BACKGROUND Depression with psychomotor agitation (PMA; "agitated depression") is a putative psychiatric phenotype that appears to associate with some forms of substance dependence. However, it is unclear whether such relationships extend across different substances and independent (I-MDE) versus substance-induced (SI-MDE) subtypes of major depressive episodes. METHOD We examined whether lifet...

Chronic pain is commonly treated by prescribing an opioid medication. For those suffering from both chronic pain and substance dependence, barriers to adequate pain management increase. This often causes both disorders to exacerbate one another. Effective treatment may also be hampered by opioid-induced hyperalgesia, tolerance, physical dependence, "chemical coping," and diminished physical and...

BACKGROUND Opioids are psychoactive analgesic drugs prescribed for pain relief and palliative care. Due to their addictive potential, effort and vigilance in controlling prescriptions is needed to avoid misuse and dependence. Despite the effort, the prevalence of opioid use disorder continues to rise. Opioid substitution therapies are commonly used to treat opioid dependence; however, there is ...

BACKGROUND Results of preclinical studies suggest that the GABA(B) receptor agonist baclofen may be useful in treatment of opioid dependence. This study was aimed at assessing the possible efficacy of baclofen for maintenance treatment of opioid dependence. METHODS A total of 40 opioid-dependent patients were detoxified and randomly assigned to receive baclofen (60 mg/day) or placebo in a 12-...

Nicotine in tobacco, tetrahydrocannabinol (delta 9-THC) in marijuana and morphine in opium are well known as drugs associated with dependence or addiction. Endogenous active substances that mimic the effects of the natural drugs and their respective receptors have been found in the mammalian central nervous system (CNS). Such active substances and receptors include acetylcholine (ACh) and the n...

BACKGROUND Naltrexone is a competitive opioid antagonist and is often used to maintain abstinence in detoxified opioid dependent patients. However, it can precipitate an accelerated withdrawal when ingested by an individual with concurrent opioid use. METHODS We report the case of a 28 year old male with opioid dependence syndrome presenting with chaotic symptoms following ingestion of naltre...

Buprenorphine (Subutex) and buprenorphine/naloxone (Suboxone) received Food and Drug Administration approval in 2002 for the treatment of opioid dependence. Introduction of these drugs expanded the availability of opioid-dependence treatment options to reduce the morbidity and mortality associated with opioid abuse, and buprenorphine has become an increasingly prescribed component of office-bas...

The mechanism of chronic pain is very complicated. Memory, pain, and opioid dependence appear to share common mechanism, including synaptic plasticity, and anatomical structures. A 48-yr-old woman with severe pain caused by bone metastasis of breast cancer received epidural block. After local anesthetics were injected, she had a seizure and then went into cardiac arrest. Following cardiopulmona...

Post Traumatic Stress Disorder (PTSD) is highly prevalent among individuals addicted to opioids and complicates the course of illness and treatment response. Evidence-based treatments for patients with co-occurring opioid abuse and PTSD are lacking. Furthermore, little is known about the potential benefits of partial agonist therapy for these co-occurring conditions. We report the case of a pat...

INTRODUCTION The recent discoveries of the existence of opiate receptors and of endogenous opioid peptides in the central nervous system of animals and man have raised hopes that an understanding of the molecular mechanism of drug addiction may soon be achieved. It is clear from the title of this chapter that that day is not yet here. I will give a brief chronological review of the significant ...