The“1＋1”Therapy for Drug Addicts

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In a Rehabilitation Center for Drug Addicts

WHEN China opens its doors to the outside world, fresh air comes in. So do flies. While drug addicts were unknown in China for 30 years, there are now reports of drug users and their related crimes. In an effort to abolish drug abuse in China, rehabilitation centers are being set up throughout the country to give medical aid to drug users trying to kick the habit. These photos were taken in a rehabilitation center in a small town in Gansu Province in the northwestern part of China.

A Visit to the Rehabilitation Center for Drug Addicts

TWENTY-four-year-old Mu Li has come to the rehabilitation center in Tianjin of her own free will. After a year on drugs, she now wants to quit. This is her second time being hospitalized. The first time, she stayed for 20 days in the center. Not long after she was discharged, however, she was on drugs again. So she came back to the center, begging to be hospitalized again. The Tianjin Rehabilitation Center for Drug Addicts (TRCDA) where Mu Li is being treated was established in 1992, although cases of drug abuse were then still rare in the city. However, with the increasing rate of drug abuse in

Review of pathological index detection and new rehabilitation technique of drug addicts

There are two major research issues with regard to detoxification;one is pathological testing of drug users and the other is rehabilitation methods and techniques.Over the years,domestic and foreign researchers have done a lot of work on pathological changes in the brain and rehabilitation techniques for drug users.This article discusses the research status of these two aspects.At present,the evaluation of brain function in drug addicts is still dominated by a single electroencephalography(EEG),nearinfrared spectroscopy(NIRS),or magnetic resonance imaging scan.The multimodal physiological data acquisition method based on EEG–NIRS technique is relatively advantageous for actual physiological data acquisition.The traditional drug rehabilitation method is based on medication and psychological counseling.In recent years,psychological correction(e.g.,emotional ventilation,intelligent physical and mental decompression,virtual reality technique and drug addiction suppression system,sports training,and rehabilitation)and physical therapy(transcranial magnetic stimulation)have gradually spread.These rehabilitations focus on comprehensive treatment from the psychological and physical aspects.In recent years,new intervention ideas such as brain–computer interface technique have been continuously proposed.In this review,we have introduced multimodal brain function detection and rehabilitation intervention,which have theoretical and practical significance in drug rehabilitation research.

Effect of Ultrasound-Guided Transversus Abdominis Plane Block Combined with Lornoxicam on Pain and Recovery Quality After Abdominal Surgery in Patients with Drug Addiction

Objective:This paper aims to analyze the analgesic effect of ultrasound-guided transversus abdominis plane block(TAPB)combined with non-steroidal anti-inflammatory analgesic drug lornoxicam on abdominal surgery in patients with a history of drug addiction.Methods:32 patients aged 18-60 who underwent lower abdominal surgery in the First People's Hospital of Liangshan Yi Autonomous Prefecture and Butuo County People's Hospital of Liangshan Yi Autonomous Prefecture from January 2022 to March 2023 were selected,the patients must have drug abuse history for more than 1 year,with a history of drug withdrawal and relapse.The patients were divided into observation group and control group by the envelope method,with 16 cases in the observation group and 16 cases in the control group.Two groups of patients underwent ultrasound-guided bilateral transversus abdominis plane block after the operation.The observation group was treated with dexmedetomidine hydrochloride 1μg/kg+0.25%ropivacaine hydrochloride 40ml,and the control group was treated with 40ml 0.9%sodium chloride injection,the two groups of patients returned to the ward after operation and given intravenous infusion of lornoxicam for relieving the pain.The visual analogue scale(VAS)score of postoperative pain,the times of rescue analgesia,the time of postoperative anal exhaust,the time of ambulation,nausea and vomiting,withdrawal symptoms,related adverse reactions,and hospitalization days were compared between the two groups.Results:The VAS score of postoperative pain in the observation group was significantly lower than that in the control group,P<0.05.Patients in the observation group used less postoperative rescue analgesics than those in the control group,P<0.05.For postoperative anal exhaust time,the difference between the two groups of patients was relatively small,and the time in the observation group was shorter,P>0.05.The time to get out of bed and the length of hospital stay were not significantly different between the control group and the observation group,P>0.05.The withdrawal symptoms of the patients in the observation group were better,P<0.05,nausea and vomiting,and other adverse reactions were lower in the control group,P<0.05.Conclusion:Ultrasound-guided transversus abdominis plane block combined with lornoxicam can be used to relieve pain in abdominal surgery for patients with drug addiction,which can effectively improve the therapeutic effect of patients and reduce the number of postoperative rescue analgesia.Thus,it has high clinical application value.

KAP Survey of Turkish University Students on Sexuality,reproductive Health,Drug Addiction and Violence

Objective To investigate the attitudes, behaviours and reflections of the university students, on sexuality, reproductive health, violence, smoking, alcohol and drug use, and to find out their expectations from a youth health service. Methods A total of 5 300 students （1 880 girls, 3 420 boys）from various Jaculties of Kyrykkale University were enrolled into this cross-sectional study. Students completed the self-administered questionnaire as one of the researchers was present at the classroom. Research monitors five categories of priority health-risk behaviours among youth and young adults. Results Mean age of 3 420 male （64.5%） and 1 880female （35.5%） students were 20.3 years. Among all 4 380 （82,9%） students [1 350 girls （71.8%）, 3 030 boys （88.5%）] had some kinds of information about sexuality, however this dropped to 2 730 students （51.5%） within the context of adequacy. Friends were the major source （34%） for the first information on sexuality. Using a condom was the mostly heard method of contraception （46.9%） and interestingly 1.1% of the students had no knowledge on any of the protection methods. Among all 25.3% of the students （33.0% boys, 11.4% girls） had some kind of sexual intercourse, and within this group 58.8% experienced his/her first sexual relationship at 18 years of age and over; 53.9% were protected in all intercourses. Using a condom was the main way of protection for boys （63.7%） and pills were for the girls （73.9%）. None of the female students mentioned having an abortion but 8% had friends who had undergone abortion. Tobacco use was 35.1% among the group, and 8. 7% of the male and 3.6% of the female students were using drugs. Although 67. 4% students claimed they never witnessed violence between their parents, 43.2% witnessed violence among their siblings, 67.0% beween friends, 72.6% in the streets and 64.2% in the school. About 30.0% of the students reported having weight problems, and 14.7% admitted visiting a doctor for that problem. If there would be a service providedfor the adolescents in the university, 67% of the students would attend in case of a problem. Past experiences were important for us and we saw that among all 8% of the participants had some kind of sexual problem, within this group 50.7% felt uncomfortable during the visit and only 60.4% were satisfied with the care of the physician. Conclusion Our study results show the current situation of adolescents in Kyrykkale University and will be used to improve policies and programs to reduce priority healthrisk behaviours among youth of our and surrounding provinces and establish a youth friendly service in Kyrykkale University within this purposes.

Non-human primate models in drug addiction deserve more attention

Dear Editor, The process of relapse involves firm or aberrant memories of environmental cues associated with drug craving or addiction. To date, it is not known where these memories are stored in the brain, what kinds of regulatory biological factors or molecules are involved, nor why it is so difficult to stop addiction psychologically. Currently, rodent animal models, such as the self-administration and conditioning place preference / aversion paradigm are still widely used in the studies of drug withdrawal syndromes or drug-associate memories. However, the differences between humans and rodents--particularly in terms of genetics, and pathology and pharmacology--have significantly limited the application of further studies on this topic. Essentially, rodents lack the longterm or life-time memories humans possess and lose their drug-associated memory only after a few weeks of withdrawal.

Incidence of Interpersonal Violence among Individuals with Drug Addiction Receiving Compulsory Treatment: A Survey at Two Drug Detention Centers in Hunan, China

Drug dependence is a serious global health problem.To assist individuals with drug addiction,China alone has established 678 Compulsory Detoxification Detention Centers （CDDCs） that treat over300,000i ndividuals who are required by national law to receive compulsory treatment;because community-based outpatient treatment failed.

Neurotransmitter-precursor-supplement Intervention for Detoxified Heroin Addicts

This study examined the effects of combined administration of tyrosine, lecithin, L-glutamine and L-5-hydroxytryptophan （5-HTP） on heroin withdrawal syndromes and mental symptoms in detoxified heroin addicts. In the cluster-randomized placebo-controlled trial, 83 detoxified heroin addicts were recruited from a detoxification treatment center in Wuhan, China. Patients in the intervention group （n=41） were given the combined treatment with tyrosine, lecithin, L-glutamine and 5-HTP and those in the control group （n=42） were administered the placebo. The sleep status and the withdrawal symptoms were observed daily throughout the study, and the mood states were monitored pre- and post-intervention. The results showed that the insomnia and withdrawal scores were significantly improved over time in participants in the intervention group as compared with those in the control group. A greater reduction in tension-anxiety, depression-dejection, anger-hostility, fatigue-inertia and total mood disturbance, and a greater increase in their vigor-activity symptoms were found at day 6 in the intervention group than in the control group （all P〈0.05）. It was concluded that the neurotransmitter-precursor-supplement intervention is effective in alleviating the withdrawal and mood symptoms and it may become a supplementary method for patients＇ recovery from heroin addiction.

BCI+VR Rehabilitation Design of Closed-Loop Motor Imagery Based on the Degree of Drug Addiction

After abusing drugs for long,drug users will experience deteriorated self-control cognitive ability,and poor emotional regulation.This paper designs a closed-loop virtual-reality(VR),motorimagery(MI)rehabilitation training system based on brain-computer interface(BCI)(MI-BCI+VR),aiming to enhance the self-control,cognition,and emotional regulation of drug addicts via personalized rehabilitation schemes.This paper is composed of two parts.In the first part,data of 45 drug addicts(mild:15;moderate:15;and severe:15)is tested with electroencephalogram(EEG)and near-infrared spectroscopy(NIRS)equipment(EEG-NIRS)under the dual-mode,synchronous signal collection paradigm.Using these data sets,a dual-modal signal convolutional neural network(CNN)algorithm is then designed based on decision fusion to detect and classify the addiction degree.In the second part,the MIBCI+VR rehabilitation system is designed,optimizing the Filter Bank Common Spatial Pattern(FBCSP)algorithm used in MI,and realizing MI-EEG intention recognition.Eight VR rehabilitation scenes are devised,achieving the communication between MI-BCI and VR scene models.Ten subjects are selected to test the rehabilitation system offline and online,and the test accuracy verifies the feasibility of the system.In future,it is suggested to develop personalized rehabilitation programs and treatment cycles based on the addiction degree.

Different types of drug abusers prefrontal cortex activation patterns and based on machine-learning classification

Drug addiction can cause abnormal brain activation changes,which are the root cause of drug craving and brain function errors.This study enrolled drug abusers to determine the effects of different drugs on brain activation.A functional near-infrared spectroscopy(fNIRS)device was used for the research.This study was designed with an experimental paradigm that included the induction of resting and drug addiction cravings.We collected the fNIRS data of 30 drug users,including 10 who used heroin,10 who used Methamphetamine,and 10 who used mixed drugs.First,using Statistical Analysis,the study analyzed the activations of eight functional areas of the left and right hemispheres of the prefrontal cortex of drug addicts who respectively used heroin,Methamphetamine,and mixed drugs,including Left/Right-Dorsolateral prefrontal cortex(L/R-DLPFC),Left/Right-Ventrolateral prefrontal cortex(L/R-VLPFC),Left/Right-Fronto-polar prefrontal cortex(L/R-FPC),and Left/Right Orbitofrontal Cortex(L/R-OFC).Second,referencing the degrees of activation of oxyhaemoglobin concentration(HbO2),the study made an analysis and got the specific activation patterns of each group of the addicts.Finally,after taking out data which are related to the addicts who recorded high degrees of activation among the three groups of addicts,and which had the same channel numbers,the paper classified the different drug abusers using the data as the input data for Convolutional Neural Networks(CNNs).The average three-class accuracy is 67.13%.It is of great significance for the analysis of brain function errors and personalized rehabilitation.

Resilience to the effects of social stress on vulnerability to developing drug addiction

We review the still scarce but growing literature on resilience to the effects of social stress on the rewarding properties of drugs of abuse.We define the concept of resilience and how it is applied to the field of drug addiction research.We also describe the internal and external protective factors associated with resilience,such as individual behavioral traits and social support.We then explain the physiological response to stress and how it is modulated by resilience factors.In the subsequent section,we describe the animal models commonly used in the study of resilience to social stress,and we focus on the effects of chronic social defeat(SD),a kind of stress induced by repeated experience of defeat in an agonistic encounter,on different animal behaviors(depression-and anxiety-like behavior,cognitive impairment and addiction-like symptoms).We then summarize the current knowledge on the neurobiological substrates of resilience derived from studies of resilience to the effects of chronic SD stress on depressionand anxiety-related behaviors in rodents.Finally,we focus on the limited studies carried out to explore resilience to the effects of SD stress on the rewarding properties of drugs of abuse,describing the current state of knowledge and suggesting future research directions.

Drug dependence and its risk factors in emergency department patients:A retrospective cross-sectional study

Objective:To determine the characteristics and risk factors of drug dependence among patients who were administered drugs with addictive potential(DAP)in an emergency department(ED).Methods:This retrospective cross-sectional study included patients who were administered DAP 3 or more times in the emergency room between September 1,2019 and March 1,2020.The demographic and baseline information were recorded.All the prescibed DAP,the reasons to use these drugs,secondary drug dependence,the department where DAP were first prescribed,types of doctors who preferred to prescribed DAP,and the risk factors for the development of drug dependence were determined.Results:A total of 3000 patients were screened from medical records,and among them,80 patients developed drug dependence.Drug dependence only developed for tramadol(n=57,71.3%),diazepam(n=11,13.8%),and biperiden(n=12,15.0%).Tramadol was the most frequently prescribed drug(n=57,71.3%).The most common reason for drug dependence was psychiatric disorders(n=29,36.3%).Drug dependence developed in renal colic patients due to the administration of tramadol(n=7,100%).On the contrary,dependence to biperiden were mainly developed in patients with psychiatric complaints(n=12,41.4%).The rate of secondary drug dependence was 15%(n=12).Of the Biperiden users,41.7%developed secondary drug dependence on diazepam.Most DAP were first prescribed in the ED(n=52,65%),and the specialist preferred to prescribe DAP(n=43,53.8%).For the development of dependence,the presence of renal colic(OR:3.387,95%confidence interval(CI):1.473-7.788,P=0.004)and low back pain(OR:5.778,95%CI:2.779-12.014,P<0.001)were the risk factors.Conclusions:Most DAP were first prescribed in the ED compared to other departments,and specialist are preferred to use DAP.Tramadol is the most commonly used drugs caused drug dependence.Psychiatric disorder patients are easier to develope drug dependence.Furthermore,renal colic and low back pain patients needs more attention to avert drug dependence.

A Brief Review of the Relationship between Addiction and Memory Systems

This essay will reexamine research on the relationship between human memory and addiction. This paper will review several studies that discussed how memory systems in the human brain are involved in the acquisition of behavior that is learned and is associated with the development of drug addiction and drug relapse. Additional information reveals that when individuals make the transition from recreational drug or impulsive use to compulsive drug abuse, which may result in a neuroanatomical change in areas of the brain from cognitive control guided by the hippocampus/dorsomedial striatum towards conditioned control of behavior managed by the dorsolateral striatum (DLS) [1]. This review also looked at studies that involved experiments with humans and lower animals, which suggested that the hippocampus mediates a cognitive/spatial type of memory, while the dorsal striatum manages stimulus-response (S-R) habit memory, and the amygdala governs the classical conditioning form of learning and stimulus-affective-associative relationships [1]. Overall, these studies utilize the hypothesis of the memory systems view of addiction, and the involvement of learning and memory in the context of drug addiction, which was proposed by them [2]. This theory has been proposed in response to drug addiction research and includes alcohol, amphetamine, and cocaine [1]. The research also explains how stress and anxiety can play a role in how strong emotional excitement can lead to dependent habit memory in rodents and humans [1]. .

Framework for internal sensation of pleasure using constraints from disparate findings in nucleus accumbens

It is necessary to find a mechanism that generates first-person inner sensation of pleasure to understand what causes addiction and associated behaviour by drugs of abuse.The actual mechanism is expected to explain several disparate findings in nucleus accumbens(NAc),a brain region associated with pleasure,in an interconnected manner.Previously,it was possible to derive a mechanism for natural learning and explain:(1)Generation of inner sensation of memory using changes generated by learning;and(2)Long-term potentiation as an experimental delayed scaled-up change by the same mechanism that occur during natural learning.By extending these findings and by using disparate third person observations in NAc from several studies,present work provides a framework of a mechanism that generates internal sensation of pleasure that can provide interconnected explanations for:(1)Ability to induce robust long-term depression(LTD)in NAc from naïve animals;(2)Impaired ability to induce LTD in“addicted”state;(3)Attenuation of postsynaptic potentials by cocaine;and(4)Reduced firing of medium spiny neurons in response to cocaine or dopamine.Findings made by this work are testable.

A Second Rung on the Ladder:Appraising the Jacob’s Ladder 2019 Remake

This paper compares the original 1990 cult film,Jacob’s Ladder,directed by Adrian Lyne,to the 2019 remake,directed by David Rosenthal.In 2015 we published an article using The Tibetan Book of the Dead as a mechanism for interpreting the original 1990 film.We believed then and do now that The Tibetan Book of the Dead provides the most comprehensive and interesting interpretation of the original film.We were anxious,then,to see how the 2019 remake dealt with concepts like enlightenment,attachment,the bardo,and other ideas from The Tibetan Book of the Dead.In the end,we decided that while the remake has many similarities with the original,the 2019 version of the film does not lend itself to interpretation using The Tibetan Book of the Dead.

Brain dopaminergic system changes in drug addiction:a review of positron emission tomography findings

Dopamine （DA） is considered crucial for the rewarding effects of drugs of abuse, but its role in addiction remains unclear. Positron emission tomography （PET） is the first technology used for in vivo measurement of components of the dopaminergic system in the human brain. In this article, we review the major findings from PET imaging studies on the involvement of DA in drug addiction, including presynaptic DA synthesis, vesicular monoamine transporter 2, the DA transporter, and postsynaptic DA receptors. These results have corroborated the role of DA in addiction and increased the understanding of its underlying mechanisms.

Preliminary research on the co-infection of human immunodeficiency virus and hepatitis virus in intravenous drug users

Objective To confirm the close relationship of high co-infection rate between HIV and hepatitis virus in intravenous drug users (IVDUs).Methods Anti-HIV, HBV and HCV were detected by ELISA in the serum from 35 scattered and 15 massed IVDUs. PCR and RT-PCR were performed to confirm the infection of HIV, HBV, HCV, HGV and TTV among the 15 massed intravenous drug abusers.Results Among the 50 IVDUs, the positive rates of anti-HCV, HBsAg, anti-HBe and anti-HBc were 92% (46/50), 12% (6/50), 10% (5/50) and 66% (33/50), respectively. In the samples of HBsAg positive, their HBeAg was also positive. Although the positive rate of serum markers was different in the massed IVDUs compared to the scattered IVDUs, no significant difference was shown. In the cases of massed IVDUs, the positive rates of HIV DNA, HBV-DNA, HCV-RNA, HGV-RNA, and TTV-DNA were 100% (15/15), 26. 6% (4/15), 53. 3% (8/15), 33. 3% (5/15) and 26. 6% (4/15), respectively. Among the 15 massed intravenous drug users, one was infected with HIV, HBV, HCV, HGV and TTV; two were infected with HIV, HBV, HCV and HGV; three were infected only with HIV; and the remaining had other forms of co-infection.Conclusion The co-infection rate of HIV, HBV, HCV, HGV and TTV in intravenous drug users is very high.

Comparison of brain functions between healthy participants and methamphetamine users with various addiction histories:Data analysis based on EEG and fNIRS

The electroencephalogram(EEG)rhythm and functional near-infrared spectroscopy(fNIRS)activation levels have not been compared between a healthy control group(HCG)and methamphetamine user group(MUG)with different addiction histories.This study used 64-electrode EEG and fNIRS to conduct an experiment that analyzed the resting and craving states.The EEG and fNIRS data of 56 participants were collected,including 14 healthy participants,14 methamphetamine users with an addiction history of 0.5–5 years,14 users with an addiction history of 5–10 years,and 14 users with an addiction history of 10–15 years.Isolated effective coherence(iCoh)within the brain network was used to process the EEG data.Statistical analysis was performed to compare differences in iCoh among the delta,theta,alpha,beta,and gamma bands and explore oxyhemoglobin activation levels in the ventrolateral prefrontal cortex,dorsolateral prefrontal cortex,orbitofrontal cortex,and frontopolar prefrontal cortex(FPC)of the control group.Finally,the Kmeans,Gaussian mixed model(GMM),linear discriminant analysis(LDA),support vector machine(SVM),Bayes,and convolutional neural networks(CNN)algorithms were used to classify methamphetamine users based on drug and neutral images.A 3-class accuracy was achieved.Changes in EEG and fNIRS activation levels of HCG and MUG with varied addiction histories were demonstrated.

Phosphodiesterase 4 inhibitors and drugs of abuse： current knowledge and therapeutic opportunities

BACKGROUND： Long-term exposure to drugs of abuse causes an upregulation of the cAMP-signaling pathway in the nucleus accumbens and other forebrain regions, this common neuroadaptation is thought to underlie aspects of drug tolerance and dependence. Phosphodiesterase 4 （PDE4） is an enzyme that the selective hydrolyzes intracellular cAMP. It is expressed in several brain regions that regulate the reinforcing effects of drugs of abuse. OBJECTIVE： Here, we review the current knowledge about central nervous system （CNS） distribution of PDE4 isoforms and the effects of systemic and brain-region specific inhibition of PDE4 on behavioral models of drug addiction. METHODS： A systematic literature search was performed using the Pubmed. RESULTS： Using behavioral sensitization, conditioned place preference and drug self-administration as behavioral models, a large number of studies have shown that local or systemic administration of PDE4 inhibitors reduce drug intake and/or drug seeking for psychostimulants, alcohol, and opioids in rats or mice. CONCLUSIONS： Preclinical studies suggest that PDE4 could be a therapeutic target for several classes of substance use disorder. We conclude by identifying opportunities for the development of subtype-selective PDE4 inhibitors that may reduce addiction liability and minimize the side effects that limit the clinical potential of non-selective PDE4 inhibitors. Several PDE4 inhibitors have been clinically approved for other diseases. There is a promising possibility to repurpose these PDE4 inhibitors for the treatment of drug addiction as they are safe and well-tolerated in patients.