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PubMed2000

Dopamine D3 receptor agents as potential new medications for drug addiction.

All drugs abused by humans increase dopamine in the shell of nucleus accumbens, which implicate the neurons of this structure in their hedonic and reinforcing properties. Among the various dopamine receptor subtypes, the D(1) (D(1)R) and D(3) (D(3)R) receptors co-localise in accumbal shell neurons. Synergistic D(1)R/D(3)R interactions at this level were found on gene expression and during induction and expression of behavioral sensitisation to levodopa in rats bearing unilateral lesions of dopamine neurons. Behavioral sensitisation to abused drugs is a component of their long-term effects. Converging pharmacologic, human postmortem and genetic studies suggest the involvement of the D(3)R in reinforcing effects of drugs; D(3)R agonists reduced cocaine self-administration in rats, without disrupting the maintenance of self-administration. These data suggest the use of D(3)R agonists as partial substitutes to treat cocaine dependence, by affecting its reward component. However, substitution therapies maintain dependence and may be inefficient on drug craving and relapse, which are the unsolved and critical problems in the treatment of drug addiction. Recently, a highly selective and partial D(3)R agonist was shown to reduce cocaine-associated cue-controlled behaviour in rats, without having any primary intrinsic effects. As drug-associated cues maintain drug-seeking in animals and elicit craving and relapse in humans, such D(3)R agents have potential therapeutic applications.

Animals↗
PubMed1978

Maternal intrauterine amine alterations in the pregnant drug addict.

The pregnant drug addict has been a good study patient. Her neural hormonal value, as measured by urinary norepinephrine and epinephrine, is altered during pregnancy. The major difference between the antepartum state in the pregnant drug addict and that in the nonpregnant drug addict is hyperactivity of the adrenal gland. The intrauterine fetal homeostasis is altered by drug addiction in that the fetus is addicted, ted, as indicated by depressed amniotic fluid norepinephrine and epinephrine levels. If detoxification takes place, the fetus can respond in a dramatic fashion with increased levels of both norepinephrine and epinephrine. Detoxification is not recommended in the second and third trimesters of pregnancy because of the potential seriousness of these neural hormonal alterations.

Amniotic Fluid↗
PubMed1994

[The four stages of drug addiction (based on clinical experience with 5,000 drug addicts)].

A medical practitioner has been inquiring on the subject for eighteen years, and confronting the discrepancy between the facts observed and the social and psychiatric approach of the plague. His study of adolescent toxicomania was proceeding from the care of 1000 drug-fiends, plus a dialogue with 3000 schoolers and the interview of about one thousand drug-fiends on their way to recovery. Four stages have been made clear in the evolution of the disease. Stage 1--Contamination of 12 to 18 year-old-individuals, among whom 90% find a safe escape through mere self-defense (contamination from the cannabis "joint" in 95% of cases). Stage 2--Occasional users, one or two "joints", now and then, several times a month, for fun, out of submissiveness to a group or search for adventure or challenge. Stage 3--Regular use of one or several drugs entailing the spiral of dependency resulting in a distorted psyche, a disinterest in studies, marginality delinquency. Recovery is possible provided they give up the use of any drugs whatever thanks to firm ans understanding help from the family or and institution, avoiding any psychiatric response. Stage 4--Drud-fiends hooked to hard drugs such as cocaine, heroin, polytoxicomaniacs they have become the slaves of drugs, undergoing a severe physical and psychic decay, they feel lovely, consider drugs as they only friend, they have a suicidal behaviour. The immuno-deficiency caused by drug-use makes intercurrent diseases likely to strike. Recovery is still possible through drastic weaning treatment, even under constraint since they endanger their own lives, and a 12 to 18 months treatment of remotivation as well as training for social reinsertion. The therapeutic community, well organized and governed, is able to provide low cost solutions to a plague that too often comes to a deadlock. Although we can't say that first and second stage teenagers are real drug-fiends, on the contrary, third and fourth stage patients have necessary gone through stage 1 and 2. It can't be denied that they suffer from the same disease. Stage 1 and 2 teenagers and cured patients don't show the psychic decay and suicidal impulse of stage 3 and 4 patients. Such symptoms are the result of the use of drugs and not its cause. Consequently the role of the narcotic product is prevailing in the evolution of the disease.

Adolescent↗
PubMed1994

[HIV-positive drug addicts treated at the Copenhagen City Drug Dependency Clinic 1986-1992].

The Copenhagen City Drug Dependency Clinic at the former Rudolph Bergh's Hospital was established in 1986 as part of the measures taken by the municipality of Copenhagen to control the spread of HIV/AIDS among the intravenous drug addicts in the City of Copenhagen. The aim was to attract those HIV-positive drug addicts who were in no formal treatment for their drug addiction at other treatment centres and to retain them in treatment for a longer period acknowledging the fact that no causal cure exists for either the drug addiction or for AIDS. The goal of the treatment was to reduce HIV-risk behaviour i.e. sharing needles and syringes and unprotected sex with multiple partners and to reduce the adverse medical and social consequences of continued drug abuse. The treatment was supported by methadone treatment. During the five year period of 1986-92 a total of 196 HIV-positive drug addicts were referred to the clinic. A little more than half of those referred for the first through the third time and five out of six referred for the fourth time were admitted to treatment at the clinic. Half of the 126 first-time treated patients were retained in treatment for up to one year, while the rest were retained in treatment from one to five years. The mean time spent in treatment at the clinic was shorter for the relatively few patients who were admitted for the second time than for those admitted for the first time. At the end of the study 39 patients (20%) had died, most of them for non-AIDS related reasons.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMedDate not supplied

[Epidemiological evaluations of human immunodeficiency virus, herpes simplex virus type 1 and 2 and cytomegalovirus infections in drug addicts].

Eighty-eight drug addicts from the "BAN Center" in Torre Annunziata (Naples) and 88 normal subjects pair-matched for age and sex were tested for IgG to human immunodeficiency virus (HIV), herpes simplex virus (HSV) type 1 and 2 and cytomegalovirus (CMV). A high prevalence of subjects with antibodies to HSV-1 and CMV (80.7% and 65.9%) were recorded in the control group testifying to the high level of these infections in Campania. Prevalences were higher in drug addicts, and drug abuse was identified as a risk factor for the acquisition of CMV infection (odds ratio = 2.3). Moreover, drug addiction is also a risk factor for HSV-2 and HIV infection as demonstrated by the observation that drug abusers were anti-HSV-2 (9.1 vs. 1.1%, odds ratio = 6.16) or anti-HIV (11.4 vs. 0%, odds ratio = 23.6) positive more frequently than normal controls. Thus, drug addiction is a risk factor for the acquisition of HIV, HSV-2 and CMV infections. This is probably due to similar habits, frequent among drug addicts from our geographic area and uncommon in the normal population, such as tattooing, needle-sharing needlestick and unsafe sex. Some of these habits, such as unsafe sex and tattooing, seem to be, per se, risk factors for the acquisition of both HIV and CMV infections. The data also suggest that HIV infection was probably introduced in Campania more recently than in northern and central Italy where the prevalence of anti-HIV positive cases among drug addicts is definitely higher.

Acquired Immunodeficiency Syndrome↗
PubMed2000

Report on drug addiction. Reprinted from the Bulletin on the New York Academy of Medicine 1995; 31(8): 592-607. The New York Academy of Medicine Committee on Public Health Subcommittee on Drug Addiction. 1995.

Under date of January 14, 1955, there was presented to the Senate of the United States by Senator Frederick G. Payne, Republican, of Maine, a joint resolution "to provide for a more effective control of narcotic drugs, and for other purposes." Co-sponsoring the Resolution with Senator Payne were forty-two other Senators from all areas of the Nation and from all political parties, including Independent Senator Wayne Morse of Oregon. The Interdepartmental Committee consisting of representatives from the Department of State, Department of the Treasury, Department of Defense, Department of Health, Education and Welfare, and the Department of Justice requested the Committee on Public Health of The New York Academy of Medicine to study this bill and submit a report. By the time the Subcommittee on Drug Addiction of the Committee on Public Health had an opportunity to convene it was informed that the narcotics bill had not come out of committee. However, representatives of the Interdepartmental Committee requested that the Committee on Public Health consider the narcotics problem and propose measures for suitable legislation. Today a number of cities are raising a hue and cry of apprehension and alarm over drug addiction. Charges and claims about it appear in the headlines, coupled with demands for action of the usual kind: crackdown by the enforcement officials. Presently it is linked with the larger problem of juvenile delinquency as one of its most serious components. Before attempting to appraise the existing situation, it is helpful to look at the legal provisions and administrative bodies designed to control narcotic traffic and addiction.

History, 20th Century↗
PubMed2005

Family and environmental factors of drug addiction among young recruits.

Drug addiction in a family results from three factors: (1) effect of pathological families on young people's behavior, (2) easy access to drugs, and (3) influence of groups of people of the same age. In the present study, it was investigated to what extent individual factors related to family and environment affect the extent of drug addiction among recruits. The study included 559 subjects. The results proved direct interdependence between the family condition and the extent of narcomania. Drug addicts came mostly from incomplete and pathological families. The main family factors of drug addiction, according to the results obtained, are family atmosphere, strength of family ties, sense of family happiness, structure of authority in the family, and alcoholism. In families where there is warmth and love, children do not or rarely take drugs. Drug addicts come from families where there is ill will and hostility (p < 0.05). Drug addicts have weaker family ties than do those who do not take drugs (w2 = 0.26, p < 0.05). In families where there was contact with drugs, authority belonged to the mother to a greater degree (54.4%) than to the father (23.6%). In 46.3% of the studied drug addicts' families, alcohol was drunk. The results of the investigations approximate results of other studies conducted among young people in Poland and elsewhere in the world.

Adult↗
PubMedDate not supplied

[Neurobiological basis of drug addiction].

INTRODUCTION. Drugs of abuse cause addiction, characterized by compulsive and out of control drug use. Several neurochemical and molecular changes take place in the brain during the first phase of drug use which lead to dependence, addiction and drug abuse. DEVELOPMENT. Every drug of abuse acts through similar neurophysiological mechanisms, mostly based on the abnormal activation of the mesolimbic dopamine system. Although the addicted brain tries to adapted to the drug action, there are permanent neural changes at the cellular and molecular levels which seem to underlie the addictive process and the emergence of abstinence symptoms after drug taking stops. Furthermore, these neural changes appear to subserve the emergence of cravings once the abstinent syndrome has been overcome. Cravings are the main factor leading to relapse, and they are often initiated by exposure to drug related cues.

Brain↗
PubMed2006

Salt addiction: a different kind of drug addiction.

Under the headline "drug addiction" the medical world has exclusively been interested in psychoactive drugs. For diagnosis of substance dependence (addiction), DSM-IV-TR has determined seven criteria, and fulfilling at least three of them signifies addiction. When studied salt intake according to these criteria it is seen that most of them are fulfilled, showing that sodium chloride, which is not classified under the psychoactive drugs, is capable of producing addiction. Namely: at the beginning of salt abstinence, anorexia and slight nausea during meal time (withdrawal symptoms); about 1000-fold difference of per capita salt consumption between several human societies, and life-long continuation of discretional salt intake behaviour (high dose and very long duration of use); difficulty of restriction of salt intake (unsuccessful efforts to cut down or control); lack of success of salt restriction campaigns in hypertensive patients (substance use despite health problem). Additionally, the decrease of salt preferences of individuals whose salt intake are restricted for some time, and vice versa, signifies tolerance. On the other hand, it is evident that as the main culprit of developing systemic hypertension and as producing or promoting some other important health problems, salt intake causes millions of deaths in the world yearly. The recognition of addicting property of salt will facilitate combating these health problems.

Asthma↗
PubMed1992

[Buprenorphine abuse in a series of 50 drug addicts hospitalized at a Drug Dependence Evaluation hospital in Marseille].

Buprenorphine, a synthetic central analgesic, marketed since 1987, was rapidly suspected to be subject to abuse. We tried to confirm this abuse in the context of our analytical activity at the Drug Dependence Evaluation and Information Centre. The study was based on 50 drug addicts admitted to Marseille Hospital between June and October 1992. Buprenorphine and its N-dealkylated metabolite were identified in the urine by high performance liquid chromatography equipped with a diode array detector. Nine (18%) of the 50 samples analysed were positive for buprenorphine and/or norbuprenorphine, with a confidence interval of 8 to 28%, which confirms the existence of abuse of this analgesic.

Adult↗