Abstract
Abuse and dependency of alcohol or drugs is a major problem today, with
severe implications for society as well as for the individual. Treatment
is often characterised by hard work and the road to recovery is (among
other problems) paved with acute and protracted withdrawal symptoms as
well as relapse. Lately there has been an increased interest, and
success, in the pharmacological treatment of dependency of different
substances (e.g. acamprosate and naltrexone for alcohol, methadone and
buprenorphine for opioids and possibly naltrexone for amphetamine and
flumazenil for benzodiazepines).
Essential for the investigation of promising substances are valid and
reliable tools for registration of relevant subjective and objective
effects during experimental treatment. Therefore, the aim of this work
was to find and test suitable tools, and to study different
psychopharmacological consequences, in experiments designed to affect
acute and/or post-acute effects of benzodiazepines and alcohol.
To study the objectives I was interested in I have performed two studies
with intravenous provocations, one with placebo and alcohol and one with
flumazenil, resulting in five separate reports on different topics.
In this thesis, I have highlighted the importance of taking gender as
well as placebo effects in account when performing pharmacological
provocations on subjects treated for benzodiazepine dependence. Further,
I have shown that it is possible to register acute tolerance to alcohol
with an objective test previously not used in this context. I have also
shown that it was possible to measure pharmacologically induced
reductions in symptoms of benzodiazepine withdrawal using subjective and
objective registrations. In addition, I have found that a reduction of
self-rated withdrawal related aggression could be measured after
intravenous flumazenil. Finally, I have pointed to the risk for loss of
important information when creating indexes of multiple measures.
