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Biomedical subjects

M A Palmen

Publications and source records attributed to M A Palmen.

4 recordsLinked to original sources

Fluoxetine abuse.

OBJECTIVE: In this report, we describe the abuse of fluoxetine (an antidepressant) in two patients who had histories of substance abuse. MATERIAL AND METHODS: Specific details of the stimulant effects of fluoxetine, used in excessive dosages and in conjunction with other drugs, are discussed. RESULTS: After hospitalization, our two patients were able to discontinue use of fluoxetine and had improved mentation. CONCLUSION: Although the mechanism for this phenomenon is unknown, we postulate that drug craving and behavioral factors are involved.

Adult↗

Nicotine dependence treatment during inpatient treatment for other addictions: a prospective intervention trial.

This study assessed the effect of treating nicotine dependence in smokers undergoing inpatient treatment for other addictions. It was a prospective, nonrandomized, controlled trial with a 1-year outcome. The subjects were smoking patients (50 controls, 51 in intervention group) in an inpatient addictions treatment unit in a medical center. The enrollment of subjects was sequential: controls were enrolled first; after a 6-week washout period, intervention subjects were enrolled. Controls received usual care, and the intervention group received nicotine dependence treatment consisting of a consultation, 10 intervention sessions, and a structured relapse prevention program. Smoking cessation rate and abstinence from alcohol or other drug use were the main outcome measures. The confirmed smoking cessation rate at 1 year was 11.8% in the intervention group and 0.0% in the control group (p = 0.027). Nicotine dependence intervention did not seen to interfere with abstinence from alcohol or other drugs (1-year relapse rate was 31.4% in the intervention group and 34.0% in controls). In this study, nicotine dependence treatment provided as part of addictive disorders treatment enhanced smoking cessation and did not have a substantial adverse effect on abstinence from the nonnicotine drug of dependence.

Adult↗

Marijuana testing--how good is it?

Testing for the use of marijuana necessitates one or more levels of assessment, depending on the clinical application of the test results. The EMIT-dau screening test with a sensitivity limit of 20 ng/ml is highly satisfactory for screening for the absence of marijuana in the urine. This test has a virtual 100% true-negative rate as long as an unadulterated urine specimen is analyzed. Positive results by the EMIT-dau procedure are presumptive because the test seems to produce false-positive results when applied to a random population of suspected drug users. In a population in a specific clinical environment such as in drug-treatment programs in which 20 of every 100 specimens will yield positive THC-COOH results by EMIT-dau screening, 3 (15%) of the 20 positive results will likely be false-positive. Our experience with the EMIT-dau suggests that of 100 test results, 3 will be false-positive, an overall 3% false-positive rate. If a positive test result will put the patient in considerable jeopardy and the screening result is the only evidence of drug use, confirmatory testing is imperative. Of the confirmatory tests, GC/MS seems to have the specificity necessary to provide a high level of confidence in the results. A combination of the EMIT procedure with a sensitivity level of 20 ng/ml and GC/MS confirmation yields virtually 100% accuracy in detection of marijuana abuse.

Cannabinoids↗