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Cancer Epidemiology, Biomarkers &... Mar 2020There is little information on human exposure to carcinogens and other toxicants related to opiate use, alone or in combination with tobacco.
BACKGROUND
There is little information on human exposure to carcinogens and other toxicants related to opiate use, alone or in combination with tobacco.
METHODS
Among male participants of the Golestan Cohort Study in Northeast Iran, we studied 28 never users of either opiates or tobacco, 33 exclusive cigarette smokers, 23 exclusive users of smoked opiates, and 30 opiate users who also smoked cigarettes (dual users; 21 smoked opiates and 9 ingested them). We quantified urinary concentrations of 39 exposure biomarkers, including tobacco alkaloids, tobacco-specific nitrosamines, polycyclic aromatic hydrocarbons (PAH), and volatile organic compounds (VOC), and used decomposition to parse out the share of the biomarker concentrations explained by opiate use and nicotine dose.
RESULTS
Dual users had the highest concentrations of all biomarkers, but exclusive cigarette smokers and exclusive opiate users had substantially higher concentrations of PAH and VOC biomarkers than never users of either product. Decomposition analysis showed that opiate use contributed a larger part of the PAH concentrations than nicotine dose, and the sum of 2- and 3-hydroxyphenanthrene (∑-phe) resulted almost completely from opiate use. Concentrations of most VOC biomarkers were explained by both nicotine dose and opiate use. Two acrylamide metabolites, a 1,3-butadiene metabolite and a dimethylformamide metabolite, were more strongly explained by opiate use. Acrylamide metabolites and ∑-phe were significantly higher in opiate smokers than opiate eaters; other biomarkers did not vary by the route of opiate intake.
CONCLUSIONS
Both cigarette smokers and opiate users (by smoking or ingestion) were exposed to many toxicants and carcinogens.
IMPACT
This high exposure, particularly among dual opiate and cigarette users, can have a substantial global public health impact.
Topics: Administration, Oral; Adult; Biomarkers; Carcinogens; Cigarette Smoking; Cohort Studies; Humans; Iran; Male; Middle Aged; Opiate Alkaloids; Smoking, Non-Tobacco Products; Tobacco Products
PubMed: 31915141
DOI: 10.1158/1055-9965.EPI-19-1212 -
International Journal of Clinical... Nov 2010The interpretation of toxicological findings is critical for the thorough investigation of the use and abuse of psychoactive substances. A positive analytical result for... (Review)
Review
The interpretation of toxicological findings is critical for the thorough investigation of the use and abuse of psychoactive substances. A positive analytical result for a sample taken could usually result in criminal proceedings and a punitive outcome for the defendant whose sample was analysed. The detection of markers of illicit opiate misuse is important both in the management of substance misuse and in the postmortem identification of illicit opiate use. The aim of this study was to emphasise the role of opiate biomarkers available at the laboratory and in the clinical environment. Urine remains the biological tool of choice for qualitative detection of illicit drug use in a clinical setting, while quantitative accuracy remains strictly the domain of blood. Accurate interpretation of the screening tests within a clinical setting alongside other relevant information remains the key to the usefulness of any test. Moreover, the finding of a morphine/codeine concentration ratio in blood exceeding unity is a strong evidence that the person had used heroin, as opposed to having taken a prescription analgesic drug containing codeine.
Topics: Biomarkers; Humans; Morphine Dependence; Morphine Derivatives; Opiate Alkaloids; Opioid-Related Disorders; Pain; Substance Abuse Detection
PubMed: 20946276
DOI: 10.1111/j.1742-1241.2010.02373.x -
Disease-a-month : DM Sep 2016
Review
Topics: Analgesics, Opioid; Chronic Pain; Humans; Opiate Alkaloids; Opioid-Related Disorders
PubMed: 27569588
DOI: 10.1016/j.disamonth.2016.05.013 -
The American Journal of Psychiatry Feb 2022
Topics: Analgesics, Opioid; Depression; Depressive Disorder, Major; Double-Blind Method; Humans; Opiate Alkaloids
PubMed: 35105159
DOI: 10.1176/appi.ajp.2021.21121204 -
International Review of Neurobiology 2018Many factors, including social elements, influence drug addiction in humans and can be modeled in laboratory rodents. In general, the presence of social reward is... (Review)
Review
Many factors, including social elements, influence drug addiction in humans and can be modeled in laboratory rodents. In general, the presence of social reward is protective against drug abuse and the absence or removal of social reward in both humans and rodents increases vulnerability to drug addiction. The current review chapter is focused on studies from our lab that have examined the effects of sociosexual behavior in male rats on drug-induced behaviors, including changes in both psychostimulant and opiate behavior. Furthermore, we review the underlying neural mechanisms by which these effects occur. Together, these results may help elucidate the neural mechanisms underlying the interaction between social and drug rewards and the mechanisms by which a loss of social rewards increase the vulnerability to drug addiction development.
Topics: Animals; Behavior, Addictive; Behavior, Animal; Central Nervous System Stimulants; Dopaminergic Neurons; Male; Nucleus Accumbens; Opiate Alkaloids; Rats; Reinforcement, Psychology; Sexual Behavior, Animal; Signal Transduction; Social Behavior; Ventral Tegmental Area
PubMed: 30193706
DOI: 10.1016/bs.irn.2018.07.008 -
Brain Injury Jun 2020To assess the validity of the Westmead PTA scale in school-aged children treated with opiate analgesics.
OBJECTIVE
To assess the validity of the Westmead PTA scale in school-aged children treated with opiate analgesics.
METHOD
Twenty-eight hospitalized children without brain injury, aged between 8 and 16 years treated with opiate analgesics for pain relief following surgery were tested on the Westmead PTA scale. Pain and stress levels were also self-reported each day.
RESULTS
Only 29% (n = 7) of children assessed over four days obtained a maximum score of 12/12 on three consecutive days, thus 71% would have been deemed to have been in PTA when they were not. The percentage of children who obtained a maximum score significantly decreased over consecutive days of assessment, due to an increase in error rate on picture memory items. Self-reported pain and stress ratings were not correlated with PTA scores.
CONCLUSIONS
Opiate analgesia can disrupt performance on the Westmead PTA scale in school-aged children resulting in a high false-positive error rate. It is therefore important to record pain medication schedules and interpret results cautiously when opiate analgesia is used following a TBI. Alteration of the method of administration of the memory items should be researched as this may increase the validity of the scale for children with TBI treated with opiate analgesics.
Topics: Adolescent; Amnesia; Amnesia, Retrograde; Analgesics, Opioid; Child; Humans; Opiate Alkaloids; Schools
PubMed: 32497441
DOI: 10.1080/02699052.2020.1763460 -
Pediatric Pulmonology Sep 2023International consensus statements on depression and anxiety in adolescents and adults with cystic fibrosis (awCF) recommend assessment for comorbid substance misuse....
BACKGROUND
International consensus statements on depression and anxiety in adolescents and adults with cystic fibrosis (awCF) recommend assessment for comorbid substance misuse. However, at CF centers, the frequency and impact of substance misuse have not been well characterized, and best practices for prevention, identification, and evidence-based treatment have not been routinely implemented.
METHODS
Medical records of 148 awCF over 3 years were reviewed to determine the prevalence of substance misuse (alcohol or opiates) and its relationship with clinical variables and healthcare utilization. Independent sample t test for continuous outcomes and χ test for binary outcomes were used to compare groups with and without substance misuse.
RESULTS
Substance misuse was documented in 28 (19%) awCF, equally distributed between alcohol (n = 13) and opiates (n = 15). Adults with substance misuse were more likely to be male. The prevalence of diagnosed anxiety and depression did not differ significantly between groups, but those with substance misuse had more severe anxiety (Generalized Anxiety Disorder-7 Item [GAD-7]: 10.0 ± 6.1 vs. 3.3 ± 4.4; p < 0.001) and depressive symptoms (Patient Health Questionnaire-9: 10.4 ± 6.5 vs. 4.0 ± 4.8; p < 0.001). Adults with substance misuse had higher annual rates of missed outpatient CF visits, more frequent "sick" visits, more frequent and longer hospitalizations, and a higher mortality rate.
CONCLUSIONS
In awCF, substance misuse is common and associated with adverse indicators of emotional and physical health, including via proxy of service utilization, suggesting that systematic approaches to addressing substance misuse in CF clinics should be considered. Prospective, longitudinal study is warranted to elucidate the complex relationships between depression, anxiety, substance misuse, and health outcomes in individuals with CF.
Topics: Adolescent; Humans; Male; Adult; Female; Longitudinal Studies; Cystic Fibrosis; Prospective Studies; Substance-Related Disorders; Opiate Alkaloids
PubMed: 37294071
DOI: 10.1002/ppul.26541 -
Nature Communications Oct 2022The nucleus accumbens (NAc) is critical in mediating reward seeking and is also involved in negative emotion processing, but the cellular and circuitry mechanisms...
The nucleus accumbens (NAc) is critical in mediating reward seeking and is also involved in negative emotion processing, but the cellular and circuitry mechanisms underlying such opposing behaviors remain elusive. Here, using the recently developed AAV1-mediated anterograde transsynaptic tagging technique in mice, we show that NAc neurons receiving basolateral amygdala inputs (NAc) promote positive reinforcement via disinhibiting dopamine neurons in the ventral tegmental area (VTA). In contrast, NAc neurons receiving paraventricular thalamic inputs (NAc) innervate GABAergic neurons in the lateral hypothalamus (LH) and mediate aversion. Silencing the synaptic output of NAc neurons impairs reward seeking behavior, while silencing of NAc or NAc→LH pathway abolishes aversive symptoms of opiate withdrawal. Our results elucidate the afferent-specific circuit architecture of the NAc in controlling reward and aversion.
Topics: Mice; Animals; Nucleus Accumbens; Reward; Ventral Tegmental Area; Dopaminergic Neurons; Opiate Alkaloids
PubMed: 36271048
DOI: 10.1038/s41467-022-33843-3 -
The European Journal of Neuroscience Jul 2020Emotional arousal is one of several factors that determine the strength of a memory and how efficiently it may be retrieved. The systems at play are multifaceted; on one... (Review)
Review
The role of catecholamines in modulating responses to stress: Sex-specific patterns, implications, and therapeutic potential for post-traumatic stress disorder and opiate withdrawal.
Emotional arousal is one of several factors that determine the strength of a memory and how efficiently it may be retrieved. The systems at play are multifaceted; on one hand, the dopaminergic mesocorticolimbic system evaluates the rewarding or reinforcing potential of a stimulus, while on the other, the noradrenergic stress response system evaluates the risk of threat, commanding attention, and engaging emotional and physical behavioral responses. Sex-specific patterns in the anatomy and function of the arousal system suggest that sexually divergent therapeutic approaches may be advantageous for neurological disorders involving arousal, learning, and memory. From the lens of the triple network model of psychopathology, we argue that post-traumatic stress disorder and opiate substance use disorder arise from maladaptive learning responses that are perpetuated by hyperarousal of the salience network. We present evidence that catecholamine-modulated learning and stress-responsive circuitry exerts substantial influence over the salience network and its dysfunction in stress-related psychiatric disorders, and between the sexes. We discuss the therapeutic potential of targeting the endogenous cannabinoid system; a ubiquitous neuromodulator that influences learning, memory, and responsivity to stress by influencing catecholamine, excitatory, and inhibitory synaptic transmission. Relevant preclinical data in male and female rodents are integrated with clinical data in men and women in an effort to understand how ideal treatment modalities between the sexes may be different.
Topics: Catecholamines; Female; Humans; Male; Memory; Norepinephrine; Opiate Alkaloids; Stress Disorders, Post-Traumatic
PubMed: 32125035
DOI: 10.1111/ejn.14714 -
International Journal of Environmental... Jan 2023The aim of the current study was to examine the effects of length of abstinence on decision making (impulsive choice) and response inhibition (impulsive action) in...
The aim of the current study was to examine the effects of length of abstinence on decision making (impulsive choice) and response inhibition (impulsive action) in former opiate users (OU). Participants included 45 OU in early remission [0−12 months of abstinence], 68 OU in sustained remission [>12 months of abstinence], and 68 control participants. Decision making was assessed with the Iowa Gambling Task (IGT), the Cambridge Gambling Task (CGT), and the Monetary Choice Questionnaire (MCQ). Response inhibition was examined with the Stop Signal Task (SST), and the Go/No-Go Task (GNG). Results revealed group differences in decision making under risk (CGT) and ambiguity (IGT), where control participants displayed better decision making compared to OU in early remission. Both groups of former OU were also characterized by higher discounting of delayed rewards (MCQ). Regression analyses revealed minimal effects of length of abstinence on performance on decision-making tasks and no effects on delay discounting. In addition, both OU groups showed reduced action inhibition (GNG) relative to controls and there were no group differences in action cancellation (SST). Length of abstinence had no effect on response inhibition. Overall, our findings suggest that neurocognitive function may not fully recover even with protracted abstinence, which should be addressed by relapse prevention and cognitive remediation programs for OU.
Topics: Humans; Decision Making; Opiate Alkaloids; Impulsive Behavior; Gambling; Reward
PubMed: 36674000
DOI: 10.3390/ijerph20021236