May 16th, 2010
If we could make it so drug addicts could stop craving the substances that have brought them to their knees, would relapse rates drop and addiction-treatment success rates soar? I sure hope so!
Medications that stop cravings?
I’ve already written about a study by the renowned addiction researcher Barry Everitt showing that medications could be used in treatment to help addicts who are struggling with strong cravings and the effect of triggers (see it here). Still, in that study the researchers used a drug that blocked pretty much all memory formation and my original idea had to do with using a very common drug, one being used every day for hypertension, and more recently, in the treatment of PTSD.
Well, a study recently completed revealed that indeed, propranolol, a common beta-blocker, may be useful in greatly reducing the amount of time needed to overcome the sometimes crippling effect of triggers on behavior.
How this trigger to cravings study worked
The researchers trained rats to take cocaine, and after they were well trained, allowed them to press a lever for a light that had previously been associated with the drug. This is a common method to test the way animals react to triggers that have been associated with the drug. Even though the animals are no longer getting any cocaine when the light goes on, the fact that it had been previously associated with the drug makes the animals press the lever, like an addict triggered by something they’ve associated with their drug use.
The animals that were given propranolol immediately after every session took half as long to stop pressing for the drug-associated light. It took multiple administrations of propranolol (seven to be exact), but the effect was clear. The next step is to see if the same effect can be observed in people.
Helping addicts transition to outpatient substance abuse treatment
I’ve been claiming for the past few years that if we look in the right places, we can find many ways to help struggling addicts who are having a hard time quitting using currently available methods. I think that the notion that sticking to the “best method we have right now” is unwise given the fact that science has progressed quite a bit in the past 20-30 years. I agree, and am thankful, that the system works for some, but there’s no question that many still have trouble recovering from addictions that devastate their own lives and the lives of many close to them. I think these medications can offer some serious help.
The thing is, that if we could seriously reduce the impact of cravings on relapse rates, it’s possible that addicts would be ready to move from residential to outpatient substance abuse treatment more quickly. Indeed, the main reason for keeping people in residential treatment is the thinking that they’re not ready to be in the world given the influence of triggers. My guess is that this is true for some addicts, but if we could provide an intervention, like propranolol, that would significantly reduce the influence of triggers, outpatient substance abuse treatment, which is a cheaper option, will be useful for many more. This would mean more people in treatment that truly works for them for less money. Sounds good to me.
Ashley N. Fricks-Gleason & John F. Marshall (2008). Post-retrieval ß-adrenergic receptor blockade: Effects on extinction and reconsolidation of cocaine-cue memories. Memory & Learning, 15, 643-648
|Posted in: Medications, Treatment
Tags: addiction, cocaine, Drugs, medication, methamphetamine, outpatient substance abuse treatment, propranolol, PTSD, rats, substance abuse treatment, treatment, weed
February 4th, 2010
Well, it seems the toxicology reports are in and Brittany’s death was, at least partially, caused by her taking of multiple prescription drugs. Still, it seems that she was trying to medicate a host of conditions brought on by her underlying anemia and pneumonia. It’s sad to think that this death could have likely been prevented had she simply taken better care of herself and gone to seek emergency care rather than loading her body with those pills. Unfortunately, this seems to be another in a string of medically preventable deaths… Sad.
Brittany Murphy, the actress from “Clueless,” and “8 Mile” died last night at Cedars-Sinai in Beverly Hills at the age of 32. Brittany has been rumored to be suffering from severe eating disorders, and recent pictures seem to support that notion. Given that she apparently died from cardiac arrest, I’m wondering if drugs (even prescription drugs) played a role in the death as well… I’ll keep updating the story as more becomes available.
My heart goes out to her family and friends. Certainly a loss suffered far too early.
UPDATE: According to the police report, a number of prescription drugs were discovered in Brittany’s bedroom including (read past the list for my take on this):
- Topamax - While TMZ reported this drug to be used as anti-seizure medication, it is also used to reduce weight-gain associated with the use of many other prescription drugs on this list. Lastly, it is considered to be a mood stabilizer.
- Methylprednisolone – An anti-inflammatory that may be used to treat bronchial infections
- Prozac - A commonly prescribed SSRI anti-depression med.
- Klonopin - A benzodiazepine anti-anxiety prescription medication that is also used to help with insomnia. Like most benzos, the probability of overdose is low if used properly, but overdose would lead to cardiac arrest.
- Carbamazepine – Another anti-convulsant mood stabilizer often used to treat bipolar disorder. This prescription drug can be very dangerous when combined with other medications due to its actions on GABA and extensive alteration of Sodium channel activity. It is also a bipolar med.
- Ativan - Once again a benzodiazepine that is often used to treat anxiety and insomnia.
- Vicoprofen - A pain reliever that includes an opioid (it sounds like vicodin for a reason).
- Propranolol - Prescription med used to treat hypertension and as an alternative, less habit-forming anti-anxiety drug.
- Biaxin - An antibiotic.
- Hydrocodone - Same as Vicoprofen, an analgesic (pain reducing) prescription drug.
What do I think killed Brittany?
With 2 benzodiazepine medications, 2 opiates, and antidepressant, and a drug that is made to lower one’s heart pressure, it’s no wonder that Brittany was found not breathing. I’m going to wait until the final toxicology report to draw a definite conclusion, but from this list, it seems highly likely that a dangerous combination of these prescription drugs was taken, which resulted in Brittany’s heart stopping. Even when taken at their prescribed strengths, these medication, when combined, can form a lethal cocktail.
You should ALWAYS check with your doctor regarding interactions between different prescriptions you’re taking, especially when those medications haven’t all been prescribed by the same physician!
|Posted in: Addiction Stories
Tags: addiction, anemia, anti, anti anxiety, antidepressant, benzo, Brittany Murphy, cardiac arrest, death, drug, drug use, Drugs, eating disorder, medication used, news, opiate, opiates, overdose, pneumonia, prescription, prescription drugs, propranolol, prozac, use, used, vicodin
October 26th, 2009
About a year ago, while sitting in a lecture on learning and memory, the idea that certain drugs can affect the emotional responses to memory long after the memory itself has been formed came up. As someone interested in addiction research, the implication for treatment immediately came up in my head:
Could we reduce the effect of triggers by giving people a pill?
In one word – Yes! But, the answer is not, in fact, that simple. Even in the studies already done in PTSD patients, the memories have to be re-triggered and the drug given at exactly the right time to be effective. In fact, in humans, some of the best work has been done in PTSD patients immediately after the traumatic event.
Addiction help through relapse prevention
Still, a recent study in animals suggests that the theory is sound. By interfering with the activity of a neurotransmitter important in the formation of memories, researchers were able to stop animals trained to self-administer cocaine from doing so. The animals, which had been trained to push a lever for cocaine when a light went on, reduced, or even stopped responding after a single dose of a substance that blocked memory formation. Essentially, the researchers prevented the animals from relapse. Again, this only worked if the drug was given while the light (as in the drug-trigger) was presented at the same time.
More recent studies, using repeated doses of the drug propranolol, have been shown to have an even more promising effect. Check out my coverage of that research here.
Given the powerful role of triggers in relapse, this avenue of research has some promising possibilities for future treatment of drug addiction.
|Posted in: Education, Medications, Treatment
Tags: addiction help, Animal research, animals, cocaine, drug-trigger, medication, neurotransmitter, propranolol, PTSD, rats, rehab, relapse, treatment, trigger