"[A] concise and detailed description of a very complex issue...rich in detail and insight."
--Leslie J. Temme, LCSW
School of Social Work, Adelphi University

"[A] 'must have' resource for practicing professionals and an invaluable teaching tool for social work students .This is precisely the book that mandated reporters seek to assist in the reporting process and understanding their legal obligations."
--Keva M. Miller, PhD, LCSW
School of Social Work, Portland State University

In all states, social workers are required to report suspected child abuse and neglect, and face serious penalties if they fail to do so. But not all cases of abuse are obvious. Mandated reporters are thus confronted with a host of both legal and ethical quandaries when filing a report: What are the responsibilities of mandated reporters? What are appropriate grounds for reporting abuse? How and when should a report be made? Does reporting suspected abuse violate client confidentiality? What if my employer encourages me not to report my suspicions?

Addressing these questions and more, this book provides clear definitions of different types of child abuse, including physical, sexual, and emotional, and delineates guidelines on how to identify risk factors and signs of child maltreatment.

The authors also clarify difficult ethical issues, including client confidentiality and privileged communication, and present numerous case studies and theoretical vignettes culled from their own experiences as social workers. This guide will be the one resource mandated reporters and social work students cannot do without.

Author: Dr. Kenneth Lau LCSW, Ms. Kathryn Krase JD LCSW, Mr. Richard H. Morse LMSW
Hardcover: 328 pages
Company: Springer Publishing Company (2008-12-02)
ISBN: 0826110983
List Price: $50.00
Amazon Price: $25.45
Used Price: $35.00

For all of her professional success, Wurtzel felt like a failure. She had lost friends and lovers, every magazine job she'd held, and way too much weight. She couldn't write, and her second book was past due. But when her doctor prescribed Ritalin to help her focus-and boost the effects of her antidepressants -- Wurtzel was spared. The Ritalin worked. And worked. The pills became her sugar...the sweetness in the days that have none. Soon she began grinding up the Ritalin and snorting it. Then came the cocaine, then more Ritalin, then more cocaine. Then I need more. I always need more. For all of my life I have needed more...

More, Now, Again is the brutally honest, often painful account of Wurtzel's descent into drug addiction. It is also a love story: How Wurtzel managed to break free of her relationship with Ritalin and learned to love life, and herself, is at the heart of this ultimately uplifting memoir that no reader will soon forget.

Author: Elizabeth Wurtzel
Paperback: 336 pages
Company: Simon & Schuster (2002-12-31) (2002-12-31)
ISBN: 0743223314
List Price: $15.00
Amazon Price: $3.87
Used Price: $0.01

The “Gale Encyclopedia of Mental Disorders” is a comprehensive two-volume set providing detailed information on mental disorders and conditions, in an easy-to-use format. It includes entries for all 150 disorders classified in the “Diagnostic and Statistical Manual of Mental Disorders,” and also features entries for prescription, alternative and over-the-counter drugs, as well as the various therapies used to treat mental disorders.

This second edition of the “Encyclopedia of Drugs, Alcohol, and Addictive Behavior” reflects changes in the attitudes about, use, and knowledge of drugs and alcohol since the first edition published in 1995. These changes include the decrease of crack cocaine use and resurgence of heroin use; changes in laws dealing with drug use (on both the state and national levels), and new discoveries leading to a better understanding of how drugs work and what makes them addictive. More than 700 articles, written for both the student and layperson, cover the social, medical and political issues related to drugs and alcohol, as well exploring and explaining types of addiction.

The “Gale Encyclopedia of Science” is written at a level somewhere between the introductory sources and the highly technical texts currently available. This six-volume set covers all major areas of science and engineering, as well as mathematics and the medical and health sciences, while providing a comprehensive overview of current scientific knowledge and technology. Alphabetically arranged entries provide a user-friendly format that makes the broad scope of information easy to access and decipher. Entries typically describe scientific concepts, provide overviews of scientific areas and, in some cases, define terms.

This second edition of the “Encyclopedia of Drugs, Alcohol, and Addictive Behavior” reflects changes in the attitudes about, use, and knowledge of drugs and alcohol since the first edition published in 1995. These changes include the decrease of crack cocaine use and resurgence of heroin use; changes in laws dealing with drug use (on both the state and national levels), and new discoveries leading to a better understanding of how drugs work and what makes them addictive. More than 700 articles, written for both the student and layperson, cover the social, medical and political issues related to drugs and alcohol, as well exploring and explaining types of addiction.

This second edition of the “Encyclopedia of Drugs, Alcohol, and Addictive Behavior” reflects changes in the attitudes about, use, and knowledge of drugs and alcohol since the first edition published in 1995. These changes include the decrease of crack cocaine use and resurgence of heroin use; changes in laws dealing with drug use (on both the state and national levels), and new discoveries leading to a better understanding of how drugs work and what makes them addictive. More than 700 articles, written for both the student and layperson, cover the social, medical and political issues related to drugs and alcohol, as well exploring and explaining types of addiction.

Life in the Fast Lane: The author on the CHE

Uppers. Crank. Bennies. Dexies. Greenies. Black Beauties. Purple Hearts. Crystal. Ice. And, of course, Speed. Whatever their street names at the moment, amphetamines have been an insistent force in American life since they were marketed as the original antidepressants in the 1930s. On Speed tells the remarkable story of their rise, their fall, and their surprising resurgence. Along the way, it discusses the influence of pharmaceutical marketing on medicine, the evolving scientific understanding of how the human brain works, the role of drugs in maintaining the social order, and the centrality of pills in American life. Above all, however, this is a highly readable biography of a very popular drug. And it is a riveting story.

Incorporating extensive new research, On Speed describes the ups and downs (fittingly, there are mostly ups) in the history of amphetamines, and their remarkable pervasiveness. For example, at the same time that amphetamines were becoming part of the diet of many GIs in World War II, an amphetamine-abusing counterculture began to flourish among civilians. In the 1950s, psychiatrists and family doctors alike prescribed amphetamines for a wide variety of ailments, from mental disorders to obesity to emotional distress. By the late 1960s, speed had become a fixture in everyday life: up to ten percent of Americans were thought to be using amphetamines at least occasionally.

Although their use was regulated in the 1970s, it didn't take long for amphetamines to make a major comeback, with the discovery of Attention Deficit Disorder and the role that one drug in the amphetamine family—Ritalin—could play in treating it. Today’s most popular diet-assistance drugs differ little from the diet pills of years gone by, still speed at their core. And some of our most popular recreational drugs—including the "mellow" drug, Ecstasy—are also amphetamines. Whether we want to admit it or not, writes Rasmussen, we’re still a nation on speed.

The precise neurochemical mechanisms underlying this drug-induced neurotoxicity remain unclear. This volume explores this question, specifically addressing the following aspects: (1) the role of genomics and proteomics in drug-induced neurotoxicity, (2) drugs of abuse and medication development, (3) molecular biology and free radicals in drug-induced neurotoxicity, (4) substituted amphetamine-induced neurochemical changes and relationship to neurotoxicity, (5) drugs of abuse and imaging brain structure and function.

NOTE: Annals volumes are available for sale as individual books or as a journal. For information on institutional journal subscriptions, please visit www.blackwellpublishing.com/nyas.

ACADEMY MEMBERS: Please contact the New York Academy of Sciences directly to place your order (www.nyas.org). Members of the New York Academy of Science receive full-text access to the Annals online and discounts on print volumes. Please visit http://www.nyas.org/MemberCenter/Join.aspx for more information about becoming a member

Paperback: 552 pages
Company: Wiley-Blackwell (2006-08-31)
ISBN: 1573316296
List Price: $154.95
Amazon Price: $57.22
Used Price: $6.64

This title looks at Crystal Meth and Other Amphetamines and the pros and cons of making particular choices young people must make about their behavior. Up-to-date and detailed information make this a valuable books for understanding what is at stake.



Author: Karla Fitzhugh
Hardcover: 56 pages
Company: Heinemann-Raintree (2005-09-15)
ISBN: 140347026X
List Price: $32.86
Amazon Price: $88.54
Used Price: $0.01

Forensic Sci Int. 2012 Jan 16;
Vevelstad M, Oiestad EL, Middelkoop G, Hasvold I, Lilleng P, Delaveris GJ, Eggen T, Mørland J, Arnestad M

During a 6 month period (July 2010-January 2011) we observed 12 fatal intoxications and 22 non-fatal cases related to the drug paramethoxymethamphetamine (PMMA) in Norway (4.8 mill inhabitants). This toxic designer drug, also known as "Death", is occasionally found in street drugs offered as "ecstasy" or "amphetamine". The present study aimed to evaluate the cause of death, and to compare the PMMA blood concentrations in fatal and non-fatal cases. Methods for identification and quantification of PMMA are presented. The median age of fatalities was 30 years (range 15-50) with 67% males; in non-fatal cases 27 years (20-47) with 86% males. In the 12 fatalities, the median PMMA blood concentration was 1.92mg/L (range 0.17-3.30), which is in the reported lethal range of 0.6-3.1mg/L in peripheral blood and 1.2-15.8mg/L in heart blood. In the 22 non-fatal cases, the median PMMA concentration was 0.07mg/L (range 0.01-0.65). Poly-drug use was frequent both in fatal and non-fatal cases. The PMA concentrations ranging from 0.00 to 0.26mg/L in both groups likely represented a PMMA metabolite. Three fatalities were attributed to PMMA only, six to PMMA and other psychostimulant drugs, and three to PMMA and CNS depressant drugs, with median PMMA concentrations of 3.05mg/L (range 1.58-3.30), 2.56 (1.52-3.23) and 0.52mg/L (0.17-1.24), respectively. Eight victims were found dead, while death was witnessed in four cases, with symptoms of acute respiratory distress, hyperthermia, cardiac arrest, convulsions, sudden collapse and/or multiple organ failure. In summary, all fatalities attributed to PMMA had high PMMA blood concentrations compared to non-fatal cases. Our sample size was too small to evaluate a possible impact of poly-drug use. A public warning is warranted against use and overdose with illegal "ecstasy" or "speed" drugs.

Law Hum Behav. 2012 Jan 16;
Walters GD

The purpose of this study was to determine (a) which of 2 dimensions of criminal thinking (proactive and/or reactive) correlates with prior substance abuse; (b) whether criminal thinking mediates the relationship between prior substance abuse and recidivism; (c) if a direct relationship exists between specific drugs of abuse and specific criminal thinking styles. First, the reconstructed Proactive (Prc) and Reactive (Rrc) Criminal Thinking scores from the Psychological Inventory of Criminal Thinking Styles (PICTS; Walters, 1995) were correlated with a dichotomous measure of prior substance abuse and a continuous measure of the number of substances abused in a sample of 2877 male federal prisoners (age: M = 34.96, SD = 9.89, range = 18-84; race: 63.6% Black, 17.3% White, 17.6% Hispanic, 1.4% other). The results indicated that only the Rrc score correlated significantly with prior substance abuse when the effect of the alternative measure (Prc in the case of Rrc and Rrc in the case of the Prc) was controlled through partial correlations. Second, reactive criminal thinking was found to mediate the relationship between a history of prior substance abuse and subsequent recidivism in a subsample of 1101 inmates who were released from prison during a 1- to 76-month follow-up. Third, both specific (alcohol with cutoff; marijuana with cognitive indolence) and global (heroin, cocaine, and amphetamine with cutoff, cognitive indolence, and discontinuity) drug-criminal thinking correlations were obtained. These results suggest that reactive criminal thinking plays a potentially important role in the drug-crime relationship. (PsycINFO Database Record (c) 2012 APA, all rights reserved).

J Med Toxicol. 2012 Jan 25;
Rosenbaum CD, Carreiro SP, Babu KM

Despite their widespread Internet availability and use, many of the new drugs of abuse remain unfamiliar to health care providers. The herbal marijuana alternatives, like K2 or Spice, are a group of herbal blends that contain a mixture of plant matter in addition to chemical grade synthetic cannabinoids. The synthetic cathinones, commonly called "bath salts," have resulted in nationwide emergency department visits for severe agitation, sympathomimetic toxicity, and death. Kratom, a plant product derived from Mitragyna speciosa Korth, has opioid-like effects, and has been used for the treatment of chronic pain and amelioration of opioid-withdrawal symptoms. Salvia divinorum is a hallucinogen with unique pharmacology that has therapeutic potential but has been banned in many states due to concerns regarding its psychiatric effects. Methoxetamine has recently become available via the Internet and is marked as "legal ketamine." Moreover, the piperazine derivatives, a class of amphetamine-like compounds that includes BZP and TMFPP, are making a resurgence as "legal Ecstasy." These psychoactives are available via the Internet, frequently legal, and often perceived as safe by the public. Unfortunately, these drugs often have adverse effects, which range from minimal to life-threatening. Health care providers must be familiar with these important new classes of drugs. This paper discusses the background, pharmacology, clinical effects, detection, and management of synthetic cannabinoid, synthetic cathinone, methoxetamine, and piperazine exposures.

Pharmacol Biochem Behav. 2011 Dec 31;
Bauzo RM, Kimmel HL, Howell LL

Extrasynaptic glutamate has been shown to regulate dopamine function in the mesocorticolimbic pathway, which plays an important role in the behavioral pharmacology of psychostimulants. Basal levels of glutamate are primarily regulated by the cystine-glutamate transporter and provide glutamatergic tone on extrasynaptic glutamate receptors. The present study examined the effects of a cystine-glutamate transporter enhancer on the neurochemical and behavioral effects of cocaine and amphetamine in nonhuman primates. It was hypothesized that augmenting extrasynaptic glutamate release with N-acetyl-l-cysteine (NAC), a cystine prodrug, would attenuate cocaine- or amphetamine-induced increases in extracellular dopamine and their corresponding behavioral-stimulant and reinforcing effects. In vivo microdialysis was used to evaluate cocaine-induced changes in extracellular dopamine (DA) in the caudate nucleus (n=3). NAC significantly attenuated cocaine-induced increases in dopamine but had inconsistent effects on amphetamine-induced increases in dopamine (n=4). Separate groups of subjects were either trained on a fixed-interval schedule of stimulus termination (n=6) or on a second-order schedule of self-administration (n=5) to characterize the behavioral-stimulant and reinforcing effects of psychostimulants, respectively. Systemic administration of NAC did not alter the behavioral-stimulant effects of either cocaine or amphetamine. Furthermore, cocaine self-administration and reinstatement of previously extinguished cocaine self-administration were not altered by pretreatment with NAC. Hence, drug interactions on caudate neurochemistry in vivo were not reflected in behavioral measures in squirrel monkeys. The present results in nonhuman primates do not support the use of NAC as a pharmacotherapy for cocaine abuse, although rodent and clinical studies suggest otherwise.

Ann Emerg Med. 2012 Jan 9;
Mugele J, Nañagas KA, Tormoehlen LM

Serotonin syndrome is associated with use of certain street drugs, including methamphetamine, cocaine, and ecstasy. We describe a case of a woman who developed clinical findings consistent with serotonin syndrome after insufflation of 3,4-methylenedioxypyrovalerone (MDPV), a synthetic amphetamine. MDPV belongs to a group of substances called phenylethylamines, which are β-ketone analogs of other drugs of abuse, such as amphetamines and 3,4-methylenedioxymethamphetamine. She also received fentanyl initially during her hospitalization, which has also been associated with serotonin syndrome. In addition to benzodiazepines and supportive care, she was treated with cyproheptadine for 8 days, with slow resolution of her symptoms.

Lancet. 2012 Jan 7; 379(9810): 55-70
Degenhardt L, Hall W

This paper summarises data for the prevalence, correlates, and probable adverse health consequences of problem use of amphetamines, cannabis, cocaine, and opioids. We discuss findings from systematic reviews of the prevalence of illicit drug use and dependence, remission from dependence, and mortality in illicit drug users, and evidence for acute and chronic effects of illicit drug use. We outline the regional and global distribution of use and estimated health burden from illicit drugs. These distributions are likely to be underestimates because they have not included all adverse outcomes of drug use and exclude those of cannabis--the mostly widely used illicit drug. In high-income countries, illicit drug use contributes less to the burden of disease than does tobacco but a substantial proportion of that due to alcohol. The major adverse health effects of cannabis use are dependence and probably psychotic disorders and other mental disorders. The health-related harms of cannabis use differ from those of amphetamine, cocaine, and opioid use, in that cannabis contributes little to mortality. Intelligent policy responses to drug problems need better data for the prevalence of different types of illicit drug use and the harms that their use causes globally. This need is especially urgent in high-income countries with substantial rates of illicit drug use and in low-income and middle-income countries close to illicit drug production areas.

Future Med Chem. 2012 Feb; 4(2): 245-65
Rush CR, Stoops WW

Cocaine use disorders are prevalent throughout the world. Agonist replacement therapy is among the most effective strategies for managing substance use disorders including nicotine and opioid dependence. This paper reviews the translational literature, including preclinical experiments, human laboratory studies and clinical trials, to determine whether agonist-replacement therapy is a viable strategy for managing cocaine dependence. Discussion is limited to transporter blockers (i.e., methylphenidate) and releasers (i.e., amphetamine analogs) that are available for use in humans in the hope of impacting clinical research and practice more quickly. The translational review suggests that agonist-replacement therapy, especially monoamine releasers, may be effective for managing cocaine dependence. Future directions for medications development are also discussed because the viability of agonist-replacement therapy for cocaine dependence may hinge on identifying novel compounds or formulations that have less abuse and diversion potential.

Expert Rev Neurother. 2012 Jan; 12(1): 13-26
Childress AC, Sallee FR

ADHD is a common neurobehavioral disorder characterized by significant impairment in attention, hyperactivity and impulsivity. Symptoms begin in childhood and can persist into adulthood. Current data suggest that abnormal functioning of the prefrontal cortex, cortical and subcortical regions of the brain have roles in ADHD. All currently approved drugs used to treat ADHD enhance dopamine and norepinephrine signals in these regions. Lisdexamfetamine dimesylate (LDX) is a long-acting amphetamine prodrug indicated for the treatment of ADHD and has been shown to be effective in children, adolescents and adults. The prodrug properties of LDX make it a desirable treatment because of its long duration of effect, and low intrasubject and intersubject pharmacokinetic variability, and attenuated response on measures of abuse liability when compared with immediate-release amphetamine. However, LDX is still classified as a controlled substance. In this article, the pharmacokinetic parameters and efficacy and safety of LDX are reviewed.

Environ Int. 2012 Feb 1; 41C: 35-43
Valcárcel Y, Martínez F, González-Alonso S, Segura Y, Catalá M, Molina R, Montero-Rubio JC, Mastroianni N, López de Alda M, Postigo C, Barceló D

This work investigates for the first time the occurrence of drugs of abuse and metabolites in surface waters from the Tagus River on its way through the province of Toledo (downstream Madrid metropolitan area) and in drinking waters in two nearby cities. Some of the studied drugs are used for therapeutic purposes but they can also be consumed as illicit drugs. The results of this preliminary study have revealed the presence of 12 out of 22 drugs of abuse analyzed in fluvial water at concentrations ranging from 1.14 to 40.9ng/L. The largest concentrations corresponded to the anxiolytics diazepam and lorazepam, the cocaine metabolite benzoilecgonine, the amphetamine-like compound ephedrine, and the methadone metabolite EDDP. All these substances, except for lorazepam, were detected in all the sampling points. Traces of methadone and ephedrine were detected in some samples of tap water. Despite the low concentrations of these pollutants, effects on wildlife or human health cannot be disregarded, especially on vulnerable population. Thus, the treatment of these substances using a heterogeneous photo-Fenton process has been evaluated, rendering a remarkable effectiveness for their degradation.

Pharmacol Biochem Behav. 2012 Mar; 101(1): 132-7
Fukushiro DF, Saito LP, Mári-Kawamoto E, Aramini TC, Costa JM, Josino FS, Uehara RA, Frussa-Filho R

Ethanol withdrawal syndrome is characterized by somatic and behavioral symptoms, including increased anxiety and anhedonia. In animal models, however, there are many studies on the anxiogenic effects occurring during the first 24h after ethanol withdrawal, while anhedonia has been overlooked. Recently, we have found that amphetamine withdrawal reduced novelty seeking and enhanced environmental habituation in mice, two motivation-related behaviors. We now investigate the effects of withdrawal from ethanol, a drug of abuse with a different pharmacological profile, on these two motivation-related behaviors. Swiss male mice (3months old) were treated with 1.8g/kg ethanol for 21 consecutive days in their home cages. Seven days after ethanol withdrawal, mice were tested in a free-choice novelty apparatus containing one familiar and one novel compartment. Novelty-seeking behavior was assessed by comparing time spent in the novel compartment versus the familiar compartment, whereas environmental habituation was concomitantly evaluated by the time-response curve of total locomotion (novel+familiar). Novelty seeking was decreased and environmental habituation was enhanced during ethanol withdrawal. These anhedonic responses were not associated with concurrent changes in the anxiety-like behavior of mice (as confirmed in the elevated plus-maze test). We propose that the concomitant evaluation of novelty-seeking behavior and environmental habituation can be useful to study the behavioral consequences not only of amphetamine withdrawal but also of ethanol withdrawal. Furthermore, the present data support recent clinical findings that suggest the occurrence of protracted anhedonia well beyond the limited period immediately following the abrupt cessation of ethanol intake.

Drug Alcohol Depend. 2012 Jan 20;
Chawarski MC, Vicknasingam B, Mazlan M, Schottenfeld RS

BACKGROUND: Malaysia has been experiencing significant drug abuse problems since the 1970s, and drug abuse is the major driver of HIV transmission in Malaysia. We investigated risk factors for HIV associated with use of amphetamine type stimulants (ATS) among not-in-treatment opiate injectors in Malaysia. METHODS: Between October of 2006 and May of 2008, we conducted a series of surveys in three major urban areas of Malaysia. A total of 732 opiate IDUs (679 males and 53 females) were enrolled in the three surveys. The survey instruments consisted of a structured interview on demographic characteristics, drug use history (including year of first use, and past month history of use of illicit drugs; lifetime and past month history of IDU or needle or equipment sharing), and HIV status. RESULTS: There were 194/704 (27.6%) HIV positive participants in the sample. Two factors were significantly associated with HIV infection in this sample: lifetime history of ATS use (OR [95%CI]: 2.3 [1.5-3.6]) and lifetime history of sharing of injection equipment (OR [95% CI]: 4.2 [1.8-9.8]). Both HIV-positive and HIV-negative participants reported high levels of current needle/equipment sharing practices: 82% vs. 75%, respectively. CONCLUSIONS: ATS use spread rapidly in the study sample after 1997 and is associated with an increased risk of HIV infection in this population already at high risk because of opiate IDU. Out-of-treatment IDUs in Malaysia engage in high risk behaviors regardless of their HIV status. Increased education and public health prevention measures are needed to reduce HIV transmission risks in this population.

J Vis Exp. 2012;
Maina FK, Khalid M, Apawu AK, Mathews TA

Extensive research has focused on the neurotransmitter dopamine because of its importance in the mechanism of action of drugs of abuse (e.g. cocaine and amphetamine), the role it plays in psychiatric illnesses (e.g. schizophrenia and Attention Deficit Hyperactivity Disorder), and its involvement in degenerative disorders like Parkinson's and Huntington's disease. Under normal physiological conditions, dopamine is known to regulate locomotor activity, cognition, learning, emotional affect, and neuroendocrine hormone secretion. One of the largest densities of dopamine neurons is within the striatum, which can be divided in two distinct neuroanatomical regions known as the nucleus accumbens and the caudate-putamen. The objective is to illustrate a general protocol for slice fast-scan cyclic voltammetry (FSCV) within the mouse striatum. FSCV is a well-defined electrochemical technique providing the opportunity to measure dopamine release and uptake in real time in discrete brain regions. Carbon fiber microelectrodes (diameter of ~ 7 µm) are used in FSCV to detect dopamine oxidation. The analytical advantage of using FSCV to detect dopamine is its enhanced temporal resolution of 100 milliseconds and spatial resolution of less than ten microns, providing complementary information to in vivo microdialysis.

Ann Clin Psychiatry. 2012 Feb; 24(1): 38-55
Beaulieu S, Saury S, Sareen J, Tremblay J, Schütz CG, McIntyre RS, Schaffer A

Mood disorders, especially bipolar disorder (BD), frequently are associated with substance use disorders (SUDs). There are well-designed trials for the treatment of SUDs in the absence of a comorbid condition. However, one cannot generalize these study results to individuals with comorbid mood disorders, because therapeutic efficacy and/or safety and tolerability profiles may differ with the presence of the comorbid disorder. Therefore, a review of the available evidence is needed to provide guidance to clinicians facing the challenges of treating patients with comorbid mood disorders and SUDs.We reviewed the literature published between January 1966 and November 2010 by using the following search strategies on PubMed. Search terms were bipolar disorder or depressive disorder, major (to exclude depression, postpartum; dysthymic disorder; cyclothymic disorder; and seasonal affective disorder) cross-referenced with alcohol or drug or substance and abuse or dependence or disorder. When possible, a level of evidence was determined for each treatment using the framework of previous Canadian Network for Mood and Anxiety Treatments recommendations. The lack of evidence-based literature limited the authors' ability to generate treatment recommendations that were strictly evidence based, and as such, recommendations were often based on the authors' opinion.Even though a large number of treatments were investigated for alcohol use disorder (AUD), none have been sufficiently studied to justify the attribution of level 1 evidence in comorbid AUD with major depressive disorder (MDD) or BD. The available data allows us to generate first-choice recommendations for AUD comorbid with MDD and only third-choice recommendations for cocaine, heroin, and opiate SUD comorbid with MDD. No recommendations were possible for cannabis, amphetamines, methamphetamines, or polysubstance SUD comorbid with MDD. First-choice recommendations were possible for alcohol, cannabis, and cocaine SUD comorbid with BD and only second-choice recommendations for heroin, amphetamine, methamphetamine, and polysubstance SUD comorbid with BD. No recommendations were possible for opiate SUD comorbid with BD. Finally, psychotherapies certainly are considered an essential component of the overall treatment of SUDs comorbid with mood disorders. However, further well-designed studies are needed in order to properly assess their potential role in specific SUDs comorbid with a mood disorder.Although certain treatments show promise in the management of mood disorders comorbid with SUDs, additional well-designed studies are needed to properly assess their potential role in specific SUDs comorbid with a mood disorder.

Pharmacol Biochem Behav. 2012 Jan 20;
Sadananda M, Natusch C, Karrenbauer B, Schwarting RK

In recent years, 50-kHz ultrasonic vocalizations of laboratory rats have become increasingly important behavioral measures in research on emotion and motivation, since these calls may help to study appetitive subjective states, for example in relation to addiction. Among others, 50-kHz calls occur when rats experience or expect rewards, including drugs of abuse, and it is assumed that these calls depend on dopamine function, especially in the meso-limbic system. One established means to induce 50-kHz calls is to challenge rats with d-amphetamine, a psychomotor stimulant, which acts largely by boosting dopamine and noradrenaline function in the brain. In a 1st experiment, we studied whether another psycho-stimulatory amphetamine, namely the derivative 3,4-methylene-dioxymethamphetamine (MDMA, Ecstasy), could also enhance 50-kHz calls by using an activity box and testing conditions, which had previously been found to be appropriate in case of d-amphetamine. In support of previous work, we found that MDMA (2.5, 5, 10mg/kg, ip) dose-dependently increased locomotion and center time, together with decreases in rearing activity, but the drug did not elicit 50-kHz calls. Assuming that this lack of effect is due to the drug's substantial pro-serotonergic effects in the brain, which may inhibit 50-kHz calls, we performed a 2nd experiment where we tested the serotonin 5-HT(1A) receptor agonist 8-hydroxy-2-tetralin (8-OH-DPAT; 0.05, 0.5, 2.5mg/kg, ip). This drug dose-dependently stimulates serotonin autoreceptors and heteroreceptors, can act in a psycho-stimulatory way and can enhance dopamine function. In the activity box, 8-OH-DPAT increased locomotor activity (0.5, 2.5mg/kg) and decreased rearing (2.5mg/kg); that is, the drug seemed to share some psycho-stimulatory effects with MDMA. Unlike MDMA, 8-OH-DPAT enhanced 50-kHz calls in a dose-dependent way, namely only with the 0.5mg/kg dose. These results are discussed with respect to their possible neurochemical mechanisms, especially on 5-HT and dopamine in the brain.

Lakartidningen. 2011 Oct 9-15; 108(45): 2304-7
Franck J

Ther Drug Monit. 2012 Feb; 34(1): 98-109
Souza DZ, Boehl PO, Comiran E, Prusch DS, Zancanaro I, Fuentefria AM, Pechansky F, Duarte PC, De Boni RB, Fröehlich PE, Limberger RP

: The use of oral fluid for monitoring drug consumption on roads has many advantages over conventional biological fluids; therefore, several immunoassays have been developed for this purpose. In this work, the ability of 3 commercial immunoassays to detect amphetamine-type stimulants (ATSs) in oral fluid was assessed. In addition, it was reviewed the main controlled ATSs available worldwide, as well as the oral fluid immunological screening tests that have been used for identifying ATSs in drivers.: The analytical specificity of amphetamine direct enzyme-linked immunosorbent assay (ELISA), methamphetamine direct ELISA (Immunalysis Corporation), and Oral-View saliva multidrug of abuse test (Alfa Scientific Designs) was evaluated using ATS-spiked oral fluid. Legislation and published articles that report the use of immunological screening tests to detect ATS consumption in conductors were reviewed, including the kit's technical information, project reports, police and drug databases.: Even at high concentrations, the tested assays were not able to detect methylphenidate, fenproporex, or diethylpropion, controlled ATSs legally marketed in many countries.: This evidences the need to develop new kits that enable one to control the misuse of prescription ATSs on roads through oral fluid immunoassays.

J Physician Assist Educ. 2011; 22(4): 15-22
Herman L, Shtayermman O, Aksnes B, Anzalone M, Cormerais A, Liodice C

Prescription stimulant use as academic performance enhancers is increasingly widespread among college students. The purpose of this study was to evaluate the prevalence of prescription stimulant use among health care students attending a university in the northeastern United States. The study investigated the specific stimulants being used and the frequency of usage. It also examined the rates of nicotine, alcohol, and drug abuse versus dependence.A web-based survey was administered to medical and health profession students regarding prescription stimulant use for nonprescribed purposes. Tobacco, alcohol, and recreational drug use were also surveyed.Approximately 10.4% (32) of students surveyed have either used a stimulant or are currently using prescription stimulants illegally. The most common reason for stimulant use was to focus and concentrate during studying (93.5%). Of the 308 students, 45.2% were female, 83.9% were Caucasian, and amphetamine-dextroamphetamine was the most commonly abused stimulant (71.4%).Results from this study are consistent with previous research of undergraduate students regarding prescription stimulant use for nonprescribed purposes, specifically for academic performance enhancement. Data from the study support that alcohol abuse and dependence among students is a pertinent concern, suggesting that substance abuse in general must be addressed. Substance abuse and awareness programs combined with stress management programs in an overall substance-abuse reduction strategy, including the use of prescription stimulant use beyond the originally intended purpose, may be beneficial. Because of the lack of research focusing on graduate health care students, further investigations should use similar populations.

Neurotoxicol Teratol. 2012 Jan 20;
Levi MS, Divine B, Hanig JP, Doerge DR, Vanlandingham MM, George NI, Twaddle NC, Bowyer JF

Previous studies focusing on amphetamine (AMPH), methamphetamine (METH) and methylphenidate (MPH) neurotoxicity have almost exclusively been conducted in rodents during the light cycle, which is when most rodents sleep. There are virtually no studies that have simultaneously compared the effects of these three stimulants on body temperature and also determined serum stimulant levels during exposure. The present study compared the effects of MPH, AMPH and METH treatment on body temperature and neurotoxicity during the waking (dark) cycle of the rat. This was done to more effectively replicate stimulant exposure in waking humans and to evaluate the relative risks of the three stimulants when taken inappropriately or non-therapeutically (e.g., abuse). Four subcutaneous injections (4×), at 2h intervals, were used to administer each dose of the stimulants tested. Several equimolar doses for the three stimulants were chosen to produce plasma levels ranging from 3 times the highest therapeutic levels (no effect on body temperature) to those only attained by accidental overdose or intentional abuse in humans. Either 4×2.0mg/kg AMPH or 4×2.2mg/kg METH administered during the waking cycle resulted in peak serum levels of between 1.5 and 2.5μM (4 to 5 times over maximum therapeutic levels of METH and AMPH) and produced lethal hyperthermia, 70% striatal dopamine depletions, and neurodegeneration in the cortex and thalamus. These results show that METH and AMPH are equipotent at producing lethal hyperthermia and neurotoxicity in laboratory animals during the wake cycle. Administration of either 4×2.2 or 4×3.3mg/kg METH during the sleep cycle produced lower peak body temperatures, minimal dopamine depletions and little neurodegeneration. These findings indicate that administration of the stimulant during the waking cycle compared to sleep cycle may significantly increase the potency of amphetamines to produce hyperthermia, neurotoxicity and lethality. In contrast, body temperature during the waking cycle was only significantly elevated by MPH at 4×22mg/kg, and the serum levels producing this effect were 2-fold (approximately 4.5μM) greater on a molar basis than hyperthermic doses of AMPH and METH. Thus, AMPH and METH were equipotent on a mg/kg body weight basis at producing hyperthermia and neurotoxicity while MPH on a mg/kg body weight basis was approximately 10-fold less potent than AMPH and METH. However, the 10-fold lower potency was in large part due to lower plasma levels produced by MPH compared to either AMPH or METH.

Am J Drug Alcohol Abuse. 2012 Jan 3;
Young AM, Havens JR, Leukefeld CG

Background: Nonmedical prescription opioid use has emerged as a major public health concern. The growing burden of nonmedical prescription opioid use in America may have unique manifestations and consequences in rural areas, which to a large extent have yet to be explored. Objectives: To describe rural-urban differences among drug users in recent and lifetime use and age of onset of use for alcohol, heroin, OxyContin®, oxycodone, hydrocodone, barbiturates, benzodiazepines, cocaine, crack, methamphetamine, amphetamine, marijuana, hallucinogens, and inhalants. Methods: A purposive sample of 212 prescription drug users was recruited from a rural Appalachian county (n = 101) and a major metropolitan area (n = 111) in Kentucky. Consenting participants were given an interviewer-administered questionnaire examining sociodemographics, psychiatric characteristics, and self-reported drug use. Results: Rural drug users had significantly earlier ages of onset for use of oxycodone, hydrocodone, benzodiazepines, cocaine, and crack. In age-, gender-, and race-adjusted logistic regression analyses, rural drug users had significantly higher odds of lifetime and recent use of methadone, OxyContin®, and oxycodone. Rural drug users also had significantly higher odds of lifetime cocaine and crack use. However, urban participants as expected had significantly higher odds of recent crack use. Conclusions: The findings demonstrate that, in this sample, nonmedical prescription opioid use is dissimilar among rural and urban drug users. Additional research is needed to better understand the individual, social, and structural level factors contributing to the burden of nonmedical opioid use, particularly in rural populations, with the aim of developing tailored substance abuse treatment and prevention.

J Anal Toxicol. 2012 Jan; 36(1): 30-5
Liang M, Liu Y, Zheng N, Ananda S, Liu L

The aim of this study is to investigate the distribution of methamphetamine (MA) and its metabolite amphetamine (AP) in rat models of acute and subacute MA-ethanol combination abuse. Rats were fed with 20% ethanol for 4 weeks (chronic active-drinking group), and MA was injected intraperitoneally into chronically drinking and normal rats over 5 and 14 days, respectively. Then the rats from the acute and subacute combination abuse groups were euthanized, and ethanol, MA, and AP concentrations in samples were quantified. Except for the similar ethanol concentrations among acute and subacute groups, the MA and AP levels between groups were quite different. The concentrations of MA and AP in rats' liver, lung, kidney, and brain were much higher than other tissues, regardless of combination with ethanol. Also, MA and AP levels in subacute rats groups were higher than those in acute groups, and the levels of MA and the formation of AP in rats subjected to the combination abuse with ethanol were higher than in MA-only intoxicated rats. We conclude that ethanol has no bearing on the MA and AP distribution in body fluids and tissues, yet it can increase MA levels and markedly accelerate the formation of AP in combination-abuse rats. Comparing the acute and subacute combination-abuse rats' samples, it can be deduced that various accumulated amounts of MA and AP were unaffected by ethanol, even after multi-dose injection, regardless of acute or subacute use.