February 2007 Reviews a report from the National Academy of Sciences’ Institute of Medicine that discusses ways to improve the quality of health care among people with mental health and substance abuse disorders.
Individuals with weak signaling in a nicotine-sensitive brain circuit were more vulnerable to nicotine dependence than those with stronger signaling, according to a study conducted while the subjects’ brains were in a resting state. A second resting-state study finds that the same circuit appears to mediate dependence associated with a genetic risk factor for smoking.
Despite the advances in treatment and prevention, roughly 50,000 new HIV infections still occur annually in the Nation. Research, in large part supported by NIDA, has produced a strategy to address this circumstance and break the epidemiological impasse: seek out HIV-infected individuals, particularly those in “hard-to-reach” groups that have minimal contact with the health care system; offer them HIV testing and treatment; and provide support to help them stay in treatment.
NIDA-supported research suggests that glucocorticoid receptor levels during early brain development affect the hard wiring of neural circuits that shape an individual’s basic emotional makeup. In mice, overexpression of the glucocorticoid gene in the first weeks after birth increased anxiety and response to cocaine in adulthood. These findings may help researchers understand the genetic background and the developmental trajectory of addiction.
Patients were more likely to take a rapid HIV test when substance abuse treatment programs offered the test onsite rather than referred for offsite testing. Patients were equally likely to accept and learn their HIV status whether the offer of onsite testing was accompanied by 30 minutes of risk reduction counseling or by 5 minutes of brief information on the testing procedure. Onsite testing accompanied by brief information was cost effective, taking into account the projected lifetime costs of treatment and the gains in health and longevity for detected cases.
People with cannabis use disorder (CUD) are likely also to have social anxiety disorder (SAD), and comorbid SAD is associated with greater severity of cannabis-related problems. These findings highlight the importance of assessing CUD patients for SAD, as that disorder can be both a contributing cause and a consequence of CUD. Treating both disorders may be a key to helping patients recover from each.