Research on cognitive functions in opioids addicted subjects treated with methadone indicate that cognitive functions are in various degree disturbed.

This study aims to assess the impact of a therapeutic dose of methadone on psychomotor velocity in HIV (+) and HIV (-) subjects treated with substitution therapy.

73 patients were examined, 32 HIV (-) and 41 HIV (+) (mean age 39.5 ± 7.7) treated with methadone for an average of 54 months. The examination was conducted twice: before and about 1.5 hours after the administration of a therapeutic dose of methadone (mean dose: 83 ± (34) mg). A test sheet was placed on the graphic tablet. In both parts of the test execution time was measured.

It was found that the average time of TMT A completion before methadone administration in HIV (-) individuals is 40.2 ± (12)s and in HIV (+) ones - 50.6 ± (25.7)s, after methadone administration in HIV (-) individuals: 36.4 ± (10.2)s, in HIV (+) - 42.4 ± (18,8,51)s. The value of T test in HIV (-) and HIV (+) subjects before the administration of a therapeutic dose of methadone amounts to t = 2.1083, p = 0.0385, and after the application it amounts to t = 1.6157, p = 0.1106.

Psychomotor velocity measured by TMT A Test before the administration of a therapeutic dose of methadone increases significantly in HIV(-) subjects in comparison to HIV (+) ones. Psychomotor velocity after the administration of a therapeutic dose of methadone is not statistically significant in HIV (-) subjects as compared to HIV (+) ones.

Adolescent smoking remains as an important health problem in different countries. Understanding the factors involved in this behaviour may help to design and implement preventive programs.

To study the association between personal, familial, school and peer factors and smoking behaviour among Chilean adolescents.

To study the association between factors from four domains (personal, family, school and peers) and current smoking amongst adolescents performing secondary analyses of the Fifth Chilean School Population National Substance Use Survey (CHSS-2003) dataset.

The CHSS-2003 is a stratified cross-sectional survey which gathers information about personal, familial, school and peer factors and cigarette use using a self-reported questionnaire. Complete data from 21,956 students for all variables of interest were used in the analyses. Theory-driven hierarchical stepwise multivariable logistic regression analyses were performed to study the association between personal, familial, school and peer factors and smoking.

Results show that higher school commitment (OR = 0.46; 95%CI: 0.38–0.56), going home after school than not (OR = 0.69; 95%CI: 0.62–0.78), higher parental monitoring (OR = 0.62; 95%CI: 0.45–0.85), lower school aggressiveness (OR = 0.49; 95%CI: 0.33–0.73) and having a stronger negative opinion about drug use (OR = 0.40; 95%CI: 0.34–0.46) reduced the risk for smoking. However, the longer the time spent with friends the higher the risk for smoking (OR = 2.47; 95%CI: 2.08–2.94).

Results confirmed the importance of some personal, familial, school and peer factors in Chile. Prevention programs in Chile should include interventions aimed to strengthen factors such as school commitment and parental monitoring in order to prevent smoking amongst adolescents.

Opiate dependence is a significant risk factor for HIV infection.

An assessment of differences between opiate addicts with and without HIV infection.

171 opiate dependent patients treated with methadone were asked about: length of dependence, age of onset of opiate dependence, dosage of methadone, effects of methadone on interviewed subjects and HIV infection.

In our sample 72 (42%) subjects had HIV infection (HIV+) and 99 (58%) subjects had not HIV infection (HIV-). Comparison of 99 HIV (-) patients with 72 HIV (+) patients revealed that in HIV (+) group there were statistically significantly more women (40 vs. 25%), patients were older (39 vs. 36 years old), had longer length of dependence (22 vs. 16 years), had longer time of maintained methadone treatment (63 vs. 26 months). It was also found that HIV (+) patients had earlier age of onset of opiate dependence than the patients in HIV (-) group (18 vs. 19 years old, p = 0,058).

Our research may suggest that HIV infection had correlation with the course of methadone substitution treatment of opiate dependence.

Sleep disturbances have been described in drugdependent patients and mainly, in alcoholics. Few studies describe the hypnotic treatment used in this setting.

Describe the prevalence of insomnia in drugdependent inpatients. Describe the hypnotic treatment, according to the substance abuse and the psychiatric comorbidity.

Descriptive study performed in drugdependent inpatients between June, 2008 and August, 2011. The Structured Clinical Interview for DSM Disorders was obtained in order to ensure the clinical diagnosis. Hypnotic treatment was dispensed to those patients who complain of insomnia according to the Psychiatric prescription. Demographic data, type of abuse drug and the hypnotic dispensed was obtained.

298 patients fulfilled inclusion criteria (71.8% men, 39.22 ± 10.13 years). The principal substances of consumption were stimulants(36.2%), followed by alcohol(34.9%), heroine(14.4%), cannabis(9.4%) and benzodiazepines(5%). 60.4% of the patients complained of insomnia during the hospital admission. The most used drugs for insomnia were mirtazapine(19.8%), trazodone(14.8%), quetiapine(14.1%), clotiapine(7.4%) and olanzapine(4.4%). Alcohol, cocaine and benzodiazepines addicted patients were treated with antidepressants as mirtazapine(17.3%, 18.5% and 40% respectively); heroin addicts were treated with antipsychotic drugs as quetiapine(27.9%). Cannabis addicts took antidepressant and antipsychotic (mirtazapine (21.4%) and olanzapine(21.4%))

61.7% of the patients fulfilled diagnostic criteria of dual diagnosis. Patients with psychotic disorder used quetiapine(17.4%); those with depressive and bipolar disorder were treated with trazodone(30.2% and 33.3% respectively), those who complain of anxious disorder and personality disorder took mirtazapine(50% and 17.4% respectively).

Sleep disturbances are frequent in drugdependent inpatients. Mirtazapine was the most frequently used drug to treat insomnia.

Maybe the most important invention of our age internet has become a part of our lives however excessive use of it has led to a new type of addiction. Internet addiction (IA) has psychological, sociological and physical negative effects especially on the adolescents.

This study aims to investigate IA among high school students and to examine the correlation between excessive internet use, depression, attention-deficit hyperactivity disorder (ADHD).

304 students were included in the study. Internet Addiction Scale (IAS), Beck Depression Inventory (BDI) and Adult ADD/ADHD Diagnosis and Evaluation Inventory was used to evaluate the subjects.

11% of the subjects in our study had IA. Prevalence of IA was significantly higher among male subjects. Males were using the internet to “surf” and game play while females were “chatting”. Total BDI scores of IA group were significantly higher than the rest of the subjects. Attention deficit, impulsivity, activity, and ADD/ADHD related features subscale scores of IA group were also significantly higher than the rest of the subjects. IAS scores of the subjects of those who use the internet for homework significantly lower than IAS scores of the subjects who do not. IAS scores of the subjects who used the internet for < 10 hours/week were significantly lower than the subjects who spent more time online.

IA is fairly common among high school students according to study. Depression and ADHD is associated with IA according to our study. These mutually aggravating disorders should be evaluated and treated carefully.

To assess the gender differences in frequency of some epidemiological characteristics amongst heroin dependant psychiatric patients in area of north-eastern post war Bosnia and Herzegovina.

We analyzed sixty heroin addicts (47 males) aged 26.6 ± 5.6 years who were treated in the Department of Psychiatry Tuzla, during the period 1st July 2007- 30th Jun 2008, and were interviewed using Pompidou questionnaire.

The average age of the first intake of heroin was 20.5 ± 4.5 year and average duration of heroin addiction was 5.2 ± 4.4 years. Parents did not know about addiction of their children for 2.8 ± 1.2 years. 23/60 used intravenous application of heroin and 36/60 snuffled it. Males significantly more often used marijuana and benzodiazepines than females. 34/60 owned driver's licenses, males significantly more frequently (31/47) than females (3/13). Material status of parents was below average for 16/60, and average for 42/60. Two thirds had judicial proceedings, and 32/60 was punished, males significantly more often. Hepatitis “C” virus infections were reported from 20/60 heroin addicts.

Majority of heroin addicts who were treated in Psychiatry Clinic in Tuzla were males, from towns, unemployed, not married, with finished secondary schools, owners of driver licenses, had average parents’ material status. Majority of them had judicial proceedings with imprisonment. Hepatitis ”C” infection was highly presented. Male patients lived more often in primary families; they used more often marijuana and benzodiazepines as secondary drug; they were more often licensed drivers and they were punished more often because of criminality than female patients.

The most modern medically assisted method of substitution treatment of opiate dependants with Buprenorphine/Naloxone (Suboxone) has been implemented in Department of Psychiatry in Tuzla from 27 July 2009. The treatment may improve quality of life (QoL) of treated opiate addicts and of their family members.

To assess QoL of treated opiate dependant individuals and their family members who signed contract to be partners in outpatient administering of substitution medicament Suboxone in Bosnia and Herzegovina.

The study was carried out in northeast part of Bosnia and Herzegovina, in August 2009-October 2011. We assessed 40 (six females) opiate addicts aged 27.5 ± 5.3 years who were in medically assisted treatment with Suboxone. The first testing realized during psychological assessment in the beginning of treatment and retest realized two years after treatment initiated; also we tested and 40 family members of treated addicts for QoL. We used Manchester Short Assessment of Quality of Life (MANSA).

During the first and second measuring of QoL there were no significant differences between opiate dependant individuals and their family members (p > 0.05). After second measuring, QoL of treated individuals increased from (mean±standard deviation=39.4 ± 9.3) to (65.1 ± 9.3)(t = −8.277, P < 0.001, Paired Samples test); and QoL of their family members increased from (44.7 ± 13.9) to (64.2 ± 9.2, t= − 5.956, P < 0.001, Paired Samples test).

Medically assisted treatment of opiate dependence with Suboxone implemented as outpatient treatment with involvement of close family members who are not drug dependant, improved quality of life of treated opiate dependants and their family members.

The most modern method of substitution treatment of opiate dependants with Buprenorphine/Naloxone (Suboxone) has been implemented in Department of Psychiatry in Tuzla from 27 July 2009. The treatment helps in discovering of hepatitis C infected intravenous users (IVUs), who are included in treatment of chronic hepatitis C (HCV) with Pegylated interferon-alpha-2a or Pegylated interferon-alpha-2b and the antiviral drug Ribavarin for a period of 24 or 48 weeks, depending on hepatitis C virus genotype.

To assess epidemiological characteristics of treated opiate dependant IVUs infected with HCV in outpatient administering of substitution medicament Suboxone in Bosnia-Herzegovina.

The study was carried out in northeast part of Bosnia and Herzegovina, in August 2009-October 2011. We assessed 112 (eleven females) opiate addicts aged 27.2 ± 4.9 years who were in medically assisted treatment with Suboxone. In the sample we found 29 (25.9) of 112, (four females) who were HCV infected.

There were 61 (54.5%) of 112 who were IVUs. HCV infected and non-infected opiate addicts did not differ regarding age, age of the first drug intake, age of the first IV use, level of retention in Suboxone treatment and daily dose of Suboxone (P > 0.05). HCV positive drug users significantly more often did intake heroin intravenously inside one month before Suboxone treatment (p < 0.001).

Medically assisted outpatient treatment of opiate dependence with Suboxone helps in discovering of HCV infected individuals and helps in recovery of both: opiate dependency and HCV infected with simultaneous treatment of chronic (HCV) with Pegylated interferon 2a/b with Ribavarin.

The substitution treatment of opiate dependants with Buprenorphine/Naloxone (Suboxone) may be implemented in prisons’ environment for heroin addicts who must aging penalties during the treatment started.

To describe the treatment of opiate dependant individuals who have to spent certain period in prison, who were previously introduced in outpatient administering of substitution medicament Suboxone in Bosnia-Herzegovina.

With presentation of clinical vignettes, authors described how opiate dependants with criminal past imprisoned in jail because of aging penalties avoided discontinuation of treatment after they were included in the Suboxone maintenance treatment program. This practice has been implemented in cooperation of Department of Psychiatry in Tuzla and Tuzla prison from 27 July 2009. We assessed 10 male opiate addicts (five married) aged 24.8 ± 4.7 years.

All exemplars described with clinical vignettes showed that opiate dependants previously had open doubts in efficacy of this particular treatment during imprisonment, and after implementation of continual treatment in prison in cooperation with jail officers (nurse and guards) they surprised with positive effects on overall outcomes of Suboxone. Also they were very satisfied with life quality during treatment in prison. Also jail officers, family members of dependant person showed satisfaction with achieved efficacy of Suboxone eider during aging penalties.

Medically assisted treatment of opiate dependence with Suboxone for imprisoned addicts implemented as outpatient treatment with involvement of jail officers who were instructed in Suboxone daily administration, improved quality of life of treated opiate dependants, and quality of their relations in prison with others.

One factor of opioid attractiveness with recreational abuse is the rate of drug absorption and corollary pharmacodynamic experience. In this study, the relationship between abuse potential and the pharmacokinetic profile (maximum plasma concentration [Cmax] and time to maximum plasma concentration [Tmax]) of differing formulations of hydromorphone and placebo was explored in recreational drug users.

This post-hoc analysis of a double-blind, placebo-controlled, randomized, 2-phase, crossover study of subjects with histories of recreational opioid use who received single oral doses of placebo and of 2 formulations of hydromorphone: immediate-release (IR) hydromorphone 8 mg (Dilaudid®) and once-daily hydromorphone extended-release (ER) (EXALGOtm) at doses of 16, 32, and 64 mg intact and 8 mg milled to disrupt the extended-release properties of EXALGO tablets.

When adjusted for dose, Cmax for all intact once-daily hydromorphone ER treatments, yielded significantly lower Cmax compared with 8-mg IR hydromorphone (P < 0.001). Tmax was delayed and AQ (Cmax/Tmax) was lower with all intact once-daily hydromorphone ER doses compared with 8 mg IR hydromorphone. In the 28 subjects completing all treatments and included in the final analyses, the intact once-daily hydromorphone ER formulations had significantly lower liking and euphoria effects for the first 4 hours (P < 0.05) compared with the 8 mg IR and 8 mg milled hydromorphone ER tablets.

If liking and euphoria effects drives opioid use, then once-daily hydromorphone ER intact may be less attractive than IR hydromorphone or hydromorphone ER milled. Delaying the peak in plasma concentrations may be associated with reduced abuse liability.

The prolonged use of MDMA or ‘ecstasy’ has been associated with a range of memory deficits, including impairments in prospective memory (PM: remembering future activities or events). What is not clear is the extent to which ecstasy users' PM problems might be underpinned by more general central executive problems within memory (CE: a set of processes underpinning the organisation and flow of information within memory).

The present study extended this research by examining whether persistent use of ecstasy damages prospective memory independent of CE.

An existing-groups design was utilised, comparing ecstasy users with a non-user group as the independent factor. Scores on the Cambridge Prospective Memory Test (CAMPROMPT: an objective measure of time- and event- based PM) constituted the PM dependent measure and scores on the Reverse Digit Span task (RDS: an objective CE task) constituted the CE dependent measure. Age, mood, and other drug use (alcohol, smoking, cannabis) were also measured.

After observing no between-group differences on age, mood, and other drug use, ecstasy users performed significantly worse on the CAMPROMPT and RDS than did the non-users. After controlling for RDS scores, the difference between users and non-users on CAMPROMPT disappeared.

The finding that ecstasy users showed reduced performance on the CAMPROMPT after controlling for CE performance suggests strongly that objective PM performance is underpinned by CE functions, suggesting CE deficits may be at the heart of ecstasy-related PM deficits.

Persistent smoking has been associated with prospective memory deficits in the past (PM: remembering future activities or events), yet no research to date has explored whether regular exposure to second-hand smoke (SHS) also damages everyday PM.

The present assessed whether SHS leads to reduced PM functioning by comparing a group of non-smokers who had been exposed to SHS on a weekly basis for several years (the SHS group), a group of non-smokers who had not been exposed to SHS (the non-SHS group) and a group of current smokers.

If SHS does damage PM then this group should show reduced performance akin to those expected in current smokers.

An existing- groups design was used to compare the SHS group, the non-SHS group, and a group of current smokers. Scores on the Cambridge Prospective Memory Test (CAMPROMPT: an objective measure of time- and event- based PM) constituted the main PM dependent measure. Age, mood, IQ, and other drug use (alcohol, smoking, and cannabis) were also measured. Anyone who reported using an illegal drug (ecstasy, cannabis) was omitted from the study.

After observing no between-group differences on age, mood, IQ and alcohol use, the SHS group and current smokers showed significant reductions in the performance on CAMPROMPT when compared to non-smokers who had never been exposed to SHS.

Everyday PM deficits are linked to SHS, adding weight to the dangers of exposure to other peoples smoke.

About 25 000 serious methamphetamine abusers live in the Czech Republic among the total population of 10 million. Dependence on methamphetamine is markedly related to the brain neurotransmitter dopamine, metabolised by catechol-O-methyltransferase enzyme.

The objective of our study was to deepen our knowledge on the genetic background of methamphetamine dependence.

The main aim of the study was to ascertain whether the Val158Met catechol-O-methyltransferase gene polymorphism is associated with methamphetamine dependence in the Czech Republic.

One hundred and twenty-three subjects dependent on methamphetamine (women N = 44), parents of sixty-seven dependent individuals, and four hundred healthy controls (women N = 250) were involved into the study. We performed a population-based as well as family-based genetic association studies.

We did not find any significant association between the Val158Met catechol-O-methyltransferase gene polymorphism and methamphetamine dependence using the population-based or family-based design (P = 0.41-0.66; Chi-Square Test or UNPHASED program, Version 3.1.4, respectively). We found a trend toward a statistically significant difference between the Val allele carriers and Met/Met homozygotes in the frequence of psychotic symptoms induced by methamphetamine (more frequent in Val carriers; P = 0.062; Chi-Square Test).

Further research involving haplotype analysis and other dopamine-related genetic polymorphisms in large populations is needed. More attention should also be paid to possible role of the Val158Met catechol-O-methyltransferase gene polymorphism in individual clinical subtypes of dependence on methamphetamine involving e.g. psychotic features or violence.

Alcohol abuse leads to long-term consequences which affect all aspects of life. Alcohol intoxication weakens personal safety as it is linked with violence and other injuries, with alcohol addiction as a significant risk of regular drinking and with toxic effects potentially affecting all organs and systems. The burden of alcohol-related diseases occurs among young people and teenagers, and lies more in men than in women.

Working Group, established by the Ministry of Health of the Republic of Belarus, identified two major types of the economic costs associated with drunkenness and alcoholism: macroeconomic and microeconomic costs.

The costs of alcoholism and alcohol abuse include a one-time injury, loss of profit and the effects of indirect influence, and they are divided into direct and indirect. There are social incidents and events caused by direct and prolonged alcohol consumption. Some types of costs cannot be calculated on the basis of available statistics indicators.

The structure of different kinds and types of macro-and microeconomic costs of drunkenness and alcoholism take into account one-time injury, loss of profit, the effects of indirect influence on the basis of medium and high risk of alcohol consumption. In 2008 the public expenses associated with drunkenness and alcoholism accounted for 7.23% of the country's GDP (GDP in 2008 totaled 128 trillion Br. rubles (approximately US $ 43 billion, according to the National Bank of Belarus for 2008).

Reduction of the alcohol-related burden should be among the top priorities of the state.

Impulsivity and alcohol drinking are both considered as important predictors of unintentional as well as intentional injuries. However, relationships between impulsivity and risky behaviors have not been investigated in alcohol dependence.

The aim of this study was to analyze relationships between the frequency of risky behaviors and level of behavioral as well as cognitive impulsivity in alcohol-dependent patients.

By means of Barratt's Impulsiveness Scale and stop-signal task the levels of cognitive and behavioral impulsivity among 304 alcohol-dependent patients were measured. Also, patients were asked to answer questions from the Short Inventory of Problems applying to risky behaviors and accidents after alcohol drinking. In addition participants filled in a questionnaire to assess frequency of other behaviors from the analyzed spectrum (suicide attempts, use of other drugs, law problems).

The statistical analysis revealed a significant association between impulsivity and frequency of risky behaviors in alcohol dependent patients. Individuals with higher scores in BIS behaved more frequently in a risky way (p = 0,000001) and had significantly more accidents (p = 0,00067) after alcohol drinking. The association for risky behaviors was strongest for non-planning (p = 0,000075) and attentional (p = 0,000002) impulsivity subscales, whereas frequency of accidents was particularly associated with motor impulsivity (p = 0,001). In addition, a significant association between global impulsivity and risk of suicide attempts, use of other drugs and frequency of law problems was observed. A multivariate analysis revealed that impulsivity and severity of alcohol dependence are the most important predictors of risky behaviors.

Impulsivity increases the frequency of risky behaviors in alcohol-dependent individuals.

There is growing evidence that cognitive deficits play an important role in the development, course and relapse of substance use disorders. In particular, functions that involve control over one's own behaviour (impulsivity), and over behaviour when confronted with motivationally relevant drug cues (craving) are related to relapse in recent studies. So far, pharmacological manipulations of cognitive deficits are rare and relapses after treatment are the rule rather than the exception.

Therefore, we performed a randomized, double-blind, placebo-controlled trial with modafinil, which is a known cognitive enhancer and a wake-promoting agent.

At first, the interaction between impulse control, overall cognitive functioning, motivational strength of drug cues, and vulnerability to relapse, will be elucidated in order to disentangle new treatment possibilities. Second, the effectiveness of a long term treatment with modafinil on impulse control and relapse will be explored.

83 abstinent alcohol dependent inpatients were randomized to a single morning dose of modafinil (300 mg/d), or matching placebo, for 10 weeks. Both neurocognitive tests (on impulsivity, craving and overall cognitive functioning) and self-report questionnaires were administered before, during and after treatment. Patients were followed up 6 months after treatment, to measure relapse rate. Primary outcome variables are test performance, craving ratings and relapse.

Data will be unblinded after finalizing the follow-up data collection. Therefore, results will be available from January 2012.

It is expected that modafinil improves cognitive functioning, increases time to first relapse and reduces relapse rates and relapse severity, compared to placebo.