Chinese Heroin Research Articles

Role of novelty seeking personality traits as mediator of the association between COMT and onset age of drug use in Chinese heroin dependent patients.

BackgroundPersonality traits such as novelty seeking (NS) are associated with substance dependence but the mechanism underlying this association remains uncertain. Previous studies have focused on the role of the dopamine pathway.ObjectiveExamine the relationships between allelic variants of the catechol-O- methlytransferase (COMT) gene, NS personality traits, and age of onset of drug use in heroin-dependent subjects in China.MethodsThe 478 heroin dependent subjects from four drug rehabilitation centers in Shanghai who were genotyped for eight tagging single nucleotide polymorphisms (SNP) on the COMT gene completed the NS subscale from the Temperament and Character Inventory. Multivaritate analyses were used to assess the potential mediating role of NS personality traits in the association between COMT gene variants and the age of onset of heroin use.Principal Findings and ConclusionsIn the univariate analysis the COMT rs737866 gene variants were independently associated with both NS and age of onset of drug use: those with the TT genotype had higher NS subscale scores and an earlier onset age of heroin use than individuals with CT or CC genotypes. In the multivariate analysis the inclusion of the NS subscore variable weakened the relationship between the COMT rs737866 TT genotype and an earlier age of onset of drug use. Our findings that COMT is associated with both NS personality traits and with the age of onset of heroin use helps to clarify the complex relationship between genetic and psychological factors in the development of substance abuse.

Human Rights, Ethics, and the Protection of Intravenous Drug Users Are Much Improved in China

Human Rights, Ethics, and the Protection of Intravenous Drug Users Are Much Improved in China

Implicit and Explicit Cognition of Chinese Heroin Abusers

Sixty-five heroin abusers receiving Methadone Maintenance Treatment (MMT), 38 heroin abusers not receiving MMT, and 30 nonusers of drugs participated in this investigation of cognition in heroin and methadone users. Heroin users were measured for both implicit and explicit cognition, while the control group of nonusers was measured only for implicit cognition. The results demonstrate that implicit cognition can influence the development of addictive behaviors, and that implicit and explicit cognition of heroin were separate and independent constructs. Based on the results of Implicit Association Tests (IAT; Greenwald, McGhee, & Schwartz, 1998) MMT appears to be a valid method for opiate withdrawal treatment as it reverses the implicit desire for heroin in heroin abusers.

Lifetime multiple substance use pattern among heroin users before entering methadone maintenance treatment clinic in Yunnan, China

Multiple substance use leads to greater levels of psycho-behavioural problems, unsafe sex, and therefore a high risk of contracting sexually transmitted diseases, and is also more difficult to treat. This study aims to determine pattern of lifetime multiple substance use among Chinese heroin users before entering methadone maintenance treatment clinic. A survey to obtain retrospective longitudinal data on lifetime multiple substance use was conducted among 203 heroin users in two of the biggest methadone maintenance clinics in Kunming City, Yunnan province. All participants used more than one substance in their lifetime. Most of them used four or more substance groups (range two to seven groups). The most common substance patterns in lifetime use were alcohol, tobacco, opiates and depressants. Approximately 80% of them had a history of simultaneous substance use (co-use). The most common combination of co-use pattern was heroin with depressant. Common reasons for co-use were to get high, to experiment, to sleep and to increase the potency of other drugs. Determinants of co-use were education, marital status and family relationship. Multiple substance use is highly prevalent among Chinese heroin users. Depressants are the most common substances used in combination with heroin.

Analysis of Mulan’s Image

Mulan is an ancient Chinese heroine. The story shows that she is the same as other women, having personal life, but also has a heart that loves her country and her parents. She always thinks about her family, society, dan country. This article was based on library research, using Mulan poem dan a folklore entitled Mulan Pergi Berperang as media to analyze Mulan’s image. It can be said that eventhough at that time there was no gender perspective concept, Mulan had been able to replace her father to go to war. She gave a lot of contributions for her country, society, and family. Analysis represents that Mulan has three images, as a heroine, as a daughter for her family, and self-image or leader for the women. Having good character and spirit to love country, people, and family make her equal to men. And, it makes her respected by people in each generation.

Gender, Consumption, and Ideological Ambiguity in David Garrick’s Production of The Orphan of China (1759)

This essay investigates how the first production of Arthur Murphy’s The Orphan of China relates English concern for French influences to a distinctive consciousness of national identity. Reflecting the colonial rivalry between England and France, Murphy’s play emphasizes the chinese heroine’s defense of individual rights in order to criticize the chinese (and implicitly French) patriotic passion for absolutist monarchy. Whereas the female body of an actress wearing chinoiserie costuming (which connoted imperial trade) might undermine the credibility of the heroine’s political objectives, the first performance may have averted ambiguity by employing several theatrical devices, including: the epilogue’s identification of the actress with lady patrons; the actress’s reported skill in conveying character through majestic elocution and gestures; the prologue’s censure of Chinese patriotism; and the epilogue’s rejection of Chinese customs. Murphy’s departure from Voltaire’s pseudo-confucian ideas about women is probably part of a larger intellectual trend that raised questions about changing attitudes toward female autonomy. in presenting the cross-cultural role of Mandane/Mrs. Yates as the other race and the other gender , Murphy constantly returns to the english self and reflects on English national identity.

Factors influencing a low rate of hepatitis C viral RNA clearance in heroin users from Southern China

To study the virological and host factors influencing hepatitis C infection outcomes in heroin users in southern China. HCV RNA and associated factors were analyzed among 347 heroin users from Guangxi Zhuang Autonomous Region, southern China who were hepatitis C virus (HCV) EIA positive for two or more consecutive visits. Using the COBAS AMPLICOR HCV TEST, a remarkably low HCV RNA negative rate of 8.6% was detected. After multivariate logistic regression analysis, HCV RNA clearance was significantly associated with the presence of HBsAg (OR = 8.436, P < 0.0001), the lack of HIV-1 infection (OR = 0.256, P = 0.038) and age younger than 25 (OR = 0.400, P = 0.029). Our study suggests HCV infection among Chinese heroin users results in high levels of viral persistence even amidst factors previously found to enhance viral clearance. Prospective studies of a possible genetic component within the Chinese population and the pathogenicity of non-genotype 1 HCV infections are needed.

Long-term methadone maintenance reduces protracted symptoms of heroin abstinence and cue-induced craving in Chinese heroin abusers

Background Cession of heroin use may be followed by a protracted-abstinence (PA) syndrome consisting of craving, negative mood, and physiological changes. PA symptoms have rarely been compared between drug-free and methadone-maintained former heroin users after similar lengths of heroin abstinence. Methods Seventy former heroin users were included in one of four groups: in day 15–45 of methadone maintenance therapy (short-term MMT), in month 5–6 of MMT (long-term MMT), opiate-free for 15–45 days after methadone-assisted heroin detoxification (short-term post-methadone), and opiate-free for 5–6 months after methadone-assisted heroin detoxification (long-term post-methadone). PA symptoms (negative mood, dyssomnia, somatization, and craving), and blood pressure and pulse were assessed pre- and post-neutral videotape and pre- and post-heroin videotape. Results Dyssomnia and the total PA score were worst in short-term post-methadone participants, mood was best in long-term MMT participants, and cue-induced craving was least severe in long-term MMT participants. Blood pressure and pulse did not differ across groups. Conclusions Even after acute withdrawal, the first months of heroin abstinence after methadone-assisted detoxification may be more difficult in terms of cue-induced craving and other PA symptoms than the first months of heroin abstinence during MMT. Our findings add to the literature supporting MMT for prevention of cue-induced heroin craving.

Nonfatal Overdose Among Heroin Users in Southwestern China

Objective: To evaluate the prevalence of and risk factors for nonfatal overdose among heroin users in southwestern China. Methods: In 2005, 731 heroin users in Sichuan Province, China were interviewed for overdose experiences in the past 12 months. Factors hypothesized to be associated with overdose were evaluated with logistic regression models. Results: Eighty-eight (12%) drug users experienced at least one overdose, with a range from 1 to 20; 45 (51%) experienced 2 or more overdoses. Over half of participants with experience of overdose were recently released from prison (52%), and 56% used benzodiazepines before overdose. Longer methadone treatment in the past year (≥180 vs. 0 days; OR,. 3; 95% CI,. 1–.8; P = .02), longer duration of using drugs (≥7 vs. <7 years; OR, 2.2; 95% CI, 1.3–3.6; P = .002), and more frequency of injecting drugs in the past 3 months (≥7 vs. <7 times/week; OR, 5.4; 95% CI, 3.2–9.0; P < .001) were independently associated with increased risk of nonfatal heroin overdose. Conclusions: Nonfatal heroin overdoses are common among Chinese heroin users. Drug users should be encouraged to participate and remain in methadone treatment to prevent overdose and be educated about proper response to overdose to reduce risk of overdose death.

Dopamine D4 receptor polymorphism modulates cue-elicited heroin craving in Chinese

Subjective craving, which contributes to the continuation of drug use in active abuser and the occurrence of relapse in detoxified abusers, is considered to be a central phenomenon in addiction. Dopamine pathway has been implicated in the mechanism underlying the cue-elicited craving for a variety of addictive substances. The objective of this study was to test the hypothesis that heroin addicts carrying D4 dopamine receptor gene (DRD4) variable number tandem repeat (VNTR) long type allele would have higher craving after exposure to a heroin-related cue. Craving was induced by a series of exposure to neutral and heroin-related cue and were assessed in a cohort of Chinese heroin abusers (n=420) recruited from the Voluntary Drug Dependence Treatment Center at Shanghai. Significantly stronger cue-elicited heroin craving was found in individuals carrying DRD4 VNTR long type allele than the non-carriers (F=31.040, p<0.001). As for baseline craving and mean change in craving responding to neutral stimuli, no significance was found (1.06+/-0.34 vs 1.07+/-0.36, F=0.067, p=0.797 and 0.42+/-0.34 vs 0.45+/-0.37, F=0.277, p=0.599, respectively). The results of our study suggest that DRD4 VNTR polymorphism contributes to cue-elicited craving in heroin dependence, indicating DRD4 VNTR represents one of potential genetic risk factors for cue-induced craving.

The effect of dopamine D2, D5 receptor and transporter (SLC6A3) polymorphisms on the cue‐elicited heroin craving in Chinese

Heroin dependence is resulted from the interaction between multiple genetic and environmental factors. Subjective craving is considered to be a central phenomenon, which contributes to the continuation of drug use in active abuser and the occurrence of relapse in detoxified abusers. Dopamine pathway has been implicated in the cue-elicited craving for a variety of addictive substances. The objective of this study was to test the hypothesis that heroin addicts carrying specific variants in dopamine-related genes would have higher levels of craving following exposure to a heroin-related cue. Craving induced by a series of exposure to heroin-related cue was assessed in a cohort of Chinese heroin abuser (n = 420) recruited from natural abstinence center at Shanghai. Significantly stronger cue-elicited heroin craving was found in individuals carrying D2 dopamine receptor gene (DRD2) TaqI RFLP A1 allele than the non-carriers (P < 0.001). Furthermore, we did not observed significant association of cue-elicited craving with the nine-repeat allelic variants in dopamine transporter gene (DAT) SLC6A3 and with the dinucleotide repeat polymorphism (DRP) 148bp allele in D5 dopamine receptor gene (DRD5). The results of our study suggest that human dopamine pathway be involved in cue-induced heroin craving, and indicate a potential genetic risk factor for persistent heroin behavior and relapse.

Comprehensive mu-opioid-receptor genotyping by pyrosequencing.

The human μ-opioid receptor, encoded by the OPRM1 gene (1)(2), is the major site for the analgesic action of opioids. The OPRM1 gene is therefore a first-line candidate for evaluating the role of mutations on the clinical effects of opioids. The mutant allele of the 118A>G single-nucleotide polymorphism (SNP) in the OPRM1 gene, which codes for an Asn40Asp μ-opioid receptor, has been associated with decreased opioid activity in carriers of the 118G allele. Morphine 6-glucuronide (M6G) and morphine have lower potencies for pupil constriction in carriers of the mutation, who also vomit less often after treatment with M6G than noncarriers (3). Carriers of the 118G allele need more alfentanil for postoperative analgesia but have less pain relief than noncarriers (4). The 118G allele has also been associated with a greater cortisol response to opioid receptor blockade with naloxone (5). Regarding opioid addiction, the mutant allele of the 17C>T SNP was found more frequently in drug addicts than in nonaddicts (6)(7). An association between the mutant alleles of the 118A>G (exon 1) and 691C>G (intron 2) SNPs and opioid dependence was reported for Chinese heroin addicts, although this was based on a small study group (8). The frequency of the mutated 118G allele was higher in Indian heroin addicts than in controls (9). Addicted individuals carrying both the mutated 118G allele and the mutated 31A allele in intron 2 consumed higher doses of heroin than individuals who did not carry these mutations (10). The simultaneous presence of the mutated alleles for SNPs −1793T>A, −1699-(−1698)insT, −1320A>G, −111C>T, and 17C>T is associated with substance dependence (11). In European Americans, allele −2044A and haplotypes that include −2044A were found to be associated with susceptibility for substance dependence (12). To promote further investigation of an association of OPRM1 mutations …

Rapid transmission of hepatitis C virus among young injecting heroin users in Southern China.

Hepatitis C virus (HCV) is quickly spread through injection drug use. The prevalence and incidence of HCV in Chinese heroin users has been rarely reported. A longitudinal cohort of young injection drug users (IDU) from southern China was established to study the risk factors for blood-borne infections (597 subjects). Individuals underwent analysis for the presence of hepatitis B surface antigen and antibodies to human immunodeficiency virus type 1 (HIV-1), HCV and hepatitis B surface antigen. Using self-reported risk behaviours, multivariate regression analysis was performed for factors associated with HCV prevalence and seroconversion. At baseline, HIV-1 and HCV prevalence was 17% and 72%, respectively. Significant factors associated with HCV seroprevalence included age >25 years (odds ratio [OR] = 1.71) and injection drug use for >2 years (OR = 2.60). HCV prevalence within one year of starting heroin use was 57% for any route of administration, and 80% if restricted to injectors. After two 6-month follow-up visits, 56 out of 159 baseline HCV seronegative individuals (148.9 total person years [py]), underwent seroconversion at an incidence rate of 37.6 per 100 py. Individuals who reported injection drug use were more likely to undergo HCV seroconversion (rate ratio [RR] = 6.59). HCV infection is rapidly acquired in heroin users who adopt injection in southern China. This study emphasizes the urgent need to implement and expand injection prevention and primary substance abuse prevention programmes in China.

Relationship of the delta-opioid receptor gene to heroin abuse in a large Chinese case/control sample.

Pharmacological and electrophysiological evidence has shown that opioid receptors are involved in the mechanism of heroin dependence. Thus, opioid receptors are appropriate candidate genes for case-control association studies of heroin dependence. Previously, two single nucleotide polymorphisms (SNPs), OPRD1 921T > C and 80G > T, of the human delta opioid receptor gene were used in population-based studies of heroin dependence. One study in a German population found that OPRD1 921T > C was associated with heroin dependence. This finding, however, was not replicated in a different German sample. To test the hypothesis that OPRD1 or a closely linked gene is associated with heroin dependence, we used 5' nuclease assays to genotype both OPRD1 SNPs in 450 Chinese heroin dependent patients and 304 unaffected controls from the same population. In addition, five SNPs distributed in four other genes: ADH2, ALDH2, OPRM1, and DRD1, were used as genomic control loci to test the case and control populations for stratification bias. Genotype and allele frequencies at OPRD1 921T > C were not significantly different, and the OPRD1 80G was absent from both Chinese opioid dependence patients and controls. Based on the genotype and allele frequencies of the genomic control loci, there was no evidence for stratification bias capable of masking an association of OPRD1 to heroin dependence in this large and homogenous Chinese sample. Therefore, these data do not support an association between the OPRD1 gene and heroin dependence in the Chinese population.

Allelic association analysis of the dopamine D2, D3, 5‐HT2A, and GABAAγ2 receptors and serotonin transporter genes with heroin abuse in Chinese subjects

Five candidate genes, the receptors DRD2, DRD3, HTR2A and GABA(A)gamma2, and the serotonin transporter (5-HTT) were analyzed for association with heroin abuse. We examined three polymorphisms (promoter - 141DeltaC, Ser311Cys, and TaqI) in the DRD2 gene, one polymorphism (Ser9Gly) in the DRD3 gene, two polymorphisms (promoter - 1438G/A and T102C) in the HTR2A gene, two polymorphisms (VNTR and Del/Ins) in 5-HTT gene, and one polymorphism (G3145A) in GABA(A)gamma2 gene in 121 Chinese heroin addicts and 194 controls. None of the polymorphisms differed significantly for allele, genotype, or haplotype frequencies, except for the DRD2 promoter polymorphism - 141DeltaC (genotype-wise and allele-wise, P = 0.05, uncorrected). An additional 344 subjects with heroin abuse and 104 controls were investigated for the - 141DeltaC polymorphism. In the second sample, there were no significant difference of genotype or allele frequencies between subjects with heroin abuse and normal controls. When we divided the sample by route of administration into nasal inhalers and IM or IV injectors, however, it produced a significant difference between inhalers of heroin and controls (genotype-wise, P = 0.006, allele-wise, P = 0.016) but not for injectors of heroin (genotype-wise, P = 0.81, allele-wise, P = 0.69). We also found that LD between all polymorphisms we examined in the gene was weak, possibly explaining why we see association of this polymorphism with heroin abuse but not with other markers in the gene. Overall our results indicates that the HTR2A, 5-HTT, DRD3 and GABA(A)gamma2 genes are not likely to be a major genetic risk factor for heroin abuse in this population, with the exception of possible association between nasal inhalation and DRD2 promoter - 141DeltaC polymorphism.

Association between mu opioid receptor gene polymorphisms and Chinese heroin addicts.

Mu opioid receptor (MOR) has been shown to be associated with alcoholism and opioid dependence. The present study examined the involvement of a polymorphism in A118G in exon 1 and C1031G in intron 2 of the MOR gene in 200 Chinese heroin-dependent and 97 control subjects. Results showed a significant association for both A118G and C1031G polymorphisms and opioid dependence. The G allele is more common in the heroin-dependent group (39.5% and 30.8% for A118G and C1031G polymorphisms, respectively) when compared to the controls (29.4% and 21.1% for A118G and C1031G polymorphisms, respectively). This study suggests that the variant G allele of both A118G and C1031G polymorphisms may contribute to the vulnerability to heroin dependence.

Association analysis of polymorphisms in the mu opioid gene and heroin abuse in Chinese subjects

We examined four polymorphisms in the μ opioid receptor gene in 282 Chinese heroin addicts from Sichuan Province, Southwest China and compared the allele and genotype frequencies to those in 258 normal controls from the same geographic region. Two of these polymorphisms (Ala6Val and Ser147Cys) were not polymorphic in the Chinese, with only Ala6 and Ser147 observed. The frequencies of the two other polymorphisms were significantly different from those observed in Caucasians, African Americans and Native Americans. The Asn40Asp and IVS2 + 691G/C polymorphisms did not differ significantly for allele (p= 0.16; p = 0.21), genotype (p= 0.32; p = 0.09) or haplotype frequencies (p= 0.24) between the Chinese heroin-addicted cases and normal controls. Similarly, we did not detect any association when the population was stratified by gender, route of administration (nasal inhalation and/or injection) and age-at-onset (above or below 25 years). This indicates that the μ opioid receptor is not likely to be a major genetic risk factor for heroin abuse in this population.

The illicit drug scene.

Drug taking is probably not in itself a social or medical problem or a cause of such problems, and most drug takers never come to the notice of official agencies. The minority who constitute a problem may be involved with drug taking for complex or psychological reasons; they may be relying on drugs until alternative support becomes available. The commonest illicit drug is cannabis. Others include lysergide (LSD), which like cannabis is obtained wholly from unlawful sources. Amphetamines (and other central nervous stimulants) and barbiturates (and other central nervous de pressants) are also taken illicitly though their source originally may have been legitimate for example, they may have been stolen from pharmacies or overprescribed by doctors. Finally, opiates may find their way on to the black market from diversion of prescribed drugs on the one hand to smuggling of Chinese heroin on the other.

British opiate users: I. People approaching London drug treatment centres.

SummaryInterviews were secured with over 90% of a sample of 230 people, all of whom had fixed drugs, had approached any outpatient drug treatment center in Greater London during the 1-year period commencing mid-November 1970, and had no significant previous clinic contact. Results include descriptions of family and demographic background, current life styles, illegal activities, initial and current drug use, periods of abstention, and physical complications.Males constituted 80% of the sample. Most of the respondents were between 18 and 25 years of age. About half of the respondents held full-time employment at the time of interview. About 25 % of the sample had been convicted of at least one nondrug offense in the previous year, but the majority of these respondents also had had at least one conviction prior to their first fix. Eleven percent of respondents report having been “planted” in the 12-month period prior to interview. Most respondents had at least tried a wide variety of drugs, including the injection of sedatives and of Chinese heroin. From the time of first fix of heroin or methadone, there was a median interval of about 1 year before respondents “first fixed daily for 7 days,“ and a further interval of about 2 years before approaching a drug clinic—but this is subject to considerable variability. On average about half of respondents’ acquaintances who had fixed also have come to clinics. The main reason given as to why the remainder did not do so was simply that they did not use enough opiates to warrant it.

Present-day methadone prescribing in England.

The “United Kingdom Statistics of Drug Addiction and Criminal Offences Involving Drugs” (published by the Home Office) gives the following data as of 31st December 1969: of the total number of 1466 known drug addicts (namely, addicts to hard drugs), 499 were taking heroin, and more than double that number, namely 1011, were taking methadone (either alone or with other drugs). A footnote explains that “as a result of a deliberate policy adopted by Hospital Clinics in the treatment of heroin addiction, of weaning patients from heroin on to methadone, methadone has supplanted heroin as the drug most commonly used by addicts.” What is meant by the phrase “most commonly used by addicts” is probably, “most commonly prescribed to addicts,” as, of course, the number of abusers or addicts buying “Chinese heroin” or English heroin or methadone on the black market is unknown. There is, in fact, a certain amount of black market dealing in these and other drugs going on.