Swedish accommodation to EU-policy has weakened state control over the alcohol supply as well as increased the inflow of drugs. Limiting alcohol and drug consumption must thus occur through reducing demand. As the Internet is virtually a universal phenomenon, influencing alcohol and drug behaviors via an Internet-based service is therefore a natural next step. A new Swedish website for self-screening via the AUDIT- and DUDIT-questionnaires is eScreen (www.escreen.se).

Self-screening via eScreen generates user feedback and treatment recommendations. In-depth self-report is possible using the Alcohol-E and DUDIT-E. Site users can follow their progress over time in diagrams showing personal risk level as well as by writing a personal electronic diary.

During the first 18 months, 2492 user-accounts were registered, evenly distributed between genders. With regard to selection bias, approximately 65% of adult site users over 18 report harmful alcohol consumption, compared to 63% of female and 51% of male adolescent users. Screening suggests that 11% of female and 16% of male adult users are dependent on illicit drugs; for adolescents the rates are virtually identical. These results will be compared to rates from an ongoing general Swedish population study.

Internet-screening for alcohol and drug problems appeals to people with harmful alcohol and drug use. Low cost combined with the potential to reach many people could make Internet-based self-help services a cost-efficient self-help tool as well as a complement for patients in treatment for substance abuse.

In adolescence alcohol can become considerable psychological stimulus, and its more regularly consuming will be the first step in making psychological and later physical dependence as well.

The aim is to establish the freqsuency of misuse of alcohol among the youth and some of risk factors which precipitate that kind of behaviour.

610 secondary school pupils (360 females and 250 males), aged 14 - 18, in Banja Luka were sampled. Selfreported Questionnaire of Risk Behaviour by K. Berg-Kelly (2000) was used.

61,4% of those sampled consum alcohol with different frequency; from every day to few times a year, from that 29,7% females in relation to 30,5% males, and there is statistically considerable difference (x2=75373, p=0,000). From that number 39,3% drink alone, 43% testees drink within a family and from that 2% drink few times a week, and 28,5% few times a year. 25,7% of these sampled had experience in drinking. Parents allow drinking in 41,5% testees in relation to 58,5% who are not allowed to drink, so there is statistically cosiderable difference (x2=33997, p=0,000).

The results should be used as a support to measures of prevention from selling alcohol to youth and establishing stronger supervision on spending money as well.

We want to present a polymorphic clinical features like: hallutinations, paranoid ideas, agitation and violence as a result of prolonged cocaine intranasal consumption.

We exposed a 30-year old male patient with ICD-X diagnostic criteria for cocaine dependence (intranasal consumption) that treated in the outpatient unit of Special Hospital of Addicitons, Belgrade, Serbia from April to July 2008. We used the medical records, psychical examination, psychiatric interwievs, standard blood sampling and cocaine urine detections sample (positive).

Observations a specific and polymorphic clinical features with presence of psychotic symptoms after cocaine consumptions in our male patient, for the first time after 5 years of cocaine dependence: auditory hallucinations (two- voice speakers), paranoid persecution ideas and suspiciousness, agitation with appearance of vegetative symptomatology (palpitations, sweating, pupil dilatation), extremely violence behavior to other people, complete social reductions (“armed to the outside world”, refused any personal contact and isolated from friends and family, permanent outdoor checking). There was an intensive fear too and impaired judgment.

Permanent cocaine consumption can result with produce a numerous of psychiatric symptoms and syndromes as our experience does. It is similar to the findings of other studies and papers reviewed. It is suppose that cocaine has numerous effects on important neurotransmitters in the brain, such as increase as well as the release of dopamine and it related with aggressiveness, hallucinations and other psychiatric symptoms.

The present study investigated the demographic characteristics of a sample with posstraumatic stress disorder (PTSD) that seeking treatment for alcohol and others drugs dependence.

Forty drug-addicted men participated of this study. All the subjects were psychiatric outpatients of IPPAD, Porto Alegre, Brazil. They were invited to play a part in a research. They completed the following instruments: Specific Traumatic Events Scale, Davidson Trauma Scale, Beck Depression Inventory, Sociodemographic characteristics. The Sociodemographic instrument had questions about the justice involvement. The measures were a self-report. SPSS 12.5 was used by the statistical analyses. Descriptive statistics include frequency, percents and means. Significance of 5%.

Twelve patients had PTSD. Aged 25 to 60 years; low income; 41,7% were married. About sixty seven per cent had some member on family with alcohol or other substance abused. The half patients (n=10) are used various psychoactive substances. 16,7% used alcohol only. The drugs more used were: alcohol (91,7%); tobacco (75,0%); cocaine (58,3%); marihuana (58,3%); Don't have related about the use of ecstasy and inhalants. The half of the sample related that was arrested due to drugs use.

The literature shows that patients with Posstraumatic Stress Disorder have more drug use, interpersonal difficulties, legal problems, more relapses or worse prognostic when compared without PTSD. It's very important to determine the psychosocial characteristics of patients seeking treatment to ascertain if these characteristics reflect a group at risk for premature termination therapy.

The present study is investigating posttraumatic stress disorder among male with substance dependence in treatment.

Forty drug-addicted men participated of this study. All the subjects were psychiatric outpatients of Ippad, Porto Alegre, Brazil. They completed the following instruments: Specific Traumatic Events Scale, Davidson Trauma Scale, Beck Depression Inventory, Sociodemographic characteristics. The measures were a self-report. SPSS 12.5 was used by the statistical analyses. Descriptive statistics include frequency, percents and means. Significance of 5%.

Overall the patients 30% had PTSD. The patients with PTSD had more family members with abuse or drugs dependence (66,7% versus 54,5%), related more exposure trauma (6,3 versus 4), when compared without PTSD. The PTSD patients punctuated more symptoms in Davidson Trauma Scale (12,8 versus 4,8). Punctuated more frequency and severity of symptoms’, mainly, hypercitability. The more frequent trauma was mugged or threatened with a weapon, 84,1%.

Psychiatric comorbidity is common among addicted patients. Post-traumatic stress disorder (PTSD) is a highly symptomatic anxiety disorder of acute onset after a major distressing life-event. In clinical practice, patients suffering from drug addiction invariably report the occurrence of psychologically stressful episodes, with frequencies of PTSD ranging from 30% to 60%. Among patients suffering from alcohol or other drugs dependence, the prevalence of PTSD is estimated to range between 10% and 40%. Global response to treatment was achieved after the recognition and appropriate treatment of the latter condition, along with the combined approach to other comorbid disorders.

The relationship between alcohol usage, depressive psychopathological board represent a reality in psychiatric practice. The neurobiochemical layers of the two psychic pathologies are inter-correlated.

The dopaminergic deficice, especially on the compensation path, for regulating the GABA-ergic and GLUTAMATE-ergic pathways, the serotoninergic and noradrenergic dysfunctions being present in both disorders.

The amygdalae's anatomical circuit with the compensation paths (ventral segment and accumbens nuclei) represents the neurobiological substratum of comorbidity.

A retrospective, observational, open study was carried out in the period 2005 - 2007 on a lot of 200 male patients aged between 19 and 65 years, admitted in the clinic with the diagnosis “addiction disorder”, established according to the DSM IV-R criteria.

An depressive board associated with addiction disorder was observed in 140 patients from the studied lot.

The alcohol use is induced by an depressive pathology, as the patients use alcohol as an anxiolytic and sedative.

The depressive disorder overlapped on the symptomatology induced by alcohol use is frequently characterized by psychomotor restlessness and suicidal ideation.

The depressive pathology is developed from the beginning of the addiction disorder or at a very short time after establishing a diagnosis, especially in the young patients.

Dual diagnosis of schizophrenic disorders and drug abuse/dependence are increasing due to more frequent use of cannabis and cocaine. It is important to differentiate between primary schizophrenia with associate drug abuse/dependence and drug-induced psychosis. The objective is to detect neuropsychological differences between drug users and non-users in schizophrenia patients, which could be used as diagnostic tools.

We conduct one case-control study on 12 schizophrenia out-patients (10 male) with vital history of drug abuse/dependence (mainly cannabis and cocaine) and one control group of 18 schizophrenia out-patients (12 male) who never used illegal drugs (global age mean: 32.8 years; SD:7.2). It was applied one neuropsychological battery sensitive to the neuropsychological deficit frequent in schizophrenia: WAIS-III, BADS, WCST, Colour Trails, Trail Making A and B, BVRT, California Verbal Learning Test (spanish version: TAVEC). Variables was summarized determining Z values and principal components. It was constructed one Logistic Regression Model to determinate the better predicting model of drug use state.

The resultant model included two predictors: WAIS Perceptive Organization Index and Trails Component. The prediction formula for Ln Odd Ratio of drug abuse/dependence group is: -13.83 + 1.09 (Trails Z score) + 0.16 (WAIS Perceptive Organization Index). It explains for 63% of the variance (p = 0.001). The ROC curve for using in diagnose was constructed.

Neuropsychological diagnosis can contribute to the differential diagnosis of schizophrenia in dual pathology. The better functioning in visual-spatial tasks increases the probability of psychosis related with drugs use.

Functional polymorphism in ADH2 and ALDH2 genes are considered most important among several genetic determinants of alcohol dependence (AD), a complex disorder.

There is no report on the widely studied Arg47His and Glu487Lys polymorphisms from Indian alcohol dependent population. We, for the first time, report allelic and genotypic frequencies of Arg47His and Glu487Lys SNPs in North Indian alcohol dependent subjects.

A total of n=174 alcohol dependent males, recruited using DSM IV criteria, were genotyped using PCR-RFLP method.

Data obtained from genetic analysis was correlated with clinical parameters using T test or Mann Whitney's U test. ADH2 gene polymorphism was found to be largely monomorphic with minor allele frequency (ADH2*2) < 0.001. For the ALDH2 Glu487Lys SNP, genotypic frequencies were 0.73 (2*1/*1), 0.16 (2*1/*2) and 0.11 (2*2/*2), with minor allele frequency (ALDH2*2) = 0.19. Various clinical parameters were found to be significantly associated with ALDH2 polymorphism.

The highlight of the study is a clear association of ALDH2 gene polymorphism with delayed onset and shorter duration of alcohol consumption among ALDH2*2/*2 individuals. Our finding bolsters the protection conferring property of the ALDH2*2 allele of Glu487Lys SNP of ALDH2 gene.

The efficacy of antidepressants has been linked in part to their ability to reduce activity of the hypothalamic-pituitary-adrenal (HPA) axis; however, the mechanism by which antidepressants regulate the HPA axis is largely unknown. Recent research has demonstrated that endocannabinoids can regulate the HPA axis and exhibit antidepressant potential.

The purpose of this study was therefore to evaluate the effect of chronic administration of delta-9-tetrahydrocannabinol (delta9-THC) on the adrenal gland of mice.

Delta9-THC (10 mg/kg, 1 THC:1 chremophor:18 saline) or vehicle (CT, 1 chremophor:18 saline) was administered i.p. for 10 days to C57Bl6 mice aged 15 weeks. At the end of the study rats were placed in metabolic cages. Noradrenaline (NA) and adrenaline (AD) levels in samples and tissues were evaluated by HPLC-ED. Statistical analysis was done by ANOVA followed by Student's t test. Results are presented as mean±SEM.

Treatment with delta9-THC did not produce changes in mice weight (CT: 25±1; delta9-THC: 24±1 g, n=5-6) but produced a significant reduction in adrenal gland weight (CT: 1.4±0.2; delta9-THC: 0.6±0.1* mg, n=5-6, *P˂0.01). However, treatment with delta9-THC did not produce significant changes in NA and AD adrenal content (NA: 7.5±2.1, 5.3±0.6; AD: 14.1±1.1, 11.1±2.1 nmol, CT and delta9-THC respectively, n=5-6) or in NA and AD urine levels (NA: 0.88±0.06, 1.18±0.17; AD: 0.64±0.07, 0.81±0.09 nmol/24h, CT and delta9-THC respectively, n=5-6).

Chronic treatment with delta9-THC reduces adrenal gland weight in mice. These results suggest that endocannabinoids may act directly at the adrenal gland to regulate the HPA axis.

The orexins (hypocretins) are neuropeptides recently identified as neurotransmitters in lateral hypothalamus neurons. Although the majority of studies associated the function of orexin neurons with arousal and sleep, these neurons also project to reward-associated brain regions, including the nucleus accumbens and ventral tegmental area. This indicates a possible role for orexins in reward function and motivation and thus in addictive diseases. Additionally, there is growing evidence from preclinical studies for an involvement of orexins in the regulation of stress, affectivity and drug seeking behavior.

We investigated orexin plasma concentrations and psychological symptoms in a sample of 34 alcohol dependent subjects on day 1 and day 14 of detoxification. For this purpose we used the Brief Symptom Inventory (BSI) as well as the Obsessive-Compulsive Drinking Scale to identify self-reported clinically relevant psychological symptoms including alcohol craving.

As a main result a significant positive correlation between orexin plasma concentration and depression as well as global distress indicies of the BSI was detected during early withdrawal (day 1), which is not shown after detoxification on day 14. No association with subjective craving for alcohol was found.

Our data indicate that orexins may be directly involved in affective dysregulation in alcohol dependent patients; moreover the effects of orexins on reinstatement of drug seeking behaviors might be mediated by impaired brain stress systems.

The substance cannabis and 3,4-methylendioxiymethamphetamine MDMA (Ecstasy) is a popular recreational stimulant commonly referred to as “club drugs”. They produce maladaptive behavioral or psychological changes. Last evidence from World Health Organization indicates increasing route for MDMA abuse in new generation.

The aim of this study is to evaluate the specific groups of patients and to make the distinction between generations and model of substance abuse.

The retrospective study includes patients treated in Special Hospital on Addictions in Belgrade diagnosed by any set of criteria during the period of last 15 years. Authors investigated early onset and frequency of MDMA and cannabis abuse patients regard to different age.

Total of 400 patients was separated to four different groups- main ages 40, 30, 20 and 18 years old.

Significant positive correlation was found between youngest patients and there first contact (14, 5 year old) with club drugs. Frequency and duration period of addiction were 1,6 year. In a contrarily, in older group (40 and 30) we found later consummation of cannabis 19,2 and 23,5 year old for MDMA. Also we notice irregular pattern of club drugs abuse and short period of intensive consumption 2,7 month.

Our data suggests that distribution of cannabis and ecstasy abuse between adolescents spreads. These results indicate that chronic and frequent drug use may lead to distinct patterns of cognitive impairment in youngest patients and may be getaway drugs for latter heroin abuse.

Comorbidity between drug misuse and mental disorders affects negatively in the prognosis of psychistric illness, so it’s important to guarantee drug abstinence at least during hospitalization. This is even more significant in a medium stay unit because patients are more serious and resistant to treatment.

In February 2003, a multidisciplinary group was formed to evaluate the situation of drug use in a psychiatric hospital and a drug screening protocol was then created.

We evaluate if with the protocol, drug use decreases during hospitalization in a medium stay unit in a psychiatric hospital.

We first compared drug use (positive results in urine samples) from 2000 to 2002 (before protocol: urine samples collected when there’s drug misuse suspicion) with the period after the protocol was enforced (from 2003 to 2006). Afterwards, we analyzed if drug use during hospitalization continues decreasing in 2007.

In the protocol urine samples are collected when there’s a past misuse history, consumption suspicion, randomly and every time they leave for home.

It is proved that drug use decreases during hospitalization since the new protocol came into force. Drug use continues reducing since the enforcement of the drug screening protocol.

The introduction and exhaustive completion of a protocol designed to decrease drug misuse in a psychiatric hospitalization unit, provokes a high reduction of drug use, and each year, the reduction of drug misuse is higher. So we think it’s convenient to generalize this kind of measures.