Alcohol

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Risk of Addiction Ever Used (%) Dependence (%) Risk (%) Tobacco 75.6 24.1 31.9 Cocaine 16.2 2.7 16.7 Heroin 1.5 0.4 23.1 <strong>Alcohol</strong> 91.5 14.1 15.4 Cannabis 46.3 4.2 9.1 Source: Anthony et al, 1994.
Addiction: Loss of control • Jean-Pierre Chirac • 45 YO, PhD, Neuroscience • Well know addiction expert • Age 11, 1 st cigarette, school bus driver • Stopped smoking numerous times • Sneaks out to smoke during meetings
Page 1 and 2: The Path to Genomic Medicine For Ad
Page 3 and 4: Use Use Use Use Use Abuse (declarat
Page 5: Possible Changes • Addiction inst
Page 9 and 10: Possible Families of Risk Factors
Page 11 and 12: Response • Genetically influenced
Page 13 and 14: Drugs of Abuse all Activate Reward
Page 15 and 16: Effects of Drugs on Dopamine Levels
Page 17 and 18: Relationship between Cue-Induced De
Page 19: “Unseen” Reward Cues activate a
Page 22 and 23: Alcoholism: FDA Approved Medication
Page 24 and 25: Alcohol - Beverage Condition Cingul
Page 26 and 27: Baclofen blunts Amygdala Connectivi
Page 28 and 29: Alcohol reward Sedating drug, facil
Page 30 and 31: True Translational Story: Naltrexon
Page 32: Naltrexone decreases Alcohol prefer
Page 38 and 39: Ethanol Responses Saline 80 70 60 5
Page 40 and 41: Naltrexone Concurrently Antagonizes
Page 42 and 43: Brain Reward System Nucleus Accumbe
Page 44 and 45: Dopamine Opioid Antagonism Dopamine
Page 46 and 47: Propose an RCT of an opiate antagon
Page 48 and 49: Naltrexone Affinity at Opioid Recep
Page 50 and 51: Receptor Blockade with Naltrexone i
Page 52 and 53: Post-Docs Tom Aronson, MD Joseph Vo
Page 54 and 55: Pharmacological Treatments for Alco
Page 56 and 57:
Days Drinking 1.0 0.8 0.6 0.4 0.2 0
Page 58 and 59:
Alcohol Relapse A. coming to treatm
Page 60 and 61:
Rates of Never Relapsing According
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Blood Alcohol levels (g/dl) 0.1 0.0
Page 64 and 65:
Studies supporting efficacy Studies
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Baseline Craving Scores % Days Heav
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Baseline b-Endorphin Levels in Low-
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Key effect: Sensitivity of Endogeno
Page 72 and 73:
BAES Stimulation Scores Among FH+ a
Page 74 and 75:
Human Mu Opioid Receptor Gene PROMO
Page 76 and 77:
Alcohol effects by genotype 50 45 4
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Lotsch et al, 2006
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Ethnicity & A118G Allele Frequency
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Subjective “high” in Naltrexone
Page 84 and 85:
OPRM1 A118G and Alcoholism Bart et
Page 86 and 87:
COMBINE Study • N = 1383; 9 rando
Page 88 and 89:
Rhesus model Ortholog of A118G alle
Page 90 and 91:
Results: Heavy Drinking Days 30 75
Page 92 and 93:
Endophenotype Endorphin Dependent A
Page 94 and 95:
Medications • Nicotine Nicotine p
Page 96 and 97:
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Alcohol

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