Preferences Regarding Treatment for Alcohol Problems.

Preferences Regarding Treatment for Alcohol Problems.

Alcohol Alcohol. 2013 Jul 10;
Andréasson S, Danielsson AK, Wallhed-Finn S

The aim of the study was to investigate preferences in the general population regarding type of treatment for alcohol problems and the preferred setting for delivery of treatment and reasons for not seeking treatment for alcohol problems. Method: Data were from a random, cross-sectional, interview survey of 9005 of the Swedish general population. Proportions of respondents preferring a certain treatment and source of treatment, and reasons suggested for why people do not seek treatment, were analysed in relation to number of standard drinks, employment status, education and income.Most frequently endorsed forms of treatment were alcoholics anonymous or similar support groups and psychotherapy. More than 50% preferred psychiatric or addiction specialist treatment. Around 10% preferred primary health care and around 20% the occupational health services. About 5% preferred the social services. Respondents rated ‘feeling ashamed’ as the most important reason why people would not seek help for alcohol problems.Large majorities of the respondents preferred treatment in the health care services and few in the social services. Internet-based treatment and pharmacological treatment attracted few respondents, the majority preferring more traditional forms of treatment. Alcohol treatment remains a stigmatized field, evidenced by shame being the most commonly reported reason for not seeking treatment. HubMed – addiction


[Faster, higher, stronger: knowledge about old and new doping substances.]

Ned Tijdschr Geneeskd. 2013; 157(28): A6450
Pieters T, de Hon O

– Physicians should possess specific diagnostic and pharmacotherapeutic skills in order to recognize symptoms associated with doping use.- It is important to be on the alert in athletes and fitness enthusiasts for physical and psychological changes due to use of anabolic steroids such as acne, stretch marks, gynecomastia, signs of acromegaly, irascibility and lethargy.- Stimulants such as amphetamines, ephedrine and cocaine lead to fat loss and increased alertness; their main side effects are cardiac problems, behavioural changes and addiction.- In addition to anabolic steroids and stimulants, erythropoietin, growth hormone, diuretics and glucocorticoids are regularly used to improve sport performance. – In cycling, a biological passport will be used in an attempt to detect doping use.- In future, the Olympic motto ‘citius, altius, fortius’ (faster, higher, stronger) will have ground-breaking consequences for the performance and health of top athletes. HubMed – addiction


Striatal dopamine transmission is reduced after chronic nicotine with a decrease in ?6-nicotinic receptor control in nucleus accumbens.

Eur J Neurosci. 2013 Jul 10;
Exley R, Clements MA, Hartung H, McIntosh JM, Franklin M, Bermudez I, Cragg SJ

Nicotine directly regulates striatal dopamine (DA) neurotransmission via presynaptic nicotinic acetylcholine receptors (nAChRs) that are ?6?2 and/or ?4?2 subunit-containing, depending on region. Chronic nicotine exposure in smokers upregulates striatal nAChR density, with some reports suggesting differential impact on ?6- or ?4-containing nAChRs. Here, we explored whether chronic nicotine exposure modifies striatal DA transmission, whether the effects of acute nicotine on DA release probability persist and whether there are modifications to the regulation of DA release by ?6-subunit-containing (*) relative to non-?6* nAChRs in nucleus accumbens (NAc) and in caudate-putamen (CPu). We detected electrically evoked DA release at carbon-fiber microelectrodes in striatal slices from mice exposed for 4-8 weeks to nicotine (200 ?g/mL in saccharin-sweetened drinking water) or a control saccharin solution. Chronic nicotine exposure subtly reduced striatal DA release evoked by single electrical pulses, and in NAc enhanced the range of DA release evoked by different frequencies. Effects of acute nicotine (500 nm) on DA release probability and its sensitivity to activity were apparent. However, in NAc there was downregulation of the functional dominance of ?6-nAChRs (?6?4?2?3), and an emergence in function of non-?6* nAChRs. In CPu, there was no change in the control of DA release by its ?6 nAChRs (?6?2?3) relative to non-?6. These data suggest that chronic nicotine subtly modifies the regulation of DA transmission, which, in NAc, is through downregulation of function of a susceptible population of ?6?4?2?3 nAChRs. This imbalance in function of ?6:non-?6 nAChRs might contribute to DA dysregulation in nicotine addiction. HubMed – addiction


Rural and remote early psychosis intervention services: the Gordian knot of early intervention.

Early Interv Psychiatry. 2013 Jul 11;
Cheng C, Dewa CS, Langill G, Fata M, Loong D

One of the basic challenges of Early Psychosis Intervention (EPI) programs for rural populations is translating best practice which developed for urban high-population density areas to rural and remote settings. This paper presents data from two different models (hub and spoke and specialist outreach) of rural EPI practice in Ontario, Canada.This cross-sectional study used a convenience sample of clients from two rural EPI programs between 2005 and 2007. Data about client outcomes specific to general functioning, admissions to hospital and emergency room (ER) visits were collected. For all dichotomous variables, chi-square tests were used to test differences between two groups.The total clients served in hub and spoke were 457 compared to 91 in specialist outreach. Although not statistically significant, the hub and spoke group showed better functioning in the community. There was a significant difference between the two groups with regard to hospital admissions. Although not significant, there was a greater percentage (58.3%) of specialist outreach clients who visited the ER in the previous 12?months as compared to clients serviced by the hub and spoke model (34.9%).The observed data from these two rural models suggest that there may be differing outcomes. There are limitations to this study, and this paper does not address why there are differences. Future work needs to continue to further explore why differences exist and whether they persist so we can provide equity and quality care for rural and remote populations. HubMed – addiction