"305.00 Alcohol Abuse" or "305.60 Cocaine Abuse").The DSM-IV requires at least three of the following symptoms present during a 12-month period for a diagnoses of polysubstance dependence. Tolerance: Use of increasingly high amounts of a substance or they find the same amount less and less effective ( the amount has to be at least 50% more of the original amount needed.) Withdrawal: Either withdrawal symptoms when the substance stops being used or the substance is used to prevent withdrawal symptoms. Loss of control: Repeated use of more substance than was initially planned or use of the substances over longer periods of time than was planned. Inability to stop using: Either unsuccessfully attempted to cut down or stop using the substances or a persistent desire to stop using. Time: Spending a lot of time studying substances, obtaining substances, using substances, being under the influence of substances, and recovering from the effects of substances. Interference with activities: Give up or reduce the amount of time involved in recreational activities, social activities, and/or occupational activities because of the use of substances. Harm to self: Continuous use of substances despite having a physical or psychological problem caused by or made worse by the use of substances.DSM-5 eliminated polysubstance disorder; there the substances must be specified, among other related changes. Treatment
Treatment for polysubstance dependence has many critical aspects. Substance rehabilitation is a lengthy and difficult process.
Severe sickle cell crises, in some cases resulting in death, have been associated with the use of filgrastim in patients with sickle cell disorders. Interactions
Increased hematopoietic activity of the bone marrow in response to growth factor therapy has been associated with transient positive bone imaging changes; this should be considered when interpreting bone-imaging results. Mechanism of action
G-CSF is a colony stimulating factor which has been shown to have minimal direct in vivo or in vitro effects on the production of other haematopoietic cell types. Neupogen (filgrastim) is the name for recombinant methionyl human granulocyte colony stimulating factor (r-metHuG-CSF). Society and culture
Biosimilars
In 2015, Sandozs filgrastim-sndz (trade name Zarxio), obtained the approval of the U.S. Food and Drug Administration (FDA) as a biosimilar. This was the first product to be passed under the Biologics Price Competition and Innovation Act of 2009 (BPCI Act), as part of the Affordable Care Act. Zarxio was approved as a biosimilar, not as an interchangeable product, the FDA notes. And under the BPCI Act, only a biologic that has been approved as an "interchangeable" may be substituted for the reference product without the intervention of the health care provider who prescribed the reference product.