Substance use disorders: Psychoneuroimmunological mechanisms and new targets for therapy

Abstract

An estimated 76.4 million people worldwide meet criteria for alcohol use disorders, and 15.3 million meet criteria for drug use disorders. Given the high rates of addiction and the associated health, economic, and social costs, it is essential to develop a thorough understanding of the impact of substance abuse on mental and physical health outcomes and to identify new treatment approaches for substance use disorders (SUDs). Psychoneuroimmunology is a rapidly expanding, multidisciplinary area of research that may be of particular importance to addiction medicine, as its focus is on the dynamic and complex interactions among behavioral factors, the central nervous system, and the endocrine and immune systems (Ader, 2001). This review, therefore, focuses on: 1) the psychoneuroimmunologic effects of SUDs by substance type and use pattern, and 2) the current and future treatment strategies, including barriers that can impede successful recovery outcomes. Evidence-based psychosocial and pharmacotherapeutic treatments are reviewed. Psychological factors and central nervous system correlates that impact treatment adherence and response are discussed. Several novel therapeutic approaches that are currently under investigation are introduced; translational data from animal and human studies is presented, highlighting immunotherapy as a promising new direction for addiction medicine.

Neuroimmune Basis of Methamphetamine Toxicity

“…7.1. The authors acknowledge Elsevier for the use of Table 7.1, a version of which was previously published in Pharmacology & Therapeutics (i.e., Loftis and Huckans, 2013). …”

Altered energy production, lowered antioxidant potential, and inflammatory processes mediate CNS damage associated with abuse of the psychostimulants MDMA and methamphetamine

“…Drug induced alterations in energy utilization, oxidative/nitrosative stress and immune response are associated with significant cognitive impairments and mood disturbances (Loftis and Huckans, 2013; Parrott, 2006). PET studies report altered brain glucose metabolism that correlates with severity of psychiatric symptoms in the limbic and orbitofrontal regions of adults who used methamphetamine (Chang et al, 2007).…”

Investigations into the efficacy of multi-component cocaine vaccines

“…3 At present, cocaine addiction is treated with behavioral therapy, including counseling, contingency management and therapeutic communities; however, maintaining abstinence is extremely difficult for addicted individuals. 4,5 Pharmacological interventions, such as small molecule therapeutics and vaccines, would offer those suffering cocaine addiction additional tools for overcoming withdrawal and relapse; however, no FDAapproved treatments for cocaine addiction are available at this time. 6,7 As a result, there is great need for more efficacious and reliable therapeutic options.…”