Chapter 4. The Chemistry of Behavior: Neurotransmitters and Neuropharmacology

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The mysterious ailments experienced by some 40 Canadian and U.S. diplomats and their families while stationed in Cuba may have had nothing to do with sonic "attacks" identified in earlier studies. According to a new Canadian study, obtained exclusively by Radio-Canada's investigative TV program Enquête, the cause could instead be neurotoxic agents used in pesticide fumigation. A number of Canadians and Americans living in Havana fell victim to an unexplained illness starting in late 2016, complaining of concussion-like symptoms, including headaches, dizziness, nausea and difficulty concentrating. Some described hearing a buzzing or high-pitched sounds before falling sick. In the wake of the health problems experienced over the past three years, Global Affairs Canada commissioned a clinical study by a team of multidisciplinary researchers in Halifax, affiliated with the Brain Repair Centre, Dalhousie University and the Nova Scotia Health Authority. "The working hypothesis actually came only after we had most of the results," Dr. Alon Friedman, the study's lead author, said in an interview. The researchers identified a damaged region of the brain that is responsible for memory, concentration and sleep-and-wake cycle, among other things, and then looked at how this region could come to be injured. "There are very specific types of toxins that affect these kinds of nervous systems ... and these are insecticides, pesticides, organophosphates — specific neurotoxins," said Friedman. "So that's why we generated the hypothesis that we then went to test in other ways." Twenty-six individuals participated in the study, including a control group of people who never lived in Havana. ©2019 CBC/Radio-Canada

Keyword: Neurotoxins; Attention
Link ID: 26627 - Posted: 09.20.2019

By Matt Richtel and Sheila Kaplan The number of vaping-related lung illnesses has risen to 530 probable cases, according to an update on Thursday by the Centers for Disease Control and Prevention, and a Missouri man became the eighth to die from the mysterious ailments. During a news briefing, Dr. Anne Schuchat, principal deputy director of the C.D.C., said officials expect more deaths because some people are suffering from severe lung illnesses. But the nation’s public health officials said they still were unable to pinpoint the cause, or causes, of the sicknesses that have resulted in hundreds of hospitalizations, with many in intensive care units. Dr. Schuchat said some patients are on ventilators and therefore are unable to tell investigators what substances they vaped. “I wish we had more answers,” she said. The C.D.C. provided the first demographic snapshot of the afflicted: Nearly three-quarters are male, two-thirds between 18 and 34. Sixteen percent are 18 or younger. “More than half of cases are under 25 years of age,” Dr. Schuchat said. Illnesses have now been reported in 38 states, and one United States territory. In the most recent case, in St. Louis, officials said on Thursday that a man in his mid-40s who had chronic pain had begun vaping last May. He was hospitalized Aug. 22 with respiratory problems and died on Wednesday. “He started out with shortness of breath and it rapidly progressed and deteriorated, developing into what is called acute respiratory distress syndrome (ARDS),” said Dr. Michael Plisco, a critical care pulmonologist at Mercy Hospital St. Louis. “Once the lungs are injured by vaping, we don’t know how quickly it worsens and if it depends on other risk factors.” He and other officials said they did not know what substance the patient had been vaping, but Dr. Plisco said in an interview that tissue samples from his lungs showed cells stained with oil. Some products include oils that if inhaled — even small droplets — can cling to the lungs and airways and cause acute inflammation, doctors have said. © 2019 The New York Times Company

Keyword: Drug Abuse
Link ID: 26626 - Posted: 09.20.2019

Scott Neuman New York Gov. Andrew Cuomo said Sunday he will push for a ban on some electronic cigarettes amid a health scare linked to vaping — a move that would follow a similar ban enacted by Michigan and a call from President Trump for a federal prohibition on certain vaping products. Speaking in Manhattan, Cuomo, a Democrat, said the state's Public Health and Health Planning Council and state health commissioner Dr. Howard Zucker would issue an emergency regulation banning flavored e-cigarette products. "Vaping is dangerous," the governor said. "At a minimum, it is addicting young people to nicotine at a very early age." The push at the state and federal levels to ban certain vaping products comes as the Centers for Disease Control and Prevention said last week that 380 confirmed or probable cases of lung disease associated with e-cigarettes had been identified in 36 states and the U.S. Virgin Islands, with six confirmed deaths. Earlier this month, Michigan imposed a similar ban. Bills to halt the sale of flavored vaping products have been introduced in California and Massachusetts. Last week, Trump, appearing beside Health and Human Services Secretary Alex Azar, announced that his administration would move toward a federal ban of flavored vaping products. "Vaping has become a very big business, as I understand it, but we can't allow people to get sick and allow our youth to be so affected," the president said. © 2019 npr

Keyword: Drug Abuse
Link ID: 26617 - Posted: 09.17.2019

By Maanvi Singh The world’s most widely used insecticides may delay the migrations of songbirds and hurt their chances of mating. In the first experiment to track the effects of a neonicotinoid on birds in the wild, scientists captured 24 white-crowned sparrows as they migrated north from Mexico and the southern United States to Canada and Alaska. The team fed half of those birds with a low dose of the commonly used agricultural insecticide imidacloprid and the other half with a slightly higher dose. An additional 12 birds were captured and dosed with sunflower oil, but no pesticide. Within hours, the dosed birds began to lose weight and ate less food, researchers report in the Sept. 13 Science. Birds given the higher amount of imidacloprid (3.9 milligrams per kilogram of body mass) lost 6 percent of their body mass within six hours. That’s about 1.6 grams for an average bird weighing 27 grams. Tracking the birds (Zonotrichia leucophrys) revealed that the pesticide-treated sparrows also lagged behind the others when continuing their migration to their summer mating grounds. The findings suggest that neonicotinoid insecticides, already implicated in dropping bee populations, could also have a hand in the decline of songbird populations across North America. From 1966 to 2013, the populations of nearly three-quarters of farmland bird species across the continent have precipitously dropped. The researchers dosed the birds in the lab with carefully measured amounts of pesticide mixed with sunflower oil. In the wild, birds might feed on seeds coated with imidacloprid. The highest dose that “we gave each bird is the equivalent of if they ate one-tenth of [a single] pesticide-coated corn seed,” says Christy Morrissey, a biologist at the University of Saskatchewan in Saskatoon, Canada. “Frankly, these were minuscule doses we gave the birds.” © Society for Science & the Public 2000–2019.

Keyword: Neurotoxins; Obesity
Link ID: 26608 - Posted: 09.13.2019

Jon Hamilton The depression drug esketamine, marketed as Spravato, appears to offer quick relief to people who are actively considering suicide. Esketamine, a chemical cousin of the anesthetic and party drug ketamine, reduced depression symptoms within hours in two large studies of suicidal patients, the drug's maker announced Monday. The studies, which included 456 patients who were suicidal, found that after 24 hours, patients who got the drug along with standard treatment were less depressed than people who got standard treatment alone. Surprisingly, though, patients who got esketamine were not significantly less suicidal, even though they had fewer symptoms of depression. The finding came from two studies sponsored by the drug's maker, Johnson & Johnson, and presented at the 32nd European College of Neuropsychopharmacology meeting in Copenhagen. Esketamine "showed a benefit in a very high-risk patient population, which is usually excluded from most clinical trials," says Dr. David Hough, a psychiatrist and esketamine compound development team leader at Janssen Research and Development LLC, a part of Johnson & Johnson. © 2019 npr

Keyword: Depression; Drug Abuse
Link ID: 26593 - Posted: 09.10.2019

By Matt Richtel and Denise Grady Hundreds of people across the country have been sickened by a severe lung illness linked to vaping, and a handful have died, according to public health officials. Many were otherwise healthy young people, in their teens or early 20s. Investigators from numerous states are working with the federal Centers for Disease Control and Prevention and the Food and Drug Administration in an urgent effort to figure out why. Here’s what we know so far. Who is at risk? Anyone who uses e-cigarettes or other vaping devices, whether to consume nicotine or substances extracted from marijuana or hemp, may be at risk because investigators have not determined whether a specific device or type of vaping liquid is responsible. The Food and Drug Administration is warning that there appears to be a particular danger for people who vape THC, the psychoactive chemical in marijuana. The F.D.A. said a significant subset of samples of vaping fluid used by sick patients included THC and also contained a chemical called vitamin E acetate. The F.D.A. issued this statement: “Because consumers cannot be sure whether any THC vaping products may contain vitamin E acetate, consumers are urged to avoid buying vaping products on the street, and to refrain from using THC oil or modifying/adding any substances to products purchased in stores.” But some of the patients who have fallen severely ill said they did not vape THC. In 53 cases of the illness in Illinois and Wisconsin, 17 percent of the patients said they had vaped only nicotine products, according to an article published on Friday in The New England Journal of Medicine. The researchers who wrote the journal article cautioned, “e-cigarette aerosol is not harmless; it can expose users to substances known to have adverse health effects, including ultrafine particles, heavy metals, volatile organic compounds and other harmful ingredients.” The health effects of some of those chemicals are not fully understood, the researchers wrote, even though the products are already on the market. © 2019 The New York Times Company

Keyword: Drug Abuse
Link ID: 26591 - Posted: 09.09.2019

Giorgia Guglielmi People who have low-risk surgery in Canada and the United States fill prescriptions for opioid painkillers at nearly seven times the rate seen in Sweden, according to recent research1. Studying these differences could help nations such as the United States to develop prescribing guidelines to counteract the surge in opioid use that is devastating some communities, say the study authors. The findings, which are published on 4 September in JAMA Network Open, are the first to quantify the differences in opioid use for people who had similar types of surgery across countries. There’s anecdotal evidence that clinicians tend to prescribe more opioids after surgery in some countries than in others, says Mark Neuman, an anaesthesiologist at the University of Pennsylvania in Philadelphia, who led the study. And over-prescription of opioids is associated with an increased risk of developing long-term dependence and addiction, he says. To investigate further, Neuman and his team gathered prescription data from between 2013 and 2016 from Canada, the United States and Sweden. The countries all have similar levels of surgical care as well as detailed data on opioid prescriptions. The team found that nearly 79% of people in Canada and about 76% of those in the United States who had one of 4 operations — and who filled their opioid prescriptions — did so within 7 days of leaving hospital, compared with 11% of people in Sweden (see ‘Painkiller prescriptions’). “That’s a striking difference,” says Gabriel Brat, a surgeon at Beth Israel Deaconess Medical Center in Boston, Massachusetts. The procedures were removals of the gallbladder, appendix, breast lumps or meniscus cartilage in the knee. © 2019 Springer Nature Publishing AG

Keyword: Drug Abuse; Pain & Touch
Link ID: 26590 - Posted: 09.09.2019

Selena Simmons-Duffin Peter Grinspoon got addicted to Vicodin in medical school, and still had an opioid addiction five years into practice as a primary care physician. Then, in February 2005, he got caught. "In my addicted mindframe, I was writing prescriptions for a nanny who had since returned back to another country," he says. "It didn't take the pharmacist long to figure out that I was not a 19-year-old nanny from New Zealand." One day, during lunch, the state police and the DEA showed up at his medical office in Boston. "I start going all, 'I'm glad you're here. How can I help you?' " he says. "And they're like, 'Doc, cut the crap. We know you're writing bad scripts.' " He was fingerprinted the next day and charged with three felony counts of fraudulently obtaining a controlled substance. He also was immediately referred to a Physician Health Program, one of the state-run specialty treatment programs developed in the 1970s by physicians to help fellow physicians beat addiction. Known to doctors as PHPs, these programs now cover other sorts of health providers, too. The programs work with state medical licensing boards — if you follow the treatment and monitoring plan they set up for you, they'll recommend to the board that you get your medical license back, Grinspoon explains. It's a significant incentive. "The PHPs basically say, 'Do whatever we say or we won't give you a letter that will help you get back to work,' " Grinspoon says. "They put a gun to your head." But the problem, he and other critics say, is that, for various reasons, most PHPs don't allow medical professionals access to the same evidence-based, "gold standard" treatment that addiction specialists today recommend for most patients addicted to opioids: medication-assisted treatment. © 2019 npr

Keyword: Drug Abuse
Link ID: 26586 - Posted: 09.07.2019

By Lena H. Sun State and federal health officials investigating mysterious lung illnesses linked to vaping have found the same chemical in samples of marijuana products used by people sickened in different parts of the country and who used different brands of products in recent weeks. The chemical is an oil derived from vitamin E. Investigators at the U.S. Food and Drug Administration found the oil in cannabis products in samples collected from patients who fell ill across the United States. FDA officials shared that information with state health officials during a telephone briefing this week, according to several officials who took part in the call. That same chemical was also found in nearly all cannabis samples from patients who fell ill in New York in recent weeks, a state health department spokeswoman said. While this is the first common element found in samples from across the country, health officials said it is too early to know whether this is causing the injuries. Vitamin E is found naturally in certain foods, such as canola oil, olive oil and almonds. The oil derived from the vitamin, known as vitamin E acetate, is commonly available as a nutritional supplement and is used in topical skin treatments. It is not known to cause harm when ingested as a vitamin supplement or applied to the skin. Its name sounds harmless, experts said, but its molecular structure could make it hazardous when inhaled. Its oil-like properties could be associated with the kinds of respiratory symptoms that many patients have reported: cough, shortness of breath and chest pain, officials said. “We knew from earlier testing by New York that they had found vitamin E acetate, but to have FDA talk about it from their overall testing plan, that was the most remarkable thing that we heard,” said one official who listened to the briefing but was not authorized to speak publicly. © 1996-2019 The Washington Post

Keyword: Drug Abuse
Link ID: 26581 - Posted: 09.06.2019

By Benedict Carey The announcement on Wednesday that Johns Hopkins Medicine was starting a new center to study psychedelic drugs for mental disorders was the latest chapter in a decades-long push by health nonprofits and wealthy donors to shake up psychiatry from the outside, bypassing the usual channels. “Psychiatry is one of the most conservative specialties in medicine,” said David Nichols, a medicinal chemist who founded the Heffter Research Institute in 1993 to fund psychedelic research. “We haven’t really had new drugs for years, and the drug industry has quit the field because they don’t have new targets” in the brain. “The field was basically stagnant, and we needed to try something different.” The fund-raising for the new Hopkins center was largely driven by the author and investor Tim Ferriss, who said in a telephone interview that he had put aside most of his other projects to advance psychedelic medicine. “It’s important to me for macro reasons but also deeply personal ones,” Mr. Ferriss, 42, said. “I grew up on Long Island, and I lost my best friend to a fentanyl overdose. I have treatment-resistant depression and bipolar disorder in my family. And addiction. It became clear to me that you can do a lot in this field with very little money.” Mr. Ferriss provided funds for a similar center at Imperial College London, which was introduced in April, and for individual research projects at the University of San Francisco, California, testing psilocybin as an aide to therapy for distress in long-term AIDS patients. Experiments using ecstasy and LSD, for end-of-life care, were underway by the mid-2000s. Soon, therapists began conducting trials of ecstasy for post-traumatic stress, with promising results. One of the most influential scientific reports appeared in 2006: a test of the effects of a strong dose of psilocybin on healthy adults. In that study, a team led by Roland Griffiths at Johns Hopkins found that the volunteers “rated the psilocybin experience as having substantial personal meaning and spiritual significance and attributed to the experience sustained positive changes in attitudes and behavior.” © 2019 The New York Times Company

Keyword: Drug Abuse; Depression
Link ID: 26580 - Posted: 09.06.2019

By Benedict Carey Since childhood, Rachael Petersen had lived with an unexplainable sense of grief that no drug or talk therapy could entirely ease. So in 2017 she volunteered for a small clinical trial at Johns Hopkins University that was testing psilocybin, the active ingredient in magic mushrooms, for chronic depression. “I was so depressed,” Ms. Petersen, 29, said recently. “I felt that the world had abandoned me, that I’d lost the right to exist on this planet. Really, it was like my thoughts were so stuck, I felt isolated.” The prospect of tripping for hours on a heavy dose of psychedelics was scary, she said, but the reality was profoundly different: “I experienced this kind of unity, of resonant love, the sense that I’m not alone anymore, that there was this thing holding me that was bigger than my grief. I felt welcomed back to the world.” On Wednesday, Johns Hopkins Medicine announced the launch of the Center for Psychedelic and Consciousness Research, to study compounds like LSD and psilocybin for a range of mental health problems, including anorexia, addiction and depression. The center is the first of its kind in the country, established with $17 million in commitments from wealthy private donors and a foundation. Imperial College London launched what is thought to be the world’s first such center in April, with some $3.5 million from private sources. “This is an exciting initiative that brings new focus to efforts to learn about mind, brain and psychiatric disorders by studying the effects of psychedelic drugs,” Dr. John Krystal, chair of psychiatry at Yale University, said in an email about the Johns Hopkins center. The centers at Johns Hopkins and Imperial College give “psychedelic medicine,” as some call it, a long-sought foothold in the scientific establishment. Since the early 2000s, several scientists have been exploring the potential of psychedelics and other recreational drugs for psychiatric problems, and their early reports have been tantalizing enough to generate a stream of positive headlines and at least two popular books. The emergence of depression treatment with the anesthetic and club drug ketamine and related compounds, which cause out-of-body sensations, also has piqued interest in mind-altering agents as aids to therapy. © 2019 The New York Times Company

Keyword: Depression; Drug Abuse
Link ID: 26577 - Posted: 09.05.2019

Nicoletta Lanese Federal health officials issued a warning yesterday (August 29), advising pregnant mothers and teens not to use marijuana. The surgeon general cautioned that marijuana use has adverse effects on brain development in teens and fetuses and has also been linked to later alcohol and opioid addiction, according to STAT News. At a press conference, officials reported that President Donald Trump has donated $100,000 toward a digital campaign to raise awareness of the risks of marijuana use in pregnancy and adolescence, according to the Associated Press. “No amount of marijuana use during pregnancy or adolescence is safe,” says Surgeon General Jerome Adams at a press conference, reports STAT News. “As I like to say, this ain’t your mother’s marijuana,” adds Department of Health and Human Services (HHS) Secretary Alex Azar. Between 1995 and 2014, the concentration of the psychoactive compound THC in marijuana plants tripled, according to the government advisory. “The higher the THC delivery, the higher the risk,” says Adams to NPR. Meanwhile, new delivery products such as vapes, waxes, and liquids make the drug easier to consume. See “Prenatal Exposure to Cannabis Affects the Developing Brain” Medicinal marijuana has been legalized in 33 states and the District of Columbia, and 11 states have legalized the drug’s recreational use, according to STAT News. However, no states allow recreational marijuana use by teens, and minors can only use medical marijuana with consent from a legal guardian and certification from a doctor, the AP reports. © 1986–2019 The Scientist.

Keyword: Drug Abuse; Development of the Brain
Link ID: 26568 - Posted: 09.04.2019

By Sheila Kaplan and Matt Richtel An 18-year-old showed up in a Long Island emergency room, gasping for breath, vomiting and dizzy. When a doctor asked if the teenager had been vaping, he said no. The patient’s older brother, a police officer, was suspicious. He rummaged through the youth’s room and found hidden vials of marijuana for vaping. “I don’t know where he purchased it. He doesn’t know,” said Dr. Melodi Pirzada, chief pediatric pulmonologist at NYU Winthrop Hospital in Mineola, N.Y., who treated the young man. “Luckily, he survived.” Dr. Pirzada is one of the many physicians across the country treating patients — now totaling more than 215 — with mysterious and life-threatening vaping-related illnesses this summer. The outbreak is “becoming an epidemic,” she said. “Something is very wrong.” Patients, mostly otherwise healthy and in their late teens and 20s, are showing up with severe shortness of breath, often after suffering for several days with vomiting, fever and fatigue. Some have wound up in the intensive care unit or on a ventilator for weeks. Treatment has been complicated by patients’ lack of knowledge — and sometimes outright denial — about the actual substances they might have used or inhaled. Health investigators are now trying to determine whether a particular toxin or substance has sneaked into the supply of vaping products, whether some people reused cartridges containing contaminants, or whether the risk stems from a broader behavior, like heavy e-cigarette use, vaping marijuana or a combination. On Friday, the Centers for Disease Control and Prevention issued a warning to teenagers and other consumers, telling them to stop buying bootleg and street cannabis and e-cigarette products, and to stop modifying devices to vape adulterated substances. © 2019 The New York Times Company

Keyword: Drug Abuse
Link ID: 26561 - Posted: 09.02.2019

Rebecca Schiller When Professor Judith Grisel sat down to write her book Never Enough (a guide to the neuroscience of addiction that has been her life’s work), she didn’t expect to share so much of her own story. Nevertheless the resulting chapters are a collision of the personal and professional, detailing the deep links between her work life and the decade of drug and alcohol addiction that almost destroyed her. On paper, Grisel was an unlikely candidate for going off the rails. One of three children, she describes a privileged upbringing in a progressive, suburban area of New Jersey. With an airline pilot father and a mother who was a registered nurse, Grisel remembers growing up in a “perfect-looking family”. As her research would go on to help demonstrate, there was no single factor that predicted her drug problems. Neuroscientists have found a complex blend of nature and nurture at work in addictive tendencies and their research shows that many genetic, epigenetic and environmental factors work together in complex ways that often remain elusive. “Why me?” is the question that underpins much of Grisel’s research, and she continues to wonder why friends who drank heavily with her in high school were spared addiction. In Never Enough she offers a smorgasbord of theories behind her own and others’ predisposition to addiction: an “extreme” personality and love of risk-taking, trying drugs at a young age, lower levels of endorphins in the brain, potential hypersensitivity to the neurological rewards of drugs alongside, more surprisingly, her own parents’ strict response to her behaviour. © 2019 Guardian News & Media Limited

Keyword: Drug Abuse
Link ID: 26538 - Posted: 08.26.2019

By Carolyn Wilke Illicit drug use lurks in the shadows — one reason it’s difficult to study. But public health researchers pull together numbers from surveys, overdose records and other sources to look for trends in how much people spend on drugs, numbers of users and frequency of use that can help policy makers fight substance abuse. Now, an analysis released August 20 by the Rand Corporation estimates that people in the United States spent between $121 billion and $146 billion dollars annually on cocaine, heroin, marijuana and methamphetamine from 2006 and 2016. The analysis puts the drugs’ combined total on the same order as Americans’ annual alcohol tab, based on market research on the alcohol industry. Among the four drugs, users in 2006 spent the most money on cocaine, around $58 billion (in 2018 dollars). But that spending on cocaine then dropped to $24 billion in 2016. Marijuana spending, meanwhile, roughly doubled to garner the greatest spending in 2016, at $52 billion. Also, from 2010 to 2016, the number of people who had used marijuana in the last month increased from an estimated 25 million to 32 million, a roughly 30 percent increase. The uptick in cannabis consumption wasn’t a surprise, says report coauthor Greg Midgette, a criminologist at the University of Maryland and the RAND Corporation. In the United States, at least 1 in 4 people now lives in a state where recreational marijuana use is legal for adults over the age of 21. Other trends also reinforce what drug policy experts knew about substance abuse in America. For instance, increasing heroin use from 2010 to 2016 likely reflects the opioid crisis (SN: 4/13/19, p. 32). But other findings were more surprising, Midgette says, such as increases in methamphetamine spending, users and consumption. From 2010 to 2016, the average purity of methamphetamine increased, and cost fell. “When the drug is available, pure and cheap, that’s troubling for public health,” he says. © Society for Science & the Public 2000–2019.

Keyword: Drug Abuse
Link ID: 26536 - Posted: 08.24.2019

By Matt Richtel and Sheila Kaplan A patient in Illinois is the first to die of a mysterious lung illness linked to vaping, public health officials announced on Friday. The death occurred as doctors and hospitals nationwide report an increasing number of vaping-related respiratory illnesses this summer: 193 cases have now been reported in 22 states, including 22 cases in Illinois, officials said. They have been stumped in recent weeks by the cause. State investigators have not found a common link — other than vaping in general — among the patients turning up in emergency rooms. Many patients, including some in Illinois, have acknowledged vaping of tetrahydrocannabinol, or (T.H.C.), the high-inducing chemical in marijuana, according to statements from federal and state health agencies. But officials don’t know whether the ailments have been caused by marijuana-type products, e-cigarettes, or some type of street concoction that was vaped, or whether a contaminant or defective device may have been involved. The Illinois patient’s death was disclosed during a news conference held by officials at the Centers for Disease Control and Prevention, the Food and Drug Administration and the state of Illinois. They did not provide details about the patient’s identity, saying only that the person was an adult who had vaped recently and then succumbed to a severe respiratory illness. Health officials did not say what product the patient had used, whether an e-cigarette or other vaping device; nor did they specify what substance was vaped. Amid the lack of information, investigators are scrambling to find shared links to the respiratory problems. Officials said earlier this week that many patients, most of whom were adolescents or young adults, had described difficulty breathing, chest pain, vomiting and fatigue. The most seriously ill patients have had extensive lung damage that required treatment with oxygen and days on a ventilator. Some are expected to have permanent lung damage. © 2019 The New York Times Company

Keyword: Drug Abuse
Link ID: 26535 - Posted: 08.24.2019

Jake Harper Jason was hallucinating. He was withdrawing from drugs at an addiction treatment center near Indianapolis, and he had hardly slept for several days. "He was reaching for things, and he was talking to Bill Gates and he was talking to somebody else I'm just certain he hasn't met," his mother, Cheryl, says. She remembers finding Jason lying on the floor of the treatment center in late 2016. "I would just bring him blankets because they didn't have beds or anything." Cheryl had taken Jason to the clinic out of desperation. Jason, now in his late 30s, has struggled with addiction since he was a teenager. Cheryl saw his drug use escalate after he was prescribed a benzodiazepine for his anxiety, and he eventually began using heroin and meth. Over the years, Jason would try to get into recovery, but treatment programs didn't help him for very long. "I thought he was going to die," Cheryl says. (Side Effects and NPR are using only first names because Jason worried he would lose his job if his employer found out about his addiction history.) In late 2016, she saw a local TV news segment about a clinic called Emerald Neuro-Recover. The staff there treats addiction with something called NAD therapy, an IV infusion that can contain amino acids and other nutritional supplements, including nicotinamide adenine dinucleotide, a compound found in living cells. The infusion, which is delivered over 10 to 15 days, cost $15,000, and it wasn't covered by insurance. But the TV report said Emerald's treatment was "proven to wipe drug cravings away." Cheryl was intrigued. Emerald and dozens of other companies across the U.S. say NAD therapy can address conditions from anxiety to depression to chronic fatigue and even Alzheimer's. © 2019 npr

Keyword: Drug Abuse
Link ID: 26534 - Posted: 08.24.2019

Scott Hensley At some point nearly everyone has to deal with pain. How do Americans experience and cope with pain that makes everyday life harder? We asked in the latest NPR-IBM Watson Health Poll. First, we wanted to know how often pain interferes with people's ability to work, go to school or engage in other activities. Overall, 18% of Americans say that's often a problem for them. Almost a quarter – 24% — say it's sometimes the case. The degree to which pain is a problem varies by age, with 22% of people 65 and older saying pain interferes often with their daily lives compared with only about 9% of people 35 and younger. Once pain strikes, how do people deal with it? The poll found that 63% of people had sought care for their pain and 37% hadn't. Younger people were less likely to have pursued care. The most common approach is an over-the-counter pain reliever. Sixty percent of people said that is something they do. Another popular choice, particularly among younger people, is exercise, including stretching and yoga. Forty percent of those under 35 say exercise is a way they seek relief. Only 11% of people 65 and older say exercise is something they try for pain. Overall, 26% of people see exercise as helpful for their pain. That level of exercise is "really exciting to see," says Brett Snodgrass, a nurse practitioner and clinical coordinator of palliative medicine at Baptist Health Systems in Memphis, Tenn. In her experience, not nearly as many people were doing that, even a few years ago. © 2019 npr

Keyword: Pain & Touch; Drug Abuse
Link ID: 26532 - Posted: 08.23.2019

By Lenny Bernstein With a nationwide prescription opioid lawsuit scheduled for trial in two months, attorneys for newborns suffering from exposure to opioids in the womb have made a last-ditch plea for special legal treatment for the infants and their guardians. Attorneys representing a group that may number more than 250,000 children have spent much of the past two years seeking a separate trial against drug companies but have been rebuffed twice by the judge who oversees the sprawling legal case. The children are still included in that lawsuit, along with about 2,000 other plaintiffs, against some two dozen defendants from the pharmaceutical industry. The children’s lawyers also have complained that attorneys for cities and counties spearheading the lawsuit have refused to let them take part in settlement negotiations that are occurring as the trial date approaches. The attorneys, from 20 firms that represent children across the country, insist that a settlement or verdict must yield billions of dollars specifically earmarked for years-long monitoring of the physical and mental health of children born with “neonatal abstinence syndrome.” That is the formal name for the cluster of difficult symptoms endured by babies who undergo withdrawal from opioids in the days after birth. Without that guarantee, the attorneys contend, cities and towns are likely to spend any money they receive from drug companies on more pressing and popular needs, as some states did with windfalls from the $206 billion settlement with tobacco companies two decades ago. “Our goal is to make sure that we do not have a tobacco-style settlement, where all of the money goes to the governmental entities, and there’s not a significant trust set aside to help these children,” said Stuart Smith, one of the lawyers representing the families. © 1996-2019 The Washington Post

Keyword: Development of the Brain; Drug Abuse
Link ID: 26531 - Posted: 08.23.2019

By Aaron E. Carroll In many areas of health policy, the best of intentions can lead to more harm than good. Such is the case with America’s approach to alcohol and pregnancy. The best evidence shows that punitive policies — such as equating drinking while pregnant as child abuse and threatening to involve child protective services — can dissuade women from getting prenatal care. Fetal alcohol spectrum disorders refer to a collection of problems in babies and children. These include low birth weight; impaired growth; and problems in the heart, kidneys and brain. Children can have developmental delays, communication difficulties, learning disabilities and lower I.Q. Some of these last a lifetime. It’s hard to know how many American children are affected. Studies done by the Centers for Disease Control and Prevention have estimated that between 2 and 15 infants per 10,000 born in the United States have fetal alcohol syndrome, the most severe form of the disorders. Some community-based studies that use the broader definition of the disorder have found more affected children, up to 5 percent. We know that infants of women who drink alcohol in pregnancy may develop these disorders. The problem is what we don’t know. We don’t know the level of alcohol exposure in utero that could cause a child to develop these disorders. We don’t know if the timing of the exposure matters. We don’t know why some women who drink little might have a child who is affected, while some can binge drink during pregnancy and have a child with no apparent problems. Because of this, most medical organizations, including the American Academy of Pediatrics and the C.D.C., recommend that women forgo alcohol during pregnancy. The only dose known to be “safe” is none, they say, and therefore women should not drink at all. © 2019 The New York Times Company

Keyword: Drug Abuse; Development of the Brain
Link ID: 26517 - Posted: 08.20.2019