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Demir B, Ozsoy F, Buyuk A, Altindag A. ECG changes in patients with opioid use disorder; P-QT wave dispersion: a retrospective study. J Addict Dis 2020; 39:234-240. [PMID: 33215556 DOI: 10.1080/10550887.2020.1848257] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
OBJECTIVE We aimed to examine the electrocardiographic arrhythmia risk predictors in patients with opioid use disorder by P wave dispersion, QT dispersion, and by comparing Tp-e/QTc ratio with healthy controls. METHODS One hundred seventeen patients who were diagnosed with opioid use disorder according to DSM-5 criteria and who were hospitalized in 25 Aralık Gaziantep State Hospital AMATEM (Alcohol and substance addiction treatment center) service and a healthy control group consisting of 168 subjects were included in the study. Electrocardiography (ECG) scans of all participants were performed in the supine position and at rest. P wave dispersion, QT dispersion, and Tp-e/QTc ratio were calculated. RESULTS Of all the participants, 12 were women (4.21%), 273 (95.78%) were men. The mean age of all participants was 30.42 ± 9.36 years. No difference was found between the gender, mean age, marital status, educational level, and smoking status of the participants (p > 0.05). The entire patient group was using heroin. Heart rate of the patient group was calculated as 68.14 ± 13.26 beats per minute, being lower than healthy controls (p < 0.05). Although QT dispersion value was lower than healthy controls (p < 0.05); P wave dispersion did not differ between groups (p > 0.05). CONCLUSION It is thought that the patients with opioid use disorder are at risk for cardiac arrhythmia based on our findings. Therefore, physicians should be careful about cardiac rhythm and conduction problems while organizing any treatment of these patients.
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Affiliation(s)
- Bahadir Demir
- Department of Psychiatry, Faculty of Medicine, Gaziantep University, Gaziantep, Turkey
| | - Filiz Ozsoy
- Clinic of Psychiatry, Tokat State Hospital, Tokat, Turkey
| | - Ahmet Buyuk
- 25 December State Hospital, Clinic of Cardiology, Gaziantep, Turkey
| | - Abdurrahman Altindag
- Department of Psychiatry, Faculty of Medicine, Gaziantep University, Gaziantep, Turkey
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Abstract
Heroin addiction is a complex psychiatric disorder with a chronic course and a high relapse rate, which results from the interaction between genetic and environmental factors. Heroin addiction has a substantial heritability in its etiology; hence, identification of individuals with a high genetic propensity to heroin addiction may help prevent the occurrence and relapse of heroin addiction and its complications. The study aimed to identify a small set of genetic signatures that may reliably predict the individuals with a high genetic propensity to heroin addiction. We first measured the transcript level of 13 genes (RASA1, PRKCB, PDK1, JUN, CEBPG, CD74, CEBPB, AUTS2, ENO2, IMPDH2, HAT1, MBD1, and RGS3) in lymphoblastoid cell lines in a sample of 124 male heroin addicts and 124 male control subjects using real-time quantitative PCR. Seven genes (PRKCB, PDK1, JUN, CEBPG, CEBPB, ENO2, and HAT1) showed significant differential expression between the 2 groups. Further analysis using 3 statistical methods including logistic regression analysis, support vector machine learning analysis, and a computer software BIASLESS revealed that a set of 4 genes (JUN, CEBPB, PRKCB, ENO2, or CEBPG) could predict the diagnosis of heroin addiction with the accuracy rate around 85% in our dataset. Our findings support the idea that it is possible to identify genetic signatures of heroin addiction using a small set of expressed genes. However, the study can only be considered as a proof-of-concept study. As the establishment of lymphoblastoid cell line is a laborious and lengthy process, it would be more practical in clinical settings to identify genetic signatures for heroin addiction directly from peripheral blood cells in the future study.
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Affiliation(s)
- Shaw-Ji Chen
- Institute of Medical Sciences, Tzu Chi University, Hualien
- Department of Psychiatry, Mackay Memorial Hospital, Taitung Branch
| | - Ding-Lieh Liao
- Department of Health Executive Yuan, Bali Psychiatric Center
| | - Tsu-Wang Shen
- Institute of Medical Sciences, Tzu Chi University, Hualien
| | - Hsin-Chou Yang
- Institute of Statistical Science, Academia Sinica, Taipei
| | - Kuang-Chi Chen
- Institute of Medical Sciences, Tzu Chi University, Hualien
| | - Chia-Hsiang Chen
- Department of Psychiatry, Chang Gung Memorial Hospital at Linkou
- Department and Graduate Institute of Biomedical Sciences, Chang Gung University, Taoyuan, Taiwan
- Correspondence: Chia-Hsiang Chen, Department of Psychiatry, Chang Gung Memorial Hospital at Linkou, No. 5 Fusing Street, Kueishan, Taoyuan, 333 Taiwan (e-mail: )
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Dissociation of heroin-induced emotional dysfunction from psychomotor activation and physical dependence among inbred mouse strains. Psychopharmacology (Berl) 2015; 232:1957-71. [PMID: 25482274 DOI: 10.1007/s00213-014-3826-5] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/02/2014] [Accepted: 11/20/2014] [Indexed: 01/10/2023]
Abstract
RATIONALE Opiate addiction is a brain disorder emerging through repeated intoxication and withdrawal episodes. Epidemiological studies also indicate that chronic exposure to opiates may lead in susceptible individuals to the emergence of depressive symptoms, strongly contributing to the severity and chronicity of addiction. We recently established a mouse model of heroin abstinence, characterized by the development of depressive-like behaviors following chronic heroin exposure. OBJECTIVES While genetic factors regulating immediate behavioral responses to opiates have been largely investigated, little is known about their contribution to long-term emotional regulation during abstinence. Here, we compared locomotor stimulation and physical dependence induced by heroin exposure, as well as emotional dysfunction following abstinence, across mice strains with distinct genetic backgrounds. METHODS Mice from three inbred strains (C57BL/6J, Balb/cByJ, and 129S2/SvPas) were exposed to an escalating chronic heroin regimen (10-50 mg/kg). Independent cohorts were used to assess drug-induced locomotor activity during chronic treatment, naloxone-precipitated withdrawal at the end of chronic treatment, and emotional-like responses after a 4-week abstinence period. RESULTS Distinct behavioral profiles were observed across strains during heroin treatment, with no physical dependence and low locomotor stimulation in 129S2/SvPas. In addition, different behavioral impairments developed during abstinence across the three strains, with increased despair-like behavior in 129S2/SvPas and Balb/cByJ, and low sociability in 129S2/SvPas and C57BL/6J. CONCLUSIONS Our results indicate that depressive-like behaviors emerge during heroin abstinence, whatever the severity of immediate behavioral responses to the drug. In addition, inbred mouse strains will allow studying several aspects of mood-related deficits associated with addiction.
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Abstract
Early studies documented an inverse association between the HIV risk and duration of injection among injection drug users (IDUs). Results from subsequent studies have been inconsistent. To examine this issue, we conducted interviews with 395 street-recruited active IDUs from 38 neighborhoods in New York City during 2005 and 2008. We observed no significant differences in drug or risky sex behaviors by duration of drug use among these IDUs. Despite this, continuing to tailor HIV prevention programs for these recent-onset IDUs is prudent. The study's limitations are noted.
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Affiliation(s)
- David Vlahov
- Center for Urban Epidemiologic Studies, New York Academy of Medicine, New York, New York 10029, USA.
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Cunningham JK, Maxwell JC, Campollo O, Cunningham KI, Liu LM, Lin HL. Proximity to the US-Mexico border: a key to explaining geographic variation in US methamphetamine, cocaine and heroin purity. Addiction 2010; 105:1785-98. [PMID: 20682010 DOI: 10.1111/j.1360-0443.2010.03032.x] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
AIMS Although illicit drug purity is a widely discussed health risk, research explaining its geographic variation within a country is rare. This study examines whether proximity to the US-Mexico border, the United States' primary drug import portal, is associated with geographic variation in US methamphetamine, heroin and cocaine purity. DESIGN Distances (proximity) between the US-Mexico border and locations of methamphetamine, cocaine and heroin seizures/acquisitions (n = 239,070) recorded in STRIDE (System to Retrieve Information from Drug Evidence) were calculated for the period of 1990-2004. The association of drug purity with these distances and other variables, including time and seizure/acquisition size, was examined using hierarchical multivariate linear modeling (HMLM). SETTING Coterminous United States. FINDINGS Methamphetamine, cocaine and heroin purity generally decreased with distance from the US-Mexico border. Heroin purity, however, after initially declining with distance, turned upwards-a U-shaped association. During 2000-04, methamphetamine purity also had a U-shaped association with distance. For each of the three drugs, temporal changes in the purity of small acquisitions (<10 g) were typically more dynamic in areas closer to the US-Mexico border. CONCLUSIONS Geographic variance in methamphetamine, cocaine and heroin purity throughout the coterminous United States was associated with US-Mexico border proximity. The U-shaped associations between border-distance and purity for heroin and methamphetamine may be due to imports of those drugs via the eastern United States and southeast Canada, respectively. That said, areas closer to the US-Mexico border generally had relatively high illicit drug purity, as well as more dynamic change in the purity of small ('retail level') drug amounts.
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Affiliation(s)
- James K Cunningham
- Department of Family and Community Medicine, The University of Arizona, Tucson, AZ 85719, USA.
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Cunningham JK, Liu LM, Callaghan R. Impact of US and Canadian precursor regulation on methamphetamine purity in the United States. Addiction 2009; 104:441-53. [PMID: 19207353 DOI: 10.1111/j.1360-0443.2008.02458.x] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
AIMS Reducing drug purity is a major, but largely unstudied, goal of drug suppression. This study examines whether US methamphetamine purity was impacted by the suppression policy of US and Canadian precursor chemical regulation. DESIGN Autoregressive integrated moving average (ARIMA)-intervention time-series analysis. SETTING Continental United States and Hawaii (1985-May 2005). Interventions US federal regulations targeting precursors, ephedrine and pseudoephedrine, in forms used by large-scale producers were implemented in November 1989, August 1995 and October 1997. US regulations targeting precursors in forms used by small-scale producers (e.g. over-the-counter medications) were implemented in October 1996 and October 2001. Canada implemented federal precursor regulations in January 2003 and July 2003 and an essential chemical (e.g. acetone) regulation in January 2004. MEASUREMENTS Monthly median methamphetamine purity series. FINDINGS US regulations targeting large-scale producers were associated with purity declines of 16-67 points; those targeting small-scale producers had little or no impact. Canada's precursor regulations were associated with purity increases of 13-15 points, while its essential chemical regulation was associated with a 13-point decrease. Hawaii's purity was consistently high, and appeared to vary little with the 1990s/2000s regulations. CONCLUSIONS US precursor regulations targeting large-scale producers were associated with substantial decreases in continental US methamphetamine purity, while regulations targeting over-the-counter medications had little or no impact. Canada's essential chemical regulation was also associated with a decrease in continental US purity. However, Canada's precursor regulations were associated with purity increases: these regulations may have impacted primarily producers of lower-quality methamphetamine, leaving higher-purity methamphetamine on the market by default. Hawaii's well-known preference for 'ice' (high-purity methamphetamine) may have helped to constrain purity there to a high, attenuated range, possibly limiting its sensitivity to precursor regulation.
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Affiliation(s)
- James K Cunningham
- Department of Family and Community Medicine, The University of Arizona, Tucson, AZ 85719, USA.
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Klein G, Juni A, Waxman AR, Arout CA, Inturrisi CE, Kest B. A survey of acute and chronic heroin dependence in ten inbred mouse strains: evidence of genetic correlation with morphine dependence. Pharmacol Biochem Behav 2008; 90:447-52. [PMID: 18472145 PMCID: PMC3627368 DOI: 10.1016/j.pbb.2008.03.030] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/22/2007] [Revised: 03/18/2008] [Accepted: 03/29/2008] [Indexed: 10/22/2022]
Abstract
Heroin and morphine exposure can cause physical dependence, with symptoms manifesting during their withdrawal. Inter-individual differences in symptom frequency during morphine withdrawal are a common finding that, in rodents, is demonstrably attributable to genotype. However, it is not known whether inter-individual differences characterize heroin withdrawal, and whether such variation can be similarly influenced by genotype. Therefore, we injected mice of ten inbred strains with acute and chronic heroin doses and compared their jumping frequencies, a common index of withdrawal magnitude, during naloxone-precipitated withdrawal. The data revealed significant strain frequency differences (range after acute and chronic heroin injection: 0-104 and 0-142 jumps, respectively) and substantial heritability (h(2)=0.94 to 0.96), indicating that genetic variance is associated with heroin withdrawal. The rank order of strain sensitivity for acute and chronic heroin withdrawal jumping, and for the current heroin and previous morphine strain data, were significantly correlated (r=0.75-0.94), indicating their genetic and, ultimately, physiological commonality. These data suggest that the genetic liability to heroin dependence remains constant across a period of heroin intake, and that heroin and morphine dependence may benefit from common treatment strategies.
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Affiliation(s)
- Gad Klein
- Neuropsychology Doctoral Subprogram Queens College, City University of New York Flushing, NY 11367
| | - Aaron Juni
- Neuropsychology Doctoral Subprogram Queens College, City University of New York Flushing, NY 11367
| | - Amanda R. Waxman
- Neuropsychology Doctoral Subprogram Queens College, City University of New York Flushing, NY 11367
| | - Caroline A. Arout
- Department of Psychology and Center for Developmental Neuroscience The College of Staten Island, City University of New York Staten Island, NY 10314
| | - Charles E. Inturrisi
- Department of Pharmacology, Weill Medical College, Cornell University New York, NY 10021
| | - Benjamin Kest
- Neuropsychology Doctoral Subprogram Queens College, City University of New York Flushing, NY 11367
- Department of Psychology and Center for Developmental Neuroscience The College of Staten Island, City University of New York Staten Island, NY 10314
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Neeley WW, Kluemper GT, Hays LR. Psychiatry in orthodontics. Part 2: Substance abuse among adolescents and its relevance to orthodontic practice. Am J Orthod Dentofacial Orthop 2006; 129:185-93. [PMID: 16473709 DOI: 10.1016/j.ajodo.2005.11.005] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2005] [Revised: 09/04/2005] [Accepted: 09/04/2005] [Indexed: 10/25/2022]
Abstract
Substance abuse by adolescents is a serious problem that will touch every orthodontic practice. Recent data show that 40% of tenth graders in the United States will use an illicit drug at some time, and 18% will do so in a 30-day period. These are significant figures that should impact orthodontic diagnosis and treatment planning. The nature of orthodontic treatment is unique in that the orthodontist will see relatively healthy adolescent patients on a monthly basis over a period of years. The orthodontist is in a prime position to recognize potential substance abuse problems and make referrals. This article discusses various types of substance abuse, diagnosis, options for referral, and orthodontic implications.
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Affiliation(s)
- Wendell W Neeley
- University of Texas Health Science Center School of Dentistry, San Antonio, Texas, USA.
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Wang J, Barke RA, Charboneau R, Roy S. Morphine Impairs Host Innate Immune Response and Increases Susceptibility toStreptococcus pneumoniaeLung Infection. THE JOURNAL OF IMMUNOLOGY 2004; 174:426-34. [PMID: 15611267 DOI: 10.4049/jimmunol.174.1.426] [Citation(s) in RCA: 139] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Chronic morphine use impairs host innate immune response and increases susceptibility to bacteria and virus. In this study a novel mouse model of chronic morphine treatment, followed by intranasal inoculation with Streptococcus pneumoniae, was used to investigate microbial events and host innate immune response. Our results show that chronic morphine treatment markedly delayed neutrophil recruitment and increased bacterial burden in the lung, spleen, and blood with a subsequent increase in mortality. In morphine-treated animals, before neutrophil recruitment, a significant decrease in TNF-alpha, IL-1, IL-6, MIP-2, and KC was observed both in bronchoalveolar lavage fluids and in lung tissue. In the early phase of infection, we found that accumulation of galectin-3 in the alveolar space of streptococcus-infected lungs was decreased after morphine treatment. The transcription factor NF-kappaB in lung resident cells was also inhibited after morphine treatment. Taken together, these results suggest that chronic morphine treatment in an S. pneumoniae infection model suppresses NF-kappaB gene transcription in lung resident cells, which, in turn, modulates the transcriptional regulation of MIP-2 and inflammatory cytokines. The decreased synthesis of MIP-2 and inflammatory cytokines coupled with the decreased release of galectin-3 result in reduced migration of neutrophils to the site of infection, thereby increasing susceptibility to S. pneumoniae infection after morphine treatment.
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Affiliation(s)
- Jinghua Wang
- Department of Pharmacology, University of Minnesota, 321 Church Street SE, Minneapolis, MN 55455, USA
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