This paper examines data on the question of possible differences between benzodiazepines in abuse liability and potential for causing physical dependence. The data on potential for causing physical dependence indicates that all benzodiazepines cause physical dependence and there is little evidence for substantial differences between them in this respect. The evidence for substantive differences between benzodiazepines with respect to abuse liability is reviewed: problems with methodology and with definitions make problematic the assertion of some authors that there are clinically meaningful differences in abuse liability. There is general agreement that all benzodiazepines have at least some abuse liability.
This study replicates and extends the results of our earlier findings which showed that 35% of children at age 9 had experimented with cigarettes for various reasons. Seven hundred eighty-seven children from the earlier sample and 361 children from the current sample participated in this study. Forty-one percent of the current sample had puffed a cigarette, 18% had tried it in the last year, 6% in the last 4 weeks and 3.5% in the last week. The study also showed that children who had puffed a cigarette had a significantly positive attitude towards smoking when compared with children who had not experimented with cigarettes. The puffers believed smoking is good, wise and fun.
The ALKO AA and ANA rats have been selectively bred for high versus low ethanol preference, respectively. AA rats have been shown to self-administer ethanol, whereas ANA rats do not. These animals also show a range of differences on tasks which measure sensitivity to ethanol, but the relationship between ethanol intake and sensitivity to this drug in these rats is not clear. This study examined sensitivity to ethanol in AA and ANA rats as determined by ethanol's rate depressant effects on schedule controlled (Fixed-Ratio (FR) 32) responding reinforced by water deliveries. Non-drug rates of responding were similar for both lines across baseline, sham injection and vehicle conditions. Ethanol produced dose-dependent decreases in responding in both the AA and ANA rats. Dose-response curves indicated that AA rats were slightly more sensitive to the acute effects of ethanol than were ANA rats, with ED50 values of 0.52 and 0.69 g/kg for AA and ANA rats, respectively. Overall, however, the effects of ethanol on rats of responding were similar across the two lines of rats. While it is possible that constraints on behavior imposed by FR schedules could be masking underlying differences in tissue sensitivity between these animals, the results indicate that ethanol intake under preference or reinforcement conditions does not appear to be highly controlled by initial sensitivity to ethanol as measured by effects on operant performance.
The opioids vary greatly in addictive potential, from the highly addictive such as heroin to the opioid antagonists such as naltrexone, which can be used to treat opioid dependence and overdose. The various opioid compounds have different euphorigenic properties and also produce withdrawal syndromes of distinct patterns of duration and intensity. Dependence liability is affected by both the pleasure-seeking motives for initiating drug use and the painful consequences of abstinence or withdrawal. Detoxification, which takes 7-10 days for the short-acting opioids, is usually the first stage in treatment. Methadone is often used as a preliminary stage in detoxification, but some patients are maintained on methadone for years, since it allows them to lead relatively normal lives. Non-opioid drugs used to control withdrawal symptoms include clonidine. After detoxification, naltrexone, a long-acting opioid antagonist, can be administered orally to prevent relapse.
The benzodiazepines were first introduced in 1960. Chlordiazepoxide (Librium) was the first of the class of drugs called benzodiazepines, in a deliberate attempt to synthesize a tranquilizer without the sedative properties and abuse, addiction, tolerance, and dependence potential potential of the barbiturates, and other sedative/hypnotic drugs. The popularity of the benzidiazepines rose steadily to a peak period in the mid 1970s when diazopam (Valium) was the most commonly prescribed drug of any kind, including antihypertensive, analgesic and other psychotropic medications. The current evaluations of bennzodiazepines use and abuse demonstrate clearly that they produce tolerance and dependence in short and long-term administration. The development of abuse and addiction is also strongly substantiated although they are not as easily appreciated and identified because of confusion in diagnosis and treatment of abuse and addiction. Significant problems in definitions, diagnosis, interpretations and conclusions exist in general practice regarging abuse and addiction, and their relationship to use of and symptoms produced by benzodiazepines. The lack of clarity in defining abuse and additction and tolerance and dependence in clinical practice leads to institution and perpetuation of the toxicity and untoward effects of the benzodiazepines.
The erythrocyte membranes from 9 healthy non-alcoholic controls and 8 alcoholic patients (fulfilled DSM-III-R criteria for alcohol dependence) were compared for changes in membrane order as measured by fluorescence polarization. The mean amount of change in fluorescence polarization in response to in vitro exposure to ethanol was significantly less in the alcoholics than controls. This increased membrane order of the peripheral blood erythrocytes suggests the presence of pharmacodynamic tolerance to ethanol in the alcoholic patients.
This study replicates and extends the result of our earlier findings which showed that 35% of children at age 9 had experimented with cigarettes for various reasons. Seven hundred eight-seven children from the earlier sample and 361 children from the current sample participated in this study. Forty-one percent of the current sample had puffed a cigarette, 18% had tried it in the last year, 6% in the last 4 weeks and 3.5% in the last week. The study also showed that children who puffed a cigarette had a significantly positive attitude towards smoking when compared with children who had not experimented with cigarettes. The puffers believed smoking is good, wise and fun.
An attempt is made to contribute toward a unifying theory of alcoholism with the concept of "pain phobia" as its central factor. A brief theoretical exposition of pain phobia is offered and results of an empirical study are presented which lend considerable support to the position that pain phobia may be a central factor underlying alcoholism. The research utilizes the Pain Phobia Scale (PPS) as the measure of pain phobia and finds that pain phobia is present to a significantly greater degree in problem drinkers than a norm group and that pain phobia also discriminates non-problem drinkers in the degree of their consumption of alcohol. Suggestions are made for how the concept of pain phobia and the PPS can be useful in the treatment and prevention of alcoholism. The possible relationship between pain phobia and all addictions is also considered.
