雷米芬太尼的依赖性潜力

目的··:评价雷米芬太尼 (Rem)的依赖性潜力。方法·· :采用大、小鼠催促戒断模型、大鼠自然戒断模型、大鼠条件性位置偏爱模型和药物辨别模型进行评价。结果·· :(1)在催促戒断试验中 ,小鼠没有出现明显的戒断反应 (P>0.05);(2)大鼠催促戒断试验中 ,Rem在出现死亡的剂量下 ,只观察到轻微的戒断症状(P<0.05);(3)在自然戒断试验中 ,大鼠没有出现明显的戒断反应;(4)在条件性位置偏爱试验中 ,Rem5.0μg·kg-1形成了明显的条件性位置偏爱效应;(5)在大鼠药物辨别试验中 ,Rem20μg·kg-1 能完全替代大鼠对2.5mg·kg-1 吗啡的辨别效应。结论·· :Rem具有产生精神依赖性和身体依赖性的潜力 ,但由于其作用时间短 ,较难形成身体依赖性 ,而其精神依赖性的形成 ,不受药物作用时间的影响     

盐酸替利定的依赖性评价

目的:评价阿片类镇痛药盐酸替利定的身体依赖性和精神依赖性潜力。方法:采用小鼠、大鼠催促戒断试验、大鼠自然戒断试验、大鼠条件性位置偏爱试验和大鼠药物辨别试验对盐酸替利定进行评价,并与吗啡进行比较。结果:在小鼠、大鼠催促戒断试验中,ig替利定后有不同程度的催促戒断反应。长期给予大剂量的替利定(30d),大鼠体重明显下降(P<0·01)。在大鼠条件性位置偏爱试验中,替利定表现有明显的强化效应。在大鼠药物辨别试验中,吗啡和替利定(ig)可分别替代2·5mg·kg-1吗啡(sc)的辨别效应,其完全替代的ED50值为8·4mg·kg-1和5·6mg·kg-1。结论:盐酸替利定具有产生身体依赖性和精神依赖性的潜力,但其产生身体依赖性的潜力比等剂量的吗啡小。     

新复方甘草口服液身体依赖性研究

目的 评价新复方甘草口服液的身体依赖性潜力。方法 采用小鼠催促戒断、大鼠催促戒断和自然戒断模型对新复方甘草口服液进行身体依赖性实验。结果 小鼠催促跳跃试验中,新复方甘草口服液三个剂量组均没有产生身体依赖性;在大鼠催促戒断试验中,新复方甘草口服液大剂量组出现明显的戒断反应;在大鼠自然戒断试验中,新复方甘草口服液没有产生身体依赖性。结论 新复方甘草口服液具有产生身体依赖性的潜力,但其产生身体依赖性的潜力很小,只有在比较敏感的模型中、使用较大的剂量才能表现出来,其在临床剂量下使用比较安全。     

狗牙花总生物碱的身体依赖性实验研究

目的评价狗牙花总生物碱的身体依赖性潜力。方法采用小鼠催促戒断和大鼠自然戒断模型对狗牙花总生物碱进行身体依赖性实验。结果在小鼠催促实验中,给予狗牙花总生物碱低剂量(140mg/kg)、高剂量(430mg/kg),连续注射7d,而后经纳洛酮激发,实验小鼠未出现明显的戒断症状、跳跃次数增加和体重下降现象。在大鼠自然戒断实验中,给予狗牙花总生物碱低剂量(210mg/kg)、高剂量(775mg/kg),连续注射30d,停药后未见大鼠出现戒断反应和体重下降现象。结论狗牙花总生物碱无身体依赖性。     

盐酸氢吗啡酮身体依赖性潜力

目的:评价盐酸氢吗啡酮产生身体依赖性的潜力。方法:采用小鼠催促戒断跳跃、大鼠催促戒断和大鼠自然戒断3种实验模型。结果:(1)在小鼠催促戒断实验中,氢吗啡酮3个剂量组(sc,累积剂量分别为7、70和480mg·kg-1)和吗啡组(sc,累积剂量为480mg·kg-1)小鼠出现跳跃的百分率和跳跃次数及体重下降百分率都明显高于对照组(P<0.01);(2)在大鼠ig给药的催促戒断实验中,氢吗啡酮3个剂量组(累积剂量分别为77.25、154.5和309.0mg·kg-1)及吗啡组(累积剂量为1030mg·kg-1)的大鼠和sc给药的催促戒断实验中氢吗啡酮3个剂量组(累积剂量分别为14.4、48和51.75mg·kg-1)及吗啡组(累积剂量为345mg·kg-1)大鼠的戒断症状分值和体重下降百分率均明显高于对照组(P<0.01);(3)在大鼠sc给药的自然戒断实验中,氢吗啡酮3个剂量组(累积剂量分别为207、310.5和621mg·kg-1)和吗啡组(累积剂量为2070mg·kg-1)大鼠在停用吗啡后体重均明显下降(P<0.05或P<0.01)。结论:盐酸氢吗啡酮与盐酸吗啡相似,对实验动物无论是ig给药还是sc给药,戒断后都可使动物出现戒断反应,都具有产生身体依赖性的潜力。     

青藤碱对吗啡依赖小鼠、大鼠及豚鼠离体回肠催促戒断反应的影响

目的 :研究青藤碱 (sinomenine ,SIN)对吗啡依赖小鼠、大鼠及豚鼠离体回肠催促戒断反应的抑制作用。方法 :连续递增sc吗啡 (morphine ,Mor) ,建立大鼠、小鼠及豚鼠吗啡身体依赖性模型 ;纳洛酮 (naloxone,Nal)催促诱发吗啡身体依赖性豚鼠离体回肠的戒断性收缩。结果 :(1)SIN 14.3 - 143mg·kg- 1 显著抑制纳洛酮催促后 3 0min内小鼠的跳台次数 ;(2 )SIN 10 0mg·kg- 1 降低纳洛酮催促后 1h内大鼠的戒断症状分值及抑制体重下降 ;(3 )SIN(1.5×10 - 4 - 6.0× 10 - 4 mol·L- 1 )剂量依赖性地抑制纳洛酮催促诱发的吗啡身体依赖性豚鼠离体回肠的戒断性收缩 ;(4)吗啡身体依赖性豚鼠ipSIN(87.0和 8.7mg·kg- 1 )后 ,其离体回肠经纳洛酮催促诱发的戒断性收缩幅值显著降低。结论 :SIN对吗啡身体依赖性大鼠、小鼠的戒断症状及豚鼠离体回肠的戒断性收缩具有抑制作用     

戒毒康胶囊对吗啡依赖性大鼠戒断症状的治疗作用评价

目的：评价戒毒康胶囊对吗啡依赖性大鼠戒断症状的治疗作用。方法：采用吗啡依赖性大鼠催促戒断模型和自然戒断模型。结果：（1）在吗啡依赖性大鼠催促戒断治疗试验中,戒毒康胶囊0．25、0．5和1．0g／kg剂量均可显著降低吗啡依赖性大鼠的催促戒断症状分值（P〈0．01）,0．5和1．0g／kg剂量抑制体重下降（P〈0．05或P〈0．01）。（2）在吗啡依赖性大鼠自然戒断治疗试验中,戒毒康胶囊0．25、0．5和1．0g／kg剂量,均可明显抑制吗啡依赖性大鼠自然戒断后的体重下降（P〈0．05或P〈0．01）。结论：戒毒康胶囊能显著降低吗啡依赖性大鼠催促戒断和自然戒断后所产生的戒断反应,具有明显的脱毒治疗作用。     

巴比妥类药物依赖性试验动物模型的建立

目的:通过建立苯巴比妥躯体依赖及戊巴比妥精神依赖的动物模型,探索镇静催眠药依赖性评价的研究方法。方法:采用小鼠听源性诱导惊厥试验、大鼠戊四唑诱导惊厥试验、大鼠自然戒断试验建立苯巴比妥身体依赖性模型;采用大鼠条件性位置偏爱试验(CPP)建立戊巴比妥精神依赖性的模型。结果:(1)小鼠ig苯巴比妥30 d后停药,铃声刺激诱导惊厥反应,d1-7均有小鼠产生惊厥反应(P<0.01),体重明显降低(P<0.05,P<0.01);(2)在大鼠戊四唑诱导惊厥试验中,苯巴比妥组大鼠由戊四唑诱导的惊厥发生率为44.44%,与对照组比较差异有显著性(P<0.05);(3)大鼠ig苯巴比妥90 d自然戒断,戒断后体重明显降低(P<0.05),食量减少(P<0.01);(4)在大鼠CPP试验中,戊巴比妥钠组大鼠在伴药盒停留时间明显高于对照组(P<0.05),形成了明显的CPP效应。结獉论獉:大鼠、小鼠剂量递增ig苯巴比妥可以形成稳定的躯体依赖;大鼠ig给予戊巴比妥钠可观察到明显的强化效应,可以建立稳定的精神依赖。这些动物模型,可用于评价镇静催眠药的依赖性潜力。     

延生口服液对吗啡依赖性大鼠的脱毒治疗作用

目的:评价延生口服液对吗啡依赖性大鼠模型脱毒治疗作用.方法:采用剂量递增法皮下注射吗啡14d和30d,分别建立大鼠吗啡依赖模型,观察延生口服液大、中、小3个剂量对纳洛酮催促和自然戒断的吗啡依赖大鼠戒断症状及体重的影响.结果:延生口服液能显著减轻吗啡依赖大鼠ip纳洛酮引起的催促戒断症状(P＜0.05)和体重下降(P＜0.01),不能明显抑制自然戒断大鼠体重下降(P＞0.05).结论:延生口服液对吗啡依赖性大鼠戒断后所产生的戒断综合征具有明显的脱毒治疗作用.     

蝎毒的身体依赖性实验评价

蝎毒的身体依赖性实验评价李芳陆苏南潘励山陈磊尹萍宁亚清王桂林张开镐郑继旺（北京医科大学中国药物依赖性研究所，北京１０００８３）以３种动物５种模型对蝎毒的身体依赖性进行了评价．小鼠催促跳跃和大鼠催促戒断试验：蝎毒设两个剂量组，小鼠为８０和８００μｇｋｇ...     

Extended-release naltrexone for alcohol and opioid dependence: A meta-analysis of healthcare utilization studies

Through improved adherence, once-monthly injectable extended-release naltrexone (XR-NTX) may provide an advantage over other oral agents approved for alcohol and opioid dependence treatment. The objective of this study was to evaluate cost and utilization outcomes between XR-NTX and other pharmacotherapies for treatment of alcohol and opioid dependence. Published studies were identified through comprehensive search of two electronic databases. Studies were included if they compared XR-NTX to other approved medicines and reported economic and healthcare utilization outcomes in patients with opioid or alcohol dependence. We identified five observational studies comparing 1,565 patients using XR-NTX to other therapies over 6 months. Alcohol dependent XR-NTX patients had longer medication refill persistence versus acamprosate and oral naltrexone. Healthcare utilization and costs was generally lower or as low for XR-NTX-treated patients relative to other alcohol dependence agents. Opioid dependent XR-NTX patients had lower inpatient substance abuse-related utilization versus other agents and $8170 lower total cost versus methadone.     

Rate of progression from first use to dependence on cocaine or opioids: A cross-substance examination of associated demographic,psychiatric, and childhood risk factors

Background

A number of demographic factors, psychiatric disorders, and childhood risk factors have been associated with cocaine dependence (CD) and opioid dependence (OD), but little is known about their relevance to the rate at which dependence develops. Identification of the subpopulations at elevated risk for rapid development of dependence and the risk factors that accelerate the course of dependence is an important public health goal.

Methods

Data were derived from cocaine dependent (n = 6333) and opioid dependent (n = 3513) participants in a multi-site study of substance dependence. Mean age was approximately 40 and 40% of participants were women; 51.9% of cocaine dependent participants and 29.5% of opioid dependent participants self-identified as Black/African–American. The time from first use to dependence was calculated for each substance and a range of demographic, psychiatric, and childhood risk factors were entered into ordinal logistic regression models to predict the (categorical) transition time to CD and OD.

Results

In both the cocaine and opioid models, conduct disorder and childhood physical abuse predicted rapid development of dependence and alcohol and nicotine dependence diagnoses were associated with slower progression to CD or OD. Blacks/African Americans were at greater risk than European Americans to progress rapidly to OD.

Conclusions

Only a subset of factors known to be associated with CD and OD predicted the rate at which dependence developed. Nearly all were common to cocaine and opioids, suggesting that sources of influence on the timing of transitions to dependence are shared across the two substances.     

Diary writing as a means to increased self-evaluation

The completion of a structured diary task is considered as a means of increasing self-evaluation. Seventeen drug dependence inpatients completed 5 weeks of the diary. Change was assessed using a self-rating of self-evaluation skill and the Rotter Locus of Control Scale. Pre-post changes on both indices indicated significantly increased internalization/self-evaluation. Clinically, the diary procedure has been helpful in gathering baseline information, encouraging self-evaluation habits, facilitating rapport, providing material useful in understanding cognitive style, and validating therapy progress. Clinicians are cautiously encouraged to use the diary procedure with substance dependence patients although design confounding variables limit the extent of the endorsement.     

Multiple Substance Dependence and Course of Alcoholism among Alaska Native Men and Women

Alcohol dependence among Native Americans and Alaska Natives is twice that found in the general population. Alaska Natives are 7 times more likely to die of alcohol-related problems. This study investigated differences in the course and consequences of alcoholism and co-occurring polysubstance dependence in a sample of 582 alcohol-dependent Alaska Natives undergoing inpatient lifetime treatment in Anchorage between 1994 and 1999. Mean age was 33.9 years. Information on lifetime psychiatric symptoms and disorders was collected by using the Semi-Structured Assessment for the Genetics of Alcoholism (SSAGA), a research diagnostic interview. Results indicate that in addition to alcohol dependence, the majority of subjects were dependent on other substances. Marijuana dependence was most common, followed by dependence on cocaine and opiates. Compared with subjects not dependent on any other drugs, subjects with co-occurring alcohol and opiate dependence showed significant differences in relation to age of first regular drink, intoxication, tolerance and withdrawal symptoms, number of medical problems, and number of psychological problems. More research and specific clinical interventions are needed for alcohol- and opiate-dependent Alaska Natives. Findings indicate the need for prevention and interventions in alcohol and illicit drug abuse in this population at an early age.     

A tale of two stimulants: Mentholated cigarettes may play a role in cocaine,but not methamphetamine,dependence

Background

Research suggests that mentholated cigarettes may play a role in cocaine dependence. The purpose of the present study was to expand upon the research on mentholated cigarettes and cocaine dependence and to evaluate the role of mentholated cigarettes in methamphetamine dependence.

Methods

Secondary analysis of a multisite, randomized trial evaluating the impact of smoking-cessation treatment in stimulant-dependent outpatients (N = 538). Participants’ reasons for concurrent use of cigarettes and illicit stimulants were assessed via self-report. Stimulant-abstinence was measured by self-report and urine drug screens. Smoking cessation was assessed via self-report and carbon monoxide levels.

Results

Of the 301 cocaine-dependent participants, 201 (67%) were menthol and 100 (33%) were non-menthol cigarette smokers. Cocaine-dependent participants who smoked menthol, compared to non-menthol, cigarettes were significantly more likely to report that cigarettes prolong their cocaine high (X²(1) = 16.3, p < .0001, OR = 3.58 [95% CI: 1.88–6.79]) and were less likely to be stimulant abstinent during active treatment (W = 3.6, p < 0.001, d = .39 [95% CI: 0.16–0.62]), at 3-month follow-up (X²(1) = 14.4, p < 0.001, OR = .32 [95% CI: 0.17–0.58]), and at 6-month follow-up (X²(1) = 4.6, p = 0.03, OR = .53 [95% CI: 0.29–0.95]). No parallel differences were found between menthol and non-menthol methamphetamine-dependent smokers. The prevalence of Caucasian menthol smokers was significantly greater in the cocaine-dependent participants (37.2%) than in the methamphetamine-dependent participants (17.61%), (X²(1) = 14.4, p < .001, OR = 2.77 [95% CI:1.62–4.73]). Smoking cessation was not significantly associated with cigarette type for either cocaine- or methamphetamine-dependent participants.

Conclusions

The present results suggest that mentholated cigarettes play a role in cocaine, but not methamphetamine, dependence.     

Comparison of Substance Use Milestones in Cannabis- and Cocaine-Dependent Patients

Objectives: To compare the progression of substance use milestones between cocaine- and cannabis-dependent patients. Methods: Using data gathered from two separate clinical studies for treatment of cocaine dependence and cannabis dependence, 130 cannabis-dependent and 112 cocaine-dependent individuals were compared on milestones related to their substance use. Results: In cannabis- vs. cocaine-dependent patients, the mean age of first use, regular use and first treatment contact differed significantly. No statistically significant differences were found between the two groups for other measured milestones. Conclusions: These results differ from most epidemiologic studies that suggest cocaine users progress more rapidly to regular use and treatment contact.     

5.12汶川地震灾后酒依赖流行病学调查研究

目的:了解5.12汶川地震灾后酒依赖的患病率及其相关因素,为灾后心理康复提供科学依据。方法:整群抽样,在具有代表性的极重灾区都江堰、北川、青川三地,以自编一般情况调查表及一般健康问卷12项(GHQ-12)为筛选工具,以SCID-I/P定式检查问卷为调查诊断工具,依据DSM-Ⅳ诊断标准,对成年地震亲历人群(≥15a)进行调查,并通过单因素和多因素的分析方法,计算这些因素对灾后酒依赖的作用强度。结果:共纳入14208例调查对象,总酒依赖时点患病率为0.80%,比1993年调查结果(0.68‰)高11.76倍。相关因素有男性、年龄较大者、受教育年限较少者、婚姻不稳定者、震中丧失亲人、震前居住地在城镇的、亲眼看到他人死亡者等。结论:酒依赖是震后主要的精神疾病之一,大量饮酒者及酒依赖患者是灾后精神卫生防治的重点人群。     

Criteria for an animal model of alcoholism

A correspondence between the various components of human alcoholism and their animal analogue has not yet been achieved; in some part, this failure resides with experimental attempts which obtain which obtain only surface equivalencies and which lack an underlying motivational structure. Seven criteria for an animal model are proposed including the oral ingestion of alcohol without food deprivation, substantial ingestion of alcohol with competing fluids available, drinking directed to the intoxicating effect of alcohol, the performance of work to obtain alcohol, the maintenance of intoxication over a long period and, finally, the production of physical dependence and, on withdrawal, the abstinence syndrome.