Long-term Detoxification Research Articles

Long-term detoxification of opioid use disorder with opium tincture assisted treatment.

Retention in treatment, craving, and relapse rate are important indicators of the success rate in addiction maintenance therapy as they evaluate the effectiveness of the therapy and make necessary adjustments to the treatment plan. However, the rate of continuation in the treatment process and the rate of craving in patients with opioid use disorder undergoing maintenance treatment with opium tincture have not been studied. The present study aimed to investigate the rate of relapse, craving, and psychiatric disorders in patients with opioid use disorder undergoing treatment of gradual detoxification with opium tincture. Ninety patients with opioid use disorder who underwent treatment with the gradual detoxification method using opium tincture in the form of Congress 60 for 11 months were enrolled in the study. The level of craving based on the Desire for Drug Questionnaire (DDQ) and patients' self-report of drug use, the level of anxiety, depression, and sleep quality of patients were evaluated using the Beck Anxiety Inventory (BAI), Beck Depression Inventory (BDI), and Pittsburgh Sleep Quality Index (PSQI), respectively. Also, suicidal thoughts were assessed by Beck Scale for Suicidal Ideation and quality of life by the World Health Organization Quality of Life Questionnaire (WHOQOL-BREF). The study found that the treatment resulted in a relapse rate of 16.7% for relapse. We also found that all sub-scales of the desire for drug questionnaire (DDQ), depression, and anxiety were significantly lower at the end of the study compared to its beginning. Additionally, quality of life and sleep significantly increased at the end of the study. All areas of craving, anxiety, and depression significantly decreased in all follow-up sessions that took place 1, 5, and 11 months after the start of treatment. Moreover, sleep disorders were improved considerably at the end of the treatment. The current study presented a low relapse rate of Iranian patients with opioid use disorder under structured treatment of gradual detoxification with opium tincture in a one-year follow-up period. Opium tincture under the Congress 60 protocol may help to control carving, decrease psychological disorders, improve quality of life, and consequently, lower relapse rate.

1-8 多溶出石炭灰の長期無害化技術の高度化

1-8 多溶出石炭灰の長期無害化技術の高度化

Sodium sensitivity as a main determinant of blood pressure changes during early withdrawal in heavy alcoholics.

Stimulated sympathetic nervous system, renin-angiotensin-aldosterone system, vasopressin, and cortisol are thought to affect blood pressure in early withdrawal of alcoholics. Hyperactivity of sodium-retaining systems with consequent volume expansion also could interact with sodium sensitivity as previously found in long-term withdrawing alcoholics. To investigate this hypothesis, blood pressure and sodium balance were measured during the first 8 days of withdrawal in 18 chronic alcoholics on a 150 mM Na diet. Results were related to the Salt Sensitivity Index of blood pressure as measured in the same alcoholics after 1 year of abstinence. Early withdrawal study: there was a positive sodium balance (+288.6 +/- 45.6 mM; p < 0.0001) and rise in mean arterial pressure (+11.8 +/- 2.9 mm Hg; p = 0.001) during early withdrawal on 150 mM Na diet. Salt Sensitivity Study after long-term detoxification: the shift from low (55 mM) to high sodium (260 mM) intake produced a larger (p = 0.04) increase in mean arterial pressure in alcoholics (+9.3 +/- 2.0 mm Hg) than in 30 teetotal controls (+5.1 +/- 1.1) (Salt Sensitivity Index, 0.047 +/- 0.008 vs. 0.023 +/- 0.0053; p < 0.05). Changes in mean blood pressure during withdrawal were highly related to sodium sensitivity index (r = 0.8; p < 0.001). Early withdrawing alcoholics exposed to a normal sodium intake experience positive Na balance and increase in blood pressure that is related to sodium sensitivity measured after long-term detoxification. This suggests that salt sensitivity plays a key role in blood pressure regulation in early withdrawing alcoholics.

Reactivation of cocaine conditioned place preference induced by stress is reversed by cholecystokinin-B receptors antagonist in rats

The effects of different cholecystokinin (CCK) receptor antagonists (devazepide and L365,260) on cocaine or stress-induced reactivation of cocaine conditioned place preference (CPP) were investigated in rats. After receiving alternate injection of cocaine (10 mg/kg) and saline for 8 consecutive days, the rats spent more time in the drug-paired side (cocaine CPP) on day 9. These animals did not show cocaine CPP on day 31 following saline-paired training daily from days 10 to 30 (21-day extinction). However, a single injection of cocaine (10 mg/kg) or 15 min of intermittent footshock could reinstate CPP on day 32 with significant more time spent in the drug-paired side in comparison with that on day 0. Systemic injection of CCK-A receptor antagonists, devazepide (0.1 and 1 mg/kg, i.p.), 30 min before cocaine priming, significantly attenuated cocaine-induced reinstatement of CPP, while CCK-B receptor antagonist, L365,260 (0.1 and 1 mg/kg, i.p.), did not show a similar effect. In contrast, pretreatment with L365,260 (0.1 and 1 mg/kg, i.p.) but not devazepide (0.1 and 1 mg/kg, i.p.) significantly blocked stress-induced reinstatement of CPP. In another experiment, CCK-A or B receptor antagonists were infused into nucleus accumbens or amygdala to determine which brain area are involved in the role of different CCK receptors in stress or drug-induced relapse to cocaine seeking. The results show that infusion of the devazepide (10 μg) into the nucleus accumbens significantly inhibited the cocaine-induced reinstatement of CPP, while infusion of devazepide (1 and 10 μg) into amygdala did not affect cocaine-induced reactivation of CPP. Interestingly, infusion of L365,260 (1 and 10 μg) into both nucleus accumbens or amygdala significantly attenuated or blocked stress-induced reinstatement of CPP. These findings demonstrate that CCK-A and B receptor have different roles in relapse to drug craving and further suggest that the brain areas involved in the CCK receptors on reinstatement of drug seeking are not identical. CCK-B receptor antagonists might be of some value in the treatment and prevention of relapse to stress-induced to drug craving following long-term detoxification.

Synthetic polymer delivery system.: Sustained release of persulfate during the photo-oxidation of an azo-dye

A synthetic delivery system based on the copolymer ethylene vinyl-acetate (from now on EVA-polymer) and the carrier, bovine serum albumin (from now on BSA) were prepared by polymer dissolution in the presence of persulfate. This system acted as a long-term polymer release device, cleaning aqueous solutions containing Orange II under visible light irradiation. The polymer and the carrier used were found to be inert and the observed oxidation was only due to persulfate. As expected, the higher initial loadings of persulfate deliver a higher amount of oxidant, leading to a faster photo-degradation of Orange II. The decoloration of Orange II by persulfate only occurred under visible light irradiation suggesting a dye sensitized process. The persulfate release during the reaction was sufficient to decolore amounts of Orange II, usually found in large water bodies (∼50mg C/l). Disks of EVA-persulfate were used in conjunction with light increasing the release performance of the synthetic delivery system. The addition of BSA can be selective in order to regulate the release of persulfate in the delivery system. The synthetic polymer delivery system was reused over many cycles, since, the polymer delivery system could be retrieved after each cycle. The repetitive use of the persulfate based disks have implications for the long-term detoxification of contaminated water, opening the way for new applications that are not possible by simple addition of persulfate-ions in homogeneous solutions.

Conversion rates of five polycyclic aromatic hydrocarbons in liquid cultures of fifty-eight fungi and the concomitant production of oxidative enzymes

Fifty-eight fungi from different physio-ecological groups were compared for their capacity to oxidize five polycyclic aromatic hydrocarbons (PAH) with three to five benzene rings (R), and produce the appertaining extracellular oxidoreductases in liquid culture. In 14 d, wood- and straw-associated basidiomycetes converted 19–90% of the original PAH compounds. The groups of wood- and straw-degrading, wood-degrading, terricolous, ectomycorrhizal, and mitosporic fungi converted PAH at a proportion of 100:75:34:19:18. All fungi preferred fluoranthene and pyrene (4R). Anthracene (3R) was preferred by wood-associated fungi. Phenanthrene (3R) and perylene (5R) were sufficiently converted by wood-associated and terricolous, but poorly by ectomycorrhizal and mitosporic fungi. Nevertheless, fungi that converted the entire set of PAH satisfactorily were found in all five groups. PAH conversion was correlated with the production of manganese peroxidase ( r = 0.98), peroxidase ( r = 0.89), and laccase ( r = 0.85), but not with monophenol monooxygenase ( r = 0.07). Mn(III) ions oxidized all PAH with preference to anthracene. Hydrogen peroxide converted PAH possibly by the products of Fenton's reaction. Limiting factors were shortages in peroxidases and H 2 O 2 . Gymnopilus sapineus and Agrocybe praecox converted top quantities of PAH in the absence of peroxidases, manganese peroxidases, and lignin peroxidases. The relative contributions of intra- and extracellular enzymes to the conversion of PAH and the possible role of the fungi in the long-term detoxification of soil xenobiotics are discussed.

Urban Homelessness: Psychological Outcomes for Mothers and Children

Homelessness is a phenomenon that has been a part of the American lifestyle since colonial times. The meaning of homelessness has changed many times since the early years of the colonial settlements with different definitions emerging in response to national and regional situations. Since the mid-eighteenth century, homelessness has increased in times of economic difficulty and declined during periods of prosperity or with the outbreak of war. In previous centuries, the homeless poor were supported by family members. This system of relief usually remedied breaks in the family structure. Since poverty was virtually uncommon, the community regarded these people as their wards and assumed responsibility for those in distress. Little stigma was attached to homelessness because it was generally felt to be due to circumstances beyond one's control.CURRENT STATUS OF THE HOMELESSOver the last century, an increase in homelessness has been largely attributed to an increase in unemployment, underemployment, and poverty in general. Currently, the nature and scale of homelessness differs depending on the definition used. While the U. S. Bureau of the Census does not define homelessness, it has adopted the definition of the U. S. Department of Housing and Urban Development (HUD). A person is considered homeless if his or her nighttime residence is in either (a) public or private emergency shelters (schools, church basements, governmental buildings, former firehouses) or where temporary vouchers are provided by private or public agencies (hotels, apartments, or boarding homes); or (b) streets, parks, subways, bus terminals, railroad stations, airports, abandoned buildings without utilities, cars, trucks, under bridges or aqueducts, or in any other public or private space that is not designed as shelter (HUD, 1984). HUD's definition excludes residents of halfway houses and long-term detoxification centers. However, it does include those individuals temporarily detained in a local jail who would normally be on the street or in emergency shelters. Also included as homeless are battered women housed in temporary shelters.National estimates of homelessness continue to fluctuate greatly. The 1990 Census found that approximately 400,000 Americans were homeless, while advocacy groups have put the figure between 700,000 and 3 million. More current data suggest that there may be as many as over a million actual homeless individuals at any given time in the continental United States--with as many as three million people experiencing homelessness at some time each year. According to recent estimates, some 13.5 million Americans have been homeless for at least a few days sometime during their lives; and an additional 12.5 million have stayed off the street only by moving in with friends at some point in their lives, for periods that ranged from a few days to a year (Link, 1994). These data minimize current beliefs that homelessness is an aberration affecting Americans who have distinct personal histories or who are situated on the fringes of society.HOMELESSNESS IN DETROITThe Detroit area, with a population of approximately 2.2 million residents, represents approximately 25% of Michigan's 9.1 million residents. The Detroit area ranks sixth in population size among major urban areas in the United States. Generally, the rate of homelessness is higher in larger cities than in smaller cities (Hopper & Hamberg, 1990). However, until recently there has been very little formal data on Detroit's homeless population.Unlike other cities in the U. S. where many of the homeless sleep on streets or in parks, the homeless of Detroit most often sleep in abandoned buildings. It has been estimated that over 27,000 people are homeless each year in the Detroit metropolitan area alone, with an average of 500 in need of shelter daily (Mobray, Solarz, Johnson, Phillips & Combs, 1986; Solarz, 1988). In 1989, there were over 1,500 emergency shelter beds in the city of Detroit. …

The formation of the ultimate carcinogen of benzo( a)pyrene during non-enzymic lipid peroxidation

Fifty-eight fungi from different physio-ecological groups were compared for their capacity to oxidize five polycyclic aromatic hydrocarbons (PAH) with three to five benzene rings (R), and produce the appertaining extracellular oxidoreductases in liquid culture. In 14 d, wood- and straw-associated basidiomycetes converted 19–90% of the original PAH compounds. The groups of wood- and straw-degrading, wood-degrading, terricolous, ectomycorrhizal, and mitosporic fungi converted PAH at a proportion of 100:75:34:19:18. All fungi preferred fluoranthene and pyrene (4R). Anthracene (3R) was preferred by wood-associated fungi. Phenanthrene (3R) and perylene (5R) were sufficiently converted by wood-associated and terricolous, but poorly by ectomycorrhizal and mitosporic fungi. Nevertheless, fungi that converted the entire set of PAH satisfactorily were found in all five groups. PAH conversion was correlated with the production of manganese peroxidase (r = 0.98), peroxidase (r = 0.89), and laccase (r = 0.85), but not with monophenol monooxygenase (r = 0.07). Mn(III) ions oxidized all PAH with preference to anthracene. Hydrogen peroxide converted PAH possibly by the products of Fenton's reaction. Limiting factors were shortages in peroxidases and H2O2. Gymnopilus sapineus and Agrocybe praecox converted top quantities of PAH in the absence of peroxidases, manganese peroxidases, and lignin peroxidases. The relative contributions of intra- and extracellular enzymes to the conversion of PAH and the possible role of the fungi in the long-term detoxification of soil xenobiotics are discussed.

An analysis of federal narcotic detoxification policy: implications for rehabilitation.

The current federal narcotic detoxification policy, limiting such treatment to 21 d, is analyzed with respect to its impact on the success rate for complete withdrawal. Data are drawn from an historical review of American Medical Association statements on narcotic addiction and a review of empirical data on short- and long-term detoxification. The 3-week limit is shown to interfere with achieving successful detoxification rates, although it continues to guide federal detoxification policy. Empirical evidence supports long-term detoxification that recognizes other factors as also having a therapeutic effect. It is time to revise the current federal policy to more accurately reflect the progress made in long-term care.