Pharmacological interventions
Ilana B. Crome, Richard Williams, Roger Bloor, Xenofon Sgouros in Substance Misuse and Young People, 2019
Young people, who want to reduce their cannabis use and are heavy users, may describe a range of withdrawal symptoms. These can sometimes be explained by nicotine withdrawal and sleep disturbances. They are best managed by smoking cessation and nicotine replacement therapy (NRT), in the first instance and effective sleep hygiene and management interventions. Young people are often interested in ‘natural’ remedies and early reports have been encouraging. Gray (2012), for example, has explored using N-Acetylcysteine to assist in cannabis cessation. N-Acetylcysteine is a simple amino-acid, which is available in health food shops as a health supplement. The mechanism of action may be through re-balancing glutamate in the nucleus accumbens.
Quitting smoking
Dominic Upton, Katie Thirlaway in Promoting Healthy Behaviour, 2013
Following withdrawal of nicotine, there may be unpleasant symptoms of nicotine withdrawal (see Table 6.12). These physical and mental symptoms occur because of adaptation of the brain to long-term administration of nicotine. Withdrawal symptoms are normally temporary but for the first few weeks can be very distressing and may lead to relapse. It take considerable will-power and support to deal with the withdrawal symptoms and the cravings often prompt people to go straight back to the cigarettes. There is a necessity to provide appropriate psychological support during this time, and this is where NRTs can be particularly effective (see previous discussion).
Cross cutting themes
Jane Hanley, Mark Williams in Fathers and Perinatal Mental Health, 2019
The inhalation of nicotine damages the pathways in the amygdala and may trigger mood swings and, in particular, the inhibition of negative emotions. It alters the balance of both dopamine and noradrenaline. The initial rush of euphoria is produced by the surge of nicotine, and it has been suggested that whilst higher doses act as a stimulant, low doses can have a depressant effect. The changes occur rapidly, which is why it can produce dependency as more smoking occurs: the more the brain becomes addicted to, and the need for, a feeling of euphoria. Smoking appears to ameliorate the symptoms of anxiety whilst nicotine withdrawal exacerbates the symptoms of anxiety and depression.
Alcohol self-administration and nicotine withdrawal alter biomarkers of stress and inflammation and prefrontal cortex changes in Gβ subunits
Published in The American Journal of Drug and Alcohol Abuse, 2023
Bryan Cruz, Karen Castañeda, Michelle Aranda, Cecilia A. Hinojosa, Roberto Castro-Gutierrez, Rodolfo J. Flores, Charles T. Spencer, Valentina Vozella, Marisa Roberto, Bharathi S. Gadad, Sukla Roychowdhury, Laura E. O’Dell
Rodent models have been utilized to study the reinforcing effects of alcohol and nicotine as well as withdrawal symptoms that emerge following abstinence from chronic drug exposure. Rodent studies examining the motivational properties of alcohol have utilized a saccharin fading procedure to train rats to elicit stable alcohol SA behavior (22–24). Rodent studies of nicotine dependence typically involve surgical implantation of an osmotic pump that delivers nicotine for approximately 7–14 days (25–27). Nicotine withdrawal can then be assessed following removal of the pump (spontaneous withdrawal) or administration of a nicotinic receptor antagonist, such as mecamylamine (precipitated withdrawal). By either method, nicotine withdrawal elicits physical signs and negative affective states, such as an increase in anxiety-like behavior (28). The present study assessed alcohol SA following nicotine exposure via osmotic pumps and then following removal of the nicotine pump to elicit spontaneous withdrawal.
Understanding the implications of the “vaping epidemic” among adolescents and young adults: A call for action
Published in Substance Abuse, 2019
Nicholas Chadi, Scott E. Hadland, Sion K. Harris
Adolescents, whose brains are still developing, have particular vulnerabilities with regard to the health consequences of e-cigarettes.9 Animal studies have shown that although nicotine has short-term stimulating effects, it has a negative long-term impact on memory and attention, thought to be attributed to permanent inhibitory effects on neuronal connectivity, which is being shaped during adolescence.15,16 Moreover, the adolescent brain is more vulnerable to developing addiction, and the addictive properties of nicotine are clearly established.17 Nicotine withdrawal symptoms appear earlier and more frequently in youth compared with adults18 and include headaches, irritability, sleep difficulty, difficulty concentrating, and increased appetite.19 Withdrawal symptoms, or fear of experiencing them, can represent an important obstacle to nicotine cessation.20
Varenicline (Chantix): The Smoking Cessation Medication Prescribers May Be Avoiding
Published in Issues in Mental Health Nursing, 2022
In conjunction with this, there is increasing thought among some that the act of smoking cessation—and not the use of varenicline—increases the risk for neuropsychiatric adverse events (Nahvi & Arnsten, 2018). The act of smoking is an important coping mechanism for many individuals, and its absence may contribute to increased suicide risk (Penberthy et al., 2016). Depression, anxiety, and irritability are known to worsen during early nicotine withdrawal, peaking within a week but lasting up to a month (Hughes, 2007; McLaughlin et al., 2015). Nicotine withdrawal syndrome is substantially more likely to occur among individuals with comorbid mental illness, and physical discomfort and nicotine cravings may also be worse in this population (Pergadia et al., 2020; Reid & Ledgerwood, 2016; Smith et al., 2014). Indeed, it seems the severity of nicotine withdrawal syndrome is associated with the severity of psychiatric symptoms (Soyster et al., 2016). My personal belief is many of the reported neuropsychiatric adverse events linked to varenicline are in fact due to nicotine withdrawal.
Related Knowledge Centers
- Anhedonia
- Anxiety
- Insomnia
- Nicotine
- Psychomotor Agitation
- Smoking Cessation
- Tobacco
- Depression
- Hunger
- Weight Gain