The giving and taking of psychotropic drugs in New Zealand

The levels of compliance with psychotropic medication in three New Zealand community-based samples are reported. At younger ages psychotropics were not frequently used, only 2 percent of 15 to 34 year olds reporting use during a 24 hour period. Psychotropic drug use was most prevalent among elderly people. However, a substantial proportion, about half, of those prescribed for took lower or less frequent doses than directed.     

Neuroimaging and drug taking in primates

Rationale  

Neuroimaging techniques have led to significant advances in our understanding of the neurobiology of drug taking and the treatment of drug addiction in humans. Neuroimaging approaches provide a powerful translational approach that can link findings from humans and laboratory animals.     

Regulation of drug taking by sensitization and habituation

The authors argue that drug taking is an operant behavior that is reinforced by the drug itself. The effectiveness of a drug as a reinforcer is modulated by sensitization and habituation to the drug as it is consumed. According to this model, drug taking stops when habituation reduces the ability of the drug to reinforce its own consumption. Drug taking resumes when spontaneous recovery restores the effectiveness of the drug as a reinforcer. This parsimonious model provides a framework for understanding many findings in the drug literature, including acute and chronic tolerance, the effect of deprivation on consumption, the contextual specificity of tolerance, polydrug abuse, cross-sensitization between stress and drugs, behavioral sensitization, priming, and reinstatement. Although this model cannot explain all aspects of drug taking (e.g., the effect of cognitive manipulations), it has many implications for understanding and controlling human drug consumption and addiction.     

Adolescent drug taking: role of family and peers

To study the influence of family and peers on drug-taking behavior in adolescents, confidential self-reports were obtained from 3333 London adolescents about their use of solvents and illicit drugs. They were also asked about their perception of their best friend's and any family member's use of drugs. The results show that both family and peer's use of drugs were influential. However, peers were more influential than family regardless of whether they took drugs or not and both factors can also have a synergistic effect. The implications of the findings are discussed.     

Determination of drug half-life while giving doses between blood samples.

Traditional methods of determining drug elimination half-life require that no doses be given between the blood samples, which delays drug administration. This article details a new method to determine drug half-life from blood samples drawn with intervening drug doses, that is, while blood levels are building rather than falling. This method was derived from one-compartment pharmacokinetic modeling to assist regulation of doses of central nervous system drugs whose blood concentrations have clinical meaning, for example, lithium and some antidepressants. It should improve the accuracy and practicality of pharmacokinetic methods to predict desirable steady-state drug doses at start-up and to monitor the total daily drug exposure during followup.     

Alcohol and HIV risk taking among intravenous drug users

PURPOSE: To determine if drug risk days are also alcohol use days for active injection drug users (IDUs). METHODS: Cross-sectional interview of 187 AUDIT-positive (> or = 8) active IDUs recruited between 2/98 and 10/99 from a needle exchange program (NEP) in Providence, RI. A drug risk day is defined as "using needles, cotton, or cookers after someone else had used it," measured using a 30-day Timeline Follow-Back procedure. RESULTS: The sample was 64% male, 87% white, with 85% meeting DSM-IV criteria for alcohol abuse/dependence. Of the total days analyzed (n = 5610), 25% were drug risk days; on 40% of these days, drinking also occurred. Using a generalized estimating equation (GEE) model to cluster by subject, alcohol use was associated with drug risk days (OR 1.53; 95% CI 1.2-1.9; P < .001), controlling for gender, age, race, cocaine use, number of daily injections, methadone treatment, and partner drug use. CONCLUSIONS: Using a data analytic strategy that allows examination of self-reports of behaviors on a day-to-day basis, we found that alcohol use is associated with drug risk taking behavior among IDUs. Whether alcohol use precedes or is subsequent to risky HIV behaviors remains to be determined.     

Compulsive drug seeking by rats under punishment: effects of drug taking history

Rationale Abstinence from drug occurs in human addicts for several reasons, including the avoidance of adverse consequences. Objectives To explore a model of drug use in the face of adverse consequences in rats through intermittent punishment of drug seeking and to investigate whether the ability to withhold seeking responses depends upon the duration of drug history. Materials and methods Rats were trained under a seeking–taking chained schedule with sucrose or cocaine as reinforcer. Pressing the seeking lever gave access to the taking lever, and a single press on this lever delivered the reinforcer after which the seeking–taking chain recycled. During punishment, half of the seeking links terminated with a mild foot shock without access to the taking link. Results After a moderate history of reinforcement, punishment of the terminal response in the seeking link suppressed both sucrose- and cocaine-seeking responses. By contrast, rats with an extended cocaine history were more resistant to punishment than those with a moderate cocaine history. This enhanced resistance to punishment was due to a sub-group of rats that showed minimal or no suppression of drug seeking. No differences in suppression of sucrose seeking were observed in animals with moderate versus extended sucrose histories. Conclusions These results suggest that an extended drug self-administration history decreases the ability of vulnerable rats to suppress their drug seeking. Electronic supplementary material The online version of this article (doi:) contains supplementary material, which is available to authorized users.     

The associative basis of cue-elicited drug taking in humans

Rationale  

Drug cues play an important role in motivating human drug taking, lapse and relapse, but the psychological basis of this effect has not been fully specified.     

Differences in attitudes towards drug taking among drug addicts: Implications for treatment

Addicts attending a London drug dependence clinic (N = 147) completed questionnaires exploring their attitudes towards their own drug taking. Three factors were extracted from the data and these were called ‘Hooked’, ‘Sick’ and ‘Therapeutic Optimism’. In-patients, regular out-patients and new out-patients, differed in attitudes towards drug taking. New out-patients regarded themselves as more Hooked and Sick than did in-patients. Regular out-patients had lower therapeutic optimism than did the other two groups. Whether these differences arise through self-selection, that is, those who regard themselves as more sick and hooked tend to drop out early, or whether increasing contact with the clinic leads to shifts in these attitudes is discussed.     

口服、肌注与鼻腔内给咪达唑仑对小儿七氟烷麻醉恢复期躁动的影响

目的 对口服、肌注与鼻腔内给咪达唑仑对小儿七氟烷麻醉恢复期躁动的影响进行分析.方法 选取在本院行扁桃体联合腺样体切除术治疗的患儿76例,按照随机数字表法将本批患者分为4组,分别为对照组(C组)、肌内注射咪达唑仑组(IM组)、鼻腔内给予咪达唑组(IN组)以及口服咪达唑仑组(0组),每组19例.C组在麻醉前30 min口服10％葡萄糖溶液10 ml,lM组、O组、IN组咪达唑仑剂量分别为0.15、0.45、0.25 mg·kg-1,利用七氟烷进行相应的麻醉诱导,并在静脉注射相应的瑞芬太尼以及七氟烷对其麻醉效果给与维持.对脱离父母的难易程度以及父母的满意度进行评分,EA发生情况采用患儿麻醉恢复期躁动表化评分表(PAED)进行评估.结果 C组(1分:17例;2分:2例;3分:0例;4分:0例)与O组(1分:0例;2分:15例;3分:4例;4分:0例)、IN组(1分:0例;2分:6例;3分:13例;4分:0例)以及IM组(1分:0例;2分:7例;3分:12例;4分:0例)相比,其在脱离父母难易程度、父母满意度所获评分提升,其相应的PAED评分及EA的发生率均降低(均P＜ 0.05);与0组相比,其相应的脱离父母难易程度上的评分明显升高,在父母的满意度方面的评分降低(均P＜ 0.05),其在EA发生率以及PAED的评分上差异均无统计学意义(均P＞0.05).结论 通过口服、肌注与鼻腔内给相应的咪达唑仑,对于预防小儿七氟烷EA的发生在效果上具有相似之处,并且通过口服的方式用药更容易被接受.     

Quinacrine不同给药途径对家兔血药浓度的影响

目的　研究 quinacrine经不同途径给药的血药浓度 ,了解 quinacrine经阴道向子宫内给药绝育 (quinacrine女性非外科绝育法 )可能产生的毒副反应。方法　以兔为模拟对象 ,用荧光分析法分别测定宫腔内缓释给药、静脉、口服和输卵管内注射等 4种不同途径给quinacrine的血药浓度变化。结果　血药浓度峰值以静脉给药法最高 ,宫腔内缓释给药法最低。宫腔内缓释给药法的血药浓度水平接近其他给药方法血药浓度水平的残余浓度。血药浓度下降的起点静脉法在给药后立即产生 ,口服法在给药后 8h出现 ,输卵管内注射法见于给药后 4h ,而宫内缓释法则可维持到 7d。结论　从是否产生全身性的毒副反应的角度看 ,quinacrine宫腔内缓释给药法比口服法低 ,用于女性非外科手术绝育是安全的     

The contribution of drug history and time since termination of drug taking to footshock stress-induced cocaine seeking in rats

Rationale There is reason to think that footshock stress-induced reinstatement of cocaine may be affected by the history of drug use and time since termination of drug taking.Objectives Here, we assessed the contribution of daily access (hours per day) and duration (number of days) of cocaine self-administration to propensity to reinstate drug seeking following footshock stress at three time points following cocaine self-administration.Methods Rats were trained to self-administer cocaine (0.5 mg kg⁻¹ infusion⁻¹) on a fixed ratio 1 schedule in one of four training combinations of hours per day and number of days [2/7, 2/21, 12/7, and 12/21 (h/day)]. Rats were then tested for the first time under extinction conditions at either day 1, 10, or 60 after termination of cocaine availability. Once extinction criterion was met (<15 lever presses in 1 h), rats were then tested for stress-induced reinstatement after 15 min of intermittent, inescapable footshock (0.8 mA, 0.5 s/shock, mean off period of 40 s).Results Rats that were given 12-h access to cocaine during training responded less in tests of extinction than those rats given 2-h access. Rats in all groups tested in extinction at days 10 and 60 showed higher responding than at day 1, suggesting an incubation of responding. In footshock stress-induced reinstatement tests, rats with greater exposure to cocaine showed a similar suppression of responding at day 1 and enhanced responding at day 60. As expected, rats that were given 12-h/21-day access to cocaine had the greatest intake of cocaine across the training phase with a slow escalation of hourly intake.Conclusion Greater access to cocaine results in suppression of cocaine seeking following footshock stress at early time points and a progressive increase over time.     

Association of cigarette smoking with drug use and risk taking behaviour in Irish teenagers

Background

Cigarette smoking has been shown to act as a ‘gateway’ to cannabis use and further risk taking behaviours. This study aims to (1) establish the prevalence of cigarette smoking and cannabis use in Irish teenagers, (2) to quantify the strength and significance of the association of cigarette smoking and cannabis use and other high risk behaviours and (3) examine whether the above associations are independent of the extent of social networking.

Methods

Adolescent students across five urban, non-fee paying schools completed an abridged European schools survey project on alcohol and other drugs (ESPAD) questionnaire.

Results

370/417 (88.7%) students completed the questionnaire. 228 (61.6%) were female, 349 (94.3%) were aged 15–16 years. 48.4% of those surveyed had smoked tobacco at some stage in their lifetime, 18.1% in the last 30 days. 15.1% have used cannabis with 5.7% using it in the last 30 days. 29.6% of cigarette smokers have used cannabis in comparison to 1.6% of non-smokers. On multivariate analysis lifetime cigarette smoking status was independently associated with hard drug use, adjusted OR = 6.0, p < 0.01; soft drug use, adjusted OR = 4.6, p < 0.01 and high risk sex practises, adjusted OR = 10.6, p < 0.05.

Conclusions

Cigarette smoking prevalence remains high in Irish teenagers and is significantly associated with drug use and other risk taking behaviours. Specific teenage smoking cessation strategies need to be developed targeting these combined high risk health behaviours.     

关于法律上吸食、注射毒品成瘾标准的探讨

随着毒情的不断变化,禁毒斗争的不断深入,在打击吸食毒品的违法活动中,我们发现法律、法规中关于如何判断吸食、注射毒品成瘾的标准存在一些问题.如何完善吸食注射毒品成瘾的标准值得我们探讨.