Lamoure J. How Do You Treat Internet Addiction. Cdn J of CME 2012; 24(3): 14
Lamoure J. How Do You Treat Internet Addiction. Cdn J of CME 2012; 24(3): 14
There are not many formats or forums at this point that address Internet addiction, and there is even some debate over... more
There are not many formats or forums at this point that address Internet addiction, and there is even some debate over whether internet addiction is a true addiction. In my clinical experience and given definitions of addiction, "I would place internet as
being a very highly addictive medium."........
...... It provides a strong “hook” to those who are looking for a form of escapism. That being said, it is legal, cost effective, accessible, and provides instant gratification. It can, however, have a deleterious impact on the patient’s quality and quantity of life, with psychosocial retardation, financial challenges, and relationship challenges.
Much like patients with food or shopping addictions, there is the challenge that it cannot be easily extricated from daily life, especially in western and first/second world countries. Standard strategies that include removal of the offending agent will not work with internet addictions as there is exposure in insidious ways.......
From "Lamoure J. How Do You Treat Internet Addiction. Cdn J of CME 2012; 24(3): 14" (In press)
Dr. Joel W. Lamoure RPh., DD., FASCP
http://www.joelwlamoure.com/id6.html
Correlates and Contexts of US Injection Drug Initiation Among Undocumented Mexican Migrant Men Who Were Deported from the United States
Robertson AM, Lozada R, Pollini RA, Rangel G, Ojeda VD. Correlates and Contexts of US Injection Drug Initiation Among Undocumented Mexican Migrant Men Who Were Deported from the United States. AIDS Behav. 2012 Jan 14. [Epub ahead of print]
Preventing the onset of injection drug use is important in controlling the spread of HIV and other blood borne... more Preventing the onset of injection drug use is important in controlling the spread of HIV and other blood borne infections. Undocumented migrants in the United States face social, economic, and legal stressors that may contribute to substance abuse. Little is known about undocumented migrants' drug abuse trajectories including injection initiation. To examine the correlates and contexts of US injection initiation among undocumented migrants, we administered quantitative surveys (N = 309) and qualitative interviews (N = 23) on migration and drug abuse experiences to deported male injection drug users in Tijuana, Mexico. US injection initiation was independently associated with ever using drugs in Mexico pre-migration, younger age at first US migration, and US incarceration. Participants' qualitative interviews contextualized quantitative findings and demonstrated the significance of social contexts surrounding US injection initiation experiences. HIV prevention programs may prevent/delay US injection initiation by addressing socio-economic and migration-related stressors experienced by undocumented migrants.
Prevention of HIV Infection Among Injection Drug Users In Resource‐Limited Settings
Vlahov D, Robertson AM, Strathdee SA. Clin Infect Dis. 2010 May 15;50 Suppl 3:S114-21.
Injection drug use contributes to considerable global morbidity and mortality associated with human immunodeficiency... more Injection drug use contributes to considerable global morbidity and mortality associated with human immunodeficiency virus (HIV) infection and AIDS and other infections due to blood-borne pathogens through the direct sharing of needles, syringes, and other injection equipment. Of approximately 16 million injection drug users (IDUs) worldwide, an estimated 3 million are HIV infected. The prevalence of HIV infection among IDUs is high in many countries in Asia and eastern Europe and could exacerbate the HIV epidemic in sub-Saharan Africa. This review summarizes important components of a comprehensive program for prevention of HIV infection in IDUs, including unrestricted legal access to sterile syringes through needle exchange programs and enhanced pharmacy services, treatment for opioid dependence (ie, methadone and buprenorphine treatment), behavioral interventions, and identification and treatment of noninjection drug and alcohol use, which accounts for increased sexual transmission of HIV. Evidence supports the effectiveness of harm-reduction programs over punitive drug-control policies.
Correlates of Seeking Injection Assistance Among Injection Drug Users In Tijuana, Mexico
Robertson AM, Vera AY, Gallardo M, Pollini RA, Patterson TL, Case P, Nguyen L, Strathdee SA. Am J Addict. 2010 Jul-Aug;19(4):357-63.
Assisted injection among injection drug users (IDUs) remains understudied. We recruited 1,056 IDUs using... more Assisted injection among injection drug users (IDUs) remains understudied. We recruited 1,056 IDUs using respondent-driven sampling in Tijuana, Mexico. Participants underwent HIV and syphilis testing and structured interviews. One-quarter (25%) sought injection assistance in the past 6 months. Seeking injection assistance was independently associated with being female (adjusted odds ratio [AOR]= 2.59; 95% confidence interval [CI]= 1.73-3.90), being born outside Baja California (AOR = 1.75; CI = 1.26-2.42), having recent abscesses (AOR = 2.59; CI = 1.93-3.47), using syringes previously used by others in the past 6 months (AOR = 1.99; CI = 1.45-2.71), and ever being arrested for carrying sterile syringes (AOR = 1.55; CI = 1.15-2.09).
Prevalence and correlates of 'agua celeste' use among female sex workers who inject drugs in Ciudad Juarez, Mexico
Morris MD, Case P, Robertson AM, Lozada R, Vera A, Clapp JD, Medina-Mora ME, Strathdee SA. Drug Alcohol Depend. 2011 Sep 1;117(2-3):219-25. Epub 2011 Mar 26.
BACKGROUND: Agua celeste, or "heavenly water", is the street name for a sky-blue colored solvent reportedly... more BACKGROUND: Agua celeste, or "heavenly water", is the street name for a sky-blue colored solvent reportedly inhaled or ingested to produce an intoxicating effect. Study aims were to (1) describe prevalence of agua celestse (AC) use, and (2) identify correlates of lifetime and recent use of AC use among female sex workers who also inject drugs (FSW-IDUs) in northern Mexico. METHODS: Between 2008 and 2010, baseline data from FSW-IDUs≥18 years old living in Tijuana or Ciudad Juarez participating in a longitudinal behavioral intervention were analyzed using logistic regression. RESULTS: Among 623 FSW-IDUs (307 from Tijuana and 316 from Ciudad Juarez (CJ)), 166 (26%) reported ever using AC, all of whom lived in CJ. Among the CJ sample, lifetime prevalence of AC use was 53%, median age of first use was 16 years (IQR: 14-23), and 10% reported it as their first abused substance. Ever using AC was independently associated with ever being physically abused and younger age, and was marginally associated with initiating injection drug use and regular sex work at age eighteen or younger. Among those ever using AC, 70/166 (42.2%) reported using it within the last 6 months, which was independently associated with using drugs with clients before or during sex, being on the street more than 8h per day, and younger age. DISCUSSIONWe observed considerable geographic variation in the use of AC in northern Mexico. Future studies exploring factors influencing use, its precise formulation(s), and its potential health effects are needed to guide prevention and treatment.
A qualitative view of drug use behaviors of Mexican male injection drug users deported from the United States
Ojeda VD, Robertson AM, Hiller SP, Lozada R, Cornelius W, Palinkas LA, Magis-Rodriguez C, Strathdee SA. J Urban Health. 2011 Feb;88(1):104-17.
Deportees are a hidden yet highly vulnerable and numerous population. Significantly, little data exists about the... more Deportees are a hidden yet highly vulnerable and numerous population. Significantly, little data exists about the substance use and deportation experiences of Mexicans deported from the United States. This pilot qualitative study describes illicit drug use behaviors among 24 Mexico-born male injection drug users (IDUs), ≥ 18 years old, residing in Tijuana, Mexico who self-identified as deportees from the United States. In-person interviews were conducted in Tijuana, Mexico in 2008. Content analysis of interview transcripts identified major themes in participants' experiences. Few participants had personal or family exposures to illicit drugs prior to their first U.S. migration. Participants reported numerous deportations. Social (i.e., friends/family, post-migration stressors) and environmental factors (e.g., drug availability) were perceived to contribute to substance use initiation in the U.S. Drugs consumed in the United States included marijuana, heroin, cocaine, methamphetamine, and crack. More than half of men were IDUs prior to deportation. Addiction and justice system experiences reportedly contributed to deportation. After deportation, several men injected new drugs, primarily heroin or methamphetamine, or a combination of both drugs. Many men perceived an increase in their substance use after deportation and reported shame and loss of familial social and economic support. Early intervention is needed to stem illicit drug use in Mexican migrant youths. Binational cooperation around migrant health issues is warranted. Migrant-oriented programs may expand components that address mental health and drug use behaviors in an effort to reduce transmission of blood-borne infections. Special considerations are merited for substance users in correctional systems in the United States and Mexico, as well as substance users in United States immigration detention centers. The health status and health behaviors of deportees are likely to impact receiving Mexican communities. Programs that address health, social, and economic issues may aid deportees in resettling in Mexico.
Deportation Experiences of Women Who Inject Drugs in Tijuana, Mexico
Robertson AM, Lozada R, Vera A, Palinkas LA, Burgos JL, Magis-Rodriguez C, Rangel G, Ojeda VD. Deportation Experiences of Women Who Inject Drugs in Tijuana, Mexico. Qual Health Res. 2011 Sep 13. [Epub ahead of print]
Deportation from the United States for drug offenses is common, yet the consequences of deportation for women drug... more Deportation from the United States for drug offenses is common, yet the consequences of deportation for women drug users are poorly documented. In 2008, in Tijuana, Mexico, we conducted an exploratory qualitative study of migration, deportation, and drug abuse by interviewing 12 Mexican injection-drug-using women reporting U.S. deportation. Women reported heavy drug use before and after deportation, but greater financial instability and physical danger following deportation than when living in the United States. We identified an unmet need for health and social services among deported drug-using women, including HIV prevention, drug treatment, physical and mental health services, and vocational training. Binational coordination is needed to help deported women resettle in Mexico.
Male injection drug users try new drugs following US deportation to Tijuana, Mexico
Robertson AM, Rangel MG, Lozada R, Vera A, Ojeda VD. Male injection drug users try new drugs following U.S. deportation to Tijuana, Mexico. Drug Alcohol Depend. 2011 Aug 9. [Epub ahead of print]
BACKGROUND: Among male injection drug users (IDUs) in Tijuana, Mexico, U.S. deportation is associated with HIV... more BACKGROUND: Among male injection drug users (IDUs) in Tijuana, Mexico, U.S. deportation is associated with HIV transmission. Changing drug use behaviors following deportation, including the use of new drugs, may increase HIV risk but are understudied. We identify correlates of trying new drugs following male IDUs' most recent U.S. deportation to Mexico. METHODS: In 2010, we recruited 328 deported male IDUs in Tijuana, Mexico. Questionnaires collected retrospective data on drug use and other HIV risk behaviors throughout migratory events. Logistic regression identified correlates of trying new drugs/combinations following their most recent deportations. Informed consent was obtained from all participants. RESULTS: Nearly one in six men (n=52, 16%) tried new drugs following their most recent deportation, including heroin (n=31), methamphetamine (n=5), and heroin/methamphetamine combined (n=17). Trying new drugs following deportation was independently associated with U.S. incarceration (adjusted odds ratio [AOR]=3.96; 95% confidence interval [C.I.] 1.78, 8.84), increasing numbers of U.S. deportations (AOR=1.11 per deportation; C.I. 1.03, 1.20), feeling sad following deportation (AOR 2.69; C.I. 1.41, 5.14), and perceiving that one's current lifestyle increases HIV/AIDS risk (AOR 3.91; C.I. 2.05, 7.44). CONCLUSIONS:Trying new drugs following U.S. deportation may be related to the unique contexts and stressors experienced by drug-abusing migrants as they attempt to reestablish their lives in Mexico. Findings imply an unmet need for health and social programs to alleviate pre- and post-deportation stressors faced by undocumented and return migrants in the U.S.-Mexico conte
DownloadFamily history of alcohol dependence and gray matter abnormalities in non-alcoholic adults
published in 'World Journal of Biological Psychiatry', 2012
Objectives. Alcohol-use disorders in adolescents are associated with gray matter (GM) abnormalities suggesting... more Objectives. Alcohol-use disorders in adolescents are associated with gray matter (GM) abnormalities suggesting neurotoxicity by alcohol. However, recently similar GM abnormalities were found in non-drinking children with a family history (FH) of alcohol dependence (AD). The question thus rises whether these abnormalities represent a transient delay in brain maturation or a persistent risk factor for developing neuropsychiatric disorders, rather than a (neurotoxic) consequence of AD. This study investigated whether a FH of AD in non-drinking adults is associated with abnormal GM-volumes similar to those observed in drinking and non-drinking adolescents with a FH of AD. Methods. GM-images were analyzed using Voxel-Based Morphometry in non-alcoholics with (FH+; N = 36) and without (FH-; N = 107) familial AD. Additionally we controlled for possible confounders: diagnosis of depression/anxiety, childhood trauma and familial depression/anxiety. Results. Smaller GM-volumes were shown in the right parahippocampal gyrus in FH+ compared with FH-. Results were unaffected by confounders. Conclusions. We demonstrated an effect of familial AD in non-alcoholic adults on GM volume in the parahippocampal gyrus, similar to drinking and non-drinking FH+ adolescents. These findings suggest that GM abnormalities in the parahippocampal gyrus represent a persistent biological susceptibility for AD or related psychopathology and not neurotoxicity of alcohol or delayed brain maturation.
Venous access and care: Harnessing pragmatics in harm reduction for people who inject drugs
Addiction, 2012, co-authored with Tim Rhodes
Aim: To explore the facilitators of long-term hepatitis C avoidance among people who inject drugs.
Design: We... more
Aim: To explore the facilitators of long-term hepatitis C avoidance among people who inject drugs.
Design: We employed a qualitative life history design. Two interviews were conducted with each participant, with the second interview incorporating reference to a computer constructed
life history time line. Interview accounts were audio-recorded, transcribed verbatim and analysed thematically.
Setting: Recruitment took place through low threshold drug services and drug user networks in South East and North London. Participants were interviewed at the recruitment services or in their homes.
Participants: The sample comprised 35 people who inject drugs, 20 of whom were hepatitis C antibody negative. Participants’ average injecting trajectory was 19 years (6 – 33), with 66%
primarily injecting heroin, and 34% a crack and heroin mix. Nine (26%) of the sample were female and the average age was 39 years (23 – 53).
Findings: Hepatitis C risk awareness was recent and de-prioritised by the majority of participants. The facilitation of venous access and care was an initial and enduring rationale
for safe injecting practices. Difficult venous access resulted in increased contamination of injecting environments and transitions to femoral injecting. Participants expressed an unmet
desire for non-judgemental venous access information and advice.
Conclusions: Harm reduction interventions which attend to the immediate priorities of people who inject drugs, such as venous access and care, have the potential to re-engage individuals
who are jaded or confused by hepatitis C prevention messages.
Increment of the operant behavior alter the presentation of stimulus conditioned to ethanol effects
Quezada, V., Alarcon, D., Miguez, G., & Betancourt, R. (2009). [Increment of the operant behavior alter the presentation of stimulus conditioned to ethanol effects] Aumento de la conducta operante tras la presentación de estímulos condicionados al efecto del etanol. Revista de Psicología, 18, 65-79.
Previous studies have shown that stimuli associated with drugs can acquire motivational proprieties, which allow them... more Previous studies have shown that stimuli associated with drugs can acquire motivational proprieties, which allow them to control operant behavior for drug consumption/seeking and other types of reward. The current research investigated whether a conditioned stimulus (CS) that has been paired with ethanol is able to disrupt the rate of responding for a reward. A Pavlovian instrumental transfer experiment was conducted with albino rats. The experimental group received paired presentations of the CS (i.e, tone) and the unconditioned stimulus (US) (i.e., the effects of ethanol). Subjects in the control group received random presentations of the US and the CS. The rate of operant behavior for food seeking in both the presence and the absence of the CS was determined for the subjects. The results show that a CS associated with ethanol increased the rate of responding for food.
2 views
Seen by:
Effects of extinction in multiple contexts on the renewal of associative tolerance to ethanol
Betancourt, R., Corada, L., Dominichetti, J., Laborda, M., Martinez, G., & Miguez, G. (2008). [Effects of extinction in multiple contexts on the renewal of associative tolerance to ethanol] Efecto de la extinción en múltiples contextos en la renovación de la tolerancia asociativa al etanol. Psicothema, 20, 285-289.
The Pavlovian analysis of drug tolerance describes how the contexts of drug administration participate in the... more The Pavlovian analysis of drug tolerance describes how the contexts of drug administration participate in the elicitation of compensatory conditioned responses that are, at least partly, responsible for tolerance. Findings indicate that if an association is acquired in one context and extinguished in another one, when exposing the subjects to the acquisition context, renewal of the conditioned response will take place. Ambiguous evidence exists about whether or not this effect diminishes when extinguishing the association in multiple contexts. This investigation evaluates the existence of the phenomenon of renewal of tolerance to ethanol, and whether it diminishes by the extinction in multiple contexts. Evidence of renewal of tolerance to ethanol in rats was found, but no diminution was observed when extinguishing in multiple contexts.
Biometrics in Pharma: Politics and Privacy
Co-authored with Daniel Shapiro, presented at the Canadian Association for American Studies Conference (CAAS), Windsor, Ontario, Canada, October 15-17, 2010.
The Drug Enforcement Agency (DEA) has announced the implementation of the use of both computerized and biometric... more
The Drug Enforcement Agency (DEA) has announced the implementation of the use of both computerized and biometric security protocols in the electronic prescription of controlled substances. Electronic prescriptions which were up until this point not allowed to be prescribed by electronic means will now be easier for physicians and the DEA to monitor and prescribe.
This paper will examine the various practical, political, and privacy issues as well as the potential benefits of the use of biometric information for the prescription of narcotics and other controlled substances. The proposed changes will build in non-repudiation and improve accountability, while introducing problems such as delegation, privacy, cost, and information security. Another consequence of strong biometric authentication is false acceptance and false rejection rates. Not only are there annoyances due to false reject rates, there are serious medical consequences when a drug cannot be obtained due to failed biometric authentication.
20 views
Seen by:
Príbehy osobnej zmeny u závislých po úspešnej resocializácii [Narratives of personal changes in addicted clients after the successful resocialization]
by jan klimas
Klimas, J. (2006). Príbehy osobnej zmeny u závislých po úspešnej resocializácii [Narratives of personal changes in addicted clients after the successful resocialization]. Poster presented at the 7th annual Slovak meeting and 45th annual Czecho-Slovak meeting of the AT Section of Psychiatric Association of The Slovak Medical Association. Predná Hora, Slovakia. October 2006.
Príspevok prináša súhrnné výsledky výskumného projektu zameraného na skúmanie osobných zmien u závislých v... more Príspevok prináša súhrnné výsledky výskumného projektu zameraného na skúmanie osobných zmien u závislých v resocializácií a faktorov, ktoré k týmto zmenám prispeli. Opiera sa o výpovednú hodnotu príbehov účastníkov výskumu, skonštruovaných na základe hypotetických zážitkov osobnej zmeny. Na skúmanie komplexných zážitkov osobnej zmeny bol zvolený kvalitatívny prístup, ktorého metódou bolo semištrutkurované interview. Nahraných a analyzovaných bolo 10 interview, uskutočnených s klientami 2 resocializačných centier na Slovensku. Výpovede participantov boli analyzované prostredníctvom „Konsenzuálneho kvalitatívneho výskumu“ /CQR/. Najpočetnejšie z vytvorených kategórii, ktoré reprezentujú zmeny u závislých v resocializácii boli zahrnuté do vytvárania typických príbehov resocializantov.