Changed accumbal responsiveness to alcohol in rats pre-treated with nicotine or the cannabinoid receptor agonist WIN 55,212-2

Alcohol, nicotine, and cannabinoid acutely increase the activity of the mesolimbic dopamine (DA) pathway. Although polysubstance consumption is a common pattern of abuse in humans, little is known about dopamine release following pre-exposure to these drugs. The purpose of this study was to test whether alcohol-induced dopamine release into the nucleus accumbens (NAc) shell is modified by different pre-treatments: water (i.g.), alcohol (1 g/kg, i.g.), nicotine (0.4 mg/kg, s.c.), and WIN 55,212-2 (1 mg/kg, s.c.). Male Wistar rats were treated (i.g.) for 14 days with either water or alcohol. In the following 5 days rats were injected (s.c.) with vehicle, nicotine, or WIN 55,212-2. Finally, a cannula was surgically implanted into the NAc shell and alcohol-induced extracellular dopamine release was monitored in freely moving rats. Alcohol (1 g/kg; i.g.) only increased the release of dopamine when animals were previously treated with water. This DA increase was markedly inhibited by (subchronic) treatment (5 days) with nicotine or WIN 55-212-2 as well as by previous (chronic) exposure to alcohol (14 days). These data demonstrate that pre-treatment with nicotine and the cannabinoid agonist WIN 55,212-2 is able to change the sensitivity of the NAc shell in response to a moderate dose of alcohol. Therefore, cannabinoid and nicotine exposure may have important implications on the rewarding effects of alcohol, because these drugs lead to long-lasting changes in accumbal dopamine transmission.     

湖南省两地区成瘾物质使用状况调查报告：使用率及相关因素

本文采用整群抽样的方法，对湖南两地区城乡共２３７７人（１５岁以上）的成瘾物质使用状况进行调查，其中男１１７９（４９．６％）人，女１１９９（５０．４％人），平均年龄男女分别为４１．２（ＳＤ＝１７．５）和４３．４（ＳＤ＝１８．６）。结果表明，饮酒率男性为５７．５％，女性为１７．３％，吸烟率男女分别为６８．２％和１１．７％；饮酒者多集中在每月饮１次左右的人群中（男５７．９％，女７７．９％），但吸烟者多集中在每日吸２０支及以上（男５２．４％，女４２．９％）的人群中。除解热镇痛剂外，男性各种精神活性物质的使用频率及剂量皆男高于女性，开始使用的年龄及成瘾的年龄男性低于女性；性别、使用频度、最早使用的年龄、婚姻与饮酒、吸烟量关系最为密切。有１４人使用过鸦片类物质，４人使用过兴奋剂。作者讨论了我国成瘾物质使用的特点，指出经济水平、社会文化背景等因素与我国社会性成瘾物质的使用有密切关系。     

Alcoholism and drug abuse in three groups — bipolar I, unipolars and their acquaintances

Objective: Previous work has shown that manic-depressive illness and alcohol abuse are linked. This study further explores the relationship of alcohol and drug abuse in bipolar I patients and unipolar depressives and a comparison group obtained through the acquaintance method. Method: Diagnosis was accomplished according to Research Diagnostic Criteria (RDC): controls=469; bipolars=277; unipolar depressives=678. Systematic data were gathered using the SADS on lifetime and current drug abuse and alcoholism. Both patients and comparison subjects were then followed prospectively for 10 years. First degree family members were interviewed using the RDC family history method. Results: The group of bipolar patients and the group of unipolar patients had higher rates of drug and alcohol abuse than the comparison group when primary and secondary affective disorder patients were combined. However, primary unipolar patients did not have higher rates of alcohol or drug abuse than the comparison group. In contrast, primary bipolar patients had higher rates of alcoholism, stimulant abuse, and ever having abused a drug than the primary unipolar group and the control group. In an evaluation of the bipolar patients, drug abusers were significantly younger at intake and had a significantly younger age of onset of bipolar disorder. There was a significant increase in family history of mania or schizoaffective mania in the drug-abusing bipolar patients as compared to the non-abusing bipolar patients. Limitation: As in all adult samples of patients with affective illness, the chronology of alcohol and substance problems vis-à-vis the onset of illness was determined retrospectively. Conclusions: (1) Alcoholism and drug abuse are more frequent in bipolar than unipolar patients. (2) The drug abuse of bipolar patients tends toward the abuse of stimulant drugs. (3) In a bipolar patient, familial diathesis for mania is significantly associated with the abuse of alcohol and drugs. (4) More provocatively, these findings suggest the hypothesis of a common familial-genetic diathesis for a subtype of bipolar I, alcohol and stimulant abuse. Clinical implications: The present analyses, coupled with two previous ones from the CDS, suggest that drug abuse may precipitate an earlier onset of bipolar I disorder in those who already have a familial predisposition for mania. Furthermore, in dually diagnosed patients with manic-depressive and alcohol/stimulant abuse history, mood stabilization of the bipolar disorder represents a rational approach to control concurrent alcohol and drug problems, and should be studied in systematic controlled trials.     

湖南省阿片类物质滥用的流行病学调查Ⅱ滥用者使用模式和人口学特征

目的:了解湖南省6地区阿片类物质滥用的类型、方式、首次滥用年龄、原因和滥用者的人口学特征。方法:采用整群抽样,入户调查与线索调查相结合的方法,对在68192名15岁~50岁社区普通居民中筛查出的370例阿片类物质滥用者的毒品滥用模式进行调查,并分析滥用者的人口学特征。结果:约95%的阿片类滥用者吸食海洛因,有少量滥用者用度冷丁和美沙酮;烫吸是首选滥用方式(81.4%),注射吸毒居第二位(38.6%);首次用药平均年龄是27±6岁,90.2%的首次用药年龄小于35岁;受他人影响(75.1%)、好奇心驱使(72.7%)和追求刺激(56.5%)是阿片类物质滥用者首次用药的三大原因;滥用者中男性(87.3%)、35岁以下者(71.1%)居多,78.7%为初中或以下者,无稳定婚姻关系和无固定职业者药物滥用率明显高于稳定婚姻关系和有固定职业者。结论:海洛因是湖南阿片类物质滥用的主要类型,使用途径以烫吸和注射为主,青中年男性、受教育程度较低者、无业/失业等非固定职业者、未婚或非稳定婚姻者是阿片类物质滥用的高危人群,应加强对高危人群的毒品滥用健康教育,有效防治毒品滥用的蔓延。     

Yohimbine: a new street drug

Following the ingestion of an alleged aphrodisiac known as "yo-yo," a 16-year-old girl experienced an acute dissociative reaction accompanied by weakness, paresthesias, and incoordination. Subsequent symptoms included anxiety, headache, nausea, palpitations, and chest pain. Hypertension, tachycardia, tachypnea, diaphoresis, pallor, tremors, and an erythematous rash were noted on physical examination. Serum epinephrine and norepinephrine levels were found to be elevated. Symptoms resolved spontaneously but lasted approximately 36 hours. The ingested substance was identified as yohimbine. The pharmacology of yohimbine and the treatment of yohimbine poisoning are discussed.     

Longitudinal studies of drug abuse in a fifteen-year-old population. 5. Prognostic factors

In an attempt to identify prognostic factors, non-drug users and abusers in the Gothenburg year cohort of 1953 were compared with reference to background data. Individuals with chronic abuse differed most from the "normal" group. Prognostic factors for drug abuse were: member of a multiproblem family, child psychiatric care, contact with the Social Welfare Administration at an early age, truancy, placement in special class, premature drop-out from school, admitted high-frequency drug use in a school questionnaire, for boys early registration for crimes and for girls nervous complaints. The results indicate the necessity of earlier and more effective prevention.     

Personality traits and platelet MAO activity in alcohol and drug abusing teenage boys

The aim of this study has been to investigate whether teenage boys with mixed drug abuse differ from those with pure alcohol abuse as concerns personality traits and platelet monoamine oxidase activity. The series included 1129 consecutive 18-year-old males called to the Enlistment Center in the northern part of Sweden. A special inventory was constructed based on Zuckerman Sensation Seeking Scale (SSS), Eysenck's Personality Inventory (EPI), the Karolinska Scales of Personality (KSP) and questions about alcohol and drug consumption. The subjects with mixed drug abuse (n = 96) had high scores in the two subscales of SSS and KSP related to ability to stand boredom, high scores in both subscales of EPI and KSP related to impulsivity, high scores in Thrill and Adventure Seeking (TAS) and Experience Seeking (ES) of SSS as well as low platelet monoamine oxidase activity. The males with pure alcohol abuse (n = 33) also showed signs of monotony avoidance and impulsivity, but this type of abuse was not clearly related to low platelet monoamine oxidase activity and not to the aspects of curiosity included in the SSS such as TAS and ES. These findings are consistent with the picture earlier found as concerns "Type II" alcoholism which has an early onset, is genetically transmitted, is associated with mixed drug abuse and social complications.     

人际心理治疗48例有儿童期虐待史大学生的焦虑障碍效果分析

目的 研究儿童期创伤焦虑障碍大学生接受人际心理治疗(IPT)的效果。方法 将某高校心理健康咨询中发现的、符合研究标准的48例焦虑障碍大学生用抛币法随机分组,治疗组25例和对照组23例,对治疗组实施IPT,在入组时和治疗结束后分别对患者进行焦虑自评量表(SAS)、功能大体评定量表(GAF)、心理弹性量表(CD-RISC)、不安全感心理自评量表(SRFIS)和抑郁症状清单评估。结果 治疗因素和时间因素分别对焦虑自评分、抑郁清单总分、大体功能分、心理不安全感分和心理弹性分存在主效应作用(F=7.407～295.961,P<0.05),且治疗因素和时间因素存在交互作用(F=5.262～81.958,P<0.05)。相关分析发现,治疗后抑郁清单总分减少值、焦虑自评分减少值、大体功能分增加值分别与治疗后心理不安全感减少值、心理弹性分增加值呈正相关(r=0.456～0.894,P<0.05)。结论 IPT能够改善48名儿童期创伤焦虑障碍患者的焦虑抑郁症状和心理社会功能,病情的改善程度与患者心理不安全感的减轻和心理复原力的增强有关。     

Administering the U.S. Family Violence Option: The role of stigma in waiver recommendations

The Family Violence Option (FVO) was designed to help survivors of domestic violence (DV) more easily secure income support in the United States (U.S.), without placing them at risk of further abuse. The objective of this study is to determine whether the decision-making of advocates responsible for determining waiver recommendations under the FVO is influenced by the relationship status of DV survivors. Recursive partitioning was used to analyse data from a sample of 237 survivor risk assessments from four New Jersey counties to determine which women receive waiver recommendations and which do not. Advocates completed risk assessments for the women and were instructed to make recommendations on waivers based on their assessment. Workers’ decision-making was examined using classification and regression trees (CART) to determine what case factors made it more or less likely for survivors to be recommended waivers. The CART results were supplemented with logistic regression analyses to ensure validity. For two of three waivers, survivors who reported currently residing with their abuser or who had ended the relationship recently were less likely to receive waiver recommendations than those who had been out of the relationship for a longer period of time (OR = 0.09–0.21), even when accounting for the type and severity of DV and the impacts of the violence on survivors’ mental health. The results indicate that DV advocates’ decision-making is complicated by factors independent of survivors’ case characteristics. This can affect the safety and well-being of women attempting to leave violent relationships by affecting their access to resources.