Addiction Rehab: Predictive Validity of Treatment Allocation Guidelines on Drinking Outcome in Alcohol-Dependent Patients.

Predictive validity of treatment allocation guidelines on drinking outcome in alcohol-dependent patients.

Filed under: Addiction Rehab

Addict Behav. 2012 Sep 12; 38(3): 1691-1698
Merkx MJ, Schippers GM, Koeter MW, Vuijk PJ, Poch M, Kronemeijer H, van den Brink W

The purpose of this study was to establish the predictive validity of guidelines for allocating patients to outpatient or inpatient treatment for an alcohol-use disorder. It was hypothesized that patients who were matched to the recommended level of care would have (a) better outcomes than patients treated at a less intensive level of care, and (b) outcomes equivalent to those of patients treated at a more intensive level of care. Matched patients were allocated according to an algorithm based on their treatment history, addiction severity, psychiatric impairment, and social stability at baseline. Outcome was measured in terms of self-reported alcohol use 30days prior to follow-up and changes in number of abstinent and heavy drinking days between intake and follow up. Of the 2,310 patients, 65.4% were successfully followed up 9.67months after intake. Only 22% of the patients were treated according to the level of care prescribed by the guidelines; 49% were undertreated; and 29% were overtreated. The results were not in line with our hypotheses. Patients treated at a more intensive level of care than recommended had favorable outcomes compared to patients treated at the recommended level of care (55.5% vs. 43.9% success). Patients allocated to the recommended level of care did not have better outcomes than those treated at a less intensive level of care (43.9% vs. 38.3% success). Based on these results, we suggest ways to improve the algorithm for allocating patients to treatment.
HubMed – addiction


Involvement of the mu-opioid receptor gene polymorphism A118G in the efficacy of detoxification of alcohol dependent patients.

Filed under: Addiction Rehab

Addict Behav. 2012 Sep 26; 38(3): 1669-1671
Marini V, Fucile C, Zuccoli ML, Testino G, Sumberaz A, Robbiano L, Martelli A, Mattioli F

INTRODUCTION: The A118G (rs 1799971) polymorphism in the mu-opioid receptor gene (OPRM1) has been reported to be associated with alcohol addiction. METHODS: In this study 109 patients diagnosed with alcohol dependence in accordance with DMS-IV criteria and 95 healthy subjects were enrolled and everyone has been genotyped. RESULTS: The percentage of alcoholic patients with higher than normal gamma-glutamyl transferase (GGT) levels significantly decreased after six months of standard detoxification treatment, both in patients with A/A genotype and in the other ones with A/G genotype. However, the percentage of alcohol dependent patients with the A/A genotype recorded a slight decrease of the GGT and the mean corpuscolar volume of erythrocytes (MCV) combination marker after six months of therapy (30% vs 12%), while subjects with the A/G genotype showed no variation. CONCLUSION: This finding suggests that alcohol dependent patients with the A/A genotype could have a faster restoration of their liver function than those ones with the A/G genotype: it might be possible that the presence of G allele confers on these patients a reduced ability in abstaining from drinking alcohol.
HubMed – addiction


Beyond personality-Experimental investigations of the effects of personality traits on in situ alcohol consumption in social and solitary drinking contexts.

Filed under: Addiction Rehab

Addict Behav. 2012 Aug 30; 38(3): 1635-1638
Kuendig H, Kuntsche E

Numerous studies have highlighted that personality traits are associated with alcohol problems and disorders; however, little is known on the link between personality and the quantities of alcohol actually ingested during given drinking episodes (i.e. in situ alcohol consumption, in grams of pure alcohol). Based on data of 123 young adults who participated in two wine-tasting assignments (one performed in group, the other individually; sequence of participation assigned at random), the results from regression models suggest that individual characteristics and personality traits are, to some extent, associated with in situ alcohol consumption, but contextual factors (e.g., in line with behavioral exposition and perceptions of norms) might overwhelm such associations in a social context, or later on in similar drinking contexts. These findings argue for the development of early preventive initiatives focusing on social influences and on specific drinking context.
HubMed – addiction


Behavioral response elicited by stimulation of the mesolimbic system after procaine and bicuculline injection into the pedunculopontine tegmental nucleus in rats.

Filed under: Addiction Rehab

Behav Brain Res. 2012 Dec 16;
Jerzemowska G, Pluci?ska K, Majkutewicz I, Orze?-Gryglewska J, Trojniar W

The pedunculopontine tegmental nucleus (PPN) is anatomically connected with dopaminergic cells in the ventral tegmental area (VTA). In the present study, VTA-stimulation induced feeding or locomotor response was tested after temporary inactivation (procaine injection) or activation (bicuculline injection) of the PPN in the ipsi- or contralateral hemisphere. Motor and motivation aspects of appetitive behavior were analyzed on the basis of the latency/stimulation frequency curve shift paradigm, in male Wistar rats (n=48). Procaine injections into the PPN had more significant effects on both types of behavioral response during VTA stimulation than bicuculline. On the day of injection (day 0) procaine increased reaction threshold of the observed responses: a rise by 22% after contra- and 17% after ipsilateral injection in the case of feeding, and an inverse result side-wise for locomotor response, i.e. around 12% and 20% respectively. Bicuculline injected into the PPN did not cause significant effects on day 0 and the values of reaction threshold oscillated around±10% for both behaviors, except in rats with locomotor reaction after contralateral injection. The observed reactions stabilized within on consecutive days (days 1-3) after procaine/bicuculline injection in both behavioral groups. The results indicate that the PPN and VTA belong to the same central circuitry involved in the regulation of psychomotor activation. However, the influence of PPN-VTA inter-hemispheric connections on reward and addiction function of the VTA is still unexplained.
HubMed – addiction



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