Addiction Rehab: Intertwined Epidemics: National Demographic Trends in Hospitalizations for Heroin- and Opioid-Related Overdoses, 1993-2009.

Intertwined epidemics: national demographic trends in hospitalizations for heroin- and opioid-related overdoses, 1993-2009.

Filed under: Addiction Rehab

PLoS One. 2013; 8(2): e54496
Unick GJ, Rosenblum D, Mars S, Ciccarone D

The historical patterns of opiate use show that sources and methods of access greatly influence who is at risk. Today, there is evidence that an enormous increase in the availability of prescription opiates is fuelling a rise in addiction nationally, drawing in new initiates to these drugs and changing the geography of opiate overdoses. Recent efforts at supply-based reductions in prescription opiates may reduce harm, but addicted individuals may switch to other opiates such as heroin. In this analysis, we test the hypothesis that changes in the rates of Prescription Opiate Overdoses (POD) are correlated with changes in the rate of heroin overdoses (HOD). ICD9 codes from the Nationwide Inpatient Sample and population data from the Census were used to estimate overall and demographic specific rates of POD and HOD hospital admissions between 1993 and 2009. Regression models were used to test for linear trends and lagged negative binomial regression models were used to model the interrelationship between POD and HOD hospital admissions. Findings show that whites, women, and middle-aged individuals had the largest increase in POD and HOD rates over the study period and that HOD rates have increased in since 2007. The lagged models show that increases in a hospitals POD predict an increase in the subsequent years HOD admissions by a factor of 1.26 (p<0.001) and that each increase in HOD admissions increase the subsequent years POD by a factor of 1.57 (p<0.001). Our hypothesis of fungibility between prescription opiates and heroin was supported by these analyses. These findings suggest that focusing on supply-based interventions may simply lead to a shift in use to heroin rather minimizing the reduction in harm. The alternative approach of using drug abuse prevention resources on treatment and demand-side reduction is likely to be more productive at reducing opiate abuse related harm. HubMed – addiction


Sex Risk Behavior Among Adolescent and Young Adult Children of Opiate Addicts: Outcomes From the Focus on Families Prevention Trial and an Examination of Childhood and Concurrent Predictors of Sex Risk Behavior.

Filed under: Addiction Rehab

Prev Sci. 2013 Feb 13;
Skinner ML, Fleming CB, Haggerty KP, Catalano RF

This study reports on rates and predictors of sex risk behavior among a sample of adolescent and young adult children of parents enrolled in methadone treatment for opiate addiction. Data are from 151 participants (80 males, 71 females) in the Focus on Families (FOF) project, a randomized trial of a family intervention and a study of the development of at-risk children. The study participants are children of parents enrolled in methadone treatment between 1990 and 1993. Participants were interviewed in 2005 when they ranged in age from 15 to 29 years. In the year prior to the follow-up, 79 % of the males and 83 % of females were sexually active, 26 % of males and 10 % of females had more than one partner in the prior year, and 34 % of males and 24 % of females reported having sex outside of a committed relationship. Twenty-four percent of males and 17 % of females met criteria for high-risk sexual behavior, reporting casual or multiple partners in the prior year and inconsistent condom use. Participants in the intervention and control conditions did not differ significantly in terms of any measure of sex risk behavior examined. None of the measures of parent behavior and family processes derived from data at baseline of the FOF study predicted whether participants engaged in high-risk sex. Among measures derived from data collected at long-term follow-up, however, having ever met criteria for substance abuse or dependence predicted greater likelihood of high-risk sexual behavior, and being married or being in a romantic relationship was associated with lower likelihood of high-risk sexual behavior. The findings point to the important role of committed relationships in regulating sex risk behavior among this population, as well as heightened levels of sex risk behavior associated with substance abuse or dependence.
HubMed – addiction


The selective D(3) receptor antagonist SB277011A attenuates morphine-triggered reactivation of expression of cocaine-induced conditioned place preference.

Filed under: Addiction Rehab

Synapse. 2013 Feb 13;
Rice OV, Heidbreder CA, Gardner EL, Schonhar CD, Ashby CR

We examined the effect of acute administration of the selective D(3) receptor antagonist SB277011A on morphine-triggered reactivation of cocaine-induced conditioned place preference (CPP) in adult male Sprague-Dawley rats. Repeated pairing of animals with 15 mg/kg i.p. of cocaine HCl or vehicle to cue-specific CPP chambers produced a significant CPP response compared to animals paired only with vehicle in both chambers. Expression of the CPP response to cocaine was then extinguished by repeatedly giving the animals vehicle injections in the cocaine-paired chambers. The magnitude of the CPP response after extinction was not significantly different from that of animals paired only with vehicle. Expression of the extinguished CPP response was reactivated by acute administration of 5 mg/kg i.p. of morphine but not by vehicle. Acute administration of 6 or 12 mg/kg i.p. (but not 3 mg/kg) of SB277011A significantly attenuated morphine-triggered reactivation of the cocaine-induced CPP. SB277011A itself (12 mg/kg i.p.) did not reactivate the extinguished CPP response. Overall, SB277011 decreases the incentive motivational actions of morphine. The present findings suggest that central D(3) dopamine receptors are involved in relapse to cocaine-seeking behavior that a final common neural mechanism exists to mediate the incentive motivational effects of psychostimulants and opiates, and that selective dopamine D(3) receptor antagonists constitute promising compounds for treating addiction. Synapse, 2013. © 2013 Wiley Periodicals, Inc.
HubMed – addiction


Provider Views of Harm Reduction Versus Abstinence Policies Within Homeless Services for Dually Diagnosed Adults.

Filed under: Addiction Rehab

J Behav Health Serv Res. 2013 Feb 13;
Henwood BF, Padgett DK, Tiderington E

Harm reduction is considered by many to be a legitimate alternative to abstinence-based services for dually diagnosed individuals, yet there is limited understanding of how varying approaches affect front-line practice within services for homeless adults. This paper examines how front-line providers working with individuals who have experienced homelessness, serious mental illness, and addiction view policies of harm reduction versus abstinence within two different approaches to homeless services: the traditional or “treatment first” approach that requires abstinence, and the more recent housing first approach that incorporates harm reduction. As part of a federally funded qualitative study, 129 in-depth interviews conducted with 41 providers were thematically analyzed to understand how providers view harm reduction versus abstinence approaches. Themes included the following: (a) harm reduction as a welcomed alternative, (b) working with ambiguity, and (c) accommodating abstinence. Drawing on recovery principles, the authors consider the broader implications of the findings for behavioral health care with this population.
HubMed – addiction


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