Sample records for abstinent stimulant users

  1. Risky Car Following in Abstinent Users of MDMA

    PubMed Central

    Dastrup, Elizabeth; Lees, Monica; Bechara, Antoine; Dawson, Jeffrey D.; Rizzo, Matthew

    2011-01-01

    Ecstasy (MDMA) use raises concerns because of its association with risky driving. We evaluated driving performance and risk taking in abstinent recreational MDMA users in a simulated car following task that required continuous attention and vigilance. Drivers were asked to follow two car lengths behind a lead vehicle (LV). Three sinusoids generated unpredictable LV velocity changes. Drivers could mitigate risk by following further behind the erratic LV. From vehicle trajectory data we performed a Fourier analysis to derive measures of coherence, gain, and delay. These measures and headway distance were compared between the different groups. All MDMA drivers met coherence criteria indicating cooperation in the car following task. They matched periodic changes in LV velocity similar to controls (abstinent THC users, abstinent alcohol users, and non-drug users), militating against worse vigilance. While all participants traveled approximately 55mph (89kph), the MDMA drivers followed 64m closer to the LV and demonstrated 1.04s shorter delays to LV velocity changes than other driver groups. The simulated car following task safely discriminated between driving behavior in abstinent MDMA users and controls. Abstinent MDMA users do not perform worse than controls, but may assume extra risk. The control theory framework used in this study revealed behaviors that might not otherwise be evident. PMID:20380914

  2. Risky car following in abstinent users of MDMA.

    PubMed

    Dastrup, Elizabeth; Lees, Monica N; Bechara, Antoine; Dawson, Jeffrey D; Rizzo, Matthew

    2010-05-01

    Ecstasy (MDMA) use raises concerns because of its association with risky driving. We evaluated driving performance and risk taking in abstinent recreational MDMA users in a simulated car following task that required continuous attention and vigilance. Drivers were asked to follow two car lengths behind a lead vehicle (LV). Three sinusoids generated unpredictable LV velocity changes. Drivers could mitigate risk by following further behind the erratic LV. From vehicle trajectory data we performed a Fourier analysis to derive measures of coherence, gain, and delay. These measures and headway distance were compared between the different groups. All MDMA drivers met coherence criteria indicating cooperation in the car following task. They matched periodic changes in LV velocity similar to controls (abstinent THC users, abstinent alcohol users, and non-drug users), militating against worse vigilance. While all participants traveled approximately 55 mph (89 kph), the MDMA drivers followed 64 m closer to the LV and demonstrated 1.04 s shorter delays to LV velocity changes than other driver groups. The simulated car following task safely discriminated between driving behavior in abstinent MDMA users and controls. Abstinent MDMA users do not perform worse than controls, but may assume extra risk. The control theory framework used in this study revealed behaviors that might not otherwise be evident. Copyright (c) 2009 Elsevier Ltd. All rights reserved.

  3. Abnormal maximal finger tapping in abstinent cannabis users.

    PubMed

    Flavel, Stanley C; White, Jason M; Todd, Gabrielle

    2013-11-01

    To investigate movement speed and rhythmicity in abstinent cannabis users, we hypothesized that abstinent cannabis users exhibit decreased maximal finger tapping frequency and increased variability of tapping compared with non-drug users. The study involved 10 healthy adult cannabis users and 10 age-matched and gender-matched controls with no history of illicit drug use. Subjects underwent a series of screening tests prior to participation. Subjects were then asked to tap a strain gauge as fast as possible with the index finger of their dominant hand (duration 5 s). The average intertap interval did not significantly differ between groups, but the coefficient of variation of the intertap interval was significantly greater in the cannabis group than in controls (p=0.011). The cannabis group also exhibited a slow tapping frequency at the beginning of the task. Rhythmicity of finger tapping is abnormal in individuals with a history of cannabis use. The abnormality appears to be long lasting and adds to the list of functional changes present in abstinent cannabis users. Copyright © 2013 John Wiley & Sons, Ltd.

  4. Persistent cognitive and dopamine transporter deficits in abstinent methamphetamine users.

    PubMed

    McCann, Una D; Kuwabara, Hiroto; Kumar, Anil; Palermo, Michael; Abbey, Rubyna; Brasic, James; Ye, Weiguo; Alexander, Mohab; Dannals, Robert F; Wong, Dean F; Ricaurte, George A

    2008-02-01

    Studies in abstinent methamphetamine (METH) users have demonstrated reductions in brain dopamine transporter (DAT) binding potential (BP), as well as cognitive and motor deficits, but it is not yet clear whether cognitive deficits and brain DAT reductions fully reverse with sustained abstinence, or whether behavioral deficits in METH users are related to dopamine (DA) deficits. This study was conducted to further investigate potential persistent psychomotor deficits secondary to METH abuse, and their relationship to brain DAT availability, as measured using quantitative PET methods with [(11)C]WIN 35428. Twenty-two abstinent METH users and 17 healthy non-METH using controls underwent psychometric testing to test the hypothesis that METH users would demonstrate selective deficits in neuropsychiatric domains known to involve DA neurons (e.g., working memory, executive function, motor function). A subset of subjects also underwent PET scanning with [(11)C]WIN 35428. METH users were found to have modest deficits in short-term memory, executive function, and manual dexterity. Exploratory correlational analyses revealed that deficits in memory, but not those in executive or motor function, were associated with decreases in striatal DAT BP. These results suggest a possible relationship between DAT BP and memory deficits in abstinent METH users, and lend support to the notion that METH produces lasting effects on central DA neurons in humans. As METH can also produce toxic effects on serotonin (5-HT) neurons, further study is needed to address the potential role of brain 5-HT depletion in cognitive deficits in abstinent METH users. (c) 2007 Wiley-Liss, Inc.

  5. Sleep Perception and Misperception in Chronic Cocaine Users During Abstinence.

    PubMed

    Hodges, Sarah E; Pittman, Brian; Morgan, Peter T

    2017-03-01

    During abstinence, chronic cocaine users experience an objective worsening of sleep that is perceived as qualitatively improving. This phenomenon has been termed "occult insomnia." The objective of this study was to determine whether chronic cocaine users experience positive sleep state misperception during abstinence. Forty-three cocaine-dependent persons were admitted to an inpatient research facility for 12 days and 11 nights to participate in a treatment study of modafinil. Polysomnographic sleep recordings were performed on study nights 3, 4, 10, and 11, when participants were on average 1 and 2 weeks abstinent from cocaine. Participants also completed sleep diary questionnaires every evening before bed and every morning upon awakening. Polysomnographic and sleep diary measurements of total sleep time, sleep latency, time awake after sleep onset, and time in bed after final awakening were compared. Chronic cocaine users accurately reported total sleep time after 1 week of abstinence but overreported total sleep time by an average of 40 min after 2 weeks of abstinence. Underestimating sleep latency and time spent awake after sleep onset were responsible for this difference. Positive sleep state misperception is revealed in chronic cocaine users after 2 weeks of abstinence and is consistent with the previously identified "occult insomnia" in this population. © Sleep Research Society 2016. Published by Oxford University Press on behalf of the Sleep Research Society. All rights reserved. For permissions, please e-mail journals.permissions@oup.com.

  6. Functional MRI of inhibitory processing in abstinent adolescent marijuana users.

    PubMed

    Tapert, Susan F; Schweinsburg, Alecia D; Drummond, Sean P A; Paulus, Martin P; Brown, Sandra A; Yang, Tony T; Frank, Lawrence R

    2007-10-01

    Marijuana intoxication appears to impair response inhibition, but it is unclear if impaired inhibition and associated brain abnormalities persist after prolonged abstinence among adolescent users. We hypothesized that brain activation during a go/no-go task would show persistent abnormalities in adolescent marijuana users after 28 days of abstinence. Adolescents with (n = 16) and without (n = 17) histories of marijuana use were compared on blood oxygen level dependent (BOLD) response to a go/no-go task during functional magnetic resonance imaging (fMRI) after 28 days of monitored abstinence. Participants had no neurological problems or Axis I diagnoses other than cannabis abuse/dependence. Marijuana users did not differ from non-users on task performance but showed more BOLD response than non-users during inhibition trials in right dorsolateral prefrontal, bilateral medial frontal, bilateral inferior and superior parietal lobules, and right occipital gyri, as well as during "go" trials in right prefrontal, insular, and parietal cortices (p < 0.05, clusters > 943 microl). Differences remained significant even after controlling for lifetime and recent alcohol use. Adolescent marijuana users relative to non-users showed increased brain processing effort during an inhibition task in the presence of similar task performance, even after 28 days of abstinence. Thus, increased brain processing effort to achieve inhibition may predate the onset of regular use or result from it. Future investigations will need to determine whether increased brain processing effort is associated with risk to use.

  7. Employment-based abstinence reinforcement promotes opiate and cocaine abstinence in out-of-treatment injection drug users.

    PubMed

    Holtyn, August F; Koffarnus, Mikhail N; DeFulio, Anthony; Sigurdsson, Sigurdur O; Strain, Eric C; Schwartz, Robert P; Silverman, Kenneth

    2014-01-01

    We examined the use of employment-based abstinence reinforcement in out-of-treatment injection drug users, in this secondary analysis of a previously reported trial. Participants (N = 33) could work in the therapeutic workplace, a model employment-based program for drug addiction, for 30 weeks and could earn approximately $10 per hr. During a 4-week induction, participants only had to work to earn pay. After induction, access to the workplace was contingent on enrollment in methadone treatment. After participants met the methadone contingency for 3 weeks, they had to provide opiate-negative urine samples to maintain maximum pay. After participants met those contingencies for 3 weeks, they had to provide opiate- and cocaine-negative urine samples to maintain maximum pay. The percentage of drug-negative urine samples remained stable until the abstinence reinforcement contingency for each drug was applied. The percentage of opiate- and cocaine-negative urine samples increased abruptly and significantly after the opiate- and cocaine-abstinence contingencies, respectively, were applied. These results demonstrate that the sequential administration of employment-based abstinence reinforcement can increase opiate and cocaine abstinence among out-of-treatment injection drug users. © Society for the Experimental Analysis of Behavior.

  8. EMPLOYMENT-BASED ABSTINENCE REINFORCEMENT PROMOTES OPIATE AND COCAINE ABSTINENCE IN OUT-OF-TREATMENT INJECTION DRUG USERS

    PubMed Central

    Holtyn, August F.; Koffarnus, Mikhail N.; DeFulio, Anthony; Sigurdsson, Sigurdur O.; Strain, Eric C.; Schwartz, Robert P.; Silverman, Kenneth

    2016-01-01

    We examined the use of employment-based abstinence reinforcement in out-of-treatment injection drug users, in this secondary analysis of a previously reported trial. Participants (N = 33) could work in the therapeutic workplace, a model employment-based program for drug addiction, for 30 weeks and could earn approximately $10 per hr. During a 4-week induction, participants only had to work to earn pay. After induction, access to the workplace was contingent on enrollment in methadone treatment. After participants met the methadone contingency for 3 weeks, they had to provide opiate-negative urine samples to maintain maximum pay. After participants met those contingencies for 3 weeks, they had to provide opiate- and cocaine-negative urine samples to maintain maximum pay. The percentage of drug-negative urine samples remained stable until the abstinence reinforcement contingency for each drug was applied. The percentage of opiate- and cocaine-negative urine samples increased abruptly and significantly after the opiate- and cocaine-abstinence contingencies, respectively, were applied. These results demonstrate that the sequential administration of employment-based abstinence reinforcement can increase opiate and cocaine abstinence among out-of-treatment injection drug users. PMID:25292399

  9. Abnormal cerebellar morphometry in abstinent adolescent marijuana users

    PubMed Central

    Medina, Krista Lisdahl; Nagel, Bonnie J.; Tapert, Susan F.

    2010-01-01

    Background Functional neuroimaging data from adults have, in general, found frontocerebellar dysfunction associated with acute and chronic marijuana (MJ) use (Loeber & Yurgelun-Todd, 1999). One structural neuroimaging study found reduced cerebellar vermis volume in young adult MJ users with a history of heavy polysubstance use (Aasly et al., 1993). The goal of this study was to characterize cerebellar volume in adolescent chronic MJ users following one month of monitored abstinence. Method Participants were MJ users (n=16) and controls (n=16) aged 16-18 years. Extensive exclusionary criteria included history of psychiatric or neurologic disorders. Drug use history, neuropsychological data, and structural brain scans were collected after 28 days of monitored abstinence. Trained research staff defined cerebellar volumes (including three cerebellar vermis lobes and both cerebellar hemispheres) on high-resolution T1-weighted magnetic resonance images. Results Adolescent MJ users demonstrated significantly larger inferior posterior (lobules VIII-X) vermis volume (p<.009) than controls, above and beyond effects of lifetime alcohol and other drug use, gender, and intracranial volume. Larger vermis volumes were associated with poorer executive functioning (p’s<.05). Conclusions Following one month of abstinence, adolescent MJ users had significantly larger posterior cerebellar vermis volumes than non-using controls. These greater volumes are suggested to be pathological based on linkage to poorer executive functioning. Longitudinal studies are needed to examine typical cerebellar development during adolescence and the influence of marijuana use. PMID:20413277

  10. Rapid Recovery of Vesicular Dopamine Levels in Methamphetamine Users in Early Abstinence

    PubMed Central

    Boileau, Isabelle; McCluskey, Tina; Tong, Junchao; Furukawa, Yoshiaki; Houle, Sylvain; Kish, Stephen J

    2016-01-01

    We previously reported very low levels of dopamine in post-mortem striatum of chronic methamphetamine users, raising the possibility that restoration of normal dopamine levels could help in this addiction and perhaps prevent early relapse. To establish relevance of this finding to the living brain, we tested whether striatal [11C]-(+)-dihydrotetrabenazine binding, a vesicular monoamine transporter probe sensitive to changes in (stored) vesicular dopamine, is elevated in methamphetamine users. Chronic methamphetamine users underwent [11C]-(+)-dihydrotetrabenazine positron emission tomography scans during early (mean 2.6 days) and later (~10 days) abstinence. Striatal [11C]-(+)-dihydrotetrabenazine binding was elevated (suggesting low stored dopamine) in methamphetamine users (n=28; 2.6 days after last use) relative to controls (n=22) (+28%, p<0.0001) and correlated with severity and recency of drug use and with cognitive impairment and withdrawal symptoms. Mean [11C]-(+)-dihydrotetrabenazine binding levels in the subgroup of methamphetamine users who could remain abstinent ~10 days following last use (n=17) were normal at the follow-up scan. Our imaging data support post-mortem findings and suggest that chronic methamphetamine users have low brain levels of stored dopamine during very early abstinence from MA, which could contribute to behavioral and cognitive deficits. Findings also suggest a rapid recovery of stored dopamine in some methamphetamine users who become abstinent and who therefore might not benefit from dopamine replacement medication (eg, levodopa). Further study is necessary to establish whether those users who could not maintain abstinence for the second scan might have a more severe and persistent dopamine deficiency and who could benefit from this medication. PMID:26321315

  11. Rapid Recovery of Vesicular Dopamine Levels in Methamphetamine Users in Early Abstinence.

    PubMed

    Boileau, Isabelle; McCluskey, Tina; Tong, Junchao; Furukawa, Yoshiaki; Houle, Sylvain; Kish, Stephen J

    2016-03-01

    We previously reported very low levels of dopamine in post-mortem striatum of chronic methamphetamine users, raising the possibility that restoration of normal dopamine levels could help in this addiction and perhaps prevent early relapse. To establish relevance of this finding to the living brain, we tested whether striatal [(11)C]-(+)-dihydrotetrabenazine binding, a vesicular monoamine transporter probe sensitive to changes in (stored) vesicular dopamine, is elevated in methamphetamine users. Chronic methamphetamine users underwent [(11)C]-(+)-dihydrotetrabenazine positron emission tomography scans during early (mean 2.6 days) and later (~10 days) abstinence. Striatal [(11)C]-(+)-dihydrotetrabenazine binding was elevated (suggesting low stored dopamine) in methamphetamine users (n=28; 2.6 days after last use) relative to controls (n=22) (+28%, p<0.0001) and correlated with severity and recency of drug use and with cognitive impairment and withdrawal symptoms. Mean [(11)C]-(+)-dihydrotetrabenazine binding levels in the subgroup of methamphetamine users who could remain abstinent ~10 days following last use (n=17) were normal at the follow-up scan. Our imaging data support post-mortem findings and suggest that chronic methamphetamine users have low brain levels of stored dopamine during very early abstinence from MA, which could contribute to behavioral and cognitive deficits. Findings also suggest a rapid recovery of stored dopamine in some methamphetamine users who become abstinent and who therefore might not benefit from dopamine replacement medication (eg, levodopa). Further study is necessary to establish whether those users who could not maintain abstinence for the second scan might have a more severe and persistent dopamine deficiency and who could benefit from this medication.

  12. Memory performance in abstinent 3,4-methylenedioxymethamphetamine (MDMA, "ecstasy") users.

    PubMed

    Groth-Marnat, Gary; Howchar, Hennedy; Marsh, Ali

    2007-02-01

    Research with animals and humans has suggested that acute and subacute use of 3,4-methylenedioxymethamphetamine (MDMA "ecstasy") may lead to memory impairment. However, research is limited by (1) low power due to small sample sizes, (2) the possible confound of polydrug use, and (3) the failure to consider intelligence as a covariate. The present study compared the memory performance on the Wechsler Memory Scale-III of 26 abstinent (2-wk. minimum) recreational MDMA users with 26 abstinent (2-wk. minimum) recreational polydrug users. Despite significantly greater polydrug use amongst these MDMA users, no significant group differences in memory were observed. Regression of total lifetime amount of MDMA use also did not predict memory performance after accounting for intelligence. In addition, the length of time since abstinence (at least 2 wk.) was not associated with an increase in memory performance. Greater total lifetime cocaine use, rather than total lifetime MDMA use, was significantly associated with greater decrements in General Memory and Delayed Verbal Memory performance.

  13. Executive function deficits in short-term abstinent cannabis users.

    PubMed

    McHale, Sue; Hunt, Nigel

    2008-07-01

    Few cognitive tasks are adequately sensitive to show the small decrements in performance in abstinent chronic cannabis users. In this series of three experiments we set out to demonstrate a variety of tasks that are sufficiently sensitive to show differences in visual memory, verbal memory, everyday memory and executive function between controls and cannabis users. A series of three studies explored cognitive function deficits in cannabis users (phonemic verbal fluency, visual recognition and immediate and delayed recall, and prospective memory) in short-term abstinent cannabis users. Participants were selected using snowball sampling, with cannabis users being compared to a standard control group and a tobacco-use control group. The cannabis users, compared to both control groups, had deficits on verbal fluency, visual recognition, delayed visual recall, and short- and long-interval prospective memory. There were no differences for immediate visual recall. These findings suggest that cannabis use leads to impaired executive function. Further research needs to explore the longer term impact of cannabis use. Copyright 2008 John Wiley & Sons, Ltd.

  14. Decreased cerebral blood flow of the right anterior cingulate cortex in long-term and short-term abstinent methamphetamine users.

    PubMed

    Hwang, Jaeuk; Lyoo, In Kyoon; Kim, Seog Ju; Sung, Young Hoon; Bae, Soojeong; Cho, Sung-Nam; Lee, Ho Young; Lee, Dong Soo; Renshaw, Perry F

    2006-04-28

    The aim of the current study was to explore changes of relative regional cerebral blood flow (rCBF) in short-term and long-term abstinent methamphetamine (MA) users. Relative rCBF in 40 abstinent MA users and 23 healthy comparison subjects was compared by the technetium-99m-hexamethyl-propylene amine oxime ((99m)Tc-HMPAO) single photon emission computed tomography (SPECT). Relative rCBF in areas that were found to differ significantly was also compared in groups of MA users with short-term (<6 months) and long-term (>or=6 months) abstinence. MA users showed decreased relative rCBF in the right anterior cingulate cortex (Brodmann area 32) relative to healthy comparison subjects. Long-term abstinent MA users had significantly greater rCBF than short-term abstinent MA users. We report that abstinent MA users have decreased rCBF in the anterior cingulate cortex with smaller relative decreases in subjects with prolonged abstinence.

  15. A qualitative study of methamphetamine users' perspectives on barriers and facilitators of drug abstinence.

    PubMed

    Herbeck, Diane M; Brecht, Mary-Lynn; Christou, Dayna; Lovinger, Katherine

    2014-01-01

    To better understand methamphetamine (MA) use patterns and the process of recovery, qualitative interviews were conducted with adult MA users (n = 20), comparing a sample that received substance abuse treatment with those who had not received treatment. Respondents provided detailed information on why and how they changed from use to abstinence and factors they considered to be barriers to abstinence. Audio recordings and transcripts were reviewed for common themes. Participants reported a range of mild/moderate to intensely destructive problems, including loss of important relationships and profound changes to who they felt they were at their core; e.g., "I didn't realize how dark and mean I was … I was like a different person." Initial abstinence was often facilitated by multiple external forces (e.g., drug testing, child custody issues, prison, relocation), but sustained abstinence was attributed to shifts in thinking and salient realizations about using. The treatment group reported using more and different resources to maintain their abstinence than the no-treatment group. Findings indicate individualized interventions and multiple, simultaneous approaches and resources were essential in reaching stable abstinence. Understanding long-term users' experiences with MA use, addiction, and abstinence can inform strategies for engaging and sustaining MA users in treatment and recovery.

  16. Increased blood 8-hydroxy-2-deoxyguanosine levels in methamphetamine users during early abstinence.

    PubMed

    Huang, Ming-Chyi; Lai, Ying-Ching; Lin, Shih-Ku; Chen, Chun-Hsin

    2018-01-01

    Reactive oxygen species (ROS) are thought to play a role in the adverse physical and mental consequences of methamphetamine usage. The oxidative DNA adduct 8-hydroxy-2'-deoxyguanosine (8-OHdG) is a well-known biomarker of ROS-induced DNA damage. Currently, there is insufficient clinical information about methamphetamine-induced oxidative DNA damage. This study examined differences in blood levels of 8-OHdG between methamphetamine users and non-users as well as alterations in 8-OHdG levels after 2 weeks of methamphetamine abstinence. We recruited 182 methamphetamine users (78.6% of male) and 71 healthy controls (95.8% of male). Baseline serum 8-OHdG levels were measured in both groups using a competitive enzyme-linked immunosorbent assay. In methamphetamine users, 8-OHdG levels were measured again 2 weeks after baseline measurement. The results showed that methamphetamine users had significantly higher 8-OHdG levels (0.34 ± 0.13 ng/mL) than healthy controls (0.30 ± 0.08 ng/mL) (p < 0.001). The 8-OHdG levels did not alter after 2 weeks of methamphetamine abstinence (0.32 ± 0.12 ng/mL, p = 0.051 compared to baseline measurement; p = 0.12 compared to healthy controls). No significant correlations were observed between baseline 8-OHdG levels in methamphetamine users and post-abstinence interval, age of the first methamphetamine use, duration of methamphetamine use, or history of frequent methamphetamine use. Our findings suggest that methamphetamine users had an enhanced level of oxidative damage, which did not normalize during early abstinence. Future studies are required to determine the effects of long-term methamphetamine abstinence and potential confounders on 8-OHdG levels in methamphetamine users.

  17. Memory deficits in abstinent MDMA (ecstasy) users: neuropsychological evidence of frontal dysfunction.

    PubMed

    Quednow, Boris B; Jessen, Frank; Kuhn, Kai-Uwe; Maier, Wolfgang; Daum, Irene; Wagner, Michael

    2006-05-01

    Chronic administration of the common club drug 3,4-methylenedioxymethamphetamine (MDMA, ecstasy) is associated with long-term depletion of serotonin (5-HT) and loss of 5-HT axons in the brains of rodents and non-human primates, and evidence suggests that recreational MDMA consumption may also affect the human serotonergic system. Moreover, it was consistently shown that abstinent MDMA users have memory deficits. Recently, it was supposed that these deficits are an expression of a temporal or rather hippocampal dysfunction caused by the serotonergic neurotoxicity of MDMA. The aim of this study is to examine the memory deficits of MDMA users neuropsychologically in order to evaluate the role of different brain regions. Nineteen male abstinent MDMA users, 19 male abstinent cannabis users and 19 male drug-naive control subjects were examined with a German version of the Rey Auditory Verbal Learning Test (RAVLT). MDMA users showed widespread and marked verbal memory deficits, compared to drug-naive controls as well as compared to cannabis users, whereas cannabis users did not differ from control subjects in their memory performance. MDMA users revealed impairments in learning, consolidation, recall and recognition. In addition, they also showed a worse recall consistency and strong retroactive interference whereby both measures were previously associated with frontal lobe function. There was a significant correlation between memory performance and the amount of MDMA taken. These results suggest that the memory deficits of MDMA users are not only the result of a temporal or hippocampal dysfunction, but also of a dysfunction of regions within the frontal cortex.

  18. A Contingency Management Method for 30-Days Abstinence in Non-Treatment Seeking Young Adult Cannabis Users*

    PubMed Central

    Schuster, Randi Melissa; Hanly, Ailish; Gilman, Jodi; Budney, Alan; Vandrey, Ryan; Evins, A. Eden

    2016-01-01

    Background Rates of young adult cannabis use are rising, perceived harm is at its historical nadir, and most users do not want to quit. Most studies evaluating effects of cannabis use in young adults are cross-sectional, limiting causal inference. A method to reliably induce abstinence periods in cannabis users would allow assessment of the effects of abstinence and resumption of use on a variety of outcomes in a within subjects, repeated measure design. Methods We examined the efficacy and feasibility of a voucher-based contingency management procedure for incentivizing one month of continuous cannabis abstinence among young adults who reported at least weekly cannabis use, volunteered to participate in a laboratory study, and did not express desire to discontinue cannabis use long-term. Continuous cannabis abstinence was reinforced with an escalating incentive schedule, and self-report of abstinence was confirmed by frequent quantitative assays of urine cannabis metabolite (THCCOOH) concentration. New cannabis use during the abstinence period was determined using an established algorithm of change in creatinine-adjusted cannabis metabolite concentration between study visits. Results Thirty-eight young adults, aged 18–25, enrolled and 34 (89.5%) attained biochemically confirmed 30-day abstinence. Among those who attained abstinence, 93.9% resumed regular use within two-weeks of incentive discontinuation. Conclusion Findings support the feasibility and efficacy of contingency management to elicit short-term, continuous cannabis abstinence among young adult, non-treatment-seeking, regular cannabis users. Further work should test the effectiveness of this CM procedure for cannabis abstinence periods longer than one month, which may be required to evaluate some effects of abstinence. PMID:27590742

  19. A contingency management method for 30-days abstinence in non-treatment seeking young adult cannabis users.

    PubMed

    Schuster, Randi Melissa; Hanly, Ailish; Gilman, Jodi; Budney, Alan; Vandrey, Ryan; Evins, A Eden

    2016-10-01

    Rates of young adult cannabis use are rising, perceived harm is at its historical nadir, and most users do not want to quit. Most studies evaluating effects of cannabis use in young adults are cross-sectional, limiting causal inference. A method to reliably induce abstinence periods in cannabis users would allow assessment of the effects of abstinence and resumption of use on a variety of outcomes in a within-subjects, repeated measures design. We examined the efficacy and feasibility of a voucher-based contingency management procedure for incentivizing one month of continuous cannabis abstinence among young adults who reported at least weekly cannabis use, volunteered to participate in a laboratory study, and did not express a desire to discontinue cannabis use long-term. Continuous cannabis abstinence was reinforced with an escalating incentive schedule, and self-report of abstinence was confirmed by frequent quantitative assays of urine cannabis metabolite (THCCOOH) concentration. New cannabis use during the abstinence period was determined using an established algorithm of change in creatinine-adjusted cannabis metabolite concentrations between study visits. Thirty-eight young adults, aged 18-25 years, enrolled and 34 (89.5%) attained biochemically confirmed 30-day abstinence. Among those who attained abstinence, 93.9% resumed regular use within two-weeks of incentive discontinuation. Findings support the feasibility and efficacy of contingency management to elicit short-term, continuous cannabis abstinence among young adult, non-treatment seeking, regular cannabis users. Further work should test the effectiveness of this contingency management procedure for cannabis abstinence in periods longer than one month, which may be required to evaluate some effects of abstinence. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  20. Mismatch Negativity and P50 Sensory Gating in Abstinent Former Cannabis Users

    PubMed Central

    Broyd, Samantha J.; Greenwood, Lisa-marie; van Hell, Hendrika H.; Croft, Rodney J.; Coyle, Hannah; Lee-Bates, Ben; Todd, Juanita; Johnstone, Stuart J.; Michie, Patricia T.; Solowij, Nadia

    2016-01-01

    Prolonged heavy exposure to cannabis is associated with impaired cognition and brain functional and structural alterations. We recently reported attenuated mismatch negativity (MMN) and altered P50 sensory gating in chronic cannabis users. This study investigated the extent of brain functional recovery (indexed by MMN and P50) in chronic users after cessation of use. Eighteen ex-users (median 13.5 years prior regular use; median 3.5 years abstinence) and 18 nonusers completed (1) a multifeature oddball task with duration, frequency, and intensity deviants and (2) a P50 paired-click paradigm. Trend level smaller duration MMN amplitude and larger P50 ratios (indicative of poorer sensory gating) were observed in ex-users compared to controls. Poorer P50 gating correlated with prior duration of cannabis use. Duration of abstinence was positively correlated with duration MMN amplitude, even after controlling for age and duration of cannabis use. Impaired sensory gating and attenuated MMN amplitude tended to persist in ex-users after prolonged cessation of use, suggesting a lack of full recovery. An association with prolonged duration of prior cannabis use may indicate persistent cannabis-related alterations to P50 sensory gating. Greater reductions in MMN amplitude with increasing abstinence (positive correlation) may be related to either self-medication or an accelerated aging process. PMID:27019754

  1. Daily marijuana users with past alcohol problems increase alcohol consumption during marijuana abstinence.

    PubMed

    Peters, Erica N; Hughes, John R

    2010-01-15

    Drug abuse treatment programs typically recommend complete abstinence because of a fear that clients who stop use of one drug will substitute another. A within-subjects study investigated whether consumption of alcohol and other substances changes during marijuana abstinence. Twenty-eight daily marijuana users who were not trying to stop or reduce their marijuana consumption completed an 8-day baseline period in which they used marijuana and other drugs as usual, a 13-day marijuana abstinence period, and a 7-day return-to-baseline period. Participants provided self-report of substance use daily and submitted urine samples twice weekly to verify marijuana abstinence. A diagnosis of past alcohol abuse or dependence significantly moderated the alcohol increase from baseline to marijuana abstinence (p<0.01), such that individuals with this diagnosis significantly increased alcohol use (52% increase) but those without this history did not (3% increase). Increases in marijuana withdrawal discomfort scores and alcohol craving scores from baseline to marijuana abstinence significantly and positively correlated with increases in alcohol use. Increases in cigarettes, caffeine, and non-marijuana illicit drugs did not occur. This study provides empirical validation of drug substitution in a subgroup of daily marijuana users, but results need to be replicated in individuals who seek treatment for marijuana problems. Copyright (c) 2009 Elsevier Ireland Ltd. All rights reserved.

  2. Predictors of Smokeless Tobacco Abstinence

    PubMed Central

    Ebbert, Jon O.; Glover, Elbert; Shinozaki, Eri; Schroeder, Darrell R.; Dale, Lowell C.

    2010-01-01

    Objectives To investigate predictors of tobacco abstinence among smokeless tobacco (ST) users. Methods Logistic regression analyses assessed characteristics associated with tobacco abstinence among ST users receiving bupropion SR. Results Older age was associated with increased tobacco abstinence in both placebo and bupropion SR groups at end of treatment and one year. Abstinence was lower at one year for subjects with a history of major depression. At end of treatment, a 2-way interaction was detected suggesting bupropion SR may be efficacious for subjects with other household tobacco users. Conclusions Younger ST users and those with a history of depression are less likely to quit ST use. PMID:18442352

  3. Predictors of Smokeless Tobacco Abstinence

    ERIC Educational Resources Information Center

    Ebbert, Jon O.; Glover, Elbert D.; Shinozaki, Eri; Schroeder, Darrell R.; Dale, Lowell C.

    2008-01-01

    Objectives: To investigate predictors of tobacco abstinence among smokeless tobacco (ST) users. Methods: Logistic regression analyses assessed characteristics associated with tobacco abstinence among ST users receiving bupropion SR. Results: Older age was associated with increased tobacco abstinence in both placebo and bupropion SR groups at end…

  4. Effects of lower-cost incentives on stimulant abstinence in methadone maintenance treatment: a National Drug Abuse Treatment Clinical Trials Network study.

    PubMed

    Peirce, Jessica M; Petry, Nancy M; Stitzer, Maxine L; Blaine, Jack; Kellogg, Scott; Satterfield, Frank; Schwartz, Marion; Krasnansky, Joe; Pencer, Eileen; Silva-Vazquez, Lolita; Kirby, Kimberly C; Royer-Malvestuto, Charlotte; Roll, John M; Cohen, Allan; Copersino, Marc L; Kolodner, Ken; Li, Rui

    2006-02-01

    Contingency management interventions that provide tangible incentives based on objective indicators of drug abstinence have improved treatment outcomes of substance abusers, but have not been widely implemented in community drug abuse treatment settings. To compare outcomes achieved when a lower-cost prize-based contingency management treatment is added to usual care in community methadone hydrochloride maintenance treatment settings. Random assignment to usual care with (n = 198) or without (n = 190) abstinence incentives during a 12-week trial. Six community-based methadone maintenance drug abuse treatment clinics in locations across the United States. Three hundred eighty-eight stimulant-abusing patients enrolled in methadone maintenance programs for at least 1 month and no more than 3 years. Participants submitting stimulant- and alcohol-negative samples earned draws for a chance to win prizes; the number of draws earned increased with continuous abstinence time. Total number of stimulant- and alcohol-negative samples provided, percentage of stimulant- and alcohol-negative samples provided, longest duration of abstinence, retention, and counseling attendance. Submission of stimulant- and alcohol-negative samples was twice as likely for incentive as for usual care group participants (odds ratio, 1.98; 95% confidence interval, 1.42-2.77). Achieving 4 or more, 8 or more, and 12 weeks of continuous abstinence was approximately 3, 9, and 11 times more likely, respectively, for incentive vs usual care participants. Groups did not differ on study retention or counseling attendance. The average cost of prizes was 120 dollars per participant. An abstinence incentive approach that paid 120 dollars in prizes per participant effectively increased stimulant abstinence in community-based methadone maintenance treatment clinics.

  5. A survey of nonmedical use of tranquilizers, stimulants, and pain relievers among college students: patterns of use among users and factors related to abstinence in non-users.

    PubMed

    Brandt, Sara A; Taverna, Elise C; Hallock, Robert M

    2014-10-01

    This study examined lifetime non-medical prescription drug use among college students at a small liberal arts college in the Northeast. We assessed the motives, frequency of use, sources, and perceived emotional/physical risks of nonmedical prescription drugs. Specifically, we examined the non-medical use of prescription pain relievers, stimulants, and anti-anxiety medication. We sent an internet-based survey to 1/3 of the student body and 303 students completed the survey. We found that 36.8% of the sample reported using prescription drugs for non-medical purposes. First-year students were less likely to have used the drugs than those in other class years. Of those reporting use, 48% reported non-medical use of pain relievers, 72.8% reported using stimulants, and 39.8% reported using anti-anxiety medication. The most commonly used pain relievers were Vicodin (hydrocodone/acetaminophen), OxyContin (oxycodone), and codeine (acetaminophen/codeine). The most commonly used stimulants were Adderall (amphetamine/dextroamphetamine) and Ritalin (methylphenidate), while the most commonly used anti-anxiety medication was Xanax (alprazolam). When non-users were asked what factors influenced their choice not to abuse prescription drugs, 82% cited a lack of interest, 61% responded it was due to a fear of damaging their physical health, and 60.1% responded fear of damaging their mental health. This study supports recent findings that show widespread non-medical use of prescription drugs among college students. Our report brings a more detailed understanding of the patterns of drug usage, and the factors influencing both drug use in those who use them and abstinence in those who choose not to use them. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  6. Spatial Working Memory Performance and fMRI Activation Interactions in Abstinent Adolescent Marijuana Users

    PubMed Central

    Padula, Claudia B.; Schweinsburg, Alecia D.; Tapert, Susan F.

    2008-01-01

    Previous studies have suggested neural disruption and reorganization in adult marijuana users. However, it remains unclear whether these effects persist in adolescents after 28 days of abstinence and, if they do, what Performance × Brain Response interactions occur. Adolescent marijuana users (n = 17) and controls (n = 17) aged 16–18 years were recruited from local schools. Functional magnetic resonance imaging data were collected after 28 days’ monitored abstinence as participants performed a spatial working memory task. Marijuana users show Performance × Brain Response interactions in the bilateral temporal lobes, left anterior cingulate, left parahippocampal gyrus, and right thalamus (clusters ≥ 1358 μl; p <.05), although groups do not differ on behavioral measures of task performance. Marijuana users show differences in brain response to a spatial working memory task despite adequate performance, suggesting a different approach to the task via altered neural pathways. PMID:18072830

  7. From Abstinence to Relapse: A Preliminary Qualitative Study of Drug Users in a Compulsory Drug Rehabilitation Center in Changsha, China

    PubMed Central

    Yang, Mei; Mamy, Jules; Gao, Pengcheng; Xiao, Shuiyuan

    2015-01-01

    Background Relapse among abstinent drug users is normal. Several factors are related to relapse, but it remains unclear what individuals’ actual life circumstances are during periods of abstinence, and how these circumstances facilitate or prevent relapse. Objective To illuminate drug users’ experiences during abstinence periods and explore the real-life catalysts and inhibitors contributing to drug use relapse. Method Qualitative in-depth interviews were conducted with 20 drug users recruited from a compulsory isolated drug rehabilitation center in Changsha. The interviews were guided by open-ended questions on individuals’ experiences in drug use initiation, getting addicted, treatment history, social environment, abstinence, and relapse. Participants were also encouraged to share their own stories. Interviews were digitally recorded and fully transcribed. The data of 18 participants who reported abstinence experiences before admission were included in the analyses. The data were analyzed using a thematic analysis with inductive hand coding to derive themes. Results Most drug users were able to successfully abstain from drugs. During abstinence, their lives were congested with challenges, such as adverse socioeconomic conditions, poor family/social support, interpersonal conflicts, and stigma and discrimination, all of which kept them excluded from mainstream society. Furthermore, the police’s system of ID card registration, which identifies individuals as drug users, worsened already grave situations. Relapse triggers reported by the participants focused mainly on negative feelings, interpersonal conflicts, and stressful events. Craving was experienced but not perceived as a relapse trigger by most participants. Conclusions This study of in-depth interview with drug users found evidence of situations and environments they live during abstinence appear rather disadvantaged, making it extremely difficult for them to remain abstinent. Comprehensive programs

  8. University students' definitions of sexual abstinence and having sex.

    PubMed

    Byers, E Sandra; Henderson, Joel; Hobson, Kristina M

    2009-10-01

    We asked 298 heterosexual Canadian university students about their definitions of the terms abstinence and having sex. For both terms, students were provided with a list of 17 sexual behaviors and indicated whether they would include each in their definition. The majority of both male and female students included activities that did not involve genital stimulation in their definition of sexual abstinence and did not include these activities in their definition of having sex. Conversely, most students did not include bidirectional sexual stimulation (penile-vaginal intercourse or penile-anal intercourse) in their definitions of sexual abstinence but did include them in their definitions of having sex. Students were quite mixed in whether activities involving unidirectional genital stimulation (e.g., oral sex, genital fondling) constituted abstinence, having sex, or neither abstinence nor having sex. However, they were more likely to see these behaviors as abstinent than as having sex. Students were more likely to rate a behavior as abstinence if orgasm did not occur. A canonical correlation analysis was used to examine the patterns of association between a number of predictors and inclusions of behaviors involving no genital stimulation, unidirectional stimulation, and bidirectional genital stimulation in abstinence definitions. The results indicated that male participants who were more involved with their religion and sexually conservative, less sexually experienced, and who had not received sexual health education at home were more likely to define bidirectional genital stimulation and less likely to define no genital stimulation and unidirectional sexual stimulation as sexual abstinence. The research and health promotion implications of these results are discussed.

  9. Illicit stimulant use in humans is associated with a long-term increase in tremor.

    PubMed

    Flavel, Stanley C; Koch, Jenna D; White, Jason M; Todd, Gabrielle

    2012-01-01

    Use of illicit stimulants such as methamphetamine, cocaine, and ecstasy is a significant health problem. The United Nations Office on Drugs and Crime estimates that 14-57 million people use stimulants each year. Chronic use of illicit stimulants can cause neurotoxicity in animals and humans but the long-term functional consequences are not well understood. Stimulant users self-report problems with tremor whilst abstinent. Thus, the aim of the current study was to investigate the long-term effect of stimulant use on human tremor during rest and movement. We hypothesized that individuals with a history of stimulant use would exhibit abnormally large tremor during rest and movement. Tremor was assessed in abstinent ecstasy users (n = 9; 22 ± 3 yrs) and abstinent users of amphetamine-like drugs (n = 7; 33 ± 9 yrs) and in two control groups: non-drug users (n = 23; 27 ± 8 yrs) and cannabis users (n = 12; 24 ± 7 yrs). Tremor was measured with an accelerometer attached to the index finger at rest (30 s) and during flexion and extension of the index finger (30 s). Acceleration traces were analyzed with fast-Fourier transform. During movement, tremor amplitude was significantly greater in ecstasy users than in non-drug users (frequency range 3.9-13.3 Hz; P<0.05), but was unaffected in cannabis users or users of amphetamine-like drugs. The peak frequency of tremor did not significantly differ between groups nor did resting tremor. In conclusion, abstinent ecstasy users exhibit an abnormally large tremor during movement. Further work is required to determine if the abnormality translates to increased risk of movement disorders in this population.

  10. Modulation of risk-taking in marijuana users by transcranial direct current stimulation (tDCS) of the dorsolateral prefrontal cortex (DLPFC).

    PubMed

    Boggio, Paulo S; Zaghi, Soroush; Villani, Ana Beatriz; Fecteau, Shirley; Pascual-Leone, Alvaro; Fregni, Felipe

    2010-12-01

    Cognitive deficits that are reported in heavy marijuana users (attention, memory, affect perception, decision-making) appear to be completely reversible after a prolonged abstinence period of about 28 days. However, it remains unclear whether the reversibility of these cognitive deficits indicates that (1) chronic marijuana use is not associated with long-lasting changes in cortical networks or (2) that such changes occur but the brain adapts to and compensates for the drug-induced changes. Therefore, we examined whether chronic marijuana smokers would demonstrate a differential pattern of response in comparison to healthy volunteers on a decision-making paradigm (Risk Task) while undergoing sham or active transcranial direct current stimulation (tDCS) of the dorsolateral prefrontal cortex (DLPFC). Twenty-five chronic marijuana users who were abstinent for at least 24h were randomly assigned to receive left anodal/right cathodal tDCS of DLPFC (n=8), right anodal/left cathodal tDCS of DLPFC (n=9), or sham stimulation (n=8); results on Risk Task during sham/active tDCS were compared to healthy volunteers from a previously published dataset. Chronic marijuana users demonstrated more conservative (i.e. less risky) decision-making during sham stimulation. While right anodal stimulation of the DLPFC enhanced conservative decision-making in healthy volunteers, both right anodal and left anodal DLPFC stimulation increased the propensity for risk-taking in marijuana users. These findings reveal alterations in the decision-making neural networks among chronic marijuana users. Finally, we also assessed the effects of tDCS on marijuana craving and observed that right anodal/left cathodal tDCS of DLPFC is significantly associated with a diminished craving for marijuana. Copyright © 2010 Elsevier Ireland Ltd. All rights reserved.

  11. Monitoring cocaine use and abstinence among cocaine users for contingency management interventions.

    PubMed

    Holtyn, August F; Knealing, Todd W; Jarvis, Brantley P; Subramaniam, Shrinidhi; Silverman, Kenneth

    2017-06-01

    During contingency management interventions, reinforcement of cocaine abstinence is arranged by delivering an incentive when a urine sample tests cocaine-negative. The use of qualitative versus quantitative urinalysis testing may have important implications for effects on cocaine abstinence. Qualitative testing (i.e., testing that solely identifies whether a particular substance is present or absent) may not detect short-term cocaine abstinence because a single instance of cocaine use can result in cocaine-positive urine over many days. Quantitative testing (i.e., testing that identifies how much of a substance is present) may be more sensitive to short-term cocaine abstinence; however, the selection of a criterion for distinguishing new use versus carryover from previous use is an important consideration. The present study examined benzoylecgonine concentrations, the primary metabolite of cocaine, in urine samples collected three times per week for 30 weeks from 28 cocaine users who were exposed to a cocaine abstinence contingency. Of the positive urine samples (benzoylecgonine concentration >300 ng/ml), 29%, 21%, 14%, and 5% of the samples decreased in benzoylecgonine concentration by more than 20%, 40%, 60%, and 80% per day, respectively. As the size of the decrease increased, the likelihood of that sample occurring during a period leading to a cocaine-negative urine sample (benzoylecgonine concentration ≤300 ng/ml) also increased. The number of days required to produce a cocaine-negative sample following a positive sample ranged from 1 to 10 days and was significantly correlated with the starting benzoylecgonine level ( r = 0.43, p < 0.001). The present analyses may aid in the development of procedures that allow for the precise reinforcement of recent cocaine abstinence during contingency management interventions.

  12. Illicit Stimulant Use in Humans Is Associated with a Long-Term Increase in Tremor

    PubMed Central

    Flavel, Stanley C.; Koch, Jenna D.; White, Jason M.; Todd, Gabrielle

    2012-01-01

    Use of illicit stimulants such as methamphetamine, cocaine, and ecstasy is a significant health problem. The United Nations Office on Drugs and Crime estimates that 14–57 million people use stimulants each year. Chronic use of illicit stimulants can cause neurotoxicity in animals and humans but the long-term functional consequences are not well understood. Stimulant users self-report problems with tremor whilst abstinent. Thus, the aim of the current study was to investigate the long-term effect of stimulant use on human tremor during rest and movement. We hypothesized that individuals with a history of stimulant use would exhibit abnormally large tremor during rest and movement. Tremor was assessed in abstinent ecstasy users (n = 9; 22±3 yrs) and abstinent users of amphetamine-like drugs (n = 7; 33±9 yrs) and in two control groups: non-drug users (n = 23; 27±8 yrs) and cannabis users (n = 12; 24±7 yrs). Tremor was measured with an accelerometer attached to the index finger at rest (30 s) and during flexion and extension of the index finger (30 s). Acceleration traces were analyzed with fast-Fourier transform. During movement, tremor amplitude was significantly greater in ecstasy users than in non-drug users (frequency range 3.9–13.3 Hz; P<0.05), but was unaffected in cannabis users or users of amphetamine-like drugs. The peak frequency of tremor did not significantly differ between groups nor did resting tremor. In conclusion, abstinent ecstasy users exhibit an abnormally large tremor during movement. Further work is required to determine if the abnormality translates to increased risk of movement disorders in this population. PMID:23272201

  13. Dysregulated responses to emotions among abstinent heroin users: correlation with childhood neglect and addiction severity.

    PubMed

    Gerra, G; Somaini, L; Manfredini, M; Raggi, M A; Saracino, M A; Amore, M; Leonardi, C; Cortese, E; Donnini, C

    2014-01-03

    The aim of this paper was to investigate the subjective responses of abstinent heroin users to both neutral and negative stimuli and the related hypothalamus-pituitary-adrenal reactions to emotional experience in relationship to their perception of childhood adverse experiences. Thirty male abstinent heroin dependents were included in the study. Emotional responses and childhood neglect perception were measured utilizing the State-Trait Anxiety Inventory Y-1 and the Child Experience of Care and Abuse Questionnaire. Neutral and unpleasant pictures selected from the International Affective Picture System and the Self-Assessment Manikin procedure have been used to determine ratings of pleasure and arousal. These ratings were compared with normative values obtained from healthy volunteers used as control. Blood samples were collected before and after the experimental sessions to determine both adrenocorticotropic hormone and cortisol plasma levels. Basal anxiety scores, cortisol and adrenocorticotropic hormone levels were higher in abstinent heroin users than in controls. Tests showed that anxiety scores did not change in controls after the vision of neutral slides, whilst they did in abstinent heroin addicts, increasing significantly; and increased less significantly after the unpleasant task, in comparison to controls. Abstinent heroin users showed significantly higher levels of parent antipathy and childhood emotional neglect perception than controls for both the father and the mother. Plasma adrenocorticotropic hormone and cortisol levels did not significantly increase after unpleasant slide set viewing among addicted individuals, because of the significantly higher basal levels characterizing the addicted subjects in comparison with controls. Multiple regression correlation showed a significant relationship between childhood neglect perception, arousal reaction, impaired hypothalamus-pituitary-adrenal axis response and addiction severity. Early adverse experiences

  14. The therapeutic workplace to promote treatment engagement and drug abstinence in out-of-treatment injection drug users: a randomized controlled trial.

    PubMed

    Holtyn, August F; Koffarnus, Mikhail N; DeFulio, Anthony; Sigurdsson, Sigurdur O; Strain, Eric C; Schwartz, Robert P; Leoutsakos, Jeannie-Marie S; Silverman, Kenneth

    2014-11-01

    Determine if employment-based reinforcement can increase methadone treatment engagement and drug abstinence in out-of-treatment injection drug users. This study was conducted from 2008 to 2012 in a therapeutic workplace in Baltimore, MD. After a 4-week induction, participants (N=98) could work and earn pay for 26 weeks and were randomly assigned to Work Reinforcement, Methadone & Work Reinforcement, and Abstinence, Methadone & Work Reinforcement conditions. Work Reinforcement participants had to work to earn pay. Methadone & Work Reinforcement and Abstinence, Methadone, & Work Reinforcement participants had to enroll in methadone treatment to work and maximize pay. Abstinence, Methadone, & Work Reinforcement participants had to provide opiate- and cocaine-negative urine samples to maximize pay. Most participants (92%) enrolled in methadone treatment during induction. Drug abstinence increased as a graded function of the addition of the methadone and abstinence contingencies. Abstinence, Methadone & Work Reinforcement participants provided significantly more urine samples negative for opiates (75% versus 54%) and cocaine (57% versus 32%) than Work Reinforcement participants. Methadone & Work Reinforcement participants provided significantly more cocaine-negative samples than Work Reinforcement participants (55% versus 32%). The therapeutic workplace can promote drug abstinence in out-of-treatment injection drug users. Clinical trial registration number: NCT01416584. Copyright © 2014 Elsevier Inc. All rights reserved.

  15. The Therapeutic Workplace to Promote Treatment Engagement and Drug Abstinence in Out-of-Treatment Injection Drug Users: A Randomized Controlled Trial

    PubMed Central

    Holtyn, August F.; Koffarnus, Mikhail N.; DeFulio, Anthony; Sigurdsson, Sigurdur O.; Strain, Eric C.; Schwartz, Robert P.; Leoutsakos, Jeannie-Marie S.; Silverman, Kenneth

    2014-01-01

    Objective Determine if employment-based reinforcement can increase methadone treatment engagement and drug abstinence in out-of-treatment injection drug users. Method This study was conducted from 2008–2012 in a therapeutic workplace in Baltimore, MD. After a 4-week induction, participants (N=98) could work and earn pay for 26 weeks and were randomly assigned to Work Reinforcement, Methadone & Work Reinforcement, and Abstinence, Methadone & Work Reinforcement conditions. Work Reinforcement participants had to work to earn pay. Methadone & Work Reinforcement, and Abstinence, Methadone, & Work Reinforcement participants had to enroll in methadone treatment to work and maximize pay. Abstinence, Methadone, & Work Reinforcement participants had to provide opiate- and cocaine-negative urine samples to maximize pay. Results Most participants (92%) enrolled in methadone treatment during induction. Drug abstinence increased as a graded function of the addition of the methadone and abstinence contingencies. Abstinence, Methadone & Work Reinforcement participants provided significantly more urine samples negative for opiates (75% versus 54%) and cocaine (57% versus 32%) than Work Reinforcement participants. Methadone & Work Reinforcement participants provided significantly more cocaine-negative samples than Work Reinforcement participants (55% versus 32%). Conclusion The therapeutic workplace can promote drug abstinence in out-of-treatment injection drug users. PMID:24607365

  16. Cognitive function in ecstasy naive abstinent drug dependants and MDMA users.

    PubMed

    Potter, Adam; Downey, Luke; Stough, Con

    2013-03-01

    'Hidden' symptoms, or subtle cognitive deficits and long-term changes in mood, have been linked to the recreational use of 3, 4-methylenedioxymethamphetamine/MDMA, and are notionally present in non-heavy polydrug users. This study assessed the cognitive functioning and mood profiles of clinically diagnosed drug dependents who had never consumed MDMA, recreational drug users that had previously consumed MDMA, with both groups having not consumed illicit drugs for 6-months, and a control group with limited illicit drug use and no MDMA usage in their past. Cognitive functioning was assessed using the Cognitive Drug Research computerised cognitive assessment system and participants completed the Profile of Mood States and Beck Depression Inventory to assess their current mood and depression. Participants in the clinically diagnosed drug dependent group scored significantly worse on the 'Quality of Working Memory' cognitive factor score than both the MDMA and control group (F (2, 33) = 5.75, p = 0.007). The control and clinical groups also differed on depression scores (U [16] = 13.00, p = 0.016) and Tension/Anxiety scores (U [16] = 16.00, p = 0.034), with the clinical group scoring significantly higher in both cases. The MDMA group did not differ from the control group on the measures of cognition or mood. These results suggest that despite a 6-month prolonged abstinence the cognitive deficits ostensibly caused by 'heavy' usage or the dependence on or abuse of illicit drugs are not reversed by abstinence.

  17. Increased vesicular monoamine transporter binding during early abstinence in human methamphetamine users: Is VMAT2 a stable dopamine neuron biomarker?

    PubMed

    Boileau, Isabelle; Rusjan, Pablo; Houle, Sylvain; Wilkins, Diana; Tong, Junchao; Selby, Peter; Guttman, Mark; Saint-Cyr, Jean A; Wilson, Alan A; Kish, Stephen J

    2008-09-24

    Animal data indicate that methamphetamine can damage striatal dopamine terminals. Efforts to document dopamine neuron damage in living brain of methamphetamine users have focused on the binding of [(11)C]dihydrotetrabenazine (DTBZ), a vesicular monoamine transporter (VMAT2) positron emission tomography (PET) radioligand, as a stable dopamine neuron biomarker. Previous PET data report a slight decrease in striatal [(11)C]DTBZ binding in human methamphetamine users after prolonged (mean, 3 years) abstinence, suggesting that the reduction would likely be substantial in early abstinence. We measured striatal VMAT2 binding in 16 recently withdrawn (mean, 19 d; range, 1-90 d) methamphetamine users and in 14 healthy matched-control subjects during a PET scan with (+)[(11)C]DTBZ. Unexpectedly, striatal (+)[(11)C]DTBZ binding was increased in methamphetamine users relative to controls (+22%, caudate; +12%, putamen; +11%, ventral striatum). Increased (+)[(11)C]DTBZ binding in caudate was most marked in methamphetamine users abstinent for 1-3 d (+41%), relative to the 7-21 d (+15%) and >21 d (+9%) groups. Above-normal VMAT2 binding in some drug users suggests that any toxic effect of methamphetamine on dopamine neurons might be masked by an increased (+)[(11)C]DTBZ binding and that VMAT2 radioligand binding might not be, as is generally assumed, a "stable" index of dopamine neuron integrity in vivo. One potential explanation for increased (+)[(11)C]DTBZ binding is that VMAT2 binding is sensitive to changes in vesicular dopamine storage levels, presumably low in drug users. If correct, (+)[(11)C]DTBZ might be a useful imaging probe to correlate changes in brain dopamine stores and behavior in users of methamphetamine.

  18. Enhanced intensity dependence and aggression history indicate previous regular ecstasy use in abstinent polydrug users.

    PubMed

    Wan, Li; Baldridge, Robyn M; Colby, Amanda M; Stanford, Matthew S

    2009-11-13

    Intensity dependence is an electrophysiological measure of intra-individual stability of the augmenting/reducing characteristic of N1/ P2 event-related potential amplitudes in response to stimuli of varying intensities. Abstinent ecstasy users typically show enhanced intensity dependence and higher levels of impulsivity and aggression. Enhanced intensity dependence and high impulsivity and aggression levels may be due to damage in the brain's serotonergic neurons as a result of ecstasy use. The present study investigated whether intensity dependence, impulsivity and aggression history can be used as indicators of previous chronic ecstasy usage. Forty-four abstinent polydrug users (8 women; age 19 to 61 years old) were recruited. All participants were currently residents at a local substance abuse facility receiving treatment and had been free of all drugs for a minimum of 21 days. The study found significantly enhanced intensity dependence of tangential dipole source activity and a history of more aggressive behavior in those who had previously been involved in chronic ecstasy use. Intensity dependence of the tangential dipole source and aggressive behavior history correctly identified 73.3% of those who had been regular ecstasy users and 78.3% of those who had not. Overall, 76.3% of the participants were correctly classified.

  19. Increased self-reported impulsivity in methamphetamine users maintaining drug abstinence.

    PubMed

    Jones, Hannah W; Dean, Andy C; Price, Kimberly A; London, Edythe D

    2016-09-01

    Impulsivity has been proposed as an important factor in the initiation and maintenance of addiction. Indirect evidence suggests that some methamphetamine users report less impulsivity when they are using methamphetamine compared to when abstaining from drug use, but this hypothesis has not been directly tested. In this study, self-reports of impulsivity were obtained from 32 methamphetamine-dependent (DSM-IV) research participants and 41 healthy control subjects, using the Barratt Impulsiveness Scale-11. The methamphetamine users were assessed during an active period of methamphetamine use, as determined through urinalysis, and again after approximately 1 week of confirmed abstinence. Control subjects likewise completed two assessments. A subset of participants also completed serial assessments of the Beck Depression Inventory (Methamphetamine Group, N = 17, Control Group, N = 38) and the Methamphetamine Withdrawal Questionnaire (Methamphetamine Group, N = 12). There was a significant interaction of group with time on impulsivity (p = 0.044), reflecting a significant increase from the first to the second assessment in the methamphetamine users (p = 0.013), but no change among healthy control subjects. In contrast, depressive and withdrawal symptoms significantly decreased between the first and second assessments in the methamphetamine users (ps ≤0.01). Change in impulsivity in methamphetamine users was not significantly correlated with change in withdrawal or depression (ps >0.05). These findings suggest that methamphetamine users report more impulsivity when abstaining from drug use, an effect that is not significantly related to methamphetamine withdrawal. Attenuation of impulsivity may reinforce continued methamphetamine use in these individuals.

  20. Deficits in social perception in opioid maintenance patients, abstinent opioid users and non-opioid users.

    PubMed

    McDonald, Skye; Darke, Shane; Kaye, Sharlene; Torok, Michelle

    2013-03-01

    This study aimed to compare emotion perception and social inference in opioid maintenance patients with abstinent ex-users and non-heroin-using controls, and determine whether any deficits in could be accounted for by cognitive deficits and/or risk factors for brain damage. Case-control. Sydney, Australia. A total of 125 maintenance patients (MAIN), 50 abstinent opiate users (ABST) and 50 matched controls (CON). The Awareness of Social Inference Test (TASIT) was used to measure emotion perception and social inference. Measures were also taken of executive function, working memory, information processing speed, verbal/non-verbal learning and psychological distress. After adjusting for age, sex, pre-morbid IQ and psychological distress, the MAIN group was impaired relative to CON (β = -0.19, P < 0.05) and ABST (β = -0.19, P < 0.05) on emotion perception and relative to CON (β = -0.25, P < 0.001) and ABST (β = -0.24, P < 0.01) on social inference. In neither case did the CON and ABST groups differ. For both emotion perception (P < 0.001) and social inference (P < 0.001), pre-morbid IQ was a significant independent predictor. Cognitive function was a major predictor of poor emotion perception (β = -0.44, P < 0.001) and social inference (β = -0.48, P < 0.001). Poor emotion recognition was also predicted by number of heroin overdoses (β = -0.14, P < 0.05). Neither time in treatment or type of maintenance medication (methadone or buprenorphine) were related to performance. People in opioid maintenance treatment may have an impaired capacity for emotion perception and ability to make inferences about social situations. © 2012 The Authors, Addiction © 2012 Society for the Study of Addiction.

  1. The influence of monetary punishment on cognitive control in abstinent cocaine-users.

    PubMed

    Hester, Robert; Bell, Ryan P; Foxe, John J; Garavan, Hugh

    2013-11-01

    Dependent drug users show a diminished neural response to punishment, in both limbic and cortical regions, though it remains unclear how such changes influence cognitive processes critical to addiction. To assess this relationship, we examined the influence of monetary punishment on inhibitory control and adaptive post-error behavior in abstinent cocaine dependent (CD) participants. 15 abstinent CD and 15 matched control participants performed a Go/No-go response inhibition task, which administered monetary fines for failed response inhibition, during collection of fMRI data. CD participants showed reduced inhibitory control and significantly less adaptive post-error slowing in response to punishment, when compared to controls. The diminished behavioral punishment sensitivity shown by CD participants was associated with significant hypoactive error-related BOLD responses in the dorsal anterior cingulate cortex (ACC), right insula and right prefrontal regions. Specifically, CD participants' error-related response in these regions was not modulated by the presence of punishment, whereas control participants' response showed a significant BOLD increase during punished errors. CD participants showed a blunted response to failed control (errors) that was not modulated by punishment. Consistent with previous findings of reduced sensitivity to monetary loss in cocaine users, we further demonstrate that such insensitivity is associated with an inability to increase cognitive control in the face of negative consequences, a core symptom of addiction. The pattern of deficits in the CD group may have implications for interventions that attempt to improve cognitive control in drug dependent groups via positive/negative incentives. Crown Copyright © 2013. Published by Elsevier Ireland Ltd. All rights reserved.

  2. The influence of monetary punishment on cognitive control in abstinent cocaine-users*

    PubMed Central

    Hester, Robert; Bell, Ryan P.; Foxe, John J.; Garavan, Hugh

    2013-01-01

    Background Dependent drug users show a diminished neural response to punishment, in both limbic and cortical regions, though it remains unclear how such changes influence cognitive processes critical to addiction. To assess this relationship, we examined the influence of monetary punishment on inhibitory control and adaptive post-error behaviour in abstinent cocaine dependent (CD) participants. Methods 15 abstinent CD and 15 matched control participants performed a Go/No-go response inhibition task, which administered monetary fines for failed response inhibition, during collection of fMRI data. Results CD participants showed reduced inhibitory control and significantly less adaptive post-error slowing in response to punishment, when compared to controls. The diminished behavioural punishment sensitivity shown by CD participants was associated with significant hypoactive error-related BOLD responses in the dorsal anterior cingulate cortex (ACC), right insula and right prefrontal regions. Specifically, CD participants’ error-related response in these regions was not modulated by the presence of punishment, whereas control participants’ response showed a significant BOLD increase during punished errors. Conclusions CD participants showed a blunted response to failed control (errors) that was not modulated by punishment. Consistent with previous findings of reduced sensitivity to monetary loss in cocaine users, we further demonstrate that such insensitivity is associated with an inability to increase cognitive control in the face of negative consequences, a core symptom of addiction. The pattern of deficits in the CD group may have implications for interventions that attempt to improve cognitive control in drug dependent groups via positive/negative incentives. PMID:23791040

  3. Glycemic Allostasis during Mental Activities on Fasting in Non-alcohol Users and Alcohol Users with Different Durations of Abstinence.

    PubMed

    Welcome, Mo; Pereverzev, Va

    2014-09-01

    Glycemic allostasis is the process by which blood glucose stabilization is achieved through the balancing of glucose consumption rate and release into the blood stream under a variety of stressors. This paper reviews findings on the dynamics of glycemic levels during mental activities on fasting in non-alcohol users and alcohol users with different periods of abstinence. Referred articles for this review were searched in the databases of PubMed, Scopus, DOAJ and AJOL. The search was conducted in 2013 between January 20 and July 31. The following keywords were used in the search: alcohol action on glycemia OR brain glucose OR cognitive functions; dynamics of glycemia, dynamics of glycemia during mental activities; dynamics of glycemia on fasting; dynamics of glycemia in non-alcohol users OR alcohol users; glycemic regulation during sobriety. Analysis of the selected articles showed that glycemic allostasis during mental activities on fasting is poorly regulated in alcohol users even after a long duration of sobriety (1-4 weeks after alcohol consumption), compared to non-alcohol users. The major contributor to the maintenance of euglycemia during mental activities after the night's rest (during continuing fast) is gluconeogenesis.

  4. Glycemic Allostasis during Mental Activities on Fasting in Non-alcohol Users and Alcohol Users with Different Durations of Abstinence

    PubMed Central

    Welcome, MO; Pereverzev, VA

    2014-01-01

    Glycemic allostasis is the process by which blood glucose stabilization is achieved through the balancing of glucose consumption rate and release into the blood stream under a variety of stressors. This paper reviews findings on the dynamics of glycemic levels during mental activities on fasting in non-alcohol users and alcohol users with different periods of abstinence. Referred articles for this review were searched in the databases of PubMed, Scopus, DOAJ and AJOL. The search was conducted in 2013 between January 20 and July 31. The following keywords were used in the search: alcohol action on glycemia OR brain glucose OR cognitive functions; dynamics of glycemia, dynamics of glycemia during mental activities; dynamics of glycemia on fasting; dynamics of glycemia in non-alcohol users OR alcohol users; glycemic regulation during sobriety. Analysis of the selected articles showed that glycemic allostasis during mental activities on fasting is poorly regulated in alcohol users even after a long duration of sobriety (1-4 weeks after alcohol consumption), compared to non-alcohol users. The major contributor to the maintenance of euglycemia during mental activities after the night's rest (during continuing fast) is gluconeogenesis. PMID:25364589

  5. Prefrontal N-acetylaspartate is strongly associated with memory performance in (abstinent) ecstasy users: preliminary report.

    PubMed

    Reneman, L; Majoie, C B; Schmand, B; van den Brink, W; den Heeten, G J

    2001-10-01

    3,4-methylenedioxymethamphetamine (MDMA or "Ecstasy") is known to damage brain serotonin neurons in animals and possibly humans. Because serotonergic damage may adversely affect memory, we compared verbal memory function between MDMA users and MDMA-naïve control subjects and evaluated the relationship between verbal memory function and neuronal dysfunction in the MDMA users. An auditory verbal memory task (Rey Auditory Verbal Learning Test) was used to study eight abstinent MDMA users and seven control subjects. In addition 1H-MRS was used in different brain regions of all MDMA users to measure N-acetylaspartate/creatine (NAA/Cr) ratios, a marker for neuronal viability. The MDMA users recalled significantly fewer words than control subjects on delayed (p =.03) but not immediate recall (p =.08). In MDMA users, delayed memory function was strongly associated with NAA/Cr only in the prefrontal cortex (R(2) =.76, p =.01). Greater decrements in memory function predicted lower NAA/Cr levels-and by inference greater neuronal dysfunction-in the prefrontal cortex of MDMA users.

  6. Persistent Microstructural Deficits of Internal Capsule in One-Year Abstinent Male Methamphetamine Users: a Longitudinal Diffusion Tensor Imaging Study.

    PubMed

    Zhuang, Wenxu; Tang, Yingying; Zhong, Na; Jiang, Haifeng; Du, Jiang; Wang, Jijun; Zhao, Min

    2016-09-01

    White matter (WM) alterations have been reported in methamphetamine (MA) users. However, knowledge about longitudinal changes in WM during abstinence from MA remains unknown. The present study aimed to examine how WM changes in long-term MA abstinent, in particular, whether the WM deficits would recover as the duration of abstinence extended. Twenty male MA dependent individuals and 19 healthy controls (HCs) were recruited and participated in both clinical assessments and diffusion tensor imaging (DTI) scans. The MA group underwent two DTI scans, a baseline scan with a duration of abstinence of 6.4 months and and a follow-up scan with a duration of abstinence of 13.0 months. Tract-Based Spatial Statistics was utilized to conduct baseline DTI analysis of MA group compared with HCs. The clusters with significant group differences of factional anisotropy (FA) were extracted as region of interests (ROIs). Mean values of DTI measurements (FA, mean diffusivity, axial diffusivity and radial diffusivity) were calculated within the ROIs in each subject's native space at baseline and follow-up. The MA group showed significant lower FA in the right internal capsule and superior corona radiate than HCs. The deficits did not recover when the duration of abstinence from MA reached 13 months. No significant correlations were found between FA and clinical measurements. Our results suggested persistent microstructure deficits of WM tracts surrounding the basal ganglia in MA dependent individuals.

  7. Characterizing Smoking and Drinking Abstinence from Social Media.

    PubMed

    Tamersoy, Acar; De Choudhury, Munmun; Chau, Duen Horng

    2015-09-01

    Social media has been established to bear signals relating to health and well-being states. In this paper, we investigate the potential of social media in characterizing and understanding abstinence from tobacco or alcohol use. While the link between behavior and addiction has been explored in psychology literature, the lack of longitudinal self-reported data on long-term abstinence has challenged addiction research. We leverage the activity spanning almost eight years on two prominent communities on Reddit: StopSmoking and StopDrinking. We use the self-reported "badge" information of nearly a thousand users as gold standard information on their abstinence status to characterize long-term abstinence. We build supervised learning based statistical models that use the linguistic features of the content shared by the users as well as the network structure of their social interactions. Our findings indicate that long-term abstinence from smoking or drinking (~one year) can be distinguished from short-term abstinence (~40 days) with 85% accuracy. We further show that language and interaction on social media offer powerful cues towards characterizing these addiction-related health outcomes. We discuss the implications of our findings in social media and health research, and in the role of social media as a platform for positive behavior change and therapy.

  8. A Randomized Trial of Employment-Based Reinforcement of Cocaine Abstinence in Injection Drug Users

    ERIC Educational Resources Information Center

    Silverman, Kenneth; Wong, Conrad J.; Needham, Mick; Diemer, Karly N.; Knealing, Todd; Crone-Todd, Darlene; Fingerhood, Michael; Nuzzo, Paul; Kolodner, Kenneth

    2007-01-01

    High-magnitude and long-duration abstinence reinforcement can promote drug abstinence but can be difficult to finance. Employment may be a vehicle for arranging high-magnitude and long-duration abstinence reinforcement. This study determined if employment-based abstinence reinforcement could increase cocaine abstinence in adults who inject drugs…

  9. Abstinence from drugs of abuse in community-based members of Narcotics Anonymous.

    PubMed

    Galanter, Marc; Dermatis, Helen; Post, Stephen; Santucci, Courtney

    2013-03-01

    Narcotics Anonymous (NA) is an abstinence-based fellowship with more than 58,000 groups worldwide. There has, however, been little research reported on its members. This study was designed to clarify the nature of the participants in NA who are primarily abstinent, long-term members. A protocol was implemented to survey members at 10 NA group meetings in three different states, through the cooperation of the NA World Service Office. A 51-item self-administered questionnaire, addressing key aspects of substance use and recovery, was anonymously completed by 396 respondents. Respondents were 71.5% male; the mean age was 38.1 years; 68.2% were White; and the principal drug problems comprised cocaine (28.5%), heroin (27.5%), other opiates (13.4%), methamphetamine (12.9%), alcohol (8.6%), marijuana (6.6%), and other stimulants (2.5%). Eighty-seven percent had prior treatment for a substance use disorder. On average respondents had first encountered NA at age 26.9, they had been abstinent an average of 5.7 years at the time they filled out the questionnaire, and 47.5% had served as sponsors. Ninety-four percent designated themselves as spiritual, and only 29.6% designated themselves as religious. NA offers support for long-term abstinence from diverse misuse of drugs among users of different backgrounds.

  10. A randomized trial of employment-based reinforcement of cocaine abstinence in injection drug users.

    PubMed

    Silverman, Kenneth; Wong, Conrad J; Needham, Mick; Diemer, Karly N; Knealing, Todd; Crone-Todd, Darlene; Fingerhood, Michael; Nuzzo, Paul; Kolodner, Kenneth

    2007-01-01

    High-magnitude and long-duration abstinence reinforcement can promote drug abstinence but can be difficult to finance. Employment may be a vehicle for arranging high-magnitude and long-duration abstinence reinforcement. This study determined if employment-based abstinence reinforcement could increase cocaine abstinence in adults who inject drugs and use cocaine during methadone treatment. Participants could work 4 hr every weekday in a workplace where they could earn about $10.00 per hour in vouchers; they were required to provide routine urine samples. Participants who attended the workplace and provided cocaine-positive urine samples during the initial 4 weeks were invited to work 26 weeks and were randomly assigned to an abstinence-and-work (n = 28) or work-only (n = 28) group. Abstinence-and-work participants had to provide urine samples showing cocaine abstinence to work and maintain maximum pay. Work-only participants could work independent of their urinalysis results. Abstinence-and-work participants provided more (p = .004; OR = 5.80, 95% CI = 2.03-16.56) cocaine-negative urine samples (29%) than did work-only participants (10%). Employment-based abstinence reinforcement can increase cocaine abstinence.

  11. Neurocognitive and psychiatric dimensions of hot, but not cool, impulsivity predict HIV sexual risk behaviors among drug users in protracted abstinence.

    PubMed

    Wilson, Michael J; Vassileva, Jasmin

    2016-03-01

    Impulsivity is an important risk factor for HIV risky drug and sexual behaviors. Research identifies hot (i.e. affectively-mediated, reward-based) and cool (motoric, attentional, independent of context) neurocognitive and psychiatric dimensions of impulsivity, though the impact of specific drugs of abuse on these varieties of impulsivity remains an open question. The present study examined the associations of neurocognitive and psychiatric varieties of hot and cool impulsivity with measures of lifetime and recent sexual risk behaviors among users of different classes of drugs. The study sample was comprised of drug users in protracted (> 1 year) abstinence: heroin mono-dependent (n = 61), amphetamine mono-dependent (n = 44), and polysubstance dependent (n = 73). Hot impulsivity was operationalized via neurocognitive tasks of reward-based decision-making and symptoms of psychopathy. Cool impulsivity was operationalized via neurocognitive tasks of response inhibition and symptoms of attention deficit/hyperactivity disorder (ADHD). Hot impulsivity was associated with sexual risk behaviors among heroin and amphetamine users in protracted abstinence, whereas cool impulsivity was not associated with sexual risk behaviors among any drug-using group. Neurocognitive hot impulsivity was associated with recent (past 30-day) sexual risk behaviors, whereas psychopathy was associated with sexual risk behaviors during more remote time-periods (past 6 month and lifetime) and mediated the association between heroin dependence and past 6-month sexual risk behaviors. Assessments and interventions aimed at reducing sexual risk behaviors among drug users should focus on hot neurocognitive and psychiatric dimensions of impulsivity, such as decision-making and psychopathy. Cool dimensions of impulsivity such as response inhibition and ADHD were not related to sexual risk behaviors among drug users in protracted abstinence.

  12. A Randomized Trial of Employment-Based Reinforcement of Cocaine Abstinence in Injection Drug Users

    PubMed Central

    Silverman, Kenneth; Wong, Conrad J; Needham, Mick; Diemer, Karly N; Knealing, Todd; Crone-Todd, Darlene; Fingerhood, Michael; Nuzzo, Paul; Kolodner, Kenneth

    2007-01-01

    High-magnitude and long-duration abstinence reinforcement can promote drug abstinence but can be difficult to finance. Employment may be a vehicle for arranging high-magnitude and long-duration abstinence reinforcement. This study determined if employment-based abstinence reinforcement could increase cocaine abstinence in adults who inject drugs and use cocaine during methadone treatment. Participants could work 4 hr every weekday in a workplace where they could earn about $10.00 per hour in vouchers; they were required to provide routine urine samples. Participants who attended the workplace and provided cocaine-positive urine samples during the initial 4 weeks were invited to work 26 weeks and were randomly assigned to an abstinence-and-work (n  =  28) or work-only (n  =  28) group. Abstinence-and-work participants had to provide urine samples showing cocaine abstinence to work and maintain maximum pay. Work-only participants could work independent of their urinalysis results. Abstinence-and-work participants provided more (p  =  .004; OR  =  5.80, 95% CI  =  2.03–16.56) cocaine-negative urine samples (29%) than did work-only participants (10%). Employment-based abstinence reinforcement can increase cocaine abstinence. PMID:17970256

  13. Biochemical Validation of Self-Reported Smokeless Tobacco Abstinence among Smokeless Tobacco Users: Results from a Clinical Trial of Varenicline in India.

    PubMed

    Jain, Raka; Jhanjee, Sonali; Jain, Veena; Gupta, Tina; Mittal, Swati; Chauhan, Prashant; Raghav, Rahul; Goelz, Patricia; Schnoll, Robert A

    2015-01-01

    The validity of self-reported tobacco use is often questioned given the potential for underestimation of use. This study used data from a double-blind, placebo-controlled clinical trial of varenicline for smokeless tobacco dependence in India to evaluate the accuracy of self-reported smokeless tobacco cessation using biochemical validation procedures and to evaluate correlates of reporting inaccuracy. Smokeless tobacco users attending a dental clinic at AIIMS were randomized to placebo or varenicline; all participants received counseling. Detailed smokeless tobacco use was recorded and abstinence was defined as cotinine-verified 7-day point prevalence cessation (cotinine < 50 ng/ml) and breath CO > 10 ppm at the end of 12 weeks of treatment. One-half of study completers (82/165) self-reported abstinence. Biochemical verification confirmed that (65.9%) subjects provided accurate self-reports while (34.1%) participants underreported tobacco use. These data indicate poor agreement between self-reported and biochemically confirmed abstinence (κ = -0.191). Underreporters of tobacco use had significantly higher baseline cotinine (p < 0.05), total craving (p < 0.012), and negative reinforcement craving (p < 0.001) vs. those whose self-reports were correctly verified. These findings provide evidence to support the need for biochemical validation of self-reported abstinence outcomes among smokeless tobacco users in cessation programs in India and identify high levels of pretreatment cotinine and craving levels as potential correlates of false reporting.

  14. Randomized Controlled Trial Comparing Exercise to Health Education for Stimulant Use Disorder: Results From the CTN-0037 STimulant Reduction Intervention Using Dosed Exercise (STRIDE) Study.

    PubMed

    Trivedi, Madhukar H; Greer, Tracy L; Rethorst, Chad D; Carmody, Thomas; Grannemann, Bruce D; Walker, Robrina; Warden, Diane; Shores-Wilson, Kathy; Stoutenberg, Mark; Oden, Neal; Silverstein, Meredith; Hodgkins, Candace; Love, Lee; Seamans, Cindy; Stotts, Angela; Causey, Trey; Szucs-Reed, Regina P; Rinaldi, Paul; Myrick, Hugh; Straus, Michele; Liu, David; Lindblad, Robert; Church, Timothy; Blair, Steven N; Nunes, Edward V

    To evaluate exercise as a treatment for stimulant use disorders. The STimulant Reduction Intervention using Dosed Exercise (STRIDE) study was a randomized clinical trial conducted in 9 residential addiction treatment programs across the United States from July 2010 to February 2013. Of 497 adults referred to the study, 302 met all eligibility criteria, including DSM-IV criteria for stimulant abuse and/or dependence, and were randomized to either a dosed exercise intervention (Exercise) or a health education intervention (Health Education) control, both augmenting treatment as usual and conducted thrice weekly for 12 weeks. The primary outcome of percent stimulant abstinent days during study weeks 4 to 12 was estimated using a novel algorithm adjustment incorporating self-reported Timeline Followback (TLFB) stimulant use and urine drug screen (UDS) data. Mean percent of abstinent days based on TLFB was 90.8% (SD = 16.4%) for Exercise and 91.6% (SD = 14.7%) for Health Education participants. Percent of abstinent days using the eliminate contradiction (ELCON) algorithm was 75.6% (SD = 27.4%) for Exercise and 77.3% (SD = 25.1%) for Health Education. The primary intent-to-treat analysis, using a mixed model controlling for site and the ELCON algorithm, produced no treatment effect (P = .60). In post hoc analyses controlling for treatment adherence and baseline stimulant use, Exercise participants had a 4.8% higher abstinence rate (78.7%) compared to Health Education participants (73.9%) (P = .03, number needed to treat = 7.2). The primary analysis indicated no significant difference between exercise and health education. Adjustment for intervention adherence showed modestly but significantly higher percent of abstinent days in the exercise group, suggesting that exercise may improve outcomes for stimulant users who have better adherence to an exercise dose. ClinicalTrials.gov identifier: NCT01141608. © Copyright 2017 Physicians Postgraduate Press, Inc.

  15. The Influence of Drug Testing and Benefit-Based Distribution of Opioid Substitution Therapy on Drug Abstinence.

    PubMed

    Gabrovec, Branko

    2015-01-01

    The objective of our research was to discover whether the new approach to urine drug testing has a positive effect on users' abstinence, users' treatment, and their cooperation, while remaining user-friendly, and whether this approach is more cost-effective. The centers are focused on providing high-quality treatment within a cost-efficient program. In this study, we focus on the influence of drug testing and benefit-based distribution of opioid substitution therapy (BBDOST) on drug abstinence. The purpose of this study was to find any possible positive effect of modified distribution of the therapy and illicit drug testing on the number of users who are abstinent from illicit drugs and users who are not abstinent from illicit drugs as well as the users' opinion on BBDOST and testing. We are also interested in a difference in abstinence rates between those on BBDOST and those not receiving BBDOST. In 2010, the method of drug testing at the center was changed (less frequent and random drug testing) to enable its users faster access to BBDOST (take-home therapy). It was found that the number of drug-abstinent program participants has increased from initial 44.5% (2010) to 54.1% (2014). According to the program participants, the new method allows them to achieve and maintain abstinence from drugs more easily. In addition, they are also satisfied with the modified way of drug testing. This opinion does not change with age, gender, and acquired benefits.

  16. Abstinence

    MedlinePlus

    ... Jobs Sports Expert Answers (Q&A) Staying Safe Videos for Educators Search English Español Abstinence KidsHealth / For Teens / Abstinence Print en español La abstinencia sexual What Is It? Abstinence is not having sex. A person who decides to practice abstinence has ...

  17. Motivated attention to cocaine and emotional cues in abstinent and current cocaine users--an ERP study.

    PubMed

    Dunning, Jonathan P; Parvaz, Muhammad A; Hajcak, Greg; Maloney, Thomas; Alia-Klein, Nelly; Woicik, Patricia A; Telang, Frank; Wang, Gene-Jack; Volkow, Nora D; Goldstein, Rita Z

    2011-05-01

    Event-related potentials (ERPs) are a direct measure of neural activity and are ideally suited to study the time-course of attentional engagement with emotional and drug-related stimuli in addiction. In particular, the late positive potential (LPP) appears to be enhanced following cocaine-related compared with neutral stimuli in human participants with cocaine use disorders (CUD). However, previous studies have not directly compared cocaine-related with emotional stimuli while examining potential differences between abstinent and current cocaine users. The present study examined ERPs in 55 CUD (27 abstinent and 28 current users) and 29 matched healthy controls while they passively viewed pleasant, unpleasant, neutral and cocaine-related pictures. To examine the time-course of attention to these stimuli, we analysed both an early and later window in the LPP as well as the early posterior negativity (EPN), established in assessing motivated attention. Cocaine pictures elicited increased electrocortical measures of motivated attention in ways similar to affectively pleasant and unpleasant pictures in all CUD, an effect that was no longer discernible during the late LPP window for the current users. This group also exhibited deficient processing of the other emotional stimuli (early LPP window - pleasant pictures; late LPP window - pleasant and unpleasant pictures). Results were unique to the LPP and not EPN. Taken together, results support a relatively early attention bias to cocaine stimuli in cocaine-addicted individuals, further suggesting that recent cocaine use decreases such attention bias during later stages of processing but at the expense of deficient processing of other emotional stimuli. European Journal of Neuroscience © 2011 Federation of European Neuroscience Societies and Blackwell Publishing Ltd. No claim to original US government works.

  18. Clinically relevant characteristics associated with early treatment drug use versus abstinence.

    PubMed

    Cochran, Gerald; Stitzer, Maxine; Nunes, Edward V; Hu, Mei-Chen; Campbell, Aimee

    2014-04-04

    This study describes early treatment drug use status and associated clinical characteristics in a diverse sample of patients entering outpatient substance abuse psychosocial counseling treatment. The goal is to more fully characterize those entering treatment with and without active use of their primary drug in order to better understand associated treatment needs and resilience factors. We examined baseline data from a NIDA Clinical Trials Network (CTN) study (Web-delivery of Treatment for Substance Use) with an all-comers sample of patients (N = 494) entering 10 outpatient treatment centers. Patients were categorized according to self-identified primary drug of abuse (alcohol, cocaine/stimulants, opioids, marijuana) and by baseline drug use status (positive/negative) based on urine testing or self-reports of recent use (alcohol). Characteristics were examined by primary drug and early use status. Classified as drug-negative were 84%, 76%, 62%, and 33% of primary opioid, stimulant, alcohol, and marijuana users; respectively. Drug-positive versus -negative patients did not differ on demographics or rates of substance abuse/dependence diagnoses. However, those negative for active use had better physical and mental health profiles, were less likely to be using a secondary drug, and were more likely to be attending 12-step self-help meetings. Early treatment drug abstinence is common among substance users entering outpatient psychosocial counseling programs, regardless of primary abused drug. Abstinence (by negative UA) is associated with better health and mental health profiles, less secondary drug use, and more days of 12-step attendance. These data highlight differential treatment needs and resiliencies associated with early treatment drug use status. NCT01104805.

  19. Procedural and declarative memory performance, and the memory consolidation function of sleep, in recent and abstinent Ecstasy/MDMA users

    PubMed Central

    Blagrove, Mark; Seddon, Jennifer; George, Sophie; Parrott, Andrew C.; Stickgold, Robert; Walker, Matthew; Jones, Katy; Morgan, Michael J.

    2013-01-01

    This study assessed the effects of ecstasy/MDMA on declarative memory (Rivermead Behavioral Memory task - RBMT), on procedural learning (Finger Tapping Task - FTT), and on the memory consolidation function of sleep for these two tasks. Testing occurred in 2 afternoon testing sessions, 24 hours apart so that a full period of sleep was allowed between them. Groups were: Non-drug taking Controls (n=24); Recent Ecstasy/MDMA users, who had taken ecstasy and/or MDMA 2–3 days before the first testing session (n=25), and Abstinent Ecstasy/MDMA users, who had not taken ecstasy/MDMA for at least 8 days before the first session (n=17). The recent ecstasy/MDMA users performed significantly worse than controls on the RBMT (mean recall 76.1% of control group recall), but did not differ from controls on FTT performance. Correspondingly there was a significant regression between the continuous variable of recency of ecstasy/MDMA use and RBMT performance. However, there was an interaction between ecstasy/MDMA use and subsequent other drug use. Controls had similar RBMT scores to recent ecstasy/MDMA users who did not take other drugs 48 – 24 hours before testing, but scored significantly better than recent ecstasy/MDMA users who took various other drugs (mainly cannabis) 48 – 24 hours before testing. For both tasks the control, recent ecstasy/MDMA and abstinent ecstasy/MDMA users did not differ in their change of performance across 24 hours; there was thus no evidence that ecstasy/MDMA impairs the memory consolidation function of sleep for either declarative or procedural memory. For participants in the two ecstasy/MDMA groups greater lifetime consumption of ecstasy tablets was associated with significantly more deficits in procedural memory. Furthermore, greater lifetime consumption of ecstasy tablets and of cocaine, were also associated with significantly more deficits in declarative memory. PMID:20615932

  20. Plasma concentrations of BDNF and IGF-1 in abstinent cocaine users with high prevalence of substance use disorders: relationship to psychiatric comorbidity.

    PubMed

    Pedraz, María; Martín-Velasco, Ana Isabel; García-Marchena, Nuria; Araos, Pedro; Serrano, Antonia; Romero-Sanchiz, Pablo; Suárez, Juan; Castilla-Ortega, Estela; Barrios, Vicente; Campos-Cloute, Rafael; Ruiz, Juan Jesús; Torrens, Marta; Chowen, Julie Ann; Argente, Jesús; de la Torre, Rafael; Santín, Luis Javier; Villanúa, María Ángeles; Rodríguez de Fonseca, Fernando; Pavón, Francisco Javier

    2015-01-01

    Recent studies have identified biomarkers related to the severity and pathogenesis of cocaine addiction and common comorbid psychiatric disorders. Monitoring these plasma mediators may improve the stratification of cocaine users seeking treatment. Because the neurotrophic factors are involved in neural plasticity, neurogenesis and neuronal survival, we have determined plasma concentrations of brain-derived neurotrophic factor (BDNF), insulin-like growth factor 1 (IGF-1) and IGF-1 binding protein 3 (IGFBP-3) in a cross-sectional study with abstinent cocaine users who sought outpatient treatment for cocaine (n = 100) and age/body mass matched controls (n = 85). Participants were assessed with the diagnostic interview 'Psychiatric Research Interview for Substance and Mental Disorders'. Plasma concentrations of these peptides were not different in cocaine users and controls. They were not associated with length of abstinence, duration of cocaine use or cocaine symptom severity. The pathological use of cocaine did not influence the association of IGF-1 with age observed in healthy subjects, but the correlation between IGF-1 and IGFBP-3 was not significantly detected. Correlation analyses were performed between these peptides and other molecules sensitive to addiction: BDNF concentrations were not associated with inflammatory mediators, lipid derivatives or IGF-1 in cocaine users, but correlated with chemokines (fractalkine/CX3CL1 and SDF-1/CXCL12) and N-acyl-ethanolamines (N-palmitoyl-, N-oleoyl-, N-arachidonoyl-, N-linoleoyl- and N-dihomo-γ-linolenoyl-ethanolamine) in controls; IGF-1 concentrations only showed association with IGFBP-3 concentrations in controls; and IGFBP-3 was only correlated with N-stearoyl-ethanolamine concentrations in cocaine users. Multiple substance use disorders and life-time comorbid psychopathologies were common in abstinent cocaine users. Interestingly, plasma BDNF concentrations were exclusively found to be decreased in users diagnosed

  1. Plasma Concentrations of BDNF and IGF-1 in Abstinent Cocaine Users with High Prevalence of Substance Use Disorders: Relationship to Psychiatric Comorbidity

    PubMed Central

    Araos, Pedro; Serrano, Antonia; Romero-Sanchiz, Pablo; Suárez, Juan; Castilla-Ortega, Estela; Barrios, Vicente; Campos-Cloute, Rafael; Ruiz, Juan Jesús; Torrens, Marta; Chowen, Julie Ann; Argente, Jesús; de la Torre, Rafael; Santín, Luis Javier; Villanúa, María Ángeles; Rodríguez de Fonseca, Fernando; Pavón, Francisco Javier

    2015-01-01

    Recent studies have identified biomarkers related to the severity and pathogenesis of cocaine addiction and common comorbid psychiatric disorders. Monitoring these plasma mediators may improve the stratification of cocaine users seeking treatment. Because the neurotrophic factors are involved in neural plasticity, neurogenesis and neuronal survival, we have determined plasma concentrations of brain-derived neurotrophic factor (BDNF), insulin-like growth factor 1 (IGF-1) and IGF-1 binding protein 3 (IGFBP-3) in a cross-sectional study with abstinent cocaine users who sought outpatient treatment for cocaine (n = 100) and age/body mass matched controls (n = 85). Participants were assessed with the diagnostic interview ‘Psychiatric Research Interview for Substance and Mental Disorders’. Plasma concentrations of these peptides were not different in cocaine users and controls. They were not associated with length of abstinence, duration of cocaine use or cocaine symptom severity. The pathological use of cocaine did not influence the association of IGF-1 with age observed in healthy subjects, but the correlation between IGF-1 and IGFBP-3 was not significantly detected. Correlation analyses were performed between these peptides and other molecules sensitive to addiction: BDNF concentrations were not associated with inflammatory mediators, lipid derivatives or IGF-1 in cocaine users, but correlated with chemokines (fractalkine/CX3CL1 and SDF-1/CXCL12) and N-acyl-ethanolamines (N-palmitoyl-, N-oleoyl-, N-arachidonoyl-, N-linoleoyl- and N-dihomo-γ-linolenoyl-ethanolamine) in controls; IGF-1 concentrations only showed association with IGFBP-3 concentrations in controls; and IGFBP-3 was only correlated with N-stearoyl-ethanolamine concentrations in cocaine users. Multiple substance use disorders and life-time comorbid psychopathologies were common in abstinent cocaine users. Interestingly, plasma BDNF concentrations were exclusively found to be decreased in users diagnosed

  2. Changes in Resting Functional Connectivity during Abstinence in Stimulant Use Disorder: A Preliminary Comparison of Relapsers and Abstainers*

    PubMed Central

    Camchong, Jazmin; MacDonald, Angus W; Mueller, Bryon A; Nelson, Brent; Specker, Sheila; Slaymaker, Valerie; Lim, Kelvin O

    2014-01-01

    BACKGROUND Previously identified resting functional connectivity (FC) differences in individuals with stimulant use disorder (SUD) suggest an imbalance in neural regions that mediate behavioral aspects relevant to addiction such as emotion regulation and reward processing. There is a need to further investigate these differences across time between those that relapse and those that do not. This is the first longitudinal study of recently abstinent SUD (SUD-RA) that identifies specific FC changes in subsequent relapsers (vs abstainers). We hypothesized that (1) subsequent relapsers (vs abstainers) will show lower FC of emotion regulation regions and higher FC of reward processing regions and (2) FC differences would be more evident across time. METHODS We examined resting FC in 18 SUD-RAs (8 females, age: M=22.05±2.64) and 15 non-substance abusing controls (NSAC; 5 females, age: M=24.21±5.76) at Time 1 (abstinent ~5 weeks). Fourteen NSAC and 12 SUD-RAs were re-examined at Time 2 (abstinent ~13 weeks). With seed-based FC measures, we examined FC differences between SUD-RAs that abstained or relapsed over the subsequent 6 months. RESULTS Relapsers (vs abstainers) had higher FC between (1) nucleus accumbens (NAcc) and left frontopolar cortex (FPC), (2) NAcc and posterior cingulate gyrus and (3) subgenual anterior cingulate and left FPC at Time 1. Relapsers (vs abstainers) showed larger reduction in FC strength within these regions across time. CONCLUSIONS Resting FC reduction found in relapsers (vs. abstainers) from five to thirteen weeks of abstinence may be a biological marker of relapse vulnerability. These preliminary findings require replication with larger sample sizes. PMID:24745476

  3. Abstinence and abstinence-only education.

    PubMed

    Ott, Mary A; Santelli, John S

    2007-10-01

    To review recent literature on medical accuracy, program effectiveness, and ethical concerns related to abstinence-only policies for adolescent sexuality education. The federal government invests over 175 million dollars annually in 'abstinence-only-until-marriage' programs. These programs are required to withhold information on contraception and condom use, except for information on failure rates. Abstinence-only curricula have been found to contain scientifically inaccurate information, distorting data on topics such as condom efficacy, and promote gender stereotypes. An independent evaluation of the federal program, several systematic reviews, and cohort data from population-based surveys find little evidence of efficacy and evidence of possible harm. In contrast, comprehensive sexuality education programs have been found to help teens delay initiation of intercourse and reduce sexual risk behaviors. Abstinence-only policies violate the human rights of adolescents because they withhold potentially life-saving information on HIV and other sexually transmitted infections. Federal support of abstinence-only as an approach to adolescent sexuality education is of much concern due to medical inaccuracies, lack of effectiveness, and the withholding and distorting of health information.

  4. Criminality Among Rural Stimulant Users in the United States.

    PubMed

    Oser, Carrie; Leukefeld, Carl; Staton-Tindall, Michele; Duvall, Jamieson; Garrity, Thomas; Stoops, William; Falck, Russel; Wang, Jichuan; Carlson, Robert; Sexton, Rocky; Wright, Patricia; Booth, Brenda

    2011-07-01

    Despite the increase in media attention on "meth cooking" in rural areas of the United States, little is known about rural stimulant use, particularly the criminality associated with stimulant use. Data were collected from community stimulant users in rural Ohio, Arkansas, and Kentucky (N=709). Findings from three logistic regression models indicate that younger stimulant users (x =32.55, SD = 10.35), those with more convictions, and those who used crack frequently were significantly more likely to have been arrested for committing a substance-related crime, a property crime, or another crime in the 6-months before entering the study. Implications include the need for longitudinal studies to further understand rural stimulant use as well as increasing community and corrections-based drug abuse prevention and treatment interventions for stimulant users who live in rural areas.

  5. Neurocognitive and psychiatric dimensions of “hot” impulsivity, but not “cool” impulsivity, predict HIV sexual risk behaviors among drug users in protracted abstinence

    PubMed Central

    Wilson, Michael J.; Vassileva, Jasmin

    2016-01-01

    Background Impulsivity is an important risk factor for HIV risky drug and sexual behaviors. Research identifies “hot” (i.e., affectively-mediated, reward-based) and “cool” (motoric, attentional, independent of context) neurocognitive and psychiatric dimensions of impulsivity, though the impact of specific drugs of abuse on these varieties of impulsivity remains an open question. Objectives The present study examined the associations of neurocognitive and psychiatric varieties of “hot” and “cool” impulsivity with measures of lifetime and recent sexual risk behaviors among users of different classes of drugs. Methods The study sample was comprised drug users in protracted (>1yr) abstinence: heroin monodependent (n=61), amphetamine monodependent (n=44), and polysubstance dependent (n= 73). “Hot” impulsivity was operationalized via neurocognitive tasks of reward-based decision-making and symptoms of psychopathy. “Cool” impulsivity was operationalized via neurocognitive tasks of response inhibition and symptoms of ADHD. Results “Hot” impulsivity was associated with sexual risk behaviors among heroin and amphetamine users in protracted abstinence, whereas “cool” impulsivity was not associated with sexual risk behaviors among any drug-using group. Neurocognitive “hot” impulsivity was associated with recent (past 30-day) sexual risk behaviors, whereas psychopathy was associated with sexual risk behaviors during more remote time-periods (past 6 month and lifetime) and mediated the association between heroin dependence and past 6-month sexual risk behaviors. Conclusion Assessments and interventions aimed at reducing sexual risk behaviors among drug users should focus on “hot” neurocognitive and psychiatric dimensions of impulsivity, such as decision-making and psychopathy. “Cool” dimensions of impulsivity such as response inhibition and ADHD were not related to sexual risk behaviors among drug users in protracted abstinence. PMID

  6. Marijuana abstinence effects in marijuana smokers maintained in their home environment.

    PubMed

    Budney, A J; Hughes, J R; Moore, B A; Novy, P L

    2001-10-01

    Although withdrawal symptoms are commonly reported by persons seeking treatment for marijuana dependence, the validity and clinical significance of a marijuana withdrawal syndrome has not been established. This controlled outpatient study examined the reliability and specificity of the abstinence effects that occur when daily marijuana users abruptly stop smoking marijuana. Twelve daily marijuana smokers were assessed on 16 consecutive days during which they smoked marijuana as usual (days 1-5), abstained from smoking marijuana (days 6-8), returned to smoking marijuana (days 9-13), and again abstained from smoking marijuana (days 14-16). An overall measure of withdrawal discomfort increased significantly during the abstinence phases and returned to baseline when marijuana smoking resumed. Craving for marijuana, decreased appetite, sleep difficulty, and weight loss reliably changed across the smoking and abstinence phases. Aggression, anger, irritability, restlessness, and strange dreams increased significantly during one abstinence phase, but not the other. Collateral observers confirmed participant reports of these symptoms. This study validated several specific effects of marijuana abstinence in heavy marijuana users, and showed they were reliable and clinically significant. These withdrawal effects appear similar in type and magnitude to those observed in studies of nicotine withdrawal.

  7. Criminality Among Rural Stimulant Users in the United States

    PubMed Central

    Leukefeld, Carl; Staton-Tindall, Michele; Duvall, Jamieson; Garrity, Thomas; Stoops, William; Falck, Russel; Wang, Jichuan; Carlson, Robert; Sexton, Rocky; Wright, Patricia; Booth, Brenda

    2009-01-01

    Despite the increase in media attention on “meth cooking” in rural areas of the United States, little is known about rural stimulant use, particularly the criminality associated with stimulant use. Data were collected from community stimulant users in rural Ohio, Arkansas, and Kentucky (N=709). Findings from three logistic regression models indicate that younger stimulant users (x =32.55, SD = 10.35), those with more convictions, and those who used crack frequently were significantly more likely to have been arrested for committing a substance-related crime, a property crime, or another crime in the 6-months before entering the study. Implications include the need for longitudinal studies to further understand rural stimulant use as well as increasing community and corrections-based drug abuse prevention and treatment interventions for stimulant users who live in rural areas. PMID:21686091

  8. Attention and memory deficits in crack-cocaine users persist over four weeks of abstinence.

    PubMed

    Almeida, Priscila P; de Araujo Filho, Gerardo M; Malta, Stella M; Laranjeira, Ronaldo R; Marques, Ana Cecilia R P; Bressan, Rodrigo A; Lacerda, Acioly L T

    2017-10-01

    Crack-cocaine addiction is an important public health problem worldwide. Although there is not a consensus, preliminary evidence has suggested that cognitive impairments in patients with crack-cocaine dependence persist during abstinence, affecting different neuropsychological domains. However, few studies have prospectively evaluated those deficits in different phases of abstinence. The main aim of present study was to examine neuropsychological performance of patients with crack-cocaine dependence during early abstinence and after four weeks, comparing with matched controls. Thirty-five males with crack-cocaine dependence, aged 18 to 50years, who met DSM-IV criteria for cocaine dependence and a control group of 33 healthy men were enrolled. They were assessed through Block Design, Digit Span and Vocabulary of Wechsler Adult Intelligence Scale (WAIS-III), the Rey Auditory Learning Test (RAVLT) and the Verbal Fluency (FAS) between 3 and 10days (mean of 6.1±2.0days) and after 4weeks of abstinence. Compared to controls, the crack-cocaine dependent group exhibited deficits in cognitive performance affecting attention, verbal memory and learning tasks in early withdrawal. Most of the cognitive deficits persisted after four weeks of abstinence. Present results observed that the group of patients with crack-cocaine dependence presented persistent deficits affecting memory and attention even after four weeks of abstinence, confirming previous studies that had disclosed such cognitive impairments. Copyright © 2017 Elsevier Inc. All rights reserved.

  9. A Qualitative Study of Methamphetamine Users’ Perspectives on Barriers and Facilitators of Drug Abstinence

    PubMed Central

    Herbeck, Diane M.; Brecht, Mary-Lynn; Christou, Dayna; Lovinger, Katherine

    2014-01-01

    To better understand methamphetamine (MA) use patterns and the process of recovery, qualitative interviews were conducted with adult MA users (n=20), comparing a sample that received substance abuse treatment with those who had not received treatment. Respondents provided detailed information on why and how they changed from use to abstinence, and factors they considered to be barriers to abstinence. Audio recordings and transcripts were reviewed for common themes. Participants reported a range of mild/moderate to intensely destructive problems, including loss of important relationships and profound changes to who they felt they were at their core, e.g., “I didn’t realize how dark and mean I was... I was like a different person.” Initial abstinence was often facilitated by multiple external forces (e.g., drug testing, child custody issues, prison, relocation), but sustained abstinence was attributed to shifts in thinking and salient realizations about using. The treatment group reported using more and different resources to maintain their abstinence than the no treatment group. Findings indicate individualized interventions and multiple, simultaneous approaches and resources were essential in reaching stable abstinence. Understanding long-term users’ experiences with MA use, addiction and abstinence can inform strategies for engaging and sustaining MA users in treatment and recovery. PMID:25052880

  10. Environmental enrichment and abstinence attenuate ketamine-induced cardiac and renal toxicity

    PubMed Central

    Li, Xingxing; Li, Shuangyan; Zheng, Wenhui; Pan, Jian; Huang, Kunyu; Chen, Rong; Pan, Tonghe; Liao, Guorong; Chen, Zhongming; Zhou, Dongsheng; Shen, Wenwen; Zhou, Wenhua; Liu, Yu

    2015-01-01

    The current study was designed to investigate the effect of abstinence in combination with environmental enrichment (EE) on cardiac and renal toxicity induced by 2 weeks of ketamine self-administration (SA) in rodents. In Experiment 1, one group of rats underwent ketamine SA for 14 days. In Experiment 2, the animals completed 2 weeks of ketamine SA followed by 2 and 4 weeks of abstinence. In Experiment 3, animals underwent 14 days of ketamine SA and 4 weeks of abstinence in which isolated environment (IE) and EE was introduced. The corresponding control groups were included for each experiment. Two weeks of ketamine SA caused significant increases in organ weight, Apoptosis Stimulating Fragment/Kidney Injury Molecule-1, and apoptotic level of heart and kidney. The extended length of withdrawal from ketamine SA partially reduced toxicity on the heart and kidney. Finally, introduction of EE during the period of abstinence greatly promoted the effect of abstinence on ketamine-induced cardiac and renal toxicity. The interactive effect of EE and abstinence was promising to promote the recovery of cardiac and renal toxicity of ketamine. PMID:26112338

  11. Repeated transcranial direct current stimulation prevents abnormal behaviors associated with abstinence from chronic nicotine consumption.

    PubMed

    Pedron, Solène; Monnin, Julie; Haffen, Emmanuel; Sechter, Daniel; Van Waes, Vincent

    2014-03-01

    Successful available treatments to quit smoking remain scarce. Recently, the potential of transcranial direct current stimulation (tDCS) as a tool to reduce craving for nicotine has gained interest. However, there is no documented animal model to assess the neurobiological mechanisms of tDCS on addiction-related behaviors. To address this topic, we have developed a model of repeated tDCS in mice and used it to validate its effectiveness in relieving nicotine addiction. Anodal repeated tDCS was applied over the frontal cortex of Swiss female mice. The stimulation electrode (anode) was fixed directly onto the cranium, and the reference electrode was placed onto the ventral thorax. A 2 × 20 min/day stimulation paradigm for five consecutive days was used (0.2 mA). In the first study, we screened for behaviors altered by the stimulation. Second, we tested whether tDCS could alleviate abnormal behaviors associated with abstinence from nicotine consumption. In naive animals, repeated tDCS had antidepressant-like properties 3 weeks after the last stimulation, improved working memory, and decreased conditioned place preference for nicotine without affecting locomotor activity and anxiety-related behavior. Importantly, abnormal behaviors associated with chronic nicotine exposure (ie, depression-like behavior, increase in nicotine-induced place preference) were normalized by repeated tDCS. Our data show for the first time in an animal model that repeated tDCS is a promising, non-expensive clinical tool that could be used to reduce smoking craving and facilitate smoking cessation. Our animal model will be useful to investigate the mechanisms underlying the effects of tDCS on addiction and other psychiatric disorders.

  12. Differences in regional blood volume during a 28-day period of abstinence in chronic cannabis smokers.

    PubMed

    Sneider, Jennifer T; Pope, Harrison G; Silveri, Marisa M; Simpson, Norah S; Gruber, Staci A; Yurgelun-Todd, Deborah A

    2008-08-01

    Cerebral blood volume (CBV) studies have provided important insight into the effects of illicit substances such as cannabis. The present study examined changes in regional blood volume in the frontal and temporal lobe, and the cerebellum during 28 days of supervised abstinence from cannabis. Dynamic susceptibility contrast MRI (DSCMRI) data were collected on 15 current, long-term cannabis users between 6 and 36 h after the subjects' last reported cannabis use (Day 0), and again after 7 and 28 days of abstinence. Resting state CBV images were also acquired on 17 healthy comparison subjects. The present findings demonstrate that at Day 7, cannabis users continued to display increased blood volumes in the right frontal region, the left and right temporal regions, and the cerebellum. However, after 28 days of abstinence, only the left temporal area and cerebellum showed significantly increased CBV values in cannabis users. These findings suggest that while CBV levels begin to normalize with continued abstinence from cannabis, specifically in frontal areas, other temporal and cerebellar brain regions show slower CBV decreases.

  13. Abnormal fronto-limbic engagement in incarcerated stimulant users during moral processing.

    PubMed

    Fede, Samantha J; Harenski, Carla L; Schaich Borg, Jana; Sinnott-Armstrong, Walter; Rao, Vikram; Caldwell, Brendan M; Nyalakanti, Prashanth K; Koenigs, Michael R; Decety, Jean; Calhoun, Vince D; Kiehl, Kent A

    2016-09-01

    Stimulant use is a significant and prevalent problem, particularly in criminal populations. Previous studies found that cocaine and methamphetamine use is related to impairment in identifying emotions and empathy. Stimulant users also have abnormal neural structure and function of the ventromedial prefrontal cortex (vmPFC), amygdala, and anterior (ACC) and posterior cingulate (PCC), regions implicated in moral decision-making. However, no research has studied the neural correlates of stimulant use and explicit moral processing in an incarcerated population. Here, we examine how stimulant use affects sociomoral processing that might contribute to antisocial behavior. We predicted that vmPFC, amygdala, PCC, and ACC would show abnormal neural response during a moral processing task in incarcerated methamphetamine and cocaine users. Incarcerated adult males (N = 211) were scanned with a mobile MRI system while completing a moral decision-making task. Lifetime drug use was assessed. Neural responses during moral processing were compared between users and non-users. The relationship between duration of use and neural function was also examined. Incarcerated stimulant users showed less amygdala engagement than non-users during moral processing. Duration of stimulant use was negatively associated with activity in ACC and positively associated with vmPFC response during moral processing. These results suggest a dynamic pattern of fronto-limbic moral processing related to stimulant use with deficits in both central motive and cognitive integration elements of biological moral processes theory. This increases our understanding of how drug use relates to moral processing in the brain in an ultra-high-risk population.

  14. Abstinence and abstinence-only education: a review of U.S. policies and programs.

    PubMed

    Santelli, John; Ott, Mary A; Lyon, Maureen; Rogers, Jennifer; Summers, Daniel; Schleifer, Rebecca

    2006-01-01

    Abstinence from sexual intercourse is an important behavioral strategy for preventing human immunodeficiency virus (HIV), other sexually transmitted infections (STIs), and pregnancy among adolescents. Many adolescents, including most younger adolescents, have not initiated sexual intercourse and many sexually experienced adolescents and young adults are abstinent for varying periods of time. There is broad support for abstinence as a necessary and appropriate part of sexuality education. Controversy arises when abstinence is provided to adolescents as a sole choice and where health information on other choices is restricted or misrepresented. Although abstinence is theoretically fully effective, in actual practice abstinence often fails to protect against pregnancy and STIs. Few Americans remain abstinent until marriage; many do not or cannot marry, and most initiate sexual intercourse and other sexual behaviors as adolescents. Although abstinence is a healthy behavioral option for teens, abstinence as a sole option for adolescents is scientifically and ethically problematic. A recent emphasis on abstinence-only programs and policies appears to be undermining more comprehensive sexuality education and other government-sponsored programs. We believe that abstinence-only education programs, as defined by federal funding requirements, are morally problematic, by withholding information and promoting questionable and inaccurate opinions. Abstinence-only programs threaten fundamental human rights to health, information, and life.

  15. Implicit processing of heroin and emotional cues in abstinent heroin users: early and late event-related potential effects.

    PubMed

    Yang, Ling; Zhang, Jianxun; Zhao, Xin

    2015-05-01

    The abnormal cognitive processing of drug cues is a core characteristic of drug dependence. Previous research has suggested that the late positive potential (LPP) of heroin users is increased by heroin-related stimuli because of the attention-grabbing nature of such stimuli. The present research used a modified emotional Stroop (eStroop) task to examine whether there was an early posterior negativity (EPN) modulation to heroin cues compared with emotional or neutral stimuli in heroin dependent subjects. Fifteen former heroin users and 15 matched controls performed the eStroop task, which was composed of positive, negative, heroin-related, and neutral pictures with superimposed color squares. Participants responded to the color of the square and not to the picture while behavioral data and event-related potentials were recorded. There were no significant differences of EPN amplitudes to emotional and neutral stimuli between heroin users and controls. However, heroin users displayed increased EPN modulation for heroin cues, whereas this modulation was absent in controls. Drug-related cues acquire motivational salience and automatically capture the attention of heroin users at early processing stages, even when engaged in a non-drug-related task. The EPN to heroin cues could represent a novel electrophysiological index with clinical implications for selecting abstinent drug users who are at increased risk of relapse or to evaluate treatment interventions.

  16. Texas Abstinence Educators' Self-Efficacy to Motivate Youth Sexual Abstinence

    ERIC Educational Resources Information Center

    Rasberry, Catherine N.; Goodson, Patricia; Buhi, Eric R.; Pruitt, B. E.; Wilson, Kelly; Suther, Sandra

    2007-01-01

    Authors examined self-efficacy to motivate abstinent behavior (among youth) in a sample of instructors teaching abstinence-only-until-marriage education in Texas (N = 104). Sixty-one percent of the sample had been trained/certified to teach abstinence education. Instructors (mostly female and White) were more confident motivating students to…

  17. History of Illicit Stimulant Use Is Not Associated with Long-Lasting Changes in Learning of Fine Motor Skills in Humans

    PubMed Central

    Todd, Gabrielle; Pearson-Dennett, Verity; Flavel, Stanley C.; Haberfield, Miranda; Edwards, Hannah; White, Jason M.

    2016-01-01

    Little is known about the long-lasting effect of use of illicit stimulant drugs on learning of new motor skills. We hypothesised that abstinent individuals with a history of primarily methamphetamine and ecstasy use would exhibit normal learning of a visuomotor tracking task compared to controls. The study involved three groups: abstinent stimulant users (n = 21; 27 ± 6 yrs) and two gender-matched control groups comprising nondrug users (n = 16; 22 ± 4 yrs) and cannabis users (n = 16; 23 ± 5 yrs). Motor learning was assessed with a three-minute visuomotor tracking task. Subjects were instructed to follow a moving target on a computer screen with movement of the index finger. Metacarpophalangeal joint angle and first dorsal interosseous electromyographic activity were recorded. Pattern matching was assessed by cross-correlation of the joint angle and target traces. Distance from the target (tracking error) was also calculated. Motor learning was evident in the visuomotor task. Pattern matching improved over time (cross-correlation coefficient) and tracking error decreased. However, task performance did not differ between the groups. The results suggest that learning of a new fine visuomotor skill is unchanged in individuals with a history of illicit stimulant use. PMID:26819778

  18. History of Illicit Stimulant Use Is Not Associated with Long-Lasting Changes in Learning of Fine Motor Skills in Humans.

    PubMed

    Todd, Gabrielle; Pearson-Dennett, Verity; Flavel, Stanley C; Haberfield, Miranda; Edwards, Hannah; White, Jason M

    2016-01-01

    Little is known about the long-lasting effect of use of illicit stimulant drugs on learning of new motor skills. We hypothesised that abstinent individuals with a history of primarily methamphetamine and ecstasy use would exhibit normal learning of a visuomotor tracking task compared to controls. The study involved three groups: abstinent stimulant users (n = 21; 27 ± 6 yrs) and two gender-matched control groups comprising nondrug users (n = 16; 22 ± 4 yrs) and cannabis users (n = 16; 23 ± 5 yrs). Motor learning was assessed with a three-minute visuomotor tracking task. Subjects were instructed to follow a moving target on a computer screen with movement of the index finger. Metacarpophalangeal joint angle and first dorsal interosseous electromyographic activity were recorded. Pattern matching was assessed by cross-correlation of the joint angle and target traces. Distance from the target (tracking error) was also calculated. Motor learning was evident in the visuomotor task. Pattern matching improved over time (cross-correlation coefficient) and tracking error decreased. However, task performance did not differ between the groups. The results suggest that learning of a new fine visuomotor skill is unchanged in individuals with a history of illicit stimulant use.

  19. Randomized Trial of Prize-Based Reinforcement Density for Simultaneous Abstinence from Cocaine and Heroin

    ERIC Educational Resources Information Center

    Ghitza, Udi E.; Epstein, David H.; Schmittner, John; Vahabzadeh, Massoud; Lin, Jia-Ling; Preston, Kenzie L.

    2007-01-01

    To examine the effect of reinforcer density in prize-based abstinence reinforcement, heroin/cocaine users (N = 116) in methadone maintenance (100 mg/day) were randomly assigned to a noncontingent control group (NonC) or to 1 of 3 groups that earned prize draws for abstinence: manual drawing with standard prize density (MS) or computerized drawing…

  20. Criminality among Rural Stimulant Users in the United States

    ERIC Educational Resources Information Center

    Oser, Carrie; Leukefeld, Carl; Staton-Tindall, Michele; Duvall, Jamieson; Garrity, Thomas; Stoops, William; Falck, Russel; Wang, Jichuan; Carlson, Robert; Sexton, Rocky; Wright, Patricia; Booth, Brenda

    2011-01-01

    Despite the increase in media attention on "meth cooking" in rural areas of the United States, little is known about rural stimulant use--particularly, the criminality associated with stimulant use. Data were collected from community stimulant users in rural Ohio, Arkansas, and Kentucky (N = 709). Findings from three logistic regression…

  1. Associations between Sexual Abstinence Ideals, Religiosity, and Alcohol Abstinence: A Longitudinal Study of Finnish Twins

    PubMed Central

    Winter, Torsten; Karvonen, Sakari; Rose, Richard J.

    2016-01-01

    We analyzed prevalence and stability of attitudes endorsing sexual abstinence ideals from late adolescence into early adulthood and studied associations of these attitudes with religiosity and alcohol abstinence in a sexually liberal Nordic society. Our population-based sample of Finnish twins permitted comparisons of co-twins concordant for religiosity but discordant for drinking to evaluate the association of sexual abstinence ideals with alcohol abstinence, controlling for household environment. From age 17 to 24, endorsement of sexual abstinence as a romantic ideal declined from 25% to 15%. Religiosity and alcohol abstinence correlated, both separately and together, with endorsing sexual abstinence. Abstinence ideals were associated with literal belief in fundamental tenets of the Bible. The association of sexual abstinence ideals with alcohol abstinence was confirmed in within-family comparisons of co-twins discordant for drinking but concordant for religiosity. Alcohol-abstinent twins were significantly more likely than their non-alcohol-abstinent twin siblings to endorse sexual abstinence ideals; that result suggests the association of sexual abstinence ideals with abstaining from alcohol is not explained by unmeasured confounds in familial background and structure. Our longitudinal results and analyses of discordant twins suggest that attitudes toward sexual abstinence ideals are embedded within other conservative attitudes and behaviors. PMID:23301620

  2. Duration of detection of methamphetamine in hair after abstinence.

    PubMed

    Suwannachom, Natiprada; Thananchai, Thiwaphorn; Junkuy, Anongphan; O'Brien, Timothy E; Sribanditmongkol, Pongruk

    2015-09-01

    Researchers in the field of hair analysis have known for at least two decades that test results for many chemical compounds remain positive for a considerable period of time after subjects have reported cessation of use. These findings were generally based on small sample populations or individual case studies. Within the last decade, hair analyses of larger populations have investigated the phenomenon of residual positives in abstinent individuals in order to determine the period of time required for various compounds to present negative hair test results at internationally accepted cutoff levels. Such data has primarily been used to establish guidelines for retesting former abusers of illicit drugs in order to evaluate claims of abstinence. To date, research has focused on cocaine and opiates. The present study is the first to examine the duration of detection of methamphetamine (MA) and its metabolite amphetamine (AP) in the hair of chronic MA users who recently ceased their consumption of the drug. The study population (n=63) consisted of inpatients at a hospital drug rehabilitation program in Chiang Mai, Thailand. Drug taking behavior was collected by personal interview at the time of enrollment. Subjects provided hair samples at approximately monthly intervals for MA and AP analysis by gas chromatography-mass spectrometry at 0.2ng/mg cutoff levels. The correlation of baseline MA and AP concentrations in hair at the beginning of abstinence with corresponding duration of detection indicated great individual variability for the rate of clearance of MA and AP from hair. In regard to duration of detection, the majority of chronic MA users remained MA positive for up to about 90 days of reported abstinence, but by 120 days, the detection rate had fallen to about 16%. All subjects tested negative for MA after 153 days of abstinence. For AP, the limit of the duration of detection was reached at 106 days. With the adoption of a margin of safety to compensate for

  3. The Coupling of Nicotine and Stimulant Craving During Treatment for Stimulant Dependence

    PubMed Central

    Magee, Joshua C.; Winhusen, Theresa

    2015-01-01

    Objective Smoking prevalence is high among substance abusers, making it important to understand when nicotine abstinence will aid, impair, or not affect abstinence from other substances. This study tested novel hypotheses about the coupling of nicotine and stimulant craving over time during stimulant dependence treatment. Method Adults (N=538) with cocaine and/or methamphetamine dependence completed a 10-week randomized controlled trial of substance use treatment with or without smoking cessation treatment. Participants reported nicotine and stimulant craving weekly and use twice per week. Results Latent Change Score modeling tested the association between weekly increases in nicotine craving and subsequent weekly changes in stimulant craving. Interestingly, results revealed a “substitution” effect: increases in nicotine craving predicted subsequent decreases in stimulant craving (γ=−.37, p=.001). Additionally, increases in nicotine craving predicted subsequent increases in nicotine use (γ=1.26, p=.04) and decreases in stimulant use (γ=−.07, p=.03). As expected, the substitution effect between nicotine and stimulant craving was stronger when stimulants were administered through the same route as nicotine (i.e., smoking; γ=−.56, p=.005) versus other routes (γ=−.32, p=.06). Finally, smoking cessation treatment eliminated the coupling between nicotine craving and stimulant craving (γ=−.07, p=.39). Conclusions Contrary to concerns about nicotine abstinence during substance dependence treatment, increases in nicotine craving may be associated with later reductions in stimulant craving and use, and unrelated when smoking cessation treatment is introduced. Weekly changes in nicotine craving convey information that can help clinicians to predict and understand shifts in stimulant craving and use during substance use disorder treatment. PMID:26460569

  4. The coupling of nicotine and stimulant craving during treatment for stimulant dependence.

    PubMed

    Magee, Joshua C; Winhusen, Theresa

    2016-03-01

    Smoking prevalence is high among substance abusers, making it important to understand when nicotine abstinence will aid, impair, or not affect abstinence from other substances. This study tested novel hypotheses about the coupling of nicotine and stimulant craving over time during stimulant dependence treatment. Adults (N = 538) with cocaine and/or methamphetamine dependence completed a 10-week randomized controlled trial of substance use treatment with or without smoking cessation treatment. Participants reported nicotine and stimulant craving weekly and use twice per week. Latent change score modeling tested the association between weekly increases in nicotine craving and subsequent weekly changes in stimulant craving. Interestingly, results revealed a "substitution" effect: increases in nicotine craving predicted subsequent decreases in stimulant craving, γ = -.37, p = .001. Additionally, increases in nicotine craving predicted subsequent increases in nicotine use, γ = 1.26, p = .04, and decreases in stimulant use, γ = -.07, p = .03. As expected, the substitution effect between nicotine and stimulant craving was stronger when stimulants were administered through the same route as nicotine (i.e., smoking), γ = -.56, p = .005, versus other routes, γ = -.32, p = .06. Finally, smoking cessation treatment eliminated the coupling between nicotine craving and stimulant craving, γ = -.07, p = .39. Contrary to concerns about nicotine abstinence during substance dependence treatment, increases in nicotine craving may be associated with later reductions in stimulant craving and use, and unrelated when smoking cessation treatment is introduced. Weekly changes in nicotine craving convey information that can help clinicians to predict and understand shifts in stimulant craving and use during substance use disorder treatment. (c) 2016 APA, all rights reserved).

  5. Effectiveness of Abstinence-Based Incentives: Interaction with Intake Stimulant Test Results

    ERIC Educational Resources Information Center

    Stitzer, Maxine L.; Petry, Nancy; Peirce, Jessica; Kirby, Kimberly; Killeen, Therese; Roll, John; Hamilton, John; Stabile, Patricia Q.; Sterling, Robert; Brown, Chanda; Kolodner, Ken; Li, Rui

    2007-01-01

    Intake urinalysis test result (drug positive vs. negative) has been previously identified as a strong predictor of drug abuse treatment outcome, but there is little information about how this prognostic factor may interact with the type of treatment delivered. The authors used data from a multisite study of abstinence incentives for stimulant…

  6. Resting state synchrony in long-term abstinent alcoholics with versus without comorbid drug dependence☆

    PubMed Central

    Camchong, Jazmin; Stenger, Victor Andrew; Fein, George

    2013-01-01

    Background We previously reported that when long-term abstinent alcoholics (LTAA; with no drug comorbidity) are compared to controls, they show increased resting state synchrony (RSS) in the executive control network and reduced RSS in the appetitive drive network suggestive of compensatory mechanisms that may facilitate abstinence. The aim of the present study was to investigate whether long-term abstinent alcoholics with comorbid stimulants dependence (LTAAS) show similar RSS mechanisms. Methods Resting-state functional MRI data were collected on 36 LTAAS (20 females, age: 47.85 ± 7.30), 23 LTAA (8 females, age: M = 47.91 ± 6.76), and 23 non-substance abusing controls (NSAC; 8 females, age: M = 47.99 ± 6.70). Using seed-based measures, we examined RSS with the nucleus accumbens (NAcc) and the subgenual anterior cingulate cortex (sgACC). Results Results showed commonalities in LTAA and LTAAS RSS (similar enhanced executive control RSS and left insula RSS) as well as differences (no attenuation of appetitive drive RSS in LTAAS and no enhancement of RSS in right insula in LTAA). Conclusions We believe these differences are adaptive mechanisms that support abstinence. These findings suggest common as well as specific targets for treatment in chronic alcoholics with vs without comorbid stimulant dependence. PMID:23639390

  7. Sexual behavior differences between amphetamine-type stimulants users and heroin users.

    PubMed

    Jia, Zhen-jun; Yan, Shi-yan; Bao, Yan-ping; Lian, Zhi; Zhang, Hao-ran; Liu, Zhi-min

    2013-01-01

    To explore the sexual behavior of amphetamine-type stimulant (ATS) users and heroin users, and to find out the dangerous sexual behaviors, even related risk factors among them. Four hundred thirty-eight ATS users and 524 heroin users were recruited in 10 compulsory detoxification treatment centers and voluntary detoxification centers in Beijing, Shenzhen, Guangzhou, Xi'an, and Taiyuan. Their sociodemographic characteristics, history of drug taking, and sexual behaviors were surveyed. Many variables of sociodemographic characteristics and sexual behaviors were significantly different between ATS users and heroin users (P < 0.05). Dangerous sexual behaviors among ATS users include sexual intercourse often or each time after taking drug (30.1%), multiple sexual intercourse (16.5%), casual sex partners (34.0%), homosexual partners (2.5%), and never or occasionally using condom with a steady sex partner (79.3%) or with casual sex partners (39.1%). The rate of ever-infecting sexually transmitted disease (STD) was high in both the groups (ATS, 20.5%; heroin, 30.9%). Sexual behavior is the main way to transmit STD and human immunodeficiency virus among ATS users. The study results will promote the government's awareness of the issue and take necessary steps to slow the spread of STD and human immunodeficiency virus among the ATS users.

  8. Predictors of motivation for abstinence at the end of outpatient substance abuse treatment

    PubMed Central

    Laudet, Alexandre B.; Stanick, Virginia

    2010-01-01

    Commitment to abstinence, a motivational construct, is a strong predictor of reductions in drug and alcohol use. Level of commitment to abstinence at treatment end predicts sustained abstinence, a requirement for recovery. This study sought to identify predictors of commitment to abstinence at treatment end to guide clinical practice and to inform the conceptualization of motivational constructs. Polysubstance users (N = 250) recruited at the start of outpatient treatment were re-interviewed at the end of services. Based on the extant literature, potential predictors were during treatment measures of substance use and related cognitions, psychological functioning, recovery supports, stress, quality of life satisfaction, and treatment experiences. In multivariate analyses, perceived harm of future drug use, abstinence self-efficacy, quality of life satisfaction, and number of network members in 12-step recovery contributed 26.6% of the variance explained in the dependent variable, a total of 49.6% when combined with the control variables (demographics and baseline level of the outcome). Gender subgroup analyses yielded largely similar results. Clinical implications of findings for maximizing commitment to abstinence when clients leave treatment are discussed as are future research directions. PMID:20185267

  9. Cerebral metabolic dysfunction and impaired vigilance in recently abstinent methamphetamine abusers.

    PubMed

    London, Edythe D; Berman, Steven M; Voytek, Bradley; Simon, Sara L; Mandelkern, Mark A; Monterosso, John; Thompson, Paul M; Brody, Arthur L; Geaga, Jennifer A; Hong, Michael S; Hayashi, Kiralee M; Rawson, Richard A; Ling, Walter

    2005-11-15

    Methamphetamine (MA) abusers have cognitive deficits, abnormal metabolic activity and structural deficits in limbic and paralimbic cortices, and reduced hippocampal volume. The links between cognitive impairment and these cerebral abnormalities are not established. We assessed cerebral glucose metabolism with [F-18]fluorodeoxyglucose positron emission tomography in 17 abstinent (4 to 7 days) methamphetamine users and 16 control subjects performing an auditory vigilance task and obtained structural magnetic resonance brain scans. Regional brain radioactivity served as a marker for relative glucose metabolism. Error rates on the task were related to regional radioactivity and hippocampal morphology. Methamphetamine users had higher error rates than control subjects on the vigilance task. The groups showed different relationships between error rates and relative activity in the anterior and middle cingulate gyrus and the insula. Whereas the MA user group showed negative correlations involving these regions, the control group showed positive correlations involving the cingulate cortex. Across groups, hippocampal metabolic and structural measures were negatively correlated with error rates. Dysfunction in the cingulate and insular cortices of recently abstinent MA abusers contribute to impaired vigilance and other cognitive functions requiring sustained attention. Hippocampal integrity predicts task performance in methamphetamine users as well as control subjects.

  10. It's the thought that counts: craving metacognitions and their role in abstinence from methamphetamine use.

    PubMed

    Lee, Nicole K; Pohlman, Sonja; Baker, Amanda; Ferris, Jason; Kay-Lambkin, Frances

    2010-04-01

    Craving is frequently reported as a trigger for relapse by those trying to remain abstinent from psychoactive substances. Metacognitive beliefs about managing craving may play an important role in determining further cognition and behavior. They are, therefore, important to measure in treatment and may serve as target cognitions to be modified in support of behavioral change. As part of the assessment battery of a randomized controlled trial among 214 methamphetamine users, we included the Craving Beliefs Questionnaire (CBQ), a measure designed to assess an individual's perception of the potential negative impact of craving, at baseline. Changes in abstinence rates were significantly related to CBQ score, suggesting that craving beliefs are associated with changes in methamphetamine use. Further validation of the CBQ is warranted. Future clinical research among methamphetamine users could focus on directly manipulating craving beliefs through cognitive therapy to affect abstinence. Copyright 2010 Elsevier Inc. All rights reserved.

  11. Illicit Stimulant Use Is Associated with Abnormal Substantia Nigra Morphology in Humans

    PubMed Central

    Todd, Gabrielle; Noyes, Carolyn; Flavel, Stanley C.; Della Vedova, Chris B.; Spyropoulos, Peter; Chatterton, Barry; Berg, Daniela; White, Jason M.

    2013-01-01

    Use of illicit stimulants such as methamphetamine, cocaine, and ecstasy is an increasing health problem. Chronic use can cause neurotoxicity in animals and humans but the long-term consequences are not well understood. The aim of the current study was to investigate the long-term effect of stimulant use on the morphology of the human substantia nigra. We hypothesised that history of illicit stimulant use is associated with an abnormally bright and enlarged substantia nigra (termed ‘hyperechogenicity’) when viewed with transcranial sonography. Substantia nigra morphology was assessed in abstinent stimulant users (n = 36; 31±9 yrs) and in two groups of control subjects: non-drug users (n = 29; 24±5 yrs) and cannabis users (n = 12; 25±7 yrs). Substantia nigra morphology was viewed with transcranial sonography and the area of echogenicity at the anatomical site of the substantia nigra was measured at its greatest extent. The area of substantia nigra echogenicity was significantly larger in the stimulant group (0.273±0.078 cm2) than in the control (0.201±0.054 cm2; P<0.001) and cannabis (0.202±0.045 cm2; P<0.007) groups. 53% of stimulant users exhibited echogenicity that exceeded the 90th percentile for the control group. The results of the current study suggest that individuals with a history of illicit stimulant use exhibit abnormal substantia nigra morphology. Substantia nigra hyperechogenicity is a strong risk factor for developing Parkinson's disease later in life and further research is required to determine if the observed abnormality in stimulant users is associated with a functional deficit of the nigro-striatal system. PMID:23418568

  12. Nondependent stimulant users of cocaine and prescription amphetamines show verbal learning and memory deficits.

    PubMed

    Reske, Martina; Eidt, Carolyn A; Delis, Dean C; Paulus, Martin P

    2010-10-15

    Stimulants are used increasingly to enhance social (cocaine) or cognitive performance (stimulants normally prescribed, prescription stimulants [e.g., methylphenidate, amphetamines]). Chronic use, by contrast, has been associated with significant verbal memory and learning deficits. This study sought to determine whether subtle learning and memory problems characterize individuals who exhibit occasional but not chronic use of stimulants. One hundred fifty-four young (age 18-25), occasional, nondependent stimulant users and 48 stimulant-naive comparison subjects performed the California Verbal Learning Test II. Lifetime uses of stimulants and co-use of marijuana were considered in correlation and median split analyses. Compared with stimulant-naive subjects, occasional stimulant users showed significant performance deficits, most pronounced in the verbal recall and recognition domains. Lifetime uses of stimulants and marijuana did not affect California Verbal Learning Test II performance. The type of stimulant used, however, was of major relevance: users of cocaine only were less impaired, whereas cumulative use of prescription stimulants was associated with impaired verbal learning and memory capacities. These results support the hypothesis of subtle and possibly pre-existing neurocognitive deficiencies in occasional users of stimulants, which might be related to the motivation for using these drugs. More importantly, despite beneficial short-term effects, cumulative use, particularly of prescription amphetamines and methylphenidate, intensifies these deficits. Copyright © 2010 Society of Biological Psychiatry. Published by Elsevier Inc. All rights reserved.

  13. Utilization of smoking cessation informational, interactive, and online community resources as predictors of abstinence: cohort study.

    PubMed

    An, Lawrence C; Schillo, Barbara A; Saul, Jessie E; Wendling, Ann H; Klatt, Colleen M; Berg, Carla J; Ahulwalia, Jasjit S; Kavanaugh, Annette M; Christenson, Matthew; Luxenberg, Michael G

    2008-12-20

    The association between greater utilization of Web-assisted tobacco interventions and increased abstinence rates is well recognized. However, there is little information on how utilization of specific website features influences quitting. To determine the association between utilization of informational, interactive, and online community resources (eg. bulletin boards) and abstinence rates, with the broader objective to identify potential strategies for improving outcomes for Web-assisted tobacco interventions. In Spring 2004, a cohort of 607 quitplan.com users consented to participate in an evaluation of quitplan.com, a Minnesota branded version of QuitNet.com. We developed utilization measures for different site features: general information, interactive diagnostic tools and quit planning tools, online expert counseling, passive (ie, reading of bulletin boards) and active (ie, public posting) online community engagement, and one-to-one messaging with other virtual community members. Using bivariate, multivariate, and path analyses, we examined the relationship between utilization of specific site features and 30-day abstinence at 6 months. The most commonly used resources were the interactive quit planning tools (used by 77% of site users). Other informational resources (ie, quitting guides) were used more commonly (60% of users) than passive (38%) or active (24%) community features. Online community engagement through one-to-one messaging was low (11%) as was use of online counseling (5%). The 30-day abstinence rate among study participants at 6 months was 9.7% (95% Confidence Interval [CI] 7.3% - 12.1%). In the logistic regression model, neither the demographic data (eg, age, gender, education level, employment, or insurance status) nor the smoking-related data (eg, cigarettes per day, time to first morning cigarette, baseline readiness to quit) nor use of smoking cessation medications entered the model as significant predictors of abstinence. Individuals who

  14. EEG deficits in chronic marijuana abusers during monitored abstinence: preliminary findings.

    PubMed

    Herning, Ronald I; Better, Warren; Tate, Kimberly; Cadet, Jean L

    2003-05-01

    Cognitive, cerebrovascular, and psychiatric impairments have been documented with chronic marijuana users. To better understand the nature and duration of these neurocognitive changes in marijuana abusers, we recorded the resting EEG of 29 abstinent chronic marijuana abusers and 21 control subjects. The marijuana abusers were tested twice: the first evaluation occurred within 72 hours of admission to the inpatient research unit; the second evaluation occurred after 28 to 30 days of monitored abstinence. A three-minute period of EEG was recorded during resting eyes-closed conditions from eight electrodes (F(3), C(3), P(3), O(1), F(4), C(4), P(4), and O(2)). The artifacted EEG was converted to six frequency bands (delta, theta, alpha(1), alpha(2), beta(1), and beta(2)) using a fast Fourier transform. During early abstinence, absolute power was significantly lower (p < 0.05) for the marijuana abusers than for the control subjects for the theta and alpha(1) bands. These reductions in theta and alpha(1) power persisted for 28 days of monitored abstinence. These EEG changes, together with cerebral blood flow deficits, might underlie the cognitive alterations observed in marijuana abusers. Additional research is needed to determine how long these deficits persist during abstinence and if treatment with neuroprotective agents may reverse them.

  15. Contingency Management is Effective in Promoting Abstinence and Retention in Treatment Among Crack Cocaine Users in Brazil: A Randomized Controlled Trial

    PubMed Central

    Miguel, André Q. C.; Madruga, Clarice S.; Cogo-Moreira, Hugo; Yamauchi, Rodolfo; Simões, Viviane; da Silva, Claudio J.; McPherson, Sterling; Roll, John M.; Laranjeira, Ronaldo R.

    2016-01-01

    BACKGROUND Crack cocaine dependence has become a severe public health problem in Brazil, and current psychosocial approaches to this problem have shown little or no effectiveness. Although contingency management is among the most effective behavioral treatments for substance use disorders, it has never been applied in the treatment of crack cocaine-dependent individuals in Brazil. AIMS To evaluate the efficacy of incorporating contingency management into standard outpatient treatment for crack cocaine dependence, as well as the impact that doing so has on treatment attendance, retention in treatment, maintenance of abstinence, and the frequency of substance use. METHODS We evaluated 65 treatment-seeking, crack cocaine-dependent individuals, randomized to receive 12 weeks of standard treatment plus contingency management (STCM; n = 33) or 12 weeks of standard treatment alone (STA; n = 32). Those in the STCM group received monetary incentives for being abstinent, earning up to US$235.50 if they remained abstinent throughout the entire treatment period. RESULTS The STCM group participants attended a mean of 19.5 (SD = 14.9) treatment sessions, compared with 3.7 (SD = 5.9) for the STA group participants (p < 0.01). Those in the STCM group were 3.8, 4.6, and 68.9 times more likely to be retained in treatment at weeks 4, 8, and 12 than were those in the STA group. The likelihood of detecting 4, 8, and 12 weeks of continuous abstinence was 17.7, 9.9, and 18.6 times higher in the STCM group than in the STA group (p < 0.05). Compared to the STA group, the STCM group submitted a significantly higher proportion of crack cocaine, THC, and alcohol negative samples (p < 0.001) when all expected samples were included in the denominator, but not when only submitted samples were considered. The average monthly cost/participant for incentives was $29.00. CONCLUSIONS Contingency management showed efficacy in a sample of Brazilian crack cocaine users. The intervention holds promise

  16. Contingency management is effective in promoting abstinence and retention in treatment among crack cocaine users in Brazil: A randomized controlled trial.

    PubMed

    Miguel, André Q C; Madruga, Clarice S; Cogo-Moreira, Hugo; Yamauchi, Rodolfo; Simões, Viviane; da Silva, Claudio J; McPherson, Sterling; Roll, John M; Laranjeira, Ronaldo R

    2016-08-01

    Crack cocaine dependence has become a severe public health problem in Brazil, and current psychosocial approaches to this problem have shown little or no effectiveness. Although contingency management is among the most effective behavioral treatments for substance use disorders, it has never been applied in the treatment of crack cocaine-dependent individuals in Brazil. The aim of this study was to evaluate the efficacy of incorporating contingency management into standard outpatient treatment for crack cocaine dependence, as well as the impact that doing so has on treatment attendance, retention in treatment, maintenance of abstinence, and the frequency of substance use. We evaluated 65 treatment-seeking, crack cocaine-dependent individuals, randomized to receive 12 weeks of standard treatment plus contingency management (STCM; n = 33) or 12 weeks of standard treatment alone (STA; n = 32). Those in the STCM group received monetary incentives for being abstinent, earning up to US$235.50 if they remained abstinent throughout the entire treatment period. The STCM group participants attended a mean of 19.5 (SD = 14.9) treatment sessions, compared with 3.7 (SD = 5.9) for the STA group participants (p < .01). Those in the STCM group were 3.8, 4.6, and 68.9 times more likely to be retained in treatment at weeks 4, 8, and 12 than were those in the STA group. The likelihood of detecting 4, 8, and 12 weeks of continuous abstinence was 17.7, 9.9, and 18.6 times higher in the STCM group than in the STA group (p < .05). Compared to the STA group, the STCM group submitted a significantly higher proportion of negative samples for crack cocaine, delta-9-tetrahydrocannabinol, and alcohol (p < .001) when all expected samples were included in the denominator but not when only submitted samples were considered. The average monthly cost/participant for incentives was $29.00. Contingency management showed efficacy in a sample of Brazilian crack cocaine users. The intervention holds

  17. Breaking the habit: a retrospective analysis of desistance factors among formerly problematic heroin users.

    PubMed

    Best, David W; Ghufran, Safeena; Day, Ed; Ray, Rajashree; Loaring, Jessica

    2008-11-01

    The aim of this study was to examine heroin careers among former users to assess desistance factors and explanations for sustained abstinence. The study surveyed 107 former problematic heroin users who have achieved long-term abstinence about their experiences of achieving and sustaining abstinence. The cohort was recruited opportunistically from three sources, drawing heavily on former users working in the addictions field. On average, the group had heroin careers lasting for just under 10 years, punctuated by an average of 2.6 treatment episodes and 3.1 periods of abstinence, and had been heroin abstinent for an average of 10 years at the time of completing the survey. The most commonly expressed reason for finally achieving abstinence was 'tired of the lifestyle' followed by reasons relating to psychological health. In contrast, when asked to explain how abstinence was sustained, clients quoted both social network factors (moving away from drug-using friends and support from non-using friends) and practical factors (accommodation and employment) as well as religious or spiritual factors. Treatment was not mentioned widely either in achieving or sustaining abstinence, in contrast to 12-Step, which was endorsed widely. The study supports a careers perspective for examining heroin careers and indicates that, while achieving abstinence is possible for chronic opiate users, the path to sustained abstinence is complex and often reliant upon external support systems.

  18. Contingency Management Abstinence Incentives: Cost and Implications for Treatment Tailoring.

    PubMed

    Cunningham, Colin; Stitzer, Maxine; Campbell, Aimee N C; Pavlicova, Martina; Hu, Mei-Chen; Nunes, Edward V

    2017-01-01

    To examine prize-earning costs of contingency management (CM) incentives in relation to participants' pre-study enrollment drug use status (baseline (BL) positive vs. BL negative) and relate these to previously reported patterns of intervention effectiveness. Participants were 255 substance users entering outpatient treatment who received the therapeutic educational system (TES), in addition to usual care counseling. TES included a CM component such that participants could earn up to $600 in prizes on average over 12-weeks for providing drug negative urines and completing web-based cognitive behavior therapy modules. We examined distribution of prize draws and value of prizes earned for subgroups that were abstinent (BL negative; N=136) or not (BL positive; N=119) at study entry based on urine toxicology and breath alcohol screen. Distribution of draws earned (median=119 vs. 17; p<.0001) and prizes redeemed (median=54 vs. 9; p<.001) for drug abstinence differed significantly for BL negative compared to BL positive participants. BL negative earned on average twice as much in prizes as BL positive participants ($245 vs. $125). Median value of prizes earned was 5.4 times greater for BL negative compared to BL positive participants ($237 vs. $44; p<.001). Two-thirds of expenditures in an abstinence incentive program were paid to BL negative participants. These individuals had high rates of drug abstinence during treatment and did not show improved abstinence outcomes with TES versus usual care (Campbell et al., 2014). Effectiveness of the abstinence-focused CM intervention included in TES may be enhanced by tailoring delivery based on patients' drug use status at treatment entry. Copyright © 2015 Elsevier Inc. All rights reserved.

  19. Brain Volume Correlates with Duration of Abstinence from Substance Abuse in a Region-Specific and Substance-Specific Manner.

    PubMed

    Korponay, Cole; Kosson, David S; Decety, Jean; Kiehl, Kent A; Koenigs, Michael

    2017-10-01

    Human neuroimaging studies indicate that the loss of brain volume associated with substance abuse may be recovered during abstinence. Subcortical and prefrontal cortical regions involved in reward and decision-making are among the regions most consistently implicated in damage and recovery from substance abuse, but the relative capacities of these different brain regions to recover volume during abstinence remains unclear, and it is unknown whether recovery capacities depend on the substance that was abused. Voxel-based morphometry in a prison inmate sample ( n =107) of long-term abstinent former regular users (FRUs) and former light users (FLUs) of alcohol, cocaine, and/or cannabis. Cross-sectional indicators of volume recovery were operationalized as 1) positive correlation between abstinence duration and volume in FRUs and 2) absence of lower volume in FRUs compared to FLUs. In FRUs of alcohol, abstinence duration positively correlated with volume in subcortical regions (particularly the putamen and amygdala) but not prefrontal regions; lower prefrontal but not subcortical volume was observed in FRUs compared to FLUs. In FRUs of cocaine, abstinence duration positively correlated with volume in both subcortical regions (particularly the nucleus accumbens) and prefrontal regions; lower volume was not observed in either subcortical or prefrontal regions in FRUs. In FRUs of cannabis, abstinence duration positively correlated with subcortical but not prefrontal volume; lower prefrontal but not subcortical volume was observed in FRUs. Subcortical structures displayed indicators of volume recovery across FRUs of all three substances, whereas prefrontal regions displayed indicators of volume recovery only in FRUs of cocaine.

  20. Non-Dependent Stimulant Users of Cocaine and Prescription Amphetamines Show Verbal Learning and Memory Deficits

    PubMed Central

    Reske, Martina; Eidt, Carolyn A.; Delis, Dean C.; Paulus, Martin P.

    2010-01-01

    Background Stimulants are used increasingly to enhance social (cocaine) or cognitive performance (stimulants normally prescribed, prescription stimulants, e.g. methylphenidate, amphetamines). Chronic use, on the other hand, has been associated with significant verbal memory and learning deficits. This study sought to determine whether subtle learning and memory problems characterize individuals who exhibit occasional but not chronic use of stimulants. Methods 154 young (age 18–25) occasional, non-dependent stimulant users and 48 stimulant naïve comparison subjects performed the California Verbal Learning test (CVLT-II). Lifetime uses of stimulants and co-use of marijuana were considered in correlation and median split analyses. Results Compared to stimulant naïve subjects, occasional stimulant users showed significant performance deficits, most pronounced in the verbal recall and recognition domains. Lifetime uses of stimulants and marijuana did not affect CVLT-II performance. The type of stimulant used, however, was of major relevance: users of cocaine only were less impaired, while cumulative use of prescription stimulants was associated with impaired verbal learning and memory capacities. Conclusions These results support the hypothesis of subtle and possibly pre-existing neurocognitive deficiencies in occasional users of stimulants, which may be related to the motivation of using these drugs. More importantly, despite beneficial short-term effects, cumulative use, particularly of prescription amphetamines and methylphenidate, intensifies these deficits. PMID:20605137

  1. Effects of electrical stimulation rate on speech recognition in cochlear implant users.

    PubMed

    Park, Sung Hye; Kim, Eunoak; Lee, Hyo-Jeong; Kim, Hyung-Jong

    2012-04-01

    The stimulus signals delivered in cochlear implant (CI) systems are generally derived by sampling the temporal envelope of each channel at some constant rate and using its intensity to control the stimulation current level delivered to the corresponding electrode site. The objective of the study was to investigate speech recognition performance of cochlear implant users in quiet and noisy environments using either moderate or high rates of electrical stimulations. Six post-lingually deafened adult users of the Nucleus CI24 cochlear implant (Contour® electrode array, Cochlear™, Macquarie Park, Australia) with the Freedom® speech processor participated in the study. Stimulation rates of 900 and 2400 pulses-per-second/channel (pps/ch) were used after both stimulation programs were balanced for loudness. Monosyllabic word and sentence recognition scores in quiet and noisy environments were evaluated for each stimulation program after two months of practice. Subjects were also asked to respond to a questionnaire to examine their preference to any stimulation rate in different hearing conditions. Word recognition scores for monosyllabic words in quiet conditions with the 900 stimulation rate was better than that of the 2400 stimulation rate, although no significant differences between them were found for sentence test in noise. A survey questionnaire indicated that most subjects preferred the 900 stimulation rate to the 2400 stimulation rate, especially in quiet conditions. Most subjects indicated a preference for 900 pps/ch rate in quiet conditions. It is recommended to remap at 900 pps/ch for those CI users whose performance in quiet conditions is less than ideal.

  2. Reduced fMRI activity predicts relapse in patients recovering from stimulant dependence.

    PubMed

    Clark, Vincent P; Beatty, Gregory K; Anderson, Robert E; Kodituwakku, Piyadassa; Phillips, John P; Lane, Terran D R; Kiehl, Kent A; Calhoun, Vince D

    2014-02-01

    Relapse presents a significant problem for patients recovering from stimulant dependence. Here we examined the hypothesis that patterns of brain function obtained at an early stage of abstinence differentiates patients who later relapse versus those who remain abstinent. Forty-five recently abstinent stimulant-dependent patients were tested using a randomized event-related functional MRI (ER-fMRI) design that was developed in order to replicate a previous ERP study of relapse using a selective attention task, and were then monitored until 6 months of verified abstinence or stimulant use occurred. SPM revealed smaller absolute blood oxygen level-dependent (BOLD) response amplitude in bilateral ventral posterior cingulate and right insular cortex in 23 patients positive for relapse to stimulant use compared with 22 who remained abstinent. ER-fMRI, psychiatric, neuropsychological, demographic, personal and family history of drug use were compared in order to form predictive models. ER-fMRI was found to predict abstinence with higher accuracy than any other single measure obtained in this study. Logistic regression using fMRI amplitude in right posterior cingulate and insular cortex predicted abstinence with 77.8% accuracy, which increased to 89.9% accuracy when history of mania was included. Using 10-fold cross-validation, Bayesian logistic regression and multilayer perceptron algorithms provided the highest accuracy of 84.4%. These results, combined with previous studies, suggest that the functional organization of paralimbic brain regions including ventral anterior and posterior cingulate and right insula are related to patients' ability to maintain abstinence. Novel therapies designed to target these paralimbic regions identified using ER-fMRI may improve treatment outcome. Copyright © 2012 Wiley Periodicals, Inc.

  3. Nicotine and Nicotine Abstinence Do Not Interfere with GABAA Receptor Neuroadaptations During Alcohol Abstinence.

    PubMed

    Hillmer, Ansel T; Kloczynski, Tracy; Sandiego, Christine M; Pittman, Brian; Anderson, Jon M; Labaree, David; Gao, Hong; Huang, Yiyun; Deluliis, Giuseppe; O'Malley, Stephanie S; Carson, Richard E; Cosgrove, Kelly P

    2016-04-01

    Alcohol dependence and tobacco smoking are highly comorbid, and treating both conditions simultaneously is controversial. Previously, we showed that tobacco smoking interferes with GABAA receptor neuroadaptations during alcohol withdrawal in humans, while this effect did not occur with continued nicotine use during alcohol abstinence in nonhuman primates. Here, we extend our previous work by measuring GABAA receptor availability with positron emission tomography (PET) during drug abstinence in nonhuman primates exposed to alcohol alone, nicotine and alcohol together, and alcohol abstinence with continued nicotine exposure. Twenty-four adolescent male rhesus macaques orally self-administered alcohol and nicotine, available separately in water and saccharin, over 20 weeks. The groups included alcohol alone (n = 8); nicotine and alcohol with simultaneous abstinence (n = 8); nicotine and alcohol with alcohol abstinence while nicotine was still available (n = 8); and a pilot group of animals consuming nicotine alone (n = 6). Animals were imaged with [(11)C]flumazenil PET to measure binding potential (BPND), an index of GABAA receptor availability. Imaging occurred at baseline (drug-naíve), and following alcohol and/or nicotine cessation at 1 day, 8 days, and 12 weeks of abstinence. Generalized linear mixed models were used to examine the time course of [(11)C]flumazenil BPND during alcohol abstinence across groups. Animals consumed 3.95 ± 1.22 g/kg/d alcohol and 55.4 ± 35.1 mg/kg/d nicotine. No significant group effects were observed in [(11)C]flumazenil BPND during alcohol abstinence; however, a main effect of time was detected. Post hoc analyses indicated that all groups abstaining from alcohol exhibited significantly increased GABAA receptor availability at 1 day and 8 days (but not 12 weeks) of abstinence relative to baseline, while no changes in [(11)C]flumazenil BPND during nicotine abstinence alone were observed. These data indicate that neither nicotine nor

  4. Effects of Electrical Stimulation Rate on Speech Recognition in Cochlear Implant Users

    PubMed Central

    Park, Sung Hye; Kim, Eunoak; Lee, Hyo-Jeong

    2012-01-01

    Background and Objectives The stimulus signals delivered in cochlear implant (CI) systems are generally derived by sampling the temporal envelope of each channel at some constant rate and using its intensity to control the stimulation current level delivered to the corresponding electrode site. The objective of the study was to investigate speech recognition performance of cochlear implant users in quiet and noisy environments using either moderate or high rates of electrical stimulations. Materials and Methods Six post-lingually deafened adult users of the Nucleus CI24 cochlear implant (Contour® electrode array, Cochlear™, Macquarie Park, Australia) with the Freedom® speech processor participated in the study. Stimulation rates of 900 and 2400 pulses-per-second/channel (pps/ch) were used after both stimulation programs were balanced for loudness. Monosyllabic word and sentence recognition scores in quiet and noisy environments were evaluated for each stimulation program after two months of practice. Subjects were also asked to respond to a questionnaire to examine their preference to any stimulation rate in different hearing conditions. Results Word recognition scores for monosyllabic words in quiet conditions with the 900 stimulation rate was better than that of the 2400 stimulation rate, although no significant differences between them were found for sentence test in noise. A survey questionnaire indicated that most subjects preferred the 900 stimulation rate to the 2400 stimulation rate, especially in quiet conditions. Conclusions Most subjects indicated a preference for 900 pps/ch rate in quiet conditions. It is recommended to remap at 900 pps/ch for those CI users whose performance in quiet conditions is less than ideal. PMID:24653862

  5. Blue-yellow colour vision impairment and cognitive deficits in occasional and dependent stimulant users.

    PubMed

    Hulka, Lea M; Wagner, Michael; Preller, Katrin H; Jenni, Daniela; Quednow, Boris B

    2013-04-01

    Specific blue-yellow colour vision impairment has been reported in dependent cocaine users and it was postulated that drug-induced changes in retinal dopamine neurotransmission are responsible. However, it is unclear whether these changes are confined to chronic cocaine users, whether they are specific for dopaminergic stimulants such as cocaine and amphetamine and whether they are related to cognitive functions such as working memory, encoding and consolidation. In 47 occasional and 29 dependent cocaine users, 23 MDMA (commonly known as 'ecstasy') users and 47 stimulant-naive controls, colour vision discrimination was measured with the Lanthony Desaturated Panel D-15 Test and memory performance with the Auditory Verbal Learning Test. Both occasional and dependent cocaine users showed higher colour confusion indices than controls. Users of the serotonergic stimulant MDMA (26%), occasional (30%) and dependent cocaine users (34%) exhibited more frequent blue-yellow colour vision disorders compared to controls (9%). Inferior performance of MDMA users was caused by a subgroup with high amphetamine co-use (55%), while MDMA use alone was not associated with decreased blue-yellow discrimination (0%). Cognitive performance was worse in cocaine users with colour vision disorder compared to users and controls with intact colour vision and both colour vision impairment and cognitive deficits were related to cocaine use. Occasional cocaine and amphetamine use might induce blue-yellow colour vision impairment, whereas the serotonergic stimulant MDMA does not impair colour vision. The association between colour vision impairment and cognitive deficits in cocaine users may reflect that retinal and cerebral dopamine alterations are linked to a certain degree.

  6. Beyond Abstinence-Only: Relationships between Abstinence Education and Comprehensive Topic Instruction

    ERIC Educational Resources Information Center

    Jeffries, William L., IV; Dodge, Brian; Bandiera, Frank C.; Reece, Michael

    2010-01-01

    In the United States, a debate exists as to whether abstinence-only or comprehensive sexuality education strategies are most beneficial for school-age youth. Despite abstinence being a fundamental component of comprehensive education, the two are often characterized as polar opposites. Few studies have examined overlaps between the approaches. The…

  7. Rat Nucleus Accumbens Core Astrocytes Modulate Reward and the Motivation to Self-Administer Ethanol after Abstinence

    PubMed Central

    Bull, Cecilia; Freitas, Kelen CC; Zou, Shiping; Poland, Ryan S; Syed, Wahab A; Urban, Daniel J; Minter, Sabrina C; Shelton, Keith L; Hauser, Kurt F; Negus, S Stevens; Knapp, Pamela E; Bowers, M Scott

    2014-01-01

    Our understanding of the active role that astrocytes play in modulating neuronal function and behavior is rapidly expanding, but little is known about the role that astrocytes may play in drug-seeking behavior for commonly abused substances. Given that the nucleus accumbens is critically involved in substance abuse and motivation, we sought to determine whether nucleus accumbens astrocytes influence the motivation to self-administer ethanol following abstinence. We found that the packing density of astrocytes that were expressing glial fibrillary acidic protein increased in the nucleus accumbens core (NAcore) during abstinence from EtOH self-administration. No change was observed in the nucleus accumbens shell. This increased NAcore astrocyte density positively correlated with the motivation for ethanol. Astrocytes can communicate with one another and influence neuronal activity through gap-junction hemichannels. Because of this, the effect of blocking gap-junction hemichannels on the motivation for ethanol was examined. The motivation to self-administer ethanol after 3 weeks abstinence was increased following microinjection of gap-junction hemichannel blockers into the NAcore at doses that block both neuronal and astrocytic channels. In contrast, no effect was observed following microinjection of doses that are not thought to block astrocytic channels or following microinjection of either dose into the nucleus accumbens shell. Additionally, the motivation for sucrose after 3 weeks abstinence was unaffected by NAcore gap-junction hemichannel blockers. Next, Designer Receptors Exclusively Activated by Designer Drugs (DREADDs) were selectively expressed in NAcore astrocytes to test the effect of astrocyte stimulation. DREADD activation increased cytosolic calcium in primary astrocytes, facilitated responding for rewarding brain stimulation, and reduced the motivation for ethanol after 3 weeks abstinence. This is the first work to modulate drug-seeking behavior with

  8. Rat nucleus accumbens core astrocytes modulate reward and the motivation to self-administer ethanol after abstinence.

    PubMed

    Bull, Cecilia; Freitas, Kelen C C; Zou, Shiping; Poland, Ryan S; Syed, Wahab A; Urban, Daniel J; Minter, Sabrina C; Shelton, Keith L; Hauser, Kurt F; Negus, S Stevens; Knapp, Pamela E; Bowers, M Scott

    2014-11-01

    Our understanding of the active role that astrocytes play in modulating neuronal function and behavior is rapidly expanding, but little is known about the role that astrocytes may play in drug-seeking behavior for commonly abused substances. Given that the nucleus accumbens is critically involved in substance abuse and motivation, we sought to determine whether nucleus accumbens astrocytes influence the motivation to self-administer ethanol following abstinence. We found that the packing density of astrocytes that were expressing glial fibrillary acidic protein increased in the nucleus accumbens core (NAcore) during abstinence from EtOH self-administration. No change was observed in the nucleus accumbens shell. This increased NAcore astrocyte density positively correlated with the motivation for ethanol. Astrocytes can communicate with one another and influence neuronal activity through gap-junction hemichannels. Because of this, the effect of blocking gap-junction hemichannels on the motivation for ethanol was examined. The motivation to self-administer ethanol after 3 weeks abstinence was increased following microinjection of gap-junction hemichannel blockers into the NAcore at doses that block both neuronal and astrocytic channels. In contrast, no effect was observed following microinjection of doses that are not thought to block astrocytic channels or following microinjection of either dose into the nucleus accumbens shell. Additionally, the motivation for sucrose after 3 weeks abstinence was unaffected by NAcore gap-junction hemichannel blockers. Next, Designer Receptors Exclusively Activated by Designer Drugs (DREADDs) were selectively expressed in NAcore astrocytes to test the effect of astrocyte stimulation. DREADD activation increased cytosolic calcium in primary astrocytes, facilitated responding for rewarding brain stimulation, and reduced the motivation for ethanol after 3 weeks abstinence. This is the first work to modulate drug-seeking behavior with

  9. The Smoking Abstinence Questionnaire: Measurement of smokers’ abstinence-related expectancies

    PubMed Central

    Hendricks, Peter S.; Wood, Sabrina B.; Baker, Majel R.; Delucchi, Kevin L.; Hall, Sharon M.

    2011-01-01

    AIM To develop and validate a measure of smokers’ expectancies for the abstinence process upon quitting smoking: the Smoking Abstinence Questionnaire (SAQ). DESIGN Principal component analysis and other psychometric analyses of self-report data. SETTING San Francisco, California. PARTICIPANTS 507 adult smokers of at least 10 cigarettes per day diverse in gender, sexual orientation, and ethnoracial status. MEASUREMENTS The primary measure was a draft version of the SAQ. Additional measures assessed a variety of other smoking-related constructs. FINDINGS Principal component analyses revealed 10 factors of the SAQ: Withdrawal, Social Improvement/Nonsmoker Identity, Adverse Outcomes, Treatment Effectiveness, Common Reasons, Barriers to Treatment, Social Support, Optimistic Outcomes, Coffee Use, and Weight Gain. The SAQ factors demonstrated internal consistencies ranging from .62 to .85 and were associated with tobacco dependence, motivation to quit, abstinence self-efficacy, withdrawal symptoms, dietary restraint, shape and weight concern, and tobacco use expectancies. The SAQ predicted smoking-related constructs above and beyond tobacco use expectancies, suggesting that abstinence-related expectancies and tobacco use expectancies are distinct from one another. CONCLUSIONS A newly developed questionnaire, the SAQ, appears to reliably capture smokers’ expectancies for abstinence (Withdrawal, Social Improvement/Nonsmoker Identity, Adverse Outcomes, Common Reasons, Optimistic Outcomes, Coffee Use, and Weight Gain) and expectancies related to the success of a quit attempt (Treatment Effectiveness, Barriers to Treatment, and Social Support). It remains to be seen how far any of these expectancies predict attempts to quit, withdrawal, treatment utilization and response, and quitting success above and beyond existing measures. PMID:21205053

  10. Race moderates the effect of menthol cigarette use on short-term smoking abstinence.

    PubMed

    Reitzel, Lorraine R; Li, Yisheng; Stewart, Diana W; Cao, Yumei; Wetter, David W; Waters, Andrew J; Vidrine, Jennifer I

    2013-05-01

    The Food and Drug Administration is in the process of reviewing evidence of the impact of mentholated cigarettes on smoking behaviors and smoking cessation in order to determine if these products should be removed from the market. More empirical research is needed to inform those decisions. The goal of this study was to examine associations of menthol cigarette use with biochemically verified continuous short-term smoking abstinence, and potential moderation by race, among adult current smokers enrolled in a cohort study (N = 183; 57.4% female; 48.1% non-Hispanic Black, 51.9% non-Hispanic White). Continuation ratio logit models, adjusted for age, race, gender, total annual household income, educational level, employment status, and partner status, were used to examine associations of menthol use with smoking abstinence with and without an interaction term for race. Menthol cigarette use was not significantly associated with smoking abstinence in the sample as a whole; however, there was a significant interaction of menthol use with race (p = .03). Follow-up analyses stratified by race indicated that among White participants, menthol users had significantly lower odds of maintaining continuous abstinence than nonmenthol users (p = .05). Exploratory analyses suggested that tobacco dependence may lie along the causal pathway and partially explain this effect. White menthol smokers in this sample were at increased risk of smoking relapse relative to White nonmenthol smokers, at least partially due to greater tobacco dependence. Results should be replicated among other treatment-seeking samples with a greater representation of White menthol and Black nonmenthol smokers.

  11. Abstinence-related word associations and definitions of abstinence and virginity among missouri high school freshmen.

    PubMed

    Wilson, Kelly L; Smith, Matthew Lee; Menn, Mindy

    2013-11-01

    The ways in which adolescents define and view sex, abstinence, and virginity impact the efforts of sexuality educators and sexual health professionals. This study examined terminology used by nonsexually active high school students to define abstinence and virginity and identified words students associate with these terms. Purposes included (1) describing words/phrases associated with abstinence; (2) describing phrases for "being abstinent until marriage" and "being a virgin;" (3) assessing concordance between word dyads associated with abstinence; and (4) assessing concordance between phrases defining "abstinent until marriage" and "a virgin." In this study, 216 freshmen provided information about beliefs, behaviors, and perceptions. Pearson chi-square tests and Wilcoxon sign-rank tests assessed sex-based differences, definitions, and levels of concordance were conducted. Girls' friends took an abstinence pledge (p = .004) and their parents (p = .025) and best friends (p < .001) think they should abstain. Male counterparts reported being dissatisfied with current sex status (p = .002) and high acceptance of sex before marriage (p = .011). Boys were more likely to endorse "negative" words than girls. Professionals need to use relevant materials incorporating terminology that resonates with adolescents and programs that engage coherent participant discussions. © 2013, American School Health Association.

  12. Use of an online smoking cessation community promotes abstinence: Results of propensity score weighting.

    PubMed

    Graham, Amanda L; Papandonatos, George D; Erar, Bahar; Stanton, Cassandra A

    2015-12-01

    We estimated the causal effects of use of an online smoking cessation community on 30-day point prevalence abstinence at 3 months. Participants (N = 492) were adult current smokers in the enhanced Internet arm of The iQUITT Study, a randomized trial of Internet and telephone treatment for smoking cessation. All participants accessed a Web-based smoking-cessation program that included a large, established online community. Automated tracking metrics of passive (e.g., reading forum posts, viewing member profiles) and active (e.g., writing forum posts, sending private messages) community use were extracted from the site at 3 months. Self-selected community use defines the groups of interest: "None," "Passive," and "Both" (passive + active). Inverse probability of treatment weighting corrected for baseline imbalances on demographic, smoking, psychosocial, and medical history variables. Propensity weights estimated via generalized boosted models were used to calculate Average Treatment Effects (ATE) and Average Treatment effects on the Treated (ATT). Patterns of community use were: None = 198 (40.2%), Passive = 110 (22.4%), and Both = 184 (37.4%). ATE-weighted abstinence rates were: None = 4.2% (95% CI = 1.5-6.9); Passive = 15.1% (95% CI = 8.4-21.9); Both = 20.4% (95% CI = 13.9-26.8). ATT-weighted abstinence rates indicated even greater benefits of community use. Community users were more likely to quit smoking at 3 months than nonusers. The estimated benefit from use of online community resources was even larger among subjects with high propensity to use them. No differences in abstinence emerged between passive and passive/active users. Results suggest that lurking in online communities confers specific abstinence benefits. Implications of these findings for online cessation communities are discussed. (PsycINFO Database Record (c) 2015 APA, all rights reserved).

  13. Decision-Making Under Risk, but Not Under Ambiguity, Predicts Pathological Gambling in Discrete Types of Abstinent Substance Users.

    PubMed

    Wilson, Michael J; Vassileva, Jasmin

    2018-01-01

    This study explored how different forms of reward-based decision-making are associated with pathological gambling (PG) among abstinent individuals with prior dependence on different classes of drugs. Participants had lifetime histories of either "pure" heroin dependence ( n = 64), "pure" amphetamine dependence ( n = 51), or polysubstance dependence ( n = 89), or had no history of substance dependence ( n = 133). Decision-making was assessed via two neurocognitive tasks: (1) the Iowa Gambling Task (IGT), a measure of decision-making under ambiguity (i.e., uncertain risk contingencies); and (2) the Cambridge Gambling task (CGT), a measure of decision-making under risk (i.e., explicit risk contingencies). The main effects of neurocognitive performance and drug class on PG (defined as ≥3 DSM-IV PG symptoms) as well as their interactional effects were assessed via multiple linear regression. Two CGT indices of decision-making under risk demonstrated positive main effects on PG. Interaction effects indicated that the effects of decision-making under risk on PG were largely consistent across participant groups. Notably, a linear relationship between greater CGT Risk-Taking and PG symptoms was not observed among amphetamine users, whereas IGT performance was selectively and positively associated with PG in polysubstance users. Overall, results indicate that reward-based decision-making under risk may represent a risk factor for PG across substance users, with some variations in these relationships influenced by specific class of substance of abuse.

  14. Changes in stimulant drug use over time in the MACS: evidence for resilience against stimulant drug use among men who have sex with men.

    PubMed

    Lim, Sin How; Ostrow, David; Stall, Ron; Chmiel, Joan; Herrick, Amy; Shoptaw, Steve; Kao, Uyen; Carrico, Adam; Plankey, Michael

    2012-01-01

    Stimulant drug use is associated with numerous health problems among men who have sex with men (MSM). This paper describes how stimulant drug use changes over a four and one-half year period from 2003 until 2008. Participants were 2,389 men (17,222 person-visits) from The Multicenter AIDS Cohort Study (MACS)-an ongoing, prospective study of HIV infection among MSM. Group-based trajectory analyses of data from these men over the study period yielded a four groups solution: consistent users (9.8%), men whose use increased (5.4%), men whose use declined (6.9%), and abstinent or rarely-using men (77.9%). There were significant differences between groups in terms of demographic, behavioral risk and HIV serostatus. Men who increased or decreased stimulant drug use over time reported congruent changes in sexual risk taking. The fact that sexual risk levels parallel stimulant drug use over time suggests that finding ways to lower rates of stimulant drug use among MSM could be a tool in HIV prevention.

  15. Risk of amphetamine use disorder and mortality among incident users of prescribed stimulant medications in the Veterans Administration.

    PubMed

    Westover, Arthur N; Nakonezny, Paul A; Halm, Ethan A; Adinoff, Bryon

    2018-05-01

    Non-medical use of prescribed stimulant medications is a growing concern. This study's aims were to ascertain the demographics of stimulant medication users compared with non-users, examine temporal trends of stimulant medication use and estimate risk factors for development of amphetamine use disorder (AUD) and mortality among new users of stimulant medications. Cox proportional hazards regression in a retrospective cohort adjusted by baseline covariates. United States, national administrative database of the Veterans Affairs (VA) health-care system. Adult incident users of stimulant medications (n = 78 829) from fiscal years (FY) 2001 to 2012. Primary outcomes were time-to-event: (1) occurrence of AUD diagnosis and (2) death. Baseline covariates included demographic information, Food and Drug Administration (FDA)-approved indications for stimulant use, substance use disorders (SUD) and depression. Stimulant users compared with non-users were younger, more likely to be non-Hispanic white and female. Incident stimulant medication users increased threefold from FY2001-FY2012 and eightfold among adults aged 18-44 years. Nearly one in 10 incident users in FY2012 had a comorbid baseline SUD. Off-label use was common-nearly three of every five incident users in FY2012. Comorbid SUDs among incident stimulant medication users were risk factors for occurrence of AUD during follow-up, with adjusted hazard ratio (AHR) estimates ranging from 1.54 to 2.83 (Ps < 0.05). Increased mortality risk was observed with occurrence of AUD during follow-up [AHR = 1.55, 95% confidence interval (CI) = 1.13-2.14, P = 0.007], while on-label prescribing was protective against death (AHR = 0.686, 95% CI = 0.63-0.75, P < 0.0001). In a US national cohort of adult incident stimulant medication users in the Veterans Affairs health-care system, measured from fiscal years 2001 to 2012, comorbid substance use disorders were common and were risk factors for development of an

  16. Abstinence Self-Efficacy and Abstinence 1 Year After Substance Use Disorder Treatment

    ERIC Educational Resources Information Center

    Ilgen, Mark; McKellar, John; Tiet, Quyen

    2005-01-01

    To better understand the relationship between abstinence self-efficacy and treatment outcomes in substance use disorder patients, experts in the field need more information about the levels of abstinence self-efficacy most predictive of treatment outcomes. Participants (N = 2,967) from 15 residential substance use disorder treatment programs were…

  17. Characterizing longitudinal health state transitions among heroin, cocaine, and methamphetamine users

    PubMed Central

    Nosyk, B; Li, L; Evans, E; Huang, D; Min, J; Kerr, T; Brecht, ML; Hser, YI

    2014-01-01

    Aims Characterize longitudinal patterns of drug use careers and identify determinants of drug use frequency across cohorts of primary heroin, methamphetamine (MA) and cocaine users. Design Pooled analysis of prospective cohort studies. Settings Illicit drug users recruited from community, criminal justice and drug treatment settings in California, USA. Participants We used longitudinal data on from five observational cohort studies featuring primary users of heroin (N=629), cocaine (N=694) and methamphetamine (N=474). The mean duration of follow-up was 20.9 years. Measurements Monthly longitudinal data was arranged according to five health states (incarceration, drug treatment, abstinence, non-daily and daily use). We fitted proportional hazards (PH) frailty models to determine independent differences in successive episode durations. We then executed multi-state Markov (MSM) models to estimate probabilities of transitioning between health states, and the determinants of these transitions. Findings Across primary drug use types, PH frailty models demonstrated durations of daily use diminished in successive episodes over time. MSM models revealed primary stimulant users had more erratic longitudinal patterns of drug use, transitioning more rapidly between periods of treatment, abstinence, non-daily and daily use. MA users exhibited relatively longer durations of high-frequency use. Criminal engagement had a destabilizing effect on health state durations across drug types. Longer incarceration histories were associated with delayed transitions towards cessation. Conclusions PH frailty and MSM modeling techniques provided complementary information on longitudinal patterns of drug abuse. This information can inform clinical practice and policy, and otherwise be used in health economic simulation models, designed to inform resource allocation decisions. PMID:24837584

  18. Aripiprazole for cocaine abstinence: a randomized controlled trial with ecological momentary assessment

    PubMed Central

    Moran, Landhing M.; Phillips, Karran A.; Kowalczyk, William J.; Ghitza, Udi E.; Agage, Daniel A.; Epstein, David H.; Preston, Kenzie L.

    2016-01-01

    Objectives. Aripiprazole blocks psychostimulant seeking in a rat model of relapse. However, in humans, it may increase ongoing use. We tested aripiprazole specifically for relapse prevention. Methadone-maintained outpatients who were abstinent from cocaine in weeks 11-12 were randomized to double-blind aripiprazole (15/mg daily) or placebo in weeks 13-27, after 12 weeks of contingency management. Participants reported craving via ecological momentary We stopped the trial because too few (18 of 41) participants met the abstinence criterion. The results were suggestive that aripiprazole delayed lapse (HR = 0.45, CI95 = 0.14 – 1.42, p = 0.17) and relapse (HR = 0.31. CI95 = 0.07 – 1.27, p = 0.10), but the effects did not reach statistical significance. Unexpectedly, the proportion of participants reporting cocaine craving was higher in the aripiprazole group (Fisher exact p = .026), though frequency of craving was similar in the aripiprazole and placebo groups (1.89% vs. 1.16%, reffect = .43, CI95 = −.08 - .76). The results suggest that in recently abstinent cocaine users, aripiprazole might delay relapse, but might also slightly increase craving. Difficulty in trial implementation underscores the fact that initial abstinence from cocaine is not a trivial hurdle. PMID:27755017

  19. Aripiprazole for cocaine abstinence: a randomized-controlled trial with ecological momentary assessment.

    PubMed

    Moran, Landhing M; Phillips, Karran A; Kowalczyk, William J; Ghitza, Udi E; Agage, Daniel A; Epstein, David H; Preston, Kenzie L

    2017-02-01

    Aripiprazole blocks psychostimulant seeking in a rat model of relapse. However, in humans, it may increase ongoing use. We tested aripiprazole specifically for relapse prevention. Methadone-maintained outpatients who were abstinent from cocaine in weeks 11-12 were randomized to double-blind aripiprazole (15 mg daily) or placebo in weeks 13-27 after 12 weeks of contingency management. Participants reported craving through ecological momentary assessment. We stopped the trial because very few (18/41) participants fulfilled the abstinence criterion. The results suggested that aripiprazole delayed lapse [hazard ratio (HR)=0.45, 95% confidence interval (CI)=0.14-1.42, P=0.17] and relapse (HR=0.31, 95% CI=0.07-1.27, P=0.10), but the effects did not reach statistical significance. Unexpectedly, the proportion of participants reporting cocaine craving was higher in the aripiprazole group (Fisher's exact P=0.026), although the frequency of craving was similar in the aripiprazole and placebo groups (1.89 vs. 1.16%, reffect=0.43, 95% CI=-0.08-0.76). The results suggest that in recently abstinent cocaine users, aripiprazole might delay relapse, but might also slightly increase craving. Difficulty in trial implementation underscores the fact that initial abstinence from cocaine is not a trivial hurdle.

  20. Satisfaction with nursing care in drug users: the evolution of a scale.

    PubMed

    Seabra, Paulo Rosário Carvalho; Sá, Luis Octávio; Amendoeira, José Joaquim Penedos; Ribeiro, Ana Leonor

    2017-07-13

    To identify the degree of satisfaction with nursing care, the significant variables and contribute to the evolution of the scale. Descriptive, correlational, cross study, with 180 drug users. Data collected using the scale called "Satisfaction of users with the Nursing Health Center26", between February and December 2012 in three treatment units in the region of Lisbon and Vale do Tejo, Portugal. Users indicated 83.3% satisfaction. The dimension "Information individualization" was the most marked (98.5%). The more stability in the programs, abstinence from stimulants and benzodiazepines and more nursing interventions, the greater the satisfaction. Better working conditions, specializing in mental health, younger ages and less experience of nurses also contributed to satisfaction. Four items of the scale were extracted, assuming new SUCECS22 designation. Satisfaction was high, influenced by structural variables of users, nurses and working conditions. The scale has proved suitable for assessment in this population.

  1. Self-Reported Reasons for Smoking: Predicting Abstinence and Implications for Smoking Cessation Treatments Among Those With a Psychotic Disorder.

    PubMed

    Clark, Vanessa; Baker, Amanda; Lewin, Terry; Richmond, Robyn; Kay-Lambkin, Frances; Filia, Sacha; Castle, David; Williams, Jill; Todd, Juanita

    2017-01-01

    People living with a psychotic illness have higher rates of cigarette smoking and face unique barriers to quitting compared to the general population. We examined whether self-reported reasons for smoking are useful predictors of successful quit attempts among people with psychosis. As part of a randomized controlled trial addressing smoking and cardiovascular disease risk behaviors among people with psychosis, self-reported reasons for smoking were assessed at baseline (n = 235), 15 weeks (n = 151), and 12 months (n = 139). Three factors from the Reasons for Smoking Questionnaire (Coping, Physiological, and Stimulation/Activation) were entered into a model to predict short- and long-term abstinence. The relationship between these factors and mental health symptoms were also assessed. Participants scoring higher on the Stimulation/Activation factor (control of weight, enjoyment, concentration, and "peps me up") at baseline were just less than half as likely to be abstinent at 15 weeks. Female participants were five times more likely to abstinent at 15 weeks, and those with a higher global functioning at baseline were 5% more likely to be abstinent. There was a positive correlation between changes over time in the Stimulation/Activation factor from baseline to 12-month follow-up and the Brief Psychiatric Rating Scale total score at 12-month follow-up. This indicates that increasingly higher endorsement of the factor was associated with more psychological symptoms. There was also a negative correlation between the change over time in the Stimulation/Activation factor and global functioning at 12 months, indicating that increasingly higher endorsement of the factor led to lower global assessment of functioning. The Stimulation/Activation factor may be particularly important to assess and address among smokers with psychosis. It is recommended that further research use the Reasons for Smoking Questionnaire among smokers with psychosis as a clinical tool to identify

  2. Long-term abstinent alcoholics have normal memory.

    PubMed

    Reed, R J; Grant, I; Rourke, S B

    1992-08-01

    It is generally believed that many non-Korsakoff alcoholics have subtle defects in memory. To determine whether such defects vary as a function of length of abstinence (LOA), we performed extensive memory testing with: (1) recently detoxified (n = 31; LOA-29 days); (2) intermediate-term abstinent (n = 28; LOA = 1.9 years); (3) long-term abstinent (n = 32; LOA-7.0 years) alcoholics; and (4) nonalcoholic controls (n = 37). All subjects were matched on age and education. Alcoholics were matched on years of alcoholic drinking. Memory measures were divided into the following domains: verbal learning, verbal recall, visual learning, visual recall, and paired associate learning. A series of MANOVAs were conducted that revealed a significant relationship between visual learning and length of abstinence, and a significant interaction between age and length of abstinence on visual recall. Long-term abstinent subjects were not significantly different from controls on any test. We conclude that memory disturbance demonstrable among recently detoxified alcoholics in the early weeks of their abstinence is not evident in demographically matched long-term abstinent alcoholics with similar drinking histories.

  3. Neutrality, abstinence, and the therapeutic alliance.

    PubMed

    Meissner, W W

    1998-01-01

    Concepts of neutrality and abstinence are discussed in terms of the variant opinions about them, pro and con, with particular reference to efforts to dispense with them based on the unavoidable role of the analyst's personal influence and subjectivity in the analytic process. Stereotypes of both neutrality and abstinence are examined, and the therapeutic alliance established as the most appropriate context within which to articulate the essential and constructive role of effective analytic neutrality and abstinence. The alliance is not possible without the persistent exercise of both neutrality and abstinence; conversely, other components of the alliance are intended to facilitate and preserve neutrality and abstinence on the part of both analyst and analysand. These elements are essential factors in effective analytic practice.

  4. Altered cerebral blood flow and neurocognitive correlates in adolescent cannabis users

    PubMed Central

    Jacobus, Joanna; Goldenberg, Diane; Wierenga, Christina E.; Tolentino, Neil J.; Liu, Thomas T.

    2012-01-01

    Rationale The effects of adolescent marijuana use on the developing brain remain unclear, despite its prevalence. Arterial spin labeling (ASL) is a noninvasive imaging technique that characterizes neurovascular status and cerebral blood flow (CBF), potentially revealing contributors to neuropathological alterations. No studies to date have looked at CBF in adolescent marijuana users. Objectives This study examined CBF in adolescent marijuana users and matched healthy controls at baseline and after 4 weeks of monitored abstinence. Methods Heavy adolescent marijuana users (n=23, >200 lifetime marijuana use days) and demographically matched controls (n=23) with limited substance exposure underwent an ASL brain scan at an initial session and after 4 weeks of sequential urine toxicology to confirm abstinence. Results Marijuana users showed reduced CBF in four cortical regions including the left superior and middle temporal gyri, left insula, left and right medial frontal gyrus, and left supramarginal gyrus at baseline; users showed increased CBF in the right precuneus at baseline, as compared to controls (corrected p values<0.05). No between group differences were found at follow-up. Conclusions Marijuana use may influence CBF in otherwise healthy adolescents acutely; however, group differences were not observed after several weeks of abstinence. Neurovascular alterations may contribute to or underlie changes in brain activation, neuropsychological performance, and mood observed in young cannabis users with less than a month of abstinence. PMID:22395430

  5. Salivary buffer capacity, pH, and stimulated flow rate of crack cocaine users.

    PubMed

    Woyceichoski, Iverson Ernani Cogo; Costa, Carlos Henrique; de Araújo, Cristiano Miranda; Brancher, João Armando; Resende, Luciane Grochocki; Vieira, Iran; de Lima, Antonio Adilson Soares

    2013-08-01

    Crack cocaine is the freebase form of cocaine that can be smoked. The use of this drug has been considered a public health problem in many countries. The aim of this study was to assess the stimulated salivary flow rate (SSFR), pH, and the buffer capacity of saliva in crack cocaine users. Stimulated whole saliva was collected from 54 selected crack cocaine users and 40 non-users. All samples were analyzed for SSFR, pH, and buffer capacity. SSFR was analyzed by gravimetric method. The buffer capacity and pH were determined using a digital pH meter. The crack cocaine users demonstrated higher buffer capacity than the control group (P > 0.05). Salivary pH was lower in crack cocaine users (P < 0.05). Mean values of the SSFR for the experimental and control groups were 1.1 and 1.3 mL/min, respectively (P > 0.05). Crack cocaine users might exhibit a significant decrease in salivary pH, but not in salivary flow rate or buffer capacity. © 2012 Blackwell Publishing Asia Pty Ltd.

  6. Predictors of Stimulant Abuse Treatment Outcomes in Severely Mentally Ill Outpatients

    PubMed Central

    Angelo, Frank N.; McDonell, Michael G.; Lewin, Michael R.; Srebnik, Debra; Lowe, Jessica; Roll, John; Ries, Richard

    2012-01-01

    Background Severe mental illness is often exclusionary criteria for studies examining factors that influence addiction treatment outcome. Therefore, little is known about predictors of treatment response of individuals receiving psychosocial treatments for addictions who suffer from co-occurring severe mental illness. Methods The impact of demographic, substance abuse severity, psychiatric severity, and service utilization variables on in-treatment performance (i.e., longest duration of abstinence) in a 12-week contingency management (CM) intervention for stimulant abuse in 96 severely mentally ill adults was investigated. A 4-step linear regression was used to identify independent predictors of in-treatment abstinence. Results This model accounted for 37.4% of variance in the longest duration of abstinence outcome. Lower levels of stimulant use (i.e., stimulant-negative urine test) and psychiatric severity (i.e., lower levels of psychiatric distress), as well as higher rates of outpatient treatment utilization at study entry were independently associated with longer duration of drug abstinence. Conclusion These data suggest that individuals with low levels of stimulant use and psychiatric severity, as well as those actively engaged in services are most likely to succeed in a typical CM intervention. For others, modifications to CM interventions, such as increasing the value of reinforcement or adding CM to evidence based psychiatric interventions may improve treatment outcomes. PMID:23273776

  7. Is abstinence education theory based? The underlying logic of abstinence education programs in Texas.

    PubMed

    Goodson, Patricia; Pruitt, B E; Suther, Sandy; Wilson, Kelly; Buhi, Eric

    2006-04-01

    Authors examined the logic (or the implicit theory) underlying 16 abstinence-only-until-marriage programs in Texas (50% of all programs funded under the federal welfare reform legislation during 2001 and 2002). Defined as a set of propositions regarding the relationship between program activities and their intended outcomes, program staff's implicit theories were summarized and compared to (a) data from studies on adolescent sexual behavior, (b) a theory-based model of youth abstinent behavior, and (c) preliminary findings from the national evaluation of Title V programs. Authors interviewed 62 program directors and instructors and employed selected principles of grounded theory to analyze interview data. Findings indicated that abstinence education staff could clearly articulate the logic guiding program activity choices. Comparisons between interview data and a theory-based model of adolescent sexual behavior revealed striking similarities. Implications of these findings for conceptualizing and evaluating abstinence-only-until-marriage (or similar) programs are examined.

  8. Making Sense of Abstinence

    ERIC Educational Resources Information Center

    Taverner, Bill; Montfort, Sue

    2011-01-01

    Young people need to know that abstinence is a far more complex, difficult concept than it is often portrayed. Abstinence is a decision about sexual behaviors that a person may make throughout his or her life. It is a choice made at a specific time in a specific situation, for a specific period of time, whether one is in a partnered relationship…

  9. Convergent evidence from alcohol-dependent humans and rats for a hyperdopaminergic state in protracted abstinence

    PubMed Central

    Hirth, Natalie; Meinhardt, Marcus W.; Noori, Hamid R.; Salgado, Humberto; Torres-Ramirez, Oswaldo; Uhrig, Stefanie; Broccoli, Laura; Vengeliene, Valentina; Roßmanith, Martin; Perreau-Lenz, Stéphanie; Köhr, Georg; Sommer, Wolfgang H.; Spanagel, Rainer; Hansson, Anita C.

    2016-01-01

    A major hypothesis in addiction research is that alcohol induces neuroadaptations in the mesolimbic dopamine (DA) system and that these neuroadaptations represent a key neurochemical event in compulsive drug use and relapse. Whether these neuroadaptations lead to a hypo- or hyperdopaminergic state during abstinence is a long-standing, unresolved debate among addiction researchers. The answer is of critical importance for understanding the neurobiological mechanism of addictive behavior. Here we set out to study systematically the neuroadaptive changes in the DA system during the addiction cycle in alcohol-dependent patients and rats. In postmortem brain samples from human alcoholics we found a strong down-regulation of the D1 receptor- and DA transporter (DAT)-binding sites, but D2-like receptor binding was unaffected. To gain insight into the time course of these neuroadaptations, we compared the human data with that from alcohol-dependent rats at several time points during abstinence. We found a dynamic regulation of D1 and DAT during 3 wk of abstinence. After the third week the rat data mirrored our human data. This time point was characterized by elevated extracellular DA levels, lack of synaptic response to D1 stimulation, and augmented motor activity. Further functional evidence is given by a genetic rat model for hyperdopaminergia that resembles a phenocopy of alcohol-dependent rats during protracted abstinence. In summary, we provide a new dynamic model of abstinence-related changes in the striatal DA system; in this model a hyperdopaminergic state during protracted abstinence is associated with vulnerability for relapse. PMID:26903621

  10. Breastfeeding and abstinence among the Yoruba.

    PubMed

    Dow, T E

    1977-08-01

    Contemporary patterns of breastfeeding and postpartum abstinence among the Yoruba of Nigera are examined. Quite extensive periods of postpartum abstinence are still observed by most rural and poorer urban women to prolong breastfeeding and increase child survivorship. Differentials in duration of breastfeeding and abstinence relate to both socioeconomic factors and age, suggesting the likelihood of large future reductions. Implications for family planning prospects and policies are noted.

  11. Abstinence education for urban youth.

    PubMed

    Carter-Jessop, L; Franklin, L N; Heath, J W; Jimenez-Irizarry, G; Peace, M D

    2000-08-01

    Teen sexual problems in the U.S. are reaching enormous proportions. Attempts to prevent common problems, pregnancy and sexually transmitted diseases, are underway through the persistent efforts of community, health, academic and government organizations. Abstinence education is one of the current attempts. However, the lack of well defined theoretical frameworks and analyses of outcomes have limited progress in the study of abstinence education. This article describes a pilot program in abstinence-only education provided to six groups of young teens within an urban middle school. The framework for the program, cognitive social learning theory, is described and operationalized. Student pretest-posttest attitudes, open-ended written comments about the program and the researchers' anecdotes about behavioral changes in the students are the outcome measures. Positive attitudes about premarital abstinence increased for all six groups; for four of the six groups the increase was statistically significant.

  12. Smoking Abstinence, Eating Style, and Food Intake.

    ERIC Educational Resources Information Center

    Duffy, Joanne; Hall, Sharon M.

    1988-01-01

    Administered the Eating Inventory and the Profile of Mood States (POMS) to smoking subjects assigned to cigarette abstinence or to continued smoking. Found abstinent smokers with high Disinhibition Scale scores overate more than did nonabstinent smokers or abstinent smokers with lower scores when participating in a subsequent ice cream tasting…

  13. Employment-based abstinence reinforcement following inpatient detoxification in HIV-positive opioid and/or cocaine-dependent patients.

    PubMed

    Dunn, Kelly E; Fingerhood, Michael; Wong, Conrad J; Svikis, Dace S; Nuzzo, Paul; Silverman, Kenneth

    2014-02-01

    Employment-based reinforcement interventions have been used to promote abstinence from drugs among chronically unemployed injection drug users. The current study used an employment-based reinforcement intervention to promote opioid and cocaine abstinence among opioid and/or cocaine-dependent, HIV-positive participants who had recently completed a brief inpatient detoxification. Participants (n = 46) were randomly assigned to an abstinence and work group that was required to provide negative urine samples in order to enter the workplace and to earn incentives for work (n = 16), a work-only group that was permitted to enter the workplace and to earn incentives independent of drug use (n = 15), and a no-voucher control group that did not receive any incentives for working (n = 15) over a 26-week period. The primary outcome was urinalysis-confirmed opioid, cocaine, and combined opioid/cocaine abstinence. Participants were 78% male and 89% African American. Results showed no significant between-groups differences in urinalysis-verified drug abstinence or HIV risk behaviors during the 6-month intervention. The work-only group had significantly greater workplace attendance, and worked more minutes per day when compared to the no-voucher group. Several features of the study design, including the lack of an induction period, setting the threshold for entering the workplace too high by requiring immediate abstinence from several drugs, and increasing the risk of relapse by providing a brief detoxification that was not supported by any continued pharmacological intervention, likely prevented the workplace from becoming established as a reinforcer that could be used to promote drug abstinence. However, increases in workplace attendance have important implications for adult training programs.

  14. Employment-based abstinence reinforcement following inpatient detoxification in HIV-positive opioid and/or cocaine-dependent patients

    PubMed Central

    Dunn, Kelly; Fingerhood, Michael; Wong, Conrad J.; Svikis, Dace S.; Nuzzo, Paul; Silverman, Kenneth

    2015-01-01

    Employment-based reinforcement interventions have been used to promote abstinence from drugs among chronically unemployed injection drug users. The current study utilized an employment-based reinforcement intervention to promote opiate and cocaine abstinence among opioid-dependent, HIV-positive participants who had recently completed a brief inpatient detoxification. Participants (n=46) were randomly assigned to an Abstinence & Work group that was required to provide negative urine samples in order to enter the workplace and earn incentives for work (n=16), a Work Only group that was permitted to enter the workplace and earn incentives independent of drug use (n=15), and a No Voucher control group that did not receive any incentives for working (n=15) over a 26-week period. The primary outcome was urinalysis-confirmed opiate, cocaine, and combined opiate/cocaine abstinence. Participants were 78% male and 89% African American. Results showed no significant between-group differences in urinalysis-verified drug abstinence or HIV risk behaviors during the 6-month intervention. The Work Only group had significantly greater workplace attendance and worked more minutes per day when compared to the No Voucher group. Several features of the study design, including the lack of an induction period, setting the threshold for entering the workplace too high by requiring immediate abstinence from several drugs, and increasing the risk of relapse by providing a brief detoxification that was not supported by any continued pharmacological intervention, likely prevented the workplace from becoming established as a reinforcer that could be used to promote drug abstinence. However, increases in workplace attendance have important implications for adult training programs. PMID:24490712

  15. Altered visual perception in long-term ecstasy (MDMA) users.

    PubMed

    White, Claire; Brown, John; Edwards, Mark

    2013-09-01

    The present study investigated the long-term consequences of ecstasy use on visual processes thought to reflect serotonergic functions in the occipital lobe. Evidence indicates that the main psychoactive ingredient in ecstasy (methylendioxymethamphetamine) causes long-term changes to the serotonin system in human users. Previous research has found that amphetamine-abstinent ecstasy users have disrupted visual processing in the occipital lobe which relies on serotonin, with researchers concluding that ecstasy broadens orientation tuning bandwidths. However, other processes may have accounted for these results. The aim of the present research was to determine if amphetamine-abstinent ecstasy users have changes in occipital lobe functioning, as revealed by two studies: a masking study that directly measured the width of orientation tuning bandwidths and a contour integration task that measured the strength of long-range connections in the visual cortex of drug users compared to controls. Participants were compared on the width of orientation tuning bandwidths (26 controls, 12 ecstasy users, 10 ecstasy + amphetamine users) and the strength of long-range connections (38 controls, 15 ecstasy user, 12 ecstasy + amphetamine users) in the occipital lobe. Amphetamine-abstinent ecstasy users had significantly broader orientation tuning bandwidths than controls and significantly lower contour detection thresholds (CDTs), indicating worse performance on the task, than both controls and ecstasy + amphetamine users. These results extend on previous research, which is consistent with the proposal that ecstasy may damage the serotonin system, resulting in behavioral changes on tests of visual perception processes which are thought to reflect serotonergic functions in the occipital lobe.

  16. Abstinence-Related Word Associations and Definitions of Abstinence and Virginity among Missouri High School Freshmen

    ERIC Educational Resources Information Center

    Wilson, Kelly L.; Smith, Matthew Lee; Menn, Mindy

    2013-01-01

    Background: The ways in which adolescents define and view sex, abstinence, and virginity impact the efforts of sexuality educators and sexual health professionals. This study examined terminology used by nonsexually active high school students to define abstinence and virginity and identified words students associate with these terms. Purposes…

  17. Perspectives on Health among Adult Users of Illicit Stimulant Drugs in Rural Ohio

    ERIC Educational Resources Information Center

    Siegal, Harvey A.; Draus, Paul J.; Carlson, Robert G.; Falck, Russel S.; Wang, Jichuan

    2006-01-01

    Context: Although the nonmedical use of stimulant drugs such as cocaine and methamphetamine is increasingly common in many rural areas of the United States, little is known about the health beliefs of people who use these drugs. Purpose: This research describes illicit stimulant drug users' views on health and health-related concepts that may…

  18. Cue-induced activation of implicit affective associations with heroin use in abstinent heroin abusers.

    PubMed

    Chen, Jianyong; Wang, Xuan; Zhang, Meng; Zhang, Feng; Shen, Mowei

    2015-06-01

    While drug-related contexts have been shown to influence drug users' implicit and explicit drug-related cognitions, this has been minimally explored in heroin abusers. This study examined the effect of heroin-related cue exposure on implicit and explicit valence and arousal-sedation associations with heroin use for abstinent heroin abusers. In Experiment 1, 39 male abstinent heroin abusers were exposed to heroin-related words and reported cravings before and after cue exposure. They subsequently performed two Extrinsic Affective Simon Tasks (EASTs), which were used to assess implicit valence and arousal-sedation associations with heroin use. Thirty-six male abstinent heroin abusers (controls) only performed the two EASTs. All participants completed measures of explicit expectancy regarding heroin use. In Experiment 2, twenty-eight newly recruited abstinent heroin abusers were exposed to heroin-related pictures, and completed the same implicit and explicit measures used in Experiment 1. A non-significant increase in craving after cue exposure was observed. While participants exposed to heroin-related words or pictures exhibited more positive implicit heroin use associations (relative to negative associations), and such trend was not observed in controls, this difference was not significant across groups. Participants still indicated negative explicit associations with heroin use after cue exposure. Exposure to cues significantly accelerated arousal and sedation responses. Whether cue exposure could change self-reported craving requires further study in abstinent heroin abusers. The exclusively male sample limits generalization of the results. The present findings extend the evidence on whether implicit and explicit heroin-related cognitions are susceptible to context. Copyright © 2014 Elsevier Ltd. All rights reserved.

  19. Dopaminergic dysfunction in abstinent dexamphetamine users: results from a pharmacological fMRI study using a reward anticipation task and a methylphenidate challenge.

    PubMed

    Schouw, M L J; De Ruiter, M B; Kaag, A M; van den Brink, W; Lindauer, R J L; Reneman, L

    2013-06-01

    Dopamine (DA) is involved in systems governing motor actions, motivational processes and cognitive functions. Preclinical studies have shown that even relatively low doses of d-amphetamine (dAMPH) (equivalent to doses used in clinical Practice) can lead to DA neurotoxicity in rodents and non-human primates (Ricaurte et al., 2005). Therefore, we investigated the DAergic function in eight male recreational users of dAMPH and eight male healthy controls using functional magnetic resonance imaging (fMRI). We compared brain activation between both groups during a monetary incentive delay task (Knutson et al., 2001) with and without an oral methylphenidate (MPH) challenge. All subjects were abstinent for at least 2 weeks during the baseline scan. The second scan was performed on the same day 1.5 h after receiving an oral dose of 35 mg MPH (approximately 0.5 mg/kg) when peak MPH binding was assumed. When anticipating reward, dAMPH users showed lower striatal activation in comparison to control subjects. In addition, MPH induced a reduction in the striatal activation during reward anticipation in healthy controls, whereas no such effect was observed in dAMPH users. The combination of these findings provides further evidence for frontostriatal DAergic dysfunction in recreational dAMPH users and is consistent with preclinical data suggesting neurotoxic effects of chronic dAMPH use. The findings of this explorative study could have important implications for humans in need for treatment with dAMPH, such as patients suffering from ADHD and therefore this study needs replication in a larger sample. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

  20. Abstinence at Successful Discharge in Publicly Funded Addiction Health Services

    PubMed Central

    Guerrero, Erick G.; Kong, Yinfei; Kim, Tina

    2016-01-01

    Abstinence at successful discharge in substance use disorder treatment is important to reducing relapse rates and increasing long-term recovery from substance use disorders. However, few studies have examined abstinence as an essential component of successful discharge. This study examined rates and correlates of reported abstinence (nonuse of drugs 30 days prior to successful discharge) among clients attending publicly funded treatment in Los Angeles County, California. Finding show that only 36% of clients who were successfully discharged reported abstinence. Black clients were less likely than non-Hispanic Whites to report abstinence at successful discharge. Clients in methadone treatment programs were less likely than outpatient clients to report abstinence, whereas clients referred to treatment through the legal system (Proposition 36) were more likely to report abstinence compared to self-referred clients. Findings underscore the importance of systematic assessment of abstinence in determining successful discharge and provide a basis for further examination of strategies to improve abstinence and reduce relapse. PMID:26882909

  1. Abstinence at Successful Discharge in Publicly Funded Addiction Health Services.

    PubMed

    Frimpong, Jemima A; Guerrero, Erick G; Kong, Yinfei; Kim, Tina

    2016-10-01

    Abstinence at successful discharge in substance use disorder treatment is important to reducing relapse rates and increasing long-term recovery from substance use disorders. However, few studies have examined abstinence as an essential component of successful discharge. This study examined rates and correlates of reported abstinence (nonuse of drugs 30 days prior to successful discharge) among clients attending publicly funded treatment in Los Angeles County, California. Finding show that only 36% of clients who were successfully discharged reported abstinence. Black clients were less likely than non-Hispanic Whites to report abstinence at successful discharge. Clients in methadone treatment programs were less likely than outpatient clients to report abstinence, whereas clients referred to treatment through the legal system (Proposition 36) were more likely to report abstinence compared to self-referred clients. Findings underscore the importance of systematic assessment of abstinence in determining successful discharge and provide a basis for further examination of strategies to improve abstinence and reduce relapse.

  2. Understanding Sexual Abstinence in Urban Adolescent Girls

    PubMed Central

    Morrison-Beedy, Dianne; Carey, Michael P.; Côté-Arsenault, Denise; Seibold-Simpson, Susan; Robinson, Kerry Anne

    2008-01-01

    Objectives To gain insight into the context of sexual abstinence and identify potential determinants of abstinence in this population. Design Four focus groups. Participants and Setting Twenty-four, predominantly African American (88%) girls aged 14 to 19 years were recruited from urban health centers and youth development programs in Rochester, New York, between September and December 2006. Data Analysis Content analysis was used to analyze the four verbatim transcripts. Using analytic induction, groups were compared and contrasted at the micro (within-group) and macro (between-group) levels to identify themes. Results Four themes were identified that provided insight into how and why these girls remain abstinent despite being in sexually active social climates. They focused on the following: self-respect (I'm worth it), impact of mothers (Mama says … think before you let it go), influence of boys and other peers (Boys will be boys), and potential negative consequences of sex (Hold on, there's a catch). Conclusions Developing interventions to maintain abstinence, delay onset of sexual activity, and promote protected first and subsequent sexual contact in abstinent girls are key to decreasing future sexual risk. These findings suggest opportunities to develop HIV prevention strategies tailored to the needs of abstinent girls. PMID:18336442

  3. Telling true from false: cannabis users show increased susceptibility to false memories.

    PubMed

    Riba, J; Valle, M; Sampedro, F; Rodríguez-Pujadas, A; Martínez-Horta, S; Kulisevsky, J; Rodríguez-Fornells, A

    2015-06-01

    Previous studies on the neurocognitive impact of cannabis use have found working and declarative memory deficits that tend to normalize with abstinence. An unexplored aspect of cognitive function in chronic cannabis users is the ability to distinguish between veridical and illusory memories, a crucial aspect of reality monitoring that relies on adequate memory function and cognitive control. Using functional magnetic resonance imaging, we show that abstinent cannabis users have an increased susceptibility to false memories, failing to identify lure stimuli as events that never occurred. In addition to impaired performance, cannabis users display reduced activation in areas associated with memory processing within the lateral and medial temporal lobe (MTL), and in parietal and frontal brain regions involved in attention and performance monitoring. Furthermore, cannabis consumption was inversely correlated with MTL activity, suggesting that the drug is especially detrimental to the episodic aspects of memory. These findings indicate that cannabis users have an increased susceptibility to memory distortions even when abstinent and drug-free, suggesting a long-lasting compromise of memory and cognitive control mechanisms involved in reality monitoring.

  4. Effect of direct physician involvement on tobacco abstinence rates and other variables affecting participants of a freedom from tobacco class.

    PubMed

    Ismail, Mohamed H; Ho, Ngoc J; Lara, Nancy Irazu

    2013-01-01

    Kaiser Permanente measures how often tobacco users are offered strategies to quit but not the success of such strategies. To compare tobacco abstinence rates for participants of the Kaiser Permanente Riverside (California) Medical Center's Freedom from Tobacco Class in 2008, before direct physician involvement, and in 2009, after direct physician involvement, and to compare other variables affecting these rates. In a retrospective study, participants were divided into two groups based on year of participation. Data were collected using electronic medical records and phone interviews. Tobacco use status between both groups at 1, 3, 6, and 12 months after the classes started and within groups by sex, number of classes attended, medication received, and class teacher. The 12-month abstinence rates were 27% in 2008 and 33% in 2009 (p = 0.3). The abstinence rate for men improved from 23% to 38% (2008 vs 2009; p = 0.05), whereas for women it was 30% vs 27% (p = 0.7). Abstinence rates decreased over time for the group as a whole (p < 0.001). Attendance of 6 or more classes was associated with higher abstinence rates. There was no significant impact on abstinence rates due to age, body mass index, class teacher, or medications used. Direct physician involvement improved men's but not women's abstinence rates among class participants. The relapse rate was significant over the first year after the class. Further research is needed to study the difference between sexes and the factors affecting relapse.

  5. "Overconfidence" versus "helplessness": A qualitative study on abstinence self-efficacy of drug users in a male compulsory drug detention center in China.

    PubMed

    Zhang, Yan; Feng, Bing; Geng, Wenxiu; Owens, Laurence; Xi, Juzhe

    2016-08-31

    Compulsory drug detention is the most frequent way to control drug use in China; however, it has often been criticized. This qualitative study aimed to investigate abstinence self-efficacy and its sources of drug users in a compulsory male drug detention center in Shanghai, China, and the attitudes of the drug users to this form of rehabilitation. Thirty-six participants were interviewed (semi-structured, in depth) about their history of drug use and rehabilitation, self-evaluation of addiction, motivations to abstain, plans for the future and attitudes toward rehabilitation. A thematic analysis was undertaken of the transcripts with responses to interview questions being coded for content. Two main types of self-efficacy were found - "overconfidence" (n = 16) and "helplessness" (n = 17). Overconfident participants underestimated their levels of addiction, overestimated their self-control and held external motivations and attributions. In contrast, helpless participants overestimated their levels of addiction, underestimated their self-control and had internal motivations and attributions. Compared to overconfident participants, helpless participants had more relapse history, and were more inclined to interpret relapse as a failure and attribute relapse to themselves. More helpless participants were abandoned by their family members, and received blame from the family members instead of encouragement, but their family members motivated them to abstain. Helpless participants experienced more negative emotions and had worse physical status. They said compulsory detention was a strong support for them and was the most effective way to abstain; while overconfident participants said compulsory detention was not necessary and not useful. It is important to increase the motivation of overconfident drug users and the perceived control of helpless drug users. Compulsory drug detention has strengths in supporting drug users who feel helpless to resist drug use

  6. Gratitude, abstinence, and alcohol use disorders: Report of a preliminary finding.

    PubMed

    Krentzman, Amy R

    2017-07-01

    Gratitude is a central component of addiction recovery for many, yet it has received scant attention in addiction research. In a sample of 67 individuals entering abstinence-based alcohol-use-disorder treatment, this study employed gratitude and abstinence variables from sequential assessments (baseline, 6months, 12months) to model theorized causal relationships: gratitude would increase pre-post treatment and gratitude after treatment would predict greater percent days abstinent 6months later. Neither hypothesis was supported. This unexpected result led to the theory that gratitude for sobriety was the construct of interest; therefore, the association between gratitude and future abstinence would be positive among those already abstinent. Thus, post-treatment abstinence was tested as a moderator of the effect of gratitude on future abstinence: this effect was statistically significant. For those who were abstinent after treatment, the relationship between gratitude and future abstinence was positive; for those drinking most frequently after treatment, the relationship between gratitude and future abstinence was negative. In this preliminary study, dispositional tendency to affirm that there is much to be thankful for appeared to perpetuate the status quo-frequent drinkers with high gratitude were drinking frequently 6months later; abstinent individuals with high gratitude were abstinent 6months later. Gratitude exercises might be contraindicated for clients who are drinking frequently and have abstinence as their treatment goal. Copyright © 2017 Elsevier Inc. All rights reserved.

  7. Auditory steady-state responses in cochlear implant users: Effect of modulation frequency and stimulation artifacts.

    PubMed

    Gransier, Robin; Deprez, Hanne; Hofmann, Michael; Moonen, Marc; van Wieringen, Astrid; Wouters, Jan

    2016-05-01

    Previous studies have shown that objective measures based on stimulation with low-rate pulse trains fail to predict the threshold levels of cochlear implant (CI) users for high-rate pulse trains, as used in clinical devices. Electrically evoked auditory steady-state responses (EASSRs) can be elicited by modulated high-rate pulse trains, and can potentially be used to objectively determine threshold levels of CI users. The responsiveness of the auditory pathway of profoundly hearing-impaired CI users to modulation frequencies is, however, not known. In the present study we investigated the responsiveness of the auditory pathway of CI users to a monopolar 500 pulses per second (pps) pulse train modulated between 1 and 100 Hz. EASSRs to forty-three modulation frequencies, elicited at the subject's maximum comfort level, were recorded by means of electroencephalography. Stimulation artifacts were removed by a linear interpolation between a pre- and post-stimulus sample (i.e., blanking). The phase delay across modulation frequencies was used to differentiate between the neural response and a possible residual stimulation artifact after blanking. Stimulation artifacts were longer than the inter-pulse interval of the 500pps pulse train for recording electrodes ipsilateral to the CI. As a result the stimulation artifacts could not be removed by artifact removal on the bases of linear interpolation for recording electrodes ipsilateral to the CI. However, artifact-free responses could be obtained in all subjects from recording electrodes contralateral to the CI, when subject specific reference electrodes (Cz or Fpz) were used. EASSRs to modulation frequencies within the 30-50 Hz range resulted in significant responses in all subjects. Only a small number of significant responses could be obtained, during a measurement period of 5 min, that originate from the brain stem (i.e., modulation frequencies in the 80-100 Hz range). This reduced synchronized activity of brain stem

  8. Cognitive, physical, and mental health outcomes between long-term cannabis and tobacco users.

    PubMed

    Lovell, M E; Bruno, R; Johnston, J; Matthews, A; McGregor, I; Allsop, D J; Lintzeris, N

    2018-04-01

    Cannabis intoxication adversely affects health, yet persistent effects following short-term abstinence in long-term cannabis users are unclear. This matched-subjects, cross-sectional study compared health outcomes of long-term cannabis and long-term tobacco-only users, relative to population norms. Nineteen long-term (mean 32.3years of use, mean age 55.7years), abstinent (mean 15h) cannabis users and 16 long-term tobacco users (mean 37.1years of use, mean age 52.9years), matched for age, educational attainment, and lifetime tobacco consumption, were compared on measures of learning and memory, response inhibition, information-processing, sustained attention, executive control, and mental and physical health. Cannabis users exhibited poorer overall learning and delayed recall and greater interference and forgetting than tobacco users, and exhibited poorer recall than norms. Inhibition and executive control were similar between groups, but cannabis users had slower reaction times during information processing and sustained attention tasks. Cannabis users had superior health satisfaction and psychological, somatic, and general health than tobacco users and had similar mental and physical health to norms whilst tobacco users had greater stress, role limitations from emotional problems, and poorer health satisfaction. Long-term cannabis users may exhibit deficits in some cognitive domains despite short-term abstinence and may therefore benefit from interventions to improve cognitive performance. Tobacco alone may contribute to adverse mental and physical health outcomes, which requires appropriate control in future studies. Copyright © 2017 Elsevier Ltd. All rights reserved.

  9. Atomoxetine in abstinent cocaine users: Cognitive, subjective and cardiovascular effects.

    PubMed

    DeVito, Elise E; Herman, Aryeh I; Konkus, Noah S; Zhang, Huiping; Sofuoglu, Mehmet

    2017-08-01

    No pharmacotherapies are approved for the treatment of cocaine use disorders (CUD). Behavioral treatments for CUD are efficacious for some individuals, but recovery rates from CUD remain low. Cognitive impairments in CUD have been linked with poorer clinical outcomes. Cognitive enhancing pharmacotherapies have been proposed as promising treatments for CUD. Atomoxetine, a norepinephrine transporter inhibitor, shows potential as a treatment for CUD based on its efficacy as a cognitive enhancer in other clinical populations and impact on addictive processes in preclinical and human laboratory studies. In this randomized, double-blind, crossover study, abstinent individuals with CUD (N=39) received placebo, 40 and 80mg atomoxetine, over three sessions. Measures of attention, response inhibition and working memory; subjective medication effects and mood; and cardiovascular effects were collected. Analyses assessed acute, dose-dependent effects of atomoxetine. In addition, preliminary analyses investigating the modulation of atomoxetine dose effects by sex were performed. Atomoxetine increased heart rate and blood pressure, was rated as having positive and negative subjective drug effects, and had only modest effects on mood and cognitive enhancement. Copyright © 2017. Published by Elsevier Inc.

  10. Measures of outcome for stimulant trials: ACTTION recommendations and research agenda.

    PubMed

    Kiluk, Brian D; Carroll, Kathleen M; Duhig, Amy; Falk, Daniel E; Kampman, Kyle; Lai, Shengan; Litten, Raye Z; McCann, David J; Montoya, Ivan D; Preston, Kenzie L; Skolnick, Phil; Weisner, Constance; Woody, George; Chandler, Redonna; Detke, Michael J; Dunn, Kelly; Dworkin, Robert H; Fertig, Joanne; Gewandter, Jennifer; Moeller, F Gerard; Ramey, Tatiana; Ryan, Megan; Silverman, Kenneth; Strain, Eric C

    2016-01-01

    The development and approval of an efficacious pharmacotherapy for stimulant use disorders has been limited by the lack of a meaningful indicator of treatment success, other than sustained abstinence. In March, 2015, a meeting sponsored by Analgesic, Anesthetic, and Addiction Clinical Trial Translations, Innovations, Opportunities, and Networks (ACTTION) was convened to discuss the current state of the evidence regarding meaningful outcome measures in clinical trials for stimulant use disorders. Attendees included members of academia, funding and regulatory agencies, pharmaceutical companies, and healthcare organizations. The goal was to establish a research agenda for the development of a meaningful outcome measure that may be used as an endpoint in clinical trials for stimulant use disorders. Based on guidelines for the selection of clinical trial endpoints, the lessons learned from prior addiction clinical trials, and the process that led to identification of a meaningful indicator of treatment success for alcohol use disorders, several recommendations for future research were generated. These include a focus on the validation of patient reported outcome measures of functioning, the exploration of patterns of stimulant abstinence that may be associated with physical and/or psychosocial benefits, the role of urine testing for validating self-reported measures of stimulant abstinence, and the operational definitions for reduction-based measures in terms of frequency rather than quantity of stimulant use. These recommendations may be useful for secondary analyses of clinical trial data, and in the design of future clinical trials that may help establish a meaningful indicator of treatment success. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  11. Reducing sexual risk with practice of periodic secondary abstinence.

    PubMed

    Haglund, Kristin

    2008-01-01

    Test a novel intervention to help sexually experienced girls increase abstinence behaviors and attitudes. A quasi-experimental repeated measures design using qualitative and quantitative data. Two alternative public schools. Thirty-three females whose mean age was 16 and who were 79% African American participated. Most (79%) had experienced a pregnancy. A 6 session, weekly, interactive intervention was delivered. Data were collected at baseline, last session, and at 5 and 7 month follow-ups. Measured outcomes related to abstinence included participants' reasons, behaviors, stages of change, and attitudes. The most common reason for abstinence was not wanting to have sex. At each postintervention data collection point, most participants (greater than or equal to 74%) reported that they had purposefully avoided sex. Duration of consecutive days of abstinence increased although only significantly at 5 month follow-up. Abstinence behaviors increased with the largest change from first to last session. Stage of change advanced from preparation to action by 7 month follow-up. Attitudes toward abstinence became more favorable. Effective sexual risk reduction interventions are critically needed to promote safety. Nurses may assist young women to decrease their sexual risks by teaching them to practice periodic abstinence.

  12. Effect of Direct Physician Involvement on Tobacco Abstinence Rates and Other Variables Affecting Participants of a Freedom from Tobacco Class

    PubMed Central

    Ismail, Mohamed H; Ho, Ngoc J; Lara, Nancy Irazu

    2013-01-01

    Context Kaiser Permanente measures how often tobacco users are offered strategies to quit but not the success of such strategies. Objective: To compare tobacco abstinence rates for participants of the Kaiser Permanente Riverside (California) Medical Center’s Freedom from Tobacco Class in 2008, before direct physician involvement, and in 2009, after direct physician involvement, and to compare other variables affecting these rates. Design: In a retrospective study, participants were divided into two groups based on year of participation. Data were collected using electronic medical records and phone interviews. Main Outcome Measures: Tobacco use status between both groups at 1, 3, 6, and 12 months after the classes started and within groups by sex, number of classes attended, medication received, and class teacher. Results: The 12-month abstinence rates were 27% in 2008 and 33% in 2009 (p = 0.3). The abstinence rate for men improved from 23% to 38% (2008 vs 2009; p = 0.05), whereas for women it was 30% vs 27% (p = 0.7). Abstinence rates decreased over time for the group as a whole (p < 0.001). Attendance of 6 or more classes was associated with higher abstinence rates. There was no significant impact on abstinence rates due to age, body mass index, class teacher, or medications used. Conclusion: Direct physician involvement improved men’s but not women’s abstinence rates among class participants. The relapse rate was significant over the first year after the class. Further research is needed to study the difference between sexes and the factors affecting relapse. PMID:23704836

  13. Stimulant use among African American and Latino MSM social networking users.

    PubMed

    Young, Sean D; Shoptaw, Steve

    2013-01-01

    High stimulant-using and at-risk HIV populations, such as African American and Latino men who have sex with men (MSM), are increasingly using social networking technologies. However, no known research has explored associations between stimulant use, sexual risk behaviors, and social networking among these populations. Participants were recruited using the Facebook Connect software application, which narrowed the sample to 118 (primarily African American and Latino MSM) active Facebook users. Participants completed demographic, Internet and social media use, and drug use survey items. Participants reported high rates of cocaine and methamphetamine use (both more than 15% within the past 12 months). More than 70% of participants reported using social networking technologies to meet people, and more than 30% used them to find sexual partners. A multivariate logistic regression showed that (1) participants using social networks to find sexual partners were more likely to have used methamphetamines within the past 12 months and (2) those who were more comfortable talking online compared to face-to-face had over 4 times the odds of methamphetamine use and over 6 times the odds of cocaine use within the past 12 months. Minority MSM who used social networks to meet men and find sexual partners had high risk for stimulant use. Understanding drug use among minority social networking users will provide insights to incorporate these technologies into drug prevention interventions.

  14. MDMA, cortisol, and heightened stress in recreational ecstasy users.

    PubMed

    Parrott, Andrew C; Montgomery, Cathy; Wetherell, Mark A; Downey, Luke A; Stough, Con; Scholey, Andrew B

    2014-09-01

    Stress develops when an organism requires additional metabolic resources to cope with demanding situations. This review will debate how recreational 3,4-methylenedioxymethamphetamine (MDMA, 'ecstasy') can increase some aspects of acute and chronic stress in humans. Laboratory studies on the acute effects of MDMA on cortisol release and neurohormone levels in drug-free regular ecstasy/MDMA users have been reviewed, and the role of the hypothalamic-pituitary-adrenal (HPA) axis in chronic changes in anxiety, stress, and cognitive coping is debated. In the laboratory, acute ecstasy/MDMA use can increase cortisol levels by 100-200%, whereas ecstasy/MDMA-using dance clubbers experience an 800% increase in cortisol levels, because of the combined effects of the stimulant drug and dancing. Three-month hair samples of abstinent users revealed cortisol levels 400% higher than those in controls. Chronic users show heightened cortisol release in stressful environments and deficits in complex neurocognitive tasks. Event-related evoked response potential studies show altered patterns of brain activation, suggestive of increased mental effort, during basic information processing. Chronic mood deficits include more daily stress and higher depression in susceptible individuals. We conclude that ecstasy/MDMA increases cortisol levels acutely and subchronically and that changes in the HPA axis may explain why recreational ecstasy/MDMA users show various aspects of neuropsychobiological stress.

  15. Initial abstinence status and contingency management treatment outcomes: does race matter?

    PubMed

    Montgomery, LaTrice; Carroll, Kathleen M; Petry, Nancy M

    2015-06-01

    Limited research has evaluated African American substance users' response to evidence-based treatments. This study examined the efficacy of contingency management (CM) in African American and White cocaine users. A secondary analysis evaluated effects of race, treatment condition, and baseline cocaine urine sample results on treatment outcomes of African American (n = 444) and White (n = 403) cocaine abusers participating in one of six randomized clinical trials comparing CM to standard care. African American and White patients who initiated treatment with a cocaine-negative urine sample remained in treatment for similar durations and submitted a comparable proportion of negative samples during treatment regardless of treatment type; CM was efficacious in both races in terms of engendering longer durations of abstinence in patients who began treatment abstinent. Whites who began treatment with a cocaine positive sample remained in treatment longer and submitted a higher proportion of negative samples when assigned to CM than standard care. African Americans who initiated treatment with a cocaine positive sample, however, did not remain in treatment longer with CM compared with standard care, and gains in terms of drug use outcomes were muted in nature relative to Whites. This interaction effect persisted through the 9-month follow-up period. CM is not equally effective in reducing drug use among all subgroups, specifically African American patients who are using cocaine upon treatment entry. Future research on improving treatment outcomes in this population is needed. (c) 2015 APA, all rights reserved).

  16. Abstinence-Only Sex Education: College Students' Evaluations and Responses

    ERIC Educational Resources Information Center

    Gardner, Emily A.

    2015-01-01

    This qualitative study explores the abstinence-only sex education experiences of a small group of young adults in the southeastern USA. Most participants felt that their abstinence-only sex education had mixed value and low overall impact in their lives. Perceptions about abstinence, virginity, and marriage varied significantly from those stressed…

  17. Examining social supply among nonmedical prescription stimulant users in the San Francisco Bay Area.

    PubMed

    Murphy, Fiona; Murphy, Sheigla; Sales, Paloma; Lau, Nicholas

    2018-04-01

    In the US, prescription stimulants are prescribed for a variety of conditions including attention deficit hyperactivity disorder (ADHD) and narcolepsy. Over the last two decades, dramatic increases in stimulant prescriptions have led to greater availability and increased risk for diversion and nonmedical use. Our own and other investigators' findings indicate that many drug "suppliers" do not fit into the traditional image of drug "dealers." These suppliers typically do not identify themselves as "dealers," but instead understand their drug distribution as sharing with people they know. Coomber and colleagues' (2007; 2013) concept of "social supply" raises the question: When friends supply or facilitate supply of drugs to friends, is this really dealing? Further, if dealing and supplying are distinct kinds of social transactions, should different types of criminal justice approaches be applied? Social supply extends our understanding of drug dealing as a complex social activity. In this article, we examine the issue of social supply among nonmedical users of prescription stimulants. We conducted a 36-month National Institute on Drug Abuse-funded project to conduct a qualitative, mixed methods study of 150 adult nonmedical prescription stimulant users in the San Francisco Bay Area. We explore intersecting factors, including life stage and social location, that contribute to decisions to use prescription stimulants nonmedically, motivations to use, knowledge about risks and benefits of prescription stimulant use, any adverse health or social consequences experienced, availability, acquisition and diversion of prescription stimulants, and differences in attitudes and behaviours. For this analysis, we rely on participants' narratives concerning prescription stimulant acquisition practices and how they understood these interactions, purchases, and exchanges with the suppliers of prescription stimulants in their social networks. The authors argue that acknowledging the

  18. Abstinence education.

    PubMed

    Zeiler, Alean

    2014-11-01

    The American College of Pediatricians strongly endorses abstinence-until-marriage sex education and recommends adoption by all school systems in lieu of "comprehensive sex education." This position is based on "the public health principle of primary prevention-risk avoidance in lieu of risk reduction," upholding the "human right to the highest attainable standard of health" (Freedman 1995).

  19. Sex differences in brain activation during stress imagery in abstinent cocaine users: a functional magnetic resonance imaging study.

    PubMed

    Li, Chiang-Shan Ray; Kosten, Thomas R; Sinha, Rajita

    2005-03-01

    Because stress mediates drug seeking and relapse, and sex differences have been observed in stress and in the development of cocaine addiction, in this study we used functional neuroimaging to examine the effect of sex on stress responses in abstinent cocaine users. In a functional magnetic resonance imaging session, 17 male and 10 female cocaine-dependent subjects participated in script-guided imagery of neutral or stress situations. Subjects rated imagery vividness, anxiety, and cocaine craving for each trial. Brain activation during the stress and neutral imagery periods relative to their own baseline was examined in individual subjects. Sex contrast was obtained in second-level group analysis. Female subjects demonstrated more activation, compared with male subjects, in left middle frontal, anterior cingulate, and inferior frontal cortices and insula, and right cingulate cortex during stress imagery. Region of interest analysis showed that the change of activity in left anterior cingulate and right posterior cingulate cortices both correlated inversely with the change of craving rating during stress imagery. The greater left frontolimbic activity in women suggests that women might use more verbal coping strategies than do men while experiencing stress. The results also suggest a distinct role of the cingulate cortices in modulating stress-induced cocaine craving.

  20. Withdrawal-Related Changes in Delay Discounting Predict Short-Term Smoking Abstinence.

    PubMed

    Miglin, Rickie; Kable, Joseph W; Bowers, Maureen E; Ashare, Rebecca L

    2017-06-01

    Impulsive decision making is associated with smoking behavior and reflects preferences for smaller, immediate rewards and intolerance of temporal delays. Nicotine withdrawal may alter impulsive decision making and time perception. However, little is known about whether withdrawal-related changes in decision making and time perception predict smoking relapse. Forty-five smokers (14 female) completed two laboratory sessions, one following 24-hour abstinence and one smoking-as-usual (order counterbalanced; biochemically verified abstinence). During each visit, participants completed measures of time perception, decision making (ie, discount rates), craving, and withdrawal. Following the second laboratory session, subjects underwent a well-validated model of short-term abstinence (quit week) with small monetary incentives for each day of biochemically confirmed abstinence. Smokers significantly overestimated time during abstinence, compared to smoking-as-usual (p = .021), but there were no abstinence effects on discount rates (p = .6). During the quit week, subjects were abstinent for 3.5 days (SD = 2.15) and smoked a total of 12.9 cigarettes (SD = 15.8). Importantly, higher discount rates (ie, preferences for immediate rewards) during abstinence (abstinence minus smoking difference score) predicted greater number of days abstinent (p = .01) and fewer cigarettes smoked during the quit week (p = .02). Withdrawal-related change in time reproduction did not predict relapse (p = .2). These data suggest that individuals who have a greater preference for immediate rewards during abstinence (vs. smoking-as-usual) may be more successful at maintaining short-term abstinence when provided with frequent (eg, daily) versus less frequent incentive schedules (eg, 1 month). Abstinence-induced changes in decision making may be important for identifying smokers who may benefit from interventions that incentivize abstinence such as contingency management (CM). The present results

  1. Social Influences on Abstinence Self-Efficacy among Justice-Involved Persons

    PubMed Central

    Majer, John M.; Callahan, Sarah; Stevick, Kate; Jason, Leonard A.

    2016-01-01

    Social influences (social support for alcohol/drug use and social support for abstinence) were examined in relation to abstinence self-efficacy among a sample of 250 justice involved persons exiting inpatient treatment for substance use disorders. Hierarchical linear regression was used to examine social influences in relation to abstinence self-efficacy. Social influences were significantly related to abstinence self-efficacy when examined independently. However, only social support for alcohol/drug use was significant when both social influences were entered into the model. Findings suggest social support for alcohol/drug use compromises abstinence social support, particularly among justice involved persons who are early in their recovery from substance use disorders. PMID:27594810

  2. Sources of motivation for abstinence: a replication analysis of the reasons for quitting questionnaire.

    PubMed

    Downey, L; Rosengren, D B; Donovan, D M

    2001-01-01

    The Reasons for Quitting Questionnaire (RFQ) as modified by McBride and colleagues (C. M. McBride et al., 1994) for use with substance users other than tobacco smokers, was administered to individuals approved for public-sector addiction treatment. Four motivation dimensions, similar to those found by McBride et al., were identified: self-concept issues, health concerns, legal issues, and social influence. A forced two-component solution yielded dimensions interpretable as intrinsic and extrinsic motivation. Self-concept issues provided the highest levels of motivation for abstinence in this sample, with moderate levels provided by health concerns, and the lowest levels provided by legal and social influence components. Intrinsic motivation was higher than extrinsic motivation. Logistic regression models, with adjustment for total motivation, tested the association of successful abstinence during a follow-up period with baseline extrinsic and intrinsic motivation, and with the difference between intrinsic and extrinsic levels. All three associations were significant: intrinsic motivation (positive association), extrinsic motivation (negative association), and the difference score (positive association). The results suggest the usefulness of the 20-item modified RFQ in evaluating motivation for abstinence among treatment seekers exhibiting severe negative consequences of addiction. Testing with samples varying in severity of addiction consequences is recommended.

  3. Forced smoking abstinence: not enough for smoking cessation.

    PubMed

    Clarke, Jennifer G; Stein, L A R; Martin, Rosemarie A; Martin, Stephen A; Parker, Donna; Lopes, Cheryl E; McGovern, Arthur R; Simon, Rachel; Roberts, Mary; Friedman, Peter; Bock, Beth

    2013-05-13

    Millions of Americans are forced to quit smoking as they enter tobacco-free prisons and jails, but most return to smoking within days of release. Interventions are needed to sustain tobacco abstinence after release from incarceration. To evaluate the extent to which the WISE intervention (Working Inside for Smoking Elimination), based on motivational interviewing (MI) and cognitive behavioral therapy (CBT), decreases relapse to smoking after release from a smoke-free prison. Participants were recruited approximately 8 weeks prior to their release from a smoke-free prison and randomized to 6 weekly sessions of either education videos (control) or the WISE intervention. A tobacco-free prison in the United States. A total of 262 inmates (35% female). Continued smoking abstinence was defined as 7-day point-prevalence abstinence validated by urine cotinine measurement. At the 3-week follow-up, 25% of participants in the WISE intervention (31 of 122) and 7% of the control participants (9 of 125) continued to be tobacco abstinent (odds ratio [OR], 4.4; 95% CI, 2.0-9.7). In addition to the intervention, Hispanic ethnicity, a plan to remain abstinent, and being incarcerated for more than 6 months were all associated with increased likelihood of remaining abstinent. In the logistic regression analysis, participants randomized to the WISE intervention were 6.6 times more likely to remain tobacco abstinent at the 3-week follow up than those randomized to the control condition (95% CI, 2.5-17.0). Nonsmokers at the 3-week follow-up had an additional follow-up 3 months after release, and overall 12% of the participants in the WISE intervention (14 of 122) and 2% of the control participants (3 of 125) were tobacco free at 3 months, as confirmed by urine cotinine measurement (OR, 5.3; 95% CI, 1.4-23.8). Forced tobacco abstinence alone during incarceration has little impact on postrelease smoking status. A behavioral intervention provided prior to release greatly improves cotinine

  4. Effect of drug use and influence of abstinence on sexual functioning in a Spanish male drug-dependent sample: a multisite study.

    PubMed

    Vallejo-Medina, Pablo; Sierra, Juan Carlos

    2013-02-01

    To date, it has been difficult to address the issue of sexual functioning and drug use, and many approaches to it have basic problems and methodological errors. The present cross-sectional study compared the sexual functioning scores of a group of drug users with those of a group of nondrug users. It explored the relationship between drug abstinence and sexual functioning. A sample of 905 males participated in this study (549 met the substance dependence criteria and 356 were controls). All of them were assessed with the Changes in Sexual Functioning Questionnaire-Drugs version. The assessment was conducted from September 2009 to January 2011. The clinical sample was evaluated in nine different substance abuse treatment facilities. Results show that, overall, all dimensions (pleasure, desire, arousal, and orgasm) were moderately impaired. Yet, differences regarding preferred substance were observed. Pleasure and orgasm were the two areas most significantly impaired. In these areas, all drugs seemed to negatively affect sexual functioning. However, desire and arousal were not affected by all the substances. In addition, at least after 2 weeks of drug abstinence, no relationship was found between drug abstinence and improvement in sexual functioning. The sample studied had an average of 1 year of drug abstinence and was found to have poorer sexual functioning than the control group. Therefore, these results seem to contradict those that argue that drug use only impairs sexual functioning temporarily. Moreover, they suggest that sexual functioning does not improve just by stopping drug use. © 2012 International Society for Sexual Medicine.

  5. Adolescent Toluene Inhalation in Rats Affects White Matter Maturation with the Potential for Recovery Following Abstinence

    PubMed Central

    Egan, Gary; Kolbe, Scott; Gavrilescu, Maria; Wright, David; Lubman, Dan Ian; Lawrence, Andrew John

    2012-01-01

    Inhalant misuse is common during adolescence, with ongoing chronic misuse associated with neurobiological and cognitive abnormalities. While human imaging studies consistently report white matter abnormalities among long-term inhalant users, longitudinal studies have been lacking with limited data available regarding the progressive nature of such abnormalities, including the potential for recovery following periods of sustained abstinence. We exposed adolescent male Wistar rats (postnatal day 27) to chronic intermittent inhaled toluene (3,000 ppm) for 1 hour/day, 3 times/week for 8 weeks to model abuse patterns observed in adolescent and young adult human users. This dosing regimen resulted in a significant retardation in weight gain during the exposure period (p<0.05). In parallel, we performed longitudinal magnetic resonance imaging (T2-weighted) and diffusion tensor imaging prior to exposure, and after 4 and 8 weeks, to examine the integrity of white matter tracts, including the anterior commissure and corpus callosum. We also conducted imaging after 8 weeks of abstinence to assess for potential recovery. Chronic intermittent toluene exposure during adolescence and early adulthood resulted in white matter abnormalities, including a decrease in axial (p<0.05) and radial (p<0.05) diffusivity. These abnormalities appeared region-specific, occurring in the anterior commissure but not the corpus callosum and were not present until after at least 4 weeks of exposure. Toluene-induced effects on both body weight and white matter parameters recovered following abstinence. Behaviourally, we observed a progressive decrease in rearing activity following toluene exposure but no difference in motor function, suggesting cognitive function may be more sensitive to the effects of toluene. Furthermore, deficits in rearing were present by 4 weeks suggesting that toluene may affect behaviour prior to detectable white matter abnormalities. Consequently, exposure to inhalants that

  6. Adolescent toluene inhalation in rats affects white matter maturation with the potential for recovery following abstinence.

    PubMed

    Duncan, Jhodie Rubina; Dick, Alec Lindsay Ward; Egan, Gary; Kolbe, Scott; Gavrilescu, Maria; Wright, David; Lubman, Dan Ian; Lawrence, Andrew John

    2012-01-01

    Inhalant misuse is common during adolescence, with ongoing chronic misuse associated with neurobiological and cognitive abnormalities. While human imaging studies consistently report white matter abnormalities among long-term inhalant users, longitudinal studies have been lacking with limited data available regarding the progressive nature of such abnormalities, including the potential for recovery following periods of sustained abstinence. We exposed adolescent male Wistar rats (postnatal day 27) to chronic intermittent inhaled toluene (3,000 ppm) for 1 hour/day, 3 times/week for 8 weeks to model abuse patterns observed in adolescent and young adult human users. This dosing regimen resulted in a significant retardation in weight gain during the exposure period (p<0.05). In parallel, we performed longitudinal magnetic resonance imaging (T₂-weighted) and diffusion tensor imaging prior to exposure, and after 4 and 8 weeks, to examine the integrity of white matter tracts, including the anterior commissure and corpus callosum. We also conducted imaging after 8 weeks of abstinence to assess for potential recovery. Chronic intermittent toluene exposure during adolescence and early adulthood resulted in white matter abnormalities, including a decrease in axial (p<0.05) and radial (p<0.05) diffusivity. These abnormalities appeared region-specific, occurring in the anterior commissure but not the corpus callosum and were not present until after at least 4 weeks of exposure. Toluene-induced effects on both body weight and white matter parameters recovered following abstinence. Behaviourally, we observed a progressive decrease in rearing activity following toluene exposure but no difference in motor function, suggesting cognitive function may be more sensitive to the effects of toluene. Furthermore, deficits in rearing were present by 4 weeks suggesting that toluene may affect behaviour prior to detectable white matter abnormalities. Consequently, exposure to inhalants that

  7. The role of prepartum motivation in the maintenance of postpartum smoking abstinence

    PubMed Central

    Heppner, Whitney L.; Ji, Lingyun; Reitzel, Lorraine R.; Castro, Yessenia; Correa-Fernandez, Virmarie; Vidrine, Jennifer Irvin; Li, Yisheng; Dolan-Mullen, Patricia; Velasquez, Mary M.; Cinciripini, Paul M.; Cofta-Woerpel, Ludmila; Greisinger, Anthony; Wetter, David W.

    2011-01-01

    Objective Motivation plays an important role in a variety of behaviors, including smoking cessation, and is integral to theory and treatment of smoking. For many women, pregnancy offers a motivational shift that helps them stop smoking and maintain abstinence during pregnancy. However, women's motivation to maintain smoking abstinence postpartum is not well-understood and may play a role in high postpartum relapse rates. The current study utilized multiple measures of prepartum motivation to maintain smoking abstinence to predict postpartum smoking abstinence. Design As part of a randomized clinical trial on postpartum smoking relapse prevention, pregnant women who quit smoking during pregnancy reported their motivation to continue smoking abstinence at a prepartum baseline session. Continued smoking abstinence was assessed at 8 and 26 weeks postpartum. Main Outcome Measure Biochemically verified continuous abstinence from smoking. Results Direct relationships among multiple measures of motivation were significant, and ranged in strength from weak to moderate. All motivation measures individually predicted continuous smoking abstinence, after controlling for treatment group, demographics, and pre-quit tobacco use. When tested simultaneously, a global motivation measure and parenthood motives for quitting remained significant predictors of abstinence. Backward selection modeling procedures resulted in a reduced model of prepartum predictors of postpartum abstinence including global motivation, parenthood motives, and stage of change. Conclusion Global motivation for smoking abstinence and parenthood motives for quitting are particularly important motivational constructs for pregnant women's continued smoking abstinence. PMID:21859215

  8. Housing and abstinence self-efficacy in formerly incarcerated individuals

    PubMed Central

    Whipple, Christopher R.; Jason, Leonard A.; Robinson, W. LaVome

    2016-01-01

    To avoid recidivism, formerly-incarcerated individuals must successfully navigate barriers to re-entry, including finding adequate housing and avoiding substance use. This study examined the role that time in diverse housing situations affect abstinence self-efficacy in formerly-incarcerated individuals. Formerly-incarcerated individuals were surveyed about previous housing situations and abstinence self-efficacy after release from prison or inpatient substance use treatment. Models were estimated with both days spent in different housing situations in the past 180 and past 30 days. More time spent in recovery situations was associated with increased abstinence self-efficacy, while more time spent in precarious situations was associated with decreased abstinence self-efficacy. PMID:28603403

  9. Abstinence Rates among College Cigarette Smokers Enrolled in A Randomized Clinical Trial Evaluating Quit and Win Contests: The Impact of Concurrent Hookah Use

    PubMed Central

    Bengtson, J.E.; Wang, Q.; Luo, X.; Marigi, Erick; Winta, Ghidei; Ahluwalia, J.S.

    2015-01-01

    Objective To examine baseline characteristics and biochemically verified 1-, 4-, and 6-month tobacco quit rates among college students enrolled in a Quit and Win cessation trial, comparing those who concurrently smoke both hookah and cigarettes with those who deny hookah use. Methods Analyses were conducted on data from 1,217 college students enrolled in a Quit and Win tobacco cessation randomized clinical trial from 2010–2012. Multivariable logistic regression (MLR) analyses examined group differences in baseline characteristics and cotinine verified 30-day abstinence at 1, 4, and 6-month follow-up, adjusting for baseline covariates. Results Participants smoked 11.5(±8.1) cigarettes per day on 28.5(±3.8) days/month, and 22% smoked hookah in the past 30 days. Hookah smokers (n=270) were more likely to be male (p<0.0001), younger (p<0.0001), report more binge drinking (p<0.0001) and score higher on impulsivity (p<0.001). MLR results indicate that hookah users, when compared to non-users, had a 36% decrease in odds of self-reported 30-day abstinence at 4-months (OR= 0.64, 95% CI=0.45–0.93, p=0.02) and a 63% decrease in odds in biochemically verified continuous abstinence at 6-months (OR = 0.37, CI=0.14–0.99, p=0.05). Conclusion College cigarette smokers who concurrently use hookah display several health risk factors and demonstrate lower short and long-term tobacco abstinence rates. PMID:25773472

  10. Persistent alterations in mesolimbic gene expression with abstinence from cocaine self-administration

    PubMed Central

    Freeman, WM; Patel, KM; Brucklacher, RM; Lull, ME; Erwin, M; Morgan, D; Roberts, DCS; Vrana, KE

    2010-01-01

    Cocaine-responsive gene expression changes have been described after either no drug abstinence or short periods of abstinence. Little data exist on the persistence of these changes after long-term abstinence. Previously, we reported that after discrete-trial, cocaine self-administration and 10 days of forced abstinence, incubation of cocaine reinforcement was observable by a progressive ratio schedule. The present study used rat discrete-trial cocaine self-administration and long-term forced abstinence to examine: extinction responding, mRNA abundance of known cocaine-responsive genes, and chromatin remodeling. At 30 and 100 days of abstinence, extinction responding increased compared to 3-day abstinent rats. Decreases in both medial prefrontal cortex (mPFC) and nucleus accumbens (NAc) c-fos, Nr4a1, Arc, and EGR1 mRNA were observed, and in most cases persisted, for 100 days of abstinence. The signaling peptides CART and NPY transiently increased in the mPFC, but returned to baseline levels following 10 days of abstinence. To investigate a potential regulatory mechanism for these persistent mRNA changes, levels of histone H3 acetylation at promoters for genes with altered mRNA expression were examined. In the mPFC, histone H3 acetylation decreased after 1 and 10 days of abstinence at the promoter for EGR1. H3 acetylation increased for NPY after 1 day of abstinence and returned to control levels by 10 days of abstinence. Behaviorally, these results demonstrate incubation after discrete-trial cocaine self-administration and prolonged forced abstinence. This incubation is accompanied by changes in gene expression that persist long after cessation of drug administration and may be regulated by chromatin remodeling. PMID:17851536

  11. Web-based treatment for substance use disorders: differential effects by primary substance.

    PubMed

    Cochran, Gerald; Stitzer, Maxine; Campbell, Aimee N C; Hu, Mei-Chen; Vandrey, Ryan; Nunes, Edward V

    2015-06-01

    This secondary analysis of data from a large, multi-site effectiveness trial (NCT01104805) sought to determine whether effects of a web-based behavioral treatment (Therapeutic Education System [TES]) differed by participants' self-identified primary drug of abuse. The all-comers sample of individuals entering outpatient psychosocial counseling treatment for substance abuse (N=497) cited cannabis (22.9%; n=114), stimulants (34.4%, n=171), opioids (21.7%, n=108), or alcohol (20.9%, n=104) as their primary substance of abuse. Participants were randomly assigned to receive treatment-as-usual (TAU) with or without TES substituted for approximately 2h of usual counseling. Multivariate analyses of abstinence outcomes examined interactions of treatment effects with primary substance. Adjusted odds ratios (AORs) demonstrated that primary stimulant users receiving TES were more likely to be abstinent in the final four weeks of treatment compared to stimulant users receiving TAU (AOR=3.59, 95% CI=1.25-10.27). Adjusted odds ratios for alcohol (AOR=3.15, 95% CI=0.85-11.65) and cannabis (AOR=2.64, 95% CI=0.73-9.52) also were of similar magnitude to stimulants but did not reach significance. Abstinence among primary opioid users was not improved by the TES intervention (AOR=0.35, 95% CI=0.09-1.47). This study supports the TES web-delivered treatment as a viable intervention for the majority of substance users entering outpatient counseling treatment, with demonstrated effectiveness among stimulant users and promising effects in alcohol and cannabis users but little or no effect in primary opioid users. Web-delivered treatments hold promise for expanding the availability of effective behavioral interventions for the majority of substance use disorders. Copyright © 2015 Elsevier Ltd. All rights reserved.

  12. Sex differences in time perception during smoking abstinence.

    PubMed

    Ashare, Rebecca L; Kable, Joseph W

    2015-04-01

    Nicotine withdrawal leads to impulsive decision-making, which reflects a preference for smaller, immediate rewards and often prompts a relapse to smoking. The mechanism by which nicotine withdrawal leads to impulsive decision-making is not well known. An essential dimension of decision-making is time perception. Impulsive decisions reflect intolerance of temporal delays and the perception that time is passing more slowly. Sex may be an important factor in impulsive decision-making and time perception, but no studies have investigated whether sex moderates the effects of nicotine withdrawal on impulsive decision-making and time perception. Thirty-three (12 female) adult smokers completed 2 laboratory sessions: following 24-hr abstinence and once smoking-as-usual (order counterbalanced, abstinence biochemically verified). Participants completed 2 time perception tasks, a decision-making task, and self-report measures of craving, withdrawal, and mood. During time reproduction, males overestimated time during abstinence compared to smoking, whereas there was no session effect for females. On the time discrimination task, smokers were less accurate during abstinence, and this effect tended to be stronger among females. In general, males had higher discounting rates compared with females, but there was no effect of abstinence. The current data suggest that the effect of abstinence on time perception may be stronger in males and that males generally exhibit steeper delay discounting rates. Time perception may be an important mechanism in smoking abstinence. Our future work will investigate the role of time perception in smoking relapse and whether this is moderated by sex. © The Author 2015. Published by Oxford University Press on behalf of the Society for Research on Nicotine and Tobacco. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  13. The Impact of Abstinence Education: What Does the Research Say?

    ERIC Educational Resources Information Center

    Young, Michael; Penhollow, Tina

    2006-01-01

    There has long been controversy in this country about the implementation of school-based sexuality education. In recent years, however, the controversy has centered on abstinence education. Critics of abstinence education programs seem to have three major concerns relative to abstinence education programming: (1) promotion of religion; (2)…

  14. Opiate v CNS depressant therapy in neonatal drug abstinence syndrome.

    PubMed

    Kandall, S R; Doberczak, T M; Mauer, K R; Strashun, R H; Korts, D C

    1983-04-01

    Paregoric and phenobarbital, administered randomly in 153 passively addicted neonates, initially appeared to control neonatal abstinence signs equally well. However, seven of the 62 phenobarbital-treated newborns had abstinence-associated seizures within the first month of life, while none of 49 paregoric-treated neonates had seizures. Forty-two neonates initially requiring no specific pharmacotherapy for abstinence signs were born to mothers taking less methadone hydrochloride just before delivery. Five of those 42 neonates, however, had seizures within the first 14 days of life. Seizure occurrence could not be predicted from analysis of early abstinence patterns. We consider paregoric to be the treatment of choice for the neonatal abstinence syndrome. Phenobarbital use should be monitored with serum drug levels and modification of recommended dosage regimens considered.

  15. Abstinence-based programs for prevention of adolescent pregnancies. A review.

    PubMed

    Thomas, M H

    2000-01-01

    This article assesses the abstinence-based programs developed by family life educators and the factors associated with positive results through a review of abstinence promotion programs of the federal government. In 1996, Section 510 was added to Title V of the Social Security Act allocating US$50 million annually from 1998-2000 to fund abstinence education programs, while in 1997, a National Strategy to Prevent Teen Pregnancy was launched by the Office of Adolescent Pregnancy Prevention to provide teen pregnancy programs to at least 25% of the communities. Presented in this paper is a discussion of the Abstinence Only programs, which focus on the prevention of pregnancy and sexually transmitted disease among adolescents, and the Abstinence Plus programs, which emphasize other prevention methods as well as abstinence. Evaluation of Abstinence Only programs include Success Express, Project Taking Charge, Sex Respect, Teen Aid, Values and Choices and Facts and Feelings. Moreover, programs such as Reducing the Risk, Postponing Sexual Involvement, Project Education Now, and Babies Later were evaluated under the Abstinence Plus programs. Several programs evaluated have shown to have a positive effect on attitudes among adolescents, but are not proven to have a significant effect on sexual behavior. In conclusion, this article encourages exploration of new approaches to address teen pregnancy and the increasing incidence of sexually transmitted diseases among adolescents, while the federal government must utilize the implementation of existing programs with positive effects.

  16. Abstinence education*

    PubMed Central

    Zeiler, Alean

    2014-01-01

    The American College of Pediatricians strongly endorses abstinence-until-marriage sex education and recommends adoption by all school systems in lieu of “comprehensive sex education.” This position is based on “the public health principle of primary prevention—risk avoidance in lieu of risk reduction,” upholding the “human right to the highest attainable standard of health” (Freedman 1995). PMID:25473134

  17. Abstinence Programs Don't Work, Largest Study to Date Concludes

    ERIC Educational Resources Information Center

    Freking, Kevin

    2007-01-01

    This article reports on a study conducted by Mathematica Policy Research Inc. of students in four abstinence programs, as well as peers from the same communities who did not participate in the abstinence programs. A federally mandated report said that students who participated in sexual-abstinence education programs partially funded by the federal…

  18. Neuropsychological deficits in long-term frequent cannabis users.

    PubMed

    Messinis, Lambros; Kyprianidou, Anthoula; Malefaki, Sonia; Papathanasopoulos, Panagiotis

    2006-03-14

    The authors examined neuropsychological functioning in 20 long-term (LT), 20 shorter term (ST) heavy frequent cannabis users, and 24 controls after abstinence for > or =24 hours prior to testing. LT users performed significantly worse on verbal memory and psychomotor speed. LT and ST users had a higher proportion of deficits on verbal fluency, verbal memory, attention, and psychomotor speed. Specific cognitive domains appear to deteriorate with increasing years of heavy frequent cannabis use.

  19. Cannabis Withdrawal, Posttreatment Abstinence, and Days to First Cannabis Use Among Emerging Adults in Substance Use Treatment: A Prospective Study

    PubMed Central

    Davis, Jordan P.; Smith, Douglas C.; Morphew, Jason W.; Lei, Xinrong; Zhang, Saijun

    2015-01-01

    Very little prospective research investigates how cannabis withdrawal is associated with treatment outcomes, and this work has not used the Diagnostic and Statistical Manual of Mental Disorders (5th ed.; DSM-5) thresholds for cannabis withdrawal. The sample included 110 emerging adults entering outpatient substance use treatment who were heavy cannabis users with no other drug use and limited alcohol use. We used survival analyses to predict days to first use of cannabis and logistic regression to predict whether participants were abstinent and living in the community at 3 months. Those meeting criteria for cannabis withdrawal were more likely to return to use sooner than those not meeting criteria for cannabis withdrawal. However, the presence of cannabis withdrawal was not a significant predictor of 3-month abstinence. Emerging adults with DSM-5 cannabis withdrawal may have difficulty initiating abstinence in the days following their intake assessment, implying the need for strategies to mitigate their more rapid return to cannabis use. PMID:26877548

  20. Perinatal Substance Use: A Prospective Evaluation of Abstinence and Relapse

    PubMed Central

    Forray, Ariadna; Merry, Brian; Lin, Haiqun; Ruger, Jennifer Prah; Yonkers, Kimberly A.

    2015-01-01

    Background Substance use decreases in pregnancy but little prospective data are available on the rates of abstinence and relapse for specific substances. This study compared rates of abstinence in pregnancy and relapse postpartum for nicotine cigarettes, alcohol, marijuana, and cocaine. Methods Data from 152 women drawn from a randomized controlled trial comparing psychological treatments for substance use in pregnancy were analyzed. Self-reports of substance use and urine for toxicology testing throughout pregnancy and 3-months, 12-months and 24-months post-delivery were collected. Multivariate Cox models were used to compare rates of abstinence and relapse across substances. Results In pregnancy, 83% of all women achieved abstinence to at least one substance. The mean (SE) days to abstinence was 145.81 (9.17), 132.01 (6.17), 151.52 (6.24), and 148.91 (7.68) for cigarettes, alcohol, marijuana and cocaine, respectively. Participants were more likely to achieve abstinence from alcohol (HR 7.24 (95% CI 4.47-11.72), marijuana (HR 4.06; 95% CI 1.87-6.22), and cocaine (HR 3.41; 95% CI 2.53-6.51), than cigarettes. Postpartum, 80% of women abstinent in the last month of pregnancy relapsed to at least one substance. The mean days to relapse was 109.67 (26.34), 127.73 (21.29), 138.35 (25.46), and 287.55 (95.85) for cigarettes, alcohol, marijuana and cocaine, respectively. Relapse to cocaine was only 34% (HR 0.34; 95% CI 0.15-0.77) that of cigarettes. Conclusions Pregnancy-related abstinence rates were high for all substances except cigarettes. Postpartum relapse was common, with cocaine using women being less likely to relapse after attaining abstinence compared to women using cigarettes, alcohol or marijuana. PMID:25772437

  1. Postural Stability in Cigarette Smokers and During Abstinence from Alcohol

    PubMed Central

    Schmidt, Thomas Paul; Pennington, David Louis; Durazzo, Timothy Craig; Meyerhoff, Dieter Johannes

    2014-01-01

    Background Static postural instability is common in alcohol dependent individuals (ALC). Chronic alcohol consumption has deleterious effects on the neural and perceptual systems subserving postural stability. However, little is known about the effects of chronic cigarette smoking on postural stability and its changes during abstinence from alcohol. Methods A modified Fregly ataxia battery was administered to a total of 115 smoking (sALC) and non-smoking ALC (nsALC) and to 74 smoking (sCON) and non-smoking light/non-drinking controls (nsCON). Subgroups of abstinent ALC were assessed at 3 time points (approximately 1 week, 5 weeks, 34 weeks of abstinence from alcohol); a subset of nsCON was re-tested at 40 weeks. We tested if cigarette smoking affects postural stability in CON and in ALC during extended abstinence from alcohol, and we used linear mixed effects modeling to measure change across time points within ALC. Results Chronic smoking was associated with reduced performance on the Sharpened Romberg eyes-closed task in abstinent ALC at all three time points and in CON. The test performance of nsALC increased significantly between 1 and 32 weeks of abstinence, whereas the corresponding increases for sALC between 1 and 35 weeks was non-significant. With long-term abstinence from alcohol, nsALC recovered into the range of nsCON and sALC recovered into the range of sCON. Static postural stability decreased with age and correlated with smoking variables but not with drinking measures. Conclusions Chronic smoking was associated with reduced static postural stability with eyes closed and with lower increases of postural stability during abstinence from alcohol. Smoking cessation in alcohol dependence treatment may facilitate recovery from static postural instability during abstinence. PMID:24721012

  2. Postural stability in cigarette smokers and during abstinence from alcohol.

    PubMed

    Schmidt, Thomas P; Pennington, David L; Durazzo, Timothy C; Meyerhoff, Dieter J

    2014-06-01

    Static postural instability is common in alcohol-dependent individuals (ALC). Chronic alcohol consumption has deleterious effects on the neural and perceptual systems subserving postural stability. However, little is known about the effects of chronic cigarette smoking on postural stability and its changes during abstinence from alcohol. A modified Fregly ataxia battery was administered to a total of 115 smoking (sALC) and nonsmoking ALC (nsALC) and to 71 smoking (sCON) and nonsmoking light/nondrinking controls (nsCON). Subgroups of abstinent ALC were assessed at 3 time points (TPs; approximately 1, 5, 34 weeks of abstinence from alcohol); a subset of nsCON was retested at 40 weeks. We tested whether cigarette smoking affects postural stability in CON and in ALC during extended abstinence from alcohol, and we used linear mixed effects modeling to measure change across TPs within ALC. Chronic smoking was associated with reduced performance on the Sharpened Romberg eyes-closed task in abstinent ALC at all 3 TPs and in CON. The test performance of nsALC increased significantly between 1 and 32 weeks of abstinence, whereas the corresponding increases for sALC between 1 and 35 weeks were nonsignificant. With long-term abstinence from alcohol, nsALC recovered into the range of nsCON and sALC recovered into the range of sCON. Static postural stability decreased with age and correlated with smoking variables but not with drinking measures. Chronic smoking was associated with reduced static postural stability with eyes closed and with lower increases of postural stability during abstinence from alcohol. Smoking cessation in alcohol dependence treatment may facilitate recovery from static postural instability during abstinence. Copyright © 2014 by the Research Society on Alcoholism.

  3. Exposure to and Views of Information about Sexual Abstinence among Older Teens

    ERIC Educational Resources Information Center

    Jones, Rachel K.; Biddlecom, Ann E.

    2011-01-01

    There is scant research of adolescents' understanding of abstinence. We conducted interviews with a sample of 58 teens to find out their exposure to abstinence information from a range of sources. Most teens had received abstinence information or messages from school, family members, and friends. For many teens, information about abstinence, or…

  4. A Qualitative Exploration of the Role of Vape Shop Environments in Supporting Smoking Abstinence.

    PubMed

    Ward, Emma; Cox, Sharon; Dawkins, Lynne; Jakes, Sarah; Holland, Richard; Notley, Caitlin

    2018-02-09

    E-cigarettes are the most popular method of quitting smoking in England and most are purchased in specialist vape shops. This qualitative study explores how the vape shop environment is experienced by quitters to support smoking abstinence. Semi-structured qualitative interviews were conducted to elicit experiences of e-cigarette use, including experiences of vape shops, in 40 people who had used e-cigarettes in a quit attempt. Observations of six shops in a range of locations were also undertaken. Interview and observation data were analysed using inductive thematic analysis and triangulated. At an individual level, smoking abstinence was supported through shop assistants' attempts to understand customers' smoking preferences in order to: (i) tailor advice about the most appropriate product; and (ii) offer an ongoing point of contact for practical help. At an interpersonal level, shops offered opportunity to socialise and reinforce a vaping identity, although the environment was perceived as intimidating for some (e.g., new and female users). At a structural level, shops ensured easy access to products perceived to be good value by customers and had adapted to legislative changes. Vape shops can provide effective behavioural support to quitters to maintain smoking abstinence. Health professionals could capitalise on this through partnership working with shops, to ensure best outcomes for clients wanting to use e-cigarettes to quit smoking.

  5. A Qualitative Exploration of the Role of Vape Shop Environments in Supporting Smoking Abstinence

    PubMed Central

    Jakes, Sarah; Holland, Richard; Notley, Caitlin

    2018-01-01

    E-cigarettes are the most popular method of quitting smoking in England and most are purchased in specialist vape shops. This qualitative study explores how the vape shop environment is experienced by quitters to support smoking abstinence. Semi-structured qualitative interviews were conducted to elicit experiences of e-cigarette use, including experiences of vape shops, in 40 people who had used e-cigarettes in a quit attempt. Observations of six shops in a range of locations were also undertaken. Interview and observation data were analysed using inductive thematic analysis and triangulated. At an individual level, smoking abstinence was supported through shop assistants’ attempts to understand customers’ smoking preferences in order to: (i) tailor advice about the most appropriate product; and (ii) offer an ongoing point of contact for practical help. At an interpersonal level, shops offered opportunity to socialise and reinforce a vaping identity, although the environment was perceived as intimidating for some (e.g., new and female users). At a structural level, shops ensured easy access to products perceived to be good value by customers and had adapted to legislative changes. Vape shops can provide effective behavioural support to quitters to maintain smoking abstinence. Health professionals could capitalise on this through partnership working with shops, to ensure best outcomes for clients wanting to use e-cigarettes to quit smoking. PMID:29425117

  6. Lower hypoxic ventilatory response in smokers compared to non-smokers during abstinence from cigarettes.

    PubMed

    Hildebrandt, Wulf; Sauer, Roland; Koehler, Ulrich; Bärtsch, Peter; Kinscherf, Ralf

    2016-11-24

    Carotid body O 2 -chemosensitivity determines the hypoxic ventilatory response (HVR) as part of crucial regulatory reflex within oxygen homeostasis. Nicotine has been suggested to attenuate HVR in neonates of smoking mothers. However, whether smoking affects HVR in adulthood has remained unclear and probably blurred by acute ventilatory stimulation through cigarette smoke. We hypothesized that HVR is substantially reduced in smokers when studied after an overnight abstinence from cigarettes i.e. after nicotine elimination. We therefore determined the isocapnic HVR of 23 healthy male smokers (age 33.9 ± 2.0 years, BMI 24.2 ± 0.5 kg m -2 , mean ± SEM) with a smoking history of >8 years after 12 h of abstinence and compared it to that of 23 healthy male non-smokers matched for age and BMI. Smokers and non-smokers were comparable with regard to factors known to affect isocapnic HVR such as plasma levels of glucose and thiols as well as intracellular levels of glutathione in blood mononuclear cells. As a new finding, abstinent smokers had a significantly lower isocapnic HVR (0.024 ± 0.002 vs. 0.037 ± 0.003 l min -1 % -1 BMI -1 , P = 0.002) compared to non-smokers. However, upon re-exposure to cigarettes the smokers' HVR increased immediately to the non-smokers' level. This is the first report of a substantial HVR reduction in abstinent adult smokers which appears to be masked by daily smoking routine and may therefore have been previously overlooked. A low HVR may be suggested as a novel link between smoking and aggravated hypoxemia during sleep especially in relevant clinical conditions such as COPD.

  7. Depressive Symptoms, Friend and Partner Relationship Quality, and Posttreatment Abstinence*

    PubMed Central

    McKee, Laura G.; Bonn-Miller, Marcel O.; Moos, Rudolf H.

    2011-01-01

    Objective: This study employed a prospective design to examine the role of friend and partner relationship quality 1 year following substance use disorder treatment in the association between depressive symptoms at discharge from treatment and abstinence from substance use 2 years after treatment. Method: The sample consisted of 1,453 male veterans who used alcohol and at least one other substance in the 3 months before treatment admission, who completed treatment, and who were abstinent from substances during the 2 weeks before discharge. Results: Fewer depressive symptoms at treatment discharge predicted better relationship quality with friends and a partner at 1 -year follow-up, as well as abstinence from substance use at 2-year follow-up. Furthermore, friend and partner relationship quality at 1 year predicted abstinence from substance use at 2 years. Friend relationship quality at 1 year mediated part of the association between fewer depressive symptoms at treatment discharge and abstinence at 2-year follow-up. Conclusions: A stronger focus in treatment on reducing depressive symptoms and enhancing the quality of patients' relationships with their friends and partner may increase the likelihood of long-term abstinence. PMID:21138721

  8. Childhood Conduct Problems and Other Early Risk Factors in Rural Adult Stimulant Users

    ERIC Educational Resources Information Center

    Kramer, Teresa L.; Han, Xiaotong; Leukefeld, Carl; Booth, Brenda M.; Edlund, Carrie

    2009-01-01

    Context: Understanding childhood risk factors associated with adult substance use and legal problems is important for treatment and prevention. Purpose: To examine the relationship of early substance use, conduct problems before age 15, and family history of substance abuse on adult outcomes in rural, stimulant users. Methods: Adult cocaine and…

  9. Rapid elimination of Carboxy-THC in a cohort of chronic cannabis users.

    PubMed

    Lewis, John; Molnar, Anna; Allsop, David; Copeland, Jan; Fu, Shanlin

    2016-01-01

    Urinary 11-nor-Δ(9)-tetrahydrocannabinol-9-carboxylic acid (Carboxy-THC) concentrations, normalised to creatinine output, have been demonstrated to be a useful tool in the interpretation of the results of a series of urine tests for cannabis. These tests, often termed historical data, can be used to identify potential chronic cannabis users who may present occupational health and safety risks within the workplace. Conversely, the data can also be used to support employee claims of previous regular, rather than recent, cannabis use. This study aimed at examining the mean elimination of Carboxy-THC in 37 chronic users undergoing voluntary abstinence over a 2-week period. Urine specimens were collected prior to the study and after 1 and 2 weeks of abstinence. Carboxy-THC levels in urine were measured by gas chromatography-mass spectrometry (GC-MS) following alkaline hydrolysis, organic solvent extraction and derivatisation to form its pentafluoropropionic derivative. The creatinine-normalised Carboxy-THC concentrations declined rapidly over the 2 weeks of abstinence period and the majority of chronic cannabis users (73%) reduced their urinary Carboxy-THC levels to below the 15-μg/L confirmatory cutoff within that time. The study further highlights the value of historical urinary Carboxy-THC data as a means of identifying potential occupational health and safety risks among chronic cannabis users.

  10. Influence of materials on teacher adoption of abstinence-only- until-marriage programs.

    PubMed

    Wilson, Kelly L; Wiley, David C

    2009-12-01

    Given the growing scientific evidence against abstinence-only-until-marriage education, health educators are supporting an evidence-based approach to teaching sexuality education. However, there is still an abundance of federal support and funding streams allocated to sustain abstinence-only programs. This study assessed indicators that influence the adoption of abstinence-only-until-marriage education as well as school teachers' likelihood of adopting such programs. Predictors included relative advantage, compatibility, complexity, and observability and were assessed with a self-administered, validated questionnaire. Additional questions were asked related to demographics, professional history, and abstinence-only-until-marriage education policies and funding. The relationships were tested with multiple regression analysis. A trend became apparent in which most teachers would allow a state- or federally funded program to be offered and presented in their schools, but most did not know if their school received funding to support abstinence-only-until-marriage education. Attendance at religious services, complexity of abstinence-only-until-marriage programs, and abstinence-only-until-marriage curriculum emerged as important predictors of the likelihood to adopt abstinence education. Trends in political agendas, policy development, and state and federal funding have supported abstinence-only-until-marriage education programs. In order to ensure an understanding about the inclusion of sexuality education in the classroom, insight into the teacher's role in the integration of sexuality education in the classroom is important.

  11. Investigating Group Contingencies to Promote Brief Abstinence from Cigarette Smoking

    PubMed Central

    Meredith, Steven E.; Dallery, Jesse

    2013-01-01

    In contingency management (CM), monetary incentives are contingent on evidence of drug abstinence. Typically, incentives (e.g., “vouchers” exchangeable for goods or services) are contingent on individual performance. We programmed vouchers contingent on group performance to investigate whether these contingencies would promote brief abstinence from cigarette smoking. Thirty-two participants were divided into small teams (n = 3 per team). During three 5-day within-subject experimental conditions, participants submitted video recordings of breath carbon monoxide (CO) measures twice daily via Mōtiv8 Systems™, an Internet-based remote monitoring application. During the interdependent contingency condition, participants earned vouchers each time they and their teammates submitted breath CO samples indicative of abstinence (i.e., negative samples). During the independent contingency condition, participants earned vouchers each time they submitted negative samples, regardless of their teammates' performance. During the no vouchers condition, no monetary incentives were contingent on abstinence. In addition, half of the participants (n = 16) could communicate with their teammates through an online peer support forum. Although forum access did not appear to promote smoking abstinence, monetary incentives did promote brief abstinence. Significantly more negative samples were submitted when vouchers were contingent on individual performance (56%) or team performance (53%) relative to when no vouchers were available (35%; F = 6.9, p = 0.002). The results show that interdependent contingencies can promote brief abstinence from cigarette smoking. Moreover, the results suggest that these contingencies may help lower treatment costs and promote social support. PMID:23421358

  12. Marijuana Use and Achievement of Abstinence from Alcohol and Other Drugs among People with Substance Dependence: A Prospective Cohort Study

    PubMed Central

    Mojarrad, Mohammadali; Samet, Jeffrey H; Cheng, Debbie M.; Winter, Michael R.; Saitz, Richard

    2014-01-01

    Background Many with alcohol and other drug dependence have concurrent marijuana use, yet it is not clear how to address it during addiction treatment. This is partially due to the lack of clarity about whether marijuana use impacts one’s ability to achieve abstinence from the target of addiction treatment. We examined the association between marijuana use and abstinence from other substances among individuals with substance dependence. Methods A secondary analysis of the Addiction Health Evaluation And Disease management study, a randomized trial testing the effectiveness of chronic disease management. Individuals met criteria for drug or alcohol dependence and reported recent drug (i.e. opioid or stimulant) or heavy alcohol use. Recruitment occurred at an inpatient detoxification unit, and all participants were referred to primary medical care. The association between marijuana use and later abstinence from drug and heavy alcohol use was assessed using longitudinal multivariable models. Results Of 563 study participants, 98% completed at least one follow-up assessment and 535 (95%) had at least one pair of consecutive assessments and were included. In adjusted analyses, marijuana use was associated with a 27% reduction in the odds of abstinence from drug and heavy alcohol use (adjusted odds ratio 0.73 [95% CI, 0.56–0.97], P=0.03). Conclusions Marijuana use among individuals with alcohol or other drug dependence is associated with a lower odds of achieving abstinence from drug and heavy alcohol use. These findings add evidence that suggests concomitant marijuana use among patients with addiction to other drugs merits attention from clinicians. PMID:24986785

  13. Multimodal Neuroimaging Differences in Nicotine Abstinent vs. Satiated Smokers.

    PubMed

    Chaarani, Bader; Spechler, Philip A; Ivanciu, Alexandra; Snowe, Mitchell; Nickerson, Joshua P; Higgins, Stephen T; Garavan, Hugh

    2018-04-06

    Research on cigarette smokers suggests cognitive and behavioral impairments. However, much remains unclear how the functional neurobiology of smokers is influenced by nicotine state. Therefore, we sought to determine which state, be it acute nicotine abstinence or satiety, would yield the most robust differences compared to non-smokers when assessing neurobiological markers of nicotine dependence. Smokers(N=15) and sociodemographically matched non-smokers(N=15) were scanned twice using a repeated-measures design. Smokers were scanned after a 24-hour nicotine abstinence, and immediately after smoking their usual brand cigarette. The neuroimaging battery included a stop-signal task of response inhibition and pseudo-continuous arterial spin labeling to measure cerebral blood flow (CBF). Whole brain voxel-wise ANCOVAs were carried out on stop success and stop fail SST contrasts and CBF maps to assess differences among non-, abstinent and satiated smokers. Cluster-correction was performed using AFNI's 3dClustSim to achieve a significance of p<0.05. Smokers exhibited higher brain activation in bilateral inferior frontal gyrus (IFG), a brain region known to be involved in inhibitory control, during successful response inhibitions relative to non-smokers. This effect was significantly higher during nicotine abstinence relative to satiety. Smokers also exhibited lower CBF in the bilateral IFG than non-smokers. These hypo-perfusions were not different between abstinence and satiety. These findings converge on alterations in smokers in prefrontal circuits known to be critical for inhibitory control. These effects are present, even when smokers are satiated, but the neural activity required to achieve performance equal to controls is increased when smokers are in acute abstinence. Our multi-modal neuroimaging study gives neurobiological insights into the cognitive demands of maintaining abstinence and suggest targets for assessing the efficacy of therapeutic interventions.

  14. Error processing in current and former cocaine users

    PubMed Central

    Castelluccio, Brian C.; Meda, Shashwath A.; Muska, Christine E.; Stevens, Michael C.; Pearlson, Godfrey D.

    2013-01-01

    Deficits in response inhibition and error processing can result in maladaptive behavior, including failure to use past mistakes to inform present decisions. A specific deficit in inhibiting a prepotent response represents one aspect of impulsivity and is a prominent feature of addictive behaviors in general, including cocaine abuse/dependence. Brain regions implicated in cognitive control exhibit reduced activation in cocaine abusers. The purposes of the present investigation were (1) to identify neural differences associated with error processing in current and former cocaine-dependent individuals compared to healthy controls and (2) to determine whether former, long-term abstinent cocaine users showed similar differences compared with current users. The present study used an fMRI Go/No-Go task to investigate differences in BOLD response to correct rejections and false alarms between current cocaine users (n=30), former cocaine users (n=29), and healthy controls (n=35). Impulsivity trait measures were also assessed and compared with BOLD activity. Nineteen regions of interest previously implicated in errors of disinhibition were queried. There were no group differences in the correct rejections condition, but both current and former users exhibited increased BOLD response relative to controls for false alarms. In current users, the pregenual cingulate gyrus and left angular/supramarginal gyri overactivated. In former users, the right middle frontal/precentral gyri, right inferior parietal lobule, and left angular/supramarginal gyri overactivated. Overall, our results support a hypothesis that neural activity in former users differs more from healthy controls than that of current users due to cognitive compensation that facilitates abstinence. PMID:23949893

  15. A randomized trial of concurrent smoking-cessation and substance use disorder treatment in stimulant-dependent smokers.

    PubMed

    Winhusen, Theresa M; Brigham, Gregory S; Kropp, Frankie; Lindblad, Robert; Gardin, John G; Penn, Pat; Hodgkins, Candace; Kelly, Thomas M; Douaihy, Antoine; McCann, Michael; Love, Lee D; DeGravelles, Eliot; Bachrach, Ken; Sonne, Susan C; Hiott, Bob; Haynes, Louise; Sharma, Gaurav; Lewis, Daniel F; VanVeldhuisen, Paul; Theobald, Jeff; Ghitza, Udi

    2014-04-01

    To evaluate the impact of concurrent treatments for substance use disorder and nicotine-dependence for stimulant-dependent patients. A randomized, 10-week trial with follow-up at 3 and 6 months after smoking quit date conducted at 12 substance use disorder treatment programs between February 2010 and July 2012. Adults meeting DSM-IV-TR criteria for cocaine and/or methamphetamine dependence and interested in quitting smoking were randomized to treatment as usual (n = 271) or treatment as usual with smoking-cessation treatment (n = 267). All participants received treatment as usual for substance use disorder treatment. Participants assigned to treatment as usual with concurrent smoking-cessation treatment received weekly individual smoking cessation counseling and extended-release bupropion (300 mg/d) during weeks 1-10. During post-quit treatment (weeks 4-10), participants assigned to treatment as usual with smoking-cessation treatment received a nicotine inhaler and contingency management for smoking abstinence. Weekly proportion of stimulant-abstinent participants during the treatment phase, as assessed by urine drug screens and self-report, was the primary outcome. Secondary measures included other substance/nicotine use outcomes and treatment attendance. There were no significant treatment effects on stimulant-use outcomes, as measured by the primary outcome and stimulant-free days, on drug-abstinence, or on attendance. Participants assigned to treatment as usual with smoking-cessation treatment, relative to those assigned to treatment as usual, had significantly better outcomes for drug-free days at 6-month follow-up (χ(2)(1) = 4.09, P <.05), with a decrease in drug-free days from baseline of -1.3% in treatment as usual with smoking-cessation treatment and of -7.6% in treatment as usual. Participants receiving treatment as usual with smoking-cessation treatment, relative to those receiving treatment as usual, had significantly better outcomes on smoking point

  16. HIV Risk Behaviors among Rural Stimulant Users: Variation by Gender and Race/Ethnicity

    ERIC Educational Resources Information Center

    Wright, Patricia B.; Stewart, Katharine E.; Fischer, Ellen P.; Carlson, Robert G.; Falck, Russel; Wang, Jichuan; Leukefeld, Carl G.; Booth, Brenda M.

    2007-01-01

    We examined data from a community sample of rural stimulant users (n = 691) in three diverse states to identify gender and racial/ethnic differences in HIV risk behaviors. Bivariate and logistic regression analyses were conducted with six risk behaviors as dependent variables: injecting drugs, trading sex to obtain money or drugs, trading money or…

  17. Attentional bias to negative affect moderates negative affect's relationship with smoking abstinence.

    PubMed

    Etcheverry, Paul E; Waters, Andrew J; Lam, Cho; Correa-Fernandez, Virmarie; Vidrine, Jennifer Irvin; Cinciripini, Paul M; Wetter, David W

    2016-08-01

    To examine whether initial orienting (IO) and inability to disengage (ITD) attention from negative affective stimuli moderate the association of negative affect with smoking abstinence during a quit attempt. Data were from a longitudinal cohort study of smoking cessation (N = 424). A negative affect modified Stroop task was administered 1 week before and on quit day to measure IO and ITD. Ecological Momentary Assessments were used to create negative affect intercepts and linear slopes for the week before quitting and on quit day. Quit day and long-term abstinence measures were collected. Continuation ratio logit model analyses found significant interactions for prequit negative affect slope with prequit ITD, odds ratio (OR) = 0.738 (0.57, 0.96), p = .02, and for quit day negative affect intercept with quit day ITD, OR = 0.62 (0.41, 950), p = .03, predicting abstinence. The Prequit Negative Affect Intercept × Prequit IO interaction predicting quit day abstinence was significant, OR = 1.42 (1.06, 1.90), p = .02, as was the Quit Day Negative Affect Slope × Quit Day IO interaction predicting long-term abstinence, OR = 1.45 (1.02, 2.08), p = .04. The hypothesis that the association of negative affect with smoking abstinence would be moderated by ITD was generally supported. Among individuals with high ITD, negative affect was inversely related to abstinence, but unrelated to abstinence among individuals with lower levels of ITD. Unexpectedly, among individuals with low IO, negative affect was inversely related to abstinence, but unrelated to abstinence among individuals with higher levels of ITD. (PsycINFO Database Record (c) 2016 APA, all rights reserved).

  18. Revisiting The Relationship between The Ejaculatory Abstinence Period and Semen Characteristics

    PubMed Central

    Ayad, Bashir M; Van der Horst, Gerhard; S Du Plessis, Stefan

    2018-01-01

    Variation in the ejaculatory abstinence period suggested by different guidance bodies have resulted in a growing concern among researchers and clinicians over what the precise period of ejaculatory abstinence ought to be for an optimal semen sample. Several studies have thus been undertaken to examine the association between the length of sexual abstinence and semen characteristics. Not all studies, however, have arrived at the same conclusions. This study aims to review all existing literature published during the past few decades pertaining to the influence of ejaculatory abstinence on semen quality. For the purpose of this systematic review, all data related to sexual abstinence duration and seminal parameters were re-analysed to homogenize the current data. Thorough PubMed, MEDLINE and Google Scholar, a literature search was conducted using the keywords “sexual abstinence”, “ejaculatory abstinence”, “semen”, “spermatozoa”, “semen analysis”, “sperm parameters”, “motility”, “reactive oxygen species (ROS)” and “DNA fragmentation”. After carefully reviewing all the literature, 30 relevant papers, both written in English and published between January 1979 and December 2016, were included in this review. The weight of the evidence suggests that the decline in semen volume and sperm concentration with shorter abstinence periods is accompanied by a substantial improvement in sperm motility characteristics, especially progressive motility and velocity. Nevertheless, available data are insufficient to support definitive conclusions regarding the influence of the ejaculatory abstinence period on advanced semen parameters (ROS, DNA fragmentation and seminal plasma antioxidant capacity) and pregnancy rates. In conclusion, taking all data into account, shortening of the abstinence period may be beneficial to sperm quality. Furthermore, we recommend that the current guidelines regarding the prescribed abstinence period should be revisited

  19. Factors Affecting Long-Term Abstinence from Substances Use

    ERIC Educational Resources Information Center

    Elsheikh, Salah Elgaily

    2008-01-01

    Objective: The purpose of this study is to explore the attitudes of abstainers from drug use that relate to the factors leading to long-term abstinence. Materials and Methods: Cross-sectional study was carried out in Al-Amal Hospital to examine, which attitudes of abstainers related to long-term abstinence. A random survey was conducted on 62…

  20. Defining Sex and Abstinence: Dialogue Is the Key

    ERIC Educational Resources Information Center

    Hamill, Shelley D.; Chepko, Stevie

    2005-01-01

    When does abstinence end and sexual activity begin? In previous generations, the continuum of sexual activity was well-defined in the old baseball analogy. Teens, parents, and teachers knew what going to first, second, or third base involved. For the current generation of young people, sex and abstinence are not so well-defined. As parents and…

  1. MDMA, serotonergic neurotoxicity, and the diverse functional deficits of recreational 'Ecstasy' users.

    PubMed

    Parrott, Andrew C

    2013-09-01

    Serotonergic neurotoxicity following MDMA is well-established in laboratory animals, and neuroimaging studies have found lower serotonin transporter (SERT) binding in abstinent Ecstasy/MDMA users. Serotonin is a modulator for many different psychobiological functions, and this review will summarize the evidence for equivalent functional deficits in recreational users. Declarative memory, prospective memory, and higher cognitive skills are often impaired. Neurocognitive deficits are associated with reduced SERT in the hippocampus, parietal cortex, and prefrontal cortex. EEG and ERP studies have shown localised reductions in brain activity during neurocognitive performance. Deficits in sleep, mood, vision, pain, psychomotor skill, tremor, neurohormonal activity, and psychiatric status, have also been demonstrated. The children of mothers who take Ecstasy/MDMA during pregnancy have developmental problems. These psychobiological deficits are wide-ranging, and occur in functions known to be modulated by serotonin. They are often related to lifetime dosage, with light users showing slight changes, and heavy users displaying more pronounced problems. In summary, abstinent Ecstasy/MDMA users can show deficits in a wide range of biobehavioral functions with a serotonergic component. Copyright © 2013 Elsevier Ltd. All rights reserved.

  2. Understanding the prevalence of lifetime abstinence from alcohol: An ecological study.

    PubMed

    Probst, Charlotte; Manthey, Jakob; Rehm, Jürgen

    2017-09-01

    The level of alcohol consumption and related burden in a country are strongly impacted by the prevalence of abstinence from alcohol use. The objective of this study was to characterize the association of lifetime abstinence from alcohol use with economic wealth (as measured in the gross domestic product [GDP]) and Muslim religion on a country level. An ecological study was performed using aggregate data of 183 countries for the year 2010. Lifetime abstinence among men and women was predicted using fractional response regression models with the natural logarithm of GDP-PPP (purchasing power parity) and the proportion of Muslim population as predictors. The models were further adjusted by the country's median age and World Health Organization region. Precision of prediction was investigated. Descriptive analyses showed a strong negative association between GDP-PPP and lifetime abstinence in countries without a Muslim majority and a GDP-PPP up to 20,000 international dollars. Regression models confirmed the negative association with GDP-PPP and showed a strong positive association between lifetime abstinence and the proportion of Muslim population. Stratified sensitivity analyses showed that in countries without a Muslim majority only GDP-PPP showed a statistically significant association whereas in Muslim majority countries only the proportion of Muslims was associated with the prevalence of lifetime abstinence. Particularly in countries with a lower GDP and without Muslim majority the prevalence of lifetime abstinence from alcohol use is strongly negatively associated with GDP-PPP. Future research should analyze the accordance in trends of GDP and lifetime abstinence over time. Copyright © 2017 Elsevier B.V. All rights reserved.

  3. Anxiety, depression and tobacco abstinence.

    PubMed

    Almadana Pacheco, Virginia; Gómez-Bastero Fernández, Ana Paulina; Valido Morales, Agustín; Luque Crespo, Estefanía; Monserrat, Soledad; Montemayor Rubio, Teodoro

    2017-09-29

    There is evidence of the relationship between mental illness and smoking and increased risk of depressive episodes after quitting smoking, even with specific treatments for abstinence. To assess the influence of a cessation program on the emotional state of patients by measuring levels of anxiety / depression and differences depending on the presence of psychiatric history. A prospective observational study of patients taking part in a combined program (pharmacological and cognitive-behavioral) for giving up smoking. Anxiety (A) and depression (D) were measured using the HADS questionnaire at baseline, first and third month of abstinence. Anxiety and depression showed significant and progressive improvement during treatment (A: baseline 9.2 ± 4.5, 5.9 ± 3.6 1 month, 3 months 4.5 ± 3.1, p.

  4. Tobacco withdrawal symptoms mediate motivation to reinstate smoking during abstinence.

    PubMed

    Aguirre, Claudia G; Madrid, Jillian; Leventhal, Adam M

    2015-08-01

    Withdrawal-based theories of addiction hypothesize that motivation to reinstate drug use following acute abstinence is mediated by withdrawal symptoms. Experimental tests of this hypothesis in the tobacco literature are scant and may be subject to methodological limitations. This study utilized a robust within-subject laboratory experimental design to investigate the extent to which composite tobacco withdrawal symptomatology level and 3 unique withdrawal components (i.e., low positive affect, negative affect, and urge to smoke) mediated the effect of smoking abstinence on motivation to reinstate smoking. Smokers (≥10 cigarettes per day; N = 286) attended 2 counterbalanced sessions at which abstinence duration was differentially manipulated (1 hr vs. 17 hr). At both sessions, participants reported current withdrawal symptoms and subsequently completed a task in which they were monetarily rewarded proportional to the length of time they delayed initiating smoking, with shorter latency reflecting stronger motivation to reinstate smoking. Abstinence reduced latency to smoking initiation and positive affect and increased composite withdrawal symptom level, urge, and negative affect. Abstinence-induced reductions in latency to initiating smoking were mediated by each withdrawal component, with stronger effects operating through urge. Combined analyses suggested that urge, negative affect, and low positive affect operate through empirically unique mediational pathways. Secondary analyses suggested similar effects on smoking quantity, few differences among specific urge and affect subtypes, and that dependence amplifies some abstinence effects. This study provides the first experimental evidence that within-person variation in abstinence impacts motivation to reinstate drug use through withdrawal. Urge, negative affect, and low positive affect may reflect unique withdrawal-mediated mechanisms underlying tobacco addiction. (c) 2015 APA, all rights reserved).

  5. Attentional Bias to Negative Affect Moderates Negative Affect’s Relationship with Smoking Abstinence

    PubMed Central

    Etcheverry, Paul E.; Waters, Andrew J.; Lam, Cho; Correa-Fernandez, Virmarie; Vidrine, Jennifer Irvin; Cinciripini, Paul M.; Wetter, David W.

    2016-01-01

    Objective To examine whether initial orienting (IO) and inability to disengage attention (ITD) from negative affective stimuli moderate the association of negative affect with smoking abstinence during a quit attempt. Methods Data were from a longitudinal cohort study of smoking cessation (N=424). A negative affect modified Stroop was administered one week before and on quit day to measure IO and ITD. Ecological Momentary Assessments were used to create negative affect intercepts and linear slopes for the week before quitting and on quit day. Quit day and long-term abstinence measures were collected. Results Continuation ratio (CR) logit model analyses found significant interactions of pre-quit negative affect slope with pre-quit ITD [OR = .738(.57, .96), p= .02] and quit day negative affect intercept with quit day ITD [OR = .62(.41, 950), p= .03] predicting abstinence. The interaction of pre-quit negative affect intercept and pre-quit IO predicting quit day abstinence was significant [OR = 1.42(1.06, 1.90), p= .02], as was the interaction of quit day negative affect slope and quit day IO predicting long-term abstinence [OR = 1.45(1.02, 2.08), p= .04]. Conclusions The hypothesis that the association of negative affect with smoking abstinence would be moderated by ITD was generally supported. Among individuals with high ITD, negative affect was inversely related to abstinence, but unrelated to abstinence among individuals with lower levels of ITD. Unexpectedly, among individuals with low IO negative affect was inversely related to abstinence, but unrelated to abstinence among individuals with higher levels of ITD. PMID:27505211

  6. Elevated plasma prolactin in abstinent methamphetamine-dependent subjects.

    PubMed

    Zorick, Todd; Mandelkern, Mark A; Lee, Buyean; Wong, Ma-Li; Miotto, Karen; Shabazian, Jon; London, Edythe D

    2011-01-01

    Methamphetamine (MA) use disorders are pervasive global social problems that produce large medical and public health burdens. Abnormalities in pituitary hormonal regulation have been observed in preclinical models of substance abuse and in human substance abusers. They have, however, not been studied before in MA-dependent human subjects. To determine if MA-dependent research volunteers differ from healthy control subjects in plasma levels of adrenocorticotropic hormone (ACTH), cortisol, or prolactin, or in pituitary dopamine D(2) receptor availability during early abstinence from MA. MA-dependent subjects (N = 31), who were not seeking treatment, resided on an inpatient ward for up to 5 weeks. Abstinence was confirmed by daily urine drug screening. Venous blood was sampled for plasma hormone levels, and positron emission tomography with [(18)F]fallypride was performed to determine dopamine D(2) receptor availability during the first week of abstinence. Venous blood was sampled again for hormone levels during the fourth week of abstinence. Matched healthy volunteers (N = 23) participated as a comparison group. MA-dependent and healthy comparison subjects did not differ in plasma ACTH or cortisol levels, but had an elevated plasma prolactin at both the first week and fourth week of abstinence. There was no group difference in pituitary dopamine D(2) receptor availability. MA-dependent individuals have abnormalities in prolactin regulation, which is not likely due to alterations in pituitary dopamine D(2) receptor availability. MA dependence is associated with elevated prolactin levels, which may contribute to medical comorbidity in afflicted individuals.

  7. Glutamatergic neurometabolites during early abstinence from chronic methamphetamine abuse.

    PubMed

    O'Neill, Joseph; Tobias, Marc C; Hudkins, Matthew; London, Edythe D

    2014-10-31

    The acute phase of abstinence from methamphetamine abuse is critical for rehabilitation success. Proton magnetic resonance spectroscopy has detected below-normal levels of glutamate+glutamine in anterior middle cingulate of chronic methamphetamine abusers during early abstinence, attributed to abstinence-induced downregulation of the glutamatergic systems in the brain. This study further explored this phenomenon. We measured glutamate+glutamine in additional cortical regions (midline posterior cingulate, midline precuneus, and bilateral inferior frontal cortex) putatively affected by methamphetamine. We examined the relationship between glutamate+glutamine in each region with duration of methamphetamine abuse as well as the depressive symptoms of early abstinence. Magnetic resonance spectroscopic imaging was acquired at 1.5 T from a methamphetamine group of 44 adults who had chronically abused methamphetamine and a control group of 23 age-, sex-, and tobacco smoking-matched healthy volunteers. Participants in the methamphetamine group were studied as inpatients during the first week of abstinence from the drug and were not receiving treatment. In the methamphetamine group, small but significant (5-15%, P<.05) decrements (vs control) in glutamate+glutamine were observed in posterior cingulate, precuneus, and right inferior frontal cortex; glutamate+glutamine in posterior cingulate was negatively correlated (P<.05) with years of methamphetamine abuse. The Beck Depression Inventory score was negatively correlated (P<.005) with glutamate+glutamine in right inferior frontal cortex. Our findings support the idea that glutamatergic metabolism is downregulated in early abstinence in multiple cortical regions. The extent of downregulation may vary with length of abuse and may be associated with severity of depressive symptoms emergent in early recovery. © The Author 2015. Published by Oxford University Press on behalf of CINP.

  8. Increased cortisol levels in hair of recent Ecstasy/MDMA users.

    PubMed

    Parrott, A C; Sands, H R; Jones, L; Clow, A; Evans, P; Downey, L A; Stalder, T

    2014-03-01

    Previous research has revealed an acute 8-fold increase in salivary cortisol following self-administrated Ecstasy/MDMA in dance clubbers. It is currently not known to what extent repeated usage impacts upon activity of the hypothalamic-pituitary-adrenal axis over a more prolonged period of time. This study investigated the integrated cortisol levels in 3-month hair samples from recent Ecstasy/MDMA users and non-user controls. One hundred and one unpaid participants (53 males, 48 females; mean age 21.75 years) completed the University of East London recreational drug use questionnaire, modified to cover the past 3-months of usage. They comprised 32 light recent Ecstasy/MDMA users (1-4 times in last 3 months), 23 recent heavy MDMA users (+5 times in last 3 months), and 54 non-user controls. Volunteers provided 3 cm hair samples for cortisol analysis. Hair cortisol levels were observed to be significantly higher in recent heavy MDMA users (mean = 55.0 ± 80.1 pg/mg), compared to recent light MDMA users (19.4 ± 16.0 pg/mg; p=0.015), and to non-users (13.8 ± 6.1 pg/mg; p<0.001). Hence the regular use of Ecstasy/MDMA was associated with almost 4-fold raised hair cortisol levels, in comparison with non-user controls. The present results are consistent with the bio-energetic stress model for Ecstasy/MDMA, which predicts that repeated stimulant drug use may increase cortisol production acutely, and result in greater deposits of the hormone in hair. These data may also help explain the neurocognitive, psychiatric, and other psychobiological problems of some abstinent users. Future study design and directions for research concerning the psychoneuroendocrinological impact of MDMA are also discussed. © 2013 Published by Elsevier B.V. and ECNP.

  9. Psychosocial interventions to reduce alcohol consumption in concurrent problem alcohol and illicit drug users.

    PubMed

    Klimas, Jan; Tobin, Helen; Field, Catherine-Anne; O'Gorman, Clodagh S M; Glynn, Liam G; Keenan, Eamon; Saunders, Jean; Bury, Gerard; Dunne, Colum; Cullen, Walter

    2014-12-03

    Problem alcohol use is common among illicit drug users and is associated with adverse health outcomes. It is also an important factor contributing to a poor prognosis among drug users with hepatitis C virus (HCV) as it impacts on progression to hepatic cirrhosis or opiate overdose in opioid users. To assess the effects of psychosocial interventions for problem alcohol use in illicit drug users (principally problem drug users of opiates and stimulants). We searched the Cochrane Drugs and Alcohol Group trials register (June 2014), the Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library, Issue 11, June 2014), MEDLINE (1966 to June 2014); EMBASE (1974 to June 2014); CINAHL (1982 to June 2014); PsycINFO (1872 to June 2014) and the reference lists of eligible articles. We also searched: 1) conference proceedings (online archives only) of the Society for the Study of Addiction, International Harm Reduction Association, International Conference on Alcohol Harm Reduction and American Association for the Treatment of Opioid Dependence; 2) online registers of clinical trials: Current Controlled Trials, Clinical Trials.org, Center Watch and the World Health Organization International Clinical Trials Registry Platform. Randomised controlled trials comparing psychosocial interventions with another therapy (other psychosocial treatment, including non-pharmacological therapies, or placebo) in adult (over the age of 18 years) illicit drug users with concurrent problem alcohol use. We used the standard methodological procedures expected by The Cochrane Collaboration. Four studies, involving 594 participants, were included. Half of the trials were rated as having a high or unclear risk of bias. The studies considered six different psychosocial interventions grouped into four comparisons: (1) cognitive-behavioural coping skills training versus 12-step facilitation (one study; 41 participants), (2) brief intervention versus treatment as usual (one study; 110

  10. Hold the Sex, Please: The Discursive Politics between National and Local Abstinence Education Providers

    ERIC Educational Resources Information Center

    Hess, Amie

    2010-01-01

    There are many assumptions made about the beliefs behind abstinence-only until marriage (AOUM) sex education, yet comparatively little research examining the views of abstinence education providers. Drawing on in-depth interviews with 21 abstinence grantees throughout New York State, I examine how individuals working in abstinence organizations…

  11. Comorbidity effects on cocaine dependence treatment and examination of reciprocal relationships between abstinence and depression.

    PubMed

    Milby, Jesse B; Conti, Kimberly; Wallace, Dennis; Mennemeyer, Stephen; Mrug, Sylvie; Schumacher, Joseph E

    2015-02-01

    We examined comorbid disorders' prevalence, their impact on abstinence, and the impact of depressive symptoms on abstinence and of abstinence on depressive symptoms. A randomized controlled trial's data on outcomes from treating cocaine dependence were used. It compared abstinence-contingent housing and work to contingency management plus behavioral day treatment. Regardless of original trial arm assignment, groups of participants with no additional Axis I disorders (n = 87) and 1 or more additional Axis I disorders (n = 113) were compared for abstinence. Changes in depression symptoms, measured by the Beck Depression Inventory, were analyzed as a function of 4 cohorts of increased consecutive weeks abstinent. An autoregressive cross-lagged path model examined reciprocal relationships between depression and abstinence. Most prevalent additional disorders were depressive disorders, followed by anxiety disorders. Additional disorders did not significantly affect abstinence. Cohorts with more abstinence were linearly related to lower depression symptoms. The cross-lagged model showed that longer abstinence predicted decreases in depressive symptoms at 6 months. However, depressive symptoms did not predict changes in abstinence. Our study adds to others that have found an effective treatment targeted at specific problems such as substance abuse, social anxiety disorder, and posttraumatic stress disorder that may have the side benefit of reducing depression. Additionally, we find that depression does not interfere with effective substance abuse treatment for cocaine dependency. This may be the 1st formal analysis comparing the ability of cocaine abstinence to predict future depressive symptoms versus depressive symptoms to predict future cocaine abstinence. (PsycINFO Database Record (c) 2015 APA, all rights reserved).

  12. Should We Be Teaching Sex Education or Sexual Abstinence?

    ERIC Educational Resources Information Center

    Stover, Del

    2007-01-01

    In this article, the author examines the controversial issue whether to teach sex education or sexual abstinence. Sex education has always been fraught with controversy. The discord in Westbrook, Maine, school district is noteworthy because of the vocal support for an abstinence-only curriculum approach to sex education that has reshaped the…

  13. Effects of length of abstinence on decision-making and craving in methamphetamine abusers.

    PubMed

    Wang, Guibin; Shi, Jie; Chen, Na; Xu, Lingzhi; Li, Jiali; Li, Peng; Sun, Yan; Lu, Lin

    2013-01-01

    The majority of drug abusers are incapable of sustaining abstinence over any length of time. Accumulating evidence has linked intense and involuntary craving, Impulsive decision-making and mood disturbances to risk for relapse. However, little is known about temporal changes of these neuropsychological functions in methamphetamine (METH)-dependent individuals. To investigate the effect of length of abstinence on decision-making, craving (baseline and cue-induced), and emotional state in METH-addicted individuals. In this cross-sectional study, 183 adult METH-dependent patients at an addiction rehabilitation center who were abstinent for 6 days (n = 37), 14 days (n = 33), 1 month (n = 31), 3 months (n = 30), 6 months (n = 26), or 1 year (n = 30) and 39 healthy subjects were administered the Iowa Gambling Task (IGT) to assess decision-making performance. Depression, anxiety, and impulsivity were also examined. One hundred thirty-nine METH abusers who were abstinent for the aforementioned times then underwent a cue session, and subjective and physiological measures were assessed. METH dependent individuals who were abstinent for longer periods of time exhibited better decision-making than those who were abstinent for shorter periods of time. And self-reported emotional symptoms improved with abstinence. METH abusers' ratings of craving decreased with the duration of abstinence, while cue-induced craving increased until 3 months of abstinence and decreased at 6 months and 1 year of abstinence. We present time-dependent alterations in decision-making, emotional state, and the incubation of cue-induced craving in METH-dependent individuals, which might have significant clinical implications for the prevention of relapse.

  14. Neurotoxicity of drugs of abuse - the case of methylenedioxy amphetamines (MDMA, ecstasy ), and amphetamines

    PubMed Central

    Gouzoulis-Mayfrank, Euphrosyne; Daumann, Joerg

    2009-01-01

    Ecstasy (MDMA, 3,4-methylendioxymethamphetamine) and the stimulants methamphetamine (METH, speed) and amphetamine are popular drugs among young people, particularly in the dance scene. When given in high doses both MDMA and the stimulant amphetamines are clearly neurotoxic in laboratory animals. MDMA causes selective and persistent lesions of central serotonergic nerve terminals, whereas amphetamines damage both the serotonergic and dopaminergic systems. In recent years, the question of ecstasy-induced neurotoxicity and possible functional sequelae has been addressed in several studies in drug users. Despite large methodological problems, the bulk of evidence suggests residual alterations of serotonergic transmission in MDMA users, although at least partial recovery may occur after long-term abstinence. However, functional sequelae may persist even after longer periods of abstinence. To date, the most consistent findings associate subtle cognitive impairments with ecstasy use, particularly with memory. In contrast, studies on possible long-term neurotoxic effects of stimulant use have been relatively scarce. Preliminary evidence suggests that alterations of the dopaminergic system may persist even after years of abstinence from METH, and may be associated with deficits in motor and cognitive performance. In this paper, we will review the literature focusing on human studies. PMID:19877498

  15. Neurotoxicity of drugs of abuse--the case of methylenedioxyamphetamines (MDMA, ecstasy), and amphetamines.

    PubMed

    Gouzoulis-Mayfrank, Euphrosyne; Daumann, Joerg

    2009-01-01

    Ecstasy (MDMA, 3,4-methylendioxymethamphetamine) and the stimulants methamphetamine (METH, speed) and amphetamine are popular drugs among young people, particularly in the dance scene. When given in high doses both MDMA and the stimulant amphetamines are clearly neurotoxic in laboratory animals. MDMA causes selective and persistent lesions of central serotonergic nerve terminals, whereas amphetamines damage both the serotonergic and dopaminergic systems. In recent years, the question of ecstasy-induced neurotoxicity and possible functional sequelae has been addressed in several studies in drug users. Despite large methodological problems, the bulk of evidence suggests residual alterations of serotonergic transmission in MDMA users, although at least partial recovery may occur after long-term abstinence. However, functional sequelae may persist even after longer periods of abstinence. To date, the most consistent findings associate subtle cognitive impairments with ecstasy use, particularly with memory. In contrast, studies on possible long-term neurotoxic effects of stimulant use have been relatively scarce. Preliminary evidence suggests that alterations of the dopaminergic system may persist even after years of abstinence from METH, and may be associated with deficits in motor and cognitive performance. In this paper, we will review the literature focusing on human studies.

  16. Computer and video game addiction-a comparison between game users and non-game users.

    PubMed

    Weinstein, Aviv Malkiel

    2010-09-01

    Computer game addiction is excessive or compulsive use of computer and video games that may interfere with daily life. It is not clear whether video game playing meets diagnostic criteria for Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV). First objective is to review the literature on computer and video game addiction over the topics of diagnosis, phenomenology, epidemiology, and treatment. Second objective is to describe a brain imaging study measuring dopamine release during computer game playing. Article search of 15 published articles between 2000 and 2009 in Medline and PubMed on computer and video game addiction. Nine abstinent "ecstasy" users and 8 control subjects were scanned at baseline and after performing on a motorbike riding computer game while imaging dopamine release in vivo with [123I] IBZM and single photon emission computed tomography (SPECT). Psycho-physiological mechanisms underlying computer game addiction are mainly stress coping mechanisms, emotional reactions, sensitization, and reward. Computer game playing may lead to long-term changes in the reward circuitry that resemble the effects of substance dependence. The brain imaging study showed that healthy control subjects had reduced dopamine D2 receptor occupancy of 10.5% in the caudate after playing a motorbike riding computer game compared with baseline levels of binding consistent with increased release and binding to its receptors. Ex-chronic "ecstasy" users showed no change in levels of dopamine D2 receptor occupancy after playing this game. This evidence supports the notion that psycho-stimulant users have decreased sensitivity to natural reward. Computer game addicts or gamblers may show reduced dopamine response to stimuli associated with their addiction presumably due to sensitization.

  17. Cost-effectiveness of prize-based incentives for stimulant abusers in outpatient psychosocial treatment programs.

    PubMed

    Olmstead, Todd A; Sindelar, Jody L; Petry, Nancy M

    2007-03-16

    To evaluate the cost-effectiveness of a prize-based intervention as an addition to usual care for stimulant abusers. This cost-effectiveness analysis is based on a randomized clinical trial implemented within the National Drug Abuse Treatment Clinical Trials Network. The trial was conducted at eight community-based outpatient psychosocial drug abuse treatment clinics. Four hundred and fifteen stimulant abusers were assigned to usual care (N=206) or usual care plus abstinence-based incentives (N=209) for 12 weeks. Participants randomized to the incentive condition earned the chance to draw for prizes for submitting substance negative samples; the number of draws earned increased with continuous abstinence time. Incremental cost-effectiveness ratios were estimated to compare prize-based incentives relative to usual care. The primary patient outcome was longest duration of confirmed stimulant abstinence (LDA). Unit costs were obtained via surveys administered at the eight participating clinics. Resource utilizations and patient outcomes were obtained from the clinical trial. Acceptability curves are presented to illustrate the uncertainty due to the sample and to provide policy relevant information. The incremental cost to lengthen the LDA by 1 week was 258 US dollars (95% confidence interval, 191-401 US dollars). Sensitivity analyses on several key parameters show that this value ranges from 163 to 269 US dollars. Compared with the usual care group, the incentive group had significantly longer LDAs and significantly higher costs.

  18. Smoking topography and abstinence in adult female smokers

    PubMed Central

    McClure, Erin A.; Saladin, Michael E.; Baker, Nathaniel L.; Carpenter, Matthew J.; Gray, Kevin M.

    2013-01-01

    Preliminary evidence, within both adults and adolescents, suggests that the intensity with which cigarettes are smoked (i.e. smoking topography) is predictive of success during a cessation attempt. These reports have also shown topography to be superior compared to other variables, such as cigarettes per day, in the prediction of abstinence. The possibility that gender may influence this predictive relationship has not been evaluated, but may be clinically useful in tailoring gender-specific interventions. Within the context of a clinical trial for smoking cessation among women, adult daily smokers completed a laboratory session that included a 1-hour ad-libitum smoking period in which measures of topography were collected (N=135). Participants were then randomized to active medication (nicotine patch vs. varenicline) and abstinence was monitored for 4 weeks. Among all smoking topography measures and all abstinence outcomes, a moderate association was found between longer puff duration and greater puff volume and continued smoking during the active 4-week treatment phase, but only within the nicotine patch group. Based on the weak topography-abstinence relationship among female smokers found in the current study, future studies should focus on explicit gender comparisons to examine if these associations are specific to or more robust in male smokers. PMID:24018226

  19. Smoking topography and abstinence in adult female smokers.

    PubMed

    McClure, Erin A; Saladin, Michael E; Baker, Nathaniel L; Carpenter, Matthew J; Gray, Kevin M

    2013-12-01

    Preliminary evidence, within both adults and adolescents, suggests that the intensity with which cigarettes are smoked (i.e., smoking topography) is predictive of success during a cessation attempt. These reports have also shown topography to be superior compared to other variables, such as cigarettes per day, in the prediction of abstinence. The possibility that gender may influence this predictive relationship has not been evaluated but may be clinically useful in tailoring gender-specific interventions. Within the context of a clinical trial for smoking cessation among women, adult daily smokers completed a laboratory session that included a 1-hour ad libitum smoking period in which measures of topography were collected (N=135). Participants were then randomized to active medication (nicotine patch vs. varenicline) and abstinence was monitored for 4weeks. Among all smoking topography measures and all abstinence outcomes, a moderate association was found between longer puff duration and greater puff volume and continued smoking during the active 4-week treatment phase, but only within the nicotine patch group. Based on the weak topography-abstinence relationship among female smokers found in the current study, future studies should focus on explicit gender comparisons to examine if these associations are specific to or more robust in male smokers. © 2013 Elsevier Ltd. All rights reserved.

  20. Cannabis and Ecstasy/ MDMA: empirical measures of creativity in recreational users.

    PubMed

    Jones, Katy A; Blagrove, M; Parrott, A C

    2009-12-01

    This study investigated the associations between chronic cannabis and Ecstasy/MDMA use and one objective and two subjective measure of creativity. Fifteen abstinent Ecstasy users, 15 abstinent cannabis users, and 15 nondrug-user controls, completed three measures of creativity: the Consequences behavioral test of creativity, self-assessed performance on the Consequences test, and Gough's Trait Self-Report Creative Adjective Checklist. The Consequences test involved five scenarios where possible consequences had to be devised; scoring was conducted by the standard blind rating (by two independent judges) for "remoteness" and "rarity," and by a frequency and rarity of responses method. Cannabis users had significantly more "rare-creative" responses than controls (Tukey, p < 0.05); this effect remained significant with gender as a covariate. There were no significant differences between the groups on the number of standard scoring "remote-creative" ideas or for fluency of responses. On self-rated creativity, there was a significant ANOVA group difference (p < 0.05), with Ecstasy users tending to rate their answers as more creative than controls (Tukey comparison; p = 0.058, two-tailed). Ecstasy users did not differ from controls on the behavioral measures of creativity, although there was a borderline trend for self-assessment of greater creativity. Cannabis users produced significantly more "rare-creative" responses, but did not rate themselves as more creative.

  1. [Personality pathological traits and brain metabolites as predictors of non-abstinence in addicts with personality disorders].

    PubMed

    Serrani Azcurra, Daniel

    2013-01-01

    Differences in pathological personality traits and disturbances in brain metabolites between non consumers, abstinent and non abstinent consumers were assessed. Participants (n=113) aged between 18-45 years with personality disorder (PD) were diagnosed with clinical interview and scales for depression, anxiety, impulsivity and dimensions of personality pathology. Brain metabolites were analyzed with magnetic resonance spectroscopy. Data were analyzed with ANOVA and multiple comparisons. Abstinent and non-abstinent differentiated from non-consumers in emotional deregulation, inhibition, and restricted expression; abstinent and non-abstinent differentiated from each other in self-aggression, dissocial behaviour, conduct disorder, stimulus seeking and intimacy problems. N-Acetyl Aspartate and creatine values were lower between non-abstinent in prefrontal, anterior cingulate cortex, cerebellar vermis and superior corona radiata. For abstinent, choline levels were greater in cerebellar vermis and n-acetyl aspartate were lower in dorso-lateral prefrontal and anterior cingulated cortex and insula. Regarding personality traits, insecure attachment, narcissism, lability, self-aggression and anxiety characterize consumers and abstinent, while suspiciousness, rejection and character hardness are found in consumers (non-abstinent and abstinent). Compulsive traits, unplanned body impulsiveness and lack of control in emotional regulation predominated in non-abstinent and participants with co-morbidities. Detachment and inhibition predominate in alcohol abuse disorder and narcissistic traits in substance abuse.

  2. Paths to tobacco abstinence: A repeated-measures latent class analysis.

    PubMed

    McCarthy, Danielle E; Ebssa, Lemma; Witkiewitz, Katie; Shiffman, Saul

    2015-08-01

    Knowledge of smoking change processes may be enhanced by identifying pathways to stable abstinence. We sought to identify latent classes of smokers based on their day-to-day smoking status in the first weeks of a cessation attempt. We examined treatment effects on class membership and compared classes on baseline individual differences and 6-month abstinence rates. In this secondary analysis of a double-blind randomized placebo-controlled clinical trial (N = 1,433) of 5 smoking cessation pharmacotherapies (nicotine patch, nicotine lozenge, bupropion SR, patch and lozenge, or bupropion SR and lozenge), we conducted repeated-measures latent class analysis of daily smoking status (any smoking vs. none) for the first 27 days of a quit attempt. Treatment and covariate relations with latent class membership were examined. Distal outcome analysis compared confirmed 6-month abstinence rates among the latent classes. A 5-class solution was selected. Three-quarters of smokers were in stable smoking or abstinent classes, but 25% were in classes with unstable abstinence probabilities over time. Active treatment (compared to placebo), and particularly the patch and lozenge combination, promoted early quitting. Latent classes differed in 6-month abstinence rates and on several baseline variables, including nicotine dependence, quitting history, self-efficacy, sleep disturbance, and minority status. Repeated-measures latent class analysis identified latent classes of smoking change patterns affected by treatment, related to known risk factors, and predictive of distal outcomes. Tracking behavior early in a change attempt may identify prognostic patterns of change and facilitate adaptive treatment planning. (c) 2015 APA, all rights reserved).

  3. Feeling Abstinent? Feeling Comprehensive? Touching the Affects of Sexuality Curricula

    ERIC Educational Resources Information Center

    Lesko, Nancy

    2010-01-01

    This interpretive study draws on interdisciplinary scholarship on affect and knowledge to ask: toward what feelings do abstinence-only and comprehensive sexuality education curricula direct us? A methodology that is attuned to double exposures is discussed, and one abstinence-only sexuality education curriculum and one comprehensive sexuality…

  4. Resting State Synchrony in Long-Term Abstinent Alcoholics

    PubMed Central

    Camchong, Jazmin; Stenger, Andy; Fein, George

    2012-01-01

    BACKGROUND Alcohol dependence (ALC) is a disorder with an impulsive and compulsive “drive” towards alcohol consumption and an inability to inhibit alcohol consumption. Neuroimaging studies suggest that these behavioral components correspond to an increased involvement of regions that mediate appetitive drive and reduced involvement of regions that mediate executive control within top-down networks. Little is known, however, about whether these characteristics are present after long periods of abstinence. METHODS Resting state functional magnetic resonance imaging data were collected to examine resting state synchrony (RSS) differences between 23 long-term abstinent alcoholics (LTAA; 8 females, age: M=48.46, SD=7.10), and 23 non-substance abusing controls (NSAC; 8 females, age: M=47.99, SD=6.70). Using seed-based measures, we examined resting-state synchrony with the nucleus accumbens (NAcc) and the subgenual anterior cingulate cortex (ACC). All participants were assessed with the intra/extradimensional set shift task outside of the scanner to explore the relationship between RSS and cognitive flexibility. RESULTS Compared to NSAC, LTAA showed (a) decreased synchrony of limbic reward regions (e.g., caudate and thalamus) with both the ACC seed and the NAcc seed and (b) increased synchrony of executive control regions (e.g., DLPFC) with both the NAcc seed and the subgenual ACC seed. RSS differences were significantly correlated with task performance. CONCLUSIONS The results are consistent with an interpretation of an ongoing compensatory mechanism in long-term abstinent alcoholics evident during rest, in which decision making networks show reduced synchrony with appetitive drive regions and increased synchrony with inhibitory control regions. In addition, RSS differences were associated with cognitive flexibility. These resting state findings indicate an adaptive mechanism present in long-term abstinence that may facilitate the behavioral control required for to

  5. Predictors of Abstinence Self-Efficacy: Examining the role of HIV-risk Sexual Behavior.

    PubMed

    Majer, John M; Glantsman, Olya; Palmer, John S; Jason, Leonard A

    Abstinence self-efficacy, or the confidence in ones' beliefs in one's ability to effectively engage in behaviors to maintain substance use abstinence, is a crucial recovery resource. However, little research has been conducted on what predicts increases in this recovery resource. Understanding predictors of abstinence self-efficacy could help social service practitioners in creating effective treatment plans/interventions while extending what is presently known in this small body of research. Predictors of abstinence self-efficacy were analyzed among a sample of ex-offenders (224 men and 46 women) who were completing inpatient treatment for substance use disorders. Hierarchical linear regression was conducted to examine changes in participants' abstinence self-efficacy in relation to factors directly related (HIV-risk drug use behaviors, substance use, 12-step meeting attendance) and indirectly related (HIV-risk sexual behaviors, incarceration histories) to substance use. HIV-risk sexual behaviors and substance use predicted significant decreases in abstinence self-efficacy whereas 12-step meeting attendance predicted significant increases. However, incarceration histories and HIV-risk drug use behaviors were not significant predictors of abstinence self-efficacy. Findings suggest HIV-risk sexual behavior should be considered when assessing relapse prevention for persons with substance use disorders, and that researchers should examine behaviors that are not directly related to substance use when investigating recovery resources.

  6. Feasibility study of a take-home array-based functional electrical stimulation system with automated setup for current functional electrical stimulation users with foot-drop.

    PubMed

    Prenton, Sarah; Kenney, Laurence P; Stapleton, Claire; Cooper, Glen; Reeves, Mark L; Heller, Ben W; Sobuh, Mohammad; Barker, Anthony T; Healey, Jamie; Good, Timothy R; Thies, Sibylle B; Howard, David; Williamson, Tracey

    2014-10-01

    To investigate the feasibility of unsupervised community use of an array-based automated setup functional electrical stimulator for current foot-drop functional electrical stimulation (FES) users. Feasibility study. Gait laboratory and community use. Participants (N=7) with diagnosis of unilateral foot-drop of central neurologic origin (>6mo) who were regular users of a foot-drop FES system (>3mo). Array-based automated setup FES system for foot-drop (ShefStim). Logged usage, logged automated setup times for the array-based automated setup FES system and diary recording of problems experienced, all collected in the community environment. Walking speed, ankle angles at initial contact, foot clearance during swing, and the Quebec User Evaluation of Satisfaction with Assistive Technology version 2.0 (QUEST version 2.0) questionnaire, all collected in the gait laboratory. All participants were able to use the array-based automated setup FES system. Total setup time took longer than participants' own FES systems, and automated setup time was longer than in a previous study of a similar system. Some problems were experienced, but overall, participants were as satisfied with this system as their own FES system. The increase in walking speed (N=7) relative to no stimulation was comparable between both systems, and appropriate ankle angles at initial contact (N=7) and foot clearance during swing (n=5) were greater with the array-based automated setup FES system. This study demonstrates that an array-based automated setup FES system for foot-drop can be successfully used unsupervised. Despite setup's taking longer and some problems, users are satisfied with the system and it would appear as effective, if not better, at addressing the foot-drop impairment. Further product development of this unique system, followed by a larger-scale and longer-term study, is required before firm conclusions about its efficacy can be reached. Copyright © 2014 American Congress of

  7. Verbal learning and memory in adolescent cannabis users, alcohol users and non-users.

    PubMed

    Solowij, Nadia; Jones, Katy A; Rozman, Megan E; Davis, Sasha M; Ciarrochi, Joseph; Heaven, Patrick C L; Lubman, Dan I; Yücel, Murat

    2011-07-01

    Long-term heavy cannabis use can result in memory impairment. Adolescent users may be especially vulnerable to the adverse neurocognitive effects of cannabis. In a cross-sectional and prospective neuropsychological study of 181 adolescents aged 16-20 (mean 18.3 years), we compared performance indices from one of the most widely used measures of learning and memory--the Rey Auditory Verbal Learning Test--between cannabis users (n=52; mean 2.4 years of use, 14 days/month, median abstinence 20.3 h), alcohol users (n=67) and non-user controls (n=62) matched for age, education and premorbid intellectual ability (assessed prospectively), and alcohol consumption for cannabis and alcohol users. Cannabis users performed significantly worse than alcohol users and non-users on all performance indices. They recalled significantly fewer words overall (p<0.001), demonstrating impaired learning (p<0.001), retention (p<0.001) and retrieval (p<0.05) (Cohen's d 0.43-0.84). The degree of impairment was associated with the duration, quantity, frequency and age of onset of cannabis use, but was unrelated to alcohol exposure or other drug use. No gender effects were detected and the findings remained after controlling for premorbid intellectual ability. An earlier age of onset of regular cannabis use was associated with worse memory performance after controlling for extent of exposure to cannabis. Despite relatively brief exposure, adolescent cannabis users relative to their age-matched counterparts demonstrated similar memory deficits to those reported in adult long-term heavy users. The results indicate that cannabis adversely affects the developing brain and reinforce concerns regarding the impact of early exposure.

  8. Implementing the Abstinence Education Provision of the Welfare Reform Legislation.

    ERIC Educational Resources Information Center

    Haskins, Ron; Bevan, Carol Statuto

    As part of its 1996 welfare reform bill, the U.S. Congress enacted a $50 million per year program to fund abstinence education. The welfare reform law addresses the problem of births to single adolescents by enforcing child support payments, giving states financial incentives to reduce nonmarital births, and creating the abstinence education…

  9. Evaluation of an Abstinence Based Intervention for Middle School Students

    ERIC Educational Resources Information Center

    Rue, Lisa; Chandran, Raj; Pannu, Aman; Bruce, David; Singh, Rana; Traxler, Karen

    2012-01-01

    Outcomes associated with an abstinence education intervention were evaluated using a single group design with a 12-month longitudinal follow-up. The intervention group of adolescents ages 12-14 years (N = 427) were enrolled in an 11.5-hour abstinence education intervention offered during the school day. Significant differences were found in the…

  10. Effects of methylphenidate during emotional processing in amphetamine users: preliminary findings.

    PubMed

    Bottelier, M A; Schouw, M L J; de Ruiter, M B; Ruhe, H G; Lindauer, R J L; Reneman, L

    2015-12-01

    D-amphetamine (dAMPH) and methylphenidate (MPH) are stimulants used in the treatment of Attention Deficit Hyperactivity Disorder (ADHD). Preclinical studies have shown that in healthy animals, dAMPH induces dopamine (DA) dysfunction, as evidenced for instance by loss of DA levels and its transporters. It has also been suggested that DA plays an important role in emotional processing, and that altered DA-ergic intervention may modulate amygdala function. To explore the role of the DA system in emotional processing we examined emotional processing using functional magnetic resonance imaging (fMRI) in eight male recreational users of dAMPH and eight male healthy controls. We compared brain activation between both groups during an emotional face-processing task with and without an oral MPH challenge. All subjects were abstinent for at least 2 weeks during the baseline scan. The second scan was performed on the same day 1½ hours after receiving an oral dose of 35 mg MPH. A significant Valence*Group interaction (p = .037) indicated amygdala hyperreactivity to fearful facial expressions in dAMPH users that was robust against adjustment for age (p = .015). Furthermore, duration of amphetamine use in years was positively correlated with amygdala reactivity in dAMPH users (r = .76; p = .029). These exploratory findings are in line with previous findings suggesting that DA plays a role in emotional processing.

  11. Abstinence-Only Sex Education Fails African American Youth.

    PubMed

    Breunig, Michelle

    Sexually transmitted infections (STIs) disproportionately affect U.S. African American (AA) youth. In AA faith communities, cultural practices have contributed to increased STI rates because abstinence-only-until-marriage education programs do not teach the use of condoms or birth control for preventing STIs or pregnancy. Comprehensive sex education or abstinence-plus programs have been reported to increase STI knowledge and reduce risk-taking behaviors in adolescents and young adults. Evidence supports computerized education to increase STI knowledge and decrease risky sexual behaviors of AA churchgoing youth.

  12. Posttreatment drug use abstinence: does the majority program clientele matter?

    PubMed

    Duncan, Alexandra; Melnick, Gerald; Ahmed, Rashid; Furr-Holden, C Debra

    2014-01-01

    The current study examines differences in organizational characteristics and client posttreatment drug use abstinence in residential substance abuse treatment programs serving clients with high or low levels of legal coercion to participate in treatment. The findings show that low legal coercion programs have higher counselor caseloads (Z = 59, p < .05) than high coercion programs. Although the results showed that programs with a large proportion of African American clients (β = 14.26, p < .0001) and high legal coercion programs (β = 19.99, p < .05) predicted longer abstinence posttreatment, the final models suggest organizational factors are the key predictors of client posttreatment abstinence.

  13. Incubation of Methamphetamine but not Heroin Craving After Voluntary Abstinence in Male and Female Rats.

    PubMed

    Venniro, Marco; Zhang, Michelle; Shaham, Yavin; Caprioli, Daniele

    2017-04-01

    We recently introduced an animal model of incubation of methamphetamine craving after choice-based voluntary abstinence in male rats. Here we studied the generality of this phenomenon to (1) female rats, and (2) male and female rats with a history of heroin self-administration. We first trained rats to self-administer palatable food pellets for 6 days (6 h per day) for either methamphetamine (0.1 mg/kg/infusion) or heroin (0.1 mg/kg/infusion) for 12 days (6 h/day). We then assessed relapse to drug seeking under extinction conditions after 1 and 21 abstinence days. Between tests, the rats underwent either voluntary abstinence (achieved via a discrete choice procedure between drug and palatable food; 20 trials/day) or home-cage forced abstinence. We found no sex differences in methamphetamine self-administration or in the strong preference for the palatable food over methamphetamine during the choice-based voluntary abstinence. In both sexes, methamphetamine seeking in the relapse tests was higher after 21 days of either voluntary or forced abstinence than after 1 day (incubation of methamphetamine craving). We also found no sex differences in heroin self-administration or the strong preference for the palatable food over heroin during the choice-based voluntary abstinence. However, male and female rats with a history of heroin self-administration showed incubation of heroin craving after forced but not voluntary abstinence. Our results show that incubation of methamphetamine craving after voluntary abstinence generalizes to female rats. Unexpectedly, prolonged voluntary abstinence prevented the emergence of incubation of heroin craving in both sexes.

  14. Smoking abstinence and reinstatement effects in adolescent cigarette smokers.

    PubMed

    Colby, Suzanne M; Leventhal, Adam M; Brazil, Linda; Lewis-Esquerre, Johanna; Stein, L A R; Rohsenow, Damaris J; Monti, Peter M; Niaura, Raymond S

    2010-01-01

    The study objectives were to examine smoking abstinence and reinstatement effects on subjective experience and cognitive performance among adolescent smokers. Adolescents (aged 14-17 years, 60 daily smokers and 32 nonsmokers) participated. Participants completed baseline assessments (Session 1) and returned to the laboratory 1-3 days later to repeat assessments (Session 2); half of the smokers were randomly assigned to 15-17 hr tobacco abstinence preceding Session 2. During Session 2, abstaining smokers reported significantly greater increases in withdrawal symptoms, smoking urges, and negative affect compared with smokers who did not abstain and compared with nonsmokers. Smoking reinstatement reversed abstinence effects, returning to baseline levels for smoking urges and negative affect. Abstaining smokers showed significantly enhanced cognitive performance on two of six tasks (two-letter search compared with nonabstaining smokers; serial reaction time compared with nonsmokers); smoking reinstatement resulted in significant decrements on these two tasks relative to nonabstaining smokers. Effects of smoking abstinence and reinstatement on self-report measures are consistent with earlier research with adolescent as well as adult smokers and may help to elucidate the motivational underpinnings of smoking maintenance among adolescent smokers. Effects found on cognitive performance were contrary to hypotheses; further research is needed to understand better the role of cognitive performance effects in smoking maintenance among adolescents.

  15. The abstinence phobias: links between substance abuse and anxiety.

    PubMed

    Hall, S M

    1984-09-01

    This paper presents a new model to explain the observed relationship between anxiety and substance abuse. Specifically, the concept of "abstinence phobias," common across psychoactive substances, is developed. The evidence needed to support this concept is outlined, and relevant data from studies of opiate, alcohol, and tobacco dependences are reviewed. Parallel data obtained from the treatment of obesity are discussed. It is concluded that the abstinence phobia merits further study; clinical implications are also considered.

  16. Resting State Synchrony in Short-Term versus Long-Term Abstinent Alcoholics

    PubMed Central

    Camchong, Jazmin; Stenger, Victor Andrew; Fein, George

    2012-01-01

    BACKGROUND We previously reported that when compared to controls, long-term abstinent alcoholics (LTAA) have increased resting state synchrony (RSS) of the inhibitory control network and reduced synchrony of the appetitive drive network, and hypothesized that these levels of synchrony are adaptive, and support the behavioral changes required to maintain abstinence. In the current study, we investigate whether these RSS patterns can be identified in short-term abstinent alcoholics. METHODS Resting state functional magnetic resonance imaging data were collected from 27 short-term abstinent alcoholics (STAA), 23 LTAA and 23 non-substance abusing controls (NSAC). We examined baseline RSS using seed-based measures. RESULTS We found ordered RSS effects from NSAC to STAA and then to LTAA within both the appetitive drive and executive control networks: increasing RSS of the executive control network, and decreasing RSS of the reward processing network. Finally, we found significant correlations between strength of RSS in these networks and (a) cognitive flexibility and (b) current antisocial behavior. DISCUSSION Findings are consistent with an adaptive progression of RSS from short- to long-term abstinence so that, compared to normal controls, the synchrony (a) within the reward network progressively decreases and (b) within the executive control network progressively increases. PMID:23421812

  17. Financial incentives to promote extended smoking abstinence in opioid-maintained patients: a randomized trial.

    PubMed

    Sigmon, Stacey C; Miller, Mollie E; Meyer, Andrew C; Saulsgiver, Kathryn; Badger, Gary J; Heil, Sarah H; Higgins, Stephen T

    2016-05-01

    Prior studies by our group demonstrated the efficacy of a brief but intensive behavioral intervention for producing initial smoking abstinence among opioid-dependent patients. In the present study, our aim was to promote longer-duration abstinence in this population. Following an initial 2-week incentive intervention for smoking abstinence, we examined whether a 10-week maintenance arm involving continuation of contingent reinforcement will produce greater smoking abstinence than a similar duration of noncontingent reinforcement. Randomized, 12-week, parallel-group study. Out-patient research clinic in Burlington, Vermont, USA. Opioid-maintained smokers (n = 88) who provided breath carbon monoxide and urinary cotinine specimens and received contingent reinforcement for smoking abstinence during weeks 1-2 (phase 1), with 63 randomized on day 14 to an extended contingent (EC; n = 31) or extended noncontingent (EN; n = 32) experimental condition for weeks 3-12 (phase 2). The EC condition consisted of voucher values that escalated across consecutive negative samples until they reached $30, after which they remained at $30 per negative sample. A positive or a missing sample resulted in no vouchers for that day and reset the value of the next negative same to $9. Two consecutive negatives returned the schedule to the pre-reset value. The EN control condition consisted of vouchers delivered for providing scheduled samples, but independent of smoking status. The primary outcome was percentage of biochemically abstinent samples during phase 2. Secondary measures included abstinence status at final study visit, complete abstinence, participants' longest duration of continuous abstinence, cotinine and carbon monoxide (CO) levels and self-reported cigarettes per day. EC participants achieved greater smoking abstinence during phase 2 than EN participants [46.7 versus 23.5% negative samples, respectively; odds ratio (OR) = 2.98, 95% confidence interval (CI) = 1.16-7.65, χ(2

  18. Do 12-step meeting attendance trajectories over 9 years predict abstinence?

    PubMed Central

    Witbrodt, Jane; Mertens, Jennifer; Kaskutas, Lee Ann; Bond, Jason; Chi, Felicia; Weisner, Constance

    2011-01-01

    This study grouped treatment-seeking individuals (n=1825) by common patterns of 12-step attendance using 5 waves of data (75% interviewed year-9) to isolate unique characteristics and use-related outcomes distinguishing each class profile. The high class reported the highest attendance and abstention. The descending class reported high baseline alcohol severity, long treatment episodes, and high initial attendance and abstinence; but by year-5 their attendance and abstinence dropped. The early-drop class, which started with high attendance and abstinence but with low problem severity, reported no attendance after year 1. The rising class, with fairly high alcohol and psychiatric severity throughout, reported initially low attendance, followed by increasing attendance paralleling their abstention. Last, the low and no classes, which reported low problem-severity and very low/no attendance, had the lowest abstention. Female gender and high alcohol severity predicted attendance all years. Consistent with a sustained benefit for 12-step exposure, abstinence patterns aligned much like attendance profiles. PMID:22206631

  19. Health Education Curriculum Content--Abstinence

    ERIC Educational Resources Information Center

    North Dakota Department of Public Instruction, 2011

    2011-01-01

    As a result of House Bill 1229, introduced and passed during the 2011 North Dakota legislative session, every school district, both public and nonpublic, must expand health education to include abstinence education, if teaching sexuality education as part of the general health curriculum. This fact sheet provides guidance for districts in meeting…

  20. Smoking abstinence and reinstatement effects in adolescent cigarette smokers

    PubMed Central

    Leventhal, Adam M.; Brazil, Linda; Lewis-Esquerre, Johanna; Stein, L. A. R.; Rohsenow, Damaris J.; Monti, Peter M.; Niaura, Raymond S.

    2010-01-01

    Introduction The study objectives were to examine smoking abstinence and reinstatement effects on subjective experience and cognitive performance among adolescent smokers. Methods Adolescents (aged 14–17 years, 60 daily smokers and 32 nonsmokers) participated. Participants completed baseline assessments (Session 1) and returned to the laboratory 1–3 days later to repeat assessments (Session 2); half of the smokers were randomly assigned to 15–17 hr tobacco abstinence preceding Session 2. Results During Session 2, abstaining smokers reported significantly greater increases in withdrawal symptoms, smoking urges, and negative affect compared with smokers who did not abstain and compared with nonsmokers. Smoking reinstatement reversed abstinence effects, returning to baseline levels for smoking urges and negative affect. Abstaining smokers showed significantly enhanced cognitive performance on two of six tasks (two-letter search compared with nonabstaining smokers; serial reaction time compared with nonsmokers); smoking reinstatement resulted in significant decrements on these two tasks relative to nonabstaining smokers. Discussion Effects of smoking abstinence and reinstatement on self-report measures are consistent with earlier research with adolescent as well as adult smokers and may help to elucidate the motivational underpinnings of smoking maintenance among adolescent smokers. Effects found on cognitive performance were contrary to hypotheses; further research is needed to understand better the role of cognitive performance effects in smoking maintenance among adolescents. PMID:19933776

  1. Acute withdrawal, protracted abstinence and negative affect in alcoholism: Are they linked?

    PubMed Central

    Heilig, M.; Egli, M.; Crabbe, J.C.; Becker, H.C.

    2012-01-01

    The role of withdrawal-related phenomena in development and maintenance of alcohol addiction remains under debate. A “self-medication” framework postulates that emotional changes are induced by a history of alcohol use, persist into abstinence, and are a major factor in maintaining alcoholism. This view initially focused on negative emotional states during early withdrawal: these are pronounced, occur in the vast majority of alcohol dependent patients, and are characterized by depressed mood and elevated anxiety. This concept lost popularity with the realization that, in most patients, these symptoms abate over 3 – 6 weeks of abstinence, while relapse risk persists long beyond this period. More recently, animal data have established that a prolonged history of alcohol dependence induces more subtle neuroadaptations. These confer altered emotional processing that persists long into protracted abstinence. The resulting behavioral phenotype is characterized by excessive voluntary alcohol intake and increased behavioral sensitivity to stress. Emerging human data support the clinical relevance of negative emotionality for protracted abstinence and relapse. These developments prompt a series of research questions: 1) Are processes observed during acute withdrawal, while transient in nature, mechanistically related to those that remain during protracted abstinence? 2) Is susceptibility to negative emotionality in acute withdrawal in part due to heritable factors, similar to what animal models have indicated for susceptibility to physical aspects of withdrawal? 3) To what extent is susceptibility to negative affect that persists into protracted abstinence heritable? PMID:20148778

  2. Voluntary temporary abstinence from alcohol during "Dry January" and subsequent alcohol use.

    PubMed

    de Visser, Richard O; Robinson, Emily; Bond, Rod

    2016-03-01

    Research suggests that temporary abstinence from alcohol may convey physiological benefits and enhance well-being. The aim of this study was to address a lack of information about: (a) correlates of successful completion of a planned period of abstinence, and (b) how success or failure in planned abstinence affects subsequent alcohol consumption. 857 British adults (249 men, 608 women) participating in the "Dry January" alcohol abstinence challenge completed a baseline questionnaire, a 1-month follow-up questionnaire, and a 6-month follow-up questionnaire. Key variables assessed at baseline included measures of alcohol consumption and drink refusal self-efficacy (DRSE). In bivariate analysis, success during Dry January was predicted by measures of more moderate alcohol consumption and greater social DRSE at baseline. Multivariate analyses revealed that success during Dry January was best predicted by a lower frequency of drunkenness in the month prior to Dry January. Structural equation modeling revealed that participation in Dry January was related to reductions in alcohol consumption and increases in DRSE among all respondents at 6-month follow-up, regardless of success, but indicated that these changes were more likely among people who successfully completed the challenge. The findings suggest that participation in abstinence challenges such as Dry January may be associated with changes toward healthier drinking and greater DRSE, and is unlikely to result in undesirable "rebound effects": very few people reported increased alcohol consumption following a period of voluntary abstinence. (c) 2016 APA, all rights reserved).

  3. Contingency Management Improves Abstinence and Quality of Life in Cocaine Abusers

    ERIC Educational Resources Information Center

    Petry, Nancy M.; Alessi, Sheila M.; Hanson, Tressa

    2007-01-01

    Contingency management (CM) treatments enhance drug abstinence. This study evaluated whether CM also improves quality of life and if these effects are mediated by abstinence. Across 3 independent trials, cocaine abusers in intensive outpatient treatment (n = 387) were randomly assigned to 12 weeks of standard treatment as usual or standard…

  4. Effectiveness of Brief Abstinence for Modifying Problematic Internet Gaming Cognitions and Behaviors.

    PubMed

    King, Daniel L; Kaptsis, Dean; Delfabbro, Paul H; Gradisar, Michael

    2017-12-01

    This pilot study tested the efficacy of a voluntary 84-hour abstinence protocol for modifying problematic Internet gaming cognitions and behaviors METHOD: Twenty-four adults from online gaming communities, including 9 individuals who screened positively for Internet gaming disorder (IGD), abstained from Internet games for 84 hours. Surveys were collected at baseline, at daily intervals during abstinence, and at 7-day and 28-day follow-up RESULTS: Brief voluntary abstinence was successful in reducing hours of gaming, maladaptive gaming cognitions, and IGD symptoms. Abstinence was highly acceptable to participants with total compliance and no study attrition. Clinically significant improvement in IGD symptoms occurred in 75% of the IGD group at 28-day follow-up. Reliable improvement in maladaptive gaming cognitions occurred in 63% of the IGD group, whose cognition score reduced by 50% and was comparable to the non-IGD group at 28-day follow-up CONCLUSIONS: Despite limitations of sample size, this study provides promising support for brief abstinence as a simple, practical, and cost-effective treatment technique for modifying unhelpful gaming cognitions and reducing Internet gaming problems. © 2017 Wiley Periodicals, Inc.

  5. Dance clubbing on MDMA and during abstinence from Ecstasy/MDMA: prospective neuroendocrine and psychobiological changes.

    PubMed

    Parrott, A C; Lock, J; Conner, A C; Kissling, C; Thome, J

    2008-01-01

    The present study is the first to prospectively compare a group of recreational Ecstasy users when dance clubbing on 3,4-methylenedioxymethamphetamine (MDMA) and when clubbing during abstinence from Ecstasy/MDMA. Twelve normal healthy volunteers (mean age = 23.2 years) were assessed at a Saturday night dance club under self-administered MDMA. On the other weekend they went to the same dance club without taking MDMA (order counterbalanced). Both conditions involved 5 test sessions conducted at similar times: pre-drug baseline, 1 h post-drug clubbing, 2.5 h post-drug clubbing, and 2 and 4 days later. The assessments included body and ambient temperature, physical activity (pedometer), as well as self-ratings for mood state, physical activity, thermal comfort and thirst. Saliva samples were analyzed for MDMA, cortisol and testosterone. The cortisol levels increased significantly by 800% when dance clubbing on MDMA, while testosterone increased significantly by 75%; neither neuroendocrine measure was altered during abstinence. Saliva analyses confirmed the presence of MDMA when dancing on Ecstasy and its absence when dancing off Ecstasy. The pedometer values and self-rated levels of dancing were similar at both weekends. Hot and cold flushes and feeling hot increased significantly under MDMA. The mean body temperature did not change significantly, although there was a borderline trend for increased values after MDMA. Feelings of happiness and excitement increased under MDMA, although they were not significantly greater than when clubbing during abstinence. Neurohormonal release may be an important part of the acute MDMA experience. The large cortisol increase provides further data on the bioenergetic stress model of recreational Ecstasy/MDMA. Copyright 2008 S. Karger AG, Basel.

  6. Dance Clubbing on MDMA and during Abstinence from Ecstasy/MDMA: Prospective Neuroendocrine and Psychobiological Changes

    PubMed Central

    Parrott, A.C.; Lock, J.; Conner, A.C.; Kissling, C.; Thome, J.

    2013-01-01

    Background/Aims The present study is the first to prospectively compare a group of recreational Ecstasy users when dance clubbing on 3,4-methylenedioxymethamphetamine (MDMA) and when clubbing during abstinence from Ecstasy/MDMA. Methods Twelve normal healthy volunteers (mean age = 23.2 years) were assessed at a Saturday night dance club under self-administered MDMA. On the other weekend they went to the same dance club without taking MDMA (order counterbalanced). Both conditions involved 5 test sessions conducted at similar times: pre-drug baseline, 1 h post-drug clubbing, 2.5 h post-drug clubbing, and 2 and 4 days later. The assessments included body and ambient temperature, physical activity (pedometer), as well as self-ratings for mood state, physical activity, thermal comfort and thirst. Saliva samples were analyzed for MDMA, cortisol and testosterone. Results The cortisol levels increased significantly by 800% when dance clubbing on MDMA, while testosterone increased significantly by 75%; neither neuroendocrine measure was altered during abstinence. Saliva analyses confirmed the presence of MDMA when dancing on Ecstasy and its absence when dancing off Ecstasy. The pedometer values and self-rated levels of dancing were similar at both weekends. Hot and cold flushes and feeling hot increased significantly under MDMA. The mean body temperature did not change significantly, although there was a borderline trend for increased values after MDMA. Feelings of happiness and excitement increased under MDMA, although they were not significantly greater than when clubbing during abstinence. Conclusions Neurohormonal release may be an important part of the acute MDMA experience. The large cortisol increase provides further data on the bioenergetic stress model of recreational Ecstasy/MDMA. PMID:18654086

  7. Attitudes toward Sexual Abstinence among Black Seventh-Day Adventist College Students

    ERIC Educational Resources Information Center

    Ashley, George; Ramirez, Octavio; Cort, Malcolm

    2013-01-01

    The purpose of this study was to identify Black Seventh-Day Adventist (SDA) college students' attitudes toward the concept of sexual abstinence. Attitude toward abstinence was operationalized as a dichotomy of acceptance or rejection of the concept as a way to order sexual behavior. The study utilized a convenience sample ("N" =…

  8. The importance of supporting autonomy and perceived competence in facilitating long-term tobacco abstinence

    PubMed Central

    Williams, Geoffrey C.; Niemiec, Christopher P.; Patrick, Heather; Ryan, Richard M.; Deci, Edward L.

    2010-01-01

    Background The Public Health Service (PHS) Guideline for Treating Tobacco Use and Dependence (1) recommends supporting autonomy and perceived competence to facilitate tobacco abstinence. Purpose To evaluate the effectiveness of an intensive tobacco-dependence intervention based on self-determination theory (SDT) and intended to support autonomy and perceived competence in facilitating long-term tobacco abstinence. Methods One thousand and six adult smokers were recruited into a randomized cessation-induction trial. Community care participants received cessation pamphlets and information on local treatment programs. Intervention participants received the same materials and were asked to meet four times with counselors over six months to discuss their health in a manner intended to support autonomy and perceived competence. The primary outcome was 24-month prolonged abstinence from tobacco. The secondary outcome was 7-day point prevalence tobacco abstinence at 24 months post-intervention. Results Smokers in the intervention were more likely to attain both tobacco abstinence outcomes and these effects were partially mediated by change in both autonomous self-regulation and perceived competence from baseline to six months. Structural equation modeling confirmed the SDT model of health-behavior change in facilitating long-term tobacco abstinence. Conclusions An intervention based on SDT and consistent with the PHS Guideline, which was intended to support autonomy and perceived competence, facilitated long-term tobacco abstinence. PMID:19373517

  9. The importance of supporting autonomy and perceived competence in facilitating long-term tobacco abstinence.

    PubMed

    Williams, Geoffrey C; Niemiec, Christopher P; Patrick, Heather; Ryan, Richard M; Deci, Edward L

    2009-06-01

    The Public Health Service (PHS) Guideline for Treating Tobacco Use and Dependence (Fiore et al. 2000) recommends supporting autonomy and perceived competence to facilitate tobacco abstinence. The aim of the study was to evaluate the effectiveness of an intensive tobacco-dependence intervention based on self-determination theory (SDT) and intended to support autonomy and perceived competence in facilitating long-term tobacco abstinence. One thousand and six adult smokers were recruited into a randomized cessation-induction trial. Community care participants received cessation pamphlets and information on local treatment programs. Intervention participants received the same materials and were asked to meet four times with counselors over 6 months to discuss their health in a manner intended to support autonomy and perceived competence. The primary outcome was 24-month prolonged abstinence from tobacco. The secondary outcome was 7-day point prevalence tobacco abstinence at 24 months postintervention. Smokers in the intervention were more likely to attain both tobacco abstinence outcomes and these effects were partially mediated by change in both autonomous self-regulation and perceived competence from baseline to 6 months. Structural equation modeling confirmed the SDT model of health-behavior change in facilitating long-term tobacco abstinence. An intervention based on SDT and consistent with the PHS Guideline, which was intended to support autonomy and perceived competence, facilitated long-term tobacco abstinence.

  10. Socioeconomic Status and the Reward Value of Smoking Following Tobacco Abstinence: A Laboratory Study

    PubMed Central

    Leventhal, Adam M.

    2014-01-01

    Introduction: Socioeconomic status (SES) indicators are robustly associated with smoking behaviors. Yet, the psychological mechanisms underlying relations are unclear. This study merged the socioecological construct of SES with laboratory psychological science to investigate how income, education, and employment status predicted the reward value of smoking following tobacco abstinence among a diverse sample of adult daily smokers. We hypothesized that participants with lower SES (i.e., less education, lower income, and unemployed) would experience greater abstinence-induced enhancement of the reward value of smoking. Methods: Adult smokers (N = 240; 68.7% male; 51.7% Black, 33.8% White, 7.1% Latino, and 7.5% other) attended 2 laboratory sessions (1 nonabstinent and 1 following 16-hr tobacco abstinence) involving behavioral assessment of (a) latency to smoking when delaying smoking was monetarily rewarded and (b) purchasing individual cigarettes. Generalized estimating equations were used to test the interaction between each SES variable (education, income, and employment) and abstinence state to illustrate whether participants with certain SES characteristics were more sensitive to the abstinence-induced enhancement of the relative reward value of smoking. Results: Participants who never attended college (vs. college attendees) exhibited greater abstinence-induced enhancement of the reward value of smoking, which was indicated by reduced willingness to delay smoking for money (ps = .03). Income and employment status did not moderate abstinence effects. Conclusions: Less-educated smokers were particularly motivated to smoke during acute abstinence. Observed educational disparities in smoking behaviors and smoking cessation might reflect a biased valuation of immediate drug-related (over less immediate alternative) rewards. Future research should explore potential mediators of this association. PMID:24935756

  11. Sex differences in negative affect and lapse behavior during acute tobacco abstinence: a laboratory study.

    PubMed

    Pang, Raina D; Leventhal, Adam M

    2013-08-01

    Heightened negative affect during acute tobacco abstinence in women relative to men could be an important factor underlying sex differences in smoking motivation. However, little controlled experimental work addresses this hypothesis. The current study investigated sex differences in withdrawal-related negative affect, time to start smoking on a lab analogue smoking lapse task, and the interrelation between sex, withdrawal-related negative affect, and smoking lapse behavior. Following a baseline session, current smokers (women: n = 68, men: n = 131) attended two counterbalanced lab sessions (16 hours smoking abstinence and ad libitum smoking) during which they completed self-report measures of mood and withdrawal symptoms followed by a laboratory analogue smoking lapse task. In this task participants are monetarily rewarded for delaying smoking. Performance on this task serves as an analogue model of smoking lapse behavior by measuring smoker's capability to resist temptation to smoke under conditions where abstinence is advantageous. Females showed greater abstinence induced increases in composite negative affect as well as several particular negative affect states (i.e., POMS Anger, Anxiety, Depression, and Confusion, ps < .05) but no differences in abstinence induced changes in other forms of affect or craving. Females also exhibited marginally greater abstinence induced decreases in their willingness to delay smoking for money (p = .10), which was mediated by abstinence induced increases in anger (p < .05). These results suggest that differential sensitivity to abstinence induced negative affect, particularly anger, could underlie sex specific smoking patterns. Negative affect during tobacco abstinence may be an important factor for understanding and treating nicotine addiction in women. PsycINFO Database Record (c) 2013 APA, all rights reserved

  12. Former substance users working as counselors. A dual relationship.

    PubMed

    Hecksher, Dorte

    2007-01-01

    All helping professionals risk participation in "dual relationships." But in the case of former substance users working as counselors, specific dilemmas and problems are accentuated. A qualitative analysis highlights some of the ethical and personal dilemmas faced by these counselors. The data are derived from an interview study initiated in 2000 in Denmark on former substance users with 4-8 years of abstinence. Through an analysis of interview data from a larger group of former substance users, it became evident that those working as counselors experienced specific dilemmas and problems. The current article is based on individual reports of five counselors with recovery status.

  13. Morning administration of oral methamphetamine dose-dependently disrupts nighttime sleep in recreational stimulant users.

    PubMed

    Herrmann, Evan S; Johnson, Patrick S; Bruner, Natalie R; Vandrey, Ryan; Johnson, Matthew W

    2017-09-01

    Use of amphetamine-type stimulants (e.g., methamphetamine) is associated with acute sleep disruptions. No prior reports have characterized the acute effects of methamphetamine on sleep using polysomnography, the gold standard for objective sleep monitoring. Recreational stimulant users (n=19) completed a baseline assessment, which included questionnaires assessing demographic and substance use characteristics, and the Pittsburgh Sleep Quality Index (PSQI), which assesses sleep quality over the past month. Participants were administered 0mg (placebo), 20mg, or 40mg oral methamphetamine at 08:15h on study days, using a double-blind, randomized, within-subjects design. Sleep was monitored using polysomnography from 22:20 that evening until 06:15 the following morning. PSQI scores indicated more than half of participants reported poor sleep quality at baseline. Methamphetamine dose-dependently increased sleep latency, and decreased total sleep time, sleep efficiency, time in NREM 2 sleep, number of REM periods, and total time in REM sleep. Sleep under placebo conditions was consistent with what would be expected from healthy adults. Morning oral administration of methamphetamine produces robust disruptions in nighttime sleep. Future research should examine relations between stimulant use and sleep disruption in naturalistic settings, with regard to both stimulant abuse and licit prescription use. Copyright © 2017. Published by Elsevier B.V.

  14. A Review of 21 Curricula for Abstinence-Only-until-Marriage Programs.

    ERIC Educational Resources Information Center

    Wilson, Kelly L.; Goodson, Patricia; Pruitt, B.E.; Buhi, Eric; Davis-Gunnels, Emily

    2005-01-01

    The authors reviewed the content, methods, and overall quality of 21 curricula used in abstinence-only-until-marriage programs. Only materials designed for use in middle school grades (fifth to eighth) or with middle school-aged audiences (9-13 years of age), which presented the abstinence message in at least 40% of their content, were included. A…

  15. Comprehensive Sexuality Education or Abstinence-Only Education: Which Is More Effective?

    ERIC Educational Resources Information Center

    Pittman, Vicki; Gahungu, Athanase

    2006-01-01

    The purpose of this study was to examine the difference in effectiveness between comprehensive sexuality abstinence-based education and abstinence-only education. A survey was developed and distributed to over 140 individuals via a variety of sources such as: (1) the researcher's e-mail lists; (2) a group of City Core/City Year volunteers; (3) a…

  16. P300 event-related potential in abstinent methamphetamine-dependent patients.

    PubMed

    Haifeng, Jiang; Wenxu, Zhuang; Hong, Cheng; Chuanwei, Li; Jiang, Du; Haiming, Sun; Zhikang, Chen; Din, Xu; Jijun, Wang; Min, Zhao

    2015-10-01

    Substance use and abuse are characterized by biases in the attentional processing of substance-related stimuli. There are no event related potential (ERP)-based studies of attentional bias for substance-related cues among methamphetamine (MA) dependent patients. The study aimed to measure changes in P300 event-related potentials elicited by MA-related words in MA-dependent individuals at baseline and after 3 and 6 months of abstinence, examining the relationship of ERP changes to craving. 26 MA-dependent patients (14 male) newly enrolled in two compulsory treatment centers in China and 29 healthy controls (15 male) were included in this study. At baseline (2-3 weeks in treatment) and after 3 and 6 months of abstinence from MA use, we obtained ERP data during a Stroop color-matching task using MA-related and neutral words. Self-reported craving was measured by a Visual Analog Scale (VAS). Increased P300 amplitudes elicited by MA-related words were observed over left-anterior electrode sites. Abnormal P300 amplitudes declined to the normal levels of healthy controls at the end of 3 months of abstinence, and the decrease was maintained up to the end of 6 months of abstinence. The behavioral data did not show similar changes. The positive relationship between the changes of VAS scores for MA craving and the changes of P300 amplitudes over left anterior electrode sites elicited by MA-related words within the first 3 months was significant. These findings highlight the potential use of ERP as an objective index to track changes in subjective MA craving among abstinent MA-dependent patients. Copyright © 2015. Published by Elsevier Inc.

  17. Relations between in-treatment and follow-up abstinence among cocaine-dependent homeless persons in three clinical trials.

    PubMed

    Vuchinich, Rudy; Wallace, Dennis; Milby, Jesse B; Schumacher, Joseph E; Mennemeyer, Stephen; Kertesz, Stefan

    2009-06-01

    Clinical trials with cocaine-dependent outpatients have found a strong relation between in-treatment and follow-up abstinence, and the strength of this relation is constant across treatment conditions with variable efficacy in generating abstinence. The authors conducted secondary analyses of data from 3 clinical trials to determine whether this relation generalizes to cocaine-dependent homeless persons. The 3 trials (total N = 543) were conducted in a community health care facility for homeless people. The 7 treatment arms across the 3 trials were combinations of day treatment, abstinence-contingent housing, and vocational training. Drug use was measured with urine toxicology testing. Consecutive weeks of abstinence during treatment were strongly related to abstinence at the 12-month follow-up, whether or not missing 12-month data were included in the analysis. The treatment arms differed in their efficacy in generating abstinence, but the relation between in-treatment and follow-up abstinence did not differ across treatment arms. These results replicate earlier reports of these relations and extend them to a population of homeless people. The lack of differences between treatment arms in the in-treatment-follow-up abstinence relation implies that that relation is independent of the treatment-specific intervention components that generate group differences in abstinence.

  18. Contingency management for college student smokers: The role of drinking as a moderator and mediator of smoking abstinence during treatment.

    PubMed

    Cassidy, Rachel N; Jackson, Kristina M; Rohsenow, Damaris J; Tidey, Jennifer W; Tevyaw, Tracy O' L; Barnett, Nancy P; Monti, Peter M; Miller, Mollie E; Colby, Suzanne M

    2018-05-01

    Contingency management (CM) is effective for promoting smoking abstinence; however, moderators and mediators of CM treatment efficacy in young adult populations are under-explored. We leveraged fine-grained data from a large randomized controlled trial: 1) to determine whether early attainment of sustained abstinence mediated the effect of treatment on abstinence; 2) to test whether heavy drinking moderated the effect of treatment on abstinence; and 3) to test a serial mediation model of the effects of drinking during early treatment on sustained smoking abstinence. College student smokers (N=110) were randomized to receive either CM treatment or noncontingent reinforcement (NR) over a 21-day treatment period. All participants received $5 for providing twice-daily breath carbon monoxide (CO) samples. In CM, additional money was provided for samples that indicated smoking reduction (Initial Phase; first 7days), and for samples ≤5ppm (Abstinence Phase; following 14days). CM treatment led to greater sustained abstinence relative to NR. Longer sustained abstinence in the Initial Phase partially mediated the effect of treatment on sustained abstinence in the Abstinence Phase. Heavier pretreatment drinkers had shorter periods of sustained abstinence in the Abstinence Phase; this effect was greater in CM. A serial mediation model determined that increased drinking during the Initial Phase led to decreased sustained abstinence, which then led to decreased sustained abstinence in the Abstinence Phase. These data provide a greater understanding of how heavy drinking and early sustained abstinence may affect success during treatment in young adults undergoing contingency management treatment for smoking. Copyright © 2018. Published by Elsevier Ltd.

  19. Predictors of early versus late smoking abstinence within a 24-month disease management program.

    PubMed

    Cox, Lisa Sanderson; Wick, Jo A; Nazir, Niaman; Cupertino, A Paula; Mussulman, Laura M; Ahluwalia, Jasjit S; Ellerbeck, Edward F

    2011-03-01

    Standard smoking cessation treatment studies have been limited to 6- to 12-month follow-up, and examination of predictors of abstinence has been restricted to this timeframe. The KanQuit study enrolled 750 rural smokers across all stages of readiness to stop smoking and provided pharmacotherapy management and/or disease management, including motivational interviewing (MI) counseling every 6 months over 2 years. This paper examines differences in predictors of abstinence following initial (6-month) and extended (24-month) intervention. Baseline variables were analyzed as potential predictors of self-reported smoking abstinence at Month 6 and at Month 24. Chi-square tests, 2-sample t tests, and multiple logistic regression analyses were used to identify predictors of abstinence among 592 participants who completed assessment at baseline and Months 6 and 24. Controlling for treatment group, the final regression models showed that male gender and lower baseline cigarettes per day predicted abstinence at both 6 and 24 months. While remaining significant, the relative advantage of being male decreased over time. Global motivation to stop smoking, controlled motivation, and self-efficacy predicted abstinence at 6 months but did not predict abstinence at Month 24. In contrast, stage of change was strongly predictive of 24-month smoking status. While the importance of some predictors of successful smoking cessation appeared to diminish over time, initial lack of interest in cessation and number of cigarettes per day strongly predicted continued smoking following a 2-year program.

  20. 12-h abstinence-induced functional connectivity density changes and craving in young smokers: a resting-state study.

    PubMed

    Zhao, Shuzhi; Li, Yangding; Li, Min; Wang, Ruonan; Bi, Yanzhi; Zhang, Yajuan; Lu, Xiaoqi; Yu, Dahua; Yang, Likun; Yuan, Kai

    2018-06-20

    Studying the neural correlates of craving to smoke is of great importance to improve treatment outcomes in smoking addiction. According to previous studies, the critical roles of striatum and frontal brain regions had been revealed in addiction. However, few studies focused on the hub of brain regions in the 12 h abstinence induced craving in young smokers. Thirty-one young male smokers were enrolled in the present study. A within-subject experiment design was carried out to compare functional connectivity density between 12-h smoking abstinence and smoking satiety conditions during resting state in young adult smokers by using functional connectivity density mapping (FCDM). Then, the functional connectivity density changes during smoking abstinence versus satiety were further used to examine correlations with abstinence-induced changes in subjective craving. We found young adult smokers in abstinence state (vs satiety) had higher local functional connectivity density (lFCD) and global functional connectivity density (gFCD) in brain regions including striatal subregions (i.e., bilateral caudate and putamen), frontal regions (i.e., anterior cingulate cortex (ACC) and orbital frontal cortex (OFC)) and bilateral insula. We also found higher lFCD during smoking abstinence (vs satiety) in bilateral thalamus. Additionally, the lFCD changes of the left ACC, bilateral caudate and right OFC were positively correlated with the changes in craving induced by abstinence (i.e., abstinence minus satiety) in young adult smokers. The present findings improve the understanding of the effects of acute smoking abstinence on the hubs of brain gray matter in the abstinence-induces craving and may contribute new insights into the neural mechanism of abstinence-induced craving in young smokers in smoking addiction.

  1. Influence of Materials on Teacher Adoption of Abstinence-Only-Until-Marriage Programs

    ERIC Educational Resources Information Center

    Wilson, Kelly L.; Wiley, David C.

    2009-01-01

    Background: Given the growing scientific evidence against abstinence-only-until-marriage education, health educators are supporting an evidence-based approach to teaching sexuality education. However, there is still an abundance of federal support and funding streams allocated to sustain abstinence-only programs. This study assessed indicators…

  2. Abstinence, Sex, and Virginity: Do They Mean What We Think They Mean?

    ERIC Educational Resources Information Center

    Hans, Jason D.; Kimberly, Claire

    2011-01-01

    Ambiguous definitions concerning which behaviors constitute sex, abstinence, and virginity may lead to arbitrary interpretations of meaning or miscommunication, which could be particularly problematic in health care, educational, and research contexts. The purpose of this study was to examine and compare definitions of sex, abstinence, and…

  3. Mixed-Amphetamine Salts Increase Abstinence From Marijuana in Patients With Co-Occurring Attention-Deficit/Hyperactivity Disorder and Cocaine Dependence

    PubMed Central

    Notzon, Daniel P.; Mariani, John J.; Pavlicova, Martina; Glass, Andrew; Mahony, Amy L.; Brooks, Daniel J.; Grabowski, John; Levin, Frances R.

    2017-01-01

    Background and Objectives The prevalence of ADHD is greater in substance use disorders than the general population, and ADHD and substance use disorders share neurobiological features such as dysregulation of reward circuitry. We tested the hypothesis that stimulants would decrease marijuana use in a randomized controlled trial of extended release mixed amphetamine salts (MAS-XR) for treatment of co-occurring ADHD and cocaine use disorders. Methods Marijuana users were defined as participants reporting use in the 30 days before study initiation, collected with timeline follow-back. The original 14-week trial utilized a 3-arm randomized design, comparing placebo, MAS-XR 60 mg, and MAS-XR 80 mg. For this analysis, both MAS-XR groups were combined, leaving n = 20 in the placebo group and n = 37 in the MAS-XR group. The primary outcome was proportion of subjects reporting any marijuana use per study week. Comparisons between groups were made using a logistic mixed effects model incorporating multiple predictors and modeling time-by-treatment interactions. Results There were no significant baseline differences in marijuana use frequency and quantity. There was a significant decrease in the proportion of participants using marijuana over time in the MAS-XR group, but no difference in the proportion of marijuana-use days over time. Discussion and Conclusions Treatment of ADHD and comorbid cocaine use disorders with MAS-XR is associated with increased weekly abstinence from marijuana but not with a decrease in the proportion of marijuana using days per week. Scientific Significance Stimulant treatment of ADHD and cocaine use disorders may diminish co-occurring cannabis use. PMID:28051838

  4. Mixed-amphetamine salts increase abstinence from marijuana in patients with co-occurring attention-deficit/hyperactivity disorder and cocaine dependence.

    PubMed

    Notzon, Daniel P; Mariani, John J; Pavlicova, Martina; Glass, Andrew; Mahony, Amy L; Brooks, Daniel J; Grabowski, John; Levin, Frances R

    2016-12-01

    The prevalence of ADHD is greater in substance use disorders than the general population, and ADHD and substance use disorders share neurobiological features such as dysregulation of reward circuitry. We tested the hypothesis that stimulants would decrease marijuana use in a randomized controlled trial of extended release mixed amphetamine salts (MAS-XR) for treatment of co-occurring ADHD and cocaine use disorders. Marijuana users were defined as participants reporting use in the 30 days before study initiation, collected with timeline follow-back. The original 14-week trial utilized a 3-arm randomized design, comparing placebo, MAS-XR 60 mg, and MAS-XR 80 mg. For this analysis, both MAS-XR groups were combined, leaving n = 20 in the placebo group and n = 37 in the MAS-XR group. The primary outcome was proportion of subjects reporting any marijuana use per study week. Comparisons between groups were made using a logistic mixed effects model incorporating multiple predictors and modeling time-by-treatment interactions. There were no significant baseline differences in marijuana use frequency and quantity. There was a significant decrease in the proportion of participants using marijuana over time in the MAS-XR group, but no difference in the proportion of marijuana-use days over time. Treatment of ADHD and comorbid cocaine use disorders with MAS-XR is associated with increased weekly abstinence from marijuana but not with a decrease in the proportion of marijuana using days per week. Stimulant treatment of ADHD and cocaine use disorders may diminish co-occurring cannabis use. (Am J Addict 2016;25:666-672). © 2016 American Academy of Addiction Psychiatry.

  5. Socioeconomic status and the reward value of smoking following tobacco abstinence: a laboratory study.

    PubMed

    Reitzel, Lorraine R; Leventhal, Adam M

    2014-11-01

    Socioeconomic status (SES) indicators are robustly associated with smoking behaviors. Yet, the psychological mechanisms underlying relations are unclear. This study merged the socioecological construct of SES with laboratory psychological science to investigate how income, education, and employment status predicted the reward value of smoking following tobacco abstinence among a diverse sample of adult daily smokers. We hypothesized that participants with lower SES (i.e., less education, lower income, and unemployed) would experience greater abstinence-induced enhancement of the reward value of smoking. Adult smokers (N = 240; 68.7% male; 51.7% Black, 33.8% White, 7.1% Latino, and 7.5% other) attended 2 laboratory sessions (1 nonabstinent and 1 following 16-hr tobacco abstinence) involving behavioral assessment of (a) latency to smoking when delaying smoking was monetarily rewarded and (b) purchasing individual cigarettes. Generalized estimating equations were used to test the interaction between each SES variable (education, income, and employment) and abstinence state to illustrate whether participants with certain SES characteristics were more sensitive to the abstinence-induced enhancement of the relative reward value of smoking. Participants who never attended college (vs. college attendees) exhibited greater abstinence-induced enhancement of the reward value of smoking, which was indicated by reduced willingness to delay smoking for money (ps = .03). Income and employment status did not moderate abstinence effects. Less-educated smokers were particularly motivated to smoke during acute abstinence. Observed educational disparities in smoking behaviors and smoking cessation might reflect a biased valuation of immediate drug-related (over less immediate alternative) rewards. Future research should explore potential mediators of this association. © The Author 2014. Published by Oxford University Press on behalf of the Society for Research on Nicotine and Tobacco

  6. Neural correlates of 12-h abstinence-induced craving in young adult smokers: a resting-state study.

    PubMed

    Li, Yangding; Yuan, Kai; Bi, Yanzhi; Guan, Yanyan; Cheng, Jiadong; Zhang, Yajuan; Shi, Sha; Lu, Xiaoqi; Yu, Dahua; Tian, Jie

    2017-06-01

    Studying the neural correlates of craving to smoke in young adulthood is of great importance to improve treatment outcomes in nicotine dependence. Previous nicotine dependence studies mainly focused on the neural substrates of craving elicited by smoking-related cues. More explicit attention to abstinence-induced craving during resting state in nicotine dependence has the potential to yield valuable information about craving, and characterizing this kind of craving is critical for developing effective interventions. Twenty-five young male smokers were enrolled in the present study. A within-subject experiment design was carried out to compare regional homogeneity (ReHo) between 12-h smoking abstinence and smoking satiety conditions during resting state in young adult smokers. Then, the ReHo changes associated with smoking abstinence (compared with satiety) were further examined for correlations with abstinence-induced changes in subjective craving. We found young adult smokers in abstinence state (compared with satiety) had higher ReHo in brain regions in fronto-striatal circuits including bilateral caudate, anterior cingulate cortex (ACC) and bilateral dorsal lateral prefrontal cortex (DLPFC), as well as brain regions in default mode network (DMN) including posterior cingulate cortex (PCC)/precuneus and angular gyrus. Additionally, we found the ReHo changes of the ACC and the bilateral caudate were positively correlated with the changes in craving induced by abstinence (i.e., abstinence minus satiety) in young adult smokers. The present findings improve the understanding of the effects of acute smoking abstinence on spontaneous brain activity and may contribute new insights into the neural mechanism of abstinence-induced craving in nicotine dependence.

  7. Acceptability and compliance with a remote monitoring system to track smoking and abstinence among young smokers.

    PubMed

    McClure, Erin A; Tomko, Rachel L; Carpenter, Matthew J; Treiber, Frank A; Gray, Kevin M

    2018-05-08

    Similar to adult smokers, quit attempts among younger smokers almost inevitably result in relapse. Unlike adults, less is known about the process of relapse in this younger age group. A technology-based remote monitoring system may allow for detailed and accurate characterization of smoking and abstinence and would help to improve cessation strategies. This study describes a mobile system that captures smoking using breath carbon monoxide (CO) and real-time self-reports of smoking behavior. Compliance, feasibility, acceptability, and accuracy of the system were measured during a quit attempt and subsequent monitoring period. The mobile application (My Mobile Monitor, M 3 ) combined breath CO with ecological momentary assessment, delivered via smartphone. Participants (N = 16; 75% female) were daily smokers between the ages of 19 and 25, who used the app for 11 days during which they agreed to make a quit attempt. Acceptability, compliance, and abstinence were measured. Participants averaged 22.3 ± 2.0 years old and smoked an average of 13.0 ± 6.1 cigarettes per day. Overall session compliance was 69% and during the quit attempt, 56% of participants abstained from smoking for at least 24 hours. Agreement between self-reported smoking compared to breath CO was generally high, when available for comparison, though underreporting of cigarettes was likely. This study demonstrates feasibility of a remote monitoring app with younger smokers, though improvements to promote compliance are needed. Remote monitoring to detect smoking and abstinence represents a step forward in the improvement of cessation strategies, but user experience and personalization are vital.

  8. Low effective organizational strategies in visual memory performance of unmedicated alcoholics during early abstinence.

    PubMed

    Daig, Isolde; Mahlberg, Richard; Schroeder, Franziska; Gudlowski, Yehonala; Wrase, Jana; Wertenauer, Florian; Bschor, Tom; Esser, Guenter; Heinz, Andreas; Kienast, Thorsten

    2010-12-14

    Alcohol-dependent patients in early abstinence show an impairment of cognitive functions which can be seen in poor implementation of newly learned skills for avoiding relapse. Executive dysfunction may persist during abstinence in alcohol-dependent persons, thus mitigating long-term abstinence. This study assessed visual memory function and choice of organizational strategies in alcoholics, as these are major factors necessary to implement ongoing behavior changes which are required for maintaining abstinence. We investigated 25 severely alcohol-dependent male patients between days 7 to 10 of abstinence, immediately after clinical withdrawal symptoms have ceased, compared to 15 healthy age, sex, and education matched controls. Pharmacological therapy had been terminated at least four half-lifes before inclusion into the study. Visual perceptual learning and organizational strategies were assessed with the Rey-Osterrieth Complex Figure Test (R-OCF). There were no group differences in copying or recalling the figure, but time differences occurred. Alcoholics and healthy controls performed worse in recalling than in copying. But, alcoholics used less effective organizational strategies. There was a deficit in choice of organizational strategy in newly abstinent and unmedicated alcohol-dependent patients. Due to the imperfect organizational strategies, alcoholics might need auxiliary therapeutic care to strengthen their cognitive ability.

  9. Differential behavioral and molecular alterations upon protracted abstinence from cocaine versus morphine, nicotine, THC and alcohol.

    PubMed

    Becker, Jérôme A J; Kieffer, Brigitte L; Le Merrer, Julie

    2017-09-01

    Unified theories of addiction are challenged by differing drug-seeking behaviors and neurobiological adaptations across drug classes, particularly for narcotics and psychostimulants. We previously showed that protracted abstinence to opiates leads to despair behavior and social withdrawal in mice, and we identified a transcriptional signature in the extended amygdala that was also present in animals abstinent from nicotine, Δ9-tetrahydrocannabinol (THC) and alcohol. Here we examined whether protracted abstinence to these four drugs would also share common behavioral features, and eventually differ from abstinence to the prototypic psychostimulant cocaine. We found similar reduced social recognition, increased motor stereotypies and increased anxiety with relevant c-fos response alterations in morphine, nicotine, THC and alcohol abstinent mice. Protracted abstinence to cocaine, however, led to strikingly distinct, mostly opposing adaptations at all levels, including behavioral responses, neuronal activation and gene expression. Together, these data further document the existence of common hallmarks for protracted abstinence to opiates, nicotine, THC and alcohol that develop within motivation/emotion brain circuits. In our model, however, these do not apply to cocaine, supporting the notion of unique mechanisms in psychostimulant abuse. © 2016 Society for the Study of Addiction.

  10. The application of Bandura's self-efficacy theory to abstinence-oriented alcoholism treatment.

    PubMed

    Rollnick, S; Heather, N

    1982-01-01

    This paper explores the relevance of self-efficacy theory (Bandura, 1977b) to the process of abstinence treatment and the phenomenon of relapse. By distinguishing between the particular efficacy and outcome expectations created in treatment it is possible to clarify some of the problems encountered between clinicians and alcoholics. Bandura's theory also explains why some treatment methods might be more effective than others. Analysis of relapse suggests that while some of the expectations created in treatment might serve to promote abstinence, others might unwittingly precipitate relapse. The understanding of abstinence treatment could be enhanced by the testing of hypotheses which emerge from this analysis.

  11. THE EFFECTS OF FIXED VERSUS ESCALATING REINFORCEMENT SCHEDULES ON SMOKING ABSTINENCE

    PubMed Central

    Romanowich, Paul; Lamb, R. J.

    2015-01-01

    Studies indicate that when abstinence is initiated, escalating reinforcement schedules maintain continuous abstinence longer than fixed reinforcement schedules. However, these studies were conducted for shorter durations than most clinical trials and also resulted in larger reinforcer value for escalating participants during the 1st week of the experiment. We tested whether escalating reinforcement schedules maintained abstinence longer than fixed reinforcement schedules in a 12-week clinical trial. Smokers (146) were randomized to an escalating reinforcement schedule, a fixed reinforcement schedule, or a control condition. Escalating reinforcement participants received $5.00 for their first breath carbon monoxide (CO) sample <3 ppm, with a $0.50 increase for each consecutive sample. Fixed reinforcement participants received $19.75 for each breath CO sample <3 ppm. Control participants received payments only for delivering a breath CO sample. Similar proportions of escalating and fixed reinforcement participants met the breath CO criterion at least once. Escalating reinforcement participants maintained criterion breath CO levels longer than fixed reinforcement and control participants. Similar to previous short-term studies, escalating reinforcement schedules maintained longer durations of abstinence than fixed reinforcement schedules during a clinical trial. PMID:25640764

  12. Employment-based abstinence reinforcement as a maintenance intervention for the treatment of cocaine dependence: a randomized controlled trial.

    PubMed

    DeFulio, Anthony; Donlin, Wendy D; Wong, Conrad J; Silverman, Kenneth

    2009-09-01

    Due to the chronic nature of cocaine dependence, long-term maintenance treatments may be required to sustain abstinence. Abstinence reinforcement is among the most effective means of initiating cocaine abstinence. Practical and effective means of maintaining abstinence reinforcement programs over time are needed. To determine whether employment-based abstinence reinforcement can be an effective long-term maintenance intervention for cocaine dependence. Participants (n = 128) were enrolled in a 6-month job skills training and abstinence initiation program. Participants who initiated abstinence, attended regularly and developed needed job skills during the first 6 months were hired as operators in a data entry business and assigned randomly to an employment-only (control, n = 24) or abstinence-contingent employment (n = 27) group. A non-profit data entry business. Participants Unemployed welfare recipients who used cocaine persistently while enrolled in methadone treatment in Baltimore. Abstinence-contingent employment participants received 1 year of employment-based contingency management, in which access to employment was contingent upon provision of drug-free urine samples under routine and then random drug testing. If a participant provided drug-positive urine or failed to provide a mandatory sample, then that participant received a temporary reduction in pay and could not work until urinalysis confirmed recent abstinence. Cocaine-negative urine samples at monthly assessments across 1 year of employment. During the 1 year of employment, abstinence-contingent employment participants provided significantly more cocaine-negative urine samples than employment-only participants [79.3% and 50.7%, respectively; P = 0.004, odds ratio (OR) = 3.73, 95% confidence interval (CI) = 1.60-8.69]. Conclusions Employment-based abstinence reinforcement that includes random drug testing is effective as a long-term maintenance intervention, and is among the most promising treatments

  13. Analytic neutrality, anonymity, abstinence, and elective self-disclosure.

    PubMed

    Shill, Merton A

    2004-01-01

    Recent contributions to the psychoanalytic literature propose new ways of understanding analytic neutrality, anonymity, abstinence, and self-disclosure. They advocate elective self-disclosure by the analyst as an antidote to the allegedly game-playing quality of transference and resistance analysis. The analytic relationship, they assert, becomes unreal when attempts are made to observe the principles of neutrality and abstinence. Both are seen as ill-conceived because of the irreducible subjectivity and unwarranted authority of the analyst. These relational and interactional views are criticized because (1) they ignore the fact that transference and resistance analysis have from Freud onward been accepted as minimal criteria qualifying a clinical process as psychoanalytic; (2) elective self-disclosure carries metapsychological implications dismissing not only Freud's theory of motivation but motivation as a basic feature of human personality; (3) they do not recognize interpersonal relations as mental events and so do not consider the ego's ability to create intrapsychic representations of object relations; (4) elective self-disclosures within the empathic parameters of the analytic situation are themselves unreal compared to the reality of the patient's experience with other objects. Abstinence and neutrality as ideals facilitate maintenance of an internal holding environment or container for the analyst's countertransference.

  14. Role of Dorsomedial Striatum Neuronal Ensembles in Incubation of Methamphetamine Craving after Voluntary Abstinence

    PubMed Central

    Venniro, Marco; Zhang, Michelle; Bossert, Jennifer M.; Warren, Brandon L.; Hope, Bruce T.

    2017-01-01

    We recently developed a rat model of incubation of methamphetamine craving after choice-based voluntary abstinence. Here, we studied the role of dorsolateral striatum (DLS) and dorsomedial striatum (DMS) in this incubation. We trained rats to self-administer palatable food pellets (6 d, 6 h/d) and methamphetamine (12 d, 6 h/d). We then assessed relapse to methamphetamine seeking under extinction conditions after 1 and 21 abstinence days. Between tests, the rats underwent voluntary abstinence (using a discrete choice procedure between methamphetamine and food; 20 trials/d) for 19 d. We used in situ hybridization to measure the colabeling of the activity marker Fos with Drd1 and Drd2 in DMS and DLS after the tests. Based on the in situ hybridization colabeling results, we tested the causal role of DMS D1 and D2 family receptors, and DMS neuronal ensembles in “incubated” methamphetamine seeking, using selective dopamine receptor antagonists (SCH39166 or raclopride) and the Daun02 chemogenetic inactivation procedure, respectively. Methamphetamine seeking was higher after 21 d of voluntary abstinence than after 1 d (incubation of methamphetamine craving). The incubated response was associated with increased Fos expression in DMS but not in DLS; Fos was colabeled with both Drd1 and Drd2. DMS injections of SCH39166 or raclopride selectively decreased methamphetamine seeking after 21 abstinence days. In Fos-lacZ transgenic rats, selective inactivation of relapse test-activated Fos neurons in DMS on abstinence day 18 decreased incubated methamphetamine seeking on day 21. Results demonstrate a role of DMS dopamine D1 and D2 receptors in the incubation of methamphetamine craving after voluntary abstinence and that DMS neuronal ensembles mediate this incubation. SIGNIFICANCE STATEMENT In human addicts, abstinence is often self-imposed and relapse can be triggered by exposure to drug-associated cues that induce drug craving. We recently developed a rat model of incubation

  15. Role of Dorsomedial Striatum Neuronal Ensembles in Incubation of Methamphetamine Craving after Voluntary Abstinence.

    PubMed

    Caprioli, Daniele; Venniro, Marco; Zhang, Michelle; Bossert, Jennifer M; Warren, Brandon L; Hope, Bruce T; Shaham, Yavin

    2017-01-25

    We recently developed a rat model of incubation of methamphetamine craving after choice-based voluntary abstinence. Here, we studied the role of dorsolateral striatum (DLS) and dorsomedial striatum (DMS) in this incubation. We trained rats to self-administer palatable food pellets (6 d, 6 h/d) and methamphetamine (12 d, 6 h/d). We then assessed relapse to methamphetamine seeking under extinction conditions after 1 and 21 abstinence days. Between tests, the rats underwent voluntary abstinence (using a discrete choice procedure between methamphetamine and food; 20 trials/d) for 19 d. We used in situ hybridization to measure the colabeling of the activity marker Fos with Drd1 and Drd2 in DMS and DLS after the tests. Based on the in situ hybridization colabeling results, we tested the causal role of DMS D 1 and D 2 family receptors, and DMS neuronal ensembles in "incubated" methamphetamine seeking, using selective dopamine receptor antagonists (SCH39166 or raclopride) and the Daun02 chemogenetic inactivation procedure, respectively. Methamphetamine seeking was higher after 21 d of voluntary abstinence than after 1 d (incubation of methamphetamine craving). The incubated response was associated with increased Fos expression in DMS but not in DLS; Fos was colabeled with both Drd1 and Drd2 DMS injections of SCH39166 or raclopride selectively decreased methamphetamine seeking after 21 abstinence days. In Fos-lacZ transgenic rats, selective inactivation of relapse test-activated Fos neurons in DMS on abstinence day 18 decreased incubated methamphetamine seeking on day 21. Results demonstrate a role of DMS dopamine D 1 and D 2 receptors in the incubation of methamphetamine craving after voluntary abstinence and that DMS neuronal ensembles mediate this incubation. In human addicts, abstinence is often self-imposed and relapse can be triggered by exposure to drug-associated cues that induce drug craving. We recently developed a rat model of incubation of methamphetamine

  16. States' implementation of the Section 510 abstinence education program, FY 1999.

    PubMed

    Sonfield, A; Gold, R B

    2001-01-01

    As part of its reworking of the nation's welfare system in 1996, Congress enacted a major new abstinence education initiative (Section 510 of Title V of the Social Security Act), projected to spend $87.5 million in federal, state and local funds per year for five years. The new program is designed to emphasize abstinence from sexual activity outside of marriage, at any age, rather than premarital abstinence for adolescents, which was typical of earlier efforts. The actual message and impact of the program, however, will depend on how it is implemented. Program coordinators in all 50 states, the District of Columbia and Puerto Rico were surveyed concerning implementation of the Section 510 abstinence education program in FY 1999. The questionnaire asked about expenditures and activities performed, about policies established for a variety of specific situations and about how the term "sexual activity" is defined and what specific components of the federal definition of "abstinence education" are emphasized. Forty-five jurisdictions spent a total of $69 million through the Section 510 program in FY 1999. Of this total, $33 million was spent through public entities, $28 million was spent through private entities and $7million (in 22 jurisdictions) was spent through faith-based entities. Almost all jurisdictions reported funding school-related activities, with 38 reporting in-school instruction and presentations. Twenty-eight jurisdictions prohibited organizations from providing information about contraception (aside from failure rates), even at a client's request, while only six jurisdictions prohibited information about sexually transmitted diseases. Few reported having a policy or rendering guidance about providing services addressing sexual abuse, sexual orientation or existing pregnancy and parenthood. Only six respondents said they defined "sexual activity" for purposes of the program, and 16 reported focusing on specific portions of the federal definition of

  17. Cognitive control dysfunction and abnormal frontal cortex activation in stimulant drug users and their biological siblings.

    PubMed

    Smith, D G; Jones, P S; Bullmore, E T; Robbins, T W; Ersche, K D

    2013-05-14

    Cognitive and neural abnormalities are known to accompany chronic drug abuse, with impairments in cognition and changes in cortical structure seen in stimulant-dependent individuals. However, premorbid differences have also been observed in the brains and behavior of individuals at risk for substance abuse, before they develop dependence. Endophenotype research has emerged as a useful method for assessing preclinical traits that may be risk factors for pathology by studying patient populations and their undiagnosed first-degree relatives. This study used the color-word Stroop task to assess executive functioning in stimulant-dependent individuals, their unaffected biological siblings and unrelated healthy control volunteers using a functional magnetic resonance imaging paradigm. Both the stimulant-dependent and sibling participants demonstrated impairments in cognitive control and processing speed on the task, registering significantly longer response latencies. However, the two groups generated very different neural responses, with the sibling participants exhibiting a significant decrease in activation in the inferior frontal gyrus compared with both stimulant-dependent individuals and control participants. Both target groups also demonstrated a decrease in hemispheric laterality throughout the task, exhibiting a disproportionate increase in right hemispheric activation, which was associated with their behavioral inefficiencies. These findings not only suggest a possible risk factor for stimulant abuse of poor inhibitory control and cortical inefficiency but they also demonstrate possible adaptations in the brains of stimulant users.

  18. Employment-based abstinence reinforcement as a maintenance intervention for the treatment of cocaine dependence: post-intervention outcomes.

    PubMed

    DeFulio, Anthony; Silverman, Kenneth

    2011-05-01

    Due to the chronicity of cocaine dependence, practical and effective maintenance interventions are needed to sustain long-term abstinence. We sought to assess the effects of long-term employment-based reinforcement of cocaine abstinence after discontinuation of the intervention. Participants who initiated sustained opiate and cocaine abstinence during a 6-month abstinence reinforcement and training program worked as data entry operators and were randomly assigned to a group that could work independently of drug use (control, n = 24), or an abstinence-contingent employment (n = 27) group that was required to provide cocaine- and opiate-negative urine samples to work and maintain maximum rate of pay. A non-profit data entry business. Unemployed welfare recipients who persistently used cocaine while in methadone treatment. Urine samples and self-reports were collected every 6 months for 30 months. During the employment year, abstinence-contingent employment participants provided significantly more cocaine-negative samples than controls (82.7% and 54.2%; P = 0.01, OR = 4.61). During the follow-up year, the groups had similar rates of cocaine-negative samples (44.2% and 50.0%; P = 0.93) and human immunodeficiency virus risk behaviors. Participants' social, employment, economic and legal conditions were similar in the two groups across all phases of the study. Employment-based reinforcement effectively maintains long-term cocaine abstinence, but many patients relapse to use when the abstinence contingency is discontinued, even after a year of abstinence-contingent employment. Relapse could be prevented in many patients by leaving employment-based abstinence reinforcement in place indefinitely, which could be facilitated by integrating it into typical workplaces. © 2011 The Authors, Addiction © 2011 Society for the Study of Addiction.

  19. [Smoking abstinence rate and its associated factors between abrupt and gradual smoking cessation].

    PubMed

    Hao, R; Zhou, J P; Ni, L; Li, Q Y; Shi, G C

    2017-12-12

    Objective: To analyze and compare the abstinence rate of smoking quitting methods and its associated factors between abrupt and gradual smoking cessation in smokers with drug-based therapy. Methods: A prospective clinical study was conducted in patients undergoing quitting smoking intervention in Ruijin Hospital smoking cessation clinic between June 2013 and May 2016. All the subjects were randomized in a 1∶1 ratio into the abrupt smoking cessation group (smoking as usual over 3 weeks before a planned quit day, and then stopping smoking abruptly) and the gradual smoking cessation group (gradually reducing tobacco use over 3 weeks before a planned quit day, and then stopping smoking totally). The primary outcome was the complete abstinence rate, and the secondary outcomes included 1-month, 3-month and 6 month 7-day point prevalence of abstinence rates and 3 month sustained abstinence rates. Changes of body weight and drug adverse events were also compared. Results: A total of 314 moderate to severe nicotine-dependent patients were admitted in the study, including 157 patients in the abrupt smoking cessation and 157 patients in the gradual smoking cessation group. Fourteen patients fell off during the follow-up. For the complete abstinence rate, the gradual smoking cessation group was higher than the abrupt smoking cessation group(55.0% vs . 36.9%, χ(2)=9.841, P =0.002) .For 7-d smoking abstinence rate in the 1st, 3rd, 6th month, there was no significant difference between the 2 groups (all P >0.05). As for the 3-month sustained abstinence rate, a higher smoking quitting rate was seen in the gradual smoking cessation group compared to the abrupt smoking cessation group in the 6-month follow-up (17.9% vs .8.7%, χ(2)=5.441, P =0.020). The adverse drug reaction incidence was higher in the abrupt smoking cessation group than the gradual smoking cessation group (Gastrointestinal discomfort: 39.2% vs . 17.7%, χ(2)=12.336, P =0.000; Dreaminess: 40.2% vs . 13.3%, χ(2

  20. Examining interest in secondary abstinence among young African American females at risk for HIV or STIs.

    PubMed

    Bradley, Erin L P; Sales, Jessica M; Murray, Colleen C; DiClemente, Ralph J

    2012-12-01

    Sexually active African American females are at increased risk for acquiring HIV or STIs. However, some reduce their risk by abstaining from sex for various periods of time following initiation, a practice known as secondary abstinence. Although this may be a valuable mechanism for reducing HIV or STI rates in this population, little is known about those interested in secondary abstinence. Baseline data were obtained from a sample of African American adolescent females, ages 14-20 years, prior to participation in an HIV-risk reduction intervention trial (N = 701). Differences in individual-level and interpersonal-level factors, as well as sociodemographic variables were examined between participants who reported strong interest in secondary abstinence and those who did not. 144 (20.5%) participants reported strong interest in secondary abstinence. Young women with strong interest in abstinence had higher odds of reporting a history of STIs and feeling negative emotions following sex because of their religious beliefs. They also had higher odds of believing their partner may be interested in abstaining and being less invested in their relationship with their main partner. Additionally, adolescents reported less interpersonal stress and more social support. African American females who are interested in practicing secondary abstinence and those who are not differ in their sexual health education needs. Findings from this study characterizing young women interested in secondary abstinence can help researchers provide more targeted health education by identifying those who may be more responsive to abstinence-promoting messages.

  1. The impact of adolescent binge drinking and sustained abstinence on affective state.

    PubMed

    Bekman, Nicole M; Winward, Jennifer L; Lau, Lily L; Wagner, Chase C; Brown, Sandra A

    2013-08-01

    While it is clear that affect is negatively impacted by heavy drinking in adulthood and that it improves with abstinence, little is known about effects of heavy drinking on mood during adolescence. This study examined negative mood states among 2 groups of 16- to 18-year-old high school students; youth with a history of recent heavy episodic drinking (HED; n = 39) and comparison youth with limited lifetime drinking experience (CON; n = 26). Affect was assessed at 3 time points during a 4- to 6-week period of monitored abstinence using the Hamilton Rating Scales for Anxiety and Depression; self-reports were obtained with the state portion of the State-Trait Anxiety Inventory, and experience sampling of current affect was assessed via daily text messages sent at randomly determined times in the morning, afternoon, and evening. Youth with a recent history of HED reported more negative affect compared with nondrinking youth during early stages of abstinence (days since last HED at assessment 1: M = 6.46; SD = 5.06); however, differences in affect were not observed after 4 to 6 weeks of abstinence. Sex differences were evident, with HED girls reporting greater depression and anxiety than HED male peers. Although not significant, response patterns indicated that boys may experience faster resolution of negative emotional states than girls with sustained abstinence. Findings suggest that high-dose drinking is associated with elevated negative affect for adolescents and that negative mood states may take longer to resolve for girls than for boys following heavy drinking episodes. Future research clarifying naturally occurring changes in affective response during early and sustained abstinence is necessary for improving programs designed to promote adolescent decision-making and to reduce risk for relapse. Copyright © 2013 by the Research Society on Alcoholism.

  2. Top-Down Network Effective Connectivity in Abstinent Substance Dependent Individuals

    PubMed Central

    Regner, Michael F.; Saenz, Naomi; Maharajh, Keeran; Yamamoto, Dorothy J.; Mohl, Brianne; Wylie, Korey; Tregellas, Jason; Tanabe, Jody

    2016-01-01

    Objective We hypothesized that compared to healthy controls, long-term abstinent substance dependent individuals (SDI) will differ in their effective connectivity between large-scale brain networks and demonstrate increased directional information from executive control to interoception-, reward-, and habit-related networks. In addition, using graph theory to compare network efficiencies we predicted decreased small-worldness in SDI compared to controls. Methods 50 SDI and 50 controls of similar sex and age completed psychological surveys and resting state fMRI. fMRI results were analyzed using group independent component analysis; 14 networks-of-interest (NOI) were selected using template matching to a canonical set of resting state networks. The number, direction, and strength of connections between NOI were analyzed with Granger Causality. Within-group thresholds were p<0.005 using a bootstrap permutation. Between group thresholds were p<0.05, FDR-corrected for multiple comparisons. NOI were correlated with behavioral measures, and group-level graph theory measures were compared. Results Compared to controls, SDI showed significantly greater Granger causal connectivity from right executive control network (RECN) to dorsal default mode network (dDMN) and from dDMN to basal ganglia network (BGN). RECN was negatively correlated with impulsivity, behavioral approach, and negative affect; dDMN was positively correlated with impulsivity. Among the 14 NOI, SDI showed greater bidirectional connectivity; controls showed more unidirectional connectivity. SDI demonstrated greater global efficiency and lower local efficiency. Conclusions Increased effective connectivity in long-term abstinent drug users may reflect improved cognitive control over habit and reward processes. Higher global and lower local efficiency across all networks in SDI compared to controls may reflect connectivity changes associated with drug dependence or remission and requires future, longitudinal

  3. Acceptability of OCT and Abstinence Requirements among Women Participating in Microbicide Safety Trials

    PubMed Central

    Breitkopf, Carmen Radecki; Loza, Melissa; Vincent, Kathleen; Moench, Thomas; Stanberry, Lawrence R.; Rosenthal, Susan L.

    2011-01-01

    Background Developing effective and safe microbicides requires study procedures (e.g. technology used, abstinence requirements, and product use) that are acceptable to participants. Methods Thirty women completed 4 study visits including pelvic examination, colposcopy, optical coherence tomography (OCT), and semi-structured, qualitative interviews. Additional requirements included abstinence (for approximately 16 days) and twice daily vaginal product use (for 5.5 days). Interviews were audio-recorded, transcribed, and analyzed using framework analysis. Themes addressing OCT experiences, acceptability of abstinence, and vaginal product use were examined. Results OCT was viewed favorably as an imaging technology. Some women reported feeling the fiber-optic probe “poking” them and over one-third spontaneously reported feeling pressure or pinching upon rotation of the speculum in connection with the OCT evaluation. Compliance with vaginal gel use was high, but for many women assigned to use a product containing nonoxynol-9 (versus placebo), the post-product use exam was more uncomfortable, relative to the initial exam or one week following product discontinuation. Nearly all women experienced product leakage; acceptability of leakage varied. Two women were not abstinent and several more found abstinence challenging. Some women involved their partner in decision making regarding trial enrollment. Strategies to remain abstinent included participating when the partner was away, avoiding early intimacy, and engaging in alternative sexual activities. Conclusions Qualitative interviews in early-phase studies provide insights and capture information that would be missed by behavioral inference alone. Understanding participant’s experiences is important in order to provide anticipatory guidance and plan future microbicide studies that facilitate adherence with trial requirements. PMID:22183842

  4. Accuracy of self-reported smoking abstinence in clinical trials of hospital-initiated smoking interventions.

    PubMed

    Scheuermann, Taneisha S; Richter, Kimber P; Rigotti, Nancy A; Cummins, Sharon E; Harrington, Kathleen F; Sherman, Scott E; Zhu, Shu-Hong; Tindle, Hilary A; Preacher, Kristopher J

    2017-12-01

    To estimate the prevalence and predictors of failed biochemical verification of self-reported abstinence among participants enrolled in trials of hospital-initiated smoking cessation interventions. Comparison of characteristics between participants who verified and those who failed to verify self-reported abstinence. Multi-site randomized clinical trials conducted between 2010 and 2014 in hospitals throughout the United States. Recently hospitalized smokers who reported tobacco abstinence 6 months post-randomization and provided a saliva sample for verification purposes (n = 822). Outcomes were salivary cotinine-verified smoking abstinence at 10 and 15 ng/ml cut-points. Predictors and correlates included participant demographics and tobacco use; hospital diagnoses and treatment; and study characteristics collected via surveys and electronic medical records. Usable samples were returned by 69.8% of the 1178 eligible trial participants who reported 7-day point prevalence abstinence. The proportion of participants verified as quit was 57.8% [95% confidence interval (CI) = 54.4, 61.2; 10 ng/ml cut-off] or 60.6% (95% CI = 57.2, 63.9; 15 ng/ml). Factors associated independently with verification at 10 ng/ml were education beyond high school education [odds ratio (OR) = 1.51; 95% CI = 1.07, 2.11], continuous abstinence since hospitalization (OR = 2.82; 95% CI = 2.02, 3.94), mailed versus in-person sample (OR = 3.20; 95% CI = 1.96, 5.21) and race. African American participants were less likely to verify abstinence than white participants (OR = 0.64; 95% CI = 0.44, 0.93). Findings were similar for verification at 15 ng/ml. Verification rates did not differ by treatment group. In the United States, high rates (40%) of recently hospitalized smokers enrolled in smoking cessation trials fail biochemical verification of their self-reported abstinence. © 2017 Society for the Study of Addiction.

  5. Abstinence following Alcohol Drinking Produces Depression-Like Behavior and Reduced Hippocampal Neurogenesis in Mice

    PubMed Central

    Stevenson, Jennie R; Schroeder, Jason P; Nixon, Kimberly; Besheer, Joyce; Crews, Fulton T; Hodge, Clyde W

    2010-01-01

    Alcoholism and depression show high degrees of comorbidity. Clinical evidence also indicates that depression that emerges during abstinence from chronic alcohol use has a greater negative impact on relapse than pre-existing depression. Although no single neurobiological mechanism can account for the behavioral pathologies associated with these devastating disorders, converging evidence suggests that aspects of both alcoholism and depression are linked to reductions in hippocampal neurogenesis. Here, we report results from a novel preclinical behavioral model showing that abstinence from voluntary alcohol drinking leads to the emergence of depression-like behavior and reductions in neurogenesis. C57BL/6J mice were allowed to self-administer ethanol (10% v/v) vs H2O in the home cage for 28 days. Alcohol was then removed for 1 or 14 days, and mice were tested in the forced swim test to measure depression-like behavior. After 14 days, but not 1 day of abstinence from alcohol drinking, mice showed a significant increase in depression-like behavior. The significant increase in depression-like behavior during abstinence was associated with a reduction in proliferating cell nuclear antigen (PCNA) and doublecortin (DCX) immunoreactivity in the dentate gyrus of the hippocampus indicating that both the number of proliferating neural progenitor cells (NPC) and immature neurons were reduced, respectively. The number of NPCs that were labeled with bromo-deoxyuridine (BrdU) at the beginning of alcohol exposure was not altered indicating that survival of NPCs is not linked to abstinence-induced depression. Chronic treatment (14 days) with the antidepressant desipramine during abstinence prevented both the emergence of depression-like behavior and the reduction in hippocampal neurogenesis indicating that abstinence-induced depression is associated with structural plasticity in the hippocampus. Overall, the results of this study support the conclusion that profound functional (ie

  6. How many individuals achieve symptom abstinence following psychological treatments for bulimia nervosa? A meta-analytic review.

    PubMed

    Linardon, Jake; Wade, Tracey D

    2018-04-01

    It is unclear how many patients with bulimia nervosa (BN) completely abstain from the core behavioral symptoms after receiving psychological treatment. The present meta-analysis of randomized controlled trials (RCTs) aimed to (a) estimate the prevalence of patients who abstain from binge eating and/or purging following all psychological treatments for BN, and (b) test whether these abstinence estimates are moderated by the type of treatment modality delivered, the definition of abstinence applied, and trial quality. Forty-five RCTs were included, with 78 psychotherapy conditions. Pooled event rates were calculated using random effects models. At post-treatment, the total weighted percentage of treatment-completers who achieved abstinence was 35.4% (95% CI = 29.6, 41.7), while the total weighted percentage of abstinence for all randomized patients (intention-to-treat) was 29.9% (95% CI = 25.7, 33.2). Abstinence estimates were highest in trials that used behavioral-based treatments (e.g., cognitive-behavioral therapy, behavior therapy). There was also evidence that guided self-help interventions produced the lowest post-treatment abstinence rates, but with no difference at follow-up from clinician-led treatments, and studies that used a shorter timeframe for defining abstinence (i.e., 14 days symptom-free compared to 28-days symptom-free) produced the highest abstinence rates. Abstinence estimates at follow-up for both the completer (34.6%; 95% CI = 29.3, 40.2) and intention-to-treat (28.6%; 95% CI = 25.1, 32.3) analyses were essentially the same as the post-treatment estimates. Over 60% of patients fail to fully abstain from core BN symptoms even after receiving our most empirically-supported treatments. The present findings highlight the urgency toward improving the effectiveness of psychological treatments for BN. © 2018 Wiley Periodicals, Inc.

  7. Extended findings of Brain Metabolite Normalization in MA-Dependent Subjects Across Sustained Abstinence: A Proton MRS Study

    PubMed Central

    Salo, Ruth; Buonocore, Michael H.; Leamon, Martin; Natsuaki, Yutaka; Waters, Christy; Moore, Charles D.; Galloway, Gantt P.; Nordahl, Thomas E.

    2010-01-01

    Objective The goal of the present study was to extend our previous findings on long-term methamphetamine (MA) use and drug abstinence on brain metabolite levels in an expanded group of MA-dependent individuals. Methods Seventeen MA abusers with sustained drug abstinence (1 year to 5 years), 30 MA abusers with short-term drug abstinence (1 month to 6 months) and 24 non-substance using controls were studied using MR spectroscopy (MRS). MRS measures of NAA/Cr, Cho/Cr and Cho/NAA were obtained in the anterior cingulate cortex (ACC) and in the primary visual cortex (PVC). Results ACC-Cho/NAA values were abnormally high in the short-term abstinent group compared to controls [F(1,52)=18.76, p<0.0001]. No differences were observed between controls and the long-term abstinent group [F(1,39)=0.97, p=0.97]. New evidence of lower ACC-NAA/Cr levels were observed in the short-term abstinent MA abusers compared to controls [F(1,52)=23.05, p<0.0001] and long-term abstinent MA abusers [F(1,45)=7.06, p=0.01]. No differences were observed between long-term abstinent MA abusers and controls [F(1,39)=0.48, p=0.49]. Conclusions The new findings of relative NAA/Cr normalization across periods of abstinence suggest that adaptive changes following cessation of MA abuse may be broader than initially thought. These changes may contribute to some degree of normalization of neuronal function in the ACC. PMID:20739127

  8. Worth the Wait? The Consequences of Abstinence-Only Sex Education for Marginalized Students

    ERIC Educational Resources Information Center

    Hoefer, Sharon E.; Hoefer, Richard

    2017-01-01

    "Abstinence-only" sex education, which is still widely used across the United States, does not prepare students to engage in healthy adult relationships. Prior research evidence indicates that abstinence-only education is less effective at preventing pregnancy and sexually transmitted infections (STIs) than comprehensive sex education.…

  9. Clinical Trial of Abstinence-Based Vouchers and Cognitive-Behavioral Therapy for Cannabis Dependence

    ERIC Educational Resources Information Center

    Budney, Alan J.; Moore, Brent A.; Rocha, Heath L.; Higgins, Stephen T.

    2006-01-01

    Ninety cannabis-dependent adults seeking treatment were randomly assigned to receive cognitive-behavioral therapy, abstinence-based voucher incentives, or their combination. Treatment duration was 14 weeks, and outcomes were assessed for 12 months post treatment. Findings suggest that (a) abstinence-based vouchers were effective for engendering…

  10. Effects of smoking abstinence on impulsive behavior among smokers high and low in ADHD-like symptoms

    PubMed Central

    Hawk, Larry W.

    2011-01-01

    Rationale Impulsivity, a multifaceted construct that includes inhibitory control and heightened preference for immediate reward, is central to models of drug use and abuse. Within a self-medication framework, abstinence from smoking may lead to an increase in impulsive behavior and the likelihood of relapse, particularly among persons with disorders (e.g., attention-deficit/hyperactivity disorder, ADHD) and personality traits (e.g., impulsivity) linked to impulsive behavior. Objectives This study aimed to examine the effects of smoking abstinence on multiple measures of impulsivity among a non-clinical sample of adult smokers selected for high and low levels of ADHD symptoms. Methods In a within-subjects design, participants selected for high or low levels of self-reported ADHD symptoms (N=56) completed sessions following overnight abstinence and when smoking as usual (order counterbalanced). Measures of impulsive behavior included response inhibition (i.e., stop signal task), interference control (i.e., attentional modification of prepulse inhibition (PPI) of startle), and impulsive choice (i.e., hypothetical delay discounting). Results As hypothesized, abstinence decreased response inhibition and PPI. Although ADHD symptoms moderated abstinence effects on impulsive choice and response inhibition, the pattern was opposite to our predictions: the low-ADHD group responded more impulsively when abstinent, whereas the high-ADHD group was relatively unaffected by abstinence. Conclusions These findings highlight the importance of utilizing multiple laboratory measures to examine a multifactorial construct such as impulsive behavior and raise questions about how best to assess symptoms of ADHD and impulsivity among non-abstinent smokers. PMID:21559802

  11. Drug users in contact with general practice.

    PubMed

    Robertson, J R

    1985-01-05

    A group of heroin users who are in contact with a general practice in north west Edinburgh are described. The study group was younger and included more women than previous studies. These people used a large variety of drugs and mainly purchased them locally. Frequent and often prolonged abstinent periods occurred with no prescribed opiate treatment. The group had experienced a high rate of drug related medical disorders. All these points raise the possibility that opiate users who are known to general practitioners may be a distinctly different population from those who attend drug dependency clinics. The frequency of remission and the prevalence of polydrug use have profound implications for planning and evaluating an effective medical response.

  12. Heterogeneity in pathways to abstinence among women in treatment for alcohol use disorder.

    PubMed

    Holzhauer, Cathryn Glanton; Epstein, Elizabeth E; Cohn, Amy M; McCrady, Barbara S; Graff, Fiona S; Cook, Sharon

    2017-04-01

    Although many providers recommend alcohol abstinence as an initial step in the treatment of alcohol use disorders (AUD), there is a scarcity of research on specific behavioral strategies to achieve this step. The current study examined efficacy of a unique abstinence planning intervention for alcohol in a cognitive behavioral therapy (CBT) outpatient protocol. 128 women enrolled in a randomized controlled trial of CBT for AUD at a university-based clinic comprised the sample. Session 1 manual-guided interventions included an abstinence planning discussion in which each woman chose a specific plan for achieving initial abstinence in collaboration with her therapist. Drinking data were collected via participant logs during the 16week within-treatment period and via Timeline Follow-Back interview at 12month follow-up. For 32.8% (n=42) of women who stopped drinking during the pre-treatment assessment period, their abstinence plan was to maintain abstinence (MA). 18.0% (n=23) of women chose a "cold turkey" approach (CT, abrupt cessation without medical assistance), and 46.1% (n=59) chose a "winding down" approach (WD, systematic reduction of drinking toward a specified quit date). Generalized Estimating Equations (GEE) analyses showed that type of abstinence plan chosen was differentially associated with percent days drinking (PDD) in later treatment (weeks 7-16) (p<0.01) and during 12month follow-up (p<0.01). Women in the WD group had the highest PDD for both time frames and women in the CT group drank more frequently during later treatment compared to those in the MA group. The association between plan and PDD during follow-up was moderated by early treatment PDD (weeks 1-7; p<0.01), such that women in the MA and WD groups had lower follow-up PDD if they were able to decrease their drinking during early treatment. Women who were maintaining abstinence at treatment entry or had planned to stop using alcohol abruptly (i.e., "cold turkey") after starting treatment had

  13. Characterizing Durations of Heroin Abstinence in the California Civil Addict Program: Results From a 33-Year Observational Cohort Study

    PubMed Central

    Nosyk, Bohdan; Anglin, M. Douglas; Brecht, Mary-Lynn; Lima, Viviane Dias; Hser, Yih-Ing

    2013-01-01

    In accordance with the chronic disease model of opioid dependence, cessation is often observed as a longitudinal process rather than a discrete endpoint. We aimed to characterize and identify predictors of periods of heroin abstinence in the natural history of recovery from opioid dependence. Data were collected on participants from California who were enrolled in the Civil Addict Program from 1962 onward by use of a natural history interview. Multivariate regression using proportional hazards frailty models was applied to identify independent predictors and correlates of repeated abstinence episode durations. Among 471 heroin-dependent males, 387 (82.2%) reported 932 abstinence episodes, 60.3% of which lasted at least 1 year. Multivariate analysis revealed several important findings. First, demographic factors such as age and ethnicity did not explain variation in durations of abstinence episodes. However, employment and lower drug use severity predicted longer episodes. Second, abstinence durations were longer following sustained treatment versus incarceration. Third, individuals with multiple abstinence episodes remained abstinent for longer durations in successive episodes. Finally, abstinence episodes initiated >10 and ≤20 years after first use lasted longer than others. Public policy facilitating engagement of opioid-dependent individuals in maintenance-oriented drug treatment and employment is recommended to achieve and sustain opioid abstinence. PMID:23445901

  14. Factors influencing abstinence, anticipation, and delay of sex among adolescent boys in high-sexually transmitted infection prevalence communities.

    PubMed

    Cummings, Teresa; Auerswald, Colette L; Ott, Mary A

    2014-05-01

    Abstinence is a core pregnancy and sexually transmitted infection (STI) prevention strategy. We explore the attitudinal, behavioral, and family contexts relating to abstinence and the decision to delay sex among adolescent boys. Adolescent boys ages 14-17 years were recruited from community sites using a venue-based sampling method. All eligible boys at venues were invited to participate in an electronic survey. Question items included sexual behaviors, attitudes related to sex, relationships, masculine values, and family contextual items. We enrolled 667 participants, mean age 15.7 years, of diverse ethnicity. A total of 252 were abstinent (38%). Abstinent participants were younger and less likely to report non-coital behaviors, and reported lower conventional masculine values. Among abstinent participants, 62% planned to delay sex, whereas 38% anticipated sex in the next year. Participants with lower conventional masculine values and more religious or moral motivations for abstinence were more likely to plan to delay sex. Abstinence among boys is common, even in high-STI risk communities. For these boys, abstinence appears to be a complex behavioral decision influenced by demographic, behavioral, attitudinal, and contextual factors such as age, race, non-coital sexual behaviors, and masculine values. Understanding the attitudes and contexts of abstinence, including plans to delay sex, can inform the development of public health programs for early fatherhood and STI prevention. Copyright © 2014 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.

  15. Family Dynamics May Influence an Individual’s Substance Use Abstinence Self-Efficacy

    PubMed Central

    Ram, Daphna; Whipple, Christopher R.; Jason, Leonard A.

    2017-01-01

    Background Previous work on substance use suggests the influence of family dynamics on emotion regulation. Objective The present study examined the role of family in substance use recovery. It is of importance to examine whether conflict with various family members influences an individual’s abstinence self-efficacy. Methods We examined individual abstinence self-efficacy scores and lifetime conflict with mother, father, and siblings in a sample of 200 women who had been justice involved. Results We found that conflict with mother was the best predictor of abstinence self-efficacy compared to conflict with father and conflict with siblings. Individuals who indicated having conflict with mother over their lifetime had lower confidence that they could abstain from use in potentially emotionally triggering situations. Conclusions/Importance These findings suggest that family dynamics, specifically lifetime conflict with mother, do play a role in an individual’s confidence to regulate emotions in high-risk relapse situations without turning to substances. Limitations include using abstinence self-efficacy as a proxy for emotion regulation and not directly measuring emotion regulation. Examining family relationships may be especially important in the treatment of women in recovery from substance use. PMID:28868520

  16. A Randomized Trial of Long-Term Reinforcement of Cocaine Abstinence in Methadone-Maintained Patients Who Inject Drugs

    ERIC Educational Resources Information Center

    Silverman, Kenneth; Robles, Elias; Mudric, Timothy; Bigelow, George E.; Stitzer, Maxine L.

    2004-01-01

    This study determined whether long-term abstinence reinforcement could maintain cocaine abstinence throughout a yearlong period. Patients who injected drugs and used cocaine during methadone treatment (n = 78) were randomly assigned to 1 of 2 abstinence-reinforcement groups or to a usual care control group. Participants in the 2…

  17. An overview of clinical tools used to assess neonatal abstinence syndrome.

    PubMed

    Orlando, Susan

    2014-01-01

    Several clinical tools have been developed to quantify the severity of withdrawal signs and symptoms exhibited by infants born to substance-using mothers. Scores from the systematic assessments are used to guide treatment of infants with moderate to severe clinical signs. This article provides an overview of published assessment tools developed for infants with neonatal abstinence syndrome. Nurses caring for infants at risk for neonatal abstinence syndrome should be knowledgeable about the tools used to evaluate these infants and guide their treatment. The ideal assessment tool should be published and include item definitions and a protocol for administering the tool. Nurses need education and training to achieve competency and interobserver reliability in the use of a selected tool. Tool-specific materials should be used to standardize training and improve accuracy in assessments. Competent and knowledgeable nurses play a critical role in improving outcomes for infants with neonatal abstinence syndrome.

  18. Weighing the Evidence: A Systematic Review on Long-Term Neurocognitive Effects of Cannabis Use in Abstinent Adolescents and Adults.

    PubMed

    Ganzer, Florian; Bröning, Sonja; Kraft, Stefanie; Sack, Peter-Michael; Thomasius, Rainer

    2016-06-01

    Findings on neurocognitive effects of sustained cannabis use are heterogeneous. Previous work has rarely taken time of abstinence into account. In this review, we focus on understanding sustained effects of cannabis, which begin when clinical symptoms of the drug have worn off after at least 14 days. We conducted a search between 2004 and 2015 and found 38 studies with such a prolonged abstinence phase. Study-design quality in terms of evidence-based medicine is similar among studies. Studies found some attention or concentration deficits in cannabis users (CU). There is evidence that chronic CU might experience sustained deficits in memory function. Findings are mixed regarding impairments in inhibition, impulsivity and decision making for CU, but there is a trend towards worse performance. Three out of four studies found evidence that motor function remains impaired even after a time of abstinence, while no impairments in visual spatial functioning can be concluded. Functional imaging demonstrates clear differences in activation patterns between CU and controls especially in hippocampal, prefrontal and cerebellar areas. Structural differences are found in cortical areas, especially the orbitofrontal region and the hippocampus. Twenty studies (57 %) reported data on outcome effects, leading to an overall effect size of r mean = .378 (CI 95 % = [.342; .453]). Heavy use is found to be more consistently associated with effects in diverse domains than early age of onset. Questions of causality-in view of scarce longitudinal studies, especially those targeting co-occurring psychiatric disorders-are discussed.

  19. Perioperative abstinence from cigarettes: physiologic and clinical consequences.

    PubMed

    Warner, David O

    2006-02-01

    Chronic exposure to cigarette smoke produces profound changes in physiology that may alter responses to perioperative interventions and contribute to perioperative morbidity. Because of smoke-free policies in healthcare facilities, all smokers undergoing surgery are abstinent from cigarettes for at least some period of time so that all are in various stages of recovery from the effects of smoke. Understanding this recovery process will help perioperative physicians better treat these patients. This review examines current knowledge regarding how both short-term (duration ranging from hours to weeks) and long-term smoking cessation affects selected physiology and pathophysiology of particular relevance to perioperative outcomes and how these changes affect perioperative risk. It will also consider current evidence regarding how nicotine replacement therapy, a valuable adjunct to help patients maintain abstinence, may affect perioperative physiology.

  20. Trajectories of abstinence-induced Internet gaming withdrawal symptoms: A prospective pilot study.

    PubMed

    Kaptsis, Dean; King, Daniel L; Delfabbro, Paul H; Gradisar, Michael

    2016-12-01

    Internet Gaming Disorder (IGD) is positioned in the appendix of the DSM-5 as a condition requiring further study. The IGD criteria refer to withdrawal symptoms, including irritability, anxiety, or sadness, that follow cessation of Internet gaming (APA, 2013). The aim of this study was to prospectively examine the nature of Internet gaming withdrawal symptoms, if they occur, under gaming abstinence conditions. This study employed a repeated-measures protocol to examine the cognitive-affective reactions of participants undertaking an 84-h Internet gaming abstinence period. The sample included individuals who met the IGD criteria as well as those who regularly played Internet games but did not meet the IGD criteria. Outcome variables included affect (positive and negative), psychological distress (depression, anxiety, stress), and Internet gaming withdrawal symptoms (craving/urge, thoughts about gaming, inability to resist gaming). A total of 24 participants ( M age  = 24.6 years, SD  = 5.8) were recruited from online gaming communities, and completed a series of online surveys before, during, and after abstaining from Massively Multiplayer Online (MMO) games. Both the IGD group and the non-IGD group experienced an abstinence-induced decline in withdrawal symptomatology, negative affect, and psychological distress. The IGD group experienced its largest decline in withdrawal symptomatology within the first 24 h of abstinence. These preliminary data suggest that gaming withdrawal symptoms may follow, at least initially, negative linear and quadratic trends. Further prospective work in larger samples involving longer periods of abstinence is required to verify and expand upon these observations.

  1. Adolescent heavy drinkers' amplified brain responses to alcohol cues decrease over one month of abstinence.

    PubMed

    Brumback, Ty; Squeglia, Lindsay M; Jacobus, Joanna; Pulido, Carmen; Tapert, Susan F; Brown, Sandra A

    2015-07-01

    alcohol use diagnosis. Across the majority of these brain regions, differences in BOLD response were no longer apparent following a month of abstinence, suggesting a decrease in alcohol cue reactivity among adolescent non-dependent heavy drinkers as a consequence of abstaining from alcohol. These results highlight the malleability of adolescent brain function despite no formal intervention targeting cue reactivity. Increased understanding of the neural underpinnings of cue reactivity could have implications for prevention and intervention strategies in adolescent heavy alcohol users. Copyright © 2015 Elsevier Ltd. All rights reserved.

  2. Understanding Motivations for Abstinence among Adolescent Young Women: Insights into Effective Sexual Risk Reduction Strategies

    PubMed Central

    Long-Middleton, Ellen R.; Burke, Pamela J.; Lawrence, Cheryl A. Cahill; Blanchard, Lauren B.; Amudala, Naomi H.; Rankin, Sally H.

    2012-01-01

    Introduction Pregnancy and sexually transmitted infections pose a significant threat to the health and wellbeing of adolescent young women. Abstinence when practiced provides the most effective means in preventing these problems, yet the perspective of abstinent young women is not well understood. The purpose of the investigation was to characterize female adolescents’ motivations for abstinence. Method As part of a larger, cross-sectional quantitative study investigating predictors of HIV risk reduction behaviors, qualitative responses from study participants who never had intercourse were analyzed in a consensus-based process using content analysis and frequency counts. An urban primary care site in a tertiary care center served as the setting, with adolescent young women ages 15–19 years included in the sample. Results Five broad topic categories emerged from the data that characterized motivations for abstinence in this sample: 1) Personal Readiness, 2) Fear, 3) Beliefs and Values, 4) Partner Worthiness and 5) Lack of Opportunity. Discussion A better understanding of the motivations for abstinence may serve to guide the development of interventions to delay intercourse. PMID:22525893

  3. Negative affect subtypes and craving differentially predict long-term cessation success among smokers achieving initial abstinence.

    PubMed

    Zuo, Yantao; Rabinovich, Norka E; Gilbert, David G

    2017-03-01

    This study aimed to examine the associations of individual trajectories of three types of negative affect (NA: anxiety, depression, and anger) and craving during a 44-day period of incentivized smoking abstinence period with cessation outcome at 3 months and at 1 year. Adult smokers (N = 140) completed questionnaire assessments of NA and craving during pre-quit baseline sessions and 15 postquit sessions over the 45 days of biochemically verified abstinence while on nicotine or placebo patch treatment. Growth curve and logistic regression analyses were used to examine the associations of trajectory parameters of the individual NA states and craving with the abstinence outcomes at 3 months and 1 year postquit. Greater declines in anxiety, depression, and anger symptoms over the first 44 days of smoking cessation were predictive of higher odds of abstinence at both 3 months and 1 year. Moreover, the greater declines in anxiety and anger remained as significant predictors of abstinence at both time points, independent of the predictive ability of the trajectory profiles of craving. The findings suggest that slower dissipation of NA, especially anxiety and anger, represents a greater risk for relapse to smoking beyond that predicted by craving during early abstinence. Thus, temporal profiles of the affective symptoms convey unique motivational significance in relapse. Reduction in NA during early abstinence may be a valid target for interventions to increase long-term cessation success rates particularly among individuals with refractory affective symptoms.

  4. Mediation and moderation of an efficacious theory-based abstinence-only intervention for African American adolescents.

    PubMed

    Zhang, Jingwen; Jemmott, John B; Jemmott, Loretta Sweet

    2015-12-01

    This secondary data analysis sought to determine what mediated reductions in self-reported sexual initiation over the 24-month postintervention period in early adolescents who received "Promoting Health among Teens," a theory-based, abstinence-only intervention (Jemmott, Jemmott, & Fong, 2010). African American Grade 6 and 7 students at inner-city public middle schools were randomized to 1 of 5 interventions grounded in social-cognitive theory and the theory of reasoned action: 8-hr abstinence-only targeting reduced sexual intercourse; 8-hr safer-sex-only targeting increased condom use; 8-hr and 12-hr comprehensive interventions targeting sexual intercourse and condom use; 8-hr control intervention targeting physical activity and diet. Primary outcome was self-report of vaginal intercourse by 24 months postintervention. Potential mediators, assessed immediately postintervention, were theory-of-reasoned-action variables, including behavioral beliefs about positive consequences of abstinence and negative consequences of sex, intention to have sex, normative beliefs about sex, and HIV and sexually transmitted infection (STI) knowledge. We tested single and serial mediation models using the product-of-coefficients approach. Of 509 students reporting never having vaginal intercourse at baseline (324 girls and 185 boys; mean age = 11.8 years, SD = 0.8), 500 or 98.2% were included in serial mediation analyses. Consistent with the theory of reasoned action, the abstinence-only intervention increased positive behavioral beliefs about abstinence, which reduced intention to have sex, which in turn reduced sexual initiation. Negative behavioral beliefs about sex, normative beliefs about sex, and HIV/STI knowledge were not mediators. Abstinence-only interventions should stress the gains to be realized from abstinence rather than the deleterious consequences of sexual involvement. (c) 2015 APA, all rights reserved).

  5. Autobiographical Memory Deficits in Alcohol-Dependent Patients with Short- and Long-Term Abstinence.

    PubMed

    Nandrino, Jean-Louis; El Haj, Mohamad; Torre, Julie; Naye, Delphine; Douchet, Helyette; Danel, Thierry; Cottençin, Oliver

    2016-04-01

    Autobiographical memory (AM) enables the storage and retrieval of life experiences that allow individuals to build their sense of identity. Several AM impairments have been described in patients with alcohol abuse disorders without assessing whether such deficits can be recovered. This cross-sectional study aimed to identify whether the semantic (SAM) and episodic (EAM) dimensions of AM are affected in individuals with alcohol dependence after short-term abstinence (STA) or long-term abstinence (LTA). A second aim of this study was to examine the factors that could disrupt the efficiency of semantic and episodic AM (the impact of depression severity, cognitive functions, recent or early traumatic events, and drinking history variables). After clinical and cognitive evaluations (alcohol consumption, depression, anxiety, IQ, memory performance), AM was assessed with the Autobiographical Memory Interview in patients with recent (between 4 and 6 weeks) and longer (at least 6 months) abstinence. Participants were asked to retrieve the number and nature of traumatic or painful life experiences in recent or early life periods (using the Childhood Traumatic Events Scale). The 2 abstinent groups had lower global EAM and SAM scores than the control group. These scores were comparable for both abstinent groups. For childhood events, no significant differences were observed in SAM for both groups compared with control participants. For early adulthood and recent events, both STA and LTA groups had lower scores on both SAM and EAM. Moreover, there was a negative correlation between the length of substance consumption and SAM scores. This study highlighted a specific AM disorder in both episodic and semantic dimensions. These deficits remained after 6 months of abstinence. This AM impairment may be explained by compromised encoding and consolidation of memories during bouts of drinking. Copyright © 2016 by the Research Society on Alcoholism.

  6. Psychological Symptoms are Associated with Both Abstinence and Risky Sex among Men with HIV

    PubMed Central

    Miller, Carol T.; Solomon, Sondra E.; Bunn, Janice Y.; Varni, Susan E.; Hodge, James J.

    2015-01-01

    Sexual abstinence is often deemed the “safest behavior” in HIV prevention, but is sometimes associated with psychological symptoms (e.g., depression) just as sexually risky behavior is. This study explored whether sexual abstinence and risky sexual behavior among men with HIV are associated with similar constellations of psychological symptoms. Prior research has not addressed this issue because abstinent people often are not included in the sample, or when data are analyzed, researchers combine abstinent people with sexually active people who practice safer sex. Past research also neglects the co-morbidity of psychological symptoms. A latent class analysis of the psychological symptoms (assessed with the Symptom Check List 90-R; Derogatis, 1994) of 140 men with HIV, mostly from rural New England, revealed three latent classes; men who were asymptomatic on all symptom domains (28.8%), men who were symptomatic on all domains (34.1%), and men who were symptomatic on internalizing domains (37.1%), but were asymptomatic on the externalizing symptoms of hostility and paranoid ideation. Logistic regression showed that sexual behavior during the past 90 days of men in the all symptom class and the internalizing symptoms class was similar, with abstinence and risky sex predominating, and safer sex being relatively uncommon for both classes. The sexual behavior of men in the asymptomatic class differed, with safer sex being relatively more likely to occur compared to the symptomatic classes. These findings suggest that the psychological symptom profile of sexually abstinent people places them at risk for inconsistent condom use should they engage in sexual behavior. PMID:25614050

  7. Internet-based group contingency management to promote abstinence from cigarette smoking: A feasibility study

    PubMed Central

    Meredith, Steven E.; Grabinski, Michael J.; Dallery, Jesse

    2011-01-01

    Background In contingency management (CM) interventions, monetary consequences are contingent on evidence of drug abstinence. Typically, these consequences are contingent on individual performance. Consequences contingent on group performance may promote social support (e.g., praise). Methods Thus, to combine social support with the monetary incentives of CM, we integrated independent and interdependent group contingencies of reinforcement into an Internet-based intervention to promote smoking abstinence. Breath carbon monoxide (CO) measures were compared between treatment conditions and a baseline control condition. Thirteen participants were divided into 5 groups or “teams” (n = 2–3 per team). Each participant submitted video recordings of CO measurement twice daily via the Internet. Teammates could monitor each other’s progress and communicate with one another through an online peer support forum. During a 4-day tapering condition, vouchers exchangeable for goods were contingent on gradual reductions in breath CO. During a 10-day abstinence induction condition, vouchers were contingent on abstinence (CO ≤4 ppm). In both treatment conditions, concurrent independent and interdependent group contingencies were arranged (i.e., a mixed contingency arrangement). Results Less than 1% of CO samples submitted during baseline were ≤4 ppm, compared to 57% submitted during abstinence induction. Sixty-five percent of participants’ comments on the online peer support forum were rated as positive by independent observers. Participants rated the intervention favorably on a treatment acceptability questionnaire. Conclusion The results suggest that the intervention is feasible and acceptable for promoting abstinence from cigarette smoking. PMID:21414733

  8. Abstinence from prolonged ethanol exposure affects plasma corticosterone, glucocorticoid receptor signaling and stress-related behaviors.

    PubMed

    Somkuwar, Sucharita S; Vendruscolo, Leandro F; Fannon, McKenzie J; Schmeichel, Brooke E; Nguyen, Tran Bao; Guevara, Jasmin; Sidhu, Harpreet; Contet, Candice; Zorrilla, Eric P; Mandyam, Chitra D

    2017-10-01

    Alcohol dependence is linked to dysregulation of the hypothalamic-pituitary-adrenal axis. Here, we investigated effects of repeated ethanol intoxication-withdrawal cycles (using chronic intermittent ethanol vapor inhalation; CIE) and abstinence from CIE on peak and nadir plasma corticosterone (CORT) levels. Irritability- and anxiety-like behaviors as well as glucocorticoid receptors (GR) in the medial prefrontal cortex (mPFC) were assessed at various intervals (2h-28d) after cessation of CIE. Results show that peak CORT increased during CIE, transiently decreased during early abstinence (1-11d), and returned to pre-abstinence levels during protracted abstinence (17-27d). Acute withdrawal from CIE enhanced aggression- and anxiety-like behaviors. Early abstinence from CIE reduced anxiety-like behavior. mPFC-GR signaling (indexed by relative phosphorylation of GR at Ser211) was transiently decreased when measured at time points during early and protracted abstinence. Further, voluntary ethanol drinking in CIE (CIE-ED) and CIE-naïve (ED) rats, and effects of CIE-ED and ED on peak CORT levels and mPFC-GR were investigated during acute withdrawal (8h) and protracted abstinence (28d). CIE-ED and ED increased peak CORT during drinking. CIE-ED and ED decreased expression and signaling of mPFC-GR during acute withdrawal, an effect that was reversed by systemic mifepristone treatment. CIE-ED and ED demonstrate robust reinstatement of ethanol seeking during protracted abstinence and show increases in mPFC-GR expression. Collectively, the data demonstrate that acute withdrawal from CIE produces robust alterations in GR signaling, CORT and negative affect symptoms which could facilitate excessive drinking. The findings also show that CIE-ED and ED demonstrate enhanced relapse vulnerability triggered by ethanol cues and these changes are partially mediated by altered GR expression in the mPFC. Taken together, transition to alcohol dependence could be accompanied by alterations

  9. The effects of cannabidiol on impulsivity and memory during abstinence in cigarette dependent smokers.

    PubMed

    Hindocha, C; Freeman, T P; Grabski, M; Crudgington, H; Davies, A C; Stroud, J B; Das, R K; Lawn, W; Morgan, C J A; Curran, H V

    2018-05-15

    Acute nicotine abstinence in cigarette smokers results in deficits in performance on specific cognitive processes, including working memory and impulsivity which are important in relapse. Cannabidiol (CBD), the non-intoxicating cannabinoid found in cannabis, has shown pro-cognitive effects and preliminary evidence has indicated it can reduce the number of cigarettes smoked in dependent smokers. However, the effects of CBD on cognition have never been tested during acute nicotine withdrawal. The present study therefore aimed to investigate if CBD can improve memory and reduce impulsivity during acute tobacco abstinence. Thirty, non-treatment seeking, dependent, cigarette smokers attended two laboratory-based sessions after overnight abstinence, in which they received either 800 mg oral CBD or placebo (PBO), in a randomised order. Abstinence was biologically verified. Participants were assessed on go/no-go, delay discounting, prose recall and N-back (0-back, 1-back, 2-back) tasks. The effects of CBD on delay discounting, prose recall and the N-back (correct responses, maintenance or manipulation) were null, confirmed by a Bayesian analysis, which found evidence for the null hypothesis. Contrary to our predictions, CBD increased commission errors on the go/no-go task. In conclusion, a single 800 mg dose of CBD does not improve verbal or spatial working memory, or impulsivity during tobacco abstinence.

  10. Messages About Abstinence, Delaying Sexual Debut and Sexual Decision-Making in Conversations Between Mothers and Young Adolescents.

    PubMed

    Ramchandani, Kanika; Morrison, Penelope; Gold, Melanie A; Akers, Aletha Y

    2018-04-01

    Little is known about the information shared during family discussions about sexuality. From a public health perspective, abstinence is one of the most important sexuality topics parents can talk about with adolescents. We sought to characterize the messages mothers communicate to young adolescents regarding abstinence. Content analysis of dyadic discussions that occurred between June 2011-December 2012 between mothers and their 10- to 14-year-old adolescent sons and daughters. Discussions were audio-recorded, transcribed, and a grounded theory approach to content analysis performed. Urban city in Western Pennsylvania. Twenty-one dyads; 15 mother-daughter dyads and 6 mother-son dyads. None. None. Four key themes emerged reflecting the high priority mothers placed on abstinence, delaying their adolescent's sexual debut, and nurturing sexual decision-making skills. Theme 1 focused on ensuring that adolescents understand what abstinence means. In defining abstinence, only 1 mother explained what sex is. The 3 remaining themes emphasized sexual decision-making and emphasized when it is acceptable to stop being abstinent (theme 2), why abstinence is important (theme 3), and mothers' desire to engage in ongoing discussions, particularly when an adolescent was considering becoming sexually active (theme 4). Messages did not vary according to mothers' age or according to adolescent age, gender, or race. Mothers convey complex information about abstinence and sexual decision-making to young, non-sexually active adolescents. Message tailoring on the basis of the adolescents' age or sex was not observed. Copyright © 2017 North American Society for Pediatric and Adolescent Gynecology. Published by Elsevier Inc. All rights reserved.

  11. Attentional dysfunction in abstinent long-term cannabis users with and without schizophrenia.

    PubMed

    Rentzsch, Johannes; Stadtmann, Ada; Montag, Christiane; Kunte, Hagen; Plöckl, Doris; Hellweg, Rainer; Gallinat, Jürgen; Kronenberg, Golo; Jockers-Scherübl, Maria Christiane

    2016-08-01

    Long-term cannabis use may confer cognitive deficits and increased risk of psychosis. However, the relationship between cannabis use and schizophrenia is complex. In particular, little is known about the effects of chronic cannabis use on the attention-related electric brain response in schizophrenia. We investigated auditory novelty and oddball P300 evoked potentials in a mixed sample of first-episode and chronic schizophrenic patients and healthy controls with (SZCA, n = 20; COCA, n = 20, abstinence ≥28 days) or without (SZ, n = 20; CO, n = 20) chronic cannabis use. Duration of regular cannabis use was 8.3 ± 5.6 (SZCA) and 9.1 ± 7.1 (COCA) years. In general, schizophrenic patients showed reduced P300 amplitudes. Cannabis use was associated with both a reduced early and late left-hemispheric novelty P300. There was a significant 'diagnosis × cannabis' interaction for the left-hemispheric late novelty P300 in that cannabis use was associated with a reduced amplitude in the otherwise healthy but not in the schizophrenic group compared with their relative control groups (corrected p < 0.02; p > 0.9, respectively). The left-hemispheric late novelty P300 in the otherwise healthy cannabis group correlated inversely with amount and duration of cannabis use (r = -0.50, p = 0.024; r = -0.57, p = 0.009, respectively). Our study confirms attentional deficits with chronic cannabis use. However, cannabis use may lead to different cognitive sequelae in patients with schizophrenia and in healthy controls, possibly reflecting preexisting alterations in the endocannabinoid system in schizophrenia.

  12. Effects of Sustained Abstinence Among Treated Substance-Abusing Homeless Persons on Housing and Employment

    PubMed Central

    Schumacher, Joseph E.; Wallace, Dennis; Vuchinich, Rudy; Mennemeyer, Stephen T.; Kertesz, Stefan G.

    2010-01-01

    Objectives. We examined whether cocaine-dependent homeless persons had stable housing and were employed 6, 12, and 18 months after they entered a randomized controlled trial comparing 2 treatments. Methods. One group (n = 103) received abstinence-contingent housing, vocational training, and work; another group (n = 103) received the same intervention plus cognitive behavioral day treatment. We examined baseline and early treatment variables for association with long-term housing and employment. Results. Although the enhanced-treatment group achieved better abstinence rates, the groups did not differ in long-term housing and employment stability. However, consecutive weeks of abstinence during treatment (and to a lesser extent, older age and male gender) predicted long-term housing and employment stability after adjustment for baseline differences in employment, housing, and treatment. Conclusions. Our data showed a relationship of abstinence with housing stability. Contrasting these results with the increasingly popular Housing First interventions reveals important gaps in our knowledge to be addressed in future research. PMID:19833998

  13. Effects of extended cannabis abstinence on clinical symptoms in cannabis dependent schizophrenia patients versus non-psychiatric controls.

    PubMed

    Rabin, Rachel A; Kozak, Karolina; Zakzanis, Konstantine K; Remington, Gary; George, Tony P

    2018-04-01

    Rates of cannabis use among patients with schizophrenia are high, however little is understood about clinical effects of continued cannabis use and cessation after illness onset. Therefore, we investigated the effects of 28-days of cannabis abstinence on psychotic and depressive symptomatology in cannabis dependent patients with schizophrenia. Males with cannabis dependence and co-morbid schizophrenia (n=19) and non-psychiatric controls (n=20) underwent 28-days of monitored cannabis abstinence. Clinical symptoms were assessed at baseline and then weekly. Abstinence was encouraged using weekly therapy sessions and contingency reinforcement, confirmed by twice-weekly urine assays. Forty-two percent (8/19) of patients and 55% (11/20) of controls achieved 28-days of sustained cannabis abstinence. In patients, PANSS subscores did not change over time irrespective of abstinence status. In contrast, patient abstainers demonstrated a more pronounced reduction in depression scores compared to non-abstainers, however, the Abstinence Status x Time interaction was non-significant. Short-term (28-days) cannabis abstinence is not associated with improvement in psychotic symptoms, but may be associated with improvement in depressive symptomatology in patients with schizophrenia. Future studies employing larger samples as well as a continuous cannabis-using group may help to better characterize the causal effects of cannabis on symptom outcomes in this disorder. Copyright © 2017 Elsevier B.V. All rights reserved.

  14. Mortality risks in alcoholism and effects of abstinence and addiction treatment.

    PubMed

    Miller, N S

    1999-06-01

    The mortality rate from alcoholism and related comorbidities is high. Studies show multiple causes of premature death from alcoholism. Several studies showed that abstinence had a positive effective on the overall survival of alcoholics. Alcoholics who abstained from alcohol, particularly continuously, showed reduced mortality rates and increased years of longevity than alcoholics who relapsed to alcohol consumption. The sources of the findings tend to be derived from treatment populations, in which abstinence is expected to occur in higher rates than in the general population.

  15. Modeling naturalistic craving, withdrawal, and affect during early nicotine abstinence: A pilot ecological momentary assessment study.

    PubMed

    Bujarski, Spencer; Roche, Daniel J O; Sheets, Erin S; Krull, Jennifer L; Guzman, Iris; Ray, Lara A

    2015-04-01

    Despite the critical role of withdrawal, craving, and positive affect (PA) and negative affect (NA) in smoking relapse, relatively little is known about the temporal and predictive relationship between these constructs within the first day of abstinence. This pilot study aims to characterize dynamic changes in withdrawal, craving, and affect over the course of early abstinence using ecological momentary assessment. Beginning immediately after smoking, moderate and heavy smoking participants (n = 15 per group) responded to hourly surveys assessing craving, withdrawal, NA, and PA. Univariate and multivariate multilevel random coefficient modeling was used to describe the progression of craving, withdrawal/NA, and PA and to test correlations between these constructs at the subject level over the course of early abstinence. Heavy smokers reported greater craving from 1-4 hr of abstinence and greater withdrawal/NA after 3 or more hours as compared with moderate smokers. Level of withdrawal/NA was strongly positively associated with craving, and PA was negatively correlated with craving; however, the temporal dynamics of these correlations differed substantially. The association between withdrawal/NA and craving decreased over early abstinence, whereas the reverse was observed for PA. These findings can inform experimental studies of nicotine abstinence as well as their clinical applications to smoking cessation efforts. In particular, these results help to elucidate the role of PA in nicotine abstinence by demonstrating its independent association with nicotine craving over and above withdrawal/NA. If supported by future studies, these findings can refine experimental methods and clinical approaches for smoking cessation. (c) 2015 APA, all rights reserved).

  16. Sustained Smoking Abstinence is Associated with Reductions in Smoking-Specific Experiential Avoidance Among Treatment-seeking Smokers

    PubMed Central

    Farris, Samantha G.; DiBello, Angelo M.; Heggeness, Luke F.; Reitzel, Lorraine R.; Vidrine, Damon J.; Schmidt, Norman B.; Zvolensky, Michael J.

    2016-01-01

    Background and Objectives Smoking-specific experiential avoidance is related to the maintenance of cigarette smoking. However, it is unclear whether sustained smoking abstinence is associated with subsequent reductions in smoking-specific experiential avoidance. Methods Daily smokers (n = 149) underwent a cessation attempt in the context of a 4-session smoking cessation treatment trial. Participants provided biochemical verification of smoking status at 1 week, 2 weeks, and 1 Month post-quit day. Smoking-specific experiential avoidance was assessed per the Avoidance and Inflexibility Scale (AIS) – the total score and two factor scores were examined at 1 Month post-quit day as a function of abstinence status. Two path models were conducted and included participant sex, treatment condition, and precessation nicotine dependence, smoking-specific experiential avoidance, and presence of emotional disorders as covariates. Results After adjusting for covariates, sustained smoking abstinence was associated with a reduction in the AIS total score at Month 1 post-quit (β = −.45, p < .001). Sustained smoking abstinence was associated with reductions across both facets of experiential avoidance -- smoking-related thoughts and feelings (β = −.44, p < .001) and internal bodily sensations (β = −.41, p < .001). Limitations Biochemical verification of smoking status was confirmed only at three time points post-quit day, and continued abstinence throughout the one-month post-quitting period is not fully known. Conclusions Sustained smoking abstinence may contribute to reductions in smoking-specific experiential avoidance. Findings contribute to the research documenting the relevance of experiential avoidance in various processes of smoking (including smoking abstinence). PMID:26773342

  17. Large-Scale Brain Network Coupling Predicts Acute Nicotine Abstinence Effects on Craving and Cognitive Function

    PubMed Central

    Lerman, Caryn; Gu, Hong; Loughead, James; Ruparel, Kosha; Yang, Yihong; Stein, Elliot A.

    2014-01-01

    IMPORTANCE Interactions of large-scale brain networks may underlie cognitive dysfunctions in psychiatric and addictive disorders. OBJECTIVES To test the hypothesis that the strength of coupling among 3 large-scale brain networks–salience, executive control, and default mode–will reflect the state of nicotine withdrawal (vs smoking satiety) and will predict abstinence-induced craving and cognitive deficits and to develop a resource allocation index (RAI) that reflects the combined strength of interactions among the 3 large-scale networks. DESIGN, SETTING, AND PARTICIPANTS A within-subject functional magnetic resonance imaging study in an academic medical center compared resting-state functional connectivity coherence strength after 24 hours of abstinence and after smoking satiety. We examined the relationship of abstinence-induced changes in the RAI with alterations in subjective, behavioral, and neural functions. We included 37 healthy smoking volunteers, aged 19 to 61 years, for analyses. INTERVENTIONS Twenty-four hours of abstinence vs smoking satiety. MAIN OUTCOMES AND MEASURES Inter-network connectivity strength (primary) and the relationship with subjective, behavioral, and neural measures of nicotine withdrawal during abstinence vs smoking satiety states (secondary). RESULTS The RAI was significantly lower in the abstinent compared with the smoking satiety states (left RAI, P = .002; right RAI, P = .04), suggesting weaker inhibition between the default mode and salience networks. Weaker inter-network connectivity (reduced RAI) predicted abstinence-induced cravings to smoke (r = −0.59; P = .007) and less suppression of default mode activity during performance of a subsequent working memory task (ventromedial prefrontal cortex, r = −0.66, P = .003; posterior cingulate cortex, r = −0.65, P = .001). CONCLUSIONS AND RELEVANCE Alterations in coupling of the salience and default mode networks and the inability to disengage from the default mode network may

  18. Mediation and Moderation of an Efficacious Theory-Based Abstinence-Only Intervention for African American Adolescents

    PubMed Central

    Zhang, Jingwen; Jemmott, John B.; Jemmott, Loretta Sweet

    2018-01-01

    Objective This secondary data analysis sought to determine what mediated reductions in self-reported sexual initiation over the 24-month post-intervention period in early adolescents who received “Promoting Health among Teens,” a theory-based, abstinence-only intervention (Jemmott, Jemmott, & Fong, 2010). Methods African American grade 6 and 7 students at inner-city public middle schools were randomized to one of five interventions grounded in social cognitive theory and the theory of reasoned action: 8-hour abstinence-only targeting reduced sexual intercourse; 8-hour safer-sex-only targeting increased condom use; 8-hour and 12-hour comprehensive interventions targeting sexual intercourse and condom use; 8-hour control intervention targeting physical activity and diet. Primary outcome was self-report of vaginal intercourse by 24 months post-intervention. Potential mediators, assessed immediately post-intervention, were theory-of-reasoned-action variables, including behavioral beliefs about positive consequences of abstinence and negative consequences of sex, intention to have sex, normative beliefs about sex, and HIV/STI knowledge. We tested single and serial mediation models using the product-of-coefficients approach. Results Of 509 students reporting never having vaginal intercourse at baseline (324 girls and 185 boys; mean age = 11.8 years; SD = 0.8), 500 or 98.2% were included in serial mediation analyses. Consistent with the theory of reasoned action, the abstinence-only intervention increased positive behavioral beliefs about abstinence, which reduced intention to have sex, which in turn reduced sexual initiation. Negative behavioral beliefs about sex, normative beliefs about sex, and HIV/STI knowledge were not mediators. Conclusions Abstinence-only interventions should stress the gains to be realized from abstinence rather than the deleterious consequences of sexual involvement. PMID:26214076

  19. Large-scale brain network coupling predicts acute nicotine abstinence effects on craving and cognitive function.

    PubMed

    Lerman, Caryn; Gu, Hong; Loughead, James; Ruparel, Kosha; Yang, Yihong; Stein, Elliot A

    2014-05-01

    Interactions of large-scale brain networks may underlie cognitive dysfunctions in psychiatric and addictive disorders. To test the hypothesis that the strength of coupling among 3 large-scale brain networks--salience, executive control, and default mode--will reflect the state of nicotine withdrawal (vs smoking satiety) and will predict abstinence-induced craving and cognitive deficits and to develop a resource allocation index (RAI) that reflects the combined strength of interactions among the 3 large-scale networks. A within-subject functional magnetic resonance imaging study in an academic medical center compared resting-state functional connectivity coherence strength after 24 hours of abstinence and after smoking satiety. We examined the relationship of abstinence-induced changes in the RAI with alterations in subjective, behavioral, and neural functions. We included 37 healthy smoking volunteers, aged 19 to 61 years, for analyses. Twenty-four hours of abstinence vs smoking satiety. Inter-network connectivity strength (primary) and the relationship with subjective, behavioral, and neural measures of nicotine withdrawal during abstinence vs smoking satiety states (secondary). The RAI was significantly lower in the abstinent compared with the smoking satiety states (left RAI, P = .002; right RAI, P = .04), suggesting weaker inhibition between the default mode and salience networks. Weaker inter-network connectivity (reduced RAI) predicted abstinence-induced cravings to smoke (r = -0.59; P = .007) and less suppression of default mode activity during performance of a subsequent working memory task (ventromedial prefrontal cortex, r = -0.66, P = .003; posterior cingulate cortex, r = -0.65, P = .001). Alterations in coupling of the salience and default mode networks and the inability to disengage from the default mode network may be critical in cognitive/affective alterations that underlie nicotine dependence.

  20. Differential Improvement of Executive Functions During Abstinence in Cocaine-Dependent Patients: A Longitudinal Study.

    PubMed

    Inozemtseva, Olga; Pérez-Solís, Lina; Matute, Esmeralda; Juárez, Jorge

    2016-09-18

    In substance abusers, deficits in executive functioning (EF) are relevant to understanding the behavioral regulation of substance consumption and the failure to remain abstinent. To determine the course of EF impairment, measured with traditional and ecological instruments, after 1 and 3 months of abstinence in patients with cocaine dependence. 26 cocaine-only-dependent in-patients (cocaine-dependent group, CDG) and 24 nondependent controls (control group, CG) recruited from a typical population were assessed using several EF tests and questionnaires [Stroop, verbal and graphic fluency, Wisconsin Card-Sorting Test (WCST), Tower of London (TOL), and Behavior Rating Inventory of Executive Function-Adult Version (BRIEF-A)] after three periods of abstinence: 1 week, 1 month, and 3 months. At 1 week (baseline), CDG underperformed CG on most EF measures (WCST categories completed; TOL-total number of moves, execution time, and rule violations; and various BRIEF-A subscales). At 1 month, CDG moderately improved its performance on several measures, meanwhile the improvement in the 12 patients who would eventually complete the 3-month abstinence proved particularly significant when compared to their baseline values. In the a posteriori comparison of the baseline values of noncompleters versus completers, scores for the former were lower on the EF tasks, but higher on the BRIEF-A. Both groups, showed significantly worse scores than CG on both instruments. Cocaine-dependent patients showed marked difficulties in the EF associated mainly with adaptive behavior to their environment. Cocaine-dependent patients with better EF at baseline improved significantly during abstinence and had better treatment adherence. Results suggest that executive improvement and treatment adherence in cocaine abusers in abstinence is related to intrinsic cognitive characteristics of patients.

  1. Gender differences in negative affect during acute tobacco abstinence differ between African American and White adult cigarette smokers.

    PubMed

    Pang, Raina D; Bello, Mariel S; Liautaud, Madalyn M; Weinberger, Andrea H; Leventhal, Adam M

    2018-06-15

    Prior studies have found heightened negative affect following tobacco abstinence in women compared to men. However, experimental work addressing whether these findings generalize across racial groups is scarce. The current study investigated whether race (Non-Hispanic White vs. Non-Hispanic African American) moderated gender differences in abstinence-induced negative affect and smoking behavior. Data were collected from 2010 to 2017 from two separate laboratory studies investigating experimentally manipulated tobacco abstinence. Following a baseline session, adult daily smokers (10 cigarettes per day; women: n=297, 83.8% Non-Hispanic African American; men: n=492, 86.2% Non-Hispanic African American) attended two counterbalanced lab sessions (16 hours abstinent vs. non-abstinent) and completed self-report measures of negative affect followed by a laboratory analogue smoking reinstatement task. We found a gender race interaction for several negative affect states and composite negative affect (ßs=-.12 to -.16, ps<.05). Analyses stratified by race showed that Non-Hispanic White women compared to Non-Hispanic White men exhibited greater abstinence-induced increases in anger, anxiety, and composite negative affect (ßs=-.20 to -.29, ps<.05). No significant gender differences in abstinence-induced negative affect were found for Non-Hispanic African American smokers (ßs=.00 to -.04, ps>.05). These findings suggest that negative affect during acute tobacco abstinence may be a clinically important and intervenable factor that can inform cessation interventions specifically for Non-Hispanic White women smokers. Further empirical exploration of mechanisms underlying interactions of gender and race in tobacco addiction may benefit smoking cessation efforts in Non-Hispanic African American women smokers. The current study contributes to a scant body of research examining the intersectional influence of race and gender on abstinence-induced negative affect-a central

  2. A Test of the Abstinence Violation Effect.

    ERIC Educational Resources Information Center

    Ruderman, Audrey J.

    According to the abstinence violation effect, highly controlled drinkers tend to overindulge following an initial slip. To investigate this relapse model, 47 male college students, ranging in age from 21 to 46, were assigned either to an unrestrained or a restrained drinker group according to their scores on the Restrained Drinking Scale. Subjects…

  3. Comparison of Puff Topography, Toxicant Exposure, and Subjective Effects in Low- and High-Frequency Waterpipe Users: A Double-Blind, Placebo-Control Study

    PubMed Central

    Cobb, Caroline O.; Blank, Melissa D.; Morlett, Alejandra; Shihadeh, Alan; Jaroudi, Ezzat; Karaoghlanian, Nareg; Kilgalen, Barbara; Austin, Janet; Weaver, Michael F.

    2015-01-01

    Introduction: Clinical laboratory work among intermittent and daily waterpipe tobacco smokers has revealed significant risks for tobacco dependence and disease associated with waterpipe tobacco smoking (WTS). No studies have compared these groups directly. This study examined whether WTS frequency was associated with differential puff topography, toxicant exposure, and subjective response using a placebo-control design. Methods: Eighty participants reporting WTS of 2–5 episodes (LOW; n = 63) or ≥20 episodes (HIGH; n = 17) per month for ≥6 months completed 2 double-blind, counterbalanced 2-hr sessions that were preceded by ≥12hr of tobacco abstinence. Sessions differed by product smoked ad libitum for 45+ min: preferred brand/flavor of waterpipe tobacco (active) or a flavor-matched tobacco-free waterpipe product (placebo). Outcomes included puff topography, plasma nicotine, carboxyhemoglobin (COHb), and subjective response. Results: HIGH users had more puffs, shorter inter-puff-intervals, and a higher total puff volume for placebo relative to active, as well as relative to LOW users during placebo. Plasma nicotine concentrations increased when smoking active (but not placebo) with no significant differences between groups at 25min post-product administration. COHb increased significantly during all conditions; the largest increase was for HIGH users when smoking placebo. There was some evidence of higher baseline scores for nicotine/tobacco nicotine abstinence symptomology. Conclusions: Higher frequency waterpipe users may be more sensitive to the effects of waterpipe smoke nicotine content. Among HIGH users, higher baseline nicotine/tobacco abstinence symptoms may indicate greater nicotine dependence. These data support continued surveillance of WTS and development of dependence measures specific to this product. PMID:25257982

  4. Attendance rates in a workplace predict subsequent outcome of employment-based reinforcement of cocaine abstinence in methadone patients.

    PubMed

    Donlin, Wendy D; Knealing, Todd W; Needham, Mick; Wong, Conrad J; Silverman, Kenneth

    2008-01-01

    This study assessed whether attendance rates in a workplace predicted subsequent outcome of employment-based reinforcement of cocaine abstinence. Unemployed adults in Baltimore methadone programs who used cocaine (N=111) could work in a workplace for 4 hr every weekday and earn $10.00 per hour in vouchers for 26 weeks. During an induction period, participants provided urine samples but could work independent of their urinalysis results. After the induction period, participants had to provide urinalysis evidence of cocaine abstinence to work and maintain maximum pay. A multiple regression analysis showed that induction period attendance was independently associated with urinalysis evidence of cocaine abstinence under the employment-based abstinence reinforcement contingency. Induction period attendance may measure the reinforcing value of employment and could be used to guide the improvement of employment-based abstinence reinforcement.

  5. Health status of illicit stimulant drug users in rural Ohio.

    PubMed

    Falck, Russel S; Wang, Jichuan; Carlson, Robert G

    2007-11-01

    The SF-8 health survey was used to assess the physical and mental health status of a community sample of not-in-treatment, illicit stimulant drug-using adults (n = 249) living in rural Ohio. Physical health status scores indicative of poor health were present in 30.5% of the sample. Poor physical health was associated with older age (OR = 1.06; 95% C.I. = 1.02-1.11), chronic disease (OR = 2.24, 95% C.I. = 1.14-4.40), and frequent opioid use (OR = 3.14, 95% C.I. = 1.16-8.50). Poor mental health status scores were present in 63.9% of the sample. Men were less likely (OR = 0.25, 95% C.I. = 0.11-0.53), and Whites more likely (OR = 3.97, 95% C.I. = 1.56-10.13), to have poor mental health scores. Frequency and type of drug use had no measurable effect on mental health status. Physical and mental health problems are likely to be pervasive among nonmedical drug users in rural areas.

  6. Multifaceted impairments in impulsivity and brain structural abnormalities in opioid dependence and abstinence.

    PubMed

    Tolomeo, S; Gray, S; Matthews, K; Steele, J D; Baldacchino, A

    2016-10-01

    Chronic opioid exposure, as a treatment for a variety of disorders or as drug of misuse, is common worldwide, but behavioural and brain abnormalities remain under-investigated. Only a small percentage of patients who receive methadone maintenance treatment (MMT) for previous heroin misuse eventually achieve abstinence and studies on such patients are rare. The Cambridge Neuropsychological Test Automated Battery and T1 weighted magnetic resonance imaging (MRI) were used to study a cohort of 122 male individuals: a clinically stable opioid-dependent patient group receiving MMT (n = 48), an abstinent previously MMT maintained group (ABS) (n = 24) and healthy controls (n = 50). Stable MMT participants deliberated longer and placed higher bets earlier in the Cambridge Gambling Task (CGT) and showed impaired strategic planning compared with healthy controls. In contrast, ABS participants showed impairment in choosing the least likely outcome, delay aversion and risk adjustment on the CGT, and exhibited non-planning impulsivity compared with controls. MMT patients had widespread grey matter reductions in the orbitomedial prefrontal cortex, caudate, putamen and globus pallidus. In contrast, ABS participants showed midbrain-thalamic grey matter reductions. A higher methadone dose at the time of scanning was associated with a smaller globus pallidus in the MMT group. Our findings support an interpretation of heightened impulsivity in patients receiving MMT. Widespread structural brain abnormalities in the MMT group and reduced brain structural abnormality with abstinence suggest benefit of cessation of methadone intake. We suggest that a longitudinal study is required to determine whether abstinence improves abnormalities, or patients who achieve abstinence have reduced abnormalities before methadone cessation.

  7. Effects of Smoking Abstinence, Smoking Cues and Nicotine Replacement in Smokers with Schizophrenia and Controls

    PubMed Central

    Tidey, Jennifer W.; Rohsenow, Damaris J.; Kaplan, Gary B.; Swift, Robert M.; Adolfo, Amy B.

    2010-01-01

    The mechanisms underlying the low smoking cessation rates among smokers with schizophrenia (SS) are unknown. In this laboratory study, we compared the responses of 21 SS and 21 non-psychiatric controls (CS) to manipulations of 5-hour smoking abstinence, transdermal nicotine replacement (0, 21 and 42 mg), and in vivo smoking cues. Results indicate that SS were more sensitive than CS to the effects of acute abstinence on CO boost, but not more sensitive to the effects of abstinence on urge levels or withdrawal symptoms. SS and CS did not differ in urge response to in vivo smoking cues, but SS were less consistent in their reactions. These findings suggest that heightened sensitivity to the effects of abstinence on smoke intake may partially account for the low cessation rates experienced by SS, but other potential mechanisms should be explored using behavioral laboratory models. PMID:18584468

  8. Sustained smoking abstinence is associated with reductions in smoking-specific experiential avoidance among treatment-seeking smokers.

    PubMed

    Farris, Samantha G; DiBello, Angelo M; Heggeness, Luke F; Reitzel, Lorraine R; Vidrine, Damon J; Schmidt, Norman B; Zvolensky, Michael J

    2016-06-01

    Smoking-specific experiential avoidance is related to the maintenance of cigarette smoking. However, it is unclear whether sustained smoking abstinence is associated with subsequent reductions in smoking-specific experiential avoidance. Daily smokers (n = 149) underwent a cessation attempt in the context of a 4-session smoking cessation treatment trial. Participants provided biochemical verification of smoking status at 1 week, 2 weeks, and 1 Month post-quit day. Smoking-specific experiential avoidance was assessed per the Avoidance and Inflexibility Scale (AIS) - the total score and two factor scores were examined at 1 Month post-quit day as a function of abstinence status. Two path models were conducted and included participant sex, treatment condition, and pre-cessation nicotine dependence, smoking-specific experiential avoidance, and presence of emotional disorders as covariates. After adjusting for covariates, sustained smoking abstinence was associated with a reduction in the AIS total score at Month 1 post-quit (β = -.45, p < .001). Sustained smoking abstinence was associated with reductions across both facets of experiential avoidance -- smoking-related thoughts and feelings (β = -.44, p < .001) and internal bodily sensations (β = -.41, p < .001). Biochemical verification of smoking status was confirmed only at three time points post-quit day, and continued abstinence throughout the one-month post-quitting period is not fully known. Sustained smoking abstinence may contribute to reductions in smoking-specific experiential avoidance. Findings add to the research documenting the relevance of experiential avoidance in various processes of smoking (including smoking abstinence). Copyright © 2015 Elsevier Ltd. All rights reserved.

  9. Exercise attenuates negative effects of abstinence during 72 hours of smoking deprivation.

    PubMed

    Conklin, Cynthia A; Soreca, Isabella; Kupfer, David J; Cheng, Yu; Salkeld, Ronald P; Mumma, Joel M; Jakicic, John M; Joyce, Christopher J

    2017-08-01

    Exercise is presumed to be a potentially helpful smoking cessation adjunct reputed to attenuate the negative effects of deprivation. The present study examined the effectiveness of moderate within-session exercise to reduce 4 key symptoms of smoking deprivation during 3 72-hr nicotine abstinence blocks in both male and female smokers. Forty-nine (25 male, 24 female) sedentary smokers abstained from smoking for 3 consecutive days on 3 separate occasions. At each session, smokers' abstinence-induced craving, cue-induced craving, negative mood, and withdrawal symptom severity were assessed prior to and after either exercise (a.m. exercise, p.m. exercise) or a sedentary control activity (magazine reading). Abstinence-induced craving and negative mood differed as a function of condition, F(2, 385) = 21, p < .0001; and, F(2, 385) = 3.38, p = .03. Planned contrasts revealed no difference between a.m. and p.m. exercise, but exercise overall led to greater pre-post reduction in abstinence-induced craving, t(385) = 6.23, p < .0001, effect size Cohen's d = 0.64; and negative mood, t(385) = 2.25, p = .03, d = 0.23. Overall exercise also led to a larger pre-post reduction in cue-induced craving in response to smoking cues, F(2, 387) = 8.94, p = .0002; and withdrawal severity, F(2, 385) = 3.8, p = .02. Unlike the other 3 measures, p.m. exercise reduced withdrawal severity over control, t(385) = 2.64, p = .009, d = 0.27, whereas a.m. exercise did not. The results support the clinical potential of exercise to assist smokers in managing common and robust negative symptoms experienced during the first 3 days of abstinence. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

  10. Does naltrexone affect craving in abstinent opioid-dependent patients?

    PubMed

    Dijkstra, Boukje A G; De Jong, Cor A J; Bluschke, Sarah M; Krabbe, Paul F M; van der Staak, Cees P F

    2007-06-01

    Naltrexone blocks the opioid receptors that modulate the release of dopamine in the brain reward system and therefore blocks the rewarding effects of heroin and alcohol. It is generally assumed that naltrexone leads to reduction of craving, but few studies have been performed to prove this. The purpose of the present study was to examine the effect of the administration of naltrexone on craving level after rapid opioid detoxification induced by naltrexone. A naturalistic study was carried out in which patients were followed during 10 months after rapid detoxification. Data about abstinence, relapse, and naltrexone use were collected by means of urine specimens. Craving was measured by the visual analogue scale craving, the Obsessive Compulsive Drug Use Scale, and the Desires for Drug Questionnaire. Results showed that patients who relapsed in opioid use experienced obviously more craving than abstinent people. Patients who took naltrexone did not experience significant less craving than those who did not. These results suggest that the use of opioids is associated with increased craving and that abstinence for opioids is associated with less craving, independent of the use of naltrexone. This is in contrast to the general opinion. Because of the naturalistic design of the study, no firm conclusions can be drawn, but the results grounded the needs of an experimental study.

  11. Blunted striatal response to monetary reward anticipation during smoking abstinence predicts lapse during a contingency-managed quit attempt.

    PubMed

    Sweitzer, Maggie M; Geier, Charles F; Denlinger, Rachel; Forbes, Erika E; Raiff, Bethany R; Dallery, Jesse; McClernon, F J; Donny, Eric C

    2016-03-01

    Tobacco smoking is associated with dysregulated reward processing within the striatum, characterized by hypersensitivity to smoking rewards and hyposensitivity to non-smoking rewards. This bias toward smoking reward at the expense of alternative rewards is further exacerbated by deprivation from smoking, which may contribute to difficulty maintaining abstinence during a quit attempt. We examined whether abstinence-induced changes in striatal processing of rewards predicted lapse likelihood during a quit attempt supported by contingency management (CM), in which abstinence from smoking was reinforced with money. Thirty-six non-treatment-seeking smokers participated in two functional MRI (fMRI) sessions, one following 24-h abstinence and one following smoking as usual. During each scan, participants completed a rewarded guessing task designed to elicit striatal activation in which they could earn smoking and monetary rewards delivered after the scan. Participants then engaged in a 3-week CM-supported quit attempt. As previously reported, 24-h abstinence was associated with increased striatal activation in anticipation of smoking reward and decreased activation in anticipation of monetary reward. Individuals exhibiting greater decrements in right striatal activation to monetary reward during abstinence (controlling for activation during non-abstinence) were more likely to lapse during CM (p < 0.025), even when controlling for other predictors of lapse outcome (e.g., craving); no association was seen for smoking reward. These results are consistent with a growing number of studies indicating the specific importance of disrupted striatal processing of non-drug reward in nicotine dependence and highlight the importance of individual differences in abstinence-induced deficits in striatal function for smoking cessation.

  12. Momentary factors during marijuana use as predictors of lapse during attempted abstinence in young adults.

    PubMed

    Shrier, Lydia A; Sarda, Vishnudas; Jonestrask, Cassandra; Harris, Sion Kim

    2018-08-01

    Young adults using marijuana heavily often try multiple times to quit on their own. We sought to identify momentary experiences during marijuana use that could aid in predicting lapse when young adults subsequently attempt abstinence. Young adults (N=34) age 18-25 using marijuana ≥5days/week and planning to quit completed a survey of sociodemographic characteristics, substance use, marijuana expectancies, use motives, perceived social support, and confidence to abstain. They completed ecological momentary assessment (EMA) smartphone reports several times/day for two weeks prior to, then during two weeks of attempted abstinence. Use period EMA reports assessed affect, craving, accessibility, situational permissibility, use, and motivation to abstain. Baseline survey and EMA data were examined in relation to subsequent lapse during attempted abstinence. Nearly 3 in 4 participants (73.5%) reported lapsing during attempted abstinence from marijuana. On bivariate analyses, lower baseline dependence severity score, negative effect expectancies, perceived family support, and confidence to abstain were each associated with lapse. Of the use period EMA variables, greater percent of days with marijuana use, reports of easy accessibility, and reports of situational permissibility were each associated with lapse. Modeled together, negative effect expectancies, perceived family support, confidence to abstain, and situational permissibility during use were highly accurate in predicting lapse during attempted abstinence. Momentary factors may add to conventionally-surveyed characteristics to enhance prediction of lapse during attempted abstinence among young adults with heavy marijuana use. Momentary assessment prior to a quit attempt may thus enable more effective personalized approaches to preventing lapse. Copyright © 2018 Elsevier Ltd. All rights reserved.

  13. Cigarette craving and withdrawal symptoms during temporary abstinence and the effect of nicotine gum.

    PubMed

    Brown, Jamie; Hajek, Peter; McRobbie, Hayden; Locker, Jo; Gillison, Fiona; McEwen, Andy; Beard, Emma; West, Robert

    2013-09-01

    It is widely believed that nicotine withdrawal symptoms appear within a few hours of stopping smoking, but few data exist documenting their emergence in naturalistic settings. In several countries, nicotine replacement products are licensed for relief of withdrawal symptoms during temporary abstinence, but again, there are no data supporting this from naturalistic settings. To examine the emergence of cigarette craving and withdrawal symptoms during temporary abstinence in a naturalistic setting while using either nicotine or placebo gum. Double-blind, randomised, placebo-controlled study in which 132 dependent smokers abstained for 6 h with the assistance of either nicotine (2 mg, n = 42 or 4 mg, n = 24) or placebo (n = 66) gum while travelling on a non-smoking train. Outcome measures were ratings of craving and mood withdrawal symptoms prior to treatment and at regular intervals during abstinence. In a multivariate analysis of all symptoms, there was no interaction between treatment and time [F(21,110) = 1.28, p = 0.20, η²(p)= 0.20] nor an effect of treatment [F(7,124) = 0.45, p = 0.87, η²(p)=  0.03]. There was an effect of time [F(21,110) = 11.59, p < 0.001, η²(p)= 0.69) and univariate analyses revealed that the majority of symptoms increased linearly throughout the period of abstinence with detectable onsets typically between the first 60 and 180 min of abstinence. Smokers who temporarily abstain in naturalistic settings experience craving and withdrawal symptoms that emerge linearly over the first 6 h of abstinence. Changes in craving and several mood withdrawal symptoms can be detected within the first 3 h. Nicotine gum may not have an acute effect on the development of these symptoms.

  14. Course of Psychiatric Symptoms and Abstinence among Methamphetamine-Dependent Persons in Sober Living Recovery Homes.

    PubMed

    Polcin, Douglas L; Witbrodt, Jane; Korcha, Rachael; Gupta, Shalika; Mericle, Amy A

    2016-01-01

    Although studies of co-occurring psychiatric disorders among methamphetamine (MA)-dependent persons have been conducted in treatment programs, none have examined them in service settings used to sustain long-term recovery, such as sober living houses (SLHs). Residents entering SLHs (N = 243) were interviewed within two weeks and at 6-, 12-, and 18-month follow-up. Measures assessed psychiatric symptoms using the Brief Symptom Inventory (BSI), past-year drug and alcohol dependence, and abstinence over six-month time periods. Overall, severity of psychiatric symptoms on the BSI was similar among MA-dependent and other dependent residents. Global psychiatric severity, depression, and somatization scales on the BSI predicted abstinence for both groups. However, phobic anxiety and hostility scales were associated with abstinence for MA-dependent residents but not for those dependent on other substances. The similarity of psychiatric symptoms among persons with and without MA dependence in SLHs is different from what studies have found in treatment programs. The association between psychiatric symptoms and abstinence for both groups suggests SLHs should consider provision of on- or off-site mental health services. Additional research is needed to understand why phobic anxiety and hostility are associated with abstinence among MA-dependent residents but not those dependent on other substances.

  15. Course of Psychiatric Symptoms and Abstinence among Methamphetamine Dependent Persons in Sober Living Recovery Homes

    PubMed Central

    Polcin, Douglas; Witbrodt, Jane; Korcha, Rachael; Gupta, Shalika; Mericle, Amy A.

    2016-01-01

    Background Although studies of co-occurring psychiatric disorders among methamphetamine (MA) dependent persons have been conducted in treatment programs, none have examined them in service settings used to sustain long-term recovery, such as sober living houses (SLHs). Methods Residents entering SLHs (N=243) were interviewed within two weeks and at 6-, 12-, and 18-month follow-up. Measures assessed psychiatric symptoms using the Brief Symptom Inventory (BSI), past year drug and alcohol dependence, and abstinence over 6-month time periods. Results Overall, severity of psychiatric symptoms on the BSI were similar among MA dependent and other dependent residents. Global psychiatric severity, depression and somatization scales on the BSI predicted abstinence for both groups. However, phobic anxiety and hostility scales were associated with abstinence for MA dependent residents but not for those dependent on other substances. Conclusion The similarity of psychiatric symptoms among persons with and without MA dependence in SLHs is different from what studies have found in treatment programs. The association between psychiatric symptoms and abstinence for both groups suggests SLHs should consider provision of on- or off-site mental health services. Additional research is needed to understand why phobic anxiety and hostility are associated with abstinence among MA dependent residents but not those dependent on other substances. PMID:27184803

  16. Effects of naltrexone on post-abstinence alcohol drinking in C57BL/6NCRL and DBA/2J mice.

    PubMed

    Tomie, Arthur; Azogu, Idu; Yu, Lei

    2013-07-01

    The present experiment evaluated the effects of naltrexone, a non-selective opioid receptor antagonist, on post-abstinence alcohol drinking in C57BL/6NCRL and DBA/2J male mice. Home cage 2-bottle (alcohol vs. water) free-choice procedures were employed. During the pre-abstinence period, alcohol intake was much lower for the DBA/2J mice relative to the C57BL/6NCRL mice, and this strain difference was observed for groups receiving either 3% or 10% alcohol concentrations. The four-day abstinence period effectively reduced alcohol intakes (i.e., a negative alcohol deprivation effect, negative ADE) in both groups of DBA/2J mice, but had no effect on alcohol intakes in either group of C57BL/6NCRL mice. Both groups trained with 3% alcohol received the second four-day abstinence period, where the effects of acute administration of either naltrexone or saline on post-abstinence alcohol drinking were assessed. Naltrexone was more effective in reducing post-abstinence drinking of 3% alcohol in the DBA/2J mice than in the C57BL/6NCRL mice. In the DBA/2J mice, naltrexone further reduced, relative to saline-injected controls, the low levels of post-abstinence alcohol intake. Thus, the low baseline levels of alcohol drinking in DBA/2J mice were further diminished by the four-day abstinence period (negative ADE), and this suppressed post-abstinence level of alcohol drinking was still further reduced by acute administration of naltrexone. The results indicate that naltrexone is effective in reducing further the low levels of alcohol drinking induced by the negative ADE. Copyright © 2013 Elsevier Inc. All rights reserved.

  17. Randomized controlled trial of contingency management for stimulant use in community mental health patients with serious mental illness.

    PubMed

    McDonell, Michael G; Srebnik, Debra; Angelo, Frank; McPherson, Sterling; Lowe, Jessica M; Sugar, Andrea; Short, Robert A; Roll, John M; Ries, Richard K

    2013-01-01

    The primary objective of this study was to determine whether contingency management was associated with increased abstinence from stimulant drug use in stimulant-dependent patients with serious mental illness treated in a community mental health center. Secondary objectives were to determine whether contingency management was associated with reductions in use of other substances, psychiatric symptoms, HIV risk behavior, and inpatient service utilization. A randomized controlled design was used to compare outcomes of 176 outpatients with serious mental illness and stimulant dependence. Participants were randomly assigned to receive 3 months of contingency management for stimulant abstinence plus treatment as usual or treatment as usual with reinforcement for study participation only. Urine drug tests and self report, clinician-report, and service utilization outcomes were assessed during the 3-month treatment period and the 3-month follow-up period. Although participants in the contingency management condition were significantly less likely to complete the treatment period than those assigned to the control condition (42% compared with 65%), they were 2.4 times (95% CI=1.9–3.0)more likely to submit a stimulant-negative urine test during treatment. Compared with participants in the control condition,they had significantly lower levels of alcohol use, injection drug use, and psychiatric symptoms and were one-fifth as likely as those assigned to the control condition to be admitted for psychiatric hospitalization during treatment. They also reported significantly fewer days of stimulant drug use during the 3-month follow-up. When added to treatment as usual, contingency management is associated with large reductions in stimulant,injection drug, and alcohol use.Reductions in psychiatric symptoms and hospitalizations are important secondary benefits.

  18. Self-reports of executive dysfunction in current ecstasy/polydrug Users.

    PubMed

    Hadjiefthyvoulou, Florentia; Fisk, John E; Montgomery, Catharine; Bridges, Nikola

    2012-09-01

    Ecstasy/polydrug users have exhibited deficits in executive functioning in laboratory tests. We sought to extend these findings by investigating the extent to which ecstasy/polydrug users manifest executive deficits in everyday life. Forty-two current ecstasy/polydrug users, 18 previous (abstinent for at least 6 months) ecstasy/polydrug users, and 50 non-users of ecstasy (including both non-users of any illicit drug and some cannabis-only users) completed the self-report Behavior Rating Inventory of Executive Function-Adult Version (BRIEF-A) measure. Current ecstasy/polydrug users performed significantly worse than previous users and non-users on subscales measuring inhibition, self-monitoring, initiating action, working memory, planning, monitoring ongoing task performance, and organizational ability. Previous ecstasy/polydrug users did not differ significantly from non-users. In regression analyses, although the current frequency of ecstasy use accounted for statistically significant unique variance on 3 of the 9 BRIEF-A subscales, daily cigarette consumption was the main predictor in 6 of the subscales. Current ecstasy/polydrug users report more executive dysfunction than do previous users and non-users. This finding appears to relate to some aspect of ongoing ecstasy use and seems largely unrelated to the use of other illicit drugs. An unexpected finding was the association of current nicotine consumption with executive dysfunction.

  19. Effects of prolonged abstinence from METH on the hippocampal BDNF levels, neuronal numbers and apoptosis in methamphetamine-sensitized rats.

    PubMed

    Hajheidari, Samira; Sameni, Hamid Reza; Bandegi, Ahmad Reza; Miladi-Gorji, Hossein

    2017-04-03

    Methamphetamine (METH) use is associated with neuronal damage in various regions of brain, while effects of prolonged abstinence on METH-induced damage are not quite clear. This study evaluated serum and hippocampal BDNF levels, neuronal numbers and apoptosis in METH-sensitized and abstinent rats. Rats were sensitized to METH (2mg/kg, daily/18 days, s.c.). All rats were evaluated for neuron counting, the TUNEL test and serum and hippocampal BDNF levels after 30 days of forced abstinence from METH. The results showed that increased BDNF levels in the hippocampus and serum of METH-sensitized rats returned to control level after 30 days of abstinence. The number of neurons in the DG and CA1 of hippocampus and also, the total hippocampal perimeter and area in METH-sensitized rats were significantly lower than the saline rats. While, the number of neurons was not significantly increased in the hippocampus after prolonged abstinence from METH. Also, METH-sensitized rats showed a significant increase in TUNEL-positive cells, whereas METH-abstinent rats showed a slight but significant decrease in TUNEL-positive cells in the DG and CA3 of hippocampus. These results suggest that despite the reduction in BDNF levels, reducing the number of neurons, perimeter and area of the hippocampus were stable after abstinence. Thus, the degenerative effects of METH have been sustained even after prolonged abstinence in the hippocampus. Copyright © 2017 Elsevier B.V. All rights reserved.

  20. Amount of earnings during prize contingency management treatment is associated with posttreatment abstinence outcomes.

    PubMed

    Petry, Nancy M; Roll, John M

    2011-12-01

    Contingency management (CM) treatments that provide patients with the opportunity to earn chances of winning prizes of varying magnitudes are becoming increasingly popular. In the CM literature, magnitude of reinforcement is linked with effect sizes, such that CM treatments that provide larger magnitude reinforcement are more efficacious than those that provide lower magnitude reinforcement. With prize CM, even when magnitudes of overall expected prize earnings are constant, some patients win more prizes than others. Thus, patients who win larger overall amounts of prizes during treatment may have better outcomes than those who win fewer prizes. This study evaluated the impact of overall amounts of prizes won on long-term abstinence outcomes. The dollar amount of prizes won during prize CM treatments was determined from 78 cocaine-abusing methadone-maintenance patients who were randomized to prize CM treatments in three clinical trials. Abstinence three months following the end of the CM intervention was the primary dependent variable. The dollar amount of prizes won during CM treatment was a significant predictor of submission of cocaine-negative urine samples and self-reports of cocaine abstinence at the follow-up evaluation, even after controlling for other variables associated with long-term abstinence, such as pretreatment urinalysis results and longest duration of abstinence achieved during treatment. These results suggest that magnitudes of earnings during prize CM may impact outcomes and call for further experimentation of parameters related to the efficacy of prize CM.

  1. Depression, impulsiveness, sleep, and memory in past and present polydrug users of 3,4-methylenedioxymethamphetamine (MDMA, ecstasy).

    PubMed

    Taurah, Lynn; Chandler, Chris; Sanders, Geoff

    2014-02-01

    Ecstasy (3,4-methylenedioxymethamphetamine, MDMA) is a worldwide recreational drug of abuse. Unfortunately, the results from human research investigating its psychological effects have been inconsistent. The present study aimed to be the largest to date in sample size and 5HT-related behaviors; the first to compare present ecstasy users with past users after an abstinence of 4 or more years, and the first to include robust controls for other recreational substances. A sample of 997 participants (52 % male) was recruited to four control groups (non-drug (ND), alcohol/nicotine (AN), cannabis/alcohol/nicotine (CAN), non-ecstasy polydrug (PD)), and two ecstasy polydrug groups (present (MDMA) and past users (EX-MDMA). Participants completed a drug history questionnaire, Beck Depression Inventory, Barratt Impulsiveness Scale, Pittsburgh Sleep Quality Index, and Wechsler Memory Scale-Revised which, in total, provided 13 psychometric measures. While the CAN and PD groups tended to record greater deficits than the non-drug controls, the MDMA and EX-MDMA groups recorded greater deficits than all the control groups on ten of the 13 psychometric measures. Strikingly, despite prolonged abstinence (mean, 4.98; range, 4-9 years), past ecstasy users showed few signs of recovery. Compared with present ecstasy users, the past users showed no change for ten measures, increased impairment for two measures, and improvement on just one measure. Given this record of impaired memory and clinically significant levels of depression, impulsiveness, and sleep disturbance, the prognosis for the current generation of ecstasy users is a major cause for concern.

  2. Attenuation of ethanol abstinence-induced anxiety- and depressive-like behavior by the phosphodiesterase-4 inhibitor rolipram in rodents.

    PubMed

    Gong, Mei-Fang; Wen, Rui-Ting; Xu, Ying; Pan, Jian-Chun; Fei, Ning; Zhou, Yan-Meng; Xu, Jiang-Ping; Liang, Jian-Hui; Zhang, Han-Ting

    2017-10-01

    Withdrawal symptoms stand as a core feature of alcohol dependence. Our previous results have shown that inhibition of phosphodiesterase-4 (PDE4) decreased ethanol seeking and drinking in alcohol-preferring rodents. However, little is known about whether PDE4 is involved in ethanol abstinence-related behavior. The objective of this study was to characterize the role of PDE4 in the development of anxiety- and depressive-like behavior induced by abstinence from ethanol exposure in different animal models. Using three rodent models of ethanol abstinence, we examined the effects of rolipram, a prototypical, selective PDE4 inhibitor, on (1) anxiety-like behavior induced by repeated ethanol abstinence in the elevated plus maze test in fawn-hooded (FH/Wjd) rats, (2) anxiety-like behavior in the open-field test and light-dark transition test following acute ethanol abstinence in C57BL/6J mice, and (3) anxiety- and depressive-like behavior induced by protracted ethanol abstinence in the elevated plus maze, forced-swim, and tail-suspension tests in C57BL/6J mice. Pretreatment with rolipram (0.1 or 0.2 mg/kg) significantly increased entries and time spent in the open arms of the elevated plus maze test in rats with repeated ethanol abstinence. Similarly, in mice with acute ethanol abstinence, administration of rolipram (0.25 or 0.5 mg/kg) dose-dependently increased the crossings in the central zone of the open-field test and duration and transitions on the light side of the light-dark transition test, suggesting anxiolytic-like effects of rolipram. Consistent with these, chronic treatment with rolipram (0.1, 0.3, or 1.0 mg/kg) increased entries in the open arms of the elevated plus maze test; it also reduced the increased duration of immobility in both the forced-swim and tail-suspension tests in mice after protracted ethanol abstinence, suggesting antidepressant-like effects of rolipram. These results provide the first demonstration for that PDE4 plays a role in modulating

  3. Blunted striatal response to monetary reward anticipation during smoking abstinence predicts lapse during a contingency-managed quit attempt

    PubMed Central

    Sweitzer, Maggie M.; Geier, Charles F.; Denlinger, Rachel; Forbes, Erika E.; Raiff, Bethany R.; Dallery, Jesse; McClernon, F.J.; Donny, Eric C.

    2017-01-01

    Rationale Tobacco smoking is associated with dysregulated reward processing within the striatum, characterized by hypersensitivity to smoking rewards and hyposensitivity to non-smoking rewards. This bias toward smoking reward at the expense of alternative rewards is further exacerbated by deprivation from smoking, which may contribute to difficulty maintaining abstinence during a quit attempt. Objective We examined whether abstinence-induced changes in striatal processing of rewards predicted lapse likelihood during a quit attempt supported by contingency management (CM), in which abstinence from smoking was reinforced with money. Methods Thirty-six non-treatment seeking smokers participated in two fMRI sessions, one following 24-hr abstinence and one following smoking as usual. During each scan, participants completed a rewarded guessing task designed to elicit striatal activation in which they could earn smoking and monetary rewards delivered after the scan. Participants then engaged in a 3-week CM-supported quit attempt. Results As previously reported, 24-hr abstinence was associated with increased striatal activation in anticipation of smoking reward and decreased activation in anticipation of monetary reward. Individuals exhibiting greater decrements in right striatal activation to monetary reward during abstinence (controlling for activation during non-abstinence) were more likely to lapse during CM (p<.05), even when controlling for other predictors of lapse outcome (e.g., craving); no association was seen for smoking reward. Conclusions These results are consistent with a growing number of studies indicating the specific importance of disrupted striatal processing of non-drug reward in nicotine dependence, and highlight the importance of individual differences in abstinence-induced deficits in striatal function for smoking cessation. PMID:26660448

  4. Nicotine abstinence syndrome precipitated by central but not peripheral hexamethonium.

    PubMed

    Malin, D H; Lake, J R; Schopen, C K; Kirk, J W; Sailer, E E; Lawless, B A; Upchurch, T P; Shenoi, M; Rajan, N

    1997-11-01

    A rodent model of nicotine dependence has been developed based on continuous subcutaneous (s.c.) infusion of nicotine tartrate. Nicotine abstinence syndrome was precipitated by s.c. injection of the nicotinic antagonist mecamylamine, which freely crosses the blood-brain barrier. In contrast, the nicotinic antagonist hexamethonium crosses the blood-brain barrier very poorly. This study determined whether central or peripheral administration of hexamethonium could precipitate nicotine abstinence. In the first experiment, 26 nicotine-dependent rats were injected s.c. with 0.5, 5 or 10 mg/kg hexamethonium dichloride or saline alone and observed for 20 min. Few abstinence signs were observed in any group; there was no significant drug effect. In the second experiment, 18 rats were cannulated in the third ventricle and rendered nicotine dependent. One week later, rats were injected through the cannula with 12 or 18 ng hexamethonium or saline alone and observed for 20 min. Both dose groups differed significantly from the saline-injected group, and there was a significant positive linear trend of signs as a function of dose. The high dose had no significant effect in 14 nondependent rats. We conclude that hexamethonium is much more potent by the central route, and there is a major central nervous system component in nicotine dependence.

  5. Sufficiency of Mesolimbic Dopamine Neuron Stimulation for the Progression to Addiction.

    PubMed

    Pascoli, Vincent; Terrier, Jean; Hiver, Agnès; Lüscher, Christian

    2015-12-02

    The factors causing the transition from recreational drug consumption to addiction remain largely unknown. It has not been tested whether dopamine (DA) is sufficient to trigger this process. Here we use optogenetic self-stimulation of DA neurons of the ventral tegmental area (VTA) to selectively mimic the defining commonality of addictive drugs. All mice readily acquired self-stimulation. After weeks of abstinence, cue-induced relapse was observed in parallel with a potentiation of excitatory afferents onto D1 receptor-expressing neurons of the nucleus accumbens (NAc). When the mice had to endure a mild electric foot shock to obtain a stimulation, some stopped while others persevered. The resistance to punishment was associated with enhanced neural activity in the orbitofrontal cortex (OFC) while chemogenetic inhibition of the OFC reduced compulsivity. Together, these results show that stimulating VTA DA neurons induces behavioral and cellular hallmarks of addiction, indicating sufficiency for the induction and progression of the disease. Copyright © 2015 Elsevier Inc. All rights reserved.

  6. Self-concept mediate the relationship between childhood maltreatment and abstinence motivation as well as self-efficacy among drug addicts.

    PubMed

    Lu, Feng-Ying; Wen, Si; Deng, Gang; Tang, Yung-Lung

    2017-05-01

    Childhood maltreatment is widely accepted as a risk factor for drug addiction from adolescence to adulthood. However, the influence of childhood maltreatment on drug treatment related variables, such as drug abstinence motivation and self-concept, as well as self-efficacy, remains unclear. This study aims at exploring whether self-concept mediates the relationship between childhood maltreatment and abstinence motivation, as well as self-efficacy, among drug addicts. This study involves 816 (550 males, 226 females, mean age=34.59, range=16-58 years) drug addicts from compulsory detoxification units. Participants completed questionnaires, including the childhood trauma questionnaire 28 - item short form (CTQ - SF), Tennessee self-concept scale (TSCS), general self-efficacy scale (GSES), and drug abstinence motivation questionnaire (DAMQ). The structural equation model (SEM) analysis, including total and specific forms of maltreatment scores, showed that childhood maltreatment was negatively associated with self-concept, self-efficacy, and abstinence motivation. Self-concept was positively associated with self-efficacy and abstinence motivation. Conversely, significant association between self-efficacy and abstinence motivation did not exist. An indirect analysis showed that self-concept mediated the relationship between childhood maltreatment and self-efficacy. Critically, self-concept arbitrated the relationship between childhood maltreatment and abstinence motivation. The indirect effect of self-concept between childhood maltreatment and abstinence motivation still existed when the total scores of maltreatment were replaced by the scores of specific forms of maltreatment. These results demonstrated that self-concept is a critical factor in understanding the relationship between childhood maltreatment and abstinence motivation, as well as self-efficacy, among drug addicts. Improving the sense of self-worth may be an effective intervention therapy among drug addicts

  7. A Qualitative Evaluation of the Students of Service (SOS) Program for Sexual Abstinence in Louisiana

    ERIC Educational Resources Information Center

    Yoo, Seunghyun; Johnson, Carolyn C.; Rice, Janet; Manuel, Powlin

    2004-01-01

    Abstinence-only programs for preventing teen pregnancy are the only options in some states but are the programs of choice in others. Effectiveness data, however, are lacking. The SOS Adolescent Family Life Program (SOS), an abstinence-only teen pregnancy prevention program, was implemented in south central Louisiana. Peer mentoring with an…

  8. Factors Associated with Intentions to Engage in Vaginal Intercourse among Sexually Abstinent Missouri High School Freshmen

    ERIC Educational Resources Information Center

    Watts, Timothy; Wilson, Kelly L.; McNeill, Elisa B.; Rosen, Brittany L.; Moore, Nancy Daley; Smith, Matthew L.

    2016-01-01

    Background: We examine personal characteristics, alcohol consumption, normative beliefs, household factors, and extracurricular engagement associated with intentions to have intercourse before marriage among abstinent students. Methods: Data were analyzed from 245 freshmen enrolled in a school-based abstinence-only-until-marriage program. Two…

  9. Spend today, clean tomorrow: Predicting methamphetamine abstinence in a randomized controlled trial

    PubMed Central

    Murtaugh, Kimberly Ling; Krishnamurti, Tamar; Davis, Alexander L.; Reback, Cathy J.; Shoptaw, Steven

    2013-01-01

    Objective This secondary analysis of data from a randomized controlled trial tested two behavioral economics mechanisms (substitutability and delay discounting) to explain outcomes using contingency management (CM) for methamphetamine dependence. Frequency and purchase type (hedonic/utilitarian and consumable/durable) of CM payments were also examined. Methods 82 methamphetamine-dependent gay/bisexual men randomly assigned to conditions delivering CM received monetary vouchers in exchange for stimulant-negative urine samples in a 16-week trial requiring thrice weekly visits (Shoptaw et al., 2005). At any visit participants could redeem vouchers for goods. A time-lagged counting process Cox Proportional Hazards model for recurrent event survival analysis examined aspects of the frequency and type of these CM purchases. Results After controlling for severity of baseline methamphetamine use and accumulated CM wealth, as measured by cumulative successful earning days, participants who redeemed CM earnings at any visit (“spenders”) were significantly more likely to produce stimulant-negative urine samples in the subsequent visit, compared to those who did not redeem (“savers”) 1.011* [1.005, 1.017], Z=3.43, p<0.001. Conclusions Findings support the economic concept of substitutability of CM purchases and explain trial outcomes as a function of frequency of CM purchases rather than frequency or accumulated total CM earnings. Promotion of frequent purchases in incentive-based programs should facilitate substitution for the perceived value of methamphetamine and improve abstinence outcomes. PMID:24001246

  10. The motivation to stay abstinent in ex-smokers: comparing the present with the past.

    PubMed

    Dijkstra, Arie; Borland, Ron; Buunk, Bram P

    2007-10-01

    Little is known about the motivation of ex-smokers to stay abstinent. In the present study we argue that ex-smokers compare their present to their past when they still smoked to conclude whether they make good progress towards a satisfactory state of continued abstinence. These temporal comparisons are thought to be central in the motivation to stay abstinent in ex-smokers. The power of temporal comparisons to predict relapse was tested in two related samples of ex-smokers (N=152 and N=197), together with two other relevant psychological factors; positive outcome expectations of smoking and self-efficacy expectations. In the first sample of ex-smokers, only temporal comparisons predicted relapse after 2 months. In the second sample of ex-smokers, temporal comparisons mediated the relation between perceived positive outcomes of smoking and relapse after 6 months. In addition, in predicting relapse after 6 months, temporal comparisons interacted with self-efficacy. The present study suggests that temporal comparisons comprise the cognitive aspect of the motivation of ex-smokers to stay abstinent. This conceptualization of the motivation in ex-smokers can be used in practice to prevent relapse.

  11. Adult Discrimination against Children: The Case of Abstinence-Only Education in Twenty-First-Century USA

    ERIC Educational Resources Information Center

    Greslé-Favier, Claire

    2013-01-01

    This paper analyses abstinence-only education programmes and discourses within the frame of theories of adult discrimination against children. To begin with, a definition of abstinence-only programmes and of the political context in which they were created will be provided. These programmes will then be analysed through the lens of children's…

  12. A Randomized Trial of Adjunct mHealth Abstinence Reinforcement With Transdermal Nicotine and Counseling for Smoking Cessation.

    PubMed

    Alessi, Sheila M; Rash, Carla J; Petry, Nancy M

    2017-03-01

    Abstinence reinforcement is efficacious for improving smoking treatment outcomes, but practical constraints related to the need for multiple in-person carbon monoxide (CO) breath tests daily to verify smoking abstinence have limited its use. This study tested an mHealth procedure to remotely monitor and reinforce smoking abstinence in individuals' natural environment. Eligible treatment-seeking smokers (N = 90) were randomized to (1) usual care and ecological monitoring with abstinence reinforcement (mHealth reinforcement) or (2) without reinforcement (mHealth monitoring). Usual care was 8 weeks of transdermal nicotine and twice-weekly telephone counseling. Following training, an interactive voice response system prompted participants to conduct CO tests 1-3 daily at pseudorandom times (7 am to 10 pm) for 4 weeks. When prompted, participants used a study cell phone and CO monitor to complete a CO self-test, video record the process, and submit videos using multimedia messaging. mHealth reinforcement participants could earn prizes for smoking-negative on-time CO tests. The interactive voice response generated preliminary earnings immediately. Earnings were finalized by comparing video records against participants' self-reports. mHealth reinforcement was associated with a greater proportion of smoking-negative CO tests, longest duration of prolonged abstinence, and point-prevalence abstinence during the monitoring/reinforcement phase compared to mHealth monitoring (p < .01, d = 0.8-1.3). Follow-up (weeks 4-24) analyses indicated main effects of reinforcement on point-prevalence abstinence and proportion of days smoked (p ≤ .05); values were comparable by week 24. mHealth reinforcement has short-term efficacy. Research on methods to enhance and sustain benefits is needed. This study suggests that mHealth abstinence reinforcement is efficacious and may present temporal and spatial opportunities to research, engage, and support smokers trying to quit that do not exist

  13. Relationships Between Craving Beliefs and Abstinence Self-Efficacy are Mediated by Smoking Motives and Moderated by Nicotine Dependence.

    PubMed

    Reese, Elizabeth D; Veilleux, Jennifer C

    2016-01-01

    Decreased abstinence self-efficacy is linked to increased craving and negative affect, as well as poorer smoking outcomes, such as lapse, relapse, and withdrawal symptom severity. Research suggests that beliefs and cognitions concerning ourselves and the world orient us toward specific goals and thus impact our judgments and behavior. This study serves to investigate whether motives for smoking mediate the relationship between beliefs about craving and abstinence self-efficacy judgments and whether this may differ by nicotine dependence. In a sample of 198 smokers (M age = 34.96, 51.8% female, 81.8% Caucasian), self-report measures of craving beliefs, situational abstinence self-efficacy, and smoking motives were measured. We examined the effect of beliefs on abstinence self-efficacy in both craving and negative affect situations, with craving and negative reinforcement smoking motives as mediators, and nicotine dependence as a moderator. Results indicate that craving beliefs predict lower abstinence self-efficacy judgments in craving situations indirectly through increased craving motives. However, this relationship was only significant for less dependent smokers. Additionally, regardless of nicotine dependence, craving beliefs predicted lower abstinence self-efficacy in negative affect situations via increased negative reinforcement smoking motives. These findings suggest that beliefs concerning the specific nature of craving correlate with smoking motives (ie, smoking goals) and thus abstinence self-efficacy judgments. Furthermore, these associations are stronger for less dependent smokers. Such findings suggest the importance of addressing craving beliefs during smoking cessation treatment, especially for less dependent smokers whose craving beliefs are associated with abstinence self-efficacy across multiple situations. © The Author 2015. Published by Oxford University Press on behalf of the Society for Research on Nicotine and Tobacco. All rights reserved

  14. Simultaneous use of alcohol with methamphetamine but not ecstasy linked with aggression among young adult stimulant users.

    PubMed

    Leslie, Ellen M; Smirnov, Andrew; Cherney, Adrian; Wells, Helene; Legosz, Margot; Kemp, Robert; Najman, Jake M

    2017-07-01

    Illicit stimulants are often combined with alcohol in nightlife entertainment districts, an environment where aggressive behaviour commonly occurs. While alcohol and methamphetamine use are each associated with aggressive behaviour, relatively little is known about the impact of the combined use of alcohol and amphetamine-type stimulants (i.e., ecstasy [MDMA] and methamphetamine) on aggression. Analysis of longitudinal data from a population-based sample of Australian young adult amphetamine-type stimulant users (n=248) to examine: (a) prevalence and timing of simultaneous alcohol and amphetamine-type stimulant use and (b) predictors of ecstasy- and methamphetamine-related aggression and hostility. Prediction models of ecstasy- and methamphetamine-related aggression and hostility were developed using multivariate logistic regression. Simultaneous alcohol consumption and amphetamine-type stimulant use was prevalent, with drinking generally occurring before consuming amphetamine-type stimulants and while 'high'. Methamphetamine-related aggression and hostility was significantly associated with recurrent risky simultaneous methamphetamine and alcohol use (Adjusted Odds Ratio [AOR] 2.74, 95% CI 1.09-6.89), a high frequency and increasing use methamphetamine trajectory (AOR 7.23, 95% CI 1.27-41.03), and high trait aggression (AOR 5.78, 95% CI 2.53-13.20). In contrast, only trait aggression (moderate: AOR 3.01, 95% CI 1.55-5.84; high: AOR 5.02, 95% CI 2.38-10.61) was associated with ecstasy-related aggression and hostility. These findings indicate a link between risky patterns of simultaneous alcohol and methamphetamine use and methamphetamine-related aggression and hostility, independent of separate use of alcohol, methamphetamine and cannabis, trait aggression, psychosis, and gender. The policy challenges of amphetamine-type stimulant and alcohol use require a targeted, multidisciplinary approach. Copyright © 2017 Elsevier Ltd. All rights reserved.

  15. Profile of executive deficits in cocaine and heroin polysubstance users: common and differential effects on separate executive components.

    PubMed

    Verdejo-García, Antonio; Pérez-García, Miguel

    2007-03-01

    Structure of executive function was examined and we contrasted performance of substance dependent individuals (polysubstance users) and control participants on neuropsychological measures assessing the different executive components obtained. Additionally, we contrasted performance of polysubstance users with preference for cocaine vs heroin and controls to explore possible differential effects of the main substance abused on executive impairment. Two groups of participants were recruited: abstinent polysubstance users and controls. Polysubstance users were further subdivided based on their drug of choice (cocaine vs heroin). We administered to all participants a comprehensive protocol of executive measures, including tests of fluency, working memory, reasoning, inhibitory control, flexibility, and decision making. Consistent with previous models, the principal component analysis showed that executive functions are organized into four separate components, three of them previously described: updating, inhibition, and shifting; and a fourth component of decision making. Abstinent polysubstance users had clinically significant impairments on measures assessing these four executive components (with effect sizes ranging from 0.5 to 2.2). Cocaine polysubstance users had more severe impairments than heroin users and controls on measures of inhibition (Stroop) and shifting (go/no go and category test). Greater severity of drug use predicted poorer performance on updating measures. Executive functions can be fractionated into four relatively independent components. Chronic drug use is associated with widespread impairment of these four executive components, with cocaine use inducing more severe deficits on inhibition and shifting. These findings show both common and differential effects of two widely used drugs on different executive components.

  16. Motivation to quit as a predictor of smoking cessation and abstinence maintenance among treated Spanish smokers.

    PubMed

    Piñeiro, Bárbara; López-Durán, Ana; Del Río, Elena Fernández; Martínez, Úrsula; Brandon, Thomas H; Becoña, Elisardo

    2016-02-01

    Although quitting motivation predicts smoking cessation, there have been inconsistent findings regarding motivation predicting long-term maintenance of abstinence. Moreover, most such research has been conducted in North America and the United Kingdom. The aim of this study was to examine motivation to quit as a predictor of smoking cessation and of abstinence maintenance in a Spanish sample. The sample comprised 286 Spanish smokers undergoing psychological treatment for smoking cessation. Motivation to quit was assessed pre-treatment and post-treatment with the Readiness to Quit Ladder. Abstinence post-treatment and at 6month follow-up was biochemically verified. Participants with higher levels of pre-treatment and post-treatment motivation were more likely to be abstinent at the end of the treatment (OR=1.36) and at 6month follow-up (OR=4.88). Among abstainers at the end of the treatment (61.9%), higher levels of motivation to quit post-treatment predicted maintaining abstinence at 6months (OR=2.83). Furthermore, participants who failed to quit smoking reported higher levels of motivation to quit post-treatment than they had pretreatment (p<.001). Motivation to quit smoking predicted short and long-term cessation, and also predicted long-term maintenance of abstinence. These results have implications for understanding motivational processes of smoking cessation in general, while extending research to Spanish smokers. They may also help in the design of cessation and relapse-prevention interventions. Specifically, the results suggest that motivational enhancement is important throughout the cessation and maintenance periods. Copyright © 2015 Elsevier Ltd. All rights reserved.

  17. Neural mechanisms of working memory in ecstasy (MDMA) users who continue or discontinue ecstasy and amphetamine use: evidence from an 18-month longitudinal functional magnetic resonance imaging study.

    PubMed

    Daumann, Jörg; Fischermann, Thomas; Heekeren, Karsten; Thron, Armin; Gouzoulis-Mayfrank, Euphrosyne

    2004-09-01

    Working memory processing in ecstasy (3,4-methylenedioxymethamphetamine) users is associated with neural alterations as measured by functional magnetic resonance imaging. Here, we examined whether cortical activation patterns change after prolonged periods of continued use or abstinence from ecstasy and amphetamine. We used an n-back task and functional magnetic resonance imaging in 17 ecstasy users at baseline (t(1)) and after 18 months (t(2)). Based on the reported drug use at t(2) we separated subjects with continued ecstasy and amphetamine use from subjects reporting abstinence during the follow-up period (n = 9 and n = 8, respectively). At baseline both groups had similar task performance and similar cortical activation patterns. Task performance remained unchanged in both groups. Furthermore, there were no detectable functional magnetic resonance imaging signal changes from t(1) to t(2) in the follow-up abstinent group. However, the continuing users showed a dose-dependent increased parietal activation for the 2-back task after the follow-up period. Our data suggest that ecstasy use, particularly in high doses, is associated with greater parietal activation during working memory performance. An altered activation pattern might appear before changes in cognitive performance become apparent and, hence, may reflect an early stage of neuronal injury from the neurotoxic drug ecstasy.

  18. Delayed emergence of methamphetamine's enhanced cardiovascular effects in nonhuman primates during protracted methamphetamine abstinence.

    PubMed

    Vaupel, D B; Schindler, C W; Chefer, S; Belcher, A M; Ahmet, I; Scheidweiler, K B; Huestis, M A; Stein, E A

    2016-02-01

    Methamphetamine abuse is linked with brain abnormalities, but its peripheral effects constitute an integral aspect of long-term methamphetamine use. Eight male rhesus monkeys with long histories of intravenous methamphetamine self-administration were evaluated 1 day, and 1, 4, 12, 26, and 52 weeks after their last methamphetamine self-administration session. On test days, isoflurane-anesthetized animals received a 0.35 mg/kg IV methamphetamine challenge. A control group consisted of 10 age and gender matched drug naïve monkeys. Cardiovascular responses to methamphetamine were followed for 2.5h. Echocardiograms were acquired at 3 and 12 months of abstinence and in the control animals. No pre-methamphetamine baseline differences existed among 7 physiological measures across all conditions and controls. As expected, methamphetamine increased heart rate and blood pressure in controls. However, immediately following the self-administration period, the blood pressure response to methamphetamine challenge was reduced when compared to control monkeys. The peak and 150-min average heart rate increases, as well as peak blood pressure increases following methamphetamine were significantly elevated between weeks 12 to 26 of abstinence. These data indicate the development of tolerance followed by sensitization to methamphetamine cardiovascular effects. Echocardiography demonstrated decreased left ventricular ejection fraction and cardiac output at 3 months of abstinence. Importantly, both cardiovascular sensitization and cardiotoxicity appeared to be reversible as they returned toward control group levels after 1 year of abstinence. Enhanced cardiovascular effects may occur after prolonged abstinence in addicts relapsing to methamphetamine and may underlie clinically reported acute cardiotoxic events. Published by Elsevier Ireland Ltd.

  19. An evaluation of an abstinence-only sex education curriculum: an 18-month follow-up.

    PubMed

    Denny, George; Young, Michael

    2006-10-01

    The article examines the results from an 18-month follow-up evaluation of an abstinence education curriculum series. Participants were students from 15 school districts recruited to participate in the project. The intervention was the Sex Can Wait curriculum series, consisting of upper elementary, middle school, and high school components. The 5-week curriculum was implemented by teachers who had participated in a special teacher training workshop. Both intervention and comparison students were surveyed before and after the curriculum intervention and at 18-month follow-up. Results indicated short-term effects as follows. Upper elementary intervention students indicated higher level of knowledge, more hopefulness for the future, and greater self-efficacy than did the comparison group. Middle school intervention students did not differ from comparison students. High school intervention students reported lower participation rates than the comparison group students in sexual intercourse (ever and last month), a more positive attitude toward abstinence and a greater intent to remain abstinent. Long-term (18 month) benefits were noted as follows: upper elementary intervention students had greater knowledge and were less likely than comparison students to report participation in sexual intercourse in the last month. Middle school intervention students were less likely than comparison students to report participation in sexual intercourse ever and sexual intercourse in the last month. High school intervention students evidenced greater knowledge and greater intent to remain abstinent than did comparison students. Results indicate that the program did have some positive benefits that should be considered by those interested in abstinence education programming.

  20. Trajectories of 12-Month Usage Patterns for Two Smoking Cessation Websites: Exploring How Users Engage Over Time.

    PubMed

    Bricker, Jonathan B; Sridharan, Vasundhara; Zhu, Yifan; Mull, Kristin E; Heffner, Jaimee L; Watson, Noreen L; McClure, Jennifer B; Di, Chongzhi

    2018-04-20

    Little is known about how individuals engage with electronic health (eHealth) interventions over time and whether this engagement predicts health outcomes. The objectives of this study, by using the example of a specific type of eHealth intervention (ie, websites for smoking cessation), were to determine (1) distinct groups of log-in trajectories over a 12-month period, (2) their association with smoking cessation, and (3) baseline user characteristics that predict trajectory group membership. We conducted a functional clustering analysis of 365 consecutive days of log-in data from both arms of a large (N=2637) randomized trial of 2 website interventions for smoking cessation (WebQuit and Smokefree), with a primary outcome of 30-day point prevalence smoking abstinence at 12 months. We conducted analyses for each website separately. A total of 3 distinct trajectory groups emerged for each website. For WebQuit, participants were clustered into 3 groups: 1-week users (682/1240, 55.00% of the sample), 5-week users (399/1240, 32.18%), and 52-week users (159/1240, 12.82%). Compared with the 1-week users, the 5- and 52-week users had 57% higher odds (odds ratio [OR] 1.57, 95% CI 1.13-2.17; P=.007) and 124% higher odds (OR 2.24, 95% CI 1.45-3.43; P<.001), respectively, of being abstinent at 12 months. Smokefree users were clustered into 3 groups: 1-week users (645/1309, 49.27% of the sample), 4-week users (395/1309, 30.18%), and 5-week users (269/1309, 20.55%). Compared with the 1-week users, 5-week users (but not 4-week users; P=.99) had 48% higher odds (OR 1.48, 95% CI 1.05-2.07; P=.02) of being abstinent at 12 months. In general, the WebQuit intervention had a greater number of weekly log-ins within each of the 3 trajectory groups as compared with those of the Smokefree intervention. Baseline characteristics associated with trajectory group membership varied between websites. Patterns of 1-, 4-, and 5-week usage of websites may be common for how people engage in e

  1. Characterizing smoking topography of cannabis in heavy users

    PubMed Central

    Stitzer, Maxine L.; Vandrey, Ryan

    2013-01-01

    Rationale Little is known about the smoking topography characteristics of heavy cannabis users. Such measures may be able to predict cannabis use-related outcomes and could be used to validate self-reported measures of cannabis use. Objectives The current study was conducted to measure cannabis smoking topography characteristics during periods of ad libitum use and to correlate topography assessments with measures of self-reported cannabis use, withdrawal and craving during abstinence, and cognitive task performance. Methods Participants (N=20) completed an inpatient study in which they alternated between periods of ad libitum cannabis use and abstinence. Measures of self-reported cannabis use, smoking topography, craving, withdrawal, and sleep measures were collected. Results Participants smoked with greater intensity (e.g., greater volume, longer duration) on initial cigarette puffs with a steady decline on subsequent puffs. Smoking characteristics were significantly correlated with severity of withdrawal, notably sleep quality and architecture, and craving during abstinence, suggesting dose-related effects of cannabis use on these outcomes. Smoking characteristics generally were not significantly associated with cognitive performance. Smoking topography measures were significantly correlated with self-reported measures of cannabis use, indicating validity of these assessments, but topography measures were more sensitive than self-report in predicting cannabis-related outcomes. Conclusions A dose–effect relationship between cannabis consumption and outcomes believed to be clinically important was observed. With additional research, smoking topography assessments may become a useful clinical tool. PMID:21922170

  2. Perceptions about sexual abstinence and knowledge of HIV/AIDS prevention among in-school adolescents in a western Nigerian city

    PubMed Central

    2011-01-01

    Background Young people are becoming increasingly exposed to the risk of HIV infection. According to the 2008 HIV/Syphilis sentinel survey in Nigeria, 3.3% of young people aged 15-19 years are infected. Primary prevention especially abstinence, remains one of the most realistic interventions for reducing further spread of the virus. However, the adoption of sexual abstinence as a prevention strategy among adolescents remains low and factors influencing its practice among urban young people in Nigeria are relatively unknown. The aim of the study was to document the sexual abstinence behaviour of in-school adolescents, the factors influencing or obstructing abstinence, and knowledge of HIV and AIDS in Ibadan, South-West Nigeria. Methods The study was a descriptive cross-sectional survey of students in Ibadan South-West Local Government Area. A total of 420 respondents (52% males and 48% females), selected through a multistage sampling technique, completed a semi-structured questionnaire. This was supplemented with eight focus group discussions (FGDs) which had an average of 9 respondents within the 10 and 19 years age group. The data from the FGDs were transcribed and summarized manually while the quantitative data was analyzed using the Statistical Package for the Social Sciences to generate frequencies, cross tabulations of variables and logistic regression analysis. Results Twelve percent of the entire sample had ever had sex. Overall, knowledge of HIV transmission and prevention was high and most respondents favoured the promotion of abstinence as an HIV prevention strategy. A smaller proportion of male respondents (79%) abstained compared with the females (98%). Major predictors of sexual abstinence were being a female, not having a boyfriend or girl friend, not using alcohol and having a positive attitude towards abstinence (P < 0.05). Sexual abstinence was also significantly associated with perceived self efficacy to refuse sex and negative perception of peers

  3. [Nevirapine induces abstinence symptoms in patients on a methadone maintenance program with HIV infection].

    PubMed

    Baño Rodrigo, M D; Agujetas Rodríguez, M; López García, M L; Guillén Llera, J L

    2000-01-01

    The objective of this study was to investigate the potential inductive effect of nevirapine (NVP) with methadone. Eight patients on the methadone maintenance programme with anti-retroviral therapy because of their infection with HIV, well maintained with methadone and without symptoms of abstinence were studied. All were included in a study of measurement of plasma levels of methadone. Anti-retroviral medication was changed, including NVP, and patients began with symptoms of abstinence 5 to 10 days later. Our results indicate an inductive effect of NVP on the methadone metabolism which caused symptoms of abstinence in all patients, which prompted an increase in the dose and plasma concentration of methadone was lost; patients continued with significantly low plasma levels (p < 0.01) after a therapy mean duration of 6.5 months, with no full recovery.

  4. Involvement of opioid and other systems in ethanol abstinence audiogenic seizures in the rat?

    PubMed

    Kotlińska, J; Langwiński, R

    1985-01-01

    The action of opiate receptor agonists: (D-Ala2)-methionine enkephalinamide (D-MEA), morphine, heroin, etorphine, and antagonists: naloxone and diprenorphine on audiogenic seizures was tested during ethanol abstinence. The action of diazepam and clonidine was also tested Morphine (5 and 20 mg/kg), but not heroin and etorphine, given intraperitoneally inhibited the seizures, similarly as intraventricularly administered D-MEA did. However, morphine given by this route was ineffective. Diazepam and clonidine inhibited audiogenic seizures: the action of clonidine was counteracted by yohimbine, but not by prazosin. The results may be considered as supporting the hypothesis on the participation of opioid system in ethanol abstinence. However, the participation of gabergic and noradrenergic systems cannot be ruled out: these systems may possibly interact with the opioid system in evoking the symptoms of ethanol abstinence.

  5. Effects of smoking abstinence on reaction time variability in smokers with and without ADHD: an ex-Gaussian analysis.

    PubMed

    Kollins, Scott H; McClernon, F Joseph; Epstein, Jeff N

    2009-02-01

    Smoking abstinence differentially affects cognitive functioning in smokers with ADHD, compared to non-ADHD smokers. Alternative approaches for analyzing reaction time data from these tasks may further elucidate important group differences. Adults smoking > or = 15 cigarettes with (n=12) or without (n=14) a diagnosis of ADHD completed a continuous performance task (CPT) during two sessions under two separate laboratory conditions--a 'Satiated' condition wherein participants smoked up to and during the session; and an 'Abstinent' condition, in which participants were abstinent overnight and during the session. Reaction time (RT) distributions from the CPT were modeled to fit an ex-Gaussian distribution. The indicator of central tendency for RT from the normal component of the RT distribution (mu) showed a main effect of Group (ADHD < Control) and a Group x Session interaction (ADHD group RTs decreased when abstinent). RT standard deviation for the normal component of the distribution (sigma) showed no effects. The ex-Gaussian parameter tau, which describes the mean and standard deviation of the non-normal component of the distribution, showed significant effects of session (Abstinent > Satiated), Group x Session interaction (ADHD increased significantly under Abstinent condition compared to Control), and a trend toward a main effect of Group (ADHD > Control). Alternative approaches to analyzing RT data provide a more detailed description of the effects of smoking abstinence in ADHD and non-ADHD smokers and results differ from analyses using more traditional approaches. These findings have implications for understanding the neuropsychopharmacology of nicotine and nicotine withdrawal.

  6. Inhibitory Control and Impulsivity Levels in Women Crack Users.

    PubMed

    Hess, Adriana Raquel Binsfeld; Menezes, Carolina B; de Almeida, Rosa Maria Martins

    2018-05-12

    investigate impulsivity levels and inhibitory control in women crack users and explore the relationships between impulsivity and inhibitory control. 52 healthy women (M = 32.83 years; SD = 9.54) and 46 crack cocaine users (M = 31.02 years; SD = 7.73), in abstinence, performed the assessment protocol included a Sociodemographic Data Questionnaire, Mini-Mental State Examination (MMSE), a GO/No-Go Task and the Barratt Impulsiveness Scale-11 (BIS-11). It was a quantitative research with cross-sectional design and control group. crack group showed higher levels of impulsivity in all domains when compared to the control group (crack group M = 76.39, SD = 11.39, control group M = 58.53, SD = 10.76, p <.01). Participants from the crack group presented a significantly higher total reaction time in the Go-NoGo task (F(1,93) = 9.93, p =.002; effect size =.09, observed power =.87) and significantly more commission (F(1,93) = 7.20, p =.009; effect size =.07, observed power =.75) and omission errors (F(1,93) = 6.04, p =.01; effect size =.06, observed power =.68), in Go/NoGo Task. Groups did also significantly differ on total standard deviations suggesting that variability in total reaction time was significantly greater in the crack group. Results showed that only in the crack group there were significant correlations between Go-NoGo parameters and Barratt Impulsiveness Scale. Our findings are consistent that impulsivity and inhibitory control are closely linked to crack use in women. Future studies should consider to evaluate crack users in different withdrawal times, controlling the impact of abstinence time in the variables studied.

  7. MEDIATORS OF THE RELATIONSHIP BETWEEN NICOTINE REPLACEMENT THERAPY AND SMOKING ABSTINENCE AMONG PEOPLE LIVING WITH HIV/AIDS

    PubMed Central

    Stanton, Cassandra A.; Lloyd-Richardson, Elizabeth E.; Papandonatos, George D.; de Dios, Marcel A.; Niaura, Raymond

    2012-01-01

    Cigarette smoking is highly prevalent among people living with HIV/AIDS and poses unique health risks. Smoking cessation programs tailored to this population have documented improved smoking outcomes with nicotine replacement therapy (NRT). The current study examined 6-month abstinence rates from a randomized clinical trial targeting 412 HIV-positive adult current smokers (51% European American, 19% African American, and 17% Hispanic American) and tested whether psychosocial variables, such as self-efficacy and decisional balance, mediated the relationship between NRT and long-term abstinence. Meeting criteria for complete mediation, 6-month smoking abstinence rates improved significantly with increases in these mediators, and the association of NRT and smoking abstinence was no longer significant once changes in self-efficacy and decisional balance were taken into account. Failure to translate gains in self-efficacy among African Americans into improved abstinence rates accounted for racial/ ethnic differences among participants. Specific psychosocial factors, such as self-efficacy, may be particularly amenable to change in cessation interventions and should be addressed with greater awareness of how cultural and social contextual factors impact treatment response among people living with HIV/AIDS. PMID:19537955

  8. Smoking abstinence-related expectancies among American Indians, African Americans, and women: potential mechanisms of tobacco-related disparities.

    PubMed

    Hendricks, Peter S; Westmaas, J Lee; Ta Park, Van M; Thorne, Christopher B; Wood, Sabrina B; Baker, Majel R; Lawler, R Marsh; Webb Hooper, Monica; Delucchi, Kevin L; Hall, Sharon M

    2014-03-01

    Research has documented tobacco-related health disparities by race and gender. Prior research, however, has not examined expectancies about the smoking cessation process (i.e., abstinence-related expectancies) as potential contributors to tobacco-related disparities in special populations. This cross-sectional study compared abstinence-related expectancies between American Indian (n = 87), African American (n = 151), and White (n = 185) smokers, and between women (n = 231) and men (n = 270) smokers. Abstinence-related expectancies also were examined as mediators of race and gender relationships with motivation to quit and abstinence self efficacy. Results indicated that American Indians and African Americans were less likely than Whites to expect withdrawal effects, and more likely to expect that quitting would be unproblematic. African Americans also were less likely than Whites to expect smoking cessation interventions to be effective. Compared with men, women were more likely to expect withdrawal effects and weight gain. These expectancy differences mediated race and gender relationships with motivation to quit and abstinence self-efficacy. Findings emphasize potential mechanisms underlying tobacco-related health disparities among American Indians, African Americans, and women and suggest a number of specific approaches for targeting tobacco dependence interventions to these populations.

  9. Smoking Abstinence-related Expectancies among American Indians, African Americans, and Women: Potential Mechanisms of Tobacco-related Disparities

    PubMed Central

    Hendricks, Peter S.; Westmaas, J. Lee; Park, Van M. Ta; Thorne, Christopher B.; Wood, Sabrina B.; Baker, Majel R.; Lawler, R. Marsh; Hooper, Monica Webb; Delucchi, Kevin L.; Hall, Sharon M.

    2014-01-01

    Research has documented tobacco-related health disparities by race and gender. Prior research, however, has not examined expectancies about the smoking cessation process (i.e., abstinence-related expectancies) as potential contributors to tobacco-related disparities in special populations. This cross-sectional study compared abstinence-related expectancies between American Indian (n = 87), African American (n = 151), and White (n = 185) smokers, and between women (n = 231) and men (n = 270) smokers. Abstinence-related expectancies also were examined as mediators of race and gender relationships with motivation to quit and abstinence self-efficacy. Results indicated that American Indians and African Americans were less likely than Whites to expect withdrawal effects, and more likely to expect that quitting would be unproblematic. African Americans also were less likely than Whites to expect smoking cessation interventions to be effective. Compared to men, women were more likely to expect withdrawal effects and weight gain.These expectancy differences mediated race and gender relationships with motivation to quit and abstinence self-efficacy. Findings emphasize potential mechanisms underlying tobacco-related health disparities among American Indians, African Americans, and women, and suggest a number of specific approaches for targeting tobacco dependence interventions to these populations. PMID:23528192

  10. Impact of HIV prevention programs on drug users in Malaysia.

    PubMed

    Kamarulzaman, Adeeba

    2009-11-01

    Faced with a rising HIV epidemic among injecting drug users, harm reduction policies and programs were introduced in Malaysia in 2005. The positive impact seen since the introduction of these programs comprise the inclusion of the health aspects of illicit drug use in the country's drug policies; better access to antiretroviral therapy for injecting drug users who are HIV infected; reduction in HIV-risk behavior; and greater social benefits, including increased employment. Despite these achievements, tension between law enforcement and public health persists, as harm reduction exists alongside an overall drug policy that is based on abstinence and zero tolerance. Unless there is harmonization of this policy, sustainability and scale-up of harm reduction programs will remain a challenge.

  11. Broken Promises: Abstinence Pledging and Sexual and Reproductive Health

    PubMed Central

    Paik, Anthony; Sanchagrin, Kenneth J.; Heimer, Karen

    2016-01-01

    Approximately 12% of girls and young women in the United States pledge abstinence. Yet most break their pledges, engaging in first intercourse before marriage. The extant literature reports few differences between pledge breakers and nonpledgers in sexually transmitted infections and nonmarital pregnancies. The present research maintains that previous studies may have obscured important differences in exposure risk and hypothesizes that female pledge breakers who have higher exposure risk are more likely to experience human papillomavirus (HPV) and nonmarital pregnancies. To test this hypothesis, this study uses the National Longitudinal Study of Adolescent to Adult Health, logistic regression, and event history modeling. The results show that, after accounting for differences in exposure risk, pledge breakers have higher risk of HPV and nonmarital pregnancy. As a set, the results are consistent with the argument that pledgers use condoms and contraceptives less consistently and highlight unintended consequences of abstinence promotion. PMID:27019521

  12. The smoker's health project: a self-determination theory intervention to facilitate maintenance of tobacco abstinence.

    PubMed

    Williams, Geoffrey C; Patrick, Heather; Niemiec, Christopher P; Ryan, Richard M; Deci, Edward L; Lavigne, Holly McGregor

    2011-07-01

    A previous randomized clinical trial based on self-determination theory (SDT) and consistent with the Public Health Service (PHS) Guideline for Treating Tobacco Use and Dependence demonstrated that an intensive intervention could change autonomous self-regulation and perceived competence, which in part facilitated long-term tobacco abstinence. The current article describes a pragmatic comparative effectiveness trial of three SDT-based intensive tobacco-dependence interventions. Eligible participants are randomized to one of the three treatment conditions designed to facilitate long-term maintenance of tobacco abstinence, namely, Community Care (CC), which includes the 6 month SDT-based intervention previously shown to promote autonomous self-regulation, perceived competence, medication use, and tobacco abstinence; Extended Need Support (ENS), which extends the 6 month SDT-based intervention to 12 months and trains an important other to provide support for smokers' basic psychological needs; and Harm Reduction (HR), which provides extended need support and recommends medication use for participants who do not want to stop smoking completely within 30 days but who are willing to reduce their cigarette use by half. The primary outcome is 12 month prolonged abstinence from tobacco, which is assessed one year following termination of treatment (two years post-randomization). Secondary outcomes include 7- and 30 day point prevalence tobacco abstinence, number of days using smoking-cessation medication, change in autonomous self-regulation and perceived competence, and perceived need support from important others. Copyright © 2011 Elsevier Inc. All rights reserved.

  13. Treating drug dependence with the aid of ibogaine: a retrospective study.

    PubMed

    Schenberg, Eduardo Ekman; de Castro Comis, Maria Angélica; Chaves, Bruno Rasmussen; da Silveira, Dartiu Xavier

    2014-11-01

    Ibogaine is an alkaloid purported to be an effective drug dependence treatment. However, its efficacy has been hard to evaluate, partly because it is illegal in some countries. In such places, treatments are conducted in underground settings where fatalities have occurred. In Brazil ibogaine is unregulated and a combined approach of psychotherapy and ibogaine is being practiced to treat addiction. To evaluate the safety and efficacy of ibogaine, we conducted a retrospective analysis of data from 75 previous alcohol, cannabis, cocaine and crack users (72% poly-drug users). We observed no serious adverse reactions or fatalities, and found 61% of participants abstinent. Participants treated with ibogaine only once reported abstinence for a median of 5.5 months and those treated multiple times for a median of 8.4 months. This increase was statistically significant (p < 0.001), and both single or multiple treatments led to longer abstinence periods than before the first ibogaine session (p < 0.001). These results suggest that the use of ibogaine supervised by a physician and accompanied by psychotherapy can facilitate prolonged periods of abstinence, without the occurrence of fatalities or complications. These results suggest that ibogaine can be a safe and effective treatment for dependence on stimulant and other non-opiate drugs. © The Author(s) 2014.

  14. A measure of smoking abstinence-related motivational engagement: development and initial validation.

    PubMed

    Simmons, Vani N; Heckman, Bryan W; Ditre, Joseph W; Brandon, Thomas H

    2010-04-01

    Although a great deal of research has focused on measuring motivation and readiness to quit smoking, little research has assessed gross motivational changes after a smoker has made an attempt to quit smoking. Unlike previous single-item global measures of motivation to remain abstinent, we developed the abstinence-related motivational engagement (ARME) scale to evaluate the degree to which abstinence motivation is reflected by an ex-smoker's daily experience in areas that include cognitive effort, priority, vigilance, and excitement. The aim of this study was to collect reliability and initial construct validity data on this new measure. Participants were 199 ex-smokers recruited from the community and smoking cessation Web sites. Participants completed online measures including a global motivation measure, the ARME scale, demographic questionnaire, and a measure of cessation self-efficacy. The 16-item ARME questionnaire demonstrated high internal consistency reliability (alpha = .89). Analyses provided support for convergent, discriminant, and construct validity of the scale. ARME demonstrated the predicted correlation with a traditional measure of global cessation motivation, yet, also as predicted, only the ARME was negatively associated with length of abstinence. Moreover, as hypothesized, ex-smokers engaged in the quitting process via ongoing smoking Web site participation showed higher ARME scores than a comparison community sample. A five-item short form demonstrated similar psychometric properties. This study provided initial support for the ARME construct and offers two versions of a reliable instrument for assessing this construct. Future research will examine the ARME as a predictor of cessation outcome and a potential target for relapse prevention.

  15. Changes in cerebral glucose metabolism during early abstinence from chronic methamphetamine abuse.

    PubMed

    Berman, S M; Voytek, B; Mandelkern, M A; Hassid, B D; Isaacson, A; Monterosso, J; Miotto, K; Ling, W; London, E D

    2008-09-01

    Changes in brain function during the initial weeks of abstinence from chronic methamphetamine abuse may substantially affect clinical outcome, but are not well understood. We used positron emission tomography with [F-18]fluorodeoxyglucose (FDG) to quantify regional cerebral glucose metabolism, an index of brain function, during performance of a vigilance task. A total of 10 methamphetamine-dependent subjects were tested after 5-9 days of abstinence, and after 4 additional weeks of supervised abstinence. A total of 12 healthy control subjects were tested at corresponding times. Global glucose metabolism increased between tests (P=0.01), more in methamphetamine-dependent (10.9%, P=0.02) than control subjects (1.9%, NS). Glucose metabolism did not change in subcortical regions of methamphetamine-dependent subjects, but increased in neocortex, with maximal increase (>20%) in parietal regions. Changes in reaction time and self-reports of negative affect varied more in methamphetamine-dependent than in control subjects, and correlated both with the increase in parietal glucose metabolism, and decrease in relative activity (after scaling to the global mean) in some regions. A robust relationship between change in self-reports of depressive symptoms and relative activity in the ventral striatum may have great relevance to treatment success because of the role of this region in drug abuse-related behaviors. Shifts in cortical-subcortical metabolic balance either reflect new processes that occur during early abstinence, or the unmasking of effects of chronic methamphetamine abuse that are obscured by suppression of cortical glucose metabolism that continues for at least 5-9 days after cessation of methamphetamine self-administration.

  16. Ibudilast may improve attention during early abstinence from methamphetamine.

    PubMed

    Birath, J Brandon; Briones, Marisa; Amaya, Stephanie; Shoptaw, Steven; Swanson, Aimee-Noelle; Tsuang, John; Furst, Benjamin; Heinzerling, Keith; Obermeit, Lisa; Maes, Lauryn; McKay, Charles; Wright, Matthew J

    2017-09-01

    Inattention is a deficit related to instilling abstinence from methamphetamine (MA) dependence. This study aimed to determine whether ibudilast (IB; 50mg bid) improves attentional abilities compared to placebo during early abstinence from MA dependence. Attention was assessed in 11 MA-dependent non-treatment seeking participants in a phase IB safety-interaction trial. The Conners' Continuous Performance Test-II (CPT-II), a measure of sustained attention and response inhibition, was administered at baseline and on day 22, 48h post a MA challenge under placebo (P; n=6) or IB 50mg bid (n=5). Group differences were compared using Mann-Whitney U Tests. Groups were similar at baseline in premorbid intellectual functioning, attention deficit hyperactivity symptom scores, impulsivity ratings, and education level, but differed in age. Demographically corrected T-scores for CPT-II performances were utilized. Although no group differences in sustained attention existed at baseline, at follow-up, the IB group (Mdn=44.4) showed reduced variability in response times compared with the P group (Mdn=69.9), U=0.00, z=-2.74, p=.006, r=.83. The IB group (Mdn=45.8) also gave fewer perseverative responses than the P group (Mdn=67.0), U=2.00, z=-2.50, p=.01, r=.75. No other significant differences were observed. Findings suggest that IB may have a protective effect on sustained attention during early abstinence from MA dependence. This may guide thinking about mechanism of action should IB demonstrate efficacy as a treatment for MA dependence. Copyright © 2017 Elsevier B.V. All rights reserved.

  17. Khat Use and Neurobehavioral Functions: Suggestions for Future Studies

    PubMed Central

    Hoffman, Richard; al’Absi, Mustafa

    2010-01-01

    Although there is a rich body of research available regarding the effect of acute and chronic khat dosing in animal models, research on the behavioral and cognitive effects of khat in human subjects is not extensive and several of the available studies have been done only in the context of observational and single-case studies. In light of the absence of a substantial literature on the neurobehavioral deficits associated with khat use and to provide a context that could be used to identify themes for future research we review previous research that has focused on other stimulant drugs. This review highlights multiple areas of neurocognitive deficit that have been identified in previous studies of individuals who have been chronic users of stimulants, such as amphetamines and methamphetamines. The review highlights a substantial body of evidence demonstrating a wide range of learning and memory impairments including deficits that persist during abstinence from active drug use. This review does not imply a similar khat effect, but due to some similarities pharmacologically between the active components of khat (cathinone and cathine) and amphetamines, future studies examining these same domains of cognitive functioning in chronic khat users and abstinent khat users appears to be warranted, if possible using some of the same or similar laboratory measures. PMID:20553832

  18. Behavioural and biochemical evidence for signs of abstinence in mice chronically treated with Δ-9-tetrahydrocannabinol

    PubMed Central

    Hutcheson, Daniel M; Th. Tzavara, Eleni; Smadja, Claire; Valjent, Emmanuel; Roques, Bernard P; Hanoune, Jacques; Maldonado, Rafael

    1998-01-01

    Tolerance and dependence induced by chronic Δ-9-tetrahydrocannabinol (THC) administration were investigated in mice. The effects on body weight, analgesia and hypothermia were measured during 6 days of treatment (10 or 20 mg kg−1 THC twice daily). A rapid tolerance to the acute effects was observed from the second THC administration.The selective CB-1 receptor antagonist SR 141716A (10 mg kg−1) was administered at the end of the treatment, and somatic and vegetative manifestations of abstinence were evaluated. SR 141716A administration precipitated several somatic signs that included wet dog shakes, frontpaw tremor, ataxia, hunched posture, tremor, ptosis, piloerection, decreased locomotor activity and mastication, which can be interpreted as being part of a withdrawal syndrome.Brains were removed immediately after the behavioural measures and assayed for adenylyl cyclase activity. An increase in basal, forskolin and calcium/calmodulin stimulated adenylyl cyclase activities was specifically observed in the cerebellum of these mice.The motivational effects of THC administration and withdrawal were evaluated by using the place conditioning paradigm. No conditioned change in preference to withdrawal associated environment was observed. In contrast, a conditioned place aversion was produced by the repeated pairing of THC (20 mg kg−1), without observing place preference at any of the doses used.This study constitutes a clear behavioural and biochemical model of physical THC withdrawal with no motivational aversive consequences. This model permits an easy quantification of THC abstinence in mice and can be useful for the elucidation of the molecular mechanisms involved in cannabinoid dependence. PMID:9884086

  19. Changes in brain-derived neurotrophic factor (BDNF) during abstinence could be associated with relapse in cocaine-dependent patients.

    PubMed

    Corominas-Roso, Margarida; Roncero, Carlos; Daigre, Constanza; Grau-Lopez, Lara; Ros-Cucurull, Elena; Rodríguez-Cintas, Laia; Sanchez-Mora, Cristina; Lopez, Maria Victoria; Ribases, Marta; Casas, Miguel

    2015-02-28

    Brain-derived neurotrophic factor (BDNF) is involved in cocaine craving in humans and drug seeking in rodents. Based on this, the aim of this study was to explore the possible role of serum BDNF in cocaine relapse in abstinent addicts. Forty cocaine dependent subjects (DSM-IV criteria) were included in an inpatient 2 weeks abstinence program. Organic and psychiatric co-morbidities were excluded. Two serum samples were collected for each subject at baseline and at after 14 abstinence days. After discharge, all cocaine addicts underwent a 22 weeks follow-up, after which they were classified into early relapsers (ER) (resumed during the first 14 days after discharge,) or late relapsers (LR) (resumed beyond 14 days after discharge). The only clinical differences between groups were the number of consumption days during the last month before detoxification. Serum BDNF levels increased significantly across the 12 days of abstinence in the LR group (p=0.02), whereas in the ER group BDNF remained unchanged. In the ER group, the change of serum BDNF during abstinence negatively correlated with the improvement in depressive symptoms (p=0.02). These results suggest that BDNF has a role in relapse to cocaine consumption in abstinent addicts, although the underlying neurobiological mechanisms remain to be clarified. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  20. Neoliberal Narratives and the Logic of Abstinence Only Education: Why Are We Still Having This Conversation?

    ERIC Educational Resources Information Center

    Clark, Lauren; Stitzlein, Sarah M.

    2018-01-01

    Given the lack of citizen or medical support for abstinence-only education, we ask how abstinence-education maintains such a stronghold in America and other Western democracies' public policy and consciousness. Our response has three parts. In the first, we outline the disproportionately negative health outcomes of sex education experienced by…

  1. The oxytocin analogue carbetocin prevents emotional impairment and stress-induced reinstatement of opioid-seeking in morphine-abstinent mice.

    PubMed

    Zanos, Panos; Georgiou, Polymnia; Wright, Sherie R; Hourani, Susanna M; Kitchen, Ian; Winsky-Sommerer, Raphaëlle; Bailey, Alexis

    2014-03-01

    The main challenge in treating opioid addicts is to maintain abstinence due to the affective consequences associated with withdrawal which may trigger relapse. Emerging evidence suggests a role of the neurohypophysial peptide oxytocin (OT) in the modulation of mood disorders as well as drug addiction. However, its involvement in the emotional consequences of drug abstinence remains unclear. We investigated the effect of 7-day opioid abstinence on the oxytocinergic system and assessed the effect of the OT analogue carbetocin (CBT) on the emotional consequences of opioid abstinence, as well as relapse. Male C57BL/6J mice were treated with a chronic escalating-dose morphine regimen (20-100 mg/kg/day, i.p.). Seven days withdrawal from this administration paradigm induced a decrease of hypothalamic OT levels and a concomitant increase of oxytocin receptor (OTR) binding in the lateral septum and amygdala. Although no physical withdrawal symptoms or alterations in the plasma corticosterone levels were observed after 7 days of abstinence, mice exhibited increased anxiety-like and depressive-like behaviors and impaired sociability. CBT (6.4 mg/kg, i.p.) attenuated the observed negative emotional consequences of opioid withdrawal. Furthermore, in the conditioned place preference paradigm with 10 mg/kg morphine conditioning, CBT (6.4 mg/kg, i.p.) was able to prevent the stress-induced reinstatement to morphine-seeking following extinction. Overall, our results suggest that alterations of the oxytocinergic system contribute to the mechanisms underlying anxiety, depression, and social deficits observed during opioid abstinence. This study also highlights the oxytocinergic system as a target for developing pharmacotherapy for the treatment of emotional impairment associated with abstinence and thereby prevention of relapse.

  2. Nigerian secondary school adolescents' perspective on abstinence-only sexual education as an effective tool for promotion of sexual health.

    PubMed

    Inyang, Mfrekemfon P; Inyang, Obonganyie P

    2013-01-01

    The success of any type of sexual education programme depends on the knowledge and preparedness for practice by adolescents. A recent study has found that an 'abstinence-only' sexual education programme is effective in reducing sexual activity among adolescents. Knowledge of abstinence-only sexual education and preparedness for practice as an effective tool for promotion of sexual health among Nigerian secondary school adolescents was studied. An analytic descriptive survey design was used for the study. The research population comprised of all public secondary schools in three southern geopolitical zones of the Niger Delta Region of Nigeria. A multistage sampling technique was used to select 2020 senior secondary school (SS1-SS3) students as sample for the study. A partially self-designed and partially adapted questionnaire from an 'abstinence-only versus comprehensive sex education' debate, from debatepedia (http://wiki.idebate.org/), entitled 'Questionnaire on Nigerian Secondary School Adolescents' Perspective on Abstinence-Only Sexual Education (QNSSAPAOSE)' was used in eliciting information from respondents. Hypotheses were formulated and tested. Frequency counts, percentage and Pearson Product Moment Correlation were used in analysing data. A greater proportion of secondary school adolescents in this study lacked knowledge of sexual education. About 80% of the respondents could not define sexual education. The general perspective on abstinence-only sexual education was negative, as revealed by the larger number of respondents who demonstrated unwillingness to practice abstinence-only sexual education. Specifically, of those who responded in favour of abstinence-only sexual education, the youngest group of adolescents (11-13 years) and the male respondents were more likely to accept this type of education than the other groups. Poor knowledge of sexual education could be responsible for unwillingness to practice abstinence-only sexual education. Sexual

  3. Clinical predictors of gaming abstinence in help-seeking adult problematic gamers.

    PubMed

    King, Daniel L; Adair, Cam; Saunders, John B; Delfabbro, Paul H

    2018-03-01

    Research into the effectiveness of interventions for problematic gaming has been limited by a lack of data concerning the clinical characteristics of voluntary treatment-seekers; the nature and history of their gaming problems; and, their reasons for seeking help. The study aimed to identify variables predictive of short-term commitment to gaming abstinence following initial voluntary contact with an online help service. A total of 186 adult gamers with gaming-related problems were recruited online. Participants completed the DSM-5 Internet gaming disorder (IGD) checklist, Depression Anxiety Stress Scales-21, Internet Gaming Cognition Scale, Gaming Craving Scale, and Gaming Quality of Life Scale. A one-week follow up survey assessed adherence with intended gaming abstinence. Abstainers were less likely to have withdrawal symptoms and less likely to play action shooting games. Participants with mood symptoms (40% of the total) reported significantly more IGD symptoms, stronger maladaptive gaming cognitions (e.g., overvaluing game rewards), more previous occurrences of gaming problems, and poorer quality of life. However, mood symptoms did not predict abstinence from or continuation of gaming. Adults with gaming disorder seeking help to reduce their gaming may benefit initially from strategies that manage withdrawal and psychoeducation about riskier gaming activities. Copyright © 2018 Elsevier B.V. All rights reserved.

  4. Attributions for Abstinence from Illicit Drugs by University Students

    ERIC Educational Resources Information Center

    Rosenberg, Harold; Baylen, Chelsea; Murray, Shanna; Phillips, Kristina; Tisak, Marie S.; Versland, Amelia; Pristas, Erica

    2008-01-01

    Aim: To assess college students' attributions for abstinence from alcohol and illicit drugs. Method: We recruited 125 undergraduates to rate the degree to which each of 41 listed reasons influenced their abstention from six specific substances (alcohol, MDMA/ecstasy, inhalants, cocaine, marijuana, and hallucinogens). Findings: Internal consistency…

  5. Making sense of abstinence: social representations in young Africans’ HIV-related narratives from six countries

    PubMed Central

    Winskell, Kate; Beres, Laura K.; Hill, Elizabeth; Mbakwem, Benjamin Chigozie; Obyerodhyambo, Oby

    2012-01-01

    Despite the prominence of abstinence promotion in HIV prevention for young Africans, there is little documentation concerning its reception and interpretation. With the purpose of informing programmatic practice, we examined how young Africans from six countries with contrasting HIV prevalence rates make sense of abstinence. ‘Scenarios from Africa’ scriptwriting contests invite young people to contribute ideas for short films about HIV. Using thematic narrative-based approaches, we analyzed a stratified random sample of 586 (~5%) of these narratives written in 2005 by young women and men aged 10–24 years from Senegal, Burkina Faso, South-East Nigeria, Kenya, Namibia and Swaziland. Abstinence was considerably more prominent as a theme in the samples from SE Nigeria, Kenya and Swaziland. It was articulated in relation to conservative Christian sexual morality and in opposition to condom use with particular intensity in SE Nigeria, with stigmatising implications for non-abstainers. However, cross-national commonalities were more striking than differences. Examples of non-stigmatising pro-abstinence messaging highlighted the appeal of discourses of romantic love and future plans across countries and demographic characteristics. The analysis yielded contextual understanding, youth-driven ideas, and recommendations to inform comprehensive HIV prevention efforts. PMID:21787256

  6. Towards a Switched-Capacitor Based Stimulator for Efficient Deep-Brain Stimulation

    PubMed Central

    Vidal, Jose; Ghovanloo, Maysam

    2013-01-01

    We have developed a novel 4-channel prototype stimulation circuit for implantable neurological stimulators (INS). This Switched-Capacitor based Stimulator (SCS) aims to utilize charge storage and charge injection techniques to take advantage of both the efficiency of conventional voltage-controlled stimulators (VCS) and the safety and controllability of current-controlled stimulators (CCS). The discrete SCS prototype offers fine control over stimulation parameters such as voltage, current, pulse width, frequency, and active electrode channel via a LabVIEW graphical user interface (GUI) when connected to a PC through USB. Furthermore, the prototype utilizes a floating current sensor to provide charge-balanced biphasic stimulation and ensure safety. The stimulator was analyzed using an electrode-electrolyte interface (EEI) model as well as with a pair of pacing electrodes in saline. The primary motivation of this research is to test the feasibility and functionality of a safe, effective, and power-efficient switched-capacitor based stimulator for use in Deep Brain Stimulation. PMID:21095987

  7. Glial dysfunction in abstinent methamphetamine abusers

    PubMed Central

    Sailasuta, Napapon; Abulseoud, Osama; Harris, Kent C; Ross, Brian D

    2010-01-01

    Persistent neurochemical abnormalities in frontal brain structures are believed to result from methamphetamine use. We developed a localized 13C magnetic resonance spectroscopy (MRS) assay on a conventional MR scanner, to quantify selectively glial metabolic flux rate in frontal brain of normal subjects and a cohort of recovering abstinent methamphetamine abusers. Steady-state bicarbonate concentrations were similar, between 11 and 15 mmol/L in mixed gray-white matter of frontal brain of normal volunteers and recovering methamphetamine-abusing subjects (P>0.1). However, glial 13C-bicarbonate production rate from [1-13C]acetate, equating with glial tricarboxylic acid (TCA) cycle rate, was significantly reduced in frontal brain of abstinent methamphetamine-addicted women (methamphetamine 0.04 μmol/g per min (N=5) versus controls 0.11 μmol/g per min (N=5), P=0.001). This is equivalent to 36% of the normal glial TCA cycle rate. Severe reduction in glial TCA cycle rate that normally comprises 10% of total cerebral metabolic rate may impact operation of the neuronal glial glutamate cycle and result in accumulation of frontal brain glutamate, as observed in these recovering methamphetamine abusers. Although these are the first studies to define directly an abnormality in glial metabolism in human methamphetamine abuse, sequential studies using analogous 13C MRS methods may determine ‘cause and effect' between glial failure and neuronal injury. PMID:20040926

  8. Delayed emergence of methamphetamine’s enhanced cardiovascular effects in nonhuman primates during protracted methamphetamine abstinence

    PubMed Central

    Vaupel, DB; Schindler, CW; Chefer, S; Belcher, AM; Ahmet, I; Scheidweiler, KB; Huestis, MA; Stein, EA

    2015-01-01

    Background Methamphetamine abuse is linked with brain abnormalities, but its peripheral effects constitute an integral aspect of long-term methamphetamine use. Methods Eight male rhesus monkeys with long histories of intravenous methamphetamine self-administration were evaluated 1 day, and 1, 4, 12, 26, and 52 weeks after their last methamphetamine self-administration session. On test days, isoflurane-anesthetized animals received a 0.35 mg/kg IV methamphetamine challenge. A control group consisted of 10 age and gender matched drug naïve monkeys. Cardiovascular responses to methamphetamine were followed for 2.5 h. Echocardiograms were acquired at 3 and 12 months of abstinence and in the control animals. Results No pre-methamphetamine baseline differences existed among 7 physiological measures across all conditions and controls. As expected, methamphetamine increased heart rate and blood pressure in controls. However, immediately following the self-administration period, the blood pressure response to methamphetamine challenge was reduced when compared to control monkeys. The peak and 150-min average heart rate increases, as well as peak blood pressure increases following methamphetamine were significantly elevated between weeks 12 to 26 of abstinence. These data indicate the development of tolerance followed by sensitization to methamphetamine cardiovascular effects. Echocardiography demonstrated decreased left ventricular ejection fraction and cardiac output at 3 months of abstinence. Importantly, both cardiovascular sensitization and cardiotoxicity appeared to be reversible as they returned toward control group levels after 1 year of abstinence. Conclusions Enhanced cardiovascular effects may occur after prolonged abstinence in addicts relapsing to methamphetamine and may underlie clinically reported acute cardiotoxic events. PMID:26775284

  9. Sexual abstinence behavior among never-married youths in a generalized HIV epidemic country: evidence from the 2005 Côte d'Ivoire AIDS indicator survey.

    PubMed

    Koffi, Alain K; Kawahara, Kazuo

    2008-12-16

    Sexual abstinence is the best available option for preventing both pregnancy and sexually transmitted infections, including HIV/AIDS. Identifying the factors associated with sexual abstinence among youths would have meaningful implications in a generalized HIV epidemic country such as the Côte d'Ivoire. Thus, we explored sexual abstinence behavior among never-married individuals aged 15 to 24 in Côte d'Ivoire and assessed factors that predict sexual abstinence. We obtained data from the nationally representative and population-based 2005 Côte d'Ivoire AIDS Indicator Survey, conducted from September 2004 to October 2005. Our sample included 3041 never-married people aged 15 to 24. Of these, 990 reported never having sexual intercourse (primary abstinence) and 137 reported sexual experience but not in the 12 months prior to the survey (secondary abstinence). In all, 1127 youths reported sexual abstinence practice. Of the 3041 never-married youths, 54.4% were male and 45.6% were female. About 33.0%, 6.7%, and 37.1% of them were practicing primary, secondary, and sexual abstinence behavior, respectively. Females of higher education level were significantly 11.14 times as likely as those of no education to practice either primary or secondary abstinence. Males who were animists, had no religion, or were practicing religions other than Christianity or Muslim were significantly less likely than other male youths to practice sexual abstinence (OR = 0.53, 95% CI = 0.30-0.95). Living in the north-west region of the country significantly decreased the odds of sexual abstinence among female youths. Similarly, female youths living in rural areas were significantly 0.42 times as likely as those in the urban zones to practice sexual abstinence. HIV/AIDS prevention program components could include media campaigns, educational intervention improvement, as well as promoting policies that shape female youth livelihoods. Likewise, youth involvement in initiatives to design

  10. Mood, cognition and serotonin transporter availability in current and former ecstasy (MDMA) users: the longitudinal perspective.

    PubMed

    Thomasius, R; Zapletalova, P; Petersen, K; Buchert, R; Andresen, B; Wartberg, L; Nebeling, B; Schmoldt, A

    2006-03-01

    Although 3,4-methylenedioxymethamphetamine (MDMA, ecstasy) is a known serotonergic neurotoxin in different animal species, there is to date no conclusive evidence of its neurotoxicity in humans. MDMA use was associated with impairments of psychological well-being, verbal memory and altered serotonergic functioning in a number of cross-sectional studies. Due to inherent methodological limitations, such as the notorious polydrug use of ecstasy users and lack of control of possible pre-existing differences between ecstasy users and control participants, researchers have called for well-controlled, prospective longitudinal studies to shed more light on the issue of MDMA neurotoxicity to the human brain. This longitudinal study investigated whether mood, cognition and central serotonin transporters (SERT) would deteriorate with continued MDMA use and whether or not they would recover over increasing periods of MDMA abstinence. In a repeated-measures design, 11 current and ten ex-ecstasy users, and 11 polydrug (but not MDMA) and 15 drug-naive controls participated three times within approximately two years. Both ecstasy user groups reported a polydrug use pattern besides heavy ecstasy use. Subjective reports of ecstasy use or abstinence were verified by toxicological analyses. On each trial, the participants underwent a cognitive test battery and filled in the Symptom Check List. The availability of central SERT was assessed with positron emission tomography using the McN5652 ligand for all groups at t1, and only for the ecstasy user groups on follow-ups. The factor Group yielded significant results in the SCL-90 scales Global Severity Index, Anxiety, Obsessive/compulsive and Interpersonal sensitivity, with the ex-ecstasy users reporting the highest symptom scores. There were significant Group effects in all measures of verbal memory, with the lowest performance in the group of ex-ecstasy users. The repeated-measures analyses yielded no significant Group x Time

  11. A measure of smoking abstinence-related motivational engagement: Development and initial validation

    PubMed Central

    Heckman, Bryan W.; Ditre, Joseph W.; Brandon, Thomas H.

    2010-01-01

    Introduction: Although a great deal of research has focused on measuring motivation and readiness to quit smoking, little research has assessed gross motivational changes after a smoker has made an attempt to quit smoking. Unlike previous single-item global measures of motivation to remain abstinent, we developed the abstinence-related motivational engagement (ARME) scale to evaluate the degree to which abstinence motivation is reflected by an ex-smoker’s daily experience in areas that include cognitive effort, priority, vigilance, and excitement. The aim of this study was to collect reliability and initial construct validity data on this new measure. Methods: Participants were 199 ex-smokers recruited from the community and smoking cessation Web sites. Participants completed online measures including a global motivation measure, the ARME scale, demographic questionnaire, and a measure of cessation self-efficacy. Results: The 16-item ARME questionnaire demonstrated high internal consistency reliability (α = .89). Analyses provided support for convergent, discriminant, and construct validity of the scale. ARME demonstrated the predicted correlation with a traditional measure of global cessation motivation, yet, also as predicted, only the ARME was negatively associated with length of abstinence. Moreover, as hypothesized, ex-smokers engaged in the quitting process via ongoing smoking Web site participation showed higher ARME scores than a comparison community sample. A five-item short form demonstrated similar psychometric properties. Discussion: This study provided initial support for the ARME construct and offers two versions of a reliable instrument for assessing this construct. Future research will examine the ARME as a predictor of cessation outcome and a potential target for relapse prevention. PMID:20190004

  12. Abstinence duration modulates striatal functioning during monetary reward processing in cocaine patients.

    PubMed

    Bustamante, Juan-Carlos; Barrós-Loscertales, Alfonso; Costumero, Víctor; Fuentes-Claramonte, Paola; Rosell-Negre, Patricia; Ventura-Campos, Noelia; Llopis, Juan-José; Ávila, César

    2014-09-01

    Pre-clinical and clinical studies in cocaine addiction highlight alterations in the striatal dopaminergic reward system that subserve maintenance of cocaine use. Using an instrumental conditioning paradigm with monetary reinforcement, we studied striatal functional alterations in long-term abstinent cocaine-dependent patients and striatal functioning as a function of abstinence and treatment duration. Eighteen patients and 20 controls underwent functional magnetic resonance imaging during a Monetary Incentive Delay task. Region of interest analyses based on masks of the dorsal and ventral striatum were conducted to test between-group differences and the functional effects in the cocaine group of time (in months) with no more than two lapses from the first time patients visited the clinical service to seek treatment at the scanning time (duration of treatment), and the functional effects of the number of months with no lapses or relapses at the scanning session time (length of abstinence). We applied a voxel-wise and a cluster-wise FWE-corrected level (pFWE) at a threshold of P < 0.05. The patient group showed lower activation in the right caudate during reward anticipation than the control group. The regression analyses in the patients group revealed a positive correlation between duration of treatment and brain activity in the left caudate during reward anticipation. Likewise, length of abstinence negatively correlated with brain activity in the bilateral nucleus accumbens during monetary outcome processing. In conclusion, caudate and nucleus accumbens show a different brain response pattern to non-drug rewards during cocaine addiction, which can be modulated by treatment success. © 2013 The Authors, Addiction Biology © 2013 Society for the Study of Addiction.

  13. Effect of wheel-running during abstinence on subsequent nicotine-seeking in rats.

    PubMed

    Sanchez, Victoria; Moore, Catherine F; Brunzell, Darlene H; Lynch, Wendy J

    2013-06-01

    Exercise appears to be a promising non-pharmacological treatment for nicotine addiction that may be useful for the vulnerable adolescent population. The aim of this study is to determine if wheel-running, an animal model of aerobic exercise, during an abstinence period would decrease subsequent nicotine-seeking in rats that had extended access to nicotine self-administration during adolescence. Male adolescent rats (n = 55) were trained to self-administer saline or nicotine infusions (5 or 10 μg/kg) under a fixed ratio 1 schedule with a maximum of 20 infusions/day beginning on postnatal day 30. After 5 days, access was extended to 23 h/day with unlimited infusions for a total of 10 days. After the last self-administration session, rats were moved to polycarbonate cages for a 10-day abstinence period where they either had access to a locked or unlocked running wheel for 2 h/day. Nicotine-seeking was examined following the 10th day of abstinence under a within-session extinction/cue-induced reinstatement paradigm. Intake was higher at the 10 μg/kg dose as compared to the 5 μg/kg dose; however, intake did not differ within doses prior to wheel assignment. Compared to saline controls, rats that self-administered nicotine at either dose showed a significant increase in drug-seeking during extinction, and consistent with our hypothesis, exercise during abstinence attenuated this effect. Nicotine led to modest but significant levels of cue-induced reinstatement; however, in this adolescent-onset model, levels were variable and not affected by exercise. Exercise may effectively reduce relapse vulnerability for adolescent-onset nicotine addiction.

  14. Effect of wheel-running during abstinence on subsequent nicotine-seeking in rats

    PubMed Central

    Sanchez, Victoria; Moore, Catherine F; Brunzell, Darlene H; Lynch, Wendy J

    2013-01-01

    Rationale Exercise appears to be a promising non-pharmacological treatment for nicotine addiction that may be useful for the vulnerable adolescent population. Objectives To determine if wheel running, an animal model of aerobic exercise, during an abstinence period would decrease subsequent nicotine-seeking in rats that had extended access to nicotine self-administration during adolescence. Methods Male adolescent rats (n = 55) were trained to self-administer saline or nicotine infusions (5 or 10 μg/kg) under a fixed ratio 1 schedule with a maximum of 20 infusions/day beginning on postnatal day 30. After 5 days, access was extended to 23-hr/day with unlimited infusions for a total of 10 days. After the last self-administration session, rats were moved to polycarbonate cages for a 10-day abstinence period where they either had access to a locked or unlocked running wheel for 2-hr/day. Nicotine-seeking was examined following the 10th day of abstinence under a within-session extinction/cue-induced reinstatement paradigm. Results Intake was higher at the 10 μg/kg dose as compared to the 5 μg/kg dose; however, intake did not differ within doses prior to wheel assignment. Compared to saline controls, rats that self-administered nicotine at either dose showed a significant increase in drug-seeking during extinction, and consistent with our hypothesis, exercise during abstinence attenuated this effect. Nicotine led to modest, but significant levels of cue-induced reinstatement; however, in this adolescent-onset model, levels were variable and not affected by exercise. Conclusions Exercise may effectively reduce relapse vulnerability for adolescent-onset nicotine addiction. PMID:23371488

  15. Snus undermines quit attempts but not abstinence: a randomised clinical trial among US smokers.

    PubMed

    Carpenter, Matthew J; Wahlquist, Amy E; Burris, Jessica L; Gray, Kevin M; Garrett-Mayer, Elizabeth; Cummings, K Michael; Alberg, Anthony J

    2017-03-01

    Observational studies and a few clinical trials suggest that use of low nitrosamine smokeless tobacco (snus) can facilitate smoking cessation. To better understand the real-world impact of snus on smoking behaviour, a large-scale, long-term clinical trial of naturalistic snus use among smokers is needed. A nationwide clinical trial compared abstinence outcomes among smokers who were randomised to receive free samples of snus versus not. Participants (N=1236) were recruited throughout the US and assessed for 1 year following a 6-week naturalistic sampling period, with high retention throughout. Primary outcomes included self-reported quit attempts, floating abstinence (any 7-day period of non-smoking) and 7-day point-prevalence abstinence at 6 months and 12 months. Secondary outcomes were changes in smoking, motivation and confidence to quit and adverse events. No tobacco industry support was provided. Within snus group, 82% used at least once, and 16% were using regularly at end of sampling period. Compared to control participants, smokers in the snus group were less likely to make any quit attempt (RR=0.83; 95% CI 0.70 to 1.00), and any 24 h quit attempt (RR=0.77; 95% CI 0.63 to 0.95). There were no group differences on any measure of abstinence. Provision of snus in a naturalistic context resulted in minimal uptake, and as a whole, undermined quit attempts and did not increase smoking abstinence. Results do not support the unguided, free provision of snus among smokers not motivated to quit as a means to facilitate quit attempts. NCT01509586, Results. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

  16. Happiness as a Buffer of the Association Between Dependence and Acute Tobacco Abstinence Effects in African American Smokers.

    PubMed

    Liautaud, Madalyn M; Leventhal, Adam M; Pang, Raina D

    2017-09-27

    African-American (AA) smokers are at disproportionate risk of tobacco dependence, utilizing smoking to regulate stress, and poor cessation outcomes. Positive emotional traits may function as coping factors that buffer the extent to which dependence increases vulnerability to adverse responses to acute tobacco abstinence (i.e., tobacco withdrawal). This laboratory study examined subjective happiness (SH; dispositional orientation towards frequent and intense positive affect [PA] and life satisfaction) as a moderator of the relation between tobacco dependence and subjective and behavioral abstinence effects among AA smokers. AA smokers (N=420, 39.0% female) completed self-report measures of tobacco dependence and SH followed by two counterbalanced experimental sessions (non-abstinent vs. 16-hr abstinent) involving self-report measures of composite withdrawal, urge to smoke, and mood, and a behavioral smoking task in which participants could: (a) earn money to delay smoking reinstatement, and (b) subsequently purchase cigarettes to smoke. Tobacco dependence was positively associated with increased abstinence effects in composite withdrawal, urge to smoke, PA, and latency to smoking reinstatement (ps<.04). SH significantly moderated the relation between dependence and abstinence-induced increases in composite withdrawal (β =-.17, p<.001), such that the predictive power of dependence on withdrawal severity grew proportionately weaker as levels of SH increased. SH may insulate against adverse effects of dependence on withdrawal during acute smoking abstinence, particularly withdrawal symptom clusters that are craving- and mood-based. Consideration of positive emotional traits as stress-coping factors in the dependence-withdrawal link may be warranted in research and practice with AA smokers. The current study contributes to a growing body of literature examining the potentially advantageous role of positive emotional traits to smokers. We do so by identifying a

  17. Cognitive and psychomotor performance, mood, and pressor effects of caffeine after 4, 6 and 8 h caffeine abstinence.

    PubMed

    Heatherley, Susan V; Hayward, Robert C; Seers, Helen E; Rogers, Peter J

    2005-04-01

    Many studies have found that caffeine consumed after overnight caffeine abstinence improves cognitive performance and mood. Much less is known, however, about the effects of caffeine after shorter periods of caffeine abstinence. The aim of this study was to measure the effects on psychomotor and cognitive performance, mood, hand steadiness, blood pressure and heart rate of caffeine administration after periods of 4, 6, and 8 h of caffeine abstinence. Participants (n = 49, 27 female) were moderate to moderate-high caffeine consumers (mean daily intake 370 mg/day). Following overnight caffeine abstinence, a 'pre-dose' of caffeine (1.2 mg/kg) was administered at 9 A.M, 11 A.M or 1 P.M. The participants started a baseline battery of measurements at 4 P.M.: before receiving caffeine (1.2 mg/kg) or placebo at 5 P.M.: They then performed the battery of tests again, starting at 5:30 P.M. This was a double-blind, placebo-controlled, randomised study. Performance and mood measurements confirmed a psychostimulant action of caffeine (versus placebo), but only after 8 h of caffeine abstinence. Caffeine also increased blood pressure after 8-h abstinence, whereas hand steadiness was decreased and perception of task demand was increased by caffeine after 4 h, but not after 6- and 8-h abstinence. A second cup-of-coffee equivalent dose of caffeine only reliably affected cognitive performance and mood after an 8-h interval between doses, but not after shorter intervals (when caffeine had some adverse effects). These results show that, apart from caffeine consumption soon after waking, the daily pattern of caffeine intake of many typical caffeine consumers is not well explained by the short-term psychostimulant effects of caffeine.

  18. Efficacy of Psychosocial Interventions in Inducing and Maintaining Alcohol Abstinence in Patients With Chronic Liver Disease: A Systematic Review.

    PubMed

    Khan, Anam; Tansel, Aylin; White, Donna L; Kayani, Waleed Tallat; Bano, Shah; Lindsay, Jan; El-Serag, Hashem B; Kanwal, Fasiha

    2016-02-01

    We conducted a systematic review of efficacy of psychosocial interventions in inducing or maintaining alcohol abstinence in patients with chronic liver disease (CLD) and alcohol use disorder (AUD). We performed structured keyword searches in PubMed, PsychINFO, and MEDLINE for original research articles that were published from January 1983 through November 2014 that evaluated the use of psychosocial interventions to induce or maintain alcohol abstinence in patients with CLD and AUD. We identified 13 eligible studies that comprised 1945 patients; 5 were randomized controlled trials (RCTs). Delivered therapies included motivational enhancement therapy, cognitive behavioral therapy (CBT), motivational interviewing, supportive therapy, and psychoeducation either alone or in combination in the intervention group and general health education or treatment as usual in the control group. All studies of induction of abstinence (4 RCTs and 6 observational studies) reported an increase in abstinence among participants in the intervention and control groups. Only an integrated therapy that combined CBT and motivational enhancement therapy with comprehensive medical care, delivered during a period of 2 years, produced a significant increase in abstinence (74% increase in intervention group vs 48% increase in control group, P = .02), which was reported in 1 RCT. All studies of maintenance of abstinence (1 RCT and 2 observational studies) observed recidivism in the intervention and control groups. Only an integrated therapy that combined medical care with CBT produced a significantly smaller rate of recidivism (32.7% in integrated CBT group vs 75% in control group, P = .03), which was reported from 1 observational study. However, data were not collected for more than 2 years on outcomes of patients with CLD and AUD. In a systematic analysis of studies of interventions to induce or maintain alcohol abstinence in patients with CLD and AUD, integrated combination psychotherapy with

  19. Efficacy of Psychosocial Interventions in Inducing and Maintaining Alcohol Abstinence in Patients with Chronic Liver Disease – A Systematic Review

    PubMed Central

    Khan, Anam; Tansel, Aylin; White, Donna L.; Kayani, Waleed Tallat; Bano, Shah; Lindsay, Jan; El-Serag, Hashem B.; Kanwal, Fasiha

    2016-01-01

    Background & Aims We conducted a systematic review of efficacy of psychosocial interventions in inducing or maintaining alcohol abstinence in patients with chronic liver disease (CLD) and alcohol use disorder (AUD). Methods We performed structured keyword searches in PubMed, PsychINFO, and MEDLINE for original research articles, published from January 1983 through November 2014, that evaluated the use of psychosocial interventions to induce or maintain alcohol abstinence in patients with CLD and AUD. Results We identified 13 eligible studies, comprising 1945 patients; 5 were randomized controlled trials (RCTs). Delivered therapies included motivational enhancement therapy (MET), cognitive behavioral therapy (CBT), motivational interviewing (MI), supportive therapy and psychoeducation either alone or in combination in the intervention group and general health education or treatment as usual in the control group. All studies of induction of abstinence (4 RCTs and 6 observational studies) reported an increase in abstinence among participants in the intervention and control groups. Only an integrated therapy that combined CBT and MET with comprehensive medical care, delivered over 2 years, produced a significant increase in abstinence (74% increase in intervention group versus 48% increase in control group; P=.02), reported in 1 RCT. All studies of maintenance of abstinence (1 RCT and 2 observational studies) observed recidivism in the intervention and control groups. Only an integrated therapy that combined medical care with CBT produced a significantly smaller rate of recidivism (32.7% in integrated CBT group versus 75% decrease in control group, P=.03), reported from 1 observational study. However, data were not collected for more than 2 y on outcomes of patients with CLD and AUD. Conclusion In a systematic analysis of studies of interventions to induce or maintain alcohol abstinence in patients with CLD and AUD, integrated combination psychotherapy with CBT

  20. Evidence for chronically altered cortical serotonin function in human female recreational ecstasy (MDMA) polydrug users

    PubMed Central

    Di Iorio, Christina R; Watkins, Tristan J; Dietrich, Mary S; Cao, Aize; Blackford, Jennifer U; Rogers, Baxter; Ansari, Mohammed S; Baldwin, Ronald M; Li, Rui; Kessler, Robert M; Salomon, Ronald M; Benningfield, Margaret; Cowan, Ronald L

    2012-01-01

    Context MDMA (ecstasy) is a popular recreational drug that produces loss of serotonin (5-HT) axons in animal models. Whether MDMA produces chronic reductions in 5-HT signaling in humans remains controversial. Objective To determine if MDMA use is associated with chronic reductions in serotonin signaling in female human cerebral cortex as reflected by increased 5-HT2A receptors. Design Cross sectional case-control study comparing 5-HT2A receptor levels in abstinent female MDMA polydrug users to MDMA-naive females; within-group design assessing the association of lifetime MDMA use and 5-HT2A receptors. Subjects had at least 90 days abstinence from MDMA use as verified by hair sampling. Cortical 5-HT2A receptor levels were assayed with the 5HT2A-specific Positron Emission Tomography (PET) radioligand [18F]setoperone. Setting Academic Medical Center Research Laboratory. Participants Volunteer female MDMA users (N=14) and MDMA-naive controls (N=10). Main exclusion criteria were non-drug-related DSM-IV axis I psychiatric disorders and general medical illness. Main Outcome Measure Cortical 5-HT2A receptor non-displaceable binding potential (5-HT2ABPND). Results MDMA users had increased 5-HT2ABPND in occipital-parietal (19.7%), temporal (20.5%), occipito-temporal-parietal (18.3%), frontal (16.6%), and fronto-parietal (18.5%) regions (p<0.05; corrected). Lifetime MDMA use associated positively with 5-HT2ABPND in fronto-parietal (β=0.665;p=0.007), occipito-temporal (β=0.798;p=0.002), fronto-limbic (β=0.634;p=0.024), and frontal (β=0.691;p=0.008) regions. In contrast, there were no regions in which MDMA use was inversely associated with receptor levels. There were no statistically significant effects of the duration of MDMA abstinence on 5-HT2ABPND. Conclusions Human recreational MDMA use is associated with long-lasting increases in 5-HT2A receptor density. 5-HT2A receptor levels correlate positively with lifetime MDMA use and do not decrease with abstinence. These

  1. Neuropsychological functioning in buprenorphine maintained patients versus abstinent heroin abusers on naltrexone hydrochloride therapy.

    PubMed

    Messinis, Lambros; Lyros, Epameinondas; Andrian, Virginia; Katsakiori, Paraskevi; Panagis, George; Georgiou, Vasileios; Papathanasopoulos, Panagiotis

    2009-10-01

    Methadone and buprenorphine are among the most widely employed pharmacological treatments currently available for opioid addiction. Cognitive effects of buprenorphine in abstinent heroin abusers are nevertheless far from being understood. Neuropsychological performance of 18 buprenorphine-maintained patients (BMP) was evaluated relative to that of 32 currently abstinent heroin abusers on naltrexone hydrochloride therapy (FHAN), and 34 non-drug dependent controls. The three groups were demographically balanced. Clinical groups reported histories of similar patterns of drug use and had increased periods of abstinence from any illicit substance use including heroin. The BMP group performed poorer than controls on the RAVLT (encoding and delayed recall of verbal information), CTT (conceptual flexibility, executive functions) and the RBANS figure copy (visual perception) and delayed recall of visual information. There were no significant differences in any of the cognitive measures between the BMP and FHAN groups or between the FHAN group and controls. Furthermore, the non-differing percentage of abnormal cases between the two patient groups led us to infer that treatment with either BPM or FHAN is not accompanied by qualitative differences in the cognitive profiles of these patients. Overall, results suggest that treatment with naltrexone in abstinent heroin abusers may result in less impairment of cognitive functions compared to treatment with buprenorphine. These findings are relevant for improved prognosis and treatment strategies in opioid dependence.

  2. Breast feeding is associated with postpartum smoking abstinence among women who quit smoking due to pregnancy

    PubMed Central

    Businelle, Michael S.; Costello, Tracy J.; Castro, Yessenia; Reitzel, Lorraine R.; Vidrine, Jennifer I.; Mullen, Patricia Dolan; Velasquez, Mary M.; Cinciripini, Paul M.; Cofta-Woerpel, Ludmila M.; Wetter, David W.

    2010-01-01

    Introduction: The purpose of this study was to characterize the relationship between breast feeding and postpartum smoking abstinence among women who quit smoking due to pregnancy and who were participating in a randomized clinical trial of an intervention designed to prevent postpartum relapse. Methods: A total of 251 women were enrolled in the intervention between 30 and 33 weeks postpartum and were followed through 26 weeks postpartum. Participant characteristics were assessed at the prepartum baseline visit, any breast feeding was assessed at 8 weeks postpartum, and smoking abstinence was assessed at 8 and 26 weeks postpartum. Results: Although 79.1% of participants intended to breast feed, only 40.2% reported breast feeding at 8 weeks postpartum. Characteristics associated with breast feeding at 8 weeks postpartum included Caucasian race/ethnicity, greater education, higher household income, and being married/living with a significant other. Logistic regression analysis indicated that breast feeding at 8 weeks postpartum was significantly associated with smoking abstinence at 8 weeks postpartum, odds ratio (OR) = 7.27 (95% CI = 3.27, 16.13), p < .001. Breast feeding at 8 weeks postpartum was also associated with abstinence at 26 weeks postpartum after controlling for smoking status at 8 weeks postpartum, OR = 2.64 (95% CI = 1.14, 6.10), p = .02. Discussion: Encouraging breast feeding among women who quit smoking due to pregnancy may facilitate postpartum smoking abstinence while increasing adherence to current infant feeding guidelines. PMID:20713441

  3. The Smoker’s Health Project: A self-determination theory intervention to facilitate maintenance of tobacco abstinence

    PubMed Central

    Williams, Geoffrey C.; Patrick, Heather; Niemiec, Christopher P.; Ryan, Richard M.; Deci, Edward L.; Lavigne, Holly McGregor

    2011-01-01

    A previous randomized clinical trial based on self-determination theory (SDT) and consistent with the Public Health Service (PHS) Guideline for Treating Tobacco Use and Dependence demonstrated that an intensive intervention could change autonomous self-regulation and perceived competence which in part facilitated long-term tobacco abstinence. The current article describes a pragmatic comparative effectiveness trial of three SDT-based intensive tobacco-dependence interventions. Eligible participants are randomized to one of three treatment conditions designed to facilitate long-term maintenance of tobacco abstinence, namely, Community Care (CC), which includes the 6-month SDT-based intervention previously shown to promote autonomous self-regulation, perceived competence, medication use, and tobacco abstinence; Extended Need Support (ENS), which extends the 6-month SDT-based intervention to 12 months and trains an important other to provide support for smokers’ basic psychological needs; and Harm Reduction (HR), which provides extended need support and recommends medication use for participants who do not want to stop smoking completely within 30 days but who are willing to reduce their cigarette use by half. The primary outcome is 12-month prolonged abstinence from tobacco, which is assessed one year following termination of treatment (two years post-randomization). Secondary outcomes include 7- and 30-day point prevalence tobacco abstinence, number of days using smoking-cessation medication, change in autonomous self-regulation and perceived competence, and perceived need support from important others. PMID:21382516

  4. Reinforcing Abstinence and Treatment Participation among Offenders in a Drug Diversion Program: Are Vouchers Effective?

    PubMed Central

    Hall, Elizabeth A.; Prendergast, Michael L.; Roll, John M.; Warda, Umme

    2010-01-01

    This study assessed a 26-week voucher-based intervention to reinforce abstinence and participation in treatment-related activities among substance-abusing offenders court referred to outpatient treatment under drug diversion legislation (California's Substance Abuse and Crime Prevention Act). Standard treatment consisted of criminal justice supervision and an evidence-based model for treating stimulant abuse. Participants were randomly assigned to four groups, standard treatment (ST) only, ST plus vouchers for testing negative, ST plus vouchers for performing treatment plan activities, and ST plus vouchers for testing negative and/or performing treatment plan activities. Results indicate that voucher-based reinforcement of negative urines and of treatment plan tasks (using a flat reinforcement schedule) showed no statistically significant effects on measures of retention or drug use relative to the standard treatment protocol. It is likely that criminal justice contingencies had a stronger impact on participants' treatment retention and drug use than the relatively low-value vouchers awarded as part of the treatment protocol. PMID:20463918

  5. Semen says: Assessing the accuracy of adolescents’ self-reported sexual abstinence using a semen Y-chromosome biomarker

    PubMed Central

    Rosenbaum, Janet E.; Zenilman, Jonathan M.; Rose, Eve; Wingood, Gina M.; DiClemente, Ralph J.

    2016-01-01

    Objective Researchers often assess condom use only among participants who report recent sexual behaviour, excluding participants who report no recent vaginal sex or who did not answer questions about their sexual behaviour, but self-reported sexual behaviour may be inaccurate. This study uses a semen Y-chromosome biomarker to assess semen exposure among participants who reported sexual abstinence or did not report their sexual behaviour. Methods This prospective cohort study uses data from 715 sexually active African-American female adolescents in Atlanta, surveyed at baseline, 6 months, and 12 months. Participants completed a 40-minute interview and were tested for semen Y-chromosome with polymerase chain reaction from a self-administered vaginal swab. We predicted Y-chromosome test results from self-reported sexual behaviour using within-subject panel regression. Results Among participants who reported abstinence from vaginal sex in the past 14 days, 9.4% tested positive for semen Y-chromosome. Among item non-respondents, 6.3% tested positive for semen Y-chromosome. Women who reported abstinence and engaged in item non-response regarding their sexual behaviour had respectively 62% and 78% lower odds of testing positive for Y-chromosome (OR 0.38 (0.21, 0.67), OR 0.22 (0.12, 0.40)), controlling for smoking, survey wave, and non-coital sexual behaviours reported during abstinence. Conclusions Adolescents who report sexual abstinence under-report semen exposure. Research should validate self-reported sexual behaviour with biomarkers. Adolescents who engage in item non-response regarding vaginal sex test positive for semen Y-chromosome at similar rates, which supports the practice of grouping non-respondents with adolescents reporting abstinence in statistical analysis. PMID:27147615

  6. Dissociated effects of anticipating smoking versus monetary reward in the caudate as a function of smoking abstinence.

    PubMed

    Sweitzer, Maggie M; Geier, Charles F; Joel, Danielle L; McGurrin, Patrick; Denlinger, Rachel L; Forbes, Erika E; Donny, Eric C

    2014-11-01

    Theories of addiction suggest that chronic smoking may be associated with both hypersensitivity to smoking and related cues and hyposensitivity to alternative reinforcers. However, neural responses to smoking and nonsmoking rewards are rarely evaluated within the same paradigm, leaving the extent to which both processes operate simultaneously uncertain. Behavioral evidence and theoretical models suggest that dysregulated reward processing may be more pronounced during deprivation from nicotine, but neuroimaging evidence on the effects of deprivation on reward processing is limited. The current study examined the impact of deprivation from smoking on neural processing of both smoking and monetary rewards. Two separate functional magnetic resonance imaging scans were performed in 38 daily smokers, one after smoking without restriction and one following 24 hours of abstinence. A rewarded guessing task was conducted during each scan to evaluate striatal blood oxygen level-dependent response during anticipation of both smoking and monetary rewards. A significant reward type by abstinence interaction was observed in the bilateral caudate and medial prefrontal cortex during reward anticipation. The blood oxygen level-dependent response to anticipation of smoking reward was significantly higher and anticipation of monetary rewards was significantly lower during abstinence compared with nonabstinence. Attenuation of monetary reward-related activation during abstinence was significantly correlated with abstinence-induced increases in craving and withdrawal. These results provide the first direct evidence of dissociated effects of smoking versus monetary rewards as a function of abstinence. The findings suggest an important neural pathway that may underlie the choice to smoke in lieu of alternative reinforcement during a quit attempt. © 2013 Society of Biological Psychiatry Published by Society of Biological Psychiatry All rights reserved.

  7. A Critical Role of Lateral Hypothalamus in Context-Induced Relapse to Alcohol Seeking after Punishment-Imposed Abstinence

    PubMed Central

    Rabei, Rana; Kaganovsky, Konstantin; Caprioli, Daniele; Bossert, Jennifer M.; Bonci, Antonello

    2014-01-01

    In human alcoholics, abstinence is often self-imposed, despite alcohol availability, because of the negative consequences of excessive use. During abstinence, relapse is often triggered by exposure to contexts associated with alcohol use. We recently developed a rat model that captures some features of this human condition: exposure to the alcohol self-administration environment (context A), after punishment-imposed suppression of alcohol self-administration in a different environment (context B), provoked renewal of alcohol seeking in alcohol-preferring P rats. The mechanisms underlying context-induced renewal of alcohol seeking after punishment-imposed abstinence are unknown. Here, we studied the role of the lateral hypothalamus (LH) and its forebrain projections in this effect. We first determined the effect of context-induced renewal of alcohol seeking on Fos (a neuronal activity marker) expression in LH. We next determined the effect of LH reversible inactivation by GABAA + GABAB receptor agonists (muscimol + baclofen) on this effect. Finally, we determined neuronal activation in brain areas projecting to LH during context-induced renewal tests by measuring double labeling of the retrograde tracer cholera toxin subunit B (CTb; injected in LH) with Fos. Context-induced renewal of alcohol seeking after punishment-imposed abstinence was associated with increased Fos expression in LH. Additionally, renewal was blocked by muscimol + baclofen injections into LH. Finally, double-labeling analysis of CTb + Fos showed that context-induced renewal of alcohol seeking after punishment-imposed abstinence was associated with selective activation of accumbens shell neurons projecting to LH. The results demonstrate an important role of LH in renewal of alcohol seeking after punishment-imposed abstinence and suggest a role of accumbens shell projections to LH in this form of relapse. PMID:24872550

  8. Comparison of comprehensive and abstinence-only sexuality education in young African American adolescents.

    PubMed

    Shepherd, Lindsay M; Sly, Kaye F; Girard, Jeffrey M

    2017-12-01

    The purpose of this study was to identify predictors of sexual behavior and condom use in African American adolescents, as well as to evaluate the effectiveness of comprehensive sexuality and abstinence-only education to reduce adolescent sexual behavior and increase condom use. Participants included 450 adolescents aged 12-14 years in the southern United States. Regression analyses showed favorable attitudes toward sexual behavior and social norms significantly predicted recent sexual behavior, and favorable attitudes toward condoms significantly predicted condom usage. Self-efficacy was not found to be predictive of adolescents' sexual behavior or condom use. There were no significant differences in recent sexual behavior based on type of sexuality education. Adolescents who received abstinence-only education had reduced favorable attitudes toward condom use, and were more likely to have unprotected sex than the comparison group. Findings suggest that adolescents who receive abstinence-only education are at greater risk of engaging in unprotected sex. Copyright © 2017 The Foundation for Professionals in Services for Adolescents. Published by Elsevier Ltd. All rights reserved.

  9. Placebo caffeine reduces withdrawal in abstinent coffee drinkers.

    PubMed

    Mills, Llewellyn; Boakes, Robert A; Colagiuri, Ben

    2016-04-01

    Expectancies have been shown to play a role in the withdrawal syndrome of many drugs of addiction; however, no studies have examined the effects of expectancies across a broad range of caffeine withdrawal symptoms, including craving. The purpose of the current study was to use caffeine as a model to test the effect of expectancy on withdrawal symptoms, specifically whether the belief that one has ingested caffeine is sufficient to reduce caffeine withdrawal symptoms and cravings in abstinent coffee drinkers. We had 24-h abstinent regular coffee drinkers complete the Caffeine Withdrawal Symptom Questionnaire (CWSQ) before and after receiving decaffeinated coffee. One-half of the participants were led to believe the coffee was regular caffeinated coffee (the 'Told Caffeine' condition) and one-half were told that it was decaffeinated (the 'Told Decaf' condition). Participants in the Told Caffeine condition reported a significantly greater reduction in the factors of cravings, fatigue, lack of alertness and flu-like feelings of the CWSQ, than those in the Told Decaf condition. Our results indicated that the belief that one has consumed caffeine can affect caffeine withdrawal symptoms, especially cravings, even when no caffeine was consumed. © The Author(s) 2016.

  10. Discrete memory impairments in largely pure chronic users of MDMA.

    PubMed

    Wunderli, Michael D; Vonmoos, Matthias; Fürst, Marina; Schädelin, Katrin; Kraemer, Thomas; Baumgartner, Markus R; Seifritz, Erich; Quednow, Boris B

    2017-10-01

    Chronic use of 3,4-methylenedioxymethamphetamine (MDMA, "ecstasy") has repeatedly been associated with deficits in working memory, declarative memory, and executive functions. However, previous findings regarding working memory and executive function are inconclusive yet, as in most studies concomitant stimulant use, which is known to affect these functions, was not adequately controlled for. Therefore, we compared the cognitive performance of 26 stimulant-free and largely pure (primary) MDMA users, 25 stimulant-using polydrug MDMA users, and 56 MDMA/stimulant-naïve controls by applying a comprehensive neuropsychological test battery. Neuropsychological tests were grouped into four cognitive domains. Recent drug use was objectively quantified by 6-month hair analyses on 17 substances and metabolites. Considerably lower mean hair concentrations of stimulants (amphetamine, methamphetamine, methylphenidate, cocaine), opioids (morphine, methadone, codeine), and hallucinogens (ketamine, 2C-B) were detected in primary compared to polydrug users, while both user groups did not differ in their MDMA hair concentration. Cohen's d effect sizes for both comparisons, i.e., primary MDMA users vs. controls and polydrug MDMA users vs. controls, were highest for declarative memory (d primary =.90, d polydrug =1.21), followed by working memory (d primary =.52, d polydrug =.96), executive functions (d primary =.46, d polydrug =.86), and attention (d primary =.23, d polydrug =.70). Thus, primary MDMA users showed strong and relatively discrete declarative memory impairments, whereas MDMA polydrug users displayed broad and unspecific cognitive impairments. Consequently, even largely pure chronic MDMA use is associated with decreased performance in declarative memory, while additional deficits in working memory and executive functions displayed by polydrug MDMA users are likely driven by stimulant co-use. Copyright © 2017 Elsevier B.V. and ECNP. All rights reserved.

  11. Nigerian secondary school adolescents’ perspective on abstinence-only sexual education as an effective tool for promotion of sexual health

    PubMed Central

    Inyang, Mfrekemfon P; Inyang, Obonganyie P

    2013-01-01

    The success of any type of sexual education programme depends on the knowledge and preparedness for practice by adolescents. A recent study has found that an ‘abstinence-only’ sexual education programme is effective in reducing sexual activity among adolescents. Knowledge of abstinence-only sexual education and preparedness for practice as an effective tool for promotion of sexual health among Nigerian secondary school adolescents was studied. An analytic descriptive survey design was used for the study. The research population comprised of all public secondary schools in three southern geopolitical zones of the Niger Delta Region of Nigeria. A multistage sampling technique was used to select 2020 senior secondary school (SS1-SS3) students as sample for the study. A partially self-designed and partially adapted questionnaire from an 'abstinence-only versus comprehensive sex education' debate, from debatepedia (http://wiki.idebate.org/), entitled 'Questionnaire on Nigerian Secondary School Adolescents’ Perspective on Abstinence-Only Sexual Education (QNSSAPAOSE)' was used in eliciting information from respondents. Hypotheses were formulated and tested. Frequency counts, percentage and Pearson Product Moment Correlation were used in analysing data. A greater proportion of secondary school adolescents in this study lacked knowledge of sexual education. About 80% of the respondents could not define sexual education. The general perspective on abstinence-only sexual education was negative, as revealed by the larger number of respondents who demonstrated unwillingness to practice abstinence-only sexual education. Specifically, of those who responded in favour of abstinence-only sexual education, the youngest group of adolescents (11-13 years) and the male respondents were more likely to accept this type of education than the other groups. Poor knowledge of sexual education could be responsible for unwillingness to practice abstinence-only sexual education. Sexual

  12. Manifestations of early brain recovery associated with abstinence from alcoholism.

    PubMed

    Bartsch, Andreas J; Homola, György; Biller, Armin; Smith, Stephen M; Weijers, Heinz-Gerd; Wiesbeck, Gerhard A; Jenkinson, Mark; De Stefano, Nicola; Solymosi, László; Bendszus, Martin

    2007-01-01

    Chronic alcohol abuse results in morphological, metabolic, and functional brain damage which may, to some extent, be reversible with early effects upon abstinence. Although morphometric, spectroscopic, and neuropsychological indicators of cerebral regeneration have been described previously, the overall amount and spatial preference of early brain recovery attained by abstinence and its associations with other indicators of regeneration are not well established. We investigated global and local brain volume changes in a longitudinal two-timepoint study with T1-weighted MRI at admission and after short-term (6-7 weeks) sobriety follow-up in 15 uncomplicated, recently detoxified alcoholics. Volumetric brain gain was related to metabolic and neuropsychological recovery. On admission and after short-term abstinence, structural image evaluation using normalization of atrophy (SIENA), its voxelwise statistical extension to multiple subjects, proton MR spectroscopy (1H-MRS), and neuropsychological tests were applied. Upon short-term sobriety, 1H-MRS levels of cerebellar choline and frontomesial N-acetylaspartate (NAA) were significantly augmented. Automatically detected global brain volume gain amounted to nearly two per cent on average and was spatially significant around the superior vermis, perimesencephalic, periventricular and frontal brain edges. It correlated positively with the percentages of cerebellar and frontomesial choline increase, as detected by 1H-MRS. Moreover, frontomesial NAA gains were associated with improved performance on the d2-test of attention. In 10 age- and gender-matched healthy control subjects, no significant brain volume or metabolite changes were observed. Although cerebral osmotic regulations may occur initially upon sobriety, significant increases of cerebellar choline and frontomesial NAA levels detected at stable brain water integrals and creatine concentrations, serum electrolytes and red blood cell indices in our patient sample

  13. Distinct Mu, Delta, and Kappa Opioid Receptor Mechanisms Underlie Low Sociability and Depressive-Like Behaviors During Heroin Abstinence

    PubMed Central

    Lutz, Pierre-Eric; Ayranci, Gulebru; Chu-Sin-Chung, Paul; Matifas, Audrey; Koebel, Pascale; Filliol, Dominique; Befort, Katia; Ouagazzal, Abdel-Mouttalib; Kieffer, Brigitte L

    2014-01-01

    Addiction is a chronic disorder involving recurring intoxication, withdrawal, and craving episodes. Escaping this vicious cycle requires maintenance of abstinence for extended periods of time and is a true challenge for addicted individuals. The emergence of depressive symptoms, including social withdrawal, is considered a main cause for relapse, but underlying mechanisms are poorly understood. Here we establish a mouse model of protracted abstinence to heroin, a major abused opiate, where both emotional and working memory deficits unfold. We show that delta and kappa opioid receptor (DOR and KOR, respectively) knockout mice develop either stronger or reduced emotional disruption during heroin abstinence, establishing DOR and KOR activities as protective and vulnerability factors, respectively, that regulate the severity of abstinence. Further, we found that chronic treatment with the antidepressant drug fluoxetine prevents emergence of low sociability, with no impact on the working memory deficit, implicating serotonergic mechanisms predominantly in emotional aspects of abstinence symptoms. Finally, targeting the main serotonergic brain structure, we show that gene knockout of mu opioid receptors (MORs) in the dorsal raphe nucleus (DRN) before heroin exposure abolishes the development of social withdrawal. This is the first result demonstrating that intermittent chronic MOR activation at the level of DRN represents an essential mechanism contributing to low sociability during protracted heroin abstinence. Altogether, our findings reveal crucial and distinct roles for all three opioid receptors in the development of emotional alterations that follow a history of heroin exposure and open the way towards understanding opioid system-mediated serotonin homeostasis in heroin abuse. PMID:24874714

  14. An ongoing process: a qualitative study of how the alcohol-dependent free themselves of addiction through progressive abstinence.

    PubMed

    Yeh, Mei-Yu; Che, Hui-Lian; Wu, Shu-Mei

    2009-11-24

    Most people being treated for alcoholism are unable to successfully quit drinking within their treatment programs. In few cases do we know the full picture of how abstinence is achieved in Taiwan. We tracked processes of abstinence in alcohol-dependency disorders, based on study evidence and results. This research explores the process of recovery from the viewpoint of the alcohol-dependent. Semi-structured interviews were conducted in two different settings, using purpose sampling, during 2003-2004. The data were analyzed using content analysis. Participants were 32 adults, purposefully selected from an Alcoholics Anonymous group and a psychiatric hospital in North Taiwan. We found that the abstinence process is an ongoing process, in which the alcohol-dependent free themselves of addiction progressively. This process never ends or resolves in complete recovery. We have identified three stages in the struggle against alcoholism: the Indulgence, Ambivalence and Attempt (IAA) cycle, in which the sufferer is trapped in a cycle of attempting to give up and failing; the Turning Point, in which a Personal Nadir is reached, and the Ongoing Process of abstinence, in which a constant effort is made to remain sober through willpower and with the help of support groups. We also discuss Influencing Factors that can derail abstinence attempts, pushing the sufferer back into the IAA cycle. This study provides important points of reference for alcohol and drug service workers and community healthcare professionals in Taiwan, casting light on the abstinence process and providing a basis for intervention or rehabilitation services.

  15. Effects of smoking abstinence on reaction time variability in smokers with and without ADHD: An ex-Gaussian analysis

    PubMed Central

    Kollins, Scott H.; McClernon, F. Joseph; Epstein, Jeff N.

    2009-01-01

    Smoking abstinence differentially affects cognitive functioning in smokers with ADHD, compared to non-ADHD smokers. Alternative approaches for analyzing reaction time data from these tasks may further elucidate important group differences. Adults smoking ≥15 cigarettes with (n = 12) or without (n = 14) a diagnosis of ADHD completed a continuous performance task (CPT) during two sessions under two separate laboratory conditions—a ‘Satiated’ condition wherein participants smoked up to and during the session; and an ‘Abstinent’ condition, in which participants were abstinent overnight and during the session. Reaction time (RT) distributions from the CPT were modeled to fit an ex-Gaussian distribution. The indicator of central tendency for RT from the normal component of the RT distribution (mu) showed a main effect of Group (ADHDabstinent). RT standard deviation for the normal component of the distribution (sigma) showed no effects. The ex-Gaussian parameter tau, which describes the mean and standard deviation of the non-normalcomponent of thedistribution, showedsignificant effects of session (Abstinent > Satiated), Group × Session interaction (ADHD increased significantly under Abstinent condition compared to Control), and a trend toward a main effect of Group (ADHD > Control). Alternative approaches to analyzing RT data provide a more detailed description of the effects of smoking abstinence in ADHD and non-ADHD smokers and results differ from analyses using more traditional approaches. These findings have implications for understanding the neuropsychopharmacology of nicotine and nicotine withdrawal. PMID:19041198

  16. An ongoing process: A qualitative study of how the alcohol-dependent free themselves of addiction through progressive abstinence

    PubMed Central

    2009-01-01

    Background Most people being treated for alcoholism are unable to successfully quit drinking within their treatment programs. In few cases do we know the full picture of how abstinence is achieved in Taiwan. We tracked processes of abstinence in alcohol-dependency disorders, based on study evidence and results. This research explores the process of recovery from the viewpoint of the alcohol-dependent. Methods Semi-structured interviews were conducted in two different settings, using purpose sampling, during 2003-2004. The data were analyzed using content analysis. Participants were 32 adults, purposefully selected from an Alcoholics Anonymous group and a psychiatric hospital in North Taiwan. Results We found that the abstinence process is an ongoing process, in which the alcohol-dependent free themselves of addiction progressively. This process never ends or resolves in complete recovery. We have identified three stages in the struggle against alcoholism: the Indulgence, Ambivalence and Attempt (IAA) cycle, in which the sufferer is trapped in a cycle of attempting to give up and failing; the Turning Point, in which a Personal Nadir is reached, and the Ongoing Process of abstinence, in which a constant effort is made to remain sober through willpower and with the help of support groups. We also discuss Influencing Factors that can derail abstinence attempts, pushing the sufferer back into the IAA cycle. Conclusion This study provides important points of reference for alcohol and drug service workers and community healthcare professionals in Taiwan, casting light on the abstinence process and providing a basis for intervention or rehabilitation services. PMID:19930698

  17. A critical role of nucleus accumbens dopamine D1-family receptors in renewal of alcohol seeking after punishment-imposed abstinence.

    PubMed

    Marchant, Nathan J; Kaganovsky, Konstantin

    2015-06-01

    In humans, places or contexts previously associated with alcohol use often provoke relapse during abstinence. This phenomenon is modeled in laboratory animals using the ABA renewal procedure, in which extinction training in context (B) suppresses alcohol seeking, and renewal of this seeking occurs when the animal returns to the original training context (A). However, extinction training does not adequately capture the motivation for abstinence in human alcoholics who typically self-initiate abstinence in response to the negative consequences of excessive use. We recently developed a procedure to study renewal in laboratory rats after abstinence imposed by negative consequences (footshock punishment). The mechanisms of renewal of punished alcohol seeking are largely unknown. Here, we used the D1-family receptor antagonist SCH 23390 to examine the role of nucleus accumbens (NAc) shell and core dopamine in renewal of alcohol seeking after punishment-imposed abstinence. We trained alcohol-preferring "P rats" to self-administer 20% alcohol in Context A and subsequently suppressed alcohol taking via response-contingent footshock punishment in Context B. We tested the effects of systemic, NAc shell, or NAc core injections of SCH 23390 on renewal of alcohol seeking after punishment-imposed abstinence. We found that both systemic and NAc shell and core injections of SCH 23390 decreased renewal of punished alcohol seeking. Our results demonstrate a critical role of NAc dopamine in renewal of alcohol seeking after punishment-imposed abstinence. We discuss these results in reference to the brain mechanisms of renewal of alcohol seeking after extinction versus punishment. (c) 2015 APA, all rights reserved).

  18. Overactivation of the Pupillary Response to Emotional Information in Short- and Long-Term Alcohol Abstinent Patients.

    PubMed

    Claisse, Caroline; Lewkowicz, Daniel; Cottencin, Olivier; Nandrino, Jean-Louis

    2016-11-01

    The aim of the study was to compare emotional information processing in patients with severe alcohol use disorder in short-term abstinence (<1 month) and long-term abstinence (at least 6 months to 9 years) with control participants. We studied the variation in pupil diameter during the presentation of pictures of human interactions associated with positive, negative or neutral valences. Overall, the results of the short-term abstinent group revealed greater pupil dilation regardless of the valence of the pictures while the pupillary response of long-term abstainers did not differ from the control group. More specifically, according to each valence, the pupil response to neutral pictures was greater for both patient groups than for controls. For the long-term abstainers, a negative correlation was found between the length of abstinence and the pupillary response to emotional stimuli. In long-term abstainers group, the high activation by neutral stimuli suggests however some difficulties in the processing of nonemotional stimuli, considered emotional ones and may constitute a potential relapse factor or the maintenance of addiction. © The Author 2016. Medical Council on Alcohol and Oxford University Press. All rights reserved.

  19. Sexual abstinence: What is the understanding and views of secondary school learners in a semi-rural area of North West Province, South Africa?

    PubMed Central

    Mokwena, Kebogile; Morabe, Mamaponesa

    2016-01-01

    Abstract Among strategies to prevent HIV, other sexually transmitted infections (STIs) and unwanted pregnancies, are programs that promote sexual abstinence among adolescents. However, literature suggests that there may be differences in the understanding of abstinence across adolescents, and this study sought to explore the understanding of sexual abstinence among both male and female learners in a secondary school in a semi-rural area of North West Province, South Africa. Focus group discussions were used to collect data from learners who were in grades 8–10 at the time of the study. The findings are that the learners in this area understand sexual abstinence as the decision not to have sex, and this was associated with prevention of HIV, STIs and unwanted pregnancies, which ensures a better future. Barriers to sexual abstinence include peer pressure, myths and wrong perceptions about sex, influence of drugs and alcohol and the influence of television. Based on how it is delivered, school-based sex education was viewed as both an enabler and barrier to sexual abstinence. It is recommended that programs to promote sexual abstinence be strengthened and such programs be community-based. PMID:27315574

  20. Sexual abstinence: What is the understanding and views of secondary school learners in a semi-rural area of North West Province, South Africa?

    PubMed

    Mokwena, Kebogile; Morabe, Mamaponesa

    2016-12-01

    Among strategies to prevent HIV, other sexually transmitted infections (STIs) and unwanted pregnancies, are programs that promote sexual abstinence among adolescents. However, literature suggests that there may be differences in the understanding of abstinence across adolescents, and this study sought to explore the understanding of sexual abstinence among both male and female learners in a secondary school in a semi-rural area of North West Province, South Africa. Focus group discussions were used to collect data from learners who were in grades 8-10 at the time of the study. The findings are that the learners in this area understand sexual abstinence as the decision not to have sex, and this was associated with prevention of HIV, STIs and unwanted pregnancies, which ensures a better future. Barriers to sexual abstinence include peer pressure, myths and wrong perceptions about sex, influence of drugs and alcohol and the influence of television. Based on how it is delivered, school-based sex education was viewed as both an enabler and barrier to sexual abstinence. It is recommended that programs to promote sexual abstinence be strengthened and such programs be community-based.

  1. Semen says: assessing the accuracy of adolescents' self-reported sexual abstinence using a semen Y-chromosome biomarker.

    PubMed

    Rosenbaum, Janet E; Zenilman, Jonathan M; Rose, Eve; Wingood, Gina M; DiClemente, Ralph J

    2017-03-01

    Researchers often assess condom use only among participants who report recent sexual behaviour, excluding participants who report no recent vaginal sex or who did not answer questions about their sexual behaviour, but self-reported sexual behaviour may be inaccurate. This study uses a semen Y-chromosome biomarker to assess semen exposure among participants who reported sexual abstinence or did not report their sexual behaviour. This prospective cohort study uses data from 715 sexually active African-American female adolescents in Atlanta, surveyed at baseline, 6 months and 12 months. Participants completed a 40 min interview and were tested for semen Y-chromosome with PCR from a self-administered vaginal swab. We predicted Y-chromosome test results from self-reported sexual behaviour using within-subject panel regression. Among the participants who reported abstinence from vaginal sex in the past 14 days, 9.4% tested positive for semen Y-chromosome. Among item non-respondents, 6.3% tested positive for semen Y-chromosome. Women who reported abstinence and engaged in item non-response regarding their sexual behaviour had respectively 62% and 78% lower odds of testing positive for Y-chromosome (OR 0.38 (0.21 to 0.67), OR 0.22 (0.12 to 0.40)), controlling for smoking, survey wave and non-coital sexual behaviours reported during abstinence. Adolescents who report sexual abstinence under-report semen exposure. Research should validate self-reported sexual behaviour with biomarkers. Adolescents who engage in item non-response regarding vaginal sex test positive for semen Y-chromosome at similar rates, which supports the practice of grouping non-respondents with adolescents reporting abstinence in statistical analysis. NCT00633906. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

  2. A critical role of lateral hypothalamus in context-induced relapse to alcohol seeking after punishment-imposed abstinence.

    PubMed

    Marchant, Nathan J; Rabei, Rana; Kaganovsky, Konstantin; Caprioli, Daniele; Bossert, Jennifer M; Bonci, Antonello; Shaham, Yavin

    2014-05-28

    In human alcoholics, abstinence is often self-imposed, despite alcohol availability, because of the negative consequences of excessive use. During abstinence, relapse is often triggered by exposure to contexts associated with alcohol use. We recently developed a rat model that captures some features of this human condition: exposure to the alcohol self-administration environment (context A), after punishment-imposed suppression of alcohol self-administration in a different environment (context B), provoked renewal of alcohol seeking in alcohol-preferring P rats. The mechanisms underlying context-induced renewal of alcohol seeking after punishment-imposed abstinence are unknown. Here, we studied the role of the lateral hypothalamus (LH) and its forebrain projections in this effect. We first determined the effect of context-induced renewal of alcohol seeking on Fos (a neuronal activity marker) expression in LH. We next determined the effect of LH reversible inactivation by GABAA + GABAB receptor agonists (muscimol + baclofen) on this effect. Finally, we determined neuronal activation in brain areas projecting to LH during context-induced renewal tests by measuring double labeling of the retrograde tracer cholera toxin subunit B (CTb; injected in LH) with Fos. Context-induced renewal of alcohol seeking after punishment-imposed abstinence was associated with increased Fos expression in LH. Additionally, renewal was blocked by muscimol + baclofen injections into LH. Finally, double-labeling analysis of CTb + Fos showed that context-induced renewal of alcohol seeking after punishment-imposed abstinence was associated with selective activation of accumbens shell neurons projecting to LH. The results demonstrate an important role of LH in renewal of alcohol seeking after punishment-imposed abstinence and suggest a role of accumbens shell projections to LH in this form of relapse. Copyright © 2014 the authors 0270-6474/14/347447-11$15.00/0.

  3. Negative Urgency Is Associated With Heightened Negative Affect and Urge During Tobacco Abstinence in Regular Smokers

    PubMed Central

    Park, Annie D.; Farrahi, Layla N.; Pang, Raina D.; Guillot, Casey R.; Aguirre, Claudia G.; Leventhal, Adam M.

    2016-01-01

    Objective: Negative urgency—the tendency to act rashly during negative affective states—is a risk factor for regular cigarette smoking. This human laboratory study tested a novel theoretical model of the underlying mechanisms linking negative urgency and smoking motivation, which purports that smokers with high negative urgency are at increased susceptibility to abstinence-induced increases in negative affect, which, in turn, provokes the urge to smoke to suppress negative affect. Method: Smokers (N = 180, >10 cigarettes/day) attended a baseline session at which they completed self-report measures of negative urgency and other co-factors and subsequently attended two counterbalanced within-subject experimental sessions (i.e., 16 hours of smoking abstinence or smoking as usual). At both experimental sessions, self-reported tobacco withdrawal symptoms, affect, and smoking urge were assessed. Results: Negative urgency was associated with larger abstinence-induced increases in tobacco withdrawal symptoms, negative affect, and urge to smoke to alleviate negative affect, both with and without controlling for anxiety, depression, tobacco dependence, and sensation seeking (βs > .18, ps < .05). The association between negative urgency and abstinence-induced increases in urge to smoke to alleviate negative affect was mediated by greater abstinence-induced increases in negative affect (βs > .062, ps = .01). Conclusions: These results provide initial support of this model by providing evidence that smokers with higher (vs. lower) negative urgency may be more prone to greater negative affect during withdrawal, which in turn may promote urge to smoke to suppress negative emotion. Research extending this model to other settings, measures, and methodological approaches may be fruitful. PMID:27588535

  4. Negative Urgency Is Associated With Heightened Negative Affect and Urge During Tobacco Abstinence in Regular Smokers.

    PubMed

    Park, Annie D; Farrahi, Layla N; Pang, Raina D; Guillot, Casey R; Aguirre, Claudia G; Leventhal, Adam M

    2016-09-01

    Negative urgency-the tendency to act rashly during negative affective states-is a risk factor for regular cigarette smoking. This human laboratory study tested a novel theoretical model of the underlying mechanisms linking negative urgency and smoking motivation, which purports that smokers with high negative urgency are at increased susceptibility to abstinence-induced increases in negative affect, which, in turn, provokes the urge to smoke to suppress negative affect. Smokers (N = 180, >10 cigarettes/day) attended a baseline session at which they completed self-report measures of negative urgency and other co-factors and subsequently attended two counterbalanced within-subject experimental sessions (i.e., 16 hours of smoking abstinence or smoking as usual). At both experimental sessions, self-reported tobacco withdrawal symptoms, affect, and smoking urge were assessed. Negative urgency was associated with larger abstinence-induced increases in tobacco withdrawal symptoms, negative affect, and urge to smoke to alleviate negative affect, both with and without controlling for anxiety, depression, tobacco dependence, and sensation seeking (βs > .18, ps < .05). The association between negative urgency and abstinence-induced increases in urge to smoke to alleviate negative affect was mediated by greater abstinence-induced increases in negative affect (βs > .062, ps = .01). These results provide initial support of this model by providing evidence that smokers with higher (vs. lower) negative urgency may be more prone to greater negative affect during withdrawal, which in turn may promote urge to smoke to suppress negative emotion. Research extending this model to other settings, measures, and methodological approaches may be fruitful.

  5. A guided abstinence experience to illustrate addiction recovery principles.

    PubMed

    Baldwin, Jeffrey N

    2008-08-15

    To develop and implement an elective pharmacy course that included a guided abstinence experience to illustrate addiction recovery principles. A 1-credit elective course to illustrate addiction recovery principles was developed and implemented. The course required students to give up a habit for 6 weeks that was causing them problems, meet weekly to discuss addiction recovery processes, and relate their experiences in a journal. Course grades were determined by class participation, submitted worksheets, and submission of the journal and a paper concerning their role as a pharmacist in dealing with those with addictions and in recovery. Pre- and posttests consisting of addiction case scenarios were used to assess students' application of course material. Graded course elements, pretesting and posttesting, and student course evaluations indicated that course objectives were met. Over the past 15 years, student enrollment has grown from approximately 10% of pharmacy classes to approximately 50% (average 31 students). A guided abstinence experience was an effective tool for teaching pharmacy students the concepts of addiction and recovery.

  6. [Previous abstinence time as a predictive factor at 12 months follow-up in a multi-component smoking cessation program].

    PubMed

    Moreno-Arnedillo, J J; Morante-Benadero, M E; Sánchez-Vegazo-Sánchez, E

    2014-01-01

    The objective of this study is to analyze the length of the longest period of previous abstinence time as a predictor of the results of a smoking cessation program at 12 months follow-up. A cross-sectional study was conducted on a sample of 475 smokers who had participated in a multi-component smoking cessation group therapy program. The independent variable is the longest abstinence time passed, measured in weeks, before the current treatment. Success was defined as self-reported abstinence. Bivariate analyses were applied to the independent variable and to other variables in order to determine the factors that would be part of a logistic regression model using contrasts Student t or χ(2) comparisons, as appropriate. Those that showed statistical significance were entered into a multivariate logistic regression model. Within the studied variables, previous abstinence time and sex were the only predictive variables of success at 12 month follow-up. The probability of being abstinent at 12 months follow-up was significantly associated with the length of the previous longest period of abstinence, and this is the best of the predictors considered. Successful cessation programs depend more on the relationship with the consumer biographical aspects than with biological factors. The history of previous attempts is a more valuable source of information for designing treatments than others traditionally considered. Copyright © 2013 Sociedad Española de Médicos de Atención Primaria (SEMERGEN). Publicado por Elsevier España. All rights reserved.

  7. Prolonged sexual abstinence after childbirth: gendered norms and perceived family health risks. Focus group discussions in a Tanzanian suburb.

    PubMed

    Mbekenga, Columba K; Pembe, Andrea B; Darj, Elisabeth; Christensson, Kyllike; Olsson, Pia

    2013-01-15

    Prolonged sexual abstinence after childbirth is a socio-cultural practice with health implications, and is described in several African countries, including Tanzania. This study explored discourses on prolonged postpartum sexual abstinence in relation to family health after childbirth in low-income suburbs of Dar es Salaam, Tanzania. Data for the discourse analysis were collected through focus group discussions with first-time mothers and fathers and their support people in Ilala, Dar es Salaam, Tanzania. In this setting, prolonged sexual abstinence intended at promoting child health was the dominant discourse in the period after childbirth. Sexual relations after childbirth involved the control of sexuality for ensuring family health and avoiding the social implications of non-adherence to sexual abstinence norms. Both abstinence and control were emphasised more with regard to women than to men. Although the traditional discourse on prolonged sexual abstinence for protecting child health was reproduced in Ilala, some modern aspects such as the use of condoms and other contraceptives prevailed in the discussion. Discourses on sexuality after childbirth are instrumental in reproducing gender-power inequalities, with women being subjected to more restrictions and control than men are. Thus, interventions that create openness in discussing sexual relations and health-related matters after childbirth and mitigate gendered norms suppressing women and perpetuating harmful behaviours are needed. The involvement of males in the interventions would benefit men, women, and children through improving the gender relations that promote family health.

  8. Prolonged sexual abstinence after childbirth: gendered norms and perceived family health risks. Focus group discussions in a Tanzanian suburb

    PubMed Central

    2013-01-01

    Background Prolonged sexual abstinence after childbirth is a socio-cultural practice with health implications, and is described in several African countries, including Tanzania. This study explored discourses on prolonged postpartum sexual abstinence in relation to family health after childbirth in low-income suburbs of Dar es Salaam, Tanzania. Methods Data for the discourse analysis were collected through focus group discussions with first-time mothers and fathers and their support people in Ilala, Dar es Salaam, Tanzania. Results In this setting, prolonged sexual abstinence intended at promoting child health was the dominant discourse in the period after childbirth. Sexual relations after childbirth involved the control of sexuality for ensuring family health and avoiding the social implications of non-adherence to sexual abstinence norms. Both abstinence and control were emphasised more with regard to women than to men. Although the traditional discourse on prolonged sexual abstinence for protecting child health was reproduced in Ilala, some modern aspects such as the use of condoms and other contraceptives prevailed in the discussion. Conclusion Discourses on sexuality after childbirth are instrumental in reproducing gender-power inequalities, with women being subjected to more restrictions and control than men are. Thus, interventions that create openness in discussing sexual relations and health-related matters after childbirth and mitigate gendered norms suppressing women and perpetuating harmful behaviours are needed. The involvement of males in the interventions would benefit men, women, and children through improving the gender relations that promote family health. PMID:23316932

  9. A randomized controlled trial to assess the effects of reimbursing the costs of smoking cessation therapy on sustained abstinence.

    PubMed

    Kaper, J; Wagena, E J; Willemsen, M C; van Schayck, C P

    2006-11-01

    We studied whether reimbursement for smoking cessation treatment (SCT) can increase prolonged abstinence from smoking up to 2 years. SETTING, PARTICIPANTS AND DESIGN: From the general population, we recruited smokers and assigned them randomly to a control group (n = 634) or an intervention group (n = 632). For 6 months, participants in the intervention group could apply for reimbursement and received information regarding the reimbursed SCT. Participants in the control group received no reimbursement or information. In this follow-up study, prolonged abstinence from smoking was defined as reported being abstinent from at least 7 days before the end of reimbursement until the follow-up assessment 6 months or 2 years later. At 6 months after the end of reimbursement, 18 participants in the control group (2.8%) and 35 participants (5.5%) in the intervention group reported sustained abstinence for at least 6 months [odds ratio (OR) = 2.0, 95% confidence interval (CI) 1.1-3.6]. Two years after the reimbursement period, 10 participants in the control group (1.6%) and 27 participants in the intervention group (4.3%) still reported sustained abstinence (OR = 4.1, 95% CI 1.7-10.2). The overall effectiveness of SCT increased with reimbursement and was 22% in the intervention group and 8% in the control group after 2 years. Reimbursement may be an effective strategy to increase the prolonged abstinence rate even after 2 years.

  10. Maintenance pharmacotherapy normalizes the relapse curve in recently abstinent tobacco smokers with schizophrenia and bipolar disorder.

    PubMed

    Evins, A Eden; Hoeppner, Susanne S; Schoenfeld, David A; Hoeppner, Bettina B; Cather, Corinne; Pachas, Gladys N; Cieslak, Kristina M; Maravic, Melissa Culhane

    2017-05-01

    To compare the effect of maintenance pharmacotherapy on sustained abstinence rates between recently abstinent smokers with schizophrenia and bipolar disorder (SBD) and general population smokers without psychiatric illness. We performed a person-level, pooled analysis of two randomized controlled trials of maintenance varenicline, conducted in adult smokers with SBD and general population smokers, controlling for severity of dependence. Smokers abstinent after 12-weeks of open varenicline treatment were randomly assigned to ≥12-weeks maintenance varenicline or identical placebo. In those assigned to maintenance placebo, the abstinence rate at week-24 was lower in those with SBD than for those without psychiatric illness (29.4±1.1% vs. 61.8±0.4%, OR:0.26, 95% CI: 0.13, 0.52, p<0.001). In smokers assigned to maintenance pharmacotherapy, however, there was no effect of diagnosis on abstinence rates at week-24 (87.2±0.8% vs. 81.9±0.2%, OR: 1.68, 95% CI: 0.53, 5.32, p=0.38). Time to first lapse was shortest in those with SBD assigned to maintenance placebo (Q1=12days, 95%CI: 4, 16), longer in those without psychiatric illness assigned to maintenance placebo (Q1=17days, 95%CI: 17, 29), still longer in general-population smokers assigned to maintenance varenicline (Q1=88, 95% CI:58,91, and longest in those with SBD who received maintenance varenicline (Q1>95days, 95%CI:non-est), (Χ 2 3df =96.99, p<0.0001; all pairwise comparisons p<0.001). Following a standard 12-week course of pharmacotherapy, people with schizophrenia and bipolar disorder were more likely to relapse to smoking without maintenance varenicline treatment. Maintenance pharmacotherapy could improve longer-term tobacco abstinence rates and reduce known smoking-related health disparities in those with SMI. Copyright © 2016 The Authors. Published by Elsevier B.V. All rights reserved.

  11. Employment characteristics and socioeconomic factors associated with disparities in smoking abstinence and former smoking among U.S. workers.

    PubMed

    Fagan, Pebbles; Shavers, Vickie L; Lawrence, Deirdre; Gibson, James Todd; O'Connell, Mary E

    2007-11-01

    This study examines the associations among employment and socioeconomic factors and the outcomes, current smoking, cigarette abstinence and former smoking among adult U.S. workers ages 18-64 (n=288,813). Multivariate logistic regression was used to examine the associations among the variables using cross-sectional data from the 1998-1999 and 2001-2002 Tobacco Use Supplements to the Current Population Survey. Lower odds of current smoking was observed among part-time workers compared to those working variable hours and multiple job holders compared to persons holding one job. The self-employed, part-time workers and multiple job holders had higher odds of former smoking than comparison groups. Employment factors were not associated with short-term abstinence or 12-month abstinence from smoking, but income, education, marital status, and duration of smoking were associated with 12-month abstinence. These data suggest that while employment factors are associated with current and former smoking, socioeconomic factors are associated with long-term quitting.

  12. Frontal Assessment Battery (FAB) is a simple tool for detecting executive deficits in chronic cannabis users.

    PubMed

    Fontes, Maria Alice; Bolla, Karen I; Cunha, Paulo Jannuzzi; Almeida, Priscila Previato; Jungerman, Flávia; Laranjeira, Ronaldo Ramos; Bressan, Rodrigo A; Lacerda, Acioly L T

    2011-06-01

    Cannabis is the most used illicit drug in the world, and its use has been associated with prefrontal cortex (PFC) dysfunction, including deficits in executive functions (EF). Considering that EF may influence treatment outcome, it would be interesting to have a brief neuropsychological battery to assess EF in chronic cannabis users (CCU). In the present study, the Frontal Assessment Battery (FAB), a brief, easy to use neuropsychological instrument aimed to evaluate EF, was used to evaluate cognitive functioning of CCU. We evaluated 107 abstinent CCU with the FAB and compared with 44 controls matched for age, estimated IQ, and years of education. CCU performed poorly as compared to controls (FAB total score = 16.53 vs. 17.09, p < .05). CCU had also a poor performance in the Motor Programming subtest (2.47 vs. 2.73, p < .05). This study examined effects of cannabis in executive functioning and showed evidence that the FAB is sensitive to detect EF deficits in early abstinent chronic cannabis users. Clinical significance of these findings remains to be investigated in further longitudinal studies. FAB may be useful as a screening instrument to evaluate the necessity for a complete neuropsychological assessment in this population.

  13. A reinforcement-based therapeutic workplace for the treatment of drug abuse: six-month abstinence outcomes.

    PubMed

    Silverman, K; Svikis, D; Robles, E; Stitzer, M L; Bigelow, G E

    2001-02-01

    This study evaluated a novel drug abuse treatment, the Therapeutic Workplace. In this treatment, patients are paid to perform jobs or to participate in job training. Salary is linked to abstinence by requiring patients to provide drug-free urine samples to gain access to the workplace. Pregnant and postpartum drug abuse patients (N = 40) were randomly assigned to a Therapeutic Workplace or usual care control group. Therapeutic Workplace participants were invited to work 3 hr every weekday for 6 months and could earn up to $4,030 in vouchers for abstinence, workplace attendance, and performance. On average, 45% of participants attended the workplace per day. Relative to controls, the Therapeutic Workplace nearly doubled patients' abstinence from opiates and cocaine (33% vs. 59% of thrice-weekly urine samples drug negative, respectively, p < .05). The Therapeutic Workplace can effectively treat heroin and cocaine abuse in pregnant and postpartum women.

  14. Cognitive impairments in poly-drug ketamine users.

    PubMed

    Liang, H J; Lau, C G; Tang, A; Chan, F; Ungvari, G S; Tang, W K

    2013-11-01

    Cognitive impairment has been found to be reversible in people with substance abuse, particularly those using ketamine. Ketamine users are often poly-substance users. This study compared the cognitive functions of current and former ketamine users who were also abusing other psychoactive substances with those of non-users of illicit drugs as controls. One hundred ketamine poly-drug users and 100 controls were recruited. Drug users were divided into current (n = 32) and ex-users (n = 64) according to the duration of abstinence from ketamine (>30 days). The Beck Depression Inventory (BDI), the Hospital Anxiety Depression Scale (HADSA) and the Severity of Dependence Scale (SDS) were used to evaluate depression and anxiety symptoms and the severity of drug use, respectively. The cognitive test battery comprised verbal memory (Wechsler Memory Scale III: Logic Memory and Word List), visual memory (Rey-Osterrieth Complex Figure, ROCF), executive function (Stroop, Wisconsin Card Sorting Test, and Modified Verbal Fluency Test), working memory (Digit Span Backward), and general intelligence (Information, Arithmetic and Digit-Symbol Coding) tests. Current users had higher BDI and HADSA scores than ex-users (p < 0.001 for BDI and p = 0.022 for HADSA) and controls (p < 0.001 for BDI and p = 0.002 for HADSA). Ex-users had higher BDI (p = 0.006) but equal HADSA scores (p = 1.000) compared to controls. Both current and ex-users had lower scores on Logical Memory delayed recall (p = 0.038 for current users and p = 0.032 for ex-users) and ROCF delayed recall (p = 0.033 for current users and p = 0.014 for ex-users) than controls. Current users also performed worse on ROCF recognition than controls (p = 0.002). No difference was found between the cognitive functions of current and ex-users. Ketamine poly-drug users displayed predominantly verbal and visual memory impairments, which persisted in ex-users. The interactive effect of ketamine and poly-drug use on memory needs further

  15. Abstinence-only and comprehensive sex education and the initiation of sexual activity and teen pregnancy.

    PubMed

    Kohler, Pamela K; Manhart, Lisa E; Lafferty, William E

    2008-04-01

    The role that sex education plays in the initiation of sexual activity and risk of teen pregnancy and sexually transmitted disease (STD) is controversial in the United States. Despite several systematic reviews, few epidemiologic evaluations of the effectiveness of these programs on a population level have been conducted. Among never-married heterosexual adolescents, aged 15-19 years, who participated in Cycle 6 (2002) of the National Survey of Family Growth and reported on formal sex education received before their first sexual intercourse (n = 1719), we compared the sexual health risks of adolescents who received abstinence-only and comprehensive sex education to those of adolescents who received no formal sex education. Weighted multivariate logistic regression generated population-based estimates. Adolescents who received comprehensive sex education were significantly less likely to report teen pregnancy (OR(adj) = .4, 95% CI = .22- .69, p = .001) than those who received no formal sex education, whereas there was no significant effect of abstinence-only education (OR(adj) = .7, 95% CI = .38-1.45, p = .38). Abstinence-only education did not reduce the likelihood of engaging in vaginal intercourse (OR(adj) = .8, 95% CI = .51-1.31, p = .40), but comprehensive sex education was marginally associated with a lower likelihood of reporting having engaged in vaginal intercourse (OR(adj) = .7, 95% CI = .49-1.02, p = .06). Neither abstinence-only nor comprehensive sex education significantly reduced the likelihood of reported STD diagnoses (OR(adj) = 1.7, 95% CI = .57-34.76, p = .36 and OR(adj) = 1.8, 95% CI = .67-5.00, p = .24 respectively). Teaching about contraception was not associated with increased risk of adolescent sexual activity or STD. Adolescents who received comprehensive sex education had a lower risk of pregnancy than adolescents who received abstinence-only or no sex education.

  16. Simultaneous masking between electric and acoustic stimulation in cochlear implant users with residual low-frequency hearing.

    PubMed

    Krüger, Benjamin; Büchner, Andreas; Nogueira, Waldo

    2017-09-01

    Ipsilateral electric-acoustic stimulation (EAS) is becoming increasingly important in cochlear implant (CI) treatment. Improvements in electrode designs and surgical techniques have contributed to improved hearing preservation during implantation. Consequently, CI implantation criteria have been expanded toward people with significant residual low-frequency hearing, who may benefit from the combined use of both the electric and acoustic stimulation in the same ear. However, only few studies have investigated the mutual interaction between electric and acoustic stimulation modalities. This work characterizes the interaction between both stimulation modalities using psychophysical masking experiments and cone beam computer tomography (CBCT). Two psychophysical experiments for electric and acoustic masking were performed to measure the hearing threshold elevation of a probe stimulus in the presence of a masker stimulus. For electric masking, the probe stimulus was an acoustic tone while the masker stimulus was an electric pulse train. For acoustic masking, the probe stimulus was an electric pulse train and the masker stimulus was an acoustic tone. Five EAS users, implanted with a CI and ipsilateral residual low-frequency hearing, participated in the study. Masking was determined at different electrodes and different acoustic frequencies. CBCT scans were used to determine the individual place-pitch frequencies of the intracochlear electrode contacts by using the Stakhovskaya place-to-frequency transformation. This allows the characterization of masking as a function of the difference between electric and acoustic stimulation sites, which we term the electric-acoustic frequency difference (EAFD). The results demonstrate a significant elevation of detection thresholds for both experiments. In electric masking, acoustic-tone thresholds increased exponentially with decreasing EAFD. In contrast, for the acoustic masking experiment, threshold elevations were present

  17. Adolescents’ Prescription Stimulant Use and Adult Functional Outcomes: A National Prospective Study

    PubMed Central

    McCabe, Sean Esteban; Veliz, Philip; Wilens, Timothy E.; Schulenberg, John E.

    2017-01-01

    Objective To assess the prospective 17-year relationship between the medical and nonmedical use of prescription stimulants during adolescence (age 18) and educational attainment and substance use disorder (SUD) symptoms in adulthood (age 35). Method A survey was self-administered by nationally representative probability samples of U.S. high school seniors from the Monitoring the Future study; 8,362 of these individuals were followed longitudinally from adolescence (age 18, high school senior years of 1976–1996) to adulthood (age 35, 1993–2013). Results An estimated 8.1% reported medical use of prescription stimulants while 16.7% reported nonmedical use of prescription stimulants by age 18. Approximately 43% of adolescent medical users of prescription stimulants had also engaged in nonmedical use of prescription stimulants during adolescence. Among past-year adolescent nonmedical users of prescription stimulants, 97.3% had used at least one other substance during the past-year. Medical users of prescription stimulants without any history of nonmedical use during adolescence did not differ significantly from population controls (i.e., non-attention-deficit/hyperactivity disorder (ADHD) and non-stimulant medicated ADHD during adolescence) in educational attainment and SUD symptoms in adulthood. In contrast, adolescent nonmedical users of prescription stimulants (with or without medical use) had lower educational attainment and more SUD symptoms in adulthood, compared to population controls and medical users of prescription stimulants without nonmedical use during adolescence. Conclusions Nonmedical use of prescription stimulants is common among adolescents prescribed these medications. The findings indicate youth should be carefully monitored for nonmedical use because this behavior is associated with lower educational attainment and more SUD symptoms in adulthood. PMID:28219488

  18. Effects of incentives for naltrexone adherence on opiate abstinence in heroin-dependent adults

    PubMed Central

    Jarvis, Brantley P.; Holtyn, August F.; DeFulio, Anthony; Dunn, Kelly E.; Everly, Jeffrey J.; Leoutsakos, Jeannie-Marie S.; Umbricht, Annie; Fingerhood, Michael; Bigelow, George E.; Silverman, Kenneth

    2017-01-01

    Aim To test whether an incentive-based intervention that increased adherence to naltrexone also increased opiate abstinence. Design Post-hoc combined analysis of three earlier randomized controlled trials that individually showed that incentives for adherence to oral and to extended-release injection naltrexone dosing schedules increased naltrexone adherence but not opiate abstinence. Setting Outpatient therapeutic workplace in Baltimore, MD, USA. Participants 140 unemployed heroin-dependent adults participating from 2006–2010. Interventions Participants were hired in a model workplace for 26 weeks and randomized to a Contingency (n=72) or Prescription (n=68) group. Both groups were offered naltrexone. Contingency participants were required to take scheduled doses of naltrexone in order to work and earn wages. Prescription participants could earn wages independent of naltrexone adherence. Measures Thrice-weekly and monthly urine samples tested for opiates and cocaine and measures of naltrexone adherence (percentage of monthly urine samples positive for naltrexone or percentage of scheduled injections received). All analyses included prerandomization attendance, opiate use, and cocaine use as covariates. Additional analyses controlled for cocaine use and naltrexone adherence during the intervention. Findings Contingency participants had more opiate abstinence than Prescription participants (68.1% vs. 52.9% opiate-negative thrice-weekly urine samples, respectively; and 71.9% vs. 61.7% opiate-negative monthly urine samples, respectively) based on initial analyses (thrice-weekly samples, OR = 3.3, 95% CI = 1.7–6.5, p < .01; monthly samples, OR = 2.6, 95% CI = 1.0–7.1, p = .06) and on analyses that controlled for cocaine use (thrice-weekly samples, OR = 3.9, 95% CI = 3.3–4.5, p < .01; monthly samples, OR = 3.4, 95% CI = 1.1–11.1, p =.04), which was high and associated with opiate use. The difference in opiate abstinence rates between Contingency participants

  19. Trajectories of drinking urges and the initiation of abstinence during cognitive-behavioral alcohol treatment.

    PubMed

    Hallgren, Kevin A; McCrady, Barbara S; Epstein, Elizabeth E

    2016-05-01

    Drinking urges during treatment for alcohol use disorders (AUDs) are common, can cause distress and predict relapse. Clients may have little awareness of how their drinking urges might be expected to change during AUD treatment in general and in response to initiating abstinence. The aim of the present study was to test whether drinking urges change on a daily level during treatment and after initiating abstinence. Secondary data analysis was performed using daily drinking urge ratings from two randomized clinical trials. Women (n = 98) and men (n = 79) with AUDs in separate clinical trials of out-patient AUD-focused cognitive-behavioral therapy. Daily dichotomous indicators of any drinking urges or acute escalations in urges (i.e. at least two more urges compared with the previous day) were examined using generalized linear mixed growth-curve modeling. Participants who initiated abstinence reported reductions in urges immediately thereafter (log odds ratios: women B = -0.701, P < 0.001; men B = -0.628, P = 0.018), followed by additional, gradual reductions over time (women B = -0.118, P < 0.001; men B = -0.141, P < 0.001). Participants who entered treatment abstaining from alcohol also reported significant reductions in urges over time (women B = -0.147, P < 0.001; men B = -0.142, P < 0.001). Participants who drank throughout treatment had smaller (women B = -0.042, P = 0.012) or no reductions in urges (men B = 0.015, P = 0.545). There was no evidence that urges increased systematically in response to initiating abstinence. Drinking urges during out-patient behavioral treatment for alcohol use disorders may be maintained in part by alcohol consumption. Initiating abstinence is associated with reductions in drinking urges immediately and then more gradually over time. © 2015 Society for the Study of Addiction.

  20. A randomized controlled trial of contingency management for psycho-stimulant use in community mental health outpatients with co-occurring serious mental illness

    PubMed Central

    McDonell, Michael G.; Srebnik, Debra; Angelo, Frank; McPherson, Sterling; Lowe, Jessica M.; Sugar, Andrea; Short, Robert A.; Roll, John M.; Ries, Richard K.

    2014-01-01

    Objective The primary objective of this study was to determine if contingency management was associated with increased stimulant drug abstinence in community mental health outpatients with serious mental illness and stimulant dependence. Secondary objectives were to determine if contingency management was associated with reductions in use of other substances, psychiatric symptoms, HIV-risk behavior, and inpatient service utilization. Method A randomized controlled design compared outcomes of 176 outpatients with serious mental illness and stimulant dependence. Participants were randomized to three months of contingency management for stimulant abstinence plus treatment-as-usual or treatment-as-usual with reinforcement for study participation only. Urine drug tests, self-report, clinician-report, and service utilization outcomes were assessed during three-month treatment and three-month follow-up periods. Results While participants in the contingency management condition were less likely to complete the treatment period (n=38; 42%) than those assigned to the control condition (n=55; 65%), X2(1)=9.8, p=0.02; those assigned to the contingency management condition were 2.4 (CI=1.9-3.0) times more likely to submit a stimulant-negative urine test during treatment. Participants assigned to contingency management experienced significantly lower levels of alcohol use, injection drug use, psychiatric symptoms, and were five times less likely than those assigned to the control condition to be admitted for psychiatric hospitalization, X2(1)=5.4, p=0.02. Contingency management participants reported significantly fewer days of stimulant drug use, relative to controls during the three-month follow-up. Conclusions When added to treatment-as-usual, contingency management is associated with large reductions in stimulant, injection drug, and alcohol use. Reductions in psychiatric symptoms and hospitalizations were important secondary benefits. PMID:23138961

  1. The effects of caffeine abstinence on sleep: a pilot study.

    PubMed

    Ho, Shuk Ching; Chung, Joanne Wai Yee

    2013-05-01

    The aim of this study was to examine whether caffeine abstinence in the evening could improve the sleep quality of those who habitually consume coffee. A double-blind control group design (caffeine and caffeine-free groups). A university. A convenience sampling of 10 students (mean age 21.4 years). It was a 14-day experiment. For the first 7 days, all participants consumed caffeinated coffee. In the following 7 days, subjects consumed caffeinated or decaffeinated coffee according to their assigned group. Sleep-wake parameters, self-reported sleep quality and level of refreshment. There were no significant differences (p>.05) among the data of the two groups identified. No significant changes (p>.05) were found in the sleep quality of either group during the study. This study confirms that caffeine abstinence in the evening might not be helpful in sleep promotion. It highlights the need to implement evidence-based practice in health promotion. Copyright © 2013 Elsevier Inc. All rights reserved.

  2. Electrophysiological evidence of enhanced performance monitoring in recently abstinent alcoholic men

    PubMed Central

    Padilla, Mayra L.; Sullivan, Edith V.; Mayer, Benjamin Z.; Turlington, Sharon R.; Hoffman, Lindsay R.; Wagstaff, Amanda E.; Pfefferbaum, Adolf

    2010-01-01

    Rationale Chronic alcoholism is associated with mild to moderate cognitive impairment. Under certain conditions, impairment can be ameliorated by invoking compensatory processes. Objective To identify electrophysiological mechanisms of such compensation that would be required to resolve response conflict. Methods 14 abstinent alcoholic men and 14 similarly aged control men performed a variation of the Eriksen flanker task during an electroencephalography (EEG) recording to examine whether alcoholics could achieve and maintain control-level performance and whether EEG markers could identify evidence for the action of compensatory processes in the alcoholics. Monitoring processes engaged following a response were indexed by the correct related negativity (CRN) and error related negativity (ERN), two medial–frontal negative event-related potentials. Results The alcoholics were able to perform at control levels on accuracy and reaction time (RT). Alcoholics generated larger ERN amplitudes following incorrect responses and larger CRNs following correct responses than controls. Both groups showed evidence of post-error slowing. Larger CRN amplitudes in the alcoholics were related to longer RTs. Also observed in the alcoholics was an association between smaller CRN amplitudes and length of sobriety, suggesting a normalization of monitoring activity with extended abstinence. Conclusions To the extent that greater amplitude of these electrophysiological markers of performance monitoring indexes greater resource allocation and performance compensation, the larger amplitudes observed in the alcoholic than control group support the view that elevated performance monitoring enables abstinent alcoholics to overcome response conflict, as was evident in their control-level performance. PMID:20941595

  3. The effects of smoking and abstinence on experience of happiness and sadness in response to positively valenced, negatively valenced, and neutral film clips.

    PubMed

    Dawkins, Lynne; Acaster, Sarah; Powell, Jane H

    2007-02-01

    Incentive motivation theories of addiction suggest that behavioural concomitants of compromised mesocorticolimbic reward activity during abstinence might include decreased affective reactions to natural reinforcers. This study tested implications for hedonic reactions in abstinent smokers. It was hypothesised that positively valenced (pleasurable) film clips would elicit lower ratings of happiness in abstinent than satiated smokers. Twenty-nine smokers, randomly assigned to either an 'abstinent' or a 'satiated' condition, and 15 non-smokers took part in a single session in which they rated (i) signs and symptoms of nicotine withdrawal and (ii) affective responses to positively valenced, negatively valenced, and neutral film clips. Compared with satiated smokers, abstinent smokers rated positive clips as eliciting significantly lower levels of happiness, and this was independent of self-reported nicotine withdrawal symptoms; the scores of non-smokers fell between those of abstinent and satiated smokers, more closely approximating those of the latter. By contrast, sadness ratings in response to negative clips were not affected by smoking status, indicating that the effect on happiness was not simply due to general emotional blunting. These results suggest that, for regular smokers, stimuli that are motivationally salient for the general population may elicit reduced positive affective responses during periods of abstinence.

  4. The Knowledge Gap Versus the Belief Gap and Abstinence-Only Sex Education.

    PubMed

    Hindman, Douglas Blanks; Yan, Changmin

    2015-08-01

    The knowledge gap hypothesis predicts widening disparities in knowledge of heavily publicized public affairs issues among socioeconomic status groups. The belief gap hypothesis extends the knowledge gap hypothesis to account for knowledge and beliefs about politically contested issues based on empirically verifiable information. This analysis of 3 national surveys shows belief gaps developed between liberals and conservatives regarding abstinence-only sex education; socioeconomic status-based knowledge gaps did not widen. The findings partially support both belief gap and knowledge gap hypotheses. In addition, the unique contributions of exposure to Fox News, CNN, and MSNBC in this process were investigated. Only exposure to Fox News was linked to beliefs about abstinence-only sex education directly and indirectly through the cultivation of conservative ideology.

  5. Abstinence, Social Norms, and Drink Responsibly Messages: A Comparison Study

    ERIC Educational Resources Information Center

    Glassman, Tavis J.; Kruger, Jessica Sloan; Deakins, Bethany A.; Paprzycki, Peter; Blavos, Alexis A.; Hutzelman, Erin N.; Diehr, Aaron

    2016-01-01

    Objective: The purpose of this study was to determine which type of prevention message (abstinence, social norms, or responsible drinking) was most effective at reducing alcohol consumption. Participants: The subjects from this study included 194 college students from a public university. Methods: Researchers employed a quasi-experimental design,…

  6. The Problematic Promotion of Abstinence: An Overview of Sex Respect.

    ERIC Educational Resources Information Center

    Goodson, Patricia; Edmundson, Elizabeth

    1994-01-01

    Presents the results of a content evaluation of the abstinence-based sexuality education curriculum, "Sex Respect," focusing on the curriculum's message and presentation. Results indicate Sex Respect omits basic content and includes misinformation, especially in the areas of human sexual response and reproductive health, and needs revision.…

  7. Experiences of violence and association with decreased drug abstinence among women in Cape Town, South Africa.

    PubMed

    Reed, Elizabeth; Myers, Bronwyn; Novak, Scott P; Browne, Felicia A; Wechsberg, Wendee M

    2015-01-01

    Drug abuse is a contributing factor in women's HIV risk in low-income communities in Cape Town, South Africa. This study assessed whether experiencing violence is associated with reduced drug abstinence among adult women (n = 603) participating in a randomized field trial for an HIV prevention study in Cape Town. In relation to drug abstinence at 12-month follow-up, multivariable regression models were used to assess (1) baseline partner and non-partner victimization, and (2) victimization at 12-month follow-up among participants reporting baseline victimization. Baseline partner (AOR = 0.6; 95 % CI 0.4-0.9) and non-partner victimization (AOR = 0.6; 95 % CI 0.4-0.9) were associated with a reduced likelihood of drug abstinence at follow-up. Among participants who reported victimization at baseline, those no longer reporting victimization at follow-up did not differ significantly in drug abstinence compared with those who reported victimization at follow-up. The study findings highlight the lasting impact of victimization on women's drug use outcomes, persisting regardless of whether violence was no longer reported at follow-up. Overall, the findings support the need for the primary prevention of violence to address the cycle of violence, drug use, and HIV among women in this setting.

  8. Patterns of change in withdrawal symptoms, desire to smoke, reward motivation and response inhibition across 3 months of smoking abstinence.

    PubMed

    Dawkins, Lynne; Powell, Jane H; Pickering, Alan; Powell, John; West, Robert

    2009-05-01

    We have demonstrated previously that acute smoking abstinence is associated with lowered reward motivation and impaired response inhibition. This prospective study explores whether these impairments, along with withdrawal-related symptoms, recover over 3 months of sustained abstinence. Participants completed a 12-hour abstinent baseline assessment and were then allocated randomly to quit unaided or continue smoking. All were re-tested after 7 days, 1 month and 3 months. Successful quitters' scores were compared with those of continuing smokers, who were tested after ad libitum smoking. Goldsmiths, University of London. A total of 33 smokers who maintained abstinence to 3 months, and 31 continuing smokers. Indices demonstrated previously in this cohort of smokers to be sensitive to the effect of nicotine versus acute abstinence: reward motivation [Snaith-Hamilton pleasure scale (SHAPS), Card Arranging Reward Responsivity Objective Test (CARROT), Stroop], tasks of response inhibition [anti-saccade task; Continuous Performance Task (CPT)], clinical indices of mood [Hospital Anxiety and Depression Scale (HADS)], withdrawal symptoms [Mood and Physical Symptoms Scale (MPSS)] and desire to smoke. SHAPS anhedonia and reward responsivity (CARROT) showed significant improvement and plateaued after a month of abstinence, not differing from the scores of continuing smokers tested in a satiated state. Mood, other withdrawal symptoms and desire to smoke all declined from acute abstinence to 1 month of cessation and were equivalent to, or lower than, the levels reported by continuing, satiated smokers. Neither group showed a change in CPT errors over time while continuing smokers, but not abstainers, showed improved accuracy on the anti-saccade task at 3 months. Appetitive processes and related affective states appear to improve in smokers who remain nicotine-free for 3 months, whereas response inhibition does not. Although in need of replication, the results suggest tentatively

  9. Patterns of change in withdrawal symptoms, desire to smoke, reward motivation, and response inhibition across three months of smoking abstinence

    PubMed Central

    Dawkins, Lynne; Powell, Jane H.; Pickering, Alan; Powell, John; West, Robert

    2009-01-01

    Aims We have previously demonstrated that acute smoking abstinence is associated with lowered reward motivation and impaired response inhibition. This prospective study explores whether these impairments, along with withdrawal-related symptoms, recover over three months of sustained abstinence. Design Participants completed a 12-hour abstinent baseline assessment and were then randomly allocated to quit unaided or continue smoking. All were re-tested after 7 days, 1 month and 3 months. Successful quitters’ scores were compared with those of continuing smokers, who were tested after ad libitum smoking. Setting Goldsmiths, University of London. Participants 33 smokers who maintained abstinence to 3 months, and 31 continuing smokers. Measurements Indices previously demonstrated in this cohort of smokers to be sensitive to the effect of nicotine vs. acute abstinence: reward motivation (SHAPS, CARROT, Stroop); tasks of response inhibition (antisaccade task; CPT) and clinical indices of mood (HADS), withdrawal symptoms (MPSS) and desire to smoke. Findings SHAPS anhedonia and reward responsivity (CARROT) showed significant improvement and plateaued after a month of abstinence, not differing from the scores of continuing smokers tested in a satiated state. Mood, other withdrawal symptoms and desire to smoke all declined from acute abstinence to 1 month of cessation and were equivalent, or lower than, the levels reported by continuing, satiated smokers. Neither group showed a change in CPT errors over time whilst continuing smokers, but not abstainers, showed improved accuracy on the antisaccade task at 3 months. Conclusion Appetitive processes and related affective states appear to improve in smokers who remain nicotine-free for 3 months whereas response inhibition does not. Although in need of replication, the results tentatively suggest that poor inhibitory control may constitute a long-term risk factor for relapse and could be a target for intervention. PMID:19344444

  10. An Abstinence Program's Impact on Cognitive Mediators and Sexual Initiation

    ERIC Educational Resources Information Center

    Weed, Stan E.; Ericksen, Irene H.; Lewis, Allen; Grant, Gale E.; Wibberly, Kathy H.

    2008-01-01

    Objectives: To evaluate the impact of an abstinence education program on sexual intercourse initiation and on possible cognitive mediators of sexual initiation for virgin seventh graders in suburban Virginia. Methods: Measures of sexual behavior and 6 mediating variables were compared at 3 time periods for program participants and a matched…

  11. Relations among affect, abstinence motivation and confidence, and daily smoking lapse risk.

    PubMed

    Minami, Haruka; Yeh, Vivian M; Bold, Krysten W; Chapman, Gretchen B; McCarthy, Danielle E

    2014-06-01

    This study tested the hypothesis that changes in momentary affect, abstinence motivation, and confidence would predict lapse risk over the next 12-24 hr using Ecological Momentary Assessment (EMA) data from smokers attempting to quit smoking. One hundred and three adult, daily, treatment-seeking smokers recorded their momentary affect, motivation to quit, abstinence confidence, and smoking behaviors in near real time with multiple EMA reports per day using electronic diaries postquit. Multilevel models indicated that initial levels of negative affect were associated with smoking, even after controlling for earlier smoking status, and that short-term increases in negative affect predicted lapses up to 12, but not 24, hr later. Positive affect had significant effects on subsequent abstinence confidence, but not motivation to quit. High levels of motivation appeared to reduce increases in lapse risk that occur over hours although momentary changes in confidence did not predict lapse risk over 12 hr. Negative affect had short-lived effects on lapse risk, whereas higher levels of motivation protected against the risk of lapsing that accumulates over hours. An increase in positive affect was associated with greater confidence to quit, but such changes in confidence did not reduce short-term lapse risk, contrary to expectations. Relations observed among affect, cognitions, and lapse seem to depend critically on the timing of assessments.

  12. Relations among Affect, Abstinence Motivation and Confidence, and Daily Smoking Lapse Risk

    PubMed Central

    Minami, Haruka; Yeh, Vivian M.; Bold, Krysten W.; Chapman, Gretchen B.; McCarthy, Danielle E.

    2016-01-01

    Aims This study tested the hypothesis that changes in momentary affect, abstinence motivation, and confidence would predict lapse risk over the next 12–24 hours using Ecological Momentary Assessment (EMA) data from smokers attempting to quit smoking. Method 103 adult, daily, treatment-seeking smokers recorded their momentary affect, motivation to quit, abstinence confidence, and smoking behaviors in near real time with multiple EMA reports per day using electronic diaries post-quit. Results Multilevel models indicated that initial levels of negative affect were associated with smoking, even after controlling for earlier smoking status, and that short-term increases in negative affect predicted lapses up to 12, but not 24, hours later. Positive affect had significant effects on subsequent abstinence confidence, but not motivation to quit. High levels of motivation appeared to reduce increases in lapse risk that occur over hours while momentary changes in confidence did not predict lapse risk over 12 hours. Conclusion Negative affect had short-lived effects on lapse risk, whereas higher levels of motivation protected against the risk of lapsing that accumulates over hours. An increase in positive affect was associated with greater confidence to quit, but such changes in confidence did not reduce short-term lapse risk, contrary to expectations. Relations observed among affect, cognitions, and lapse seem to depend critically on the timing of assessments. PMID:24955665

  13. Longitudinal changes in drug use severity and physical health-related quality of life among untreated stimulant users.

    PubMed

    Borders, Tyrone F; Booth, Brenda M; Falck, Russel S; Leukefeld, Carl; Wang, Jichuan; Carlson, Robert G

    2009-11-01

    The primary objective of this study was to investigate whether drug use severity is associated with physical health-related quality of life (HRQL) over time. Data are from a longitudinal, multi-state, natural history community study of users of cocaine and/or methamphetamine who were interviewed at 6-month intervals over 2 years with a 79% follow-up participation rate. Physical HRQL was assessed with the physical component summary (PCS) of the SF-8 Health Survey and drug, alcohol, and psychiatric severity were all assessed with the Addiction Severity Index (ASI). Random coefficient regression analyses were conducted to test for longitudinal associations between the independent variables and SF-8 PCS scores. Reductions in drug use severity over time were accompanied by only minor improvements in SF-8 PCS scores, underscoring the potential long-term harm of illicit drug use on physical health. Greater psychiatric severity was strongly associated with lower SF-8 PCS scores, suggesting that clinical attention to mental health issues could potentially lead to improvements in perceived physical health as well as among stimulant users.

  14. Longitudinal Changes in Drug Use Severity and Physical Health-Related Quality of Life among Untreated Stimulant Users

    PubMed Central

    Borders, Tyrone F.; Booth, Brenda M.; Falck, Russel S.; Leukefeld, Carl; Wang, Jichuan; Carlson, Robert G.

    2009-01-01

    The primary objective of this study was to investigate whether drug use severity is associated with physical health-related quality of life (HRQL) over time. Data are from a longitudinal, multi-state, natural history community study of users of cocaine and/or methamphetamine who were interviewed at 6-month intervals over 2 years with a 79% follow-up participation rate. Physical HRQL was assessed with the physical component summary (PCS) of the SF-8™ Health Survey and drug, alcohol, and psychiatric severity were all assessed with the Addiction Severity Index (ASI). Random coefficient regression analyses were conducted to test for longitudinal associations between the independent variables and SF-8 PCS scores. Reductions in drug use severity over time were accompanied by only minor improvements in SF-8 PCS scores, underscoring the potential long-term harm of illicit drug use on physical health. Greater psychiatric severity was strongly associated with lower SF-8 PCS scores, suggesting that clinical attention to mental health issues could potentially lead to improvements in perceived physical health as well among stimulant users. PMID:19560873

  15. Other drug use does not impact cognitive impairments in chronic ketamine users.

    PubMed

    Zhang, Chenxi; Tang, Wai Kwong; Liang, Hua Jun; Ungvari, Gabor Sandor; Lin, Shih-Ku

    2018-05-01

    Ketamine abuse causes cognitive impairments, which negatively impact on users' abstinence, prognosis, and quality of life. of cognitive impairments in chronic ketamine users have been inconsistent across studies, possibly due to the small sample sizes and the confounding effects of concomitant use of other illicit drugs. This study investigated the cognitive impairment and its related factors in chronic ketamine users with a large sample size and explored the impact of another drug use on cognitive functions. Cognitive functions, including working, verbal and visual memory and executive functions were assessed in ketamine users: 286 non-heavy other drug users and 279 heavy other drug users, and 261 healthy controls. Correlations between cognitive impairment and patterns of ketamine use were analysed. Verbal and visual memory were impaired, but working memory and executive functions were intact for all ketamine users. No significant cognitive differences were found between the two ketamine groups. Greater number of days of ketamine use in the past month was associated with worse visual memory performance in non-heavy other drug users. Higher dose of ketamine use was associated with worse short-term verbal memory in heavy other drug users. Verbal and visual memory are impaired in chronic ketamine users. Other drug use appears to have no impact on ketamine users' cognitive performance. Copyright © 2018. Published by Elsevier B.V.

  16. A Preliminary Investigation of a Relapse Prevention Mobile Application to Maintain Smoking Abstinence Among Individuals With Posttraumatic Stress Disorder.

    PubMed

    Hicks, Terrell A; Thomas, Shaun P; Wilson, Sarah M; Calhoun, Patrick S; Kuhn, Eric R; Beckham, Jean C

    2017-01-01

    Smokers with posttraumatic stress disorder (PTSD) have increased difficulty achieving and maintaining abstinence. Contingency management approaches to smoking cessation interventions have demonstrated short-term efficacy but are limited by high rates of relapse. The goal of this pilot study was to evaluate the usability and feasibility of a smartphone-based smoking cessation application (Stay Quit Coach) designed to prevent relapse among individuals with PTSD. Smokers (N = 11) were randomized to (1) QUIT4EVER, an intervention combining mobile contingency management smoking cessation counseling and medications, and Stay Quit Coach or (2) a contact control condition that was identical to QUIT4EVER except Stay Quit Coach was not included. The primary outcome was prolonged smoking abstinence. Among those queried during the follow-up periods, average Stay Quit Coach helpfulness ratings were high and ranged from 7.25 to 10 on a 10-point Likert scale (with higher scores corresponding to greater helpfulness). The Stay Quit Coach was rated by participants as being most effective at helping to quit smoking, helping to remain quit, and providing support and relevant information about quitting. Among the three quitters in the QUIT4EVER group, all reported abstinence at 3 and 6 months; however, abstinence was only bioverified for one quitter at 6 months. Among the four quitters in the contact control condition group, three reported abstinence at 3 and 6 months, but abstinence was not confirmed by bioverification. Smokers with PTSD express interest in and helpfulness of Stay Quit Coach for remaining abstinent after a quit attempt. Combined use of mobile contingency management and Stay Quit Coach is a feasible and acceptable adjunctive smoking cessation treatment for reducing smoking among smokers with PTSD. Adequately powered clinical trials are needed to demonstrate the long-term efficacy of this combined approach to smoking cessation. This study [Use of Technological

  17. Developing Non-Somatotopic Phantom Finger Sensation to Comparable Levels of Somatotopic Sensation through User Training With Electrotactile Stimulation.

    PubMed

    Chai, Guohong; Zhang, Dingguo; Zhu, Xiangyang

    2017-05-01

    Cutaneous electrical stimulation can provide tactile feedback for upper-limb amputees through somatotopic feedback (SF) or non-somatotopic feedback (NF). The SF delivers electrotactile stimulus to projection finger maps (PFMs) on the stumps of amputees, which outperforms NF that transfers stimulus to other human intact skin areas in general. However, the SF areas on stumps are very limited and often occupied by electromyography (EMG) sensors in application of myoelectric prosthesis. This work aims at improving NF performance on human upper arms through user training with electrotactile stimulation. The experiments were conducted over seven consecutive days on nine able-bodied subjects and two forearm amputees. The performance measures of NF/SF included the correct identification rates (CIR s ), the response time and the NASA-TLX questionnaire. The between-day CIR s on NF sites increased logarithmically with a mean course of 3-day rapid-improving phase and plateaued in the relative-steady phase. The response time and NASA-TLX scores could also rapidly reduce to the comparable levels of the SF areas during the same mean period of 3-day rapid-improving phase, respectively. These results indicated that the performance of NF could be highly improved to the equivalent level as that of SF through 3-day electrotactile training, which we named as "3-day effect". It provides important insights that intact skin areas without phantom sensations can effectively replace SF sites to transfer tactile feedback after continuous user training, which validates effectiveness of non-invasive interfaces of tactile feedback for upper-limb amputees in practice.

  18. Effect of the Novel Positive Allosteric Modulator of Metabotropic Glutamate Receptor 2 AZD8529 on Incubation of Methamphetamine Craving After Prolonged Voluntary Abstinence in a Rat Model.

    PubMed

    Caprioli, Daniele; Venniro, Marco; Zeric, Tamara; Li, Xuan; Adhikary, Sweta; Madangopal, Rajtarun; Marchant, Nathan J; Lucantonio, Federica; Schoenbaum, Geoffrey; Bossert, Jennifer M; Shaham, Yavin

    2015-10-01

    Cue-induced methamphetamine craving increases after prolonged forced (experimenter-imposed) abstinence from the drug (incubation of methamphetamine craving). Here, we determined whether this incubation phenomenon would occur under conditions that promote voluntary (self-imposed) abstinence. We also determined the effect of the novel metabotropic glutamate receptor 2 positive allosteric modulator, AZD8529, on incubation of methamphetamine craving after forced or voluntary abstinence. We trained rats to self-administer palatable food (6 sessions) and then to self-administer methamphetamine under two conditions: 12 sessions (9 hours/day) or 50 sessions (3 hours/day). We then assessed cue-induced methamphetamine seeking in extinction tests after 1 or 21 abstinence days. Between tests, the rats underwent either forced abstinence (no access to the food- or drug-paired levers) or voluntary abstinence (achieved via a discrete choice procedure between methamphetamine and palatable food; 20 trials per day) for 19 days. We also determined the effect of subcutaneous injections of AZD8529 (20 and 40 mg/kg) on cue-induced methamphetamine seeking 1 day or 21 days after forced or voluntary abstinence. Under both training and abstinence conditions, cue-induced methamphetamine seeking in the extinction tests was higher after 21 abstinence days than after 1 day (incubation of methamphetamine craving). AZD8529 decreased cue-induced methamphetamine seeking on day 21 but not day 1 of forced or voluntary abstinence. We introduce a novel animal model to study incubation of drug craving and cue-induced drug seeking after prolonged voluntary abstinence, mimicking the human condition of relapse after successful contingency management treatment. Our data suggest that positive allosteric modulators of metabotropic glutamate receptor 2 should be considered for relapse prevention. Published by Elsevier Inc.

  19. Functional connectivity alterations in brain networks relevant to self-awareness in chronic cannabis users.

    PubMed

    Pujol, Jesus; Blanco-Hinojo, Laura; Batalla, Albert; López-Solà, Marina; Harrison, Ben J; Soriano-Mas, Carles; Crippa, Jose A; Fagundo, Ana B; Deus, Joan; de la Torre, Rafael; Nogué, Santiago; Farré, Magí; Torrens, Marta; Martín-Santos, Rocío

    2014-04-01

    Recreational drugs are generally used to intentionally alter conscious experience. Long-lasting cannabis users frequently seek this effect as a means to relieve negative affect states. As with conventional anxiolytic drugs, however, changes in subjective feelings may be associated with memory impairment. We have tested whether the use of cannabis, as a psychoactive compound, is associated with alterations in spontaneous activity in brain networks relevant to self-awareness, and whether such potential changes are related to perceived anxiety and memory performance. Functional connectivity was assessed in the Default and Insula networks during resting state using fMRI in 28 heavy cannabis users and 29 control subjects. Imaging assessments were conducted during cannabis use in the unintoxicated state and repeated after one month of controlled abstinence. Cannabis users showed increased functional connectivity in the core of the Default and Insula networks and selective enhancement of functional anticorrelation between both. Reduced functional connectivity was observed in areas overlapping with other brain networks. Observed alterations were associated with behavioral measurements in a direction suggesting anxiety score reduction and interference with memory performance. Alterations were also related to the amount of cannabis used and partially persisted after one month of abstinence. Chronic cannabis use was associated with significant effects on the tuning and coupling of brain networks relevant to self-awareness, which in turn are integrated into brain systems supporting the storage of personal experience and motivated behavior. The results suggest potential mechanisms for recreational drugs to interfere with higher-order network interactions generating conscious experience. Copyright © 2014 Elsevier Ltd. All rights reserved.

  20. The Effects of State-Mandated Abstinence-Based Sex Education on Teen Health Outcomes.

    PubMed

    Carr, Jillian B; Packham, Analisa

    2017-04-01

    In 2011, the USA had the second highest teen birth rate of any developed nation, according to the World Bank, . In an effort to lower teen pregnancy rates, several states have enacted policies requiring abstinence-based sex education. In this study, we utilize a difference-in-differences research design to analyze the causal effects of state-level sex education policies from 2000-2011 on various teen sexual health outcomes. We find that state-level abstinence education mandates have no effect on teen birth rates or abortion rates, although we find that state-level policies may affect teen sexually transmitted disease rates in some states. Copyright © 2016 John Wiley & Sons, Ltd. Copyright © 2016 John Wiley & Sons, Ltd.

  1. Functional imaging studies in cannabis users.

    PubMed

    Chang, Linda; Chronicle, Edward P

    2007-10-01

    Cannabis remains the most widely used illegal drug in the United States. This update examines the available literature on neuroimaging studies of the brains of cannabis users. The majority of studies examining the acute effects of delta-9-tetrahydrocannabinol (THC) administration used PET methods and concluded that administration of THC leads to increased activation in frontal and paralimbic regions and the cerebellum. These increases in activation are broadly consistent with the behavioral effects of the drug. Although there is only equivocal evidence that chronic cannabis use might result in structural brain changes, blood-oxygenation-level-dependent-fMRI studies in chronic users consistently show alterations, or neuroadaptation, in the activation of brain networks responsible for higher cognitive functions. It is not yet certain whether these changes are reversible with abstinence. Given the high prevalence of cannabis use among adolescents, studies are needed to evaluate whether cannabis use might affect the developing brain. Considerable further work, employing longitudinal designs, is also required to determine whether cannabis use causes permanent functional alterations in the brains of adults.

  2. Opioid Abstinence Reinforcement Delays Heroin Lapse during Buprenorphine Dose Tapering

    ERIC Educational Resources Information Center

    Greenwald, Mark K.

    2008-01-01

    A positive reinforcement contingency increased opioid abstinence during outpatient dose tapering (4, 2, then 0 mg/day during Weeks 1 through 3) in non-treatment-seeking heroin-dependent volunteers who had been maintained on buprenorphine (8 mg/day) during an inpatient research protocol. The control group (n = 12) received $4.00 for completing…

  3. Strategic self-regulation, decision-making and emotion processing in poly-substance abusers in their first year of abstinence.

    PubMed

    Verdejo-García, Antonio; Rivas-Pérez, Cristina; Vilar-López, Raquel; Pérez-García, Miguel

    2007-01-12

    Individuals with substance dependence (ISD) frequently show signs of impaired emotion processing, self-regulation and decision-making, even after prolonged abstinence from drug use and partial recovery of other neuropsychological functions. These impairments have been associated with alterations in the orbitofrontal cortex (OFC) in lesion and imaging studies. The aim of this study was to examine the performance of a group of ISD, who had been abstinent for at least 4 months, on a series of emotional perception, self-regulation and decision-making tests sensitive to OFC dysfunction. Thirty ISD (poly-substance abusers in their first year of abstinence) and 35 healthy comparison (HC) participants were in the study. We administered the Ekman Faces Test (EFT), the Revised Strategy Application Test (R-SAT) and the Iowa Gambling Task (IGT) to both ISD and HC. Results showed that the ISD presented significant deficits in the recognition of facial emotional expressions and decision-making as measured by the EFT and the IGT. The ISD also showed poorer strategy awareness, impaired self-regulation and higher impulsivity on the R-SAT. We found significant correlations between the different measures linked to OFC functioning. We did not find significant correlations between length of abstinence and performance on these tests. These results suggest that the evaluation of emotion, self-regulation and decision-making contributes greatly to the characterization of the persistent deficits exhibited by ISD during prolonged abstinence.

  4. Abstinence versus Moderation Goals in Brief Motivational Treatment for Pathological Gambling.

    PubMed

    Stea, Jonathan N; Hodgins, David C; Fung, Tak

    2015-09-01

    The present study examined the nature and impact of participant goal selection (abstinence versus moderation) in brief motivational treatment for pathological gambling via secondary analyses from a randomized controlled trial. The results demonstrated that the pattern of goal selection over time could be characterized by both fluidity and stability, whereby almost half of participants switched their goal at least one time, over 25% of participants selected an unchanging goal of 'quit most problematic type of gambling', almost 20% selected an unchanging goal of 'quit all types of gambling', and approximately 10% selected an unchanging goal of 'gamble in a controlled manner.' The results also demonstrated that pretreatment goal selection was uniquely associated with three variables, whereby compared to participants who selected the goal to 'cut back on problem gambling', those who selected the goal to 'quit problem gambling' were more likely to have greater gambling problem severity, to have identified video lottery terminal play as problematic, and to have greater motivation to overcome their gambling problem. Finally, the results demonstrated that goal selection over time had an impact on the average number of days gambled over the course of treatment, whereby those with abstinence-based goals gambled significantly fewer days than those with moderation-based goals. Nevertheless, goal selection over time was not related to dollars gambled, dollars per day gambled, or perceived goal achievement. The findings do not support the contention that abstinence-based goals are more advantageous than moderation goals and are discussed in relation to the broader alcohol treatment literature.

  5. Determinants of 12-step group affiliation and moderators of the affiliation-abstinence relationship.

    PubMed

    Timko, Christine; Billow, Rachel; DeBenedetti, Anna

    2006-06-28

    This study examined characteristics of substance use disorder (SUD) outpatients at intake to treatment (N=345) that were associated with more 12-step group attendance and involvement, Steps worked, and acceptance of 12-step philosophy at a 6-month follow-up (N=281, 81.4%). Patient characteristics covered the domains of sociodemographics, SUD severity, personal functioning, and previous help received. Distinguishing baseline characteristics of patients who attended more 12-step group meetings during follow-up were being less-educated, more engaged in religious practices, and more extroverted and interpersonally competent, and having had more previous 12-step group exposure. These patient characteristics were generally similar to those associated with more 12-step meeting involvement and philosophy acceptance. More 12-step meeting attendance and involvement were related to abstinence at 6 months. Associations of attendance with abstinence were stronger among patients who were younger, white, less-educated, unstably employed, less religious, and less interpersonally skilled. These patients may have had fewer available social resources and so benefitted more from the fellowship and support for abstinence that 12-step group members often provide. We suggest methods by which treatment providers may encourage 12-step group affiliation among patients likely to benefit from it on substance use outcomes.

  6. Male and Female Stimulant Use Among Rural Kentuckians: The Contribution of Spirituality and Religiosity

    PubMed Central

    Staton-Tindall, Michele; Oser, Carrie B.; Duvall, Jamieson L.; Havens, Jennifer R.; Webster, J. Matthew; Leukefeld, Carl; Booth, Brenda M.

    2017-01-01

    This study describes gender-specific patterns of drug use among active rural stimulant users and examines religiosity and spirituality as factors that may be related to stimulant use among males and females. The study includes a sample of 225 active rural stimulant users from Kentucky who were recruited using respondent driven sampling and completed face-to-face interviews. Findings suggest gender specific patterns among active rural stimulant users, with females reporting more amphetamine use. In addition, bivariate findings indicate that there is an inverse relationship between spirituality, religiosity, and stimulant use (specifically methamphetamine and amphetamine use), particularly for males. However, when further examining this relationship in multivariate models controlling for age and race, few significant findings were noted for spirituality and religiosity in predicting gender-specific stimulant use patterns. These findings suggest that treatment interventions that incorporate spirituality and religiosity should not only be gender specific, but should also target clients differentially. Findings on the degree of reported spirituality and religiosity also suggest that religious and/or faithbased organizations could be utilized for drug use interventions for rural stimulant users. PMID:29104311

  7. Sex Differences in Gray Matter Changes and Brain-Behavior Relationships in Patients with Stimulant Dependence.

    PubMed

    Regner, Michael F; Dalwani, Manish; Yamamoto, Dorothy; Perry, Robert I; Sakai, Joseph T; Honce, Justin M; Tanabe, Jody

    2015-12-01

    To investigate whether sex modulates the effects of stimulant dependence on gray matter volume (GMV) in patients who have achieved long-term abstinence and to characterize how sex modulates GMV according to specific behavioral measures, such as dependence symptom count, behavioral approach, and impulsivity. Colorado Multiple Institutional Review Board approval and informed consent were obtained. In this prospective parallel group study, 127 age- and sex-matched participants (68 control subjects [28 women, 40 men] and 59 patients with stimulant dependence [28 women, 31 men]) underwent T1-weighted spoiled gradient-echo inversion recovery magnetic resonance imaging of the brain at 3 T. Images were segmented by using voxel-based morphometric software. After adjustment for age, education, and head size, the effects of group according to sex on GMV and main effects were analyzed throughout the whole brain by using an analysis of covariance family-wise cluster corrected for multiple comparisons, with a threshold P value of less than .05. Dependence symptom count and behavioral measurements were correlated with GMV in the whole brain and in five a priori regions of interest. The effects of group according to sex on GMV were significant in numerous regions (P < .001). Compared with female control subjects, women with stimulant dependence had significantly lower GMV in widespread brain regions (P < .001). There were no significant differences in GMV between male control subjects and men with stimulant dependence (P = .625). Dependence symptom count negatively correlated with GMV in the nucleus accumbens in women (left: r = -0.364, P = .047; right: r = -0.407, P = .031) but not in men (left: r = -0.063, P = .737; right: r = -0.174, P = .349). Behavioral approach (P = .002) and impulsivity (P = .013) correlated negatively with frontal and temporal GMV changes in women with stimulant dependence but not in the other groups. Vast changes in GMV were observed in women with

  8. Abstinence-Only-Until-Marriage: An Updated Review of U.S. Policies and Programs and Their Impact.

    PubMed

    Santelli, John S; Kantor, Leslie M; Grilo, Stephanie A; Speizer, Ilene S; Lindberg, Laura D; Heitel, Jennifer; Schalet, Amy T; Lyon, Maureen E; Mason-Jones, Amanda J; McGovern, Terry; Heck, Craig J; Rogers, Jennifer; Ott, Mary A

    2017-09-01

    Adolescence is marked by the emergence of human sexuality, sexual identity, and the initiation of intimate relations; within this context, abstinence from sexual intercourse can be a healthy choice. However, programs that promote abstinence-only-until-marriage (AOUM) or sexual risk avoidance are scientifically and ethically problematic and-as such-have been widely rejected by medical and public health professionals. Although abstinence is theoretically effective, in actual practice, intentions to abstain from sexual activity often fail. Given a rising age at first marriage around the world, a rapidly declining percentage of young people remain abstinent until marriage. Promotion of AOUM policies by the U.S. government has undermined sexuality education in the United States and in U.S. foreign aid programs; funding for AOUM continues in the United States. The weight of scientific evidence finds that AOUM programs are not effective in delaying initiation of sexual intercourse or changing other sexual risk behaviors. AOUM programs, as defined by U.S. federal funding requirements, inherently withhold information about human sexuality and may provide medically inaccurate and stigmatizing information. Thus, AOUM programs threaten fundamental human rights to health, information, and life. Young people need access to accurate and comprehensive sexual health information to protect their health and lives. Copyright © 2017 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.

  9. Dopamine transporter dysfunction in Han Chinese people with chronic methamphetamine dependence after a short-term abstinence.

    PubMed

    Yuan, Jie; Lv, Rongbin; Robert Brašić, James; Han, Mei; Liu, Xingdang; Wang, Yuankai; Zhang, Guangming; Liu, Congjin; Li, Yu; Deng, Yanping

    2014-01-30

    Single-photon emission-computed tomography (SPECT) after the administration of (99m)Tc-TRODAT-1 was performed on healthy subjects and subjects with methamphetamine (METH)dependence at time 1 (T1) after 24-48 h of abstinence, time 2 (T2) after 2 weeks of abstinence, and time 3 (T3) after 4 weeks of abstinence. In contrast to values in controls, the values of the striatal DAT specific uptake ratios (SURs) in subjects with METH dependence were significantly lower at T1 (n=25), T2 (n=9), and T3 (n=8); a mild increase in SURs was observed at T2 and T3, but values were still significantly lower than those in controls. In subjects with METH dependence, there was a trend for a negative correlation of striatal DAT SURs and craving for METH at T1. METH craving, anxiety and depression scores significantly decreased from T1 to T2 to T3. We conclude that Han Chinese people with METH dependence experience significant striatal DAT dysfunction, and that these changes may be mildly reversible after 4 weeks of abstinence, but that DAT levels still remain significantly lower than those in healthy subjects. The mild recovery of striatal DAT may parallel improvements in craving, anxiety and depression. © 2013 Published by Elsevier Ireland Ltd.

  10. Intolerance for smoking abstinence among nicotine-deprived, treatment-seeking smokers.

    PubMed

    Germeroth, Lisa J; Baker, Nathaniel L; Saladin, Michael E

    2018-09-01

    The Intolerance for Smoking Abstinence Discomfort Questionnaire (IDQ-S) assesses distress tolerance specific to nicotine withdrawal. Though developed to assess withdrawal-related distress, the IDQ-S has not been validated among nicotine-deprived, treatment-seeking smokers. The present study extended previous research by examining the predictive utility of the IDQ-S among abstinent, motivated-to-quit smokers. Abstinent, treatment-seeking smokers completed the IDQ-S Withdrawal Intolerance and Lack of Cognitive Coping scales, assessments of nicotine dependence and reinforcement, and smoking history at baseline. At baseline and at 24-h, 2-week, and 1-month follow-up, participants completed a smoking cue-reactivity task (collection of cue-elicited craving and negative affect), and assessments of cigarettes per day (CPD; daily diaries at follow-up), carbon monoxide (CO), and cotinine. Greater IDQ-S Withdrawal Intolerance was associated with younger age, higher nicotine dependence and reinforcement, and less smoking years (ps < .03). Greater IDQ-S Lack of Cognitive Coping was associated with less education, lower nicotine dependence and reinforcement, higher baseline CPD, and no prior quit attempts (ps < .04). IDQ-S scales did not significantly predict cue-elicited craving or negative affect, CPD, CO, or cotinine levels at follow-up (ps > .10). Withdrawal intolerance and lack of cognitive coping did not predict smoking outcomes among nicotine-deprived, treatment-seeking smokers, but were associated with smoking characteristics, including nicotine dependence and reinforcement. Withdrawal intolerance and lack of cognitive coping may not be especially useful in predicting craving and smoking behavior, but future studies should replicate the present study's findings and assess the stability of the IDQ-S before forming firm conclusions about its predictive utility. Copyright © 2018 Elsevier Ltd. All rights reserved.

  11. Brain serotonin transporter density and aggression in abstinent methamphetamine abusers.

    PubMed

    Sekine, Yoshimoto; Ouchi, Yasuomi; Takei, Nori; Yoshikawa, Etsuji; Nakamura, Kazuhiko; Futatsubashi, Masami; Okada, Hiroyuki; Minabe, Yoshio; Suzuki, Katsuaki; Iwata, Yasuhide; Tsuchiya, Kenji J; Tsukada, Hideo; Iyo, Masaomi; Mori, Norio

    2006-01-01

    In animals, methamphetamine is known to have a neurotoxic effect on serotonin neurons, which have been implicated in the regulation of mood, anxiety, and aggression. It remains unknown whether methamphetamine damages serotonin neurons in humans. To investigate the status of brain serotonin neurons and their possible relationship with clinical characteristics in currently abstinent methamphetamine abusers. Case-control analysis. A hospital research center. Twelve currently abstinent former methamphetamine abusers (5 women and 7 men) and 12 age-, sex-, and education-matched control subjects recruited from the community. The brain regional density of the serotonin transporter, a structural component of serotonin neurons, was estimated using positron emission tomography and trans-1,2,3,5,6,10-beta-hexahydro-6-[4-(methylthio)phenyl]pyrrolo-[2,1-a]isoquinoline ([(11)C](+)McN-5652). Estimates were derived from region-of-interest and statistical parametric mapping methods, followed by within-case analysis using the measures of clinical variables. The duration of methamphetamine use, the magnitude of aggression and depressive symptoms, and changes in serotonin transporter density represented by the [(11)C](+)McN-5652 distribution volume. Methamphetamine abusers showed increased levels of aggression compared with controls. Region-of-interest and statistical parametric mapping analyses revealed that the serotonin transporter density in global brain regions (eg, the midbrain, thalamus, caudate, putamen, cerebral cortex, and cerebellum) was significantly lower in methamphetamine abusers than in control subjects, and this reduction was significantly inversely correlated with the duration of methamphetamine use. Furthermore, statistical parametric mapping analyses indicated that the density in the orbitofrontal, temporal, and anterior cingulate areas was closely associated with the magnitude of aggression in methamphetamine abusers. Protracted abuse of methamphetamine may reduce

  12. Neural Signatures of Cognitive Flexibility and Reward Sensitivity Following Nicotinic Receptor Stimulation in Dependent Smokers: A Randomized Trial.

    PubMed

    Lesage, Elise; Aronson, Sarah E; Sutherland, Matthew T; Ross, Thomas J; Salmeron, Betty Jo; Stein, Elliot A

    2017-06-01

    Withdrawal from nicotine is an important contributor to smoking relapse. Understanding how reward-based decision making is affected by abstinence and by pharmacotherapies such as nicotine replacement therapy and varenicline tartrate may aid cessation treatment. To independently assess the effects of nicotine dependence and stimulation of the nicotinic acetylcholine receptor on the ability to interpret valence information (reward sensitivity) and subsequently alter behavior as reward contingencies change (cognitive flexibility) in a probabilistic reversal learning task. Nicotine-dependent smokers and nonsmokers completed a probabilistic reversal learning task during acquisition of functional magnetic resonance imaging (fMRI) in a 2-drug, double-blind placebo-controlled crossover design conducted from January 21, 2009, to September 29, 2011. Smokers were abstinent from cigarette smoking for 12 hours for all sessions. In a fully Latin square fashion, participants in both groups underwent MRI twice while receiving varenicline and twice while receiving a placebo pill, wearing either a nicotine or a placebo patch. Imaging analysis was performed from June 15, 2015, to August 10, 2016. A well-established computational model captured effects of smoking status and administration of nicotine and varenicline on probabilistic reversal learning choice behavior. Neural effects of smoking status, nicotine, and varenicline were tested for on MRI contrasts that captured reward sensitivity and cognitive flexibility. The study included 24 nicotine-dependent smokers (12 women and 12 men; mean [SD] age, 35.8 [9.9] years) and 20 nonsmokers (10 women and 10 men; mean [SD] age, 30.4 [7.2] years). Computational modeling indicated that abstinent smokers were biased toward response shifting and that their decisions were less sensitive to the available evidence, suggesting increased impulsivity during withdrawal. These behavioral impairments were mitigated with nicotine and varenicline

  13. Community-based abstinence education project: program outcomes.

    PubMed

    Bailey, Denise Nagle; Wolf, Zane Robinson

    2015-01-01

    Middle school and adolescent populations demonstrate high rates of unintended pregnancies and sexually transmitted infections, with young people in inner cities in the United States especially vulnerable. Teen births remain high, and youth are affected physically, mentally, socially, and economically. The Sex After Marriage primary prevention program, a federally funded, community-based abstinence education (CBAE) initiative, was implemented for 3 years in Philadelphia neighborhoods with vulnerable youth 12 to 18 years of age, supporting adults, healthcare professionals, and the general public. The three-tiered program offered a middle school curriculum, Sex Can Wait, at 16 different sites. The CBAE program delivered by the university's nursing center attempted to support vulnerable youths' decisions to postpone sexual activity by matching the interests of young people through an established curriculum, by holding workshops for supporting adults, and by creating a multimedia approach to supplement abstinence education initiatives including public service announcements and a website. Youth and college ambassadors and community colleagues were trained in the curriculum with a focus on healthy lifestyles. Youth and parents in experimental and control groups completed self-report surveys before and after program implementation. The project achieved most of its objectives on program evaluation. Youth (n = 1,428) 12 to 18 years of age received services, with most completing ≥75% of the program. Parents (n = 338) and other participating adults (n = 486) also received education or services. The need for risk reduction programs persists for youth in light of pregnancy, birth, and sexually transmitted disease statistics. Bailey Wolf. © 2014 Wiley Periodicals, Inc.

  14. Are Prescription Stimulants “Smart Pills”?

    PubMed Central

    Smith, M. Elizabeth; Farah, Martha J.

    2013-01-01

    Use of prescription stimulants by normal healthy individuals to enhance cognition is said to be on the rise. Who is using these medications for cognitive enhancement, and how prevalent is this practice? Do prescription stimulants in fact enhance cognition for normal healthy people? We review the epidemiological and cognitive neuroscience literatures in search of answers to these questions. Epidemiological issues addressed include the prevalence of nonmedical stimulant use, user demographics, methods by which users obtain prescription stimulants, and motivations for use. Cognitive neuroscience issues addressed include the effects of prescription stimulants on learning and executive function, as well as the task and individual variables associated with these effects. Little is known about the prevalence of prescription stimulant use for cognitive enhancement outside of student populations. Among college students, estimates of use vary widely but, taken together, suggest that the practice is commonplace. The cognitive effects of stimulants on normal healthy people cannot yet be characterized definitively, despite the volume of research that has been carried out on these issues. Published evidence suggests that declarative memory can be improved by stimulants, with some evidence consistent with enhanced consolidation of memories. Effects on the executive functions of working memory and cognitive control are less reliable but have been found for at least some individuals on some tasks. In closing, we enumerate the many outstanding questions that remain to be addressed by future research and also identify obstacles facing this research. PMID:21859174

  15. "Sex Respect": Abstinence Education and Other Deployments for Sexual "Freedom"

    ERIC Educational Resources Information Center

    Jackson, Liz

    2006-01-01

    Those who view the right to a religiously neutral, empirically-based public education as fundamental have been able to do little more than watch in terror as abstinence-only sex education, which excludes information on either safe sex or birth control, has come to prevail in United States (US) schools. Among causes for concern are abstinence…

  16. Project IMPACT: A pharmacotherapy pilot trial investigating the abstinence and treatment adherence of Latino light smokers

    PubMed Central

    de Dios, Marcel A.; Anderson, Bradley J.; Stanton, Cassandra; Audet, Daniel A.; Stein, Michael

    2012-01-01

    Light smoking is particularly prevalent among Latino smokers. Nicotine replacement (NRT) and varenicline are effective medications for smoking cessation for moderate-heavy smokers, but have not been tested in light smokers and thus there are no treatment guidelines for use with light smokers. This pilot trial tested the efficacy of NRT and varenicline in increasing smoking abstinence among Latino light smokers. A 3-group (NRT, varenicline, varenicline-placebo) randomized design was used and Latino light smokers (≤10 cpd) received 12 weeks of treatment which included a culturally-informed behavioral health session and ongoing medication management visits. At follow-up, there were no abstinent participants in the placebo and NRT groups. However, 30% of participants in the varenicline group were abstinent at the 3, 4, and 6 month follow-up. This study represents the only investigation that specifically targets Latino light smokers using these treatments and characterizing their treatment adherence. PMID:22377389

  17. Alcohol and drug treatment involvement, 12-step attendance and abstinence: 9-year cross-lagged analysis of adults in an integrated health plan.

    PubMed

    Witbrodt, Jane; Ye, Yu; Bond, Jason; Chi, Felicia; Weisner, Constance; Mertens, Jennifer

    2014-04-01

    This study explored causal relationships between post-treatment 12-step attendance and abstinence at multiple data waves and examined indirect paths leading from treatment initiation to abstinence 9-years later. Adults (N = 1945) seeking help for alcohol or drug use disorders from integrated healthcare organization outpatient treatment programs were followed at 1-, 5-, 7- and 9-years. Path modeling with cross-lagged partial regression coefficients was used to test causal relationships. Cross-lagged paths indicated greater 12-step attendance during years 1 and 5 and were casually related to past-30-day abstinence at years 5 and 7 respectfully, suggesting 12-step attendance leads to abstinence (but not vice versa) well into the post-treatment period. Some gender differences were found in these relationships. Three significant time-lagged, indirect paths emerged linking treatment duration to year-9 abstinence. Conclusions are discussed in the context of other studies using longitudinal designs. For outpatient clients, results reinforce the value of lengthier treatment duration and 12-step attendance in year 1. Copyright © 2014 Elsevier Inc. All rights reserved.

  18. Increased error-related thalamic activity during early compared to late cocaine abstinence.

    PubMed

    Li, Chiang-Shan R; Luo, Xi; Sinha, Rajita; Rounsaville, Bruce J; Carroll, Kathleen M; Malison, Robert T; Ding, Yu-Shin; Zhang, Sheng; Ide, Jaime S

    2010-06-01

    Altered cognitive control is implicated in the shaping of cocaine dependence. One of the key component processes of cognitive control is error monitoring. Our previous imaging work highlighted greater activity in distinct cortical and subcortical regions including the dorsal anterior cingulate cortex (dACC), thalamus and insula when participants committed an error during the stop signal task (Li et al., 2008b). Importantly, dACC, thalamic and insular activity has been associated with drug craving. One hypothesis is that the intense interoceptive activity during craving prevents these cerebral structures from adequately registering error and/or monitoring performance. Alternatively, the dACC, thalamus and insula show abnormally heightened responses to performance errors, suggesting that excessive responses to salient stimuli such as drug cues could precipitate craving. The two hypotheses would each predict decreased and increased activity during stop error (SE) as compared to stop success (SS) trials in the SST. Here we showed that cocaine dependent patients (PCD) experienced greater subjective feeling of loss of control and cocaine craving during early (average of day 6) compared to late (average of day 18) abstinence. Furthermore, compared to PCD during late abstinence, PCD scanned during early abstinence showed increased thalamic as well as insular but not dACC responses to errors (SE>SS). These findings support the hypothesis that heightened thalamic reactivity to salient stimuli co-occur with cocaine craving and loss of self control. Copyright (c) 2010 Elsevier Ireland Ltd. All rights reserved.

  19. External trial deep brain stimulation device for the application of desynchronizing stimulation techniques.

    PubMed

    Hauptmann, C; Roulet, J-C; Niederhauser, J J; Döll, W; Kirlangic, M E; Lysyansky, B; Krachkovskyi, V; Bhatti, M A; Barnikol, U B; Sasse, L; Bührle, C P; Speckmann, E-J; Götz, M; Sturm, V; Freund, H-J; Schnell, U; Tass, P A

    2009-12-01

    In the past decade deep brain stimulation (DBS)-the application of electrical stimulation to specific target structures via implanted depth electrodes-has become the standard treatment for medically refractory Parkinson's disease and essential tremor. These diseases are characterized by pathological synchronized neuronal activity in particular brain areas. We present an external trial DBS device capable of administering effectively desynchronizing stimulation techniques developed with methods from nonlinear dynamics and statistical physics according to a model-based approach. These techniques exploit either stochastic phase resetting principles or complex delayed-feedback mechanisms. We explain how these methods are implemented into a safe and user-friendly device.

  20. Biphasic alterations in serotonin-1B (5-HT1B) receptor function during abstinence from extended cocaine self-administration.

    PubMed

    O'Dell, Laura E; Manzardo, Ann M; Polis, Ilham; Stouffer, David G; Parsons, Loren H

    2006-12-01

    Alterations in 5-HT1B receptor function during cocaine abstinence were evaluated in rats given either limited- or extended access (LA and EA, respectively) to cocaine self-administration. The locomotor response to the 5-HT1B/1A agonist RU24969 was significantly reduced in cocaine-experienced animals relative to cocaine-naïve controls following 6 h of abstinence but became sensitized over the subsequent 14 days of abstinence. Both the early phase subsensitivity and later phase supersensivity to RU 24969-induced activity were greater in EA versus LA animals. Intra-nucleus accumbens administration of the 5-HT1B agonist CP 93, 129 produced significantly greater increases in dialysate dopamine levels in EA versus control animals following 14 days of abstinence. However, there was no difference between EA and cocaine-naïve control animals in the augmentation of cocaine-induced increases in nucleus accumbens DA produced by intra-VTA CP 93, 129. Collectively these findings demonstrate that 5-HT1B receptor function is persistently altered by cocaine self-administration.

  1. Compassion Fatigue, Burnout, and Neonatal Abstinence Syndrome.

    PubMed

    Sweigart, Erin

    2017-01-01

    NICU nurses have seen a dramatic increase in cases of neonatal abstinence syndrome (NAS). The care needs of infants with NAS are highly demanding and can lead to feelings of frustration and emotional exhaustion among NICU nurses. Although studies have examined the experiences of nurses caring for NAS patients, none have specifically addressed the risk for compassion fatigue and burnout. Nurses need practical strategies to reduce their risk for compassion fatigue and burnout when caring for these patients. Improved education and implementation of self-care measures can help nurses more effectively manage stress and positively impact care of these infants and their families.

  2. Cannabis withdrawal in chronic, frequent cannabis smokers during sustained abstinence within a closed residential environment.

    PubMed

    Lee, Dayong; Schroeder, Jennifer R; Karschner, Erin L; Goodwin, Robert S; Hirvonen, Jussi; Gorelick, David A; Huestis, Marilyn A

    2014-01-01

    Chronic, frequent cannabis smokers may experience residual and offset effects, withdrawal, and craving when abstaining from the drug. We characterized the prevalence, duration, and intensity of these effects in chronic frequent cannabis smokers during abstinence on a closed research unit. Non-treatment-seeking participants (N = 29 on admission, 66% and 34% remaining after 2 and 4 weeks) provided subjective effects data. A battery of five instruments was computer-administered daily to measure psychological, sensory, and physical symptoms associated with cannabinoid intoxication and withdrawal. Plasma and oral fluid specimens were concurrently collected and analyzed for cannabinoids. Outcome variables were evaluated as change from admission (Day 0) with regression models. Most abstinence effects, including irritability and anxiety were greatest on Days 0-3 and decreased thereafter. Cannabis craving significantly decreased over time, whereas decreased appetite began to normalize on Day 4. Strange dreams and difficulty getting to sleep increased over time, suggesting intrinsic sleep problems in chronic cannabis smokers. Symptoms likely induced by residual drug effects were at maximum intensity on admission and positively correlated with plasma and oral fluid cannabinoid concentrations on admission but not afterward; these symptoms showed overall prevalence higher than cannabis withdrawal symptoms. The combined influence of residual/offset drug effects, withdrawal, and craving was observed in chronic cannabis smokers during monitored abstinence. Abstinence symptoms were generally more intense in the initial phase, implying importance of early intervention in cannabis quit attempts. Sleep disturbance persisting for an extended period suggests that hypnotic medications could be beneficial in treating cannabis dependence. © American Academy of Addiction Psychiatry.

  3. Cannabis Withdrawal in Chronic, Frequent Cannabis Smokers during Sustained Abstinence within a Closed Residential Environment

    PubMed Central

    Lee, Dayong; Schroeder, Jennifer R.; Karschner, Erin L.; Goodwin, Robert S.; Hirvonen, Jussi; Gorelick, David A.; Huestis, Marilyn A.

    2013-01-01

    Objectives Chronic, frequent cannabis smokers may experience residual and offset effects, withdrawal, and craving when abstaining from the drug. We characterized the prevalence, duration, and intensity of these effects in chronic frequent cannabis smokers during abstinence on a closed research unit. Methods Non-treatment-seeking participants (N=29 on admission, 66% and 34% remaining after 2 and 4 weeks) provided subjective effects data. A battery of 5 instruments was computer-administered daily to measure psychological, sensory, and physical symptoms associated with cannabinoid intoxication and withdrawal. Plasma and oral fluid specimens were concurrently collected and analyzed for cannabinoids. Outcome variables were evaluated as change from admission (Day 0) with regression models. Results Most abstinence effects, including irritability and anxiety were greatest on Days 0–3 and decreased thereafter. Cannabis craving significantly decreased over time, whereas decreased appetite began to normalize on Day 4. Strange dreams and difficulty getting to sleep increased over time, suggesting intrinsic sleep problems in chronic cannabis smokers. Symptoms likely induced by residual drug effects were at maximum intensity on admission and positively correlated with plasma and oral fluid cannabinoid concentrations on admission but not afterward; these symptoms showed overall prevalence higher than cannabis withdrawal symptoms. Conclusions The combined influence of residual/offset drug effects, withdrawal and craving was observed in chronic cannabis smokers during monitored abstinence. Abstinence symptoms were generally more intense in the initial phase, implying importance of early intervention in cannabis quit attempts. Sleep disturbance persisting for an extended period suggests that hypnotic medications could be beneficial in treating cannabis dependence. PMID:24724880

  4. Association of testosterone levels and heroin usage characteristics in male heroin users.

    PubMed

    Wang, Zhuo; Zhou, Xiao-Bo; Yang, Xiao-Rong; Song, Hui; Cao, Bing-Rong; Yin, Fei; Kang, Lin; An, Zhen-Mei; Li, Jing

    2017-05-01

    Previous studies have shown that heroin abuse can alter the gonadal functions. Few studies examined the association between testosterone levels and heroin use in the existing literature. We aimed to determine the association between gonadal hormones and heroin usage characteristics over 12 weeks of abstinence in heroin users. We collected data on patient demographics and heroin use patterns for 65 men aged 18 to 45 and for 29 age-matched healthy controls. Serum levels of total testosterone, estradiol, and prolactin were assessed at 5 time points. Testosterone levels gradually increased and prolactin levels decreased in heroin users in this study. In heroin users, a significant positive correlation was observed between the way of using drug and the testosterone levels, the way of using drug and the estradiol levels, between the duration of heroin dependence and the testosterone levels, between the duration of heroin dependence and the estradiol levels on D0, and between relapse time and testosterone levels on D84. Our data reveal testosterone might promote injection drug use and repeated relapse in male heroin users.

  5. Transcranial Direct Current Brain Stimulation Increases Ability to Resist Smoking.

    PubMed

    Falcone, Mary; Bernardo, Leah; Ashare, Rebecca L; Hamilton, Roy; Faseyitan, Olufunsho; McKee, Sherry A; Loughead, James; Lerman, Caryn

    2016-01-01

    The ability to exert self-control over temptation is a fundamental component of smoking behavior change. Transcranial direct current stimulation (tDCS) of the dorsolateral prefrontal cortex (DLPFC) has been shown to modulate cognitive control circuits. Although prior studies show that stimulation reduces cigarette craving and self-reported smoking, effects on ability to resist smoking have not been investigated directly. We assessed effects of a single 20-minute session of 1.0 mA anodal stimulation over the left DLPFC with cathodal stimulation over the right supra-orbital area (vs. sham stimulation) on ability to resist smoking in a validated smoking lapse paradigm. Twenty-five participants completed two tDCS sessions (active and sham stimulation) in a within-subject, double-blind, randomized and counterbalanced order with a 2-week washout period. Following overnight abstinence, participants received tDCS in the presence of smoking related cues; they had the option to smoke at any time or receive $1 for every 5 minutes they abstained. After 50 minutes, they participated in a 1 hour ad libitum smoking session. Primary and secondary outcomes were time to first cigarette and cigarette consumption, respectively. In multiple regression models, active tDCS (compared to sham) significantly increased latency to smoke (p = 0.02) and decreased the total number of cigarettes smoked (p = 0.014) during the session. These findings suggest that acute anodal stimulation over the left DLPFC (with cathodal stimulation over the right supra-orbital area) can improve ability to resist smoking, supporting the therapeutic potential of tDCS for smoking cessation treatment. Copyright © 2016 Elsevier Inc. All rights reserved.

  6. Drug Metabolizing Enzyme and Transporter Gene Variation, Nicotine Metabolism, Prospective Abstinence, and Cigarette Consumption

    PubMed Central

    Bergen, Andrew W.; Michel, Martha; Nishita, Denise; Krasnow, Ruth; Javitz, Harold S.; Conneely, Karen N.; Lessov-Schlaggar, Christina N.; Hops, Hyman; Zhu, Andy Z. X.; Baurley, James W.; McClure, Jennifer B.; Hall, Sharon M.; Baker, Timothy B.; Conti, David V.; Benowitz, Neal L.; Lerman, Caryn; Tyndale, Rachel F.; Swan, Gary E.

    2015-01-01

    The Nicotine Metabolite Ratio (NMR, ratio of trans-3’-hydroxycotinine and cotinine), has previously been associated with CYP2A6 activity, response to smoking cessation treatments, and cigarette consumption. We searched for drug metabolizing enzyme and transporter (DMET) gene variation associated with the NMR and prospective abstinence in 2,946 participants of laboratory studies of nicotine metabolism and of clinical trials of smoking cessation therapies. Stage I was a meta-analysis of the association of 507 common single nucleotide polymorphisms (SNPs) at 173 DMET genes with the NMR in 449 participants of two laboratory studies. Nominally significant associations were identified in ten genes after adjustment for intragenic SNPs; CYP2A6 and two CYP2A6 SNPs attained experiment-wide significance adjusted for correlated SNPs (CYP2A6 P ACT=4.1E-7, rs4803381 P ACT=4.5E-5, rs1137115, P ACT=1.2E-3). Stage II was mega-regression analyses of 10 DMET SNPs with pretreatment NMR and prospective abstinence in up to 2,497 participants from eight trials. rs4803381 and rs1137115 SNPs were associated with pretreatment NMR at genome-wide significance. In post-hoc analyses of CYP2A6 SNPs, we observed nominally significant association with: abstinence in one pharmacotherapy arm; cigarette consumption among all trial participants; and lung cancer in four case:control studies. CYP2A6 minor alleles were associated with reduced NMR, CPD, and lung cancer risk. We confirmed the major role that CYP2A6 plays in nicotine metabolism, and made novel findings with respect to genome-wide significance and associations with CPD, abstinence and lung cancer risk. Additional multivariate analyses with patient variables and genetic modeling will improve prediction of nicotine metabolism, disease risk and smoking cessation treatment prognosis. PMID:26132489

  7. Drug Metabolizing Enzyme and Transporter Gene Variation, Nicotine Metabolism, Prospective Abstinence, and Cigarette Consumption.

    PubMed

    Bergen, Andrew W; Michel, Martha; Nishita, Denise; Krasnow, Ruth; Javitz, Harold S; Conneely, Karen N; Lessov-Schlaggar, Christina N; Hops, Hyman; Zhu, Andy Z X; Baurley, James W; McClure, Jennifer B; Hall, Sharon M; Baker, Timothy B; Conti, David V; Benowitz, Neal L; Lerman, Caryn; Tyndale, Rachel F; Swan, Gary E

    2015-01-01

    The Nicotine Metabolite Ratio (NMR, ratio of trans-3'-hydroxycotinine and cotinine), has previously been associated with CYP2A6 activity, response to smoking cessation treatments, and cigarette consumption. We searched for drug metabolizing enzyme and transporter (DMET) gene variation associated with the NMR and prospective abstinence in 2,946 participants of laboratory studies of nicotine metabolism and of clinical trials of smoking cessation therapies. Stage I was a meta-analysis of the association of 507 common single nucleotide polymorphisms (SNPs) at 173 DMET genes with the NMR in 449 participants of two laboratory studies. Nominally significant associations were identified in ten genes after adjustment for intragenic SNPs; CYP2A6 and two CYP2A6 SNPs attained experiment-wide significance adjusted for correlated SNPs (CYP2A6 PACT=4.1E-7, rs4803381 PACT=4.5E-5, rs1137115, PACT=1.2E-3). Stage II was mega-regression analyses of 10 DMET SNPs with pretreatment NMR and prospective abstinence in up to 2,497 participants from eight trials. rs4803381 and rs1137115 SNPs were associated with pretreatment NMR at genome-wide significance. In post-hoc analyses of CYP2A6 SNPs, we observed nominally significant association with: abstinence in one pharmacotherapy arm; cigarette consumption among all trial participants; and lung cancer in four case:control studies. CYP2A6 minor alleles were associated with reduced NMR, CPD, and lung cancer risk. We confirmed the major role that CYP2A6 plays in nicotine metabolism, and made novel findings with respect to genome-wide significance and associations with CPD, abstinence and lung cancer risk. Additional multivariate analyses with patient variables and genetic modeling will improve prediction of nicotine metabolism, disease risk and smoking cessation treatment prognosis.

  8. Comparative effectiveness of intervention components for producing long-term abstinence from smoking: a factorial screening experiment.

    PubMed

    Schlam, Tanya R; Fiore, Michael C; Smith, Stevens S; Fraser, David; Bolt, Daniel M; Collins, Linda M; Mermelstein, Robin; Piper, Megan E; Cook, Jessica W; Jorenby, Douglas E; Loh, Wei-Yin; Baker, Timothy B

    2016-01-01

    To identify promising intervention components that help smokers attain and maintain abstinence during a quit attempt. A 2 × 2 × 2 × 2 × 2 randomized factorial experiment. Eleven primary care clinics in Wisconsin, USA. A total of 544 smokers (59% women, 86% white) recruited during primary care visits and motivated to quit. Five intervention components designed to help smokers attain and maintain abstinence: (1) extended medication (26 versus 8 weeks of nicotine patch + nicotine gum); (2) maintenance (phone) counseling versus none; (3) medication adherence counseling versus none; (4) automated (medication) adherence calls versus none; and (5) electronic medication monitoring with feedback and counseling versus electronic medication monitoring alone. The primary outcome was 7-day self-reported point-prevalence abstinence 1 year after the target quit day. Only extended medication produced a main effect. Twenty-six versus 8 weeks of medication improved point-prevalence abstinence rates (43 versus 34% at 6 months; 34 versus 27% at 1 year; P = 0.01 for both). There were four interaction effects at 1 year, showing that an intervention component's effectiveness depended upon the components with which it was combined. Twenty-six weeks of nicotine patch + nicotine gum (versus 8 weeks) and maintenance counseling provided by phone are promising intervention components for the cessation and maintenance phases of smoking treatment. © 2015 Society for the Study of Addiction.

  9. Criminogenic Needs, Substance Use, and Offending among Rural Stimulant Users

    PubMed Central

    Timko, Christine; Booth, Brenda M.; Han, Xiaotong; Schultz, Nicole R.; Blonigen, Daniel M.; Wong, Jessie J.; Cucciare, Michael A.

    2017-01-01

    There is a need to understand the determinants of both substance use and criminal activity in rural areas in order to design appropriate treatment interventions for these linked problems. The present study drew on a predominant model used to assess and treat offenders -- the Risk-Need-Responsivity (RNR) model -- to examine risk factors for substance use and criminal activity in a rural drug using sample. This study extends the RNR model’s focus on offenders to assessing rural-dwelling individuals using stimulants (N=462). We examined substance use and criminal justice outcomes at 6-month (91%) and 3-year (79%) follow-ups, and used Generalized Estimating Equations to examine the extent to which RNR criminogenic need factors at baseline predicted outcomes at follow-ups. Substance use and criminal justice outcomes improved at six months, and even more at three years, post-baseline. As expected, higher risk was associated with poorer outcomes. Antisocial personality patterns and procriminal attitudes at baseline predicted poorer legal and drug outcomes measured at subsequent follow-ups. In contrast, less connection to antisocial others and fewer work difficulties predicted lower alcohol problem severity, but more frequent alcohol use. Engagement in social-recreational activities was associated with fewer subsequent arrests and less severe alcohol and drug problems. The RNR model’s criminogenic need factors predicted drug use and crime-related outcomes among rural residents. Services adapted to rural settings that target these factors, such as telehealth and other technology-based resources, may hasten improvement on both types of outcomes among drug users. PMID:29051795

  10. End-of-treatment abstinence self-efficacy, behavioral processes of change, and posttreatment drinking outcomes in Project MATCH.

    PubMed

    Crouch, Taylor Berens; DiClemente, Carlo C; Pitts, Steven C

    2015-09-01

    This study evaluated whether alcohol abstinence self-efficacy at the end of alcohol treatment was moderated by utilization of behavioral processes of change (coping activities used during a behavior change attempt). It was hypothesized that self-efficacy would be differentially important in predicting posttreatment drinking outcomes depending on the level of behavioral processes, such that the relation between self-efficacy and outcomes would be stronger for individuals who reported low process use. Analyses were also estimated with end-of-treatment abstinence included as a covariate. Data were analyzed from alcohol-dependent individuals in both treatment arms of Project MATCH (Matching Alcoholism Treatments to Client Heterogeneity; N = 1,328), a large alcohol treatment study. Self-efficacy was moderated by behavioral process use in predicting drinking frequency 6 and 12 months posttreatment and drinking quantity 6 months posttreatment such that self-efficacy was more strongly related to posttreatment drinking when low levels of processes were reported than high levels, but interactions were attenuated when end-of-treatment abstinence was controlled for. Significant quadratic relations between end-of-treatment self-efficacy and 6- and 12-month posttreatment drinking quantity and frequency were found (p < .001, ƒ² = 0.02-0.03), such that self-efficacy most robustly predicted outcomes when high. These effects remained significant when end-of-treatment abstinence was included as a covariate. Findings highlight the complex nature of self-efficacy's relation with drinking outcomes. Although the interaction between self-efficacy and behavioral processes was attenuated when end-of-treatment abstinence was controlled for, the quadratic effect of self-efficacy on outcomes remained significant. The pattern of these effects did not support the idea of "overconfidence" as a negative indicator. (c) 2015 APA, all rights reserved).

  11. The effects of nicotine dependence and acute abstinence on the processing of drug and non-drug rewards.

    PubMed

    Lawn, W; Freeman, T P; Hindocha, C; Mokrysz, C; Das, R K; Morgan, C J A; Curran, H V

    2015-07-01

    Drug addiction may be characterised by a hypersensitivity to drug rewards and a hyposensitivity to non-drug rewards. This imbalance may become further polarised during acute abstinence. (i) Examine the differences between dependent and occasional smokers in choices for, motivation for and self-reported wanting and liking of cigarette and non-drug rewards. (ii) Examine the effects of 12-h nicotine abstinence on these metrics. Dependent (n = 20) and occasional, non-dependent smokers (n = 20) were tested after ad libitum smoking and ≥12-h of nicotine abstinence. A novel task was developed (Drug, Reward and Motivation-Choice (DReaM-Choice)) in which different rewards (cigarettes, music and chocolate) could be won. In each trial, participants chose between two rewards and then could earn the chosen reward via repeated button-pressing. Participants subsequently 'consumed' and rated subjective liking of the rewards they had won. Compared with occasional smokers, dependent smokers made more choices for (p < 0.001), pressed more for (p = 0.046) and reported more wanting (p = 0.007) and liking (p < 0.001) of cigarettes, and also made fewer choices for chocolate (p = 0.005). There were no differences between the groups on button-pressing for chocolate or music. However, the balance between drug and non-drug reward processing was different between the groups across all metrics. Twelve-hour nicotine abstinence led to more cigarette choices (p < 0.001) and fewer music choices (p = 0.042) in both groups. Nicotine dependence was associated with a hypersensitivity to cigarette rewards, but we found little evidence indicating a hyposensitivity to non-drug rewards. Our findings question the moderating influence of dependence on how acute nicotine abstinence affects reward processing.

  12. Preliminary evidence of motor impairment among polysubstance 3,4-methylenedioxymethamphetamine users with intact neuropsychological functioning

    PubMed Central

    BOUSMAN, CHAD A.; CHERNER, MARIANA; EMORY, KRISTEN T.; BARRON, DANIEL; GREBENSTEIN, PATRICIA; ATKINSON, J. HAMPTON; HEATON, ROBERT K.; GRANT, IGOR

    2013-01-01

    Neuropsychological disturbances have been reported in association with use of the recreational drug “ecstasy,” or 3,4-methylenedioxymethamphetamine (MDMA), but findings have been inconsistent. We performed comprehensive neuropsychological testing examining seven ability domains in 21 MDMA users (MDMA+) and 21 matched control participants (MDMA−). Among MDMA+ participants, median [interquartile range] lifetime MDMA use was 186 [111, 516] doses, with 120 [35–365] days of abstinence. There were no significant group differences in neuropsychological performance, with the exception of the motor speed/dexterity domain in which 43% of MDMA+ were impaired compared with 5% of MDMA− participants (p = .004). Motor impairment differences were not explained by use of other substances and were unrelated to length of abstinence or lifetime number of MDMA doses. Findings provide limited evidence for neuropsychological differences between MDMA+ and MDMA− participants with the exception of motor impairments observed in the MDMA+ group. However, replication of this finding in a larger sample is warranted. PMID:20735886

  13. Differential Transitions between Cocaine Use and Abstinence for Men and Women

    ERIC Educational Resources Information Center

    Gallop, Robert J.; Crits-Christoph, Paul; Ten Have, Thomas R.; Barber, Jacques P.; Frank, Arlene; Griffin, Margaret L.; Thase, Michael E.

    2007-01-01

    The longitudinal course of cocaine dependence is characterized by alternating periods of abstinence and relapse. Although gender has emerged as an important predictor of relapse, previous studies have examined mean differences in use by gender. Focusing strictly on differences in averages between men and women does not address potential gender…

  14. Deep brain stimulation surgery for alcohol addiction.

    PubMed

    Voges, Juergen; Müller, Ulf; Bogerts, Bernhard; Münte, Thomas; Heinze, Hans-Jochen

    2013-01-01

    The consequences of chronic alcohol dependence cause important health and economic burdens worldwide. Relapse rates after standard treatment (medication and psychotherapy) are high. There is evidence from in vivo investigations and from studies in patients that the brain's reward system is critically involved in the development and maintenance of addictive behavior, suggesting that modification of this system could significantly improve the prognosis of addictive patients. Motivated by an accidental observation, we used the nucleus accumbens (NAc), which has a central position in the dopaminergic reward system for deep brain stimulation (DBS) of alcohol addiction. We report our first experiences with NAc DBS for alcohol dependence and review the literature addressing the mechanisms leading to addiction. Five patients were treated off-label with bilateral NAc DBS for severe alcohol addiction (average follow-up 38 months). All patients experienced significant and ongoing improvement of craving. Two patients remained completely abstinent for more than 4 years. NAc stimulation was tolerated without permanent side effects. Simultaneous recording of local field potentials from the target area and surface electroencephalography while patients performed neuropsychological tasks gave a hint on the pivotal role of the NAc in processing alcohol-related cues. To our knowledge, the data presented here reflect the first attempt to treat alcohol-addicted patients with NAc DBS. Electrical NAc stimulation probably counterbalances the effect of drug-related stimuli triggering involuntarily drug-seeking behavior. Meanwhile, two prospective clinical studies using randomized, double-blind, and crossover stimulation protocols for DBS are underway to corroborate these preliminary results. Published by Elsevier Inc.

  15. Cognitive measures in long-term cannabis users.

    PubMed

    Pope, Harrison G; Gruber, Amanda J; Hudson, James I; Huestis, Marilyn A; Yurgelun-Todd, Deborah

    2002-11-01

    The cognitive effects of long-term cannabis use are insufficiently understood. Most studies concur that cognitive deficits persist at least several days after stopping heavy cannabis use. But studies differ on whether such deficits persist long term or whether they are correlated with increasing duration of lifetime cannabis use. The authors administered neuropsychological tests to 77 current heavy cannabis users who had smoked cannabis at least 5000 times in their lives, and to 87 control subjects who had smoked no more than 50 times in their lives. The heavy smokers showed deficits on memory of word lists on Days 0, 1, and 7 of a supervised abstinence period. By Day 28, however, few significant differences were found between users and controls on the test measures, and there were few significant associations between total lifetime cannabis consumption and test performance. Although these findings may be affected by residual confounding, as in all retrospective studies, they suggest that cannabis-associated cognitive deficits are reversible and related to recent cannabis exposure rather than irreversible and related to cumulative lifetime use.

  16. Promoting Abstinence from Cocaine and Heroin with a Methadone Dose Increase and a Novel Contingency

    PubMed Central

    Schmittner, John; Umbricht, Annie; Schroeder, Jennifer R.; Moolchan, Eric T.; Preston, Kenzie L.

    2010-01-01

    To test whether a combination of contingency management and methadone dose increase would promote abstinence from heroin and cocaine, we conducted a randomized controlled trial using a 2 X 3 (Dose X Contingency) factorial design in which dose assignment was double-blind. Participants were 252 heroin- and cocaine-abusing outpatients on methadone maintenance. They were randomly assigned to methadone dose (70 or 100 mg/day, double blind) and voucher condition (noncontingent, contingent on cocaine-negative urines, or “split”). The “split” contingency was a novel contingency that reinforced abstinence from either drug while doubly reinforcing simultaneous abstinence from both: the total value of incentives was “split” between drugs to contain costs. The main outcome measures were percentages of urine specimens negative for heroin, cocaine, and both simultaneously; these were monitored during a 5-week baseline of standard treatment (to determine study eligibility), a 12-week intervention, and a 10-week maintenance phase (to examine intervention effects in return-to-baseline conditions). DSM-IV criteria for ongoing drug dependence were assessed at study exit. Urine-screen results showed that the methadone dose increase reduced heroin use but not cocaine use. The Split 100mg group was the only group to achieve a longer duration of simultaneous negatives than its same-dose Noncontingent control group. The frequency of DSM-IV opiate and cocaine dependence diagnoses decreased in the active intervention groups. For a split contingency to promote simultaneous abstinence from cocaine and heroin, a relatively high dose of methadone appears necessary but not sufficient; an increase in overall incentive amount may also be required. PMID:19101098

  17. Frequency and structure of stimulant designer drug consumption among suspected drug users in Budapest and South-East Hungary in 2012-2013.

    PubMed

    Institóris, László; Árok, Zsófia; Seprenyi, Katalin; Varga, Tibor; Sára-Klausz, Gabriella; Keller, Éva; Tóth, Réka A; Sala, Leonardo; Kereszty, Éva; Róna, Kálmán

    2015-03-01

    Identification of abuse and frequency patterns of stimulant designer drugs (SDDs) provides important information for their risk assessment and legislative control. In the present study urine and/or blood samples of suspected drug users in criminal cases were analysed by GC-MS for 38 SDDs, and for the most frequent illicit and psychoactive licit drugs in Hungary. Between July 2012 and June 2013, 2744 suspected drug users were sampled in Budapest and during 2012 and 2013, 774 persons were sampled in South-East Hungary (Csongrád County - neighbour the Romanian and Serbian borders). In Budapest 71.4% of cases, and in South-East Hungary 61% of cases were positive for at least one substance. Pentedrone was the most frequent SDD in both regions; however, the frequency distribution of the remaining drugs was highly diverse. SDDs were frequently present in combination with other drugs - generally with amphetamine or other stimulants, cannabis and/or benzodiazepines. The quarterly distribution of positive samples indicated remarkable seasonal changes in the frequency and pattern of consumption. Substances placed on the list of illicit drugs (mephedrone, 4-fluoro-amphetamine, MDPV, methylone, 4-MEC) showed a subsequent drop in frequency and were replaced by other SDDs (pentedrone, 3-MMC, methiopropamine, etc.). Newly identified compounds from seized materials were added to the list of new psychoactive substances ("Schedule C"). While the risk assessment of substances listed in Schedule C has to be performed within 2 years after scheduling, continuous monitoring of their presence and frequency among drug users is essential. In summary, our results suggest which substances should be dropped from the list of SDDs measured in biological samples; while the appearance of new substances from seized materials indicate the need for developing adequate standard analytical methods. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  18. Treatment of neonatal abstinence syndrome.

    PubMed

    Johnson, K; Gerada, C; Greenough, A

    2003-01-01

    Neonatal abstinence syndrome (NAS) is suffered by infants withdrawing from substances on which they have become physically dependent after in utero exposure. They may require prolonged treatment and spend weeks or even months in hospital. A wide range of drugs have been used to treat NAS. The efficacy of few, however, have been adequately investigated. Evidence suggests that opioids are the most appropriate, at least in infants exposed to diamorphine or methadone. In all "head to head" trials, diazepam has been shown to be ineffective. Morphine and methadone are currently the most commonly prescribed opioids to treat NAS, but randomised trials have not been undertaken to determine which is the more beneficial. Many infants with NAS have been exposed to multiple substances in utero. Further research is required into whether a single opiate or a multiple drug regimen is the best option for such patients.

  19. Pretreatment measures of brain structure and reward-processing brain function in cannabis dependence: an exploratory study of relationships with abstinence during behavioral treatment.

    PubMed

    Yip, Sarah W; DeVito, Elise E; Kober, Hedy; Worhunsky, Patrick D; Carroll, Kathleen M; Potenza, Marc N

    2014-07-01

    Cannabis is widely abused, and efficacies of therapeutics for cannabis dependence remain suboptimal. Magnetic resonance imaging (MRI) may aid in the identification of biological markers for successful treatment outcomes (i.e., abstinence). Twenty men with cannabis dependence and twenty non-substance-using healthy comparison (HC) men underwent MRI scanning. Cannabis-dependent individuals then participated in a 12-week randomized clinical trial of behavioral treatments (contingency management (CM), cognitive behavioral therapy (CBT) or both). Pretreatment functional and structural data were compared between the cannabis-dependent and HC participants. In addition, individuals with cannabis dependence were subdivided based on the successful achievement of 21 days of consecutive abstinence during treatment to assess whether abstinent versus non-abstinent cannabis-dependent participants displayed different pretreatment functional and structural characteristics when compared to HC participants. In comparison to HC participants, cannabis-dependent participants demonstrated greater ventral striatal activation during the receipt of losing outcomes and smaller putamenal volumes. Cannabis-dependent participants who did not subsequently achieve 21 days of consecutive abstinence had increased activity within the striatum during the receipt of losing outcomes, relative to HC participants. Cannabis-dependent participants who did not achieve 21 days of abstinence had decreased bilateral putamen volumes prior to treatment, relative to HC participants. Individual differences in pretreatment striatal function and structure may relate to individual differences in treatment responses for cannabis dependence. While mechanisms underlying these associations require further exploration, the striatum might mediate treatment responses via its role in associative reward-learning (e.g., through skills training in CBT or reinforcement of abstinence in CM). Copyright © 2014 Elsevier Ireland Ltd

  20. Clinical ratings and plasma HVA during cocaine abstinence.

    PubMed

    Martin, S D; Yeragani, V K; Lodhi, R; Galloway, M P

    1989-08-01

    Six patients were evaluated over a 21-day period during inpatient recovery from chronic repeated cocaine use. Serial evaluations of Hamilton depression rating, cocaine craving, plasma homovanillic acid (pHVA), and plasma 3-methoxy-4-hydroxyphenylethyleneglycol (pMHPG) concentrations were determined. There was a distinct increase in cocaine craving between 1 and 2 weeks after the last cocaine use. Levels of pHVA also increased at the time of heightened craving. The data provide preliminary evidence to suggest that changes in cocaine craving during abstinence are positively correlated with changes in dopamine turnover.