Addiction Research - Science topic

AA/NA program is about acceptance, and about letting go. Members follow the 12 steps, through reflection and through looking deep within themselves. Many do recover 'if they have the capacity to be honest (with themselves)', and as they, members often say 'it works if you work it'. Addicts/Alcoholics usually start going to the meetings when they hit their rock bottom, and they are left with limited options, if any. Those who are persistent, work the steps, and want to stay clean and sober, lead a good life, with everything they need in their life. Their meetings are very emotional, there is a sense of fellowship, they laugh and cry together, and through the program, many achieve high spiritual growth. So, I believe that this is a successful recovery program, however, a person has to work want his/her recovery, and have Faith.

And no, this is not about religion as we know it. Hope that this was helpful.

Dear Ahmed Ismail Ebada,

see my answer to this question:

How can I calculate using of energy by WSN node?

Maybe my answer to this question can help you a little.

Best regards

Anatol Badach

There are four kinds of tools available to measure social networking addiction.

1) Tools that measure generalized internet addiction such as Internet addiction scale (Young, 1998), Pathological Internet Use Scale (Morahan-Martin & Schumacher, 2000), Online Cognition Scale (Davis et al., 2002), and Internet-Related Problem Scale (Armstrong et al., 2000).

2) Since Facebook has recently been one of the most popular media, many measures have been developed to measure Facebook-related addiction (Çam & Isbulan, 2012; Andreassen et al., 2012b; Sofiah et al., 2011).

3) Two scales that assess generalized social media addiction are Bergen Social Media Addiction Scale (Andreassen et al., 2016) and Social media disorder (Van den Eijnden et al., 2016).

4) Tools that measure social networking addiction such as Addictive tendencies toward SNS (Wu et al., 2013) and Social networking addiction scale (Shahnawaz et al., 2013).

However, a closer look at these tools revealed that none measured social networking addiction except for the last two. The first category of tools measures generalized internet addiction while the second category of tools measures a very specific parameter that is Facebook. The third category of tools which are of recent origin measure social media addiction. In a review on social networking sites, Kuss and Griffiths (2017) categorically stated that “social networking and social media use have often been interchangeable in the scientific literature, but, they are not same” Also, they stated that “Facebook addiction is only one example of SNS addiction.”

urbanization and industrialization are the end cause of urbanization and industrialization

Dear Colleagues and Friends from RG,

In the context of the above discussion, I propose to add to our considerations the following important issue:

Scientific conferences make it possible to make friends with other scientists and researchers. During the conference there are opportunities to conduct discussions and debates on interesting topics. Thanks to this, it is possible to undertake scientific cooperation and create international research teams and projects.

Do you agree with me on the above matter?

- What do you think about this topic?

- What is your opinion on this topic?

Please reply.

I invite you to discussion and scientific cooperation.

Thank you very much.

Best wishes.

Dariusz Prokopowicz

It might be a good idea to run your extinction rats separately so to not interfere with their extinction learning, although I have run cue-reinstatement testing alongside extinction before within the same session (across different boxes) and didn't notice any issues. That being said, I don't see a problem running multiple rats for cue-reinstatement within the same session. The rats learn to self-administer drug (with the paired contingent cues) alongside all the other rats, and they are possibly hearing the cues from the other boxes during this learning process. This experience in and of itself could be a salient cue as well! I guess it could depend on the specific question you're trying to answer. For example, if you were trying to measure cue-dependent, second-by-second neurochemical recordings in real time during a reinstatement session, having potentially salient "background noise" coming from other boxes could introduce some variability perhaps. For most purposes though, I don't see why it would be a significant issue to run multiple reinstatement tests across different boxes within the same session.

I think it should be the student with low of inefficient level of dopamine because band there will be reduction in some cognitive function and dopamine also excite the nerve fiber with low level this will be reduce leading to craving for stimulants

I took the survey to help. A good piece of work!

I think addictions treatment should not just focus on the old model of abstinence and 12 steps. There are many newer techniques including acupuncture and holistic approaches which should be integrated into the treatment protocol. The old approach of "confront, confront..." does not work with every addict. Use of the "Stages for Change" model ( Prochaska and DiClemente) along with a full blown assessment of where the client is and their support system and beliefs is vital.

These graphs show the status of research in the area of engineering in the country of Uganda. These results are performed using Scopus. Scopus is a bibliographic database started in 2004, of abstracts and citations of articles from scientific journals. It covers areas of: science, technology, medicine and social sciences (including arts and humanities). It covers more than 35,000 titles from all areas. Apart from magazines, it has monographic series, conference proceedings, books (emptied at the book and chapter level) or patents (more than 39 million, emptied from five official offices: WIPO, EPO, United States, Japan and United Kingdom). Its temporary coverage is from 1996, although it sometimes reaches 1970.

The graphics appear as an attachment to this message.

The assumption is that the "social worker" or "therapist" or "counselor" (all of whom do not prescribe medication) can discern from the conversation signs of intellectual and emotional impairment. If you are just having challenges and difficulties in life that cause you discomfort then medication is not called for. If you are unable to deal with challenges due to mental or emotional impairment then you may need medication (or medication change). To save the medical doctor (psychiatrist) time the client is "screened" with this approach. It is to use the doctor (who is usually more expensive) only after it has been determined what your problem is (physiological or not physiological). A third option is to seek out practitioners who understand the emerging orthomolecular techniques that address the dysfunctional metabolic cycles that underlie various mental illnesses. This is more problematic if you have been on medication for 10 years or more but it may be worth consideration. I review a popular book "Nutrient Power" written for the non-expert on this approach that I think has great promise and quality researchers involved at:

https://timcburgess.blogspot.com/2019/06/review-nutrient-power.html

There is evidence to suggest that they, like Asians (see studies on Japanese) are more susceptible to ALCOHOL, in the sense that it takes less alcohol to create the equivalent or greater sense of intoxication, than, for example, someone of Scottish origin. There is NO EVIDENCE that I HAVE SEEN to suggest that Native Americans are more susceptible to ALCOHOLISM, more properly referred to as Alcohol Use Disorder (DSM-V). It is important to make this distinction.

Simple outcome measure:

Percent with a diagnosis of opioid use disorder who are discharged on medication-assisted treatment-

1. Percent discharged on oral suboxone (good) or oral methadone

2. Percent discharged on sublocade (best)

3. percent discharged on naltrexone/Vivitrol (okay)

4. percent discharged without any medication protection (poor)

Patients in category #4 are at HIGH RISK of relapse, overdose and death.

Patients in categories 1-3 have protection against the risk of death via overdose.

75,000 Americans died of opioid overdose last year. Treatment should PROTECT patients in the initial phase of recovery (year #1 at least) from death.

Other outcome measures are secondary.

Treatment centers that don't encourage patients to protect themselves from death with these life-saving medications are setting them up for failure and death after they live the highly structured and supportive environment.

On appropriate meds = lower risk

No meds = extremely high risk

I read two very pertinent guide books at the beginning of my PhD. Try reading this one to start: https://www.amazon.com/Authoring-PhD-Doctoral-Dissertation-Palgrave-ebook/dp/B006UH4F12

Three things that I took from these guide books:

I hope this advice helps you.

Thanks Beatrice for sharing your article! You have interesting data from regression analysis & factors contributing to drug abuse. Apart from biological research, I also collaborate with Premium Business schools on IP policy / Pharma policy. I am currently working as CO-author with Premium B-school. I am happy to collaborate as co-author, if you have any interesting mix Research (Biology/chemistry)/IPR policy/Market research. Please email me, if interested!

Addiction may begin with attitudes towards addiction in early years. There was a time when, e.g., the Swedish king asked people to grow their own tobacco in their gardens! Here our take on attitudes in schools:

Dear Holloway,

Doctors in Iran use hybrid pharmacies with outsourcing capabilities.

There are many herbs used as calcium channel blockers. But whether they contain gabapentins etc is to be researched.....

Frederik A De Wolff 45.02  Leiden University

What is the incidence and mechanism of the excitatory effect of opiates in some humans?

Some patients on opiate or opioid analgesics paradoxically react with hyperactivity, verbosity and insomnia. As a student (more than 50 years ago) this was demonstrated during the pharmacology lectures bij injecting a cat with morphine and show it a white mouse, whereupon the cat panicked and jumped up and down its cage. Our pharmacology professor then explained that 'a small percentage of the human population reacted like cats', and indeed, this is reported incidentally by patients.

Can anybody explain the incidence and mechanism of this paradoxical effect?

What is the incidence and mechanism of the excitatory effect of opiates in some humans?. Available from: https://www.researchgate.net/post/What_is_the_incidence_and_mechanism_of_the_excitatory_effect_of_opiates_in_some_humans [accessed Jun 6, 2017].

 Charles Schaffer & I found evidence that nearly one-third of bipolar patients when taking mu-opiates would have a manic-like reaction that might last a day or two.  In some cases this was the subject[s first manic episode.  There is evidence of interaction between dopamine and opiate system and perhaps a large subset of bipolar patients might be overly sensitive to the DA-opiate interaction.  We published one report but not the second, which had incidence around 35 percent.  Thanks you.Tom Nordahl UCD

Dear Mr. Cassady,

I am interested in doing research and data analysis on facebook addiction. 

Are you still looking for collaborator?

i am expert in data analysis.

best regards

I think I know what you are asking. Syndemic according to medical dictionary is: A set of linked health problems involving two or more afflictions, interacting synergistically, and contributing to excess burden of disease in a population. Syndemics occur when health-related problems cluster by person, place, or time. For example, the SAVA syndemic is comprised of substance abuse, violence, and AIDS, three conditions that disproportionately afflict those living in poverty in US cities. To prevent a syndemic, one must prevent or control not only each affliction but also the forces that tie those afflictions together. From syn-, together + (epi)-demic.

So your connecting nicotine, tobacco and cancer does make sense. It is a new idea and worth debating and discussing.

Cheers

PS: Drinking Smoke by Mac Marshall, University of Hawaii Press might be of your interest

For detecting 'any use' in the previous month (or two, or three) hair testing is generally more reliable and sensitive than body fluid testing. For skinhead hairstyles, pubic, leg or armpit hair are alternatives. If someone has a sudden total Brazilian body-waxing when told they have to give a hair sample in the next day or two, it looks rather suspicious. 

For rat and mouse,

The LD50 for METH with intraperitoneal (ip) administration is 55 and 57 mg/kg, in rat and mouse, respectively (Davis et al., 1987; Yamamoto, 1963). But temperature is very important eg. at 29oC 80% of rats were died with 9 mg/kg i.p. administration  just 4-5 degree above ambient temp.

For human, 

A lethal dose of methamphetamine varies depending on characteristics of the drug and the user. In fact, each person has a different sensitivity to a specific amount of methamphetamine due to personal tolerance to meth. Therefore, toxic levels are different for each individual. Meth overdose may also be complicated by other drugs the user may have taken. Diseases that the person may have developed also play a role due to the current health condition of the body.

Oral administration = ~ 150mg a day

Injection (iv)= ~100mg or higher

Smoking and snorting methamphetamine = ~50 mg or higher

Thanks to you both!

nice Ayca

Non parametric ANOVA

If you want to use this for research, I would consider using a validated instrument such as the Problem Gambling Severity Index of the Canadian Problem Gambling Index (Ferris & Wynne, 2001).  The problem with the DSM is that it changes, most recently with the omission of the criminality criterion. Other widely used instruments such as the SOGS (DSM-III) and NODS (DSM-IV) become obsolete with each new edition.  In contrast, the PGSI has been used across a wide variety of contexts and includes, arguably, the strongest behavioral and addition-based criteria of earlier instruments.  It's what we use in research studies as well as with clinical clients.  Best of all, it's only 9 questions.  With the DSM-5, you are limited to just asking the criteria questions at present as there is no validated instrument.  Hope this helps. 

What do you mean when you say "matching"? Are you trying to match the two data sets or are you trying to merge the two data sets? If your question is to match the two data sets, then you can use the following syntax

update file = "D:\dataset1.sav"

/in = flag1

/file = "D:\dataset22.sav"

/by all.

exe.

save outfile "D:\combined.sav".

value labels flag1 0 'mismatch' 1 'match'.

freq var = flag1

I hope this helps

There is excellent research on neural and pharmacological aspects of addiction. please see proceedings of last three years of addiction therapy and education conferences by OMICS  

Hola Ana, 

Si entendí correctamente tu pregunta, vos estás investigando la percepción, procesos y funcionalidades que tiene una familia hacia el cuidado de uno de los suyos, que es adicto. Si es así, siempre es útil realizar estudios cualitativos que involucren grupos focales y/o entrevistas semi-estructuradas para poder explorar los sentimientos de la familia, tan difíciles de medir con simples cuestionarios. Yo recomendaría comenzar por los grupos focales y continuar con entrevistas de profundización.

Cordial saludo desde Paraguay  

 hallo I reaserch about medicin of islsm for exampel rasez, Avecina

If a paper refers to a concentration, for example, 1 uM methamphetamine given by reverse dialysis, then you weigh extra into the solution to take into account the HCl salt, and use the 185.7 MW to give both 1 uM methamphetamine and 1 uM HCl.  If a paper says 2 mg/kg and that the dose refers to the weight of the salt, or specifically mentions the HCl with the dose, then 2 mg/kg refers to 1.6 mg/kg methamphetamine and 0.4 mg/kg HCl. You would calculate the concentration of methamphetamine in saline using 1.6 mg/kg, the dosing volume of saline in ml/kg, and the 149.2 MW. If a paper says the dose refers to the freebase, then 2 mg/kg would be 2 mg/kg methamphetamine and 0.5 mg/kg HCl. The concentration of methamphetamine would be calculated using 2 mg/kg, the dosing volume in ml/kg, and the 149.2 MW. If a paper doesn't clarify if the dose refers to the salt or freebase, then it is not clear how to exactly replicate their dose, but since the weight of HCl is relatively low, the deviation from their dose will be relatively low.

Hi, as far as I know, for the traditional African Society there are some good books out there. One of the best ones on the history of drugs is in Italian unfortunately and cannot find the translation its called "Le Droghe, Enrico Malizia, Stefania Borgo" and has a whole section on African drug ritual, as well as impact on the African and other cultures as well as a great description on how some drugs in later days spread some diseases due to inefficient and unsanitary delivery methods. Another book I can suggest is "Food of the Gods: The Search for the Original Tree of Knowledge : a Radical History of Plants, Drugs and Human Evolution" by Terrence McKenna, which is mainly based on African societal and tribal rituals. As well, since I do sense you are trying to make a study that has some backbone foundations in history, I would also look up some old Medical Journals from Italian records in Ethiopia or Medical Journal records from some of what was once colonies, since they did keep record of tribal societies and indigenous population at the time. As well last but not least I would also work my way up and learn from hallucinogenic uses of various mixtures like acacia and fermented substances.

Even though this is just wiki and not really a "peer reviewed source" this is a good start:

I think if you follow the path of acacia and it's various mixtures and how society has changed you might find some good stuff on addiction and tribal ritualism in older days.

Hope this helped

Dear Austin,

The Addiction Severity Index - ASI (McLellan, 1980) is a semi-structured interview for substance abuse assessment and treatment planning.

Hi Christine,

In addition to the excellent references provided by Beatrice and Harshvardhan, these resources may interest you:

Hi Alexandra,

If you you just want the scale you can download it here:

If you want to read the whole article, you can request the full text to the original author in researchgate:

Best regards,

Alejandro

have a look at pubmed

behavioral changes, motivational interwieving, clues ... 

  Eg.  http://www.ncbi.nlm.nih.gov/pubmed/?term=smoking+cessation+motivationnal

Thanks Devin Hosea for reply...kindly guide me fo Dx and Tx...both

Nicotine is very often used as self-treatment, even if symptoms are of psychiatric illness are unnamed/undefined. This is a sample abstract of an article which describes how this happens. In practise, I have seen psychotic symptoms which appeared to be a consequence of THC use, but not nicotine.

Encephale. 2008 Jun;34(3):299-305. doi: 10.1016/j.encep.2007.04.003. Epub 2007 Dec 26.

[Smoking and schizophrenia: epidemiological and clinical features].

[Article in French]

Dervaux A1, Laqueille X.

Author information

 

Abstract

FREQUENCY:

The prevalence of cigarette smoking is significantly higher among patients with schizophrenia (60-90%) than in the general population (23-30%). While tobacco smoking decreases in the general population (from 45% in the 1960's to 23-30% in the 2000's), smoking in patients with schizophrenia remains high. Patients with schizophrenia smoke more cigarettes than control subjects. Patients smoke more deeply, thereby increasing their exposure to the harmful elements in tobacco smoke.

IMPACT OF SMOKING IN SCHIZOPHRENIC PATIENTS:

As in the general population, smoking contributes to the reduced life expectancy in patients with schizophrenia. Patients with schizophrenia are at increased risk for cardiovascular disease due to high rates of cigarette smoking. In the Department of Mental Health of the commonwealth of Massachusetts, cardiovascular disease was the factor the most strongly associated with excess mortality. Cardiac deaths were elevated more than six-fold. Weight gain, insulin resistance, metabolic syndrome and diabetes mellitus are frequent in patients with schizophrenia, and may worsen the risk of cardiovascular diseases. It has been reported that the risk for lung cancer in patients with schizophrenia is lower than that of the general population, despite increased smoking. However, in a study conducted in Finland, a slightly increased cancer risk was found in patients with schizophrenia. Half of the excess cases were attributable to lung cancer.

IMPROVEMENT OF COGNITIVE DEFICITS:

Patients with schizophrenia may use nicotine to reduce cognitive deficits and negative symptoms or neuroleptic side effects. Smoking may transiently alleviate negative symptoms in schizophrenic patients by increasing dopaminergic and glutamatergic neurotransmission in the prefrontal cortex. In patients with schizophrenia, nicotine improves some cognitive deficits: (1) sensory gating deficits and abnormalities in smooth pursuit eye movements associated with schizophrenia are transiently normalized with the administration of nicotine ; (2) high-dose nicotine transiently normalizes the abnormality in P50 inhibition in patients with schizophrenia and in their relatives; (3) in tasks that tax working memory and selective attention, nicotine may improve performance in schizophrenia patients by enhancing activation of and functional connectivity between brain regions that mediate task performance (Jacobsen et al. 2004; Paktar et al.2002); (4) cigarette smoking may selectively enhance visuospatial working memory and attentional deficits in smokers with schizophrenia. However, Harris et al., found that nicotine affects only the attention without effects of nicotine on learning, memory or visuospatial/constructional abilities. In addition, smoking could facilitate disinhibition in schizophrenic patients.

PMID:

18558153

[PubMed - indexed for MEDLINE]

Prevention of smoking would be the ideal, and unlikely to happen unless families are also involved. Achieving impulse control could be considered a major developmental task which is likely deemed desirable by the young people who wish to positively influence. A shared goal rather than an imposed one altering the locus of control may make all the difference.

Good luck.

 Dear Beatrice,

Thank you for your answer. I have met the Norwegian Group but not the paper from Belgium. 

Dear Xiaomo, 

Check these out if they help you: 

You will find this article useful.

A helpful resource is a book entitled, "The Heart and Soul of Change" edited by Duncan, Miller, Wampold, & Hubble (2010). The editors and contributors make a compelling case that common factors (e.g., therapeutic relationship/alliance, collaboration in goal setting, hope, empathy, etc.) are far more important than specific factors (i.e., techniques and interventions associated with treatment models such as CBT, MI, or 12 Step Facilitation). A chapter devoted to substance abuse and dependence treatment summarizes research from Project MATCH, COMBINE, and the Cannabis Youth Treatment Study and conclude, essentially, that all treatments are equally effective. My takeaway - Treatment effectiveness hinges less on which treatment is provided and more on establishing a collaborative relationship, seeking feedback about the effectiveness of interventions, and altering the treatment course based on the feedback.

Dear Nader,

The following resources may interest you:

Hi Christine,

In addition to the AA (Alcoholic Anonymous) model and the CBT (Cognitive-behavioral therapy) approaches to the treatment of substance-related disorders, there are strengths-based approaches such as motivational interviewing (MI) and solution-focused brief therapy (SFBT), etc. They attempt to elicit the client's motivation, cooperation, and strengths from the very beginning in the treatment process. Please see the following links.

Dear Cris,

From what I have encountered from studying addiction in university is that all treatments of addiction starts with people realising they have a problem. For people to come to terms with this there is a need to have a talking strategy in place I.e. CBT and a coping mechanism also. There has been found to be links between internet addiction and impulse control disorders, of which CBT has had very positive. I have attached a paper from 2007 which talks about tests to identify the addiction and the treatment to go along with it. 

Dear  Mara, 

Check these papers out if they help you:

Thank you Margaret.

The students I am referring are in a safe collegiate recovery program that includes a residence hall that is substance free. They are all in recovery and are required to attend meetings and have a sponsor. I am searching for evidence-based research that supports the requirements or presents alternative evidence.

I would suggest looking at secondary analyses from Project MATCH or the COMBINE study. Then look at predictors of percentage of days abstinent (a marker of frequency) and drinks per drinking day.

We recently looked at this in a depressed alcohol dependent sample (Foulds et al, Alcohol and Alcoholism,doi: 10.1093/alcalc/agv122) and found the personality trait novelty seeking predicted more heavy drinking on drinking days. 

Personality measures are probably worth considering for your analyses.

The first question I have is for which purpose you plan to use the ASI. The ASI is not an appropriate intake tool. The only realistic use of the ASI is as a before and after measure of potential treatment impacts.

Thanks Prof  Lewis，Prof  Susana  and Prof John！

Not easy to find, I know.  This article does a meta-analysis to estimate rates:

Estimating the Number of Persons Who Inject Drugs in the United States by Meta-Analysis to Calculate National Rates of HIV and Hepatitis C Virus Infections  http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0097596

SAMHSA estimates for 2014 put at 1.6% of the population, or 4,256, 000. Down slightly from 2013:

http://www.samhsa.gov/data/sites/default/files/NSDUH-DetTabs2014/NSDUH-DetTabs2014.pdf 

SAMHSA may break it down by state.  Check the main page to see:

John

Dear Giti

       you may can use the stigma scale after modification. I use it in my dissertation with schizophrenic patients. try it. Best of luck

I would suggest looking at landmark work by George Vaillant. 

eg Addiction Volume 98, Issue 8, pages 1043–1051, August 2003

Thanks gals and guys!

Re: Your chapter. The RCT difficulty- I feel like the RCT issue could be overcome with moderate suspension of the insistence on psychological measurement  must resemble medical trials. My opinion is that psychology tries to fit itself as a square peg into a round hole by the insistence (fetish) with empirical measurement. To me that misses the larger point of psychology- which is to examine, treat, and understand the subjective psychological experience.

One salient point you made about the "morality" of dosages- that by reducing the overall intake to maintain thresholds, administered responsibly by a third party (or even in the case of self-dosing), which does show effectiveness- has essentially been subject to moral argument rather than scientific ones.

I see this as well. I think most people in the field see this. However, my observational experience with the transformative effects of abstinence-based recovery (when done in full) really moves the discussion into the social and moral realm. Since the "problem is removed" from the lives of the sufferer in 12-Step work (anecdotal), then that would seem to be preferable (and ethical) over giving an addict just enough that they are neither intoxicated nor in withdrawal, which seems somewhat cruel when juxtaposed, to the radical improvements those in abstinence based recovery seem to undergo when done completely. At the same time, one cannot (truly) account for readiness and willingness to change, which is likely the single best determinant of outcomes, no matter what treatment is used.

I can see the basis of the moral argument. We could stop terrorism by implanting a chip in every human and monitoring them, but we don't, and shouldn't, though empirically, it would fix the problem. Thus morality is a consideration. In the end, the basic question still remains- Can we adequately compare, or should we really try to compare the two? After reading your work, I can more clearly define what the inherent problems of such a comparison would be beyond the RCT issue.

I really do like your point about having treatment options which are informed, which allow for the person receiving service to choose  the option which best fits (like family planning and BC). I wish we could do this in substance abuse. Unfortunately, too many people come in for services unwillingly, and thus would choose only the most comfortable choice, which may not be the best for him. I think a lot more work could be done at the intake level of substance abuse which could reduce or eliminate this phenomena. 

Thank you again. 

Do you know the IAT (Internet Addiction Test, do not mix it with Implicit Association Test)? it may helps you if you decide to create one specific for your research

 We  use structural, validated  questonirare

Since you are not one of the PIs could you forward this question to someone who can answer it?

A different take on addiction is delivered by Bruce Alexander in his 2008 book "The Globalization of Addiction". While he does not directly address cross-addiction in his book, it's easy to see how it would fit within his theory.

Here is the link to a speech Alexander gave that contains salient points of the book. Maybe you find it interesting.http://www.brucekalexander.com/articles-speeches/277-rise-and-fall-of-the-official-view-of-addiction-6

Hi Ian

You may found some information on 

http://www.intnsa.org 

Regards

Paulo Seabra

Absolutely; in fact, a recent paper in the Canadian Journal of Psychiatry concluded that stigmatization was the NUMBER ONE predictor of relapse.  I would guide you to the work of Michel Perrault at McGill (a co-author on the recent CJP article - 2014) and to that of Sarah Wakeman at Harvard, who wrote an article also in 2014 in the Journal of American Medicine -- and see my short comment in the American Journal of Public Health published July 2014.  Stigmatization in general is highly detrimental to recovery from substance use disorders; stigmatization from caregivers (MDs, RNs, etc) is bordering on unethical -- patients need empathy and understanding in their treatment, not disdain and scorn -- I think this is pretty obvious, and the vast majority of caregivers I know do not hold their pts in low regard because they have a psychiatric illness.  I don't think there is a study out there on MD/RN's stigmatizing their pts illness because there aren't many who do.  But if we are to take the results of the CJP study and apply simple induction, it's pretty obvious that stigmatization by caregivers would have an even more negative effect on remission rates than stigmatization by society at large.

http://www.s-p-q.com 

Promis Shorter Questionnaire examines addictive tendencies across a whole range of behaviours

Well dear aging is nature but nature has no aging :)

In our Punajbi culture we used to say that Heart should be young, aging is useles!!

However, keep this in mind https://www.researchgate.net/publication/228100311_Maintaining_Clinical_Relevance_Considerations_for_the_Future_of_Research_into_D-Cycloserine_and_Cue_Exposure_Therapy_for_Addiction

http://www.ncbi.nlm.nih.gov/pubmed/21455709 

You have to check the diff diagnosis as there are many potential causative agents for rhabdomylosis, ranging from statins to SSRIs to autoimmune issues.  My guess is that you will find, as suggested above, that it is not opioid use directly causing rhabdo, but rather secondary effects, such as Hep-C, etc.  What do you mean by "severe" rhabdo?  Some sort of really acute muscular deterioration occurring in a very short time period?  How long do the patients wait to present?  Do you run blood tests to confirm the urine tests?  I think this is a very interesting finding, but it's hard to guess as to whether it is related to pt SUD without a full differential diagnosis.

I worked voluntarily with an adult chronic alcoholic when the services seemed to fail him and attitudes in the hospitals etc were harmful. I simply worked a motivational program whereby he felt it safe to move from behind the mask of addiction. Harrowing but sober now eight years.

I would consider adjusting the SAAPPQ (short alcohol and alcohol problems perception questionnaire, Gorman 1991). Well-used to capture staff attitudes.

The National Scientific Council on the Developing Child is a working group based at Harvard doing extensive work in examining resilience for adverse childhood events in general.  This includes the chaotic home environments that can be experienced by children of parents with substance use issues, rather than specific adverse experiences.  The research focuses on the mechanisms of resilience and how to promote resilience in children; however, the findings are equally relevent for adults.  

Individuals need strong social interaction, coping and stress management skill sets, as well as warm, supportive relationships to navigate life and thrive. Individuals growing up in homes with substance abuse and many other parental challenges often do not receive adequate warmth and nurturing within their family of origin because of the ways that parental substance use alter family systems.  Adaptive social interaction and coping skills are frequently absent in adult children of substance users as well, as the opportunities to learn those skills from parents can be infrequent or absent.  

Through supportive mentoring relationships through work, education, softball leagues, what have you, as well as counseling and various other experiences adults can build these skills and capacities over time and be resilient.

Do you mean "cross addiction" as in addiction to one substance leading to addiction to other substances, or do you mean "cross addiction" in the sense of substance addiction (or the cessation of same) leading to other behavioral addictions, such as sex/gambling addiction?

I've used xylazine (Anased) to test catheter patency in the past and it has worked well. It's not scheduled so it should be easier to get. For rats, we would give IV administration of 0.05 ml of xylazine (20 mg/ml) and if we saw motor ataxia within 5 seconds, the catheter would be considered patent. I'm not sure if you're using mice or rats but it should work for both.

I don't think you can PHARMACOLOGICALLY inhibit fosB accumulation as the stimulant effects a transcription change that increases fosB.  That's why the viral/genetic vectors work - I am not aware of a medication or compound/enzyme (in the pharmacopeia) that would reduce fosB accumulations once the RNA transcription is engendered by the stimulant.  You'd have to simply reverse the transcription with a viral vector - which you already know.  

The fallacy that pathological gambling is a "brain disease" has spread like an axiom driven by psychiatry interested in “pathologize”, to give drugs and obtain benefits for it. The brain changes that are attributed to addiction (either to the game or to substances) are not necessarily evidence of disease, but sometimes vulnerabilities, being pre-addiction and favoring their establishment and maintenance. As Kevin and Paul said, the experiment of rat park, replicated countless times over the last decade in the paradigm of environmental enrichment, definitely rejects the concept of "disease" and places addictive behaviours in an evolutionary context in which the learning history, experience, alternatives, cultural conditionants and much other environmental elements interact with the biology of the individual in lead to a loss of control and automated compulsive behavior. It is time to reject old dogmas and study phenomena from scientific knowledge. Addiction is not, in any case, a disease but a complex behavioral framework that results in changes in the structure and brain function, as in many other cases that no one would call "disease" (i.e., romantic infatuation).

I dont know if this is of much help. I was part in putting out a special issue of Nordic Journal of Alcohol and Drug. It is social Scientific scholars that writes in the special issue... Here is a link to the issue:

Hi, I think you shouldn't use MAST but AUDIT or a brief version of AUDIT which best properties in old people. :

Källmén, H., Wennberg, P., Ramstedt, M., & Hallgren, M. (2014). The psychometric properties of the AUDIT: a survey from a random sample of elderly Swedish adults. BMC public health, 14(1), 672.

There is a dearth of outcome data for all treatment modalities for all substance use disorders.  That said, the general consensus of clinicians IN THE UNITED STATES is against substitution (medication) therapy for stimulants (cocaine, methamphetamine, methylphenidate, d-amphetimine, a-amphetimine, dextroamphetamine, e.g. all DOPAMINE upregulators).  [In response to Dr. Rich's comment, I think the original question was aimed at stopping individuals from using methamphetamine using non-medicinal means.  Yes methamphetamine can induce psychosis, but clinicians can stop this not by treating psychosis directly but by trying to get meth users to stop using it.]  So, for clinicians wanting to take an abstinence-based approach, it seems that "talk therapy" like CBT and support-group therapy like 12-step programs (NA, AA, CA, etc) have shown success - but only anecdotally - we don't really know how effective these modalities are and for which patients they work, and how well they work, in achieving long-term remission from methamphetamine (stimulant) use disorders.  I think that, like with all substance use disorders, the best results will be obtained by keeping patients in long-term outpatient treatment following intensive residential treatment.  As Dr. Buttfield said "support" is the key, whatever the particular structure of a pt's aftercare plan.  Given how little real outcome data we have, the best strategy is probably to apply all available treatment modalities and hope that something helps.  But the *anecdotal* results so far are not terribly encouraging; most pts with stimulant use disorders have great difficulty achieving remission for any meaningful period of time.  In other words, the average Px for a pt presenting with stimulant use disorder is not terribly auspicious.  

For now, it seems that the only two viable non-medicinal treatments are direct therapy (CBT or otherwise) and mutual support therapy (12 step or other group therapy approaches).  I really hope that more treatment modalities will be developed for patients suffering from stimulant use disorder.  Remember also that most SUD patients have high comorbidity with other psychiatric disorders (which contribute to the difficulty of achieving absence/remission) -- it is important to Dx and Tx these as well as SUD itself.  

A final comment on the Karila et al article cited above, which reviews medicinal/pharmacological Tx (Rx) treatments.  There are really three types of strategies in medication, and I think it is important to categorize potential medications as such (1) "blockers" - e.g. medications that stop the stimulant from acting, such as naltrexone.  The problem with naltrexone, which works very well with both opioids and alcohol and has shown promise with stimulants, is PATIENT NON-COMPLIANCE.  Patients may take the medication during a study, but often will stop in conjunction with resuming use.  As such, it is not really a treatment, except in long-acting forms such as the monthly IV injection of naltrexone (Vivitrol in the US, manufactured by Alkermes).  The problem with this, again, is that patients will often decline to take medication that blocks the psychoactive effects of the substance they want to use.  Blocking strategies have had weak results so far EXCEPT in conjunction with rigorous aftercare programs, such as those required of physicians in recovery and pharmacists in recovery.

 (2) "Mitigating medications".  In my opinion, these show the most promise.  Bupropion, for example, is a very WEAK stimulant (and antidepressant and anxiolytic in some patients) - and if it can provide enough dopamine/norepinephrine/adrenaline upregulation that a patient will resist the urge to use a much stronger stimulant, then it is BY FAR a better alternative 

(3) substitution (harm reduction).  As Karila et al note, substitution with d-amphetamine, a STRONG stimulant, logically shows promise.  However, as with any substitution strategy, the patient remains dependent on a substitute stimulant with dangerous morbidity - but which may arguably be substantially less harmful than dependence on methamphetamine.  The Karila review, written in 2010, concludes "Despite the lack of success in most studies to date, increasing efforts are being made to develop medications for the treatment of methamphetamine dependence and several promising agents are targets of further research."  I am unaware of any such compounds emerging as likely candidates for medicinal treatment in the past several years.  

Furthermore, LONG-TERM COMPLIANCE is something that is rarely studied in the RCTs cited by Karila.  Unfortunately, there seems to be an inverse relationship between the effectiveness (measured in terms of pt quality of life) and pt compliance on medication.  With a blocking strategy, you get LOW LONG TERM COMPLIANCE, and with a strong-substitution strategy, you get much higher compliance (naturally) but then you are really just switching the patient from methamphetamine to a stimulant with less deleterious effects, while you try to keep the dose at a steady level (very difficult given rapid tolerance and relatively flat dose-response curves of many stimulant-substitution alternatives).  I am personally (subjectively) much more optimistic about opioid substitution therapy than I am about stimulant substation therapy for that reason -- but I have no data to  back up this conjecture.