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Acupuncture alters key neurotransmitters

Steffensen is going beyond the previous claims and is studying the neuroscience behind acupuncture. He has shown it to be an effective method of activating pathways from the peripheral nervous system to the central nervous system. Here's how: Those suffering from withdrawal have dysregulated dopamine levels in the midbrain reward/pleasure system This causes dysregulation of GABA neurons in this system, and they become hyperactive, inhibiting dopamine neurons and lowering dopamine levels during withdrawl Lowered dopamine levels is the driving force for relapse Accupuncture stimulation inhibits GABA neurons This restores dopamine levels and effectively lowers the driving force for relapse

Study reveals lack of self-awareness among doctors when prescribing opioids: Emergency department physicians underestimated how often they prescribed opioids, but prescriptions decreased after they saw their actual data -- ScienceDaily

Some 65 percent of those surveyed prescribed more opioids that they thought they did. Michael and his team found participants discharged 119,428 patients and wrote 75,203 prescriptions, of which 15,124 (or about 20 percent) were for opioids over the course of the 12-month study. The researchers then monitored the doctors after they were shown their actual prescription rates. "Everyone showed an overall decrease in prescribing opioids," Michael said. "After seeing their real data, the people with inaccurate self-perceptions, on average, had 2.1 fewer opioid prescriptions per 100 patients six months later and 2.2 percent fewer prescriptions per 100 patients at 12 months."

Our Other Prescription Drug Problem | NEJM

Benzodiazepines have proven utility when they are used intermittently and for less than 1 month at a time. But when they are used daily and for extended periods, the benefits of benzodiazepines diminish and the risks associated with their use increase. Many prescribers don’t realize that benzodiazepines can be addictive and when taken daily can worsen anxiety, contribute to persistent insomnia, and cause death. Other risks associated with benzodiazepines include cognitive decline, accidental injuries and falls, and increased rates of hospital admission and emergency department visits. Fortunately, there are safer treatment alternatives for anxiety and insomnia, including selective serotonin-reuptake inhibitors and behavioral interventions. Just as with opioids, some patients benefit from long-term use of benzodiazepines. But even in low-risk patients, it is best to avoid daily dosing to mitigate the development of tolerance, dependence, and withdrawal.

Department of Health | The amphetamine withdrawal syndrome

Animal and human studies have confirmed that the methamphetamine withdrawal syndrome may be protracted (the mood disturbance may last up to a year in some cases) and tends to be more severe than cocaine withdrawal (see Cho & Melega, 2002 for a thorough review; Davidson et al., 2001; Volkow, Chang, Wang, Fowler, Franceschi et al., 2001). Similarly, there is some evidence to suggest that individuals who have experienced a methamphetamine-related psychosis are at risk of further psychotic episodes, even in the absence of further psychostimulant use (Yui, Ikemoto, Ishiguro & Goto, 2000).

Engineering euphoria

Isomers of the same molecule, although very similar, often have different effects. For instance, the right-handed isomer of methamphetamine, dextromethamphetamine, is the most potent human stimulant known: This is the “meth” that tweakers crave. But the left-handed isomer of methamphetamine, levomethamphetamine, is a vasoconstrictor with little to no psychoactive effect and is used in nasal decongestants and inhalers. In contrast, both isomers of amphetamine are psychostimulants, so Shire combines both the l- and d- isomers in Adderall, each packaged in two different types of salt carriers. By creating a custom racemic mix of l- and d- isomers, and by using a custom blend of salt carriers for each molecule, Adderall meets the definition of an amphetamine formulation that can be patented for prescription use. In a word: genius. Formulating the perfect blend of speed for children sounds like a task more suited to a crime syndicate than a pharmaceutical company, but Shire put some serious thought into packaging amphetamine into pills for kids with short attention spans. The l- isomer of amphetamine, levoamphetamine, packs a euphoric rush of norepinephrine for a quick and speedy high, with a small release of dopamine for a short period of increased alertness and focus. Levoamphetamine (a.k.a. benzedrine) is a favorite of tweakers who want the most bang for their buck. The d- isomer of amphetamine, dextroamphetamine, produces less of an initial rush but increases the supply of dopamine and norepinephrine in the brain’s synaptic clefts for many hours. Dextroamphetamine (a.k.a. dexedrine) is considered by many to be the first “smart drug,” used experimentally to increase focus, memory, and intelligence.

ADHD drugs increase brain glutamate, predict positive emotion in healthy people -- ScienceDaily

In this new study, subjects were first screened for mental and physical health and then underwent MRI spectroscopy scans designed to detect the concentration of neural compounds in specific regions of their brain. From the medical literature on psychostimulants, White and her team wanted to look in the anterior cingulate cortex, which is a "hub" brain region that connects multiple brain networks involved in emotion, decision-making and behavior. They found that two ADHD medications, d-amphetamine and Desoxyn, significantly increased the overall amount of glutamate in the right dorsal anterior cingulate cortex, even after controlling for possible confounding factors, such as volume of gray matter in the region. The rise in brain glutamate predicted both the duration and the intensity of positive emotion, measured by participant ratings about whether they liked the drug or felt high after consuming it.

The Last All-Nighter - NYTimes.com

I wish it had ended that easily. In the months that followed, I was exhausted all the time. I slept through appointments and was unable to stay up to meet deadlines. The drug had curbed my appetite, and helped me to drop from a size 8 to a 4. Without it now I was ravenous and neurotic about what I was eating and how I looked. I was sensitive and emotional from the new chemical imbalance, which gaining weight and falling behind at work exacerbated. It was hard to understand that I was experiencing withdrawal, because I was never warned of possible side effects. Without the drug I felt stupid, unable to focus or follow a thought through to completion. I was shy, and unwilling to initiate conversation. The witty, articulate woman I once was seemed to no longer exist. I felt dumb, out of it. I spoke slowly because it took immense effort to gather and express coherent thoughts. I didn’t understand what I was going through, and that made it more difficult to stay healthy. It felt like another phase of the depression I had become so used to. But once I made it through the hardest part, weeks where my body was literally recalibrating itself to function without the stimulant, I felt like my old self again — relaxed, yet motivated to take care of my mind and body; interested in engaging with the world around me. The person I was so eager to shed in lieu of a new, accomplished, adult me, actually ended up being the one most capable of handling the tumult of living in the hectic life of a 20-something starting out in New York.

The real reason why women drink — Quartz

That’s the summer I realize that everyone around me is tanked. But it also dawns on me that the women are super double tanked — that to be a modern, urbane woman means to be a serious drinker. This isn’t a new idea — just ask the Sex and the City girls (or the flappers). A woman with a single malt scotch is bold and discerning and might fire you from her life if you fuck with her. A woman with a PBR is a Cool Girl who will not be shamed for belching. A woman drinking MommyJuice wine is saying she’s more than the unpaid labor she gave birth to. The things women drink are signifiers for free time and self-care and conversation — you know, luxuries we can’t afford. How did you not see this before? I ask myself. You were too hammered, I answer back. That summer I see, though. I see that booze is the oil in our motors, the thing that keeps us purring when we should be making other kinds of noise.

Feel anxious? Have trouble sleeping? You may be traveling for business too often -- ScienceDaily

People who travel for business two weeks or more a month report more symptoms of anxiety and depression and are more likely to smoke, be sedentary and report trouble sleeping than those who travel one to six nights a month, according to a latest study conducted by researchers at Columbia University's Mailman School of Public Health and City University of New York. Among those who consume alcohol, extensive business travel is associated with symptoms of alcohol dependence. Poor behavioral and mental health outcomes significantly increased as the number of nights away from home for business travel rose. This is one of the first studies to report the effects of business travel on non-infectious disease health risks. The results are published online in the Journal of Occupational and Environmental Medicine.

Withdrawing -- and what helped

Maybe dealing with life’s distresses has its own chemistry. I know I hated every second of it. I don’t know if the medication helped. But I do know that I’m very glad I’m off.

How exercise is key to successfully quitting smoking -- ScienceDaily

Researchers also showed there was an increased activation of a type of receptor in the brain called α7 nicotinic acetylcholine, which is a target of nicotine. The findings support the protective effect of exercise preceding smoking cessation against the development of physical dependence, which may aid smoking cessation by reducing the severity of withdrawal symptoms. Dr Alexis Bailey, Senior Lecturer in Neuropharmacology, at St George's, University of London, said: "The evidence suggests that exercise decreases nicotine withdrawal symptoms in humans; however, the mechanisms mediating this effect are unclear. "Our research has shed light on how the protective effect of exercise against nicotine dependence actually works." In the study, nicotine-treated mice that were undertaking two or 24 hours a day of wheel running exercise displayed a significant reduction of withdrawal symptom severity compared with the sedentary group.

Wasted lives: The cost of alcohol addiction - British Columbia - CBC News

Last year, at least 36 per cent of emergency room visits to St. Paul's and Vancouver General Hospital for substance abuse were alcohol-related.  That number is conservative and just relates to cases where excessive drinking was the cause, Ahamad said. It doesn't include broken bones, injuries related to impaired driving, violence caused by someone who had been drinking or other long-term consequences of alcohol abuse.   By comparison, 24 per cent of emergency room visits relating to substance abuse were because of opioids. In Canada, as a whole, there were more hospital admissions for alcohol-related conditions than for heart attacks last year and the cost to the medical system is high, with the average stay entirely caused by alcohol estimated at more than $8,000.

Spatial and Sex-Dependent Responses of Adult Endogenous Neural Stem Cells to Alcohol Consumption: Stem Cell Reports

hronic alcohol abuse results in alcohol-related neurodegeneration, and critical gaps in our knowledge hinder therapeutic development. Neural stem cells (NSCs) are a subpopulation of cells within the adult brain that contribute to brain maintenance and recovery. While it is known that alcohol alters NSCs, little is known about how NSC response to alcohol is related to sex, brain region, and stage of differentiation. Understanding these relationships will aid in therapeutic development. Here, we used an inducible transgenic mouse model to track the stages of differentiation of adult endogenous NSCs and observed distinct NSC behaviors in three brain regions (subventricular zone, subgranular zone, and tanycyte layer) after long-term alcohol consumption. Particularly, chronic alcohol consumption profoundly affected the survival of NSCs in the subventricular zone and altered NSC differentiation in all three regions. Significant differences between male and female mice were further discovered.

Low Dopamine Levels During Withdrawal Promote Relapse to Smoking

“This study is an elegant example of yet another way that addiction ‘hijacks’ the reward system. The phasic release of dopamine triggers us to seek things that, in theory, help us to adapt to our environment,” commented Dr. John Krystal, editor of Biological Psychiatry. “However, in addiction the phasic release of dopamine is heightened and it triggers the pursuit of abused substances. This disturbance of dopamine function would, conceivably, make it that much harder to avoid seeking drugs of abuse.”

Personal experience with Xanax

I started out taking Xanax 0.25 mg nightly only as a sleep aid, as my eyes felt like sandpaper and were interfering with my sleep.  After only a few weeks, I began to experience severe anxiety during the day, which required more Xanax (up to 1 mg per day).  I began to think that I was going crazy. I also developed a tremor and underwent an extensive neurologic evaluation, including a lumbar puncture that resulted in a severe spinal headache and an ER visit for a blood patch to stop the leaking cerebrospinal fluid. Xanax was never suggested as a cause for my tremor, although my dose relieved the symptoms of the tremor. It got to the point where I needed to dose every 6 hours as the Xanax would only last a few hours, then I would experience severe symptoms like difficulty breathing, chest tightness, and inability to swallow.  I lost about 15 pounds (I am only 5’3” and got down to 115 pounds).  I looked like a skeleton.  I was terrified to be alone. I would wake up at night after 3 hours of sleep with my heart pounding and in a sheer panic. After doing my own research, I discovered that I was experiencing inter-dose withdrawals and had become dependent on Xanax.

Kids in high-achieving schools: 2-3x addiction rates?

"We found rates of addiction to drugs or alcohol among 19 to 24 percent of women in the older cohort by the age of 26, and 23 to 40 percent among men. These rates were 3 and 2 times as high respectively, as compared to national norms," Luthar said. "Among the younger cohort by the age of 22 years, rates of addiction were between 11 and 16 percent among women (close to national norms) but 19 to 27 percent among men, or about twice as high as national norms." Luthar said a look into the lives of these adolescents provide some clues to the cause of these high rates of addictions. When the NESSY groups were first assessed, they all attended the best schools in the region -- suburban schools with very high-standardized test scores, rich extra curricular offerings and high proportions of their graduates heading off to very selective universities. In general, kids at such schools experience enormous pressures to achieve, and many come to live by the dual credos of "I can, therefore I must" and "we work hard and we play hard" with the playing involving parties with drugs and alcohol. Also implicated is affluence in the school community. "Not all of these students were from wealthy families but most were; as parents typically had advanced educational degrees and median incomes much higher than national norms," Luthar said. "And without question, most of the parents wanted their kids to head off to the best universities, as did the kids themselves."

Psychiatric drugs killing more users than heroin, cocaine: experts | Vancouver Sun

“The interesting thing about this is that it’s a prescription drug and people think they’re safe,” Ahamad said. “But as it turns out, we’re probably prescribing these drugs in a way that’s leading to harm.” Kerr noted that the rise in BZD-related deaths — “It’s been an epidemic brewing for many, many years” — very closely mirrors a rise in opioid-related deaths that has been widely documented. He cited a fourfold increase in BZD-related deaths in the United States between 1999 and 2014, and also noted that there are 50 per cent more deaths each year in the U.S. due to psychiatric medicine than heroin. “These studies really reveal how very dangerous these drugs are, and they should be used with great caution,” Kerr said. “We can’t just focus on opioids, we need to look at other medications that are used in combination.”

Even small quantities of opioids prescribed for minor injuries increase risk of long-term use -- ScienceDaily

patients who received their first opioid prescription for an ankle sprain treated in U.S. emergency departments (EDs) commonly received prescriptions for anywhere from 15 to 40 pills, according to new research from the Perelman School of Medicine at the University of Pennsylvania. Those who received 30 or more pills compared to less than 15 pills were twice as likely to fill an additional opioid prescription within three to six months.

Highest odds for stimulants: male, US, upper year medical student

Psychostimulant use was significantly correlated with use of other drugs (Table 1). Lifetime use of psychostimulants was significantly associated with male gender (21 % male (519/1,087) versus 15 % female (568/1,087), Chi squared p = 0.007, 28 no response). Students who mainly grew up outside the U.S. were significantly less likely to report any lifetime psychostimulant use than their U.S.-reared counterparts (outside of U.S. psychostimulant use prevalence = 4 % vs. 20 % U.S. reared; Chi squared p = 0.013). Overall prevalence of psychostimulant use while in medical school was significantly associated with current year in medical school, with first year students being least likely to report use compared to their second, third, fourth and fifth-year colleagues (41 % first year (n = 42/196), 66 % second year (n = 59/196), 60 % third year (n = 52/196), 71 % fourth year (n = 41/196), 50 % fifth year or beyond (n = 2/196); Chi squared p = 0.048, two no response). Students who self-reported attending a school that determined class rank were significantly more likely to respond that they had used psychostimulants while in medical school (class rank assessed 68 % versus no class rank 51 %, Chi squared p = 0.018). Items not significantly correlated with psychostimulant use included age, marital status, estimated class rank (split by quartiles), tobacco use, caffeine intake, or weight loss supplementation.

Drug Abuse Among Doctors: Easy, Tempting, and Not Uncommon

Another reason that physicians don't report their colleagues, researcher Lisa Merlo says, is because medical schools fail to educate them about the disease of addiction. Most medical schools include only a lecture or two on addiction, she says. By contrast, the University of Florida requires all third-year students to complete a 2-week rotation in addiction medicine. "Every physician in the United States has to deliver a baby to graduate, but how many of them are ever going to deliver babies in practice?" she asks. "But every doctor is going to see addicted patients."

Drug Abuse Among Doctors: Easy, Tempting, and Not Uncommon

Access rapidly becomes an addict's top priority, he notes, and self-medicating physicians will do everything in their power to ensure it continues. "They're often described as the best workers in the hospital," he says. "They'll overwork to compensate for other ways in which they may be falling short, and to protect their supply. They'll sign up for extra call and show up for rounds they don't have to do." Physicians are intelligent and skilled at hiding their addictions, he says. Few, no matter how desperate, seek help of their own accord.

Tanning dependence linked to other addictive behaviors, new study finds -- ScienceDaily

The connections between tanning dependence and other disorders revealed by the study represent an opportunity for clinicians to address those related conditions. "People who are tanning dependent could also be assessed for SAD," said Cartmel. "There are ways of addressing SAD other than indoor tanning. Regarding the alcohol dependence association, it may be possible that addressing that behavior could help address tanning dependence." The underlying mechanisms for the addiction to UV light are not yet fully understood. According to other studies, "The biological rationale for tanning dependence is that exposure to UV light results in both melanin, and endorphin production," said Cartmel. She also added that there was another interesting preliminary finding: those with tanning dependence were five times more likely to exhibit "exercise addiction." She said it is too early, however, to determine the implication. "Exercise addiction" itself has really not been well researched," she said. "One hypothesis behind the finding is that people who exercise excessively do so because they are very aware of their appearance, and they also feel that being tanned improves their appearance. Or it may be that we will eventually find out that these individuals have more of an addictive or risk-taking personality type. If you have one type of dependence, you may be more likely to have another addiction," Cartmel said.

Do children inherit drug protection from parents exposed to nicotine or drugs? Study suggests link between children and fathers -- ScienceDaily

What researchers found is that the offspring of nicotine-exposed fathers, compared to the offspring of fathers that were never exposed to nicotine, were protected from toxic levels of nicotine. Researchers then tested whether this resistance was specific for nicotine by treating both sets of offspring with cocaine, which acts via a wholly distinct molecular pathway than nicotine. Surprisingly, the children of nicotine-exposed fathers were also protected from cocaine. This multi-toxin resistance is likely a result of enhanced drug metabolism in the liver, and corresponds to an increase in expression levels of genes involved in drug metabolism. These genes were also packaged in a more open and accessible configuration in the liver cells, allowing for increased expression.

Do children inherit drug protection from parents exposed to nicotine or drugs? Study suggests link between children and fathers -- ScienceDaily

"Children born of fathers who have been exposed to nicotine are programmed to be not only more resistant to nicotine toxicity, but to other chemicals as well," said Dr. Rando, professor of biochemistry & molecular pharmacology. "If a similar phenomenon occurs in humans, this raises many important questions. For example, if your father smoked does that mean chemotherapy might be less effective for you? Are you more or less likely to smoke? It's important to understand what information is specifically being passed down from father to offspring and how that impacts us."

Nicotine withdrawal leads to reckless behavior?

The first period of nicotine abstinence proceeded as expected. The surprise came after three months when the lab rats suddenly became fearless and sought out well-lighted areas that prey animals normally avoid. At the same time, signaling in the brain's reward system changed, as shown by a study at Sahlgrenska Academy. "This indicates very long-lasting changes caused by nicotine that were previously unknown. The nicotine appears to create a cascade of effects that only get worse and worse over time," says Julia Morud Lekholm, researcher in addiction biology at the Institute of Neuroscience and Physiology. The experiment was done another two times. The researchers wanted to make sure that the unexpected results were not an isolated case. In total, 108 animals were tested, of which half received nicotine and half a salt solution over a three-week period. The outcome was the same every time. "The nicotine treated animals spend much more time in these more frightening areas compared with those that only received salt solution injections. We don't see this right after the nicotine treatment, only after three or more months into abstinence. So then the animals have not received any nicotine for three months, and suddenly they demonstrate an increased spontaneous impulsiveness, which is very strange," says Julia Morud Lekholm. Strong impact "What's interesting is that at the same time we can also begin to see changes in the GABAergic system in the brain, which is the system that normally slows the brain's signaling," she continues. After another four months, the GABA system in the studied region of the rats' brains was so strongly affected that it had been completely reversed. Instead of dampening the nerve cell signaling, it increased it. In other words, a highly activated system, and an extensive risk of relapsing into smoking, for example, if people had been involved. "Of course, rats and people are very different, but in terms of the type of brain circuit that we study, the brain's reward system, we are very much alike. Also in terms of risk-taking behavior, it's possible to translate to humans to some extent. Having poor impulse control isn't good for life in general, of course. One can end up in many bad situations and this may also have effects on the consumption of other drugs later in life," says Julia Morud Lekholm.

Potential way to reduce drug cravings: Vagus nerve stimulation therapy -- ScienceDaily

"They still check a couple of times each session, thinking that maybe something will happen. They go from 60 lever presses down to something like 10 per session. They clearly haven't forgotten what the lever used to do and still have cravings for the drug," Kroener said. Eventually, the light and tone (but not the drug) were reinstated, causing intense cravings in the animals and a relapse to drug-seeking, which results in more lever presses. However, the animals that experienced VNS treatment during the extinction phase of the experiment pressed the lever less frequently, by nearly 40 or 50 percent which, Kroener said, means their craving was very much reduced. "That's what you want in addiction treatment," he said. "You want to have less craving and less responsiveness to the old cues and the old environment that previously signified drug taking.