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Results for “Behavior, Addictive”

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PubMed2006

Decision-making deficits in alcohol-dependent patients with and without comorbid personality disorder.

BACKGROUND: Impairments in decision making are a consistent finding in substance use disorder (SUD) populations. However, decision-making deficits are not specific for SUDs and are also reported in the context of other psychiatric disorders such as antisocial and borderline personality disorders (PDs). Given the frequent comorbidity between SUD and cluster B PD, it might be questioned whether the decision-making impairments typically reported in SUD populations reflect the addictive disorder, the cluster B PD, or a combination of the 2. METHODS: In the current study, we compare the decision-making performance of non-substance-abusing controls (n=53) on the Iowa Gambling Task (IGT) with the decision-making performance of 3 abstinent alcohol-dependent samples, i.e., alcoholic patients without any PD (n=38), alcoholic patients with a cluster A or C PD (n=19), and alcoholic patients with a cluster B PD (n=23). RESULTS: Overall, all 3 alcohol-dependent subsamples performed inferior compared with controls. Between alcoholic subsamples, the alcoholic patients with a cluster A or C PD had the highest IGT score, followed by the alcoholic patients without a PD, while the cluster B alcoholic patients were the most impaired. CONCLUSION: These findings suggest that impairments in decision making underlie both alcohol dependence and cluster B PD, and alcoholic patients with a comorbid cluster B PD are particularly impaired in their decision making. These deficits may underlie the severe problems that characterize cluster B alcoholic patients specifically in inappropriate behaviors (e.g., poly substance abuse, legal, and professional dysfunction).

Adult↗

PubMed2004

Rats on the grog: novel pharmacotherapies for alcohol craving.

Current pharmacotherapies for alcohol dependence in humans (e.g., naltrexone, acamprosate) are meeting with only limited therapeutic success. The development of novel pharmacotherapies is urgently needed but is reliant upon the screening of large numbers of candidate "anticraving" drugs using appropriate animal models. The development of animal models is complex because (1) laboratory animals are often reluctant to consume large quantities of alcohol, (2) inducing a state of alcohol dependence, analogous to the human condition, may require many months of alcohol exposure, (3) concluding that a given drug selectively reduces alcohol craving requires very carefully controlled experiments, and (4) false positives and false negatives may result from the sometimes distinct physiology and psychology of the alcohol-addicted human and rat. To address some of these problems, our laboratory has recently developed the "beer model" of alcohol dependence and craving. Rats, like humans, have a prodigious appetite for beer and will drink much more beer than equivalent ethanol solutions in water. Beer consumption in rats leads to clear signs of intoxication, anxiety reduction, and signs of withdrawal when beer access is suddenly denied. We have found that beer craving in rats is selectively reduced by the cannabinoid receptor antagonist SR 141716 and the opioid receptor antagonist naltrexone. Combining these two drugs appears to have a synergistic anticraving effect. Other promising pharmacotherapies for the future are discussed.

Alcoholism↗

PubMedDate not supplied

Guilt, shame, and depression in clients in recovery from addiction.

Men and women in recovery from addiction were compared on levels of depression, guilt, and shame. The measurement of guilt included subscales of Survivor Guilt, Separation Guilt, Omnipotent Responsibility Guilt, Trait Guilt, State Guilt, and Adaptive Guilt. The sample included 75 men and 33 women in treatment in a residential treatment community. It was found that women were significantly higher than men in depression. The recovering subjects were compared to nonaddicted subjects and established norms, and it was found that the recovering people were higher on depression, shame, and the subscales of maladaptive guilt. Both men and women in recovery were significantly lower than norms in adaptive guilt.

Adult↗

PubMed2000

Methamphetamine dependence: medication development efforts based on the dual deficit model of stimulant addiction.

Converging lines of evidence indicate that withdrawal from prolonged exposure to stimulants and alcohol results in synaptic deficits of both dopamine (DA) and serotonin (5-HT). According to the dual deficit model proposed by the authors, DA dysfunction during cocaine or alcohol withdrawal underlies anhedonia and psychomotor retardation, whereas 5-HT dysfunction gives rise to depressed mood, obsessional thoughts, and lack of impulse control. This model predicts that pharmacotherapies which correct only one of the two neurochemical deficits will not be effective. On the other hand, pharmacotherapies which "correct" both of the proposed DA and 5-HT abnormalities should be effective in treating stimulant and alcohol dependence. This paper reviews two approaches, based on the dual deficit model, taken by our laboratory to develop medications to treat stimulant abuse.

Animals↗

PubMed2004

Nitric oxide synthesis inhibition attenuates conditioned reinstatement of ethanol-seeking, but not the primary reinforcing effects of ethanol.

BACKGROUND: Nitric oxide (NO) signaling has been implicated in regulating aspects of the reinforcing and addictive actions of cocaine. These experiments were designed to examine whether NO-dependent neurotransmission also participates in mediating the addictive actions of another drug of abuse, ethanol, with emphasis on both the primary reinforcing effects of ethanol and the incentive motivational effects of ethanol-related contextual stimuli. METHODS: Male Wistar rats were operantly trained to orally self-administer 10% (w/v) ethanol in daily 30-min sessions and to associate distinct discriminative stimuli with the availability of ethanol (S+) versus nonreward (S-). Rats were treated with the NO synthase inhibitor NG-nitro-L-arginine methyl ester (L-NAME; 0, 10, or 40 mg/kg intraperitoneally) 30 min before self-administration tests that were conducted after establishment of stable levels of daily ethanol intake and conditioned reinstatement tests that were performed after extinction of ethanol-maintained operant responding. RESULTS: L-NAME did not alter the primary reinforcing effects of ethanol in self-administration tests. In contrast, L-NAME dose-dependently attenuated the recovery of extinguished responding induced by the ethanol S in the absence of ethanol availability during reinstatement tests. CONCLUSIONS: These results suggest that the NO system does not play a role in behavior reinforced directly by ethanol. However, the results implicate NO-dependent neurotransmission in alcohol-seeking responses elicited by drug-related contextual stimuli.

Alcohol Drinking↗

PubMed1993

Sensation seeking, gambling and gambling addictions.

Male off-course bettors were assessed using: the Sensation-Seeking Scale (SSS) Form V, two measures of subjective arousal while betting, and questions concerning chasing, preferences for gambling activities and other aspects of betting behaviour. The SSS was also administered to a random sample of the male general population of Glasgow, together with questions concerning preferences for gambling activities to allow comparison between regular gamblers and the general population. In comparison with the general population and with non-gamblers, off-course bettors scored lower on SSS; gamblers preferring the casino and/or the race-track scored higher on SSS; gamblers betting on many different forms scored higher on SSS. A further analysis produced a cluster of variables among off-course bettors associated with impaired control of gambling, among which both SSS scores and chasing were prominent features.

Adult↗

PubMed2006

Experiences of a national sample of qualified addiction specialists who have and have not prescribed buprenorphine for opioid dependence.

The limited availability of medication-assisted treatment has created a treatment gap leaving many opioid dependent individuals without access to appropriate treatment. Survey data from a national random sample of 545 addictions physicians with waivers to provide buprenorphine treatment under The Drug Addiction Treatment Act of 2000 are presented. During the first year, an estimated 63,204 opioid dependent patients were treated with buprenorphine; many were dependent on prescription opioids and were new to drug treatment. Prescribing physicians reported high treatment effectiveness and patient satisfaction, with minimal adverse reactions or evidence of diversion. However, many waivered physicians had not provided buprenorphine treatment. Prescribers identified challenges such as induction logistics, recordkeeping requirements, the 30-patient limit, DEA involvement, and limited patient compliance. Buprenorphine treatment could potentially reduce the treatment gap by providing safe and effective treatment for opioid dependence and by attracting patients who do not typically seek care at opioid treatment programs.

Attitude of Health Personnel↗

PubMed2006

Addiction treatment agencies' use of data: a qualitative assessment.

Addiction treatment agencies typically do not prioritize data collection, management, and analysis, and these agencies may have barriers to integrating data in agency quality improvement. This article describes qualitative findings from an intervention designed to teach 23 addiction treatment agencies how to make data-driven decisions to improve client access to and retention in care. Agencies demonstrated success adopting process improvement and data-driven strategies to make improvements in care. Barriers to adding a process improvement and data-driven focus to care included a lack of a data-based decision making culture, lack of expertise and other resources, treatment system complexity, and resistance. Factors related to the successful adoption of process-focused data include agency leadership valuing data and providing resources, staff training on data collection and use, sharing of change results, and success in making data-driven decisions.

Behavior, Addictive↗

PubMed2006

Predicting craving among cocaine users.

INTRODUCTION: Craving for cocaine seems to play an important role in the continued use of and dependence on the substance. AIMS: to describe characteristics of the craving phenomenon in a sample of cocaine users and to identify those that could predict the appearance of the phenomenon. METHOD: 205 cocaine users attending an outpatient clinic were interviewed to assess patterns of drug consumption and characteristics of craving for the drug. FINDINGS: Subjects were mostly young (24.8+/-12.8 years) and male (86.2%). One hundred and two subjects (49.8%) were addicted to cocaine and the remainders (50.2%) were non-addicted occasional cocaine users. The majority of subjects (60.5%) reported having had craving episodes during the previous week. Frequency of cocaine use during the previous month correlated with the number of reported craving fits (r=0.425; p<0.001) and with the duration of the craving fits (r=0.351; p<0.001). Users of crack reported more craving episodes than did the users of snorted cocaine (p<0.001) and the frequency of craving fits was inversely proportional to the duration of abstinence from the drug (r=-0.405; p<0.001). CONCLUSION: Both the method of drug consumption and the abstinence period elapsed since previous drug intake were identified as predictive parameters of craving.

Adult↗

PubMedDate not supplied

The role of cognitive factors in cue reactivity: extinction on demand.

Cue reactivity measures have become common in addictions research for their apparent objectivity. We used an analog paradigm to examine whether such measures are subject to impression management. Students with conditioned reactions of salivation to the sight and smell of a lemon were assigned to a control group, an experimental group asked to reduce salivation, or an experimental group asked to reduce salivation and promised a reward if successful. Both experimental groups reduced salivation more than the control group; the group rewarded for reduction reduced salivation more than the group that was only asked to do so. This suggests that cue reactivity measures can be manipulated by research participants or clients in treatment. Suggestions for research and implications for treatment are addressed.

Analysis of Variance↗

PubMed2002

Effects of GBR 12909, WIN 35,428 and indatraline on cocaine self-administration and cocaine seeking in rats.

RATIONALE: It has been proposed that drugs that decrease cocaine self-administration or cocaine seeking by laboratory animals might be effective pharmacotherapies in the treatment of cocaine addiction. Previous studies have suggested that the dopamine uptake inhibitor, GBR 12909, might be such a candidate drug because it decreases cocaine self-administration. Other studies have shown that GBR 12909 elicits cocaine seeking, which might limit its utility as an anti-cocaine pharmacotherapy. OBJECTIVES: The present study sought to compare the potency of GBR 12909 in decreasing cocaine self-administration and in eliciting cocaine seeking. These findings were compared to effects produced by the cocaine analog, WIN 35,428 and the non-specific monoamine uptake inhibitor, indatraline. METHODS: A within-session protocol was used to obtain the dose-effect relationship for cocaine self-administration in a single 5-6 h daily test session. Rats were pretreated with GBR 12909 (3.0-30.0 mg/kg), WIN 35,428 (0.1-1.0 mg/kg) or indatraline (0.03-1.00 mg/kg) 30 min prior to the test session. RESULTS: GBR 12909 and WIN 35,428 decreased responding maintained by intermediate and high doses of cocaine but indatraline failed to alter the cocaine dose-effect curve. Other groups of rats demonstrated that pretreatment with all three drugs reinstated extinguished cocaine-taking behavior, although indatraline was less efficacious than either GBR 12909 or WIN 35,428. Cocaine-produced drug seeking was enhanced by pretreatment with the highest doses of GBR 12909 and WIN 35,428 but was unaffected by pretreatment with indatraline. A low dose of GBR 12909 that decreased cocaine self-administration failed to produce drug seeking but equal doses of WIN 35,428 were required to decrease cocaine self-administration and to elicit drug seeking. CONCLUSIONS: These data suggest a preferred profile of effects of GBR 12909 as an anti-cocaine pharmacotherapy. It is noted, however, that this drug might be expected to potentiate the ability of cocaine to elicit cocaine seeking following abstinence.

Animals↗

PubMedDate not supplied

Dares to addiction: youth definitions and perspectives on gambling.

BACKGROUND: Over the past decade, there has been a rapid growth of gambling in Canada and internationally. Although youth are a potentially vulnerable group, little is known about what they understand and if they are being affected by the recent increase in gambling. METHODS: This study examined how youth view gambling using an inductive qualitative research design and analysis based on grounded theory principles. Twelve focus groups were conducted comprising 103 participants (median age = 15 years) with diverse representation of Ontario youth. Focus-group questions were designed to capture youth's experiences and opinions about gambling. RESULTS: Youth participants defined a spectrum of gambling from a dare and friendly betting to legalized forms of gambling (lotteries, casinos) and addiction. Their opinions varied according to age and gambling type. For example, daring and friendly betting were identified as positive activities used by younger adolescents to relieve boredom and establish social relationships. Gambling was separate from daring because of its association with money. Many participants had minimal awareness of the potential negative impact of gambling. Information technology (Internet) was seen as an attractive medium for playing games and gambling where no money was involved. CONCLUSION: Lack of awareness of gambling among youth and its consequences underscores the need for public education. The diverse range of gambling behaviour and age-dependent access to money need careful consideration in defining youth gambling "problems" and in designing public health interventions.

Adolescent↗

PubMed1999

Selective inhibition of cocaine-seeking behaviour by a partial dopamine D3 receptor agonist.

Environmental stimuli that are reliably associated with the effects of many abused drugs, especially stimulants such as cocaine, can produce craving and relapse in abstinent human substance abusers. In animals, such cues can induce and maintain drug-seeking behaviour and also reinstate drug-seeking after extinction. Reducing the motivational effects of drug-related cues might therefore be useful in the treatment of addiction. Converging pharmacological, human post-mortem and genetic studies implicate the dopamine D3 receptor in drug addiction. Here we have designed BP 897, the first D3-receptor-selective agonist, as assessed in vitro with recombinant receptors and in vivo with mice bearing disrupted D3-receptor genes. BP 897 is a partial agonist in vitro and acts in vivo as either an agonist or an antagonist. We show that BP 897 inhibits cocaine-seeking behaviour that depends upon the presentation of drug-associated cues, without having any intrinsic, primary rewarding effects. Our data indicate that compounds like BP 897 could be used for reducing the drug craving and vulnerability to relapse that are elicited by drug-associated environmental stimuli.

Animals↗

PubMed1999

Prevention of nicotine addiction: neuropsychopharmacological issues.

Most children and adolescents try smoking cigarettes; up to two-thirds discontinue. What explains the one-third or more who continue smoking? What physiological, pharmacological, and other environmental factors affect the risk of developing a pattern of chronic tobacco use? How can the transition from occasional use to chronic use be slowed, if not halted? What are the safest, most effective means of intervention for those children and adolescents who develop patterns of chronic daily cigarette smoking and would like to quit? How can they be motivated to want to quit? These are just a few of the issues that might be resolved in part by further neuropsychopharmacological research, but the challenges and barriers to conducting such research on children and adolescents are substantial. The barriers may be better understood by a brief summary of what neuropsychopharmacology research involves, and a corresponding summary of the disincentives to conduct such research.

Adolescent↗

PubMed2000

Integrating group psychotherapy and 12-step work: a collaborative approach.

Group therapists can expect to treat an increasing number of patients who are active in a 12-step program or other addiction-related self-help groups. The value of simultaneous participation in these two modalities has been recognized; 12-step work supports abstinence necessary for the focus on emotional growth in psychotherapy. However, mere simultaneous participation in the two modalities fails to incorporate the benefits of a collaborative relationship where both modalities are used to support both abstinence and emotional growth. The conjoint approach to group and individual treatment is used to (a) argue for the possibility of a collaborative relationship between psychotherapy and a patient's 12-step work, (b) understand the benefits and challenges to collaboration, and (c) provide guidelines for how to work collaboratively with a 12-step program. Illustrations are provided of typical issues raised by this type of collaborative relationship.

Adult↗

PubMed1998

Misadventures in the drug trade.

Dan Waldorf was a research sociologist who worked in the field of drug use and abuse for 27 years. Most of that time was either in San Francisco or New York City. He wrote two books, three monographs, and 38 articles on the subject--with this being his final article. Fate intervened because this article is autobiographical. Dan's work and his life were intertwined in ways that provided unique insights into drugs and addict lifestyles. The focus of much of his work was "to attack and demolish myths about drug users and heroin addicts" (his words). Dan's legacy is broad ranging, including historical accounts of morphine users and the federal response to close down morphine clinics in the first quarter of this century; he made snowball sampling methods respectable; he saw rationality in the actions of heroin addicts and demonstrated this drug was not all-consuming; and he performed a similar service for cocaine. He struggled to maintain his career as a drug researcher, often without the support of federal monies. As recently as two years before his death, he traveled around the country to document the history of underground needle exchange programs that were developing--using his retirement savings. This article documents his many scientific contributions to our understanding of drug use in general, and the interface of drug use and crime in particular. Dan led a simple yet ever so rich life because he never shied away from telling the truth, and the wisdom of his vision helped so many others of us to see. That is his greatest legacy--and his gift.

Behavior, Addictive↗

PubMed1999

Exploring the impact of extended phenotype in stratified samples.

We have performed initial nonparametric sib-pair genome scans in the early (N = 52) and late (N = 53) onset subgroups of the COGA pedigrees, stratified near the median value of pedigree mean age of onset for ALDX1 diagnosis of alcoholism. Because the early group contained a higher proportion of smokers, traits of alcoholism, smoking, and addiction (defined as either alcoholism or smoking) were examined. Subgroups and phenotypic definitions influenced initial linkage results, corrected for the number of analyzed traits. Evidence for linkage to the ALDX1 alcoholism phenotype at the ADH3 functional candidate gene was increased in the late onset subgroup (Bonferroni corrected significance level < 0.002), as compared with the unstratified sample that replicated COGA linkage obtained in the same analysis; there was no evidence for linkage at this locus in the early onset subgroup. The theoretical implication of this result is that the loss of power due to contracting sample size through stratification may in some cases be more than offset by extraction of a more homogeneous subgroup from the etiologically complex trait.

Adolescent↗

PubMed1999

Response patterns of the Spanish version of the 49-item short form of the Addiction Research Center Inventory after the use of sedatives, stimulants, and opioids.

This report examines the validity of the Spanish version of the 49-item short form of the Addiction Research Center Inventory (ARCI) for measuring subjective effects after the use of sedatives, stimulants, and opioids. Data from four clinical trials in which this questionnaire was used have been analyzed. The Spanish ARCI short form was found to be sensitive in measuring subjective effects after the administration of alcohol, triazolam, and flunitrazepam (sedatives), cocaine (stimulants), and morphine, pentazocine, and naloxone (opioids) and to distinguishing among them. The response patterns were similar to those previously reported for the same drugs with the English version of ARCI. It is concluded that Spanish version of the 49-item short form of ARCI is a valid instrument for assessing the subjective effects of psychoactive drugs in the Spanish-speaking population context.

Administration, Oral↗