Chapter 4. The Chemistry of Behavior: Neurotransmitters and Neuropharmacology
Follow us on Facebook and Twitter, or subscribe to our mailing list, to receive news updates. Learn more.
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.
By ANDREW POLLACK An experimental drug derived from marijuana has succeeded in reducing epileptic seizures in its first major clinical trial, the product’s developer announced on Monday, a finding that could lend credence to the medical marijuana movement. The developer, GW Pharmaceuticals, said the drug, Epidiolex, achieved the main goal of the trial, reducing convulsive seizures when compared with a placebo in patients with Dravet syndrome, a rare form of epilepsy. GW shares more than doubled on Monday. If Epidiolex wins regulatory approval, it would be the first prescription drug in the United States that is extracted from marijuana. The drug is a liquid containing cannabidiol, a component of marijuana that does not make people high. As many as 30 percent of the nearly 500,000 American children with epilepsy are not sufficiently helped by existing drugs, according to GW. Parents of some of these children have been flocking to try marijuana extracts, prepared by medical marijuana dispensaries. A number of states, in response to pressure from these parents, have passed or considered legislation to make it easier to obtain marijuana-based products. And some families have become “marijuana refugees,” moving to Colorado where it has been easier to obtain a particular extract, known as Charlotte’s Web, after the girl who first used it to control seizures. Hundreds of other children and young adults have been using Epidiolex outside of clinical trials, under programs that allow desperate patients to use experimental drugs. While many parents have reported significant reductions in seizures, experts have been cautious about anecdotal reports, saying that such treatments needed to be compared with a placebo to make sure they work. As such, the results from the GW trial have been closely watched. © 2016 The New York Times Company
By KATHARINE Q. SEELYE CAMBRIDGE, Mass. — In Philadelphia last spring, a man riding a city bus at rush hour injected heroin into his hand, in full view of other passengers, including one who captured the scene on video. In Cincinnati, a woman died in January after she and her husband overdosed in their baby’s room at Cincinnati Children’s Hospital Medical Center. The husband was found unconscious with a gun in his pocket, a syringe in his arm and needles strewn around the sink. Here in Cambridge a few years ago, after several people overdosed in the bathrooms of a historic church, church officials reluctantly closed the bathrooms to the public. “We weren’t medically equipped or educated to handle overdoses, and we were desperately afraid we were going to have something happen that was way out of our reach,” said the Rev. Joseph O. Robinson, rector of the church, Christ Church Cambridge. With heroin cheap and widely available on city streets throughout the country, users are making their buys and shooting up as soon as they can, often in public places. Police officers are routinely finding drug users — unconscious or dead — in cars, in the bathrooms of fast-food restaurants, on mass transit and in parks, hospitals and libraries. The visibility of drug users may be partly attributed to the nature of the epidemic, which has grown largely out of dependence on legal opioid painkillers and has spread to white, urban, suburban and rural areas. © 2016 The New York Times Company
Keyword: Drug Abuse
Link ID: 21961 - Posted: 03.07.2016
By ANNA FELS THERE was something odd about my new patient. She was elegantly dressed and self-possessed, and yet she was slowly, rhythmically chewing gum, something I rarely see in my psychiatry sessions. Was she trying to cover up anxiety about this first encounter, I wondered, or was she perhaps hoping to project a kind of cool, laid-back style? We talked for a long time about why she had come to see me. Then, as is my practice with a new patient, I asked what, if any, psychiatric medications and nonprescription, psychoactive substances — legal or illegal — she had used. Her answer was a new one for me. She stated that she chewed approximately 40 pieces of nicotine gum per day and had done so for well over a decade. Responses to this question are often illuminating and can be rather humbling. Although doctors are trained to focus on prescription medications, there are and have always been nonprescription “remedies” for psychiatric conditions. And people’s preferences for one type of substance over another can give a glimpse into their symptoms and even their brain chemistry. If a patient tells me he falls asleep on cocaine, I wonder if he might have attention deficit disorder. A patient who smokes marijuana to calm down before important business meetings leads me in the direction of social phobia or other anxiety disorders. I often wonder if people who take ketamine recreationally might be depressed, since this anesthetic has been shown to have antidepressant effects and is, in fact, being investigated for potential therapeutic use. Sorting through patients’ uses of psychoactive substances, from cocaine to alcohol to coffee, leaves me with an appreciation of the wildly different neurochemistry of people’s brains. One person will drink alcohol and feel euphoric, witty and extroverted, and the next will be logy and nauseated. © 2016 The New York Times Company
Keyword: Drug Abuse
Link ID: 21960 - Posted: 03.07.2016
Angus Chen We know we should put the cigarettes away or make use of that gym membership, but in the moment, we just don't do it. There is a cluster of neurons in our brain critical for motivation, though. What if you could hack them to motivate yourself? These neurons are located in the middle of the brain, in a region called the ventral tegmental area. A paper published Thursday in the journal Neuron suggests that we can activate the region with a little bit of training. The researchers stuck 73 people into an fMRI, a scanner that can detect what part of the brain is most active, and focused on that area associated with motivation. When the researchers said "motivate yourself and make this part of your brain light up," people couldn't really do it. "They weren't that reliable when we said, 'Go! Get psyched. Turn on your VTA,' " says Dr. Alison Adcock, a psychiatrist at Duke and senior author on the paper. That changed when the participants were allowed to watch a neurofeedback meter that displayed activity in their ventral tegmental area. When activity ramps up, the participants see the meter heat up while they're in the fMRI tube. "Your whole mind is allowed to speak to a specific part of your brain in a way you never imagined before. Then you get feedback that helps you discover how to turn that part of the brain up or down," says John Gabrieli, a neuroscientist at the Massachusetts Institute of Technology who was not involved with the work. © 2016 npr
Link ID: 21954 - Posted: 03.05.2016
Ewan Birney The Daily Mail recently ran an article about how alcohol abuse could harm future generations, via the (exciting-sounding) mechanism of trans-generational epigenetics. This is an emotive topic, combining a commonplace habit (drinking beer and wine) with a scary outcome (harming your children, grandchildren and future generations) and adding a twist of science for gravitas. It’s not surprising that this research has been handed a megaphone by the mainstream press – but does the science stack up? To start with, the research was carried out in rats, as multi-generational experiments on humans are both grossly unethical and logistically extremely hard. This crucial bit of information is missing from both the Daily Mail headline and the paper’s title. Secondly, the big effects of alcohol consumption were mainly seen on the rats’ children and grandchildren – the effects on their great grandchildren were smaller. That is really important, because if there’s no effect on great grandchildren, it’s probably not due to epigenetics. Drinking large amounts of alcohol (for a rat) whilst pregnant would be expected to have an effect on the children and even the grandchildren. This is because the eggs of female mammals are made early on in foetal development, whilst a daughter is developing in the womb. So if that cell (the egg) also gives rise to a daughter, she will have directly experienced exposures that occurred during her maternal grandmother’s pregnancy. © 2016 Guardian News and Media Limited or its affiliated companies.
With the opioid epidemic reaching into every corner of the U.S., more people are talking about addiction as a chronic disease rather than a moral failing. For researcher A. Thomas McLellan, who has spent his entire career studying substance abuse, the shift is a welcome one, though it has come frustratingly late. McLellan is co-founder of the Treatment Research Institute in Philadelphia and former deputy director of the White House Office of National Drug Control Policy. His work has focused on understanding addiction as a disease and improving the ways it is treated, a mission that took a personal turn midway through his career when he lost a son to overdose. NPR's Audie Cornish spoke with McLellan about how addiction is viewed and how that view has shaped the treatment system we have today. He also has suggestions on how to make it better. On why addiction has traditionally been seen as a criminal justice issue, not a health issue Think about it. If you didn't have brain science, which has just really emerged in the last two or three decades, all you had to look at was the behavior of addicted people. They are not pleasant people when they are in full addiction. They steal, they lie, they swear they're going to do something and they don't. It's quite easy to think of this as it has been thought of for literally hundreds of years: as a character disorder, as poor upbringing as a problem of parenting. And that's how we approached it. It's not coincidence that the Justice Department has played such a pivotal role. The emerging science shows this is a brain disease. It's got the same genetic transmutability as a lot of chronic illnesses. And the organ that it affects is the brain, and within the brain it is motivation, inhibition, cognition, all those things that produce the aberrant, unpleasant behaviors that are associated with addiction. © 2016 npr
Keyword: Drug Abuse
Link ID: 21935 - Posted: 02.27.2016
By Roni Caryn Rabin Fatal prescription-drug overdoses in the United States have increased sharply in recent years. But while most of the deaths have involved opioid painkillers like oxycodone, a new study suggests that anti-anxiety medications now are playing an outsize role in overdose deaths. The number of Americans filling prescriptions for anti-anxiety drugs — benzodiazepines like Valium and Xanax that are used to treat anxiety, panic disorders and insomnia — increased 67 percent between 1996 and 2013, the study found. But the rate of overdose deaths involving these drugs increased more than fourfold. The analysis, published online last week in The American Journal of Public Health, found that 5.6 percent of American adults filled a benzodiazepine prescription in 2013, up from 4.1 percent in 1996. (The actual number of Americans filling a benzodiazepine prescription rose to 13.5 million in 2013, up from 8.1 million in 1996.) Meanwhile, the rate of overdose deaths involving anti-anxiety drugs reached 3.07 per 100,000 adults in 2013, up from 0.58 per 100,000 adults in 1996. With public attention focused primarily on opioid painkillers, the role of anti-anxiety drugs “fell under the radar,” said Dr. Marcus Bachhuber, the study’s author and an assistant professor of medicine at Montefiore Medical Center/Albert Einstein College of Medicine in the Bronx. Yet when benzodiazepines are abused or combined with other drugs or alcohol, they contribute to depressing the respiratory system, which can be deadly, he said. “If we’re going to address the prescription drug crisis, we can’t just focus on opioids,” he said. “We need to think more broadly about other drugs, like benzodiazepines.” © 2016 The New York Times Company
Keyword: Drug Abuse
Link ID: 21934 - Posted: 02.27.2016
By GABRIELLE GLASER On the rainy fall morning of their first appointment, Dr. Mark Willenbring, a psychiatrist, welcomed a young web designer into his spacious office with a firm handshake and motioned for him to sit. The slender 29-year-old patient, dressed in a plaid shirt, jeans and a baseball cap, slouched into his chair and began pouring out a story of woe stretching back a dozen years. Addicted to heroin, he had tried more than 20 traditional faith- and abstinence-based rehabilitation programs. In 2009, a brother died of an OxyContin overdose. Last summer, he attempted suicide by swallowing a fistful of Xanax. When he woke up to find he was still alive, he overdosed on heroin. At a boot camp for troubled teenagers, he said, staffers beat him and withheld food. After he refused to climb a mountain in a team-building exercise, they strapped him to a gurney and dragged him up themselves. The young man in the psychiatrist’s office paused, tears sliding down his cheeks. “Sounds like a prison camp,” Dr. Willenbring said softly, leaning forward in his chair to pass a box of tissues. He began explaining the neuroscience of alcohol and drug dependence, 60 percent of which, he said, is attributable to a person’s genetic makeup. Listening intently, the young patient seemed relieved at the idea that his previous failures in rehab might reflect more than a lack of will. Dr. Willenbring, 66, has repeated this talk hundreds of times. But while scientifically unassailable, it is not what patients usually hear at addiction treatment centers. © 2016 The New York Times Company
Keyword: Drug Abuse
Link ID: 21925 - Posted: 02.23.2016