Pharmacotherapy of drug abusers: adjunctive psychopharmacologic management of nonopiate mixed substance abusers in an outpatient setting

Lithium in drinking water and the incidences of crimes, suicides, and arrests related to drug addictions

Using data for 27 Texas counties from 1978-1987, it is shown that the incidence rates of suicide, homicide, and rape are significantly higher in counties whose drinking water supplies contain little or no lithium than in counties with water lithium levels ranging from 70-170 micrograms/L; the differences remain statistically significant (p less than 0.01) after corrections for population density. The corresponding associations with the incidence rates of robbery, burglary, and theft were statistically significant with p less than 0.05. These results suggest that lithium has moderating effects on suicidal and violent criminal behavior at levels that may be encountered in municipal water supplies. Comparisons of drinking water lithium levels, in the respective Texas counties, with the incidences of arrests for possession of opium, cocaine, and their derivatives (morphine, heroin, and codeine) from 1981-1986 also produced statistically significant inverse associations, whereas no significant or consistent associations were observed with the reported arrest rates for possession of marijuana, driving under the influence of alcohol, and drunkenness. These results suggest that lithium at low dosage levels has a generally beneficial effect on human behavior, which may be associated with the functions of lithium as a nutritionally-essential trace element. Subject to confirmation by controlled experiments with high-risk populations, increasing the human lithium intakes by supplementation, or the lithiation of drinking water is suggested as a possible means of crime, suicide, and drug-dependency reduction at the individual and community level.

History and current status of sedative-hypnotic drug use and abuse

Sedative-hypnotic drug use and abuse increased in Europe after World War II and peaked about 1972. Clinical and follow-up descriptions of abusers support the concept of a psychiatric addiction syndrome, different from a low-dose withdrawal syndrome. Although these drugs may be prescribed unnecessarily, large portions of the general population with pathological psychic distress and insomnia do not receive psychotropic treatment, in spite of findings pointing to genetic and biochemical factors in the genesis of these. Research on underlying mechanisms and the rationale for maintenance therapy is needed.

Relapse in opiate addicts: a behavioral analysis

Behavioral interviewing was used to study the relapse antecedents and concomitants of 38 opiate addicts on methadone maintenance. Relapse situations were categorized with regard to intra- or interpersonal determinants and implications for behavioral treatment interventions were discussed. Situations were also analyzed within an opponent process theory of motivation framework. Practical and theoretical difficulties with the study of relapse situations in substance abusing populations were highlighted.

Multiple drug abuse involving nonopiate, nonalcoholic substances. II. Physical damage, long-term psychological effects and treatment approaches and success

A review of the literature of multiple drug abuse involving two or more drug categories where at least one is a nonopiate, nonalcoholic substance (MDA NONA) suggested the possibility that sedative-hypnotics were the culpable agent for neuropsychological deficits in this group. Individually, amphetamines and hallucinogens, primarily LSD, have been associated with long-term psychological disturbance. While many abusers of these drugs who develop psychoses have been documented to be emotionally disturbed prior to drug usage, indicating that the drug exacerbated a prepsychotic condition, other abusers have no such history, indicating a drug-induced psychosis. Current treatment approaches appear to be ineffective for MDA-NONA abusers, as indicated by poor retention rates and relapse to drug use.

Multiple drug abuse involving nonopiate, nonalcoholic substances. I. Prevalence

A review of the literature on multiple drug abuse involving two or more drug categories, where at least one is a nonopiate, nonalcoholic substance (MDA-NONA), revealed that Whites and, to a lesser extent, females are overly represented, disproportionate to their composition in other patterns of drug use. In addition, there is evidence that MDA-NONA abusers are very psychologically disturbed and sociopathically deviant, although it has not been established that their clinical picture is worse than that presented by other drug populations. Theoretical frameworks are presented in an attempt to explain these epidemiological findings.