Drugs and alcohol, dependence and recovery.
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Qurʾān
القرآن6 shownVerses named for this subject by hand come first. The rest are found by the subject’s own Arabic and English senses and are shown as lexical matches, not as anchors anyone has confirmed.
Qur'ān 2:219Arabic sense: الخمر, خمر | English sense: intoxicant
۞يَسۡـَٔلُونَكَ عَنِ ٱلۡخَمۡرِ وَٱلۡمَيۡسِرِۖ قُلۡ فِيهِمَآ إِثۡمࣱ كَبِيرࣱ وَمَنَٰفِعُ لِلنَّاسِ وَإِثۡمُهُمَآ أَكۡبَرُ مِن نَّفۡعِهِمَاۗ وَيَسۡـَٔلُونَكَ مَاذَا يُنفِقُونَۖ قُلِ ٱلۡعَفۡوَۗ كَذَٰلِكَ يُبَيِّنُ ٱللَّهُ لَكُمُ ٱلۡأٓيَٰتِ لَعَلَّكُمۡ تَتَفَكَّرُونَ
They ask you [Prophet] about intoxicants and gambling: say, ‘There is great sin in both, and some benefit for people: the sin is greater than the benefit.’ They ask you what they should give: say, ‘Give what you can spare.’ In this way, God makes His messages clear to you, so that you may reflect
Qur'ān 5:90Arabic sense: الخمر, خمر | English sense: intoxicant
يَٰٓأَيُّهَا ٱلَّذِينَ ءَامَنُوٓاْ إِنَّمَا ٱلۡخَمۡرُ وَٱلۡمَيۡسِرُ وَٱلۡأَنصَابُ وَٱلۡأَزۡلَٰمُ رِجۡسࣱ مِّنۡ عَمَلِ ٱلشَّيۡطَٰنِ فَٱجۡتَنِبُوهُ لَعَلَّكُمۡ تُفۡلِحُونَ
You who believe, intoxicants and gambling, idolatrous practices, and [divining with] arrows are repugnant acts- Satan’s doing- shun them so that you may prosper
Qur'ān 5:91English sense: intoxicant | Arabic sense: الخمر, خمر
إِنَّمَا يُرِيدُ ٱلشَّيۡطَٰنُ أَن يُوقِعَ بَيۡنَكُمُ ٱلۡعَدَٰوَةَ وَٱلۡبَغۡضَآءَ فِي ٱلۡخَمۡرِ وَٱلۡمَيۡسِرِ وَيَصُدَّكُمۡ عَن ذِكۡرِ ٱللَّهِ وَعَنِ ٱلصَّلَوٰةِۖ فَهَلۡ أَنتُم مُّنتَهُونَ
With intoxicants and gambling, Satan seeks only to incite enmity and hatred among you, and to stop you remembering God and prayer. Will you not give them up
Qur'ān 12:41Arabic sense: خمر | English sense: wine
يَٰصَٰحِبَيِ ٱلسِّجۡنِ أَمَّآ أَحَدُكُمَا فَيَسۡقِي رَبَّهُۥ خَمۡرࣰ اۖ وَأَمَّا ٱلۡأٓخَرُ فَيُصۡلَبُ فَتَأۡكُلُ ٱلطَّيۡرُ مِن رَّأۡسِهِۦۚ قُضِيَ ٱلۡأَمۡرُ ٱلَّذِي فِيهِ تَسۡتَفۡتِيَانِ
Fellow prisoners, one of you will serve his master with wine; the other will be crucified and the birds will peck at his head. That is the end of the matter on which you asked my opinion.’
Qur'ān 47:15Arabic sense: خمر | English sense: wine
مَّثَلُ ٱلۡجَنَّةِ ٱلَّتِي وُعِدَ ٱلۡمُتَّقُونَۖ فِيهَآ أَنۡهَٰرࣱ مِّن مَّآءٍ غَيۡرِ ءَاسِنࣲ وَأَنۡهَٰرࣱ مِّن لَّبَنࣲ لَّمۡ يَتَغَيَّرۡ طَعۡمُهُۥ وَأَنۡهَٰرࣱ مِّنۡ خَمۡرࣲ لَّذَّةࣲ لِّلشَّٰرِبِينَ وَأَنۡهَٰرࣱ مِّنۡ عَسَلࣲ مُّصَفࣰّ ىۖ وَلَهُمۡ فِيهَا مِن كُلِّ ٱلثَّمَرَٰتِ وَمَغۡفِرَةࣱ مِّن رَّبِّهِمۡۖ كَمَنۡ هُوَ خَٰلِدࣱ فِي ٱلنَّارِ وَسُقُواْ مَآءً حَمِيمࣰ ا فَقَطَّعَ أَمۡعَآءَهُمۡ
Here is a picture of the Garden promised to the pious: rivers of water forever pure, rivers of milk forever fresh, rivers of wine, a delight for those who drink, rivers of honey clarified and pure, [all] flow in it; there they will find fruit of every kind; and they will find forgiveness from their Lord. How can this be compared to the fate of those stuck in the Fire, given boiling water to drink that tears their bowels
Qur'ān 12:36Arabic sense: خمر
وَدَخَلَ مَعَهُ ٱلسِّجۡنَ فَتَيَانِۖ قَالَ أَحَدُهُمَآ إِنِّيٓ أَرَىٰنِيٓ أَعۡصِرُ خَمۡرࣰ اۖ وَقَالَ ٱلۡأٓخَرُ إِنِّيٓ أَرَىٰنِيٓ أَحۡمِلُ فَوۡقَ رَأۡسِي خُبۡزࣰ ا تَأۡكُلُ ٱلطَّيۡرُ مِنۡهُۖ نَبِّئۡنَا بِتَأۡوِيلِهِۦٓۖ إِنَّا نَرَىٰكَ مِنَ ٱلۡمُحۡسِنِينَ
Two young men went into prison alongside him. One of them said, ‘I dreamed that I was pressing grapes’; the other said, ‘I dreamed that I was carrying bread on my head and that the birds were eating it.’ [They said], ‘Tell us what this means- we can see that you are a knowledgeable man.’
Research library, full list
651 to 675 of 1,310Addiction severity pattern associated with adult and childhood Attention Deficit Hyperactivity Disorder (ADHD) in patients with addictions.
Attention Deficit Hyperactivity Disorder (ADHD) is highly prevalent among adults with addictive disorders, but little is known about addiction patterns associated with ADHD diagnosis. This study examined addiction severity in patients with co-occurring addictive disorders and ADHD controlling for the potential influence of associated psychiatric comorbidity. Data were collected in French outpatient addiction treatment centers. A total of 217 patients seeking treatment for substance or gambling addiction were included. At treatment entry, participants were interviewed with the Addiction Severity Index, the Conners Adult ADHD Diagnosis Interview for the DSM-IV (CAADID), the Mini International Neuropsychiatric Interview (MINI) and the Structured Clinical Interview for DSM-IV Axis II for borderline personality disorder (SCID II). History of ADHD was associated with an earlier onset of addict…
matched on Substance-Related Disorders (mesh), Behavior, Addictive (mesh)
The relationship between forgiveness, spirituality, traumatic guilt and posttraumatic stress disorder (PTSD) among people with addiction.
Spirituality and forgiveness have been shown to be associated with psychological well-being, while guilt has been associated with poor health. Little is known, however, about the relationship between forgiveness, spirituality, guilt, posttraumatic stress (PTSD) and psychological co-morbidity among people in recovery from addiction. Eighty-one people (F = 36, M = 45) in recovery from drug and alcohol addiction were recruited from two residential units and two drop-in centres in a city in the United Kingdom. They completed the Posttraumatic Stress Diagnostic Scale (PDS), the General Health Questionnaire-28 (GHQ-28), the Spiritual Involvement and Beliefs Scale (SIBS), the Heartland Forgiveness Scale (HFS), the Traumatic Guilt Inventory (TGI), the Michigan Alcoholism Screening Test (MAST-22) and the Drug Abuse Screening Test (DAST-20). The control group comprised of 83 (F = 34, M = 49) indiv…
matched on Substance-Related Disorders (mesh), Behavior, Addictive (mesh)
Pregabalin abuse and dependence in Germany: results from a database query.
Purpose: Pregabalin (PRG) is approved for the treatment of neuropathic pain, partial seizures and generalised anxiety disorder in many countries and currently under study for other indications. Supported by case reports and the results of a limited number of studies there is an ongoing debate on the potential of PRG to cause addictive behaviours. However, currently available evidence on this issue is sparse, and any definitive assessment of PRG's potential for abuse and dependence is not yet in sight. The aim of our study was to identify the number of cases of PRG abuse or dependence reported to the database of a German medical regulatory body and to obtain insights into further usage-specific parameters.
Methods: We conducted a query of the entire database of the German Federal Institute for Drugs and Medical Devices (BfArM) regarding reports of PRG abuse or dependence and analysed thes…
matched on Substance-Related Disorders (mesh), Substance Withdrawal Syndrome (mesh)
"Liking" and "wanting" linked to Reward Deficiency Syndrome (RDS): hypothesizing differential responsivity in brain reward circuitry.
In an attempt to resolve controversy regarding the causal contributions of mesolimbic dopamine (DA) systems to reward, we evaluate the three main competing explanatory categories: "liking,""learning," and "wanting" [1]. That is, DA may mediate (a) the hedonic impact of reward (liking), (b) learned predictions about rewarding effects (learning), or (c) the pursuit of rewards by attributing incentive salience to reward-related stimuli (wanting). We evaluate these hypotheses, especially as they relate to the Reward Deficiency Syndrome (RDS), and we find that the incentive salience or "wanting" hypothesis of DA function is supported by a majority of the evidence. Neuroimaging studies have shown that drugs of abuse, palatable foods, and anticipated behaviors such as sex and gaming affect brain regions involving reward circuitry, and may not be unidirectional. Drugs of abuse enhance DA signali…
matched on Substance-Related Disorders (mesh), Behavior, Addictive (mesh)
Donovan DM, Bigelow GE, Brigham GS, Carroll KM, Cohen AJ, Gardin JG, Hamilton JA, Huestis MA, Hughes JR, Lindblad R, Marlatt GA, Preston KL, Selzer JA, Somoza EC, Wakim PG, Wells EA (2012)MEDLINE-indexed journal, not yet read by usAddiction (Abingdon, England)148 citations Primary outcome indices in illicit drug dependence treatment research: systematic approach to selection and measurement of drug use end-points in clinical trials.
Aims: Clinical trials test the safety and efficacy of behavioral and pharmacological interventions in drug-dependent individuals. However, there is no consensus about the most appropriate outcome(s) to consider in determining treatment efficacy or on the most appropriate methods for assessing selected outcome(s). We summarize the discussion and recommendations of treatment and research experts, convened by the US National Institute on Drug Abuse, to select appropriate primary outcomes for drug dependence treatment clinical trials, and in particular the feasibility of selecting a common outcome to be included in all or most trials.
Methods: A brief history of outcomes employed in prior drug dependence treatment research, incorporating perspectives from tobacco and alcohol research, is included. The relative merits and limitations of focusing on drug-taking behavior, as measured by self-re…
matched on Substance-Related Disorders (mesh), Substance Withdrawal Syndrome (mesh)
Short-term outcomes of mothers and newborn infants with comorbid psychiatric disorders and drug dependency.
Objectives: The aim of the present study was to determine the characteristics and short-term outcomes of mother-infant pairs with comorbid drug dependency and psychiatric disorders.
Methods: A population-based retrospective chart review was carried out of 879 drug-dependent mother and infant pairs in New South Wales (NSW) and the Australian Capital Territory (ACT) who delivered between 1 January and 31 December 2004.
Results: Psychiatric comorbidity (dual diagnosis, DD) was identified in 396 (45%) of the 879 drug-dependent women. DSM-IV depression (79%), followed by anxiety (20%), was most prevalent. DD women were more likely to use amphetamines (29% vs 18%, p < 0.05), less likely to use opiates (42% vs 51%, p < 0.05) and to have had no antenatal care (24% vs 8%, p < 0.05). They also had more previous pregnancies (4, range = 2-5 vs 3, range = 2-5, p < 0.05) and domestic violence (29% vs …
matched on Substance-Related Disorders (mesh), Substance Withdrawal Syndrome (mesh)
Epidemiological associations between gambling behavior, substance use & mood and anxiety disorders.
Objective: To compare gambling behaviors in a random sample of community residents with and without mental disorders identified by the Composite International Diagnostic Interview (CIDI).
Method: A large national community survey conducted by Statistics Canada included questions about problems arising from gambling activities as per the Canadian Problem Gambling Index (CPGI). We compared respondents within three gambling severity categories (non-problem, low severity and moderate/high severity gambling) across three diagnostic groupings (mood/anxiety disorders, substance dependence/harmful alcohol use, no selected psychiatric disorder).
Results: Of the 14,934 respondents age 18-64 years who engaged in at least one type of gambling activity in the previous 12 months, 5.8% fell in the low severity gambling category while 2.9% fell in the moderate/high severity category. Females accounted f…
matched on Substance-Related Disorders (mesh), Behavior, Addictive (mesh)
Mindfulness-based interventions for adolescent health.
Purpose of review: Mindfulness, the practice of paying attention to the present moment, purposefully and nonjudgmentally, has been gaining popularity as adjunct treatment for adolescents with a range of physical and mental health problems. Research conducted in adults and emerging research conducted in adolescents has shown that mindfulness-based interventions can improve outcomes in several areas. The purpose of this review is to discuss recent research on the effects of mindfulness and suggest exercises that primary care clinicians can offer to their adolescent patients.
Recent findings: Research has shown positive effects of mindfulness across several health conditions commonly encountered during adolescence. Mindfulness-based Interventions can reduce symptoms of anxiety and depression. The application of mindfulness can help with the prevention and treatment of binge eating, over-eat…
matched on substance use disorder (text), craving (text)
Blum K, Chen AL, Chen TJ, Braverman ER, Reinking J, Blum SH, Cassel K, Downs BW, Waite RL, Williams L, Prihoda TJ, Kerner MM, Palomo T, Comings DE, Tung H, Rhoades P, Oscar-Berman M (2008)reviewMEDLINE-indexed journal, not yet read by usTheoretical biology & medical modelling96 citations Activation instead of blocking mesolimbic dopaminergic reward circuitry is a preferred modality in the long term treatment of reward deficiency syndrome (RDS): a commentary.
Background and hypothesis: Based on neurochemical and genetic evidence, we suggest that both prevention and treatment of multiple addictions, such as dependence to alcohol, nicotine and glucose, should involve a biphasic approach. Thus, acute treatment should consist of preferential blocking of postsynaptic Nucleus Accumbens (NAc) dopamine receptors (D1-D5), whereas long term activation of the mesolimbic dopaminergic system should involve activation and/or release of Dopamine (DA) at the NAc site. Failure to do so will result in abnormal mood, behavior and potential suicide ideation. Individuals possessing a paucity of serotonergic and/or dopaminergic receptors, and an increased rate of synaptic DA catabolism due to high catabolic genotype of the COMT gene, are predisposed to self-medicating any substance or behavior that will activate DA release, including alcohol, opiates, psychostimul…
matched on substance use disorder (text), craving (text)
The association between perceived stigma and substance use disorder treatment outcomes: a review.
Substance use disorders (SUDs) take a heavy toll on those who have them and on society more broadly. These disorders are often difficult to treat, and relapse is common. Perhaps, because of these factors, these disorders are highly stigmatized worldwide. The purpose of this study is to examine empirical work intended to determine the impact of perceived social stigma and self-stigma on the process of recovering from SUDs with the assistance of formal treatment services. Qualitative studies confirmed that stigma experiences are common among those with these disorders and that these experiences can negatively impact feelings and beliefs about treatment. One quantitative study provided good statistical support for a direct effect of stigma on outcomes, but this was contradicted by other longitudinal data. In general, quantitative articles suggested an indirect effect of stigma on treatment …
matched on substance use disorder (text), relapse (text)
The Insula: A Brain Stimulation Target for the Treatment of Addiction.
Substance use disorders (SUDs) are a growing public health concern with only a limited number of approved treatments. However, even approved treatments are subject to limited efficacy with high long-term relapse rates. Current treatment approaches are typically a combination of pharmacotherapies and behavioral counselling. Growing evidence and technological advances suggest the potential of brain stimulation techniques for the treatment of SUDs. There are three main brain stimulation techniques that are outlined in this review: transcranial magnetic stimulation (TMS), transcranial direct current stimulation (tDCS), and deep brain stimulation (DBS). The insula, a region of the cerebral cortex, is known to be involved in critical aspects underlying SUDs, such as interoception, decision making, anxiety, pain perception, cognition, mood, threat recognition, and conscious urges. This review f…
matched on substance use disorder (text), relapse (text)
Verdejo-Garcia A, Lorenzetti V, Manning V, Piercy H, Bruno R, Hester R, Pennington D, Tolomeo S, Arunogiri S, Bates ME, Bowden-Jones H, Campanella S, Daughters SB, Kouimtsidis C, Lubman DI, Meyerhoff DJ, Ralph A, Rezapour T, Tavakoli H, Zare-Bidoky M, Zilverstand A, Steele D, Moeller SJ, Paulus M, Baldacchino A, Ekhtiari H (2019)reviewMEDLINE-indexed journal, not yet read by usFrontiers in psychiatry60 citations A Roadmap for Integrating Neuroscience Into Addiction Treatment: A Consensus of the Neuroscience Interest Group of the International Society of Addiction Medicine.
Although there is general consensus that altered brain structure and function underpins addictive disorders, clinicians working in addiction treatment rarely incorporate neuroscience-informed approaches into their practice. We recently launched the Neuroscience Interest Group within the International Society of Addiction Medicine (ISAM-NIG) to promote initiatives to bridge this gap. This article summarizes the ISAM-NIG key priorities and strategies to achieve implementation of addiction neuroscience knowledge and tools for the assessment and treatment of substance use disorders. We cover two assessment areas: cognitive assessment and neuroimaging, and two interventional areas: cognitive training/remediation and neuromodulation, where we identify key challenges and proposed solutions. We reason that incorporating cognitive assessment into clinical settings requires the identification of c…
matched on substance use disorder (text), relapse (text)
Technology and Social Media Use Among Patients Enrolled in Outpatient Addiction Treatment Programs: Cross-Sectional Survey Study.
Background: Substance use disorder research and practice have not yet taken advantage of emerging changes in communication patterns. While internet and social media use is widespread in the general population, little is known about how these mediums are used in substance use disorder treatment.
Objective: The aims of this paper were to provide data on patients' with substance use disorders mobile phone ownership rates, usage patterns on multiple digital platforms (social media, internet, computer, and mobile apps), and their interest in the use of these platforms to monitor personal recovery.
Methods: We conducted a cross-sectional survey of patients in 4 intensive outpatient substance use disorder treatment facilities in Philadelphia, PA, USA. Logistic regressions were used to examine associations among variables.
Results: Survey participants (N=259) were mostly male (72.9%, 188/259), A…
matched on Behavior, Addictive (mesh), substance use disorder (text), craving (text), relapse (text)
How important are sex differences in cannabinoid action?
In humans as in animals, males and females are dissimilar in their genetic and hormonally driven behaviour; they process information differently, perceive experience and emotions in different ways, display diverse attitudes, language and social skills, and show sex-related differences in the brain anatomy and organization. Drug addiction is a widespread relapsing illness that affects both men and women. Sex-dependent differences have been frequently observed in the biological and behavioural effects of substances of abuse, including cannabis. Beside sex differences observed in the cannabinoid-induced effects related to cannabis abuse and dependence, cannabinoids have been shown to exert sex-dependent effects also in other physiological and behavioural aspects, such as food intake and energy balance (more evident in males), or anxiety and depression (more evident in females). Research has…
matched on Marijuana Abuse (mesh), relapse (text)
Substance craving changes in university students receiving heart rate variability biofeedback: A longitudinal multilevel modeling approach.
Background: Previously published findings from a study of university students living in substance use disorder (SUD) recovery housing showed an eight-session heart rate variability biofeedback (HRVB) intervention significantly reduced craving. That study, however, uncovered pronounced inter-participant variability in craving change patterns through the course of HRVB that warranted further exploration. The purpose of the current investigation was to examine how within- and between-person factors may have differentially influenced craving changes.
Methods: A longitudinal multilevel modeling approach was used with time at level-1 nested within persons at level-2. Multilevel models of change were estimated to model craving trajectories and predictor relationships over time as a function of age, sex, length of abstinence, daily HRVB practice, anxiety, depression, and stress.
Results: A quadr…
matched on Substance-Related Disorders (mesh), substance use disorder (text), craving (text)
Assessing heart rate variability biofeedback as an adjunct to college recovery housing programs.
Heart rate variability biofeedback (HRV BFB) shows promise as an adjunct intervention for individuals receiving treatment for substance use disorder (SUD), potentially due to its capacity to reduce craving and negative affect. The present study sought to examine the utility of integrating HRV biofeedback into a college recovery housing program and gauging its ability to reduce craving and negative affect in young adults in remission from SUD. Forty-six residents of an SUD recovery house at a public university in the northeastern United States took part in a non-randomized controlled trial. The active intervention was 12 weeks of HRV BFB performed over a college semester. The control intervention was a semester-long, waitlist condition. Changes in craving, perceived stress, anxiety, and depressive symptoms were measured across time during the active HRV BFB intervention and compared to ch…
matched on Substance-Related Disorders (mesh), substance use disorder (text), craving (text)
Xinwen Wen; Lirong Yue; Zhe Du and 3 others (2023)reviewMEDLINE-indexed journal, not yet read by usPsychoradiology18 citations
Implications of neuroimaging findings in addiction
Addiction is a chronic and often relapsing brain disorder characterized by drug abuse and withdrawal symptoms and compulsive drug seeking (Koob and Volkow, 2010) when access to the drug is restricted. Addiction leads to structural and functional brain changes implicated in reward, memory, motivation, and control (Volkow et al., 2019; Lüscher et al., 2020). Neuroimaging technology provides us with the scientific and intuitive methods (Canario et al., 2021; Dong et al., 2022) to study brain mechanism of addiction noninvasively, which has built a bridge between addictive behavior and neural mechanism. Brain structural and functional plasticity has been studied in addiction, such as dysfunctions in the dopaminergic system (Liu and Li, 2018) and corticostriatal circuits (Volkow and Morales, 2015; von Deneen et al., 2022). Notably, the brain activation and connectivity patterns in abstainers e…
matched on craving (text), relapse (text)
Animal Models of Drug Relapse and Craving after Voluntary Abstinence: A Review.
Relapse to drug use during abstinence is a defining feature of addiction. During the last several decades, this clinical scenario has been studied at the preclinical level using classic relapse/reinstatement models in which drug seeking is assessed after experimenter-imposed home-cage forced abstinence or extinction of the drug-reinforced responding in the self-administration chambers. To date, however, results from studies using rat relapse/reinstatement models have yet to result in Food and Drug Administration-approved medications for relapse prevention. The reasons for this state of affairs are complex and multifaceted, but one potential reason is that, in humans, abstinence is often self-imposed or voluntary and occurs either because the negative consequences of drug use outweigh the drug's rewarding effects or because of the availability of nondrug alternative rewards that are chose…
matched on craving (text), relapse (text)
Advances in behavioral animal models of alcohol use disorder.
Alcohol use disorder (AUD) is a multifaceted neuropsychiatric disease that combines behavioral, psychosocial, and neurobiological aspects. Over the previous decade, animal models have advanced in modeling the major psychological constructs that characterize AUD. These advances pave the road for more sophisticated behavioral models that capture addiction-related aspects, such as alcohol craving, compulsive seeking and intake, dependence, and relapse. In this review, we survey the recent progress in behavioral animal modeling of five aspects of AUD: alcohol consumption, dependence, and seeking; compulsivity in alcohol intake despite adverse outcomes; vulnerability and resilience factors in alcohol addiction; relapse despite treatment; and relapse prevention by manipulating alcohol-associated memory reconsolidation. These advances represent a general attempt to grasp the complexity and mult…
matched on craving (text), relapse (text)
Current Findings and Mechanisms of Action of Disulfiram in the Treatment of Alcohol Dependence.
As an alcohol-aversive agent, disulfiram occupies an exceptional position in the pharmacological relapse prevention of alcohol dependence. In contrast to anti-craving drugs, disulfiram does not modulate neurobiological mechanisms of addiction, but rather works by producing an aversive reaction when combined with alcohol. Therapeutic and adverse effects are therefore closely related: On the one hand, the aversiveness of the disulfiram ethanol reaction has the potential to support abstinence in a subgroup of alcohol-dependent patients, while on the other hand it becomes a health threat if the patient fails to maintain complete abstinence. The exceptional position of disulfiram is also related to the role that expectations play in the mediation of therapeutic effects. These are not determined by the pharmacological effects or the actual occurrence of a disulfiram-ethanol reaction, but are a…
matched on craving (text), relapse (text)
New pharmacological treatment strategies for relapse prevention.
Here we discuss treatment strategies that are based on pharmacological interventions to reduce craving and relapse in alcohol-dependent patients. We will first provide a historical overview about relapse prevention strategies. We will then review the development of disulfiram, naltrexone, acamprosate, and nalmefene and discuss their neurobiological modes of action. Then the concept of convergent genomic analysis will be introduced for the discovery of new molecular treatment targets. Finally, we will provide convincing evidence for the use of N-methyl-D-aspartate (NMDA) receptor channel blockers as substitution drugs. Important conclusions of this review are: (i) learning from other addictive substances is very helpful-e.g., substitution therapies as applied to opiate addiction for decades could also be translated to alcoholics, (ii) the glutamate theory of alcohol addiction provides a c…
matched on craving (text), relapse (text)
Sinha R (2013)reviewMEDLINE-indexed journal, not yet read by usCurrent opinion in neurobiology138 citations The clinical neurobiology of drug craving.
Drug craving has re-emerged as a relevant and important construct in the pathophysiology of addiction with its inclusion in DSM-V as a key clinical symptom of addictive disorders. This renewed focus has been due in part to the recent neurobiological evidence on craving-related neural activation and clinical evidence supporting its association with drug use, relapse, and recovery processes. This review covers the neurobiology of drug craving and relapse risk with a primary focus on cocaine addiction and a secondary emphasis on alcohol addiction. A conceptualization of drug craving on the continuum of healthy desire and compulsive seeking, and the associated neurobiological adaptations associated with the development of an increased craving/wanting state is presented. Altered dopamine neurochemistry as well as disrupted prefrontal control and hyperactive striatal-limbic responses in experi…
matched on craving (text), relapse (text)
The endogenous opioid system in cocaine addiction: what lessons have opioid peptide and receptor knockout mice taught us?
Cocaine addiction has become a major concern in the UK as Britain tops the European 'league table' for cocaine abuse. Despite its devastating health and socio-economic consequences, no effective pharmacotherapy for treating cocaine addiction is available. Identifying neurochemical changes induced by repeated drug exposure is critical not only for understanding the transition from recreational drug use towards compulsive drug abuse but also for the development of novel targets for the treatment of the disease and especially for relapse prevention. This article focuses on the effects of chronic cocaine exposure and withdrawal on each of the endogenous opioid peptides and receptors in rodent models. In addition, we review the studies that utilized opioid peptide or receptor knockout mice in order to identify and/or clarify the role of different components of the opioid system in cocaine-add…
matched on craving (text), relapse (text)
Neurobiology of relapse to heroin and cocaine seeking: an update and clinical implications.
The central problem in the treatment of cocaine and heroin addiction is high rates of relapse to drug use after periods of forced or self-imposed abstinence. Relapse can be modeled in laboratory animals a reinstatement procedure in which responding for drug is extinguished and then reinstated by acute exposure to the drug, drug cues, or stress. In this review, we first summarize data from recent (2003-2005) studies on the neural substrates involved in reinstatement of heroin and cocaine seeking. We also discuss the neural mechanisms underlying the progressive increase in cocaine seeking after withdrawal (incubation of cocaine craving). Finally, we provide an update on several novel candidate medications for relapse prevention suggested by recent preclinical studies, and we discuss the translation of findings from nonhuman laboratory studies to the clinical phenomenon of relapse.
matched on craving (text), relapse (text)
Kiefer F, Mann K (2005)reviewMEDLINE-indexed journal, not yet read by usEuropean journal of pharmacology36 citations New achievements and pharmacotherapeutic approaches in the treatment of alcohol dependence.
The treatment of alcohol dependence mainly consists of psychological, social, and pharmacotherapeutic interventions aiming to reduce physical withdrawal, craving, and alcohol relapse. During the last years, it has become increasingly clear that adjuvant pharmacotherapy is efficacious especially in rehabilitation programs for alcohol dependent patients. The development of alcohol dependence seems to involve adaptive changes in amino acid neurotransmitter systems, stimulation of dopamine and opioid peptide systems, and changes in serotonergic activity. Disulfiram, naltrexone and acamprosate are approved treatments for the management of abstinence maintenance treatment. New compounds are under investigation. This review discusses the neurobiological basis of alcohol addiction, pharmacological targets for relapse prevention treatment and pre-clinical and clinical results with the most promis…
matched on craving (text), relapse (text)