DOCSLIB.ORG

Predicting Relapse to Alcohol and Drug Abuse Via Quantitative Electroencephalography Lance O

Total Page：16

File Type：pdf, Size：1020Kb

Download full-text PDF Read full-text
Predicting Relapse to Alcohol and Drug Abuse Via Quantitative Electroencephalography Lance O Predicting Relapse to Alcohol and Drug Abuse via Quantitative Electroencephalography Lance O. Bauer, Ph.D. A sensitive and specific screening test that would identify abstinence and 22 additional subjects with no history of the subset of substance-abusing patients at highest risk for substance dependence. Importantly, in subsequent logistic relapse would constitute an important advance for treatment regression analyses, fast ␤ power was found to be superior to planning. This study examined the relative value of severity of illness, depression level, and childhood conduct quantitative electroencephalography as a rapid, inexpensive, problems in predicting relapse. With fast ␤ power as the sole and noninvasive measure of relapse potential. The subjects predictor, the sensitivity, specificity, and positive and were 107 substance-dependent patients enrolled in negative predictive value parameters for discriminating residential treatment programs. All were unmedicated and outcomes were 0.61, 0.85, 0.75, and 0.74, respectively. free of the complicating effects of major medical and Additional ANCOVAs revealed that the EEG difference neurological disorders. Structured clinical interview data between relapse-prone and abstinence-prone groups was and a 5-minute recording of the resting, eyes-closed related to the interaction of two premorbid factors, viz., electroencephalogram were obtained after patients had childhood Conduct Disorder and paternal alcoholism. The verifiably maintained abstinence for 1–5 months. Patients enhancement of fast ␤ electroencephalographic activity in were then monitored for relapse or successful abstinence by patients who will later relapse most likely originates from a research staff for an ensuing 6-month period. ANCOVAs of premorbid and subtle dysfunction involving frontal brain EEG power spectral density within pre-defined frequency regions. bands revealed an enhanced amount of high frequency [Neuropsychopharmacology 25:332–340, 2001] (19.5–39.8 Hz) ␤ activity among the 48 patients who later © 2001 American College of Neuropsychopharmacology. relapsed compared to both 59 patients who maintained Published by Elsevier Science Inc. KEY WORDS: Electroencephalography; Relapse; Alcohol; (Daley and Marlatt 1997). In outcome studies of alcoholics, Cocaine; Heroin; Alcoholism; Drug Abuse; Substance for example, approximately 65–70% of patients have been related disorders; Recurrence; Frontal Cortex found to relapse within one year of treatment, with the ma- Relapse rates following treatment for substance depen- jority of these patients relapsing within less than three dence are remarkably high, and efforts to address this un- months (Hunt et al. 1971; Emrick 1974; Miller and Hester fortunate reality are becoming an integral part of treatment 1986). In outcome studies of drug- or polysubstance-depen- dent patients, relapse rates following treatment are similar to, if not greater than, those found for patients solely depen- From the Department of Psychiatry, MC-2103, University of Con- dent on alcohol (Emrick 1974; McKay et al. 1999). necticut Health Center, Farmington, CT 06030, Tel.: 860-679-4154, A number of investigators have focused on analyz- Fax: 860-679-4077, E-mail: bauer@psychiatry. uchc.edu Address correspondence to: Lance Bauer, Ph.D., Neural Dynamics ing the multiple variables associated with relapse in an Laboratory, University of Connecticut School of Medicine, Farming- attempt to develop screening tools that might identify ton, CT 06030-2103 subpopulations most in need of relapse-prevention Received July 24, 2000; revised November 2, 2000; accepted Feb- ruary 2, 2001. treatment. A number of risk factors have been identi- Online publication: 2/7/01 at www.org/citations/Npp02070177. fied. More severe levels of alcohol or drug dependence NEUROPSYCHOPHARMACOLOGY 2001–VOL. 25, NO. 3 © 2001 American College of Neuropsychopharmacology Published by Elsevier Science Inc. 0893-133X/01/$–see front matter 655 Avenue of the Americas, New York, NY 10010 PII S0893-133X(01)00236-6 NEUROPSYCHOPHARMACOLOGY 2001–VOL. 25, NO. 3 QEEG and Relapse Prediction 333 have, for example, been associated with an increased for a 3-month period after leaving treatment. Via detec- likelihood of relapse (Booth et al. 1991; Kampman et al. tion procedures which included self-reports, weekly 1998; Langenbucher et al. 1996; McLellan et al. 1994; breathalyzer tests, and collateral informants, the patient Winterer et al. 1998). In such studies, severity of depen- group was divided into subgroups defined by the dence has been quantified using scores on either alco- presence versus absence of any alcohol use during the hol or drug use problem scales, DSM symptom counts, 3-month post-treatment period. Differences in baseline or the number of previous hospitalizations. EEG spectral power, and in autonomic, demographic, The presence of an additional, comorbid psychiatric and other pre-treatment characteristics were tested be- disorder is likewise associated with an increased risk for tween the Relapse-prone and Abstinence-prone patient relapse. One such disorder is the presence of severe con- groups, and the nonalcoholic control group. duct problems both before and after age 15, i.e., a conjoint The results showed that patients with unfavorable diagnosis of Conduct Disorder (CD) and Antisocial Per- versus favorable outcomes were similar in demo- sonality Disorder (ASPD) (Hesselbrock 1991; Leal et al. graphic and clinical characteristics. In the face of these 1994; Woody et al. 1984, 1985). Comorbid depression also similarities, EEG activity alone significantly differenti- appears to promote relapse. However, the association be- ated the groups: Relapse-prone patients exhibited more tween comorbid depression and treatment outcome is high frequency ␤ activity in their EEGs than Absti- complex, and appears to depend upon the nature of the nence-prone patients. This suggestion of heightened treatment, the gender and age composition of the patient central nervous system arousal associated with future sample, and the preferred drug of abuse (Hesselbrock relapse was convergently validated by the demonstra- 1991; Bobo et al. 1998; Brown et al. 1998; Hodgins et al. tion of corresponding elevations in cardiac output and 1999; Kranzler et al. 1996; Rounsaville et al. 1986; Sellman rate within the Relapse-prone group. and Joyce 1996; Ziedonis and Kosten 1991). In 1998, a group from Germany (Winterer et al. 1998) Although the above-mentioned clinical studies have replicated our 1994 findings using 38 alcohol-dependent demonstrated an association between greater illness se- patients studied after seven days of abstinence. Their verity, psychiatric comorbidity, and relapse, the associ- analyses of demographic and substance use characteris- ation has not been replicated in other studies. Further- tics also revealed relatively few differences between the more, when these same variables have been entered Abstinence-prone and Relapse-prone groups. When into more rigorous analyses (e.g., logistic regression or measures of EEG activity were entered into a discrimi- discriminant function) designed to predict the outcome nant function analysis, the sensitivity for predicting re- of individual cases, the resulting sensitivity and speci- lapse was about 88%. Abstinent outcomes were correctly ficity in prediction have been less than ideal. In part, the identified for 92% of the cases. The overall classification limited power of CD/ASPD, depression, and illness se- accuracy of approximately 90% was greater than the 59% verity for specifying outcome might be attributed to in- accuracy associated with only clinical measures. accuracy in the patient’s recall of his/her history and In 1999, a research group from New York University severity of substance abuse as well as imprecision in the (Prichep et al. 1999) extended the idea of relating base- diagnosis of comorbid disorders. Accordingly, the ad- line EEG activity to outcome in a group of cocaine- dition of an objective measure, which is less influenced dependent patients enrolled in a residential treatment by the reliabilities and validities of the patient’s report program. Their approach to the analysis was somewhat and the clinical diagnosis, might markedly improve our different. For example, in the NYU study, retention in ability to forecast outcome and plan appropriate pre- treatment was the criterion variable, not relapse per se. ventive measures. These investigators also assigned their 35 patients to Several recent studies employing objective and groups not on the basis of treatment outcome, but on quantitative electroencephalographic (EEG) techniques the basis of a cluster analysis of several EEG variables. have already demonstrated an association between the The relationships between the empirically-derived EEG amount of ␤ (i.e. Ͼ 13 Hz) activity in the spontaneous clusters and several demographic and substance use electroencephalogram and relapse to alcohol or cocaine variables were then examined. There were no signifi- abuse. Our initial report on this topic (Bauer 1994) de- cant differences between the EEG clusters except for the scribed a study of 17 alcohol-dependent inpatients and membership’s average length of stay in residential 14 healthy, nonalcoholic volunteers from the commu- treatment. One cluster of patients, which was character- nity. The patients were tested after 7 and 14 days of ver- ized by a shorter length of stay in treatment in compari- ified abstinence. The control group was also repeatedly
Load more

Recommended publications
  • Empirical Evidence for Definitions of Episode, Remission, Recovery, Relapse and Recurrence in Depression: a Systematic Review
    Epidemiology and Psychiatric Sciences (2019), 28, 544–562. © Cambridge University Press 2018 ORIGINAL ARTICLE doi:10.1017/S2045796018000227 Empirical evidence for definitions of episode, remission, recovery, relapse and recurrence in depression: a systematic review P. L. de Zwart1*, B. F. Jeronimus1,2 and P. de Jonge1,2 1 University of Groningen, University Medical Center Groningen, Department of Psychiatry, Interdisciplinary Center Psychopathology and Emotion Regulation (ICPE), Groningen, The Netherlands 2 University of Groningen, Faculty of Behavioural and Social Sciences, Department of Developmental Psychology, Groningen, The Netherlands Aims. For the past quarter of a century, Frank et al.’s (1991) consensus-based definitions of major depressive disorder (MDD) episode, remission, recovery, relapse and recurrence have been the paramount driving forces for consistency in MDD research as well as in clinical practice. This study aims to review the evidence for the empirical validation of Frank et al.’s proposed concept definitions and to discuss evidence-based modifications. Methods. A literature search of Web of Science and PubMed from 1/1/1991 to 08/30/2017 identified all publications which referenced Frank et al.’s request for definition validation. Publications with data relevant for validation were included and checked for referencing other studies providing such data. Results. A total of 56 studies involving 39 315 subjects were included, mainly presenting data to validate the severity and duration thresholds for defining remission and recovery. Most studies indicated that the severity threshold for defining remission should decrease. Additionally, specific duration thresholds to separate remission from recovery did not add any predictive value to the notion that increased remission duration alleviates the risk of reoccurrence of depressive symp- toms.
    [Show full text]
  • Impact of Disclosure of Relapse for Self-Identified Sexual Addicts
    Sexual Addiction & Compulsivity, 20:157–170, 2013 Copyright © Taylor & Francis Group, LLC ISSN: 1072-0162 print / 1532-5318 online DOI: 10.1080/10720162.2013.786659 ARTICLES Impact of Disclosure of Relapse for Self-Identified Sexual Addicts M. DEBORAH CORLEY Sante´ Center for Healing, Argyle, Texas SARA E. POLLARD and JOSHUA N. HOOK University of North Texas, Denton, Texas JENNIFER P. SCHNEIDER Tucson, Arizona Disclosure as a process of both recovery and healing within commit- ted relationships is advocated by couple and addiction therapists. The traumatic impact for partners of an initial disclosure or discov- ery of betrayals has been well documented, but less is known about the impact of disclosure for sex addicts. The present study explored the experience of relapse and disclosure among sex addicts. Relapse was a common experience among sex addicts, and the disclosure of relapse had a range of consequences for the addict and the re- lationship. Voluntary disclosure of relapse (rather than the partner discovering relapses independently) was associated with positive relational outcomes. The majority of sexual behaviors engaged in by sexual addicts who are in a committed relationship are considered a violation of trust by their partners (Bird, Butler, & Fife, 2007; Kalichman & Cain, 2004; Young, Griffin-Shelley, Cooper, O’Mara, & Buchanan, 2000). This violation is also considered a betrayal and may be described as a secret sexual, romantic, or emotional involvement that violates the rules of and commitment to an exclusive re- lationship (Glass, 2002; Laaser, 2011; Whisman & Wagers, 2005). The most significant betrayals are those associated with repeated secrets, lies, decep- tions, and broken promises (Corley & Schneider, 2002; Corley, Schneider, Thanks to Dr.
    [Show full text]
  • Alcohol Use Disorder Relapse Factors a Systematic Review
    Psychiatry Research 278 (2019) 97–115 Contents lists available at ScienceDirect Psychiatry Research journal homepage: www.elsevier.com/locate/psychres Alcohol use disorder relapse factors: A systematic review T ⁎ Wilco Sliedrechta, , Ranne de Waartb, Katie Witkiewitzc, Hendrik G. Roozend a De Hoop GGZ, Provincialeweg 70, 3329 KP Dordrecht, the Netherlands b Mentrum/Arkin, Wisselwerking 46-48, 1112 XR Diemen, the Netherlands c The University of New Mexico (UNM), MSC 03-2220, Univ of New Mexico, Albuquerque, NM 87131, USA d The University of New Mexico (UNM), Center on Alcoholism, Substance Abuse, and Addictions (CASAA), MSC 11 6280, 1 Univ of New Mexico, Albuquerque, NM 87106, USA ARTICLE INFO ABSTRACT Keywords: A relapsing-remitting course is very common in patients with an Alcohol Use Disorder (AUD). Understanding the Remittance determinants associated with alcohol resumption remains a formidable task. This paper examines relapse de- Recurrence terminants based on a systematic review of recent alcohol literature (2000–2019). Relevant databases were Relapse determinants consulted for articles that contained information about specific relapse determinants and reported statistical Dual diagnosis significance of each relapse determinant in predicting relapse. Relapse was broadly defined based on the Biopsychosocial model characterization in the included articles. From the initial identified 4613 papers, a total of 321 articles were Spiritual included. Results encompass multiple relapse determinants, which were ordered according to biopsychosocial and spiritual categories, and presented, using a descriptive methodology. Psychiatric co-morbidity, AUD se- verity, craving, use of other substances, health and social factors were consistently significantly associated with AUD relapse. Conversely, supportive social network factors, self efficacy, and factors related to purpose and meaning in life, were protective against AUD relapse.
    [Show full text]
  • Getting Through Amphetamine Withdrawal – a Guide for People
    Amphetamine_wdl_220404.qxd 28/04/2004 12:19 PM Page i GETTING THROUGH AMPHETAMINE WITHDRAWAL A guide for people trying to stop amphetamine use Amphetamine_wdl_220404.qxd 28/04/2004 12:19 PM Page ii GETTING THROUGH AMPHETAMINE WITHDRAWAL CONTENTS About this book x Making the decision to stop using amphetamines x Amphetamine withdrawal x What is withdrawal? x How long will the symptoms last? What kinds of symptoms will I have? x Getting started x Organise a safe environment x Organise support x Structure your day x The role of medication x Getting through withdrawal x Cravings x Sleep x September 1996 Relaxing x Revised May 2004 Mood swings x © Turning Point Alcohol and Drug Centre Inc. Strange thoughts x 54-62 Gertrude Street, Fitzroy VIC 3065 Eating again x T: 03 8413 8413 Aches and pains x F: 03 9416 3420 High-risk situations x Counselling x E: [email protected] It’s all too much x www.turningpoint.org.au Sex and withdrawal x Original edition by Dr Nik Lintzeris, Dr Adrian Dunlop and After withdrawal x David Thornton What next? x Updated (2004) by Dr Adrian Dunlop, Sandra Hocking, Dr Getting back on track if you ‘slip up’ x Nicole Lee and Peter Muhleisen Notes for supporters x Cartoonist: Mal Doreian Useful contact numbers x ISBN 0_958 6979_1_4 1 Amphetamine_wdl_220404.qxd 28/04/2004 12:19 PM Page 2 GETTING THROUGH AMPHETAMINE WITHDRAWAL MAKING THE DECISION TO STOP USING AMPHEATMINES ABOUT THIS BOOK This book is written for people who are thinking about You may find it helpful to make a list of the positives and the or trying to stop using amphetamines, even if just for a negatives about using amphetamines.
    [Show full text]
  • The Addictive Potential of Sexual Behavior (Impulse) Review2
    Page 1 of 9 Impulse: The Premier Journal for Undergraduate Publications in the Neurosciences Submitted for Publication January, 2018 The Addictive Potential of Sexual Behavior Heather Bool D’Youville College, Buffalo, New York This paper examines the addictive potential of sexual behavior through behavioral and neurophysiological mechanisms analogous to other formalized addictions. Sexual behavior refers to any action or thought preformed with the intention of sexual gratification, such as the consumption of explicit material, masturbation, fantasizing of sexual scenarios, and sexual intercourse. Addiction is defined by the presence of tolerance, preoccupation, withdrawal, dependence, and the continuation of behavior despite risk and/or harm. Sexual addiction demonstrates high relapse potential due to the frequency of reward-associated cues encountered in daily life, and the low effort and risk required for sexual pleasure. Currently, sexual addiction lacks a formal diagnosis despite behavioral, psychological, and physiological evidence. An official diagnosis recognized by a governing authority, such as the American Psychological Association, would offer greater access to treatment, funding for research, and exposure and education for the general public about this disorder. Abbreviations: None Keywords: Sexual Behavior; Addiction; Sexual Addiction; Neurophysiology; Behavioral Neuroscience Introduction “Sexual addiction” is an umbrella term Confusion remains regarding the for sexual impulsivity, sexual compulsivity, out- etiology and nosology of sexual addiction, of-control sexual behavior, hypersexual which has led to the lack of a universally behavior or disorder, sexually excessive accepted criterion and, more importantly, the behavior or disorder, Don Jaunism, satyriasis, absence of a formal diagnosis. A lack of and obsessive-compulsive sexual behavior operationalization of the disorder has severe (Beech et al., 2009; Karila et al., 2014; effects on research; due to the use of Rosenberg et al., 2014).
    [Show full text]
  • “How Can I Prepare for My Husband's Next Porn Relapse?”
    BLOG “How Can I Prepare for My Husband’s Next Porn Relapse?” ONCE UPON A TIME, I WAS BLISSFULLY HAPPY. No, my life wasn’t perfect or easy. Instead, it was real. Messy, but meaningful. I lived and worked passionately within the world of pornography addiction and betrayal trauma recovery, with a job I adored and the marriage I’d always wanted. And then, without warning, it all came crashing down. MY STORY IS A BIT UNUSUAL. The incident I’m describing didn’t occur at the start of our recovery from my husband’s porn addiction, it happened after nearly a decade of intensive “his, hers, and ours” recovery work. I’d thought that, surely, the worst was behind us. I believed I was one of a lucky few whose husband grasped the make-or-break importance of staying sexually sober, who understood the imperative of gut-level honesty. I trusted my husband deeply (not entirely, but significantly), and I thanked God every day for giving me the most empathetic pornography addict I’d ever met. Relapse And then, out of the blue, my husband disclosed a porn relapse that knocked me to my knees. There I sat. Unknowing. Unraveled. Disbelieving. Disoriented. I felt an entire dictionary of adverbs and adjectives, dizzy I do believe (emphatically) that relapse prevention matters. with a cyclone of fractured vocabulary. And yet, despite that But as I don’t possess the formula for making it happen, flood of emotion and experience, I can identify, with razor I lobby instead for the next best thing: I work to ensure precision, the one single word that embodies that horrific that my clients are well prepared for the possibility of their day: unprepared.
    [Show full text]
  • Therapy Manuals for Drug Addiction. Manual 1
    i ACKNOWLEDGMENTS The development of earlier versions of this manual was supported by several research grants from the National Institute on Drug Abuse. The current manual was written by Dr. Kathleen Carroll of Yale University under Contract Number N-OIDA-4-2205 with the National Institute on Drug Abuse. Dr. Lisa Onken, the NIDA Project Officer, offered valuable guidance and comments throughout the preparation of this manual. The material presented in this manual is the result of a program of research by Dr. Kathleen Carroll and Dr. Bruce Rounsaville and their colleagues at Yale University. The development of this therapy model for treatment of drug abuse drew extensively from the work of Alan Marlatt and others (Marlatt and Gordon 1985; Chancy et al. 1978; Jaffe et al. 1988; Ito et al. 1984). The structure and sequence of sessions presented in this therapy model was partially developed by work on Project MATCH published by the National Institute on Alcohol Abuse and Alcoholism (Kadden et al. 1992) and the manual developed by Peter Monti and his colleagues (1989). These sources are particularly reflected here in the a skills-training material, and we have acknowledged the original sources in each of those sections. Yale University Research Team Coinvestigators: Bruce Rounsaville, M.D. Roseann Bisighini, M.S. Charla Nich, M.S. Monica Canning-Ball Sam Ball, Ph.D. Joanne Corvino, M.P.H. Lisa Fenton, Psy.D. Kea Cox Frank Gawin, M.D. Lynn Gordon, R.N. Tom Kosten, M.D. Tami Frankforter Elinor McCance-Katz, M.D., Ph.D. jenniffer Owler Douglas Ziedonis, M.D.
    [Show full text]
  • Substance Use Disorders: Tips for Friends and Families Developed in Collaboration with Fbhpartners’ Providers and the Client and Family Advisory Board
    Substance Use Disorders: Tips for Friends and Families Developed in collaboration with FBHPartners’ Providers and the Client and Family Advisory Board Learn about Substance Use Disorders Help Build a Support Network Many times, substance use disorders are seen as a choice or character defect Family, friends, and significant others play an instead of a chronic disease even though it affects about one in ten people important role in the recovery of a loved one and are even more common in people with other mental health disorders. with a substance use disorder. These are people Treatment can include a range of medications, counseling and support that your loved one can turn to in moments of crisis will vary based on the needs of the individual. Learning more about or confusion. Lasting recovery is more likely addiction can help ease your feelings of anxiety or anger and help you when an individual has a variety of supporters provide your loved one with more support. rather than just a few. It is not healthy for either of you if you are the only source of support. Communicate Openly Though it may be scary, discuss your concerns about their substance use Attend Family Counseling Together with your loved one. Let them know what specific concerns you have and Meeting with a professional together can that you are there to support them. Encourage them to talk with a enhance the family relationship and look at the professional and/or attend support group meetings. Having open and honest family relationships as a system instead of many communication will help give you and your loved one clear expectations.
    [Show full text]
  • Methamphetamine Research Report
    Research Report Revised Octubre 2019 Methamphetamine Research Report Table of Contents Methamphetamine Research Report Overview What is methamphetamine? What is the scope of methamphetamine misuse in the United States? How is methamphetamine misused? How is methamphetamine manufactured? How is methamphetamine different from other stimulants, such as cocaine? What are the immediate (short-term) effects of methamphetamine misuse? What are the long-term effects of methamphetamine misuse? What are the risks of methamphetamine misuse during pregnancy? Are people who misuse methamphetamine at risk for contracting HIV/AIDS and hepatitis B and C? What treatments are effective for people who misuse methamphetamine? What treatments are under development for methamphetamine use and addiction? Where can I get further information about methamphetamine? References Page 1 Methamphetamine Research Report Provides an overview of the latest scientific findings on methamphetamine, including short- and long- term health consequences, effects on pregnancy, and potential prevention and treatment options. Esta publicación está disponible para su uso y puede ser reproducida, en su totalidad, sin pedir autorización al NIDA. Se agradece la citación de la fuente, de la siguiente manera: Fuente: Instituto Nacional sobre el Abuso de Drogas; Institutos Nacionales de la Salud; Departamento de Salud y Servicios Humanos de los Estados Unidos. Overview The misuse of methamphetamine—a potent and highly addictive stimulant—remains an extremely serious problem in the United States. In some areas of the country, it poses an even greater threat than opioids, and it is the drug that most contributes to violent crime.36 According to data from the 2017 National Survey on Drug Use and Health (NSDUH), over 14.7 million people (5.4 percent of the population) have tried methamphetamine at least once.
    [Show full text]
  • Relapse Prevention
    Relapse Prevention An Overview of Marlatt’s Cognitive-Behavioral Model Mary E. Larimer, Ph.D., Rebekka S. Palmer, and G. Alan Marlatt, Ph.D. Relapse prevention (RP) is an important component of alcoholism treatment. The RP model proposed by Marlatt and Gordon suggests that both immediate determinants (e.g., high-risk situations, coping skills, outcome expectancies, and the abstinence violation effect) and covert antecedents (e.g., lifestyle factors and urges and cravings) can contribute to relapse. The RP model also incorporates numerous specific and global intervention strategies that allow therapist and client to address each step of the relapse process. Specific interventions include identifying specific high-risk situations for each client and enhancing the client’s skills for coping with those situations, increasing the client’s self-efficacy, eliminating myths regarding alcohol’s effects, managing lapses, and restructuring the client’s perceptions of the relapse process. Global strategies comprise balancing the client’s lifestyle and helping him or her develop positive addictions, employing stimulus control techniques and urge- management techniques, and developing relapse road maps. Several studies have provided theoretical and practical support for the RP model. KEY WORDS: AODD (alcohol and other drug dependence) relapse; relapse prevention; treatment model; cognitive therapy; behavior therapy; risk factors; coping skills; self efficacy; expectancy; AOD (alcohol and other drug) abstinence; lifestyle; AOD craving; intervention; alcohol cue; reliability (research methods); validity (research methods); literature review elapse, or the return to heavy cess, a series of events that unfold over alcohol use following a period of time (Annis 1986; Litman et al. 1979; MARY E.
    [Show full text]
  • Examining Oxytocin As a Potential Pharmacotherapy for Methamphetamine Addiction
    Medical University of South Carolina MEDICA MUSC Theses and Dissertations 2015 Examining Oxytocin as a Potential Pharmacotherapy for Methamphetamine Addiction Brittney M. Cox Medical University of South Carolina Follow this and additional works at: https://medica-musc.researchcommons.org/theses Recommended Citation Cox, Brittney M., "Examining Oxytocin as a Potential Pharmacotherapy for Methamphetamine Addiction" (2015). MUSC Theses and Dissertations. 447. https://medica-musc.researchcommons.org/theses/447 This Dissertation is brought to you for free and open access by MEDICA. It has been accepted for inclusion in MUSC Theses and Dissertations by an authorized administrator of MEDICA. For more information, please contact [email protected]. Examining Oxytocin as a Potential Pharmacotherapy for Methamphetamine Addiction by Brittney M. Cox A dissertation submitted to the faculty of the Medical University of South Carolina in partial fulfillment of the requirements for the degree of Doctor of Philosophy in the College of Graduate Studies. Department of Neurosciences 2015 Approved by: Gary Aston-Jones Advisory Committee Chairman Ronald E See Co-Chairman Carmela M Reichel Judson Chandler Patrick J Mulholland Stan B Floresco ii Abstract Human and animal studies suggest that females differ in their motivation to use methamphetamine (meth), and have increased propensity to relapse. However, addiction pharmacotherapies have primarily only been tested in males, which may not accurately predict treatment outcomes in females. Evidence suggests that oxytocin, an endogenous peptide well known for its role in social behaviors and childbirth, is a promising addiction pharmacotherapy. This dissertation first examines sex differences in the effect of oxytocin to decrease meth and sucrose seeking. Our data indicate that systemic oxytocin decreased responding for meth differentially in males and females on a progressive ratio schedule of reinforcement (a measure of motivation) in females but not males, although it reduced reinstatement of meth seeking similarly in both sexes.
    [Show full text]
  • Stimulant Use Disorder
    Disclosure Information Frances R. Levin, MD Support: Research/Salary/Training Support Federal: National Institute on Drug Abuse: National Institute on Drug Abuse: Substance Abuse and Mental Health Services Administration (SAMHSA) New York State: Salary Support- Research Scientist Industry Support: US World Meds (provides medication for study); Consultant: Major League Baseball Unpaid Scientific Advisory Board Member: Novartis, Alkermes, Indivior Everything I talk about is Off-Label Use No medication has been FDA-approved for the Treatment of Stimulant Use Disorder Psychosocial Treatments Systematic reviews of cognitive and behavioral treatments conclude that good clinical outcomes are achieved with Cognitive-Behavioral Treatment (CBT; with and without Motivational Interviewing [MI] Contingency Management (CM) therapies involving the use of reinforcement (Lee and Rawson, 2008). There are questions regarding the durability of treatment effects (especially with respect to CM) Furthermore, the effectiveness of psychosocial interventions is compromised by: Poor rates of treatment induction and retention (Shearer, 2007), Cognitive deficits in executive functioning, particularly those related to inhibitory control, have been hypothesized to potentially render heavily cognitive-based treatments less or ineffective (Baicy and London, 2007 Aharonovich 2008). COCAINE METHAMPHETAMINE (Chan et al., 2019) (Siefried et al. CNS Drugs 2020) 43 randomized controlled trials, 4065 participants, 23 medications; 21 of the studies with 5 medications (Mitrazapine, MPH, Modafinil, Naltrexone, Bupropion) Outcomes and measures varied widely, making it difficult to synthesize the data 55 Primary Outcome measures (most common ones chosen) Abstinence was the most common measure but looked at in MANY ways Reduction in Use Craving Withdrawal When meta-analyses done, often can only do it on a small subset of the studies that share the same outcome measure Adherence- measured by pill count, MEMS, 11 studies did not report adherence.
    [Show full text]