Current drug abuse reviews
-
Curr Drug Abuse Rev · Sep 2010
ReviewDevelopment of tamper deterrent formulations: state of the pharmaceutical industry.
Prescription drug abuse is a significant and growing health and socio-economical problem in the US and the world. According to the 2008 UN World Drug Report, the number of people who have consumed an illicit drug at least once in 2006/2007 reached 240 million, roughly 6% of the world population aged 15 to 64. In the last few years, pharmaceutical manufacturers started developing new formulations specifically designed to provide tamper deterrent features. ⋯ Tamper deterrent formulations (TDF) for other drugs of abuse, including stimulants and sedatives are also in various stages of development. Three major challenges face the development of TDF: the increased sophistication of the tampering methods used by abusers, the ambiguity of the regulatory requirements for labeling and marketing and the exaggerated expectations of what these formulations can deliver. This review details the approaches used by pharmaceutical manufacturers to impart tamper deterrent features into their formulations; the in vitro and in vivo tests that have been proposed or used to assess the performance of TDF; and the current regulatory landscape.
-
Hyperalgesia has been observed during ethanol withdrawal, comparable to the hyperalgesia observed during withdrawal from opioids. To determine the extent of this phenomenon and its potential mechanisms, both behavioral and in vitro studies are examined, and the roles of GABA(A), glutamate and other receptors in mediating the acute and chronic antinociceptive effects of ethanol are reviewed. Hyperalgesia during ethanol withdrawal is a robust phenomenon that has been observed in various strains of mice and rats, with different methods of exposure to ethanol, and with a variety of nociceptive assays. ⋯ Although some key pathways have been identified, further mechanistic work is necessary to fully characterize the mechanisms for the development of hyperalgesia following chronic exposure to ethanol. An understanding of how the hyperalgesia may fit in with other manifestations of ethanol withdrawal may be an important variable in determining treatment outcome. Clinical research is essential to determine the significance of the hyperalgesia to the severity of withdrawal and to relapse.
-
Curr Drug Abuse Rev · Nov 2008
ReviewBehavioral pharmacology of cannabinoids with a focus on preclinical models for studying reinforcing and dependence-producing properties.
Cannabis preparations as recreational drugs are the most widely used illicit drugs in the world. Although cannabis derivatives produce clear subjective motivational responses in humans leading to drug-seeking behavior and in a specific proportion in repeated drug use, the reinforcing/rewarding attributes of these subjective effects are difficult to define in experimental animals. This led to the notion of cannabinoids being considered as "atypical" or "anomalous" drugs of abuse. ⋯ The aim of the present article is to review from a preclinical perspective the current status of what is known about the behavioral pharmacology of cannabinoids including the recently identified cannabinoid neurotransmission modifiers with a particular emphasis on their motivational/reinforcing and dependence-producing properties. We conclude that cannabinoids exhibit reinforcing/rewarding properties in experimental animals mostly under particular experimental conditions, which is not the case for other drugs of abuse, such as opiates, psychostimulants, alcohol and nicotine. The paper will discuss these findings critically and also point to open questions that should be addressed in the future in order to improve our understanding of these specific actions of cannabinoids that will also impact drug discovery and development efforts of related compounds as therapeutics in the clinic.
-
Curr Drug Abuse Rev · Nov 2008
ReviewOpioid antagonists for pharmacological treatment of alcohol dependence - a critical review.
Alcohol dependence is a widespread psychiatric disorder. While relapse prevention therapy in alcoholism was exclusively dominated by social and psychological treatments for many years, in the last decades the benefits of pharmacological agents for the rehabilitation treatment in alcoholism have become increasingly evident. Naltrexone, an opiate receptor antagonist, blocks the pleasant and reinforcing effects of alcohol by preventing the stimulation of opioid receptors and the reduction of dopamine release in the ventral tegmental area (VTA). ⋯ The review at hand gives on overview of the current evidence on opioid antagonists for the treatment of alcohol dependence regarding the possible mechanism of action, the substances' safety profiles and their effectiveness. The corresponding evidence is critically reviewed taking into consideration the influence of the study design on the magnitude and consistency of effect sizes as well the impact of patient characteristics on the response to the treatment with opioid antagonists. Future studies on the role of different subtypes of alcoholics according to their genetic or psychological profile to explain or even predict the effects of opioid antagonists in the treatment of alcohol dependence are needed.