At Home Drug Withdrawal

Sobriety Success

The dependence on sobriety is defined as the state of sobriety. When a person is sober, they can live on a daily basis without their thoughts and behaviors being controlled by substance dependence. They do not feel obliged to use it because they manage to live without it. They see and appreciate so much the benefits of living without substance that they do not feel they have to use drugs or alcohol. Therefore, they refrain from using it to continue enjoying this new, healthier lifestyle. The success product of sobriety is a step-by-step manual for everyone. The product has been said to be beneficial for many people around the world. The reason why the product is gaining so much popularity among individuals. They see and appreciate so much the benefits of life without substance that they do not feel they have to use drugs or alcohol. Therefore, they refrain from using it to continue enjoying this new, healthier lifestyle. This strategy encourages you to maintain the long-term vision of recovery. Recognize that this is not a one-off thing, something you try for a few weeks to several months, then return to your previous life. You will be in recovery if you decide it's the life you want to live for the rest of your life. As such, there is no immediate timeline to which you must adhere, nor should you strive to achieve goals that you are clearly not ready to face. More here...

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Cocaine And Other Stimulants

COCAINE is an indirect catecholamine agonist that acts by blocking the reuptake of monoamines, including DOPAMINE (DA), NOREPINEPHRINE (NE), and serotonin (5-HT). During the process of reup-take, the previously released neurotransmitter is actively transported back from the synaptic cleft into the presynaptic terminal of the neuron where the neurotransmitter was produced and released (Pitts & Marwah, 1987). In contrast to cocaine, AMPHETAMINE acts not only by inhibiting uptake, but also by releasing catecholamines from newly synthesized storage pools from the presynaptic terminal of the neuron (e.g., Carlsson & Waldeck, Amphetamine and cocaine are both potent PSYCHOMOTOR stimulants. They produce increased alertness and energy and lower ANXIETY and social inhibitions. The acute reinforcing actions of the stimulants are primarily determined by their augmentation of DA systems. With prolonged consumption (1) acute TOLERANCE becomes substantial, and (2) the individual starts to...

Role As Cocaine Supplier

Proximity to the U.S. marketplace, remote and vast tracts of unpatrollable land, powerful criminal organizations, indigenous entrepreneurial spirit, and a long tradition of violence and smuggling make Colombia an ideal source for illegal drugs. Coca production rose dramatically in the 1990s as the governments of Bolivia and Peru pursed aggressive eradication programs. The U.S. government estimated that Colombian coca cultivation doubled between 1995 and 1999, constituting over two-thirds of the production in South America. Cultivation takes place in the Llanos (plains) region, which encompasses almost half of eastern Colombia. Heavy growth also occurs in the Caqueta, Guaviare, Putumayo, and Vaupes departments (counties or provinces), with evidence of crop expansion in the Bolivar department and in south and southwest Colombia. In addition, new, more potent strains of coca have been developed that reach maturity more quickly and yield more product in the cocaine conversion process....

Amphetamines And Cocaine

Amphetamines and Cocaine act as CNS stimulants, which means that they generally increase arousal and psychomotor activity. As might be expected, acute administration can improve performance on many tasks, particularly when vigilance or speed of response is important. It can also reverse the effects of fatigue, which suggests that atten-tional resources are enhanced. However, this increase in arousal can be coupled with a dysfunction in higher-order control processes used to monitor or inhibit ongoing behavior, such that there is a corresponding increase in errors, impulsivity, and hyperactivity. Neurological consequences of a single dose of cocaine can include intracerebral hemorrhages, seizures, and strokes. These complications appear in only a small proportion of cocaine users, but the factors that place one at risk are not yet known. Although there is little research on the existence or nature of cumulative effects of chronic stimulant use, some recent evidence indicates mild...

The Criminality Of Drug Abusers

In examining the criminality of drug abusers, it is important to note that the onset of illicit drug use typically does not result in the onset of criminal behavior. Rather, it is the frequency, not the onset, of drug use that increases criminal activity. Further, the positive relationship between drug-use frequency and crime frequency is not consistent across all types of drug use and all types of crime. Such a relationship has been observed with respect to only three types of drug abuse heroin addiction, cocaine abuse, and multiple-drug use. In addition, such associations are more common for property crime than for violent crime. Researchers have also suggested that heavy heroin use and, more recently, heavy cocaine abuse have contributed to record numbers of homicides in large cities in the United States. The ways in which drugs can contribute to violence is the basis for a prominent theory in the drugs-crime field, discussed later in this article. The 1999 ADAM report on U.S. drug...

Epidemiology Of Drug Abuse

Of the best ways to introduce an article on the epidemiology of drug use and drug dependence is to ask some basic questions that epidemiologic studies can answer but laboratory and clinical studies cannot. Here are some examples In the late 1990s in the United States, about how many ages 12 to 17 had used cocaine at least once In the late 1990s, within which U.S. population subgroups were active cocaine users most likely to be found Within the United States in the early 1990s, among those aged 15 to 24 who had used cocaine, what proportion had become dependent on it In the early 1990s, which age group within the U.S. population was most likely to have experimented with cocaine, and which age group was most likely to have developed cocaine dependence Are these same subgroups of young adults at especially high risk of becoming dependent on psy-choactive drugs such as marijuana or cocaine In the late 1990s, among those aged 12 to 17 in the United States, an estimated 496,000 to 682,000...

Epidemiology Of Drug Use And Drug Dependence Outside The United States

Each year, the United States allocates more resources to epidemiologic surveys of drug use than does any other country in the world. For this reason, it has been possible to assemble a wealth of epidemiologic survey data on the prevalence of drug use and drug dependence within the United States. Other countries also have conducted surveys of this type and have produced valuable evidence about their experience with tobacco, alcohol, and other drugs. (See the bibliography for some references that can be consulted to gain more information about the results of these surveys.)

Other Aspects Of Epidemiology As Applied To Drug Use And Drug Dependence

A broad range of research questions must be answered in order to gain a complete understanding of the epidemiology of drug use and drug dependence. The focus in this article has been on quantity. How many people in the population (or what proportion) have been affected by drug use and by drug dependence Although many epidemiologists now devote their research careers to surveys that are needed to answer this kind of basic question, more stress ought to be placed on the other central questions for epidemiology, especially when the answers to these questions can guide society toward effective strategies for prevention of drug use and drug dependence. These questions are. At its best, epidemiology provides critically important answers to each of these questions, and it works to ensure that new findings are translated rapidly into effective strategies for prevention. This is the future agenda for epidemiologic research on drug use and drug dependence. (SEE ALSO Amphetamine Epidemics...

The Role Of The Limbic System In Drug Abuse

A large number of experiments have focused on identifying the brain circuits that mediate the reinforcing effects of abused drugs, because the reinforcing effects are responsible for drug abuse. These experiments have included the use of drug self-administration techniques and sophisticated neurochemical procedures to measure the involvement of specific NEUROTRANSMITTER systems. As of the early 1990s, evidence indicates that limbic structures and brain cells that project to limbic structures play an important role in these processes. It is clear that dopamine-containing neurons that project from the ventral tegmental area to the nucleus accumbens have a critical role in the reinforcing actions of COCAINE and AMPHETAMINE. Removal of these inputs with toxic agents that selectively destroy dopamine-releasing brain cells disrupts intravenous self-administration of these drugs. Additional evidence of the importance of this region in drug abuse comes from glucose-utilization studies. The...

Approaches To Developing Medications For Drug Abuse

Researchers can use the knowledge gained from animal and human studies of the effects of drugs on the brain as they develop medications for alcohol and drug dependence. Most likely, one medication will be needed to help detoxify the drug-dependent individual and a second medication to help sustain abstinence from drug use. This two-phase medication regimen is used for opiate and alcohol treatment, and it may ultimately be the approach used for countering dependency on other drugs, such as cocaine, sedatives, and nicotine. In theory, a pharmacological treatment agent or medication would block or reduce either the acute, rewarding effect of the drug or the discomfort of withdrawal. In practice, few treatment drugs have been found to be very effective in sustaining abstinence from drugs or alcohol. Any pharmacological agent should be able to be given orally, as this is much easier than other routes of administration, such as injections. The agent itself must be medically safe and not...

Examples Of Medications Used To Treat Drug Abuse

Some of the best examples of pharmacotherapies for drug abuse were developed for opiate addicts. One of the first pharmacological agents used to treat opiate addicts is METHADONE. Methadone itself is an opiate drug and effectively reduces or blocks the withdrawal discomfort brought on by discontinuing use of heroin or other illegal opiate. Although methadone is itself addictive, it is delivered to the opiate-dependent patients in a facility with psychological and other medical and support treatments and services. Methadone is safer than opiates obtained illegally in part because it is given orally. Because illegal opiates are often injected by addicts, they can lead to many diseases including AIDS and hepatitis, if the needles are shared with an infected person. Illegal drug use is expensive, and many addicts steal to support their habit. Moreover, since drugs obtained illegally vary in their quality and purity, there is a greater chance of getting an overdose that...

Costs Of Smoking And Drug Abuse

In considering the social costs of illicit drug use, the illegal status of these drugs makes an enormous difference (Kleiman, 1992). The consequences of criminalizing transactions in these drugs include the bloody wars between rival drug-dealing organizations, crime by addicts seeking funds for their next fix, and the spread of disease through use of unclean needles, as well as the billions of dollars spent in law-enforcement efforts. Harwood et al. estimated that, in 1992, drug abuse problems incurred a social cost of 97.7 billion.

Cocaine Pharmacotherapy

Pharmacological treatment of Cocaine abuse is defined as the use of medication to facilitate initial abstinence from cocaine abuse and to reduce subsequent relapse. The initiation of abstinence from cocaine abuse involves reduction in the withdrawal symptoms associated with cessation of cocaine. This Withdrawal syndrome resembles depression but includes a great deal of anxiety and craving for cocaine. Craving for cocaine often persists for several weeks after abstinence has been attained, and places or things associated with cocaine use in the past, called cues, can continue to stimulate cocaine craving for many months. Because of this persistence of what is known as conditioned craving, relapse to cocaine abuse can occur after the patient has become abstinent. Preventing relapse is an important function of medication treatment. An objective of the use of medications in cocaine dependence is to reverse changes that are caused in the brain after chronic cocaine use. These brain...

Drug Abuse 2000 and Beyond Drug

Addiction is a medical and public health problem that affects everyone, either directly or indirectly. A recent study estimated that drug abuse and addiction cost the United States more than 110 billion per year. If one adds the cost of nicotine to this figure, the number dramatically soars. Improved prevention and treatment are the best ways to reduce that cost. Fortunately, advances in science have revolutionized our fundamental understanding of the nature of drug abuse and addiction, and what to do about it. Three decades of scientific research and clinical practice have yielded a variety of effective approaches to drug addiction treatment. Extensive data document that drug addiction treatment is as effective as treatments for most other similarly chronic medical conditions. In spite of scientific evidence that establishes the effectiveness of drug abuse treatment, many people believe that treatment is generally ineffective. In part, this is because of unrealistic expectations....

Concommitant Cocaine And Ethanol Consumption

A survey conducted in 1991, found that 9 million people in the US abuse cocaine and ethanol simultaneously 55 , The combined use of cocaine and ethanol appears to be associated with increased morbidity and mortality over either drug alone. Their simultaneous use increased the risk of drug-induced sudden death 18fold 56 , Deaths due to drug overdose involving the use of ethanol were associated with cocaine blood concentrations that were lower than those measured in subjects dying of cocaine overdose alone (900 vs. 2,800 mg L, respectively) 57 , This is suggestive of an additive or synergistic effect of ethanol on cocaine-induced catastrophic events 57 , Several hypotheses have been proposed to account for this synergistic effect. Since the combined use of both drugs in human volunteers produces a greater increase in heart rate than either substance alone, the combination may do more than either of its individual constituents to substantially increase the determinants of myocardial...

National Institute on Drug Abuse NIDA

The National Institute on Drug Abuse is the world's premier research institute supporting research on the health aspects of drug abuse and addiction. NIDA's vast portfolio supports research on all drugs of abuse from opiates and cocaine to new and emerging drugs such as methamphetamine and ecstasy. In addition to research on illegal drugs, NIDA supports an extensive research portfolio to combat what may be the nation's most critical and costly public health problem tobacco use. NIDA's nicotine research continues to increase our understanding of the social, economic, cultural and biological factors that influence smoking initiation and vulnerability to nicotine addiction, and continues to bring the nation the most effective prevention and treatment approaches available. Additionally, NIDA supports research on the health conse quences of nicotine as well as on the medical consequences of all illicit drugs. Given that drug abuse is the greatest vector for the spread of HIV, a significant...

Special Action Office For Drug Abuse Prevention Saodap

A separate agency in the EOP from 1971 to 1975, SAODAP was responsible for providing leadership and coordination of all federal drug-abuse prevention activities (demand related) and to coordinate the demand-related activities with the supply-related efforts of law enforcement agencies. Authorization and Role. Established by President Richard M. Nixon (E. O. 11599, June 17, 1971). Legislative authorization Public Law 92-255, March 21, 1972 the ''Drug Abuse Office and Treatment Act of 1972.'' The director reported to the president, working through the Domestic Council and the White House staff. SAODAP had a staff of over 100 and an annual budget of approximately 50 million. About 50 percent of the budget was in a ''Special Fund for Drug Abuse'' to be transferred to other federal agencies as an incentive to develop more effective prevention programs. SAODAP provided oversight of all categories of ''Demand Reduction ' functions and made recommendations to the Office of Management and...

Comparison Of Cocaine And Methamphetamine Smoking

100 Percent Meth Ice

Vapor inhalation of the ( + ) isomer of methamphetamine hydrochloride, colloquially known as ice has several differences when compared to vapor inhalation of cocaine freebase. Although both methamphetamine and cocaine freebase have their origin as a salt, cocaine hydrochloride must be pretreated with an alkaline substance to remove the hydrochloride, thus creating the freebase of cocaine that can be heated and inhaled as vapor. In contrast, methamphetamine hydrochloride can be heated and inhaled without adulterating the original compound. When heated, cocaine freebase has a melting temperature of 208 F while methamphetamine hydrochloride melts at 268 F. Once the appropriate melting temperature is met for each substance, vapors will form and can be inhaled. Significant amounts of cocaine freebase vapor are lost through pyrolysis (chemical change caused by heat) and little condensation appears on the water pipe, suggesting decreased amounts of inhaled vapor. Meth-amphetamine...

Perpetuation Of Drug Abuse Euphoria And Withdrawal

Many people who are drug- or alcohol-dependent want to stop their habit, but often they have a difficult time doing so. There are at least two reasons for this difficulty. First, the drugs produce pleasant or euphoric feelings that the user wants to experience again and again. Second, unpleasant effects can occur when the drug use is stopped. The latter effect, commonly known as WITHDRAWAL, has been shown after prolonged use of many drugs, including alcohol, OPIATES (such as Heroin), Sedative Hypnotics, and anxiety-reducing drugs. Other drugs, such as COCAINE and even CAFFEINE (COFFEE and COLA drinks) and NICOTINE (cigarettes), are also believed to be associated with withdrawal effects after prolonged use. These unpleasant withdrawal effects are alleviated by further drug use. Thus drugs are used and abused because they produce immediate pleasant effects and because the drug reduces the discomfort of withdrawal. The symptoms of withdrawal are fairly specific for each drug and include...

National Council On Alcoholism And Drug Dependence Ncadd

This is the ninth largest voluntary health organization in the United States and the country's major public advocate for the prevention and treatment of alcohol and other drug problems. Working through hundreds of local affiliate councils, state councils, and its New York City and Washington offices, NCADD sponsors prevention and education programs, information and referral services, scientific and clinical consensus development, public policy advocacy, and other related activities. During its early years, the council's activity consisted mainly of developing literature and presenting lectures to professional and lay groups on the concept of alcoholism as a disease and of organizing local affiliates to pursue this educational process in their own communities. By 1947, a survey of American adults showed that 36 percent believed alcoholism to be a disease, a remarkable increase from 6 percent who held this view in 1943. As interest in alcohol and drug problems expanded, the council...

Wiklers Pharmacologic Theory Of Drug Addiction Abraham

Wikler (died 1981) was one of the first researchers who, in the late 1940s, strongly advocated the idea that drug abuse and relapse following treatment are influenced by basic learning processes. Early in his career, Wikler became interested in reports from relapsed heroin addicts that despite being free of withdrawal symptoms during treatment and upon discharge, they experienced withdrawal symptoms and craving when they returned to their drug-use environments and that these feelings were responsible for their return to drug use. Based on these and other anecdotes, Wikler who was familiar with the recent work of Russian physiologist Ivan Petrovich Parlor (1849-1936) on conditioning proposed that events which reliably signal drug self-administration or drug withdrawal elicit conditioned responses (CRs) that take the At the heart of Wikler's model lies the notion that classical conditioning mechanisms are activated when events surrounding drug use reliably begin to signal upcoming drug...

Iatrogenic Addiction Nonopioids See Prescription Drug Abuse

As a Schedule I drug under the CONTROLLED SUBSTANCES Act, ibogaine is considered to be highly subject to abuse and without any approved medical use. To be approved by the FDA, an agent must be shown to be safe and effective. Throughout the early 1990s the only reports of the efficacy of ibogaine have been anecdotal ones from individuals in Europe who were addicted to heroin, COCAINE, and TOBACCO. Those who take ibogaine are generally highly motivated since the drug is expensive, costing up to several thousand dollars. While many reported a decrease in drug CRAVING after taking ibogaine, relapse to drug use within a few months was also observed. As a result of pressure from activists, the U.S. government funded animal studies of ibogaine's actions on opioid and cocaine withdrawal, opioid and cocaine self-administration, and neurotoxicity. Studies in animals have not been entirely consistent. High doses of ibogaine reduced some manifestations of opioid withdrawal in monkeys. Studies in...

Drug Abuse Policy Office Dapo Office Of Policy Development

Similar in organization and responsibilities to the preceding DPO, the Drug Abuse Policy Office (DAPO) was the principal EOP drug-abuse staff during the eight years of President Ronald W. Reagan's administration. In 1981, DAPO was established within the White House Office of Policy Development. Authorization and Role. The statutory basis for the office (21 USC 1111 & 1112) required the president to establish a system to assist with drug abuse policy functions and to designate a single officer to direct the drug functions. Presidential Executive Order 12368, signed on June 24, 1982, assigned the Office of Policy Development (OPD) to assist the president with drug-abuse policy functions, including international and domestic drug-abuse functions by all executive agencies. The director of ODAP was responsible for advising the president on drug-abuse matters and assisting Nancy D. Reagan and her staff in developing the First Lady's drug-abuse prevention program. The director and staff...

See Elimination of Drug Addiction and Alcoholism as Qualifying Impairments in Social Security Disability Programs

The PRWORA also requires or permits the states to enforce a variety of ''behavioral requirements'' for continuing eligibility for full TANF benefits. Among these is the PRWORA's permitting states to mandate treatment for alcohol and drug abusers as well as to require random drug testing under the threat of forfeited benefits. (A failed provision of the original legislation would have forced the states to implement these provisions.) However, recent research on TANF parents in some states has produced the startling (to some) finding that the prevalence of substance-abuse disorders in the adult TANF population, as measured by a rigorous standard, is very similar to that in the population at large about 8 to 10 percent. To date, only Louisiana, Michigan, Nevada, and New York have expressed serious interest in drug testing and any implementation plan will face a court test. However, a number of states, including California, are exploring mechanisms for mandatory treatment and the use of...

Polydrug Abuse Pharmacotherapy

Senting with dependencies upon two or more such substances. The Diagnostic and Statistical Manual of the American Psychiatric Association (DSM-IV) and the International Classification of Diseases of the World Health Organization (ICD-10) define a condition called ''polydrug dependence'' or ''multiple drug dependence,'' in which there is dependence on three or more psy-choactive substances at one time. Polydrug dependence is particularly common among adolescents and young adults. However, if one includes Nicotine and Caffeine dependence, over half of patients with psychoactive-substance dependence are polydrug-dependent. The use of specific, preferred combinations of drugs is typically seen in polydrug users. Opioids and Cocaine are often used together, as are Alcohol and cocaine or nicotine and alcohol. Alcohol, Benzodiazepines, and cocaine are often used together by opiate users, especially Methadone users. Illicit-drug users often show nicotine and caffeine dependence. Some...

Cocaine Cardiotoxicity

As cocaine abuse has become widespread, the number of cocaine related cardiovascular events, such as angina pectoris, myocardial ischemia and infarction, cardiac myopathy, left ventricular hypertrophy, and sudden death has increased substantially 1-15 , These occur in young subjects, a significant percentage of whom had no evidence of atherosclerotic coronary artery disease on subsequent angiography 10,11,18-21 . Twice as many men as women experience cocaine related cardiac ischemic events, at least partly caused by a greater frequency of cocaine use in men. The concomitant use of cigarettes and or ethanol is pervasive, with up to 75 of cocaine users admitting to each. Although myocardial ischemia, infarction, and sudden death are most likely to occur in chronic cocaine users, they have been reported in first time users as well. These events can occur from any route of administration and with a large or small amount of the drug 3,4,8,9,20-29 , It is thought that the pathophysiology of...

Neutral Cues Cocaine Cues

Positron emission tomography (PET) scanning with 18F fluorodeoxyglucose as a tracer for cerebral glucose metabolism, showing increased activity in brain regions implicated in several forms of memory, when human volunteers who abused cocaine were exposed to drug-related stimuli. Cocaine abusers were studied under a neutral condition (left) and also in a test session in which they were presented with drug-related stimuli, such as a videotape of cocaine self-administration. They reported varying degrees of craving. A subject who reported high cocaine craving when viewing the cocaine cues (right) showed brain activation in the dorsolateral prefrontal cortex (DL) (upper scans), a brain region that is important in short-term memory, and the amygdala (AM) (lower scans), a brain region that is important in emotional aspects of memory. The findings, which have implications for treatment of cocaine addiction, suggest that a distributed network, which integrates emotional and other...

Mechanisms of cocaine cardiotoxicity

Cocaine abuse induces coronary vasospasm 1-5 , myocardial infarction 6-8 , hypertension 9,10 , stroke 7,H , and fatal cardiac rhythm disorders, including ventricular fibrillation 12-15 , Chronic cocaine abuse has also been shown to cause dilated cardiomyopathy 16,17 , and left ventricular hypertrophy in normotensive cocaine users 18-20 , It is only since modern electrocardiographic techniques have come into widespread use that the effect of cocaine on cardiac rhythm has been effectively studied. These techniques were the first to demonstrate that cocaine produced severe intractable ventricular arrhythmias that resulted in death during routine nasal surgery 21 . Cocaine functions as a strong cardiac stimulant that potentiates the actions of the sympathetic nervous system by inhibiting both peripheral and central neuronal catecholamine uptake 22-24 , The resulting changes in cardiac autonomic neural balance may significantly contribute to the formation of arrhythmias, since increased...

Growth Of The Drug Addiction And Alcoholism Impairment Category

From the advent of SSI in January 1974, until March 1996, drug addiction and alcoholism (DA& A) were treated as potentially disabling impairments. The DI program adopted the more liberal SSI addiction standard in 1975. In Social Security lingo, beneficiaries who qualified on this basis were known as ''DA& As.'' In the SSI program, DA& As were obliged to be in treatment and to have a ''representative payee,'' a third party who received their checks and managed their funds. ''DA& As in the DI program were not subject to such requirements until 1994. This disparity reflected the historical reference tendency for American income maintenance programs to combine material aid and moral surveillance in welfare programs (WELFARE POLICY AND SUBSTANCE Abuse in the United States), but to treat the beneficiaries of the ''insurance-like'' programs as though they were the recipients of an insurance benefit for which they had paid premiums in full.

Office Of Drug Abuse Policy Odap

In March 1976, Congress authorized the Office of Drug Abuse Policy, located in the EOP and intended to be the successor agency to SAODAP. President Gerald R. Ford did not activate the new agency, choosing instead to continue with the existing FDM staff. President Jimmy Carter opened ODAP in March of 1977 and abolished it one year later. The director's office was located in the West Wing of the White House and the staff offices were in the Old Executive Office Building. Authorization and Role. Congress established ODAP in Public Law 94-237 and provided an annual budget of 1.2 million. The director was the principal advisor to the president on policies, objectives, and priorities for federal drug-abuse functions. The director coordinated the performance of drug-abuse functions by federal departments and agencies. ODAP, with a staff of approximately fifteen, conducted a comprehensive set of drug-policy reviews using interagency study teams. The director and staff sought a close...

Relation Of Adhd To Drug Abuse

With respect to alcohol and other drug abuse, augmented risk appears to be circumscribed to youth who have both ADHD and a conduct disor der. The association, however, between ADHD and substance abuse is complex. Alcohol and other drugs may be more subjectively rewarding for ADHD youth and adults than in the general population. Drug use is commonly tied to a general pattern of social deviancy and nonnormative peer affiliation. Where the ADHD person has been ostracized by the normative peer group, the use of alcohol drugs may be just another manifestation of generalized maladjustment. Furthermore, alcohol drug use may be mediated by a coexisting psychiatric disorder, such as anxiety and depression, and thus reflect an attempt at self-medication. Therefore, although there is substantial evidence demonstrating an increased risk for alcohol drug abuse in ADHD youth, this association is complex and is contingent on many factors. Additionally, it is interesting to note that recent studies...

Assessment Of Substance Abuse Drug Abuse Screening Test Dast

The Drug Abuse Screening Test (DAST) was designed to be used in a variety of settings to provide a quick index of drug-related problems. The DAST yields a quantitative index of the degree of consequences related to drug abuse. This instrument takes approximately 5 minutes to administer and may be given in questionnaire, interview, or computerized formats. The DAST provides a brief, self-report instrument for population screening, identifying drug problems in clinical settings and treatment evaluation. DAST-20 and DAST-10 Versions. The DAST was modeled after the widely used Michigan Alcoholism Screening Test (Selzer, 1971). Measurement properties of the DAST were initially evaluated using a clinical sample of 256 drug-alcohol-abuse clients (Skinner, 1982). The 20-item DAST has excellent internal consistency reliability (alpha) at 0.95 for total sample and 0.86 for the drug-abuse sample. Good discrimination is evident among clients classified by their reason for seeking treatment. Most...

Cocaine Behavioral Approaches No

Consensus exists about how to treat Cocaine dependence. This statement is particularly alarming given that in 1998 it was estimated that 1.8 million persons in the United States were dependent on cocaine. The abuse of cocaine was first recognized in the medical literature in the late 1800s. Early proposed treatments included various herbal and medical potions, nutritional supplements, hot baths, substitution of Morphine, long stays in sanatoriums, education, and psychotherapy. Systematic evaluation of the effectiveness of these early treatments did not occur. The goals and focus of behavioral approaches for cocaine dependence vary greatly depending on the beliefs held by the treatment provider regarding the causes of cocaine dependence. The efficacy of the various treatments is only beginning to be evaluated. This article describes the primary behavioral approaches used to treat cocaine and discusses the efficacy of those interventions. Although numerous behaviorally-based...

Longterm Opioid Addiction Careers

Three-fourths of the addicts studied had experienced at least one ''relapse'' to daily opioid use after they had temporarily quit. Among those who had ever temporarily quit daily opioid use at least once, 85 percent had done so while in a drug-abuse treatment, 78 percent had quit while in a jail or prison, 69 percent had temporarily quit ''on their own'' (without treatment), and 41 percent had quit while in a hospital for medical treatment. The most frequent reasons cited for quitting addiction the last time involved psychological and emotional problems. Ex-addicts reported they had ''become tired of the hustle'' (rated as being important by 83 of the sample) andneeded a change after ''hittingbottom'' (considered important by 80 ). Other reasons cited as being important were ''personal or special'' events such as a marriage or the death of a friend (64 ), fear of being sent to jail (56 ), and the need to meet family responsibilities (54 ) (See Simpson & Sells, 1990, for further...

Incidence And Prevalence Of Drug Abuse

Although the casual use of drugs is decreasing in the United States, reported drug abuse is increasing in women of child-bearing age. While it is believed that more children are being raised by alcohol-, tobacco-, or other drug (ATOD)-abusing parents, the scope of the problem is undetermined. Longitudinal studies of children of ATOD-abusing parents are currently underway by the U.S. Centers for Disease Control (CDC), the NATIONAL INSTITUTE ON Drug Abuse (NIDA), and the National Institute on Alcoholism and Alcohol Abuse (NIAAA). The Children of Alcoholics Foundation estimates that in the U.S. population about one in eight were raised in homes with one alcoholic parent. Studies suggest that as many as 11 percent of newborns are drug-exposed in utero. About six million women of childbearing age are marijuana users and 10,000 children per year are born to women using opiates. Polydrug use and frequent use of alcohol and other drugs by parents increases the difficulty of researching any...

Cocaine And Amphetamine

The problems associated with chronic cocaine and amphetamine use and withdrawal are much more serious than those associated with caffeine. By the mid-1980s, more than 20 million people had used cocaine in the United States. With the recent introduction of cocaine in the free alkaloid base (FREEBASE or CRACK) form, there has been a significant increase in cocaine-related medical, economic, social, and legal problems. In the free-base form, cocaine can be smoked, resulting in blood levels and brain concentrations of the drug that compare to those observed when the drug is injected intravenously. In non-user subjects in a laboratory setting, the administration of cocaine or amphetamine produces an elevation of mood, an increase in energy and alertness, and a decrease in fatigue and boredom. In some individuals, how In nonlaboratory settings, heavy users of cocaine often take the drug in bouts or binges, only stopping when their supply runs out or they collapse from exhaustion....

Alcohol and cocaine

CAUSES OF SUBSTANCE ABUSE LEARNING WIKLER'S PHARMACOLOGIC THEORY OF DRUG ADDICTION AND DRUG ABUSE DIRECTORS RESEARCH CLINICAL RESEARCH Division of Cardiovascular Disease UMDNJ, New Jersey Medical School, Newark, NJ COMPLICATIONS CARDIOVASCULAR SYSTEM (ALCOHOL AND COCAINE) Substance Abuse Treatment Unit Yale University School of Medicine, New Haven, CT WITHDRAWAL COCAINE National Institute on Drug Abuse, Baltimore, MD RESEARCH, ANIMAL MODEL CONDITIONED WITHDRAWAL National Institute on Drug Abuse Addiction Research Center, Baltimore, MD Texas Christian University, Fort Worth, TX DRUG ABUSE REPORTING PROGRAM (DARP) DRUG ABUSE TREATMENT OUTCOME STUDIES

Cocaine

Cocaine abuse has dramatically increased in the United States since the 1980s. One consequence has been the recognition of cocaine's unpredictable medical side effects the most dramatic and devastating of which are cardiovascular. These include acute impairment of blood supply to the heart muscle, and heart attacks, as well as hypertension, accelerated arteriosclerosis, ruptured aorta artery, inflammation of heart muscle, cardiomyopathy (heart disease), cardiac arrythmia, and sudden death. Cocaine has two separate primary pharmaco-logic effects on the heart and vascular system. First, it causes an accumulation of CATECHOLAMINES accomplished by increasing their release (which include epinephrine also called adrenaline , Norepinephrine, and Dopamine) from both brain and spinal cord stores and by blocking their reup-take at nerve endings. The result is a more pronounced and long lasting stimulation of the sympathetic nervous system, heart muscle, and vascular smooth muscle, represented...

Cocaine Craving

Cocaine craving is a behavioral phenomonon in which cocaine users, upon exposure to cues they associate with illicit cocaine use, feel strongly compelled to use more cocaine. Maas and colleagues (1998) used the BOLD fMRI technique to map brain activation during cue-induced cocaine craving (Maas et al., 1998). That study found increased brain activation in the cingulate and left dorsolateral prefrontal cortices (Fig. 12) during the presentation of an audiovisual program containing cocaine cues in cocaine abusers, but not in controls (Maas et al., 1998). The anatomical activation pattern paralleled findings from emission tomographic studies (Grant et al., 1996 Childress et al., 1999), suggesting that the fMRI technique may be useful both for measuring the craving response and for determining the efficacy of treatments designed to diminish cocaine craving. The results also suggest the presence of an additional confound in BOLD fMRI studies using cocaine-dependent subjects namely, that...

Methamphetamine

Sachdeva and Woodward (1989) described a case of right thalamic T2 hyperin-tensity indicative of infarction, in a man who reported strokelike symptoms approx 36 h after snorting methamphetamine. Multiple cavernous angiomas were found in a chronic cocaine user who developed strokelike symptoms shortly after methamphetamine use (Ellis and Speed, 1998). Although the strokes in these two cases were symptomatic, clinically silent strokes similar to those found in cocaine abusers have been noted in association with methamphetamine abuse, such as the one shown in Fig. 10. Gadolinium-induced focal nodular enhancement of cortical sulci found in a young amphetamine abuser with AIDS was interpreted to reflect arterial ectasia and vasculitis (Lazar et al., 1992). That patient subsequently developed hemiparesis, and MR followup revealed a newly appeared right basal ganglia intracerebral hematoma (Lazar et al., 1992). 1H MRS abnormalities suggestive of neuronal loss and glial dysfunction have been...

Cocaine Use Patterns

Cocaine may be taken in various ways that differ in speed of onset, in blood levels, and, consequently, in brain levels. Subjective effects are most intense when brain levels of cocaine are rapidly increasing to high concentrations. Routes of administration, in ascending order of efficiency, are chewing Coca leaves (absorption through the mucous membranes of the mouth), oral ingestion of cocaine hydrochloride, intranasal absorption of cocaine hydrochloride, smoking of alkaloidal (Freebase) cocaine (Crack), and intravenous injection of cocaine hydrochloride. The use of crack is actually the most rapid delivery of cocaine to the brain, and generally preferred over intravenous use. There are also different use patterns. Some patients rarely use cocaine except at parties and in relatively low doses. Some ethnic and social groups are particularly likely to use cocaine by the intranasal route, a method that achieves lower brain levels than administration via crack (freebase inhalation) or...

Cocaine Treatment

Alterman et al. (1994) found that a twenty-seven hour per week day hospital treatment was just as effective as more costly inpatient treatment for low SES male veterans. Both groups showed significant improvements in functioning at the seven-month follow-up evaluation. Although a greater proportion of subject assigned to inpatient treatment completed treatment, the day hospital treatment costs were 40 to 60 percent of inpatient treatment. Another randomized clinical trial comparing day and residential treatment programs for drug abuse (mostly Cocaine) found no overall differences in substance use problems between the two treatment conditions (Guydish et al.,1998). Comparing Outpatient Treatment Intensities. As a result of finding no superior effect of inpatient treatment and given the limited availability of inpatient care, researchers are now comparing various intensities of outpatient treatment. Coviello et al. (in press) found no differences between male veterans randomly assigned...

Cocaine Dependence

Cocaine abuse has increased markedly since the 1970s, and by 1984, more than 20 million Americans reported that they had tried cocaine. In addition to psychotherapy and other traditional ap proaches to substance-abuse treatment, a variety of pharmacotherapeutic interventions may be of benefit to cocaine abusers. Pharmacotherapy for cocaine abuse may be employed to address specific symptoms that occur during the cocaine-withdrawal syndrome. Gawin and Kleber identified three phases in the cocaine abstinence syndrome. The crash phase generally begins soon after cocaine use ends and may last up to four days. Symptoms experienced at this time may include depression, suicidal ideation, irritability, anxiety, and intense cocaine craving. Sedatives such as alcohol and heroin may be used by addicts to alleviate these symptoms. The second or withdrawal phase may last two to ten weeks and is characterized by anxiety, depression, inability to experience pleasure, and increased cocaine craving....

Coca and Cocaine

Coca contains fourteen drugs, cocaine being the most important. The other drugs are present in smaller amounts and seem to modify the stimulating effect of the cocaine. In addition, coca leaves contain many vitamins and minerals that are probably important in the diets of Indians who use them. There are several varieties of coca some taste like green tea, some like wintergreen. Coca users put dried leaves in the mouth and work them into a large wad. They suck on this wad for thirty minutes or so, swallowing the juices, after which they spit out the residue. To get an effect from coca, a tiny amount of some alkali, such as lime (the powdered mineral) or ashes, must be added to the wad of leaves. In the late 1800s coca became very popular in Europe and America in the form of tonics and wines. Coca-Cola began as one of these early preparations. At the same time, scientists isolated cocaine from the leaves and made it available to doctors in the form of a pure white powder. As the first...

Cocaine Anonymous

Cocaine Anonymous (CA) is a community-based self-help group organization modeled after Alcoholics Anonymous (AA). The basic principles are the same as AA's. The program is based on the ''disease'' model of substance dependence. Achievement and maintenance of abstinence from cocaine is presumed to be facilitated by following the Twelve Steps of CA (which are based on the original Twelve Steps of AA). CA is available to anyone who expresses a desire to stop using cocaine and all other mind-altering substances. All that is necessary to become a group member is that one attend meetings. Meetings vary from large open ones that anyone can attend to small, closed discussions reserved for specific groups. For example, a group of young people, professionals, or women is organized to address specific concerns. At most meetings, experiences are shared and advice and support are given. Two other components of the CA program are sponsorship and education. A sponsor is a person who has been in...

Development Of Abuseliability Testing Procedures

The origins of assessing drug-abuse liability with humans can be found in some of the earliest writings of civilization, describing the subjective effects of naturally occurring substances, such as wine. Since the mid-nineteenth century, literary accounts of the use and misuse of opium, marijuana, and cocaine, among other substances, have emphasized their mood-altering effects and their potential for abuse. Only in recent years, however, have systematic methods for measuring such subjective effects been refined through the use of standardized questionnaires. Volunteers who are experienced drug users complete the questionnaires after they have taken a drug their answers to the subjective-effects questions how they feel, their likes and dislikes readily distinguish between the various drugs and doses, as well as between drug presence or absence (i.e., placebo). Among the most important factors in assessing abuse liability is the determination of whether humans will take the drug when it...

Effectiveness Of Abuseliability Testing

Because of the availability of procedures for abuse-liability testing in humans, it seems reasonable to ask how well they work. That is, has it been possible to predict from the results of these tests whether a new drug will be abused when it becomes generally available The two major sources available for checking the effectiveness of human abuse-liability testing procedures are case reports by clinicians of patient drug abuse, and EPIDEMIOLOGICAL surveys of large numbers of individuals as well as of specific target sites (e.g., hospital emergency rooms). Both of these approaches have many shortcomings, since they lack the precision and focus that human laboratory testing can provide. But despite the draw-backs, they can detect abuse-liability problems in both specific groups of individuals and the population at large, in a manner that has generally validated the results of human laboratory-testing procedures.

Drugspecific Negative Consequences

Discussion in this section is limited to the specific negative consequences of a few of the most prevalent illicit drugs marijuana, cocaine, and heroin. Other illicit substances that could have been discussed here include LYSERGIC ACID DIETHYLAMIDE (LSD), PHENCYCLIDINE (PCP), and other ''alphabet'' or ''designer'' drugs (''ecstacy,'' etc.), Amphetamine, and Methamphetamine (and its smokable form, ''ice''). This discussion also could Cocaine. Many readers undoubtedly have heard that Sigmund FREUD, the famous Viennese psychoanalyst, was an avid user and proponent of cocaine. The initial account of his observations of the drug's effects for himself and some of his patients indeed was glowing. It was translated from German and reprinted in an American medical journal in the mid-1880s, thus popularizing the drug in the United States and prompting its incorporation into products from patent medicines to soft drinks. Less well reported is the fact that Freud and his colleagues had discovered...

The unique efficacy of dryneedling acupuncture in sports medicine

Some athletes resort to drugs to achieve better performance, and they risk paying a high price for this in the future. Anabolic steroids greatly increase the risk of cardiovascular damage, heart attack, and stroke, because they cause hypertension, a decrease in high-density blood lipoproteins, and an increase in low-density lipoproteins. The consumption of male sex hormones by male athletes can decrease testicular function, causing both lowered sperm formation and a reduction in the natural secretion of testosterone. The use of amphetamines and cocaine

Addiction And Dependence

The term addiction was used in everyday and legal English long before its application to drug problems. In the sixteenth century it was used to designate the state of being legally bound or given over (e.g., bondage of a servant to a master) or, figuratively, of being habitually given over to some practice or habit in both senses, it implied a loss of liberty of action. At the beginning of the twentieth century it came to be used more specifically for the state of being given over to the habitual excessive use of a drug, and the person who was ''given over'' to such drug use was described as an addict. By extension from the original meanings of addiction, drug addiction meant a practice of drug use that the user could not voluntarily cease, and loss of control over drinking was considered an essential feature of alcohol addiction. The emphasis was placed upon the degree to which the drug use dominated the person's life, in such forms as constant preoccupation with obtaining and using...

Reinforcement And Its Relation To Dependence

Liking for the drug) but drug-induced sensitization of the process of incentive saliency (i.e., the subject's awareness of, and ''wanting'' for, drug-related stimuli becomes progressively greater, so that they have a steadily increased probability of controlling behavior). Yet another, and closely related, hypothesis is that drug-taking generally occurs within certain specific environmental or social contexts, and cues arising from these contexts can become linked to the drug effects as conditional stimuli, which then become able to elicit drug-taking behavior and further reinforcement. This is analogous to the role of the bell in Pavlov's experiments in which salivation, at first elicited by the feeding of meat to a dog, could eventually be elicited by the bell alone if the bell was always sounded just before the presentation of the meat. In this view, when the drug-taking comes under the control of such extraneous stimuli and is no longer a purely voluntary act, the transition to...

Tolerance And Sensitization

The term tolerance, which has long held a prominent place in the literature on drug dependence, has a number of different meanings. All of them relate to the degree of sensitivity or susceptibility of an individual to the effects of a drug. Initial tolerance refers to the degree of sensitivity or resistance displayed on the first exposure to the drug it is expressed in terms of the degree of effect (as measured on some specified test) produced by a given dose of the drug, or by the concentration of drug in the body tissues or fluids resulting from that dose the smaller the effect produced by that dose or concentration, the greater is the tolerance. Initial tolerance can vary markedly from one individual to another, or from one species to another, as a result of genetic differences, constitutional factors, or environmental circumstances. Sensitization refers to a change opposite to tolerance, that occurs with respect to certain effects of a few drugs (most notably, central stimulant...

Adjunctive Drug Taking Drug

Abuse is usually viewed as a behavior that occurs because of what the drugs do in the body. Most people assume that drug abuse is mainly driven by the immediate, attractive effects and sensations produced by the drugs their physiological and psychological effects. But there is another, less direct way drugs can become of overwhelming importance to a person and dominate life. Excessive drug use can develop as a side effect of other strongly desired behavior that, for various reasons, cannot be engaged in or completed. The adjunctive behavior of greatest interest with respect to the problem of drug abuse is, of course, the excessive seeking and taking of drugs. A few examples will be given. But first, as indicated above, it is important to understand that adjunctive drug taking is only one kind of excessive behavior that can be driven by a generator schedule. Thus, drug abuse is just one sort of adjunctive behavior it is not a special problem driven exclusively by the pharmacological...

Gaining Acceptance of Microbial Endocrinology

In Toronto that focused on the role of neuroendocrine mediators and immunity in drug addiction, I gave a microbial endocrinology-based lecture as part of a session on stress and its relationship to drug addiction sequelae such as increased prevalence of infectious disease in drug addicts. At the conclusion of my talk before I could take any questions, the session chair addressed the audience and said that my ideas were so radical that they should not be taken seriously, and the audience should in essence forget what I just presented. More than one member of that audience has approached me over the years to recount that episode and the shock of the audience being told to disregard what they had just heard as well to ask why I did not get mad (which I did not). Such opposition, although admittedly more restrained, was also encountered during the early years in terms of gaining acceptance into the scientific literature. I have been told by more than one individual that the integration of...

Us Patterns And Trends

In the 1940s and 1950s amphetamines were prescribed liberally and soon surpassed cocaine as an illicit stimulant widely available on the street. The increase in the popularity of amphetamines was influenced by easy availability, low cost, and long duration of effect (eight to twelve hours). Between the 1930s and the 1970s the public could obtain amphetamines, such as Benzedrine, in a variety of over-the-counter (OTC) nasal inhaler preparations. Abuse involved breaking open the inhalers and ingesting directly or soaking the fillers in alcohol or coffee. Although inhaler use may have introduced hundreds of thousands of Americans to amphetamine abuse, this type of abuse was most prevalent in prison populations and among deviant groups. The ability to cause euphoria, dysphoria, and psychic stimulation resulted in removal of amphetamine-like drugs from OTC inhaler preparations in 1971. However, amphetamine products remained available in pill, capsule, or injectable form. During World War...

International Patterns And Trends

Methamphetamine has been the single most prevalent drug of abuse in Japan since the 1940s. Based on indicators from law-enforcement data, epidemic patterns appeared at several periods during that time. The increase of methamphetamine abuse in Japan during the 1940s and early 1950s has been attributed to the wholesale appearance of the drug in the black market following World War II. Both amphetamine and methamphetamine were available to Japanese forces during the war and became widely used by the beleaguered civilian population following military defeat. In response to the escalation in abuse, Japan s Stimulants Drug Law of 1951 was enacted and the eventual decline in abuse was attributed to the effectiveness of the penal provisions of the law and subsequent control of the raw materials used to produce the drug. After a hiatus of fifteen years, Japan s methamphetamine abuse began to increase again and continued at relatively elevated levels through the mid-1980s. That epidemic...

Amsterdam Drug Use In

AMYGDALA The amygdala, a region of the brain, is part of the limbic system. The limbic system is a group of similar brain structures related functionally. They provide the basis for emotion and motivated behaviors including REWARD-related events. The amygdala is located in the temporal lobe and consists of several different parts. It plays a role in various brain functions including epilepsy, emotion, learning and memory, and drug abuse. The amygdala has long been established as an important area mediating stimulus-reward associations. This behavior is believed to play an important role in the seeking and using of drugs of abuse, especially COCAINE. An informative way to study drug abuse in animal models is through the SELF-ADMINISTRATION of drugs that are abused by humans. Rats can be trained to self-administer cocaine, and then the experimenter can interfere with the neurochemical transmission in the amygdala in particular, modulating DOPAMINE RECEPTORS and concentrations. The...

Gavril W Pasternak Anesthetic See Inhalants

Anhedonia may be idiopathic (of unknown cause), may occur as a side effect of certain drugs (for example, the NEUROLEPTICS), which act as do-pamine-receptor antagonists, or may be an aspect of certain psychiatric disorders, such as depression. It is conjectured that a state of anhedonia may occur during the ''crash'' that follows a prolonged bout of drug self-administration, particularly COCAINE or amphetamine-like stimulants. Dackis, C. A., and Gold, M. S. (1985). New concepts in cocaine addiction The dopamine depletion hypothesis. Neuroscience Biobehavioral Review, 9, 469-477. Wise, R. A. (1985). The anhedonia hypothesis Mark III.

Functional Magnetic Resonance Imaging

In the context of trying to use fMRI to understand the effects of drugs of abuse on the brain, it is important to consider the fact that some drugs have direct effects on the cerebral vasculature (Iadecola, 1998 Krimer et al., 1998), which will also alter BOLD signals independent of neuronal activity levels. Evidence of such a pharmacological effect is provided by the recent observation that ethanol, a vasodilator, reduces BOLD signal intensity changes in response to photic stimulation after oral administration (Levin et al., 1998b) (Chapter 6, Fig. 4). Pharmacological vasoconstriction, induced by cocaine, has been associated with increased BOLD signal intensity change within 5 min of drug administration (Levin 1999). That finding stands in contrast to the report of unaltered BOLD signal intensity 25 min following cocaine administration (Gollub et al., 1998). These apparently divergent findings are, perhaps, best reconciled by the observation that plasma cocaine levels peak...

Other Magnetic Resonance Methods

The 3DTOF technique acquires multiple thin slice ( 1.5 mm thick) images of brain which are used to reconstruct composite images of the brain vascular system. The composite images are known as maximum intensity projections (MlPs) and include only the brightest pixels from each source image which presumably are from flowing blood. It is possible to produce maximum intensity projection images in many different orientations using 3DTOF data. Angiographic techniques may be particularly useful in characterizing the blood flow abnormalities associated with acute and chronic drug abuse.

James A Inciardi Revised by Frederick K Grittner

In 1977, a U.S. government interagency team led by the Office of Drug Abuse Policy (ODAP) conducted a comprehensive review of border control and recommended consolidation of the principal border-control functions into a single bordermanagement agency. Executive departments failed to agree on distribution of resources and organizational placement of the new agency. The bordermanagement agency never materialized. As for policing illegal narcotic shipments, the U.S. Customs Service has employed technology to assist its agents. For example, giant x-ray machines have been installed at ports of entry. Trucks and their cargo are examined in this non-intrusive way to detect cocaine vapors. Other high-tech equipment, such as night-vision goggles, motion sensors and low-light TV cameras are now being used on the border.

Biological Basis Of Addiction

Havioral effects that are not the same in everybody and can even change in the same individual. For example, alcohol can produce feelings of euphoria in a social situation or depression when one is alone. Another example is cocaine, a very potent stimulant of brain systems involved in euphoria and feelings of well-being. However, when animals are given simultaneous infusions of cocaine without control of delivery, cocaine becomes a stressor that will lead to the animal s death much faster than animals controlling and self-administering the drug. Dopamine Hypothesis of Drug Abuse. It is STIMULANTS like amphetamine and cocaine, which have direct actions upon dopamine releasing nerve cells, but convincing evidence for dopamine being primarily responsible for the abuse of alcohol (eth-anol) opiates, and particularly for BENZODIAZEPINES is lacking. Dopamine-releasing nerve cells clearly have an important function in the behavioral process and in the euphoria produced by psy-chomotor...

What Causes Bipolar Disorder

Bipolar disorder is likely caused by multiple factors that interact with each other. It often runs in families and there is a genetic component to the disorder. For example, your chances of getting bipolar disorder are higher if your parents or siblings have this disorder. However, even though someone may have inherited the genes for bipolar disorder, there is no guarantee that this person will develop the disorder. A stressful environment or negative life events may interact with an underlying genetic or biological vulnerability to produce the disorder. In other words, some people are born with genes that make it more likely that they will get bipolar disorder. It is not known why some people with these genes develop bipolar disorder and others do not. Often, a stressful event seems to trigger the first episode. Therefore, an individual's coping skills or style for handling stress also may play a role in the development of symptoms. In some cases, drug abuse (e.g., alcohol,...

Britain Drug Use In The legal use of

In the early twentieth century, there was limited involvement either by doctors or by the state in the control of drug use and addiction. The supply of opiates and other drugs was controlled by the pharmaceutical chemist. As dispensers and sellers of drugs over the counter, they were the de facto agents of control. A rudimentary medical system of treatment operated via the Inebriates Acts (codified in 1890), whereby some inebriates could be committed to a form of compulsory institutional treatment. Legislation covered only liquids that were drunk (e.g., LAUDANUM) not injectables. Users of hypodermic morphine or cocaine were therefore not included under this system. Drug addiction was not perceived as a pressing social problem in early twentieth-century Britain, nor, indeed, was it one. Numbers of addicts decreased as overall consumption declined. No specific figures are available for that period, but various indicators, such as poisoning mortality statistics, indicate this conclusion....

British Journal Of Addictions

BRITISH SYSTEM OF DRUG-ADDICTION TREATMENT To many observers from outside the United Kingdom (U.K.), the British System is synonymous with heroin maintenance, with doctors supplying drugs on demand to addicts. To some it has been viewed as an approach of extreme folly to others it is an effective policy of supreme pragmatism. To those who know and work within it, the British System is somewhat

What Is The British System

An Evolving System of Health and Social Care for Drug Takers. Since the 1920s, the British policy toward addiction has been principally in the form of treatment conducted by medical practitioners. This differed from most other jurisdictions, particularly the United States, where addiction was deemed a deviant and criminal activity under the HARRISON NARCOTICS ACT (1914) through and until the revisions of the late 1960s and early 1970s. While the burden of care for drug takers has expanded over time from the general practitioner to specialist psychiatrist and then back to the generalist (often the general practitioner), the British System has to a large extent been located in the public-health sector, latterly in the National Health Service. Specialist drug-dependence clinics were established throughout the U.K. from the 1960s onward. 2. Control and Monitoring of Drug Takers and Their Physicians. The extent to which the British System has aimed to exercise control over drug takers has...

Milestones In The History Of The British System

Introduction of the Dangerous Drugs Act following the International Opium Convention at the Hague (1912). This restricts the dispensing of several drugs to physicians, including opiates and cocaine. The Dangerous Drugs Act implements the recommendations of the Brain Committee and prohibits physicians from prescribing heroin or cocaine to drug takers (except for the purpose of relieving pain caused by organic illness or injury) unless specially licensed by the Home Office. This practically restricts prescribing to the newly established specialist clinics.

Baseline Maximum Taper High DowM M

Comparison of representative brain SPECT images of heroin- and cocaine-abusing men enrolled in a placebo-controlled trial of the partial opiate agonist buprenorphine for the treatment of polydrug dependence. Images are from three subjects, receiving high or low dose buprenorphine (12 or 6 mg, respectively) or placebo, and studied at three separate time points (at baseline, at maximum dose during buprenorphine treatment, and following a taper off treatment). A comparable midcortical slice includes the basal ganglia, thalamus, and frontal, temporal, parietal, and occipital cortex. Arrows indicate perfusion defects. The subject receiving high dose buprenorphine shows marked improvement in perfusion, seen as dark (purple) areas becoming light (orange or yellow), whereas the patient receiving the low dose shows more mild improvement. The patient receiving placebo shows no improvement in perfusion. Following drug taper, buprenorphine treatment groups show reduced perfusion. These...

Civil Commitment Programs

The federal NARA and the California and New York compulsory treatment programs had a similar intent They made it possible for the necessary legislation to be enacted and for commitment procedures to be carried out. They served to control and rehabilitate the compulsive drug abuser by providing secure treatment environments as an alternative to regular incarceration in correctional facilities (Leukefeld & Tims, 1988). Eligible addicts convicted of a crime could be committed by the court or could choose commitment over incarceration. Addicts not involved in criminal proceedings could commit themselves voluntarily or could be involuntarily institutionalized upon the petition of another individual (such as a peace officer) (Mc-Glothlin, Anglin, & Wilson, 1977). Integral to each of these programs was supervised aftercare with antinarcotics testing. Length of commitment terms ranged from three years in NARA to seven years in CAP. daily heroin use as well as in property crime and...

Classification Of Drug Types

Cloning is an essential technique in modern molecular biology it is used widely in studying genetic effects in the drug-abuse field. Cloning much larger organisms such as cows and sheep is expected to have a major impact in that production of the best of any species can theoretically be accomplished by cloning. This is an important goal in agriculture today.

Marian W Fischman

COCA PLANT The coca plant is a cultivated shrub, generally found in the Andean Highlands and the northwestern areas of the Amazon in South America. The plant, however, can be grown in many parts of the world and in the early part of the twentieth century much of the cocaine used in medicine was obtained from plants grown in Asia. Of the more than 200 species of the genus Erythroxy-lon, only E. coca variety ipadu, E. novogranatense, and E. novogranatense variety truxillense contain significant amounts of COCAINE, ranging from 0.6 to 0.8 percent. In addition to cocaine, the leaves of the coca plant contain eleven other ALKALOIDS, although no others are extracted for their eu-phorogenic effects. Substantial cocaine plasma levels can be attained when coca leaves are chewed along with an alkaline substance, which increases the bioavail-ability of the drug by changing its pH. Volunteers allowed to chew either the leaf or the powdered form of coca mixed with an alkaline substance reported...

Albert D Arvallo Ronald Ross Watson

COCAINE The abuse of cocaine has become a major public-health problem in the United States since the 1970s. During that period it emerged from relative obscurity, described by experts as a harmless recreational drug with minimal toxicity. By the mid-1980s, cocaine use had increased substantially and its ability to lead to drug taking at levels that caused severe medical and psychological problems was obvious. Cocaine (also known as coke, snow, lady, CRACK and ready rock''), is an ALKALOID with both local anesthetic and Psychomotor Stimulant properties. It is generally taken in binge cycles, with periods of hours to days in which users take the drug repeatedly, alternating with periods of days to weeks when no cocaine is used. Many users are recalcitrant to treatment, and the introduction of substantial criminal penalties associated with its possession and sale have not yet been effective in reducing its prevalence of heavy use. In fact, although occasional use of cocaine diminished...

The Drugcrime Relationship

Coerced treatment is considered within the context of the relationship between drugs and crime that has been well documented. For example, since the mid-1970s, both the National Institute on Drug Abuse and the National Institute of Justice have supported projects to understand the drug-crime connection, with findings that suggest that drug use enhances criminal careers. In fact, a survey of inmates in state and federal correctional facilities indicates that 83 percent of state prisoners reported previous drug use and 57 percent reported using a drug in the month before their offense (BJS, 1998). The Drug Use Forecasting (DUF) system, renamed ADAM (Arrestee Drug Abuse Monitoring Program) has consistently reported that 51 to 83 percent of male arrestees in major urban cities test positive for drugs (ADAM Annual Report, 1998). In fact, two-thirds of prisoners are drug abusers whereas over 60 percent of persons who come into contact with jails and lock-ups use a drug other than alcohol at...

Chronic And Relapsing Nature Of Substance Abuse

It is easy to forget that drug abuse can be chronic and relapsing. Without proper followup and treatment, substance abusers often return to drug use. It is no secret that recovery is a difficult process that is not completely understood, with or without coerced treatment. Intervention and treatment efforts need to focus on those factors that keep individuals drug free. These options can range from urine testing to methadone treatment. Nevertheless, many people believe that substance-abuse treatment does not work. They cite professional and or personal experiences about individuals who immediately return to drug use during treatment and or supervision. However, after discussion it becomes clear that the proper blend of treatment combined with followup supervision, relapse prevention, and self-help Arrestee Drug Abuse Monitoring Program Annual Report. (1998). Washington, D.C. U.S. Government Printing Office. Belenko, S. (1998). Research on Drug Courts A Critical Review. National Court...

Historical And Institutional Factors

In the mid-to-late 1970s, the United States directed its international drug-control attention to eliminating the heroin and marijuana crossing our border at Mexico. As the U.S.-Mexican crackdown began to achieve positive results and the number of U.S. smokers of Mexican marijuana diminished, Colombian traffickers seized the opportunity to break into the lucrative U.S. drug market by smuggling large amounts of marijuana and small packages of cocaine. In the early 1980s, Florida became the destination of choice for smugglers because of its long coastlines, access to boats and planes, location in the Caribbean, and large Hispanic population by 1986, Colombia supplied an estimated 80 percent of the cocaine HCl. In controlling all stages of cocaine production, from cultivation to sale, Colombian traffickers have developed sometimes competitive, sometimes symbiotic, relationships with each other and with insurgent groups. The guerrillas benefit from the illicit drug trade by providing...

Drugreduction Efforts

Among the principal Andean SOURCE COUNTRIES for coca, Colombia has become most committed to defeating the cocaine cartels, since they threaten to undermine its society. Colombians recognize and fear that the violence and corruption endemic to drug trafficking are harming their economy, political system, and society. By the late 1990s, the government sought international assistance to overcome the growing power of drug organizations. CRAIG, R. B. (1987). Illicit drug traffic Implications for South American source countries. Journal of Inter-american and World Affairs, 29 (2), 1-34. GUGLIOTTA, G., & LEEN, J. (1989). Kings of cocaine Inside the Medellin cartel. New York Simon & Schuster.

Small Vessel Vasculitis

Other forms of small vessel vasculitis seen in adolescents include hypersensitivity vasculitis (usually following drugs such as penicillin, antithyroid agents, retinoids) that is treated by removing the offending agent, and cryoglobulinaemic vasculitis that is rarely seen in the context of hepatitis C and intravenous drug abuse.

The Acute Effects Of Alcohol

At the level of the cell, very high doses of alcohol (ethanol) seem to act by disrupting fat (lipid) structure in the central nervous system (anesthetic effect). Lower doses are thought to interact with various proteins and NEUROTRANSMITTERS (which act as Receptors), such as Glutamate, GABA (GaMMA-AmINO Butyric Acid), cyclic AMP (adenosine mono-phosphate), and G proteins. Other actions may involve ion (calcium) channels. The reinforcing (rewarding) effects of alcohol may be mediated via DOPAMINE (a neurotransmitter) in specific brain regions dopamine acts as an intermediary compound in the reinforcement process. The reinforcement of responses to other drugs of abuse, such as COCAINE, are also thought to be mediated via dopamine.

Acute Effects Of Other Drugs Of Abuse

Stimulants such as cocaine and AMPHETAMINE produce euphoria, increased confidence, increased sensory awareness, increased ANXIETY and suspi-ciousness, decreased appetite, and a decreased need for sleep. Physiological effects include increases in heart rate, blood pressure, and pupil size, and decreases in skin temperature. The term opioid refers to both drugs derived from OPIUM (opiates) and other synthetic drugs with similar actions those acting on the same receptor system. The term NARCOTIC is usually synonymous with opioid, but it can technically also include other drugs included in the HARRISON NARCOTIC ACT (e.g., cocaine). Opioids produce euphoria, sedation (to which rapid tolerance develops), itching, increased talkativeness, increased or decreased activity, a sensation of stomach turning, nausea, and vomiting. There are minor changes in blood pressure and the pupils become constricted (made smaller). Users of other drugs of abuse (e.g., cocaine and opioids) also have higher...

Alcohol Use And Abuse Among Adolescents

Another significant reason for concern about alcohol ingestion by adolescents is the close association of alcohol abuse with the use of other drugs. There is considerable evidence that alcohol use tends to precede use of illicit drugs, and some researchers argue that, based on long-term studies, alcohol serves as a ''gate-way'' to the use of illicit substances. As early as the eighth grade, alcohol users were found to have a significantly higher prevalence of cigarette smoking, and use of marijuana and cocaine than non-users of alcohol. This difference persists through grade 12 and thereafter (Kandel and Yamaguchi, 1993).

Substance Abuse And Other Anxiety Disorders

Panic attacks have been shown to be induced by psychostimulants, particularly COCAINE. The rate of panic attacks among users of cocaine has been reported to be as high as 64 percent. Anxiety symptoms during the withdrawal phase from cocaine also increases the risk for alcohol abuse and or benzodiazepine abuse. These substances are frequently used to ease the crash phase.

Substance Abuse And Schizophrenia

Only recently has the high prevalence of alcoholism in schizophrenia been noted. Likewise, the recognition of high rates of other substance abuse in the schizophrenic population was not appreciated until the 1980s. A review of published estimates of the prevalence of alcohol abuse in schizophrenia reported a range of 8.4 to 47 percent (Mueser, 1990). Stimulant abuse in this review was reported between 4 and 15 percent. The question of whether substance abuse induces a chronic schizophrenic-like psychosis even after the drugs are stopped is still open to debate. It is generally held, however, that individuals who develop schizophrenia coupled with drug abuse would most likely have developed schizophrenia regardless, but the abuse may have caused an earlier onset. The early drug use may represent efforts at self-treatment. Treatment of the schizophrenic with drug abuse presents a major clinical challenge. Such patients tend to be disruptive, prone to frequent relapse of psychosis and...

Substance Abuse And Attention Deficit Disorder

Children with attention deficit hyperactivity disorder (ADHD) have been noted to be at risk for development of alcoholism and cocaine abuse as they grow into adolescence and adulthood. Family studies of children with ADHD and alcoholism have demonstrated higher rates of alcoholism in family members than that seen in the general population. Goodwin (1975) compared previously hyperactive adult adoptees with and without alcoholism. As children, these alcoholics were hyperactive, truant, shy, aggressive, disobedient, and friendless. In these adoptees, those with alcoholism clearly had an excess of alcoholism in their biological parents. No alcoholism was found among the biological parents of the nonalcoholic hyperactive adoptees. These findings suggest that in the case of alcoholism and hyperactivity, the risk for alcoholism comes from a genetic basis and not necessarily from just having ADHD. It has been estimated that 15 to 20 percent of cocaine users might also be afflicted with ADHD....

Substance Abuse And Other Complications

(SEE ALSO Conduct Disorder Research Mood and Drugs Social Costs of Alcohol and Drug Abuse Structured Clinical Interview for DSM-III-R Vulnerability) New York State Psychiatric Institute. (1996). Who Gets Addicted to Cocaine and Why New York Psychiatric Institute Newsletter, 15. Regier, D. A., ET AL. (1990). Comorbidity of mental disorders and other drug abuse Results from the epidemiology catchment area (ECA) study. Journal of

Other Addictive Drugs

Multiple Substance Abuse and Nutrition. Drug abuse includes the experimental use of various addictive drugs as well as chronic addiction to one or more of these social drugs. The term addiction here refers both to PHYSICAL DEPENDENCE on the drug, such that when the drug is withdrawn specific physical withdrawal symptoms occur, and to PSYCHOLOGICAL Dependence on the drug even without physical dependence. Alcohol has been called the GATEWAY Drug, because its early use is frequently accompanied by and or followed by use of other drugs. and duration of use abuse, and the time in life when the drug or drugs are abused. NARCOTIC drugs, such as HEROIN, impair appetite so food intake is often diminished. If the drug is injected intravenously, malnutrition may be secondary to blood-borne bacterial infection or ACQUIRED IMMUNODEFICIENCY Syndrome (AIDS). Amphetamine (speed) is the stimulant drug that has the most inhibitory effect on appetite if taken in large doses, it also prevents sleep and...

Theories On The Drugscrime Relationship

In the late 1970s, drugs-crime theories became increasingly complex, partly because studies tended to have fewer methodological problems that interfered with the measurement of both drug use and crime. With improvements in techniques, researchers gradually become more aware of heterogeneity among drug abusers on many dimensions, including the type and severity of drug-use patterns and related criminal activity. Also, more recent studies have found that drug use and crime, in most instances, do not initially have a causal relationship but, rather, are often the joint result of multiple influences. Among the many factors contributing to drug use and or crime are those involving the fam ily, such as lack of parental supervision, parental rejection, family conflict, lack of discipline, and parental deviance association with deviant peers school dropout, failure, and discipline problems and early antisocial behavior. Consistent with the notion that all drug abusers are not alike, varying...

Classification Systems

Alcoholism and drug Addiction have been variously defined as medical diseases, mental disorders, social problems, and behavioral conditions. In some cases, they are considered the symptom of an underlying mental disorder (Babor, 1992). Some of these definitions permit the classification of alcoholism and drug dependence within standard nomenclatures such as the International Classification of Diseases and the Diagnostic and Statistical Manual of Mental Disorders. The recent revisions of both of these diagnostic systems has resulted in a high degree of compatibility between the classification criteria used in the United States and those used internationally. Both systems now diagnose dependence according to the elements first proposed by Edwards and Gross (1976). They also include a residual category (harmful alcohol use ICD-10 alcohol abuse DSM-III-R ) that allows classification of psychological, social, and medical consequences directly related to substance use.

The Dependence Syndrome Concept

The syndrome concept implicit in the diagnosis of alcohol and drug dependence in ICD and DSM is a way of describing the nature and severity of addiction (Babor, 1992). Table 2 describes four dependence syndrome elements in relation to the criteria for DSM-III-R, DSM-IV, and ICD-10. The same elements apply to the diagnosis of dependence on all psychoactive substances, including alcohol, marijuana, opiates, cocaine, sedatives, ph-encycledine, other hallucinogens, and tobacco. The elements represent biological, psychological (cognitive), and behavioral processes. This helps to explain the linkages and interrelationships that account for the coherence of signs and symptoms. The co-occurrence of signs and symptoms is the essential feature of a syndrome. If three or more criteria do occur repeatedly during the same period, it is likely that dependence is responsible for the amount, frequency, and pattern of the person's substance use. One explanation for the salience of drug and...

Daniel X Freedman R N Pechnick

DISEASE CONCEPT OF ALCOHOLISM AND DRUG ABUSE Throughout most of recorded history, excessive use of ALCOHOL was viewed as a willful act leading to intoxication and other sinful behaviors. The Bible warns against drunkenness Islam bans alcohol use entirely. Since the early nineteenth century, the moral perspective has competed with a conceptualization of excessive use of alcohol as a disease or disorder, not necessarily a moral failing. The disease (or disorder) concept has, in turn, been evolving with considerable In the United States, the ratification in 1920 of the Eighteenth Amendment, which prohibited the production, sale, and distribution of alcohol, temporarily dampened scientific inquiry into the nature of alcoholism. But concern about the problematic and excessive use of other drugs, such as Opioids, Cocaine, and Barbiturates, continued to stimulate writings both in the United States and

Early Models Of The Disease Concept

Meanwhile, from the late 1950s and throughout the 1960s, the Expert Committee on Addiction-Producing Drugs of the WORLD HEALTH ORGANIZATION (WHO) continued to formulate and refine definitions of addiction and HABITUATION that could facilitate WHO's responsibility (required by international treaties) for control of NARCOTICS, cocaine, and CANNABIS. In the 1950s, the presence of physical dependence was emphasized in the definition of drug dependence, and the WHO Expert Committee was still concerned with differentiating between psychic dependence and physical dependence. At one level, the concept of psychic dependence was compatible with the psychodynamic view that these disorders were a response to psychic distress (such as negative mood states). According to the psychodynamic model, excessive alcohol or drug consumption was merely a response to underlying psychopathology. This model was also consis tent with Jellinek's view of one of the species of alcoholism, in which individuals...

Problem Drinking As A Distinct Dimension

Some Recent Attempts to Define Alcoholism and or Drug Dependence Drug dependence. A state, psychic and sometimes also physical, resulting from the interaction between a living organism and a drug, characterized by behavioural and other responses that always include a compulsion to take the drug on a continuous or periodic basis in order to experience its psychic effects, and sometimes to avoid the discomfort of its absence. Tolerance may or may not be present. A person may be dependent on more than one drug. (World Health Organization Technical Report Series, 1969, no. 407, p. 6.) This definition was reaffirmed in the WHO Expert Committee on Drug Dependence Nineteenth Report, World Health Organization Technical Report Series, 1973, no. 526, p. 16. Alcoholism is a primary, chronic disease with genetic, psychosocial, and environmental factors influencing its development and manifestations. The disease is often progressive and fatal. It is characterized by continuous or periodic impaired...

From Psychic And Physical Dependence To Dependence Syndrome

The changing perspectives on the general concept of drug dependence, given momentum by the 1977 WHO report on alcohol and by other research, were ultimately reflected in changes in the definitions and other positions of the World Health Organization and in its 1980 International Classification of Diseases, 9th edition (ICD-9). With its publication, the concept of an alcohol dependence syndrome formally emerged at an international level. The ICD-9 concept of dependence was based on a 1976 proposal by researchers Griffith Edwards and Milton Gross, who defined seven characteristics of the alcohol dependence syndrome and proposed that there are certain implicit assumptions to the syndrome First, it is a symptom complex involving both biological processes and learning. Second, it should be defined along a continuum By the late 1970s, the American Psychiatric Association's Diagnostic and Statistical Manual, 3rd edition (DSM-III), moved away from more descriptive and psychodynamic...

Criteria For Diagnosis Of A Generic Dependence Disorder

The American Psychiatric Association's DSM-III-R, published in 1987, built on both DSM-III and the WHO memorandum. It presented nine criteria for diagnosing a generic dependence syndrome, applied to a wide variety of drugs. The user must have experienced at least three criteria in order for the practitioner to consider any degree of dependence to be present. Neither tolerance nor physical dependence was a required criterion. The presence of more than three criteria would indicate a more severe degree of dependence. Drug abuse was a residual category used for designating drug-related problems when dependence was not present. The DSM-III-R conceptualization of dependence was controversial. Because for many years physical dependence and tolerance had been considered evidence of ''true disease,'' many clinicians believed that changing these criteria from the necessary and required status they had had in DSM-III was a mistake that erroneously broadened the category of drug dependence. Much...

Challenges To The Disease Concept

The classic disease model of alcoholism and drug dependence has served as a challenge to some behavioral researchers and social scientists they have raised a number of questions about biologically based theories of such behaviors. Critics of the disease concept point to studies showing that some former alcoholics could apparently return to normal drinking. Such findings challenged the concept of alcoholism as a progressive disease. The concept of inevitable ''loss of control'' over drinking was also challenged by Merry's study (1966) in which alcoholics were given drinks containing either vodka or a placebo (no alcohol) on alternate days and reported having no more desire to drink after consuming the vodka than after the placebo. The results suggested that if ''loss of control'' did occur in alcoholics, it was not triggered as a biological response to alcohol but rather as a learned response with associated EXPECTANCIES concerning drinking behavior. Researchers Nancy Mello and Jack...

Locomotor response to psychostimulants

Suppression of glucocorticoids by removing the endogenous source of these hormones (i.e. adrenalectomy) reduces the psychomotor stimulant effects of cocaine (Marinelli et al., 1994) and amphetamine (Cador et al., 1993 Mormede et al., 1994). Detailed dose-response studies have shown that adrenalectomy does not modify the locomotor response to low doses of cocaine, but decreases the response to higher doses, thereby producing a vertical downward shift in the effects of psychostimulants and a 50 decrease in the maximal locomotor response to these drugs. The decrease in drug effects caused by adrenalectomy is corticosterone-dependent as it is dose-dependently reversed by exogenous administration of corticosterone (a subcutaneous corticosterone pellet delivering constant basal levels of the hormone) (Cador et al., 1993 Marinelli et al, 1997a). The response to cocaine is fully restored when basal concentrations of corticosterone are reached (Fig. 1). Locomotor Response to Cocaine (20 mg kg,...

Dropouts And Substance

As much is known about the substance use of those who become high school dropouts. Nonetheless, by putting together evidence from a variety of sources, including the NATIONAL HOUSEHOLD SURVEY ON DRUG Abuse and the Epidemiologic Catchment Area surveys sponsored by the U.S. government, it is possible to say that high school dropouts are much more likely to have started using TOBACCO, ALCOHOL, and other drugs, as compared with their peers who remained in school. There also is some evidence that dropping out of high school is associated with an increased risk of adult-onset alcohol-dependence syndromes, even among persons whose dropping out could not have been caused by the consequences of starting to drink during the adolescent years. Whether this conclusion also holds for adult-onset DEPENDENCE on other drugs such as Cocaine or Marijuana is not yet clear but is under study. In the meantime, the broad range of unfortunate effects of dropping out of school makes it important to sustain...

Selfadministration of psychostimulants

Several studies in rodents have shown that suppressing or reducing basal levels of circulating corticosterone decreases the reinforcing effects of psychostimulants as measured by intravenous self-administration. For example, suppression of glucocorticoids by adrenalectomy prevents the acquisition of cocaine self-administration over a wide range of cocaine doses (Goeders and Guerin, 1996a, 1996b). Detailed dose-response studies have shown that adrenalectomy induces a vertical downward shift of the dose-response curve to cocaine (Deroche et al., 1997b) during the maintenance phase indicating that, regardless of the cocaine dose, drug intake is always lower in adrenalectomized animals than in controls. These findings suggest that reducing circulating levels of glucocorticoids decreases the reinforcing efficacy of cocaine (Piazza et al., 2000). The decrease in drug effects is reversed dose-dependently by exogenous administration of corticosterone the response to cocaine is fully restored...

Trends In Drugrelated Emergencies And Deaths

In 1999, the largest number of episodes (196,277, or 35 of all episodes) were due to use of ALCOHOL in combination with other drugs. The other drugs mentioned most frequently were COCAINE (168,763, or 30 ), Heroin Morphine (84,409, or 15 ), amphetamine (11,954, or 2 ), and methamphetamine speed (10,447, or 2 ). In 1999, marijuana hashish mentions exceeded heroin morphine mentions, changing a rank ordering of illicit drug mentions that had been constant since Long-term Trends, 1990 1999. The number of drug-related episodes rose 49 percent from 1990 to 1999, from 371,208 to 554,932. Although males consistently outnumber females in illicit drug mentions, their long-term patterns of growth are similar. From 1990 to 1999, mentions of cocaine and heroin morphine more than doubled for both males and females. ED mentions of marijuana hashish in 1999 were five and six times their 1990 levels for males and females, respectively. Mentions of the four major illicit drugs increased from 1990 to...

Drug Interdiction The interdiction

Seize them, together with the transport and or persons that carry them on their way from the producing country to the importing country many of the SEIZURES occur just as the drugs are brought across the border. The principal drugs subject to U.S. interdiction are COCAINE and MARIJUANA, both of which are imported primarily from Latin America. The United States, uniquely among modern nations, has made interdiction a significant part of its effort to control the supply of drugs, at least for cocaine and marijuana, since about 1975. In addition to other federal agencies, it has involved the military in this effort. Though interdictors have seized large quantities of drugs, there are still numerous questions about the effectiveness of the program as a method of reducing the use of drugs, particularly cocaine.

Evaluation Techniques

Evaluation of the effectiveness of interdiction has been a vexed issue ever since the activity became prominent in the late 1970s. Very large quantities of drugs, particularly of cocaine, have been seized, but the size if such seizures has been cited both as evidence of success and of failure. It has been questioned whether more cocaine is being seized because interdictors are getting better at their job or because more cocaine is being shipped. demand for those drugs. As noted earlier, more stringent interdiction has two effects it raises prices and thus reduces final demand in the United States, but it also increases the amount that must be shipped to meet a given consumption (because of a higher replacement rate). It appears that, based on reasonable assumptions about the cost structure of the cocaine trade, the second effect has proven greater than the first.

Relapse in pychostimulant selfadministration

Although basal levels of corticosterone play a faciliatatory role on many behavioral responses to psychostimulants, their role in relapse is more controversial. Suppression of glucocorticoids does not seem to have important effects on relapse induced by drug priming. Thus, cocaine-induced reinstatement of drug seeking behavior is only minimally decreased by adrenalectomy (Erb et al., 1998), and is not modified by ketoconazole, which reduces circulating levels of corticosterone (Mantsch and Goeders, 1999b). Instead, corticosterone plays a significant role in cue-induced reinstatement of drug seeking, although this has only been examined following administration of ketoconazole. Treatment with ketoconazole prevents reinstatement of cocaine seeking behavior produced by contingent exposure to a light and tone previously paired with cocaine during self-administration (Goeders, 2002 Goeders and Clampitt, 2002). As we will see later, corticosterone seems to play a more important role in...

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