Search results for "heroin"
showing 10 items of 41 documents
El tratamiento de las toxicomanías y la medicina basada en la evidencia: una alianza necesaria
2007
La medicina basada en la evidencia (MBE) se ha convertido en el nuevo paradigma de la práctica clínica. Desde su desarrollo inicial en la década de los 90 en la Universidad de Ontario y su difusión europea posterior, representa el más alto estándar de calidad en la práctica como ha sido reconocido no sólo por los clínicos y otros profesionales de la salud sino también por administraciones y otros agentes del sistema sanitario. A pesar de este papel destacado en la atención sanitaria, su penetración más allá de un reducido número de profesionales de la salud es muy limitada. La MBE tiene sus raíces en la aplicación de la mejor evidencia publicada a pacientes individuales considerando también…
Development and validation of a reliable method for studying the distribution pattern for opiates metabolites in brain
2012
Abstract Brain distribution pattern of “street” heroin metabolites (morphine and codeine) was investigated in two fatalities due to “acute narcotism”. A suitable sample pretreatment prior to solid-phase-extraction was developed to achieve a good recovery of the analytes and to eliminate the interfering species. After derivatization with MSTFA, samples were analyzed by GC/MS. Specificity, accuracy, precision and linearity of the method were evaluated; LOD and LOQ were, respectively, 10 ng/25 ng for morphine and 5 ng/10 ng for codeine. This method was applied to the analysis of six brain areas (hippocampus, frontal lobe, occipital lobe, nuclei, bulb and pons) coming from two cases of heroin-r…
New perspectives on the manipulation of opiate urges and the assessment of cognitive effort associated with opiate urges
2000
Behavioral models of drug urges assume that conditioned urges are strongly associated with drug consumption. An alternative, cognitive model assumes that urges represent the operation of cognitively demanding processes devoted to either supporting or blocking the automatized drug-use behavior. In Study 1, the effect of verbal drug cues and mood induction on self-reported opiate urges were examined. Twenty-four opiate addicts were either instructed to listen to verbal drug cures or neutral cues. Negative mood induction was applied on 12 addicts. Study 2 examined the cognitive processes underlying these urges. In a dual task paradigm, participants responded to a probe stimulus and listened si…
Unexpected variation of the codeine/morphine ratio following fatal heroin overdose.
2014
Postmortem samples from 14 cases of suspected heroin overdose were subjected to a preliminary systematic toxicological analysis in order to highlight the presence of unknown exogenous compounds (e.g., drugs of abuse, alcohol) that may have played a role in the mechanism of death. This analysis unveiled histories of poly-drug use in seven of the cases under investigation. Moreover, the concentrations of morphine and codeine in the brain were also investigated, and the results were compared with the data obtained from the blood specimens. The concentration of morphine in blood ranged from 33 to 688 ng/mL, while the concentration of codeine ranged from 0 to 193 ng/mL. However, in the brain, th…
Safety and tolerability of slow-release oral morphine versus methadone in the treatment of opioid dependence
2014
Opioid substitution treatment (OST) for opioid dependence may be limited by adverse events (AEs). Increasing the range of therapeutic options optimizes outcomes and facilitates patient management. An international, multi-center, two-phase study investigated the efficacy and safety of slow-release oral morphine (SROM) versus methadone in patients receiving methadone therapy for opioid dependence. In phase 1 (two way cross-over, 11 weeks each period) patients were randomized to SROM or methadone oral solution. In phase 2 (25 weeks), patients continued treatment with SROM (group A) or switched from methadone to SROM (group B). In total, 211 out of 276 completed phase 1 and 198 entered phase 2 …
Long-Term Drug Misuse Increases the Risk of Cognitive Dysfunctions in Intimate Partner Violence Perpetrators: Key Intervention Targets for Reducing D…
2019
Intimate partner violence against women (IPVAW) is a major public health problem, with an important mortality rate in women across the world. In this regard, it has been well-established that drug misuse explains (at least in part) an increased risk of IPVAW perpetration. Even though alcohol is the most widely studied drug underlying IPVAW, other drugs, such as cannabis and cocaine also seem to be significant indicators of this type of violence. Nonetheless, little is known about mediators, such as cognitive domains that facilitate proneness to violence after drug consumption. Therefore, the primary objective of the present study was to compare drug misuse patterns and cognitive performance…
Adrenocorticotropic hormone and cortisol plasma levels directly correlate with childhood neglect and depression measures in addicted patients.
2008
Hypothalamic-pituitary-adrenal (HPA) axis dysfunction has been reported to be involved in vulnerability to alcohol and drug dependence in humans, possibly underlying both addictive behaviour and depression susceptibility. The aim of the present study was to investigate the possible interactions between childhood adverse experiences, depressive symptoms and HPA axis function in addicted patients, in comparison with healthy control. Eighty-two abstinent heroin or cocaine dependent patients and 44 normal controls, matched for age and sex, completed the symptoms Check List-90 (SCL-90), measuring depressive symptoms, and the Childhood Experience of Care and Abuse Questionnaire. Blood samples wer…
Comparative Study of the Perceived Quality of Life of Patients in Treatment for Cocaine and Heroin Dependence in Spain: Differences by Gender and Tim…
2014
This is a cross-sectional study in which we compared the perceived quality of life (QoL) of patients receiving outpatient treatment for cocaine (n = 727) and heroin dependence (n = 469), by analyzing differences by gender and time in treatment. Participants were recruited from addictive behavior centers in Spain in 2004. The World Health Organization Quality of Life Assessment Instrument (WHOQOL-Bref) was used as a measure. Analysis of covariance and multivariate linear regression were used. This study shows the relevance of considering the role of gender in QoL studies, and the need to evaluate the effectiveness of treatment in the improvement of QoL. Limitations of the study were noted.
Patient perspectives on methadone maintenance treatment in the Valencia Region: dose adjustment, participation in dosage regulation, and satisfaction…
2005
Desired adjustment of methadone dose, perceived participation in dosage regulation, and satisfaction with methadone treatment centres were assessed in a sample of opioid-dependent patients from the Valencia Region (eastern Spain). An independent interviewer asked 278 consecutively arriving patients to answer the survey, and 165 (59.4%) completed it. Adjustment of methadone dose was assessed with a -10 to +10 visual analogue scale (VAS-MD); participation in methadone dose regulation, with specific questions; and patient satisfaction, with the Verona Service Satisfaction Scale for methadone treatment (VSSS-MT). The methadone dose (mg/d) prescribed by physicians was (mean+/-S.D.) 68.0+/-30.4. …
“Puffy hand syndrome”
2016
Resume La toxicomanie intraveineuse est responsable de nombreuses complications notamment cutanees et infectieuses. Il existe un syndrome rarement observe en rhumatologie se traduisant par des « grosses mains » : le puffy hand syndrome. Nous en rapportons deux cas rencontres en consultation de rhumatologie chez deux patients toxicomanes. Il s’agit d’un œdeme des mains, bilateral, indolore, ne prenant pas le godet, survenant chez un de nos patients pendant l’intoxication par heroine, et chez l’autre 2 ans apres avoir arrete ses injections. Chez nos deux patients les bilans complementaires (biologiques, radiologiques, echographiques) etaient sans particularite, ce qui a permis dans le context…