Recreational drug use concurrent with abuse or dependence on other psychoactive substances

In an effort to identify instances of the non-problematic use of a drug concurrent with the problematic use of one or more other drugs, we used structured interviews to obtain comprehensive drug use histories from 48 clients admitted to an intensive outpatient program. We classified clients on the basis of whether they demonstrated evidence of concurrent problematic and non-problematic drug use (Index and Probable Index cases) or only problematic drug use patterns (Non-Index cases). Both Index and Non-Index drug use patterns were about equally common in our sample. Both Index and Probable Index cases used a variety of drugs in a non-problematic manner and were generally congruent in their self-labelling of their drug use relative to their DSM-IV status for each drug used. We discuss several limitations of the study, including our reliance on retrospective, self-report data; potential problems with generalization to other populations; and possible changes in drug use patterns over time.     

精神活性处方药物滥用现状

目前精神活性处方药物滥用问题日益严重,西方发达国家近年来阿片类药物、苯二氮艹卓类药物的使用呈现逐渐升高态势,与此同时还需要面对新精神活性物质逐渐流行的挑战。我国精神药品的使用虽较过去更为普遍、广泛,尚不及西方发达国家问题严重,但我们仍需未雨绸缪,避免步人后尘。     

Race/ethnicity and gender differences in drug use and abuse among college students

This study examines race/ethnicity and gender differences in drug use and abuse for substances other than alcohol among undergraduate college students. A probability-based sample of 4,580 undergraduate students at a Midwestern research university completed a cross-sectional Web-based questionnaire that included demographic information and several substance use measures. Male students were generally more likely to report drug use and abuse than female students. Hispanic and White students were more likely to report drug use and abuse than Asian and African American students prior to coming to college and during college. The findings of the present study reveal several important racial/ethnic differences in drug use and abuse that need to be considered when developing collegiate drug prevention and intervention efforts.     

Understanding gender differences in adolescent drug abuse: issues of comorbidity and family functioning

Female adolescent drug use has increased dramatically in the last 30 years, and there is a growing consensus that the syndrome of female adolescent substance abuse is different from the well-recognized male pattern. Gender differences in patterns of comorbidity and family functioning were investigated in a sample of 95 youths (42 girls and 53 boys) referred for substance abuse treatment. The findings indicate that male and female adolescent substance users differ in several clinically meaningful ways. The results from a discriminant function analysis indicate that substance-using adolescents referred to treatment are distinguished especially by the greater degree to which girls have internalizing symptoms and family dysfunction. The clinical implications of these gender differences are articulated.     

FDA对药品说明书的药物滥用和依赖项目的撰写要求

美国食品药品管理局（FDA）于2019年07月发布了"人用处方药和生物制品说明书的药物滥用和依赖项目——内容和格式供企业用指导原则"（草案）。该指导原则介绍了撰写药物滥用和药物依赖项=目的一般原则以及对其中管制物质、滥用和依赖性3个小项的撰写要求。而我国目前尚无类似指导原则，详细介绍该指导原则，期望对我国说明书这部分内容的撰写和监管有帮助。     

药物滥用和药物依赖预防中的社会心理因素

1 引言 我们生活在一个变幻着的世界中,传统的价值观和社会结构体系在迅速瓦解.今天,人类正面临着历史上最大的一次危机,这一危机也可能成为人类社会发展中的一个转折点.在这变幻和瓦解的过程中,压力和不确定性普遍存在.虽然现代文明和科学技术的进步增加了人们对社会保障的期望,但经济危机、失业以及违法犯罪的增加同样使世界变得难以预测,也加深了社会的焦虑感.当前,普遍存在的吸毒和酗酒问题就是这一困境的反映.这也是隐藏在那些寻求生活真谛的人们心中的一种危机.     

药物代谢的种属和性别差异研究

药物代谢的种属和性别差异已成为人们日益关注的研究热点,了解药物代谢的种属和性别差异对临床合理用药及新药的筛选和研发具有重要的意义。本文综述了国内外药物代谢的种属和性别差异的研究现状,阐述药物代谢的种属和性别差异研究的重要性。     

Drug abuse and dependency: understanding gender differences in etiology and management

OBJECTIVE: To review the etiology, consequences, and treatment needs of drug abuse and dependency, especially in women. DATA SOURCES: Original studies and literature reviews published primarily since 1990. DATA SYNTHESIS: Many studies, conducted mostly during the past 10 years, are providing new information regarding the genesis of two separate drug problems: willful abuse (misuse) of drugs and pathological drug dependency. Recent studies have also highlighted important differences between the sexes in the causes, consequences, and management of drug abuse and dependency. The neurobiologic and genetic contributions to the pathological disease of addiction provide important directions for future treatments, as a supplement to existing self-help and structured behavioral therapies. Pharmacotherapy also has an important role in reducing drug craving and relapse in addicted patients. CONCLUSION: Although the precise causes of drug abuse and dependency continue to challenge researchers, important differences have been identified between men and women in terms of how drug use begins, how it progresses, and effective methods of treatment. Pharmacists and other health care professionals need to understand gender differences in the etiology and management of drug abuse and dependency and develop the capacity to recognize and refer women who may be abusing or dependent on drugs.     

香港精神药物滥用的新趋势、面对挑战的新行动及新政策

１精神药物滥用的新趋势虽然香港的药物滥用人数从整体上看有下降趋势,但在精神药物方面却有上升的趋势。在１９９４年,滥用精神药物的人士有２３２８人,但至１９９９年已增加到３４９３人,其中８２．３ %是男性,１７．７ %是女性。当中２１ａ以下的人士占３６．２ %,而２１ａ及以上的则占６３．８ %。有６４．８ %的滥用精神药物者只有初中的教育程度,另外有高中或以上教育程度者则占１６．９ %。少于一半（４４ %）的滥用精神药物者是有职业（全职或散工）,而大多数（４５ %）是无业者,有７ %是学生。同伴影响（４８ %）是滥用精…     

Puberty, hormones, and sex differences in alcohol abuse and dependence

Sex differences in patterns of drinking and rates of alcohol abuse and dependence begin to emerge during the transition from late puberty to young adulthood. Increases in pubertal hormones, including gonadal and stress hormones, are a prominent developmental feature of adolescence and could contribute to the progression of sex differences in alcohol drinking patterns during puberty. This paper reviews experimental and correlational studies of gonadal and stress-related hormone changes and their effects on alcohol drinking and other associated actions of alcohol. Mechanisms are suggested by which reproductive hormones and stress-related hormones may modulate neural circuits within the brain reward system to produce sex differences in alcohol drinking patterns and vulnerability to alcohol abuse and dependence which become apparent during the late pubertal period.     

Personality and gender differences in effects of d-amphetamine on risk taking

The effects of stimulant drugs on risk-taking behavior vary across individuals, even in healthy samples. These differences could relate to personality, which may share common mechanisms with drug effects or impulsive, risk-taking behavior. The current study investigated the role of temperament and gender in the effects of amphetamine on risk taking. Forty healthy men and women, aged 18 to 35, completed the Balloon Analogue Risk Task (BART; Lejuez et al., 2002) with three reward values after ingesting placebo or d-amphetamine (10, 20 mg). They completed the Multidimensional Personality Questionnaire Brief Form (MPQ-BF; Patrick et al., 2002), with three main scales: Trait reward sensitivity (Agentic Positive Emotionality; AgPEM), impulsivity (Constraint; CON), and negative affect (Negative Emotionality; NEM). d-Amphetamine (20 mg) decreased risk behavior in low AgPEM males, but increased risk behavior in high AgPEM males, producing positive correlations with AgPEM in men (r >or= +.55, p<.05). The drug did not affect risk-taking in women. There was evidence of discriminant validity between the AgPEM, NEM, and CON dimensions and behavioral responses to amphetamine. Implications for treatment and addiction are discussed. (c) 2008 APA, all rights reserved.     

Individual differences in drug abuse vulnerability: d-Amphetamine and sensation-seeking status

Rationale While the personality dimensions of novelty seeking and sensation seeking are associated with drug abuse vulnerability, the mechanisms associated with this vulnerability remain obscure.Objective This study examined the behavioral effects of d-amphetamine in healthy volunteers scoring in the upper and lower quartiles based on age- and gender-adjusted population norms on the impulsive Sensation-Seeking Scale (SSS) of the Zuckerman–Kuhlman personality questionnaire (ZKPQ).Method Participants completed 7-day outpatient studies examining the subjective, performance, and cardiovascular effects of d-amphetamine (0, 7.5, and 15 mg/70 kg, p.o.) under double-blind conditions according to a randomized block design. Performance tasks included behavioral measures of impulsivity, including attention, inhibition, and risk-taking behavior.Results No differences in baseline performance or d-amphetamine effects on measures of attention, inhibition, and risk-taking behavior were observed. High impulsive sensation seekers reported greater increases on several subjective report measures associated with drug abuse potential, including visual analog scales feel drug, like drug, and high.Conclusions Healthy adults scoring in the top quartile on the population of the impulsive SSS of the ZKPQ may be vulnerable to the abuse potential of d-amphetamine.     

An exploratory study of drug abuse and dependence information in package inserts

Information about drug abuse and dependence from package inserts of centrally acting drugs was evaluated for content. Of the 77 labels reviewed, 40 were opiate agonists, 18 were stimulants, and the remainder fell into other selected categories. The amount of information ranged from 0-66 sentences, with greatest variability found in the opiate agonists (range 9-66). Information amount was significantly correlated with the year of drug approval (p < 0.001) but not with the latest label revision (p = 0.749). Information amount did not differ significantly with warning strength or schedule. While most package inserts explain physical dependence, tolerance, and withdrawal, there is a lack of information about psychological dependence. Variability in information about abuse and dependence potential is high and can affect prescribing by physicians and counseling by pharmacists, underscoring the need for further studies.     

Pharmacokinetic determinants of drug abuse and dependence. A conceptual perspective

Drugs that produce physical dependence or have similar pharmacological profiles to highly abused drugs are unlikely to be considered acceptable for marketing. Thus, the prediction of abuse and dependence becomes an important issue in the development of new psychotropic drugs. Both pharmacokinetic and non-pharmacokinetic factors play an important role in predicting dependence and abuse liability of drugs. Evidence for the importance of pharmacological factors includes: the demonstration of drug binding to receptors of abused drugs; tolerance; ability to maintain self-administration; and spontaneous or antagonist precipitated withdrawal. The pharmacokinetic properties that presumably contribute to persistent self-administration and abuse include rapid delivery of drug to the central nervous system (CNS), rapid absorption, low protein binding and high free drug clearance. The pharmacokinetic properties of a drug associated with dependence will include long half-life, low free drug clearance and presence of the drug in the body at high enough concentrations and for sufficient time to permit tolerance to develop. These properties have important clinical implications for treatment and research in the area of abuse and dependence liability of psychoactive drugs.     

Ethnic and gender differences and similarities in adolescent drug use and refusals of drug offers.

This paper examines the relationship among ethnicity, gender, drug use, and resistance to drug offers among a sample of 2,622 African American, Mexican American, and White American seventh graders. A number of similarities were noted. First, these adolescents did not seem to possess large or sophisticated repertoires of offer resistance strategies. Second, most offers came from acquaintances in contrast to more intimate offers among older youths. Ethnic and gender differences were also noted. Ethnicity had significant effects on use and the offer process. Mexican Americans received more offers, used more drugs, and were more likely to be offered drugs by peer family members and at parties. European Americans were more likely to receive drug offers from acquaintances and at friends' homes and on the street. African Americans were more likely to receive offers from dating partners and parents, and in the park, and were more likely to resist offers of drugs-using explanations. Gender significantly affected drug offers and types of offers. Males were more at risk for offers and use at a younger age. Offers of drugs to males were more likely to come from parents or other males, while offers to females were more likely to come from other females or dating partners. Males also were more likely to receive drug offers that appeal to their social standing or self-image while females received either simple offers or those that minimize effects. Finally, offers of drugs to males were more likely to be made in public, while those to females were more likely to occur in private. Cultural explanations are offered for these findings.     

The role of pharmacogenetically-variable cytochrome P450 enzymes in drug abuse and dependence

The risk of drug dependence is determined by the interaction of drug, individual and environment. 'Pharmacogenetics' is the study of the influence of heredity on the response to drugs and their fate in the body; these studies aim to improve the understanding of inter-individual variability in drug response. The authors have applied this research approach to the study of drug metabolism and dependence. Specifically the interaction of genetically variable hepatic cytochrome P450 (CYP) enzymes and their effect on self-administration of drugs has been examined. Many drugs of abuse are substrates (e.g., amphetamines, codeine, nicotine) or inhibitors (e.g., (-)-cocaine) of polymorphic CYPs. Drug metabolism by genetically polymorphic enzymes can have significant clinical implications relating to drug toxicity, therapeutic failure, drug-drug interactions, disease susceptibility and abuse liability. There is good evidence that drug metabolism by genetically variable CYPs can influence the risk of drug dependence, the amount of drug consumed by dependent individuals and some of the toxicities associated with drug-taking behavior. It is anticipated that pharmacogenetics will be used to identify individuals at a greater risk for specific drug dependencies, provide information that can lead to novel treatment and prevention approaches as well as provide guidance for individualization of treatment choice.