Current drug abuse reviews最新文献

Background: Depression and problematic substance use represent two of the major social and health problems facing young people internationally. Frequently, these conditions co-occur and this co-occurrence is associated with greater functional impact, poorer treatment outcomes, and increased costs to both society and the individual.

Objective: This review aims to identify peer-reviewed published trials of interventions for co-occurring substance use and depression delivered to young people, describe these interventions, and critique the methodological quality of the studies.

Method: Eleven electronic databases were searched. The reference lists of relevant review papers were searched manually for additional studies not identified by the electronic database search.

Results: Initially, 1,976 studies were identified, of which 22 were classified as trial studies of youth-based treatment interventions for co-occurring substance use and depression. Ten of these studies met criteria for review. The majority (60%) utilized a pharmacotherapy component, but found it to be generally no better than placebo when both groups received adjunct counselling. METHODological quality of studies varied.

Conclusions: There is a dearth of trials of interventions for co-occurring depression and substance use disorders in young people. The limited data available is promising regarding the overall effectiveness of a psychological counselling approach. Given the importance of early intervention, and the difficulties faced when engaging youth in treatment, there is a need for further focused effort amongst this group. This may require more innovative techniques in intervention design and implementation. Recent advances in Internet- and mobile phone-based therapies present a potential avenue for further research.

The present study is an analytical review of the methodology used in studies of efficacy of screening instruments to detect harmful use/ alcohol dependence according to the gender in population surveys. Systematic review of bibliography was done, using data from Web of Science, Pubmed and PsycInfo. Population studies were included without date range, in English, Spanish or Portuguese languages, with sample of adults, evaluating psychometric characteristics of any alcohol screening instrument, whereas studies in special population or under treatment as well as prevalence of alcohol consumption were excluded. Thirteen studies were selected to be included in the present review. According to the studies, the instruments that presented a better performance among men were AUDIT and its derivatives (6 studies) and CAGE (2 studies), whereas among women, AUDIT and its derivatives (7 studies), followed by CAGE (3 studies). The increase of consumption and problems related to alcohol use and its implications for public health indicate the need and urgency for adequacy of screening instruments to differences of gender in general population. The population surveys in the area are scarce. Furthermore, the found studies present heterogeneous methodology which makes accurate comparisons difficult.

Methadone has been used as a pharmacotherapy for the treatment of opiate dependence since the mid-1960s. Many studies examining the benefits of methadone maintenance treatment (MMT) for opiate dependence have documented a significant reduction in both criminal behavior and the use of other opiates. Nevertheless, emerging evidence suggests that MMT may impair cognitive function. However, it is unclear as to the part methadone dose, duration of MMT or plasma level may play in any observed deficits. Given the large number of people enrolled in MMT world-wide and the potential for deficits in cognitive function, a systematic review of the research investigating the association between MMT and cognitive function seemed warranted. The following databases were searched with a combination of free-text and thesaurus terms (methadone AND cognition): MEDLINE In-Process, EMBASE, PsycINFO and EBM Reviews-Cochrane Central Register of Controlled Trials. Seventy-eight articles were retrieved of which 35 met the inclusion criteria. The majority of research suggests that MMT is associated with impaired cognitive function and that deficits extended across a range of domains. However, caution is required when interpreting these results due to the methodological limitations associated with many studies. Further research that includes a combination of psychological and physiological measures within well-controlled group comparison studies is required to more accurately assess which cognitive domains are affected.

An active lifestyle throughout the life cycle seems to delay cognitive aging and dementia and has also been evaluated as an intervention against addiction to cocaine and other drugs of abuse. In epidemiological studies with humans, it has proved difficult to separate the cognitive, social and physical components from other variables that influence lifestyle. Studies in animal models are useful for evaluating the impact of each of these factors and for uncovering the underlying mechanisms of the benefits of complex environments. Preclinical studies have employed the Environmental Enrichment paradigm (EE) which has been proposed as a preclinical model of positive life experiences in humans. EE has been associated with protective effects against addiction to some drugs, but few studies have been carried out in order to evaluate how its actions interact with nicotine addiction. In this context, the main aim of this review is to provide an analysis of the preclinical studies evaluating the interaction between exposure to enriched environments with the neurobiological and behavioral effects of nicotine administration. These studies will contribute to the development of future preventive and therapeutic applications of enriched environments and positive experiences for drug addiction in human beings, taking into account individual vulnerability. They also may shed light on new approaches to the treatment of nicotine addiction, as interventions based in physical exercise in interaction with other environmental variables.

Objective: High rates of smoking and nicotine dependence have a profoundly negative impact on the health and well being of individuals with schizophrenia. Treating smoking is a critical step in improving the health and quality of life of people affected by this illness. This paper reviews the literature on smoking cessation interventions in schizophrenia and discusses potential barriers to effective treatment with this population.

Methods: The criteria used to select studies for inclusion were: (1) Sample included 50% or more individuals with schizophrenia spectrum diagnosis (SSD); (2) Some individual or group intervention for smoking cessation was provided; and (3) Some smoking-related outcome variable was measured (self-reported smoking, breath carbon monoxide, etc).

Results: Both pharmacologic and psychosocial smoking cessation treatments have been found to be useful in helping individuals with schizophrenia reduce and quit smoking in the short term. Few interventions have been found to be effective in promoting smoking abstinence in the long term.

Conclusions: Intervention development must include strategies to overcome barriers to smoking cessation that are most relevant to individuals with schizophrenia and focus on translating short term gains into long term abstinence.

Ghrelin is a gut-brain hormone that regulates energy balance through food consumption. While ghrelin is well known for its role in hypothalamic activation and homeostatic feeding, more recent evidence suggests that ghrelin also is involved in hedonic feeding through the dopaminergic reward pathway. This paper investigated how ghrelin administration (intraperitoneal, intracerebroventricular, or directly into dopaminergic reward-relevant brain regions) activates the dopaminergic reward pathway and associated reward-relevant behavioral responses in rodents. A total of 19 empirical publications that examined one or more of these variables were included in this review. Overall, ghrelin administration increases dopamine levels in the nucleus accumbens, as well as reward-relevant behaviors such as food (both standard chow and palatable foods) and alcohol consumption. Ghrelin administration also increases operant responding for sucrose, and conditioned place preference. Following a review of the small body of literature examining the effects of ghrelin administration on the dopamine reward pathway, we present a model of the relationship between ghrelin and dopaminergic reward activation. Specifically, ghrelin acts on ghrelin receptors (GHS-R1A) in the ventral tegmental area (VTA) and lateral dorsal tegmental nucleus (LDTg) to stimulate the mesolimbic dopamine reward pathway, which results in increased rewarding behaviors in rodents. Results from this review suggest that selective antagonism of the ghrelin system may serve as potential treatment for addictive drug use. This review highlights gaps in the literature, including a lack of examination of sex- or age-related differences in the effects of ghrelin on dopamine reward processes. In light of vulnerability to drug abuse among female and adolescent populations, future studies should target these individual difference factors.

Background: The hidden nature of the use of opioids, amphetamines, cocaine, and cannabis (the most commonly used and studied illicit drugs) precludes the accurate estimation of how many people use them and further important aspects of the use. Among the many aspects of drug use, the permanence times in specific drug using states related to the lifestyles of the various sub populations of users are of interest, per se, as essential components of estimates relating prevalence and incidence of drug use and for evaluating policies.

Methods: Several administrative databases and surveys collected in Italy and in different EU countries concerning different sub-populations of drug users were analysed to estimate the permanence time in a specific drug using state and the stages of a typical drug-using career.

Results: Cannabis is mostly the first illegal substance used. The age at onset corresponds to the very beginning of adolescence and various sources indicate that this onset happens earlier for men than for women. For problematic drug users, the switch from cannabis to heavy drugs happens within a rather narrow period of time, within 5-6 years from the first use of cannabis, along with the first episode of drug dealing. The latency period distribution estimated from different data sources is quite stable, with men presenting longer latency periods than women.

Conclusions: The comparative analysis of several data sources allowed a more complete overview of the different subpopulations on the drug scene and provides interesting data to understand and to estimate parameters for dynamic models of drug use.