Versus Abuse

The Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision (DSM-IV-TR American Psychiatric Association, 2000) specifies that the symptoms of substance-related disorders may include tolerance withdrawal loss of control unsuccessful efforts to cut down or quit a great deal of time committed to finding, using, or recovering from using substances impairment in specific areas of one s life and continued use in spite of negative consequences. To meet criteria for dependence, the individual must have three or more of these 

Note The slope of this graph is merely to show the relative number of people who abstain, use drugs, or have drug problems, in order to provide some perspective. 

A person can meet criteria for abuse or dependence for one drug and not others, although there is concern about what has been referred to as cross-addiction. Cross-addiction means that a person who is dependent upon one substance may be dependent upon another, very similar one. An example might be a person who is diagnosed as dependent upon tranquilizers and who, you may fear, is also addicted to a similar substance such as alcohol. However, the research is not entirely clear on whether cross-addiction occurs, and I have known clients who had very specific problems with one substance who did not generalize into problems with other, similar substances. A person also may meet criteria for abuse or dependence for multiple substances generally, this is referred to more simply as substance abuse or substance dependence. 

---

These potential effects are impacted by such factors as circumstances of use (e.g., medical use supervised by medical professionals versus abuse), dosage, and route of administration. In general, effects increase as drug potency increases. The onset of these effects ranges from an immediate response to the drug to the user experiencing the impact 30-60 minutes later. The duration of their effects lasts from three to seven hours. 

The RISC versus CISC conundmm has led to the much abused and ultimately extremely confusiag term MIPS (millions of iastmctions per second). Measures of performance that can be more directiy related to a computer s abiUty to perform usehil work should always be preferred over machine MIPS. The throughput of a computer is a function of the number of iastmctions to be executed, the average number of iastmctions that can be executed per clock cycle, and the time per clock cycle. 

J Consult Clin Psychol 61 1100—1104, 1993 Stephens RS, Roffman RA, Simpson EE Treating adult marijuana dependence a test of the relapse prevention model. J Consult Clin Psychol 62 92—99, 1994 Stephens RS, Roffman RA, Curtin L Comparison of extended versus brief treatments for marijuana use. J Counsul Clin Psychol 68 898—908, 2000 Substance Abuse and Mental Health Services Administration The BASIS Report Marijuana Treatment Admissions Increase 1993-1999. Rockville, MB, Substance Abuse and Mental Health Services Administration, 2002a Substance Abuse and Mental Health Services Administration Results from the 2001 National Household Survey on Brug Abuse Vol I. Summary of National Findings. Rockville, MB, Substance Abuse and Mental Health Services Administration, 2002b... 

Kalman D, Hayes K, Colby SM, et al Concurrent versus delayed smoking cessation treatment for persons in early alcohol recovery a pilot study. J Subst Abuse Treat 20 233-238, 2001... 

Langenbucher J, Martin CS, Labouvie E, Sanjuan PM, Bavly L and Pollock NK (2000). Toward the DSM-V The withdrawal-gate model versus the DSM-IV in the diagnosis of alcohol abuse and dependence. Journal of Consulting and Clinical Psychology, 68, 799-809. 

Straterra is the first new chemical entity approved to treat ADHD in over 30 years, and it has major advantages over the stimulant medications in that it has been clinically demonstrated to have no abuse liability. The nonstimulant mechanism of action also appears to come with some caveats in terms of efficacy versus the stimulants. Synthetically, the main challenge within this molecule is installing the chiral center, which is... 

The visual hallucinations are often composed of extremely vivid colors of geometric patterns, such as cones, spirals, or cobweb-Uke structures. Other types of hallucinations are possible. A true hallucination involves the belief by the individual that the (altered) sensations and perceptions actually represent reality. However, generally the person abusing LSD and related drugs retains the ability to test reality versus illusion and knows that the experience is not real. Thus, the... 

TABLE 12-1. Medical users versus nonmedical users and/or abuses of benzodiazepine (BZD)... 

BASIC NEUROBIOLOGY OF DRUG ABUSE DEPENDENCE VERSUS ADDICTION... 

This method involves preparation of a standard curve by equilibration of a specific amount of dry standard material in duplicate or triplicate over different saturated salt solutions. The standard curve is a plot of aw versus water content of the standard material. The standard must be stable during reuse of the material, and the chamber used should be exactly the same as will be used later. For the measurement, the size of each standard should be in a controlled narrow range, (e.g., —1.6 0.1 g). Once the standard curve is made, dry aliquots of the same mass of standard are equilibrated over a large quantity of the food material (-10 to 20 g). The moisture content of the standard material is then measured (e.g., by mass gain) and aw is estimated from the standard curve (Vos and Labuza, 1974). This method avoids preparation or storing of saturated salts for each determination moreover, use of a standard shortens the equilibration, thus requiring less time for measurement, and less abuse of temperature for sample as well as standard. 

A final area of difficulty is in the application of data analysis to specific models of adsorption isotherms. This difficulty results from the fact that different models for adsorption isotherms generate plots of surface versus dissolved concentration that have characteristic shapes. If a plot of observational data results in a curve with a shape similar to that generated by a model, this result is often taken as proof that the particular model applies. Unfortunately, this assumption has been made for situations where many of the basic requirements of the model are violated in the system under study. The Langmuir adsorption isotherm model has suffered considerable abuse by geochemists in this regard. It should be remembered that "shapes" of adsorption isotherms are far from proof that a specific model applies. 

Plasma zinc levels are commonly decreased in the elderly (Gil). These authors reported mean ( SD) plasma levels in normal young adults at 12.7 ( 1.4) mmol/liter versus 10.5 ( 4.7) mmol/liter in the elderly intracellular levels (neutrophils) were 1.26 ( 0.28) and 0.95 ( 0.26) nmol/mg protein, respectively. This deficiency is most often due to lack of dietary lean meat, poultry, and fish. As a result, zinc intake is frequently less than the minimum recommended intake of 15 mg/day. Moreover, Zn deficiency is particularly common in individuals with diabetes mellitus, liver and renal diseases, malabsorption, alcohol abuse, and those taking diuretic medications (K13). Interestingly, many of the signs and symptoms of Zn deficiency are the same as those often attributed to the aging process (Table 3). 

Methylphenidate shares the pharmacological properties and the abuse potential of the amphetamines. When given intravenously, it activates psychotic symptoms in schizophrenic patients if administered during the active phase of their illness, but not after remission. It failed to produce a psychotic reaction in most manic or depressed patients or in healthy subjects (27). Adults with childhood-onset ADHD had an earlier onset of psychoactive substance use disorders, independent of any psychiatric co-morbidity (33). However, bipolar disorders conferred a significantly increased risk for early onset psychoactive substance use disorders independent of ADHD. The question arises as to the contribution of stimulant treatment to psychoactive substance use disorders. There were no differences in medicated versus unmedicated adolescents with ADHD in a review of eight outcome studies comprising 580 adolescents briefly treated with stimulants for six months to five years (34). 

Fortun J, Navas E, Martinez-Beltran J, Perez-Molina J, Martin-Davila P, Guerrero A, Moreno S. Short-course therapy for right-side endocarditis due to Staphylococcus aureus in drug abusers cloxacilhn versus glycopeptides in combination with gentamicin. Clin Infect Dis 2001 33(l) 120-5. 

---