Addiction Rehab: [Staging and Profiling in Addication].
[Staging and profiling in addication].
Filed under: Addiction Rehab
Tijdschr Psychiatr. 2012; 54(11): 941-8
van den Brink W, Schippers GM
Summary background The existence or non-existence of the formal diagnosis ‘substance abuse’ or ‘dependence’ is in fact of little consequence in terms of the severity of the affliction, the course of the disorder and the response to a specific type of treatment. Furthermore, the effective treatments that are currently available seem to work only in a minority of the patients in routine clinical practice. A possible reason for these discrepancies is too much heterogeneity within the diagnostic categories. The planned merging of the diagnoses ‘substance abuse’ and ‘dependence’ into a single diagnostic category ‘substance use disorder’ in dsm-5 is likely to increase the heterogeneity still further. aim To provide suggestions for improvement of diagnosis and treatment through staging and profiling of addiction and dependency. method Study of the relevant literature. results A possible solution is to reduce the heterogeneity by the introduction of staging and profiling. Therefore, we present a model for addiction which is based on existing models in oncology and on current knowledge about the neurobiology of addiction. In addition, we demonstrate in what way individual patients with an addiction can be characterised and profiled in more detail through the use of phenotypical, endophenotypical and genetic information.conclusion The combination of diagnosis, staging and profiling will lead to more effective and efficient treatment for patients suffering from addiction.
HubMed – addiction
Cariprazine (RGH-188), a D(3)-preferring dopamine D (3)/D (2) receptor partial agonist antipsychotic candidate demonstrates anti-abuse potential in rats.
Filed under: Addiction Rehab
Psychopharmacology (Berl). 2012 Nov 9;
Román V, Gyertyán I, Sághy K, Kiss B, Szombathelyi Z
RATIONALE: Cariprazine (RGH-188) is a D(3)-preferring dopamine D(3)/D(2) receptor partial agonist antipsychotic candidate for the treatment of schizophrenia and bipolar mania. Substance abuse is a frequent comorbidity of both disorders and is associated with serious health issues. Based on preclinical efficacy, dopamine D(2) and D(3) receptor partial agonists and antagonists are assumed to have relapse-preventing potential in human cocaine addiction. OBJECTIVES: We investigated the anti-abuse potential of cariprazine in cocaine self-administration paradigms. Aripiprazole and bifeprunox were used as comparators because of their pharmacological similarity to cariprazine. METHODS: The effects of compounds on cocaine’s rewarding effect were investigated in a continuous self-administration regimen. The relapse-preventing potential of drugs was studied in rats with a history of cocaine self-administration after a period of complete abstinence in a relapse to cocaine-seeking paradigm. RESULTS: Cariprazine, as well as aripiprazole and bifeprunox, were able to reduce the rewarding effect of cocaine (minimum effective doses were 0.17, 1, and 0.1 mg/kg, respectively) and attenuated relapse to cocaine seeking with half maximal effective dose [ED(50)] values of 0.2, 4.2, and 0.17 mg/kg, respectively. CONCLUSIONS: These results may predict a relapse-preventing action for cariprazine in humans in addition to its already established antipsychotic and antimanic efficacy.
HubMed – addiction
Preliminary Evidence for a Gene-Environment Interaction in Predicting Alcohol Use Disorders in Adolescents.
Filed under: Addiction Rehab
Alcohol Clin Exp Res. 2012 Nov 8;
Miranda R, Reynolds E, Ray L, Justus A, Knopik VS, McGeary J, Meyerson LA
BACKGROUND: Emerging research suggests that genetic influences on adolescent drinking are moderated by environmental factors. The present study builds on molecular-genetic findings by conducting the first analysis of gene-environment interactions in the association between a functional single nucleotide polymorphism (SNP) of the ?-opioid receptor (OPRM1) gene (A118G) and risk of developing an alcohol use disorder (AUD) during adolescence. Specifically, we tested whether variation in parenting practices or affiliation with deviant peers moderated the link between the OPRM1 gene and risk of an AUD. METHODS: Adolescents reporting European ancestry (N = 104), ages 12 to 19 years (M = 15.60, SD = 1.77), were interviewed to ascertain AUD diagnoses, provided a DNA sample for genetic analyses, and completed measures of parental monitoring and deviant peer affiliation. Logistic regression was used to test the effects of environmental variables and their interactions with OPRM1 genotype as predictors of AUD diagnosis while controlling for age and sex. RESULTS: Case-control comparisons showed that the proportion of youth with an AUD (n = 18) significantly differed by genotype such that 33.3% of G allele carriers met criteria for an AUD compared to 10.8% of youth who were homozygous for the A allele (p = 0.006). The OPRM1 × parental monitoring (odds ratio = 0.16) and OPRM1 × deviant peer affiliation (odds ratio = 7.64) interactions were significant predictors of AUD risk, such that G allele carriers with high levels of deviant peer affiliation or lower levels of parental monitoring had the greatest likelihood of developing an AUD (p-values <0.01). CONCLUSIONS: This study provides initial evidence that the association between the A118G SNP of the OPRM1 gene and risk of AUDs is moderated by modifiable factors. These results are limited, however, by the small sample size and require replication. HubMed – addiction
The Mediating Role of Alcohol-Related Memory Associations on the Relation between Perceived Parental Drinking and the Onset of Adolescents’ Alcohol Use.
Filed under: Addiction Rehab
Addiction. 2012 Nov 9;
Van Der Vorst H, Krank M, Engels RC, Pieters S, Burk WJ, Mares SH
AIMS: The aim of the current study was to examine the mediating role of alcohol-related memory associations in the relation between perceived parental drinking and the onset of adolescents’ alcohol use. Gender and grade were also included in the analyses. DESIGN: We tested a mediation model within a structural path modeling framework using longitudinal data (two waves). SETTING AND PARTICIPANTS: The sample consisted of 608 Canadian adolescents (43% boys), who did not have any alcohol experiences at the first measurement. The adolescents were recruited from all grade seven to nine classes in a large school district in western Canada. MEASUREMENTS: Alcohol-related memory associations were tested with the Word Association Test. We used adolescent self reports of alcohol use and parental drinking. FINDINGS: Results clearly showed a mediation effect of alcohol-related memory associations (Estimate =.023, (95% CI =.002 -.044) ). That is, parental drinking as perceived by the adolescent was positively related to alcohol-related memory associations, which in turn predicted adolescents’ alcohol use a year later. Gender (B = -.10, p <.05) and grade (B =.13, p <.001) were related to alcohol-related memory associations. That is, boys and adolescents of higher grades had more memory associations. CONCLUSIONS: Children appear to form memory associations related to alcohol before they ever drink alcohol themselves, and these associations appear to mediate the link between their perceptions of their parents' drinking and their own initial alcohol use. HubMed – addiction
Drinking Before Going to Licensed Premises: An Event-Level Analysis of Predrinking, Alcohol Consumption, and Adverse Outcomes.
Filed under: Addiction Rehab
Alcohol Clin Exp Res. 2012 Nov 8;
Labhart F, Graham K, Wells S, Kuntsche E
BACKGROUND: Research in the United States and the United Kingdom indicates that drinking before going out (commonly called “predrinking”) is common among young people and associated with increased harm. On the basis of Swiss data, this study investigates differences in alcohol consumption and adverse or risky outcomes for evenings when persons consumed alcohol before going to a licensed premise (i.e., predrinking), drank on-premise only, or drank off-premise only. METHODS: Using the recently developed Internet-based cell phone-optimized assessment technique (ICAT), alcohol consumption and drinking location were assessed at 6 time points (5 pm to the next morning) on Thursdays, Fridays, and Saturdays over 5 consecutive weeks by means of participants’ cell phones. Overall, 7,828 assessments provided by 183 young adults (53.0% women, mean age [SD] = 23.1 [3.1]) on 1,441 evenings were analyzed by means of cluster-adjusted means and proportion tests and of multilevel structural equation models. The extent to which alcohol consumption mediated the association between predrinking and adverse outcomes was also examined. RESULTS: Higher alcohol consumption occurred on evenings with predrinking (7.1 drinks on average) compared with on-premise only (4.2 drinks) and off-premise only (4.3 drinks) evenings. Adverse outcomes occurred more often on evenings with predrinking (with 23.8% of predrinking nights involving at least 1 outcome) than on evenings with on-premise drinking only (13.9%) and off-premise drinking only (12.0%). Predrinking was indirectly associated with adverse outcomes, mediated by larger amounts of alcohol consumed in the evening. CONCLUSIONS: Because of its association with heavier consumption and related adverse outcomes, predrinking, especially combined with on-premise drinking, represents a major target for prevention. Educational interventions as well as structural measures, such as reduction in late-night off-sale opening hours, and staff training in responsible beverage service, are needed to prevent high total consumption and related adverse consequences among young people.
HubMed – addiction
Saving Teens in Trouble: Dr. Karen Minden CM, PhD – The founder of Pine River Institute talks with E. Brian Johnson at Bellwood’s “Many Faces of Addiction” Syposium 2011 about the work of helping teens with mental health issues and substance abuse.
Related Addiction Rehab Information…