Nicotine dependence is a worldwide health problem. The results of the implementation of a treatment program using Varenicline as a specific medicine for nicotine dependence during admission in a clinic for chemical dependency treatment are demonstrated, and also that this treatment is possible and safe for patients with comorbid psychiatric disorders and drug abuse disorders.

Between August 2012 and August 2013, 122 patients were evaluated in a clinic for psychiatric and drug abuse tratment in Rio de Janeiro, Brazil. The treatment consisted of a smoking cessation therapy concurrently with the psychiatric treatment. These patients had used pharmacological therapy associated with intensive cognitive behavioral therapy, occupational therapy and moderate physical activity. Smoking was limited to three cigarretes daily since the first day of hospitalization. The medicine used for treatment was Varenicline.

despite the drastic reduction to three cigarretes daily, 100% of the patients adhered to treatment e are discharged from the clinic as tobacco abstainers. Only 67,21% answered the questionnaire after 12 month of follow-up, and 52,43% were still in abstinence.

A high number of patients accepted the treatment. Behavioral group therapy and physical activities can be important allies for Varenicline. The use of Varenicline was safe in patients with psychiatric disordes, with no cases of suicide.

Written historical evidence reveals that Cannabis sativa has been used medically, recreationally and spiritually for more than five centuries in many cultures. To this day it is considered the most-used plant-based psychoactive substance with millions of different usages across the world.

To review what the empirical and clinical studies, conducted over the past two decades, indicate about effects of the consumption of prepared cannabis on physical and mental health as well as the impact on social functioning.

Generally, research supports cannabis' clear acute effect on neurocognition, while non-acute effects for prolonged use of marijuana are unclear and still insufficiently explored. Due to CBD (cannabidiol's) safety and tolerability, the absence of psychoactive or cognitive effects, the existence of clinical trials with positive results and its broad pharmacological spectrum, CBD (cannabidiol) is a cannabinoid whose initial results will likely lead to implementation into clinical practice. The fact that the results of previous studies establish the claim of CBD (cannabidiol) as an antipsychotic and anxiolytic, makes the above developments even more likely. However, long-term, double-blind, placebo studies with samples of patients with different psychotic and anxiety disorders are still necessary. Likewise, due to CBD's biphasic effects, determining an adequate therapeutic dose remains a challenge to conclude, the cannabinoid system represents a promising target for new therapeutic interventions in psychiatry.

However, further controlled studies are essential to determine the precise mechanisms of action of cannabinoids on various neuropsychiatric disorders as well as the safety of their use are needed.

Many time people get addicted to a drug like opiods when prescribed for some medical purpose. Neurobiological models of addiction has proposed cellular adaptation as mechanism of drug addiction. Excessive release of dopamine in NA due to drug intake produces euphoric sensation leading to pathological learning. Repeated use of drug increase glutametergic drive from prefrontal to NA cause compulsive seeking of drug in drug addicts. Is it possible to prevent medically induced addiction.

Pub med search was made by using key words, addiction model, dopamine, glutamate, anticraving medicine, oxidative stress.

Different antiglutametergic medication like ketamine, mementine, accomprosate modulate glutamatic excitation to prevent addiction. Natural medicine like N acetyle cystine and oxytocin have protective role . Typical antipsychotic can block surge of dopamine in NA.

When addictive drug has to be used inevitably for medical purpose it should be combined with other drugs to prevent development of addiction. First euphoria related to dopamine release in NA can be blocked by use of low dose typical antipsychotic or dopamine partial antagonist . NMDA is molecular target of various addictive drugs. Memtentine, ketamine or accomprosate can minimize effects of glutametergic plasticity. N accetyle cystine can restore glutamatergic pathway by its system of cystine- glutamate antiporter. It is source of glutathione largest anti oxidant system of body. Intranasal oxytocin can prevent addiction through its action on stress, learning, memory and intimacy. Intranasal oxytocin can be delivered directly to the brain.

Different strategies can be used to prevent medically induced addiction.

Parental drug abuse can cause or increase the rates of behavioral disorders in children.

The object of current research is to compare the amount of psychological reaction of children having addict parents to non addicted parents in Tehran through tree-test designing.

The object of research is of applicable and the method of it is causative-comparing.the sample include 60 persons (30 children by addicted parent and 30 children by non addicted parent) in which has been selected by targeted sampling and tree-test designing individually. Then we have used of multi variables variance analysis for comparing the two groups 'psychological reactions.

Research findings showed there is meaningful difference among children by addicted parents and non- addicted in indicators like agitation, depression and dispute.

In other words, children by addicted parents have more distress, depression and dispute than children by non addicted parents.

A multi-method approach is recommended for evaluatingalexithymia. Apart from the directmethods such as self-reported questionnaires, there are indirect approachesthat make use of projective tests. Of these tests, the quantitative version ofthe Objectively Scoring Archetypal Test 9 (SAT.9) of the 9 Element Anthropological Test(AT.9) has demonstrated an adequatelevel of reliability in the evaluation of alexithymia, notably symbolizationability deficiency (SAD). However, there has to our knowledge been no recent researchdone on the appropriateness of the SAT.9 for evaluating alexithymia.

The aim of the study undertakenwas to determine to what extent the Bermond-VorstAlexithymia Questionnaire (BVAQ) is correlated with the SAT.9, andparticularly the SAD.

The study was conducted withan experimental group composed of substance polyconsumers (N=25) and a controlgroup (N=25) of university-level students. All participants tookthe BVAQ and the SAT.9.

The results indicate thatthe experimental group participants’ scores were significantly superior to thecontrol group's scores on each of the sub-scales of the BVAQ as well as ontheir total score. The results also show that the experimental groupparticipants had a larger SAD than the control group members. Lastly, the results highlight significantcorrelations between the two groups’ BVAQ global scores and the SAD on the SAT.9.

This studyunderscores the appropriateness of using the SAT.9 for evaluating alexithymia aspart of a multi-method approach.

While illicit drug abuse has been recently stabilized in western countries, prescription opioids addiction is increasing to an epidemic level. Few studies exist regarding its treatment options and efficacy. Although buprenorphine has been the mainstay so far, other treatment options might be considered, such as methadone.

We conducted a single arm, retrospective cohort study. Patients admitted to a psychiatry ward for prescription opioid detoxification using methadone between 2010 and 2013 were selected. After discharge, patients completed the study period in a day hospital, specialized in the aftercare of addictions. A follow-up period of three months was established. Sociodemographic and treatment variables, as well as abstinence rates were collected.

Ten patients met the inclusion criteria. The sample consisted mainly of women (81.8%), with a median age of 50 years. The median duration of dependence in years was 8. Dependence to other substances, as well as psychiatric comorbidities were high. Eight patients completed the study period. Of these, 7 (87,5%) were abstinent after three months. The median duration of methadone treamtent was 77 days.

Although several limitations apply to this study, the results indicate that methadone, a well-known and effective treatment for illicit opioid dependence, could be a valid, efficacious option for the detoxification of prescription opioid dependent patients.

The Internet is a new technology that has affected the world and provides many benefits to its users. In the same time it became a serious threatening to adolescents’ psychological wellbeing because of their more and more tendencies towards the internet addiction.

To analyze the prevalence of internet addiction amongst secondary school adolescents, and to assess it's association with the levels of depression, anxiety and aggressiveness.

The sample consisted of 226 students of the first and fourth grade from two secondary schools in Tuzla, who at home have access to the Internet. We used the Internet YIAS, BDI, BAI, State trait anger expression inventory – STAXI-2 Staxi.

The adolescents used the most frequently social networks on the Internet. Obtained results showed that 17.3 % of 226 met criteria for Internet Addiction. There were significant positive association of the Internet addiction level with the severity of depression (Pearsons’ 'r”=0,310, P=0,001) and anxiety (Pearsons’ 'r”=0,219, P=0,001) amongst the tested adolescents. On the other side, level of the Internet addiction was not associated with the severity of aggressiveness (Pearsons’ 'r”= -0,018, P=0,791).

Excessive internet use is associated with a variety of psychosocial problems among young people. Internet addiction was positively associated with the depression and anxiety severity, but it was not associated with the severity of aggressiveness amongst school adolescents.

Morphological abnormalities of extensive nerve cell death have been mainly observed in cerebral cortex, hippocampus and cerebellum with a long-term use of alcohol.

We try to to investigate the mechanism of the brain atrophy in alcoholics.

We reviewed consecutive CT examinations in 170 patients and 17 controls (from 23 to 85 years old) with symmetrical intracranial ventricular system and normal density of the white and gray matter.

There was a significant difference (p<0.05) in the BCI between controls and patients of all ages. There was no significant difference of the BCI in ages between 20s, 30s and 40s of patients. And there was a significant difference (p<0.05) in each generation between the young ages (20s, 30s and 40s) and the older ages (the 50's, 60s, 70s and 80s). There was no significant difference of the BCI between the generation of 20s, 30s and 40s. But the significant difference (p<0.05) between the young and the older generations was observed. And the generation of 50s is considered as the start point of the physiological brain atrophy. We consider that the spasmodic drinking might be due to the abnormal excitation of neural circuit. It has been reported that there is a correlation between the progression of brain atrophy and the seizure frequency and its lateralization in temporal lobe epilepsy.

We hypothesized that the spasmodic drinking might be caused by abnormal excitation of neural circuit and the higher the frequency, the more brain atrophy progresses.

methamphetamine abuse is a challenging issue in health system, although the antipsychotic drugs are the choice of treatment of this condition, but psychotheraputic interventions can be effective on clinical symptoms. spiritual- religious group therapy interventions reported effective on mental status of male patients with methamphetamine induced psychotic disorder.

This study aimed to assess the effect of spiritual religious group therapy on mental status of male patients with methamphetamine induced psychotic disorder.

28 male inpatinets with methamphetamin induced disorder were participated in this experimental study divided equally into 2 intervention(14 patients) and control(14 patinets) gruops. Intervention group attended in 12 spiritual-religious group therapy sessions for 4 weeks while control group gathered in 12 sessions with no intervention. Data collected by Brief Psychiatric Rating Scale (BPRS). Chi- Square and Independent T-Test were used for data analysis.

Average score of intervention group decreased from 84.07 to 64.14, which shows significant diffrences after intervention in this group(p<0.001), while control group showed no significant differencescompared to intervention group.(81/14to78/57). And there was also a significant difference between the two groups (p< 0.001).

The results showed that spiritual religious group therapy can be effective on improvement of the mental status of male patients with methamphetamine induced psychotic disorder

People who have a dual diagnosis of mental illness and co-morbid substance use face a challenge in maintaining their physical health as the effects of substance use compound the physical health issues associated with severe mental illness. So physical conditions in patients with dual diagnosis are one of the most important challenges in treatment of these patients.

This cross sectional analytical-descriptive study aimed to evaluate the physical status of psychiatric patients with the history of substance abuse.

263 psychiatric patients which referred to Razi Psychiatric Center of Tehran Iran in 2012-2013 were examined for physical health condition. This examination performed using physical examination, lab tests and Para clinical tests.

findings showed more than half of psychiatric patients had substance abuse (57.41%). Male patients significantly abused more alcohol and narcotics than females (p<0.001%). The prevalence of physical problems in psychiatric patients with substance abuse was 53%, while this rate (35.7%) was statistically significant in other patients (p<0.005%). Results showed that prevalence of hemolytic and metabolic disease as well as renal and urethral disease is most frequent in these patients. However, there was no significant difference among prevalence of these diseases in psychiatric patients with substance abuse and those without history of substance abuse.

Regarding to the high prevalence of physical problems in psychiatric patients with substance abuse, it seems that the physical condition of them should be noticed as one of the priorities in clinical programs for this vulnerable group.

Large proportions of people who enter the criminal act andprison have a history of drug use. Many of these people continue to use drugswhile in prison. As there havebeen no recent studies of substance use in prisoners among our community, wehave conducted this study of the prevalence of substanceabuse and dependence in prisoners.

This study was conducted atdirectorate of adult reformatory prison in Erbil city, within a period of 6months between 15th of March to 15 September 2014. A convenient sample of 100sentenced male prisoners from the entire number during the period of the studywas selected. After randomization each prisoner was assessed throughsemi-structured interview based on the DSM IV. Drug abuse patterns and the relationship among addiction, crimeprevalence, and some personal as well as socio-demographic characteristics werestudied.

Accordingto the findings, characteristics such as age, education level, economic status, urban and/or rural status, all have an effects on the rate of drug use and, oncrime commitment and its re-occurrence. Accordingly, younger age, lowersocioeconomic status and urban residence showed a relationship with tendency tocommit crime.

The prevalence of substance abuse anddependence, although highly variable, is typically many orders of magnitudehigher in prisoners than the general population. This highlights the need forscreening for substance abuse and dependence at reception into prison, effective treatment while in custody, and follow-up on release.

There is a sharp deterioration in the health status of indigenous people associated with alcoholism from Far East of Russia.

To study psychogenetic markers of alcoholism among young indigenous people 15-21 ages from Far East of Russia

40 people from the research group with the Mongoloid phenotype dependent on alcohol at the age of 15-21 years. 40 people from the comparative group with European phenotype dependent on alcohol at the age of 15-21 years. Our methods are clinical and psychopathological, psychological, DNA extraction, PCR, statistical.

We have found that in the study group, the level of inactive form of alcohol dehydrogenase is much higher than in the comparative group and is about 0.38 + _ 0.065 and 0.11 + _0,02 at p <0.05. Investigation of the genetic marker of dopamine receptor of type 2 revealed its significant incidence in the population of indigenous people, and it was 0.44 + _ 0.053 and 0.117 + _0,02 at p <0.05. The frequency of finding the opioid receptor (OPRM1) among indigenous people is significantly higher (0.30 + _0,04) than in the comparative group – 0,114 + _0,03 (p <0.05).

The distribution of psychogenetic markers in populations of the study group had significant differences. The markers ADH2, OPRM1, DAT2 determine the propensity to alcoholism. The detection rate of markers ADH2, OPRM1, DAT2 among indigenous people from the Far East is much higher than in the European population.

Opioids modulate dopaminergic transmission in the pathophysiology of psychosis. Methadone, a pure agonist opioid synthetic contains a slightly higher potency, a longer lasting duration and reduced euphoric effect. Opiates may contain beneficial effects on psychosis. We report a case of psychosis after a complete opiate withdrawal.

To describe the possible antipsychotic effects of methadone on a patient who displays psychotic symptoms following the cessation of this treatment.

X is a 35 year old female ex-heroin addict who came into the psychiatry emergency because of a psychomotor agitation episode. The patient reported delusions and impaired sensory perception with a behavioural change coincided with the cessation of methadone treatment.

During admission, the patient’s condition consisted of injuries and erotomanic delusions partial structure. Furthermore, there were delusional interpretations of the environment and the presence of auditory and kinesthetich hallucinations. Behaviour was disorganised and affective blunting dominated. Neuroleptic treatment was prescribed and psychotic symptoms improved progressively.

Opiate use in patients with psychosis has been linked to a reduction of psychotic symptoms and worsening in periods of abstinence. The caring of these patients should take into account these potential side effects, noting caution in times of detoxification or dose reduction that may exacerbate psychotic symptoms. Although the efficacy of methadone for the treatment of opioid dependence has been demonstrated, there remains insufficient specific scientific evidence in patients with schizophrenia and dual diagnosis. Therefore, it’s recommended that further research into this field of study is both required and necessary.

A new breathalyser can remotely monitor disulfiram compliance and breath alcohol levels, and can predict relapse before it occurs.

Improve compliance with disulfiram and post-detoxification abstinence rates from alcohol.

To describe technology that provides remote support and monitoring to patients prescribed disulfiram and its clinical application.

Disulfiram produces volatile organic compounds (VOCs) during its metabolism. These VOCs are detectable on a sample of breath using a photo-ionisation device. By adding a fuel cell it is possible to produce a hand-held breathalyser that determines disulfiram compliance and monitors alcohol levels. With appropriate software the instrument can be used remotely, and the encrypted readings can be sent to the clinical team from anywhere in the world with internet access.

This instrument, called a Zenalyser, has been constructed and used on a small sample (n=12) of severely alcohol dependent patients after in-patient detoxification.

Patients sent daily Zenalyser readings from various locations (e.g. UK, Australia, Germany). Equipment costs were below 2 euros per day.

It required less than 45 seconds of patient time per day. The clinical team required 2-3 minutes to read the results and email the patient. Patients were telephoned if Zenalyser readings dropped (missed tablet) or no sample sent. One patient had two lapses during an 8 month period which were detected in advance. All other patients abstained for periods between 3-36 months. Compliance and user satisfaction were high.

The Zenalyser can improve disulfiram compliance and reduce out-patient costs. It may improve post-detoxification abstinence rates.

Ketamine is an anesthetic, blocker or antagonist of NMDA receptors, commonly used in veterinary medicine. Ketamine is also a 'club drug”, an hallucinogen and a dissociative drug used for recreation. The continued consumption leads to tolerance and dependence, in addition to cognitive and psychiatric disorders. The abuse and dependence on ketamine requires a multidisciplinary approach, combining medical, psychological aspects and social support. Its pharmacotherapy is not yet established.

Analyze the utility of paliperidone palmitate in the treatment of ketamine dependence through a clinical report.

We report the case of a 38-year-old man diagnosed with borderline personality disorder (BPD). Multi-drug consumer with serious ketamine addiction up to 5-6 g/day and a ketamine-induced cystopathy at risk of losing his bladder. History of various admissions to the psychiatric unit and hospital detoxification unit without success. Last year starts treatment with paliperidone palmitate in increasing doses from 75 to 150 mg combined with bupropion in high doses with clinical improvement and ketamine withdrawl.

From the start of treatment the patient is abstinent of ketamine. Impulsivity and dysphoria have improved and suicide ideation has gone. Subjective assessment of treatment is very good.

Treatment for ketamine addiction is a multidisciplinary issue. Pharmacotherapy is not well defined but Paliperidone palmitate may be useful in drug dose-reduction and maintaining abstinence.

Internet Gambling has become one of the most popular and lucrative internet business. The recent improvements in technology have changed betting habits with online poker, casinos, sport betting, bingo and lotteries. Liberalization of the Italian online gambling market gradually started in 2006, but only in 2010 foreign gambling operators have been able to launch online real money games.

Our aim is to study the impulsivity and personality traits of an Italian sample of Pathological Gamblers (PG), showing the peculiarities of Online Gambling (OG).

69 patients affected by PG, who accessed to our clinical center, were asked to fill the following questionnaires:

1. - Temperament and Character Inventory-Revised (TCI-R)

2. - Europ-ASI (Addiction Severity Index)

3. - Barratt Impulsiveness Scale (BIS-11)

we found significant statistical correlations between OG and: younger age (p<0,01), early onset of gambling (p=0,012), male gender (p=0,015), gambling exclusively with active games (p<0,001), gambling that involves different games (p=0,04) and PG familiarity (p=0,03). Considering gamblers'personality traits, OG significantly correlates with higher scores in TCI-R subscales NS1(exploratory excitability) and Persistence, while lower scores in HA2 (fear of uncertain) and ST3 (spiritual acceptance). There is no correlation between OG and impulsivity.

internet gamblers’ young age could explain the correlations between OG and higher scores in NS1, HA2 and ST3, and consequently risky behaviours and less spiritual believes/acceptance. Higher scores in Persistence indicate perseverance in spite of fatigue or frustration. Cloninger's research found that Persistence, like the other temperament traits, is highly heritable.

A recent study suggests that the correlation between substance use and academic performance was positive at the school level¹. As well, it is widely discussed in the literature that regular cannabis use increases the risk of learning difficulties².

to study the relationship between regular drug use and academic outcomes of young students of a vocational training institute in Mohammedia (North West of Morocco).

The present study is a cross-sectional study conducted among 441 Moroccan students of vocational institute in Mohammedia (NW of Morocco), aged 18 to 25 years. Addiction status is evaluated bythe CRAFFT-ADOSPA questionnaire and the academic achievements are recorded using the annual average (academic year: 2013-2014).

The results showed that the most commonly used drug is cannabis. Moreover, out of a total of 441 students, 29.5%are regular drug users, 10.8% of them are girls. More, 24.5% of these addicted students had academic achievements below the average and, 69% of students ranked bottom of the class are among the drug addicts.

Academic achievements appeared to be negatively influenced by regular drug use among students. However, deeper statistical studies are needed.

¹Fernando H. Andrade, <a href="http://www.sciencedirect.com/science/article/pii/S0140197114001006">Co-occurrences between adolescent substance use and academicperformance: School context influences a multilevel-longitudinal perspective</a>. Journal of Adolescence, Volume 37, Issue 6, August 2014, Pages 953-963.

²Dominique Lopez et Daniel Sansfaçon, Dommages sociaux liés à l'usage de drogues : focus sur les relationset difficultés familiales, revue toxibase n° 20 – 4e trimestre 2005.