scholarly journals Neurobiology of opioid dependence in creating addiction vulnerability

F1000Research ◽  
2016 ◽  
Vol 5 ◽  
pp. 1748 ◽  
Author(s):  
Christopher J. Evans ◽  
Catherine M. Cahill
Keyword(s):  
Stressful Life Event ◽  
Physical Symptoms ◽  
Addictive Behaviors ◽  
Cellular Mechanisms ◽  
Opioid Drugs ◽  
The Usa ◽  
Drug Dependent ◽  
Neuronal Systems ◽  
Long Acting ◽  
Dependent State

Opioid drugs are potent modulators of many physiological and psychological processes. When given acutely, they can elicit the signature responses of euphoria and analgesia that societies have coveted for centuries. Repeated, or chronic, use of opioids induces adaptive or allostatic changes that modify neuronal circuitry and create an altered normality — the “drug-dependent” state. This state, at least that exhibited by those maintained continuously on long-acting opioid drugs such as methadone or buprenorphine, is generally indistinguishable from the drug-naïve state for most overt behaviors. The consequences of the allostatic changes (cellular, circuit, and system adaptations) that accompany the drug-dependent state are revealed during drug withdrawal. Drug cessation triggers a temporally orchestrated allostatic re-establishment of neuronal systems, which is manifested as opposing physiological and psychological effects to those exhibited by acute drug intoxication. Some withdrawal symptoms, such as physical symptoms (sweating, shaking, and diarrhea) resolve within days, whilst others, such as dysphoria, insomnia, and anxiety, can linger for months, and some adaptations, such as learned associations, may be established for life. We will briefly discuss the cellular mechanisms and neural circuitry that contribute to the opioid drug-dependent state, inferring an emerging role for neuroinflammation. We will argue that opioid addictive behaviors result from a learned relationship between opioids and relief from an existing or withdrawal-induced anxiogenic and/or dysphoric state. Furthermore, a future stressful life event can recall the memory that opioid drugs alleviate negative affect (despair, sadness, and anxiety) and thereby precipitate craving, resulting in relapse. A learned association of relief of aversive states would fuel drug craving in vulnerable people living in an increasingly stressful society. We suggest that this route to addiction is contributive to the current opioid epidemic in the USA.

scholarly journals Living With Neuroendocrine Tumors: Assessment of Quality of Life Through a Mobile Application

2019 ◽  
pp. 1-10 ◽  
Author(s):  
Jared R. Adams ◽  
David Ray ◽  
Renee Willmon ◽  
Sonia Pulgar ◽  
Arvind Dasari
Keyword(s):  
Quality Of Life ◽  
Neuroendocrine Tumors ◽  
Mobile Application ◽  
Somatostatin Analogs ◽  
Physical Symptoms ◽  
Measurement Information ◽  
Treatment Change ◽  
Patient Reported ◽  
Long Acting

PURPOSE To understand the quality of life (QoL) for patients with neuroendocrine tumors (NETs) through comparison of QoL questionnaires and symptom tracking as well as journaling via the Carcinoid NETs Health Storylines mobile application (app). PATIENTS AND METHODS This was a 12-week prospective, observational study of US patients with NET who were taking long-acting somatostatin analogs. National Institutes of Health Patient-Reported Outcomes Measurement Information System (PROMIS) and European Organisation for Research and Treatment of Cancer (EORTC) questionnaires were administered three times. Patients also monitored symptoms, mood, bowel movements, food, activity, and sleep, and they journaled in their app, which was coded by theme and sentiment for qualitative analysis. RESULTS Of the 120 patients with NET, 78% were women (mean age, 57 years); 76% had gastroenteropancreatic NETs, and 88% had metastases. Lanreotide depot and octreotide long-acting release (LAR) were used by 41% and 59%, respectively. The most common symptoms at baseline were fatigue (76.7%), diarrhea (62.5%), abdominal discomfort (64.1%), and trouble sleeping (57.5%). The majority completed five of six survey assessments (median, 5; mean, 5.1) and tracked four symptoms in the app (median, 4; mean, 5.5); the average frequency was 41.6 days for each symptom (median, 43; mean, 41.6; range, 1 to 84 days [12 weeks]). Without treatment change, most EORTC-assessed physical symptoms decreased from baseline to midpoint (eg, 59.3% at baseline v 33% at midpoint reported “quite a bit” or “very much” diarrhea; P = .002). App-based symptom tracking revealed large day-to-day variation, but weekly averages correlated well with survey scores. Journal entries showed that more patients made predominantly negative unsolicited entries about their injection experience with octreotide LAR compared with lanreotide (13 of 17 v two of 13; P < .001). CONCLUSION Patients with NET experience a large symptom burden that varies daily. A decrease in physical symptoms on QoL surveys suggests an effect from daily app-based monitoring or journaling, which may reduce recall bias and benefit the patient’s experience of symptoms.

The Role of Legal Coercion in the Treatment of Offenders with Alcohol and Heroin Problems

1997 ◽  
Vol 30 (2) ◽  
pp. 103-120 ◽  
Author(s):  
Wayne Hall
Keyword(s):  
Drug Treatment ◽  
Drug Dependence ◽  
Legal Coercion ◽  
Coerced Treatment ◽  
The Usa ◽  
Dependent Property ◽  
Drug Dependent ◽  
Drug Problems ◽  
Prison Populations

This article discusses the ethical justification for, and reviews the American evidence on the effectiveness of, treatment for alcohol and heroin dependence that is provided under legal coercion to offenders whose alcohol and drug dependence has contributed to the commission of the offence with which they have been charged or convicted. The article focuses on legally coerced treatment for drink-driving offenders and heroin-dependent property offenders. It outlines the various arguments that have been made for providing such treatment under legal coercion, namely: the over-representation of alcohol and drug dependent persons in prison populations; the contributory causal role of alcohol and other drug problems in the offences that lead to their imprisonment; the high rates of relapse to drug use and criminal involvement after incarceration; the desirability of keeping injecting heroin users out of prisons as a way of reducing the transmission of infectious diseases such as HIV and hepatitis; and the putatively greater cost-effectiveness of treatment compared with incarceration. The ethical objections to legally coerced drug treatment are briefly discussed before the evidence on the effectiveness of legally coerced treatment for alcohol and other drug dependence is reviewed. The evidence, which is primarily from the USA, gives qualified support for some forms of legally coerced drug treatment, provided that these programs are well resourced, carefully implemented, and their performance is monitored to ensure that they provide a humane and effective alternative to imprisonment. Expectations about what these programs can achieve also need to be realistic.

Cost effectiveness of long-acting risperidone injection versus alternative antipsychotic agents in patients with schizophrenia in the USA

2005 ◽  
Vol 23 (S1) ◽  
pp. 75-89 ◽  
Author(s):  
Natalie Christine Edwards ◽  
Julie C. Locklear ◽  
Marcia F. T. Rupnow ◽  
Ronald J. Diamond
Keyword(s):  
Cost Effectiveness ◽  
Antipsychotic Agents ◽  
The Usa ◽  
Long Acting

scholarly journals Frequency of 6-week follow-up appointment scheduling after intrauterine device insertion

2017 ◽  
Vol 44 (1) ◽  
pp. 33-36 ◽  
Author(s):  
Abigail Bernard ◽  
Catherine L Satterwhite ◽  
Madhuri Reddy
Keyword(s):  
Medical Center ◽  
Intrauterine Device ◽  
Value Added ◽  
University Of Kansas ◽  
Patient Demographics ◽  
The Usa ◽  
Long Acting ◽  
The University ◽  
Record Review

IntroductionLong-acting reversible contraception (LARC) is widely recommended to reduce unintended pregnancy in the USA. As intrauterine device (IUD) use increases, evaluating the role of post-insertion follow-up is important.MethodsA retrospective patient record review was conducted to assess the follow-up experience of women who had an IUD placed at the University of Kansas Medical Center from 1 January to 30 June 2015. Data were collected on patient demographics, IUD placement, follow-up visit attendance, and outcomes in the 12 months following placement. The primary outcome of interest was the proportion of patients who attended a 6-week follow-up visit. Secondary outcomes included adverse events detected at the 6-week visit and IUD removal within a year of placement.ResultsAmong 380 women who had an IUD inserted, physician documentation of a recommended 6-week follow-up visit was present in 91.3% of patient medical records. Two-thirds (66.6%) of patients receiving a recommendation returned for a follow-up visit. Of the 380 women who had an IUD placed, 66 (17.4%) had their IUD removed within 1 year of placement. Of those, 50 women attended the 6-week follow-up visit and 16 did not (19.8% vs 12.6%, p=0.08). Of the IUD removals, 14 occurred at the 6-week visit. After excluding IUD removals which occurred at the 6-week visit, attending a 6-week follow-up visit was not associated with IUD removal or retention (p=0.52).ConclusionDespite recommendations to forgo the 6-week follow-up visit, visits were still common, with no demonstrated value added.

scholarly journals Antipsychotic long-acting injections: Prescribing practice in the UK

2009 ◽  
Vol 195 (S52) ◽  
pp. s37-s42 ◽  
Author(s):  
Thomas R. E. Barnes ◽  
Amber Shingleton-Smith ◽  
Carol Paton
Keyword(s):  
Demographic Variables ◽  
High Dose ◽  
Clinical Settings ◽  
Audit Data ◽  
Younger Age ◽  
Prescribing Practice ◽  
The Usa ◽  
Oral Antipsychotic ◽  
Long Acting ◽  
The Uk

BackgroundData from the USA, Australia and Europe suggest that the proportion of patients with schizophrenia prescribed an antipsychotic long-acting injection (LAI) varies from around a quarter to a third. Use of LAIs has been associated with male gender and younger age.AimsTo characterise the use of LAIs in people with schizophrenia in three clinical settings in the UK.MethodThe study used audit data from quality improvement programmes conducted by the Prescribing Observatory for Mental Health.ResultsLong-acting injections were found to be prescribed for between a quarter and a third of patients, depending on the clinical setting. Flupentixol, risperidone and zuclopenthixol were most commonly prescribed and were combined with an oral antipsychotic in half of cases, frequently constituting high-dose prescribing. The use of LAIs was not consistently associated with age, gender or ethnicity.ConclusionsAntipsychotic LAIs are commonly prescribed. We did not replicate previous findings with respect to demographic variables associated with their use.

scholarly journals Effects of alpha, beta momorcharin fruit extract with the combination of Cyclophosphamide in the treatment of glioma cancer In-vivo

2021 ◽  
Vol 2 (1) ◽  
pp. 151-156
Author(s):  
Gunasekar Manoharan ◽  
Bhargava Gottam
Keyword(s):  
Cell Line ◽  
Xenobiotic Metabolism ◽  
Cellular Mechanisms ◽  
African Countries ◽  
Fruit Extract ◽  
The Usa ◽  
The Individual ◽  
And Oxidative Stress ◽  
Scientific Name

The vegetable Momordica charantia L., (family: Cucurbitaceae) is a scientific name of the plant and its fruit. It is also known by other names, for instance in the USA it is known as Bitter gourd or balsam pear while it’s referred to as the African cucumber in many African countries. M. charantia is believed to posse’s anti-carcinogenic properties and it can modulate its effect via xenobiotic metabolism and oxidative stress. This study was specifically designed to investigate the cellular mechanisms whereby α, β momorcharin an extract of M. charantia can induce cell death with the combination of Cyclophosphamide. Different concentration (200µM - 1000µM) of the α, β momorcharin fruit extract were treated (24 hrs incubation) separately with three different cancer cell lines 1321N1, Gos-3, U87-MG and normal L6 muscle cell line. The results also show that Cyclophosphamide (250 µg) with (1000 µM) of the α, β momorcharin extract of M. charantia, and result in significant decreases in cell viability for each cell line, these effects were additive compared to the individual effect of Cyclophosphamide.

scholarly journals Prolonged morphine exposure during adolescence alters the responses of lateral paragigantocellularis neurons to naloxone in adult morphine dependent rats

2021 ◽  
Vol 71 (1) ◽  
Author(s):  
Sara Sabuee ◽  
S. Mohammad Ahmadi-Soleimani ◽  
Hossein Azizi
Keyword(s):  
Adolescent Male ◽  
Neuronal Responses ◽  
Cellular Mechanisms ◽  
Unit Recording ◽  
Free Interval ◽  
Baseline Activity ◽  
Opioid Drugs ◽  
Male Wistar Rats ◽  
Excitatory Responses ◽  
Drug Free

Abstract Introduction Adolescence is a critical period in brain development, and it is characterized by persistent maturational alterations in the function of central nervous system. In this respect, many studies show the non-medical use of opioid drugs by adolescents. Although this issue has rather widely been addressed during the last decade, cellular mechanisms through which adolescent opioid exposure may induce long-lasting effects are not duly understood. The present study examined the effect of adolescent morphine exposure on neuronal responses of lateral paragigantocellularis nucleus to naloxone in adult morphine-dependent rats. Methods Adolescent male Wistar rats (31 days old) received increasing doses of morphine (from 2.5 to 25 mg/kg, twice daily, s.c.) for 10 days. Control subjects were injected saline with the same protocol. After a drug-free interval (20 days), animals were rendered dependent on morphine during 10 days (10 mg/kg, s.c., twice daily). Then, extracellular single-unit recording was performed to investigate neural response of LPGi to naloxone in adult morphine-dependent rats. Results Results indicated that adolescent morphine treatment increases the number of excitatory responses to naloxone, enhances the baseline activity and alters the pattern of firing in neurons with excitatory responses in adult morphine-dependent rats. Moreover, the intensity of excitatory responses is reduced following the early life drug intake. Conclusion It seems that prolonged opioid exposure during adolescence induces long-lasting neurobiological changes in LPGi responsiveness to future opioid withdrawal challenges.

Risk factors associated with driving under the influence of drugs in the USA

2020 ◽  
pp. injuryprev-2020-044015
Author(s):  
Toni Marie Rudisill ◽  
Gordon S Smith
Keyword(s):  
Risk Factors ◽  
Survey Design ◽  
Driving Under The Influence ◽  
Health Concern ◽  
Mental Health Issue ◽  
Factors Associated ◽  
Lifestyle Behaviours ◽  
The Usa ◽  
Drug Dependent ◽  
Reported Data

BackgroundDriving under the influence of drugs (DUID) is a burgeoning public health concern in the USA. Because little is known about individuals who engage in DUID, the purpose of this study was to analyse potential sociodemographic characteristics and behavioural risk factors associated with the behaviour.MethodsSelf-reported data from drivers ≥18 years of age who ever used drugs and participated in the 2018 National Survey on Drug Use and Health were used. Characteristics of those who reported to engage and not engage in DUID were compared via frequencies, percentages and logistic regression analyses, which accounted for the multistage survey design.ResultsAmong eligible respondents, 10.4% (weighted n=117 275 154) reported DUID. DUID was higher among those aged 18–25 year (34%), males (65%), unmarried individuals (61%), lesbian/gay/bisexuals (13%), those whom abused or were drug dependent (45%), engaged in numerous risky lifestyle behaviours (12%) and those taking medication for a mental health issue (22%). Nearly 20% and 6% of respondents engaged in DUID abused or were dependent on marijuana or methamphetamine, respectively. The adjusted odds of DUID were greatest among those 18–25 years of age (OR 3.7; 95% CI 2.8 to 5.0), those never/not married (OR 1.8; 95% CI 1.5 to 2.2), those who abused or were drug dependent (OR 4.0; 95% CI 3.5 to 4.7), exhibited riskier lifestyle behaviours (OR 8.0; 95% CI 5.9 to 11.0), were employed (OR 1.3; 95% CI 1.1 to 1.6) or lesbian/gay/bisexuals (OR 1.4; 95% CI 1.1 to 1.7).ConclusionsDUID was common among some population sub-groups who may benefit from intervention.

scholarly journals Long-Acting Glucagon-Like Peptide-1 Receptor Agonists Suppress Voluntary Alcohol Intake in Male Wistar Rats

2020 ◽  
Vol 14 ◽  
Author(s):  
Vincent N. Marty ◽  
Mehdi Farokhnia ◽  
Joseph J. Munier ◽  
Yatendra Mulpuri ◽  
Lorenzo Leggio ◽  
...  
Keyword(s):  
Wistar Rats ◽  
Alcohol Intake ◽  
Ethanol Intake ◽  
Addictive Behaviors ◽  
Gut Hormone ◽  
Male Wistar Rats ◽  
Glucagon Like Peptide ◽  
Glucagon Like Peptide 1 ◽  
Long Acting ◽  
Alcohol Seeking

Alcohol use disorder (AUD) is a chronic relapsing condition characterized by compulsive alcohol-seeking behaviors, with serious detrimental health consequences. Despite high prevalence and societal burden, available approved medications to treat AUD are limited in number and efficacy, highlighting a critical need for more and novel pharmacotherapies. Glucagon-like peptide-1 (GLP-1) is a gut hormone and neuropeptide involved in the regulation of food intake and glucose metabolism via GLP-1 receptors (GLP-1Rs). GLP-1 analogs are approved for clinical use for diabetes and obesity. Recently, the GLP-1 system has been shown to play a role in the neurobiology of addictive behaviors, including alcohol seeking and consumption. Here we investigated the effects of different pharmacological manipulations of the GLP-1 system on escalated alcohol intake and preference in male Wistar rats exposed to intermittent access 2-bottle choice of 10% ethanol or water. Administration of AR231453 and APD668, two different agonists of G-protein receptor 119, whose activation increases GLP-1 release from intestinal L-cells, did not affect voluntary ethanol intake. By contrast, injections of either liraglutide or semaglutide, two long-acting GLP-1 analogs, potently decreased ethanol intake. These effects, however, were transient, lasting no longer than 48 h. Semaglutide, but not liraglutide, also reduced ethanol preference on the day of injection. As expected, both analogs induced a reduction in body weight. Co-administration of exendin 9-39, a GLP-1R antagonist, did not prevent liraglutide- or semaglutide-induced effects in this study. Injection of exendin 9-39 alone, or blockade of dipeptidyl peptidase-4, an enzyme responsible for GLP-1 degradation, via injection of sitagliptin, did not affect ethanol intake or preference. Our findings suggest that among medications targeting the GLP-1 system, GLP-1 analogs may represent novel and promising pharmacological tools for AUD treatment.

Troubled Teens: Managing Disorders of Transition and Consumption

1997 ◽  
Vol 55 (1) ◽  
pp. 4-21 ◽  
Author(s):  
Christine Griffin
Keyword(s):  
Young People ◽  
Research Literature ◽  
Late Nineteenth Century ◽  
Specific Class ◽  
Full Time ◽  
Treatment Regimes ◽  
Youth Research ◽  
The Usa ◽  
The Moment ◽  
Dependent State

This article focuses on the representation of youth as a key moment of transition in contemporary western societies, set between the dependent state of childhood and the supposed maturity and independence of adult status. Young people are viewed as gendered, racialized and sexualized beings who also occupy specific class locations, and are assumed to move through crucial points of transition as they leave full-time education and enter the job market, as well as the (hetero)sexual and marriage marketplaces. The article examines some of the main discursive configurations and treatment regimes through which ‘troubled teens’ are constructed and managed, especially in relation to notions about disordered patterns of consumption and transition. The paper considers the moment of the ‘discovery’ of adolescence in the late nineteenth century, going on to examine young women's particular relationships to discourses around consumption in the contemporary British youth research literature, and to debates about ‘disrupted transitions’ and citizenship in the 1990s. The article ends with a brief examination of one approach to the ‘problem of troubled teens’ in the USA: Specialty Schools that offer a combination of educational, therapeutic and correctional regimes aimed at young people who have been identified in relation to various disorders of transition and consumption.

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