MedWorm: Addiction

Cost estimates vary on mental health parity law

L.A. Times - Health — Sat, 11 Oct 2008 22:51:19 +0100

Agencies predict that health insurance costs could increase from 0.2% to 5%, depending on the type of plan. Will the Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act of 2008 increase the cost of health insurance? (Source: L.A. Times - Health)

MedWorm Sponsored Message: Learn more about drug and alcohol addiction treatment options at The Addiction Recovery Guide. Join discussions on an active addiction message board with forums organized by drug-type at The Addiction Recovery Guide.

Rural-urban differences in provider practice related to preconception counselling and fetal alcohol spectrum disorders.

Canadian Journal of Rural Medicine — Sat, 11 Oct 2008 17:19:44 +0100

Rural-urban differences in provider practice related to preconception counselling and fetal alcohol spectrum disorders.

Can J Rural Med. 2008;13(4):180-8

Authors: Tough SC, Ediger K, Hicks M, Clarke M

Objective: Fetal alcohol spectrum disorders (FASDs) are the most common form of nongenetic birth defect in North America with devastating, long-term consequences. Physicians are the primary providers of medical care for pregnant women and they play an important role in the prevention and diagnosis of FASD. We sought to determine whether differences exist between rural and urban health care providers in knowledge of, attitudes about and awareness of FASD and preconception counselling. Methods: Surveys were mailed to a national, random sample of Canadian health care providers (n = 5361) between October 2001 and May 2002. Bivariate data analysis was completed using SPSS 14.0. Results: Compared with their urban counterparts, rural providers were more likely to report being prepared to access resources related to alcohol use and dependency, yet they were less likely to agree that it was the physician's role to manage these issues (78.4% v. 82.8%, p < 0.05). Rural providers were more likely than urban providers to use a standardized tool to screen patients for alcohol use, to ask all pregnant women if they were drinking, to have cared for a patient with an FASD (56.7% v. 48.8%), to agree that providers do not make a diagnosis because of lack of time and training, and to recognize legal issues and inappropriate behaviour as secondary outcomes of FASD. Rural and urban providers were similar in their diagnostic knowledge of FASD. Conclusion: Few differences between rural and urban providers exist with regard to knowledge and diagnosis of FASD; however, rural providers are more prepared to access resources for women with addiction issues and are more likely to care for patients with an FASD.

PMID: 18845070 [PubMed - in process]

(Source: Canadian Journal of Rural Medicine)

Jordanian nurses' and physicians' learning needs for promoting smoking cessation.

Progress in Cardiovascular Nursing — Sat, 11 Oct 2008 17:14:33 +0100

Jordanian nurses' and physicians' learning needs for promoting smoking cessation.

Prog Cardiovasc Nurs. 2008;23(2):79-83

Authors: Shishani K, Nawafleh H, Sivarajan Froelicher E

Smoking causes many health problems, including myocardial infarction, stroke, and peripheral vascular disease, and has devastating effects on the cardiovascular system. This study was performed to assess: (1) the prevalence of smoking among Jordanian nurses and physicians, (2) the differences in prevalence of smoking by sex, and 3) nurses' and physicians' learning needs for promoting smoking cessation. A descriptive cross-sectional design was used. Five Jordanian hospitals were randomly selected; 164 nurses (65.3%) and 87 physicians (34.7%) participated in the study. Prevalence of smoking among nurses and physicians was 41.5% (n = 66) and 43.6% (n = 38), respectively, and significantly more men than women smoked (odds ratio, 5.45; confidence interval, 2.52-11.74 [P = .00]). Many Jordanian nurses and physicians do not recognize the addictive aspect of smoking, and health professionals receive no formal training in smoking cessation approaches to use with patients. Most nurses and physicians recognize that University curricula must include information about smoking cessation.

PMID: 18843829 [PubMed - in process]

(Source: Progress in Cardiovascular Nursing)

Cost estimates vary on mental health parity law

L.A. Times - Health — Sat, 11 Oct 2008 05:48:25 +0100

Self-administration of cocaine, cannabis and heroin in the human laboratory: benefits and pitfalls

Addiction Biology — Sat, 11 Oct 2008 04:00:00 +0100

The objective of this review is to describe self-administration procedures for modeling addiction to cocaine, cannabis and heroin in the human laboratory, the benefits and pitfalls of the approach, and the methodological issues unique to each drug. In addition, the predictive validity of the model for testing treatment medications will be addressed. The results show that all three drugs of abuse are reliably and robustly self-administered by non-treatment-seeking research volunteers. In terms of pharmacotherapies, cocaine use is extraordinarily difficult to disrupt either in the laboratory or in the clinic. A range of medications has been shown to significantly decrease cocaine's subjective effects and craving without decreasing either cocaine self-administration or cocaine abuse by patients. These negative data combined with recent positive findings with modafinil suggest that self-administration procedures are an important intermediary step between pre-clinical and clinical studies. In terms of cannabis, a recent study suggests that medications that improve sleep and mood during cannabis withdrawal decrease the resumption of marijuana self-administration in abstinent volunteers. Clinical data on patients seeking treatment for their marijuana use are needed to validate these laboratory findings. Finally, in contrast to cannabis or cocaine dependence, there are three efficacious Food and Drug Administration-approved medications to treat opioid dependence, all of which decrease both heroin self-administration and subjective effects in the human laboratory. In summary, self-administration procedures provide meaningful behavioral data in a small number of individuals. These studies contribute to our understanding of the variables maintaining cocaine, marijuana and heroin intake, and are important in guiding the development of more effective drug treatment programs. (Source: Addiction Biology)

Abnormalities in brain of cocaine addicts

Health News - UPI.com — Sat, 11 Oct 2008 03:23:47 +0100

BOSTON, Oct. 10 (UPI) -- Abnormalities in cocaine addicts' brains appear to correlate with dysfunction in areas of attention and for reward-based decision-making, U.S. researchers say. (Source: Health News - UPI.com)

Results of heroin study to be leaked friday

CTV Health — Fri, 10 Oct 2008 22:48:05 +0100

Advocates of drug reform say they will release results from a trial drug program that provided prescription heroin to addicts at a news conference Friday, in defiance of efforts to silence the study in the midst of the federal election campaign. (Source: CTV Health)

Cocaine addicts' brains reveal predisposition to abuse

Alcohol, Tobacco and Other Drugs News — Fri, 10 Oct 2008 18:40:16 +0100

A brain imaging study conducted by researchers at Massachusetts General Hospital revealed that abnormalities appearing in the cerebral cortex of cocaine addicts correlate with dysfunction in regions of the brain responsible for attention and reward-based decision-making. (Source: Alcohol, Tobacco and Other Drugs News)

From food to booze

Psychology Today Addiction Center — Fri, 10 Oct 2008 13:09:19 +0100

Does weight-loss surgery breed alcoholism? (Source: Psychology Today Addiction Center)

Addiction: on the wagon

Psychology Today Addiction Center — Fri, 10 Oct 2008 13:09:19 +0100

Alcoholism may not be a life-long disease. (Source: Psychology Today Addiction Center)

The surprising truth about addiction

Psychology Today — Fri, 10 Oct 2008 13:09:07 +0100

Why change is in reach. (Source: Psychology Today)

Cocaine and the brain

Medical Headlines From Ivanhoe.com — Fri, 10 Oct 2008 05:00:00 +0100

Are drug users predisposed to addiction? A new study examines the source of cocaine addiction. (Source: Medical Headlines From Ivanhoe.com)

Dual orexin actions on dorsal raphe and laterodorsal tegmentum neurons: noisy cation current activation and selective enhancement of ca2+ transients mediated by l-type calcium channels

Journal of Neurophysiology — Fri, 10 Oct 2008 04:00:00 +0100

The hypocretin/orexins (Hcrt/Orxs) are hypothalamic neuropeptides that regulate stress, addiction, feeding, and arousal behaviors. They depolarize many types of central neurons and can increase [Ca2+]i in some, including those of the dorsal raphe (DR) and laterodorsal tegmental (LDT) nuclei—two structures likely to contribute to the behavioral actions of Hcrt/Orx. In this study, we used simultaneous whole cell and Ca2+-imaging methods in mouse brain slices to compare the Hcrt/Orx-activated current in DR and LDT neurons and to determine whether it contributes to the Ca2+ influx evoked by Hcrt/Orx. We found Hcrt/Orx activates a similar noisy cation current that reversed near 0 mV in both cell types. Contrary to our expectation, this current did not contribute to the somatic Ca2+ influx evoked by Hcrt/Orx. In contrast, Hcrt/Orx enhanced the Ca2+ transients produced by voltage steps (–60 to –30 mV) by ~30% even in neurons lacking an inward current. This effect was abolished by nifedipine, augmented by Bay-K and abolished by bisindolylmaleimide I. Thus Hcrt/Orx has two independent actions: activation of noisy cation channels that generate depolarization and activation of a protein kinase C (PKC)-dependent enhancement of Ca2+ transients mediated by L-type Ca2+ channels. Immunocytochemistry verified that both these actions occurred in serotonergic and cholinergic neurons, indicating that Hcrt/Orx can function as a neuromodulator in these key neurons of the reticular activating system. Because regulation of Ca2+ transients mediated by L-channels is often linked to the control of transcriptional signaling, our findings imply that Hcrt/Orxs may also function in the regulation of long-term homeostatic or trophic processes. (Source: Journal of Neurophysiology)

Mayoclinic.com: smoking-related illnesses come with significant costs — both financial and quality of life

Mayo Clinic Health Information — Thu, 09 Oct 2008 19:23:35 +0100

Being addicted to tobacco brings a host of health problems related to the substances in tobacco smoke. These effects include damage to the lungs, heart and blood vessels. (Source: Mayo Clinic Health Information)

Cocaine addicts' brains predisposed to abuse

AuntMinnie.com Headlines — Thu, 09 Oct 2008 16:32:58 +0100

CHICAGO (Reuters), Oct 10 - Cocaine addicts may have brain deficits that predispose them to drug abuse, and abusing drugs appears to make matters worse, U.S. researchers said on Wednesday. They compared MRIs of 20 cocaine addicts with 20 carefully matched volunteers to map out cocaine-related differences in the brain. (Source: AuntMinnie.com Headlines)

Cocaine addicts display a thinner cortex which may reflect drug use and a pre-existing disposition to drug abuse

Health News from Medical News Today — Thu, 09 Oct 2008 12:00:00 +0100

New research findings suggest that structural abnormalities in the brains of cocaine addicts are related in part to drug use and in part to a predisposition toward addiction. (Source: Health News from Medical News Today)

The transcription factors nur77 and retinoid x receptors participate in amphetamine-induced locomotor activities

Psychopharmacology — Thu, 09 Oct 2008 09:14:26 +0100

Abstract Introduction The major substrate underlying amphetamine (AMPH)-induced locomotor activity is associated with dopamine forebrain circuits. Brain regions associated with AMPH-induced locomotor activity express high levels of retinoid receptors. However, the role of these transcription factors in dopamine-mediated effects remains poorly understood. Two nuclear receptor families, the retinoic acid receptors (RAR) and the retinoid X receptors (RXR), transduce retinoic acid signal. RARs are specifically involved in retinoid signaling, whereas RXRs also participate in other signaling pathways as partners for other nuclear receptors such as Nur77, an orphan member of the nuclear receptor family expresses in dopamine system. Materials and methods To explore the role of retinoid receptors and Nur77 in AMPH-induced locomotor activity, we administered selective retinoid receptor drugs in combination with AMPH in adult wild-type and Nur77-deficient mice. At a low dose, AMPH similarly increased ambulatory activity in wild-type and Nur77-deficient mice, while it did not alter non-ambulatory activity. Results and discussion At a high dose, AMPH did not alter ambulatory activity anymore, while non-ambulatory activity strongly increased in wild-type mice. Nur77-deficient mice still displayed a higher ambulatory activity with no change in non-ambulatory activity. HX531, a synthetic RXR antagonist, blocks AMPH-induced ambulatory activity, whereas RAR drugs tested remained without effect. Interestingly, the effect of HX531 was abolished in Nur77-deficient mice, suggesting that this orphan nuclear receptor is essential for the action of the RXR drug. Conclusion This study shows that RXR and Nur77 participate in AMPH-induced locomotor activity and prompts for further investigations on the role of Nur77 and RXR in addiction and reward-related behaviors. Content Type Journal ArticleCategory Original InvestigationDOI 10.1007/s00213-008-1343-0Authors Emmanuelle Bourhis, University of Montreal Pavillon Jean-Coutu Faculty of Pharmacy C.P. 6128 Succursale centre-ville Montreal QC H3C 3J7 CanadaJérôme Maheux, University of Montreal Pavillon Jean-Coutu Faculty of Pharmacy C.P. 6128 Succursale centre-ville Montreal QC H3C 3J7 CanadaBrigitte Paquet, Neuroscience Unit, CRCHUL Quebec QC G1V 4G2 CanadaHiroyuki Kagechika, Tokyo Medical and Dental University School of Biomedical Science Tokyo JapanKoichi Shudo, Research Foundation Itsuu Laboratory Tokyo JapanPierre-Paul Rompré, University of Montreal Fernand Seguin Research Center, Faculty of Medicine, Dept. of Psychiatry Montreal CanadaClaude Rouillard, Neuroscience Unit, CRCHUL Quebec QC G1V 4G2 CanadaDaniel Lévesque, University of Montreal Pavillon Jean-Coutu Faculty of Pharmacy C.P. 6128 Succursale centre-ville Montreal QC H3C 3J7 Canada Journal PsychopharmacologyOnline ISSN 1432-2072Print ISSN 0033-3158 (Source: Psychopharmacology)

Effectiveness of a peer-support community in addiction recovery: participation as intervention

Occupational Therapy International — Thu, 09 Oct 2008 04:00:00 +0100

The main purpose of the study was to determine whether a peer-support community programme would reduce relapse rates among clients recovering from substance addictions and homelessness and result in increased perceived community affiliation, supportive behaviours, self-determination and quality of life.Mixed methods were utilized including semi-structured interviews, participant observation and a pretest/post-test to evaluate changes on the quality of life rating, the Medical Outcomes Study-Social Support Survey, and the Volitional Questionnaire. Data from the prior year's permanent supportive housing programme were used for comparison of relapse rates.Significant reduction of risk of relapse was found in clients who participated in the programme. Significant differences were found on three subscales of the Medical Outcomes Study-Social Support Survey. Improvement that did not reach statistical significance was seen on the quality of life rating. Qualitative evidence supported improvements in perceived community affiliation and supportive behaviours.Evidence suggests that a peer-supported community programme focused on self-determination can have a significant positive impact on recovery from substance addictions and homelessness. Limitations include a small sample size and lack of a randomized control group. Copyright © 2008 John Wiley & Sons, Ltd. (Source: Occupational Therapy International)

The association of persistent pain with out-patient addiction treatment outcomes and service utilization

Addiction — Thu, 09 Oct 2008 04:00:00 +0100

Aims To estimate the prevalence of persistent pain among veterans in out-patient addiction treatment and examine associated addiction treatment outcomes and medical and psychiatric service use.Design, setting and participants Analysis of data from a prospective randomized controlled trial comparing on-site versus referral primary care of veterans with substance dependence (n = 582), excluding opioid dependence who had at least one follow-up interview during the 12-month study period in a Veterans Affairs (VA) out-patient addiction treatment center.Measurements Pain status was classified as persistent (pain was rated moderate to very severe at all time-points), low (pain was rated none to mild at all time-points) or intermittent (all others). Main outcome measures were addiction treatment retention, addiction severity index (ASI) alcohol and drug composite scores, VA service utilization and treatment costs.Findings A total of 33.2% of veterans reported persistent pain and 47.3% reported intermittent pain. All groups benefited from addiction treatment, but veterans with persistent pain were in treatment for an estimated 35.1 fewer days [95% confidence interval (CI) = [minus]64.1, [minus]6.1, P = 0.018], less likely to be abstinent from alcohol or drugs at 12 months [odds ratio (OR)adj = 0.52; 95% CI = 0.30,0.89; P = 0.018], had worse ASI alcohol composite scores at 12 months ([beta]adj = 0.09; 95% CI = 0.02,0.15; P = 0.007), were more likely to be medically hospitalized (ORadj = 2.70; 95% CI = 1.02,7.13; P = 0.046) and had higher total service costs compared to those with low pain ($17 766 versus $13 261, P = 0.012).Conclusions Persistent pain is common among veterans in out-patient addiction treatment and is associated with poorer rates of abstinence, worse alcohol use severity and greater service utilization and costs than those with low pain. (Source: Addiction)

Exploring the cold-to-hot empathy gap in smokers

Psychological Science — Thu, 09 Oct 2008 04:00:00 +0100

ABSTRACT[mdash]Many decisions related to cigarette smoking require people in an affectively neutral, or "cold," state to predict how they will feel or behave when in a craving, or "hot," state. Research in other domains has revealed that individuals in cold states often underestimate the impact of being in a hot state on their own future behavior. In a study testing whether this is true of cigarette craving, 98 smokers were assigned to one of three conditions: hot (during a high-craving first session, they made predictions about a high-craving state in a second session), cold (during a low-craving first session, they made predictions about a high-craving state in a second session), and comparison (they experienced a high-craving session only). As predicted, in contrast to smokers in the hot group, smokers in the cold group underpredicted the value they would place on smoking during the second session. Results support the existence of a cold-to-hot empathy gap in smokers and help to explain diverse aspects of tobacco addiction. (Source: Psychological Science)

Cocaine addicts' brains predisposed to abuse: study

Reuters: Health — Wed, 08 Oct 2008 21:31:38 +0100

CHICAGO (Reuters) - Cocaine addicts may have brain deficits that predispose them to drug abuse, and abusing drugs appears to make matters worse, U.S. researchers said on Wednesday. (Source: Reuters: Health)

Study finds abnormalities in cerebral cortex of cocaine addicts

Huliq Health News — Wed, 08 Oct 2008 16:59:56 +0100

A brain imaging study carried out at Massachusetts General Hospital (MGH) reveals abnormalities in the cortex – the outer surface of the brain – of cocaine addicts that appear to correlate with dysfunction in areas responsible for attention and for reward-based decision-making. (Source: Huliq Health News)

Brain serotonin transporter in human methamphetamine users

Psychopharmacology — Wed, 08 Oct 2008 12:18:49 +0100

Abstract Rationale Research on methamphetamine (MA) toxicity primarily focuses on the possibility that some of the behavioural problems in human MA users might be caused by damage to brain dopamine neurones. However, animal data also indicate that MA can damage brain serotonin neurones, and it has been suggested that cognitive problems and aggression in MA users might be explained by serotonergic damage. As information on the brain serotonin system in human MA users is fragmentary, our objective was to determine whether protein levels of serotonin transporter (SERT), a key marker of serotonin neurones, are decreased in brain of chronic MA users. Methods SERT immunoreactivity was measured using an immunoblotting procedure in autopsied brain of 16 chronic MA users testing positive for the drug in blood and brain and matched controls. Results SERT levels were non-significantly decreased (−14% to −33%) in caudate, putamen and thalamus (normal in hippocampus), and, unlike the robust striatal dopamine reduction, there was marked overlap between control and MA user ranges. Concentrations of SERT were significantly decreased (−23% to −39%) in orbitofrontal and occipital cortices (normal in frontopolar and temporal cortices). Conclusions Our data suggest that MA might modestly damage brain serotonin neurones and/or inhibit SERT protein expression, with cerebral cortex being more affected than sub-cortical regions. The SERT reduction in orbitofrontal cortex complements other data suggesting involvement of this area in MA-related behaviour. Decreased brain SERT could also be related to the clinical finding that treatment with a selective serotonin re-uptake inhibitor might increase relapse to MA. Content Type Journal ArticleCategory Original InvestigationDOI 10.1007/s00213-008-1346-xAuthors Stephen J. Kish, Centre for Addiction and Mental Health Human Neurochemical Pathology Laboratory 250 College Street Toronto Ontario CanadaPaul S. Fitzmaurice, ESR Institute of Environmental Science and Research Auckland New ZealandIsabelle Boileau, Centre for Addiction and Mental Health Human Neurochemical Pathology Laboratory 250 College Street Toronto Ontario CanadaGregory A. Schmunk, Office of the Polk County Medical Examiner Des Moines IA USALee-Cyn Ang, University of Western Ontario Division of Neuropathology, London Health Science Center London Ontario CanadaYoshiaki Furukawa, Centre for Addiction and Mental Health Movement Disorder Research Laboratory Toronto Ontario CanadaLi-Jan Chang, Centre for Addiction and Mental Health Human Neurochemical Pathology Laboratory 250 College Street Toronto Ontario CanadaDennis J. Wickham, Clark County Office of the Medical Examiner Vancouver WA USAAllan Sherwin, McGill University Department of Neurology and Neurosurgery Montreal Quebec CanadaJunchao Tong, Centre for Addiction and Mental Health Human Neurochemical Pathology Laboratory 250 College Street Toronto Ontario Canada Journal PsychopharmacologyOnline ISSN 1432-2072Print ISSN 0033-3158 (Source: Psychopharmacology)

Molecular genetics of adult adhd: converging evidence from genome-wide association and extended pedigree linkage studies

Journal of Neural Transmission — Wed, 08 Oct 2008 10:50:04 +0100

Abstract A genome-wide association (GWA) study with pooled DNA in adult attention-deficit/hyperactivity disorder (ADHD) employing ~500K SNP markers identifies novel risk genes and reveals remarkable overlap with findings from recent GWA scans in substance use disorders. Comparison with results from our previously reported high-resolution linkage scan in extended pedigrees confirms several chromosomal loci, including 16q23.1-24.3 which also reached genome-wide significance in a recent meta-analysis of seven linkage studies (Zhou et al. in Am J Med Genet Part B, 2008). The findings provide additional support for a common effect of genes coding for cell adhesion molecules (e.g., CDH13, ASTN2) and regulators of synaptic plasticity (e.g., CTNNA2, KALRN) despite the complex multifactorial etiologies of adult ADHD and addiction vulnerability. Content Type Journal ArticleCategory Biological Psychiatry - Rapid CommunicationDOI 10.1007/s00702-008-0119-3Authors Klaus-Peter Lesch, University of Wuerzburg ADHD Clinical Research Program, Molecular and Clinical Psychobiology, Department of Psychiatry, Psychosomatics and Psychotherapy Fuechsleinstr. 15 97080 Wuerzburg GermanyNina Timmesfeld, University of Marburg Institute of Medical Biometry and Epidemiology Marburg GermanyTobias J. Renner, University of Wuerzburg ADHD Clinical Research Program, Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy Wuerzburg GermanyRebecca Halperin, The Translational Genomics Research Institute Neurogenomics Division, TGen Phoenix USAChristoph Röser, University of Wuerzburg ADHD Clinical Research Program, Molecular and Clinical Psychobiology, Department of Psychiatry, Psychosomatics and Psychotherapy Fuechsleinstr. 15 97080 Wuerzburg GermanyT. Trang Nguyen, University of Marburg Institute of Medical Biometry and Epidemiology Marburg GermanyDavid W. Craig, The Translational Genomics Research Institute Neurogenomics Division, TGen Phoenix USAJasmin Romanos, University of Wuerzburg ADHD Clinical Research Program, Molecular and Clinical Psychobiology, Department of Psychiatry, Psychosomatics and Psychotherapy Fuechsleinstr. 15 97080 Wuerzburg GermanyMonika Heine, University of Wuerzburg ADHD Clinical Research Program, Molecular and Clinical Psychobiology, Department of Psychiatry, Psychosomatics and Psychotherapy Fuechsleinstr. 15 97080 Wuerzburg GermanyJobst Meyer, University of Trier Department of Neurobehavioral Genetics Trier GermanyChristine Freitag, Saarland University Hospital Department of Child and Adolescent Psychiatry Homburg GermanyAndreas Warnke, University of Wuerzburg ADHD Clinical Research Program, Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy Wuerzburg GermanyMarcel Romanos, University of Wuerzburg ADHD Clinical Research Program, Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy Wuerzburg GermanyHelmut Schäfer, University of Marburg Institute of Medical Biometry and Epidemiology Marburg GermanySusanne Walitza, University of Wuerzburg ADHD Clinical Research Program, Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy Wuerzburg GermanyAndreas Reif, University of Wuerzburg ADHD Clinical Research Program, Molecular and Clinical Psychobiology, Department of Psychiatry, Psychosomatics and Psychotherapy Fuechsleinstr. 15 97080 Wuerzburg GermanyDietrich A. Stephan, The Translational Genomics Research Institute Neurogenomics Division, TGen Phoenix USAChristian Jacob, University of Wuerzburg ADHD Clinical Research Program, Molecular and Clinical Psychobiology, Department of Psychiatry, Psychosomatics and Psychotherapy Fuechsleinstr. 15 97080 Wuerzburg Germany Journal Journal of Neural TransmissionOnline ISSN 1435-1463Print ISSN 0300-9564 (Source: Journal of Neural Transmission)

Desperate housewives: an analysis of the characterisations of female gamblers portrayed in gambling movies in hong kong

International Journal of Mental Health and Addiction — Wed, 08 Oct 2008 09:51:56 +0100

Abstract This article examines portrayals of female gamblers in recent Hong Kong movies. The authors report that the depiction of female gamblers is very different from that of male gamblers in the movies made in the same period. Whereas the male gamblers are pitching a lonely and desperate battle against an evil opponent, the female gamblers portrayed in the movies are housewives or small-time players who gamble only for their personal gain. A generally negative overtone in portrayals of female gamblers was interpreted as a reflection of the traditional view that discourages women from gambling. The shift of gambling themes in the Hong Kong movies has been identified to reflect the most salient concerns among Hong Kong residents. Such changes are attributed to particular social and cultural changes in the community. Content Type Journal ArticleDOI 10.1007/s11469-008-9180-2Authors Keis Ohtsuka, Victoria University School of Social Sciences and Psychology P.O. Box 14428 Melbourne Vic 8001 AustraliaChi Chuen Chan, Victoria University School of Social Sciences and Psychology P.O. Box 14428 Melbourne Vic 8001 Australia Journal International Journal of Mental Health and AddictionOnline ISSN 1557-1882Print ISSN 1557-1874 (Source: International Journal of Mental Health and Addiction)

Study finds abnormalities in cerebral cortex of cocaine addicts

EurekAlert! - Social and Behavioral Science — Wed, 08 Oct 2008 04:00:00 +0100

(Massachusetts General Hospital) A brain imaging study reveals abnormalities in the cerebral cortex of cocaine addicts that appear to correlate with dysfunction in areas responsible for attention and for reward-based decision-making, a potential neural signature that could underlie behaviors typically seen in addiction. While some of these abnormalities may reflect an inborn vulnerability to drug use, others appear to be the result of long-term cocaine exposure. (Source: EurekAlert! - Social and Behavioral Science)

Thinner cortex in cocaine addicts may reflect drug use and a pre-existing disposition to drug abuse

EurekAlert! - Social and Behavioral Science — Wed, 08 Oct 2008 04:00:00 +0100

(Cell Press) New research findings suggest that structural abnormalities in the brains of cocaine addicts are related in part to drug use and in part to a predisposition toward addiction. The research, published by Cell Press in the Oct. 9 issue of the journal Neuron, maps the topography of the addicted brain and provides new insight into the effect of cocaine on neural systems mediating cognition and motivation. (Source: EurekAlert! - Social and Behavioral Science)

[best evidence topic reports] towards evidence based emergency medicine: best bets from the manchester royal infirmary

Emergency Medicine Journal — Wed, 08 Oct 2008 04:00:00 +0100

(Source: Emergency Medicine Journal)

[best evidence topic reports] bet 3 training and prescription of naloxone for personal use in overdose for opiate addicts

Emergency Medicine Journal — Wed, 08 Oct 2008 04:00:00 +0100

(Source: Emergency Medicine Journal)

Neuroscience: brain's defence against cocaine

Nature — Wed, 08 Oct 2008 04:00:00 +0100

Neuroscience: Brain's defence against cocaine Nature 455, 743 (2008). doi:10.1038/455743a Authors: L. Judson Chandler & Peter W. Kalivas Long-term exposure to cocaine changes the organization of synaptic connections within the addiction circuitry of the brain. This process might protect against the development and persistence of addiction. (Source: Nature)

Long-term effects of the focus on families project on substance use disorders among children of parents in methadone treatment

Addiction — Wed, 08 Oct 2008 04:00:00 +0100

Aims This study examines the efficacy of the Focus on Families project (currently called Families Facing the Future), a preventive intervention to reduce substance use disorders among children in families with a parent in methadone treatment.Design One hundred and thirty families were assigned randomly to a methadone clinic treatment-as-usual control condition or treatment-as-usual plus the Focus on Families intervention between 1991 and 1993.Setting Participants were recruited from two methadone clinics in the Pacific Northwest.Participants This study examines the development of substance use disorders among the 177 children (56.84% male) involved in the program using data from a long-term follow-up in 2005, when these participants ranged in age from 15 to 29 years.Intervention The intervention was delivered through group parent-training workshops at the methadone clinics and through individualized home-based services. The intervention taught parenting skills and skills for avoiding relapse to drug abuse.Measurements At long-term follow-up, substance use disorders were measured by the Composite International Diagnostic Interview (CIDI). Survival analyses were used to assess intervention versus control differences in the hazard of developing substance use disorders.Findings Overall, intervention and control participants did not differ significantly in risk of developing substance use disorders. However, there was evidence of a significant difference in intervention effect by gender. There was a significant reduction in the risk of developing a substance use disorder for intervention group males compared to control group males (hazard ratio = 0.53, P = 0.03), while intervention versus control differences among females were non-significant and favored the control condition.Conclusions Results from this study suggest that helping parents in recovery focus on both reducing their drug use and improving their parenting skills may have long-term effects on reducing substance use disorders among their male children. However, the overall long-term benefits of this program are not supported by the results for female children. (Source: Addiction)

Early-onset depressive disorders predict the use of addictive substances in adolescence: a prospective study of adolescent finnish twins

Addiction — Wed, 08 Oct 2008 04:00:00 +0100

Aims To explore the developmental relationships between early-onset depressive disorders and later use of addictive substances.Design, setting and participants A sample of 1545 adolescent twins was drawn from a prospective, longitudinal study of Finnish adolescent twins with baseline assessments at age 14 years and follow-up at age 17.5 years.Measurements At baseline, DSM-IV diagnoses were assessed with a professionally administered adolescent version of Semi-Structured Assessment for Genetics of Alcoholism (C-SSAGA-A). At follow-up, substance use outcomes were assessed via self-reported questionnaire.Findings Early-onset depressive disorders predicted daily smoking [odds ratio (OR) 2.29, 95% confidence interval (CI) 1.49[ndash]3.50, P < 0.001], smokeless tobacco use (OR = 2.00, 95% CI 1.32[ndash]3.04, P = 0.001), frequent illicit drug use (OR = 4.71, 95% CI 1.95[ndash]11.37, P = 0.001), frequent alcohol use (OR = 2.02, 95% CI 1.04[ndash]3.92, P = 0.037) and recurrent intoxication (OR = 1.83, 95% CI 1.18[ndash]2.85, P = 0.007) 3 years later. ORs remained significant after adjustment for comorbidity and exclusion of baseline users. In within-family analysis of depression-discordant co-twins (analyses that control for shared genetic and familial background factors), early-onset depressive disorders at age 14 predicted significantly frequent use of smokeless tobacco and alcohol at age 17.5.Conclusions Our results suggest important predictive associations between early-onset depressive disorders and addictive substance use, and these associations appear to be independent of shared familial influences. (Source: Addiction)

Comparing topiramate with naltrexone in the treatment of alcohol dependence*

Addiction — Wed, 08 Oct 2008 04:00:00 +0100

Aim To compare the efficacy of topiramate with naltrexone in the treatment of alcohol dependence.Design The investigation was a double-blind, placebo-controlled, 12-week study carried out at the University of São Paulo, Brazil.Sample A total of 155 patients, 18[ndash]60 years of age, with an International Classification of Diseases (ICD-10) diagnosis of alcohol dependence.Methods After a 1-week detoxification period, patients were assigned randomly to receive topiramate (induction to 300 mg/day), naltrexone (50 mg/day) or placebo.Measurements Time to first relapse (consumption of >60 g ethyl alcohol), cumulative abstinence duration and weeks of heavy drinking.Findings In intention-to-treat analyses, topiramate was statistically superior to placebo on a number of measures including time to first relapse (7.8 versus 5.0 weeks), cumulative abstinence duration (8.2 versus 5.6 weeks), weeks of heavy drinking (3.4 versus 5.9) and percentage of subjects abstinent at 4 weeks (67.3 versus 42.6) and 8 weeks (61.5 versus 31.5), but not 12 weeks (46.2 versus 27.8). Results remained significant after controlling for Alcoholics Anonymous attendance, which was higher in topiramate than in other groups. There were no significant differences between naltrexone versus placebo or naltrexone versus topiramate groups, but naltrexone showed trends toward inferior outcomes when compared to topiramate.Conclusions The results of this study support the efficacy of topiramate in the relapse prevention of alcoholism. Suggestive evidence was also obtained for superiority of topiramate versus naltrexone, but this needs to be verified in future research with larger sample sizes. (Source: Addiction)

Dilemmas in harm minimization

Addiction — Wed, 08 Oct 2008 04:00:00 +0100

This paper discusses the dilemmas inherent in pursuing a philosophy of (drug) harm minimization. The dilemmas arise (i) because all drug control policies produce harms as well as benefits; (ii) because many of these harms and benefits cannot be measured; and (iii) because even when they can be measured, judgements about what harms matter the most are irreducibly political. The paper concludes by proposing that the interests of drug policy might be better served if we abandoned the idea of an overarching goal in favour of a set of goals dealing with specific identifiable problems. (Source: Addiction)

Evaluation of short-term psychological functions in opiate addicts after ablating the nucleus accumbens via stereotactic surgery

Karger Publishers — Tue, 07 Oct 2008 15:18:50 +0100

Stereotact Funct Neurosurg 2008;86:320-329 (DOI:10.1159/000160155) (Source: Karger Publishers)

New national statistics reveal more drug addicts in treatment - and they are staying the course, uk

Health News from Medical News Today — Tue, 07 Oct 2008 15:00:00 +0100

Figures published today by the National Treatment Agency for Substance Misuse (NTA) show that more than 202,000 people were recorded in drug treatment for 2007/08, which over-achieves the target set by the government. (Source: Health News from Medical News Today)

New book explores lives of women shoplifters, sex workers

Alcohol / Addiction / Illegal Drugs News From Medical News Today — Tue, 07 Oct 2008 12:00:00 +0100

A new book by a Rutgers University-Camden criminologist reveals the profound impact of shoplifting and prostitution on both a region and the lives of the women who depend on these illegal acts. Out in the Storm - Drug-Addicted Women Living as Shoplifters and Sex Workers by Gail A. Caputo, an associate professor of criminal justice at Rutgers-Camden, offers vivid insights from 100 hours of interviews with 38 women who sold themselves and the merchandise they shoplifted. (Source: Alcohol / Addiction / Illegal Drugs News From Medical News Today)

Excluding inmates from health research thwarts advancement of public health, expert argues

ScienceDaily Headlines — Tue, 07 Oct 2008 07:11:06 +0100

More and more persons with mental illnesses, addiction disorders, and chronic and infectious diseases receive their medical care in a jail or prison. As of mid-2007, approximately 13 million inmates had been admitted to US jails during the previous 12 months. (Source: ScienceDaily Headlines)

Stress from hurricane strains recovery of addicts

PsycPORT.com — Tue, 07 Oct 2008 04:00:00 +0100

October 06, 2008 Oct. 6--Houstonians are still confronting the lingering effects of Hurricane Ike: damaged homes, piles of debris, lost work and ends that won't meet. But for recovering alcoholics and addicts, coping with post-Ike realities may also mean reaching out to sobriety buddies instead of the bottle or drugs. (Source: PsycPORT.com)

Methamphetamine abuse and dentistry

Oral Diseases — Tue, 07 Oct 2008 04:00:00 +0100

Methamphetamine is a highly addictive powerful stimulant that increases wakefulness and physical activity and produces other effects including cardiac dysrhythmias, hypertension, hallucinations, and violent behavior. The prevalence of methamphetamine use is estimated at 35 million people worldwide and 10.4 million people in the United States. In the United States, the prevalence of methamphetamine use is beginning to decline but methamphetamine trafficking and use are still significant problems. Dental patients who abuse methamphetamine can present with poor oral hygiene, xerostomia, rampant caries ('Meth mouth'), and excessive tooth wear. Dental management of methamphetamine users requires obtaining a thorough medical history and performing a careful oral examination. The most important factor in treating the oral effects of methamphetamine is for the patient to stop using the drug. Continued abuse will make it difficult to increase salivary flow and hinder the patient's ability to improve nutrition and oral hygiene. Local anesthetics with vasoconstrictors should be used with care in patients taking methamphetamine because they may result in cardiac dysrhythmias, myocardial infarction, and cerebrovascular accidents. Thus, dental management of patients who use methamphetamine can be challenging. Dentists need to be aware of the clinical presentation and medical risks presented by these patients. (Source: Oral Diseases)

Pancreatic pseudocyst with stent placement in the background of narcotic use: a case report

BioMed Central — Tue, 07 Oct 2008 04:00:00 +0100

A 49 year old gentleman presents with recurrent abdominal pain. The patient has a known history of chronic pancreatitis, alcoholism and narcotic addiction. Work-up, including computed tomography (CT) of the abdomen, demonstrated a 5.6 X 5.8 cm fluid collection contiguous with the pancreas. This was not seen on CT 18 months earlier. The patient's pain did not improve with bowel rest and pain control. He was transferred to another institution for endoscopic placement of a transgastric pancreatic stent. The procedure decreased the size the cyst and the patient's pain became more manageable. (Source: BioMed Central)

Why we couldn't save nicole

washingtonpost.com - Health — Tue, 07 Oct 2008 04:00:00 +0100

We're a hardy family, used to weathering all manner of surprises as we've seen four kids through various stages of toddlerhood, childhood and adolescence. So when our fun-loving 22-year-old, Nicole, shocked us by admitting a heroin addiction and asked for our help in overcoming it, my husband an... (Source: washingtonpost.com - Health)

The effect of traumatic brain injury on the health of homeless people.

cmaj — Tue, 07 Oct 2008 04:00:00 +0100

The effect of traumatic brain injury on the health of homeless people.

CMAJ. 2008 Oct 7;179(8):779-84

Authors: Hwang SW, Colantonio A, Chiu S, Tolomiczenko G, Kiss A, Cowan L, Redelmeier DA, Levinson W

BACKGROUND: We sought to determine the lifetime prevalence of traumatic brain injury and its association with current health conditions in a representative sample of homeless people in Toronto, Ontario. METHODS: We surveyed 601 men and 303 women at homeless shelters and meal programs in 2004-2005 (response rate 76%). We defined traumatic brain injury as any self-reported head injury that left the person dazed, confused, disoriented or unconscious. Injuries resulting in unconsciousness lasting 30 minutes or longer were defined as moderate or severe. We assessed mental health, alcohol and drug problems in the past 30 days using the Addiction Severity Index. Physical and mental health status was assessed using the SF-12 health survey. We examined associations between traumatic brain injury and health conditions. RESULTS: The lifetime prevalence among homeless participants was 53% for any traumatic brain injury and 12% for moderate or severe traumatic brain injury. For 70% of respondents, their first traumatic brain injury occurred before the onset of homelessness. After adjustment for demographic characteristics and lifetime duration of homelessness, a history of moderate or severe traumatic brain injury was associated with significantly increased likelihood of seizures (odds ratio [OR] 3.2, 95% confidence interval [CI] 1.8 to 5.6), mental health problems (OR 2.5, 95% CI 1.5 to 4.1), drug problems (OR 1.6, 95% CI 1.1 to 2.5), poorer physical health status (-8.3 points, 95% CI -11.1 to -5.5) and poorer mental health status (-6.0 points, 95% CI -8.3 to -3.7). INTERPRETATION: Prior traumatic brain injury is very common among homeless people and is associated with poorer health.

PMID: 18838453 [PubMed - in process]

(Source: cmaj)

Molecular genetics of adult adhd: converging evidence from genome-wide association and extended pedigree linkage studies.

The American Journal of Medicine — Tue, 07 Oct 2008 04:00:00 +0100

Molecular genetics of adult ADHD: converging evidence from genome-wide association and extended pedigree linkage studies.

J Neural Transm. 2008 Oct 7;

Authors: Lesch KP, Timmesfeld N, Renner TJ, Halperin R, Röser C, Nguyen TT, Craig DW, Romanos J, Heine M, Meyer J, Freitag C, Warnke A, Romanos M, Schäfer H, Walitza S, Reif A, Stephan DA, Jacob C

A genome-wide association (GWA) study with pooled DNA in adult attention-deficit/hyperactivity disorder (ADHD) employing ~500K SNP markers identifies novel risk genes and reveals remarkable overlap with findings from recent GWA scans in substance use disorders. Comparison with results from our previously reported high-resolution linkage scan in extended pedigrees confirms several chromosomal loci, including 16q23.1-24.3 which also reached genome-wide significance in a recent meta-analysis of seven linkage studies (Zhou et al. in Am J Med Genet Part B, 2008). The findings provide additional support for a common effect of genes coding for cell adhesion molecules (e.g., CDH13, ASTN2) and regulators of synaptic plasticity (e.g., CTNNA2, KALRN) despite the complex multifactorial etiologies of adult ADHD and addiction vulnerability.

PMID: 18839057 [PubMed - as supplied by publisher]

(Source: The American Journal of Medicine)

Biophysicists create new model for protein-cholesterol interactions in brain and muscle tissue

ScienceDaily Headlines — Tue, 07 Oct 2008 00:00:00 +0100

Using 3,200 computer processors and long-established data on cholesterol, a clearer picture emerges of a protein involved in inflammation, Alzheimer's disease, Parkinson's disease, addiction and more. (Source: ScienceDaily Headlines)

Hazelden starts $10 million expansion

bizjournals.com Health Care:Hospitals headlines — Mon, 06 Oct 2008 21:16:33 +0100

Hazelden Springbrook, a residential drug and alcohol addiction treatment program with a facility in Newberg, will starting a $10 million expansion and renovation at its Oregon campus this week. (Source: bizjournals.com Health Care:Hospitals headlines)

A little alcohol goes a longer way in women than in men-in good ways and bad, from the harvard heart letter

Health News from Medical News Today — Mon, 06 Oct 2008 16:00:00 +0100

Alcohol can be a boon or a bane for health. The difference lies in the dose-a little is good, a lot is bad. But the dividing line between a little and a lot differs from person to person. It depends on many things, including sex. Women are more vulnerable than men to alcohol's long-term effects, reports the October 2008 issue of the Harvard Heart Letter. (Source: Health News from Medical News Today)

U.s. congress passes mental health coverage boost

Medscape Medical News Headlines — Mon, 06 Oct 2008 15:08:04 +0100

A measure boosting insurance coverage for mental illness and treatment of drug and alcohol addiction secured final U.S. congressional passage on Friday as part of financial industry bailout legislation. Reuters Health Information (Source: Medscape Medical News Headlines)

Parental warning: an increase in repoting children nicotine dependence symptoms.

Pediatrics News - Doctors Lounge — Mon, 06 Oct 2008 10:59:55 +0100

Parents who smoke cigarettes around their kids trigger symptoms of nicotine dependence in children. [Addict Behav]. (Source: Pediatrics News - Doctors Lounge)

Who to hold public hearing on ways of reducing the harmful use of alcohol

Alcohol / Addiction / Illegal Drugs News From Medical News Today — Mon, 06 Oct 2008 10:00:00 +0100

Each year, more than two million people die from alcohol-related causes which is why World Health Organization (WHO) was asked by its Member States in May at the World Health Assembly to develop a global strategy to combat the harmful use of alcohol. All parties with an interest in reducing the harmful use of alcohol are now invited to share their views in a public hearing being organized by the World Health Organization (WHO). (Source: Alcohol / Addiction / Illegal Drugs News From Medical News Today)