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Addiction treatment

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By Christopher Cook, BA,CADC, SAP Addiction professional. LPC, CADC, CRNP- student, Interventionist, project manager, owner, Director, eval/refer for SUDs/Eating D/o's
Yonatan M Kupchik, Michael D Scofield, Kenner C Rice, Kejun Cheng, Bernard P Roques, Peter W Kalivas
The ventral pallidum (VP) is a target of dense nucleus accumbens projections. Many of these projections coexpress GABA and the neuropeptide enkephalin, a δ and μ opioid receptor (MOR) ligand. Of these two, the MOR in the VP is known to be involved in reward-related behaviors, such as hedonic responses to palatable food, alcohol intake, and reinstatement of cocaine seeking. Stimulating MORs in the VP decreases extracellular GABA, indicating that the effects of MORs in the VP on cocaine seeking are via modulating GABA neurotransmission...
January 15, 2014: Journal of Neuroscience: the Official Journal of the Society for Neuroscience
Susana Barbosa Méndez, Alberto Salazar-Juárez
BACKGROUND: Anxiety and depression, key symptoms of the cocaine withdrawal syndrome in human addicts, are considered the main factors that precipitate relapse in chronic cocaine addiction. Preclinical studies have found that rodents exposed to different withdrawal periods show an increase in anxiety and depressive-like behavior. Mirtazapine - a tetracyclic medication - is used primarily to treat depression and, sometimes, anxiety. It has also successfully improved withdrawal symptoms in drug-dependent patients...
May 2019: Journal of Psychopharmacology
Chiung-Chun Huang, Che-Ming Yeh, Mei-Ying Wu, Alice Y W Chang, Julie Y H Chan, Samuel H H Chan, Kuei-Sen Hsu
Neuroadaptation in the nucleus accumbens (NAc), a central component of the mesolimbic dopamine (DA) system, has been implicated in the development of cocaine-induced psychomotor sensitization and relapse to cocaine seeking. However, little is known about the cellular and synaptic mechanisms underlying such adaptation. Using a mouse model of behavioral sensitization, we show that animals withdrawn from repeated cocaine exposure have a selective deficit in the ability to elicit metabotropic glutamate receptor (mGluR)-dependent long-term depression (LTD) in the shell of the NAc in response to bath application of the group I mGluR agonist (S)-3,5-dihydroxyphenylglycine (DHPG)...
March 16, 2011: Journal of Neuroscience: the Official Journal of the Society for Neuroscience
Bart de Laat, Alissa Goldberg, Julia Shi, Jeanette M Tetrault, Nabeel Nabulsi, Ming-Qiang Zheng, Soheila Najafzadeh, Hong Gao, Michael Kapinos, Jim Ropchan, Stephanie S O'Malley, Yiyun Huang, Evan D Morris, Suchitra Krishnan-Sarin
BACKGROUND: Naltrexone is a nonselective opioid receptor antagonist used as a treatment for alcohol use disorder. However, only modest clinical effects have been observed, possibly because of limited knowledge about the biological variables affecting the efficacy of naltrexone. We investigated the potential role of the kappa opioid receptor (KOR) in the therapeutic effect of naltrexone. METHODS: A total of 48 non-treatment-seeking heavy drinkers (16 women) who met DSM-IV criteria for alcohol dependence participated in two alcohol drinking paradigms (ADPs) separated by a week of open-label naltrexone (100 mg daily)...
June 8, 2019: Biological Psychiatry
Harrison J VanDolah, Brent A Bauer, Karen F Mauck
Cannabidiol (CBD) oils are low tetrahydrocannabinol products derived from Cannabis sativa that have become very popular over the past few years. Patients report relief for a variety of conditions, particularly pain, without the intoxicating adverse effects of medical marijuana. In June 2018, the first CBD-based drug, Epidiolex, was approved by the US Food and Drug Administration for treatment of rare, severe epilepsy, further putting the spotlight on CBD and hemp oils. There is a growing body of preclinical and clinical evidence to support use of CBD oils for many conditions, suggesting its potential role as another option for treating challenging chronic pain or opioid addiction...
June 12, 2019: Mayo Clinic Proceedings
Lael Reinstatler, Nagy A Youssef
OBJECTIVE: To review the published literature on the efficacy of ketamine for the treatment of suicidal ideation (SI). METHODS: The PubMed and Cochrane databases were searched up to January 2015 for clinical trials and case reports describing therapeutic ketamine administration to patients presenting with SI/suicidality. Searches were also conducted for relevant background material regarding the pharmacological function of ketamine. RESULTS: Nine publications (six studies and three case reports) met the search criteria for assessing SI after administration of subanesthetic ketamine...
March 2015: Drugs in R&D
Guillaume Ferré, Georges Czaplicki, Pascal Demange, Alain Milon
Dynorphin is a neuropeptide involved in pain, addiction and mood regulation. It exerts its activity by binding to the kappa opioid receptor (KOP) which belongs to the large family of G protein-coupled receptors. The dynorphin peptide was discovered in 1975, while its receptor was cloned in 1993. This review will describe: (a) the activities and physiological functions of dynorphin and its receptor, (b) early structure-activity relationship studies performed before cloning of the receptor (mostly pharmacological and biophysical studies of peptide analogues), (c) structure-activity relationship studies performed after cloning of the receptor via receptor mutagenesis and the development of recombinant receptor expression systems, (d) structural biology of the opiate receptors culminating in X-ray structures of the four opioid receptors in their inactive state and structures of MOP and KOP receptors in their active state...
2019: Vitamins and Hormones
Shimaalsadat Sajadi, Majid Kazemi, Babak Bakhtar, Hamid Ostadebrahimi
BACKGROUND: The neonates of addicted women are at risk for neonatal abstinence syndrome. This study aimed to compare the effects of auricular seed acupressure and foot reflexology on neonatal abstinence syndrome among the neonates of addicted women. METHODS: Thirty one neonates of addicted women were purposively recruited and randomly allocated through coin flipping to receive either foot reflexology then seed acupressure or seed acupressure then foot reflexology...
August 2019: Complementary Therapies in Clinical Practice
Constanza Garcia-Keller, Cora Smiley, Cara Monforton, Samantha Melton, Peter W Kalivas, Justin Gass
Converging epidemiological studies show that a life-threatening event increases the incidence of posttraumatic stress disorder (PTSD), which carries 30% to 50% comorbidity with substance use disorders (SUDs). Such comorbidity results in greater drug use and poorer treatment outcomes. There is overlap between the enduring synaptic neuroadaptations produced in nucleus accumbens core (NAcore) by acute restraint stress and cocaine self-administration. Because of these coincident neuroadaptations, we hypothesized that an odor paired with acute restraint stress would reinstate drug seeking and chose two mechanistically distinct drugs of abuse to test this hypothesis: alcohol and cocaine...
July 7, 2019: Addiction Biology
Brian M Cox, Thomas E Cote, Irwin Lucki
The marked increase in deaths related to opioid drugs since 1999 was associated with an increase in the number of prescriptions for opioid drugs. This was accompanied by increasing demand for improved management of chronically painful conditions. These factors suggest that improvements are needed in the education of physicians with regard to the management of chronic pain, the optimal therapeutic application of opioid drugs, and the avoidance of substance use disorders. In this paper we address the evidence that physician education can influence prescribing practices and discuss approaches to enhancing the pre-clinical and clinical education of medical students in pain management and substance use disorders...
July 18, 2019: Journal of Pharmacology and Experimental Therapeutics
Hassan Ziaaddini, Shima Heshmati, Maryam Chegeni, Mahboobeh Mousavi-Ramezanzade, Shahrzad Mazhari
Background: Buprenorphine sublingual tablets are now available in Iran for opioid detoxification in clinics. Aim of the present study was to compare the efficiency of buprenorphine with buprenorphine/naloxone in short-term detoxification in a group of Iranian male opioid-dependent patients. Methods: A double-blind trial was carried out on a group of male opioid dependent patients in a psychiatric hospital in Kerman, Iran, during year 2017. A group of 100 men who met the diagnostic criteria for opiate dependence were included in the study from individuals who had referred for detoxification...
October 2018: Addiction & Health
Oscar D'Agnone
Opioid dependence (OD) may be effectively treated with well-evidenced regimens including psychosocial and pharmacotherapeutic interventions. Treatment has benefits but also limitations including risk of diversion, impact of mandatory daily supervision, and stigma. An injectable prolonged release buprenorphine with flexible dose options has recently been approved by the European Commission and is available in the UK and other European Countries. Initial positive treatment experience in patients with different clinical scenarios (patients with no recent treatment history, a transfer from oral methadone, and change from sublingual buprenorphine tablets) provides evidence of the potential benefit in a range of situations for this therapeutic option...
2019: Case Reports in Psychiatry
Howard D Chilcoat, Halle R Amick, Molly R Sherwood, Kelly E Dunn
Opioid use disorder (OUD) and its consequences are a major public health concern. The partial agonist buprenorphine is a safe and effective treatment for OUD, but concerns about abuse, misuse, and diversion of buprenorphine have been raised. This narrative review examined the rates and motives for use of illicit buprenorphine in the United States. Findings from the 17 included studies suggest the majority of study participants using illicit buprenorphine do so for reasons related to misuse (to manage opioid withdrawal symptoms or achieve or maintain abstinence from other opioids)...
September 2019: Journal of Substance Abuse Treatment
Felicity Callard, Constantina Stan Papoulias
This article analyses how and with what consequences body-mind relations (the sphere of the psychosomatic) are being modelled in the 21st century through considering the interdiscipline of neuropsychoanalysis. The promise of the term psychosomatic lies in its efforts to rework standard, bifurcated models of mind and body: somatic acts are simultaneously psychic acts. But neuropsychoanalysis, as it brings the neurosciences and psychoanalysis together to model an embodied 'MindBrain', ends up evacuating another potent characteristic found in much of the psychosomatic tradition-its refusal to adjudicate, a priori, what counts as the adaptive or well-regulated subject...
June 2019: Medical Humanities
Darin Weinberg
Addiction science and public policy have for some time been articulated in conformity with a broader antinomy in Western thought between biological reductionism and liberal voluntarism. Hence, mainstream debates have concerned whether and how addiction might be understood as a disease in the biomedically orthodox sense of anatomical or physiological pathology or whether and how addiction might be understood as a voluntary choice of some kind. The fact that those who staff these debates have appeared either unable or unwilling to consider alternatives to this antinomy has resulted in a rather unhappy and intransigent set of intellectual anomalies both on the biomedical and the social scientific sides of this divide...
June 2019: Medical Humanities
Robert A Gardner, David H Epstein, Kenzie L Preston, Karran A Phillips
Background: Treatment with methadone is effective in reducing heroin use, HIV risk, and death; however, not all patients respond to treatment. Better outcomes may emerge with personalized treatment based on factors that influence treatment courses. Objectives: To investigate psychosocial variables contributing to treatment response, using a comprehensive definition of treatment response. Methods: Seventy participants seeking treatment for heroin and cocaine addiction completed up to 40 weeks of daily methadone...
July 18, 2019: Substance Use & Misuse
David A Wiss
The opioid crisis has reached epidemic proportions in the United States with rising overdose death rates. Identifying the underlying factors that contribute to addiction vulnerability may lead to more effective prevention strategies. Supply side environmental factors are a major contributing component. Psychosocial factors such as stress, trauma, and adverse childhood experiences have been linked to emotional pain leading to self-medication. Genetic and epigenetic factors associated with brain reward pathways and impulsivity are known predictors of addiction vulnerability...
2019: Frontiers in Public Health
Sheng-Tzung Tsai, Hock-Kean Liew, Hao-Ming Li, Shinn-Zong Lin, Shin-Yuan Chen
Drug and alcohol addiction has become an emerging public health issue and is a great burden to patients, their families, and society. It is characterized by high relapse rates and significant morbidity and mortality, and most available treatments result in only modest improvement. These findings highlight the necessity for new approaches to treat addiction. Scientific reports in the past two decades suggest that addiction involves impaired neural plasticity and decreased hippocampal neurogenesis. Stem cell therapy and its derived neurotrophic factors can potentially target the underlying pathophysiology of addiction...
July 4, 2019: Cell Transplantation
Thomas Larrieu, Sophie Layé
The central nervous system (CNS) has the highest concentration of lipids in the organism after adipose tissue. Among these lipids, the brain is particularly enriched with polyunsaturated fatty acids (PUFAs) represented by the omega-6 (ω6) and omega-3 (ω3) series. These PUFAs include arachidonic acid (AA) and docosahexaenoic acid (DHA), respectively. PUFAs have received substantial attention as being relevant to many brain diseases, including anxiety and depression. This review addresses an important question in the area of nutritional neuroscience regarding the importance of ω3 PUFAs in the prevention and/or treatment of neuropsychiatric diseases, mainly depression and anxiety...
2018: Frontiers in Physiology
Norah Mulvaney-Day, Brent J Gibbons, Shums Alikhan, Mustafa Karakus
Objectives. To assess the impact of the 2008 Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act (MHPAEA) on mental and substance use disorder services in the private, large group employer-sponsored insurance market in the United States. Methods. We analyzed data from the IBM MarketScan Commercial Database from January 2005 through September 2015 by using population-level interrupted time series regressions to determine whether parity implementation was associated with utilization and spending outcomes...
June 2019: American Journal of Public Health
2019-07-11 16:52:52
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