Chapter 4. Development of the Brain

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Martha Bebinger For two decades — as opioid overdose deaths rose steadily — the federal government limited access to buprenorphine, a medication that addiction experts consider the gold-standard for treating patients with an opioid use disorder. Study after study shows it helps people continue addiction treatment while reducing the risk of overdose, and death. Clinicians who wanted to prescribe the medicine had to complete an 8-hour training. They could only treat a limited number of patients and had to keep special records. They were given a Drug Enforcement Administration (DEA) registration number starting with X, a designation that many doctors say made them a target for drug enforcement audits. "Just the process associated with taking care of our patients with a substance use disorder made us feel like, 'boy, this is dangerous stuff,'" says Dr. Bobby Mukkamala, who chairs the American Medical Association's task force on substance use disorder. "The science doesn't support that but the rigamarole suggested that." That rigamarole is mostly gone. Congress eliminated what became known as the "X-waiver" in legislation President Biden signed late last year. Now begins what some addiction experts are calling a truth serum moment. Was the X-waiver and the burdens that came with it the real reason only about 7% of clinicians in the U.S. were cleared to prescribe buprenorphine? Or was it an excuse that masked hesitation about treating addiction, if not outright disdain for these patients? There's great optimism among some leaders that getting rid of the X-waiver will expand access to buprenorphine and reduce overdoses. One study from 2021 shows taking buprenorphine reduces the risk by 50%. The medication is an opioid that produces much weaker effects than heroin or fentanyl and reduces cravings for those deadlier drugs. © 2023 npr

Keyword: Drug Abuse
Link ID: 28691 - Posted: 03.08.2023

By McKenzie Prillaman Psychedelics go beneath the cell surface to unleash their potentially therapeutic effects. These drugs are showing promise in clinical trials as treatments for mental health disorders (SN: 12/3/21). Now, scientists might know why. These substances can get inside nerve cells in the cortex — the brain region important for consciousness — and tell the neurons to grow, researchers report in the Feb. 17 Science. Several mental health conditions, including depression and post-traumatic stress disorder, are tied to chronic stress, which degrades neurons in the cortex over time. Scientists have long thought that repairing the cells could provide therapeutic benefits, like lowered anxiety and improved mood. Psychedelics — including psilocin, which comes from magic mushrooms, and LSD — do that repairing by promoting the growth of nerve cell branches that receive information, called dendrites (SN: 11/17/20). The behavior might explain the drugs’ positive outcomes in research. But how they trigger cell growth was a mystery. It was already known that, in cortical neurons, psychedelics activate a certain protein that receives signals and gives instructions to cells. This protein, called the 5-HT2A receptor, is also stimulated by serotonin, a chemical made by the body and implicated in mood. But a study in 2018 determined that serotonin doesn’t make these neurons grow. That finding “was really leaving us scratching our heads,” says chemical neuroscientist David Olson, director of the Institute for Psychedelics and Neurotherapeutics at the University of California, Davis. © Society for Science & the Public 2000–2023.

Keyword: Drug Abuse; Depression
Link ID: 28673 - Posted: 02.18.2023

By Laura Sanders You’d be forgiven for thinking that depression has a simple explanation. The same mantra — that the mood disorder comes from a chemical imbalance in the brain — is repeated in doctors’ offices, medical textbooks and pharmaceutical advertisements. Those ads tell us that depression can be eased by tweaking the chemicals that are off-kilter in the brain. The only problem — and it’s a big one — is that this explanation isn’t true. The phrase “chemical imbalance” is too vague to be true or false; it doesn’t mean much of anything when it comes to the brain and all its complexity. Serotonin, the chemical messenger often tied to depression, is not the one key thing that explains depression. The same goes for other brain chemicals. The hard truth is that despite decades of sophisticated research, we still don’t understand what depression is. There are no clear descriptions of it, and no obvious signs of it in the brain or blood. The reasons we’re in this position are as complex as the disease itself. Commonly used measures of depression, created decades ago, neglect some important symptoms and overemphasize others, particularly among certain groups of people. Even if depression could be measured perfectly, the disorder exists amid myriad levels of complexity, from biological confluences of minuscule molecules in the brain all the way out to the influences of the world at large. Countless combinations of genetics, personality, history and life circumstances may all conspire to create the disorder in any one person. No wonder the science is stuck. So here, up front, is your fair warning: There will be no satisfying wrap-up at the end of this story. You will not come away with a scientific explanation for depression, because one does not exist. But there is a way forward for depression researchers, Aftab says. It requires grappling with nuances, complexity and imperfect data. © Society for Science & the Public 2000–2023.

Keyword: Depression
Link ID: 28670 - Posted: 02.15.2023

By Ted Alcorn Ever wake up regretting the last round of drinks from the previous night? There’s a medicine that might help. A recent study adds to the evidence that people who binge-drink may benefit from taking a dose of the medication naltrexone before consuming alcohol, a finding that may be welcomed now that alcohol-related deaths in the United States have surpassed 140,000 a year. Nearly half of American drinkers reported bingeing, defined as more than four drinks in a sitting for men and more than three for women, in the previous month, according to a U.S. government health survey. Some may view binge-drinking as harmless because the habit is widespread and a low percentage of binge drinkers are dependent on alcohol, according to experts. But it is considered a major risk factor for alcohol-related illness and injuries, and it heightens the possibility that an individual will develop an alcohol disorder. In the study, which was published in December in the American Journal of Psychiatry, 120 men who wanted to reduce bingeing but were not severely dependent on alcohol were given naltrexone to take whenever they felt a craving for alcohol or anticipated a period of heavy drinking. Naltrexone, which blocks endorphins and reduces the euphoria of intoxication, was approved in the United States for the treatment of alcohol dependence nearly 30 years ago. But it is typically prescribed for patients with more severe alcohol disorders to take daily to abstain from drinking. The new study’s targeted approach, in which patients were advised to take the pill one hour before they expected to drink, is less common, although studies going back decades have also demonstrated the effectiveness of the as-needed dosing method. © 2023 The New York Times Company

Keyword: Drug Abuse
Link ID: 28666 - Posted: 02.15.2023

By Nicola Jones The first hurdle was simply getting hold of some cannabis, given that it was illegal. “I was lucky,” Mechoulam recounts in a personal chronicle of his life’s work, published this month in the Annual Review of Pharmacology and Toxicology. “The administrative head of my Institute knew a police officer. ... I just went to Police headquarters, had a cup of coffee with the policeman in charge of the storage of illicit drugs, and got 5 kg of confiscated hashish, presumably smuggled from Lebanon.” By 1964, Mechoulam and his colleagues had determined, for the first time, the full structure of both delta-9-tetrahydrocannabinol, better known to the world as THC (responsible for marijuana’s psychoactive “high”) and cannabidiol, or CBD. That chemistry coup opened the door for cannabis research. Over the following decades, researchers including Mechoulam would identify more than 140 active compounds, called cannabinoids, in the cannabis plant, and learn how to make many of them in the lab. Mechoulam helped to figure out that the human body produces its own natural versions of similar chemicals, called endocannabinoids, that can shape our mood and even our personality. And scientists have now made hundreds of novel synthetic cannabinoids, some more potent than anything found in nature. Today, researchers are mining the huge number of known cannabinoids — old and new, found in plants or people, natural and synthetic — for possible pharmaceutical uses. But, at the same time, synthetic cannabinoids have become a hot trend in recreational drugs, with potentially devastating impacts. For most of the synthetic cannabinoids made so far, the adverse effects generally outweigh their medical uses says biologist João Pedro Silva of the University of Porto in Portugal, who studies the toxicology of substance abuse, and coauthored a 2023 assessment of the pros and cons of these drugs in the Annual Review of Pharmacology and Toxicology. But, he adds, that doesn’t mean there aren’t better things to come. © 2023 Annual Reviews

Keyword: Drug Abuse
Link ID: 28649 - Posted: 02.01.2023

Liam Drew The emergence of disease-causing bacteria that are resistant to antibiotics is often attributed to the overuse of antibiotics in people and livestock. But researchers have homed in on another potential driver of resistance: antidepressants. By studying bacteria grown in the laboratory, a team has now tracked how antidepressants can trigger drug resistance1. “Even after a few days exposure, bacteria develop drug resistance, not only against one but multiple antibiotics,” says senior author Jianhua Guo, who works at the Australian Centre for Water and Environmental Biotechnology at the University of Queensland in Brisbane. This is both interesting and scary, he says. Globally, antibiotic resistance is a significant public-health threat. An estimated 1.2 million people died as a direct result of it in 20192, and that number is predicted to climb. Early clues Guo became interested in the possible contributions of non-antibiotic drugs to antibiotic resistance in 2014, after work by his lab found more antibiotic-resistance genes circulating in domestic wastewater samples than in samples of wastewater from hospitals, where antibiotic use is higher. Guo’s group and other teams also observed that antidepressants — which are among the most widely prescribed medicines in the world — killed or stunted the growth of certain bacteria. They provoke “an SOS response”, Guo explains, triggering cellular defence mechanisms that, in turn, make the bacteria better able to survive subsequent antibiotic treatment. © 2023 Springer Nature Limited

Keyword: Depression
Link ID: 28645 - Posted: 01.27.2023

By Jan Hoffman PHILADELPHIA — Over a matter of weeks, Tracey McCann watched in horror as the bruises she was accustomed to getting from injecting fentanyl began hardening into an armor of crusty, blackened tissue. Something must have gotten into the supply. Switching corner dealers didn’t help. People were saying that everyone’s dope was being cut with something that was causing gruesome, painful wounds. “I’d wake up in the morning crying because my arms were dying,” Ms. McCann, 39, said. In her shattered Philadelphia neighborhood, and increasingly in drug hot zones around the country, an animal tranquilizer called xylazine — known by street names like “tranq,” “tranq dope” and “zombie drug” — is being used to bulk up illicit fentanyl, making its impact even more devastating. Xylazine causes wounds that erupt with a scaly dead tissue called eschar; untreated, they can lead to amputation. It induces a blackout stupor for hours, rendering users vulnerable to rape and robbery. When people come to, the high from the fentanyl has long since faded and they immediately crave more. Because xylazine is a sedative and not an opioid, it resists standard opioid overdose reversal treatments. More than 90 percent of Philadelphia’s lab-tested dope samples were positive for xylazine, according to the most recent data. “It’s too late for Philly,” said Shawn Westfahl, an outreach worker with Prevention Point Philadelphia, a 30-year-old health services center in Kensington, the neighborhood at the epicenter of the city’s drug trade. “Philly’s supply is saturated. If other places around the country have a choice to avoid it, they need to hear our story.” A study published in June detected xylazine in the drug supply in 36 states and the District of Columbia. In New York City, xylazine has been found in 25 percent of drug samples, though health officials say the actual saturation is certainly greater. In November, the Food and Drug Administration issued a nationwide four-page xylazine alert to clinicians. © 2023 The New York Times Company

Keyword: Drug Abuse
Link ID: 28630 - Posted: 01.14.2023

By Andrew Jacobs PORTLAND, Ore. — The curriculum was set, the students were enrolled and Oregon officials had signed off on nearly every detail of training for the first class of “magic” mushroom facilitators seeking state certification. But as the four-day session got underway inside a hotel conference room in early December, an important pedagogical tool was missing: the mushrooms themselves. That’s because state officials, two years after Oregon voters narrowly approved the adult use of psilocybin, were still hammering out the regulatory framework for the production and sale of the tawny hallucinogenic fungi. Instead, the students, most of them seasoned mental health professionals, would have to role play with one another using meditation or intensive breathing practices that could lead to altered states of consciousness — the next best thing to the kind of psychedelic trip they would encounter as licensed guides. Not that anyone was complaining. Like many of the two dozen students who paid nearly $10,000 for the course, Jason Wright, 48, a hospital psychiatric nurse in Portland, said he was thrilled to be part of a bold experiment with national implications. “It’s incredible to be on the front lines of something that has the potential to change our relationship with drugs that should never have been criminalized in the first place,” he said. On Jan. 1, Oregon became the first state in the nation to legalize the adult use of psilocybin, a naturally occurring psychedelic that has shown significant promise for treating severe depression, post-traumatic stress disorder and end-of-life anxiety among the terminally ill, among other mental health conditions. © 2023 The New York Times Company

Keyword: Drug Abuse; Depression
Link ID: 28617 - Posted: 01.04.2023

By Yan Zhuang Delirium. Fever. Hallucinations. Not what you expect when adding baby spinach to a salad, but these are among the alarming symptoms dozens of Australians have experienced after consuming what are thought to be contaminated batches of the leafy greens. More than 100 people reported symptoms, including at least 54 who have sought medical help, after eating baby spinach that the authorities believe to be tainted. Four major supermarket chains have recalled products containing the suspect spinach. The authorities said that the spinach had caused “possible food-related toxic reactions” with those affected experiencing symptoms including delirium, hallucinations, blurred vision, rapid heartbeat and fever. Some Australians took to social media to jokingly ask how they could obtain hallucinogenic spinach. “Never have I been so interested in salad,” one Twitter user said. But the authorities have stressed that the symptoms are far from pleasant. “They’re unable to see properly, they’re confused, they’re having hallucinations,” Darren Roberts, the medical director of New South Wales’s Poisons Information Center, said of the victims in an interview on local television. “And we’re talking about scary hallucinations; it’s nothing that’s fun.” Its producer, Riviera Farms in the state of Victoria, said it believed its product had been “contaminated with a weed.” What weed could make spinach hallucinogenic? The health department of the state of Victoria has said that the symptoms suggested “anticholinergic syndrome,” a type of poisoning mainly caused by plants in the Solanaceae family, which includes nightshade, jimson weed and mandrake root. Anticholinergic plants and drugs inhibit the production of a brain chemical called acetylcholine, which is linked to memory, thinking and the visual system, according to Dominic ffytche, a professor of visual psychiatry at King’s College London, who specializes in visual hallucinations (and who really does lowercase his last name). Acetylcholine can also be lost naturally and is linked to Alzheimer’s, some type of dementias and other neurodegenerative diseases, he said. © 2022 The New York Times Company

Keyword: Drug Abuse
Link ID: 28607 - Posted: 12.21.2022

By Susan Coll Last summer, my husband had gone hiking with our two dogs when one of them — a year-old rescue who weighs in at over 50 pounds, can scale steep inclines like a mountain goat and has the speed and grace of an Olympic athlete — suddenly collapsed. Unable to stand, Dafna was disoriented and had also become incontinent. Was it a seizure? A stroke? A snake bite? We piled into our car and headed to an emergency veterinary clinic. I held Dafna’s head in my lap, convinced the end was near. This puppy had destroyed two pairs of my prescription eyeglasses, a new leather wallet, and had torn gashes in my clothes. She’d chewed through my daughter’s internet cords. Still, I loved her like no other. At the clinic, the staff rushed Dafna to a back room with the professionalism expected in a life-or-death situation. But we thought we also noticed a hint of amusement? Even a smirk? A few moments later, we learned why. The vet explained that while they were running a urine test to confirm their suspicions, they were pretty sure Dafna had ingested THC, maybe from a marijuana plant growing wild along the trail, or perhaps she’d eaten a discarded pot roach. Basically, our dog was stoned. It turns out that’s not so unusual these days. In Vermont, where we were and where possession and use of marijuana was legalized in 2018, the vet said she now sees as many as 10 cases per week of pot intoxication. According to ASPCApro and local vets, that’s happening across the country. © 1996-2022 The Washington Post

Keyword: Drug Abuse
Link ID: 28599 - Posted: 12.17.2022

Miryam Naddaf More than 3,500 genetic variations that potentially affect smoking and drinking behaviour have been identified in a study involving almost 3.4 million people with African, American, East Asian and European ancestry. The findings, published in Nature on 7 December1, highlight how increasing the sample size and ethnic diversity improves the power of such genome-screening analyses — called genome-wide association studies (GWASs) — to reveal how various traits are linked to genes, combinations of genes or mutations. Smoking and drinking are important risk factors for several physical and mental illnesses, including cardiovascular diseases and psychiatric disorders. Although both behaviours are influenced by environmental and social factors, there is evidence that genetics can affect tobacco and alcohol consumption. “We’re at a stage where genetic discoveries are being translated into clinical [applications],” says study co-author Dajiang Liu, a statistical geneticist at Penn State College of Medicine in Hershey, Pennsylvania. “If we can forecast someone's risk of developing nicotine or alcohol dependence using this information, we can intervene early and potentially prevent a lot of deaths.” Scientists use GWASs to find genetic ties to diseases or behaviours by comparing genetic sequences in large numbers of people. But so far, most of these studies have focused on European populations. Liu and his colleagues constructed a model that incorporated the genomic data of 3,383,199 people, 21% of whom had non-European ancestry. They identified 3,823 genetic variants that were associated with smoking or drinking behaviours. Thirty-nine of these were linked with the age at which individuals started smoking, 243 with the number of cigarettes smoked per day and 849 with the number of alcoholic drinks consumed per week.

Keyword: Drug Abuse; Genes & Behavior
Link ID: 28587 - Posted: 12.10.2022

ByDennis Normile Smoking kills. Ayesha Verrall has seen it up close. As a young resident physician in New Zealand’s public hospitals in the 2000s, Verrall watched smokers come into the emergency ward every night, struggling to breathe with their damaged lungs. Later, as an infectious disease specialist, she saw how smoking exacerbated illness in individuals diagnosed with tuberculosis and HIV/AIDS. She would tell them: “The best thing you can do to promote your health, other than take the pills, is to quit smoking.” Verrall is still urging citizens to give up cigarettes—no longer just one by one, but by the thousands. As New Zealand’s associate minister for health, she has led the development of the Smokefree Aotearoa 2025 Action Plan, which could make New Zealand the first country in the world to achieve smoke-free status—typically defined as an adult smoking rate of no more than 5%. (Aotearoa, loosely “Land of the Long White Cloud,” is a traditional Māori name for the country.) New Zealand’s Parliament is about to vote on the plan, which Chris Bostic, Washington, D.C.–based policy director at Action on Smoking & Health (ASH), calls “a huge deal. This will be the most comprehensive antitobacco policy in history.” Unveiled in December 2021, the plan features three radical interventions. One, called the smoke-free generation strategy, will make it illegal to ever sell combustible tobacco products to those born in 2009 or later. The goal is to create an ever-growing cohort that never picks up the smoking habit. A second provision calls for reducing the number of tobacco retailers by as much as 95%, to make cigarettes harder to get. The boldest proposal in the eyes of experts is reducing cigarettes’ nicotine content to below addictive levels. This “cuts right at the heart of why people smoke in the first place,” says Geoffrey Fong, head of the International Tobacco Control Policy Evaluation Project at the University of Waterloo. It’s potentially a “true game changer in the battle against smoking.”

Keyword: Drug Abuse
Link ID: 28585 - Posted: 12.10.2022

By Roni Caryn Rabin Deaths due to substance abuse, particularly of alcohol and opioids, rose sharply among older Americans in 2020, the first year of the coronavirus pandemic, as lockdowns disrupted routines and isolation and fear spread, federal health researchers reported on Wednesday. Alcohol and opioid deaths remained far less common among older people than among those middled-aged and younger, and rates had been rising in all groups for years. But the pronounced uptick — another data point in the long list of pandemic miseries — surprised government researchers. Deaths from opioids increased among Americans aged 65 and older by 53 percent in 2020 over the previous year, the National Center for Health Statistics found. Alcohol-related deaths, which had already been rising for a decade in this age group, rose by 18 percent. “The rate of alcohol deaths in older people is much lower than for younger adults, but the change caught our eye,” said Ellen Kramarow, a health statistician at the center and the lead author of the report, which analyzed death certificate data. Overdose deaths from synthetic opioids account for fewer than 1 percent of deaths in people over 65, Dr. Kramarow noted. “But the shape of the curve jumped out at us,” she said. Physiological changes that occur with aging leave older adults more vulnerable to the ill effects of alcohol and drugs, as metabolism and excretion of substances slow down, increasing the risk of toxicity. Smaller amounts have bigger effects, researchers have found. Alcohol and opioids can interact poorly with prescription medications that many older adults take for common conditions like hypertension, diabetes and mood disorders. Misuse can lead to falls and injuries, exacerbate underlying medical conditions and worsen declines in cognition. © 2022 The New York Times Company

Keyword: Drug Abuse; Stress
Link ID: 28581 - Posted: 12.06.2022

By Meredith Wadman It just got easier for U.S. scientists to get their hands on some pot—for research, that is. President Joe Biden today signed into law a bill that streamlines access to marijuana for medical research. The new law is expected to speed the issuance of government permits to scientists who want to study cannabis, whose medicinal promise has been widely touted but remains, with a few exceptions, unproven. It will also expedite applications from producers—including universities—that want to grow and distribute the drug for research. It also obliges the federal government to make sure an adequate, uninterrupted supply of marijuana is available to scientists. “We will now be able to treat marijuana like we treat any other substance or pharmaceutical for which we hope there is potential benefit. We will be able to subject it to rigorous scientific trial,” says Representative Andy Harris (R–MD), a physician and former National Institutes of Health (NIH)–funded researcher who helped usher the bipartisan legislation through Congress. “This is exciting,” says Ziva Cooper, the director of the Center for Cannabis and Cannabinoids at the University of California (UC), Los Angeles. “The bill is a significant step forward with respect to chipping away at the barriers” for research. Scientists are eager to study cannabis and its derivatives as potential treatments for cancer, chronic pain, post-traumatic stress disorder, and other conditions. Other cannabis researchers welcomed the new law but said it doesn’t go far enough. In particular, they are disappointed it does not include a provision from an earlier draft of the legislation that would have allowed scientists to buy and study the marijuana available to consumers in the 37 states that have legalized its recreational or medical use.

Keyword: Drug Abuse
Link ID: 28574 - Posted: 12.03.2022

By Gary Stix  Many people with bipolar disorder have a strong attraction to marijuana. A 2019 review of 53 studies found that almost a quarter of a combined sample of 51,756 individuals with the condition used cannabis or had a problematic pattern of consumption (cannabis use disorder), compared with 2 to 7 percent in the general population—and an earlier study placed usage estimates still higher. Cannabis and bipolar disorder do not go particularly well together. Consumption may increase manic and psychotic symptoms, and there may be a greater risk of suicide. But can the allure of cannabis be explained as a mere form of substance misuse? Why are people with bipolar disorder so attracted to marijuana? Could they be getting any possible benefit from it? Alannah Miranda of the University of California, San Diego, is a postdoctoral scholar working with U.C.S.D. psychiatry professors William Perry and Arpi Minassian to explore these questions. Miranda presented her and her colleagues’ unpublished work at this year’s giant Society for Neuroscience conference, which attracted more than 24,000 people earlier this month. She talked to Scientific American about what she discovered in this continuing study, which has been funded by the National Institute on Drug Abuse. [An edited transcript of the interview follows.] Tell me about what you’re studying. I’m researching the effects of cannabis on cognition in people with bipolar disorder. People with bipolar disorder report that it’s helping alleviate some of their symptoms in terms of issues related to memory, attention, focus and anxiety. © 2022 Scientific American,

Keyword: Schizophrenia; Drug Abuse
Link ID: 28569 - Posted: 11.30.2022

Linda Geddes Science correspondent Lead exposure during childhood may lead to reduced cognitive abilities in later life, meaning people experience symptoms of dementia sooner, data suggest. The study, one of the first to investigate the decades-long consequences of lead poisoning, suggests countries could face an explosion of people seeking support for dementia as individuals who were exposed to high lead levels during early life progress into old age. “In the US, and I would imagine the UK, the prime years when children were exposed to the most lead was in the 1960s and 70s. That’s when the most leaded gasoline was getting used, lead paint was still common, and municipal water systems hadn’t done much to clean up their lead,” said Prof John Robert Warren at the University of Minnesota in Minneapolis, who was involved in the research. “Those children who are now in their 40s, 50s and early 60s, will soon be entering the time of life when cognitive impairment and dementia are really common. So there’s this coming wave, potentially, of problems for the people who were most exposed.” Although scientists have long known that children and adults who are exposed to lead have poorer cognitive and educational outcomes, few studies have investigated the longer-term consequences. Warren and his colleagues combined data from the US-based longitudinal Health and Retirement Study (HRS), which has followed the brain health of thousands of adults over several decades, with census records to pinpoint where 1,089 of these individuals lived as children. They also mapped the locations of towns and cities that used lead pipes and had acidic or alkaline water – a proxy for high lead exposure. The research, published in Science Advances, revealed that people who lived in cities with lead-contaminated water as children had worse baseline cognitive functioning – a measure of their ability to learn, process information, and reason – at age 72, compared with those who did not. The difference was equivalent to being roughly eight years older. © 2022 Guardian News & Media Limited

Keyword: Neurotoxins; Alzheimers
Link ID: 28550 - Posted: 11.13.2022

By Katherine Ellison News organizations were quick to trumpet the recent findings of a small study suggesting that “magic mushrooms” could be part of a breakthrough treatment for alcoholism. It’s no wonder. Every year, alcohol abuse kills more than 140,000 Americans and affects millions more, with a steep increase in deaths in recent years, according to data published by the Centers for Disease Control and Prevention on Nov. 4. But excitement about the psilocybin study also raises a question: Why aren’t there more medical treatments for such an obviously devastating problem? “There is a desperate need for new medications, and there are many good avenues that we’re pursuing,” said Dorit Ron, a neurology professor at the University of California at San Francisco Medical Center, who has been studying potential treatments that include rapamycin, a drug designed to help transplant patients tolerate new organs. But getting promising new medications into the hands of doctors and their patients has proved difficult, said George Koob, director of the National Institute on Alcohol Abuse and Alcoholism (NIAAA), adding “it doesn’t go for lack of trying.” Lack of awareness by doctors, funding decisions by the pharmaceutical industry and the stigma surrounding alcoholism have all held up progress, he said. Can pills help? Ron and other researchers say medication can play a vital role in combating alcohol use disorder, the medical condition commonly known as alcoholism. But fewer than 2 percent of people with an alcohol addiction take medication for the condition, national surveys show, compared with 13.4 percent of those dealing with opioid addiction.

Keyword: Drug Abuse
Link ID: 28542 - Posted: 11.09.2022

By Leo Sands Psilocybin, the active hallucinogen found in psychedelic mushrooms — also known as “magic mushrooms” — can effectively alleviate a severe bout of depression when administered in a single dose and combined with talk therapy, a new clinical study found. Adults with depression who were administered a single 25-miligram dose of psilocybin were more likely to experience significant improvements in their mental health — both immediately and for up to three months — than others who were randomly assigned smaller doses of the same drug, said the peer-reviewed study, which was published Wednesday in the New England Journal of Medicine. “There’s something about the psychedelic experience that leads to a rapid resolution of depression symptoms,” said James Rucker, a consultant psychiatrist at King’s College London who worked on the trial. “We don’t really know what that is at the moment, but it’s very different to standard antidepressants.” The trial’s findings could be an encouraging sign for the 16 million Americans estimated each year by the Centers for Disease Control and Prevention to have depression, many of whom struggle to find treatments that work for them. Its authors hope the study — which was relatively small, with just 79 participants receiving the 25 mg dose — will pave the way for eventual regulatory approval of psilocybin by the Food and Drug Administration for use as a drug against depression. The new study randomly assigned 233 adults with depression three doses of psilocybin — 25 mg, 10 mg and 1 mg — across 22 sites in 10 countries. The authors found that the group given the largest dose recorded the most significant improvements in their depression, both immediately and for several weeks after.

Keyword: Depression; Drug Abuse
Link ID: 28540 - Posted: 11.05.2022

By Aimee Cunningham The death rate from alcohol use rose sharply in the United States in the first year of the pandemic. From 2019 to 2020, the rate of alcohol-induced deaths climbed 26 percent, from 10.4 per 100,000 people to 13.1 per 100,000, researchers report in a National Center for Health Statistics data brief published November 4. The rate of alcohol-induced deaths has generally increased yearly for the last two decades, but the annual uptick tended to be 7 percent or less. Deaths from alcoholic liver disease, which includes hepatitis and cirrhosis, were the most common driver of the increased rate. Deaths from mental and behavioral disorders due to alcohol use — mortality from dependence syndrome or withdrawal, for example — were the second most frequent contributor. The death rate from alcohol use jumped 26 percent overall from 2019 to 2020, a marked increase from previous years. Other researchers have reported that adults were drinking more frequently, and more heavily, early in the pandemic compared with the year before. There is also evidence of an increase in cases of alcoholic liver disease. A study at Johns Hopkins Hospital in Baltimore reported that 2.3 times as many patients with severe alcoholic liver disease and with recent unhealthy drinking were referred to their liver transplant center from July to December of 2020 compared with those months in 2019. © Society for Science & the Public 2000–2022.

Keyword: Drug Abuse; Stress
Link ID: 28539 - Posted: 11.05.2022

Jon Hamilton Computer games designed to boost self-esteem appear to prolong the antidepressant benefits of the mind-bending anesthetic ketamine. A recent study of 154 people found that those who played games featuring smiling faces and positive messages remained free of depression up to three months after a ketamine infusion, a team reports in the American Journal of Psychiatry. People who got ketamine alone tended to relapse after a week or two. The results are important because "we need new approaches that help people get feeling better faster and help them stay feeling better," says Rebecca Price, an author of the study and an associate professor of psychiatry and psychology at the University of Pittsburgh. Established drugs like Prozac and Zoloft can take weeks to ease depression, and don't work for every patient. Ketamine can offer immediate relief, but the effects often fade after a few days or weeks. "And then returning for infusions over and over to keep that relief going can end up being really burdensome and costly," Price says, "and just isn't accessible to all patients." So Price and a team of researchers wanted to find a way to make ketamine's antidepressant effects last longer. They decided to focus on a common symptom of depression: low self-esteem and self-loathing. The team drew on research suggesting that ketamine temporarily causes certain brain areas to enter a state in which they form lots of new connections. During this period, the brain seems to be more receptive to learning and change. "So we tried to use that window of opportunity just after ketamine to strengthen associations specifically between the idea of me, myself, and positive information and attributes," Price says. © 2022 npr

Keyword: Depression; Drug Abuse
Link ID: 28535 - Posted: 11.02.2022