Addiction Rehab: Deep Brain Stimulation of the Nucleus Accumbens for the Treatment of Addiction.
Deep brain stimulation of the nucleus accumbens for the treatment of addiction.
Filed under: Addiction Rehab
Ann N Y Acad Sci. 2012 Dec 10;
Müller UJ, Voges J, Steiner J, Galazky I, Heinze HJ, Möller M, Pisapia J, Halpern C, Caplan A, Bogerts B, Kuhn J
Despite novel medications and other therapeutic strategies, addiction to psychotropic substances remains one of the most serious public health problems worldwide. In this review, beginning with an introduction of deep brain stimulation (DBS), we highlight the importance of the nucleus accumbens (NAc) in the context of the reward circuitry and addictive behavior. We will provide a short historic overview of other neurosurgical approaches to treat addiction and describe the experimental and preclinical data on DBS in addiction. Finally, we call attention to key ethical issues related to using DBS to treat addiction that are important for future research and the design of clinical trials.
HubMed – addiction
Attention deficit hyperactivity disorder (ADHD) among illicit psychostimulant users: a hidden disorder?
Filed under: Addiction Rehab
Addiction. 2012 Dec 11;
Kaye S, Darke S, Torok M
AIMS: To estimate the prevalence, nature and correlates of symptomatology consistent with adult attention deficit hyperactivity disorder (ADHD) among illicit psychostimulant users. METHODS: 269 regular illicit psychostimulant users were administered a structured interview assessing demographics, drug use and treatment history, psychostimulant dependence, and self-reported symptoms consistent with adult ADHD. RESULTS: Almost half (45%) screened positive for adult ADHD (ADHD+ve). Symptoms of inattention (90%) were more prevalent than symptoms of hyperactivity/impulsivity (57%). Of those who screened positive for adult ADHD, only 17% had received a prior diagnosis of ADHD. The ADHD+ve group differed from other participants in several respects: an earlier initiation of substance use and injecting drug use; more extensive polydrug use; a higher frequency of recent stimulant use and injecting drug use; a greater likelihood of stimulant dependence; and a greater likelihood of having received treatment for drug dependence. After controlling for other factors, screening positive for ADHD was independently associated with fewer years of education, earlier initiation of regular tobacco use and more extensive lifetime polydrug use. CONCLUSIONS: Clinicians should be aware of the potential for patients of drug and alcohol treatment services to have undiagnosed and/or untreated ADHD that may impact on their compliance with, and retention in, treatment.
HubMed – addiction
Opioid drugs in maintenance and detoxification treatment of opiate addiction; proposed modification of dispensing restrictions for buprenorphine and buprenorphine combination as used in approved opioid treatment medications. Final rule.
Filed under: Addiction Rehab
Fed Regist. 2012 Dec 6; 77(235): 72752-61
This final rule amends the federal opioid treatment program regulations by modifying the dispensing requirements for buprenorphine and buprenorphine combination products approved by the Food and Drug Administration (FDA) for opioid dependence and used in federally certified and registered opioid treatment programs. In particular, this rule would allow opioid treatment programs more flexibility in dispensing take-home supplies of buprenorphine–removing restrictions on the time a patient needs to be in treatment in order to receive take-home supplies–after the assessment and documentation of a patient’s responsibility and stability to receive opioid addiction treatment medication. Opioid treatment programs that use these products in the treatment of opioid dependence will continue to adhere to all other federal treatment standards established for methadone.
HubMed – addiction
Methadone maintenance therapy in Vietnam: an overview and scaling-up plan.
Filed under: Addiction Rehab
Adv Prev Med. 2012; 2012: 732484
Nguyen TT, Nguyen LT, Pham MD, Vu HH, Mulvey KP
Vietnam is among the countries with the highest rate of HIV transmission through injecting drug users. HIV prevalence among injecting drug users is 20% and up to 50% in many provinces. An estimated number of drug users in the country by the end of 2011 were 171,000 in which the most common is heroin (85%). Detoxification at home, community, and in rehabilitation centers have been the main modalities for managing heroin addiction until Methadone Maintenance Treatment (MMT) was piloted in 2008. Recent reports have demonstrated positive treatment outcomes. Incidence of HIV was found remarkably low among patients on MMT. Treatment has significantly improved the quality of life as well as stability for society. The government has granted the Ministry of Health (MoH) to expand Methadone treatment to at least 30 provinces to provide treatment for more than 80,000 drug users by 2015. The Vietnam Administration for HIV/AIDS Control (VAAC) and MOH have outlined the role and responsibility of key departments at the central and local levels in implementing and maintaining MMT treatment. This paper will describe the achievements of the MMT pilot program and the scaling-up plan as well as strategies to ensure quality and sustainability and to overcome the challenges in the coming years.
HubMed – addiction
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