1
|
Fitzgerald ND, Liu Y, Wang A, Striley CW, Setlow B, Knackstedt L, Cottler LB. Sequencing hour-level temporal patterns of polysubstance use among persons who use cocaine, alcohol, and cannabis: A back-translational approach. Drug Alcohol Depend 2024; 258:111272. [PMID: 38555662 DOI: 10.1016/j.drugalcdep.2024.111272] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/11/2023] [Revised: 03/07/2024] [Accepted: 03/19/2024] [Indexed: 04/02/2024]
Abstract
BACKGROUND Polysubstance use is highly prevalent among persons who use cocaine; however, little is known about how alcohol and cannabis are used with cocaine. We identified temporal patterns of cocaine+alcohol and cocaine+cannabis polysubstance use to inform more translationally relevant preclinical models. METHODS Participants who used cocaine plus alcohol and/or cannabis at least once in the past 30 days (n=148) were interviewed using the computerized Substance Abuse Module and the newer Polysubstance Use-Temporal Patterns Section. For each day in the past 30 days, participants reported whether they had used cocaine, alcohol, and cannabis; if any combinations of use were endorsed, participants described detailed hourly use of each substance on the most "typical day" for the combination. Sequence analysis and hierarchical clustering were applied to identify patterns of timing of drug intake on typical days of cocaine polysubstance use. RESULTS We identified five temporal patterns among the 180 sequences of reported cocaine polysubstance use: 1) limited cocaine/cocaine+alcohol use (53%); 2) extensive cannabis then cocaine+alcohol+cannabis use (22%); 3) limited alcohol/cannabis then cocaine+alcohol use (13%); 4) extensive cocaine+cannabis then cocaine+alcohol+cannabis use (4%); and 5) extensive cocaine then cocaine+alcohol use (8%). While drug intake patterns differed, prevalence of use disorders did not. CONCLUSIONS Patterns were characterized by cocaine, alcohol, and cannabis polysubstance use and by the timing, order, duration, and quantity of episode-level substance use. The identification of real-world patterns of cocaine polysubstance use represents an important step toward developing laboratory models that accurately reflect human behavior.
Collapse
Affiliation(s)
- Nicole D Fitzgerald
- Department of Epidemiology, Colleges of Medicine and Public Health & Health Professions, University of Florida, Gainesville, FL, USA; Center for Addiction Research and Education, University of Florida, Gainesville, FL, USA.
| | - Yiyang Liu
- Department of Epidemiology, Colleges of Medicine and Public Health & Health Professions, University of Florida, Gainesville, FL, USA; Center for Addiction Research and Education, University of Florida, Gainesville, FL, USA
| | - Anna Wang
- Department of Epidemiology, Colleges of Medicine and Public Health & Health Professions, University of Florida, Gainesville, FL, USA; Center for Addiction Research and Education, University of Florida, Gainesville, FL, USA
| | - Catherine W Striley
- Department of Epidemiology, Colleges of Medicine and Public Health & Health Professions, University of Florida, Gainesville, FL, USA; Center for Addiction Research and Education, University of Florida, Gainesville, FL, USA
| | - Barry Setlow
- Center for Addiction Research and Education, University of Florida, Gainesville, FL, USA; Department of Psychiatry, College of Medicine, University of Florida, Gainesville, FL, USA
| | - Lori Knackstedt
- Center for Addiction Research and Education, University of Florida, Gainesville, FL, USA; Department of Psychology, College of Liberal Arts and Sciences, University of Florida, Gainesville, FL, USA
| | - Linda B Cottler
- Department of Epidemiology, Colleges of Medicine and Public Health & Health Professions, University of Florida, Gainesville, FL, USA; Center for Addiction Research and Education, University of Florida, Gainesville, FL, USA
| |
Collapse
|
2
|
van Amsterdam J, Gresnigt F, van den Brink W. Cardiovascular Risks of Simultaneous Use of Alcohol and Cocaine-A Systematic Review. J Clin Med 2024; 13:1475. [PMID: 38592322 PMCID: PMC10935323 DOI: 10.3390/jcm13051475] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2024] [Revised: 02/19/2024] [Accepted: 03/02/2024] [Indexed: 04/10/2024] Open
Abstract
Background: The simultaneous use of cocaine and alcohol is highly prevalent and is associated with high numbers of emergency department admissions, primarily due to cardiovascular complications. Aims: To answer the question of whether the co-use of cocaine and alcohol increases the cardiovascular risk compared to the use of cocaine alone. Method: A systematic review of human studies comparing the cardiovascular risk of co-used cocaine and alcohol with the use of cocaine alone. Results: Despite a higher myocardial workload induced by the co-use of cocaine and alcohol and the potentiation of cocaine's cardiovascular effects by alcohol, the findings on the risk and severity of cardiovascular symptoms due to combined use are inconsistent. However, the co-use of cocaine and alcohol clearly leads to higher mortality. Interestingly, the presence of cocaethylene, a unique metabolite generated only via a pharmacokinetic interaction between alcohol and cocaine, carries an 18- to 25-fold increase over the absence of cocaethylene (cocaine-alone users) in the risk of sudden death and is associated with myocardial injury and cardiac arrest, probably due to the inhibition of cardiac ion channels by cocaethylene. Conclusion: Despite the inconsistency in some of the results, it is concluded that the co-use of cocaine and alcohol poses an additional risk of cardiovascular fatalities compared to the use of cocaine alone.
Collapse
Affiliation(s)
- Jan van Amsterdam
- Department of Psychiatry, Amsterdam UMC, University of Amsterdam, Meibergdreef 9, 1012 WP Amsterdam, The Netherlands;
- Amsterdam Neuroscience, Research Program Compulsivity, Impulsivity & Attention, P.O. Box 22660, 1100 DD Amsterdam, The Netherlands
| | - Femke Gresnigt
- Emergency Department, OLVG Hospital, Oosterpark 9, 1091 AC Amsterdam, The Netherlands;
- Dutch Poison Information Center, UMC Utrecht, University Utrecht, 3508 GA Utrecht, The Netherlands
| | - Wim van den Brink
- Department of Psychiatry, Amsterdam UMC, University of Amsterdam, Meibergdreef 9, 1012 WP Amsterdam, The Netherlands;
- Amsterdam Neuroscience, Research Program Compulsivity, Impulsivity & Attention, P.O. Box 22660, 1100 DD Amsterdam, The Netherlands
| |
Collapse
|
3
|
Psarianos A, Chryssanthopoulos C, Theocharis A, Paparrigopoulos T, Philippou A. Effects of a Two-Month Exercise Training Program on Concurrent Non-Opiate Substance Use in Opioid-Dependent Patients during Substitution Treatment. J Clin Med 2024; 13:941. [PMID: 38398255 PMCID: PMC10888880 DOI: 10.3390/jcm13040941] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2023] [Revised: 01/14/2024] [Accepted: 01/25/2024] [Indexed: 02/25/2024] Open
Abstract
BACKGROUND This randomized controlled trial aimed to evaluate the effects of a two-month exercise intervention on the concurrent non-opiate substance use (alcohol, cocaine, cannabis, and benzodiazepines) in opioid users during their medication treatment. METHODS Ninety opioid users (41 females) in methadone and buprenorphine medication treatment were randomly divided into four groups: (a) buprenorphine experimental (BEX; n = 26, aged 41.9 ± 6.1 yrs); (b) buprenorphine control (BCON; n = 25, aged 41.9 ± 5.6 yrs); (c) methadone experimental (MEX; n = 20, aged 46.7 ± 6.6 yrs); and (d) methadone control (MCON; n = 19, aged 46.1 ± 7.5 yrs). The experimental groups (BEX and MEX) followed an aerobic exercise training program on a treadmill for 20 min at 70% HRmax, 3 days/week for 8 weeks. Socio-demographic, anthropometric, and clinical characteristics, as well as non-opioid drug use in days and quantity per week, were assessed before and after the intervention period. RESULTS Following the exercise training, the weekly non-opioid substance consumption (days) decreased (p < 0.05) in both exercise groups and was lower in BEX compared to MEX, while no differences were observed (p > 0.05) between the control groups (BCON vs. MCON) or compared to their baseline levels. Similarly, the daily amount of non-opiate substance intake was reduced (p < 0.05) post-training in BEX and MEX, whereas it did not differ (p > 0.05) in BCON and MCON compared to the baseline. CONCLUSIONS The two-month exercise intervention reduced the non-opioid drug use in both the methadone and buprenorphine substitution groups compared to the controls, suggesting that aerobic exercise training may be an effective strategy for treating patients with OUDs.
Collapse
Affiliation(s)
- Alexandros Psarianos
- 1st Department of Psychiatry, Medical School, National and Kapodistrian University of Athens, 11528 Athens, Greece; (A.P.); (T.P.)
- Greek Organization Against Drugs (OΚAΝA), 10433 Athens, Greece;
| | - Costas Chryssanthopoulos
- Department of Physiology, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece;
| | | | - Thomas Paparrigopoulos
- 1st Department of Psychiatry, Medical School, National and Kapodistrian University of Athens, 11528 Athens, Greece; (A.P.); (T.P.)
| | - Anastassios Philippou
- Department of Physiology, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece;
| |
Collapse
|
4
|
Gonzalez-Suarez AD, Thorn CF, Whirl-Carrillo M, Klein TE. PharmGKB summary: disulfiram pathway. Pharmacogenet Genomics 2023; 33:207-216. [PMID: 37728645 PMCID: PMC10627108 DOI: 10.1097/fpc.0000000000000509] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/21/2023]
Affiliation(s)
| | | | | | - Teri E. Klein
- Department of Biomedical Data Science, Stanford, CA 94305
- Department of Medicine, Stanford University School of Medicine, Stanford, CA 94305
| |
Collapse
|
5
|
Clauss NJ, Mayer FP, Owens WA, Vitela M, Clarke KM, Bowman MA, Horton RE, Gründemann D, Schmid D, Holy M, Gould GG, Koek W, Sitte HH, Daws LC. Ethanol inhibits dopamine uptake via organic cation transporter 3: Implications for ethanol and cocaine co-abuse. Mol Psychiatry 2023; 28:2934-2945. [PMID: 37308680 PMCID: PMC10615754 DOI: 10.1038/s41380-023-02064-5] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/05/2022] [Revised: 12/20/2022] [Accepted: 03/29/2023] [Indexed: 06/14/2023]
Abstract
Concurrent cocaine and alcohol use is among the most frequent drug combination, and among the most dangerous in terms of deleterious outcomes. Cocaine increases extracellular monoamines by blocking dopamine (DA), norepinephrine (NE) and serotonin (5-HT) transporters (DAT, NET and SERT, respectively). Likewise, ethanol also increases extracellular monoamines, however evidence suggests that ethanol does so independently of DAT, NET and SERT. Organic cation transporter 3 (OCT3) is an emergent key player in the regulation of monoamine signaling. Using a battery of in vitro, in vivo electrochemical, and behavioral approaches, as well as wild-type and constitutive OCT3 knockout mice, we show that ethanol's actions to inhibit monoamine uptake are dependent on OCT3. These findings provide a novel mechanistic basis whereby ethanol enhances the neurochemical and behavioral effects of cocaine and encourage further research into OCT3 as a target for therapeutic intervention in the treatment of ethanol and ethanol/cocaine use disorders.
Collapse
Affiliation(s)
- N J Clauss
- Department of Cellular and Integrative Physiology, University of Texas Health Science Center at San Antonio, San Antonio, TX, 78229, USA
| | - F P Mayer
- Center for Physiology and Pharmacology, Medical University of Vienna, 1090, Vienna, Austria
- Department of Neuroscience, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, DK-2200, Denmark
| | - W A Owens
- Department of Cellular and Integrative Physiology, University of Texas Health Science Center at San Antonio, San Antonio, TX, 78229, USA
| | - M Vitela
- Department of Cellular and Integrative Physiology, University of Texas Health Science Center at San Antonio, San Antonio, TX, 78229, USA
| | - K M Clarke
- Department of Cellular and Integrative Physiology, University of Texas Health Science Center at San Antonio, San Antonio, TX, 78229, USA
| | - M A Bowman
- Department of Cellular and Integrative Physiology, University of Texas Health Science Center at San Antonio, San Antonio, TX, 78229, USA
| | - R E Horton
- Department of Cellular and Integrative Physiology, University of Texas Health Science Center at San Antonio, San Antonio, TX, 78229, USA
| | - D Gründemann
- Department of Pharmacology, Faculty of Medicine and University Hospital Cologne, University of Cologne, 50931, Cologne, Germany
| | - D Schmid
- Center for Physiology and Pharmacology, Medical University of Vienna, 1090, Vienna, Austria
| | - M Holy
- Center for Physiology and Pharmacology, Medical University of Vienna, 1090, Vienna, Austria
| | - G G Gould
- Department of Cellular and Integrative Physiology, University of Texas Health Science Center at San Antonio, San Antonio, TX, 78229, USA
| | - W Koek
- Department of Cell Systems and Anatomy, University of Texas Health Science Center at San Antonio, San Antonio, TX, 78229, USA
| | - H H Sitte
- Center for Physiology and Pharmacology, Medical University of Vienna, 1090, Vienna, Austria
- Center for Addiction Research and Science, Medical University Vienna, Waehringerstrasse 13 A, 1090, Vienna, Austria
| | - L C Daws
- Department of Cellular and Integrative Physiology, University of Texas Health Science Center at San Antonio, San Antonio, TX, 78229, USA.
- Department of Pharmacology, University of Texas Health Science Center at San Antonio, San Antonio, TX, 78229, USA.
| |
Collapse
|
6
|
Abreu LCC, Conceição SDS, de Carvalho DSB, Machado AC, Lyrio AO, Souza ES, Souza CS, de Matos PJDS, Batista JET, Gomes JDA, Hintz AM, Pereira PPDS, da Cruz SS, Gomes-Filho IS, Figueiredo ACMG. Factors Associated with Cocaine Consumption among Suicide Victim. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:14309. [PMID: 36361188 PMCID: PMC9654489 DOI: 10.3390/ijerph192114309] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/27/2022] [Revised: 10/14/2022] [Accepted: 10/21/2022] [Indexed: 06/16/2023]
Abstract
Cocaine use is an increasingly frequent event, especially in young people, and can cause irreversible consequences, such as suicide. To evaluate the factors associated with cocaine use in the moments preceding to suicide. This is a population-based, cross-sectional, and analytical study conducted in the Brazilian Federal District by researchers from the Department of Health and the Civil Police Institute of Criminalistics. All people who died due to suicide in 2018 were included in the survey. Cocaine use was considered the dependent variable, and robust Poisson regression was performed to estimate the crude and adjusted prevalence ratios and their respective population confidence intervals. In 2018, 12,157 deaths were recorded, of which suicide accounted for 1.56% of all deaths. It was observed that being between 25 and 44 years old, male, and under the influence of alcohol or cannabis, had a strong positive association with cocaine consumption among suicide victims. Males, people with black skin, with lower level of education, with employment, and who were under the effect of the use of cannabis and/or alcohol in the previous hours of death had a higher propensity to consume cocaine immediately before suicide, with a moderate to strong magnitude of prevalence ratio. The findings of this research indicated the need for monitoring, by health services, of people most vulnerable to suicide through the consumption of psychoactive substances.
Collapse
Affiliation(s)
| | | | | | - Ana Cristina Machado
- Department of Public Health of the Federal District, Brasília 70390-125, Federal District, Brazil
| | - Amanda Oliveira Lyrio
- Department of Health of University of Brasilia, Brasília 70910-900, Federal District, Brazil
| | - Elivan Silva Souza
- Department of Health of University of Brasilia, Brasília 70910-900, Federal District, Brazil
| | - Cauê Silva Souza
- Health Sciences Teaching and Research Foundation’s, Brasília 70710-907, Federal District, Brazil
| | | | | | | | - Alexandre Marcelo Hintz
- Department of Health, Feira de Santana State University, Feira de Santana 44036-900, Bahia, Brazil
| | | | - Simone Seixas da Cruz
- Department of Epidemiology, Federal University of Recôncavo of Bahia, Santo Antônio de Jesus 44430-622, Bahia, Brazil
| | - Isaac Suzart Gomes-Filho
- Department of Health, Feira de Santana State University, Feira de Santana 44036-900, Bahia, Brazil
| | | |
Collapse
|
7
|
Fitzgerald ND, Liu Y, Wang A, Striley CW, Setlow B, Knackstedt L, Cottler LB. Test-retest reliability of a new assessment to detect detailed temporal patterns of polysubstance use. Int J Methods Psychiatr Res 2022; 31:e1912. [PMID: 35684977 PMCID: PMC9464326 DOI: 10.1002/mpr.1912] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/02/2021] [Revised: 03/11/2022] [Accepted: 03/29/2022] [Indexed: 11/14/2022] Open
Abstract
OBJECTIVE While polysubstance use is highly prevalent among people who use drugs, the field lacks a reliable assessment that can detect detailed temporal patterns of polysubstance use. This study assessed the test-retest reliability of the newly developed Polysubstance Use-Temporal Patterns Section (PSU-TPS). METHODS Participants who used cocaine plus alcohol and/or marijuana at least once in the past 30 days (n = 48) were interviewed at baseline and approximately 7 days later (retest) using the Substance Abuse Module and the PSU-TPS. Reliability of PSU-TPS measures of quantity, frequency, and duration of polysubstance use was examined using intra-class correlation coefficients (ICCs) and kappa tests. RESULTS Excellent reliability was observed for frequencies of concurrent polysubstance use patterns in the past 30 days (ICC range: 0.90-0.94) and quantity of alcohol use (ICC = 0.83), and fair to good reliability was observed for duration of substance use (ICC range: 0.52-0.73). CONCLUSION Detailed information regarding cocaine, alcohol, and marijuana polysubstance use in the past 30 days can be reliably measured with the PSU-TPS. Data on the order and timing of polysubstance use at the hourly level will improve our understanding of the implications of sequential and simultaneous use patterns, which can help inform treatment and prevention efforts.
Collapse
Affiliation(s)
- Nicole D Fitzgerald
- Department of Epidemiology, Colleges of Medicine and Public Health & Health Professions, University of Florida, Gainesville, Florida, USA
| | - Yiyang Liu
- Department of Epidemiology, Colleges of Medicine and Public Health & Health Professions, University of Florida, Gainesville, Florida, USA
| | - Anna Wang
- Department of Epidemiology, Colleges of Medicine and Public Health & Health Professions, University of Florida, Gainesville, Florida, USA
| | - Catherine W Striley
- Department of Epidemiology, Colleges of Medicine and Public Health & Health Professions, University of Florida, Gainesville, Florida, USA
| | - Barry Setlow
- Department of Psychiatry, College of Medicine, University of Florida, Gainesville, Florida, USA
| | - Lori Knackstedt
- Department of Psychology, College of Liberal Arts and Sciences, University of Florida, Gainesville, Florida, USA
| | - Linda B Cottler
- Department of Epidemiology, Colleges of Medicine and Public Health & Health Professions, University of Florida, Gainesville, Florida, USA
| |
Collapse
|
8
|
Patterns of Prescription Medicine, Illicit Drugs, and Alcohol Misuse among High-Risk Population: A Factor Analysis to Delineate Profiles of Polydrug Users. Healthcare (Basel) 2022; 10:healthcare10040710. [PMID: 35455887 PMCID: PMC9031601 DOI: 10.3390/healthcare10040710] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2022] [Revised: 04/07/2022] [Accepted: 04/07/2022] [Indexed: 01/29/2023] Open
Abstract
Polydrug use is a serious health and social problem worldwide. Treatment remains a challenge because it requires planning based on estimates of the nature and extent of drug consumption and the characteristics of the population in need. To this end, 103 subjects, who voluntarily asked to begin rehabilitation treatment, were monitored through hair analysis to investigate the nature and extent of their polydrug use. A factor analysis was carried out to delineate polydrug user profiles based on the following variables: age, sex, type of illicit drug use, type of prescription drug misuse, and amount of alcohol consumption. Twenty-three percent of subjects tested positive to more than one illicit drug (mainly cocaine), 44% to unprescribed drugs (mainly benzodiazepines), and 66% were hard drinkers. The profiles of drug users outlined included “single drug cocaine user”, and “single drug opiate user”. Moreover, a particularly problematic profile of cocaine users, common between genders and age groups, who combine high levels of alcohol and unprescribed benzodiazepines and opiates, emerged (“hard polydrug abusers”). From a treatment policy perspective, these findings support the importance of preventive analysis before rehabilitation treatment begins in order to identify different patterns of drug abusers to implement personalized multidisciplinary measures.
Collapse
|
9
|
Tamargo JA, Sherman KE, Sékaly RP, Bordi R, Schlatzer D, Lai S, Khalsa JH, Mandler RN, Ehman RL, Baum MK. Cocaethylene, simultaneous alcohol and cocaine use, and liver fibrosis in people living with and without HIV. Drug Alcohol Depend 2022; 232:109273. [PMID: 35033954 PMCID: PMC8885871 DOI: 10.1016/j.drugalcdep.2022.109273] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/21/2021] [Revised: 11/29/2021] [Accepted: 12/18/2021] [Indexed: 11/03/2022]
Abstract
BACKGROUND The simultaneous consumption of cocaine and alcohol results in the production of cocaethylene (CE) in the liver, a highly toxic metabolite. Prior research suggests that cocaine use contributes to liver disease and its concomitant use with alcohol may increase its hepatotoxicity, but studies in humans are lacking. We evaluated the role of cocaine, its simultaneous use with alcohol, and CE on liver fibrosis. METHODS We performed a cross-sectional analysis of the Miami Adult Studies on HIV (MASH) cohort. Cocaine use was determined via self-report, urine screen, and blood metabolites, using liquid chromatography with tandem mass spectrometry. Hazardous drinking was determined with the AUDIT-C and liver fibrosis with the Fibrosis-4 Index (FIB-4). RESULTS Out of 649 participants included in this analysis, 281 (43.3%) used cocaine; of those, 78 (27.8%) had CE in blood. Cocaine users with CE had higher concentrations of cocaine metabolites in blood and were more likely to drink hazardously than cocaine users without CE and cocaine non-users. Overall, cocaine use was associated with liver fibrosis. CE in blood was associated with 3.17 (95% CI: 1.61, 6.23; p = 0.0008) times the odds of liver fibrosis compared to cocaine non-users, adjusting for covariates including HIV and HCV infection. The effect of CE on liver fibrosis was significantly greater than that of cocaine or alcohol alone. CONCLUSIONS CE is a reliable marker of simultaneous use of cocaine and alcohol that may help identify individuals at risk of liver disease and aid in the prevention of its development or progression.
Collapse
Affiliation(s)
| | | | - Rafick-Pierre Sékaly
- Emory University, Atlanta, GA, USA; Case Western Reserve University, Cleveland, OH, USA.
| | - Rebeka Bordi
- Emory University, Atlanta, GA, USA; Case Western Reserve University, Cleveland, OH, USA.
| | | | | | - Jag H Khalsa
- George Washington University, Washington, DC, USA.
| | | | | | | |
Collapse
|
10
|
Pergolizzi J, Breve F, Magnusson P, LeQuang JAK, Varrassi G. Cocaethylene: When Cocaine and Alcohol Are Taken Together. Cureus 2022; 14:e22498. [PMID: 35345678 PMCID: PMC8956485 DOI: 10.7759/cureus.22498] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2021] [Accepted: 02/14/2022] [Indexed: 11/30/2022] Open
Abstract
Cocaine is taken frequently together with ethanol and this combination produces a psychoactive metabolite called cocaethylene which has similar properties to the parent drug and may be more cardiotoxic. Cocaethylene has a longer half-life than cocaine, so that people who combine cocaine and ethanol may experience a longer-lasting, as well as more intense, psychoactive effect. Cocaethylene is the only known instance where a new psychoactive substance is formed entirely within the body. Although known to science for decades, cocaethylene has not been extensively studied and even its metabolic pathways are not entirely elucidated. Like its parent drug, cocaethylene blocks the reuptake of dopamine and increases post-synaptic neuronal activity; the parent drug may also block reuptake of serotonin as well. Cocaethylene has been studied in animal models in terms of its pharmacology and its potential neurological effects. Since the combination of cocaine and alcohol is commonly used, it is important for clinicians to be aware of cocaethylene, its role in prolonging or intensifying cocaine intoxication, and how it may exacerbate cocaine-induced cardiovascular disorders. Most cardiac-related risk assessment tools do not ask about cocaine use, which can prevent clinicians from making optimal therapeutic choices. Greater awareness of cocaethylene is needed for clinicians, and those who use cocaine should also be aware of the potential for polysubstance use of cocaine and ethanol to produce a potentially potent and long-lasting psychoactive metabolite.
Collapse
|
11
|
Suen LW, Davy-Mendez T, LeSaint KT, Riley ED, Coffin PO. Emergency department visits and trends related to cocaine, psychostimulants, and opioids in the United States, 2008-2018. BMC Emerg Med 2022; 22:19. [PMID: 35120449 PMCID: PMC8814795 DOI: 10.1186/s12873-022-00573-0] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2021] [Accepted: 01/18/2022] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Drug-related emergency department (ED) visits are escalating, especially for stimulant use (i.e., cocaine and psychostimulants such as methamphetamine). We sought to characterize rates, presentation, and management of ED visits related to cocaine and psychostimulant use, compared to opioid use, in the United States (US). METHODS We used 2008-2018 National Hospital Ambulatory Medical Care Survey data to identify a nationally representative sample of ED visits related to cocaine and psychostimulant use, with opioids as the comparator. To make visits mutually exclusive for analysis, we excluded visits related to 2 or more of the three possible drug categories. We estimated annual rate trends using unadjusted Poisson regression; described demographics, presenting concerns, and management; and determined associations between drug-type and presenting concerns (categorized as psychiatric, neurologic, cardiopulmonary, and drug toxicity/withdrawal) using logistic regression, adjusting for age, sex, race/ethnicity, and homelessness. RESULTS Cocaine-related ED visits did not significantly increase, while psychostimulant-related ED visits increased from 2008 to 2018 (2.2 visits per 10,000 population to 12.9 visits per 10,000 population; p < 0.001). Cocaine-related ED visits had higher usage of cardiac testing, while psychostimulant-related ED visits had higher usage of chemical restraints than opioid-related ED visits. Cocaine- and psychostimulant-related ED visits had greater odds of presenting with cardiopulmonary concerns (cocaine adjusted odds ratio [aOR] 2.95, 95% CI 1.70-5.13; psychostimulant aOR 2.46, 95% CI 1.42-4.26), while psychostimulant-related visits had greater odds of presenting with psychiatric concerns (aOR 2.69, 95% CI 1.83-3.95) and lower odds of presenting with drug toxicity/withdrawal concerns (aOR 0.47, 95%CI 0.30-0.73) compared to opioid-related ED visits. CONCLUSION Presentations for stimulant-related ED visits differ from opioid-related ED visits: compared to opioids, ED presentations related to cocaine and psychostimulants are less often identified as related to drug toxicity/withdrawal and more often require interventions to address acute cardiopulmonary and psychiatric complications.
Collapse
Affiliation(s)
- Leslie W. Suen
- National Clinician Scholars Program, Philip R. Lee Institute for Health Policy Studies, University of California San Francisco, 290 Illinois Street, Suite 7227, Box 0936, San Francisco, CA 94158 USA
- San Francisco Veterans Affairs Medical Center, San Francisco, CA USA
| | - Thibaut Davy-Mendez
- Division of Infectious Diseases, Department of Medicine, University of North Carolina, Chapel Hill, NC USA
| | - Kathy T. LeSaint
- Department of Emergency Medicine, University of California, San Francisco, San Francisco, CA USA
| | - Elise D. Riley
- Department of Medicine, Division of HIV, Infectious Diseases and Global Medicine, School of Medicine, University of California, San Francisco, San Francisco, CA USA
| | - Phillip O. Coffin
- Department of Medicine, Division of HIV, Infectious Diseases and Global Medicine, School of Medicine, University of California, San Francisco, San Francisco, CA USA
- Department of Public Health, San Francisco, CA USA
| |
Collapse
|
12
|
Trauma and Emotion Regulation: Associations with Depressive Symptoms and Cocaine Use among Treatment-seeking Adults. Int J Ment Health Addict 2022. [DOI: 10.1007/s11469-021-00713-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
|
13
|
Colvin KJ, Killen HS, Kanter MJ, Halperin MC, Engel L, Dickinson MB, Fimmel AI, Holland JG, Currie PJ. Differential effects of intra-ventral tegmental area ghrelin and glucagon-like peptide-1 on the stimulatory action of D-amphetamine and cocaine-induced ethanol intake in male Sprague Dawley rats. Behav Brain Res 2021; 421:113726. [PMID: 34954300 DOI: 10.1016/j.bbr.2021.113726] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2021] [Revised: 12/15/2021] [Accepted: 12/17/2021] [Indexed: 12/24/2022]
Abstract
In order to further elucidate the role of mesolimbic peptides in the expression of ethanol reward, the present study investigated the effects of ghrelin and glucagon-like peptide-1 (GLP-1) on ethanol intake, in addition to ethanol intake stimulated by systemic d-amphetamine or cocaine treatment. While a number of studies suggest that ghrelin plays an important role in mesolimbic reward, emerging data now indicate that GLP-1 receptor mechanisms inhibit reward signaling, possibly by directly or indirectly inhibiting ghrelinergic activity within the mesolimbic system. In the present study all rats were initially habituated to a 6% ethanol solution. We then demonstrated that intraperitoneal injections of d-amphetamine and cocaine increased ethanol intake compared to the vehicle condition. In subsequent testing we examined the effects of ventral tegmental area (VTA) ghrelin or vehicle paired with a fixed dose of d-amphetamine or vehicle. In separate rats we then investigated the impact of the GLP-1 agonist exendin-4 (Ex-4), injected into the VTA, on ethanol intake alone, or when Ex-4 was co-administered with d-amphetamine or cocaine. Our results indicated that VTA ghrelin significantly increased ethanol intake, and most importantly, potentiated the effect of d-amphetamine and cocaine on ethanol consumption. Conversely, VTA Ex-4 inhibited ethanol intake and antagonized the stimulatory effect of d-amphetamine and cocaine on ethanol consumption. In a final study we further demonstrated that VTA Ex-4 treatment significantly inhibited the combined stimulatory effects of ghrelin paired with d-amphetamine or ghrelin paired with cocaine. Overall our findings are consistent with a critical role for both ghrelin and GLP-1 receptor mechanisms in mesolimbic ethanol reward circuitry. Moreover, our results further suggest that ghrelin and GLP-1 modulate the stimulatory effect of psychostimulants on ethanol intake.
Collapse
Affiliation(s)
- Kayla J Colvin
- Department of Psychology, Reed College, 3203 SE Woodstock Blvd., Portland, OR 97202, USA
| | - Henry S Killen
- Department of Psychology, Reed College, 3203 SE Woodstock Blvd., Portland, OR 97202, USA
| | - Maxwell J Kanter
- Department of Psychology, Reed College, 3203 SE Woodstock Blvd., Portland, OR 97202, USA
| | - Maximilian C Halperin
- Department of Psychology, Reed College, 3203 SE Woodstock Blvd., Portland, OR 97202, USA
| | - Liv Engel
- Department of Psychology, Reed College, 3203 SE Woodstock Blvd., Portland, OR 97202, USA
| | - Matthew B Dickinson
- Department of Psychology, Reed College, 3203 SE Woodstock Blvd., Portland, OR 97202, USA
| | - Anna I Fimmel
- Department of Psychology, Reed College, 3203 SE Woodstock Blvd., Portland, OR 97202, USA
| | - James G Holland
- Department of Psychology, Reed College, 3203 SE Woodstock Blvd., Portland, OR 97202, USA
| | - Paul J Currie
- Department of Psychology, Reed College, 3203 SE Woodstock Blvd., Portland, OR 97202, USA.
| |
Collapse
|
14
|
Nelson KH, Manke HN, Bailey JM, Vlachos A, Maradiaga KJ, Huang S, Weiss TD, Rice KC, Riley AL. Ethanol pre-exposure differentially impacts the rewarding and aversive effects of α-pyrrolidinopentiophenone (α-PVP): Implications for drug use and abuse. Pharmacol Biochem Behav 2021; 211:173286. [PMID: 34634300 DOI: 10.1016/j.pbb.2021.173286] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/10/2021] [Revised: 09/17/2021] [Accepted: 10/03/2021] [Indexed: 11/15/2022]
Abstract
RATIONALE Exposure to a drug can subsequently impact its own reactivity as well as that of other drugs. Given that users of synthetic cathinones, i.e., "bath salts", typically have extensive and varied drug histories, an understanding of the effects of drug history on the behavioral and physiological consequences of synthetic cathiones may be important to their abuse liability. OBJECTIVES The goal of the current work was to assess the effects of an ethanol pre-exposure on the rewarding and aversive effects of α-PVP. METHODS Adult male Sprague Dawley rats were exposed to ethanol prior to combined conditioned taste avoidance/conditioned place preference training in which rats were injected with 1.5, 3 or 5 mg/kg of racemic α-PVP or vehicle. Following a 7-day washout period, rats were then tested for thermoregulatory effects of α-PVP using subcutaneous probes to measure body temperature changes over the course of 8 h. This was followed 10 days later by assessments for α-PVP-induced locomotor activity and stereotypies over a 1-h session. RESULTS α-PVP induced significant dose- and trial-dependent taste avoidance that was significantly attenuated by ethanol history and dose- and time-dependent increases in locomotor activity that were significantly increased by ethanol. α-PVP also induced place preferences and dose- and time-dependent increases in body temperature, but these measures were unaffected by ethanol history. CONCLUSIONS α-PVP's aversive effects (as measured by taste avoidance) were attenuated, while its rewarding effects (as indexed by place preference conditioning) were unaffected, by ethanol pre-exposure. Such a pattern may indicate increased α-PVP abuse liability, as changes in the balance of aversion and reward may impact overall drug effects and likelihood of drug intake. Future self-administration studies will be necessary to explore this possibility.
Collapse
Affiliation(s)
- Katharine H Nelson
- Psychopharmacology Laboratory, Department of Neuroscience, Center for Neuroscience and Behavior, American University, 4400 Massachusetts Ave, NW, Washington, D. C. 20016, USA.
| | - Hayley N Manke
- Psychopharmacology Laboratory, Department of Neuroscience, Center for Neuroscience and Behavior, American University, 4400 Massachusetts Ave, NW, Washington, D. C. 20016, USA
| | - Jacob M Bailey
- Psychopharmacology Laboratory, Department of Neuroscience, Center for Neuroscience and Behavior, American University, 4400 Massachusetts Ave, NW, Washington, D. C. 20016, USA
| | - Anna Vlachos
- Psychopharmacology Laboratory, Department of Neuroscience, Center for Neuroscience and Behavior, American University, 4400 Massachusetts Ave, NW, Washington, D. C. 20016, USA
| | - Karina J Maradiaga
- Psychopharmacology Laboratory, Department of Neuroscience, Center for Neuroscience and Behavior, American University, 4400 Massachusetts Ave, NW, Washington, D. C. 20016, USA
| | - Shihui Huang
- Psychopharmacology Laboratory, Department of Neuroscience, Center for Neuroscience and Behavior, American University, 4400 Massachusetts Ave, NW, Washington, D. C. 20016, USA
| | - Tania D Weiss
- Psychopharmacology Laboratory, Department of Neuroscience, Center for Neuroscience and Behavior, American University, 4400 Massachusetts Ave, NW, Washington, D. C. 20016, USA
| | - Kenner C Rice
- Drug Design and Synthesis Section, National Institute on Drug Abuse (NIDA), National Institute on Alcohol Abuse and Alcoholism (NIAAA), Bethesda, MD 20892, USA
| | - Anthony L Riley
- Psychopharmacology Laboratory, Department of Neuroscience, Center for Neuroscience and Behavior, American University, 4400 Massachusetts Ave, NW, Washington, D. C. 20016, USA.
| |
Collapse
|
15
|
Affiliation(s)
- Renee D Goodwin
- Department of Epidemiology and Biostatistics, Graduate School of Public Health and Health Policy, The City University of New York, New York, NY, USA
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, USA
| | - Melody Wu
- Department of Epidemiology and Biostatistics, Graduate School of Public Health and Health Policy, The City University of New York, New York, NY, USA
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, USA
| | - Larry Davidson
- Department of Psychiatry, School of Medicine at Yale University, New Haven, CT, USA
| |
Collapse
|
16
|
Kong Q, Wu X, Xu M. A Genetically Modified Skin Graft for Treating Alcohol Use Disorder and/or Polysubstance Abuse With Cocaine. ADVANCES IN DRUG AND ALCOHOL RESEARCH 2021; 1:10007. [PMID: 38390403 PMCID: PMC10880775 DOI: 10.3389/adar.2021.10007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/04/2021] [Accepted: 05/21/2021] [Indexed: 02/24/2024]
Abstract
Alcohol use disorder (AUD) is one of the foremost public health problems. Alcohol is also frequently co-abused with cocaine. There is a huge unmet need for the treatment of AUD and/or cocaine co-abuse. We have developed and used a skin stem cell-based gene delivery platform and found that production of the glucagon-like peptide-1 (GLP1) from the grafted genetically modified skin reduced development and reinstatement of alcohol-induced drug-taking and seeking, voluntary oral alcohol consumption and alcohol-induced increase in dopamine (DA) levels in the nucleus accumbens (NAc). Moreover, we have developed a novel co-grafting procedure for both modified human butyrylcholinesterase (hBChE)- and GLP1-expressing cells. Skin grafts-derived hBChE and GLP1 reduced acquisition of drug-taking and toxicity induced by concurrent alcohol and cocaine injections. These results imply that gene delivery through skin transplants may add a new option to treat drug abuse and co-abuse.
Collapse
Affiliation(s)
- Qingyao Kong
- Department of Anesthesia and Critical Care, The University of Chicago, Chicago, IL, United States
| | - Xiaoyang Wu
- Ben May Department for Cancer Research, The University of Chicago, Chicago, IL, United States
| | - Ming Xu
- Department of Anesthesia and Critical Care, The University of Chicago, Chicago, IL, United States
| |
Collapse
|
17
|
Anjos TGD, Carvalho DSBD, Machado AC, Carvalho MDSLD, Lyrio AO, Souza ES, Gomes JDA, Hintz AM, Cruz SSD, Gomes-Filho IS, Figueiredo ACMG, Pereira MG. Associated factors to abusive alcoholic beverage consumption in suicide victims. Drug Alcohol Depend 2021; 221:108613. [PMID: 33662671 DOI: 10.1016/j.drugalcdep.2021.108613] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/30/2020] [Revised: 01/25/2021] [Accepted: 01/26/2021] [Indexed: 10/22/2022]
Abstract
BACKGROUND Suicide is a worldwide phenomenon, as well as a challenge for public health, and alcoholic beverage abuse is one of the most important risk factors. However, the association between possible factors related to alcoholic beverage consumption in suicide victims has rarely been investigated. OBJECTIVE To evaluate the factors associated with abusive alcoholic beverage consumption among people who died from suicide in the Brazilian Federal District (BFD). METHOD A population-based and cross-sectional study with suicide victims in the BFD between 2016 and 2017. Information was collected about sociodemographic characteristics, autopsy appraisal, and drug use. A trained team evaluated all cases to define factors associated with abusive alcoholic beverage consumption. This outcome was measured using the Blood Alcohol Concentration. Poisson regression analysis was applied to calculate the Prevalence Ratios and respective populational confidence intervals. RESULTS The findings of the present study were collected from a database containing information related to 278 suicide victims. Being male and having cocaine identified in the toxicological test were the factors that showed a strong association with abusive alcohol beverage consumption in suicide victims. Other factors showed a slight association (PR < 1.5): having an education level with greater than 8 years of study, being black, having a professional occupation or being retired or pensioner, and having the presence of cannabis in the toxicological test. CONCLUSION Socioeconomic-demographic and behavioral factors proved to be positively associated with abusive alcoholic beverage consumption among suicide victims, suggesting the need for effective public health policy measures to combat this health problem.
Collapse
Affiliation(s)
| | | | | | | | | | - Elivan Silva Souza
- Department of Health of Univesity of Brasilia, Federal District, Brazil.
| | | | | | - Simone Seixas da Cruz
- Department of Epidemiology, Federal University of Recôncavo of Bahia, Bahia, Brazil.
| | | | | | | |
Collapse
|
18
|
Li H, Xiao Y, Han L, Jia Y, Luo S, Zhang D, Zhang L, Wu P, Xiao C, Kan W, Du J, Bao H. Ganoderma lucidum polysaccharides ameliorated depression-like behaviors in the chronic social defeat stress depression model via modulation of Dectin-1 and the innate immune system. Brain Res Bull 2021; 171:16-24. [PMID: 33705858 DOI: 10.1016/j.brainresbull.2021.03.002] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2020] [Revised: 02/28/2021] [Accepted: 03/03/2021] [Indexed: 02/07/2023]
Abstract
Major depressive disorder (MDD) is a prevalent, chronic, and recurrent disease. At least one-third of patients have treatment-resistant depression; therefore, there is an urgent need for novel drug development. Cumulative studies have suggested an inflammatory mechanism for the pathophysiology of MDD. Ganoderma lucidum polysaccharides (GLP) is an anti-inflammatory and immunomodulatory agent. Here, we found that an injection of GLP led to a rapid and robust antidepressant effect after 60 min in the tail suspension test. This antidepressant effect remained after 5 days of treatment with GLP in the forced swim test. Unlike psychostimulants, GLP did not show a hyperactive effect in the open field test. After 60 min or 5 days of treatment, GLP exhibited an antidepressant effect in a chronic social defeat stress (CSDS) depression animal model. Moreover, after 5 days of treatment, GLP attenuated the expression of the proinflammatory cytokines IL-1β and TNF-α, enhanced the expression of the anti-inflammatory cytokine IL-10 and the neurotrophic factor BDNF, and inhibited the activation of microglia and proliferation of astrocytes in the hippocampus of CSDS mice. In addition, after 5 days of treatment, GLP significantly enhanced GluA1 S845 phosphorylation as well as GluA1 and GluA2 expression levels in the hippocampus of CSDS mice. To determine whether the antidepressant effect was mediated by Dectin-1, we found that GLP treatment enhanced Dectin-1 expression in the hippocampus in CSDS mice, and the Dectin-1-specific inhibitor laminarin almost completely blocked the antidepressant effect of GLP. This study identified GLP, an agonist of Dectin-1, as a novel and rapid antidepressant with clinical potential and multiple beneficial mechanisms, particularly in regulating the neuroimmune system and, subsequently, AMPA receptor function.
Collapse
Affiliation(s)
- Haoran Li
- Yunnan University, School of Medicine, 2 Cuihu North Road, Kunming, Yunnan, 650091, PR China
| | - Yuhuan Xiao
- Yunnan University, School of Medicine, 2 Cuihu North Road, Kunming, Yunnan, 650091, PR China
| | - Li Han
- Yunnan University, School of Medicine, 2 Cuihu North Road, Kunming, Yunnan, 650091, PR China
| | - Yue Jia
- Yunnan University, School of Medicine, 2 Cuihu North Road, Kunming, Yunnan, 650091, PR China
| | - Shaolei Luo
- Yunnan University, School of Medicine, 2 Cuihu North Road, Kunming, Yunnan, 650091, PR China
| | - Dandan Zhang
- Yunnan University, School of Medicine, 2 Cuihu North Road, Kunming, Yunnan, 650091, PR China
| | - Ling Zhang
- The National Clinical Research Center for Mental Disorders & Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital & Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, 100088, PR China
| | - Peng Wu
- Yunnan Plateau Characteristic Agricultural Industry Research Institute, Yunnan Agricultural University, Kunming, Yunnan, 650201, PR China
| | - Chunjie Xiao
- Yunnan University, School of Medicine, 2 Cuihu North Road, Kunming, Yunnan, 650091, PR China
| | - Weijing Kan
- The National Clinical Research Center for Mental Disorders & Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital & Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, 100088, PR China
| | - Jing Du
- Yunnan University, School of Medicine, 2 Cuihu North Road, Kunming, Yunnan, 650091, PR China; The National Clinical Research Center for Mental Disorders & Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital & Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, 100088, PR China.
| | - Hongkun Bao
- Yunnan University, School of Medicine, 2 Cuihu North Road, Kunming, Yunnan, 650091, PR China.
| |
Collapse
|
19
|
Kong Q, Li Y, Yue J, Wu X, Xu M. Reducing alcohol and/or cocaine-induced reward and toxicity via an epidermal stem cell-based gene delivery platform. Mol Psychiatry 2021; 26:5266-5276. [PMID: 33619338 PMCID: PMC8380265 DOI: 10.1038/s41380-021-01043-y] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/19/2020] [Revised: 01/14/2021] [Accepted: 02/01/2021] [Indexed: 01/31/2023]
Abstract
Alcohol use disorder (AUD) is one of the foremost public health problems. Alcohol is also frequently co-abused with cocaine. There is a huge unmet need for the treatment of AUD and/or cocaine co-abuse. We recently demonstrated that skin grafts generated from mouse epidermal stem cells that had been engineered by CRISPR-mediated genome editing could be transplanted onto mice as a gene delivery platform. Here, we show that expression of the glucagon-like peptide-1 (GLP1) gene delivered by epidermal stem cells attenuated development and reinstatement of alcohol-induced drug-taking and seeking as well as voluntary oral alcohol consumption. GLP1 derived from the skin grafts decreased alcohol-induced increase in dopamine levels in the nucleus accumbens. In exploring the potential of this platform in reducing concurrent use of drugs, we developed a novel co-grafting procedure for both modified human butyrylcholinesterase (hBChE)- and GLP1-expressing cells. Epidermal stem cell-derived hBChE and GLP1 reduced acquisition of drug-taking and toxicity induced by alcohol and cocaine co-administration. These results imply that cutaneous gene delivery through skin transplants may add a new option to treat drug abuse and co-abuse.
Collapse
Affiliation(s)
- Qingyao Kong
- grid.170205.10000 0004 1936 7822Department of Anesthesia and Critical Care, The University of Chicago, Chicago, IL USA
| | - Yuanyuan Li
- grid.170205.10000 0004 1936 7822Ben May Department for Cancer Research, The University of Chicago, Chicago, IL USA
| | - Jiping Yue
- grid.170205.10000 0004 1936 7822Ben May Department for Cancer Research, The University of Chicago, Chicago, IL USA
| | - Xiaoyang Wu
- Ben May Department for Cancer Research, The University of Chicago, Chicago, IL, USA.
| | - Ming Xu
- Department of Anesthesia and Critical Care, The University of Chicago, Chicago, IL, USA.
| |
Collapse
|
20
|
Schlagal CR, Wu P. Alcohol and Cocaine Combined Substance Use on Adult Hypothalamic Neural Stem Cells and Neurogenesis. Brain Plast 2020; 6:41-46. [PMID: 33680845 PMCID: PMC7903003 DOI: 10.3233/bpl-190091] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
Many advancements have been made over the years looking at the individual and combined effects of drugs of abuse on the brain, with one key area of research focusing on the effects on neurogenesis. An integral part of fetal brain development and, later, maintenance in the adult brain, neurogenesis occurs in three main regions: subventricularzone of the lateral ventricles (SVZ), subgranularzone of the dentate gyrus (SGZ), and the tanycyte layer in the hypothalamus (TL). We will review current literature on combined drugs of abuse and their effect on adult neurogenesis. More specifically, this review will focus on the effect of combining cocaine and alcohol. Additionally, the tanycyte layer will be explored in more depth and probed to look at the neurogenic properties of tanycytes and their role in neurogenesis.
Collapse
Affiliation(s)
- Caitlin R Schlagal
- Neuroscience, Cell Biology and Anatomy, University of Texas Medical Branch, Galveston, TX, USA
| | - Ping Wu
- Neuroscience, Cell Biology and Anatomy, University of Texas Medical Branch, Galveston, TX, USA
| |
Collapse
|
21
|
Liu P, Du J. Oridonin is an antidepressant molecule working through the PPAR-γ/AMPA receptor signaling pathway. Biochem Pharmacol 2020; 180:114136. [PMID: 32628930 DOI: 10.1016/j.bcp.2020.114136] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2020] [Revised: 06/30/2020] [Accepted: 07/01/2020] [Indexed: 12/12/2022]
Abstract
Oridonin is a diterpene compound that regulates the activity of PPAR-γ (peroxisome proliferator-activated receptor gamma) transcription factor. Cumulative evidence indicates that AMPA (α-amino-3-hydroxy-5-methyl-4-isoxazole propionic acid)-type glutamate receptors (AMPARs) play an important role in the treatment of depression. In the article, we found that after treatment with oridonin, the immobility time of mice was significantly reduced in the tail suspension test (TST) and the forced-swim test (FST). After five consecutive days of treatment in mice, oridonin significantly enhanced the expression of PPAR-γ, GluA1 (Ser845) phosphorylation, and GluA1 in the total protein extract of the prefrontal cortex (PFC). Blocking PPAR-γ was able to block antidepressant effects of oridonin. In synaptosome fractions of the PFC, oridonin treatment also significantly increased the GluA1 (Ser845) phosphorylation and GluA1 levels. Moreover, antidepressant actions of oridonin were blocked by AMPA receptor-specific antagonist GYKI 52466. This study demonstrates that oridonin regulates PPAR-γ/AMPA receptor signaling in the prefrontal cortex, and that oridonin can be identified as a novel antidepressant with clinical potential.
Collapse
Affiliation(s)
- Ping Liu
- School of Medicine, Yunnan University, Kunming, Yunnan, PR China
| | - Jing Du
- School of Medicine, Yunnan University, Kunming, Yunnan, PR China.
| |
Collapse
|
22
|
Hood LE, Leyrer-Jackson JM, Olive MF. Pharmacotherapeutic management of co-morbid alcohol and opioid use. Expert Opin Pharmacother 2020; 21:823-839. [PMID: 32103695 PMCID: PMC7239727 DOI: 10.1080/14656566.2020.1732349] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2019] [Accepted: 02/17/2020] [Indexed: 12/12/2022]
Abstract
Opioid use disorder (OUD) and alcohol use disorder (AUD) are two highly prevalent substance-related disorders worldwide. Co-use of the substances is also quite prevalent, yet there are no pharmacological treatment approaches specifically designed to treat co-morbid OUD and AUD. Here, the authors critically summarize OUD, AUD and opioid/alcohol co-use and their current pharmacotherapies for treatment. They also review the mechanisms of action of opioids and alcohol within the brain reward circuitry and discuss potential combined mechanisms of action and resulting neuroadaptations. Pharmacotherapies that aim to treat AUD or OUD that may be beneficial in the treatment of co-use are also highlighted. Preclinical models assessing alcohol and opioid co-use remain sparse. Lasting neuroadaptations in brain reward circuits caused by co-use of alcohol and opioids remains largely understudied. In order to fully understand the neurobiological underpinnings of alcohol and opioid co-use and develop efficacious pharmacotherapies, the preclinical field must expand its current experimental paradigms of 'single drug' use to encompass polysubstance use. Such studies will provide insights on the neural alterations induced by opioid and alcohol co-use, and may help develop novel pharmacotherapies for individuals with co-occurring alcohol and opioid use disorders.
Collapse
Affiliation(s)
- Lauren E. Hood
- Department of Psychology, Arizona State University, Tempe, Arizona, USA
| | | | - M. Foster Olive
- Department of Psychology, Arizona State University, Tempe, Arizona, USA
| |
Collapse
|
23
|
Marcos A, Moreno M, Orihuel J, Ucha M, Mª de Paz A, Higuera-Matas A, Capellán R, Crego AL, Martínez-Larrañaga MR, Ambrosio E, Anadón A. The effects of combined intravenous cocaine and ethanol self-administration on the behavioral and amino acid profile of young adult rats. PLoS One 2020; 15:e0227044. [PMID: 32203565 PMCID: PMC7089423 DOI: 10.1371/journal.pone.0227044] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2019] [Accepted: 12/11/2019] [Indexed: 12/22/2022] Open
Abstract
Under paradigms of combined intravenous cocaine and ethanol self-administration, the effects on behavior have been poorly explored. Numerous studies have found sex differences in amino acids profile and behavioral responses to each drug, yet few have focused on the interactions between cocaine and ethanol. The main objective of this work was to explore the acquisition and maintenance of intravenous self-administration behavior with a combination of cocaine and ethanol in male and female young adult rats. Likewise, the amino acids profile in blood plasma was quantified 48 hours after the last self-administration session. Male and female 52 days old Wistar rats were randomly assigned to one of 3 groups: i) saline control, ii) cocaine (1 mg/kg bodyweight/injection) and iii) cocaine and ethanol (1 mg + 133 mg/kg bodyweight/ injection). After 24 self-administration sessions carried out on a fixed-ratio-1 schedule, with a limit of 15 doses per session, 14 plasma amino acids were quantified by mean Capillary Electrophoresis technique. The curve of cocaine and ethanol combined self-administration was similar to that associated with cocaine administration alone, with females acquiring self-administration criterion before males. The self-administration of cocaine and ethanol altered the plasma concentration and relative ratios of the amino acid L-Tyrosine. In our intravenous self-administration model, females appeared more vulnerable to acquire abusive consumption of the cocaine and ethanol combination, which altered plasma L-Tyrosine levels.
Collapse
Affiliation(s)
- Alberto Marcos
- Psychobiology Department, School of Psychology, Universidad Nacional de Educación a Distancia, Madrid, Spain
| | - Mario Moreno
- Psychobiology Department, School of Psychology, Universidad Nacional de Educación a Distancia, Madrid, Spain
| | - Javier Orihuel
- Psychobiology Department, School of Psychology, Universidad Nacional de Educación a Distancia, Madrid, Spain
| | - Marcos Ucha
- Psychobiology Department, School of Psychology, Universidad Nacional de Educación a Distancia, Madrid, Spain
| | - Ana Mª de Paz
- Departamento de Psicología Básica I, Facultad de Psicología, Universidad Nacional de Educación a Distancia (UNED), Madrid, Spain
| | - Alejandro Higuera-Matas
- Psychobiology Department, School of Psychology, Universidad Nacional de Educación a Distancia, Madrid, Spain
| | - Roberto Capellán
- Psychobiology Department, School of Psychology, Universidad Nacional de Educación a Distancia, Madrid, Spain
| | - Antonio L. Crego
- Departamento de Química Analítica, Química Física e Ingeniería Química, Facultad de Ciencias, Universidad de Alcalá, Ctra. Madrid-Barcelona, Alcalá de Henares, Madrid, Spain
| | - María-Rosa Martínez-Larrañaga
- Department of Pharmacology and Toxicology, Faculty of Veterinary Medicine, Universidad Complutense de Madrid, Madrid, Spain
| | - Emilio Ambrosio
- Psychobiology Department, School of Psychology, Universidad Nacional de Educación a Distancia, Madrid, Spain
- * E-mail:
| | - Arturo Anadón
- Department of Pharmacology and Toxicology, Faculty of Veterinary Medicine, Universidad Complutense de Madrid, Madrid, Spain
| |
Collapse
|
24
|
Elliott L, Haddock CK, Campos S, Benoit E. Polysubstance use patterns and novel synthetics: A cluster analysis from three U.S. cities. PLoS One 2019; 14:e0225273. [PMID: 31794586 PMCID: PMC6890248 DOI: 10.1371/journal.pone.0225273] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2019] [Accepted: 10/31/2019] [Indexed: 02/04/2023] Open
Abstract
The rapid emergence of novel psychoactive substances within the past decade has raised new concerns about the harms associated with unregulated drug use. Synthetic analogues-chemically related to established psychoactive substances like cannabis sativa and catha edulis-in particular have proliferated rapidly, allowing little opportunity for scientific research or the establishment of informal guidelines for safe use among consumers. To explore how synthetic substance use relates to other forms of use, this paper presents an analysis of polysubstance use among a sample of 676 people who use illicit substances in the United States. Participants were sampled from three greater metropolitan areas (Houston/Galveston, Texas; New York City; and New Orleans, Louisiana). Study researchers used cluster-type analyses to develop dendrogram visualizations of the interrelationships between substance types. Results suggest a considerable variation in substance and polysubstance use patterns across states in the U.S. Polysubstance use clustered around well-observed combinations like MDMA/cannabis and cocaine/heroin. Synthetic cannabinoids and cathinones showed no strong clustering with other substances. High rates of binge drinking among users of other substances further support the importance of interventions sensitive to the clinical challenges of polysubstance use.
Collapse
Affiliation(s)
- Luther Elliott
- New York University, College of Global Public Health, Center for Drug Use and HIV/HCV Research, New York, New York, United States of America
- * E-mail:
| | | | - Stephanie Campos
- New York State Psychiatric Institute, Columbia University, New York, New York, United States of America
| | - Ellen Benoit
- North Jersey Community Research Initiative, Research Division, Newark, New Jersey, United States of America
| |
Collapse
|
25
|
Alcohol Interaction with Cocaine, Methamphetamine, Opioids, Nicotine, Cannabis, and γ-Hydroxybutyric Acid. Biomedicines 2019; 7:biomedicines7010016. [PMID: 30866524 PMCID: PMC6466217 DOI: 10.3390/biomedicines7010016] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2019] [Revised: 02/21/2019] [Accepted: 02/27/2019] [Indexed: 12/18/2022] Open
Abstract
Millions of people around the world drink alcoholic beverages to cope with the stress of modern lifestyle. Although moderate alcohol drinking may have some relaxing and euphoric effects, uncontrolled drinking exacerbates the problems associated with alcohol abuse that are exploding in quantity and intensity in the United States and around the world. Recently, mixing of alcohol with other drugs of abuse (such as opioids, cocaine, methamphetamine, nicotine, cannabis, and γ-hydroxybutyric acid) and medications has become an emerging trend, exacerbating the public health concerns. Mixing of alcohol with other drugs may additively or synergistically augment the seriousness of the adverse effects such as the withdrawal symptoms, cardiovascular disorders, liver damage, reproductive abnormalities, and behavioral abnormalities. Despite the seriousness of the situation, possible mechanisms underlying the interactions is not yet understood. This has been one of the key hindrances in developing effective treatments. Therefore, the aim of this article is to review the consequences of alcohol's interaction with other drugs and decipher the underlying mechanisms.
Collapse
|
26
|
Jones AW. Forensic Drug Profile: Cocaethylene. J Anal Toxicol 2019; 43:155-160. [DOI: 10.1093/jat/bkz007] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2018] [Revised: 01/08/2019] [Accepted: 01/30/2019] [Indexed: 01/26/2023] Open
Abstract
AbstractThis article is intended as a brief review or primer about cocaethylene (CE), a pharmacologically active substance formed in the body when a person co-ingests ethanol and cocaine. Reference books widely used in forensic toxicology contain scant information about CE, even though this cocaine metabolite is commonly encountered in routine casework. CE and cocaine are equi-effective at blocking the reuptake of dopamine at receptor sites, thus reinforcing the stimulant effects of the neurotransmitter. In some animal species, the LD50 of CE was lower than for cocaine. CE is also considered more toxic to the heart and liver compared with the parent drug cocaine. The plasma elimination half-life of CE is ~2 h compared with ~1 h for cocaine. The concentrations of CE in blood after drinking alcohol and taking cocaine are difficult to predict and will depend on the timing of administration and the amounts of the two precursor drugs ingested. After an acute single dose of cocaine and ethanol, the concentration–time profile of CE runs on a lower level to that of cocaine, although CE is detectable in blood for several hours longer. A strong case can be made for adding together the concentrations of cocaine and CE in forensic blood samples when toxicological results are interpreted in relation to acute intoxication and the risk of an overdose death.
Collapse
Affiliation(s)
- Alan Wayne Jones
- Department of Clinical Pharmacology, University of Linköping, Linköping, Sweden
| |
Collapse
|
27
|
Liu Y, Williamson V, Setlow B, Cottler LB, Knackstedt LA. The importance of considering polysubstance use: lessons from cocaine research. Drug Alcohol Depend 2018; 192:16-28. [PMID: 30195242 PMCID: PMC7450360 DOI: 10.1016/j.drugalcdep.2018.07.025] [Citation(s) in RCA: 88] [Impact Index Per Article: 14.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/08/2018] [Revised: 07/11/2018] [Accepted: 07/12/2018] [Indexed: 02/07/2023]
Abstract
BACKGROUND Polysubstance use (PSU) is prevalent among individuals with substance use disorders, but the vast majority of preclinical substance use research has focused on individual substances in isolation. Cocaine has been prevalent in the repertoire of persons who use more than one illicit substance. METHODS We conducted a meta-analysis combining results from literature searches and secondary data analyses to estimate the prevalence of simultaneous and concurrent cocaine + alcohol and cocaine + cannabis use among cocaine users. We next summarized the small body of literature on behavioral, cognitive and neurobiological consequences of cocaine PSU across species, with a focus on alcohol and cannabis. Finally, we used systematic literature searches to assess the extent to which human and animal studies on the neurobiological consequences of cocaine include PSU subjects. RESULTS The estimated prevalence of simultaneous and concurrent alcohol use among human cocaine users was 74% and 77%, respectively. The estimated prevalence of simultaneous and concurrent cannabis use among cocaine users was 38% and 64%, respectively. Consumption of alcohol or cannabis with cocaine enhances subjective responses to cocaine, concomitant with changes in cocaine metabolism that increase blood cocaine levels, and, in the case of alcohol, produce the psychoactive metabolite cocaethylene. There is also consistent evidence for neurobiological effects of cocaine + alcohol combinations. However, animal PSU research with cocaine lags behind human research. CONCLUSION Based on the prevalence and known consequences of PSU, consideration of PSU in both human and animal research is vital for understanding patterns of substance use.
Collapse
Affiliation(s)
- Yiyang Liu
- Department of Epidemiology, College of Public Health and Health Professions, College of Medicine, 2004 Mowry Road, PO Box 100231, USA
| | - Victoria Williamson
- Department of Psychology, University of Florida, 945 Center Dr., P.O. Box 112250, Gainesville, FL 32611, USA
| | - Barry Setlow
- Department of Psychology, University of Florida, 945 Center Dr., P.O. Box 112250, Gainesville, FL 32611, USA,Department of Psychiatry, University of Florida College of Medicine, PO Box 100256, Gainesville, FL 32610-0256, USA,Department of Neuroscience, 1149 Newell Drive, Room L1-100, Gainesville, FL 32611, USA,Center for Addiction Research and Education, Gainesville, FL 32611, USA
| | - Linda B. Cottler
- Department of Epidemiology, College of Public Health and Health Professions, College of Medicine, 2004 Mowry Road, PO Box 100231, USA,Center for Addiction Research and Education, Gainesville, FL 32611, USA
| | - Lori A. Knackstedt
- Department of Psychology, University of Florida, 945 Center Dr., P.O. Box 112250, Gainesville, FL 32611, USA,Center for Addiction Research and Education, Gainesville, FL 32611, USA,Corresponding author at: Department of Psychology, University of Florida, 945 Center Dr., Room Psy 114, Gainesville, FL 32611, USA. (L.A. Knackstedt)
| |
Collapse
|
28
|
Shemesh-Darvish L, Shinar D, Hallak H, Gross A, Rosenstock M. TV-1380 attenuates cocaine-induced changes in cardiodynamic parameters in monkeys and reduces the formation of cocaethylene. Drug Alcohol Depend 2018; 188:295-303. [PMID: 29807217 DOI: 10.1016/j.drugalcdep.2018.01.033] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/27/2017] [Revised: 12/21/2017] [Accepted: 01/11/2018] [Indexed: 10/17/2022]
Abstract
BACKGROUND TV-1380 is a rationally mutated, human BChE fused to human serum albumin that has high hydrolytic enzymatic activity against cocaine and as well as an extended elimination half-life. OBJECTIVE The present studies examined the safety of TV-1380 and its protective effect when given to monkeys alone or concomitantly with cocaine and ethanol. METHODS A set of studies was conducted in monkeys with TV-1380. The parameters tested included telemetric assessment of cardiovascular parameters, clinical pathology, plasma analysis of cardiac troponin I, ex-vivo analyses of cocaethylene and PK analysis of serum concentrations of TV-1380, cocaine and its metabolites, and histopathological examinations. RESULTS TV-1380 treatment in monkeys was well tolerated. TV-1380 pretreatment prior to cocaine significantly attenuated the cardiac effects of cocaine and reduced cocaine-induced elevations in serum cardiac troponin I. TV-1380 changed the metabolic fate of cocaine resulting in decreased exposure to benzoylecgonine, while increasing the exposure to ecgonine methyl ester in plasma.TV-1380 reduced the plasma levels of the toxic metabolite cocaethylene formed after co-administration of ethanol and cocaine. CONCLUSION The results of this study demonstrate that TV-1380 not only accelerates the elimination of cocaine, but also protects the treated animal from the cardiac effects of cocaine, and inhibits the formation of the toxic cocaethylene metabolite when cocaine is given together with ethanol, supporting further clinical development of modified BChE products as possible treatments for cocaine abuse.
Collapse
Affiliation(s)
| | - Doron Shinar
- Non-Clinical Development, Teva Pharmaceutical Ltd, Netanya, Israel
| | - Hussein Hallak
- Non-Clinical Development, Teva Pharmaceutical Ltd, Netanya, Israel
| | - Aviva Gross
- Non-Clinical Development, Teva Pharmaceutical Ltd, Netanya, Israel
| | - Moti Rosenstock
- Non-Clinical Development, Teva Pharmaceutical Ltd, Netanya, Israel
| |
Collapse
|
29
|
Saha TD, Grant BF, Chou SP, Kerridge BT, Pickering RP, Ruan WJ. Concurrent use of alcohol with other drugs and DSM-5 alcohol use disorder comorbid with other drug use disorders: Sociodemographic characteristics, severity, and psychopathology. Drug Alcohol Depend 2018; 187:261-269. [PMID: 29689486 DOI: 10.1016/j.drugalcdep.2018.03.006] [Citation(s) in RCA: 42] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/23/2017] [Revised: 03/01/2018] [Accepted: 03/01/2018] [Indexed: 11/16/2022]
Abstract
BACKGROUND Little is known about the sociodemographic profiles, the intensity of drinking, the severity of alcohol use disorder (AUD), and psychopathology among individuals with specific patterns of concurrent alcohol and drug use and AUD and other drug use disorders (DUDs) comorbidity. METHODS Data were from the National Epidemiologic Survey on Alcohol and Related Conditions-III. We examined sociodemographic correlates and psychopathology among individuals with specific patterns of concurrent use of alcohol and drug and AUD-DUD comorbidity relative to alcohol use or AUD only, respectively, using multinomial logistic regression. We also examined whether concurrent alcohol and drug use and AUD-DUD comorbidity increased the intensity of drinking and severity of AUD, respectively. RESULTS The majority (62.0%) of past-year drinkers used only alcohol. The 12-month prevalence of AUD only was 53.5%. Individuals with concurrent use of alcohol and drugs and AUD-DUD comorbidity were more likely to be men, younger, never/previously married, with lower education and income (odds ratios (ORs) ≥ 1.2). Concurrent use of alcohol and drugs and AUD- DUD comorbidity groups were more likely to experience psychopathology than the alcohol use only and AUD only groups, respectively (ORs ≥ 1.3). The intensity of drinking was greater among the concurrent use groups relative to the alcohol use only group, while the severity of AUD was greater among AUD-DUD comorbidity groups relative to the AUD only group. CONCLUSIONS Research on consequences and treatment outcome of concurrent use of alcohol and drugs and AUD-DUD comorbidity is warranted to inform the development of more effective prevention/intervention programs.
Collapse
Affiliation(s)
- Tulshi D Saha
- Epidemiology and Biometry Branch, Division of Epidemiology and Prevention Research, National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health, 5635 Fishers Lane, Rockville, MD 20852, USA.
| | | | - S Patricia Chou
- Epidemiology and Biometry Branch, Division of Epidemiology and Prevention Research, National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health, 5635 Fishers Lane, Rockville, MD 20852, USA.
| | - Bradley T Kerridge
- Epidemiology and Biometry Branch, Division of Epidemiology and Prevention Research, National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health, 5635 Fishers Lane, Rockville, MD 20852, USA.
| | - Roger P Pickering
- Epidemiology and Biometry Branch, Division of Epidemiology and Prevention Research, National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health, 5635 Fishers Lane, Rockville, MD 20852, USA.
| | - W June Ruan
- Epidemiology and Biometry Branch, Division of Epidemiology and Prevention Research, National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health, 5635 Fishers Lane, Rockville, MD 20852, USA.
| |
Collapse
|
30
|
Scherer M, Canham S, Voas RB, Furr-Holden CD. Intercorrelation of Alcohol and Other Drug Use Disorders among a National Sample of Drivers. J Psychoactive Drugs 2018; 50:143-150. [PMID: 28846058 PMCID: PMC6117115 DOI: 10.1080/02791072.2017.1366605] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
This study examined the relationship between alcohol, marijuana, cocaine, and painkiller use disorders in a sample of drivers. We studied nighttime drivers aged 16 to 87 (n = 4,277) from the 2007 National Roadside Survey who reported substance use behaviors and provided breath tests for alcohol. Logistic regression analyses assessed the relationships between (1) substance (i.e., alcohol/marijuana/cocaine/pain killer) use disorders; (2) demographic characteristics; and (3) BAC levels. Overall, 13.2% of participants met criteria for marijuana use disorder, 7% met criteria for cocaine use disorder, and 15.4% met criteria for extra-medicinal painkiller use disorder. When self-report data were analyzed, three reciprocal associations emerged: (1) marijuana use disorders and alcohol use disorders were correlated; (2) marijuana use disorders and cocaine use disorders were correlated; and (3) cocaine use disorders and painkiller use disorders were correlated. BAC data revealed that marijuana and cocaine use disorders were both associated with positive BAC levels, but only cocaine use disorders were associated with BAC levels over the legal limit. Results suggest significant poly-substance use disorders in a sample of nighttime drivers, with variations by demographic characteristics. The individual and public health consequences of multiple substance use disorders among drivers are significant.
Collapse
Affiliation(s)
- Michael Scherer
- a Associate Research Scientist, Pacific Institute for Research and Evaluation , Calverton , MD , USA
| | - Sarah Canham
- b Research Associate, Department of Gerontology , Simon Fraser University , Vancouver , BC , Canada
| | - Robert B Voas
- c Senior Research Scientist, Pacific Institute for Research and Evaluation , Calverton , MD , USA
| | - C Debra Furr-Holden
- d Endowed Professor, Department of Epidemiology and Biostatics , Michigan State University , Flint , MI , USA
| |
Collapse
|
31
|
|
32
|
Gilmore D, Zorland J, Akin J, Johnson JA, Emshoff JG, Kuperminc GP. Mortality risk in a sample of emergency department patients who use cocaine with alcohol and/or cannabis. Subst Abus 2017; 39:266-270. [DOI: 10.1080/08897077.2017.1389799] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- Devin Gilmore
- Department of Psychology, Georgia State University, Atlanta, Georgia, USA
| | - Jennifer Zorland
- Department of Psychology, Georgia State University, Atlanta, Georgia, USA
| | - Joanna Akin
- Department of Psychology, Georgia State University, Atlanta, Georgia, USA
| | - J. Aaron Johnson
- Department of Family Medicine, Medical Center of Central Georgia and Mercer University School of Medicine, Macon, Georgia, USA
| | - James G. Emshoff
- Department of Psychology, Georgia State University, Atlanta, Georgia, USA
| | | |
Collapse
|
33
|
Conner KR, Lathrop S, Caetano R, Wiegand T, Kaukeinen K, Nolte KB. Presence of Alcohol, Cocaine, and Other Drugs in Suicide and Motor Vehicle Crash Decedents Ages 18 to 54. Alcohol Clin Exp Res 2017; 41:571-575. [DOI: 10.1111/acer.13320] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2016] [Accepted: 12/20/2016] [Indexed: 12/19/2022]
Affiliation(s)
- Kenneth R. Conner
- Department of Emergency Medicine; University of Rochester Medical Center; Rochester New York
| | - Sarah Lathrop
- New Mexico Office of the Medical Investigator; University of New Mexico; Albuquerque New Mexico
| | - Raul Caetano
- Prevention Research Center; Pacific Institute for Research and Evaluation; Oakland California
| | - Timothy Wiegand
- Department of Emergency Medicine; University of Rochester Medical Center; Rochester New York
| | - Kimberly Kaukeinen
- Department of Biostatistics and Computational Biology; University of Rochester Medical Center; Rochester New York
| | - Kurt B. Nolte
- New Mexico Office of the Medical Investigator; University of New Mexico; Albuquerque New Mexico
| |
Collapse
|
34
|
John WS, Nader MA. Effects of ethanol on cocaine self-administration in monkeys responding under a second-order schedule of reinforcement. Drug Alcohol Depend 2017; 170:112-119. [PMID: 27886524 PMCID: PMC5744897 DOI: 10.1016/j.drugalcdep.2016.11.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/23/2016] [Revised: 11/03/2016] [Accepted: 11/03/2016] [Indexed: 10/20/2022]
Abstract
BACKGROUND Concurrent alcohol use among cocaine abusers is common but the behavioral variables that promote co-abuse are not well understood. The present study examined the effects of intragastric (i.g.) ethanol (EtOH) administration in monkeys responding under a schedule of cocaine reinforcement in which extensive drug seeking was maintained by conditioned stimuli. METHODS Four adult male cynomolgus monkeys (Macaca fascicularis) were trained to respond under a second-order fixed-interval (FI) 600s (fixed-ratio (FR) 30:S) schedule of cocaine (0.003-0.56mg/kg/injection) presentation. Sessions ended after 5 injections or 90min had elapsed. Different EtOH doses (0.5-2.0g/kg, i.g.) were administered 30min before the session, typically on Tuesdays and Fridays. Blood ethanol concentrations (BECs) were also assessed. Pattern of FI responding was assessed by determining quarter-life (QL) values. RESULTS Cocaine self-administration was characterized as an inverted U-shaped function of dose; QL values increased monotonically with dose. EtOH pretreatments dose-dependently decreased self-administration at several cocaine doses in 3 of 4 monkeys. In one animal, EtOH increased low-dose cocaine-maintained responding. For all monkeys, QL values were increased by EtOH when low- and high-cocaine doses were self-administered, suggesting additive effects of EtOH and cocaine. Furthermore, BECs were not altered following cocaine self-administration. CONCLUSIONS The reductions in cocaine self-administration and the increases in QL values following EtOH, suggest that EtOH was enhancing cocaine-related conditioned reinforcement. A better understanding of the behavioral mechanisms that mediate the co-abuse of alcohol and cocaine will lead to improved treatments for both drugs.
Collapse
|
35
|
Bao H, Ran P, Zhu M, Sun L, Li B, Hou Y, Nie J, Shan L, Li H, Zheng S, Xu X, Xiao C, Du J. The Prefrontal Dectin-1/AMPA Receptor Signaling Pathway Mediates The Robust and Prolonged Antidepressant Effect of Proteo-β-Glucan from Maitake. Sci Rep 2016; 6:28395. [PMID: 27329257 PMCID: PMC4916609 DOI: 10.1038/srep28395] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2016] [Accepted: 06/03/2016] [Indexed: 01/13/2023] Open
Abstract
Proteo-β-glucan from Maitake (PGM) is a strong immune regulator, and its receptor is called Dectin-1. Cumulative evidence suggests that AMPA receptors are important for the treatment of depression. Here, we report that PGM treatment leads to a significant antidepressant effect in the tail suspension test and forced swim test after sixty minutes of treatment in mice. After five consecutive days of PGM treatment, this antidepressant effect remained. PGM treatment did not show a hyperactive effect in the open field test. PGM significantly enhanced the expression of its receptor Dectin-1, as well as p-GluA1(S845) and GluA1, but not GluA2 or GluA3 in the prefrontal cortex (PFC) after five days of treatment. The Dectin-1 inhibitor Laminarin was able to block the antidepressant effect of PGM. At the synapses of PFC, PGM treatment significantly up-regulated the p-GluA1(S845), GluA1, GluA2, and GluA3 levels. Moreover, PGM’s antidepressant effects and the increase of p-GluA1(S845)/GluA1 lasted for 3 days after stopping treatment. The AMPA-specific antagonist GYKI 52466 was able to block the antidepressant effect of PGM. This study identified PGM as a novel antidepressant with clinical potential and a new antidepressant mechanism for regulating prefrontal Dectin-1/AMPA receptor signalling.
Collapse
Affiliation(s)
- Hongkun Bao
- State Key Laboratory for Conservation and Utilization of Bio-resources in Yunnan, Yunnan University, Kunming, Yunnan, P. R. China.,School of Medicine, Yunnan University, Kunming, Yunnan, P. R. China
| | - Pengzhan Ran
- State Key Laboratory for Conservation and Utilization of Bio-resources in Yunnan, Yunnan University, Kunming, Yunnan, P. R. China.,School of Medicine, Yunnan University, Kunming, Yunnan, P. R. China
| | - Ming Zhu
- State Key Laboratory for Conservation and Utilization of Bio-resources in Yunnan, Yunnan University, Kunming, Yunnan, P. R. China.,School of Medicine, Yunnan University, Kunming, Yunnan, P. R. China
| | - Lijuan Sun
- State Key Laboratory for Conservation and Utilization of Bio-resources in Yunnan, Yunnan University, Kunming, Yunnan, P. R. China.,School of Medicine, Yunnan University, Kunming, Yunnan, P. R. China
| | - Bai Li
- State Key Laboratory for Conservation and Utilization of Bio-resources in Yunnan, Yunnan University, Kunming, Yunnan, P. R. China.,School of Medicine, Yunnan University, Kunming, Yunnan, P. R. China
| | - Yangyang Hou
- State Key Laboratory for Conservation and Utilization of Bio-resources in Yunnan, Yunnan University, Kunming, Yunnan, P. R. China.,School of Medicine, Yunnan University, Kunming, Yunnan, P. R. China
| | - Jun Nie
- State Key Laboratory for Conservation and Utilization of Bio-resources in Yunnan, Yunnan University, Kunming, Yunnan, P. R. China.,School of Medicine, Yunnan University, Kunming, Yunnan, P. R. China
| | - Liping Shan
- Beijing Gragen Biotechnology Co. Ltd., Beijing, P. R. China
| | - Hongliang Li
- State Key Laboratory for Conservation and Utilization of Bio-resources in Yunnan, Yunnan University, Kunming, Yunnan, P. R. China.,School of Medicine, Yunnan University, Kunming, Yunnan, P. R. China
| | - Shangyong Zheng
- State Key Laboratory for Conservation and Utilization of Bio-resources in Yunnan, Yunnan University, Kunming, Yunnan, P. R. China.,School of Medicine, Yunnan University, Kunming, Yunnan, P. R. China
| | - Xiufeng Xu
- Department of Psychiatry, The First Affiliated Hospital of Kunming Medical University, Kunming, Yunnan, P. R. China
| | - Chunjie Xiao
- State Key Laboratory for Conservation and Utilization of Bio-resources in Yunnan, Yunnan University, Kunming, Yunnan, P. R. China.,School of Medicine, Yunnan University, Kunming, Yunnan, P. R. China
| | - Jing Du
- State Key Laboratory for Conservation and Utilization of Bio-resources in Yunnan, Yunnan University, Kunming, Yunnan, P. R. China.,School of Medicine, Yunnan University, Kunming, Yunnan, P. R. China
| |
Collapse
|
36
|
Abstract
Alcohol consumption with psychostimulants is very common among drug addicts. There is little known about the possible pharmacological interactions between alcohol and psychostimulants. Among most commonly co-abused psychostimulants with alcohol are methamphetamine, cocaine, 3,4-methylenedioxymethamphetaminen, and nicotine. Co-abuse of alcohol with psychostimulants can lead to several neurophysiological dysfunctions such as decrease in brain antioxidant enzymes, disruption of learning and memory processes, cerebral hypo-perfusion, neurotransmitters depletion as well as potentiation of drug seeking behaviour. Moreover, co-abuse of alcohol and psychostimulants can lead to increase in heart rate, blood pressure, myocardial oxygen consumption and cellular stress, and the risk of developing different types of cancer. Co-abuse of alcohol with psychostimulants during pregnancy can lead to fetal brain abnormalities. Further studies are needed to investigate the pharmacokinetics, pharmacodynamics, and neurochemical changes on co-abuse of alcohol and psychostimulants.
Collapse
Affiliation(s)
- Yusuf S Althobaiti
- University of Toledo, College of Pharmacy and Pharmaceutical Sciences, Department of Pharmacology and Experimental Therapeutics, Toledo, OH, USA
| | - Youssef Sari
- University of Toledo, College of Pharmacy and Pharmaceutical Sciences, Department of Pharmacology and Experimental Therapeutics, Toledo, OH, USA
| |
Collapse
|
37
|
Acute Kidney Injury Associated With Alcohol and Cocaine Abuse: A Case Report. ADDICTIVE DISORDERS & THEIR TREATMENT 2016. [DOI: 10.1097/adt.0000000000000079] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
|
38
|
A randomized factorial trial of disulfiram and contingency management to enhance cognitive behavioral therapy for cocaine dependence. Drug Alcohol Depend 2016; 160:135-42. [PMID: 26817621 PMCID: PMC4767616 DOI: 10.1016/j.drugalcdep.2015.12.036] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/21/2015] [Revised: 12/21/2015] [Accepted: 12/26/2015] [Indexed: 11/22/2022]
Abstract
BACKGROUND This study evaluated the extent to which the addition of disulfiram and contingency management for adherence and abstinence (CM), alone and in combination, might enhance the effects of cognitive behavioral therapy (CBT) for cocaine use disorders. METHODS Factorial randomized double blind (for medication condition) clinical trial where CBT served as the platform and was delivered in weekly individual sessions in a community-based outpatient clinic. 99 outpatients who met DSM-IV criteria for current cocaine dependence were assigned to receive either disulfiram or placebo, and either CM or no CM. Cocaine and other substance use was assessed via a daily calendar with thrice weekly urine sample testing for 12 weeks with a one-year follow-up (80% interviewed at one year). RESULTS The primary hypothesis that CM and disulfiram would produce the best cocaine outcomes was not confirmed, nor was there a main effect for disulfiram. For the primary outcome (percent days of abstinence, self report), there was a significant interaction, with the best cocaine outcomes were seen for the combination of CM and placebo, with the two groups assigned to disulfiram associated with intermediate outcomes, and poorest cocaine outcome among those assigned to placebo and no CM. The secondary outcome (urinalysis) indicated a significant effect favoring CM over no CM but the interaction effect was not significant. One year follow-up data indicated sustained treatment effects across conditions. CONCLUSIONS CM enhances outcomes for CBT treatment of cocaine dependence, but disulfiram provided no added benefit to the combination of CM and CBT.
Collapse
|
39
|
Barrett SP, Jemcov A, Darredeau C. Patterns and Effects of Alcohol and Psychostimulant Co-administration: a Brief Review of Pharmacological Considerations and Subjective Responses. CURRENT ADDICTION REPORTS 2016. [DOI: 10.1007/s40429-016-0080-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
|
40
|
Peacock A, Norman T, Bruno R, Pennay A, Droste N, Jenkinson R, Quinn B, Lubman DI, Miller P. Typology of alcohol consumers in five Australian nighttime entertainment districts. Drug Alcohol Rev 2015; 35:539-48. [DOI: 10.1111/dar.12370] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2015] [Revised: 11/02/2015] [Accepted: 11/04/2015] [Indexed: 11/28/2022]
Affiliation(s)
- Amy Peacock
- School of Medicine (Psychology); University of Tasmania; Hobart Australia
| | - Thomas Norman
- School of Medicine (Psychology); University of Tasmania; Hobart Australia
| | - Raimondo Bruno
- School of Medicine (Psychology); University of Tasmania; Hobart Australia
| | - Amy Pennay
- Centre for Alcohol Policy Research; La Trobe University; Melbourne Australia
| | - Nicolas Droste
- School of Psychology; Deakin University; Geelong Australia
| | - Rebecca Jenkinson
- Burnet Institute; Melbourne Australia
- Department of Epidemiology and Preventive Medicine; Monash University; Melbourne Australia
| | - Brendan Quinn
- Burnet Institute; Melbourne Australia
- Department of Epidemiology and Preventive Medicine; Monash University; Melbourne Australia
| | - Dan I. Lubman
- Turning Point; Eastern Health; Melbourne Australia
- Eastern Health Clinical School; Monash University; Melbourne Australia
| | - Peter Miller
- School of Psychology; Deakin University; Geelong Australia
| |
Collapse
|
41
|
Gautam P, Warner TD, Kan EC, Sowell ER. Executive function and cortical thickness in youths prenatally exposed to cocaine, alcohol and tobacco. Dev Cogn Neurosci 2015; 16:155-165. [PMID: 25743199 PMCID: PMC4522382 DOI: 10.1016/j.dcn.2015.01.010] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2014] [Revised: 01/19/2015] [Accepted: 01/23/2015] [Indexed: 12/30/2022] Open
Abstract
Small and detrimental, albeit inconsistent, effects of prenatal cocaine exposure (PCE) during early childhood have been reported. The teratogenic effects of prenatal alcohol (PAE) and tobacco exposure (PTE) on neurobehavior are more firmly established than PCE. We tested if co-exposure to all three drugs could be related to greater differences in brain structure than exposure to cocaine alone. Participants (n=42, PCE=27; age range=14-16 years) received an executive function battery prior to a T1-weighted 3T structural MRI scan. Cortical thickness was measured using FreeSurfer (v5.1). Fetal drug exposure was quantified through maternal self-reports usage during pregnancy. Using general linear modeling, we found no main effects of PCE on cortical thickness, but significant main effects of PAE and PTE in superior and medial frontal regions, after co-varying for the effects of age, sex, and each drug of exposure. Significant alcohol-by-tobacco interactions, and significant cocaine-by-alcohol interactions on cortical thickness in medial parietal and temporal regions were also observed. Poly-drug exposure and cognitive function also showed significant interactions with cortical thickness: lower cortical thickness was associated with better performance in PCE-exposed adolescents. Results suggest that although children with PCE have subtle but persistent brain cortical differences until mid-to-late adolescence.
Collapse
Affiliation(s)
- Prapti Gautam
- Department of Pediatrics, Keck School of Medicine, University of Southern California, Children's Hospital of Los Angeles, Los Angeles, CA, United States
| | - Tamara D Warner
- Department of Pediatrics, University of Florida, Gainesville, FL, United States
| | - Eric C Kan
- Department of Pediatrics, Keck School of Medicine, University of Southern California, Children's Hospital of Los Angeles, Los Angeles, CA, United States
| | - Elizabeth R Sowell
- Department of Pediatrics, Keck School of Medicine, University of Southern California, Children's Hospital of Los Angeles, Los Angeles, CA, United States; Department of Neurology, University of California at Los Angeles, Los Angeles, CA, United States.
| |
Collapse
|
42
|
Li B, Hou Y, Zhu M, Bao H, Nie J, Zhang GY, Shan L, Yao Y, Du K, Yang H, Li M, Zheng B, Xu X, Xiao C, Du J. 3'-Deoxyadenosine (Cordycepin) Produces a Rapid and Robust Antidepressant Effect via Enhancing Prefrontal AMPA Receptor Signaling Pathway. Int J Neuropsychopharmacol 2015; 19:pyv112. [PMID: 26443809 PMCID: PMC4851261 DOI: 10.1093/ijnp/pyv112] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/29/2015] [Accepted: 09/29/2015] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND The development of rapid and safe antidepressants for the treatment of major depression is in urgent demand. Converging evidence suggests that glutamatergic signaling seems to play important roles in the pathophysiology of depression. METHODS We studied the antidepressant effects of 3(')-deoxyadenosine (3'-dA, Cordycepin) and the critical role of the α-amino-3-hydroxy-5-methyl-4-isoxazole propionic acid (AMPA) receptor in male CD-1 mice via behavioral and biochemical experiments. After 3'-dA treatment, the phosphorylation and synaptic localization of the AMPA receptors GluR1 and GluR2 were determined in the prefrontal cortex (PFC) and hippocampus (HIP). The traditional antidepressant imipramine was applied as a positive control. RESULTS We found that an injection of 3'-dA led to a rapid and robust antidepressant effect, which was significantly faster and stronger than imipramine, after 45min in tail suspension and forced swim tests. This antidepressant effect remained after 5 days of treatment with 3'-dA. Unlike the psycho-stimulants, 3'-dA did not show a hyperactive effect in the open field test. After 45min or 5 days of treatment, 3'-dA enhanced GluR1 S845 phosphorylation in both the PFC and HIP. In addition, after 45min of treatment, 3'-dA significantly up-regulated GluR1 S845 phosphorylation and GluR1, but not GluR2 levels, at the synapses in the PFC. After 5 days of treatment, 3'-dA significantly enhanced GluR1 S845 phosphorylation and GluR1, but not GluR2, at the synapses in the PFC and HIP. Moreover, the AMPA-specific antagonist GYKI 52466 was able to block the rapid antidepressant effects of 3'-dA. CONCLUSION This study identified 3'-dA as a novel rapid antidepressant with clinical potential and multiple beneficial mechanisms, particularly in regulating the prefrontal AMPA receptor signaling pathway.
Collapse
Affiliation(s)
- Bai Li
- *These authors contributed equally to this work
| | | | - Ming Zhu
- *These authors contributed equally to this work
| | | | | | | | | | | | | | | | | | | | | | | | - Jing Du
- #These two authors are co-corresponding authors
| |
Collapse
|
43
|
Kampman KM, Lynch KG, Pettinati HM, Spratt K, Wierzbicki MR, Dackis C, O'Brien CP. A double blind, placebo controlled trial of modafinil for the treatment of cocaine dependence without co-morbid alcohol dependence. Drug Alcohol Depend 2015; 155:105-10. [PMID: 26320827 PMCID: PMC4582003 DOI: 10.1016/j.drugalcdep.2015.08.005] [Citation(s) in RCA: 57] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/12/2015] [Revised: 08/08/2015] [Accepted: 08/11/2015] [Indexed: 10/23/2022]
Abstract
BACKGROUND Modafinil is a medication approved for narcolepsy and shift work sleep disorder. It has both dopaminergic and glutamatergic activity that could be useful for the treatment of cocaine dependence. Modafinil has reduced cocaine subjective effects and cocaine self-administration in human laboratory trials and has reduced cocaine use in cocaine dependent patients in some clinical trials. METHODS This was an 8-week, double blind, placebo controlled clinical trial involving 94 cocaine dependent subjects. Subjects received 300mg of modafinil or identical placebo daily along with weekly individual therapy. The primary outcome measure was cocaine use measured by self-report, and confirmed by twice weekly urine benzoylecgonine tests (UBT). Additional outcome measures included cocaine craving measured by the Brief Substance Craving Scale and global improvement measured by the Clinical Global Impression Scale (CGI). RESULTS The odds ratio (OR) in favor of abstinence for modafinil vs. placebo was 2.54 (p=. 03) and modafinil-treated subjects were significantly more likely than placebo-treated subjects to be abstinent from cocaine during the last 3 weeks of the trial, 23% vs. 9%, χ(2)=3.9, p<.05. Modafinil treated subjects were more likely to report very low levels of cocaine craving intensity and duration on the Brief Substance Craving Scale (OR=2.04, p=.03 and OR 1.06, p=.03 respectively). Modafinil-treated subjects were also more likely than placebo-treated subjects to rate themselves as "very much improved" on the CGI (OR=2.69, p=.03). CONCLUSION Modafinil may be an efficacious treatment for cocaine dependence.
Collapse
Affiliation(s)
- Kyle M. Kampman
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, 3900 Chestnut Street, Philadelphia, PA, USA, 19104
| | - Kevin G. Lynch
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, 3900 Chestnut Street, Philadelphia, PA, USA, 19104
| | - Helen M. Pettinati
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, 3900 Chestnut Street, Philadelphia, PA, USA, 19104
| | - Kelly Spratt
- Department of Medicine, Perelman School of Medicine, University of Pennsylvania, 3400 Spruce Street, Philadelphia, PA, USA, 19104
| | - Michael R. Wierzbicki
- Center for Clinical Epidemiology and Biostatistics, Perelman School of Medicine, University of Pennsylvania, 3400 Spruce Street, Philadelphia, PA, USA, 19104
| | - Charles Dackis
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, 3900 Chestnut Street, Philadelphia, PA, USA, 19104
| | - Charles P. O'Brien
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, 3900 Chestnut Street, Philadelphia, PA, USA, 19104
| |
Collapse
|
44
|
Murray DE, Durazzo TC, Mon A, Schmidt TP, Meyerhoff DJ. Brain perfusion in polysubstance users: relationship to substance and tobacco use, cognition, and self-regulation. Drug Alcohol Depend 2015; 150:120-8. [PMID: 25772434 PMCID: PMC4387082 DOI: 10.1016/j.drugalcdep.2015.02.022] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/25/2014] [Revised: 02/17/2015] [Accepted: 02/17/2015] [Indexed: 10/23/2022]
Abstract
BACKGROUND Brain perfusion is altered in both alcohol dependence and stimulant dependence. Although most substance users also abuse/depend on alcohol concurrently (polysubstance users; PSU), rigorous perfusion research in PSU is limited. Also, the relationships of perfusion abnormalities with cognition, impulsivity, or decision making are not well known. METHODS Arterial spin labeling MRI and neuropsychological measures assessed perfusion levels and neurocognition in 20 alcohol-dependent individuals with comorbid-stimulant dependence (PSU), 26 individuals dependent on alcohol only (ALC), and 31 light/non-drinking controls (LD). The patient groups included smokers and non-smokers. RESULTS ALC had lower perfusion than LD in subcortical and cortical brain regions including the brain reward/executive oversight system (BREOS). Contrary to our hypothesis, regional perfusion was generally not lower in PSU than ALC. However, smoking PSU had lower perfusion than smoking ALC in several regions, including BREOS. Lower BREOS perfusion related to greater drinking severity in smoking substance users and to greater smoking severity in smoking ALC. Lower regional perfusion in ALC and PSU correlated with worse performance in different cognitive domains; smoking status affected perfusion-cognition relationships in ALC only. Lower BREOS perfusion in both substance using groups related to higher impulsivity. CONCLUSION Although regional perfusion was not decreased in PSU as a group, the combination of cigarette smoking and polysubstance use is strongly related to hypoperfusion in important cortical and subcortical regions. As lower perfusion relates to greater smoking severity, worse cognition and higher impulsivity, smoking cessation is warranted for treatment-seeking PSU and ALC.
Collapse
Affiliation(s)
- Donna E. Murray
- Center for Imaging of Neurodegenerative Diseases (CIND), San Francisco VA Medical Center, San Francisco, CA,Department of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, CA,Please send correspondence to: Donna E. Murray, Center for Imaging of Neurodegenerative Diseases (114M), San Francisco VA Medical Center, 4150 Clement Street (114M), San Francisco, CA 94121, USA, Office: 415-221-4810 x2553, Fax: 415-668-2864,
| | - Timothy C. Durazzo
- Center for Imaging of Neurodegenerative Diseases (CIND), San Francisco VA Medical Center, San Francisco, CA,Department of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, CA
| | - Anderson Mon
- School of Applied Sciences and Statistics, Koforidua Polytechnic, Ghana
| | - Thomas P. Schmidt
- Center for Imaging of Neurodegenerative Diseases (CIND), San Francisco VA Medical Center, San Francisco, CA,Department of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, CA
| | - Dieter J. Meyerhoff
- Center for Imaging of Neurodegenerative Diseases (CIND), San Francisco VA Medical Center, San Francisco, CA,Department of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, CA
| |
Collapse
|
45
|
Pennay A, Miller P, Busija L, Jenkinson R, Droste N, Quinn B, Jones SC, Lubman DI. 'Wide-awake drunkenness'? Investigating the association between alcohol intoxication and stimulant use in the night-time economy. Addiction 2015; 110:356-65. [PMID: 25220360 DOI: 10.1111/add.12742] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/27/2014] [Revised: 07/08/2014] [Accepted: 09/09/2014] [Indexed: 11/30/2022]
Abstract
AIMS We tested whether patrons of the night-time economy who had co-consumed energy drinks or illicit stimulants with alcohol had higher blood alcohol concentration (BAC) levels than patrons who had consumed only alcohol. DESIGN Street intercept surveys (n = 4227) were undertaken between 9 p.m. and 5 a.m. over a period of 7 months. SETTING Interviews were undertaken with patrons walking through entertainment precincts, queuing to enter venues or exiting venues in five Australian cities. PARTICIPANTS The response rate was 92.1%; more than half the study sample was male (60.2%) and the median age was 23 years (range 18-72). MEASUREMENTS Data were collected on demographics, length of drinking session, venue types visited, types and quantity of alcohol consumed and other substance use. A BAC reading was recorded and a subsample of participants was tested for other drug use. FINDINGS Compared with the total sample (0.068%), illicit stimulant consumers (0.080%; P = 0.004) and energy drink consumers (0.074%; P < 0.001) had a significantly higher median BAC reading, and were more likely to engage in pre-drinking (65.6, 82.1 and 77.6%, respectively, P < 0.001) and longer drinking sessions (4, 5 and 4.5 hours, respectively, P < 0.001). However, stimulant use was not associated independently with higher BAC in the final multivariable model (illicit stimulants P = 0.198; energy drinks P = 0.112). Interaction analyses showed that stimulant users had a higher BAC in the initial stages of the drinking session, but not after 4-6 hours. CONCLUSIONS While stimulant use does not predict BAC in and of itself, stimulants users are more likely to engage in prolonged sessions of heavy alcohol consumption and a range of risk-taking behaviours on a night out, which may explain higher levels of BAC among stimulants users, at least in the initial stages of the drinking session.
Collapse
Affiliation(s)
- Amy Pennay
- Centre for Health Equity, Melbourne School of Population and Global Health, University of Melbourne and Centre for Alcohol Policy Research, Turning Point, Eastern Health, Melbourne, Vic, Australia
| | | | | | | | | | | | | | | |
Collapse
|
46
|
Abstract
Illicit stimulants, such as cocaine, amphetamine, and their derivatives (e.g., "ecstasy"), continue to exact heavy toll on health care in both developed and developing countries. The US Department of Health and Human Service reported over one million illicit drug-related emergency department visits in 2010, which was higher than any of the six previous years. Both inhaled and intravenous forms of these substances of abuse can result in a variety of acute and chronic injuries to practically every part of the respiratory tract, leading potentially to permanent morbidities as well as fatal consequences--including but not limited to nasal septum perforation, pulmonary hypertension, pneumothorax, pneumomediastinum, interstitial lung disease, alveolar hemorrhage, reactive airway disease, pulmonary edema, pulmonary granulomatosis, infections, foreign body aspiration, infections, bronchoconstriction, and thermal injuries. Stimulants are all rapidly absorbed substances that can also significantly alter the patient's systemic acid-base balance and central nervous system, thereby leading to further respiratory compromise. Mounting evidence in the past decade has demonstrated that adulterants coinhaled with these substances (e.g., levamisole) and the metabolites of these substances (e.g., cocaethylene) are associated with specific forms of systemic and respiratory complications as well. Recent studies have also demonstrated the effects of stimulants on autoimmune-mediated injuries of the respiratory tract, such as cocaine-induced midline destructive lesions. A persistent challenge to studies involving stimulant-associated respiratory toxidromes is the high prevalence of concomitant usage of various substances by drug abusers, including tobacco smoking. Now more than ever, health care providers must be familiar with the multitude of respiratory toxidromes as well as the diverse pathophysiology related to commonly abused stimulants to provide timely diagnosis and effective treatment.
Collapse
|
47
|
Pettinati HM, Kampman KM, Lynch KG, Dundon WD, Mahoney EM, Wierzbicki MR, O'Brien CP. A pilot trial of injectable, extended-release naltrexone for the treatment of co-occurring cocaine and alcohol dependence. Am J Addict 2014; 23:591-7. [PMID: 25251201 DOI: 10.1111/j.1521-0391.2014.12146.x] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2013] [Revised: 04/21/2014] [Accepted: 05/01/2014] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND There is a high co-occurrence of cocaine and alcohol use disorders, and patients with both of these problems are difficult to treat. There is a reasonable rationale and some empirical data to justify a pilot trial of an injectable, extended-release formulation of naltrexone for treating co-occurring cocaine and alcohol addiction. METHODS Eighty cocaine (n = 80) and alcohol dependent, treatment-seeking subjects were randomly assigned to receive either two monthly extended-release injections of naltrexone or two matching placebo injections in an 8-week clinical trial, with weekly medical management plus cognitive behavioral therapy visits. RESULTS No differences in reduction in cocaine or alcohol use were observed between the injectable naltrexone and placebo groups during the 8-week trial. CONCLUSIONS Injectable extended-release naltrexone, while an ideal method for ensuring medication adherence in these traditionally hard-to-treat patients, did not result in any measurable reduction in cocaine or alcohol use over the course of 8 weeks of treatment.
Collapse
Affiliation(s)
- Helen M Pettinati
- Department of Psychiatry, Center for the Studies of Addiction, University of Pennsylvania, Perelman School of Medicine, Philadelphia, Pennsylvania
| | | | | | | | | | | | | |
Collapse
|
48
|
Devoto P, Flore G, Saba P, Bini V, Gessa GL. The dopamine beta-hydroxylase inhibitor nepicastat increases dopamine release and potentiates psychostimulant-induced dopamine release in the prefrontal cortex. Addict Biol 2014; 19:612-22. [PMID: 23289939 DOI: 10.1111/adb.12026] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
The dopamine-beta-hydroxylase inhibitor nepicastat has been shown to reproduce disulfiram ability to suppress the reinstatement of cocaine seeking after extinction in rats. To clarify its mechanism of action, we examined the effect of nepicastat, given alone or in association with cocaine or amphetamine, on catecholamine release in the medial prefrontal cortex and the nucleus accumbens, two key regions involved in the reinforcing and motivational effects of cocaine and in the reinstatement of cocaine seeking. Nepicastat effect on catecholamines was evaluated by microdialysis in freely moving rats. Nepicastat reduced noradrenaline release both in the medial prefrontal cortex and in the nucleus accumbens, and increased dopamine release in the medial prefrontal cortex but not in the nucleus accumbens. Moreover, nepicastat markedly potentiated cocaine- and amphetamine-induced extracellular dopamine accumulation in the medial prefrontal cortex but not in the nucleus accumbens. Extracellular dopamine accumulation produced by nepicastat alone or by its combination with cocaine or amphetamine was suppressed by the α2 -adrenoceptor agonist clonidine. It is suggested that nepicastat, by suppressing noradrenaline synthesis and release, eliminated the α2 -adrenoceptor mediated inhibitory mechanism that constrains dopamine release and cocaine- and amphetamine-induced dopamine release from noradrenaline or dopamine terminals in the medial prefrontal cortex.
Collapse
Affiliation(s)
- Paola Devoto
- Department of Biomedical Sciences; Neuroscience and Clinical Pharmacology Division; University of Cagliari; Italy
- Center of Excellence ‘Neurobiology of Addiction’; University of Cagliari; Italy
- ‘Guy Everett Laboratory’; University of Cagliari; Italy
| | - Giovanna Flore
- Department of Medical Sciences ‘M. Aresu’; University of Cagliari; Italy
| | - Pierluigi Saba
- Department of Biomedical Sciences; Neuroscience and Clinical Pharmacology Division; University of Cagliari; Italy
| | - Valentina Bini
- Department of Biomedical Sciences; Neuroscience and Clinical Pharmacology Division; University of Cagliari; Italy
| | - Gian Luigi Gessa
- Department of Biomedical Sciences; Neuroscience and Clinical Pharmacology Division; University of Cagliari; Italy
- Center of Excellence ‘Neurobiology of Addiction’; University of Cagliari; Italy
- ‘Guy Everett Laboratory’; University of Cagliari; Italy
| |
Collapse
|
49
|
Graziani M, Nencini P, Nisticò R. Genders and the concurrent use of cocaine and alcohol: Pharmacological aspects. Pharmacol Res 2014; 87:60-70. [PMID: 24972039 DOI: 10.1016/j.phrs.2014.06.009] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/25/2014] [Revised: 06/13/2014] [Accepted: 06/16/2014] [Indexed: 12/19/2022]
Abstract
AIMS Gender-related differences in the pharmacological effects of addictive drug are an emerging issue. This review examines gender differences in both pharmacokinetic and pharmacodynamic aspects of alcohol and cocaine intake since they cause complex pharmacological interactions, not least the formation of the active metabolite cocaethylene. METHODS The MEDLINE database was searched from 1990 to 2014 in order to find articles related to gender differences in alcohol, cocaine and cocaethylene pharmacokinetics and pharmacodynamics. RESULTS Besides the well known gender differences in alcohol pharmacokinetics, women appear more susceptible to alcohol-mediated brain damage and seem to suffer more than men the acute effects of alcohol on hepatic and gonadal hormones. No significant gender differences have been found in the pharmacokinetics of cocaine taken alone; yet, in women pharmacological sensitivity to the drug seems to vary in relation to menstrual cycle; moreover, progesterone attenuates subjective effects of cocaine in women. Higher ratings at a subjective measure of mental/physical well-being have been observed in women when given cocaine and alcohol, alone or in combination. Finally, among subjects dependent on both alcohol and cocaine, men only benefit from naltrexone, whereas women used more cocaine during the trial and were less compliant to therapy than men. CONCLUSIONS The observed subtle gender differences in the pharmacokinetics and pharmacodynamics of both alcohol and cocaine may have no subtle influence on the natural history of the co-abuse of the two drugs by women.
Collapse
Affiliation(s)
- Manuela Graziani
- Department of Physiology and Pharmacology "Vittorio Erspamer", Sapienza University of Rome, Rome, Italy; Drug Addiction and Clinical Pharmacology Unit, University Hospital Umberto I, Sapienza University of Rome, Rome, Italy.
| | - Paolo Nencini
- Department of Physiology and Pharmacology "Vittorio Erspamer", Sapienza University of Rome, Rome, Italy; Drug Addiction and Clinical Pharmacology Unit, University Hospital Umberto I, Sapienza University of Rome, Rome, Italy
| | - Robert Nisticò
- Department of Physiology and Pharmacology "Vittorio Erspamer", Sapienza University of Rome, Rome, Italy; IRCSS Santa Lucia Foundation, Rome, Italy
| |
Collapse
|
50
|
Fox HC, Morgan PT, Sinha R. Sex differences in guanfacine effects on drug craving and stress arousal in cocaine-dependent individuals. Neuropsychopharmacology 2014; 39:1527-37. [PMID: 24395021 PMCID: PMC3988558 DOI: 10.1038/npp.2014.1] [Citation(s) in RCA: 83] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/23/2013] [Revised: 11/08/2013] [Accepted: 11/11/2013] [Indexed: 12/12/2022]
Abstract
Currently, no FDA-approved medication exists for the treatment of cocaine use disorder. Furthermore, as women become increasingly more at risk for the consequences of cocaine addiction, the need to establish better-tailored treatment medications is paramount. We examine the effects of the alpha2 adrenergic agonist, guanfacine HCl, on responses to stress and drug cue in a group of cocaine-dependent men and women who also abuse alcohol and nicotine. Forty early abstinent treatment-seeking cocaine-dependent males and females were randomly assigned to receive either daily placebo (12 M/7 F) or guanfacine (2 or 3 mg) (15 M/6 F) for 3 weeks. In week 4, they participated in a laboratory experiment and were exposed to three 10-min guided imagery conditions (stress/stress, cue/cue, and stress/cue), one per day, consecutively in a random, counterbalanced order. Craving, negative emotion, anxiety, and cardiovascular function were assessed at baseline, immediately following imagery exposure, and at various recovery time points. Guanfacine significantly attenuated cocaine craving, alcohol craving, anxiety, and negative emotion following exposure to all three imagery conditions in females, but not males. Guanfacine did, however, reduce sympathetic tone as well as stress and cue-induced nicotine craving and systolic blood pressure (SBP) in both males and females. These findings highlight sex-specific effects of guanfacine on drug craving, anxiety, and negative mood with significant effects in women and not men. The findings suggest further evaluation of guanfacine in the treatment of cocaine use disorder with a specific focus on sex differences in treatment response.
Collapse
Affiliation(s)
- Helen C Fox
- Department of Psychiatry, The Connecticut Mental Health Center, Yale University School of Medicine, New Haven, CT, USA
| | - Peter T Morgan
- Department of Psychiatry, The Connecticut Mental Health Center, Yale University School of Medicine, New Haven, CT, USA
| | - Rajita Sinha
- Department of Psychiatry, The Yale Stress Center, Yale University School of Medicine, New Haven, CT, USA,Department of Psychiatry, The Yale Stress Center, Yale University School of Medicine, 2 Church Street South Suite 209, New Haven, CT 06519, USA, Tel: +1 203 737 5805, Fax: +1 203 974 7076, E-mail:
| |
Collapse
|