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Query: UMLS:C0278080 (physical dependence)
 1,658 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

A current practice among drug abusers in certain Midwestern and Eastern cities is the intravenous injection of aqueous mixtures prepared from tablets of pentazocine and tripelennamine. Patients present with acute hypoxic episodes and symptoms suggesting physical dependence to pentazocine. Two cases are presented illustrating acute respiratory distress with hypoxia. Available evidence indicates that the respiratory syndrome is produced by talc from the injected tablets. Respiratory support and short-term oxygen therapy have been effective in managing this syndrome. Approaches to the treatment of pentazocine dependence and the role of the antihistamine in potentiating the narcotic activity are also discussed. Physicians, drug abuse counselors, and others should be aware of the abuse potential and pulmonary damage which can result from the intravenous use of this drug combination.
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PMID:Abuse and pulmonary complications of injecting pentazocine and tripelennamine tablets. 45 20

Hospital-wide rumors and anecdotal reports had suggested that there was a potentially serious problem of alcohol and drug abuse among the psychiatric patients of this hospital. The authors describe a systematic, evaluative approach which gave direct and detailed information on the nature and extent of the problem thus permitting effective administrative solutions. Results of the study indicated that there were two qualitatively different populations of substance abusing patients. A considerable population of patients were routinely using alcohol and "soft" drugs on the hospital grounds, while another disturbing percentage of patients gave evidence of psychological or physical dependence on alcohol or hard drugs. Data from the evaluation was instrumental in implementing additional security measures to deal with casual substance abuse and additional, confidential treatment resources to deal with the more serious substance abuse problems in patients and staff.
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PMID:Evaluation of substance abuse problems in a psychiatric hospital. 64 Oct 22

A procedure for administering naloxone to narcotic-dependent individuals and a technique for quantitating the ensuing acute withdrawal syndrome have been developed to assess the degree of physical dependence. Successive injections of increasing doses of naloxone produce a controlled increase in severity of withdrawal signs and symptoms as measured by a subjective and an objective assessment battery. There is good agreement between the subjective and objective assessments and a global reting of withdrawal severity. The objective measures are, however, most sensitive and produce a withdrawal syndrome score related to the duration of the current cycle of drug abuse. Hand tremor, trapezius electromyogram and heart rate are the most sensitive signs of withdrawal and can be used in combination to form the basis of a simplified and shortened antagonist assessment test for physical dependence.
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PMID:The quantitative assessment of physical dependence on opiates. 72 Feb 11

The self-administration of drugs to achieve altered states of consciousness is recognized as normal human behaviour. Community attitudes towards drug use vary according to the drug and often bear little relationship to the known pharmacological and toxicological effects of the drug. For an objective assessment of the potential dangers associated with drug use, a distinction is made between drug use and drug abuse. It is stressed that the progression from drug use to drug abuse involves social and psychological factors in addition to the pharmacological factors which are outlined in this paper. The sequential development of drug dependency is described under the headings: Induction; continued consumption; compulsive consumption; withdrawal; abstinence; reinduction. Man uses psychotropic drugs because he finds the effects rewarding. Some experimental models to explore the neurophysiological basis of the reward are described. Experiments employing inhibitors of protein synthesis suggest that the phenomena of tolerance and physical dependence involve the synthesis of new protein. It has been suggested that the new protein might be new receptor molecules for the drug or neurotransmitter substances. These new receptors might constitute a "drug memory" and provide a possible explanation for high relapse rate of drug dependent subjects. A pharmacological basis for the methadone maintenance programme of management of narcotic dependent subjects is briefly outlined.
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PMID:Some pharmacological aspects of drug dependence. 121 42

Animal laboratory studies can provide useful information concerning the potential of drugs for abuse. Over the past 50 years, methods have been developed for use with animal subjects which allow the evaluation of pharmacological properties of drugs which are particularly relevant to their abuse. The methods for preclinical drug abuse liability testing are reviewed under six heading: (1) establishment of the degree of pharmacological equivalence to known drugs of abuse, (2) drug discrimination studies, (3) tests of tolerance and cross-tolerance, (4) tests of physical dependence capacity, (5) drug self-administration tests of reinforcing effects, and (6) evaluation of toxicity and performance impairment at self-administered doses. Preclinical studies can be helpful early in drug development to select lead compounds with low abuse potential for further study. In the case of new or already marketed medications, animal testing can often compliment and extend abuse liability evaluation in human subjects. The results of abuse potential evaluation studies can be useful in making decisions about the possible need for regulation under national and international drug laws, and thus play an important role in drug abuse prevention.
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PMID:Drug abuse potential evaluation in animals. 178 86

The treatment of severe pain requires the use of potent opioid analgesic medications. Many patients with opioid sensitive pain are being undermedicated. This results in increased morbidity and needless suffering. The most important reason for this undertreatment is the fear of addiction engendered by opioids, a fear that is greatly out of proportion to the real risk. The risk of addiction is greatly overestimated in part because many people do not understand the distinctions between drug abuse and drug addiction, on the one hand, and physical dependence and tolerance, on the other. Dependence and tolerance are virtually inevitable outcomes of long-term opioid use, but they are neither sufficient to cause addiction nor the equivalent of it. Indeed, the evidence shows that only a tiny fraction of patients treated with opioids become addicted. There is little risk of addiction for those patients receiving properly administered opioids for pain.
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PMID:Perspectives on the medical use of drugs of abuse. 196 89

Survey data from the United States indicate that tobacco use is associated with the initiation of use of other addicting substances, and that increasing levels of tobacco use are associated with increasing levels of use of other psychoactive substances. Furthermore, factors affecting initiation, abstinence, and relapse to the use of tobacco, alcohol, and opioids are similar in nature. In addition, there are similarities in the addictive process underlying the use of these substances. Taken together, these data suggest that tobacco use is involved, possibly more than by simple association, in the use of other substances containing psychoactive chemicals. In the present paper we discuss the involvement of tobacco in the use of alcohol, opioids, cocaine, and other substances, as well as some of the implications of these observations for researchers and clinicians. One such implication is that it may be possible to use tobacco and nicotine as models for phenomena of interest to other substance use researchers. For example, drug abuse treatment and prevention strategies could be explored using tobacco use as a target behavior, and biological phenomena such as the development of tolerance and physical dependence may be more readily studied with nicotine than with many other drugs. Certain pharmacologic differences across substances are also discussed in light of their implications for development of treatment and drug control policies.
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PMID:Involvement of tobacco in alcoholism and illicit drug use. 218 May 11

The present review discusses the available data on the kinetic properties of non-opiate abused drugs including psychomotor stimulants, hallucinogens and CNS-depressants. Some of the drugs of abuse reviewed here are illicit drugs (e.g. cannabis, cocaine), while others are effective pharmacological agents but have the potential to be abused (e.g. benzodiazepines). Although some of the drugs mentioned in this review have been in use for centuries (e.g. caffeine, nicotine, cocaine, cannabis), knowledge of their kinetics and metabolism is very recent and in some cases still incomplete. This is partially due to the difficulties inherent in studying drugs of abuse in humans, and to the complex metabolism of some of these drugs (e.g. cannabis, caffeine) which has made it difficult to develop sensitive assays to determine biological pathways. Although drugs of abuse may have entirely different intrinsic pharmacological effects, the kinetic properties of such drugs are factors contributing to abuse and dependence. The pharmacokinetic properties that presumably contribute to self-administration and drug abuse include rapid delivery of the drug into the central nervous system and high free drug clearance. Kinetic characteristics also play an important role in the development of physical dependence and on the appearance of a withdrawal syndrome: the longer the half-life, the greater the likelihood of the development of physical dependence; the shorter the half-life, the earlier and more severe the withdrawal. The balance between these 2 factors, which has not yet been carefully studied, will also influence abuse patterns. The clinical significance of kinetic characteristics with respect to abuse is discussed where possible.
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PMID:Clinical pharmacokinetics of non-opiate abused drugs. 256 76

The study concerns the use of a new antidepressant, tianeptine, as a treatment of depressive and/or amotival syndrome, in 30 drug addicts, detoxified from opiates. From a thymoanaleptic point of view, 85% of the patients exhibit a positive result after 28 days of treatment with 37.5 mg/day. These good results are confirmed by the evolution of the Hamilton Depression Rating Scale global score, which significantly decreases from D0 to D14 and from D14 to D28. The acceptability of the antidepressant is good. Anticholinergic side-effects are very uncommon. Tianeptine appears devoid of any obvious psychostimulant or sedative effect. The drug compliance, estimated by counting the tablets, is very satisfying: there is no tendency to a spontaneous increase of dosing. The follow-up of the patients after drug cessation has not shown any symptoms suggesting psychological or physical dependence towards the drug. During this study in subjects particularly predisposed to the abuse of psychoactive drugs, tianeptine has not induced anything suggesting the possibility of drug abuse or tolerance.
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PMID:[Treatment with tianeptine of depressive disorders in drug addicts under withdrawal. Assessment of efficacy and study of dependence]. 332 2

When judiciously used, benzodiazepines are therapeutically effective and remarkably safe. Long-term use may result in addiction and physical dependence in some patients. The physician's awareness of this risk helps in the prevention of dependence. Four variables play a part in the development of dependence, ie, dose, duration of treatment, the history, and the patient's personality. A dosage higher than the usual therapeutic dose not only is not needed in most patients but produces more side effects. Short term therapy carries a low risk of dependence and is preferred. It is advisable not to use benzodiazepines in patients with a history of alcohol or drug abuse, as dependent personalities pose a higher risk than other personality types.
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PMID:Benzodiazepines: selective use to avoid addiction. 612 69


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