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Preclinical assays of drug discrimination and drug self-administration are widely used to examine abuse-related drug effects, and opioid antagonists have been extensively studied in these procedures. Studies with opioid antagonists have served two general purposes. First, antagonists selective for mu, kappa and delta receptors have been used as tools to characterize the pharmacological and neuroanatomical...
Pharmacotherapies for opiate dependence first involve detoxification from physical dependence on opiates and then maintenance of that abstinent state. There are now three agents of distinct pharmacological classes available to achieve both phases: the opiate agonist methadone, the partial opioid agonist buprenorphine, and the opioid antagonist naltrexone. This chapter reviews the role of naltrexone...
Ultra-low-dose opioid antagonist cotreatment was first shown parad oxically to enhance opioid analgesia and to reduce analgesic tolerance and physical dependence. In this chapter, we review data demonstrating that ultra-low-dose naloxone or naltrexone reduces several components of opioid dependence and addiction. While the reduction in opioid dependence, first demonstrated as a reduction in somatic...
Dependence on and abuse of prescription opiate drugs is now a major health problem with initiation of prescription opiate abuse exceeding cocaine in young people. Coincident with the emergence of abuse and dependence on prescription opiates there has been an increased emphasis on the treatment of pain. Pain is now the “5th vital sign” and physicians face disciplinary action for failure to adequately...
Psychomotor stimulant abuse continues to be a major health problem. Despite intensive study, pharmacological therapies for the treatment of stimulant addiction and the prevention of relapse are lacking. Furthermore, although certain individuals may be at greater risk for the development of compulsive drug-seeking behavior, the neural substrates mediating individual differences in sensitivity to the...
Cannabinoids are usually abused by humans in the form of marijuana. They are the most frequently abused illicit class of drugs in the United States, but no pharmacological treatment is currently available to help in reducing marijuana abuse and dependence. Although the dopaminergic system plays a critical role in the reinforcing effects of drugs of abuse, other neurotransmitter systems are implicated...
There are a number of efficacious pharmacotherapies currently available for smoking cessation, including nicotine replacement, buproprion, and varenicline. Each of these FDA-approved treatment options operates by a different mechanism of action to increase smoking quit rates. This chapter reviews the existing literature that addresses the role of the endogenous opioid system in nicotine dependence...
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