Tobacco addiction: more from Dr Chapman.
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The proportion of having keitai (Japanese mobile phone) has increased rapidly in young children. To research how junior high school students use their own keitai and to examine the impact of using it on their psychology, especially on their friendship, we recruited 651 students, grade 8, from five public junior high schools in the Tokyo metropolitan area. Each student participant completed a questionnaire that we had created. The response rates were 88.8% (n = 578) for participants. The proportion of having their own keitai was 49.3% (n = 285) and that of not having it was 50.7% (n = 293). We found that they used it much more frequently for e-mail than as a phone. Most of them exchanged e-mails between schoolmates, and more than a half of them exchanged e-mails more than 10 times a day. Sociable students estimated that their own keitai was useful for their friendship. But they experienced some insecurity or started staying up late at night engaged in e-mail exchanges, and they thought that they could not live without their own keitai. Our findings suggest that keitai having an e-mail function play a big part in the junior high-school students' daily life, and its impact on students' friendships, psychology, or health should be discussed among students to prevent keitai addiction.
RATIONALE: Modafinil is a drug that promotes wakefulness and, as such, is used to treat hypersomnia and narcolepsy. Preclinical and clinical studies suggest that modafinil could possess weak reinforcing effects in drug-experienced subjects. However, its abuse potential in drug-naive healthy individuals is still totally uninvestigated, despite the fact that availability of modafinil has recently increased. OBJECTIVES: The purpose of our study was to investigate the potential addictive properties of modafinil by testing its reinforcing effects in naive rats. The interactions of modafinil with the reinforcing effects of cocaine were also tested. METHODS: First, using i.v. self-administration and place conditioning tests, we studied the reinforcing and rewarding effects of a large range of doses of modafinil in naive rats. Second, we tested the influence of modafinil on reinforcing and incentive effects of cocaine in rats trained for cocaine self-administration. The effects of modafinil were compared with those of amphetamine and haloperidol. RESULTS: Modafinil did not produce reinforcing or rewarding effects and did not modify the effects of cocaine. CONCLUSIONS: Our results suggest that modafinil does not possess an addictive potential in naive individuals. Furthermore, it would be behaviorally distinct from classical central nervous system stimulants which are known to alter cocaine-induced effects. However, as shown previously in nonhuman primates and in humans, modafinil could possibly have reinforcing effects in cocaine-experienced individuals.
There is a broad range of forensic issues in addiction psychiatry. For many psychiatrists, what is most challenging about addressing these issues is their origin in the law, which is a system and a way of thinking that may feel foreign to the medical practitioner. To address forensic issues, addiction psychiatrists should learn and understand the specific legal questions that arise in each forensic context. They should become familiar with the relevant definitions, criteria, and legal requirements that apply in each specific area of their practice, rather than assume that clinical definitions and reasoning will carry them. If they perform forensic evaluations, addiction psychiatrists must distance themselves from the wish to help the examinee, focusing on the role of neutral examiner. Comfort and effectiveness with forensic issues require familiarity with, knowledge of, and ultimately respect for the forensic contexts of addiction psychiatric practice.
Drugs of abuse have very different acute mechanisms of action but converge on the brain's reward pathways by producing a series of common functional effects after both acute and chronic administration. Some similar actions occur for natural rewards as well. Researchers are making progress in understanding the molecular and cellular basis of these common effects. A major goal for future research is to determine whether such common underpinnings of addiction can be exploited for the development of more effective treatments for a wide range of addictive disorders.
In the rat, continuous access to d-amphetamine (d-AMPH) leads to lengthy bouts of self-administration, voluntary abstinence, and relapse to self-administration. Previous studies have revealed that the progression from psychostimulant self-administration to abstinence to relapse is mediated in part by the ventral hippocampus. Stimulation of the ventral subiculum (vSub) during voluntary abstinence from d-AMPH self-administration reinstates self-administration and increases nucleus accumbens (NAc) dopamine efflux. Quantitative proteomic examination of the hippocampus from rats naive to amphetamine, during a self-administration session 'Binge', during voluntarily abstinence 'Abstinent', and after reinstatement of self-administration 'Relapse', revealed a differential proteomic state during abstinence. Actin- and cytoskeletal-related proteins were over-represented in the changes occurring during abstinence and suggest a decrease in actin filament polymerization. These changes may underlie alterations in neuronal tone during abstinence that could affect both neurotransmission and behavior. These data provide the first classification of addiction-related behaviors based on clustering of quantitative proteomic measurements. .
The Self-Medication Hypothesis (SMH) is a popular explanation for chemical dependencies. The SMH ignores or leaves out important biological research which has explored the mechanisms of reward, motivation to use alcohol/drugs, as well as the impact on mood of chronic, excessive alcohol/drug use. A new psychology is needed which includes this biological research as well as the psychological observations contained in the SMH. Self Psychology is used to create an integrated psychology for the addictions.
Illicit use of drugs frequently begins and escalates during adolescence, with long-term adverse consequences. Because it is increasingly accepted that neural development continues through adolescence, addiction research has become more invested in understanding the behavioral and molecular consequences of early exposure to drugs of abuse. In a novel binge administration paradigm designed to model the pattern of human adolescent drug use, we administered ascending doses of cocaine or saline during a 12-d developmental period [postnatal day 35 (P35) to P46] corresponding to human adolescence. During adulthood (P70), rats treated with this regimen displayed increased responsiveness to the stimulant effects of cocaine. Adult rats also displayed abnormally rapid shifts in attention when performing an attentional set-shifting task, which measures the ability to shift attention between stimuli and whose performance requires an intact prefrontal cortex (PFC). Treatment with cocaine during adolescence also caused acute alterations in the expression of genes encoding cell adhesion molecules and transcription factors within the PFC. Furthermore, we observed decreases in histone methylation, which may indicate a role for chromatin remodeling in the observed changes in gene expression patterns. These findings suggest that exposure to cocaine during adolescence has far-reaching molecular and behavioral consequences in the rat PFC that develop over time and endure long after drug administration has ceased.
The terms addiction, dependence, tolerance and abuse are not interchangeable and cannot be used as synonyms. Two types of addictions, chemical and behaviour addictions, have similar cycles, but the "pull" type mechanisms are more characteristic of the chemical addictions and the "push" type mechanisms of the behaviour addictions. Among the integrative, complex conceptual models, the definitions of the WHO model are most in harmony with the latest research findings, although this model too is in need of revision on several points. The modern diagnostic systems are polythetic; they advance beyond the principle of "all or nothing" and despite their shortcomings they can be used effectively in clinical practice. Aspirations in the direction of both expanding and restricting the concept addiction can be observed.
The concept of addiction is increasingly bound to a general model of heterogeneous and polymorphous dependences. In this paper we examine upstream what could found this universal addictive principle, asking the question of the neurobiological root of addictivity. In other words, is the root of our brain working in an addictive way? To answer affirmatively to this question we gather two sets of datas: firstly, the conditions of the brain addictivity and secondly, the brain mechanisms that suggest this kind of addictive working. These datas are common if we consider them one by one, but their synthesis in a bundle of heuristic clues could be interesting to examine and to submit to thought. The model we suggest proposes that the architecture of our brain and the type of functioning of our neurones, imply the presence of a natural addictive set of problems in all human beings, between a fight against cerebral background noise--a dysphoric source--and a stimulation need. Finally, considering some neurobiological data in the last five years, we propose a triangular model of the addict brain, that involves three associated systems: "arousal" system, "liking" system and "wanting" system. This model, supported by the sensation seeking one, will allow us to suggest an explanation of the processes that lead to pathological addictions, according to the principles of a natural and universal addictivity.
The nutritive sucking performance of congenitally addicted infants undergoing narcotic withdrawal was used to provide objective measures of adaptive behavior in a series of 50 infants born to mothers addicted either to heroin or methadone. Sucking rates as well as average pressures developed during sucking were significantly reduced for the addicted infants relative to a control group born to normal mothers and a second control group born to toxemic mothers. The subgroup of infants born to methadone-addicted mothers was significantly more depressed with regard to sucking behavior than the infants of heroin-addicted mothers. Furthermore, infants treated with paregoric (an opiate) for symptoms of the narcotic withdrawal syndrome showed significantly less depression of the sucking response than those treated with sedatives such as phenobarbital.
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An evolution in theoretical models and methodological paradigms for investigating cognitive biases in the addictions is discussed. Anomalies in traditional cognitive perspectives, and problems with the self-report methods which underpin them, are highlighted. An emergent body of cognitive research, contextualized within the principles and paradigms of cognitive neuropsychology rather than social learning theory, is presented which, it is argued, addresses these anomalies and problems. Evidence is presented that biases in the processing of addiction-related stimuli, and in the network of propositions which motivate addictive behaviours, occur at automatic, implicit and pre-conscious levels of awareness. It is suggested that methods which assess such implicit cognitive biases (e.g. Stroop, memory, priming and reaction-time paradigms) yield findings which have better predictive utility for ongoing behaviour than those biases determined by self-report methods of introspection. The potential utility of these findings for understanding "loss of control" phenomena, and the desynchrony between reported beliefs and intentions and ongoing addictive behaviours, is discussed. Applications to the practice of cognitive therapy are considered.