23 research outputs found
Psychosocial and treatment correlates of opiate free success in a clinical review of a naltrexone implant program
Background: There is on-going controversy in relation to the efficacy of naltrexone used for the treatment of heroin addiction, and the important covariates of that success. We were also interested to review our experience with two depot forms of implantable naltrexone. Methods: A retrospective review of patients' charts was undertaken, patients were recalled by telephone and by letter, and urine drug screen samples were collected. Opiate free success (OFS) was the parameter of interest. Three groups were defined. The first two were treated in the previous 12 months and comprised "implant" and "tablet" patients. A third group was "historical" comprising those treated orally in the preceding 12 months. Results: There were 102, 113 and 161 patients in each group respectively. Groups were matched for age, sex, and dose of heroin used, but not financial status or social support. The overall follow-up rate was 82%. The Kaplan Meier 12 month OFS were 82%, 58% and 52% respectively. 12 post-treatment variables were independently associated with treatment retention. In a Cox proportional hazard multivariate model social support, the number of detoxification episodes, post-treatment employment, the use of multiple implant episodes and spiritual belief were significantly related to OFS. Conclusion: Consistent with the voluminous international literature clinically useful retention rates can be achieved with naltrexone, which may be improved by implants and particularly serial implants, repeat detoxification, meticulous clinical follow-up, and social support. As depot formulations of naltrexone become increasingly available such results can guide their clinical deployment, improve treatment outcomes, and enlarge the policy options for an exciting non-addictive pharmacotherapy for opiate addiction
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Motivational properties of septal stimulation as the US in classical conditioning of heart rate in rabbits
Examined heart-rate (HR) classical conditioning, shuttle-box training, and bar-press self-stimulation in male albino rabbits in 3 experiments as a function of 3 intensities of electrical stimulation of the septal region. In the HR classical conditioning experiment (n = 24), CRs failed to occur in a low-intensity group even though reliable UCRs were elicited. In 2 higher intensity groups HR CRs were decelerative. 12 Ss from Exp. 1 made approach responses to the lowest UCS intensity, but escape responses to higher intensities when tested in the shuttle box. In the self-stimulation experiment, 8 naive Ss bar pressed at all 3 intensities. At the 2 highest values, bar pressing was accompanied by attempted escape responses. It is concluded that HR classical conditioning to septal stimulation requires an aversive component to the UCS. (35 ref.
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Cardiovascular classical conditioning in rabbits (Oryctolagus cuniculus) using appetitive or aversive hypothalamic stimulation as the US
Examined the bar-press self-stimulation, shuttle-box preference, and cardiovascular classical conditioning of 2 groups of 6 male rabbits as a function of electrical stimulation of the medial or lateral hypothalamus. Results show that Ss having access to lateral hypothalamic stimulation bar-pressed to receive stimulation and made approach responses in the shuttle box. Ss having access to medial hypothalamic stimulation did not bar-press and made escape responses in the shuttle box. The cardiovascular UCRs of all Ss consisted of a blood-pressure increase and heart-rate decrease; CRs consisted of heart-rate decreases. Thus, while medial and lateral hypothalamic stimulation had different motivational properties, both provided effective UCSs for eliciting similar heart-rate CRs. Data indicate that cardiovascular changes elicited by hypothalamic stimulation are not merely global adjustments to aversive stimulation. (18 ref.