391 results on '"Gerra, G."'
Search Results
102. The Italian Manifesto for the treatment of heroin addiction. The mixed care model a proposed layout for a new healthcare system for citizens with heroin addiction
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Maremmani, I., Barra, M., Burton-Phillips, E., Cecchini, I., Di Chiara, G., Gerra, G., Mantovani, L., Pier Paolo Pani, Pitts, G., Rossi, A., Somaini, L., Starace, F., Maremmani, I, Barra, M, Burton-Phillips, E, Cecchini, I, di Chiara, G, Gerra, G, Mantovani, L, Pani, P, Pitts, G, Rossi, A, Somaini, L, and Starace, F
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Addiction, mixed care model
103. Effects of dopamine receptor stimulation on opiate-induced modifications of pituitary-gonadal function
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Rastelli G, Gerra G, Graziano Ceresini, Giorgio Valenti, A. Pezzarossa, and P.P. Vescovi
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Adult ,Male ,endocrine system ,medicine.medical_specialty ,Adolescent ,Endocrinology, Diabetes and Metabolism ,Pharmacology ,Dopamine agonist ,Receptors, Dopamine ,Endocrinology ,Internal medicine ,Testis ,medicine ,Humans ,Testosterone ,Bromocriptine ,business.industry ,Dopaminergic ,Luteinizing Hormone ,Opioid-Related Disorders ,eye diseases ,Prolactin ,Dopamine receptor ,Pituitary Gland ,Opiate ,Luteinizing hormone ,business ,hormones, hormone substitutes, and hormone antagonists ,medicine.drug - Abstract
We evaluated the effects of the dopaminergic drug bromocriptine (Br) on prolactin (PRL), luteinizing hormone (LH) and testosterone (Te) levels in a homogeneous group of opiate addicts in a methadone maintenance program (20 mg twice daily). Basal blood levels of PRL, LH and Te were determined in 15 adult male drug addicts, before 30 and 60 days after Br administration (7.5 mg/day) was started. 15 healthy volunteers served as controls for the evaluation of basal values of the hormones. Before treatment PRL values were high, while LH and Te levels were lower than normal. 30 days later, PRL lowered significantly while LH and Te increased significantly. 60 days later, the blood hormone values were still significantly different from pretreatment values, and close to the normal range. This observation shows that Br, probably through an increase of dopaminergic tone, may counteract some effects of opiates on the hypothalamic-pituitary-gonadal axis.
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- 1985
104. [Psychobiologic risk factors and vulnerability to psychostimulants in adolescents and animal models]
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Giovanni Laviola, Adriani W, Ml, Terranova, and Gerra G
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Mice ,Psychotropic Drugs ,Risk-Taking ,Adolescent ,Risk Factors ,Substance-Related Disorders ,Models, Animal ,Psychology, Adolescent ,Age Factors ,Animals ,Humans - Abstract
Adolescence is associated with an increased risk of developing drug abuse/dependence. During this ontogenetic phase, brain and hormonal systems are still undergoing crucial maturational rearrangements, which take place together with significant modifications in psychosocial development. However, the neurohormonal and behavioural facets of adolescence have been poorly investigated in relation to the vulnerability to psychostimulants such as MDMA ("ecstasy") and amphetamine. Novelty-seeking, a temperamental/behavioural trait that is typical of this age period, might substantially contribute to psychobiological vulnerability to drugs. In animal models of periadolescence, the search for novel stimuli and sensations actually shares a common neurobiological substrate (the reward-related brain mesolimbic pathways) with psychostimulants. Periadolescent mice are characterized by an unbalanced and "extremes-oriented" behaviour and by elevated levels of novelty-seeking. A deeper understanding of psychostimulant effects during adolescence, and the interaction between genetic, neurobiologic, psychosocial, and environmental factors, will lead to earlier and more effective prevention strategies.
105. Erratum: Ferroelectricity in asymmetric metal-ferroelectric-metal heterostructures: A combined first-principles-phenomenological approach (vol 98, art no 207601, 2007)
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Gerra, G., Tagantsev, A. K., and Setter, N.
106. B-endorphin, met-enkephalin and ACTH during water immersion
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Vescovi, P. P., Gerra, G., Coruzzi, P., Giulio Pioli, Pedrazzoni, M., Maninetti, L., Michelini, M., and Novarini, A.
107. Effect of sauna-induced hyperthermia on pituitary secretion of prolactin and gonadotropin hormones
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Vescovi, P. P., Maninetti, L., Gerra, G., Pedrazzoni, M., Giulio Pioli, Girasole, G., and Passeri, M.
108. Interface-induced phenomena in polarization response of ferroelectric thin films
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Tagantsev, A. K. and Gerra, G.
109. ACTH and B-endorphin in response to psychological stress
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Vescovi, P. P., Mutti, A., Gerra, G., Ferroni, C., Giulio Pioli, Girasole, G., Pedrazzoni, M., Pezzarossa, A., and Passeri, M.
110. Labour pain and plasma beta-endorphin levels in human subjects
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Vescovi, P. P., Gerra, G., Maninetti, L., Pedrazzoni, M., Michelini, M., Giulio Pioli, and Passeri, M.
111. Psychobiological risk factors for vulnerability to psychostimulants in human adolescents and animal models,Fattori psicobiologici di rischio e vulnerabilita agli psicostimolanti in soggetti adolescenti e modelli animali
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Giovanni Laviola, Adriani, W., Terranova, M. L., and Gerra, G.
112. Ionic polarizability of conductive metal oxides and critical thickness for ferroelectricity in BaTiO3
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Gerra, G., Tagantsev, A. K., Setter, N., and Parlinski, K.
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total-energy calculations ,polarization ,perovskite films ,thin-films ,wave basis-set ,phase-transitions ,fatigue - Abstract
We report a first-principles investigation of ultrathin BaTiO3 films with SrRuO3 electrodes. We find that the ionic relaxations in the metal-oxide electrode play a crucial role in stabilizing the ferroelectric phase. Comparison with frozen-phonon calculations shows that the degree of softness of the SrRuO3 lattice has an essential impact on the screening of ferroelectric polarization in BaTiO3. The critical thickness for ferroelectricity in BaTiO3 is found to be 1.2 nm. The results of our calculations provide a possible explanation for the beneficial impact of oxide electrodes on the switching and dielectric properties of ferroelectric capacitors.
113. Clonidine effects on growth hormone secretion in chronic alcoholic men
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Vescovi, P. P., Gerra, G., Giulio Pioli, Mineo, F., and Passeri, M.
114. MDMA (Ecstasy): Neuroendocrine and behavioural effects,MDMA (Ecstasy): Aspetti neuroendocrini e comportamentali
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Gerra, G., Zaimovic, A., Moi, G., Giovanni Laviola, and Macchia, T.
115. Impaired ACTH and β-endorphine response to sauna-induced hyperthermia in heroin addicts
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Vescovi, P. P., Pedrazzoni, M., Gerra, G., Giulio Pioli, Maninetti, L., Michelini, M., and Passeri, M.
116. Effect of methadone on TSH and thyroid hormone secretion
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Rastelli G, Giorgio Valenti, P.P. Vescovi, Gerra G, and Gian Paolo Ceda
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Adult ,Male ,endocrine system ,medicine.medical_specialty ,Thyroid Hormones ,endocrine system diseases ,Endocrinology, Diabetes and Metabolism ,medicine.medical_treatment ,Clinical Biochemistry ,Thyrotropin ,Stimulation ,Biochemistry ,Basal (phylogenetics) ,Endocrinology ,Internal medicine ,medicine ,Humans ,Thyroid Hormone Secretion ,Chemotherapy ,Triiodothyronine ,Chemistry ,Biochemistry (medical) ,General Medicine ,Opioid-Related Disorders ,Male patient ,Drug addict ,hormones, hormone substitutes, and hormone antagonists ,Methadone ,medicine.drug - Abstract
The hypothalamus-pituitary-thyroid function was studied in 15 male patients on chronic methadone treatment (40 mg/day). No significant variations of TSH, T4, T3 and rT3 levels were documented, either in basal conditions or after TRH stimulation; however a reduced TSH pituitary response was recorded in some patients (6 out of 15).
117. Psychopathological symptoms of heroin addicts at treatment entry
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Maremmani, I., Pier Paolo Pani, Maremrnani, A. G. I., Pacini, M., Bizzarri, I. V., Trogu, E., Rovai, L., Bacciardi, S., Rugani, F., Perugi, G., Gerra, G., and Osso, L.
118. Predictors for Non-Relapsing Status in Methadone-Maintained Heroin Addicts. A Long-Term Perspective Study
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Maremmani, I., Pacini, M., Lamanna, F., Pier Paolo Pani, Trogu, M., Perugi, G., Deltito, J., and Gerra, G.
119. Opioid therapy and restoration of the immune function in heroin-addicted patients
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Somaini, L., CRISTINA GIARONI, and Gerra, G.
120. Effect of Methadone on TSH and Thyroid Hormone Secretion
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Vescovi, P., primary, Gerra, G., additional, Rastelli, G., additional, Ceda, G., additional, and Valenti, G., additional
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- 1984
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121. Pyridoxine (Vit. B6) Decreases Opioids-Induced Hyperprolactinemia
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Vescovi, P., primary, Gerra, G., additional, Rastelli, G., additional, Ceresini, G., additional, and Moccia, G., additional
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- 1985
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122. Pyridoxine (Vit. B6) Decreases Opioids-Induced Hyperprolactinemia
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Gerra G, P.P. Vescovi, Rastelli G, G Moccia, and Graziano Ceresini
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Adult ,Male ,medicine.medical_specialty ,Adolescent ,Heroin Dependence ,business.industry ,Endocrinology, Diabetes and Metabolism ,Biochemistry (medical) ,Clinical Biochemistry ,Prolactin blood ,Pyridoxine ,General Medicine ,Opioid-Related Disorders ,Biochemistry ,Prolactin ,Endocrinology ,Growth Hormone ,Internal medicine ,Humans ,Medicine ,business ,Methadone ,medicine.drug - Published
- 1985
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123. Subtyping patients with heroin addiction at treatment entry: factor derived from the Self-Report Symptom Inventory (SCL-90)
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Maremmani I, Pani PP, Pacini M, Bizzarri JV, Trogu E, Maremmani AG, Gerra G, Perugi G, and Dell'Osso L
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- 2010
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124. Heroin addiction in adult children of alcoholics: biological and clinical effects of fluoxetine
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Gerra, G., Caccavari, R., Delsignore, R., Maestri, D., Monica, C., and Passeri, M.
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- 1992
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125. Neuroendocrine response to psychological performance testing
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Folli, D., Mutti, A., Van der Venne, M.Th., Berlin, A., Gerra, G., Cavazzini, S., Maninetti, L., Caccavari, R., and Vescovi, P.
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- 1992
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126. Clonidine + anatagonist holds promise for heroin treatment.
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Gerra, G. and Marcato, A.
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CLONIDINE , *TREATMENT of heroin abuse , *THERAPEUTICS - Abstract
Confirms the use of clonidine combined with either naltrexone or naloxone for limiting symptoms of withdrawal in outpatient heroin detoxification. Participation of the patients in psychotherapy; Report on lower levels of withdrawal symptoms; Other benefits of the clonidine treatment.
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- 1995
127. Flumazenil effects on growth hormone response to gammahydroxybutyric acid
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Gerra, G., Caccavari, R., Fontanesi, B., Marcato, A., Affini, G. Fertonani, Maestri, D., Avanzini, P., Lecchini, R., Delsignore, R., and Mutti, A.
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Gamma-hydroxybutyric acid (GHBA) has been recently introduced for alcohol detoxication but few data are available concerning the central mechanism of action of this gamma-aminobutyric acid (GABA) catabolite. GHBA ability to stimulate growth hormone (GH) and prolactin (PRL) secretion has been reported: the involvement of GABA, dopamine or serotonin systems acting on pituitary hormones has been hypothesized. In the present study we investigated GH and PRL responses to GHBA with or without flumazenil (a benzodiazepine receptor antagonist) i.v. pretreatment. Our study included nine male healthy volunteers (aged 23.2 ± 2.5 years) who were submitted to three tests in random order: (1) oral GHB administration; (2) oral GHBA and i.v. flumazenil administration; (3) oral placebo and i.v. saline administration. Blood samples for GH and PRL assays were collected during the three tests at – 15,15,0,15,30,45,60 and 90 min. GHBA induced a significant increase in GH plasma levels; flumazenil pretreatment antagonized GHBA action on GH secretion. No changes were obtained with placebo and saline administration. A subpopulation of GABA receptors or GHBA-specific receptors seems to be involved in GHBA action. The benzodiazepine receptor antagonist flumazenil was able to influence the sensitivity and the neuroendocrine consequences of GHBA binding site stimulation.
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- 1994
128. Clonidine and Opiate Receptor Antagonists in the Treatment of Heroin Addiction
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Gerra, G., Marcato, A., Caccavari, R., and Fontanesi, B.
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- 1995
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129. Reorganization of Substance Use Treatment and Harm Reduction Services During the COVID-19 Pandemic: A Global Survey
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Seyed Ramin Radfar, Cornelis A. J. De Jong, Ali Farhoudian, Mohsen Ebrahimi, Parnian Rafei, Mehrnoosh Vahidi, Masud Yunesian, Christos Kouimtsidis, Shalini Arunogiri, Omid Massah, Abbas Deylamizadeh, Kathleen T. Brady, Anja Busse, ISAM-PPIG Global Survey Consortium, Marc N. Potenza, Hamed Ekhtiari, Alexander Mario Baldacchino, Adrian Octavian Abagiu, Franck David Noel Abouna, Mohamed Hassan Ahmed, Basma Al-ansari, Feda Mahmmoud Abu Al-khair, Mandhar Humaid Almaqbali, Atul Ambekar, Hossein Mohaddes Ardabili, Sidharth Arya, Victor Olufolahan Lasebikan, Murad Ali Ayasreh, Debasish Basu, Zoubir Benmebarek, Roshan Bhad, Mario Blaise, Nicolas Bonnet, Jennifer Brasch, Barbara Broers, Jenna L. Butner, Moses Camilleri, Giovanna Campello, Giuseppe Carra, Ivan Celic, Fatemeh Chalabianloo, Abhishek Chaturvedi, José de Jesús Eduardo Noyola Cherpitel, Kelly J. Clark, Melissa Anne Cyders, Ernesto de Bernardis, John Edward Derry, Naveen Kumar Dhagudu, Pavla Dolezalova, Geert Dom, Adrian John Dunlop, Mahmoud Mamdouh Elhabiby, Hussien Elkholy, Nsidibe Francis Essien, Ghandi Ilias Farah, Marica Ferri, Georgios D Floros, Catherine Friedman, Clara Hidalgo Fuderanan, Gilberto Gerra, Abhishek Ghosh, Maka Gogia, Ilias A. Grammatikopoulos, Paolo Grandinetti, Amira Guirguis, David Gutnisky, Paul Steven Haber, Peyman Hassani-Abharian, Zahra Hooshyari, Islam Ibrahim Mokhtar Ibrahim, Hada Fong-ha Ieong, Regina Nova Indradewi, Shelly Iskandar, Shobhit Jain, Sandi James, Seyyed Mohammad hossein Javadi, Keun Ho Joe, Darius Jokubonis, Acka Tushevska Jovanova, Rama Mohamed Kamal, Alexander Ivanov Kantchelov, Preethy Kathiresan, Gary Katzman, Paul Kawale, Audrey Margaret Kern, Felix Henrique Paim Kessler, Sung-Gon Sue Kim, Ann Marie Kimball, Zeljko Kljucevic, Kristiana Siste, Roneet Lev, Hae Kook Lee, Aiste Lengvenyte, Shaul Lev-ran, Geni Seseja Mabelya, Mohamed Ali El Mahi, J. Maphisa Maphisa, Icro Maremmani, Laura Masferrer, Orlagh McCambridge, Garrett Gregory McGovern, Aung Kyi Min, Amir Moghanibashi-Mansourieh, Jazman Mora-Rios, Indika Udaya Kumara Mudalige, Diptadhi Mukherjee, Pejic Munira Munira, Bronwyn Myers, Jayakrishnan Menon T N, Venkata Lakshmi Narasimha, Nkemakolam Ndionuka, Ali-Akbar Nejatisafa, Kamran Niaz, Asad Tamizuddin Nizami, Jan H. Nuijens, Laura Orsolini, Vantheara Oum, Adegboyega Adekunle Oyemade, Irena Rojnia Palavra, Sagun Ballav Pant, Joselyn Paredes, Eric Peyron, Randall Alberto Quirós, Rouhollah Qurishi, Noor ul Zaman Rafiq, Ranjini Raghavendra Rao, Woraphat Ratta-apha, Karren-Lee Raymond, Jens Reimer, Eduardo Renaldo, Tara Rezapour, James Roy Robertson, Carlos Roncero, Fazle Roub, Elizabeth Jane Rubenstein, Claudia Ines Rupp, Elizabeth Saenz, Mohammad Salehi, Lampros Samartzis, Laura Beatriz Sarubbo, Nusa Segrec, Bigya Shah, Hongxian Shen, Tomohiro Shirasaka, Steve Shoptaw, Fransiskus Muronga Sintango, Veronica Andrea Sosa, Emilis Subata, Norberto Sztycberg, Fatemeh Taghizadeh, Joseph Brian Tay Wee Teck, Christian Tjagvad, Marta Torrens, Judith Meme Twala, Ramyadarshni Vadivel, Joseph Robert Volpicelli, Jelmer Weijs, Steven Michael Wintoniw, Apisak Wittayanookulluk, Marcin Wojnar, Sadia Yasir, Yimenu Yitayih, Min Zhao, Arash Khojasteh Zonoozi, ISAM-PPIG Global Survey Consortium, Radfar, S, De Jong, C, Farhoudian, A, Ebrahimi, M, Rafei, P, Vahidi, M, Yunesian, M, Kouimtsidis, C, Arunogiri, S, Massah, O, Deylamizadeh, A, Brady, K, Busse, A, Potenza, M, Ekhtiari, H, Baldacchino, A, Abagiu, A, Abouna, F, Ahmed, M, Al-ansari, B, Mahmmoud Abu Al-khair, F, Almaqbali, M, Ambekar, A, Ardabili, H, Arya, S, Lasebikan, V, Ayasreh, M, Basu, D, Benmebarek, Z, Bhad, R, Blaise, M, Bonnet, N, Brasch, J, Broers, B, Butner, J, Camilleri, M, Campello, G, Carra, G, Celic, I, Chalabianloo, F, Chaturvedi, A, de Jesus Eduardo Noyola Cherpitel, J, Clark, K, Cyders, M, de Bernardis, E, Derry, J, Dhagudu, N, Dolezalova, P, Dom, G, Dunlop, A, Elhabiby, M, Elkholy, H, Essien, N, Farah, G, Ferri, M, Floros, G, Friedman, C, Fuderanan, C, Gerra, G, Ghosh, A, Gogia, M, Grammatikopoulos, I, Grandinetti, P, Guirguis, A, Gutnisky, D, Haber, P, Hassani-Abharian, P, Hooshyari, Z, Ibrahim, I, Ieong, H, Indradewi, R, Iskandar, S, Jain, S, James, S, Javadi, S, Joe, K, Jokubonis, D, Jovanova, A, Kamal, R, Kantchelov, A, Kathiresan, P, Katzman, G, Kawale, P, Kern, A, Kessler, F, Kim, S, Kimball, A, Kljucevic, Z, Siste, K, Lev, R, Lee, H, Lengvenyte, A, Lev-ran, S, Mabelya, G, Mahi, M, Maphisa, J, Maremmani, I, Masferrer, L, Mccambridge, O, Mcgovern, G, Min, A, Moghanibashi-Mansourieh, A, Mora-Rios, J, Mudalige, I, Mukherjee, D, Munira, P, Myers, B, Menon T N, J, Narasimha, V, Ndionuka, N, Nejatisafa, A, Niaz, K, Nizami, A, Nuijens, J, Orsolini, L, Oum, V, Oyemade, A, Palavra, I, Pant, S, Paredes, J, Peyron, E, Alberto Quiros, R, Qurishi, R, Rafiq, N, Rao, R, Ratta-apha, W, Raymond, K, Reimer, J, Renaldo, E, Rezapour, T, Robertson, J, Roncero, C, Roub, F, Rubenstein, E, Rupp, C, Saenz, E, Salehi, M, Samartzis, L, Sarubbo, L, Segrec, N, Shah, B, Shen, H, Shirasaka, T, Shoptaw, S, Sintango, F, Sosa, V, Subata, E, Sztycberg, N, Taghizadeh, F, Teck, J, Tjagvad, C, Torrens, M, Twala, J, Vadivel, R, Volpicelli, J, Weijs, J, Wintoniw, S, Wittayanookulluk, A, Wojnar, M, Yasir, S, Yitayih, Y, Zhao, M, Zonoozi, A, University of St Andrews. School of Medicine, University of St Andrews. Centre for Minorities Research (CMR), and University of St Andrews. Population and Behavioural Science Division
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opioid agonist treatment ,RC435-571 ,Psychological intervention ,addiction services ,Health administration ,Experimental Psychopathology and Treatment ,0302 clinical medicine ,RA0421 ,RA0421 Public health. Hygiene. Preventive Medicine ,Pandemic ,Severe acute respiratory syndrome coronavirus 2 ,Drug addiction ,030212 general & internal medicine ,harm reduction ,Original Research ,Psychiatry ,Public health ,Addiction medicine ,substance use disorder ,public health ,3rd-DAS ,Opiate agonist treatment ,Addiction services ,Outreach ,Substance abuse ,Psychiatry and Mental health ,RM ,COVID-19 pandemic ,drug policy ,medicine.medical_specialty ,03 medical and health sciences ,SDG 3 - Good Health and Well-being ,Drug policy ,medicine ,Substance use disorders ,Harm reduction ,business.industry ,SDG 16 - Peace, Justice and Strong Institutions ,COVID-19 ,medicine.disease ,addiction service ,RM Therapeutics. Pharmacology ,Coronavirus ,Family medicine ,Human medicine ,business ,030217 neurology & neurosurgery - Abstract
Background:The coronavirus disease 2019 (COVID-19) pandemic has impacted people with substance use disorders (SUDs) worldwide, and healthcare systems have reorganized their services in response to the pandemic.Methods:One week after the announcement of the COVID-19 as a pandemic, in a global survey, 177 addiction medicine professionals described COVID-19-related health responses in their own 77 countries in terms of SUD treatment and harm reduction services. The health responses were categorized around (1) managerial measures and systems, (2) logistics, (3) service providers, and (4) vulnerable groups.Results:Respondents from over 88% of countries reported that core medical and psychiatric care for SUDs had continued; however, only 56% of countries reported having had any business continuity plan, and 37.5% of countries reported shortages of methadone or buprenorphine supplies. Participants of 41% of countries reported partial discontinuation of harm-reduction services such as needle and syringe programs and condom distribution. Fifty-seven percent of overdose prevention interventions and 81% of outreach services were also negatively impacted.Conclusions:Participants reported that SUD treatment and harm-reduction services had been significantly impacted globally early during the COVID-19 pandemic. Based on our findings, we highlight several issues and complications resulting from the pandemic concerning people with SUDs that should be tackled more efficiently during the future waves or similar pandemics. The issues and potential strategies comprise the following: (1) helping policymakers to generate business continuity plans, (2) maintaining the use of evidence-based interventions for people with SUDs, (3) being prepared for adequate medication supplies, (4) integrating harm reduction programs with other treatment modalities, and (5) having specific considerations for vulnerable groups such as immigrants and refugees.
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- 2021
130. COVID-19 and substance use disorders: Recommendations to a comprehensive healthcare response. an international society of addiction medicine practice and policy interest group position paper
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Ali, Farhoudian, Alexander, Baldacchino, Nicolas, Clark, Gilberto, Gerra, Hamed, Ekhtiari, Geert, Dom, Azarakhsh, Mokri, Mandana, Sadeghi, Pardis, Nematollahi, Maryanne, Demasi, Christian G, Schütz, Seyed Mohammadreza, Hash-Emian, Payam, Tabarsi, Susanna, Galea-Singer, Giuseppe, Carrà, Thomas, Clausen, Christos, Kouimtsidis, Serenella, Tolomeo, Seyed Ramin, Radfar, Emran Mohammad, Razaghi, Farhoudian, A, Baldacchino, A, Clark, N, Gerra, G, Ekhtiari, H, Dom, G, Mokri, A, Sadeghi, M, Nematollahi, P, Demasi, M, Schütz, C, Hashemian, S, Tabarsi, P, Galea-singer, S, Carrà, G, Clausen, T, Kouimtsidis, C, Tolomeo, S, Radfar, S, and Mohammad Razaghi, E
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Coronavirus ,Opioid substitution therapy ,Harm reduction ,Public health ,Policy ,Coronavirus Disease 2019 (COVID-19) ,Pandemic ,Addiction medicine ,Coronaviru ,Perspectives Paper ,Substance use disorder ,Methadone ,Coronavirus, Coronavirus Disease 2019 (COVID-19), Pandemic, Public health, Substance use disorder, Addiction medicine, Harm reduction, Policy, Methadone, Opioid substitution therapy - Abstract
Coronavirus Disease 2019 (COVID-19) is escalating all over the world and has higher morbidities and mortalities in certain vulnerable populations. People Who Use Drugs (PWUD) are a marginalized and stigmatized group with weaker immunity responses, vulnerability to stress, poor health conditions, high-risk behaviors, and lower access to health care services. These conditions put them at a higher risk of COVID-19 infection and its complications. In this paper, an international group of experts on addiction medicine, infectious diseases, and disaster psychiatry explore the possible raised concerns in this issue and provide recommendations to manage the comorbidity of COVID-19 and Substance Use Disorder (SUD).
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- 2020
131. Adverse childhood experiences (ACEs), genetic polymorphisms and neurochemical correlates in experimentation with psychotropic drugs among adolescents
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Somaini, L., Donnini, C., Manfredini, M., Raggi, M.A., Saracino, M.A., Gerra, M.L., Amore, M., Leonardi, C., Serpelloni, G., and Gerra, G.
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EXPERIENCE in children , *GENETIC polymorphisms , *NEUROCHEMISTRY , *PSYCHIATRIC drugs , *CHILD psychology , *SUBSTANCE use of teenagers , *HYPOTHALAMIC-pituitary-adrenal axis , *BLOOD plasma - Abstract
Abstract: Epidemiological and clinical data show frequent associations between adverse childhood experiences (ACEs) and substance abuse susceptibility particularly in adolescents. A large body of evidences suggests that the possible dysregulation of neuroendocrine responses as well as neurotransmitters function induced by childhood traumatic experiences and emotional neglect could constitute one of the essential biological changes implementing substance abuse vulnerability. Moreover, genotype variables and its environment interactions have been associated with an increased risk for early onset substance abuse. In this paper we present several data that support the hypothesis of the involvement of hypothalamus–pituitary–adrenal (HPA) axis in mediating the combined effect of early adverse experiences and gene variants affecting neurotransmission. The presented data also confirm the relationship between basal plasma levels of cortisol and ACTH, on the one hand, and retrospective measures of neglect during childhood on the other hand: the higher the mother and father neglect (CECA-Q) scores are, the higher the plasma levels of the two HPA hormones are. Furthermore, such positive relationship has been proved to be particularly effective and important when associated with the “S” promoter polymorphism of the gene encoding the 5-HTT transporter, both in homozygote and heterozygote individuals. [Copyright &y& Elsevier]
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- 2011
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132. Dysregulated responses to emotions among abstinent heroin users: Correlation with childhood neglect and addiction severity
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Mario Amore, Matteo Manfredini, Maria Addolorata Saracino, Maria Augusta Raggi, Claudia Donnini, C. Leonardi, Elena Cortese, Lorenzo Somaini, Gilberto Gerra, Gerra, G, Somaini, L., Manfredini, M., Raggi, M.A., Saracino, M.A., Amore, M., Leonardi, C., Cortese, E., and Donnini, C.
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Adult ,Male ,Child abuse ,medicine.medical_specialty ,Mood Disorder ,Adolescent ,Hydrocortisone ,media_common.quotation_subject ,Vulnerability ,Addiction ,Poison control ,Affect (psychology) ,Severity of Illness Index ,Arousal ,Young Adult ,Adrenocorticotropic Hormone ,Emotional response ,Surveys and Questionnaires ,medicine ,Surveys and Questionnaire ,Humans ,Child Abuse ,Child ,Psychiatry ,Biological Psychiatry ,International Affective Picture System ,media_common ,Psychiatric Status Rating Scales ,Pharmacology ,Analysis of Variance ,Heroin Dependence ,Mood Disorders ,Infant ,Psychiatric Status Rating Scale ,Adverse childhood experience ,Child, Preschool ,Linear Models ,HPA axi ,Linear Model ,Anxiety ,medicine.symptom ,Psychology ,State-Trait Anxiety Inventory ,Human ,Clinical psychology - Abstract
The aim of this paper was to investigate the subjective responses of abstinent heroin users to both neutral and negative stimuli and the related hypothalamus-pituitary-adrenal reactions to emotional experience in relationship to their perception of childhood adverse experiences. Thirty male abstinent heroin dependents were included in the study. Emotional responses and childhood neglect perception were measured utilizing the State-Trait Anxiety Inventory Y-1 and the Child Experience of Care and Abuse Questionnaire. Neutral and unpleasant pictures selected from the International Affective Picture System and the Self-Assessment Manikin procedure have been used to determine ratings of pleasure and arousal. These ratings were compared with normative values obtained from healthy volunteers used as control. Blood samples were collected before and after the experimental sessions to determine both adrenocorticotropic hormone and cortisol plasma levels. Basal anxiety scores, cortisol and adrenocorticotropic hormone levels were higher in abstinent heroin users than in controls. Tests showed that anxiety scores did not change in controls after the vision of neutral slides, whilst they did in abstinent heroin addicts, increasing significantly; and increased less significantly after the unpleasant task, in comparison to controls. Abstinent heroin users showed significantly higher levels of parent antipathy and childhood emotional neglect perception than controls for both the father and the mother. Plasma adrenocorticotropic hormone and cortisol levels did not significantly increase after unpleasant slide set viewing among addicted individuals, because of the significantly higher basal levels characterizing the addicted subjects in comparison with controls. Multiple regression correlation showed a significant relationship between childhood neglect perception, arousal reaction, impaired hypothalamus-pituitary-adrenal axis response and addiction severity. Early adverse experiences seem to affect the entire interaction between hyper-arousal, reduced hormonal response to stress and addiction severity. Our findings, although obtained in a small number of subjects, indicate a significant link between the perception of parental style/care/support during childhood and the ability to cope with stressful emotional stimuli in adulthood and addiction severity. © 2013 Elsevier Inc.
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- 2014
133. Childhood neglect and parental care perception in cocaine addicts: Relation with psychiatric symptoms and biological correlates
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Grazia Dell'Agnello, Matteo Manfredini, Lorenzo Somaini, Gilberto Gerra, A. Zaimovic, Elena Cortese, C. Leonardi, Maria Augusta Raggi, Claudia Donnini, Francesca Petracca, Vincenzo Caretti, G. Gerra, C. Leonardi, E. Cortese, A. Zaimovic, G. Dell’Agnello, M. Manfredini, L. Somaini, F. Petracca, V. Caretti, M.A. Raggi, C. Donnini, Gerra, G, Leonardi, C, Cortese, E, Zaimovic, A, Dell'Agnello, G, Manfredini, M, Somaini, L, Petracca, F, Caretti, V, Raggi, MA, and Donnini, C
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Adult ,Male ,medicine.medical_specialty ,endocrine system ,Adolescent ,Hydrocortisone ,Cognitive Neuroscience ,media_common.quotation_subject ,Poison control ,Hostility ,Adrenocorticotropic hormone ,PSYCHIATRIC SYMPTOMS ,Neglect ,PROLACTIN (PRL) ,Cocaine-Related Disorders ,Young Adult ,Behavioral Neuroscience ,Adrenocorticotropic Hormone ,Surveys and Questionnaires ,Electrochemistry ,medicine ,Humans ,Child Abuse ,Child ,Psychiatry ,Chromatography, High Pressure Liquid ,Childhood neglect, parental care, cocaine addiction ,Retrospective Studies ,media_common ,Parenting ,Mental Disorders ,Addiction ,Psychiatric assessment ,Homovanillic Acid ,medicine.disease ,Prolactin ,Neuropsychology and Physiological Psychology ,HOMOVANILLIC ACID (HVA) ,NEGLECT ,Child, Preschool ,Regression Analysis ,Female ,medicine.symptom ,Addictive behavior ,Psychology ,COCAINE ,Anxiety disorder ,hormones, hormone substitutes, and hormone antagonists ,Personality - Abstract
Childhood neglect and poor child–parent relationships have been reported to increase substance use disorders susceptibility. Stressful environmental factors, including emotional neglect, could affect individual personality traits and mental health, possibly inducing stable changes in hypothalamic–pituitary–adrenal (HPA) axis and brain mono-amine function, in turn involved in addictive behavior vulnerability. Therefore, we decided to investigate homovanillic (HVA) and prolactin (PRL) plasma levels, as expression of possible changes in dopamine function, ACTH and cortisol plasma levels, as measures of HPA axis function, and concomitant psychiatric symptoms profile in abstinent cocaine addicts, in relationship to their childhood history of neglect and poor parental care perception. Methods: Fifty abstinent cocaine dependent patients, and 44 normal controls, matched for age and sex, were submitted to a detailed psychiatric assessment (DSM IV criteria). All patients and controls completed the Symptoms Check List-90 (SCL-90) and the Buss Durkee Hostility Inventory (BDHI), to evaluate psychiatric symptoms frequency and aggressiveness levels. The Childhood Experience of Care and Abuse-Questionnaire (CECA-Q) and Parental Bonding Instrument (PBI) have been used to retrospectively investigate parent–child relationships. Blood samples were collected to determine HVA, PRL, ACTH and cortisol basal plasma levels. Results: Cocaine addicted individuals in general showed significantly lower HVA, and higher PRL, ACTH and cortisol basal levels respect to controls. In particular, neuroendocrine changes characterized cocaine addicts with childhood history of neglect and low perception of parental care. Obsessive–compulsive, depression and aggressiveness symptoms have been found related to poor parenting, inversely associated to HVA levels and directly associated to PRL, ACTH and cortisol levels. Conclusions: These findings suggest the possibility that childhood experience of neglect and poor parent–child attachment may partially contribute to a complex neurobiological derangement including HPA axis and dopamine system dysfunctions, playing a crucial role in addictive and affective disorders susceptibility.
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- 2009
134. Adrenocorticotropic hormone and cortisol plasma levels directly correlate with childhood neglect and depression measures in addicted patients
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Elena Cortese, Amir Zaimovic, Francesca Petracca, Vincenzo Caretti, Matteo Manfredini, Claudio Donnini, Grazia Dell'Agnello, Cristina Baroni, C. Leonardi, Lorenzo Somaini, Gilberto Gerra, GERRA G, LEONARDI C, CORTESE E, ZAIMOVIC A, DELL'AGNELLO G, MANFREDINI M, SOMAINI L, PETRACCA F, CARETTI V, BARONI C, and DONNINI C
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Adult ,Male ,endocrine system ,medicine.medical_specialty ,Hypothalamo-Hypophyseal System ,Hydrocortisone ,media_common.quotation_subject ,Statistics as Topic ,Medicine (miscellaneous) ,Poison control ,Pituitary-Adrenal System ,Adrenocorticotropic hormone ,Heroin ,Neglect ,Life Change Events ,Stress Disorders, Post-Traumatic ,Cocaine-Related Disorders ,Adrenocorticotropic Hormone ,Risk Factors ,childhood neglect, depression, adrenocorticotropic hormone ,Injury prevention ,medicine ,Humans ,Child Abuse ,Psychiatry ,Child ,Depression (differential diagnoses) ,media_common ,Pharmacology ,Depressive Disorder ,Heroin Dependence ,Addiction ,medicine.disease ,Object Attachment ,Substance abuse ,Psychiatry and Mental health ,Female ,Psychology ,Arousal ,hormones, hormone substitutes, and hormone antagonists ,medicine.drug ,Clinical psychology - Abstract
Hypothalamic-pituitary-adrenal (HPA) axis dysfunction has been reported to be involved in vulnerability to alcohol and drug dependence in humans, possibly underlying both addictive behaviour and depression susceptibility. The aim of the present study was to investigate the possible interactions between childhood adverse experiences, depressive symptoms and HPA axis function in addicted patients, in comparison with healthy control. Eighty-two abstinent heroin or cocaine dependent patients and 44 normal controls, matched for age and sex, completed the symptoms Check List-90 (SCL-90), measuring depressive symptoms, and the Childhood Experience of Care and Abuse Questionnaire. Blood samples were collected to determine adrenocorticotropic hormone (ACTH) and cortisol basal plasma levels at 8:00 and 8:30 a.m. Addicted individuals showed significantly higher neglect and depression scores and ACTH-cortisol plasma levels respect to control subjects. Depression scores at SCL-90 in addicted patients positively correlated with plasma ACTH and cortisol values. In turn, plasma ACTH levels were directly associated with childhood neglect measures, reaching statistical significance with 'mother-neglect' scores. Plasma cortisol levels were related to 'father antipathy' among cocaine addicts. These findings suggest the possibility that childhood experience of neglect and poor parent-child attachment may have a persistent effect on HPA axis function as an adult, partially contributing, together with genetic factors and other environmental conditions, to both depressive traits and substance abuse neurobiological vulnerability.
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- 2008
135. Commentary on "Computational approaches to modeling gambling behaviour: Opportunities for understanding disordered gambling".
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Gerra G, Gerra ML, and Tadonio L
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- Humans, Gambling
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- 2023
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136. Evidence-based Treatment for Stimulant Use Disorder: Time to Hit the Community.
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Tardelli VS, Bisaga A, Tadonio L, Gerra G, and Fidalgo TM
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- Humans, Central Nervous System Stimulants therapeutic use, Substance-Related Disorders therapy, Attention Deficit Disorder with Hyperactivity drug therapy
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- 2023
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137. Prescription psychostimulants for cocaine use disorder: A review from molecular basis to clinical approach.
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Tardelli VS, Berro LF, Gerra G, Tadonio L, Bisaga A, and Fidalgo TM
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- Humans, Animals, Evidence-Based Medicine, Cognitive Behavioral Therapy, Cocaine-Related Disorders drug therapy, Cocaine-Related Disorders therapy, Central Nervous System Stimulants pharmacology, Central Nervous System Stimulants therapeutic use, Prescription Drugs pharmacology, Prescription Drugs therapeutic use
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Cocaine use is a public health concern in many countries worldwide, particularly in the Americas and Oceania. Overdose deaths involving stimulants, such as cocaine, have been increasing markedly in North America, especially with concurrent opioid involvement. To date, no pharmacological treatment is available to treat stimulant (including cocaine) use disorders. Prescription psychostimulants (PPs) could be useful to treat cocaine use disorder (CUD) as they share the pharmacological effects with cocaine, as evidenced by a recent meta-analysis that assessed 38 randomized clinical trials (RCTs). PPs were found to promote sustained abstinence and reduce drug use in patients with CUD. The aim of this paper is to provide a narrative review of the clinical pharmacology of PPs and comment on the current stage of evidence supporting PPs to treat CUD. We also propose a model of care that integrates PPs with evidence-based psychosocial interventions (such as cognitive-behavioural therapy [CBT] and contingency management [CM]), a harm reduction approach and case management with social support., (© 2023 Society for the Study of Addiction.)
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- 2023
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138. Continuing Increase in Stimulant Dependence - Time to Implement Medical Treatment.
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Bisaga A, Tardelli VS, Gerra G, Busse A, Campello G, Kashino W, Saenz E, and Fidalgo TM
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- Humans, Central Nervous System Stimulants therapeutic use, Substance-Related Disorders epidemiology, Substance-Related Disorders therapy
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- 2022
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139. Violent Behaviours among Adolescents and Young Adults: Association with Psychoactive Substance Use and Parenting Styles.
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Benedetti E, Colasante E, Cerrai S, Gerra G, Tadonio L, Pellegrini P, and Molinaro S
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- Adolescent, Cross-Sectional Studies, Female, Humans, Male, Parenting psychology, Young Adult, Adolescent Behavior psychology, Alcoholic Intoxication, Substance-Related Disorders epidemiology
- Abstract
This study extends existing research on the relationship between psychoactive substance use among young people and violent behaviour, by evaluating the possible effect of the modification of parenting in a nationally representative sample of 14,685 Italian students drawn from the 2019 wave of the ESPAD Italia survey (51% male; mean age about 17 years). Parental dimensions considered in the study were rule-setting, monitoring, and emotional support, as well as the possible absence of a parent. Relative risk ratios and binary logistic regressions were used to estimate the associations separately for adolescents (15-17) and young adults (18-19). Overall, parental rule-setting, perceived parental monitoring, and emotional support were protective factors for substance use, and the strength of this relationship increased with the frequency of use. Among adolescents, the absence of a parent represented a risk factor. In both age groups, the odds of engaging in violent behaviour was increased among those reporting alcohol intoxication and substance use and the greater the frequency of use, the greater the increase in the odds. As parental monitoring and emotional support decreased, the odds of engaging in violent behaviour increased (except in the case of lower parental support among young adults), while the opposite applies to parental rule-setting. The odds of engaging in violent behaviour were increased among those reporting the absence of a parent only in the adolescent age group. Parental rule-setting was found to have an effect only among adolescents, increasing the odds of violent behaviour among frequent drinkers. Our results might be helpful to signal adolescents who would be more prone to adopt violent behaviour in order to target prevention policies.
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- 2022
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140. An observational prospective cohort study of naloxone use at witnessed overdoses, Kazakhstan, Kyrgyzstan, Tajikistan, Ukraine.
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Dietze P, Gerra G, Poznyak V, Campello G, Kashino W, Dzhonbekov D, Kiriazova T, Nikitin D, Terlikbayeva A, Krupchanka D, and Busse A
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- Analgesics, Opioid therapeutic use, Humans, Kazakhstan, Kyrgyzstan, Naloxone therapeutic use, Narcotic Antagonists therapeutic use, Prospective Studies, Tajikistan, Ukraine, Drug Overdose drug therapy, Drug Overdose epidemiology, Opioid-Related Disorders drug therapy
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Objective: To determine whether participation in the United Nations Office on Drugs and Crime (UNODC) and the World Health Organization's (WHO) Stop Overdose Safely (S-O-S) take-home naloxone training project in Kazakhstan, Kyrgyzstan, Tajikistan and Ukraine resulted in naloxone use at witnessed opioid overdoses., Methods: An observational prospective cohort study was performed by recruiting participants in the implementation of the S-O-S project, which was developed as part of the broader S-O-S initiative. Training included instruction on overdose responses and naloxone use. Study participants were followed for 6 months after completing training. The primary study outcome was participants' naloxone use at witnessed overdoses, reported at follow-up., Findings: Between 400 and 417 S-O-S project participants were recruited in each country. Overall, 84% (1388/1646) of participants were interviewed at 6-month follow-up. The percentage who reported witnessing an overdose between baseline and follow-up was 20% (71/356) in Tajikistan, 33% (113/349) in Kyrgyzstan, 37% (125/342) in Ukraine and 50% (170/341) in Kazakhstan. The percentage who reported using naloxone at their most recently witnessed overdose was 82% (103/125) in Ukraine, 89% (152/170) in Kazakhstan, 89% (101/113) in Kyrgyzstan and 100% (71/71) in Tajikistan., Conclusion: Implementation of the UNODC-WHO S-O-S training project in four low- to middle-income countries resulted in the reported use of take-home naloxone at around 90% of witnessed opioid overdoses. The percentage varied between countries but was generally higher than found in previous studies. Take-home naloxone is particularly important in countries where emergency medical responses to opioid overdoses may be limited., ((c) 2022 The authors; licensee World Health Organization.)
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- 2022
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141. Early parent-child interactions and substance use disorder: An attachment perspective on a biopsychosocial entanglement.
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Gerra ML, Gerra MC, Tadonio L, Pellegrini P, Marchesi C, Mattfeld E, Gerra G, and Ossola P
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- Child, Preschool, Epigenesis, Genetic genetics, Humans, Hypothalamo-Hypophyseal System, Object Attachment, Parent-Child Relations, Pituitary-Adrenal System, Substance-Related Disorders genetics, Substance-Related Disorders psychology
- Abstract
This review aims to elucidate environmental and genetic factors, as well as their epigenetic and neuroendocrine moderators, that may underlie the association between early childhood experiences and Substance Use Disorders (SUD), through the lens of parental attachment. Here we review those attachment-related studies that examined the monoaminergic systems, the hypothalamic pituitary adrenal stress response system, the oxytoninergic system, and the endogenous opioid system from a genetic, epigenetic, and neuroendocrine perspective. Overall, the selected studies point to a moderating effect of insecure attachment between genetic vulnerability and SUD, reasonably through epigenetic modifications. Preliminary evidence suggests that vulnerability to SUDs is related with hypo-methylation (e.g. hyper-expression) of high-risk polymorphisms on the monoaminergic and hypothalamic pituitary adrenal system and hyper-methylation (e.g. hypo-expressions) of protective polymorphisms on the opioid and oxytocin system. These epigenetic modifications may induce a cascade of neuroendocrine changes contributing to the subclinical and behavioural manifestations that precede the clinical onset of SUD. Protective and supportive parenting could hence represent a key therapeutic target to prevent addiction and moderate insecure attachment., (Copyright © 2021 Elsevier Ltd. All rights reserved.)
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- 2021
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142. Alcohol use disorders among adult children of alcoholics (ACOAs): Gene-environment resilience factors.
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Ossola P, Gerra MC, Gerra ML, Milano G, Zatti M, Zavan V, Volpi R, Marchesi C, Donnini C, Gerra G, and Di Gennaro C
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- Adult, Adult Children psychology, Adult Children statistics & numerical data, Alcoholism epidemiology, Alcoholism genetics, Alleles, Case-Control Studies, Child of Impaired Parents psychology, Cluster Analysis, Female, Genetic Predisposition to Disease genetics, Humans, Logistic Models, Male, Middle Aged, Psychiatric Status Rating Scales, Receptors, Dopamine D2 genetics, Risk Factors, Serotonin Plasma Membrane Transport Proteins genetics, Surveys and Questionnaires, Alcoholism etiology, Child of Impaired Parents statistics & numerical data, Gene-Environment Interaction
- Abstract
Both genetic and early environmental factors contribute to the pathogenesis of Alcohol Use Disorder (AUD). Gender and psychopathology symptoms might further moderate this association, resulting in an impairment of both the dopaminergic and serotoninergic pathways that sustain the binge, withdrawal and craving cycle. In a sample of of adult children of alcoholic parents (ACOAs) (n = 107) we compared those with and without an AUD, on socio-demographic variables, adverse childhood experiences, psychopathology symptoms and two polymorphisms associated with an impaired serotoninergic and dopaminergic neurotransmission (5HTTLPR and Taq1A/DRD2). A logistic regression revealed that an early caring environment might lower the risk of developing an AUD. When controlling for the actual psychopathology symptoms, being male and having the genotype associated with an impaired dopaminergic neurotransmission were still associated with AUD. Results were confirmed by an unsupervised approach that showed how the clusters characterised by being male and having the high risk genotypes were still associated with AUD compared to being female without the unfavourable dopamine genotype.Our results point to the need for implementing prevention strategies aimed at creating a caring environment especially in those families with an alcoholic parent. We further suggest that psycho-education as a symptom recognition and avoiding self-medication could improve the outcome in those subjects at higher risk, especially males., (Copyright © 2020 Elsevier Inc. All rights reserved.)
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- 2021
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143. Managing dual disorders: a statement by the Informal Scientific Network, UN Commission on Narcotic Drugs.
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Volkow ND, Torrens M, Poznyak V, Sáenz E, Busse A, Kashino W, Krupchanka D, Kestel D, Campello G, and Gerra G
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- 2020
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144. Prescription psychostimulants for the treatment of stimulant use disorder: a systematic review and meta-analysis.
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Tardelli VS, Bisaga A, Arcadepani FB, Gerra G, Levin FR, and Fidalgo TM
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- Amphetamine therapeutic use, Cocaine therapeutic use, Double-Blind Method, Humans, Lisdexamfetamine Dimesylate therapeutic use, Methylphenidate therapeutic use, Modafinil therapeutic use, Randomized Controlled Trials as Topic methods, Substance-Related Disorders psychology, Treatment Outcome, Central Nervous System Stimulants therapeutic use, Prescription Drugs therapeutic use, Substance-Related Disorders diagnosis, Substance-Related Disorders drug therapy
- Abstract
Rationale: Agonist-based pharmacologic intervention is an accepted approach in treatment of opioid and tobacco use disorders., Objectives: We conducted a systematic review and meta-analysis to evaluate usefulness of an agonist approach as treatment of (psycho)stimulant use disorder (PSUD)., Methods: We reviewed PubMed/Medline, LILACS, and ClinicalTrials.gov databases searching for randomized, double-blind, placebo-controlled, parallel-design studies evaluating outcomes of individuals treated for cocaine- or amphetamine-type substance use disorder. We combined results of all trials that included the following prescription psychostimulants (PPs): modafinil, methylphenidate, or amphetamines (mixed amphetamine salts, lisdexamphetamine, and dextroamphetamine). The combined sample consisted of 2889 patients. Outcomes of interest included the following: drug abstinence (defined as 2-3 weeks of sustained abstinence and the average maximum days of consecutive abstinence), percentage of drug-negative urine tests across trial, and retention in treatment. We conducted random-effects meta-analyses and assessed quality of evidence using the GRADE system., Results: Thirty-eight trials were included. Treatment with PPs increases rates of sustained abstinence [risk ratio (RR) = 1.45, 95% confidence interval (CI) = (1.10, 1.92)] and duration of abstinence [mean difference (MD) = 3.34, 95% CI = (1.06, 5.62)] in patients with PSUD, particularly those with cocaine use disorder (very low-quality evidence). Prescription amphetamines were particularly efficacious in promoting sustained abstinence in patients with cocaine use disorder [RR = 2.44, 95% CI = (1.66, 3.58)], and higher doses of PPs were particularly efficacious for treatment of cocaine use disorder [RR = 1.95, 95% CI = (1.38, 2.77)] (moderate-quality evidence). Treatment with prescription amphetamines also yielded more cocaine-negative urines [MD = 8.37%, 95% CI = (3.75, 12.98)]. There was no effect of PPs on the retention in treatment., Conclusion: Prescription psychostimulants, particularly prescription amphetamines given in robust doses, have a clinically significant beneficial effect to promote abstinence in the treatment of individuals with PSUD, specifically the population with cocaine use disorder.
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- 2020
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145. COVID-19 and Substance Use Disorders: Recommendations to a Comprehensive Healthcare Response. An International Society of Addiction Medicine Practice and Policy Interest Group Position Paper.
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Farhoudian A, Baldacchino A, Clark N, Gerra G, Ekhtiari H, Dom G, Mokri A, Sadeghi M, Nematollahi P, Demasi M, Schütz CG, Hash-Emian SM, Tabarsi P, Galea-Singer S, Carrà G, Clausen T, Kouimtsidis C, Tolomeo S, Radfar SR, and Razaghi EM
- Abstract
Coronavirus Disease 2019 (COVID-19) is escalating all over the world and has higher morbidities and mortalities in certain vulnerable populations. People Who Use Drugs (PWUD) are a marginalized and stigmatized group with weaker immunity responses, vulnerability to stress, poor health conditions, high-risk behaviors, and lower access to health care services. These conditions put them at a higher risk of COVID-19 infection and its complications. In this paper, an international group of experts on addiction medicine, infectious diseases, and disaster psychiatry explore the possible raised concerns in this issue and provide recommendations to manage the comorbidity of COVID-19 and Substance Use Disorder (SUD)., Competing Interests: Conflict of interest The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright© 2020 Iranian Neuroscience Society.)
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- 2020
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146. COVID-19 and Substance Use Disorder: Study Protocol for the International Society of Addiction Medicine Practice and Policy Interest Group Global Survey.
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Baldacchino A, Radfar SR, De Jong C, Rafei P, Yunesian M, Gerra G, Brady K, Ebrahimi M, Vahidi M, Khojasteh Zonoozi A, Mohaddes Ardabili H, Busse A, Saenz E, Campello G, Niaz K, Ekhtiari H, and Farhoudian A
- Abstract
Introduction: As one of the major health problems in the present century, the COVID-19 pandemic affected all parts of the global communities and the health of substance users are potentially at a greater risk of harm. This global study has been designed and conducted by the International Society of Addiction Medicine Practice and Policy Interest Group (ISAM-PPIG) to understand better the health related issues of people with Substance Use Disorders (SUD) as well as responses of the relevant health care systems during the pandemic., Methods: This is a cross-sectional study using convenient sampling. The data gathering was carried out with two follow-up stages each two months apart through an online conducted survey prepared using Google platform. The survey started by emergence of COVID-19 as a pandemic in March 2020 and respondents were followed till September 2020 when most of the initial lockdowns by most countries are supposed to be reopened., Ethics and Dissemination: The study was approved by the ethics committee of University of Social Welfare and Rehabilitation Sciences, Tehran, Iran. The results will be published in relevant peer reviewing journals and communicated with different international stakeholders., Competing Interests: Conflict of interest The authors declare that they have no competing interests., (Copyright© 2020 Iranian Neuroscience Society.)
- Published
- 2020
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147. Socioeconomic Status, Parental Education, School Connectedness and Individual Socio-Cultural Resources in Vulnerability for Drug Use among Students.
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Gerra G, Benedetti E, Resce G, Potente R, Cutilli A, and Molinaro S
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- Adolescent, Child, Europe, Humans, Social Class, Students, Schools, Socioeconomic Factors, Substance-Related Disorders
- Abstract
Background and Aims: Families who live in a disadvantaged socioeconomic situation frequently face substandard housing, unsafe neighborhoods, inadequate schools and more stress in their daily lives than more affluent families, with a host of psychological and developmental consequences that can hinder their children's development in many ways. However, the measurement of socioeconomic status among youth and its link with different forms of illicit substance use is challenging and still unclear. This paper extends existing research on the relationship between socioeconomic status and illicit drug use among adolescents by focusing on three different patterns of use (experimental, episodic and frequent) and making use of two indicators to improve the measurement of individual socioeconomic characteristics in a big sample of European students., Methods: Data were drawn from the European school Survey Project on Alcohol and other Drugs (ESPAD), which, since 1995, collects comparable data among 15-to-16-year-old students to monitor trends in drug use and other risk behaviors across Europe. The sample comes from 28 countries that participated in the 2015 data collection. The consumption of cannabis, cocaine and heroin are considered, and the related patterns are identified based on the frequency of use. Family characteristics at student level are defined through two dimensions: parental educational level and perceived socioeconomic status. Multivariate multilevel mixed-effects logistic regression was performed in order to measure the association between individual characteristics and vulnerability for drug use., Results: Some patterns of use, episodic and frequent in particular, were found strongly associated with a lower socioeconomic status and lower parental education., Conclusions: Our results suggest that drug policies should be combined with actions aimed at removing barriers to social inclusion that are attributable to the socioeconomic background of adolescents.
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- 2020
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148. Implementation and Evaluation of a Psychoactive Substance Use Intervention for Children in Afghanistan: Differences Between Girls and Boys at Treatment Entry and in Response to Treatment.
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Momand AS, Mattfeld E, Gerra G, Morales B, Browne T, Haq MU, O'Grady KE, and Jones HE
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Psychoactive substance use among children in Afghanistan is an issue of concern. Somewhere around 300,000 children in the country have been exposed to opioids that either parents directly provided to them or by passive exposure. Evidence-based and culturally appropriate drug prevention and treatment programs are needed for children and families. The goals of this study were to: (1) examine lifetime psychoactive substance use in girls and boys at treatment entry; and (2) examine differential changes in substance use during and following treatment between girls and boys. Children ages 10-17 years old entering residential treatment were administered the Alcohol, Smoking and Substance Involvement Screening Test for Youth (ASSIST-Y) at pre- and post-treatment, and at three-month follow-up. Residential treatment was 45 days for children and 180 days for adolescents and consisted of a comprehensive psychosocial intervention that included education, life skills, individual and group counseling and, for older adolescents, vocational skills such as embroidery and tailoring. Girls and boys were significantly different regarding lifetime use of five substances at treatment entry, with girls less likely than boys to have used tobacco, cannabis, stimulants, and alcohol, and girls more likely than boys to have used sedatives. Differences between boys and girls were found for past-three-month use of four substances at treatment entry, with girls entering treatment with higher past-three-month use of opioids and sedatives, and boys with higher past-three-month use of tobacco, cannabis, and alcohol. Change over the course of treatment showed a general decline for both girls and boys in the use of these substances. Girls and boys in Afghanistan come to treatment with different substance use histories and differences in past-three-month use. Treatment of children for substance use problems must be sensitive to possible differences between girls and boys in substance use history., Competing Interests: Competing interests. The authors declare that there is no conflict of interest regarding the publication of this paper.
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- 2020
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149. Addressing the opioid crisis globally.
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Volkow ND, Icaza MEM, Poznyak V, Saxena S, and Gerra G
- Published
- 2019
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150. Determination of oxycodone and its major metabolites in haematic and urinary matrices: Comparison of traditional and miniaturised sampling approaches.
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Protti M, Catapano MC, Samolsky Dekel BG, Rudge J, Gerra G, Somaini L, Mandrioli R, and Mercolini L
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- Blood Specimen Collection, Body Fluids chemistry, Chromatography, Liquid methods, Doping in Sports methods, Dried Blood Spot Testing methods, Drug Monitoring methods, Humans, Miniaturization methods, Plasma chemistry, Specimen Handling methods, Tandem Mass Spectrometry methods, Urine chemistry, Morphinans blood, Morphinans urine, Oxycodone blood, Oxycodone urine, Oxymorphone blood, Oxymorphone urine
- Abstract
Oxycodone is a widely prescribed, full agonist opioid analgesic. As such, it is used clinically to treat different kinds of painful conditions, with a relatively high potential for doping practices in athletes. In this paper, different classic and innovative miniaturised matrices from blood and urine have been studied and compared, to evaluate their relative merits and drawbacks within therapeutic drug monitoring (TDM) and to implement new protocols for anti-doping analysis. Plasma, dried blood spots (DBS) and dried plasma spots (DPS) have been studied for TDM purposes, while urine, dried urine spots (DUS) and volumetric absorptive microsamples (VAMS) from urine for anti-doping. These sampling techniques were coupled to an original bioanalytical method based on liquid chromatography-tandem mass spectrometry (LC-MS/MS) for the evaluation and monitoring of the levels of oxycodone and its major metabolites (noroxycodone and oxymorphone) in patients under pain management and in athletes. The method was validated according to international guidelines, with good results in terms of precision, extraction yield and accuracy for all considered micromatrices. Thus, the proposed sampling, pre-treatment and analysis are attractive strategies for oxycodone determination in human blood and urine, with advanced options for application to derived micromatrices. Microsampling procedures have significant advantages over classic biological matrices like simplified sampling, storage and processing, but also in terms of precision (<9.0% for DBS, <7.7% for DPS, <7.1% for DUS, <5.3% for VAMS) and accuracy (>73% for DBS, >78% for DPS, >74% for DUS, >78% for VAMS). As regards extraction yield, traditional and miniaturised sampling approaches are comparable (>67% for DBS, >74% for DPS, >75% for DUS, >75% for VAMS). All dried matrices have very low volumes, leading to a significant advantage in terms of analysis feasibility. On the other hand, this also leads to a corresponding decrease in the overall sensitivity., (Copyright © 2018 Elsevier B.V. All rights reserved.)
- Published
- 2018
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