Psychose und Sucht (Doppel-Diagnose)

INHALT
Zusammenfassung
1. Einleitung
1.1. Zum Frühverlauf der Schizophrenie
1.2. Zur Komorbidität von Psychose und Sucht
1.2.1. Epidemiologie
1.2.2. Erklärungsansätze zur Komorbidität
1.2.3. Probleme in der Therapie komorbider Patienten
1.3. Fragestellungen dieser Arbeit
2. Material und Methoden
2.1. Untersuchungsrahmen
2.2. Art der Datenerhebung
2.3. Beschreibung der Gesamt-Stichprobe
2.4. Beschreibung der Stichprobe der berücksichtigten Patienten
2.5. Zusammenfassung
3. Ergebnisse
3.1. Psychopathologie im Verlauf
3.2. Bestimmung der Parallelisierungszeitpunkte
3.3. Das Konsummuster zwischen 1988 und 1997
3.4. Varianzanalyse zum Konsummuster
3.5. Das Konsummuster an den Parallelisierungszeitpunkten
3.6. Einfluß von subjektiver Symptomatik und Diagnose-Zeitpunkt
4. Diskussion
4.1. Methodische Fragen
4.2. Diskussion der Ergebnisse
4.3. Fazit und Ausblick

weiterlesen: PsychoseundSucht_Studie

Effect of filtration on morphine and particle content of injections prepared from slow-release oral morphine tablets

Background: Injections of mixtures prepared from crushed tablets contain insoluble particles
which can cause embolisms and other complications. Although many particles can be removed by
filtration, many injecting drug users do not filter due to availability, cost or performance of filters,
and also due to concerns that some of the dose will be lost.
Methods: Injection solutions were prepared from slow-release morphine tablets (MS Contin®)
replicating methods used by injecting drug users. Contaminating particles were counted by
microscopy and morphine content analysed by liquid chromatography before and after filtration.
Results: Unfiltered tablet extracts contained tens of millions of particles with a range in sizes from
< 5 μm to > 400 μm. Cigarette filters removed most of the larger particles (> 50 μm) but the
smaller particles remained.

Commercial syringe filters (0.45 and 0.22 μm) produced a dramatic
reduction in particles but tended to block unless used after a cigarette filter. Morphine was retained
by all filters but could be recovered by following the filtration with one or two 1 ml washes.

The combined use of a cigarette filter then 0.22 μm filter, with rinses, enabled recovery of 90% of the
extracted morphine in a solution which was essentially free of tablet-derived particles.
Conclusions: Apart from overdose and addiction itself, the harmful consequences of injecting
morphine tablets come from the insoluble particles from the tablets and microbial contamination.
These harmful components can be substantially reduced by passing the injection through a
sterilizing (0.22 μm) filter. To prevent the filter from blocking, a preliminary coarse filter (such as
a cigarette filter) should be used first. The filters retain some of the dose, but this can be recovered
by following filtration with one or two rinses with 1 ml water.

Although filtration can reduce the
non-pharmacological harmful consequences of injecting tablets, this remains an unsafe practice due
to skin and environmental contamination by particles and microorganisms, and the risks of bloodborne
infections from sharing injecting equipment.

Read the whole  story:Filtration_and_injection_2010

Wie effektiv sind Spritzenfilter?

filtereffectiveness2005

Abstract
Aims: (a) To compare in the laboratory the effectiveness of various filters at removing particles from
heroin injections; (b) To measure the amount of heroin retained by the filters; and (c) To describe the
relevance of these preliminary findings to future research.
Design: A laboratory-based investigation. Injections were prepared with street heroin obtained from
the police, copying the methods of injectors. Pieces of cigarette filter, hand-rolling cigarette filter,
cotton wool from buds and commercially produced syringe filters were tested. The Coulter Multisizer
(IIe) was used to count and size particles; Capillary Zone Electrophoresis was used to measure the
amount of heroin retained in the filters.
Findings: All methods of filtration reduced the amount of particles, with the commercially produced
syringe filter producing the largest reduction. The syringe filter retained the most heroin after use;
however, less drug material was evident on the spoon, suggesting further work is needed with a range
of quantities. The cigarette, hand-rolling and cotton bud filters all retained some drug with no
significant difference detected between the different filters.
Conclusions: This preliminary study suggests all the filters tested may convey health benefits. Further
work is needed with varying quantities of drug, acid and water and to establish safety in use. Then
future studies can establish the health consequences for injecting drug users from the use of such
filters.