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Gary Astonjones - One of the best experts on this subject based on the ideXlab platform.
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orexin hypocretin 1 receptor antagonist reduces Heroin self administration and cue induced Heroin seeking
European Journal of Neuroscience, 2012Co-Authors: Rachel J Smith, Gary AstonjonesAbstract:The orexin / hypocretin system is involved in several addiction-related behaviors. The present experiments examined the involvement of orexin in Heroin reinforcement and relapse by administering the orexin 1 receptor antagonist SB-334867 prior to Heroin self-administration or prior to cue- or Heroin-induced reinstatement of extinguished Heroin seeking in male Sprague Dawley rats. SB-334867 (30 mg/kg, i.p.) reduced Heroin intake during self-administration under fixed ratio-1 (FR-1) and progressive ratio (PR) schedules. SB-334867 also attenuated reinstatement of Heroin seeking elicited by cues, but not reinstatement elicited by a Heroin prime. These results indicate that orexin antagonism reduces Heroin self-administration, and they support a role for orexin in cue-triggered drug relapse.
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orexin hypocretin 1 receptor antagonist reduces Heroin self administration and cue induced Heroin seeking
European Journal of Neuroscience, 2012Co-Authors: Rachel J Smith, Gary AstonjonesAbstract:The orexin/hypocretin system is involved in several addiction-related behaviors. In the present experiments, we examined the involvement of orexin in Heroin reinforcement and relapse by administering the orexin 1 receptor antagonist SB-334867 prior to Heroin self-administration or prior to cue-induced or Heroin-induced reinstatement of extinguished Heroin seeking in male Sprague Dawley rats. SB-334867 (30 mg/kg, intraperitoneal) reduced Heroin intake during self-administration under fixed ratio-1 and progressive ratio schedules. SB-334867 also attenuated reinstatement of Heroin seeking elicited by cues, but not reinstatement elicited by a Heroin prime. These results indicate that orexin antagonism reduces Heroin self-administration, and they support a role for orexin in cue-triggered drug relapse.
Rachel J Smith - One of the best experts on this subject based on the ideXlab platform.
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orexin hypocretin 1 receptor antagonist reduces Heroin self administration and cue induced Heroin seeking
European Journal of Neuroscience, 2012Co-Authors: Rachel J Smith, Gary AstonjonesAbstract:The orexin / hypocretin system is involved in several addiction-related behaviors. The present experiments examined the involvement of orexin in Heroin reinforcement and relapse by administering the orexin 1 receptor antagonist SB-334867 prior to Heroin self-administration or prior to cue- or Heroin-induced reinstatement of extinguished Heroin seeking in male Sprague Dawley rats. SB-334867 (30 mg/kg, i.p.) reduced Heroin intake during self-administration under fixed ratio-1 (FR-1) and progressive ratio (PR) schedules. SB-334867 also attenuated reinstatement of Heroin seeking elicited by cues, but not reinstatement elicited by a Heroin prime. These results indicate that orexin antagonism reduces Heroin self-administration, and they support a role for orexin in cue-triggered drug relapse.
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orexin hypocretin 1 receptor antagonist reduces Heroin self administration and cue induced Heroin seeking
European Journal of Neuroscience, 2012Co-Authors: Rachel J Smith, Gary AstonjonesAbstract:The orexin/hypocretin system is involved in several addiction-related behaviors. In the present experiments, we examined the involvement of orexin in Heroin reinforcement and relapse by administering the orexin 1 receptor antagonist SB-334867 prior to Heroin self-administration or prior to cue-induced or Heroin-induced reinstatement of extinguished Heroin seeking in male Sprague Dawley rats. SB-334867 (30 mg/kg, intraperitoneal) reduced Heroin intake during self-administration under fixed ratio-1 and progressive ratio schedules. SB-334867 also attenuated reinstatement of Heroin seeking elicited by cues, but not reinstatement elicited by a Heroin prime. These results indicate that orexin antagonism reduces Heroin self-administration, and they support a role for orexin in cue-triggered drug relapse.
John Strang - One of the best experts on this subject based on the ideXlab platform.
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s50 understanding Heroin overdose a study of the acute respiratory depressant effects of injected pharmaceutical Heroin
Thorax, 2015Co-Authors: Caroline J Jolley, Jimmy D. Bell, Gerrard F Rafferty, John Moxham, John StrangAbstract:Introduction and objectives Opioids are respiratory depressants and Heroin/opioid overdose is a major contributor to the excess mortality of Heroin addicts. The individual and situational variability of respiratory depression caused by intravenous Heroin is poorly understood. The aim of this study was to use advanced physiological monitoring to follow the time course and severity of acute opioid-induced respiratory depression. Methods 10 patients (9/10 with chronic airflow obstruction) undergoing supervised injectable opioid treatment for Heroin addiction received their usual prescribed dose of injectable opioid (diamorphine or methadone) (IOT), and their usual prescribed dose of oral opioid (methadone or sustained release oral morphine) after 30 min. The main outcome measures were pulse oximetry (SpO 2 %), end-tidal CO 2 % (ETCO 2 %) and neural respiratory drive (NRD) (quantified using parasternal intercostal muscle electromyography). Significant respiratory depression was defined as absence of inspiratory airflow >10s, SpO 2 % 10s and ETCO 2 % per breath >6.5%. Results ETCO 2 % indicated significant respiratory depression following IOT in 8/10 patients, with levels increasing from baseline 4.7 (4.5 to 5.4)% to 5.4 (5.1 to 5.7)% at 30 min, p = 0.01. The median (range) peak ETCO 2 % per breath was 6.9% (5.2 to 7.8). In contrast, SpO 2 % indicated significant respiratory depression in only 4/10 patients, with small absolute changes in SpO 2 % from 96.5 (95.1 to 99.2)% at baseline to 96.2 (95.2 to 97.0%) at 30 min. A non-significant decline in NRD from baseline (109.5 (69.5 to 185.1) a.u.) to 30 min post IOT 84.3 (59.2 to 118.1) a.u., p = 0.12) was also observed. Baseline NRD and opioid-induced drop in SpO 2 % were inversely related (r = -0.67, p = 0.04). Conclusion Significant acute respiratory depression is commonly induced by opioid drugs prescribed to treat opioid addiction. Hypoventilation is reliably detected by capnography, but not by SpO 2 % alone. Chronic suppression of NRD in the presence of underlying lung disease may be a risk factor for acute opioid-induced respiratory depression.
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understanding Heroin overdose a study of the acute respiratory depressant effects of injected pharmaceutical Heroin
PLOS ONE, 2015Co-Authors: Caroline J Jolley, Jimmy D. Bell, Gerrard F Rafferty, John Moxham, John StrangAbstract:Opioids are respiratory depressants and Heroin/opioid overdose is a major contributor to the excess mortality of Heroin addicts. The individual and situational variability of respiratory depression caused by intravenous Heroin is poorly understood. This study used advanced respiratory monitoring to follow the time course and severity of acute opioid-induced respiratory depression. 10 patients (9/10 with chronic airflow obstruction) undergoing supervised injectable opioid treatment for Heroin addiction received their usual prescribed dose of injectable opioid (diamorphine or methadone) (IOT), and their usual prescribed dose of oral opioid (methadone or sustained release oral morphine) after 30 minutes. The main outcome measures were pulse oximetry (SpO2%), end-tidal CO2% (ETCO2%) and neural respiratory drive (NRD) (quantified using parasternal intercostal muscle electromyography). Significant respiratory depression was defined as absence of inspiratory airflow >10s, SpO2% 10s and ETCO2% per breath >6.5%. Increases in ETCO2% indicated significant respiratory depression following IOT in 8/10 patients at 30 minutes. In contrast, SpO2% indicated significant respiratory depression in only 4/10 patients, with small absolute changes in SpO2% at 30 minutes. A decline in NRD from baseline to 30 minutes post IOT was also observed, but was not statistically significant. Baseline NRD and opioid-induced drop in SpO2% were inversely related. We conclude that significant acute respiratory depression is commonly induced by opioid drugs prescribed to treat opioid addiction. Hypoventilation is reliably detected by capnography, but not by SpO2% alone. Chronic suppression of NRD in the presence of underlying lung disease may be a risk factor for acute opioid-induced respiratory depression.
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emergency naloxone for Heroin overdose
BMJ, 2006Co-Authors: John Strang, Michael Kelleher, David Best, Soraya Mayet, Victoria ManningAbstract:Competing interests: None declared. Summary of good practice with take-home naloxone and extra references w1-w7 are on bmj.com
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Heroin is more than just diamorphine
Addiction Research, 1997Co-Authors: John Strang, Laura KingAbstract:Heroin isn't just Heroin anymore. Over the last two decades, there has been diversification in the forms and ‘brands’ of Heroin which exist in both the domestic as well as international marketplaces. Closer examination reveals important differences between these ‘brands’. Black market Heroin may now be obtained in either the form of salt (hydrochloride) or the separated base. Importantly, the different forms have different suitabilities for use by injection or by ‘chasing the dragon’, with the salt form being most suitable for injecting, whilst many of the base forms are either used by ‘chasing’ or are chemically transformed to the salt before injection. Country of origin and obvious physical characteristics such as colour are strong predictors of ‘salt’ or ‘base’ status. When consideration is given to the more recent technique of chasing the dragon, a new interpretation can be attached to some of the other drugs found in samples of black market Heroin (often described as ‘impurities’). New data have iden...
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frequency of non fatal Heroin overdose survey of Heroin users recruited in non clinical settings
BMJ, 1996Co-Authors: Michael Gossop, Beverly Powis, Paul Griffiths, Sara Williamson, John StrangAbstract:Heroin users are at risk of overdose, sometimes with fatal consequences. Studies have examined accident and emergency room data1 and recorded deaths,2 though such figures underestimate the full extent to which overdoses occur and are only a rough indicator of the prevalence of overdose among drug takers. A recent Australian study reported that about two thirds of a sample of Heroin injectors had taken an overdose.3 The present study describes the frequency of drug overdose and the factors related to overdose among Heroin users recruited in non-clinical settings. During 1994, 438 Heroin users were contacted and interviewed by privileged access interviewers4 as part of a study of early and episodic Heroin users. Information on demographics, patterns of drug use, and overdose was collected by structured interviews. Onset of Heroin use was comparatively recent for many of our sample (11% were in the first year of Heroin use and 48% in the first three years of use), and …
Luis Sordo - One of the best experts on this subject based on the ideXlab platform.
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predictors of non use of illicit Heroin in opioid injection maintenance treatment of long term Heroin dependence
Addictive Behaviors, 2015Co-Authors: Eugenia Oviedojoekes, Luis Sordo, Daphne Guh, David C Marsh, Kurt Lock, Suzanne BrissetteAbstract:Abstract Aims To investigate baseline and concurrent predictors of non-use of illicit Heroin among participants randomized to injectable opioids in the North American Opiate Medication Initiative (NAOMI) clinical trial. Methods NAOMI was an open-label randomized controlled trial comparing the effectiveness of injectable diacetylmorphine and hydromorphone for long-term opioid-dependency. Outcomes were assessed at baseline and during treatment (3, 6, 9, 12 months). Days of non-use of illicit Heroin in the prior month at each follow-up visit were divided into three categories: Non-use; Low use (1 to 7 days) and High use (8 days or more). Tested covariates were: Sociodemographics, Health, Treatment, Drug use and illegal activities. Mixed-effect proportional odds models with random intercept for longitudinal ordinal outcomes were used to assess the predictors of the non-use of illicit Heroin. Results 139 participants were included in the present analysis. At each follow-up visit, those with non-use of illicit Heroin represented 47.5% to 54.0% of the sample. Fewer days of cocaine use (p = 0.074), fewer days engaged in illegal activities at baseline (p Conclusions The independent effect of several concurrent factors besides the injection of opioid dose suggests benefits from the clinic that go beyond the provision of the medication alone. Thus, this supervised model of care presents an opportunity to maximize the beneficial impact of medical and psychosocial components of the treatment on improving outcomes associated with non-use of illicit Heroin.
Eugenia Oviedojoekes - One of the best experts on this subject based on the ideXlab platform.
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predictors of non use of illicit Heroin in opioid injection maintenance treatment of long term Heroin dependence
Addictive Behaviors, 2015Co-Authors: Eugenia Oviedojoekes, Luis Sordo, Daphne Guh, David C Marsh, Kurt Lock, Suzanne BrissetteAbstract:Abstract Aims To investigate baseline and concurrent predictors of non-use of illicit Heroin among participants randomized to injectable opioids in the North American Opiate Medication Initiative (NAOMI) clinical trial. Methods NAOMI was an open-label randomized controlled trial comparing the effectiveness of injectable diacetylmorphine and hydromorphone for long-term opioid-dependency. Outcomes were assessed at baseline and during treatment (3, 6, 9, 12 months). Days of non-use of illicit Heroin in the prior month at each follow-up visit were divided into three categories: Non-use; Low use (1 to 7 days) and High use (8 days or more). Tested covariates were: Sociodemographics, Health, Treatment, Drug use and illegal activities. Mixed-effect proportional odds models with random intercept for longitudinal ordinal outcomes were used to assess the predictors of the non-use of illicit Heroin. Results 139 participants were included in the present analysis. At each follow-up visit, those with non-use of illicit Heroin represented 47.5% to 54.0% of the sample. Fewer days of cocaine use (p = 0.074), fewer days engaged in illegal activities at baseline (p Conclusions The independent effect of several concurrent factors besides the injection of opioid dose suggests benefits from the clinic that go beyond the provision of the medication alone. Thus, this supervised model of care presents an opportunity to maximize the beneficial impact of medical and psychosocial components of the treatment on improving outcomes associated with non-use of illicit Heroin.