Goals: to focus on the Quality of life in clients of the substitution program according the duration of treatment at the Department of Addictology, 1. LF UK a VFN in Prague. Background: The topic of dissertation was chosen on the basis of a 16-year clinical experience of the author with the target group of clients in methadone substitution. I realized based on long-term observation, that clients go through certain stages of satisfaction with their lives. This may correspond with their functioning in the program. The theoretical part describes the substitution treatment for opiate dependence and quality of life concept. Methods: A total selection method was chosen. Data are collected using a standardized questionnaire World Health Organization - WHOQOL-BREF (short version). File: The research sample consists of 39 patients (out of total of 65 clients of Substitution centre, Department of Addictology First Faculty of Medicine, Charles University and General Teaching Hospital in Prague. Results: There were no significant differences in the quality of life in relation to the duration of treatment. The highest quality of life had clients in the category 2-5 years in the program. The lowest score gained clients in category over 5 years. Patients in category of 2 years received an average score. The...

Desde os tempos antigos, o leite de papoula é usado como sedativo e poderoso analgésico. Hoje, na terapêutica, a morfina - a qual se encontra em grande proporção no leite da papoula - continua sendo utilizada como analgésico em casos de dor moderada e severa. Concomitantemente, drogas derivadas da morfina têm sido amplamente utilizadas; sendo a heroína uma das drogas com maior potencial viciante conhecido. <br /> O desenvolvimento de antagonistas do receptor alvo da morfina/heroína (receptor &mu;-opioide) pode auxiliar tanto no desenvolvimento de medicamentos analgésicos mais seguros e potentes, bem como no desenvolvimento de medicamentos que podem ter utilidade no tratamento da dependência por drogas opiáceas. <br /> Com o intuito de criar a relação entre a atividade biológica de um conjunto de 51 moléculas e sua respectiva ação antagonista ao receptor &mu;-opioide, foram selecionadas, da literatura, moléculas que apresentam interações biológicas contra o receptor &mu;-opioide. <br /> As moléculas selecionadas tiveram suas geometrias otimizadas e suas propriedades calculadas pelo método DFT/B3LYP, com um conjunto de funções de base 6-31g++(d,p). Os dados obtidos, como informações sobre a estrutura eletrônica, propriedades topológicas e físico-químicas, foram relacionados com os valores de pKi. Para a correta análise das variáveis que são úteis na descrição da atividade biológica, métodos de análise estatística como PCA, HCA, SIMCA e KNN foram utilizados, além do método de PLS para a construção do modelo matemático de relação entre atividade biológica e as variáveis. <br /> Os resultados mostram que variáveis como a energia do orbital LUMO, a quantidade de nitrogênios na cadeia da molécula, o volume de alguns substituintes e o valor das variáveis E1p e E3u (mensuradas respectivamente pela polarizabilidade molecular e peso atômico) têm grande relação com a atividade biológica. <br /> O modelo criado é útil na previsão da atividade biológica de outras moléculas, bem como ao fornecer ideias para uma síntese planejada de novos compostos com atividade antagonista promissora. / Since antiquity, the poppy\'s milk has been used as sedative and powerful analgesic. Nowadays, in the therapy, the morphine - that is found in large proportion in poppy\'s milk - is still being used as painkiller in cases of moderate and severe pain. Concurrently, drugs made from morphine have been widely used; being the heroin the drug with the highest known addictive potential. <br /> The development of the antagonists of the morphine/heroine target receptor (&mu;-opiate receptor) can help on more safety and powerful medicine developments, and also to develop medicines that can be useful in treating opiate drugs addiction. <br /> In order to create the relationship between biological activity of a set of 51 molecules and their respective antagonist action by &mu;-opiate receptor, was selected, from the literature, molecules that show biological interaction against &mu;-opiate receptor. <br /> The selected molecules had their geometries optimized and their properties calculated by DFT/B3LYP method, with a set of base functions 6-31g++(d,p). The data obtained, as information about the electronic structure, topological properties and physical-chemical, were related to the pKi values. To the correct analysis of the variables that are useful on the description of the biological activity, were used statistical analysis methods as PCA, HCA, SIMCA and KNN, other than the PLS method for building the mathematical model of relationship between the biological activity and the variables. <br /> The results show that variables as the energies of LUMO orbital, the quantity of nitrogen in the molecular chain, the volume of some substituents and the value of the variables E1p and E3u (measured respectively by molecular polarity and atomic weight) has big relationship with the biological activity. <br /> The created model is useful in biological activity prevision for other molecules, as well as providing ideas for a planned synthesis of new compounds with promissory antagonist activity.

Hintergrund: Die Datenlage zur Substitutionstherapie Opiatabhängiger ist defizitär. Vor diesem markant defizitären Erkenntnishintergrund erscheint es sinnvoll und notwendig, eine versorgungsepidemiologische Studie zur aktuellen Versorgungslage opiatabhängiger Substitutionspatienten durchzuführen, um offene Fragen zu klären. Hierfür haben wir ein mehrstufiges Forschungsprojekt unter dem Akronym COBRA initiiert. COBRA steht für "Cost-Benefit and Risk Appraisal of Substitution Treatments" und signalisiert, dass wir uns in umfassender Weise um eine Evaluation der Risiken, Vor- und Nachteile verschiedener Interventionsstrategien und Modalitäten in der Substitutions- und Versorgungspraxis Opiatabhängiger in Deutschland bemühen. Zielsetzungen des COBRA-Projekts sind: • Die Charakterisierung von bestehenden Einrichtungsformen und -modellen; • Die Charakterisierung von: – Merkmalen opiatabhängiger Patienten in diesen Einrichtungen (Schwere, Dauer/ Stadium, Komorbidität, Delinquenz, Desintegration etc.), – der Diagnostik sowie den Indikations- und Allokationsentscheidungen in der Versorgungsrealität sowie – den eingesetzten Interventionsmethoden (Substitutionsmittel, Therapie komorbider Störungen, psychotherapeutische und soziale Interventionen) • Die Ermittlung von Problemen der Substitutionstherapie bei verschiedenen Risikogruppen (z.B. Hepatitis-C- und HIVPatienten) • Die Beschreibung des Kurzzeitverlaufs und Outcomes hinsichtlich verschiedener klinischer und sozialer Kriterien Methodik: Die Studie teilt sich in einen deskriptiv-klinisch-epidemiologischen und einen analytisch-evaluativen Teil. Der deskriptive Teil soll zunächst darüber Auskunft geben, wie viele und welche Arten von Substitutionseinrichtungen in Deutschland wie viele Opiatabhängige erreichen und behandeln. Auf dieser Grundlage soll dann im evaluativen Teil an möglichst repräsentativen Einrichtungen und Patienten beurteilt werden, wie und mit welchen Methoden welche Arten von Patienten und Problemlagen versorgt werden. Durch Abgleich mit den wissenschaftlichen Bewertungsmaßstäben können daraus Defizite, Probleme und mögliche verbesserte Allokationsstrategien abgeleitet werden. Ergebnisse: Es werden erste Vorstudienbefunde und Ihre Design- Konsequenzen vorgestellt und diskutiert. / In the present paper, we will describe aims, methods, and design along with selected pre-study findings of an epidemiological study in a nationally representative sample of substitution doctors (N = 381) and their patients (n = 2500) in Germany. The project has three major components: (a) Pre-study: We sent mailed questionnaires to a sample of over 1000 substitution doctors to describe qualification and setting characteristics, treatment profiles and attitudes of substitution doctors in Germany. (b) Cross-sectional study: With a two-step epidemiological design (target day assessment of the patients, clinical appraisals by the doctors), our main aims were (1) to determine the number of opiate addicts treated by methadone or buprenorphine or other substitution drugs; (2) to find predictors and correlates for treatment, taking into account doctors, patients, and system variables; and (3) to evaluate cross-sectional differences between groups with regard to clinical presentation (comorbidity), clinical course, acceptance/compliance, critical incidences, and social integration. (c) Furthermore, the study includes a prospective-longitudinal cohort study of a total of 1000 patients sampled from this data base. The cohort will be followed-up over a period of three months to investigate whether buprenorphine patients have a more favorable course and outcome in terms of clinical, psychosocial, pharmaco-economic, and related measures. Selected pre-study findings are summarized, highlightening that current registers include a considerable proportion of doctors and a considerable heterogeneity of setting characteristics in terms of the number of patients, choice of substitution drugs and involvement in hepatitis- C treatment.

Frankfurt (Main), Univ., Diss., 2002

Prescription opioid use is highly prevalent and may be replacing heroin as the predominant illicit opioid that is used. Little is known about specific prescription opioid use characteristics, or issues faced by these individuals in treatment. The major aims of the two studies comprising this thesis were: 1) to systematically and quantitatively assess different occasions of use for the prescription opioid hydromorphone; and 2) to evaluate how current substance use and psychiatric symptoms may be related in a population of prescription opioid users enrolled in a low-threshold Methadone Maintenance Treatment (MMT) program. Eighty-two participants from a low-threshold MMT program in Halifax, Nova Scotia were interviewed regarding their lifetime and current substance use, specific past occasions of hydromorphone use, and current psychiatric symptoms. A subsample of 26 participants was interviewed a second time, one day later, to assess reliability of participants’ self-report on the above-mentioned study measures. It was found that many variables were reliably reported between the two interviews by the subsample. With regards to the first major thesis aim, hydromorphone was found to be a prevalent, highly-favoured prescription opioid in the sample. Characteristics of initial, but not later, hydromorphone use varied by prescription status at initiation. Later use of hydromorphone shared many characteristics previously documented with heroin. With regards to the second major thesis aim, participants reported high rates of current substance use and psychiatric symptoms. Current substance use and psychiatric symptoms appeared to be related; notably, non-prescribed benzodiazepine use predicted depression and anxiety symptoms, and general anxiety predicted non-prescribed benzodiazepine use. In summary, while the results may not be representative of all prescription opioid users, or MMT clients, the thesis presented novel findings with a unique and vulnerable population. The findings supplement the existing literature in terms of describing how prescription opioids may be used during specific occasions, and in describing psychiatric and substance use issues faced by prescription opioid users enrolled in low-threshold MMT in Nova Scotia.

No description available.

Zugl.: Bremen, University, Magisterarbeit.

Desde os tempos antigos, o leite de papoula é usado como sedativo e poderoso analgésico. Hoje, na terapêutica, a morfina - a qual se encontra em grande proporção no leite da papoula - continua sendo utilizada como analgésico em casos de dor moderada e severa. Concomitantemente, drogas derivadas da morfina têm sido amplamente utilizadas; sendo a heroína uma das drogas com maior potencial viciante conhecido. <br /> O desenvolvimento de antagonistas do receptor alvo da morfina/heroína (receptor &mu;-opioide) pode auxiliar tanto no desenvolvimento de medicamentos analgésicos mais seguros e potentes, bem como no desenvolvimento de medicamentos que podem ter utilidade no tratamento da dependência por drogas opiáceas. <br /> Com o intuito de criar a relação entre a atividade biológica de um conjunto de 51 moléculas e sua respectiva ação antagonista ao receptor &mu;-opioide, foram selecionadas, da literatura, moléculas que apresentam interações biológicas contra o receptor &mu;-opioide. <br /> As moléculas selecionadas tiveram suas geometrias otimizadas e suas propriedades calculadas pelo método DFT/B3LYP, com um conjunto de funções de base 6-31g++(d,p). Os dados obtidos, como informações sobre a estrutura eletrônica, propriedades topológicas e físico-químicas, foram relacionados com os valores de pKi. Para a correta análise das variáveis que são úteis na descrição da atividade biológica, métodos de análise estatística como PCA, HCA, SIMCA e KNN foram utilizados, além do método de PLS para a construção do modelo matemático de relação entre atividade biológica e as variáveis. <br /> Os resultados mostram que variáveis como a energia do orbital LUMO, a quantidade de nitrogênios na cadeia da molécula, o volume de alguns substituintes e o valor das variáveis E1p e E3u (mensuradas respectivamente pela polarizabilidade molecular e peso atômico) têm grande relação com a atividade biológica. <br /> O modelo criado é útil na previsão da atividade biológica de outras moléculas, bem como ao fornecer ideias para uma síntese planejada de novos compostos com atividade antagonista promissora. / Since antiquity, the poppy\'s milk has been used as sedative and powerful analgesic. Nowadays, in the therapy, the morphine - that is found in large proportion in poppy\'s milk - is still being used as painkiller in cases of moderate and severe pain. Concurrently, drugs made from morphine have been widely used; being the heroin the drug with the highest known addictive potential. <br /> The development of the antagonists of the morphine/heroine target receptor (&mu;-opiate receptor) can help on more safety and powerful medicine developments, and also to develop medicines that can be useful in treating opiate drugs addiction. <br /> In order to create the relationship between biological activity of a set of 51 molecules and their respective antagonist action by &mu;-opiate receptor, was selected, from the literature, molecules that show biological interaction against &mu;-opiate receptor. <br /> The selected molecules had their geometries optimized and their properties calculated by DFT/B3LYP method, with a set of base functions 6-31g++(d,p). The data obtained, as information about the electronic structure, topological properties and physical-chemical, were related to the pKi values. To the correct analysis of the variables that are useful on the description of the biological activity, were used statistical analysis methods as PCA, HCA, SIMCA and KNN, other than the PLS method for building the mathematical model of relationship between the biological activity and the variables. <br /> The results show that variables as the energies of LUMO orbital, the quantity of nitrogen in the molecular chain, the volume of some substituents and the value of the variables E1p and E3u (measured respectively by molecular polarity and atomic weight) has big relationship with the biological activity. <br /> The created model is useful in biological activity prevision for other molecules, as well as providing ideas for a planned synthesis of new compounds with promissory antagonist activity.

No description available.

Newborn rats were injected SC during the first week of life with 80 μ/kg Met-enkephalin, DSIP, MIF-I, or diluent. When tested 3 months later in a 12-choice maze for a reward of food, hungry rats injected neonatally with Met-enkephalin were found to run the maze faster and with fewer errors than the controls. DSIP and MIF-I did not improve performance in the maze, indicating some specificity to the findings. Tyrosine hydroxylase and choline acetyltransferase activity in several parts of the brain were not significantly different among the groups. Radioimmunoassay of brain parts from a small number of adult rats indicated slightly more DSIP-like material in the thalamus and striatum of females injected neonatally with DSIP as compared with those injected with diluent. The results extend our previous observations of the persistence of central effects of peripherally injected Met-enkephalin from several minutes to three months when administration occurs early in life. The findings further suggest an effect of peptides on the organization of the developing brain.