Addiction Rehab: Does Alcoholics Anonymous Work Differently for Men and Women? a Moderated Multiple-Mediation Analysis in a Large Clinical Sample.

Does Alcoholics Anonymous work differently for men and women? A moderated multiple-mediation analysis in a large clinical sample.

Filed under: Addiction Rehab

Drug Alcohol Depend. 2012 Nov 30;
Kelly JF, Hoeppner BB

BACKGROUND: Alcoholics Anonymous (AA) began as a male organization, but about one third is now female. Studies have found that women participate at least as much as men and benefit equally from AA, but it is unclear whether women benefit from AA in the same or different ways as men. This study tested whether gender moderated the mechanisms through which AA aids recovery. METHODS: A cohort study of alcohol dependent adults (N=1726; 24% female; Project MATCH) was assessed on AA attendance during treatment; with mediators at 9 months; outcomes (Percent Days Abstinent [PDA] and Drinks per Drinking Day [DDD]) at 15 months. Multiple mediator models tested whether purported mechanisms (i.e., self-efficacy, depression, social networks, spirituality/religiosity) explained AA’s effects differently for men and women controlling for baseline values, mediators, treatment, and other confounders. RESULTS: For PDA, the proportion of AA’s effect accounted for by the mediators was similar for men (53%) and women (49%). Both men and women were found to benefit from changes in social factors but these mechanisms were more important among men. For DDD, the mediators accounted for 70% of the effect of AA for men and 41% for women. Again, men benefitted mostly from social changes. Independent of AA’s effects, negative affect self-efficacy was shown to have a strong relationship to outcome for women but not men. CONCLUSIONS: The recovery benefits derived from AA differ in nature and magnitude between men and women and may reflect differing needs based on recovery challenges related to gender-based social roles and drinking contexts.
HubMed – addiction


Profiling Two Indole-2-Carboxamides for Allosteric Modulation of the CB1 Receptor.

Filed under: Addiction Rehab

J Neurochem. 2012 Dec 3;
Ahn KH, Mahmoud MM, Samala S, Lu D, Kendall DA

Allosteric modulation of G-protein coupled receptors (GPCRs) represents a novel approach for fine-tuning GPCR functions. The cannabinoid CB1 receptor, a GPCR associated with the CNS, has been implicated in the treatment of drug addiction, pain, and appetite disorders. We report here the synthesis and pharmacological characterization of two indole-2-carboxamides: 5-chloro-3-ethyl-1-methyl-N-(4-(piperidin-1-yl)phenethyl)-1H-indole-2-carboxamide (ICAM-a) and 5-chloro-3-pentyl-N-(4-(piperidin-1-yl)phenethyl)-1H-indole-2-carboxamide (ICAM-b). While both ICAM-a and ICAM-b enhanced CP55,940 binding, ICAM-b exhibited the strongest positive cooperativity thus far demonstrated for enhancing agonist binding to the CB1 receptor. Although it displayed negative modulatory effects on G-protein-coupling to CB1, ICAM-b induced ?-arrestin-mediated downstream activation of ERK signaling. These results indicate that this compound represents a novel class of CB1 ligands that produce biased signaling via CB1. © 2012 International Society for Neurochemistry, J. Neurochem. (2012) 10.1111/jnc.12115.
HubMed – addiction


Age of Alcohol and Cannabis Use Onset Mediates the Association of Transmissible Risk in Childhood and Development of Alcohol and Cannabis Disorders: Evidence for Common Liability.

Filed under: Addiction Rehab

Exp Clin Psychopharmacol. 2012 Dec 3;
Kirisci L, Tarter R, Ridenour T, Zhai ZW, Fishbein D, Reynolds M, Vanyukov M

Age at the time of first alcohol and cannabis use was investigated in relation to a measure of transmissible (intergenerational) risk for addiction in childhood and development of alcohol use disorder (AUD) and cannabis use disorder (CUD). It was hypothesized that age at the time of first experience with either substance mediates the association between transmissible risk and subsequent diagnosis of both disorders. The Transmissible Liability Index (TLI; (Vanyukov et al., 2009) was administered to 339 10- to 12-year-old boys (n = 254) and girls (n = 85). Age at the time of first alcohol and cannabis use, and diagnosis of AUD and CUD, were prospectively tracked to age 22. Each standard deviation unit increase in TLI severity corresponded to a reduction in age of alcohol and cannabis use onset by 3.2 months and 4.6 months, respectively. Age at the time of first alcohol use mediated the association of TLI with both AUD and CUD. Parallel results were obtained for cannabis. Whereas transmissible risk is congenerous to both AUD and CUD, its magnitude was 7 times greater in youths who initiated substance use with cannabis. TLI predicts age of first use of alcohol and cannabis that is common to developing both AUD and CUD. The ramifications of these findings for prevention are discussed. (PsycINFO Database Record (c) 2012 APA, all rights reserved).
HubMed – addiction


Accessing Hepatitis C patients who are difficult to reach: it is time to overcome barriers.

Filed under: Addiction Rehab

J Viral Hepat. 2012 Dec; 19(12): 829-35
Bruggmann P

With the arrival of simple, efficient and safe interferon-free treatment regimens, hepatitis C virus (HCV) therapy will have the potential to be successfully used for the majority of infected patients and prevent the associated morbidity and mortality. With the current treatment uptake rates, only a very small proportion of HCV-infected patients are reached. Paradoxically, treatment rates are lowest in the most affected at-risk group – people who inject drugs (PWID) – which is the major driving force behind the spread of HCV infection. To conquer the increasing problem of HCV-related liver disease, many existing but modifiable obstacles, which prevent detection, assessment and treatment uptake, have to be overcome in this population. This review article summarizes the existing literature on the most relevant barriers preventing HCV care and describes measures to overcome these obstacles.
HubMed – addiction



DON’T BREAK THE BOTTLE IAN PERMANN – I wrote this in rehab.


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