Chapter 4. The Chemistry of Behavior: Neurotransmitters and Neuropharmacology

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Ronald Crystal The goal of antiaddiction vaccines is to prevent addictive molecules from reaching the brain, where they produce their effects and can create chemical dependencies. Vaccines can accomplish this task, in theory, by generating antibodies—proteins produced by the immune system—that bind to addictive particles and essentially stop them in their tracks. But challenges remain. Among them, addictive molecules are often too small to be spotted by the human immune system. Thus, they can circulate in the body undetected. Researchers have developed two basic strategies for overcoming this problem. One invokes so-called active immunity by tethering an addictive molecule to a larger molecule, such as the proteins that encase a common cold virus. This viral shell does not make people sick but does prompt the immune system to produce high levels of antibodies against it and whatever is attached to it. In our laboratory, we have tested this method in animal models and successfully blocked chemical forms of cocaine or nicotine from reaching the brain. Another approach researchers are testing generates what is known as passive immunity against addictive molecules in the body. They have cultured monoclonal antibodies that can bind selectively to addictive molecules. The hurdle with this particular method is that monoclonal antibodies are expensive to produce and need to be administrated frequently to be effective. © 2016 Scientific American

Keyword: Drug Abuse; Neuroimmunology
Link ID: 22254 - Posted: 05.26.2016

By Lucas Powers, CBC News You're standing on the side of the road, with traffic whizzing past. The police officer who pulled you over suspects you may have smoked the reefer before departing for McDonald's. But she's in a bit of a quagmire, because, really, there's no reliable way to know for sure. Are you high? If you are high, how high are you, really? Or really did you just want those little cheeseburgers (no ketchup and extra pickles)? So she does the most logical thing: a field sobriety test. Tried and true. Walk the line. Touch the tip your nose. Can't do it? That's... suspicious. Maybe a night in the clink? Some Canadian cops also have roadside saliva swabs that can be used to test for the presence of drugs, but they are useless, legally speaking (for now.) Now, had you been quaffing ales before the drive, a breathalyzer — controversial as they can be in terms of accuracy and reliability — would have cleared up the situation pretty quickly. Of course, no such roadside device exists for cannabis and its psychotropic ingredient THC. There's growing evidence that cannabis can impair driving by slowing reaction times and encouraging perplexing moves by drivers, like slowing way down and being reluctant to change lanes. Doctors at Toronto's Centre for Addiction and Mental Health are doing the world's biggest-ever clinical study, asking exactly what causes this behaviour, and how dangerous it is. Either way, an innovation war worth billions to the victor has been declared over developing a cannabis breathalyzer. ©2016 CBC/Radio-Canada.

Keyword: Drug Abuse
Link ID: 22236 - Posted: 05.23.2016

Andrea Hsu Scientists and doctors say the case is clear: The best way to tackle the country's opioid epidemic is to get more people on medications that have been proven in studies to reduce relapses and, ultimately, overdoses. Yet, only a fraction of the more than 4 million people believed to abuse prescription painkillers or heroin in the U.S. are being given what's called medication-assisted treatment. One reason is the limited availability of the treatment. But it's also the case that stigma around the addiction drugs has inhibited their use. Methadone and buprenorphine, two of the drugs used for treatment, are themselves opioids. A phrase you often hear about medication-assisted treatment is that it's merely replacing one drug with another. While doctors and scientists strongly disagree with that characterization, it's a view that's widespread in recovery circles. Now, the White House is pushing to change the landscape for people seeking help. In his 2017 budget, President Obama has asked Congress for $1.1 billion in new funding to address the opioid epidemic, with almost all of it geared toward expanding access to medication-assisted treatment. The White House is also highlighting success stories. At the National Prescription Drug Abuse and Heroin Summit held in Atlanta in March, President Obama appeared on stage with Crystal Oertle, a 35-year-old mother of two from Ohio. Oertle spoke of her spiral into addiction, which began with prescription painkillers and progressed to heroin. She tried unsuccessfully to quit on her own several times, before being prescribed buprenorphine a year ago. © 2016 npr

Keyword: Drug Abuse
Link ID: 22226 - Posted: 05.18.2016

Zoe Cormier A hallucinogenic drug derived from magic mushrooms could be useful in treating depression, the first safety study of this approach has concluded. Researchers from Imperial College London gave 12 people psilocybin, the active component in magic mushrooms. All had been clinically depressed for a significant amount of time — on average 17.8 years. None of the patients had responded to standard medications, such as selective serotonin re-uptake inhibitors (SSRIs), or had electroconvulsive therapy. One week after receiving an oral dose of psilocybin, all patients experienced a marked improvement in their symptoms. Three months on, five patients were in complete remission. “That is pretty remarkable in the context of currently available treatments,” says Robin Carhart-Harris, a neuropsychopharmacologist at Imperial College London and first author of the latest study, which is published in The Lancet Psychiatry1. The equivalent remission rate for SSRIs is around 20%. The study's authors are not suggesting that psilocybin should be a treatment of last resort for depressed patients. “Our conclusion is more sober than that — we are simply saying that this is doable,” says Carhart-Harris. “We can give psilocybin to depressed patients, they can tolerate it, and it is safe. This gives us an initial impression of the effectiveness of the treatment.” © 2016 Nature Publishing Group

Keyword: Depression; Drug Abuse
Link ID: 22224 - Posted: 05.17.2016

By CLYDE HABERMAN At respected research centers in the United States and other countries, scientists have spent much of their professional lives in drug rehabilitation. It is not because they themselves struggle with addiction. What they are trying to rehabilitate are the drugs. Their focus is on mind-altering compounds that fell far from grace nearly half a century ago, LSD prominent among them. Along with other psychedelics, it was outlawed by the federal government, damned as bearing a high potential for abuse and offering no accepted medical benefit. But in recent years, researchers have sought to rescue hallucinogens from exile by examining their efficacy in treating certain disorders of the mind, and perhaps even in understanding the nature of consciousness and spirituality. The work of these scientists now draws the attention of Retro Report, a series of video documentaries that examine major news stories of the past and their enduring significance. Psychoactive substances, often derived from mushrooms, have been part of human cultures from Central and South America to the Sahara for thousands of years. But there is no need to look that far back; 1938 will do. That was when Albert Hofmann, a Swiss chemist searching for a drug to combat circulatory ailments, happened to synthesize lysergic acid diethylamide: LSD or, more familiarly, acid. Five years later, Dr. Hofmann, who died in 2008 at age 102, accidentally ingested a small dose of his creation and discovered its mind-blowing potential as he embarked on the first known acid trip. Many more such journeys would follow, for him and for countless others. © 2016 The New York Times Company

Keyword: Depression; Drug Abuse
Link ID: 22219 - Posted: 05.16.2016

By JONAH BROMWICH It’s relatively easy to determine when someone is too drunk to drive. If a driver’s blood-alcohol level is 0.08 percent or higher, that person is considered legally impaired. But a study says that measuring the effects of marijuana on drivers is far trickier, and that blood tests are an unreliable indication of impairment by cannabis. As more states consider legalizing the substance, that presents a challenge to legislators seeking to create laws on driving while impaired by marijuana. The study, commissioned by the AAA Foundation for Traffic Safety, found that laws in six states that legally assess impairment by measuring how much THC (the active ingredient in marijuana) is in a person’s blood are not supported by science. “There is no concentration of the drug that allows us to reliably predict that someone is impaired behind the wheel in the way that we can with alcohol,” said Jake Nelson, AAA’s director of traffic safety advocacy and research. Lawmakers in those states looked to policies on drunken driving for cues on how to legislate against driving while high. But the body absorbs alcohol and cannabis in different ways, the study said. While drunkenness directly correlates to alcohol in the bloodstream, cannabis impairment takes place only when THC makes its way into the fatty tissue of the brain. Regular marijuana users, including those who take the drug medicinally, often show no signs of impairment after using, according to Jolene Forman, a staff lawyer for the Drug Policy Alliance, a drug-reform advocacy group. She also said that marijuana can stay in the blood for hours, days and even weeks after its effects wear off. © 2016 The New York Times Company

Keyword: Drug Abuse
Link ID: 22214 - Posted: 05.14.2016

By Nicholas Bakalar Exposure to pesticides may increase the risk for amyotrophic lateral sclerosis, also known as Lou Gehrig’s disease, a new study has found. The study, in JAMA Neurology, included 156 patients with A.L.S. and 128 controls. All participants completed questionnaires providing information on age, sex, ethnicity, education, marital status, residential history, occupational history, smoking and military service. The researchers used the information on residence and occupation to estimate long-term exposure to pesticides, and then took blood samples to determine serum levels of 122 persistent environmental pollutants. The scientists divided exposure into four time periods: ever exposed, exposed in the last 10 years, exposed 10 to 30 years ago, and exposed more than 30 years ago. Exposure to pesticides at any time was associated with a fivefold increased relative risk for A.L.S. compared to no exposure. Even exposure more than 30 years ago tripled the risk. Military service was associated with double the risk, confirming findings of previous studies. “This is an association, not causality,” cautioned the senior author, Dr. Eva L. Feldman, a professor of neurology at the University of Michigan. “We found that people with A.L.S. were five times more likely to have been exposed to pesticides, but we don’t want people to conclude that pesticides cause A.L.S.” © 2016 The New York Times Company

Keyword: ALS-Lou Gehrig's Disease ; Neurotoxins
Link ID: 22212 - Posted: 05.14.2016

By Lisa Damour Parents of teenagers face a confounding crosscurrent. While the legalization of marijuana in several American states now bolsters the common belief among adolescents that the drug is safe for recreational use, research documenting marijuana’s diffuse and possibly permanent harm to the teenage brain continues to pile up. Normally developing teenagers question authority and are likely to be skeptical of adults bearing bad news about a widely used party drug. So how do we have successful conversations about the hazards of marijuana use? An open-ended exchange that credits the adolescent’s own observations may do more good than a single sit-down or lecture. Beyond that, we might consider how the facts are often received by adolescents. With all the talk about cannabis legalization, parents may feel compelled to remind their teenagers that recreational marijuana is still banned for most American adults and for anyone under 21. Adolescents who use marijuana risk immediate legal consequences and, in districts with zero-tolerance policies, may be barred from organized school activities, suspended or expelled. They may also face long-term penalties affecting some jobs, internships, colleges and travel visas. But the repercussions of being caught with marijuana don’t faze all teenagers. Most adolescents can name celebrities, famous athletes and classmates who use marijuana regularly, even flagrantly, without running into trouble. Teenagers tend to bristle at rules that seem arbitrary, such as the state-by-state regulations for marijuana and the fact that alcohol, which has a lot in common with pot, is legal. Further, adolescents can be understandably cynical about laws that aren’t applied evenly to everyone: While African-Americans and whites use the drug at similar rates, African-Americans are nearly four times as likely to be arrested for marijuana possession. However real and lasting the penalties for pot use may be, parents often run into resistance when trying to make this case to teenagers. © 2016 The New York Times Company

Keyword: Drug Abuse; Development of the Brain
Link ID: 22207 - Posted: 05.12.2016

By Maia Szalavitz Both the FDA and the CDC have recently taken steps to address an epidemic of opioid overdose and addiction, which is now killing some 29,000 Americans each year. But these regulatory efforts will fail unless we acknowledge that the problem is actually driven by illicit—not medical—drug use. You’ve probably read that 80 percent of heroin users started with prescription medications—and you may have seen billboards that compare giving pain medication to children to giving them heroin. You have probably also heard and seen media stories of people with addiction who blame their problem on medical use. But the simple reality is this: According to the large, annually repeated and representative National Survey on Drug Use and Health, 75 percent of all opioid misuse starts with people using medication that wasn’t prescribed for them—obtained from a friend, family member or dealer. And 90 percent of all addictions—no matter what the drug—start in the adolescent and young adult years. Typically, young people who misuse prescription opioids are heavy users of alcohol and other drugs. This type of drug use, not medical treatment with opioids, is by far the greatest risk factor for opioid addiction, according to a study by Richard Miech of the University of Michigan and his colleagues. For this research, the authors analyzed data from the nationally representative Monitoring the Future survey, which includes thousands of students. While medical use of opioids among students who were strongly opposed to alcohol and other drugs did raise later risk for misuse, the overall risk for this group remained small and their actual misuse occurred less than five times a year. In other words, it wasn’t actually addiction. Given that these teens had generally rejected experimenting with drugs, an increased risk of misuse associated with medical care makes sense since they’d otherwise have no source of exposure. © 2016 Scientific American

Keyword: Drug Abuse
Link ID: 22202 - Posted: 05.11.2016

Aaron E. Carroll People get hooked on cigarettes, and enjoy them for that matter, because of the nicotine buzz. The nicotine doesn’t give them cancer and lung disease, though. It’s the tar and other chemicals that do the real harm. A robust debate is going on among public health officials over whether electronic cigarettes, or e-cigarettes, can alleviate the harms of smoking tobacco, or whether they should be treated as negatively as conventional cigarettes. In other countries, such as Britain, officials are more in favor of e-cigarettes, encouraging smokers to switch from conventional to electronic. Last week, the Food and Drug Administration issued new rules on e-cigarettes, banning their sale to anyone under 18 and requiring that adults under the age of 26 show a photo identification to buy them. Electronic cigarettes carry the promise of delivering the nicotine without the dangerous additives. The use of e-cigarettes by youth has increased sharply in recent years. In 2011, about 1.5 percent of high school students reported using them in the last month. In 2014, more than 12 percent of students did. That means that nearly 2.5 million American middle and high school students used them in the past month. The problem is that nicotine is generally considered less safe for children and adolescents than for adults. Poisoning is possible. It’s thought that nicotine may interfere with brain development. Most worrisome, it’s believed that becoming addicted to nicotine in any form makes smoking more likely later in life. E-cigarettes are perceived to be less harmful than conventional cigarettes, and they are thought to be useful aids to quitting. These perceptions, however, are not always fully grounded in evidence. © 2016 The New York Times Company

Keyword: Drug Abuse
Link ID: 22201 - Posted: 05.11.2016

By JAN HOFFMAN The pop superstar Prince may have lived an outsize life, but emerging details about his long struggle with pain and reliance on opioids will resonate with thousands of patients who have stumbled down that well-trod path. It is a remarkably common narrative in the unfolding story of the nation’s opioid epidemic. Many details have yet to be confirmed about Prince’s case, but a typical trajectory can go something like this. A patient undergoes a procedure to address a medical issue — extracted wisdom teeth for example, or, as Prince did, orthopedic surgery. To help the patient get through recovery, a dentist or surgeon writes a prescription for opioid painkillers, like Percocet or Vicodin. Procedure over, problem addressed. But that prescription may not be written judiciously. “Opioids may be required after a procedure for a few days, but sometimes, physicians practice sloppy prescribing habits and they give patients much more than they need,” said Dr. Patrick G. O’Connor, a professor of medicine at Yale School of Medicine and a past president of the American Board of Addiction Medicine. “And the more patients take, the more likely they are to become dependent.” After a follow-up visit or two, the specialist who did the procedure has no reason to continue seeing the patient. (That doctor could also be an emergency room physician who treated kidney stones, sciatica or any number of other conditions involving stabbing pain.) Yet the patient’s pain may persist, demanding to be tamed. The patient, who now knows just how effective these drugs are, wants to refill the prescription. “The default approach is you go to your primary care provider, and they’ll take care of it,” said Dr. Jonathan H. Chen, an instructor at the Stanford University School of Medicine, who has researched the distribution of opioid prescriptions. As he spoke during a break in his shift in a same-day urgent care clinic, he had just attended to a patient who had recently had shoulder surgery but said she was still in pain. © 2016 The New York Times Company

Keyword: Drug Abuse; Pain & Touch
Link ID: 22191 - Posted: 05.07.2016

Laura Sanders Ketamine, a drug that has shown promise in quickly easing depression, doesn’t actually do the job itself. Instead, depression relief comes from one of the drug’s breakdown products, a new study in mice suggests. The results, published May 4 in Nature, identify a potential depression-fighting drug that works quickly but without ketamine’s serious side effects or potential for abuse. The discovery “could be a major turning point,” says neuroscientist Roberto Malinow of the University of California, San Diego. “I’m sure that drug companies will look at this very closely.” Depression is a pernicious problem with few good treatments. Traditional antidepressants don’t work for everyone, and when the drugs do work, they can take weeks to kick in. Ketamine, developed in the 1960s as a sedative for people and now used commonly by veterinarians to knock out animals, can ease depression in minutes, not weeks, small studies show. But the new study suggests that a metabolite of ketamine — not the drug itself — fights depression. Inside the body, ketamine gets converted into a slew of related molecules. One of these breakdown molecules, a chemical called (2R,6R)-hydroxynorketamine, is behind the benefits, neuropharmacologist Todd Gould of the University of Maryland School of Medicine in Baltimore and colleagues found. On its own, a single dose of (2R,6R)-HNK reduced signs of depression in mice, restoring their drive to search for a hidden platform in water, to try to escape a shock and to choose sweet water over plain. A type of ketamine that couldn’t be broken down easily into HNKs didn’t ease signs of depression in mice. Finding that a breakdown product, and not ketamine itself, was behind the results was a big surprise, Gould says. © Society for Science & the Public 2000 - 2016

Keyword: Depression; Drug Abuse
Link ID: 22184 - Posted: 05.05.2016

By John Horgan I had to ask Anthony Bossis about bad trips. Bossis, a psychologist at New York University, belongs to an intrepid cadre of scientists reviving research into psychedelics’ therapeutic potential. I say “reviving” because research on psychedelics thrived in the 1950s and 1960s before being crushed by a wave of anti-psychedelic hostility and legislation. Psychedelics such as LSD, psilocybin and mescaline are still illegal in the U.S. But over the past two decades, researchers have gradually gained permission from federal and other authorities to carry out experiments with the drugs. Together with physicians Stephen Ross and Jeffrey Guss, Bossis has tested the potential of psilocybin—the primary active ingredient of “magic mushrooms”--to alleviate anxiety and depression in cancer patients. Journalist Michael Pollan described the work of Bossis and others in The New Yorker last year. Pollan said researchers at NYU and Johns Hopkins had overseen 500 psilocybin sessions and observed “no serious adverse effects.” Many subjects underwent mystical experiences, which consist of "feelings of unity, sacredness, ineffability, peace and joy," as well as the conviction that you have discovered "an objective truth about reality." Pollan’s report was so upbeat that I felt obliged to push back a bit, pointing out that not all psychedelic experiences—or mystical ones--are consoling. In The Varieties of Religious Experience, William James emphasized that some mystics have “melancholic” or “diabolical” visions, in which ultimate reality appears terrifyingly alien and uncaring. Taking psychedelics in a supervised research setting doesn’t entirely eliminate the risk of a bad trip. That lesson emerged from a study in the early 1990s by psychiatrist Rick Strassman, who injected dimethyltryptamine, DMT, into human volunteers. © 2016 Scientific American

Keyword: Drug Abuse; Depression
Link ID: 22179 - Posted: 05.04.2016

By SABRINA TAVERNISE Taking a stance sharply at odds with most American public health officials, a major British medical organization urged smokers to switch to electronic cigarettes, saying they are the best hope in generations for people addicted to tobacco cigarettes to quit. The recommendation, laid out in a report published Thursday by the Royal College of Physicians, summarizes the growing body of science on e-cigarettes and finds that their benefits far outweigh the potential harms. It concludes resoundingly that, at least so far, the devices are helping people more than harming them, and that the worries about them — including that using them will lead young people to eventually start smoking traditional cigarettes — have not come to pass. “This is the first genuinely new way of helping people stop smoking that has come along in decades,” said John Britton, director of the U.K. Center for Tobacco and Alcohol Studies at the University of Nottingham, who led the committee that produced the report. E-cigarettes, he said, “have the potential to help half or more of all smokers get off cigarettes. That’s a huge health benefit, bigger than just about any medical intervention.” That conclusion is likely to be controversial in the United States, where arguments about e-cigarettes have jolted the traditionally low-key public health community. E-cigarettes deliver nicotine without the harmful tar and chemicals that cause cancer. Some public health experts see e-cigarettes as the first real chance in years for 40 million addicted Americans to quit. But others, including the federal Centers for Disease Control and Prevention, have focused on the potential dangers of e-cigarettes, for example that they could extend smoking habits, that they could be a gateway to traditional cigarettes for children, or that their vapor could to turn out to have long-term health effects. © 2016 The New York Times Company

Keyword: Drug Abuse
Link ID: 22153 - Posted: 04.28.2016

By Matthew A. Scult My heart pounds as I sprint to the finish line. Thousands of spectators cheer as a sense of elation washes over me. I savor the feeling. But then, the image slowly fades away and my true surroundings come into focus. I am lying in a dark room with my head held firmly in place, inside an MRI scanner. While this might typically be unpleasant, I am a willing research study participant and am eagerly anticipating what comes next. I hold my breath as I stare at the bar on the computer screen representing my brain activity. Then the bar jumps. My fantasy of winning a race had caused the “motivation center” of my brain to surge with activity. I am participating in a study about neurofeedback, a diverse and fascinating area of research that combines neuroscience and technology to monitor and modulate brain activity in real time. My colleagues, Katie Dickerson and Jeff MacInnes, in the Adcock Lab at Duke University, are studying whether people can train themselves to increase brain activity in a tiny region of the brain called the VTA. Notably, the VTA is thought to be involved in motivation—the desire to get something that you want. For example, if I told you that by buying a lottery ticket you would be guaranteed to win $1,000,000, you would probably be very motivated to buy the ticket and would have a spike in brain activity in this region of your brain. But while studies have shown that motivation for external rewards (like money) activate the VTA, until now, we didn’t know whether people could internally generate a motivational state that would activate this brain region. To see if people can self-activate the VTA, my colleagues are using neurofeedback, which falls under the broader umbrella of biofeedback. © 2016 Scientific American

Keyword: Drug Abuse; Attention
Link ID: 22143 - Posted: 04.26.2016

Richard A. Friedman DRUG companies are eager to tell you about their newest medicines. Turn on your TV or go online and there’s a new drug — with a hefty price tag — for whatever ails you, from antidepressants to painkillers to remedies for erectile dysfunction. The pharmaceutical industry spends lavishly to get your attention: In 2014, drug makers poured $4.5 billion into so-called direct-to-consumer advertising, a 30 percent increase over two years. Drug makers claim they are educating the public with their ads, providing information that will help you make better choices about your medical care. So in the spirit of education, let’s consider a recent online ad for Latuda, a new antipsychotic medication. A young woman rides a bike off into the sun as we are told that Latuda has been shown to be effective for many people with bipolar depression, followed by that staccato recitation of potential side effects that most viewers tune out. Here’s what a helpful prescription drug label could look like, with facts that are now out of reach. These are question marks because, although many clinical trial results are published, they are difficult to find and compare. Rules should mandate that all studies are accessible. Note the same high cost for a four-fold range of Latuda doses. Often the lowest dose is just as effective; some low-dose consumers realize they can save money by ordering the higher-dose units and splitting them into pieces. The ideal label would have statistics on how many people have serious side effects. Data are not included for these drugs because they may take years to emerge, if ever. Other drugs have well-known side effects. Fair enough. But the ad omits something that most consumers would like to know: There are many older and cheaper treatments that are just as effective. In fact, Latuda is one of 10 “second generation” antipsychotic medications, many available in generic forms, that essentially work the same way. Of course, the goal of drug companies is not to educate, but to sell products. We could ban the ads, as almost every other country does, and which I’d strongly support. But such a campaign in the United States would face fierce legislative and legal challenges. Instead, let’s help the drug companies make their ads truly educational. © 2016 The New York Times Company

Keyword: Schizophrenia; Depression
Link ID: 22140 - Posted: 04.25.2016

By THE EDITORIAL BOARD At the urging of Mexico, Guatemala and Colombia, world leaders met at the United Nations in a special session last week to discuss saner ways to fight the drug trade. They did not get very far toward a shift in approach. Nonetheless, there was a consensus that investing in health care, addiction treatment and alternatives to incarceration would do more to end the drug trade than relying primarily on prohibition and criminalization. “A war that has been fought for more than 40 years has not been won,” President Juan Manuel Santos of Colombia said in an interview. “When you do something for 40 years and it doesn’t work, you need to change it.” Mr. Santos and the presidents of Mexico and Guatemala argue that the war on drugs, which has been largely directed under terms set by the United States, has had devastating effects on their countries, which are hubs of the cocaine, marijuana and heroin trade. “When two elephants fight, the grass always suffers the most,” President Jimmy Morales of Guatemala said, referring to the drug cartels and American law enforcement agencies. Since 2014, the three governments and like-minded allies have sought to lay the groundwork for changes to the current approach, which is grounded in three international drug accords adopted between the early 1960s and 1988. Those treaties, which required that signatories outlaw the trade and possession of controlled substances — including marijuana — were conceived at a time when international leaders saw law enforcement as the most effective way to curb drug production and consumption. Unfortunately, several countries with considerable diplomatic clout, including China and Russia, maintain that criminalization should remain the cornerstone of the fight against drugs. © 2016 The New York Times Company

Keyword: Drug Abuse
Link ID: 22138 - Posted: 04.25.2016

By DAN LEVIN VANCOUVER, British Columbia — Dave Napio started doing heroin over four decades ago, at 11 years old. Like many addicts these days, he heads to Vancouver’s gritty Downtown Eastside neighborhood when he needs a fix. But instead of seeking out a dealer in a dark alley, Mr. Napio, 55, gets his three daily doses from a nurse at the Crosstown Clinic, the only medical facility in North America permitted to prescribe the narcotic at the center of an epidemic raging across the continent. And instead of robbing banks and jewelry stores to support his habit, Mr. Napio is spending time making gold and silver jewelry, hoping to soon turn his hobby into a profession. “My whole life is straightening out,” Mr. Napio, who spent 22 of his 55 years in prison, said during a recent interview in the clinic’s mirror-lined injection room. “I’m becoming the guy next door.” Mr. Napio is one of 110 chronic addicts with prescriptions for diacetylmorphine hydrochloride, the active ingredient in heroin, which he injects three times a day at Crosstown as part of a treatment known as heroin maintenance. The program has been so successful at keeping addicts out of jail and away from emergency rooms that its supporters are seeking to expand it across Canada. But they have been hindered by a tangle of red tape and a yearslong court battle reflecting a conflict between medicine and politics on how to address drug addiction. The clinic’s prescription program began as a clinical trial more than a decade ago. But it has garnered more interest recently as a plague of illicit heroin use and fatal overdoses of legal painkillers has swept across the United States, fueling frustration over ideological and legal obstacles to forms of treatment that studies show halt the spread of disease through needles and prevent deaths. © 2016 The New York Times Company

Keyword: Drug Abuse
Link ID: 22123 - Posted: 04.21.2016

For the first time, scientists have scanned the brains of subjects taking LSD, and found that the LSD state mimics that of infants. NPR's Rachel Martin speaks with researcher Robin Carhart-Harris. RACHEL MARTIN, HOST: Picture yourself in a boat on a river with tangerine trees and marmalade skies. Now picture yourself as a baby. You gaze up at your mother. She's got those kaleidoscope eyes. Pretty trippy, right? Turns out in a new study of brain scans, that the minds of people on LSD function in a similar way to babies' brains. Dr. Robin Carhart-Harris from Imperial College London's Center for Neuropsychopharmacology joins us from the studios of the BBC to talk about this study. So I understand this was the first time that brain scans like this have ever been done, looking specifically at the brains of people who have used LSD. How much LSD had your subjects taken? I mean, what were the prerequisites for a brain that you were going to scan? CARHART-HARRIS: Yeah, so they had to have had at least one experience with a psychedelic drug. So that includes LSD. It also includes magic mushrooms, other concoctions like ayahuasca, which is an Amazonian brew that has psychedelic properties. We gave them a moderate dose of LSD, roughly equivalent to what you might call a hit of LSD or one blotter of LSD if it was to be taken recreationally. MARTIN: So what kind of vetting did you have to do of the participants in your study because we should say different people respond to LSD in different ways? There are risks associated with this drug. CARHART-HARRIS: That's quite right. All drugs have risks, and LSD's no exception. One of the risks is that you might recruit someone who has a psychological vulnerability. So we're very, very careful when we recruit our volunteers to ensure that they have a solid mental health background. They don't have any personal or family history of any psychotic disorders - so those are things like schizophrenia. We have a psychiatrist assess them. We also evaluate their health. So they are very thoroughly screened. © 2016 npr

Keyword: Drug Abuse; Brain imaging
Link ID: 22112 - Posted: 04.18.2016

By Jillian Bell, CBC News New medical marijuana products produced by yeast could soon be on the market, the co-founder of a biotech company says. That could potentially lead to a wider range of cannabinoid-based drugs that proponents say could be more effective for treating certain medical conditions than medical marijuana itself. The appropriate use of medical marijuana has been a controversial topic, with many arguing that further research is needed to evaluate its efficacy as a treatment for a variety of ailments. In Canada, where the Liberal government has said it will legalize marijuana, medical marijuana is already used to treat a variety of conditions and symptoms, including lack of appetite in people with HIV/AIDS and nausea in those undergoing cancer treatment. The most well-known cannabinoid is tetrahydrolcannabinol, or THC, which is approved by the U.S. Food and Drug Administration to treat nausea and improve appetite. It's found in large amounts in marijuana plants, which is the reason why medical marijuana is often prescribed to treat nausea and increase appetite. But other cannabinoids, like cannabidiol (CBD) and cannabigerol (CBG) may have the potential to be potent treatments for other conditions as well. CBG also has its own medical properties. But it can also be easily chemically converted into other cannabinoids, including THC. ©2016 CBC/Radio-Canada.

Keyword: Drug Abuse
Link ID: 22111 - Posted: 04.18.2016