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PubMed2006

On the effects of psychostimulants, antidepressants, and the antiparkinsonian drug levodopa on dopamine neurons.

The dopaminergic system constitutes the principal target of many psychostimulants, antidepressant, and antiparkinsonian drugs. The effects caused by these compounds are partly associated with an increased dopamine (DA) levels within the terminal areas of DA neurons and in the ventral midbrain. Therefore, several substances of abuse, antidepressants, and endogenous compounds (levodopa and trace amines [TAs]) regulate the activity of DA cells by activating D2 autoreceptors located on the terminals, soma, and dendrites. Considering our past and recent experimental studies on this issue, here we will briefly reexamine the mechanisms of action of several psychoactive drugs on DA neurons. In particular, we propose three different modalities by which the mesencephalic DA neurons can be regulated by drugs: amphetamine/TAs-like, cocaine-like, and levodopa-like. We, therefore, discuss the potential therapeutic and addictive properties of the psychoactive substances.

Amphetamine↗
PubMed2004

Inability to access addiction treatment and risk of HIV infection among injection drug users.

It was recently found that 94% of the nearly $500 million allocated annually to Canada's illicit drug strategy has been spent on enforcement-based interventions. As a result, lack of funds for addiction treatment has meant demand for substance abuse treatment among illicit drug users has exceeded availability. This study evaluated whether injection drug users (IDUs) who reported being unable to access addiction treatment were at elevated risk of HIV infection. A prospective analysis was done of factors associated with syringe borrowing by baseline HIV-negative IDUs among participants enrolled in the Vancouver Injecting Drug Users Study (VIDUS). Since serial measures for each individual were available, variables potentially associated with syringe borrowing were evaluated using generalized estimating equations (GEEs) with logit link for binary outcomes. Overall, 1157 HIV-negative IDUs were enrolled into the VIDUS cohort between May 1996 and May 2002. Unsuccessful attempts to access addiction treatment were associated with reporting syringe borrowing during follow-up in both univariate (odds ratio 1.72; 95% CI 1.47-2.00; P<0.001) and in multivariate GEE analyses (adjusted odds ratio 1.29; 95% CI 1.09-1.53; P=0.003). Inability to access addiction treatment was independently associated with syringe borrowing among HIV-negative IDUs at risk for HIV infection. These findings suggest that the limited provision of addiction treatment may result in a major missed opportunity to reduce HIV transmission behavior among IDUs and that the expansion of addiction treatment services has major potential to reduce the substantial human and fiscal costs of HIV infection.

British Columbia↗
PubMed1999

Addiction careers and careers in addiction.

Research into resocialization of criminals or into recovery from substance dependence has stressed the need to give up the deviant identity and lifestyle. However, addiction careers, crime, and other types of deviant behavior require a wide range of skills. Such competence may facilitate the alternative or simultaneous pursuit of "respectable" careers in treatment, prevention, research, or policy matters. Former alcoholics fill important positions in the service structures of Alcoholics Anonymous, current or former users are appreciated as partners in AIDS prevention programs, and drug addicts can become privileged-access interviewers and be recruited by research institutes. The paper discusses "market conditions" that favor or impede career shifts. How society and professionals perceive individuals with a history of stigma varies from complete rejection to admiration or recognition of usefulness. This assessment depends on such factors as degree of political and scientific interest in controlling, changing, and detecting hidden deviant populations, as well as public fascination with "authentic" deviants, combined with increasing scepticism about conventional expert knowledge.

Career Choice↗
PubMed1990

Neuropsychodynamics of alcoholism and addiction: personality, psychopathology, and cognitive style.

The literature on the neuropsychology, personality, and psychopathology of alcoholism and addiction is reviewed. Neuropsychological studies of substance abusers have found deficits in abstract concept formation, set-maintenance, set-shifting, behavioral control, and cognitive flexibility. However, the evidence that these deficits are the result of direct substance effects on the brain is slim. Both alcoholics and as-yet nondrinking offspring of alcoholics have been found to be deficient in verbal skills and language functioning. Personality studies of alcoholics and addicts have emphasized such characteristics as field dependency, external locus of control, attenuated time extension, poor ego strength, and disturbed object relations. The psychopathology of alcoholics and opiate abusers seems to be dominated by impulsive character disorder, although there may also be a subgroup of anxious, depressed substance abusers. The present review integrates brain-behavioral perspectives with the data on personality and psychopathology, focusing on the relevance of a multidimensional neuropsychological model to psychodynamic concepts of ego functioning and the substance abusers' problems in the regulation of affect and behavior. It is argued that the concept of cognitive style is useful for understanding the relationship of neuropsychological functioning to personality dynamics, and that this approach can be especially productive in understanding the addictions.

Alcohol Drinking↗
PubMed1997

[Management of drug addict pregnant women and their children].

Children of substance abuse mothers have an increased risk of severe pathological disorders such as perinatal diseases (prematurity, intrauterine growth retardation, infections) with their neurological and respiratory complications and sequelae, and transmission of drug addiction related infections, ie human immunodeficiency virus, hepatitis B and C virus, syphilis. Many of these children present a drug withdrawal syndrome characterized by restlessness and jetteriness during the neonatal period. This is frequently followed by a post withdrawal period of several weeks duration with crying, excitement, sleep and feeding difficulties. Although these drug withdrawal manifestations have no incidence on the vital prognosis, it severely impairs the mother-infant interaction. Despite these disorders it appears that the outcome of these children is mainly related to their familial environment which is exposed to many risk factors: mother-child separation, violence, delinquency, precariousness, unhealthy housing, prostitution, drug dependency, parental death or imprisonment... Early medico-psycho-social intervention starting during pregnancy and a prolonged support for several years are the only way to improve their spontaneously poor outcome.

Female↗
PubMed2000

Psychiatric symptoms among clients seeking treatment for drug dependence. Intake data from the National Treatment Outcome Research Study.

BACKGROUND: Many people with substance use disorders are vulnerable to other psychiatric disorders and present to addiction treatment services with comorbid psychiatric symptoms. AIMS: To describe the prevalence of recent psychiatric treatment and current psychiatric symptoms and explore links between substance misuse, personal/social functioning and symptom severity. METHOD: Subjects were 1075 adults recruited to the National Treatment Outcome Research Study (NTORS), of whom 90% were opiate-dependent. Psychiatric symptoms at intake were recorded using sub-scales from the Brief Symptom Inventory. RESULTS: Recent psychiatric treatment was reported by one in five subjects. Psychiatric symptom levels were high and females had elevated scores on all scales. Symptoms were elevated among opiate users who were also frequent users of benzodiazepines, alcohol and, in particular, stimulants. Gender, physical health, drug dependence and personal relationship problems were more powerful predictors of psychiatric symptoms than substance use. CONCLUSIONS: Addictions service providers should be vigilant to psychiatric problems among their clients at intake to treatment. Psychiatric symptoms are more closely linked to polydrug use than to opiate use in this population.

Adolescent↗
PubMed2005

Authority for practitioners to dispense or prescribe approved narcotic controlled substances for maintenance or detoxification treatment. Final rule.

DEA is amending its regulations to allow qualified practitioners not otherwise registered as a narcotic treatment program to dispense and prescribe to narcotic dependent persons Schedule III, IV, and V narcotic controlled drugs approved by the Food and Drug Administration specifically for use in maintenance or detoxification treatment. This Final Rule is in response to amendments to the Controlled Substances Act by the Drug Addiction Treatment Act of 2000 (DATA) that are designed to expand and improve treatment of narcotic addiction. This Final Rule is intended to accomplish the goals of DATA while preventing the diversion of Schedule III, IV, and V narcotic controlled drugs approved by the Food and Drug Administration specifically for maintenance / detoxification treatment.

Certification↗
PubMed1965

DRUG ADDICTION.

Explore the source record for details and available documents.

Government↗
PubMed2004

Comparison of pretreatment characteristics and treatment outcomes for alcohol-, cocaine-, and multisubstance-dependent patients.

We investigated whether pretreatment characteristics and measures of outcome differed for alcohol-, cocaine-, and multisubstance-dependent patients receiving outpatient substance abuse treatment. One hundred and forty substance dependent individuals (32 alcohol, 76 cocaine, and 32 multisubstance) enrolled in a 12-week outpatient treatment program were compared across measures of addiction severity, personality, and treatment-readiness at admission. In-treatment, end-of-treatment and 9-month follow-up assessments of treatment outcome were then compared across the three groups. Outcome measures included reduction in problem severity, abstinence, retention, number of sessions attended, dropout, and counselor and patient ratings of treatment benefit. At admission, the multisubstance group had a higher proportion of positive urines, reported more severe drug, alcohol and psychiatric problems, and displayed higher impulsivity and anxiety scores than one or both of the other groups. However, multisubstance patients were more treatment ready in terms of adopting a total abstinence orientation than alcohol or cocaine patients. While a significant reduction in symptoms occurred for the total sample during treatment as well as at follow-up, comparisons of outcomes did not consistently favor any particular group. The three groups had equivalent improvements in eleven of fourteen during-treatment and five of seven follow-up measures. Despite pretreatment differences, in severity and treatment-readiness, outcomes were more similar than different for alcohol-, cocaine-, and multisubstance-dependent patients. Clinicians should be cautious about forecasting treatment-outcomes for addicted patients based on their primary substances of abuse.

Alcoholism↗
PubMedDate not supplied

What is the addicts' grapevine when there's 'bad dope'? An investigation in New Jersey.

After a rash of fatal overdoses among drug users that was attributed to the synthetic narcotic analgesic fentanyl, the New Jersey Department of Health conducted street interviews with 160 injection drug users in an attempt to identify the channels through which this population had heard about the outbreak and to gauge drug addicts' responses to the incident. The results of the investigation suggest that the drug users learn about such severe threats to health from a variety of sources. The frequency with which some of these sources are reported differs significantly according to the sex of the drug user and, even when sex is controlled, the frequency may vary substantially from city to city in a relatively limited geographic area. Although television was, for this population, a more important source of information about the outbreak than was any other formal means of communication, drug users did not regard TV as a reliable source of good information about "bad dope." Moreover, it does not appear that broadcasts of public warning messages about such substances are a guarantee that addicts will not search for the drug. The data reported in this study point up a need for health officials' greater understanding of the channels through which drug users receive information on threats to their health. The study also provides an understanding of how public health messages are perceived and processed by needle users. The final lesson is the need for close collaboration among drug enforcement personnel, testing laboratories, and health officials in the various affected locales to clarify the public health message.

Adult↗
PubMed2005

The relationship between physical maltreatment and substance use among adolescents: a survey of 95,788 adolescents in Hong Kong.

PURPOSE: To determine the prevalence of corporal punishment and the infliction of injuries from a beating occurring without provocation in the previous 6 months among secondary school children in Hong Kong, and to examine the associations between these two forms of physical maltreatment with substance-use-related behaviors and attitudes. METHODS: Using secondary data, a cross-sectional, self-administered, anonymous survey of 95,788 secondary school students was conducted in Hong Kong. RESULTS: The prevalence of physical maltreatment showed statistically significant associations with younger age, attendance in Chinese-speaking day schools, temporary housing, residence with only one parent, poorer parental relationship, greater peer influence, perceptions of excessive academic pressure, and feelings of being blamed for poor academic performance. Adolescents who had experienced corporal punishment were more likely to be current users of alcohol (OR = 1.11), tobacco (OR = 1.31), psychoactive substances (OR = 1.60), or heroin (OR = 1.90). Those who had been beaten to injury by a family member without provocation within the past 6 months also were more likely to be current users of alcohol (OR = 1.35), tobacco (OR = 1.65), psychoactive substances (OR = 2.39), and heroin (OR = 3.07). Additionally, students who experienced physical maltreatment were more likely to be acquainted with habitual substance users, have better access to psychoactive substances, to have engaged in sex after abusing drugs, have obtained money from illegal sources to purchase drugs, and believe that psychoactive substances are not harmful or addictive. CONCLUSIONS: Physical maltreatment showed strong associations with drug-related behaviors and attitudes, after adjusting for potential confounders. Further longitudinal studies are required to understand the causal direction of the relationship.

Adolescent↗
PubMed1997

Sensation Seeking Scales and consumer satisfaction with a substance abuse treatment program.

Satisfaction of 119 addicts with an addiction treatment program was measured by an 11 item satisfaction scale. The scale's internal consistency was acceptable (Cronbach's alpha = .75). The total satisfaction score was weakly but significantly correlated with Zuckerman's Sensation Seeking scales: Those with higher scores on the Boredom Susceptibility scale (i.e., those easily bored) reported less satisfaction, whereas those with higher scores on Thrill and Adventure Seeking scale (i.e., risk, adventure, and thrill seekers) reported higher levels of treatment satisfaction. Older patients were more satisfied with the feedback they received from their psychological tests and also with staff's respect for their rights.

Adolescent↗
PubMed2001

Correlates of employment: a cohort study.

Employment is often viewed as a potent indicator of substance abuse treatment outcome. This study was conducted to determine if personality and/or demographic characteristics of a cohort of unemployed substance dependent persons presenting for addiction treatment might predict employment 9 months postadmission. By using stepwise discriminant function analysis, seven variables predictive of employment were identified. The positive value of employment was clearly documented. Those who gained employment were functioning better with regard to social and drug-use parameters than those who did not.

Adult↗