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Neurologic Clinics Nov 2020Substance use disorders-and their associated neurologic complications-are frequently encountered by neurologists as well as emergency room physicians, internists,... (Review)
Review
Substance use disorders-and their associated neurologic complications-are frequently encountered by neurologists as well as emergency room physicians, internists, psychiatrists, and medical intensivists. Prominent neurologic sequelae of drug abuse, such as seizure and stroke, are common and often result in patients receiving medical attention. However, less overt neurologic manifestations, such as dysautonomia and perceptual disturbances, may be initially misattributed to primary medical or psychiatric illness, respectively. This article focuses on the epidemiology, pharmacology, and complications associated with commonly used recreational drugs, including opioids, alcohol, marijuana, cocaine, and hallucinogens.
Topics: Humans; Illicit Drugs; Neurotoxicity Syndromes; Substance-Related Disorders
PubMed: 33040873
DOI: 10.1016/j.ncl.2020.08.005 -
Pharmacology, Biochemistry, and Behavior Jan 2020Addiction to drug and alcohol is regarded as a major health problem worldwide for which available treatments show limited effectiveness. The biggest challenge remains to... (Review)
Review
Addiction to drug and alcohol is regarded as a major health problem worldwide for which available treatments show limited effectiveness. The biggest challenge remains to enhance the capacities of interventions to reduce craving, prevent relapse and promote long-term recovery. New strategies to meet these challenges are being explored. Findings from preclinical work suggest that environmental enrichment (EE) holds therapeutic potential for the treatment of substance use disorders, as demonstrated in a number of animal models of drug abuse. The EE intervention introduced after drug exposure leads to attenuation of compulsive drug taking, attenuation of the rewarding (and reinforcing) effects of drugs, reductions in control of behavior by drug cues, and, very importantly, relapse prevention. Clinical work also suggests that multidimensional EE interventions (involving physical activity, social interaction, vocational training, recreational and community involvement) might produce similar therapeutic effects, if implemented continuously and rigorously. In this review we survey preclinical and clinical studies assessing the efficacy of EE as a behavioral intervention for substance use disorders and address related challenges. We also review work providing empirical evidence for EE-induced neuroplasticity within the mesocorticolimbic system that is believed to contribute to the seemingly therapeutic effects of EE on drug and alcohol-related behaviors.
Topics: Animals; Brain; Conditioning, Psychological; Environment; Exercise; Humans; Recurrence; Substance-Related Disorders; Treatment Outcome
PubMed: 31778722
DOI: 10.1016/j.pbb.2019.172829 -
Forensic Science Review Jul 2023Drug usage data in a community has traditionally been obtained through population surveys, records from law enforcement activities related to drug-related crime, drug... (Review)
Review
Drug usage data in a community has traditionally been obtained through population surveys, records from law enforcement activities related to drug-related crime, drug treatment centers, prison data, and hospital records. Wastewater-based epidemiology has gained traction in the last 10 years as a formidable complimentary tool to monitor, track, and estimate community consumption of both illicit and therapeutic drugs within a community. In wastewater-based epidemiology, targeted biomarkers (parent drug and/or metabolite) of illicit and therapeutic drugs are quantified in wastewater and back-calculated to community consumption. In conjunction with more traditional methods of obtaining drug usage data, information from wastewater-based epidemiology has been used to detect the types and amounts of drugs being used within a community. One of the main advantages of wastewater-based epidemiology is the near-real-time data obtained from it, which assists with the quick adaptation of both harm reduction and supply mitigation strategies. Wastewater-based epidemiology has also seen an increase in forensic application through the detection of production facilities within a community, determining the synthesis route of certain illicit drugs like methamphetamine, and enantiomeric profiling to distinguish between illicit and therapeutic use of drugs. This review summarizes the main focus areas and applications of wastewater-based epidemiology from a forensic perspective.
Topics: Humans; Wastewater; Substance Abuse Detection; Illicit Drugs; Substance-Related Disorders; Forensic Sciences
PubMed: 37531496
DOI: No ID Found -
Spine Oct 2019Retrospective analysis of data extracted from the MarketScan database (2000-2016) using International Classification of Diseases (ICD)-9, ICD-10, and Current Procedural...
STUDY DESIGN
Retrospective analysis of data extracted from the MarketScan database (2000-2016) using International Classification of Diseases (ICD)-9, ICD-10, and Current Procedural Terminology-4 codes.
OBJECTIVE
Evaluate the economic costs and health care utilization associated with spine infections.
SUMMARY OF BACKGROUND DATA
Spinal infections (SI) are associated with significant morbidity and mortality. A recent spike in SI is attributed to the drug abuse epidemic. Management of SI represents a large burden on the health care system.
METHODS
We assessed payments and outcomes at the index hospitalization, 1-, 3-, 6-, and 12-month follow up. Outcomes assessed included length of stay, complications, operation rates, and health care utilization. Outcomes were compared between cohorts with spinal infections: (1) with prior surgery, (2) drug abuse, and (3) without previous exposure to surgery or drug abuse, denoted as control.
RESULTS
We identified 43,972 patients; 15.6% (N = 6847) of patients underwent prior surgery, 3.8% (N = 1,668) were previously expose to drug abuse while 80.6% fell into the control group. Both the postsurgical and drug abuse groups longer hospital stay compared with the control cohort (5 d vs. 4 d, P < 0.0001). Exposure to IV drug abuse was associated with increased risk of complications compared with the control group (43% vs. 38%, P < 0.0001). Payments at 1-month follow-up were significantly (P < 0.0001) higher among the postsurgical group compared with both groups. However, at 12-months follow-up, payments were significantly (P < 0.0001) higher in the drug abuse group compared with both groups. Only postsurgical infections were associated with higher number of surgical interventions both at presentation and 1 year follow up.
CONCLUSION
SI following surgery or IV drug abuse are associated with higher payments, complication rates, and longer hospital stays. Drug abuse related SI are associated with the highest complication rates, readmissions, and overall payments at 1 year of follow up despite the lower rate of surgical interventions.
LEVEL OF EVIDENCE
3.
Topics: Adult; Aged; Cohort Studies; Delivery of Health Care; Female; Hospitalization; Humans; Insurance, Health, Reimbursement; Male; Middle Aged; Patient Acceptance of Health Care; Postoperative Care; Postoperative Complications; Retrospective Studies; Spinal Diseases; Substance-Related Disorders; Time Factors
PubMed: 31145379
DOI: 10.1097/BRS.0000000000003102 -
PloS One 2022Prior research has found a high prevalence of childhood sexual abuse (CSA) among sexual minority men (SMM) in the US, and has indicated that CSA is associated with...
BACKGROUND
Prior research has found a high prevalence of childhood sexual abuse (CSA) among sexual minority men (SMM) in the US, and has indicated that CSA is associated with higher rates of alcohol and drug use disorders. However, most of these studies have focused almost exclusively on White SMM. We assessed associations of CSA, alcohol use, and drug use problems among adult Black SMM.
METHODS
Participants were 1,016 Black SMM recruited from six US cities (Atlanta, Boston, Los Angeles, New York City, San Francisco, and Washington, DC) between July 2009 and December 2011. We used hierarchical logistic regression to evaluate the associations between CSA, alcohol use problems (≥ 8 AUDIT), and drug use problems (excluding marijuana).
RESULTS
Mean (SD) age was 37.8 (11.7) years, and 28.6% and 49.2% reported alcohol and drug use disorders in the past six months, respectively. Most of the study participants reported history of CSA (70.3%). Adjusting for sociodemographic and confounding variables, CSA was associated with higher odds of alcohol use problems (odds ratio (OR) = 1.52, 95% CI 1.09, 2.12) and drug use problems (OR = 1.58, 95% CI 1.19, 2.10) than non-CSA group.
CONCLUSION
Prevalence of CSA is high among BSMM in the US and is positively associated with alcohol and drug use problems. Substance use interventions should address the psychological health needs of BSMM with a history of CSA.
Topics: Male; Adult; Child; Humans; Alcoholism; Cities; Child Abuse, Sexual; Substance-Related Disorders; Sexual and Gender Minorities
PubMed: 36548261
DOI: 10.1371/journal.pone.0279238 -
International Journal of Molecular... Sep 2022Recent data show that young people, mainly due to the pressure of some risk factors or due to disrupted interpersonal relationships, utilise greater reward value and... (Review)
Review
Could Alcohol Abuse and Dependence on Junk Foods Inducing Obesity and/or Illicit Drug Use Represent Danger to Liver in Young People with Altered Psychological/Relational Spheres or Emotional Problems?
Recent data show that young people, mainly due to the pressure of some risk factors or due to disrupted interpersonal relationships, utilise greater reward value and display greater sensitivity to the reinforcing properties of "pleasurable stimuli", specifically in those situations in which an enhanced dopamine release is present. Alcoholic beverages, foods rich in sugar and fat, and illicit drug use are pleasurable feelings associated with rewards. Research shows that there is a link between substance abuse and obesity in brain functioning. Still, alcohol excess is central in leading to obesity and obesity-related morbidities, such as hepatic steatosis, mainly when associated with illicit drug dependence and negative eating behaviours in young people. It is ascertained that long-term drinking causes mental damage, similarly to drug abuse, but also affects liver function. Indeed, beyond the pharmacokinetic interactions of alcohol with drugs, occurring in the liver due to the same metabolic enzymes, there are also pharmacodynamic interactions of both substances in the CNS. To complicate matters, an important noxious effect of junk foods consists of inducing obesity and obesity-related NAFLD. In this review, we focus on some key mechanisms underlying the impact of these addictions on the liver, as well as those on the CNS.
Topics: Adolescent; Alcoholism; Dopamine; Humans; Illicit Drugs; Liver; Obesity; Substance-Related Disorders; Sugars
PubMed: 36142317
DOI: 10.3390/ijms231810406 -
Alternative Therapies in Health and... Sep 2023Drug addiction, or substance abuse disorder, has a long history. The use of a drug that causes dependence has been used in various religious and tribal initiation... (Review)
Review
BACKGROUND
Drug addiction, or substance abuse disorder, has a long history. The use of a drug that causes dependence has been used in various religious and tribal initiation ceremonies. Currently, recreational use or peer modelling leads an individual to substance abuse. The magnitude of the problem of addiction increases multifold in the presence of stressors like broken families, joblessness, occupational stress, etc.
OBJECTIVES
The de-addiction process is used to relieve an individual's craving for the drug. It is a painful process, as several effects of withdrawal compel a person to return to the drugs again and again. Our aim is to explore the available literature on the use of Unani medicine for de-addiction.
METHODOLOGY
We surveyed various classical books from the available literature for drug de-addiction in Unani medicine. Indexed journals were also surveyed for the available related material using various keywords like "opium addiction" and "Unani medicine and de-addiction " and the information was filtered for this review.
RESULTS
We observed that there was an elaborate scheme for de-addiction in opium addiction and the process is so general that it could serve as a framework for the de-addiction process for other similar drugs.
CONCLUSION
Unani medicine is significant in the literature as being among the the available de-addiction addiction processes and may furnish several leads for various herbal drugs that may be used for de-addiction in the future.
Topics: Humans; Medicine, Unani; Substance-Related Disorders
PubMed: 35452418
DOI: No ID Found -
Giornale Italiano Di Cardiologia (2006) Jun 2022Cocaine abuse is widely increasing, especially in younger individuals. Cocaine is a major cause of chest pain and acute coronary syndrome and is the leading cause for...
Cocaine abuse is widely increasing, especially in younger individuals. Cocaine is a major cause of chest pain and acute coronary syndrome and is the leading cause for drug abuse-related visits to emergency departments, most of which are due to cardiovascular complaints. Cocaine use, especially long-term, is associated with an increased risk of all-cause mortality, and with several significant, life-threatening cardiovascular diseases although the multifactorial underlying cellular and molecular pathophysiological mechanisms of acute and chronic cocaine cardiotoxicity are not well established due to limited studies. Current findings have important public health implications, reinforcing recommendations for substance use screening among young adults with heart diseases, and highlighting the need for education on its deleterious effects. Cocaine should be considered a cardiovascular risk factor, requiring attention to early detection of vascular disease in cocaine users.
Topics: Cardiovascular Diseases; Cocaine; Cocaine-Related Disorders; Heart Disease Risk Factors; Humans; Risk Factors; Substance-Related Disorders; Young Adult
PubMed: 35674035
DOI: 10.1714/3810.37941 -
Journal of Hazardous Materials Sep 2020Drug abuse trends in South Korea were assessed by estimating the consumption rates of drugs that may be abused or misused by performing wastewater-based drug...
Drug abuse trends in South Korea were assessed by estimating the consumption rates of drugs that may be abused or misused by performing wastewater-based drug epidemiology. Of the 29 target compounds, 10 were found in samples from three wastewater treatment plants. Ephedrine had the highest mean estimated consumption rate, 574.1 mg d (1000 people). The anti-obesity drugs phendimetrazine and phentermine had the second and fifth highest mean estimated consumption rates, 182.9 and 113.1 mg d (1000 people), respectively. The zolpidem consumption rate was 65.8 mg d (1000 people). Methamphetamine was the only illicit drug detected in wastewater, and the estimated consumption rates (14.9-28.6 mg d (1000 people)) were similar to consumption rates found in previous Korean studies (not detected to 45.8 mg d (1000 people)). The mean estimated meperidine and cis-tramadol (opioid) consumption rates were 120 and 27.5 mg d (1000 people), respectively, and were 8.2 and 1.7 times higher, respectively, than the consumption rates found in 2013. Methylphenidate was detected in the influent and effluent samples at mean concentrations of 2.7 and 2.6 ng L, respectively, but the methylphenidate consumption rate could not be estimated because of the low excretion rate for humans (<1%).
Topics: Humans; Illicit Drugs; Republic of Korea; Substance-Related Disorders; Wastewater; Wastewater-Based Epidemiological Monitoring; Water Pollutants, Chemical
PubMed: 32388180
DOI: 10.1016/j.jhazmat.2020.122622 -
Experimental Neurology May 2021The heightened incidence of opioid use during pregnancy has resulted in unprecedented rates of neonates prenatally exposed to opioids. Prenatal opioid exposure (POE)... (Review)
Review
The heightened incidence of opioid use during pregnancy has resulted in unprecedented rates of neonates prenatally exposed to opioids. Prenatal opioid exposure (POE) results in significantly adverse medical, developmental, and behavioral outcomes in offspring. Of growing interest is whether POE contributes to future vulnerability to substance use disorders. The effects of POE on brain development is difficult to assess in humans, as the timing, dose, and route of drug exposure together with complex genetic and environmental factors affect susceptibility to addiction. Preclinical models of POE have allowed us to avoid methodological difficulties and confounding factors of POE in humans. Here, we review the effects of maternal opioid exposure on the developing brain with an emphasis on the neurobiological basis of drug addiction and on preclinical models of POE and their limitations. These studies have indicated that POE increases self-administration of drugs, reward-driven behaviors in the conditioned place paradigm, and locomotor sensitization. While addiction is multifaceted and vulnerability to drug addiction is still inconclusive in human studies of prenatally exposed infants, animal studies do provide a noteworthy corroboration of negative behavioral outcomes.
Topics: Analgesics, Opioid; Animals; Conditioning, Psychological; Female; Humans; Locomotion; Pregnancy; Prenatal Exposure Delayed Effects; Substance-Related Disorders
PubMed: 33516730
DOI: 10.1016/j.expneurol.2021.113621