scholarly journals Prevention of Opioid Addiction

2021 ◽  
Vol 2 (8) ◽  
pp. 731-740
Author(s):  
Stephanie A Ihezie ◽  
Nachum Dafny

Opioid addiction is classified as a Substance Use Disorder (SUD), a complex and chronic health condition with physical, social, and psychological consequences. While there is no cure for it, we present a novel approach towards preventing a hallmark feature of addiction-- the opiate withdrawal syndrome. Opioids exert numerous effects, acutely and chronically, on the nervous system with physical dependence, tolerance, and withdrawal being the most adverse chronic features. The degree of opioid dependence can be quantified by the frequency and/or intensity of the behavioral expression of withdrawal seen after abrupt termination of opioid consumption or after treatment with an opioid antagonist such as naloxone. Although the Central Nervous System (CNS) is the primary area of opioid impact, the involvement of the immune system in modifying CNS phenomena was suggested nearly two centuries ago and proved by several groups within the last few decades. Through a series of studies with immunomodulators alpha interferon, cyclosporine A, and cortisol, preclinical experiments show that administration of these agents prior to chronic morphine exposure prevents the expression of opiate withdrawal a hallmark feature of addiction. This review provides updates on current developments in the management of the opioid epidemic and an overview of studies on preventative immunomodulation prior to repetitive opioid administration as a means of addressing one of the underlying symptomatology driving the epidemic.

Author(s):  
Т.П. Ветлугина ◽  
Е.В. Матафонова ◽  
Н.А. Бохан ◽  
В.Б. Никитина ◽  
А.И. Мандель ◽  
...  

Цель исследования: изучение динамики показателей иммунитета и уровня кортизола у больных опийной наркоманией в процессе терапии синдрома отмены. Методика. В исследование включено 136 больных опийной наркоманией (инъекции экстракта опия) с сформировавшейся физической зависимостью. Пациенты получали в стационаре стандартную терапию с полной отменой наркотика. Исследование проводилось на следующих этапах: при поступлении в стационар (опийный абстинентный синдром - ОАС); на 5-7-е сут. терапии (переход в постабстинентное состояние - ПАС); на 25-28-е сут. лечения (становление терапевтической ремиссии - СТР). Лабораторные методы включали определение количества лимфоцитов с рецепторами CD3, CD4, CD8, СD16, с рецепторами к дофамину (D-RFC); содержание иммуноглобулинов М, G, А, уровня кортизола и циркулирующих иммунных комплексов (ЦИК) в сыворотке крови. Результаты. Основной иммуноэндокринный паттерн на всех этапах терапии синдрома отмены характеризуется дефицитом субпопуляций Т-лимфоцитов CD3, CD4, СD8; увеличением числа лимфоцитов с рецепторами к дофамину (D-RFC); активацией гуморальных факторов иммунитета (IgM, IgG, ЦИК); высокой концентрацией кортизола. На этапе ОАС и ПАС эти изменения были наиболее выражены; на 25-28-е сут. лечения отмечена позитивная динамика Т-лимфоцитов СD3 и цитотоксических Т-лимфоцитов (СD8); хелперы/индукторы CD4 оставались устойчиво сниженными; D-RFC лимфоциты, параметры гуморального иммунитета и концентрация кортизола - повышенными. Длительный срок наркотизации при употреблении высоких доз наркотика связан с большей выраженностью нарушений. Заключение. Установленная дизрегуляция параметров иммуноэндокринной системы у больных опийной наркоманией на всех этапах терапии синдрома отмены в наблюдаемые сроки (25-28 сут.) свидетельствует о неустойчивости достигнутой терапевтической ремиссии и необходимости проведения дальнейших реабилитационных мероприятий. The purpose: investigate changes in immunity parameters and cortisol level in subjects with opiate addiction during the treatment of opiate withdrawal syndrome. Methods. The study enrolled 136 subjects with opiate addiction with physical dependence receiving injections of opium extract. Patients received conventional therapy with complete opiate withdrawal. The study was performed at the following stages: at admission to the hospital (acute withdrawal syndrome (AWS); on days 5-7 of therapy (transition into post-withdrawal state - PWS); on days 25-28 of therapy (formation of therapeutic remission - FTR). Laboratory methods included determination count of lymphocytes with receptors CD3, CD4, CD8, СD16, with receptors to dopamine (D-RFC); the serum levels of IgМ, IgG, IgА, cortisol, circulating immune complexes (CIC). Results. The principal immunoendocrine pattern for all stages of withdrawal syndrome therapy is characterized in comparison to the reference normal values quantitative deficit of CD3, CD4, СD8 Т-lymphocyte subpopulations, increased count of lymphocytes with receptors to dopamine, activation of humoral immunity factors (IgM, IgG, CIC), high cortisol level. At AWS and PAS stages such changes are most pronounced; on days 25-28 of therapy positive changes in cytotoxic Т-lymphocytes (СD8) and Т-lymphocytes СD3 was revealed. CD4 count remained steadily reduced, count of lymphocytes with receptors to dopamine and cortisol level were elevated. Clinical and immunological analysis demonstrated that consumption of high opiate doses, long-term narcotization are associated with higher intensity of disorders detected. Conclusion. Dysregulation of immunoendocrine parameters was revealed in subjects with opiate addiction at all stages of withdrawal syndrome therapy within the term observed evidencing instability of therapeutic remission achieved and necessity in further rehabilitation events.


1977 ◽  
Vol 05 (01) ◽  
pp. 25-30 ◽  
Author(s):  
Gregory S. Chen

From the results of clinical and basic research, there is clear evidence the acupuncture analgesia is closely associated with the nervous system, especially the central nervous system. Stimulation of certain acupuncture loci which have been used for analgesia during operations aslo can calm the withdrawal symptoms of morphine and heroin addicts. Acupuncture analgesia can be antagonized by the specific narcotic antagonist, naloxone. These findings suggest the factor or factors produced by acupuncture stimulation would also have agonist activity on opiate receptors. Moreover, the morphine receptors are most concentrated in those parts of the brain concerned with preception of pain and the pathway of acupuncture stimulation. Since the opiate receptors are associated with the synaptic fraction of brain cell membrane preparations, the natural ligand of these receptors may be a neuro-transmitter. Enkephalin has stronger binding affinity to opiate receptors than morphine, which suggests that it is the natural ligand for these receptors. In other words, enkephalin might be the natural "pain killer" produced in the brain to suppress pain. If we summate all the information available now, it is possible to suggest that enkephalin may be the product of the nervous system released by acupuncture stimulation to create an analgesic effect as well as suppress opiate withdrawal symptoms.


2019 ◽  
Vol 41 (5) ◽  
pp. 20-24 ◽  
Author(s):  
Marianne Menictas ◽  
Mashfiqui Rabbi ◽  
Predrag Klasnja ◽  
Susan Murphy

It is likely that you or someone you know is affected by a chronic health condition. For example, a staggering six in 10 adults in the USA are currently suffering from a chronic disease (National Center for Chronic Disease Prevention and Health Promotion, 2019). Unfortunately, chronic conditions are not treatable overnight, but they can often be improved by regular incorporation of preventative behaviours (e.g., taking medication, healthy sleeping habits, being physically active, healthy eating, etc.). However, due to the many contingencies that arise in our lives, regular incorporation of healthy behaviours is difficult, and often when we need help in enacting these behaviours, support from clinical professionals is not available.


2021 ◽  
Vol 2 ◽  
Author(s):  
Linda Nguyen ◽  
Hanae Davis ◽  
Samantha Bellefeuille ◽  
Jessica Havens ◽  
Susan M. Jack ◽  
...  

Background: As children and adolescents with a chronic health condition (CHC) age and transition to adulthood, many will increasingly assume responsibilities for the management of their healthcare. For individuals with CHCs, family members including siblings often provide significant and varied supports. There are a range of resources in Canada to support siblings of individuals with a CHC, but these resources are not synthesized and the extent to which they relate to healthcare management remains unclear.Purpose: The purpose of this document review was to identify, describe, and synthesize the types of resources currently available to provide general information and healthcare management information about how siblings can provide support to individuals with CHCs in Canada.Methods: Print and electronic resources were systematically identified and retrieved from the websites of organizations, treatment centers, and children's hospitals that are part of Children's Healthcare Canada. Each unique resource was treated as a text document. Documents that met the following inclusion criteria were included: addressed the topic of siblings of individuals with a CHC and written in English. Data were extracted from included documents and qualitative conventional content analysis was conducted. Throughout the process of this review, we partnered with a Sibling Youth Advisory Council.Results: The systematic search yielded 1,628 non-duplicate documents, of which 163 documents met the inclusion criteria. Of the total of 163 documents, they were delivered in the following formats: 17 (10%) general informational products (e.g., booklets, videos) about a CHC and sibling relationships, 39 about support programs and workshops (24%), 34 news articles (21%) that described the roles of siblings, and 6 (3%) healthcare management informational products (e.g., toolkit, tipsheets), 31 blogs (19%) and 39 interviews (24%) with parents and siblings. In the blogs and interviews, siblings and parents described how siblings developed knowledge and skills for healthcare management, as well as their role and identity over time.Significance: This study identified that there are limited resources available about healthcare management for siblings of CHC in Canada. Resources are needed to facilitate conversations in the family about the role of siblings with healthcare management of their sibling with a CHC.


2021 ◽  
Author(s):  
Louben Dorval ◽  
Brian I. Knapp ◽  
Olufolake A. Majekodunmi ◽  
Sophia Eliseeva ◽  
Jean M Bidlack

As a result of the opioid epidemic, there is a desire to identify new targets for treating opioid use disorder. Previous studies showed that fibroblast growth factor 21 (FGF21) decreased alcohol and sweet preference in mice. In this study, FGF21-transgenic (FGF21-Tg) mice, expressing high FGF21 serum levels, and wildtype (WT) C57BL/6J littermates were treated with morphine and saline to determine if differences exist in their physiological and behavioral responses to opioids. FGF21-Tg mice displayed reduced preference for morphine in the conditioned place preference assay compared to WT littermates. Similarly, FGF21-Tg mice had an attenuation of the magnitude and rate of acute morphine antinociceptive tolerance development, and acute and chronic morphine physical dependence, but exhibited no change in chronic morphine antinociceptive tolerance. The ED50 values for morphine-induced antinociception in the 55-degree C hot plate and the 55-degree C warm-water tail withdrawal assays were similar in both strains of mice. Likewise, FGF21-Tg and WT littermates had comparable responses to morphine-induced respiratory depression. Overall, FGF21-Tg mice had an attenuated preference for morphine, a reduced development of morphine-induced dependence, and a reduction in the development of acute morphine antinociceptive tolerance. FGF21 and its receptor have therapeutic potential for reducing opioid withdrawal symptoms and craving, and augmenting opioid therapeutics for acute pain treatment.


2015 ◽  
Vol 25 (5) ◽  
pp. 462-474 ◽  
Author(s):  
M. A. Ferro

Background.Despite the considerable physical, emotional and social change that occurs during emerging adulthood, there is little research that examines the association between having a chronic health condition and mental disorder during this developmental period. The aims of this study were to examine the sex-specific prevalence of lifetime mental disorder in an epidemiological sample of emerging adults aged 15–30 years with and without chronic health conditions; quantify the association between chronic health conditions and mental disorder, adjusting for sociodemographic and health factors; and, examine potential moderating and mediating effects of sex, level of disability and pain.Method.Data come from the Canadian Community Health Survey-Mental Health. Respondents were 15–30 years of age (n = 5947) and self-reported whether they had a chronic health condition. Chronic health conditions were classified as: respiratory, musculoskeletal/connective tissue, cardiovascular, neurological and endocrine/digestive. The World Health Organization Composite International Diagnostic Interview 3.0 was used to assess the presence of mental disorder (major depressive disorder, suicidal behaviour, bipolar disorder and generalised anxiety disorder).Results.Lifetime prevalence of mental disorder was significantly higher for individuals with chronic health conditions compared with healthy controls. Substantial heterogeneity in the prevalence of mental disorder was found in males, but not in females. Logistic regression models adjusting for several sociodemographic and health factors showed that the individuals with chronic health conditions were at elevated risk for mental disorder. There was no evidence that the level of disability or pain moderated the associations between chronic health conditions and mental disorder. Sex was found to moderate the association between musculoskeletal/connective tissue conditions and bipolar disorder (β = 1.71, p = 0.002). Exploratory analyses suggest that the levels of disability and pain mediate the association between chronic health conditions and mental disorder.Conclusions.Physical and mental comorbidity is prevalent among emerging adults and this relationship is not augmented, but may be mediated, by the level of disability or pain. Findings point to the integration and coordination of public sectors – health, education and social services – to facilitate the prevention and reduction of mental disorder among emerging adults with chronic health conditions.


Author(s):  
Tianyao Zhang ◽  
Xiaoyan He ◽  
Lijuan Wu ◽  
Xianrong Feng ◽  
Yu Yang ◽  
...  

Opioid addiction is a chronic brain disorder characterized by a series of withdrawalsymptoms in behavioral, psychological, and neurobiological manifestations.Withdrawal symptoms are the main causeof relapse after periods of abstinence; thus,the treatment is focused on abstinence symptoms. Due to most of all types of opioidagonist drugs carry a potential for addiction and exacerbation of withdrawalsymptoms, nondrug methods have great potentials i n clinical applications.Electro acupuncture (EA), as a novel nonpharmacological approach, combined withmethadone has a long term positive efficacy on treating addict ion . Therefore, we designed a protocol to evaluate the adjuvant effect of EA for treating withdrawalsymptoms of opioid addiction addiction.MethodTo review reports of relevant clinical trials, we will searchEnglish language databases(EMBASE, PubMed, and the Cochrane Central Register of Controlled Trials) andChinese databases (Chinese Biomedical Lit eratures, China National KnowledgeInfrastructure, Wanfang, and VIP). We will collect documents from the earliestpossible date up t to May 2020. We will also search online trial registries such as ClinicalTrials.gov (ClinicalTrials.gov/), the European Medicine Agency(www.ema.europa.eu/ema/), and WHO International Clinical Trials Registry Platform(www.who.int/ictrp). We will select randomized controlled trials RCT forwithdrawal from opioid addiction involving EA methadone and methadone alonetreatment. W e will use psychological assessment scales to evaluate treatment majoroutcomes which include numerous components such as OWS, VAS, HAMD, HAMA;then u rinalysis and m ethadone dosage also will be measure as the additional outcomes.Finally, RevMan5 software will be used for literature quality evaluation and dataana lysis.Result: To evaluate the efficacy of EA in combination therapy by observing the outcomes of corresponding scale, urinalysis and decreasing methadone.Conclusion: This protocol will be used to evaluate the efficacy and safety of EA in combination with methadone in treatment of opioid addiction withdrawal symptomsAbbreviationsOpioid dependence, OWS=Opiate Withdrawal Scale, VAS=Craving Visual Analog Scale, PWSS=Post-withdrawal symptoms Scale, HAMD=Hamilton Depression Scale, HAMA=Hamilton Anxiety Scale, RCTs =Randomized Controlled Trials, EA=Electrical Acupuncture, PRISMA=Preferred Reporting Items for Systematic Reviews and Meta-Analyses.


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