Reinforcing aspects of androgens

Are androgens reinforcing? Androgenic-anabolic steroids (AAS) are drugs of abuse. They are taken in large quantities by athletes and others to increase performance, often with negative long-term health consequences. As a result, in 1991, testosterone was declared a controlled substance. Recently, Brower [K.J. Brower, Anabolic steroid abuse and dependence. Curr. Psychiatry Rep. 4 (2002) 377-387.] proposed a two-stage model of AAS dependence. Users initiate steroid use for their anabolic effects on muscle growth. With continued exposure, dependence on the psychoactive effects of AAS develops. However, it is difficult in humans to separate direct psychoactive effects of AAS from the user's psychological dependence on the anabolic effects of AAS. Thus, studies in laboratory animals are useful to explore androgen reinforcement. Testosterone induces a conditioned place preference in rats and mice, and is voluntarily consumed through oral, intravenous, and intracerebroventricular self-administration in hamsters. Active, gonad-intact male and female hamsters will deliver 1 microg/microl testosterone into the lateral ventricles. Indeed, some individuals self-administer testosterone intracerebroventricularly to the point of death. Male rats develop a conditioned place preference to testosterone injections into the nucleus accumbens, an effect blocked by dopamine receptor antagonists. These data suggest that androgen reinforcement is mediated by the brain. Moreover, testosterone appears to act through the mesolimbic dopamine system, a common substrate for drugs of abuse. Nonetheless, androgen reinforcement is not comparable to that of cocaine or heroin. Instead, testosterone resembles other mild reinforcers, such as caffeine, nicotine, or benzodiazepines. The potential for androgen addiction remains to be determined.     

Does crossing over repeated treatment with the dopamine reuptake inhibitors cocaine and BTCP modify their effects on cocaine-induced locomotion?

Because the dopamine reuptake inhibitors cocaine and BTCP produce different behavioral effects after repeated administration, we studied whether they could alter each other’s effects by examining the effects of crossing over repeated treatment with cocaine and BTCP on cocaine-induced locomotion. Male C57BL/6 mice were treated repeatedly with cocaine or BTCP during a first phase (days 1–3) and 3 days later, treated repeatedly with the same or the other compound during a second phase (days 7–9), after which they were administered one of several doses of cocaine on the next day. Locomotor activity was assessed after every daily treatment. The results show that 1) cocaine induced sensitization to its locomotor effects, 2) cocaine-induced sensitization was not altered by subsequent repeated treatment with BTCP, 3) initial repeated treatment with BTCP induced apparent cross-tolerance to cocaine, and 4) the initial effects of repeated BTCP were not markedly altered by subsequent repeated treatment with cocaine. The results indicate that the initial effects produced by repeated cocaine or BTCP are enduring and relatively difficult to alter by crossing over repeated treatment with the other compound. Thus, sensitization to the locomotor effects of cocaine in mice appeared to be attenuated by prior repeated treatment with BTCP but not reversed when followed by repeated treatment with BTCP. Received: 11 January 1998/Final version: 17 September 1998     

Loss of tolerance to morphine after a change in route of administration: control of within-session tolerance by interoceptive conditioned stimuli

Tolerance to morphine analgesia (tail-immersion test) was examined after manipulation of two aspects of a tolerance test: 1) the route of drug administration and 2) the time interval between the test dosing and the tolerance test. The intravenous (IV) and intraperitoneal (IP) routes were used, together with a novel test for tolerance in which the test morphine was infused IV just 2 min before measuring the opiate effect. The first experiment validated this test as an assay for tolerance by examining the log dose-response (LDR) curve changes produced by daily IP injection with 0, 20 or 200 mg/kg morphine; the IV test confirmed the expected parallel shift to the right and flattening of the LDR curve. In the second experiment, all rats of two groups were injected once daily for 3 weeks with 20 mg/kg morphine and with saline except that one group received the morphine IV (and saline IP), the other morphine IP (saline IV). The results indicated route-specific tolerance. On a test using 20 mg/kg given IV morphine, tolerance was significantly greater in rats treated with IV morphine than in those treated IP. However, a larger effect on tolerance was produced by a pretest application of 5 mg/kg morphine 30 min before the actual tolerance test. This manipulation was designed to prime short-term, adaptive processes hypothesized to occur within a normal tolerance test session as morphine is taking effect. The tolerance on the test increased (equivalent to 2 to 3 fold shift in the LDR curve) when the pretest morphine was given with the same route as the chronic morphine, regardless of treatment group. It was concluded that opiate tolerance may be modulated by conditioned stimuli produced by morphine acting through different routes. These interoceptive cues appear to modulate rapidly acquired and short-lived adaptive processes taking place within a given test session.     

Conceptual crises and the addictions: A philosophy of science perspective

This article examines the field of addictions and suggests that it is in the midst of a conceptual crisis. As a result of its immaturity, the addiction's field evidences energy, naivete, curiosity, intensely conflicting and polarized explanations of its identity and purpose, anomalous research findings, and few “facts”. From a philosophy of science perspective, these characteristics are considered as indicators of the developmental stages that are associated with the evolotion of scientific disciplines. A philosophy of science perspective is applied to the history of the substance abuse field and the consequent implications examined. A discussion of normal science, language, the role of paradigms, and scientific reductionism is included.     

“I'm Going to Shut Down All of Your Tricks”: Depictions of Treatment Professionals in Addiction Entertainment

Background: Previous research on addiction themed reality television shows has focused on the depiction of addiction and treatment and has concluded that these shows reinforce stigma. Existing research has not investigated the depiction of treatment professionals in these series. Objectives: This study fills the gap in existing research by analyzing the representations of treatment professionals in reality television shows, including the ways that the shows are edited, the statements made by treatment professionals, and interactions between treatment professionals and laypersons. Methods: The data for this study was drawn from two popular reality shows Intervention and Celebrity Rehab with Dr. Drew. Using a total of 117 episodes, a qualitative content analysis of the representations of treatment professionals in the two series was conducted. Results: The data reveal the ways that depictions of treatment professionals are carefully controlled compared to those of people with substance use issues. In addition, treatment professionals are granted opportunities to interpret, explain, and diagnose the behaviors and experiences of people with substance use problem. Finally, when confronted with resistance treatment professionals assert their authority and demand compliance with their orders. Conclusions/Importance: In strategically presenting treatment professionals in sharp contrast to people with substance use problems, these portrayals of treatment professionals actually reinforce rather than contradict the stigma of addiction.     

From myth of marginality to portrayals of an addictive society: Reporting on addictions in the Finnish press (1968–2006)

This study uses a systematically collected dataset to explore and discuss how the coverage of addiction has changed in Finland's biggest daily, Helsingin Sanomat, during the period 1968–2006. Newspaper texts have been collected through systematic reading of 432 issues (N = 432) from sampled weeks with the main aim of investigating some general trends in the addiction reporting over time. The study consists of two main parts. First, based on a systematic reading the themes, formats and frequency of addiction reporting were examined. In the second stage, a content analysis was conducted on a corpus of texts on addiction (n = 200) selected with the main criteria of dealing with “continous problematic repetitive behavior” that is related to excessive alcohol use, drug intake, tobacco use, compulsive eating, gambling, and sexual behavior. Variables to be analyzed are (1) type of addiction dealt with, (2) who is the addict, and (3) view(s) on type of problem as portrayed in the text. The results from the study show that the addiction reporting starts out from being a more clear product of so called time-out culture (Jensen BK. 1995. The social semiotics of mass communication. London: SAGE Publications), reflecting on the extraordinary and describing marginality. In the end of the 1990s, the texts start to have another function as compulsive behaviors are seen as something more common, and described more often from the individual's perspective. At the same time, a general tabloidization is putting its marks on the form and content of the addiction coverage.     

What is needed in future drug treatment research? A systematic approach to identify gaps on effectiveness of drug treatment from the EMCDDA

Abstract

There is a perceived global need to bridge the existing gap between researchers and other stakeholders to make research more helpful and to realign “the mismatch between what clinical researchers do and what patients need”. The EMCDDA carried out a pilot analysis to explore the gaps in research on treatment for drug dependence as indicated by systematic reviewers of studies on effectiveness of interventions together with a stakeholder’s consultation to ensure a broader participation in the definition of research needs. The rough comparisons of the gaps identified by the researchers in the reviews and those suggested by the stakeholders reflect their different perception of research. The reviewers focus on the quality of studies and on how this may impair reaching conclusive evidence, while the stakeholders are more concerned by the management of effective interventions and by the needs of specific patients. With this exercise, the EMCDDA wants to contribute to the broader debate on how to translate evidence into action and it offers a possible way to support decision makers to set the health research agenda.     

Lee Robins' studies of heroin use among US Vietnam veterans

The work of Robins and her colleagues on heroin addiction among Vietnam veterans sets out in microcosm many of the key factors that play out in the development and maintenance of substance addiction beyond the pharmacology of the drug: price, availability, the process of delivery of the addictive substance, availability of other substances, social norms, education and life circumstances. Robins' studies found high rates of heroin use (34%) and symptoms of heroin dependence (20%) among US soldiers while serving in Vietnam. In the first year after returning to the United States only 1% became re‐addicted to heroin, although 10% tried the drug after their return. Like other seminal studies, this work needs to be read in the original, because relying upon secondary interpretations risks being given a selectively edited version of their findings in service of varied policy and theoretical agendas.     

Challenging the addiction/health binary with assemblage thinking: An analysis of consumer accounts

Critical analyses of drug use and ‘addiction’ have identified a series of binary oppositions between addiction and free will, independence, self-control, responsibility, productivity and autonomy. This critical work has also examined how science, policy and popular discourses frequently characterise addiction as antithetical to health and well-being. Furthermore, those diagnosed with addiction are often understood as indifferent to health and well-being, or as lacking the knowledge or desire required to maintain them. In this article, we draw on data from 60 qualitative interviews with people who self-identify as living with an ‘addiction’, ‘dependence’ or ‘habit’, to argue that the binary opposition between addiction and health struggles to attend to their rich and varied health perspectives and experiences. We explore three themes in the interview data: reinscribing the binary opposition between addiction and health/well-being; strategies for maintaining health and well-being alongside addiction; and alcohol and other drug consumption as aiding health and well-being. Perhaps because addiction and health have been so thoroughly understood as antithetical, such perspectives and experiences have received surprisingly little research and policy attention. Yet they offer fertile ground for rethinking the strengths and capacities of those who self-identity as living with an addiction, dependence or habit, as well as untapped resources for responding to the harm sometimes associated with alcohol and other drug use.