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PubMed2003

Smoking status and substance abuse severity in a residential treatment sample.

Treatment seeking substance abusers were classified as current smokers or non-smokers to identify differences between groups on psychiatric and substance use severity variables. The Addiction Severity Index (fifth edition; ASI) was administered to 313 substance abusers seeking treatment in a private, residential addictions treatment program. Since current smokers were younger and less educated than non-smokers, these variables were entered as covariates in all analyses. As measured by the ASI, current smokers experienced a significantly greater number of days with drug problems in the last 30 days and were seen as being in significantly more need of drug treatment and alcohol treatment by ASI interviewers. These findings indicate that smoking status may be a marker for greater substance use severity, although the fact that participants were not randomly assigned to groups precludes making causal interpretations of these data. Areas of future research are suggested including examining the potential mediating role of third variables such as personality and temperament.

Adolescent↗
PubMedDate not supplied

[Addiction and personality].

Within the field of substance abuse, it is now widely admitted that the addictive personality does not exist. No one personality type is predisposed to addiction. The predisposition to drug dependence involves many different factors: psychological, social, familial, biological. None of these factors can be the sole determinant of drug dependence. Keeping that in mind, it is of interest to review the recent data on the relationship between personality traits or disorders and opiate and cocaine dependence. Using DSM and ICD categorical assessment, no single personality disorder emerged, instead a range of personality disorders has been evaluated in opiate and cocaine dependent subjects. Every type of personality disorders (PD) existed but cluster BPD were the most common (especially antisocial personality disorder in opiate addicts). However, it is noteworthy that a large minority to a majority of subjects did not display any king of PD. The implication of these results is that antisocial PD is probably over-diagnosed in drug dependence clinical settings. The studies reviewed failed to demonstrate that personality disorders were strong predictors of outcome in opiate or cocaine dependence. However, opiate dependent PD subjects entering treatment had more severe problems and lower retention rate than non PD subjects. But the amount of improvement was not significantly different between PD subjects and non PD subjects. This demonstrated that substance dependent PD patients could benefit from treatment whose intensity and duration must be adjusted. There is good support for the idea that Sensation Seeking trait is a vulnerability factor to substance abuse. But after dependence develops, sensation seeking is probably irrelevant to continued use of the drugs. This break between the psychopathology of vulnerability of substance abuse and the psychopathology of dependence raises the question of the existence of dramatically different factors involved in both phases of addiction.

Behavior, Addictive↗
PubMed2004

Effects of dopamine receptor D4 variation on alcohol and tobacco use and on novelty seeking: multivariate linkage and association analysis.

The dopamine D4 receptor gene contains a polymorphic sequence consisting of a variable number of 48-base-pair (bp) repeats, and there have been a number of reports that this polymorphism is associated with variation in novelty seeking or in substance abuse and addictive behaviors. In this study we have assessed the linkage and association of DRD4 genotype with novelty seeking, alcohol use, and smoking in a sample of 377 dizygotic twin pairs and 15 single twins recruited from the Australian Twin Registry (ATR). We found no evidence of linkage or association of the DRD4 locus with any of the phenotypes. We made use of repeated measures for some phenotypes to increase power by multivariate genetic analysis, but allelic effects were still non-significant. Specifically, it has been suggested that the DRD4 7-repeat allele is associated with increased novelty seeking in males but we found no evidence for this, despite considerable power to do so. We conclude that DRD4 variation does not have an effect on use of alcohol and the problems that arise from it, on smoking, or on novelty seeking behavior.

Australia↗
PubMed2006

Increased local and decreased remote functional connectivity at EEG alpha and beta frequency bands in opioid-dependent patients.

RATIONALE: Although researchers now have a working knowledge of key brain structures involved in realization of actions of substance abuse and addiction, deeper understanding will require examination of network interactions between cortical neuronal assemblies and their subcortical tails in the effects of opioid dependence. OBJECTIVES: Given that repeated exposure to opiates initiates a widespread reorganization of cortical regions, we predict that opioid dependence would result in a considerable reorganization of local and remote functional connectivity in the neocortex. METHODS: We applied the novel operational architectonics approach that enables us to estimate two local and remote functional cortex connectivities by means of electroencephalogram structural synchrony measure. RESULTS: In 22 opioid-dependent patients, we found the evidence that brain functional connectivity was indeed disrupted by chronic opioid abuse (i.e., the local functional connectivity increased and remote functional connectivity decreased in opioid abusers). This significant difference between "opioid" and "control" populations was the same for alpha and beta frequency bands. Additionally, significant negative relations between duration (years) of daily opioid abuse and the number/strength of functional connections in the posterior section of the cortex were found.

Adult↗
PubMed1989

Typology and correlates of smokeless tobacco use.

The incidence, use patterns, and correlates of smokeless tobacco have become increasingly important as usage rates rise and harmful health effects become established. The present study assessed the incidence of smokeless tobacco use in a Southeastern U.S. sample and selected correlates of use. From the responses of 3725 high school students, 19.9% reported trying smokeless tobacco products (35.5% for males, 5.8% for females). Most agreed that tobacco use has harmful health consequences. Those disagreeing with these health beliefs were more likely to use smokeless tobacco. Cigarette smoking was strongly associated with initial use. Of those reporting any use of smokeless tobacco, most used it for less than an hour per day, but 18% reported 3 or more hours of use per day. Forty-four percent reported a first use of smokeless tobacco before 13 years of age. Early initial use was associated with greater frequency and duration of use. Early initial users also reported greater influence from family and advertisements. Encouragement from friends, however, appeared to be the major factor regardless of age at initial use. Of particular concern is that 8.4% of those having any experience with smokeless tobacco felt they were addicted to the substance. Finally, 27.9% reported swallowing the substance or spittle, suggesting the need for further research on the potential health implications of this behavior.

Adolescent↗
PubMed2005

Psychological differences between binge and chronic methamphetamine using gay and bisexual men.

Methamphetamine use among gay and bisexual men in New York City continues to pervade the psychological and physical well being of those who engage in its use. While the behavioral and contextual factors associated with methamphetamine use have been examined, there is a paucity of literature examining the psychological and psychosocial correlates associated with varying levels of addiction to the substance. We assessed these correlates among 49 methamphetamine-using gay and bisexual men in New York City. Findings suggest that "Chronic" users report higher levels of avoidant coping and are more likely to use methamphetamine to avoid unpleasant emotions, to avoid physical pain, and to engage in pleasant times with others than those who are "Binge" users. While previous research demonstrates the value of treatment approaches that consider the synergy of mental health, drug use, and sexual-risk taking, our findings suggest the importance of identifying the frequency and current progression of methamphetamine use when addressing the psychological meanings it has for the individual user.

Adult↗
PubMedDate not supplied

Alcohol in the older population, Part 2: MAST you speak the truth in an AUDIT or are you too CAGE-y?

The concept of the "older population" is changing as increasing numbers of baby boomers begin to age, bringing more and more clients to the attention of case managers. Alcohol use and abuse can mimic symptoms of illness and have negative consequences for the older population across physical, social, and psychological parameters. It is therefore necessary in good case management to consider the impact of substance abuse and addiction in the older and geriatric populations. The unique nature of this problem gives us much to consider, and a systematic approach can promote a timely resolution.

Aged↗
PubMed2005

Caffeine and amphetamine produce cross-sensitization to nicotine-induced locomotor activity in mice.

Sensitization development is linked to the addictive potential of the drugs. The same mechanisms might play a role in sensitization development to the different addictive drugs. The aim of the study was to investigate the development of cross-sensitization to caffeine and amphetamine in nicotine-induced locomotor sensitization in mice. Caffeine (2.5-20 mg/kg), amphetamine (1-16 mg/kg) or saline were injected to Swiss-Webster mice and locomotor activity was recorded for 30 min. Nicotine (0.5-2 mg/kg) or saline were injected to mice and locomotor activity was recorded for 30 min. Process was applied for 19 days, every other day (10 sessions). Caffeine (5 mg/kg), amphetamine (4 mg/kg) or saline were challenged to the different groups of nicotine-sensitized mice 2 days later on the last nicotine injection, and locomotor activity was recorded. Repetitive injections of nicotine (0.5-2 mg) produced locomotor sensitization in mice. After caffeine and amphetamine challenge injections, locomotor activity of the nicotine-sensitized mice was found to be significantly higher than saline-pretreated mice. Saline challenge did not produce any significant effect in nicotine- or saline-pretreated mice. Our results suggest that a cross-sensitization developed to both caffeine and amphetamine in nicotine-sensitized mice. In conclusion, similar central mechanisms may be responsible for the development of addiction to these substances.

Amphetamine↗
PubMed2001

Oral cocaine produces dose-related hepatotoxicity in male mice.

Cocaine remains a widely abused substance. While most addicts take cocaine intranasally, a considerable number abuse cocaine by mouth. It has been assumed that after oral exposure cocaine is hydrolyzed in the stomach rendering it ineffective. This study investigated the effect of orally administered cocaine on liver function and integrity as well as its effect on liver and blood antioxidative enzymes. Male CF-1 mice were orally administered either 0, 5, 10 or 20 mg cocaine/kg body weight and sacrificed 24 h after the last treatment. Serum alanine aminotransferase (ALT) and aspartate aminotransferase (AST) were measured as markers of liver injury. Blood and liver glutathione (GSH) levels were determined as well as the activities of glutathione peroxidase (GPx) and catalase (CAT). In addition, the activity of liver glutathione reductase (GRx) was also measured. The results demonstrated that oral cocaine caused hepatotoxicity in a dose dependent manner. Serum ALT and AST were elevated while blood GSH concentration decreased in all cocaine treated animals. In addition, there was a significant dose dependent decrease in the activities of GPx and CAT in blood and liver of cocaine treated animals. However, hepatic GSH content and GRx activity manifested a significant increase, particularly in the group, which received 20 mg/kg cocaine. This study is the first to demonstrate that cocaine-induced hepatotoxicity results following the oral route of administration.

Administration, Oral↗
PubMed1998

Biology of addiction.

It is unknown why an individual becomes addicted to drugs. Substance abuse is typified by a wide variety of use patterns and variation in individual responses. Behavioral psychology teaches that if something either increases the individual's sense of pleasure or decreases his or her discomfort, then the individual is likely to repeat the behavior. Evidence has suggested that abusers report a sense of pleasure when they use substances because of the ability of the substance to stimulate the release of neurotransmitters known to be used by the brain's pleasure system. This article provides an overview of the substance-related disorders, including their definition in the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV).

Adolescent↗
PubMed2004

Factor analysis of barriers to treatment for problem gambling.

Attitudes toward problem gambling treatment were investigated in a telephone survey of 1,203 persons in Central Queensland Australia (598 women and 605 men, mean age = 45.8 years). Survey items were compiled from existing substance abuse questionnaires (Center on Alcoholism, Substance Abuse and Addictions, 1995; Sobell et al., 1991). An exploratory factor analysis identified five potential barriers to treatment, including: availability, stigma, cost, uncertainty, and avoidance. Relative to those with few problems, respondents who had numerous gambling problems were more concerned about treatment costs, and the availability and effectiveness of treatment. In addition to the above concerns, older persons more often negatively judged the treatment seeker. In contrast, educated respondents had generally more positive attitudes towards problem gamblers and treatment seeking.

Australia↗
PubMed2005

Dopamine receptor DRD2 genotype and smoking cessation outcome following treatment with bupropion SR.

The A1 allele of the dopamine D2 receptor gene (DRD2) is associated with a reduced number of dopamine binding sites in the brain and with the increased likelihood of substance abuse and addictive behavior. In a study of smokers enrolled in an open-label, randomized effectiveness trial, we investigated whether variants in the DRD2 receptor gene are associated with smoking cessation outcomes following treatment with a combination of bupropion SR and behavioral counseling. Adherence to treatment and point-prevalent smoking status were assessed at 3 and 12 months, respectively, following a target quit date. Compared to women who carry both A2 alleles, women with at least one A1 allele were more likely to report having stopped taking bupropion due to medication side effects (odds ratio (OR)=1.91, 95% confidence interval (CI)=1.01-3.60; P<0.04) and at 12 months were somewhat more likely to report smoking (OR=0.76, 95% CI=0.56-1.03; P<0.076). Significant associations or trends were not observed in men. In women, individual variability in responsiveness to bupropion-based treatment may be partially due to differences in genetic variants influencing dopamine receptor function.

Adult↗
PubMed2000

Alienation from self and others: the psychosocial problem of rural alcoholic women.

The purpose of this study was to describe women's perspectives in becoming and being alcohol dependent. Using grounded theory techniques, 14 adult Black and White women receiving treatment for alcohol addiction at rural substance abuse centers participated in an intensive interview. Data analysis focused on the identification of the basic psychosocial problem and the process of becoming alcohol dependent. The results are presented in 2 parts. Part 1, "Alienation From Self and Others," focuses on the basic psychosocial problem faced by women in becoming alcohol dependent. Part 2, "Running Away to Nowhere," on page 142 of this issue of Archives, describes the process used by women to resolve this problem.

Adult↗
PubMed1997

[Psychological, psychotherapeutic and other non-pharmacologic forms of therapy in treatment of insomnia. Position of the "Insomnia" Study Group of the German Society of Sleep Research and Sleep Medicine].

Psychological and psychotherapeutic techniques are an essential part of the treatment of insomnia. Mainly two facts stress the importance of psychological/psychotherapeutical strategies for insomnia: (1) Concepts for non-drug treatment aim at improvement of the symptoms and the underlying cause of the disease and (2) disadvantages of hypnotic therapy such as substance abuse or addiction are avoided. Effective treatment techniques such as patients education and counseling, sleep hygiene, stimulus control and relaxation techniques should be known to every therapist, especially general practitioners who treat the majority of patients haring difficulties in initiating or maintaining sleep. Several other effective behavioural techniques, e.g. sleep restriction, or cognitive therapy, and psychotherapy should be used only by skilled and trained experts. Insomniacs with chronic and severe complaints should be treated by therapists with experience in sleep medicine. Multimodal treatment strategies are provided for by sleep disorder centres and combine effective treatment elements in structured therapeutic concepts. There is absolute consensus of opinion that every hypnotic treatment of an insomniac patient should be combined with basal elements of non-drug treatment strategies.

Behavior Therapy↗
PubMed2000

HIV-1 infected women and prenatal care utilization: barriers and facilitators.

In an effort to understand issues affecting prenatal care access and utilization from the perspectives of human immunodeficiency virus (HIV)-infected women who receive inadequate prenatal care, we conducted three in-depth qualitative and quantitative interviews. From a thematic analysis of the narrative interviews, four broad areas emerged as pertinent to these women's prenatal care experiences. These were issues related to pregnancy, HIV, psychosocial conditions, and the health care system. For these women, the barriers to prenatal care utilization included the unexpected and unplanned nature of the pregnancy and mental health issues related to HIV infection. Poverty, periodic homelessness, addiction to illicit substances, and lack of social support were also important barriers. Furthermore, perceptions of the health care system as threatening, including fears related to consequences of disclosing illicit activities, discrimination, and breach of confidentiality emerged as salient barriers. Facilitating factors included the pregnancy being experienced as a life-transforming event, concern for their children, especially preventing HIV-1 vertical transmission, availability of treatment, and support from health care professionals. Prominent throughout the interviews were the women's mental health concerns and need for professional support.

Adult↗
PubMed2002

Hospice care for the incarcerated in the United States: an introduction.

Prison populations throughout the Unites States are growing; the 1990s saw an average 6.5% per year increase. Average inmate age is increasing, as are both the number and rate of inmate deaths. Aging inmates experience health concerns typical of the general, free, aging population. Inmates have higher incidence of health complications associated with various circumstances, risk behaviors, and associated medical conditions. These circumstances include prison violence, incarceration-related constraints on exercise, and diet. Inmates are more likely to have a history of alcohol abuse, substance abuse or addiction and sex industry work. Risk-behavior conditions include human immunodeficiency virus/acquired immune deficiency syndrome (HIV/AIDS), hepatitis B and C, liver disease, tuberculosis, endocarditis, and cardiomyopathy. Hospice is increasingly the preferred response to the health and care needs of terminally ill inmates. Implementing hospice behind bars has some unique challenges in addition to those inherent in hospice work. This series will provide an in-depth look at four hospice programs for inmates in the United States.

Age Factors↗
PubMed2005

Inhalants: not to be taken lightly anymore.

PURPOSE OF REVIEW: Until recently, inhalant abuse and dependence have been overlooked as serious problems, perhaps because of their relatively low prevalence. The purpose of this review is to summarize recent advances in our understanding of the consequences, pharmacology, and etiology of inhalant use, and how we might develop preventive and management strategies to combat abuse and dependence on these drugs. RECENT FINDINGS: Animal models have cast light on how reinforcement of inhalant use occurs, and on mechanisms of development of tolerance and dependence. The reinforcing effects occur principally through GABA and dopamine-mediated mechanisms (rather than NMDA-mediated mechanisms). Assays for inhalants provide greater opportunities for accurate diagnosis. In addition to known medical consequences of inhalant use (including death), other risks associated with inhalant use and addiction include addiction to other substances, major depression, suicide, and impaired learning and memory. SUMMARY: The extensive medical, psychiatric, and psychological damage that can be caused by inhalant use argues for much greater attention to be paid to developing prevention and treatment programmes for inhalant abuse and dependence. These are currently nonexistent, but are badly needed.

Journal Article↗
PubMed2006

The dopamine transporter proteome.

Dopamine (DA) uptake through the neuronal plasma membrane DA transporter (DAT) is essential for the maintenance of normal DA homeostasis in the brain. The DAT-mediated re-uptake system limits not only the intensity but also the duration of DA actions at presynaptic and postsynaptic receptors. This protein is the primary target for cocaine and amphetamine, both highly addictive and major substances of abuse worldwide. DAT is also the molecular target for therapeutic agents used in the treatment of mental disorders, such as attention deficit hyperactivity disorder and depression. Given the role played by the DAT in regulation of DA neurotransmission and its contribution to the abuse potential of psychostimulants, it becomes not only important but also necessary to understand the functional regulation of this protein. To investigate the cellular and molecular mechanisms associated with DAT function and regulation, our laboratory and others have embarked on a systematic search for DAT protein-protein interactions. Recently, a growing number of proteins have been shown to interact with DAT. These novel interactions might be important in the assembly, targeting, trafficking and/or regulation of transporter function. In this review, I summarize the main findings obtained from the characterization of DAT-interacting proteins and discuss the functional implications of these novel interactions. Based on these new data, I propose to use the term DAT proteome to explain how interacting proteins regulate DAT function. These novel interactions might help define new mechanisms associated with the function of the transporter.

Animals↗