Alcohol-sensitizing drugs

The first type of pharmacotherapy for alcohol problems uses compounds that alter the metabolism of alcohol if it is consumed. Peachey and Annis (1985) reviewed these compounds, which they called the alcohol-sensitizing drugs. The most popular of these are disulfiram (trade name Antabuse) and carbimide (Temposil). Antabuse has been in use in the United States since 1948. Temposil, on the other hand, is not available in the United States and is used less frequently overall than Antabuse (NIAAA, 2000). In any case, use of both agents in treatment is based on similar assumptions regarding the psychological effects of their chemical action. 

Pe.achey, J. E., Annis, J. (1985). New strategies for using the alcohol-sensitizing drugs. In C. A. Naranjo E. M. Sellers (Eds.), Research advances in new psychopharmacological treatments for alcoholism 199-216). Amsterdam Elsevier Science Publishers. 

A. W , Jones, J.. S ciman, ami M. Hillbom, "Concemraiion-iime Profiles of Ethanol. md Acetaldehyde in Human Volunteers Treated with the Alcohol-sensitizing Drug. Caldutn Cnrbimide." fir J. Clin. Pfmrmmo/.. 25, 21. -21 (198li ),... 

Post, R.M. Central stimulants. Clinical and experimental evidence on tolerance and sensitization. In Israel, Y. Glaser, F.B. Kalant, H. Popham, R.E. Schmidt, W. and Smart, R.G., eds. Research Advances in Alcohol and Drug Problems. Vol. 6. New York Plenum, 1981. pp. 1-65. 

Social and economic harms Some invasions of privacy or breaches of confidentiality could result in embarrassment with one s business or social group, loss of employment, or criminal prosecution. Confidential safeguards must be strong in these instances. Examples of these particular sensitivities include information about alcohol or drug abuse, mental illness, illegal activities, and sexual behavior. Participation in research may also result in additional costs to the participant. 

Anamnestic evidence of alcoholism or drug abuse and also personal questions relating to sexual habits should be handled with extreme care and sensitivity. Once one has gained the patient s trust, it is considerably easier to obtain the relevant details. It is essential to establish whether the patient has been exposed to any foreign sub-... 

The policy must permit the driver to retiim to safety-sensitive functions only upon the successfiil completion of an educational or treatment program, as determined by an alcohol and drug abuse evaluation expert (employee assistance professional, substance abuse professional, qualified alcohol and drug counselor, etc.)... 

An employer must not allow a driver to perform or continue to perform safety-sensitive functions if the driver refuses any of the alcohol or drug tests listed above. 

The job was designated as a safety-sensitive function in any Department of Transportation (DOT) regulated mode subject to the Part 40 alcohol and drug testing requirements. 

If the driver was involved, as part of his/her previous emplo3rment, in a safety-sensitive function that required alcohol and drug testing as specified in Part 40, the prospective employer must also investigate the following information ... 

According to FMCSA regulation, no person who has failed an alcohol or drug test, or refused to test, will be allowed to perform safety-sensitive functions until the referral, evaluation, and treatment requirements have been complied with. The following company disciplinary measures apply to all reasonable suspicion, post-accident, and random tests. 

Age, weight, degree of physical fitness, degree of acclimatization, metabolism, use of alcohol or drugs, and a variety of medical conditions, such as hypertension, all affect a person s sensitivity to heat. However, even the type of clothing worn must be considered. Prior heat injury predisposes an individual to additional injury. It is difficult to predict just who will be affected and when, because individual susceptibility varies. In addition, environmental factors include more than the ambient air temperature. Radiant heat, air movement, conduction, and relative humidity all affect an individual s response to heat. 

A variety of factors can affect a person s sensitivity and tolerance to heat, such as age, gender, ethnicity, body dimensions, weight, physical fitness, acclimatization, metabolism, alcohol or drug use, and medical conditions such as obesity, hypertension, and history or predisposition to heat injuries. Individuals with degenerative cardiovascular system diseases, diabetes, and/or malnutrition are at increased risk when exposed to heat and when stress is placed on the cardiovascular system (Ogawa 1998 NIOSH 1986). 

Not everyone is affected equally by the heat. Age, weight, degree of physical fitness, metabolism, medications, use of alcohol or drugs, and a variety of medical conditions such as hypertension all affect a person s sensitivity to heat. 

Kleber HD, Weissman MM, Rounsaville BJ, et al Imipramine as treatment for depression in addicts. Arch Gen Psychiatry 40 649-633, 1983 Kleber HD, Riordan CE, Rounsaville BJ, et al Clonidine in outpatient detoxification from methadone maintenance. Arch Gen Psychiatry 42 391-394, 1983 Kleber HD, Topazian M, Gaspari J, et al Clonidine and naltrexone in the outpatient treatment of heroin withdrawal. Am J Drug Alcohol Abuse 13 1-17, 1987 Kornetsky C. Brain stimulation reward, morphine-induced stereotypy, and sensitization implications for abuse. Neurosci Biobehav Rev 27 777-786, 2004 Kosten TR, Kleber HD Buprenorphine detoxification from opioid dependence a pilot study. Life Sci 42 633-641, 1988... 

Nation JR, Liver,ore CL, Burkey RT. 1996. Chronic lead exposure attenuates sensitization to the locomotor-stimulating effects of cocaine. Drug Alcohol Dependence 41 143-149. 

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