Mémoire numérisé par la Division de la gestion de documents et des archives de l'Université de Montréal.

The aim of teh work is to determine the causes of a long-term increase in production and distribution of cocaine in the Andean states and heroin in the Southeast and Southwest Asia, despite repression and active national drug policy, as well as international organizations. This paper describes the process of cultivation and drug production, distribution channels of drugs coming on the consumer markets. It explains and analyze the reasons and causes of involvement in drug trafficking and drug industry and its consequences for social and economic situation of individual countries, describes the national drug policy and the drug policy of international community and shows the connection of the drug trade with other elements of international crime.

Abuse of painkiller drugs and non-medical use of drugs among young adults continues to be a public health crisis in the United States. Living arrangements and source of treatment referral were considered as the social context that could contribute to increased admissions to treatment for drug abuse. The purpose of this study was to examine the relationship between, independent living arrangement, the principal source of referral, and abuse of opioid, heroin, and cocaine. Steered by the conceptual framework of the biopsychosocial model, this study used the data from the 2015 Treatment Episode Data Set: Admissions managed by the Substance Abuse and Mental Health Services Administration. Multiple logistic regression analyses were performed to test the hypotheses regarding a predictive relationship between independent living arrangement, the principal source of treatment referral, and admissions to treatment for abuse of opioid, heroin, and cocaine. The results showed a significant association between the source of treatment referrals and independent living arrangement, and the increased odds of admissions for prescription opioids use disorder, heroin use disorder, and cocaine use disorder among adults aged 18-34 living in the United States. The implication for positive social change included a need for a targeted treatment and other intervention programs for young adults' users with associated higher-risk treatment referral categories and exposed to neighborhoods factors and health-risk behaviors in reducing the crisis of drug abuse in the United States.

<p>The endogenous opioid enkephalin neuropeptides are mediators of pain perception and have been implicated in human addictions. The preproenkephalin gene and its mRNA have also provided many examples of tissue- and species-specific variations in mRNA structure produced through a variety of transcriptional and post-transcriptional mechanisms. Resultant differences in mRNA structure, in several cases, have impact on translation of enkephalin prepropeptide. The reports and discussion presented herein describe studies of the preproenkephalin gene and mRNA structure in the guinea pig, an animal that may have specific advantages for modeling the human endogenous opioid system. A guinea pig brain cDNA library was constructed and screened for clones of preproenkephalin and preprodynorphin, which were then sequenced. These studies confirmed the predicted mRNA structure that had been previously proposed based on homology with gene sequences and other methods. Multiple transcription initiation sites for each of these prepropeptide genes were also identified. Studies were conducted in the guinea pig to evaluate the effects of the administration of cocaine in a “binge” paradigm for two and seven days on preproenkephalin mRNA levels in several brain regions. “Binge” cocaine administration for seven (but not two) days resulted in differential changes in mRNA levels in different brain regions. Decreases were observed in the nucleus accumbens and hypothalamus, and increases in the frontal cortex, amygdala and hippocampus. These findings differ from those of previous rodent studies and suggest that this species may provide a useful alternative model for the study of the effects of cocaine on preproenkephalin gene expression in the human brain. Human genetic studies were also conducted in opioid-dependent (formerly heroin-addicted) and control subjects to test the hypothesis that the preproenkephalin gene is associated with heroin addiction. In two separate studies, we obtained evidence that this gene may be associated with the development of human heroin addiction.</p>

The endogenous opioid enkephalin neuropeptides are mediators of pain perception and have been implicated in human addictions. The preproenkephalin gene and its mRNA have also provided many examples of tissue- and species-specific variations in mRNA structure produced through a variety of transcriptional and post-transcriptional mechanisms. Resultant differences in mRNA structure, in several cases, have impact on translation of enkephalin prepropeptide. The reports and discussion presented herein describe studies of the preproenkephalin gene and mRNA structure in the guinea pig, an animal that may have specific advantages for modeling the human endogenous opioid system. A guinea pig brain cDNA library was constructed and screened for clones of preproenkephalin and preprodynorphin, which were then sequenced. These studies confirmed the predicted mRNA structure that had been previously proposed based on homology with gene sequences and other methods. Multiple transcription initiation sites for each of these prepropeptide genes were also identified. Studies were conducted in the guinea pig to evaluate the effects of the administration of cocaine in a “binge” paradigm for two and seven days on preproenkephalin mRNA levels in several brain regions. “Binge” cocaine administration for seven (but not two) days resulted in differential changes in mRNA levels in different brain regions. Decreases were observed in the nucleus accumbens and hypothalamus, and increases in the frontal cortex, amygdala and hippocampus. These findings differ from those of previous rodent studies and suggest that this species may provide a useful alternative model for the study of the effects of cocaine on preproenkephalin gene expression in the human brain. Human genetic studies were also conducted in opioid-dependent (formerly heroin-addicted) and control subjects to test the hypothesis that the preproenkephalin gene is associated with heroin addiction. In two separate studies, we obtained evidence that this gene may be associated with the development of human heroin addiction.

Mémoire numérisé par la Division de la gestion de documents et des archives de l'Université de Montréal

Background: To assess the long-term course of the feasibility and safety of orally administered heroin [diacetylmorphine (DAM)] tablets in substitution treatment of severely addicted opioid users. Design: Open-label, prospective cohort study with 2 non-randomly assigned treatment arms: DAM tablets only (n = 128) or DAM tablets combined with injected DAM and/or other opioids (n = 237). The average duration of the observation period was 62 months. Study endpoints were the time to discharge from treatment and the number of serious adverse events. Results: Both patient groups had a higher than 70% retention rate after the first 48 months of treatment, with similar long-term retention rates (after 8 years both groups had retention over 50%). The physician-verified rate of serious adverse events was 0.01 events per application year among the exclusively oral substitution group (intention-to-treat analysis) during the last year of observation, and 0.005 events per application year in the other group. Conclusions: Because of their feasibility and safety over years, DAM tablets may be a valuable long-term therapeutic alternative. / Dieser Beitrag ist mit Zustimmung des Rechteinhabers aufgrund einer (DFG-geförderten) Allianz- bzw. Nationallizenz frei zugänglich.

Zugl.: Düsseldorf, Universiẗat, Diss., 2008.

Thesis (MA(Clinical Psychology))--University of Pretoria, 2004. / Includes bibliographical references.

The purpose of this study is to describe the subjective psychological experience of relapse in cocaine/crack and heroin users with the aim of identifying the significant cognitive, emotional and social themes involved in relapse. A better understanding of relapse may aid in providing more effective treatment for substance users. Both the intra- and interpsychic factors involved in relapse that emerge from the study are viewed from within a broad systems theory approach. In this study, not only the whole system is of relevance, but also the subsystems. Various sub systems are also identified to allow for the recognition of patterns, functions and recursive feedback loops that maintain substance-using behaviour. Due to the qualitative nature of the study, the context surrounding substance abuse and the substance users assumes vital importance. The interrelationships between the various intrapsychic structures, the family unit, the social contexts, the drugs themselves and the physiological aspects of substance abuse are identified. A qualitative research design was applied. In-depth semi-structured interviews were used to gather data from the eight participants, who were crack and heroin users who attended the in-patient rehabilitation programme at Phoenix House. Seven of the participants were still in the in-patient rehabilitation programme at the time of the interview, while one participant was in the aftercare programme. All have been through a rehabilitation process before and were at Phoenix House due to a relapse. A thematic analysis was conducted and the process of analysis settled on eight overall themes. Extensive descriptions of these themes are provided. The discussion highlights the role of relapse in the cycle of self-destruction that constitutes substance abuse, in addition to the role relapse plays in the process of recovery. Connection seems to be the key to breaking the cycle of alienation that users experience. Falling into the trap of rejecting users without looking beyond their behaviour allows them to continue functioning in a way that confirms their view of themselves as unlovable, which, in turn, maintains their behaviour. Although systems theory is an independent approach in its own right, the nature of its view allows for the incorporation of other approaches. Where possible and relevant, other theories are incorporated into the discussion of the results, with the aim of gaining an integrated understanding of the findings of the study within the broader field of substance abuse. / Dissertation (MA (Clinical Psychology))--University of Pretoria, 2005. / Psychology / unrestricted