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PubMed2000

Chronic nicotine administration in the drinking water affects the striatal dopamine in mice.

Although tobacco contains a large variety of substances, its addictive properties are most probably due to the reinforcing actions of nicotine that motivates continued tobacco use. Animals and humans self-administer nicotine, a response that appears to involve the mesolimbic dopamine system and to be common to other abused drugs. The present article reviews animal models to administer nicotine chronically. We also describe a new animal model in which nicotine is given to mice in drinking water as their sole source of fluid. This treatment produced nicotine plasma concentrations comparable to or above those found in smokers. We found that mice withdrawn from nicotine were tolerant to the effects of nicotine challenge on striatal dopamine metabolism as well as on body temperature and locomotor activity. Furthermore, 3H-nicotine binding in the cortex and midbrain was significantly increased in mice withdrawn from nicotine. The last part of the article will focus on the effects of this chronic nicotine treatment on striatal dopamine. Dopamine and its metabolites and locomotor activity were increased in the forenoon in mice still drinking nicotine solutions. We also report recent data in which chronic nicotine administration in the drinking water enhanced the effect of dopamine receptor agonist, quinpirole, on striatal metabolism. The animal model described appears to be a relevant method for studying the mechanisms that are thought to be involved in nicotine dependence.

Animals↗
PubMed1999

An assessment of nicotine dependence among pregnant adolescents.

Studies have reported that between 28 and 62% of pregnant teenagers smoke (Cornelius, Taylor, Geva, & Day, 1995; Trollestrup, Frost, & Starzyk, 1992). Because smoking is prevalent among pregnant teenagers, the purpose of this research is to assess nicotine dependence in this high-risk group. This study analyzed baseline data from a sample of pregnant teen smokers who had volunteered to participate in a smoking cessation study (N = 94). Nicotine dependence was measured by adapting the Fagerstrom Tolerance Questionnaire (FTQ; Prokhorov, Pallonen, Fava, Ding, & Niaura, 1996), and by a 6-item withdrawal symptom scale. The overall FTQ score found among pregnant adolescents was 3.10 (SD = 2.3) compared to the mean overall FTQ score among vocational-technical students of 4.27 (SD = 2.2) (Prokhorov et al., 1996). Duration of smoking in years was significantly correlated with the overall FTQ score (r = 0.43, p < .01). Quantity of smoking, as measured by average number of cigarettes smoked, significantly correlated with overall FTQ scores (r = 0.67, p < .01). Lighter smokers were more likely to have previously attempted to quit, however, among the quit attempters, those who smoked 10+ cigarettes per day reported greater severity of withdrawal symptoms than those who smoked less per day. Prenatal education and smoking cessation programs for pregnant teenagers, and pregnant women in general, need to consider that nicotine dependence is an important issue. Early pregnancy may be an opportune time to intervene among pregnant smokers; incentives may be necessary to attract those women who are the heaviest smokers, and possibly the most dependent on nicotine.

Adolescent↗
PubMed1998

Pregnancy and other risk behaviors among adolescent girls in Ohio.

PURPOSE: The purpose of this study was to determine whether teenage girls who had been pregnant were more likely to engage in other risk or problem behaviors than girls who had had sexual intercourse without becoming pregnant. METHODS: The 1993 Ohio Youth Risk Behavior Survey was administered to a random sample of 2461 high school students. A subset of 592 girls (mean age 16.1 +/- 1.1 years, 69.2% Caucasian, 24.1% African-American, 2.4% Hispanic, 4.3% other) reported sexual activity (SA) on the anonymous survey. Demographic factors plus risk and problem behaviors were compared between 98 girls who had been pregnant and 494 girls who had never been pregnant using Chi-square analysis. Risk and problem behaviors were classified into four distinct groups: recent risk behaviors, age of onset of behavior, lifetime behavior, and general behavior. Variables which were univariately significant at p < 0.15 were considered in one of four stepwise multiple logistic regression models based on behavior type, with demographic factors considered in all four models. The final logistic regression model was developed using variables which were significant at p < 0.01. Variables which were significantly associated with pregnancy were summarized as odds ratios (OR) and 99% confidence intervals (CI); these ORs were adjusted for the effects of the other variables in the model. RESULTS: Pregnancy was more common in girls of color than in Caucasian girls (OR 99% and CI, 2.09, 1.06-4.11) and in older girls than in younger girls (1.52, 1.12-2.08). Among SA girls, weapon carrying in the past 30 days (4.06, 1.75-9.42) was significantly associated with pregnancy, whereas alcohol use in the past 30 days (0.37, 0.18-0.76) was less likely to be associated with pregnancy. The risk of pregnancy increased 1.75 times (1.26-2.43) for each additional sexual partner. Girls who had tried cocaine were 4.88 times (1.40-16.95) more likely to have been pregnant, and the risk of having been pregnant increased 1.43 times (1.14-1.80) for each additional year of SA. Past history of sexually transmitted disease (3.50, 1.28-9.55) was associated with increased pregnancy risk. CONCLUSIONS: Girls who had been pregnant also had engaged in other risk behaviors, including recent weapon carrying and cocaine use. A history of previous sexually transmitted diseases plus increasing numbers of partners add to the risk of pregnancy. Counseling and educational efforts should continue to identify teens at risk both to prevent pregnancy and to decrease associated risks.

Adolescent↗
PubMed1999

Exploring associations in developmental trends of adolescent substance use and risky sexual behavior in a high-risk population.

This study examined associations between the development of adolescent alcohol, cigarette, and marijuana use and risky sexual behavior, over time, using latent growth modeling methodology. Gender differences in the development and relationships between use of substances and risky sexual behavior were also examined. Participants were 257 adolescents (mean age = 15.96 years) assessed at three time points over an 18-month period. The intercepts of marijuana with cigarettes and alcohol, and all three substances with risky sexual behavior were significantly related. Development of the three substances showed similar patterns and development of cigarette use covaried with development of risky sexual behavior. There were no significant differences for boys and girls in these relationships. Results are discussed in relation to the need for greater understanding of nonsexual and sex-related problem behaviors and for analyses examining development and change in these behaviors during adolescence.

Adolescent↗
PubMed2001

A review of the effects of perceived drug use opportunity of self-reported urge.

Although persons addicted to drugs reliably report experiencing cravings or urges during drug cue exposure, less is known about factors that may moderate this effect. This article reviews cue exposure studies with people who smoke, are dependent on alcohol, or are addicted to cocaine or opiates. Perceived drug use opportunity is found to affect urge ratings. Specifically, people who are addicted to substances and who perceive an opportunity to consume their drug of choice report higher urges than do those who do not anticipate being able to use the drug. This factor was proposed to explain why those in treatment for substance dependence report urges that are about half the strength of those in nontreatment settings. The impact of perceived drug use opportunity on urge is considered from a variety of perspectives, including conditioning theories, a cognitive appraisal framework, and motivated reasoning theory. Conceptual and methodological implications of perceived drug use opportunity are addressed.

Clinical Trials as Topic↗
PubMed1996

Sexual abuse history and associated multiple risk behavior in adolescent runaways.

Relationships between sexual abuse and sexual risk, substance use, emotional distress, and conduct problems were examined among 190 runaways. Those who had been abused were significantly more likely than nonabused peers to engage in unprotected sex, have more sexual partners, and use alcohol and drugs, but did not differ in emotional distress. Those abused after age 13 were more often engaged in sex work than nonabused peers. Males abused before age 13 had more sexual partners than those not abused, and runaway males were significantly more likely to have been sexually abused than has been reported in prior research.

Adolescent↗
PubMed1999

Betel quid chewing and risk of adverse pregnancy outcomes among aborigines in southern Taiwan.

It is known that substance use is associated with increased risk of adverse pregnancy, outcomes. The aims of this study were to estimate the prevalence of alcohol, cigarette, betel quid and drug use during pregnancy and to assess the risk of adverse effects of betel quid chewing on pregnancy outcomes in aboriginal women in southern Taiwan. The study population included 62 women with adverse pregnancy outcomes and 124 age-matched women. Subjects were interviewed at their homes by trained interviewers using a structure questionnaire. Prevalences of various substance use in aborigines with adverse pregnancy outcomes were estimated as follows: alcohol, 43.6%; smoking, 14.5%; betel quid chewing, 43.6% and over-the-counter drug use, 8.1%; whereas in the comparison group it was alcohol, 38.7%; smoking, 8.1%; betel quid chewing, 28.2% and none used drugs. Univariate analysis revealed that adverse pregnancy outcomes were associated with maternal betel quid chewing, maternal illness during pregnancy, and the number of pregnancies (gravidity) experienced. After adjusting for maternal illness and number of previous pregnancies covariates, the prevalence of adverse pregnancy outcome was computed to be 2.8-fold higher among betel quid chewing women as compared to non-chewers (AOR=2.8, 95% CI=1.2-6.8). Among the aboriginal women, prenatal care is essential not only for routine care, but also to focus health education on the harmful effects of substance use, especially betel quid use during pregnancy.

Adult↗
PubMed1999

Brief intervention for alcohol use in pregnancy: a randomized trial.

AIMS: To assess the impact of a brief intervention on antepartum alcohol consumption. DESIGN: A randomized clinical trial. SETTING: The obstetrics practices of the Brigham and Women's Hospital in Boston, MA, USA. PARTICIPANTS: Two hundred and fifty eligible women initiating prenatal care. INTERVENTION: A comprehensive assessment of alcohol use (assessment only, AO) or the same comprehensive assessment with a brief intervention (BI). MEASUREMENT: Demographic background and obstetric history of subjects, current and lifetime use of alcohol and substances, composite Addiction Severity Index scores, and antepartum alcohol use. FINDINGS: Of the 250, 247 (99%) subjects provided information on their antepartum drinking. Both the AO and BI groups had reductions in antepartum alcohol consumption, but differences in reductions by group were not statistically significant (p > 0.05). Risk of antepartum drinking after either the AO or BI was increased nearly threefold if the subject had any prenatal alcohol consumption before assessment (p = 0.0001). For the 143 subjects who were abstinent pre-assessment, however, those who received the BI maintained higher rates of abstinence (86% versus 72%, p = 0.04). CONCLUSIONS: After a comprehensive assessment of alcohol use, subjects in both the AO and BI groups reduced their antepartum alcohol consumption. The importance of screening for prenatal alcohol use is underscored by the findings that any prenatal alcohol consumption increases the risk of continued antepartum drinking.

Adolescent↗
PubMed2001

[Neuropsychological follow-up of attention deficit/hyperactive disorder in adulthood before and after treatment with methylphenidate].

Attention-deficit/hyperactivity disorder (ADHD) in adulthood is frequently overlooked. Motor restlessness, impulsivity, low frustration tolerance, and conduct disorders are diagnostically ambiguous, but are predominantly ascribed to affective disorders, anxiety disorders, and personality disorders. Furthermore, substance-induced addiction may develop consecutively to untreated ADHD. We report on a case of primary diagnosis of ADHD in adulthood with secondary cocaine dependency, who was neuropsychologically assessed before and following treatment with methylphenidate. Frequency of errors and reaction time in performance on attention tests, concentration tasks, and multiple stimuli-/reaction tasks improved under treatment with methylphenidate. ADHD may be treated efficiently even after primary diagnosis in adulthood. Differential diagnosis of ADHD should be considered in disorders associated with motor hyperactivity, impulsivity, stress intolerance and conduct disorders.

Adult↗
PubMed1991

[Sex behavior and knowledge about AIDS among students].

604 out of 700 students (330 females, 274 males; mean age 23.3 [19-64] years) completed a questionnaire, which was handed out by their teachers and consisted of 26 questions concerning sexual practices and knowledge about AIDS. 285 subjects were studying natural sciences, 134 arts and 185 medicine. There were significant differences between the sexes (P less than 0.01) in drug use (alcohol, cannabis), use of condoms, promiscuity and with respect to discussion of AIDS. Fewer females than males said that they occasionally used intoxicants before sex (14% vs 25%). Women also used condoms less frequently than men (23% vs 44%), although more insisted on their use if their partner declined (68% vs 58%). 55% of the men and 72% of the women were living within a stable relationship. More women (70%) than men (56%) said they would discuss AIDS before having sex with a new partner. There were significant differences between students from individual disciplines (P less than 0.01) with regard to their knowledge, use of condoms, promiscuity, and discussion of AIDS: arts students were less well informed and changed sexual partners more frequently. The same was true of students more than 30 years old. There are important differences between students with regard to their knowledge about AIDS and sexual behaviour risk factors. Educational programmes need to take this fact into account.

Acquired Immunodeficiency Syndrome↗
PubMed2004

An introduction to Kundalini yoga meditation techniques that are specific for the treatment of psychiatric disorders.

The ancient system of Kundalini yoga includes a vast array of meditation techniques and many were discovered to be specific for treating the psychiatric disorders as we know them today. One such technique was found to be specific for treating obsessive-compulsive disorder (OCD), the fourth most common psychiatric disorder, and the tenth most disabling disorder worldwide. Two published clinical trials are described here for treating OCD using a specific Kundalini yoga protocol. This OCD protocol also includes techniques that are useful for a wide range of anxiety disorders, as well as a technique specific for learning to manage fear, one for tranquilizing an angry mind, one for meeting mental challenges, and one for turning negative thoughts into positive thoughts. Part of that protocol is included here and published in detail elsewhere. In addition, a number of other disorder-specific meditation techniques are included here to help bring these tools to the attention of the medical and scientific community. These techniques are specific for phobias, addictive and substance abuse disorders, major depressive disorders, dyslexia, grief, insomnia and other sleep disorders.

Depression↗
PubMed2000

Reproducibility of the University of Toronto self-administered questionnaire used to assess environmental sensitivity.

Environmental sensitivity patients report symptoms provoked by low-level exposure to a wide range of substances. Features of published case definitions include nature of onset, chronicity, symptom provocation by multiple substances, symptom provocation by an escalating number of exposures, involvement of multiple body systems including the nervous system, provocation by unrelated substances, and addictive behaviors. This study assessed the reproducibility of a Canadian self-administered questionnaire, the University of Toronto Health Survey, designed to determine the prevalence of the features described in these case definitions. A total of 191 eligible respondents aged 16-70 years who attended several types of medical practices in 1994 were invited to complete a second questionnaire 5-7 months after the first; 134 (70.2%) complied. Total agreement on whether patients satisfied each of seven case definitions ranged from 80% to 90%. After adjustment for chance, major agreement was observed for three of the seven case definitions (kappa = 0.69, 0.68, and 0.78). The survey achieved good reproducibility regarding self-report of symptoms described in published case definitions of environmental sensitivity.

Adolescent↗
PubMed1988

Pregnancy and AIDS.

Since the first cases of a new acquired immunodeficiency syndrome (AIDS) described by Oleske et al. and Rubinstein et al. in children in 1983, we have witnessed an ever-increasing number of such observations. As serology is not being performed on all pregnant women in many European countries, obstetricians must try to identify those belonging to risk groups: intravenous drug abusers, natives of affected regions or women having travelled to these areas, women having numerous sexual partners, presenting with other sexually transmitted diseases or living with infected individuals, prostitutes, transfused women. If the woman belongs to risk groups, HIV antibody testing is to be done at the beginning of pregnancy. The risks for the mother remain ill-defined, due in part to the difficulties inherent in keeping track of heroin abusers. Aggravation is certain if the mother is affected with AIDS or an associated syndrome called ARC (AIDS-related complex). It is debatable and at least rarer if the mother presents no clinical symptoms. Infant risks are becoming better known. The existence of materno-fetal contamination by transplacental route is undebatable. However, contamination during delivery or during the passage through the maternal genital tract cannot be excluded. The proportion of contaminated infants is approximately 40%. The disease in the infant is highly dangerous. According to these data, the procedure adopted by most obstetricians is the following: abortion is recommended at the first trimester of the pregnancy, a free choice is left open for the woman at the second trimester and at the third trimester delivery is carried out naturally. Caesarean sections are only done when there are obstetrical indications.(ABSTRACT TRUNCATED AT 250 WORDS)

Acquired Immunodeficiency Syndrome↗
PubMed1988

HIV and intravenous drug use.

There is now evidence from a wide variety of geographic areas that many intravenous drug users will change their behavior in order to reduce their risk of developing AIDS. There is even evidence from some areas that the behavior change has led to relative stabilization of seroprevalence rates, although longer-term studies will be needed to establish this definitively. AIDS behavior change in the area of sexual risk reduction appears to be much more difficult than change of drug injection behavior. Conceptual models of AIDS-related behavior change are needed, particularly models that can incorporate the injection of different drugs and variation in social and psychological characteristics among drug injectors. There is increasing evidence for a wider spectrum of HIV-related morbidity and mortality among intravenous drug users than is captured by the current surveillance definition for AIDS, again emphasizing the need for effective prevention programs.

Acquired Immunodeficiency Syndrome↗
PubMed1988

AIDS--legal issues.

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Acquired Immunodeficiency Syndrome↗