heroin and Anxiety-Disorders

Early onset of heroin use is a severity marker of heroin use disorder. We studied the interaction between early onset and rapid transition to heroin dependence recorded with retrospective interviews in 213 patients with severe heroin dependence and history of methadone maintenance treatment. General linear models were used to identify independent factors associated with early onset, factors associated with rapid transition to dependence, and a multivariate model was used to study the interaction of those two dimensions. Lifetime history of anxiety disorders and age at onset of cannabis use are shared common risk factors and are associated with the interaction.

Topics: Adult; Age of Onset; Analgesics, Opioid; Anxiety Disorders; Female; Heroin; Heroin Dependence; Humans; Male; Methadone; Middle Aged; Opiate Substitution Treatment; Retrospective Studies; Risk Factors; Time Factors

Benzodiazepine (BZD) use is widespread among opioid-maintained patients worldwide. We conducted a cross-sectional survey to investigate motives and patterns of BZD use and psychiatric comorbidity in a convenience sample of patients (n=193) maintained on oral opioid agonists or diacetylmorphine (DAM). Prolonged BZD use and high-risk behaviors like parenteral use were common. After principal component analysis, motives were divided into those related to negative affect regulation, positive affect regulation (i.e. reward-seeking) and somato-medical problems. Negative affect regulation and somato-medical motives were associated with prolonged use. Psychiatric comorbidity was associated with several self-therapeutic motives, most importantly to lose anxiety. Patients maintained on DAM were more likely to be ex-users of BZD and report high positive affect regulation. Therefore, patients maintained on different agonists may have deviating motives for BZD use, which could be of importance when addressing this issue. Treatment of psychiatric comorbidity, in particular anxiety, depressive and sleeping disorders, may be helpful in reducing BZD use, particularly in patients maintained on oral opioids.

Topics: Adult; Analgesics, Opioid; Anxiety Disorders; Benzodiazepines; Depressive Disorder; Epidemiologic Methods; Female; Heroin; Humans; Male; Middle Aged; Motivation; Opiate Substitution Treatment; Prescription Drug Misuse; Self Medication; Sleep Initiation and Maintenance Disorders; Substance-Related Disorders; Young Adult

To contrast the characteristics of two groups of anabolic-androgenic steroid (AAS) users-those with versus those without AAS dependence.. Subanalysis of data from the Anabolic 500, a cross-sectional survey.. One hundred twelve male AAS-dependent users and 367 AAS-nondependent users who completed an online survey between February 19 and June 30, 2009.. Respondents were recruited from the Internet discussion boards of 38 fitness, bodybuilding, weightlifting, and steroid Web sites. The respondents provided online informed consent and completed the Anabolic 500, a 99-item Web-based survey. Self-reported data included demographics, exercise patterns, use of AAS and other performance-enhancing agents, adverse effects of AAS use, behavior consistent with Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision (DSM-IV-TR) criteria for AAS dependence, history of illicit drug and alcohol use, history of sexual or physical abuse, and psychiatric conditions diagnosed according to the DSM-IV-TR. Behavior consistent with AAS dependence was identified in 23.4% of the survey participants. These AAS-dependent users were more excessive in their AAS use (e.g., higher doses, higher quantity of agents, longer duration of use), more likely to report a history of illicit heroin use in the last 12 months (5.4% vs 1.9%, p=0.049), and more likely to report a diagnosis of an anxiety disorder (16.1 vs 8.4%, p=0.020) or major depressive disorder (15.2% vs 7.4%, p=0.012) than AAS-nondependent users.. Data from the Anabolic 500 survey showed that almost one quarter of AAS users were dependent on these drugs. These AAS-dependent users had a higher rate of heroin use as well as anxiety and major depressive disorders compared with AAS-nondependent users. These findings can help clinicians and researchers better understand and address the potential illicit drug use and psychiatric comorbidities that may be present among AAS-dependent users.

Topics: Adolescent; Adult; Anabolic Agents; Androgens; Anxiety Disorders; Cohort Studies; Cross-Sectional Studies; Depressive Disorder, Major; Diagnostic and Statistical Manual of Mental Disorders; Dose-Response Relationship, Drug; Health Surveys; Heroin; Humans; Internet; Male; Middle Aged; Performance-Enhancing Substances; Steroids; Substance-Related Disorders; Young Adult

The function of the GABAergic system was examined in 20 subjects with heroin dependence and abuse, 2 months after detoxification, and in 10 healthy volunteers, by measuring the growth hormone (GH) response to a challenge with the GABA B receptor agonist baclofen. Ten heroin addicts had comorbid anxiety disorder (Group A), while the other ten had heroin addiction uncomplicated by Axis I and II psychopathologies (Group B). GH responses to baclofen stimulation of Group A patients were significantly blunted, while those of Group B subjects did not differ from responses of healthy volunteers. Our data show that the function of the GABAergic system is impaired only in heroin addicts with comorbid anxiety disorders (anxious cluster), suggesting that the GABA system is not persistently influenced by prolonged exposure to opioid receptor stimulation.

Topics: Adult; Analysis of Variance; Anxiety Disorders; Baclofen; GABA Agonists; Heroin; Heroin Dependence; Humans; Inactivation, Metabolic; Male; Psychiatric Status Rating Scales; Receptors, GABA

Residents in a detoxification/motivation program for drug users provided speech samples just after detoxification and again 5 weeks later. Content analysis scales were used to obtain scores for Hostility (Inward, Outward, and Ambivalent), Cognitive Anxiety, Pawn, Origin, and Sociality. Comparisons were made with scores from a previous sample of students, unemployed people, and drug users. At the end of the program there were significant positive changes in all scores except those for Hostility Outward and Pawn. Of particular interest was the anger expressed just after detoxification and maintained at a significantly high level during the following weeks. This suggests a need for drug-treatment programs to include specific anger-management interventions.

Topics: Adaptation, Psychological; Adolescent; Adult; Anger; Anxiety Disorders; Depressive Disorder; Female; Heroin; Heroin Dependence; Hospital Units; Humans; Interview, Psychological; Male; New South Wales; Substance Withdrawal Syndrome

Topics: Anxiety Disorders; Chronic Disease; Depression; Euphoria; Heroin; Humans; Hypnotics and Sedatives; Hypochondriasis; MMPI; Morphine; Morphine Dependence; Neurasthenia; Personality; Personality Disorders; Personality Inventory; Substance Withdrawal Syndrome