heroin and Psychotic-Disorders

The incidence of chronic heroin use disorder, including overdose deaths, has reached epidemic proportions. Here we summarise and evaluate our knowledge of the relationship between chronic heroin use disorder and the brain through a narrative review. A broad range of areas was considered including causal mechanisms, cognitive and neurological consequences of chronic heroin use and novel neuroscience-based clinical interventions. Chronic heroin use is associated with limited or very limited evidence of impairments in memory, cognitive impulsivity, non-planning impulsivity, compulsivity and decision-making. Additionally, there is some evidence for certain neurological disorders being caused by chronic heroin use, including toxic leukoencephalopathy and neurodegeneration. However, there is insufficient evidence on whether these impairments and disorders recover after abstinence. Whilst there is a high prevalence of comorbid psychiatric disorders, there is no clear evidence that chronic heroin use per se causes depression, bipolar disorder, PTSD and/or psychosis. Despite the growing burden on society from heroin use, knowledge of the long-term effects of chronic heroin use disorder on the brain remains limited. Nevertheless, there is evidence for progress in neuroscience-based interventions being made in two areas: assessment (cognitive assessment and neuroimaging) and interventions (cognitive training/remediation and neuromodulation). Longitudinal studies are needed to unravel addiction and neurotoxic mechanisms and clarify the role of pre-existing psychiatric symptoms and cognitive impairments.

Topics: Bipolar Disorder; Brain; Cognitive Dysfunction; Comorbidity; Heroin; Humans; Impulsive Behavior; Neuroimaging; Neurosciences; Opioid-Related Disorders; Psychotic Disorders

This study's main objective is to carry out a systematic review of the onset of psychotic symptoms after opioid withdrawal. The opiate dependence correlated to psychiatric symptoms has been well described.. Following the PRISMA methodology. The consecutive search strategy was applied: (morphine OR buprenorphine OR oxycodone OR tramadol OR fentanyl OR remifentanil OR opioids OR heroin OR methadone) AND (Psychosis OR psychotic symptoms OR schizophrenia).. 12 case reports, 3 series of cases, 2 clinical studies, and 2 reviews were found. It seems that the time association is present in all of them; symptoms appear days after the interruption of the opioid. Most of the articles reported are case reports that describe symptoms that appear after the suspension of the opioid substance; in most cases, the reintroduction of the opioid had therapeutic effects and provoked a remission of these symptoms. These preliminary findings indicate that opiates could have an antipsychotic effect; however, the literature is scarce. It is critical to consider, if needed, in opioid-dependent patients who start with psychosis after the opioid withdrawal the possible replacement or reintroduction of opioids to prevent further deterioration in the patient's mental status.. This study encompasses a comprehensive description of the literature concerning the possible not well-studied outcome of opioid withdrawal. There are some reports of temporal association between withdrawal and psychotic symptoms that improved after the reintroduction of the opioid; it could be taken into consideration in the clinical practice.

Topics: Analgesics, Opioid; Buprenorphine; Heroin; Humans; Methadone; Morphine; Oxycodone; Psychotic Disorders; Substance Withdrawal Syndrome; Tramadol

The distribution of naloxone to heroin users is a suggested intervention to reduce overdose and death rates. However, the level of willingness of drug users to administer this medication to others is unclear. Drug users recruited from the community between January 2002 and January 2004 completed a structured interview that assessed topics including drug use, overdose history, and attitudes toward using overdose remedies to assist others. Of the 329 drug users, 82% had used heroin and 64.3% reported that they had injected drugs. Nearly two thirds (64.6%) said that they had witnessed a drug overdose and more than one third (34.6%) had experienced an accidental drug overdose. Most participants (88.5%) said that they would be willing to administer a medication to another drug user in the event of an overdose. Participants who had used heroin (p = .024), had injected drugs (p = .022), had witnessed a drug overdose (p = .001), or had a history of one or more accidental drug overdoses (p = .009) were significantly more willing to treat a companion who had overdosed. Drug users were willing to use naloxone in the event of a friend's overdose. Specific drug use and overdose histories were associated with the greatest willingness to administer naloxone.

Topics: Adolescent; Adult; Cocaine; Cocaine-Related Disorders; Drug Overdose; Female; Friends; Helping Behavior; Heroin; Heroin Dependence; Humans; Interpersonal Relations; Male; Naloxone; Narcotic Antagonists; Psychotic Disorders

Topics: Adult; Heroin; Humans; Male; Methadone; Psychotic Disorders; Self Medication; Substance-Related Disorders

Topics: Antipsychotic Agents; Heroin; History, 19th Century; Humans; Morphine; Psychotic Disorders; Substance-Related Disorders; United Kingdom

Topics: Adolescent; Adult; Anxiety; Criminal Psychology; Depression; Female; Heroin; Heroin Dependence; Hostility; Humans; Internal-External Control; Male; Middle Aged; MMPI; Personality; Psychological Tests; Psychotic Disorders; Substance-Related Disorders; Therapeutic Community; Voluntary Health Agencies

Topics: Cyclazocine; Heroin; Heroin Dependence; Humans; Naloxone; Psychotic Disorders

Topics: Antisocial Personality Disorder; Heroin; Humans; Logic; MMPI; Psychological Tests; Psychotic Disorders; Substance-Related Disorders

Topics: Adult; Antisocial Personality Disorder; Heroin; Humans; MMPI; Paranoid Disorders; Psychological Tests; Psychometrics; Psychotic Disorders; Schizophrenic Psychology; Substance-Related Disorders

Topics: Adolescent; Adolescent Psychiatry; Adult; Alcoholism; Amphetamine; Cannabis; Ego; Female; Heroin; Homosexuality; Humans; Lysergic Acid Diethylamide; Male; Opium; Personality Development; Psychoanalytic Therapy; Psychotic Disorders; Substance-Related Disorders

Topics: Adolescent; Adult; Alcoholism; Amphetamine; Barbiturates; Cannabis; Cocaine; Hepatitis A; Hepatitis B; Heroin; Humans; Lysergic Acid Diethylamide; Male; Middle Aged; Opium; Phenothiazines; Prisons; Psychotic Disorders; Sepsis; Smoking; Substance-Related Disorders; United Kingdom