Opioid Receptor Subtype-Specific Cross-Tolerance to the Effects of Morphine on Schedule-Controlled Behavior in Mice
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Ketamine As a Rapid Antidepressant
BJPsych Advances (2016), vol. 22, 222–233 doi: 10.1192/apt.bp.114.014274 ARTICLE Ketamine as a rapid anti depressant: the debate and implications Roger C. M. Ho & Melvyn W. Zhang Roger Ho is an Associate Professor response rates to SSRIs and NaSSAs are around SUMMARY and consultant psychiatrist in 62% and 67% respectively (Papakostas 2008). the Department of Psychological Ketamine, a synthetic derivative of phencyclidine, Environmental factors such as relationship Medicine, Yong Loo Lin School of is a commonly misused party drug that is Medicine, National University of problems, financial difficulties and comorbid restricted in high-income countries because of Singapore. He has a special interest substance misuse often lead to poor treatment its addictive potential. Ketamine is also used as in psychoneuroimmunology and response, and antidepressants combined with the interface between medicine an anaesthetic in human and veterinary medicine. and psychiatry. Melvyn Zhang In the 1990s, research using ketamine to study the CBT have shown promising results in prevention is a senior resident with the pathophysiology of schizophrenia was terminated of mood disorders (Brenner 2010). Although 70– National Addiction Management owing to ethical concerns. Recently, controversy 90% of patients with depression achieve remission, Service, Institute of Mental Health, surrounding the drug has returned, as researchers around 10–30% are refractory to initial treatment Singapore. Correspondence Dr Roger C. M. have demonstrated that intravenous ketamine but respond to switching or combination of Ho, National University of Singapore, infusion has a rapid antidepressant effect and antidepressants, electroconvulsive therapy (ECT) Department of Psychological have therefore proposed ketamine as a novel or psychotherapy. -
Case Discussions in Palliative Medicine Levorphanol For
JOURNAL OF PALLIATIVE MEDICINE Volume 21, Number 3, 2018 Case Discussions in Palliative Medicine ª Mary Ann Liebert, Inc. DOI: 10.1089/jpm.2017.0475 Feature Editor: Craig D. Blinderman Levorphanol for Treatment of Intractable Neuropathic Pain in Cancer Patients Akhila Reddy, MD,1,* Amy Ng, MD,1,* Tarun Mallipeddi,2 and Eduardo Bruera, MD1 Abstract Neuropathic pain in cancer patients is often difficult to treat, requiring a combination of several different pharmacological therapies. We describe two patients with complex neuropathic pain syndromes in the form of phantom limb pain and Brown-Sequard syndrome who did not respond to conventional treatments but re- sponded dramatically to the addition of levorphanol. Levorphanol is a synthetic strong opioid that is a potent N- methyl-d-aspartate receptor antagonist, mu, kappa, and delta opioid receptor agonist, and reuptake inhibitor of serotonin and norepinephrine. It bypasses hepatic first-pass metabolism and thereby not subjected to numerous drug interactions. Levorphanol’s unique profile makes it a potentially attractive opioid in cancer pain man- agement. Keywords: Brown-Sequard syndrome; cancer; cancer pain; levorphanol; neuropathic pain; phantom limb pain Introduction changes, structural reorganization of spinal cord and primary somatosensory cortex, and increased sensitization of spinal ne-third of cancer patients who experience pain cord may be the neurological basis for PLP.8,9 Because the Oalso experience neuropathic pain1 and about half the pathophysiology of PLP is not clearly understood, the treat- patients with cancer who suffer from neuropathic pain also ment options are mainly based on clinical experience.9 There have nociceptive pain.2 Most neuropathic pain exists as are case series showing that tramadol and methadone may be mixed pain in combination with nociceptive pain. -
Hallucinogens and Dissociative Drugs
Long-Term Effects of Hallucinogens See page 5. from the director: Research Report Series Hallucinogens and dissociative drugs — which have street names like acid, angel dust, and vitamin K — distort the way a user perceives time, motion, colors, sounds, and self. These drugs can disrupt a person’s ability to think and communicate rationally, or even to recognize reality, sometimes resulting in bizarre or dangerous behavior. Hallucinogens such as LSD, psilocybin, peyote, DMT, and ayahuasca cause HALLUCINOGENS AND emotions to swing wildly and real-world sensations to appear unreal, sometimes frightening. Dissociative drugs like PCP, DISSOCIATIVE DRUGS ketamine, dextromethorphan, and Salvia divinorum may make a user feel out of Including LSD, Psilocybin, Peyote, DMT, Ayahuasca, control and disconnected from their body PCP, Ketamine, Dextromethorphan, and Salvia and environment. In addition to their short-term effects What Are on perception and mood, hallucinogenic Hallucinogens and drugs are associated with psychotic- like episodes that can occur long after Dissociative Drugs? a person has taken the drug, and dissociative drugs can cause respiratory allucinogens are a class of drugs that cause hallucinations—profound distortions depression, heart rate abnormalities, and in a person’s perceptions of reality. Hallucinogens can be found in some plants and a withdrawal syndrome. The good news is mushrooms (or their extracts) or can be man-made, and they are commonly divided that use of hallucinogenic and dissociative Hinto two broad categories: classic hallucinogens (such as LSD) and dissociative drugs (such drugs among U.S. high school students, as PCP). When under the influence of either type of drug, people often report rapid, intense in general, has remained relatively low in emotional swings and seeing images, hearing sounds, and feeling sensations that seem real recent years. -
Hallucinogens
Hallucinogens What Are Hallucinogens? Hallucinogens are a diverse group of drugs that alter a person’s awareness of their surroundings as well as their thoughts and feelings. They are commonly split into two categories: classic hallucinogens (such as LSD) and dissociative drugs (such as PCP). Both types of hallucinogens can cause hallucinations, or sensations and images that seem real though they are not. Additionally, dissociative drugs can cause users to feel out of control or disconnected from their body and environment. Some hallucinogens are extracted from plants or mushrooms, and others are synthetic (human-made). Historically, people have used hallucinogens for religious or healing rituals. More recently, people report using these drugs for social or recreational purposes. Hallucinogens are a Types of Hallucinogens diverse group of drugs Classic Hallucinogens that alter perception, LSD (D-lysergic acid diethylamide) is one of the most powerful mind- thoughts, and feelings. altering chemicals. It is a clear or white odorless material made from lysergic acid, which is found in a fungus that grows on rye and other Hallucinogens are split grains. into two categories: Psilocybin (4-phosphoryloxy-N,N-dimethyltryptamine) comes from certain classic hallucinogens and types of mushrooms found in tropical and subtropical regions of South dissociative drugs. America, Mexico, and the United States. Peyote (mescaline) is a small, spineless cactus with mescaline as its main People use hallucinogens ingredient. Peyote can also be synthetic. in a wide variety of ways DMT (N,N-dimethyltryptamine) is a powerful chemical found naturally in some Amazonian plants. People can also make DMT in a lab. -
SENATE BILL No. 52
As Amended by Senate Committee Session of 2017 SENATE BILL No. 52 By Committee on Public Health and Welfare 1-20 1 AN ACT concerning the uniform controlled substances act; relating to 2 substances included in schedules I, II and V; amending K.S.A. 2016 3 Supp. 65-4105, 65-4107 and 65-4113 and repealing the existing 4 sections. 5 6 Be it enacted by the Legislature of the State of Kansas: 7 Section 1. K.S.A. 2016 Supp. 65-4105 is hereby amended to read as 8 follows: 65-4105. (a) The controlled substances listed in this section are 9 included in schedule I and the number set forth opposite each drug or 10 substance is the DEA controlled substances code which has been assigned 11 to it. 12 (b) Any of the following opiates, including their isomers, esters, 13 ethers, salts, and salts of isomers, esters and ethers, unless specifically 14 excepted, whenever the existence of these isomers, esters, ethers and salts 15 is possible within the specific chemical designation: 16 (1) Acetyl fentanyl (N-(1-phenethylpiperidin-4-yl)- 17 N-phenylacetamide)......................................................................9821 18 (2) Acetyl-alpha-methylfentanyl (N-[1-(1-methyl-2-phenethyl)-4- 19 piperidinyl]-N-phenylacetamide)..................................................9815 20 (3) Acetylmethadol.............................................................................9601 21 (4) AH-7921 (3.4-dichloro-N-[(1- 22 dimethylaminocyclohexylmethyl]benzamide)...............................9551 23 (4)(5) Allylprodine...........................................................................9602 -
Problems of Drug Dependence 1980 Proceedings of the 42Nd Annual Scientific Meeting the Committee on Problems of Drug Dependence
National Institute on Drug Abuse MONOGRAPH SERIES Problems of Drug Dependence 1980 Proceedings of the 42nd Annual Scientific Meeting The Committee on Problems of Drug Dependence, Inc. U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES • Public Health Service • Alcohol, Drug Abuse, and Mental Health Administration Problems of Drug Dependence, 1980 Proceedings of the 42nd Annual Scientific Meeting, The Committee on Problems of Drug Dependence, Inc. Editor: Louis S. Harris, Ph.D. NIDA Research Monograph 34 February 1981 DEPARTMENT OF HEALTH AND HUMAN SERVICES Public Health Service Alcohol, Drug Abuse, and Mental Health Administration National Institute on Drug Abuse Division of Research 5600 Fishers Lane Rockville, Maryland 20857 For sale by the Superintendent of Documents, U.S. Government Printing Office Washington, D.C. 20402 The NIDA Research Monograph series is prepared by the Division of Research of the National Institute on Drug Abuse. Its primary objective is to provide critical reviews of research problem areas and techniques, the content of state-of-the-art conferences, integrative research reviews and significant original research. Its dual publication emphasis is rapid and targeted dissemination to the scientific and professional community. Editorial Advisory Board Avram Goldstein, M.D. Addiction Research Foundation Palo Alto, California Jerome Jaffe, M.D. College of Physicians and Surgeons Columbia University, New York Reese T. Jones, M.D. Langley Porter Neuropsychiatric Institute University of California San Francisco, California William McGlothlin, Ph.D. Deportment of Psychology, UCLA Los Angeles, California Jack Mendelson, M.D. Alcohol and Drug Abuse Research Center Harvard Medical School McLean Hospital Belmont, Massachusetts Helen Nowlis, Ph.D. Office of Drug Education, DHHS Washington, D.C Lee Robins, Ph.D. -
DEMAND REDUCTION a Glossary of Terms
UNITED NATIONS PUBLICATION Sales No. E.00.XI.9 ISBN: 92-1-148129-5 ACKNOWLEDGEMENTS This document was prepared by the: United Nations International Drug Control Programme (UNDCP), Vienna, Austria, in consultation with the Commonwealth of Health and Aged Care, Australia, and the informal international reference group. ii Contents Page Foreword . xi Demand reduction: A glossary of terms . 1 Abstinence . 1 Abuse . 1 Abuse liability . 2 Action research . 2 Addiction, addict . 2 Administration (method of) . 3 Adverse drug reaction . 4 Advice services . 4 Advocacy . 4 Agonist . 4 AIDS . 5 Al-Anon . 5 Alcohol . 5 Alcoholics Anonymous (AA) . 6 Alternatives to drug use . 6 Amfetamine . 6 Amotivational syndrome . 6 Amphetamine . 6 Amyl nitrate . 8 Analgesic . 8 iii Page Antagonist . 8 Anti-anxiety drug . 8 Antidepressant . 8 Backloading . 9 Bad trip . 9 Barbiturate . 9 Benzodiazepine . 10 Blood-borne virus . 10 Brief intervention . 11 Buprenorphine . 11 Caffeine . 12 Cannabis . 12 Chasing . 13 Cocaine . 13 Coca leaves . 14 Coca paste . 14 Cold turkey . 14 Community empowerment . 15 Co-morbidity . 15 Comprehensive Multidisciplinary Outline of Future Activities in Drug Abuse Control (CMO) . 15 Controlled substance . 15 Counselling and psychotherapy . 16 Court diversion . 16 Crash . 16 Cross-dependence . 17 Cross-tolerance . 17 Custody diversion . 17 Dance drug . 18 Decriminalization or depenalization . 18 Demand . 18 iv Page Demand reduction . 19 Dependence, dependence syndrome . 19 Dependence liability . 20 Depressant . 20 Designer drug . 20 Detoxification . 20 Diacetylmorphine/Diamorphine . 21 Diuretic . 21 Drug . 21 Drug abuse . 22 Drug abuse-related harm . 22 Drug abuse-related problem . 22 Drug policy . 23 Drug seeking . 23 Drug substitution . 23 Drug testing . 24 Drug use . -
Measures and CDS for Safer Opioid Prescribing: a Literature Review
Measures and CDS for Safer Opioid Prescribing: A Literature Review Measures and CDS for Safer Opioid Prescribing: A Literature Review Executive Summary The U.S. opioid epidemic continues to pose significant challenges for patients, families, clinicians, and public health policy. Opioids are responsible for an estimated 315,000 deaths (from 1999 to 2016) and have caused 115 deaths per day.1 In 2017, the U.S. Department of Health and Human Services declared the opioid epidemic a public health crisis.2 The total economic burden of opioid abuse in the United States has been estimated to be $78.5 billion per year.3 Although providing care for chronic opioid users is important, equally vital are efforts to prevent so-called opioid-naïve patients (patients with no history of opioid use) from developing regular opioid use, misuse, or abuse. However, much remains unclear regarding what role clinician prescribing habits play and what duration or dose of opioids may safely be prescribed without promoting long-term use.4,5 In 2013, ECRI Institute convened the Partnership for Health IT Patient Safety, and its component, single-topic-focused workgroups followed. For this subject, the Electronic Health Record Association (EHRA): Measures and Clinical Decision Support (CDS) for Safer Opioid Prescribing workgroup included members from the Healthcare Information and Management Systems Society (HIMSS) EHRA and the Partnership team. The project was oriented towards exploring methods to enable a synergistic cycle of performance measurement and identifying electronic health record (EHR)/health information technology (IT)–enabled approaches to support healthcare organizations’ ability to assess and measure opioid prescribing. -
Hallucinogens
Hallucinogens What are hallucinogens? Hallucinogens are a diverse group of drugs that alter a person’s awareness of their surroundings as well as their own thoughts and feelings. They are commonly split into two categories: classic hallucinogens (such as LSD) and dissociative drugs (such as PCP). Both types of hallucinogens can cause hallucinations, or sensations and images that seem real though they are not. Additionally, dissociative drugs can cause users to feel out of control or disconnected from their body and environment. Some hallucinogens are extracted from plants or mushrooms, and some are synthetic (human- made). Historically, people have used hallucinogens for religious or healing rituals. More recently, people report using these drugs for social or recreational purposes, including to have fun, deal with stress, have spiritual experiences, or just to feel different. Common classic hallucinogens include the following: • LSD (D-lysergic acid diethylamide) is one of the most powerful mind-altering chemicals. It is a clear or white odorless material made from lysergic acid, which is found in a fungus that grows on rye and other grains. LSD has many other street names, including acid, blotter acid, dots, and mellow yellow. • Psilocybin (4-phosphoryloxy-N,N- dimethyltryptamine) comes from certain types of mushrooms found in tropical and subtropical regions of South America, Mexico, and the United States. Some common names for Blotter sheet of LSD-soaked paper squares that users psilocybin include little smoke, magic put in their mouths. mushrooms, and shrooms. Photo by © DEA • Peyote (mescaline) is a small, spineless cactus with mescaline as its main ingredient. Peyote can also be synthetic. -
Demonstration and Affinity Labeling of a Stereoselective Binding Site for A
Proc. Nati. Acad. Sci. USA Vol. 82, pp. 940-944, February 1985 Neurobiology Demonstration and affinity labeling of a stereoselective binding site for a benzomorphan opiate on acetylcholine receptor-rich membranes from Torpedo electroplaque (cholinergic receptor/ion channel/photoaffinity labeling/N-aliyl-N-normetazocine/phencyclidine) ROBERT E. OSWALD, NANCY N. PENNOW, AND JAMES T. MCLAUGHLIN Department of Pharmacology, New York State College of Veterinary Medicine, Cornell University, Ithaca, NY 14853 Communicated by R. H. Wasserman, October 3, 1984 ABSTRACT The interaction of an optically pure benzo- Benzomorphan opiates have been shown to inhibit the morphan opiate, (-)-N-allyl-N-normetazocine [(-)-ANMC], binding of [3H]PCP to central nervous system synaptic mem- with the nicotinic acetylcholine receptor from Torpedo electro- branes (15, 16) and to modify the activity of serum cholines plaque was studied by using radioligand binding and affinity terase (17). Some opiate derivatives, in particular the benzo- labeling. The binding was complex with at least two specific morphans, can inhibit the binding of [3H]perhydrohistrioni- components having equilibrium dissociation constants of 0.3 cotoxin and [3H]PCP to the Torpedo AcChoR (18, 19). In the jiM and 2 jiM. The affinity of the higher affinity component present studies, a radioactive optically pure benzomorphan, was decreased by carbamoylcholine but not by a-bungaro- (-)-[3H]N-allyl-N-normetazocine {(-)-[3H]ANMC}, was toxin. The effect of carbamoylcholine was not blocked by a- used to measure reversible binding to and affinity labeling of bungarotoxin. In comparison, the affinity of [3Hlphencycli- the Torpedo electroplaque AcChoR. Specific binding was dine, a well-characterized ligand for a high-affinity site for shown to be complex with at least one component having noncompetitive blockers on the acetylcholine receptor, is in- lower affinity in the presence rather than the absence of cho- creased by carbamoylcholine and the increase is blocked by a- linergic effectors. -
Drugs of Abuseon September Archived 13-10048 No
U.S. DEPARTMENT OF JUSTICE DRUG ENFORCEMENT ADMINISTRATION WWW.DEA.GOV 9, 2014 on September archived 13-10048 No. v. Stewart, in U.S. cited Drugs of2011 Abuse EDITION A DEA RESOURCE GUIDE V. Narcotics WHAT ARE NARCOTICS? Also known as “opioids,” the term "narcotic" comes from the Greek word for “stupor” and originally referred to a variety of substances that dulled the senses and relieved pain. Though some people still refer to all drugs as “narcot- ics,” today “narcotic” refers to opium, opium derivatives, and their semi-synthetic substitutes. A more current term for these drugs, with less uncertainty regarding its meaning, is “opioid.” Examples include the illicit drug heroin and pharmaceutical drugs like OxyContin®, Vicodin®, codeine, morphine, methadone and fentanyl. WHAT IS THEIR ORIGIN? The poppy papaver somniferum is the source for all natural opioids, whereas synthetic opioids are made entirely in a lab and include meperidine, fentanyl, and methadone. Semi-synthetic opioids are synthesized from naturally occurring opium products, such as morphine and codeine, and include heroin, oxycodone, hydrocodone, and hydromorphone. Teens can obtain narcotics from friends, family members, medicine cabinets, pharmacies, nursing 2014 homes, hospitals, hospices, doctors, and the Internet. 9, on September archived 13-10048 No. v. Stewart, in U.S. cited What are common street names? Street names for various narcotics/opioids include: ➔ Hillbilly Heroin, Lean or Purple Drank, OC, Ox, Oxy, Oxycotton, Sippin Syrup What are their forms? Narcotics/opioids come in various forms including: ➔ T ablets, capsules, skin patches, powder, chunks in varying colors (from white to shades of brown and black), liquid form for oral use and injection, syrups, suppositories, lollipops How are they abused? ➔ Narcotics/opioids can be swallowed, smoked, sniffed, or injected. -
Opioids Regulate Cgmp Formationin Cloned Neuroblastoma Cells
Proc. NatL. Acad. Sci. USA Vol. 79, pp. 690-694, January 1982 Neurobiology Opioids regulate cGMP formation in cloned neuroblastoma cells (cyclic nucleotides/opiate receptor/desensitization) GERMAINE J. GWYNN AND ERMINIO COSTA* Laboratory of Preclinical Pharmacology, National Institute of Mental Health, Saint Elizabeths Hospital, Washington, D.C. 20032 Communicated by Floyd E. Bloom, October 8, 1981 ABSTRACT Opioid agonists caused a rapid dose-related el- cumulation in rat striatal slices with characteristics that fulfill evation of the cGMP content of N4TG1 murine neuroblastoma the criteria for a specific narcotic action (6). In contrast, the cells. An excellent correlation was found between the rank order decrements in the cGMP content ofcerebellar tissue observed of potency of agonists in stimulating cGMP accumulation and in after morphine administration are probably indirect effects of displacing [3H]etorphine ([H]ETP) bound to intact cells. The nar- opioid receptor stimulation mediated by the modulation of y- cotic antagonists naloxone and diprenorphine failed to increase aminobutyric acid or acetylcholine collateral neuronal loops (7, cGMP content; moreover, in the presence of 5 ,IM naloxone, the 8). A functional role for cGMP in opioid action is further sug- EC50 of ETP increased from w9 nM to >1 ,uM. N4TG1 cells that had been incubated for 20 min with 0.32 ItM ETP and thoroughly gested by the pivotal role that calcium ions play both in regu- washed displayed a marked loss in sensitivity to subsequent ETP lating cGMP formation (for review, see refs. 9, 10) and in me- challenge. This desensitization was characterized by a 40-50% diating the acute and chronic effects ofopioids (for review, see decrease in maximal response and an increase in the apparent Ka refs.