Addiction Treatment Blog

In 1954, Olds and Milner discovered that there appeared to be pleasure spots in the brain. Implanting electrodes in certain areas of the brain, through which a rat can give itself an electric current by pressing on a lever, produced in most brain areas nothing of note. In some areas, however, the rats seemed keen on the effects of self-stimulation and, in some cases, if left to their own devices would self-stimulate to the exclusion of all else – even food and drink.

As mentioned, noradrenaline was discovered in the brain in 1954. In 1959, a second catecolamine, dopamine, was identified, which was shown to be deficient in Parkinson’s disease.

The later mapping of dopamine-containing neurones has shown that they too, like noradrenergic neurones, tend to originate in a discrete area, the ventral tegmentum. Some of these neurones run to strictly motor areas of the brain and constitute the nigrostriatal system, and it is loss of nerve calls in this pathway that leads to Parkinson’s disease. Read more…

It is as natural to die as to be born; and to a little infant, perhaps, the one is as painful as the other.

Sir Francis Bacon, 1561-1626, Essays, ‘Of Death’.

Drug Abuse in Pregnancy

It is particularly difficult to study drug abuse in human pregnancy. There are a number of reasons for this.

• Recruitment. Suitable women may be difficult to identify because they may feel guilty about their drug taking, be afraid to tell healthcare staff about illegal drug use and be frightened of reproaches from relatives should this come to light.
• Confounding. The lifestyle of many women who abuse drugs may already predispose them to an adverse pregnancy outcome, e.g. living conditions, general health, reproductive health, nutritional status and socioeconomic group. Separating environmental and personal confounders is particularly difficult when trying to follow-up drug-exposed infants after birth.
• Multi-drug use. It is almost impossible to study any single drug of abuse in complete isolation because multi-drug use is common. Tobacco and alcohol alone are frequently consumed by those who abuse street drugs, and these are known to have adverse effects upon the foetus.
• Identification. Many drug abusers do not know exactly what they are taking, either in terms of identity (due to adulteration) or in terms of dose (due to impurity and dilution).
• Collecting data. Usually studies rely on maternal recall of the extent and nature of drug use during pregnancy and this may not be reliable.
• Changing use. The pattern of use may change during the pregnancy. Mothers may increase or decrease dose or frequency. Read more…

Illness is in part what the world as done to a victim but in a larger part is what the victim has done with his world, and with himself.

Karl Menninger, quoted in ‘Illness as Metaphor’ by Susan Sontag.

Drug abuse is a cause for many serious illnesses, including HIV (AIDS).

From time to time the healthcare professional will encounter an individual with a medical condition who abuses drugs. Although not condoning the taking of these substances, it is desirable that those in a position to advise are able to provide information on whether the drug is liable to exacerbate the condition. The sections below provide brief details which may be helpful in advising those with some of the more common medical conditions. The information given should be used as a guide only. The data available are sparse in most cases and while it is hoped that the details in this chapter will be useful, every patient’s particular circumstances will differ and one should be cautious about extrapolating limited information to all situations in which it could be applicable.

It is difficult to find data in the advisability of drug abuse in those suffering from concomitant medical conditions. The data given here are based upon details of side effects that have been reported in the medical literature and knowledge of drug handling by the body. This information is incomplete because none of the drugs of abuse have been subject to large-scale clinical trials at the doses abused. This is the main mechanism by which side effect profiles of therapeutic drugs are determined. This being the case, most of the data on adverse effects from street drugs are derived from small-scale studies, case reports, surveys and anecdotal evidence. Causality can also be difficult to ascertain because many users employ a variety of drugs simultaneously. Many drug abusers have a poor quality of life due to bad living conditions and/or inadequate nutrition; this may make them more susceptible to various diseases. Read more…

There are variety of amphetamine and ecstasy-based drugs.

Amphetamine itself has been abused since the 1930s but the first derivative to gain acceptance on the street was 3,4-methylenedioxyamphetamine (MDA), known at the time as the ‘love drug‘ because it purportedly dispelled feelings of hate or anger and encouraged emotional closeness between users. MDA abuse began in the USA in the mid-1960s but the drug was declared illegal in 1970. However, a large number of other amphetamine derivatives were introduced during this period and the banning of MDA merely opened the door to related drugs such as MDMA (3,4-methylenedioxymethamphetamine or ecstasy). DOM is an example of an especially hallucinogenic derivative, while methamphetamine is highly stimulatory. MDMA itself seems to have particularly prominent effects on central 5-hydroxytryptamine (5HT) neurones. This may explain why MDMA intoxication seems to involve an overly emotional element. The drug also has a low hallucinogenic potential with less stimulatory effect than amphetamine.

Other related drugs with less potent sympathomimetic effects and less abuse potential, such as phentermine, are still used as appetite suppressants in the treatment of obesity. Another derivative methylphenidate, is used to treat attention deficit hyperactivity disorder in children.

Amphetamine

History

Amphetamine was first synthesised in 1887 and has since been used to treat a range of medical conditions; some of these are listed in table below. Amphetamine use proliferated in the 1930s when it was found to have similar, although more potent, effects to the widely used drug ephedrine. Ephedrine was extracted from plants and so supplies were limited and expensive.

Vast quantities of amphetamine were synthesised and issued to troops and workers during World War II for use as a stimulant during periods of strenuous activity. Amphetamine was also widely used to treat comparatively trivial conditions such as rhinitis. Together, these two factors played a large part in facilitating the early rise of amphetamine abuse; the population could obtain amphetamine easily and experiment freely with its psychoactive effects. The drug is known on the street as ‘speed‘, ‘whiz‘ or ‘uppers‘. Read more…