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      Yoga as an Adjunct for Management of Opioid Dependence Syndrome: A Nine-Month Follow-Up Case Report

      case-report

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          Abstract

          Opioid dependence syndrome (ODS) is a chronic relapsing remitting condition associated with significant impairment and mortality risk. Opioid substitution therapy is used worldwide, but long-term retention rates are low and there is risk of misuse and diversion. Yoga practice can improve quality of life, reduce chronic pain, and enhance endogenous opioids (beta-endorphins). We describe a case of ODS where yoga was added to the conventional management and who was followed up for 9 months. Assessments were done for clinical symptoms, urine drug screening, plasma beta-endorphins, and Buprenorphine dosage. We observed an improvement in his clinical symptoms and reduction in the requirements for Buprenorphine. A slight increase in basal plasma beta-endorphin levels was also observed at the 9-month follow-up (from 2.02 pmol/L at baseline to 6.51 pmol/L).

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          Most cited references16

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          The ICD-10 Classification of Mental and Behavioural Disorders : Clinical Descriptions and Diagnostic Guidelines

          Provides clinical descriptions diagnostic guidelines and codes for all mental and behavioural disorders commonly encountered in clinical psychiatry. The book was developed from chapter V of the Tenth Revision of the International Statistical Classification of Diseases and Related Health Problems (ICD-10). The clinical descriptions and diagnostic guidelines were finalized after field testing by over 700 clinicians and researchers in 110 institutes in 40 countries making this book the product of the largest ever research effort designed to improve psychiatric diagnosis. Every effort has been made to define categories whose existence is scientifically justifiable as well as clinically useful. The classification divides disorders into ten groups according to major common themes or descriptive likeness a new feature which makes for increased convenience of use. For each disorder the book provides a full description of the main clinical features and all other important but less specific associated features. Diagnostic guidelines indicate the number balance and duration of symptoms usually required before a confident diagnosis can be made. Inclusion and exclusion criteria are also provided together with conditions to be considered in differential diagnosis. The guidelines are worded so that a degree of flexibility is retained for diagnostic decisions in clinical work particularly in the situation where provisional diagnosis may have to be made before the clinical picture is entirely clear or information is complete. ... As befitting a publication of considerable influence the amount of work that went into preparing ICD-10 has been formidable... - The International Journal of Social Psychiatry
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            The ICD-10 Classification of Mental and Behavioural Disorders: Clinical Descriptions and Diagnostic Guidelines

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              Beta-endorphin and drug-induced reward and reinforcement.

              Although drugs of abuse have different acute mechanisms of action, their brain pathways of reward exhibit common functional effects upon both acute and chronic administration. Long known for its analgesic effect, the opioid beta-endorphin is now shown to induce euphoria, and to have rewarding and reinforcing properties. In this review, we will summarize the present neurobiological and behavioral evidences that support involvement of beta-endorphin in drug-induced reward and reinforcement. Currently, evidence supports a prominent role for beta-endorphin in the reward pathways of cocaine and alcohol. The existing information indicating the importance of beta-endorphin neurotransmission in mediating the reward pathways of nicotine and THC, is thus far circumstantial. The studies described herein employed diverse techniques, such as biochemical measurements of beta-endorphin in various brain sites and plasma, and behavioral measurements, conducted following elimination (via administration of anti-beta-endorphin antibodies or using mutant mice) or augmentation (by intracerebral administration) of beta-endorphin. We suggest that the reward pathways for different addictive drugs converge to a common pathway in which beta-endorphin is a modulating element. Beta-endorphin is involved also with distress. However, reviewing the data collected so far implies a discrete role, beyond that of a stress response, for beta-endorphin in mediating the substance of abuse reward pathway. This may occur via interacting with the mesolimbic dopaminergic system and also by its interesting effects on learning and memory. The functional meaning of beta-endorphin in the process of drug-seeking behavior is discussed.
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                Author and article information

                Contributors
                Journal
                Case Rep Psychiatry
                Case Rep Psychiatry
                CRIPS
                Case Reports in Psychiatry
                Hindawi
                2090-682X
                2090-6838
                2021
                23 July 2021
                : 2021
                : 5541995
                Affiliations
                1Department of Psychiatry, National Institute of Mental Health and Neurosciences (NIMHANS), Hosur Main Road, Bengaluru 560029, India
                2Department of Integrative Medicine, National Institute of Mental Health and Neurosciences (NIMHANS), Hosur Main Road, Bengaluru 560029, India
                3Centre for Addiction Medicine, Department of Psychiatry, National Institute of Mental Health and Neurosciences (NIMHANS), Hosur Main Road, Bengaluru 560029, India
                4Department of Clinical Psychopharmacology and Neurotoxicology, NIMHANS, Bengaluru, India
                Author notes

                Academic Editor: Michael Kluge

                Author information
                https://orcid.org/0000-0001-6409-5879
                https://orcid.org/0000-0002-2665-0533
                https://orcid.org/0000-0002-1558-5721
                https://orcid.org/0000-0003-1718-6246
                https://orcid.org/0000-0001-7864-8200
                https://orcid.org/0000-0001-9111-8714
                https://orcid.org/0000-0001-6024-0055
                https://orcid.org/0000-0002-3052-5233
                https://orcid.org/0000-0002-7738-9670
                Article
                10.1155/2021/5541995
                8324390
                34336342
                95a4ec73-c103-4163-91b4-80ccbb693394
                Copyright © 2021 Prateek Varshney et al.

                This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 23 February 2021
                : 29 June 2021
                Funding
                Funded by: Department of Science and Technology
                Award ID: DST/005/504/2018/01112
                Categories
                Case Report

                Clinical Psychology & Psychiatry
                Clinical Psychology & Psychiatry

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