Addiction Relapse Prevention

Anesthesia and Addiction, International Anesthesiology Clinics 49 (1), Winter 2011

by Ethan Bryson

By Ethan O. Bryson, M.D., and Elizabeth A. M. Frost, M.D.
Philadelphia, Lippincott Williams & Wilkins, 2011.
Pages: 176. Price: $176.00.

This is a review of the special issue of the International Anesthesiology Clinics book on Anesthesia and Addiction... more This is a review of the special issue of the International Anesthesiology Clinics book on Anesthesia and Addiction that Dr. Frost and I put together that was published in the January 2012 issue of Anesthesiology.

Addiction and Autonomy: are Addicts Autonomous?

by Srdjan Sremac

Nova Prisutnost 9(2011)1, 171-188. Co-authored with Frans Koopmans.

In the article, the authors deal with how addiction can be related to autonomy. First, they will provide a definition... more In the article, the authors deal with how addiction can be related to autonomy. First, they will provide a definition of substance addiction and the way various theories have interpreted this phenomenon. Further, they will give a general description of the concept of autonomy and relate this to the phenomenon of addiction. Subsequently, the authors will deal with the way some explanatory models of addiction (the disease model, disorder of choice model, and existential disorder model) see the relationship of autonomy and addiction and focus on the following questions: How does addiction relate to autonomy? Does addiction make volitional choice impossible, i.e. are addicts out of control? Is addictive behavior a rational activity?

Key words: Addiction, autonomy, disease model, disorder of choice model, existential disorder model, spirituality.

Dose-dependent differences in short ultrasonic vocalizations emitted by rats during cocaine self-administration

by David Barker

Rationale 
The motivational impetuses underlying self-administration of cocaine and other drugs of abuse... more Rationale 
The motivational impetuses underlying self-administration of cocaine and other drugs of abuse are not fully understood. One emerging factor is affect. Both positive and negative affective states have been hypothesized to influence drug seeking and drug taking. In parallel, it has been posited that the ultrasonic vocalizations (USVs) of Rattus norvegicus provide insight into the animals’ affective reactions. Furthermore, it has been shown that mesolimbic dopamine (DA) plays a key role in cocaine self-administration and in USV production. Thus, affective processing as measured by rodent USVs likely coincides with cocaine self-administration, but to date has not been studied.
Objective 
The present study examined USVs in both the negative affective (18–32.99 kHz) and positive affective (38–80 kHz) ranges of rats during self-administration of a low (0.355 mg/kg/infusion) or high (0.71 mg/kg/infusion) dose of cocaine.
Results 
USVs in both ranges were observed in both dose groups. Vocalizations of the low-dose animals occurred primarily in the 22-kHz range (18–32.99 kHz), but exhibited shorter durations (10–500 ms) than those traditionally observed for 22-kHz calls in aversive situations. In contrast, USVs of the high-dose group were primarily observed in the 50-kHz frequency range (38–80 kHz), typically associated with appetitive outcomes.
Conclusions 
These results provide evidence for the presence of USVs during cocaine self-administration. The observed dose-dependent difference in USVs provides novel support for the view that affect is one potential motivational factor influencing human drug use and relapse behaviors. Rodent USVs may provide a powerful tool for understanding the role of affect in addiction.

Evidence for learned skill during cocaine self-administration in rats.

by David Barker

RATIONALE:
It has been proposed that cocaine abuse results in skilled or "automatic" drug-taking... more RATIONALE:
It has been proposed that cocaine abuse results in skilled or "automatic" drug-taking behaviors. Brain regions important for skill learning are implicated in cocaine self-administration. However, the development of skill during self-administration has not been investigated.

OBJECTIVES:
The present experiment investigated the development of skilled self-administration over extended drug use by employing a novel operant vertical head movement under discriminative stimulus (S(D)) control. In addition, the capacity of the head movement to serve as an operant was tested by manipulating drug levels above or below satiety drug levels via frequent noncontingent microinfusions (0.2 s) of cocaine.

RESULTS:
Animals acquired the vertical head movement operant, which increased in number over days. Task learning was demonstrated by reduced reaction time in response to the S(D), increased propensity to self-administer upon S(D) presentation, and escalated drug consumption over days. Skill learning was demonstrated by (1) an increase over days in the velocity of operant movements, as a function of shorter duration but not altered distance, and (2) an increase over days in the probability of initiating the operant at the optimal starting position. Evidence that responding was specific to self-administration was revealed during periods of experimenter-manipulated drug level: maintaining drug levels above satiety decreased responding while maintaining drug levels below satiety increased responding.

CONCLUSIONS:
Under the specific set of circumstances tested herein, cocaine self-administration became skilled over extended drug use. The vertical head movement can be used as an operant comparable to lever pressing with the additional benefit of quantifying skill learning.

Tackling Problem Drug Use: A New Conceptual Framework

by Julian Buchanan

Journal of Social Work in Mental Health (The Haworth Social Work Practice Press, an imprint of The Haworth Press, Inc.) Vol. 2, No. 2/3, 2004, pp. 117-138;

Successful ‘recovery’ from long-term problem drug use has depended largely upon understanding and tackling the... more Successful ‘recovery’ from long-term problem drug use has depended largely upon understanding and tackling the physiological and psychological nature of drug dependence; however, drawing upon research and practice in Liverpool, England, the author questions whether this discourse is sufficient given the changing nature, context and attitudes towards drug consumption in the twenty-first century. This article emphasises the importance of incorporating structural and social factors. Drawing upon qualitative data from three separate studies, the author illustrates how stigmatisation, marginalisation, and social exclusion are significant debilitating components that have tended to be overlooked. This paper contributes new insights into the damaging impact of political rhetoric and structural discrimination that has placed many long-term drug users vulnerable to relapse. In response to these findings the author offers a new conceptual framework for practice that incorporates and pro-motes an understanding of the social nature and context of long-term drug dependence.

Inaugural Professorial Lecture: Questionnaire, Powerpoint, Lecture Notes (preview and download below)

by Julian Buchanan

Feel free to use, so long as you reference my work.
If you want a copy of the PowerPoint version email me.
If you have any feedback/comments I'm always interested!

julianbuchanan@gmail.com

Since the late 1970s illicit drug use has established itself as a major social problem. The response has largely been... more Since the late 1970s illicit drug use has established itself as a major social problem. The response has largely been dominated by tougher measures to coerce people to accept treatment and become drug free or ultimately face prison. But after decades of tough drug policies our prisons have become crowded silos for drug users and people with multiple personal difficulties. Relatively little progress seems to have been made in reducing the overall size of the drugs problem or the proportion of people taking illicit drugs.

This lecture will reflect upon the way in which a ‘war on drugs’ is played out as a ‘war on drug users’. While most strategies have concentrated upon the physical and psychological aspects of dependence, this paper will highlight the important but often overlooked structural and social context of problem drug use. It will be argued that the stigmatisation of illicit drug use has made it more difficult for problem drug users to recover. Alternative conceptual models that promote a more inclusive approach will be explored.

Understanding Problematic Drug Use: A Medical Matter or a Social Issue?

by Julian Buchanan

Buchanan, J. (2006) 'Understanding Problematic Drug Use: A Medical Matter or a Social Issue ?'. British Journal of Community Justice, 4, (2) 387–397

his paper questions the notion that problem drug use is essentially a physiological medical problem that requires... more his paper questions the notion that problem drug use is essentially a physiological medical problem that requires coercive treatment, from which success are measured by way of drug testing to determine the abstinence from the drug. The article argues that the causes and solutions to problem drug use are much more to do with socio-economic factors than physiological or psychological factors. In particular it explores the connections between the emergence and sudden rise in problematic drug use that occurred across the UK in the mid 1980s, with de-industrialisation and the decline of opportunities for unskilled non academic young people. Further the paper critically examines the notion of the ‘problem drug user’, in particular how those identified and labelled, are perceived and treated by wider society, and how this adversely impacts upon drug rehabilitation and social integration.

The anesthetic implications of illicit opioid abuse

by Ethan Bryson

Bryson EO. Addiction and Anesthesiology: International Anesthesiology Clinics: The anesthetic implications of illicit opioid abuse, 49 (1): 67-78, 2011

Propofol Abuse

by Ethan Bryson

Bryson EO, Frost EAM. Addiction and Anesthesiology: International Anesthesiology Clinics: Propofol Abuse, 49 (1): 173-80, 2011

The perioperative implications of tobacco, marijuana, and other inhaled toxins

by Ethan Bryson

Bryson EO, Frost EAM. Addiction and Anesthesia: International Anesthesiology Clinics: The perioperative implications of tobacco, marijuana, and other inhaled toxins, 49 (1): 103-8, 2011

The drug seeking anesthesia care provider

by Ethan Bryson

Bryson EO, Hamza H. Addiction and Anesthesia: International Anesthesiology Clinics: The drug seeking anesthesia care provider, 49 (1): 157-71, 2011

Perioperative implications of buprenorphine maintenance treatment for addiction

by Ethan Bryson

Gevirtz C, Frost EAM, Bryson EO. Addiction and Anesthesia: International Anesthesiology Clinics: Perioperative implications of buprenorphine maintenance treatment for addiction, 49 (1): 147-155, 2011

Intranasal Self-Administration of Remifentanil As the Foray Into Opioid Abuse by An Anesthesia Resident

by Ethan Bryson

Anesthesia and Analgesia (2010) Feb 1;110(2):524-5

Should Anesthesia Residents With a History of Substance Abuse Be Allowed to Continue Training In Clinical Anesthesia? The Results of a Survey of Anesthesia Residency …

by Ethan Bryson

Juornal of Clinical Anesthesia (2009) Nov;21(7):508-13

The Impaired Anesthesiologist: Where Do We Draw the Line?

by Ethan Bryson

Bryson EO, the Impaired Anesthesiologist, Where do we draw the line? Journal of Clinical Anesthesiology 22(5):311-2, 2010

Addiction and Substance Abuse in Anesthesiology

by Ethan Bryson

Anesthesiology (2008) 109:905–17