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Revista Peruana de Medicina... Mar 2012Risk/ protective factors (RPF) are main elements for the analysis, understanding and formulation of answers for the prevention of drug dependences. The objective of this... (Review)
Review
Risk/ protective factors (RPF) are main elements for the analysis, understanding and formulation of answers for the prevention of drug dependences. The objective of this article is to present a literature review about the RPF and their implications in the design of preventive programs. It will focus on individual (genetic aspects, early experiences and psicosocial skills), family (parental control and monitoring, permissiveness, parenting styles), peer (group pressure and social norms) and communitarian (disorganization) RPF. On the other hand, the need of incorporating a multifactor conceptual framework for the preventive approach to drug dependences, articulating the intervention spaces (school, family and community), assuming and evolving perspective allowing the implementations of sustained actions is evidenced. On top, the implications for future research and public policy formulation are discussed.
Topics: Humans; Peru; Risk Factors; Substance-Related Disorders
PubMed: 22510915
DOI: 10.1590/s1726-46342012000100016 -
Health and Human Rights Jun 2020The primary purpose of political, civil, socioeconomic, and cultural rights is to protect the dignity of all human beings. Good mental health and well-being is defined...
The primary purpose of political, civil, socioeconomic, and cultural rights is to protect the dignity of all human beings. Good mental health and well-being is defined by the "social, psychosocial, economic, and physical environment that enables individuals and populations to live a life of dignity, with full enjoyment of their rights and in the equitable pursuit of their potential." Stigmatization, discrimination, and negative stereotypes are barriers to mental health and well-being. Individuals with mental health problems, including those with drug dependence, suffer stigmatization, which is a direct affront to dignity and may have enduring health impacts. This paper discusses the implications of stigma for a human-rights based approach to improving mental health among those with drug dependence, with a focus on the opioid epidemic now ravaging the United States. It explores the public health burden of stigma related to substance misuse, including stigma in the context of treatment and health care. It also discusses the role of policy initiatives-including decriminalization-in addressing stigma related to substance misuse.
Topics: Human Rights; Humans; Public Health; Respect; Social Stigma; Substance-Related Disorders; United States
PubMed: 32669788
DOI: No ID Found -
Brain Research Dec 2015Disruptions to inhibitory control are believed to contribute to multiple aspects of drug abuse, from preexisting vulnerability in at-risk individuals, through escalation... (Review)
Review
Disruptions to inhibitory control are believed to contribute to multiple aspects of drug abuse, from preexisting vulnerability in at-risk individuals, through escalation to dependence, to promotion of relapse in chronic users. Paradigms investigating the suppression of actions have been investigated in animal and human research on drug addiction. Rodent research has focused largely on impulsive behaviors, often gauged by premature responding, as a viable model highlighting the relevant role of dopamine and other neurotransmitters primarily in the striatum. Human research on action inhibition in stimulant dependence has highlighted impaired performance and largely prefrontal cortical abnormalities as part of a broader pattern of cognitive abnormalities. Animal and human research implicate inhibitory difficulties mediated by fronto-striatal circuitry both preceding and as a result of excessive stimulus use. In this regard, response-inhibition has proven a useful cognitive function to gauge the integrity of fronto-striatal systems and their role in contributing to impulsive and compulsive features of drug dependence.
Topics: Animals; Behavior, Addictive; Corpus Striatum; Frontal Lobe; Humans; Inhibition, Psychological; Neural Pathways; Substance-Related Disorders
PubMed: 25218611
DOI: 10.1016/j.brainres.2014.09.012 -
Comprehensive Psychiatry 1991Alcohol and drug dependence among the elderly is common and yet frequently underdiagnosed. The practice of self-administration of prescribed medications, particularly... (Review)
Review
Alcohol and drug dependence among the elderly is common and yet frequently underdiagnosed. The practice of self-administration of prescribed medications, particularly sedative/hypnotics, benzodiazepines, and nonprescription, over-the-counter (OTC) medications is prevalent, with untoward consequences in the geriatric population. Dementia, depression, and anxiety syndromes are some of the consequences of alcohol and drug dependence, and may mimic other causes of these disorders. The clinician's index of suspicion must be high enough to make the proper diagnosis of these alcohol- and drug-induced syndromes. Unnecessary evaluations, improper diagnosis, and ineffective and costly treatments may be avoided if alcohol and drug dependence is identified and treated. Effective treatment for alcohol and drug dependence does exist for the elderly and may be instituted in a cost-effective manner.
Topics: Adolescent; Adult; Aged; Alcoholism; Animals; Catchment Area, Health; Diagnosis, Differential; Drug Utilization; Female; Humans; Illicit Drugs; Male; Middle Aged; Nonprescription Drugs; Prevalence; Prognosis; Self Administration; Substance-Related Disorders; United States
PubMed: 2022115
DOI: 10.1016/0010-440x(91)90008-z -
Biological & Pharmaceutical Bulletin Sep 2008Drug addiction/dependence is defined as a chronically relapsing disorder that is characterized by compulsive drug taking, inability to limit intake, and intense drug... (Review)
Review
Drug addiction/dependence is defined as a chronically relapsing disorder that is characterized by compulsive drug taking, inability to limit intake, and intense drug cravings. The positive reinforcing/rewarding effects of drugs primarily depend on the mesocorticolimbic dopamine system innervating the nucleus accumbens while the craving for drugs is associated with activation of the prefrontal cortex. The chronic intake of drugs causes homeostatic molecular and functional changes in synapses, which may be critically associated with the development of drug dependence. Recent studies have demonstrated that various cytokines and proteinases are produced in the brain on treatment with drugs of abuse, and play a role in drug dependence. These endogenous modulators of drug dependence are classified into two groups, pro-addictive and anti-addictive factors. The former including basic fibroblast growth factor, brain-derived neurotrophic factor, tissue plasminogen activator, matrix metalloproteinase (MMP)-2 and MMP-9 act to potentiate the rewarding effects of drugs, while the latter such as tumor necrosis factor-alpha and glial cell line-derived neurotrophic factor reduce the reward. These findings suggest that an imbalance between pro-addictive and anti-addictive factors contributes to the development and relapse of drug dependence. Furthermore, targeting these endogenous modulators would provide new therapeutic approaches to the treatment of drug dependence.
Topics: Animals; Brain-Derived Neurotrophic Factor; Fibrinolysin; Glial Cell Line-Derived Neurotrophic Factor; Humans; Matrix Metalloproteinases; Substance-Related Disorders; Tissue Plasminogen Activator; Tumor Necrosis Factor-alpha
PubMed: 18758051
DOI: 10.1248/bpb.31.1635 -
Australian Family Physician Nov 2004Benzodiazepine dependency can occur as a result of treatment for anxiety disorders or sleep disturbance. While benzodiazepine withdrawal can be challenging, cessation of... (Review)
Review
BACKGROUND
Benzodiazepine dependency can occur as a result of treatment for anxiety disorders or sleep disturbance. While benzodiazepine withdrawal can be challenging, cessation of use can be even more difficult if there are other comorbidities such as oestrogen deficiency with vasomotor symptoms and anxiety disorders.
OBJECTIVE
This article provides practical information for general practitioners in the management of patients with benzodiazepine dependence.
DISCUSSION
Some patients may have common medical presentations and coexisting drug dependence. It is often difficult to separate these two issues. In the case of benzodiazepine dependence, gradual withdrawal over time and nonpharmacological treatment of the symptoms of withdrawal such as anxiety or insomnia is effective. Better outcomes are achieved where the GP discusses and plans strategies well in advance with the patient. Treatment often involves multiple interventions from various health professionals. General practitioners are ideally placed to coordinate such treatment.
Topics: Anti-Anxiety Agents; Anxiety Disorders; Benzodiazepines; Clinical Protocols; Drug Tolerance; Family Practice; Female; Humans; Middle Aged; Oxazepam; Relaxation Therapy; Sleep Initiation and Maintenance Disorders; Substance Withdrawal Syndrome; Substance-Related Disorders
PubMed: 15584332
DOI: No ID Found -
Pharmacology, Biochemistry, and Behavior Nov 2009This review presents a novel conceptualization of addiction, integrating the concepts of interoception (i.e., the CNS representation of visceral feelings) and... (Review)
Review
This review presents a novel conceptualization of addiction, integrating the concepts of interoception (i.e., the CNS representation of visceral feelings) and alliesthesia (i.e., that rewarding properties of stimuli are dependent on the internal state of the individual) with existing theories. It is argued that the body state, as defined by the integration of interoceptive information, is a crucial arbiter of the risk for initiation of and transition to compulsive use of addictive compounds. Overall, individuals at risk for drug dependence are characterized by an altered internal bodily state that leads to a change in hedonic and incentive motivational properties of addictive drugs. Specifically, drug dependent individuals experience alliesthesia of interoceptive processing, leading to increased incentive motivational properties of the drug over time and thereby increasing the probability of subsequent use. This extension of previous theories of addiction to include interoception and alliesthesia is based upon a clearly delineated set of neural substrates mediating interoception, key elements of which also recently have been implicated in drug addiction. The model thereby provides new potential targets for interventions that are aimed at changing the internal state that puts the individual at risk for continued substance use.
Topics: Animals; Central Nervous System; Emotions; Humans; Models, Biological; Motivation; Perception; Pleasure; Reward; Sensation; Substance-Related Disorders
PubMed: 19698739
DOI: 10.1016/j.pbb.2009.08.005 -
Comprehensive Psychiatry 1991The comorbidity of psychiatric disorders and alcohol and drug dependence is high. The prevalence rate for each disorder is high as determined by studies in general and... (Review)
Review
The comorbidity of psychiatric disorders and alcohol and drug dependence is high. The prevalence rate for each disorder is high as determined by studies in general and patient populations. Moreover, the severity of the course is likely to be greater when the two disorders are combined, prompting the attention of clinicians and researchers. Of importance, the intoxication and withdrawal from alcohol and drugs produce psychiatric symptoms and syndromes that can mimic psychiatric disorders. The prevalence rates for comorbidity of both categories of disorders vary according to the populations studied, methodological approaches used, and duration of longitudinal follow-up postdiagnosis of the disorders. It is evident from a review of the literature that there is a growing urgency for proper diagnosis, improved training programs, and treatment intervention strategies for alcohol and drug dependence in psychiatric populations. Suggestions for broad assessment and specific interventions for alcohol/drug dependence in psychiatric settings are offered, and increased time in psychiatric residency training is recommended.
Topics: Ambulatory Care; Comorbidity; Cross-Sectional Studies; Hospitalization; Humans; Incidence; Mental Disorders; Risk Factors; Substance-Related Disorders; United States
PubMed: 1884607
DOI: 10.1016/0010-440x(91)90048-h -
Drug and Alcohol Dependence Jan 2009Since the introduction of Red Bull in Austria in 1987 and in the United States in 1997, the energy drink market has grown exponentially. Hundreds of different brands are... (Review)
Review
Since the introduction of Red Bull in Austria in 1987 and in the United States in 1997, the energy drink market has grown exponentially. Hundreds of different brands are now marketed, with caffeine content ranging from a modest 50 mg to an alarming 505 mg per can or bottle. Regulation of energy drinks, including content labeling and health warnings differs across countries, with some of the most lax regulatory requirements in the U.S. The absence of regulatory oversight has resulted in aggressive marketing of energy drinks, targeted primarily toward young males, for psychoactive, performance-enhancing and stimulant drug effects. There are increasing reports of caffeine intoxication from energy drinks, and it seems likely that problems with caffeine dependence and withdrawal will also increase. In children and adolescents who are not habitual caffeine users, vulnerability to caffeine intoxication may be markedly increased due to an absence of pharmacological tolerance. Genetic factors may also contribute to an individual's vulnerability to caffeine-related disorders including caffeine intoxication, dependence, and withdrawal. The combined use of caffeine and alcohol is increasing sharply, and studies suggest that such combined use may increase the rate of alcohol-related injury. Several studies suggest that energy drinks may serve as a gateway to other forms of drug dependence. Regulatory implications concerning labeling and advertising, and the clinical implications for children and adolescents are discussed.
Topics: Advertising; Beverages; Caffeine; Central Nervous System Stimulants; Drug Tolerance; Humans; Legislation, Food; Substance Withdrawal Syndrome; Substance-Related Disorders; United States
PubMed: 18809264
DOI: 10.1016/j.drugalcdep.2008.08.001 -
CMAJ : Canadian Medical Association... Mar 2001Recent scientific advances have led to a greater understanding of the neurobiological processes that underlie drug abuse and addiction. These suggest that multiple... (Review)
Review
Recent scientific advances have led to a greater understanding of the neurobiological processes that underlie drug abuse and addiction. These suggest that multiple neurotransmitter systems may play a key role in the development and expression of drug dependence. These advances in our knowledge promise not only to help us identify the underlying cause of drug abuse and dependence, but also to aid the development of effective treatment strategies.
Topics: Animals; Brain; Disease Models, Animal; Humans; Illicit Drugs; Neurotransmitter Agents; Substance-Related Disorders
PubMed: 11276551
DOI: No ID Found