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By Manoel Vicente Barros Junior Brazilian Medical Student
George R Uhl, George F Koob, Jennifer Cable
Substance and alcohol use disorders impose large health and economic burdens on individuals, families, communities, and society. Neither prevention nor treatment efforts are effective in all individuals. Results are often modest. Advances in neuroscience and addiction research have helped to describe the neurobiological changes that occur when a person transitions from recreational substance use to a substance use disorder or addiction. Understanding both the drivers and consequences of substance use in vulnerable populations, including those whose brains are still maturing, has revealed behavioral and biological characteristics that can increase risks of addiction...
January 15, 2019: Annals of the New York Academy of Sciences
Emmanuel Darcq, Brigitte Lina Kieffer
Drug addiction is a worldwide societal problem and public health burden, and results from recreational drug use that develops into a complex brain disorder. The opioid system, one of the first discovered neuropeptide systems in the history of neuroscience, is central to addiction. Recently, opioid receptors have been propelled back on stage by the rising opioid epidemics, revolutions in G protein-coupled receptor research and fascinating developments in basic neuroscience. This Review discusses rapidly advancing research into the role of opioid receptors in addiction, and addresses the key questions of whether we can kill pain without addiction using mu-opioid-receptor-targeting opiates, how mu- and kappa-opioid receptors operate within the neurocircuitry of addiction and whether we can bridge human and animal opioid research in the field of drug abuse...
August 2018: Nature Reviews. Neuroscience
Robert D Rogers, Frederick G Moeller, Alan C Swann, Luke Clark
Alcohol misuse and dependence, and many of its accompanying psychological problems, are associated with heightened levels of impulsivity that both accelerate the development of clinically significant illness and complicate clinical outcome. This article reviews recent developments in our understanding of impulsivity as they relate to brain circuitry that might underlie these comorbid factors, focusing upon the clinical features of substance use (and dependence), bipolar disorder, and pathological gambling. Individuals who are affected by these disorders exhibit problems in several domains of impulsive behavior including deficient response or "motor" control, and the tolerance of prolonged delays prior to larger rewards at the expense of smaller rewards ("delay-discounting")...
August 2010: Alcoholism, Clinical and Experimental Research
D Pringuey, F Cherikh, S Lunacek, B Giordana, E Fakra, R Belzeaux, M Adida, J-M Azorin
The comorbidity of affective disorders with alcohol use disorder remains insufficiently taken into account. In spite of the well-known frequency of the addict comorbidity in most psychiatric disorders, the level of association between affective disorders and alcohol is still underestimated and poorly understood. The label of "double diagnosis" relates to a simple addition of two independent pathologies. It is suggested to consider a "dual psychopathology" combining the effects of one disorder on the other...
December 2014: L'Encéphale
Alvaro Camacho, Hagop S Akiskal
BACKGROUND: Stimulant abuse and dependence in confusing admixtures with features of bipolar disorder has been variously conceptualized. DSM-IV-TR rules tend to be liberal in permitting the diagnosis of substance-induced disorder, and rather strict for a bipolar diagnosis in such cases. Accordingly, if bipolarity is ever considered in this interface, it usually pertains to syndromal bipolar I disorder. METHOD: We therefore focused on the more prevalent but relatively neglected admixture of stimulant abuse with bipolar II and lesser degrees of bipolarity...
March 2005: Journal of Affective Disorders
Robert M Post, Peter Kalivas
BACKGROUND: Bipolar disorder has a high co-occurrence with substance use disorders, but the pathophysiological mechanisms have not been adequately explored. AIMS: To review the role of stress in the onset and recurrence of affective episodes and substance misuse. METHOD: We review the mechanisms involved in sensitisation (increased responsivity) to recurrence of stressors, mood episodes and cocaine use. RESULTS: Evidence suggests that intermittent stressors, mood episodes and bouts of cocaine use not only show sensitisation to themselves, but cross-sensitisation to the others contributing to illness progression...
March 2013: British Journal of Psychiatry: the Journal of Mental Science
Jiri Modestin, Sandra Kayser-Rapold, Marianne Vogt Wehrli, Martin Neuenschwander, Tina Malti
BACKGROUND: The main purpose of the study was to investigate whether there are differences between dual patients with affective disorders regarding the different kinds of substances abused - a topic which has hardly been dealt with in the literature. METHODS: Clinical charts of 94 dual and 94 non-dual patients, matched for sex, age, and diagnosis, were scrutinized and the data of both groups compared with each other, with regard to the substance of abuse. RESULTS: A total of 17...
September 2007: Journal of Affective Disorders
Francisco Arias, Nestor Szerman, Pablo Vega, Beatriz Mesías, Ignacio Basurte, David Rentero
Given its prevalence and impact on public health, the comorbidity of bipolar and substance use disorders is one of the most relevant of dual diagnoses. The objective was to evaluate the characteristics of patients from community mental health and substance abuse centres in Madrid. The sample consisted of 837 outpatients from mental health and substance abuse centres. We used the Mini International Neuropsychiatric Interview (MINI) and Personality Disorder Questionnaire (PDQ4+) to evaluate axis I and II disorders...
June 28, 2017: Adicciones
Clément Palpacuer, Renan Duprez, Alexandre Huneau, Clara Locher, Rémy Boussageon, Bruno Laviolle, Florian Naudet
BACKGROUND AND AIMS: Pharmacologically controlled drinking in the treatment of alcohol dependence or alcohol use disorders (AUDs) is an emerging concept. Our objective was to explore the comparative effectiveness of drugs used in this indication. DESIGN: Systematic review with direct and network meta-analysis of double-blind randomized controlled trials (RCTs) assessing the efficacy of nalmefene, naltrexone, acamprosate, baclofen or topiramate in non-abstinent adults diagnosed with alcohol dependence or AUDs...
February 2018: Addiction
José R Maldonado
Benzodiazepine (BZDP) agents are the standard for the prophylaxis and treatment of all phases of alcohol withdrawal syndrome. However, BZDPs have their drawbacks: cognitive impairment, significant neurologic and medical side effects. There are data suggesting that the alcohol recidivism rate and abuse potential is higher for BZDPs treated patients, compared to alternatives. Clinical and research data demonstrate the efficacy and safety of various pharmacologic alternatives to benzodiazepines for the prevention and management of AWS...
July 2017: Critical Care Clinics
Sean J Belouin, Jack E Henningfield
The purpose of this commentary is to provide an introduction to this special issue of Neuropharmacology with a historical perspective of psychedelic drug research, their use in psychiatric disorders, research-restricting regulatory controls, and their recent emergence as potential breakthrough therapies for several brain-related disorders. It begins with the discovery of lysergic acid diethylamide (LSD) and its promising development as a treatment for several types of mental illnesses during the 1940s. This was followed by its abuse and stigmatization in the 1960s that ultimately led to the placement of LSD and other psychedelic drugs into the most restrictively regulated drug schedule of the United States Controlled Substances Act (Schedule I) in 1970 and its international counterparts...
November 2018: Neuropharmacology
Robin L Carhart-Harris
The entropic brain hypothesis proposes that within upper and lower limits, after which consciousness may be lost, the entropy of spontaneous brain activity indexes the informational richness of conscious states. Here the hypothesis is revisited four years on from its original publication. It is shown that the principle that the entropy of brain activity is elevated in the psychedelic state is increasingly well supported by separate and independent studies and analyses, and evidence for greater brain criticality under psychedelics is also highlighted...
November 2018: Neuropharmacology
George J Annas
As Massachusetts prepares to implement its new medical-marijuana law, agents of the federal Drug Enforcement Administration (DEA) have reportedly visited at least seven Massachusetts physicians at their homes or offices and told them they must either give up their DEA registration or sever formal..
September 11, 2014: New England Journal of Medicine
Benjamin Chadwick, Michael L Miller, Yasmin L Hurd
Cannabis use is increasingly pervasive among adolescents today, even more common than cigarette smoking. The evolving policy surrounding the legalization of cannabis reaffirms the need to understand the relationship between cannabis exposure early in life and psychiatric illnesses. cannabis contains psychoactive components, notably Δ(9)-tetrahydrocannabinol (THC), that interfere with the brain's endogenous endocannabinoid system, which is critically involved in both pre- and post-natal neurodevelopment. Consequently, THC and related compounds could potentially usurp normal adolescent neurodevelopment, shifting the brain's developmental trajectory toward a disease-vulnerable state, predisposing early cannabis users to motivational, affective, and psychotic disorders...
October 14, 2013: Frontiers in Psychiatry
J W Toumbourou, T Stockwell, C Neighbors, G A Marlatt, J Sturge, J Rehm
A major proportion of the disease burden and deaths for young people in developed nations is attributable to misuse of alcohol and illicit drugs. Patterns of substance use established in adolescence are quite stable and predict chronic patterns of use, mortality, and morbidity later in life. We integrated findings of systematic reviews to summarise evidence for interventions aimed at prevention and reduction of harms related to adolescent substance use. Evidence of efficacy was available for developmental prevention interventions that aim to prevent onset of harmful patterns in settings such as vulnerable families, schools, and communities, and universal strategies to reduce attractiveness of substance use...
April 21, 2007: Lancet
Rebecca L Hartman, Marilyn A Huestis
BACKGROUND: Cannabis is the most prevalent illicit drug identified in impaired drivers. The effects of cannabis on driving continue to be debated, making prosecution and legislation difficult. Historically, delays in sample collection, evaluating the inactive Δ(9)-tetrahydrocannabinol (THC) metabolite 11-nor-9-carboxy-THC, and polydrug use have complicated epidemiologic evaluations of driver impairment after cannabis use. CONTENT: We review and evaluate the current literature on cannabis' effects on driving, highlighting the epidemiologic and experimental data...
March 2013: Clinical Chemistry
Martin R Wilkins
No abstract text is available yet for this article.
January 2006: Clinical Medicine: Journal of the Royal College of Physicians of London
Li Rita Zhang, Hal Morgenstern, Sander Greenland, Shen-Chih Chang, Philip Lazarus, M Dawn Teare, Penella J Woll, Irene Orlow, Brian Cox, Yonathan Brhane, Geoffrey Liu, Rayjean J Hung
To investigate the association between cannabis smoking and lung cancer risk, data on 2,159 lung cancer cases and 2,985 controls were pooled from 6 case-control studies in the US, Canada, UK, and New Zealand within the International Lung Cancer Consortium. Study-specific associations between cannabis smoking and lung cancer were estimated using unconditional logistic regression adjusting for sociodemographic factors, tobacco smoking status and pack-years; odds-ratio estimates were pooled using random effects models...
February 15, 2015: International Journal of Cancer. Journal International du Cancer
Hercilio P Oliveira, Andre Malbergier
OBJECTIVES: To determine whether and to what extent cannabis dependence is associated with comorbid psychiatric disorders and specific stages of change in treatment-seeking patients. METHODS: We evaluated 80 cannabis-dependent, treatment-seeking patients residing in an urban area. Data on cannabis dependence, psychiatric disorders, and motivation were obtained using the Schedules for Clinical Assessment in Neuropsychiatry and the University of Rhode Island Change Assessment (URICA)...
April 2014: Revista Brasileira de Psiquiatria
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