scholarly journals Risk Assessment for Heroin Use and Craving Score Using Polygenic Risk Score

2021 ◽  
Vol 11 (4) ◽  
pp. 259
Author(s):  
Chieh-Liang Huang ◽  
Ping-Ho Chen ◽  
Hsien-Yuan Lane ◽  
Ing-Kang Ho ◽  
Chia-Min Chung
Keyword(s):  
Methadone Maintenance ◽  
University Hospital ◽  
Heroin Addiction ◽  
Polygenic Risk Score ◽  
Heroin Use ◽  
Risk Alleles ◽  
General Linear Regression Model ◽  
Reward Pathways ◽  
Genetic And Environmental Factors ◽  
Dose Response Effect

Addiction is characterized by drug-craving, compulsive drug-taking, and relapse, and results from the interaction between multiple genetic and environmental factors. Reward pathways play an important role in mediating drug-seeking and drug-taking behaviors, and relapse. The objective of this study was to identify heroin addicts who carry specific genetic variants in their dopaminergic reward systems. A total of 326 heroin-dependent patients undergoing methadone maintenance therapy (MMT) were recruited from the Addiction Center of the China Medical University Hospital. A heroin-use and craving questionnaire was used to evaluate the urge for heroin, the daily or weekly frequency of heroin usage, daily life disturbance, anxiety, and the ability to overcome heroin use. A general linear regression model was used to assess the associations of genetic polymorphisms in one’s dopaminergic reward system with heroin-use and craving scores. Results: The most significant results were obtained for rs2240158 in GRIN3B (p = 0.021), rs3983721 in GRIN3A (p = 0.00326), rs2129575 in TPH2 (p = 0.033), rs6583954 in CYP2C19 (p = 0.033), and rs174699 in COMT (p = 0.036). These were all associated with heroin-using and craving scores with and without adjustments for age, sex, and body mass index. We combined five variants, and the ensuing dose-response effect indicated that heroin-craving scores increased with the numbers of risk alleles (p for trend = 0.0008). These findings will likely help us to understand the genetic mechanism of craving, which will help in predicting the risk of relapse in clinical practice and the potential for therapies to target craving in heroin addiction.

Effectiveness of Methadone Maintenance for Heroin Addiction

1998 ◽  
Vol 83 (1) ◽  
pp. 295-302 ◽  
Author(s):  
John B. Murray
Keyword(s):  
New York ◽  
New York City ◽  
World War Ii ◽  
Methadone Maintenance ◽  
The United States ◽  
Heroin Addiction ◽  
World War ◽  
Heroin Use ◽  
Employment Support ◽  
The 1960S

Methadone maintenance programs have effectively reduced heroin dependency and are available in most countries affected by heroin addiction. Methadone, developed in Germany during World War II as a pain killer, does not have the euphoric effects of heroin and the goal of treatment is to substitute methadone for heroin use. Recidivism is probably a life-long risk. Methadone maintenance programs began in the 1960s in the United States in New York City. Once tolerance is developed, it may be used continually without harmful side effects. Dosage is important for effectiveness as are counseling, rehabilitation services, and employment support. Reduction in criminality and AIDS has been associated with methadone maintenance programs.

Association study of genetic polymorphisms in GABRD with treatment response and dose in methadone maintenance treatment

2021 ◽  
Author(s):  
Xiaohu Xie ◽  
Jun Gu ◽  
Dingding Zhuang ◽  
Xiaoyu Chen ◽  
Yun Zhou ◽  
...  
Keyword(s):  
Treatment Response ◽  
Methadone Maintenance Treatment ◽  
Maintenance Treatment ◽  
Methadone Maintenance ◽  
Methadone Treatment ◽  
Heroin Addiction ◽  
High Dose ◽  
Nucleotide Polymorphisms ◽  
Single Nucleotide ◽  
Delta Subunit

Aim: This study determined if gene variants in the GABA receptor delta subunit ( GABRD) are associated with treatment response and dose in methadone maintenance treatment (MMT) for heroin addiction. Materials & methods: A total of 286 MMT patients were recruited and divided into response and nonresponse groups based on retention time in therapy. A total of 177 responders were classified into low dose and high dose subgroups according to the stabilized methadone dose. Four (single nucleotide polymorphisms) SNPs (rs13303344, rs4481796, rs2376805 and rs2229110) in GABRD were genotyped using the TaqMan SNP assay. Logistic regression was used to assess the genetic effects of the SNPs in MMT. Results: No significant associations were observed between the SNPs and treatment response or dose, except the frequency of haplotype ACGC at the four SNPs significantly differed between responders and nonresponders. Conclusion: The results indicated that GABRD variants may play a small role in modulating methadone treatment response.

The Heroin Problem: Policy Alternatives in Dealing with Heroin Use

1974 ◽  
Vol 4 (1) ◽  
pp. 69-91 ◽  
Author(s):  
Robert E. Marks
Keyword(s):  
Methadone Maintenance ◽  
Cost Benefit Analysis ◽  
Cost Benefit ◽  
Detailed Comparison ◽  
Therapeutic Communities ◽  
Heroin Use ◽  
Policy Alternatives ◽  
The Social ◽  
The Individual ◽  
Heroin Maintenance

The paper examines the social and private aspects of heroin use in the U.S. today and attempts to estimate the associated costs, both society's and the individual user's. Possible goals of any government policy are discussed. Twelve possible policy alternatives are examined, eight dealing with the demand for heroin, and four dealing with its supply. These alternatives are compared using a rough cost-benefit analysis in terms of costs and benefits to society at large. A more detailed comparison is made of therapeutic communities, methadone maintenance, and the British experience of prescription heroin maintenance as alternatives. The conclusion is reached that to minimize social cost while containing the spread of heroin usage a scheme of prescription heroin should be implemented; but if the spread of usage is seen as benign, the best policy is to sell the drug freely to any adult as alcohol is today.

METHADONE AND CHILDREN

PEDIATRICS ◽  
1971 ◽  
Vol 48 (2) ◽  
pp. 173-175
Author(s):  
Saul Blatman
Keyword(s):  
United States ◽  
Urban Areas ◽  
Methadone Maintenance ◽  
The United States ◽  
Heroin Addiction ◽  
Analgesic Drug ◽  
Heroin Addicts ◽  
Near Future

The increasing use of methadone maintenance (substitution) programs1-3 in the treatment of adult heroin addiction has created situations for children which require the attention of pediatricians. Methadone is an analgesic drug. In urban areas, thousands of heroin addicts are now receiving high dosage of methadone, usually 80 to 120 mg daily. This approach to heroin addiction has met with greater success than any other form of treatment. It is expected that increasing numbers of heroin addicts will be treated in the near future by this method throughout the United States and Canada.4 Pediatricians should focus on three aspects of the problem as follows:

scholarly journals Setting up a methadone maintenance clinic in a hostel in London's West End

2006 ◽  
Vol 30 (9) ◽  
pp. 337-339
Author(s):  
John Dunn ◽  
David Robertson ◽  
Paul Davis ◽  
Babak Khosrawan ◽  
Suneel Christian
Keyword(s):  
Treatment Outcomes ◽  
Substance Misuse ◽  
Methadone Maintenance ◽  
Homeless People ◽  
Clinical Implications ◽  
Original Cohort ◽  
Heroin Use ◽  
The Past ◽  
Outreach Clinic ◽  
Set Up

Aims and MethodA satellite methadone prescribing service was set up in a hostel in London's West End. The aim was to investigate if it were feasible to engage and retain these hard-to-reach, chaotic, polydrug users in treatment. A basic needs assessment was undertaken with staff and clients at the hostel. Treatment outcomes were assessed at 16 weeks using the Maudsley Addiction Profile.ResultsAt 16 weeks 87% of the original cohort (26 out of 30) were still in treatment. There were also significant reductions in mean heroin use (from 29.7 to 14.5 out of the past 30 days, P<0.001) and in the frequency of injecting (from 25.9 to 15.9 days, P<0.001).Clinical ImplicationsThis outreach clinic offers a model for developing services to homeless people with substance misuse problems.

scholarly journals Further evidence for the association of GAL, GALR1 and NPY1R variants with opioid dependence

2020 ◽  
Vol 21 (13) ◽  
pp. 903-917
Author(s):  
Matthew Randesi ◽  
Orna Levran ◽  
Wim van den Brink ◽  
Peter Blanken ◽  
Jan M van Ree ◽  
...  
Keyword(s):  
Interaction Effect ◽  
Opioid Dependence ◽  
Methadone Maintenance ◽  
Heroin Dependence ◽  
Heroin Addiction ◽  
Drug Induced ◽  
Stress Related Genes ◽  
Stress Influences

Aim: Heroin addiction is a chronic, relapsing disease that has genetic and environmental, including drug-induced, contributions. Stress influences the development of addictions. This study was conducted to determine if variants in stress-related genes are associated with opioid dependence (OD). Patients & methods: One hundred and twenty variants in 26 genes were analyzed in 597 Dutch subjects. Patients included 281 OD in methadone maintenance with or without heroin-assisted treatment and 316 controls. Results: Twelve SNPs in seven genes showed a nominally significant association with OD. Experiment-wise significant associations (p < 0.05) were found for three SNP pairs, through an interaction effect: NPY1R/ GAL rs4691910/rs1893679, NPY1R/ GAL rs4691910/rs3136541 and GALR1/GAL rs9807208/rs3136541. Conclusion: This study lends more evidence to previous reports of association of stress-related variants with heroin dependence.

Factors associated with lapses to heroin use during methadone maintenance

1998 ◽  
Vol 52 (3) ◽  
pp. 183-192 ◽  
Author(s):  
David A Wasserman ◽  
Meryle G Weinstein ◽  
Barbara E Havassy ◽  
Sharon M Hall
Keyword(s):  
Methadone Maintenance ◽  
Heroin Use ◽  
Factors Associated

Clinical Efficacy of Acupuncture as an Adjunct to Methadone Treatment Services for Heroin Addicts: A Randomized Controlled Trial

2014 ◽  
Vol 42 (03) ◽  
pp. 569-586 ◽  
Author(s):  
Yuan-Yu Chan ◽  
Wan-Yu Lo ◽  
Tsai-Chung Li ◽  
Lih-Jong Shen ◽  
Szu-Nian Yang ◽  
...  
Keyword(s):  
Methadone Maintenance ◽  
Short Form ◽  
Controlled Trial ◽  
Scientific Evidence ◽  
Methadone Treatment ◽  
Sham Acupuncture ◽  
Opiate Dependence ◽  
Heroin Addiction ◽  
Daily Consumption ◽  
Heroin Addicts

Scant scientific evidence supports the efficacy of acupuncture in the treatment of opiate dependence. The purpose of this study was to examine the effectiveness of acupuncture for heroin addicts on methadone maintenance by measuring the daily consumption of methadone, variations in the 36-item Short Form Health Survey-36 (SF-36) and Pittsburgh Sleep Quality Index (PSQI) scores, and heroin craving. Sixty heroin addicts were randomly assigned to true acupuncture (electroacupuncture at the Hegu [LI4] and Zusanli [ST36] acupoints, as well as acupuncture at the Ear Shenmen) or sham acupuncture (minimal acupuncture at the Hegu and Zusanli acupoints without electrical stimulation and superficial acupuncture at the Ear Shenmen), twice weekly for 4 weeks. From week 2 onwards, the daily dose of methadone was reduced by a significantly greater amount with true acupuncture compared with sham acupuncture. True acupuncture was also associated with a greater improvement in sleep latency at follow-up. All adverse events were mild in severity. Acupuncture appears to be a useful adjunct to methadone maintenance therapy (MMT) in heroin addiction.

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