ScienceDaily (Apr. 7, 2008) — Simple environmental enrichment and increased social stress can both affect the level of individual drug use, according to new monkey research at Wake Forest University School of Medicine.
Previous research has shown that social rank -- whether animals are dominant or subordinate within their social groups -- can affect the amount of cocaine that monkeys will self-administer. Housed in groups of four, male cynomolgus monkeys will invariably stratify by social rank from the most dominant to the most subordinate.
Once exposed to cocaine and taught to self-administer the drug, the more subordinate animals are far more inclined to engage in the human equivalent of serious drug abuse than are the dominant animals. Research has shown differences in certain neurochemicals in the brains of the animals, both as predictors and results of the social ranking, and therefore as predictors of drug abuse.
Click here to read entire article at Science Daily.com
Monday, April 7, 2008
Wednesday, March 26, 2008
What is Alcohol Harm Reduction?
Excerpt from IHRA.net
Alcohol is no ordinary commodity. It is a legal drug which brings health, personal, cultural and social benefits for many people around the world – yet causes significant mental, physical and social harms for many others. To effectively tackle this dilemma, the alcohol field in general needs to generate and embrace new ideas and more practical approaches.
Alcohol harm reduction can be broadly defined as measures that aim to reduce the negative consequences of drinking.
A comprehensive alcohol policy needs population-level interventions, which focus on the availability and accessibility of alcohol (such as taxation and restricted licensing hours). But it needs more than this - such measures alone will not reduce alcohol related harms. In the last 20 years there has also developed an increasing (but less promoted) interest in alcohol harm reduction interventions. These tend to focus on particular risk behaviours (such as drinking and driving, binge drinking), particular risk groups (such as pregnant women, young people) and particular drinking contexts (such as bars and clubs). These approaches have broadened the sphere of interest in alcohol related harms to include social nuisance and public order problems. Very often (but not exclusively) such interventions operate at the community level.
Examples of this approach in practice are:
- Campaigns against drinking and driving (including designated driver schemes and improved public transport in the evenings)
- Serving alcohol in shatter-proof glass to prevent injuries
- Training bar staff to serve alcohol responsibly
- Promoting the safer design of drinking environments (such as bars)
- Managing the ‘night-time economy’ and the ‘drinking environment’ in order to maximise pleasure and minimise violence and anti-social behaviour
- Brief interventions advising people on moderate or controlled drinking
- Education in schools and universities advising people on moderate or controlled drinking
- Providing shelters for homeless drinkers (known as ‘Wet Centres’)
- Providing shelters for heavily intoxicated individuals (known as ‘Sobering-Up Centres’)
The benefits of alcohol harm reduction approaches are as follows:
- They are practical approaches (so much so that many people deliver alcohol harm reduction on a regular basis without realising it)
- They are realistic approaches in that they (often) do not rely upon national consensus, funding, policies or legislation
- They can be designed and delivered by local communities and stakeholders to address specific local needs and contexts
- Their short-term aim is to minimise the impacts of drinking alcohol
- Their longer-term aim is to change drinking cultures – encouraging the benefits of responsible drinking and discouraging harmful drinking
Introduction to Harm Reduction Psychotherapy
Ideas have different meanings at different moments in history. Ideas that once appeared crazy, dangerous, or incomprehensible later become so much a part of accepted truth that society temporarily forgets the time when these ideas were dormant. New ideas arise in response to current conditions as an attempt to make sense of and help guide us in responding to these conditions. Ideas determine our view of reality both expanding and limiting our possibilities. As history marches on and conditions change, ideas that were once progressive and useful can become stale, empty, regressive barriers to change. When the dinosaurs of outmoded ideas die, the ideas that have been hiding in the hinterlands creep back into the mainstream to repopulate the field, New ideas once again arise that attempt to explain the limitations of those that came before. This is as true for individual psychology as it is for scientific paradigms.
Within the drug and alcohol treatment field, there have been a number of great ideas that have represented new paradigms for understanding problematic substance use. The application of these ideas to clinical treatment led to revolutionary changes in practice that resulted in dramatic improvements in the care available to people with substance use problems. The addiction-as-disease concept (Jellinek, 1962) challenged the moral model of drug misuse which blamed the problem on the inappropriate values or immoral character of the user. The disease paradigm opened the way to treatment rather than punishment, for these problems. The self-medication hypothesis (Khantzian, 1985) pointed out that for many, drug use is a form of self-care that reflects an attempt to cope with painful feelings. This idea highlighted the important dimension of the meaningfulness of drug use and the necessity to recognize and address the under- lying issues the user is trying to heal through drug use. Relapse prevention (Marlatt and Gordon, 1985) pointed out that, rather than viewing a return to problematic drug use after a period of abstinence or diminished use as failure, relapse should be seen as a common natural part of the process of changing behavior, which can be an opportunity for learning that might decrease the possibility of future relapses.
Harm reduction is the most recent of these important new ideas in the substance use treatment field. It heralds a paradigm shift in the way we understand and respond to problematic drug and alcohol use. Harm reduction rejects the presumption that abstinence is the best or only acceptable goal for all problem drug and alcohol users. Harm reduction sees substance use varying on a continuum of harmful consequences to the user and the community. In doing so, harm reduction accepts small, incremental steps in the direction of reduced harm with the goal being to facilitate the greatest reduction in harm for a given person at this point in time. Inherent in this change in the treatment focus is a radical redefinition of the relationship between the client and the clinician, a departure from the paternalistic model associated with more traditional substance use treatment. Harm reduction places respect for the client's strengths and capacity to change as the starting point for developing egalitarian relationships in which clients are encouraged to collaborate in setting up the treatment and choosing goals and strategies that they find useful. This shift in basic assumption is actually consistent with psychodynamic and behavioral models of drug misuse and has many beneficial implications for treatment that will be discussed in this book. A growing group of clinicians, researchers, and public policy makers have recognized that the philosophy of harm reduction has a critically important role to play in our efforts as a field and in the larger society to improve the treatment of people struggling with substance use problems.
Thursday, February 28, 2008
Brain Stress System Presents Possible Treatment
ScienceDaily (Feb. 28, 2008) — A brain circuit that underlies feelings of stress and anxiety shows promise as a new therapeutic target for alcoholism, according to new studies by researchers at the National Institute on Alcohol Abuse and Alcoholism (NIAAA), part of the National Institutes of Health (NIH).
In preclinical and clinical studies currently reported online in Science Express, NIAAA Clinical Director Markus Heilig, M.D., Ph.D., and colleagues from the NIH, Lilly Research Laboratories, and University College in London found that a brain molecule known as the neurokinin 1 receptor, or NK1R, appears to be a central actor in stress-related drinking.
The researchers first demonstrated that NK1R plays an integral role in alcohol consumption in animals. Mice that were genetically engineered to lack NK1 receptors consumed much less alcohol than did normal mice with fully functional NK1R. Subsequently, in a small clinical study, the researchers showed that an experimental compound designed to block NK1 receptors reduced alcohol craving and improved overall wellbeing among recently detoxified alcohol-dependent individuals who had high levels of anxiety.
Click here to read entire article at Science Daily.com
In preclinical and clinical studies currently reported online in Science Express, NIAAA Clinical Director Markus Heilig, M.D., Ph.D., and colleagues from the NIH, Lilly Research Laboratories, and University College in London found that a brain molecule known as the neurokinin 1 receptor, or NK1R, appears to be a central actor in stress-related drinking.
The researchers first demonstrated that NK1R plays an integral role in alcohol consumption in animals. Mice that were genetically engineered to lack NK1 receptors consumed much less alcohol than did normal mice with fully functional NK1R. Subsequently, in a small clinical study, the researchers showed that an experimental compound designed to block NK1 receptors reduced alcohol craving and improved overall wellbeing among recently detoxified alcohol-dependent individuals who had high levels of anxiety.
Click here to read entire article at Science Daily.com
Common Heart Drug May Reduce Cocaine Cravings
ScienceDaily (Feb. 28, 2008)
Researchers from Boston University School of Medicine and Harvard Medical School have found that diltiazem, a drug used in the treatment of high blood pressure, reduces cocaine cravings in a rat model.
Previous work showed that two brain chemicals, dopamine and glutamate, independently contribute to the development of cocaine addiction. This new research indicates that calcium channels provide critical links between dopamine and glutamate that drives the intense craving associated with cocaine addiction. Diltiazem, one of a class of drugs known as calcium channel blockers, disrupts the connection between dopamine and glutamate formed during chronic cocaine use.
According to the researchers, brain calcium plays an important role in learning and memory in that calcium influences an enzyme known as the "memory molecule." "Our work shows that cocaine increases the levels of this molecule specifically in a brain area that controls motivation. Thus, cocaine use teaches the brain to be addicted, resulting in a dysfunctional form of learning that drives the overwhelming desire to consume more cocaine," said senior author Chris Pierce, a professor of pharmacology and psychiatry at Boston University School of Medicine.
Currently, there are no effective drug therapies for cocaine addiction. Pierce noted that research such as this using animal models could lead to desperately needed medications. "The strength of this work is that it tells us something fundamental about how brain chemistry changes as cocaine addiction takes hold. Importantly, our findings also suggest new strategies for developing cocaine addiction therapies, which thus far remain elusive," he added.
These findings will appear in the March issue of the leading medical journal Nature Neuroscience.
This study was supported by grants from the National Institutes of Health.
Adapted from materials provided by Boston University.
Researchers from Boston University School of Medicine and Harvard Medical School have found that diltiazem, a drug used in the treatment of high blood pressure, reduces cocaine cravings in a rat model.
Previous work showed that two brain chemicals, dopamine and glutamate, independently contribute to the development of cocaine addiction. This new research indicates that calcium channels provide critical links between dopamine and glutamate that drives the intense craving associated with cocaine addiction. Diltiazem, one of a class of drugs known as calcium channel blockers, disrupts the connection between dopamine and glutamate formed during chronic cocaine use.
According to the researchers, brain calcium plays an important role in learning and memory in that calcium influences an enzyme known as the "memory molecule." "Our work shows that cocaine increases the levels of this molecule specifically in a brain area that controls motivation. Thus, cocaine use teaches the brain to be addicted, resulting in a dysfunctional form of learning that drives the overwhelming desire to consume more cocaine," said senior author Chris Pierce, a professor of pharmacology and psychiatry at Boston University School of Medicine.
Currently, there are no effective drug therapies for cocaine addiction. Pierce noted that research such as this using animal models could lead to desperately needed medications. "The strength of this work is that it tells us something fundamental about how brain chemistry changes as cocaine addiction takes hold. Importantly, our findings also suggest new strategies for developing cocaine addiction therapies, which thus far remain elusive," he added.
These findings will appear in the March issue of the leading medical journal Nature Neuroscience.
This study was supported by grants from the National Institutes of Health.
Adapted from materials provided by Boston University.
Friday, January 11, 2008
Should Heroin Be Prescribed To Addicts?
ScienceDaily (Jan. 11, 2008) — Experts debate whether heroin should be prescribed to addicts who are difficult to treat in a recent issue of the British Medical Journal.
Maintenance treatment with heroin is appropriate for heroin misusers under certain circumstances, argue Jürgen Rehm from the Centre for Addiction and Mental Health in Toronto and Benedikt Fischer from the University of Victoria, British Columbia.
They point to trials in Switzerland, the Netherlands and Germany, which found heroin assisted maintenance treatment feasible and effective for those resistant to treatment. They also found it to be cost effective compared with methadone maintenance treatment.
In the UK, heroin has also been a treatment option for heroin misusers for several decades, but the practice remains controversial.
Click here to read entire article at Science Daily.com
Maintenance treatment with heroin is appropriate for heroin misusers under certain circumstances, argue Jürgen Rehm from the Centre for Addiction and Mental Health in Toronto and Benedikt Fischer from the University of Victoria, British Columbia.
They point to trials in Switzerland, the Netherlands and Germany, which found heroin assisted maintenance treatment feasible and effective for those resistant to treatment. They also found it to be cost effective compared with methadone maintenance treatment.
In the UK, heroin has also been a treatment option for heroin misusers for several decades, but the practice remains controversial.
Click here to read entire article at Science Daily.com
Wednesday, November 7, 2007
Behavior Therapy Plus Medication May Help Teens With Depression And Substance Use Disorders
ScienceDaily (Nov. 7, 2007) — The antidepressant fluoxetine combined with cognitive behavioral therapy appears as effective for treating depression among teens who also have substance use disorders as among those without substance abuse problems, according to a report in the November issue of Archives of Pediatrics & Adolescent Medicine.
"Adolescents with substance use disorders (SUDs) have higher rates of depression (15 percent to 24 percent) than adolescents in the general population," the authors write as background information in the article. "Comorbid [co-occuring] depression is also associated with more severe substance abuse, poorer drug treatment outcomes and higher relapse rates."
Paula D. Riggs, M.D., and colleagues at the University of Colorado Denver conducted a randomized controlled trial of the antidepressant fluoxetine in 126 teens (average age 17) who met diagnostic criteria for major depressive disorder, lifetime conduct disorder and at least one substance abuse disorder other than tobacco. The adolescents were randomly assigned to receive either 20 milligrams of fluoxetine daily or placebo, along with cognitive behavioral therapy, a type of psychotherapy addressing the way individuals currently think and act rather than past events. The cognitive behavior therapy was focused on substance abuse rather than depression.
Click here to read entire article at Science Daily.com
"Adolescents with substance use disorders (SUDs) have higher rates of depression (15 percent to 24 percent) than adolescents in the general population," the authors write as background information in the article. "Comorbid [co-occuring] depression is also associated with more severe substance abuse, poorer drug treatment outcomes and higher relapse rates."
Paula D. Riggs, M.D., and colleagues at the University of Colorado Denver conducted a randomized controlled trial of the antidepressant fluoxetine in 126 teens (average age 17) who met diagnostic criteria for major depressive disorder, lifetime conduct disorder and at least one substance abuse disorder other than tobacco. The adolescents were randomly assigned to receive either 20 milligrams of fluoxetine daily or placebo, along with cognitive behavioral therapy, a type of psychotherapy addressing the way individuals currently think and act rather than past events. The cognitive behavior therapy was focused on substance abuse rather than depression.
Click here to read entire article at Science Daily.com
Tuesday, November 6, 2007
Medication Plus Counseling May Help Teens Kick The Smoking Habit
ScienceDaily (Nov. 6, 2007) — The medication bupropion plus counseling appears to help adolescents quit cigarette smoking in the short term, according to a new report.
Almost one-fourth of U.S. high school students currently smoke cigarettes, according to background information in the article. Many teen smokers want to quit, but studies estimate that only about 4 percent of those who try are successful each year. The antidepressant bupropion has been shown to help adults quit smoking and also is used to treat attention deficit disorders in children.
Myra L. Muramoto, M.D., M.P.H., Scott J. Leischow, Ph.D., and colleagues at the University of Arizona, Tucson, conducted a clinical trial of 312 adolescents age 14 to 17 who smoked six or more cigarettes per day and had tried to quit at least twice before. They were randomly assigned to receive 150 milligrams (105 teens) or 300 milligrams (104 teens) of bupropion per day, or placebo (103 teens). Participants visited the clinic weekly for seven weeks--six weeks of treatment plus one week post-treatment--and received 10- to 20-minute individual cessation counseling sessions. They were interviewed by phone after 12 weeks and in person after 26 weeks.
Click here to read entire article at Science Daily.com
Almost one-fourth of U.S. high school students currently smoke cigarettes, according to background information in the article. Many teen smokers want to quit, but studies estimate that only about 4 percent of those who try are successful each year. The antidepressant bupropion has been shown to help adults quit smoking and also is used to treat attention deficit disorders in children.
Myra L. Muramoto, M.D., M.P.H., Scott J. Leischow, Ph.D., and colleagues at the University of Arizona, Tucson, conducted a clinical trial of 312 adolescents age 14 to 17 who smoked six or more cigarettes per day and had tried to quit at least twice before. They were randomly assigned to receive 150 milligrams (105 teens) or 300 milligrams (104 teens) of bupropion per day, or placebo (103 teens). Participants visited the clinic weekly for seven weeks--six weeks of treatment plus one week post-treatment--and received 10- to 20-minute individual cessation counseling sessions. They were interviewed by phone after 12 weeks and in person after 26 weeks.
Click here to read entire article at Science Daily.com
Wednesday, October 24, 2007
Hypnotherapy For Smoking Cessation Sees Strong Results
ScienceDaily (Oct. 24, 2007) — Hospitalized patients who smoke may be more likely to quit smoking through the use of hypnotherapy than patients using other smoking cessation methods. A new study* shows that smoking patients who participated in one hypnotherapy session were more likely to be nonsmokers at 6 months compared with patients using nicotine replacement therapy (NRT) alone or patients who quit "cold turkey". The study also shows that patients admitted to the hospital with a cardiac diagnosis are three times more likely to quit smoking at 6 months than patients admitted with a pulmonary diagnosis.
"Our results showed that hypnotherapy resulted in higher quit rates compared with NRT alone," said Faysal Hasan, MD, FCCP, North Shore Medical Center, Salem, MA. "Hypnotherapy appears to be quite effective and a good modality to incorporate into a smoking cessation program after hospital discharge."
Dr. Hasan and colleagues from North Shore Medical Center and Massachusetts General Hospital compared the quit rates of 67 smoking patients hospitalized with a cardiopulmonary diagnosis. All patients were approached about smoking cessation and all included in the study were patients who expressed a desire to quit smoking.
Click here to read entire article at Science Daily.com
"Our results showed that hypnotherapy resulted in higher quit rates compared with NRT alone," said Faysal Hasan, MD, FCCP, North Shore Medical Center, Salem, MA. "Hypnotherapy appears to be quite effective and a good modality to incorporate into a smoking cessation program after hospital discharge."
Dr. Hasan and colleagues from North Shore Medical Center and Massachusetts General Hospital compared the quit rates of 67 smoking patients hospitalized with a cardiopulmonary diagnosis. All patients were approached about smoking cessation and all included in the study were patients who expressed a desire to quit smoking.
Click here to read entire article at Science Daily.com
Thursday, October 11, 2007
Highs And Lows Of Drug Cravings
ScienceDaily (Oct. 11, 2007) — The anticipation of a cocaine fix and the actual craving to abuse the drug are two closely related phenomena, according to new evidence published in the journal Substance Abuse Treatment, Prevention, and Policy.
The study, by Rinah Yamamoto and colleagues at McLean Hospital in Belmont, Massachusetts assessed the suspected link by contrasting reactions to varying perceived availability of the drug. The researchers suggest that more appropriate care could be given if the degree of dependency and abuse were assessed in a natural environment with a potential access to the drug, rather than in a clinical setting.
Yamamoto explains that craving, is an intense and often irrepressible urge to seek and consume the drug, which can result in relapses even after extended periods of abstinence. In searching for effective therapies, understanding how craving, cognition and motivation are entwined is essential.
Click here to continue reading article at Science Daily.com
The study, by Rinah Yamamoto and colleagues at McLean Hospital in Belmont, Massachusetts assessed the suspected link by contrasting reactions to varying perceived availability of the drug. The researchers suggest that more appropriate care could be given if the degree of dependency and abuse were assessed in a natural environment with a potential access to the drug, rather than in a clinical setting.
Yamamoto explains that craving, is an intense and often irrepressible urge to seek and consume the drug, which can result in relapses even after extended periods of abstinence. In searching for effective therapies, understanding how craving, cognition and motivation are entwined is essential.
Click here to continue reading article at Science Daily.com
Monday, September 10, 2007
Teen Binge Drinkers Risk Alcoholism And Social Exclusion As Adults
ScienceDaily (Sep. 10, 2007) — Teen binge drinkers are significantly more likely to become heavy drinkers as adults and find themselves with a string of criminal convictions, indicates a study in the Journal of Epidemiology and Community Health.
The researchers monitored the health and prospects of more than 11,000 UK children born in 1970 (The 1970 British Birth Cohort Study) at the ages of 16 and 30.
They collected information on binge drinking during the preceding fortnight and habitual drinking during the previous year from the 16 year olds.
One in four of the 16 year olds were habitual drinkers, drinking more than two to three times a week.
Binge drinking was classified as two or more episodes in which four or more drinks had been consumed in a row. Almost 18% fell into this category of drinker, with more young men than women binge drinking.
Click here to read entire article at Science Daily.com
The researchers monitored the health and prospects of more than 11,000 UK children born in 1970 (The 1970 British Birth Cohort Study) at the ages of 16 and 30.
They collected information on binge drinking during the preceding fortnight and habitual drinking during the previous year from the 16 year olds.
One in four of the 16 year olds were habitual drinkers, drinking more than two to three times a week.
Binge drinking was classified as two or more episodes in which four or more drinks had been consumed in a row. Almost 18% fell into this category of drinker, with more young men than women binge drinking.
Click here to read entire article at Science Daily.com
Tuesday, July 3, 2007
Researchers Identify Alcoholism Subtypes
ScienceDaily (July 3, 2007) — Analyses of a national sample of individuals with alcohol dependence (alcoholism) reveal five distinct subtypes of the disease, according to a new study by scientists at the National Institute on Alcohol Abuse and Alcoholism (NIAAA), part of the National Institutes of Health (NIH).
"Our findings should help dispel the popular notion of the 'typical alcoholic,'" notes first author Howard B. Moss, M.D., NIAAA Associate Director for Clinical and Translational Research. "We find that young adults comprise the largest group of alcoholics in this country, and nearly 20 percent of alcoholics are highly functional and well-educated with good incomes. More than half of the alcoholics in the United States have no multigenerational family history of the disease, suggesting that their form of alcoholism was unlikely to have genetic causes."
"Clinicians have long recognized diverse manifestations of alcoholism," adds NIAAA Director Ting-Kai Li, M.D, "and researchers have tried to understand why some alcoholics improve with specific medications and psychotherapies while others do not. The classification system described in this study will have broad application in both clinical and research settings." A report of the study is now available online in the journal Drug and Alcohol Dependence.
Click here to read entire article at Science Daily.com
"Our findings should help dispel the popular notion of the 'typical alcoholic,'" notes first author Howard B. Moss, M.D., NIAAA Associate Director for Clinical and Translational Research. "We find that young adults comprise the largest group of alcoholics in this country, and nearly 20 percent of alcoholics are highly functional and well-educated with good incomes. More than half of the alcoholics in the United States have no multigenerational family history of the disease, suggesting that their form of alcoholism was unlikely to have genetic causes."
"Clinicians have long recognized diverse manifestations of alcoholism," adds NIAAA Director Ting-Kai Li, M.D, "and researchers have tried to understand why some alcoholics improve with specific medications and psychotherapies while others do not. The classification system described in this study will have broad application in both clinical and research settings." A report of the study is now available online in the journal Drug and Alcohol Dependence.
Click here to read entire article at Science Daily.com
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