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By Lenny Bernstein The federal government on Thursday proposed new guidelines for prescribing opioids that would eliminate numerical dosage recommendations for treatment of chronic pain in favor of a more flexible approach by caregivers. FAQ: What to know about the omicron variant of the coronavirus The recommendations call for doctors and other prescribers to weigh the risks and benefits of starting, increasing and halting treatment with opioids. They leave out previous advice on the amount and duration of painkiller treatments that patients and doctors have contended was sometimes misinterpreted, causing serious harm to people suffering unrelenting pain. For some with chronic pain, the problem is not in their backs or knees but their brains Some states and caregivers adopted tight rules based on the recommendations, first issued in 2016, resulting in patients having difficulty obtaining pain drugs or having them cut off abruptly. “There’s not a one size fits all,” said Christopher Jones, acting director of the National Center for Injury Prevention and Control, part of the Centers for Disease Control and Prevention. “We’ve heard that quite clearly. When you have hard thresholds like 90 [morphine milligram equivalents] or a specific duration, it makes it too easy for policymakers or others to take that out of context and apply that as a rigid cap.” Bobby Mukkamala, chairman of the American Medical Association Board of Trustees, issued a statement saying that “for nearly six years, the AMA has urged the CDC to reconsider its problematic guideline on opioid prescriptions that proved devastating for patients with pain. The CDC’s new draft guideline — if followed by policymakers, health insurance companies and pharmacy chains — provides a path to remove arbitrary prescribing thresholds, restore balance and support comprehensive, compassionate care.” Andrew Kolodny, one of the fiercest critics of opioid manufacturers, said he believes some of the opposition was orchestrated by drug companies that saw the attempt to curb opioid prescribing — especially of high-dose pills — as a threat to their profit margins. © 1996-2022 The Washington Post

Related chapters from BN: Chapter 4: The Chemistry of Behavior: Neurotransmitters and Neuropharmacology
Related chapters from MM:Chapter 4: Development of the Brain
Link ID: 28195 - Posted: 02.12.2022

By Christina Caron After 10 years of marriage, Ree, 42, and her husband were ready to call it quits. Even their therapist had given up, she said, in part because her husband “was so closed off, just unable to open up.” “We loved each other a lot and we were very compatible, however, we didn’t know how to deal with conflict,” Ree said. She was often anxious about their relationship and could be “a little neurotic at times,” but the more she pushed her husband to connect, the more withdrawn he became. Their sex life suffered. Then a friend suggested that they try the illegal drug MDMA, popularly known as Ecstasy or Molly. For Ree — who, along with her husband, requested anonymity to speak about drug use, and is referred to by a nickname — the answer was an “immediate no.” MDMA, long associated with rave culture, is currently categorized as a Schedule I drug — meaning it has a high potential for abuse and no accepted medical use in the United States. “We are about as strait-laced as you can come,” she said. “We’re not people who break laws or do drugs.” Six months later, after reading “How to Change Your Mind,” the best-selling book by Michael Pollan that details his transformative experience with psychedelics, Ree reconsidered. And that’s how they found themselves in a secluded area of Utah at a large, rented house with a beautiful view of the mountains to trip on MDMA with five other couples. In recent years, clinical trials have shown that MDMA, when combined with talk therapy, can bring relief to those suffering from post-traumatic stress disorder, a finding that has elevated MDMA’s reputation from party drug to potential therapeutic. Some couples, drawn to the drug’s ability to produce feelings of empathy, trust and compassion, have started using unregulated MDMA on their own in an effort to help them reconnect, improve communication and have better sex. © 2022 The New York Times Company

Related chapters from BN: Chapter 16: Psychopathology: Biological Basis of Behavior Disorders; Chapter 4: The Chemistry of Behavior: Neurotransmitters and Neuropharmacology
Related chapters from MM:Chapter 12: Psychopathology: The Biology of Behavioral Disorders; Chapter 4: Development of the Brain
Link ID: 28192 - Posted: 02.09.2022

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. 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. © 2022 Scientific American,

Related chapters from BN: Chapter 4: The Chemistry of Behavior: Neurotransmitters and Neuropharmacology; Chapter 18: Attention and Higher Cognition
Related chapters from MM:Chapter 4: Development of the Brain; Chapter 14: Attention and Higher Cognition
Link ID: 28142 - Posted: 01.08.2022

By Gretchen Reynolds People who work out regularly and are aerobically fit tend to guzzle a surprising amount of alcohol, according to a new study, well timed for the holidays, of the interplay between fitness, exercise and imbibing. The study, which involved more than 40,000 American adults, finds that active, physically fit men and women are more than twice as likely to be moderate or heavy drinkers as people who are out of shape. The results add to mounting evidence from previous studies — and many of our bar tabs — that exercise and alcohol frequently go hand in hand, with implications for the health effects of each. Many people, and some researchers, might be surprised to learn how much physically active people tend to drink. In general, people who take up one healthy habit, such as working out, tend to practice other salubrious habits, a phenomenon known as habit clustering. Fit, active people seldom smoke, for instance, and tend to eat healthful diets. So, it might seem logical that people who often exercise would drink alcohol sparingly. But multiple studies in recent years have found close ties between working out and tippling. In one of the earliest, from 2001, researchers used survey answers from American men and women to conclude that moderate drinkers, defined in that study as people who finished off about a drink a day, were twice as likely as those who didn’t drink at all to exercise regularly. Later studies found similar patterns among college athletes, who drank substantially more than other collegians, a population not famous for its temperance. © 2021 The New York Times Company

Related chapters from BN: Chapter 4: The Chemistry of Behavior: Neurotransmitters and Neuropharmacology; Chapter 11: Motor Control and Plasticity
Related chapters from MM:Chapter 4: Development of the Brain; Chapter 5: The Sensorimotor System
Link ID: 28121 - Posted: 12.22.2021

By Kim Tingley When they first appeared in the United States in the mid-2000s, “electronic nicotine delivery systems” — e-cigarettes, vapes, e-liquids and other wares that contain the stimulant found in tobacco — were subject to little federal oversight. Their makers could incorporate countless other ingredients and flavorings. Like cigarettes before them, the devices proved extremely attractive to young people; in 2018, the surgeon general declared youth vaping an “epidemic” and noted that one in five high schoolers and one in 20 middle schoolers used e-cigarettes. Nicotine can harm the developing brain, and e-cigarettes contain potentially harmful toxins like heavy metals; the long-term effects of vaping — the heating of nicotine to create an inhaled aerosol — are uncertain. Despite these concerns, public-​health officials in the U.S. hope that, given a choice in the open market, people already addicted to nicotine will choose e-cigarettes over cigarettes — a deadly consumer product so successful at attracting and retaining users that it has killed as many as 24 million Americans over the past six decades. Because e-cigarettes generally contain fewer toxic chemicals than tobacco smoke, they are believed to be less damaging than cigarettes. If a sizable number of the one in seven adults in the U.S. who smoke switched to e-cigarettes, the theory goes, significantly fewer people might suffer from cancer and cardiovascular and respiratory diseases. In 2016, in an effort to mitigate the potential harms of e-cigarettes, the Food and Drug Administration began regulating them as “new tobacco products.” It became illegal to sell e-cigarettes to anyone under 18 (a cutoff that rose nationally to 21 in late 2019), and the agency was empowered to require warning labels. The F.D.A. also gained the authority to keep products out of the marketplace, unless it could be demonstrated that their public-health benefit outweighed their risks. (As a result of legislation passed in 2009, this condition applies to new tobacco products in general; cigarettes themselves, and other tobacco products on the market before Feb. 15, 2007, don’t have to meet the same standard.) As of last month, the agency had denied nearly a million applications. But a vaporizer and two liquids, in regular tobacco and menthol flavors, were authorized, after the F.D.A. declared that data submitted by their manufacturer showed that they were indeed less toxic than cigarettes and could, in the words of the agency’s news release, “benefit addicted adult smokers who switch to these products.” This would “outweigh the risk to youth” and lead to an overall “protection of the public health.” © 2021 The New York Times Company

Related chapters from BN: Chapter 4: The Chemistry of Behavior: Neurotransmitters and Neuropharmacology
Related chapters from MM:Chapter 4: Development of the Brain
Link ID: 28090 - Posted: 11.24.2021

By Andrew Jacobs APPLE VALLEY, Calif. — Jose Martinez, a former Army gunner whose right arm and both legs were blown off by a roadside bomb in Afghanistan, has a new calling: He’s become one of the most effective lobbyists in a campaign to legalize the therapeutic use of psychedelic drugs across the country. On a Zoom call this spring with Connie Leyva, a Democratic legislator in California who has long opposed relaxing drug laws, Mr. Martinez told her how psilocybin, the psychoactive ingredient in “magic” mushrooms, had helped to finally quell the physical pain and suicidal thoughts that had tormented him. Ms. Leyva says she changed her mind even before the call ended, and she later voted yes on the bill, which is expected to become law early next year. “We ask these men and women to go fight for our freedoms,” she said in an interview. “So if this is something that is helping them live a more normal life, I feel like I shouldn’t stand in the way.” In the two years since Oregon, Washington, D.C., and a half-dozen municipalities decriminalized psilocybin, vets have become leading advocates in the drive to legalize psychedelic medicine, which they credit with helping ease the post-traumatic stress, anxiety and depression that are often tied to their experiences in the military. The campaign has been propelled by the epidemic of suicides among veterans of Iraq and Afghanistan, but also by the national reckoning over the mass incarceration of people on drug charges that has softened public attitudes on prohibition. More than 30,000 service members have taken their own lives in the years since Sept. 11 — four times the number of those who died on the battlefield — and the Department of Veterans Affairs has struggled to address the crisis with the traditional repertoire of pharmacological interventions. © 2021 The New York Times Company

Related chapters from BN: Chapter 4: The Chemistry of Behavior: Neurotransmitters and Neuropharmacology; Chapter 16: Psychopathology: Biological Basis of Behavior Disorders
Related chapters from MM:Chapter 4: Development of the Brain; Chapter 12: Psychopathology: The Biology of Behavioral Disorders
Link ID: 28072 - Posted: 11.13.2021

By Matt Richtel and Sheila Kaplan The Food and Drug Administration for the first time on Tuesday authorized an electronic cigarette to be sold in the United States, a significant turn in one of the most contentious public health debates in decades. In greenlighting a device and tobacco-flavored cartridges marketed by R.J. Reynolds under the brand name Vuse, the agency signaled that it believed that the help certain vaping devices offer smokers to quit traditional cigarettes is more significant than the risks of ensnaring a new generation. “The authorized products’ aerosols are significantly less toxic than combusted cigarettes based on available data,” the F.D.A. said in a statement announcing the decision. The statement concluded, “The F.D.A. determined that the potential benefit to smokers who switch completely or significantly reduce their cigarette use, would outweigh the risk to youth.” The watershed decision could pave the way for authorization of some other electronic cigarettes, including those of the once-dominant maker Juul, to stay on the market. For more than a year, the manufacturers of e-cigarettes have been in a holding pattern — most of their products on the market but awaiting official authorization — as the F.D.A. has investigated whether they were a benefit or a danger to public health. “The importance of the F.D.A. authorizing a vaping product as ‘appropriate for the protection of public health’ should not be understated,” said Gregory Conley, president of the American Vaping Association, an industry group. He added, “Now that the F.D.A. has acted, we are hopeful that adult consumers and health communicators will begin to understand the harm reduction benefits offered by these and other smoke-free products.” © 2021 The New York Times Company

Related chapters from BN: Chapter 4: The Chemistry of Behavior: Neurotransmitters and Neuropharmacology
Related chapters from MM:Chapter 4: Development of the Brain
Link ID: 28032 - Posted: 10.13.2021

By Erin Blakemore Methamphetamine overdoses are on the rise, a study published in JAMA Psychiatry says. When researchers from the National Institute on Drug Abuse (NIDA) and the Centers for Disease Control and Prevention analyzed data from 2015 to 2019, they found that meth overdose deaths in the United States had almost tripled. During that time span, meth-related overdoses rose from 5,526 to 15,489. This was accompanied by a 43 percent increase in people reporting meth use. Researchers believe over 2 million adults used meth during the period, up from 1.4 million. They used data from the National Vital Statistics System, which tracks births, deaths and the reasons people die. Then they looked at data from the National Survey on Drug Use and Health, which analyzes a random sample of adults in the United States. Advertisement The study shows stark differences in who uses meth. American Indians and Alaska Natives were the most likely to report methamphetamine-use disorder, meth injection and overall meth use. Black people who don’t inject meth also experienced a sharp rise in meth use, which increased more than tenfold. Gay men had the highest prevalence of meth injection. More than three times the women who reported meth use in previous years said they used the drug between 2015 and 2019. Age was a factor, too. Young adults 18 to 23 showed a fourfold increase in meth use without injection. Overall, the number rose by nearly half for all U.S. adults.

Related chapters from BN: Chapter 4: The Chemistry of Behavior: Neurotransmitters and Neuropharmacology
Related chapters from MM:Chapter 4: Development of the Brain
Link ID: 28020 - Posted: 10.06.2021

David Kleinfeld My colleagues and I recently found that we were able to train mice to voluntarily increase the size and frequency of seemingly random dopamine impulses in their brains. Conventional wisdom in neuroscience has held that dopamine levels change solely in response to cues from the world outside of the brain. Our new research shows that increases in dopamine can also be driven by internally mediated changes within the brain. Dopamine is a small molecule found in the brains of mammals and is associated with feelings of reward and happiness. In 2014, my colleagues and I invented a new method to measure dopamine in real time in different parts of the brains of mice. Using this new tool, my former thesis student, Conrad Foo, found that neurons in the brains of mice release large bursts of dopamine – called impulses – for no easily apparent reason. This occurs at random times, but on average about once a minute. Pavlov was famously able to train his dogs to salivate at the sound of a bell, not the sight of food. Today, scientists believe that the bell sound caused a release of dopamine to predict the forthcoming reward. If Pavlov’s dogs could control their cue-based dopamine responses with a little training, we wondered if our mice could control their spontaneous dopamine impulses. To test this, our team designed an experiment that rewarded mice if they increased the strength of their spontaneous dopamine impulses. The mice were able to not only increase how strong these dopamine releases were, but also how often they occurred. When we removed the possibility of a reward, the dopamine impulses returned to their original levels. In the 1990s, neuroscientist Wolfram Schultz discovered that an animal’s brain will release dopamine if the animal expects a reward, not just when receiving a reward. This showed that dopamine can be produced in response to the expectation of a reward, not just the reward itself – the aforementioned modern version of Pavlov’s dog. © 2010–2021, The Conversation US, Inc.

Related chapters from BN: Chapter 4: The Chemistry of Behavior: Neurotransmitters and Neuropharmacology; Chapter 17: Learning and Memory
Related chapters from MM:Chapter 4: Development of the Brain; Chapter 13: Memory and Learning
Link ID: 27993 - Posted: 09.15.2021

By Nora D. Volkow The provisional drug overdose death statistics for 2020 confirmed the addiction field’s worst fears. More people died of overdoses in the United States last year than in any other one-year period in our history. More than 93,000 people died. The increase from the previous year was also more than we’ve ever seen—up 30 percent. These data are telling us that something is wrong. In fact, they are shouting for change. It is no longer a question of “doing more” to combat our nation’s drug problems. What we as a society are doing—putting people with drug addiction behind bars, underinvesting in prevention and compassionate medical care—is not working. Even as we work to create better scientific solutions to this crisis, it is beyond frustrating—it is tragic—to see the effective prevention and treatment tools we already have just not being used. The benefits of providing effective substance use disorder treatments—especially medication for opioid use disorder—are well-known. Yet decades of prejudice against treating substance use disorders with medication has greatly limited their reach, partly accounting for why only 18 percent of people with opioid use disorder receive medications. Historical reluctance to provide these treatments and of insurers to cover them reflects the stigma that has long made people with addiction a low priority. We must eliminate the attitudes and infrastructure barring treating people with substance use disorders. This means making it easier for clinicians to provide life-saving medications, expanding models of care like digital health technologies and mobile clinics that can reach people where they are, and ensuring that payers cover treatments that work. © 2021 Scientific American

Related chapters from BN: Chapter 4: The Chemistry of Behavior: Neurotransmitters and Neuropharmacology
Related chapters from MM:Chapter 4: Development of the Brain
Link ID: 27970 - Posted: 09.01.2021

Terry Gross Human beings are programmed to approach pleasure and avoid pain. It's an instinct that dates back millions of years, to a time when people needed to actively seek food, clothing and shelter every day, or risk death. But psychiatrist Anna Lembke says that in today's world, such basic needs are often readily available — which changes the equation. "Living in this modern age is very challenging. ... We're now having to cope with: How do I live in a world in which everything is provided?" Lembke says. "And if I consume too much of it — which my reflexes compel me to do — I'm going to be even more unhappy." Lembke is the medical director of addiction medicine at Stanford University and chief of the Stanford Addiction Medicine Dual Diagnosis Clinic. Her new book, Dopamine Nation, explores the interconnection of pleasure and pain in the brain and helps explain addictive behaviors — not just to drugs and alcohol, but also to food, sex and smart phones. Lembke says that her patients who are struggling with substance abuse often believe their addictions are fueled by depression, anxiety and insomnia. But she maintains that the reverse is often true: Addictions can become the cause of pain — not the relief from it. That's because the behavior triggers, among other things, an initial response of the neurotransmitter dopamine, which floods the brain with pleasure. But once the dopamine wears off, a person is often left feeling worse than before. "They start out using the drug in order to feel good or in order to experience less pain," Lembke says. "Over time, with repeated exposure, that drug works less and less well. But they find themselves unable to stop, because when they're not using, then they're in a state of a dopamine deficit." © 2021 npr

Related chapters from BN: Chapter 4: The Chemistry of Behavior: Neurotransmitters and Neuropharmacology; Chapter 17: Learning and Memory
Related chapters from MM:Chapter 4: Development of the Brain; Chapter 13: Memory and Learning
Link ID: 27964 - Posted: 08.28.2021

By Michael Pollan After a half century spent waging war on drugs, Americans seem ready to sue for peace. The 2020 elections brought plenty of proof that voters have leapt ahead of politicians in recognizing both the failures of the drug war and the potential of certain illicit drugs as powerful tools for healing. Ballot initiatives in five states — four of them traditionally red — legalized some form of cannabis use. By substantial margins, Oregon passed two landmark drug reform initiatives: Fifty-nine percent of voters supported Measure 110, which decriminalized the possession of small quantities of all drugs, even hard ones like heroin and cocaine. A second proposal, Measure 109, specifically legalized psilocybin therapy, directing the state’s health department to license growers of so-called magic mushrooms and train facilitators to administer them beginning in 2023. In the past two years, a new drug policy reform movement called Decriminalize Nature has persuaded local governments in a half dozen municipalities, including Washington, D.C., to decriminalize “plant medicines” such as psilocybin, ayahuasca, iboga and the cactuses that produce mescaline. Last month, the California State Senate passed a bill that would make legal the personal possession, use and “social sharing” of psychedelics, including LSD and MDMA, a.k.a. Ecstasy or Molly. Political opposition to all these measures has been notably thin. Neither party, it seems, has the stomach for persisting in a war that has achieved so little while doing so much damage, especially to communities of color and our civil liberties. But while we can now begin to glimpse an end to the drug war, it is much harder to envision what the drug peace will look like. How will we fold these powerful substances into our society and our lives so as to minimize their risks and use them most constructively? The blunt binaries of “Just say no” that have held sway for so long have kept us from having this conversation and from appreciating how different one illicit drug is from another. © 2021 The New York Times Company

Related chapters from BN: Chapter 4: The Chemistry of Behavior: Neurotransmitters and Neuropharmacology; Chapter 16: Psychopathology: Biological Basis of Behavior Disorders
Related chapters from MM:Chapter 4: Development of the Brain; Chapter 12: Psychopathology: The Biology of Behavioral Disorders
Link ID: 27907 - Posted: 07.14.2021

By Sheila Kaplan Sales have plunged by $500 million. The work force has been cut by three-quarters. Operations in 14 countries have been abandoned. Many state and local lobbying campaigns have been shut down. Juul Labs, the once high-flying e-cigarette company that became a public health villain to many people over its role in the teenage vaping surge, has been operating as a shadow of its former self, spending the pandemic largely out of the public eye in what it calls “reset” mode. Now its very survival is at stake as it mounts an all-out campaign to persuade the Food and Drug Administration to allow it to continue to sell its products in the United States. The agency is trying to meet a Sept. 9 deadline to decide whether Juul’s devices and nicotine pods have enough public health benefit as a safer alternative for smokers to stay on the market, despite their popularity with young people who never smoked but became addicted to nicotine after using Juul products. Major health organizations, including the American Heart Association, American Lung Association, American Academy of Pediatrics and the American Cancer Society’s Cancer Action Network, have asked the agency to reject Juul’s application. “The stakes are high,” said Eric Lindblom, a senior scholar at the O’Neill Institute for National and Global Health Law at Georgetown University, and a former F.D.A. adviser on tobacco. “If the F.D.A. blows it on this one, they will face public health lawsuits.” Juul is sparing no expense to push back. Last week, the company agreed to pay $40 million to settle just one lawsuit (with North Carolina) out of thousands lodged against it, avoiding a looming jury trial. The company had urgently sought the deal to avoid courtroom testimony from parents and teenagers while the F.D.A. is reviewing its vaping products. © 2021 The New York Times Company

Related chapters from BN: Chapter 4: The Chemistry of Behavior: Neurotransmitters and Neuropharmacology
Related chapters from MM:Chapter 4: Development of the Brain
Link ID: 27889 - Posted: 07.06.2021

By Anil Ananthaswamy “Everything became imbued with a sense of vitality and life and vividness. If I picked up a pebble from the beach, it would move. It would glisten and gleam and sparkle and be absolutely captivating,” says neuroscientist Anil Seth. “Somebody looking at me would see me staring at a stone for hours.” Or what seemed like hours to Seth. A researcher at the UK’s University of Sussex, he studies how the brain helps us perceive the world within and without, and is intrigued by what psychedelics such as LSD can tell us about how the brain creates these perceptions. So a few years ago, he decided to try some, in controlled doses and with trusted people by his side. He had a notebook to keep track of his experiences. “I didn’t write very much in the notebook,” he says, laughing. Instead, while on LSD, he reveled in a sense of well-being and marveled at the “fluidity of time and space.” He found himself staring at clouds and seeing them change into faces of people he was thinking of. If his attention drifted, the clouds morphed into animals. Seth went on to try ayahuasca, a hallucinogenic brew made from a shrub and a vine native to South America and often used in shamanistic rituals there. This time, he had a more emotional trip that dredged up powerful memories. Both experiences strengthened Seth’s conviction that psychedelics have great potential for teaching us about the inner workings of the brain that give rise to our perceptions. He’s not alone. Armed with fMRI scans, EEG recordings, computational models of the brain and reports from volunteers tripping on psychedelics, a small but growing number of neuroscientists are trying to take advantage of these drugs and the hallucinations they induce to better understand how the brain produces perceptions. © 2021 Annual Reviews, Inc

Related chapters from BN: 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: Development of the Brain; Chapter 5: The Sensorimotor System
Link ID: 27883 - Posted: 06.29.2021

By Lenny Bernstein MORGANTOWN, W.Va. — After nearly two decades of hardcore drug addiction — after overdoses and rehabs and relapses, homelessness and dead friends and ruined lives — Gerod Buckhalter had one choice left, and he knew it. He could go on the same way and die young in someone’s home or a parking lot, another casualty in a drug epidemic that has claimed nearly 850,000 people like him. Or he could let a surgeon cut two nickel-size holes in his skull and plunge metal-tipped electrodes into his brain. More than 600 days after he underwent the experimental surgery, Buckhalter has not touched drugs again — an outcome so outlandishly successful that neither he nor his doctors dared hope it could happen. He is the only person in the United States to ever have substance use disorder relieved by deep brain stimulation. The procedure has reversed Parkinson’s disease, epilepsy and a few other intractable conditions, but had never been attempted for drug addiction here. The device, known as a deep brain stimulator, also is recording the electrical activity in Buckhalter’s brain — another innovation that researchers hope will help locate a biomarker for addiction and allow earlier intervention with other people. Buckhalter, 35, is a walking, talking laboratory for the outer edge of drug addiction therapy, a living experiment in what may be possible someday. Yet for all the futuristic prospects, he is also proof of how difficult treatment of addiction remains. Quelling it with a scalpel helps refute the false belief that substance use disorder is a weakness or a moral failing, rather than a brain disease. But it does not address the psychological, social and socioeconomic factors that complicate the disease.

Related chapters from BN: Chapter 4: The Chemistry of Behavior: Neurotransmitters and Neuropharmacology
Related chapters from MM:Chapter 4: Development of the Brain
Link ID: 27859 - Posted: 06.19.2021

By Rachel Nuwer In an important step toward medical approval, MDMA, the illegal drug popularly known as Ecstasy or Molly, was shown to bring relief to those suffering from severe post-traumatic stress disorder when paired with talk therapy. Of the 90 people who took part in the new study, which is expected to be published later this month in Nature Medicine, those who received MDMA during therapy experienced a significantly greater reduction in the severity of their symptoms compared with those who received therapy and an inactive placebo. Two months after treatment, 67 percent of participants in the MDMA group no longer qualified for a diagnosis of PTSD, compared with 32 percent in the placebo group. MDMA produced no serious adverse side effects. Some participants temporarily experienced mild symptoms like nausea and loss of appetite. “This is about as excited as I can get about a clinical trial,” said Gul Dolen, a neuroscientist at Johns Hopkins University School of Medicine, who was not involved in the research. “There is nothing like this in clinical trial results for a neuropsychiatric disease.” Before MDMA-assisted therapy can be approved for therapeutic use, the Food and Drug Administration needs a second positive Phase 3 trial, which is currently underway with 100 participants. Approval could come as early as 2023. Mental health experts say that this research — the first Phase 3 trial conducted on psychedelic-assisted therapy — could pave the way for further studies on MDMA’s potential to help address other difficult-to-treat mental health conditions, including substance abuse, obsessive compulsive disorder, phobias, eating disorders, depression, end-of-life anxiety and social anxiety in autistic adults. © 2021 The New York Times Company

Related chapters from BN: Chapter 4: The Chemistry of Behavior: Neurotransmitters and Neuropharmacology; Chapter 16: Psychopathology: Biological Basis of Behavior Disorders
Related chapters from MM:Chapter 4: Development of the Brain; Chapter 12: Psychopathology: The Biology of Behavioral Disorders
Link ID: 27804 - Posted: 05.05.2021

Ariana Remmel Scientists in search of psychedelic drug treatments have developed a way to determine whether a molecule is likely to cause hallucinations, without testing it on people or animals. Growing evidence suggests that psychedelic compounds, which are active in the brain, have potential to treat psychiatric illnesses such as post-traumatic stress disorder (PTSD), but researchers are trying to find out whether there is a way to keep the beneficial properties of these drugs without the hallucinogenic side effects, which can complicate treatment. It is currently almost impossible to predict whether a potential drug will cause hallucinations before it is tested on animals or people. “That really slows down drug discovery,” says David Olson, a chemical neuroscientist at the University of California, Davis. To address this, a team led by Olson and neuroscientist Lin Tian, also at Davis, designed a fluorescent sensor to predict whether a molecule is hallucinogenic, based on the structure of a brain receptor targeted by psychedelics. Using their approach, the researchers identified a psychedelic-like molecule without hallucinogenic properties that they later found had antidepressant activity in mice1. The discovery adds “more fuel for the fire” of efforts to make drugs from psychedelic-like molecules without side effects, says Bryan Roth, a molecular pharmacologist at the University of North Carolina School of Medicine in Chapel Hill. © 2021 Springer Nature Limited

Related chapters from BN: Chapter 4: The Chemistry of Behavior: Neurotransmitters and Neuropharmacology; Chapter 16: Psychopathology: Biological Basis of Behavior Disorders
Related chapters from MM:Chapter 4: Development of the Brain; Chapter 12: Psychopathology: The Biology of Behavioral Disorders
Link ID: 27798 - Posted: 05.01.2021

By Nambi Ndugga and Austin Frakt American deaths from misuse of substances, including alcohol, have increased over the past two decades, but not uniformly across various demographic groups. Overall rates of alcohol abuse and related deaths have consistently and significantly increased for white non-Hispanic Americans, while Black Americans have experienced a much slower and less significant incline, and some other groups have had declines. More recently, alcohol use has been up during the pandemic, with one study showing a greater increase in misuse among women than among men. (For men, heavy drinking is considered more than four drinks per day and 14 drinks per week, and for women, more than three drinks per day and seven drinks per week, according to the National Institute on Alcohol Abuse and Alcoholism.) “Alcohol kills many more people than many may realize,” said Yusuf Ransome, an assistant professor at Yale’s School of Public Health. “It is a major contributor to deaths linked to physical injuries, interpersonal violence, motor vehicle crashes, self-harm and other harmful outcomes.” One reason for this might be that alcohol is often viewed as socially acceptable. “Alcohol use has been normalized because it is consumed sometimes at family and communal gatherings, casual outings, and that’s the type of drinking that is typically seen or showed within the media,” he said. “We rarely see the long-term health impacts of excessive alcohol use, nor do we show the acute dangers of alcohol misuse and abuse.” Between 2000 and 2016, according to research published in JAMA, alcohol-related deaths continually increased for white men (2.3 percent per year on average) and white women (4.1 percent), with middle-aged white Americans accounting for the highest increase in deaths. Rapid increases during this period in mortality related to alcohol and drugs like opioids among white Americans — particularly those without a college degree — have been termed “deaths of despair.” Sign up for The Upshot Newsletter: Analysis that explains politics, policy and everyday life, with an emphasis on data and charts. © 2021 The New York Times Company

Related chapters from BN: Chapter 4: The Chemistry of Behavior: Neurotransmitters and Neuropharmacology; Chapter 15: Emotions, Aggression, and Stress
Related chapters from MM:Chapter 4: Development of the Brain; Chapter 11: Emotions, Aggression, and Stress
Link ID: 27779 - Posted: 04.21.2021

Greg Rosalsky Last month, New Jersey Governor Phil Murphy signed three bills making it official: marijuana will soon be growing legally in the gardens of the Garden State for anyone over 21 to enjoy. The bills follow through on a marijuana legalization ballot initiative that New Jerseyans approved overwhelmingly last year. New Jersey is now one of a dozen states, plus the District of Columbia, which have let loose the magic dragon — and more states, like Virginia, may be on the way. It's been almost a decade since Colorado and Washington legalized marijuana. That's given economists and other researchers enough time to study the effects of the policy. Here are some of the most interesting findings: Legalization didn't seem to substantially affect crime rates — Proponents of legalizing weed claimed it would reduce violent crimes. Opponents said it would increase violent crimes. A study by the CATO Institute finds, "Overall, violent crime has neither soared nor plummeted in the wake of marijuana legalization." Legalization seems to have little or no effect on traffic accidents and fatalities — Opponents of marijuana legalization argued it would wreak havoc on the road. A few studies have found that's not the case. Economists Benjamin Hansen, Keaton S. Miller & Caroline Weber, for instance, found evidence suggesting it had no effect on trends in traffic fatalities in both Colorado and Washington. © 2021 npr

Related chapters from BN: Chapter 4: The Chemistry of Behavior: Neurotransmitters and Neuropharmacology
Related chapters from MM:Chapter 4: Development of the Brain
Link ID: 27734 - Posted: 03.17.2021

By Matt Richtel Texas has one of the most restrictive medical marijuana laws in the country, with sales allowed only by prescription for a handful of conditions. That hasn’t stopped Lukas Gilkey, chief executive of Hometown Hero CBD, based in Austin, Texas. His company sells joints, blunts, gummy bears, vaping devices and tinctures that offer a recreational high. In fact, business is booming online as well, where he sells to many people in other states with strict marijuana laws. But Mr. Gilkey says that he is no outlaw, and that he’s not selling marijuana, just a close relation. He’s offering products with a chemical compound — Delta-8-THC — extracted from hemp. It is only slightly chemically different from Delta 9, which is the main psychoactive ingredient in marijuana. And that small distinction, it turns out, may make a big difference in the eyes of the law. Under federal law, psychoactive Delta 9 is explicitly outlawed. But Delta-8-THC from hemp is not, a loophole that some entrepreneurs say allows them to sell it in many states where hemp possession is legal. The number of customers “coming into Delta 8 is staggering,” Mr. Gilkey said. “You have a drug that essentially gets you high, but is fully legal,” he added. “The whole thing is comical.” The rise of Delta 8 is a case study in how industrious cannabis entrepreneurs are pulling apart hemp and marijuana to create myriad new product lines with different marketing angles. They are building brands from a variety of potencies, flavors and strains of THC, the intoxicating substance in cannabis, and of CBD, the nonintoxicating compound that is often sold as a health product. With Delta 8, entrepreneurs also believe they have found a way to take advantage of the country’s fractured and convoluted laws on recreational marijuana use. It’s not quite that simple, though. Federal agencies, including the Drug Enforcement Administration, are still considering their options for enforcement and regulation. © 2021 The New York Times Company

Related chapters from BN: Chapter 4: The Chemistry of Behavior: Neurotransmitters and Neuropharmacology
Related chapters from MM:Chapter 4: Development of the Brain
Link ID: 27714 - Posted: 02.28.2021