Physical Harm Due to Chronic Substance Use.

Physical harm due to chronic substance use.

Regul Toxicol Pharmacol. 2013 Mar 27;
Amsterdam JV, Pennings E, Brunt T, Brink WV

Chronic use at high dose of illicit drugs, alcohol and tobacco is associated with physical disease. The relative physical harm of these substances has not been described before, but will benefit the guiding of policy measures about licit and illicit substances. The physical harm of 19 addictive substances (including alcohol and tobacco), consisting of toxicity and the risk and severity of somatic disease (not psychiatric disease) was assessed based on literature data and the professional opinion of experts using scores ranging from 0 (no physical harm) to 3 (very serious physical harm). For alcohol, tobacco and some illicit drugs strong associations between long-term use or use in high dose versus the risk of somatic disease have been described, whereas for other substances such data are not availible. Magic mushrooms, LSD and methylphenidate obtained relatively low scores (0.45-0.65) for physical harm, whereas relatively high scores were given for heroin (2.09), crack (2.32), alcohol (2.13) and tobacco (2.10). For cannabis, tobacco, and alcohol the estimated societal disease burden was higher than at individual level. The present ranking solely based on their physical harm was very similar to a previous ranking based on a combination of dependence liability, physical harm and social impairments. HubMed – addiction


Health consequences of easier access to alcohol: New Zealand evidence.

J Health Econ. 2013 Mar 14; 32(3): 570-585
Conover E, Scrimgeour D

We evaluate the health effects of a reduction in New Zealand’s minimum legal purchase age for alcohol. Difference-in-differences (DD) estimates show a substantial increase in alcohol-related hospitalizations among those newly eligible to purchase liquor, around 24.6% (s.e.=5.5%) for males and 22% (s.e.=8.1%) for females. There is less evidence of an effect among ineligible younger cohorts. There is little evidence of alcohol either complementing or substituting for drugs. We do not find evidence that earlier access to alcohol is associated with learning from experience. We also present regression discontinuity estimates, but emphasize DD estimates since in a simulation of a rational addiction model DD estimates are closer than regression discontinuity estimates to the policy’s true effect. HubMed – addiction


[Atypical depression: Clinical perspectives.]

Encephale. 2013 Mar 28;
Lutz M, Morali A, Lang JP

OBJECTIVE: This paper examines whether atypical depression is still a valid entity as a diagnosis subtype in the light of publications with most recent antidepressants. METHOD: First, we present the origins of the diagnosis sub-specification of atypical depression, which is based on a different drug response to tricyclic antidepressants and mono amino oxydase inhibitors. Secondly, we discuss the different definitions that can be found for the terms of atypical depression. We present more specifically the definition of atypical depression as it is described in the DSM-IV, with its most important criterion: mood reactivity. Then we present a review of scientific publications questioning atypical depression validity as a clinical syndrome (based on medline researches). We will see whether this diagnosis is still relevant with the latest drugs used to treat mood disorders. A special focus is made on the link between atypical depression and bipolar disorder, based on Benazzi’s work. RESULTS: Most of publications confirm that atypical depression is a valid syndrome regarding first antidepressants clinical trials. Nevertheless, more studies with the latest antidepressants and atypical antipsychotics are needed to confirm this hypothesis. The link between atypical depression and bipolar disorders seems to be quite strong although it requires further investigations. DISCUSSION: There are very few double-blind drug trials focusing on atypical depressions and results need to be confirmed by trials with new drugs. Moreover, we regret that there are no studies including cerebral imagery. More studies are also needed on neurobiology and psychotherapy specificity. CONCLUSION: Atypical depression is still a useful concept, because of its specific clinical presentation, evolution and treatments, even if more studies should be done. Atypical depression could also be useful to diagnose more easily some bipolar disorders and should help clinicians to focus more on suicidal risks and addiction evaluation for these patients, considering the mood reactivity and the link with bipolar disorder. To conclude, we propose that atypical depression should still figure in the future DSM-V for these different reasons. HubMed – addiction


Neurobiology of an endophenotype: modeling the progression of alcohol addiction in rodents.

Curr Opin Neurobiol. 2013 Mar 28;
Mahoney MK, Olmstead MC

Most adults in Western society consume alcohol on a regular basis with few or no negative consequences. However, for certain individuals, alcohol use escalates, leading to uncontrolled drinking bouts, craving, and repeated episodes of relapse. The transition from regulated to uncontrolled and compulsive drinking is a defining feature (i.e. an endophenotype) of alcohol addiction. This behavioral progression can be modeled in rodent paradigms that parallel the diagnostic criteria for addiction in humans. Using these criteria as a framework, this review outlines the neurobiological factors associated with increased vulnerability to excessive, compulsive, and dysregulated alcohol intake in rodents. We conclude by noting gaps in the literature and outline important directions for future research. HubMed – addiction


Implicit sequence learning and working memory: Correlated or complicated?

Cortex. 2013 Mar 13;
Janacsek K, Nemeth D

The relationship between implicit/incidental sequence learning and working memory motivated a series of research because it is plausible that higher working memory capacity opens a “larger window” to a sequence, allowing thereby the sequence learning process to be easier. Although the majority of studies found no relationship between implicit sequence learning and working memory capacity, in the past few years several studies have tried to demonstrate the shared or partly shared brain networks underlying these two systems. In order to help the interpretation of these and future results, in this mini-review we suggest the following factors to be taken into consideration before testing the relationship between sequence learning and working memory: 1) the explicitness of the sequence; 2) the method of measuring working memory capacity; 3) online and offline stages of sequence learning; and 4) general skill- and sequence-specific learning. HubMed – addiction