Neuroplasticity in the Mesolimbic System Induced by Sexual Experience and Subsequent Reward Abstinence
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Addiction, Opioids, and Beyond
Addiction, Opioids and Beyond Chronic Pain Mental Illness Substance Dep Medical Illness Genetics/Env Objectives Understanding Definitions in Substance Dependency and Addiction. Review of Basic Epidemiology in Opioids Understanding Basic Addiction Physiology and how it relates to Schizophrenia Knowledge the General Overview of SUD Treatment Knowledge of non-pharmacological treatments of SUD. Understanding of Prescription Opioids, Side Effects and Dangers Understanding Prescription Opioids in the setting of Chronic Pain Understand MAT for Opioids (Tip43) with Naltrexone, Methadone and Buprenorphine Naloxone WHAT DOES ADDICTION MEAN? In 2016 11.5 million people 12 years and older misused opioid pain medications 1.8 million had substance use disorder involving prescription pain medications Between 2000 to 2015, more then 500,000 person died from opioid overdoses Opioid and 2012 clinicians wrote 259 million prescription for opioids Overdose 2.5 million people with Opioid Addiction (JAMA) US deaths from drug overdoses hit record high in 2014, propelled by abuse of prescription painkillers and heroin. (CDC) Heroin related deaths tripled since 2010. Only 2.2% of US Physician have waiver to prescribe Buprenorphine (JAMA) Statistically, nonmedical use of drugs from individuals obtained a majority of their drugs from friends and relatives, however 80% of those “friends and family” obtained from ONE DOCTOR. Addiction Poorly Understood • Regard Addiction as a moral problem • Fail to adequately screen • 1% of medical school curriculum • Believe interventions are ineffective JAMA,2003,290, 1299 Defining the Word "Addiction" The American Society of Addiction Medicine (ASAM), American Pain Society (APS), and American Academy of Pain Medicine (AAPM) define addiction as a primary, chronic, neurobiological disease with genetic, psychosocial, and environmental factors influencing its development and manifestations characterized by one or more of the behaviors listed above (ASAM, 2001). -
Tolerance and Dependence
Tolerance and Dependence Drug Tolerance is a decrease in the effect of a drug as a consequence of repeated exposure. • Change over repeated exposures. • Different effects may show different tolerance. • Tolerance is reversible. Mechanisms of Tolerance • Pharmacokinetic Tolerance • Enzyme Induction Effects. • Pharmacodynamic Tolerance • NT depletion • Receptor Plasticity 1 Receptor Plasticity and Tolerance • Drugs that are NT agonists can cause receptor downregulation. • Drugs that are NT antagonists can cause receptor upregulation. Pharmacodynamic drug tolerance can also affect “normal” synaptic transmission. • Serious side-effect of drug use. Mechanisms of tolerance continued… Learned Tolerance - Learned behaviors compensate for drug effects. • Practice effects. • Reward and punishment . Context-Specific Tolerance • Stimuli in the environment (context) become able to counteract the effects of a drug. Pavlovian Conditioning • A neutral stimulus paired with a biologically relevant stimulus becomes able to elicit a response. Siegel et al. (1982) - Demonstrated that drug tolerance can be conditioned. 2 Group Control 15 injections of saline in distinctive room. High dose of heroin in distinctive room on Day 16. • Results: 96% died of overdose. Group Same 15 injections of heroin in distinctive room. Hig h dose o f hero in in dis tincti ve room on D ay 16 . • Results: 32% died of overdose. Group Different 15 injections of heroin in distinctive room. High dose of heroin in new room on Day 16. • Results: 64% died of overdose. Siegel’s Theory: • When an environment consistently predicts drug administration... • … the environment begins to elicit a “compensatory” response that is opposite to the drug’s effect. • The compensatory response counteracts the drug’s effect. -
AND DRUG' ABUSE' ( , \ I ., : for VOLUNTEER .AFTERCARE OFFICERS
=£q, G& ~. ~I o II g ~ L>- ".,-~..- ". 'PR'OBATIQN AND AFTERCA'RE SERVICE " rI ! ,~ i I!' 0 i! ,1 u I', :( ~ II' 1 r :.:" I I) 'tbLLECTED ,READINGS ,~ ~ - '., ,\ ON It, DR!J.GS ·AND DRUG' ABUSE' ( , \ i ., : FOR VOLUNTEER .AFTERCARE OFFICERS. ri ll, "' , 'I: o '.> .. , 4 . , . I:o..-__________:i-.._---... __ ~~ ___~;L __~ ______ fF PROBATION AND AFTERCARE SERVICE COLLECTED READUNGS ON DRUGS AND DRUG ABUSE FOR VOLUNTEER AFTERCARE OFFICERS 1977 a If' t «(, CONTENTS ARTICLE PAGE PART I - THE DRUG SCENE Speech by Dr Goh Keng Swee, Deputy Prime Minister and Minister of Defence, at the Launching of the NADAC Month at the National Theatre Or! Wedr!e~dev, 4th August 1976. 1 II Speech by Mr Chua Sian Chin, Minister for Home Affairs and Education at the Opening Ceremony of the First Meeting of ASEAN Drug Experts at the Crystal Ballroom, Hyatt Hotel, on Tuesday, 26th October 1976. 6 PART II - PREVENTIVE EDUCATION III The Objectives of Anti-Drug Abuse Education by Dr Tow Siang Hwa, Past President, Singapore Anti-Narcotics Association 8 .. PART III - DRUGS AND THEIR EFFECTS IV CommonlY Abused Drugs by Dr Yeow Teow Seng, Associate Profassor oi Pharmacology, University of Singapore 12 V The Non-Medical Uses of Dependence-Producing Drugs by Dr Leong Hon Koon 18 VI Psychiatric Aspects of Drug Abuse by Dr Paul W Ngui, Consultant Psychlatrist 23 VII Sad End to All Drug Trips by Dr Chao Tzu Cheng, Senior Forensic Pathologist, Ministry of Health 27 PART IV - SOCIAL CONSIDERATIONS OF DRUG ABUSE VIII Patterns & Social Consequences of Drug Abuse & the Rehabilitation of Drug Addict by K V Veloo, Chief Probation & Aftercare Officer 29 IX Social Factors of Drug Abuse by K V Veloo, Chief Probation & Aftercare Officer 34 f X Some Causes of Adolescent Problems , by S Vasoo, Deputy Director, Singapore Council of Social Service 39 " ,. -
How Psychoactive Drugs Affect Us
HOW PSYCHOACTIVE DRUGS AFFECT US Part II 7th February 2014 Ms. Cathy Ngarachu Physiological Responses to Drugs • Determines how drugs affect people and why it is difficult to control their levels of use. • They include: • Tolerance to Drug • Tissue Dependence • Psychological Dependence & Reward-reinforcing action of drugs • Withdrawal Tolerance • Results from the body’s attempt to eliminate a drug that it treats as a toxin • With continued drug use the body tries to neutralize the toxic effects by: • Requiring larger amounts of the drugs to achieve the original effects • Degree of effects depend on the : • Amount used • Duration of use • Frequency of use • Individual’s chemistry • State of mind Kinds of Tolerance • Dispositional Tolerance • Speeds up the metabolism to handle the drug in order to eliminate it • Example: Increases the amount of cytocells and mitochondria in the liver to neutralize the drug….. So it will take more of the drug to achieve the same level of intoxication Kinds of Tolerance • Pharmacodynamic Tolerance • Results from the desensitization of nerve cells to the action of the drug • Ex. The nerve cells become less sensitive and begin producing an antidote or antagonist to the drug, ie. The brain will generate more opiod receptor sites. Kinds of Tolerance • Behavioral Tolerance: • Brain adjustments that affect behavior • Someone who is high may make himself appear sober when threatened, then revert back to the high state • Reverse Tolerance • Person has greater sensitivity to the drug, after prolong use, and the body’s ability to metabolize the drug decreases. • Ex. A person who has drunk a 12-pack of beer daily for ten years, may find themselves drinking 3-4 beers to achieve the effect due to tissue damage of the liver and kidneys. -
Neurobiological and Neurobehavioral Mechanisms of Chronic Alcohol Drinking
Neurobiological and Neurobehavioral Mechanisms of Chronic Alcohol Drinking Neurobiological and Neurobehavioral Mechanisms of Chronic Alcohol Drinking Alcoholism comprises a set of complex behaviors seeking behaviors, have been developed. These in which an individual becomes increasingly models, which remain an integral part of the preoccupied with obtaining alcohol. These study of alcoholism, include animals that pref- behaviors ultimately lead to a loss of control over erentially drink solutions containing alcohol, consumption of the drug and to the development animals that self-administer alcohol during of tolerance, dependence, and impaired social and withdrawal, animals with a history of dependence occupational functioning. that self-administer alcohol, and animals that self- administer alcohol after a period of abstinence Although valuable information regarding toler- from the drug. Genetic models for alcoholism ance and dependence has been, and continues to also exist and include animals that have been bred be, gathered through human studies, much of the selectively for high alcohol consumption. Studies detailed understanding of the impact of exposure using such models are uncovering the systemic, to alcohol on behavior and on the biological cellular, and molecular neurobiological mech- mechanisms underlying those behaviors has been anisms that appear to contribute to chronic obtained through the use of animal models for alcohol consumption. The challenge of current alcoholism and a variety of in vitro, or cellular, and future studies is to understand which specific systems. Through the use of cellular systems and cellular and subcellular systems undergo mole- animal models, researchers can control the genetic cular changes to influence tolerance and depen- background and experimental conditions under dence in motivational systems that lead to which a specific alcohol-related behavior or chronic drinking. -
The Effects of Alcohol and Nicotine Pretreatment During Adolescence on Adulthood Responsivity to Alcohol Antoniette M
University of South Florida Scholar Commons Graduate Theses and Dissertations Graduate School 2007 The effects of alcohol and nicotine pretreatment during adolescence on adulthood responsivity to alcohol Antoniette M. Maldonado University of South Florida Follow this and additional works at: http://scholarcommons.usf.edu/etd Part of the American Studies Commons Scholar Commons Citation Maldonado, Antoniette M., "The effects of alcohol and nicotine pretreatment during adolescence on adulthood responsivity to alcohol" (2007). Graduate Theses and Dissertations. http://scholarcommons.usf.edu/etd/2272 This Thesis is brought to you for free and open access by the Graduate School at Scholar Commons. It has been accepted for inclusion in Graduate Theses and Dissertations by an authorized administrator of Scholar Commons. For more information, please contact [email protected]. The Effects of Alcohol and Nicotine Pretreatment During Adolescence on Adulthood Responsivity to Alcohol by Antoniette M. Maldonado A thesis submitted in partial fulfillment of the requirements for the degree of Masters of Arts Department of Psychology College of Arts and Sciences University of South Florida Major Professor: Cheryl L. Kirstein, Ph.D. Mark Goldman, Ph.D. Toru Shimizu, Ph.D. David J. Drobes, Ph.D. Date of Approval: 18 October, 2007 Keywords: addiction, adolescent, alcohol-nicotine interactions, conditioned place preference, novelty preference © Copyright 2007, Antoniette M. Maldonado Dedication To my mom, Sylvia Ann Valdez. Mom, you are my very best friend and I do not know what I would have done without all of the support you gave me through every single step of this journey. You make such a difference in my life and I cannot even begin to describe how grateful I am to have you still here with me. -
New Persistent Opioid Abuse and the Brain Reward Circuit
Zhang L, Boysen PG. New Persistent Opioid Abuse and the Brain Reward Circuit. J Anesthesiol & Pain Therapy. 2020;1(1):11-13 Letter to the Editor Open Access New Persistent Opioid Abuse and the Brain Reward Circuit Ly Zhang*, Philip G. Boysen Department of Anesthesiology, University of Mississippi Medical Center, The Mississippi Critical Care Organization, USA Article Info New persistent opioid abuse in peri-operative and peri- procedural patients is reported to be ~6% in two large population- Article Notes 1 Received: December 06, 2019 based studies . In addressing the opioid crisis the CDC has developed Accepted: April 08, 2020 2 *Correspondence: approved opioids are prescribed by licensed professionals . The *Dr. Ly Zhang, Department of Anesthesiology, University of three categories. The first is prescription drugs, when legal and Mississippi Medical Center, The Mississippi Critical Care and fentanyl . Over time CDC data indicates a sharp uptick in opioid Organization, USA; Email: [email protected]. second and third3,4 categories involve illicit drugs, specifically heroin ©2020 Zhang L. This article is distributed under the terms of the prescription drugs5. Understanding the neurobiology of addiction Creative Commons Attribution 4.0 International License. deaths for heroin and fentanyl, but a flat incidence of overdose with and public health issues are integral to the understanding of how adds insight to the problem and treatment. In addition, the social the brain reward circuit is activated in the first place. human primates 50 years ago. Rats taught to push a lever to self – The brain reward circuit was described in rodents, then in non- aspectsadminister of addictive addictive behavior. -
Selective Serotonin Reuptake Inhibitors, Fluoxetine and Paroxetine, Attenuate the Expression of the Established Behavioral Sensitization Induced by Methamphetamine
Neuropsychopharmacology (2007) 32, 658–664 & 2007 Nature Publishing Group All rights reserved 0893-133X/07 $30.00 www.neuropsychopharmacology.org Selective Serotonin Reuptake Inhibitors, Fluoxetine and Paroxetine, Attenuate the Expression of the Established Behavioral Sensitization Induced by Methamphetamine 1 1 1 1 1 ,1 Yujiro Kaneko , Atsushi Kashiwa , Takashi Ito , Sumikazu Ishii , Asami Umino and Toru Nishikawa* 1 Section of Psychiatry and Behavioral Sciences, Tokyo Medical and Dental University Graduate School, Yushima, Bunkyo-ku, Tokyo, Japan To obtain an insight into the development of a new pharmacotherapy that prevents the treatment-resistant relapse of psychostimulant- induced psychosis and schizophrenia, we have investigated in the mouse the effects of selective serotonin reuptake inhibitors (SSRI), fluoxetine (FLX) and paroxetine (PRX), on the established sensitization induced by methamphetamine (MAP), a model of the relapse of these psychoses, because the modifications of the brain serotonergic transmission have been reported to antagonize the sensitization phenomenon. In agreement with previous reports, repeated MAP treatment (1.0 mg/kg a day, subcutaneously (s.c.)) for 10 days induced a long-lasting enhancement of the increasing effects of a challenge dose of MAP (0.24 mg/kg, s.c.) on motor activity on day 12 or 29 of withdrawal. The daily injection of FLX (10 mg/kg, s.c.) or PRX (8 mg/kg, s.c.) from 12 to 16 days of withdrawal of repeated MAP administration markedly attenuated the ability of the MAP pretreatment to augment the motor responses to the challenge dose of the stimulant 13 days after the SSRI injection. The repeated treatment with FLX or PRX alone failed to affect the motor stimulation following the challenge of saline and MAP 13 days later. -
Nicotine and Neurotransmitters
Module 2 —Legal Doesn’t Mean Harmless Overview Overview Summary This module focuses on how two drugs, nicotine and alcohol, change the functioning of the brain and body. Both drugs are widely used in the community, and for adults, using them is legal. Nonetheless, both alcohol and nicotine can have a strong impact on the functioning of the brain. Each can cause a number of negative effects on the body and brain, ranging from mild symptoms to addiction. The goal of this module is to help students understand that, although nicotine and alcohol are legal for adults, they are not harmless substances. Students will learn about how nicotine and alcohol change or disrupt the process of neurotransmission. Students will explore information on the short- and long- term effects of these two drugs, and also learn why these drugs are illegal for children and teens. Through the media, students are exposed to a great deal of information about alcohol and tobacco, much of which is misleading or scientifically inaccurate. This module will provide information on what researchers have learned about how nicotine and alcohol change the brain, and the resulting implications for safety and health. Learning Objectives At the end of this module: • Students can explain how nicotine disrupts neurotransmission. • Students can explain how alcohol use may harm the brain and the body. • Students understand how alcohol can intensify the effect of other drugs. • Students can define addiction and understand its basis in the brain. • Students draw conclusions about why our society regulates the use of nicotine and alcohol for young people. -
ASAM National Practice Guideline for the Treatment of Opioid Use Disorder: 2020 Focused Update
The ASAM NATIONAL The ASAM National Practice Guideline 2020 Focused Update Guideline 2020 Focused National Practice The ASAM PRACTICE GUIDELINE For the Treatment of Opioid Use Disorder 2020 Focused Update Adopted by the ASAM Board of Directors December 18, 2019. © Copyright 2020. American Society of Addiction Medicine, Inc. All rights reserved. Permission to make digital or hard copies of this work for personal or classroom use is granted without fee provided that copies are not made or distributed for commercial, advertising or promotional purposes, and that copies bear this notice and the full citation on the fi rst page. Republication, systematic reproduction, posting in electronic form on servers, redistribution to lists, or other uses of this material, require prior specifi c written permission or license from the Society. American Society of Addiction Medicine 11400 Rockville Pike, Suite 200 Rockville, MD 20852 Phone: (301) 656-3920 Fax (301) 656-3815 E-mail: [email protected] www.asam.org CLINICAL PRACTICE GUIDELINE The ASAM National Practice Guideline for the Treatment of Opioid Use Disorder: 2020 Focused Update 2020 Focused Update Guideline Committee members Kyle Kampman, MD, Chair (alpha order): Daniel Langleben, MD Chinazo Cunningham, MD, MS, FASAM Ben Nordstrom, MD, PhD Mark J. Edlund, MD, PhD David Oslin, MD Marc Fishman, MD, DFASAM George Woody, MD Adam J. Gordon, MD, MPH, FACP, DFASAM Tricia Wright, MD, MS Hendre´e E. Jones, PhD Stephen Wyatt, DO Kyle M. Kampman, MD, FASAM, Chair 2015 ASAM Quality Improvement Council (alpha order): Daniel Langleben, MD John Femino, MD, FASAM Marjorie Meyer, MD Margaret Jarvis, MD, FASAM, Chair Sandra Springer, MD, FASAM Margaret Kotz, DO, FASAM George Woody, MD Sandrine Pirard, MD, MPH, PhD Tricia E. -
MRO Manual Before 2004
Note: This manual is essentially the same as the 1997 HHS Medical Review Officer (MRO) Manual except for changes related to the new Federal Custody and Control Form (CCF). The appendix has also been deleted since the new Federal Custody and Control Form is available as a separate file on the website. Medical Review Officer Manual for Federal Agency Workplace Drug Testing Programs for use with the new Federal Drug Testing Custody and Control Form (OMB Number 0930-0158, Exp Date: June 30, 2003) This manual applies to federal agency drug testing programs that come under Executive Order 12564 and the Department of Health and Human Services (HHS) Mandatory Guidelines. Table of Contents Chapter 1. The Medical Review Officer (MRO) ............................................................... 1 Chapter 2. Federal Drug Testing Custody and Control Form .......................................... 3 Chapter 3. The MRO Review Process ............................................................................ 3 A. Administrative Review of the CCF ........................................................................... 3 I. State Initiatives and Laws ....................................................................................... 15 Chapter 4. Specific Drug Class Issues .......................................................................... 15 A. Amphetamines ....................................................................................................... 15 B. Cocaine ................................................................................................................ -
The Effects of Nicotine Administration on Behavior and Markers of Brain Plasticity in a Rodent Model of Psychosis" (2012)
East Tennessee State University Digital Commons @ East Tennessee State University Electronic Theses and Dissertations Student Works 5-2012 The ffecE ts of Nicotine Administration on Behavior and Markers of Brain Plasticity in a Rodent Model of Psychosis Marla K. Perna East Tennessee State University Follow this and additional works at: https://dc.etsu.edu/etd Part of the Chemical Actions and Uses Commons Recommended Citation Perna, Marla K., "The Effects of Nicotine Administration on Behavior and Markers of Brain Plasticity in a Rodent Model of Psychosis" (2012). Electronic Theses and Dissertations. Paper 1432. https://dc.etsu.edu/etd/1432 This Dissertation - Open Access is brought to you for free and open access by the Student Works at Digital Commons @ East Tennessee State University. It has been accepted for inclusion in Electronic Theses and Dissertations by an authorized administrator of Digital Commons @ East Tennessee State University. For more information, please contact [email protected]. The Effects of Nicotine Administration on Behavior and Markers of Brain Plasticity in a Rodent Model of Psychosis ________________________ A dissertation presented to the faculty of the Department of Anatomy and Cell Biology East Tennessee State University In partial fulfillment of the requirements for the degree Doctor of Philosophy in Biomedical Sciences ________________________ by Marla Perna May 2012 ________________________ Russell W. Brown, Chair Ronald H. Baisden Theresa A. Harrison Gregory A. Ordway Brooks B. Pond David S. Roane Keywords: psychosis, adolescence, nicotine, dopamine, synaptic plasticity ABSTRACT The Effects of Nicotine Administration on Behavior and Markers of Brain Plasticity in a Rodent Model of Psychosis by Marla Perna Schizophrenia affects about 1% of the population.