L-Dopa Gains Psychostimulant-Like Properties After Nigral Dopaminergic Loss.

L-dopa gains psychostimulant-like properties after nigral dopaminergic loss.

Ann Neurol. 2013 Mar 12;
Engeln M, Fasano S, Ahmed SH, Cador M, Baekelandt V, Bezard E, Fernagut PO

Dopamine Dysregulation Syndrome shares some core behavioral features of psychostimulant addiction, suggesting that dopamine replacement therapy can acquire psychostimulant-like properties in some patients with Parkinson’s disease (PD). We here report strong experimental evidence supporting this hypothesis in an alpha-synuclein rat model of PD. Though L-Dopa had no effect in controls, it acquired two prominent psychostimulant-like properties in Parkinsonian rats: i) it produced intense reward on its own and in parallel ii) decreased interest in other nondrug reward. These two effects may combine to explain the addictive use of L-Dopa after loss of midbrain dopamine neurons in some PD patients. ANN NEUROL 2010. HubMed – addiction

Costs of Criminal Justice Involvement Among Persons With Serious Mental Illness in Connecticut.

Psychiatr Serv. 2013 Mar 15;
Swanson JW, Frisman LK, Robertson AG, Lin HJ, Trestman RL, Shelton DA, Parr K, Rodis E, Buchanan A, Swartz MS

OBJECTIVE This study sought to describe patterns and costs of criminal justice involvement among adults with serious mental illness who received services across public agencies within a single state. Costs were examined from the perspective of state agencies providing mental health, substance abuse, and criminal justice services. METHODS Administrative records for 25,133 adults who were served by the Connecticut Department of Mental Health and Addiction Services (DMHAS) during fiscal years 2006 and 2007 and who had a diagnosis of schizophrenia or bipolar disorder were matched with records of the state Medicaid program, Judicial Branch, Department of Correction, and Department of Public Safety. Unit costs for service events were combined with utilization data to calculate costs per person. RESULTS About one in four individuals was involved with the justice system during the two-year period. The justice-involved group incurred costs approximately double those of the group with no involvement-$ 48,980 compared with $ 24,728 per person. Costs were shared by several state agencies and Medicaid. DMHAS bore the largest proportion of state service costs, covering 49% of total costs for persons with justice involvement and 69% of costs for those without involvement. CONCLUSIONS Criminal justice involvement is a complex and costly problem that affects a substantial proportion of adults with serious mental illness who receive services across state agencies. Applying per-person cost estimates in other states could help mental health and criminal justice systems to better plan, coordinate, and deliver cost-effective services to individuals with serious mental illness who become involved with the criminal justice system. HubMed – addiction

Mental Health Promotion in the Health Care Setting: Collaboration and Engagement in the Development of a Mental Health Promotion Capacity-Building Initiative.

Health Promot Pract. 2013 Mar 14;
Horn MA, Rauscher AB, Ardiles PA, Griffin SL

Health Compass is an innovative, multiphased project that aims to transform health care practice and shift organizational culture by building the capacity of Provincial Health Services Authority (PHSA) health care providers to further promote the mental health and well-being of patients and families accessing PHSA’s health care services. Health Compass was developed within a health promotion framework, which involved collaboration and engagement with stakeholders across all partnering PHSA agencies. This approach led to the development of an educational and training resource that contributes to increased capacity for mental health promotion within the health care setting. Based on interviews with Health Compass’ internal Project Team and findings from a Stakeholder Engagement Evaluation Report, this article outlines the participatory approach taken to develop the Health Compass Mental Health Promotion Resource and E-Learning Tool. A number of key facilitators for collaboration and engagement are discussed, which may be particularly applicable to the implementation of a mental health promotion program or initiative within a complex health care setting. HubMed – addiction

The Quitting Rollercoaster: How Recent Quitting History Affects Future Cessation Outcomes (Data From the International Tobacco Control 4-Country Cohort Study).

Nicotine Tob Res. 2013 Mar 14;
Partos TR, Borland R, Yong HH, Hyland A, Cummings KM

INTRODUCTION: Most smokers have a history of unsuccessful quit attempts. This study used data from 7 waves (2002-2009) of the International Tobacco Control 4-country cohort study to examine the role of smokers’ quitting history (e.g., recency, length, and number of previous quit attempts) on their subsequent likelihood of making a quit attempt and achieving at least 6 months of sustained abstinence. METHODS: Generalized estimating equations were used, allowing for estimation of relationships between variables across repeated observations while controlling for correlations from multiple responses by the same individual (29,682 observations from 13,417 individuals). RESULTS: The likelihood of a future quit attempt increased independently with recency and number of prior attempts. By contrast, the likelihood of achieving sustained abstinence of at least 6 months was reduced for smokers with a failed quit attempt within the last year (15.1% vs. 27.1% for those without, p < .001). Two or more failed attempts (vs. only one) in the previous year were also associated with a lower likelihood of achieving sustained abstinence (OR: 0.57, 95% CI: 0.38-0.85). Effects persisted after controlling for levels of addiction, self-efficacy to quit, and use of stop-smoking medications. CONCLUSIONS: There appears to be a subset of smokers who repeatedly attempt but fail to remain abstinent from tobacco. Understanding why repeated attempts might be less successful in the long term is an important research priority because it implies a need to tailor treatment approaches for those who are motivated to quit but persistently relapse back to smoking. HubMed – addiction