IU Indianapolis ScholarWorks :: Browsing by Subject "addiction"

Browsing by Subject "addiction"

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The adverse childhood experiences questionnaire: Two decades of research on childhood trauma as a primary cause of adult mental illness, addiction, and medical diseases
(Taylor & Francis, 2019-01-01) Zarse, Emily M.; Neff, Mallory R.; Yoder, Rachel; Hulvershorn, Leslie; Chambers, Joanna E.; Chambers, R. Andrew; Psychiatry, School of Medicine
Objective. In 1998, Felitti and colleagues published the first study of the Adverse Childhood Experiences-Questionnaire (ACE-Q), a 10-item scale used to correlate childhood maltreatment and adverse rearing contexts with adult health outcomes. This paper qualitatively reviews nearly two decades of research utilizing the ACE-Q, highlighting its contribution to our understanding of the causal roots of common, interlinked comorbidities of the brain and body.Methods. An OVID/PubMed search was conducted for English language articles published before 2016, containing the phrase “Adverse Childhood Experiences” in which the ACE-Q was utilized. Source review included a manual search of bibliographies, resulting in 134 articles, including 44 based on the original ACE-Q study population.Results. ACE-Q research has demonstrated that exposures to adverse childhood experiences converge dose-dependently to potently increase the risk for a wide array of causally interlinked mental illnesses, addictions, and multi-organ medical diseases. The intergenerational transmission of this disease burden via disrupted parenting and insecure rearing contexts is apparent throughout this literature. However, the ACE-Q does not tease out genetic or fetal drug exposure components of this transmission.Conclusions. Adverse childhood experiences and rearing may generate a public health burden that could rival or exceed all other root causes. Translating this information to health-care reform will require strengthening brain-behavioral health as core public and preventative health-care missions. Greater integration of mental health and addiction services for parents should be accompanied by more research into brain mechanisms impacted by different forms and interactions between adverse childhood experiences.
ANSA: Becoming a Recovery Focused Tool
(Office of the Vice Chancellor for Research, 2013-04-05) Walton, Betty A.; Kim, Hea-Won; Park, SeonHye
The Adult Needs and Strength Assessment (ANSA, Lyons, 2009) has been used across public mental health and addiction services in Indiana to help develop intervention plans and to monitor client progress. ANSA consists of six core domains (Life Functioning, Behavioral Health Needs, Risk Behaviors, Strengths, Acculturation, and Caregiver). Domain items are rated on a four-point scale to describe the degree to which a need interferes with functioning or a useful strength is present. Despite statewide implementation, literature related to the ANSA is scarce. The study evaluates the psychometric properties of ANSA and its role as an outcome performance measure. Adults for whom the ANSA had been rated at four points between 2008 and 2010 were included (N=6320). Internal consistency reliability was measured for each ANSA domain and outcome measure. Reliable change indices (RCI) for each domain were used to calculate significant change. At each point of assessment and across time, the Cronbach’s alphas for all domains, except Risk Behaviors, are in the acceptable to high ranges (0.71 to 0.92), indicating good internal consistency and stability. For outcome performance measures, a more realistic timeframe for assessments (12 months) was required to document reliable improvement in at least one ANSA domain for individuals with serious mental health needs. The Residential Stability outcome measure has the low internal consistency and stability. From the recovery perspective, a new Community Integration measure was proposed as an alternative outcome measure and proved to be reliable (α = .90). Study findings helped enhance the ANSA tool, create a new outcome measure, and inform state policy. Specifically, bridging research to practice, findings resulted in restructuring the ANSA Risk Domain and modifying how outcomes are measured for adults in recovery focused behavioral health services.
Balancing the Risks and Benefits of Benzodiazepines
(AMA, 2021-01) Hirschtritt, Matthew E.; Olfson, Mark; Kroenke, Kurt; Medicine, School of Medicine
In September 2020, the US Food and Drug Administration (FDA) announced an anticipated update to the boxed warning on all benzodiazepines to explicitly “address the serious risks of abuse, addiction, physical dependence, and withdrawal reactions” among this class of medications.1 The current boxed warning for benzodiazepines (eg, alprazolam, lorazepam, clonazepam, diazepam) highlights only the risks of coadministration of opioids and benzodiazepines. Benzodiazepines are prescribed for multiple indications, most notably generalized anxiety disorder, panic, social phobia, insomnia, and seizure prophylaxis and rescue.
Caenorhabditis elegans as a Model to Study the Molecular and Genetic Mechanisms of Drug Addiction
(Elsevier, 2016) Engleman, Eric A.; Katner, Simon N.; Neal-Beliveau, Bethany S.; Department of Psychiatry, IU School of Medicine
Drug addiction takes a massive toll on society. Novel animal models are needed to test new treatments and understand the basic mechanisms underlying addiction. Rodent models have identified the neurocircuitry involved in addictive behavior and indicate that rodents possess some of the same neurobiologic mechanisms that mediate addiction in humans. Recent studies indicate that addiction is mechanistically and phylogenetically ancient and many mechanisms that underlie human addiction are also present in invertebrates. The nematode Caenorhabditis elegans has conserved neurobiologic systems with powerful molecular and genetic tools and a rapid rate of development that enables cost-effective translational discovery. Emerging evidence suggests that C. elegans is an excellent model to identify molecular mechanisms that mediate drug-induced behavior and potential targets for medications development for various addictive compounds. C. elegans emit many behaviors that can be easily quantitated including some that involve interactions with the environment. Ethanol (EtOH) is the best-studied drug-of-abuse in C. elegans and at least 50 different genes/targets have been identified as mediating EtOH's effects and polymorphisms in some orthologs in humans are associated with alcohol use disorders. C. elegans has also been shown to display dopamine and cholinergic system-dependent attraction to nicotine and demonstrate preference for cues previously associated with nicotine. Cocaine and methamphetamine have been found to produce dopamine-dependent reward-like behaviors in C. elegans. These behavioral tests in combination with genetic/molecular manipulations have led to the identification of dozens of target genes/systems in C. elegans that mediate drug effects. The one target/gene identified as essential for drug-induced behavioral responses across all drugs of abuse was the cat-2 gene coding for tyrosine hydroxylase, which is consistent with the role of dopamine neurotransmission in human addiction. Overall, C. elegans can be used to model aspects of drug addiction and identify systems and molecular mechanisms that mediate drug effects. The findings are surprisingly consistent with analogous findings in higher-level organisms. Further, model refinement is warranted to improve model validity and increase utility for medications development.
Different Lines of Rats Selectively-Bred for High Alcohol-Drinking Demonstrate Disparate Preferences for Nicotine Self-administration
(Ashdin, 2016-05) Rezvani, Amir H.; Levin, Edward D.; Wells, Corinne; Slade, Susan; Morrison, Margaret; Marshall, Lindsey; Morris, Matt; Confino, Jamie; Allenby, Cheyenne; Lumeng, Lawrence; Department of Medicine, IU School of Medicine
Background. Alcohol and nicotine are commonly co-abused. The search for a common core of neural, behavioral, and genetic factors underlying addiction has been the goal of addiction research. Purpose. Genetic predisposition to high alcohol intake has been studied in rats by selectively breeding rats that have high preference for alcohol. The current experiments were conducted to determine if the level of intravenous nicotine administration for the various lines of alcohol-preferring rats differs from that for nonalcohol-preferring controls. Study design. Adult alcohol-naïve selectively-bred alcohol-preferring male rats from four lines (P, AA, HAD-1, sP) and their control nonalcohol-preferring rats (NP, ANA, LAD-1, sNP) were trained and given access to self-administer nicotine (0.03 mg/kg/infusion). Results. The results show that the P rats self-administered significantly more nicotine than NP rats. In contrast, there were no significant differences in nicotine self-administration between the sP and sNP or the AA and ANA rats. Unexpectedly, high alcohol-drinking HAD-1 rats self-administered significantly less nicotine than low alcohol-drinking LAD-1 rats. Conclusion. This suggests that some genetic factors that underlie high-alcohol intake have more general effects in promoting high nicotine intake tendencies, while other genetic factors are more specific to only heavy drinking.
Drivers of Substance Misuse and Addiction in Indiana
(Fairbanks School of Public Health, 2023-02) Greene, Marion; Kooreman, Harold; Kampman, Haleigh
Substance use continues to be a significant concern in Indiana. Misuse of alcohol and/or illicit drugs can lead to numerous negative consequences, often affecting a person’s physical and mental health, relationships with family and friends, and their ability to hold a job. As drug use progresses into dependence and addiction, there is an increased risk that individuals become involved with the justice system. Arrests and incarcerations can occur for using illicit drugs, driving under the influence of a substance, or for engaging in drug-related criminal activities such as dealing. Furthermore, persons addicted to drugs, especially opioids and sedative-hypnotics, are at risk for accidental or intentional overdose, which can be fatal. These consequences not only affect the individual, but also have a considerable impact on their families and the community.
Evaluation of Indiana Access to Recovery
(Office of the Vice Chancellor for Research, 2013-04-05) Watson, Dennis P.
This presentation will discuss the evaluation of Indiana’s Access to Recovery (ATR) program. ATR is a 4-year federal demonstration grant managed by Indiana’s Division of Mental Health and Addiction (DMHA). ATR provides clients with access to services that are considered necessary components of recovery, but are often not available under traditional funding schemes (e.g., transportation, food access, housing). The evaluation started in May of 2012, and it is being carried out in collaboration with DMHA with funding from the Solution Center. Undergraduate and graduate student evaluators from the Center for Health Policy (CHP) are carrying out their work under the supervision of a faculty mentor. To date these students have: completed a literature review to assist DMHA in understanding ways to incentivize the work being carried out by providers; carried out 6 client focus groups and 15 provider phone interviews for formative evaluation purposes; and developed a logic model of the program. Students have also provided ongoing feedback to DMHA through their attendance at regularly scheduled advisory board meetings. Students are currently in the process of analyzing a large administrative database to provide feedback related to the effectiveness of the program. These finding will be of great benefit to DMHA as they seek to secure additional funding for ATR after the initial demonstration comes to a close. The presentation will discuss some of the early findings of the evaluation and a number of the lessons that students have learned about working in collaboration with a government partner.
First Do No Harm - The Indiana Providers Guide to the Safe, Effective Management of Chronic Non-Terminal Pain
(State of Indiana, 2013) Bell-Sharp, Kim; Gregory, Eigner; Brooks, Tracy L.; Elliott, Alicia; Cragen, Debbie; Ersin, Ozlem H.; Croasdell, Lori; Fernandes, Taya; Duwve, Joan; Fielding, Stephen M.; Gentry, Mark E.; Greene, Marion S.; King, Timothy E.; Kelley, Kristen; Konchalski, Jan; Kuzma, Abigail; LaHood, Amy; MacKie, Palmer J.; McMahan, Deborah; Mowry, James B.; Park, Esther J.; Pontones, Pam; Ring, Barry S.; Robinson, Natalie; Roth, Daniel C.; Rumsey, Todd C.; Schreier, Eric M.; Stone, Cynthia L.; Straub, Tom; Welch, Peggy; Sybesma, J. Michelle; Symmes, Shelly; Whitworth, Michael; Vaught, Cynthia; Weitlauf, Sharon L.; Weaver, Tamara; Zachodni, Carla
"First Do No Harm: The Indiana Healthcare Providers Guide to the Safe, Effective Management of Chronic Non-Terminal Pain" was developed by the Indiana Prescription Drug Abuse Prevention Task Force’s Education Committee under the leadership of Dr. Deborah McMahan. This provider toolkit, based on expert opinion and recognized standards of care, was developed over many months with the input of healthcare providers representing multiple specialties and all corners of the state. First Do No Harm provides options for the safe and responsible treatment of chronic pain, including prescriptions for opioids when indicated, with the ultimate goals of patient safety and functional improvement. It was developed as an interactive compendium to the new Medical Licensing Board rule addressing Opioid Prescribing for Chronic, Non-terminal Pain to give healthcare providers tools they can use to comply with the rule.
Innovations in Opioid Law and Policy Interventions Workshop: Summary of Proceedings
(Indiana University, 2018-08-31) Terry, Nicolas P.; Silverman, Ross D.; Hoss, Aila; Beukema, Emily
In 2017, Indiana University, in cooperation with Indiana Governor Eric Holcomb and community partners, launched the Grand Challenge: Responding to the Addictions Crisis initiative, a university-wide effort to advance interdisciplinary research and interventions in response to the substance abuse crisis affecting Indiana and the nation. The “Legal and Policy Best Practices in Response to the Substance Abuse Crisis” project is one of sixteen funded under Phase 1 of the Grand Challenge. In July 2018, and as part of this project, the research team convened a group of national experts to discuss legal and policy innovations to respond to the opioid use disorder (OUD) crisis. This report summarizes the proceedings of this workshop and updates some of the recommendations made by the team in their March 2018 Preliminary Report. During the workshop, experts answered targeted questions relating to the challenges in implementing law and policy recommendations to respond to the addiction crisis, as well as identified gaps in the current research. Participants provided examples of innovative interventions to respond to this crisis across four primary topic categories: (1) Criminalization; (2) Public Health; (3) Treatment; and (4) Effectuating Change.
A medium throughput rodent model of relapse from addiction with behavioral and pharmacological specificity
(Elsevier, 2019-08) Eiler, William J. A., II; Gleason, Scott D.; Smith, Jodi L.; Witkin, Jeffrey M.; Neurological Surgery, School of Medicine
One of most formidable problems in the treatment of addiction is the high rate of relapse. The discovery of medicines to help mitigate relapse are aided by animal models that currently involve weeks of training and require surgical preparations and drug delivery devices. The present set of experiments was initiated to investigate a rapid 8-day screening method that utilizes food instead of intravenous drug administration. Male Sprague-Dawley rats were trained in a reinstatement paradigm in which every lever press produced a 45 mg food pellet concurrently paired with a light and tone. Behavior was subsequently extinguished with lever responses producing neither food nor food-associated stimuli. Reinstatement of responding was evaluated under conditions in which the first three responses of every 5 min time bin produced a food pellet along with food-associated stimuli. The mGlu5 receptor antagonists MPEP and MTEP produced a significant reduction in reinstatement while failing to alter responding where every response produced food. The cannabinoid CB1 receptor antagonist rimonabant and the mGlu2/3 receptor agonist LY379268 also selectively reduced reinstatement. Other compounds including clozapine, d-amphetamine, chlordiazepoxide, ABT-431, naltrexone and citalopram were without effect. The results suggest that relapse-like behavioral effects can be extended to non-pharmacological reinforcers. Drug effects demonstrated both behavioral and pharmacological specificity. The present experimental design thus allows for efficient and rapid assessment of the effects of drugs that might be useful in the treatment of addiction-associated relapse.

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