Heroin Addiction - A Medical Dictionary, Bibliography, and Annotated Research Guide to Internet References

HEROIN

ADDICTION A M EDICAL D ICTIONARY , B IBLIOGRAPHY , AND A NNOTATED R ESEARCH G UIDE TO I NTERNET R E FERENCES

J AMES N. P ARKER , M.D. AND P HILIP M. P ARKER , P H .D., E DITORS

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ICON Health Publications ICON Group International, Inc. 4370 La Jolla Village Drive, 4th Floor San Diego, CA 92122 USA Copyright ©2004 by ICON Group International, Inc. Copyright ©2004 by ICON Group International, Inc. All rights reserved. This book is protected by copyright. No part of it may be reproduced, stored in a retrieval system, or transmitted in any form or by any means, electronic, mechanical, photocopying, recording, or otherwise, without written permission from the publisher. Printed in the United States of America. Last digit indicates print number: 10 9 8 7 6 4 5 3 2 1

Publisher, Health Care: Philip Parker, Ph.D. Editor(s): James Parker, M.D., Philip Parker, Ph.D. Publisher's note: The ideas, procedures, and suggestions contained in this book are not intended for the diagnosis or treatment of a health problem. As new medical or scientific information becomes available from academic and clinical research, recommended treatments and drug therapies may undergo changes. The authors, editors, and publisher have attempted to make the information in this book up to date and accurate in accord with accepted standards at the time of publication. The authors, editors, and publisher are not responsible for errors or omissions or for consequences from application of the book, and make no warranty, expressed or implied, in regard to the contents of this book. Any practice described in this book should be applied by the reader in accordance with professional standards of care used in regard to the unique circumstances that may apply in each situation. The reader is advised to always check product information (package inserts) for changes and new information regarding dosage and contraindications before prescribing any drug or pharmacological product. Caution is especially urged when using new or infrequently ordered drugs, herbal remedies, vitamins and supplements, alternative therapies, complementary therapies and medicines, and integrative medical treatments. Cataloging-in-Publication Data Parker, James N., 1961Parker, Philip M., 1960Heroin Addiction: A Medical Dictionary, Bibliography, and Annotated Research Guide to Internet References / James N. Parker and Philip M. Parker, editors p. cm. Includes bibliographical references, glossary, and index. ISBN: 0-597-83982-4 1. Heroin Addiction-Popular works. I. Title.

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Disclaimer This publication is not intended to be used for the diagnosis or treatment of a health problem. It is sold with the understanding that the publisher, editors, and authors are not engaging in the rendering of medical, psychological, financial, legal, or other professional services. References to any entity, product, service, or source of information that may be contained in this publication should not be considered an endorsement, either direct or implied, by the publisher, editors, or authors. ICON Group International, Inc., the editors, and the authors are not responsible for the content of any Web pages or publications referenced in this publication.

Copyright Notice If a physician wishes to copy limited passages from this book for patient use, this right is automatically granted without written permission from ICON Group International, Inc. (ICON Group). However, all of ICON Group publications have copyrights. With exception to the above, copying our publications in whole or in part, for whatever reason, is a violation of copyright laws and can lead to penalties and fines. Should you want to copy tables, graphs, or other materials, please contact us to request permission (E-mail: [email protected]). ICON Group often grants permission for very limited reproduction of our publications for internal use, press releases, and academic research. Such reproduction requires confirmed permission from ICON Group International Inc. The disclaimer above must accompany all reproductions, in whole or in part, of this book.

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Acknowledgements The collective knowledge generated from academic and applied research summarized in various references has been critical in the creation of this book which is best viewed as a comprehensive compilation and collection of information prepared by various official agencies which produce publications on heroin addiction. Books in this series draw from various agencies and institutions associated with the United States Department of Health and Human Services, and in particular, the Office of the Secretary of Health and Human Services (OS), the Administration for Children and Families (ACF), the Administration on Aging (AOA), the Agency for Healthcare Research and Quality (AHRQ), the Agency for Toxic Substances and Disease Registry (ATSDR), the Centers for Disease Control and Prevention (CDC), the Food and Drug Administration (FDA), the Healthcare Financing Administration (HCFA), the Health Resources and Services Administration (HRSA), the Indian Health Service (IHS), the institutions of the National Institutes of Health (NIH), the Program Support Center (PSC), and the Substance Abuse and Mental Health Services Administration (SAMHSA). In addition to these sources, information gathered from the National Library of Medicine, the United States Patent Office, the European Union, and their related organizations has been invaluable in the creation of this book. Some of the work represented was financially supported by the Research and Development Committee at INSEAD. This support is gratefully acknowledged. Finally, special thanks are owed to Tiffany Freeman for her excellent editorial support.

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About the Editors James N. Parker, M.D. Dr. James N. Parker received his Bachelor of Science degree in Psychobiology from the University of California, Riverside and his M.D. from the University of California, San Diego. In addition to authoring numerous research publications, he has lectured at various academic institutions. Dr. Parker is the medical editor for health books by ICON Health Publications. Philip M. Parker, Ph.D. Philip M. Parker is the Eli Lilly Chair Professor of Innovation, Business and Society at INSEAD (Fontainebleau, France and Singapore). Dr. Parker has also been Professor at the University of California, San Diego and has taught courses at Harvard University, the Hong Kong University of Science and Technology, the Massachusetts Institute of Technology, Stanford University, and UCLA. Dr. Parker is the associate editor for ICON Health Publications.

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About ICON Health Publications To discover more about ICON Health Publications, simply check with your preferred online booksellers, including Barnes&Noble.com and Amazon.com which currently carry all of our titles. Or, feel free to contact us directly for bulk purchases or institutional discounts: ICON Group International, Inc. 4370 La Jolla Village Drive, Fourth Floor San Diego, CA 92122 USA Fax: 858-546-4341 Web site: www.icongrouponline.com/health

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Table of Contents FORWARD .......................................................................................................................................... 1 CHAPTER 1. STUDIES ON HEROIN ADDICTION ................................................................................. 3 Overview........................................................................................................................................ 3 Federally Funded Research on Heroin Addiction .......................................................................... 3 E-Journals: PubMed Central ....................................................................................................... 17 The National Library of Medicine: PubMed ................................................................................ 18 CHAPTER 2. NUTRITION AND HEROIN ADDICTION ....................................................................... 51 Overview...................................................................................................................................... 51 Finding Nutrition Studies on Heroin Addiction ......................................................................... 51 Federal Resources on Nutrition ................................................................................................... 53 Additional Web Resources ........................................................................................................... 54 CHAPTER 3. ALTERNATIVE MEDICINE AND HEROIN ADDICTION................................................. 55 Overview...................................................................................................................................... 55 National Center for Complementary and Alternative Medicine.................................................. 55 Additional Web Resources ........................................................................................................... 59 General References ....................................................................................................................... 60 CHAPTER 4. DISSERTATIONS ON HEROIN ADDICTION................................................................... 61 Overview...................................................................................................................................... 61 Dissertations on Heroin Addiction .............................................................................................. 61 Keeping Current .......................................................................................................................... 62 CHAPTER 5. CLINICAL TRIALS AND HEROIN ADDICTION ............................................................. 63 Overview...................................................................................................................................... 63 Recent Trials on Heroin Addiction .............................................................................................. 63 Keeping Current on Clinical Trials ............................................................................................. 63 CHAPTER 6. BOOKS ON HEROIN ADDICTION ................................................................................. 65 Overview...................................................................................................................................... 65 Book Summaries: Online Booksellers........................................................................................... 65 The National Library of Medicine Book Index ............................................................................. 67 Chapters on Heroin Addiction ..................................................................................................... 68 CHAPTER 7. MULTIMEDIA ON HEROIN ADDICTION ...................................................................... 69 Overview...................................................................................................................................... 69 Bibliography: Multimedia on Heroin Addiction.......................................................................... 69 CHAPTER 8. PERIODICALS AND NEWS ON HEROIN ADDICTION ................................................... 71 Overview...................................................................................................................................... 71 News Services and Press Releases................................................................................................ 71 Academic Periodicals covering Heroin Addiction........................................................................ 73 CHAPTER 9. RESEARCHING MEDICATIONS .................................................................................... 75 Overview...................................................................................................................................... 75 U.S. Pharmacopeia....................................................................................................................... 75 Commercial Databases ................................................................................................................. 76 Researching Orphan Drugs ......................................................................................................... 76 APPENDIX A. PHYSICIAN RESOURCES ............................................................................................ 81 Overview...................................................................................................................................... 81 NIH Guidelines............................................................................................................................ 81 NIH Databases............................................................................................................................. 83 Other Commercial Databases....................................................................................................... 85 APPENDIX B. PATIENT RESOURCES ................................................................................................. 87 Overview...................................................................................................................................... 87 Patient Guideline Sources............................................................................................................ 87 Finding Associations.................................................................................................................... 89 APPENDIX C. FINDING MEDICAL LIBRARIES .................................................................................. 91

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Overview...................................................................................................................................... 91 Preparation................................................................................................................................... 91 Finding a Local Medical Library.................................................................................................. 91 Medical Libraries in the U.S. and Canada ................................................................................... 91 ONLINE GLOSSARIES.................................................................................................................. 97 Online Dictionary Directories ..................................................................................................... 97 HEROIN ADDICTION DICTIONARY....................................................................................... 99 INDEX .............................................................................................................................................. 131

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FORWARD In March 2001, the National Institutes of Health issued the following warning: "The number of Web sites offering health-related resources grows every day. Many sites provide valuable information, while others may have information that is unreliable or misleading."1 Furthermore, because of the rapid increase in Internet-based information, many hours can be wasted searching, selecting, and printing. Since only the smallest fraction of information dealing with heroin addiction is indexed in search engines, such as www.google.com or others, a non-systematic approach to Internet research can be not only time consuming, but also incomplete. This book was created for medical professionals, students, and members of the general public who want to know as much as possible about heroin addiction, using the most advanced research tools available and spending the least amount of time doing so. In addition to offering a structured and comprehensive bibliography, the pages that follow will tell you where and how to find reliable information covering virtually all topics related to heroin addiction, from the essentials to the most advanced areas of research. Public, academic, government, and peer-reviewed research studies are emphasized. Various abstracts are reproduced to give you some of the latest official information available to date on heroin addiction. Abundant guidance is given on how to obtain free-of-charge primary research results via the Internet. While this book focuses on the field of medicine, when some sources provide access to non-medical information relating to heroin addiction, these are noted in the text. E-book and electronic versions of this book are fully interactive with each of the Internet sites mentioned (clicking on a hyperlink automatically opens your browser to the site indicated). If you are using the hard copy version of this book, you can access a cited Web site by typing the provided Web address directly into your Internet browser. You may find it useful to refer to synonyms or related terms when accessing these Internet databases. NOTE: At the time of publication, the Web addresses were functional. However, some links may fail due to URL address changes, which is a common occurrence on the Internet. For readers unfamiliar with the Internet, detailed instructions are offered on how to access electronic resources. For readers unfamiliar with medical terminology, a comprehensive glossary is provided. For readers without access to Internet resources, a directory of medical libraries, that have or can locate references cited here, is given. We hope these resources will prove useful to the widest possible audience seeking information on heroin addiction. The Editors

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From the NIH, National Cancer Institute (NCI): http://www.cancer.gov/cancerinfo/ten-things-to-know.

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CHAPTER 1. STUDIES ON HEROIN ADDICTION Overview In this chapter, we will show you how to locate peer-reviewed references and studies on heroin addiction.

Federally Funded Research on Heroin Addiction The U.S. Government supports a variety of research studies relating to heroin addiction. These studies are tracked by the Office of Extramural Research at the National Institutes of Health.2 CRISP (Computerized Retrieval of Information on Scientific Projects) is a searchable database of federally funded biomedical research projects conducted at universities, hospitals, and other institutions. Search the CRISP Web site at http://crisp.cit.nih.gov/crisp/crisp_query.generate_screen. You will have the option to perform targeted searches by various criteria, including geography, date, and topics related to heroin addiction. For most of the studies, the agencies reporting into CRISP provide summaries or abstracts. As opposed to clinical trial research using patients, many federally funded studies use animals or simulated models to explore heroin addiction. The following is typical of the type of information found when searching the CRISP database for heroin addiction: •

Project Title: ADDICTION TREATMENT IN RUSSIA: ORAL AND DEPOT NALTREXONE Principal Investigator & Institution: Woody, George E.; Professor; Psychiatry; University of Pennsylvania 3451 Walnut Street Philadelphia, Pa 19104 Timing: Fiscal Year 2003; Project Start 30-SEP-2003; Project End 30-JUN-2007

2 Healthcare projects are funded by the National Institutes of Health (NIH), Substance Abuse and Mental Health Services (SAMHSA), Health Resources and Services Administration (HRSA), Food and Drug Administration (FDA), Centers for Disease Control and Prevention (CDCP), Agency for Healthcare Research and Quality (AHRQ), and Office of Assistant Secretary of Health (OASH).

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Summary: (provided by applicant): The usual treatment of heroin addiction in Russia involves detoxification and 2-4 weeks of rehabilitation with referral to outpatient followup. Though most patients complete inpatient treatment, few keep follow-up appointments and relapse rates are high. More effective therapies are needed, especially in view of the epidemic of heroin addiction that has resulted in the spread of HIV and other infectious diseases. A recently completed study of 52 patients randomized to oral naltrexone (ON) or oral naltrexone placebo (ONP) has shown efficacy in preventing relapse and reducing HIV risk but dropout was a problem with only 44% of ON patients proven to have not relapsed by 6 months as compared to 16% of ONP patients. A larger study of 280 patients randomized to ON or ONP with or without fluoxetine will further evaluate these early results and determine if adding a SSRI improves outcome. Recruitment into this study is almost completed but is not finished and outcome data are not yet available. We think that retention and outcome can be also improved by depot injectable naltrexone (DIN), and in this study we propose to compare ON with DIN. DIN is not approved for use in Russia and we would like the results of this study to be acceptable to Russian authorities that might approve it for general use. Thus we propose a placebo-controlled, double-blind/double-dummy design since a placebocontrolled trial is required by the Russian equivalent of our FDA as a condition for approval of a pharmacotherapy. Participants will be male and female heroin addicts who have been detoxified in addiction treatment hospitals in St. Petersburg and have a family member willing and able to supervise medication compliance and facilitate follow-up. After giving informed consent and confirming the absence of physiologic dependence, 300 patients will be randomly assigned to a 6-month treatment in one of three groups of 100 each: oral naltrexone (ON) + depot injectable naltrexone placebo (DINP); oral naltrexone placebo (ONP) + depot injectable naltrexone (DIN); or ONP + DINP. All patients will receive biweekly clinical management/compliance enhancement counseling. Assessments will be done at baseline, at each biweekly appointment during the 6-month of medication treatment, and at 3 and 6 months following the end of the medication. Primary outcome will be the relapse free proportion at months 1-6; secondary outcomes will be time to dropout, opioid positive urines, HIV risk, use of alcohol and other drugs, psychiatric symptoms, and other measures of overall adjustment. We hypothesize that outcomes will be better with DIN than ON, and that each will be more effective than placebo. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: ADDICTIONS: GENOTYPES, POLYMOPHISMS, AND FUNCTION Principal Investigator & Institution: Kreek, Mary J.; Lab/Biology/Addictive Diseases; Rockefeller University New York, Ny 100216399 Timing: Fiscal Year 2001; Project Start 30-SEP-1999; Project End 31-AUG-2004 Summary: Drug addiction continues to be a major medical and social problem. It is estimated that one million or more persons in the United States are currently addicted to heroin, with millions more worldwide. Cocaine addiction and alcohol dependence are frequent comorbid conditions in heroin addicts in addition to being major primary addictions. Many studies over the past thirty years have shown that these drugs disrupt physiologic systems, and that these disruptions may contribute to drug addiction and alcohol dependence and to relapse to drug or alcohol abuse following withdrawal and abstinence. Clinical observations suggest that individuals differ in their response to heroin, cocaine, and alcohol; however, little is known about specific underlying hereditary genetic factors which might influence individual susceptibility to the addictive properties of these substances. Studies also suggest that both common and

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distinct heritable factors account for the genetic variance in the susceptibility to the separate addictive diseases. We hypothesize that there is a heritable as well as environmental basis for the acquisition and persistence of, and relapse to, specific addictive diseases. In this R01 application we propose to expand and increase our existing collection of DNA and immortalized cell lines from individuals without and with opioid and related drug dependencies and psychiatric comorbidities. Two separate types of genetic analyses will be used to determine association and linkage. All study subjects will be extensively characterized with respect to the addictive diseases, medical history, family medical addictive disease history; psychiatric comorbidity, and psychological profile, as well as ethnic background. A hypothesis driven approach will be utilized for the discovery of unknown polymorphisms in genes known to be involved in the responses to drugs of abuse, using traditional and novel methods. Functional studies of variant gene products caused by polymorphisms we identify will be performed, since altered function of these proteins may be important in individual responses to drugs of abuse, individual differences in the development and persistence of addiction, or in relapse to addiction, as well as in many aspects of normal physiology in which that gene product is involved. A better understanding of the consequences of genetic contributions with respect to protection from, or susceptibility to, heroin addiction and related codependencies and comorbid conditions, could have enormous importance in both prevention and treatment of this problem. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: ANTECEDENTS TO HIV RISK BEHAVIORS AMONG DRUG USERS Principal Investigator & Institution: Booth, Robert E.; Professor; Psychiatry; University of Colorado Hlth Sciences Ctr P.O. Box 6508, Grants and Contracts Aurora, Co 800450508 Timing: Fiscal Year 2001; Project Start 01-AUG-1999; Project End 31-JUL-2004 Summary: Research into the determinants of HIV risk behaviors among injection drug users, including individual, social, environmental and pharmacological factors, has taught us much in the past decade. Few investigations, however, have addressed all of these factors and their inter-relationships. Questions remain about the complex nature of antecedents to risky behavior, such as needle sharing and unprotected sex, in this population. Why are some individuals more likely to engage in risk behaviors than others? Are individual behaviors, such as self efficacy and negotiation skills, more important than social roles and relationships? Do pharmacological factors, such as the physically debilitating nature of heroin addiction have more influence on risk than environmental factors, such as paraphernalia laws? Do drug users differ in their general 'riskiness' compared to non-drug users? We are proposing to conduct a two-phase approach to understanding these issues. The first is a semi-structured qualitative assessment of current IDUs, crack smokers, and individuals who have never used drugs, focusing on antecedents to risk and the context and the circumstances in which risk taking occurs. The second, building on observations from the qualitative study, is a quantitative evaluation of predictors of risk taking, including individual, social, environmental and pharmacological factors. Particular emphasis will be placed on the role that gender plays in accounting for differences in risk. A comparison between current drug users and controls who have never used drugs, looking at differences in personality and psychological and social functioning will also be conducted. Findings from this investigation are intended to lead to the development of interventions that can reduce the occurrence of HIV risk behaviors among injection drug users. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen

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Project Title: BUPRENORPHINE MICROCAPSULES FOR HEROIN ADDICTION Principal Investigator & Institution: Nuwayser, Elie S.; Biotek, Inc. 21-C Olympia Ave Woburn, Ma 01801 Timing: Fiscal Year 2002; Project Start 05-APR-2002; Project End 31-OCT-2003 Summary: (provided by applicant): The overall objective of the program is to develop a new more economical sustained action injectable formulation of -buprenorphine, based on microcapsules prepared by BIOTEK's air suspension process. The microcapsules will be used in a large placebo controlled study in Phase II of the SBIR program. Recently we tested 30-day buprenorphine microcapsules in five (5) heroin addicts at the Johns Hopkins University School of Medicine, Behavioral Pharmacology Research Unit. For all five subjects the depot buprenorphine medication appeared to provide remarkable relief from opioid withdrawal without evidence of intoxication or respiratory depression over the six weeks of post-depot observation and assessment. Furthermore, the formulation was very effective in dramatically reducing responsiveness to exogenous opioid challenge for a duration of at least several weeks. Clinically, all five participants successfully achieved opioid detoxification, without other medications for withdrawal relief, and without clinically significant withdrawal signs or symptoms. During the subsequent 2-week outpatient phase all patients reported abstinence from opioids and urine toxicology samples were negative for opioids. These remarkable and very exciting findings compel us to drive forward and expand and accelerate the testing of depot buprenorphine in a large population of heroin addicts with appropriate placebo controls. Support is sought under the SBIR program to develop and optimize a more economic formulation of depot buprenorphine microcapsules, by using a new process which produces a much higher yield (5-6 fold increase) of microcapsules in the injectable size range. In preliminary studies detailed in this application, we have demonstrated significant reduction in manufacturing costs and the equivalency of the buprenorphine release profile from the old and new formulation. During Phase II of the SBIR program, microcapsule development will be completed, a large number of vials will be prepared under cGMP. The current IND will be updated and submitted to the FDA with a clinical protocol to test the formulation in a larger population of heroin addicts with appropriate placebo controls. PROPOSED COMMERCIAL APPLICATION: A sustained action opioid agonist/antagonist formulation, such as microencapsulated buprenorphine would be a significant advance. Once a month treatment is an economic advantage and allows staff members to devote more time to patients and less to dose administration. This formulation will provide opioid antagonism like that of naltrexone, but there would be less motivation for the post addict to drop out of therapy due to the agonistic action similar to that of methadone or LAAM. The overall treatment plan would not need to revolve about a rigid dosing schedule. Rather treatment could be designed to best benefit the patient, and an example of habitual drug taking behavior is eliminated. The drug thus becomes an adjunct not the major aspect of therapy. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen

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Project Title: HIV RISK REDUCTION AND DRUG ABUSE TREATMENT IN MALAYSIA Principal Investigator & Institution: Schottenfeld, Richard S.; Professor; Psychiatry; Yale University 47 College Street, Suite 203 New Haven, Ct 065208047 Timing: Fiscal Year 2001; Project Start 30-SEP-2001; Project End 31-AUG-2005 Summary: (provided by applicant): Combining drug abuse and HIV risk reduction counseling with opioid agonist maintenance treatment (OMT) or antagonist

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maintenance treatment with naltrexone (NMT) is effective for reducing illicit drug use and preventing HIV transmission associated with heroin dependence, but support for NMT remains tenuous and OMT is not currently available in many Western Pacific countries (e.g., Malaysia, Indonesia and Singapore) where heroin addiction and HIV infection are epidemic and closely linked with injection drug use (IDU) and high-risk sexual behaviors among addicts. Promising results of NMT in Malaysia have created interest in evaluating OMT using buprenorphine (BMT) and comparing the efficacy of counseling alone and counseling combined with BMT or NMT. We are proposing a 24week, randomized double blind clinical trial to evaluate the efficacy for maintaining abstinence and reducing HIV risk behaviors of manual-guided, HIV risk reduction and drug counseling (DC-HIV) alone or when combined with BMT or NMT for recently detoxified and currently abstinent heroin dependent patients (N=l80) in Malaysia (Specific Aim 1). The study will allow evaluation of 3 hypotheses: DC-HIV plus naltrexone is superior to DC-HIV alone; DC-HIV plus buprenorphine is superior to DCHIV alone; and DC-HIV plus naltrexone is superior to DC-HIV plus buprenorphine. Primary outcome measures, assessed by 3x/wk urine toxicology testing and self-report, include resumption of heroin use, 1 or 3 weeks continuous relapse and reductions in HIV risk behaviors. The project will also evaluate the characteristics of treatmentseeking heroin addicts in Malaysia (including specific risk behaviors and patterns of HIV risk behaviors; prevalence of psychiatric and other medical comorbidity; and patterns of social, family, vocational, and criminal activity and service needs--Specific Aim 2). This data will be used to revise the DC-HIV manual to address the specific circumstances and risk behaviors of Malaysian heroin addicts. Finally, the project will also provide clinical training for health professionals and training and mentoring in drug abuse treatment and HIV prevention research to clinical researchers who will continue development, implementation, evaluation and dissemination of HIV prevention and drug abuse treatment approaches in Malaysia after the project ends (Specific Aim 3). The results of the study will inform government policy and support for HIV prevention and drug abuse treatment efforts in Malaysia and possibly also in other Western Pacific countries. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: IN VITRO AND IN VIVO PHARMACOLOGY OF OPIOIDS Principal Investigator & Institution: Traynor, John R.; Senior Associate Research Scientist; University of Michigan at Ann Arbor 3003 South State, Room 1040 Ann Arbor, Mi 481091274 Timing: Fiscal Year 2003; Project Start 01-JUL-2003; Project End 30-JUN-2008 Summary: This project has three aims. 1. The characterization of opioids as Potential PET agents. 2. To develop an understanding of the molecular mechanisms behind potential treatment agents. 3. To characterize and provide novel opioid compounds in accordance with a major aim of the Center. Aim 1. We will identify selective agonists and antagonists with properties that make them suitable for labeling as PET agents for the visualization of mu, delta and kappa opioid receptors in monkey and in man. This involves close collaboration with the chemistry (Husbands, Project 1A) and radiochemistry (Kilbourn, Project 1B) components of the Center and with the potential end users (Winger, Project 4; Ko, Project 3 and Zubieta). Aim 2. Buprenorphine is a popular alternative as a medication for the treatment of heroin abuse. Methoclocinnamox is a lead compound we have developed as a longer lasting alternative. The mechanisms by which these drugs are beneficial in heroin addiction are not clear. For example, it could be their agonist action or their antagonist actions (or

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both) that are most important. Newer ideas concerning the cellular actions of morphine and related mu opioids includes agonist-specific states of the mu receptor that might activate different intracellular pathways and roles for receptor dimers and heterodimers. We will compare the cellular actions of buprenorphine and MCCAM and opioids that differ in their structure, efficacy or receptor kinetics using cells that express mu or mu and delta receptors and that we will express different Galpha subunits, or measure activation of different Galpha subunits. Acute opioid actions at different levels of the signaling cascade, and mechanisms contributing to tolerance development (phosphorylation, internalization and down-regulation) will be determined. In addition we will examine the effects of these agents in a cellular model of physiological dependence and withdrawal (adenylyl cyciase supersensitivity). We hope to uncover how these treatment agents differ from other opioids and, in conjunction with chemistry and modeling, provide clues for the design of safer and more effective agents. Aim 3. Seeks to identify and develop opioid compounds for the scientific and clinical community and to examine compounds submitted to the Drug Evaluation Committee of the College on Problems of Drug Dependence as part of their abuse liability evaluation. This is an important undertaking of the Center and provides a valuable service to government agencies and academia. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: METHADONE AND BUPERNORPHINE: ANTE- AND POSTPARTUM Principal Investigator & Institution: Johnson, Rolley E.; Associate Professor; Psychiatry and Behavioral Scis; Johns Hopkins University 3400 N Charles St Baltimore, Md 21218 Timing: Fiscal Year 2001; Project Start 30-SEP-1999; Project End 31-AUG-2003 Summary: Approximately 1/3 of opioid addicts are women of child-bearing age. Pregnancy during opioid dependence presents a complex array of therapeutic challenges. Methadone is the only maintenance pharmacotherapy recommended for use in pregnant opioid-dependent women. Methadone offers many benefits relative to continued untreated heroin addiction or medical detoxification, but it also has medical complications. Compared to non-drug exposed infants, opioid exposed infants have longer and more costly neonatal hospitalizations and display neurophysical and behavioral disruption. It is estimated that 55 percent-94 percent of infants exposed to opioids in utero will show signs of opioid withdrawal. Buprenorphine offers the potential of providing benefits comparable to methadone with fewer medical problems. Buprenorphine is reported to produce only a mild abstinence syndrome following abrupt withdrawal. Its potential will be assessed in a randomized controlled clinical trial comparing methadone and buprenorphine in this special population. Results will be compared to opiate dependent controls who choose nonpharmacological treatment. This comprehensive interdisciplinary effort will be conducted in the Center for Addiction of Pregnancy. Subjects randomized to equivalent optimal doses of methadone (N=35) or buprenorphine (N=35) will be followed through pregnancy and compared to nonpharmacologically treated (N=35) subjects. Primary outcome measures are: neonatal abstinence symptoms and length (days) of hospital stay. Secondary fetal/neonatal outcome measures are: standard antenatal measures, NICU Network Neurobehavioral Scale, fetal growth ratio, total anti-withdrawal medication given, infant cry behavior and physical birth parameters. Secondary maternal outcome measures include: treatment retention, objective and subjective measures o drug use, global assessments, dose adequacy and safety data. Additionally, mother and infant pharmacokinetic data will be collected to aid in interpretation of outcomes. The study will provide critical clinical

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data comparing the neonatal abstinence syndrome and safety/efficacy of methadone and buprenorphine in the mother and infant pre- and postpartum using rigorous scientific methodology. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: METHADONE MAINTENANCE FOR PRISONERS Principal Investigator & Institution: Kinlock, Timothy W.; Friends Research Institute, Inc. Box 10676, 505 Baltimore Ave Baltimore, Md 21285 Timing: Fiscal Year 2003; Project Start 15-JUN-2003; Project End 30-APR-2008 Summary: (provided by applicant): Most prisoners with histories of pre-incarceration heroin addiction do not receive treatment while incarcerated and seldom enter treatment upon release. Effective treatment for such prisoners is urgently needed because rapid readdiction typically follows release, placing these individuals at risk of HIV infection and other negative consequences of addiction. Additional research to develop effective treatments that begin during incarceration and continue in the community is clearly needed. Based on evidence of methadone maintenance treatment effectiveness in community settings, it appears an especially promising approach for inmates with heroin addiction histories. A five-year study is proposed to examine the benefits of a methadone maintenance treatment program for prison inmates who have been incarcerated for some time and are not currently addicted, initiating maintenance treatment prior to release from prison and continuing treatment in the community. Other than three studies of methadone maintenance with short-term jail inmates, the only study of longer-term inmates was a locally-conducted pilot study involving prison inmates in pre-release status. Based on this pilot research, which found that initiating maintenance treatment in prison is feasible and facilitates entry into community-based treatment after release, we are proposing a more rigorous examination of this unique treatment approach. In the proposed study, prisoners with pre-incarceration histories of heroin addiction having 3-6 months left to serve before release (N=360) will be randomly assigned to one of three conditions: (1) initiation of methadone maintenance in prison, with transfer to community-based methadone maintenance with the same provider immediately upon release; (2) immediate access to methadone maintenance treatment upon release from prison, but no maintenance treatment in prison; and (3) no experimental intervention. This study design will permit disentanglement of the effects of two distinct program components, namely (a) the provision of methadone maintenance treatment prior to release, and (b) the availability of immediate entry into maintenance treatment in the community upon release. Participants in all three conditions will receive drug abuse counseling in prison, along with information on how to access treatment resources in the community. Participants will be assessed at baseline (study entry) and at 1, 3, 6, and 12 months following their release from prison. Outcome measures include: treatment entry and retention in the community; heroin use; cocaine use; HlV-risk behaviors; criminal activity; and employment. The proposed research will also examine the relationship of initial motivation for treatment, early criminal involvement, and cocaine abuse history to treatment outcome. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen

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Project Title: ADDICTION

MU

OPIOD

RECEPTOR

POLYMORPHISMS

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HEROIN

Principal Investigator & Institution: Balfour, Margaret E.; Cell Biol, Neurobiol/Anatomy; University of Cincinnati 2624 Clifton Ave Cincinnati, Oh 45221

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Timing: Fiscal Year 2001; Project Start 01-DEC-2000 Summary: Although many complex environmental and social factors contribute to the development of heroin addiction, increasing evidence suggests that there is also genetic component. The mu opioid receptor has been implicated because of its ability to bind addictive opioids. This lab has identified two single nucleotide polymorphisms (SNPs) in this receptor that correlate with heroin addiction and are common in the population. An A to G transition at base pair 118 (A118G) may confer a protective effects against addiction in one of the ethnic groups studied, while a C to T transition at base pair 17 (C17T) may predispose patients to the development of heroin addiction. The A118G SNP has been shown to alter binding affinity to the endogenous ligand beta-endorphin, and reduce G-protein coupled Inwardly Rectifying K+ (GIRK) channel activation. This project will determine if these SNPs have altered binding affinity to clinically relevant opioids and other endogenous peptide agonists. Electrophysiological studies will focus on the functional conseque4nces of these SNPs on channel function: effects on GIRK channel activation will be performed in Xenopus oocytes, while effects on N-type Ca2+ channel inhibition will be studied in the NG108-15 cell line. Changes in channel function or activation may indicate alterations in cellular response to opioids that could affect a patient's susceptibility to addiction. Dose response curves for each agonist will be generated for each polymorphism, and these will be compared to those of the prototype receptor. Cyclic AMP levels will be measured in transfected NG108-15 cells to determine the effects of each SNP on tolerance and the response to sudden morphine withdrawal. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: MU OPIOID RECEPTOR GENE IN HEROIN ADDICTS Principal Investigator & Institution: Yu, Lei; Professor; Cell Biol, Neurobiol/Anatomy; University of Cincinnati 2624 Clifton Ave Cincinnati, Oh 45221 Timing: Fiscal Year 2001; Project Start 30-SEP-1994; Project End 31-JUL-2004 Summary: Addiction to heroin is a major social problem, affecting over a million people in the United States. In the body and brain, heroin is hydrolyzed to morphine, which acts at the mu opioid receptor and results in a euphoric effect, thus conferring the reinforcing properties of the drug and contributing to addiction. Drug addiction is a complex process, thought to result from the interaction of social, environmental, and biological factors including a genetic component. In our original proposal, we hypothesized that genetic polymorphisms might exist in the mu opioid receptor and alter receptor function, contributing to variation in individual susceptibility to heroin abuse. During the current funding period we have observed five different single nucleiotide polymorphisms (SNPs); two of these SNPs were relatively common (10.5 percent and 6.6 percent allelic frequency), and both showed differential distributions among ethnic groups. One appeared to exert a protective effect against opioid addiction in one of the ethnic groups; it also altered beta-endorphin binding affinity and agonist potency. The other common variant occurred with a significantly higher frequency in former heroin addicts, suggesting a genetic predisposition for opioid dependence. In this competing renewal application, we propose to extend our study of the clinical and functional significance of genetic variation in the human mu opioid receptor. We will examine a larger number of study subjects, and determine the allele distribution in former heroin addicts and controls among different ethnic groups. We will also examine their impact on receptor modulation of neuronal Ca2+ channels and inhibition of adenylyl cyclase activity. Furthermore, we will determine the effects of the mu receptor polymorphisms on the cellular responses to chronic morphine treatment, since the primary problems that develop during heroin addiction come from prolonged exposure

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to the opioid drug. Results from the proposed study in this renewal application will provide valuable information in two areas: First of all, by studying the effects of sequence variants on the cellular function of the mu receptor, we will understand how genetic polymorphisms impact on receptor activity and neuronal excitability. Furthermore, by determining distribution of these genetic variations between opioiddependent individuals and normal controls, we will start to appreciate the role of genetic polymorphism is predisposition for or protection against opioid dependence. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: MU RECEPTOR POLYMORPHISMS AND HEROIN ADDICTION Principal Investigator & Institution: Berrettini, Wade H.; Karl E. Rickels Professor; University of Pennsylvania 3451 Walnut Street Philadelphia, Pa 19104 Timing: Fiscal Year 2002; Project Start 30-SEP-1992; Project End 30-JUN-2007 Summary: (provided by applicant) Using a genetic murine model for opioid addiction and linkage analysis, we identified a chromosome 10 locus (later defined as the mu oploid receptor [OPRM1] gene) that determines 50% of the variance in how much morphine a mouse consumes during a two-bottle choice paradigm experiment. This study is consonant with phenotypic evaluations of OPRM1 gene knock-out mice, which are indifferent to the rewarding properties of morphine. These murine studies suggest that variation in the OPRM1 gene may convey some risk for opioid dependence (OD). Twin and family studies of OD are consistent with a heritable component of risk that is attributable specifically to opioids. This application proposes to study OD patients and matched controls, to examine OPRMI gene sequence variants as potential susceptibility factors for OD. We have determined, through multiplex sequencing, 25 common transcribed / regulatory OPRM gene variants. Preliminary analysis suggests that some OPRM promotor variants (which may alter transcription factor binding sites) may be found at higher frequency among OD persons compared to controls. These preliminary results indicate the need for a more extensive examination of the OPRM1 gene sequence in a genomically-controlled association study of sufficient power to detect a small effect. In addition, variation in the pro-opiomelanocortin cDNA and other opioid cDNAs will be assessed in case-control association studies of OD probands and ethnically-matched controls, using haplotype analysis. These studies may identify genes of the endogenous opioid systems as risk factors for genetic susceptibility to OD. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen

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Project Title: NEURO-COGNITIVE ASPECTS OF OPIATE ABUSE & ANTISOCIAL BEHAVIOR Principal Investigator & Institution: Vassileva, Jasmin L.; Psychiatry; University of Illinois at Chicago 1737 West Polk Street Chicago, Il 60612 Timing: Fiscal Year 2003; Project Start 30-SEP-2003; Project End 31-AUG-2005 Summary: (provided by applicant): Rates of heroin addiction are increasing worldwide with concomitant legal and health costs, including increased risk of HIV and hepatitis C viral transmission. However, at present it is difficult to impossible to study the consequences of "pure" heroin use since the majority of addicts are polysubstancedependent. Further, co-morbid conditions, such as Antisocial Personality Disorder (APD) and psychopathy, additionally complicate the clinical picture and daily function of heroin-dependent persons. Study of the effect of drugs of abuse on the brain and the development of addiction are particularly difficult, due to difficulty in isolating drug effects on cognition from dysfunction associated with co-morbid conditions. We

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propose to develop a program of studies with the long-term goals of investigating neurocognitive aspects of brain function in drug addicts with and without a diagnosis of ASPD / psychopathy. This program will be developed in Bulgaria, a low-middle income country in Southeastern Europe with significantly high prevalence of heroin addiction. Bulgaria's geographical position make it a key country on the "Balkan Drug Route", one of the main routes for international drug traffic from South-West Asia to Western Europe, through which approximately 80% of the heroin currently used in Western Europe passes. Consequently, heroin is easily available in the country, and in fact heroin addiction has become one of the most significant health and legal problems. Patterns of heroin addiction in Bulgaria are unique in that polysubstance dependence is uncommon. Consequently study of Bulgarian addicts provides a unique opportunity to evaluate neurocognitive and psychiatric consequences of relatively "pure" heroin use. In addition, the nature of the Bulgarian legal system facilitates the opportunity to study heroin dependent subjects both with and without APD because all detainees arrested for drug-related charges undergo mandated medical and psychiatric evaluation prior to disposition of their cases. We have partnered with physicians and mental health professionals in Sofia who have access to a large population of pre-trial detainees, a large majority of whom have been detained for drug-related crimes. Research on addiction and its neuro-cognitive consequences is minimal in Bulgaria, despite a significant need to address these concerns. In the proposed project the PI, her colleagues the University of Illinois-Chicago, and at the Clinic of Forensic Psychiatry and Psychology at the State University Hospital of Neurology and Psychiatry in Sofia, Bulgaria, will initiate the development of resources for studies of neuro-cognitive function in heroin addicts with and without APD/psychopathy, and without polysubstance dependence. This preliminary work will culminate in a pilot study of neuro-cognition in heroin addicts with and without ASPD/psychopathy and an R01 application based on these pilot findings and other hypotheses developed in the course of the two years. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: NEUROCOGNITIVE FUNCTION IN RUSSIAN HEROIN ADDICTS Principal Investigator & Institution: Fishbein, Diana H.; Senior Research Scientist; Research Triangle Institute Box 12194, 3040 Cornwallis Rd Research Triangle Park, Nc 27709 Timing: Fiscal Year 2003; Project Start 10-SEP-2003; Project End 30-APR-2006 Summary: (provided by applicant): Research on the neurocognitive consequences of chronic heroin use is sparse, despite the global existence of millions of addicts and young initiates. Most U.S. studies include polydrug abusers and are unable to precisely distinguish between neurocognitive consequences of specific drugs. This deficit is particularly true for heroin addiction, which is often also preceded by several years of extensive use of other drugs, confounding the ability to assess single drug effects. Thus, it is important to determine whether there are neurocognitive impairments associated specifically with heroin addiction that may differ from those associated with alcoholism or whether the same deficits are common to multiple drug users. To elucidate differential neurocognitive consequences of heroin use, it is necessary to identify a population with a dependency on only one drug. Most studies of drug effects on brain function also do not measure prefrontally modulated executive cognitive function (ECF) and focus largely on general neuropsychological function. Recent research using stateof-the-art cognitive instruments provides support for a relationship between specific dimensions of ECF and drug abuse propensity and persistence. ECF may predict relapse

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propensity, and intact function may be a prerequisite for favorable responses to treatment programs that require a certain level of cognitive processing. There is also insufficient research on gender disparities in the cognitive consequences of drug use, despite differences in historical patterns of use, neurologic drug effects, and involvement of contextual factors. ECF assessment of male and female heroin addicts entering treatment is useful for the evaluation of aspects of cognitive functioning that may be relevant for optimal therapeutic management and treatment planning. To evaluate differential relationships between ECF in heroin addicts versus alcoholics among these groups, the proposed study will focus on single drug users without extensive prior use of other drugs from an inpatient treatment facility in St. Petersburg, Russia. Two control groups will be included: polydrug abusers from the facility and a group of nondrug abusers from the community. Neurocognitive tests will be administered after detoxification. Mediating effects of personality traits on cognitive outcomes will further be assessed. This innovative design and unique sample population will generate findings critical to understanding differences in ECF among heroin addicts, alcoholics, and polydrug abusers, as well as differential gender effects. Because the nature and degree of recovery from drug abuse are likely a function of the type or pattern of neurocognitive impairment, differential drug effects must be considered. This study will significantly contribute to NIDA's goal to support international collaborative research to increase understanding of consequences of drug abuse. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: NOVEL MEDICATION APPROACHES FOR SUBSTANCE ABUSE Principal Investigator & Institution: Kleber, Herbert D.; Professor of Psychiatry and Director; New York State Psychiatric Institute 1051 Riverside Dr New York, Ny 10032 Timing: Fiscal Year 2001; Project Start 30-SEP-1994; Project End 31-AUG-2004 Summary: This MDRC renewal brings together talented new and experienced investigators, unique resources, and innovative techniques to develop medications for the treatment of Cocaine. heroin. and marijuana abuse. Existing medications for treating heroin addiction have serious flaws, and no effective agents have been developed for the other two drugs of abuse. The current MDRC has as its major theme the development of effective medications for subgroups of the addict population and the search for better methods to identify them. The renewal expands this focus to the development and/or utilization of models for more efficient and productive testing of promising medications, and consists of two Cores and five Projects, among which there is considerable interaction. The Administrative/Clinical Core, in addition to centralized recruiting, coordination, support and provision of basic psychosocial therapy, will carry out placebo-controlled pilot studies on promising new medications, and supports inpatient and outpatient research facilities for pilots and projects. The Statistical, Education, and Training Core provides statistical support, from design to analysis, and extensive education (with our Fellowship program) to medical students, residents, and fellows. Project 1 uses the smoked heroin self-administration model developed in the current MDRC to evaluate the buprenorphine/naloxone combination tablet, depot naltrexone, and two NMDA receptor antagonists. Project 2 combines innovative imaging of the Dl and D2 receptors with our model of cocaine self-administration to investigate whether the DI/D2 ratio is associated with cocaine craving and seeking, and thus could be a marker for rational medication development. Project 3 using the targeted subgroup model and innovative design features, builds on a promising pilot of venlafaxine, expanding it to a major double-blind clinical trial in depressed cocaine

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abusers. Project 4 aims to develop and implement a screening model for potential new agents for heroin detoxification. Using a three-arm screening model, an alphaadrenergic agonist, a calcium channel blocker, two NMDA antagonists and two partial opioid agonists will be compared to the alpha- adrenergic agonist clonidine. Project 5 proposes to develop a model for studying the effects of potential treatment medications with marijuana abusers, evaluating agents that may either ameliorate marijuana abstinence symptoms or reduce marijuana's acute effects. Overall, the Center has the potential to develop better medications and models for treating abuse of these three drugs, and, to meet this goal, has the unique ability to rapidly move back and forth between human laboratory and clinical studies. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: OPIATE DEPENDENCE: COMBINED NALTREXONE/BEHAVIOR THERAPY Principal Investigator & Institution: Nunes, Edward V.; New York State Psychiatric Institute 1051 Riverside Dr New York, Ny 10032 Timing: Fiscal Year 2001; Project Start 30-SEP-1997; Project End 30-JUN-2005 Summary: (Applicant's Abstract) The goal of this Stage II project (NIDA Behavioral Therapies Development Program PA-99-107) is to test the efficacy of a new combination of behavioral therapy with oral naltrexone maintenance for the treatment of heroin addiction, and to test a new long-acting depot parenteral formulation of naltrexone in initiating treatment. Antagonist maintenance with naltrexone is an important alternative to agonist maintenance or drug-free treatment, but it has not, to date, lived up to its potential. During the first two years of a Stage I project, Behavioral Naltrexone Therapy (BNT) was developed to address four limitations of naltrexone maintenance: 1) Difficulty transitioning patients from opiates to naltrexone; 2) Poor compliance; 3) Possible dysphoric effects; and 4) Inadequate psychotherapeutic context. After hospitalization for rapid transition from opiates to naltrexone, therapy sessions over six months draw elements from Network Therapy, the Community Reinforcement Approach, and voucher incentives contingent on compliance with naltrexone and abstinence from opiates. A significant other attends sessions and monitors compliance. Depression is identified early and treated. A treatment manual and therapy adherence instrument were developed. Results of a pilot trial are promising, although naltrexone discontinuation and relapse during the first month remains a significant problem. At the same time, a depot parenteral formulation of naltrexone was studied which produces therapeutic blood levels and blockade of opiate effects for 3 to 4 weeks after injection. It is hypothesized that a dose of depot naltrexone, administered after transition to oral naltrexone and before discharge from hospital, will prevent attrition during the initial outpatient weeks, allowing the behavioral regimen to take hold and substantially improving the long-term efficacy of our combination of behavioral therapy and oral naltrexone. In the proposed Stage II trial 160 heroin dependent patients will be randomly assigned to one of four conditions in a 2 by 2 factorial design: 1) BNT plus a dose of depot naltrexone prior to hospital discharge; 2) BNT plus a placebo injection; 3) Compliance Enhancement (CE), a control condition simulating standard treatment with naltrexone, plus depot naltrexone; and 4) CE plus placebo injection. Specific Aims are: 1) To test the efficacy of Behavioral Naltrexone Therapy (BNT) compared to control therapy for the maintenance treatment of opiate dependence; and 2) To test the efficacy of depot naltrexone in reducing early attrition, improving initial stabilization on oral naltrexone, and improving long term outcome of Behavioral Naltrexone Therapy (BNT). Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen

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Project Title: PRECLINICAL DEVELOPMENT OF DRUGS FOR STIMULANT ABUSE Principal Investigator & Institution: Deutsch, Howard M.; Principal Research Scientist; School of Chemistry & Biochem; Georgia Institute of Technology 225 North Ave Nw Atlanta, Ga 30332 Timing: Fiscal Year 2001; Project Start 20-JAN-1999; Project End 30-NOV-2003 Summary: The purpose of this work is to synthesize and test compounds which will be useful therapeutic agents in the treatment of stimulant abuse. Synthetic efforts will center around the derivatization of two indirect acting dopamine agonists, methylphenidate and LR-5182 (a bicyclooctane). The aim is to alter their basic structures in such a manner as to generate either (1) potent, long-lasting agonists which will substitute for the abused (analagous to methadone in the treatment of heroin addiction), (2) partial agonists or mixed agonist-antagonists which will lessen the subjective effects of the abused stimulant, but exhibit a mild stimulant effect of their own; or (3) antagonists, which will block the subjective effect of the abused stimulant, but have no intrinsic stimulant activity. The compounds will be evaluated using a multi-tiered battery of tests. The first level will consist of the in vitro determination of potency to block dopamine uptake and [3H]WIN 35,428 binding, selectivity for the dopamine transporter, and right-shift of the cocaine inhibition curve against dopamine uptake Based on the outcome, some compounds will progress to the second level of testing, where their ability to substitute for and/or antagonize cocaine in drug discrimination and conditioned place preference tests in rats will be assessed. Compounds judged to have therapeutic potential at this point will then advance to testing in primate selfadministration and drug- discrimination paradigms. Although the aim is to develop agents for the treatment of stimulant abuse, the findings may also have application in other disorders involving dopaminergic pathways, including attention deficit disorder, Parkinson's disease, Tourette's syndrome, and schizophrenia. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen

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Project Title: RENOVATION OF FOURTH FLOOR OF FASER HALL Principal Investigator & Institution: Wells, Barbara G.; Professor and Dean; None; University of Mississippi P.O. Box 907 University, Ms 386770907 Timing: Fiscal Year 1999; Project Start 30-SEP-1999; Project End 29-SEP-2004 Summary: The specific aim of this project is on the renovation of the fourth floor of Faser Hall and 5000 gross square feet of new laboratory space on the third and fourth floors of Faser Hall in order to improve the capability of The University of Mississippi to support a burgeoning, cutting-edge biomedical research program. At the foundation of this program are a number of PHS-funded research projects to discover, design, and synthesize new drugs for unmet therapeutic needs in human health, an important national priority. The School of Pharmacy Building named Faser Hall was completed and occupied in May, 1969. Faser Hall has been the location of the research endeavors of the Pharmaceutical Sciences for nearly thirty years. While some renovation and repairs have occurred over this time, the current structure and infrastructure is quite antiquated for conducting contemporary, state-of-the-art biomedical research. Expansive research growth has occurred during this period making the laboratories more crowded. The University of Mississippi School of Pharmacy has undertaken a long-term and comprehensive plan to totally renovate Faser Hall. This will result in increased research space, more efficient use of research space, and an enhancement of the laboratories to meet contemporary safety standards. The State of Mississippi and the University have

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provided $2,000,000 for the development of a comprehensive planning strategy for the replacement of the roof and significant infrastructure changes including the renovation of the fourth floor and for new construction of 5000 gross square of new laboratory space designated as "swing space" which will become permanent research facilities for the third and fourth floors. Current projects and personnel will be moved into this swing space while renovation occurs in Faser Hall, thus greatly minimizing disruption to active biomedical research. This request is for $1.0 million of total funds from NIH to match with State funds to achieve complete renovation of the research laboratories on the entire fourth floor of Faser Hall and construction of additional research space on the third and fourth floors. The fourth floor currently houses the Drug Discovery, Design and Synthesis Research Program which as significant current and pending NIH grants. This unit encompasses a number of important therapeutic areas (including AIDS and associated opportunistic infections, cancer, malaria, contraception, cardiovascular disease, treatment of cocaine and heroin addiction, immune-mediated diseases). The current laboratories are small and crowded, and contain relatively few hoods, most of which are small and marginally functional; a research environment which is less than ideal for the quality research being conducted. Completion of the renovation as planned for the fourth floor and the construction of laboratories extended from the third and fourth floors will greatly increase the usable space and provide contemporary and safer laboratories for conducting biomedical research. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: ROLE OF ENDOGENOUS OPIODS IN HEROIN ABUSE Principal Investigator & Institution: Maidment, Nigel T.; None; University of California Los Angeles 10920 Wilshire Blvd., Suite 1200 Los Angeles, Ca 90024 Timing: Fiscal Year 2001; Project Start 01-AUG-1995; Project End 30-JUN-2004 Summary: (Adapted From The Applicant's Abstract): Previous research has implicated the mesotelencephalic dopaminergic system as the primary substrate mediating the reinforcing effects of many abused drugs. However, endogenous opioid peptides have also been implicated in this phenomenon. The presence of enkephalins in the nucleus accumbens-pallidal projection, and the demonstrated importance of this pathway in reinforcement, provides an anatomical basis for such a hypothesis. Previously, using microdialysis linked to a solid-phase radioimmunoassay, we demonstrated that opiate administration elevates extracellular concentrations of enkephalins in the pallidum. The first part of the current proposal will examine further the mechanisms underlying this effect. Repeated intermittent administration of opiate and psychostimulant drugs induces a state of behavioral sensitization believed to be largely dependent on a sensitized mesotelencephalic dopamine system. This phenomenon has been implicated in the attribution of 'incentive salience' to environmental cues associated with drug administration. However, not all the evidence is in favor of such a hypothesis and the possible role of other neurotransmitters/neuromodulators in this process needs to be investigated. Our preliminary data suggest that heroin-induced pallidal enkephalin release may exhibit acute sensitization. We will therefore examine if repeated intermittent administration of heroin induces sensitization to the enkephalin-releasing effect of this drug. We will determine for how long such sensitization persists and whether its expression is dependent on conditioned environmental cues. The final part of the proposal will combine microdialysis with a modified conditioned placepreference paradigm to examine if environmental cues themselves elicit a pallidal enkephalin release response in animals conditioned to associate such cues with heroin

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administration. These studies will provide valuable information concerning the mechanisms underlying heroin addiction. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: VULNERABILITY TO THE REINFORCING EFFECTS OF OPIOIDS Principal Investigator & Institution: Morgan, Drake; Physiology and Pharmacology; Wake Forest University Health Sciences Winston-Salem, Nc 27157 Timing: Fiscal Year 2001; Project Start 01-APR-2001; Project End 31-MAR-2006 Summary: (provided by applicant) Current estimates suggest that there are 600,000 people in need of treatment for heroin addiction. Unfortunately, there is very little scientific data regarding vulnerability to heroin abuse. This makes it extraordinarily difficult to study the biological substrates responsible for the findings that some people exposed to heroin progress to a compulsive and uncontrolled use of the drug, whereas others use heroin several times, and then stop using it. This question is impossible to experimentally evaluate in humans because of the obvious ethical issues involved in exposing drug-naive people to heroin. If animal models are to be used to understand this phenomenon, then appropriate self-administration methods that allow for a differential sensitivity to be expressed need to be developed. Furthermore, if a procedure that screens for this eventual "vulnerability" was used, then biological studies can be conducted in essentially drug-naive animals, allowing the determination of the mechanisms that produce this differential reaction to drugs of abuse. This proposal is designed to investigate the relationship between sensitivity to the analgesic effects of opioids and various measures of the reinforcing effects of opioids (primarily heroin). Once this relationship is established, animals can be screened for "vulnerability" to drug addiction, and extensive neurobiological and biochemical analyses can be conducted in drug-naive animals. In particular, the following questions will be answered over the course of this award: 1. What is the relationship between sensitivity to the analgesic effects and the reinforcing effects of opioids? 2. What are the differences in the localization, characteristics, or coupling efficiency of the opioid system across subgroups (i.e. "vulnerable" or "resistant") of animals? 3. What are the differences in the expression of various genetic markers and proteins in the brain pathways relevant to opioid reinforcement across these subgroups of animals? This series of experiments will provide extensive training for the candidate in the neurobiology and biochemistry of drug abuse, to complement the behavioral background already established. In the end, this research will identify neurobiological, biochemical and genetic determinants of susceptibility to heroin use. An improved understanding of the individual risk of drug addiction will lead to the development of better prevention and treatment strategies. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen

E-Journals: PubMed Central3 PubMed Central (PMC) is a digital archive of life sciences journal literature developed and managed by the National Center for Biotechnology Information (NCBI) at the U.S. National Library of Medicine (NLM).4 Access to this growing archive of e-journals is free and 3 4

Adapted from the National Library of Medicine: http://www.pubmedcentral.nih.gov/about/intro.html.

With PubMed Central, NCBI is taking the lead in preservation and maintenance of open access to electronic literature, just as NLM has done for decades with printed biomedical literature. PubMed Central aims to become a world-class library of the digital age.

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unrestricted.5 To search, go to http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=Pmc, and type “heroin addiction” (or synonyms) into the search box. This search gives you access to full-text articles. The following is a sample of items found for heroin addiction in the PubMed Central database: •

Medical prescription of heroin to treatment resistant heroin addicts: two randomised controlled trials. by van den Brink W, Hendriks VM, Blanken P, Koeter MW, van Zwieten BJ, van Ree JM.; 2003 Aug 9; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&artid=169643

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Time for a new approach to heroin addiction, Vancouver says. by Jones D.; 2003 Jun 24; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&artid=161627

The National Library of Medicine: PubMed One of the quickest and most comprehensive ways to find academic studies in both English and other languages is to use PubMed, maintained by the National Library of Medicine.6 The advantage of PubMed over previously mentioned sources is that it covers a greater number of domestic and foreign references. It is also free to use. If the publisher has a Web site that offers full text of its journals, PubMed will provide links to that site, as well as to sites offering other related data. User registration, a subscription fee, or some other type of fee may be required to access the full text of articles in some journals. To generate your own bibliography of studies dealing with heroin addiction, simply go to the PubMed Web site at http://www.ncbi.nlm.nih.gov/pubmed. Type “heroin addiction” (or synonyms) into the search box, and click “Go.” The following is the type of output you can expect from PubMed for heroin addiction (hyperlinks lead to article summaries): •

“I got a yen for that darvon-N”: a pilot study on the use of propoxyphene napsylate in the treatment of heroin addiction. Author(s): Inaba DS, Newmeyer JA, Gay GR, Whitehead CA. Source: The American Journal of Drug and Alcohol Abuse. 1974; 1(1): 67-78. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=4157058&dopt=Abstract

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“Markers” for the MacAndrew and the Cavior heroin addiction MMPI scales. Author(s): Burke HR. Source: J Stud Alcohol. 1983 May; 44(3): 558-63. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6645538&dopt=Abstract

5 The value of PubMed Central, in addition to its role as an archive, lies in the availability of data from diverse sources stored in a common format in a single repository. Many journals already have online publishing operations, and there is a growing tendency to publish material online only, to the exclusion of print. 6 PubMed was developed by the National Center for Biotechnology Information (NCBI) at the National Library of Medicine (NLM) at the National Institutes of Health (NIH). The PubMed database was developed in conjunction with publishers of biomedical literature as a search tool for accessing literature citations and linking to full-text journal articles at Web sites of participating publishers. Publishers that participate in PubMed supply NLM with their citations electronically prior to or at the time of publication.

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A bibliography of the methadone maintenance treatment of heroin addiction. Author(s): Langrod J. Source: Int J Addict. 1970 September; 5(3): 581-91. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=4944745&dopt=Abstract

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A case history: heroin addiction. Author(s): O'Connell B. Source: Manch Med Gaz. 1967 October; 47(1): 22-5. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=5634092&dopt=Abstract

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A city that has controlled heroin addiction. Author(s): McCarrick H. Source: Nurs Times. 1969 July 24; 65(30): 945-6. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=5791750&dopt=Abstract

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A heroin addiction scale for the MMPI: effectiveness in differential diagnosis in a psychiatric setting. Author(s): Lachar D, Berman W, Grisell JL, Schooff K. Source: Int J Addict. 1979 January; 14(1): 135-42. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=468416&dopt=Abstract

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A heroin addiction scale revisited. Author(s): Kranitz L. Source: Int J Addict. 1972; 7(4): 715-9. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=4147318&dopt=Abstract

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A morphine-triggered delivery system useful in the treatment of heroin addiction. Author(s): Roskos KV, Tefft JA, Heller J. Source: Clin Mater. 1993; 13(1-4): 109-19. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10146246&dopt=Abstract

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A multiple baseline analysis of treatment for heroin addiction. Author(s): Epstein LH, Parker FC, Jenkins CC. Source: Addictive Behaviors. 1976; 1(4): 327-30. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=998363&dopt=Abstract

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A rationale for the use of methadone in heroin addiction. Author(s): Drew LR. Source: The Medical Journal of Australia. 1987 January 19; 146(2): 118. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3796416&dopt=Abstract

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A report of over four years of experience in Hawaii. Methadone for heroin addiction. Author(s): Quisenberry WB. Source: Hawaii Med J. 1974 November; 33(11): 409-11. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=4448628&dopt=Abstract

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A social history of heroin addiction. Author(s): Merry J. Source: The British Journal of Addiction to Alcohol and Other Drugs. 1975 September; 70(3): 307-10. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1103920&dopt=Abstract

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A vitamin profile of heroin addiction. Author(s): el-Nakah A, Frank O, Louria DB, Quinones MA, Baker H. Source: American Journal of Public Health. 1979 October; 69(10): 1058-60. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=484761&dopt=Abstract

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Acute myelopathy in association with heroin addiction. Author(s): Ell JJ, Uttley D, Silver JR. Source: Journal of Neurology, Neurosurgery, and Psychiatry. 1981 May; 44(5): 448-50. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7264695&dopt=Abstract

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Acute myoglobinuria as a fatal complication of heroin addiction. Author(s): Chan YF, Wong PK, Chow TC. Source: The American Journal of Forensic Medicine and Pathology : Official Publication of the National Association of Medical Examiners. 1990 June; 11(2): 160-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2343845&dopt=Abstract

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Acute myoglobinuria associated with heroin addiction. Author(s): Richter RW, Challenor YB, Pearson J, Kagen LJ, Hamilton LL, Ramsey WH. Source: Jama : the Journal of the American Medical Association. 1971 May 17; 216(7): 1172-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=5108401&dopt=Abstract

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After the Aquarian age: observations on the changing face of heroin addiction in a San Francisco clinic population. Author(s): Newmeyer JA. Source: The American Journal of Drug and Alcohol Abuse. 1974; 1(2): 199-206. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=4467724&dopt=Abstract

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Altered HPA axis responsivity to metyrapone testing in methadone maintained former heroin addicts with ongoing cocaine addiction. Author(s): Schluger JH, Borg L, Ho A, Kreek MJ. Source: Neuropsychopharmacology : Official Publication of the American College of Neuropsychopharmacology. 2001 May; 24(5): 568-75. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11282257&dopt=Abstract

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Amyloid fibrils in urinary sediment. Heroin addiction with renal amyloidosis. Author(s): Brus I, Steiner G, Maceda A, Lejano R. Source: N Y State J Med. 1979 April; 79(5): 768-71. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=286178&dopt=Abstract

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An epidemiologic evaluation of long-term methadone maintenance treatment for heroin addiction. Author(s): Gearing FR, Schweitzer MD. Source: American Journal of Epidemiology. 1974 August; 100(2): 101-12. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=4850534&dopt=Abstract

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An evaluation of detoxification as an initial step in the treatment of heroin addiction. Author(s): Sheffet A, Quinones M, Lavenhar MA, Doyle K, Prager H. Source: The American Journal of Psychiatry. 1976 March; 133(3): 337-40. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1259047&dopt=Abstract

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An exploratory study of the relation of heroin addiction to crime in New Orleans. Author(s): Bloom WA, Capel WC. Source: Proc Natl Conf Methadone Treat. 1973; 1: 123-32. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=4808138&dopt=Abstract

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An hypothesis about heroin addiction, murder, prostitution, and suicide: acting out parenting conflicts. Author(s): Offenkrantz W, Tobin A, Freedman R. Source: Int J Psychoanal Psychother. 1978-79; 7: 602-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=738834&dopt=Abstract

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Application of urine analysis to diagnosis and treatment of heroin addiction. Author(s): Marks V, Fry D, Chapple PA, Gray G. Source: British Medical Journal. 1969 April 19; 1(650): 153-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=5778937&dopt=Abstract

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B vitamins status: effect of prolonged heroin addiction and methadone treatment. Author(s): Prayurahong B, Migasena P, Pongpaew P, Vudhivai N, Busapathumrong P. Source: J Med Assoc Thai. 1991 March; 74(3): 131-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1861128&dopt=Abstract

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Clonidine and opiate receptor antagonists in the treatment of heroin addiction. Author(s): Gerra G, Marcato A, Caccavari R, Fontanesi B, Delsignore R, Fertonani G, Avanzini P, Rustichelli P, Passeri M. Source: Journal of Substance Abuse Treatment. 1995 January-February; 12(1): 35-41. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7752296&dopt=Abstract

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Clubbing of the fingers in heroin addiction. Author(s): Chotkowski LA. Source: The New England Journal of Medicine. 1984 July 26; 311(4): 262. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6738630&dopt=Abstract

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Coming to grips with an urban heroin addiction epidemic. Author(s): DuPont RL. Source: Jama : the Journal of the American Medical Association. 1973 January 1; 223(1): 46-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=4739086&dopt=Abstract

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Communicable-disease theory of heroin addiction. Author(s): Jonas S. Source: The New England Journal of Medicine. 1973 February 22; 288(8): 421-2. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=4684051&dopt=Abstract

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Control programs for heroin addiction. Author(s): Nix JT. Source: Jama : the Journal of the American Medical Association. 1970 February 23; 211(8): 1377-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=5467039&dopt=Abstract

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Controversy over brain surgery for heroin addiction in Russia. Author(s): Orellana C. Source: Lancet. Neurology. 2002 October; 1(6): 333. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12849380&dopt=Abstract

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Criminal justice and voluntary patients in treatment for heroin addiction. Author(s): Perpich J. Source: Proc Natl Conf Methadone Treat. 1973; 1: 78-84. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=4808233&dopt=Abstract

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Criminality during the life course of heroin addiction. Author(s): Ball JC, Nurco DN. Source: Nida Res Monogr. 1984 March; 49: 305-12. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6434976&dopt=Abstract

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Cross-validation of a heroin addiction (He) scale in a treatment setting. Author(s): Parr WC, Woodward WA, Robinowitz R, Penk WE. Source: Int J Addict. 1981 April; 16(3): 549-53. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7275399&dopt=Abstract

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Cross-validation of a heroin addiction scale from the Minnesota Multiphasic Personality Inventory. Author(s): Sheppard C, Ricca E, Fracchia J, Rosenberg N, Merlis S. Source: The Journal of Psychology. 1972 July; 81(2D Half): 263-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=4402487&dopt=Abstract

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Cutaneous clues to heroin addiction. Author(s): Young AW Jr, Sweeney EW. Source: American Family Physician. 1973 February; 7(2): 79-87. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=4265323&dopt=Abstract

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Cutaneous stigmas of heroin addiction. Author(s): Young AW Jr, Rosenberg FR. Source: Archives of Dermatology. 1971 July; 104(1): 80-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=5120168&dopt=Abstract

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Dental and associated attitudinal aspects of heroin addiction: a pilot study. Author(s): Picozzi A, Dworkin SF, Leeds JG, Nash J. Source: Journal of Dental Research. 1972 May-June; 51(3): 869. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=4402356&dopt=Abstract

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Dermatologic complications of heroin addiction. Author(s): Minkin W, Cohen HJ. Source: The New England Journal of Medicine. 1967 August 31; 277(9): 473-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6032902&dopt=Abstract

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Disseminated extrapulmonary tuberculosis in association with heroin addiction. Author(s): Firooznia H, Seliger G, Abrams RM, Valensi V, Shamoun J. Source: Radiology. 1973 November; 109(2): 291-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=4742315&dopt=Abstract

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Editorial: Heroin Addiction: a communicable disease or a sociological phenomena? Author(s): Stimmel B. Source: The American Journal of Drug and Alcohol Abuse. 1974; 1(3): 445-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=4467734&dopt=Abstract

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Editorial: Present status of methadone treatment of heroin addiction. Author(s): Senay EC. Source: Southern Medical Journal. 1975 January; 68(1): 1-2. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1171524&dopt=Abstract

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Effect of maternal heroin addiction on 67 liveborn neonates. Withdrawal symptoms, small body size, and small head circumference were frequent findings. Author(s): Vargas GC, Pildes RS, Vidyasagar D, Keith LG. Source: Clinical Pediatrics. 1975 August; 14(8): 751-3 Passim. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1167237&dopt=Abstract

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Effectiveness of methadone maintenance for heroin addiction. Author(s): Murray JB. Source: Psychological Reports. 1998 August; 83(1): 295-302. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9775685&dopt=Abstract

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Effects of chronic heroin addiction on pituitary-thyroid function in man. Author(s): Brambilla F, Nobile P, Zanoboni A, Zanoboni-Muciaccia W, Meroni PL. Source: J Endocrinol Invest. 1980 July-September; 3(3): 251-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6776179&dopt=Abstract

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Effects of heroin addiction on the responses of glucose, C-peptide and insulin to a standard meal. Author(s): Zandomeneghi R, Luciani A, Massari M, Montanari P, Pavesi C. Source: Clinical Science (London, England : 1979). 1988 March; 74(3): 283-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3278831&dopt=Abstract

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Effects of heroin addiction on thyrotrophin, thyroid hormones and porlactin secretion in men. Author(s): Chan V, Wang C, Yeung RT. Source: Clinical Endocrinology. 1979 June; 10(6): 557-65. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=113145&dopt=Abstract

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Endogenous opiates, heroin addiction, and non-insulin-dependent diabetes. Author(s): Giugliano D, Ceriello A, Quatraro A, D'Onofrio F. Source: Lancet. 1985 October 5; 2(8458): 769-70. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2864496&dopt=Abstract

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Epidemiologic approach to heroin addiction in Dade County, Florida. Author(s): Davies JE, Edmundson WF, Blackbourne BD, Carmichael LP, Engel D, Moore T. Source: J Fla Med Assoc. 1971 April; 58(4): 37-40. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=5549094&dopt=Abstract

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Experiences with a combination of group therapy and methadone maintenance in the treatment of heroin addiction. Author(s): LaRosa JC, Lipsius SH, LaRosa JH. Source: Int J Addict. 1974; 9(4): 605-17. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=4435971&dopt=Abstract

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Factors associated with heroin addiction among male adults in Lahore, Pakistan. Author(s): Emmanuel F, Akhtar S, Rahbar MH. Source: J Psychoactive Drugs. 2003 April-June; 35(2): 219-26. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12924744&dopt=Abstract

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Fetal complications of maternal heroin addiction: abnormal growth, infections, and episodes of stress. Author(s): Naeye RL, Blanc W, Leblanc W, Khatamee MA. Source: The Journal of Pediatrics. 1973 December; 83(6): 1055-61. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=4757521&dopt=Abstract

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Further comments on the communicable disease model of heroin addiction. Author(s): Sidel VW, Drucker E. Source: The American Journal of Drug and Alcohol Abuse. 1976; 3(2): 369-72. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1032749&dopt=Abstract

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Further studies on the effects of heroin addiction on the hypothalamic-pituitarygonadal function in man. Author(s): Celani MF, Carani C, Montanini V, Baraghini GF, Zini D, Simoni M, Ferretti C, Marrama P. Source: Pharmacol Res Commun. 1984 December; 16(12): 1193-203. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6522443&dopt=Abstract

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Galactorrhea-amenorrhea syndrome associated with heroin addiction. Author(s): Pelosi MA, Sama JC, Caterini H, Kaminetzky HA. Source: American Journal of Obstetrics and Gynecology. 1974 April 1; 118(7): 966-70. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=4856399&dopt=Abstract

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Gastric emptying, glucose tolerance and associated hormonal changes in heroin addiction. Author(s): Ghodse AH, Reed JL. Source: Psychological Medicine. 1984 August; 14(3): 521-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6387756&dopt=Abstract

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Guillan-Barre syndrome in heroin addiction. Author(s): SMith WR, Wilson AF. Source: Jama : the Journal of the American Medical Association. 1975 March 31; 231(13): 1367-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1173082&dopt=Abstract

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Heroin addiction among young people: a new development in Sri Lanka. Author(s): Mendis N. Source: Bull Narc. 1985 April-September; 37(2-3): 25-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3878170&dopt=Abstract

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Heroin addiction and cognitive style: disembedding performance in the male heroin addict. Author(s): Ross L. Source: The British Journal of Addiction to Alcohol and Other Drugs. 1979 March; 74(1): 51-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=283828&dopt=Abstract

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Heroin addiction and its treatment in Hawaii: a cross-cultural perspective. Author(s): Streltzer J, Molarte A, Severson L. Source: Hawaii Med J. 1980 October; 39(10): 251-3. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7204015&dopt=Abstract

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Heroin addiction and methadone maintenance: when will we ever learn. Author(s): Stimmel B. Source: Journal of Addictive Diseases : the Official Journal of the Asam, American Society of Addiction Medicine. 1999; 18(2): 1-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10334371&dopt=Abstract

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Heroin addiction and methadone treatment in America: using our heads in the search for solutions. Author(s): Basham R. Source: Hum Organ. 1977 Fall; 36(3): 296-9. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10236341&dopt=Abstract

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Heroin addiction and motivational milieu therapy. Author(s): Van Bilsen HP, van Emst AJ. Source: Int J Addict. 1986 June; 21(6): 707-13. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3744621&dopt=Abstract

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Heroin addiction and naltrexone. Author(s): Byrne A. Source: Aust Fam Physician. 1998 May; 27(5): 344. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9612997&dopt=Abstract

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Heroin addiction and pregnancy. Author(s): Bashore RA, Ketchum JS, Staisch KJ, Barrett CT, Zimmermann EG. Source: The Western Journal of Medicine. 1981 June; 134(6): 506-514. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7257365&dopt=Abstract

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Heroin addiction and pregnancy. Author(s): Perlmutter JF. Source: Obstetrical & Gynecological Survey. 1974 July; 29: 439-46. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=4453390&dopt=Abstract

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Heroin addiction and renal disease. Author(s): Arruda JA, Kurtzman NA. Source: Contrib Nephrol. 1977; 7: 69-78. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=330109&dopt=Abstract

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Heroin addiction and road traffic accidents. Author(s): Edwards G, Quartaro PJ. Source: British Medical Journal. 1978 December 16; 2(6153): 1710. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=737446&dopt=Abstract

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Heroin addiction and sex hormones in males. Author(s): Malik SA, Khan C, Jabbar A, Iqbal A. Source: J Pak Med Assoc. 1992 September; 42(9): 210-2. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1433805&dopt=Abstract

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Heroin addiction and the fifth estate. Author(s): Casselman BW. Source: Jama : the Journal of the American Medical Association. 1965 November 8; 194(6): 680. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=5897251&dopt=Abstract

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Heroin addiction and the role of methadone in its treatment. Author(s): Goldstein A. Source: Archives of General Psychiatry. 1972 April; 26(4): 291-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=4622401&dopt=Abstract

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Heroin addiction and the Wechsler Digit Span test. Author(s): Keiser TW, Lowy D. Source: Journal of Clinical Psychology. 1980 January; 36(1): 347-51. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7391253&dopt=Abstract

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Heroin addiction as a family phenomenon: a new conceptual model. Author(s): Stanton MD, Todd TC, Heard DB, Kirschner S, Kleiman JI, Mowatt DT, Riley P, Scott SM, Van Deusen JM. Source: The American Journal of Drug and Alcohol Abuse. 1978; 5(2): 125-50. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=371388&dopt=Abstract

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Heroin addiction as an occupation: traditional addicts and heroin-addicted polydrug users. Author(s): Sackman BS, Sackman MM, DeAngelis GG. Source: Int J Addict. 1978 April; 13(3): 427-41. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=669865&dopt=Abstract

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Heroin addiction during pregnancy. Author(s): Statzer DE, Wardell JN. Source: American Journal of Obstetrics and Gynecology. 1972 May 15; 113(2): 273-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=5025881&dopt=Abstract

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Heroin addiction in adolescents. Author(s): Boyd P. Source: Journal of Psychosomatic Research. 1970 September; 14(3): 295-301. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=5487633&dopt=Abstract

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Heroin addiction in an adolescent population. Author(s): Wiener JM, Egan JH. Source: J Am Acad Child Psychiatry. 1973 January; 12(1): 48-58. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=4683868&dopt=Abstract

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Heroin addiction in Bahrain: 15 years experience. Author(s): Abdel-Mawgoud M, al-Haddad MK. Source: Addiction (Abingdon, England). 1996 December; 91(12): 1859-64. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8997766&dopt=Abstract

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Heroin addiction in pregnancy. Author(s): Kroll D. Source: Midwives Chron. 1986 July; 99(1182): 153-6. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3637609&dopt=Abstract

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Heroin addiction in the suburbs--an epidemiologic study. Author(s): Levengood R, Lowinger P, Schooff K. Source: American Journal of Public Health. 1973 March; 63(3): 209-14. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=4687868&dopt=Abstract

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Heroin addiction in the United Kingdom (1954-1964). Author(s): Bewley T. Source: British Medical Journal. 1965 November 27; 5473: 1284-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=5849146&dopt=Abstract

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Heroin addiction treated by atropine coma. Author(s): Wandzel L, Falicki Z. Source: The American Journal of Psychiatry. 1987 September; 144(9): 1243. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3631332&dopt=Abstract

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Heroin addiction treatment and crime reduction. Author(s): Dupont RL. Source: The American Journal of Psychiatry. 1972 January; 128(7): 856-60. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=5009264&dopt=Abstract

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Heroin addiction trends. Author(s): Greene MH, Dupont RL. Source: The American Journal of Psychiatry. 1974 May; 131(5): 545-50. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=4819047&dopt=Abstract

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Heroin addiction, ethics and philosophy of medicine. Author(s): ten Have H, Sporken P. Source: Journal of Medical Ethics. 1985 December; 11(4): 173-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=4078854&dopt=Abstract

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Heroin addiction, methadone maintenance, and pregnancy. Author(s): Yacavone D, Scher J, Kim YR, Schwitz B, O'Connor H. Source: J Am Osteopath Assoc. 1976 May; 75(9): 826-9. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1046439&dopt=Abstract

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Heroin addiction, renal failure, and methadone maintenance: a follow-up report. Author(s): Charuvastra VC, Ouren J, Powell B. Source: Drug and Alcohol Dependence. 1980 September; 6(3): 137-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7000479&dopt=Abstract

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Heroin addiction. Author(s): Moser RH. Source: Jama : the Journal of the American Medical Association. 1974 November 4; 230(5): 728-31. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=4479134&dopt=Abstract

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Heroin addiction. A comparison of two inpatient treatment methods. Author(s): LaRouche ML, Donlon PT. Source: Mich Med. 1970 September; 69(17): 751-4. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=5469838&dopt=Abstract

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Heroin addiction. Sequential treatment employing pharmacologic supports. Author(s): Goldstein A. Source: Archives of General Psychiatry. 1976 March; 33(3): 353-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1259524&dopt=Abstract

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Heroin addiction. Some of its complications. Author(s): Aleman J. Source: J Fla Med Assoc. 1971 April; 58(4): 29-31. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=5549093&dopt=Abstract

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Heroin addiction: a treatable disease. Author(s): Krepick DS, Long BL. Source: Nurs Clin North Am. 1973 March; 8(1): 41-52. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=4487808&dopt=Abstract

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Heroin addiction: acute presentation of medical complications. Author(s): Sternbach G, Moran J, Eliastam M. Source: Annals of Emergency Medicine. 1980 March; 9(3): 161-9. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6987920&dopt=Abstract

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Heroin addiction: beta-endorphin immunoreactivity in plasma increases during withdrawal. Author(s): Emrich HM, Nusselt L, Gramsch C, John S. Source: Pharmacopsychiatria. 1983 May; 16(3): 93-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6310651&dopt=Abstract

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Heroin addiction: insights from Alexis de Tocqueville. Author(s): Haller JS. Source: N Y State J Med. 1986 March; 86(3): 121-2. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3458043&dopt=Abstract

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Heroin addiction: its relation to sexual behavior and sexual experience. Author(s): De Leon G, Wexler HK. Source: Journal of Abnormal Psychology. 1973 February; 81(1): 36-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=4690214&dopt=Abstract

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Heroin addiction: morals revisited. Author(s): van Bilsen HP. Source: Journal of Substance Abuse Treatment. 1986; 3(4): 279-84. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3295275&dopt=Abstract

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Heroin addiction: neurobiology, pharmacology, and policy. Author(s): Goldstein A. Source: J Psychoactive Drugs. 1991 April-June; 23(2): 123-33. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1662715&dopt=Abstract

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Heroin addiction: relationship between the plasma levels of testosterone, dihydrotestosterone, androstenedione, LH, FSH, and the plasma concentration of heroin. Author(s): Bolelli G, Lafisca S, Flamigni C, Lodi S, Franceschetti F, Filicori M, Mosca R. Source: Toxicology. 1979 December; 15(1): 19-29. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=120622&dopt=Abstract

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Heroin addiction: some of its problems. Author(s): Merry J. Source: Nurs Times. 1968 January 19; 64(3): 77-8. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=5638356&dopt=Abstract

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Heroin addiction: the epidemic of the 70's. Author(s): Spelman JW. Source: Archives of Environmental Health. 1970 November; 21(5): 589-90. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=5479282&dopt=Abstract

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Heroin addiction: the needle as transitional object. Author(s): Miller J. Source: The Journal of the American Academy of Psychoanalysis. 2002 Summer; 30(2): 293-304. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12197257&dopt=Abstract

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Heroin addiction: the science and ethics of the new treatment pluralism. Author(s): Gaughwin MD, Ryan P. Source: The Medical Journal of Australia. 1999 February 1; 170(3): 129-30. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10065126&dopt=Abstract

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Heroin addiction: what can the GP do? Author(s): Manzie PP. Source: Aust Fam Physician. 1978 October; 7(10): 1233-40. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=736836&dopt=Abstract

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Heroin addiction--a metabolic disease. Author(s): Dole VP, Nyswander ME. Source: Archives of Internal Medicine. 1967 July; 120(1): 19-24. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6028693&dopt=Abstract

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Heroin addiction--an epidemic disease. Author(s): Dole VP. Source: Harvey Lect. 1973; 67: 199-211. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=4710919&dopt=Abstract

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Hyperimmunoglobulinemia in heroin addiction: some epidemiologic observations, including some possible effects of route of administration and multiple drug abuse. Author(s): Cushman P Jr. Source: American Journal of Epidemiology. 1974 March; 99(3): 218-24. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=4814691&dopt=Abstract

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Immediate precursors to heroin addiction. Author(s): Weppner RS, Agar MH. Source: Journal of Health and Social Behavior. 1971 March; 12(1): 10-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=5572812&dopt=Abstract

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Immunoglobulin alterations associated with heroin addiction. Author(s): Rabin BS, D'Amanda D. Source: Clinical and Experimental Immunology. 1973 July; 14(3): 359-63. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=4199091&dopt=Abstract

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Immunologic abnormalities in heroin addiction. Author(s): Wetli CV, Noto TA, Fernandez-Carol A. Source: Southern Medical Journal. 1974 February; 67(2): 193-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=4130051&dopt=Abstract

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Immunological studies on heroin addiction. II. Applications of a sensitive hemagglutination-inhibition test for detecting morphine to diagnostic problems in chronic heroin addiction. Author(s): Catlin DH, Adler FL, Liu CT. Source: Clinical Immunology and Immunopathology. 1973 July; 1(4): 446-55. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=4805540&dopt=Abstract

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Increased opsonic capacity of serum in chronic heroin addiction. Author(s): Nickerson DS, Williams RC Jr, Boxmeyer M, Quie PG. Source: Annals of Internal Medicine. 1970 May; 72(5): 671-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=4194419&dopt=Abstract

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Influence of heroin addiction on neuropsychological functioning. Author(s): Fields FR, Fullerton JR. Source: Journal of Consulting and Clinical Psychology. 1975 February; 43(1): 114. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1114231&dopt=Abstract

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Inhalant abuse and heroin addiction: a comparative study on 574 opiate addicts with and without a history of sniffing. Author(s): Altenkirch H, Kindermann W. Source: Addictive Behaviors. 1986; 11(2): 93-104. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3739809&dopt=Abstract

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Interpersonal behavior in a small group setting during the heroin addiction cycle. Author(s): Babor TF, Meyer RE, Mirin SM, Davies M, Valentine N, Rawlins M. Source: Int J Addict. 1976; 11(3): 513-23. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=965127&dopt=Abstract

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Intracranial mycotic aneurysms and subacute bacterial endocarditis in heroin addiction. Author(s): Gilroy J, Andaya L, Thomas VJ. Source: Neurology. 1973 November; 23(11): 1193-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=4200998&dopt=Abstract

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Is there a hero in heroin addiction? Author(s): Sherman JP. Source: Aust Fam Physician. 1985 January; 14(1): 4. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3985865&dopt=Abstract

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Ketamine psychotherapy for heroin addiction: immediate effects and two-year follow-up. Author(s): Krupitsky E, Burakov A, Romanova T, Dunaevsky I, Strassman R, Grinenko A. Source: Journal of Substance Abuse Treatment. 2002 December; 23(4): 273-83. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12495789&dopt=Abstract

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Lack of hepatocyte involvement in the genesis of the sinusoidal dilatation related to heroin addiction: a morphometric study. Author(s): Trigueiro de Araujo MS, Gerard F, Chossegros P, Guerret S, Grimaud JA. Source: Virchows Arch a Pathol Anat Histopathol. 1992; 420(2): 149-53. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1549903&dopt=Abstract

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Lay theories of heroin addiction. Author(s): Furnham A, Thomson L. Source: Social Science & Medicine (1982). 1996 July; 43(1): 29-40. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8816008&dopt=Abstract

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Lead brachial neuropathy in heroin addiction. A case report. Author(s): Antonini G, Palmieri G, Spagnoli LG, Millefiorini M. Source: Clinical Neurology and Neurosurgery. 1989; 91(2): 167-70. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2543530&dopt=Abstract

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Lead poisoning during heroin addiction. Author(s): Antonini G, Palmieri G, Millefiorini E, Spagnoli LG, Millefiorini M. Source: Italian Journal of Neurological Sciences. 1989 February; 10(1): 105-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2925342&dopt=Abstract

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Letter: Heroin addiction and nephropathy. Author(s): Rao TK, Nicastri AD, Friedman EA. Source: Annals of Internal Medicine. 1974 September; 81(3): 416. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=4852806&dopt=Abstract

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Life change, disease, perception and heroin addiction. Author(s): Roszell DK, Mules JE, Glickfeld G, Dudley DL. Source: Drug and Alcohol Dependence. 1975 September; 1(1): 57-69. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1235102&dopt=Abstract

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Life cycle and loss--the spiritual vacuum of heroin addiction. Author(s): Coleman SB, Kaplan JD, Downing RW. Source: Family Process. 1986 March; 25(1): 5-23. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3956709&dopt=Abstract

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Maintenance or suppression? A comparative look at the heroin addiction policies of Great Britain and the U.S. Author(s): Sessions KB. Source: The British Journal of Addiction to Alcohol and Other Drugs. 1976 December; 71(4): 385-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1070333&dopt=Abstract

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Major psychotherapeutic modalities for heroin addiction: a brief overview. Author(s): Platt JJ, Husband SD, Taube D. Source: Int J Addict. 1990-91; 25(12A): 1453-77. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2133580&dopt=Abstract

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Malaria: a new facet of heroin addiction in Australia. Author(s): Baker JE, Crawford GP. Source: The Medical Journal of Australia. 1978 October 21; 2(9): 427-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=366360&dopt=Abstract

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Managing heroin addiction with a long-acting morphine product (Kapanol) Author(s): Sherman JP. Source: The Medical Journal of Australia. 1996 August 19; 165(4): 239. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8773665&dopt=Abstract

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Maternal and fetal effects of heroin addiction during pregnancy. Author(s): Little BB, Snell LM, Klein VR, Gilstrap LC 3rd, Knoll KA, Breckenridge JD. Source: J Reprod Med. 1990 February; 35(2): 159-62. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2304039&dopt=Abstract

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Methadone and heroin addiction: rehabilitation without a “cure”. Author(s): Walsh J. Source: Science. 1970 May 8; 168(932): 684-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=5438500&dopt=Abstract

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Methadone dose assessment in heroin addiction. Author(s): Aylett P. Source: Int J Addict. 1982 December; 17(8): 1329-36. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7174170&dopt=Abstract

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Methadone maintenance in heroin addiction. Author(s): Pearson BA. Source: The American Journal of Nursing. 1970 December; 70(12): 2571-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=5202881&dopt=Abstract

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Methadone maintenance therapy for heroin addiction. Some surgical considerations. Author(s): Cushman P Jr. Source: American Journal of Surgery. 1972 March; 123(3): 267-70. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=5011931&dopt=Abstract

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Methadone maintenance treatment of heroin addiction. Author(s): Davis EP. Source: Del Med J. 1971 September; 43(9): 248-51. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=5097505&dopt=Abstract

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Methadone treatment of heroin addiction. Author(s): Freedman DX, Senay EC. Source: Annual Review of Medicine. 1973; 24: 153-64. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=4575849&dopt=Abstract

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Methadone vs. psychotherapy in the treatment of heroin addiction. Author(s): Karkus HD. Source: Int J Addict. 1973; 8(3): 427-34. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=4749900&dopt=Abstract

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Methadone withdrawal in the treatment of heroin addiction. Author(s): Gudeman JE, Shader RI, Hemenway TS. Source: Dis Nerv Syst. 1972 May; 33(5): 297-303. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=4665829&dopt=Abstract

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Methadone-related opioid agonist pharmacotherapy for heroin addiction. History, recent molecular and neurochemical research and future in mainstream medicine. Author(s): Kreek MJ. Source: Annals of the New York Academy of Sciences. 2000; 909: 186-216. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10911931&dopt=Abstract

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Miliary tuberculosis, tuberculosis of ribs and heroin addiction. Author(s): Merry J, Gompels BM. Source: The British Journal of Psychiatry; the Journal of Mental Science. 1970 June; 116(535): 645-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=5452366&dopt=Abstract

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Miliary tuberculosis, tuberculosis of ribs, and heroin addiction. Author(s): Merry J, Gompels BM. Source: Lancet. 1970 January 10; 1(7637): 87. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=4188656&dopt=Abstract

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Morbid and mortal effects of heroin addiction. Author(s): Ahmed I. Source: J Pak Med Assoc. 1985 October; 35(10): 296-7. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3935812&dopt=Abstract

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Mortality in heroin addiction: impact of methadone treatment. Author(s): Gronbladh L, Ohlund LS, Gunne LM. Source: Acta Psychiatrica Scandinavica. 1990 September; 82(3): 223-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2248048&dopt=Abstract

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Mothering practices and heroin addiction. Author(s): Singer A. Source: The American Journal of Nursing. 1974 January; 74(1): 77-82. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=4491944&dopt=Abstract

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Mycotic aneurysm of the right subclavian artery. A complication of heroin addiction. Author(s): Ho KL, Rassekh ZS. Source: Chest. 1978 July; 74(1): 116-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=580925&dopt=Abstract

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Naltrexone and behavior therapy for heroin addiction. Author(s): Rawson RA, Glazer M, Callahan EJ, Liberman RP. Source: Nida Res Monogr. 1979 June; (25): 26-43. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=117373&dopt=Abstract

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Naltrexone for heroin addiction: encouraging results from Italy. Author(s): Schifano F, Marra R. Source: Int J Clin Pharmacol Ther Toxicol. 1990 April; 28(4): 144-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2338367&dopt=Abstract

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Naltrexone in the management of heroin addiction: critique of the rationale. Author(s): Goldstein A. Source: Nida Res Monogr. 1976 September; (9): 158-61. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=187941&dopt=Abstract

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Naltrexone treatment of heroin addiction: efficacy and safety in a double-blind dosage comparison. Author(s): Judson BA, Carney TM, Goldstein A. Source: Drug and Alcohol Dependence. 1981 July; 7(4): 325-46. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7023894&dopt=Abstract

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Naltrexone treatment of heroin addiction: one-year follow-up. Author(s): Judson BA, Goldstein A. Source: Drug and Alcohol Dependence. 1984 July; 13(4): 357-65. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6479015&dopt=Abstract

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Narcotic antagonists: new methods to treat heroin addiction. Author(s): Hammond AL. Source: Science. 1971 August 6; 173(996): 503-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=5564039&dopt=Abstract

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Narcotic-induced hypogonadism during therapy for heroin addiction. Author(s): Daniell HW. Source: Journal of Addictive Diseases : the Official Journal of the Asam, American Society of Addiction Medicine. 2002; 21(4): 47-53. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12296501&dopt=Abstract

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Necrotizing cellulitis of the scrotum: a new complication of heroin addiction. Author(s): Alguire PC. Source: Cutis; Cutaneous Medicine for the Practitioner. 1984 July; 34(1): 93-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6467982&dopt=Abstract

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Neonatal effects of heroin addiction and methadone-treated pregnancies. Preliminary report on 70 live births. Author(s): Davis MM, Brown BS, Glendinning ST. Source: Proc Natl Conf Methadone Treat. 1973; 2: 1153-64. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=4808262&dopt=Abstract

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Neurological complications of heroin addiction. Author(s): Richter RW, Baden MM. Source: Trans Am Neurol Assoc. 1969; 94: 330-2. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=5374479&dopt=Abstract

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Neurosurgical complications of heroin addiction: brain abscess and mycotic aneurysm. Author(s): Amine AR. Source: Surgical Neurology. 1977 June; 7(6): 385-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=578016&dopt=Abstract

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No association between the serotonin transporter promoter region (5-HTTLPR) and the dopamine D3 receptor (BalI D3DR) polymorphisms and heroin addiction. Author(s): Kotler M, Cohen H, Kremer I, Mel H, Horowitz R, Ohel N, Gritsenko I, Nemanov L, Katz M, Ebstein R. Source: Molecular Psychiatry. 1999 July; 4(4): 313-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10483044&dopt=Abstract

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Nontraumatic plexitis and heroin addiction. Author(s): Challenor YB, Richter RW, Bruun B, Pearson J. Source: Jama : the Journal of the American Medical Association. 1973 August 20; 225(8): 958-61. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=4740559&dopt=Abstract

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Observations on the changing face of heroin addiction in a San Francisco clinic population. Author(s): Newmeyer JA, Gay GR. Source: Anesthesia and Analgesia. 1974 September-October; 53(5): 717-22. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=4472220&dopt=Abstract

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On the role of chemotherapy in the treatment of heroin addiction. Author(s): Goldstein A. Source: The American Journal of Drug and Alcohol Abuse. 1975; 2(3-4): 279-88. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1227291&dopt=Abstract

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Organization of the treatment and supervision of heroin addiction. Author(s): Connell PH. Source: Addiction (Abingdon, England). 1995 June; 90(6): 843-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7633303&dopt=Abstract

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Osteomyelitis and disc infection secondary to Pseudomonas aeruginosa in heroin addiction. Case report. Author(s): Selby RC, Pillay KV. Source: Journal of Neurosurgery. 1972 October; 37(4): 463-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=4341860&dopt=Abstract

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Outpatient detoxification of heroin addiction, 1969--1973 (methadone, darvon, codeine, clonidine). Author(s): Rappolt RT, Lawrence F. Source: Clin Toxicol. 1979; 14(1): 141-2. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=436383&dopt=Abstract

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Outpatient induction to methadone maintenance treatment for heroin addiction. Author(s): Nichols AW, Salwen MB, Torrens PR. Source: Archives of Internal Medicine. 1971 May; 127(5): 903-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=5560867&dopt=Abstract

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Outpatient treatment of heroin addiction. Author(s): Merry J. Source: Lancet. 1967 January 28; 1(7483): 205-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=4163139&dopt=Abstract

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Overall evaluation of treatment modalities for heroin addiction in a toxicology unit. Author(s): Ledda F, Blandina P, Botti P, Caramelli L, Fantozzi R, Masini E, Moroni F, Peruzzi S, Zorn AM, Mannaioni PF. Source: Subst Alcohol Actions Misuse. 1983; 4(4): 283-304. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6670053&dopt=Abstract

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Patterns of heroin addiction in the District of Columbia. Author(s): DuPont RL, Greene MH. Source: Proc Natl Conf Methadone Treat. 1973; 1: 786-93. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=4808234&dopt=Abstract

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Pemphigus erythematosus and heroin addiction. Author(s): Fellner MJ, Wininger J. Source: International Journal of Dermatology. 1978 May; 17(4): 308-11. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=659032&dopt=Abstract

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Physical effects of heroin addiction. Author(s): Pillari G, Narus J. Source: The American Journal of Nursing. 1973 December; 73(12): 2105-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=4491096&dopt=Abstract

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Plasma testosterone levels in heroin addiction and during methadone maintenance. Author(s): Mendelson JH, Mendelson JE, Patch VD. Source: The Journal of Pharmacology and Experimental Therapeutics. 1975 January; 192(1): 211-17. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1123724&dopt=Abstract

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Pregnancy complicated by heroin addiction. Author(s): Pelosi MA, Frattarola M, Apuzzio J, Langer A, Hung CT, Oleske JM, Bai J, Harrigan JT. Source: Obstetrics and Gynecology. 1975 May; 45(5): 512-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1124166&dopt=Abstract

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Primary chromoblastomycosis of the medulla oblongata: complication of heroin addiction. Author(s): Kasantikul V, Shuangshoti S, Sampatanukul P. Source: Surgical Neurology. 1988 April; 29(4): 319-21. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3353844&dopt=Abstract

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Pseudoepidemics of heroin addiction. Author(s): Richman A, Abbey H. Source: Drug and Alcohol Dependence. 1977 July; 2(4): 221-37. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=885066&dopt=Abstract

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Quinine amblyopia related to heroin addiction. Author(s): Brust JC, Richter RW. Source: Annals of Internal Medicine. 1971 January; 74(1): 84-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=5539279&dopt=Abstract

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Rapid intravenous detoxification in heroin addiction. Author(s): Byrne A. Source: The British Journal of Psychiatry; the Journal of Mental Science. 1998 May; 172: 451. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9747418&dopt=Abstract

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Recent trends in the demography of heroin addiction among youthful offenders. Author(s): Platt JJ. Source: Int J Addict. 1976; 11(2): 221-36. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1262090&dopt=Abstract

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Relapse in heroin addiction--a brief report. Author(s): Rehman AU, Deeba F. Source: J Pak Med Assoc. 1992 May; 42(5): 125-7. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1507391&dopt=Abstract

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Remembering those who died from heroin addiction. Author(s): Birchard K. Source: Lancet. 1999 July 31; 354(9176): 436. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10437912&dopt=Abstract

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Retrospective audit: heroin addiction. Author(s): Craig RJ. Source: Int J Addict. 1981 April; 16(3): 567-80. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7275401&dopt=Abstract

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Safety and side-effects of buprenorphine in the clinical management of heroin addiction. Author(s): Lange WR, Fudala PJ, Dax EM, Johnson RE. Source: Drug and Alcohol Dependence. 1990 August; 26(1): 19-28. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2209411&dopt=Abstract

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Severe systemic infections complicating “mainline” heroin addiction. Author(s): Briggs JH, McKerron CG, Souhami RL, Taylor DJ, Andrews H. Source: Lancet. 1967 December 9; 2(7528): 1227-31. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=4168697&dopt=Abstract

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Sexual behavior in heroin addiction and methadone maintenance. Correlation with plasma luteinizing hormone. Author(s): Cushman P Jr. Source: N Y State J Med. 1972 June 1; 72(11): 1261-5. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=4503902&dopt=Abstract

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Sexual dynamics and strength of heroin addiction: a three-factor model of an ideology. Author(s): TenHouten S. Source: J Psychoactive Drugs. 1982 January-June; 14(1-2): 101-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7119934&dopt=Abstract

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Skin complications of heroin addiction. Bullous impetigo. Author(s): Young AW Jr. Source: N Y State J Med. 1973 June 15; 73(12): 1681-4. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=4513637&dopt=Abstract

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Slow detoxification in heroin addiction. Combined use of methadone and psychotherapy. Author(s): Rosenthal R. Source: N Y State J Med. 1972 December 15; 72(24): 2998-3000. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=4508422&dopt=Abstract

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Specialists criticise treatment for heroin addiction. Author(s): Mayor S. Source: Bmj (Clinical Research Ed.). 1997 May 10; 314(7091): 1365. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9161305&dopt=Abstract

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Spontaneous external biliary fistula in a patient with heroin addiction. Author(s): Sanowski RA. Source: The American Journal of Gastroenterology. 1978 December; 70(6): 649-52. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=742617&dopt=Abstract

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Staff attitudes and conflict regarding the use of methadone in the treatment of heroin addiction. Author(s): Brown BS, Jansen DR, Bass UF 3rd. Source: The American Journal of Psychiatry. 1974 February; 131(2): 215-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=4809049&dopt=Abstract

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Statistics of heroin addiction. Author(s): Lennane J. Source: The New England Journal of Medicine. 1972 February 10; 286(6): 322-3. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=5007236&dopt=Abstract

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Substitution therapy for heroin addiction. Author(s): Bell J, Dru A, Fischer B, Levit S, Sarfraz MA. Source: Substance Use & Misuse. 2002 June-August; 37(8-10): 1149-78. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12180559&dopt=Abstract

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Sulpiride and extrapyramidal syndromes in chronic heroin addiction. Author(s): De Maio D, Caponeri MA, Cicchetti V, Mellado C, Scieghi G. Source: Neuropsychobiology. 1978; 4(1): 36-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=622221&dopt=Abstract

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The 'acute' abdomen in heroin addiction. Author(s): Leguit P Jr, Slot H, Roos C. Source: The British Journal of Surgery. 1982 October; 69(10): 598. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7127041&dopt=Abstract

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The British approach to the treatment of heroin addiction. Author(s): Edwards G. Source: Lancet. 1969 April 12; 1(7598): 768-72. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=4180228&dopt=Abstract

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The causes of heroin addiction-- a review of the literature. Part II. Author(s): Salmon R, Salmon S. Source: Int J Addict. 1977 October; 12(7): 937-51. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=591147&dopt=Abstract

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The causes of heroin addiction. A review of the literature. Part I. Author(s): Salmon R, Salmon S. Source: Int J Addict. 1977 August; 12(5): 679-96. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=336553&dopt=Abstract

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The changing face of heroin addiction in the Haight-Ashbury. Author(s): Sheppard CW, Smith DE, Gay GR. Source: Int J Addict. 1972; 7(1): 109-22. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=5043828&dopt=Abstract

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The communicable disease model of heroin addiction: a critique. Author(s): Drucker E, Sidel VW. Source: The American Journal of Drug and Alcohol Abuse. 1974; 1(3): 301-11. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=4467729&dopt=Abstract

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The decline of heroin addiction in the District of Columbia. Author(s): DuPont RL, Green MH. Source: Proc Natl Conf Methadone Treat. 1973; 2: 1474-83. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=4808302&dopt=Abstract

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The diagnosis and management of heroin addiction. Author(s): Bewley TH. Source: The Practitioner. 1968 February; 200(196): 215-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=5636683&dopt=Abstract

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The Dole-Nyswander treatment of heroin addiction. Author(s): Ausubel DP. Source: Jama : the Journal of the American Medical Association. 1966 March 14; 195(11): 949-50. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=5951970&dopt=Abstract

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The dynamics of a heroin addiction epidemic. Author(s): DuPont RL, Greene MH. Source: Science. 1973 August 24; 181(101): 716-22. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=4724929&dopt=Abstract

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The dysphoria of heroin addiction. Author(s): Handelsman L, Aronson MJ, Ness R, Cochrane KJ, Kanof PD. Source: The American Journal of Drug and Alcohol Abuse. 1992; 18(3): 275-87. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1329491&dopt=Abstract

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The economic costs of heroin addiction in the United States. Author(s): Mark TL, Woody GE, Juday T, Kleber HD. Source: Drug and Alcohol Dependence. 2001 January 1; 61(2): 195-206. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11137285&dopt=Abstract

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The effect of heroin addiction on pituitary-testicular function. Author(s): Wang C, Chan V, Yeung RT. Source: Clinical Endocrinology. 1978 November; 9(5): 455-61. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=569031&dopt=Abstract

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The effect of maternal heroin addiction on neonatal jaundice. Author(s): Nathenson G, Cohen MI, Litt IF, McNamara H. Source: The Journal of Pediatrics. 1972 November; 81(5): 899-903. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=5086717&dopt=Abstract

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The growth of heroin addiction in the United Kingdom. Author(s): Spear HB. Source: The British Journal of Addiction to Alcohol and Other Drugs. 1969 October; 64(2): 245-55. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=5259111&dopt=Abstract

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The heroin market, crime and treatment of heroin addiction in Atlanta. Author(s): Alexander M. Source: Proc Natl Conf Methadone Treat. 1973; 1: 733-51. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=4808227&dopt=Abstract

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The impact of heroin addiction upon criminality. Author(s): Ball JC, Rosen L, Friedman EG, Nurco DN. Source: Nida Res Monogr. 1979; 27: 163-9. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=121331&dopt=Abstract

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The influence of Canadian addicts on heroin addiction in the United Kingdom. Author(s): Spear HB, Glatt MM. Source: The British Journal of Addiction to Alcohol and Other Drugs. 1971 September; 66(2): 141-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=5289087&dopt=Abstract

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The major medical complications of heroin addiction. Author(s): Louria DB, Hensle T, Rose J. Source: Annals of Internal Medicine. 1967 July; 67(1): 1-22. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=5339228&dopt=Abstract

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The management of heroin addiction at a general hospital drug addiction treatment centre. Author(s): Hicks RC. Source: The British Journal of Addiction to Alcohol and Other Drugs. 1969 October; 64(2): 235-43. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=5259110&dopt=Abstract

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The operation of the data system in the methadone maintenance treatment program for heroin addiction. Author(s): Warner A, Dole VP. Source: American Journal of Public Health. 1971 October; 61(10): 2106-14. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=5096810&dopt=Abstract

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The quest of therapy for heroin addiction. Experience with calcium gluconate. Author(s): Williams EY, Rickman EE, Elder ZB. Source: Journal of the National Medical Association. 1972 May; 64(3): 205-10. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=5035713&dopt=Abstract

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The sixth Thomas James Okey Memorial Lecture. Vietnam veterans' rapid recovery from heroin addiction: a fluke or normal expectation? Author(s): Robins LN. Source: Addiction (Abingdon, England). 1993 August; 88(8): 1041-54. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8401158&dopt=Abstract

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The treatment of heroin addiction: naltrexone alone and with behavior therapy. Author(s): Callahan EJ, Rawson RA, McCleave B, Arias R, Glazer M, Liberman RP. Source: Int J Addict. 1980 August; 15(6): 795-807. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7461877&dopt=Abstract

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The use of l-alpha-acetylmethadol in treatment of heroin addiction: an open study. Author(s): Wilson BK, Spannagel V, Thomson CP. Source: Int J Addict. 1976; 11(6): 1091-100. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1025033&dopt=Abstract

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Time for a new approach to heroin addiction, Vancouver says. Author(s): Jones D. Source: Cmaj : Canadian Medical Association Journal = Journal De L'association Medicale Canadienne. 2003 June 24; 168(13): 1699. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12821633&dopt=Abstract

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Transverse myelitis associated with heroin addiction. Author(s): Richter RW, Rosenberg RN. Source: Jama : the Journal of the American Medical Association. 1968 November 4; 206(6): 1255-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=5695789&dopt=Abstract

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Transverse myelopathy as an illustration of the neurologic and neuropathologic features of heroin addiction. Author(s): Pearson J, Richter RW, Baden MM, Challenor YB, Brunn B. Source: Human Pathology. 1972 March; 3(1): 107-13. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=5060674&dopt=Abstract

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Treating heroin addiction at Simmons House. Author(s): Greaves GM, Ryz K. Source: Nurs Times. 1970 January 8; 66(2): 49-50. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=5410533&dopt=Abstract

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Treating heroin addiction: comparison of methadone therapy, hospital therapy without methadone, and therapeutic community. Author(s): Vidjak N. Source: Croatian Medical Journal. 2003 February; 44(1): 59-64. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12590430&dopt=Abstract

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Treatment of heroin addiction with aversion therapy, relaxation training and systematic desensitization. Author(s): O'Brien JS, Raynes AE, Patch VD. Source: Behaviour Research and Therapy. 1972 February; 10(1): 77-80. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=5030251&dopt=Abstract

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Treatment of heroin addiction. Author(s): Jolliffe DW, Melville AW. Source: J R Coll Gen Pract. 1983 June; 33(251): 368. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6887104&dopt=Abstract

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Treatment of heroin addiction. Author(s): Oppenheim GB. Source: Lancet. 1969 June 7; 1(7606): 1154-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=4182716&dopt=Abstract

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Treatment of heroin addiction. Author(s): Chapple PA, Gray G, Marks V. Source: Lancet. 1969 May 3; 1(7601): 940. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=4180912&dopt=Abstract

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Treatment of heroin addiction. Multimodality approach. Author(s): Kissin B, Sang E. Source: N Y State J Med. 1973 May 1; 73(9): 1059-65. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=4512163&dopt=Abstract

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U.S.A. and British attitudes to heroin addiction and treatment centres. Author(s): Merry J. Source: The British Journal of Addiction to Alcohol and Other Drugs. 1968 December; 63(3): 247-50. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=5249831&dopt=Abstract

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Unusual complication of heroin addiction. Author(s): Roselle HA, Mezzigan E, Yale NE Jr. Source: Jama : the Journal of the American Medical Association. 1971 May 31; 216(9): 1483. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=5108526&dopt=Abstract

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Urine testing schedules in methadone maintenance treatment of heroin addiction. Author(s): Goldstein A, Brown BW Jr. Source: Jama : the Journal of the American Medical Association. 1970 October 12; 214(2): 311-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=5469069&dopt=Abstract

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Use of fluoxetine in heroin addiction. Author(s): Maremmani I, Castrogiovanni P, Daini L, Zolesi O. Source: The British Journal of Psychiatry; the Journal of Mental Science. 1992 April; 160: 570-1. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1571772&dopt=Abstract

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Use of heroin addiction scale to differentiate addicts from rehabilitation clients. Author(s): Kwant F, Rice JA, Hays JR. Source: Psychological Reports. 1976 April; 38(2): 547-53. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1265186&dopt=Abstract

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Vascular hepatotoxicity related to heroin addiction. Author(s): de Araujo MS, Gerard F, Chossegros P, Porto LC, Barlet P, Grimaud JA. Source: Virchows Arch a Pathol Anat Histopathol. 1990; 417(6): 497-503. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2125388&dopt=Abstract

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What can professional psychotherapists do about heroin addiction? Author(s): Alexander BK. Source: Med Law. 1986; 5(4): 323-30. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3784793&dopt=Abstract

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CHAPTER 2. NUTRITION AND HEROIN ADDICTION Overview In this chapter, we will show you how to find studies dedicated specifically to nutrition and heroin addiction.

Finding Nutrition Studies on Heroin Addiction The National Institutes of Health’s Office of Dietary Supplements (ODS) offers a searchable bibliographic database called the IBIDS (International Bibliographic Information on Dietary Supplements; National Institutes of Health, Building 31, Room 1B29, 31 Center Drive, MSC 2086, Bethesda, Maryland 20892-2086, Tel: 301-435-2920, Fax: 301-480-1845, E-mail: [email protected]). The IBIDS contains over 460,000 scientific citations and summaries about dietary supplements and nutrition as well as references to published international, scientific literature on dietary supplements such as vitamins, minerals, and botanicals.7 The IBIDS includes references and citations to both human and animal research studies. As a service of the ODS, access to the IBIDS database is available free of charge at the following Web address: http://ods.od.nih.gov/databases/ibids.html. After entering the search area, you have three choices: (1) IBIDS Consumer Database, (2) Full IBIDS Database, or (3) Peer Reviewed Citations Only. Now that you have selected a database, click on the “Advanced” tab. An advanced search allows you to retrieve up to 100 fully explained references in a comprehensive format. Type “heroin addiction” (or synonyms) into the search box, and click “Go.” To narrow the search, you can also select the “Title” field.

7 Adapted from http://ods.od.nih.gov. IBIDS is produced by the Office of Dietary Supplements (ODS) at the National Institutes of Health to assist the public, healthcare providers, educators, and researchers in locating credible, scientific information on dietary supplements. IBIDS was developed and will be maintained through an interagency partnership with the Food and Nutrition Information Center of the National Agricultural Library, U.S. Department of Agriculture.

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The following information is typical of that found when using the “Full IBIDS Database” to search for “heroin addiction” (or a synonym): •

A randomized trial of adding fluoxetine to a naltrexone treatment programme for heroin addicts. Author(s): Centro de Drogodependencias de Barakaldo, Vizcaya, Spain. Source: Landabaso, M A Iraurgi, I Jimenez Lerma, J M Sanz, J Fernadez de Corres, B Araluce, K Calle, R Gutierrez Fraile, M Addiction. 1998 May; 93(5): 739-44 0965-2140

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Altered HPA axis responsivity to metyrapone testing in methadone maintained former heroin addicts with ongoing cocaine addiction. Author(s): Laboratory of the Biology of Addictive Diseases, The Rockefeller University, New York, NY 10021-6399, USA. Source: Schluger, J H Borg, L Ho, A Kreek, M J Neuropsychopharmacology. 2001 May; 24(5): 568-75 0893-133X

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B vitamins status: effect of prolonged heroin addiction and methadone treatment. Author(s): Department of Clinical Tropical Medicine, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand. Source: Prayurahong, B Migasena, P Pongpaew, P Vudhivai, N Busapathumrong, P JMed-Assoc-Thai. 1991 March; 74(3): 131-5 0125-2208

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Buprenorphine responders: a diagnostic subgroup of heroin addicts? Author(s): Department of Psychiatry, New York University School of Medicine, NY. Source: Resnick, R B Resnick, E Galanter, M Prog-Neuropsychopharmacol-BiolPsychiatry. 1991; 15(4): 531-8 0278-5846

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Changes in the cAMP-related signal transduction mechanism in postmortem human brains of heroin addicts. Author(s): Department of Neuropsychiatry, School of Medicine, Sapporo Medical University, Japan. Source: Shichinohe, S Ozawa, H Hashimoto, E Tatschner, T Riederer, P Saito, T J-NeuralTransm. 2001; 108(3): 335-47

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Chronic naltrexone suppresses platelet aggregation induced by adrenaline and 5hydroxytryptamine in former heroin addicts. Author(s): Department of Pharmacology, Faculty of Medicine, University of the Basque Country, Leioa. Source: Garcia Sevilla, J A Ulibarri, I Giralt, M T Areso, P Oliveros, R G Gutierrez, M JNeural-Transm. 1988; 73(2): 157-60 0300-9564

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Clonidine and opiate receptor antagonists in the treatment of heroin addiction. Author(s): Drug Addiction Service-Parma, Italy. Source: Gerra, G Marcato, A Caccavari, R Fontanesi, B Delsignore, R Fertonani, G Avanzini, P Rustichelli, P Passeri, M J-Subst-Abuse-Treat. 1995 Jan-February; 12(1): 3541 0740-5472

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Death and survival in a cohort of heroin addicts from London clinics: a 22-year follow-up study. Author(s): Addiction Research Unit, Institute of Psychiatry, London, UK. Source: Oppenheimer, E Tobutt, C Taylor, C Andrew, T Addiction. 1994 October; 89(10): 1299-308 0965-2140

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Decreased density of I2-imidazoline receptors in the postmortem brain of heroin addicts. Author(s): Department de Biologia Fonamental i Ciencies de la Salut, Universitat de les Illes Balears, Palma de Mallorca (Balears), Spain.

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Source: Sastre, M Ventayol, P Garcia Sevilla, J A Neuroreport. 1996 January 31; 7(2): 50912 0959-4965 •

Naltrexone for heroin addiction: encouraging results from Italy. Author(s): Alcoholic and Drug Addicts Advisory Clinic, Local Health Unit N. 12, Conegliano, Italy. Source: Schifano, F Marra, R Int-J-Clin-Pharmacol-Ther-Toxicol. 1990 April; 28(4): 144-6 0174-4879

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Safety and side-effects of buprenorphine in the clinical management of heroin addiction. Author(s): Addiction Research Center, National Institute on Drug Abuse, Baltimore, MD 21224. Source: Lange, W R Fudala, P J Dax, E M Johnson, R E Drug-Alcohol-Depend. 1990 August; 26(1): 19-28 0376-8716

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Severe rhabdomyolysis mimicking transverse myelitis in a heroin addict. Author(s): Department of Medicine, Veterans General Hospital, Taipei, Taiwan, R.O.C. Source: Yang, C C Yang, G Y Ger, J Tsai, W J Deng, J F J-Toxicol-Clin-Toxicol. 1995; 33(6): 591-5 0731-3810

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The dysphoria of heroin addiction. Author(s): Psychiatry Service, Veterans Affairs Medical Center, Bronx, New York 10468. Source: Handelsman, L Aronson, M J Ness, R Cochrane, K J Kanof, P D Am-J-DrugAlcohol-Abuse. 1992; 18(3): 275-87 0095-2990

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The role of withdrawal in heroin addiction: enhances reward or promotes avoidance? Author(s): Department of Experimental Psychology, University of Cambridge, Downing Street, Cambridge CB23EB, UK. [email protected] Source: Hutcheson, D M Everitt, B J Robbins, T W Dickinson, A Nat-Neurosci. 2001 September; 4(9): 943-7 1097-6256

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The treatment of heroin addicts with dextromethorphan: a double-blind comparison of dextromethorphan with chlorpromazine. Author(s): Istanbul Medical Faculty, Department of Pharmacology and Clinical Pharmacology, Turkey. Source: Koyuncuoglu, H Saydam, B Int-J-Clin-Pharmacol-Ther-Toxicol. 1990 April; 28(4): 147-52 0174-4879

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Use of qigong therapy in the detoxification of heroin addicts. Author(s): Institute of Qigong Research, Guangzhou University, People's Republic of China. Source: Li, Ming Chen, Kevin Mo, Zhixian Altern-Ther-Health-Med. 2002 Jan-February; 8(1): 50-4, 56-9 1078-6791

Federal Resources on Nutrition In addition to the IBIDS, the United States Department of Health and Human Services (HHS) and the United States Department of Agriculture (USDA) provide many sources of information on general nutrition and health. Recommended resources include: •

healthfinder®, HHS’s gateway to health information, including diet and nutrition: http://www.healthfinder.gov/scripts/SearchContext.asp?topic=238&page=0

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•

The United States Department of Agriculture’s Web site dedicated to nutrition information: www.nutrition.gov

•

The Food and Drug Administration’s Web site for federal food safety information: www.foodsafety.gov

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The National Action Plan on Overweight and Obesity sponsored by the United States Surgeon General: http://www.surgeongeneral.gov/topics/obesity/

•

The Center for Food Safety and Applied Nutrition has an Internet site sponsored by the Food and Drug Administration and the Department of Health and Human Services: http://vm.cfsan.fda.gov/

•

Center for Nutrition Policy and Promotion sponsored by the United States Department of Agriculture: http://www.usda.gov/cnpp/

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Food and Nutrition Information Center, National Agricultural Library sponsored by the United States Department of Agriculture: http://www.nal.usda.gov/fnic/

•

Food and Nutrition Service sponsored by the United States Department of Agriculture: http://www.fns.usda.gov/fns/

Additional Web Resources A number of additional Web sites offer encyclopedic information covering food and nutrition. The following is a representative sample: •

AOL: http://search.aol.com/cat.adp?id=174&layer=&from=subcats

•

Family Village: http://www.familyvillage.wisc.edu/med_nutrition.html

•

Google: http://directory.google.com/Top/Health/Nutrition/

•

Healthnotes: http://www.healthnotes.com/

•

Open Directory Project: http://dmoz.org/Health/Nutrition/

•

Yahoo.com: http://dir.yahoo.com/Health/Nutrition/

•

WebMD®Health: http://my.webmd.com/nutrition

•

WholeHealthMD.com: http://www.wholehealthmd.com/reflib/0,1529,00.html

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CHAPTER 3. ALTERNATIVE MEDICINE AND HEROIN ADDICTION Overview In this chapter, we will begin by introducing you to official information sources on complementary and alternative medicine (CAM) relating to heroin addiction. At the conclusion of this chapter, we will provide additional sources.

National Center for Complementary and Alternative Medicine The National Center for Complementary and Alternative Medicine (NCCAM) of the National Institutes of Health (http://nccam.nih.gov/) has created a link to the National Library of Medicine’s databases to facilitate research for articles that specifically relate to heroin addiction and complementary medicine. To search the database, go to the following Web site: http://www.nlm.nih.gov/nccam/camonpubmed.html. Select “CAM on PubMed.” Enter “heroin addiction” (or synonyms) into the search box. Click “Go.” The following references provide information on particular aspects of complementary and alternative medicine that are related to heroin addiction: •

“Have a piss, drink ogogoro, smoke igbo, but don't take gbana”--hard and soft drugs in Nigeria: a critical comparison of official policies and the view on the street. Author(s): Klein A. Source: J Psychoactive Drugs. 2001 April-June; 33(2): 111-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11476258&dopt=Abstract

•

A cognitive behavioral analysis of relaxation training in drug abusers. Author(s): Chaney EF, Roszell DK. Source: Drug and Alcohol Dependence. 1983 October; 12(2): 201-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6360608&dopt=Abstract

•

A free clinic approach to drug abuse. Author(s): Gay GR, Smith DE.

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Source: Preventive Medicine. 1973 December; 2(4): 543-53. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=4778462&dopt=Abstract •

A multiple baseline analysis of treatment for heroin addiction. Author(s): Epstein LH, Parker FC, Jenkins CC. Source: Addictive Behaviors. 1976; 1(4): 327-30. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=998363&dopt=Abstract

•

A primer on heroin. Author(s): Kaplan J. Source: Stanford Law Rev. 1975 February; 27(3): 801-26. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=800295&dopt=Abstract

•

A randomized double-blind study of neuroelectric therapy in opiate and cocaine detoxification. Author(s): Gariti P, Auriacombe M, Incmikoski R, McLellan AT, Patterson L, Dhopesh V, Mezochow J, Patterson M, O'Brien C. Source: Journal of Substance Abuse. 1992; 4(3): 299-308. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1458046&dopt=Abstract

•

A review of biofeedback for mental disorders. Author(s): Futterman AD, Shapiro D. Source: Hosp Community Psychiatry. 1986 January; 37(1): 27-33. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3510953&dopt=Abstract

•

A self-help group for drug-addicted clients. Assisted implementation in outpatient treatment. Author(s): Felix-Ortiz de la Garza M, Sorensen JL. Source: Journal of Substance Abuse Treatment. 1995 July-August; 12(4): 259-68. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8830153&dopt=Abstract

•

Acupuncture and addiction: an overview. Author(s): Lau MP. Source: Addict Dis. 1976; 2(3): 449-63. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=937095&dopt=Abstract

•

Acupuncture for crack-cocaine detoxification: experimental evaluation of efficacy. Author(s): Lipton DS, Brewington V, Smith M. Source: Journal of Substance Abuse Treatment. 1994 May-June; 11(3): 205-15. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8072048&dopt=Abstract

Alternative Medicine 57

•

Acupuncture heroin detoxification: a single-blind clinical trial. Author(s): Washburn AM, Fullilove RE, Fullilove MT, Keenan PA, McGee B, Morris KA, Sorensen JL, Clark WW. Source: Journal of Substance Abuse Treatment. 1993 July-August; 10(4): 345-51. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8411294&dopt=Abstract

•

Acupuncture in heroin addicts; changes in Met-enkephalin and beta-endorphin in blood and cerebrospinal fluid. Author(s): Clement-Jones V, McLoughlin L, Lowry PJ, Besser GM, Rees LH, Wen HL. Source: Lancet. 1979 August 25; 2(8139): 380-3. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=89447&dopt=Abstract

•

Acupuncture in heroin withdrawal. Author(s): Sainsbury MJ. Source: The Medical Journal of Australia. 1974 July 20; 2(3): 102-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=4547132&dopt=Abstract

•

Acupuncture in narcotic withdrawal: a preliminary report on biochemical changes in the blood and urine of heroin addicts. Author(s): Wen HL, Ng YH, Ho WK, Fung KP, Wong HK, Ma L, Wong HC. Source: Bull Narc. 1978 April-June; 30(2): 31-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=216444&dopt=Abstract

•

Acupuncture in the treatment of addiction: a review and analysis. Author(s): Whitehead PC. Source: Int J Addict. 1978 January; 13(1): 1-16. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=344235&dopt=Abstract

•

Autonomic functions and audiovisual reaction time in heroin addicts. Author(s): Kapoor R, Singh SH, Gandhi A. Source: Indian J Physiol Pharmacol. 1993 July; 37(3): 209-12. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8276497&dopt=Abstract

•

Fast detoxification of heroin addicts by acupuncture and electrical stimulation (AES) in combination with naloxone. Author(s): Wen HL. Source: Comp Med East West. 1977 Fall-Winter; 5(3-4): 257-63. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=610976&dopt=Abstract

•

Immunoassayable beta-endorphin level in the plasma and CSF of heroin addicted and normal subjects before and after electroacupuncture. Author(s): Wen HL, Ho WK, Ling N, Mehal ZD, Ng YH.

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Source: The American Journal of Chinese Medicine. 1980 Spring-Summer; 8(1-2): 154-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6967253&dopt=Abstract •

Impaired ACTH and beta-endorphin response to sauna-induced hyperthermia in heroin addicts. Author(s): Vescovi PP, Pedrazzoni M, Gerra G, Pioli G, Maninetti L, Michelini M, Passeri M. Source: Acta Endocrinol (Copenh). 1989 October; 121(4): 484-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2552728&dopt=Abstract

•

Impaired prolactin response to hyperthermia in heroin addicts. Author(s): Vescovi PP, Pedrazzoni M, Maninetti L, Pioli G, Gerra G, Passeri M. Source: Acta Endocrinol (Copenh). 1990 December; 123(6): 619-21. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2126655&dopt=Abstract

•

Inhibition by peripheral electric stimulation of the reinstatement of morphineinduced place preference in rats and drug-craving in heroin addicts. Author(s): Wang B, Zhang B, Ge X, Luo F, Han J. Source: Beijing Da Xue Xue Bao. 2003 June 18; 35(3): 241-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12914237&dopt=Abstract

•

Juvenile drug addiction: a typology of heroin addicts and their families. Author(s): Cancrini L, Cingolani S, Compagnoni F, Costantini D, Mazzoni S. Source: Family Process. 1988 September; 27(3): 261-71. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3224697&dopt=Abstract

•

Ketamine psychotherapy for heroin addiction: immediate effects and two-year follow-up. Author(s): Krupitsky E, Burakov A, Romanova T, Dunaevsky I, Strassman R, Grinenko A. Source: Journal of Substance Abuse Treatment. 2002 December; 23(4): 273-83. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12495789&dopt=Abstract

•

Opioid receptor imaging with positron emission tomography and [(18)F]cyclofoxy in long-term, methadone-treated former heroin addicts. Author(s): Kling MA, Carson RE, Borg L, Zametkin A, Matochik JA, Schluger J, Herscovitch P, Rice KC, Ho A, Eckelman WC, Kreek MJ. Source: The Journal of Pharmacology and Experimental Therapeutics. 2000 December; 295(3): 1070-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11082442&dopt=Abstract

•

The changing face of heroin addiction in the Haight-Ashbury. Author(s): Sheppard CW, Smith DE, Gay GR.

Alternative Medicine 59

Source: Int J Addict. 1972; 7(1): 109-22. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=5043828&dopt=Abstract •

Therapeutic effect of abstinence capsule on withdrawal symptoms of heroin addicts. Author(s): Yang X, Mao C, Jing F, Zhu G, Yang J, Liu G, Fang Z, Li Y, Cao X. Source: J Tradit Chin Med. 1999 December; 19(4): 243-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10921125&dopt=Abstract

•

Treatment of heroin addiction with aversion therapy, relaxation training and systematic desensitization. Author(s): O'Brien JS, Raynes AE, Patch VD. Source: Behaviour Research and Therapy. 1972 February; 10(1): 77-80. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=5030251&dopt=Abstract

•

Use of qigong therapy in the detoxification of heroin addicts. Author(s): Li M, Chen K, Mo Z. Source: Alternative Therapies in Health and Medicine. 2002 January-February; 8(1): 50-4, 56-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11795622&dopt=Abstract

Additional Web Resources A number of additional Web sites offer encyclopedic information covering CAM and related topics. The following is a representative sample: •

Alternative Medicine Foundation, Inc.: http://www.herbmed.org/

•

AOL: http://search.aol.com/cat.adp?id=169&layer=&from=subcats

•

Chinese Medicine: http://www.newcenturynutrition.com/

•

drkoop.com®: http://www.drkoop.com/InteractiveMedicine/IndexC.html

•

Family Village: http://www.familyvillage.wisc.edu/med_altn.htm

•

Google: http://directory.google.com/Top/Health/Alternative/

•

Healthnotes: http://www.healthnotes.com/

•

MedWebPlus: http://medwebplus.com/subject/Alternative_and_Complementary_Medicine

•

Open Directory Project: http://dmoz.org/Health/Alternative/

•

HealthGate: http://www.tnp.com/

•

WebMD®Health: http://my.webmd.com/drugs_and_herbs

•

WholeHealthMD.com: http://www.wholehealthmd.com/reflib/0,1529,00.html

•

Yahoo.com: http://dir.yahoo.com/Health/Alternative_Medicine/

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General References A good place to find general background information on CAM is the National Library of Medicine. It has prepared within the MEDLINEplus system an information topic page dedicated to complementary and alternative medicine. To access this page, go to the MEDLINEplus site at http://www.nlm.nih.gov/medlineplus/alternativemedicine.html. This Web site provides a general overview of various topics and can lead to a number of general sources.

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CHAPTER 4. DISSERTATIONS ON HEROIN ADDICTION Overview In this chapter, we will give you a bibliography on recent dissertations relating to heroin addiction. We will also provide you with information on how to use the Internet to stay current on dissertations. IMPORTANT NOTE: When following the search strategy described below, you may discover non-medical dissertations that use the generic term “heroin addiction” (or a synonym) in their titles. To accurately reflect the results that you might find while conducting research on heroin addiction, we have not necessarily excluded non-medical dissertations in this bibliography.

Dissertations on Heroin Addiction ProQuest Digital Dissertations, the largest archive of academic dissertations available, is located at the following Web address: http://wwwlib.umi.com/dissertations. From this archive, we have compiled the following list covering dissertations devoted to heroin addiction. You will see that the information provided includes the dissertation’s title, its author, and the institution with which the author is associated. The following covers recent dissertations found when using this search procedure: •

A Sociocultural Study of Alcoholism and Heroin Addiction. by Carney, Francis Joseph, Jr., PhD from Tufts University, 1974, 669 pages http://wwwlib.umi.com/dissertations/fullcit/7521220

•

An Exploratory Study of Heroin Addiction among White, Middle-class Male Addicts Receiving Methadone Maintenance Treatment by Platt, Joshua Paul, PhD from University of Pittsburgh, 1985, 167 pages http://wwwlib.umi.com/dissertations/fullcit/8517994

•

From Down Under: a Qualitative Study on Heroin Addiction Recovery by Cloud, William A., PhD from University of Denver, 1987, 228 pages http://wwwlib.umi.com/dissertations/fullcit/8728718

•

Heroin Addiction, Anomie, and Social Policy in the United States and Britain (narcotics, Drugs, Epidemiology, Sociocultural, Sociology) by Hamm, Mark Steven, DPA from Arizona State University, 1985, 220 pages http://wwwlib.umi.com/dissertations/fullcit/8514325

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•

Heroin Addiction: a Study of Deviance and Group Relations. by Hunt, Dana Eser, PhD from University of Pennsylvania, 1976, 194 pages http://wwwlib.umi.com/dissertations/fullcit/7700846

•

Locus of Control and Heroin Addiction in a Methadone Maintenance Setting by Heinbach, Henry, DSW from Yeshiva University, 1996, 203 pages http://wwwlib.umi.com/dissertations/fullcit/9638327

•

Personality Profiles and Psychological Orientations of Employed and Unemployed Rehabilitated Male Heroin Addicts: a Comparison Study by Gandell, Maria Dolores Martinez De, PhD from The Ohio State University, 1981, 257 pages http://wwwlib.umi.com/dissertations/fullcit/8207185

•

That Fast Life: an Emic Ethnography of the Black Heroin Addict Hustler by Rosenstiel, Charles Ronald, PhD from University of Kentucky, 1980, 285 pages http://wwwlib.umi.com/dissertations/fullcit/8028000

•

The Economics of Heroin Addiction and Criminal Activity by Wilkins, Allen J., PhD from the University of Wisconsin - Madison, 1984, 208 pages http://wwwlib.umi.com/dissertations/fullcit/8422720

Keeping Current Ask the medical librarian at your library if it has full and unlimited access to the ProQuest Digital Dissertations database. From the library, you should be able to do more complete searches via http://wwwlib.umi.com/dissertations.

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CHAPTER 5. CLINICAL TRIALS AND HEROIN ADDICTION Overview In this chapter, we will show you how to keep informed of the latest clinical trials concerning heroin addiction.

Recent Trials on Heroin Addiction The following is a list of recent trials dedicated to heroin addiction.8 Further information on a trial is available at the Web site indicated. •

Effects of Dynorphin 1-13 on Heroin Addiction - 1 Condition(s): Opioid-Related Disorders; Substance Withdrawal Syndrome Study Status: This study is completed. Sponsor(s): National Institute on Drug Abuse (NIDA); University of Minnesota Purpose - Excerpt: Evaluate effects of IV dynorphin in humans during acute heroin abstinence, in order to determine that dynorphin suppresses acute opiate withdrawal, reduces opiate craving, and is safe at doses required to produce the above effects. Phase(s): Phase II Study Type: Observational Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00000244

Keeping Current on Clinical Trials The U.S. National Institutes of Health, through the National Library of Medicine, has developed ClinicalTrials.gov to provide current information about clinical research across the broadest number of diseases and conditions.

8

These are listed at www.ClinicalTrials.gov.

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The site was launched in February 2000 and currently contains approximately 5,700 clinical studies in over 59,000 locations worldwide, with most studies being conducted in the United States. ClinicalTrials.gov receives about 2 million hits per month and hosts approximately 5,400 visitors daily. To access this database, simply go to the Web site at http://www.clinicaltrials.gov/ and search by “heroin addiction” (or synonyms). While ClinicalTrials.gov is the most comprehensive listing of NIH-supported clinical trials available, not all trials are in the database. The database is updated regularly, so clinical trials are continually being added. The following is a list of specialty databases affiliated with the National Institutes of Health that offer additional information on trials: •

For clinical studies at the Warren Grant Magnuson Clinical Center located in Bethesda, Maryland, visit their Web site: http://clinicalstudies.info.nih.gov/

•

For clinical studies conducted at the Bayview Campus in Baltimore, Maryland, visit their Web site: http://www.jhbmc.jhu.edu/studies/index.html

•

For cancer trials, visit the National Cancer Institute: http://cancertrials.nci.nih.gov/

•

For eye-related trials, visit and search the Web page of the National Eye Institute: http://www.nei.nih.gov/neitrials/index.htm

•

For heart, lung and blood trials, visit the Web page of the National Heart, Lung and Blood Institute: http://www.nhlbi.nih.gov/studies/index.htm

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For trials on aging, visit and search the Web site of the National Institute on Aging: http://www.grc.nia.nih.gov/studies/index.htm

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For rare diseases, visit and search the Web site sponsored by the Office of Rare Diseases: http://ord.aspensys.com/asp/resources/rsch_trials.asp

•

For alcoholism, visit the National Institute on Alcohol Abuse and Alcoholism: http://www.niaaa.nih.gov/intramural/Web_dicbr_hp/particip.htm

•

For trials on infectious, immune, and allergic diseases, visit the site of the National Institute of Allergy and Infectious Diseases: http://www.niaid.nih.gov/clintrials/

•

For trials on arthritis, musculoskeletal and skin diseases, visit newly revised site of the National Institute of Arthritis and Musculoskeletal and Skin Diseases of the National Institutes of Health: http://www.niams.nih.gov/hi/studies/index.htm

•

For hearing-related trials, visit the National Institute on Deafness and Other Communication Disorders: http://www.nidcd.nih.gov/health/clinical/index.htm

•

For trials on diseases of the digestive system and kidneys, and diabetes, visit the National Institute of Diabetes and Digestive and Kidney Diseases: http://www.niddk.nih.gov/patient/patient.htm

•

For drug abuse trials, visit and search the Web site sponsored by the National Institute on Drug Abuse: http://www.nida.nih.gov/CTN/Index.htm

•

For trials on mental disorders, visit and search the Web site of the National Institute of Mental Health: http://www.nimh.nih.gov/studies/index.cfm

•

For trials on neurological disorders and stroke, visit and search the Web site sponsored by the National Institute of Neurological Disorders and Stroke of the NIH: http://www.ninds.nih.gov/funding/funding_opportunities.htm#Clinical_Trials

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CHAPTER 6. BOOKS ON HEROIN ADDICTION Overview This chapter provides bibliographic book references relating to heroin addiction. In addition to online booksellers such as www.amazon.com and www.bn.com, excellent sources for book titles on heroin addiction include the Combined Health Information Database and the National Library of Medicine. Your local medical library also may have these titles available for loan.

Book Summaries: Online Booksellers Commercial Internet-based booksellers, such as Amazon.com and Barnes&Noble.com, offer summaries which have been supplied by each title’s publisher. Some summaries also include customer reviews. Your local bookseller may have access to in-house and commercial databases that index all published books (e.g. Books in Print®). IMPORTANT NOTE: Online booksellers typically produce search results for medical and non-medical books. When searching for “heroin addiction” at online booksellers’ Web sites, you may discover non-medical books that use the generic term “heroin addiction” (or a synonym) in their titles. The following is indicative of the results you might find when searching for “heroin addiction” (sorted alphabetically by title; follow the hyperlink to view more details at Amazon.com): •

A Small Journal of Heroin Addiction by Robin Marchesi, Robin Marchesi (2000); ISBN: 0743300521; http://www.amazon.com/exec/obidos/ASIN/0743300521/icongroupinterna

•

A World of Opportunities: Life-Style and Economic Behavior of Heroin Addicts in Amsterdam (Suny Series in New Social Studies on Alcohol and Drugs) by Ed Leuw, et al (1995); ISBN: 0791422410; http://www.amazon.com/exec/obidos/ASIN/0791422410/icongroupinterna

•

Behind the Wall of Respect: Community Experiments in Heroin Addiction Control by Patrick H. Hughes; ISBN: 0226359301; http://www.amazon.com/exec/obidos/ASIN/0226359301/icongroupinterna

•

Effective medical treatment of heroin addiction : January 1994 through September 1997 plus selected earlier citations : 941 citations (SuDoc HE 20.3615/2:97-7) by Mary E.

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Conway; ISBN: B00010UP5E; http://www.amazon.com/exec/obidos/ASIN/B00010UP5E/icongroupinterna •

Heroin Addiction; ISBN: 0898746949; http://www.amazon.com/exec/obidos/ASIN/0898746949/icongroupinterna

•

Heroin Addiction and Drug Policy: The British System by John Strang (Editor), Michael Gossop (Editor) (1994); ISBN: 0192620460; http://www.amazon.com/exec/obidos/ASIN/0192620460/icongroupinterna

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Heroin Addiction Care and Control by Spear; ISBN: 1904319041; http://www.amazon.com/exec/obidos/ASIN/1904319041/icongroupinterna

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Heroin addiction in Britain; what Americans can learn from the English experience by Horace Freeland Judson; ISBN: 0151400989; http://www.amazon.com/exec/obidos/ASIN/0151400989/icongroupinterna

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Heroin Addiction: Theory, Research, and Treatment: Treatment Advances and AIDS by Jerome J. Platt (1995); ISBN: 0894648810; http://www.amazon.com/exec/obidos/ASIN/0894648810/icongroupinterna

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Heroin Addiction: Treatment and Control in Britain by Edna Oppenheimer, Gerry V. Stimson; ISBN: 0422778907; http://www.amazon.com/exec/obidos/ASIN/0422778907/icongroupinterna

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Heroin Addiction: What Americans Can Learn from the English Experience by Horace Freeland. Judson; ISBN: 0394720172; http://www.amazon.com/exec/obidos/ASIN/0394720172/icongroupinterna

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Mainline to nowhere; the making of a heroin addict by Yves J. Kron (Author), Edward M. Brown (Author); ISBN: B00005WC1P; http://www.amazon.com/exec/obidos/ASIN/B00005WC1P/icongroupinterna

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Pathways from Heroin Addiction: Recovery Without Treatment (Health, Society, and Policy) by Patrick Biernacki; ISBN: 0877224102; http://www.amazon.com/exec/obidos/ASIN/0877224102/icongroupinterna

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Personality characteristics of heroin addicts and their professed reasons for heroin use by Richard H. Fulmer; ISBN: 089561054X; http://www.amazon.com/exec/obidos/ASIN/089561054X/icongroupinterna

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Prescription of Narcotics for Heroin Addicts: Main Result of the Swiss National Cohort Study by Ambros Uchtenhagen (Editor) (1999); ISBN: 380556791X; http://www.amazon.com/exec/obidos/ASIN/380556791X/icongroupinterna

•

Rio Arriba County strategy to combat heroin addiction : hearing before a subcommittee of the Committee on Appropriations, United States Senate, One Hundred Sixth Congress, first session, special hearing (SuDoc Y 4.AP 6/2:S.HRG.10674); ISBN: 0160587042; http://www.amazon.com/exec/obidos/ASIN/0160587042/icongroupinterna

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Ripping and running; a formal ethnography of urban heroin addicts by Michael Agar; ISBN: 0128021500; http://www.amazon.com/exec/obidos/ASIN/0128021500/icongroupinterna

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The De-Addiction Process; Studies in the De-Addiction of Confirmed Heroin Addicts. by Leon. Brill; ISBN: 0398025320; http://www.amazon.com/exec/obidos/ASIN/0398025320/icongroupinterna

Books

•

The Street Addict Role: A Theory of Heroin Addiction (Suny Series, the New Inequalities) by Richard C. Stephens (1991); ISBN: 0791406202; http://www.amazon.com/exec/obidos/ASIN/0791406202/icongroupinterna

•

Treating the Heroin Addict (4 Cassettes) by Cardwell C. Nuckols; ISBN: 1561680044; http://www.amazon.com/exec/obidos/ASIN/1561680044/icongroupinterna

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The National Library of Medicine Book Index The National Library of Medicine at the National Institutes of Health has a massive database of books published on healthcare and biomedicine. Go to the following Internet site, http://locatorplus.gov/, and then select “Search LOCATORplus.” Once you are in the search area, simply type “heroin addiction” (or synonyms) into the search box, and select “books only.” From there, results can be sorted by publication date, author, or relevance. The following was recently catalogued by the National Library of Medicine:9 •

An exploration of the natural history of heroin addiction. Author: Henderson, Irwin.; Year: 1970; Vancouver, Narcotic

•

Army drug abuse program: a future model? A report prepared by John E. Flaherty, Jr. of the Task Force on Federal Heroin Addiction Programs and submitted to the Criminal Law Section of the American Bar Association and the Drug Abuse Council. Author: Flaherty, John E.; Year: 1973; [Washington, Drug Abuse Council, c1973]

•

Community implications of methadone use in treating heroin addiction; a technical guide. Author: Public Technology, inc.; Year: 1973; Washington, 1973

•

Drug culture in India: a street ethnographic study of heroin addiction in Bombay Author: Charles, M.; Year: 1999; Jaipur, India, Rawat Publications, 1999

•

Effective medical treatment of heroin addiction: January 1994 through September 1997 plus selected earlier citations: 941 citations Author: Conway, Mary E. (Mary Elizabeth); Year: 1997; Bethesda, Md.: U.S. Dept. of Health and Human Services, Public Health Service, National Institutes of Health, National Library of Medicine, Reference Section, [1997]

•

Heroin addiction Author: Platt, Jerome J.; Year: 9999; Malabar, Fla.: R.E. Krieger Pub. Co., 1988, c1986-; ISBN: 0894643258 http://www.amazon.com/exec/obidos/ASIN/0894643258/icongroupinterna

•

Heroin addiction: theory, research, and treatment Author: Platt, Jerome J.; Year: 1976; New York: Wiley, c1976; ISBN: 0471691143 http://www.amazon.com/exec/obidos/ASIN/0471691143/icongroupinterna

•

NIH Consensus Development Conference on Effective Medical Treatment of Heroin Addiction: November 17-19, 1997, William H. Natcher Conference Center, National Institutes of Health, Bethesda, Md. Author: National Institute on Drug Abuse.; Year: 1997; Bethesda, Md.: National Institutes of Health, Continuing Medical Education, 1997

9

In addition to LOCATORPlus, in collaboration with authors and publishers, the National Center for Biotechnology Information (NCBI) is currently adapting biomedical books for the Web. The books may be accessed in two ways: (1) by searching directly using any search term or phrase (in the same way as the bibliographic database PubMed), or (2) by following the links to PubMed abstracts. Each PubMed abstract has a "Books" button that displays a facsimile of the abstract in which some phrases are hypertext links. These phrases are also found in the books available at NCBI. Click on hyperlinked results in the list of books in which the phrase is found. Currently, the majority of the links are between the books and PubMed. In the future, more links will be created between the books and other types of information, such as gene and protein sequences and macromolecular structures. See http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=Books.

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•

The street addict role: a theory of heroin addiction Author: Stephens, Richard C.; Year: 1991; Albany, N.Y.: State University of New York Press, c1991; ISBN: 0791406199 http://www.amazon.com/exec/obidos/ASIN/0791406199/icongroupinterna

Chapters on Heroin Addiction In order to find chapters that specifically relate to heroin addiction, an excellent source of abstracts is the Combined Health Information Database. You will need to limit your search to book chapters and heroin addiction using the “Detailed Search” option. Go to the following hyperlink: http://chid.nih.gov/detail/detail.html. To find book chapters, use the drop boxes at the bottom of the search page where “You may refine your search by.” Select the dates and language you prefer, and the format option “Book Chapter.” Type “heroin addiction” (or synonyms) into the “For these words:” box.

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CHAPTER 7. MULTIMEDIA ON HEROIN ADDICTION Overview In this chapter, we show you how to keep current on multimedia sources of information on heroin addiction. We start with sources that have been summarized by federal agencies, and then show you how to find bibliographic information catalogued by the National Library of Medicine.

Bibliography: Multimedia on Heroin Addiction The National Library of Medicine is a rich source of information on healthcare-related multimedia productions including slides, computer software, and databases. To access the multimedia database, go to the following Web site: http://locatorplus.gov/. Select “Search LOCATORplus.” Once in the search area, simply type in heroin addiction (or synonyms). Then, in the option box provided below the search box, select “Audiovisuals and Computer Files.” From there, you can choose to sort results by publication date, author, or relevance. The following multimedia has been indexed on heroin addiction: •

Battling cocaine and heroin addiction [videorecording]: an interdisciplinary approach to a persistent problem Source: Warren K. Bickel, Stephen T. Higgins; Year: 1999; Format: Videorecording; Secaucus, N.J.: Network for Continuing Medical Education, c1999

•

Chasing the dragon [videorecording]: heroin addiction Source: GWC; Year: 1997; Format: Videorecording; Cahokia, IL: GWC, c1997

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CHAPTER 8. PERIODICALS AND NEWS ON HEROIN ADDICTION Overview In this chapter, we suggest a number of news sources and present various periodicals that cover heroin addiction.

News Services and Press Releases One of the simplest ways of tracking press releases on heroin addiction is to search the news wires. In the following sample of sources, we will briefly describe how to access each service. These services only post recent news intended for public viewing. PR Newswire To access the PR Newswire archive, simply go to http://www.prnewswire.com/. Select your country. Type “heroin addiction” (or synonyms) into the search box. You will automatically receive information on relevant news releases posted within the last 30 days. The search results are shown by order of relevance. Reuters Health The Reuters’ Medical News and Health eLine databases can be very useful in exploring news archives relating to heroin addiction. While some of the listed articles are free to view, others are available for purchase for a nominal fee. To access this archive, go to http://www.reutershealth.com/en/index.html and search by “heroin addiction” (or synonyms). The following was recently listed in this archive for heroin addiction: •

Methadone care for US heroin addicts found lacking Source: Reuters Health eLine Date: August 20, 2002

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•

Take-home meds may work for some heroin addicts Source: Reuters Health eLine Date: January 11, 2002

•

For survivors, heroin addiction can last lifetime Source: Reuters Health eLine Date: May 16, 2001

•

Opioid receptor polymorphism may predispose Chinese to heroin addiction Source: Reuters Medical News Date: March 16, 2001

•

Options grow for heroin addiction treatment Source: Reuters Health eLine Date: November 02, 2000

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Longer methadone treatment best for heroin addicts Source: Reuters Health eLine Date: March 10, 2000

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Heroin addicts benefit from better access to methadone Source: Reuters Health eLine Date: March 08, 2000

•

Use of pharmaceutical heroin to treat heroin addiction considered Source: Reuters Medical News Date: May 21, 1999

•

NIH Panel Recommends Wider Use Of Methadone For Heroin Addicts Source: Reuters Medical News Date: November 20, 1997

•

Drug Czar Promotes Methadone Maintenance For Heroin Addicts Source: Reuters Medical News Date: October 06, 1997

•

Drug Reduces Heroin Addiction Source: Reuters Health eLine Date: June 24, 1997

•

Necrotizing Fasciitis In U.S. Heroin Addicts Source: Reuters Medical News Date: April 23, 1996 The NIH

Within MEDLINEplus, the NIH has made an agreement with the New York Times Syndicate, the AP News Service, and Reuters to deliver news that can be browsed by the public. Search news releases at http://www.nlm.nih.gov/medlineplus/alphanews_a.html. MEDLINEplus allows you to browse across an alphabetical index. Or you can search by date at the following Web page: http://www.nlm.nih.gov/medlineplus/newsbydate.html. Often, news items are indexed by MEDLINEplus within its search engine.

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Business Wire Business Wire is similar to PR Newswire. To access this archive, simply go to http://www.businesswire.com/. You can scan the news by industry category or company name. Market Wire Market Wire is more focused on technology than the other wires. To browse the latest press releases by topic, such as alternative medicine, biotechnology, fitness, healthcare, legal, nutrition, and pharmaceuticals, access Market Wire’s Medical/Health channel at http://www.marketwire.com/mw/release_index?channel=MedicalHealth. Or simply go to Market Wire’s home page at http://www.marketwire.com/mw/home, type “heroin addiction” (or synonyms) into the search box, and click on “Search News.” As this service is technology oriented, you may wish to use it when searching for press releases covering diagnostic procedures or tests. Search Engines Medical news is also available in the news sections of commercial Internet search engines. See the health news page at Yahoo (http://dir.yahoo.com/Health/News_and_Media/), or you can use this Web site’s general news search page at http://news.yahoo.com/. Type in “heroin addiction” (or synonyms). If you know the name of a company that is relevant to heroin addiction, you can go to any stock trading Web site (such as http://www.etrade.com/) and search for the company name there. News items across various news sources are reported on indicated hyperlinks. Google offers a similar service at http://news.google.com/. BBC Covering news from a more European perspective, the British Broadcasting Corporation (BBC) allows the public free access to their news archive located at http://www.bbc.co.uk/. Search by “heroin addiction” (or synonyms).

Academic Periodicals covering Heroin Addiction Numerous periodicals are currently indexed within the National Library of Medicine’s PubMed database that are known to publish articles relating to heroin addiction. In addition to these sources, you can search for articles covering heroin addiction that have been published by any of the periodicals listed in previous chapters. To find the latest studies published, go to http://www.ncbi.nlm.nih.gov/pubmed, type the name of the periodical into the search box, and click “Go.” If you want complete details about the historical contents of a journal, you can also visit the following Web site: http://www.ncbi.nlm.nih.gov/entrez/jrbrowser.cgi. Here, type in the name of the journal or its abbreviation, and you will receive an index of published articles. At http://locatorplus.gov/, you can retrieve more indexing information on medical

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periodicals (e.g. the name of the publisher). Select the button “Search LOCATORplus.” Then type in the name of the journal and select the advanced search option “Journal Title Search.”

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CHAPTER 9. RESEARCHING MEDICATIONS Overview While a number of hard copy or CD-ROM resources are available for researching medications, a more flexible method is to use Internet-based databases. Broadly speaking, there are two sources of information on approved medications: public sources and private sources. We will emphasize free-to-use public sources.

U.S. Pharmacopeia Because of historical investments by various organizations and the emergence of the Internet, it has become rather simple to learn about the medications recommended for heroin addiction. One such source is the United States Pharmacopeia. In 1820, eleven physicians met in Washington, D.C. to establish the first compendium of standard drugs for the United States. They called this compendium the U.S. Pharmacopeia (USP). Today, the USP is a non-profit organization consisting of 800 volunteer scientists, eleven elected officials, and 400 representatives of state associations and colleges of medicine and pharmacy. The USP is located in Rockville, Maryland, and its home page is located at http://www.usp.org/. The USP currently provides standards for over 3,700 medications. The resulting USP DI® Advice for the Patient® can be accessed through the National Library of Medicine of the National Institutes of Health. The database is partially derived from lists of federally approved medications in the Food and Drug Administration’s (FDA) Drug Approvals database, located at http://www.fda.gov/cder/da/da.htm. While the FDA database is rather large and difficult to navigate, the Phamacopeia is both user-friendly and free to use. It covers more than 9,000 prescription and over-the-counter medications. To access this database, simply type the following hyperlink into your Web browser: http://www.nlm.nih.gov/medlineplus/druginformation.html. To view examples of a given medication (brand names, category, description, preparation, proper use, precautions, side effects, etc.), simply follow the hyperlinks indicated within the United States Pharmacopeia (USP).

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Commercial Databases In addition to the medications listed in the USP above, a number of commercial sites are available by subscription to physicians and their institutions. Or, you may be able to access these sources from your local medical library.

Mosby’s Drug Consult™ Mosby’s Drug Consult™ database (also available on CD-ROM and book format) covers 45,000 drug products including generics and international brands. It provides prescribing information, drug interactions, and patient information. Subscription information is available at the following hyperlink: http://www.mosbysdrugconsult.com/.

PDRhealth The PDRhealth database is a free-to-use, drug information search engine that has been written for the public in layman’s terms. It contains FDA-approved drug information adapted from the Physicians’ Desk Reference (PDR) database. PDRhealth can be searched by brand name, generic name, or indication. It features multiple drug interactions reports. Search PDRhealth at http://www.pdrhealth.com/drug_info/index.html. Other Web Sites Drugs.com (www.drugs.com) reproduces the information in the Pharmacopeia as well as commercial information. You may also want to consider the Web site of the Medical Letter, Inc. (http://www.medletter.com/) which allows users to download articles on various drugs and therapeutics for a nominal fee.

Researching Orphan Drugs Although the list of orphan drugs is revised on a daily basis, you can quickly research orphan drugs that might be applicable to heroin addiction by using the database managed by the National Organization for Rare Disorders, Inc. (NORD), at http://www.rarediseases.org/. Scroll down the page, and on the left toolbar, click on “Orphan Drug Designation Database.” On this page (http://www.rarediseases.org/search/noddsearch.html), type “heroin addiction” (or synonyms) into the search box, and click “Submit Query.” When you receive your results, note that not all of the drugs may be relevant, as some may have been withdrawn from orphan status. Write down or print out the name of each drug and the relevant contact information. From there, visit the Pharmacopeia Web site and type the name of each orphan drug into the search box at http://www.nlm.nih.gov/medlineplus/druginformation.html. You may need to contact the sponsor or NORD for further information. NORD conducts “early access programs for investigational new drugs (IND) under the Food and Drug Administration’s (FDA’s) approval ‘Treatment INDs’ programs which allow for a limited number of individuals to receive investigational drugs before FDA marketing approval.” If the orphan product about which you are seeking information is approved for

Researching Medications

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marketing, information on side effects can be found on the product’s label. If the product is not approved, you may need to contact the sponsor. The following is a list of orphan drugs currently listed in the NORD Orphan Drug Designation Database for heroin addiction: •

Levomethadyl acetate hydrochoride (trade name: Orlaam) http://www.rarediseases.org/nord/search/nodd_full?code=245

If you have any questions about a medical treatment, the FDA may have an office near you. Look for their number in the blue pages of the phone book. You can also contact the FDA through its toll-free number, 1-888-INFO-FDA (1-888-463-6332), or on the World Wide Web at www.fda.gov.

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APPENDICES

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APPENDIX A. PHYSICIAN RESOURCES Overview In this chapter, we focus on databases and Internet-based guidelines and information resources created or written for a professional audience.

NIH Guidelines Commonly referred to as “clinical” or “professional” guidelines, the National Institutes of Health publish physician guidelines for the most common diseases. Publications are available at the following by relevant Institute10: •

Office of the Director (OD); guidelines consolidated across agencies available at http://www.nih.gov/health/consumer/conkey.htm

•

National Institute of General Medical Sciences (NIGMS); fact sheets available at http://www.nigms.nih.gov/news/facts/

•

National Library of Medicine (NLM); extensive encyclopedia (A.D.A.M., Inc.) with guidelines: http://www.nlm.nih.gov/medlineplus/healthtopics.html

•

National Cancer Institute (NCI); guidelines available at http://www.cancer.gov/cancerinfo/list.aspx?viewid=5f35036e-5497-4d86-8c2c714a9f7c8d25

•

National Eye Institute (NEI); guidelines available at http://www.nei.nih.gov/order/index.htm

•

National Heart, Lung, and Blood Institute (NHLBI); guidelines available at http://www.nhlbi.nih.gov/guidelines/index.htm

•

National Human Genome Research Institute (NHGRI); research available at http://www.genome.gov/page.cfm?pageID=10000375

•

National Institute on Aging (NIA); guidelines available at http://www.nia.nih.gov/health/

10

These publications are typically written by one or more of the various NIH Institutes.

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•

National Institute on Alcohol Abuse and Alcoholism (NIAAA); guidelines available at http://www.niaaa.nih.gov/publications/publications.htm

•

National Institute of Allergy and Infectious Diseases (NIAID); guidelines available at http://www.niaid.nih.gov/publications/

•

National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS); fact sheets and guidelines available at http://www.niams.nih.gov/hi/index.htm

•

National Institute of Child Health and Human Development (NICHD); guidelines available at http://www.nichd.nih.gov/publications/pubskey.cfm

•

National Institute on Deafness and Other Communication Disorders (NIDCD); fact sheets and guidelines at http://www.nidcd.nih.gov/health/

•

National Institute of Dental and Craniofacial Research (NIDCR); guidelines available at http://www.nidr.nih.gov/health/

•

National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK); guidelines available at http://www.niddk.nih.gov/health/health.htm

•

National Institute on Drug Abuse (NIDA); guidelines available at http://www.nida.nih.gov/DrugAbuse.html

•

National Institute of Environmental Health Sciences (NIEHS); environmental health information available at http://www.niehs.nih.gov/external/facts.htm

•

National Institute of Mental Health (NIMH); guidelines available at http://www.nimh.nih.gov/practitioners/index.cfm

•

National Institute of Neurological Disorders and Stroke (NINDS); neurological disorder information pages available at http://www.ninds.nih.gov/health_and_medical/disorder_index.htm

•

National Institute of Nursing Research (NINR); publications on selected illnesses at http://www.nih.gov/ninr/news-info/publications.html

•

National Institute of Biomedical Imaging and Bioengineering; general information at http://grants.nih.gov/grants/becon/becon_info.htm

•

Center for Information Technology (CIT); referrals to other agencies based on keyword searches available at http://kb.nih.gov/www_query_main.asp

•

National Center for Complementary and Alternative Medicine (NCCAM); health information available at http://nccam.nih.gov/health/

•

National Center for Research Resources (NCRR); various information directories available at http://www.ncrr.nih.gov/publications.asp

•

Office of Rare Diseases; various fact sheets available at http://rarediseases.info.nih.gov/html/resources/rep_pubs.html

•

Centers for Disease Control and Prevention; various fact sheets on infectious diseases available at http://www.cdc.gov/publications.htm

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NIH Databases In addition to the various Institutes of Health that publish professional guidelines, the NIH has designed a number of databases for professionals.11 Physician-oriented resources provide a wide variety of information related to the biomedical and health sciences, both past and present. The format of these resources varies. Searchable databases, bibliographic citations, full-text articles (when available), archival collections, and images are all available. The following are referenced by the National Library of Medicine:12 •

Bioethics: Access to published literature on the ethical, legal, and public policy issues surrounding healthcare and biomedical research. This information is provided in conjunction with the Kennedy Institute of Ethics located at Georgetown University, Washington, D.C.: http://www.nlm.nih.gov/databases/databases_bioethics.html

•

HIV/AIDS Resources: Describes various links and databases dedicated to HIV/AIDS research: http://www.nlm.nih.gov/pubs/factsheets/aidsinfs.html

•

NLM Online Exhibitions: Describes “Exhibitions in the History of Medicine”: http://www.nlm.nih.gov/exhibition/exhibition.html. Additional resources for historical scholarship in medicine: http://www.nlm.nih.gov/hmd/hmd.html

•

Biotechnology Information: Access to public databases. The National Center for Biotechnology Information conducts research in computational biology, develops software tools for analyzing genome data, and disseminates biomedical information for the better understanding of molecular processes affecting human health and disease: http://www.ncbi.nlm.nih.gov/

•

Population Information: The National Library of Medicine provides access to worldwide coverage of population, family planning, and related health issues, including family planning technology and programs, fertility, and population law and policy: http://www.nlm.nih.gov/databases/databases_population.html

•

Cancer Information: Access to cancer-oriented databases: http://www.nlm.nih.gov/databases/databases_cancer.html

•

Profiles in Science: Offering the archival collections of prominent twentieth-century biomedical scientists to the public through modern digital technology: http://www.profiles.nlm.nih.gov/

•

Chemical Information: Provides links to various chemical databases and references: http://sis.nlm.nih.gov/Chem/ChemMain.html

•

Clinical Alerts: Reports the release of findings from the NIH-funded clinical trials where such release could significantly affect morbidity and mortality: http://www.nlm.nih.gov/databases/alerts/clinical_alerts.html

•

Space Life Sciences: Provides links and information to space-based research (including NASA): http://www.nlm.nih.gov/databases/databases_space.html

•

MEDLINE: Bibliographic database covering the fields of medicine, nursing, dentistry, veterinary medicine, the healthcare system, and the pre-clinical sciences: http://www.nlm.nih.gov/databases/databases_medline.html

11

Remember, for the general public, the National Library of Medicine recommends the databases referenced in MEDLINEplus (http://medlineplus.gov/ or http://www.nlm.nih.gov/medlineplus/databases.html). 12 See http://www.nlm.nih.gov/databases/databases.html.

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•

Toxicology and Environmental Health Information (TOXNET): Databases covering toxicology and environmental health: http://sis.nlm.nih.gov/Tox/ToxMain.html

•

Visible Human Interface: Anatomically detailed, three-dimensional representations of normal male and female human bodies: http://www.nlm.nih.gov/research/visible/visible_human.html

The NLM Gateway13 The NLM (National Library of Medicine) Gateway is a Web-based system that lets users search simultaneously in multiple retrieval systems at the U.S. National Library of Medicine (NLM). It allows users of NLM services to initiate searches from one Web interface, providing one-stop searching for many of NLM’s information resources or databases.14 To use the NLM Gateway, simply go to the search site at http://gateway.nlm.nih.gov/gw/Cmd. Type “heroin addiction” (or synonyms) into the search box and click “Search.” The results will be presented in a tabular form, indicating the number of references in each database category. Results Summary Category Journal Articles Books / Periodicals / Audio Visual Consumer Health Meeting Abstracts Other Collections Total

Items Found 5701 181 911 112 9 6914

HSTAT15 HSTAT is a free, Web-based resource that provides access to full-text documents used in healthcare decision-making.16 These documents include clinical practice guidelines, quickreference guides for clinicians, consumer health brochures, evidence reports and technology assessments from the Agency for Healthcare Research and Quality (AHRQ), as well as AHRQ’s Put Prevention Into Practice.17 Simply search by “heroin addiction” (or synonyms) at the following Web site: http://text.nlm.nih.gov.

13

Adapted from NLM: http://gateway.nlm.nih.gov/gw/Cmd?Overview.x.

14

The NLM Gateway is currently being developed by the Lister Hill National Center for Biomedical Communications (LHNCBC) at the National Library of Medicine (NLM) of the National Institutes of Health (NIH). 15 Adapted from HSTAT: http://www.nlm.nih.gov/pubs/factsheets/hstat.html. 16 17

The HSTAT URL is http://hstat.nlm.nih.gov/.

Other important documents in HSTAT include: the National Institutes of Health (NIH) Consensus Conference Reports and Technology Assessment Reports; the HIV/AIDS Treatment Information Service (ATIS) resource documents; the Substance Abuse and Mental Health Services Administration's Center for Substance Abuse Treatment (SAMHSA/CSAT) Treatment Improvement Protocols (TIP) and Center for Substance Abuse Prevention (SAMHSA/CSAP) Prevention Enhancement Protocols System (PEPS); the Public Health Service (PHS) Preventive Services Task Force's Guide to Clinical Preventive Services; the independent, nonfederal Task Force on Community Services’ Guide to Community Preventive Services; and the Health Technology Advisory Committee (HTAC) of the Minnesota Health Care Commission (MHCC) health technology evaluations.

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Coffee Break: Tutorials for Biologists18 Coffee Break is a general healthcare site that takes a scientific view of the news and covers recent breakthroughs in biology that may one day assist physicians in developing treatments. Here you will find a collection of short reports on recent biological discoveries. Each report incorporates interactive tutorials that demonstrate how bioinformatics tools are used as a part of the research process. Currently, all Coffee Breaks are written by NCBI staff.19 Each report is about 400 words and is usually based on a discovery reported in one or more articles from recently published, peer-reviewed literature.20 This site has new articles every few weeks, so it can be considered an online magazine of sorts. It is intended for general background information. You can access the Coffee Break Web site at the following hyperlink: http://www.ncbi.nlm.nih.gov/Coffeebreak/.

Other Commercial Databases In addition to resources maintained by official agencies, other databases exist that are commercial ventures addressing medical professionals. Here are some examples that may interest you: •

CliniWeb International: Index and table of contents to selected clinical information on the Internet; see http://www.ohsu.edu/cliniweb/.

•

Medical World Search: Searches full text from thousands of selected medical sites on the Internet; see http://www.mwsearch.com/.

18 Adapted 19

from http://www.ncbi.nlm.nih.gov/Coffeebreak/Archive/FAQ.html.

The figure that accompanies each article is frequently supplied by an expert external to NCBI, in which case the source of the figure is cited. The result is an interactive tutorial that tells a biological story. 20 After a brief introduction that sets the work described into a broader context, the report focuses on how a molecular understanding can provide explanations of observed biology and lead to therapies for diseases. Each vignette is accompanied by a figure and hypertext links that lead to a series of pages that interactively show how NCBI tools and resources are used in the research process.

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APPENDIX B. PATIENT RESOURCES Overview Official agencies, as well as federally funded institutions supported by national grants, frequently publish a variety of guidelines written with the patient in mind. These are typically called “Fact Sheets” or “Guidelines.” They can take the form of a brochure, information kit, pamphlet, or flyer. Often they are only a few pages in length. Since new guidelines on heroin addiction can appear at any moment and be published by a number of sources, the best approach to finding guidelines is to systematically scan the Internet-based services that post them.

Patient Guideline Sources The remainder of this chapter directs you to sources which either publish or can help you find additional guidelines on topics related to heroin addiction. Due to space limitations, these sources are listed in a concise manner. Do not hesitate to consult the following sources by either using the Internet hyperlink provided, or, in cases where the contact information is provided, contacting the publisher or author directly. The National Institutes of Health The NIH gateway to patients is located at http://health.nih.gov/. From this site, you can search across various sources and institutes, a number of which are summarized below. Topic Pages: MEDLINEplus The National Library of Medicine has created a vast and patient-oriented healthcare information portal called MEDLINEplus. Within this Internet-based system are “health topic pages” which list links to available materials relevant to heroin addiction. To access this system, log on to http://www.nlm.nih.gov/medlineplus/healthtopics.html. From there you can either search using the alphabetical index or browse by broad topic areas. Recently, MEDLINEplus listed the following when searched for “heroin addiction”:

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•

Other guides Amphetamine Abuse http://www.nlm.nih.gov/medlineplus/amphetamineabuse.html Marijuana Abuse http://www.nlm.nih.gov/medlineplus/marijuanaabuse.html Pregnancy and Substance Abuse http://www.nlm.nih.gov/medlineplus/pregnancyandsubstanceabuse.html

You may also choose to use the search utility provided by MEDLINEplus at the following Web address: http://www.nlm.nih.gov/medlineplus/. Simply type a keyword into the search box and click “Search.” This utility is similar to the NIH search utility, with the exception that it only includes materials that are linked within the MEDLINEplus system (mostly patient-oriented information). It also has the disadvantage of generating unstructured results. We recommend, therefore, that you use this method only if you have a very targeted search. The NIH Search Utility The NIH search utility allows you to search for documents on over 100 selected Web sites that comprise the NIH-WEB-SPACE. Each of these servers is “crawled” and indexed on an ongoing basis. Your search will produce a list of various documents, all of which will relate in some way to heroin addiction. The drawbacks of this approach are that the information is not organized by theme and that the references are often a mix of information for professionals and patients. Nevertheless, a large number of the listed Web sites provide useful background information. We can only recommend this route, therefore, for relatively rare or specific disorders, or when using highly targeted searches. To use the NIH search utility, visit the following Web page: http://search.nih.gov/index.html. Additional Web Sources A number of Web sites are available to the public that often link to government sites. These can also point you in the direction of essential information. The following is a representative sample: •

AOL: http://search.aol.com/cat.adp?id=168&layer=&from=subcats

•

Family Village: http://www.familyvillage.wisc.edu/specific.htm

•

Google: http://directory.google.com/Top/Health/Conditions_and_Diseases/

•

Med Help International: http://www.medhelp.org/HealthTopics/A.html

•

Open Directory Project: http://dmoz.org/Health/Conditions_and_Diseases/

•

Yahoo.com: http://dir.yahoo.com/Health/Diseases_and_Conditions/

•

WebMD®Health: http://my.webmd.com/health_topics

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Finding Associations There are several Internet directories that provide lists of medical associations with information on or resources relating to heroin addiction. By consulting all of associations listed in this chapter, you will have nearly exhausted all sources for patient associations concerned with heroin addiction. The National Health Information Center (NHIC) The National Health Information Center (NHIC) offers a free referral service to help people find organizations that provide information about heroin addiction. For more information, see the NHIC’s Web site at http://www.health.gov/NHIC/ or contact an information specialist by calling 1-800-336-4797. Directory of Health Organizations The Directory of Health Organizations, provided by the National Library of Medicine Specialized Information Services, is a comprehensive source of information on associations. The Directory of Health Organizations database can be accessed via the Internet at http://www.sis.nlm.nih.gov/Dir/DirMain.html. It is composed of two parts: DIRLINE and Health Hotlines. The DIRLINE database comprises some 10,000 records of organizations, research centers, and government institutes and associations that primarily focus on health and biomedicine. To access DIRLINE directly, go to the following Web site: http://dirline.nlm.nih.gov/. Simply type in “heroin addiction” (or a synonym), and you will receive information on all relevant organizations listed in the database. Health Hotlines directs you to toll-free numbers to over 300 organizations. You can access this database directly at http://www.sis.nlm.nih.gov/hotlines/. On this page, you are given the option to search by keyword or by browsing the subject list. When you have received your search results, click on the name of the organization for its description and contact information. The Combined Health Information Database Another comprehensive source of information on healthcare associations is the Combined Health Information Database. Using the “Detailed Search” option, you will need to limit your search to “Organizations” and “heroin addiction”. Type the following hyperlink into your Web browser: http://chid.nih.gov/detail/detail.html. To find associations, use the drop boxes at the bottom of the search page where “You may refine your search by.” For publication date, select “All Years.” Then, select your preferred language and the format option “Organization Resource Sheet.” Type “heroin addiction” (or synonyms) into the “For these words:” box. You should check back periodically with this database since it is updated every three months.

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The National Organization for Rare Disorders, Inc. The National Organization for Rare Disorders, Inc. has prepared a Web site that provides, at no charge, lists of associations organized by health topic. You can access this database at the following Web site: http://www.rarediseases.org/search/orgsearch.html. Type “heroin addiction” (or a synonym) into the search box, and click “Submit Query.”

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APPENDIX C. FINDING MEDICAL LIBRARIES Overview In this Appendix, we show you how to quickly find a medical library in your area.

Preparation Your local public library and medical libraries have interlibrary loan programs with the National Library of Medicine (NLM), one of the largest medical collections in the world. According to the NLM, most of the literature in the general and historical collections of the National Library of Medicine is available on interlibrary loan to any library. If you would like to access NLM medical literature, then visit a library in your area that can request the publications for you.21

Finding a Local Medical Library The quickest method to locate medical libraries is to use the Internet-based directory published by the National Network of Libraries of Medicine (NN/LM). This network includes 4626 members and affiliates that provide many services to librarians, health professionals, and the public. To find a library in your area, simply visit http://nnlm.gov/members/adv.html or call 1-800-338-7657.

Medical Libraries in the U.S. and Canada In addition to the NN/LM, the National Library of Medicine (NLM) lists a number of libraries with reference facilities that are open to the public. The following is the NLM’s list and includes hyperlinks to each library’s Web site. These Web pages can provide information on hours of operation and other restrictions. The list below is a small sample of

21

Adapted from the NLM: http://www.nlm.nih.gov/psd/cas/interlibrary.html.

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libraries recommended by the National Library of Medicine (sorted alphabetically by name of the U.S. state or Canadian province where the library is located)22: •

Alabama: Health InfoNet of Jefferson County (Jefferson County Library Cooperative, Lister Hill Library of the Health Sciences), http://www.uab.edu/infonet/

•

Alabama: Richard M. Scrushy Library (American Sports Medicine Institute)

•

Arizona: Samaritan Regional Medical Center: The Learning Center (Samaritan Health System, Phoenix, Arizona), http://www.samaritan.edu/library/bannerlibs.htm

•

California: Kris Kelly Health Information Center (St. Joseph Health System, Humboldt), http://www.humboldt1.com/~kkhic/index.html

•

California: Community Health Library of Los Gatos, http://www.healthlib.org/orgresources.html

•

California: Consumer Health Program and Services (CHIPS) (County of Los Angeles Public Library, Los Angeles County Harbor-UCLA Medical Center Library) - Carson, CA, http://www.colapublib.org/services/chips.html

•

California: Gateway Health Library (Sutter Gould Medical Foundation)

•

California: Health Library (Stanford University Medical Center), http://wwwmed.stanford.edu/healthlibrary/

•

California: Patient Education Resource Center - Health Information and Resources (University of California, San Francisco), http://sfghdean.ucsf.edu/barnett/PERC/default.asp

•

California: Redwood Health Library (Petaluma Health Care District), http://www.phcd.org/rdwdlib.html

•

California: Los Gatos PlaneTree Health Library, http://planetreesanjose.org/

•

California: Sutter Resource Library (Sutter Hospitals Foundation, Sacramento), http://suttermedicalcenter.org/library/

•

California: Health Sciences Libraries (University of California, Davis), http://www.lib.ucdavis.edu/healthsci/

•

California: ValleyCare Health Library & Ryan Comer Cancer Resource Center (ValleyCare Health System, Pleasanton), http://gaelnet.stmarysca.edu/other.libs/gbal/east/vchl.html

•

California: Washington Community Health Resource Library (Fremont), http://www.healthlibrary.org/

•

Colorado: William V. Gervasini Memorial Library (Exempla Healthcare), http://www.saintjosephdenver.org/yourhealth/libraries/

•

Connecticut: Hartford Hospital Health Science Libraries (Hartford Hospital), http://www.harthosp.org/library/

•

Connecticut: Healthnet: Connecticut Consumer Health Information Center (University of Connecticut Health Center, Lyman Maynard Stowe Library), http://library.uchc.edu/departm/hnet/

22

Abstracted from http://www.nlm.nih.gov/medlineplus/libraries.html.

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•

Connecticut: Waterbury Hospital Health Center Library (Waterbury Hospital, Waterbury), http://www.waterburyhospital.com/library/consumer.shtml

•

Delaware: Consumer Health Library (Christiana Care Health System, Eugene du Pont Preventive Medicine & Rehabilitation Institute, Wilmington), http://www.christianacare.org/health_guide/health_guide_pmri_health_info.cfm

•

Delaware: Lewis B. Flinn Library (Delaware Academy of Medicine, Wilmington), http://www.delamed.org/chls.html

•

Georgia: Family Resource Library (Medical College of Georgia, Augusta), http://cmc.mcg.edu/kids_families/fam_resources/fam_res_lib/frl.htm

•

Georgia: Health Resource Center (Medical Center of Central Georgia, Macon), http://www.mccg.org/hrc/hrchome.asp

•

Hawaii: Hawaii Medical Library: Consumer Health Information Service (Hawaii Medical Library, Honolulu), http://hml.org/CHIS/

•

Idaho: DeArmond Consumer Health Library (Kootenai Medical Center, Coeur d’Alene), http://www.nicon.org/DeArmond/index.htm

•

Illinois: Health Learning Center of Northwestern Memorial Hospital (Chicago), http://www.nmh.org/health_info/hlc.html

•

Illinois: Medical Library (OSF Saint Francis Medical Center, Peoria), http://www.osfsaintfrancis.org/general/library/

•

Kentucky: Medical Library - Services for Patients, Families, Students & the Public (Central Baptist Hospital, Lexington), http://www.centralbap.com/education/community/library.cfm

•

Kentucky: University of Kentucky - Health Information Library (Chandler Medical Center, Lexington), http://www.mc.uky.edu/PatientEd/

•

Louisiana: Alton Ochsner Medical Foundation Library (Alton Ochsner Medical Foundation, New Orleans), http://www.ochsner.org/library/

•

Louisiana: Louisiana State University Health Sciences Center Medical LibraryShreveport, http://lib-sh.lsuhsc.edu/

•

Maine: Franklin Memorial Hospital Medical Library (Franklin Memorial Hospital, Farmington), http://www.fchn.org/fmh/lib.htm

•

Maine: Gerrish-True Health Sciences Library (Central Maine Medical Center, Lewiston), http://www.cmmc.org/library/library.html

•

Maine: Hadley Parrot Health Science Library (Eastern Maine Healthcare, Bangor), http://www.emh.org/hll/hpl/guide.htm

•

Maine: Maine Medical Center Library (Maine Medical Center, Portland), http://www.mmc.org/library/

•

Maine: Parkview Hospital (Brunswick), http://www.parkviewhospital.org/

•

Maine: Southern Maine Medical Center Health Sciences Library (Southern Maine Medical Center, Biddeford), http://www.smmc.org/services/service.php3?choice=10

•

Maine: Stephens Memorial Hospital’s Health Information Library (Western Maine Health, Norway), http://www.wmhcc.org/Library/

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•

Manitoba, Canada: Consumer & Patient Health Information Service (University of Manitoba Libraries), http://www.umanitoba.ca/libraries/units/health/reference/chis.html

•

Manitoba, Canada: J.W. Crane Memorial Library (Deer Lodge Centre, Winnipeg), http://www.deerlodge.mb.ca/crane_library/about.asp

•

Maryland: Health Information Center at the Wheaton Regional Library (Montgomery County, Dept. of Public Libraries, Wheaton Regional Library), http://www.mont.lib.md.us/healthinfo/hic.asp

•

Massachusetts: Baystate Medical Center Library (Baystate Health System), http://www.baystatehealth.com/1024/

•

Massachusetts: Boston University Medical Center Alumni Medical Library (Boston University Medical Center), http://med-libwww.bu.edu/library/lib.html

•

Massachusetts: Lowell General Hospital Health Sciences Library (Lowell General Hospital, Lowell), http://www.lowellgeneral.org/library/HomePageLinks/WWW.htm

•

Massachusetts: Paul E. Woodard Health Sciences Library (New England Baptist Hospital, Boston), http://www.nebh.org/health_lib.asp

•

Massachusetts: St. Luke’s Hospital Health Sciences Library (St. Luke’s Hospital, Southcoast Health System, New Bedford), http://www.southcoast.org/library/

•

Massachusetts: Treadwell Library Consumer Health Reference Center (Massachusetts General Hospital), http://www.mgh.harvard.edu/library/chrcindex.html

•

Massachusetts: UMass HealthNet (University of Massachusetts Medical School, Worchester), http://healthnet.umassmed.edu/

•

Michigan: Botsford General Hospital Library - Consumer Health (Botsford General Hospital, Library & Internet Services), http://www.botsfordlibrary.org/consumer.htm

•

Michigan: Helen DeRoy Medical Library (Providence Hospital and Medical Centers), http://www.providence-hospital.org/library/

•

Michigan: Marquette General Hospital - Consumer Health Library (Marquette General Hospital, Health Information Center), http://www.mgh.org/center.html

•

Michigan: Patient Education Resouce Center - University of Michigan Cancer Center (University of Michigan Comprehensive Cancer Center, Ann Arbor), http://www.cancer.med.umich.edu/learn/leares.htm

•

Michigan: Sladen Library & Center for Health Information Resources - Consumer Health Information (Detroit), http://www.henryford.com/body.cfm?id=39330

•

Montana: Center for Health Information (St. Patrick Hospital and Health Sciences Center, Missoula)

•

National: Consumer Health Library Directory (Medical Library Association, Consumer and Patient Health Information Section), http://caphis.mlanet.org/directory/index.html

•

National: National Network of Libraries of Medicine (National Library of Medicine) provides library services for health professionals in the United States who do not have access to a medical library, http://nnlm.gov/

•

National: NN/LM List of Libraries Serving the Public (National Network of Libraries of Medicine), http://nnlm.gov/members/

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•

Nevada: Health Science Library, West Charleston Library (Las Vegas-Clark County Library District, Las Vegas), http://www.lvccld.org/special_collections/medical/index.htm

•

New Hampshire: Dartmouth Biomedical Libraries (Dartmouth College Library, Hanover), http://www.dartmouth.edu/~biomed/resources.htmld/conshealth.htmld/

•

New Jersey: Consumer Health Library (Rahway Hospital, Rahway), http://www.rahwayhospital.com/library.htm

•

New Jersey: Dr. Walter Phillips Health Sciences Library (Englewood Hospital and Medical Center, Englewood), http://www.englewoodhospital.com/links/index.htm

•

New Jersey: Meland Foundation (Englewood Hospital and Medical Center, Englewood), http://www.geocities.com/ResearchTriangle/9360/

•

New York: Choices in Health Information (New York Public Library) - NLM Consumer Pilot Project participant, http://www.nypl.org/branch/health/links.html

•

New York: Health Information Center (Upstate Medical University, State University of New York, Syracuse), http://www.upstate.edu/library/hic/

•

New York: Health Sciences Library (Long Island Jewish Medical Center, New Hyde Park), http://www.lij.edu/library/library.html

•

New York: ViaHealth Medical Library (Rochester General Hospital), http://www.nyam.org/library/

•

Ohio: Consumer Health Library (Akron General Medical Center, Medical & Consumer Health Library), http://www.akrongeneral.org/hwlibrary.htm

•

Oklahoma: The Health Information Center at Saint Francis Hospital (Saint Francis Health System, Tulsa), http://www.sfh-tulsa.com/services/healthinfo.asp

•

Oregon: Planetree Health Resource Center (Mid-Columbia Medical Center, The Dalles), http://www.mcmc.net/phrc/

•

Pennsylvania: Community Health Information Library (Milton S. Hershey Medical Center, Hershey), http://www.hmc.psu.edu/commhealth/

•

Pennsylvania: Community Health Resource Library (Geisinger Medical Center, Danville), http://www.geisinger.edu/education/commlib.shtml

•

Pennsylvania: HealthInfo Library (Moses Taylor Hospital, Scranton), http://www.mth.org/healthwellness.html

•

Pennsylvania: Hopwood Library (University of Pittsburgh, Health Sciences Library System, Pittsburgh), http://www.hsls.pitt.edu/guides/chi/hopwood/index_html

•

Pennsylvania: Koop Community Health Information Center (College of Physicians of Philadelphia), http://www.collphyphil.org/kooppg1.shtml

•

Pennsylvania: Learning Resources Center - Medical Library (Susquehanna Health System, Williamsport), http://www.shscares.org/services/lrc/index.asp

•

Pennsylvania: Medical Library (UPMC Health System, Pittsburgh), http://www.upmc.edu/passavant/library.htm

•

Quebec, Canada: Medical Library (Montreal General Hospital), http://www.mghlib.mcgill.ca/

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•

South Dakota: Rapid City Regional Hospital Medical Library (Rapid City Regional Hospital), http://www.rcrh.org/Services/Library/Default.asp

•

Texas: Houston HealthWays (Houston Academy of Medicine-Texas Medical Center Library), http://hhw.library.tmc.edu/

•

Washington: Community Health Library (Kittitas Valley Community Hospital), http://www.kvch.com/

•

Washington: Southwest Washington Medical Center Library (Southwest Washington Medical Center, Vancouver), http://www.swmedicalcenter.com/body.cfm?id=72

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ONLINE GLOSSARIES The Internet provides access to a number of free-to-use medical dictionaries. The National Library of Medicine has compiled the following list of online dictionaries: •

ADAM Medical Encyclopedia (A.D.A.M., Inc.), comprehensive medical reference: http://www.nlm.nih.gov/medlineplus/encyclopedia.html

•

MedicineNet.com Medical Dictionary (MedicineNet, Inc.): http://www.medterms.com/Script/Main/hp.asp

•

Merriam-Webster Medical Dictionary (Inteli-Health, Inc.): http://www.intelihealth.com/IH/

•

Multilingual Glossary of Technical and Popular Medical Terms in Eight European Languages (European Commission) - Danish, Dutch, English, French, German, Italian, Portuguese, and Spanish: http://allserv.rug.ac.be/~rvdstich/eugloss/welcome.html

•

On-line Medical Dictionary (CancerWEB): http://cancerweb.ncl.ac.uk/omd/

•

Rare Diseases Terms (Office of Rare Diseases): http://ord.aspensys.com/asp/diseases/diseases.asp

•

Technology Glossary (National Library of Medicine) - Health Care Technology: http://www.nlm.nih.gov/nichsr/ta101/ta10108.htm

Beyond these, MEDLINEplus contains a very patient-friendly encyclopedia covering every aspect of medicine (licensed from A.D.A.M., Inc.). The ADAM Medical Encyclopedia can be accessed at http://www.nlm.nih.gov/medlineplus/encyclopedia.html. ADAM is also available on commercial Web sites such as drkoop.com (http://www.drkoop.com/) and Web MD (http://my.webmd.com/adam/asset/adam_disease_articles/a_to_z/a).

Online Dictionary Directories The following are additional online directories compiled by the National Library of Medicine, including a number of specialized medical dictionaries: •

Medical Dictionaries: Medical & Biological (World Health Organization): http://www.who.int/hlt/virtuallibrary/English/diction.htm#Medical

•

MEL-Michigan Electronic Library List of Online Health and Medical Dictionaries (Michigan Electronic Library): http://mel.lib.mi.us/health/health-dictionaries.html

•

Patient Education: Glossaries (DMOZ Open Directory Project): http://dmoz.org/Health/Education/Patient_Education/Glossaries/

•

Web of Online Dictionaries (Bucknell University): http://www.yourdictionary.com/diction5.html#medicine

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HEROIN ADDICTION DICTIONARY The definitions below are derived from official public sources, including the National Institutes of Health [NIH] and the European Union [EU]. Abdomen: That portion of the body that lies between the thorax and the pelvis. [NIH] Abscess: Accumulation of purulent material in tissues, organs, or circumscribed spaces, usually associated with signs of infection. [NIH] Acting Out: Expressing unconscious emotional conflicts or feelings, often of hostility or love, through overt behavior. [NIH] Adjustment: The dynamic process wherein the thoughts, feelings, behavior, and biophysiological mechanisms of the individual continually change to adjust to the environment. [NIH] Adrenal Cortex: The outer layer of the adrenal gland. It secretes mineralocorticoids, androgens, and glucocorticoids. [NIH] Adrenaline: A hormone. Also called epinephrine. [NIH] Adrenergic: Activated by, characteristic of, or secreting epinephrine or substances with similar activity; the term is applied to those nerve fibres that liberate norepinephrine at a synapse when a nerve impulse passes, i.e., the sympathetic fibres. [EU] Adverse Effect: An unwanted side effect of treatment. [NIH] Affinity: 1. Inherent likeness or relationship. 2. A special attraction for a specific element, organ, or structure. 3. Chemical affinity; the force that binds atoms in molecules; the tendency of substances to combine by chemical reaction. 4. The strength of noncovalent chemical binding between two substances as measured by the dissociation constant of the complex. 5. In immunology, a thermodynamic expression of the strength of interaction between a single antigen-binding site and a single antigenic determinant (and thus of the stereochemical compatibility between them), most accurately applied to interactions among simple, uniform antigenic determinants such as haptens. Expressed as the association constant (K litres mole -1), which, owing to the heterogeneity of affinities in a population of antibody molecules of a given specificity, actually represents an average value (mean intrinsic association constant). 6. The reciprocal of the dissociation constant. [EU] Agonist: In anatomy, a prime mover. In pharmacology, a drug that has affinity for and stimulates physiologic activity at cell receptors normally stimulated by naturally occurring substances. [EU] Algorithms: A procedure consisting of a sequence of algebraic formulas and/or logical steps to calculate or determine a given task. [NIH] Alimentary: Pertaining to food or nutritive material, or to the organs of digestion. [EU] Alkaline: Having the reactions of an alkali. [EU] Alkaloid: A member of a large group of chemicals that are made by plants and have nitrogen in them. Some alkaloids have been shown to work against cancer. [NIH] Allergen: An antigenic substance capable of producing immediate-type hypersensitivity (allergy). [EU] Alternative medicine: Practices not generally recognized by the medical community as standard or conventional medical approaches and used instead of standard treatments. Alternative medicine includes the taking of dietary supplements, megadose vitamins, and

100 Heroin Addiction

herbal preparations; the drinking of special teas; and practices such as massage therapy, magnet therapy, spiritual healing, and meditation. [NIH] Amber: A yellowish fossil resin, the gum of several species of coniferous trees, found in the alluvial deposits of northeastern Germany. It is used in molecular biology in the analysis of organic matter fossilized in amber. [NIH] Amblyopia: A nonspecific term referring to impaired vision. Major subcategories include stimulus deprivation-induced amblyopia and toxic amblyopia. Stimulus deprivationinduced amblopia is a developmental disorder of the visual cortex. A discrepancy between visual information received by the visual cortex from each eye results in abnormal cortical development. Strabismus and refractive errors may cause this condition. Toxic amblyopia is a disorder of the optic nerve which is associated with alcoholism, tobacco smoking, and other toxins and as an adverse effect of the use of some medications. [NIH] Amenorrhea: Absence of menstruation. [NIH] Amino Acid Sequence: The order of amino acids as they occur in a polypeptide chain. This is referred to as the primary structure of proteins. It is of fundamental importance in determining protein conformation. [NIH] Amino Acids: Organic compounds that generally contain an amino (-NH2) and a carboxyl (COOH) group. Twenty alpha-amino acids are the subunits which are polymerized to form proteins. [NIH] Amino Acids: Organic compounds that generally contain an amino (-NH2) and a carboxyl (COOH) group. Twenty alpha-amino acids are the subunits which are polymerized to form proteins. [NIH] Amphetamines: Analogs or derivatives of amphetamine. Many are sympathomimetics and central nervous system stimulators causing excitation, vasopression, bronchodilation, and to varying degrees, anorexia, analepsis, nasal decongestion, and some smooth muscle relaxation. [NIH] Amyloid: A general term for a variety of different proteins that accumulate as extracellular fibrils of 7-10 nm and have common structural features, including a beta-pleated sheet conformation and the ability to bind such dyes as Congo red and thioflavine (Kandel, Schwartz, and Jessel, Principles of Neural Science, 3rd ed). [NIH] Amyloidosis: A group of diseases in which protein is deposited in specific organs (localized amyloidosis) or throughout the body (systemic amyloidosis). Amyloidosis may be either primary (with no known cause) or secondary (caused by another disease, including some types of cancer). Generally, primary amyloidosis affects the nerves, skin, tongue, joints, heart, and liver; secondary amyloidosis often affects the spleen, kidneys, liver, and adrenal glands. [NIH] Anaesthesia: Loss of feeling or sensation. Although the term is used for loss of tactile sensibility, or of any of the other senses, it is applied especially to loss of the sensation of pain, as it is induced to permit performance of surgery or other painful procedures. [EU] Analgesic: An agent that alleviates pain without causing loss of consciousness. [EU] Analog: In chemistry, a substance that is similar, but not identical, to another. [NIH] Anaphylatoxins: The family of peptides C3a, C4a, C5a, and C5a des-arginine produced in the serum during complement activation. They produce smooth muscle contraction, mast cell histamine release, affect platelet aggregation, and act as mediators of the local inflammatory process. The order of anaphylatoxin activity from strongest to weakest is C5a, C3a, C4a, and C5a des-arginine. The latter is the so-called "classical" anaphylatoxin but shows no spasmogenic activity though it contains some chemotactic ability. [NIH]

Dictionary 101

Anatomical: Pertaining to anatomy, or to the structure of the organism. [EU] Androgenic: Producing masculine characteristics. [EU] Androstenedione: A steroid with androgenic properties that is produced in the testis, ovary, and adrenal cortex. It is a precursor to testosterone and other androgenic hormones. [NIH] Anemia: A reduction in the number of circulating erythrocytes or in the quantity of hemoglobin. [NIH] Anesthesia: A state characterized by loss of feeling or sensation. This depression of nerve function is usually the result of pharmacologic action and is induced to allow performance of surgery or other painful procedures. [NIH] Aneurysm: A sac formed by the dilatation of the wall of an artery, a vein, or the heart. [NIH] Animal model: An animal with a disease either the same as or like a disease in humans. Animal models are used to study the development and progression of diseases and to test new treatments before they are given to humans. Animals with transplanted human cancers or other tissues are called xenograft models. [NIH] Antagonism: Interference with, or inhibition of, the growth of a living organism by another living organism, due either to creation of unfavorable conditions (e. g. exhaustion of food supplies) or to production of a specific antibiotic substance (e. g. penicillin). [NIH] Antibiotic: A drug used to treat infections caused by bacteria and other microorganisms. [NIH]

Antibody: A type of protein made by certain white blood cells in response to a foreign substance (antigen). Each antibody can bind to only a specific antigen. The purpose of this binding is to help destroy the antigen. Antibodies can work in several ways, depending on the nature of the antigen. Some antibodies destroy antigens directly. Others make it easier for white blood cells to destroy the antigen. [NIH] Anticoagulant: A drug that helps prevent blood clots from forming. Also called a blood thinner. [NIH] Antidepressant: A drug used to treat depression. [NIH] Antiemetic: An agent that prevents or alleviates nausea and vomiting. Also antinauseant. [EU]

Antigen: Any substance which is capable, under appropriate conditions, of inducing a specific immune response and of reacting with the products of that response, that is, with specific antibody or specifically sensitized T-lymphocytes, or both. Antigens may be soluble substances, such as toxins and foreign proteins, or particulate, such as bacteria and tissue cells; however, only the portion of the protein or polysaccharide molecule known as the antigenic determinant (q.v.) combines with antibody or a specific receptor on a lymphocyte. Abbreviated Ag. [EU] Antigen-Antibody Complex: The complex formed by the binding of antigen and antibody molecules. The deposition of large antigen-antibody complexes leading to tissue damage causes immune complex diseases. [NIH] Antipsychotic: Effective in the treatment of psychosis. Antipsychotic drugs (called also neuroleptic drugs and major tranquilizers) are a chemically diverse (including phenothiazines, thioxanthenes, butyrophenones, dibenzoxazepines, dibenzodiazepines, and diphenylbutylpiperidines) but pharmacologically similar class of drugs used to treat schizophrenic, paranoid, schizoaffective, and other psychotic disorders; acute delirium and dementia, and manic episodes (during induction of lithium therapy); to control the movement disorders associated with Huntington's chorea, Gilles de la Tourette's syndrome, and ballismus; and to treat intractable hiccups and severe nausea and vomiting.

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Antipsychotic agents bind to dopamine, histamine, muscarinic cholinergic, a-adrenergic, and serotonin receptors. Blockade of dopaminergic transmission in various areas is thought to be responsible for their major effects : antipsychotic action by blockade in the mesolimbic and mesocortical areas; extrapyramidal side effects (dystonia, akathisia, parkinsonism, and tardive dyskinesia) by blockade in the basal ganglia; and antiemetic effects by blockade in the chemoreceptor trigger zone of the medulla. Sedation and autonomic side effects (orthostatic hypotension, blurred vision, dry mouth, nasal congestion and constipation) are caused by blockade of histamine, cholinergic, and adrenergic receptors. [EU] Antitussive: An agent that relieves or prevents cough. [EU] Aorta: The main trunk of the systemic arteries. [NIH] Aqueous: Having to do with water. [NIH] Arterial: Pertaining to an artery or to the arteries. [EU] Arteries: The vessels carrying blood away from the heart. [NIH] Aspartate: A synthetic amino acid. [NIH] Assay: Determination of the amount of a particular constituent of a mixture, or of the biological or pharmacological potency of a drug. [EU] Atropine: A toxic alkaloid, originally from Atropa belladonna, but found in other plants, mainly Solanaceae. [NIH] Autoimmune disease: A condition in which the body recognizes its own tissues as foreign and directs an immune response against them. [NIH] Autonomic: Self-controlling; functionally independent. [EU] Aversion therapy: Negative conditioning, consisting of pairing the unwanted symptom or behavior (e. g. alcoholism) with painful or unpleasant stimuli until the undesirable behavior is suppressed. [NIH] Axillary: Pertaining to the armpit area, including the lymph nodes that are located there. [NIH]

Axillary Vein: The venous trunk of the upper limb; a continuation of the basilar and brachial veins running from the lower border of the teres major muscle to the outer border of the first rib where it becomes the subclavian vein. [NIH] Basal Ganglia: Large subcortical nuclear masses derived from the telencephalon and located in the basal regions of the cerebral hemispheres. [NIH] Base: In chemistry, the nonacid part of a salt; a substance that combines with acids to form salts; a substance that dissociates to give hydroxide ions in aqueous solutions; a substance whose molecule or ion can combine with a proton (hydrogen ion); a substance capable of donating a pair of electrons (to an acid) for the formation of a coordinate covalent bond. [EU] Behavior Therapy: The application of modern theories of learning and conditioning in the treatment of behavior disorders. [NIH] Belladonna: A species of very poisonous Solanaceous plants yielding atropine (hyoscyamine), scopolamine, and other belladonna alkaloids, used to block the muscarinic autonomic nervous system. [NIH] Beta-Endorphin: A peptide consisting of amino acid sequence 61-91 of the endogenous pituitary hormone beta-lipotropin. The first four amino acids show a common tetrapeptide sequence with methionine- and leucine enkephalin. The compound shows opiate-like activity. Injection of beta-endorphin induces a profound analgesia of the whole body for several hours. This action is reversed after administration of naloxone. [NIH] Bile: An emulsifying agent produced in the liver and secreted into the duodenum. Its

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composition includes bile acids and salts, cholesterol, and electrolytes. It aids digestion of fats in the duodenum. [NIH] Bile Ducts: Tubes that carry bile from the liver to the gallbladder for storage and to the small intestine for use in digestion. [NIH] Bile Pigments: Pigments that give a characteristic color to bile including: bilirubin, biliverdine, and bilicyanin. [NIH] Biliary: Having to do with the liver, bile ducts, and/or gallbladder. [NIH] Biliary Fistula: Abnormal passage in any organ of the biliary tract or between biliary organs and other organs. [NIH] Biliary Tract: The gallbladder and its ducts. [NIH] Binding Sites: The reactive parts of a macromolecule that directly participate in its specific combination with another molecule. [NIH] Biochemical: Relating to biochemistry; characterized by, produced by, or involving chemical reactions in living organisms. [EU] Biological Factors: Compounds made by living organisms that contribute to or influence a phenomenon or process. They have biological or physiological activities. [NIH] Biotechnology: Body of knowledge related to the use of organisms, cells or cell-derived constituents for the purpose of developing products which are technically, scientifically and clinically useful. Alteration of biologic function at the molecular level (i.e., genetic engineering) is a central focus; laboratory methods used include transfection and cloning technologies, sequence and structure analysis algorithms, computer databases, and gene and protein structure function analysis and prediction. [NIH] Bladder: The organ that stores urine. [NIH] Blood Coagulation: The process of the interaction of blood coagulation factors that results in an insoluble fibrin clot. [NIH] Blood Platelets: Non-nucleated disk-shaped cells formed in the megakaryocyte and found in the blood of all mammals. They are mainly involved in blood coagulation. [NIH] Blood pressure: The pressure of blood against the walls of a blood vessel or heart chamber. Unless there is reference to another location, such as the pulmonary artery or one of the heart chambers, it refers to the pressure in the systemic arteries, as measured, for example, in the forearm. [NIH] Blood vessel: A tube in the body through which blood circulates. Blood vessels include a network of arteries, arterioles, capillaries, venules, and veins. [NIH] Bowel: The long tube-shaped organ in the abdomen that completes the process of digestion. There is both a small and a large bowel. Also called the intestine. [NIH] Bowel Movement: Body wastes passed through the rectum and anus. [NIH] Brachial: All the nerves from the arm are ripped from the spinal cord. [NIH] Brachiocephalic Trunk: The first and largest artery branching from the aortic arch. It distributes blood to the right side of the head and neck and to the right arm. [NIH] Branch: Most commonly used for branches of nerves, but applied also to other structures. [NIH]

Buprenorphine: A derivative of the opioid alkaloid thebaine that is a more potent and longer lasting analgesic than morphine. It appears to act as a partial agonist at mu and kappa opioid receptors and as an antagonist at delta receptors. The lack of delta-agonist activity has been suggested to account for the observation that buprenorphine tolerance may

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not develop with chronic use. [NIH] Calcium: A basic element found in nearly all organized tissues. It is a member of the alkaline earth family of metals with the atomic symbol Ca, atomic number 20, and atomic weight 40. Calcium is the most abundant mineral in the body and combines with phosphorus to form calcium phosphate in the bones and teeth. It is essential for the normal functioning of nerves and muscles and plays a role in blood coagulation (as factor IV) and in many enzymatic processes. [NIH] Calcium channel blocker: A drug used to relax the blood vessel and heart muscle, causing pressure inside blood vessels to drop. It also can regulate heart rhythm. [NIH] Calcium Gluconate: The calcium salt of gluconic acid. The compound has a variety of uses, including its use as a calcium replenisher in hypocalcemic states. [NIH] Carbohydrate: An aldehyde or ketone derivative of a polyhydric alcohol, particularly of the pentahydric and hexahydric alcohols. They are so named because the hydrogen and oxygen are usually in the proportion to form water, (CH2O)n. The most important carbohydrates are the starches, sugars, celluloses, and gums. They are classified into mono-, di-, tri-, polyand heterosaccharides. [EU] Carcinogenic: Producing carcinoma. [EU] Cardiac: Having to do with the heart. [NIH] Cardiovascular: Having to do with the heart and blood vessels. [NIH] Cardiovascular disease: Any abnormal condition characterized by dysfunction of the heart and blood vessels. CVD includes atherosclerosis (especially coronary heart disease, which can lead to heart attacks), cerebrovascular disease (e.g., stroke), and hypertension (high blood pressure). [NIH] Carrier Proteins: Transport proteins that carry specific substances in the blood or across cell membranes. [NIH] Case report: A detailed report of the diagnosis, treatment, and follow-up of an individual patient. Case reports also contain some demographic information about the patient (for example, age, gender, ethnic origin). [NIH] Catecholamine: A group of chemical substances manufactured by the adrenal medulla and secreted during physiological stress. [NIH] Caudal: Denoting a position more toward the cauda, or tail, than some specified point of reference; same as inferior, in human anatomy. [EU] Caudate Nucleus: Elongated gray mass of the neostriatum located adjacent to the lateral ventricle of the brain. [NIH] Cell: The individual unit that makes up all of the tissues of the body. All living things are made up of one or more cells. [NIH] Cell Differentiation: Progressive restriction of the developmental potential and increasing specialization of function which takes place during the development of the embryo and leads to the formation of specialized cells, tissues, and organs. [NIH] Cell proliferation: An increase in the number of cells as a result of cell growth and cell division. [NIH] Cellulitis: An acute, diffuse, and suppurative inflammation of loose connective tissue, particularly the deep subcutaneous tissues, and sometimes muscle, which is most commonly seen as a result of infection of a wound, ulcer, or other skin lesions. [NIH] Central Nervous System: The main information-processing organs of the nervous system, consisting of the brain, spinal cord, and meninges. [NIH]

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Cerebrospinal: Pertaining to the brain and spinal cord. [EU] Cerebrospinal fluid: CSF. The fluid flowing around the brain and spinal cord. Cerebrospinal fluid is produced in the ventricles in the brain. [NIH] Cerebrovascular: Pertaining to the blood vessels of the cerebrum, or brain. [EU] Chemotactic Factors: Chemical substances that attract or repel cells or organisms. The concept denotes especially those factors released as a result of tissue injury, invasion, or immunologic activity, that attract leukocytes, macrophages, or other cells to the site of infection or insult. [NIH] Chemotherapy: Treatment with anticancer drugs. [NIH] Chlorpromazine: The prototypical phenothiazine antipsychotic drug. Like the other drugs in this class chlorpromazine's antipsychotic actions are thought to be due to long-term adaptation by the brain to blocking dopamine receptors. Chlorpromazine has several other actions and therapeutic uses, including as an antiemetic and in the treatment of intractable hiccup. [NIH] Chromosome: Part of a cell that contains genetic information. Except for sperm and eggs, all human cells contain 46 chromosomes. [NIH] Chronic: A disease or condition that persists or progresses over a long period of time. [NIH] Clinical study: A research study in which patients receive treatment in a clinic or other medical facility. Reports of clinical studies can contain results for single patients (case reports) or many patients (case series or clinical trials). [NIH] Clinical trial: A research study that tests how well new medical treatments or other interventions work in people. Each study is designed to test new methods of screening, prevention, diagnosis, or treatment of a disease. [NIH] Cloning: The production of a number of genetically identical individuals; in genetic engineering, a process for the efficient replication of a great number of identical DNA molecules. [NIH] Coca: Any of several South American shrubs of the Erythroxylon genus (and family) that yield cocaine; the leaves are chewed with alum for CNS stimulation. [NIH] Cocaine: An alkaloid ester extracted from the leaves of plants including coca. It is a local anesthetic and vasoconstrictor and is clinically used for that purpose, particularly in the eye, ear, nose, and throat. It also has powerful central nervous system effects similar to the amphetamines and is a drug of abuse. Cocaine, like amphetamines, acts by multiple mechanisms on brain catecholaminergic neurons; the mechanism of its reinforcing effects is thought to involve inhibition of dopamine uptake. [NIH] Codeine: An opioid analgesic related to morphine but with less potent analgesic properties and mild sedative effects. It also acts centrally to suppress cough. [NIH] Cofactor: A substance, microorganism or environmental factor that activates or enhances the action of another entity such as a disease-causing agent. [NIH] Cognition: Intellectual or mental process whereby an organism becomes aware of or obtains knowledge. [NIH] Collagen: A polypeptide substance comprising about one third of the total protein in mammalian organisms. It is the main constituent of skin, connective tissue, and the organic substance of bones and teeth. Different forms of collagen are produced in the body but all consist of three alpha-polypeptide chains arranged in a triple helix. Collagen is differentiated from other fibrous proteins, such as elastin, by the content of proline, hydroxyproline, and hydroxylysine; by the absence of tryptophan; and particularly by the

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high content of polar groups which are responsible for its swelling properties. [NIH] Communicable disease: A disease that can be transmitted by contact between persons. [NIH] Comorbidity: The presence of co-existing or additional diseases with reference to an initial diagnosis or with reference to the index condition that is the subject of study. Comorbidity may affect the ability of affected individuals to function and also their survival; it may be used as a prognostic indicator for length of hospital stay, cost factors, and outcome or survival. [NIH] Complement: A term originally used to refer to the heat-labile factor in serum that causes immune cytolysis, the lysis of antibody-coated cells, and now referring to the entire functionally related system comprising at least 20 distinct serum proteins that is the effector not only of immune cytolysis but also of other biologic functions. Complement activation occurs by two different sequences, the classic and alternative pathways. The proteins of the classic pathway are termed 'components of complement' and are designated by the symbols C1 through C9. C1 is a calcium-dependent complex of three distinct proteins C1q, C1r and C1s. The proteins of the alternative pathway (collectively referred to as the properdin system) and complement regulatory proteins are known by semisystematic or trivial names. Fragments resulting from proteolytic cleavage of complement proteins are designated with lower-case letter suffixes, e.g., C3a. Inactivated fragments may be designated with the suffix 'i', e.g. C3bi. Activated components or complexes with biological activity are designated by a bar over the symbol e.g. C1 or C4b,2a. The classic pathway is activated by the binding of C1 to classic pathway activators, primarily antigen-antibody complexes containing IgM, IgG1, IgG3; C1q binds to a single IgM molecule or two adjacent IgG molecules. The alternative pathway can be activated by IgA immune complexes and also by nonimmunologic materials including bacterial endotoxins, microbial polysaccharides, and cell walls. Activation of the classic pathway triggers an enzymatic cascade involving C1, C4, C2 and C3; activation of the alternative pathway triggers a cascade involving C3 and factors B, D and P. Both result in the cleavage of C5 and the formation of the membrane attack complex. Complement activation also results in the formation of many biologically active complement fragments that act as anaphylatoxins, opsonins, or chemotactic factors. [EU] Complementary and alternative medicine: CAM. Forms of treatment that are used in addition to (complementary) or instead of (alternative) standard treatments. These practices are not considered standard medical approaches. CAM includes dietary supplements, megadose vitamins, herbal preparations, special teas, massage therapy, magnet therapy, spiritual healing, and meditation. [NIH] Complementary medicine: Practices not generally recognized by the medical community as standard or conventional medical approaches and used to enhance or complement the standard treatments. Complementary medicine includes the taking of dietary supplements, megadose vitamins, and herbal preparations; the drinking of special teas; and practices such as massage therapy, magnet therapy, spiritual healing, and meditation. [NIH] Computational Biology: A field of biology concerned with the development of techniques for the collection and manipulation of biological data, and the use of such data to make biological discoveries or predictions. This field encompasses all computational methods and theories applicable to molecular biology and areas of computer-based techniques for solving biological problems including manipulation of models and datasets. [NIH] Conception: The onset of pregnancy, marked by implantation of the blastocyst; the formation of a viable zygote. [EU] Concomitant: Accompanying; accessory; joined with another. [EU] Confounding: Extraneous variables resulting in outcome effects that obscure or exaggerate the "true" effect of an intervention. [NIH]

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Connective Tissue: Tissue that supports and binds other tissues. It consists of connective tissue cells embedded in a large amount of extracellular matrix. [NIH] Connective Tissue: Tissue that supports and binds other tissues. It consists of connective tissue cells embedded in a large amount of extracellular matrix. [NIH] Consciousness: Sense of awareness of self and of the environment. [NIH] Constriction: The act of constricting. [NIH] Contraception: Use of agents, devices, methods, or procedures which diminish the likelihood of or prevent conception. [NIH] Contraindications: Any factor or sign that it is unwise to pursue a certain kind of action or treatment, e. g. giving a general anesthetic to a person with pneumonia. [NIH] Control group: In a clinical trial, the group that does not receive the new treatment being studied. This group is compared to the group that receives the new treatment, to see if the new treatment works. [NIH] Controlled clinical trial: A clinical study that includes a comparison (control) group. The comparison group receives a placebo, another treatment, or no treatment at all. [NIH] Controlled study: An experiment or clinical trial that includes a comparison (control) group. [NIH]

Coordination: Muscular or motor regulation or the harmonious cooperation of muscles or groups of muscles, in a complex action or series of actions. [NIH] Cor: The muscular organ that maintains the circulation of the blood. c. adiposum a heart that has undergone fatty degeneration or that has an accumulation of fat around it; called also fat or fatty, heart. c. arteriosum the left side of the heart, so called because it contains oxygenated (arterial) blood. c. biloculare a congenital anomaly characterized by failure of formation of the atrial and ventricular septums, the heart having only two chambers, a single atrium and a single ventricle, and a common atrioventricular valve. c. bovinum (L. 'ox heart') a greatly enlarged heart due to a hypertrophied left ventricle; called also c. taurinum and bucardia. c. dextrum (L. 'right heart') the right atrium and ventricle. c. hirsutum, c. villosum. c. mobile (obs.) an abnormally movable heart. c. pendulum a heart so movable that it seems to be hanging by the great blood vessels. c. pseudotriloculare biatriatum a congenital cardiac anomaly in which the heart functions as a three-chambered heart because of tricuspid atresia, the right ventricle being extremely small or rudimentary and the right atrium greatly dilated. Blood passes from the right to the left atrium and thence disease due to pulmonary hypertension secondary to disease of the lung, or its blood vessels, with hypertrophy of the right ventricle. [EU] Coronary: Encircling in the manner of a crown; a term applied to vessels; nerves, ligaments, etc. The term usually denotes the arteries that supply the heart muscle and, by extension, a pathologic involvement of them. [EU] Coronary heart disease: A type of heart disease caused by narrowing of the coronary arteries that feed the heart, which needs a constant supply of oxygen and nutrients carried by the blood in the coronary arteries. When the coronary arteries become narrowed or clogged by fat and cholesterol deposits and cannot supply enough blood to the heart, CHD results. [NIH] Coronary Thrombosis: Presence of a thrombus in a coronary artery, often causing a myocardial infarction. [NIH] Cortical: Pertaining to or of the nature of a cortex or bark. [EU] Cues: Signals for an action; that specific portion of a perceptual field or pattern of stimuli to which a subject has learned to respond. [NIH]

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Curative: Tending to overcome disease and promote recovery. [EU] Cytotoxic: Cell-killing. [NIH] Databases, Bibliographic: Extensive collections, reputedly complete, of references and citations to books, articles, publications, etc., generally on a single subject or specialized subject area. Databases can operate through automated files, libraries, or computer disks. The concept should be differentiated from factual databases which is used for collections of data and facts apart from bibliographic references to them. [NIH] Degenerative: Undergoing degeneration : tending to degenerate; having the character of or involving degeneration; causing or tending to cause degeneration. [EU] Density: The logarithm to the base 10 of the opacity of an exposed and processed film. [NIH] Depolarization: The process or act of neutralizing polarity. In neurophysiology, the reversal of the resting potential in excitable cell membranes when stimulated, i.e., the tendency of the cell membrane potential to become positive with respect to the potential outside the cell. [EU] Deprivation: Loss or absence of parts, organs, powers, or things that are needed. [EU] Desensitization: The prevention or reduction of immediate hypersensitivity reactions by administration of graded doses of allergen; called also hyposensitization and immunotherapy. [EU] Detoxification: Treatment designed to free an addict from his drug habit. [EU] Dextroamphetamine: The d-form of amphetamine. It is a central nervous system stimulant and a sympathomimetic. It has also been used in the treatment of narcolepsy and of attention deficit disorders and hyperactivity in children. Dextroamphetamine has multiple mechanisms of action including blocking uptake of adrenergics and dopamine, stimulating release of monamines, and inhibiting monoamine oxidase. It is also a drug of abuse and a psychotomimetic. [NIH] Dextromethorphan: The d-isomer of the codeine analog of levorphanol. Dextromethorphan shows high affinity binding to several regions of the brain, including the medullary cough center. This compound is a NMDA receptor antagonist (receptors, N-methyl-D-aspartate) and acts as a non-competitive channel blocker. It is used widely as an antitussive agent, and is also used to study the involvement of glutamate receptors in neurotoxicity. [NIH] Diagnostic procedure: A method used to identify a disease. [NIH] Digestive system: The organs that take in food and turn it into products that the body can use to stay healthy. Waste products the body cannot use leave the body through bowel movements. The digestive system includes the salivary glands, mouth, esophagus, stomach, liver, pancreas, gallbladder, small and large intestines, and rectum. [NIH] Dihydrotestosterone: Anabolic agent. [NIH] Dilatation: The act of dilating. [NIH] Direct: 1. Straight; in a straight line. 2. Performed immediately and without the intervention of subsidiary means. [EU] Discrimination: The act of qualitative and/or quantitative differentiation between two or more stimuli. [NIH] Disposition: A tendency either physical or mental toward certain diseases. [EU] Dissociation: 1. The act of separating or state of being separated. 2. The separation of a molecule into two or more fragments (atoms, molecules, ions, or free radicals) produced by the absorption of light or thermal energy or by solvation. 3. In psychology, a defense mechanism in which a group of mental processes are segregated from the rest of a person's mental activity in order to avoid emotional distress, as in the dissociative disorders (q.v.), or

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in which an idea or object is segregated from its emotional significance; in the first sense it is roughly equivalent to splitting, in the second, to isolation. 4. A defect of mental integration in which one or more groups of mental processes become separated off from normal consciousness and, thus separated, function as a unitary whole. [EU] Dopamine: An endogenous catecholamine and prominent neurotransmitter in several systems of the brain. In the synthesis of catecholamines from tyrosine, it is the immediate precursor to norepinephrine and epinephrine. Dopamine is a major transmitter in the extrapyramidal system of the brain, and important in regulating movement. A family of dopaminergic receptor subtypes mediate its action. Dopamine is used pharmacologically for its direct (beta adrenergic agonist) and indirect (adrenergic releasing) sympathomimetic effects including its actions as an inotropic agent and as a renal vasodilator. [NIH] Dopamine Agonists: Drugs that bind to and activate dopamine receptors. [NIH] Drive: A state of internal activity of an organism that is a necessary condition before a given stimulus will elicit a class of responses; e.g., a certain level of hunger (drive) must be present before food will elicit an eating response. [NIH] Drug Interactions: The action of a drug that may affect the activity, metabolism, or toxicity of another drug. [NIH] Drug Tolerance: Progressive diminution of the susceptibility of a human or animal to the effects of a drug, resulting from its continued administration. It should be differentiated from drug resistance wherein an organism, disease, or tissue fails to respond to the intended effectiveness of a chemical or drug. It should also be differentiated from maximum tolerated dose and no-observed-adverse-effect level. [NIH] Dynorphins: A class of opioid peptides including dynorphin A, dynorphin B, and smaller fragments of these peptides. Dynorphins prefer kappa-opioid receptors (receptors, opioid, kappa) and have been shown to play a role as central nervous system transmitters. [NIH] Dysphoria: Disquiet; restlessness; malaise. [EU] Dysphoric: A feeling of unpleasantness and discomfort. [NIH] Effector: It is often an enzyme that converts an inactive precursor molecule into an active second messenger. [NIH] Effector cell: A cell that performs a specific function in response to a stimulus; usually used to describe cells in the immune system. [NIH] Efficacy: The extent to which a specific intervention, procedure, regimen, or service produces a beneficial result under ideal conditions. Ideally, the determination of efficacy is based on the results of a randomized control trial. [NIH] Electroacupuncture: A form of acupuncture using low frequency electrically stimulated needles to produce analgesia and anesthesia and to treat disease. [NIH] Electrons: Stable elementary particles having the smallest known negative charge, present in all elements; also called negatrons. Positively charged electrons are called positrons. The numbers, energies and arrangement of electrons around atomic nuclei determine the chemical identities of elements. Beams of electrons are called cathode rays or beta rays, the latter being a high-energy biproduct of nuclear decay. [NIH] Embryo: The prenatal stage of mammalian development characterized by rapid morphological changes and the differentiation of basic structures. [NIH] Endemic: Present or usually prevalent in a population or geographical area at all times; said of a disease or agent. Called also endemial. [EU] Endocarditis: Exudative and proliferative inflammatory alterations of the endocardium,

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characterized by the presence of vegetations on the surface of the endocardium or in the endocardium itself, and most commonly involving a heart valve, but sometimes affecting the inner lining of the cardiac chambers or the endocardium elsewhere. It may occur as a primary disorder or as a complication of or in association with another disease. [EU] Endocardium: The innermost layer of the heart, comprised of endothelial cells. [NIH] Endorphins: One of the three major groups of endogenous opioid peptides. They are large peptides derived from the pro-opiomelanocortin precursor. The known members of this group are alpha-, beta-, and gamma-endorphin. The term endorphin is also sometimes used to refer to all opioid peptides, but the narrower sense is used here; opioid peptides is used for the broader group. [NIH] Endotoxins: Toxins closely associated with the living cytoplasm or cell wall of certain microorganisms, which do not readily diffuse into the culture medium, but are released upon lysis of the cells. [NIH] Enkephalin: A natural opiate painkiller, in the hypothalamus. [NIH] Environmental Health: The science of controlling or modifying those conditions, influences, or forces surrounding man which relate to promoting, establishing, and maintaining health. [NIH]

Enzymatic: Phase where enzyme cuts the precursor protein. [NIH] Enzyme: A protein that speeds up chemical reactions in the body. [NIH] Epidemic: Occurring suddenly in numbers clearly in excess of normal expectancy; said especially of infectious diseases but applied also to any disease, injury, or other healthrelated event occurring in such outbreaks. [EU] Epinephrine: The active sympathomimetic hormone from the adrenal medulla in most species. It stimulates both the alpha- and beta- adrenergic systems, causes systemic vasoconstriction and gastrointestinal relaxation, stimulates the heart, and dilates bronchi and cerebral vessels. It is used in asthma and cardiac failure and to delay absorption of local anesthetics. [NIH] Erythrocytes: Red blood cells. Mature erythrocytes are non-nucleated, biconcave disks containing hemoglobin whose function is to transport oxygen. [NIH] Esophagus: The muscular tube through which food passes from the throat to the stomach. [NIH]

Estrogen: One of the two female sex hormones. [NIH] Ethnic Groups: A group of people with a common cultural heritage that sets them apart from others in a variety of social relationships. [NIH] Excitability: Property of a cardiac cell whereby, when the cell is depolarized to a critical level (called threshold), the membrane becomes permeable and a regenerative inward current causes an action potential. [NIH] Exhaustion: The feeling of weariness of mind and body. [NIH] Exogenous: Developed or originating outside the organism, as exogenous disease. [EU] Extracellular: Outside a cell or cells. [EU] Extracellular Space: Interstitial space between cells, occupied by fluid as well as amorphous and fibrous substances. [NIH] Extrapyramidal: Outside of the pyramidal tracts. [EU] Family Planning: Programs or services designed to assist the family in controlling reproduction by either improving or diminishing fertility. [NIH]

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Fixation: 1. The act or operation of holding, suturing, or fastening in a fixed position. 2. The condition of being held in a fixed position. 3. In psychiatry, a term with two related but distinct meanings : (1) arrest of development at a particular stage, which like regression (return to an earlier stage), if temporary is a normal reaction to setbacks and difficulties but if protracted or frequent is a cause of developmental failures and emotional problems, and (2) a close and suffocating attachment to another person, especially a childhood figure, such as one's mother or father. Both meanings are derived from psychoanalytic theory and refer to 'fixation' of libidinal energy either in a specific erogenous zone, hence fixation at the oral, anal, or phallic stage, or in a specific object, hence mother or father fixation. 4. The use of a fixative (q.v.) to preserve histological or cytological specimens. 5. In chemistry, the process whereby a substance is removed from the gaseous or solution phase and localized, as in carbon dioxide fixation or nitrogen fixation. 6. In ophthalmology, direction of the gaze so that the visual image of the object falls on the fovea centralis. 7. In film processing, the chemical removal of all undeveloped salts of the film emulsion, leaving only the developed silver to form a permanent image. [EU] Fluoxetine: The first highly specific serotonin uptake inhibitor. It is used as an antidepressant and often has a more acceptable side-effects profile than traditional antidepressants. [NIH] Fold: A plication or doubling of various parts of the body. [NIH] Fungi: A kingdom of eukaryotic, heterotrophic organisms that live as saprobes or parasites, including mushrooms, yeasts, smuts, molds, etc. They reproduce either sexually or asexually, and have life cycles that range from simple to complex. Filamentous fungi refer to those that grow as multicelluar colonies (mushrooms and molds). [NIH] Gallbladder: The pear-shaped organ that sits below the liver. Bile is concentrated and stored in the gallbladder. [NIH] Gas: Air that comes from normal breakdown of food. The gases are passed out of the body through the rectum (flatus) or the mouth (burp). [NIH] Gastrin: A hormone released after eating. Gastrin causes the stomach to produce more acid. [NIH]

Gastrointestinal: Refers to the stomach and intestines. [NIH] Gastrointestinal tract: The stomach and intestines. [NIH] Gene: The functional and physical unit of heredity passed from parent to offspring. Genes are pieces of DNA, and most genes contain the information for making a specific protein. [NIH]

Genetic Markers: A phenotypically recognizable genetic trait which can be used to identify a genetic locus, a linkage group, or a recombination event. [NIH] Genetic transcription: The process by which the genetic information encoded in the gene, represented as a linear sequence of deoxyribonucleotides, is copied into an exactly complementary sequence of ribonucleotides known as messenger RNA. [NIH] Germ Cells: The reproductive cells in multicellular organisms. [NIH] Gland: An organ that produces and releases one or more substances for use in the body. Some glands produce fluids that affect tissues or organs. Others produce hormones or participate in blood production. [NIH] Glomerular: Pertaining to or of the nature of a glomerulus, especially a renal glomerulus. [EU]

Glucose: D-Glucose. A primary source of energy for living organisms. It is naturally occurring and is found in fruits and other parts of plants in its free state. It is used

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therapeutically in fluid and nutrient replacement. [NIH] Glucose tolerance: The power of the normal liver to absorb and store large quantities of glucose and the effectiveness of intestinal absorption of glucose. The glucose tolerance test is a metabolic test of carbohydrate tolerance that measures active insulin, a hepatic function based on the ability of the liver to absorb glucose. The test consists of ingesting 100 grams of glucose into a fasting stomach; blood sugar should return to normal in 2 to 21 hours after ingestion. [NIH] Glucose Tolerance Test: Determination of whole blood or plasma sugar in a fasting state before and at prescribed intervals (usually 1/2 hr, 1 hr, 3 hr, 4 hr) after taking a specified amount (usually 100 gm orally) of glucose. [NIH] Glutamate: Excitatory neurotransmitter of the brain. [NIH] Glycoprotein: A protein that has sugar molecules attached to it. [NIH] Gonad: A sex organ, such as an ovary or a testicle, which produces the gametes in most multicellular animals. [NIH] Gonadal: Pertaining to a gonad. [EU] Governing Board: The group in which legal authority is vested for the control of healthrelated institutions and organizations. [NIH] Government Agencies: Administrative units of government responsible for policy making and management of governmental activities in the U.S. and abroad. [NIH] Granulocytes: Leukocytes with abundant granules in the cytoplasm. They are divided into three groups: neutrophils, eosinophils, and basophils. [NIH] Growth: The progressive development of a living being or part of an organism from its earliest stage to maturity. [NIH] Habitual: Of the nature of a habit; according to habit; established by or repeated by force of habit, customary. [EU] Haptens: Small antigenic determinants capable of eliciting an immune response only when coupled to a carrier. Haptens bind to antibodies but by themselves cannot elicit an antibody response. [NIH] Heart attack: A seizure of weak or abnormal functioning of the heart. [NIH] Hemolytic: A disease that affects the blood and blood vessels. It destroys red blood cells, cells that cause the blood to clot, and the lining of blood vessels. HUS is often caused by the Escherichia coli bacterium in contaminated food. People with HUS may develop acute renal failure. [NIH] Hemorrhage: Bleeding or escape of blood from a vessel. [NIH] Hemostasis: The process which spontaneously arrests the flow of blood from vessels carrying blood under pressure. It is accomplished by contraction of the vessels, adhesion and aggregation of formed blood elements, and the process of blood or plasma coagulation. [NIH]

Hepatic: Refers to the liver. [NIH] Hepatitis: Inflammation of the liver and liver disease involving degenerative or necrotic alterations of hepatocytes. [NIH] Hepatocyte: A liver cell. [NIH] Hepatotoxicity: How much damage a medicine or other substance does to the liver. [NIH] Hereditary: Of, relating to, or denoting factors that can be transmitted genetically from one generation to another. [NIH]

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Heredity: 1. The genetic transmission of a particular quality or trait from parent to offspring. 2. The genetic constitution of an individual. [EU] Heroin Dependence: Strong dependence, both physiological and emotional, upon heroin. [NIH]

Heterodimers: Zippered pair of nonidentical proteins. [NIH] Heterogeneity: The property of one or more samples or populations which implies that they are not identical in respect of some or all of their parameters, e. g. heterogeneity of variance. [NIH]

Hiccup: A spasm of the diaphragm that causes a sudden inhalation followed by rapid closure of the glottis which produces a sound. [NIH] Homologous: Corresponding in structure, position, origin, etc., as (a) the feathers of a bird and the scales of a fish, (b) antigen and its specific antibody, (c) allelic chromosomes. [EU] Hormonal: Pertaining to or of the nature of a hormone. [EU] Hormone: A substance in the body that regulates certain organs. Hormones such as gastrin help in breaking down food. Some hormones come from cells in the stomach and small intestine. [NIH] Hydrogen: The first chemical element in the periodic table. It has the atomic symbol H, atomic number 1, and atomic weight 1. It exists, under normal conditions, as a colorless, odorless, tasteless, diatomic gas. Hydrogen ions are protons. Besides the common H1 isotope, hydrogen exists as the stable isotope deuterium and the unstable, radioactive isotope tritium. [NIH] Hyperbilirubinemia: Pathologic process consisting of an abnormal increase in the amount of bilirubin in the circulating blood, which may result in jaundice. [NIH] Hypersensitivity: Altered reactivity to an antigen, which can result in pathologic reactions upon subsequent exposure to that particular antigen. [NIH] Hypertension: Persistently high arterial blood pressure. Currently accepted threshold levels are 140 mm Hg systolic and 90 mm Hg diastolic pressure. [NIH] Hyperthermia: A type of treatment in which body tissue is exposed to high temperatures to damage and kill cancer cells or to make cancer cells more sensitive to the effects of radiation and certain anticancer drugs. [NIH] Hypogonadism: Condition resulting from or characterized by abnormally decreased functional activity of the gonads, with retardation of growth and sexual development. [NIH] Hypothalamic: Of or involving the hypothalamus. [EU] Hypothalamus: Ventral part of the diencephalon extending from the region of the optic chiasm to the caudal border of the mammillary bodies and forming the inferior and lateral walls of the third ventricle. [NIH] Id: The part of the personality structure which harbors the unconscious instinctive desires and strivings of the individual. [NIH] Immune response: The activity of the immune system against foreign substances (antigens). [NIH]

Immune system: The organs, cells, and molecules responsible for the recognition and disposal of foreign ("non-self") material which enters the body. [NIH] Immunization: Deliberate stimulation of the host's immune response. Active immunization involves administration of antigens or immunologic adjuvants. Passive immunization involves administration of immune sera or lymphocytes or their extracts (e.g., transfer factor, immune RNA) or transplantation of immunocompetent cell producing tissue

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(thymus or bone marrow). [NIH] Immunogenic: Producing immunity; evoking an immune response. [EU] Immunology: The study of the body's immune system. [NIH] Immunotherapy: Manipulation of the host's immune system in treatment of disease. It includes both active and passive immunization as well as immunosuppressive therapy to prevent graft rejection. [NIH] Impairment: In the context of health experience, an impairment is any loss or abnormality of psychological, physiological, or anatomical structure or function. [NIH] Impetigo: A common superficial bacterial infection caused by staphylococcus aureus or group A beta-hemolytic streptococci. Characteristics include pustular lesions that rupture and discharge a thin, amber-colored fluid that dries and forms a crust. This condition is commonly located on the face, especially about the mouth and nose. [NIH] In vitro: In the laboratory (outside the body). The opposite of in vivo (in the body). [NIH] In vivo: In the body. The opposite of in vitro (outside the body or in the laboratory). [NIH] Incarceration: Abnormal retention or confinement of a body part; specifically : a constriction of the neck of a hernial sac so that the hernial contents become irreducible. [EU] Incontinence: Inability to control the flow of urine from the bladder (urinary incontinence) or the escape of stool from the rectum (fecal incontinence). [NIH] Indicative: That indicates; that points out more or less exactly; that reveals fairly clearly. [EU] Induction: The act or process of inducing or causing to occur, especially the production of a specific morphogenetic effect in the developing embryo through the influence of evocators or organizers, or the production of anaesthesia or unconsciousness by use of appropriate agents. [EU] Infarction: A pathological process consisting of a sudden insufficient blood supply to an area, which results in necrosis of that area. It is usually caused by a thrombus, an embolus, or a vascular torsion. [NIH] Infection: 1. Invasion and multiplication of microorganisms in body tissues, which may be clinically unapparent or result in local cellular injury due to competitive metabolism, toxins, intracellular replication, or antigen-antibody response. The infection may remain localized, subclinical, and temporary if the body's defensive mechanisms are effective. A local infection may persist and spread by extension to become an acute, subacute, or chronic clinical infection or disease state. A local infection may also become systemic when the microorganisms gain access to the lymphatic or vascular system. 2. An infectious disease. [EU]

Inflammation: A pathological process characterized by injury or destruction of tissues caused by a variety of cytologic and chemical reactions. It is usually manifested by typical signs of pain, heat, redness, swelling, and loss of function. [NIH] Informed Consent: Voluntary authorization, given to the physician by the patient, with full comprehension of the risks involved, for diagnostic or investigative procedures and medical and surgical treatment. [NIH] Ingestion: Taking into the body by mouth [NIH] Inhalation: The drawing of air or other substances into the lungs. [EU] Initiation: Mutation induced by a chemical reactive substance causing cell changes; being a step in a carcinogenic process. [NIH] Inotropic: Affecting the force or energy of muscular contractions. [EU]

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Insulin: A protein hormone secreted by beta cells of the pancreas. Insulin plays a major role in the regulation of glucose metabolism, generally promoting the cellular utilization of glucose. It is also an important regulator of protein and lipid metabolism. Insulin is used as a drug to control insulin-dependent diabetes mellitus. [NIH] Insulin-dependent diabetes mellitus: A disease characterized by high levels of blood glucose resulting from defects in insulin secretion, insulin action, or both. Autoimmune, genetic, and environmental factors are involved in the development of type I diabetes. [NIH] Intermittent: Occurring at separated intervals; having periods of cessation of activity. [EU] Interstitial: Pertaining to or situated between parts or in the interspaces of a tissue. [EU] Intestinal: Having to do with the intestines. [NIH] Intoxication: Poisoning, the state of being poisoned. [EU] Intracellular: Inside a cell. [NIH] Intramuscular: IM. Within or into muscle. [NIH] Intravenous: IV. Into a vein. [NIH] Intrinsic: Situated entirely within or pertaining exclusively to a part. [EU] Ion Channels: Gated, ion-selective glycoproteins that traverse membranes. The stimulus for channel gating can be a membrane potential, drug, transmitter, cytoplasmic messenger, or a mechanical deformation. Ion channels which are integral parts of ionotropic neurotransmitter receptors are not included. [NIH] Ions: An atom or group of atoms that have a positive or negative electric charge due to a gain (negative charge) or loss (positive charge) of one or more electrons. Atoms with a positive charge are known as cations; those with a negative charge are anions. [NIH] Ischemia: Deficiency of blood in a part, due to functional constriction or actual obstruction of a blood vessel. [EU] Jaundice: A clinical manifestation of hyperbilirubinemia, consisting of deposition of bile pigments in the skin, resulting in a yellowish staining of the skin and mucous membranes. [NIH]

Kb: A measure of the length of DNA fragments, 1 Kb = 1000 base pairs. The largest DNA fragments are up to 50 kilobases long. [NIH] Kinetics: The study of rate dynamics in chemical or physical systems. [NIH] Labile: 1. Gliding; moving from point to point over the surface; unstable; fluctuating. 2. Chemically unstable. [EU] Lactation: The period of the secretion of milk. [EU] Large Intestine: The part of the intestine that goes from the cecum to the rectum. The large intestine absorbs water from stool and changes it from a liquid to a solid form. The large intestine is 5 feet long and includes the appendix, cecum, colon, and rectum. Also called colon. [NIH] Latent: Phoria which occurs at one distance or another and which usually has no troublesome effect. [NIH] Lesion: An area of abnormal tissue change. [NIH] Leucine: An essential branched-chain amino acid important for hemoglobin formation. [NIH] Levo: It is an experimental treatment for heroin addiction that was developed by German scientists around 1948 as an analgesic. Like methadone, it binds with opioid receptors, but it is longer acting. [NIH]

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Levorphanol: A narcotic analgesic that may be habit-forming. It is nearly as effective orally as by injection. [NIH] Library Services: Services offered to the library user. They include reference and circulation. [NIH]

Linkage: The tendency of two or more genes in the same chromosome to remain together from one generation to the next more frequently than expected according to the law of independent assortment. [NIH] Lipid: Fat. [NIH] Liver: A large, glandular organ located in the upper abdomen. The liver cleanses the blood and aids in digestion by secreting bile. [NIH] Lobe: A portion of an organ such as the liver, lung, breast, or brain. [NIH] Localization: The process of determining or marking the location or site of a lesion or disease. May also refer to the process of keeping a lesion or disease in a specific location or site. [NIH] Localized: Cancer which has not metastasized yet. [NIH] Lutein Cells: The cells of the corpus luteum which are derived from the granulosa cells and the theca cells of the Graafian follicle. [NIH] Lymphatic: The tissues and organs, including the bone marrow, spleen, thymus, and lymph nodes, that produce and store cells that fight infection and disease. [NIH] Maintenance therapy: Treatment that is given to help a primary (original) treatment keep working. Maintenance therapy is often given to help keep cancer in remission. [NIH] Malaise: A vague feeling of bodily discomfort. [EU] Malaria: A protozoan disease caused in humans by four species of the genus Plasmodium (P. falciparum (malaria, falciparum), P. vivax (malaria, vivax), P. ovale, and P. malariae) and transmitted by the bite of an infected female mosquito of the genus Anopheles. Malaria is endemic in parts of Asia, Africa, Central and South America, Oceania, and certain Caribbean islands. It is characterized by extreme exhaustion associated with paroxysms of high fever, sweating, shaking chills, and anemia. Malaria in animals is caused by other species of plasmodia. [NIH] Malaria, Falciparum: Malaria caused by Plasmodium falciparum. This is the severest form of malaria and is associated with the highest levels of parasites in the blood. This disease is characterized by irregularly recurring febrile paroxysms that in extreme cases occur with acute cerebral, renal, or gastrointestinal manifestations. [NIH] Malaria, Vivax: Malaria caused by Plasmodium vivax. This form of malaria is less severe than malaria, falciparum, but there is a higher probability for relapses to occur. Febrile paroxysms often occur every other day. [NIH] Marijuana Abuse: The excessive use of marijuana with associated psychological symptoms and impairment in social or occupational functioning. [NIH] Mediate: Indirect; accomplished by the aid of an intervening medium. [EU] Mediator: An object or substance by which something is mediated, such as (1) a structure of the nervous system that transmits impulses eliciting a specific response; (2) a chemical substance (transmitter substance) that induces activity in an excitable tissue, such as nerve or muscle; or (3) a substance released from cells as the result of the interaction of antigen with antibody or by the action of antigen with a sensitized lymphocyte. [EU] Medical Staff: Professional medical personnel who provide care to patients in an organized facility, institution or agency. [NIH]

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MEDLINE: An online database of MEDLARS, the computerized bibliographic Medical Literature Analysis and Retrieval System of the National Library of Medicine. [NIH] Medullary: Pertaining to the marrow or to any medulla; resembling marrow. [EU] Membrane: A very thin layer of tissue that covers a surface. [NIH] Meninges: The three membranes that cover and protect the brain and spinal cord. [NIH] Menstruation: The normal physiologic discharge through the vagina of blood and mucosal tissues from the nonpregnant uterus. [NIH] Mental Disorders: Psychiatric illness or diseases manifested by breakdowns in the adaptational process expressed primarily as abnormalities of thought, feeling, and behavior producing either distress or impairment of function. [NIH] Mental Health: The state wherein the person is well adjusted. [NIH] Methionine: A sulfur containing essential amino acid that is important in many body functions. It is a chelating agent for heavy metals. [NIH] Methylphenidate: A central nervous system stimulant used most commonly in the treatment of attention-deficit disorders in children and for narcolepsy. Its mechanisms appear to be similar to those of dextroamphetamine. [NIH] MI: Myocardial infarction. Gross necrosis of the myocardium as a result of interruption of the blood supply to the area; it is almost always caused by atherosclerosis of the coronary arteries, upon which coronary thrombosis is usually superimposed. [NIH] Microdialysis: A technique for measuring extracellular concentrations of substances in tissues, usually in vivo, by means of a small probe equipped with a semipermeable membrane. Substances may also be introduced into the extracellular space through the membrane. [NIH] Milieu Therapy: A treatment program based on manipulation of the patient's environment by the medical staff. The patient does not participate in planning the treatment regimen. [NIH]

Modeling: A treatment procedure whereby the therapist presents the target behavior which the learner is to imitate and make part of his repertoire. [NIH] Molecular: Of, pertaining to, or composed of molecules : a very small mass of matter. [EU] Molecule: A chemical made up of two or more atoms. The atoms in a molecule can be the same (an oxygen molecule has two oxygen atoms) or different (a water molecule has two hydrogen atoms and one oxygen atom). Biological molecules, such as proteins and DNA, can be made up of many thousands of atoms. [NIH] Morals: Standards of conduct as right or wrong. [NIH] Morphine: The principal alkaloid in opium and the prototype opiate analgesic and narcotic. Morphine has widespread effects in the central nervous system and on smooth muscle. [NIH] Motility: The ability to move spontaneously. [EU] Mucosa: A mucous membrane, or tunica mucosa. [EU] Mycosis: Any disease caused by a fungus. [EU] Mycotic: Pertaining to a mycosis; caused by fungi. [EU] Myelitis: Inflammation of the spinal cord. Relatively common etiologies include infections; autoimmune diseases; spinal cord; and ischemia (see also spinal cord vascular diseases). Clinical features generally include weakness, sensory loss, localized pain, incontinence, and other signs of autonomic dysfunction. [NIH] Myocardium: The muscle tissue of the heart composed of striated, involuntary muscle

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known as cardiac muscle. [NIH] Naive: Used to describe an individual who has never taken a certain drug or class of drugs (e. g., AZT-naive, antiretroviral-naive), or to refer to an undifferentiated immune system cell. [NIH] Naloxone: A specific opiate antagonist that has no agonist activity. It is a competitive antagonist at mu, delta, and kappa opioid receptors. [NIH] Naltrexone: Derivative of noroxymorphone that is the N-cyclopropylmethyl congener of naloxone. It is a narcotic antagonist that is effective orally, longer lasting and more potent than naloxone, and has been proposed for the treatment of heroin addiction. The FDA has approved naltrexone for the treatment of alcohol dependence. [NIH] Narcolepsy: A condition of unknown cause characterized by a periodic uncontrollable tendency to fall asleep. [NIH] Narcosis: A general and nonspecific reversible depression of neuronal excitability, produced by a number of physical and chemical aspects, usually resulting in stupor. [NIH] Narcotic: 1. Pertaining to or producing narcosis. 2. An agent that produces insensibility or stupor, applied especially to the opioids, i.e. to any natural or synthetic drug that has morphine-like actions. [EU] NCI: National Cancer Institute. NCI, part of the National Institutes of Health of the United States Department of Health and Human Services, is the federal government's principal agency for cancer research. NCI conducts, coordinates, and funds cancer research, training, health information dissemination, and other programs with respect to the cause, diagnosis, prevention, and treatment of cancer. Access the NCI Web site at http://cancer.gov. [NIH] Necrosis: A pathological process caused by the progressive degradative action of enzymes that is generally associated with severe cellular trauma. It is characterized by mitochondrial swelling, nuclear flocculation, uncontrolled cell lysis, and ultimately cell death. [NIH] Need: A state of tension or dissatisfaction felt by an individual that impels him to action toward a goal he believes will satisfy the impulse. [NIH] Needle Sharing: Usage of a single needle among two or more people for injecting drugs. Needle sharing is a high-risk behavior for contracting infectious disease. [NIH] Neonatal: Pertaining to the first four weeks after birth. [EU] Neonatal Abstinence Syndrome: Fetal and neonatal addiction and withdrawal as a result of the mother's dependence on drugs during pregnancy. Withdrawal or abstinence symptoms develop shortly after birth. Symptoms exhibited are loud, high-pitched crying, sweating, yawning and gastrointestinal disturbances. [NIH] Nephropathy: Disease of the kidneys. [EU] Nerve: A cordlike structure of nervous tissue that connects parts of the nervous system with other tissues of the body and conveys nervous impulses to, or away from, these tissues. [NIH] Nervous System: The entire nerve apparatus composed of the brain, spinal cord, nerves and ganglia. [NIH] Neurologic: Having to do with nerves or the nervous system. [NIH] Neuronal: Pertaining to a neuron or neurons (= conducting cells of the nervous system). [EU] Neurons: The basic cellular units of nervous tissue. Each neuron consists of a body, an axon, and dendrites. Their purpose is to receive, conduct, and transmit impulses in the nervous system. [NIH] Neuropathy: A problem in any part of the nervous system except the brain and spinal cord. Neuropathies can be caused by infection, toxic substances, or disease. [NIH]

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Neurotoxicity: The tendency of some treatments to cause damage to the nervous system. [NIH]

Neurotransmitters: Endogenous signaling molecules that alter the behavior of neurons or effector cells. Neurotransmitter is used here in its most general sense, including not only messengers that act directly to regulate ion channels, but also those that act through second messenger systems, and those that act at a distance from their site of release. Included are neuromodulators, neuroregulators, neuromediators, and neurohumors, whether or not acting at synapses. [NIH] Nonverbal Communication: Transmission of emotions, ideas, and attitudes between individuals in ways other than the spoken language. [NIH] Norepinephrine: Precursor of epinephrine that is secreted by the adrenal medulla and is a widespread central and autonomic neurotransmitter. Norepinephrine is the principal transmitter of most postganglionic sympathetic fibers and of the diffuse projection system in the brain arising from the locus ceruleus. It is also found in plants and is used pharmacologically as a sympathomimetic. [NIH] Nucleus: A body of specialized protoplasm found in nearly all cells and containing the chromosomes. [NIH] Nucleus Accumbens: Collection of pleomorphic cells in the caudal part of the anterior horn of the lateral ventricle, in the region of the olfactory tubercle, lying between the head of the caudate nucleus and the anterior perforated substance. It is part of the so-called ventral striatum, a composite structure considered part of the basal ganglia. [NIH] Oocytes: Female germ cells in stages between the prophase of the first maturation division and the completion of the second maturation division. [NIH] Opacity: Degree of density (area most dense taken for reading). [NIH] Operon: The genetic unit consisting of a feedback system under the control of an operator gene, in which a structural gene transcribes its message in the form of mRNA upon blockade of a repressor produced by a regulator gene. Included here is the attenuator site of bacterial operons where transcription termination is regulated. [NIH] Opioid Peptides: The endogenous peptides with opiate-like activity. The three major classes currently recognized are the enkephalins, the dynorphins, and the endorphins. Each of these families derives from different precursors, proenkephalin, prodynorphin, and proopiomelanocortin, respectively. There are also at least three classes of opioid receptors, but the peptide families do not map to the receptors in a simple way. [NIH] Opium: The air-dried exudate from the unripe seed capsule of the opium poppy, Papaver somniferum, or its variant, P. album. It contains a number of alkaloids, but only a few morphine, codeine, and papaverine - have clinical significance. Opium has been used as an analgesic, antitussive, antidiarrheal, and antispasmodic. [NIH] Opportunistic Infections: An infection caused by an organism which becomes pathogenic under certain conditions, e.g., during immunosuppression. [NIH] Optic Nerve: The 2nd cranial nerve. The optic nerve conveys visual information from the retina to the brain. The nerve carries the axons of the retinal ganglion cells which sort at the optic chiasm and continue via the optic tracts to the brain. The largest projection is to the lateral geniculate nuclei; other important targets include the superior colliculi and the suprachiasmatic nuclei. Though known as the second cranial nerve, it is considered part of the central nervous system. [NIH] Outpatient: A patient who is not an inmate of a hospital but receives diagnosis or treatment in a clinic or dispensary connected with the hospital. [NIH]

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Ovary: Either of the paired glands in the female that produce the female germ cells and secrete some of the female sex hormones. [NIH] Ovum: A female germ cell extruded from the ovary at ovulation. [NIH] Palliative: 1. Affording relief, but not cure. 2. An alleviating medicine. [EU] Pancreas: A mixed exocrine and endocrine gland situated transversely across the posterior abdominal wall in the epigastric and hypochondriac regions. The endocrine portion is comprised of the Islets of Langerhans, while the exocrine portion is a compound acinar gland that secretes digestive enzymes. [NIH] Parenteral: Not through the alimentary canal but rather by injection through some other route, as subcutaneous, intramuscular, intraorbital, intracapsular, intraspinal, intrasternal, intravenous, etc. [EU] Parturition: The act or process of given birth to a child. [EU] Penicillin: An antibiotic drug used to treat infection. [NIH] Peptide: Any compound consisting of two or more amino acids, the building blocks of proteins. Peptides are combined to make proteins. [NIH] Perception: The ability quickly and accurately to recognize similarities and differences among presented objects, whether these be pairs of words, pairs of number series, or multiple sets of these or other symbols such as geometric figures. [NIH] Pharmacokinetic: The mathematical analysis of the time courses of absorption, distribution, and elimination of drugs. [NIH] Pharmacologic: Pertaining to pharmacology or to the properties and reactions of drugs. [EU] Pharmacotherapy: A regimen of using appetite suppressant medications to manage obesity by decreasing appetite or increasing the feeling of satiety. These medications decrease appetite by increasing serotonin or catecholamine—two brain chemicals that affect mood and appetite. [NIH] Phospholipases: A class of enzymes that catalyze the hydrolysis of phosphoglycerides or glycerophosphatidates. EC 3.1.-. [NIH] Phosphorus: A non-metallic element that is found in the blood, muscles, nevers, bones, and teeth, and is a component of adenosine triphosphate (ATP; the primary energy source for the body's cells.) [NIH] Phosphorylation: The introduction of a phosphoryl group into a compound through the formation of an ester bond between the compound and a phosphorus moiety. [NIH] Physiologic: Having to do with the functions of the body. When used in the phrase "physiologic age," it refers to an age assigned by general health, as opposed to calendar age. [NIH]

Physiology: The science that deals with the life processes and functions of organismus, their cells, tissues, and organs. [NIH] Pilot study: The initial study examining a new method or treatment. [NIH] Pituitary Gland: A small, unpaired gland situated in the sella turcica tissue. It is connected to the hypothalamus by a short stalk. [NIH] Plants: Multicellular, eukaryotic life forms of the kingdom Plantae. They are characterized by a mainly photosynthetic mode of nutrition; essentially unlimited growth at localized regions of cell divisions (meristems); cellulose within cells providing rigidity; the absence of organs of locomotion; absense of nervous and sensory systems; and an alteration of haploid and diploid generations. [NIH]

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Plasma: The clear, yellowish, fluid part of the blood that carries the blood cells. The proteins that form blood clots are in plasma. [NIH] Platelet Activation: A series of progressive, overlapping events triggered by exposure of the platelets to subendothelial tissue. These events include shape change, adhesiveness, aggregation, and release reactions. When carried through to completion, these events lead to the formation of a stable hemostatic plug. [NIH] Platelet Aggregation: The attachment of platelets to one another. This clumping together can be induced by a number of agents (e.g., thrombin, collagen) and is part of the mechanism leading to the formation of a thrombus. [NIH] Platelets: A type of blood cell that helps prevent bleeding by causing blood clots to form. Also called thrombocytes. [NIH] Pleomorphic: Occurring in various distinct forms. In terms of cells, having variation in the size and shape of cells or their nuclei. [NIH] Poisoning: A condition or physical state produced by the ingestion, injection or inhalation of, or exposure to a deleterious agent. [NIH] Policy Making: The decision process by which individuals, groups or institutions establish policies pertaining to plans, programs or procedures. [NIH] Polymerase: An enzyme which catalyses the synthesis of DNA using a single DNA strand as a template. The polymerase copies the template in the 5'-3'direction provided that sufficient quantities of free nucleotides, dATP and dTTP are present. [NIH] Polymorphism: The occurrence together of two or more distinct forms in the same population. [NIH] Polypeptide: A peptide which on hydrolysis yields more than two amino acids; called tripeptides, tetrapeptides, etc. according to the number of amino acids contained. [EU] Postsynaptic: Nerve potential generated by an inhibitory hyperpolarizing stimulation. [NIH] Potentiation: An overall effect of two drugs taken together which is greater than the sum of the effects of each drug taken alone. [NIH] Practicability: A non-standard characteristic of an analytical procedure. It is dependent on the scope of the method and is determined by requirements such as sample throughout and costs. [NIH] Practice Guidelines: Directions or principles presenting current or future rules of policy for the health care practitioner to assist him in patient care decisions regarding diagnosis, therapy, or related clinical circumstances. The guidelines may be developed by government agencies at any level, institutions, professional societies, governing boards, or by the convening of expert panels. The guidelines form a basis for the evaluation of all aspects of health care and delivery. [NIH] Precursor: Something that precedes. In biological processes, a substance from which another, usually more active or mature substance is formed. In clinical medicine, a sign or symptom that heralds another. [EU] Predisposition: A latent susceptibility to disease which may be activated under certain conditions, as by stress. [EU] Prevalence: The total number of cases of a given disease in a specified population at a designated time. It is differentiated from incidence, which refers to the number of new cases in the population at a given time. [NIH] Probe: An instrument used in exploring cavities, or in the detection and dilatation of strictures, or in demonstrating the potency of channels; an elongated instrument for

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exploring or sounding body cavities. [NIH] Progesterone: Pregn-4-ene-3,20-dione. The principal progestational hormone of the body, secreted by the corpus luteum, adrenal cortex, and placenta. Its chief function is to prepare the uterus for the reception and development of the fertilized ovum. It acts as an antiovulatory agent when administered on days 5-25 of the menstrual cycle. [NIH] Progression: Increase in the size of a tumor or spread of cancer in the body. [NIH] Progressive: Advancing; going forward; going from bad to worse; increasing in scope or severity. [EU] Projection: A defense mechanism, operating unconsciously, whereby that which is emotionally unacceptable in the self is rejected and attributed (projected) to others. [NIH] Prolactin: Pituitary lactogenic hormone. A polypeptide hormone with a molecular weight of about 23,000. It is essential in the induction of lactation in mammals at parturition and is synergistic with estrogen. The hormone also brings about the release of progesterone from lutein cells, which renders the uterine mucosa suited for the embedding of the ovum should fertilization occur. [NIH] Promoter: A chemical substance that increases the activity of a carcinogenic process. [NIH] Promotor: In an operon, a nucleotide sequence located at the operator end which contains all the signals for the correct initiation of genetic transcription by the RNA polymerase holoenzyme and determines the maximal rate of RNA synthesis. [NIH] Pro-Opiomelanocortin: A precursor protein, MW 30,000, synthesized mainly in the anterior pituitary gland but also found in the hypothalamus, brain, and several peripheral tissues. It incorporates the amino acid sequences of ACTH and beta-lipotropin. These two hormones, in turn, contain the biologically active peptides MSH, corticotropin-like intermediate lobe peptide, alpha-lipotropin, endorphins, and methionine enkephalin. [NIH] Prophase: The first phase of cell division, in which the chromosomes become visible, the nucleus starts to lose its identity, the spindle appears, and the centrioles migrate toward opposite poles. [NIH] Propoxyphene: A narcotic analgesic structurally related to methadone. Only the dextroisomer has an analgesic effect; the levo-isomer appears to exert an antitussive effect. [NIH] Prostitution: The practice of indulging in promiscuous sexual relations for money. [NIH] Protein C: A vitamin-K dependent zymogen present in the blood, which, upon activation by thrombin and thrombomodulin exerts anticoagulant properties by inactivating factors Va and VIIIa at the rate-limiting steps of thrombin formation. [NIH] Protein S: The vitamin K-dependent cofactor of activated protein C. Together with protein C, it inhibits the action of factors VIIIa and Va. A deficiency in protein S can lead to recurrent venous and arterial thrombosis. [NIH] Proteins: Polymers of amino acids linked by peptide bonds. The specific sequence of amino acids determines the shape and function of the protein. [NIH] Proteolytic: 1. Pertaining to, characterized by, or promoting proteolysis. 2. An enzyme that promotes proteolysis (= the splitting of proteins by hydrolysis of the peptide bonds with formation of smaller polypeptides). [EU] Protocol: The detailed plan for a clinical trial that states the trial's rationale, purpose, drug or vaccine dosages, length of study, routes of administration, who may participate, and other aspects of trial design. [NIH] Psychiatric: Pertaining to or within the purview of psychiatry. [EU] Psychiatry: The medical science that deals with the origin, diagnosis, prevention, and

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treatment of mental disorders. [NIH] Psychotherapy: A generic term for the treatment of mental illness or emotional disturbances primarily by verbal or nonverbal communication. [NIH] Public Policy: A course or method of action selected, usually by a government, from among alternatives to guide and determine present and future decisions. [NIH] Publishing: "The business or profession of the commercial production and issuance of literature" (Webster's 3d). It includes the publisher, publication processes, editing and editors. Production may be by conventional printing methods or by electronic publishing. [NIH]

Purulent: Consisting of or containing pus; associated with the formation of or caused by pus. [EU] Pustular: Pertaining to or of the nature of a pustule; consisting of pustules (= a visible collection of pus within or beneath the epidermis). [EU] Pyramidal Tracts: Fibers that arise from cells within the cerebral cortex, pass through the medullary pyramid, and descend in the spinal cord. Many authorities say the pyramidal tracts include both the corticospinal and corticobulbar tracts. [NIH] Radiation: Emission or propagation of electromagnetic energy (waves/rays), or the waves/rays themselves; a stream of electromagnetic particles (electrons, neutrons, protons, alpha particles) or a mixture of these. The most common source is the sun. [NIH] Radioimmunoassay: Classic quantitative assay for detection of antigen-antibody reactions using a radioactively labeled substance (radioligand) either directly or indirectly to measure the binding of the unlabeled substance to a specific antibody or other receptor system. Nonimmunogenic substances (e.g., haptens) can be measured if coupled to larger carrier proteins (e.g., bovine gamma-globulin or human serum albumin) capable of inducing antibody formation. [NIH] Randomized: Describes an experiment or clinical trial in which animal or human subjects are assigned by chance to separate groups that compare different treatments. [NIH] Reaction Time: The time from the onset of a stimulus until the organism responds. [NIH] Receptor: A molecule inside or on the surface of a cell that binds to a specific substance and causes a specific physiologic effect in the cell. [NIH] Receptors, Serotonin: Cell-surface proteins that bind serotonin and trigger intracellular changes which influence the behavior of cells. Several types of serotonin receptors have been recognized which differ in their pharmacology, molecular biology, and mode of action. [NIH] Recombination: The formation of new combinations of genes as a result of segregation in crosses between genetically different parents; also the rearrangement of linked genes due to crossing-over. [NIH] Rectum: The last 8 to 10 inches of the large intestine. [NIH] Refer: To send or direct for treatment, aid, information, de decision. [NIH] Refractive Errors: Deviations from the average or standard indices of refraction of the eye through its dioptric or refractive apparatus. [NIH] Regimen: A treatment plan that specifies the dosage, the schedule, and the duration of treatment. [NIH] Relapse: The return of signs and symptoms of cancer after a period of improvement. [NIH] Remission: A decrease in or disappearance of signs and symptoms of cancer. In partial remission, some, but not all, signs and symptoms of cancer have disappeared. In complete remission, all signs and symptoms of cancer have disappeared, although there still may be

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cancer in the body. [NIH] Renal amyloidosis: A disease of unknown etiology characterized by the abnormal deposition of amyloid, a translucent homogenous glycoprotein, in various organs and tissues of the body. [NIH] Renal failure: Progressive renal insufficiency and uremia, due to irreversible and progressive renal glomerular tubular or interstitial disease. [NIH] Rhabdomyolysis: Necrosis or disintegration of skeletal muscle often followed by myoglobinuria. [NIH] Risk factor: A habit, trait, condition, or genetic alteration that increases a person's chance of developing a disease. [NIH] Salivary: The duct that convey saliva to the mouth. [NIH] Salivary glands: Glands in the mouth that produce saliva. [NIH] Schizoid: Having qualities resembling those found in greater degree in schizophrenics; a person of schizoid personality. [NIH] Schizophrenia: A mental disorder characterized by a special type of disintegration of the personality. [NIH] Schizotypal Personality Disorder: A personality disorder in which there are oddities of thought (magical thinking, paranoid ideation, suspiciousness), perception (illusions, depersonalization), speech (digressive, vague, overelaborate), and behavior (inappropriate affect in social interactions, frequently social isolation) that are not severe enough to characterize schizophrenia. [NIH] Screening: Checking for disease when there are no symptoms. [NIH] Scrotum: In males, the external sac that contains the testicles. [NIH] Second Messenger Systems: Systems in which an intracellular signal is generated in response to an intercellular primary messenger such as a hormone or neurotransmitter. They are intermediate signals in cellular processes such as metabolism, secretion, contraction, phototransduction, and cell growth. Examples of second messenger systems are the adenyl cyclase-cyclic AMP system, the phosphatidylinositol diphosphate-inositol triphosphate system, and the cyclic GMP system. [NIH] Secretion: 1. The process of elaborating a specific product as a result of the activity of a gland; this activity may range from separating a specific substance of the blood to the elaboration of a new chemical substance. 2. Any substance produced by secretion. [EU] Sedative: 1. Allaying activity and excitement. 2. An agent that allays excitement. [EU] Sediment: A precipitate, especially one that is formed spontaneously. [EU] Sensitization: 1. Administration of antigen to induce a primary immune response; priming; immunization. 2. Exposure to allergen that results in the development of hypersensitivity. 3. The coating of erythrocytes with antibody so that they are subject to lysis by complement in the presence of homologous antigen, the first stage of a complement fixation test. [EU] Sensory loss: A disease of the nerves whereby the myelin or insulating sheath of myelin on the nerves does not stay intact and the messages from the brain to the muscles through the nerves are not carried properly. [NIH] Sequencing: The determination of the order of nucleotides in a DNA or RNA chain. [NIH] Serotonin: A biochemical messenger and regulator, synthesized from the essential amino acid L-tryptophan. In humans it is found primarily in the central nervous system, gastrointestinal tract, and blood platelets. Serotonin mediates several important physiological functions including neurotransmission, gastrointestinal motility, hemostasis,

Dictionary 125

and cardiovascular integrity. Multiple receptor families (receptors, serotonin) explain the broad physiological actions and distribution of this biochemical mediator. [NIH] Serum: The clear liquid part of the blood that remains after blood cells and clotting proteins have been removed. [NIH] Serum Albumin: A major plasma protein that serves in maintaining the plasma colloidal osmotic pressure and transporting large organic anions. [NIH] Sex Characteristics: Those characteristics that distinguish one sex from the other. The primary sex characteristics are the ovaries and testes and their related hormones. Secondary sex characteristics are those which are masculine or feminine but not directly related to reproduction. [NIH] Side effect: A consequence other than the one(s) for which an agent or measure is used, as the adverse effects produced by a drug, especially on a tissue or organ system other than the one sought to be benefited by its administration. [EU] Signal Transduction: The intercellular or intracellular transfer of information (biological activation/inhibition) through a signal pathway. In each signal transduction system, an activation/inhibition signal from a biologically active molecule (hormone, neurotransmitter) is mediated via the coupling of a receptor/enzyme to a second messenger system or to an ion channel. Signal transduction plays an important role in activating cellular functions, cell differentiation, and cell proliferation. Examples of signal transduction systems are the GABA-postsynaptic receptor-calcium ion channel system, the receptor-mediated T-cell activation pathway, and the receptor-mediated activation of phospholipases. Those coupled to membrane depolarization or intracellular release of calcium include the receptormediated activation of cytotoxic functions in granulocytes and the synaptic potentiation of protein kinase activation. Some signal transduction pathways may be part of larger signal transduction pathways; for example, protein kinase activation is part of the platelet activation signal pathway. [NIH] Signs and Symptoms: Clinical manifestations that can be either objective when observed by a physician, or subjective when perceived by the patient. [NIH] Skeletal: Having to do with the skeleton (boney part of the body). [NIH] Small intestine: The part of the digestive tract that is located between the stomach and the large intestine. [NIH] Smooth muscle: Muscle that performs automatic tasks, such as constricting blood vessels. [NIH]

Specialist: In medicine, one who concentrates on 1 special branch of medical science. [NIH] Species: A taxonomic category subordinate to a genus (or subgenus) and superior to a subspecies or variety, composed of individuals possessing common characters distinguishing them from other categories of individuals of the same taxonomic level. In taxonomic nomenclature, species are designated by the genus name followed by a Latin or Latinized adjective or noun. [EU] Specificity: Degree of selectivity shown by an antibody with respect to the number and types of antigens with which the antibody combines, as well as with respect to the rates and the extents of these reactions. [NIH] Sperm: The fecundating fluid of the male. [NIH] Spinal cord: The main trunk or bundle of nerves running down the spine through holes in the spinal bone (the vertebrae) from the brain to the level of the lower back. [NIH] Spinal Cord Vascular Diseases: Hypoxic-ischemic and hemorrhagic disorders of the spinal cord. Arteriosclerosis, emboli, and vascular malformations are potential causes of these

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conditions. [NIH] Stabilization: The creation of a stable state. [EU] Staphylococcus: A genus of gram-positive, facultatively anaerobic, coccoid bacteria. Its organisms occur singly, in pairs, and in tetrads and characteristically divide in more than one plane to form irregular clusters. Natural populations of Staphylococcus are membranes of warm-blooded animals. Some species are opportunistic pathogens of humans and animals. [NIH] Staphylococcus aureus: Potentially pathogenic bacteria found in nasal membranes, skin, hair follicles, and perineum of warm-blooded animals. They may cause a wide range of infections and intoxications. [NIH] Steroid: A group name for lipids that contain a hydrogenated cyclopentanoperhydrophenanthrene ring system. Some of the substances included in this group are progesterone, adrenocortical hormones, the gonadal hormones, cardiac aglycones, bile acids, sterols (such as cholesterol), toad poisons, saponins, and some of the carcinogenic hydrocarbons. [EU] Stimulant: 1. Producing stimulation; especially producing stimulation by causing tension on muscle fibre through the nervous tissue. 2. An agent or remedy that produces stimulation. [EU]

Stimulus: That which can elicit or evoke action (response) in a muscle, nerve, gland or other excitable issue, or cause an augmenting action upon any function or metabolic process. [NIH] Stomach: An organ of digestion situated in the left upper quadrant of the abdomen between the termination of the esophagus and the beginning of the duodenum. [NIH] Streptococci: A genus of spherical Gram-positive bacteria occurring in chains or pairs. They are widely distributed in nature, being important pathogens but often found as normal commensals in the mouth, skin, and intestine of humans and other animals. [NIH] Stress: Forcibly exerted influence; pressure. Any condition or situation that causes strain or tension. Stress may be either physical or psychologic, or both. [NIH] Striatum: A higher brain's domain thus called because of its stripes. [NIH] Stroke: Sudden loss of function of part of the brain because of loss of blood flow. Stroke may be caused by a clot (thrombosis) or rupture (hemorrhage) of a blood vessel to the brain. [NIH] Stupor: Partial or nearly complete unconsciousness, manifested by the subject's responding only to vigorous stimulation. Also, in psychiatry, a disorder marked by reduced responsiveness. [EU] Subacute: Somewhat acute; between acute and chronic. [EU] Subclavian: The direct continuation of the axillary vein at the lateral border of the first rib. It passes medially to join the internal jugular vein and form the brachiocephalic vein on each side. [NIH] Subclavian Artery: Artery arising from the brachiocephalic trunk on the right side and from the arch of the aorta on the left side. It distributes to the neck, thoracic wall, spinal cord, brain, meninges, and upper limb. [NIH] Subclinical: Without clinical manifestations; said of the early stage(s) of an infection or other disease or abnormality before symptoms and signs become apparent or detectable by clinical examination or laboratory tests, or of a very mild form of an infection or other disease or abnormality. [EU] Subcutaneous: Beneath the skin. [NIH] Substance P: An eleven-amino acid neurotransmitter that appears in both the central and

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peripheral nervous systems. It is involved in transmission of pain, causes rapid contractions of the gastrointestinal smooth muscle, and modulates inflammatory and immune responses. [NIH]

Substrate: A substance upon which an enzyme acts. [EU] Suppression: A conscious exclusion of disapproved desire contrary with repression, in which the process of exclusion is not conscious. [NIH] Suppurative: Consisting of, containing, associated with, or identified by the formation of pus. [NIH] Sympathomimetic: 1. Mimicking the effects of impulses conveyed by adrenergic postganglionic fibres of the sympathetic nervous system. 2. An agent that produces effects similar to those of impulses conveyed by adrenergic postganglionic fibres of the sympathetic nervous system. Called also adrenergic. [EU] Synapses: Specialized junctions at which a neuron communicates with a target cell. At classical synapses, a neuron's presynaptic terminal releases a chemical transmitter stored in synaptic vesicles which diffuses across a narrow synaptic cleft and activates receptors on the postsynaptic membrane of the target cell. The target may be a dendrite, cell body, or axon of another neuron, or a specialized region of a muscle or secretory cell. Neurons may also communicate through direct electrical connections which are sometimes called electrical synapses; these are not included here but rather in gap junctions. [NIH] Synaptic: Pertaining to or affecting a synapse (= site of functional apposition between neurons, at which an impulse is transmitted from one neuron to another by electrical or chemical means); pertaining to synapsis (= pairing off in point-for-point association of homologous chromosomes from the male and female pronuclei during the early prophase of meiosis). [EU] Synergistic: Acting together; enhancing the effect of another force or agent. [EU] Systemic: Affecting the entire body. [NIH] Testicles: The two egg-shaped glands found inside the scrotum. They produce sperm and male hormones. Also called testes. [NIH] Testicular: Pertaining to a testis. [EU] Testis: Either of the paired male reproductive glands that produce the male germ cells and the male hormones. [NIH] Testosterone: A hormone that promotes the development and maintenance of male sex characteristics. [NIH] Therapeutic Community: Psychotherapeutic technique which emphasizes socioenvironmental and interpersonal influences in the resocialization and rehabilitation of the patient. The setting is usually a hospital unit or ward in which professional and nonprofessional staff interact with the patients. [NIH] Therapeutics: The branch of medicine which is concerned with the treatment of diseases, palliative or curative. [NIH] Thoracic: Having to do with the chest. [NIH] Thorax: A part of the trunk between the neck and the abdomen; the chest. [NIH] Threshold: For a specified sensory modality (e. g. light, sound, vibration), the lowest level (absolute threshold) or smallest difference (difference threshold, difference limen) or intensity of the stimulus discernible in prescribed conditions of stimulation. [NIH] Thrombin: An enzyme formed from prothrombin that converts fibrinogen to fibrin. (Dorland, 27th ed) EC 3.4.21.5. [NIH]

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Thrombomodulin: A cell surface glycoprotein of endothelial cells that binds thrombin and serves as a cofactor in the activation of protein C and its regulation of blood coagulation. [NIH]

Thrombosis: The formation or presence of a blood clot inside a blood vessel. [NIH] Thrombus: An aggregation of blood factors, primarily platelets and fibrin with entrapment of cellular elements, frequently causing vascular obstruction at the point of its formation. Some authorities thus differentiate thrombus formation from simple coagulation or clot formation. [EU] Thyroid: A gland located near the windpipe (trachea) that produces thyroid hormone, which helps regulate growth and metabolism. [NIH] Thyroid Gland: A highly vascular endocrine gland consisting of two lobes, one on either side of the trachea, joined by a narrow isthmus; it produces the thyroid hormones which are concerned in regulating the metabolic rate of the body. [NIH] Thyroid Hormones: Hormones secreted by the thyroid gland. [NIH] Tissue: A group or layer of cells that are alike in type and work together to perform a specific function. [NIH] Tolerance: 1. The ability to endure unusually large doses of a drug or toxin. 2. Acquired drug tolerance; a decreasing response to repeated constant doses of a drug or the need for increasing doses to maintain a constant response. [EU] Tomography: Imaging methods that result in sharp images of objects located on a chosen plane and blurred images located above or below the plane. [NIH] Toxic: Having to do with poison or something harmful to the body. Toxic substances usually cause unwanted side effects. [NIH] Toxicity: The quality of being poisonous, especially the degree of virulence of a toxic microbe or of a poison. [EU] Toxicology: The science concerned with the detection, chemical composition, and pharmacologic action of toxic substances or poisons and the treatment and prevention of toxic manifestations. [NIH] Toxins: Specific, characterizable, poisonous chemicals, often proteins, with specific biological properties, including immunogenicity, produced by microbes, higher plants, or animals. [NIH] Trachea: The cartilaginous and membranous tube descending from the larynx and branching into the right and left main bronchi. [NIH] Transduction: The transfer of genes from one cell to another by means of a viral (in the case of bacteria, a bacteriophage) vector or a vector which is similar to a virus particle (pseudovirion). [NIH] Transfection: The uptake of naked or purified DNA into cells, usually eukaryotic. It is analogous to bacterial transformation. [NIH] Transmitter: A chemical substance which effects the passage of nerve impulses from one cell to the other at the synapse. [NIH] Treatment Outcome: Evaluation undertaken to assess the results or consequences of management and procedures used in combating disease in order to determine the efficacy, effectiveness, safety, practicability, etc., of these interventions in individual cases or series. [NIH]

Tryptophan: An essential amino acid that is necessary for normal growth in infants and for nitrogen balance in adults. It is a precursor serotonin and niacin. [NIH]

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Tubercle: A rounded elevation on a bone or other structure. [NIH] Tuberculosis: Any of the infectious diseases of man and other animals caused by species of Mycobacterium. [NIH] Tyrosine: A non-essential amino acid. In animals it is synthesized from phenylalanine. It is also the precursor of epinephrine, thyroid hormones, and melanin. [NIH] Ulcer: A localized necrotic lesion of the skin or a mucous surface. [NIH] Unconscious: Experience which was once conscious, but was subsequently rejected, as the "personal unconscious". [NIH] Uremia: The illness associated with the buildup of urea in the blood because the kidneys are not working effectively. Symptoms include nausea, vomiting, loss of appetite, weakness, and mental confusion. [NIH] Urethra: The tube through which urine leaves the body. It empties urine from the bladder. [NIH]

Urinary: Having to do with urine or the organs of the body that produce and get rid of urine. [NIH] Urine: Fluid containing water and waste products. Urine is made by the kidneys, stored in the bladder, and leaves the body through the urethra. [NIH] Vaccine: A substance or group of substances meant to cause the immune system to respond to a tumor or to microorganisms, such as bacteria or viruses. [NIH] Vascular: Pertaining to blood vessels or indicative of a copious blood supply. [EU] Vasodilator: An agent that widens blood vessels. [NIH] VE: The total volume of gas either inspired or expired in one minute. [NIH] Vein: Vessel-carrying blood from various parts of the body to the heart. [NIH] Venlafaxine: An antidepressant drug that is being evaluated for the treatment of hot flashes in women who have breast cancer. [NIH] Venous: Of or pertaining to the veins. [EU] Ventral: 1. Pertaining to the belly or to any venter. 2. Denoting a position more toward the belly surface than some other object of reference; same as anterior in human anatomy. [EU] Ventricle: One of the two pumping chambers of the heart. The right ventricle receives oxygen-poor blood from the right atrium and pumps it to the lungs through the pulmonary artery. The left ventricle receives oxygen-rich blood from the left atrium and pumps it to the body through the aorta. [NIH] Veterinary Medicine: The medical science concerned with the prevention, diagnosis, and treatment of diseases in animals. [NIH] Viral: Pertaining to, caused by, or of the nature of virus. [EU] Virus: Submicroscopic organism that causes infectious disease. In cancer therapy, some viruses may be made into vaccines that help the body build an immune response to, and kill, tumor cells. [NIH] Visual Cortex: Area of the occipital lobe concerned with vision. [NIH] Vitro: Descriptive of an event or enzyme reaction under experimental investigation occurring outside a living organism. Parts of an organism or microorganism are used together with artificial substrates and/or conditions. [NIH] Windpipe: A rigid tube, 10 cm long, extending from the cricoid cartilage to the upper border of the fifth thoracic vertebra. [NIH]

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Withdrawal: 1. A pathological retreat from interpersonal contact and social involvement, as may occur in schizophrenia, depression, or schizoid avoidant and schizotypal personality disorders. 2. (DSM III-R) A substance-specific organic brain syndrome that follows the cessation of use or reduction in intake of a psychoactive substance that had been regularly used to induce a state of intoxication. [EU] Xenograft: The cells of one species transplanted to another species. [NIH] Yawning: An involuntary deep inspiration with the mouth open, often accompanied by the act of stretching. [NIH] Zymogen: Inactive form of an enzyme which can then be converted to the active form, usually by excision of a polypeptide, e. g. trypsinogen is the zymogen of trypsin. [NIH]

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INDEX A Abdomen, 43, 99, 103, 116, 126, 127 Abscess, 38, 99 Acting Out, 21, 99 Adjustment, 4, 99 Adrenal Cortex, 99, 101, 122 Adrenaline, 52, 99 Adrenergic, 14, 99, 102, 109, 110, 127 Adverse Effect, 99, 100, 125 Affinity, 10, 99, 108 Agonist, 6, 7, 10, 14, 15, 36, 99, 103, 109, 118 Algorithms, 99, 103 Alimentary, 99, 120 Alkaline, 99, 104 Alkaloid, 99, 102, 103, 105, 117 Allergen, 99, 108, 124 Alternative medicine, 73, 99 Amber, 100, 114 Amblyopia, 41, 100 Amenorrhea, 25, 100 Amino Acid Sequence, 100, 102, 122 Amino Acids, 100, 102, 120, 121, 122 Amphetamines, 100, 105 Amyloid, 21, 100, 124 Amyloidosis, 100 Anaesthesia, 100, 114 Analgesic, 17, 100, 103, 105, 115, 116, 117, 119, 122 Analog, 100, 108 Anaphylatoxins, 100, 106 Anatomical, 16, 101, 114 Androgenic, 101 Androstenedione, 31, 101 Anemia, 101, 116 Anesthesia, 39, 101, 109 Aneurysm, 37, 38, 101 Animal model, 17, 101 Antagonism, 6, 101 Antibiotic, 101, 120 Antibody, 99, 101, 106, 112, 113, 114, 116, 123, 124, 125 Anticoagulant, 101, 122 Antidepressant, 101, 111, 129 Antiemetic, 101, 102, 105 Antigen, 99, 101, 106, 113, 114, 116, 123, 124 Antigen-Antibody Complex, 101, 106

Antipsychotic, 101, 105 Antitussive, 102, 108, 119, 122 Aorta, 102, 126, 129 Aqueous, 102 Arterial, 102, 107, 113, 122 Arteries, 102, 103, 107, 117 Aspartate, 102, 108 Assay, 102, 123 Atropine, 29, 102 Autoimmune disease, 102, 117 Autonomic, 57, 102, 117, 119 Aversion therapy, 47, 59, 102 Axillary, 102, 126 Axillary Vein, 102, 126 B Basal Ganglia, 102, 119 Base, 10, 102, 108, 115 Behavior Therapy, 37, 46, 102 Belladonna, 102 Beta-Endorphin, 10, 30, 57, 58, 102 Bile, 102, 103, 111, 115, 116, 126 Bile Ducts, 103 Bile Pigments, 103, 115 Biliary, 43, 103 Biliary Fistula, 43, 103 Biliary Tract, 103 Binding Sites, 11, 103 Biochemical, 17, 57, 103, 124 Biological Factors, 10, 103 Biotechnology, 17, 18, 67, 73, 83, 103 Bladder, 103, 114, 129 Blood Coagulation, 103, 104, 128 Blood Platelets, 103, 124 Blood pressure, 103, 104, 113 Blood vessel, 103, 104, 105, 107, 112, 115, 125, 126, 128, 129 Bowel, 103, 108 Bowel Movement, 103, 108 Brachial, 34, 102, 103 Brachiocephalic Trunk, 103, 126 Branch, 95, 103, 125, 127 Buprenorphine, 6, 7, 8, 13, 42, 52, 53, 103 C Calcium, 14, 46, 104, 106, 125 Calcium channel blocker, 14, 104 Calcium Gluconate, 46, 104 Carbohydrate, 104, 112 Carcinogenic, 104, 114, 122, 126

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Cardiac, 104, 107, 110, 118, 126 Cardiovascular, 16, 104, 125 Cardiovascular disease, 16, 104 Carrier Proteins, 104, 123 Case report, 34, 39, 104, 105 Catecholamine, 104, 109, 120 Caudal, 104, 113, 119 Caudate Nucleus, 104, 119 Cell Differentiation, 104, 125 Cell proliferation, 104, 125 Cellulitis, 38, 104 Central Nervous System, 100, 104, 105, 108, 109, 117, 119, 124 Cerebrospinal, 57, 105 Cerebrospinal fluid, 57, 105 Cerebrovascular, 104, 105 Chemotactic Factors, 105, 106 Chemotherapy, 39, 105 Chlorpromazine, 53, 105 Chromosome, 11, 105, 116 Chronic, 10, 12, 24, 33, 43, 52, 104, 105, 114, 126 Clinical study, 105, 107 Clinical trial, 3, 7, 13, 57, 63, 64, 83, 105, 107, 122, 123 Cloning, 103, 105 Coca, 105 Cocaine, 4, 9, 13, 15, 16, 21, 52, 56, 69, 105 Codeine, 39, 105, 108, 119 Cofactor, 105, 122, 128 Cognition, 11, 105 Collagen, 105, 121 Communicable disease, 24, 25, 44, 106 Comorbidity, 5, 7, 106 Complement, 17, 100, 106, 124 Complementary and alternative medicine, 55, 60, 106 Complementary medicine, 55, 106 Computational Biology, 83, 106 Conception, 106, 107 Concomitant, 11, 106 Confounding, 12, 106 Connective Tissue, 104, 105, 107 Consciousness, 100, 107, 109 Constriction, 107, 114, 115 Contraception, 16, 107 Contraindications, ii, 107 Control group, 13, 107 Controlled clinical trial, 8, 107 Controlled study, 6, 107 Coordination, 13, 107 Cor, 107, 122

Coronary, 104, 107, 117 Coronary heart disease, 104, 107 Coronary Thrombosis, 107, 117 Cortical, 100, 107 Cues, 16, 107 Curative, 108, 127 Cytotoxic, 108, 125 D Databases, Bibliographic, 83, 108 Degenerative, 108, 112 Density, 52, 108, 119 Depolarization, 108, 125 Deprivation, 100, 108 Desensitization, 47, 59, 108 Detoxification, 4, 6, 8, 13, 14, 21, 39, 41, 42, 53, 56, 57, 59, 108 Dextroamphetamine, 108, 117 Dextromethorphan, 53, 108 Diagnostic procedure, 73, 108 Digestive system, 64, 108 Dihydrotestosterone, 31, 108 Dilatation, 34, 101, 108, 121 Direct, iii, 108, 109, 123, 126, 127 Discrimination, 15, 108 Disposition, 12, 108 Dissociation, 99, 108 Dopamine, 15, 16, 39, 102, 105, 108, 109 Dopamine Agonists, 15, 109 Drive, ii, vi, 6, 51, 109 Drug Interactions, 76, 109 Drug Tolerance, 109, 128 Dynorphins, 109, 119 Dysphoria, 44, 53, 109 Dysphoric, 14, 109 E Effector, 106, 109, 119 Effector cell, 109, 119 Efficacy, 4, 5, 7, 8, 9, 14, 37, 56, 109, 128 Electroacupuncture, 57, 109 Electrons, 102, 109, 115, 123 Embryo, 104, 109, 114 Endemic, 109, 116 Endocarditis, 33, 109 Endocardium, 109, 110 Endorphins, 110, 119, 122 Endotoxins, 106, 110 Enkephalin, 16, 57, 102, 110, 122 Environmental Health, 31, 82, 84, 110 Enzymatic, 104, 106, 110 Enzyme, 109, 110, 121, 122, 125, 127, 129, 130 Epidemic, 4, 7, 22, 31, 32, 44, 110

Index 133

Epinephrine, 99, 109, 110, 119, 129 Erythrocytes, 101, 110, 124 Esophagus, 108, 110, 126 Estrogen, 110, 122 Ethnic Groups, 10, 110 Excitability, 11, 110, 118 Exhaustion, 101, 110, 116 Exogenous, 6, 110 Extracellular, 16, 100, 107, 110, 117 Extracellular Space, 110, 117 Extrapyramidal, 43, 102, 109, 110 F Family Planning, 83, 110 Fixation, 111, 124 Fluoxetine, 4, 48, 52, 111 Fold, 6, 111 Fungi, 111, 117 G Gallbladder, 103, 108, 111 Gas, 111, 113, 129 Gastrin, 111, 113 Gastrointestinal, 110, 111, 116, 118, 124, 127 Gastrointestinal tract, 111, 124 Gene, 5, 11, 67, 103, 111, 119 Genetic Markers, 17, 111 Genetic transcription, 111, 122 Germ Cells, 111, 119, 120, 127 Gland, 99, 111, 120, 124, 126, 128 Glomerular, 111, 124 Glucose, 24, 26, 111, 112, 115 Glucose tolerance, 26, 112 Glucose Tolerance Test, 112 Glutamate, 108, 112 Glycoprotein, 112, 124, 128 Gonad, 112 Gonadal, 25, 112, 126 Governing Board, 112, 121 Government Agencies, 8, 112, 121 Granulocytes, 112, 125 Growth, 8, 15, 25, 45, 101, 104, 112, 113, 120, 124, 128 H Habitual, 6, 112 Haptens, 99, 112, 123 Heart attack, 104, 112 Hemolytic, 112, 114 Hemorrhage, 112, 126 Hemostasis, 112, 124 Hepatic, 112 Hepatitis, 11, 112 Hepatocyte, 34, 112

Hepatotoxicity, 49, 112 Hereditary, 4, 112 Heredity, 111, 113 Heroin Dependence, 7, 113 Heterodimers, 8, 113 Heterogeneity, 99, 113 Hiccup, 105, 113 Homologous, 113, 124, 127 Hormonal, 26, 113 Hormone, 42, 99, 102, 110, 111, 113, 115, 122, 124, 125, 127, 128 Hydrogen, 102, 104, 113, 117 Hyperbilirubinemia, 113, 115 Hypersensitivity, 99, 108, 113, 124 Hypertension, 104, 107, 113 Hyperthermia, 58, 113 Hypogonadism, 38, 113 Hypothalamic, 25, 113 Hypothalamus, 110, 113, 120, 122 I Id, 54, 59, 88, 94, 96, 113 Immune response, 101, 102, 112, 113, 114, 124, 127, 129 Immune system, 109, 113, 114, 118, 129 Immunization, 113, 114, 124 Immunogenic, 114, 123 Immunology, 32, 33, 99, 114 Immunotherapy, 108, 114 Impairment, 13, 114, 116, 117 Impetigo, 42, 114 In vitro, 15, 114 In vivo, 114, 117 Incarceration, 9, 114 Incontinence, 114, 117 Indicative, 65, 114, 129 Induction, 40, 101, 114, 122 Infarction, 107, 114, 117 Infection, 7, 9, 39, 99, 104, 105, 114, 116, 118, 119, 120, 126 Inflammation, 104, 112, 114, 117 Informed Consent, 4, 114 Ingestion, 112, 114, 121 Inhalation, 113, 114, 121 Initiation, 9, 114, 122 Inotropic, 109, 114 Insulin, 24, 112, 115 Insulin-dependent diabetes mellitus, 115 Intermittent, 16, 115 Interstitial, 110, 115, 124 Intestinal, 112, 115 Intoxication, 6, 115, 130 Intracellular, 8, 114, 115, 123, 124, 125

134 Heroin Addiction

Intramuscular, 115, 120 Intravenous, 41, 115, 120 Intrinsic, 15, 99, 115 Ion Channels, 115, 119 Ions, 102, 108, 113, 115 Ischemia, 115, 117 J Jaundice, 45, 113, 115 K Kb, 82, 115 Kinetics, 8, 115 L Labile, 106, 115 Lactation, 115, 122 Large Intestine, 108, 115, 123, 125 Latent, 115, 121 Lesion, 115, 116, 129 Leucine, 102, 115 Levo, 115, 122 Levorphanol, 108, 116 Library Services, 94, 116 Linkage, 5, 11, 111, 116 Lipid, 115, 116 Liver, 100, 102, 103, 108, 111, 112, 116 Lobe, 116, 122, 129 Localization, 17, 116 Localized, 100, 111, 114, 116, 117, 120, 129 Lutein Cells, 116, 122 Lymphatic, 114, 116 M Maintenance therapy, 36, 116 Malaise, 109, 116 Malaria, 16, 35, 116 Malaria, Falciparum, 116 Malaria, Vivax, 116 Marijuana Abuse, 13, 88, 116 Mediate, 109, 116 Mediator, 116, 125 Medical Staff, 116, 117 MEDLINE, 83, 117 Medullary, 108, 117, 123 Membrane, 106, 108, 110, 115, 117, 125, 127 Meninges, 104, 117, 126 Menstruation, 100, 117 Mental Disorders, 56, 64, 117, 123 Mental Health, iv, 3, 12, 64, 82, 84, 117 Methionine, 102, 117, 122 Methylphenidate, 15, 117 MI, 45, 97, 117 Microdialysis, 16, 117 Milieu Therapy, 27, 117

Modeling, 8, 117 Molecular, 7, 36, 39, 83, 85, 100, 103, 106, 117, 122, 123 Molecule, 101, 102, 103, 106, 108, 109, 117, 123, 125 Morals, 31, 117 Morphine, 8, 10, 11, 19, 33, 35, 58, 103, 105, 117, 118, 119 Motility, 117, 124 Mucosa, 117, 122 Mycosis, 117 Mycotic, 33, 37, 38, 117 Myelitis, 47, 53, 117 Myocardium, 117 N Naive, 17, 118 Naloxone, 13, 57, 102, 118 Naltrexone, 4, 6, 7, 13, 14, 27, 37, 38, 46, 52, 53, 118 Narcolepsy, 108, 117, 118 Narcosis, 118 Narcotic, 38, 57, 67, 116, 117, 118, 122 NCI, 1, 64, 81, 118 Necrosis, 114, 117, 118, 124 Need, 6, 11, 12, 17, 68, 76, 77, 89, 118, 128 Needle Sharing, 5, 118 Neonatal, 8, 38, 45, 118 Neonatal Abstinence Syndrome, 9, 118 Nephropathy, 34, 118 Nerve, 99, 101, 116, 118, 119, 121, 126, 128 Nervous System, 102, 104, 116, 118, 119, 127 Neurologic, 13, 47, 118 Neuronal, 10, 118 Neurons, 105, 118, 119, 127 Neuropathy, 34, 118 Neurotoxicity, 108, 119 Neurotransmitters, 16, 119 Nonverbal Communication, 119, 123 Norepinephrine, 99, 109, 119 Nucleus, 16, 119, 122 Nucleus Accumbens, 16, 119 O Oocytes, 10, 119 Opacity, 108, 119 Operon, 119, 122 Opioid Peptides, 16, 109, 110, 119 Opium, 117, 119 Opportunistic Infections, 16, 119 Optic Nerve, 100, 119 Outpatient, 4, 6, 13, 14, 39, 40, 56, 119 Ovary, 101, 112, 120

Index 135

Ovum, 120, 122 P Palliative, 120, 127 Pancreas, 108, 115, 120 Parenteral, 14, 120 Parturition, 120, 122 Penicillin, 101, 120 Peptide, 10, 24, 102, 119, 120, 121, 122 Perception, 34, 120, 124 Pharmacokinetic, 8, 120 Pharmacologic, 30, 101, 120, 128 Pharmacotherapy, 4, 8, 36, 120 Phospholipases, 120, 125 Phosphorus, 104, 120 Phosphorylation, 8, 120 Physiologic, 4, 99, 117, 120, 123 Physiology, 5, 17, 120 Pilot study, 9, 12, 18, 23, 120 Pituitary Gland, 120, 122 Plants, 99, 102, 105, 111, 119, 120, 128 Plasma, 30, 31, 40, 42, 57, 112, 121, 125 Platelet Activation, 121, 125 Platelet Aggregation, 52, 100, 121 Platelets, 121, 128 Pleomorphic, 119, 121 Poisoning, 34, 115, 121 Policy Making, 112, 121 Polymerase, 121, 122 Polymorphism, 10, 11, 72, 121 Polypeptide, 100, 105, 121, 122, 130 Postsynaptic, 121, 125, 127 Potentiation, 121, 125 Practicability, 121, 128 Practice Guidelines, 84, 121 Precursor, 101, 109, 110, 119, 121, 122, 128, 129 Predisposition, 10, 121 Prevalence, 7, 12, 121 Probe, 117, 121 Progesterone, 122, 126 Progression, 101, 122 Progressive, 104, 109, 112, 118, 121, 122, 124 Projection, 16, 119, 122 Prolactin, 58, 122 Promoter, 39, 122 Promotor, 11, 122 Pro-Opiomelanocortin, 11, 110, 119, 122 Prophase, 119, 122, 127 Propoxyphene, 18, 122 Prostitution, 21, 122 Protein C, 10, 100, 122

Protein S, 67, 103, 122 Proteins, 5, 17, 100, 101, 104, 105, 106, 113, 117, 120, 121, 122, 123, 125, 128 Proteolytic, 106, 122 Protocol, 6, 122 Psychiatric, 4, 5, 7, 12, 13, 14, 19, 117, 122 Psychiatry, 3, 5, 6, 8, 11, 12, 13, 20, 21, 28, 29, 30, 36, 39, 41, 43, 48, 52, 53, 56, 111, 122, 126 Psychotherapy, 34, 36, 42, 58, 123 Public Policy, 83, 123 Publishing, 18, 123 Purulent, 99, 123 Pustular, 114, 123 Pyramidal Tracts, 110, 123 R Radiation, 113, 123 Radioimmunoassay, 16, 123 Randomized, 4, 7, 8, 52, 56, 109, 123 Reaction Time, 57, 123 Receptor, 8, 10, 11, 13, 22, 39, 52, 58, 72, 101, 108, 109, 123, 125 Receptors, Serotonin, 123, 125 Recombination, 111, 123 Rectum, 103, 108, 111, 114, 115, 123 Refer, 1, 106, 110, 111, 116, 118, 123 Refractive Errors, 100, 123 Regimen, 14, 109, 117, 120, 123 Relapse, 4, 7, 12, 14, 41, 123 Remission, 116, 123 Renal amyloidosis, 21, 124 Renal failure, 30, 112, 124 Rhabdomyolysis, 53, 124 Risk factor, 11, 124 S Salivary, 108, 124 Salivary glands, 108, 124 Schizoid, 124, 130 Schizophrenia, 15, 124, 130 Schizotypal Personality Disorder, 124, 130 Screening, 14, 105, 124 Scrotum, 38, 124, 127 Second Messenger Systems, 119, 124 Secretion, 24, 115, 124 Sedative, 105, 124 Sediment, 21, 124 Sensitization, 16, 124 Sensory loss, 117, 124 Sequencing, 11, 124 Serotonin, 39, 102, 111, 120, 123, 124, 128 Serum, 33, 100, 106, 123, 125 Serum Albumin, 123, 125

136 Heroin Addiction

Sex Characteristics, 125, 127 Side effect, 75, 77, 99, 102, 125, 128 Signal Transduction, 52, 125 Signs and Symptoms, 123, 125 Skeletal, 124, 125 Small intestine, 103, 113, 125 Smooth muscle, 100, 117, 125, 127 Specialist, 89, 125 Species, 100, 102, 110, 116, 125, 126, 129, 130 Specificity, 99, 125 Sperm, 105, 125, 127 Spinal cord, 103, 104, 105, 117, 118, 123, 125, 126 Spinal Cord Vascular Diseases, 117, 125 Stabilization, 14, 126 Staphylococcus, 114, 126 Staphylococcus aureus, 114, 126 Steroid, 101, 126 Stimulant, 15, 108, 117, 126 Stimulus, 100, 109, 115, 123, 126, 127 Stomach, 108, 110, 111, 112, 113, 125, 126 Streptococci, 114, 126 Stress, 25, 104, 121, 126 Striatum, 119, 126 Stroke, 64, 82, 104, 126 Stupor, 118, 126 Subacute, 33, 114, 126 Subclavian, 37, 102, 126 Subclavian Artery, 37, 126 Subclinical, 114, 126 Subcutaneous, 104, 120, 126 Substance P, 124, 126 Substrate, 16, 127 Suppression, 35, 127 Suppurative, 104, 127 Sympathomimetic, 108, 109, 110, 119, 127 Synapses, 119, 127 Synaptic, 125, 127 Synergistic, 122, 127 Systemic, 42, 100, 102, 103, 110, 114, 127 T Testicles, 124, 127 Testicular, 45, 127 Testis, 101, 127 Testosterone, 31, 40, 101, 127 Therapeutic Community, 47, 127 Therapeutics, 40, 58, 76, 127 Thoracic, 126, 127, 129 Thorax, 99, 127 Threshold, 110, 113, 127 Thrombin, 121, 122, 127, 128

Thrombomodulin, 122, 128 Thrombosis, 122, 126, 128 Thrombus, 107, 114, 121, 128 Thyroid, 24, 128, 129 Thyroid Gland, 128 Thyroid Hormones, 24, 128, 129 Tissue, 101, 105, 107, 109, 113, 115, 116, 117, 118, 120, 121, 125, 126, 128 Tolerance, 8, 10, 103, 112, 128 Tomography, 58, 128 Toxic, iv, 100, 102, 118, 128 Toxicity, 109, 128 Toxicology, 6, 7, 31, 40, 84, 128 Toxins, 100, 101, 110, 114, 128 Trachea, 128 Transduction, 125, 128 Transfection, 103, 128 Transmitter, 109, 115, 116, 119, 127, 128 Treatment Outcome, 9, 128 Tryptophan, 105, 124, 128 Tubercle, 119, 129 Tuberculosis, 23, 36, 129 Tyrosine, 109, 129 U Ulcer, 104, 129 Unconscious, 99, 113, 129 Uremia, 124, 129 Urethra, 129 Urinary, 21, 114, 129 Urine, 6, 7, 21, 48, 57, 103, 114, 129 V Vaccine, 122, 129 Vascular, 49, 114, 125, 128, 129 Vasodilator, 109, 129 VE, 46, 129 Vein, 101, 102, 115, 126, 129 Venlafaxine, 13, 129 Venous, 102, 122, 129 Ventral, 113, 119, 129 Ventricle, 104, 107, 113, 119, 129 Veterinary Medicine, 83, 129 Viral, 11, 128, 129 Virus, 128, 129 Visual Cortex, 100, 129 Vitro, 129 W Windpipe, 128, 129 Withdrawal, 4, 6, 8, 10, 24, 30, 36, 53, 57, 59, 63, 118, 130 X Xenograft, 101, 130

Index 137

Y Yawning, 118, 130

Z Zymogen, 122, 130

138 Heroin Addiction

Index 139

140 Heroin Addiction