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Cocaine addiction treatment

8/09/12 11:38am

Cocktail of Meds Could Treat Coke Addiction

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Not only rodent coke-fiends might benefit.
Photo credit: Jay Kusnetz

A cocktail of FDA-approved medications—including the opioid buprenorphine (Suboxone, Subutex)—could treat cocaine addiction without producing physical dependence, according to a new rat study, published in Science Translational Medicine. The trick is adding the opioid-blocking drug naltrexone, which can preserve the anti-coke effects of buprenorphine without producing a high—or leading to the physical dependence that develops with daily opioid use. As noted in TIME.com:

Buprenorphine itself is a marvel of multiplicity. At low doses, it acts like an opioid, cutting physical and emotional pain and reducing anxiety by activating a class of opioid receptors, known as mu receptors. At high doses, it has the opposite effect: preventing opioid-like action and inducing withdrawal symptoms rather than relief. That’s what makes it an especially safe drug for maintenance of people with opioid addictions. But buprenorphine has another action as well: it blocks the kappa opioid receptor, a target that has long intrigued pharmacologists because it seems to be one of the “brakes” on the pleasure-producing dopamine system. When people repeatedly take drugs—particularly stimulants like cocaine and methamphetamine—the brain releases excessive amounts of dopamine. This triggers a feedback loop: it overactivates kappa opioid receptors, which in turn shuts dopamine down. Now “it’s payback time,” says [lead researcher] George Koob [of the Scripps Institute], because your brain’s pleasure pathways conform to an austerity plan, getting increasingly stingy with the joy juice.

But the study found that in the right dosage, adding naltrexone to buprenorphine preserves the kappa blocking effect of the drug, without the high and addiction potential associated with the mu receptor—at least in rats. A clinical trial in patients with both cocaine and heroin addiction is currently recruiting. (A clinical trial is one of the best places to get top notch addiction care: even if you wind up in the control group, you'll still get treatment based on the best available evidence). If the combo proves effective, expect trials in people with cocaine and amphetamine addictions that don’t involve opioids. Since both drugs are already approved, providers could use them in treatment as soon as the best dosing is discovered. But using two separate pills might prove tricky if addicted people decide to skip the naltrexone to get high on buprenorphine. Not that it would be a very good high: the version used in addiction treatment has abuse deterrent drugs in it that mean it can only be taken orally, although it could have some effect and daily use without the naltrexone would produce dependence. The cocktail could also potentially help depression and chronic pain, both of which may involve reduced pleasure caused by an overactive kappa opioid system. 

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By Maia Szalavitz

celebrity rehab

8/09/12 10:43am

Brigitte Nielsen: "A Relapse Can Happen"

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Nielsen needed a moment to herself.
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Celebrity Rehab star Brigitte Nielsen has spoken out about the alarming photos released over the weekend of her drinking vodka and stumbling drunk around an LA park. She told Entertainment Tonight that while the incident was definitely a relapse, there is "no cause for alarm" from fans. She cited the stress of a non-stop work schedule and major health issues in her family to leading up to the highly public incident, but made it clear that it was not part of a pattern of similar behavior. “At that moment in time, I felt like I needed a moment to myself, in a park," she said. "The vodka came about as a desperate move to try to release some pressure and is under no circumstances an indication of how I lead my life on a day to day basis. It’s a very sad situation, but, you know, a relapse can happen... Life goes on and you have to press on, learn from your mistakes, deal with the issue.” The Danish former model and actress appeared on the first season of Celebrity Rehab in 2007 to address her alcoholism, which she had been struggling with for well over a decade. She confirmed that Dr. Drew has been in touch with her since the photos surfaced and invited her back to the Pasadena Recovery Center for an off-camera stint in treatment.

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By McCarton Ackerman

Headlines

8/09/12 5:00am

Morning Roundup: August 9, 2012

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Minnesota Governor Mark Dayton.
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By Gabrielle Wuhl

Drug Smuggling

8/08/12 4:50pm

Why K2 Is the Prisoner's Choice

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Prisoners beat the system with K2.
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Cops and DEA agents raided dozens of businesses suspected of selling drugs like K2 and Spice in almost 100 cities recently, as part of the first-ever nationwide crackdown on synthetic drugs. They might have done better to focus on our country's correctional facilities: K2 use is rampant on the inside, where its properties help users avoid detection. "K2 is cheaper and easier to get than marijuana and you smuggle it in the same way," one prisoner tells The Fix. "The thing about it is, when you smoke it you won't get a dirty and the guards don't know what the fuck the smell is. They think it's incense or something. The homies have been beating the urine tests and we smoke K2 everyday."

In prison the C/Os carry out random drug testing and urinalysis. If a prisoner gets a dirty, he can go to the hole for 60 days—as well as losing phone, commissary, visiting and email privileges for up to six months, and getting 41 good-time credit days taken away. That's some pretty steep sanctions, giving some prisoners second thoughts about smoking marijuana. But they still want to get stoned, so they smoke K2: the "consequence-free" high. "I've been smoking K2 like crazy," the prisoner says. "This is fun for me. This is how I do my time. I spend all my money on K2. I want to stay stoned. But going to the hole for dirties is some bullshit. Ain't nobody trying to go the hole for that. It's like going to jail when you're already in prison."

The Special Housing Unit or SHU—known as the hole or the bucket—is where prisoners are housed when they're found guilty of disciplinary infractions like dirty urine, getting drunk or smuggling in drugs. It's basically 24-hour lockdown in a cell. Smoking K2 enables prisoners to get high and still avoid that. But the prison administrators will catch on soon—if they haven't already. "My homie told me they got new cups for the tests that register for K2," the prisoner says. "But that's a rumor. I'll know for sure when they piss me, because I've been burning that K2 up."

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By Seth Ferranti

Crazy drunk

8/08/12 3:57pm

Cops Nab Naked Priest on Drunk Driving Spree

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Forgotten Photo via

Whether or not this is a sin, it's definitely weird: a Michigan pastor has been arrested for driving drunk while in the nude. He was subsequently suspended from his duties at the Sacred Heart parish in Dearborn, after the Catholic Archdiocese of Detroit learned of his unusual preparations for Mass. Rev. Peter Petroske, 57, has been placed on administrative leave after being pulled over—one block away from his church—in a vehicle which also contained a laptop. His blood-alcohol level was only just over the limit, raising the alarming possibility that he didn't need to get that drunk in order to decide to go for a naked spin. The arrest took place last Friday, but Petroske conducted Mass as normal the following Sunday. The Archdiocese learned of his arrest that night—and Petroske then reportedly "fully cooperated" with them. Petroske has served in the Detroit area for over 20 years, and has been head of Sacred Heart Parish, which also operates a school, since 2008. "He's been just a fantastic pastor, an inspiring speaker," says Dearborn resident Ned Nikodem. "Obviously something very strange must have occurred." He's not wrong. Petroske can console himself that he joins a distinguished list of religious leaders whose relationships with substances have led to spectacular falls from grace. His leave from his parish is indefinite.

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By McCarton Ackerman

Teen Drinking

8/08/12 3:00pm

Can Teen MRIs Predict Risky Drinking?

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Could an MRI predict this? Photo via

Brain scans of teenagers could help predict problem drinking later in life, according to a new study. Using MRI scans, researchers at the University of California, San Diego, examined the brains of 40 teens before they started drinking, and then again three years later—when about half of the participants had started drinking alcohol. The subjects who displayed less activity in the areas of the brain used for higher-order decision-making (called "working memory") were more likely to become heavy drinkers over the next three years. "It suggests there might be some pre-existing vulnerability," says lead researcher Lindsay M. Squeglia, adding that teens with a less active working memory might have more trouble weighing risks—which could lend itself to a proclivity towards substance abuse. The study also revealed the impact of drinking on the teens' brain development. After three years, the brains of participants who had begun drinking heavily (four or more drinks for females and five or more for males) had to work harder harder than before to complete the same tasks. "That's the opposite of what you'd expect, because their brains should be getting more efficient as they get older," says Squeglia, suggesting that heavy drinking may negatively impact developing brains during an especially crucial time in a person's life. "You're learning to drive, you're getting ready for college. This is a really important time of your life for cognitive development," Squeglia says.

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By Chrisanne Grise

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