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Drug Addiction - Science topic

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Hello All,
First I want to start this discussion by thanking you for helping me with this as it is something I have been struggling to figure out.
I picked up this study from a graduate student before and now I am stumped by how to run the data using either SPSS or R (preferably R) or another recommendation. I have attached the data I am working with and as you can see it is divided into three treatment groups: Saline, 10mg/kg, 20mg/kg. By Sex: Male & Female and across three time periods: 12HR, 24HR, 36HR. I was looking at withdrawal scores and in particular certain attributes associated with withdrawal in the rat which is 11 items. What would be the best method to run this data if I want to look for effect of treatment and sex differences on the withdrawal behaviors?
Thank you again.
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2-Way MANOVA? As long as your dependent variables are gaussian normally distributed and have equal variances between groups.
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Socio-cognitive deficits have been associated with certain psychiatric diagnoses such as Schiz, MDD, ASD. However, other strata of the population that show significant Socio-cognitive deficits are problematic substance users. Individuals with any sort of drug addiction or behavioral addictions, such as gambling or gaming disorders have been traditionally treated with motivational enhancement therapies and/or social skills training such as assertiveness training or enhancement of social communication. I'm inquisitive if intervention programs have also included more higher-level skills encompassing Socio-cognitive variables, such as empathy or social perspective-taking. I am looking forward to insights and reflections of mental health practitioners who are working in this area.
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By virtue of my specialization in Islamic research, I find that the Islamic religion has assigned to the body three rights: spiritual care through the worship of God Almighty, social care by taking care of the family, the wife and children, and the third right is the right of the body to take care of the path of sleep, proper nutrition, and exercise.. Greetings.
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It would be so nice if i could get help because i have to prepare one class about how sport helps people with some sort of addiction to any substance and i haven't found much information about it.
I really apreciate any help, thank you.
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There's a recent systematic review on exercise for improving mental health and quality of life for substance users which might help. check out the evidence they use: The Benefits of Physical Exercise on Mental Disorders and Quality of Life in Substance Use Disorders Patients. Systematic Review and Meta-Analysis.
Giménez-Meseguer J, Tortosa-Martínez J, Cortell-Tormo JM.Int J Environ Res Public Health. 2020 May 23;17(10):3680. doi: 10.3390/ijerph17103680.
However, it might be worth looking at mutual aid recovery evidence too for testimonials as there's lots of anecdotal evidence. My research into recovery has revealed a lot of stories from people who have engaged in hobbies such as exercise, gardening, cooking, etc. but we haven't published this as yet. Try this website for some ideas: https://www.arkbh.com/physical-activity-addiction-recovery/
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To evaluate participants with follow up interviews, who completed residential rehabilitation and now currently in the community. The objective is to assess why they relapsed if they did, and what helped them to be abstinent after engaging with a community.
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Norman G Hoffmann Thank you for adding more details, I certainly agree the choice of method collection will depend on the research problem/question. I hope our answers help Lahiru Channaka
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1. Symptoms lead to self-Medication
2. Demographic variables effect on
3. Source of Medicine (Essay Access)
4. Source of Drug Information (Medication knowledge
5. Reasons for self-medications (Motivators)
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Actually, factors affecting self medication practice among university students can be identified with only research. Therefore, as per findings from different studies I have seen, the following are the major once.
1.knowledge of students about self medication
2.Attitude of students about self medication among university students
3.age of students
4.sex of students
5.Economic status of students
6. religion of students
7.year of study of students
8. Type of department of students who are attending
9.distance of health institution or pharmacy to university
10. Availability of clinics in the university or around
11.Accessability of health professionals around
etc
Dear researcher, besides these, you can better search others from different literatures.
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A common misconception surrounding drug addiction is that it solely affects the life of the user. However, the idea that they aren’t hurting anyone except for themselves is an excuse that many individuals who abuse drugs use in order to justify their addiction. Drug addiction is not a one-person phenomenon, and it creates a domino effect on the lives of those around them. It is a social problem that normalizes drug use and affects individuals and their families.
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Thanks Marriane for your inputs
Rashmi
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I am interested in looking at the effect of exercise on treatment of substance abuse. Will the endorphins released during exercise, decrease the need to drink alcohol or take an illicit drug?
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Dear Shikha Vij
Epidemiological studies reveal that individuals who report abuse of dangerous substances are less likely to generally adhere to guidelines for physical activity (with the exception of certain populations, such as adolescents and athletes). A growing body of evidence indicates that individuals with substance use disorders (SUDs) are interested in exercise and that they may benefit from regular exercises, in terms of general health / fitness and recovery from SUD.
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My question is simple -
Do you want to help someone ?
Do you want to help change someones life for the better ?
Do you want to have an impact on lowering the suicide rate?
What would you do for someone you love? Anything..
The struggle of addiction and mental health is more prominent today than ever before. With suicide & mental health rates increasing everyday and the lack of information & resources out there required to help tackle and deal with these things are limited.
Granted that there are services out there that do help and do work but are not always easily accessible or in some cases to late. The world is changing and it is becoming more prominent that suicide and mental health are real issues that are being overlooked in some cases where they should not of been.
Change is needed to a better quality of service, information and care that is currently being provided.
Please help us with our research to understand more from holistic overview,
help us to help those that are indeed struggling but are not getting the attention that is required.
Link below is to the study :-
Thank You
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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.
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See above.
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Thank you so much for your thoughtful and useful answer. And for the time taken to respond. Kind wishes to you
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Drug addiction is more prevalent among teenagers.
World drug day celebrated on 26th June bring a sense of awareness to us about this cursed practice.
Parents have to keep watch their children activities
5.6% percent of world population is involved in drung aged between 15-64
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Nirmala S.V.S.G Bruce Robin Nyamweha
Hassan Izzeddin Sarsak
Aparna Sathya Murthy
Ali mohamed rashed
Emre Pakdemirli Allen Joshua George Aparna Sathya Murthy Teodora Hristova thank you all of you your suggestion. I am indeed ready to launch an international network + project where you can contribute your inputs for noble cause in making the world drug free at your own country. You can do so by making people aware about drug addiction, its consequences and prevention by arranging lectures, seminars and sessions among your students and colleagues.
If you are ready to be a part this mission you can indicate your pre-objectives to email by 15th July.
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Is it possible to measure dopamine level from plasma to observe this association (plasma is stored in -20 degree) ?
I already found articles where higher dopamine concentration is found in Parkinsonism and internet addiction disorder.Is it possible to measure using ELISA kit?
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This has been studied. This paper is a bit older but I think that it is what you are looking for.
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I have implanted bilateral cannula in the nucleus accumbens of adult rat. After one month of implantation, the rat some how removed the cannula along with dental cement. Since we used this rat to study drug addiction, I think this might happen sooner or later. Can I implant the cannula again to the same brain region to this rat after the wound is recovered? or should I sacrifice this rat?
thank you
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It is generally standard practice (at least in my experience) to sacrifice the animal if their head-mounts come off. Unless you're using dialysis probes/cannulas, generally these should not be coming off. Did the rat have an infection underneath? If so, then more sterile surgical techniques need to be used. Making sure to properly disinfect tools in-between rats and making sure the skull is dry before laying down the dental cement are important factors for maintaining healthy head-mounts in my experience. I also use thinner, more "liquidy" layers of acrylic as the foundation to make sure it is rock solid. Lastly, make sure you're mounding up the acrylic to the very top of the cannula as much as possible to prevent the rat from messing with it and bending the cannulas or pulling them out.
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As aripiprazole is a partial D2 agonist, one may hypothesize that it may be an effective agent for the management of psychostimulant-addicted patients. The literature published to date is inconclusive. I am using this in my practice.
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For substance dependence, including to psychostimulants, one should consider medications which reduce the psycho-behavioral and/or somatic dependency on the drug on pharmacodynamical level, mainly in relation to the present developed increase of the sensetization of dopaminergic and noradrenergic receptors (via increased AMPA receptors number, connected to sodium-NA2+ channels), thus here are some suggestions: lamogrigine (sodium-channel blocker, glutamate release blocker; flupethixol (D1/D2 antagonist, 5HT2A), perhaps also zuclopenthixol (D1/D2, alpha-1, H1, 5HT2A antagonist); baclofen (GABA-B agonist); valproate (indirect GABA increase, 5HT1A agonistic properties); perhaps also GABA-ergic drugs such as gabapentin, pregabalin, levetiracetam, oxcarbazepine and topiramate; and, naturally, benzodiazepines, eg diazepam; magnesium and zinc. 
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Neurosocialogy 
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much recent activity on web re differences between fruit of the marijuana plant, illegal
in most states , with high levels of THC, which triggers major mood effects, delusions
and hallucinations, and cannabinoid from hemp (legal in all U.S. states) and uniquely
therapeutic with intractable seizures as well as other medical issues- high levels of
CBD which does not induce psychiatric symptoms and low levels of THC, which 
has no demonstrated health benefits-  might want to locate Sanjai Gupta TV special
on CBD dramatic benefits for intractable childhood seizure
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Hello,
I am planning a humble research project about an online group of self help (mutual aid). I would like to know about some serious experience (or bibliographical reference) about this kind of online group. I know how these groups work face to face but not much online. I mean groups for support to other members in certain circumstances. For instance people with no common disorders could get in touch with other patients in the other corner of the world because it is not easy for them the contact face to face (for the distance). Thanks for reading!
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In his classic book, The Theory and Practice of Group Psychotherapy, Yalom (2005) discussed internet support groups and their effectiveness. These groups can "take the form of synchronous, real-time groups...or asynchronous groups, in which members post messages and comments, like a bulletin board." (p. 520). These groups can be professionally directed or self-directed.
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Recently, I noticed that Roche company claimed that they have developed a brain shuttle technology which could dramatically (50-fold in animal study) increase the penetration of target proteins (antibodies in their study) into the brain. Although the details of the brain shuttle technology are not published, I think it is not hard to utilize this technology to increase the penetration of other peptides, e.g. opioid peptides, into the brain. A sudden expose of opioid peptides (or combination with other drugs) may lead to short-term euphoria and further addiction. Therefore, I am worried with the help of this technology, the injection of opioid peptides might be much easier than current addictive drugs to cause addiction.
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Frustratingly I think the short answer is "Yes".
We have see throughout history that as the availability and purity of drugs has increased so too has addiction.  Furthermore, the method of drug delivery has likewise been been correlated to addiction as we have moved from, for example, chewing coca leaves to snorting isolated cocaine to injecting and smoking the drug.  As the level of euphoria increases I'd like to generalize and say that the likelihood of addiction also increases.
The follow-up question would seem to be - what to do about this?  In my experience and through my layman's research I've found little to suggest that the availability of, purity of, and efficacy of delivery systems for drugs will ever do anything but increase over time.  This leaves us only one obvious "solution" to the worldwide substance use disorder epidemic - prevention.  The sooner we start talking openly to children about the dangers of addictive substances (including refined sugar) the more likely we are to dissuade them from trying that first drug.  If we concurrently embrace treatment instead of stigma and incarceration then we have as good a system as we can hope to have.  
Now, what I'd *really* be interested in is finding a way to decrease the ACEs that are clearly prime contributors to so many people's addiction issues.  Let's stop harming the children and make them feel loved - at least some will find less reason to seek artificial attachment through substances and behaviors.
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I have seen some promising study results using naltrexone doses of 0.25 to 0.5 mg. daily in conjunction with opioid tapers. I have several patients who are interested to try this, but I fear precipitating withdrawal.
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We used Naltrexon with success but it was not used in conjunction with the taper off period. Rather, it was used in a relapse prevention strategy after detox or other controlled environment initiatives
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I visited a village where little children were addictive of of gutka since two three years  at the age of 6- 10 years.When I have  interviewed from his father he said" I also want this he leave this addiction but I failure While I go to my work and return at night I became failure to leave this addiction And No another  addictive gutka in my home instead of him Many times I tried to motivated him and insist him to leave this habit even many times I didn't give him pocket money instead of these effort I became fail .His mother is also remain angry with him due this habit". When I little 
investigate more than 50 children were addictive of the gutka I amazed how kids became addictive of gutka  I tried to  motivate them to leave the habit but I think there is   more effort needed
to do more and which kinds of steps should be taken ? Dear scholars Which kinds of steps should more steps to get solution from this village and which kind of other steps should be taken......while Many elders are also addictive of gutka and when I discussed the side effects of gutka they said we already aware ....?...A  serious problem.....
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The substance seems to be pretty integrated in the community since they begin at very early age. Indivual level measures will then be of little help I'm afraid. Measures need to be at a community level, e.g., education and policy work among elders to limit access for youths. An idea could be to convey that this is  especially problematic  among children and youths (it would be important for harm reduction to at least delay exposure to the substance). It would probably be easier to get the elders along with that instead of attacking their own use. Wish you success with your work!! It would be very interesting to hear of your results. You should write an article about this!!
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I'm working with the American Cannabis Nurses Association and would like feedback as to what resources people trust most for evidence based practices for medical cannabis. 
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My experiences has been that clinicians that are members and attend the International Cannabinoid Research Society conferences are truly interested in the medicine side of cannabinoids.  There are clinicians who have been working with specific pathologies for several years.   As a person interested in research this is extremely helpful.  Their experiences (unfortunately because of no research are trial and error) with positive outcomes will be helpful for me to formulate a starting point if I was looking at a trial of sorts.  I work with Alzheimer's and Parkinson's, in addition to exploring the driving issues with THC.   
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I found some studies that look at substance use in pilots who were involved in accidents. What I would like to have are overall numbers, what is the prevalence of substance abuse in pilots specifically or in the airline industry in general.
Any suggestions to credible sources are welcome.
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Dear Oliver, 
check this out if it helps you: 
"According to the Federal Aviation Administration and the Office of Aerospace Medicine, 11 percent of the 5,321 pilots involved in aviation accidents between 1990 and 2005 tested positive for drug use. Between 2004 and 2008, 37 percent of the 1,353 pilots who died in aviation accidents tested positive for drugs."
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In particular the risks and harms that women face either in or out of treatment ?
Please let me know if you have seen any articles, papers or unpublished data / information, many thanks
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Hello Ian,
Italy has a recent (2015) study you might like to peruse as well...
Looking forward to your contribution.
Blessings~ Bre
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I've heard many stories from women about how pain meds prescribed following childbirth caused a relapse or led to opiate addiction.  I couldn't find any research that looked at prevalence or risk factors.  
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There is a greater risk of relapse of a recovering addict of pain is not properly controlled. There is always an inherent risk of relapse when giving pain medicine to a recovering addict but the other option is cruel. The individual has to have a strong program of recovery and fellowship of others to speak with for guidance when giving pain medicine.
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I recently read the meta-analysis and commentary on gabapentin addiction potential by Smith et al in the July edition of Addiction.  I was actually quite surprised at the Commentary piece, which suggested that prescribers should avoid dispensing gabapentin to patients with Substance Use Disorders.  The mechanism of action of gabapentin is unclear, but it has never been shown to have any euphoric qualities on its own.  It has mild sedative qualities and, if overused, causes sedation but not euphoria.  The underlying studies in Smith (2016) mostly involved polysubstance use, mostly with opioids and benzodiazepines.  I am wondering if anyone, in clinical practice, has any anecdotal evidence of pts using gabapentin (a) to induce euphoria, e.g. not just to induce sleep or sedation and/or (b) to sustain an "Addictive Disorder" as defined by the DSM.  From what little I know of the neurophysiology and pharmacokinetics of gabapentin, it is really hard for me to imagine how gabapentin alone would stimulate any sort of euphoria - for example, bind to a Mu receptor, etc.  The only possible mechanism I could imagine would be that it up regulates glutamate, but that has been reported only with pregabalin, a much stronger analogue of gabapentin.  Any reports from the field?
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Report from the field: once in my 40 years of practicing general psychiatry I was able to use gabapentin to help withdraw a patient from clonazepam. Subsequently she reported being "addicted" to gabapentin and stopped seeing me....she NEVER reported either clonazepam or gabapentin causing euphoria....
One anecdotal report...but I have been assuming GABA was involved.....
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I'm starting a qualitative study of the processes experienced by families when one of its members use drugs. Attempt to investigate how care and what has connotations in family dynamics and processes of vulnerability / generativity
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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  
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In the sociology of medicine, but most importantly the research literature on public health and social policy there is a need to emphasize on the topic of drug addiction further than it has already been adavnced
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Greetings Mr Phatlane - Comments you've received so far all suggest that you define your question with more rigour. Defining addiction as I do after 40+ years of assessing and treating persons with substance use disorders, I observe that the cognitive processes of such persons have altered significantly. From this you can go two ways: the substance has altered cognitive processes temporarily OR, the brain has been altered permanently and cognition follows. Repeated assessment of such individuals-in-treatment for up to 4 years after abstinence was achieved suggests that the second option is a useful one, since significant traces of executive decline and lengthened reaction-time measured during active substance abuse remain after 4 years. This data is unpublished since funds were not available to include a control group & extend the study to 10 years. THUS, I suggest again that you consider a PTSD model of 'addiction', and define addiction consistently.         Good fortune in your research.
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I´m thinking of fentanyl-derivats + methadone or buprenorphine and MDMA, pregabalin + buprenorphin and so on.
The numbers of drug related death are growing again, not only, because of large amounts of relatively cheap heroine, but presumably also because of new psychoactive substances in combination with other drugs and medications. As long as we lean on Immunoassays we even can´t get a solid evaluation on the dimensions of the problem.
Thank you
Chaim
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I would like to know if there are documented studies on how Addiction (mainly alcohol and drugs) was perceived in the traditional African Society or research on the 'conceptualization of  addiction in Africa.
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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
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I am looking for any research which has looked at the use of quitlines among youth tobacco users and any research which has looked at the use of NRT among youth tobacco users.  I would also be interested in reasons why they might or might not not be effective with youth (e.g., brain biology, etc).
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Hi Joyce, I am now Professor Emeritus (2014) from George Washington U (2014)
and have moved to Florida. I published the 5th edition of my "Evaluation ..." textbook with Oxford U, Press (2015) and continue to be involved with smoking and drinking research with pregnant women. I think one of the primary issues with NRT and youth (< 17) is age and Informed Consent. I also suspect that legal liability is an issue. Cheers
Richard
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I have been thinking about using Clarity to compare the expression of specific protein before and after addictive drug treatment, to kind of visualizing aberrant plasticity at molecular level. But wondering if the resolution of Clarity would be good enough for this purpose, since the abnormal circuits are the primary reports from the Clarity methodology.
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There are many treatments which treat drug abuse like Therapeutic Community, other than that which is better?
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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.
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Substance abuse is a patterned consumption of a drug in amounts or with harmful methods  Studies shoes that the social support may be helpful to recovery or relapse from it. What is the social support impression on prevention or treatment of it?
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Audio verbal hallucination distress   multiple drug addict and also withdrawal session .Sometime it give suicidal or homicidal ideas ,which is distressing .Intervention related vocalisation therapy might reduce distress or threats 
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A different approach is found in An experience sampling study of worry and rumination in psychosis.Hartley, S.; Haddock, G.; Vasconcelos e Sa, D.; Emsley, R.; Barrowclough, C. Psychological Medicine, Vol 44(8), Jun 2014, 1605-1614.
Background: Increasing research effort is being dedicated to investigating the links between emotional processes and psychosis, despite the traditional demarcation between the two. Particular focus has alighted upon two specific anxious and depressive processes, worry and rumination, given the potential for links with aspects of delusions and auditory hallucinations. This study rigorously explored the nature of these links in the context of the daily life of people currently experiencing psychosis. Method: Experience sampling methodology (ESM) was used to assess the momentary links between worry and rumination on the one hand, and persecutory delusional ideation and auditory hallucinations on the other. Twenty-seven participants completed the 6-day experience sampling period, which required repeated self-reports on thought processes and experiences. Multilevel modelling was used to examine the links within the clustered data. Results: We found that antecedent worry and rumination predicted delusional and hallucinatory experience, and the distress they elicited. Using interaction terms, we have shown that the links with momentary symptom severity were moderated by participants’ trait beliefs about worry/rumination, such that they were reduced when negative beliefs about worry/rumination (meta-cognitions) were high. Conclusions: The current findings offer an ecologically valid insight into the influence of worry and rumination on the experience of psychotic symptoms, and highlight possible avenues for future intervention strategies. (PsycINFO Database Record (c) 2014 APA, all rights reserved)
Power and perceived expressed emotion of voices: Their impact on depression and suicidal thinking in those who hear voices. doi: http://dx.doi.org/10.1002/cpp.798
By Connor, Charlotte; Birchwood, Max
Clinical Psychology & Psychotherapy, Vol 20(3), May-Jun 2013, 199-205.
Considerable focus has been given to the interpersonal nature of the voice-hearing relationship and how appraisals about voices may be linked with distress and depression (the ‘cognitive model’). Research hitherto has focused on appraisals of voice power, but the supportive and affiliative quality of voices, which may act to mitigate distress, is not understood. We explored appraisals of voices’ power and emotional support to determine their significance in predicting depression and suicidal thought. We adapted the concept of expressed emotion (EE) and applied it to measure voice hearers’ perception of the relationship with their voice(s). In a sample of 74 voice hearers, 55.4% were moderately depressed. Seventy-eight who rated their voices as high in both power and EE had a large and significant elevation in depression, suggesting that co-occurrence of these appraisals impacts on depression. Analysis of the relationship between power and EE revealed that many voices perceived as low in power were, nevertheless, perceived as high in EE. Those rating their voices as emotionally supportive showed the lowest levels of depression and suicidal thinking. These findings highlight the protective role that the supportive dimension of the voice/voice-hearer relationship may have. (PsycINFO Database Record (c) 2014 APA, all rights reserved)
The relationship between metacognitive beliefs, auditory hallucinations, and hallucination‐related distress in clinical and non‐clinical voice‐hearers.Hill, Katy; Varese, Filippo; Jackson, Mike; Linden, David E. J.
British Journal of Clinical Psychology, Vol 51(4), Nov 2012, 434-447
Objectives: To test the hypothesis that metacognitive beliefs are implicated in the development of distress associated with auditory verbal hallucinations (AVHs) rather than in their aetiology. Design. A cross sectional questionnaire design was used. Methods: Three groups of participants were recruited (n = 20 in each group); clinical voice-hearers diagnosed with psychiatric disorders; non-clinical voice-hearers with no psychiatric history; and non-clinical participants with no history of voices or psychiatric disorder. All participants were screened for psychiatric symptomatology and completed a self-report measure of their metacognitive beliefs (MCQ-30). In addition, the two groups of voice-hearers were interviewed about dimensions of their voices (i.e., content, frequency, distress, and disruption). Results: The clinical group scored significantly higher than the two non-clinical groups on two subscales of the MCQ-30 (negative beliefs about worry concerning controllability and danger and negative beliefs about thoughts concerning need for control). There were no significant differences between the two non-clinical groups on MCQ-30 scores. Regression analyses revealed that the negative beliefs about need for control subscale of the MCQ-30 was the only significant predictor of voice-related distress, although this effect was no longer significant after controlling for the effect of group. Conclusions: These results are consistent with previous findings suggesting that metacognitive beliefs are not directly implicated in the aetiology of AVHs, but may be associated with psychological distress. Further research is however needed to determine whether metacognitive style may directly impact upon voice-related distress. (PsycINFO Database Record (c) 2013 APA, all rights reserved)
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Information to clarify the Moral Theory in addressing why people use and abuse drugs and other illicit substances. Based on research by Le Moal and Koob 2007  
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Perhaps it is all very simple - people would not take drugs if the drugs did not make them "feel better" when they take them (conditioning/learning). If that is so then these people (who take drugs) do so to experience positive emotions and avoid negative emotions. Our brains are wired in such a way as the ensure our survival (and the survival of the species) by maximising positive (feeling good) emotions and minimising negative (feeling bad) emotions. Perhaps at the end of the day it is all about conditioning - and not necessarily a "medical" (illness) condition. Comments?
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I am searching for research supporting AA 12-step meetings during college years for those diagnosed with substance use disorders.
Thanks.
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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.
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[Edited question:]
Sorry, I wasn't being specific enough in my original question (but thanks for your responses so far!). Things like personality and genetics don't really change from day to day, so they can't directly correlate with / predict / cause someone to drink on one day but not another. I'm looking for antecedent causal variables that can fluctuate from day to day, and thereby cause fluctuating behavior from day to day. There are some daily-drinking-diary studies out there on this kind of thing (e.g., daytime experiences of negative social interactions leading to more drinking that evening), and to achieve greater specificity I want to parse "more drinking" into the binary variable "if drank" and the interval variable "how much drank, provided drinking occurred." Different daytime events may be differentially stronger predictors of these two criterion variables, and I'm looking to learn what people know about this possibility. In any research, have these variables been parsed before with respect to the causes of a single drinking episode? Aside from established research, what are your best guesses? Thanks!
[Original question:]
I'm aware of the frequency/quantity literature on characterizing global drinking traits, but would like to hone in on what causes whether or not a person will drink on a given day versus how much they will drink on a given day, provided they have at least one drink. Studies on daily determinants of other kinds of potentially problematic behavior or experiential avoidance would also be useful (e.g., drug use, binge eating); I'm primarily interested in functional and methodological approaches to this kind of distinction. Thanks!   
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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.
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There is almost no standardized protocol for weaning away from areca nut. As recent research indicate that areca nut share a nictotinic pathway, use of cytisine or the related compound varenicline could be useful to wean areca nut abusers. Has any body got experience in this? 
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Thanks for the inputs. I am also looking for RCTs in this direction
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As our study is looking for someone who overuse their smartphone, and we try to let them experience a period which can reduce their overuse habit.But somehow,  less some previours research, don't know 'how long' will much appropriate? what's name of the withdrawal addition process? can this process modified and apply to smartphone users?  Wish you can help us , and please provide some evidences and literatures. thanks a lot!!!
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Thanks Prof  Lewis,Prof  Susana  and Prof John!
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I am searching for data on the prevalence of IDU in the USA, by state if possible.  Does this exist?  So far all I have been able to find is estimates from 1992-2002, and I would say the climate has changed since then. 
(Not necessarily looking for heroin use rates, as it can be used without needles and other drugs can be used with needles, etc.)
If you have any leads on this I would greatly appreciate you sharing!  Thanks.
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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:
SAMHSA may break it down by state.  Check the main page to see:
John
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I'll try to brief my point of view of this subjetc:
The target is not necessarily to be weaned off but to regain the control of one's life. When working with people addicted to drugs, as it can be read in several guidelines - say NICE for instance - psychotherapies + psycho-pharmacology is recommended. There are several strategies that can be tried, depending on the substance or substances: abstinence, reduction, maintenance. Treatment plan should be tailored patient by patient and patient-centered. Several stages are usually required, including relapses. It takes months - years. Family or social support optimizes prognosis.
Advice: don't focus on the drug. Focus on the person. In the person, don't focus on what is wrong, but on what should be enhanced.
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I am looking at public policy dealing with child abuse and neglect, specifically the role of DCF in dealing with opiate-dependent parents. What I am wanting to show is that long term abstinence-based recovery is linked to an improvement in socioeconomic status if the treatment is comprehensive. And that recovery improves not only the person and their family, but that recovery helps lift families out of poverty.
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I would suggest looking at landmark work by George Vaillant. 
eg Addiction Volume 98, Issue 8, pages 1043–1051, August 2003
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many papers about drug addiction and self administration construct experiments involving drug seeking under second order schedule of reinforcement, and as freshman in this field I'd like to know what does that mean .   thanks a lot.
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Dear Wu,
In a fixed-ratio (FR) schedule a reinforcer (e.g., a drug such as cocaine or morphine) is delivered after a constant number of responses. In a FR 15 a reinforcer is delivered after every 15 responses. Then after 15 more responses a reinforcer is delivered. In a fixed-interval (FI) schedule a reinforcer is delivered for the first response after a constant time period. In a FI 2 min, a reinforcer is delivered for the first response after 2 min. Then the 2 min timer restarts during which no responses are reinforced until the first response after 2 min. In a second order schedule a 'response' is completing a schedule of reinforcement and the schedule is also on a second schedule of reinforcement. For example,on a fixed ratio 10 (fixed interval 1 min ) [sometimes written FR10 (FI 1min)] completing the FI 1 min is a 'response'. No reinforcer is delivered. Completing 10 FI 1 min is reinforced. The FI 1 min is on a FR 10 schedule.  
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Hi all, I need some related studies in regard of "empowering family and community of drug addicts" to be reviewed. I need to know what have been done on this topic and what is needed to be done in the new researches; specifically, researches conducted in Malaysia. Indeed, I need to find the gaps. I have searched for it but I could not find many of them. Only a few ones!
Would you please let me know if you have already done a similar research or have a similar paper in your archives?
Your assistance is greatly appreciated.
Regards,
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Dear Farimah,
     I have published a number of papers on this subject.  I have attached one.  Others are posted at www.williamwhitepapers.com
Bill
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I am conducting a cross-cultural analysis using the Standard Cross-Cultural Sample (Murdock y White 2006) in order to elucidate the frequency of the consumption of inebriating plants, mushrooms and drinks in human cultures. I have not been able to find any previous attempts to do this. Does anyone know about such an investigation?
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Dear Jose,
You may find these book helpful.
1.Mushrooms: poisons and panaceas. 1995 (422 pp.),ISBN
0-7167-2649-1
2.Cannabis and Culture edited by Vera Rubin 1975
Good luck!!
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I am a medical postgraduate reasearcher, having a research proposal about epigenetic modification by already existing drugs used in other medical uses in drug addiction
Kindly contact by e mail: [personal information removed by admin]
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See if you can get in touch with Giuseppe Riva
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Cross addiction refers to the presence of two or more addictions - a common trait among addicts. Many cross addicted patients develop secondary dependencies in an effort to deal with their Cross addiction refers to the presence of two or more addictions - a common trait among addicts. Many cross addicted patients develop secondary dependencies in an effort to deal with their primary addiction..
What are the somatic and psychological factors that cause a cross addiction after primary addiction?
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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
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I am a candidate masters in advanced psychiatric nursing at the university of the Western Cape, South Africa. My area of interest is substance use disorders as well as psychiatric disorders. My research topic is Psychiatric comorbidity with substance use disorders in adult inpatient treatment centers. I experience difficulty in searching for an appropriate tool to measure this phenomena, especially with the DSM 5 criteria.
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Hi Helen,
I am an addiction psychiatrist and researcher, and find that the PRISM is particularly good for this purpose. Most of the tools or diagnostic instruments have been based on the DSM IV however, and haven't been updated for DSM5 yet. This is, by and large, not a major problem.
This article is somewhat dated but summarizes the range of tools pretty well.
Kind regards,
Shalini
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Is information available on the number of nurses, non-professional workers etc in the drug treatment sector in the UK ?
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Hi Ian
You may found some information on 
Regards
Paulo Seabra
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Does anyone have any guidance regarding nursing / physician attitudes of patient drug abuse and if attitude or stigmatization of that population can affect patient outcomes? 
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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.
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Dear Colleagues, I am recently working as psychotherapist in a Stationary Clinic for drug-dependent patients. I wonder if you could suggest me Materials, publications or psychoeducative interventions that I could use to prepare group dynamics with my patients. Any suggestion? Thank you very much for your advice!
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Dear Juan,
The following links would give you an overview of some of the possible treatments for your patients.
Darryl Inaba's Uppers, Downers, All Arounders would provide good materials for your psychoeducational groups.
Alan Marlatt's relapse prevention would be good for relapse prevention groups.
Depending on your work setting and community resources, you can refer your patients to NA (Narcotics Anonymous) or AA (Alcoholics Anonymous) meetings, and their associated services (i.e., work the 12 steps with the patient's sponsor, and read the Big Book (of testimonies), etc.).
Best wishes,
Stephen
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All the above factors might be involved, although the prevailing factor is drug-drug interactions in drug addicts infected with HIV, namely the following drugs competing with each other at the active center of hepatic CYP3A4: methadone vs NNRTIs, PI vs NNRTIs, epistatins vs NNRTIs, antifungal ketoconazole vs NNRTIs, taxol vs NNRTIs, etc.
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It is most likely due to treatment time.  In other words, CYPs get genetically induced (up regulated) if you will, the longer the patient is on antiHIV-meds.  A plot of treatment time versus CYP activity will clarify my point.
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Recent have seen individuals with opiate addiction who are presenting ER with severe rhabdo after being clean.  They are presenting with negative urine drug screens.  Any ideas on what the causative agent(s) might be?
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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.
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I am interested in any commentaries or research into whether drug addiction (specifically opiates) should be approached medically or criminally. If possible research that focuses on UK or cross country comparisons. Many thanks 
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Florencia, Apologies for the delay but yes that would be wonderful thankyou
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I’m researching treatment options for children in foster care who are struggling with drug addiction. I read about Multidimensional Treatment Foster Care (MTFC), Family therapy, multisystem therapy and functional family therapy. I was wondering if anyone knows of Interventions, advice or recommendations for most effective treatments. I’m really looking to find out what you’d consider to be the most efficient method.
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Hi Sonya,
You mentioned "Multidimensional Treatment Foster Care (MTFC), Family therapy, multisystemic therapy and functional family therapy." They all are systemic therapies and would be quite effective with children in foster care who experience problems of drug addiction. For they take a holistic approach and would involve not only the identified patient (IP) with drug addiction problems, but his/her social and environmental contexts (e.g., foster family, friends, school, social circle, community, etc.) as well.
Many interventions can be used from these therapies. I know functional family therapy (FFT) quite well. I have found the three phrases of treatment in FFT to be helpful. Specific interventions such as positive reframing, reducing blame, building working alliance between the client and the therapist and among family members, reducing risk factors and increasing protective factors, and skills building (e.g, communication, problem-solving, parenting skills, etc.), when working in concert, can be effective.
Best,
Stephen
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Hi
I work with self-administration, and, as you know, performing a patency test by injecting methohexital (Brevital) into the catheter is essential. The problem is that this ultrashort- barbiturate is very difficult to find if you don't have a DEA license. Is there a similar compound that can do the same thing? or maybe another technique to verify that the catheter is working? I hope someone can give me suggestions! Thank you!
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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.
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In France, the prescription of benzodiazepines (BZD ) is a problem . Care for patients with chronic use is difficult. In terms of public health, it is particularly relevant to avoid this situation by prescribing these treatments wisely. A thesis carried out in 2012 resulted in the design of two brief first prescription of BZD guides , one to complaints for anxiety and the other for insomnia.
How would it be possible to assess the relevance of these guides, in actual practice conditions of general practice (GP) , knowing that the conditions of research in MG do not allow a large-scale intervention study ?
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I love this discussion because it's so important. I spent the 70's (my first decade in private practice) getting people OFF benzos. My "decision support" is simple: NEVER use these drugs (always remember never to say always or never). UNLESS you have no choice. I never, prescribe them EXCEPT in a few circumstances: EtOH withdrawal, certain phobic reactions (such as flying, and only for the duration, w/ the caveats of memory loss, DVT etc), and those who have already become addicted by other physicians' unwise (in my opinion) prescribing.  Now that we know that several if not most of the antidepressants are also excellent for anxiety, we can use other means, including NON-DRUG therapy, which also works very well. We certainly DO want to alleviate crippling anxiety or insomnia, but we'll never do it with benzos, though they "work" at first.  Also, now that the "powers that be" have begun to agree w/ me (I've been saying & doing this for YEARS), touting how the elderly (& all the rest of us) have more falls, more depression, more cognitive impairment w/ these drugs, it's much easier to reason with patients. I know this is a research site -- but it's really difficult to research Common Sense and the Art of Medicine.
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I welcome suggestions for improving both DNA rates and drop outs within addiction services.
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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:
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I am searching for the efficacy of non-pharmacological methods for methamphetamine dependency.
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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.  
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We are studying the psychopathology of addiction using the SCL-90 questionnaire. We have these questionnaires of heroin / cocaine / alcohol patients. We do need SCL-90 questionnaire of a group of depressed subjects (not addicts). Noone wants to share and collaborate to a paper?
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Dear Angelo,
yes, we do have several data sets with SCL on adult subjects. Coherently with our field of research, most of these subjects are parents of children with or without psychological difficulties or psychiatric diagnoses. In short, we have data both on clinical and healthy samples (diagnosis on children and/or parents).
Please, have a look at my researchgate page and see some of my recent papers. You will see that there are data particularly about mothers and fathers and their offspring.
Best regards
Luca
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I am interested in substance-induced psychosis, and was wondering if anyone has come across measures of psychosis in this population that can be conducted based on individual recall, i.e. when the person is no longer psychotic. 
Has anyone used the BPRS or PANSS in this manner before? Any comments on their utility/validity in this population?
Would appreciate any help anyone can offer.
Regards,
Shalini.
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I tend to agree with Aida in that both the PANSS & BPRS are used to determine the severity of symptoms that are present when the tests are being administered. In my opinion, retrospective use of these tests based on recall should not be used as this will lead to a lot of ambiguity and patients might not necessarily be able to recall all aspects of what these questionnaires seek to determine.
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Something that will closely model human behavior.
I have doubts about using Balb/c mice because they seem to be used as a depressive model. Any suggestions?
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I would like to repeat that the "best strain" depends on the substance to be tested.
You may also consider using two or more different strains for the same study if you are interested in genetic vulnerability.
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poly drug abuser
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Maybe there is a reason that they use these drugs. Perhaps it helps them to deal with specific issues that they face and have found that alternatives promoted by the establishment do more harm than the illegal or unprescribed alternatives that they have found to work.
I would ask the patient why they use it, and not be judgmental, be supportive in trying to understand what value this provides to them, then try to find whether they might be willing to consider alternatives (but don't force them to or try to manipulate them into thinking that you have all the keys, for example, or they will never trust you).
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There seems to me to be a black hole in the literature regarding Cocaethylene. My research (independently) has suggested a much more prominent awareness of the increased euphoric effects rewarding the addict despite their knowledge of the higher chance of sudden death and/or myocardial infarction within the Cocaine and Alcohol Addicts realm than there is in the Substance Abuse Research data bases or Educational literature... calling for the necessity of further research. Is anyone aware of current research on the consequences or treatment protocols for Cocaethylene addiction?
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There is no evidence that cocaethylene per se has activity that is different from cocaine itself or alcohol itself, other than the potential for prolongation of the usually short half-life of cocaine.  However, in conversations with thousands of people who used cocaine and alcohol together, patients have told me they felt the cocaine more intensely but not for a more prolonged period of time. However, there is clinical evidence that the cardiac toxicity of cocaine may be prolonged in drinkers, perhaps because of the chronicity of cocaethylene duration.  Interesting question whether cocaethylene may have prolonged psychoactive effects, but am aware of no evidence on that.
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Methadone maintenance is in the patients perspective a quiet "boring" drug. We think that not only cocaine is often used in high dose maintenance, but also alcohol (carbonic acid + alcohol = "cick"). My question is:
Does anybody know wheher there are combination maintenance programs with fast acting morphine in daytime and low methadone for the night?
regards
c. jellinek
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I agree with Dr. Dillon that methadone is quickly becoming obsolete for patients with Opioid Use Disorder (DSM Dx 304.xx), but for different reasons.  Methadone, WHEN ADMINISTERED PROPERLY, remains the "gold standard" for maintenance treatment.  The problem is, it's very expensive to administer it properly - you need drugs-of-misuse screening tests, complementary therapy - in other words, a very well-run methadone clinic - these are few and far between.  I have not observed the "drool effect" Dr. Dillon references in PROPERLY DOSED PATIENTS in top-decile clinics, which I have visited.  On the other hand, patients with too high a dose of a strong opioid will always drool, nod, etcetera.  
Buprenorphine is safer and more convenient for the patient, and far less mis-usable amongst pts with even mild opioid tolerance.  Speaking of safety, and to answer the original question: no!  Not only do you risk hyperalgesia but also you risk RESPIRATORY DEPRESSION AND MORTALITY if you COMBINE MORPHINE AND METHADONE.  This is a VERY VERY RISKY MAINTENANCE STRATEGY (mixing long-acting and short-acting opioids) and even assuming it's all done inpatient, the risks of something going wrong, in my option, outweigh any possible benefits.  
Best option: switch to buprenorphine.  Worst option, if you feel you MUST augment morphine (again, not suggesting you do this): use something a little less RD (respiratory depressive) than morphine, such as hydrocodone (fast acting, high bioavailability through oral administration).  
Also, with all due respect, maintenance medications are supposed to be "quiet BORING drugs" and patients should get used to it.  The meds (bupe and methadone) are supposed to eliminate the craving for opioids, and NOT act as a euphorigenic.   
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I have done a short review of biofeedback and addictions treatment. I have not noticed any current studies that demonstrate the effectiveness of biofeedback therapy in addictions. I am interested as I am a Licensed Clinical Alcohol and Drug Counselor and a MSW candidate.
Please provide links to resources. Thank you.
Don.
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Ed Boyer from UMass has published on use of biofeedback on craving --see below.  there are additional publications in this area.
Preliminary efforts directed toward the detection of craving of illicit substances: the iHeal project.
Boyer EW, Fletcher R, Fay RJ, Smelson D, Ziedonis D, Picard RW.
J Med Toxicol. 2012 Mar;8(1):5-9. doi: 10.1007/s13181-011-0200-4.
PMID:
22311668
[PubMed - indexed for MEDLINE]
Free PMC Article
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During drug-addiction studies in rats: We depend on the visual observations and kinetic disturbances in rats for determination of addiction or dependence. What are the additional parameters that can be measured in blood to confirm that rat is being drug-addicted or not?
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Receptor density for the drug, up/down regulation of mRNA with increased/decreased exposure to drug.
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Methadone is a strong opioid analgesic which was one among the first synthesized substitutes for morphine. It has all morphine-like effects and high habit-forming potential. The modern approach recommends its oral administration only for the strong and intense pains and exclusively to the patients with cancer of different localization and the degree of dissemination. According to the opinion of WHO experts it is justifiable to use as late as stage III of this illness, when the pain still persists despite administration of non-opiate analgesic. The major undesirable effects of heptanon are respiratory and circulatory depression, respiration arrest, shock and cardial arrest. Heptanon was used in the treatment of opiate addiction for heroin withdrawal, not more than 15-21 days. Otherwise, the use of Methadon had produced a new type of a legal, iatrogenic addiction lasting for several months or even for several years. The licit use of this drug as a substitute for the illicit use of heroin has only deepened the already formed dependence. Long-term administration within the Methadon-maintenance programs has turned the addicts into lifelong drug abusers who continued their drug practice with a new opiate addiction. The medicine, and the practice too, have demonstrated that the treatment of Methadon iatrogenic addiction is not any easier than that of the morphine or heroin addiction; there are many who believe that it is even more difficult. For those who still believe in Methadon as a drug of choice for the treatment of drug dependence, there is a question: is the narcotic given by a physician within the treatment program effective enough to help the addict restore to normal living?
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The choice is NOT between methadone and abstinence - if it were, the answer would be easy. While the data on use of extended-release naltrexone are not in, the issue is retention. Long-term non-agonist treatment results in between 5-15% of patients remaining in treatment.  The mortaility of those not in treatment approaches 8% per year; for those in treatment it is 1.7% per year.  That is really the issue. People not on agonist therapy leave treatment in high numbers, those on agonist therapy remain in treatment in high numbers. Those in treatment survive, large numbers of those out of treatment don't. So the question isn't whether they can return to a "normal" life (although large numbers do), the question is keeping them alive.
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PWID programs
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in France and particulary in my region (north of France), OST is commonly prescribed to non-injecting opiate-dependent individuals. The buprenorphine is prescribed by all the GP. To have the first prescription of methadone the patient has to see a practitionner who work in an addiction center then the GP ensure the follow up
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I'm currently exploring the literature on older illicit drug users (heroin, cocaine methamphetamine etc) and there seems to be very little on interventions for this particular cohort. While acknowledging the studies and reviews of interventions with older alcohol and prescription drug users, I would be really interested in hearing from people who have carried out therapies, treatments (excluding methadone) with older (45+) clients/patients.
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April: (See: The sample was mainly composed of men (n = 20), with an average age of 32 years (ranging between 20 and 47). The sample's average duration of crack use was 11.5 years, with a minimum of 4 years and a maximum of 20 years.)  http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3091576/
I wil write more later as I have interviewed crack addicts in their 60s.
Marilyn-- :-)
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There is a body of literature attesting to the need for a system approach to addiction prevention and treatment. The best example of that is recovery management. I believe that recovery management is currently the best hope for long-term treatment of addiction. Do you feel recovery management is a promising approach to the prevention and treatment of addiction?
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Thank you very much for the comments so far. It's ironic that many of the concepts of Recovery Management have a long historical perspective and are used, informally in 12-Step groups; so there is a precedent for it. While Recovery Management can include formal treatment, the emphasis is on addiction as an on-going, life-long process. Dr. Kurtz’s use of the word “process” is important in this context. It helps in seeing it as a system of that includes many different resources that are needed for a given individual to become abstinent, sober and continue to improve as their recovery improves.
Recovery changes the emphasis from treating acute pathology to helping the addicted person and those affected by him or her heal and manage problems related to alcohol and other drugs (as well as behavioral addictions) A person’s needs will change over time and through Recovery Management positive changes in their lives can change accordingly. In addition, the people close to them can change as well (i.e. through Al-Anon, etc.).
You might be interested in the sites for the Recovery Initiative and the Recovery to Practice (RTP) Initiative. The links are below. 
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I am looking for articles or research that will aid in a psychodynamic understanding of addiction, especially in individuals diagnosed with bipolar disorder.
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There is no date. You can use it and write n.d. instaed of the year.
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Let's say drug X produces a maximum response of 50, so its ED50 is the dose that elicits a response of 25. Drug Y produces a maximum response of 30, so its ED50 is the dose that elicits a response of 15. Isn't comparing these two with statistics like comparing apples and oranges? Yes, you could normalize the maximum response of each to 100, but that seems to be misleading when comparing two drugs. What I really need is a good published reference about the do's and don't of ED50 values, maximum responses, etc. and their analyses, especially in behavioral pharmacology.
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I may not be a good source for the book you want but I will tell you it's the ED50 that is reliable and repeatable. At best, maximal doses will be estimated as something like an ED99 and have much larger confidence intervals than ED50s. At worst, the maximal dose will be some imaginary number like twice the ED50.
I'm sure it's the maximal dose that is wanted by physicians and biologists. Unfortunately, it's easier (smaller confidence intervals) for statistics to estimate central tendencies than it is to estimate extreme values. You generally need a very expensive sample and a strong ethical rationale to obtain a maximal dose estimate with a confidence interval small enough to actually inspire confidence in the estimate.
It's not an easy read but my most current favorite on estimating ED50s (with a couple of short references to ED99s) is Statistical Techniques in Bioassay by Z. Govindarajulu (2001). The classic reference is Probit Analysis by Finney (1952).
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I am trying to determine if the use of CNO in drinking water or chow is a reasonable method of delivery for sustained activation of the DREADD receptor.
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Never tested it myself:
1. Dissolve the CNO in a small volume of DMSO
2. Diluted the dissolved CNO in drinking water (e.g., 5mg/200ml)
3. Give mice with CNO drinking water and protect from light using foil-wrapped bottles
4. The mice will receive 5mg/kg/day CNO (assume that mice weight 30g and consume 6ml water per day)
5. Prepare fresh daily.
6. A small amount of saccharine in the drinking water will mask the slightly bitter taste of CNO
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I am looking to know more about the role nutrition plays in drug addiction/rehabilitation. I have taught nutrition in various drug rehabilitation facilities internationally and I have noticed that the patients are lacking in good nutritional foods that can and will aid the body in healing itself. Thus, my theory is that poor nutrition is keeping drug addicts from reaching true rehabilitation.
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Hello Devra, drug is a general word. People may be addicted to legal
drugs like sugar causing sugar addiction which may lead to diabetes and
high blood pressure, nicotine where a withdrawal may lead to massive
weight gain, antidepressants like Prozac which may lead to a weight gain
of 20-30 kg within the first three month of intake. Also a legal drug may be
fast food combined with soda pops loaded with sugar which lead to depression
like symptoms caused by low BDNF which is crying for compensation with more
fast food as one of the self rewarding methods.
There are ways out of misery by changing food. But things with dopamine increase
are not so easy and may in my opinion only contribute a little.
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There are no studies that focus on any maintenance treatment for stimulants abuse; besides, craving to stimulants remains for many years. For instance, methamphetamine craving remains for many years and this craving could resulting in relapsing; So why there are no evidences about maintenance treatment for stimulants?
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Yes. In the UK there are a dozen or more treatment agencies which prescribe dexamphetamine tablets or syrup to injecting amphetamine users, usually on the condition that they agree to stop or reduce injecting. I wrote a review of the literature on this topic about 10 years ago, and presented it to a conference in 2010 (attached). I concluded that there is enough preliminary evidence of the effectiveness of this form of substitute prescribing for a larger roll-out and research evaluation to be conducted. If anyone wants a copy of the full review paper, email me at: director@3Dresearch.org.uk
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I am looking for recommended material to read about drug addiction. Everyone will experience a drug at some point in their lives, whether it be alcohol, caffeine, or chocolate for example. These are social drugs, but some tend to take drug use a step further by experimenting with potentially addictive drugs. I wish to follow an addicts transition from casual use to compulsive use, and also find out why it is so hard to quit.
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So, there is nothing "unnatural" about addiction. Addiction is a learned behaviour. When you were born, your brain had roughly the same number of neurons it does now. But (assuming you are an adult) your brain has quadrupled in size since you were born. You haven't increased the number of brain cells, you've grown many more connections between them. When you learn anything, new pathways are physically burned in your brain, connecting neurons that were not connected before.
If this is the first time you have encountered this information, then reading this paragraph has subtly changed the structure of your brain, just now.
Using heroin every day changes your brain structure.
But then, so does playing the piano every day, or learning to surf, or type, or play a video game etc, or learning a second language. Other experiences are less benign, but still modify both your brain chemistry and structure- for example acute trauma or being subjected to high levels of chronic stress.
London cab drivers have to learn the whole layout of the cities central business district by heart before they are licensed- it's a grueling testing process that takes most people months or years to complete. When scientists put them in fMRI scanners they can actually see structural differences in the part of the brain that is most involved in spatial navigation and spatial memory (see link below).
A similar study looked at people from religious minorities who are schooled in dogmatically narrow ways of thinking, and who are subjected to social stressors because of their beliefs. In later life the part of their brain that stores memory becomes (on average) smaller, not just shrinking but also growing new connections more slowly than people of the same age who come from less stressed, more open-minded backgrounds. (See link below).
So, to summarise, if you repeat any experience that modifies your brain chemistry regularly enough, then your nervous systemn will change the way it regulates it’s chemistry to adapt, and it will learn to expect the drug when exposed to certain situations, places and people.
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Is it ethical practice in the provision of methadone to drug users not to offer abstinence programmes to them?
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The much of the literature was about heroin dependent long term addicts and clearly the two options were long term residential treatment of at least 6 months or opioid maintenance. Short term detox treatments in these populations were clearly ineffective. Now days we have a great deal of prescription opioid dependence , some with patients with chronic pain, some with anxiety , and some with clearly addiction as the primary disorder. The data is not as clear in these populations because the duration of dependence varies, but the longer the duration, the more it seems that they are like the old heroin dependent patients. Injectable naltrexone has now come on and shows some promise and is FDA approved for this. A new application of a