Drug Users Need More Choices at Addiction Treatment Facilities.
Drug users need more choices at addiction treatment facilities.
BMJ. 2013; 346: f1520
Alaei A, Alaei K
Over-the-counter medicine abuse – a review of the literature.
J Subst Use. 2013 Apr; 18(2): 82-107
Cooper RJ
The sale of over-the-counter (OTC) medicines from pharmacies can help individuals self-manage symptoms. However, some OTC medicines may be abused, with addiction and harms being increasingly recognised. This review describes the current knowledge and understanding of OTC medicine abuse.Comprehensive search of international empirical and review literature between 1990 and 2011.OTC MEDICINE ABUSE WAS IDENTIFIED IN MANY COUNTRIES AND ALTHOUGH IMPLICATED PRODUCTS VARIED, FIVE KEY GROUPS EMERGED: codeine-based (especially compound analgesic) medicines, cough products (particularly dextromethorphan), sedative antihistamines, decongestants and laxatives. No clear patterns relating to those affected or their experiences were identified and they may represent a hard-to-reach group, which coupled with heterogeneous data, makes estimating the scale of abuse problematic. Associated harms included direct physiological or psychological harm (e.g. opiate addiction), harm from another ingredient (e.g. ibuprofen-related gastric bleeding) and associated social and economic problems. Strategies and interventions included limiting supplies, raising public and professional awareness and using existing services and Internet support groups, although associated evaluations were lacking. Terminological variations were identified.OTC medicine abuse is a recognised problem internationally but is currently incompletely understood. Research is needed to quantify scale of abuse, evaluate interventions and capture individual experiences, to inform policy, regulation and interventions. HubMed – addiction
Elevated IGF1 in clinical opiate dependence.
Neuro Endocrinol Lett. 2013 Feb 25; 34(4): 18-26
Reece AS
OBJECTIVE: To compare IGF1 levels in opiate dependent and general patients both absolutely and by age. DESIGN: A naturalistic observational study was undertaken of opiate dependent and general medical patients. SETTING: Primary care. PATIENTS: 74 opiate substance use dependent (SUD) patients were compared with 262 non-SUD (NSUD) patients. RESULTS: (1) Comparative IGF1 levels; (2) age and sex corrected IGF1 levels; (3) IGF1 levels corrected for age, sex, and hepatic and immune biomarkers. MAIN FINDINGS: The SUD patients were younger (32.60+0.89 vs. 42.49+0.96 years, mean+S.E.M., p<0.0001) and had more males (72.9% and 39.3%, p<0.0001) than the NSUD patients. Restriction of the age range to 15-45 years (70 vs. 153 patients) made the difference in ages non-significant (31.27+0.71 vs. 32.32+0.61 years, p=0.47) but IGF1 remained elevated in SUD (26.56+1.21 vs. 22.65+0.57nmol/L, p=0.0039). When multiple regression was used to correct for the age and sex disparities, the age: addiction interaction remained significantly elevated (p=0.0003). In an additive model opiate dependence showed a 23.8% elevation in IGF1. When the interactive model was further adjusted by the inclusion of ALT and CRP as indices of hepatic inflammation and immune activation respectively, addictive status remained significant both alone (p=0.0134) and in 2-, 3- and 4-way interactions with age, male sex, and ALT (all p<0.0255). CONCLUSION: These data demonstrate that serum IGF1 is elevated in opiate dependence both absolutely and after adjustment for age, sex, and markers of immune and hepatic activation. HubMed – addiction
Role of intra-accumbal cannabinoid CB1 receptors in the potentiation, acquisition and expression of morphine-induced conditioned place preference.
Behav Brain Res. 2013 Mar 21;
Karimi S, Azizi P, Shamsizadeh A, Haghparast A
Recent studies demonstrate a functional interaction between opioid and endogenous cannabinoid system. These two systems possess similar pharmacological effects on drug addiction and reward. The present study was designed to investigate the role of intra-accumbal cannabinoid CB1 receptors in the acquisition and expression of morphine-induced conditioned place preference (CPP). Two-hundred forty eight adult male albino Wistar rats were used in these experiments. Using a 3-day schedule of conditioning, it was found that subcutaneous administration of morphine (0.2-10mg/kg) induced CPP at the doses of 5 and 10mg/kg. Solely intra-accumbal administration of WIN55,212-2 (1, 2 and 4mmol/0.5?l DMSO) as CB1 receptor agonist could induce CPP. Also, our results showed that ineffective dose of WIN55,212-2 (1mmol) when administered before the ineffective dose of morphine (2mg/kg) could induce the CPP and potentiate the rewarding effect of morphine. On the other hand, intra-accumbal injection of the cannabinoid CB1 receptor antagonist AM251 (90?mol/0.5?l DMSO) alone induced a significant conditioned place aversion. Moreover, intra-NAc injection of AM251 (45 and 90?mol/0.5?l DMSO) inhibited morphine-induced CPP. Interestingly, injection of WIN55,212-2 (1, 2 and 4mmol) or AM251 (15, 45 and 90?mol) into the NAc had no effect on the expression of morphine (5mg/kg)-induced CPP. These observations provide evidence that cannabinoid CB1 receptors in the NAc are involved in development of reward-related behaviors and they can potentiate the rewarding effects of morphine. It seems that these receptors can affect the reward modulatory system at the level of nucleus accumbens in rats. HubMed – addiction
Meta-analysis of structural brain abnormalities associated with stimulant drug dependence and neuroimaging of addiction vulnerability and resilience.
Curr Opin Neurobiol. 2013 Mar 20;
Ersche KD, Williams GB, Robbins TW, Bullmore ET
Since the first study in stimulant-dependent individuals using structural MRI was published fifteen years ago, much evidence has accumulated on brain abnormalities associated with stimulant drug dependence. Here we conducted a voxel-based morphometry meta-analysis of published MRI data in stimulant-dependent individuals to clarify the most robust abnormalities underlying the disorder. We found that neuroimaging studies in stimulant-dependent individuals consistently report a gray matter decline in the prefrontal cortex regions associated with self-regulation and self-awareness. One of the next key questions that neuroimaging research today needs to address is the question of causality, namely to what extent these brain abnormalities are caused by the toxic effects of drug exposure, or the possibility that these may have predated drug-taking and even predisposed individuals for the development of drug dependence. Although the question of causality has not yet been answered completely, there has been significant progress made to date. HubMed – addiction