COMT Val158Met Modulates Subjective Responses to Intravenous Nicotine and Cognitive Performance in Abstinent Smokers.

COMT Val158Met modulates subjective responses to intravenous nicotine and cognitive performance in abstinent smokers.

Pharmacogenomics J. 2013 Mar 5;
Herman AI, Jatlow PI, Gelernter J, Listman JB, Sofuoglu M

The catechol-O-methyltransferase (COMT) Val158Met polymorphism may be a risk factor for nicotine addiction. This study examined the influence of the COMT Val158Met polymorphism on subjective, physiological and cognitive effects of intravenous (IV) nicotine use in African Americans (AAs; n=56) and European Americans (EAs; n=68) smokers. Overnight abstinent smokers received saline followed by 0.5 and 1.0?mg per 70?kg doses of nicotine, administered 30?min apart. Smokers with valine (Val)/Val genotype, compared with methionine (Met) carriers, had greater negative subjective effects from IV nicotine and had more severe withdrawal severity following overnight abstinence from smoking. Women with Val/Val genotype reported greater difficulty concentrating and irritability than men with Val/Val or Met carrier genotypes. The Val/Val genotype was associated with better performance on the math task and in AA smokers it was associated with greater systolic blood pressure. These results support the rationale of pharmacologically inhibiting COMT to aid with smoking cessation among Val/Val genotype smokers.The Pharmacogenomics Journal advance online publication, 5 March 2013; doi:10.1038/tpj.2013.1. HubMed – addiction


Trajectories of health care service utilization and differences in patient characteristics among adults with specific chronic pain: analysis of health plan member claims.

J Pain Res. 2013; 6: 137-49
Ruetsch C, Tkacz J, Kardel PG, Howe A, Pai H, Levitan B

The lack of consistency surrounding the diagnosis of chronic non-cancer pain, treatment approaches, and patient management suggests the need for further research to better characterize the chronic non-cancer pain population.The purpose of this study was to identify distinct trajectories of health care service utilization of chronic non-cancer pain patients and describe the characteristic differences between trajectory groups.This study utilized the MarketScan claims databases. A total of 71,392 patients diagnosed with either low back pain or osteoarthritis between 2006 and 2009 served as the study sample. Each subject’s claims data were divided into three time periods around an initial diagnosis date: pre-period, post-Year 1, and post-Year 2. Subjects were categorized as either high (H) or low (L) cost at each post period, resulting in the creation of four trajectory groups based on the post-Year 1 and 2 cost pattern: H-H, H-L, L-H, and L-L. Multivariate statistical tests were used to predict and discriminate between trajectory group memberships.The H-H, L-H, and H-L groups each utilized significantly greater pre-period high-cost venue services, post-Year 1 outpatient services, and post-Year 1 opioids compared to the L-L group ( < 0.001). Additionally, the H-H and L-H groups displayed elevated Charlson comorbidity index scores compared with the L-L group ( < 0.001), with each showing increased odds of having both opioid dependence and cardiovascular disease diagnoses ( < 0.01).This study identified patient characteristics among chronic pain patients that discriminated between different levels of post-index high-cost venue service utilization and trajectories of change in the same. With implications for managed care program implementation and resource management, this study highlights results from a developed algorithm that employed a variety of accessible data elements to effectively discriminate between patients based on their pattern of high-cost venue service utilization over time. HubMed – addiction


Assessment of Cancer Pain Management Knowledge in Southwest China: A Survey of 259 Physicians from Small City and County Hospitals.

J Palliat Med. 2013 Mar 4;
Liao Z, Hao J, Guo Y, Reyes-Gibby C, Guo H

Abstract Background: Pain management is a critical issue in the care of cancer patients in China, especially in small city and county hospitals in southwest China. Objective: The study intended to determine Chinese physicians’ competence in cancer pain management and to assess their opinions on barriers to optimal pain management. Design: A questionnaire on pain management was given to 259 fellows after their general orientation meeting at a tertiary teaching hospital. The questionnaire was adapted from an earlier study by the Eastern Cooperative Oncology Group (ECOG). Results: The majority of the fellows believed that 70% of cancer patients suffer pain. Nearly 90% (224/259) indicated that their training in cancer pain management was poor. The fellows stated that concern about morphine addiction was the primary reason they hesitated to prescribe opioids, and they identified inadequate assessment of cancer pain as the most significant barrier to optimal management of cancer pain. Conclusion: The study reflects to some extent the state of pain management in hospitals in southwest China. Medical students and physicians in China need improved pain management education. HubMed – addiction


Mice from lines selectively bred for high voluntary wheel running exhibit lower blood pressure during withdrawal from wheel access.

Physiol Behav. 2013 Feb 28;
Kolb EM, Kelly SA, Garland T

Exercise is known to be rewarding and have positive effects on mental and physical health. Excessive exercise, however, can be the result of an underlying behavioral/physiological addiction. Both humans who exercise regularly and rodent models of exercise addiction sometimes display behavioral withdrawal symptoms, including depression and anxiety, when exercise is denied. However, few studies have examined the physiological state that occurs during this withdrawal period. Alterations in blood pressure (BP) are common physiological indicators of withdrawal in a variety of addictions. In this study, we examined exercise withdrawal in four replicate lines of mice selectively bred for high voluntary wheel running (HR lines). Mice from the HR lines run almost 3-fold greater distances on wheels than those from non-selected control lines, and have altered brain activity as well as increased behavioral despair when wheel access is removed. We tested the hypothesis that male HR mice have an altered cardiovascular response (heart rate, systolic, diastolic, and mean arterial pressure [MAP]) during exercise withdrawal. Measurements using an occlusion tail-cuff system were taken during 8days of baseline, 6days of wheel access, and 2days of withdrawal (wheel access blocked). During withdrawal, HR mice had significantly lower systolic BP, diastolic BP, and MAP than controls, potentially indicating a differential dependence on voluntary wheel running in HR mice. This is the first characterization of a cardiovascular withdrawal response in an animal model of high voluntary exercise. HubMed – addiction