Can the dopaminergic-related effects of general anesthetics be linked to mechanisms involved in drug abuse and addiction?

BACKGROUND: General anesthetics (GA) are well known for the ability to induce a state of reversible loss of consciousness and unresponsiveness to painful stimuli. However, evidence from animal models and clinical studies show that GA exposure may induce behavioral changes beyond acute effects. Most research and concerns are focused on changes in cognition and memory. METHODS: We will look at effects of GA on behavior that is mediated by the dopaminergic system. RESULTS: Pharmacological resemblance of GA with drugs of abuse, and the complexity and importance of dopaminergic systems in both reward seeking and addictive illnesses make us believe that it deserves an overview about what is already known and what matters to us as healthcare workers and specifically as anesthesiologists. CONCLUSION: A review of available evidence strongly suggests that there may be a link between the effects of GA on the brain and substance abuse, partly explained by their influence on the dopaminergic system.

Externalizing disorders and substance use: empirically derived subtypes in a population-based sample of adults.

PURPOSE: Attention-deficit/hyperactivity disorder (ADHD), conduct disorder (CD), and oppositional defiant disorder (ODD) are common externalizing disorders of childhood. The common effects of these disorders on substance abuse need further investigation. The current study investigated the joint clusters of childhood/adolescence ADHD, CD, and ODD, and their influence on substance abuse/dependence in a population-based sample of adults. METHODS: The data were drawn from the PsyCoLaus study (n = 3,720) conducted in Lausanne, Switzerland. The population-based sample included 238 subjects meeting criteria for ADHD/ODD/CD diagnoses before the age of 15. Latent class analyses (LCA) were performed to derive comorbidity subtypes, which were subsequently characterized with respect to psychosocial correlates and substance use. RESULTS: The best fit in LCAs was achieved with three latent classes: an ADHD subtype (35.7 %); an externalizing multimorbid subtype (33.6 %) involving ODD, ADHD, and CD; and a third subtype with CD (30.7 %). The CD subtype showed the highest association with substance use. Apart from this, the externalizing multimorbid subtype was also significantly linked to substance use. The ADHD subtype had only elevated frequencies for alcohol dependence in comparison with subjects that had no history of ADHD, ODD, and CD during childhood or adolescence. Finally, important interactions between subtypes and sex were observed with regard to substance use. CONCLUSIONS: This study provides evidence showing that subtyping the externalizing disorders, ADHD, ODD and CD, along their comorbidity patterns leads to important differences regarding substance use. This could have implications for the etiology, prevention, and treatment of substance use disorders.

International ADHD in substance use disorders prevalence study.

Dr Van Hout has been invited by the ICASA network and IASP research team [Drs Geurt van de Glind; Trimbos Institute, The Netherlands; Dr Pieter-Jan Carpentier, ICASA; Josep Antoni Ramos-Quiroga, University of Barcelona, Spain, Professor Dr Frances Levin, University of Columbia, New York, USA and Professor Dr. Wim van den Brink, University of Amsterdam, The Netherlands] to undertake the research protocol for Ireland as part of this European study of the prevalence of ADHD in adult patients referred for treatment of addiction problems. The research team at Waterford Institute of Technology, School of Health Sciences will undertake this national study as part of the International Collaboration on ADHD and Substance Abuse [ICASA] â?~International ADHD in Substance Use Disorders Prevalence Studyâ?T [IASP study]. The International Collaboration on ADHD and Substance Abuse [ICASA] will provide Dr Van Hout and her team with full support from ICASA of the measurement instruments available and a central database at the University of Amsterdam, and will undergo training for procedures for data capture from Dr van de Glind, Trimbos Institute, The Netherlands. Eight European countries (Norway, Sweden, the Netherlands, Belgium, France, Spain, Switzerland and Hungary) USA and Australia have already participated in the first phase of the IASP study, which will close in September 2011. Over 2500 Substance Use Disorder [SUD] patients were sampled with approximately 38% scoring positive on the ADHD screener (ASRS). Of these 2500 patients over 1000 patients were evaluated on ADHD, Depression, Bipolar Disorder, Anti-Social Personality and Borderline Personality Disorder. A preliminary estimate of the prevalence of ADHD in SUD treatment seeking patients was recorded at 20 %. The second phase of study [IASP 2011] will commence in September 2011 for countries including Ireland, South Africa, Egypt and Brazil. Dr Van Hout has also been invited to partake in a systematic review paper on the risk factors for development of SUD in children/adolescents with ADHD in collaboration with the ICASA foundation.This resource was contributed by The National Documentation Centre on Drug Use.

A Matter of Substance, January 2009.

A publication of the IDPH Division of Behavioral Health to find out what's happening with Substance Abuse Prevention and Treatment.

A Matter of Substance, April 2009.

A publication of the IDPH Division of Behavioral Health to find out what's happening with Substance Abuse Prevention and Treatment.

A Matter of Substance, July 2009.

A publication of the IDPH Division of Behavioral Health to find out what's happening with Substance Abuse Prevention and Treatment.

A Matter of Substance, August 2009.

A publication of the IDPH Division of Behavioral Health to find out what's happening with Substance Abuse Prevention and Treatment.

A Matter of Substance, October 2009.

A publication of the IDPH Division of Behavioral Health to find out what's happening with Substance Abuse Prevention and Treatment.

A Matter of Substance, September 2009.

A publication of the IDPH Division of Behavioral Health to find out what's happening with Substance Abuse Prevention and Treatment.

A Matter of Substance, November 2009.

A publication of the IDPH Division of Behavioral Health to find out what's happening with Substance Abuse Prevention and Treatment.

A Matter of Substance, December 2009.

A publication of the IDPH Division of Behavioral Health to find out what's happening with Substance Abuse Prevention and Treatment.

A Matter of Substance, January 2010.

A publication of the IDPH Division of Behavioral Health to find out what's happening with Substance Abuse Prevention and Treatment.

A Matter of Substance, March 2010.

A publication of the IDPH Division of Behavioral Health to find out what's happening with Substance Abuse Prevention and Treatment.

A Matter of Substance, May 2010.

A publication of the IDPH Division of Behavioral Health to find out what's happening with Substance Abuse Prevention and Treatment.