Craving

Vitreous silica is susceptible to attack by alkaline solutions, especially at higher concentrations and temperatures. For 5% NaOH at 95°C, although craving may be evident, surface corrosion is only 10 p.m after 24 h (87). For 45 wt % NaOH at 200°C, dissolution proceeds at 0.54 mm /h (88). The corrosion rates in other alkaline solutions are Hsted in Table 3. Alkaline-earth ions inhibit alkaline solution attack on vitreous siUca. Their presence leads to the formation of hydrated metal siUcate films which protect the glass surface (90). 

Mood and hedonic value associated with feeding, food intake, foraging, consummatory behaviors, and craving in addiction complex regulation by food entrainable oscillators in the brain and periphery, neuropeptides (including orexins) and biogenic amines. 

Individuals experiencing dmg withdrawal can become conditioned to environmental situations. Previously neutral stimuli can elicit many of the symptoms of dmg withdrawal, and this conditioned withdrawal has motivational significance especially in alcohol and opiate addiction. Thus conditioned withdrawal may trigger craving and relapse in a particular situation. 

Drug addiction is defined as a syndrome in which drug use (e.g., psychostimulants, opiates, alcohol) pervades all life activities of the user. Life becomes governed by the drug and the addicted patient can lose social compatibility (e.g., loss of partner and friends, loss of job, crime). Behavioral characteristics of this syndrome are compulsive drug use, craving, and chronic relapses that can occur even after years of abstinence. 

The pharmacodynamic effects of ethanol are complex, and any attempt to link its actions to specific neurotransmitters or isolated brain regions is simplistic. A complicated neural network involved in the actions of ethanol accounts for its reinforcing, intoxicating, and abstinence effects. At the present time, use of medications that target neurotransmitters and neuromodulators affected by ethanol represents a reasonable strategy for the development of pharmacotherapies that reduce the reinforcing effects of alcohol and the craving and withdrawal symptoms that commonly occur in the context of alcohol dependence. 

Verheul et al. (2004) pooled data from seven European acamprosate studies in an effort to identify patient-related predictors of response to the medication. Although they examined a number of potential predictors, including patients level of physiological dependence before treatment, family history of alcoholism, age of onset of alcoholism, baseline anxiety symptom severity, baseline craving, and gender, none was shown to interact with acamprosate treatment. These findings led the authors to conclude that, although the effect size for acamprosate was moderate, the medication can be considered potentially effective for all patients with alcohol dependence. 

Petrakis IL, Trevisan L, Boutros NN, et al Effect of tryptophan depletion on alcohol cue-induced craving in abstinent alcoholic patients. Alcohol Clin Exp Res 23 1151-1155, 2001... 

Detoxification is more successful when the patient is transitioned from a stable methadone dose with the support of ongoing therapy than when the patient comes directly from the street for detoxification from heroin. Some practitioners believe that detoxification with clonidine can be more rapid than with methadone, at least on an outpatient basis. One important hmitation of clonidine is that, although it suppresses autonomic signs of withdrawal, subject-reported symptoms, such as lethargy, restlessness, insomnia, and craving, are not well relieved (Charney et al. 1981 Jasinski et al. 1985). Anxiety may... 

Methadone maintenance was first introduced in 1964 by Dole and Nyswan-der (1965). The basis for use of methadone is that high doses alleviate craving... 

When patients elect detoxification from maintenance, a very gradual reduction of dosage is preferred, with careful monitoring of drug craving and withdrawal symptoms. Three to 6 months is recommended for most elective detoxifications. As many as one-third of methadone maintenance clients have been found to have a marked fear of detoxification (Milby et al. 1986). 

Ciraulo DA, Rotrosen J, Leiderman D, et al Nefazodone induced alterations of cocaine craving and use in dysphoric cocaine users. Drug Alcohol Depend 60 S38, 2000 Connell PH Amphetamine Psychosis (Maudsley Monographs No 5). London, Oxford University Press, 1938... 

Kranzler HR, Bauer LO, Hersh D, et al Carbamazepine treatment of cocaine dependence a placebo-controlled trial. Drug Alcohol Depend 38 203-211, 1995 Levin FR, Lehman AF Meta-analysis of desipramine an adjunct in the treatment of cocaine addiction. J Clin Pharmacol 11 374-378, 1991 Lima MS, Reisser AA, Soares BG, et al Antidepressants for cocaine dependence. Cochrane Database Syst Rev 4 CD002950, 2001 Ling W, Shoptaw S, Majewska D Baclofen as a cocaine anti-craving medication a preliminary clinical study 0etter). Neuropsychopharmacology 18 403 04, 1998... 

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