WITHDRAW Project

The WITHDRAW Project was established to offer a clinical psychological service to people who wanted to withdraw from tranquillisers. It is unique in that it has a research study running parallel with it which allows for the research findings to influence the development of the clinical service and for clinical impressions to be investigated by research. It aims to identify those people who may successfully withdraw from tranquillisers, to assess the severity of the psychological problems before and after treatment, and to evaluate the WITHDRAW three-tier model of intervention. 

Further details on managing withdrawal can be found in the leaflet Gently does it (WITHDRAW Project 1987). 

WITHDRAW Project (1986) Aspects of Withdrawal from Benzodiazepines— A guide for those who work with tranquilliser withdrawal, WITHDRAW Project, North Birmingham Health Authority. 

Diane Hammersley is a Psychologist with the Community Centre for Addiction in Birmingham, working on the WITHDRAW Project. 

Brown, J.G., and Eychaner, J.H., 1988. Simulation of five ground-water withdrawal projections for the Black Mesa area, Navajo and Hopi Indian Reservations, Arizona. U.S. Geol. Survey Water-Resources Invest., 88-4000, 51 pp. 

Monitor for subsidence from fluid withdrawal projects... 

Typically, funding to embark on information and/or knowledge management initiatives within the life sciences only occurs after a serious failure within the business, such as a project failure or a withdrawal of a medicine from the market. Recently, COX-2 programs across the industry are under close scrutiny since the highly publicized withdrawal of Vioxx [10]. Of course, there has been no withdrawal of aspirin, paracetamol, alcohol, or tobacco products, which are well known as toxic. 

Both electron-withdrawing and -donating substituents Z on the aromatic nucleus afforded smooth conversion and similar enantioselectivity despite the projected difference in indole nucleophilicity. 

The cells comprising lamina V are more diverse than those of lamina IV and their dendrites extend vertically toward the superficial layers. Cell bodies in lamina V contribute to three projection pathways, the SCT, PSDC and STT. However, the STT cells appear to be predominant in this lamina. Lamina V plays an important role in nociception since it receives both A - and C-fibre inputs. Some cells in lamina V also respond to cutaneous low- and high-threshold mechanical stimuli and receive nociceptive inputs from the viscerae. Many of these neurons also project onto mononeurons and so act as interneurons in the polysynaptic withdrawal reflex to noxious stimuli. 

In summary, when undertaking a project such as the recovery of LNAPL, treatment of the coproduced water, prior to reinjection, may not be beneficial or technically necessary. A large percentage of the spilled or leaked petroleum hydrocarbon (40 to 60%) will be retained in the unsaturated zone as residual saturation. This residual hydrocarbon cannot be recovered by conventional withdrawal techniques. Without removing this continual source of contamination to the groundwater system, dissolved contamination will continue. Therefore, in most cases, it may be pointless and extremely costly to treat the coproduced groundwater prior to reinjection while the free- and residual-phase hydrocarbon contamination exists. 

Carboni and colleagues have reported that mecamylamine-precipitated withdrawal of nicotine increases DA overflow in the prefrontal cortex and have suggested that this increase in DA overflow may also contribute to the aversive consequences of abrupt nicotine withdrawal (Carboni et al. 2000). This response to nicotine withdrawal is not a universal finding since Hildebrand and colleagues failed to observe any changes in DA overflow in the prefrontal cortex following mecamylamine-precipitated withdrawal (Hildebrand et al. 1998). Thus, again, the putative role of these mesocortical projections in the behavioural responses to nicotine withdrawal remains unproven. 

Heimer L, Zahm DS, ChurchUl L, Kalivas PW, Wohltman C (1991) Specificity in the projection patterns of accumbal core and medial shell in the rat. Neuroscience 41 89-125 Hemby SE, No C, Koves TR, Smith JE, Dworkin SI (1997) Differences in extracellular dopamine concentration in the nucleus accumbens during response-dependent and response-independent cocaine administration in the rat. Psychopharmacology 133 7-16 Hildebrand BE, Nomikos GG, Hertel P, Sclrilstrom B, Svensson TH (1998) Reduced dopamine output in the nucleus accumbens but not the prefrontal cortex in rats displaying mecamylamine-precipitated nicotine withdrawal syndrome. Brain Res 779 214-225 Ikemoto S (2003) Involvement of the olfactory tubercle in cocaine reward intracranial selfadministration studies. J Neurosd 23 9305-9311... 

Balfour DJ (2002) Neuroplasticity within the mesoaccumbens dopamine system and its role in tobacco Dependence, Curr Drug Targets CNS Neurol Disord 1 413-21 Balfour DJ (2004) The neurobiology of tobacco dependence a preclinical perspective on the role of the dopamine projections to the nucleus accumbens. Nicotine Tob Res 6 899-912 Barik J, Wonnacott S (2006) Indirect modulation by alpha7 nicotinic acetylcholine receptors of noradrenaline release in rat hippocampal slices interaction with glutamate and GABA systems and effect of nicotine withdrawal. Mol Pharmacol 69 618-628... 

The first words of this book are devoted to my friend Dr Steve Pask, who had urged me to undertake its writing in collaboration with him, which I eventually did. His contributions include much of the text and some valuable constructive criticism, and it was to the great regret of both of us that circumstances forced him to withdraw from the project. Without him this book would never have come to be. However, I alone take responsibility for what it is now. 

When a clinical trial involving placebo or no-treatment control (see Box 5.2) is undertaken, the researcher and the IRB are obliged to ensure that patients or authorized third parties are fully informed about any therapy withdrawn or withheld for purposes of the research project, about the anticipated consequences of withdrawing or withholding the therapy and about the reasons why investigators deem a placebo-controlled trial to be necessary. 

Blenheim Project (1982) How to Stop (A Do-It-Yourself Guide to Opiate Withdrawal), London Blenheim Project. 

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