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PubMed2004

Occupational exposure and addictions for physicians: case studies and theoretical implications.

Risk of addiction through occupational exposure to drugs of abuse is an important but relatively neglected public health problem. Stress and access may have much less of a role in addiction among certain populations than originally was thought. Risk of addition may be increased dramatically by unintentional exposure in the workplace to potent substances that sensitize the brain. Everyone knows that second-hand inhalation of crack vapors is a very dangerous proposition, but rarely has alarm been raised about exposing anesthesiologists to second-hand fentanyl. Additional studies of the relationship between exposure in the workplace and addiction are necessary. These studies should include biological measures, such as blood levels in exposed workers, and sensitive assays that quantitatively assess levels of exposure in the workplace.

Behavior, Addictive↗

PubMed2005

[Chewing tobacco. An emerging habit among adolescents].

INTRODUCTION: In France, unlike in the United States and Scandinavia, the use of "smokeless tobacco" (also called "chewing tobacco") was rare, but this habit is starting to expand, especially in the world of sports. At ski championships, for example, it is used as a doping agent. Adolescents in mountain areas are now imitating their competitive-skiing peers. CASE: A 16-year-old girl living in a ski resort became addicted to the tobacco paste, "Snuss", and consumed 15-20 doses of Snuss daily, together with a dozen cigarettes. DISCUSSION: "Smokeless tobacco" is emerging as a habit in France, its use encouraged by its discretion, low cost, and rapid induction of addiction. Its growth in Alpine areas requires the urgent development of impact studies to facilitate the organization of information campaigns to treat and prevent its use.

Adolescent↗

PubMed2006

Increasing executive and "self-soothing" capacities in the treatment of addictive disorders.

Freud noted many years ago (1917/1963, 1933/1964) that the talking cure was developed due to the rather primitive nature of neuroscientific knowledge with regard to the brain and hence might eventually be made unnecessary or irrelevant by subsequent discoveries of the neuropsychological causation of neurotic symptoms. The opposite may be true, however. These discoveries may validate the potential effectiveness of therapeutic work with a wide variety of difficult personality disorders and addictive forms of pathology. The recent work of neuroscientists such as Barkley, Davidson, Goldberg, Schore and Volkow and Fowler may allow for empirical demonstrations of benign changes in brain functions following an effective course of treatment.

Behavior, Addictive↗

PubMed2001

Blockade or stimulation of D1 dopamine receptors attenuates cue reinstatement of extinguished cocaine-seeking behavior in rats.

RATIONALE: D(1) dopamine receptor antagonists and agonists attenuate cocaine reinstatement of cocaine-seeking behavior (i.e., responding in the absence of cocaine reinforcement). OBJECTIVES: The present study investigated the effects of a D(1) antagonist (SCH-23390), partial agonist (SKF-38393), and full agonist (SKF-81297) on reinstatement of cocaine-seeking behavior elicited by presentation of cocaine-paired cues. METHODS: Rats that had been trained to self-administer cocaine with a light/tone stimulus complex paired with each infusion underwent extinction across days. After responding diminished, rats were given response-contingent access to the cocaine-paired stimulus complex. The effects of SCH-23390 (0-10.0 microg/kg), SKF-38393 (0-3.0 mg/kg), and SKF-81297 (0-3.0 mg/kg) on cue reinstatement of cocaine-seeking behavior were examined. The ability of the two D(1) agonists to independently reinstate cocaine-seeking behavior and the effects of SKF-81297 on cocaine reinstatement were also examined. To investigate the possibility of behavioral interference, the effects of SKF-38393 and SKF-81297 on grooming and stereotypy were assessed. RESULTS: SCH-23390 and SKF-81297, but not SKF-38393, attenuated cue reinstatement. However, while SKF-81297 dose-dependently increased response latency, SCH-23390 did not. SKF-81297 also independently reinstated responding at the two lowest doses tested while SKF-38393 had no effect. Furthermore, SKF-81297 decreased cocaine reinstatement and increased response latency only at the highest dose. Finally, stereotypy was observed at all doses of SKF-81297 that also decreased responding, although the patterns of changes in these behaviors did not completely correspond. CONCLUSIONS: While the antagonist and full agonist produced similar effects on cocaine-seeking behavior, only the agonist increased response latency, suggesting that different processes mediate the effects of these drugs.

Animals↗

PubMed2006

The zebrafish as a model system for assessing the reinforcing properties of drugs of abuse.

Recent reports make use of the zebrafish to study complex behavior such as addiction, anxiety, or learning and memory. We have established reliable tests and appropriate controls to measure these behavioral parameters in the zebrafish adult. Our assays are robust enough to permit the detection of dominant mutations affecting drug-induced reward, and therefore can be used in forward genetic screens. We provide the reader with the technical details of these tests, as well as their appropriate and crucial, although often overlooked, control assays. In particular, our results make it possible to use the zebrafish as a promising model to identify new genetic components of the reward pathway, or other measurable behaviors.

Animals↗

PubMed2003

Internet gambling: issues, concerns, and recommendations.

The influence of technology in the field of gambling innovation continues to grow at a rapid pace. After a brief overview of gambling technologies and deregulation issues, this review examines the impact of technology on gambling by highlighting salient factors in the rise of Internet gambling (i.e., accessibility, affordability, anonymity, convenience, escape immersion/dissociation, disinhibition, event frequency, asociability, interactivity, and simulation). The paper also examines other factors in relation to Internet gambling including the relationship between Internet addiction and Internet gambling addiction. The paper ends by overviewing some of the social issues surrounding Internet gambling (i.e., protection of the vulnerable, Internet gambling in the workplace, electronic cash, and unscrupulous operators). Recommendations for Internet gambling operators are also provided.

Behavior, Addictive↗

PubMed2007

A double-blind placebo-controlled experimental study of nicotine: II--Effects on response inhibition and executive functioning.

RATIONALE: Smokers may show abnormal functioning in prefrontal cortex during acute abstinence, reflecting deficient activity in mesocorticolimbic circuitry. Cognitive correlates of this putatively include impaired response inhibition and other aspects of executive functioning. OBJECTIVES: To investigate whether inhibitory control and other executive functions in smokers are impaired during acute abstinence relative to post-nicotine. METHODS: 145 smokers were tested twice after overnight abstinence-once after nicotine and once after placebo lozenges (order counterbalanced, double-blind)-on an antisaccade task, a continuous performance task (CPT), a delayed response spatial working memory task and a verbal fluency test. RESULTS: Compared with placebo, nicotine was associated with better inhibitory control on the antisaccade task and fewer impulsive responses to filler stimuli (motor errors) on the CPT; at the first assessment only, nicotine also reduced impulsive responses to 'catch' stimuli on the CPT. However, it did not affect CPT response bias (an index of impulsive vs cautious decision-making), spatial working memory, or verbal fluency. CONCLUSIONS: Smoking abstinence appears to be associated with a difficulty in inhibiting prepotent motor responses, and with nicotine to attenuate this difficulty. However, more 'cognitive' forms of inhibitory control (e.g. decision-making) and the other aspects of executive function tested here appear to be unaffected.

Adult↗

PubMed2001

Craving predicts use during treatment for methamphetamine dependence: a prospective, repeated-measures, within-subject analysis.

Clinical lore dictates that craving drives the compulsive use of drugs and alcohol - the core feature of substance dependence. Yet limited research has yielded mixed results, suggesting that craving is neither necessary nor sufficient for continued use or relapse to addictive substances. To investigate the role of craving in compulsive methamphetamine use, 31 men and women in treatment for methamphetamine dependence were asked to indicate, once each week for 12 weeks, the severity of craving that they had experienced during the previous 24 h, using a 100-mm visual analog scale. In a prospective, repeated-measures, within-subject analysis, craving intensity significantly predicted methamphetamine use in the week immediately following each craving report. Craving remained a highly significant predictor in multivariate models controlling for pharmacological intervention, and for methamphetamine use during the prior week. Craving scores that preceded use were 2.7 times higher than scores that preceded abstinence. Risk of subsequent use was 2.5 times greater for scores in the upper half of the scale relative to scores in the lower half. The results obtained demonstrate that, while craving alone may be neither necessary nor sufficient to explain substance addiction, when measured prospectively in a carefully-designed study craving emerges as a salient predictive factor in continued methamphetamine use for patients in treatment for methamphetamine dependence.

Adult↗

PubMed2004

Shyness and locus of control as predictors of internet addiction and internet use.

The new psychological disorder of Internet addiction is fast accruing both popular and professional recognition. Past studies have indicated that some patterns of Internet use are associated with loneliness, shyness, anxiety, depression, and self-consciousness, but there appears to be little consensus about Internet addiction disorder. This exploratory study attempted to examine the potential influences of personality variables, such as shyness and locus of control, online experiences, and demographics on Internet addiction. Data were gathered from a convenient sample using a combination of online and offline methods. The respondents comprised 722 Internet users mostly from the Net-generation. Results indicated that the higher the tendency of one being addicted to the Internet, the shyer the person is, the less faith the person has, the firmer belief the person holds in the irresistible power of others, and the higher trust the person places on chance in determining his or her own course of life. People who are addicted to the Internet make intense and frequent use of it both in terms of days per week and in length of each session, especially for online communication via e-mail, ICQ, chat rooms, newsgroups, and online games. Furthermore, full-time students are more likely to be addicted to the Internet, as they are considered high-risk for problems because of free and unlimited access and flexible time schedules. Implications to help professionals and student affairs policy makers are addressed.

Adolescent↗

PubMed2004

Functional microcircuitry in the accumbens underlying drug addiction: insights from real-time signaling during behavior.

An understanding of the neurobiological basis of drug addiction requires examination of real-time (subsecond) cellular and chemical responses in the brain reward system during drug-seeking and drug-taking behavior. Electrophysiological and electrochemical studies in the rodent nucleus accumbens have examined changes in cell firing and rapid dopamine signaling during crucial periods of behavioral responding for drugs, and show the associative nature of those signals. These findings are considered with respect to the functional microcircuitry in the nucleus accumbens that underlies goal-directed behavior and the role of this circuit in drug addiction.

Action Potentials↗

PubMed1994

Addiction versus intimacy as related to sexual involvement in a relationship.

Forty couples aged 18-25 years who were in love relationships of three months or more were tested concerning the level of addiction or maturity in the relationship. The results of three questionnaires revealed significant positive correlations between the following: self-esteem and maturity, adjustment and maturity, adjustment and relationship satisfaction, relationship satisfaction and maturity, relationship satisfaction and self-esteem, sexual satisfaction and maturity, and sexual satisfaction and relationship satisfaction. In a multiple regression, three variables (adjustment, relationship satisfaction, and intercourse) predicted a significant amount of the variance surrounding the maturity variable. The results supported the hypotheses proposed.

Adolescent↗

PubMed2005

Anticraving medications for relapse prevention: a possible new class of psychoactive medications.

Psychiatrists have gradually developed a list of medications that are effective in the treatment of addictive disorders. Although alcoholism has received the most attention, nicotine, heroin, and cocaine have all been shown to be influenced by heredity. Of course, the immediate goal is the reduction of drug craving and the prevention of relapse to compulsive drug taking. A medication that can aid in the maintenance of the opiate-free state is naltrexone, a specific opiate antagonist. Naltrexone is also a good example of an anticraving medication used in the treatment of alcoholism. Clinicians currently have two types of medication to aid in the treatment of tobacco use disorder, arguably the most important addiction. Bupropion and nicotine replacement can be given in a coordinated fashion to provide the best available results. At present, no medication is approved by the Food and Drug Administration for the indication of cocaine addiction. Recently, however, five different medications, already approved for other purposes, have been found to be effective among cocaine addicts. Despite clinical trials that show benefit, anticraving medications are not well known and are underused by clinicians. Addiction is a heterogeneous condition, with variability in reactivity to the drug of abuse and to the medications available to treat it. Recent developments in pharmacogenetics may result in improved selection of medications based on genotype.

Alcoholism↗

PubMed2000

Personality and polymorphisms of genes involved in aminergic neurotransmission.

Genetic factors significantly contribute to the determination of human personality traits assessed by self-report questionnaires. However, only in the past few years have common genetic polymorphisms especially the dopamine D4 receptor and the serotonin transporter promoter region been associated with specific personality traits such as novelty seeking and harm avoidance, respectively. The effects of these genes are modest and several genes are likely accounting for individual differences in personality dimensions that can be attributed to genetic factors. Molecular genetic studies of adult personality have also been extended to investigations of early human temperament and some of the genes associated with adult personality traits are also contributing to the earliest developmental expressions of human behavior. Additionally, some of these same genes have also been implicated in various types of abnormal behavior including addiction, obsessive-compulsive disorder, attention deficit, depression, aggression and psychosis. Future research directions will no doubt take advantage of the bioinformatics revolution coinciding with the completion of the first phase of the human genome project. It should soon be possible to identify many of the genes contributing to specific personality traits and to better define their role in determining normal and abnormal behavior from early development through adulthood.

Animals↗

PubMed2004

[Animal model of addiction].

Animal models are a valuable tool in the investigation of the nervous system. Many similarities between animal and human dependency behaviours have been observed. Animal model based on the self-administration response has contributed to understanding of the neurobiological basis of particular stages of the dependence process. Animals are used also to study the mechanism of alcohol dependence. Working out an animals model of addiction should include references to the clinically important phenomena related to psychological dependence which has not been displayed. This situation get us to consider the latest findings and theories about evolution of the wise human.

Animals↗

PubMed1993

Addiction: the treatment of dual diagnosis.

Dual diagnosis is used when two disorders occur simultaneously in one person. The two disorders can refer to two medical illnesses, a psychiatric illness and a medical or surgical illness, or two psychiatric illnesses. The cost of misdiagnosis of dual disorders is high.

Alcoholism↗

PubMedDate not supplied

The physical, behavioral, and psychosocial consequences of Internet use in college students.

The purposes of this study were to identify the physical, behavioral, and psychosocial consequences of Internet use in undergraduate college students; and to evaluate whether time, social norms, and adopter category predict the consequences of Internet use. Rogers' model for studying consequences of innovation was adapted for this study. A descriptive, correlational design was used. Convenience sampling yielded 293 undergraduate students who answered the online survey. Consequences of Internet use were assessed with the researcher-developed instrument, the Internet Consequences Scale (ICONS). Mean scores on the behavioral and psychosocial subscales of the ICONS indicated positive consequences of Internet use, while the physical consequences subscale revealed negative consequences. Multiple regression analyses revealed a small, but significant, amount of variance in consequences of Internet use that could be explained by time, social norms, and adopter category, thus supporting the adapted model for the study of consequences of Internet use in college students.

Adult↗

PubMed2000

[Maintenance treatment for opioid dependence in care centers: the OPPIDUM program of the Evaluation and Information Centers for Drug Addiction].

The aim of this study was to analyze information concerning multiple drug addiction, illicit behaviors and use of the venous route by maintenance treatment patients included in the October 1998 survey of the OPPIDUM program. Among 1,462 observations, 71% of the subjects were taking maintenance treatments (60% high-dose buprenorphine and 40% methadone). High-dose buprenorphine was taken without medical supervision in 10% of cases. Indicators of abuse were high in this case: multiple drug addiction and intravenous use of buprenorphine (28%). Patients maintained by methadone were older and living in better socio-economic conditions than patients maintained by high-dose buprenorphine. However, in the two groups, the percentage of patients using the intravenous route was the same (15% and 21%). More cocaine was used by the methadone group (16% versus 7%). Thirty-seven percent of the subjects maintained on high-dose buprenorphine were followed by a general practitioner. They appeared to be more unbalanced and in more precarious condition than subjects treated in specialized care centers but they were not representative of the patients maintained by buprenorphine. It would be important to determine why these subjects consult a specialized care center.

Adult↗

PubMed1994

Hyperinsulinemic obesity and carbohydrate addiction: the missing link is the carbohydrate frequency factor.

It is proposed that chronic hyperinsulinemia is largely responsible for hunger, cravings and weight gain observed in many obese. This form of obesity can be treated by decreasing frequency of daily intake of carbohydrates to one well-balance meal each day and allowing for additional meals that are low in fat, low carbohydrates and high fiber. Animal experimentation and epidemiological evidence support the role of chronic hyperinsulinemia as a major factor in obesity and accounts for the frequent failures of diet and behavioral modification programs. Chronic hyperinsulinemia upsets metabolic balances and favors anabolic metabolism; fosters carbohydrate cravings; promotes insulin resistance which further promotes anabolic metabolism; and insulin resistance in turn exacerbates chronic hyperinsulinemia. This vicious cycle maintains excess weight and defeats diet and behavioral modification attempts to treat obesity. An eating program focused on reduction of chronic hyperinsulinemia coupled with appropriate exercise and behavior modification can successfully and permanently bring down cravings, hunger and body weight.

Animals↗