IN THIS ISSUE OF JAMA, PATRICK ET AL 1 DESCRIBE THE EFfects on newborn infants of the widespread availability of prescription opiate medications. These medications provide superior pain control for cancer and chronic pain, but have been overprescribed, diverted, and sold illegally, creating a new opiate addiction pathway and a public health burden for maternal and child health. Overdose mortali...

In teaching medical students and residents about substance dependence, I often use the phrase " the addiction takes on a life of its own. " This intuitive expression begins to introduce how the severely addicted person becomes merely the " means " for the substance, how the person is displaced within his own body, how there becomes a fundamental separation within the addicted person who himself...

The extra-hypothalamic actions of corticotropin-releasing hormone (CRH) have been accorded an important role in coordinating responses to stressors and contributing to the consequences of drug abuse. Recent proposals suggest that CRH actions in the bed nucleus of the stria terminalis coordinate responses to tonic/unpredictable stressors whereas these actions in the central nucleus of the amygda...

Abstract INTRODUCTION Opiate dependence is a national crisis. The use of opiate in patients diagnosed with gliomas undergoing surgery not well understood. OBJECTIVE objective this study was to evaluate for and risk factors prolonged use. METHODS A retrospective chart review conducted on ≥ 18 years who underwent glioma from 1/2016 1/2020. Clinical data collected dose calculated as morphine equiv...

Many clients who undergo methadone maintenance (MM) treatment for heroin and other opiate dependence prefer abstinence from methadone. Attempts at methadone detoxification are often unsuccessful, however, due to distressing physical as well as psychological symptoms. Outcomes from a MM client who voluntarily participated in an Acceptance and Commitment Therapy (ACT) - based methadone detoxifica...

OBJECTIVES To evaluate the characteristics of patients with various substance-related disorders, and to examine rates of retention in treatment. METHODS We assessed the demographic characteristics, substance abuse, and psychological distress of 239 men and women at admission. Six-month performance was evaluated, using as criteria length of stay in treatment, abstinence, attendance in therapy ...

INTRODUCTION This study was designed to determine the short-term effect of acetyl-l-carnitine (ALC) on symptoms of withdrawal in opiate-dependent subjects and animals and, in particular, on pain, given the efficacy of ALC in other typologies of pain. The study consists of 2 branches: a clinical study and a preclinical one, both with a randomized placebo-controlled design. METHODS Thirty subje...

the current preliminary study aimed to explore the reasons that a group of opiate-dependent patients reported for entry into opium tincture treatment (ott).through examinations of 52 qualitative focus group interviews with patients from six ott centers and 10 health providers (in key informant interviews) in tehran, this study highlights the factors that participants reported as the reasons ass...

The relation between illicit drug dependence and the likelihood of drug overdose is unclear. We recruited 1,066 habitual drug users for this analysis through street-based outreach in New York City. In this sample, 99.3% of respondents used heroin in the past year and 87.1% of respondents used cocaine; 819 (77.5%) heroin users and 735 (79.2%) cocaine users were severely dependent on either drug ...

The pharmacological actions of opiate drugs are best characterized by sedation, analgesia, respiratory depression and changes in temperature. Repeated exposure to opiates, however, produces tolerance to these effects such that the magnitude of response is much reduced or absent. From this it must be assumed that the binding of opiates to their receptor sites activate certain biochemical events ...