Addiction Rehab: Thorndike’s Law 2.0: Dopamine and the Regulation of Thrift.

Thorndike’s Law 2.0: Dopamine and the Regulation of Thrift.

Filed under: Addiction Rehab

Front Neurosci. 2012; 6: 116
Beeler JA

Dopamine is widely associated with reward, motivation, and reinforcement learning. Research on dopamine has emphasized its contribution to compulsive behaviors, such as addiction and overeating, with less examination of its potential role in behavioral flexibility in normal, non-pathological states. In the study reviewed here, we investigated the effect of increased tonic dopamine in a two-lever homecage operant paradigm where the relative value of the levers was dynamic, requiring the mice to constantly monitor reward outcome and adapt their behavior. The data were fit to a temporal difference learning model that showed that mice with elevated dopamine exhibited less coupling between reward history and behavioral choice. This work suggests a way to integrate motivational and learning theories of dopamine into a single formal model where tonic dopamine regulates the expression of prior reward learning by controlling the degree to which learned reward values bias behavioral choice. Here I place these results in a broader context of dopamine’s role in instrumental learning and suggest a novel hypothesis that tonic dopamine regulates thrift, the degree to which an animal needs to exploit its prior reward learning to maximize return on energy expenditure. Our data suggest that increased dopamine decreases thriftiness, facilitating energy expenditure, and permitting greater exploration. Conversely, this implies that decreased dopamine increases thriftiness, favoring the exploitation of prior reward learning, and diminishing exploration. This perspective provides a different window onto the role dopamine may play in behavioral flexibility and its failure, compulsive behavior.
HubMed – addiction


Selection and utilization of assessment instruments in substance abuse treatment trials: the National Drug Abuse Treatment Clinical Trials Network experience.

Filed under: Addiction Rehab

Subst Abuse Rehabil. 2012 Jul 17; 3(1): 81-89
Rosa C, Ghitza U, Tai B

Based on recommendations from a US Institute of Medicine report, the National Institute on Drug Abuse established the National Drug Abuse Treatment Clinical Trials Network (CTN) in 1999, to accelerate the translation of science-based addiction treatment research into community-based practice, and to improve the quality of addiction treatment, using science as the vehicle. One of the CTN’s primary tasks is to serve as a platform to forge bi-directional communications and collaborations between providers and scientists, to enhance the relevance of research, which generates empirical results that impact practice. Among many obstacles in moving research into real-world settings, this commentary mainly describes challenges and iterative experiences in regard to how the CTN develops its research protocols, with focus on how the CTN study teams select and utilize assessment instruments, which can reasonably balance the interests of both research scientists and practicing providers when applied in CTN trials. This commentary also discusses the process by which the CTN further selects a core set of common assessment instruments that may be applied across all trials, to allow easier cross-study analyses of comparable data.
HubMed – addiction


Review: maintenance antipsychotics prevent relapse in patients with schizophrenia.

Filed under: Addiction Rehab

Evid Based Ment Health. 2012 Aug 17;
Agid O, Remington G

HubMed – addiction


CA7-04: Costs of Care for Persons with Opioid Dependence in Two Integrated Health Systems.

Filed under: Addiction Rehab

Clin Med Res. 2012 Aug; 10(3): 170
Lynch F, McCarty D, Mertens J, Perrin N, Green C, Parthasarathy S, Anderson B, Koch M

Background/Aims Opioid dependence is a growing public health concern and results in high costs to individuals, health care systems, and society. Recent legislation allowing expansion of buprenorphine for replacement therapy use in general medical care settings may increase access to care for opioid dependence, but little is known about its impact on services utilization and commercial health systems costs. In this retrospective cohort study, we examined how the introduction of buprenorphine affected the pattern of medical care and addiction medicine (AM) services provided to patients with opioid dependence and associated costs. Methods Using electronic health records, we identified individuals with two or more diagnoses of opioid dependence per year from 2000 through 2008 in two large non-profit, integrated health systems (System A: N=4,425; System B: N=7122) and assessed health system utilization and costs. Results In both health systems and across the study period, the number of opioid-dependent persons increased considerably and the use of buprenorphine for opioid dependence treatment increased steadily. In System A, those receiving buprenorphine plus AM counseling had significantly higher costs than those receiving methadone plus AM counseling (Z= -9.22, p<.001), and significantly lower costs than those with little or no AM counseling (Z=2.81, p=.005). There were no differences in costs between those receiving buprenorphine plus AM counseling and those with AM counseling only (Z=1.30, p=.192). The treatment group by period interaction (?2 = 9.66, df=3, p=.022) was significant, with costs decreasing over time in the buprenorphine plus AM counseling group and increasing over time in all other groups. In System B, costs were significantly lower for the buprenorphine plus AM counseling group than for the group with little or no AM counseling (Z= -5.14, p<.001) and higher than for the group with AM counseling only (Z=5.56, p=.001). The treatment group by period interaction was not significant (?2 =1.23, df=2, p=.540). Discussion Buprenorphine treatment is emerging as a viable alternative to other AM treatment approaches for persons with opioid dependence. Results of this study provide further evidence that buprenorphine treatment can be provided at a similar cost to alternative strategies in private integrated health systems. HubMed – addiction


Peter Riederer “70th birthday” Neurobiological foundations of modern addiction treatment.

Filed under: Addiction Rehab

J Neural Transm. 2012 Aug 19;
Jacob C

Alcohol dependence is caused by complex interactions of multiple susceptibility genes with little effect each and environmental factors. Candidate genes influence metabolism of alcohol, such as alcohol dehydrogenase and aldehyde dehydrogenase, and modulatory transmitter systems, such as the dopaminergic, serotonergic, acetylcholinergic, gamma-aminobutyric acidergic, and various neuropeptidergic systems. Dysfunctional behavioral choices, learning, and memory are involved in the etiology of alcohol dependence. Systematic promotion and maintenance of motivation is a lifetime challenge in the treatment of alcohol use disorders. The second step of treatment management is the discontinuation of alcohol consumption. Withdrawal symptoms can be treated with gamma-aminobutyric acidergic substances such as benzodiazepines. Long-term relapse prevention is another challenge. Multimodal treatment can include naltrexone, a non-selective opioid receptor antagonist, or acamprosate, an N-methyl-D: -aspartate receptor modulator, which are first line for pharmacological treatment on the basis of recent Cochrane analyses. Due to the complexity of etiology with both psychological and neurobiological factors, future treatment management of alcoholism may include the combination of individualized disorder-specific psychotherapy and drugs acting on different neuronal pathways, on the basis of individual vulnerability. However, the question remains unsolved whether an individualized approach is feasible and how subgroups should be defined.
HubMed – addiction



Crunk Addiction (Rehab – Amy Winehouse) – This is a video that me and some friends did for a school project, it turned out great, so I put it on YouTube. Hopefully, I will be able to do this with some more of our projects, subscibe and watch for more uploads. Disclaimer – I do not own the song and i give full credit to the owner. Also, I do not own Crunk and give full credit to the makers of crunk. Lastly, Crunk is an energy drink not an actual drug, the maker of this video and all affiliated with this video do not suggest in anyway that anyone do drugs.


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