Tag Archives: Analgesic

Can Dopamine Depletion Cause Cocaine Addiction

January 20, 2015

Research Shows Dopamine Depletion Causes Cocaine Addiction

Dopamine depletionThe importance of dopamine in our bodies can never be underestimated. This is one of the most crucial neurotransmitters in the body. Dopamine has very many functions in the body but to many people it is famous for its good feeling effects that it is always identified with but this should not be the case as it has functions beyond the mesolimbic pathway. In the brain dopamine plays such roles as: It plays a big role in starting movement, and the destruction of dopamine neurons in an area of the brain called the substantia nigra is what produces the symptoms of Parkinson’s disease. Dopamine also plays an important role as a hormone acting to inhibit prolactin to stop the release of breast milk. Back in the mesolimbic pathway, dopamine can play a role in psychosis, and many antipsychotics for treatment of schizophrenia target dopamine. Dopamine is involved in the frontal cortex in executive functions like attention. In the rest of the body, dopamine is involved in nausea, in kidney function, and in heart function.

For emphasis, dopamine isn’t only associated with good feelings but in itself has many functions. This neurotransmitter is involved in many different important pathways. However, most people can only identify dopamine with such aspects as motivation, addiction, attention, or lust, their knowledge of dopamine is limited to the mesolimbic pathway. It is a pathway which starts with cells in the ventral tegmental area, buried deep in the middle of the brain, which send their projections out to places like the nucleus accumbens and the cortex.

Whenever a person engages in any pleasurable activity like sex, use of drugs or partying the brain will respond by increasing the levels of dopamine released in the nucleus accumbens .However during addiction the dopamine signaling in this area is changed. For any drug to have any pleasurable feeling to the user then the level of dopamine must be increased and this is what causes euphoric feelings that drug users will do anything to achieve.

Cocaine abuse and dopamine surges

Cocaine is one of the drugs of pleasure that are largely used even today despite its unpleasant effects on the user. Cocaine abuse is known to trigger large surges of dopamine extracellular in limbic areas, specifically, nucleus accumbens. Researchers have shown that human imaging studies correlate descriptors of reward, for instance, the “high” and euphoria with cocaine induced increases in dopamine nucleus accumbens. There is also the issue of saliency of the reward, which seems to be driven by the novelty or unexpectedness of the activity. It is the euphoric properties of cocaine that lead to the development of chronic abuse, and appear to involve the acute activation of central dopamine neuronal systems. This is based upon known effects of cocaine on dopamine neurons, and the role played by dopamine in reward states and self-stimulation behavior. When a person uses cocaine for a long time his neurotransmitter and neuroendocrine alterations will eventually occur. Dopamine depletion is hypothesized to result from overstimulation of these neurons and excessive synaptic metabolism of the neurotransmitter. It is this depletion of dopamine that may underlie dysphoric aspects of cocaine abstinence, and cocaine cravings.

Some scientists have opined neurochemical disruptions caused by cocaine are consistent with the concept of physical rather than psychological addiction. Possible pharmacological interventions in cocaine addiction are outlined and the psychological approach to these patients is discussed. With many research findings on cocaine relations with dopamine, it is clear that cocaine addiction stems from the depletion of synaptic dopamine in the mesolimbic dopamine reward system, leading to a dysphoric withdrawal state that drives cocaine seeking to restore dopamine to normal, drug-naïve level.

Owing to its euphoric feelings, people who use cocaine find it hard to quit. When your brain has been conditioned to produce high levels of dopamine only when you are using cocaine then it will be hard for you to quit using this drug as every time you try to quit all the withdrawal symptoms, some of which may be too severe sets in and that ties a person to cocaine abuse thereby causing addiction and dependence thereafter. These cravings contribute not only to addiction but to relapse after a hard-won sobriety. A person addicted to cocaine may be in danger of relapse when he interacts with the people he used to take it with. These triggers do something to his brain that awakens his cravings for cocaine.

Dopamine depletionUsing dopamine antagonists to treat cocaine addiction

Today there is evidence that cocaine exerts its rewarding effects through the acute activation of dopamine pathways in the brain. Chronic cocaine administration is hypothesized to lead to dopamine depletion, which results in cocaine craving and cocaine abstinence states. This is a condition that has chained many to cocaine use but there is hope as treatment of cocaine addiction with bromocriptine which is a dopamine antagonist has been found to be effective in quelling all the cravings associated with cocaine addiction.

Drug addiction is a vice that should be fought by all means that is why we at AWAREmed Health and Wellness Resource Center are committed to availing help to addicts and offering them a place to call home. We offer NER Treatment and Amino acid therapy that are the most effective approaches to addiction treatment and recovery. You call on Dr. Dalal Akoury (MD) today and begin your journey to victory against addiction.

Dopamine Depletion Causes Cocaine Addiction

 

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Substance Abuse and HIV/AIDS among Urban Minority Youth

December 2, 2014

How to Prevent Substance Abuse and HIV/AIDS among Urban Minority Youth

Substance abuse and HIV/AIDs are major problems that the urban minority youth have to face daily. Substance abuse among the urban minority youths has been linked to many societal ills including theft and robbery, the urban youth minority that are involved in substance abuse face some of the toughest life choices especially after becoming dependent on the drugs of abuse . once they have got dependent on the drugs of abuse they will find it hard to supplement most of their daily needs as in most cases drug addicts are avoided by employers, once jobless and the heightening cravings for the substances of abuse they will turn to some other ways of finding their daily supply of the drugs that they use. Turning to robbery has become one of the immediate choices that they bump into and hence they become a problem that the whole society suffers from. In most cases the youths may be felled by police bullets while escaping from crime scenes and some who are lucky will be sent to rehabilitation centers and that in itself affects the economy of a country as the country will spend more on these centers sometimes having to forego other expenses just to cater for the youths.

The biggest problem with the urban minority youths is their environment. Most of the people they interact with especially through the media lead lives of drug abuse, most of these youths are driven by their love for certain genres, they therefore idolize such artists so much that they will want to lead a life like theirs, this is a great problem having drug users as role models therefore there is need for educating the youths to stay away from drug use through the use of messages that may be sent through broadcast media such as radio and television. The urban minority youths needs to access relevant information that may help them stay away from drug abuse.

HIV and Youth Statistics

The urban minority youths are also involved in active sex. In most cases these youths do not get serious with their relationships, these relationships are sex based and having one night stands with different women is something that these youths take pride of. It is the involvement of these youths with multiple sexual partners that put them at high risk of contacting HIV/AIDS.  The urban minority youths need access to drug abuse and HIV/AIDS preventing messages in their immediate environment. Painting walls and having these messages artistically inscribed on the walls can be a good way to market this ideology and help the youths know of the dangers of drug abuse and involving oneself in risky sexual behaviors such us having multiple sexual partners. Other ways that can help these youths to stay away from drug abuse and HIV/AIDS may include:

Evidence-based prevention protocols

In a research study done to assess whether evidence-based prevention protocols could positively influence substance abuse and HIV/AIDS knowledge and reduce sexual risk-taking behaviors among urban minority youth by the by the U.S. Centers for Disease Control and Prevention (CDC) and the Center for Substance Abuse Prevention (CSAP) dubbed Be Proud! Be Responsible! CASASTART; Focus on Youth; and Street Smart. This research study that involved sessions comprised of six, 50-minute modules that incorporated role-plays, discussions, and multimedia formats to actively educate and engage youth in prevention activities.

This study used the National Minority Substance Abuse / HIV Prevention Initiative Cohort 7 Youth Questionnaire. The National Minority Substance Abuse / HIV Prevention Initiative Cohort 7 Youth Questionnaire was developed by CSAP as part of a national cross site evaluation of all Minority AIDS Initiative (MAI) funded programs throughout the United States. Sexual risk behavior served as the outcome variable, with the following ten predictors being assessed for the study: disapproval / alcohol use, school importance, delinquency/crime, disapproval / tobacco use, disapproval / marijuana use, illicit drug use, stress- related alcohol and drug use, HIV/AIDS knowledge, HIV/AIDS testing, and negative peer attitudes.

The findings of the study showed changes in pre and posttest measures which revealed that participants who were at heightened risk were also more inclined to get tested for HIV/AIDS after receiving the intervention (95% confidence level). At posttest, an increase in HIV/AIDS knowledge seemed to have a buffering effect against risky sexual behaviors. Additionally, participants who thought of school more favorably were less likely to engage in sexual risk taking behaviors at posttest (95% confidence level). This study therefore showed the importance of educating the urban minority youths and creating awareness of the dangers of drug abuse and HIV/AIDS as paramount to fighting these two vices in the urban minority youths.  The intervention used the pretest-posttest design and worked with four urban high schools and five summer camp programs located in the Northeastern United States having a total of 653 African American and Hispanic/Latino youth, ranging in ages from 13 to 18.

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Promoting Talent

The youths have talents that need to be exploited in a bid to find avenues though which the drug abuse and HIV/AIDS prevention messages can be spread. Apart from using their talents as a media through which this message reach many people it also keeps them occupied and gives them a reason to focus more in their own developments other than indulging in drug abuse and risky sexual behaviors.

Finally, Dr. Dalal Akoury (MD) of AWAREmed Health and Wellness Resource Center is committed to availing help to addicts by availing some of the most integrative approaches to healing an addict chained to any behavior. Call on Dr. Dalal Akoury (MD) at Myrtle Beach, South Carolina for help.

How to Prevent Substance Abuse and HIV/AIDS among Urban Minority Youth

 

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Endogenous Opioids

October 4, 2014

Endogenous Opioids and Opioid Receptors

endogenous opioidsThe term opioids are not new to many, it has been heard as the media is always abreast with all information about these opioid drugs which to the public are known mostly for the wrong reasons. People have got misinformed about these drugs so much that when you tell a layman that these drugs are used in hospital then to him you will something much worse than an alien. However to the medical fraternity these opioids are essentials that are hard to survive without. That said and left, back to the topic; Endogenous Opioids is a new term to many and if your prediction is as right as mine then you are hearing it for the first time. What does it really mean? The endogenous opioids are opiate-like substance, such as an endorphin, produced by the body. If you thought that you can live without these endogenous opioids then you need to wake up from your momentary slumber. Every day of our lives we face pain of all sorts even the most insignificant pains needs the actions of these opioids to give you peace.

Today, the endogenous opioid system is one of the most studied innate pain-relieving systems. The endogenous opioid system consists of widely scattered neurons that produce three opioids: beta-endorphin, the met- and leu-enkephalins, and the dynorphins. These opioids act as neurotransmitters and neuromodulators at three major classes of receptors, termed mu, delta, and kappa, and produce analgesia. The endogenous opioids works in the same manner as the narcotic opioids in that they bind to the same receptors and they also have both good and negative effects. There might be all sorts of information out there that you can lay your hands that may speak well of the opioids but the bitter truth is we all depend on despite the negative light they have been portrayed in.We are all naturally dependent on opioids for our emotional health. Both narcotics and internally generated endogenous opioids exert their action on the body by interacting with specific membrane receptor-proteins on our nerve cells.

There are three large pro-compounds that are produced by the body and these are: proenkephalin, prodynorphin, and pro-opiomelanocortin. However, endorphins can further decompose to small fragments, oligomers, which are still active. Oligomers pass the blood-brain barrier more readily. Enzymatic degradation of small-chain endorphins is accomplished by dipeptidyl carboxypeptidase, enkephalinases, angiotensinases, and other enzymes. This limits their lifetime in the unbound state.

Presynaptically opioid receptors inhibit transmission of excitatory pathways. These pathways include acetylcholine, the catecholamines, serotonin, and substance P. Substance P is a neuropeptide active in neurons that mediate our sense of pain. Endogenous opioids are also involved in glucose regulation. Opioid receptors are functionally designated as mu, delta, kappa among others. These categories can be further sub-classified by function or structure. Decoding the human genome has allowed the genetic switching-mechanisms that control the expression of each opioid receptor to be determined at the transcriptional and post-transcriptional level.

Opioid-driven inhibition of neuronal excitability is mediated by the activation of a variety of potassium channels in the plasma membrane. The disparate subjective and behavioral effects evoked by activation of the different categories of opioid receptor are typically not the outcome of different cellular responses, but reflect the different anatomical distributions of each receptor. Unlike kappa opioid receptors, however, both mu and delta opioid receptors internalize on exposure to agonists. Activation of any type of opioid receptor inhibits adenylate cyclase, resulting in a fall in intracellular cAMP and diminished action potential firing. This causes a reduced flow of nociceptive information to the brain. Conversely, opioid addicts undergoing withdrawal suffer elevated cAMP levels and enhanced protein kinase A activity, resulting in increased neurotransmitter release.

Role of Mu receptors in addiction

The Mu opioid receptors are the gateway to addiction. This is because they mediate positive reinforcement following direct or indirect activation. In an experiment where mice without mu receptors were used, it was found that the morphine’s analgesic and addictive properties are abolished in these mice. This shows that mu receptors mediate both the therapeutic and the adverse activities of opioids. The mice that were lacking mu receptors were found to lack of morphine-induced analgesia, reward, and dependence. The mice had increased sensitivity to pain. This shows that the mu receptors play a critical role in addiction. These mu receptors function as switches upon direct or indirect reinforcement of opioid abuse. Mu-opioid receptors are a key molecular switch triggering brain reward systems and potentially initiating addictive behaviors. The lack of mu-receptors abolishes the analgesic effect of morphine, as well as place-preference activity and physical dependence. This receptor therefore mediates therapeutic analgesia and adverse activities of morphine.

Opioid withdrawal symptom

endogenous opioidsWhen a person has been using the opioids for some time, he will become physically adapted to the drugs so much that when he stops abruptly he will experience the symptoms of withdrawal. Withdrawal is not only faced by opioid user only but also other sick people who are on other drugs as well. However to limit the withdrawal symptoms, there are some factors that come in handy. One of these factors is the pace and how you exit from using these drugs. Your doctor will be of help in helping you by developing safe exit strategies that will limit the withdrawal symptoms.

Finally, you need more information to stay away from dependence on alcohol and drugs as these have crippled societies and that is why here at AWAREmed we are dedicated to finding the best solutions to addiction and dependence on substances. Dr. Dalal Akoury (MD) is always in the mood of helping any patient to be addiction free. Do not hesitate to call on her for help in managing any sort of chronic pain or any type of addiction as well as other diseases.

Endogenous Opioids and Opioid Receptors

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Types of Opioids and Their Uses

October 4, 2014

Type of Opioids, Their Uses and Side Effects

172468400_80_80Opioids are drugs that many people cannot do without. They are essential in hospitals as they are the most effective drugs that can be used to aid the pain patients. Diseases such as cancer are synonymous to pain and in some situations going through the treatments will be very painful and therefore there is need for a drug that will work in different ways to curb the pain that may be disabling to the patient. Chronic pain in itself presents a torture to the patient and without pain relievers, such pain may cripple a patient. The opioids are not news to many years; people know them some as dangerous drugs that should never have been created in the first place. While to many they has become very valuable essentials that they cannot survive without- the pain patients (and even addicts). However, people are not always informed about the given types of opioids.  The opioids are mostly classified according to their source. There are opioids that are naturally extracted from the poppy plant and used without designing or any other further processing. These will fall under natural opioids.  Opioids may be extracted from the poppy plant but then is further processed. This group is referred to use semi-synthetic opioids while there are some that are some opioids that are processed in the labs. The opioids falling in this group are known as synthetic opioids.

The naturally sourced opioids

The natural opioids are those that are naturally available from the poppy plant. After extraction they are not further processed in a manner that will deplete their contents. Some of these natural opioids are used as pain relievers in hospitals.

Here are examples of the opioids;

Morphine

Morphine is naturally extracted from poppy plant. It is the most dominant opiate in the poppy plant. It was the first active ingredient that was extracted from the poppy plant. Apart from morphine there are also other alkanoids of different types that are found in the opium. The major source of morphine is a chemical extraction from opium.

Despite its use in hospitals for pain relief in patients with intense pain, morphine has a high potential of addiction, tolerance and psychological dependence which develops very rapidly. However psychological dependence takes a little bit longer to develop and may take several months. With morphine, tolerance to respiratory depression and euphoria develops more rapidly than tolerance to analgesia.

Thebaine

Thebaine is naturally available in small quantities in opium. It is also known as Paramorphine. It is white, crystalline, slightly water-soluble and poisonous alkaloid.  The Thebaine-Constituent of Raw-Opium is normally between 0.2% and 1.5%. However higher amounts have been reported. It is not used for therapeutic or recreational purposes, but is converted industrially into a variety of compounds such as oxycodone, oxymorphone, nalbuphine, naloxone, naltrexone, buprenorphine and etorphine.

In the past thabaine was believed to have no properties that were like those of morphine. However there are many studies that have found that thebaine has a considerable potential for dependence both psychological and physical when used in large doses for a long period of time.

Codeine

Naturally extracted from the poppy plant, codeine is used in hospitals as a narcotic pain-reliever and cough suppressant. It functions similar to morphine and hydrocodone. Moreover, when taken a small amount of codeine is converted to morphine in the body. However the mechanism of action of codeine is not known but just like morphine, codeine binds to opioid receptors in the brain. These receptors are important for transmitting the sensation of pain throughout the body and brain. Codeine increases tolerance to pain, decreasing discomfort, but the pain still is apparent to the patient. Despite its ability to suppress coughs and enable pain tolerance, it has the following side effects, noisy breathing, sighing, slow breathing with long pauses between breaths, drowsiness and blue colored lips.

Semi-synthetic opioids

This is a group of drugs that are naturally extracted from the poppy plant but are further processed before they are used. An example is heroine.

Heroine

Comes from the opium poppy but is further processed. When pure it is a white powder that has a bad taste. Some heroin is dark brown, and black tar heroin is either sticky or hard and looks like roofing tar. It has pain relieving properties. Unlike most pain relieving narcotics that are accepted in most states when prescribed by doctors, heroin is illegal in most countries basically because it is highly addictive and has quite grave side effects. Some of the withdrawal symptoms include; sleeplessness, bad chills and sweats, muscle pain, stomach cramps, nausea, vomiting, and diarrhea.

Synthetic opioids

These are opioids that are made in laboratories. They include;

Methadone

Methadone is used as a pain reliever and as part of drug addiction detoxification and maintenance programs and is only available from certified pharmacies. This drug helps reduce the severity of withdrawal symptoms that are suffered by heroin addicts when they stop using heroin. Some of its side effects include; rapid heart rhythm, severe dizziness and chest pain among others.

Oxycodone

This is an FDA approved drug for use in pain relief as well as suppressing coughs. This drug is a strong pain reliever and works better for both opioidsmoderate and severe pain. It increases tolerance to pain hence eliminating discomfort. It also causes sedation. May cause very severe side effects when mixed with alcohol. Cases of death have been reported.

Fentanyl

Fentanyl is an opioid medication that is used for anesthesia to help prevent pain after surgery or any other medical procedure that may result in moderate or severe pain. It is injected in the muscle or in the vain through IV. It is mostly used before surgery. Side effects include severe dizziness, drowsiness and impaired reactions.

Finally, you need more information to stay away from dependence on alcohol and drugs as these have crippled societies and that is why here at AWAREmed we are dedicated to finding the best solutions to addiction and dependence on substances. Dr. Dalal Akoury (MD) is always in the mood of helping any patient to be addiction free. Do not hesitate to call on her for help in managing any sort of chronic pain or any type of addiction as well as other diseases.

Type of Opioids, Their Uses and Side Effects 

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Opiates And The Risks of Breast Cancer

September 29, 2014

The relationship between opiates and breast cancer has been focused on three important aspects. The first aspect has been what the use of opiates is with regard to cancer in general and breast cancer in particular. The second aspect of this relationship has been whether or not the use of opiates for specific functions with regard to cancer treatment endangers the lives of the patients by contributing to recurrence of cancer long after its successful treatment. The third aspect has been the exact mechanisms by which opiates produce the said effect in the body of patients and what should be done about it. All these aspects are addressed in this article in the sections that follow.

Breast Cancer And The Use Of Opiates

Breast cancer is one of the most common forms of cancer among women in the world. Two reasons for this have been advanced. The first one is that breast cancer is generally associated with estrogen, a special type of hormone responsible for femininity. Since this hormone is predominantly found in women (sometimes in high levels), this makes them completely exposed to possible development of breast cancer. The second one arises from the observed trend of an increasing risk of breast cancer and age among women. There are several underlying reasons for this but the fact remains that with people in general living longer they get exposed to certain health conditions. For women, breast cancer is the common health condition that comes with age.

Opiates have been extensively used in the treatment of cancer as part of modern therapies. The use of opiates is in the form of drugs that are derived from morphine, a common type of plant that represents what opiates are, which is used as an extremely powerful painkiller for cancer patients. The exact mechanism by which opiates (in the form of morphine-based pain killers) works to relieve patients of pain is a complex process. But it suffices to say that the active chemical compound in opiates activates special cells within the nervous system of the patient leading to massive decline in pain sensations. This presents great relief to patients, particularly when one considers the intensity of cancer-induced pain which patients do experience.

Breast Cancer

Opiates And Breast Cancer: The Danger Of Recurrence

There has been considerable concern about the relationship between opiates and cancer recurrence in patients. The concern has been based on the growing discovery that some patients who, in the course of their treatment for cancer used morphine-derived drugs as pain killers, showed signs of the disease recurring after some time. The argument has been that the opiates that are found in the drugs must be responsible for this observed phenomenon.

There are two important things that should be understood from this. The first one regards the exact use of opiates in cancer patients. In practice, opiates are used as pain killers on patients before other forms of therapy, such as surgery, are used. During such times, the drugs are usually administered in heavy doses as a way of dealing with the equally intense pain.

The second one regards the use of the drugs during times when the disease is still in its early stages of development. There have been a number of studies that have sought to demonstrate the exact effect of opiates on cancer cells. It has been shown, with mixed reactions, that opiates do show anti-cancer properties at times and that they can actually be used to inhibit the rate of growth of cancer cells. Although this is so, the efficacy, extent and possible mechanism by which this occurs remains a subject of research.

What has caught our attention is the increasing proof that indeed using opiates as pain killers in patients of breast cancer may contribute to the cancer occurring again in them later.

Ways of recurrence as a result of opiate use in breast cancer patients

Breast CancerThere are several ways in which use of opiates as pain killers leads to recurrence of breast cancer in patients. Basically, this ability is understood by the role that the compound plays in the processes of metastasis and angiogenesis. These two processes are critical for the growth and development of cancer. Through angiogenesis, cancer cells are able to derive their own supply of blood from the existing circulatory system, thus fueling their own growth. Similarly, through metastasis, cancer cells are able to spread to other parts of the body via the circulatory system.

Opiates have been found to enhance angiogenesis by their effect on the immune system. Naturally, the body produces special hormones that work to prevent possible development of cancer cells. Use of opiates has been found to suppress the production of the hormones, thus weakening the immune system and exposing a patient to possible recurrence of breast cancer long after treatment.

Further, it has been found that opiates encourage cancer cells to spread through the body long after treatment. What usually happens is that a few cancer cells may be circulating in the body after treatment of breast cancer. Opiates do have a direct effect on these cells in the body. It is this effect that may encourage the cells to spread and redevelop into new cancer growth over eth course of time.

Use of opiates as part of the standard therapies used to treat cancer is set to continue. On the other hand, fears about its association with recurrence of breast cancer will linger. What this calls for is careful and judicious use of the right therapies in treating cancer. AWAREmed Health and Wellness Resource Center has been known as a leading centre for cancer treatment and management for a long time. We run a range of highly specialized services in cancer diagnosis, treatment and overall care of patients. Our focus is on using alternative therapies to boost the effectiveness of other methods used in standard therapies. The result of this is your overall recovery and wellness within the shortest time possible.

Breast Cancer And The Use Of Opiates

 

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