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By ANN SANNER Associated Press COLUMBUS, Ohio (AP) — A few weeks before their prom king’s death, students at an Ohio high school had attended an assembly on narcotics that warned about the dangers of heroin and prescription painkillers. But it was one of the world’s most widely accepted drugs that killed Logan Stiner — a powdered form of caffeine so potent that as little as a single teaspoon can be fatal. The teen’s sudden death in May has focused attention on the unregulated powder and drawn a warning from federal health authorities urging consumers to avoid it. ‘‘I don’t think any of us really knew that this stuff was out there,’’ said Jay Arbaugh, superintendent of the Keystone Local Schools. The federal Food and Drug Administration said Friday that it’s investigating caffeine powder and will consider taking regulatory action. The agency cautioned parents that young people could be drawn to it. An autopsy found that Stiner had a lethal amount of caffeine in his system when he died May 27 at his home in LaGrange, Ohio, southwest of Cleveland. Stiner, a wrestler, had more than 70 micrograms of caffeine per milliliter of blood in his system, as much as 23 times the amount found in a typical coffee or soda drinker, according to the county coroner. His mother has said she was unaware her son took caffeine powder. He was just days away from graduation and had planned to study at the University of Toledo. Caffeine powder is sold as a dietary supplement, so it’s not subject to the same federal regulations as certain caffeinated foods. Users add it to drinks for a pick-me-up before workouts or to control weight gain. A mere 1/16th of a teaspoon can contain about 200 milligrams of caffeine, roughly the equivalent of two large cups of coffee. That means a heaping teaspoon could kill, said Dr. Robert Glatter, an emergency physician at Lenox Hill ?Hospital in New York.

Related chapters from BP7e: Chapter 4: The Chemistry of Behavior: Neurotransmitters and Neuropharmacology
Related chapters from MM:Chapter 4: The Chemistry of Behavior: Neurotransmitters and Neuropharmacology
Link ID: 19857 - Posted: 07.21.2014

By Lizzie Wade This week, a team from the National Institute on Drug Abuse (NIDA) reported that heavy marijuana use may damage the brain's pleasure center. Meanwhile, researchers in the United Kingdom say they’ve figured out why pot makes you paranoid. But does focusing research on cannabis’s “bad side” give the drug short shrift? Science talked to Ian Mitchell, an emergency physician at the University of British Columbia’s Southern Medical Program in Kamloops, Canada, and author of the blog Clinical Cannabis in Context, who says that politics influences research in this controversial field. As a doctor who recommends medical cannabis to patients, he follows research on the drug and often critiques studies he believes are based on outdated information or were performed with an anticannabis bias. This interview has been edited for clarity and brevity. Q: What do you think of the NIDA study? A: They said they gave marijuana abusers Ritalin and nothing happened. One of the ways you could interpret that is, OK, these pleasure centers are damaged. But you could also say, perhaps marijuana decreases the effects of [Ritalin] on people. That would be equally as right an interpretation. Q: Why do we hear more about studies that show negative effects of marijuana? A: NIDA is at the center of cannabis research in America. And their mandate, very plainly, is to study drug abuse. So they overwhelmingly fund studies that look at abuse. In America, if you wanted to run a study that showed a benefit of cannabis, you weren’t allowed to do that because NIDA couldn’t give you samples to use. So there were no trials [on potential medical benefits] being done. For example, there hasn’t been a good trial yet to study marijuana’s potential for treating posttraumatic stress disorder. They couldn’t get it done, due to all these political roadblocks. © 2014 American Association for the Advancement of Science

Related chapters from BP7e: Chapter 4: The Chemistry of Behavior: Neurotransmitters and Neuropharmacology; Chapter 16: Psychopathology: Biological Basis of Behavior Disorders
Related chapters from MM:Chapter 4: The Chemistry of Behavior: Neurotransmitters and Neuropharmacology; Chapter 12: Psychopathology: Biological Basis of Behavioral Disorders
Link ID: 19843 - Posted: 07.17.2014

By Lizzie Wade It probably won’t come as a surprise that smoking a joint now and then will leave you feeling … pretty good, man. But smoking a lot of marijuana over a long time might do just the opposite. Scientists have found that the brains of pot abusers react less strongly to the chemical dopamine, which is responsible for creating feelings of pleasure and reward. Their blunted dopamine responses could leave heavy marijuana users living in a fog—and not the good kind. After high-profile legalizations in Colorado, Washington, and Uruguay, marijuana is becoming more and more available in many parts of the world. Still, scientific research on the drug has lagged. Pot contains lots of different chemicals, and scientists don’t fully understand how those components interact to produce the unique effects of different strains. Its illicit status in most of the world has also thrown up barriers to research. In the United States, for example, any study involving marijuana requires approval from four different federal agencies, including the Drug Enforcement Administration. One of the unanswered questions about the drug is what, exactly, it does to our brains, both during the high and afterward. Of particular interest to scientists is marijuana’s effect on dopamine, a main ingredient in the brain’s reward system. Pleasurable activities such as eating, sex, and some drugs all trigger bursts of dopamine, essentially telling the brain, “Hey, that was great—let’s do it again soon.” Scientists know that drug abuse can wreak havoc on the dopamine system. Cocaine and alcohol abusers, for example, are known to produce far less dopamine in their brains than people who aren’t addicted to those drugs. But past studies had hinted that the same might not be true for those who abuse marijuana. © 2014 American Association for the Advancement of Science

Related chapters from BP7e: Chapter 4: The Chemistry of Behavior: Neurotransmitters and Neuropharmacology
Related chapters from MM:Chapter 4: The Chemistry of Behavior: Neurotransmitters and Neuropharmacology
Link ID: 19832 - Posted: 07.15.2014

By JOSHUA A. KRISCH Excessive alcohol consumption, including binge drinking, is responsible for 10 percent of deaths among working-age adults in the United States, according to a recent study from the Centers for Disease Control and Prevention. The researchers used an online tool called the Alcohol-Related Disease Impact application to estimate alcohol-related deaths ranging from car crashes and alcohol poisoning to liver and heart disease. They defined binge drinking as at least five consecutive drinks for men and four consecutive drinks for women. One in six adults from 20 to 65 reported binge drinking at least four times a month; the actual number is likely higher because subjects tend to underreport their drinking habits, the researchers said. The number of Americans who binge drink skyrocketed during the 1990s and leveled off in 2001, but the average frequency of binge drinking episodes is still rising. Excessive drinking is the fourth leading cause of preventable death in the United States, after smoking, poor nutrition and physical inactivity. “It’s a huge public health problem any way you slice it,” said Robert D. Brewer, a co-author of the paper and the director of the alcohol program at the C.D.C.“There are things that we can do about it,” like raising the alcohol tax and encouraging doctors to talk to their patients about alcohol abuse, “but a lot of those strategies tend to be underused.” © 2014 The New York Times Company

Related chapters from BP7e: Chapter 4: The Chemistry of Behavior: Neurotransmitters and Neuropharmacology
Related chapters from MM:Chapter 4: The Chemistry of Behavior: Neurotransmitters and Neuropharmacology
Link ID: 19799 - Posted: 07.08.2014

By GABRIELLE GLASER When their son had to take a medical leave from college, Jack and Wendy knew they — and he — needed help with his binge drinking. Their son’s psychiatrist, along with a few friends, suggested Alcoholics Anonymous. He had a disease, and in order to stay alive, he’d have to attend A.A. meetings and abstain from alcohol for the rest of his life, they said. But the couple, a Manhattan reporter and editor who asked to be identified only by their first names to protect their son’s privacy, resisted that approach. Instead, they turned to a group of psychologists who specialize in treating substance use and other compulsive behaviors at the Center for Motivation and Change. The center, known as the C.M.C., operates out of two floors of a 19th-century building on 30th Street and Fifth Avenue. It is part of a growing wing of addiction treatment that rejects the A.A. model of strict abstinence as the sole form of recovery for alcohol and drug users. Instead, it uses a suite of techniques that provide a hands-on, practical approach to solving emotional and behavioral problems, rather than having abusers forever swear off the substance — a particularly difficult step for young people to take. And unlike programs like Al-Anon, A.A.’s offshoot for family members, the C.M.C.’s approach does not advocate interventions or disengaging from someone who is drinking or using drugs. “The traditional language often sets parents up to feel they have to make extreme choices: Either force them into rehab or detach until they hit rock bottom,” said Carrie Wilkens, a psychologist who helped found the C.M.C. 10 years ago. “Science tells us those formulas don’t work very well.” When parents issue edicts, demanding an immediate end to all substance use, it often lodges the family in a harmful cycle, said Nicole Kosanke, a psychologist at the C.M.C. Tough love might look like an appropriate response, she said, but it often backfires by further damaging the frayed connections to the people to whom the child is closest. © 2014 The New York Times Company

Related chapters from BP7e: Chapter 4: The Chemistry of Behavior: Neurotransmitters and Neuropharmacology
Related chapters from MM:Chapter 4: The Chemistry of Behavior: Neurotransmitters and Neuropharmacology
Link ID: 19794 - Posted: 07.04.2014

Heidi Ledford If shown to be possible in humans, addiction to the Sun could help explain why some tanners continue to seek out sunlight despite being well aware of the risks. The lure of a sunny day at the beach may be more than merely the promise of fun and relaxation. A study published today reports that mice exposed to ultraviolet (UV) rays exhibit behaviours akin to addiction. The researchers found that mice exposed repeatedly to UV light produced an opioid called β-endorphin, which numbs pain and is associated with addiction to drugs. When they were given a drug that blocks the effect of opioids, the mice also showed signs of withdrawal — including shaky paws and chattering teeth. If the results hold true in humans, they would suggest an explanation for why many tanners continue to seek out sunlight, despite the risks — and, in some cases, even after being diagnosed with skin cancer. “This offers a clear potential mechanism for how UV radiation can be rewarding and, in turn, potentially addictive,” says Bryon Adinoff, an addiction psychiatrist at the University of Texas Southwestern Medical Center in Dallas, who was not involved with the study. “That’s a big deal.” Oncologist David Fisher of the Massachusetts General Hospital in Boston and his colleagues became interested in sunlight addiction after studying the molecular mechanisms of pigment production in the skin after UV light exposure. In the new study published today in Cell1, they show that in mice, some skin cells also synthesize β-endorphin in response to chronic, low doses of UV light. © 2014 Nature Publishing Group

Related chapters from BP7e: Chapter 4: The Chemistry of Behavior: Neurotransmitters and Neuropharmacology
Related chapters from MM:Chapter 4: The Chemistry of Behavior: Neurotransmitters and Neuropharmacology
Link ID: 19752 - Posted: 06.21.2014

By Robert Dudley When we think about the origins of agriculture and crop domestication, alcohol isn’t necessarily the first thing that comes to mind. But our forebears may well have been intentionally fermenting fruits and grains in parallel with the first Neolithic experiments in plant cultivation. Ethyl alcohol, the product of fermentation, is an attractive and psychoactively powerful inebriant, but fermentation is also a useful means of preserving food and of enhancing its digestibility. The presence of alcohol prolongs the edibility window of fruits and gruels, and can thus serve as a means of short-term storage for various starchy products. And if the right kinds of bacteria are also present, fermentation will stabilize certain foodstuffs (think cheese, yogurt, sauerkraut, and kimchi, for example). Whoever first came up with the idea of controlling the natural yeast-based process of fermentation was clearly on to a good thing. Using spectroscopic analysis of chemical residues found in ceramic vessels unearthed by archaeologists, scientists know that the earliest evidence for intentional fermentation dates to about 7000 BCE. But if we look deeper into our evolutionary past, alcohol was a component of our ancestral primate diet for millions of years. In my new book, The Drunken Monkey, I suggest that alcohol vapors and the flavors produced by fermentation stimulate modern humans because of our ancient tendencies to seek out and consume ripe, sugar-rich, and alcohol-containing fruits. Alcohol is present because of particular strains of yeasts that ferment sugars, and this process is most common in the tropics where fruit-eating primates originated and today remain most diverse. © 1986-2014 The Scientist

Related chapters from BP7e: Chapter 4: The Chemistry of Behavior: Neurotransmitters and Neuropharmacology; Chapter 6: Evolution of the Brain and Behavior
Related chapters from MM:Chapter 4: The Chemistry of Behavior: Neurotransmitters and Neuropharmacology
Link ID: 19751 - Posted: 06.21.2014

By Brian Palmer Maureen Dowd, a 62-year-old Pulitzer Prize–winning columnist for the New York Times, had a bad marijuana trip earlier this year. As part of her research into the legalization of recreational cannabis in Colorado, she ate a few too many bites of a pot-infused candy bar, entered a “hallucinatory state,” and spent eight paranoid hours curled up on her hotel room bed. Dowd used the experience as a jumping-off point to discuss the risks of overdosing on edible marijuana, which has become a major issue in pot-friendly states. It’s also possible, however, that Dowd just doesn’t handle cannabis very well. While pot mellows most people out, everyone has heard of someone who barricaded himself or herself in a dorm room after a few bongs hits in college. (Or maybe that someone is you.) Why do people react so differently to the same drug? The question itself may be something of a fallacy. Cannabis is not a single drug—it contains dozens of compounds, and they appear to have varying, and sometimes opposing, effects on the brain. Tetrahydrocannabinol, or THC, and cannabidiol, or CBD, have been the subject of some intriguing research. In 2010, researchers showed that pretreating people with a dose of CBD can protect against the less pleasant effects of THC, such as paranoia. In a similar 2012 study, participants took pills that contained only one of the two chemicals, rather than the combination that you receive in cannabis. The subjects who took THC pills were more likely to suffer paranoia and delusion than those who took CBD. The researchers went one step further to investigate which specific cognitive effects of THC are likely to lead to paranoia and other symptoms of psychosis. After taking either THC or CBD, participants watched a series of arrows appear on a screen and responded by indicating which direction the arrows were pointing. Most of the arrows pointed directly left or right, but occasionally a tilted arrow appeared. (Researchers called the tilted arrows “oddballs.”) Subjects who took the CBD had a heightened brain activity response to the oddballs. That’s the way a nondrugged person typically reacts—repetitions of the same stimulus don’t interest us, but a sudden change grabs our attention. The THC-takers had an abnormal response: They found the left and right arrows, which constituted the overwhelming majority of the images, more noteworthy than the oddballs. © 2014 The Slate Group LLC

Related chapters from BP7e: Chapter 4: The Chemistry of Behavior: Neurotransmitters and Neuropharmacology; Chapter 18: Attention and Higher Cognition
Related chapters from MM:Chapter 4: The Chemistry of Behavior: Neurotransmitters and Neuropharmacology; Chapter 14: Attention and Consciousness
Link ID: 19734 - Posted: 06.16.2014

By J. DAVID GOODMAN and ANEMONA HARTOCOLLIS Amid the weeknight bustle of a Walmart parking lot in Centereach, N.Y., a young woman in a pickup truck had lost consciousness and was turning blue. Her companion called 911. Possible drug overdose; come fast. A Suffolk County police officer, Matthew Siesto, who had been patrolling the lot, was the first to arrive. Needles were visible in the center console; the woman was breathing irregularly, and her pupils had narrowed to pinpoints. It seemed clear, Officer Siesto recalled of the October 2012 episode, that the woman had overdosed on heroin. He went back to his squad car and retrieved a small kit of naloxone, an anti-overdose medication he had only recently been trained to use in such circumstances. He prepared the dose, placed the atomizer in her nostril and sprayed. “Within a minute,” the officer said, “she came back.” Once the exclusive purview of paramedics and emergency room doctors, administering lifesaving medication to drug users in the throes of an overdose is quickly becoming an everyday part of police work amid a national epidemic of heroin and opioid pill abuse. On Wednesday, Gov. Andrew M. Cuomo committed state money to get naloxone into the hands of emergency medical workers across New York, saying the heroin epidemic in the state was worse than that seen in the 1970s, and the problem is growing. Last month, the New York police commissioner, William J. Bratton, announced that the city’s entire patrol force would soon be trained and equipped with naloxone. “Officers like it because it puts them in a lifesaving opportunity,” Mr. Bratton said, suggesting that beat officers would carry it on their belts. © 2014 The New York Times Company

Related chapters from BP7e: Chapter 4: The Chemistry of Behavior: Neurotransmitters and Neuropharmacology
Related chapters from MM:Chapter 4: The Chemistry of Behavior: Neurotransmitters and Neuropharmacology
Link ID: 19728 - Posted: 06.14.2014

​Nathan Greenslit A recent neuroscience study from Harvard Medical School claims to have discovered brain differences between people who smoke marijuana and people who do not. Such well-intentioned and seemingly objective science is actually a new chapter in a politicized and bigoted history of drug science in the United States. The study in question compared magnetic resonance imaging (MRI) scans of 20 “young adult recreational marijuana users” (defined as individuals 18 to 25 who smoke at least once a week but who are not “dependent”), to 20 “non-using controls” (age-matched individuals who have smoked marijuana less than five times in their lives). The researchers reported differences in density, volume, and shape between the nucleus accumbens and amygdala regions of the two groups’ brains—areas hypothesized to affect a wide range of emotions from happiness to fear, which could influence basic decision-making. Researchers did not make any claims about how marijuana affected actual emotions, cognition, or behavior in these groups; instead; the study merely tried to establish that the aggregated brain scans of the two groups look different. So, who cares? Different-looking brains tell us literally nothing about who these people are, what their lives are like, why they do or do not use marijuana, or what effects marijuana has had on them. Neither can we use such brain scans to predict who these people will become, or what their lives will be like in the future. Nonetheless the study invented two new categories of person: the “young casual marijuana user” and the young non-marijuana user. This is the latest example of turning to brain imaging to make something seem objective. Establishing brain differences among certain groups highlights the uniquely ignoble political history surrounding the criminalization of a plant. © 2014 by The Atlantic Monthly Group

Related chapters from BP7e: Chapter 4: The Chemistry of Behavior: Neurotransmitters and Neuropharmacology
Related chapters from MM:Chapter 4: The Chemistry of Behavior: Neurotransmitters and Neuropharmacology
Link ID: 19725 - Posted: 06.14.2014

A moderate dose of MDMA. commonly known as Ecstasy or Molly, that is typically nonfatal in cool, quiet environments can be lethal in rats exposed to conditions that mimic the hot, crowded, social settings where the drug is often used by people, a study finds. Scientists have identified the therapeutically-relevant cooling mechanism to enable effective interventions when faced with MDMA-induced hyperthermia. The study, publishing tomorrow in the Journal of Neuroscience, was conducted by researchers at the National Institute on Drug Abuse’s Intramural Research Program (NIDA IRP). NIDA is a part of the National Institutes of Health. While MDMA can have a range of adverse health effects, previous studies have shown that high doses of MDMA increase body temperature, while results with moderate doses were inconsistent. This has led some people to assume that the drug is harmless if taken in moderation. However, this study shows that in rats even moderate doses of MDMA in certain environments can be dangerous because it interferes with the body’s ability to regulate temperature. “We know that high doses of MDMA can sharply increase body temperature to potentially lead to organ failure or even death,” said NIDA Director Dr. Nora D. Volkow. “However, this current study opens the possibility that even moderate doses could be deadly in certain conditions.” It is impossible to predict who will have an adverse reaction even to a low dose of MDMA. However, in this study scientists gave the rats low to moderate doses that have been shown in past studies to not be fatal. They monitored the rats to determine drug-induced changes in brain and body temperature and in the body’s ability to cool itself through blood vessel dilation. When rats were alone and in a room-temperature environment, a moderate dose of MDMA modestly increased brain and body temperature and moderately diminished the rats’ ability to eliminate excessive heat. However, when researchers injected the same dose in rats that were either in a warmer environment or in the presence of another rat in the cage, brain temperature increased, causing death in some rats. These fatal temperature increases were because the drug interfered with the body’s ability to eliminate heat.

Related chapters from BP7e: Chapter 4: The Chemistry of Behavior: Neurotransmitters and Neuropharmacology; Chapter 13: Homeostasis: Active Regulation of the Internal Environment
Related chapters from MM:Chapter 4: The Chemistry of Behavior: Neurotransmitters and Neuropharmacology; Chapter 9: Homeostasis: Active Regulation of the Internal Environment
Link ID: 19695 - Posted: 06.05.2014

by Laura Sanders Some people think marijuana is nature’s gift to humankind: a nonaddictive drug, safe at any dose, that opens the mind, lifts the spirit and transports the user to a more profound reality. “The illegality of cannabis is outrageous, an impediment to full utilization of a drug which helps produce the serenity and insight, sensitivity and fellowship so desperately needed in this increasingly mad and dangerous world,” a user named Mr. X wrote in the 1971 book Marihuana Reconsidered. Close to 30 years later, Mr. X was revealed to be the legendary science communicator and astronomer Carl Sagan. His message still reverberates with many Americans, whose support for legalizing marijuana has tripled since 1989 — from 16 percent to 54 percent today. In Colorado and Washington state, voters legalized recreational marijuana use in November 2012. That formal embrace of marijuana may signal a growing shift in acceptance. Today, 21 states and the District of Columbia sanction medical use (up from 16 in 2010) and 17 have curbed punishments for possession of small amounts of recreational cannabis. Marijuana as medicine is gaining support in studies, both to tamp down nausea and pain and to directly counter insidious diseases such as epilepsy, cancer and multiple sclerosis (SN: 6/19/10, p. 16). But what about for healthy people? Is marijuana really a safe way to rise above the tumult and distress of daily life? Michele Leonhart, the head of the U.S. Drug Enforcement Administration, says no. In congressional testimony in 2012, she portrayed marijuana as a dangerous addictive drug on par with methamphetamines or heroin. Like other drugs cordoned off by her agency to a list called Schedule I, she said, marijuana has no medical use and a high potential for abuse. © Society for Science & the Public 2000 - 2013.

Related chapters from BP7e: Chapter 4: The Chemistry of Behavior: Neurotransmitters and Neuropharmacology
Related chapters from MM:Chapter 4: The Chemistry of Behavior: Neurotransmitters and Neuropharmacology
Link ID: 19676 - Posted: 05.31.2014

By IAN AUSTEN Hershey stopped producing chocolate in Smiths Falls, Ontario, six years ago. The work went to Mexico, but the factory remains, along with reminders of the glory days: A sign that once directed school buses delivering children for tours. A fading, theme-park-style entrance that marks what used to be the big attraction — a “Chocolate Shoppe” that sold about $4 million of broken candy and bulk bars a year. The once ever-present sweet smell of chocolate is gone, too. In the high-ceilinged warehouse, where stacks of Hershey’s bars and Reese’s Peanut Butter Cups once awaited shipment, the nose now picks up a different odor: the woody, herbal aroma of 50,000 marijuana plants. Clinical, climate-controlled rooms with artificial sunlight house rows upon rows of plants at various stages of growth. In the “mother room,” horticulturalists use cuttings to start new plants. The “flowering rooms” are flooded with intense light 12 hours a day to nurture nearly grown plants in strains with vaguely aristocratic names like Argyle, Houndstooth and Twilling. The new owner of this factory, at 1 Hershey Drive, is Tweed Marijuana. It is one of about 20 companies officially licensed to grow medical marijuana in Canada. A court ordered the government to make marijuana available for medicinal purposes in 2000, but the first system for doing so created havoc. The government sold directly to approved consumers, but individuals were also permitted to grow for their own purposes or to turn over their growing to small operations. The free-for-all approach prompted a flood of complaints from police and local governments. So the Canadian government decided to create an extensive, heavily regulated system for growing and selling marijuana. The new rules allow users with prescriptions to buy only from one of the approved, large-scale, profit-seeking producers like Tweed, a move intended to shut down the thousands of informal growing operations scattered across the country. © 2014 The New York Times Company

Related chapters from BP7e: Chapter 4: The Chemistry of Behavior: Neurotransmitters and Neuropharmacology
Related chapters from MM:Chapter 4: The Chemistry of Behavior: Neurotransmitters and Neuropharmacology
Link ID: 19657 - Posted: 05.25.2014

Puffing on a battery-powered, electronic cigarette to satisfy nicotine cravings could help longtime smokers quit their tobacco addiction. The evidence supporting that claim has been thin in the past, but researchers have now reported that adults in England who used the devices were 60% more likely to remain smoke-free than those who turned to nicotine patches or went cold turkey. Some public health researchers, though, still worry that’s not enough to cancel out the negative effects of e-cigarettes, which might keep other smokers hooked on nicotine or prevent them from seeking out more effective ways to quit. “This is an important study because, until now, the data on quitting smoking with e-cigarettes has been mostly anecdotal,” says Neal Benowitz, a physician at the University of California, San Francisco (UCSF), who studies tobacco addiction and was not involved in the work. E-cigarettes produce a nicotine-rich vapor that’s free of many of the toxins and carcinogens that make tobacco cigarettes so unhealthy. Their popularity has skyrocketed since they hit the market in the early 2000s; a 2012 survey found that 30% of adult smokers in the United States had tried e-cigarettes. But studies attempting to establish both the risks and benefits of the devices have had varied conclusions. One recent review of the scientific literature, which included Benowitz as an author, reported that smokers who used e-cigarettes were less likely to quit smoking than those who didn’t use the devices. The results were based on broad surveys of all smokers, however, not just those attempting to quit. Another paper concluded that e-cigarettes are about as effective as nicotine patches at helping people stop smoking. Since 2006, researchers in England have run an ongoing surveillance program, in conjunction with the government’s research bureau, called the Smoking Toolkit Study. Every month, they survey a new sample of 1800 random adults about their smoking behavior. © 2014 American Association for the Advancement of Science.

Related chapters from BP7e: Chapter 4: The Chemistry of Behavior: Neurotransmitters and Neuropharmacology
Related chapters from MM:Chapter 4: The Chemistry of Behavior: Neurotransmitters and Neuropharmacology
Link ID: 19640 - Posted: 05.20.2014

By Venkat Srinivasan In 1995, Ivan Goldberg, a New York psychiatrist, published one of the first diagnostic tests for Internet Addiction Disorder. The criteria appeared on psycom.net, a psychiatry bulletin board, and began with an air of earnest authenticity: “A maladaptive pattern of Internet use, leading to clinically significant impairment or distress as manifested by three (or more) of the following.” The test listed seven symptoms. You might have a problem if you were online “for longer periods of time than was intended,” or if you made “unsuccessful efforts to cut down or control Internet use.” Hundreds of people heard of the diagnostic test, logged on, clicked through and diagnosed themselves as being Internet addicts. Goldberg’s test, however, was a parody of the rigid language in the Diagnostic and Statistical Manual of Mental Disorders (DSM), the American Psychiatric Association (APA)’s psychiatric research manual. In a New Yorker story in January 1997, Goldberg said having an Internet addiction support group made “about as much sense as having a support group for coughers.” I’ve been researching the science and controversy over the last five years and wrote a long story about it last year for The Caravan. Since Goldberg’s prank, about one hundred scientific journals in psychology, sociology, neuroscience, anthropology, healthy policy and computer science have taken up the addiction question in some form. And after two decades of ridicule, research, advocacy and pushbacks, the debate is still about four basic questions. What do you call it? Does the ‘it’ exist? How do we size up such an addiction? Does it matter? © 2014 Scientific American

Related chapters from BP7e: Chapter 4: The Chemistry of Behavior: Neurotransmitters and Neuropharmacology
Related chapters from MM:Chapter 4: The Chemistry of Behavior: Neurotransmitters and Neuropharmacology
Link ID: 19621 - Posted: 05.15.2014

A single alcohol binge can cause bacteria to leak from the gut and increase levels of bacterial toxins in the blood, according to a study funded by the National Institutes of Health. Increased levels of these bacterial toxins, called endotoxins, were shown to affect the immune system, with the body producing more immune cells involved in fever, inflammation, and tissue destruction. Binge drinking is defined by NIAAA as a pattern of drinking alcohol that brings blood alcohol concentration (BAC) to 0.08g/dL or above. For a typical adult, this pattern corresponds to consuming five or more drinks for men, or four or more drinks for women, in about two hours. Some individuals will reach a 0.08g/dL BAC sooner depending on body weight. Binge drinking is known to pose health and safety risks, including car crashes and injuries. Over the long term, binge drinking can damage the liver and other organs. “While the negative health effects of chronic drinking are well-documented, this is a key study to show that a single alcohol binge can cause damaging effects such as bacterial leakage from the gut into the blood stream,” said Dr. George Koob, director of the National Institute on Alcohol Abuse and Alcoholism, part of NIH. The study was led by Gyongyi Szabo, M.D., Ph.D., Professor and Vice Chair of Medicine and Associate Dean for Clinical and Translational Sciences at the University of Massachusetts Medical School. The article appears online in PLOS ONE In the study, 11 men and 14 women were given enough alcohol to raise their blood alcohol levels to at least .08 g/dL within an hour. Blood samples were taken every 30 minutes for four hours after the binge and again 24 hours later.

Related chapters from BP7e: Chapter 4: The Chemistry of Behavior: Neurotransmitters and Neuropharmacology
Related chapters from MM:Chapter 4: The Chemistry of Behavior: Neurotransmitters and Neuropharmacology
Link ID: 19620 - Posted: 05.15.2014

By ANAHAD O’CONNOR Two medications could help tens of thousands of alcoholics quit drinking, yet the drugs are rarely prescribed to patients, researchers reported on Tuesday. The medications, naltrexone and acamprosate, reduce cravings for alcohol by fine-tuning the brain’s chemical reward system. They have been approved for treating alcoholism for over a decade. But questions about their efficacy and a lack of awareness among doctors have resulted in the drugs’ being underused, the researchers said. Less than a third of all people with alcohol problems receive treatment of any kind, and less than 10 percent are prescribed medications. The Affordable Care Act requires that insurers provide coverage for substance abuse treatments and services, and addiction specialists expect to see increases this year in the number of people seeking help for alcoholism. George Koob, the director of the National Institute on Alcohol Abuse and Alcoholism, said the new study should reassure doctors that naltrexone and acamprosate, while not silver bullets, can help many patients. “This is an important paper,” said Dr. Koob, who was not involved in the study. “There are effective medications for the treatment of alcoholism, and it would be great if the world would use them.” In the new study, which was published online on Tuesday in JAMA, the journal of the American Medical Association, a team of researchers based mostly at the University of North Carolina at Chapel Hill compiled findings from the most rigorous trials of medications for alcoholism in the past few decades. Ultimately, they analyzed data on roughly 23,000 people from 122 randomized trials. The researchers focused on a measure known as the “number needed to treat,” an indicator of how many people need to take a pill for one person to be helped. The study found that to prevent one person from returning to drinking, the number needed to treat for acamprosate was 12; for naltrexone, the number was 20. By comparison, large studies of widely used drugs, like the cholesterol-lowering statins, have found that 25 to more than 100 people need treatment to prevent one cardiovascular event. © 2014 The New York Times Company

Related chapters from BP7e: Chapter 4: The Chemistry of Behavior: Neurotransmitters and Neuropharmacology
Related chapters from MM:Chapter 4: The Chemistry of Behavior: Neurotransmitters and Neuropharmacology
Link ID: 19615 - Posted: 05.15.2014

By KATIE THOMAS Almost overnight, a powerful new painkiller has become a $100 million business and a hot Wall Street story. But nearly as quickly, questions are emerging about how the drug is being sold, and to whom. The drug, Subsys, is a form of fentanyl, a narcotic that is often used when painkillers like morphine fail to provide relief. The product was approved in 2012 for a relatively small number of people — cancer patients — but has since become an outsize moneymaker for the obscure company that makes it, Insys Therapeutics. In the last year, the company’s sales have soared and its share price has jumped nearly 270 percent. Behind that business success is an unusual marketing machine that may have pushed Subsys far beyond the use envisioned by the Food and Drug Administration. The F.D.A. approved Subsys only for cancer patients who are already using round-the-clock painkillers, and warned that it should be prescribed only by oncologists and pain specialists. But just 1 percent of prescriptions are written by oncologists, according to data provided by Symphony Health, which analyzes drug trends. About half of the prescriptions were written by pain specialists, and a wide range of doctors prescribed the rest, including general practice physicians, neurologists and even dentists and podiatrists. Interviews with several former Insys sales representatives suggest the company, based in Chandler, Ariz., has aggressively marketed the painkiller, including to physicians who did not treat many cancer patients and by paying its sales force higher commissions for selling higher doses of the drug. Under F.D.A. rules, manufacturers may market prescription drugs only for approved uses. But doctors may prescribe drugs as they see fit. Over the last decade, pharmaceutical companies have paid billions of dollars to settle claims that they encouraged doctors to use drugs for nonapproved treatments, or so-called off-label uses, to increase sales and profits. © 2014 The New York Times Compan

Related chapters from BP7e: Chapter 4: The Chemistry of Behavior: Neurotransmitters and Neuropharmacology; Chapter 8: General Principles of Sensory Processing, Touch, and Pain
Related chapters from MM:Chapter 4: The Chemistry of Behavior: Neurotransmitters and Neuropharmacology; Chapter 5: The Sensorimotor System
Link ID: 19612 - Posted: 05.15.2014

Victoria Colliver If all traditional cigarette smokers switched to electronic cigarettes, lives would be saved and overall public health would improve, scientists and doctors say. But UCSF researchers, in a paper published Monday, say a growing body of research shows that people who take up e-cigarettes aren't necessarily giving up conventional cigarettes, and on top of that, the devices are being heavily marketed to young people, creating a potential new market for the nicotine and tobacco industry. "Our bottom line is, at the moment, it doesn't seem like e-cigarettes are having a big impact on the population in terms of quitting," said UCSF's Dr. Neal Benowitz, a leading nicotine researcher and a co-author of the scientific review published in Circulation, a journal of the American Heart Association. E-cigarettes, battery-operated devices that vaporize a nicotine solution, have been sold in the U.S. only since the mid-2000s, but their popularity is exploding, particularly among teenagers. The percentage of U.S. middle and high school students who said they've tried e-cigarettes was 3.3 percent in 2011 but rose to 6.8 percent by the following year, according to a survey by the U.S. Centers for Disease Control and Prevention. Health effects unclear Some manufacturers claim the devices help people stop smoking and some users agree, but researchers in the study say that's unclear. The paper cites studies that show people tend to use e-cigarettes with combustible cigarettes, rather than as an alternative. © 2014 Hearst Communications, Inc.

Related chapters from BP7e: Chapter 4: The Chemistry of Behavior: Neurotransmitters and Neuropharmacology
Related chapters from MM:Chapter 4: The Chemistry of Behavior: Neurotransmitters and Neuropharmacology
Link ID: 19605 - Posted: 05.13.2014

By Brian Palmer The Journal of Neuroscience recently published a study linking recreational marijuana use to subtle changes in brain structure. The researchers, led by Jodi Gilman of Massachusetts General Hospital, identified increased gray matter density in the left nucleus accumbens and some bordering areas. The study was fine, but the media coverage was abysmal. Reporters overstated the findings, mischaracterized the study, and failed to mention previous research done on pot smoking and health. Goldfish may not have a three-second memory, but some journalists seem to. When a new paper comes out, it’s often treated as the first ever and final word on the topic. There is a significant body of literature on the neurological and wider health effects of marijuana, and to ignore it when covering new studies seems to me a form of journalistic malpractice. A press release from the Society for Neuroscience trumpeted the Gilman study’s importance because it looked at casual users rather than regular pot smokers, who form the basis of most marijuana studies. That claim is dubious in the extreme. The subjects averaged 3.83 days of smoking and 11.2 total joints per week. Characterizing these people as casual pot smokers was a great media hook, but it defied common sense. Occasional users wondered if they’d done permanent damage, and parents were concerned that their teenagers might face profound neurological changes from experimenting with pot. Any reporter who read the study, however, should have known not to take that bait. Even by the standards of past medical studies, it’s a stretch to call these subjects casual pot smokers. © 2014 The Slate Group LLC.

Related chapters from BP7e: Chapter 4: The Chemistry of Behavior: Neurotransmitters and Neuropharmacology
Related chapters from MM:Chapter 4: The Chemistry of Behavior: Neurotransmitters and Neuropharmacology
Link ID: 19559 - Posted: 05.03.2014