Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0020175 (hunger)
 5,670 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

At this time, 27 years after the initial studies on development of methadone for the maintenance treatment of opiate addiction were begun, it has been shown that [table; see text] methadone meets most criteria for a pharmacologic agent for chronic treatment of an addiction. It is effective after oral dosing: it has a long biological half-life in humans, it causes minimal side effects when used in chronic treatment, and it has no true toxic effects or serious side effects. Also methadone has been shown to be very effective when appropriately used in programs which combine pharmacotherapy with the best elements of "drug free" treatment, that is, counseling and psychological support. In addition to pharmacological treatment, there should be access to, if not on-site, medical and behavioral care as needed, as well as linkage to resources for various aspects of rehabilitation. At this time many of the actions, as well as the specific sites of action, and mechanisms of actions of methadone as used in chronic treatment of opiate addiction have been defined by scientific experimentation, both at the preclinical and clinical levels. It is known that methadone prevents abstinence symptoms, prevents drug hunger or craving, blocks euphorogenic effects of other opiates, and prevents relapse to illicit use of opiates. It is known that the site of action of methadone is at specific opioid receptors. Research to date suggests that there is no demonstrable down-regulation or up-regulation of opioid receptors during chronic opioid agonist perfusion, although chronic administration of the opioid antagonist naltrexone does appear to up-regulate opioid receptors. Clinical studies show that chronic use of methadone allows normalization of release and peripheral levels of one of the classes of endogenous opioids, beta-endorphin, and the related peptides derived from POMC released and processed from the anterior pituitary in humans. Also levels of beta-endorphin in cerebrospinal fluid become normal during chronic maintenance treatment, reflecting apparently normal processing and release of beta-endorphin at brain or hypothalamic sites of POMC production. Available data from studies of beta-endorphin indicate that there is a [table; see text] normalization, rather than disruption, of the endogenous opioid system in general during steady state administration of methadone, as contrasted with intermittent dosing and then abrupt withdrawal of short-acting opiates such as heroin. Although there is still much to be learned about the neurobiology of opiate addiction, at this time we do know a great deal about the effects of opiates and opioids.(ABSTRACT TRUNCATED AT 400 WORDS)
 ...
PMID:Rationale for maintenance pharmacotherapy of opiate dependence. 134 39

The general public feels that cocaine is not particularly dangerous because it does not produce a well defined physical dependency and abstinence syndrome. However, when addiction is defined as compulsion, loss of control and continued use in spite of adverse consequences, cocaine drug hunger can be seen as an agent of addictive disease. Withdrawal from cocaine dependence usually involves depression, anxiety and lethargy. These usually clear within a week, leaving only the "drug hunger" to contend with. Medication is rarely needed. When cocaine is the primary addiction, after withdrawal the most effective treatment is group therapy with other recovering cocaine abusers. We incorporate the principles of recovery and define positive and constructive alternatives in dealing with cocaine hunger. Recovery programs should be flexible and involve individual and family education on recovery and the nature of addictive disease. Exercise that produces cardiopulmonary stimulation is a helpful means of reducing drug hunger and anxiety during recovery therapy.
 ...
PMID:Diagnostic, treatment and aftercare approaches to cocaine abuse. 610 Jan 90

Concomitant alcohol and narcotic abuse, and also combined addictive disease or narcotic addiction and alcoholism are very common. Interactions of both a pharmacodynamic and also dispositional type may occur between ethanol and either the short-acting exogenous opioids, such as heroin and morphine, or the long-acting exogenous opioid, methadone. Over half of the so-called "overdose" cases in which exogenous opioids (heroin or methadone) are implicated, are in fact cases in which concomitant abuse of alcohol has played a prominent role. Extensive studies have been carried out to determine factors which may alter the disposition of the long-acting exogenous opioid, methadone, which can be used successfully in the maintenance treatment of addiction. Chronic use of methadone, administered orally, can result in a steady state with respect to both drug levels and overall functioning. Many different physiological systems may be altered by acute or chronic use of short-acting narcotics such as heroin or morphine. Normalization of these functions occurs in the chronic steady state of long-term methadone treatment. However, many factors including chronic liver disease and use abuse of other drugs, including alcohol may alter this steady state. Studies have been carried out to determine the dispositional interactions between ethanol and methadone both in humans and in animal models. Also studies have been carried out to determine the effects of liver disease, which may result from alcohol abuse and/or sequelae of viral hepatitis infection on methadone disposition. Any factor which alters exogenous opioid disposition, specifically the steady state which may be achieved during chronic methadone maintenance treatment, may cause drug hunger and therefore drug-seeking behavior. Interactions between ethanol and methadone and also probably between ethanol and heroin may be major factors in contributing to the concomitant addictive diseases of narcotic addiction and alcoholism and also may contribute to persistent illicit drug use of a narcotic or non-narcotic type in patients receiving methadone treatment for heroin addiction. Treatment goals for the future are discussed in this report.
 ...
PMID:Opioid interactions with alcohol. 639 Nov 8

There has been little study of the abuse liability of ephedrine, a naturally occurring drug used in medicine for thousands of years and currently sold as a "legal" stimulant. The present study measured the reinforcing and subjective effects of ephedrine in a group of 27 adults (18 females and 9 males) with no history of drug dependence. A discrete-trial choice procedure was used to assess the reinforcing effects of a single oral dose of ephedrine selected to produce a moderate subjective response in each subject (range: 37.5-75 mg). A number of variables (gender, current and past drug use, personality, and baseline mood and arousal) were examined in an attempt to identify sources of variability in response to ephedrine. Of the 27 subjects, 5 chose ephedrine on either 2 or 3 out of a possible 3 occasions; overall, ephedrine was chosen on 17% of occasions. In the group as a whole, ephedrine had no effect on ratings of drug liking, but did increase ratings of "high" and scores on the MBG ("euphoria") scale of the Addiction Research Center Inventory. Ephedrine also increased scores on a number of mood scales reflecting CNS stimulation and anxiety. Ephedrine choice was positively associated with current use of marijuana and lower levels of baseline anxiety and hunger, as well as with lower scores on two scales measuring dimensions of the personality trait of harm avoidance. Males and females differed in their response to ephedrine--males chose ephedrine more frequently than females and showed a more positive mood response to the drug.(ABSTRACT TRUNCATED AT 250 WORDS)
 ...
PMID:Factors influencing the reinforcing and subjective effects of ephedrine in humans. 786 49

The controversial discussion about the use of methadone in the treatment of drug addicts has occupied specialists in West Germany for decades. Owing to the political pressure to find a solution to the drug problem, methadone has been an established place in the classical drug treatment system for a long time. Therefore, there has been a supplement (in 1991) to the guidelines of the N.U.B. that under special conditions, it is now possible, for a physician working in a practice or outpatient clinic to use methadone substitution as a routine procedure. The psychosocial care of the patient ist also very important in addition to the purely medical provision of a substitute drug which blocks the heroin hunger and helps prevent criminal activity. The profound dependence of a drug addict is not created primarily by the consumption of addictive substances but must be seen as the result of a severely disturbed personality development and treated accordingly. The individual context of the particular drug scene, scene behavior and jargon should also be taken into account. It is not sufficient to explain addiction and dependence by means of chemical formula or physiological processes. Thus, a substitution treatment always includes two crucial aspects: the soothing and protecting aspect of the medicine administered and the conflict and insight orientated aspect of the therapeutic commitment. The physician, the clinic employees and the social worker should be comprehensively and thoroughly qualified in order to deal with the equally wide-ranging demands of substitutions therapy.
 ...
PMID:[Possibilities and limits of drug substitution treatment in ambulatory practice]. 892 30

The aims were to explore adolescent smokers' understanding and their physiological and psychological experience of addiction to nicotine and to assess the content validity of the Hooked on Nicotine Checklist (HONC), a 10-item measure of nicotine dependence in youth. Six focus group interviews were conducted with male and female smokers recruited by school staff from among known smokers at one English and two French high schools in Montreal. Participants were 64 high-school students aged 14-17 years. Measurements were focus group discussion of smoking patterns and levels for self and others; feelings and sensations while smoking; physical and mental experiences of urges, feelings and sensations when smoking is prohibited; the physical, psychological, and social meanings of being hooked, dependent, or addicted; levels of dependence, desire to quit, and quit attempts. Participants readily identified nicotine dependence as relevant to their smoking experience. Dependence was described as the need to smoke, sometimes experienced as sensations of emptiness in the chest or blood and sometimes as a feeling in the mind. Smoking urges were often situationally determined and associated with hunger. With the exception of feeling sad, blue, or depressed on smoking withdrawal, participants endorsed almost all the symptoms in the HONC as relevant to their experience of dependence and identified several other symptoms as well. Adolescents are able to provide self-reports of symptoms of dependence that are consistent with a theoretically driven conceptualization of nicotine dependence. The HONC demonstrates content validity among adolescents but could be improved through removal of the item related to depression on withdrawal and possibly addition of items related to stress and appetite.
 ...
PMID:The hardest thing is the habit: a qualitative investigation of adolescent smokers' experience of nicotine dependence. 1202 53

Education for social development is a life long activity that requires cooperation with donors, governments, and community organizations to solve problems in areas such as agriculture productivity, infant mortality, AIDS, malnutrition, population growth, and drug and alcohol abuse. Education should be a 2-way street with the audience in control, driven by the needs of the individual. Behavioral change is the most important goal in education, because what a person does will liberate him from disease, addiction, hunger, and inequalities. Interpersonal communications are best for teaching complex skills, broadcast media work well for simple ideas, and print media is best suited for detailed material for repeated referral. To design an educational program the audiences needs must be assessed in the following areas: the technical, social/psychological, and environmental. Project implementation must take into consideration political and economic needs of the environment in which it will operate. Evaluation requires testing the product in draft form with a target audience, and getting them involved in the evaluation. If the target group can't understand the message or identify with the image and finds the material unattractive, then it is changed and tested again.
 ...
PMID:Education for social development. 1231 51

Some rituals about a regular consumption of tea, smokeless tobacco (chewing) and milk are described by one of the authors at the time of his anthropological investigation among the Tuaregs of Timbuktu's region (Mali). He carries out some ethnographical and clinical materials which highlight the dependence to these substances and the role of their psychostimulant and anorexigene effects in a society much ritualised. The subject of this article appears original in the literature which approaches more the dependence to coffee than tea, to cigarettes than to chewing tobacco. The observation of daily life of a tuareg encampment shows a ritual consumption of tea at four time a day. The motivations of the Tuaregs are the increase of vigilance and performance with that psychostimulant substance. They describe an intoxication syndrome related to caffeineism, observed among European tourists. The Tuaregs are aware of their addiction to tea and distinguish psychological dependence from physical dependence. The psychological dependence corresponds to a powerful desire to drink tea at ritual moments, while the physical dependence appears at waking-up and when the time of preparing this beverage is too late. The Tuaregs describe also a phenomenon of loss tolerance after an abstinence period. In spite of the maraboutic prohibition to drink tea, which diverts Tuaregs of their religious practice, they defy this ban from the waking-up to take that infusion before the matinal prayer. That addiction appears also in the identity of the Tuaregs who are called "the sons of tea". The consumption of chewing tobacco, mixed with ash, rhythms the daily life. The mean number of chewing is about fifteen by day; every chewing last 30 minutes. The first chewing of the day occurs 15 minutes after waking-up. The Tuaregs use tobacco in order to get relaxation and vigilance. They suggest intoxication symptoms and especially a withdrawal syndrome which appears at the waking-up or after an important interval between chewing. The authors raise the idea about the dependence to this type of tobacco, consistent with the Anglo-Saxon literature of the 80th which tried to implement scales and criteria as to assess the dependence to smokeless tobacco. The Tuaregs could be more addicted than American consumers in regard to american studies: they use more chewing a day and they can't refrain from chewing at the waking-up. Empirical addition of plant ash, made up of hydroxide of calcium, may act a role in pharmacokinetic by alkalinising the pH. It could increase the absorption of nicotine through the mouth mucus membrane. The authors raise the idea about the dependence to the milk, much consumed and ritualised among those nomadic breeders. They rely on the observation of a withdrawal syndrome clearly identified in the tuareg medical nosography. These regular consumptions integrate the daily life within other rituals. Tea and tobacco facilitate certain motor stimulation, a struggle against hunger and some relaxation regarding an hostile environment over climatological, ecological and economical plan. The brutal and unexpected occurring of one of those rituals disrupt, indeed invert, the usual order of social rituals. Those social and religious disruptions materialise the pathological effect of that double dependence to nicotine and caffeine. That one is called by a term which translate its subjective and social appearance, reflecting so the interaction between man, environment and psychoactive substance. This article highlight the importance of cultural factors in the etiopathogeny of poly-dependence among Tuareg subjects. The question about the diagnostic of the dependence in the DSM IV and the CIM-10 is raised. The DSM IV could be completed because it doesn't evoke addiction to caffeine of tea such like it is consumed in West actually. That hermeneutic approach, including anthropological observations and clinical investigations, allow to understand that addiction to psychoactive substances among Tuareg subjects is consistent with their survival in hostile environments.
 ...
PMID:[The Tuaregs addiction to tea, to smokeless tobacco and to milk: ethnological and clinical approach]. 1264 Mar 26

Smoking is related to 30% of cancer deaths. It is a risk factor for respiratory tract, esophagus, stomach, pancreas, uterine cervix, kidney and bladder carcinomas. Nicotine induces tolerance and addiction by acting on the central dopaminergic pathways, thus leading to pleasure and reward sensations within the limbic system. It stimulates the central nervous system (CNS), enhances alertness and reduces the appetite. A 50% reduction of nicotine consumption may trigger withdrawal symptoms in addicted individuals: anxiety, anger, sleep disorders, hunger, cognitive dysfunction and cigarette craving. Medical advice is the cornerstone of smoking cessation. Pharmacotherapy of nicotine addiction comprises first-line (bupropion and nicotine replacement therapy) and second-line (clonidine and nortriptyline) drugs. Bupropion is a non-tricyclic antidepressant that inhibits dopamine uptake, whose contraindications are: epilepsy, eating disorders, uncontrolled hypertension, recent alcohol abstinence and current therapy with MAO inhibitors. Nicotine replacement therapy can be done with patches or gums. Counseling groups and behavioral interventions are efficacious. The effects of acupuncture on smoking cessation are not fully elucidated. Prompt smoking cessation or gradual reduction strategies have similar success rates.
 ...
PMID:Methods for smoking cessation and treatment of nicotine dependence. 1687 54

Opioids acting at the mu opioid (MOP) receptor produce powerful analgesia. They also produce an intensely rewarding effect that can lead to addiction. The analgesic effect of MOP receptor agonists derives from a direct inhibitory effect on pain transmission at the spinal-cord level and through activation of a descending pain-modulatory pathway. The rewarding effect of MOP agonists is the result of their actions in the mesostriatal dopamine pathway classically associated with both natural and drug rewards. Both the analgesic and rewarding effect of MOP agonists are best understood in the context of decision making under conditions of conflict. Pain is one of many competing motivational states, and endogenous opioids suppress responses to noxious stimuli in the presence of conflicting motivations, such as hunger or a threatening predator. When a food reward is available, MOP agonists microinjected into the mesostriatal circuit promote its consumption, while concomitantly suppressing responses to noxious stimulation. The mesostriatal "reward" circuit, thus, appears to perform a function critical to decision making and can either amplify or suppress responses to noxious stimuli.
 ...
PMID:Understanding how opioids contribute to reward and analgesia. 1754 20


1 2 3 4 5 Next >>