Journal of addiction research & therapy最新文献

In accord with the new definition of addiction published by American Society of Addiction Medicine (ASAM) it is well-known that individuals who present to a treatment center involved in chemical dependency or other documented reward dependence behaviors have impaired brain reward circuitry. They have hypodopaminergic function due to genetic and/or environmental negative pressures upon the reward neuro-circuitry. This impairment leads to aberrant craving behavior and other behaviors such as Substance Use Disorder (SUD). Neurogenetic research in both animal and humans revealed that there is a well-defined cascade in the reward site of the brain that leads to normal dopamine release. This cascade has been termed the "Brain Reward Cascade" (BRC). Any impairment due to either genetics or environmental influences on this cascade will result in a reduced amount of dopamine release in the brain reward site. Manipulation of the BRC has been successfully achieved with neuro-nutrient therapy utilizing nutrigenomic principles. After over four decades of development, neuro-nutrient therapy has provided important clinical benefits when appropriately utilized. This is a review, with some illustrative case histories from a number of addiction professionals, of certain molecular neurobiological mechanisms which if ignored may lead to clinical complications.

Objective: To examine the relative prevalence of marijuana and tobacco use among low-income post-partum women, using self-report, urine, and hair testing data; and to further explore perceptions of the substances among postpartum women by evaluating perceived risk and monetary cost of prenatal marijuana versus tobacco use.

Methods: Data from two studies were available for a total of 100 (Study 1) and 50 (Study 2) low-income, primarily African-American post-partum women. Study 1 participants completed brief self-report measures of substance use as well as urine and hair samples; study 2 participants completed a brief opinion survey regarding the risks and monetary costs of prenatal marijuana use.

Results: In Study 1, the self-reported prevalence of any tobacco or marijuana use in the past three months was 17% and 11%, respectively. However, objectively-defined marijuana use was more prevalent than self-reported tobacco use: 14% tested positive for marijuana by urinalysis, and 28% by hair analysis. Study 2 participants were more likely to believe that there is a safe level of marijuana use during pregnancy, and nearly half believed that using marijuana during pregnancy was less expensive than smoking cigarettes.

Conclusion: Marijuana use may be as or more prevalent than tobacco use among low-income, African-American pregnant women. These findings may in part be attributable to perceptions of roughly equivalent cost and the lack of a clear public health message regarding prenatal marijuana use, combined with growing pro-marijuana advocacy. A broader public health response to address prenatal marijuana use, along with other substances of abuse, is needed.

Nicotine addiction is a complex process that begins with self-administration. Consequently, this process has been studied extensively using animal models. A person is usually not called "smoker" if s/he has smoked for a week or a month in a lifetime; in general, a smoker has been smoking for many years. Furthermore, a smoker has free access to cigarettes and can smoke whenever she/he wants, provided there are no social/legal restraints. Subsequently, in an animal model of tobacco addiction, it will be desirable to expose the animal to free access nicotine for 24 hours/day for many weeks, starting at different stages of development.

Background: The development of alcohol use disorders is genetically influenced, and may be mediated through differences in the subjective response to alcohol. There is some evidence to suggest that response differences to alcohol could be conveyed by heritable differences in GABA_A receptors. The purpose of this study was to investigate whether individuals with a family history positive (FHP) for alcohol dependence would experience alterations in response to the GABA_A receptor agonist thiopental, in comparison to family history negative (FHN) subjects.

Methods: 73 subjects (24 FHP and 49 FHN) between the ages of 21 and 30 years were administered sub-anesthetic doses of the GABA_A receptor agonist thiopental and placebo on two separate test days. Various alcohol-related measures were administered, including those examining subjective effects, coordination, and cognition.

Results: Sub-anesthetic doses of thiopental produced alcohol-like subjective effects, as well as alcohol-like impaired coordination and cognition in healthy subjects. While there were no significant main effects in subjective, coordination, or cognitive effects between FHP and FHN individuals, analysis of peak effects suggested FHP had blunted sedative, but not stimulant effects compared to FHN.

Conclusion: Thiopental produced alcohol-like effects and perceived similarities to alcohol in healthy individuals. Subtle differences in sedative effects are consistent with reports of blunted FHP response to the negative but not stimulant effects of alcohol. Future studies are needed to better understand how this insight informs our understanding of the heritable risk for alcoholism and the treatment of alcohol use disorders.

A(2A) receptor antagonists have been proposed as therapeutic tools for dopaminergically-relevant diseases, including Parkinson's disease and substance dependence. The acute subjective and cardiovascular effects of a novel, selective adenosine A(2A) receptor antagonist (SYN115) were examined. Across an 8-hour experimental testing day, 22 non-treatment seeking cocaine-dependent subjects received either placebo capsules (PO) at both the AM and PM dosing times (Plc/Plc, N = 9), or placebo in the AM and 100 mg SYN115 in the PM (Plc/SYN115, N =13). Cardiovascular measures (HR, BP) were obtained across the test day, and subjective effects (ARCI, VAS) were obtained once before and once after the AM and PM doses (four time points total). There were no between-group effects on cardiovascular function, however subjective effects consistent with stimulation were observed on the VAS scales in the SYN115 group. In cocaine-dependent subjects, SYN115 may produce stimulant-like effects through a unique mechanism of action. Due to known monoamine dysfunction related to chronic cocaine use, these effects may be specific to this population relative to healthy control or other patient populations.

Events evoke seamlessly integrated stimulus evaluation and response preparation processing streams, guided by regulative functions that change behavior flexibly in accord with the internal goals and contextual demands. The neural basis of the effects of alcohol intoxication on these processing streams is poorly understood, despite the evidence of alcohol's deleterious effects on both attention and motor control. In an attempt to separate and examine relative susceptibility of these two dimensions, we employed a color version of the Eriksen flanker task that manipulated compatibility at the stimulus- and response-processing levels. Functional magnetic resonance imaging (fMRI) was performed in healthy social drinkers as they participated in both alcohol (0.6 g/kg ethanol for men, 0.55 g/kg for women) and placebo conditions in a counterbalanced design. Alcohol increased reaction times to response-level incongruity and decreased accuracy overall. Relative to the no-conflict condition, the observed brain activity was predominantly evoked by response-related conflict in medial prefrontal and lateral prefrontal cortices under placebo, in agreement with extensive evidence of their role in conflict processing. Activity evoked by response incongruity in the medial frontal cortex and insula was insignificant under alcohol, indicating its interference with response inhibition and preparation. Conversely, activity in ventrolateral prefrontal and premotor areas was relatively greater under alcohol than placebo, suggesting their compensatory engagement. This finding is consistent with the compensatory prefrontal activity increase found in studies with chronic alcoholic individuals, indicating functional reorganization with a goal of optimizing response strategy. These results delineate functional differences and selective susceptibility of a prefrontal network subserving response-level conflict processing. Our findings are incompatible with notions that moderate alcohol primarily affects attentional or stimulus-related processing and argue instead that its primary influence is on response inhibition, selection, and execution, with ramifications for the models of behavioral self-control and the inability to refrain from drinking.

AIMS: To examine whether smoking habits, nicotine dependence (ND) and plasma cotinine levels differ by diurnal type. DESIGN: Data originated from the national FINRISK 2007 survey. Regression analyses were calculated to examine the association between diurnal type and smoking status, ND, and nicotine intake. PARTICIPANTS: 7091 FINRISK participants with smoking and diurnal type information and a subset of 1746 ever smokers with detailed smoking, and ND assessments. MEASUREMENTS: Diurnal type assessed with a six-item sum scale was categorized as morning, intermediate and evening type. Smoking status was determined as current (daily or occasional), former, and never smokers. ND was measured with the Fagerström Test for Nicotine Dependence (FTND), the Hooked on Nicotine Checklist (HONC), and the Nicotine Dependence Syndrome Scale (NDSS). For current smokers, plasma cotinine was analyzed as biochemical measurement of nicotine intake. FINDINGS: Evening type was associated with current smoking (OR=1.66, 95% CI 1.40, 1.97). A significant association with diurnal type was seen for FTND among men (beta= -0.46, 95% CI -0.72, -0.21), sexes combined for HONC (beta= -0.31, 95% CI -0.52, -0.11) and NDSS (beta= -0.86, 95% CI -1.43, -0.29) and for cotinine among men (beta= -0.73, 95% CI -1.16, -0.29). Adjustment for depressive symptoms attenuated the association of diurnal type with NDSS to be non-significant. CONCLUSIONS: Diurnal type was associated with multiple ND measures and nicotine intake, interestingly more so among men. Evening type persons are at higher risk of dependence, but depressive symptoms attenuates this association clearly.

Alcohol dependence is characterized as a multi-factorial disorder caused by a complex interaction between genetic and environmental liabilities across development. A variety of neurocognitive deficits/dysfunctions involving impairments in different brain regions and/or neural circuitries have been associated with chronic alcoholism, as well as with a predisposition to develop alcoholism. Several neurobiological and neurobehavioral approaches and methods of analyses have been used to understand the nature of these neurocognitive impairments/deficits in alcoholism. In the present review, we have examined relatively novel methods of analyses of the brain signals that are collectively referred to as event-related oscillations (EROs) and show promise to further our understanding of human brain dynamics while performing various tasks. These new measures of dynamic brain processes have exquisite temporal resolution and allow the study of neural networks underlying responses to sensory and cognitive events, thus providing a closer link to the physiology underlying them. Here, we have reviewed EROs in the study of alcoholism, their usefulness in understanding dynamical brain functions/dysfunctions associated with alcoholism as well as their utility as effective endophenotypes to identify and understand genes associated with both brain oscillations and alcoholism.

In this review, I examine the definition, etiology, measurement, prevention and treatment of workaholism, based on a systematic search of the literature. While there is some debate regarding the parameters of the concept, viewed as a negative consequential addiction, workaholism involves excessive time spent working, preoccupation with work to the exclusion of other life domains, loss of control over the parameters of one's work and disenchantment with work, and negative social, emotional, and health consequences. The etiology of workaholism is not clear but may pertain to persons with compulsive personality traits, who are driven to work harder than that demanded from work contexts, and who have learned to place work as a main means of gratification compared to other lifestyle alternatives. Most measurement approaches rely on self-report questionnaires, tested primarily with convenience samples. Refinement of current assessments is ongoing. Prevention and treatment implications are discussed, which include intra- and extra-personal level approaches. Finally, limitations of the work completed in this arena are mentioned and needed future research directions are suggested.

Objectives: The primary aim of this article is to review literature regarding the relationship between substance use and HIV transmission in Peru.

Methods: Detailed search of published literature completed in PubMed and Google-Scholar and other local Peruvian publications. Mesh words: "Peru"; "substance-related-disorders"; "HIV"; "sexual-behavior" and their combinations. From 3921 articles, 150 were chosen for more careful review and only 26 were used for the review. No date limit was used in this review.

Results: Peruvian HIV epidemic is limited to MSM and its prevalence goes up to 33% in certain MSM-subpopulations. Transmission is mainly through sexual contact. Drug use doubled the risk for casual sex, decreased by half the chances of using condoms, increased the number of partners per year and the risk for STD's. Peruvian HIV-positive populations have higher rates drug use and using drugs have been associated with a higher prevalence of being HIV-positive. This may be also true for other populations such as pregnant women in which there is an association between drug use and HIV.

Conclusions: Although the amount of Peruvian research in this area limits the review, there seems to be a relationship between using drugs, having risky-sexual-behaviors and being HIV positive in Peru. HIV-prevention strategies for Peruvians must address the link between sex and substance use.