Drug and alcohol dependence
-
Drug Alcohol Depend · Jun 2012
Randomized Controlled TrialEffects of cold pressor pain on the abuse liability of intranasal oxycodone in male and female prescription opioid abusers.
Approximately 1.9 million persons in the U.S. have prescription opioid use disorders often with concomitant bodily pain, but systematic data on the impact of pain on abuse liability of opioids is lacking. The purpose of this study was to determine whether pain alters the intranasal abuse liability of oxycodone, a commonly prescribed and abused analgesic, in males and females. ⋯ The CPT was a reliably painful and stressful stimulus that did not diminish the abuse liability of intranasal oxycodone. Females were more sensitive to oxycodone on several abuse liability measures that warrant further follow-up. Snorting oxycodone rapidly produced psychoactive effects indicative of substantial abuse liability.
-
Drug Alcohol Depend · Jun 2012
ReviewCommon and specific liability to addiction: approaches to association studies of opioid addiction.
Opioid addiction, whether to opiates such as heroin and morphine, and/or to non-medical use of opioids, is a major problem worldwide. Although drug-induced and environmental factors are essential for the liability to develop opioid addiction, the genetic background of an individual is now known also to play a substantial role. ⋯ In spite of the inherent difficulties in obtaining large well-phenotyped cohorts for genetic studies, new findings have been reported that are being used to develop testable hypotheses into the biological basis of opioid addiction.
-
Drug Alcohol Depend · Jun 2012
ReviewCommon liability to addiction and "gateway hypothesis": theoretical, empirical and evolutionary perspective.
Two competing concepts address the development of involvement with psychoactive substances: the "gateway hypothesis" (GH) and common liability to addiction (CLA). ⋯ Whereas the "gateway" hypothesis does not specify mechanistic connections between "stages", and does not extend to the risks for addictions, the concept of common liability to addictions incorporates sequencing of drug use initiation as well as extends to related addictions and their severity, provides a parsimonious explanation of substance use and addiction co-occurrence, and establishes a theoretical and empirical foundation to research in etiology, quantitative risk and severity measurement, as well as targeted non-drug-specific prevention and early intervention.
-
Drug Alcohol Depend · Jun 2012
Patient satisfaction with methadone maintenance treatment: the relevance of participation in treatment and social functioning.
Patients' satisfaction with methadone maintenance treatment (MMT) is a key measure of treatment quality. The main objective of the present study is to identify independent factors that contribute significantly to satisfaction with MMT. ⋯ Patients from larger centres, who perceive themselves as participating to some extent in treatment decisions, and showing lower deterioration in social functioning are more likely to be satisfied with MMT.
-
Drug Alcohol Depend · May 2012
Multicenter StudyReceipt of opioid agonist treatment in the Veterans Health Administration: facility and patient factors.
Opioid agonist treatment (OAT)-through licensed clinic settings (C-OAT) using methadone or buprenorphine or office-based settings with buprenorphine (O-OAT)-is an evidence-based treatment for opioid dependence. Because of limited availability of on-site C-OAT (n=28 of 128 facilities) in the Veterans Health Administration (VHA), O-OAT use has been encouraged. This study examined OAT utilization across VHA facilities and the patient and facility factors related to variability in utilization. ⋯ In FY2008, prior to the VHA national mandate of access to buprenorphine OAT, substantial variation in the use of OAT existed, partially explained by patient- and facility-level factors. Implementation efforts should focus on increasing access to this evidence-based treatment, especially in facilities at the low end of the distribution.