No / This article adopts a 'dialogical' relational perspective to explore the recently introduced initiative of coercive treatment for drug misuse in the UK. Conversational interviews were undertaken with 11 people who had been sentenced to the Drug Treatment and Testing Order. Receiving treatment for drug misuse is often storied within a motivational account that is expectant of a 'readiness to change'; such assumptions seem theoretically problematic when change is legally imposed. Therefore, moral and ethical concerns surround the introduction of this initiative, however the interview data illustrates the potential that participation might offer for the creation of 'counterstories' where a more moral self can be enacted. Our analysis suggests that this counterstory is co-constructed thus being an outcome of both self and other. Furthermore such stories appear fragile; constantly under assault from detrimental authoritative discourses that are not only part of wider social understandings around drug misuse but also permeate the policy and practice of coercive treatment.

No / This scholarly examination of the worldwide web of narcotics today provides students, social workers, health providers, law enforcement officers and policy makers with an up-to-date, overall exploration of the world of drugs. Vast resources are pumped into the 'war on drugs'. But in practice, prohibition has failed. Narcotics use continues to rise, while technology and globalisation have made a whole new range of drugs available to a vast consumer market. Where wealth and demand exist, supply continues to follow. Prohibition has failed to stem consumption and production, criminalised social groups, impeded research into alternative medicine and disease, promoted violence and gang warfare, and impacted negatively on the environment. The alternative is a humane policy framework that recognizes the incentives to produce, traffic and consume narcotics.

The striatum represents the main input nucleus of the basal ganglia, a system of subcortical nuclei critically involved into motor control and motivational processes and altered in several conditions such as Parkinson’s diseases or drug addiction. The projection neurons of the striatum are GABAergic (γ-aminobutyric acid) medium-sized spiny neurons (MSNs), and account for the large majority of striatal neurons, while interneurons represent about 10% of striatal cells. The MSNs are subdivided into two subpopulations that form two main efferent pathways: the striatonigral and striatopallidal neurons. The striatonigral MSNs project to the entopeduncular nucleus (EP) and substancia nigra pars reticulata (SNr) (direct pathway) and co-express dopamine D1 receptors (D1R) and substance P neuropeptide (SP). On the other hand, striatopallidal MSNs project to the lateral globus pallidus (LGP) (indirect pathway) and co-express dopamine D2 receptor (D2R), adenosine A2A receptor (A2AR) and enkephalin (Enk). The D1R striatonigral and D2R striatopallidal MSNs are equal in number and shape and are mosaically distributed through all the striatum. The dorsal striatum is mainly involved in motor control and learning while the ventral striatum is crucial for motivational processes. In view of the still debating respective functions of projection D2R-striatopallidal and D1R-striatonigral neurons and striatal interneurons, both in motor control and learning of skills and habits but also in more cognitive processes such as motivation, we were interested in the development of models allowing the removal of selective striatum neuronal populations in adult animal brain. Because of the mosaical organisation of the striatum, a targeting of specific neuronal type, with techniques such as chemical lesions or surgery, is still impossible. Taking advantage of new transgenic approaches, the goal of the present work was to generate and/or to initiate the characterization of genetic models in which a selective subtype of striatal neuron can be ablated in an inducible way. We used a transgenic approach in which mice express a monkey diphtheria toxin (DT) receptor (DTR) in D2R-striatopallidal or D1R-striatonigral neurons. Local stereotactic injections of DT can then induce selective neuronal ablation in functionally different striatal areas.<p>We first investigated functions of D2R-striatopallidal neurons in motor control and drug reinforcement by their selective ablation in the entire striatum or restricted to the ventral striatum. This DTR strategy produced selective D2R striatopallidal MSN ablation with integrity of the other striatal neurons as well as the striatal dopaminergic function. D2R MSN ablation in the entire striatum induced permanent hyperlocomotion while ventral striatum-restricted ablation increased amphetamine place preference.<p>We next compared respective roles of D2R-striatopallidal and D1R-striatonigral neurons in motor control and skill learning in functionally different striatum subregions.<p>Finally, to target nitrergic interneurons of the striatum, we developed a bacterial artificial chromosome genetic strain in which the cre-recombinase expression is under the control of the neuronal nitric oxide gene promoter.<p><p>Altogether, those results show that DTR expression and DT local injections is an efficient and flexible strategy to ablate selective striatum neuronal types with spatial resolution. We provide the first direct experimental evidences that D2R striatopallidal neurons inhibit both locomotor and drug-reinforcement processes and that D2R and D1R MSNs in different striatum subregions have distinct functions in motor control and motor skill learning. Those results strongly support a cell-type and topographic functional organization of the striatum and underscore the need for characterization of the specific cellular and molecular modifications that are induced in D2R and D1R MSNs during drug-reinforcement or procedural learning.<p> / Doctorat en Sciences médicales / info:eu-repo/semantics/nonPublished

Thesis (MTh)--Stellenbosch University, 2012. / ENGLISH ABSTRACT: Drugs are a very real problem in South-Africa. It affects health and is endemic to societal problems. Methamphetamine, popularly called “Tik,” is relatively cheap and easy to come by. Many young people use it and become addicted - with very bad repercussions for their families and society at large. In the Bellville South area most families suffer because of this scourge and are desperately looking for help. Faith communities have no option but to address the problem. The research focuses on the Bellville-South community where numerous families struggle with the scourge, desparately looking for help. As such faith communites are challenged to get involved and address tik-addiction and the related sociao-economic problems. The leadership of the Rhenish Church in Bellville took on the challenge to live up to the needs of families and society and to provide guidance for families. It is realistic to accept that there is no easy quick-fix solution to the problem. A holistic approach is needed. Thus the congregation has to do some real soul-searching and address its being functions, identity and calling in a time like this. How can the church be a safe haven for its members and the suffering community‟s parents and children? The research took an analytical look at the congregation, describing it from different angles. It also made a study of the drug problem, focussing on Tik. From a normative angle it looked at the essence of a missional church and asked how a missional church should address these challenges. It develops a strategy to guide leadership and congregation to support the families affected by the scourge. Eventually a missional ministry should be in place that will reach out in love and care to serve the community. / AFRIKAANSE OPSOMMING: Dwelmmisbruik is ‟n geweldige probleem in Suid-Afrika. Hierdie probleem hou nie net gesondheidrisiko‟s in nie, maar veroorsaak ook ernstige en dikwels verwoestende sosiale probleme. Methamphetamine, populêr bekend as Tik, is redelik goedkoop en vrylik beskikbaar. Dit word deur talle jongmense gebruik met die gepaardgaande veelvuldige gevolge en verslawing. Dit affekteer individue, gesinne, en totale gemeenskappe. Hierdie studie fokus op die gemeenskap van Bellville-Suid waar talle gesinne worstel met die euwel en desperaat soek om hulp. Hierdie situasie van tikverslawing en gepaardgaande sosiale uitdagings daag veral die verskillende geloofsgemeenskappe uit om betrokke te raak by die aanspreek van die probleem. Ook die Rynse Kerk Bellville staan midde in die sosiaal-maatskaplik en sosio-ekonomies uitdagings en behoeftes. Die leierskap van die gemeente is soekend om hulself te bekwaam om op „n sinvolle wyse lidmate te begelei in hoe om veral die uitdagings rondom tikverslawing aan te spreek. Aangesien gesinne in besonder deur hierdie verskynsel geraak word, fokus hierdie studie op die behoeftes van gesinne. Die gemeente besef dat daar nie ‟n resep vir so iets is nie en dat die probleem holisties aangepak moet word. Die gemeente word dus verplig om baie ernstig selfondersoek te doen en na sy wese, sy identiteit en roeping te kyk. Hoe kan die gemeente ‟n veilige hawe vir sy lidmate en gemeenskap se ouers en kinders word? Die ondersoek beskryf die Rynse Kerk Bellville asook die probleem van tikverslawing in die families van die gemeente. Hoe sou daar in die lig van „n missionale teologie op die uitdagings gereageer word? ‟n Bedieningsplan word voorgestel om die leierskap en lidmate te bemagtig om ondersteunend betrokke te raak by geaffekteerde families. Die doel hiervan is om ‟n missionale bediening te vestig wat met barmhartigheid en liefde die gemeenskap dien.

Opium, the dried resin obtained from the unripe seedpods of the poppy flower, has been used for medicinal and euphoric purposes since ancient times. Morphine, the main active ingredient of opium, and other clinically useful opioid analgesics all mediate their effects through activating the mu opioid receptor. Studies involving the mu opioid receptor knockout mice showed that the interaction with the mu opioid receptor is also responsible for many notorious side effects associated with these drugs including dependence and addiction. Therefore, selective antagonists for the mu opioid receptor are needed to study its function in drug abuse and addiction. Previously, based on molecular modeling studies and the “message-address” concept, a series of 14-O-substituted naltrexone derivatives were designed and synthesized. These compounds carried an ester-linked heteroaromatic substitution at the 14-position of naltrexone which was designed to interact with the putative “address” site, that was identified in the mu opioid receptor through molecular modeling studies. The lead compound of this series was determined to have a high affinity and selectivity for the mu opioid receptor. Because the 14-O-substituted naltrexone derivatives were not very stable, the ester linkage in these compounds was replaced by an amide one and a series of 14-N-substituted naltrexone derivatives were synthesized. The affinity and selectivity of these novel naltrexone derivatives were determined in a competitive radioligand binding assay. Interestingly, the 14-N-substituted naltrexone derivatives did not maintain the high selectivity of the 14-O-substituted series. It was hypothesized that the conformational constraint introduced by the amide linker was detrimental to the mu opioid receptor selectivity. Therefore, three 14-N-substituted naltrexone derivatives which carried more flexible linkages were synthesized and evaluated. The mu opioid receptor selectivity was not recovered by introducing rotational freedom into the linker. Some of these 14-N-substitued naltrexone derivatives were determined to be mu-kappa opioid receptor dual selective antagonists. Since the mu opioid receptor antagonists are effective at treating drug addiction, while growing evidence suggests that the kappa opioid receptor antagonists may be beneficial in lowering drug cravings, these novel mu-kappa opioid receptor dual selective antagonists may find unique clinical utility in the treatment of opioid dependence.

The thesis describes a demonstration of the use of drama and psychodrama approach as a method when working with a drug dependent client during the treatment in a therapeutic community. In the theoretical part I focus on clarification of terms associated with the name of thesis, especially with the concepts of dramatherapy, psychodrama, catharsis, abreaction, corrective emotional experience. Furthermore, the theoretical section contains information on individual methods and possibilities of their use. The main objective of thesis was to illustrate a specific therapeutic method by the analysis of particular work, in my case dramatherapy and psychodrama. In the practical part I analysed from available documents and observing to which extent dramatherapy and psychodrama may be beneficial for a client in the treatment in the therapeutic community and demonstrated their impact on the client. The outcome of thesis is a description of each session, which can serve as an inspiration for starting dramatherapists working with drug dependent clients. Furthermore, it is also the analysis of client's development, a progress in the treatment and a thorough analysis during and after the sessions. KEYWORDS dramatherapy, psychodrama, catharsis, abreaction, corrective emotional experience, therapeutic community...

Nos pressupostos winnicotianos, experiências provenientes de uma maternagem insatisfatória podem não propiciaro desenvolvimento adequado dos fenômenos tradicionais, resultando em patologias como a adicção. Devido aos poucos estudos existentes relacionando o fenômeno adicção com a maternagem, decidiu-se investigar o funcionamento psíquico de mães de adictos a drogas, a fim de se verificar quais características deste funcionamento poderiam dificultar o desempenho adequado da função materna. Fizeram parte deste estudo 10 mães de adictos a drogas (cocaína), que foram atendidas individualmente em situação de psicodiagnóstico, incluindo Entrevista semidirigida sobre o filho, Entrevista baseada na Escala Diagnóstica Adaptativa Operacionalizada (EDAO) sobre elas próprias e aplicação do Método de Rorschach. As mães foram convidadas a participar desta pesquisa à medida que seus filhos - do sexo masculino e adicto à droga cocaína - davam entrada para tratamento no Centro de Atenção Psicossocial em Álcool e Droga (CAPS-AD) do município de Santana de Parnaíba (região oeste da Grande São Paulo, Brasil). Os filhos adictos não apresentavam perturbação neurológica ou psicológica grave e foram avaliados por outro profissional diferente do resposnável por esta coleta de dados. Na região atendida, predomina uma população de baixa renda. Os dados foram analisados e relacionados entre si, privilegiando os processos de pensamento, de socialização e a dinâmica afetiva, utilizando-se o referencial psicanalítico winnicottiano. Os resultados do grupo no Método de Rorschach e nas Entrevistas configuraram um perfil marcado por um funcionamento psíquico imaturo, por um embotamento afetivo e intelectual, dificuldades de relacionamento objetal adulto, atitudes ambíguas e tendência à repetição de vivências conjugais geradoras de sofrimento, decorrentes de violência e abusos. Tal funcionamento parece derivar-se das próprias vivências precoces, permeadas por uma maternagem não suficientemente boa, que compromete o desenvolvimento do processo de sepração e individuação. A partir deste funcionamento, estas mães não se mostraram capazes de favorecer o desenvolvimento adequado de seus filhos pelas próprias dificuldades na passagem da dependência para a independência e no desenvolvimento de um espaço transicional. / Winnicott reported that an unsatisfatory good-enough mothering experience may not provide the appropriate transitional phenomena development leading to pathologies, for instance the addition. Considering the few studies regarding the relations between the addictive phenomenon and mothering from the mother perspective, was decided upon the investigation on the drug-addicted mother\'s psychic functioning, in order to verify if these performance characteristics could disturb the proper mother\'s function development. This study copes with 10 drug-addict mothers (cocain) that were attended individually in psychodiagnostic assessment, including a semi-structured interview referring to their son, an Adaptive Operational Diagnostic Scale (EDAO) interview and the Rorschach Method. The mothers were invited to participate in the study as long as that their sons, also drug addicted (cocain), had been brought for the treatment at the Alcohool and Drugs Psychological Care Center (CAPS-AD) in the Santana de Parnaíba municipality (São Paulo west region, Brazil), and this is predominantly low-income population. Theis sons were addicts and they did not present neurological or psychological severe disturbance, they were evaluated by another professional other than the person responsible for data collection. Using the Winnicott\'s psychoanalitic reference the data was analyzed and related among each other, focusing on the thought and socialization processes, and on the affective dynamics. The Rorschach Method and interviews results suggested a group with an immature psychological functioning profile, distinguished by an affective flattening, an intellectual blunting, a difficulty in an adult object-reaction, double-meaning attitudes and repeated marital experiences that causes suffering by its violence and abuse. These characterists seem to be a consequence of their own previous experiences and from an unsatisfactory good-enough mothering, hindering their separation/individuation process development. Consequently, the mothers were not able to assist their sons with a proper development considering their own difficulties related to the dependence-independence process and their transitional area development.

O objeto deste estudo é a concepção Redução de Danos, optou-se pelo estudo qualitativo, exploratório e de campo. O objetivo principal é identificar e analisar as concepções dos profissionais de um Centro de Atenção Psicossocial Álcool e outras Drogas da cidade de São Paulo acerca da Redução de Danos. Foi desenvolvido com profissionais da equipe técnica de saúde mental e o coordenador do serviço. O marco conceitual teórico deste estudo é a Reforma Psiquiátrica e os pressupostos da Redução de Danos. Para a obtenção do material empírico a técnica empregada foi à entrevista semi-estruturada. Os instrumentos para coleta de dados contemplam a caracterização sociodemográfica dos colaboradores e um roteiro para entrevista que foi gravada. Os dados foram transcritos e analisados sob a luz do método Hermenêutico Dialético. Na análise emergiram quatro categorias: dificuldade em classificar a gravidade do consumo; a droga para encobrir as necessidades de grupos sociais desfavorecidos; a droga como necessidade de todas as classes nos tempos atuais e formas da RD de trabalhar com o consumo. O resultado aponta que para os sujeitos deste estudo a RD se posiciona como uma abordagem que se opõe ao modelo hegemônico de guerra as drogas e não parte do ponto único e exclusivo do uso de drogas como doença. Afirmam que a RD não é contra a abstinência e visa diminuir riscos e danos a saúde considerando todo o contexto, o desejo e as possibilidades de cada pessoa. Nesse sentido, amplia a oferta e as possibilidades de cuidados para as pessoas que fazem uso prejudicial dos diversos psicoativos. / The object of this study is the concept of Harm Reduction. It was opted to use a field research, with exploratory and qualitative approach. The main objective was to identify and analyze the views about Harm Reduction of professionals from a Psychosocial Care Center for Alcohol and Other Drugs in São Paulo. The study as developed throughout all of the professional categories, e.g. higher-level, technical and coordinators of the staff. The theoretical framework of this study is the Psychiatric Reform and the assumptions of Harm Reduction. To obtain the empirical data, it were used semi-structured interviews as technique. The instruments for data collection include the sociodemographic characteristics of the members of the staff and a guide for the interviews, which were recorded. Data was transcribed and analyzed under the view of the Hermeneutic Dialectic method. In the analysis, four categories emerged: e.g. difficulties in classifying the severity of consumption; drugs as a way to cover the needs of disadvantaged groups; drugs as a need for all classes in the current times and ways of working with Harm Reduction and the consumption. The result shows that for the subjects in this study the Harm Reduction stands as an approach that opposes the hegemonic model of the war on drugs and not part of the one and only point of drug use as a disease. Claim that the Harm Reduction is not against abstinence and aims to reduce health risks and damage considering the entire context, the desire and the possibilities of each person. In this sense, extends the offer and the possibilities of care for people who make use of the various harmful psychoactive.

Álcool é substância lícita de abuso, promovendo dependência pela modulação de sistemas neurotransmissores, como GABAérgico e dopaminérgico. Taurina, um aminoácido utilizado como suplemento alimentar e constituinte de bebidas energéticas, exerce efeito modulatório positivo sobre receptores GABAA. Estudos em animais sugerem efeito terapêutico da taurina na síndrome de abstinência. No entanto, não se sabe o efeito da taurina sobre o comportamento de animais durante o uso de álcool. Portanto, o objetivo deste estudo foi avaliar o efeito do tratamento com taurina sobre o consumo voluntário de álcool e comportamentos de ratos. Foram oferecidas duas garrafas para ratos Wistar machos adultos, uma contendo álcool 20% em solução de sacarina 0,08% e a outra contendo apenas solução de sacarina 0,08% por 6 semanas. Ao grupo controle foram oferecidas duas garrafas contendo sacarina 0,08%. O consumo diário de líquidos dos dois grupos foi monitorado. No 22º dia eles foram divididos em 4 grupos (n=12/grupo) para receber taurina 100 mg/kg (grupos Álcool/TAU e Controle/TAU), via intraperitoneal, uma vez ao dia, por 19 dias, ou solução salina 0,9% (grupos Álcool/SAL e Controle/SAL). Nos dias 22 e 33, os ratos foram expostos ao teste de campo aberto e, no dia 34, ao teste de claro/escuro. Nossos resultados mostraram que o tratamento com taurina aumentou em mais de 10% a preferência por álcool em relação aos animais não tratados. O consumo de álcool médio no grupo Álcool/SAL foi 12 g/kg/dia, enquanto que no grupo Álcool/TAU foi 20 g/kg/dia, sendo que taurina aumentou significativamente o consumo a partir o sexto dia de tratamento. No campo aberto, dose aguda de taurina reduziu a ambulação total de animais controle, além de aumentar os cruzamentos centrais do grupo álcool. Taurina aguda e crônica aumentou a latência de auto-limpeza (grooming) e apenas o tratamento crônico reduziu 8 a frequência de grooming independentemente dos grupos. No teste de claro/escuro, taurina aumentou o tempo de permanência no compartimento claro, o número de transições entre os compartimentos e a latência para entrar no compartimento escuro apenas no grupo álcool, indicando efeito tipo-ansiolítico. Conclui-se que o tratamento crônico com taurina aumenta o consumo voluntário e preferência por álcool em ratos, possivelmente por efeito sinérgico com o álcool que facilita a ativação da via de recompensa dopaminérgica. O efeito tipo-ansiolítico da taurina no grupo álcool também pode ser justificado por efeito aditivo sobre receptores GABAA. Demonstramos que a taurina não apresenta efeito antiaditivo e, talvez, como o acamprosato, possa ser efetiva no controle da recaída, somente após abstinência. / Alcohol is a licit substance of abuse, promoting dependence by the modulation of different neurotransmitter systems, such as GABAergic and dopaminergic. Taurine, an amino acid used as food supplement and constituent of energy drinks, exerts positive modulatory effect on GABAA receptors. Animal studies suggest a therapeutic effect of taurine on withdrawal alcohol syndrome. However, the effect of taurine on the behavior of animals during alcohol use is not known. Therefore, the aim of this study was to evaluate the effect of taurine treatment on voluntary alcohol consumption and on behaviors of rats. Two bottles were offered to adult male Wistar rats, one containing 20% alcohol in 0.08% saccharin solution and another containing only 0.08% saccharin solution for 6 weeks. Two bottles containing 0.08% saccharin were offered to the control group. The daily liquid intake of both groups was monitored. On day 22 they were divided into 4 groups (n =12/group) to receive taurine 100 mg/kg (Alcohol/TAU and Control/TAU groups), intraperitoneally, once a day, for 19 days, or 0.9% saline (Alcohol/SAL and Control/SAL groups). On days 22 and 33, rats were exposed to the open field test and, on day 34, to the light/dark test. Our results showed that taurine treatment increased by more than 10% the alcohol preference compared to untreated animals. The average alcohol consumption in the Alcohol/SAL group was 12 g/kg/day, while in the Alcohol/TAU group it was 20 g/kg/day, and taurine significantly increased the consumption from the day 6 of treatment. In the open field, acute dose of taurine reduced the total ambulation of control animals and increased central crossings of alcohol group. Acute and chronic taurine increased the latency for grooming, and only chronic treatment reduced the frequency of grooming independently of the groups. On the light/dark test, taurine increased the time spent in light compartment, the number of 10 transitions between compartments and the latency to enter the dark compartment only in the alcohol group, indicating an anxiolytic-like effect. It is concluded that chronic taurine treatment increases alcohol voluntary consumption and preference in rats, possibly due to synergistic effects with alcohol that facilitates the activation of the dopaminergic reward pathway. The anxiolytic-like effect of taurine in the alcohol group may also be justified by additive effect on GABAA receptors. Our results show that taurine has no anti-additive effect and, perhaps as acamprosate, may be effective in controlling relapse only after abstinence.

Made available in DSpace on 2016-03-22T17:26:27Z (GMT). No. of bitstreams: 1 Frederico Moreira.pdf: 992275 bytes, checksum: 2617eada80a01f5af65e54ba3d556cf2 (MD5) Previous issue date: 2010-12-17 / This work aims to examine reading comprehension levels reached by chemical dependents regarding several text genres as compared to that of nondependents. The study subjects were divided into two groups of 20 people: G1, constituted by drug users, and G2, constituted by non-users. For testing subjects reading comprehension levels, we used two narrative texts, a fable and a short story, and also an expositive one, all of them prepared according to Cloze procedure. Chemical dependency stages were established by means of ASSIST test, which sets scores for identifying drug use stages through the lives of subjects. Results show that non-users present higher scores in Cloze procedure for all text genres used, which shows they have higher levels of reading comprehension than drug users. Data also proved that drugs damage important brain areas linked to users cognition, such as memory functions, focus and impulses / O presente trabalho tem como objetivo investigar o nível de compreensão leitora entre dependentes químicos, comparando-a com os não dependentes, em diferentes gêneros textuais. O estudo foi constituído de dois grupos, os usuários de drogas (G1) e não usuários de drogas (G2) cada grupo composto de 20 sujeitos. Para verificar a compreensão leitora, os participantes foram expostos a três textos, um do gênero fábula, outro do gênero conto e o terceiro do gênero divulgação científica para leigos, todos elaborados através do procedimento Cloze. O grau de dependência química, por sua vez, foi analisado por meio do teste ASSIST, que estabelece pontuações que indicam o nível de uso de drogas durante a vida dos sujeitos. Os resultados mostram que o grupo dos não usuários de drogas obteve maiores médias no procedimento Cloze em todos os gêneros textuais, mostrando assim um grau significativamente maior de compreensão leitora do que o grupo dos usuários de drogas. Os dados ainda sugerem a idéia de que a droga causa prejuízos em áreas importantes que se coadunam com a cognição de seus usuários, como funções de memória, concentração e controle de impulsos