OPIOIDS (A)<5>
Database EMBASE
Accession Number 2006029820
Authors Sorge R.E. Rajabi H. Stewart J.
Institution
(Sorge, Rajabi, Stewart) Center for Studies in Behavioral Neurobiology, Department of Psychology, ConcordaUniversity, Montreal, Que., Canada.
(Stewart) Center for Studies in Behavioral Neurobiology, Concordia University, SP-A-244, 7141 Sherbrooke St. W., Montreal, Que. H4B 1R6, Canada.
Country of Publication
United Kingdom
Title
Rats maintained chronically on buprenorphine show reduced heroin and cocaine seeking in tests of extinction and drug-induced reinstatement.
Source
Neuropsychopharmacology. 30(9)(pp 1681-1692), 2005. Date of Publication: Sep 2005.
Abstract
Buprenorphine is being introduced as a maintenance therapy in opioid addiction, but it is not clear how buprenorphine will affect co-use of cocaine in opioid users. We examined the effects of chronic buprenorphine (BUP0: 0.0 mg/kg/day; BUP1.5: 1.5 mg/kg/day; BUP3: 3.0 mg/kg/day) on the locomotor activity effects of acute heroin (0.25 mg/kg, subcutaneously (s.c.)) and cocaine (20 mg/kg, intraperitoneally (i.p.)). Buprenorphine had no effect on the stimulatory effect of heroin, but potentiated the locomotor response to cocaine. To investigate further the interactions between buprenorphine (BUP1.5 and BUP3), heroin (0.125, 0.25 and 0.375 mg/kg, s.c.), and cocaine (10, 20 and 30 mg/kg, i.p.), we used in vivo microdialysis and high-performance liquid chromatography to analyze extracellular levels of dopamine (DA) in the nucleus accumbens (NAc). Buprenorphine attenuated the heroin-induced rise in NAc DA, but greatly potentiated the cocaine-induced rise. Finally, we examined the potential of the highest dose of buprenorphine (BUP3) to reduce heroin and cocaine seeking in the presence of drug-associated cues under extinction conditions and in tests for reinstatement induced by heroin (0.25 mg/kg, s.c.), cocaine (20 mg/kg, i.p.), and 15-min footshock stress (0.8 mA, 0.5 s/shock, 40 s mean OFF time) in rats trained to self-administer both drugs. Buprenorphine reduced heroin and cocaine seeking during extinction and following acute heroin and cocaine priming injections, but had no effect on stress-induced reinstatement. These results indicate that the suppression of responding following priming injections of drugs did not result from reduced motor activity, but possibly from a reduction in the salience of drug-associated cues induced by chronic buprenorphine treatment. copyright 2005 Nature Publishing Group. All rights reserved.
ISSN 0893-133X
Publication Type Journal: Article
Journal Name Neuropsychopharmacology
Volume 30
Issue Part 9
Page 1681-1692
Year of Publication 2005
Date of Publication Sep 2005
OPIOIDS <15>
Database EMBASE
Accession Number 2005579198
Authors Joseph R. Moselhy H.F.
Institution
(Joseph) Department of General Adult Psychiatry, Lyndon Clinic, Hobs Meadow, Solihull, BirminghamB92 8RW, United Kingdom.
(Moselhy) Department of Addiction Psychiatry, Sandwell Mental Health NHS and Social Care Trust, West Bromwich, United Kingdom.
Country of Publication
United Kingdom
Title
National survey of methadone prescribing for maintenance treatment: 'Opiophobia' among substance misuse services?
Source
Psychiatric Bulletin. 29(12)(pp 459-461), 2005. Date of Publication: Dec 2005.
Abstract
Aims and method: The aims of this study were to describe the characteristics of substance misuse services prescribing methadone for maintenance treatment of opioid dependence and to determine the average daily doses of methadone prescribed across England. A postal questionnaire survey of all substance misuse treatment centres in England was carried out. Results: A total of 298 treatment centres were identified and contacted, 212 of which responded to the survey (response rate of 71%). Of these, 157 were prescribing methadone for maintenance treatment; the majority (71%) were community-based and 125 centres had doctors attached. The most common formulation of methadone prescription was oral methadone mixture (152 centres, 97%). The mean daily dose of methadone prescribed was 47 mg. Surprisingly, 37 (24%) of the respondents felt that methadone maintenance treatment should be time-limited and 21 teams (13%) stated that patients should receive only drug substitution and no psychosocial interventions. Clinical implications: There is currently a move among substance misuse services towards community-based treatment. In our survey, the mean daily dose of methadone prescribed was less than the dosage recommended by the Department of Health. This suggests that specialist addiction services are continuing to underprescribe heroin substitutes. The inadequate understanding of some of the respondents of the basic principles of methadone maintenance treatment also raises concerns, and highlights the need for further training and education.
ISSN 0955-6036
Publication Type Journal: Article
Journal Name Psychiatric Bulletin
Volume 29
Issue Part 12
Page 459-461
Year of Publication 2005
Date of Publication Dec 2005
OPIOIDS <20>
Database EMBASE
Accession Number 2005568809
Authors Goodwin J.L.R. Kraemer J.J. Bajwa Z.H.
Institution
(Goodwin) P.O. Box 1676, Mount Shasta, CA96067, United States.
Country of Publication
United Kingdom
Title
The use of opioids in the treatment of osteoarthritis: When, why, and how?
Source
Current Pain and Headache Reports. 9(6)(pp 390-398), 2005. Date of Publication: Dec 2005.
Abstract
As life expectancy increases every decade, the incidence and prevalence of osteoarthritis (OA) also will increase. Despite progress in our knowledge of the pathophysiology of OA, the management of OA-mediated pain continues to challenge physicians. Concern regarding the cardiovascular effects of cyclooxygenase-2 inhibitors and the gastrointestinal and renal side effects of nonsteroidal anti-inflammatory drugs (NSAIDs) in general has limited the use of these medications in the management of chronic non-cancer pain. Appropriately dosed and monitored use of opioids for OA pain, when more conservative methods have failed, has potentially fewer life-threatening complications associated with it than the more commonly and often less successfully employed pharmacotherapeutic approaches to care. When used as part of a multimodal approach to pain control, opioids are a safe and effective treatment for joint pain, including that of OA. Patients for whom NSAIDs are contraindicated, or for whom combined acetaminophen, tramadol, and NSAID therapy is ineffective, may be started on low-dose opioids and titrated as needed and tolerated. Patient education and informed consent, exercise, complementary medicine, and the use of a controlled substance agreement increases the likelihood of patient compliance with treatment guidelines, improving functional capacity and quality of life. Copyright copyright 2005 by Current Science Inc.
ISSN 1531-3433
Publication Type Journal: Review
Journal Name Current Pain and Headache Reports
Volume 9
Issue Part 6
Page 390-398
Year of Publication 2005
Date of Publication Dec 2005
OPIOIDS<23>
Database EMBASE
Accession Number 2005566624
Authors Raistrick D. West D. Finnegan O. Thistlethwaite G. Brearley R. Banbery J.
Institution
(Raistrick, Finnegan, Thistlethwaite, Brearley, Banbery) Leeds Addiction Unit, Leeds, United Kingdom.
(West) Leeds North-west Primary Care Group, Leeds, United Kingdom.
(Raistrick) 19 Springfield Mount, LeedsLS2 9NG, United Kingdom.
Country of Publication
United Kingdom
Title
A comparison of buprenorphine and lofexidine for community opiate detoxification: Results from a randomized controlled trial.
Source
Addiction. 100(12)(pp 1860-1867), 2005. Date of Publication: Dec 2005.
Abstract
Objective: To investigate whether a buprenorphine opiate detoxification regimen can be considered to be at least as clinically effective as a lofexidine regimen. Design: An open-label randomized controlled trial (RCT) using a non-inferiority approach. Non-inferiority is demonstrated if, within a 95% confidence interval, buprenorphine performs within a preset tolerance limit of clinically acceptable difference in outcomes and completion rates between the two treatments. Methods: Individuals ready for heroin detoxification were given information about the trial and invited to participate. Consenting participants (n = 210) were then randomized to one of the two treatments. Detoxification was undertaken in a specialist out-patient clinic according to predefined protocols. The primary outcome was whether or not an individual completed the detoxification. Abstinence at 1-month follow-up was used as a secondary outcome measure. Additional secondary outcome measures were substance use, dependence, psychological health, social satisfaction, and treatment satisfaction. Data were also collected for individuals who declined randomization and instead chose their treatment (n = 271). Results: A total of 46% of those on lofexidine and 65% of those on buprenorphine completed detoxification. Of these, 35.7% of the lofexidine and 45.9% of the buprenorphine groups reported abstinence at 1 month. Of those not completing detoxification abstinence was reported at 27.5% and 29.0%, respectively; 271 individuals who opted not to be allocated randomly and instead chose one of the two treatments produced similar results. Conclusions: Buprenorphine is at least as effective as lofexidine detoxification treatment. Whether or not individuals were randomized to, or chose, a treatment appeared not to affect the study's outcome. copyright 2005 Society for the Study of Addiction.
ISSN 0965-2140
Publication Type Journal: Article
Journal Name Addiction
Volume 100
Issue Part 12
Page 1860-1867
Year of Publication 2005
Date of Publication Dec 2005
OPIOIDS<26>
Database EMBASE
Accession Number 2005566621
Authors Paterson S. Lintzeris N. Mitchell T.B. Cordero R. Nestor L. Strang J.
Institution
(Paterson, Cordero) Toxicology Unit, ImperialCollegeLondon, United Kingdom.
(Lintzeris, Mitchell, Nestor, Strang) National Addiction Centre, Institute of Psychiatry, KingsCollegeLondon, United Kingdom.
(Lintzeris) National Drug and Alcohol Research Centre, University of New South Wales, Kensington, NSW, Australia.
(Lintzeris) C/O National Addiction Centre, 4 Windsor Walk, LondonSE5 8AF, United Kingdom.
Country of Publication
United Kingdom
Title
Validation of techniques to detect illicit heroin use in patients prescribed pharmaceutical heroin for the management of opioid dependence.
Source
Addiction. 100(12)(pp 1832-1839), 2005. Date of Publication: Dec 2005.
Abstract
Background: The clinical implementation and evaluation of heroin substitution programmes have been confounded by the lack of objective and validated biomarkers for illicit heroin use in patients prescribed pharmaceutical heroin. This study examined the capacity to detect illicit heroin use by gas chromatography-mass spectrometry (GC-MS) analysis of urine samples for the presence of opium impurities common to illicit, but not pharmaceutical heroin. Aims: To characterize the diagnostic properties of the metabolites of noscapine and papaverine in comparison to morphine as a gold-standard marker of illicit heroin use: and to examine the relationships between the self-reported time since most recent heroin use and the detection of these opioids in urine. Design: A cross-sectional study of 52 opioid-dependent patients in treatment (not prescribed heroin), who self-reported illicit heroin use within the preceding 2 weeks. Self-report data regarding recent drug use and a urine sample were collected. GC-MS analyses of urines were conducted and reported by laboratory staff blinded to self-report data. Findings: The metabolites of papaverine (hydroxypapaverine and dihydroxypapeverine) were found to have high sensitivity, specificity and negative predictive values as markers for illicit heroin use compared to the 'gold-standard' morphine. Other opioids, including 6-mono-acetylmorphine (6-MAM), codeine and noscapine metabolites (e.g. meconine) were less adequate in detecting heroin use. Conclusions: GC-MS detection of papaverine metabolites in urine appears to be suitable method of identifying illicit heroin use for clinical and research purposes. copyright 2005 Society for the Study of Addiction.
ISSN 0965-2140
Publication Type Journal: Article
Journal Name Addiction
Volume 100
Issue Part 12
Page 1832-1839
Year of Publication 2005
Date of Publication Dec 2005
OPIOIDS <27>
Database EMBASE
Accession Number 2005566620
Authors Baca C.T. Grant K.J.
Institution
(Baca, Grant) Center on Alcoholism, Substance Abuse, and Addictions (CASAA), Family and Community Medicine, University of New Mexico, Albuquerque, NM, United States.
(Baca) 160 Washington SE #62, Albuquerque, NM87108, United States.
Country of Publication
United Kingdom
Title
Take-home naloxone to reduce heroin death.
Source
Addiction. 100(12)(pp 1823-1831), 2005. Date of Publication: Dec 2005.
Abstract
Background: This paper reviews the relevant literature related to the distribution of take-home naloxone. Methods: A Medline search was conducted on articles published between January 1990 and June 2004 to identify scientific literature relevant to this subject. Those publications were reviewed, and from them other literature was identified and reviewed. Results: The prevalence, pathophysiology and circumstances of heroin overdose, and also bystander response are included in this review. Naloxone peer distribution has been instituted to varying degrees in the United States, Italy, Spain, Germany and the United Kingdom. Conclusion: At this point the evidence supporting naloxone distribution is primarily anecdotal, although promising. Although the distribution of naloxone holds promise for further reducing heroin overdose mortality, problems remain. Naloxone alone may be insufficient in some cases to revive the victim, and cardiopulmonary resuscitation (CPR), especially rescue breathing, may also be needed. A second dose of naloxone might be necessary. Complications following resuscitation from overdose may infrequently need in-hospital care. Mortality from injecting without anyone else present will be unaffected by take-home naloxone. Take-home naloxone should be studied in a rigorous scientific manner. copyright 2005 Society for the Study of Addiction.
ISSN 0965-2140
Publication Type Journal: Review
Journal Name Addiction
Volume 100
Issue Part 12
Page 1823-1831
Year of Publication 2005
Date of Publication Dec 2005
OPIOIDS<34>
Database EMBASE
Accession Number 2005561578
Authors Jagsch R. Gombas W. Schindler S.-D. Eder H. Moody D.E. Fischer G.
Institution
(Jagsch) Faculty of Psychology, Clinical and Health Psychology, University of Vienna, Vienna, Austria.
(Gombas) Department of Social Psychiatry, University Hospital of Vienna, Vienna, Austria.
(Schindler, Eder, Fischer) Department of General Psychiatry, University Hospital of Vienna, Vienna, Austria.
(Moody) Center for Human Toxicology, University of Utah, Salt Lake City, UT, United States.
(Jagsch) Faculty of Psychology, Clinical and Health Psychology, University of Vienna, Universitatsstrasse 7, 1010 Vienna, Austria.
Country of Publication
United Kingdom
Title
Opioid plasma concentrations in methadone- and buprenorphine-maintained patients.
Source
Addiction Biology. 10(4)(pp 365-371), 2005. Date of Publication: Dec 2005.
Abstract
This is the first trial to compare the relationship of opioid plasma concentrations in methadone- versus buprenorphine-maintained subjects. Sixty subjects (19 females and 41 males) seeking treatment who met Diagnostic and Statistical Manual version IV (DSM-IV) criteria for opioid dependence were recruited and treated at the Drug Addiction Outpatient Clinic at the University of Vienna. Of these, 44 (11 female and 33 male) were included in the analyses of plasma concentrations. Subjects received either daily sublingual buprenorphine (2 mg or 8 mg tablets; maximum daily dose: 8 mg) or oral methadone (racemic R-/S-methadone) and were maintained on a stable dose after an induction period of 2 weeks. Mean dose and mean plasma concentrations were correlated on an individual and collective basis. Correlation was 0.51 for buprenorphine, whereas the score for methadone was 0.69. Intra-individual variation was much higher for buprenorphine (p < 0.0001), while the concentration-to-dose ratio was very small. Based on the differences of the pharmacokinetics of blood plasma of the two agents, we tried to explain the differences in the acceptance of treatment, which was significantly lower in the buprenorphine-maintained group. No such differences could be evaluated between completers and dropouts in buprenorphine-maintained subjects, neither concerning withdrawal scores nor dose, plasma concentration, concentration-to-dose ratios or intra-individual variation. copyright Society for the Study of Addiction to Alcohol and Other Drugs.
ISSN 1355-6215
Publication Type Journal: Article
Journal Name Addiction Biology
Volume 10
Issue Part 4
Page 365-371
Year of Publication 2005
Date of Publication Dec 2005
OPIOIDS<37>
Database EMBASE
Accession Number 2005561575
Authors Moshtaghi-Kashanian G.-R. Esmaeeli F. Dabiri S.
Institution
(Moshtaghi-Kashanian, Esmaeeli, Dabiri) Biochemistry Department, Medical School, Kerman University of Medical Sciences, Kerman, Iran, Islamic Republic of.
(Moshtaghi-Kashanian) Biochemistry Department, Medical School, Kerman University of Medical Sciences, POB 444, Kerman, Iran, Islamic Republic of.
Country of Publication
United Kingdom
Title
Enhanced prolactin levels in opium smokers.
Source
Addiction Biology. 10(4)(pp 345-349), 2005. Date of Publication: Dec 2005.
Abstract
In Iran, opium is smoked for pleasure or as a medication by some people. It is a complex mixture of 40 different alkaloids, including morphine and codeine along with many impurities. Although it is well established that opioids or tobacco affect many physiological functions in humans, to our knowledge there has been no specific study looking at these effects in opium smokers. To assess that, we investigated the circulating levels of prolactin, TSH, LH, FSH and testosterone in male opium smokers who also smoke cigarettes (n = 23, aged 28.4 +/- 4.1 years), and comparing this with the corresponding values for nicotine abusers (n = 12, 15-25 cigarettes/day) or a healthy control group (n = 20) of the same age. Our results showed that 86.96% of the opium-dependent and 41.67 % of the nicotine-dependent group displayed high prolactin values (p < 0.002). In addition, there was a positive correlation between the dose of opium and the plasma prolactin level of opium dependents (p = 0.748, p < 0.001). Low FSH was detected in 43.48% of the opium smokers and 50% of the cigarette smokers (p < 0.001) with normal LH and testosterone levels. TSH of the opium smokers was also lower than that of the other two groups (p < 0.002). In conclusion, the present data indicate that chronic opium and cigarette smoking may synergistically influence pituitary hormone production through the effects on neuropeptides produced either locally or systemic. copyright Society for the Study of Addiction to Alcohol and Other Drugs.
ISSN 1355-6215
Publication Type Journal: Article
Journal Name Addiction Biology
Volume 10
Issue Part 4
Page 345-349
Year of Publication 2005
Date of Publication Dec 2005
OPIOIDS <40>
Database EMBASE
Accession Number 2005561572
Authors Miller S.C.
Institution
(Miller) Addiction Services, VeteransAdministrationMedicalCenter, Dayton, OH, United States.
(Miller) Department of Psychiatry, WrightStateUniversitySchool of Medicine, Dayton, OH, United States.
(Miller) Building 302, Addiction Services, VA MedicalCenter, 4100 W. Third Street, Dayton, OH45428, United States.
Country of Publication
United Kingdom
Title
Dextromethorphan psychosis, dependence and physical withdrawal.
Source
Addiction Biology. 10(4)(pp 325-327), 2005. Date of Publication: Dec 2005.
Abstract
As part of a synthesis of evidence regarding the abuse and addiction liability of dextromethorphan (DM), an over-the-counter cough medicine available in over 140 preparations, an uncommonly published case of dextromethorphan dependence (addiction) is described, with specific, rarely published complications. The individual was interviewed and several medical databases were also reviewed (Medline, 1966-present; PubMed) for all content relating to the Keywords: dextromethorphan, abuse, dependence, cough medicine, addiction, withdrawal, psychosis. The patient evidenced history suggesting substance dependence, substance-induced psychosis and substance withdrawal in relation to DM. A literature review revealed that DM has specific serotonergic and sigma-1 opioidergic properties. Dextrorphan (DOR), the active metabolite of DM, has similar properties; however, DOR is a weaker sigma opioid receptor agonist, and a stronger NMDA receptor antagonist. DM and DOR display specific biological features of addiction, and are capable of inducing specific psychiatric sequelae. A specific, reproducible toxidrome with significant psychiatric effects occurred, when DM was abused at greater than indicated doses, with more profound and potentially life-threatening effects at even higher doses. DM withdrawal appears evident. DM's active metabolite, DOR, has pharmacodynamic properties and intoxication effects similar to dissociatives, and may be more responsible for the dissociative effect that this DM abuser sought. However, it is this same metabolite that may be fraught with the potentially life-threatening psychoses and dissociative-induced accidents, as well as addiction. While DM has been hypothesized as the most commonly abused dissociative, health-care providers seem largely unaware of its toxidrome and addiction liability. copyright Society for the Study of Addiction to Alcohol and Other Drugs.