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Challenges and opportunities in using wastewater analysis to measure drug use in a small prison facility.

Pub Med: Keyword Buprenorphine - 4 hours 27 min ago

Challenges and opportunities in using wastewater analysis to measure drug use in a small prison facility.

Drug Alcohol Rev. 2014 Oct 1;

Authors: van Dyken E, Lai FY, Thai PK, Ort C, Bruno R, Hall W, Kirkbride KP, Mueller JF, Prichard J

Abstract
INTRODUCTION AND AIMS: Wastewater analysis (WWA) is intended to be a direct and objective method of measuring substance use in large urban populations. It has also been used to measure prison substance use in two previous studies. The application of WWA in this context has raised questions as to how best it might be used to measure illicit drug use in prisons, and whether it can also be used to measure prescription misuse. We applied WWA to a small regional prison to measure the use of 12 licit and illicit substances. We attempted to measure the non-medical use of methadone and buprenorphine and to compare our findings with the results of the prison's mandatory drug testing (MDT).
DESIGN AND METHODS: Representative daily composite samples were collected for two periods of 12 consecutive days in May to July 2013 and analysed for 18 drug metabolites. Prescription data and MDT results were obtained from the prison and compared with the substance use estimates calculated from WWA data.
RESULTS: Daily use of methamphetamine, methadone, buprenorphine and codeine was detected, while sporadic detection of ketamine and methylone was also observed. Overall buprenorphine misuse appeared to be greater than methadone misuse.
DISCUSSION AND CONCLUSIONS: Compared with MDT, WWA provides a more comprehensive picture of prison substance use. WWA also has the potential to measure the misuse of medically prescribed substances. However, a great deal of care must be exercised in quantifying the usage of any substance in small populations, such as in prisons. [van Dyken E, Lai FY, Thai PK, Ort C, Bruno R, Hall W, Kirkbride KP, Mueller JF, Prichard J. Challenges and opportunities in using wastewater analysis to measure drug use in a small prison facility. Drug Alcohol Rev 2014].

PMID: 25272148 [PubMed - as supplied by publisher]

Pharmacokinetics of oral transmucosal and intramuscular dexmedetomidine combined with buprenorphine in cats.

Pub Med: Keyword Buprenorphine - 4 hours 27 min ago

Pharmacokinetics of oral transmucosal and intramuscular dexmedetomidine combined with buprenorphine in cats.

J Vet Pharmacol Ther. 2014 Oct 1;

Authors: Porters N, de Rooster H, Bosmans T, Baert K, Cherlet M, Croubels S, De Backer P, Polis I

Abstract
Plasma concentrations and pharmacokinetics of dexmedetomidine and buprenorphine after oral transmucosal (OTM) and intramuscular (i.m.) administration of their combination in healthy adult cats were compared. According to a crossover protocol (1-month washout), a combination of dexmedetomidine (40 μg/kg) and buprenorphine (20 μg/kg) was given OTM (buccal cavity) or i.m. (quadriceps muscle) in six female neutered cats. Plasma samples were collected through a jugular catheter during a 24-h period. Plasma dexmedetomidine and buprenorphine concentrations were determined by liquid chromatography-tandem mass spectrometry. Plasma concentration-time data were fitted to compartmental models. For dexmedetomidine and buprenorphine, the area under the plasma concentration-time curve (AUC) and the maximum plasma concentrations (Cmax ) were significantly lower following OTM than following i.m. administration. For buprenorphine, time to reach Cmax was also significantly longer after OTM administration than after i.m. injection. Data suggested that dexmedetomidine (40 μg/kg) combined with buprenorphine (20 μg/kg) is not as well absorbed from the buccal mucosa site as from the intramuscular injection site.

PMID: 25269566 [PubMed - as supplied by publisher]

Disordered eating in obese individuals

MedWorm Addiction Feeds - October 1, 2014 - 6:49pm
This article provides an overview of current thinking about the association between disordered eating and obesity, emphasizing binge eating, binge eating disorder and food addiction as useful conceptual models. Recent findings: Binge eating, recurrent and persistent episodes of overeating coupled with a lack of control over eating, and binge eating disorder, the Diagnostic and Statistical Manual-5 mental disorder, have been a major focus of work to clarify the relationship between disordered eating and obesity. A second focus has been the addiction model of aberrant eating, which posits that recurrent overeating of palatable food is similar to addictive behavior and characterized by dysregulation of the dopaminergic reward system. We describe efforts to integrate these models by focusing o...

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Chronic wheel running-induced reduction of extinction and reinstatement of methamphetamine seeking in methamphetamine dependent rats is associated with reduced number of periaqueductal gray dopamine neurons

MedWorm Addiction Feeds - October 1, 2014 - 6:25pm
Abstract Exercise (physical activity) has been proposed as a treatment for drug addiction. In rodents, voluntary wheel running reduces cocaine and nicotine seeking during extinction, and reinstatement of cocaine seeking triggered by drug-cues. The purpose of this study was to examine the effects of chronic wheel running during withdrawal and protracted abstinence on extinction and reinstatement of methamphetamine seeking in methamphetamine dependent rats, and to determine a potential neurobiological correlate underlying the effects. Rats were given extended access to methamphetamine (0.05 mg/kg, 6 h/day) for 22 sessions. Rats were withdrawn and were given access to running wheels (wheel runners) or no wheels (sedentary) for 3 weeks after which they experienced extinction and re...

Medication Lotto: Can a Drug Cause a Gambling Addiction?Medication Lotto: Can a Drug Cause a Gambling Addiction?

MedWorm Addiction Feeds - October 1, 2014 - 11:19am
What could be causing this older man's newfound passion for gambling? Medscape Internal Medicine (Source: Medscape Internal Medicine Headlines)

Feeling Conflicted?

MedWorm Addiction Feeds - October 1, 2014 - 10:51am
An important idea in behavioral is that our behavior seems to be controlled by a narrow-minded “doers” who cares about immediate gratification and a farsighted “planner” who is concerned with the long-term satisfaction. read more (Source: Psychology Today Addiction Center)

Study: Public Feels More Negative Toward People With Drug Addiction Than Those With Mental Illness

MedWorm Addiction Feeds - October 1, 2014 - 8:47am
People are significantly more likely to have negative attitudes toward those suffering from drug addiction than those with mental illness, and don't support basic benefits for them, new Johns Hopkins Bloomberg School of Public Health research suggests. (Source: Public Health News Headlines from Johns Hopkins)

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Is residential treatment effective for opioid use disorders? A longitudinal comparison of treatment outcomes among opioid dependent, opioid misusing, and non-opioid using emerging adults with substance use disorder.

Pub Med: Keyword Buprenorphine - October 1, 2014 - 6:30am

Is residential treatment effective for opioid use disorders? A longitudinal comparison of treatment outcomes among opioid dependent, opioid misusing, and non-opioid using emerging adults with substance use disorder.

Drug Alcohol Depend. 2014 Sep 18;

Authors: Schuman-Olivier Z, Claire Greene M, Bergman BG, Kelly JF

Abstract
BACKGROUND: Opioid misuse and dependence rates among emerging adults have increased substantially. While office-based opioid treatments (e.g., buprenorphine/naloxone) have shown overall efficacy, discontinuation rates among emerging adults are high. Abstinence-based residential treatment may serve as a viable alternative, but has seldom been investigated in this age group.
METHODS: Emerging adults attending 12-step-oriented residential treatment (N=292; 18-24 years, 74% male, 95% White) were classified into opioid dependent (OD; 25%), opioid misuse (OM; 20%), and no opiate use (NO; 55%) groups. Paired t-tests and ANOVAs tested baseline differences and whether groups differed in their during-treatment response. Longitudinal multilevel models tested whether groups differed on substance use outcomes and treatment utilization during the year following the index treatment episode.
RESULTS: Despite a more severe clinical profile at baseline among OD, all groups experienced similar during-treatment increases on therapeutic targets (e.g., abstinence self-efficacy), while OD showed a greater decline in psychiatric symptoms. During follow-up relative to OM, both NO and OD had significantly greater Percent Days Abstinent, and significantly less cannabis use. OD attended significantly more outpatient treatment sessions than OM or NO; 29% of OD was completely abstinent at 12-month follow-up.
CONCLUSIONS: Findings here suggest that residential treatment may be helpful for emerging adults with opioid dependence. This benefit may be less prominent, though, among non-dependent opioid misusers. Randomized trials are needed to compare more directly the relative benefits of outpatient agonist-based treatment to abstinence-based, residential care in this vulnerable age-group, and to examine the feasibility of an integrated model.

PMID: 25267606 [PubMed - as supplied by publisher]

What is Workaholism?

MedWorm Addiction Feeds - October 1, 2014 - 12:03am
Is the workaholic a victim of sick organisations and a sick society which put too much pressure on individuals at work? Or are they simply people happy at, and passionate about their work?read more (Source: Psychology Today Work Center)

Struggling with Substance Abuse/Addiction during Pregnancy

MedWorm Addiction Feeds - September 30, 2014 - 11:17pm
Friends of mine who are mothers and addicts in recovery say that one of the most horrifying experiences of their lives was using during pregnancy. They knew what they were doing might hurt their unborn children, but they could not stop. read more (Source: Psychology Today Addiction Center)

Treatment of substance abuse can lessen risk of future violence in mentally ill

MedWorm Addiction Feeds - September 30, 2014 - 11:00pm
(University at Buffalo) If a person is dually diagnosed with a severe mental illness and a substance abuse problem, are improvements in their mental health or in their substance abuse most likely to reduce the risk of future violence? A new study from the University at Buffalo Research Institute on Addictions suggests that reducing substance abuse has a greater influence in reducing violent acts by patients with severe mental illness. (Source: EurekAlert! - Medicine and Health)

Public feels more negative toward drug addicts than mentally ill

MedWorm Addiction Feeds - September 30, 2014 - 11:00pm
(Johns Hopkins University Bloomberg School of Public Health) People are significantly more likely to have negative attitudes toward those suffering from drug addiction than those with mental illness, and don't support insurance, housing and employment policies that benefit those dependent on drugs, new Johns Hopkins Bloomberg School of Public Health research suggests. (Source: EurekAlert! - Medicine and Health)

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Smoking status and survival: impact on mortality of continuing to smoke one year after the angiographic diagnosis of coronary artery disease, a prospective cohort study

MedWorm Addiction Feeds - September 30, 2014 - 7:00pm
Conclusions: CABG patients were more likely to quit smoking than those treated with MT alone or PCI. Quitting smoking was associated with improved long-term survival; smoking remains a key risk factor for mortality in patients with CAD. These data underscore the importance of nicotine addiction management in patients with CAD and the need to emphasize cessation particularly in those patients undergoing MT or PCI. (Source: BMC Cardiovascular Disorders)

The relationship between labour market categories and alcohol use trajectories in midlife

MedWorm Addiction Feeds - September 30, 2014 - 7:00pm
Conclusions Being employed is a strong determinant of alcohol use for men and women in midlife, making the workplace a good target for health promotion programmes and policies aimed at reducing alcohol use. Caution is needed when interpreting the health effects of alcohol consumption as low alcohol users may have previously been heavy drinkers. (Source: Journal of Epidemiology and Community Health)

Risk of overdose and death following codeine prescription among immigrants

MedWorm Addiction Feeds - September 30, 2014 - 7:00pm
Background Immigrants may be at a higher risk of adverse drug reactions, in that poor language proficiency reduces individuals understanding of drug label instructions. Additionally, there are reports of severe or fatal toxicity due to CYP2D6 ultrarapid hepatic metabolism of codeine to morphine among some ethnic groups, especially those from Eastern Africa. Methods Between 2002 and 2012 we conducted a population-based cohort study among residents of Ontario, Canada. We used administrative health databases that linked immigrants and Canadian-born individuals to both prescription medication use and emergency department visits and hospital admissions. The primary composite outcome was the risk of drug overdose or all-cause mortality within 30 days of codeine prescription, comparing pati...

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Employment status and mental health among persons with and without a disability: evidence from an Australian cohort study

MedWorm Addiction Feeds - September 30, 2014 - 7:00pm
Conclusions These results suggest a greater reduction in mental health for those persons with disabilities who were unemployed or economically inactive than those who were employed. This highlights the value of employment for people with disabilities. (Source: Journal of Epidemiology and Community Health)

Socioeconomic differences in alcohol‐related risk‐taking behaviours

MedWorm Addiction Feeds - September 30, 2014 - 7:00pm
ConclusionsSocioeconomically advantaged Australians engage in alcohol‐related risky behaviour at higher rates than more disadvantaged Australians even with alcohol consumption controlled. The significant socioeconomic disparities in negative consequences linked to alcohol consumption cannot in this instance be explained via differences in behaviour while drinking. Other factors not directly related to alcohol consumption may be responsible for health inequalities in outcomes with significant alcohol involvement. [Livingston M. Socioeconomic differences in alcohol‐related risk‐taking behaviours. Drug Alcohol Rev 2014] (Source: Drug and Alcohol Review)

Working together: Expanding the availability of naloxone for peer administration to prevent opioid overdose deaths in the Australian Capital Territory and beyond

MedWorm Addiction Feeds - September 30, 2014 - 7:00pm
Abstract IssueSince the mid‐1990s, there have been calls to make naloxone, a prescription‐only medicine in many countries, available to heroin and other opioid users and their peers and family members to prevent overdose deaths. ContextIn Australia there were calls for a trial of peer naloxone in 2000, yet at the end of that year, heroin availability and harm rapidly declined, and a trial did not proceed. In other countries, a number of peer naloxone programs have been successfully implemented. Although a controlled trial had not been conducted, evidence of program implementation demonstrated that trained injecting drug‐using peers and others could successfully administer naloxone to reverse heroin overdose, with few, if any, adverse effects. ApproachIn 2009 Australian drug researche...

Who are the New South Wales Aboriginal drug and alcohol workforce? A first description

MedWorm Addiction Feeds - September 30, 2014 - 7:00pm
ConclusionsTo improve worker retention and encourage professional skills development, discrepancies in salary and award conditions need addressing. Clarifying position descriptions and improving access to formal supervision are important to maximise workforce potential and reduce stress. [Ella S, Lee KSK,Childs S, Conigrave KM. Who are the New South Wales Aboriginal drug and alcohol workforce? A first description. Drug Alcohol Rev 2014] (Source: Drug and Alcohol Review)

Challenges and opportunities in using wastewater analysis to measure drug use in a small prison facility

MedWorm Addiction Feeds - September 30, 2014 - 7:00pm
ConclusionsCompared with MDT, WWA provides a more comprehensive picture of prison substance use. WWA also has the potential to measure the misuse of medically prescribed substances. However, a great deal of care must be exercised in quantifying the usage of any substance in small populations, such as in prisons. [van Dyken E, Lai FY, Thai PK, Ort C, Bruno R, Hall W, Kirkbride KP, Mueller JF, Prichard J. Challenges and opportunities in using wastewater analysis to measure drug use in a small prison facility. Drug Alcohol Rev 2014] (Source: Drug and Alcohol Review)

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