DOCSLIB.ORG

The State of the Drugs Problem in Europe

Total Page：16

File Type：pdf, Size：1020Kb

Download full-text PDF Read full-text

Load more

ISS N1 60 9- 61 50 RT AL 08 PO 20 THESTATE OF THEDRUGSNU PROBLEMINEUROPE RE AN EN RT AL 08 PO 20 THESTATE OF THEDRUGSNU PROBLEMINEUROPE RE AN Legalnotice This publicationofthe European MonitoringCentrefor Drugsand Drug Addiction(EMCDDA)isprotected by copyright.The EMCDDA acceptsnoresponsibility or liability forany consequences arisingfromthe useofthe data contained in this document. The contentofthis publicationdoesnot necessarilyreflect theofficial opinions of theEMCDDA’spartners, theEUMemberStatesorany institution or agencyofthe European UnionorEuropeanCommunities. Agreat deal of additionalinformation on theEuropeanUnion is availableonthe Internet. It canbe accessedthrough theEuropaserver(http://europa.eu). Europe Direct is aservice to help youfind answerstoyourquestionsabout theEuropeanUnion Freephonenumber (*): 00 80067891011 (*)Certain mobile telephone operatorsdonot allowaccess to 00 800numbersorthese callsmay be billed. This report is availableinBulgarian,Spanish, Czech, Danish, German, Estonian,Greek,English,French, Italian, Latvian, Lithuanian,Hungarian, Dutch, Polish,Portuguese,Romanian,Slovak, Slovenian,Finnish, Swedish, Turkishand Norwegian. Alltranslations were made by theTranslationCentrefor theBodiesofthe European Union. Cataloguingdata canbefound at theend of this publication. Luxembourg:Office forOfficial Publications of theEuropeanCommunities,2008 ISBN 978-92-9168-324-6 ©EuropeanMonitoringCentrefor Drugsand Drug Addiction, 2008 Reproductionisauthorisedprovidedthe sourceisacknowledged. PrintedinLuxembourg PRINTED ON WHITECHLORINE-FREE PAPER RuadaCruzdeSanta Apolónia,23–25,1149-045Lisbon, Portugal Tel. (351)218 11 30 00 • Fax(351) 218131711 [email protected] • http://www.emcdda.europa.eu Contents Foreword 5 Acknowledgements 7 Introductorynote 9 Commentary:The drug situationinEurope— newperspectivesand some old realities 11 Chapter1:Policies andlaws Internationaland EU policy developments •Nationalstrategies• Public expenditure•Nationallegislation•Crime •Nationalresearch 18 Chapter2:Respondingtodrug problemsinEurope—anoverview Prevention •Treatment•Harmreduction•Socialreintegration • Health andsocialresponses in prison 28 Chapter3:Cannabis Supplyand availability •Prevalenceand patterns of use•Treatment 36 Chapter4:Amphetamines,ecstasy andLSD Supplyand availability •Prevalenceand patterns of use•Recreationalsettings• Treatmentprovision 47 Chapter5:Cocaine andcrack cocaine Supplyand availability •Prevalenceand patterns of use• Treatmentand harm reduction 58 Chapter6:Opioid useand drug injection Heroin supplyand availability •Prevalenceand patterns of use• Injectingdrug use•Treatment of problem opioid use 68 Chapter7:Drug-relatedinfectiousdiseasesand drug-relateddeaths Infectiousdiseases •Preventinginfectiousdiseases •Deathsand mortality• Reducing deaths 78 Chapter8:Newdrugsand emergingtrends EU actiononnew psychoactivesubstances •Internetshops •GHB andGBL 90 References 95 3 Foreword We areproud to present this,the thirteenth,annual report developmentand politicalstability of producer and of theEuropeanMonitoringCentrefor Drugsand Drug transitcountries? Onehas only to considerthe worrying Addiction. This report is only possible throughthe hard developments resultingfromthe transiting of cocaine work anddedicationofour partners in theReitoxnetwork throughWestAfricatoberemindedofthe collateral of nationalfocal points andthe expertsthroughout damage that this problem cancause. Europe whohavecontributed to theanalysis. We also On apositivenote, drug useinEuropeappears to be areindebted to thoseEUagenciesand international stabilising,and progress canbenoted in theway in which organisations workinginthe drugsfield.Our report is a EU Member States areaddressingthis issue. Formost collective endeavourand we thank all thosewho have formsofdrug use, ouroverall assessmentisthatweare contributed to it.The rationale behind this work is that a not seeing increases,and in someareas thetrendsappear cool-headedanalysisofwhatweknowabout thedrug to be downward.Interms of responses,wehaveseen situationisaconditionfor an informed, productiveand virtuallyall Member States adoptastrategic approach, reasoneddebate. It ensuresthatopinionsare enlightened andgreater cohesion is visible at theEuropeanlevel. by facts, andthatthose making difficultpolicychoices can Treatmentavailability continues to grow,and in some have aclear understandingofthe costsand benefitsofthe countriesithas reachedthe pointwhere themajorityof optionsavailable. heroin users, onceconsideredahiddenpopulation, are This year hasbeenanexceptionallybusytimefor drug nowincontactwithservices of one sort or another. Not many yearsago,HIV infection amongdrug injectors was policy,and theEMCDDAhas been honoured to have acentral concern in thedrug policy debate.Since then, supported both thefinalevaluationofthe currentEU apragmatic mixtureofprevention, treatmentand harm- actionplanondrugsand thereviewofthe 1998 United reductionmeasureshas become thenorminEurope, and NationsGeneralAssemblySpecialSessiononthe drug ratesofnew infection attributed to drug usehavefallen problem.Itisgratifyingtonotethat, by international andcontinuetodoso. standards, Europe stands outasone of theparts of the worldwhere monitoringcapacitiesare most developed. Good news makespoorheadlines andcan be overlooked. Nonetheless,weare awareofthe limitationsofour current However, it is importanttorecogniseprogress where information resources,and areconstantlyworkingwithour it hasbeenmade. Increasingly, in Europe,wehave partners to improvethe qualityand relevanceofthe data an understandingofwhatmeasurescan be effective available. in addressingdrug problems. An acceptance that our activities can, anddo, make adifferenceisaprerequisite An underlying theme of thepolicydebateondrugsis to securing investmentand policy support. This is not to say thecosts, both hidden andmorevisible,ofEurope’sdrug that ourreportdoesnot highlightmanyareas of concern problem.This issueisaddressedinvarious partsofthis forthe European Union. Examplesinclude thecontinuing report.The EMCDDA hasbeenworkingtodevelopan increases in cocaineuse andthe considerabledifferences understandingofthe public expenditures associated with that still existbetween countriesinthe availability and tacklingdrug useinEUMemberStates. This work is in qualityofservices forthose with problems. We must itsinfancy,and estimatesderived areindicativerather thereforeconcludethat, even if progress hasbeenmade, than precise. Nonetheless,theypoint to considerable thejourneyremainsfar from finished. However, today sums beingspent,withpreliminary figuresofbetween in Europe,morethanatany time in thepast,wehavea EUR28billion andEUR 40 billion. Less easy to express stronger agreementonthe direction we should take. in economic termsisthe harm caused by drug use. MarcelReimen What costsdowecount in lookingatthe tragic loss Chairman, EMCDDA ManagementBoard of lifecausedbydrugsinEurope, thenegativeimpact on communities wheredrugsare producedorsold,or WolfgangGötz in theway that drug trafficking undermines thesocial Director, EMCDDA 5 Acknowledgements The EMCDDA wouldliketothank thefollowing fortheir help in producingthis report: • theheads of theReitoxnationalfocal points andtheir staff; • theservices within each Member Statethatcollectedthe rawdatafor this report; • themembers of theManagementBoard andthe Scientific Committeeofthe EMCDDA; • theEuropeanParliament, theCouncil of theEuropeanUnion —inparticularits Horizontal WorkingParty on Drugs— andthe European Commission; • theEuropeanCentrefor DiseasePreventionand Control(ECDC), theEuropeanMedicinesAgency (EMEA)and Europol; • thePompidou Groupofthe CouncilofEurope, theUnited NationsOffice on Drugsand Crime, theWHO Regional Officefor Europe,Interpol,the WorldCustoms Organisation, theESPAD project andthe SwedishCouncil forInformation on Alcoholand otherDrugs(CAN),and theEuropeanCentrefor theEpidemiologicalMonitoringofAIDS(EuroHIV); • theTranslationCentrefor theBodiesofthe European Unionand theOffice forOfficial Publications of theEuropean Communities. Reitox nationalfocal points Reitox is theEuropeaninformation network on drugsand drug addiction.The network is comprised of nationalfocal points in theEUMemberStates, Norway,the candidatecountriesand at theEuropeanCommission.Under theresponsibility of their governments, thefocal points arethe nationalauthorities providing drug information to theEMCDDA. The contactdetailsofthe nationalfocal points maybefound at: http://www.emcdda.europa.eu/about/partners/reitox-network 7 Introductory note This annual report is basedoninformation provided to theEMCDDAbythe EU Member States andcandidatecountries andNorway(participating in thework of theEMCDDAsince 2001)inthe form of anationalreport. The statisticaldata reported here relatetothe year 2006 (orthe last year available).Graphicsand tables in this report mayreflectasubset of EU countries: theselection is made on thebasis of thosecountriesfromwhich dataare availablefor theperiodof interest. Retail prices of drugsreported to theEMCDDAreflectthe pricetothe user.Reports on purity or potency, from most countries, arebased on asample of alldrugsseized, anditisgenerally not possible to relatethe reported datatoa specific levelofthe drug market.For purity or potencyand retail prices,all analyses arebased on typical(modal) values or,intheir absence, mean (ormedian) values. Reportsofthe prevalenceofdrug usebased on general populationsurveysmostly refertothe nationalpopulationaged 15– 64 years. Countriesusing different upperorlower agelimitsinclude:Bulgaria (18–60),
Recommended publications
  • Medications to Treat Opioid Use Disorder Research Report

    Medications to Treat Opioid Use Disorder Research Report

    Research Report Revised Junio 2018 Medications to Treat Opioid Use Disorder Research Report Table of Contents Medications to Treat Opioid Use Disorder Research Report Overview How do medications to treat opioid use disorder work? How effective are medications to treat opioid use disorder? What are misconceptions about maintenance treatment? What is the treatment need versus the diversion risk for opioid use disorder treatment? What is the impact of medication for opioid use disorder treatment on HIV/HCV outcomes? How is opioid use disorder treated in the criminal justice system? Is medication to treat opioid use disorder available in the military? What treatment is available for pregnant mothers and their babies? How much does opioid treatment cost? Is naloxone accessible? References Page 1 Medications to Treat Opioid Use Disorder Research Report Discusses effective medications used to treat opioid use disorders: methadone, buprenorphine, and naltrexone. Overview An estimated 1.4 million people in the United States had a substance use disorder related to prescription opioids in 2019.1 However, only a fraction of people with prescription opioid use disorders receive tailored treatment (22 percent in 2019).1 Overdose deaths involving prescription opioids more than quadrupled from 1999 through 2016 followed by significant declines reported in both 2018 and 2019.2,3 Besides overdose, consequences of the opioid crisis include a rising incidence of infants born dependent on opioids because their mothers used these substances during pregnancy4,5 and increased spread of infectious diseases, including HIV and hepatitis C (HCV), as was seen in 2015 in southern Indiana.6 Effective prevention and treatment strategies exist for opioid misuse and use disorder but are highly underutilized across the United States.
  • Apo-Ropinirole

    Apo-Ropinirole

    New Zealand Data Sheet APO-ROPINIROLE 1. PRODUCT NAME APO-ROPINIROLE 0.25mg, 0.5mg, 1mg, 2mg, 3mg, 4mg and 5mg tablets 2. QUALITATIVE AND QUANTITATIVE COMPOSITION Ropinirole hydrochloride 0.25mg Ropinirole hydrochloride 0.5mg Ropinirole hydrochloride 1mg Ropinirole hydrochloride 2mg Ropinirole hydrochloride 3mg Ropinirole hydrochloride 4mg Ropinirole hydrochloride 5mg Excipient(s) with known effect Contains lactose. For the full list of excipients, see section 6.1 3. PHARMACEUTICAL FORM APO-ROPINIROLE is available as oral, film coated tablets in the following strengths: APO-ROPINIROLE 0.25mg tablets are white, pentagonal, biconvex film-coated tablet identified by an engraved “ROP” over “.25” on one side and “APO’ on the other side. Each tablet typically weighs about 153mg. APO-ROPINIROLE 0.5mg tablets are yellow, pentagonal, biconvex film-coated tablet identified by an engraved “ROP” over “.5” on one side and “APO’ on the other side. Each tablet typically weighs about 153mg. APO-ROPINIROLE 1mg tablets are green, pentagonal, biconvex film-coated tablet identified by an engraved “ROP” over “1” on one side and “APO’ on the other side. Each tablet typically weighs about 153mg. APO-ROPINIROLE 2mg tablets are pink, pentagonal, biconvex film-coated tablet identified by an engraved “ROP” over “2” on one side and “APO’ on the other side. Each tablet typically weighs about 153mg. APO-ROPINIROLE 3mg tablets are purple, pentagonal, biconvex film-coated tablet identified by an engraved “ROP” over “3” on one side and “APO’ on the other side. Each tablet typically weighs about 153mg. APO-ROPINIROLE 4mg tablets are pale brown, pentagonal, biconvex film-coated tablet identified by an engraved “ROP” over “4” on one side and “APO’ on the other side.
  • Understanding Addiction, Helping Clients and Colleagues

    Understanding Addiction, Helping Clients and Colleagues

    ALABAMA LAWYER ASSISTANCE PROGRAM Understanding Addiction, Helping Clients and Colleagues By Jeanne Marie Leslie rugs change the brain–they according to the American Bar change its structure and how it Association, is 15 to 18 percent.3 D works.1 Many of these changes Lawyers rank high in the incidences of are responsible for the behaviors we see depression compared to other professions in individuals addicted to drugs. and a disproportionate number of Neuroscience has made significant lawyers commit suicide;4 in Alabama advances in our ability to identify and there are about a dozen lawyer suicides understand the mechanisms involved in every year. And these are only the ones the addicted brain. These advancements about which we know. Many lawyers, clearly confirm what many in the addic- including some you know, may be strug- tion medicine field have known for some gling with an addiction or mental health time: the obsession and compulsion to problem when help is readily available use drugs in the addicted brain is instinc- through ALAP. tual and paramount to survival.2 Ignorance and stigma have contributed Addiction Facts to the confusion, moral judgments and Dr. Nora D. Volkow, director of the poor understanding of this destructive National Institute of Drug Abuse and often fatal disease. Our courts are (NIDA), explains how the neuro-chemi- overwhelmed by the behaviors, criminal cal mechanisms of drug abuse catalyze and civil, associated with addiction. and accelerate the onset addiction: Therefore, understanding addiction is “Recognizing drug addiction as a chron- essential for lawyers. Lawyers are in ic, relapsing disease characterized by com- unique positions to initiate change, to pulsive drug seeking and use is critical to advocate for medical treatment over tra- being able to identify and help those who ditional sanctions and to refer individuals have it.
  • ASAM National Practice Guideline for the Treatment of Opioid Use Disorder: 2020 Focused Update

    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.
  • Amphetamines Help People Struggling with Amphetamine Addiction

    Amphetamines Help People Struggling with Amphetamine Addiction

    Reducing Harm & Finding Help, Continued detox facilities, and addiction treatment programs can help with withdrawal. Amphetamine addiction can be treated in a residential setting (often called “rehab”) or in an outpatient setting (when the patient lives at home, but goes to treatment appointments 1-7 times per week). Effective types of counseling for benzodiazepine addiction include cognitive behavioral therapy, motivational interviewing, and twelve- step facilitation. There are also recovery support groups and online forums that can Amphetamines help people struggling with amphetamine addiction. Narcotics Anonymous, Alcoholics Anonymous, and groups like SMART Recovery or LifeRing are all available to support people with Information about amphetamine addiction. Recovery apps specific to amphetamine addiction can be downloaded to your smart phone that Your Health provide lists of recovery support meetings, reading material, tools like sobriety counters, and more. © 2016 Institute for Research, Education and Training in Addictions Amphetamines – Amphetamines & who inject amphetamines and/or share equipment can develop injection site What Are They? My Health, Continued infections, damage to their veins, Hepatitis B & C, HIV, and blood clots. Amphetamines are a category of drug that decisions. For some people, amphetamine include prescription medications (like intoxication can create or worsen mental Adderall), methamphetamine (often illness symptoms like anxiety, paranoia, and shortened to “meth”), and MDMA (often hallucinations. called “ecstasy” or “Molly”). Although these drugs are not identical, they are all included Unknown drugs: Because some amphetamines in the category of amphetamines. are illegal, they carry additional risks. Users of methamphetamine and MDMA cannot be Amphetamines are stimulants. They can sure of the drug’s contents or dose.
  • Molecular Mechanisms of Addiction

    Molecular Mechanisms of Addiction

    Molecular Mechanisms of Addiction Eric J. Nestler Nash Family Professor The Friedman Brain Institute Medical Model of Addiction • Pathophysiology - To identify changes that drugs produce in a vulnerable brain to cause addiction. • Individual Risk - To identify specific genes and non-genetic factors that determine an individual’s risk for (or resistance to) addiction. - About 50% of the risk for addiction is genetic. Only through an improved understanding of the biology of addiction will it be possible to develop better treatments and eventually cures and preventive measures. Scope of Drug Addiction • 25% of the U.S. population has a diagnosis of drug abuse or addiction. • 50% of U.S. high school graduates have tried an illegal drug; use of alcohol and tobacco is more common. • >$400 billion incurred annually in the U.S. by addiction: - Loss of life and productivity - Medical consequences (e.g., AIDS, lung cancer, cirrhosis) - Crime and law enforcement Diverse Chemical Substances Cause Addiction • Opiates (morphine, heroin, oxycontin, vicodin) • Cocaine • Amphetamine and like drugs (methamphetamine, methylphenidate) • MDMA (ecstasy) • PCP (phencyclidine or angel dust; also ketamine) • Marijuana (cannabinoids) • Tobacco (nicotine) • Alcohol (ethanol) • Sedative/hypnotics (barbiturates, benzodiazepines) Chemical Structures of Some Drugs of Abuse Cocaine Morphine Ethanol Nicotine ∆9-tetrahydrocannabinol Drugs of Abuse Use of % of US population as weekly users 100 25 50 75 0 Definition of Drug Addiction • Loss of control over drug use. • Compulsive drug seeking and drug taking despite horrendous adverse consequences. • Increased risk for relapse despite years of abstinence. Definition of Drug Addiction • Tolerance – reduced drug effect after repeated use. • Sensitization – increased drug effect after repeated use.
  • Integrated Approaches for Genome-Wide Interrogation of The

    Integrated Approaches for Genome-Wide Interrogation of The

    MINIREVIEW THE JOURNAL OF BIOLOGICAL CHEMISTRY VOL. 290, NO. 32, pp. 19471–19477, August 7, 2015 © 2015 by The American Society for Biochemistry and Molecular Biology, Inc. Published in the U.S.A. 5-HT serotonin receptor agonism have long been docu- Integrated Approaches for 2B mented to induce severe, life-threatening valvular heart disease Genome-wide Interrogation of (6–8). Indeed, based on the potent 5-HT2B agonist activity of the Druggable Non-olfactory G certain ergot derivatives used in treating Parkinson disease and migraine headaches (e.g. pergolide, cabergoline, and dihydroer- Protein-coupled Receptor gotamine), we correctly predicted that these medications * would also induce valvular heart disease (7, 8). Two of these Superfamily drugs (pergolide and cabergoline) were withdrawn from the Published, JBC Papers in Press, June 22, 2015, DOI 10.1074/jbc.R115.654764 Bryan L. Roth1 and Wesley K. Kroeze international market following large-scale trials demonstrating From the Department of Pharmacology, University of North Carolina their life-threating side effects (8, 9). In follow-up studies, we Chapel Hill School of Medicine, Chapel Hill, North Carolina 27514 surveyed 2200 FDA-approved and investigational medications, finding that 27 had potentially significant 5-HT2B agonism, of G-protein-coupled receptors (GPCRs) are frequent and fruit- which 6 are currently FDA-approved (guanfacine, quinidine, ful targets for drug discovery and development, as well as being xylometazoline, oxymetazoline, fenoldopam, and ropinirole) off-targets for the side effects of a variety of medications. Much (10). Interestingly, of the 2200 drugs screened, around 30% dis- of the druggable non-olfactory human GPCR-ome remains played significant 5-HT2B antagonist activity (10), indicating under-interrogated, and we present here various approaches that 5-HT2B receptors represent a “promiscuous target” for that we and others have used to shine light into these previously approved and candidate medications.
  • Neuronal Dopamine D3 Receptors: Translational Implications for Preclinical Research and CNS Disorders

    Neuronal Dopamine D3 Receptors: Translational Implications for Preclinical Research and CNS Disorders

    biomolecules Review Neuronal Dopamine D3 Receptors: Translational Implications for Preclinical Research and CNS Disorders Béla Kiss 1, István Laszlovszky 2, Balázs Krámos 3, András Visegrády 1, Amrita Bobok 1, György Lévay 1, Balázs Lendvai 1 and Viktor Román 1,* 1 Pharmacological and Drug Safety Research, Gedeon Richter Plc., 1103 Budapest, Hungary; [email protected] (B.K.); [email protected] (A.V.); [email protected] (A.B.); [email protected] (G.L.); [email protected] (B.L.) 2 Medical Division, Gedeon Richter Plc., 1103 Budapest, Hungary; [email protected] 3 Spectroscopic Research Department, Gedeon Richter Plc., 1103 Budapest, Hungary; [email protected] * Correspondence: [email protected]; Tel.: +36-1-432-6131; Fax: +36-1-889-8400 Abstract: Dopamine (DA), as one of the major neurotransmitters in the central nervous system (CNS) and periphery, exerts its actions through five types of receptors which belong to two major subfamilies such as D1-like (i.e., D1 and D5 receptors) and D2-like (i.e., D2, D3 and D4) receptors. Dopamine D3 receptor (D3R) was cloned 30 years ago, and its distribution in the CNS and in the periphery, molecular structure, cellular signaling mechanisms have been largely explored. Involvement of D3Rs has been recognized in several CNS functions such as movement control, cognition, learning, reward, emotional regulation and social behavior. D3Rs have become a promising target of drug research and great efforts have been made to obtain high affinity ligands (selective agonists, partial agonists and antagonists) in order to elucidate D3R functions. There has been a strong drive behind the efforts to find drug-like compounds with high affinity and selectivity and various functionality for D3Rs in the hope that they would have potential treatment options in CNS diseases such as schizophrenia, drug abuse, Parkinson’s disease, depression, and restless leg syndrome.
  • Everything You Wanted to Know but May Have Been Afraid to Ask

    Everything You Wanted to Know but May Have Been Afraid to Ask

    Wellness Tip Sheet Maryland State Bar Association’s Lawyer Assistance Program Everything you wanted to know but may have been afraid to ask What is Sexual Addiction? According to Dr. Founder of the International Institute for Trauma and Addiction Professionals (IITAP), sexual addiction is defined as any sexually related compulsive behavior which interferes with normal living and causes severe stress on family, friends, loved ones, or one’s work environment. Sexual addiction is sometimes referred to as sexual dependency or sexual compulsivity. By any name it is a compulsive behavior that completely dominates the addict’s life. Sexual addicts make sex a priority, making it more important than family, friends and work. Sex becomes the organizing principle of addicts’ lives. They are willing to sacrifice what they cherish most in order to preserve and continue their unhealthy behavior. Background Information: • It is estimated that 3 to 6% of the US population suffer from sexual addiction. That’s about 17 to 37 million people • Although it has traditionally been considered a middle aged male dominant addiction, females now represent more than 20% of the affected population. • Sex addiction does not discriminate. It crosses all educational, socioeconomic, racial and sexual-orientation lines, but one commonality among addicts is a sense of shame. • There has been progress in the medical field which includes sexual addiction being diagnosed as a disorder and having treatment options available. • In the past ten years treatment options have gone from fewer than 100 therapists to over 1,500, with treatment centers specializing in sexual addiction. What Causes Sexual Addiction? Sexual addiction, just like any addiction, is very complex.
  • Randomized Controlled Trial of Dexamphetamine Maintenance for the Treatment of Methamphetamine

    Randomized Controlled Trial of Dexamphetamine Maintenance for the Treatment of Methamphetamine

    RESEARCH REPORT doi:10.1111/j.1360-0443.2009.02717.x Randomized controlled trial of dexamphetamine maintenance for the treatment of methamphetamine dependenceadd_2717 146..154 Marie Longo1, Wendy Wickes1, Matthew Smout1, Sonia Harrison1, Sharon Cahill1 & Jason M. White1,2 Pharmacotherapies Research Unit, Drug and Alcohol Services South Australia, Norwood, South Australia, Australia1 and Discipline of Pharmacology, University of Adelaide, Adelaide, South Australia, Australia2 ABSTRACT Aim To investigate the safety and efficacy of once-daily supervised oral administration of sustained-release dexam- phetamine in people dependent on methamphetamine. Design Randomized, double-blind, placebo-controlled trial. Participants Forty-nine methamphetamine-dependent drug users from Drug and Alcohol Services South Australia (DASSA) clinics. Intervention Participants were assigned randomly to receive up to 110 mg/day sustained- release dexamphetamine (n = 23) or placebo (n = 26) for a maximum of 12 weeks, with gradual reduction of the study medication over an additional 4 weeks. Medication was taken daily under pharmacist supervision. Measurements Primary outcome measures included treatment retention, measures of methamphetamine consump- tion (self-report and hair analysis), degree of methamphetamine dependence and severity of methamphetamine withdrawal. Hair samples were analysed for methamphetamine using liquid chromatography-mass spectrometry. Findings Treatment retention was significantly different between groups, with those who received dexamphetamine remaining in treatment for an average of 86.3 days compared with 48.6 days for those receiving placebo (P = 0.014). There were significant reductions in self-reported methamphetamine use between baseline and follow-up within each group (P < 0.0001), with a trend to a greater reduction among the dexamphetamine group (P = 0.086).
  • How Unusual Was Autumn 2006 in Europe? G

    How Unusual Was Autumn 2006 in Europe? G

    How unusual was autumn 2006 in Europe? G. J. van Oldenborgh To cite this version: G. J. van Oldenborgh. How unusual was autumn 2006 in Europe?. Climate of the Past Discussions, European Geosciences Union (EGU), 2007, 3 (3), pp.811-837. hal-00298188 HAL Id: hal-00298188 https://hal.archives-ouvertes.fr/hal-00298188 Submitted on 8 Jun 2007 HAL is a multi-disciplinary open access L’archive ouverte pluridisciplinaire HAL, est archive for the deposit and dissemination of sci- destinée au dépôt et à la diffusion de documents entific research documents, whether they are pub- scientifiques de niveau recherche, publiés ou non, lished or not. The documents may come from émanant des établissements d’enseignement et de teaching and research institutions in France or recherche français ou étrangers, des laboratoires abroad, or from public or private research centers. publics ou privés. Clim. Past Discuss., 3, 811–837, 2007 Climate www.clim-past-discuss.net/3/811/2007/ of the Past CPD © Author(s) 2007. This work is licensed Discussions 3, 811–837, 2007 under a Creative Commons License. Climate of the Past Discussions is the access reviewed discussion forum of Climate of the Past How unusual was autumn 2006 in Europe? G. J. van Oldenborgh Title Page How unusual was autumn 2006 in Abstract Introduction Europe? Conclusions References Tables Figures G. J. van Oldenborgh ◭ ◮ KNMI, De Bilt, The Netherlands ◭ ◮ Received: 21 May 2007 – Accepted: 21 May 2007 – Published: 8 June 2007 Back Close Correspondence to: G. J. van Oldenborgh ([email protected]) Full Screen / Esc Printer-friendly Version Interactive Discussion EGU 811 Abstract CPD The temperatures in large parts of Europe have been record high during the meteoro- logical autumn of 2006.
  • Early Piribedil Monotherapy of Parkinson's Disease

    Early Piribedil Monotherapy of Parkinson's Disease

    View metadata, citation and similar papers at core.ac.uk brought to you by CORE provided by Repositório Científico do Centro Hospitalar do Porto Movement Disorders Vol. 21, No. 12, 2006, pp. 2110–2115 © 2006 Movement Disorder Society Early Piribedil Monotherapy of Parkinson’s Disease: A Planned Seven-Month Report of the REGAIN Study Olivier Rascol, MD, PhD,1* Bruno Dubois, MD,2 Alexandre Castro Caldas, MD,3 Stephen Senn, MD,4 Susanna Del Signore, MD,5 and Andrew Lees, MD,6 on behalf of the Parkinson REGAIN Study Group 1INSERM U455, Clinical Investigation Center and Departments of Clinical Pharmacology and Neurosciences, Faculte´deMe´decine, Toulouse, France 2INSERM U610/Groupe Hospitalier Pitie´-Salpeˆtrie`re, Paris, France 3Instituto de Cie¨nsas da Sau`de, Lisbon, Portugal 4Department of Statistics, University of Glasgow, Glasgow, United Kingdom 5Institut de Recherches Internationales Servier, Courbevoie, France 6Royal Free and University College Medical School, University College London/Reta Lila, Weston Institute of Neurological Studies, London, United Kingdom Abstract: Piribedil is a D2 dopamine agonist, which has been significantly higher for piribedil (42%) than for placebo (14%) shown to improve symptoms of Parkinson’s disease (PD) when (OR ϭ 4.69; 95% CI ϭ 2.82–7.80; P Ͻ 0.001). Piribedil combined with L-dopa. The objective of this study was to significantly improved several UPDRS III subscores. UPDRS compare the efficacy of piribedil monotherapy to placebo in II improved on piribedil by Ϫ1.2 points, while it deteriorated patients with early PD over a 7-month period. Four hundred by 1.5 points on placebo (estimated effect ϭ 2.71; 95% CI ϭ and five early PD patients were randomized (double-blind) to 1.8–3.62; P Ͻ 0.0001).