Polysubstance abuse

Liu X, Matochik JA, Cadet JL, London ED. (1998). Smaller volume of prefrontal lobe in polysubstance abusers a magnetic resonance imaging study. Neuropsychopharmacology. 18(4) 243-52. 

The efficacy of acamprosate in promoting abstinence has not been demonstrated in subjects who have not undergone detoxification and not achieved alcohol abstinence prior to beginning acamprosate treatment. The efficacy of acamprosate in promoting abstinence from alcohol in polysubstance abusers has not been adequately assessed. 

Loof et al. (1995) reported the use of carbamazepine (300-1200 mg/day, serum levels 10-11.5 pg/mL) in 28 children and adolescents with sexual abuse histories. By treatment end, 22 of 28 patients were asymptomatic of PTSD. The remaining six were significantly improved in all PTSD symptoms except for continued abuse-related nightmares. Half of this cohort had com-orbid ADHD, depression, ODD or polysubstance abuse and were treated with concomitant medications, e.g., methylphenidate, clonidine, sertraline, fluoxetine, or imipramine. 

Persico, Antonio M., David J. Vandenbergh, Stevens S. Smith, and George R. Uhl. 1993. "Dopamine Transporter Gene Polymorphisms Are Not Associated with Polysubstance Abuse." Biological Psychiatry 34 265-67. 

Smith, Stevens S., Bruce F. O Hara, Antonio M. Persico, David A. Gorelick, David B. Newlin, David Vlahov, Liza Solomon, Roy Pickens, and George R. Uhl. 1992. "Genetic Vulnerability to Drug Abuse The D2 Dopamine Receptor Taq I B1 Restriction Fragment Length Polymorphism Appears More Frequently in Polysubstance Abuse." Archives of General Psychiatry 49 723-27. 

Vandenbergh, David J., Lawrence A, Rodriguez, Ivan T. Miller, George R. Uhl, and Herbert M. Lachman. 1997a. "High-Activity Catechol-O-Methyltrans-ferase Allele Is More Prevalent in Polysubstance Abusers." American journal of Medical Genetics 74 439-42. 

Nagle, Jeanne. Polysubstance Abuse. New York Rosen Publishing Group, Inc., 2000. 

A 46-year-old white man with a history of polysubstance abuse took for zolpidem for 2 years and gradually increased the total dosage to about 400 mg/day in divided doses he was detoxified using a standard benzodiazepine 7-day diazepam tapering regimen (37). 

A rare case of polysubstance abuse, which unmasked myasthenia and caused complete external ophthalmoplegia, has been reported (140). 

Risk of dependence, particularly for treatment periods longer than 12 weeks and especially in patients with past or current polysubstance abuse... 

A 24-year-old woman, with a history of polysubstance abuse and extensive psychiatric history, presented with acute opioid overdose caused by the intentional oral ingestion of a fentanyl patch (Duragesic) (74). 

Treatment of the Polysubstance Abuser Treatment of Dual-Diagnosis Patients Relapse... 

In this section we discuss three topics that we think are important and tliat apply to botli alcohol and drug treatment. The first is treatment of the polysubstance abuser, or the person who uses more than one drug. We then briefly review the treatment of dual-diagnosis patients and especially how such treatment involves the use of psychotropic medication. The last topic is relapse (see Figure 15.1), which has challenged alcohol and drug treatment providers for many years. 

Zhang PW, Ishiguro H, OhtsukiT et al (2010) Human cannabinoid receptor 1 5 exons, candidate regulatory regions, polymorphisms, haplotypes and association with polysubstance abuse. Mol Psychiatry 9 916-931... 

Persico AM, Bird G, Gabbay FH, Uhl GR (1996) D2 dopamine receptor gene TaqI Al and B1 restriction fragment length polymorphisms enhanced frequencies in psychostimulant-preferring polysubstance abusers. Biol Psychiatry 40 776-784... 

The methods described here outline analysis of the structure of the CBr gene, protein expression, molecular genomic and expression studies, polymorphisms, haplotypes, and association with polysubstance abuse. 

Analysis of CB1r Gene and Genetic Variation in Polysubstance Abuse... 

Polysubstance abusers and controls are collected from research volunteers of each population recruited from the same area. This reduces the risk of stratification problems in each group of subjects. Postmortem brain subjects are obtained from Brain Bank for RNA/cDNA analysis, with careful evaluation for their quality that depend on postmortem interval (PMl), pH and 28S/18S, as well as their age, sex, ethnicity, cause of death, etc. 

Linkage studies are performed in family samples that have an inherited pattern of polysubstance abuse phenotype. 

Genotyping data for individuals in famihes are analyzed with computer linkage software (e.g., GENEHUNTER) to evaluate linkages to chromosomal regions that contribute genetically to polysubstance abuse. 

The fine mapping of the CBi gene improves the understanding of CBi gene association with polysubstance abuse. 

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