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PubMed2002

[Infections and other causes of mortality correlated with drug addiction].

Drug use and related injection practices determine an excess mortality in drug abusers compared to the general population adjusted for age and gender. HIV/AIDS and overdose are the most important causes of death among injecting drug users; however, excess mortality is also due to other causes, such as cirrhosis and endocarditis. Infections have a great impact on the health of injection drug users. Viral infections, such as HIV, HCV, and HBV, are the most important ones, but bacterial and fungal infections, and, to a lesser extent, protozoal infections, are also common. In depth knowledge of drug-related morbidity and mortality causes is important to improve clinical skills and to implement control activities.

Cause of Death↗
PubMed2003

Prevalence of HIV infection in the drug addicts of Bangladesh: drug habit, sexual practice and lifestyle.

The aim of this study was to investigate the prevalence of HIV infection in drug addicts and to address their drug habit, sexual life style and socioeconomic factors. This study was conducted among 505 male drug addicts comprising 250 intravenous drug users (IDUs) and 255 non-IDUs. Enzyme-linked immunosorbent assay was used to screen HIV antibody in the sera of drug addicts. Seropositivity was confirmed by line immunoassay method. Results showed 3.76% (n =19) HIV-seroprevalence, of which 2.77% (n =14) were IDUs and the rest (0.99%, n =5) were non-IDUs. Amongst the IDUs (n =250) the seroprevalence rate was 5.6% (n =14) and in the non-IDUs (n =255), it was 1.96% (n =5). The seropositive addicts used multiple drugs for long periods of time, the majority of them (63.2%, n =12) started addiction with cannabis but ended up with heroin. Unprotected sex (did not use condom), multiple sexual partnerships and sexually transmitted diseases were common among the seropositives. Prevalence of these behavioural and biological risk factors in drug addicts was responsible for their being HIV infected. Most of the HIV-positive addicts were literate young adults (84.2%), employed (73.7%) and married (63.2%). None of them were homosexual. This study reveals that HIV-seroprevalence in the drug addicts of Bangladesh is still at the embryonic stage, it has not yet reached the threshold level.

Adolescent↗
PubMed1990

[Tolerated and forbidden addictive drugs: various effects on the management of adolescent drug dependent patients].

Of the 168 drug addicts admitted to the Zurich University Psychiatric Clinic between 1973 and 1979, 137 were followed up after an average period of five years, 40 of them dependent on legally tolerated drugs, 97 on prohibited drugs. The two groups were compared in terms of medical and social care, tutelary measures and arrests. Whereas the two groups were comparable as regards emergency inpatient treatment in general hospitals and psychiatric clinics, outpatient care was much more common among illegal-drug addicts. The men in this group were also hospitalized significantly more frequently and for longer periods in special therapeutic clinics. Surprisingly, there was no difference between the groups as regards the percentage of men imprisoned, whereas women dependent on illegal drugs were arrested more often than women dependent on legal drugs. Tutelary measures were significantly more frequent with legal drug addicts. These data suggest that those dependent on legal drugs, particularly young men, still receive insufficient treatment and that social consequences of addiction to legal drugs are underestimated.

Adolescent↗
PubMed1996

Differences in dental treatment plan and planning for drug-addicted and non-drug-addicted patients.

This study investigated whether dental treatment plans and planning of general practitioners are different for addicted and identical non-addicted patients. Dental practitioners (n = 500) were sent a questionnaire with information on and questions about treatment for either an addicted or an identical non-addicted patient; response rate was 41 %. Loglinear analysis showed that after controlling for the influence of four demographic variables (sex, age number of patients and number of National Health Service insured patients), the treatment plans made for addicted patients were less elaborate than those for non-addicted. For the addicted, fillings or frames were proposed more often, whereas for non-addicted patients more often crowns or bridges were proposed. Extraction instead of filling was more often proposed for the addicted patient. Less elaborate treatment for addicted patients corresponds to the way dentists specialized in treating drug addicts work, with one exception: extraction should be avoided whether a patient is addicted or not. Treatment planning did not differentiate for addicted and non-addicted patients, whereas dentists specialized in treating addicted patients do recommend an adjusted treatment plan for the addicted.

Adult↗
PubMed2004

[Drug Addiction Self-Help Recovery scale (DASH-scale): an approach to the measurement of recovery from drug addiction in self-help program among drug addicts].

The purpose of the study was to develop a scale for measuring the recovery in self-help program for drug addicts. Our study sites were fourteen self-help groups for drug addicts called "DARC: Drug Addiction Rehabilitation Center". DARC activities were based on Narcotics Anonymous types of self-help program. The 25-items DASH-scale questionnaire was developed using data, which were obtained through in-depth interview among DARC staff. A cross-sectional study among recovering addicts participating in "DARC" activities was implemented from Jan 2004 to Feb 2004. 164 subjects were responded to our questionnaire. Factor analysis was carried out and items with weaker or split loadings were removed. Factor analysis of DASH-scale results produced a surprisingly clean four-factor solution. 19-items were left to form the final DASH-scale; regular life-style (6 items), acceptance of drug addiction (5 items), sympathy with member (5 items), reborn (3 items). The internal consistency (Cronbach's Alpha) of these scales was very high (0.87). Low but significant concurrent correlations were observed between the DASH-scale and the Rosenberg Self-Esteem Scale (0.22), Purpose in Life Test (0.35). Discriminant validity of the DASH-scale was supported by significant increase with exposed period of self-help program. Evidence supports the DASH-scale was possible to measure recovery in self-help program.

Adult↗
PubMed1991

The molecular biology of addictive drugs.

The additive drugs alcohol, morphine, cocaine, and amphetamine are each associated with the development of tolerance and physical dependence. Changes in gene expression occur in cell culture and in vivo with the administration of these centrally-acting drugs. This article reviews those experiments that have studied drug-induced alterations in gene transcription. Ethanol has diverse effects on the amounts of messenger RNA molecules within the central nervous system. Ion channels, neuropeptides, membrane receptors, and immediate early genes represent several regulated mRNAs. The effects are selective, however, as many other specific products are not altered. Evidence for a genetic predisposition to ethanol use reinforces the importance of the genotype. Opioids, cocaine, and amphetamine also affect gene transcription. Messenger RNAs studied have included many of those demonstrated to be altered by alcohol use. Interestingly, use of any of these drugs alters the expression of immediate early genes. These genes may represent an initial step in the pathway that leads to drug addiction. The composite of drug-induced changes in gene expression results in the cellular responses of tolerance and dependence. The characterization of these changes should provide a better understanding of the molecular mechanisms of drug addiction.

Alcoholism↗
PubMed2005

Synaptic plasticity and drug addiction.

Recent studies have suggested that the development of addictive behaviours shares common features with traditional learning models. Synaptic plasticity, a possible substrate for learning, has been demonstrated in neural reward circuits and might contribute to the learning of addictive behaviours. Changes in the strength of synaptic connections have been investigated in dopaminergic cells of the ventral tegmental area in response to several addictive drugs. Rapid and persistent forms of synaptic plasticity (specifically, long-lasting synaptic potentiation) have been demonstrated to accompany some of the behavioural effects of addictive drugs. We hypothesize that drug-induced synaptic plasticity might play a role in reward-related learning and addiction by modifying the fine tuning of dopaminergic cell firing.

Brain↗
PubMed1977

[Psychological dependence? A possible different formulation of the problem for a therapeutic rearrangement in chronic drug addictions].

Disputing the concept of "psychic dependence", the Authors review six motivations to use addictive drugs, four of which pertain to the moment to assume the habit, although the latter two, which are identifiable with physical and psychic dependence, depend on te breaking the habit. While physical dependence is linked to withdrawal syndrome, psychic dependence, on the Author's opinion, is related to a long-standing previous state of true or masked endogenous depression (in this case it would be well termed as "neuropsychological dependence"), and the drug taking is only a maladaptive self-medication. This thesis is substantiated by the literature, reporting, in chronic drug addicts the use of the whole series of antidepressants (i.e. tricyclics, doxepine, lithium, etc.), with noticeable therapeutical success. According with other reports and with personal experience, the Authors maintain a great importance to drugs acting, directly or not, on GABA, i.e. l-glutamine, piracetam, and, particularly, N-dipropilacetic acid.

Antidepressive Agents↗
PubMed1977

Psychic dependence? A different formulation of the problem with a view to the reorientation of therapy for chronic drug addiction.

Disputing the concept of "psychic dependence", the authors review six motivations to use addictive drugs, four of which pertain to the moment of assumption of the habit, and two of which, identifiable with physical and psychic dependence, depend on breaking of the habit. While physical dependence is linked to withdrawal syndrome, psychic dependence, in the authors' opinion, is related to a longstanding previous state of true of masked endogenous depression (in this case it would be well termed "neuropsychological dependence"), and the drug taking is only a maladaptive self-medication. This thesis is substantiated by the literature reporting, in chronic drug addicts, the use of the whole series of antidepressants (i.e. tricyclics, doxepine, lithium, etc.) with noticeable therapeutical success. In accordance with other reports and with personal experience, the authors assign great importance to the drugs acting, directly or indirectly, on GABA, i.e. L-glutamine, piracetam, and, particularly, N-dipropylacetic acid.

Aminobutyrates↗
PubMedDate not supplied

Young drug addicts and the drug scene.

The drug scene generally comprises the following four distinct categories of young people: neophytes, addicts who enjoy a high status vis-à-vis other addicts, multiple drug addicts, and non-addicted drug dealers. It has its own evolution, hierarchy, structure and criteria of success and failure. The members are required to conform to the established criteria. The integration of the young addict into the drug scene is not voluntary in the real sense of the word, for he is caught between the culture that he rejects and the pseudo-culture of the drug scene. To be accepted into the drug scene, the neophyte must furnish proof of his reliability, which often includes certain forms of criminal activities. The addict who has achieved a position of importance in the drug world serves as a role model for behaviour to the neophyte. In a more advanced phase of addiction, the personality of the addict and the social functions of the drug scene are overwhelmed by the psychoactive effects of the drug, and this process results in the social withdrawal of the addict. The life-style of addicts and the subculture they develop are largely influenced by the type of drug consumed. For example, it is possible to speak of a heroin subculture and a cocaine subculture. In time, every drug scene deteriorates so that it becomes fragmented into small groups, which is often caused by legal interventions or a massive influx of new addicts. The fragmentation of the drug scene is followed by an increase in multiple drug abuse, which often aggravates the medical and social problems of drug addicts.

Adolescent↗