First Known Biological Mechanisms for Addiction Uncovered


Pier Vincenzo Piazza and Olivier Manzoni, of the Neurocentre Magendie in Bordeaux, and their team of researchers are the first to discover an existing correlation between consistent impairment of synaptic plasticity in the brain and the transition to addiction.

“The results from the teams at Neurocentre Magendie call into question the hitherto held idea that addiction results from pathological cerebral modifications which develop gradually with drug usage. Their results show that addiction may, instead, come from a form of anaplasticity, i.e. from incapacity of addicted individuals to counteract the pathological modifications caused by the drug to all users.”
In 2004, this research team discovered that addictive behaviors are not restricted to the human species, but similar behaviors can be found in rats that self-administer cocaine.

From this breakthrough, Piazza and Manzoni have now discovered the first known biological mechanisms for addiction, where the transition from regular and controlled drug use can transform into a loss of control over cocaine consumption.

Researchers compared addicted and non-addicted rats and found that the brains of rats with an addiction to cocaine are permanently unable to produce a form of plasticity called long term depression (LTD).

LTD is a neurophysiologic activity-dependent reduction in the efficacy of neuronal synapses that lasts hours or more. It may occur as a result of strong synaptic stimulation or from persistent weak synaptic stimulation. It is required for learning to occur by developing engrams, which are a hypothetical means by which memory traces are stored as biochemical changes in the brain in response to external stimuli. Basically, LTD can no longer be achieved with persistent drug use.

Nevertheless, LTD is not altered after only a short period of cocaine use, but a significant deficit can be found in all users with prolonged use. A lack of LTD allows behavior to become less flexible which can easily lead to addiction.

“The brain of the majority of users is able to produce the biological adaptations which allow to counteract the effects of the drug and to recover a normal LTD. By contrast, the anaplasticity (or lack of plasticity) exhibited by the addicts leaves them without defences and hence the LTD deficit provoked by the drug becomes chronic. This permanent absence of synaptic plasticity would explain why drug seeking behaviour becomes resistant to environmental constraints (difficulty in procuring the substance, adverse consequences of taking the drug on health, social life, etc.) and consequently more and more compulsive. Gradually, control of the taking of the drug is lost and addiction appears.”
Consequently, the team is confident that new treatments for addiction can be developed by studying the brains of non-addicts, while a good understanding of the biological mechanisms that enable addiction can lead to ways counteract the anaplastic state that leads to addiction.

Addiction: A Loss of Plasticity of the Brain?
Long-term depression

© www.understandingaddictions.com

Prescription Painkiller Abuse Still Rising


A new study has found that visits to United States Emergency rooms as a result of prescription painkiller abuse have increased by 111% in only 5 years. According to the Substance Abuse and Mental Health Services Administration and the U.S. Centers for Disease Control and Prevention, ER visits associated with prescription painkiller abuse increased from 305,885 from 144,644 per year between 2004 and 2008.

Gil Kerlikowske, director of the Office of the National Drug Control Policy, states: "the abuse of prescription drugs is our nation's fastest-growing drug problem". In addition, Dr. Thomas Frieden, CDC director, says: “visits to emergency departments for non-medical use of prescription pain drugs such as oxycodone are now as common as visits for illicit drugs”.

This study identified three of the most widely abused prescription painkillers as Oxycodone, Hydrocodone and Methadone.

Of course, the study of these ER trends suggests there is also a rise in other prescription pain medications, such as morphine, fentanyl and hydromorphone, which appear to rise alongside the rate at which these drugs are prescribed in the U.S.

“The report recommends measures such as prescribing opioid medications like OxyContin for acute or chronic pain only after determining that alternatives fail to offer enough pain relief, and monitoring the patient's dose.” In my opinion, the public should be shocked and outraged that this is not already happening.

Apparently, Canada has only recently issued stricter guidelines to ensure doctors are prescribing opioids as more of a last resort treatment.

“As opioids have become more widely used and abused, the number of people who've died as a result of taking opioids has doubled since 1991 to about 300 people a year in Ontario alone, according to a study published in the Canadian Medical Association Journal in December 2009.” These statistics should be very alarming and society should really open their eyes. Addiction has many faces.

SOME FACTS:

Oxycodone: An opioid analgesic medication synthesized from opium-derived thebaine. It was developed in 1916 in Germany, as one of several new semi-synthetic opioids in an attempt to improve on the existing opiates and opioids: morphine, diacetylmorphine (heroin), and codeine.

History: Freund and Speyer of the University of Frankfurt in Germany first synthesized oxycodone from thebaine in 1916, a few years after the German pharmaceutical company Bayer had stopped the mass production of heroin due to hazardous use, harmful use, and dependence. It was hoped that a thebaine-derived drug would retain the analgesic effects of morphine and heroin with less dependence.

OxyContin is the brand name of a time-release formula of oxycodone produced by the pharmaceutical company Purdue Pharma. It was approved by the U.S. Food and Drug Administration in 1995 and first introduced to the U.S. market in 1996. By 2001, OxyContin was the best-selling non-generic narcotic pain reliever in the U.S. In 2008, sales in the U.S. totaled $2.5 billion. An analysis of data from the U.S. Drug Enforcement Administration found that retail sales of oxycodone jumped nearly six-fold between 1997 and 2005.

Other types/brands: Oxy•IR, COR, OxyNorm, Percocet (oxycodone with paracetamol/acetaminophen), Depalgos (oxycodone with paracetamol), Percodan (oxycodone HCl and aspirin), Proladone (suppositories of oxycodone pectinate), Eukodol/Eucodol (Injectable oxycodone hydrochloride or tartrate), Roxicodone, Targin (oxycodone/naloxone).

Side Effects: euphoria, constipation, fatigue, dizziness, nausea, lightheadedness, headache, dry mouth, anxiety, pruritus, diaphoresis, dimness in vision due to miosis, loss of appetite, nervousness, abdominal pain, diarrhea, ischuria, dyspnea, and hiccups. In less than 5% of patients: impotence, enlarged prostate gland, and decreased testosterone secretion.

Special Precautions: In high doses, overdoses, or in patients not tolerant to opiates, oxycodone can cause shallow breathing, bradycardia, cold, clammy skin, apnea, hypotension, miosis (pupil constriction), circulatory collapse, respiratory arrest, and death. There is a high risk of experiencing severe withdrawal symptoms if a patient discontinues oxycodone abruptly.

Hydrocodone or dihydrocodeinone: A semi-synthetic opioid derived from either of two naturally occurring opiates, codeine and thebaine. Hydrocodone is an orally active narcotic analgesic (pain reliever) and antitussive (cough suppressant).

History: Hydrocodone was first synthesized in Germany in 1920 and was approved by the Food and Drug Administration on 23 March 1943 for sale in the United States and approved by Health Canada for sale in Canada under the brand name Hycodan.

Other types/brands: Vicodin, Hydrococet, Symtan, Anexsia, Damason-P, Dicodid, Hycodan (or generically Hydromet), Hycomine, Hycet, Lorcet, Lortab, Norco, Novahistex, Hydrovo, Duodin, Kolikodol, Orthoxycol, Panacet, Zydone, Mercodinone, Synkonin, Norgan, Xodol and Hydrokon.

Side effects: dizziness, lightheadedness, nausea, sweating, drowsiness, constipation, vomiting, and euphoria. Vomiting in some patients is so severe that hospitalization is required. Some less common side effects are allergic reaction, blood disorders, changes in mood, itching, racing heartbeat, mental fogginess, anxiety, lethargy, difficulty urinating, spasm of the ureter, irregular or depressed respiration, and rash.

Special Precautions: Because all commercially available hydrocodone compounds prescribed in the United States contain secondary analgesics, there are serious health risks posed by concurrently consuming any amount of alcohol with hydrocodone compounds. Symptoms of hydrocodone overdose include respiratory depression; extreme somnolence; blue, clammy, or cold skin; narrowed or widened pupils; bradycardia; coma; seizures; cardiac arrest; and death.

Methadone: A synthetic opioid, used medically as an analgesic, antitussive and a maintenance anti-addictive for use in patients on opioids. It is commonly approved as an analgesic and for the treatment of opioid dependence. It is also known as Symoron, Dolophine, Amidone, Methadose, Physeptone, Heptadon, Phy and many other names.

History: Methadone was developed in 1939 Germany by scientists working for I.G. Farbenkonzern at the Farbwerke Hoechst who were looking for a synthetic opioid that could be created with readily available precursors, to solve Germany's opium shortage problem. Contrary to popular belief, the drug was was not named either in honour of or personally by Adolf Hitler, but it was given the trade name Dolophine from the Latin dolor meaning pain and "-phine", a typical ending, not unlike so many other trade and chemical names for analgesics of all types in German, English, French, and other languages.

Side effects: Thrombus, Hypoventilation, Constipation, Increased sweating, heat intolerance, Chronic fatigue, sleepiness and exhaustion, Constricted pupils, Nausea, Low blood pressure, Hallucination, Headache, Vomiting, Cardiac arrhythmia, Anorexia, Weight gain, Gynecomastia, Stomach pains, Dry mouth, Perspiration, Flushing, Itching, Difficulty urinating, Swelling of the hands, arms, feet, and legs, Agitation, Mood changes, Blurred vision, Insomnia, Impotence, Skin rash and Seizures.
Abuse of painkillers skyrockets in U.S.
Oxycodone
Hydrocodone
Methadone

© www.understandingaddictions.com

China: Cruel and Unusual Treatments For Internet Addiction


In recent news, fourteen teenage internet addicts escaped from a treatment center in Huai'an, Jiangsu Province. After attacking a drillmaster, the teens fled by taxi. However, the escape came to an end when the cab driver dropped them off at the local police station because they failed to pay the cab fare.

According to the media, this escape attempt has forced the public to have a more in depth look at the harsh treatments that teens face at internet addiction treatment centers in China. Patients are treated poorly by drillmasters while being forced to study unchallenging curriculum and eat bad food. Many are also abused physically and mentally in these treatment centers. In some cases electric shocks and injections are part of the treatment.

“According to a survey by CCTV, the number of teenage Internet addicts in China has increased from 4 million to more than 13 million in just a few years.” Not to mention the fact that treatment for internet addiction has grown into booming business. “There are more than 300 Internet treatment centers in China, some of which are aimed purely at profit. [...] Parents spent 18,000 yuan ($2,635) on a half-year treatment for their children in the Huai’an treatment center.”

“It is ridiculous that physical punishments and mental restraints are being carried out under the guise of saving children.” Treatment for internet addiction may be successful; however these boot camp-like centers appear to be doing more harm than good to kids.

What is internet addiction?

Internet addiction disorder (IAD) is defined as excessive computer use that interferes with daily life.

There is much debate over whether to include "Internet Addiction" as a diagnosis in the May 2013 edition of the DSM-V. Some experts argue that internet addiction disorder exists and should be included, while others insist that it is neither an addiction nor a specific disorder.

Still others believe that most, if not all, internet addicts already fall under existing diagnostic labels. For many individuals, overuse or inappropriate use of the internet is simply a manifestation of their depression, anxiety, impulse control disorder, or pathological gambling. In addition, IAD has often been compared to food addiction, in which patients overeat as a form of self-medication for depression, anxiety, etc., without actually being addicted to food or eating.

How is internet addiction typically treated?

Content-control software, which controls access to specific pages on the internet, has been used to treat this disorder. Other treatment methods include counseling and cognitive behavioral therapy.

Many treatment centers appear to be popping up all over the world. “In August 2009, ReSTART, a residential treatment center for "pathological computer use", opened near Seattle, Washington, United States. It offers a 45-day program intended to help people wean themselves from pathological computer use, and can handle up to six patients at a time.”

Violence no cure for Web addicts
Internet addiction disorder

© www.understandingaddictions.com

Sex Addiction and The Medial Prefrontal Cortex


“The medial prefrontal cortex (mPFC) is a brain region involved in decision-making and behavioral flexibility, and it has been identified as a potential mediator of behavioral inhibition.” This study suggests that people with lesions in the mPFC may be more apt to engage in risky sexual activities or to compulsively seek out sexual behavior.

Sexual addiction refers to the phenomenon in which individuals report being unable to manage their sexual behavior. It has also been called "sexual dependency," and "sexual compulsivity."
Some experts, like the infamous Dr. Drew Pinsky, believe that sexual addiction is literally an addiction, directly analogous to alcohol and drug addictions. On the other hand, some experts believe that sexual addiction is actually a form of obsessive compulsive disorder and refer to it as sexual compulsivity.

While studying whether the mPFC will inhibit sexual behavior in the face of aversive consequences, Dr. Lique Coolen and his team of researchers found that lesions in this area of a rat’s brain resulted in compulsive sexual behavior. Although behavior may be compulsive, these lesions had no effect on sexual performance or the ability to learn from reward or punishment.

However, although the rats with lesions in the mPFC were capable of linking their sexual behavior with negative outcomes, they did not have the ability to restrain their desire to seek sexual rewards.

Even though the study may not have put forth any conclusive data, it does suggest that the mPFC plays an important role in regulating the compulsive seeking of rewards. If nothing else, these results may encourage more research to more fully understand impulse control disorders and/or addictive behaviors. Individuals with compulsive sexual behavior are quite often afflicted with psychiatric disorders as well, such as substance abuse and mood disorders.

Frontal Cortex Dysfunction May Contribute to Compulsive Sexual Behavior, Study Suggests
Sexual addiction

© www.understandingaddictions.com

Binge Drinkers More Likely to Report Poor Health


From recent data analysis, Centers for Disease Control and Prevention (CDC) have established that excessive drinking is responsible for about 79,000 deaths in the United States each year. Of those deaths, binge drinkers account for more than half.
To further investigate this phenomenon, researchers studied the self-perceptions of drinkers and found that binge drinkers are 13% to 23% more likely to report having poor health.

In the study, a woman is considered a binge drinker if she consumes 4 or more drinks per occasion, while a man is considered a binge drinker if he consumes 5 or more drinks per occasion. At the same time, heavy drinking is defined as consuming at least 14 drinks per week for men and 7 or more drinks per week for women.

"What's more, adult binge drinkers typically … consume an average of about eight drinks per binge episode, well in excess of the cut-points used to define this behavior. Even so, most binge drinkers are not alcohol dependent" says D. Brewer, alcohol program leader at the CDC. Nevertheless, binge drinking is often associated with various health and social problems, such as car crashes, violence, STDs, and unintended pregnancies.

Data from the 2008 Behavioral Risk Factor Surveillance System (BRFSS) was studied, which included 89,919 men drinkers and 110,668 women drinkers. Each subject was asked to rate their health by answering only one question: "Would you say that, in general, your health is excellent, very good, good, fair, or poor?"

"Self-rated health (SRH) is a single question that has been used by many national and international health surveys to measure participants' perception of their overall health status," explained James Tsai, an epidemiologist at the CDC and corresponding author for the study. "Several decades of research has accumulated substantial and consistent evidence that SRH is strong predictor of future morbidity and mortality, as well as functional decline and health care utilization."
Results show that nearly 35 million adults reported binge drinking in 2008, where more than 40% of those adults reported four or more binge drinking episodes in only the past 30 days. Findings also illustrate that these binge drinkers are significantly more likely to report having suboptimal health. As a result, people who feel less healthy are more likely to be hospitalized and have a higher risk of death than those who report feeling healthy.

"These results support broad-based implementation of screening and brief interventions for excessive drinking in health-care settings," said Tsai. "The magnitude of the prevalence of binge drinking and the estimated population size also underscores the need to identify and implement effective population-based prevention and intervention strategies."
Brewer suggests that society needs to take a more proactive stance on reducing binge drinking by implementing certain strategies such as increasing taxes on alcohol products, limiting the number of businesses that sell alcohol within regional proximities or restricting the days and hours that alcohol is sold.

Of course, these types of strategies may not be the answer, but they may help to lower binge drinking statistics, such as self-reports of poor health, hospitalizations, deaths etc.; not to mention lowering the risk that binge drinking could develop into dependence.

Binge Drinkers Report Sub-Optimal Health Status More Often Than Non-Binge Drinkers

© www.understandingaddictions.com

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