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Understanding and using anti-depressant medication
Published in Chris Williams, Roch Cantwell, Karen Robertson, Overcoming Postnatal Depression, 2020
Chris Williams, Roch Cantwell, Karen Robertson
Anti-depressants are not addictive in the way that some other drugs are, but stopping them in one go may cause you to have unpleasant withdrawal effects. You don’t get addicted to modern anti-depressants in the same way as you can to alcohol or tablets such as benzodiazepines (see below).
Cost-Effective Screening of Addicted Persons for Significant Illness
Published in Frank Lynn Iber, Alcohol and Drug Abuse as Encountered in Office Practice, 2020
Features of depression are common in long-standing addiction ends, and are particularly prominent after depressant abuse (including alcohol) and use of stimulants, including cocaine. This diagnosis is often overlooked by screening doctors. Although modest depression associated with withdrawal reverses in about three weeks, severe depression, usually existing prior to the substance abuse, will be worsened during the withdrawal period and immediately afterward. Panic reactions, anxiety that is not believed to be a part of withdrawal, delusions, or hallucinations, or paranoia are features that are highly significant. These are usually uncovered during the interview and subsequent examination. Abusers often have suicidal thoughts and direct questioning about such ideas is essential to plan appropriate treatment.
Central nervous system depressants
Published in Ilana B. Crome, Richard Williams, Roger Bloor, Xenofon Sgouros, Substance Misuse and Young People, 2019
Alcohol (ethanol) is a CNS depressant believed to act on two main neurotransmitter systems (Crews, 2012): (1) The gamma-aminobutyric acid (GABA) system has a major inhibitory effect on the brain and is connected with receptors that are also affected by tranquillisers and sedatives. Substances that activate the GABA system are known to produce reduced brain activity and have a depressant effect on many functions.(2) The glutamate system has a significant excitatory neurotransmitter function and alcohol appears to block the N-methyl-D-aspartate (NMDA) receptor involved in the glutamate system functions; this blockade results in a further depression of activity in brain function.
Sleep is something, not nothing: an interprofessional approach to sleep assessment and treatment to support substance use recovery
Published in Journal of Social Work Practice in the Addictions, 2023
Jennifer Gardner, Margaret Swarbrick, Robert H. Kitzinger
Do poor sleep patterns, sleep disturbances, and other sleep issues contribute to problematic substance usage, or does problematic substance usage result in poor sleep patterns, sleep disturbances, and other sleep issues? Research has suggested bidirectional effects between both substance use and circadian rhythm disturbance and increased potential for the development of substance dependence from circadian disturbance (Hasler et al., 2012). Disturbances in sleep are considered risk factors for development of a substance use disorder (APA, 2022). Sleep is also impacted in all stages of substance use, e.g., intoxication and withdrawal. During stimulant intoxication, an individual experiences light, restless and disrupted sleep (APA, 2022). During depressant and opiate intoxication, an individual experiences initial drowsiness and daytime sleepiness, followed by increased disruption of sleep at night due to acute withdrawal effects (APA, 2022; Hasler et al., 2012). Individuals seeking residential treatment for substance use disorders report sleep as a concern (Nettleton et al., 2017). Regardless of the research to support either claim, sleep disturbance is clearly problematic enough to demonstrate that professionals should remain aware of the need to assess and offer treatment to help people create sleep routines and habits as a component of treatment and on ongoing recovery support.
Prevalence and high-risk behaviors associated with non-fatal overdose among people who use illicit opioids: A systematic review and meta-analysis
Published in Journal of Substance Use, 2022
Bahram Armoon, Azadeh Bayani, Mark D. Griffiths, Amir-Hossein Bayat, Rasool Mohammadi, Ladan Fattah Moghaddam, Elahe Ahounbar
Witnessing others’ overdose has been reported as a key risk factor for self-overdose in prior research. Such experience (witnessing overdose) is highly prevalent in young PWIDUs (Ochoa et al., 2005).The findings suggested that the likelihood of experiencing a recent overdose experience was greater among those using methamphetamine, and in line with the results of some other empirical studies (Gossop et al., 2002; Kinner et al., 2012). In the present study, there were associations between non-fatal overdose and non-injection methamphetamine use among PWIDUs as has been reported in several studies (Coffin et al., 2003; Sergeev et al., 2003). There were also associations in the present study between overdose and opiates, alcohol, and benzodiazepines use among PWIDs as has been reported in several studies (Coffin et al., 2003; Sergeev et al., 2003). Such drugs are depressants of the central nervous system, therefore, the risk of overdose is increased following their use, in particular when consumed in combination with other psychoactive substances. Prior findings have indicated an association between a significantly-declined risk of overdose and non-injection use of any illicit substance (Brugal et al., 2002; Darke & Hall, 2003).
Effects of innovation and insurance coverage on price elasticity of demand for prescription drugs: some empirical lessons in pharmacoeconomics
Published in Journal of Medical Economics, 2020
DiNardi18 also addressed price sensitivity, but from the opposite angle of uninsurance. Dependent health insurance coverage until age 26 was introduced by the ACA, leading to increased prescription drug purchases by (otherwise extremely price-sensitive) young adults. The effects of aging out of dependent coverage after 26 (e.g. becoming uninsured or obtaining less generous coverage) was tested by DiNardi on legal purchases of the most commonly misused prescription drugs. These were central nervous system depressants (for anxiety, sleep disorders), opiods (pain relief), and stimulants (attention deficit disorders). Using a regression discontinuity design and data from the Medical Expenditure Panel Survey (2010–2017) to estimate aging-out effects, DiNardi reported the following outcomes for age 26+ individuals: Increased likelihood of becoming uninsured. Decreased likelihood of purchasing prescription depressants and opiods (with results driven by women who face greater adverse health consequences, although effects on purchases are smaller, negative, and imprecise for males). Losing coverage can lead age 26+ individuals not only to forego treatment and decrease prescription drug consumption, but to price-substitute to risky drugs or drug alternatives sold on the black market. Thus, resort to illegal drug use increases. The study suggests that “[p]olicies and interventions targeted to individuals nearing their 26th birthday and at risk of losing insurance coverage may be useful to reduce [these] potential negative health effects.”18