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At least 127 records · Page 7Linked to original sources
PubMed1998

A long-term program of research on drug use and crime.

This paper describes the major findings emanating from a long-term research program conducted in Baltimore, Maryland, on the drugs-crime relationship. It is the compilation of experiences, studies, and findings related to the research career of David N. Nurco, D.S.W., and his colleagues. Covering a period of over 30 years, the program of research, described in the report from the personal perspective of Dr. Nurco, has moved from the study of the nature and correlates of narcotic drug use to the development of data-based interventions. Topics investigated involve many aspects of narcotic addiction, including the relationship between addiction status and crime rates; changes in addict behavior over time; individual variation among addicts in the type, frequency, and severity of crime; and an examination of the early adolescent behavior of males who eventually become narcotic addicts in contrast to that of their never-addicted peers. It concludes with a description of the program's ongoing research, principally dealing with community-based interventions.

Adolescent↗
PubMed1997

The most important unresolved issue in the addictions: conceptual chaos.

This article suggests that the field of addiction study and treatment remains in a state of conceptual chaos. The addictions is an emerging scientific field that lacks conceptual clarity. To develop the precision necessary for scientific advance, we must begin by developing improved definitions of substance use, abuse, dependence, and addiction. Complicating matters, psychoactive substance use is not a necessary and sufficient cause of addiction. For example, pathological gamblers experience addiction, including tolerance and withdrawal, often in the absence of any drug use. The neurobiology of subjective experience may be a more important factor in helping to explain addictive behaviors. Consequently, this article concludes that it is improper to consider drugs as the necessary precondition for addiction. Better operational definitions will advance addictions research.

Behavior, Addictive↗
PubMed1998

Oxytocin and neuroadaptation to cocaine.

Oxytocin (OT) has been implicated in neuroadaptive processes such as learning, memory, and social-affiliative behavior as well as in the regulation of physiological responses leading to adaptation to the changing external and internal environment. Drugs of abuse constitute a major challenge to the homeostasis of the body and behavior. Drug tolerance, dependence and addiction may involve neuroadaptive mechanisms related to learning and memory at cellular and systems levels. Considerable effort has been made toward the understanding the neurobiological mechanisms of addictive behavior. Neuropeptides OT and vasopressin (VP) might be involved in these processes based on their effects on neuroadaptation and on their neuroanatomical localization and pharmacological actions. It has been demonstrated that both OT and VP have modulatory effects on opiate and alcohol tolerance and dependence. This chapter summarize the effects of OT, and in lesser extent VP, on neuroadaptation to cocaine, a psychostimulant drug of abuse. We have shown that OT inhibits acute cocaine-induced locomotor hyperactivity, exploratory activity and stereotyped behavior in rodents. Furthermore, OT facilitated, whereas VP inhibited the development of behavioral sensitization to cocaine. In a different model, OT inhibited the development of tolerance to the stereotyped behavior-inducing effects of cocaine as well as cocaine intravenous self-administration in rats. We demonstrated that OT acts through its specific receptors in the basal forebrain and in the hippocampus. OT and VP contents in the hypothalamus and limbic structures were altered by acute and chronic cocaine administration in a dose-dependent and region-selective manner. The differential plasticity of the brain OT-ergic and VP-ergic neurotransmissions in response to cocaine may underlie the differences in the involvement of these neuropeptides in cocaine addiction. Interaction of OT with dopaminergic neurotransmission in the nucleus accumbens, a key brain structure in drug addiction, as well as OT-ergic regulation of hippocampal processes may be among the mechanisms of action through which OT modulates neuroadaptation to cocaine. A better understanding of the role of OT in neuroadaptation to cocaine may provide an insight into both the mechanisms of neuropeptide actions in the brain as well as into the neurobiology of drug addiction.

Animals↗
PubMed1994

Rx for health care costs: resolving addictions in the general medical setting.

The literature on addictions treatment cost offsets suggests that resolving addictive disorders in the general medical setting will drive down the demand for health care, promote more efficient use of care by both patients and their families, and preserve scarce resources that can be deployed more wisely elsewhere. The demand to reduce waste and trim health care expenditures challenges the historic gulf between general medical practice and the management of addictive behaviors. An example of an addiction treatment technology developed in medical settings for use by medical personnel, brief intervention, is reviewed, with reference to its cost-saving potential under health care reform.

Alcoholism↗
PubMed1995

[Study of urinary excretion of codeine and morphine after oral ingestion of codeine].

Results of an investigation on the urinary excretion of codeine and morphine after oral ingestion of 1 mg.kg-1 b.w codeine are reported. The investigation run on seven clinically healthy subjects showed: low digestive absorption of codeine (# 20%); rapid biotransformation of codeine into morphine (first urines excreted after absorption); rapid disappearance of codeine from urines (#30 hrs); persistence of morphine alone (#68 hrs); rapid evolution of the codeine/morphine ratio (inversion of the ratio after #18 hrs); total elimination of morphine which can be greater than for codeine; very different half-life periods for codeine and morphine (5.1 and 13.6 hrs); no other codeine metabolites (nor-codeine and nor-morphine); very high individual variations; one subject with low activity of cytochrome P 450 dbl/buFL. Finally, in an epidemiological survey of drug addict behaviors and detection of drug addiction, it seems very difficult, may be even illusory and hazardous, to try and justify morphine found in urines (morphine, heroin, codeine, codethyline, pholcodine...) except in the very legitimate case where the ratio of urine concentrations of codeine and morphine is greater than one.

Administration, Oral↗
PubMed1993

The stages of exercise behavior.

The stages of change model has shown promise in advancing knowledge about smoking behavior change and other negative addictive behaviors. The model was applied to the study of exercise, a healthy rather than unhealthy behavior. A stages of exercise behavior questionnaire was administered to a sample of 235 employees. Next, the ability of a second questionnaire measuring physical activity behavior to differentiate employees according to stage of exercise was tested. Results revealed that 51% of employees were participating in no physical activity (Precontemplation, Contemplatation) and 49% were participating in occasional or regular physical activity (Preparation, Action, Maintenance). Scores on physical activity behavior items significantly differentiated employees among the stages. This model developed on smoking and other behaviors can be generalized to exercise behavior. Understanding the stages of exercise behavior could yield important information for enhancing rates of participation in physical activity.

Adult↗
PubMed1997

A range of research-based pharmacotherapies for addiction.

Modern approaches to the treatment of addiction have been influenced by several important factors. These include advances in our understanding of the nature of addiction based on longitudinal studies, and progress in elucidating the biological underpinnings of addictive behavior. In addition, changes in the system for delivery of services have begun to shape the way that addiction is treated.

Alcoholism↗
PubMed1999

Compulsive physical activity in adolescents with anorexia nervosa: a psychobehavioral spiral of pathology.

The excessive exercising that is frequently observed in anorexia nervosa (AN) has been viewed both as an addictive behavior and as a type of obsessive compulsive disorder. The present study tested a nonrecursive structural equation model that specified associations among personality factors, cognitions, and behavior in the development and progression of excessive exercise in adolescent patients with AN. As proposed, findings indicated that both addictive personality and obsessive-compulsive personality contributed to excessive exercising by means of their influence on obligatory/pathological cognitions about exercising. Childhood physical activity also predicted excessive exercising. The implications of these results are discussed from a psychobiological perspective.

Adolescent↗
PubMed1995

Addictive characteristics of the behavior of self-mutilation.

Self-mutilation has numerous characteristics that also have been identified in the self-destructive behavior of addiction; these characteristics include similarities in origin, in emotions experienced, in family structure and in the repetitive nature of tension-release responses. Clinicians must deal with the various obstacles when trying to provide care to patients with self-mutilation behaviors, including the lack of information and a preferred treatment and the fact that self-mutilation is an act that occurs in isolation and privacy. The advanced clinician can utilize knowledge of the processes of self-mutilation and addiction to assist unit staff in understanding potential needs of these particular clients and provide resource information to the staff, which may assist in resolving some of the fear and frustration in interacting with self-destructive clients.

Adolescent↗
PubMed1975

Behavior of narcotics-addicted newborns.

The behavior of narcotics-addicted and nonaddicted newborns on the first 2 days of life was assessed with the Brazelton Neonatal Behavioral Assessment Scale. In addition to classic signs of narcotics abstinence, addicted infants were less able to be maintained in an alert state and less able to orient to auditory and visual stimuli. These deficits were especially pronounced at 48 hours of age. Addicted infants were as capable of self-quieting and responding to soothing intervention as normal neonates, although they were substantially more irritable. These characteristics and addicted infants' greater resistance to cuddling are discussed in terms of their potential impact on early infant-care-giver interaction.

Adult↗
PubMed1997

Reduction of environmental tobacco smoke exposure in asthmatic children. A 2-year follow-up.

STUDY OBJECTIVE: To examine the long-term maintenance of a previously reported behavioral counseling intervention to reduce asthmatic children's exposure to environmental tobacco smoke (ETS). PARTICIPANTS: Families of asthmatic children (6 to 17 years), including at least one parent who smoked in the home, recruited from four pediatric allergy clinics. DESIGN: Participants were randomized to one of three groups: behavioral counseling to reduce ETS exposure, self-monitoring control, and usual medical care control. Counseling concluded at month 6, and the original trial ended at month 12. Two follow-up interviews occurred at months 20 and 30. MEASUREMENTS AND RESULTS: The originally reported analysis of baseline to 12 months was reanalyzed with a more robust restricted maximum likelihood procedure. The 2-year follow-up period was analyzed similarly. Significantly greater change occurred in the counseling group than the control groups and was sustained throughout the 2 years of follow-up. Further exploratory analyses suggested that printed counseling materials given to all participants at month 12 (conclusion of the original study) were associated with decreased exposure in the control groups. CONCLUSION: Such long-term maintenance of behavior change is highly unusual in the general behavioral science literature, let alone for addictive behaviors. We conclude that ETS exposure can be reduced and that a clinician-delivered treatment may provide substantial benefit.

Adult↗
PubMed1998

The neuropsychiatry of chronic cocaine abuse.

This review integrates findings from neuropsychological, PET, and MRI studies in human subjects and neurochemical findings in animals to make inferences about neuropsychiatric consequences of chronic abuse of cocaine. It also aims to develop insights into brain-behavioral relationships that may explain the perpetuation of addictive behaviors. Such insights promise to lead to a better understanding of the neuropsychiatry of cocaine abuse and to promote the development of more efficacious treatments. The authors present evidence suggesting that cocaine abusers have specific dysfunction of executive functions (decision making, judgment) and that this behavior is associated with dysfunction of specific prefrontal brain regions, the orbitofrontal cortex, and anterior cingulate gyrus. Suggestions for future research and treatment are also discussed.

Aged↗
PubMed1981

Behavioral assessment technique as a clinical intervention.

Behavioral assessment procedures have been used to predict the onset of addictive behaviors. However, no controlled studies have been conducted to demonstrate the usefulness of such procedures in the treatment of drug abuse. A group using the Behavioral Assessment Technique (BAT) as an indicator for clinical intervention was compared to a group in which the BAT was not used clinically. The results indicated that the BAT was not particularly effective for clinical purposes. This failure was independent of the BAT's accuracy in predicting drug usage. Alternative hypotheses were discussed.

Behavior↗
PubMed1998

Genetic influences on smoking: candidate genes.

Twin studies consistently indicate important genetic influences on multiple aspects of smoking behavior, including both initiation and cessation; however, knowledge regarding the role of specific genes is extremely limited. Habit-forming actions of nicotine appear to be triggered primarily at nicotinic receptors on the cell bodies of dopaminergic neurons in the mesolimbic "reward" system of the brain, a region implicated in addiction to other substances including cocaine, opiates, and alcohol. Important aspects of the dopaminergic pathway include synthesis of dopamine in dopaminergic neurons, release of dopamine by presynaptic neurons, receptor activation of postsynaptic neurons, dopamine re-uptake by presynaptic neurons, and metabolism of released dopamine. Research examining the role of allelic variation in genes involved in these functions is being actively pursued with respect to addictive behavior as well as personality traits and psycho- and neuropathologic conditions and has implications for smoking research. In addition, genetic differences in nicotinic receptors or nicotine metabolism might reasonably be hypothesized to play a role in smoking addiction. A role of dopaminergic or other genes in smoking cessation is of particular potential importance, as research in this area may lead to the identification of subgroups of individuals for whom pharmacologic cessation aids may be most effective.

Behavior, Addictive↗
PubMed1981

Volitional problems in carrying through a difficult decision: the case of drug addiction.

Attempts by young drug addicts to decrease or quit drug consumption were studied by means of a series of interviews. Interest was focused on volitional problems arising due to difficulties in living up to commitments in the face of temptations and various types of emotional stress. It was found that relapses occurred mostly under the influence of emotional stress and that they were preceded by various forms of twisted reasoning, a finding similar to those for other types of addictive behaviors such as smoking and alcoholism. The techniques used by the drug addicts to fight temptations were similar to those reported by other patients. Knowledge of techniques seemed to be rather scarce. There was a correlation between knowledge of technique and success in quitting drug habits. Strong stimulus pull factors were evident in some cases and were apparently counteracted by more or less successful attempts by the patients to escape the tempting situation.

Adolescent↗
PubMed1997

Clinical realities and economic considerations: special therapeutic issues in intrathecal therapy--tolerance and addiction.

The long-term use of opioid analgesics in chronic nonmalignant pain has long been controversial. Rational discussion has been impeded by outdated research and myths regarding the risks of this therapy. Some of the misconceptions relate to the inappropriate use of the terms tolerance and addiction. Analgesic tolerance is a phenomenon in which exposure to the opioid itself causes the patient who has achieved analgesia to require a higher dosage to maintain the same level of effect. This appears to be very uncommon in the clinical setting. A need for dose escalation results from factors other than tolerance, including disease progression. Addiction is an association of psychological dependence and aberrant drug-related behaviors. Addiction to opioids in the context of pain treatment is rare in those with no history of addictive disorder. Clinicians need to become aware of the new findings regarding the low risk of addiction and tolerance in this setting.

Analgesics, Opioid↗
PubMedDate not supplied

Evolutionary game theory and multiple chemical sensitivity.

Newlin's [Newlin D.B. Evolutionary game theory of tolerance and sensitization in substance abuse. Paper presented to the Research Society on Alcoholism, Hilton Head, SC, 1998] evolutionary game theory of addictive behavior specifies how evolutionarily stable strategies for survival and reproduction may lead to addiction. The game theory of multiple chemical sensitivity (MCS) assumes that: (1) the MCS patient responds to low-level toxicants as stressors or as direct threats to their survival and reproductive fitness, (2) this activates the cortico-mesolimbic dopamine system, (3) this system is a survival motivation center--not a 'reward center', (4) the subject emits a counter-response that is in the same direction as the naive response to the chemicals, (5) previously neutral stimuli associated with chemicals also trigger conditioned responses that mimic those to the chemicals, (6) these counter-responses further activate the dopaminergic survival motivation system, and (7) this produces a positive feedback loop that leads to strong neural sensitization in these structures and in behavior controlled by this system, despite a small initial response. Psychologically, the MCS patient with a sensitized cortico-mesolimbic dopamine system is behaving as though his/her survival is directly threatened by these chemicals. Non-MCS subjects have counter-responses opposite in direction to those of the chemicals and show tolerance. An autoshaping/sign-tracking model of this game is discussed. This evolutionary game makes several specific, testable predictions about differences between MCS subjects, non-MCS controls, and substance abusers in laboratory experiments, and between sensitized and nonsensitized animals.

Animals↗