heroin and Morphine-Dependence

Current pharmacotherapies for treating morphine/heroin dependence are designed to substitute or block addiction by targeting the drug itself rather than the brain. The heroin addict is still being exposed to addictive opiates, and consequently may develop tolerance to and experience withdrawal and drug's toxic effects from the treatment with high incidence of relapse to addictive drug consumption. As for other drugs of abuse, an alternative approach for morphine/heroin addiction is an antibody-based antagonism of heroin's brain entry. This review summarizes the literature examining important aspects of neurobiological and pharmacological processes involved in opiate dependence. Thereafter, classical pharmacological interventions for opiate dependence treatment and its major clinical limitations are reviewed. Finally, relevant preclinical studies are examined for comparisons in the design, use, immunogenic profile and efficacy of several models of morphine/heroin vaccine as immunologic interventions on the pharmacokinetics and behavioral of morphine/heroin in the rat as animal model.

Topics: Animals; Antibodies; Heroin; Heroin Dependence; Humans; Morphine; Morphine Dependence; Rats; Secondary Prevention; Vaccines, Conjugate

In the nervous system, the interaction of opioids like heroin and morphine with the G protein-coupled Mu-opioid receptor (MOR) provokes the development of tolerance to these opioids, as well as physical dependence. Tolerance implies that higher doses of these drugs must be consumed in order to obtain an equivalent sensation, a situation that contributes notably to the social problems surrounding recreational opioid abuse. The mechanisms that promote opioid tolerance involve a series of adaptive changes in the MOR and in the post-receptor signalling elements. Pharmacological studies have consistently identified a number of signalling proteins relevant to morphine-induced tolerance, including the delta-opioid receptor (DOR), protein kinase C (PKC), protein kinase A (PKA), calcium/calmodulin-dependent kinase II (CaMKII), nitric oxide synthase (NOS), N-methyl-D-aspartate acid glutamate receptors (NMDAR), and regulators of G-signalling (RGS) proteins. Thus, it is feasible that these treatments which diminish morphine tolerance target distinct elements within the same regulatory machinery. In this scheme, the signals originated at the agonist-activated MORs would be recognised by elements such as the NMDARs, which in turn exert a negative feedback on MOR-evoked signalling. This process involves DOR regulation of MORs, MOR-induced activation of NMDARs (probably via the regulation of Src, recruiting PKC and Galpha subunits) and the NMDAR-mediated activation of CaMKII. The active CaMKII promotes the sequestering of morphine-activated Gbetagamma dimers by phosducin-like proteins (PhLP) and of Galpha subunits by RGS proteins and tolerance to opioids like morphine develops. Future efforts to study these phenomena should focus on fitting additional pieces into this puzzle in order to fully define the mechanism underlying the desensitization of MORs in neural cells.

Topics: Animals; Brain; Calcium-Calmodulin-Dependent Protein Kinase Type 2; Cyclic AMP-Dependent Protein Kinases; Dose-Response Relationship, Drug; Drug Tolerance; G-Protein-Coupled Receptor Kinases; Heroin; Heroin Dependence; Humans; Mice; Morphine; Morphine Dependence; Narcotics; Protein Kinase C; Receptors, G-Protein-Coupled; Receptors, N-Methyl-D-Aspartate; Receptors, Opioid, mu; RGS Proteins; Signal Transduction; Substance Withdrawal Syndrome; Young Adult

Extensive clinical experience has been obtained in the use of opiates during the last decade in special units devoted to symptom control in advanced cancer. Important contradictions have emerged with the clinical pharmacological literature on opiates calling into question its relevance to the treatment of chronic pain. Specifically in the case of morphine it is clear that: it is a very effective analgesic given orally, dosage must be individualized, parenteral use or exotic analgesic 'cocktails' are usually unnecessary, and tolerance, dependence and respiratory depression are rarely common or serious problems which prevent effective pain control provided morphine is used appropriately in accordance with its pharmacological characteristics. Heroin is a suitable alternative to morphine (particularly for intramuscular administration) if differences in milligram potency are taken into account, but has no advantages in terms of either analgesic efficacy or side effects. This paper summarizes clinical experience in the use of oral morphine for cancer pain at St. Christopher's Hospice, any data from clinical investigations which support this approach, and comments on the areas of controversy which have emerged.

Topics: Administration, Oral; Analgesics; Constipation; Delayed-Action Preparations; Drug Combinations; Heroin; Humans; Morphine; Morphine Dependence; Nausea; Neoplasms; Palliative Care; Respiratory Insufficiency

Topics: Analgesics; Analgesics, Opioid; Clinical Trials as Topic; Drug Administration Schedule; Drug Evaluation; Drug Tolerance; Heroin; Heroin Dependence; Humans; Kinetics; Methadone; Methadyl Acetate; Morphine; Morphine Dependence; Patient Dropouts; Substance Withdrawal Syndrome; Time Factors

Topics: Adolescent; Adult; Antisocial Personality Disorder; Child; Child Development; Family; Father-Child Relations; Female; Group Processes; Heroin; Humans; Interpersonal Relations; Male; Marriage; Minority Groups; Morphine Dependence; Mother-Child Relations; Motivation; Personality Development; Psychological Theory; Social Behavior; Substance-Related Disorders; Urban Population

Topics: Alcoholism; Amphetamine; Aversive Therapy; Barbiturates; Heroin; Humans; Lysergic Acid Diethylamide; Methadone; Morphine Dependence; Psychodrama; Psychotherapy; Psychotherapy, Group; Substance Withdrawal Syndrome; Substance-Related Disorders

Topics: Crime; Cyclazocine; Economics; Germany, West; Heroin; Humans; Methadone; Morphine Dependence; Naloxone; Narcotic Antagonists

Topics: Adult; Aged; Blood Pressure; Body Temperature; Body Weight; Cardiovascular Diseases; Female; Gastrointestinal Diseases; Heroin; Humans; Liver Diseases; Lung Diseases; Lymphatic Diseases; Male; Middle Aged; Morphine Dependence; Pulse; Skin Diseases; Splenic Diseases; Substance-Related Disorders; Urologic Diseases

Topics: Adolescent; Amphetamine; Amphetamines; Barbiturates; Cannabis; Codeine; Heroin; Humans; Hydromorphone; Jurisprudence; Meperidine; Mescaline; Methadone; Morphine Dependence; Nalorphine; Narcotic Antagonists; Psychotherapy; Statistics as Topic; Substance-Related Disorders

Clinical observations and recent findings suggested different acceptance of morphine and heroin by intravenous drug users in opiate maintenance programs. We postulated that this is caused by differences in the perceived effects of these drugs, especially how desired and adverse effects of both drugs interacted.. We measured the desired and adverse effects of high doses of injected morphine and heroin in patients to determine the causal interactions between both types of effects and test the hypothesis of a differential mechanism of action.. Thirty-three patients (five females, 28 males; mean duration of previous street heroin use 10.7 years, mean age 30.1 years) were randomly allocated double-blind to the substance groups. The average daily dose per participant in the heroin condition (n=17) was 491 mg, in the morphine condition (n=16) 597 mg. The observation period lasted 3 weeks; an average of 70 injections was received. After each injection of either substance, various aspects of drug effects were recorded systematically. Ratings were summarized into the factors "euphoria" and "adverse effects". Time series models were computed for each participant on the basis of the factor scores, using vector autoregression (VAR).. A highly significant difference between the substances was found in the interaction between "euphoria" and "adverse effects". Adverse effects of heroin preceded higher euphoria, whereas adverse effects of morphine preceded subsequent lower euphoria. Additionally, the finding of a higher level of adverse effects in morphine was replicated.. Results point to different mechanisms of action of the two opioids when the perceived drug effects are evaluated in a field setting. This may explain the better acceptance of heroin in opiate-assisted treatment of intravenous drug patients. The method used can be a valuable tool for the comparison of substance groups other than opioids.

Topics: Adult; Dose-Response Relationship, Drug; Double-Blind Method; Drug Administration Schedule; Drug Interactions; Euphoria; Female; Heroin; Heroin Dependence; Humans; Male; Methadone; Morphine Dependence; Patient Acceptance of Health Care; Substance Abuse, Intravenous

Five morphine-maintained individuals participated in an inpatient study evaluating the effects of a monetary alternative ($10, $20, $40) on intranasal (i.n.) heroin (placebo, 12.5, 25, 50, 100 mg) self-administration, using a procedure in which subjects chose between money and heroin. Each money amount was tested in combination with each heroin dose. Subjects responded under a progressive-ratio schedule (PR 50, 100, ..., 2800); the PR value increased independently for each option. Subjective, performance, and physiological effects were also measured during each session. Heroin breakpoint values increased in a dose-related manner, relative to placebo, when $10 or $20 was available. In contrast, only the highest dose produced a heroin breakpoint value that was significantly different from placebo when $40 was available. Heroin also produced dose-related increases in several ratings of drug effect, including "I feel ..." "a good drug effect", "high", "mellow", and "stimulated". These effects were not significantly affected by the alternative money condition. These results demonstrated: (1) the dose-related reinforcing effects of i.n. heroin in opioid-dependent individuals; (2) that i.n. heroin self-administration can be modified by the availability of an alternative reinforcer (i.e. money); and (3) that self-reported drug effects can be differentiated from drug self-administration.

Topics: Administration, Intranasal; Adult; Dose-Response Relationship, Drug; Heroin; Humans; Male; Morphine; Morphine Dependence; Narcotics; Psychomotor Performance; Reward; Self Administration; Time Factors

Topics: Analgesics; Analgesics, Opioid; Clinical Trials as Topic; Drug Administration Schedule; Drug Evaluation; Drug Tolerance; Heroin; Heroin Dependence; Humans; Kinetics; Methadone; Methadyl Acetate; Morphine; Morphine Dependence; Patient Dropouts; Substance Withdrawal Syndrome; Time Factors

Topics: Adaptation, Psychological; Adolescent; Adult; Clinical Trials as Topic; Follow-Up Studies; Heroin; Humans; Lysergic Acid Diethylamide; Monitoring, Physiologic; Morphine Dependence; Prisons; Psychotherapy; Residential Treatment; Socioeconomic Factors

Topics: Cyclopropanes; Heroin; Humans; Injections, Subcutaneous; Male; Morphinans; Morphine; Morphine Dependence; Nalorphine; Naloxone; Narcotic Antagonists; Prisons; Surveys and Questionnaires

Topics: Administration, Oral; Clinical Trials as Topic; Codeine; Heroin; Humans; Methadone; Morphine Dependence; Pentazocine; Placebos; Self Medication; Substance-Related Disorders

Topics: Alcohols; Clinical Trials as Topic; Heroin; Humans; Methadone; Morphine Dependence; Placebos; Substance Withdrawal Syndrome

Topics: Bridged-Ring Compounds; Clinical Trials as Topic; Cyclazocine; Electroencephalography; Frontal Lobe; Furans; Heroin; Humans; Injections, Intravenous; Ketones; Male; Methadone; Morphine Dependence; Narcotic Antagonists; Occipital Lobe; Phenanthrenes; Seizures

Topics: Adolescent; Adult; Black or African American; Clinical Trials as Topic; Crime; Educational Status; Ethnicity; Follow-Up Studies; Heroin; Humans; Male; Methadone; Morphine Dependence; Motivation; New York City; Prisons; White People; Work

Topics: Behavior; Clinical Trials as Topic; Heroin; Humans; Injections, Intravenous; Male; Methods; Morphine; Morphine Dependence; Placebos; Substance Withdrawal Syndrome; Substance-Related Disorders; Time Factors

Topics: Animals; Heroin; Male; Mice; Mice, Inbred ICR; Morphine Dependence; Naloxone; Narcotic Antagonists; Opioid-Related Disorders; Secologanin Tryptamine Alkaloids; Substance Withdrawal Syndrome

There is a lack of safe and effective non-opioid medications for the treatment of opioid addiction. Aquaporin-4 (AQP4), a water channel protein expressed in astrocytes, regulates the progression of neurological diseases. Our previous work demonstrated that AQP4 deficiency in mice attenuated morphine-induced physiological dependence. However, the role of AQP4 in the neurobiology of behaviours related to opioid addiction in mice remains unclear. Here, we report that Aqp4-knockout mice exhibited attenuated heroin consumption and heroin-seeking behaviours. Furthermore, Aqp4-knockout mice displayed diminished hyperactivity induced by morphine and heroin and subsequently showed dramatically inhibited morphine-induced behavioural sensitization. This attenuated hyperlocomotion to opioids was accompanied by a decreased dopamine response to the opioid-induced increase in the levels of extracellular dopamine in the NAc. In addition, Aqp4-knockout mice displayed upregulation of dopamine transporters in the striatum, suggesting a probable neurobiological mechanism for uptake of the extracellular dopamine. The present findings suggest that deficiency of AQP4 decreases opiate-induced drug seeking and taking behaviours, and AQP4 may be involved in the treatment of addiction. Therefore, the development of a pharmacological antagonist to AQP4 may be valuable to investigate as opioid addiction therapy.

Topics: Analgesics, Opioid; Animals; Aquaporin 4; Behavior, Addictive; Dopamine; Heroin; Mice; Mice, Knockout; Morphine; Morphine Dependence; Nucleus Accumbens; Opioid-Related Disorders

Dependence can develop during chronic opioid use, and the emergence of withdrawal might promote drug taking.. This study examined how chronic morphine administration or withdrawal modified self administration of heroin or cocaine.. Four monkeys responded under a fixed ratio 10 schedule to receive i.v. infusions of heroin (0.56-560 microg/kg/infusion) or cocaine (1-100 microg/kg/infusion). Monkeys received morphine twice daily; the final dose was 10 mg/kg/12 h. Dose-effect curves for heroin or cocaine were determined in 150-min sessions throughout morphine administration and during temporary suspension when withdrawal signs were also monitored. Heroin dose-effect curves and withdrawal signs were determined daily following termination of morphine administration.. Before monkeys received morphine, heroin, and cocaine maintained responding with unit doses of 1.78 microg/kg of heroin and 10 microg/kg/injection of cocaine resulting in, on average, 13.4 and 20.8 infusions, respectively. When monkeys received morphine daily, self administration of heroin and cocaine decreased to, on average, 3.1 and 11.3 infusions, respectively. Responding for heroin or cocaine recovered following temporary (17-53 h) suspension of morphine administration. The number of heroin infusions and total withdrawal signs increased when morphine administration was terminated. Withdrawal signs peaked 3-4 days after morphine; however, the number of infusions remained elevated for 8 weeks.. Changes in self administration responding did not precisely covary with signs of withdrawal and responding for small doses of heroin persisted long after discontinuation of morphine, suggesting that non-pharmacologic (e.g., conditioned reinforcing) effects might contribute to the maintenance of lever pressing under these conditions.

Topics: Animals; Cocaine; Conditioning, Operant; Dose-Response Relationship, Drug; Female; Heroin; Macaca mulatta; Male; Morphine Dependence; Narcotics; Reinforcement Schedule; Self Administration; Substance Withdrawal Syndrome

Although morphine and heroin analgesia is mediated by mu-opioid receptors encoded by the MOR-1 gene, distinct isoforms are involved. Both opioids also induce dependence by acting at mu-opioid receptors, but which variants are utilized is not known. Here, we assayed morphine and heroin analgesia and dependence in mice treated with antisense oligodeoxynucleotides (AO) targeting MOR-1 exons 1-4. Whereas AOs targeting exons 1 and 4 blocked morphine analgesia, those targeting exons 2 and 3 blocked heroin analgesia. Neither morphine nor heroin analgesia was compromised 5 days after the last AO injection. In morphine and heroin dependent mice, only exon 1 AO significantly reduced jumping incidence during naloxone (50mg/kg) precipitated withdrawal. Neither analgesia nor withdrawal jumping was attenuated in controls pretreated with saline or a mismatch oligodeoxynucleotide control sequence. While these data confirm previous reports that morphine and heroin analgesia are not mediated by a single mu-opioid receptor, both opiates nonetheless apparently induce dependence via a mu-opioid receptor isoform containing exon 1. For heroin, the possibility that analgesia and dependence are mediated by distinct mu-opioid receptor isoforms offers the prospect of developing potent opiate analgesics possessing reduced dependence liability.

Topics: Analgesia; Analgesics, Opioid; Analysis of Variance; Animals; Exons; Heroin; Heroin Dependence; Hot Temperature; Male; Mice; Morphine; Morphine Dependence; Motor Activity; Naloxone; Narcotic Antagonists; Oligonucleotides, Antisense; Pain Measurement; Protein Isoforms; Receptors, Opioid, mu; Substance Withdrawal Syndrome

Opioid receptor agonists can enhance some effects of cannabinoid receptor agonists, and cannabinoid receptor agonists can enhance some effects of opioid receptor agonists; however, the generality of these interactions is not established.. This study examined interactions between the discriminative stimulus and antinociceptive effects of mu opioid receptor agonists and Delta(9)-tetrahydrocannabinol (THC) in rhesus monkeys.. Neither heroin nor morphine (intravenous (i.v.) or subcutaneous (s.c.)) altered the discriminative stimulus effects of THC in monkeys (n = 5) discriminating 0.1 mg/kg THC i.v. In contrast, THC (s.c.) markedly attenuated the discriminative stimulus effect of morphine and heroin in nondependent monkeys (n = 4) discriminating 1.78 mg/kg morphine s.c. Doses of THC that attenuated the discriminative stimulus effects of morphine in nondependent monkeys failed to modify the discriminative stimulus effects of morphine in morphine-dependent (5.6 mg/kg/12 h) monkeys (n = 4) discriminating 0.0178 mg/kg naltrexone s.c. THC also failed to modify the discriminative stimulus effects of naltrexone in morphine-dependent monkeys or the effects of midazolam in monkeys (n = 4) discriminating 0.32 mg/kg midazolam s.c. Doses of THC (s.c.) that attenuated the discriminative stimulus effects of morphine in nondependent monkeys enhanced the antinociceptive effects of morphine (s.c.) in nondependent monkeys. While mu receptor agonists did not alter the discriminative stimulus effects of THC, THC altered the effects of mu receptor agonists in a context-dependent manner.. That the same doses of THC enhance, attenuate, or do not affect morphine, depending on the condition, suggests that attenuation of morphine by THC can result from perceptual masking rather than common pharmacodynamic mechanisms or pharmacokinetic interactions.

Topics: Analgesics; Analgesics, Opioid; Animals; Data Interpretation, Statistical; Discrimination, Psychological; Dose-Response Relationship, Drug; Dronabinol; Drug Interactions; Female; Heroin; Hot Temperature; Hypnotics and Sedatives; Macaca mulatta; Male; Midazolam; Morphine; Morphine Dependence; Naltrexone; Narcotic Antagonists; Pain Measurement; Receptors, Opioid, mu; Substance Withdrawal Syndrome

Topics: Germany; Health Policy; Heroin; Humans; Methadone; Morphine Dependence

Both pre-clinical and clinical studies make feasible the use of vaccines as novel therapeutic medications to treat drug addiction. No reports to date have shown the development of structural models of opiate candidate vaccines for treating human addiction to such compounds. Here we report on the initial development of a novel structural formulation of a bi-valent vaccine against morphine/heroin. This vaccine was able to trigger and establish a high titer antibody response to haptenized drug with antibodies displaying equivalent specificities for both morphine and heroin. Such antibodies did not cross-recognize structurally dissimilar opiate medications. Furthermore, the evaluation of the potential therapeutic effectiveness of this vaccine was targeted to relapse prevention using a schedule of heroin delivery in the rat self-administration model. Antibodies against heroin blocked its reinforcing effects in rodents. The type of carrier protein used in this vaccine allows further evaluation of its potential therapeutic value for preventing relapse to heroin addiction in humans.

Topics: Animals; Antibodies; Antibody Specificity; Cross Reactions; Enzyme-Linked Immunosorbent Assay; Haptens; Heroin; Heroin Dependence; Male; Models, Animal; Models, Chemical; Morphine; Morphine Dependence; Rats; Secondary Prevention; Tetanus Toxoid; Vaccines, Conjugate

The purpose of this study was the evaluation of clinical heroin symptoms and buprenorphine drug addiction in the withdrawal period with the purpose of their comparison, study of parameters of bone metabolism in the both groups. In the study group were included 40 patients with heroin and 27 with buprenorphine addiction in the period of abstinence. Our investigations have shown, that in the both groups, among clinical symptoms ossalgias, arthralgias and mialgias attributes to the expressed dysfunction of vegetative system, were most prominent. Decrease of sexual functions was found in half of inspected patients. Biochemical investigations have shown intensive clearance of calcium with the urine that indicates intensifying resorbtion processes in the bone tissue. Symptoms of hypogonadism were accompanied by the decrease of the level of testosterone in the blood. Parameters of mineral consistency of the bone tissue was decreased both in patients with heroin and buprenorphine addiction.

Topics: Behavioral Symptoms; Biomarkers; Bone and Bones; Bone Density; Buprenorphine; Female; Heroin; Heroin Dependence; Humans; Male; Morphine Dependence; Pain; Radiography; Substance Withdrawal Syndrome

The present study was designed to explore the relationship between the cannabinoid and opioid receptors in animal models of opioid-induced reinforcement. The acute administration of SR141716A, a selective central cannabinoid CB1 receptor antagonist, blocked heroin self-administration in rats, as well as morphine-induced place preference and morphine self-administration in mice. Morphine-dependent animals injected with SR141716A exhibited a partial opiate-like withdrawal syndrome that had limited consequences on operant responses for food and induced place aversion. These effects were associated with morphine-induced changes in the expression of CB1 receptor mRNA in specific nuclei of the reward circuit, including dorsal caudate putamen, nucleus accumbens, and septum. Additionally, the opioid antagonist naloxone precipitated a mild cannabinoid-like withdrawal syndrome in cannabinoid-dependent rats and blocked cannabinoid self-administration in mice. Neither SR141716A nor naloxone produced any intrinsic effect on these behavioral models. The present results show the existence of a cross-interaction between opioid and cannabinoid systems in behavioral responses related to addiction and open new strategies for the treatment of opiate dependence.

Topics: Animals; Avoidance Learning; Cannabinoids; Caudate Nucleus; Conditioning, Operant; Disease Models, Animal; Heroin; Heroin Dependence; Male; Mice; Morphine; Morphine Dependence; Naloxone; Narcotic Antagonists; Nucleus Accumbens; Piperidines; Putamen; Pyrazoles; Rats; Rats, Wistar; Receptors, Cannabinoid; Receptors, Drug; Receptors, Opioid; Rimonabant; RNA, Messenger; Self Administration; Septum of Brain

Acute dependence on and tolerance to heroin and morphine were assessed in rhesus monkeys using measures of respiration. Respiratory frequency (f) and minute volume (V(e)) were measured in monkeys breathing air or 5% CO(2) in air using a pressure-displacement plethysmograph. Cumulative doses of naltrexone (0.0001-1.0 mg/kg, i.m) did not alter these parameters in untreated monkeys. Twenty-four hours after a cumulative dose of heroin (1 mg/kg, i.m.), naltrexone produced an increase in both f and V(e) when monkeys were breathing air or 5% CO(2). Following 1 to 3 days of treatment with heroin (0.5 mg/kg/day, i.m.) or morphine (16 mg/kg/day, i.m.), naltrexone produced an increase in f and V(e) that was related to the dose of naltrexone and the number of days of agonist administration. Two days following termination of heroin administration, naltrexone-induced respiratory stimulation declined and had disappeared completely by the fifth day. In tolerance studies, heroin (0.032-0.5 mg/kg, i.m.) and morphine (1-16 mg/kg, i. m.) were injected cumulatively each day for three consecutive days. These drugs suppressed f and V(e) to nearly the same extent on day 3 as they had on day 1 of administration. These results suggest that dependence to morphine and heroin can be measured under conditions of acute 1 to 3 day administration conditions in primates using f and V(e) as reliable and quantitative indicators of opioid withdrawal. Under these conditions, tolerance does not occur.

Topics: Analgesics, Opioid; Animals; Carbon Dioxide; Dose-Response Relationship, Drug; Drug Tolerance; Heroin; Heroin Dependence; Macaca mulatta; Morphine; Morphine Dependence; Naltrexone; Narcotic Antagonists; Respiration; Time Factors

Non-dependent and dependent opiate users appear to be driven by two distinct motivational factors: the primary reinforcing properties of the drug, and the negative reinforcing effects associated with relieving the negative affective component of opiate withdrawal in the dependent state.. To investigate the motivational significance of opioid dependence on heroin self-administration (HSA) in rodents.. Rats were trained to self-administer heroin intravenously (0.06 mg/kg per infusion; FRI), and opiate dependence was induced by subcutaneous implantation of two morphine (75 mg base) pellets. Rats in a non-dependent control group received placebo pellets. Three days after pellet implantation, HSA was resumed in daily 3-h sessions until baseline criteria were met and testing was conducted with subcutaneous injections of vehicle or naloxone (0, 0.003, 0.01, 0.03 mg/kg) 115 min into the session.. Morphine-dependent rats significantly increased HSA upon 0.01 mg/kg naloxone treatment, but decreased response rates at 0.03 mg/kg. Placebo pellet-implanted rats increased heroin intake at the 0.01 and 0.03 mg/kg doses. In a second experiment, the HSA session was shortened to 1 h and the training dose reduced to 0.03 mg/kg per infusion in new groups of animals. HSA in placebo pellet-implanted rats was increased only following the highest dose of the antagonist, while dependent rats were still affected by naloxone doses of 0.003-0.03 mg/kg. When subjected to a progressive-ratio schedule (experiment 3), breaking point values in dependent animals were 198% above baseline.. The present study supports the hypothesis that dependence-induction by morphine-pellet implant in rats resulted in increased sensitivity to very small naloxone doses, as measured by changes in HSA. Taken together, these data suggest that opiate dependence, as measured by changes in sensitivity to naloxone, is a continuum which can contribute to the motivational state of drug-seeking.

Topics: Animals; Heroin; Illicit Drugs; Male; Morphine; Morphine Dependence; Naloxone; Narcotic Antagonists; Rats; Rats, Wistar; Reinforcement, Psychology; Self Administration; Substance Withdrawal Syndrome

Topics: Heroin; Humans; Legislation, Drug; Male; Morphine Dependence; Travel; United Kingdom; United States

Morphine and codeine were isolated from blood with C18 Bond Elut columns and derivatised with pentafluoropropionic anhydride (PFPA). The PFPA-derivatives were examined by means of gas chromatography/mass spectrometry using electron impact and chemical ionisation (positive and negative mode). The negative chemical ionisation, as most sensitive, was applied for the quantitation of both examined substances in forensic blood samples.

Topics: Codeine; Diagnosis, Differential; Gas Chromatography-Mass Spectrometry; Heroin; Heroin Dependence; Humans; Morphine; Morphine Dependence

Tissue sections from injection marks from 30 drug addicts and sections from endocrine organs and kidneys from an additional 33 addicts were studied together with endocrine organs and kidneys from 20 'normal' persons. All 83 persons were submitted for medico-legal autopsy at the Institute of Forensic Medicine in Copenhagen. In fresh injection marks haemorrhage in dermis and subcutis was present histologically in all cases. Acute inflammation was present in 38% and acute inflammation together with chronic changes in 41%. Fibrotic thickening of vein wall was seen in 14% and thrombosis in 10%. Birefringent foreign material occurred in 35%. In old injection marks and scars chronic inflammatory changes were observed in 93%, fibrotic thickening of vein wall in 20% and thrombosis in 10% of the cases. Birefringent material occurred in 17%. By comparison of changes in injection marks with the size and histological changes in the corresponding axillary lymph nodes, there was a tendency to a relation between chronic inflammatory changes in old injection marks/scars and enlargement of the lymph nodes in question, but no correlation to the histological degree of immunoactivity. Regarding alterations in the endocrine organs and the kidneys no important differences were demonstrated between drug addicts and 'normal' persons.

Topics: Adrenal Glands; Adult; Cicatrix; Endocrine Glands; Female; Heroin; Heroin Dependence; Humans; Injections, Intravenous; Kidney; Male; Morphine; Morphine Dependence; Ovary; Pituitary Gland; Skin; Testis; Thyroid Gland; Veins

The analysis of drugs of abuse in urine is a valuable tool for the detection of illicit drug use and the treatment and rehabilitation of addicts. In order for the results to be conclusive, however, several precautions have to be taken during the collection, storage, mailing and analysis of the urinary specimen. Since immunological methods for the determination of drugs of abuse are not completely specific, all positive results on immunoassay should be confirmed, at least for forensic purposes, by a chromatographic technique. Although much more complicated and time-consuming, some chromatographic techniques such as gas chromatography-mass spectrometry offer the possibility of unambiguously identifying drugs of abuse. However, in some cases, even with this method it is not possible to decide whether the identified metabolite of a drug of abuse stems from food or illicit or elicit drug use. A single urinary analysis is, therefore, sometimes not sufficient to provide unambiguous proof of the use of illicit drugs. However, definite evidence of repeated drug abuse can be obtained if the person involved is carefully instructed as to which medicines or food must not be taken during the investigation period and yet the analysis of several urinary specimens taken at intervals of one or two days proves positive.

Topics: Amphetamines; Anti-Anxiety Agents; Barbiturates; Benzodiazepines; Cannabinoids; Chromatography; Cocaine; Heroin; Heroin Dependence; Humans; Illicit Drugs; Immunologic Techniques; Morphine; Morphine Dependence; Pharmaceutical Preparations; Specimen Handling; Substance-Related Disorders

Topics: Adult; Female; Heroin; Heroin Dependence; Humans; Infant, Newborn; Infant, Newborn, Diseases; Maternal-Fetal Exchange; Morphine; Morphine Dependence; Pregnancy; Pregnancy Complications; Substance-Related Disorders

Heroin and morphine metabolites can be detected in hair with the use of commercially available radioimmunoassay reagents and with minor sample preparation. Hair samples obtained from morphine-treated mice and heroin users contained nanogram levels of the drug per milligram of hair (single human hair). The results of the hair analyses for all subjects admitting the use of heroin were positive, whereas the results of only 30% of thin-layer chromatographic urinanalyses of these same subjects were positive. In addition, differences in drug concentration for sections of hair near the scalp and near the distal end correlated with the length of time the drug had been used. These results exemplify the potential advantages of the use of hair analysis over urine and serum analyses in terms of accessibility, sample stability, and long-term retention of information.

Topics: Animals; Chromatography, Thin Layer; Forensic Medicine; Hair; Heroin; Heroin Dependence; Humans; Mice; Morphine; Morphine Dependence; Narcotics; Opioid-Related Disorders; Radioimmunoassay; Reagent Kits, Diagnostic

Mice were given single s.c. injections of morphine sulphate (M.S.), heroin hydrochloride (H.HCl) and the sparingly-soluble diheroin pamoate (H.Pam) and 3,5-di-tert-butyl-2,6-dihydroxybenzoate (H.Bnz) in three vehicles, saline, peanut oil, or a slow-release vehicle (SRV) and tested for analgesia by both the tail-clip and hotplate techniques. Duration of analgesia as assessed by the tail-clip method was always longer than that by the hotplate when equivalent doses were used in any vehicle. The H.Pam and H.Bnz salts significantly prolonged the analgesia: the mean duration in mice injected with equivalent amounts of heroin base was 3.0 hr for the group receiving heroin HCl in saline and 7.8 hr after H.Bnz in slow-release vehicle. An inverse relationship was evident between the degree of dissociation of H from the three salts, at pH 7.3 and their durations of analgesia in vivo. This was statistically significant (p less than 0.01) at the higher dose level. All mice were challenged with naloxone hydrochloride (1 mg/kg) 24 hr after the injection of each narcotic agonist preparation. The jumping behaviour elicited by naloxone was not consistently related to dose, salt form, or vehicle employed for the injection of agonists, but from 12.5 too 54.2% of all the mice did jump at that time. The durations of analgesia observed and the intensity of the jumping response correlated significantly with the mean number of jumps per mouse after the naloxone challenge.

Topics: Analgesia; Animals; Delayed-Action Preparations; Guinea Pigs; Heroin; Heroin Dependence; Humans; Male; Morphine; Morphine Dependence; Naloxone; Reaction Time; Substance Withdrawal Syndrome; Time Factors

3,6-Diformyl- and 3,6-dipropanoylmorphine and 6-formyl- and 6-propanoylmorphine were prepared to obtain longer acting, heroin-like compounds. The 6-acylated compounds were more potent than heroin subcutaneously and were orally effective, and their duration of action was at least two to three times greater than that of heroin in monkey species.

Topics: Acetylation; Analgesics; Animals; Haplorhini; Heroin; Humans; Mice; Morphine Dependence; Morphine Derivatives; Time Factors

Topics: Dextropropoxyphene; Drug Tolerance; Heroin; Heroin Dependence; Humans; Methadone; Morphine; Morphine Dependence; Naloxone; Substance Withdrawal Syndrome

Topics: 5-Hydroxytryptophan; Animals; Behavior, Animal; Delayed-Action Preparations; Disease Models, Animal; Drug Synergism; Heroin; Humans; Male; Morphine; Morphine Dependence; Motor Activity; Naloxone; Rats; Substance Withdrawal Syndrome; Theophylline

Topics: Analgesics; Animals; Chemical Phenomena; Chemistry; Codeine; Heroin; Humans; Hydromorphone; Levorphanol; Meperidine; Methadone; Morphinans; Morphine Dependence; Structure-Activity Relationship

Topics: Analgesics; Animals; Antitussive Agents; Codeine; Cyclazocine; Dextromethorphan; Dogs; Electric Stimulation; Guinea Pigs; Heroin; Humans; Hydroxylation; In Vitro Techniques; Mice; Morphinans; Morphine; Morphine Dependence; Naloxone; Narcotic Antagonists; Rats; Trachea

Topics: Adolescent; Adult; Evaluation Studies as Topic; Heroin; Heroin Dependence; Humans; Male; Military Medicine; Morphine Dependence; Psychoses, Substance-Induced; Vietnam

Topics: Animals; Avoidance Learning; Codeine; Cyclazocine; Electric Stimulation; Electrodes, Implanted; Female; Haplorhini; Heroin; Humans; Light; Macaca; Male; Morphine; Morphine Dependence; Nalorphine; Narcotic Antagonists; Narcotics; Pentazocine; Reinforcement Schedule; Reinforcement, Psychology

Topics: Dose-Response Relationship, Drug; Heroin; Heroin Dependence; Humans; Methadone; Morphine Dependence; Substance-Related Disorders

Topics: Adult; Alkaloids; Chromatography, Gas; Chromatography, Thin Layer; Codeine; Heroin; Humans; Mass Spectrometry; Morphinans; Morphine; Morphine Dependence; Noscapine; Opium; Papaverine; Thebaine

Topics: Autopsy; Death, Sudden; Ethanol; Half-Life; Heroin; Heroin Dependence; Humans; Injections, Intravenous; Lung; Morphine; Morphine Dependence; Poisoning; Time Factors

Topics: Adolescent; Adult; Aged; Burns; Colon; Endotoxins; Female; Gastrointestinal Hemorrhage; Heroin; Humans; Intestinal Obstruction; Ischemia; Kidney Transplantation; Liver Cirrhosis; Liver Diseases; Lung Diseases, Parasitic; Male; Middle Aged; Mononuclear Phagocyte System; Morphine Dependence; Peritonitis; Sepsis; Shock, Septic; Transplantation, Homologous; Urinary Fistula; Urinary Tract Infections

Topics: Adolescent; Adult; Attitude; Educational Status; Emotions; Family Characteristics; Father-Child Relations; Heroin; Humans; Intelligence Tests; Interpersonal Relations; Interview, Psychological; Middle Aged; MMPI; Morphine Dependence; Mother-Child Relations; Occupations; Peer Group; Psychological Tests; Remission, Spontaneous; Sex; Social Behavior; Substance-Related Disorders; Surveys and Questionnaires

Topics: Heroin; Humans; Male; MMPI; Morphine Dependence; Personality; Probability

Topics: Adult; Heroin; Hospitals, Psychiatric; Humans; Male; Mental Disorders; MMPI; Morphine Dependence; Personality; Substance-Related Disorders

Topics: Adolescent; Adult; Age Factors; Amphetamine; Antisocial Personality Disorder; Anxiety; Barbiturates; Depression; Diagnosis, Differential; Female; Hallucinogens; Heroin; Humans; Male; MMPI; Morphine Dependence; Personality; Personality Assessment; Social Class; Substance-Related Disorders; Therapeutic Community

Topics: Alkalosis; Carbon Dioxide; Female; Heroin; Humans; Hyperventilation; Infant, Newborn; Infant, Newborn, Diseases; Morphine Dependence; Oxygen; Pregnancy; Pregnancy Complications; Substance-Related Disorders

Topics: Adult; Female; Heroin; Humans; Male; Methadone; Middle Aged; Morphine Dependence; Psychotherapy, Group

Topics: Acute Kidney Injury; Adult; Biopsy; Electromyography; Heroin; Humans; Leg; Male; Morphine Dependence; Muscles; Muscular Diseases; Myoglobinuria; Pulmonary Edema

Topics: Drug and Narcotic Control; Heroin; Humans; Methadone; Morphine Dependence; New Zealand; Substance-Related Disorders

Topics: Adolescent; Adult; Age Factors; Aged; Autopsy; Female; Forensic Medicine; Heroin; History, 20th Century; Humans; Injections; Malaria; Male; Middle Aged; Morphine Dependence; New York City; Pulmonary Edema; Quinine; Racial Groups; Sex Factors; Substance-Related Disorders; Thrombophlebitis; Urban Population

Topics: Animals; Anxiety; Compulsive Behavior; Conditioning, Classical; Conditioning, Operant; Dogs; Drug Tolerance; Haplorhini; Heroin; Humans; Life Style; Methadone; Mice; Morphine Dependence; Motivation; Narcotic Antagonists; Rats; Recurrence; Reward; Substance Withdrawal Syndrome; Time Factors

Topics: Adult; Amino Acids; Body Weight; Catheterization; Diet Therapy; Female; Heroin; Humans; Hypertonic Solutions; Male; Methods; Morphine Dependence; Nitrogen; Parenteral Nutrition; Subclavian Vein; Tetanus

Topics: Adolescent; Adult; Affective Symptoms; Amphetamine; Family Practice; Heroin; Humans; Lysergic Acid Diethylamide; Morphine Dependence; Opium; Substance-Related Disorders

Topics: Costs and Cost Analysis; Criminal Psychology; Drug Tolerance; Evaluation Studies as Topic; Heroin; Humans; Methadone; Morphine Dependence; Recurrence; Remission, Spontaneous; Social Problems; Stress, Psychological; Substance Withdrawal Syndrome

Topics: Acute Disease; Antibodies; Antigens; Biopsy; Chronic Disease; Drug Synergism; Ethanol; Hepatitis B Antigens; Heroin; Humans; Liver Diseases; Liver Function Tests; Morphine Dependence; Radioimmunoassay

Topics: Adult; Counseling; Crime; District of Columbia; Female; Follow-Up Studies; Government Agencies; Heroin; Humans; Male; Mental Health Services; Methadone; Morphine Dependence; Rehabilitation Centers; Substance-Related Disorders

Topics: Adolescent; Adult; Appointments and Schedules; Cooperative Behavior; Female; Follow-Up Studies; Heroin; Humans; Male; Massachusetts; Methadone; Morphine Dependence; Outpatient Clinics, Hospital; Psychiatric Department, Hospital; Psychotherapy; Psychotherapy, Group; Retrospective Studies

Topics: Adolescent; Adult; Aged; Cannabis; Crime; Female; Follow-Up Studies; Heroin; Humans; Interpersonal Relations; Male; Mental Health Services; Methadone; Middle Aged; Morphine Dependence; Personal Satisfaction; Prisons; Retrospective Studies; Socioeconomic Factors; Substance-Related Disorders

Topics: Adolescent; Adult; Age Factors; Antigens; Autopsy; Black or African American; Female; Florida; Hepatitis B; Hepatomegaly; Heroin; Humans; Hyperplasia; Liver; Lung; Lymph Nodes; Male; Mononuclear Phagocyte System; Morphine Dependence; Needles; Pulmonary Edema; Sex Factors; Spleen; Splenomegaly; Substance-Related Disorders

Topics: Group Processes; Health Education; Heroin; Humans; Male; Military Medicine; Morphine Dependence; Personality; Social Behavior; Social Environment; Substance Withdrawal Syndrome; United States; Vietnam; Warfare

Topics: Adolescent; Attitude; Barbiturates; Cannabis; Heroin; Humans; Jurisprudence; Morphine Dependence; Occupational Health Services; Occupational Medicine; Social Problems; Substance-Related Disorders; United States

Topics: Adolescent; Adult; Female; Heroin; Humans; Male; Morphine Dependence; New York; Pigmentation Disorders; Quinine; Skin Diseases; Substance-Related Disorders

Topics: Adult; Aversive Therapy; Female; Heroin; Humans; Male; Morphine Dependence; Relaxation

Topics: Chromatography, Gas; Chromatography, Thin Layer; False Positive Reactions; Heroin; Humans; Methadone; Military Medicine; Morphine; Morphine Dependence; Substance-Related Disorders; United States; Vietnam

Topics: Community Mental Health Services; Counseling; Heroin; Humans; Maryland; Methadone; Morphine Dependence; Professional-Patient Relations; Psychotherapy; Workforce

Topics: Administration, Oral; Adult; Constipation; Erectile Dysfunction; Evaluation Studies as Topic; Female; Heroin; Hospitalization; Humans; Male; Methadone; Middle Aged; Morphine Dependence; Narcotics; Psychotherapy; Recurrence; Social Adjustment; Substance Withdrawal Syndrome; Sweating

Topics: Adolescent; Child; Heroin; Humans; Methadone; Morphine Dependence; Narcotics; Substance-Related Disorders; United States

Topics: Adult; Age Factors; Ethnicity; Family Characteristics; Female; Follow-Up Studies; Heroin; Humans; Male; Methadone; Morphine Dependence; New York City; Occupations; Patient Readmission; Prognosis; Referral and Consultation; Religion; Sampling Studies; Sex Factors; Time Factors

Topics: Black or African American; Cannabis; Chicago; Costs and Cost Analysis; Crime; Heroin; Humans; Legislation, Drug; Morphine Dependence; Newspapers as Topic; Social Control, Formal

Topics: Adult; California; Community Mental Health Services; Female; Heroin; Hospitalization; Hospitals, Teaching; Humans; Internship and Residency; Length of Stay; Male; Methadone; Morphine Dependence; Psychiatric Department, Hospital; Psychiatry; Referral and Consultation; Substance Withdrawal Syndrome

Topics: Chicago; Communicable Disease Control; Epidemiologic Methods; Heroin; Humans; Models, Theoretical; Morphine Dependence; Research; Social Behavior; Social Environment; Urban Population

Topics: Adolescent; Adult; Amphetamine; California; Cannabis; Child; Community Health Services; Female; Heroin; Humans; Male; Medical Records; Methadone; Middle Aged; Morphine Dependence; Self Medication; Socioeconomic Factors; Substance Withdrawal Syndrome; Substance-Related Disorders

Topics: Dosage Forms; Drug Prescriptions; Drug Utilization; England; Heroin; Humans; Legislation, Drug; Methadone; Morphine Dependence; Seasons; Substance Withdrawal Syndrome

Topics: Administration, Oral; Adolescent; Adult; Ambulatory Care; Amobarbital; Barbiturates; Community Health Services; Female; Heroin; House Calls; Humans; Injections, Intramuscular; Male; Morphine Dependence; Pentobarbital; Phenobarbital; Secobarbital; Substance Withdrawal Syndrome; Substance-Related Disorders; Volunteers

Topics: Adult; Amphetamine; Cannabis; Female; Heroin; Humans; Lysergic Acid Diethylamide; Male; Methadone; Morphine Dependence; Perception; Semantic Differential

Topics: Amphetamine; Attitude; Cannabis; Ethanol; Heroin; Humans; Lysergic Acid Diethylamide; Models, Theoretical; Morphine Dependence; Occupational Medicine; Opium; Smoking; Social Change; Students; Substance-Related Disorders; United States; Universities

Topics: Alcohol Drinking; Alcoholism; Cannabis; Delayed-Action Preparations; Disulfiram; Heroin; Humans; Methadone; Morphine Dependence; Substance Withdrawal Syndrome; Substance-Related Disorders

Topics: Adult; Community Health Services; Female; Financing, Government; Heroin; Humans; Male; Methadone; Morphine Dependence; Ohio; Pilot Projects; Psychotherapy, Group; Referral and Consultation; Social Control, Formal

Topics: Adolescent; Adult; Age Factors; Amphetamine; Antisocial Personality Disorder; Barbiturates; Cannabis; Family; Female; Heroin; Hospitalization; Hospitals, Psychiatric; Humans; Lysergic Acid Diethylamide; Male; Mental Disorders; Morphine Dependence; Personality Disorders; Probability; Sex Factors; Sexual Behavior; Social Class; Student Dropouts; Substance-Related Disorders

Topics: Adult; Age Factors; Amphetamine; Attitude; Barbiturates; Cannabis; Educational Status; Family Characteristics; Hallucinogens; Heroin; Humans; Male; Marriage; Military Medicine; Morphine Dependence; Opium; Substance-Related Disorders; Surveys and Questionnaires; Time Factors; United States; Vietnam

Topics: Administration, Oral; Adult; Female; Heroin; Humans; Infant, Newborn; Infant, Newborn, Diseases; Methadone; Morphine Dependence; Pregnancy; Pregnancy Complications

Topics: Adult; Aneurysm; Brain; Ganglia, Spinal; Globus Pallidus; Heroin; Humans; Hypotension; Infarction; Male; Morphine Dependence; Muscular Atrophy; Necrosis; Peripheral Nerves; Spinal Cord

Topics: Acute Disease; Autopsy; Chronic Disease; Granuloma; Heroin; Humans; Lung; Lung Diseases; Morphine Dependence; Talc

Topics: Acute Disease; Adolescent; Adult; Autopsy; Chemical and Drug Induced Liver Injury; Female; Hepatitis A; Hepatitis B; Heroin; Humans; Liver; Liver Diseases; Lymph Nodes; Male; Morphine Dependence; Necrosis; Pulmonary Edema

Topics: Cicatrix; Heroin; Humans; Injections, Intravenous; Morphine Dependence; Substance-Related Disorders

Topics: Female; Gestational Age; Heroin; Humans; Male; Methadone; Morphine Dependence; Pregnancy; Substance Withdrawal Syndrome

Topics: Adult; Criminal Psychology; Employment; Evaluation Studies as Topic; Follow-Up Studies; Heroin; Hospitalization; Humans; Methadone; Morphine Dependence; Remission, Spontaneous; Substance Withdrawal Syndrome; United States; Voluntary Health Agencies

Topics: Adult; Cocaine; Criminal Psychology; Drug and Narcotic Control; Female; Heroin; Humans; Male; Methadone; Morphine Dependence; Motivation; Narcotics; Substance-Related Disorders; United States

Topics: Adolescent; Adult; Ambulatory Care; Evaluation Studies as Topic; Female; Heroin; Hospitalization; Humans; Male; Methadone; Morphine Dependence; New York; Outpatient Clinics, Hospital; Patient Readmission; Statistics as Topic

Topics: Criminal Psychology; Heroin; Humans; Methadone; Morphine Dependence; Rehabilitation, Vocational; Substance-Related Disorders; United States

Topics: Adult; Anxiety; Black or African American; Community Health Services; Cooperative Behavior; Counseling; Depression; Evaluation Studies as Topic; Heroin; Humans; Illinois; Interview, Psychological; Male; Methadone; Morphine Dependence; Object Attachment; Paranoid Disorders; Personality; Personality Disorders; Professional-Patient Relations; Psychotherapy, Group

Topics: Adult; Cells, Cultured; Chromosome Aberrations; Chromosomes; Dose-Response Relationship, Drug; Female; Heroin; Humans; In Vitro Techniques; Leukocytes; Male; Methadone; Middle Aged; Mitosis; Morphine; Morphine Dependence; Quinine; Substance-Related Disorders

Topics: Chromatography, Thin Layer; Color; False Negative Reactions; Heroin; Humans; Methadone; Morphine Dependence; Quinine; Specific Gravity

Topics: Adolescent; Adult; Antidotes; Cannabis; Female; Hallucinogens; Heroin; Humans; Lysergic Acid Diethylamide; Male; Mescaline; Morphine; Morphine Dependence; Poisoning; Substance Withdrawal Syndrome; Substance-Related Disorders

Topics: Animals; Bilirubin; Diazepam; Endoplasmic Reticulum; Female; Glucuronates; Heroin; Hexosyltransferases; Humans; Infant, Newborn; Jaundice, Neonatal; Liver; Male; Maternal-Fetal Exchange; Microscopy, Electron; Morphine; Morphine Dependence; Pregnancy; Protein Binding; Rats; Serum Albumin; Substance Withdrawal Syndrome

Topics: Adolescent; Adult; Dextromoramide; Drug and Narcotic Control; Europe; Female; Heroin; Humans; Legislation, Drug; Male; Methadone; Morphine Dependence; Social Problems; Substance-Related Disorders

Topics: Female; Heroin; Humans; Male; MMPI; Morphine Dependence; Personality; Research; Substance-Related Disorders

Topics: Analgesics; Drug and Narcotic Control; Health Education; Heroin; Humans; Morphine Dependence; Piperidines; Substance-Related Disorders; United Kingdom; World Health Organization

Topics: Cannabis; Heroin; Humans; Legislation, Drug; Lysergic Acid Diethylamide; Morphine Dependence; Punishment; Substance-Related Disorders; United Kingdom

Topics: Costs and Cost Analysis; Crime; Health Expenditures; Heroin; Humans; Methadone; Morphine Dependence; New York City; Prisons; Rehabilitation; Reinforcement, Social; United States

Topics: Female; Heroin; Humans; Infant, Newborn; Infant, Newborn, Diseases; Maternal-Fetal Exchange; Methadone; Morphine Dependence; Pregnancy; Substance Withdrawal Syndrome

Topics: Acute Disease; Adolescent; Adult; Atrial Fibrillation; Heroin; Humans; Male; Morphine Dependence; Poisoning; Pulmonary Edema

Topics: Community Health Services; Computers; Demography; Heroin; Hospitals; Humans; Information Services; Information Systems; Jurisprudence; Methadone; Morphine Dependence; New York City; Records; Socioeconomic Factors

Topics: Administration, Oral; Heroin; Humans; Methadone; Morphine Dependence

Topics: Age Factors; Chicago; Demography; Female; Group Structure; Heroin; Humans; Male; Mental Health; Methadone; Morphine Dependence; Psychiatric Status Rating Scales; Psychotherapy; Role; Sampling Studies; Sex Factors; Social Adjustment; Socioeconomic Factors; Substance-Related Disorders

Topics: Alcohol Drinking; Alcoholism; Automatism; Habits; Heroin; Humans; Morphine Dependence; Recurrence; Reinforcement, Psychology; Smoking; Statistics as Topic; Substance-Related Disorders

Topics: Female; Heroin; Humans; Infant, Newborn; Infant, Newborn, Diseases; Maternal-Fetal Exchange; Michigan; Morphine Dependence; Pregnancy

Topics: Adult; Community Health Services; Female; Heroin; Humans; Male; Methadone; Michigan; Morphine Dependence

Topics: Adult; Animals; Anti-Bacterial Agents; Dogs; Endocarditis, Bacterial; Female; Heart; Hemodynamics; Heroin; Humans; Male; Morphine Dependence; Pseudomonas Infections; Tricuspid Valve Insufficiency

Topics: Attitude of Health Personnel; Attitude to Health; Behavior Therapy; Emergency Medical Services; Heroin; Hospitals; Humans; Legislation, Medical; Methadone; Morphine Dependence; Psychotherapy, Group; Social Class; Substance-Related Disorders; Therapeutic Community; United States

Topics: Adult; Age Factors; Black or African American; Female; Heroin; Humans; Life Style; Male; Maryland; Methadone; Morphine Dependence; Physician-Patient Relations; Professional-Patient Relations; Prognosis; Sex Factors; Substance-Related Disorders; Voluntary Health Agencies; White People

Topics: Female; Fertility; Heroin; Humans; Infant, Newborn; Maternal-Fetal Exchange; Methadone; Morphine Dependence; Pregnancy; Pregnancy Complications

Topics: Female; Fertility; Heroin; Humans; Infant, Newborn; Morphine Dependence; Pregnancy; Pregnancy Complications

Topics: Adult; Cholangitis; Cholecystitis; Female; Heroin; Humans; Infant, Newborn; Infant, Newborn, Diseases; Male; Methadone; Morphine Dependence; Pregnancy; Pregnancy Complications; Substance Withdrawal Syndrome

Topics: Adolescent; Adult; Antisocial Personality Disorder; Heroin; Humans; Male; Morphine Dependence; Personality; Prisons

A survey of the first year's referral of heroin-addicted adolescents was undertaken exactly two years after the opening of a special treatment unit. Out of 130 patients presenting 78 were selected for treatment and were followed up. The drug-taking pattern of this group is reported. At the time of the survey 27% were assessed as off all addictive drugs.

Topics: Adolescent; Child; Depression; Female; Follow-Up Studies; Heroin; Hospitals, Special; Humans; London; Male; Milieu Therapy; Morphine Dependence; Obsessive-Compulsive Disorder; Psychotherapy; Psychotherapy, Group; Social Class

Topics: Adult; Age Factors; Amphetamine; Barbiturates; Cannabis; Cocaine; Drug and Narcotic Control; Heroin; Humans; Hypnotics and Sedatives; London; Lysergic Acid Diethylamide; Male; Methadone; Morphine Dependence; Substance-Related Disorders; United Kingdom

Topics: Adolescent; Adult; Age Factors; Amphetamine; Barbiturates; Cannabis; Crime; Female; Geography; Heroin; Humans; Juvenile Delinquency; Lysergic Acid Diethylamide; Male; Methadone; Middle Aged; Morphine Dependence; Poverty; Prognosis; Sex Factors; Substance-Related Disorders; United Kingdom

Topics: Adolescent; Adult; Culture; Group Structure; Heroin; Humans; Interview, Psychological; Life Style; Male; Morphine Dependence

Topics: Administration, Oral; Heroin; Humans; Injections, Intravenous; Methadone; Morphine Dependence; Pharmaceutical Vehicles; Solutions; Substance-Related Disorders; Tablets; Technology, Pharmaceutical

Topics: Attitude to Health; Community Health Services; Demography; Health Occupations; Heroin; Humans; Methadone; Michigan; Morphine Dependence; Public Health Administration; Public Health Nursing; Socioeconomic Factors; Substance-Related Disorders

Topics: Attitude; Cannabis; Drug and Narcotic Control; Health Education; Heroin; Humans; Jurisprudence; Legislation, Drug; Morphine Dependence; Role; Social Control, Formal; Students; Substance-Related Disorders; United States

Topics: Adolescent; Adult; Amphetamine; Cannabis; Costs and Cost Analysis; Drug and Narcotic Control; Heroin; Humans; Legislation, Drug; Lysergic Acid Diethylamide; Mental Disorders; Morphine Dependence; Narcotics; Substance-Related Disorders; United States

Topics: American Medical Association; Female; Health Education; Heroin; Humans; Legislation, Drug; Methadone; Morphinans; Morphine; Morphine Dependence; Pain; Personality; Pregnancy; Pregnancy Complications; Socioeconomic Factors; Substance Withdrawal Syndrome; United States

Topics: Adult; Chronic Disease; Crime; Economics; Heroin; Humans; Methadone; Middle Aged; Morphine Dependence; New York City

Topics: Adult; Female; Heroin; Humans; Male; Middle Aged; Morphine Dependence; Skin Manifestations; Substance-Related Disorders

Topics: Adolescent; Adult; Age Factors; Amphetamine; Cocaine; Drug and Narcotic Control; Female; Heroin; Humans; London; Male; Methadone; Morphine Dependence; Outpatient Clinics, Hospital; Socioeconomic Factors; Substance-Related Disorders

Topics: Adolescent; Female; Heroin; Humans; Juvenile Delinquency; Male; Morphine Dependence; Sex Factors; Social Class; Substance-Related Disorders; United Kingdom; United States

Topics: Community Mental Health Services; Connecticut; Heroin; Humans; Morphine Dependence

Topics: Heroin; Humans; Methadone; Morphine Dependence

Topics: Heroin; Hospitals; Humans; Methadone; Morphine Dependence; New York City

Topics: Heroin; Humans; Methadone; Morphine Dependence; Therapeutic Community

Topics: Adult; Amphetamine; Aspergillosis; Cannabis; Eye Diseases; Heroin; Humans; Inflammation; Injections, Intravenous; Lysergic Acid Diethylamide; Male; Methylphenidate; Morphine Dependence; Mycoses; Substance-Related Disorders

Topics: Administration, Oral; Analgesics; Drug and Narcotic Control; Heroin; Humans; Injections, Intravenous; Injections, Subcutaneous; Methadone; Morphine Dependence; Substance-Related Disorders

Topics: Codeine; Heroin; Humans; Levallorphan; Meperidine; Methadone; Morphine; Morphine Dependence; Nalorphine; Narcotic Antagonists; Stereoisomerism; Substance-Related Disorders

Topics: Administration, Oral; Adult; Aged; Ambulatory Care; Heroin; Humans; Male; Methadone; Middle Aged; Morphine Dependence; Rehabilitation; Social Class

Topics: Adult; Female; Heroin; Humans; Male; Morphine Dependence; Socioeconomic Factors; Substance-Related Disorders

A follow-up study of girls in a London remand home during the years 1966-8 showed that 20.6% of those taking non-narcotic drugs on admission, but only 1% of non-drug-taking control admissions, had used narcotics by June 1970. Narcotic use on admission and progression to narcotic use were associated with frequent drug taking, marked involvement in a drug milieu, and a high incidence of personal morbidity. Adolescents who use illicit drugs and have a history of court appearances for any reason are particularly vulnerable to subsequent narcotic usage and other forms of serious drug abuse.

Topics: Adolescent; Amphetamine; Cannabis; Cocaine; Educational Status; Family; Female; Heroin; Humans; Juvenile Delinquency; London; Lysergic Acid Diethylamide; Mental Disorders; Methadone; Morphine Dependence; Parent-Child Relations; Personality Disorders; Sexual Behavior; Socioeconomic Factors; Substance-Related Disorders; Work

Topics: Adult; Heroin; Humans; Male; Morphine Dependence; Ribs; Tuberculosis, Miliary; Tuberculosis, Osteoarticular

Topics: Barbiturates; Drug Prescriptions; Family Practice; Heroin; Humans; Hypnotics and Sedatives; London; Morphine Dependence; Pharmacy Service, Hospital; Substance-Related Disorders

Topics: Adolescent; Adult; Drug Prescriptions; Epidemiologic Methods; Female; Heroin; Hospitalization; Humans; Income; London; Male; Middle Aged; Morphine Dependence; Occupations; Self Medication; Socioeconomic Factors; Substance-Related Disorders

Topics: Adult; Anxiety; Community Health Services; Depression; Evaluation Studies as Topic; Heroin; Humans; Illinois; Interview, Psychological; Male; Methadone; Middle Aged; MMPI; Morphine Dependence; Personality; Psychological Tests; Psychotherapy, Group; Social Behavior Disorders

Topics: Bibliographies as Topic; Heroin; Humans; Methadone; Morphine Dependence; Substance Withdrawal Syndrome

Topics: Adolescent; Adult; Antidepressive Agents; Cannabis; Epidemiologic Methods; Female; Heroin; Humans; Hypnotics and Sedatives; Lysergic Acid Diethylamide; Male; Middle Aged; Morphine Dependence; Registries; Statistics as Topic; Substance-Related Disorders; Tranquilizing Agents; United States

Topics: Europe; Heroin; Humans; Morphine Dependence; Nursing

Topics: Heroin; Humans; Methadone; Morphine Dependence; Psychiatric Nursing

Topics: Academies and Institutes; Attitude of Health Personnel; Heroin; Humans; Methadone; Morphine Dependence; New York

Topics: Amphetamine; Barbiturates; Cannabis; Central Nervous System; Heroin; Humans; Legislation, Drug; Lysergic Acid Diethylamide; Morphine; Morphine Dependence; Narcotics; Psychopharmacology; Substance-Related Disorders; Terminology as Topic

Topics: Adolescent; Adolescent Psychiatry; Heroin; Humans; Morphine Dependence; Nurse-Patient Relations; Therapeutic Community

Topics: Chlorpromazine; Female; Heroin; Humans; Infant, Newborn; Infant, Newborn, Diseases; Maternal-Fetal Exchange; Morphine Dependence; Phenobarbital; Pregnancy; Pregnancy Complications; Substance Withdrawal Syndrome

Topics: Heroin; Humans; Methadone; Morphine Dependence; Oregon

Topics: Adult; Age Factors; Alcoholism; Barbiturates; Community Mental Health Services; Crime; Educational Status; Female; Heroin; Humans; Male; Methadone; Morphine Dependence; Occupations; Sex Factors; Social Behavior Disorders; Substance-Related Disorders; Unemployment

Topics: Adult; Brain Diseases; Encephalitis; Fungi; Heroin; Humans; Infections; Injections, Intravenous; Male; Morphine Dependence; Mycoses

Topics: Adult; Aneurysm, Infected; Blood Vessel Prosthesis; Femoral Artery; Heroin; Humans; Iliac Artery; Injections, Intra-Arterial; Male; Middle Aged; Morphine Dependence; Popliteal Artery

Topics: Attitude of Health Personnel; Heroin; Humans; Methadone; Morphine Dependence; Public Health; United States

Topics: Alcohols; Heroin; Humans; Methadone; Morphine Dependence

Topics: Adult; Drug Contamination; Heart; Heart Arrest; Heroin; Humans; Male; Morphine Dependence; Quinine

Topics: Adult; Female; Heroin; Humans; Male; Methadone; Morphine Dependence

Topics: Female; Heroin; Humans; Male; Morphine Dependence; Psychoses, Substance-Induced; Sex Factors; United States

Topics: Adolescent; Advertising; Heroin; Humans; Morphine Dependence; Parent-Child Relations; Psychology, Adolescent; Social Medicine; Social Values; United Kingdom

Topics: Adolescent; Adult; Heroin; Hospitals, General; Humans; Methadone; Morphine Dependence; New York City

Topics: Amphetamine; Animals; Barbiturates; Brain; Cannabis; Central Nervous System; Cocaine; Drug Tolerance; Guinea Pigs; Heroin; Humans; Hypothalamus; Ileum; Lysergic Acid Diethylamide; Morphine; Morphine Dependence; Nerve Endings; Opium; Psychoses, Substance-Induced; Substance Withdrawal Syndrome; Substance-Related Disorders

Topics: Adolescent; Community Mental Health Services; Female; Financing, Government; Heroin; Hospitals, General; Humans; Male; Methadone; Morphine Dependence; New York City; Public Health Administration; Research Support as Topic

Topics: Adolescent; Adult; Evaluation Studies as Topic; Heroin; Humans; Methadone; Morphine Dependence; New York City; Regional Health Planning; Research; Research Support as Topic

Topics: Adult; Ambulatory Care; Community Mental Health Services; Evaluation Studies as Topic; Female; Heroin; History, 16th Century; Humans; Illinois; Male; Methadone; Morphine Dependence; Substance Withdrawal Syndrome

Topics: Adult; Ambulatory Care; Community Mental Health Services; Female; Financing, Organized; Heroin; Hospitals, General; Hospitals, Teaching; Humans; Male; Methadone; Minnesota; Morphine Dependence; Outpatient Clinics, Hospital; Private Practice; Psychotherapy; Substance Withdrawal Syndrome

Topics: Adult; Chromatography, Thin Layer; Community Mental Health Services; Counseling; Heroin; Hospitalization; Humans; Male; Methadone; Missouri; Morphine Dependence; Outpatient Clinics, Hospital; Professional-Patient Relations; Substance Withdrawal Syndrome

Topics: Adult; Community Mental Health Services; Female; Heroin; Humans; Male; Maryland; Methadone; Morphine Dependence; Private Practice; Professional-Patient Relations; Volunteers

Topics: Adult; Aged; Community Mental Health Services; Counseling; Evaluation Studies as Topic; Female; Heroin; Humans; Male; Methadone; Middle Aged; Morphine Dependence; Outpatient Clinics, Hospital; Pennsylvania

Topics: Adult; Aged; Ambulatory Care; British Columbia; Community Mental Health Services; Crime; Criminal Psychology; Employment; Evaluation Studies as Topic; Female; Heroin; Humans; Male; Methadone; Middle Aged; Morphine Dependence; Prisons; Substance Withdrawal Syndrome

Topics: Adult; Alcoholism; Amphetamine; Barbiturates; Child, Preschool; Community Health Services; Evaluation Studies as Topic; Female; Forensic Medicine; Heroin; Homicide; Humans; Male; Methadone; Middle Aged; Morphine Dependence; Narcotics; New York City; Substance-Related Disorders; Suicide

Topics: Adolescent; Adult; Community Mental Health Services; Crime; Drug Prescriptions; Emergency Service, Hospital; Evaluation Studies as Topic; Fees and Charges; Female; Financing, Personal; Florida; Heroin; Humans; Male; Methadone; Morphine Dependence; Substance Withdrawal Syndrome; Volunteers

Topics: Analgesics; Azocines; Cyclazocine; Evaluation Studies as Topic; Heroin; Hospitalization; Hospitals, General; Hospitals, Teaching; Humans; Methadone; Morphinans; Morphine Dependence; Naloxone; Narcotic Antagonists; Narcotics; New York City; Outpatient Clinics, Hospital; Psychotherapy; Substance Withdrawal Syndrome; Substance-Related Disorders

Topics: Adolescent; Adult; Age Factors; Alcoholism; Community Mental Health Services; Drug and Narcotic Control; Educational Status; Employment; Ethnicity; Evaluation Studies as Topic; Female; Heroin; Humans; Male; Methadone; Middle Aged; Morphine Dependence; New York City; Recurrence; Social Behavior; Substance-Related Disorders

Topics: Adolescent; Adult; Aged; Amphetamine; Barbiturates; Cannabis; Cocaine; Crime; Educational Status; Ethnicity; Heroin; Humans; Lysergic Acid Diethylamide; Male; Meperidine; Methadone; Middle Aged; Morphine Dependence; New York; Opium; Substance-Related Disorders

Topics: Adult; Aged; British Columbia; Community Health Services; Criminal Psychology; Employment; Evaluation Studies as Topic; Female; Heroin; Humans; Male; Methadone; Middle Aged; Morphine Dependence; Outpatient Clinics, Hospital; Social Behavior; Substance Withdrawal Syndrome

Topics: Adult; Community Health Services; Criminal Psychology; Employment; Evaluation Studies as Topic; Female; Heroin; Hospitalization; Humans; Male; Methadone; Middle Aged; Morphine Dependence; Outpatient Clinics, Hospital; Pennsylvania

Topics: Adolescent; Adult; California; Community Health Services; Female; Heroin; Hospitals, Psychiatric; Humans; Jurisprudence; Legislation, Drug; Length of Stay; Male; Middle Aged; Morphine Dependence; Narcotics; Outpatient Clinics, Hospital; Patient Readmission; Prisons; Referral and Consultation; Rehabilitation Centers; Residential Treatment; Substance-Related Disorders

Topics: Adolescent; Adult; Barbiturates; Death Certificates; Female; Forensic Medicine; Heroin; Humans; Hypnotics and Sedatives; Male; Maryland; Middle Aged; Morphine Dependence; Narcotics; Salicylates; Substance-Related Disorders; Suicide; Tranquilizing Agents

Topics: Alcoholism; Community Health Services; Heroin; Hospitals, Teaching; Humans; Morphine Dependence; Neurology; Substance-Related Disorders

Topics: Drug and Narcotic Control; Drug Prescriptions; Heroin; Humans; Legislation, Drug; Morphine Dependence; Motivation; Physician-Patient Relations; United Kingdom

Topics: Drug and Narcotic Control; England; Heroin; Humans; Morphine Dependence

Topics: England; Heroin; Humans; Morphine Dependence

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

Topics: Adult; Aged; Brain Diseases; Cerebral Cortex; Endocarditis, Bacterial; Female; Fungi; Granuloma; Heroin; Humans; Male; Meningitis; Middle Aged; Morphine Dependence; Substance-Related Disorders

Topics: Adult; Candidiasis; Endocarditis; Heroin; Humans; Injections, Intravenous; Male; Morphine Dependence; Pseudomonas Infections; Pulmonary Embolism; Staphylococcal Infections; Sterilization; Tricuspid Valve

Topics: Heroin; Humans; Methadone; Morphine Dependence

Topics: Alcoholism; Antisocial Personality Disorder; Crime; Heroin; Humans; Medicine; Methadone; Morphine Dependence; Motivation; Social Behavior; Social Behavior Disorders; Social Problems; Social Welfare; Substance-Related Disorders

Topics: Adult; Drug Contamination; Heroin; Humans; Morphine Dependence; Myelitis

Topics: Adult; Heroin; Humans; Injections, Intravenous; Male; Morphine Dependence; Respiration, Artificial; Respiratory Center; Respiratory Insufficiency

Topics: Adult; Anesthesia, General; Asphyxia; Barbiturates; Brain; Brain Diseases; Female; Forensic Medicine; Globus Pallidus; Heart Arrest; Heroin; Humans; Hypoxia, Brain; Injections, Intravenous; Male; Middle Aged; Morphine Dependence; Necrosis; Peptic Ulcer Perforation; Suicide

Topics: Adolescent; Adult; Bis-Trimethylammonium Compounds; Female; Hemoglobinometry; Heroin; Humans; Liver Function Tests; Male; Morphine Dependence

Topics: Adult; Heroin; Humans; Morphine Dependence; Substance Withdrawal Syndrome

Topics: Adult; Female; Heroin; Humans; Male; Morphine Dependence

Dr T H Bewley discusses recent increases in the incidence of all types of drug dependence in Great Britain.Dr P H Connell considers the problem of amphetamine dependence historically and in different age groups and draws attention to the sociocultural patterns of behaviour which have sprung up amongst the adolescent and young adult population. Treatment is discussed.Dr R H V Ollendorff outlines a theory of drug addiction based upon seven aetiological factors, and stresses the importance of the general practitioner in treating the addict.

Topics: Adult; Alcoholism; Amphetamine; Barbiturates; Cannabis; Cocaine; Female; Hallucinogens; Heroin; Humans; Lysergic Acid Diethylamide; Middle Aged; Morphine Dependence; Substance-Related Disorders; United Kingdom

Topics: Adolescent; Adult; Female; Heroin; Humans; Injections; Lung; Lung Abscess; Male; Morphine Dependence; New York City; Pleural Effusion; Pneumonia; Pseudomonas Infections; Pulmonary Edema; Radiography; Spondylitis; Substance-Related Disorders; Tetanus; United States

Topics: Heroin; Humans; Morphine Dependence; Pulmonary Edema

Topics: Crime; Heroin; Humans; Male; Methadone; Morphine Dependence

Topics: Adolescent; Adult; Crime; Ethnicity; Heroin; Humans; Male; Methadone; Middle Aged; Morphine Dependence; New York City

Topics: Heroin; Humans; Methadone; Morphine Dependence

Topics: Adolescent; Female; Heroin; Hospitals, Psychiatric; Humans; Morphine Dependence

Topics: Amphetamine; Barbiturates; Female; Heroin; Humans; Male; Morphine Dependence; New York City; Opium; Substance Withdrawal Syndrome; Substance-Related Disorders

Topics: Female; Heroin; Humans; Male; Methadone; Morphine Dependence; Rehabilitation

Topics: Adolescent; Adult; Alcoholism; Cocaine; Heroin; Hospitals, Psychiatric; Humans; Male; Middle Aged; Morphine Dependence; Psychiatry; Psychotherapy; Psychotherapy, Group; Rehabilitation

Topics: Barbiturates; Heroin; Hot Temperature; Humans; Morphine; Morphine Dependence

Topics: Chromatography, Thin Layer; Heroin; Humans; Morphine; Morphine Dependence; Urine

Topics: Heroin; Humans; Methadone; Morphine Dependence

Topics: Adult; Barbiturates; Cocaine; Drug Hypersensitivity; Heroin; Humans; Male; Middle Aged; Morphine Dependence; Substance-Related Disorders

Topics: Adolescent; Alcoholism; Barbiturates; Black People; Connecticut; Depression; Depressive Disorder; Geriatrics; Heroin; Meperidine; Morphine Dependence; Neurotic Disorders; Social Conditions; Statistics as Topic; Substance-Related Disorders

Topics: Barbiturates; Codeine; Drug Tolerance; Ethchlorvynol; Glutethimide; Heroin; Hydromorphone; Hypnotics and Sedatives; Meperidine; Meprobamate; Methadone; Morphine Dependence; Narcotics; Opium; Pentobarbital; Seizures; Statistics as Topic; Substance-Related Disorders; Toxicology; Urea

Topics: Aminopyrine; Animals; Aspirin; Atropine; Behavior, Animal; Codeine; Heroin; Histamine H1 Antagonists; Humans; Lysergic Acid Diethylamide; Morphine; Morphine Dependence; Noscapine; Rats; Substance Withdrawal Syndrome

Topics: Chromatography; Heroin; Humans; Morphine; Morphine Dependence; Narcotics; Research; Urine

Topics: Heroin; Heroin Dependence; Humans; Morphine; Morphine Dependence; Substance-Related Disorders