Experimental and clinical psychopharmacology
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Exp Clin Psychopharmacol · Oct 2008
Retrospective accounts of initial subjective effects of opioids in patients treated for pain who do or do not develop opioid addiction: a pilot case-control study.
This pilot case-control study retrospectively assessed between-groups differences in subjective opioid effects in patients treated for the first time with opioids for chronic pain. Cases were individuals in an inpatient substance abuse treatment center for primary prescription opioid addiction whose initial exposure to prescription opioids was reported for chronic pain. ⋯ The Morphine Benzedrine Group subscale of an adapted 49-item Addiction Center Research Inventory (ARCI), designed to measure euphoria and other drug effects, showed an average score of 8.70 (+/-4.18) in cases versus 2.55 (+/-3.36) in controls (p<0.001), indicating a significantly greater "euphoric" effect of opioids in the cases compared to the controls. Differences in the subjective response to opioids suggest that: (1) a subgroup of patients does develop euphoria when taking opioids for pain, which may be a risk factor for eventual development of prescription opioid addiction; and (2) subjective effects predictive of eventual addiction may include stimulation and other experiences not typically associated with opioids.
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Exp Clin Psychopharmacol · Oct 2007
Factors associated with nonmedical use of prescription opioids among heroin-abusing research volunteers.
This retrospective study examined factors associated with nonmedical opioid use among 208 heroin-abusing research volunteers in the metropolitan Detroit area. Drug and medical history data were obtained from structured questionnaires administered during screening for behavioral pharmacology research studies. Analyses included demographic data (gender and race), history of drug use (prescribed, nonmedical, and route of use), and potentially relevant medical conditions (e.g., pain). ⋯ Odds ratios (ORs) from logistic regression--which predicted membership in lifetime heroin use only (n=52) versus heroin plus nonmedical opioid use (n=156) groups--indicated that nonmedical opioid use was significantly associated with legitimate prescription opioid use (OR=10.5), having ever sought treatment for heroin use (OR=4.21), and a history of lung problems (OR=3.66) and dental pain (OR=2.58). The finding of a significant positive association (R(2)=.83) between lifetime rates of medical and nonmedical use of specific opioids in this study is consistent with previous observations that prescription opioid use or availability is a prominent risk factor for nonmedical opioid use. A limitation of this study is that age-of-onset data were not originally collected; thus, the relative (predictive) order of pain conditions, medical use, and nonmedical use of opioids cannot be determined retrospectively.
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Exp Clin Psychopharmacol · Aug 2007
Evaluating reactivity to ecological momentary assessment during smoking cessation.
Ecological momentary assessment (EMA) consists of assessing phenomena in real time in the natural environment. EMA allows for more fine-grained analyses of addictive behavior and minimizes threats to internal validity, such as recall biases and errors. However, because of the intensive monitoring involved in EMA, measurement reactivity is a concern. ⋯ Abstinence rates did not differ between the groups at Day 7 or at Day 28 postcessation. For the 20 subscales assessed at each of 3 assessment times, there were significant differences between participants with and without EMA experience for 3 subscales at the 1st of 3 assessment times, and significant differences for 3 different subscales at the 3rd assessment time. These differences suggest some reactivity to EMA, although the inconsistent pattern across time indicates that further research is needed to definitively conclude that EMA induces reactivity.
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Exp Clin Psychopharmacol · Apr 2007
Randomized Controlled Trial Comparative StudyBehavioral and subjective effects of d-amphetamine and modafinil in healthy adults.
Modafinil is indicated for the management of excessive daytime sleepiness; however, recent studies have examined a broad range of potential uses. Given that clinical uses of modafinil may be expanding, this study compared modafinil and d-amphetamine effects on subjective and performance measures. Across 11 sessions, 11 healthy adults were tested after oral doses of placebo (5 sessions), modafinil (1.75 mg/kg, 3.50 mg/kg, or 7.00 mg/kg), and d-amphetamine (0.035 mg/kg, 0.070 mg/kg, 0.140 mg/kg) under double-blind, randomized conditions. ⋯ Both medications sustained performance that deteriorated across time on the Sternberg Number Recognition Test. Modafinil also enhanced performance rate on the Digit-Symbol Substitution Task above baseline levels and increased response rate on the Repeated Acquisition of Response Sequences Task. These results suggest that modafinil engenders alerting effects and increases performance in healthy non-sleep-deprived individuals comparable with that of d-amphetamine.
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Exp Clin Psychopharmacol · Nov 2006
Randomized Controlled TrialCognitive and subjective acute dose effects of intramuscular ketamine in healthy adults.
Ketamine is a noncompetitive N-methyl-D-aspartate (NMDA) antagonist. Given the purported role of the NMDA receptor in long-term potentiation, the primary purpose of the present study was to further understand the dose-related effects of ketamine on memory. The study was also designed to provide information about the relative effects of ketamine on memory versus nonmemory effects and to more fully characterize ketamine's overall pattern and time course of effects. ⋯ Subjective effects lasted longer than memory and most psychomotor impairments. Ketamine produces selective, transient, dose- and time-related effects. In conjunction with previous studies of drugs with different mechanisms of actions, the observed selectivity of effects enhances the understanding of the pharmacological mechanisms underlying memory, attention, psychomotor performance, and subjective experience.