• Modafinil with CBT may improve drug rehab for gay men with HIV

    Posted on July 23, 2013
    Methamphetamine use has been linked to increased risk of human immunodeficiency virus (HIV) among gay men. Methamphetamine is a highly addictive stimulant that may lower inhibitions, increase sexual arousal, and lead to risky sexual behavior such as unprotected sex. Further, methamphetamine may be injected, and needle-sharing is also a risk factor for HIV.  These two epidemics have spread concurrently among gay men. There is a need for specialized approaches for addiction treatment and drug rehab for gay men with HIV, if such approaches could be developed. Researchers from the New York State Psychiatric Institute and Columbia University evaluated the efficacy of modafinil plus cognitive behavioral therapy as a treatment for methamphetamine dependence among gay men with HIV (McElhiney...
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  • Drug rehab may soon include pharmacogenetics

    Posted on July 23, 2013
    Pharmacogenetics looks at genetic variation to predict individual differences in response to medications. Individuals may metabolize the same medication in different ways, and their genotype may indicate some of these differences in drug metabolism. Proponents of pharmacogenetics hope that this relatively new field of study will lead to increased efficacy and safety for a wide array of drugs, including those used for addiction treatment. The addiction medicine aspects of drug rehab may be substantially improved if pharmacogenetics lives up to its promise. Haile, Kosten, and Kosten researched how genetic variation might affect responses to cocaine, amphetamine, and methamphetamine and how genetic differences might guide pharmacotherapy. They performed a cross-referenced literature sea...
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  • Will an anti-cocaine vaccine improve drug treatment?

    Posted on July 23, 2013
    A clinical trial supported by the National Institute on Drug Abuse (NIDA) marks the first successful, placebo-controlled demonstration of a vaccine against illicit drug addiction. The anti-cocaine vaccine causes the immune system to produces antibodies which attach to cocaine molecules, preventing them from entering the brain. Thus, the vaccine blocks the drug’s effect. The study followed 115 patients who received either the anti-cocaine vaccine or a placebo. Participants in both groups received 5 vaccinations over 12 weeks and were followed for an additional 12 weeks. All participants participated in drug treatment which consisted of weekly relapse prevention sessions with a trained substance abuse counselor. They also had their blood tested for antibodies to cocaine, and their urin...
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  • Aripiprazole (Abilify) in Alcohol Treatment & Recovery

    Posted on July 23, 2013
    Aripiprazole (Abilify) has been approved by the FDA for the treatment of schizophrenia and acute manic and mixed episodes of bipolar disorder and as an adjunct for the treatment of major depressive disorder. Although other FDA-approved atypical antipsychotics (clozapine, risperidone, olanzapine, quetiapine, and ziprasidone) antagonize the D2 dopamine receptor, aripiprazole acts as a dopamine receptor partial agonist. Might a dopamine receptor partial agonist have a useful role in alcohol recovery? Antagonist vs. Agonist An agonist binds to a specific receptor and triggers a response that often mimics the response of another drug or naturally occurring substance. For example, methadone is an opioid agonist that mimics the effects of opiates. Antagonists, on the other hand, bind to ...
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  • Predictors of response to naltrexone in alcohol rehab

    Posted on July 23, 2013
    Naltrexone is commonly prescribed in alcohol rehab. It is an opioid receptor antagonist that blocks opioid receptors and thus blocks the feeling of pleasure derived from alcohol consumption. Several double-blind clinical trials have shown that naltrexone is more effective than placebo in treatment for alcohol dependence. However, naltrexone may not work well for everyone. Its effectiveness varies among individuals. This has led some researchers to speculate that perhaps not all alcohol dependent individuals derive pleasure from an increase in endogenous opioids after alcohol consumption; perhaps there is a subtype of alcohol dependent individuals which may derive more benefit from naltrexone treatment. Certain clinical predictors might be able to identify individuals who would derive th...
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  • High-dose baclofen for alcohol treatment

    Posted on July 23, 2013
    Oliver Ameisen, an associate professor of medicine and cardiologist at Weill Medical College of Cornell University, reported in Alcohol and Alcoholism that he successfully used high-dose baclofen as an alcohol treatment and achieved complete and prolonged suppression of symptoms of his own alcohol dependence (2005). Ameisen had been diagnosed with alcohol dependence and comorbid anxiety disorder. He reports that his anxiety disorder preceded his addiction to alcohol. He had tried other medications for alcohol dependence with no success. Ameisen decided to try baclofen, a gamma-amino butyric acid receptor agonist that is used to control spasticity. Previous research showed that baclofen had reduced alcohol craving in alcohol dependent patients and suppressed cocaine self-administratio...
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