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PubMed2006

Dissociation between opioid and CRF1 antagonist sensitive drinking in Sardinian alcohol-preferring rats.

RATIONALE: The role of positive vs negative ethanol reinforcement in ethanol intake of Sardinian alcohol-preferring (sP) rats is unclear. OBJECTIVES: To test the hypothesis that spontaneous ethanol self-administration of sP rats was sensitive to the opioid receptor antagonist naltrexone, whereas withdrawal-induced, but not spontaneous, ethanol self-administration would be sensitive to corticotropin-releasing factor(1) (CRF(1)) antagonists, implicating differential roles for positive and negative reinforcement, respectively. METHODS: Male sP rats operantly (FR1, 30 min/day) self-administered ethanol (10% v/v) until responding stabilized. One group (n=11) was made ethanol dependent through intermittent ethanol vapor exposure. Both nondependent (n = 10) and dependent rats received the CRF(1) antagonist LWH-63 (5, 10, and 20 mg/kg, s.c.). Separate nondependent sP rats (n = 10) received the opioid antagonist naltrexone (16, 50, 150, and 450 microg/kg, s.c.). Finally, CRF(1) antagonists (MJL-1-109-2, LWH-63, and R121919) were studied for their actions on home-cage ethanol drinking in nondependent sP rats (n = 6-8/group) under continuous, limited-access, or stressed conditions. RESULTS: Naltrexone potently reduced ethanol self-administration in nondependent sP rats. LWH-63 reduced heightened ethanol self-administration of vapor-sensitive, dependent sP rats. CRF(1) antagonists did not reduce ethanol intake in nondependent sP rats. R121919 (10 mg/kg, s.c.) retained antistress activity in sP rats, blunting novelty stress-induced suppression of ethanol intake. CONCLUSIONS: Spontaneous ethanol self-administration of sP rats was opioid dependent with CRF(1) receptors implicated in withdrawal-induced drinking. Opioid and CRF(1) receptors play different roles in ethanol reinforcement and perhaps the ethanol addiction cycle. Such distinctions may apply to subtypes of alcoholic patients who differ in their motivation to drink and ultimately treatment response.

Alcohol Drinking↗
PubMed2004

Memory and addiction: shared neural circuitry and molecular mechanisms.

An important conceptual advance in the past decade has been the understanding that the process of drug addiction shares striking commonalities with neural plasticity associated with natural reward learning and memory. Basic mechanisms involving dopamine, glutamate, and their intracellular and genomic targets have been the focus of attention in this research area. These two neurotransmitter systems, widely distributed in many regions of cortex, limbic system, and basal ganglia, appear to play a key integrative role in motivation, learning, and memory, thus modulating adaptive behavior. However, many drugs of abuse exert their primary effects precisely on these pathways and are able to induce enduring cellular alterations in motivational networks, thus leading to maladaptive behaviors. Current theories and research on this topic are reviewed from an integrative systems perspective, with special emphasis on cellular, molecular, and behavioral aspects of dopamine D-1 and glutamate NMDA signaling, instrumental learning, and drug cue conditioning.

Animals↗
PubMed2006

Double dissociating effects of sensory stimulation and cocaine on serotonin activity in the occipital and temporal cortices.

Visual cues that become associated with the consumption of psychostimulant drugs energize craving and the intake of the drug by mechanisms of which little is known. In two experiments using in vivo microdialysis in freely moving rats we compared the effects of visual and auditory stimulation with that of cocaine (0, 5, 10, 20mg/kg; i.p.) on the extracellular serotonin (5-HT) activity in the occipital and temporal cortices in relation to behavior. Visual stimulation increased 5-HT in the occipital, but not temporal cortex, parallel to an increase in locomotion. Auditory stimulation decreased 5-HT in the auditory, but not occipital cortex, thus, showing a double dissociated 5-HT response. These data suggest that a locally restricted 5-HT response to sensory stimulation may gate behavioral activity sense-modality selectively. Cocaine affected 5-HT in the occipital cortex and behavioral activity in the same direction as visual stimulation, but in an amplified and prolonged way. In the temporal cortex cocaine also caused an increase in 5-HT. The findings demonstrate common effects of visual stimulation and cocaine on 5-HT activity in the occipital cortex in relation to locomotor activity. The results suggest that concepts of how neutral visual cues become powerful energizers of addiction-related behaviors should be expanded to incorporate not only an acute enhancement of reward processing mechanisms, but, in parallel, also an amplified processing of visual stimuli in the occipital cortex.

Acoustic Stimulation↗
PubMed2001

Ego atrophy in substance abuse: addiction from a socio-cultural perspective.

The use of intoxicants is indexed in American history adopting a social perspective of the role of alcoholism in traditional American society. Appealing to societal patterns, the elaboration of substance abuse as a disease is explored with a diagnostic focus on intervention as it relates to pathogenesis. Using clinical vignettes, the ego is proposed as the focus of pathology in the addiction process, featuring a regression to the defenses of projection and denial. Following the model proposed in Zinberg's seminal paper on addiction and ego function, various deficits are annotated that typify such regression. The ultimate clinical picture is one of ego atrophy, where basic interests and object relations are usurped by the all-consuming preoccupation with the substance of abuse.

Behavior, Addictive↗
PubMed2006

A personal intervention substance abuse treatment approach: Substance abuse treatment in a least restrictive residential model.

The following paper will detail demographic information about alcohol and substance abuse issues in the acquired brain injury (ABI) population. Included in such a review will be a systematic presentation of the current data on the incidence of such issues as well as a comprehensive treatment model with outcome data provided. Pre- and post-test measures of separate functional outcome areas were employed to assess the effects of the treatment package. The paper will document the core elements of a substance abuse treatment programme that is based upon community inclusion and positive, proactive treatment methods in facilitating decreases in substance abuse behaviour. The programme employed a host of individual and group session protocols specifically targeted at education and self-monitoring of behaviour in order to facilitate more effective self-control of addictive behaviours. The positive outcomes achieved by the participants involved in the study provide clinical justification for a proactive behavioural approach to substance abuse in the ABI population.

Adolescent↗
PubMed2003

Internet addiction in students: a cause of concern.

The Internet was originally designed to facilitate communication and research activities. However, the dramatic increase in the use of the Internet in recent years has led to pathological use (Internet addiction). This study is a preliminary investigation of the extent of Internet addiction in school children 16-18 years old in India. The Davis Online Cognition Scale (DOCS) was used to assess pathological Internet use. On the basis of total scores obtained (N = 100) on the DOCS, two groups were identified--dependents (18) and non-dependents (21), using mean +/- 1/2 SD as the criterion for selection. The UCLA loneliness scale was also administered to the subjects. Significant behavioral and functional usage differences were revealed between the two groups. Dependents were found to delay other work to spend time online, lose sleep due to late-night logons, and feel life would be boring without the Internet. The hours spent on the Internet by dependents were greater than those of non-dependents. On the loneliness measure, significant differences were found between the two groups, with the dependents scoring higher than the non-dependents.

Adolescent↗
PubMed1999

Hypothesis for temporal displacement of metabolic and neuronal accommodation in smoking addiction.

Using the overlapping criteria of (1) current smoking status and (2) homeostatic accommodation of smoking, the categories of nonsmoker, beginning smoker, smoker, and quitting smoker are structured into a cyclic representation of smoking addiction. This cyclic representation reveals that elimination of homeostatic accommodation of smoking is a critical success factor to the process of becoming a nonsmoker, while the act of stopping smoking is necessary yet insufficient to the success of that process. Homeostatic accommodation is described as having two components: metabolic and neuronal. A hypothesis for temporal displacement of metabolic and neuronal accommodation is presented to explain the behavior of "chippers" (occasional smokers) and adolescent smokers. Recommendations are made for research on the rates of development and dissipation of metabolic and neuronal accommodation of smoking, and for the development of a bimodal therapy that addresses both metabolic and neuronal accommodation and reduces relapse for quitting smokers.

Behavior, Addictive↗
PubMed1992

[Pregnant seropositive drug addicts].

Understanding actual experiences of sexuality and pregnancy in HIV positive drug addicts is essential for the prevention of AIDS dissemination. A rigorous organization and a coherent therapeutic project are needed for pregnancy supervision (pregnancy being carried on in over 50 percent of cases), for psychological preparation to the recognition of foetus reality and birth, and for newborn follow up to prevent his abandonment. The specific problems of pregnancy, seropositivity and drug addiction should be taken into account at the same time. The intervention of a voluntary, motivated and polyvalent team and a hospital opening towards outreach workers are two essential conditions of success.

Adult↗
PubMed2006

The effects of smoking deprivation and nicotine administration on emotional reactivity.

Although converging lines of evidence suggest that nicotine and mood are related at a fundamental biological level, this link has not been reliably demonstrated in laboratory studies. In this study, startle probe methodology was used to examine the effects of nicotine administration and deprivation on emotional processes associated with motivation. Smokers (N = 115) completed four laboratory sessions crossing deprivation (12-hr deprived vs. nondeprived) with nicotine spray (active vs. placebo). Participants viewed affective pictures (positive, negative, neutral) and pictures involving cigarette cues, while startle probes were administered. Deprivation decreased startle responding to cigarette cues, suggesting an activation of appetitive processes. Nicotine administration suppressed overall startle responding during deprivation. In addition, during deprivation, random exposure to negative stimuli over two blocks of trials resulted in decreased adaptation of the startle response, suggesting that some sensitization to negative emotional cues may take place during nicotine withdrawal. These effects are consistent with formulations of addiction, stressing that withdrawal may both increase the reinforcement salience of smoking stimuli and decrease habituation to negative emotional stimuli.

Adult↗
PubMed1999

Association of methylphenidate-induced craving with changes in right striato-orbitofrontal metabolism in cocaine abusers: implications in addiction.

OBJECTIVE: The authors have shown that decreases in dopamine D2 receptors in cocaine abusers were associated with decreased metabolism in the cingulate and prefrontal and orbitofrontal cortices. To assess whether increasing dopamine would reverse these metabolic decrements, they measured the effects of methylphenidate, a drug that increases dopamine, on brain glucose metabolism in 20 cocaine abusers. METHOD: The subjects underwent two [18F]fluorodeoxyglucose positron emission tomography scans, one after two sequential placebo injections and one after two intravenous doses of methylphenidate. D2 receptors were measured with [11C]raclopride to evaluate their relation to methylphenidate-induced metabolic changes. RESULTS: Methylphenidate induced variable changes in brain metabolism: subjects with the higher D2 measures tended to increase metabolism, whereas those with the lower D2 measures tended to decrease metabolism. Methylphenidate's effects were significant for increases in metabolism in the superior cingulate, right thalamus, and cerebellum. Methylphenidate-induced changes in the right orbitofrontal cortex and right striatum were associated with craving, and those in the prefrontal cortex were associated with mood. CONCLUSIONS: Although methylphenidate increased metabolism in the superior cingulate, it only increased metabolism in orbitofrontal or prefrontal cortices in the subjects in whom it enhanced craving and mood, respectively. This indicates that dopamine enhancement is not sufficient per se to increase metabolism in these frontal regions. Activation of the right orbitofrontal cortex and right striatum (brain regions found to be abnormal in compulsive disorders) in the subjects reporting craving may be one of the mechanisms underlying compulsive drug administration in addicted persons. The predominant correlation of craving with right but not left brain regions suggests laterality of reinforcing and/or conditioned responses.

Adult↗
PubMed1995

Mens sana in corpore sano, or exercise abuse? Clinical considerations.

The national preoccupation with health, body functioning, and appearance has made physical exercise a common and widespread activity. Exercise undoubtedly helps to promote and maintain health and could be easily overlooked as a manifestation of different kinds of psychopathology. The author proposes a dynamic view of the meaning of exercise that helps in distinguishing three different categories: healthy-neurotic, compulsive, and addictive. Clinical vignettes illustrating each group are offered, as well as psychological characteristics found in the course of psychotherapy that would be helpful in the assessment, treatment, and prognosis of individuals with difficulties in this area.

Adult↗
PubMed1995

The impact of exercise deprivation on well-being of habitual exercises.

The literature examining the effects of exercise deprivation on well-being was overviewed. A general consensus in this area indicates that exercise deprivation has adverse effects on subjective states and/or well-being. The studies, however, do not identify the determinants of exercise deprivation and therefore numerous questions remain unresolved. The few experimental studies, performed in this field of research, support anecdotal reports on the effects of exercise deprivation. However, inconsistencies in methodologies call for substantially more work in this field. A large part of the overviewed inquiries examined solely runners and mostly within the realms of the running addiction literature. It is suggested that the impact of exercise deprivation on well-being should also be examined apart from the running-addiction perspective by using experimental paradigms. Finally, some key methodological and conceptual issues, associated with exercise deprivation research, are discussed with the aim to provide bases as well as incentives in the undertaking of future studies.

Adolescent↗
PubMed2004

Neuroscience research on the addictions: a prospectus for future ethical and policy analysis.

The increasing evidence that many addictive phenomena have a genetic and neurobiological basis promises improvements in societal responses to addiction that raise important ethical and social policy issues. One of the major potential benefits of such research is improved treatment of drug addiction, but in order to do the research required to realize this promise, it will be necessary to address ethical doubts raised about the capacity of addicted persons to give free and informed consent to participate in studies that involve the administration of drugs of dependence. Neuroscience research on addiction promises to transform the long running debate between moral and medical models of addiction by providing a detailed causal explanation of addiction in terms of brain processes. We must avoid causal models of addiction being misinterpreted as supporting simple-minded social policies, e.g., that we identify the minority of the community that is genetically and biologically vulnerable to addiction and hence can neglect social policy options for reducing addiction, including drug control policies. Causal accounts of addiction supplied by neuroscience and genetic research may also be seen to warrant the use of pharmacotherapies and drug vaccines under legal coercion. Neuroscientists also need to anticipate the ethical issues that may arise if the knowledge that they produce delivers interventions that enhance human cognitive and other capacities. Advances in neuroimaging that enable us to identify "addicts" or predict future risk of addiction will raise concerns about invasion of privacy, third-party use of neuroimaging data, the powers of courts to coerce defendants to undergo such tests, and consumer protection against the overinterpretation of test results. Given the strong public and media interest in the results of their research, neuroscientists and geneticists have a moral obligation, and a professional interest, to minimize popular misunderstandings of their work in the media that may rebound to its detriment.

Animals↗
PubMed2006

The three year course of alcohol use disorders in the general population: DSM-IV, ICD-10 and the Craving Withdrawal Model.

AIMS: To determine the course of alcohol use disorders (AUD) in a prospective general population study using three different classification systems: Diagnostic and Statistical Manual version IV (DSM-IV), International Classification of Diseases version 10 (ICD-10) and the craving withdrawal model (CWM). The latter is an alternative classification, which requires craving and withdrawal for alcohol dependence and raises the alcohol abuse threshold to two criteria. DESIGN, SETTING AND PARTICIPANTS: Data were derived from the Netherlands Mental Health Survey and Incidence Study (NEMESIS), a large (n=7,076) representative general population study with a baseline and 1- and 3-year follow-up assessments. MEASUREMENTS: Diagnostic status according to DSM-IV, ICD-10 and CWM at baseline and at follow-up was established using a structured interview (Composite International Diagnostic Interview: CIDI). FINDINGS: DSM-IV abuse, ICD-10 harmful use and CWM abuse all showed a favourable course with remission rates of 81, 89 and 71%, respectively, at 1-year follow-up and 85, 92 and 79% at 3-year follow-up. Dependence according to DSM-IV, ICD-10 and CWM had a somewhat less favourable course, with remission rates (no dependence) of 67, 67 and 57% at 1-year follow-up and 74, 69 and 73% at 3-year follow-up, respectively. Subjects who were remitted at 1-year follow-up showed relapse-rates of 0-14% for dependence and 4-12% for abuse at 3-year follow-up. Although CWM diagnoses tended towards greater diagnostic stability than DSM-IV and ICD-10, most differences were not significant. CONCLUSION: The conviction that addiction is a chronic relapsing disease may apply to treatment-seeking alcoholics, but our data show a far more favourable course of alcohol use disorders in the general population.

Adolescent↗
PubMed2005

The genetics of addictions: uncovering the genes.

The addictions are common chronic psychiatric diseases that today are prevented and treated using relatively untargeted and only partially effective methods. The addictions are moderately to highly heritable, which is paradoxical because these disorders require use; a choice that is itself modulated by both genes and environment. The addictions are interrelated and related to other psychiatric diseases by common neurobiological pathways, including those that modulate reward, behavioural control and the anxiety or stress response. Our future understanding of addictions will be enhanced by the identification of genes that have a role in altered substance-specific vulnerabilities such as variation in drug metabolism or drug receptors and a role in shared vulnerabilities such as variation in reward or stress resiliency.

Behavior, Addictive↗
PubMed1998

[Tobacco dependence].

The present review discusses the potential of nicotine psychic and physical dependence. Since the 1964 Surgeon General's Report on Smoking and Health, much attention has been given to nicotine dependence. Many epidemiological studies indicated that about 50% of smokers could be nicotine dependent; however, few of them had the experience of "progressive neglect of alternative pleasures or interest in favour of smoking." Additionally, some clinical and experimental data indicated that nicotine could not be considered more addictive than cocaine and morphine. As to the physical dependence on nicotine, the nicotine withdrawal syndrome is reported to be observed in about 30% of smokers. However, symptoms of the nicotine withdrawal syndrome are not specific but can appear in smokers put under stress. Several investigators have reported that signs of nicotine withdrawal in experimental animals are weaker than those with opioids, barbiturates and alcohol, and have indicated that it is unclear whether behaviors observed in animal models of nicotine physical dependence are signs of the nicotine withdrawal syndrome. From the current review, it can be considered that the potential for nicotine dependence may not be higher than that for other drug dependence and that nicotine physical dependence potential may be weaker than hitherto believed.

Animals↗
PubMed2001

Anxious adults vs. cool children: children's views on smoking and addiction.

Tobacco addiction represents a major public health problem, and most addicted smokers take up the habit during adolescence. We need to know why. With the aim of gaining a better understanding of the meanings smoking and tobacco addiction hold for young people, 85 focused interviews were conducted with adolescent children from economically deprived areas of Northern Ireland. Through adopting a qualitative approach within the community rather than the school context, the adolescent children were given the opportunity to freely express their views in confidence. Children seem to differentiate conceptually between child smoking and adult smoking. Whereas adults smoke to cope with life and are thus perceived by children as lacking control over their consumption, child smoking is motivated by attempts to achieve the status of cool and hard, and to gain group membership. Adults have personal reasons for smoking, while child smoking is profoundly social. Adults are perceived as dependent on nicotine, and addiction is at the core of the children's understanding of adult smoking. Child smoking, on the other hand, is seen as oriented around social relations so that addiction is less relevant. These ideas leave young people vulnerable to nicotine addiction. It is clearly important that health promotion efforts seek to understand and take into account the actions of children within the context of their own world-view to secure their health.

Adolescent↗