Alcohol Treatment Info

Psychol Addict Behav. 2008 Mar; 22(1): 135-40Hendricks PS, Brandon THThis study compared smokers’ expectancies for the full act of smoking with those for nicotine per se by means of a word association task. Smokers (N = 201) were randomized to receive instructions to complete either “Smoking makes one ____.” or “Nicotine makes one ____.” with as many words as possible within 30 s. Results indicated that smokers held similar expectancies for smoking and nicotine; however, negative consequences (e.g., health risks) were more associated with smoking than with nicotine, and addiction expectancies were more associated with nicotine than with smoking. These findings suggest that smokers have a more realistic conceptualization of nicotine’s role in smoking than had been indicated from earlier surveys. These findings have important implications for both nicotine-based and behavioral interventions, as well as for experimental designs that rely upon the perceived manipulation of nicotine content. (PsycINFO Database Record (c) 2008 APA, all rights reserved).

Psychol Bull. 2008 Mar; 134(2): 301-10Homer BD, Solomon TM, Moeller RW, Mascia A, Deraleau L, Halkitis PNThe highly addictive drug methamphetamine has been associated with impairments in social cognitions as evidenced by changes in users’ behaviors. Physiological changes in brain structure and functioning, particularly in the frontal lobe, have also been identified. The authors propose a biopsychosocial approach to understanding the effects of methamphetamine addiction by relating the physiological effects of the drug to the behaviors and social cognitions of its users, through the application of the theory of mind paradigm. Although onset of methamphetamine use has been linked to the desire for socialization, chronic use has been associated with an increase in depression, aggressiveness, and social isolation, behaviors that also implicate involvement of the frontal lobe. The reviewed literature provides strong circumstantial evidence that social-cognitive functioning is significantly impacted by methamphetamine use and that the social isolation, depression, and aggressiveness associated with chronic use is due to more than just the social withdrawal associated with addiction. Treatment considerations for methamphetamine must therefore consider the role of social cognition, and pharmacological responses must address the documented impact of the drug on frontal lobe functioning. (PsycINFO Database Record (c) 2008 APA, all rights reserved).

Adicciones. 2008; 20(1): 5-13Brewer CAddiction treatment aims to reduce the harm that addiction causes to individuals and society. However, many clinics, especially in the private sector, have ideological objections to using medico-pharmacological treatments and are often critical of other services that do offer pharmacological treatments. This situation contrasts sharply with the attitude of family planning (FP) clinics, even though they too aim to reduce harm. Ironically, the most anti-pharmacological clinics are often those which proclaim most loudly that addiction is a ‘disease’, while avoiding unwanted pregnancy, which is not usually seen as a disease, is widely and effectively achieved with medical techniques. FP clinics typically consider widely varying patterns of sexual behaviour, social contexts and patient attitudes in devising individual treatment plans, while addiction clinics commonly have a one-size-fits-all, take-it-orleave- it approach. Addiction services could learn some useful clinical and ideological lessons from FP clinics.

Adicciones. 2008; 20(1): 15-18Pereiro Gomez C, Bermejo Barrera AAccording to the European Drug and Drug Addiction Observatory, after Cannabis, Cocaine is the most widely used illegal drug in Europe. Awareness of the damage caused by consuming this substance is clear in some areas, while in others it may be ignored, underestimated or poorly dimensioned. The information systems that do exist almost certainly underestimate the number of deaths connected with cocaine. Apart from the potential the drug has to cause direct damage to different organs of the body, its consumption can lead to serious problems arising from other circumstances that are not always connected with this drug, including murders, traffic accidents and accidents at work, infectious diseases related to high-risk behaviour, and suicides. Cocaine is increasingly present in cases of violence such as fights or aggressions, in many cases accompanied by the use of knives and firearms. Serious behavioural disorders are being seen more and more frequently in the healthcare services, and in clinics we are witnessing a worrying increase on a day-to-day basis of conflictive episodes associated with the use of cocaine amongst our patients. This damage does not only affect a marginal population, but instead all levels of society, and often goes unnoticed or unreported. Coordination between different institutions and healthcare areas is essential in order to obtain this information, and in this way to provide a more precise picture of the consequences of Cocaine consumption, as today we are still far from having quantified its true dimension.

Adicciones. 2008; 20(1): 59-72Nadal Alemany RThere is considerable variation in individual vulnerability to addiction that may be related to personality factors. One of the most widely studied personality traits in relation to susceptibility to addiction has been novelty or sensation-seeking. In the present review we mainly analyze basic research data on the relationship between addiction and novelty-seeking. In animal models, this trait has been assessed mainly by means of motor activity in an inescapable novel environment. Thus, two typologies of rats have been established, the so-called LR (lowresponders) and the HR (high-responders), which respectively show low and high levels of activity in a novel environment. HR animals are more sensitive to the motor-stimulating effects of various drugs, and show greater behavioural sensitization with repeated drug administration, than LR animals. Moreover, HR subjects initially acquire operant self-administration behaviour more easily than LR subjects. Hypothalamicpituitary- adrenal axis reactivity in certain stressful situations is also greater in HR than in LR subjects. At the level of the central nervous system, HR subjects also show greater activity of the hypothalamic-pituitary-adrenal axis. With regard to dopaminergic systems, microdialysis studies show that cocaine has a greater neurochemical effect (more increase in dopamine levels) in HR than in LR animals. Human data are generally in agreement with those from the animal literature, though there are also contradictory results in both humans and animals, suggesting that this topic is complex and still far from being fully understood.

Addict Sci Clin Pract. 2007 Dec; 4(1): 19-31Samet S, Waxman R, Hatzenbuehler M, Hasin DSEfficient, organized assessment of substance use disorders is essential for clinical research, treatment planning, and referral to adjunctive services. In this article, we discuss the basic concepts of formalized assessment for substance abuse and addiction, as established by the Diagnostic and Statistical Manual of Mental Disorders, 4th Edition, Text Revision, and describe six widely used structured assessment instruments. Our aim is to help researchers and clinical programs identify the instruments that best suit their particular situations and purposes.

Addict Sci Clin Pract. 2007 Dec; 4(1): 34-41Sylvestre DA disease whose reputation is often worse than its reality, hepatitis C is usually benign. Most infected individuals do not experience symptoms requiring treatment, and roughly half of those treated will become free of detectable virus for an extended, perhaps permanent, period. Moreover, a growing body of data suggests that drug users can attain successful treatment outcomes, even when not completely abstinent. Addiction professionals belong in the forefront of prevention and management of this disease. We can assist our patients by helping them stabilize their lifestyles, correcting misperceptions about the disease, teaching prevention and health maintenance, promoting access to diagnosis and treatment, monitoring for treatment side effects, and providing encouragement to remain in treatment.

Addict Sci Clin Pract. 2007 Dec; 4(1): 45-55Dennis M, Scott CKThis article reviews progress in adapting addiction treatment to respond more fully to the chronic nature of most patients’ problems. After reviewing evidence that the natural history of addiction involves recurrent cycles of relapse and recovery, we discuss emerging approaches to recovery management, including techniques for improving the continuity of care, monitoring during periods of abstinence, and early reintervention; recent developments in the field related to self-management, mutual aid, and other recovery supports; and system-level interventions. We also address the importance of adjusting treatment funding and organizational structures to better meet the needs of individuals with a chronic disease.

Org Biomol Chem. 2008 Mar 7; 6(5): 836-43Zheng F, Zhan CG(-)-Cocaine is a widely abused drug and there is currently no available anti-cocaine therapeutic. Promising agents, such as anti-cocaine catalytic antibodies and high-activity mutants of human butyrylcholinesterase (BChE), for therapeutic treatment of cocaine overdose have been developed through structure-and-mechanism-based design and discovery. In particular, a unique computational design strategy based on the modeling and simulation of the rate-determining transition state has been developed and used to design and discover desirable high-activity mutants of BChE. One of the discovered high-activity mutants of BChE has a approximately 456-fold improved catalytic efficiency against (-)-cocaine. The encouraging outcome of the structure-and-mechanism-based design and discovery effort demonstrates that the unique computational design approach based on transition state modeling and simulation is promising for rational enzyme redesign and drug discovery. The general approach of the structure-and-mechanism-based design and discovery may be used to design high-activity mutants of any enzyme or catalytic antibody.

Am J Drug Alcohol Abuse. 2008; 34(2): 123-6Kosten TR, Gardner TJ