigators concerning the relationship between crime and narcotic (primarily heroin) addiction has revealed a remarkable degree of consistency of findings across studies. The major conclusion supported by the majority of these studies is that narcotic addicts commit a vast amount of crime and that much of this is directly related to the need to purchase drugs. A large proportion of the crimes committed does not consist merely of drug sales or possession, but involves other criminal behaviors including serious crimes. The strongest evidence of a causal relationship between narcotic drug use and crime is derived from longitudinal studies in which the amount of crime committed during periods of active addiction far exceeds that committed during periods of nonaddiction. Much of this crime goes unreported, although addicts, under conditions of strict confidentiality, have provided information that permits realistic estimates of criminal activity. Use of this methodology has permitted the identification of different types of addicts, especially with respect to the amounts and types of crimes in which they are engaged. The implication of these findings is that although addicts as a group commit a great amount of crime, they cannot be regarded as a homogeneous class. Some addicts commit many crimes, regardless of current addiction status, whereas others commit relatively few, and these are obviously related to their need to purchase drugs. There is a discernible impact of treatment on narcotic drug use and criminality. Although the relationships between addict characteristics and treatment response have yet to be fully determined, extensive prior criminal involvement is associated with a negative outcome.

Crime↗

End-stage renal disease and non-narcotic analgesics: a case-control study.

1. To assess the risk of end-stage renal disease (ESRD) associated with the regular use of three classes of non-narcotic analgesics, we performed a case-control study of 340 patients with ESRD on a haemodialysis maintenance program and 673 hospital controls. 2. The overall odds ratio estimate for non-narcotic analgesics taken at least every other day for 30 days or longer before the first symptom of renal disease was 2.89 (95% CI, 1.78 to 4.68). 3. The risk increased in relation to the use duration. 4. The previous regular consumption of combinations containing phenacetin was strongly associated with ESRD (odds ratio, 19.05; 95% CI, 2.31 to 157.4). The odds ratio for previous regular consumption of salicylates was 2.54 (95% CI, 1.24 to 5.20) and for pyrazolones 2.16 (95% CI, 0.87 to 5.32). 5. An analysis for possible confounding by a history of repeated headaches, arthritis, kidney stones, hypertension, and diabetes did not alter the results. 6. The odds ratio estimates for different pathological subgroups of ESRD patients in relation to previous use of any non-narcotic analgesic were glomerulonephritis. 10.57 (95% CI, 1.25 to 89.0), interstitial nephritis, 3.33 (95% CI, 1.21 to 9.17), cystic kidney disease, 0.71 (95% CI, 0.25 to 1.97), and unknown, 5.15 (95% CI, 2.29-11.57). 7. The results of this study suggest that the regular consumption of analgesics should be routinely considered as a risk factor for any non-congenital cause of chronic renal failure. They also suggest that the risk of ESRD associated with the regular consumption of phenacetin is much higher than the risk associated with other non-narcotic analgesics.

Adolescent↗

Effects of narcotic analgesics on the uptake and release of 5-hydroxytryptamine in rat synaptosomal preparations.

1 The effects of various narcotic analgesics on the uptake and release of labelled 5-hydroxytryptamine (5-HT) in brain and spinal cord synaptosomes were investigated.2 Methadone was most active in inhibiting 5-HT uptake (IC(50) 2.5 x 10(-7) M). Levorphanol also inhibited 5-HT uptake to a large extent (IC(50) 8.8 x 10(-7) M) while dextrophan, pethidine and pentazocine showed much less activity. Etorphine and morphine had virtually no such activity, with IC(50)S higher than 10(-4) and 10(-3) M respectively.3 The same order of potency as ;5-HT releasers' was found when radioactivity was measured in [(3)H]-5-HT preloaded synaptosomal pellets incubated for 20 min with the various narcotics. Methadone, like chlorimipramine, showed a significant effect at a concentration of 10(-7) M while morphine, at a concentration of 10(-4) M, had no effect.4 When 5-HT release was studied by a perfusion technique, which largely prevents reuptake of the released amine, only fenfluramine, an anorectic agent proposed as a 5-HT releaser, significantly increased spontaneous 5-HT release. These data suggest that the apparent 5-HT release induced by various narcotics in traditional incubation techniques may largely depend on their ability to interfere with neurotransmitter reuptake mechanisms.5 The effects of the various narcotics on 5-HT uptake have no relationship to their relative potency as analgesics in the rat. In the light of their poor effectiveness as 5-HT releasers, it can be concluded that mechanisms other than 5-HT uptake inhibition and release are probably involved in the analgesic effects of these compounds in intact animals.

Analgesics, Opioid↗

Narcotic and nicotine effects on the neonatal auditory system.

To evaluate narcotic and nicotine effects on the neonatal auditory system, brain stem auditory evoked responses were recorded in 15 infants prenatally exposed to both narcotics and nicotine (median gestational age 38.4 weeks, median birth weight 2820 g), in 15 nicotine exposed infants (gestational age 40.0 weeks, birth weight 3000 g) and in 24 healthy term infants (gestational age 40.1 weeks, birth weight 3310 g) who served as controls. Whereas nicotine-exposed and control infants were similar in all brain stem auditory evoked response measurements, narcotic/nicotine infants had bilaterally increased wave V latencies (left: p = 0.005; right: p = 0.04) and I-V intervals (left: p = 0.02; right: p = 0.01) when compared to controls. Our findings suggest that prenatal narcotic but not nicotine exposure negatively affects maturation or integrity of the neonatal auditory brain stem tract and that neither narcotic nor nicotine exposure is associated with hearing loss in the neonate.

Brain Stem↗

Female narcotic addicts: a follow-up study of criminal and addiction careers.

A sample of 66 female narcotic addicts first examined in prison in 1967-8 was followed-up four years later. At the end of the period of follow-up 36% were off narcotics, 32% were still addicted, and 15% had died. Altogether 62% committed further offences. Drug offences and offences against property were almost equally frequent and accounted for over two-thirds of all convictions. There was no evidence of a link between prostitution and narcotic addiction. A significant association was found between continued delinquency and continued addiction during the period of follow-up. Addiction career and criminal career coincided in over three-quarters of the subjects, who tended either to continue manifesting both forms of deviant behaviour (46%) or to relinquish both (30%). The findings are in keeping with the view that narcotic addiction and crime are not causally related but may be parallel effects of common underlying factors leading to social deviance.

Crime↗

A controlled comparison of cyclazocine and naloxone treatment of the paroled narcotic addict.

A controlled, double-blind study of the comparative effectiveness of the narcotic antagonists, cyclazocine and naloxone, was undertaken in a metropolitan narcotic clinic offering an abstinence program involving urine monitoring and ancillary counseling services. Seventy male addict parolees were randomly assigned to 6-month treatment with either cyclazocine, 4 mg administered on a daily basis, or naloxone, 500-2,000 mg administered on a locally developed and researched 'contingent' basis, i.e., whenever there was indication of narcotic drug use (daily and contingent placebos were utilized to preserve the double-blind). Criteria of treatment effectiveness included narcotic drug usage, clinic attendance, length of participation in the program, disposition at 6 months, and incidence of side effects. The two subsamples of 35 individuals were similar with respect to relevant demographic characteristics. Examination of comparative effects revealed little to no significant differences between the two groups in terms of measures of program adherence, treatment outcome, and personal and social adjustment. Side effects were more prevalent among cyclazocine patients. Typically, these included moderately severe somatic effects and perceptual and cognitive disturbances.

Adolescent↗

Extraordinary analgesic requirement in a patient previously unexposed to narcotics.

Patient-controlled analgesia (PCA) is a relatively new therapeutic modality that allows patients to administer doses of intravenous narcotics, using a syringe pump and sequencing device. We used PCA to deliver analgesic therapy to a 35-year-old man seriously injured in an aviation accident. Although the patient gave no previous history of narcotic use or abuse, he required morphine dosing rates as high as 56 mg/h to maintain adequate analgesia. The delivery of relatively high doses of narcotic was not accompanied by significant sedation, as might be expected. The patient underwent two surgical procedures while on PCA therapy. Following each procedure, dosing requirements increased, but within three days after each operation, dosing tapered. The patient was converted to oral hydromorphone therapy, which gradually was tapered and then discontinued. PCA should be considered a useful therapeutic adjunct in the management of patients refractive to empirical narcotic analgesic regimens.

Adult↗

Outcomes and complications of continuous intraspinal narcotic analgesia for cancer pain control.

Preliminary reports of continuous intraspinal morphine analgesia have been enthusiastic regarding the resultant cancer pain control. Reports of continuous intraspinal infusion have not documented the duration of useful analgesia, need for concomitant analgesic therapies, or complication rates. Thus, the overall outcomes and complications of six chronic intrathecal and eight epidural morphine infusions were analyzed in the first 14 cancer pain patients implanted with continuous intraspinal morphine infusion reservoirs at this clinic. A five-point scale was used to assess the analgesic therapy required to maintain pain control during three consecutive intervals of intraspinal morphine infusion (zero to two months, two to six months, after six months). Comparison with pre-implant narcotic requirements revealed equal or reduced narcotic use for up to six months of therapy, with a definite trend toward escalation of intraspinal narcotics, systemic analgesia, and adjunctive procedures after two months. This occurred most likely due to narcotic tolerance and disease progression. Failure of pain control was the rule with continuous intraspinal morphine after six months. Three patients ultimately required neurolytic blocks. No clear difference was found in pain control requirements between epidural and intrathecal morphine infusion. No infection or respiratory depression occurred as a direct result of the intraspinal morphine implanted system.

Aged↗

Low-dose synthetic narcotic infusions for cerebral relaxation during craniotomies.

Thirty patients undergoing craniotomies were given infusions of fentanyl 1 microgram X kg-1 X hr-1, sufentanil 0.1 microgram X kg-1 X hr-1, or normal saline in a double-blind study of cerebral relaxation. Significantly better relaxation scores were achieved in patients given a narcotic infusion, but there was no difference between the scores with the two narcotics. Infusions of narcotics at these low rates did not delay recovery or alter the requirement for other anesthetic agents. Narcotic infusion rates that do not delay recovery or alter depth of anesthesia significantly improve cerebral relaxation.

Brain↗

A twenty-year follow-up of narcotic addicts in Tucson, Arizona.

This preliminary report from an epidemiological study of heroin addiction in Tucson, Arizona, 1956-1976, examines the status of heroin addicts 20 years after they have been identified as narcotics abusers, focusing on the maturation hypothesis which holds that heroin addicts tend to cease use of narcotics spontaneously by age forty. A cohort of 51 subjects was identified from Public Records of Court Appearances for narcotic offenses during a 36-month period (1955-1957), located and, where possible, interviewed. Records from a minimum of two agencies (law enforcement, corrections, treatment, welfare) were used to establish current status of the individual with reference to the use of narcotics and/or other drugs. Demographic, ethnic, socioeconomic makeup of the sample, as well as criminal involvement and treatment episodes, is included. After 20 years, one individual is drug-free or abstinent. Twenty-three are considered still addicted to heroin, 16 of these are in prison; seven are addicted to methadone or alcohol. Thirteen are dead. Six could not be located; however, five could be traced well beyond 1956 through criminal activities. All but one person have passed their fortieth birthdays. For these 51 addicts, the maturation hypothesis does not hold.

Adolescent↗

Abnormal liver function tests as biological markers for alcoholism in narcotic addicts.

Liver Function Test (LFT) abnormalities are frequently observed in narcotic addicts. However, the role of alcohol in producing such changes remains unclear. In order to evaluate the effects of alcohol in producing LFT elevations as well as the use of routine LFTs to serve as biochemical markers for alcoholism in narcotic addicts, 612 addicts participating in a randomized control trial of intervention in alcoholism were studied. Baseline parameters including LFTs and history of alcohol use were obtained on entry into the study and subsequently periodically during follow-up which varied from 6 months to 2 1/2 years (mean 13.5 months). On entry to the study, 104 of 612 (17%) of addicts were classified as alcoholics. Mean values of LFTs (SGOT, SGPT, Alkaline phosphatase, GGTP) in the alcoholic cohort were significantly increased compared to those among nonalcoholics (p less than 0.01 to less than 0.001 for individual tests). Mean values of LFTs did not significantly change during methadone maintenance in either group. Although a greater proportion of alcoholic addicts had elevated LFTs, the predictive values for each test (18 to 35%) were sufficiently low to prevent them from being used as biochemical markers of alcoholism. These findings suggest that although elevations in LFTs are frequently present in narcotic addicts and are significantly greater among addicts who are also alcoholic, most elevations are not specifically due to alcohol. Conventional LFTs are therefore of limited value in assessing alcoholism among narcotic addicts.

Alcoholism↗

Narcotic bowel syndrome treated with clonidine. Resolution of abdominal pain and intestinal pseudo-obstruction.

We describe the cases of five patients having a syndrome of chronic abdominal pain, vomiting, weight loss, and features of intestinal pseudo-obstruction associated with prolonged use or abuse of narcotic analgesics. In each patient, abdominal complaints were originally attributed to either mechanical bowel obstruction or an underlying gastrointestinal disorder often involving prior abdominal surgery. Symptoms resolved rapidly in all patients when narcotic administration was stopped. Clonidine therapy was used to alleviate symptoms of narcotic analgesic withdrawal. The narcotic bowel syndrome is a clinically important and frequently unrecognized cause of chronic abdominal pain.

Abdomen↗

Behavioral functions of narcotic antagonists: response-drug contingencies.

Behavioral effects of the narcotic antagonist naloxone are discussed in terms of stimulus functions. As an eliciting stimulus, the effects of naloxone depend on prior administration of narcotic. Administered independently of responding, naloxone can increase or decrease rates of narcotic-reinforced responding depending on the dose of naloxone. When naloxone is administered as a consequence of narcotic self-injection, the further probability of that behavior is reduced; thus, naloxone can function as a punishing stimulus. As a negatively-reinforcing stimulus, naloxone can maintain behavior which terminates or prevents delivery in morphine-dependent monkeys. In animals with previous naloxone avoidance-escape experience, unavoidable-inescapable injection of naloxone produce increases in avoidance-escape response rates. In these animals, responding subsequently can be maintained, at least temporarily, when naloxone is administered only as the consequence of responding.

Animals↗

Use of intercostal bupivacaine with epinephrine after surgery to decrease use of narcotics and duration of intubation.

BACKGROUND: Postoperative pain plays a significant part in the recovery of patients after open heart surgery. OBJECTIVE: To determine if the use of intercostal bupivacaine with epinephrine is associated with decreases in use of narcotics and intubation times after open heart surgery. METHODS: A randomly selected experimental group of 25 patients received injections of bupivacaine with epinephrine in the intercostal tissues before chest closure in open heart surgery. A control group of 22 patients received no bupivacaine, only standard care. Postoperative use of narcotics and intubation times were determined for both groups. RESULTS: Compared with the control group, the group given bupivacaine with epinephrine used significantly less narcotics (P=.008) and had significantly shorter intubation times (P=.003). CONCLUSION: Injection of intercostal bupivacaine with epinephrine before chest closure in open heart surgery decreases use of narcotics and length of intubation postoperatively, thus speeding up recovery times.

Adult↗

[Immune system in chronic narcotic intoxication].

The analysis of the literature data demonstrates that secondary immunodeficiency in chronic narcotic intoxication results, primarily, from T-system dysfunction and attenuation of both cellular and humoral reactions. However, some evidence exist on the absence of such effects or even stimulation of the immune system by narcotic drugs. Morphological analysis of changes in the lymphoid organs of drug addicts who had died of different diseases in chronic narcotic intoxication was made by only few researchers, so functional morphology of immune system organs in chronic narcotic intoxication is an issue of the day which requires further investigation.

Humans↗

Studies on the narcotic receptor in the guinea-pig ileum.

Studies were conducted on the development and loss of tolerance to morphine in the coaxially stimulated guinea-pig ileum. In ilea from guinea pigs made tolerant to morphine by the procedure of morphine-pellet implantation, the morphine-naloxone pA2 was decreased from 8.5 to 7.6, suggesting a qualitative rather than a quantitative change in the receptors. This change in the pA2 was in the opposite direction from that previously observed with analgesic receptors. Three hours after the administration of a single injection of morphine to the guinea pig, the ileum showed tolerance to morphine, which disappeared by 6 hours. With naloxone as the antagonist, the narcotic analgesics, morphine, methadone, etorphine and levorphanol, yielded higher pA2 values than the narcotic antagonist analgesics, nalorphine, pentazocine and cyclazocine, a result similar to that seen with the analgesic receptors. However, the interaction between naloxone and the narcotic antagonists in the ileum differed from that in the central nervous system when the slopes of the pAx plots were examined. Thus, although the interaction of analgesics with the ileal receptors appears to correlate with the acute effects of the drugs, caution must be exercised to use the ileal receptors as models of analgesic receptors for the study of chronic narcotic effects, i.e., tolerance and dependence.

Animals↗

A comparison of epidural narcotics, with and without a test dose, to epidural lidocaine for extracorporeal shock wave lithotripsy.

We sought to compare epidural lidocaine to several short-acting epidural narcotics for their efficacy in controlling pain during extracorporeal shock wave lithotripsy (ESWL), hemodynamic changes, side effects and patient acceptance. To determine what contribution, if any, the local anesthetic test dose makes to the above factors, we also compared epidural sufentanil with and without a preceding test dose of local anesthetic with epinephrine. One hundred ASA I-III patients scheduled for elective ESWL were divided equally into five groups to receive one of the following epidural drugs through an epidural catheter: 2% lidocaine with 1:200,000 epinephrine (Group L), 1000 micrograms alfentanil (Group A), 200 micrograms fentanyl (Group F) or 60 micrograms sufentanil (Groups S and S-). Group S- differed from all other groups in omission of the test dose and direct injection of the opioid through the epidural needle. Significant hypotension occurred in 20% of patients in Group L compared to 0% in the narcotic groups (p less than 0.01). Clinically significant respiratory depression was not observed in any group. Mild pruritus was observed in up to 60% of patients in the narcotic groups (p less than 0.01). Sedation was observed in all of the narcotic groups, particularly in Group S-, in which more than half of patients were drowsy (p less than 0.05). Requirements for adjuvant analgesics during ESWL were highest in Group A. Patient acceptance was high throughout the study. We conclude that epidural alfentanil, fentanyl and sufentanil are as effective as epidural lidocaine plus epinephrine in providing analgesia during ESWL.(ABSTRACT TRUNCATED AT 250 WORDS)

Alfentanil↗

Histamine release by four narcotics: a double-blind study in humans.

Histamine release and hemodynamic changes associated with four narcotics were studied in 60 adults (28 men, 32 women) scheduled for general surgery under balanced anesthesia. Under double-blind conditions, incremental equipotent doses of meperidine, morphine, fentanyl, or sufentanil were administered IV for induction of anesthesia, prior to thiopental, succinylcholine, and intubation. Arterial blood samples were drawn before and 1, 6, and 20 min after narcotic administration. Of the 16 patients given meperidine (mean dose 4.3 +/- 0.2 (SEM) mg/kg), five (31%) had clinical signs (hypotension, tachycardia, erythema) and elevations in plasma histamine levels ranging from 3.2 to 49.7 ng/ml 1 min after narcotic administration. Plasma epinephrine levels at this time were also elevated in these five patients. One of the ten patients given morphine (0.6 +/- 0.02 mg/kg) developed hypotension, tachycardia, and an increase in plasma histamine level to 12.4 ng/ml. None of 34 patients given either fentanyl (7 +/- 0.4 micrograms/kg) or sufentanil (1.3 +/- 0.1 microgram/kg) had clinical signs of histamine release or elevations of plasma histamine levels. In the six patients in whom histamine release occurred, there was a significant correlation between the histamine levels at 1 min and the magnitude of change in heart rate, blood pressure, and plasma epinephrine level. All six histamine releasers were young women, ranging in age from 18 to 35 yr. Histamine release occurred more frequently after meperidine than after the other narcotics, including morphine, and the degree of hemodynamic compromise was related to the increase in plasma histamine concentration.

Adolescent↗