Neuroimaging of opiate-dependent individuals indicates both altered brain structure and function. Magnetic resonance-based arterial spin labeling has been used to measure noninvasively cerebral blood flow (i.e. perfusion) in alcohol, tobacco and stimulant dependence; only one arterial spin labeling paper in opiate-dependent individuals demonstrated frontal and parietal perfusion deficits. Additional research on regional brain perfusion in opiate dependence and its relationship to cognition and self-regulation (impulsivity, risk taking and decision making) may inform treatment approaches for opiate-dependent individuals. Continuous arterial spin labeling magnetic resonance imaging at 4 T and neuropsychological measures assessed absolute brain perfusion levels, cognition and self-regulation in 18 cigarette smoking opiate-dependent individuals (sODI) stable on buprenorphine maintenance therapy. The sODI were compared with 20 abstinent smoking alcohol-dependent individuals (a substance-dependent control group), 35 smoking controls and 29 nonsmoking controls. sODI had lower perfusion in several cortical and subcortical regions including regions within the brain reward/executive oversight system compared with smoking alcohol-dependent individuals and nonsmoking controls. Perfusion was increased in anterior cingulate cortex and globus pallidus of sODI. Compared with all other groups, sODI had greater age-related declines in perfusion in most brain reward/executive oversight system and some other regions. In sODI, lower regional perfusion related to greater substance use, higher impulsivity and weaker visuospatial skills. Overall, sODI showed cortical and subcortical hypoperfusion and hyperperfusion. Relating to neuropsychological performance and substance use quantities, the frontal perfusion alterations are clinically relevant and constitute potential targets for pharmacological and cognitive-based therapeutic interventions to improve treatment outcome in opiate dependence.
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http://dx.doi.org/10.1111/adb.12523 | DOI Listing |
Cureus
December 2024
Department of Medicine, Tower Health Medical Group, Reading, USA.
Objective: The recent development of xylazine adulteration of the illicit opiate supply has been associated with necrotic extremity wounds of unclear pathogenesis. This study sought to understand the prevalence and characteristics of delusional infestation (DI) among patients with opiate use disorders who also carried a diagnosis of cellulitis.
Methods: A retrospective cross-sectional study was performed in one health system to identify patients with opiate use disorder and cellulitis over the past three years who also described symptoms of DI.
J Addict Med
March 2024
From the Department of Psychiatry, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada (KAT, CGS); Department of Psychiatry and Psychotherapy, Universitätsklinikum Bonn, Bonn, Germany (CD); and British Columbia Mental Health and Substance Use Disorders, Provincial Health Services Authority, BC, Canada (CGS).
Objectives: More than 60 million people use opioids each year, and many countries have declared an opioid overdose crisis. Heroin, one of the most commonly used opioids, has depressant effects on autonomic functioning; however, few studies have been able to examine the effects of heroin or its pharmaceutically prepared equivalent, diamorphine, in human clinical populations. The present study examined heart rate and oxygen saturation in the minutes immediately after acute diamorphine administration in outpatients with heroin dependence.
View Article and Find Full Text PDFSociol Health Illn
March 2024
Department of Sociology and Social Anthropology, Dalhousie University, Halifax, Nova Scotia, Canada.
As opioid fatalities rise in North America, the need to improve the supports available to those who are dependent on opioids and pregnant has become more urgent. This paper discusses the social organisation of drug treatment supports for those who are pregnant, using Canadian clinical practice guidelines (CPGs) for methadone maintenance treatment (MMT) as a case study. Pregnant patients are a priority population for MMT, both in Canada and internationally; the regulatory bodies that oversee MMT in Canada are the provincial Colleges of Physician and Surgeons and Health Canada.
View Article and Find Full Text PDFTrials
October 2022
Division of Psychiatry, Department of Brain Sciences, Imperial College London, London, UK.
Background: Treatment of opiate addiction with opiate substitution treatment (e.g. methadone) is beneficial.
View Article and Find Full Text PDFFront Psychiatry
September 2022
Department of Psychiatry, Faculty of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Background: Opioid dependency is a chronic relapsing disorder for which different therapeutically interventions have been developed. Naltrexone is a non-selective opioid antagonist that can be utilized for maintenance therapy in opioid dependency. In this systematic review, we aimed to evaluate the effects of naltrexone on retention in treatment and being opioid-free.
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