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Muchhala KH, Kallurkar PS, Kang M, Koseli E, Poklis JL, Xu Q, Dewey WL, Fettweis JM, Jimenez NR, Akbarali HI. The role of morphine- and fentanyl-induced impairment of intestinal epithelial antibacterial activity in dysbiosis and its impact on the microbiota-gut-brain axis. FASEB J 2024; 38:e23603. [PMID: 38648368 PMCID: PMC11047137 DOI: 10.1096/fj.202301590rr] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2023] [Revised: 03/22/2024] [Accepted: 03/26/2024] [Indexed: 04/25/2024]
Abstract
Recent evidence suggests that chronic exposure to opioid analgesics such as morphine disrupts the intestinal epithelial layer and causes intestinal dysbiosis. Depleting gut bacteria can preclude the development of tolerance to opioid-induced antinociception, suggesting an important role of the gut-brain axis in mediating opioid effects. The mechanism underlying opioid-induced dysbiosis, however, remains unclear. Host-produced antimicrobial peptides (AMPs) are critical for the integrity of the intestinal epithelial barrier as they prevent the pathogenesis of the enteric microbiota. Here, we report that chronic morphine or fentanyl exposure reduces the antimicrobial activity in the ileum, resulting in changes in the composition of bacteria. Fecal samples from morphine-treated mice had increased levels of Akkermansia muciniphila with a shift in the abundance ratio of Firmicutes and Bacteroidetes. Fecal microbial transplant (FMT) from morphine-naïve mice or oral supplementation with butyrate restored (a) the antimicrobial activity, (b) the expression of the antimicrobial peptide, Reg3γ, (c) prevented the increase in intestinal permeability and (d) prevented the development of antinociceptive tolerance in morphine-dependent mice. Improved epithelial barrier function with FMT or butyrate prevented the enrichment of the mucin-degrading A. muciniphila in morphine-dependent mice. These data implicate impairment of the antimicrobial activity of the intestinal epithelium as a mechanism by which opioids disrupt the microbiota-gut-brain axis.
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Affiliation(s)
- Karan H. Muchhala
- Department of Pharmacology and Toxicology, Virginia Commonwealth University, Richmond, VA, United States
| | - Prajkta S. Kallurkar
- Department of Pharmacology and Toxicology, Virginia Commonwealth University, Richmond, VA, United States
| | - Minho Kang
- Department of Pharmacology and Toxicology, Virginia Commonwealth University, Richmond, VA, United States
| | - Eda Koseli
- Department of Pharmacology and Toxicology, Virginia Commonwealth University, Richmond, VA, United States
| | - Justin L. Poklis
- Department of Pharmacology and Toxicology, Virginia Commonwealth University, Richmond, VA, United States
| | - Qingguo Xu
- Department of Pharmaceutics, School of Pharmacy, Virginia Commonwealth University, Richmond, VA, United States
| | - William L. Dewey
- Department of Pharmacology and Toxicology, Virginia Commonwealth University, Richmond, VA, United States
| | - Jennifer M. Fettweis
- Department of Microbiology and Immunology, School of Medicine, Virginia Commonwealth University, Richmond, VA, United States
| | - Nicole R. Jimenez
- Department of Microbiology and Immunology, School of Medicine, Virginia Commonwealth University, Richmond, VA, United States
| | - Hamid I. Akbarali
- Department of Pharmacology and Toxicology, Virginia Commonwealth University, Richmond, VA, United States
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Urhan M, Gezmen Karadağ M. Diet quality, nutritional status and taste recognition are impaired in men with substance use disorder. NUTR BULL 2024; 49:40-51. [PMID: 38115211 DOI: 10.1111/nbu.12654] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2022] [Revised: 11/22/2023] [Accepted: 11/27/2023] [Indexed: 12/21/2023]
Abstract
This study aimed to (1) evaluate the nutritional status, prevalence of malnutrition and dietary habits in individuals using substances and (2) examine the possible effects of substance use on the perception of five basic tastes. Ninety male individuals with substance use disorder (SUD) (heroin = 78, cocaine = 12) and 32 non-users participated in the study conducted at Manisa Alcohol and Substance Addiction Treatment Center (AMATEM), Turkey. To determine the quality of the diet, the mean nutrient adequacy ratio (MAR) was calculated based on 24-h recall food consumption records of the individuals. Subjective Global Assessment (SGA) was employed to determine nutritional status, and anthropometric measurements were also taken from the individuals. The taste detection and recognition thresholds were determined with solutions with different concentrations for bitter, sour, sweet, umami and salty tastes and scored, with higher scores indicating lower thresholds. Mild-moderate malnutrition was determined in 50% of the individuals with SUD based on SGA. The body mass index (BMI) of individuals with SUD was found to be 21.2 ± 1.88 kg/m2 , and 24.1 ± 1.64 kg/m2 for non-users (p < 0.001). Diet quality, evaluated by MAR, was lower in individuals with SUD (54.7 ± 18.9%) than in non-users (93.5 ± 9.0%) (p < 0.001). The taste detection and taste recognition thresholds of individuals with SUD were impaired, and the threshold scores for sour, salty, sweet and umami taste recognition were significantly lower compared with non-users, with the lowest substance user threshold scores observed for the sweet recognition threshold. Standardised nutritional and behavioural interventions designed by dietitians should be provided for drug users in treatment centres and integrated with medical treatment practices.
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Affiliation(s)
- Murat Urhan
- Department of Nutrition and Dietetics, Faculty of Health Science, Ege University, Karşıyaka, İzmir, Turkey
| | - Makbule Gezmen Karadağ
- Department of Nutrition Dietetics, Gazi University Faculty of Health Science, Çankaya, Ankara, Turkey
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Migdanis A, Migdanis I, Papadopoulou SK, Hadjivasiliou L, Trifonova N, Villioti M, Giaginis C, Kosti RI, Androutsos O. Αssessment of Dietary Intake and Nutritional Status of Former Opioid Users Undergoing Detoxification Process. Cureus 2023; 15:e50068. [PMID: 38186545 PMCID: PMC10767476 DOI: 10.7759/cureus.50068] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/05/2023] [Indexed: 01/09/2024] Open
Abstract
RATIONALE Opioid dependence is often associated with impaired nutritional status, weight changes, nutritional deficiencies, and increased sugar consumption. Scientific quantified data on the dietary habits and intake of such patients are sparse. METHODS This was a cross-sectional study. The study was conducted among 60 male and female former heroin addicts, who sought detoxification at the OKANA replacement therapy unit, in a public university hospital. All patients were treated for their addiction with buprenorfine/naloxone in combination with counseling. With the use of an administered questionnaire, several parameters were assessed and recorded, including nutritional habits, anthropometric characteristics, recent weight and medical history, and physical activity level of the participants. Additionally, a three-day dietary recall was performed and quantified with the aid of nutritional analysis software. The results were compared with the macronutrient requirements, calculated total energy expenditure, and the population reference intake (PRI) of the participants. Finally, the level of compliance of the participants to the Mediterranean diet model was assessed using the Mediterranean diet score tool. RESULTS The vast majority of the participants (77%) had a normal BMI of 18.5-25, and 15% were categorized as underweight (<18.5). Furthermore, 63% of the patients reported a mean unintended weight reduction of 9 kg over the last three months. Regarding mean energy and protein intake, no significant differences between reported intake and calculated requirements were recorded. Sugar consumption was high since it reached 20% of the total energy intake. Micronutrient intake was significantly lower for vitamins K, E, and C and potassium compared with the PRI (p=0.034, p=0.001, p=0.046, and p=0.001, respectively). Finally, a low adherence of the participants to the Mediterranean diet model was observed since 38% scored ≤15 and 62% ≤ 30 on the Mediterranean diet score tool. CONCLUSIONS According to the results of the study, the general nutritional status of this category of patients seems to be impaired, presenting an apparent weight reduction and an inadequate intake of some micronutrients and displaying disturbed eating behaviors. Further data on the field are required to build a future evidence base. Dietary assessment and individualized nutritional counseling, when necessary, might need to be incorporated into the typical clinical management of this patient category to avoid nutritional deficiencies and improve the withdrawal process.
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Affiliation(s)
- Athanasios Migdanis
- Faculty of Medicine, University of Thessaly, Larissa, GRC
- Department of Nutrition and Dietetics, University of Thessaly, Trikala, GRC
| | - Ioannis Migdanis
- Faculty of Medicine, University of Thessaly, Larissa, GRC
- Department of Nutrition and Dietetics, University of Thessaly, Trikala, GRC
| | - Sousana K Papadopoulou
- Department of Nutrition and Dietetics, International Hellenic University, Thessaloniki, GRC
| | | | - Nevena Trifonova
- Department of Nutrition and Dietetics, University of Thessaly, Trikala, GRC
| | - Maria Villioti
- Faculty of Medicine, University of Thessaly, Larissa, GRC
| | | | - Rena I Kosti
- Department of Nutrition and Dietetics, University of Thessaly, Trikala, GRC
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Halbout B, Hutson C, Agrawal S, Springs ZA, Ostlund SB. Differential effects of acute and prolonged morphine withdrawal on motivational and goal-directed control over reward-seeking behavior. BIORXIV : THE PREPRINT SERVER FOR BIOLOGY 2023:2023.09.14.557822. [PMID: 37745601 PMCID: PMC10515939 DOI: 10.1101/2023.09.14.557822] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/26/2023]
Abstract
Opioid addiction is a relapsing disorder marked by uncontrolled drug use and reduced interest in normally rewarding activities. The current study investigated the impact of spontaneous withdrawal from chronic morphine exposure on emotional, motivational, and cognitive processes involved in regulating the pursuit and consumption of natural food rewards in male rats. In Experiment 1, rats experiencing acute morphine withdrawal lost weight and displayed somatic signs of drug dependence. However, hedonically-driven sucrose consumption was significantly elevated, suggesting intact and potentially heightened emotional reward processing. In Experiment 2, rats undergoing acute morphine withdrawal displayed reduced motivation when performing an effortful response for palatable food reward. Subsequent reward devaluation testing revealed that acute withdrawal also disrupted their ability to exert flexible goal-directed control over their reward-seeking behavior. Specifically, morphine-withdrawn rats displayed insensitivity to reward devaluation both when relying on prior action-outcome learning and when given direct feedback about the consequences of their actions. In Experiment 3, rats tested after prolonged morphine withdrawal displayed heightened rather than diminished motivation for food rewards and retained their ability to engage in flexible goal-directed action selection. However, brief re-exposure to morphine was sufficient to impair motivation and disrupt goal-directed action selection, though in this case insensitivity to reward devaluation was only observed in the presence of morphine-paired context cues and in the absence of response-contingent feedback. We suggest that these opioid-withdrawal induced deficits in motivation and goal-directed control may contribute to addiction by interfering with the pursuit of adaptive alternatives to drug use.
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Affiliation(s)
- Briac Halbout
- Department of Anesthesiology and Perioperative Care, School of Medicine, University of California, Irvine, Irvine, CA, 92697, USA
| | - Collin Hutson
- Department of Anesthesiology and Perioperative Care, School of Medicine, University of California, Irvine, Irvine, CA, 92697, USA
| | - Stuti Agrawal
- Department of Anesthesiology and Perioperative Care, School of Medicine, University of California, Irvine, Irvine, CA, 92697, USA
| | - Zachary A. Springs
- Department of Anesthesiology and Perioperative Care, School of Medicine, University of California, Irvine, Irvine, CA, 92697, USA
| | - Sean B. Ostlund
- Department of Anesthesiology and Perioperative Care, School of Medicine, University of California, Irvine, Irvine, CA, 92697, USA
- Department of Neurobiology and Behavior, School of Biological Sciences, University of California, Irvine, Irvine, CA, 92697, USA
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5
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Byanyima JI, Li X, Vesslee SA, Kranzler HR, Shi Z, Wiers CE. Metabolic profiles associated with opioid use and opioid use disorder: a narrative review of the literature. CURRENT ADDICTION REPORTS 2023; 10:581-593. [PMID: 37982033 PMCID: PMC10656052 DOI: 10.1007/s40429-023-00493-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/02/2023] [Indexed: 11/21/2023]
Abstract
Purpose of Review Opioid use disorder (OUD) is a chronic, relapsing condition that is epidemic in the USA. OUD is associated with serious adverse consequences, including higher incarceration rates, impaired medical and mental health, and overdose-related fatalities. Several medications with demonstrated clinical efficacy in reducing opioid use are approved to treat OUD. However, there is evidence that medications for OUD cause metabolic impairments, which raises concerns over the long-term metabolic health of individuals recovering from OUD. Here, we summarize the scientific literature on the metabolic effects of the use of opioids, including medications for treating OUD. Recent Findings Our findings showed lower body weight and adiposity, and better lipid profiles in individuals with OUD. In individuals with diabetes mellitus, opioid use was associated with lower blood glucose levels. In contrast, among individuals without underlying metabolic conditions, opioids promoted insulin resistance. Treatment of OUD patients with the agonists methadone or buprenorphine caused weight gain, increased liking and intake of sugar, and impaired lipid profile and glucose metabolism, whereas treatment with the antagonist naltrexone demonstrated evidence for reduced sweet preferences. Summary Our findings highlighted a gap in knowledge regarding the safety of medications for OUD. Further research is needed to determine how best to reduce the risk of metabolic disorder in the treatment of OUD with opioid agonists versus antagonists.
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Affiliation(s)
- Juliana I Byanyima
- Center for Studies of Addiction, Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, 3535 Market St. Suite 500, Philadelphia, PA 191904, USA
| | - Xinyi Li
- Center for Studies of Addiction, Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, 3535 Market St. Suite 500, Philadelphia, PA 191904, USA
| | - Sianneh A Vesslee
- Center for Studies of Addiction, Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, 3535 Market St. Suite 500, Philadelphia, PA 191904, USA
| | - Henry R Kranzler
- Center for Studies of Addiction, Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, 3535 Market St. Suite 500, Philadelphia, PA 191904, USA
| | - Zhenhao Shi
- Center for Studies of Addiction, Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, 3535 Market St. Suite 500, Philadelphia, PA 191904, USA
| | - Corinde E Wiers
- Center for Studies of Addiction, Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, 3535 Market St. Suite 500, Philadelphia, PA 191904, USA
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Muchhala K, Kang M, Koseli E, Poklis J, Xu Q, Dewey W, Fettweis J, Jimenez N, Akbarali H. The Role of Morphine-Induced Impairment of Intestinal Epithelial Antibacterial Activity in Dysbiosis and its Impact on the Microbiota-Gut-Brain Axis.. [PMID: 37503065 PMCID: PMC10371156 DOI: 10.21203/rs.3.rs-3084467/v2] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/04/2024]
Abstract
Abstract
Recent evidence suggests that chronic exposure to opioid analgesics such as morphine disrupt the intestinal epithelial layer and cause intestinal dysbiosis. Inhibiting opioid-induced dysbiosis can preclude the development of tolerance to opioid-induced antinociception, suggesting an important role of the gut-brain axis in mediating opioid effects. However, the mechanism underlying opioid-induced dysbiosis remains unclear. Host-produced antimicrobial peptides (AMPs) are critical for the integrity of the intestinal epithelial barrier as they prevent the pathogenesis of the enteric microbiota. Here, we report that chronic morphine exposure reduces expression of the antimicrobial peptide, Regenerating islet-derived 3 gamma (Reg3γ), in the ileum resulting in reduced intestinal antimicrobial activity against Gram-positive bacteria, L. reuteri. Fecal samples from morphine-treated mice had reduced levels of the phylum, Firmicutes, concomitant with reduced levels of short-chain fatty acid, butyrate. Fecal microbial transplant (FMT) from morphine-naïve mice restored the antimicrobial activity, the expression of Reg3γ, and prevented the increase in intestinal permeability and the development of antinociceptive tolerance in morphine-dependent mice. Similarly, oral gavage with sodium butyrate dose-dependently reduced the development of antinociceptive tolerance, and prevented the downregulation of Reg3γ and the reduction in antimicrobial activity. The alpha diversity of the microbiome was also restored by oral butyrate in morphine-dependent mice. These data implicate impairment of the antimicrobial activity of the intestinal epithelium as a mechanism by which morphine disrupts the microbiota-gut-brain axis.
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7
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Muchhala K, Kang M, Koseli E, Poklis J, Xu Q, Dewey W, Fettweis J, Jimenez N, Akbarali H. The Role of Morphine-Induced Impairment of Intestinal Epithelial Antibacterial Activity in Dysbiosis and its Impact on the Microbiota-Gut-Brain Axis. RESEARCH SQUARE 2023:rs.3.rs-3084467. [PMID: 37503065 PMCID: PMC10371156 DOI: 10.21203/rs.3.rs-3084467/v1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/29/2023]
Abstract
Recent evidence suggests that chronic exposure to opioid analgesics such as morphine disrupt the intestinal epithelial layer and cause intestinal dysbiosis. Inhibiting opioid-induced dysbiosis can preclude the development of tolerance to opioid-induced antinociception, suggesting an important role of the gut-brain axis in mediating opioid effects. However, the mechanism underlying opioid-induced dysbiosis remains unclear. Host-produced antimicrobial peptides (AMPs) are critical for the integrity of the intestinal epithelial barrier as they prevent the pathogenesis of the enteric microbiota. Here, we report that chronic morphine exposure reduces expression of the antimicrobial peptide, Regenerating islet-derived 3 gamma (Reg3γ), in the ileum resulting in reduced intestinal antimicrobial activity against Gram-positive bacteria, L. reuteri. Fecal samples from morphine-treated mice had reduced levels of the phylum, Firmicutes, concomitant with reduced levels of short-chain fatty acid, butyrate. Fecal microbial transplant (FMT) from morphine-naïve mice restored the antimicrobial activity, the expression of Reg3γ, and prevented the increase in intestinal permeability and the development of antinociceptive tolerance in morphine-dependent mice. Similarly, oral gavage with sodium butyrate dose-dependently reduced the development of antinociceptive tolerance, and prevented the downregulation of Reg3γ and the reduction in antimicrobial activity. The alpha diversity of the microbiome was also restored by oral butyrate in morphine-dependent mice. These data implicate impairment of the antimicrobial activity of the intestinal epithelium as a mechanism by which morphine disrupts the microbiota-gut-brain axis.
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8
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Kong D, Sun JX, Yang JQ, Li YS, Bi K, Zhang ZY, Wang KH, Luo HY, Zhu M, Xu Y. Ketogenic diet: a potential adjunctive treatment for substance use disorders. Front Nutr 2023; 10:1191903. [PMID: 37575322 PMCID: PMC10414993 DOI: 10.3389/fnut.2023.1191903] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2023] [Accepted: 07/13/2023] [Indexed: 08/15/2023] Open
Abstract
Substance use disorders (SUD) can lead to serious health problems, and there is a great interest in developing new treatment methods to alleviate the impact of substance abuse. In recent years, the ketogenic diet (KD) has shown therapeutic benefits as a dietary therapy in a variety of neurological disorders. Recent studies suggest that KD can compensate for the glucose metabolism disorders caused by alcohol use disorder by increasing ketone metabolism, thereby reducing withdrawal symptoms and indicating the therapeutic potential of KD in SUD. Additionally, SUD often accompanies increased sugar intake, involving neural circuits and altered neuroplasticity similar to substance addiction, which may induce cross-sensitization and increased use of other abused substances. Reducing carbohydrate intake through KD may have a positive effect on this. Finally, SUD is often associated with mitochondrial damage, oxidative stress, inflammation, glia dysfunction, and gut microbial disorders, while KD may potentially reverse these abnormalities and serve a therapeutic role. Although there is much indirect evidence that KD has a positive effect on SUD, the small number of relevant studies and the fact that KD leads to side effects such as metabolic abnormalities, increased risk of malnutrition and gastrointestinal symptoms have led to the limitation of KD in the treatment of SUD. Here, we described the organismal disorders caused by SUD and the possible positive effects of KD, aiming to provide potential therapeutic directions for SUD.
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Affiliation(s)
- Deshenyue Kong
- General Hospital of Eastern Theater Command, Nanjing, China
- Yunnan Technological Innovation Centre of Drug Addiction Medicine, Yunnan University, Kunming, China
- First Affiliated Hospital of Kunming Medical University, Kunming, China
| | - Jia-xue Sun
- Yunnan Technological Innovation Centre of Drug Addiction Medicine, Yunnan University, Kunming, China
- First Affiliated Hospital of Kunming Medical University, Kunming, China
| | - Ji-qun Yang
- Third People’s Hospital of Kunming City/Drug Rehabilitation Hospital of Kunming City, Kunming, China
| | - Yuan-sen Li
- Yunnan Technological Innovation Centre of Drug Addiction Medicine, Yunnan University, Kunming, China
- First Affiliated Hospital of Kunming Medical University, Kunming, China
| | - Ke Bi
- Yunnan Technological Innovation Centre of Drug Addiction Medicine, Yunnan University, Kunming, China
- First Affiliated Hospital of Kunming Medical University, Kunming, China
| | - Zun-yue Zhang
- Yunnan Technological Innovation Centre of Drug Addiction Medicine, Yunnan University, Kunming, China
| | - Kun-hua Wang
- Yunnan Technological Innovation Centre of Drug Addiction Medicine, Yunnan University, Kunming, China
| | - Hua-you Luo
- First Affiliated Hospital of Kunming Medical University, Kunming, China
| | - Mei Zhu
- First Affiliated Hospital of Kunming Medical University, Kunming, China
| | - Yu Xu
- General Hospital of Eastern Theater Command, Nanjing, China
- Yunnan Technological Innovation Centre of Drug Addiction Medicine, Yunnan University, Kunming, China
- First Affiliated Hospital of Kunming Medical University, Kunming, China
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9
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Zhou Y, Stubbs RJ, Finlayson G. A neurocognitive perspective on the relationship between exercise and reward: Implications for weight management and drug addiction. Appetite 2023; 182:106446. [PMID: 36592797 DOI: 10.1016/j.appet.2022.106446] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2022] [Revised: 11/24/2022] [Accepted: 12/29/2022] [Indexed: 01/01/2023]
Abstract
The impact of exercise on food reward is increasingly being discussed as an interplay between executive function (EF), homeostasis and mechanisms promoting or undermining intentional behaviour change. Integrating current knowledge of neurocognitive processes encompassing cognitive and affective networks within an energy balance framework will provide a more comprehensive account. Reward circuitry affected by recreational drugs and food overlap. Therefore the underlying processes explaining changes in drug-taking behaviour may offer new insights into how exercise affects the reward value of recreational drugs and food. EF is important for successful self-regulation, and training EF may boost inhibitory control in relation to food- and drug-related reward. Preclinical and clinical observations suggest that reward-seeking can transfer within and between categories of reward. This may have clinical implications beyond exercise improving metabolic health in people with obesity to understanding therapeutic responses to exercise in people with neurocognitive deficits in non-food reward-based decision making such as drug dependence.
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Affiliation(s)
- Yu Zhou
- Appetite Control & Energy Balance Research Group, School of Psychology, Faculty of Medicine and Health, University of Leeds, Leeds, United Kingdom; School of Psychology, Shanghai University of Sport, Shanghai, People's Republic of China
| | - R James Stubbs
- Appetite Control & Energy Balance Research Group, School of Psychology, Faculty of Medicine and Health, University of Leeds, Leeds, United Kingdom
| | - Graham Finlayson
- Appetite Control & Energy Balance Research Group, School of Psychology, Faculty of Medicine and Health, University of Leeds, Leeds, United Kingdom.
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Gebremichael B, Misgana T, Tamiru D, Tariku M, Tesfaye D, Alemu D, Weldesenbet AB, Dheresa M. Undernutrition and associated factors among rural pregnant women in Eastern Ethiopia. SAGE Open Med 2022; 10:20503121221104430. [PMID: 35722439 PMCID: PMC9201300 DOI: 10.1177/20503121221104430] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2021] [Accepted: 05/09/2022] [Indexed: 11/16/2022] Open
Abstract
Objectives: Maternal undernutrition is a burning issue in Ethiopia. However, updated
evidence is limited in the eastern part of the country; particularly the
mental health-related factors of undernutrition. The study, hence, aimed at
assessing the prevalence and predictors of undernutrition among rural
pregnant women in eastern Ethiopia. Methods: A cross-sectional research was carried out at a community level among 1015
randomly selected pregnant women. A structured questionnaire was used to
collect the data through face-to-face interviews. The characteristics of
participants were described and summarized by frequencies, percentages, and
summary measures. Logistic regression was performed to find out factors
related to undernutrition. Results: The prevalence of undernutrition was 43.8% (95% confidence interval: 40.8,
47.0). Early marriage (adjusted odds ratio = 2.63, confidence interval:
2.00, 3.47), no antenatal care follow-up (adjusted odds ratio = 1.73, 95%
confidence interval: 1.31, 2.29), inadequately diversified diet (adjusted
odds ratio = 2.48, 95% confidence interval: 1.77, 3.48), current substance
use (adjusted odds ratio = 1.50, 95% confidence interval: 1.02, 2.19),
history of mental illness (adjusted odds ratio = 2.44, 95% confidence
interval: 1.02, 5.82), and common mental disorders (adjusted odds
ratio = 1.81, 95% confidence interval: 1.34, 2.43) were the significant
predictors of undernutrition among pregnant women. Conclusions: Undernutrition was a significant public health issue among rural pregnant
women. Age at first marriage, antenatal care follow-up, dietary diversity,
current substance use, history of mental illness, and common mental disorder
were the independent predictors of undernutrition. Therefore, the health
offices of Kersa and Haramaya districts should invest their efforts to
prevent undernutrition among pregnant women through nutrition counselling
and education, and mental health and psychosocial support.
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Affiliation(s)
- Berhe Gebremichael
- School of Public Health, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Tadesse Misgana
- Department of Psychiatry, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Dawit Tamiru
- Department of Midwifery, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Mandaras Tariku
- Department of Psychiatry, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Dejene Tesfaye
- Department of Psychiatry, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Daniel Alemu
- Department of Psychiatry, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Adisu Birhanu Weldesenbet
- School of Public Health, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Merga Dheresa
- School of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
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11
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Liu H, Zhang Y, Zhang S, Xu Z. Effects of acute aerobic exercise on food-reward mechanisms in smoking-addicted individuals: An fNIRS study. Physiol Behav 2022; 254:113889. [PMID: 35738424 DOI: 10.1016/j.physbeh.2022.113889] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2022] [Revised: 06/16/2022] [Accepted: 06/17/2022] [Indexed: 12/21/2022]
Abstract
PURPOSE In addition to its toxic effects on the human cardiovascular and respiratory systems, tobacco dependence also causes damage to brain function and cognitive activity. Therefore, the main objective of this study was to investigate the effects of acute aerobic exercise on food-reward function and its food-cued prefrontal brain activation in tobacco-dependent individuals. METHOD Ninety-three participants who met the study criteria were randomly divided into a moderate-intensity exercise group (65%-75% HRmax), a high-intensity exercise group (75%-85% HRmax), and a quiet control group (n = 31 in each group). Participants were asked to perform a 35-minute target-intensity exercise or rest. The participants took the Leeds Food Preference Questionnaire and the Visual Food Cues Paradigm Task immediately before the experiment and immediately after completing the exercise or control intervention, and oxyhemoglobin concentrations in each prefrontal brain region were measured at the same time as the Visual Food Cues Paradigm Task. RESULTS Acute aerobic exercise significantly increased implicit cravings for low-calorie sweets in nicotine-dependent individuals (high: p = 0.040; moderate: p = 0.001), while acute moderate-intensity aerobic exercise also significantly increased the activation levels of the left dorsolateral prefrontal cortex (DLPFC: CH15: p = 0.030; CH22: p = 0.003) as well as the left orbitofrontal area (OFC: CH21: p = 0.007) in the food-reward brain region in nicotine-dependent individuals. CONCLUSION Acute aerobic exercise improves food-reward function and effectively increases activation levels in the DLPFC and OFC cerebral cortex in tobacco-dependent individuals, facilitating restoration of sensitivity to their drug-hijacked natural reward circuits.
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Affiliation(s)
- Hongen Liu
- Shandong Sport University, Century Avenue, Licheng District, Jinan City, Shandong Province, 10600, China
| | - Yingying Zhang
- Shandong Sport University, Century Avenue, Licheng District, Jinan City, Shandong Province, 10600, China
| | - Si Zhang
- Shandong Sport University, Century Avenue, Licheng District, Jinan City, Shandong Province, 10600, China
| | - Zhao Xu
- Shandong Sport University, Century Avenue, Licheng District, Jinan City, Shandong Province, 10600, China.
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12
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Quraishi R, Kathiresan P, Verma K, Rao R, Jain R. Effect of chronic opioid use on the hematological and inflammatory markers: A retrospective study from North India. Indian J Psychiatry 2022; 64:252-256. [PMID: 35859548 PMCID: PMC9290418 DOI: 10.4103/indianjpsychiatry.indianjpsychiatry_751_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/08/2021] [Revised: 01/25/2022] [Accepted: 03/01/2022] [Indexed: 11/05/2022] Open
Abstract
BACKGROUND Chronic opioid use affects biological functioning implicating the hematopoietic and immune system. It may alter various hematological parameters and inflammatory markers. This study aimed to assess the association of opioid dependence with the hematological parameters and inflammatory markers in the Indian population. METHODS A retrospective chart review was done among opioid dependent (ODS) males and healthy controls (HC) who visited the center's laboratory between Jan 2017 and Dec 2018 for hematological investigations. Clinical records reviewed for opioid use details like type, duration, and route of administration. The hematological profile presented as Mean or median. Mann-Whitney U test was used to compare the hematological parameters between the cases and controls. RESULTS The study included 191 ODS patients and 123 controls. Among ODS patients, a significant decrease in the levels of hemoglobin, mean corpuscular volume, and mean corpuscular hemoglobin and an increase in RBC count and lymphocytes was observed when compared to controls. The inflammatory markers, Neutrophil-Lymphocyte Ratio (NLR) and Platelet-Lymphocyte Ratio, were significantly lower among ODS. Longer duration of opioid use leads to increased NLR among ODS patients. Opioid use by injection did not alter any of the hematological parameters compared to non-injection drug use. CONCLUSION Chronic opioid use has a significant effect on the hematopoietic cells. Opioid use for longer durations increases the inflammatory markers suggesting underlying infections.
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Affiliation(s)
- Rizwana Quraishi
- National Drug Dependence Treatment Centre, AIIMS, New Delhi, India
| | | | - Kamini Verma
- National Drug Dependence Treatment Centre, AIIMS, New Delhi, India
| | - Ravindra Rao
- National Drug Dependence Treatment Centre, AIIMS, New Delhi, India
| | - Raka Jain
- National Drug Dependence Treatment Centre, AIIMS, New Delhi, India
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13
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Levis SC, Mahler SV, Baram TZ. The Developmental Origins of Opioid Use Disorder and Its Comorbidities. Front Hum Neurosci 2021; 15:601905. [PMID: 33643011 PMCID: PMC7904686 DOI: 10.3389/fnhum.2021.601905] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2020] [Accepted: 01/20/2021] [Indexed: 12/12/2022] Open
Abstract
Opioid use disorder (OUD) rarely presents as a unitary psychiatric condition, and the comorbid symptoms likely depend upon the diverse risk factors and mechanisms by which OUD can arise. These factors are heterogeneous and include genetic predisposition, exposure to prescription opioids, and environmental risks. Crucially, one key environmental risk factor for OUD is early life adversity (ELA). OUD and other substance use disorders are widely considered to derive in part from abnormal reward circuit function, which is likely also implicated in comorbid mental illnesses such as depression, bipolar disorder, and schizophrenia. ELA may disrupt reward circuit development and function in a manner predisposing to these disorders. Here, we describe new findings addressing the effects of ELA on reward circuitry that lead to OUD and comorbid disorders, potentially via shared neural mechanisms. We discuss some of these OUD-related problems in both humans and animals. We also highlight the increasingly apparent, crucial contribution of biological sex in mediating the range of ELA-induced disruptions of reward circuitry which may confer risk for the development of OUD and comorbid neuropsychiatric disorders.
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Affiliation(s)
- Sophia C. Levis
- Department of Anatomy and Neurobiology, University of California, Irvine, Irvine, CA, United States
- Department of Neurobiology and Behavior, University of California, Irvine, Irvine, CA, United States
| | - Stephen V. Mahler
- Department of Neurobiology and Behavior, University of California, Irvine, Irvine, CA, United States
| | - Tallie Z. Baram
- Department of Anatomy and Neurobiology, University of California, Irvine, Irvine, CA, United States
- Department of Pediatrics, University of California, Irvine, Irvine, CA, United States
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14
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Mahboub N, Rizk R, Karavetian M, de Vries N. Nutritional status and eating habits of people who use drugs and/or are undergoing treatment for recovery: a narrative review. Nutr Rev 2020; 79:627-635. [PMID: 32974658 PMCID: PMC8114851 DOI: 10.1093/nutrit/nuaa095] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
A comprehensive overview is presented of the nutritional issues faced by people who use drugs or are undergoing treatment for recovery. Chronic substance use affects a person’s nutritional status and body composition through decreased intake, nutrient absorption, and dysregulation of hormones that alter the mechanisms of satiety and food intake. Anthropometrics alone is not the best indicator of nutritional status, because this population has hidden deficiencies and disturbed metabolic parameters. Socioeconomic factors (eg, higher education, higher income, presence of a partner, living at home) positively affect nutritional status. Scarce available data on users undergoing treatment indicate improvement in anthropometric and metabolic parameters but with micronutrient intake remaining suboptimal. Weight gain is noted especially among women who use drugs and potentially increases their risk of relapse. Finally, specific amino acids and omega-3 fatty acids are promising in decreasing relapse and improving mental health during treatment; however, additional high-quality studies are needed. Nutrition intervention for people who use drugs or are undergoing treatment for recovery is underused; comprehensive programs addressing this population’s unique needs are necessary. Future research will identify which components are needed.
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Affiliation(s)
- Nadine Mahboub
- Department of Nutrition and Food Sciences, Lebanese International University, Beirut, Lebanon, and Department of Health Promotion, Maastricht University, Maastricht, The Netherlands
| | - Rana Rizk
- Institut National de Santé Publique, d'Epidémiologie Clinique et de Toxicologie, The Lebanese University, Beirut, Lebanon, and Department of Health Services Research, Maastricht University, Maastricht, The Netherlands
| | - Mirey Karavetian
- College of Natural and Health Sciences, Zayed University, Dubai, United Arab Emirates
| | - Nanne de Vries
- Department of Health Promotion, Maastricht University, Maastricht, The Netherlands
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15
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Elman I, Howard M, Borodovsky JT, Mysels D, Rott D, Borsook D, Albanese M. Metabolic and Addiction Indices in Patients on Opioid Agonist Medication-Assisted Treatment: A Comparison of Buprenorphine and Methadone. Sci Rep 2020; 10:5617. [PMID: 32221389 PMCID: PMC7101411 DOI: 10.1038/s41598-020-62556-0] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2020] [Accepted: 03/03/2020] [Indexed: 12/18/2022] Open
Abstract
Metabolic hormones stabilize brain reward and motivational circuits, whereas excessive opioid consumption counteracts this effect and may impair metabolic function. Here we addressed the role of metabolic processes in the course of the agonist medication-assisted treatment for opioid use disorder (OUD) with buprenorphine or methadone. Plasma lipids, hemoglobin A1C, body composition, the oral glucose tolerance test (oGTT) and the Sweet Taste Test (STT) were measured in buprenorphine- (n = 26) or methadone (n = 32)- treated subjects with OUD. On the whole, the subjects in both groups were overweight or obese and insulin resistant; they displayed similar oGTT and STT performance. As compared to methadone-treated subjects, those on buprenorphine had significantly lower rates of metabolic syndrome (MetS) along with better values of the high-density lipoproteins (HDL). Subjects with- vs. without MetS tended to have greater addiction severity. Correlative analyses revealed that more buprenorphine exposure duration was associated with better HDL and opioid craving values. In contrast, more methadone exposure duration was associated with worse triglycerides-, HDL-, blood pressure-, fasting glucose- and hemoglobin A1C values. Buprenorphine appears to produce beneficial HDL- and craving effects and, contrary to methadone, its role in the metabolic derangements is not obvious. Our data call for further research aimed at understanding the distinctive features of buprenorphine metabolic effects vis-à-vis those of methadone and their potential role in these drugs' unique therapeutic profiles.
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Affiliation(s)
- Igor Elman
- Center for Pain and the Brain, Department of Anesthesia, Critical Care and Pain Medicine, Boston Children's Hospital, Boston, MA, USA.
| | - Margaret Howard
- Rhode Island Department of Behavioral Healthcare, Cranston, RI, USA
| | - Jacob T Borodovsky
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO, USA
| | - David Mysels
- Department of Psychiatry, Alpert Medical School of Brown University, Providence, RI, USA
| | - David Rott
- Department of Cardiology, Sheba Medical Center, Sackler School of Medicine, Tel Aviv, Israel
| | - David Borsook
- Center for Pain and the Brain, Department of Anesthesia, Critical Care and Pain Medicine, Boston Children's Hospital, Massachusetts General Hospital and McLean Hospital, Harvard Medical School, Boston, MA, USA
| | - Mark Albanese
- Cambridge Health Alliance, Harvard Medical School, Cambridge, MA, USA
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16
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Yazdanian M, Armoon B, Noroozi A, Mohammadi R, Bayat AH, Ahounbar E, Higgs P, Nasab HS, Bayani A, Hemmat M. Dental caries and periodontal disease among people who use drugs: a systematic review and meta-analysis. BMC Oral Health 2020; 20:44. [PMID: 32041585 PMCID: PMC7011515 DOI: 10.1186/s12903-020-1010-3] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2019] [Accepted: 01/15/2020] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND The aim of our study was to perform a systematic review of the literature and meta-analysis in order to investigate relationship between drug use and oral health. METHODS We searched for studies in English published before July 1, 2019 on PsycINFO, PubMed, SciELO, Scopus, and Web of Science. We assessed the relationship between drug use (methamphetamines, heroin; opiates; crack, cocaine and cannabis as dependent variables) and reported tooth loss, periodontal disease, or decayed, missing, and filled teeth index as an independent variable. The data were analyzed using Stata 12.0 software. RESULTS We initially identified 1836 potential articles (with 1100 duplicates) and screened the remaining 736 titles and abstracts, comprising 54 studies. In the next step, we evaluated the full-texts; 44 studies were excluded, accordingly. In total, we included 10 publications in the meta-analysis. Drug type was associated with periodontal disease (OR 1.44; 95% CI 0.8-2.6) and pooled estimates showed that type of drug used increased the odds of the number of decayed, missed and filled teeth (DMFT) (OR 4.11; 95% CI 2.07-8.15) respectively. CONCLUSIONS The analytical challenges of segregating the impact of individual drug types on oral health diseases mean that investigations on the direct relationship between oral health status and drug use are limited. Developing programs to improve potential confounding with various substances and addressing the dental health needs of people who use drugs is vital if we are to improve their overall quality of life.
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Affiliation(s)
- Mohsen Yazdanian
- Research Center for Prevention of Oral and Dental Diseases, Baqiyatallah University of Medical Sciences, Tehran, IR Iran
| | - Bahram Armoon
- Research Center for Prevention of Oral and Dental Diseases, Baqiyatallah University of Medical Sciences, Tehran, IR Iran
| | - Alireza Noroozi
- Iranian National Center for Addiction Studies, Tehran University of Medical Sciences, Tehran, Iran
| | - Rasool Mohammadi
- Department of Public Health,, Loresatn University of Medical Sciences, Khoram Abad, Iran
| | - Amir-Hosein Bayat
- Social Determinants of Health Research Center, Saveh University of Medical Sciences, Saveh, Iran
| | - Elahe Ahounbar
- Social Determinants of Health Research Center, Saveh University of Medical Sciences, Saveh, Iran
| | - Peter Higgs
- Department of Public Health, School of Psychology and Public Health, La Trobe University, Melbourne, Australia
| | - Hormoz Sanaei Nasab
- Health Research Center, Life Style Institute, Baqiyatallah University of Medical Sciences, Tehran, Iran
| | - Azadeh Bayani
- Student Research Committee, School of Allied Medical Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Morteza Hemmat
- Social Determinants of Health Research Center, Saveh University of Medical Sciences, Saveh, Iran
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17
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Effects of moderate- and high-intensity acute aerobic exercise on food reward and appetite in individuals with methamphetamine dependence. Physiol Behav 2019; 211:112649. [DOI: 10.1016/j.physbeh.2019.112649] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2019] [Revised: 06/19/2019] [Accepted: 08/12/2019] [Indexed: 12/21/2022]
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18
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The influence of opioid dependence on salt consumption and related psychological parameters in mice and humans. Drug Alcohol Depend 2019; 203:19-26. [PMID: 31400713 DOI: 10.1016/j.drugalcdep.2019.05.021] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/14/2018] [Revised: 05/22/2019] [Accepted: 05/22/2019] [Indexed: 01/15/2023]
Abstract
BACKGROUND The consumption of dietary salt (NaCl) is controlled by neuronal pathways that are modulated by endogenous opioid signalling. The latter is disrupted by chronic use of exogenous opioid receptor agonists, such as morphine. Therefore, opioid dependence may influence salt consumption, which we investigated in two complimentary studies in humans and mice. METHODS Human study: three groups were recruited: i. Individuals who are currently opioid dependent and receiving opioid substitution treatment (OST); ii. Previously opioid dependent individuals, who are currently abstinent, and; iii. Healthy controls with no history of opioid dependence. Participants tasted solutions containing different salt concentrations and indicated levels of salt 'desire', salt 'liking', and perceptions of 'saltiness'. Mouse study: preference for 0.1 M versus 0.2 M NaCl and overall levels of salt consumption were recorded during and after chronic escalating morphine treatment. RESULTS Human study: Abstinent participants' 'desire' for and 'liking' of salt was shifted towards more highly concentrated salt solutions relative to control and OST individuals. Mouse study: Mice increased their total salt consumption during morphine treatment relative to vehicle controls, which persisted for 3 days after cessation of treatment. Preference for 'low' versus 'high' concentrations of salt were unchanged. CONCLUSION These findings suggest a possible common mechanistic cross-sensitization to salt that is present in both mice and humans and builds our understanding of how opioid dependence can influence dietary salt consumption. This research may help inform better strategies to improve the diet and overall wellbeing of the growing number of individuals who develop opioid dependence.
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Wiss DA. A Biopsychosocial Overview of the Opioid Crisis: Considering Nutrition and Gastrointestinal Health. Front Public Health 2019; 7:193. [PMID: 31338359 PMCID: PMC6629782 DOI: 10.3389/fpubh.2019.00193] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2019] [Accepted: 06/26/2019] [Indexed: 12/11/2022] Open
Abstract
The opioid crisis has reached epidemic proportions in the United States with rising overdose death rates. Identifying the underlying factors that contribute to addiction vulnerability may lead to more effective prevention strategies. Supply side environmental factors are a major contributing component. Psychosocial factors such as stress, trauma, and adverse childhood experiences have been linked to emotional pain leading to self-medication. Genetic and epigenetic factors associated with brain reward pathways and impulsivity are known predictors of addiction vulnerability. This review attempts to present a biopsychosocial approach that connects various social and biological theories related to the addiction crisis. The emerging role of nutrition therapy with an emphasis on gastrointestinal health in the treatment of opioid use disorder is presented. The biopsychosocial model integrates concepts from several disciplines, emphasizing multicausality rather than a reductionist approach. Potential solutions at multiple levels are presented, considering individual as well as population health. This single cohesive framework is based on the interdependency of the entire system, identifying risk and protective factors that may influence substance-seeking behavior. Nutrition should be included as one facet of a multidisciplinary approach toward improved recovery outcomes. Cross-disciplinary collaborative efforts, new ideas, and fiscal resources will be critical to address the epidemic.
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Affiliation(s)
- David A. Wiss
- Fielding School of Public Health, University of California, Los Angeles, Los Angeles, CA, United States
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20
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Gholamhossenian A, Shahouzehi B, Shokoohi M, Najafipour H. B12 and Folate Concentrations in Opium Addicts Compared to Healthy Subjects: A Case Control Study from Kerman Coronary Artery Disease Risk Study. ADDICTION & HEALTH 2019; 10:198-204. [PMID: 31105918 PMCID: PMC6511400 DOI: 10.22122/ahj.v10i3.547] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Background Opium addiction is a global problem which has implicated many societies. Opium addiction and drug abuse is related to harmful consequences which affect life style, biochemical factors, and vitamins values, and also is considered as a risk for heart diseases. Folate and B12 levels are related to homocysteine and studies about their levels in opium addicts are controversial; therefore, we designed this study to evaluate B12 and folate values in opium addicts. Methods From the Kerman Coronary Artery Disease Risk Study (KERCADRS) which is a population-based study, we randomly selected 340 men and entered them into two groups: case (n = 170) and control group (n = 170). Then vitamin B12 and folate levels were measured. Findings Opium addiction did not change B12 and folate levels significantly in opium addicts compared to non-addict control subjects. However, only some variables including blood pressure (BP) and diabetes positively and cigarette smoking, triglyceride (TG), alcohol, and cardiovascular disease (CVD) history negatively affected folate, and none of clinical and demographic variables influenced the B12 levels (P > 0.050). TG had significant effects on B12 and folate levels although opium addiction did not show any impact. Conclusion High TG levels were accompanied by low levels of B12 and folate. Reduced B12 and folate values are accompanied by serum homocysteine elevation. As TG elevates in opium addicts, it can be considered as an important factor which affects vitamins levels and reduces their absorption. Opium addiction elevates homocysteine level, since we can conclude that homocysteine elevation in opium addicts is independent of B12 and folate levels.
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Affiliation(s)
- Ahmad Gholamhossenian
- Professor, Physiology Research Center, Institute of Basic and Clinical Physiology Sciences AND Department of Clinical Biochemistry, School of Medicine, Kerman University of Medical Sciences, Kerman, Iran
| | - Beydolah Shahouzehi
- Assistant Professor, Cardiology Research Center, Institute of Basic and Clinical Physiology Sciences AND Department of Clinical Biochemistry, School of Medicine, Kerman University of Medical Sciences, Kerman, Iran
| | - Mostafa Shokoohi
- Assistant Professor, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran
| | - Hamid Najafipour
- Professor, Physiology Research Center AND Department of Physiology, School of Medicine, Kerman University of Medical Sciences, Kerman, Iran
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Arora PC, Ragi KGS, Arora A, Gupta A. Oral Health Behavior and Treatment Needs among Drug Addicts and Controls in Amritsar District: A Case-controlled Study. J Neurosci Rural Pract 2019; 10:201-206. [PMID: 31001005 PMCID: PMC6454970 DOI: 10.4103/jnrp.jnrp_309_18] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
Background: Substance and drug abuse is associated with severe psychosocial problems, violence and health complications. Aims: The aim of the study was to evaluate and compare the oral hygiene status and sugar eating patterns among drug addicts with their age, gender and socio-economic status matched controls. Settings and Design: The present study comprised of two groups-Group A comprised of 100 drug addicts and Group B included 100 controls. The study sample were interviewed and subjected to a comprehensive intra-oral examination. Methods and Material: Standardized methods of evaluation were performed using mouth mirror, dental probe, explorer and WHO probe. Statistical Analysis: The data was subjected to statistical analysis using Chi Square test and student t-test. Results and Conclusions: CPITN index revealed bleeding in 56% addicts and calculus in 20% addicts. The mean DMFT of group A was 5.71 as compared to 2.45 in group B. The frequency of sugar consumption was found to be high in addicts as compared to the controls. Significant P values (< 0.001) of DMFT index, periodontal status and frequency of sugar consumption were obtained on statistical analysis. The caries status was found to be poor in addicts, but the periodontal treatment needs were similar for both group A and B. Oral health promotion should be undertaken in drug rehabilitation centers for overall success of withdrawl treatment.
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Affiliation(s)
- Preeti Chawla Arora
- Department of Oral Medicine, Diagnosis and Radiology, SGRD Institute of Dental Science and Research, Amritsar, Punjab, India
| | | | - Aman Arora
- Department of Prosthodontics and Crown and Bridge and Implantology, SGRD Institute of Dental Science and Research, Amritsar, Punjab, India
| | - Ambika Gupta
- Department of Oral Medicine and Radiology, PGIDS, Rohtak, Haryana, India
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22
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Forde H, Solomon-Moore E. A Qualitative Study to Understand the Potential Efficacy of an Information-Based Sugar Reduction Intervention among Low Socioeconomic Individuals in the UK. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16030413. [PMID: 30709042 PMCID: PMC6388364 DOI: 10.3390/ijerph16030413] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/13/2018] [Revised: 01/04/2019] [Accepted: 01/30/2019] [Indexed: 02/08/2023]
Abstract
Sugar consumption in the UK consistently exceeds recommendations, despite the association it has with poor health outcomes. Low socioeconomic groups are most likely to over-consume sugar, which could exacerbate existing health disparities. Various interventions attempt to reduce the amount of sugar consumed, but their effectiveness is still unclear. This study qualitatively explored the sugar consumption behaviours of individuals experiencing food poverty, and examined how an information-based sugar reduction intervention might influence these behaviours. Eight clients and six volunteers from a food bank in Bristol (UK) completed semi-structured, one-to-one interviews that were thematically analysed. Food bank clients appeared to heavily consume sugar, with little understanding of the associated health effects and limited awareness of the intervention. Consumption behaviours were particularly influenced by personal and psychological factors, such as mental health; in addition to social factors, like familial behaviours and food access issues. It emerged that food bank clients’ often-challenging personal circumstances were likely to promote their sugar consumption. Making intervention materials visually appealing and easily comprehendible were found to be important for improving an intervention’s reception. Recommendations were developed to improve the efficacy of similar information-based sugar reduction interventions among socioeconomically deprived groups.
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Affiliation(s)
- Hannah Forde
- UKCRC Centre for Diet and Activity Research (CEDAR), MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, Box 285 Institute of Metabolic Science, Cambridge Biomedical Campus, Cambridge CB2 0QQ, UK.
- Centre for Exercise, Nutrition and Health Sciences, School for Policy Studies, University of Bristol, 8 Priory Road, Bristol BS8 1TZ, UK.
| | - Emma Solomon-Moore
- Department for Health, University of Bath, Claverton Down, Bath BA2 7AY, UK.
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Wiss DA, Schellenberger M, Prelip ML. Registered Dietitian Nutritionists in Substance Use Disorder Treatment Centers. J Acad Nutr Diet 2018; 118:2217-2221. [DOI: 10.1016/j.jand.2017.08.113] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2017] [Indexed: 02/06/2023]
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24
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Hakimian J, Minasyan A, Zhe-Ying L, Loureiro M, Beltrand A, Johnston C, Vorperian A, Romaneschi N, Atallah W, Gomez-Pinilla F, Walwyn W. Specific behavioral and cellular adaptations induced by chronic morphine are reduced by dietary omega-3 polyunsaturated fatty acids. PLoS One 2017; 12:e0175090. [PMID: 28380057 PMCID: PMC5381919 DOI: 10.1371/journal.pone.0175090] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2017] [Accepted: 03/20/2017] [Indexed: 12/12/2022] Open
Abstract
Opiates, one of the oldest known drugs, are the benchmark for treating pain. Regular opioid exposure also induces euphoria making these compounds addictive and often misused, as shown by the current epidemic of opioid abuse and overdose mortalities. In addition to the effect of opioids on their cognate receptors and signaling cascades, these compounds also induce multiple adaptations at cellular and behavioral levels. As omega-3 polyunsaturated fatty acids (n-3 PUFAs) play a ubiquitous role in behavioral and cellular processes, we proposed that supplemental n-3 PUFAs, enriched in docosahexanoic acid (DHA), could offset these adaptations following chronic opioid exposure. We used an 8 week regimen of n-3 PUFA supplementation followed by 8 days of morphine in the presence of this diet. We first assessed the effect of morphine in different behavioral measures and found that morphine increased anxiety and reduced wheel-running behavior. These effects were reduced by dietary n-3 PUFAs without affecting morphine-induced analgesia or hyperlocomotion, known effects of this opiate acting at mu opioid receptors. At the cellular level we found that morphine reduced striatal DHA content and that this was reversed by supplemental n-3 PUFAs. Chronic morphine also increased glutamatergic plasticity and the proportion of Grin2B-NMDARs in striatal projection neurons. This effect was similarly reversed by supplemental n-3 PUFAs. Gene analysis showed that supplemental PUFAs offset the effect of morphine on genes found in neurons of the dopamine receptor 2 (D2)-enriched indirect pathway but not of genes found in dopamine receptor 1(D1)-enriched direct-pathway neurons. Analysis of the D2 striatal connectome by a retrogradely transported pseudorabies virus showed that n-3 PUFA supplementation reversed the effect of chronic morphine on the innervation of D2 neurons by the dorsomedial prefontal and piriform cortices. Together these changes outline specific behavioral and cellular effects of morphine that can be reduced or reversed by dietary n-3 PUFAs.
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Affiliation(s)
- Joshua Hakimian
- Department of Psychiatry and Biobehavioral Sciences, University of California Los Angeles, Los Angeles, California
- Brain Research Institute, University of California Los Angeles, Los Angeles, California
| | - Ani Minasyan
- Department of Psychiatry and Biobehavioral Sciences, University of California Los Angeles, Los Angeles, California
- Brain Research Institute, University of California Los Angeles, Los Angeles, California
| | - Lily Zhe-Ying
- Brain Research Institute, University of California Los Angeles, Los Angeles, California
- UCLA Integrative Biology and Physiology, University of California Los Angeles, Los Angeles, California
| | - Mariana Loureiro
- Department of Psychiatry and Biobehavioral Sciences, University of California Los Angeles, Los Angeles, California
- Brain Research Institute, University of California Los Angeles, Los Angeles, California
| | - Austin Beltrand
- Department of Psychiatry and Biobehavioral Sciences, University of California Los Angeles, Los Angeles, California
- Brain Research Institute, University of California Los Angeles, Los Angeles, California
| | - Camille Johnston
- Department of Psychiatry and Biobehavioral Sciences, University of California Los Angeles, Los Angeles, California
- Brain Research Institute, University of California Los Angeles, Los Angeles, California
| | - Alexander Vorperian
- Department of Psychiatry and Biobehavioral Sciences, University of California Los Angeles, Los Angeles, California
- Brain Research Institute, University of California Los Angeles, Los Angeles, California
| | - Nicole Romaneschi
- Department of Psychiatry and Biobehavioral Sciences, University of California Los Angeles, Los Angeles, California
- Brain Research Institute, University of California Los Angeles, Los Angeles, California
| | - Waleed Atallah
- Department of Psychiatry and Biobehavioral Sciences, University of California Los Angeles, Los Angeles, California
- Brain Research Institute, University of California Los Angeles, Los Angeles, California
| | - Fernando Gomez-Pinilla
- Brain Research Institute, University of California Los Angeles, Los Angeles, California
- UCLA Integrative Biology and Physiology, University of California Los Angeles, Los Angeles, California
| | - Wendy Walwyn
- Department of Psychiatry and Biobehavioral Sciences, University of California Los Angeles, Los Angeles, California
- Brain Research Institute, University of California Los Angeles, Los Angeles, California
- * E-mail:
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25
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Waddington F, Naunton M, Kyle G, Cooper G. Nutritional intake of opioid replacement therapy patients in community pharmacies: A pilot study. Nutr Diet 2015. [DOI: 10.1111/1747-0080.12192] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- Freya Waddington
- Faculty of Health; University of Canberra; Canberra Australian Capital Territory Australia
| | - Mark Naunton
- Faculty of Health; University of Canberra; Canberra Australian Capital Territory Australia
| | - Greg Kyle
- Faculty of Health; University of Canberra; Canberra Australian Capital Territory Australia
| | - Gabrielle Cooper
- Faculty of Health; University of Canberra; Canberra Australian Capital Territory Australia
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Visnegarwala F, Shlay JC, Barry V, Gibert CL, Xiang Y, Wang J, Kotler D, Raghavan S, El-Sadr WM. Effects of HIV Infection on Body Composition Changes Among Men of Different Racial/Ethnic Origins. HIV CLINICAL TRIALS 2015; 8:145-54. [PMID: 17621461 DOI: 10.1310/hct0803-145] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
PURPOSE To compare racial/ethnic differences and effects of HIV on body composition among antiretroviral (ART)-naïve HIV seropositive (HIV+) men to a representative sample of HIV seronegative (HIV-) men. We hypothesized that the effect of HIV infection will be uniform across all racial/ethnic groups. METHOD A cross-sectional analysis was performed comparing HIV- (NHANES 1999-2002) and ART-naïve HIV+ men (CPCRA 061). Regional subcutaneous fat area was estimated by skinfold caliper. Total body fat (TBF), fat-free mass (FFM), and body fat index (BFI) were derived by Durnin-Womersley formula (TBF-DW, FFM-DW, BFI [TBF-DW/height(2)]). Bioelectric impedance analyses (BIA) was used to assess TBF-BIA, FFM-BIA, and body cell mass (BCM). Multivariate regression modeling adjusted for age, smoking, and hepatitis C for each measurement was performed. RESULTS HIV+ men (n = 321) were older and more likely to be smokers than HIV- men (n = 1,996). The HIV- men were heavier in weight (+17.8 kg, p < .001) and had higher BMI (+4.3 kg/m(2), p < .001), BCM (+2.4 kg, p = .02), FFM (+5.9 kg, p < .001), TBF-DW (+5.95 kg, p < .001), BFI (+1.6 kg/m(2), p < .001), and regional fat mass than the HIV+ men. In the multivariate model, there were significant percentage differences between HIV- and HIV+ African American men for all body composition measurements (weight +15.3%; BMI +14.5%; BCM +5.2%; TBF-DW +15%; BFI 13.9%; FFM-DW 7.9%) and all circumference and skinfold measurements; all ps < .05. For Caucasian men, the following differences were significant between HIV- and HIV+: weight +14.4%; BMI +14.0%; BCM +6.0%; TBF-DW +17.7%; BFI 17.1%; FFM-DW 8.7%; and all circumference and skinfold measurements. Similarly, among Latino men the following differences were significant: weight +10.1%; BMI +12.3%; FFM-DW +7.7%; and arm, waist, and thigh circumferences and mid-arm skinfold fat area. The interaction terms for race/ethnicity were not significant across the three racial groups for weight, BMI, BCM, TBF-BIA, and BFI. CONCLUSION Compared to HIV uninfected men, among HIV-infected ART-naïve men there was a significant effect of HIV infection itself on body composition among all racial/ethnic groups.
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Karajibani M, Montazerifar F, Dashipour A, Lashkaripour K, Abery M, Salari S. Effectiveness of Educational Programs on Nutritional Behavior in Addicts Referring to Baharan Hospital, Zahedan (Eastern of IR Iran). INTERNATIONAL JOURNAL OF HIGH RISK BEHAVIORS & ADDICTION 2014; 3:e18932. [PMID: 25032162 PMCID: PMC4080462 DOI: 10.5812/ijhrba.18932] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/06/2014] [Revised: 05/08/2014] [Accepted: 05/11/2014] [Indexed: 11/16/2022]
Abstract
Background: There are many factors which affect nutritional status of addicted such as lack o f knowledge, incorrect attitude toward modification of food pattern, and careless to food intake. Objectives: The aim of this study was to determine the effectiveness of educational program on nutritional behavior in addicts referring to Baharan hospital in Zahedan. Patients and Methods: Thirty-six addict patients were selected randomly. After recording general demographic data of patients, nutritional behaviors were determined. To determine the effectiveness of nutritional educational program, pre and post-tests were performed. Evaluation of nutritional behavior was determined as poor, fair and satisfactory levels. Statically analysis was performed by SPSS software. Results: Most addict patients had a medium level of education. Improvement in knowledge, attitude and practice (KAP) of patients after intervention was observed as follows; decreasing KAP in poor level (2.8% vs. 30.6%), (3% vs. 50%), (25% vs. 80.6%), respectively; also, increasing KAP in fair level (7% vs. 55.6 %), (15% vs. 15%), (19% vs. 7%), respectively and increasing KAP in satisfactory levels (77.8% vs. 13.8%), (50% vs. 8.3%), and (22.2% vs. 0%), respectively (P < 0.0001). There was a significant difference regarding the grade of KAP in patients based on gender, marital status, and education level after education (P < 0.0001). Conclusions: This study showed that nutritional KAP was improved in addicts. After intervention, there was a significant difference in the score of knowledge, attitude, and practice scores in patients in the current study. KAP was improved in patients after intervention including; decreased KAP in poor level and increased KAP in fair and satisfactory levels. This finding indicates that addict patients would like to modify their life style.
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Affiliation(s)
- Mansour Karajibani
- Department of Health Promotion Research Center and Nutrition, School of Medicine, Zahedan University of Medical Sciences, Zahedan, IR Iran
- Corresponding author: Mansour Karajibani, Department of Nutrition, Medical School, Zahedan University of Medical Sciences, Zahedan, IR Iran. Tel: +98-5413425716-20, Fax: +98-5413425728, E-mail:
| | - Farzaneh Montazerifar
- Department of Health Promotion Research Center and Nutrition, Pregnancy Health Research Center, School of Medicine, Zahedan University of Medical Sciences, Zahedan, IR Iran
| | - Alireza Dashipour
- Department of Nutrition and Food Science, School of Medicine, Zahedan University of Medical Sciences, Zahedan, IR Iran
| | - Kobra Lashkaripour
- Department of Psychiatry and Psychology, Baharan Psychiatric Hospital, Zahedan University of Medical Sciences, Zahedan, IR Iran
| | - Maryam Abery
- Department of Nutrition, School of Medicine, Zahedan University of Medical Sciences, Zahedan, IR Iran
| | - Sajedeh Salari
- Department of Nutrition, School of Medicine, Zahedan University of Medical Sciences, Zahedan, IR Iran
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Wight V, Kaushal N, Waldfogel J, Garfinkel I. Understanding the Link between Poverty and Food Insecurity among Children: Does the Definition of Poverty Matter? ACTA ACUST UNITED AC 2014; 20:1-20. [PMID: 25045244 DOI: 10.1080/10796126.2014.891973] [Citation(s) in RCA: 47] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
This paper examines the association between poverty and food insecurity among children, using two different definitions of poverty-the official poverty measure (OPM) and the new supplemental poverty measure (SPM) of the Census Bureau, which is based on a more inclusive definition of family resources and needs. Our analysis is based on data from the 2001-11 Current Population Survey and shows that food insecurity and very low food security among children decline as income-to-needs ratio increases. The point estimates show that the associations are stronger as measured by the new supplemental measure of income-to-needs ratio than when estimated through the official measure. Statistical tests reject the hypothesis that poor households' odds of experiencing low food security are the same whether the SPM or OPM measure is used; but the tests do not reject the hypothesis when very low food security is the outcome.
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Affiliation(s)
- Vanessa Wight
- Columbia University School of Social Work, 1255 Amsterdam Avenue, New York, NY 10027
| | - Neeraj Kaushal
- Columbia University School of Social Work, 1255 Amsterdam Avenue, New York, NY 10027
| | - Jane Waldfogel
- Columbia University School of Social Work, 1255 Amsterdam Avenue, New York, NY 10027
| | - Irv Garfinkel
- Columbia University School of Social Work, 1255 Amsterdam Avenue, New York, NY 10027
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Beynon C, Baron L, Hackett A. Perceptions of food choices of people aged 50 and over in contact with a specialist drug service: a pilot qualitative interview study. JOURNAL OF SUBSTANCE USE 2013. [DOI: 10.3109/14659891.2012.707282] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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A Preliminary Study Examining Nutritional Risk Factors, Body Mass Index, and Treatment Retention in Opioid-Dependent Patients. J Behav Health Serv Res 2013; 42:401-8. [DOI: 10.1007/s11414-013-9371-x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
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31
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Carroll ME, Kohl EA, Johnson KM, LaNasa RM. Increased impulsive choice for saccharin during PCP withdrawal in female monkeys: influence of menstrual cycle phase. Psychopharmacology (Berl) 2013; 227:413-24. [PMID: 23344553 PMCID: PMC3656971 DOI: 10.1007/s00213-012-2963-y] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/27/2012] [Accepted: 12/27/2012] [Indexed: 02/07/2023]
Abstract
BACKGROUND In previous studies with male and female rhesus monkeys, withdrawal of access to oral phencyclidine (PCP) self-administration reduced responding for food under a high fixed-ratio (FR) schedule more in males than females, and with a delay discounting (DD) task with saccharin (SACC) as the reinforcer impulsive choice for SACC increased during PCP withdrawal more in males than females. OBJECTIVES The goal of the present study was to examine the effect of PCP (0.25 or 0.5 mg/ml) withdrawal on impulsive choice for SACC in females during the follicular and luteal phases of the menstrual cycle. MATERIALS AND METHODS In component 1, PCP and water were available from two drinking spouts for 1.5 h sessions under concurrent FR 16 schedules. In component 2, a SACC solution was available for 45 min under a DD schedule. Monkeys had a choice of one immediate SACC delivery (0.6 ml) or six delayed SACC deliveries, and the delay was increased by 1 s after a response on the delayed lever and decreased by 1 s after a response on the immediate lever. There was then a 10-day water substitution phase, or PCP withdrawal, that occurred during the mid-follicular phase (days 7-11) or the late luteal phase (days 24-28) of the menstrual cycle. Access to PCP and concurrent water was then restored, and the PCP withdrawal procedure was repeated over several follicular and luteal menstrual phases. RESULTS PCP deliveries were higher during the luteal (vs follicular) phase. Impulsive choice was greater during the luteal (vs follicular) phase during withdrawal of the higher PCP concentration. CONCLUSIONS PCP withdrawal was associated with elevated impulsive choice for SACC, especially in the luteal (vs follicular) phase of the menstrual cycle in female monkeys.
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Affiliation(s)
- Marilyn E Carroll
- Department of Psychiatry, University of Minnesota, MMC 392, Minneapolis, MN 55455, USA.
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Rouibi K, Contarino A. The corticotropin-releasing factor receptor-2 mediates the motivational effect of opiate withdrawal. Neuropharmacology 2013; 73:41-7. [PMID: 23707482 DOI: 10.1016/j.neuropharm.2013.05.011] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2013] [Revised: 04/22/2013] [Accepted: 05/09/2013] [Indexed: 12/25/2022]
Abstract
Altered motivational processes are key features of drug dependence and withdrawal, yet their neural mechanisms remain largely unknown. The present study shows that genetic disruption of the corticotropin-releasing factor receptor-2 (CRF₂-/-) does not impair motivation for palatable food in drug-naïve mice. However, CRF₂ receptor-deficiency effectively reduces the increase in palatable food-driven motivation induced by opiate withdrawal. Indeed, both in male and female wild-type mice, withdrawal from escalating morphine doses (20-100 mg/kg) induces a dramatic and relatively long-lasting (6 days) increase in palatable food-driven operant behavior under a progressive ratio (PR) schedule of reinforcement. In contrast, either male or female morphine-withdrawn CRF₂-/- mice show smaller and shorter (2 days) increases in motivation than wild-type mice. Nevertheless, CRF₂ receptor-deficiency does not impair the ability to discriminate reinforced behavior prior to, during the partial opiate withdrawal periods occurring between morphine injections and following drug discontinuation, indicating preserved cognitive function. Moreover, CRF₂ receptor-deficiency does not affect the ambulatory or body weight effects of intermittent morphine injections and withdrawal. These results provide initial evidence of a gender-independent and specific role for the CRF₂ receptor in the motivational effects of opiate withdrawal.
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Affiliation(s)
- Khalil Rouibi
- Univ. Bordeaux, INCIA, UMR 5287, F-33000 Bordeaux, France
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Smith DG, Robbins TW. The neurobiological underpinnings of obesity and binge eating: a rationale for adopting the food addiction model. Biol Psychiatry 2013; 73:804-10. [PMID: 23098895 DOI: 10.1016/j.biopsych.2012.08.026] [Citation(s) in RCA: 286] [Impact Index Per Article: 26.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/01/2012] [Revised: 08/31/2012] [Accepted: 08/31/2012] [Indexed: 01/17/2023]
Abstract
The food addiction model of overeating has been proposed to help explain the widespread advancement of obesity over the last 30 years. Parallels in neural substrates and neurochemistry, as well as corresponding motivational and behavioral traits, are increasingly coming to light; however, there are still key differences between the two disorders that must be acknowledged. We critically examine these common and divergent characteristics using the theoretical framework of prominent drug addiction models, investigating the neurobiological underpinnings of both behaviors in an attempt to justify whether classification of obesity and binge eating as an addictive disorder is merited.
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Affiliation(s)
- Dana G Smith
- Behavioural and Clinical Neuroscience Institute and Department of Psychology, University of Cambridge, Cambridge, United Kingdom.
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Green A, Kaul A, O'Shea J, Sharma E, Bennett L, Mullings EL, Munafò MR, Nutt DJ, Melichar JK, Donaldson LF. Opiate agonists and antagonists modulate taste perception in opiate-maintained and recently detoxified subjects. J Psychopharmacol 2013; 27:265-75. [PMID: 23364815 DOI: 10.1177/0269881112472567] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Heroin addicts consume large quantities of refined sugars. This study investigated the effect of opiate use and antagonism on sweet taste in opiate-maintained drug users and detoxified former chronic opiate users, using a within-subject design. Seven opiate users received methadone and seven buprenorphine maintenance. Six detoxified subjects received naltrexone. Sucrose recognition thresholds and measurements of pleasantness and intensity were determined before and four hours after 1) a single dose of methadone or buprenorphine or 2) naltrexone. Control data were taken from a cohort of healthy volunteers including smokers. All measures of sweet and salt taste perception were significantly greater in opiate users and recently detoxified subjects compared to control subjects, with the exception of sweet pleasantness, which returned to control level after detoxification. Acute methadone administration reduced salt thresholds and unpleasantness to control levels. Increased sweet thresholds and salt unpleasantness in detoxified subjects were reversed by acute opioid antagonism, returning to control levels. These results suggest that opiate use and antagonism alters taste perception. Some of the alterations reverse on detoxification (sweet pleasantness), and others can be reversed by opioid antagonism (sweet threshold, salt unpleasantness). Changes in taste perception may underlie altered consumption of refined sugars in opiate users.
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Affiliation(s)
- Amy Green
- Psychopharmacology Unit, University of Bristol, Bristol, UK
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The effect of nucleus accumbens lesions on appetite, sexual function, and nicotine dependence in recovering heroin addicts. Transl Neurosci 2013. [DOI: 10.2478/s13380-013-0146-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
AbstractThe nucleus accumbens (NAc) is a key part of the neural circuitry that creates reward, pleasure and motivation that facilitates human feeding, sexual and smoking behaviors. In the brain reward system, the NAc is a crucial component responsible for natural and drug-induced reinforcement behaviors. Yet it is unclear whether NAc is indispensible for all reward behaviors in human beings. The present study aimed to investigate the long-term effects of NAc ablation on sexual function, appetite, and nicotine dependence level in chronic heroin users. Eighteen former heroin-dependent patients (male) with bilateral NAc ablation via stereotactic radiofrequency surgery for alleviating drug psychological dependence were recruited. Their postoperative time ranged from 12 to 103 months. All subjects received MRI scans for assessing the accuracy of the lesion site. Evaluation of appetite, sexual function, and nicotine dependence were measured using the Simplified Nutrition Appetite Questionnaire, the Brief Sexual Function Inventory, and the Fagerström Test for Nicotine Dependence, respectively. After precluding the potential confounding variables, such as drug use (dosage and duration), post-operation duration, age, body-weight, marital status and education level, ANOVA with repeated measures revealed that the NAc ablation improved the patients’ appetite, sexual drive and sexual satisfaction. Yet there was no change in male erectile function, ejaculatory function, or nicotine dependence levels compared to the preoperative. These may suggest that although NAc is a key part of the neural circuitry, the NAc surgical lesions left the fundamental aspects of natural and drug-induced reinforcement and motivation almost intact.
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Stice E, Figlewicz DP, Gosnell BA, Levine AS, Pratt WE. The contribution of brain reward circuits to the obesity epidemic. Neurosci Biobehav Rev 2012; 37:2047-58. [PMID: 23237885 DOI: 10.1016/j.neubiorev.2012.12.001] [Citation(s) in RCA: 176] [Impact Index Per Article: 14.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2012] [Revised: 11/21/2012] [Accepted: 12/03/2012] [Indexed: 12/22/2022]
Abstract
One of the defining characteristics of the research of Ann E. Kelley was her recognition that the neuroscience underlying basic learning and motivation processes also shed significant light upon mechanisms underlying drug addiction and maladaptive eating patterns. In this review, we examine the parallels that exist in the neural pathways that process both food and drug reward, as determined by recent studies in animal models and human neuroimaging experiments. We discuss contemporary research that suggests that hyperphagia leading to obesity is associated with substantial neurochemical changes in the brain. These findings verify the relevance of reward pathways for promoting consumption of palatable, calorically dense foods, and lead to the important question of whether changes in reward circuitry in response to intake of such foods serve a causal role in the development and maintenance of some cases of obesity. Finally, we discuss the potential value for future studies at the intersection of the obesity epidemic and the neuroscience of motivation, as well as the potential concerns that arise from viewing excessive food intake as an "addiction". We suggest that it might be more useful to focus on overeating that results in frank obesity, and multiple health, interpersonal, and occupational negative consequences as a form of food "abuse".
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Affiliation(s)
- Eric Stice
- Oregon Research Institute, 1776 Millrace Drive, Eugene, OR 97403, United States.
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Montazerifar F, Karajibani M, Lashkaripour K. Effect of methadone maintenance therapy on anthropometric indices in opioid dependent patients. INTERNATIONAL JOURNAL OF HIGH RISK BEHAVIORS & ADDICTION 2012; 1:100-3. [PMID: 24971244 PMCID: PMC4070119 DOI: 10.5812/ijhrba.4968] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/03/2012] [Revised: 06/30/2012] [Accepted: 07/08/2012] [Indexed: 11/16/2022]
Abstract
Background Opium abuse significantly affects the nutritional status of users and frequently leads to undernourishment. Methadone maintenance therapy has been used as one of the possible ways to prevent of infection diseases such as HIV and hepatitis B and C and improve the quality of life in opioid-dependent patients. Objectives The aim of this study was to assess the anthropometric and socio-demographic characteristics of opium addicted persons before and after 8 weeks of methadone maintenance therapy (MMT). Patients and Methods A clinical cross-sectional study was carried out on 55 opium users (15 women and 40 men; mean aged 31.6 ± 10 years), dependent on opium and its derivatives at the Addiction Treatment Clinic of the Baharan psychiatric Hospital, Zahedan, Sistan and Baluchistan Province, Iran, in 2011. The patients were examined before and after 8 weeks MMT. Weight and height of participants were taken and the body mass index (BMI) was calculated. Results Body weight increased significantly from 61.4 ± 14.4 to 65.3 ± 14.2 kg and BMI from 21.4 ± 4.2 to 23 ± 5.6 (kg/m2) after 8 weeks of methadone maintenance therapy in opium users (P < 0.01). The percentages of underweight, overweight and obese patients were; 27.3%, 18.2% and 3.6%, respectively pre-MMT, and 12.7%, 18.2% and 7.2%, respectively after MMT. Conclusions The study shows that methadone Maintenance Therapy led to improvements in nutritional status.
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Affiliation(s)
- Farzaneh Montazerifar
- Pregnancy Health Research Center, Zahedan University of Medical Sciences, Zahedan, IR Iran
- Health Promotion Research Center Zahedan University of Medical Sciences, Zahedan, IR Iran
- Department of Nutrition, School of Medicine, Zahedan University of Medical Sciences, Zahedan, IR Iran
| | - Mansour Karajibani
- Pregnancy Health Research Center, Zahedan University of Medical Sciences, Zahedan, IR Iran
- Health Promotion Research Center Zahedan University of Medical Sciences, Zahedan, IR Iran
- Department of Nutrition, School of Medicine, Zahedan University of Medical Sciences, Zahedan, IR Iran
| | - Kobra Lashkaripour
- Department of Psychiatry ,Baharan Psychiatric Hospital, Zahedan University of Medical Sciences, Zahedan, IR Iran
- Corresponding author: Kobra Lashkaripour, Department of psychiatry, Baharan Psychiatric Hospital, Zahedan University of Medical Sciences, Zahedan, IR Iran. Tel.: +98-5415422637, Fax: +98-5415422637, E-mail:
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Najafi M, Sheikhvatan M. Plausible impact of dietary habits on reduced blood sugar in diabetic opium addicts with coronary artery disease. Int Cardiovasc Res J 2012; 6:75-8. [PMID: 24757596 PMCID: PMC3987411] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2012] [Revised: 07/18/2012] [Accepted: 08/23/2012] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND The effect of opium on glycemic control in diabetics is a controversial issue, as some studies have shown glucose lowering effect of opium in diabetes while the results of other studies do not support this idea. The possible role of opioid peptides in the regulation of food intake has been previously investigated. However, there is no data available about relationship between opium using and dietary pattern. OBJECTIVES The aim of the present study was to determine the daily intake of different nutrients in opium addict with diabetes diagnosed with coronary artery disease (CAD). METHODS This study comprised 232 consecutive diabetic patients with CAD, and candidates for isolated coronary artery bypass surgery in Tehran Heart Center. Of these, 26 patients were opium addicts. Nutritional assessment was obtained by a validated semi-quantitative food frequency questionnaire (FFQ). RESULTS In opium addicts compared to non-addicts, consumption of carbohydrates (360.0±120.9 versus 447.8±249.8 Gr/day, P=0.016) and vitamin A (1170.4±570.2 versus 1496.3±889.6 μg/d as Retinol Activity Equivalent (RAE), P=0.040) was lower than non-addicts and intake of other nutrients were similar across two group of patients. CONCLUSIONS Opium addiction in diabetic patients may lead to decrease of vitamin A and carbohydrate intake. This study showed that carbohydrate intake in addicted diabetic patients is lower than their non-addict counterpart. Thus, the so called lowering effect of opium on blood sugar may be due to nutritional habit of addicted patients.
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Affiliation(s)
- Mahdi Najafi
- Anesthesiology Department, Tehran Heart Center, Tehran University of Medical Sciences, Tehran, IR Iran,Corresponding author: Mahdi Najafi, Research Department, Tehran Heart Center, Tehran University of Medical Sciences, Tehran, IR Iran, Zip code: 1411713138, Tehran, IR Iran, Tel: +98-21-88029674, Fax: +98-21-88029731 E-mail:
| | - Mehrdad Sheikhvatan
- Research Department, Tehran Heart Center, Tehran University of Medical Sciences, Tehran, IR Iran
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Increased motivation to eat in opiate-withdrawn mice. Psychopharmacology (Berl) 2012; 221:675-84. [PMID: 22207240 DOI: 10.1007/s00213-011-2612-x] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/12/2011] [Accepted: 12/05/2011] [Indexed: 10/14/2022]
Abstract
RATIONALE In drug-dependent individuals, the primary excessive motivation is for drugs. Studies also indicate altered interest for "natural" rewarding activities associated with motivational disorders that may be relevant to drug dependence. However, to date, the impact of drug dependence and withdrawal upon motivation for "natural" rewards remains unclear. METHODS AND OBJECTIVES In the present study, we use a food-driven operant behavior paradigm to assess the impact of opiate intake and withdrawal upon the motivational properties of highly palatable food (HPF) in mice. RESULTS Our findings indicate that early (8-h) opiate withdrawal does not affect either the motivational or the discriminative properties of HPF intake. However, starting 32 h after the last morphine injection, opiate withdrawal increases operant behavior aimed at obtaining HPF. The increased HPF-driven behavior lasts at least 12 days following opiate withdrawal, indicating long-lasting effects upon motivation. Using a paradigm of reward contingency reversal, we also address the impact of opiate withdrawal upon cognitive functions. Our results indicate that opiate withdrawal does not affect the ability to learn a new operant rule to obtain HPF. Indeed, opiate withdrawal ameliorates the acquisition of the new HPF-driven operant task, most probably due to the persistent and long-lasting increased motivation. Finally, analysis of ambulatory activity and body weight (BW) changes reveal that motivational and cognitive effects are totally independent of caloric and/or motor effects of opiate dosing and withdrawal. CONCLUSIONS These results clearly demonstrate that excessive opiate intake and withdrawal produces dramatic and long-lasting motivational disorders relevant to drug dependence.
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Montoro C, Ipharraguerre I, Bach A. Blocking opioid receptors alters short-term feed intake and oro-sensorial preferences in weaned calves. J Dairy Sci 2012; 95:2531-9. [DOI: 10.3168/jds.2011-5053] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2011] [Accepted: 01/11/2012] [Indexed: 01/28/2023]
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Neale J, Nettleton S, Pickering L, Fischer J. Eating patterns among heroin users: a qualitative study with implications for nutritional interventions. Addiction 2012; 107:635-41. [PMID: 21933297 DOI: 10.1111/j.1360-0443.2011.03660.x] [Citation(s) in RCA: 49] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
AIM To provide new insights into heroin users' eating patterns in order to inform nutritional interventions. DESIGN Seventy-seven audio-recorded in-depth interviews which elicited detailed data on eating patterns. SETTING Community and residential drug services, pharmacies and peer support groups in Southern England, UK. PARTICIPANTS Forty current or ex-heroin users (21 men and 19 women), of whom 37 (20 men and 17 women) were re-interviewed after 3 months. MEASUREMENTS Audio data transcribed verbatim, coded systematically and analysed inductively. FINDINGS Heroin users' eating patterns were influenced by individual, social, cultural, economic and environmental factors. During active heroin use, participants consumed quick, convenient, cheap and sweet foods, ate infrequently and had little interest in food. Eating patterns often improved during stays in residential services and after heroin cessation. Ex-heroin users began to take pleasure in food preparation and eating and identified therapeutic benefits to cooking. Initially, weight gain was experienced positively, but subsequently generated anxieties as participants, particularly women, struggled to control their appetite and worried about becoming overweight. Findings complement and add to previous research and sociological and anthropological literatures. CONCLUSIONS Heroin users have dysfunctional eating patterns that are amenable to change and community and residential services could enable them to experience the many health, psychological and social benefits of improved eating practices. Nutritional interventions need to be tailored to individual needs and circumstances, but also monitored and evaluated so that there is a future evidence base.
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Affiliation(s)
- Joanne Neale
- Faculty of Health and Life Sciences, Oxford Brookes University, Oxford, UK.
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Nolan LJ, Stolze MR. Drug use is associated with elevated food consumption in college students. Appetite 2012; 58:898-906. [PMID: 22349780 DOI: 10.1016/j.appet.2012.02.014] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2011] [Revised: 02/09/2012] [Accepted: 02/10/2012] [Indexed: 01/21/2023]
Abstract
Higher food consumption, particularly of sweets, has been reported by substance-dependent persons in various stages of treatment but no investigation of substance use and actual food consumption has been conducted in non-dependent persons. Sixty-two male and female college students completed the Core Alcohol and Drug Survey and the amount of each of six snack foods (including both sweet and savory items) they consumed were measured. Participants also rated appetite before and after eating and rated the pleasantness of and desire to eat each food. Hierarchical multivariate regression revealed that, while controlling for the influence of BMI and intermeal interval, frequency and breadth of substance use significantly predicted elevated food consumption and elevated ratings of hunger and desire to eat. Furthermore, the link between breadth of drug use and food consumption was mediated by higher desire to eat and not by pleasantness of the food. The relationship between substance use and eating behavior may not be restricted only to those in recovery or treatment for persons diagnosed with substance use disorders.
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Affiliation(s)
- Laurence J Nolan
- Department of Psychology, Wagner College, 1 Campus Rd., Staten Island, NY 10301, USA.
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Grinshpoon A, Barchana M, Lipshitz I, Rosca P, Weizman A, Ponizovsky AM. Methadone maintenance and cancer risk: an Israeli case registry study. Drug Alcohol Depend 2011; 119:88-92. [PMID: 21704463 DOI: 10.1016/j.drugalcdep.2011.05.028] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/26/2010] [Revised: 05/23/2011] [Accepted: 05/24/2011] [Indexed: 10/18/2022]
Abstract
OBJECTIVES This study explored cancer incidence rates in a large cohort of Israeli (Jewish and Arab) opioid-dependent individuals receiving methadone maintenance treatment (MMT), and how the incidences vary by ethnicity and sex. METHOD The record linkage between the Israel National Addiction Registry (INAR) and the Israel National Cancer Registry (INCR) was performed. Information about the Israeli general population from the Central Bureau of Statistics was used for comparison to match sex and year of birth to the cohort under study. Age standardized incidence ratios (SIRs) and 95% confidence intervals (CIs) were calculated. RESULTS Though the SIR values for aggregated cancer sites for both men and women on MMT did not differ significantly from the corresponding figures in the general population (0.88, 95% CI 0.76-1.00, and 1.06, 95% CI 0.76-1.36, respectively), the risks were substantially increased for lung (1.97, 95% CI 1.13-2.82), larynx (3.62, 95% CI 1.11-6.13) and liver (6.8, 95% CI 1.76-11.83) cancers among Jewish men and for cervix uteri cancer among Jewish women (2.41, 95% CI 0.99-3.84). By contrast, the SIR values for colorectal cancer among Jewish men (0.46, 95% CI 0.09-0.82) and for breast cancer among Jewish women (0.36, 95% CI 0.00-0.71) were significantly lower than expected. CONCLUSIONS The results suggest that the increased and reduced site-specific cancer risks are counterbalanced, resulting in the absence of the expected excess cancer risk for the entire cohort. The reduced risks for colorectal and breast cancers suggest a protective effect of MMT, warranting further investigation.
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Affiliation(s)
- Alexander Grinshpoon
- Sha'ar Menashe Mental Health Center, Affiliated to Bruce Rappoport Faculty of Medicine, Technion Institute, Haifa, Israel
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Mysels DJ, Sullivan MA. The relationship between opioid and sugar intake: review of evidence and clinical applications. J Opioid Manag 2011; 6:445-52. [PMID: 21269006 DOI: 10.5055/jom.2010.0043] [Citation(s) in RCA: 69] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Opioid dependence poses significant public health risks arising from associated morbidity and mortality caused by accidents, infectious diseases, and social ramifications of crime and unemployment, among other complications. Opioid use, acute and chronic, is also associated with weight gain, glycemic dysregulation, and dental pathology. The literature supporting the connection between opiate use and development of preference for sweet tastes is reviewed, and further association with dental pathology, weight gain, and loss of glycemic control are considered. Additionally, the impact of sweet tastes on the endogenous opioid system, as pertaining to analgesia, is also discussed. The authors discuss the clinical implications in relation to the aforementioned conditions while treating the opiate-dependent patient.
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Affiliation(s)
- David J Mysels
- Department of Psychiatry, Cambridge Health Alliance/Harvard Medical School, Somerville, Massachusetts, USA
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Mackridge AJ, Beynon CM, McVeigh J, Whitfield M, Chandler M. Meeting the health needs of problematic drug users through community pharmacy: A qualitative study. JOURNAL OF SUBSTANCE USE 2010. [DOI: 10.3109/14659890903513459] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Dürsteler-MacFarland KM, Fischer DA, Mueller S, Schmid O, Moldovanyi A, Wiesbeck GA. Symptom complaints of patients prescribed either oral methadone or injectable heroin. J Subst Abuse Treat 2010; 38:328-37. [DOI: 10.1016/j.jsat.2010.01.008] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2009] [Revised: 01/11/2010] [Accepted: 01/15/2010] [Indexed: 11/17/2022]
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Tang AM, Forrester JE, Spiegelman D, Flanigan T, Dobs A, Skinner S, Wanke C. Heavy injection drug use is associated with lower percent body fat in a multi-ethnic cohort of HIV-positive and HIV-negative drug users from three U.S. cities. THE AMERICAN JOURNAL OF DRUG AND ALCOHOL ABUSE 2010; 36:78-86. [PMID: 20141402 DOI: 10.3109/00952990903544851] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND The clinical implications of lower body weight in drug using populations are uncertain given that lower mean weights may still fall within the healthy range. OBJECTIVES To determine the effect of type, mode and frequency of drug use on underlying body composition after accounting for differences in body shape and size. METHODS We conducted a cross-sectional analysis of 511 participants from the Tufts Nutrition Collaborative (TNC) Study. Data included measures of body composition, a 24-hour dietary recall, and a detailed health history and lifestyle questionnaire. Multivariate regression analysis was used to determine the independent effect of drug use on percent body fat (BF) after adjusting for BMI and waist circumference. RESULTS Heavy injection drug users (IDUs) had a 2.6% lower percent BF than non-users after adjusting for BMI, waist circumference, and other confounders. (p = 0.0006). Differences in percent BF were predominantly due to higher lean mass, rather than lower fat mass. Cocaine and heroin had similar effects on body composition. CONCLUSIONS In the U.S., where the general population is prone to over-nutrition, the average percent BF for heavy injectors does not fall into a range low enough to suggest harmful effects. However, in populations with substantial levels of under-nutrition, small differences in percent BF among drug users will have a greater impact on health status. SCIENTIFIC SIGNIFICANCE Differences in BMI, weight and body composition are not always straightforward. Accounting for underlying nutritional status and relative differences in fat and FFM is critical when interpreting results. diagnosed patients and prevent them from returning to prison.
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Affiliation(s)
- Alice M Tang
- Department of Public Health and Community Medicine, Tufts University School of Medicine, Boston, Massachusetts 02111, USA.
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Abstract
OBJECTIVE Given the lack of reliable murine model of binge-like eating, we tried to induce this pathological behavior in mice. METHOD We used an experimental protocol mimicking the etiological factors involved in the development of binge eating in humans, that is, food restriction, refeeding (R-R) in presence of high palatable food, and stress (S). RESULTS Mice subjected to at least three cycles of R-R plus S (forced swimming stress), showed a binge-like behavior evident as early as 4 h, persisting 24 h after stress application and not associated to depressive-like behavior. However, after the third R-R/S cycle, food intakes of mice returned to normal levels. DISCUSSION (i) at least three cycles of R-R plus S are required to promote abnormal eating in mice, (ii) this is not associated to depressive-like behaviors, and (iii) the enhanced pathological behavior showed a transient nature not persisting after the third R-R/S cycle.
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Affiliation(s)
- Daniele Consoli
- Department of Experimental and Clinical Pharmacology, Medical School, University of Catania, Catania, Italy.
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Forrester JE, Tucker KL, Skinner S, Terrin N. Drug use and weight loss in HIV-infected Hispanic men. AIDS Care 2008; 20:868-75. [PMID: 18608065 DOI: 10.1080/09540120701767174] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Weight loss is an independent risk factor for mortality in HIV but the role of drug use in HIV-related weight loss is not well described. We conducted this study to determine the role of drug use in HIV-related weight loss. Men (n=304), all of whom were Hispanic, were recruited into one of three groups: HIV-infected drug users; HIV-non-infected drug users; and HIV-infected non-drug users. Body mass index (BMI) was measured at successive visits. The groups were re-categorized based on self-reported drug use at the current visit into: (1) users of cocaine alone; (2) users of cocaine and opiates; (3) users of opiates alone; (4) former drug users; and (5) those who denied ever using drugs (all HIV-infected). The effect on BMI of the duration of use of the specific drug types was evaluated using repeated-measures analyses. Longer duration of exclusive opiate use or mixed cocaine and opiate use did not affect BMI in the men, regardless of HIV status. Exclusive cocaine use was associated with a decline in BMI among HIV-infected men (-0.070 kg/m(2) per month duration of use; SE=0.033; p=0.037) but not among HIV-uninfected men (0.024 kg/m(2) per month; SE=0.023; p=0.29). Adjustment for marijuana, cigarette and alcohol use in all men, or for CD4 count, viral load or HIV medication use in the HIV-infected men, did not alter the conclusions. We conclude that the use of opiates or combined opiates and cocaine does not increase the risk of weight loss in the presence or absence of HIV infection. Exclusive cocaine use may exacerbate weight loss in HIV-infection.
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Affiliation(s)
- J E Forrester
- Tufts University School of Medicine, Boston, MA, USA.
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Inability to Control Eating: Addiction to Food or Normal Response to Abnormal Environment? ACTA ACUST UNITED AC 2008. [DOI: 10.1300/j023v15n01_07] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
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