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PubMed2006

Brain activation during craving for alcohol measured by positron emission tomography.

OBJECTIVE: Craving for alcohol is probably involved in acquisition and maintenance of alcohol dependence to a substantial degree. However, the brain substrates and mechanisms that underlie alcohol craving await more detailed elucidation. METHOD: Positron emission tomography was used to map regional cerebral blood flow (CBF) in 21 detoxified patients with alcohol dependence during exposure to alcoholic and non-alcoholic beverages. RESULTS: During the alcohol condition compared with the control condition, significantly increased CBF was found in the ventral putamen. Additionally, activated areas included insula, dorsolateral prefrontal cortex and cerebellum. Cerebral blood flow increase in these regions was related to self-reports of craving assessed in the alcoholic patients. CONCLUSIONS: In this investigation, cue-induced alcohol craving was associated with activation of brain regions particularly involved in brain reward mechanisms, memory and attentional processes. These results are consistent with studies on craving for other addictive substances and may offer strategies for more elaborate studies on the neurobiology of addiction.

Adult↗
PubMed2006

Adolescent rats are protected from the conditioned aversive properties of cocaine and lithium chloride.

In humans, most drug use is initiated during adolescence and adolescent users are more likely to become drug-dependent than adult users. Repeated, high levels of use are required for the transition from use to addiction. Individual levels of drug use are thought to result from a balance between the pleasant or rewarding and the unpleasant or aversive properties of the drug. Repeated high levels of drug use are required for the transition from drug use to dependence. We hypothesized that diminished aversive effects of drugs of abuse during adolescence might be one reason for higher rates of use and addiction during this phase. We therefore tested adolescent and adult CD rats in single-dose cocaine conditioned taste aversion (CTA) at a range of doses (10-40 mg/kg), and examined whether various behavioral markers of addiction vulnerability were correlated to outcome in cocaine CTA. We found that adolescents are indeed less susceptible to cocaine CTA. In fact, age was the predominant predictor of CTA outcome, predominating over measures of novelty-seeking, anxiety, and stress hormone levels, which are all known to be related to drug intake in other models. Furthermore, we found that adolescent rats are also less susceptible to conditioned taste aversion to a low dose of a non-addictive substance, lithium chloride. These results suggest that one explanation for elevated drug use and addiction among adolescents is reduced aversive or use-limiting effects of the drugs. This contributes to our understanding of why adolescence is a particularly vulnerable period for development of drug abuse.

Aging↗
PubMed1990

Involvement of tobacco in alcoholism and illicit drug use.

Survey data from the United States indicate that tobacco use is associated with the initiation of use of other addicting substances, and that increasing levels of tobacco use are associated with increasing levels of use of other psychoactive substances. Furthermore, factors affecting initiation, abstinence, and relapse to the use of tobacco, alcohol, and opioids are similar in nature. In addition, there are similarities in the addictive process underlying the use of these substances. Taken together, these data suggest that tobacco use is involved, possibly more than by simple association, in the use of other substances containing psychoactive chemicals. In the present paper we discuss the involvement of tobacco in the use of alcohol, opioids, cocaine, and other substances, as well as some of the implications of these observations for researchers and clinicians. One such implication is that it may be possible to use tobacco and nicotine as models for phenomena of interest to other substance use researchers. For example, drug abuse treatment and prevention strategies could be explored using tobacco use as a target behavior, and biological phenomena such as the development of tolerance and physical dependence may be more readily studied with nicotine than with many other drugs. Certain pharmacologic differences across substances are also discussed in light of their implications for development of treatment and drug control policies.

Adolescent↗
PubMed2003

Pharmacology of drugs of abuse.

The pharmacology of most addictive substances is being studied extensively, not just for their acute effects but also the mechanisms that lead to drug seeking and addiction. The understanding of how these drugs alter their effects at the molecular level with continuing use gives promise toward investigation of novel substances that may be used for treatment. Genetic predisposition and gender differences are also some of the areas where more research is needed. Women who are addicted are likely to continue drug use during pregnancy, which can have an impact on the next generation. Prevention measures at the population level are as important. Programs need to address risks, social issues, and environmental factors that promote drug use and addiction.

Adolescent↗
PubMed2006

Dopamine D4 receptor polymorphism modulates cue-elicited heroin craving in Chinese.

RATIONALE: Subjective craving, which contributes to the continuation of drug use in active abuser and the occurrence of relapse in detoxified abusers, is considered to be a central phenomenon in addiction. Dopamine pathway has been implicated in the mechanism underlying the cue-elicited craving for a variety of addictive substances. OBJECTIVES: The objective of this study was to test the hypothesis that heroin addicts carrying D4 dopamine receptor gene (DRD4) variable number tandem repeat (VNTR) long type allele would have higher craving after exposure to a heroin-related cue. MATERIALS AND METHODS: Craving was induced by a series of exposure to neutral and heroin-related cue and were assessed in a cohort of Chinese heroin abusers (n=420) recruited from the Voluntary Drug Dependence Treatment Center at Shanghai. RESULTS: Significantly stronger cue-elicited heroin craving was found in individuals carrying DRD4 VNTR long type allele than the non-carriers (F=31.040, p<0.001). As for baseline craving and mean change in craving responding to neutral stimuli, no significance was found (1.06+/-0.34 vs 1.07+/-0.36, F=0.067, p=0.797 and 0.42+/-0.34 vs 0.45+/-0.37, F=0.277, p=0.599, respectively). CONCLUSIONS: The results of our study suggest that DRD4 VNTR polymorphism contributes to cue-elicited craving in heroin dependence, indicating DRD4 VNTR represents one of potential genetic risk factors for cue-induced craving.

Adolescent↗
PubMedDate not supplied

Smoking and adolescence.

Nicotine is one of the most addictive substances known and tobacco use started in adolescence can over time become a serious addiction with long-term health consequences. Tobacco was brought from America to Europe and has been used not only in Indian rituals, but also for medical purposes. In the 1950s and 1960s the adverse effects were revealed and the health community came out against tobacco smoking. This short communication presents recent trends in American and Israeli adolescent smoking. Recent surveys have shown a decrease in adolescent smoking, but it is still important to continue to reduce the numbers of adolescents who become nicotine dependent. Both American and Israeli youth had a current prevalence of smoking of 28%, so clinicians and practitioners must therefore do their utmost to help prevent smoking onset and try to intervene early to stop smoking among adolescents.

Adolescent↗
PubMed2001

The effects of macro-level interventions on addictive behavior.

Drug addictions are often viewed as compulsive behaviors, not sensitive to the typical rules of self-discipline or market forces. Nonetheless, many governments try to discourage consumption of addictive substances through macro policy tools, such as taxation, regulation and prohibition, in an effort to reduce the harmful consequences that result from their consumption. The government's ability to discourage this type of behavior through these macro policies depends critically on the responsiveness of addictive consumption to market interventions. This paper reviews the growing literature that applies economic principles to the analysis of "substance abuse." Specifically, we review the impact of prices and public policies on the demands for tobacco, alcohol, and illicit drugs. The findings from these studies clearly demonstrate that even addictive behaviors are sensitive to changes in the price of substances being abused. When the full price of the addictive good rises, consumption of that good falls, even among abusers. Therefore, public policies that raise the full price of a drug to a consumer, particularly youth, are likely to result in long run reductions in rates of addiction.

Adolescent↗
PubMedDate not supplied

Nicotine dependence and psychiatric disorders.

Nicotine addiction is the single largest preventable cause of morbidity and mortality in the Western World. Smoking is not any more just a bad habit, but a substance addiction problem. The pharmacological aspects of nicotine show that this substance has a broad distribution in the different body compartnents, due mainly to its lipophilic characteristic. There are nicotinic receptors as members of cholinergic receptors' family. They are located in neuromuscular junction and in the central nervous system (CNS). Although they are similar, pentameric structure with an ionic channel to sodium, there are some differences in the protein chains characteristics. Repeated administration of nicotine in rats, results in the sensitization phenomenon, which produces increase in the behavioral locomotor activity response. It has been found that most psychostimulants-induced behavioral sensitization through a nicotine receptor activation. Nicotine receptors in CNS are located mainly in presynaptic membrane and in that way they regulated the release of several neurotransmitters, among them acetylcholine, dopamine, serotonin, and norepinephrine. In some activities like sleep-wake cycle, nicotine receptors have a functional significance. Nicotine receptor stimulation promotes wake time, reduces both, total sleep time and rapid eye movement sleep (REMS). About nicotine dependence, this substance full fills all the criteria for dependence and withdrawal syndrome. There are some people that have more vulnerability for to become nicotine dependent, those are psychiatric patients. Among them schizophrenia, major depression, anxiety disorders and attention deficit disorder, represent the best example in this area. Nicotine may have some beneficial effects, among them are some neuroprotective effects in disorders like Parkinson's disease, and Gilles de la Tourette' syndrome. Also there are several evidences that support the role of nicotine in cognitive improvement functions like attention, concentration, and memory. Finally there are several strategies to deal with nicotine dependence, Nicotine Replacement Therapy (NRT), which are nicotine chewing-gum, transdermal nicotine patches, and nicotine inhalators device. Also some antidepressants like bupropion has shown to be effective in smoking cessation treatment. To know more about nicotine phenomenon would be important, because that will allow a more mature perspective about the damage and beneficial effects of that substance.

Aging↗
PubMedDate not supplied

Use of qigong therapy in the detoxification of heroin addicts.

CONTEXT: Qigong is a traditional Chinese health practice believed to have special healing and recovery power. Little scientific documentation was found on qigong and its effectiveness, and no literature was found on qigong as a treatment of substance addiction. OBJECTIVE: To explore the effectiveness of qigong therapy on detoxification of heroin addicts compared to medical and nonmedical treatment. DESIGN: Participants were randomly assigned to 1 of 3 groups: qigong treatment group (n = 34), medication group (n = 26), and no-treatment control group (n = 26). PARTICIPANTS: Eighty-six male heroin addicts, aged 18 to 52 years, who met the substance-dependence criteria of the Diagnostic and Statistical Manual of Mental Disorders, Third Edition Revised, with a history of heroin use from .5 to 11 years. All were residents at a mandatory drug-treatment center in the People's Republic of China. INTERVENTION: The qigong group practiced Pan Gu qigong and received qi adjustments from a qigong master daily. The medication group received the detoxification drug lofexidine-HCl by a 10-day gradual reduction method. The control group received only basic care and medications to treat severe withdrawal symptoms. MEASURES: Urine morphine test, electrocardiogram, Hamilton Anxiety Scale, and a withdrawal-symptom evaluation scale were applied before and during the 10-day intervention. RESULTS: Reduction of withdrawal symptoms in the qigong group occurred more rapidly than in the other groups. From day 1, the qigong group had significantly lower mean symptom scores than did the other groups (P <.01). Both the qigong and medication groups had much lower anxiety scores than did the control group (P<.01), and the qigong group had significantly lower anxiety scores than did the medication group (P<.01). All subjects had a positive response to the urine morphine test before treatment. Fifty percent of the qigong group had negative urine tests on day 3, compared to 23% in the control group and 8% in the medication group (P <.01). By day 5 of treatment, all subjects in the qigong group had negative urine tests, compared to day 9 for the medication group and day 11 for the control group. CONCLUSIONS: Results suggest that qigong may be an effective alternative for heroin detoxification without side effects, though we cannot completely eliminate the possibility of the placebo effect from the current study.

Adult↗
PubMed2004

A common haplotype of the nicotine acetylcholine receptor alpha 4 subunit gene is associated with vulnerability to nicotine addiction in men.

Nicotine is the major addictive substance in cigarettes, and genes involved in sensing nicotine are logical candidates for vulnerability to nicotine addiction. We studied six single-nucleotide polymorphisms (SNPs) in the CHRNA4 gene and four SNPs in the CHRNB2 gene with respect to nicotine dependence in a collection of 901 subjects (815 siblings and 86 parents) from 222 nuclear families with multiple nicotine-addicted siblings. The subjects were assessed for addiction by both the Fagerstrom Test for Nicotine Dependence (FTND) and the Revised Tolerance Questionnaire (RTQ). Because only 5.8% of female offspring were smokers, only male subjects were included in the final analyses (621 men from 206 families). Univariate (single-marker) family-based association tests (FBATs) demonstrated that variant alleles at two SNPs, rs1044396 and rs1044397, in exon 5 of the CHRNA4 gene were significantly associated with a protective effect against nicotine addiction as either a dichotomized trait or a quantitative phenotype (i.e., age-adjusted FTND and RTQ scores), which was consistent with the results of the global haplotype FBAT. Furthermore, the haplotype-specific FBAT showed a common (22.5%) CHRNA4 haplotype, GCTATA, which was significantly associated with both a protective effect against nicotine addiction as a dichotomized trait (Z=-3.04, P<.005) and significant decreases of age-adjusted FTND (Z=-3.31, P<.005) or RTQ scores (Z=-2.73, P=.006). Our findings provide strong evidence suggesting a common CHRNA4 haplotype might be protective against vulnerability to nicotine addiction in men.

Adult↗
PubMedDate not supplied

Illegal drug use and public policy.

The period from the 1980s to the present has witnessed a lively and unsettled debate concerning the legalization of marijuana, cocaine, heroin, and other illicit substances in the United States. Proponents of legalization argue that the demand for these harmful and potentially addictive substances is not responsive to price. Opponents argue that prices will fall tremendously in a regime characterized by legalization and that the option of legalization and taxation is not feasible. In this paper we summarize theoretical and empirical evidence suggesting that none of these propositions is correct.

Adolescent↗
PubMed2007

[An anthropological view of addiction].

In psychiatric discourse, addiction is normally understood according to the original paradigm of "dependency" which claims lifelong and unchangeable dependency on the addictive substance or "psychotropic technique". In the attempt to reduce damage or achieve abstinency, therapeutic interests and understanding of the human mind contradict this inflexibility. This contradiction in psychiatric understanding of addiction can be viewed as a dynamic part of the addiction process. A philosophical anthropology of addiction is presented in that light. Using the concept "the psychotropic technique achieves a superior position", both sides of the psychiatric understanding are combined and integrated. The addictive mind and its self-awareness can then be understood as a "fragile monoidentity". Implications of such an understanding are discussed.

Anthropology, Cultural↗
PubMed2006

Discriminative-stimulus effects of methamphetamine and morphine in rats are attenuated by cAMP-related compounds.

Animal models of drug discrimination have been used to examine the subjective effects of addictive substances. The cAMP system is a crucial downstream signaling pathway implicated in the long-lasting neuroadaptations induced by addictive drugs. We examined effects of rolipram, nefiracetam, and dopamine D2-like receptor antagonists, all of which have been reported to modulate cAMP level in vivo, on the discriminative-stimulus effects of methamphetamine (METH) and morphine in rats. All these compounds inhibited the discriminative-stimulus effects of METH, while only rolipram and nefiracetam attenuated the discriminative-stimulus effects of morphine. In addition, neither nifedipine nor neomycin, two voltage-sensitive calcium channel blockers, was found to modulate the effect of nefiracetam on METH-associated discriminative stimuli, suggesting that the inhibitory effect of nefiracetam may not involve the activation of calcium channels. These findings suggest that the cAMP signaling cascade may play a key role in the discriminative-stimulus effects of METH and morphine and may be a potential target for the development of therapeutics to counter drugs of abuse.

Analysis of Variance↗
PubMed1988

Tobacco addiction as a psychiatric disease.

Tobacco is the most widely used addictive substance in the world. Since the Surgeon General's 1964 report, medicine has sought out the genesis of tobacco addiction (TA) and has evolved methods of treatment and prevention. Psychiatry was slower than other medical specialties to acknowledge TA as a legitimate area for psychiatric intervention, probably because the many psychiatrists who were smokers identified with their smoking patients. Since 1980, the American Psychiatric Association has recognized nicotine dependence and nicotine withdrawal as diagnostic entities. The complications of TA are in the province of other medical specialists, but psychiatrists have unique tools for treating addictive disorders. This paper describes some of the addictive qualities of tobacco, and presents illustrative cases of successful treatment of TA using hypnosis. It describes an effective cooperative community program under medical aegis, focusing on education, therapy, and prevention, which has resulted in the virtual disappearance of tobacco consumption in hospitals and schools in the community. By sharing their expertise in the treatment of individual patients, and the design of effective community programs that include education, prevention, and treatment, psychiatrists will be active leaders in the medical community's program to reduce tobacco addiction.

Adult↗
PubMedDate not supplied

When is domestic violence a hidden face of addiction?

This article reviews studies that address the comorbidity of domestic violence, addictive disorders, and sexual abuse, and presents a model in which domestic violence parallels the chief features of chemical dependency. Domestic violence and addictive disorders share a number of behavioral features, including loss of control, continuation of behavior despite adverse consequences, preoccupation or obsession, development of tolerance, and family involvement. Domestic violence predisposes the next generation to both domestic violence and addictive disorders. Sexual abuse within the family of origin and/or the couple relationship is a common feature of both domestic violence and substance addiction, and predisposes to both disorders in the next generation. Clinicians encountering patients who are perpetrators or victims of domestic violence or sexual trauma, or have addictive disorders, must assess for the presence of comorbid problems.

Adult↗
PubMed1991

To surrender drugs: a grief process in its own right.

The basic thesis of this article is that addictive substances, because of their need-grafifying and self-medication value, become so central to the life of the addicted person that their absence is associated with a grief reaction. Painful feelings of loss and helplessness accompany drug surrender. This view contrasts with formulations that indicate that mourning experiences observed in recovering persons are specific to and determined by unresolved past losses of loved ones. The author discusses the theoretical underpinnings of the drug-loss grief reaction. Also presented are case vignettes that demonstrate the grief aspects of drug surrender. Finally, the role of brief psychotherapy as a vehicle for helping clients cope with their grief reactions is discussed.

Adaptation, Psychological↗
PubMed2002

[Nicotine dependence--medico-biological aspects].

The nicotine in tobacco products is strongly addictive. This was generally recognised no earlier than in the late 1970s, though it was well known within the international tobacco industry in the early 1960s. Nicotine acts as an addictive substance by binding to acetylcholine receptors and causing the release of dopamine in the brain, though other signalling substances are also important for the action of nicotine in the central nervous system. Withdrawal syndrome is the typical evidence of physical addiction to nicotine. Nicotine addiction can develop rapidly. There are, however, individual differences; genetic predisposition may have a bearing on these differences.

Brain↗
PubMed1996

Prevalence study of serious substance abusers in the Czech Republic.

In October of 1995, a prevalence study of serious substance abusers was carried out in the Czech Republic. The prevalence study focused on: 1. persons hospitalized because of drug addiction as of 31.10.1995; 2. persons who visited one of the treatment/contact centres during October of 1995. Data on serious addictive substance abusers were collected from 142 treatment/contact centres. The overall prevalence in the 15-39-year age group is 30.3/100,000 inhabitants, the highest in Prague (115.0/100,000 inhabitants), followed by Northern Bohemia (34.1) and Northern Moravia (32.0). The most frequently used primary drug remains pervitin (349 users, i.e. 35.5%), followed by heroin in the second place (126, i.e. 12.9%), marihuana in the third place (94, i.e. 9.4%) and toluene in the fourth place (81, 8.1%). The 15-19-year age group is the most affected, and corresponds to 36.9% of all users. In this age category, women predominate (47.2% of all users). Heroin is equally used in the 15-19-year and 20-24-year age groups, while pervitin is used most in the 15-19-year age group, as are marihuana and toluene; the frequency of gambling increases more or less with age. Heroin is used most in Northern Bohemia (48.4%) and Prague (24.6%), and pervitin in Prague (34.7%) and Northern Moravia (18.9%). Data on injection administration of drugs, which is dangerous because of the possibility of transmission of hepatitis and HIV, confirm that almost two thirds of all users prefer this means of application. The great majority of all serious abusers are persons with only elementary schooling.

Adolescent↗