Chapter 4. The Chemistry of Behavior: Neurotransmitters and Neuropharmacology
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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
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
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
Ian Sample Science editor The risks of heavy cannabis for mental health are serious enough to warrant global public health campaigns, according to international drugs experts who said young people were particularly vulnerable. The warning from scientists in the UK, US, Europe and Australia reflects a growing consensus that frequent use of the drug can increase the risk of psychosis in vulnerable people, and comes as the UN prepares to convene a special session on the global drugs problem for the first time since 1998. The meeting in New York next week aims to unify countries in their efforts to tackle issues around illicit drug use. While the vast majority of people who smoke cannabis will not develop psychotic disorders, those who do can have their lives ruined. Psychosis is defined by hallucinations, delusions and irrational behaviour, and while most patients recover from the episodes, some go on to develop schizophrenia. The risk is higher among patients who continue with heavy cannabis use. Public health warnings over cannabis have been extremely limited because the drug is illegal in most countries, and there are uncertainties over whether it really contributes to mental illness. But many researchers now believe the evidence for harm is strong enough to issue clear warnings. “It’s not sensible to wait for absolute proof that cannabis is a component cause of psychosis,” said Sir Robin Murray, professor of psychiatric research at King’s College London. © 2016 Guardian News and Media Limited
Zoe Cormier Researchers have published the first images showing the effects of LSD on the human brain, as part of a series of studies to examine how the drug causes its characteristic hallucinogenic effects1. David Nutt, a neuropsychopharmacologist at Imperial College London who has previously examined the neural effects of mind-altering drugs such as the hallucinogen psilocybin, found in magic mushrooms, was one of the study's leaders. He tells Nature what the research revealed, and how he hopes LSD (lysergic acid diethylamide) might ultimately be useful in therapies. Why study the effects of LSD on the brain? For brain researchers, studying how psychedelic drugs such as LSD alter the ‘normal’ brain state is a way to study the biological phenomenon that is consciousness. We ultimately would also like to see LSD deployed as a therapeutic tool. The idea has old roots. In the 1950s and 60s thousands of people took LSD for alcoholism; in 2012, a retrospective analysis of some of these studies suggested that it helped cut down on drinking. Since the 1970s there have been lots of studies with LSD on animals, but not on the human brain. We need that data to validate the trial of this drug as a potential therapy for addiction or depression. Why hasn’t anyone done brain scans before? Before the 1960s, LSD was studied for its potential therapeutic uses, as were other hallucinogens. But the drug was heavily restricted in the UK, the United States and around the world after 1967 — in my view, due to unfounded hysteria over its potential dangers. The restrictions vary worldwide, but in general, countries have insisted that LSD has ‘no medical value’, making it tremendously difficult to work with. © 2016 Nature Publishing Group
Ian Dunt There is a remarkable lack of research into a drug that some scientists initially considered to be a key tool in understanding consciousness, and that has since been shown to help people deal with anxiety and depression. The new study on the impact of LSD on the brain is the first in the UK since the drug was banned in 1966. Incredibly, it’s also the first anywhere to use brain scans taken while a person is under the influence of the drug. Nowadays, we associate LSD with hippies murmuring about the nature of reality, but it wasn’t always this way. Between the invention of the drug in 1952 and its banning in the UK, around a thousand papers on it were published. Then LSD was made illegal. The UK Home Office promised to allow scientists to continue experiments with the drug, and it’s true that they remain legal. But they are also effectively impossible. The obstacles against research – regulatory, financial, professional and political – are just too high for any sensible person to cope with. Research using outlawed drugs with no accepted medical value requires a “schedule 1” licence from the Home Office. It takes about a year to get and involves a barrage of criminal record checks. All told, its price tag comes in at about £5000, with a costly annual top-up assessment to follow. © Copyright Reed Business Information Ltd.
By Melinda Wenner Moyer What if you could pop a pill that made you smarter? It sounds like a Hollywood movie plot, but a new systematic review suggests that the decades-long search for a safe and effective “smart drug” (see below) might have notched its first success. Researchers have found that modafinil boosts higher-order cognitive function without causing serious side effects. Modafinil, which has been prescribed in the U.S. since 1998 to treat sleep-related conditions such as narcolepsy and sleep apnea, heightens alertness much as caffeine does. A number of studies have suggested that it could provide other cognitive benefits, but results were uneven. To clear up the confusion, researchers then at the University of Oxford analyzed 24 studies published between 1990 and 2014 that specifically looked at how modafinil affects cognition. In their review, which was published last year in European Neuropsychopharmacology, they found that the methods used to evaluate modafinil strongly affected the outcomes. Research that looked at the drug's effects on the performance of simple tasks—such as pressing a particular button after seeing a certain color—did not detect many benefits. Yet studies that asked participants to do complex and difficult tasks after taking modafinil or a placebo found that those who took the drug were more accurate, which suggests that it may affect “higher cognitive functions—mainly executive functions but also attention and learning,” explains study co-author Ruairidh Battleday, now a medical doctor and Ph.D. student at the University of California, Berkeley. But don't run to the pharmacy just yet. Although many doctors very likely prescribe the drug off-label to help people concentrate—indeed, a 2008 survey by the journal Nature found that one in five of its readers had taken brain-boosting drugs, and half those people had used modafinil—trials have not yet been done on modafinil's long-term effectiveness or safety. © 2016 Scientific American
Sara Reardon Prozac (fluoxetine) and similar antidepressants are among the most prescribed drugs in the United States, but scientists still don’t know exactly how they work. Now one piece of that puzzle — the structure of a protein targeted by several widely used antidepressants — has been solved. The finding, reported on 6 April in Nature1, could enable the development of better, more-targeted depression drugs. But it may come too late for drug companies, many of which have abandoned the search for depression treatments. Prozac and its kin — drugs called selective serotonin reuptake inhibitors (SSRIs) — were first discovered2 in 1972. They address one hallmark of depression: low levels of the molecule serotonin, which neurons use to signal one another. By preventing a protein called serotonin transporter (SERT) form absorbing the serotonin back into neurons that release it, the drugs boost serotonin levels in the junctions between cells. But the details of this mechanism have long eluded researchers, who have sought to crystallize and visualize the SERT protein since the early 1990s. “It’s tough to make, and once you make it, it tends to fall apart in your hands,” says Eric Gouaux, a crystallographer at Oregon Health & Science University in Portland. Gouaux and his colleagues finally succeeded by creating small mutations in the SERT gene to make the protein more stable. For the first time, they were able to see the pocket in which two SSRIs — Paxil (paroxetine) and Lexapro (escitalopram) — bind. They also identified a second pocket, called an allosteric site. When escitalopram binds to both sites, the transporter protein and the drug bond more tightly, which increases the medicine's effect. © 2016 Nature Publishing Group
Link ID: 22083 - Posted: 04.07.2016
JUST say no. That’s supposed to be our reaction to recreational drugs. The trouble is, lots of people say yes please. As a result, the world’s governments have been waging a war on drugs for more than a century. Since 1961, the battle has been orchestrated via international treaties targeting all parts of the supply chain, from the producers to the smugglers, the sellers to the buyers. Yet this supposedly united front has developed some conspicuous cracks. Now those countries backing a different approach have called a UN meeting later this month to make the case for change. The question is whether the UN is ready to soften its stance or whether it will plough on despite mountains of evidence suggesting its zero-tolerance approach has failed. As the reformers collate this to present at the meeting, New Scientist looks at how the approaches taken by different countries stack up (see “Drugs around the world”, below), and asks what can happen next. Some nations are already taking change into their own hands. Portugal allows personal use of any drug – including cocaine and heroin – and several South and Central American countries are moving in the same direction. As for cannabis, the number of places where its open sale has been decriminalised in some form grows ever larger. © Copyright Reed Business Information Ltd.
Keyword: Drug Abuse
Link ID: 22082 - Posted: 04.07.2016
By Chris Brown, Chris Corday, Canada's infatuation with getting a legal high may soon lead straight to Mary Jean Dunsdon's Vancouver kitchen. The self-described diva of cooking with cannabis has been baking and selling intoxicating edibles for the better part of 20 years. "I've easily sold 700,000 to one million cookies," she told CBC News recently in her kitchen. To her customers, Dunsdon, best known by her nickname Watermelon, is a trusted brand. Package "I've done it all: 'nice cream cones', marijuana bacon, I've made 'weedish meatballs'," she said. With legalization on the way in Canada, Dunsdon is hoping her underground bakery and the goodies she sells to a loyal base of medical and recreational customers will finally emerge from the shadows and capture a slice of a new market for marijuana edibles. She has good reason to be optimistic about her future in the business of bud. In the U.S. states where recreational marijuana is already legal, edibles — basically any food or drinks containing marijuana — are the fastest growing segment of the market. New Frontier Financials, which tracks the growth of the U.S. marijuana industry, says Washington state's sale of about 280,000 units of edible marijuana in March is double what it was just 10 months ago. For Canada, it's a trend line that offers a glimpse into the future and also a cautionary tale. "Edibles will be more popular. Way more popular than smoking," said Dunsdon. Watermelon During our visit, Dunsdon ground up marijuana leaf and bud and sprinkled the herb mixture over a fillet of wild B.C. chinook salmon. The topping bears a striking resemblance to pesto. "If you eat it, and eat just the right amount, it's probably the nicest thing you've ever felt," she said. ©2016 CBC/Radio-Canada.
Keyword: Drug Abuse
Link ID: 22081 - Posted: 04.07.2016
Mo Costandi This spectacular image – which took the best part of a year to create – shows the fine structure of a nerve terminal at high resolution, revealing, for the very first time, an intricate network of fine filaments that controls the movements of synaptic vesicles. The brain is soft and wet, with the consistency of a lump of jelly. Yet, it is the most complex and highly organized structure that we know of, containing hundreds of billions of neurons and glial cells, and something on the order of one quadrillion synaptic connections, all of which are arranged in a very specific manner. This high degree of specificity extends down to the deepest levels of brain organization. Just beneath the membrane at the nerve terminal, synaptic vesicles store neurotransmitter molecules, and await the arrival of a nervous impulse, whereupon they fuse with the membrane and release their contents into the synaptic cleft, the miniscule gap at the junction between nerve cells, and diffuse across it to bind to receptor protein molecules embedded at the surface of the partner cell. 3D model of a nerve terminal in atomic detail The process of neurotransmitter release is tightly orchestrated. Ready vesicles are ‘docked’ in the ‘active zone’ lying beneath the cell membrane, and are depleted when they fuse with the membrane, only to be replenished from a reservoir of pre-prepared vesicles located further inside the cell. Spent vesicles are quickly pulled back out of the membrane, reformed, refilled with neurotransmitter molecules, and then returned to the reservoir, so that they can be shuttled into the active zone when needed. An individual nerve cell may use up hundreds, or perhaps thousands, of vesicles every second, and so this recycling process occurs continuously to maintain the signalling between nerve cells. © 2016 Guardian News and Media Limited
Keyword: Development of the Brain
Link ID: 22067 - Posted: 04.04.2016
Opioids are becoming the latest serious addiction problem in this country. Among these drugs manufactured from opium, heroin is the most serious, dangerous, cheap and available everywhere. In April's edition of Harper's Magazine, Dan Baum has examined a new response to this latest addiction problem: the legalization of drugs. NPR's Linda Wertheimer asks Baum about how he began to delve into the topic of America's war on drugs and why he calls attempts at legalization a big risk based on our approach to solving the widespread problem. Interview Highlights You go back, covering the war on drugs, I wonder if you could tell us the story which kicks off your article. I was starting a book on the politics of drug enforcement. And in 1994 I got word that John Erlichman was doing minority recruitment at an engineering firm in Atlanta. Well, I'm 60. Erlichman was one of the great villains of American History, a Watergate villain. And he was Richard Nixon's drug policy advisor. And Richard Nixon was the one who coined the phrase, "war on drugs." And he told me an amazing thing. I started asking him some earnest, wonky policy questions and he waved them away. He said, "Can we cut the B.S.? Can I just tell you what this was all about?" The Nixon campaign in '68 and the Nixon White House had two enemies: black people and the anti-war left. He said, and we knew that if we could associate heroin with black people and marijuana with the hippies, we could project the police into those communities, arrest their leaders, break up their meetings and most of all, demonize them night after night on the evening news. And he looked me in the eyes and said, "Did we know we were lying about the drugs? Of course we did." © 2016 npr
Keyword: Drug Abuse
Link ID: 22046 - Posted: 03.29.2016
Kristin Gourlay Swaddled in soft hospital blankets, Lexi is 2 weeks old and weighs 6 pounds. She's been at Women and Infants Hospital in Providence, R.I., since she was born, and is experiencing symptoms of opioid withdrawal. Her mother took methadone to wean herself from heroin when she got pregnant, just as doctors advised. But now the hospital team has to wean newborn Lexi from the methadone. As rates of opioid addiction have continued to climb in the U.S., the number of babies born with neonatal abstinence syndrome has gone up, too — by five-fold from 2000 to 2012, according to the National Institute of Drug Abuse. It can be a painful way to enter the world, abruptly cut off from the powerful drug in the mother's system. The baby is usually born with some level of circulating opioids. As drug levels decline in the first 72 hours, various withdrawal symptoms may appear — such as trembling, vomiting, diarrhea or seizures. At some point, if symptoms mount in number or severity, doctors will begin giving medication to help ease them. The idea is to give the baby just enough opioid to reduce those symptoms, and then slowly, over days or weeks, decrease that dose to zero. A doctor comes to check on Lexi and her mother, Carrie. To protect her family's privacy, Carrie asked us not to use the family name. "So, hi, Peanut!" the doctor says to the baby. "Any concerns?" she asks Carrie. "Coming down has been catching up with her," says Carrie. © 2016 npr
By KATHARINE Q. SEELYE LAWRENCE, Mass. — When Eddie Frasca was shooting up heroin, he occasionally sought out its more potent, lethal cousin, fentanyl. “It was like playing Russian roulette, but I didn’t care,” said Mr. Frasca, 30, a carpenter and barber who said he had been clean for four months. When he heard that someone had overdosed or even died from fentanyl, he would hunt down that batch. “I’d say to myself, ‘I’m going to spend the least amount of money and get the best kind of high I can,’ ” he said. Fentanyl, which looks like heroin, is a powerful synthetic painkiller that has been laced into heroin but is increasingly being sold by itself — often without the user’s knowledge. It is up to 50 times more powerful than heroin and up to 100 times more potent than morphine. A tiny bit can be fatal. In some areas in New England, fentanyl is now killing more people than heroin. In New Hampshire, fentanyl alone killed 158 people last year; heroin killed 32. (Fentanyl was a factor in an additional 120 deaths; heroin contributed to an additional 56.) “It sort of snuck up on us,” said Detective Capt. Robert P. Pistone of the Haverhill Police Department in Massachusetts. He said that a jump in deaths in 2014 appeared to be caused by heroin, but that lab tests showed the culprit was fentanyl. Fentanyl represents the latest wave of a rolling drug epidemic that has been fueled by prescription painkillers, as addicts continue to seek higher highs and cheaper fixes. © 2016 The New York Times Company
Keyword: Drug Abuse
Link ID: 22032 - Posted: 03.26.2016
Angus Chen You've probably heard that a little booze a day is good for you. I've even said it at parties. "Look at the French," I've said gleefully over my own cup. "Wine all the time and they still live to be not a day younger than 82." I'm sorry to say we're probably wrong. The evidence that alcohol has any benefit on longevity or heart health is thin, says Dr. Timothy Naimi, a physician and epidemiologist at Boston Medical Center. He and his colleagues published an analysis 87 of the best research studies on alcohol's effect on death from any cause in the Journal of Studies on Alcohol and Drugs on Tuesday. "[Our] findings here cast a great deal of skepticism on this long, cherished belief that moderate drinking has a survival advantage," he says. In these studies, the participants get sorted into categories based on how much alcohol they think they drink. Researchers typically size up occasional, moderate and heavy drinkers against non-drinkers. When you do this, the moderates, one to three drinks a day, usually come out on top. They're less likely to die early from health problems like heart disease or cancer and injury. But then it gets very tricky, "because moderate drinkers tend to be very socially advantaged," Naimi says. Moderate drinkers tend to be healthier on average because they're well-educated and more affluent, not because they're drinking a bottle of wine a week on average. "[Their] alcohol consumption ends up looking good from a health perspective because they're already healthy to begin with." © 2016 npr
By Maryse Zeidler, CBC News Effective immediately, the overdose-reversing drug naloxone is available without a prescription in Canada. Health groups and advocates across the country have been clamouring for naloxone to be widely available in order to prevent deaths, following a flood of fatalities linked to street drugs containing the powerful opiate fentanyl. Health Canada issued a statement about the change on Tuesday following a brief consultation period that began in mid-January. The ministry said all 130 responses it received on the subject were in favour of the change. It said doctors, pharmacists and patient organizations were some of the groups included in the consultation. The most common comment, said Health Canada, was "the need for a more user-friendly dosage form." Currently the drug is administered through injection — it said a nasal-spray form isn't yet available in Canada. Other concerns included the need to train those administering the drug and the acknowledgement that making naloxone more widely available "is not the cure to the opioid abuse problem and we must not lose sight of the underlying causes of drug addiction."
Keyword: Drug Abuse
Link ID: 22018 - Posted: 03.23.2016
People who want to quit smoking are more likely to succeed if they go "cold turkey" by stopping abruptly, a study in Annals of Internal Medicine shows. Volunteers who used this approach were 25% more likely to remain abstinent half a year from the date that they give up than smokers who tried to gradually wean themselves off instead. The NHS says that picking a convenient date to quit is important. Make a promise, set a date and stick to it, it advises. And sticking to the "not a drag" rule can really help too. "Whenever you find yourself in difficulty say to yourself, 'I will not have even a single drag' and stick with this until the cravings pass," the service says. And it recommends seeing a GP to get professional support and advice to give up smoking. In the British Heart Foundation-funded study, nearly 700 UK volunteers were randomly assigned to one of two groups - a gradual quit group or an immediate quit group. All of the participants were also offered advice and support and access to nicotine patches and replacement therapy, like nicotine gum or mouth spray - services which are available for free on the NHS. After six months, 15.5% of the participants in the gradual-cessation group were abstinent compared with 22% in the abrupt-cessation group. Lead researcher Dr Nicola Lindson-Hawley, from Oxford University, said: "The difference in quit attempts seemed to arise because people struggled to cut down. It provided them with an extra thing to do, which may have put them off quitting altogether." Even though more people in the study said they preferred the idea of quitting gradually than abruptly, individuals were still more likely to stop for good in the abrupt group. © 2016 BBC.
Keyword: Drug Abuse
Link ID: 21993 - Posted: 03.16.2016
The CDC recommends non-opioid therapy, including exercise and over-the-counter pain medications, as the preferred treatment for chronic pain. It says opioids should only be prescribed — at the lowest effective dosage possible — when the benefits from pain reduction and bodily function outweigh the risks. In 2014, American doctors wrote nearly 200 million prescriptions for opioid painkillers, while deaths linked to the drugs climbed to roughly 19,000 — the highest number on record. The number of Canadians who die every year from opioids is not readily known — the Canadian Centre on Substance Abuse does not track the statistics — but Toronto physician Nav Persaud told CBC News in 2014 that more than 1,000 Canadians die from painkillers every year. A 2012 study says one in eight deaths among young adults age 25 to 34 in Ontario and one out of every 170 deaths in the province as a whole are opioid overdoses. One in four people who entered a withdrawal management program at St. Joseph's Healthcare in Hamilton, Ont., were opioid patients in 2012, up from one in ten in 2002. Other studies have cast doubt on the effectiveness of opioids on chronic pain, raising questions on whether its limited long-term effects are worth the harmful risks. "The science is clear," CDC director Tom Frieden said Tuesday. "For the vast majority of patients, the known and often fatal risks [of opioids] far outweigh the proven and transient benefits." ©2016 CBC/Radio-Canada.