Chapter 4. The Chemistry of Behavior: Neurotransmitters and Neuropharmacology

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By Ted Alcorn Oregon is a drinker’s paradise. The state boasts more craft distilleries than Kentucky and is second only to California in the number of wineries. Some call Portland “beervana” for its bevy of breweries. But Oregon also has among the highest prevalence of problem drinking in the country. Last year, 2,153 residents died of causes attributed to alcohol, according to the Oregon Health Authority — more than twice the number of people killed by methamphetamines, heroin and fentanyl combined. Sonja Grove, a retiree in Portland whose adult son drank himself to death in April 2020, feels the toll is overlooked compared with those of other drugs. “Alcoholism has sort of taken a back seat.” In 2021, confronted by these conflicting trends, as the pandemic raged on, Oregon lawmakers made it easier to drink. They permanently legalized the sale of to-go cocktails, which the Distilled Spirits Council of the United States called a “lifeline,” and increased the number of cases that wineries could ship directly to consumers. Reginald Richardson, director of the state’s Alcohol and Drug Policy Commission, described the policies as incongruent. “We obviously want to create an environment that’s pro-business, that helps the state to develop, but we’ve got this other thing,” he said. That disconnect is typical: Before Covid lockdowns, no state permitted bars or restaurants to deliver liquor to customers at home, according to a trade association. Now, 28 have relaxed the rules. In contrast, policies that experts consider most effective at curbing excessive drinking have been ignored. For example, even as alcohol-related deaths soared to record highs in the last few years, alcohol taxes have fallen to the lowest rates in a generation. Americans drank more during the pandemic, but national data on the change have only recently become available. Alcohol tax revenues collected by the U.S. Treasury Department rose by eight percent in the fiscal year that ended on Sept. 30, 2021, compared with the previous year, and remain well above pre-pandemic levels. © 2022 The New York Times Company

Keyword: Drug Abuse
Link ID: 28482 - Posted: 09.17.2022

By Jackie Rocheleau After experimenting on a hen, his dog, his goldfish, and himself, dentist William Morton was ready. On Oct. 16, 1846, he hurried to the Massachusetts General Hospital surgical theater for what would be the first successful public test of a general anesthetic. His concoction of sulfuric ether and oil from an orange (just for the fragrance) knocked a young man unconscious while a surgeon cut a tumor from his neck. To the onlooking students and clinicians, it was like a miracle. Some alchemical reaction between the ether and the man’s brain allowed him to slip into a state akin to light sleep, to undergo what should have been a painful surgery with little discomfort, and then to return to himself with only a hazy memory of the experience. General anesthesia redefined surgery and medicine, but over a century later it still carries significant risks. Too much sedation can lead to neurocognitive disorders and may even shorten lifespan; too little can lead to traumatic and painful wakefulness during surgery. So far, scientists have learned that, generally speaking, anesthetic drugs render people unconscious by altering how parts of the brain communicate. But they still don’t fully understand why. Although anesthesia works primarily on the brain, anesthesiologists do not regularly monitor the brain when they put patients under. And it is only in the past decade that neuroscientists interested in altered states of consciousness have begun taking advantage of anesthesia as a research tool. “It’s the central irony” of anesthesiology, says George Mashour, a University of Michigan neuroanesthesiologist, whose work entails keeping patients unconscious during neurosurgery and providing appropriate pain management. Mashour is one of a small set of clinicians and scientists trying to change that. They are increasingly bringing the tools of neuroscience into the operating room to track the brain activity of patients, and testing out anesthesia on healthy study participants. These pioneers aim to learn how to more safely anesthetize their patients, tailoring the dose to individual patients and adjusting during surgery. They also want to better understand what governs the transitions between states of consciousness and even hope to crack the code of coma. © 2022 NautilusThink Inc, All rights reserved.

Keyword: Sleep; Consciousness
Link ID: 28480 - Posted: 09.17.2022

By Christina Jewett Juul Labs, fighting for its survival in the United States, on Tuesday tentatively agreed to pay $438.5 million to settle an investigation by nearly three dozen states over marketing and sales practices that they contend set off the nation’s teenage vaping crisis. The company said that it did not acknowledge any wrongdoing in the settlement, but that it was trying to “resolve issues from the past” while awaiting a decision by the Food and Drug Administration over whether it would be permitted to continue to sell its products. Juul has been trying to reposition itself as a seller of vaping products that could help adults quit smoking traditional cigarettes, in an effort to rehabilitate its tarnished reputation and improve its diminished market value. The tentative settlement prohibits the company from marketing to youth, funding education in schools and misrepresenting the level of nicotine in its products. But Juul had already discontinued several marketing practices and withdrawn many of its flavored pods that appealed to teenagers, under public pressure from lawmakers, parents and health experts a few years ago when the vaping crisis was at a peak. “We think that this will go a long way in stemming the flow of youth vaping,” William Tong, Connecticut’s attorney general, said at a news conference on Tuesday. “We are under no illusions and cannot claim that it will stop youth vaping. It continues to be an epidemic. It continues to be a huge problem. But we have essentially taken a big chunk out of what was once a market leader.” The multistate investigation found that the company appealed to young people by hiring young models, using social media to court teenagers and giving out free samples, he said. And, he added, the inquiry revealed that the company had a “porous” age verification system for its products and that 45 percent of its Twitter followers were ages 13 to 17. Jason Miyares, the attorney general for Virginia, pointed out in a statement that the company’s former strategy of selling flavors like mango and crème brûlée appealed to youth as did the sleek design of its device that was easy to conceal. One term of the settlement banned the company from depicting anyone under 35 in its marketing images, Mr. Miyares’ statement said. © 2022 The New York Times Company

Keyword: Drug Abuse
Link ID: 28464 - Posted: 09.07.2022

Perspective by Steven Petrow A few weeks ago, I mentioned to a friend that I was interested in learning more about psychedelics, especially how they might help me with depression and anxiety. That’s a broad category of plant medicines including psilocybin (“magic”) mushrooms, MDMA (ecstasy), DMT (Dimitri or the Businessman’s Trip), ketamine (“special K”) and some others. I’d been hesitant to be open about my search, because I’m old enough to remember the warnings about “bad trips” that scramble your brain. Imagine my surprise when my friend told me he’d recently taken his first “trip,” which he described as life-changing. I asked him — a real estate developer living in Northern California, married with kids — why he decided to try a psychedelic substance. “My work felt increasingly stale and meaningless,” he explained to me over a beer. “Despite a massive amount of reflection and coaching around how to break the rut, I felt as though I was still off track.” He and the others who have used these medicines spoke on the condition of anonymity because most of these psychedelics are Schedule I substances, meaning they are illegal to manufacture, buy, possess or distribute. When I confided my interest in psychedelics to a few other friends, several said they had tried the drugs and experienced several benefits: from easing anxiety to finding spiritual insights to combating depression and, among some with cancer, helping to reduce the fear of dying. They are hardly outliers. According to a new YouGovAmerica study, “one in four Americans say they’ve tried at least one psychedelic drug,” amounting to some 72 million U.S. adults. (The study included the medicines mentioned earlier, plus LSD, mescaline and salvia.) Was I missing a beat by not getting onboard?

Keyword: Depression; Drug Abuse
Link ID: 28463 - Posted: 09.07.2022

By Matt Richtel This article examines the increase in anxiety, depression, self harm and suicide among U.S. adolescents. Parents and teenagers dealing with these issues can find resources here. One morning in the fall of 2017, Renae Smith, a high school freshman on Long Island, N.Y., could not get out of bed, overwhelmed at the prospect of going to school. In the following days, her anxiety mounted into despair. “I should have been happy,” she later wrote. “But I cried, screamed and begged the universe or whatever godly power to take away the pain of a thousand men that was trapped inside my head.” Intervention for her depression and anxiety came not from the divine but from the pharmaceutical industry. The following spring, a psychiatrist prescribed Prozac. The medication offered a reprieve from her suffering, but the effect dissipated, so she was prescribed an additional antidepressant, Effexor. A medication cascade had begun. During 2021, the year she graduated, she was prescribed seven drugs. These included one for seizures and migraines — she experienced neither, but the drug can be also used to stabilize mood — and another to dull the side effects of the other medications, although it is used mainly for schizophrenia. She felt better some days but deeply sad on others. Her senior yearbook photo shows her smiling broadly, “but I felt terrible that day,” said Ms. Smith, who is now 19 and attends a local community college. “I’ve gotten good at wearing a mask.” She had come to exemplify a medical practice common among her generation: the simultaneous use of multiple heavy-duty psychiatric drugs. Psychiatrists and other clinicians emphasize that psychiatric drugs, properly prescribed, can be vital in stabilizing adolescents and saving the lives of suicidal teens. But, these experts caution, such medications are too readily doled out, often as an easy alternative to therapy that families cannot afford or find, or aren’t interested in. © 2022 The New York Times Company

Keyword: Drug Abuse; Depression
Link ID: 28450 - Posted: 08.27.2022

By Andrew Jacobs A small study on the therapeutic effects of using psychedelics to treat alcohol use disorder found that just two doses of psilocybin magic mushrooms paired with psychotherapy led to an 83 percent decline in heavy drinking among the participants. Those given a placebo reduced their alcohol intake by 51 percent. By the end of the eight-month trial, nearly half of those who received psilocybin had stopped drinking entirely compared with about a quarter of those given the placebo, according to the researchers. The study, published Wednesday in JAMA Psychiatry, is the latest in a cascade of new research exploring the benefits of mind-altering compounds to treat a range of mental health problems, from depression, anxiety and post-traumatic stress disorder to the existential dread experienced by the terminally ill. Although most psychedelics remain illegal under federal law, the Food and Drug Administration is weighing potential therapeutic uses for compounds like psilocybin, LSD and MDMA, the drug better known as Ecstasy. Dr. Michael Bogenschutz, director at NYU Langone Center for Psychedelic Medicine and the study’s lead investigator, said the findings offered hope for the nearly 15 million Americans who struggle with excessive drinking — roughly 5 percent of all adults. Excessive alcohol use kills an estimated 140,000 people each year. “These are exciting results,” Dr. Bogenschutz said. “Alcohol use disorder is a serious public health problem, and the effects of currently available treatments and medications tend to be small.” The double-blind randomized trial followed 93 participants for 32 weeks and divided them into two groups: One received psilocybin and the other a placebo in the form of antihistamine pills. The participants, all of whom struggled with excessive drinking, also took part in 12 therapy sessions that began several weeks before they received their first doses and continued for a month after the final dose. The psilocybin dosage was determined according to participants’ weight, and their heart rate and blood pressure were monitored during the eight-hour sessions. © 2022 The New York Times Company

Keyword: Drug Abuse; Depression
Link ID: 28448 - Posted: 08.27.2022

By Andrew Jacobs Marijuana and hallucinogen use among young adults reached an all-time record last year after having leveled off during the first year of the coronavirus pandemic, according to federal survey data. The findings, part of the government’s annual survey of drug use among young Americans, also found that nicotine vaping and excessive alcohol consumption continued to climb in 2021 after a brief pause. Another worrying trend among young people, ages 19 to 30: mounting consumption of alcoholic beverages suffused with THC, the psychoactive ingredient in cannabis. But there were some bright spots in the survey. Cigarette smoking and opioid abuse among young adults dropped last year, a continuing trend that has heartened public health experts. Taken in its entirety, the report provides a mixed picture of substance use in the United States that experts say reflects a number of disparate trends affecting young Americans: the devastating mental health effects of the pandemic; the increased availability of legal marijuana; and the emerging therapeutic embrace of psychedelics to treat depression, post-traumatic stress disorder and other psychological problems. “Overall, the results are very concerning,” said Dr. Nora Volkow, director of the National Institute on Drug Abuse, which publishes the annual Monitoring the Future survey. “What they tell us is that the problem of substance abuse among young people has gotten worse in this country, and that the pandemic, with all its mental stressors and turmoil, has likely contributed to the rise.” The online survey of people ages 19 to 60 was conducted from April to October 2021. Substance use research experts said the mounting use of marijuana in young adults was especially notable. The survey found that 43 percent in the 19-30 age group had used cannabis 20 or more times over the previous month, up from 34 percent. In 2011, that figure was 29 percent. Daily marijuana consumption also jumped significantly, to 11 percent from 6 percent in 2011. © 2022 The New York Times Company

Keyword: Drug Abuse
Link ID: 28443 - Posted: 08.24.2022

By Emma Yasinski In the years since a family member of mine started taking methadone, a drug that helps him avoid the excruciating withdrawal symptoms and intense cravings that come with an opioid use disorder, he’s attended the funerals of three of his closest friends with whom he used to use drugs. The number of acquaintances he’s lost is in the double digits. Methadone might have saved them — if only they could have picked it up from their local pharmacy. Like heroin or oxycodone, methadone stimulates the opioid receptors in the brain. The difference is that while heroin rapidly floods these receptors leading to an intense high, the effect of methadone is more gradual and long-lasting. At the appropriate dose, my family member (whom I’m not naming due to the continued stigma surrounding opioids) and other patients can get full days of relief from pain, withdrawal, and cravings, without the intoxication. But methadone is tightly regulated. Rather than pick it up from the local pharmacy, patients have to visit a specialized clinic — often daily — to get each individual dose. In March 2020, concerns about Covid-19 led the Substance Abuse and Mental Health Services Administration, or SAMHSA, to relax those restrictions. The agency announced that states could request an exception allowing clinics to offer a greater amount of take-home doses— up to 28 days — for patients the clinical team believed were stable and could safely handle the medication. Some clinics embraced the opportunity. In a multistate survey of 170 opioid treatment programs, about half followed the relaxed SAMHSA guidelines for newly enrolled or less stable patients. And two-thirds of the clinics surveyed offered their stable patients a full four weeks of take-home doses. The pandemic provided the natural experiment to demonstrate that loosening regulations on methadone in the U.S. was safe for both patients and communities. More than two years later, on July 13, researchers at the National Institute on Drug Abuse and the National Center for Injury Prevention and Control published some of the most powerful results of that experiment. While deadly overdoses involving opioids rose to staggering heights in the U.S. during the first year of the pandemic, the percentage of overdose deaths involving methadone decreased.

Keyword: Drug Abuse
Link ID: 28435 - Posted: 08.13.2022

Adam Miller · CBC News · A new analysis of the cause of depression has seemingly upended what we know about this common condition and challenged the use of antidepressants. But it may also leave patients with more questions than answers as the science evolves. A systematic umbrella review of 17 studies published in Molecular Psychology on July 20 looked at the decades-old theory that depression is caused by low serotonin, and found there was "no consistent evidence" of "an association between serotonin and depression." The theory that depression is caused by a chemical imbalance in the brain has been around since the 1960s. But for years, many experts have doubted this, feeling it oversimplified a complex condition. "The serotonin theory is very old and has been very popular since the '90s, when the pharmaceutical industry started promoting it," said Dr. Joanna Moncrieff, a psychiatry professor at University College London and lead author of the study. "But since about 2005, probably a bit before then, there's been sort of rumours that actually the evidence isn't very strong, or it's inconsistent. Some studies are positive, some studies are negative, but no one's really got that evidence together anywhere." Moncrieff and her team set out to challenge the serotonin theory in a systematic review of available research. They also went a step further in their conclusion by suggesting that antidepressants are ineffective at treating depression — and have largely worked as a placebo. ©2022 CBC/Radio-Canada.

Keyword: Depression
Link ID: 28434 - Posted: 08.13.2022

Martha Bebinger Approaching a van that distributes safe supplies for drug use in Greenfield, Mass., a man named Kyle noticed an alert about xylazine. "Xylazine?" he asked, sounding out the unfamiliar word. "Tell me more." A street-outreach team from Tapestry Health delivered what's becoming a routine warning. Xylazine is an animal tranquilizer. It's not approved for humans, but it's showing up in about half of the drug samples that Tapestry tests in the rolling hills of western Massachusetts. It's appearing mostly in the illegal fentanyl supply but also in cocaine. Kyle rocked backward on his heels at the mention of cocaine. He and his friends regularly use cocaine, but lately, they had suspected that something else was in the bag. "The past week, we've all been just racking our brains, like 'What is going on?'" he said. "Because if we cook it up and we smoke it, we're falling asleep after." Kyle's deep sleep might have been triggered by fentanyl too, but Kyle said one of his buddies used a test strip to check for the opioid and none was detected. Xylazine surged first in some areas of Puerto Rico and then in Philadelphia, where it was found in 91% of opioid samples last year, the most recent reporting period. Data from January to mid-June shows that xylazine was in 28% of drug samples tested by the Massachusetts Drug Supply Data Stream (MADDS), a state-funded network of community drug-checking and advisory groups that uses mass spectrometers to let people know what's in bags or pills purchased on the street. Some areas of the state, including western Massachusetts, are seeing xylazine in 50% to 75% of samples. In Greenfield, that's a big change from last year, when xylazine wasn't a concern. © 2022 npr

Keyword: Drug Abuse
Link ID: 28423 - Posted: 08.06.2022

By Andrew Jacobs At some point in the next few years, the 30 million smokers in the United States could wake up one day to find that cigarettes sold at gas stations, convenience stores and smoke shops contain such minuscule amounts of nicotine that they cannot get their usual fix when lighting up. Would the smokers be plunged into the agonizing throes of nicotine withdrawal and seek out their favorite, full-nicotine brand on illicit markets, or would they turn to vaping, nicotine gum and other less harmful ways to get that angst-soothing rush? Such scenarios inched closer to the realm of possibility in June, when the Food and Drug Administration said that it would move toward slashing nicotine levels in cigarettes in an effort to reduce the health effects of an addiction that claims 480,000 lives a year. The agency set next May as its timetable for introducing a fully developed proposal. But many experts hope regulators will champion an immediate 95 percent reduction in nicotine levels — the amount federally funded studies have determined is most effective for helping smokers kick the habit. It could be years before any new policy takes effect, if it survives opposition from the tobacco industry. Even so, health experts say any effort to decrease nicotine in cigarettes to nonaddictive levels would be a radical experiment, one that has never been implemented by any other country. The science of nicotine addiction has come a long way since 1964, when a U.S. Surgeon General report first linked smoking to cancer and heart disease, although it would take another two decades for the mechanics of nicotine dependence to be understood and widely accepted. Tobacco contains more than 7,000 chemicals, many of them harmful when burned and inhaled, but it is nicotine that keeps smokers coming back for more. Nicotine stimulates a surge of adrenaline in the brain while indirectly producing a flood of dopamine, the chemical that promotes feelings of contentment and relaxation. The effects, however, are short-lived, which is why heavy smokers need a fresh injection a dozen or more times a day. © 2022 The New York Times Company

Keyword: Drug Abuse
Link ID: 28418 - Posted: 08.03.2022

By Sarah Wild In 2015, psychiatrist Mark Horowitz tried to come off his antidepressants. He reduced his dosage by a set proportion over the course of several months, which is much longer than what the United Kingdom’s guidelines recommended. But in the process of tapering, he experienced a storm of new symptoms, including anxiety, dizziness, and bouts of insomnia. “I’d wake in the morning, feeling like I was being chased by an animal on the edge of a cliff,” he says. Ultimately, he felt he had no choice but to go back on his medication. As it happened, Horowitz had recently completed a Ph.D. on the neurobiology of antidepressants. During his training, he recalls, his professors had told him that stopping antidepressants was fairly easy. Their view was supported by the scientific literature, which had found that any withdrawal symptoms were minor and faded quickly. Experiences such as Horowitz’s were considered an anomaly. But a series of widely reported studies published over the past seven years suggest that discontinuation symptoms are common and can be severe, including everything from panic attacks and flu-like symptoms to electric shock sensations in the head. The longer people remain on antidepressants and the higher their dose, the more likely they are to experience withdrawal symptoms. Each year, millions of people begin taking antidepressants. They have been shown to help anxiety sufferers feel calmer and lift the moods of those with severe depression and balance their emotions. For many, the intervention is lifesaving. Yet even today, few physicians inform their patients about the potential difficulties of coming off the medication. Most national guidelines suggest a slow taper, but there is little to no guidance on precisely how to do this. Patients who experience intense withdrawal symptoms may end up remaining on antidepressants or turning to online peer support groups for help.

Keyword: Depression
Link ID: 28414 - Posted: 07.30.2022

Ismaeel Yunusa Taking oxycodone at the same time as certain selective serotonin reuptake inhibitors (SSRIs), a commonly prescribed class of antidepressant, can increase the risk of opioid overdose, according to a study my colleagues and I published. Doctors prescribe the opioid oxycodone to treat moderate to severe pain after surgeries and injuries or certain conditions like cancer. Opioids are also a common drug of abuse. In the U.S., over 70% of drug overdose deaths in 2019 involved an opioid. Because many patients with depression also experience chronic pain, opioids are often coprescribed with antidepressants like SSRIs. Prior research has shown that certain SSRIs, namely fluoxetine (Prozac or Sarafem) and paroxetine (Paxil, Pexeva or Brisdelle), can strongly inhibit a liver enzyme crucial to the proper breakdown of drugs in the body, including oxycodone. The resulting increased concentration of oxycodone in the blood may lead to accidental overdose. To see whether different types of SSRIs might affect a patient’s risk of overdosing on oxycodone, my colleagues and I examined data from three large U.S. health insurance claims databases. We included over 2 million adults who began taking oxycodone while using SSRIs between 2000 and 2020. The average age of the group was around 50, and a little over 72% were women. A little over 30% were taking the SSRIs paroxetine and fluoxetine. We found that patients taking paroxetine or fluoxetine had a 23% higher risk of overdosing on oxycodone than those using other SSRIs. © 2010–2022, The Conversation US, Inc.

Keyword: Depression; Drug Abuse
Link ID: 28413 - Posted: 07.30.2022

By Linda Searing People who drink a moderate amount of coffee — up to 3½ cups a day — might have a better chance at a longer life span, even if their coffee is lightly sweetened with sugar, according to research published in Annals of Internal Medicine. For about seven years, the researchers tracked the coffee consumption and health of 171,616 participants, who were an average of nearly 56 years old and were free of cancer and cardiovascular disease when the study started. They found that those who regularly drank 1½ to 3½ cups of coffee a day, whether plain or sweetened with about a teaspoon of sugar, were up to 30 percent less likely to die in that time frame from any cause, including cancer and cardiovascular disease, than were those who did not drink coffee. The type of coffee — whether instant, ground or decaffeinated — made no difference, but the results were described as inconclusive for the use of artificial sweeteners. The latest research does not prove that coffee alone was responsible for participants’ lowered mortality risk. Still, over the years, research has revealed a variety of health benefits for coffee, linking its consumption to a reduced risk for Type 2 diabetes, Parkinson’s disease, depression and more. Nutritionists often attribute the benefits of coffee to the abundance of antioxidants in coffee beans, which may help reduce internal inflammation and cell damage and protect against disease. Drinking caffeinated coffee also provides an energy boost and increased alertness. Caffeine, however, can disrupt sleep and be risky during pregnancy.

Keyword: Drug Abuse; Obesity
Link ID: 28406 - Posted: 07.23.2022

By Chris Vognar Sign up for the Watching newsletter, for Times subscribers only. Streaming TV and movie recommendations from critic Margaret Lyons and friends. Get it in your inbox. In late 2012, the best-selling author and journalist Michael Pollan (“The Omnivore’s Dilemma”) was at a dinner party in Berkeley, Calif. Among his fellow diners was a prominent developmental psychiatrist, in her 60s, who spoke at some length about a recent LSD trip. This pricked up Pollan’s ears. His first thought, as he shared during a recent video interview: “People like that are taking LSD?” The psychiatrist went on to explain that the drug gave her a better understanding of the way children think. “Her hypothesis,” Pollan said, “was that the effects of psychedelics, LSD in that case, give us a taste of what child consciousness would be like — this kind of 360-degree taking-in of information, not particularly focused, fascinated by everything.” Pollan had already heard about clinical trials in which doctors were giving cancer patients psilocybin to help them deal with their fear of death. Now, he was really curious about psychedelic therapy. That curiosity became an article in The New Yorker (“The Trip Treatment,” 2015). The article became a book, “How to Change Your Mind” (2019). And now the book has become a four-part Netflix series of the same name, which debuted Tuesday. Pollan is an executive producer (along with the Oscar-winning filmmaker Alex Gibney) and the primary on-camera presence. A thoughtful and wide-ranging look at psychedelic therapy, the series is grounded in accounts of their centuries-long sacramental use and of their uneasy history in modern society, especially in the United States. In particular, it focuses on four substances — LSD, mescaline, MDMA (known as Ecstasy or Molly) and psilocybin (the active ingredient in magic mushrooms) — and the ways in which they are being used to treat patients with maladies including post-traumatic stress disorder, addiction, depression, anxiety and obsessive-compulsive disorder. © 2022 The New York Times Company

Keyword: Drug Abuse; Depression
Link ID: 28401 - Posted: 07.16.2022

By Ryan McDonald In color and consistency, black tar heroin is often compared to a Tootsie Roll. To become runny enough to pass through the point of a needle, a pellet of black tar must be heated in water to near boiling. After the drug has been injected, the syringes must be vigorously flushed to prevent the caramel-like residue from crystallizing. In the late 1990s and early 2000s, two researchers methodically recorded these details while trying to explain a lingering puzzle of the AIDS epidemic: why people who use injection drugs west of the Mississippi River had lower rates of HIV than similar individuals elsewhere. Their observations eventually formed the basis of a 2003 paper, which noted that from Houston, to Los Angeles, to Seattle, the majority of available heroin was black tar, rather than the powder form common on the East Coast. The paper’s authors hypothesized that, among other things, the boiling of water and flushing of needles reduced the probability of transmitting HIV through shared equipment. These observations and hypotheses were possible because the researchers, Philippe Bourgois and Dan Ciccarone, had immersed themselves among people who use heroin. In doing so, they were practicing ethnography, a research approach that seeks to understand how people think and behave in their natural environments through observation, interviews, and open-ended survey questions. Ethnographic research is conducted in a range of fields, including substance use and addiction. As the opioid epidemic stretches into a third decade and drug overdose deaths in the United States top 100,000 per year, some social scientists say this approach has taken on new urgency.

Keyword: Drug Abuse
Link ID: 28397 - Posted: 07.14.2022

By Kim Tingley “Time,” when we give it any thought, tends to strike us as extrinsic, a feature of our landscape: We track our passage through it as if traversing an invisible geography, our progress charted by wristwatch, clock, calendar. Humans didn’t invent time, of course, but you might reasonably argue that because we invented the units we use to keep track of it — hours, minutes, seconds — we have every right to tinker with them when we want to. This, at least, was the position the Senate took on March 15, when in a surprise, and surprisingly uncontested, vote it passed the Sunshine Protection Act. The new law would, if the House concurs and the president signs, make daylight saving time permanent, beginning on Nov. 5, 2023. The change has long been a desire of the retail industry because it is convinced that shoppers spend more money when it stays light out later. But lawmakers also seem to have regarded the annual rolling back of the clock as a personal affront: the groggy mornings that result from turning 6 a.m. into 5 a.m., the morale killer for Boston and Billings alike when darkness abruptly descends shortly after 4 in the afternoon. When the yeas prevailed, there was bipartisan applause, as if a particularly hostile foreign adversary had been defeated. What most of those lawmakers very likely didn’t realize was that the enemy was not just outside us — a social agreement about how to label every moment of our existence relative to the sun — it was also inside us, where our internal organs are keeping time, too. In fact, most of our physiological functions are governed by an untold number of carefully synchronized biological clocks that each complete one cycle about every 24 hours. Those cycles are known as circadian rhythms, after the Latin for “about” (circa) and “day” (dies). © 2022 The New York Times Company

Keyword: Biological Rhythms
Link ID: 28394 - Posted: 07.12.2022

By Christina Jewett and Andrew Jacobs The Food and Drug Administration is planning to require tobacco companies to slash the amount of nicotine in traditional cigarettes to make them less addictive and reduce the toll of smoking that claims 480,000 lives each year. The proposal, which could take years to go into effect, would put the United States at the forefront of global antismoking efforts. Only one other nation, New Zealand, has advanced such a plan. The headwinds are fierce. Tobacco companies have already indicated that any plan with significant reductions in nicotine would violate the law. And some conservative lawmakers might consider such a policy another example of government overreach, ammunition that could spill over into the midterm elections. Few specifics were released on Tuesday, but according to a notice published on a U.S. government website, a proposed rule would be issued in May 2023 seeking public comment on establishing a maximum nicotine level in cigarettes and other products. “Because tobacco-related harms primarily result from addiction to products that repeatedly expose users to toxins, F.D.A. would take this action to reduce addictiveness to certain tobacco products, thus giving addicted users a greater ability to quit,” the notice said. The F.D.A. declined to provide further details. But in a statement posted on its website, Dr. Robert M. Califf, the agency’s commissioner, said: “Lowering nicotine levels to minimally addictive or non-addictive levels would decrease the likelihood that future generations of young people become addicted to cigarettes and help more currently addicted smokers to quit.” “This one rule could have the greatest impact on public health in the history of public health,” said Mitch Zeller, the recently retired F.D.A. tobacco center director. “That’s the scope and the magnitude we’re talking about here because tobacco use remains the leading cause of preventable disease and death.” © 2022 The New York Times Company

Keyword: Drug Abuse
Link ID: 28377 - Posted: 06.25.2022

By Oliver Whang Cats, so often, are a mystery, even to those that know them best. Why do they sleep so much? Why do they want your full attention one minute, none the next? How can they find their way back home after being stranded miles away for years? The writer Haruki Murakami, who is known for putting cats in his novels and essays, once confessed to not knowing why he does so; a cat “sort of naturally slips in,” he said. Another mystery: Why do cats love catnip? When exposed to the plant, which belongs to the mint family, the majority of domestic cats will lick it, rub against it, chew it and roll around in it. They brim with euphoria, getting high off the stuff. They also go wild for other plants, particularly silver vine, which is not closely related to catnip but elicits the same response from felines, including big cats like jaguars and tigers. For years, this behavior was just another cat-related enigma. But a new study, published Tuesday in the journal iScience, suggests that the reaction to catnip and silver vine might be explained by the bug repellent effect of iridoids, the chemicals in the plants that induce the high. Researchers, led by Masao Miyazaki, an animal behavior scientist at Iwate University in Japan, found that the amount of these iridoids released by the plant increased by more than 2,000 percent when the plant was damaged by cats. So perhaps kitty’s high confers an evolutionary advantage: keeping bloodsucking insects at bay. Kristyn Vitale, a cat behavior expert at Unity College who was not associated with the research, noted that the study built on strong previous work. Last year, the same lab published a study that found that cats would try their best to coat themselves in DEET-like iridoids, whether by rolling on the chemicals or by rising up to nuzzle them with their cheeks. “This indicates there may be a benefit to the cat physically placing the compounds on their body,” Dr. Vitale said. © 2022 The New York Times Company

Keyword: Drug Abuse
Link ID: 28373 - Posted: 06.15.2022

By Benjamin Mueller Taking a scan of an injured brain often produces a map of irretrievable losses, revealing spots where damage causes memory difficulties or tremors. But in rare cases, those scans can expose just the opposite: plots of brain regions where an injury miraculously relieves someone’s symptoms, offering clues about how doctors might accomplish the same. A team of researchers has now taken a fresh look at a set of such brain images, drawn from cigarette smokers addicted to nicotine in whom strokes or other injuries spontaneously helped them quit. The results, the scientists said, showed a network of interconnected brain regions that they believe underpins addiction-related disorders affecting potentially tens of millions of Americans. The study, published in the scientific journal Nature Medicine on Monday, supports an idea that has recently gained traction: that addiction lives not in one brain region or another, but rather in a circuit of regions linked by threadlike nerve fibers. The results may provide a clearer set of targets for addiction treatments that deliver electrical pulses to the brain, new techniques that have shown promise in helping people quit smoking. “One of the biggest problems in addiction is that we don’t really know where in the brain the main problem lies that we should target with treatment,” said Dr. Juho Joutsa, one of the study’s lead authors and a neurologist at the University of Turku in Finland. “We are hoping that after this, we have a very good idea of those regions and networks.” Research over the last two decades has solidified the idea that addiction is a disease of the brain. But many people still believe that addiction is voluntary. © 2022 The New York Times Company

Keyword: Drug Abuse; Stroke
Link ID: 28371 - Posted: 06.14.2022