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PubMed1967

Rehabilitation and the narcotic addict: results of a comparative methadone withdrawal program.

The purpose of this retrospective study was to compare (1) regular methadone withdrawal treatment and (2) prolonged methadone withdrawal treatment in 105 and 71 voluntary patients respectively, who attended the Narcotic Addiction Foundation (N.A.F.) between 1959 and mid-1964. Treatment consisted of individual counselling and medical care for all, and only residential care and psychiatric assessment for selected cases. The number of treatment sessions and the details of drug therapy are described.One hundred and fifty-three of 176 patients (87%) were interviewed approximately one to five years after the first clinic contact. Forty-three per cent showed some overall improvement in their behaviour. Rehabilitation was defined as change in a specific area-drug use, work, criminal behaviour, community associations, friendship patterns and family relationships-rather than in terms of abstention from drugs only. Age affected comparative results.

Adolescent↗
PubMed1984

[Aortic baroreceptor function in narcotized rabbits during alpha-adrenoceptor blockade with prazosin].

Since alpha-adrenoceptor blockade alters the mechanical vessel wall properties, the arterial baroreceptor function is to be changed also by this type of blockade. In 13 rabbits narcotized with chloralose and urethan, therefore, the aortic baroreceptor function was tested together with the baroreceptor heart reflex prior to and after intravenous administration of prazosin (0.005, 0.01, 0.05 mg per kg BW). By inflation and respective deflation of a balloon catheter lying with its tip in the thoracal aorta the arterial blood pressure level ahead was changed over a range as much as 30 to 50 mm Hg. The arterial blood pressure in the aortic arch, the heart rate and the electroneurogram from the peripheral stump of the left aortic nerve were registered. Intravenous administration of prazosin slowed down the arterial blood pressure in a dose related manner, and the heart rate remained similar. After having applied any doses of prazosin the baroreceptor heart reflex was completely abolished. The baroreceptor sensitivity was remarkably increased by prazosin. The characteristic curve describing the baroreceptor function was shifted to the left and was steeper. It was concluded that the baroreceptor heart reflex is directly blocked by the action of prazosin against the transmission in the parasympathetic pathway, and, mediated by the influence of prazosin on the vessel wall properties, the arterial baroreceptor becomes more sensitive.

Animals↗
PubMedDate not supplied

[Effect of psychotropic substances and narcotic analgesics on 14C-noradrenaline uptake by rat cerebral cortex synaptosomes].

The effect of different groups of neurotropic substances was studied on labeled noradrenaline and gamma-aminobutyric acid (GABA) uptake by synaptosomes of the rat brain cortex. It has been shown that each group of the test compounds is characterized by specific qualitative and quantitative features of the action on the above processes. Thus, psychostimulants actively inhibit noradrenaline uptake without changing GABA uptake. On the contrary, neuroleptics exert a pronounced inhibitory effect on GABA uptake and insignificantly inhibit noradrenaline accumulation. Antidepressants are very potent while narcotic analgesic drugs are less potent inhibitors of the accumulation of both neuromediators. Morphine and nalorphine have no effect on these processes.

Analgesics, Opioid↗
PubMed1981

Inhibition of ganglionic transmission by narcotic analgesics; an effect antagonized by naloxone, nalorphine and calcium.

Methadone, azidomorphine, oxycodone and fentanyl inhibit synaptic transmission in isolated sympathetic ganglia of the frog and rat, just as did morphine and pethidine in our previous investigations. This inhibitory effect can be antagonized not only by naloxone and nalorphine but also by increasing calcium concentration of the perfusion fluid of the ganglia. The inhibitory effect on transmission of narcotic analgesics takes place on specific opiate receptors of the peripheral ganglia.

Analgesics, Opioid↗
PubMedDate not supplied

[Effect of narcotic analgesics of nociceptive transmission in the spinal cord].

The action of morphine, promedol, fentanyl and pentazocin on nociceptive transmission in the spinal cord was studied in unanesthetized spinal rats with the use of intraarterial injection of bradykinin. When used in the same doses, the opiates also reduced the firing of the axons of the ascending portions of the spinal cord. Naloxon rapidly antagonized the action of the narcotics.

Analgesics, Opioid↗
PubMed1982

Propoxyphene napsylate maintenance treatment of narcotic dependence: use of a non-methadone model.

One hundred seventy-eight (178) heroin addicts entered propoxyphene napsylate (PN) maintenance. Patients attended a general medical clinic two times each week and took home a three- to four-day supply of PN which was usually taken in doses of 300 to 400 mg three to four times per day. Over a 21-month period, the subjects entered and re-entered PN treatment 166 times (1.5 times per patient) and remained a mean of 10.6 weeks per treatment. A comparison with a group of methadone maintenance patients indicated similar performance in employment and heroin use. The ability to take PN, attend a clinic less often than daily, and discontinue and re-enter treatment on a discretionary basis is preferred treatment approach for some narcotic addicts.

Adult↗
PubMed1982

Effect of benzodiazepines on the central action of narcotic analgesics.

The effects of benzodiazepine (mainly diazepam) on the following central action of narcotic analgesics were tested: antinociceptive action (Randall-Selitto and hot plate tests), hypermotility, inhibition of methylphenidate stereotypy, catalepsy. Diazepam, in doses not affecting the pain threshold markedly potentiated morphine, codeine, etorphine, pentazocine and fentanyl antinociception. Hypermotility produced by morphine and fentanyl was inhibited by pretreatment with chlordiazepoxide, diazepam and clonazepam. Diazepam potentiated the inhibitory effect of opiates on methylphenidate-induced stereotyped gnawing in mice and increased the catalepsy induced by morphine and fentanyl in rats. In all experiments the effects of diazepam were suppressed by the substances which impair GABA-ergic neurotransmission: bicuculline and picrotoxin. Obtained results indicate that benzodiazepine potentiate the antinociceptive and cataleptogenic effects of opiates and their inhibitory influence on methylphenidate stereotypy. However, these drugs antagonize locomotor hyperactivity in mice. All these actions seem to be related to facilitation of GABA-ergic neurotransmission by benzodiazepines.

Analgesics, Opioid↗
PubMed1984

Suprofen: the pharmacology and clinical efficacy of a new non-narcotic peripheral analgesic.

Suprofen is a potent, peripherally-acting, non-narcotic analgesic agent. The mechanism of action of the compound involves inhibition of prostaglandin biosynthesis and, perhaps, direct antagonism of the peripheral, pain inducing actions of prostaglandins, bradykinin and other pain mediators. Suprofen at a dose of 200 mg appears to be equal or greater in efficacy as an analgesic modality than those of ibuprofen, propoxyphene, naproxen and diflunisal or a combination of 650 mg aspirin plus 60 mg codeine. Its clinical utility has been amply demonstrated in the treatment of a number of types of pain including general and orthopedic surgery, episiotomy, post-partum pain, dysmenorrhea, dental pain and musculoskeletal disorders. Suprofen represents a new class of orally effective nonnarcotic analgesics with potential for effective clinical use in the treatment of pain.

Animals↗
PubMedDate not supplied

[Narcotization of dolphins without blocking their own respiration].

Narcotization procedure for porpoises is suggested without blocking their respiration. Premedication: atropine (1 mg per 50 kg, intravenously), Seduxen (5 mg per 100 kg, intravenously). Narcosis: sodium oxybutyrate (1 g per 50 kg, intravenously), Droperidol (12.5 mg per 100 kg, intravenously), Phentanyl (0.5 mg per 100 kg, intravenously).

Anesthesia↗
PubMedDate not supplied

Pulmonary complications in the morbidly obese following jejunoileal bypass surgery under narcotic anesthesia.

The postoperative pulmonary complications detected by chest roentgenogram were correlated with the age, body weight, excess weight/ideal body weight, results of spirometry, arterial blood gas values and duration of anesthesia in 99 obese patients (mean weight 146.8 kg) who underwent jejunoileal bypass surgery under narcotic anesthesia. The overall postoperative pulmonary complication rate was 25.3 per cent. Age, body weight, excess weight/ideal body weight, preoperative vital capacity (VC), VC per cent of the predicted, forced expiratory volume 1 sec. over forced vital capacity (FEV1/FVC) PaO2 per cent of the predicted, PaCO2 and duration of anesthesia were of no value in predicting postoperative pulmonary complications. The presence of associated clinical diseases expected to affect pulmonary function (e.g., chronic bronchitis, congestive heart failure) was the only significant variable in this regard (p less than 0.01). In 85 patients who did not have an associated disease expected to affect pulmonary function, the incidence of pulmonary complication was 20 per cent; the results of spirometry were essentially normal, but the PaO2 was significantly decreased. In 14 patients with an associated disease expected to affect pulmonary function, the incidence of pulmonary complication was 57.1 per cent. The mean VC and mean PaO2 were significantly decreased; the mean age and mean PaCO2 were significantly higher in the group as compared with those in the patients without an associated disease.

Adolescent↗
PubMed1981

[Treatment of postoperative pain with non-narcotic drugs; evaluation of lysine acetylsalicylate in high doses. Double-blind controlled study].

Further work on the treatment of postoperative pain with non-narcotic analgesics involving an investigation of the effect of twice the customary dose of lysine acetylsalicylate in a double-blind trial versus meperidine is reported. In addition to subjective and objective pain, the parameters included blood pressure, pulse rate, breathing rate, sweating, pupil diameter, nausea, vomiting, somnolence, hiccuping feeling of cold, erythema, dizziness, and nasograstric sound intolerance. Application of Wilcoxon's non-parametric tests and the chi-square test showed that the drug was as good as or better than meperidine with regard to pain, and performed very well overall with respect to the other parameters. The conclusion is drawn that its administration in high doses is justified in many patients subjected to general surgery.

Abdomen↗
PubMed1981

The anti-inflammatory, analgesic and antipyretic activities of non-narcotic analgesic drug mixtures in rats.

The effects of non-narcotic analgesics have been examined, separately and in admixture, on carrageenan-induced hind paw oedema and on yeast-induced hyperalgesia and hyperthermia in adult rats. The efficacy of the drugs was evaluated using the kinetics of drug-receptor interaction. In addition, the hypothesis was tested that the anti-inflammatory, analgesic and antipyretic activities of the drug mixtures used equal the addition of the activities of the individual drugs and could be predicted from their intrinsic activities and affinities. Dose-dependent inhibition of paw oedema, hyperalgesia and hyperthermia was observed after oral administration of acetylsalicylic acid (aspirin), paracetamol, phenacetin (60, 125, 250 and 500 mg.kg--1), and caffeine (12.5, 25, 50 and 100 mg.kf--1). Over the dose-ranges used, the anti-inflammatory activities of paracetamol, phenacetin and caffeine tended to be smaller than that of aspirin. The dose producing a semi-maximal effect for caffeine was lower than that for aspirin which in turn was comparable to that for paracetamol or phenacetin. The analgesic activities of phenacetin and caffeine were classified as stronger than that of aspirin, whereas the efficacy of paracetamol was similar. Paracetamol and aspirin were comparable as antipyretics. The antipyretic activity of phenacetin was higher but that of caffeine was lower than that of aspirin. For caffeine the dose producing a semi-maximal effect was lower than that of aspirin. Within the dose-ranges used, low doses of mixtures of aspirin with either paracetamol, phenacetin or caffeine exhibited anti-inflammatory, analgesic and antipyretic activities which were not different from the activities expected on the basis of addition. Incidentally, at some of the higher dose levels potentiation of the activity of the drugs was found. Low doses of the triple combinations: aspirin + paracetamol + caffeine and aspirin + phenacetin + caffeine showed anti-inflammatory and antipyretic activities which were not different from those expected on the basis of addition, but the activities observed with higher doses of these combinations indicated potentiation. It is concluded that, in the rat, the anti-inflammatory, analgesic and antipyretic activities of dual and triple combinations of aspirin, paracetamol, phenacetin and caffeine at least equal the activities expected on the basis of addition.

Analgesics↗
PubMed1982

The treatment of narcotic withdrawal: a historical review.

The history of narcotic withdrawal treatment is filled with "cures" enthusiastically received and then quietly dropped when they turned out to be either ineffective, dangerous, or both. Methods reviewed include the Towns-Lambert belladonna treatment, sodium thiocyanate, bromide sleep treatment, Narcosan, insulin, autogenous serum, ECT, hibernation, methadone, phenothiazines, propranolol, propoxyphene, acupuncture, vitamin C, and the naloxone flush. There is need to be aware of the psychologic as well as physical aspects of withdrawal. Better detoxification techniques would help patients who are ready to discontinue the use of methadone as well as those who want to start naltrexone treatment.

History, 19th Century↗
PubMed1982

Psychiatric illness in male and female narcotic addicts.

This report describes the results of initial psychiatric interviews on 100 male and 100 female narcotic addicts who were matched by age, race, and geographic origin. The majority met criteria for antisocial personality whereas about one in four males and one in seven females met criteria for alcoholism. Between one-third and one-half of the subjects met criteria for secondary depression. Bipolar affective disorder and schizophrenia rates were not elevated. Males significantly more often were diagnosed as having antisocial personality and alcoholism whereas females significantly more often were diagnosed as having a non-drug depression. Treatment implications of the observed differences between males and females are discussed.

Adult↗
PubMed1982

Intraspinal narcotic tolerance: preliminary experience with continuous bupivicaine HCL infusion via implanted infusion device.

Spinal opiate receptor tolerance is the major limitation of continuous intraspinal narcotic analgesia delivered by implanted reservoir pump. Six intractable pain patients receiving continuous epidural morphine were given trials of low dose bupivicaine HCL in order to assess the effects on implanted reservoir function, analgesia, and safety. Daily infusion of 2.6-18.8 mg bupivicaine HCL had no consistent effect on flow rates. Subjectively, three patients had at least partial relief of pain while their intraspinal morphine doses were weaned. No sympathectomy was appreciated at these doses. The future of continuous intraspinal analgesia might require further advances in implantable infusion pump technology to allow manipulation of both daily infusion doses and multiple intraspinal analgesics. Further study is needed to assess the safety and effectiveness of higher continuous intraspinal bupivicaine doses for chronic pain relief.

Artificial Organs↗
PubMed1981

Narcotic-related deaths in the District of Columbia: 1971-1979.

Two hundred eighty-seven deaths directly related to narcotic abuse occurred in the District of columbia between July 1971 and December 1979. Factors contributing to death in some cases included lack of opiate tolerance as well as the conjoint abuse of ethanol. Free morphine was identified more often in the blood of victims dying rapidly than in the blood of those with longer post-injection survival. A statistically significant correlation between the number of heroin-related fatalities and the purity of heroin available to the user was observed over the 8 1/2-year study period.

Adolescent↗
PubMed1980

Hemodynamic failure induced by narcotic and toxic doses of 12 CNS depressants in intact and pithed rats.

UNLABELLED: Heart rate (HR), cardiac output (CO), stroke volume (SV), arterial blood pressure (BP), and peripheral resistance (PR) were assessed in awake rats and in rats anesthetized with hexobarbital, pentobarbital, secobarbital, secbutabarbital, methaqualone, chloral hydrate, urethane, ethanol, guaiphenesine, meprobamate, diazepam and chlorpromazine (respired artificially). Anesthesia mostly was accompanied by an increase of HR and PR and a decrease of CO and SV, whereas BP remained unchanged or somewhat declined. Infusion of further amounts of the CNS depressants caused a dose-dependent decrease of HR, CO and BP but did not influence SV whereas PR declined but did not fall considerably beyond the values in awake rats. A strong decline of CO, SV and BP but no change of HR and PR occurred after pithing in rats. Anesthetic doses of hexobarbital, pentobarbital, secobarbital, secbutabarbital, methaqualone, and guaiphenesine produced no hemodynamic effects in pithed rats. Chloral hydrate, urethane, ethanol, meprobamate, diazepam, and chlorpromazine, on the other hand, in anesthetic doses depressed the CO and BP of pithed rats without influencing PR. In toxic doses, the CNS depressants caused comparable hemodynamic changes in pithed as in anesthetized rats. CONCLUSION: Hemodynamic failure induced by narcotic doses of CNS depressants is mainly due to a depression of the vasomotor center(s) and an impairment of cardiovascular reflex control, that after toxic doses is mainly caused by the direct cardiovascular-depressive actions of these drugs.

Animals↗
PubMed1980

[Relationship between the chief histocompatibility systems of mice and humans and predisposition to develop narcotic dependence].

Experiments on congenitally resistant lines of mice have demonstrated the relationship between H-2 haplotype and pronounced physical dependence in chronic morphine administration. Distribution of HLA-antigens was studied in a group of polynarcomanic patients who showed a significant increase in the occurrence of HLA-B5- and HLA-CW4-antigens. Potential use of these antigens as genetic markers of predisposition to narcotization is discussed.

Animals↗