Intervene: an Emergency Guide to Bbrreeaakkttthhrroouugghhsss Heavy Drinking and Alcoholism
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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. -
Ramsey Scott, Which Was Published in 2016
This digital proof is provided for free by UDP. It documents the existence of the book The Narco- Imaginary: Essays Under The Influence by Ramsey Scott, which was published in 2016. If you like what you see in this proof, we encourage you to purchase the book directly from UDP, or from our distributors and partner bookstores, or from any independent bookseller. If you find our Digital Proofs program useful for your research or as a resource for teaching, please consider making a donation to UDP. If you make copies of this proof for your students or any other reason, we ask you to include this page. Please support nonprofit & independent publishing by making donations to the presses that serve you and by purchasing books through ethical channels. UGLY DUCKLING PRESSE uglyducklingpresse.org THE NARCO IMAGINARY UGLY DUCKLING PRESSE The Narco-Imaginary: Essays Under The Influence by Ramsey Scott (2016) - Digital Proof THE NARCO- IMAGINARY Essays Under the Influence RAMSEY SCOTT UDP :: DOSSIER 2016 UGLY DUCKLING PRESSE The Narco-Imaginary: Essays Under The Influence by Ramsey Scott (2016) - Digital Proof THE Copyright © 2016 by Ramsey Scott isbn: 978-1-937027-44-5 NARCO- DESIGN AnD TYPEsETTING: emdash and goodutopian CoVEr PRINTING: Ugly Duckling Presse IMAGINARY Distributed to the trade by SPD / Small Press Distribution: 1341 Seventh Street, Berkeley, CA 94710, spdbooks.org Funding for this book was provided by generous grants from the National Endowment for the Arts, the New York State Council on the Arts, and the Department of Cultural Affairs -
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. -
Neuroplasticity in the Mesolimbic System Induced by Sexual Experience and Subsequent Reward Abstinence
Western University Scholarship@Western Electronic Thesis and Dissertation Repository 6-21-2012 12:00 AM Neuroplasticity in the Mesolimbic System Induced by Sexual Experience and Subsequent Reward Abstinence Kyle Pitchers The University of Western Ontario Supervisor Lique M. Coolen The University of Western Ontario Graduate Program in Anatomy and Cell Biology A thesis submitted in partial fulfillment of the equirr ements for the degree in Doctor of Philosophy © Kyle Pitchers 2012 Follow this and additional works at: https://ir.lib.uwo.ca/etd Recommended Citation Pitchers, Kyle, "Neuroplasticity in the Mesolimbic System Induced by Sexual Experience and Subsequent Reward Abstinence" (2012). Electronic Thesis and Dissertation Repository. 592. https://ir.lib.uwo.ca/etd/592 This Dissertation/Thesis is brought to you for free and open access by Scholarship@Western. It has been accepted for inclusion in Electronic Thesis and Dissertation Repository by an authorized administrator of Scholarship@Western. For more information, please contact [email protected]. NEUROPLASTICITY IN THE MESOLIMBIC SYSTEM INDUCED BY SEXUAL EXPERIENCE AND SUBSEQUENT REWARD ABSTINENCE (Spine Title: Sex, Drugs and Neuroplasticity) (Thesis Format: Integrated Article) By Kyle Kevin Pitchers Graduate Program in Anatomy and Cell Biology A thesis submitted in partial fulfillment of the requirements for degree of Doctor of Philosophy The School of Graduate and Postdoctoral Studies The University of Western Ontario London, Ontario, Canada © Kyle K. Pitchers, 2012 THE UNIVERSITY -
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. -
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 ................................................................................................................ -
Family Practice Grand Rounds Early Diagnosis and Treatment
Family Practice Grand Rounds Early Diagnosis and Treatment of Alcoholism Antonnette V. Graham, RN, MSW, David Sedlacek, PhD, Kenneth G. Reeb, MD, and Jay S. Thompson, MD Cleveland, Ohio ANTONNETTE V. GRAHAM, RN, MSW This patient is a very attractive, 34-year-old, single (Assistant Professor, Department of Family Med woman. She is currently employed as a school icine): Today we are going to discuss what many psychologist and is finishing her dissertation for people believe is the number-one health problem her doctorate in psychology. She lives alone in a in the United States—alcoholism.1 It is often felt middle-class suburb of a large northeastern city. that alcoholism affects the lives of more patients, She is the eldest of four children. Her father is a either because of their own drinking or because retired college administrator, and her mother is of the drinking of a family member, than any other currently employed as an executive secretary. disease. There is no family history of alcoholism. Miss Current prevalency estimates of alcoholism and Carr’s parents and siblings drink socially. On Miss alcohol-related problems indicate that in many pa Carr’s initial visit to the Family Practice Center, tients these problems go undetected by physicians her physical examination and laboratory values until they become manifested by severe physical were normal. sequelae. Current thinking among experts is that MRS. GRAHAM: Thank you, Miss Carr, for early intervention leads to better prognosis. No attending our Grand Rounds today. I’d like to longer is it felt that alcoholics must “ bottom out” focus today’s discussion on how alcohol has af before help can be effective. -
Behavioral Tolerance: Research and Treatment Implications
US DEPARTMENT OF HEALTH EDUCATION AND WELFARE • Public Health Service • Alcohol Drug Abuse and Mental Health Administration Behavioral Tolerance: Research and Treatment Implications Editor: Norman A. Krasnegor, Ph.D. NIDA Research Monograph 18 January 1978 DEPARTMENT OF HEALTH, EDUCATION, AND WELFARE Public Health Service Alcohol, Drug Abuse, and Mental Health Administration National lnstitute on Drug Abuse Division of Research 5600 Fishers Lane RockviIle. Maryland 20657 For sale by tho Superintendent of Documents, U.S. Government Printing Office Washington, D.C. 20402 (Paper Cover) Stock No. 017-024-00699-8 The NIDA Research Monogroph series iS prepared by the Division of Research of the National Institute on Drug Abuse Its primary objective is to provide critical re- views 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 Polo Alto California Jerome Jaffe, M.D College Of Physicians and Surgeons Columbia University New York Reese T Jones, M.D Langley Porter Neuropsychitnc Institute University of California San Francisco California William McGlothlin, Ph D Department of Psychology UCLA Los Angeles California Jack Mendelson. M D Alcohol and Drug Abuse Research Center Harvard Medical School McLeon Hospital Belmont Massachusetts Helen Nowlis. Ph.D Office of Drug Education DHEW Washington DC Lee Robins, Ph.D Washington University School of Medicine St Louis Missouri NIDA Research Monograph series Robert DuPont, M.D. DIRECTOR, NIDA William Pollin, M.D. DIRECTOR, DIVISION OF RESEARCH, NIDA Robert C. -
Rapid and Persistent Sensitization to the Reinforcing Effects of Cocaine
Neuropsychopharmacology (2006) 31, 121–128 & 2006 Nature Publishing Group All rights reserved 0893-133X/06 $30.00 www.neuropsychopharmacology.org Rapid and Persistent Sensitization to the Reinforcing Effects of Cocaine ,1,2 2 1,2 Drake Morgan* , Yu Liu and David CS Roberts 1 2 Department of Physiology and Pharmacology, Wake Forest University School of Medicine, Winston-Salem, NC, USA; Neuroscience Program, Wake Forest University School of Medicine, Winston-Salem, NC, USA The development of drug addiction involves a transition from recreational use to compulsive drug seeking and taking, and this progression can occur rapidly with cocaine use. These data highlight the importance of early drug exposure and the development of drug dependence; however, little experimental attention has been paid to this phenomenon in animal models of drug abuse. The present experiments demonstrate a progressive and rapid sensitization to the reinforcing strength of cocaine assessed using a progressive ratio (PR) schedule in rats. The first experiment found that rats show increased breakpoints over a 2-week period following acquisition. Subsequent experiments examined the role of total cocaine intake during the initial exposure period and found that low intakes (20 mg/ kg/day  5 days) resulted in sensitization, whereas relatively higher intake (60 or 100 mg/kg/day  5 days) suppressed the development of sensitization. In contrast, this higher level of intake (60 mg/kg/day  5 days) only transiently suppressed the expression of sensitization. Examination of breakpoints maintained by various doses of cocaine revealed an upward and leftward displacement of the cocaine dose– effect curve, relative to nonsensitized animals.