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Vadim Yuferov,1,* Eduardo R Butelman,1,* Matthew Randesi,1 Wim van den Brink,2 Peter Blanken,3 Jan M van Ree,4 Mary Jeanne Kreek1 1Laboratory of the Biology of Addictive Diseases, The Rockefeller University, New York, NY, 10065, USA; 2Amsterdam University Medical Centers, Location Academic Medical Center, Department of Psychiatry, University of Amsterdam, Amsterdam, The Netherlands; 3Parnassia Addiction Research Centre, The Hague, The Netherlands; 4Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht, The Netherlands*These authors contributed equally to this workCorrespondence: Eduardo R ButelmanLaboratory on the Biology of Addictive Diseases, The Rockefeller University, 1230 York Avenue, New York, NY, 10065, USATel +1 212 327-8490Fax +1 212 327-8574Email butelme@rockefeller.eduIntroduction: A functional tandem repeat polymorphism in the promoter of the serotonin transporter (SERT) gene (SLC6A4) has been studied for association to neuropsychiatric conditions, including substance use disorders. Short (S) forms of this repeat result in reduced transcription, and presumably greater synaptic levels of serotonin, which are involved in opioid and cocaine-induced reward. Dual exposure to heroin and cocaine is a common pattern of poly-drug use and is associated with considerable morbidity. We hypothesize that SLC6A4 variants are associated with cocaine exposure in subjects with an opioid dependence diagnosis (OD), and also in non-dependent opioid users (NOD). Other single nucleotide polymorphisms (SNPs) of SLC6A4 may also be likewise associated.Materials and Methods: This study determined whether variants of the SLC6A4 promoter repeats and two intronic SNPs, rs16965628 and rs2066713, are associated with categorical diagnoses of opioid dependence (DSM-IV criteria) and with dimensional aspects of cocaine use, in a Caucasian cohort (n=591). Three groups of subjects were examined: (1) 276 subjects with opioid dependence diagnosis (OD); (2) 163 subjects who had used opioids for non-medical reasons but never had an opioid dependence diagnosis (NOD); (3) 152 healthy controls (HC).Results: Aside from high exposure to heroin in the OD group, relatively high exposure to cocaine was detected in both OD and NOD groups. The SERT repeat genotype (classified as “long-long” [LL] versus ”short-long” plus “short-short” [SL+SS]) was not associated with categorical opioid dependence diagnoses. A nominally significant association was identified with the [SL+SS] genotype of SLC6A4 and cocaine KMSK scores ≥“cutpoint” for a cocaine dependence diagnosis (p=0.026). The [SL+SS] genotype was associated with more rapid cocaine escalation than the LL genotype. No significant associations of rs16965628 and rs2066713 SNPs were found overall.Conclusion: The functional SERT promoter tandem repeat genotype may be associated to heavy cocaine exposure and more rapid escalation of cocaine use, in persons with and without opioid dependence diagnosis.Keywords: cocaine, serotonin transporter, SLC6A4, KMSK scale, escalation

Aim: Heroin addiction is a chronic, relapsing disease that has genetic and environmental, including drug-induced, contributions. Stress influences the development of addictions. This study was conducted to determine if variants in stress-related genes are associated with opioid dependence (OD). Patients & methods: One hundred and twenty variants in 26 genes were analyzed in 597 Dutch subjects. Patients included 281 OD in methadone maintenance with or without heroin-assisted treatment and 316 controls. Results: Twelve SNPs in seven genes showed a nominally significant association with OD. Experiment-wise significant associations (p < 0.05) were found for three SNP pairs, through an interaction effect: NPY1R/ GAL rs4691910/rs1893679, NPY1R/ GAL rs4691910/rs3136541 and GALR1/GAL rs9807208/rs3136541. Conclusion: This study lends more evidence to previous reports of association of stress-related variants with heroin dependence.

Aim: To determine if selected serotonergic and noradrenergic gene variants are associated with heroin addiction. Subjects & methods: A total of 126 variants in 19 genes in subjects with Dutch European ancestry from The Netherlands. Subjects included 281 opioid-dependent volunteers in methadone maintenance or heroin-assisted treatment, 163 opioid-exposed but not opioid-dependent volunteers who have been using illicit opioids but never became opioid-dependent and 153 healthy controls. Results: Nominal associations were indicated for 20 variants in six genes including an experiment-wise significant association from the combined effect of three SLC18A2 SNPs (rs363332, rs363334 and rs363338) with heroin dependence (pfinal = 0.047). Conclusion: Further studies are warranted to confirm and elucidate the role of these variants in the vulnerability to opioid addiction.

The dynorphin/kappa opioid receptor (Dyn/KOR) system is involved in reward processing and dysphoria/anhedonia. Exposure to mu-opioid receptor agonists such as heroin increases expression of the prodynorphin gene (PDYN) in the brain. In this study in a Caucasian cohort, we examined the association of the functional PDYN 68-bp repeat polymorphism with opioid use disorders. In this case-control study, 554 subjects with Caucasian ancestry (142 healthy controls, 153 opioid-exposed, but never opioid dependent, NOD, and 259 with an opioid dependence diagnosis, OD) were examined for association of the PDYN 68-bp repeats with the diagnosis of opioid dependence (DSM-IV criteria), with a dimensional measure of heroin exposure (KMSK scale), and age trajectory parameters of heroin use (age of heroin first use, and age of onset of heaviest use). The PDYN 68-bp repeat genotype (classified as: “short-short” [SS], “long-long” [LL], and “short-long” [SL], based on the number of repeats) was not associated with categorical opioid dependence diagnoses. However, the LL genotype was associated with later age of first heroin use than the SS + SL genotype (19 versus 18 years; p < 0.01). This was also confirmed by a significant positive correlation between the number of repeats and the age of first use of heroin, in volunteers with OD (Spearman r = 0.16; p = 0.01). This suggests that the functional PDYN 68-bp repeat genotype is associated with the age of first use of heroin in Caucasians diagnosed with opioid dependence.

Background Most studies investigating the role of personality as a risk factor for the development of opioid dependence compare dependent opioid users with healthy controls who never used heroin. In order to understand the potential protective role of personality, it is crucial to compare illicit opioid users who never became dependent with dependent opioid users. Aims This study aims to examine the role of personality as a risk factor for opioid use and as a protective factor for the development of opioid dependence. Methods Comparing personality factors between three groups: (1) 161 never-dependent illicit opioid users who have been using illicit opioids but never became opioid dependent; (2) 402 dependent opioid users in methadone maintenance treatment or heroin-assisted treatment; and (3) 135 healthy controls who never used heroin. Personality was assessed with a short version of Cloninger's Temperament and Character Inventory. Results Never-dependent opioid users reported more Novelty Seeking and Harm Avoidance and less Self-Directedness and Cooperativeness than healthy controls and more Reward Dependence and Self-Directedness, and less Harm Avoidance than dependent opioid users. Furthermore, never-dependent opioid users reported more Self-Transcendence than both dependent opioid users and healthy controls. Conclusions Never-dependent opioid users may have started to use opioids partly due to their tendency to seek novel and/or spiritual experiences (high Novelty Seeking, high Self-Transcendence) and their tendency to avoid aversive stimuli (high Harm Avoidance), whereas they may have been protected against the development of dependence by their need for social approval (high Reward Dependence) and their self-efficacy (high Self-Directedness).

Aims To determine the efficacy of contingency management (CM), targeting cocaine use, as an add-on intervention for heroin dependent patients in supervised heroin-assisted treatment (HAT) with frequent cocaine use. Design Multi-center, open-label, parallel group, randomized controlled trial. Setting Twelve specialized addiction treatment centers for HAT in The Netherlands; April 2006–January 2011. Participants 214 chronic, treatment-refractory heroin dependent patients in HAT, with frequent cocaine use. Interventions Routine, daily supervised diacetylmorphine treatment, co-prescribed with oral methadone (HAT), with and without 6 months contingency management for cocaine use as an add-on intervention; HAT + CM and HAT-only, respectively. Measurements Primary outcome was the longest, uninterrupted duration of cocaine abstinence, based upon laboratory urinalysis. Secondary outcome measures included other cocaine-related measures, treatment retention in HAT, and multi-domain health-related treatment response. Findings In an intention-to-treat analysis, HAT + CM was more effective than HAT-only in promoting longer, uninterrupted duration of cocaine abstinence (3.7 weeks versus 1.6 weeks; negative binomial regression: Exp(B) = 2.34, 95%-CI: 1.70–3.23; p

Aims: To investigate in heroin-assisted treatment (HAT) compared to methadone maintenance treatment (MMT): the course of heroin craving and illicit heroin use, their mutual association, and their association with multi-domain treatment response. Design: RCTs on the efficacy of 12 months co-prescribed injectable or inhalable HAT compared to 12 months continued oral MMT. Setting: Outpatient treatment in MMT- or specialized HAT-centers in the Netherlands. Participants: Chronic, treatment-refractory heroin dependent patients (n=73). Study parameters: General craving for heroin (Obsessive Compulsive Drug Use Scale): self-reported illicit heroin use; multi-domain treatment response in physical, mental and social health and illicit drug use. Findings: The course of heroin craving and illicit heroin use differed significantly, with strong reductions in HAT but not in MMT. General heroin craving was significantly related to illicit heroin use. Heroin craving was not and illicit heroin use was marginally related to multi-domain treatment response, but only in MMT and not in HAT. Conclusions: Heroin craving and illicit heroin use were significantly associated and both strongly decreased in HAT but not in MMT. Craving was not related to multi-domain treatment response and illicit heroin use was marginally related to treatment response in MMT, but not in HAT. The latter was probably due to the strong reduction in illicit heroin use in most patients in HAT and the small sample size of the sub-study. It is hypothesized that the strong reductions in craving for heroin in HAT are related to the stable availability of prescribed, pharmaceutical grade heroin. (C) 2011 Elsevier Ireland Ltd. All rights reserved

Motor dominance is well established, but sensory dominance is much less clear. We therefore studied the cortical evoked magnetic fields using magnetoencephalography (MEG) in a group of 20 healthy right handed subjects in order to examine whether standard electrical stimulation of the median and ulnar nerve demonstrated sensory lateralization. The global field power (GFP) curves, as an indication of cortical activation, did not depict sensory lateralization to the dominant left hemisphere. Comparison of the M20, M30, and M70 peak latencies and GFP values exhibited no statistical differences between the hemispheres, indicating no sensory hemispherical dominance at these latencies for each nerve. Field maps at these latencies presented a first and second polarity reversal for both median and ulnar stimulation. Spatial dipole position parameters did not reveal statistical left-right differences at the M20, M30 and M70 peaks for both nerves. Neither did the dipolar strengths at M20, M30 and M70 show a statistical left-right difference for both nerves. Finally, the Laterality Indices of the M20, M30 and M70 strengths did not indicate complete lateralization to one of the hemispheres. After electrical median and ulnar nerve stimulation no evidence was found for sensory hand dominance in brain responses of either hand, as measured by MEG. The results can provide a new assessment of patients with sensory dysfunctions or perceptual distortion when sensory dominance occurs way beyond the estimated norm.

Traditional behavioral tests, such as the open field test, measure an animal's responsiveness to a novel environment. However, it is generally difficult to assess whether the behavioral response obtained from these tests relates to the expression level of motor activity and/or to avoidance of anxiogenic areas. Here, an automated home cage environment for mice was designed to obtain independent measures of motor activity levels and of sheltered feeding preference during three consecutive days. Chronic treatment with the anxiolytic drug chlordiazepoxide (5 and 10 mg/kg/day) in C57BL/6J mice reduced sheltered feeding preference without altering motor activity levels. Furthermore, two distinct chromosome substitution strains, derived from C57BL/6J (host strain) and A/J (donor strain) inbred strains, expressed either increased sheltering preference in females (chromosome 15) or reduced motor activity levels in females and males (chromosome 1) when compared to C57BL/6J. Longitudinal behavioral monitoring revealed that these phenotypic differences maintained after adaptation to the home cage. Thus, by using new automated behavioral phenotyping approaches, behavior can be dissociated into distinct behavioral domains (e.g., anxiety-related and motor activity domains) with different underlying genetic origin and pharmacological responsiveness.

Heavy ecstasy use has been associated with neurocognitive deficits in various behavioral and brain imaging studies. However, this association is not conclusive owing to the unavoidable confounding factor of polysubstance use. The present study, as part of the Netherlands XTC Toxicity study, investigated specific effects of ecstasy on working memory, attention, and associative memory, using functional magnetic resonance imaging ( fMRI). A large sample (n = 71) was carefully composed based on variation in the amount and type of drugs that were used. The sample included 33 heavy ecstasy users (mean 322 pills lifetime). Neurocognitive brain function in three domains: working memory, attention, and associative memory, was assessed with performance measures and fMRI. Independent effects of the use of ecstasy, amphetamine, cocaine, cannabis, alcohol, tobacco, and of gender and IQ were assessed and separated by means of multiple regression analyses. Use of ecstasy had no effect on working memory and attention, but drug use was associated with reduced associative memory performance. Multiple regression analysis showed that associative memory performance was affected by amphetamine much more than by ecstasy. Both drugs affected associative memory-related brain activity, but the effects were consistently in opposite directions, suggesting that different mechanisms are at play. This could be related to the different neurotransmitter systems these drugs predominantly act upon, that is, serotonin (ecstasy) vs dopamine (amphetamine) systems.

Rationale Heavy ecstasy use in humans has been associated with cognitive impairments and changes in cognitive brain function supposedly due to damage to the serotonin system. There is concern that even a single dose of 3,4-methylenedioxymethamphetamine may be neurotoxic, but very little is known about the consequences of a low dose of ecstasy for cognitive brain function. Objectives The objective of the study was to assess the effects of a low dose of ecstasy on human cognitive brain function using functional magnetic resonance imaging (fMRI). Materials and method We prospectively studied, as part of the NeXT (Netherlands XTC toxicity) study, sustained effects of a low dose of ecstasy on brain function in 25 subjects before and after their first episode of ecstasy use (mean 2.0 +/- 1.4 ecstasy pills, on average 11.1 +/- 12.9 weeks since last ecstasy use), compared to 24 persistent ecstasy-naive controls, also measured twice and matched with the novice users on age, gender, IQ, and cannabis use. Cognitive brain function was measured in the domains of working memory, selective attention, and associative memory using fMRI. Results No significant effects were found of a low dose of ecstasy on working memory, selective attention, or associative memory neither at the behavioral level nor at the neurophysiological level. Conclusions This study yielded no firm evidence for sustained effects of a low dose of ecstasy on human cognitive brain function. The present findings are relevant for the development of prevention and harm reduction strategies. Furthermore, the study is relevant to the discussion concerning potential therapeutic use of ecstasy

Objective: To determine the patterns of acquisitive crime during methadone maintenance treatment among chronic, treatment-resistant heroin users eligible for heroin assisted treatment in the Netherlands. Methods: We retrospectively assessed the type and number of illegal activities during 1 month of standard methadone maintenance treatment in 51 patients prior to the start of heroin assisted treatment. Data were collected using a semi-structured interview focussed on crime with special emphasis on property crime. Volume analyses consisted of frequencies and descriptives of mean numbers of offences per day and per type. Results: In a Dutch population of problematic drug users eligible for and prior to commencing heroin assisted treatment, 70% reported criminal activities and 50% reported acquisitive crimes. Offending took place on 20.5 days per month with on average 3.1 offences a day. Acquisitive crime consisted mainly of shoplifting (mean 12.8 days, 2.2 times/day) and theft of bicycles (mean 5.8 days, 2.4 times/day); theft from a vehicle and burglaries were committed less frequently. The majority of these patients (63%) reported to have started offending in order to acquire illicit drugs and alcohol. Conclusion: During methadone maintenance treatment, 50% of criminally active, problematic heroin users eligible for heroin assisted treatment reported acquisitive crime. Shoplifting, thefts and/or other property crimes were committed on average two to three times on a crime day. This study discusses that the detail provided by self-reported crime data can improve cost estimates in economic evaluations of heroin assisted treatment. © 2006 Elsevier Ireland Ltd. All rights reserved.

Alcohol consumption and addiction have been related to anxiety and the anxiolytic effect of ethanol. It has been shown in mice that losers with repeated experience of social defeats are more anxious than winners with repeated experience of victories. Mice with a different social status were tested for their oral ethanol consumption using a free two bottle choice paradigm and for their social approach behaviour after ethanol consumption using the partition test, in which anxiety is an important component. In addition, the sensitivity of the animals for the κ-opioid receptor agonist U-50,488H (2.5 mg/kg, s.c.) was assessed using the partition test, in which this drug has been shown to induce anxiolytic-like effects. Further, the effect of daily treatment with U-50,488H for 8 days on ethanol consumption was tested in animals that had consumed ethanol and were subjected during these 8 days to a period of 5 days of interruption of ethanol supply and subsequently to a period of 3 days of renewed access to ethanol. Losers consumed more ethanol than winners. Consumption of ethanol was accompanied by a decrease of anxiety level, as evidenced by an increased approach behaviour in the partition test. U-50,488H stimulated ethanol consumption after a period of 5 days of interruption of ethanol supply and drug treatment in the losers, but not in the winners. U-50,488H increased approach behaviour in the losers not consuming ethanol and decreased this behaviour in the winners, especially in those that had consumed ethanol. It is postulated that U-50,488H acts as a partial agonist in this respect. The increased anxiety may be related to the enhanced ethanol consumption in the losers, which may be of relevance for the etiology of alcohol addiction.

In the present study the effects of neonatal excitotoxic lesions of the amygdala or ventral hippocampus on local cerebral glucose utilisation in the adult rat were studied by means of the [14C]2-deoxyglucose autoradiographic method. Our hypothesis was that damage to the brain during early development leads to long-term functional activity changes in brain regions outside the primary lesioned area which might underlie the behavioural deficits observed in animals with neonatal brain damage. Cerebral glucose utilisation in animals with a neonatal amygdala lesion was significantly decreased in the amygdala itself and in several other brain regions. The neonatal ventral hippocampal lesion did not cause significant changes in cerebral glucose utilisation, except for a decrease in the primary damaged region (i.e. caudal ventral hippocampus). Behaviourally, animals lesioned in the amygdala displayed increased ambulatory activity both before and after puberty when exposed to a novel open field, while neonatal ventral hippocampal lesions did not affect adult exploratory behaviour as compared to sham controls. These results support our hypothesis that neonatal brain damage leads to long-term functional activity changes in brain regions outside the primary lesioned area. Moreover, they suggest that this long-term effect depends on the primary area lesioned since only damage to the amygdala, and not to the ventral hippocampus, affects the functional organisation of the brain of the animals later in life. Additionally, the findings may suggest that the functional changes in the brain may underlie the behavioural deficits observed after neonatal amygdala lesion in the rat.

BACKGROUND: In several European countries and in Canada, clinical trials are being conducted in which heroin-addicted patients are treated with pharmaceutically prepared heroin in order to reduce the destructive behaviour that is so often associated with this drug. OBJECTIVE: To develop an integrated population pharmacokinetic model for heroin (diamorphine) and its pharmacodynamically active metabolites 6-acetylmorphine, morphine, morphine-3-glucuronide and morphine-6-glucuronide. Additionally, the influence on heroin pharmacokinetics of several covariates that are typical for this population was determined. METHOD: Plasma concentration data from 106 heroin-dependent patients in The Netherlands (74 heroin inhalers and 32 injectors) were obtained. The 'chasing the dragon' technique was used for inhalation, in which the fumes of heroin base, heated on aluminum foil, were inhaled. Heroin doses varied between 66 and 450 mg. Heroin, 6-acetylmorphine and morphine data were fitted simultaneously using sequential two-compartment models. Morphine-3-glucuronide and morphine-6-glucuronide data were fitted separately to one-compartment models. All data analysis was performed using nonlinear mixed-effect modelling. RESULTS: The bioavailability of inhaled heroin was estimated to be 53% (95% CI 43.7, 62.3). The terminal half-lives of heroin and 6-acetylmorphine were estimated to be 7.6 and 21.8 minutes, respectively. The clearances of morphine and the morphine-glucuronides were estimated to be 73.6 L/h (95% CI 62.8, 84.4) and between 6 and 10 L/h, respectively. The terminal half-life of 6-acetylmorphine was 13% lower in cocaine users (p < 0.05). No other significant relationships between covariates and pharmacokinetic parameters were discovered. CONCLUSIONS: Pharmacokinetic parameters of heroin and its five major metabolites were assessed simultaneously in one integrated model. Covariate analyses revealed that sex, bodyweight, benzodiazepine use and creatinine clearance (>60 mL/min) do not need to be taken into account in the medical prescription of pharmaceutically prepared heroin for the treatment of heroin dependency

RATIONALE: Excessive use of cannabis may have long-term effects on cognitive abilities. Mild impairments have been found in several cognitive domains, particularly in memory and attention. It is not clear, however, whether these effects also occur with moderate, recreational use of cannabis. Furthermore, little is known about underlying brain correlates. OBJECTIVES: The aim of this study is to assess brain function in frequent but relatively moderate cannabis users in the domains of working memory and selective attention. METHODS: Functional magnetic resonance imaging was used to examine verbal working memory and visuo-auditory selective attention in ten frequent cannabis users (after 1 week of abstinence) and ten non-using healthy controls. Groups were similar in age, gender and estimated IQ. RESULTS: Cannabis users and controls performed equally well during the working memory task and the selective attention task. Furthermore, cannabis users did not differ from controls in terms of overall patterns of brain activity in the regions involved in these cognitive functions. However, for working memory, a more specific region-of-interest analysis showed that, in comparison to the controls, cannabis users displayed a significant alteration in brain activity in the left superior parietal cortex. CONCLUSION: No evidence was found for long-term deficits in working memory and selective attention in frequent cannabis users after 1 week of abstinence. Nonetheless, frequent cannabis use may affect brain function, as indicated by altered neurophysiological dynamics in the left superior parietal cortex during working memory processing

A pharmacokinetic-pharmacodynamic study was performed in opioid-dependent patients in the Netherlands, who were currently treated with high doses of pharmaceutically prepared heroin on medical prescription. Besides intravenous heroin, heroin was prescribed for inhalation by "chasing the dragon" method. In this technique, heroin base is heated on aluminium foil, and heroin vapours are inhaled into the lungs. Not much is known about the pharmacokinetics profile and bioavailability of this specific administration method. Therefore, a study was performed on pharmacokinetics and pharmacodynamics of heroin inhalation and intravenous use. Eleven patients who injected heroin and 9 patients who inhaled heroin entered the study. They were on steady-state heroin treatment for at least 12 months. For safety reasons, there was no crossing-over between heroin injection or inhalation. In a double-blind randomised study, 67-100-150% of the regular heroin maintenance dose was administered to each patient. Maximal single heroin dose was 450 mg. Plasma concentrations of heroin and its metabolites 6-monoacetylmorphine, morphine and morphine-glucuronides were analysed using LC-MS-MS. Blood pressure, heart rate, skin temperature and reaction time were assessed. Furthermore, visual analogue scales regarding craving and appreciation of heroin effect were scored by the subjects. Both in inhaling and injecting patients, the areas under curve of heroin and all measured metabolites were linearly related to heroin dose. Mean C(max) of heroin and its metabolites were 2-6 times lower after inhalation, than after intravenous injection. Bioavailability (F) of heroin inhalation was estimated as 52% (95% CI 44-61%). Heroin was rapidly cleared from plasma. Cl/F was 930 l/hr (95% CI 799-1061 l/hr) after intravenous administration, and 1939 l/hr (95% CI 1661-2217 l/hr) after inhalation. Heroin Cl and Vd were correlated to body weight (R(2) 15-19%). Morphine-glucuronides levels were inversely related to creatinine clearance. After heroin administration, the reaction time was significantly prolonged with 28+/-5.3 msec. in injecting and 13+/-4.9 msec. in inhaling patients. Cardiovascular changes were only mild after heroin administration. Craving-scores declined immediately after heroin administration in both administration groups. Subjective heroin effect was rated more positively in heroin inhaling than in injecting patients, despite the lower C(max) levels following heroin inhalation. In both groups, in this blinded study heroin dose increments were more appreciated than dose reductions. Increments of 50% of the regular heroin dose did not cause any serious side effect.

Objective: To evaluate the validity of the EuroQol (EQ-5D) in a population of chronic, treatment-resistant heroin-dependent patients. Methods: The EQ-5D is studied relative to the Maudsley Addiction Profile (MAP), the Symptom Checklist (SCL-90) and the European Addiction Severity Index (EuropASI) which were used to assess the participant’s physical functioning, mental health and social integration, respectively. Data were gathered from 430 patients participating in the Dutch heroin trials with an intended 12-month treatment period. The EQ-5D was used as a separate health outcome measure. Statistical analyses were conducted using Spearman’s and Pearson’s correlations. Results: The EQ-5D dimensions mobility, self-care and usual activities generally showed low correlations with relevant parameters of the MAPHSS, SCL-90 and EuropASI (r = 0.132–0.369). The EQ-5D dimension pain/discomfort showed low to moderate hypothesized correlations with all disease-specific measures ( r = 0.153–0.496). The EQ-5D dimension anxiety/depression showed moderate to high correlations with the SCL-90 (including the sum score) and some of the EuropASI parameters (r = 0.133–0.615). The EQ-5D utility scores were moderately correlated with the MAP-HSS (r = −0.468) and the SCL-90 (r = −0.491) total score and with response to treatment at month 12. Conclusion: The majority of hypothesized associations between the EQ-5D and the disease or domain-specific measures could be confirmed. The validity of the EQ-5D-based utility score appears to be suitable in the evaluation of chronic, heroin-dependent populations. © 2005 Elsevier Ireland Ltd. All rights reserved.

For a pharmacokinetic-pharmacodynamic study in opioid tolerant patients, who were treated with heroin in combination with methadone, a liquid chromatographic assay with tandem mass spectrometry detection (LC-MS/MS) was developed for the simultaneous determination of heroin, methadone, heroin metabolites 6-monoacetylmorphine, morphine, and morphine-6 and 3-glucuronide and methadone metabolite EMDP. To detect any abuse of substances besides the prescribed opioids the assay was extended with the detection of cocaine, its metabolites benzoylecgonine and norcocaine and illicit heroin adulterants acetylcodeine and codeine. Heroin-d6, morphine-d3, morphine-3-glucuronide-d3 and methadone-d9 were used as internal standards. The sample pre-treatment consisted of solid phase extraction using mixed mode sorbent columns (MCX Oasis). Chromatographic separation was performed at 25 degrees C on a reversed phase Zorbax column with a gradient mobile phase consisting of ammonium formate (pH 4.0) and acetonitrile. The run time was 15 min. MS with relatively mild electrospray ionisation under atmospheric pressure was applied. The triple quadrupole MS was operating in the positive ion mode and multiple reaction monitoring (MRM) was used for drug quantification. The method was validated over a concentration range of 5-500 ng/mL for all analytes. The total recovery of heroin varied between 86 and 96% and of the heroin metabolites between 76 and 101%. Intra-assay and inter-assay accuracy and precision of all analytes were always within the designated limits (< or =20% at lower limit of quantification (LLQ) and < or =15% for other samples). This specific and sensitive assay was successfully applied in pharmacokinetic studies with medically prescribed heroin and toxicological cases.

In the present study we show that the endogenous opioid systems play a modulating role in cocaine-induced reinstatement of drug-seeking behavior in rats. We investigated the effect of blockade of opioid receptors on reinstatement of cocaine-seeking behavior by cocaine priming. Drug-naive rats were allowed to initiate self-administration behavior of cocaine (30 and 60 mug per infusion, i.v.) for 5 consecutive daily sessions, and after a 5-day extinction period during which the rats did not receive cocaine, a test for cocaine-induced (1 mg/kg, i.v.) reinstatement followed. The effect of cocaine priming was tested on days 1, 3, and 5 after extinction, while on days 2 and 4 the animals received saline priming. Before each daily reinstatement test, different groups of animals received an injection with the opioid receptor antagonist naltrexone (3 mg/kg, s.c.) or with placebo. We observed that cocaine readily reinstated extinguished responding in the rats, and that this reinstatement responding did not change over the consecutive reinstatement tests. Pretreatment with naltrexone progressively attenuates the cocaine-induced reinstatement, with a significant reduction on days 3 and 5 of reinstatement testing. Discriminative lever-pressing (active versus inactive lever) during reinstatement phase, however, remains present in animals treated with naltrexone. This implies that repeated opioid receptor blockade progressively attenuates cocaine-induced drug-seeking behavior in abstained animals, but this cannot simply be attributed to extinction of cocaine-seeking behavior.

In preparation for a treatment program concerning the medical coprescription of heroin and methadone to treatment-resistant addicts in the Netherlands, we studied a novel strategy for monitoring co-use of illicit (nonprescribed) heroin. A deuterated analogue of heroin was added (1:20) to pharmaceutical, smokable heroin (a powder mixture of 75% w/w diacetylmorphine base and 25% w/w caffeine anhydrate), to be used by inhalation after volatilization ("chasing the dragon"). Plasma and urine samples were collected from nine male patients who had used pharmaceutical, smokable heroin during a four-day stay in a closed clinical research unit, and these samples were analyzed by liquid chromatography coupled with tandem mass spectrometry. Ratios of deuterated and undeuterated diacetylmorphine and 6-acetylmorphine (MAM/MAM-d3) in plasma and urine were calculated from peak areas of these substances in the respective chromatograms. The MAM/MAM-d3 ratios in plasma and urine were normally distributed (with small standard deviations) and independent from concentrations of 6-acetylmorphine and from time after use of pharmaceutical heroin. A MAM/MAM-d3 ratio in urine above 32.8 was considered indicative of co-use of illicit heroin, and this value was associated with a false-positive rate of only 1% (95% confidence interval: -1 to 3%). The MAM/MAM-d3 ratio was detectable in urine for 4-9.5 h after use of pharmaceutical, smokable heroin. Addition of stable, isotopically labelled heroin to pharmaceutical, smokable heroin is considered to be a feasible strategy for the detection of co-use of illicit heroin by patients in heroin-assisted treatment.

Presently, there is a considerable interest in heroin-assisted treatment: co-prescription of heroin to certain subgroups of chronic, treatment-resistant, opioid dependent patients. In 2002, nine countries had planned (Australia, Belgium, Canada, France, Spain) or ongoing (Germany, The Netherlands, Switzerland, United Kingdom) clinical trials on this subject. These trials (and the routine heroin-assisted treatment programs that might result) will need pharmaceutical heroin (diacetylmorphine) to prescribe to the patients. Research into the development of pharmaceutical forms of heroin for prescription to addicts can benefit from the large amount of knowledge that already exists regarding this substance. Therefore, in this paper we review the physicochemical and pharmaceutical properties of diacetylmorphine and the clinically investigated routes of administration, as well as routes of administration utilised on the street in the context of developing pharmaceutical heroin formulations for prescription to addicts. Patient acceptability of the formulation is essential, because heroin-assisted treatment is aimed at treatment-resistant addicts, who often have to be encouraged to participate (or to maintain participation) in a treatment program. This means that the most suitable products would have pharmacokinetic profiles mimicking that of diacetylmorphine for injection, with rapid peak concentrations of diacetylmorphine and 6-acetylmorphine, ensuring the 'rush effect' and the sustained presence of morphine(-6-glucuronide) creating the prolonged euphoria. Diacetylmorphine for inhalation after volatilisation (via 'chasing the dragon') seems to be a suitable candidate, while intranasal and oral diacetylmorphine are currently thought to be unsuitable. However, oral and intranasal delivery systems might be improved and become suitable for use by heroin dependent patients.

Synthetic glucocorticoids, like dexamethasone (DEX), have been frequently administered to premature infants to prevent chronic lung disease. Major concern has arisen about the long-term neurodevelopmental sequelae of this DEX treatment. In the present study, we found that neonatal DEX treatment in rats, using a treatment protocol resembling the one used in the clinical situation, increased social play behaviour in juvenile life. Furthermore, neonatal DEX treatment increased sexual motivation and intromission behaviour in the bi-level chamber, decreased submissive behaviour during an aggressive encounter, and impaired social memory in adulthood. These changes in social behaviour are not due to a general behavioural impairment since anxiety behaviour in the elevated plus maze and exploratory activity in the open-field were not affected in DEX rats. In addition, DEX rats showed no alteration in the total duration of social interest or social activity during a social interaction test. These effects of neonatal DEX treatment on behaviour later in life likely result from neurodevelopmental actions of the hormone since we found no differences in received maternal care between DEX and SAL treated pups. Together these results indicate that neonatal treatment with DEX selectively alters aspects of the behavioural response to social challenges. Thus, neonatal DEX treatment may lead to inappropriate interactions with conspecifics later in life. These data therefore warrant investigation of lasting and potentially adverse effects of treatment of human neonates with DEX on social functioning.

This study was aimed to determine the effects of mu- and kappa-opioid receptor activation in relation to the social status of mice, being a winner with repeated experience of victories or a loser with repeated experience of social defeats. The behaviors of the animals were assessed in a social encounter test measuring the communicative behavior towards a familiar and an unfamiliar partner behind a perforated transparent partition (partition test) and in an elevated plus-maze test estimating the anxiety level of mice. Placebo and graded doses of the mu-opioid receptor agonist DAMGO (0.5 and 2 mg/kg s.c.) and the kappa-opioid receptor agonist U-50,488H (0.6, 1.25, and 2.5 mg/kg s.c.) were administered to the control mice, winners and losers in two experiments. In the partition test, the winners spent somewhat more time and the losers less time than the controls in the vicinity of their partner probably related to a lower and higher level of anxiety respectively. In the plus-maze test the losers appeared to have a somewhat higher anxiety level than the controls and winners. In both tests DAMGO produced anxiogenic-like effects in the winners and the controls, but not in the losers. Winners hardly responded to treatment with U-50,488H, while the losers responded dose dependently with an anxiolytic-like effect in both tests. It is concluded that anxiety-like responses in mice are differentially affected by stimulation of mu- and kappa-opioid receptors and that the effects depend on the social status of the animals.

Although mu-opioid receptors have been extensively investigated for their role in drug reinforcement, little is known about the contribution of these receptors to the acute and sensitized locomotor response to cocaine. In this study mu-opioid receptor involvement in acute cocaine-induced locomotor activity and in the development of cocaine-induced behavioral sensitization was evaluated using mu-opioid receptor knockout mice and chronic naltrexone (NTX) pretreatment as models. In addition, co-administration of the specific mu-opioid receptor antagonist CTOP with repeated saline or cocaine injections was used to establish the involvement of mu-opioid receptors in sensitization to the locomotor stimulant effects of cocaine. The acute locomotor response to cocaine (3, 10, 20, or 30 mg/kg i.p.) of mu-opioid receptor knockout or chronic NTX pretreated mice was not different from the cocaine response of their respective controls. With respect to cocaine-induced behavioral sensitization, induced by daily injections of 20 mg/kg cocaine for 11 subsequent days, mu-opioid receptor knockout mice developed behavioral sensitization to the locomotor stimulant effects of cocaine (challenge 10 mg/kg i.p.) comparable to wild-type littermates and the mu-opioid receptor antagonist CTOP did not affect cocaine-induced sensitization either. However, mice that were pretreated with NTX exhibited augmented cocaine-induced behavioral sensitization relative to placebo pretreated controls, which may be ascribed to increased delta-opioid receptor levels as has been described for chronic NTX pretreated mice. The present findings suggest that mu-opioid receptors are not required for the acute locomotor response to cocaine nor are they essential for the development of cocaine-induced behavioral sensitization.

Pervasive developmental disorders such as autism are characterized by deficits in social interaction and communication. Disturbed development of limbic structures such as the amygdala might underlie these deficits. The authors examined the effects of amygdala lesions on Postnatal Day 7 and juvenile isolation (2 weeks of individual housing during Weeks 4 and 5 of life) on rat locomotor and social activity later in life. Before puberty, but more pronounced after puberty, lesioned rats displayed enhanced locomotor activity. Adult social behavior was selectively disturbed by the lesion and the isolation procedure. In particular, the combination of neonatal lesions and juvenile isolation severely disrupted social interaction. These results suggest that a combination of neonatal amygdala damage and juvenile isolation may serve as an animal model of certain psychopathological neurodevelopmental disorders, such as autism.

The discovery of endogenous opioids has markedly influenced the research on the biology of drug dependence. Evidence has been presented that these brain substances are self-administered by laboratory animals. This finding, among others, has led to the hypothesis that endogenous opioids are involved in reinforcing habits, including dependence on drugs of abuse. The course of drug dependence is presented as a continuum from no drug use via controlled use to an actual dependence on the drug. Specific brain opioid systems belonging to four conceptualized brain circuits are described to be involved during the different phases of the drug dependence continuum. More recent research to delineate the role of endogenous opioid systems in drug dependence has focussed on genetic research in humans and animals. Among others, the findings obtained from studies of opioid receptor and opioid peptide precursor knockout mice provided further support for a role of endogenous opioid systems in drug dependence, in agreement with previous pharmacological studies.

Day 7 amygdala-lesioned (D7 AMX) rats have been proposed as a model for neurodevelopmental psychopathological disorders such as schizophrenia. Patients with schizophrenia are sensitive to stress and show an impaired hypothalamic-pituitary-adrenal response to certain stressful stimuli. Therefore, we investigated neuroendocrine and behavioral stress responses in the D7 AMX lesion model. Plasma concentrations of ACTH, corticosterone, and catecholamines were measured in response to foot shock and novelty in D7 and D21 lesioned (AMX) and non-lesioned (SHAM) animals. Behavior was recorded and analyzed afterwards. D7 AMX rats, unlike other rats, had a reduced ACTH response to foot shock and showed less active behavior in response to novelty. Neurodevelopmental dysfunction of target structures of the amygdala is associated with disturbed endocrine and behavioral responses to stress. These data accord with the notion that the D7 amygdala-lesioned rat can function as a neurodevelopmental model with relevance to schizophrenia.

Chronic treatment with the opioid antagonist naltrexone induces functional supersensitivity to opioid agonists, which may be explained by receptor up-regulation induced by opioid receptor blockade. In the present study, the levels of opioid receptor subtypes through the brain of mice were determined after chronic naltrexone treatment using quantitative in vitro autoradiography. This is the first complete mapping study in mice for micro-, delta- and kappa-opioid receptors after chronic naltrexone exposure. Treatment with naltrexone clearly induced up-regulation of micro- (mean 80%) and, to a lesser extent, delta-opioid receptors (mean 39%). The up-regulation of micro- and delta-opioid receptors was evident throughout the brain, although there was variation in the percentage change across brain regions. In contrast, consistent up-regulation of kappa-opioid receptors was observed in cortical structures only and was not so marked as for micro- and delta-opioid receptors. In noncortical regions kappa-opioid receptor expression was unchanged. Taken together, the present findings suggest opioid receptor subtype-selective regulation by chronic naltrexone treatment in mice.

Neurotensin has been implicated in the pathophysiology of schizophrenia. The neonatal amygdala lesion in rat has been proposed to be a neurodevelopmental model for some aspects of schizophrenia. [125I] Neurotensin binding was assessed in adult rats using in vitro autoradiography following a lesion of the basolateral amygdala at postnatal day 7 (Pd 7) or postnatal day 21 (Pd 21). The Pd 7 and Pd 21 lesions differentially affected neurotensin receptor densities in the hippocampal complex and (less pronounced) in the dopaminergic cell regions, implying a neurodevelopmental cause. These results may be of relevance for the involvement of neurotensin in the pathogenesis of schizophrenia.

Physical stress (PS) and emotional stress (ES) have opposite long-term effects on open field behaviour. PS consisted of a repeated mild foot shock treatment, which the ES animals witnessed. PS caused a long-term decrease in locomotor activity and exploration behaviours and increased immobility. ES induced an increase in locomotor activity. These changes in open field behaviour could be the result of several factors such as increased anxiety, a shift in coping strategy or simply a change in locomotor activity. To investigate the effect of the PS and ES treatment on these separate factors, the following behavioural tests were performed: defensive withdrawal, shock prod bury, large open field and social interaction. PS animals initially showed immobility in the shock prod bury test and the large open field, while the differences measured over the entire test period were small or not present. PS did not induce differences in the defensive withdrawal and the social interaction tests. ES and control animals did not differ significantly in any of the tests. The effects of PS in the shock prod bury test in particular can be interpreted as an indication of a passive coping style. However, PS animals showed the same behaviour as controls, but started displaying the behaviour after the initial immobility response. It is concluded that neither PS nor ES affects the coping style and anxiety level of the rats. PS induces a delay in behavioural responding and ES induces locomotor activation per se. It seems that the shock prod bury test is most suitable to distinguish between exploration and coping style.

Cueing a stressor can influence the perception of and the direct reaction to a stressor. Until now, only the direct reaction of an animal to the cue or to the subsequent stressor has been examined. This experiment assesses the long-term behavioural effects of cueing two different stressors. Rats were exposed to physical stress (PS) or emotional stress (ES) in a two-compartment box for 5 consecutive days. PS rats daily received mild foot shocks during 10 min. ES rats were forced to witness the PS rats being foot shocked. A control group was placed in the same box without receiving shocks. Every foot shock was either cued or not cued with a 3-s light signal. In an additional experiment the effect of longer and stronger foot shocks was also investigated. Effects of stress treatments were measured 5 days after the last stress session in a small open field. Data showed that PS and ES had opposite long-term effects on open field activity (activity PS decreased and ES increased). Cueing stress resulted in a more pronounced effect in the PS, but not in the ES group. Presenting the light signal during emotional stress and control treatment resulted in an overall behavioural activation in the open field. All animals were exposed to the light stimulus in an open field after habituation. Both PS groups showed less active exploration during the test, while all cue-naïve animals showed more ambulations. No emotional stress effect was present. The direct reaction of the animals to the cue also differed with treatment: cued PS animals became inactive, while animals of all other groups primarily reacted with active exploration. Increasing the intensity of the foot shocks resulted in an increased physical stress effect, similar to cued physical stress; no effect was found on emotional stress effects. The results indicated that stress associated cues can increase the long-term behavioural effects of physical but not of emotional stress. Exposure to the cue induces a conditioned response in the cued PS group. Witnessing cued or more severe stressors did not influence the emotional stress effect. The findings again demonstrate that emotional and physical stressors are fundamentally different.

The involvement of the frontal cortex and thalamic nucleus in odor discrimination in humans was assessed. Six patients with frontal lobe brain damage, seven patients with alcoholic Korsakoff’s syndrome and 16 healthy comparison subjects completed odor detection and odor discrimination tasks. Multivariate general linear modeling with age as a covariant revealed significantly decreased odor discrimination ability in frontal lobe damaged patients and marginally decreased odor discrimination ability in Korsakoff’s syndrome patients as compared to the healthy comparison subjects. No deficits were found in odor detection ability. The findings suggest that in human odor discrimination, there is more involvement of cortico-cortical pathways than of thalamo-cortical pathways.

Injection drug use (involving the injection of illicit opiates) poses serious public health problems in many countries. Research has indicated that injection drug users are at higher risk for morbidity in the form of HIV/AIDS and Hepatitis B and C, and drug-related mortality, as well as increased criminal activity. Methadone maintenance treatment is the most prominent form of pharmacotherapy treatment for illicit opiate dependence in several countries, and its application varies internationally with respect to treatment regulations and delivery modes. In order to effectively treat those patients who have previously been resistant to methadone maintenance treatment, several countries have been studying and/or considering heroin-assisted treatment as a complementary form of opiate pharmacotherapy treatment. This paper provides an overview of the prevalence of injection drug use and the opiate dependence problem internationally, the current opiate dependence treatment landscape in several countries, and the status of ongoing or planned heroin-assisted treatment trials in Australia, Canada and certain European countries.

Recently, an animal model for neurodevelopmental disorders has been developed. In this model, the effects of an early neonatal (postnatal day 7 [Pd 7]) basolateral amygdala lesion are compared with the effects of a lesion later in life (Pd 21). The reported data indicate that amygdala damage at a specific point early in life results in enduring behavioral disturbances that become more manifest after puberty, for example, only an early lesion resulted in a disruption of the prepulse inhibition, which is also observed in people suffering from schizophrenia. Accordingly, it was postulated that the early damage may affect the neuroanatomic and neurochemical organization and functioning of other brain structures. This was studied by use of the anterograde tracers biotinylated dextran amine and Phaseolus vulgaris-leucoagglutinin. At neonatal days 7, 9, 11, 13, and 26, amygdaloid fibers were in particular present in the mediodorsal thalamus (MDT), nucleus accumbens (Acb), and prefrontal cortex (PFC). The development of the topography of the amygdaloid innervation, however, differed markedly for the MDT and Acb compared with the PFC. For the MDT and Acb, no major changes in innervation were observed between Pd 7 and Pd 26, whereas the innervation of the PFC reorganized from a neonatal diffuse (Pd 7 and 9) to a restricted pattern (Pd 11, 13, and 26). In addition, the innervation changed to an adult-like bilaminar pattern. These data provide information on the circuitry that may be involved in the aberrant neurodevelopment of neonatally amygdala-lesioned rats, which have been proposed as an animal model for neurodevelopmental psychopathological disorders.

In this controlled clinical study, the bioavailability and pharmacodynamics of inhaled heroin are evaluated and compared between ‘chasing the dragon’ and inhalation from a heating device, and at three dose levels, 25, 50 and 100 mg heroin, in two separate study phases. In study phase 1, no differences between the inhalation methods were detected on any of the physiological or behavioral measures, nor in bioavailability. Subjectively, the participants had a strong preference for the method of chasing, which was therefore used in study phase 2. In phase 2, heroin produced a dose-related increase in subjective drug-liking, body temperature and heart rate, and a clear, dose-related decline in reaction time. Linearly dose-related differences were found in the amount of total morphine in urine, amounting to an average of 45% of the parent heroin base received. Based on these findings, it is concluded that chasing is quite an effective route of heroin administration, producing rapid, dose-related subjective and objective effects and a sufficiently high and reproducible bioavailability.

Neurodevelopmental disorders in medial temporal lobe structures may underlie psychopathological diseases such as schizophrenia and autism. To construct an animal model for these developmental disorders, social and non-social behavioural responses were assessed in rats with ibotenic acid lesions of the (baso-)lateral and central amygdala or ventral hippocampus, induced early in life. Lesioning the amygdala on day 7 after birth resulted in a variety of behavioural disturbances later in life, whereas after similar lesions on day 21 after birth no disturbances developed, except for deficits in social behaviours. Lesioning the hippocampus led to much less disturbances. The results show that amygdala and hippocampus damage at a specific point early in life results in enduring behavioural disturbances that become more manifest after puberty. In particular, lesions of the amygdala on day 7 of life may serve as a rat model with face and construct validity for neurodevelopmental disorders in studying psychopathology.

Disruption of circadian rhythm can impair long-term passive avoidance memory of rats and mice. The present study investigated whether disruption of circadian rhythm can also impair social memory of male rats. Social memory was assessed using the social discrimination test, in which a short-term olfactory memory is formed by social interaction with a juvenile rat during a learning trial. After an intertrial interval, a retrieval trial is performed, in which social memory is expressed as a decreased attention paid to the same juvenile as compared to a new juvenile. First, the social memory at four different time points across the light–dark cycle was measured with an intertrial interval of 10 or 25 min. There was no significant circadian variation of social memory across the light–dark cycle. Subsequently, the effect of a −6 or 12-h phase shift on social memory was studied. These phase shifts were previously found to impair long-term passive avoidance memory. However, no effect of either phase shift was observed in the social discrimination test. It is concluded that the disruption of circadian rhythm had no effect on the social memory of rats. Differences between short-term social memory and long-term passive avoidance memory are discussed in relation to their apparent differential susceptibility to the effects of circadian rhythm disruption.

Rationale: Endogenous vasopressin is involved in the social memory of the male rat and administration of exogenous vasopressin improves social memory. These findings are mainly based on studies using sexually experienced males that were tested in the social recognition test. Objective: The present study was aimed to establish whether the modulation of social memory by vasopressin fragments depends on the sexual experience of the male rat. For this purpose, the social discrimination test was used, since this test is more suitable than the social recognition test for measuring social memory in sexually naive males. Methods: Male rats were tested in the social discrimination test and treated subcutaneously with the vasopressin metabolite [pGlu4,Cyt6]vasopressin-(4-8) (VP4-8). VP4-8 shares with vasopressin the effects on memory processes but lacks the peripheral effects of vasopressin. Results: VP4-8 (1 µg/kg) acutely improved the social memory of sexually experienced male rats, confirming previous reports. However, in sexually naive males VP4-8 failed to improve social memory in doses ranging from 0.1 µg/kg to 1 µg/kg. Instead, 1 µg/kg VP4-8 or 6 µg/kg desglycinamide-vasopressin were found to exert a delayed effect in sexually naive rats. This delayed effect resulted in an improved social memory 2 days after administration. Conclusions: Vasopressin sensitisation is discussed as a possible underlying mechanism of the observed delayed effect of vasopressin fragments. It is concluded that in male rats sexual experience can influence the modulation of social memory by vasopressin.

Na de start in 1998 van een eerste fase in Amsterdam en Rotterdam is in de loop van 2000 in zes gemeenten in Nederland, te weten de genoemde en Den Haag, Groningen, Heerlen en Utrecht, het onderzoek naar de effectiviteit van heroine op medisch voorschrift van start gegaan. In dit artikel wordt ingegaan op de achtergrond en onderzoeksopzet van dit multicenter onderzoek en worden enkele eerste ervaringen beschreven.

Het gebruik van stoffen, al of niet uit planten, en het doen van bepaalde handelingen om de geest te verruimen of althans te beinvloeden vormen in veel culturen een eeuwenoude traditie. Mensen gebruiken geestbeinvloedende stoffen om zich goed te voelen ’ dus als genotsmiddel ’ of om zich beter te voelen ’ dus als een vorm van zelfmedicatie. Herhaald en intensief gebruik van (sommige van) dergelijke stoffen kan een verandering in de hersenen teweegbrengen, hetgeen in combinatie met persoonlijkheidskenmerken en omgevingsfactoren, weer kan leiden tot verslaving.

The acute effects of juvenile isolation on sucrose intake and its long-term consequences on adult social behavior were investigated. Additionally, the role of the endogenous opioid systems was studied. Juvenile rats were housed in one of three conditions: in groups or in isolation with (partial isolation, PI) or without 30 min of daily social contact from 22 to 35 days-of-age. During this period the rats were treated daily with saline or morphine. Juvenile isolated rats showed an increased sucrose intake as compared to non-isolated controls, with PI-rats somewhere in-between, suggesting a negative correlation between the amount of social contact and sucrose consumption. Morphine treatment during the isolation period enhanced the sucrose intake in non-isolated rats, whereas it decreased sucrose consumption in (partial) isolated rats. With regard to the long-term effects, (partial) isolated rats decreased social activity as compared to non-isolated controls which was reversed by morphine treatment during the isolation period. In non-isolated rats, morphine treatment caused an opposite effect: it decreased social activity as compared to the saline treated controls. The data suggest that stimulation of endogenous opioid systems in the juvenile phase may have an important modulatory role in the expression of adult social behavior. The results are discussed in relation to a possible function of morphine as a substitute for the release of endogenous opioid peptides during social play.

The discovery of endogenous opioids has markedly influenced the research on the biology of addiction and reward brain processes. Evidence has been presented that these brain substances modulate brain stimulation reward, self-administration of different drugs of abuse, sexual behaviour and social behaviour. There appears to be two different domains in which endogenous opioids, present in separate and distinct brain regions, are involved. One is related to the modulation of incentive motivational processes and the other to the performance of certain behaviours. It is concluded that endogenous opioids may play a role in the vulnerability to certain diseases, such as addiction and autism, but also when the disease is present, such as alcoholism.