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https://www.readbyqxmd.com/read/28719091/multimodal-analgesia-as-an-alternative-to-the-risks-of-opioid-monotherapy-in-surgical-pain-management
#1
John J Savarese, Norman G Tabler
Clinicians have long been aware of the danger of overreliance on opioids to manage acute pain, such as the pain accompanying surgery. The risk of adverse drug events is higher with opioids than with any other common class of drugs. Overreliance on opioids increases length of stay and hospital costs, while decreasing patient satisfaction. Opioids can lead to problems that continue well after discharge, including chronic pain, abuse and addiction, and even death. Increasingly, prescribed opioids have proved to lead to heroin addiction...
July 2017: Journal of Healthcare Risk Management: the Journal of the American Society for Healthcare Risk Management
https://www.readbyqxmd.com/read/28708940/the-street-like-synthesis-of-krokodil-results-in-the-formation-of-an-enlarged-cluster-of-known-and-new-morphinans-with-therapeutic-potential
#2
José Soares, Emanuele Alves, André Silva, Natália Figueiredo, João F Neves, Sara Cravo, Maria Rangel, Annibal Netto, Félix Carvalho, Ricardo Jorge Dinis-Oliveira, Carlos Afonso
"Krokodil" is the street name for a homemade injectable drug that has been used as a cheap substitute for heroin. Codeine is the opioid starting material for krokodil synthesis and desomorphine is the opioid claimed to be the main component of krokodil and the main responsible for its addictive and psychoactive characteristics. However, due to its peculiar manufacture, using cheap raw materials, krokodil is composed by a large and complex mixture of different substances. In order to shed some light upon the chemical complexity of krokodil, its profiling was conducted by reverse phase high performance liquid chromatography coupled to photodiode array detector (RP-HPLC-DAD) and by liquid chromatography coupled to high resolution tandem mass spectrometry (LC-ESI-IT-Orbitrap-MS)...
July 14, 2017: Chemical Research in Toxicology
https://www.readbyqxmd.com/read/28703355/neuronal-representation-of-individual-heroin-choices-in-the-orbitofrontal-cortex
#3
Karine Guillem, Viridiana Brenot, Audrey Durand, Serge H Ahmed
Drug addiction is a harmful preference for drug use over and at the expense of other non-drug-related activities. We previously identified in the rat orbitofrontal cortex (OFC) a mechanism that influences individual preferences between cocaine use and an alternative action rewarded by a non-drug reward (i.e. sweet water). Here, we sought to test the generality of this mechanism to a different addictive drug, heroin. OFC neuronal activity was recorded while rats responded for heroin or the alternative non-drug reward separately or while they chose between the two...
July 13, 2017: Addiction Biology
https://www.readbyqxmd.com/read/28683227/supervised-injectable-heroin-a-clinical-perspective
#4
James Bell, Rob van der Waal, John Strang
BACKGROUND: Six recent randomised control trials (RCTs) have suggested that supervised injectable heroin (SIH) can be effective in patients who persist in street heroin use during methadone treatment. However, short-term randomised control trials have limitations in assessing the effectiveness of treatments for addictive disorders, which are chronic and relapsing disorders of motivation. These RCTs particularly fail to capture the process of the SIH treatment and the diversity of influence and change over time...
July 2017: Canadian Journal of Psychiatry. Revue Canadienne de Psychiatrie
https://www.readbyqxmd.com/read/28666251/evaluation-of-a-community-based-integrated-heroin-addiction-treatment-model-in-chinese-patients
#5
Hong-He Zhang, Lin-Xiang Tan, Wei Hao, Qi-Jian Deng
In this study, we analyzed the efficacy and feasibility of a community-based integrated heroin addiction treatment model in Chinese patients. The 210 heroin addicts belonging to six Chinese communities received an integrated biopsychosocial intervention that included pharmacological treatment, counseling and social assistance. High proportions of study participants were retained at the 12-month (91.9%; 193/210) and 24-month (88.1%; 185/210) follow-up visits. The number of morphine-positive subjects declined from 61...
June 27, 2017: Oncotarget
https://www.readbyqxmd.com/read/28663492/a-vaccine-for-heroin-addiction
#6
Priscilla N Kelly
No abstract text is available yet for this article.
June 30, 2017: Science
https://www.readbyqxmd.com/read/28654734/can-a-rapid-measure-of-self-exposure-to-drugs-of-abuse-provide-dimensional-information-on-depression-comorbidity
#7
Eduardo Roque Butelman, Silvia Bacciardi, Angelo Giovanni Icro Maremmani, Maya Darst-Campbell, Joel Correa da Rosa, Mary Jeanne Kreek
BACKGROUND AND OBJECTIVES: Addictions to heroin or to cocaine are associated with substantial psychiatric comorbidity, including depression. Poly-drug self-exposure (eg, to heroin, cocaine, cannabis, or alcohol) is also common, and may further affect depression comorbidity. METHODS: This case-control study examined the relationship of exposure to the above drugs and depression comorbidity. Participants were recruited from methadone maintenance clinics, and from the community...
June 27, 2017: American Journal on Addictions
https://www.readbyqxmd.com/read/28649663/addictive-neurons
#8
Sodikdjon A Kodirov
Since the reward center is considered to be the area tegmentalis ventralis of the hypothalamus, logically its neurons could mainly be responsible for addiction. However, the literature asserts that almost any neurons of CNS can respond to one or another addictive compound. Obviously not only addictive nicotine, but also alcohol, amphetamine, cannabis, cocaine, heroin and morphine may influence dopaminergic cells alone in VTA. Moreover, paradoxically some of these drugs ameliorate symptoms, counterbalance syndromes, cure diseases and improve health, not only those related to the CNS and in adults, but also almost all other organs and in children, e...
2017: Therapeutic Targets for Neurological Diseases
https://www.readbyqxmd.com/read/28645064/heroin-and-saccharin-demand-and-preference-in-rats
#9
Lindsay P Schwartz, Jung S Kim, Alan Silberberg, David N Kearns
BACKGROUND: Several recent studies have investigated the choice between heroin and a non-drug alternative reinforcer in rats. A common finding in these studies is that there are large individual differences in preference, with some rats preferring heroin and some preferring the non-drug alternative. The primary goal of the present study was to determine whether individual differences in how heroin or saccharin is valued, based on demand analysis, predicts choice. METHODS: Rats lever-pressed for heroin infusions and saccharin reinforcers on fixed-ratio schedules...
June 13, 2017: Drug and Alcohol Dependence
https://www.readbyqxmd.com/read/28635181/buprenorphine-requires-concomitant-activation-of-nop-and-mop-receptors-to-reduce-cocaine-consumption
#10
Marsida Kallupi, Qianwei Shen, Giordano de Guglielmo, Dennis Yasuda, V Blair Journigan, Nurulain T Zaveri, Roberto Ciccocioppo
Buprenorphine's clinical use is approved for the treatment of heroin addiction; however, evidence supporting its efficacy in cocaine abuse also exists. While for heroin it has been demonstrated that the effect of buprenorphine is mediated by its ability to activate μ-opioid peptide receptor (MOP) receptors, the mechanism through which it attenuates cocaine intake remains elusive. We explored this mechanism using operant models where rodents were trained to chronically self-administer cocaine for 2 hours daily...
June 21, 2017: Addiction Biology
https://www.readbyqxmd.com/read/28604329/report-on-the-first-government-funded-opioid-substitution-programme-for-heroin-users-in-the-western-cape-province-south-africa
#11
Graeme Michie, Shuaib Hoosain, Muiruri Macharia, Lize Weich
BACKGROUND: Although pharmacological opioid substitution treatment (OST) is a well-established treatment modality for heroin addiction, it is a relatively recent introduction in low- and middle-income countries. OBJECTIVE: To report on a pilot OST programme initiated in 2013 that was the only public-funded programme in South Africa (SA) at the time. Participants were offered standard care only (n=68) or, for the OST group (n=67), standard care plus Suboxone (Reckitt Benckiser), a synthetic partial opioid agonist, in a 12-week clinician-monitored programme...
May 24, 2017: South African Medical Journal, Suid-Afrikaanse Tydskrif Vir Geneeskunde
https://www.readbyqxmd.com/read/28598964/changes-in-expression-of-dopamine-its-receptor-and-transporter-in-nucleus-accumbens-of-heroin-addicted-rats-with-brain-derived-neurotrophic-factor-bdnf-overexpression
#12
Yixin Li, Baijuan Xia, Rongrong Li, Dan Yin, Wenmei Liang
BACKGROUND The aim of this study was to explore how changes in the expression of BDNF in MLDS change the effect of BDNF on dopamine (DA) neurons, which may have therapeutic implications for heroin addiction. MATERIAL AND METHODS We established a rat model of heroin addiction and observed changes in the expression of BDNF, DA, dopamine receptor (DRD), dopamine transporter (DAT), and other relevant pathways in NAc. We also assessed the effect of BDNF overexpression in the NAc, behavioral changes of heroin-conditioned place preference (CPP), and naloxone withdrawal in rats with high levels of BDNF...
June 9, 2017: Medical Science Monitor: International Medical Journal of Experimental and Clinical Research
https://www.readbyqxmd.com/read/28586701/the-extent-of-and-factors-associated-with-self-reported-overdose-and-self-reported-receipt-of-naloxone-among-people-who-inject-drugs-pwid-in-england-wales-and-northern-ireland
#13
Charlotte O'Halloran, Katelyn Cullen, Jaquelyn Njoroge, Lucy Jessop, Josie Smith, Vivian Hope, Fortune Ncube
BACKGROUND: Overdose is a major cause of death among PWID, and for opioid overdoses naloxone administration can reduce harm. However, globally there is limited national level data on the extent of non-fatal overdose and naloxone uptake. The first national level data on the extent of self-reported overdose and self-reported receipt of naloxone among UK PWID, providing a baseline to monitor the impact of the recent policy change regarding naloxone availability, is presented. METHODS: Data on self-reported overdose and receipt of naloxone during the preceding year for 2013-2014 from a national survey of PWID was analysed...
June 3, 2017: International Journal on Drug Policy
https://www.readbyqxmd.com/read/28571505/buprenorphine-implants-in-medical-treatment-of-opioid-addiction
#14
Steven Chavoustie, Michael Frost, Ole Snyder, Joel Owen, Mona Darwish, Ryan Dammerman, Victoria Sanjurjo
Opioid use disorder is a chronic, relapsing disease that encompasses use of both prescription opioids and heroin and is associated with a high annual rate of overdose deaths. Medical treatment has proven more successful than placebo treatment or psychosocial intervention, and the partial µ-opioid receptor agonist and κ-opioid receptor antagonist buprenorphine is similar in efficacy to methadone while offering lower risk of respiratory depression. However, frequent dosing requirements and potential for misuse and drug diversion contribute to significant complications with treatment adherence for available formulations...
June 21, 2017: Expert Review of Clinical Pharmacology
https://www.readbyqxmd.com/read/28550642/post-heroin-dose-tissue-distribution-of-6-monoacetylmorphine-6-mam-with-maldi-imaging
#15
Belin G Teklezgi, Annapurna Pamreddy, Sooraj Baijnath, Nirmala D Gopal, Tricia Naicker, Hendrik G Kruger, Thavendran Govender
Heroin is an illicit opioid drug which is commonly abused and leads to dependence and addiction. Heroin is considered a pro-drug and is rapidly converted to its major active metabolite 6-monoacetylmorphine (6-MAM) which mediates euphoria and reward through the stimulation of opioid receptors in the brain. The aim of this study was to investigate the distribution and localization of 6-MAM in the healthy Sprague Dawley rat brain following intraperitoneal (i.p) administration of heroin (10 mg/kg), using matrix-assisted laser desorption/ionization mass spectrometric imaging (MALDI-MSI), in combination with quantification via liquid chromatography mass spectrometry (LC-MS/MS)...
August 2017: Journal of Molecular Histology
https://www.readbyqxmd.com/read/28546432/regulation-of-the-endoplasmic-reticulum-stress-response-and-neuroprotective-effects-of-acupuncture-on-brain-injury-caused-by-heroin-addiction
#16
Yong-Long Gao, Yang Zhang, Jiang-Peng Cao, Sheng-Bing Wu, Xing-Hui Cai, Yan-Chun Zhang, Rong-Jun Zhang, Xiao-Ge Song, Li-Da Zhang
OBJECTIVES: To evaluate regulation of the endoplasmic reticulum stress (ERS) response by acupuncture and to investigate its neuroprotective effect on brain injury caused by heroin addiction. METHODS: A total of 48 male Sprague-Dawley rats were randomly divided into a healthy control group (Control), an untreated heroin exposed group (Heroin) and a heroin exposed group receiving electroacupuncture (EA) treatment at GV14 and GV20 (Heroin+acupuncture) with n=16 rats per group...
May 25, 2017: Acupuncture in Medicine: Journal of the British Medical Acupuncture Society
https://www.readbyqxmd.com/read/28541119/treatment-of-opioid-use-disorder-with-ibogaine-detoxification-and-drug-use-outcomes
#17
Thomas Kingsley Brown, Kenneth Alper
BACKGROUND: Ibogaine is a monoterpene indole alkaloid used in medical and nonmedical settings for the treatment of opioid use disorder. Its mechanism of action is apparently novel. There are no published prospective studies of drug use outcomes with ibogaine. OBJECTIVES: To study outcomes following opioid detoxification with ibogaine. METHODS: In this observational study, 30 subjects with DSM-IV Opioid Dependence (25 males, 5 females) received a mean total dose of 1,540 ± 920 mg ibogaine HCl...
May 25, 2017: American Journal of Drug and Alcohol Abuse
https://www.readbyqxmd.com/read/28538519/expression-of-brain-derived-neurotrophic-factors-neurotrophin-3-and-neurotrophin-4-in-the-nucleus-accumbens-during-heroin-dependency-and-withdrawal
#18
Yixin Li, Baijuan Xia, Rongrong Li, Dan Yin, Yanlin Wang, Wenmei Liang
Neurotrophins, brain-derived neurotrophic factors (BDNF), neurotrophin-3 (NT-3), and neurotrophin-4 (NT-4), have been implicated in the modulation of heroin dependency. This study was designed to explore the expression alterations of BDNF, NT-3, and NT-4 in the context of heroin dependence and withdrawal in the rat nucleus accumbens (NAc). Heroin dependence was induced by a progressive intraperitoneal treatment of heroin. The results showed that the expression levels of BDNF and NT-4 were significantly decreased in the NAc of rats with heroin addiction in comparison with the control group, whereas there was a significant increase in BDNF and NT-4 expressions in the groups of rats with both naloxone-induced and spontaneous withdrawal...
August 2, 2017: Neuroreport
https://www.readbyqxmd.com/read/28534263/n-acetylaspartylglutamate-inhibits-heroin-self-administration-and-heroin-seeking-behaviors-induced-by-cue-or-priming-in-rats
#19
Huaqiang Zhu, Miaojun Lai, Weisheng Chen, Disen Mei, Fuqiang Zhang, Huifeng Liu, Wenhua Zhou
Activation of presynaptic group II metabotropic glutamate receptors (mGluR2/3) inhibits drug reward and drug-seeking behavior, but the role of N-acetylaspartylglutamate (NAAG), an agonist of endogenous mGluR2/3, in heroin reward and heroin-seeking behavior remained unclear. Here, we aimed to explore the effects of exogenous NAAG on heroin self-administration and heroin-seeking behavior. First, rats were trained to self-administer heroin under a fixed ratio 1 (FR1) schedule for 10 days, then received NAAG (50 or 100 μg/10 μL in each nostril) in the absence or presence of LY341495 (1 mg/kg, i...
May 22, 2017: Neuroscience Bulletin
https://www.readbyqxmd.com/read/28534187/total-hypothalamic-volume-is-reduced-in-postmortem-brains-of-male-heroin-addicts
#20
Ulf J Müller, Kolja Schiltz, Christian Mawrin, Henrik Dobrowolny, Thomas Frodl, Hans-Gert Bernstein, Bernhard Bogerts, Kurt Truebner, Johann Steiner
The hypothalamus is at the core of the stress responses systems of the brain. Most interestingly, even though changes of HPA-function have been observed in opiate addiction not much is known about structural changes of the hypothalamus. Volumes of hypothalamus in heroin addicts (n = 14) and healthy controls (n = 12) were assessed by using morphometry of serial whole-brain sections. Total brain volume was larger in the heroin group (mean 1478.85 ± 62.34 cm(3) vs. mean 1352.38 ± 103.24 cm(3)), as the heroin group was more than 10 years younger (p = 0...
May 22, 2017: European Archives of Psychiatry and Clinical Neuroscience
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