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      Assessment of Alcohol and Tobacco Use Disorders Among Religious Users of Ayahuasca

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          Abstract

          The aims of this study were to assess the impact of ceremonial use of ayahuasca—a psychedelic brew containing N,N-dimethyltryptamine (DMT) and β-carboline —and attendance at União do Vegetal (UDV) meetings on substance abuse; here we report the findings related to alcohol and tobacco use disorder. A total of 1,947 members of UDV 18+ years old were evaluated in terms of years of membership and ceremonial attendance during the previous 12 months. Participants were recruited from 10 states from all major regions of Brazil. Alcohol and tobacco use was evaluated through questionnaires first developed by the World Health Organization and the Substance Abuse and Mental Health Services Administration. Analyses compared levels of alcohol and tobacco use disorder between the UDV and a national normative sample ( n = 7,939). Binomial tests for proportions indicated that lifetime use of alcohol and tobacco was higher in UDV sample compared to the Brazilian norms for age ranges of 25–34 and over 34 years old, but not for the age range of 18–24 years old. However, current use disorders for alcohol and tobacco were significantly lower in the UDV sample than the Brazilian norms. Regression analyses revealed a significant impact of attendance at ayahuasca ceremonies during the previous 12 months and years of UDV membership on the reduction of alcohol and tobacco use disorder.

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          Serotonin 5-HT2 receptor interactions with dopamine function: implications for therapeutics in cocaine use disorder.

          Cocaine exhibits prominent abuse liability, and chronic abuse can result in cocaine use disorder with significant morbidity. Major advances have been made in delineating neurobiological mechanisms of cocaine abuse; however, effective medications to treat cocaine use disorder remain to be discovered. The present review will focus on the role of serotonin (5-HT; 5-hydroxytryptamine) neurotransmission in the neuropharmacology of cocaine and related abused stimulants. Extensive research suggests that the primary contribution of 5-HT to cocaine addiction is a consequence of interactions with dopamine (DA) neurotransmission. The literature on the neurobiological and behavioral effects of cocaine is well developed, so the focus of the review will be on cocaine with inferences made about other monoamine uptake inhibitors and releasers based on mechanistic considerations. 5-HT receptors are widely expressed throughout the brain, and several different 5-HT receptor subtypes have been implicated in mediating the effects of endogenous 5-HT on DA. However, the 5-HT2A and 5-HT2C receptors in particular have been implicated as likely candidates for mediating the influence of 5-HT in cocaine abuse as well as to traits (e.g., impulsivity) that contribute to the development of cocaine use disorder and relapse in humans. Lastly, new approaches are proposed to guide targeted development of serotonergic ligands for the treatment of cocaine use disorder.
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            Cognitive training for substance use disorders: Neuroscientific mechanisms.

            This article reviews the emerging research on cognitive training for substance use disorders, and discusses the neuroscientific mechanisms that underlie cognitive training effects in addiction. Four cognitive training interventions are reviewed: cognitive bias modification (CBM), response inhibition, working memory (including specific and multi-component approaches), and goal-directed interventions. Based on the knowledge of the mechanisms involved in these trainings they can be clustered in two classes: (1) CBM and response inhibition, which have shown to operate via reorientation of stimulus-action approach biases and rewiring of the medial prefrontal cortex and the amygdala; (2) Working memory and goal-oriented interventions, which have been associated with improvements in stimulus-outcome representations e.g. increased future-based delay-discounting and decision-making, and rewiring of the dorsolateral and ventrolateral prefrontal cortices. The cognitive trainings are generally efficacious in improving the trained cognitive processes. The transfer to clinical outcomes is notable and theoretically coherent, although evidence is still preliminary. Replication studies and randomised controlled trials that incorporate neuroscience-based mechanistic accounts are needed to gauge the significance of this line of research.
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              Effects of Ayahuasca and its Alkaloids on Drug Dependence: A Systematic Literature Review of Quantitative Studies in Animals and Humans.

              Recently, the anti-addictive potential of ayahuasca, a dimethyltryptamine(DMT)- and β-carboline-rich hallucinogenic beverage traditionally used by indigenous groups of the Northwest Amazon and currently by syncretic churches worldwide, has received increased attention. To better evaluate this topic, we performed a systematic literature review using the PubMed database to find quantitative studies (using statistical analysis) that assessed the effects of ayahuasca or its components in drug-related symptoms or disorders. We found five animal studies (using harmaline, harmine, or ayahuasca) and five observational studies of regular ayahuasca consumers. All animal studies showed improvement of biochemical or behavioral parameters related to drug-induced disorders. Of the five human studies, four reported significant reductions of dependence symptoms or substance use, while one did not report significant results. The mechanisms responsible for the anti-addictive properties of ayahuasca and its alkaloids are not clarified, apparently involving both peripheral MAO-A inhibition by the β-carbolines and central agonism of DMT at 5-HT2A receptors expressed in brain regions related to the regulation of mood and emotions. Although results are promising, controlled studies are needed to replicate these preliminary findings.
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                Author and article information

                Contributors
                Journal
                Front Psychiatry
                Front Psychiatry
                Front. Psychiatry
                Frontiers in Psychiatry
                Frontiers Media S.A.
                1664-0640
                24 April 2018
                2018
                : 9
                : 136
                Affiliations
                [1] 1Department of Philosophy and Human Sciences, Universidade Estadual de Santa Cruz , Ilhéus, Brazil
                [2] 2Department of Medical Psychology and Psychiatry, Faculty of Medical Sciences, Universidade Estadual de Campinas , Campinas, Brazil
                [3] 3New York School of Medicine , New York, NY, United States
                [4] 4University of New Mexico, Simpson Hall , Albuquerque, NM, United States
                [5] 5Department of Psychiatry and Human Behavior, University of Mississippi Medical Center , Jackson, MS, United States
                [6] 6Department of Health Sciences, Universidade Estadual de Santa Cruz , Ilhéus, Brazil
                [7] 7Departamento de Psiquiatria, Universidade Federal de São Paulo , São Paulo, Brazil
                [8] 8School of Human Evolution and Social Change, Arizona State University , Tempe, AZ, United States
                Author notes

                Edited by: Andrew Robert Gallimore, Okinawa Institute of Science and Technology, Japan

                Reviewed by: Vijay Arjun Ramchandani, National Institute on Alcohol Abuse and Alcoholism, United States; Santiago J. Ballaz, Yachay Tech University, Ecuador

                *Correspondence: Paulo Cesar Ribeiro Barbosa pcrbarbosa@ 123456uesc.br

                This article was submitted to Neuropharmacology, a section of the journal Frontiers in Psychiatry

                †Retired.

                Article
                10.3389/fpsyt.2018.00136
                5928846
                29740355
                9d79f9fe-4029-496b-a7df-5762582b522f
                Copyright © 2018 Barbosa, Tófoli, Bogenschutz, Hoy, Berro, Marinho, Areco and Winkelman.

                This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

                History
                : 22 December 2017
                : 29 March 2018
                Page count
                Figures: 0, Tables: 6, Equations: 0, References: 57, Pages: 12, Words: 9357
                Categories
                Psychiatry
                Original Research

                Clinical Psychology & Psychiatry
                ayahuasca,hoasca,união do vegetal,alcohol,tobacco,substance use disorder

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