ORCID Profile
0000-0002-1787-4375
Current Organisations
Metro North Hospital and Health Service
,
Royal Brisbane and Women's Hospital
,
University of Queensland
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Publisher: Springer Science and Business Media LLC
Date: 05-08-2017
Publisher: Humana Press
Publisher: American Psychiatric Association Publishing
Date: 10-2001
DOI: 10.1176/APPI.AJP.158.10.1680
Abstract: The brain circuitry of opiate craving was investigated with positron emission tomography (PET) imaging of regional cerebral blood flow (rCBF). Twelve abstinent opiate-dependent subjects listened to audiotaped autobiographical scripts of an episode of craving and a neutral episode while undergoing a PET scan with the tracer [(15)O]H(2)O. Statistical parametric mapping was used to analyze the PET images of rCBF changes. Comparison of the drug-related and neutral stimulus conditions revealed activation of rCBF in the left medial prefrontal and left anterior cingulate cortices and deactivation in the occipital cortex in response to the drug-related stimulus. A further statistical parametric mapping analysis with a subjective rating of craving as a covariate showed a positive association of between craving and rCBF in the left orbitofrontal cortex. The patterns of cerebral activation reflect the different brain regions mediating the salience of opiate-related stimuli and the subjective experience of craving for opiates.
Publisher: Elsevier BV
Date: 03-2003
Publisher: Cambridge University Press (CUP)
Date: 10-2004
DOI: 10.1111/J.0924-2708.2004.00095.X
Abstract: Buprenorphine is a partial μ-opioid receptor agonist that is being increasingly used in clinical practice in the treatment of opioid dependence in the UK, USA, and, elsewhere. Its unique pharmacological properties mean it is a relatively safe drug, it can be given by alternate day dispensing, and it is associated with relatively mild symptoms on withdrawal. The interpretation of the research literature on buprenorphine is however, complex, and often appears to be in conflict with how buprenorphine is used in clinical practice. This article describes these apparent contradictions, their likely explanations, and how these may further inform our clinical practice. The article also describes the clinically relevant pharmacological properties of buprenorphine, compares it to methadone, relates the evidence to clinical experience, and provides practical advice on how to manage the most common clinical techniques. The best quality evidence suggests that very rapid buprenorphine induction is not associated with a higher drop-out rate than methadone, that buprenorphine is probably as good as methadone for maintenance treatment, and is superior to methadone and α-2 adrenergic agonists for detoxification. However, buprenorphine cannot yet be considered the ‘gold standard’ treatment for opiate dependence because of the higher drop-out rates that may occur on induction using current techniques, its high-cost relative to methadone, and because the place of buprenorphine in treatment is still continuing to evolve.
Publisher: Wiley
Date: 08-2606
DOI: 10.1111/J.1369-1600.2006.00001.X
Abstract: Craving is a commonly used term to describe an intense desire for a substance or behaviour however, its underlying neurobiology is not fully characterized. We have successfully used a cue exposure paradigm with functional neuro-imaging (H2 15O PET PET, positron emission tomography) in abstinent opiate addicts. This study showed that salient cue exposure results in activation in the left anterior cingulate/mediofrontal cortex and elicited craving correlated with activity in the left orbitofrontal cortex. We therefore aimed to replicate this study in alcohol dependence to see if a similar pattern of neural activation occurred. We recruited six abstinent alcohol-dependent and six non-dependent subjects who each underwent a 12-run PET scan using H2 15O to measure changes in regional blood flow during exposure to an alcoholic drink or its visually matched non-alcoholic drink. Physiological data and subjective ratings were also recorded. Statistical parametric mapping (SPM99) was used to analyse the PET images. Compared with control subjects, abstinent alcohol-dependent subjects rated their alcohol craving higher at baseline and throughout the study, but there was no significant change in the scores in response to the cues in either group. SPM analysis across all subjects showed significant activation in the occipital cortex in response to the alcohol cue as compared with the neutral one. Analysis of the same regions that were activated in the opiate study, revealed significant increases in signal activation in the left medial prefrontal area, but only in abstinent alcohol-dependent subjects. In conclusion, in abstinent alcohol dependence we suggest that a simple cue exposure paradigm is not sufficiently powerful in functional imaging studies to determine the underlying neurobiology of subjective craving. Comparisons with the finding in opiate dependence suggest a shared region, the anterior cingulate/left medial prefrontal cortex is involved in the cue response in dependent subjects but not controls.
Publisher: SAGE Publications
Date: 27-06-2019
Abstract: To examine the position statement of the Royal Australian and New Zealand College of Psychiatrists (RANZCP) regarding the availability of electronic cigarettes in Australia. There is limited evidence supporting the efficacy of nicotine e-cigarettes as an effective tobacco harm-reduction or cessation strategy for people with mental illness. The recommendations to increase their availability under regulation must be balanced with the physical and mental health risks of vapour inhalation and nicotine use, particularly for youth. Future recommendations by the RANZCP in relation to e-cigarettes must consider both the available evidence for harm reduction and the potential risks associated with youth e-cigarette use.
Publisher: Elsevier BV
Date: 10-2007
Publisher: Springer Vienna
Date: 2003
DOI: 10.1007/978-3-7091-6020-6_6
Abstract: Substance dependence is a major health problem but increasing understanding of its neurobiology is likely to lead to improved prevention and treatment. Fundamental aspects of dependence include tolerance and withdrawal and the fact that the drug becomes the centre of the addict's world. Neuroimaging has been key in defining underlying neurobiological mechanisms. The activity in particular brain regions has been shown to be altered in addiction. These include the anterior cingulate which is involved in emotional salience and the orbitofrontal cortex, involved in impulse control. Dopamine is the key neurotransmitter since most abused drugs increase its levels, and many pharmacotherapies have targeted this system. The opiate system is also key in mediating the pleasurable effects of some drugs such as alcohol by increasing dopamine levels. The GABA and glutamate systems mediate many of the other effects of alcohol. As the neurobiology of different components of addiction become evident, pharmacological approaches involve exploiting our new understanding which will likely lead to improved treatments.
Publisher: SAGE Publications
Date: 13-05-2019
Abstract: The aim of the current study was to review drug harms as they occur in Australia using the Multi-criteria Decision Analysis (MCDA) methodology adopted in earlier studies in other jurisdictions. A facilitated workshop with 25 experts from across Australia, was held to score 22 drugs on 16 criteria: 9 related to harms that a drug produces in the in idual and 7 to harms to others. Participants were guided by facilitators through the methodology and principles of MCDA. In open discussion, each drug was scored on each criterion. The criteria were then weighted using a process of swing weighting. Scoring was captured in MCDA software tool. MCDA modelling showed the most harmful substances to users were fentanyls (part score 50), heroin (part score 45) and crystal meth hetamine (part score 42). The most harmful substances to others were alcohol (part score 41), crystal meth hetamine (part score 24) and cigarettes/tobacco (part score 14). Overall, alcohol was the most harmful drug when harm to users and harm to others was combined. A supplementary analysis took into consideration the prevalence of each substance in Australia. Alcohol was again ranked the most harmful substance overall, followed by cigarettes, crystal meth hetamine, cannabis, heroin and pharmaceutical opioids. The results of this study make an important contribution to the emerging international picture of drug harms. They highlight the persistent and pervasive harms caused by alcohol. Policy implications and recommendations are discussed. Policies to reduce harm from alcohol and meth hetamine should be a priority.
Publisher: BMJ
Date: 09-2015
Publisher: Sri Lanka Journals Online (JOL)
Date: 29-06-2011
Publisher: Elsevier BV
Date: 2014
DOI: 10.1016/J.ADDBEH.2013.06.009
Abstract: Impulsive temperament has long been considered as a risk factor for substance use disorders (SUD). Considering the heterogeneity of impulsivity, a biologically-based 2-factor model incorporating reward sensitivity and rash impulsiveness facets, has been proposed. Here we report how these two facets of impulsiveness could be associated with different aspects of dependent heroin use and associated risky behaviour. Two hundred and ninety three dependent heroin users and 232 non-users were assessed on reward sensitivity, rash impulsivity, and the related trait of punishment sensitivity. After adjusting for multiple comparisons, heroin users were found to be more rash-impulsive and reward-sensitive than non-users (p<0.001). Within users, rash impulsivity was associated with high risk behaviour including escalating heroin consumption, injecting heroin use, hazardous drinking, low treatment-seeking and risky sexual behaviour. Reward sensitivity was uniquely associated with early onset of drug use. While greater impulsivity is a common trait in drug users compared with non-users, the use of a 2-factor model of impulsivity provides additional information regarding specific aspects of drug initiation and maintenance that can be targeted in the prevention and treatment of heroin dependence.
Publisher: Wiley
Date: 10-10-2014
DOI: 10.1111/DAR.12218
Abstract: The rate of alcohol-related emergency department (ED) presentations in young people has increased dramatically in recent decades. Injuries are the most common type of youth alcohol-related ED presentation, yet little is known about these injuries in young people. This paper describes the characteristics of alcohol-related ED injury presentations in young people over a 13-year period and determines if they differ by gender and/or age group (adolescents: 12-17 years young adults: 18-24 years). The Queensland Injury Surveillance Unit (QISU) database collects injury surveillance data at triage in participating EDs throughout Queensland, Australia. A total of 4667 cases of alcohol-related injuries in young people (aged 12-24 years) were identified in the QISU database between January 1999 and December 2011, using an injury surveillance code and nursing triage text-based search strategy. Overall, young people accounted for 38% of all QISU alcohol-related ED injury presentations in patients aged 12 years or over. The majority of young adults presented with injuries due to violence and falls, whereas adolescents presented due to self-harm or intoxication without other injury. Males presented with injuries due to violence, whereas females presented with alcohol-related self-harm and intoxication. There is a need for more effective ways of identifying the degree of alcohol involvement in injuries among young people presenting to EDs.
Publisher: SAGE Publications
Date: 22-08-2007
Abstract: The aim of this study was to make a comparison of brain structure between a group of opioid-dependent subjects and healthy controls. We report the results of an `optimized' voxel-based morphometry study on a s le of nine opioid-dependent subjects with no comorbid substance misuse disorders versus 21 healthy controls. We found a significant reduction in grey matter volume of the thalamus after controlling for age and total grey matter volume. Regression analysis of substance use variables in the opioid-dependent s le shows that only level of alcohol use negatively predicts grey matter volume for this region of difference. We suggest that level of nondependent alcohol use could influence reduced thalamic grey matter volume in opioid-dependent subjects.
Publisher: SAGE Publications
Date: 10-2019
Publisher: SAGE Publications
Date: 17-09-2012
Abstract: Generalized Anxiety Disorder (GAD) may involve hypo-responsiveness of noradrenaline a2 receptors. To test this hypothesis, we used 99m Tc-hexa-methyl-propylene-amine-oxime (HMPAO) Single Photon Emission Computed Tomography to measure regional cerebral perfusion in patients with untreated GAD, venlafaxine-treated patients and healthy controls during word generation before and after clonidine. Concurrent psychological and physiological measures supported noradrenergic hypofunction in GAD in some cases. A single-day split-dose technique was used. Images were processed using SPM5 (Institute of Neurology). Factorial analysis revealed no significant results. Exploratory analyses were done. Regional perfusion during verbal fluency differed by group pre-clonidine. Compared with healthy controls, patients with untreated GAD displayed increased perfusion in the left Broca’s area and left occipitotemporal region. Treated GAD patients displayed increased cerebellar perfusion bilaterally. Clonidine was associated with different changes in cerebral perfusion in each group. Increases were seen in the right supra-marginal gyrus in healthy subjects, in the left pre-central gyrus in treated GAD patients and in the right cerebellum and middle frontal gyrus in untreated GAD patients. Despite these differences, the findings were not consistent with a noradrenergic hypo-responsiveness hypothesis, as the treated group showed a different pattern of response rather than a normalization of response.
Publisher: Oxford University Press (OUP)
Date: 03-2003
DOI: 10.1093/BMB/65.1.209
Abstract: Alcohol and psycho-active substance misuse has far-reaching social, psychological and physical consequences. Advances in neuroimaging technology have allowed neurobiological theories of addiction to become better characterized. We describe the neurobiology of dependence, withdrawal, abstinence and craving states in alcohol, stimulant and opiate misuse. Structural neuroimaging techniques such as CT and MRI with new analytical approaches such as voxel-based morphometry have shown wide-spread changes in stimulant and opiate abuse and atrophy, particularly in the frontal lobes, in alcoholism. Functional neuroimaging techniques such as PET, SPECT and fMRI reveal altered regional cerebral activity by all drugs of abuse. The neurochemistry of addiction, particularly involving dopamine, serotonin, opiate and GABA, has been studied with PET and SPECT and similarities between all drugs of abuse have been found such as reduced dopaminergic markers. The evidence derived from these advances in neuroimaging is likely to herald the emergence of new biological treatments in this important field.
Publisher: Wiley
Date: 05-10-2018
DOI: 10.1111/ADD.14424
Publisher: Wiley
Date: 12-09-2010
Publisher: Elsevier BV
Date: 12-2012
DOI: 10.1016/J.MIDW.2011.08.003
Abstract: this study examined the clinical utility and precision of routine screening for alcohol and other drug use among women attending a public antenatal service. a survey of clients and audit of clinical charts. clients attending an antenatal clinic of a large tertiary hospital in Queensland, Australia, from October to December 2009. data were collected from two sources. First, 32 women who reported use of alcohol or other drugs during pregnancy at initial screening were then asked to complete a full substance use survey. Second, data were collected from charts of 349 new clients who attended the antenatal clinic during the study period. Both sensitivity (86%, 67%) and positive predictive value (100%, 92%) for alcohol and other drug use respectively, were high. Only 15% of surveyed women were uncomfortable about being screened for substance use in pregnancy, yet the chart audit revealed poor staff compliance. During the study period, 25% of clients were either not screened adequately or not at all. KEY CONCLUSIONS AND IMPLICATIONS FOR PRACTISE: despite recommended universal screening in pregnancy and the apparent acceptance by our participants, alcohol and other drug (A&OD) screening in the antenatal setting remains problematic. Investigation into the reasons behind, and ways to overcome, the low screening rate could improve health outcomes for mothers and children in this at-risk group. Targeted education and training for midwives may form part of the solution as these clinicians have a key role in implementing prevention and early intervention strategies.
Publisher: Elsevier BV
Date: 12-2003
DOI: 10.1016/J.NEUROIMAGE.2003.07.025
Abstract: We investigated the functional connectivity of brain regions activated during opiate craving. Previously we used recorded autobiographical scripts to induce opiate craving in 12 abstinent opiate-dependent subjects while they were undergoing positron emission tomography (PET) scanning using the regional cerebral blood flow (rCBF) tracer H2 15O. SPM99 was used to examine the connectivity patterns associated with the primary brain regions activated in response to drug-craving memories (anterior cingulate, AC) and correlated with opiate craving (orbitofrontal cortex, OFC). Two separate connectivity patterns were identified associated with the OFC and AC regions. The AC region was associated with activity in the left temporal region. The left OFC region activity correlated with activity in the right OFC, and left parietal and posterior insular regions. There was also a positive association with the hippoc us and brainstem. Both the AC and OFC regions showed a negative association with posterior visual areas. We suggest that the patterns of functional connectivity reflect the ability of drug-related stimuli to activate attentional and memory circuits to a greater degree than non-drug-related stimuli. This argues that neural circuits of dependence and craving are not specific "craving" or "addiction" brain regions but are "normal" circuits activated to a greater degree.
Publisher: Royal College of Psychiatrists
Date: 07-2008
DOI: 10.1192/BJP.BP.107.041228
Abstract: Drugs of dependence cause dopamine release in the rat striatum. Human neuroimaging studies have shown an increase in dopamine in the equivalent region in response to stimulants and other drugs We tested whether opioids provoke dopamine release and its relationship to the subjective experience In two combined studies 14 heroin addicts on methadone maintenance treatment underwent two positron emission tomography brain scans of the dopamine system using [ 11 C]-raclopride following an injection of placebo and either 50 mg intravenous diamorphine or 10 mg subcutaneous hydromorphone in a double-blind, random order design Both opioids produced marked subjective and physiological effects, but no measurable change in [ 11 C]-raclopride binding The absence of a dopamine response to opioid agonists contrasts with that found with stimulant drugs and suggests dopamine may not play the same role in addiction to opioids. This questions the role of dopamine in the subjective experience of heroin in opioid addicts
Publisher: Elsevier BV
Date: 10-2009
DOI: 10.1016/J.EURONEURO.2009.06.007
Abstract: The importance of the opioid receptor system in substance dependence is increasingly recognised. We used PET with the non-selective tracer [11C]diprenorphine to examine opioid receptor binding in early abstinence from alcohol dependence and the relationship to craving. We recruited 11 alcohol dependent patients and 13 controls. Subjects underwent one [11C]diprenorphine PET scan in early abstinence from dependent alcohol use (approximately 2 weeks) and 2 months later if continuously abstinent. Global and regional [11C]diprenorphine volumes of distribution (VD) were increased in alcohol dependent patients compared with controls but did not reach significance. We demonstrated a correlation between global and regional [11C]diprenorphine VD and craving in alcohol dependent patients which persisted in the anterior cingulate cortex into extended abstinence. This confirms previous work showing increased opioid receptor availability in early abstinence from substances of abuse and correlation with craving suggesting that the opioid system plays a fundamental role in this phase of addiction.
Publisher: American Society for Pharmacology & Experimental Therapeutics (ASPET)
Date: 03-09-2004
Publisher: Oxford University Press (OUP)
Date: 17-08-2011
Publisher: Hindawi Limited
Date: 02-01-1970
DOI: 10.1111/HSC.12423
Abstract: Social factors, health behaviours and the direct effects of substances contribute to the poor oral health and restricted access to dental services experienced by people who are dependent on drugs and/or alcohol. Admission for inpatient withdrawal management provides an opportunity for intervention to promote oral health but to be effective it must be acceptable to patients. To support intervention design, we examined patients' views about oral health, practices and treatment access, and appropriateness of health-promoting intervention in this context. Given paucity of knowledge in the area we employed a qualitative approach, data were collected in semi-structured interviews with inpatients of a public specialist alcohol and drug unit in Australia in September 2014. Analysis employed the framework approach. All 14 participants wanted 'good teeth' but few diligently attended to oral healthcare most sought assistance only in emergencies. Participants' knowledge of services was limited and practical and affective barriers hindered access. With none recalling attention to oral health during admission, support was strong for incorporation of oral health in inpatient assessments. Participants wanted information about the impact of substances on oral health and oral hygiene practices provided in various formats, and facilitated referral to non-judgemental, affordable treatment. Patients regarded promotion of oral health in the inpatient context as important, relevant and acceptable. Support should respect the different knowledge, practices and motivations for oral health and recovery, of patients. Addressing practical and affective barriers to dental services will require collaboration between drug and alcohol and dental services, and this should be the focus of further research.
Publisher: Springer Berlin Heidelberg
Date: 2010
DOI: 10.1007/978-3-642-15745-5_23
Abstract: Kinetic analysis is an essential tool of Positron Emission Tomography image analysis. However it requires a pure tissue time activity curve (TAC) in order to calculate the system parameters. Pure tissue TACs are particularly difficult to obtain in the brain as the low resolution of PET means almost all voxels are a mixture of tissues. Factor analysis explicitly accounts for mixing but is an underdetermined problem that can give arbitrary results. A joint factor and kinetic analysis is proposed whereby factor analysis explicitly accounts for mixing of tissues. Hence, more meaningful parameters are obtained by the kinetic models, which also ensure a less ambiguous solution to the factor analysis. The method was tested using a cylindrical phantom and the 18F-DOPA data of a brain cancer patient.
Publisher: SAGE Publications
Date: 31-01-2018
Publisher: Elsevier BV
Date: 06-2012
Publisher: Elsevier BV
Date: 08-2008
Publisher: Walter de Gruyter GmbH
Date: 2005
DOI: 10.1515/REVNEURO.2005.16.2.151
Abstract: Functional and effective connectivity are relatively new techniques in the analysis of functional neuroimaging studies in humans. They have previously been used in studies of 'normal' psychological and neurological processes such as vision before gradually transferring into use in pathological disease states such as schizophrenia. These techniques are now beginning to extend into the field of substance misuse and dependence. So far, most functional neuroimaging studies in this field have shown consistent patterns of activation in several brain regions, and theories are emerging based upon these and animal models. Studies of brain connectivity can now begin to help further unravel the tangle of disparate brain regions and their connections that underpin the psychopharmacological processes of dependence.
Publisher: Wiley
Date: 08-2004
Publisher: Royal College of Psychiatrists
Date: 07-2007
DOI: 10.1192/BJP.BP.106.031120
Abstract: Although opioid receptor function in humans is clearly reduced during opioid dependence, what happens to the receptor in early abstinence is not understood. This study sought to examine changes in opioid receptor availability in early abstinence from opioid dependence. Ten people with opioid dependence who had completed inpatient detoxification and 20 healthy controls underwent [ 11 C]-diprenorphine positron emission tomography. Clinical variables were assessed with structured questionnaires. Opioid receptor binding was characterised as the volume of distribution of [ 11 C]-diprenorphine using a template of predefined brain volumes and an exploratory voxel-by-voxel analysis. Compared with controls, participants with opioid dependence had increased [ 11 C]-diprenorphine binding in the whole brain and in 15 of the 21 a priori regions studied. This study suggests that opioid receptor binding is increased throughout the brain in early abstinence from dependent opioid use. These data complement the findings in cocaine and alcohol dependence.
Publisher: Springer Science and Business Media LLC
Date: 08-08-2014
Publisher: Wiley
Date: 03-08-2021
DOI: 10.1111/ADD.15146
Publisher: Elsevier BV
Date: 09-2000
Publisher: Elsevier BV
Date: 03-2007
Publisher: Elsevier BV
Date: 07-2012
DOI: 10.1016/J.NUT.2011.11.003
Abstract: Chronic substance abuse is recognized to affect nutritional status and is associated with nutrient deficiencies and malnutrition. This study aimed to identify the prevalence of malnutrition and nutritional risk factors using a spread of measurements in patients undergoing alcohol and drug treatment. Sixty-seven patients (48 male, 19 female) admitted to a public hospital detoxification unit participated: 49 were alcohol dependent (73%) and the remaining were opiate, benzodiazepine, and/or hetamine dependent. Nutritional status was assessed by the Subjective Global Assessment. An appetite questionnaire (Simplified Nutritional Appetite Questionnaire), a diet-quality questionnaire (Australian Recommended Food Score), and blood biochemistry and hematologic tests were also applied. The prevalence of mild/moderate malnutrition was 24% according to the Subjective Global Assessment. Weight and body mass index were associated with nutritional status (P < 0.05). Appetite and diet quality were poor overall, with 88% of all participants requiring advice and guidance. Blood markers showed that 50% of all subjects were deficient in iron or vitamins (low vitamin A levels in 21%, low iron levels in 18%, low-range potassium in 12%, and low vitamin C levels in 8%). The prevalence of malnutrition in this patient population is likely to underestimate the prevalence of nutritional risk factors and micronutrient undernutrition. Multiple tools assessing nutritional status, appetite, diet quality, and blood test results have different advantages and can further identify the specific needs and appropriateness of nutritional education in patients during treatment for drug and alcohol use.
Publisher: Wiley
Date: 25-03-2016
DOI: 10.1111/ACER.13034
Abstract: Stress, craving, and depressed mood have all been implicated in alcohol use treatment lapses. Few studies have examined all 3 factors. Progress has been limited because of difficulties with craving assessment. The Alcohol Craving Experience Questionnaire (ACE) is a new measure of alcohol craving. It is both psychometrically sound and conceptually rigorous. This prospective study examines a stress-treatment response model that incorporates mediation by craving and moderation by depressed mood and pharmacotherapy. Five hundred and thirty-nine consecutively treated alcohol-dependent patients voluntarily participated in an abstinence-based 12-week cognitive-behavioral therapy (CBT) program at a hospital alcohol and drug outpatient clinic. Measures of stress, craving, depressed mood, and alcohol dependence severity were administered prior to treatment. Treatment lapse and treatment dropout were assessed over the 12-week program duration. Patients reporting greater stress experienced stronger and more frequent cravings. Stronger alcohol craving predicted lapse, after controlling for dependence severity, stress, depression, and pharmacotherapy. Alcohol craving mediated stress to predict lapse. Depressed mood and anticraving medication were not significant moderators. Among treatment seeking, alcohol-dependent patients, craving mediated the relationship between stress and lapse. The effect was not moderated by depressed mood or anticraving medication.
Publisher: Elsevier BV
Date: 02-2001
DOI: 10.1016/S1471-4892(01)00011-X
Abstract: The final common pathway of addiction (the dopamine hypothesis of reward) has recently been evolving, with the mesocorticolimbic dopaminergic system now seen as key to natural rewards and drug-seeking behaviour, though perhaps having less of a role in the maintenance of such behaviour. The perception of a common pathway has meant that treatments for one drug of addiction have 'crossed-over' and become possible treatments for other addictive drugs.
Publisher: Cambridge University Press (CUP)
Date: 1996
DOI: 10.1017/S0963180100007209
Abstract: Today's clinical AIDS research is in trouble. Principal investigators are confronted with young and frequently highly knowledgeable patients. Many of these people with AIDS (PWAs) are often unwilling to adhere to the trial protocols. These PWAs believe they are ethically justified in breaching trial protocols because they do not consider themselves true volunteers in such trials. PWAs argue that they do not really volunteer because existing legislation prevents them from buying and using experimental drugs or from testing alternative treatment strategies. Their only access to such agents is participation in clinical trials.
Publisher: Elsevier BV
Date: 03-2003
Publisher: Elsevier BV
Date: 12-2003
DOI: 10.1016/J.EURONEURO.2003.08.006
Abstract: Addiction provides fertile ground for the application of the tools of functional neuroimaging. They can be ided into studies of neural activity and neurotransmitter function. Using the former, both opiates and stimulants cause a global decrease in brain metabolism. Against this background, acute doses have still been shown to produce relative increases in brain activation in specific regions, e.g., anterior cingulate, thalamus, and amygdala. These are also regions frequently found with cue-exposure paradigms. Our own work on cue-exposure has shown that heroin-related stimuli provoke activation of the anterior cingulate and orbitofrontal regions. Brain metabolism has also been shown to increase in drug withdrawal from alcohol and cocaine. Neurotransmitter studies have shown that in alcohol dependence, GABA(A)-benzodiazepine (GABA-BDZ) receptors are reduced in a number of brain regions and suggest that there may be 'capacity within the system' in some benzodiazepine functions, but tolerance to others, e.g., time asleep. Finally, 11C-Ro15-4513 offers new opportunities for imaging the GABA-BDZ system.
Location: United Kingdom of Great Britain and Northern Ireland
No related grants have been discovered for Mark Daglish.