Drug and alcohol dependence
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Drug Alcohol Depend · Oct 2015
Abstinence phenomena of chronic cannabis-addicts prospectively monitored during controlled inpatient detoxification (Part II): Psychiatric complaints and their relation to delta-9-tetrahydrocannabinol and its metabolites in serum.
To investigate the impact of inpatient detoxification treatment on psychiatric symptoms of chronic cannabis addicts and to analyze the influence of serum cannabinoid levels on the severity of these symptoms. ⋯ Inpatient cannabis detoxification treatment significantly improved psychiatric symptoms. Serum THC-levels were not associated with affective symptoms and anxiety but predicted cognitive impairment and motor retardation.
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Drug Alcohol Depend · Sep 2015
Controlled Clinical TrialCannabis effects on driving lateral control with and without alcohol.
Effects of cannabis, the most commonly encountered non-alcohol drug in driving under the influence cases, are heavily debated. We aim to determine how blood Δ(9)-tetrahydrocannabinol (THC) concentrations relate to driving impairment, with and without alcohol. ⋯ SDLP was a sensitive cannabis-related lateral control impairment measure. During drive blood THC ≥8.2μg/L increased SDLP similar to notably-impairing alcohol concentrations. Despite OF's screening value, OF variability poses challenges in concentration-based effects interpretation.
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Drug Alcohol Depend · Sep 2015
Management of benzodiazepine-resistant alcohol withdrawal across a healthcare system: Benzodiazepine dose-escalation with or without propofol.
Severe cases of alcohol withdrawal syndrome (AWS) may not resolve despite escalating doses of benzodiazepines (BZDs). Benzodiazepine-resistant alcohol withdrawal (RAW) is a subset of severe alcohol withdrawal defined by the requirement of ≥40mg of diazepam administered within one hour. Use of adjunct agents, such as propofol, may be beneficial to minimize BZD adverse effects and improve symptom control. While limited evidence suggests propofol as an effective adjunct in AWS through improved sedation, evidence is currently lacking for the addition of only propofol to BZDs for management of RAW. ⋯ The addition of propofol for RAW treatment is associated with significant increases in clinical care. While randomized, prospective evaluations are necessary to determine the cause of this association, our data suggests use of adjunctive propofol therapy in RAW is associated with longer and more complicated hospital admissions.
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Drug Alcohol Depend · Aug 2015
Meta AnalysisRegional gray matter deficits in alcohol dependence: A meta-analysis of voxel-based morphometry studies.
Many studies have revealed a widespread pattern of gray matter (GM) atrophy by using voxel-based morphometry (VBM) studies involving the pathophysiology of alcohol dependence. However, the spatial localization of GM abnormalities reported in previous studies is heterogeneous. Here, we aimed to investigate the concurrence across VBM studies to help clarify the structural abnormalities underpinning this condition. ⋯ By conducting the first comprehensive meta-analysis of VBM studies, we identified consistent regional GM atrophy particularly within several neurofunctional networks associated with alcohol dependence. Our study demonstrated a characteristic pattern of GM abnormalities and provided further insights into understanding the underlying nature of alcohol dependence.
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Drug Alcohol Depend · Aug 2015
Drug use patterns predict risk of non-fatal overdose among street-involved youth in a Canadian setting.
Non-fatal drug overdose is a major cause of morbidity among people who use drugs, although few studies have examined this risk among street-involved youth. We sought to determine the risk factors associated with non-fatal overdose among Canadian street-involved youth who reported illicit drug use. ⋯ Rates of non-fatal overdose were high among street-involved youth. Drug use patterns, in particular prescription opiate use, were associated with overdose. These findings underscore the importance of addiction treatment and prevention efforts aimed at reducing the risk of overdose among youth.