Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0278080 (physical dependence)
 1,658 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Contemporary standard pharmacological care for the treatment of noncancer pain includes the use of opioid medications. The responsiveness of neuropathic pain to opioids has long been an area of controversy. Evidence from multiple randomized controlled trials indicates that opioids can relieve pain in a variety of neuropathic pain syndromes. Opioids are typically reserved for moderate to severe pain that cannot be relieved by the nonsteroidal anti-inflammatory drugs (NSAIDs). Opioids are often used in combination with other adjuvants or other analgesic agents. The advantage of opioids is the lack of a ceiling effect of the pure mu opioid agonists. The disadvantages of these drugs are a series of mechanism-based opioids-related side effects (e.g., nausea, drowsiness, constipation) and the potential issue of their abuse and misuse. Each patient needs to undergo a comprehensive evaluation and receive education on the treatment. The physician must be well conversant with the differential diagnosis and definitions of physical dependence, tolerance, pseudotolerance, aberrant behaviors, addiction, and pseudoaddiction. No specific opioid drug is intrinsically ''better'' than the others. Opioid rotation refers to the switch from one opioid to another when the degree of analgesia obtained is limited by the persistence of adverse effects or the occurrence of clinically relevant tolerance. This approach is based on the observation that a patient's response varies from opioid to opioid. At present, after 1) appropriate selection of patients and 2) longitudinal patient care with routine assessment of degree of analgesia, functional daily activities, adverse events and aberrant behaviors is carried out, opioid therapy can be the safest and most effective treatment measure for quality of life improvement in the chronic pain patient.
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PMID:Opioid therapy for chronic noncancer pain: practice guidelines for initiation and maintenance of therapy. 1601 15

College students who use alcohol and marijuana often use them simultaneously, so that their effects overlap. The present study examined whether negative consequences experienced by simultaneous alcohol and marijuana (SAM) users vary from those experienced by individuals who use alcohol and marijuana concurrently but not simultaneously (CAM) or single-substance users. We considered 9 types of consequences: cognitive, blackout, vomiting, academic/occupational, social, self-care, physical dependence, risky behaviors, and driving under the influence (DUI). Further, we examined whether consequences experienced by SAM users are attributed to using alcohol, marijuana, or both simultaneously. The sample included past-year alcohol and marijuana users age 18-24 (N = 1,390; 62% female; 69% White; 12% Hispanic) recruited from 3 U.S. college campuses. SAM users experienced a greater overall number of consequences than CAM or alcohol-only users, even controlling for frequency and intensity of alcohol and marijuana use and potentially confounding psychosocial and sociodemographic factors. Experiencing specific consequences differed between simultaneous and concurrent users, but after adjusting for consumption and other covariates, only blackouts differed. In contrast, SAM users were more likely to experience each consequence than alcohol-only users, with strongest effects for DUI, blackouts, and cognitive consequences. Among SAM users, consequences were most likely to be attributed to alcohol and were rarely attributed to simultaneous use. Being a user of both alcohol and marijuana and using alcohol and marijuana together so that their effects overlap each contribute to risk, suggesting there is value in targeting the mechanisms underlying type of user as well as those underlying type of use. (PsycINFO Database Record (c) 2020 APA, all rights reserved).
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PMID:Consequences of alcohol and marijuana use among college students: Prevalence rates and attributions to substance-specific versus simultaneous use. 3194 87

Alcohol expectancies have been linked to the development of alcohol pathology. Research has shown college drinkers can be classified into unique drinking profiles that vary by use and related problems. The current study examines paths of alcohol expectancy activation as a function of drinking profile. College student drinkers (n = 1,226; 60.77% female) completed assessments of alcohol involvement and alcohol expectancies. Latent profile analysis (LPA) was used to classify drinking profiles. Multidimensional scaling (MDS) techniques were then applied to examine differences in the likely activation of alcohol expectancies as a function of drinking profile. LPA identified 6 classes of college student drinkers: light drinkers with minor problems, moderate drinkers with mild problems, moderate drinkers with severe problems, heavy drinkers with mild problems, heavy drinkers with severe problems, and heavy drinkers with physical dependence. MDS was used to develop a hypothetical memory network of alcohol expectancies. Preference mapping was then used to plot paths of expectancy activation through the hypothetical memory network for each drinking profile. Light drinkers showed expectancy activation along a prosocial-antisocial dimension. As use patterns became increasingly pathological, paths of activation shifted toward arousal-sedation. The shift in activation paths from prosocial-antisocial to arousal-sedation was driven more by alcohol-related pathology than by consumption. This suggests that individuals high in arousal-sedation expectancies may be at an increased risk for more severe alcohol pathology. Further, individuals high in arousal-sedation expectancies may benefit most from programs that restructure expectancy pathways away from arousal-sedation. (PsycINFO Database Record (c) 2020 APA, all rights reserved).
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PMID:Organization and activation of alcohol expectancies across empirically derived profiles of college student drinkers. 3196 Nov 65