Medical Consequences

Anabolic-Androgenic Steroids May Damage the Heart and Arteries

Use of anabolic-androgenic steroids (AAS) is associated with compromised heart pumping and atherosclerotic plaque. Clinicians should inquire about AAS use when young or middle-aged men present with left ventricular dysfunction or coronary artery disease.

Substance Use Disorders Are Associated With Major Medical Illnesses and Mortality Risk in a Large Integrated Health Care System

Strong associations exist between substance use disorder diagnoses and 19 major medical illnesses among patients in a large, integrated health care system. The study indicates that these associations may persist even in health care systems that provide specialized treatment for substance use disorders and have capacity to integrate behavioral and medical care.

Gene Variants Reduce Opioid Risks

Two recent studies represent early steps toward the goal of personalized therapy for pain and addiction based on patients’ genetic makeup. One study associated a rare variant of the gene for the μ-opioid receptor (OPRM1) with a decreased risk for addiction to heroin or cocaine. The other linked variants in two genes— OPRM1, and for the enzyme catechol- O-methyltransferase (COMT)—with reduced severity of neonatal abstinence syndrome (NAS) in newborns who were prenatally exposed to methadone or buprenorphine. The μ-opioid receptors are relay stations for cell-to-cell signaling in the body’s

HIV Infection Accelerates Hepatitis C–Related Liver Fibrosis

Hepatitis C virus (HCV) infection causes liver fibrosis that worsens as patients age, potentially progressing to cirrhosis and culminating in liver failure. A NIDA-funded study shows that concurrent infection with human immunodeficiency virus (HIV) is likely to hasten the onset of these clinical turning points. Dr. Gregory Kirk and colleagues at the Johns Hopkins University (JHU), Baltimore, assessed liver fibrosis serially in more than 1,100 current and former injection drug users who were infected with HCV. After allowing for other factors that speed fibrosis, the JHU team estimated that

Medications That Treat Opioid Addiction Do Not Impair Liver Health

A trial that compared buprenorphine/naloxone (Bup/Nx) to methadone produced no evidence that either medication damages the liver. Researchers concluded that Bup/Nx and methadone are equally safe for the liver, and Bup/Nx may be considered a first line alternative to the more established medication for treating opioid addiction. Dr. Andrew Saxon at the Veterans Affairs Puget Sound Health Care System in Seattle, and Dr. Walter Ling at the University of California, Los Angeles Integrated Substance Abuse Program, conducted the trial with colleagues in the NIDA Clinical Trials Network. Dr. Saxon’s

Prenatal Methamphetamine Exposure Linked With Problems

In the latest findings from an ongoing study of the effects of prenatal methamphetamine exposure on child development, primary caregivers reported more signs of increased emotionality, anxiety, and depression in exposed nonexposed children at ages 3 and 5 years. The caregivers also reported that at age 5, methamphetamine-exposed children were less able to sustain attention and more prone to act out aggressively or destructively than were nonexposed children. The NIDA-supported Infant Development, Environment, and Lifestyle (IDEAL) study has followed more than 200 children exposed to

Potential Pain Medication Targets Peripheral Nerves

Oxycodone, hydrocodone, morphine, and other opioids are the most effective analgesic medications currently available, but they can be addictive and lethal when misused. The United States is currently experiencing an epidemic of such misuse; treatment admissions for abuse of prescription opioids quadrupled from 1998 to 2008, and opioid overdose was second only to road accidents as a cause of unintentional deaths in 2009. As part of NIDA’s comprehensive efforts to curb this epidemic, investigators are searching for safer analgesic alternatives. A NIDA-supported group at the University of

Prenatal Cocaine Exposure Increases Monkeys' Impulsivity Into Adulthood

Dr. Michael Nader and colleagues at Wake Forest University School of Medicine are conducting an ongoing study of the effects of prenatal cocaine exposure throughout the lifetimes of a cohort of rhesus monkeys of both sexes. Recently, the team reported that at 14 years of age, 10 prenatally drug-exposed animals were much slower than 10 controls at stopping a formerly rewarding behavior that no longer paid off: pressing a lever that previously had delivered banana-flavored pellets but no longer did so. This result indicates that, in monkeys, cocaine exposure during gestation can impair the

Research Focuses on Groups With High Smoking Rates

In the 60 years since public health researchers first established that cigarettes cause lung cancer, the percentage of Americans who smoke has dropped from 40 to 20. Yet despite all we now know about tobacco’s disabling and deadly effects, 46 million Americans still smoke. The figure attests to the tenacity of the addiction and the critical need for more effective prevention and treatment interventions. A large portion of today's smokers belong to subpopulations that have not benefited as much as the general population from health information and clinical advances. People with psychiatric

Marker for Neuronal Damage Resolves a Year after Methamphetamine

Dr. Ruth Salo and colleagues at the University of California, Davis, extended previous findings that biochemical markers for nerve damage and viability persist in the brain through 6 months of abstinence from methamphetamine, but normalize after longer abstinence. In the new study, the researchers once again used proton magnetic resonance spectroscopy, imaging the brains of 30 former abusers of the stimulant who had been abstinent 1 to 6 months, 17 who had been abstinent 1 to 5 years, and 30 individuals who had never used the drug. As in the team’s two prior studies (see "Brain Recovery in

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