Dopaminergic Involvement During Mental Fatigue in Health and Cocaine Addiction.

Dopaminergic involvement during mental fatigue in health and cocaine addiction.

Filed under: Addiction Rehab

Transl Psychiatry. 2012; 2: e176
Moeller SJ, Tomasi D, Honorio J, Volkow ND, Goldstein RZ

Dopamine modulates executive function, including sustaining cognitive control during mental fatigue. Using event-related functional magnetic resonance imaging (fMRI) during the color-word Stroop task, we aimed to model mental fatigue with repeated task exposures in 33 cocaine abusers and 20 healthy controls. During such mental fatigue (indicated by increased errors, and decreased post-error slowing and dorsal anterior cingulate response to error as a function of time-on-task), healthy individuals showed increased activity in the dopaminergic midbrain to error. Cocaine abusers, characterized by disrupted dopamine neurotransmission, showed an opposite pattern of response. This midbrain fMRI activity with repetition was further correlated with objective indices of endogenous motivation in all subjects: a state measure (task reaction time) and a trait measure (dopamine D2 receptor availability in caudate, as revealed by positron emission tomography data collected in a subset of this sample, which directly points to a contribution of dopamine to these results). In a second sample of 14 cocaine abusers and 15 controls, administration of an indirect dopamine agonist, methylphenidate, reversed these midbrain responses in both groups, possibly indicating normalization of response in cocaine abusers because of restoration of dopamine signaling but degradation of response in healthy controls owing to excessive dopamine signaling. Together, these multimodal imaging findings suggest a novel involvement of the dopaminergic midbrain in sustaining motivation during fatigue. This region might provide a useful target for strengthening self-control and/or endogenous motivation in addiction.
HubMed – addiction

Opioid addiction and abuse in primary care practice: a comparison of methadone and buprenorphine as treatment options.

Filed under: Addiction Rehab

J Natl Med Assoc. 2012 Jul-Aug; 104(7-8): 342-50
Bonhomme J, Shim RS, Gooden R, Tyus D, Rust G

Opioid abuse and addiction have increased in frequency in the United States over the past 20 years. In 2009, an estimated 5.3 million persons used opioid medications nonmedically within the past month, 200000 used heroin, and approximately 9.6% of African Americans used an illicit drug. Racial and ethnic minorities experience disparities in availability and access to mental health care, including substance use disorders. Primary care practitioners are often called upon to differentiate between appropriate, medically indicated opioid use in pain management vs inappropriate abuse or addiction. Racial and ethnic minority populations tend to favor primary care treatment settings over specialty mental health settings. Recent therapeutic advances allow patients requiring specialized treatment for opioid abuse and addiction to be managed in primary care settings. The Drug Addiction Treatment Act of 2000 enables qualified physicians with readily available short-term training to treat opioid-dependent patients with buprenorphine in an office-based setting, potentially making primary care physicians active partners in the diagnosis and treatment of opioid use disorders. Methadone and buprenorphine are effective opioid replacement agents for maintenance and/or detoxification of opioid-addicted individuals. However, restrictive federal regulations and stigmatization of opioid addiction and treatment have limited the availability of methadone. The opioid partial agonist-antagonist buprenorphine/naloxone combination has proven an effective alternative. This article reviews the literature on differences between buprenorphine and methadone regarding availability, efficacy, safety, side-effects, and dosing, identifying resources for enhancing the effectiveness of medication-assisted recovery through coordination with behavioral/psychological counseling, embedded in the context of recovery-oriented systems of care.
HubMed – addiction

[Feeding and adolescence].

Filed under: Addiction Rehab

Rev Med Brux. 2012 Sep; 33(4): 346-53
Dain E

Adolescence is a transition period during which young people face many changes. Their desire to assert and differentiate themselves is reflected even in their food choices. These choices may have impacts until their adult lives. Moreover the media affect them in contradictory ways from images of extreme thinnesses to enticing advertisements of calorie food. A lack of self-esteem may appear, and in case of fertile ground may cause either diet, either addiction, or eating disorder. A comforting family as well as empathetic physicians have a main role in the medical care.
HubMed – addiction

TJ’s Rehab 01: Webdiver Gradion – So the counterpoint to addiction? Rehab. A review of a good toy as requested by the viewers of my vlog. So, the core figure of the Webdiver line, how does it stack up? Is it worth the price tag stuck on it? …will I suck at reviewing good toys?

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