New Uncontrolled Benzodiazepine, Phenazepam, Emerging Drug of Abuse.

New uncontrolled benzodiazepine, phenazepam, emerging drug of abuse.

Filed under: Addiction Rehab

Innov Clin Neurosci. 2012 Sep; 9(9): 10
Oyemade A

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Pharmacological Secondary Prevention of PTSD in Youth: Challenges and Opportunities for Advancement.

Filed under: Addiction Rehab

J Trauma Stress. 2012 Oct; 25(5): 543-50
Maccani MA, Delahanty DL, Nugent NR, Berkowitz SJ

Child and adolescent posttraumatic stress disorder (PTSD) is associated with an increased risk for a number of deleterious mental and physical health outcomes that if untreated may persist throughout the life course. Efficacious interventions applied soon after trauma exposure have the potential to reduce or prevent the development of PTSD symptoms and their associated impact on behavior and physical health. We review extant research related to treatment-modifiable peritraumatic predictors of pediatric PTSD, which have informed an emerging field of pharmacologic secondary prevention (i.e., occurring shortly following trauma exposure) of PTSD. Challenges and opportunities for early posttrauma PTSD prevention are described. Finally, we offer new models for biologically informed integration of pharmacologic and psychosocial secondary prevention intervention strategies for children and adolescents.
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Dependence and Addiction During Chronic Opioid Therapy.

Filed under: Addiction Rehab

J Med Toxicol. 2012 Oct 17;
Juurlink DN, Dhalla IA

The use of opioids for chronic noncancer pain has increased dramatically over the past 25 years in North America and has been accompanied by a major increase in opioid addiction and overdose deaths. The increase in opioid prescribing is multifactorial and partly reflects concerns about the effectiveness and safety of alternative medications, particularly the nonsteroidal anti-inflammatory drugs. However, much of the rise in opioid prescribing reflects the assertion, widely communicated to physicians in the 1990s, that the risks of dependence and addiction during chronic opioid therapy were low, predictable, and could be minimized by the use of controlled-release opioid formulations. In this narrative review, we offer a critical appraisal of the publications most frequently cited as evidence that the risk of addiction during chronic opioid therapy is low. We conclude that very few well-designed studies support the notion that opioid addiction is rare during chronic opioid therapy and that none can be readily generalized to present-day practice. Despite serious methodological limitations, these studies have been repeatedly mischaracterized as showing that the risk of addiction during chronic opioid therapy is rare. These studies are countered by a larger, more rigorous and contemporary body of evidence demonstrating that dependence and addiction are relatively common consequences of chronic opioid therapy, occurring in up to one-third of patients in some series.
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Potentiation of dopamine D1-like receptor signaling by concomitant activation of ?- and ?-opioid receptors in mouse medial prefrontal cortex.

Filed under: Addiction Rehab

Neurochem Int. 2012 Oct 13;
Olianas MC, Dedoni S, Onali P

Opioid receptors located in the ventral tegmental area are known to regulate dopamine (DA) release from mesocortical afferents to medial prefrontal cortex (mPFC) but little is known on whether in this cortical region activation of opioid receptors affect DA receptor signaling. In the present study we show that in mouse mPFC concomitant activation of either ?- or ?-opioid receptors, but not ?-opioid receptors, potentiated DA D1-like receptor-induced stimulation of adenylyl cyclase activity through a G protein ?? subunit-dependent mechanism. In tissue slices of mPFC, the combined addition of the opioid agonist leu-enkephalin and the DA D1-like receptor agonist SKF 81297 produced more than additive increase in the phosphorylation state of AMPA and NMDA receptor subunits GluR1 and NR1, respectively. Moreover, in primary cultures of mouse frontal cortex neurons, DA D1-like receptor-induced Ser133 phosphorylation of the transcription factor cyclic AMP responsive element binding protein was potentiated by concurrent stimulation of opioid receptors. Double immunofluorescence analysis of cultured cortical cells indicated that a large percentage of DA D1 receptor positive cells expressed either ?- or ?-opioid receptor immunoreactivity. These data indicate that in mouse mPFC activation of ?- and ?-opioid receptors enhances DA D1-like receptor signaling likely through converging regulatory inputs on ??-stimulated adenylyl cyclase isoforms. This previously unrecognized synergistic interaction may selectively affect DA D1 transmission at specific postsynaptic sites where the receptors are co-localized and may play a role in prefrontal DA D1 regulation of opioid addiction.
HubMed – addiction

 

The distribution of mental health service costs for depression in the alberta population.

Filed under: Addiction Rehab

Can J Psychiatry. 2012 Sep; 57(9): 564-9
Slomp M, Jacobs P, Ohinmaa A, Bland R, Block R, Dewa CS, Wang C

Objectives: In Canada, most mental health services are embedded in the public health care system. Little is known of the cost distribution within the mental health population. Our study aims to estimate the depression care costs of patients with a depression diagnosis, ranking them by the increasing total depression health care costs. Methods: For fiscal year 2007/08, we extracted administrative health care records from across the continuum, including physicians, outpatient services, and hospitals. Using a unique patient identifier, all service costs were merged for each person. Costs were summed by service categories and then divided by the served population into 10 equal-size groups. Further, we divided costs in the top decile into 10 percentile groups. Results: There were 208 167 people (5.9% of Albertans) who had at least 1 health care visit for depression. The total cost for depression treatment services was $ 114.5 million, an average $ 550 per treated person. In the first 9 deciles, most costs were for general practitioners. By the ninth decile, cost per person was about $ 400. Within the tenth decile, costs increased regularly, and in the top 1 percentile (1% of patients) there was an increase of cost per patient to $ 25 826 from $ 5792 in the previous percentile. Conclusion: Per person costs were highly skewed. Until the ninth decile, the cost increased slowly, consisting of mainly physician costs. In the last decile, costs increased substantially, mainly because of hospitalizations. Thus both primary care and specialist care play key roles.
HubMed – addiction

 


 

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