Chapter 4. The Chemistry of Behavior: Neurotransmitters and Neuropharmacology
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Laura Sanders Fewer teenagers in the United States used drugs in 2016 than in previous decades. The positive news comes from an annual survey of almost 45,500 U.S. students in grades eight, 10 and 12. “There’s a lot of good news here,” says pediatrician Sharon Levy of Boston Children’s Hospital. Public health messages from pediatricians, educators and others seem to be sinking in, she says. “I think that’s fabulous. Substance use is one of the most important — yet modifiable — behavioral health issues of adolescents.” Adolescents’ use of many of the substances, including alcohol and cigarettes, hit an all-time low since the survey, known as the Monitoring the Future study, began collecting data 42 years ago. Heroin, methamphetamines, inhalants and stimulants also hit lows this year. E-cigarettes have been particularly concerning as more adolescents gave the new devices a try, reaching a high in 2015 (SN: 5/28/16, p. 4). For the first time, the number of students who vape is declining, the survey found. In 2015, 16.3 percent of 12th-graders reported vaping in the last 30 days. In 2016, that fell to 12.5. Similar declines were evident among eighth- and 10th-graders. In a happy surprise, misuse of prescription opioid use decreased in the last five years among 12th-graders. The drop was “a big surprise,” particularly against a backdrop of a much wider opioid epidemic in the general population (SN: 9/3/16, p. 14), Nora Volkow, the director of the National Institute on Drug Abuse in Bethesda, Md., said December 13 at a news briefing. |© Society for Science & the Public 2000 - 2016.
Keyword: Drug Abuse
Link ID: 22984 - Posted: 12.14.2016
By CATHERINE SAINT LOUIS As the opioid epidemic sweeps through rural America, an ever-greater number of drug-dependent newborns are straining hospital neonatal units and draining precious medical resources. The problem has grown more quickly than realized and shows no signs of abating, researchers reported on Monday. Their study, published in JAMA Pediatrics, concludes for the first time that the increase in drug-dependent newborns has been disproportionately larger in rural areas. The rising rates are due largely to widening use of opioids among pregnant women, the researchers found. From 2004 to 2013, the proportion of newborns born dependent on drugs increased nearly sevenfold in hospitals in rural counties, to 7.5 per 1,000 from 1.2 per 1,000. By contrast, the uptick among urban infants was nearly fourfold, to 4.8 per 1,000 from 1.4 per 1,000. “The problem is accelerating in rural areas to a greater degree than in urban areas,” said Dr. Veeral Tolia, a neonatologist who works at Baylor University Medical Center in Dallas and was not involved in the new report. Other recent studies have underscored the breadth of the problem. The hospital costs associated with treating addicted newborns rose to $1.5 billion in 2013, from $732 million in 2009, according to a study in the Journal of Perinatology. Some neonatal intensive care units, called NICUs, now devote 10 percent of their hours to caring for infants who have withdrawal symptoms. Hospitals in the eye of this storm are commonly underresourced, experts said. “Typically, rural hospitals that deliver babies have traditionally focused on the lower-risk population in areas they serve,” said Dr. Alison V. Holmes, an associate professor of pediatrics at Geisel School of Medicine at Dartmouth. © 2016 The New York Times Company
By BENEDICT CAREY About one in six American adults reported taking at least one psychiatric drug, usually an antidepressant or an anti-anxiety medication, and most had been doing so for a year or more, according to a new analysis. The report is based on 2013 government survey data on some 242 million adults and provides the most fine-grained snapshot of prescription drug use for psychological and sleep problems to date. “I follow this area, so I knew the numbers would be high,” said Thomas J. Moore, a researcher at the Institute for Safe Medication Practices, a nonprofit in Alexandria, Va., and the lead author of the analysis, which was published Monday in JAMA Internal Medicine. “But in some populations, the rates are extraordinary.” Mr. Moore and his co-author, Donald R. Mattison of Risk Sciences International in Ottawa, combed household survey and insurance data compiled by the federal Agency for Healthcare Research and Quality. They found that one in five women had reported filling at least one prescription that year — about two times the number of men who had — and that whites were about twice as likely to have done so than blacks or Hispanics. Nearly 85 percent of those who had gotten at least one drug had filled multiple prescriptions for that drug over the course of the year studied, which the authors considered long-term use. “To discover that eight in 10 adults who have taken psychiatric drugs are using them long term raises safety concerns, given that there’s reason to believe some of this continued use is due to dependence and withdrawal symptoms,” Mr. Moore said. Dr. Mark Olfson, a professor of psychiatry at Columbia University, who was not involved in the study, said the new analysis provided a clear, detailed picture of current usage: “It reflects a growing acceptance of and reliance on prescription medications” to manage common emotional problems, he said. © 2016 The New York Times Company
By MATT RICHTEL Soaring use of e-cigarettes among young people “is now a major public health concern,” according to a report being published Thursday from the United States Surgeon General. It is the first comprehensive look on the subject from the nation’s highest public-health authority, and it finds that e-cigarettes are now the most commonly used tobacco product among youths, surpassing tobacco cigarettes. E-cigarettes, which turn nicotine into inhalable vapor, can harm developing brains of teenagers who use them, and also can create harmful aerosol for people around the user, the equivalent of secondhand smoke, the report said, citing studies in animals. “Adolescent brains are particularly sensitive to nicotine’s effects,” and can experience “a constellation of nicotine-induced neural and behavioral alterations,” the report said. It urged stronger action to prevent young people from getting access to e-cigarettes. Some researchers have said that e-cigarette use among youth could act as a gateway to traditional smoking, but the report says the relationship is not yet fully established. Cigarette smoking among youth has fallen sharply in recent years but use of nicotine products over all remains essentially flat among young people. With its focus on youth, the report did not address adult use of e-cigarettes, and the most divisive issue of whether the technology is an effective tool to help smokers of traditional cigarettes quit their deadly habit. The report also did not break new scientific ground, but public health advocates said the voice of the surgeon general in the debate marked a milestone. “It’s the most comprehensive and objective answer to the question of whether e-cigarette use is a matter of serious concern that requires government action,” said Matthew Myers, President of the Campaign for Tobacco Free Kids. “The answer, based on the findings, is: yes.” © 2016 The New York Times Company
People who consistently smoked an average of less than one cigarette per day over their lifetime had a 64 percent higher risk of earlier death than never smokers, and those who smoked between one and 10 cigarettes a day had an 87 percent higher risk of earlier death than never smokers, according to a new study from researchers at the National Cancer Institute (NCI). Risks were lower among former low-intensity smokers compared to those who were still smokers, and risk fell with earlier age at quitting. The results of the study were reported Dec. 5, 2016, in JAMA Internal Medicine. NCI is part of the National Institutes of Health. When researchers looked at specific causes of death among study participants, a particularly strong association was observed for lung cancer mortality. Those who consistently averaged less than one cigarette per day over their lifetime had nine times the risk of dying from lung cancer than never smokers. Among people who smoked between one and 10 cigarettes per day, the risk of dying from lung cancer was nearly 12 times higher than that of never smokers. The researchers looked at risk of death from respiratory disease, such as emphysema, as well as the risk of death from cardiovascular disease. People who smoked between one and 10 cigarettes a day had over six times the risk of dying from respiratory diseases than never smokers and about one and half times the risk of dying of cardiovascular disease than never smokers. Smoking has many harmful effects on health, which have been detailed in numerous studies since the U.S. Surgeon General’s 1964 report linking smoking to lung cancer. The health effects of consistent low-intensity smoking, however, have not been well studied and many smokers believe that low-intensity smoking does not affect their health.
Keyword: Drug Abuse
Link ID: 22954 - Posted: 12.06.2016
Sarah Boseley Health editor A single dose of psilocybin, the active ingredient of magic mushrooms, can lift the anxiety and depression experienced by people with advanced cancer for six months or even longer, two new studies show. Researchers involved in the two trials in the United States say the results are remarkable. The volunteers had “profoundly meaningful and spiritual experiences” which made most of them rethink life and death, ended their despair and brought about lasting improvement in the quality of their lives. The results of the research are published in the Journal of Psychopharmacology together with no less than ten commentaries from leading scientists in the fields of psychiatry and palliative care, who all back further research. While the effects of magic mushrooms have been of interest to psychiatry since the 1950s, the classification of all psychedelics in the US as schedule 1 drugs in the 1970s, in the wake of the Vietnam war and the rise of recreational drug use in the hippy counter-culture, has erected daunting legal and financial obstacles to running trials. “I think it is a big deal both in terms of the findings and in terms of the history and what it represents. It was part of psychiatry and vanished and now it’s been brought back,” said Dr Stephen Ross, director of addiction psychiatry at NYU Langone Medical Center and lead investigator of the study that was based there. © 2016 Guardian News and Media Limited
By Nicole Ireland, CBC News Ten years ago, litigation lawyer Michele Hollins was a "perpetually happy person," with twin daughters and a partnership in her Calgary law firm. Then, depression struck. For a while, Hollins was able to hide her illness at work, then go home and "become a complete automaton," she says, unable to eat or even muster the energy to get ready for bed. At its worst, the depression crippled her at work, to the point where Hollins would walk into her office, say hello to her assistant and then "close the door and lay on the floor and cry for hours." At her lowest point, she says she would "spend most of the day trying to figure out how to collect myself enough to get to my car and get home." That raw vulnerability doesn't match the general impression society has of lawyers as tough and ambitious. But research suggests that they are at much higher risk of depression, anxiety and substance abuse issues than people in the broader population — and may even be more susceptible than those in other high-stress professions, such as medicine. A U.S. study published in the Journal of Addiction Medicine last February found the rate of problem drinking among lawyers was between two and three times higher than among other highly educated professionals, including physicians. The study was funded by the American Bar Association and the Hazelden Betty Ford Foundation. The rate of depression was about three times higher than the general population in the U.S., according to lead researcher Patrick Krill, who will be presenting his research to lawyers and law students in Toronto on Monday at a professional development session hosted by the Law Society of Upper Canada. ©2016 CBC/Radio-Canada.
By NICHOLAS BAKALAR Having one or two alcoholic drinks a day is associated with a lower risk of stroke, a review of studies has found. But drinking more than that increases the risk. The analysis, in BMC Medicine, used data from 27 studies. Compared with nondrinkers or occasional drinkers, people who had one or two drinks a day had an 8 percent reduced risk of ischemic stroke. Ischemic strokes, caused by blockage of an artery supplying blood to the brain, account for about 87 percent of all strokes. Heavier drinking, however, increased stroke risk. Having up to four daily drinks led to an 8 percent increased risk of ischemic stroke, and at more than four drinks, the risk increased by 14 percent. Drinking more than four drinks a day also increased the risk of hemorrhagic stroke, the result of a burst or leaking blood vessel in or near the brain, by up to 82 percent. More moderate drinking did not raise hemorrhagic stroke risk. The lead author, Susanna C. Larsson, an associate professor of epidemiology at the Karolinska Institutet in Sweden, warned that alcohol is not health food. “Nondrinkers should not start to drink as a health measure,” she said. “And I wouldn’t recommend that a person who has a drink or two on the weekend increase his consumption.” © 2016 The New York Times Company
Tom Goldman Voters in seven more states said "yes" to marijuana this month. Pot now is legal for recreational or medicinal use in more than half the country. It's still against federal law and classified as a Schedule 1 drug, meaning U.S. officials consider marijuana to have a high risk of abuse or harm, and no accepted medical use in treatment. Also, it's still banned in professional sports. Many athletes hope that will change as momentum grows nationwide for legalization. That's especially true in the National Football League, where pain is a constant companion. Advocates say marijuana could offer a safer and better way to manage the pain. Football hurts. As a fan watching from home, that's not always obvious — players collide, fall down, pop back up. They rarely wince or show weakness. That's just not how it's done in football. Kyle Turley hurt plenty during his eight NFL seasons in the 1990s and 2000s. As an offensive lineman, he was involved in jarring collisions nearly every play when his team had the ball. He hurt after his career -– Turley sometimes walks with a cane. And in a recent video, he displayed one by one the bottles of powerful painkillers he used. "Vicodin, Flexeril, Percocets, Vioxx, morphine," Turley recited as he plopped the bottles down on a kitchen counter. © 2016 npr
Sara Reardon Lasers shone into the brains of mice can now activate individual neurons — and change the animals behaviour. Scientists have used the technique to increase how fast mice drink a milkshake, but it could also help researchers to map brain functions at a much finer scale than is currently possible. Neuroscientists at Stanford University in California conducted their experiments on mice that were genetically engineered to have light-sensitive neurons in a brain region called the orbitofrontal cortex. That area is involved in perceiving, and reacting to, rewards. By shining a laser at specific neurons, the researchers increased the pace at which the mice consumed a high-calorie milkshake. The results, reported on 12 November at the annual meeting of the Society for Neuroscience in San Diego, California, illustrate for the first time that the technique, known as optogenetics, can control behaviour by activating a sequence of individual cells. One goal of optogenetics is to create automated systems that manipulate the brain on the fly using only light, says Michael Häusser, a neuroscientist at University College London, UK. This might be done by engineering neurons to contain one protein that makes the cell fire when activated by a flash of coloured light, and another that causes the cell to flash in a different colour when it fires. A device that detected this second colour could quickly determine sites of activity associated with certain behaviours and customize which cells the first light would stimulate in response. Such a system might be able to alter the neural processes that link alcohol with reward in addiction, or a visual trigger with flashbacks in post-traumatic stress disorder. © 2016 Macmillan Publishers Limited,
By Greg Miller In the mid-19th century, some European doctors became fascinated with a plant-derived drug recently imported from India. Cannabis had been used as medicine for millennia in Asia, and physicians were keen to try it with their patients. No less an authority than Sir John Russell Reynolds, the house physician to Queen Victoria and later president of the Royal College of Physicians in London, extolled the medical virtues of cannabis in The Lancet in 1890. “In almost all painful maladies I have found Indian hemp by far the most useful of drugs,” Reynolds wrote. Like other doctors of his day, Reynolds thought cannabis might help reduce the need for opium-based painkillers, with their potential for abuse and overdose. “The bane of many opiates and sedatives is this, that the relief of the moment, the hour, or the day, is purchased at the expense of to-morrow’s misery,” he wrote. “In no one case to which I have administered Indian hemp, have I witnessed any such results.” More than 125 years later, the misery caused by opioids is clearer than ever, and there are new hints that cannabis could be a viable alternative. Some clinical studies suggest that the plant may have medical value, especially for difficult-to-treat pain conditions. The liberalization of marijuana laws in the United States has also allowed researchers to compare overdoses from painkiller prescriptions and opioids in states that permit medical marijuana versus those that don’t. Yet following up on those hints isn’t easy. Clinical studies face additional hurdles because the plant is listed on Schedule I, the U.S. Drug Enforcement Administration’s (DEA’s) list of the most dangerous drugs. © 2016 American Association for the Advancement of Science.
Keyword: Drug Abuse
Link ID: 22832 - Posted: 11.04.2016
Ian Sample Science editor The devastating impact of cigarette smoke on the body’s DNA has been laid bare by the first comprehensive study into the damage tobacco inflicts on human cells. People who smoke a pack of cigarettes each day for a year develop on average 150 extra mutations in every lung cell, and nearly 100 more mutations than usual in each cell of the voice box, researchers found. More still build up in the mouth, bladder, liver and other organs. While chemicals in tobacco smoke have long been known to raise the risk of at least 17 forms of cancer, the precise molecular mechanisms through which they mutate DNA and give rise to tumours in different tissues have never been clear. “This is about running down the root cause of cancers,” said David Phillips, a professor of environmental carcinogenesis at King’s College London and a co-author on the study. “By identifying the root causes, we gain the sort of knowledge we need to think more seriously about cancer prevention.” More than 70 of the 7,000 chemicals found in tobacco smoke are known to cause cancer. Some damage DNA directly, but others ramp up mutations in more subtle ways, often by disrupting the way cells function. The more mutations a cell acquires, the more likely it is to turn cancerous. © 2016 Guardian News and Media Limited
Keyword: Drug Abuse
Link ID: 22828 - Posted: 11.04.2016
By SABRINA TAVERNISE WASHINGTON — A decade after electronic cigarettes were introduced in the United States, use has flattened, sales have slowed and, this fall, NJoy, once one of the country’s biggest e-cigarette manufacturers, filed for bankruptcy. It is quite a reversal for an invention once billed as the biggest chance to end smoking as we know it and take aim at the country’s largest cause of preventable death. Use of the devices is slumping because they are not as good as cigarettes at giving a hit of nicotine. Dealing another strike against them, the country’s top public health authorities have sent an unwavering message: Vaping is dangerous. The warning is meant to stop people who have never smoked — particularly children — from starting to vape. But a growing number of scientists and policy makers say the relentless portrayal of e-cigarettes as a public health menace, however well intentioned, is a profound disservice to the 40 million American smokers who could benefit from the devices. Smoking kills more than 480,000 Americans a year. “We may well have missed, or are missing, the greatest opportunity in a century,” said David B. Abrams, senior scientist at the Truth Initiative, an antismoking group. “The unintended consequence is more lives are going to be lost.” American public health experts, led by the Centers for Disease Control and Prevention, have long been suspicious of e-cigarettes. The possible risks of vaping are vast, officials warn, including the potential to open a dangerous new door to addiction for youth. Scientists will not know the full effect for years, so for now, they caution, be wary. But mounting evidence suggests vaping is far less dangerous than smoking, a fact that is rarely pointed out to the American public. Britain, a country with about the same share of smokers, has come to the opposite conclusion from the United States. This year, a prestigious doctors’ organization told the public that e-cigarettes were 95 percent less harmful than cigarettes. British health officials are encouraging smokers to switch. © 2016 The New York Times Company
Keyword: Drug Abuse
Link ID: 22826 - Posted: 11.03.2016
By Laura Wright, Researchers have the clearest-ever picture of the receptor that gives humans the 'high' from marijuana, which could lead to a better understanding of how the drug affects humans. Scientists have long known that molecules from THC, the psychoactive component of marijuana, bind to and activate the receptor known as CB1. But now they know that it has a three-dimensional crystal structure. The authors of the paper, which was published Thursday in the journal Cell, say this information is crucial to improve our understanding of this receptor as marijuana use becomes widespread and, in many places, legalized. Now that they know the shape of the receptor, they can get a better idea of how different molecules bind to it, which is what causes reactions in humans. "What is important is to understand how different molecules bind to the receptor, how they control the receptor function, and how this can affect different people," said Raymond Stevens, co-author of the study. Dr. Mark Ware, the executive director of the Canadian Consortium for the Investigation of Cannabinoids and the director of clinical research at the Alan Edwards pain management unit at the McGill University Health Centre, called the discovery a "breakthrough." "Suddenly we've been given the design of the building," he explained. "We can work out ways to get in the building, we know where the windows and doors and stairs are, and we know kind of how the building is structured now." They both said that knowing the receptor's design can lead to better drug design. K2 synthetic pot It's also a key step to understanding the differences between natural cannabinoids, found in the marijuana plant, and synthetic cannabinoids, made in labs. ©2016 CBC/Radio-Canada.
Keyword: Drug Abuse
Link ID: 22776 - Posted: 10.22.2016
By DONNA DE LA CRUZ Some of the most troubling images of the opioid crisis involve parents buying or using drugs with their children in tow. Now new research offers a glimpse into the addicted brain, finding that the drugs appear to blunt a person’s natural parenting instincts. Researchers at the Perelman School of Medicine at the University of Pennsylvania scanned the brains of 47 men and women before and after they underwent treatment for opioid dependence. While in the scanner, the study subjects looked at various images of babies, and the researchers measured the brain’s response. The brain scans were compared with the responses of 25 healthy people. What the study subjects didn’t know was that the photos had been manipulated to adjust the “baby schema,” the term used to describe the set of facial and other features like round faces and big eyes that make our brains register babies as irresistible, kicking in our instinct to care for them. Sometimes the babies’ features were exaggerated to make them even more adorable; in others, the chubby cheeks and big eyes were reduced, making the faces less appealing. Studies show that a higher baby schema activates the part of the brain called the ventral striatum, a key component of the brain reward pathway. Compared with the brains of healthy people, the brains of people with opioid dependence didn’t produce strong responses to the cute baby pictures. But once the opioid-dependent people received a drug called naltrexone, which blocks the effects of opioids, their brains produced a more normal response. “When the participants were given an opioid blocker, their baby schema became more similar to that of healthy people,” said Dr. Daniel D. Langleben, one of the researchers. “The data also raised in question whether opioid medications may affect social cognition in general.” © 2016 The New York Times Company
Lauren Silverman It's been a wild ride for kratom lately. Since Aug. 31, when the Drug Enforcement Administration announced its intention to classify the plant as a Schedule I substance, a group of kratom vendors filed a lawsuit against the government to block the move, angry advocates took to social media in protest and scientists questioned whether they would be able to continue kratom research. Now, the DEA is withdrawing its notice of intent to put kratom in the most restrictive category of controlled substances, with drugs like LSD and heroin. The DEA says it will instead open an official public comment period — to last until Dec. 1, 2016 — for people to share their experiences using kratom as a medical treatment. It has also requested that the Food and Drug Administration expedite scientific research. DEA spokesman Russ Baer says the DEA received more than 2,000 phone calls since August, mostly in opposition to the plan to classify kratom as Schedule I. "So in a spirit of transparency, and to open this up to public dialogue, we withdrew our notice to temporarily schedule kratom," Baer says. "We will then give full consideration to those comments before we move forward with any action." Kratom is derived from the leaves of a tree native to Southeast Asia. It is a relative of the coffee plant. According to David Kroll, a pharmacologist and medical writer, farmers and indigenous people have used it for hundreds of years as both a stimulant to increase work output and also as a way to relax. © 2016 npr
Keyword: Drug Abuse
Link ID: 22752 - Posted: 10.13.2016
By MIKE IVES HONG KONG — President Rodrigo Duterte of the Philippines was elected in May after pledging to kill 100,000 criminals in his first six months in office, vowing that fish in Manila, the capital, would grow fat from eating the bodies of drug dealers and other “do nothings.” In Mr. Duterte’s first three months as president, his bloody campaign led to the killing of about 1,400 drug suspects by the police and hundreds of others by extrajudicial means, according to official estimates. He has also publicly accused thousands of government officials of being involved in the drug trade, in some cases offering no evidence. The campaign has taken particular aim at people who use or sell shabu, a cheap form of methamphetamine that has caused grave health and social problems across the country. Mr. Duterte has likened shabu addicts to zombies and claimed — absent evidence — that many are “no longer viable for rehabilitation” because abusing the drug shrinks their brains. What is methamphetamine? Methamphetamine is an addictive stimulant that can be made from ephedrine and other readily available chemicals. It typically comes in either tablets, called yaba in parts of Asia, or crystalline form. The first variety is common in mainland Southeast Asia, and the second — known as shabu, ice or crystal meth, among other names — is more popular in the Philippines and many other countries. It also tends to be more potent and more deeply intertwined with international drug manufacturing and smuggling networks, according to a report by the United Nations Office on Drugs and Crime. How does the drug affect people who use it? Smoking, snorting, ingesting or injecting methamphetamine can cause aggression, memory loss and a range of other health complications, including heart attack or sudden death. Links between methamphetamine abuse and crime, disease transmission and other social problems have also been documented. A study by the RAND Corporation found that the effects of methamphetamine abuse, including the burden of addiction and treatment, cost the United States $23.4 billion in 2005. © 2016 The New York Times Company
Keyword: Drug Abuse
Link ID: 22751 - Posted: 10.13.2016
By CASEY SCHWARTZ Have you ever been to Enfield? I had never even heard of it until I was 23 and living in London for graduate school. One afternoon, I received notification that a package whose arrival I had been anticipating for days had been bogged down in customs and was now in a FedEx warehouse in Enfield, an unremarkable London suburb. I was outside my flat within minutes of receiving this news and on the train to Enfield within the hour, staring through the window at the gray sky. The package in question, sent from Los Angeles, contained my monthly supply of Adderall. Adderall, the brand name for a mixture of amphetamine salts, is more strictly regulated in Britain than in the United States, where, the year before, in 2005, I became one of the millions of Americans to be prescribed a stimulant medication. The train to Enfield was hardly the greatest extreme to which I would go during the decade I was entangled with Adderall. I would open other people’s medicine cabinets, root through trash cans where I had previously disposed of pills, write friends’ college essays for barter. Once, while living in New Hampshire, I skipped a day of work to drive three hours each way to the health clinic where my prescription was still on file. Never was I more resourceful or unswerving than when I was devising ways to secure more Adderall. Adderall is prescribed to treat Attention Deficit Hyperactivity Disorder, a neurobehavioral condition marked by inattention, hyperactivity and impulsivity that was first included in the D.S.M. in 1987 and predominantly seen in children. That condition, which has also been called Attention Deficit Disorder, has been increasingly diagnosed over recent decades: In the 1990s, an estimated 3 to 5 percent of school-age American children were believed to have A.D.H.D., according to the Centers for Disease Control and Prevention; by 2013, that figure was 11 percent. It continues to rise. And the increase in diagnoses has been followed by an increase in prescriptions. In 1990, 600,000 children were on stimulants, usually Ritalin, an older medication that often had to be taken multiple times a day. By 2013, 3.5 million children were on stimulants, and in many cases, the Ritalin had been replaced by Adderall, officially brought to market in 1996 as the new, upgraded choice for A.D.H.D. — more effective, longer lasting. © 2016 The New York Times Company
By Gareth Cook According to the American Psychiatric Association, about 5 percent of American children suffer from Attention Deficit Hyperactivity Disorder (ADHD), yet the diagnosis is given to some 15 percent of American children, many of whom are placed on powerful drugs with lifelong consequences. This is the central fact of the journalist Alan Schwarz’s new book, ADHD Nation. Explaining this fact—how it is that perhaps two thirds of the children diagnosed with ADHD do not actually suffer from the disorder—is the book’s central mystery. The result is a damning indictment of the pharmaceutical industry, and an alarming portrait of what is being done to children in the name of mental health. What prompted you to write this book? In 2011, having spent four years exposing the dangers of concussions in the National Football League and youth sports for The New York Times, I wanted another project. I had heard that high school students in my native Westchester County (just north of New York City) were snorting Adderall before the S.A.T.'s to focus during the test. I was horrified and wanted to learn more. I saw it not as a "child psychiatry" story, and not as a "drug abuse" story, but one about academic pressure and the demands our children feel they're under. When I looked deeper, it was obvious that our nationwide system of ADHD treatment was completely scattershot—basically, many doctors were merely prescribing with little thought into whether a kid really had ADHD or not, and then the pills would be bought and sold among students who had no idea what they were messing with. I asked the ADHD and child-psychiatry establishment about this, and they denied it was happening. They denied that there were many false diagnoses. They denied that teenagers were buying and selling pills. They denied that the national diagnosis rates reported by the C.D.C.—then 9.5 percent of children aged 4-17, now 11 percent and still growing—were valid. They basically denied that anything about their world was malfunctioning at all. In the end, they doth protest too much. I wrote about 10 front-page stories for The New York Times on the subject from 2012-2014. © 2016 Scientific American,
Ben Allen Louis Casanova is playing cards with a friend on the back deck of a recovery house in Philadelphia's northern suburbs. He's warm and open as he talks about his past few years. The guy everyone calls Louie started using drugs like Xanax and Valium during his freshman year of high school. At age 18, Casanova turned to heroin. About two years later, the rehab shuffle began. "I relapsed and then I was just getting high. And then I went to treatment again in February of 2015," he says. "Then I relapsed again and went back to treatment." He's 23 now. He's hurt people close to him and his criminal record, fueled by his drug addiction, is long. By Louie's count, he has been through eight inpatient rehabs. Louis says his stays have ranged from about 18 to 45 days. "I did 30 days, and after that I came here," he concludes, talking about his latest visit. A month's stay can be pretty typical among people who go to an inpatient facility. But why? "As far as I know, there's nothing magical about 28 days," says Kimberly Johnson, director of the Center for Substance Abuse Treatment at SAMHSA, the federal agency that studies treatment services. Anne Fletcher, author of the book Inside Rehab, agrees. "It certainly is not scientifically based," she says. "I live in Minnesota where the model was developed and a lot of treatment across the country really stemmed from that." She says the late Daniel Anderson was one of the primary architects of the "Minnesota model," which became the prevailing treatment protocol for addiction specialists. At a state hospital in Minnesota in the 1950s, Anderson saw alcoholics living in locked wards, leaving only to be put to work on a farm. © 2016 npr
Keyword: Drug Abuse
Link ID: 22719 - Posted: 10.02.2016