Addiction Rehab: Substance-Use Disorders in Adolescents and Adults With ADHD: Focus on Treatment.

Substance-use disorders in adolescents and adults with ADHD: focus on treatment.

Filed under: Addiction Rehab

Neuropsychiatry (London). 2012 Aug; 2(4): 301-312
Wilens TE, Morrison NR

A high prevalence of comorbidity of ADHD and substance-use disorders (SUDs) has been shown in the literature. In this article, the literature for the treatment of adolescents and adults with co-occurring ADHD and SUD is examined. Findings from pharmacotherapy suggest mild improvement in ADHD without demonstrable changes in SUD unless the addiction was stabilized prior to treating the ADHD. No unique adverse effects, worsening of SUD, misuse or diversion of stimulants are reported in the included studies. Treating ADHD pharmacologically in individuals with ADHD plus SUD only has a modest impact on ADHD and SUD that is not observed in controlled trials. Limited data in adults with ADHD and brief abstinence of their SUD showed improvements in both ADHD and SUD with treatment. Further studies of cognitive behavioral therapy, sequencing of therapies and longer term treatment outcomes for groups with ADHD and active SUD are necessary.
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Evaluating Genetic Counseling for Family Members of Individuals With Schizophrenia in the Molecular Age.

Filed under: Addiction Rehab

Schizophr Bull. 2012 Oct 27;
Costain G, Esplen MJ, Toner B, Hodgkinson KA, Bassett AS

Background:Myths and concerns about the extent and meaning of genetic risk in schizophrenia may contribute to significant stigma and burden for families. Genetic counseling has long been proposed to be a potentially informative and therapeutic intervention for schizophrenia. Surprisingly, however, available data are limited. We evaluated a contemporary genetic counseling protocol for use in a community mental health-care setting by non-genetics professionals. Methods: We used a pre-post study design with longitudinal follow-up to assess the impact of genetic counseling on family members of individuals with schizophrenia, where molecular testing had revealed no known clinically relevant genetic risk variant. We assessed the outcome using multiple measures, including standard items and scales used to evaluate genetic counseling for other complex diseases. Results: Of the 122 family members approached, 78 (63.9%) actively expressed an interest in the study. Participants (n = 52) on average overestimated the risk of familial recurrence at baseline, and demonstrated a significant improvement in this estimate postintervention (P < .0001). This change was associated with an enduring decrease in concern about recurrence (P = .0003). Significant and lasting benefits were observed in other key areas, including increased knowledge (P < .0001) and a decreased sense of stigma (P = .0047). Endorsement of the need for genetic counseling was high (96.1%). Conclusions: These results provide initial evidence of the efficacy of schizophrenia genetic counseling for families, even in the absence of individually relevant genetic test results or professional genetics services. The findings support the integration of contemporary genetic counseling for families into the general management of schizophrenia in the community. HubMed – addiction


Spatial memory, plasticity and nucleus accumbens.

Filed under: Addiction Rehab

Rev Neurosci. 2012 Oct 25;
Rinaldi A, Oliverio A, Mele A

Abstract Research on the function of the nucleus accumbens, the most ventral component of the striatal complex, has traditionally focused on locomotor activity, reward, motivation and addiction. However, based on the existence of projections to the nucleus accumbens from the allocortical regions involved in spatial navigation, it has been suggested that this structure plays a role in spatial learning and memory. Lesion and neuropharmacological studies confirm this view, also revealing the complex dynamics of the receptors involved in these processes. Moreover, the effects of post-training intra-nucleus accumbens drug administrations demonstrate the necessity of off-line neural activity within this structure in order to consolidate spatial memory. Blockade of molecular processes implicated in synaptic plasticity, such as cAMP response element-binding protein (CREB)-induced transcription or extracellular matrix remodeling, provides further experimental support to this hypothesis. These observations imply that experience-dependent synaptic plasticity responsible for long-term stabilization of spatial information might occur within the nucleus accumbens, similarly to what has been observed in the hippocampus. This suggests that a comprehensive understanding of spatial memory processing should be viewed in the context of a wider neural circuit.
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Screening for HIV among substance users undergoing detoxification.

Filed under: Addiction Rehab

Int J STD AIDS. 2012 Oct; 23(10): e1-5
Hossain KJ, Akter N, Kamal M, Mandal MC, Aktharuzzaman M

The primary aim of this study was to investigate HIV infection among drug users. A total of 3538 drug users were, registered at the Outpatient Department of Central Drug Addiction Treatment Centre (CTC), Tejgoan, Dhaka, from July 2007 to June 2008. Of them, 43.2% were residents of Dhaka City and the others (56.8%) were from the different districts of Bangladesh. Among them, 1196 were recruited consecutively following defined selection criteria. Interviewer-administered questionnaires were completed and blood specimens taken. Results showed that only 0.67% were HIV-seropositive. Their socioeconomic profile included 75.0% educated, 62.5% unemployed, age ranged from 30 to 50 years, and all were married. They used heroin primarily with other illicit substances used occasionally. They reported that needle sharing when using injection drugs was infrequent. Drug users had sex with multiple commercial sexual partners and did not use condoms during sex. While Bangladesh is in the midst of international drug-trafficking and drug-producing zones, and lies near high HIV prevalence countries, the country is in the embryonic stage of an HIV epidemic. Nationwide preventive measures are warranted in Bangladesh.
HubMed – addiction



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