Dependence

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  • 文章类型: Journal Article
    目的:本研究的目的是研究老年女性患者贫血与日常生活的基本活动和工具活动之间的关系。
    方法:540名老年女性门诊患者纳入本横断面研究。贫血定义为血红蛋白低于12g/dL。患者的人口统计学特征,合并症,老年抑郁量表,迷你营养评估,还记录了简易精神状态检查(MMSE)。用手测力计测量握力(HGS)以检测功能障碍。使用日常生活基本活动(BADL)和日常生活工具活动(IADL)问卷来评估功能能力。
    结果:参与者的平均年龄为77.42±7.42岁。贫血患者的患病率为35%。在年龄方面,贫血组和非贫血组之间观察到显着差异,糖尿病(DM)的存在,高血压,冠状动脉疾病(CAD),慢性肾脏病(CKD),营养不良,强直症,MMSE,BADL和IADL评分(p<0.05)。在多变量分析中,调整后的年龄,DM,高血压,CAD和CKD;贫血与BADL/IADL评分降低之间存在显著关联,强直症,falls,跌倒的风险,MMSE,营养不良(p<0.05)。调整所有混杂变量后,在贫血的老年女性中,BADL和IADL总分的恶化仍比无贫血的女性更常见(p<0.05).
    结论:在门诊就诊的老年妇女中,每3人中就有1人贫血。观察到贫血与BADL和IADL指标的依赖性相关。因此,应常规检查老年妇女贫血的存在,并应调查和处理可能的原因,以提高其功能能力。
    OBJECTIVE: The aim of the present study was to examine the relationship between anemia and basic and instrumental activities of daily living in older female patients.
    METHODS: 540 older female outpatients were included in this cross-sectional study. Anemia was defined as a hemoglobin below 12 g/dL. Patients\' demographic characteristics, comorbidities, Geriatric Depression Scale, Mini Nutritional Assessment, and Mini-Mental State Examination (MMSE) were also recorded. Handgrip strength (HGS) was measured with a hand dynamometer to detect dynapenia. Basic Activities of Daily Living (BADL) and Instrumental Activities of Daily Living (IADL) questionnaires were used to evaluate functional capacity.
    RESULTS: The mean age of the participants was 77.42 ± 7.42 years. The prevalence of patients with anemia was 35%. A significant difference was observed between anemic and non-anemic groups in terms of age, presence of diabetes mellitus (DM), hypertension, coronary artery disease (CAD), chronic kidney disease (CKD), malnutrition, dynapenia, and MMSE, BADL and IADL scores (p < 0.05). In multivariate analysis, after adjustment for age, DM, hypertension, CAD and CKD; there were significant associations between anemia and reduced BADL/IADL scores, dynapenia, falls, the risk of falls, MMSE, and malnutrition (p < 0.05). After adjusting for all confounding variables, deterioration in total BADL and IADL total scores were still more common among anemic older females than those without anemia (p < 0.05).
    CONCLUSIONS: One out of every three older women presenting at one outpatient clinic were anemic. Anemia was observed to be associated with dependence in both BADL and IADL measures. Therefore, the presence of anemia in elderly women should be routinely checked, and possible causes should be investigated and treated to improve their functional capacity.
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  • 文章类型: Journal Article
    努力揭示分子,细胞,成瘾的电路机制主要集中在神经元上。然而,关于神经胶质细胞影响突触功能的能力的积累数据,电路活动,行为要求我们探索这些非神经元细胞如何导致物质使用障碍和成瘾。重要的工作表明,胶质细胞,包括小胶质细胞,暴露于滥用药物后表现出表型的变化,并且神经胶质反应的改变可以影响与药物寻求和药物服用相关的行为。虽然这些是了解小胶质细胞如何影响成瘾的关键第一步,在知识方面仍然存在巨大的差距,需要加以解决。本章回顾了一些关键研究,这些研究表明了小胶质细胞如何受到成瘾的影响并可能导致成瘾。它还讨论了迫切需要更多知识来揭示新的治疗和预防方法的领域。
    Efforts to reveal the molecular, cellular, and circuit mechanisms of addiction have largely focused on neurons. Yet accumulating data regarding the ability of glial cells to impact synaptic function, circuit activity, and behavior demands that we explore how these nonneuronal cells contribute to substance use disorders and addiction. Important work has shown that glial cells, including microglia, exhibit changes in phenotype following exposure to drugs of abuse and that modification of glial responses can impact behaviors related to drug seeking and drug taking. While these are critical first steps to understanding how microglia can impact addiction, there are still substantial gaps in knowledge that need to be addressed. This chapter reviews some of the key studies that have shown how microglia are affected by and can contribute to addiction. It also discusses areas where more knowledge is urgently needed to reveal new therapeutic and preventative approaches.
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  • 文章类型: Journal Article
    背景:耐受性和依赖性是苯二氮卓(BZD)治疗期间观察到的最相关风险。
    目的:使用Tyrer检验评估患者对BZD治疗的依赖程度;确定有发展BZD依赖风险的患者的概况;并讨论社区药房在配药过程中提供的药学服务的作用。
    方法:前瞻性横断面描述性观察研究(2020年8月至2021年2月),涉及127名使用BZD的患者。他们在分配药物服务期间自愿回答了问卷。该研究由西班牙药品和健康产品局(AEMPS)进行评估和编码(代码:DAA-CLO-2020-01),用SPSS25.0进行统计学分析。
    结果:19.05%的使用BZD的患者被怀疑患有BZD耐受性,所有患者中有77.88%被确定为BZD依赖的高风险。依赖关系的Tyrer测试表明,13分中的平均得分为5.59分。在高度焦虑或抑郁共存的情况下,发现发展依赖的风险增加了18倍。
    结论:社区药房,通过规范的护理实践,并得到Tyrer测试等工具的支持,可以在检测中起决定性作用,预防,并解决与BZD治疗相关的风险。
    BACKGROUND: Tolerance and dependence stand out as the most relevant risks observed during benzodiazepine (BZD) treatments.
    OBJECTIVE: To evaluate the degree of dependence of patients on BZD treatments using the Tyrer test; to define a profile of patients at risk of developing BZD dependence; and to discuss the role of the pharmaceutical care offered by the community pharmacy during dispensing.
    METHODS: Prospective cross-sectional descriptive observational study (August 2020-February 2021) involving 127 patients using BZD. They voluntarily answered a questionnaire during the dispensing pharmaceutical care service. The study was evaluated and codified (code: DAA-CLO-2020-01) by the Spanish Agency for Drugs and Health Products (AEMPS), and statistical analysis was performed with SPSS 25.0.
    RESULTS: 19.05% of patients using BZD were suspected of suffering from BZD tolerance, and 77.88% of all patients were identified as being at a high risk of BZD dependence. The Tyrer test for dependence indicated a mean score of 5.59 out of 13 points. An 18-fold increased risk of developing dependence was detected in the case of coexistence of high anxiety or depression.
    CONCLUSIONS: The community pharmacy, through protocolized care practices and supported by tools such as the Tyrer test, can play a decisive role in the detection, prevention, and resolution of the risks associated with BZD treatments.
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  • 文章类型: Journal Article
    酒精是一种有害的药物,减少其消耗对用户来说是一个重大挑战。此外,酒精依赖通常对治疗有抵抗力,没有完全有效的治疗模式可用于化学依赖。经典迷幻药,比如LSD,psilocybin,和ayahuasca已用于不同的临床和临床前试验,在治疗耐药的精神病理学疾病中表现出有希望的药物治疗效果,比如上瘾,尤其是与酒精依赖有关。在这项工作中,我们对关于迷幻药用于酒精使用障碍治疗的潜力的新兴研究进行了叙述性综述.迷幻药已经证明了治疗药物成瘾的潜力,尤其是AUD,主要是通过调节大脑的神经可塑性。鉴于5-羟色胺能迷幻药在重复使用时不会产生身体依赖或戒断症状,它们可能被认为是管理药物使用障碍的有希望的治疗选择.然而,可以发现某些限制。尽管许多参与者在临床研究中只有一个治疗剂量就取得了积极的结果,在这些影响的持续时间内存在巨大的个体间差异。因此,应使用不同剂量和实验方案进行进一步研究,以加强有关迷幻药的证据。
    Alcohol is a harmful drug, and reducing its consumption is a significant challenge for users. Furthermore, alcohol dependence is often treatment-resistant, and no completely effective treatment model is available for chemical dependence. Classic psychedelics, such as LSD, psilocybin, and ayahuasca have been used in different clinical and pre-clinical trials, demonstrating promising pharmacotherapeutic effects in the treatment of treatment-resistant psychopathological conditions, such as addiction, especially related to alcohol dependence. In this work, we conducted a narrative review of the emerging research regarding the potential of psychedelics for alcohol use disorder treatment. Psychedelic substances have demonstrated potential for treating drug addiction, especially AUD, mostly by modulating neuroplasticity in the brain. Given that serotonergic psychedelics do not produce physical dependence or withdrawal symptoms with repeated use, they may be considered promising treatment options for managing drug use disorders. However, certain limitations could be found. Although many participants achieve positive results with only one treatment dose in clinical studies, great inter-individual variability exists in the duration of these effects. Therefore, further studies using different doses and experimental protocols should be conducted to enhance evidence about psychedelic substances.
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  • 文章类型: Journal Article
    合成代谢-雄激素类固醇(AAS)依赖性影响大约30%的使用AAS的人。目前,评估和诊断AAS依赖性的措施适用于其他形式的药物滥用(例如,alcohol),包含具有内部一致性和构造捕获广度的问题。此外,没有可用的措施来评估AAS的渴望,这代表了AAS依赖性的一个潜在重要的共同因素。因此,本研究旨在为AAS依赖和AAS渴望的测量提供有效性证据。
    从两个样本中使用AAS的男性和女性力量运动员收集数据(n样本1=206;n样本2=224)。样本1完成了新的措施以及评估理论上相关结构的工具(兴奋剂道德脱离,兴奋剂自我调节效能量表,渴望来自威斯康星州吸烟戒断量表的物品,AAS改编的《精神疾病诊断和统计手册》第4版),而样品2完成了新仪器。
    使用样本1数据的探索性和验证性因子分析(CFA)来最终确定两种测量的项目集,并确定AAS依赖性量表(AASDS)和AAS渴望量表(AASCS)的阶乘结构。AASDS由五个一阶因子的15个项目组成,这些因子由一个二阶因子表示。AASCS由四个一阶因子的16个项目组成,这些因子由一个二阶因子表示。支持并发的证据,通过两个量表与理论相关变量的关联,提供了两个量表获得的分数的收敛效度和判别效度。CFA与来自样品2的数据确认了两个尺度的因子结构。
    AASDS和AASCS代表了AAS依赖性和AAS渴望用于使用AAS的力量运动员的研究的有效和可靠的度量。
    UNASSIGNED: Anabolic-androgenic steroid (AAS) dependence affects approximately 30% of people who use AAS. Presently, measures to assess and diagnose AAS dependence are adapted from scales specific to other forms of drug misuse (e.g., alcohol), containing issues with internal consistency and breadth of construct capture. Additionally, there are no measures available to assess AAS craving, which represents a potentially important coeval factor to AAS dependence. Therefore, this study aimed to develop and provide evidence of validity for measures of AAS dependence and AAS craving.
    UNASSIGNED: Data were collected from male and female strength athletes who use AAS across two samples (n sample 1 = 206; n sample 2 = 224). Sample 1 completed the new measures alongside instruments assessing theoretically related constructs (Doping Moral Disengagement, Doping Self-Regulatory Efficacy Scale, craving items from the Wisconsin Smoking Withdrawal Scale, AAS adapted Diagnostic and Statistical Manual for Mental Disorder 4th Edition), whereas Sample 2 completed the new instruments.
    UNASSIGNED: Exploratory and Confirmatory Factor Analyses (CFA) with Sample 1 data were used to finalize the item sets for both measures and determine the factorial structures of the AAS Dependence Scale (AASDS) and AAS Craving Scale (AASCS). The AASDS consists of 15-items across five first-order factors that are represented by one second-order factor. The AASCS consists of 16-items across four first-order factors that are represented by one second-order factor. Evidence supporting the concurrent, convergent and discriminant validity of scores obtained with both scales was provided through their associations with the theoretically related variables. CFA with the data from Sample 2 confirmed the factor structures for both scales.
    UNASSIGNED: The AASDS and AASCS represent valid and reliable measures of AAS dependence and AAS craving for use in research with strength athletes who use AAS.
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  • 文章类型: Journal Article
    背景:认定为性少数群体的大学生(即,拉拉,同性恋,双性恋,或其他性取向)比异性恋或“异性恋”同龄人使用电子烟的风险更高。然而,对因素知之甚少,例如电子烟结果预期,这可能会影响患病率的差异。因此,目前的研究调查了异性恋和性少数大学生电子烟使用者在过去一个月电子烟使用天数方面的差异,电子烟依赖,和电子烟结果预期。该研究的第二个目的是检查结果预期是否成为性少数群体地位与电子烟使用频率和依赖性之间关联的解释机制。方法:参与者是异性恋者(n=90;Mage=19.65,SD=2.70;76.7%女性;77.8%白人)和性少数(n=44;Mage=20.02,SD=2.18;68.2%女性;90.9%白人)完成自我报告措施的大学生电子烟使用者。结果:被认定为性少数群体的学生报告了更大的电子烟依赖性,过去30天使用频率更高,以及更大的负面影响和积极的强化电子烟结果预期。后续调解分析表明,通过对负面后果和积极强化的预期,性少数群体地位对过去一个月电子烟使用和电子烟依赖的两天都有显着的间接影响。结论:这些发现表明,积极的强化和消极的后果结果预期可能会导致大学生中电子烟使用的差异,这些大学生被认定为性少数群体,并且可能是针对该人群的戒烟干预措施的有用目标。
    Background: College students who identify as a sexual minority (i.e., lesbian, gay, bisexual, or other sexual orientation) are at higher risk for e-cigarette use than their heterosexual or \"straight\" peers. However, little is known about factors, such as e-cigarette outcome expectancies, that might influence these differences in prevalence rates. Therefore, the current study examined differences between heterosexual and sexual minority college student e-cigarette users in terms of days of past-month e-cigarette use, e-cigarette dependence, and e-cigarette outcome expectancies. A secondary aim of the study was to examine whether outcome expectancies served as an explanatory mechanism in the association between sexual minority status and e-cigarette use frequency and dependence. Methods: Participants were heterosexual (n = 90; Mage = 19.65, SD = 2.70; 76.7% female; 77.8% White) and sexual minority (n = 44; Mage = 20.02, SD = 2.18; 68.2% female; 90.9% White) college student e-cigarette users who completed self-report measures. Results: Students who identified as a sexual minority reported greater e-cigarette dependence, more frequent past 30-day use, and greater negative consequences and positive reinforcement e-cigarette outcome expectancies. Follow-up mediation analyses indicated a significant indirect effect of sexual minority status on both days of past-month e-cigarette use and e-cigarette dependence through expectancies for negative consequences and positive reinforcement. Conclusions: These findings suggest that positive reinforcement and negative consequences outcome expectancies may be contributing to the disparities in e-cigarette use among college students who identify as a sexual minority and could be useful targets for cessation interventions for this population.
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  • 文章类型: Journal Article
    我们在小鼠中进行了探索,镇痛药,容忍度,依赖性,和系统性对乙酰氨基酚(APAP)的奖励作用。
    研究采用成年小鼠(C57Bl6)。(1)足底内福尔马林退缩+福尔马林异常性疼痛。在第1天福尔马林闪烁之前,将小鼠在DMSO(5%)/吐温80(5%)或水基制剂中的腹膜内给予APAP,并在第12天评估APAP之前和之后的触觉阈值。(2)爪切口。在雄性小鼠的后爪切口后24小时和8天后,评估了腹膜内APAP对触觉异常性疼痛的影响。(3)重复交割。小鼠每天(4天)接受镇痛剂量的APAP或媒介物,并在第5天福尔马林退缩时进行测试。(4)有条件的地方偏好。连续3天,车辆在早上在两个房间中的任何一个房间和每个下午被给予,另一个腔室中吗啡或APAP的镇痛剂量。在第5天和第10天,允许动物选择“优选”室。
    雄性小鼠中的福尔马林导致双相退缩和持久的福尔马林后触觉异常性疼痛。对乙酰氨基酚剂量依赖性地降低了2期退缩,退缩后观察到逆转的异常性疼痛。在相当的APAP剂量下,雌性小鼠表现出类似的减少2期退缩。APAP可暂时逆转切口异常性疼痛。重复的APAP递送在顺序注射或戒断迹象后没有显示效果丧失。吗啡,但不是APAP或车辆,导致了强烈的地点偏好。
    在福尔马林和爪切开后观察到APAP减少了畏缩和异常性疼痛,并且没有耐受性,依赖,或奖励财产。
    UNASSIGNED: We explored in mice, the analgesic, tolerance, dependency, and rewarding effects of systemic acetaminophen (APAP).
    UNASSIGNED: Studies employed adult mice (C57Bl6). (1) Intraplantar formalin flinching + post formalin allodynia. Mice were given intraperitoneal APAP in a DMSO (5%)/Tween 80 (5%) or a water-based formulation before formalin flinching on day 1 and tactile thresholds assessed before and after APAP at day 12. (2) Paw incision. At 24 hours and 8 days after hind paw incision in male mice, effects of intraperitoneal APAP on tactile allodynia were assessed. (3) Repeated delivery. Mice received daily (4 days) analgesic doses of APAP or vehicle and tested upon formalin flinching on day 5. (4) Conditioned place preference. For 3 consecutive days, vehicle was given in the morning in either of 2 chambers and in each afternoon, an analgesic dose of morphine or APAP in the other chamber. On days 5 and 10, animals were allowed to select a \"preferred\" chamber.
    UNASSIGNED: Formalin in male mice resulted in biphasic flinching and an enduring postformalin tactile allodynia. Acetaminophen dose dependently decreased phase 2 flinching, and reversed allodynia was observed postflinching. At a comparable APAP dose, female mice showed similarly reduced phase 2 flinching. Incision allodynia was transiently reversed by APAP. Repeated APAP delivery showed no loss of effect after sequential injections or signs of withdrawal. Morphine, but not APAP or vehicle, resulted in robust place preference.
    UNASSIGNED: APAP decreased flinching and allodynia observed following formalin and paw incision and an absence of tolerance, dependence, or rewarding properties.
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  • 文章类型: Journal Article
    为了追求副作用比阿片类药物少的新的先导化合物,新的合成植物化学核心,3,3-二溴黄酮(3,3-DBF),已经成为疼痛管理的有希望的候选人。急性试验表明,3,3-DBF通过μ阿片受体具有剂量依赖性的中枢和外周抗伤害感受活性。本研究旨在探讨3,3-DBF在小鼠中的重复给药效果,并与吗啡进行比较。用3,3-DBF(30mg/kg)治疗小鼠,吗啡(6mg/kg),或车辆10天,与单一治疗组一起。不像吗啡,3,3-DBF在热板试验中表现出抗伤害作用而不诱导耐受性。运动活动和运动协调测试(通过倒置筛选和旋转杆测试进行评估)显示,3,3-DBF处理组和对照组之间没有显着差异。胃肠转运试验表明,3,3-DBF不诱发便秘,与吗啡相反。此外,用Gellert-Holtzman量表评估的戒断体征与吗啡不具有可比性.此外,3,3-DBF表现出抗抑郁样活性,减少强制游泳和尾部悬挂测试中的不动时间,类似于丙咪嗪。总之,3,3-DBF表现出抗伤害作用而不诱导耐受性或依赖性,并表现出抗抑郁特性。这些发现强调了3,3-DBF作为疼痛管理及其合并症的有前途的治疗剂的潜力。通过最小化副作用提供优于吗啡的优势。
    In the pursuit of new lead compounds with fewer side effects than opioids, the novel synthetic phytochemical core, 3,3-dibromoflavanone (3,3-DBF), has emerged as a promising candidate for pain management. Acute assays demonstrated dose-dependent central and peripheral antinociceptive activity of 3,3-DBF through the μ-opioid receptor. This study aimed to explore repeated administration effects of 3,3-DBF in mice and compare them with morphine. Mice were treated with 3,3-DBF (30 mg/kg), morphine (6 mg/kg), or vehicle for 10 days, alongside single-treatment groups. Unlike morphine, 3,3-DBF demonstrated antinociceptive effects in the hot plate test without inducing tolerance. Locomotor activity and motor coordination tests (evaluated through the inverted screen and rotarod tests) revealed no significant differences between the 3,3-DBF-treated and control groups. The gastrointestinal transit assay indicated that 3,3-DBF did not induce constipation, in contrast to morphine. Furthermore, withdrawal signs assessed with the Gellert-Holtzman scale were not comparable to morphine. Additionally, 3,3-DBF exhibited antidepressant-like activity, reducing immobility time in the forced swimming and tail suspension tests, akin to imipramine. In summary, 3,3-DBF demonstrated antinociceptive effects without inducing tolerance or dependence and exhibited antidepressant properties. These findings highlight the potential of 3,3-DBF as a promising therapeutic agent for pain management and its comorbidities, offering advantages over morphine by minimizing side effects.
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  • 文章类型: Journal Article
    这项研究的目的是分析65岁以上老年人的虐待及其与一些危险因素-抑郁症状的关系。依赖性,性别和年龄-在西班牙人口。
    方法:以电子方式对167名参与者进行了一系列问卷调查(M=72.42;SD=6.46),包括评估抑郁症的缩写Yesavage量表,卡茨日常生活基本活动指数,以评估依赖性,以及美国医学协会和加拿大特别工作组问卷,以评估滥用的嫌疑。
    结果:怀疑滥用的患病率为40.72%,在5.99%的既定抑郁症中,并获得了1.20%的严重依赖。有依赖的人群(75%)的滥用率高于没有依赖的人群(37%)。在抑郁症的情况下,已确定的抑郁症患者的虐待发生率为70%,无抑郁症患者的虐待发生率为35.4%.
    结论:女性的虐待率高于男性,尽管这种差异没有统计学意义。同样的事情发生在年龄上。然而,已经确定的抑郁和依赖是被证实遭受虐待的危险因素。
    The aim of this study was to analyze elder abuse in people over 65 years of age and its relationship with some risk factors-depression symptoms, dependency, gender and age-in the Spanish population.
    METHODS: A battery of questionnaires was administered to a sample of 167 participants electronically (M = 72.42; SD = 6.46), including the Abbreviated Yesavage Scale to assess depression, the Katz Index for Basic Activities of Daily Living to assess dependency, and the American Medical Association and the Canadian Task Force Questionnaire to assess suspicion of abuse.
    RESULTS: A prevalence of 40.72% of suspected abuse, of 5.99% of established depression, and of 1.20% of severe dependence was obtained. The prevalence of abuse was higher in the population with dependency (75%) than without dependency (37%). In the case of depression, the prevalence of abuse was 70% for people with established depression and 35.4% for people without depression.
    CONCLUSIONS: Women have higher rates of abuse than men, although this difference is not statistically significant. The same occurs with age. Nevertheless, having established depression and dependency are confirmed risk factors for suffering abuse.
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  • 文章类型: Journal Article
    澳大利亚是世界上甲基苯丙胺晶体使用率最高的国家之一,一种高度上瘾的兴奋剂,通常与慢性,复发性依赖。甲基苯丙胺的使用与贪婪和暴力犯罪有关,造成巨大的个人和社会成本。虽然短期的兴奋和刺激为甲基苯丙胺的使用提供了积极的加强,从甲基苯丙胺中撤出的厌恶状态和相关的渴望,禁欲可能持续五周,继续使用甲基苯丙胺的负面强化。尽管许多依赖甲基苯丙胺的使用者经历了高度的心理困扰,可能只有不到一半的人参与治疗或支持服务,目前的干预和治疗方案有很高的停药率。污名和歧视,甚至来自护理人员和健康临床医生,是依赖甲基苯丙胺的使用者在澳大利亚获得治疗的主要障碍。
    Australia has one of the highest rates in the world of the use of the crystalline form of methamphetamine, a highly addictive stimulant that is often associated with a chronic, relapsing dependency. Methamphetamine use is associated with both acquisitive and violent offending, which cause substantial personal and societal costs. Whilst the short-term euphoria and stimulation provide a positive reinforcement to methamphetamine use, the aversive states of withdrawing from methamphetamine and the associated craving, which may last up to five weeks into abstinence, underlie the negative reinforcement to continued methamphetamine use. Although many methamphetamine-dependent users experience high levels of psychological distress, it is likely that less than half engage with treatment or support services, and current intervention and treatment programmes have high discontinuation rates. Stigma and discrimination, even from paramedics and health clinicians, are prominent barriers to methamphetamine-dependent users accessing treatment in Australia.
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