Psychotic Symptoms of Cocaine Self-Injectors in a Harm Reduction Program.
Psychotic symptoms of cocaine self-injectors in a harm reduction program.
Subst Abus. 2013 Apr-Jun; 34(2): 118-21
Roncero C, Martínez-Luna N, Daigre C, Grau-López L, Gonzalvo B, Pérez-Pazos J, Casas M
ABSTRACT Background: Psychotic symptoms are common among cocaine users. Methods: An observational naturalistic study on the effects and events of intravenous cocaine use in a drug consumption room was carried out; the patients were diagnosed of cocaine dependence (according to the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision). Results: Twenty-one patients, 81% men self-injected cocaine 375 times. Psychotic symptoms were observed in 62% of the patients and 21% of the self-injections; delusions were observed in 9.3%, psychotic self-reference with insight in 9.1%, illusions in 6.4%, and hallucinations in 5.3%. A higher presence of psychotic symptoms was noted with cannabis used in the previous month (76.9% versus 44.4%; P = .001) (no psychotic symptoms group); also, a greater use of benzodiazepines was observed: 75.6% versus 63.6% (P = .046). Lower use of methadone in the group with psychosis was observed: 75.6% versus 97.3% (P = .001). Motor alterations were tremor 58%, stereotyped movements 24%, and behaviour alteration 6%, significantly more frequent in the psychotic group. Conclusions: Thus, there was a high frequency of psychotic symptoms after intravenous cocaine use; patients with psychotic symptoms reported higher use of cannabis and benzodiazepines in the previous month and lower use of methadone. More tremors and stereotyped movements were observed in the group with psychotic symptoms. It is necessary to give a special approach to cocaine intravenous users.
HubMed – Methadone
Treating opioid use disorders during pregnancy: historical, current, and future directions.
Subst Abus. 2013 Apr-Jun; 34(2): 89-91
Jones HE
ABSTRACT The historical and current contexts of opioid use disorders during pregnancy are reviewed. There has been a long history of use of opioids by women in the United States, including by prescription prior to 1919. Neonatal abstinence syndrome was first identified coincident with this use. Methadone and more recently buprenorphine have proven to be successful pharmacotherapeutic agents in the treatment of opioid use disorder in pregnant women. However, these medications should be seen as only one ingredient of a comprehensive treatment approach for this population. The 21st century needs to witness a heightened emphasis on the myriad factors that lead to opioid use in women, and a broader education of those professionals who may come in contact with pregnant women with opioid use disorder.
HubMed – Methadone
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