Addiction Rehab: Polypharmacy Reviews Among Elderly Populations Project: Assessing Needs in Patient-Provider Communication.

Polypharmacy reviews among elderly populations project: assessing needs in patient-provider communication.

Filed under: Addiction Rehab

Hawaii J Med Public Health. 2013 Jan; 72(1): 15-22
Takane AK, Balignasay MD, Nigg CR

Adults sixty-five years of age and older are a growing population, and are the largest consumers of prescription and nonprescription medications in the United States with potentially increased medication interaction risks. Therefore, an investigation to determine if elderly populations at two minority serving, independent housing sites perceived any issues regarding their medication use, including any communication challenges with their providers. The data were collected using a survey in which participants had to recall information about their medication use and past provider interaction.Participants (N=21; 90.5% female; using 5.1 ± 2.6 medications) completed a needs assessment. Results indicated that patients felt comfortable talking to their doctors. However, the communication that occurs may not have included education on polypharmacy. Many participants did not believe that they could describe details about their medications, such as the purpose (47.6%), instructions (42.9%), side effects (66.7%), and the possible risk of addiction (42.9%). This assessment indicates a need for an intervention that is focused on communication about polypharmacy and medication review education.
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The atypical dopamine transport inhibitor, JHW 007, prevents amphetamine-induced sensitization and synaptic reorganization within the nucleus accumbens.

Filed under: Addiction Rehab

Prog Neuropsychopharmacol Biol Psychiatry. 2013 Feb 1;
Velázquez-Sánchez C, García-Verdugo JM, Murga J, Canales JJ

Benztropine (BZT) analogs, a family of agents with high affinity for the dopamine transporter have been postulated as potential treatments in stimulant abuse due to their ability to attenuate a wide range of effects evoked by psychomotor stimulants such as cocaine and amphetamine (AMPH). Repeating administration of drugs, including stimulants, can result in behavioural sensitization, a progressive increase in their psychomotor activating effects. We examined in mice the sensitizing effects and the neuroplasticity changes elicited by chronic AMPH exposure, and the modulation of these effects by the BZT derivative and atypical dopamine uptake inhibitor, JHW007, a candidate medication for stimulant abuse. The results indicated that JHW007 did not produce sensitized locomotor activity when given alone but prevented the sensitized motor behavior induced by chronic AMPH administration. Morphological analysis of medium spiny neurons of the nucleus accumbens revealed that JHW 007 prevented the neuroadaptations induced by chronic AMPH exposure, including increments in dendritic arborization, lengthening of dendritic processes and increases in spine density. Furthermore, data revealed that AMPH produced an increase in the density of asymmetric, possibly glutamatergic synapses in the nucleus accumbens, an effect that was also blocked by JHW007 pretreatment. The present observations demonstrate that JHW007 is able to prevent not only AMPH-induced behavioural sensitization but also the long-term structural changes induced by chronic AMPH in the nucleus accumbens. Such findings support the development and evaluation of BZT derivatives as possible leads for treatment in stimulant addiction.
HubMed – addiction


Substance abuse precedes internet addiction.

Filed under: Addiction Rehab

Addict Behav. 2013 Jan 16; 38(4): 2022-2025
Lee YS, Han DH, Kim SM, Renshaw PF

The purpose of the current study was to evaluate possible overlapping substance abuse and internet addiction in a large, uniformly sampled population, ranging in age from 13 to 18years. Participants (N=73,238) in the current study were drawn from the 6th Korea Youth Risk Behavior Web-based Survey (KYRBWS-V) for students from 400 middle schools and 400 high schools in 16 cities within South Korea. Of adolescent internet users, 85.2% were general users (GU), 11.9% were users with potential risk for internet addiction (PR), and 3.0% were users with high risk for internet addiction (HR). There was a difference in the number of students with alcohol drinking among the GU, PR, and HR groups (20.8% vs 23.1% vs 27.4%). There was a difference in the number of students who smoked among the GS, PR, and HR groups (11.7% vs 13.5% vs 20.4%). There was a difference in the number of students with drug use among the GU, PR, and HR groups (1.7% vs 2.0% vs 6.5%). After adjusting for sex, age, stress, depressed mood, and suicidal ideation, smoking may predict a high risk for internet addiction (OR=1.203, p=0.004). In addition, drug use may predict a high risk for internet addiction (OR=2.591, p<0.001). Because students with a high risk for internet addiction have vulnerability for addictive behaviors, co-morbid substance abuse should be evaluated and, if found, treated in adolescents with internet addiction. HubMed – addiction


Motivational counseling reduces future police charges in court referred youth.

Filed under: Addiction Rehab

Accid Anal Prev. 2013 Jan 16; 53C: 89-99
Nirenberg T, Baird J, Longabaugh R, Mello MJ

By the age of 18, between 16 and 27% of adolescents in the U.S. have been arrested for an offense and by the age of 23 this increases to a staggering 25-41%. Most youth that get into legal trouble have a substance abuse problem and many youth report high risk driving behaviors. Adjudication of adolescents for an offense may provide an opportunity to provide a secondary prevention program for such high risk behaviors. In this regard the primary aim of the present study was to test two hypotheses: (1) that interventions involving group motivational interviewing would decrease future legal charges beyond those achieved by the combination of sanctions and remedial actions otherwise mandated by the court; and (2) that the addition of a trauma room exposure to the group MI intervention would increase the effectiveness of MI in decreasing these future legal charges. Court mandated youth who have had a high risk driving police charge and/or alcohol related police charge and who are drivers (n=992) were randomly assigned to one of the three 20h interventions; enhanced prototypic community service (CS), Motivational Intervention with typical community service (MI), and Motivational Intervention with exposure to a hospital trauma center (MI-H). As hypothesized, the probability of being charged with an offense within the 6 months post-treatment was significantly less for participants in the combined MI groups than those in the CS group. The combined MI groups also had significantly fewer overall number of police charge events than the CS group at 6 months. Mediation analyses revealed that the relationship between MI vs. CS interventions and subsequent police charges was partially accounted for by the youth’s experience of the MI component of the intervention. Despite fewer police charges at 6 months the combined MI group reported (1) significantly more hazardous drinking and (2) a greater amount of speeding and distracted driving than the control group over this same 6-month period. Hypothesis 2, that MI-H would be more effective than MI in reducing police charges, was not supported. This was so despite evidence supporting the hypotheses that (1) trauma room exposure would increase participants’ emotional arousal during the intervention and (2) increased arousal would be predictive of fewer police charges. Despite support for the theorized causal pathway, the combination of trauma room exposure and MI did not result in better outcomes than MI combined with traditional community service. Given this discrepancy between empirical supports for the theory in the face of the absence of incremental effectiveness of the MI-H treatment condition, a better understanding of the participant’s hospital experience will be necessary if we are to successfully utilize the trauma room exposure to increase the effectiveness of MI interventions for this target group to achieve better outcomes.
HubMed – addiction


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