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'It never killed anybody': Is this drink really a new 'alcohol alternative'?

Julia Wright Shot-sized bottle. Fancy label. Clearish-yellow liquid. It looks like the single-serving bottles of rum or vodka near the checkout of your local liquor store. But don't let the packaging fool you. Pace isn't your typical tipple. Health Canada says it's a controlled substance and its sale is illegal. "Pace is an illegal and unauthorized product in Canada," the federal department said in a statement to CBC News. "Health Canada is taking appropriate follow-up actions to prevent the sale of this product in Canada." But the manufacturer, Diet Alcohol Corporation of the Americas, describes Pace as legal on its website. It describes the drink as a brand-new "alcohol alternative" that packs a similar buzz to booze — with zero alcohol, calories or hangover. The company describes the active ingredient in Pace, MEAI, as a "new synthetic" that delivers "a mild inebriation along with a feeling of contentedness that curbs overconsumption and excessive drinking." It also says on its website that the product is "absolutely" legal. MEAI — the active ingredient in Pace — reduces the desire to binge drink, according to the manufacturers. But the drug's long-term health impacts haven't been studied and aren't well understood. According to Ezekiel Golan, lead scientist with Pace, "tens of thousands" of bottles have already been sold online and shipped to Canadians. ©2018 CBC/Radio-Canada.

Related chapters from BN8e: Chapter 4: The Chemistry of Behavior: Neurotransmitters and Neuropharmacology
Related chapters from MM:Chapter 4: The Chemistry of Behavior: Neurotransmitters and Neuropharmacology
Link ID: 25766 - Posted: 12.10.2018

Older Americans Are Flocking to Medical Marijuana

By Paula Span Shari Horne broke her toes a decade ago, and after surgery, “I have plates and pins and screws in my feet, and they get achy at times,” she said. So Ms. Horne, 66, applies a salve containing cannabidiol, derived from the cannabis, or marijuana, plant. It eases the pain. The salve didn’t help when she developed bursitis in her shoulder, but a tincture of cannabidiol mixed with T.H.C., the psychoactive ingredient in cannabis, provided relief. Using a pipe, she also smokes “a few hits” of a cannabis brand called Blue Dream after dinner, because “I think relaxing is healthy for you.” Many of her neighbors in Laguna Woods, Calif., a community of mostly older adults in Orange County, where she serves on the City Council, have developed similar routines. “People in their 80s and 90s, even retired Air Force colonels, are finding such relief” with cannabis, said Ms. Horne. “Almost everybody I know is using it in one form or another” — including her husband Hal, 68, a retired insurance broker, who says it helps him sleep. In fact, so many Laguna Woods seniors use medical cannabis — for ailments ranging from arthritis and diabetes nerve pain to back injuries and insomnia — that the local dispensary, Bud and Bloom, charters a free bus to bring residents to its Santa Ana location to stock up on supplies. Along with a catered lunch, the bus riders get a seniors discount. Physicians who treat older adults expect their cannabis use to increase as the number of states legalizing medical marijuana keeps growing. After the midterm elections, when Utah and Missouri voters approved medical use, 33 states and the District of Columbia have legalized medical marijuana, along with ten states that also have legalized recreational use. © 2018 The New York Times Company

Related chapters from BN8e: Chapter 8: General Principles of Sensory Processing, Touch, and Pain; Chapter 4: The Chemistry of Behavior: Neurotransmitters and Neuropharmacology
Related chapters from MM:Chapter 5: The Sensorimotor System; Chapter 4: The Chemistry of Behavior: Neurotransmitters and Neuropharmacology
Link ID: 25761 - Posted: 12.08.2018

Is America Ready For Prescription Heroin?

Elana Gordon In several European countries and Canada, patients with longterm opioid addiction are prescribed pharmaceutical grade heroin which they inject in clinics like the Patrida Medical Clinic in Berlin. Some addiction specialists want to pilot similar programs in the U.S. The U.S. drug crisis does not appear to be letting up. The nation experienced a shattering 47,000 opioid-related overdose deaths in 2017. Driving the surge are potent, cheap synthetics like fentanyl. They've spread into the illicit drug supply, and in response communities have been trying a range of interventions, from increasing naloxone trainings to upping treatment resources. But a new analysis from policy think tank, the Rand Corporation, concludes it's time to pilot an approach from outside the U.S.: offering pharmaceutical-grade heroin — yes, heroin — as a form of treatment for long time heroin users who haven't had success with other treatments. It's already happening in several European countries and Canada. But it would challenge culture, laws and practice in the U.S. "These are controversial interventions," says lead author Beau Kilmer, who co-directs RAND's drug policy research center. "There are some people that don't even want to have conversations about this. But given where we are with opioid deaths near 50,000 and fentanyl deaths near 30,000, it's important that we have discussions about these interventions that are grounded in the research and grounded in the experiences of other countries." © 2018 npr

The neuroscience behind the appeal of vaping

Olivier Oullier Smoking is declining in popularity around the world. According to the World Health Organisation (WHO), lighting up could decrease from 22.1 per cent of men and women in 2010 to 18.9 by 2025. In the US alone, the number of adult smokers is expected to plummet from 19 per cent in 2010 to 12.5 per cent within seven years. In my native France, where smoking is so endemic scientists once called it “the French paradox”, because smokers did not seem to suffer adverse effects at the same rate as the rest of the world, health minister Agnes Buzyn announced one million people had been persuaded to give up in the past year. So what has contributed to this trend? In addition to price increases and countless public health prevention campaigns, there is evidence that the growth in smoking e-cigarettes, known as vaping, has played a significant role in decreasing tobacco consumption over the past decade, with the belief that it is less toxic. Last year the e-cigarettes market was valued at $10.24 billion and could reach $16.85bn by 2023, according to Mordor Intelligence. A study published by the Drug and Alcohol Review last month claims former smokers who have quit and now vape are less likely to take up smoking cigarettes regularly again. Yet public health experts remain divided when it comes to their attitude towards vaping. A 2016 WHO report submitted before the Framework Convention on Tobacco Control, to which 180 countries have signed up, stated nations should consider cutting the use of e-cigarettes because there was not enough evidence to show they curbed smoking. It suggested countries should consider imposing restrictions on vaping, including tighter controls on sales and advertising. WHO argued while the long-term effects were largely unknown, these were reasonable measures. The UAE is among those countries which ban vaping amid fears of its impact on health.

How K2 and Other Synthetic Cannabinoids Got Their Start in the Lab

Ashley Yeager About a decade ago, Clemson University chemist John Huffman started getting calls from law enforcement agencies. Officials from the Drug Enforcement Administration (DEA) and other federal agencies wanted to know more about JWH-18, a synthetic cannabinoid bearing Huffman’s initials that he’d created in the lab in 2004 and described in scientific paper in 2005. The compound was turning up in incense, which, rather than being burnt for its scent, was being smoked and was making people sick. Huffman’s intent, like other scientists who had generated synthetic cannabinoids over the years, was not to create recreational drugs. It was to study the effects of cannabis in the body and how the cannabinoid system works, as well as to develop molecules to image areas of the brain. “The chemistry to make these things is very simple and very old,” Huffman told The Washington Post in 2015. “You only have three starting materials and only two steps. In a few days, you could make 25 grams, which could be enough to make havoc.” And havoc it’s been. The number of emergency room visits as a result of smoking synthetic cannabinoids, often laced with other drugs, is in the thousands annually, and poison control centers have seen a spike in calls about the compounds in recent years, with nearly 8,000 in 2015. Called K2 or Spice, these synthetic compounds first started sickening Americans in 2008, with illnesses reported in Europe before the drugs reached the US. In 2011, the DEA made it illegal to sell JWH-018 and four related compounds or products that contained them, but that hasn’t kept new synthetic cannabinoids from emerging on the illegal drug market and leading to life-threatening overdoses. © 1986 - 2018 The Scientist

How Coffee May Protect Brain Health: A New Study Suggests The Benefits Aren't Just From Caffeine

David DiSalvo Coffee has been getting considerable attention for a growing list of health benefits, with brain health high among them. While not without a few downsides, studies have shown impressive upsides of moderate coffee consumption, often linked to its high caffeine content. But a new lab study suggests that when it comes to brain health, coffee offers more than the stimulating effects of our favorite legal drug–in fact, decaf could be just as effective. The study began with a question: why has previous research found that coffee consumption correlates with lower risk of developing neurodegenerative diseases like Alzheimer’s and Parkinson’s? “We wanted to investigate why that is—which compounds [in coffee] are involved and how they may impact age-related cognitive decline," said lead study author Dr. Donald Weaver, co-director of the Krembil Brain Institute in Toronto. To investigate why, the research team evaluated several compounds (including caffeine) released during the roasting process in three types of coffee beans: caffeinated dark roast, caffeinated light roast, and decaffeinated dark roast. The analysis focused on how the compounds interact with amyloid beta and tau, the toxic proteins linked to the development of Alzheimer’s disease. Results from previous studies suggest that coffee compounds could provide a neuroprotective effect by inhibiting these proteins from forming the terminally disruptive clumps and tangles found in the brains of Alzheimer’s patients. ©2018 Forbes Media LLC

This City’s Overdose Deaths Have Plunged. Can Others Learn From It?

By Abby Goodnough DAYTON, Ohio — Dr. Randy Marriott clicked open the daily report he gets on drug overdoses in the county. Only one in the last 24 hours — stunningly low compared to the long lists he used to scroll through last year in a grim morning routine. “They just began to abruptly drop off,” said Dr. Marriott, who oversees the handoff of patients from local rescue squads to Premier Health, the region’s biggest hospital system. Overdose deaths in Montgomery County, anchored by Dayton, have plunged this year, after a stretch so bad that the coroner’s office kept running out of space and having to rent refrigerated trailers. The county had 548 overdose deaths by Nov. 30 last year; so far this year there have been 250, a 54 percent decline. Dayton, a hollowed-out manufacturing center at the juncture of two major interstates, had one of the highest opioid overdose death rates in the nation in 2017 and the worst in Ohio. Now, it may be at the leading edge of a waning phase of an epidemic that has killed hundreds of thousands of people in the United States over the last decade, including nearly 50,000 last year. For the first time in years, the number of opioid deaths nationwide has begun to dip, according to preliminary data from the Centers for Disease Control and Prevention — with totals for the preceding 12 months falling slightly but steadily between December 2017 and April 2018. The flattening curve — along with declining opioid prescription rates and survey data suggesting far fewer Americans tried heroin last year and more got addiction treatment — is the first encouraging news in a while. While it’s too soon to know if the improvement is part of a long-term trend, it is clear there are some lessons to be learned from Dayton. The New York Times spent several days here interviewing police and public health officials; doctors, nurses and other treatment providers; people recovering from opioid addiction and people who are still using heroin and other drugs. © 2018 The New York Times Company

The Price of Cool: A Teenager, a Juul and Nicotine Addiction

By Jan Hoffman READING, Mass. — He was supposed to inhale on something that looked like a flash drive and threw off just a wisp of a cloud? What was the point? A skeptical Matt Murphy saw his first Juul at a high school party in the summer of 2016, in a suburban basement crowded with kids shouting over hip-hop and swigging from Poland Spring water bottles filled with bottom-shelf vodka, followed by Diet Coke chasers. Everyone knew better than to smoke cigarettes. But a few were amusing themselves by blowing voluptuous clouds with clunky vapes that had been around since middle school. This Juul looked puny in comparison. Just try it, his friend urged. It’s awesome. Matt, 17, drew a pleasing, minty moistness into his mouth. Then he held it, kicked it to the back of his throat and let it balloon his lungs. Blinking in astonishment at the euphoric power-punch of the nicotine, he felt it — what he would later refer to as “the head rush.” “It was love at first puff,” said Matt, now 19. The next day, he asked to hit his friend’s Juul again. And the next and the next. He began seeking it out wherever he could, that irresistible feeling — three, sometimes four hits a day. So began a toxic relationship with an e-cigarette that would, over the next two years, develop into a painful nicotine addiction that drained his savings, left him feeling winded when he played hockey and tennis, put him at snappish odds with friends who always wanted to mooch off his Juul and culminated in a shouting, tearful confrontation with his parents. © 2018 The New York Times Company

She Couldn’t Quit Smoking. Then She Tried Juul

By Jan Hoffman Try as she might, Brittany Kligman couldn’t free herself of a pack-a-day cigarette habit, eight years in duration. And she ached to. She was mortified the time that a taxi driver sniffed as she entered his cab and remarked, “You’re a smoker, huh?” (And she had just showered!) She was getting more sinus infections. Because her chest felt uncomfortably tight when she exercised, she stopped high intensity interval training. Then SoulCycle classes. Finally, she quit working out. Then Ms. Kligman, 33, tried Juul, the sleek vaping device she credits for her liberation. Since last January, it’s been hello nicotine salts, goodbye tar. Juul gave her everything she enjoyed about cigarettes — the nicotine jolt as well as something ritualized to do with her hands — but without the stink, the stigma and the carcinogens. “The last cigarette I smoked was on July 5 when I ran out of pods,” Ms. Kligman said, referring to cartridges of mango-flavored liquid, as she took discreet hits while chatting at a downtown Manhattan cafe. “I couldn’t finish it — it made me sick. And I thought, ‘How did I used to do this?’ ” But this week, under pressure to keep its products away from teenagers, Juul announced it was suspending sales of many of its flavors (including Ms. Kligman’s beloved mango) at retail stores. The next day, the Food and Drug Administration issued new requirements that stores can only sell flavored e-cigarettes from closed-off spaces that are inaccessible to minors, a stipulation that could force many outlets to stop carrying the products. The new restrictions make smokers-turned-vapers like Ms. Kligman uneasy. “If you’re going to sell an adult product, you have to be prepared to secure it,” she said. “But it also seems like they’re making a lot of steps and loops for people like me. They’re taking away a flavor I used for smoking cessation. ” She not only intends to stock up on mango at her corner smoke shop, but is working up a Plan B: “I’ll switch to Juul’s tobacco flavor. I can get around this. Just like the kids will — they can always find a way.” © 2018 The New York Times Company

Q&A: The ABCs of E-Cigarettes

By Jan Hoffman The term “electronic cigarette” refers to a battery-powered device that heats a tank or cartridge of liquid usually containing nicotine, flavorings and other chemicals, but not the cancer-causing tar found in tobacco cigarettes. Users inhale and exhale the vapor. The devices come in numerous shapes, including ones that look like pens, flash drives and hookahs. Many consumers are confused about the health implications of e-cigarettes. This is a primer about what research so far shows about these devices. Are they safer than traditional cigarettes? Yes. But that does not mean they are safe. E-cigarettes contain far fewer dangerous chemicals than those released in burning tobacco. Tobacco cigarettes typically contain 7,000 chemicals, including nearly 70 known to be carcinogenic. E-cigarettes also don’t release tar, the tobacco residue that damages lungs but also contributes to the flavor of tobacco products. In the United States, cigarettes are associated with 480,000 deaths a year from coronary heart disease, stroke and numerous cancers, among other illnesses. The research on e-cigarettes is young because the products have only been around for a little over a decade. Exacerbated by the voltage of a given device, certain e-cigarette flavors can irritate the airways, researchers say: benzaldehyde (added to cherry flavored liquids), cinnamaldehyde (gives cinnamon flavor), and diacetyl (a buttery flavor that can cause lung tissue damage called “popcorn lung.”) Some flavors become irritants when added to vaping liquids. The process of turning liquid chemicals into vapor releases harmful particulates deep into the lungs and atmosphere, including heavy metals. © 2018 The New York Times Company

Herbert Fingarette, Contrarian Philosopher on Alcoholism, Dies at 97

By Sam Roberts Herbert Fingarette, a contrarian philosopher who, while plumbing the perplexities of personal responsibility, defined heavy drinking as willful behavior rather than as a potential disease, died on Nov. 2 at his home in Berkeley, Calif. He was 97. His daughter, Ann Fingarette Hasse, said the cause was heart failure. Professor Fingarette challenged the theory that alcoholism is a progressive disease that can be dealt with only by abstinence, and he concluded that treatment could include moderated drinking. Many academics and medical professionals denounced those views as heresy. But they were invoked by the United States Supreme Court in the 1988 decision Traynor v. Turnage. In that ruling, the court affirmed the government’s denial of education benefits to two veterans who had argued that they missed filing deadlines for those benefits because of their addiction as recovering alcoholics. Their claim that alcoholism is a disease beyond a drinker’s control was endorsed by the American Medical Association and the American Psychiatric Association. But it was rejected by the court, which ruled that certain types of alcohol abuse resulted from deliberate misconduct. Much of Professor Fingarette’s research and writing concerned accountability. That included what he called the self-deception, validated by science, that alcoholics cannot help themselves. In “Heavy Drinking: The Myth of Alcoholism as a Disease” (1988), Professor Fingarette all but accused the treatment industry of conspiring to profit from the conventional theory that alcoholism is a disease. He maintained that heavy use of alcohol is a “way of life,” that many heavy drinkers can choose to reduce their drinking to moderate levels, and that most definitions of the word “alcoholic” are phony. © 2018 The New York Times Company

Related chapters from BN8e: Chapter 4: The Chemistry of Behavior: Neurotransmitters and Neuropharmacology; Chapter 18: Attention and Higher Cognition
Related chapters from MM:Chapter 4: The Chemistry of Behavior: Neurotransmitters and Neuropharmacology; Chapter 14: Attention and Consciousness
Link ID: 25688 - Posted: 11.16.2018

Marijuana may change the decision-making part of teen brains

Laura Sanders SAN DIEGO — Marijuana use during teenage years may change the brain in key decision-making areas, a study in rats suggests. “Adolescence is a dangerous time to be insulting the brain, particularly with drugs of abuse,” study coauthor Eliza Jacobs-Brichford said November 7 at the annual meeting of the Society for Neuroscience. Jacobs-Brichford and colleagues gave adolescent male and female rats a marijuana-like compound. Afterward, the researchers found changes in parts of the brain involved in making decisions. Normally, many of the nerve cells there are surrounded by rigid structures called perineuronal nets, sturdy webs that help stabilize connections between nerve cells. But in male rats that had been exposed to the marijuana-like compound in adolescence, fewer of these nerve cells, which help put the brakes on other cells’ activity, were covered by nets. Drug exposure didn’t seem to affect the nets in female rats. “Males look more susceptible to these drugs,” said Jacobs-Brichford, a behavioral neuroscientist at the University of Illinois at Chicago. Citations E. Jacobs-Brichford et al. Effects of adolescent WIN exposure on perineuronal net emergence in PFC. Society for Neuroscience Annual Meeting, San Diego, November 7, 2018. |© Society for Science & the Public 2000 - 2018

FDA Approves Controversial New Opioid 10 times More Powerful than Fentanyl

By Ed Silverman, In a highly controversial move, the Food and Drug Administration approved an especially powerful opioid painkiller despite criticism that the medicine could be a “danger” to public health. And in doing so, the agency addressed wider regulatory thinking for endorsing such a medicine amid nationwide angst about overdoses and deaths attributed to opioids. The drug is called Dsuvia, which is a tablet version of an opioid marketed for intravenous delivery, but is administered under the tongue using a specially developed, single-dose applicator. These “unique features” make the medicine well-suited for the military and therefore was a priority for the Pentagon, a point that factored heavily into the decision, according to FDA Commissioner Scott Gottlieb. Although an FDA advisory committee last month recommended approval, the agency was urged by critics not to endorse the drug because it is 10 times more powerful than fentanyl, a highly addictive opioid. Among those who opposed approval were four U.S. senators and the FDA advisory panel chair, who could not attend the meeting, but took the rare step of later writing a letter to the agency. The objections included complaints that Dsuvia has no unique medical benefits and might be easily diverted by medical personnel, despite a risk mitigation plan the manufacturer, AcelRx Pharmaceuticals, must maintain. There was also criticism the FDA failed to convene the Drug Safety and Risk Management Advisory Committee, not just the Anesthetic and Analgesic Drug Products Advisory Committee. Last year, the FDA refused to approve the medicine over concerns about usage directions and a need for additional safety data. © 2018 Scientific American

Young people’s memories improved when they stopped using marijuana

Laura Sanders Taking a monthlong break from pot helps clear away young people’s memory fog, a small study suggests. The results show that not only does marijuana impair teenagers’ and young adults’ abilities to take in information, but that this memory muddling may be reversible. Scientists have struggled to find clear answers about how marijuana affects the developing brain, in part because it’s unethical to ask children to begin using a drug for a study. But “you can do the opposite,” says neuropsychologist Randi Schuster. “You can get kids who are currently using, and pay them to stop.” For a study published October 30 in the Journal of Clinical Psychiatry, Schuster and her colleagues did just that. The team recruited 88 Boston-area youngsters ages 16 to 25 years old who reported using marijuana at least once a week, and offered 62 of them money to quit for a month. Participants were paid more money as the experiment went along, with top earners banking $535 for their month without pot. The money “worked exceptionally well,” says Schuster, of Massachusetts General Hospital in Boston and Harvard Medical School. Urine tests showed that 55 of the 62 participants stopped using marijuana for the 30 days of the experiment. Along with regular drug tests, participants underwent attention and memory tests. Tricky tasks that required close monitoring of number sequences and the directions and locations of arrows revealed that, over the month, young people’s ability to pay attention didn’t seem to be affected by their newfound abstinence. |© Society for Science & the Public 2000 - 2018

Related chapters from BN8e: Chapter 4: The Chemistry of Behavior: Neurotransmitters and Neuropharmacology; Chapter 17: Learning and Memory
Related chapters from MM:Chapter 4: The Chemistry of Behavior: Neurotransmitters and Neuropharmacology; Chapter 13: Memory, Learning, and Development
Link ID: 25628 - Posted: 10.31.2018

Why Is CBD Everywhere?

By Alex Williams It’s hard to say the precise moment when CBD, the voguish cannabis derivative, went from being a fidget spinner alternative for stoners to a mainstream panacea. Maybe it was in January, when Mandy Moore, hours before the Golden Globes, told Coveteur that she was experimenting with CBD oil to relieve the pain from wearing high heels. “It could be a really exciting evening,” she said. “I could be floating this year.” Maybe it was in July, when Willie Nelson introduced a line of CBD-infused coffee beans called Willie’s Remedy. “It’s two of my favorites, together in the perfect combination,” he said in a statement. Or maybe it was earlier this month, when Dr. Sanjay Gupta gave a qualified endorsement of CBD on “The Dr. Oz Show.” “I think there is a legitimate medicine here,” he said. “We’re talking about something that could really help people.” So the question now becomes: Is this the dawning of a new miracle elixir, or does all the hype mean we have already reached Peak CBD? Either way, it would be hard to script a more of-the-moment salve for a nation on edge. With its proponents claiming that CBD treats ailments as diverse as inflammation, pain, acne, anxiety, insomnia, depression, post-traumatic stress and even cancer, it’s easy to wonder if this all natural, non-psychotropic and widely available cousin of marijuana represents a cure for the 21st century itself. The ice caps are melting, the Dow teeters, and a divided country seems headed for divorce court. Is it any wonder, then, that everyone seems to be reaching for the tincture? “Right now, CBD is the chemical equivalent to Bitcoin in 2016,” said Jason DeLand, a New York advertising executive and a board member of Dosist, a cannabis company in Santa Monica, Calif., that makes disposable vape pens with CBD. “It’s hot, everywhere and yet almost nobody understands it.” With CBD popping up in nearly everything — bath bombs, ice cream, dog treats — it is hard to understate the speed at which CBD has moved from the Burning Man margins to the cultural center. © 2018 The New York Times Company

What Causes Alcohol-Induced Blackouts?

By Charles F. Zorumski One minute you’re enjoying a nice buzz, the next your brain stops recording events that are taking place. The result can mean having vague or no memory of a time period ranging anywhere from a few minutes up to several hours. Scary—isn’t it? Unfortunately, alcohol-induced blackouts aren’t a rarity, either. A 2015 survey of English teenagers who drank showed 30 percent of 15-year-olds and 75 percent of 19-year-olds suffered alcohol-induced blackouts. In medical terms this memory loss is a form of temporary anterograde amnesia, a condition where the ability to form new memories is, for a limited time, impaired. That means you can’t remember a stretch of time because your brain was unable to record and store memories in the first place. Advertisement Neuroscientists do not fully understand how blackouts occur. Researchers long assumed alcohol impairs memory because it kills brain cells. Indeed, long-standing alcohol abuse can damage nerve cells and permanently impact memory and learning. It is unlikely, however, that brain damage is behind acute blackouts. It is clear that processes in the hippocampus—the area of brain involved in the formation, storage and retrieval of new memories—are disturbed. Specifically, it appears alcohol impairs the so-called long-term potentiation of synapses at the pyramidal cells in the hippocampus. Alcohol alters the activity of certain glutamate receptors, thereby boosting the production of specific steroid hormones. This in turn slows the long-term potentiation of hippocampal synapses. Normally this mechanism, responsible for strengthening the synaptic transfer of information between neurons, is the basis of memory formation. © 2018 Scientific American

Naltrexone: A History and Future Directions

By: A. Benjamin Srivastava, M.D., and Mark S. Gold, M.D. T he opioid epidemic is one of the foremost public health crises in the United States. A recent analysis from Stanford University suggested that without any changes in currently available treatment, prevention, and public health approaches, we should expect to have 510,000 deaths from prescription opioids and street heroin from 2016 to 2025 in the US.1 Both the lay press and scientific literature are full of proposals, analyses, and potential solutions. Most focus on expanding access to and dissemination of overdose reversal treatment (naloxone), and the medication-assisted treatment (MAT) drugs methadone, buprenorphine, and naltrexone. Obviously, expanding the availability of naloxone and MAT drugs are important steps that can be readily implemented, especially using an approach similar to what was done during the HIV epidemic.2,3 But in addition to such efforts, we must invest in research to develop new treatments informed by neuroscientific evidence. A comprehensive discussion of naltrexone should be understood within the context of naloxone, which is considered its short-acting version based on relative half-lives (three hours for naloxone, 13 hours for oral naltrexone). When first synthesized, naloxone was a novel medication as well as a cornerstone of research into the pharmacology of the opioid system. Naloxone successfully competes against opioids to bind to the “Mu” opioid receptor on neurons, completely blocking the opioid’s downstream effects. As a “Mu opioid receptor (MOR) antagonist,” it reverses the potentially deadly effects of opioid overdose. © 2018 The Dana Foundation

Related chapters from BN8e: Chapter 4: The Chemistry of Behavior: Neurotransmitters and Neuropharmacology; Chapter 8: General Principles of Sensory Processing, Touch, and Pain
Related chapters from MM:Chapter 4: The Chemistry of Behavior: Neurotransmitters and Neuropharmacology; Chapter 5: The Sensorimotor System
Link ID: 25609 - Posted: 10.24.2018

Herbert D. Kleber, Pioneer in Addiction Treatment, Dies at 84

By Katharine Q. Seelye Fresh from completing his medical residency at Yale-New Haven Hospital in 1964, Dr. Herbert Kleber fulfilled his military obligation by volunteering for the United States Public Health Service. He expected to do research at the National Institutes of Health. But to his dismay he was assigned instead to the Public Health Service Prison Hospital at Lexington, Ky. This was the notorious “narcotics farm,” a centralized prison and drug treatment center where thousands of drug users were incarcerated at one time or another, including the actor Peter Lorre, the jazz trumpeter Chet Baker and the Beat writer William S. Burroughs, who described his experience there in his vivid novel “Junky” (1953). Dr. Kleber fulfilled his two-year obligation in place of being drafted and returned to Yale, intent on a career in psychiatry. But because he had worked at Lexington, people assumed he knew all about addiction. After all, Lexington’s Addiction Research Center was an incubator for advanced research (and was the forerunner for the National Institute on Drug Abuse). Patients, doctors and parents kept asking for his help. Finally, he gave in to what he decided was his destiny and, thanks to that unwanted detour to Lexington, went on to become one of the nation’s foremost experts in the field of drug addiction. Dr. Kleber died on Oct. 5 while vacationing in Greece with his wife, Anne Burlock Lawver, his son, Marc, and his daughter-in-law, Judith. Marc Kleber confirmed the death and said his father, who lived in Manhattan, died of a heart attack on the island of Santorini. He was 84. Dr. Kleber was a pioneer in researching the pathology of addiction and in developing treatments to help patients reduce the severe discomforts of withdrawal, avoid relapse and stay in recovery. When he began his work, in the 1970s, health care professionals were paying little attention to addiction. It was a blip in the medical school curriculum. © 2018 The New York Times Company

Addiction Treatment Gap Is Driving A Black Market For Suboxone

Jake Harper Months in prison didn't rid Daryl of his addiction to opioids. "Before I left the parking lot of the prison, I was shooting up, getting high," he says. Daryl has used heroin and prescription painkillers for more than a decade. Almost four years ago he became one of more than 200 people who tested positive for HIV in a historic outbreak in Scott County, Ind. After that diagnosis, he says, he went on a bender. But about a year ago, Daryl had an experience that made him realize he might be able to stay away from heroin and opioids. For several days, he says, he couldn't find drugs. He spent that time in withdrawal. "It hurts all over. You puke, you get diarrhea," Daryl says. His friend offered him part of a strip of Suboxone, a brand-name version of the addiction medication buprenorphine that is combined with naloxone. Buprenorphine is a long-acting opioid that is generally used to treat opioid addiction. It reduces cravings for the stronger opioids he had been taking, prevents physical withdrawal from those drugs and comes with a significantly lower risk of fatal overdose. Daryl injected the buprenorphine, and his opioid withdrawal symptoms disappeared. (Daryl is his middle name, which NPR is using to protect his identity because it is illegal to use buprenorphine without a prescription.) "At first it felt like I was high," Daryl says. "But I think that's what normal feels like now. I have not been normal in a long time." © 2018 npr

I'm Just a Middle-Aged House Dad Addicted to Pot

By Neal Pollack AUSTIN, Tex. — My name is Neal, and I’m a marijuana addict. A year ago I wouldn’t have said that, because it would have meant giving up marijuana. I would rather have given up breathing. When I had my first cup of coffee in the morning, I pressed the little button on my vape pen, waited for the blue glow, took a huge inhale and then blew it into the mug so that I could suck in the THC and caffeine at the same time. Then I took another hit, and another. In the afternoons, I’d smoke a bowl, or pop a gummy bear, or both. At night, I got high before eating dinner or watching the ballgame. Maybe I’d stop getting stoned a little bit before bed, but what was the point? If I went to bed high, I could wake up high, too. What a time for people to get stoned! Marijuana has left the counterculture, exploded into the mainstream and transformed into a multibillion-dollar industry. Cannabis is now an essential part of any hip wellness and beauty regimen. Netflix offers a marijuana-themed cooking show. Cannabis should be legal. It has medical uses. Millions of people, most of them black and Latino men, have unjustly gone to jail for selling what should have been easily available in stores. States with the political courage to legalize it have seen their tax rolls bloom and have created thousands of jobs. Also, it’s delicious. But I’m not a child with intractable epilepsy, or a veteran with PTSD, or a person who just wants to chill a little, or Willie Nelson. Unless you count writing articles about marijuana, I’m not profiting from the industry. I’m just a middle-aged house dad with a substance-abuse problem. Like most pot addicts in denial, I spent years telling myself that marijuana isn’t addictive, and so I didn’t have a problem. But clearly I did. And I’m not the only one who suffers this way. © 2018 The New York Times Company

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