Substance use & misuse
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Substance use & misuse · Jan 2011
Multicenter StudyDoes concurrent cocaine use compromise 1-year treatment outcomes for opiate users?
The current study aimed to determine whether cocaine use compromises treatment outcomes for opiate users. Data were collected from 404 opiate users at treatment intake and 1-year follow-up as part of a national treatment outcome study. ⋯ Regression analysis revealed that those who used cocaine at intake were more likely to use cocaine at 1-year follow-up, to commit crime, and to be homeless. It is concluded that treatment for opiate use "works" even in the presence of concurrent cocaine use.
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Substance use & misuse · Jan 2011
Access to sterile syringes for injecting drug users in New York City: politics and perception (1984-2010).
In the United States, political and social environments have shaped public health response to injecting drug use, and New York City represents a salient example. The history of "harm reduction" in New York City is characterized within changing historical periods and in relation to the actions of stakeholders. The expansion is traced over four periods: (i) 1984-1989: emergence, activism, and science; (ii) 1990-1994 reckoning: syringe exchange legislation and consolidation; (iii) 1995-1999: bureaucratization, opposition, and challenges to institutional control; and (iv) 2000-2010 revitalization: expansion of syringe access and harm reduction. ⋯ Without this "push," it is unlikely that New York City would have experienced the dramatic decline in HIV infection among drug injectors in the 1990s. Second, successful arguments for expanding syringe access in New York City were based on the high HIV/AIDS infection rates. Thus, program developments were advocated as HIV prevention interventions, rather than as expanded services for addressing broader health and social issues of injecting drug use.
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Substance use & misuse · Jan 2011
Randomized Controlled TrialSwitching from methadone to diamorphine: 2-year results of the german heroin-assisted treatment trial.
Several international clinical studies have found diamorphine treatment for opioid-dependent patients to show significantly better effects compared with methadone maintenance treatment. ⋯ The results of the course of methadone-diamorphine switchers are a methodologically independent contribution toward confirming the positive effects of diamorphine treatment for difficult-to-treat opioid-dependent patients. This study supports the hypothesis that changing from optimized methadone treatment under the conditions of the clinical trial to diamorphine treatment is associated with improvements in health and drug use behavior. The study's limitations are noted.
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Substance use & misuse · Nov 2010
Current trends in tramadol-related fatalities, Tehran, Iran 2005-2008.
Tramadol is a widely prescribed drug. Abuse of tramadol as well as tramadol-related deaths have been increasing in Iran. The objective of the present study is to evaluate the trends of tramadol-related deaths that occurred between 2005 and 2008 in Tehran, Iran. ⋯ The majority of the cases were young male adults. Tramadol-related deaths in 2008 were 32.5 times more than in 2005. These results suggest that tramadol-related fatalities are growing in Iran especially among substance abusers.
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Noninvasive brain stimulation of the dorsolateral prefrontal cortex with repetitive transcranial magnetic stimulation and transcranial direct current stimulation can modify decision-making behaviors in healthy subjects. The same type of noninvasive brain stimulation can suppress drug craving in substance user patients, who often display impaired decision-making behaviors. We discuss the implications of these studies for the cognitive neurosciences and their translational applications to the treatment of addictions. We propose a neurocognitive model that can account for our findings and suggests a promising therapeutic role of brain stimulation in the treatment of substance abuse and addictive behavior disorders.