naloxone and Marijuana-Abuse

Substance abuse is a significant health problem in the adolescent population. Prevention is a formidable challenge, but attempts at discouraging experimentation in early adolescence and the promotion of healthy adult role models may be effective strategies. Questions that may elicit a history suggestive of abuse should be a routine part of the adolescent medical history. Pediatricians should be familiar with the important clinical findings resulting from intoxication with the various substances of abuse and should be able to recognize the "telltale" signs of abuse. Effective management is based on attention to the basics of life support, careful attention to the physical findings, and judicious use of specific therapeutic agents. Above all, a compassionate attitude should prevail if acute-phase recovery and long-term rehabilitation are to be successful.

Topics: Absorption; Adolescent; Adult; Alcoholic Intoxication; Amphetamines; Anti-Anxiety Agents; Benzodiazepines; Cocaine; Diagnosis, Differential; Female; Fever; Glucose; Hallucinogens; Humans; Hypotension; Illicit Drugs; Lysergic Acid Diethylamide; Marijuana Abuse; Mescaline; Methaqualone; Mushroom Poisoning; Naloxone; Narcotics; Nitrites; Poisoning; Solvents; Substance-Related Disorders

Cannabis use is common among opioid-dependent patients, but studies of its association with treatment outcome are mixed. In this secondary analysis, the association of cannabis use with opioid treatment outcome is assessed.. In the main study, participants (n=152) aged 15-21 years were randomized to receive psychosocial treatments and either a 12-week course of buprenorphine-naloxone with a dose taper to zero in weeks 9-12, or a 2-week detoxification with buprenorphine-naloxone. Drug use was assessed by self-report and urine drug screen at baseline and during study weeks 1-12. The association between cannabis and opioid use at weeks 4, 8, and 12 was examined using logistic regression models.. Participants reported a median of 3.0 days (range=0-30) cannabis use in the past month; half (50.3%; n=77) reported occasional use, one-third reported no use (33.1%; n=50), and one-sixth reported daily cannabis use (16.6%; n=25). Median lifetime cannabis use was 4.0 years (range=0-11) and median age of initiation of use was 15.0 years (range 9-21). Neither past cannabis use (age of initiation and use in the month prior to baseline) nor concurrent use was associated with level of opioid use.. Overall, cannabis use had no association with opioid use over 12 weeks in this sample of opioid-dependent youth. While cannabis use remains potentially harmful, it was not a predictor of poor opioid treatment outcome.

Topics: Adult; Buprenorphine; Data Interpretation, Statistical; Female; Humans; Logistic Models; Male; Marijuana Abuse; Naloxone; Narcotic Antagonists; Narcotics; Opioid-Related Disorders; Substance Abuse Detection; Treatment Outcome; Young Adult

Topics: Alcoholism; Cocaine-Related Disorders; Dopamine; Drug Overdose; Heroin Dependence; History, 20th Century; History, 21st Century; Humans; Marijuana Abuse; Methadone; Methamphetamine; Naloxone; National Institutes of Health (U.S.); Neurosciences; Opioid-Related Disorders; Positron-Emission Tomography; Prefrontal Cortex; Psychiatry; Reward; Socioeconomic Factors; United States

conduct needs assessments and treatment compliance evaluations in MMT and Suboxone Substitution State Programs in Georgia (Republic of). 506 patients (2 females) were surveyed (92% on Methadone, 8% on Suboxone) from 6 Tbilisi and 4 regional State Programs in 2011 November. Mean age - 40±8,56 (22-65) year; 254 (51.4%) were in treatment for 1-3 year. Evaluation was carried out on the base of structured self-questionnaire that covers demographics, drug use history, general drug use trends, psychotherapeutic sessions' acceptance and open label question regarding treatment challenges and satisfaction. 305 (60.3%) attended individual and 57 (11.3%) group psychotherapy sessions with 50.79% attending once/month or rare. The main reason given for therapy non-attendance - no needs for it (29.48%); the main drugs before admission - heroin (80.04%), buprenorphine (53.49%); Main drugs used in Georgia nowadays - desomorphine ("crocodile"), alcohol and marihuana. Commonly used drugs by program patients (136 positive answers) - alcohol-13.62%, marihuana-10.39%, pregabalin - 8.17%, opioids- 6.62% (mostly-"crocodile"), home-made stimulants-6.23%, sedatives -5.45%. 55.4% are extremely satisfied with treatment, 82.4% - with program staff. Patients' main wishes- free of charge programs (46.4%) and provide take-home doses (22.07%). Methadone and Suboxone ST are being well accepted in Georgia and appear to be reducing illegal opioid use. However, the psychotherapeutic sessions' attendance is very low.

Topics: Adult; Aged; Buprenorphine; Buprenorphine, Naloxone Drug Combination; Female; Georgia (Republic); Government Programs; Heroin Dependence; Humans; Hypnotics and Sedatives; Male; Marijuana Abuse; Methadone; Middle Aged; Naloxone; Needs Assessment; Opiate Substitution Treatment; Patient Compliance; Patient Satisfaction; Psychotherapy; Substance-Related Disorders; Surveys and Questionnaires; Young Adult

Topics: Acute Disease; Amphetamines; Cocaine-Related Disorders; Hallucinogens; Humans; Marijuana Abuse; Naloxone; Opioid-Related Disorders; Substance-Related Disorders

The peripubertal period appears to be critical in relation to the abuse of cannabinoids and opioids in humans. However there is little information about the acute effects of cannabinoids and their interactions with opioids in young experimental animals. We have studied the effects of the cannabinoid agonist CP 55,940 (0.1, 0.2, 0.4 and 0.6 mg/kg) on the nociceptive responses (tail immersion test) and holeboard activity of 40-day-old rats, and the involvement of the CB(1) receptor (antagonism by SR 141716A, 3 mg/kg). The implication of the opioid system was evaluated using the opioid antagonist naloxone (1 mg/kg) and a combined treatment with subeffective doses of CP 55,940 (0.1 mg/kg) and morphine (1 mg/kg). The effects of CP 55,940 on the serum corticosterone levels (radioimmunoassay) and on the dopamine and DOPAC contents of discrete brain regions (high-performance liquid chromatography) were also assessed. The antinociceptive effect of CP 55,940 was of a similar magnitude at all the doses used. The results show the involvement of the CB(1) receptor. The cannabinoid agonist significantly depressed the holeboard activity in a dose-dependent manner. The results indicate that the CB(1) receptor is involved in the effects on motor activity but not in the effects on the exploratory activity. The behavioural effects of CP 55,940 were modulated by morphine. The cannabinoid agonist (0.6 mg/kg) induced a CB(1)-mediated increase in the serum corticosterone levels, but no effect on the dopaminergic systems of either the striatum or the limbic forebrain was found.

Topics: Analgesics; Animals; Behavior, Animal; Cannabinoids; Corticosterone; Cyclohexanols; Dopamine; Dose-Response Relationship, Drug; Drug Interactions; Female; Grooming; Male; Marijuana Abuse; Morphine; Motor Activity; Naloxone; Narcotic Antagonists; Neostriatum; Neurosecretory Systems; Nociceptors; Pain Measurement; Piperidines; Pyrazoles; Rats; Rats, Wistar; Receptors, Cannabinoid; Receptors, Drug; Rimonabant; Sex Characteristics

Topics: Adult; Chemotaxis, Leukocyte; Granulocytes; Heroin Dependence; Humans; Immunity, Cellular; Immunity, Innate; Marijuana Abuse; Methadone; Middle Aged; Monocytes; Naloxone; Narcotics; Substance-Related Disorders