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2.
PLoS One ; 14(5): e0217811, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31150518

RESUMO

Sharing of injection drug use paraphernalia is a dyadic process linked to the transmission of HIV and hepatitis C virus (HCV). Despite this, limited research exists identifying specific dyadic interpersonal factors driving injecting partners' engagement in needle/syringe and ancillary injecting equipment sharing among young adults. Using semi-structured in-depth interview data collected between 2014 and 2015 from twenty-seven people who inject drugs (PWID), we applied an inductive approach to identify key injection drug-related interpersonal factors and developed a conceptual model integrating the findings based on interdependence theory. Interactions between injecting partners resulted in varying levels of injecting-related trust, cooperation, intimacy, and power. These factors interacted to collectively influence the type and level of risk perceived and enacted by injecting partners. The relationship between these injecting-related interpersonal factors, on the one hand, and risk perception on the other was dynamic and fluctuated between actions that protect the self (person-centered) and those that protect the partnership (partnership-centered). These findings indicate that the interpersonal context exerts substantial influence that shapes risk perception in all types of injecting partnerships. Partnership-focused prevention strategies should consider the dynamics of trust, cooperation, intimacy, and power, in characterizing dyadic risk perceptions and in understanding risky injecting practices among PWID.


Assuntos
Infecções por HIV/psicologia , Hepatite C/psicologia , Dependência de Heroína/psicologia , Abuso de Substâncias por Via Intravenosa/psicologia , Adulto , Feminino , HIV/patogenicidade , Infecções por HIV/transmissão , Infecções por HIV/virologia , Hepacivirus/patogenicidade , Hepatite C/transmissão , Hepatite C/virologia , Heroína , Dependência de Heroína/virologia , Humanos , Relações Interpessoais , Masculino , Uso Comum de Agulhas e Seringas , Fatores de Risco , Assunção de Riscos , Comportamento Sexual/psicologia , Parceiros Sexuais/psicologia , Abuso de Substâncias por Via Intravenosa/virologia , Confiança/psicologia
3.
Curr Med Sci ; 39(3): 472-482, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-31209821

RESUMO

The high rate of relapse among heroin users remains a significant public concern in China. In the present study, we utilized a Motivation-Skill-Desensitization-Mental Energy (MSDE) intervention and evaluated its effects on abstinence and mental health. Eighty-nine male heroin users in a drug rehabilitation center were enrolled in the study. The participants in the MSDE intervention group (n=46) received MSDE intervention, which included motivational interviewing, coping skills training, eye movement desensitization and reprocessing, and mindfulness-based psychotherapy. The participants in the control group (n=43) received a series of lectures on skills training. A significant increase in Contemplation Ladder score (P<0.001) and decreases in scores on the Obsessive Compulsive Drug Use Scale (P<0.001), Beck Depression Inventory (P<0.001), and Aggression Questionnaire (P=0.033) were found immediately after intervention. Compared to the control group, the MSDE intervention group reported significantly higher abstinence rates (P=0.027) and retention rates (P<0.001) at follow-up. Overall, the MSDE intervention, which uses a combined strategy for relapse prevention, could be a promising approach for preventing relapse among heroin users in China.


Assuntos
Terapia Cognitivo-Comportamental/métodos , Dessensibilização e Reprocessamento através dos Movimentos Oculares/métodos , Dependência de Heroína/terapia , Mentalização/fisiologia , Motivação/fisiologia , Adulto , Agressão/psicologia , China , Seguimentos , Dependência de Heroína/psicologia , Dependência de Heroína/reabilitação , Humanos , Masculino , Saúde Mental , Cooperação do Paciente/psicologia , Cooperação do Paciente/estatística & dados numéricos , Inventário de Personalidade , Centros de Tratamento de Abuso de Substâncias , Inquéritos e Questionários
4.
Artigo em Inglês | MEDLINE | ID: mdl-30978986

RESUMO

A sample of heroin users (n = 250) in methadone maintenance treatment (MMT) was used in this cross-sectional study to clarify the mechanisms of the effects of stigma on quality of life (QoL) through psychological distress and social functioning. All the participants had their self-stigma, psychological distress, social functioning, and QoL measured. Psychological distress and social functioning were proposed to be mediators between self-stigma and QoL. Several linear models using structural equation modeling were conducted to examine the mediated effects. The negative effects of self-stigma on QoL were significantly mediated by psychological distress, as self-stigma directly and significantly influenced psychological distress, but not social functioning. This study demonstrated a linear model describing the effects of self-stigma on QoL for opioid-dependent individuals; psychological distress was also an important mediator between self-stigma and their QoL. Clinicians were able to notice the importance of reducing self-stigma for opioid-dependent individuals according to the following results: higher levels of self-stigma were associated with high psychological distress, decreased social functioning, and impaired QoL. Our mediation findings suggest that treating psychological distress is better than treating social functioning if we want to eliminate the effects of self-stigma on QoL for heroin users.


Assuntos
Dependência de Heroína/psicologia , Dependência de Heroína/terapia , Metadona/uso terapêutico , Tratamento de Substituição de Opiáceos/psicologia , Qualidade de Vida/psicologia , Autoimagem , Estigma Social , Estresse Psicológico , Adulto , Idoso , Idoso de 80 Anos ou mais , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade
5.
Drug Alcohol Depend ; 196: 62-65, 2019 03 01.
Artigo em Inglês | MEDLINE | ID: mdl-30708289

RESUMO

BACKGROUND: Some countries allow physicians to prescribe pharmaceutical-grade diamorphine to dependent users who have previously undergone treatment but are still using street-sourced heroin; this is not allowed in the US. This study provides the first nationally representative US data concerning public support for prescribing diamorphine to dependent users. We also test the hypothesis that calling it "diamorphine" instead of "heroin" increases support for this approach. METHODS: The RAND American Life Panel is a nationally representative, probability-based survey of US adults. Of the 3345 panel members invited to take the survey, 2530 (75.6%) provided a valid response to our question module. Respondents were randomly assigned to have the question refer to the prescribed drug as either "heroin" or "diamorphine." The groups did not significantly differ on sex, age, race/ethnicity, or education. We compare the distribution of responses for the two groups and conduct Pearson's chi-squared test with the Rao-Scott correction. RESULTS: For those asked whether the US should try prescribing pharmaceutical-grade "heroin," the share answering "Yes" (20.8%) was 15 percentage points lower than those responding "No" (35.8%). When the question asked about "diamorphine," the results were nearly reversed: the share answering "Yes" (30.6%) was almost 12 percentage points higher than those responding "No" (18.9%). The distributions of responses were significantly different (p < 0.001). CONCLUSIONS: Support for prescribing diamorphine to dependent users is low in the US. While the results are consistent with the hypothesis that referring to heroin as diamorphine may reduce stigma associated with the substance and increase support for prescribing it, opinions may change as individuals learn they are different names for the same substance.


Assuntos
Analgésicos Opioides/uso terapêutico , Dependência de Heroína/tratamento farmacológico , Dependência de Heroína/epidemiologia , Heroína/uso terapêutico , Inquéritos e Questionários , Adulto , Prescrições de Medicamentos , Feminino , Dependência de Heroína/psicologia , Humanos , Masculino , Pessoa de Meia-Idade , Entorpecentes/uso terapêutico , Estados Unidos/epidemiologia , Adulto Jovem
6.
AIDS Educ Prev ; 31(1): 1-16, 2019 02.
Artigo em Inglês | MEDLINE | ID: mdl-30742480

RESUMO

This article examined the differences in causes and health consequences between synthetic drug and heroin abuse in urban China. Two-group comparisons were conducted to quantify differences in individual characteristics, causes of drug use, and HIV/STI risky sexual behavior between synthetic drug and heroin users; logistic regressions were employed to assess the net effect of synthetic drug use on risky sexual behavior. Results revealed that causes of synthetic drug use differed from those of heroin use; a combination of the knowledge gap concerning the harmful impact of synthetic drugs and the lesser punishment for their use appeared a main reason behind the shift from heroin to synthetic drugs; and synthetic drug use was a significant and powerful risk factor for HIV/STI risky sexual behavior. Educational and behavioral interventions are urgently needed to prevent the initiation of synthetic drug use among users to reduce their HIV/STI risky sexual behavior.


Assuntos
Usuários de Drogas/estatística & dados numéricos , Dependência de Heroína/epidemiologia , Heroína/efeitos adversos , Transtornos Relacionados ao Uso de Substâncias/epidemiologia , Medicamentos Sintéticos/efeitos adversos , População Urbana , Adulto , China/epidemiologia , Feminino , Infecções por HIV/prevenção & controle , Heroína/administração & dosagem , Dependência de Heroína/psicologia , Humanos , Modelos Logísticos , Masculino , Fatores de Risco , Assunção de Riscos , Comportamento Sexual , Medicamentos Sintéticos/administração & dosagem
7.
Drug Alcohol Depend ; 195: 132-139, 2019 02 01.
Artigo em Inglês | MEDLINE | ID: mdl-30634108

RESUMO

OBJECTIVES: Difficulties in emotion regulation (DER) may be important in heroin craving in individuals with heroin dependence who have experienced childhood trauma (CT). However, no research has been performed on DER in the context of heroin dependence. The aim of this study was to evaluate direct and indirect relations of CT to the subscales of heroin craving (i.e., heroin thoughts and interference, intention to use heroin and control of its consumption, and resistance to thoughts and decisions to use heroin) via DER dimensions in individuals with a DSM diagnosis of heroin dependence. METHODS: In a cross-sectional design, 330 males with heroin dependence completed the Childhood Trauma Questionnaire-Short Form (CTQ-SF), the Difficulties in Emotion Regulation Scale (DERS), the Obsessive-Compulsive Drug Use Scale-Form Heroin (OCDUS-Form Heroin), and the Depression Anxiety Stress Scales (DASS). RESULTS: The results revealed that CT had no direct relations to the subscales of heroin craving, but it indirectly was related to all three subscales of heroin craving via one of the DER dimensions named limited access to emotion regulation strategies (Strategies) after adjusting for demographic and clinical factors. CONCLUSIONS: The findings suggest that Strategies may be related to heroin craving in individuals with heroin dependence who have CT. This proposes that treatment and prevention attempts focused on training the use of effective emotion regulation strategies may be useful to reduce heroin craving in individuals with heroin dependence who have experienced a history of CT.


Assuntos
Experiências Adversas da Infância/tendências , Sintomas Afetivos/epidemiologia , Sintomas Afetivos/psicologia , Fissura , Dependência de Heroína/epidemiologia , Dependência de Heroína/psicologia , Adolescente , Adulto , Sintomas Afetivos/diagnóstico , Idoso , Fissura/fisiologia , Estudos Transversais , Emoções/fisiologia , Dependência de Heroína/diagnóstico , Humanos , Masculino , Pessoa de Meia-Idade , Inquéritos e Questionários , Adulto Jovem
8.
Subst Use Misuse ; 54(2): 324-330, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30526206

RESUMO

BACKGROUND: Perceived devaluation is a barrier to seeking mental and physical health services among people who use illicit drugs. OBJECTIVE: Assessing the prevalence and correlates of perceived devaluation within a cohort of street-involved youth. METHODS: Data were drawn from an open prospective cohort of street-involved youth who use illicit drugs (aged 14-26 at study enrollment) between December 2013 and May 2015 in Vancouver, Canada. Perceived devaluation was measured using an adapted version of Perceived Devaluation and Discrimination scale. Multivariable generalized estimating equations were constructed to examine factors independently associated with high perceived devaluation. RESULTS: Among 411 street-involved youth, 95.1% reported high perceived devaluation at some point during the study period. In a multivariable analysis, youth who reported high perceived devaluation were significantly more likely to engage in: unprotected sex (Adjusted Odds Ratio [AOR] = 1.56, 95% Confidence Interval 1.03-2.37); heavy alcohol use (AOR = 2.31, 95% CI 1.22-4.36); and daily heroin use (AOR = 2.07, 95% CI 1.16-3.70). Youth who resided in the Downtown Eastside neighborhood were significantly less likely to report high perceived devaluation (AOR = 0.41, 95% CI 0.26-0.65). CONCLUSIONS: Perceived devaluation was extremely prevalent among street-involved youth in our sample. We also observed that youth most in need of health and social services were significantly more likely to report high levels of perceived devaluation which may result in a reluctance to seek out key services and supports. These findings highlight the need to implement stigma reduction interventions for vulnerable youth in this setting.


Assuntos
Jovens em Situação de Rua/estatística & dados numéricos , Preconceito/estatística & dados numéricos , Estigma Social , Transtornos Relacionados ao Uso de Substâncias/epidemiologia , Adolescente , Adulto , Colúmbia Britânica/epidemiologia , Canadá/epidemiologia , Estudos de Coortes , Feminino , Dependência de Heroína/epidemiologia , Dependência de Heroína/psicologia , Jovens em Situação de Rua/psicologia , Humanos , Masculino , Razão de Chances , Preconceito/psicologia , Prevalência , Estudos Prospectivos , Características de Residência , Fatores de Risco , Transtornos Relacionados ao Uso de Substâncias/psicologia , Sexo sem Proteção/psicologia , Sexo sem Proteção/estatística & dados numéricos , Adulto Jovem
9.
Brain Stimul ; 12(1): 175-183, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30245163

RESUMO

BACKGROUND: Deep brain stimulation (DBS) is currently used to treat addiction, with the nucleus accumbens (NAc) as one promising target. The anterior limb of the internal capsule (ALIC) is also a potential target, as it carries fiber tracts connecting the mesocorticolimbic circuits that are crucially involved in several psychiatric disorders, including addiction. Stimulating the NAc and ALIC simultaneously may have a synergistic effect against addiction. METHODS: Eight patients with a long history of heroin use and multiple relapses, despite optimal conventional treatments, were enrolled. Customized electrodes were implanted through the ALIC into the NAc, and deep brain stimulation (DBS) treatment began two weeks after surgery. The patients were followed for at least 24 months. The duration of drug-free time, severity of drug cravings, psychometric evaluations, and PET studies of glucose metabolism before and after DBS were conducted. All adverse events were recorded. RESULTS: With DBS, five patients were abstinent for more than three years, two relapsed after abstaining for six months, and one was lost of follow-up at three months. The degree of cravings for drug use after DBS was reduced if the patients remained abstinent (p < 0.001). Simultaneous DBS of the NAc and ALIC also improved the quality of life, alleviated psychiatric symptoms, and increased glucose metabolism in addiction-related brain regions. Moreover, stimulation-related adverse events were few and reversible. CONCLUSIONS: Simultaneous DBS of the NAc and ALIC appears to be safe, with few side effects, and may prevent long-term heroin relapse after detoxification in certain patients. (This trial was registered at ClinicalTrials.gov, NCT01274988).


Assuntos
Estimulação Encefálica Profunda/tendências , Dependência de Heroína/diagnóstico por imagem , Dependência de Heroína/terapia , Cápsula Interna/diagnóstico por imagem , Núcleo Accumbens/diagnóstico por imagem , Adulto , Estimulação Encefálica Profunda/métodos , Feminino , Seguimentos , Dependência de Heroína/psicologia , Humanos , Cápsula Interna/fisiologia , Masculino , Pessoa de Meia-Idade , Núcleo Accumbens/fisiologia , Projetos Piloto , Qualidade de Vida , Recidiva , Fatores de Tempo , Adulto Jovem
10.
Artigo em Inglês | MEDLINE | ID: mdl-30171993

RESUMO

Exposure to stress not only increases the vulnerability to heroin dependence (HD) but also provokes relapse. The etiology of HD and the role of life stress remain unclear, but prior studies suggested that both genetic and environmental factors are important. Opioid related genes, including OPRM1, OPRD1, OPRK1, and POMC, are obvious candidates for HD. Therefore, this study was conducted to explore whether the genetic polymorphisms of the candidates could affect vulnerability to HD and response to life stress in patients with HD. Ten polymorphisms of the opioid related genes were analyzed in 801 patients and 530 controls. The Life Event Questionnaire was used to assess the perspective and response to life stress in the past year. The genotype distribution and allelic frequency analyses showed that the minor C allele of rs2234918 in OPRD1 is over-represented in the HD group (P = .006 and P = .002, respectively). This finding was further confirmed by logistic regression analysis, showing that C allele carriers have a 1.42 times greater risk for HD compared to T/T homozygotes. A subgroup of 421 patients and 135 controls were eligible for life stress assessment. Patients with HD have a higher occurrence of negative events (No), negative events score (Ns), and average negative event score (Na) than those of controls (all P < .001), but there was no difference regarding positive recent events between the two groups. Gene-stress assessment in the HD group showed that T/T homozygotes of OPRD1 rs2236857 have more severe stress than C allele carriers (Ns, P = .004 and Na, P = .047). Our results indicate that the OPRD1 gene may not only play a role in the pathogenesis of HD but also affect the response to life stress among patients with HD in our Han Chinese population. Patients with the risk genotype may need additional psychosocial intervention for relapse prevention.


Assuntos
Predisposição Genética para Doença , Dependência de Heroína/genética , Dependência de Heroína/psicologia , Polimorfismo de Nucleotídeo Único , Receptores Opioides delta/genética , Estresse Psicológico/genética , Adulto , Grupo com Ancestrais do Continente Asiático/genética , Estudos de Casos e Controles , China , Feminino , Frequência do Gene , Estudos de Associação Genética , Haplótipos , Dependência de Heroína/complicações , Heterozigoto , Homozigoto , Humanos , Masculino , Estresse Psicológico/complicações
11.
Acta Pharmacol Sin ; 40(3): 365-373, 2019 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-29967454

RESUMO

Cannabinoid CB1 receptors (CB1Rs) have been shown to be a promising target in medication development for the treatment of addiction. However, clinical trials with SR141716A (rimonabant, a selective CB1R antagonist/inverse agonist) for the treatment of obesity and smoking cessation failed due to unwanted side effects, such as depression, anxiety, and suicidal tendencies. Recent preclinical studies suggest that the neutral CB1R antagonist AM4113 may retain the therapeutic anti-addictive effects of SR141716A in nicotine self-administration models and possibly has fewer unwanted side effects. However, little is known about whether AM4113 is also effective for other drugs of abuse, such as opioids and psychostimulants, and whether it produces depressive side effects similar to SR141716A in experimental animals. In this study, we demonstrated that systemic administration of AM4113 (3 and 10 mg/kg) dose-dependently inhibited the self-administration of intravenous heroin but not cocaine or methamphetamine, whereas SR141716A (3 and 10 mg/kg) dose-dependently inhibited the self-administration of heroin and methamphetamine but not cocaine. In the electrical brain-stimulation reward (BSR) paradigm, SR141716A (3 and 10 mg/kg) dose-dependently increased the BSR stimulation threshold (i.e., decreased the stimulation reward), but AM4113 had no effect on BSR at the same doses, suggesting that SR141716A may produce aversive effects while AM4113 may not. Together, these findings show that neutral CB1R antagonists such as AM4113 deserve further research as a new class of CB1R-based medications for the treatment of opioid addiction without SR141716A-like aversive effects.


Assuntos
Antagonistas de Receptores de Canabinoides/farmacologia , Depressão/prevenção & controle , Comportamento de Procura de Droga/efeitos dos fármacos , Dependência de Heroína/prevenção & controle , Pirazóis/farmacologia , Receptor CB1 de Canabinoide/antagonistas & inibidores , Animais , Comportamento Animal/efeitos dos fármacos , Cocaína/efeitos adversos , Condicionamento Operante/efeitos dos fármacos , Heroína/efeitos adversos , Dependência de Heroína/psicologia , Masculino , Metanfetamina/efeitos adversos , Ratos Long-Evans , Recompensa , Rimonabanto/efeitos adversos , Rimonabanto/farmacologia , Autoadministração
12.
Cad Saude Publica ; 34(11): e00179417, 2018 11 23.
Artigo em Inglês | MEDLINE | ID: mdl-30484562

RESUMO

Heroin consumption in Mexico is low compared with its use in the United States; however, this practice is more common in the northern region of Mexico than in the rest of the country, being documented only in cities that are located exactly at the Mexico-U.S. border. The Mexican legal framework is focused on rehabilitation, but its effects on the lives of users are unknown. The objective of this research was to analyze how the regulatory Mexican framework is conceptualized and practiced in the daily life of a group of heroin users from a northern city, where consumption has recently spread and has not been documented. We collected the official registered data from users and conducted a qualitative study in Hermosillo, Sonora. A research on the legal framework was conducted, as well as on the city's context. Data on heroin users can be found at HIV health center, as there is no other source of such records. The Mexican legal framework aims at rehabilitation and at avoiding criminalization; however, the daily life of users drives them towards crime circuits: people commit crimes to stay in prison, where they can control the addiction and get heroin, in case of abstinence. The Mexican State has no empirical information to improve its programs and laws related to the use of heroin. The daily practices of users become not only epidemiological but social risks to the community and to the users themselves. Also, the lack of access due to stigmatization, criminalization and violence, increases the inequities, creating a cycle that reproduces poverty and suffering as part of a social structure. Therefore, changes are needed in the justice system.


Assuntos
Usuários de Drogas/psicologia , Dependência de Heroína/psicologia , Dependência de Heroína/reabilitação , Saúde Pública , Autoimagem , Crime , Feminino , Infecções por HIV , Humanos , Masculino , México , Programas Nacionais de Saúde/legislação & jurisprudência , Pesquisa Qualitativa , Centros de Tratamento de Abuso de Substâncias/legislação & jurisprudência , Fatores de Tempo
13.
Psychopharmacology (Berl) ; 235(11): 3273-3288, 2018 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-30310960

RESUMO

Methadone as the most prevalent opioid substitution medication has been shown to influence the neurophysiological functions among heroin addicts. However, there is no firm conclusion on acute neuroelectrophysiological changes among methadone-treated subjects as well as the effectiveness of methadone in restoring brain electrical abnormalities among heroin addicts. This study aims to investigate the acute and short-term effects of methadone administration on the brain's electrophysiological properties before and after daily methadone intake over 10 weeks of treatment among heroin addicts. EEG spectral analysis and single-trial event-related potential (ERP) measurements were used to investigate possible alterations in the brain's electrical activities, as well as the cognitive attributes associated with MMN and P3. The results confirmed abnormal brain activities predominantly in the beta band and diminished information processing ability including lower amplitude and prolonged latency of cognitive responses among heroin addicts compared to healthy controls. In addition, the alteration of EEG activities in the frontal and central regions was found to be associated with the withdrawal symptoms of drug users. Certain brain regions were found to be influenced significantly by methadone intake; acute effects of methadone induction appeared to be associative to its dosage. The findings suggest that methadone administration affects cognitive performance and activates the cortical neuronal networks, resulting in cognitive responses enhancement which may be influential in reorganizing cognitive dysfunctions among heroin addicts. This study also supports the notion that the brain's oscillation powers and ERPs can be utilized as neurophysiological indices for assessing the addiction treatment traits.


Assuntos
Analgésicos Opioides/administração & dosagem , Eletroencefalografia/efeitos dos fármacos , Potenciais Evocados Auditivos/efeitos dos fármacos , Dependência de Heroína/tratamento farmacológico , Dependência de Heroína/fisiopatologia , Metadona/administração & dosagem , Adulto , Encéfalo/efeitos dos fármacos , Encéfalo/fisiopatologia , Eletroencefalografia/métodos , Potenciais Evocados Auditivos/fisiologia , Feminino , Dependência de Heroína/psicologia , Humanos , Masculino , Pessoa de Meia-Idade , Resultado do Tratamento , Adulto Jovem
14.
Neuropsychopharmacology ; 43(13): 2615-2626, 2018 12.
Artigo em Inglês | MEDLINE | ID: mdl-30283001

RESUMO

Opioid abuse is a rapidly growing public health crisis in the USA. Despite extensive research in the past decades, little is known about the etiology of opioid addiction or the neurobiological risk factors that increase vulnerability to opioid use and abuse. Recent studies suggest that the type 2 metabotropic glutamate receptor (mGluR2) is critically involved in substance abuse and addiction. In the present study, we evaluated whether low-mGluR2 expression may represent a risk factor for the development of opioid abuse and addiction using transgenic mGluR2-knockout (mGluR2-KO) rats. Compared to wild-type controls, mGluR2-KO rats exhibited higher nucleus accumbens (NAc) dopamine (DA) and locomotor responses to heroin, higher heroin self-administration and heroin intake, more potent morphine-induced analgesia and more severe naloxone-precipitated withdrawal symptoms. In contrast, mGluR2-KO rats displayed lower motivation for heroin self-administration under high price progressive-ratio (PR) reinforcement conditions. Taken together, these findings suggest that mGluR2 may play an inhibitory role in opioid action, such that deletion of this receptor results in an increase in brain DA responses to heroin and in acute opioid reward and analgesia. Low-mGluR2 expression in the brain may therefore be a risk factor for the initial development of opioid abuse and addiction.


Assuntos
Deleção de Genes , Dependência de Heroína/metabolismo , Heroína/administração & dosagem , Receptores de Glutamato Metabotrópico/deficiência , Esquema de Reforço , Animais , Comportamento Aditivo/genética , Comportamento Aditivo/metabolismo , Comportamento Aditivo/psicologia , Dependência de Heroína/genética , Dependência de Heroína/psicologia , Locomoção/efeitos dos fármacos , Locomoção/fisiologia , Masculino , Núcleo Accumbens/efeitos dos fármacos , Núcleo Accumbens/metabolismo , Ratos , Ratos Transgênicos , Ratos Wistar , Receptores de Glutamato Metabotrópico/genética , Autoadministração
15.
J Psychoactive Drugs ; 50(5): 390-401, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-30204554

RESUMO

Possibly through its effects on glia, the peroxisome proliferator-activated gamma receptor (PPARγ) agonist pioglitazone (PIO) has been shown to alter the effects of heroin in preclinical models. Until now, these results have not been assessed in humans. Heroin-dependent participants were randomized to either active (45 mg, n = 14) or placebo (0 mg, n = 16) PIO maintenance for the duration of the three-week study. After stabilization on buprenorphine (8 mg), participants began a two-week testing period. On the first to fourth test days, participants could self-administer drug or money by making verbal choices for either option. On the fifth day, active heroin and money were administered and participants could work to receive heroin or money using a progressive ratio choice procedure. Test days 6-10 were identical to test days 1-5 with the exception that, during one of the test weeks, placebo was available on the first four days, and during the other week heroin was available. PIO failed to alter the reinforcing or positive subjective effects of heroin, but it did reduce heroin craving and overall anxiety. Although we were unable to replicate the robust effects found in preclinical models, these data provide an indication of drug effects that deserves further exploration.


Assuntos
Fissura/efeitos dos fármacos , Dependência de Heroína/psicologia , PPAR gama/agonistas , Pioglitazona/administração & dosagem , Adulto , Ansiedade/tratamento farmacológico , Ansiedade/etiologia , Buprenorfina/administração & dosagem , Feminino , Humanos , Hipoglicemiantes/administração & dosagem , Hipoglicemiantes/farmacologia , Masculino , Pessoa de Meia-Idade , Pioglitazona/farmacologia , Autoadministração , Método Simples-Cego
16.
Psychopharmacology (Berl) ; 235(10): 3005-3015, 2018 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-30178302

RESUMO

RATIONALE: Drug addiction is a complex disease that is impacted by numerous factors. One such factor, time of day, influences drug intake, but there have been no investigations of how time of day affects the amount of drug taken and the development of addiction-like behavior. Previous data from our group show circadian disruption in rats given access to heroin during the light phase, which is important because circadian disruption, itself, can increase drug intake. Thus, the goal of this experiment was to determine how time of day of access affects heroin self-administration and the development of addiction-like behaviors including escalation of heroin intake, willingness to work for heroin on a progressive ratio schedule of reinforcement, seeking during extinction, incubation of seeking, and reinstatement of heroin-seeking behavior. MATERIALS AND METHODS: Male Sprague Dawley rats were given the opportunity to self-administer heroin for 6 h per trial during the second half of either the light or dark phase for 18 trials, including one progressive ratio challenge. Rats then underwent 14 days of abstinence, with a 5-h extinction test occurring on both the first and the 14th days of abstinence. The second extinction test was followed by a heroin prime and 1 h of reinstatement testing. On the following day, a subset of rats were tested in an additional extinction test where rats were tested either at the same time of the day as their previous self-administration sessions or during the opposite light/dark phase. RESULTS: Relative to Light Access rats, Dark Access rats took more heroin, exhibited more goal-directed behavior, exhibited more seeking during the dark phase, failed to extinguish seeking during the 5-h extinction test in the dark phase, and exhibited greater incubation of heroin seeking following abstinence. However, Dark Access rats did not escalate drug taking over trials, work harder for drug, or seek more during drug-induced reinstatement than Light Access rats. CONCLUSIONS: These results show that time of access to heroin affects overall heroin intake and seeking in extinction, but does not affect other addiction-like behaviors in rats.


Assuntos
Comportamento Aditivo/psicologia , Ritmo Circadiano/fisiologia , Extinção Psicológica/efeitos dos fármacos , Dependência de Heroína/psicologia , Heroína/administração & dosagem , Animais , Modelos Animais de Doenças , Masculino , Ratos , Ratos Sprague-Dawley , Autoadministração
17.
Drug Alcohol Depend ; 192: 80-87, 2018 11 01.
Artigo em Inglês | MEDLINE | ID: mdl-30243143

RESUMO

BACKGROUND: Since 2000, heroin use patterns have shifted within the United States. How this change may relate to polydrug use among local heroin users is unknown. Although polydrug use has been studied, user perceptions of drug use in terms of health risks, arrest risk, availability, cost, liking, and dependence have not been considered. METHODS: Data are presented from a brief, face-to-face survey conducted in 2016 of 200 non-in-treatment heroin users from Cleveland, OH. We assessed the use of and attitudes on alcohol, marijuana, methamphetamine, heroin, crack cocaine, powder cocaine, and prescription drugs. We estimated polydrug (concurrent past month) use with cluster analysis and latent profiles. Regression analysis estimated the strength of relationships between attitudes and frequency of use. RESULTS: We identified five clusters: Cluster 1 used heroin concomitantly with alcohol and occasionally crack; Cluster 2 used heroin and crack cocaine daily; Cluster 3 used heroin daily and almost exclusively; Cluster 4 used heroin and marijuana daily; and Cluster 5 were part-time drug users. Drug use frequency was associated with liking and being anxious when drugs could not be obtained. High perceived availability of heroin and cocaine and low cost facilitated polydrug use. CONCLUSIONS: Understanding polydrug use clusters among heroin users is important for addressing the larger opioid epidemic. Users' perceptions of a drug's availability and cost appeared to facilitate polydrug use and justify more detailed future research on drug access.


Assuntos
Usuários de Drogas , Dependência de Heroína/diagnóstico , Dependência de Heroína/epidemiologia , Adulto , Alcoolismo/diagnóstico , Alcoolismo/epidemiologia , Alcoolismo/psicologia , Transtornos Relacionados ao Uso de Anfetaminas/diagnóstico , Transtornos Relacionados ao Uso de Anfetaminas/epidemiologia , Transtornos Relacionados ao Uso de Anfetaminas/psicologia , Analgésicos Opioides/efeitos adversos , Transtornos Relacionados ao Uso de Cocaína/diagnóstico , Transtornos Relacionados ao Uso de Cocaína/epidemiologia , Transtornos Relacionados ao Uso de Cocaína/psicologia , Cocaína Crack/efeitos adversos , Usuários de Drogas/psicologia , Feminino , Heroína/efeitos adversos , Dependência de Heroína/psicologia , Humanos , Masculino , Abuso de Maconha/diagnóstico , Abuso de Maconha/epidemiologia , Abuso de Maconha/psicologia , Pessoa de Meia-Idade , Ohio/epidemiologia , Autorrelato , Transtornos Relacionados ao Uso de Substâncias/diagnóstico , Transtornos Relacionados ao Uso de Substâncias/epidemiologia , Transtornos Relacionados ao Uso de Substâncias/psicologia
18.
BMC Res Notes ; 11(1): 589, 2018 Aug 14.
Artigo em Inglês | MEDLINE | ID: mdl-30107818

RESUMO

OBJECTIVE: The objective of the study was to describe psychological features of abstinent heroin users undergoing rehabilitation in Saint Petersburg, Russia. Study subjects (n = 197) were recruited prospectively at the time of their admission to rehabilitation between March 2010 and May 2011 at 7 inpatient opiate addiction rehabilitation centers in Saint-Petersburg and neighboring regions, Russia. The centers provided varying rehabilitation programs; 6 of them were religious centers. Socio-demographic information and self-reported HIV status were collected. Personality profiles and severity of drug-associated problems were estimated before and after rehabilitation using the Minnesota Multiphasic Personality Inventory 2 (MMPI-2), and the Addiction Severity Index (ASI). RESULTS: Thirty-three (17%) subjects dropped out before completing rehabilitation (non-completers). All subjects (completers and non-completers) had psychopathological personality profiles according to MMPI-2. These profiles were refractory to clinically significant improvement after rehabilitation, although some statistically significant changes toward improvement were observed. ASI scores showed statistically and clinically significant improvements after rehabilitation on all scales. Participants in longer-term versus shorter-term rehabilitation programs showed similar changes in their pre- and post-rehabilitation MMPI-2 and ASI scores. Our results suggest that unmet psychiatric needs should be addressed to potentially improve treatment completion in this population.


Assuntos
Dependência de Heroína/psicologia , Personalidade , Heroína , Dependência de Heroína/reabilitação , Humanos , MMPI , Transtornos da Personalidade , Federação Russa
19.
Exp Brain Res ; 236(11): 2971-2981, 2018 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-30099573

RESUMO

Episodic future thinking refers to the ability to travel forward in time to pre-experience an event. Although future thinking has been intimately linked with self and identity, to our knowledge, no prior research has compared episodic future thinking in populations with different substance use disorders. This study investigates whether there are differences in episodic future thinking between these alcohol and opiate users. The study recruited participants who were on the opiate substitution program (n = 31) and individuals who had been diagnosed with alcohol dependence (n = 21) from the Royal Prince Alfred Hospital Drug and Health Services. Healthy controls (n = 23) were recruited via Royal Prince Alfred Hospital databases and the general community. Past and future thinking was measured using four cue words. After each cue word, participants rated their phenomenological experience (e.g. emotion, reliving experience). Results indicated that alcohol-dependent individuals performed significantly higher in episodic future thinking compared to opiate users. These findings indicate that not all substance use disorder groups share similar episodic thinking capabilities. Our results suggest that the self-projection component of rehabilitation programs may have to be tailored to the different episodic construction abilities found in substance use disorder groups.


Assuntos
Alcoolismo/psicologia , Usuários de Drogas/psicologia , Dependência de Heroína/psicologia , Imaginação , Memória Episódica , Pensamento , Adulto , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Testes Neuropsicológicos , Adulto Jovem
20.
Drug Alcohol Depend ; 191: 145-151, 2018 10 01.
Artigo em Inglês | MEDLINE | ID: mdl-30107320

RESUMO

BACKGROUND AND AIMS: Little is known about transition pathways among heroin users prior to treatment. This study examined the demographic and clinical predictors of transition speed from heroin use, to dependence, to first treatment episode. METHODS: 1149 heroin-dependent participants recruited from opioid agonist treatment clinics in Sydney, Australia, underwent a structured interview. Age of onset (AOO) was collected for heroin use, dependence and treatment-seeking, childhood maltreatment, psychiatric history and other substance dependence. Discrete-time survival analyses modelled years from onset of use to dependence, and from dependence to treatment-seeking, including demographic and clinical covariates. FINDINGS: Median AOO for first heroin use, dependence and treatment-seeking was 18 years (inter-quartile range, or IQR = 6), 21 years (IQR = 7), and 24 years (IQR = 10) respectively. In adjusted models, younger birth cohorts (vs. born <1960), greater childhood maltreatment and later AAO of first heroin use were associated with more rapid transitions from heroin use to dependence. Living independently, parental violence, and alcohol dependence were associated with slower transitions. Earlier treatment-seeking was associated with younger birth cohorts, having dependent children and later AOO of dependence. Delayed treatment-seeking was associated with <10 years school education, living independently, depression and alcohol dependence. CONCLUSIONS: In this treatment sample, onset of heroin use occurred during late adolescence, suggesting the need for targeted interventions in mid-adolescence. Transitions to heroin dependence, then treatment-seeking, occurred during early adulthood. Rapid transitions from use to dependence were associated with younger birth cohorts, greater exposure to childhood maltreatment, and later onset of use.


Assuntos
Dependência de Heroína/psicologia , Aceitação pelo Paciente de Cuidados de Saúde/psicologia , Tempo para o Tratamento/estatística & dados numéricos , Adolescente , Adulto , Sobreviventes Adultos de Maus-Tratos Infantis/psicologia , Fatores Etários , Idade de Início , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , New South Wales , Centros de Tratamento de Abuso de Substâncias , Fatores de Tempo , Adulto Jovem
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