Chapter 4. The Chemistry of Behavior: Neurotransmitters and Neuropharmacology

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By Abby Goodnough The addiction treatment program at Highland Hospital’s emergency room is only one way that cities and health care providers are connecting with people in unusual settings. Another is in San Francisco, where city health workers are taking to the streets to find homeless people with opioid use disorder and offering them buprenorphine prescriptions on the spot. The city is spending $6 million on the program in the next two years, partly in response to a striking increase in the number of people injecting drugs on sidewalks and in other public areas. Most of the money will go toward hiring 10 new clinicians for the city’s Street Medicine Team, which already provides medical care for the homeless. Members of the team will travel around the city offering buprenorphine prescriptions to addicted homeless people, which they can fill the same day at a city-run pharmacy. At the end of a recent yearlong pilot, about 20 of the 95 participants were still taking buprenorphine under the care of the street medicine team. Dr. Barry Zevin, the city’s medical director for Street Medicine and Shelter Health, hopes to provide buprenorphine to 250 more people through the program. That’s only a tiny fraction of the estimated 22,500 people in San Francisco who actively inject drugs, he said, but it’s a start. What follows is a condensed, edited interview with Dr. Zevin, who has been providing medical care to the homeless in San Francisco since 1991. Why offer buprenorphine on the streets instead of in a medical clinic? Most health care for the homeless happens under the model of waiting for people to come in to a health center. But a lot of people never come in. There are a lot of mental health, substance abuse and cognitive problems in this population, a lot of chronic illness. Appointments are the enemy of homeless people. On the street there are no appointments, and no penalties or judgments for missing appointments. © 2018 The New York Times Company

Keyword: Drug Abuse
Link ID: 25354 - Posted: 08.20.2018

By Daniela J. Lamas NORTH ANDOVER, Mass. — It was a Sunday afternoon, and in the cozy house at the end of the street, Andrew Foote sat in his usual chair while a movie played on the television. The young man’s hands rested on two pillows, wrists bent and fingers contracted into fists. From time to time, he rocked forward as if to stand but then collapsed backward, into the chair. His few words were slow and slurred. The simple fact that Andrew was living at home is somewhat miraculous. Heroin and fentanyl caused him to stop breathing, but he learned to breathe on his own again. His kidneys failed and then recovered. But Andrew’s brain, starved of oxygen too long, was left severely damaged. More than four years have passed since the overdose. For Andrew’s parents, the fear that their son will die has now been replaced by a new set of realities and unanswerable questions: Is this a good life? Is he happy? What will happen to him when they grow old? In the opioid epidemic, outcomes like Andrew’s are a largely unseen casualty. “People think that if you overdose on drugs, you either die or you’re O.K.,” his mother, Linda Foote, told me. “But that’s not true.” Andrew was a golden child. He was the oldest of four, a high school football star who remained humble despite the trophies that decorated his room — now alongside a urinary catheter, pill boxes and equipment for his feeding tube. “How many touchdowns did you make in high school?” his mother prompted. His long-term memory had remained relatively preserved, though it was hard for him to call up the words. As we waited, my gaze traveled to a framed collage of family photos. There was Andrew in his letterman’s jacket, blond hair cut short, lips curled upward in a shy smile. He was still a handsome guy. Mrs. Foote took pride in this, but his expression had dimmed. © 2018 The New York Times Company

Keyword: Drug Abuse
Link ID: 25353 - Posted: 08.20.2018

By Abby Goodnough OAKLAND, Calif. — Every year, thousands of people addicted to opioids show up at hospital emergency rooms in withdrawal so agonizing it leaves them moaning and writhing on the floor. Usually, they’re given medicines that help with vomiting or diarrhea and sent on their way, maybe with a few numbers to call about treatment. When Rhonda Hauswirth arrived at the Highland Hospital E.R. here, retching and shaking violently after a day and a half without heroin, something very different happened. She was offered a dose of buprenorphine on the spot. One of three medications approved in the United States to treat opioid addiction, it works by easing withdrawal symptoms and cravings. The tablet dissolved under her tongue while she slumped in a plastic chair, her long red hair obscuring her ashen face. Soon, the shakes stopped. “I could focus a little more. I could see straight,” said Ms. Hauswirth, 40. “I’d never heard of anyone going to an emergency room to do that.” Highland, a clattering big-city hospital where security wands constantly beep as new patients get scanned for weapons, is among a small group of institutions that have started initiating opioid addiction treatment in the E.R. Their aim is to plug a gaping hole in a medical system that consistently fails to provide treatment on demand, or any evidence-based treatment at all, even as more than two million Americans suffer from opioid addiction. According to the latest estimates, overdoses involving opioids killed nearly 50,000 people last year. By providing buprenorphine around the clock to people in crisis — people who may never otherwise seek medical care — these E.R.s are doing their best to ensure a rare opportunity isn’t lost. “With a single E.R. visit we can provide 24 to 48 hours of withdrawal suppression, as well as suppression of cravings,” said Dr. Andrew Herring, an emergency medicine specialist at Highland who runs the buprenorphine program. “It can be this revelatory moment for people — even in the depth of crisis, in the middle of the night. It shows them there’s a pathway back to feeling normal.” © 2018 The New York Times Company

Keyword: Drug Abuse
Link ID: 25351 - Posted: 08.18.2018

By Kerri Smith, Cole Skinner was hanging from a wall above an abandoned quarry when he heard a car pull up. He and his friends bolted, racing along a narrow path on the quarry’s edge and hopping over a barbed-wire fence to exit the grounds. The chase is part of the fun for Skinner and his friend Alex McCallum-Toppin, both 15 and pupils at a school in Faringdon, UK. The two say that they seek out places such as construction sites and disused buildings—not to get into trouble, but to explore. There are also bragging rights to be earned. “It’s just something you can say: ‘Yeah, I’ve been in an abandoned quarry’,” says McCallum-Toppin. “You can talk about it with your friends.” Science has often looked at risk-taking among adolescents as a monolithic problem for parents and the public to manage or endure. When Eva Telzer, a neuroscientist at the University of North Carolina in Chapel Hill, asks family, friends, undergraduates or researchers in related fields about their perception of teenagers, “there’s almost never anything positive,” she says. “It’s a pervasive stereotype.” But how Alex and Cole dabble with risk—considering its social value alongside other pros and cons—is in keeping with a more complex picture emerging from neuroscience. Adolescent behaviour goes beyond impetuous rebellion or uncontrollable hormones, says Adriana Galván, a neuroscientist at the University of California, Los Angeles. “How we define risk-taking is going through a shift.” © 2018 Scientific American

Keyword: Development of the Brain; Drug Abuse
Link ID: 25350 - Posted: 08.18.2018

Alex Smith Dr. Jodi Jackson has worked for years to address infant mortality in Kansas. Often, that means she is treating newborns in a high-tech neonatal intensive care unit with sophisticated equipment whirring and beeping. That is exactly the wrong place for an infant like Lili. Lili's mother, Victoria, used heroin for the first two-thirds of her pregnancy and hated herself for it. (NPR is using her first name only, because she has used illegal drugs.) "When you are in withdrawal, you feel your baby that's in withdrawal too," says Victoria, recalling the sensations she remembers from her pregnancy. "You feel your baby uncomfortable inside of you, and you know that. And then you use and then the baby's not [uncomfortable], and that's a really awful, vulgar thought, but it's true. That's how it is. It's terrible." Though Victoria went into recovery before giving birth, Lili was born dependent on the methadone Victoria took to treat her opioid addiction. Treatment for infants like Lili has evolved, Jackson says. "What happened 10, 15 years ago, is [drug dependent] babies were immediately removed from the mom, and they were put in an ICU warmer with bright lights with nobody holding them," says Jackson, who is a neonatologist at Children's Mercy Hospital in Kansas City, Missouri. "Of course, they are going to be upset about that! And so the risk of withdrawal is much higher." © 2018 npr

Keyword: Drug Abuse; Development of the Brain
Link ID: 25344 - Posted: 08.17.2018

Mike Robinson To call gambling a “game of chance” evokes fun, random luck and a sense of collective engagement. These playful connotations may be part of why almost 80 percent of American adults gamble at some point in their lifetime. When I ask my psychology students why they think people gamble, the most frequent suggestions are for pleasure, money or the thrill. While these might be reasons why people gamble initially, psychologists don’t definitely know why, for some, gambling stops being an enjoyable diversion and becomes compulsive. What keeps people playing even when it stops being fun? Why stick with games people know are designed for them to lose? Are some people just more unlucky than the rest of us, or simply worse at calculating the odds? As an addiction researcher for the past 15 years, I look to the brain to understand the hooks that make gambling so compelling. I’ve found that many are intentionally hidden in how the games are designed. And these hooks work on casual casino-goers just as well as they do on problem gamblers. Uncertainty as its own reward in the brain One of the hallmarks of gambling is its uncertainty – whether it’s the size of a jackpot or the probability of winning at all. And reward uncertainty plays a crucial role in gambling’s attraction. Dopamine, the neurotransmitter the brain releases during enjoyable activities such as eating, sex and drugs, is also released during situations where the reward is uncertain. In fact dopamine release increases particularly during the moments leading up to a potential reward. © 2010–2018, The Conversation US, Inc.

Keyword: Drug Abuse; Attention
Link ID: 25328 - Posted: 08.14.2018

Ann Robinson Imagine a neurological condition that affects one in 20 under-18s. It starts early, causes significant distress and pain to the child, damages families and limits the chances of leading a fulfilled life as an adult. One in 20 children are affected but only half of these will get a diagnosis and a fifth will receive treatment. If those stats related to a familiar and well-understood illness, such as asthma, there would be little debate about the need to improve intervention rates. But this is attention deficit hyperactivity disorder (ADHD), and the outcry is muted. If anything, we hear warnings that too many children are being labelled this way, and too many given prescriptions. In the United States, ADHD is diagnosed at more than twice the incidence in Britain. The true prevalence is likely to be the same on both sides of the Atlantic. So what’s the story? Is the US too gung-ho, or is the UK dragging its heels? Are American doctors too quick to medicate children, or British doctors too slow? Emily Simonoff, co-author of a new meta-analysis in the journal the Lancet Psychiatry, says the problem in the UK is “predominantly about undermedication and underdiagnosis”. Her study examined a range of drug treatments compared to placebo, and it shows that methylphenidate (better known by under the brand name Ritalin) works best for children and amphetamines for adults. © 2018 Guardian News and Media Limited

Keyword: ADHD; Drug Abuse
Link ID: 25321 - Posted: 08.13.2018

by Antonia Noori Farzan It’s been well-documented that a decreased sex drive can be one of the side effects of antidepressants like Prozac. But the amount of these drugs that end up in sewage plants may also have an impact on the mating habits of wild birds, a new study from the University of York shows. Researchers found that female starlings that had been exposed to small doses of fluoxetine, the generic name for Prozac, became less attractive to male starlings, which sung to them less often and treated them more aggressively. Kathryn Arnold, one of the study’s authors and a senior lecturer in ecology at the University of York, described it as “the first evidence that low concentrations of an antidepressant can disrupt the courtship of songbirds.” That’s problematic because birds that are slow to find a mate may not get the chance to breed, she wrote. “We’re definitely not saying that it’s bad to take antidepressants, but certainly there is a greater need for new technologies to clean out sewage,” Arnold told The Washington Post. Birds like to graze at sewage treatment plants, which are teeming with worms, flies and maggots, she explained. But because antidepressants often make their way through the human body and into sewage plants without fully breaking down, those insects are frequently laced with prescription drugs. © 1996-2018 The Washington Post

Keyword: Depression; Sexual Behavior
Link ID: 25320 - Posted: 08.13.2018

Leah Rosenbaum Pregnant women aren’t immune to the escalating opioid epidemic. Data on hospital deliveries in 28 U.S. states shows the rate of opioid use among pregnant women has quadrupled, from 1.5 per 1,000 women in 1999 to 6.5 per 1,000 women in 2014, the U.S. Centers for Disease Control and Prevention reports. The highest increases in opioid use among pregnant women were in Maine, New Mexico, Vermont and West Virginia, according to the CDC study, published online August 9 in Morbidity and Mortality Weekly Report. “This analysis is a stark reminder that the U.S. opioid crisis is taking a tremendous toll on families,” says coauthor Jean Ko, a CDC epidemiologist in Atlanta. In this first look at opioid use during pregnancy by state, Washington, D.C. had the lowest rate in 2014, at 0.7 per 1,000 women, and Vermont had the highest, at 48.6 per 1,000. However, the data from the U.S. Health and Human Services Department represents only the 28 states that record opioid use at childbirth during the studied time frame. “We knew the incidence was increasing” as the number of babies going through opioid withdrawal has also gone up, says Matthew Grossman, a pediatrician at Yale University. Overall, the number of U.S. deaths attributed to opioids has also been steadily rising (SN: 3/31/18, p. 18). In 2014, there were 14.7 opioid deaths per 100,000 people, up from 6.2 per 100,000 in 2000, according to the CDC. © Society for Science & the Public 2000 - 2018

Keyword: Drug Abuse
Link ID: 25312 - Posted: 08.10.2018

Ina Jaffe The antipsychotic drug Seroquel was approved by the FDA years ago to help people with schizophrenia, bipolar disorder and other serious mental illnesses. But too frequently the drug is also given to people who have Alzheimer's disease or other forms of dementia. The problem with that? Seroquel can be deadly for dementia patients, according to the FDA. Now some researchers have conducted an experiment that convinced some of the general practice doctors who prescribe Seroquel most frequently to cut back. All the scientists did was have Medicare send letters — three of them over the course of six months — to the roughly 5,000 general practitioners who prescribe Seroquel the most. The letters (attached to this document) had two elements: First there was a peer comparison aspect. The doctors who got the letters were told that they wrote a lot more prescriptions for Seroquel than the average for their state — in some cases as many as 8 times more. The Centers for Medicare and Medicaid Services which regulates Medicare, was a partner in the study and sent the letters. So the in addition to peer pressure, they contained a government warning: "You have been flagged as a markedly unusual prescriber, subject to review by the Center for Program Integrity." Researchers then tracked the physicians' prescribing habits for two years. © 2018 npr

Keyword: Schizophrenia; Drug Abuse
Link ID: 25303 - Posted: 08.07.2018

Lesley Mcclurg The first prescription medication extracted from the marijuana plant is poised to land on pharmacists' shelves this fall. Epidiolex, made from purified cannabidiol, or CBD, a compound found in the cannabis plant, is approved for two rare types of epilepsy. Its journey to market was driven forward by one family's quest to find a treatment for their son's epilepsy. Scientific and public interest in CBD had been percolating for several years before the Food and Drug Administration finally approved Epidiolex in June. But CBD — which doesn't cause the mind-altering high that comes from THC, the primary psychoactive component of marijuana — was hard to study, because of tight restrictions on using cannabis in research. Sam Vogelstein's family and his doctors found ways to work around those restrictions in their fight to control his seizures. Sam's seizures started in 2005 when he was four years old. It's a moment his mother, Evelyn Nussenbaum, will never forget. The family was saying goodbye to a dinner guest when Sam's face suddenly slackened and he fell forward at the waist. Article continues after sponsorship "He did something that looked like a judo bow after a match," says Nussenbaum. Two months passed before Sam had another seizure, but then he started having them every week. Eventually he was suffering through 100 seizures a day. © 2018 npr

Keyword: Epilepsy; Drug Abuse
Link ID: 25296 - Posted: 08.06.2018

Frances Perraudin Deaths caused by the drug fentanyl rose by nearly 30% last year, according to figures from the Office for National Statistics. While statistics show that the rate of deaths from drug poisoning in England and Wales has remained steady – 66.1 deaths per 1 million people (3,756 deaths) – fatalities involving the synthetic opioid fentanyl were up 29%. There were 75 deaths in 2017, up from 58 deaths in 2016. Fentanyl has been found mixed with street heroin, causing accidental overdose in users. The drug can up to 100 times stronger than heroin and is sometimes prescribed as a painkiller for the terminally ill. One type of fentanyl, carfentanyl, is 10,000 times stronger and is used as an elephant tranquilliser. It was first seen mentioned in death certificates in 2017 and accounted for 27 deaths, 87% of the 31 deaths related to types of fentanyl in 2017. In April 2017, after a spate of deaths linked to fentanyl in northern England, Public Health England issued a warning to heroin users to be extra careful when using the drug, urging them to test a small amount first and not to take it alone. The ONS statistics also show that deaths from cocaine were up for the sixth year in a row. There were 432 deaths related to the drug in 2017, compared with 371 deaths in 2016. In June a report by the European Monitoring Centre for Drugs and Drug Addiction (EMCDDA) found that purity of street cocaine across Europe was at its highest level in a decade and the number of people seeking treatment for use of the drug was on the rise. © 2018 Guardian News and Media Limited

Keyword: Drug Abuse; Pain & Touch
Link ID: 25295 - Posted: 08.06.2018

By Emily Baumgaertner WASHINGTON — A fast-acting class of fentanyl drugs approved only for cancer patients with high opioid tolerance has been prescribed frequently to patients with back pain and migraines, putting them at high risk of accidental overdose and death, according to documents collected by the Food and Drug Administration. The F.D.A. established a distribution oversight program in 2011 to curb inappropriate use of the dangerous medications, but entrusted enforcement to a group of pharmaceutical companies that make and sell the drugs. Some of the companies have been sued for illegally promoting other uses for the medications and in one case even bribing doctors to prescribe higher doses. About 5,000 pages of documents, obtained by researchers at the Johns Hopkins Bloomberg School of Public Health through the Freedom of Information Act and provided to The New York Times, show that the F.D.A. had data showing that so-called off-label prescribing was widespread. But officials did little to intervene. “If any opioids were going to be tightly regulated, it would be these,” said Dr. Andrew Kolodny, an opioid policy researcher at Brandeis University, who was not involved in the investigation. “They had the fox guarding the henhouse, people were getting hurt — and the F.D.A. sat by and watched this happen.” Officials at the F.D.A. said they had reviewed evidence indicating that many patients without cancer were given the drugs. But they said that piecemeal data from various stakeholders — prescriber surveys, insurance claims and industry reports — made it difficult for the agency to measure potential harm to patients. “The information we have isn’t very good, but it seems to indicate people who aren’t cancer patients are getting this and people who aren’t opioid tolerant are getting this,” Dr. Janet Woodcock, the director of the Center for Drug Evaluation and Research at the F.D.A., said in an interview. © 2018 The New York Times Company

Keyword: Drug Abuse; Pain & Touch
Link ID: 25291 - Posted: 08.04.2018

Illegal, underground and said to be brimming with health benefits — the practice of microdosing psychedelic drugs is growing increasingly popular, yet it remains relatively unstudied and its reported benefits unproven. A group of Canadian researchers is hoping to change that with new data that begins to shed light on how and why people microdose, and what they say are its effects and drawbacks. Microdosing is the practice of taking minute doses of hallucinogens like LSD or psilocybin (the active compound in so-called magic mushrooms) for therapeutic purposes. The amounts are too small to produce a high but large enough to quell anxiety or improve mood, according to users. Researchers at the University of Toronto, York University and Toronto's Centre for Addiction and Mental Health collaborated on the study, which they say is the first of its kind. The team targeted microdosing communities on Reddit and other social media channels with an anonymous online survey last year. They received 909 completed responses from current and former microdosers as well as others who had no experience with the practice. The survey yielded information about how much and how often people microdosed: typically 10 to 20 micrograms of LSD (about one- or two-tenths of a tab) or 0.2 to 0.5 grams of dried magic mushrooms, about once every three days or once per week. Thomas Anderson presented the findings at the Beyond Psychedelics conference in Prague in June. Those who microdosed reported a number of benefits, including improved mood, increased focus and productivity, and better connection with others. ©2018 CBC/Radio-Canada.

Keyword: Drug Abuse; Depression
Link ID: 25290 - Posted: 08.04.2018

Sara Reardon A consumer-advocacy group is filing a complaint with the US government about two clinical trials in Minnesota that allegedly gave agitated patients ketamine and other sedatives without their consent, despite evidence that doing so could harm their health. The trials were conducted by researchers at Hennepin County Medical Center (HCMC) in Minneapolis, Minnesota, between 2014 and June 2018. In its complaint, the advocacy group Public Citizen in Washington DC alleges that the studies’ organizers and the HCMC’s ethics-review board allowed the trials to proceed without obtaining consent from patients. In both studies, paramedics responding to medical emergencies injected agitated people with either ketamine or another sedative to determine which drug worked fastest. Patients were only notified afterwards that they had received a sedative. Sixty-four doctors, bioethicists and academic researchers have co-signed Public Citizen’s complaint, which the group plans to submit to the US Office for Human Research Protections (OHRP) and the Food and Drug Administration (FDA) on 25 July. “This isn’t even a close call,” says Michael Carome, director of Public Citizen’s health-research group. “This is clearly a prospective, high-risk experiment. This is really just a colossal failure of their programme to protect human subjects.” A spokesperson for Hennepin Healthcare, which operates Hennepin County Medical Center, told Nature that the hospital will not comment on the studies until after ongoing internal and external investigations are complete. © 2018 Springer Nature Limited.

Keyword: Drug Abuse
Link ID: 25286 - Posted: 08.03.2018

Ed Yong Imagine emerging into the sun after 17 long years spent lying underground, only for your butt to fall off. That ignominious fate regularly befalls America’s cicadas. These bugs spend their youth underground, feeding on roots. After 13 or 17 years of this, they synchronously erupt from the soil in plagues of biblical proportions for a few weeks of song and sex. But on their way out, some of them encounter the spores of a fungus called Massospora. A week after these encounters, the hard panels of the cicadas’ abdomens slough off, revealing a strange white “plug.” That’s the fungus, which has grown throughout the insect, consumed its organs, and converted the rear third of its body into a mass of spores. The de-derriered insects go about their business as if nothing unusual has happened. And as they fly around, the spores rain down from their exposed backsides, landing on other cicadas and saturating the soil. “We call them flying saltshakers of death,” says Matt Kasson, who studies fungi at West Virginia University. Massospora and its butt-eating powers were first discovered in the 19th century, but Kasson and his colleagues have only just shown that it has another secret: It doses its victims with mind-altering drugs. Perhaps that’s why “the cicadas walk around as if nothing’s wrong even though a third of their body has fallen off,” Kasson says.

Keyword: Drug Abuse
Link ID: 25272 - Posted: 07.31.2018

By Perri Klass, M.D. Whenever I write about children getting medications for anxiety, for depression, or especially for attention deficit hyperactivity disorder, a certain number of readers respond with anger and suspicion, accusing me of being part of a conspiracy to medicate children for behaviors that are either part of the normal range of childhood or else the direct result of bad schools, bad environments or bad parenting. Others suggest that doctors who prescribe such medications are in the corrupt grip of the drug companies. And there are parents with stories of unexpected side effects and doctors who didn’t listen. (Of course, there are also parents who write to say that the right medication at the right moment really helped, or adults regretting that no one offered them something that might have helped back when they were struggling.) Putting children, especially young children, on psychotropic medications is scary for parents, sometimes scary for children and also, often, scary for the doctors who do the prescribing. As a pediatrician, I have often had occasion to be grateful to colleagues with more experience and training who could help a family figure out the right medication, dosing and follow-up. It is a big deal, and there are side effects to worry about and doctors should listen to families’ concerns. But when a child is suffering and struggling, families need help, and medications are often part of the discussion. And so, without presuming to judge what should be done for any specific child, I want to talk about the discussion that needs to take place around medicating a child in distress, and how the doctor and the family should monitor medications when they are prescribed. © 2018 The New York Times Company

Keyword: ADHD; Drug Abuse
Link ID: 25267 - Posted: 07.30.2018

by Lenny Bernstein A quarter of the adults who went to hospital emergency departments with sprained ankles were prescribed opioid painkillers, a new study shows, in another sign of how commonly physicians turn to narcotics even for minor injuries. The state-by-state review revealed wide variation in the use of opioids for the sprains, from 40 percent in Arkansas to 2.8 percent in North Dakota. All but one of the nine states that recorded above-average opioid prescribing are in the South or Southwest. None are in the parts of Appalachia or New England that have been hit hardest by the opioid epidemic. The analysis of 30,832 private insurance claims from 2011 to 2015 revealed that emergency department prescriptions can influence long-term opioid use. The median prescription was 15 tablets, or three days’ worth of hydrocodone, oxycodone, tramadol or other narcotics. Patients who received the largest amounts were five times as likely to continue with prolonged opioid use than those given 10 tablets or fewer, though their overall numbers were relatively small. The recipients were not known to have previously used opioids. Opioid prescriptions written by emergency room doctors are responsible for a small portion of the vast amount of narcotic painkillers consumed by patients each year. Most prescriptions come from primary-care physicians. There were about 215 million prescriptions for the drugs in 2016, according to the Centers for Disease Control and Prevention. © 1996-2018 The Washington Post

Keyword: Drug Abuse; Pain & Touch
Link ID: 25264 - Posted: 07.28.2018

By Dave Philipps SANTA CRUZ, Calif. — Some of the local growers along the coast here see it as an act of medical compassion: Donating part of their crop of high-potency medical marijuana to ailing veterans, who line up by the dozens each month in the echoing auditorium of the city’s old veterans’ hall to get a ticket they can exchange for a free bag. One Vietnam veteran in the line said he was using marijuana-infused oil to treat pancreatic cancer. Another said that smoking cannabis eased the pain from a recent hip replacement better than prescription pills did. Several said that a few puffs temper the anxiety and nightmares of post-traumatic stress disorder. “I never touched the stuff in Vietnam,” said William Horne, 76, a retired firefighter. “It was only a few years ago I realized how useful it could be.” The monthly giveaway bags often contain marijuana lotions, pills, candies and hemp oils, as well as potent strains of smokable flower with names like Combat Cookies and Kosher Kush. But the veterans do not get any medical guidance on which product might help with which ailment, how much to use, or how marijuana might interact with other medications. Ordinarily, their first stop for advice like that would be the Department of Veterans Affairs health system, with its thousands of doctors and hundreds of hospitals and clinics across the country dedicated to caring for veterans. But the department has largely said no to medical marijuana, citing federal law. It won’t recommend cannabis products for patients, and for the most part it has declined even to study their potential benefits. That puts the department out of step with most of the country, where at least 30 states now have laws that allow the use of medical marijuana in some form. © 2018 The New York Times Company

Keyword: Drug Abuse
Link ID: 25254 - Posted: 07.26.2018

A handful of Alzheimer's patients signed up for a bold experiment: they let scientists beam sound waves into the brain to temporarily jiggle an opening in its protective shield. The so-called blood-brain barrier prevents germs and other damaging substances from leaching in through the bloodstream — but it can block drugs for Alzheimer's, brain tumours and other neurological diseases. Canadian researchers on Wednesday reported early hints that technology called focused ultrasound can safely poke holes in that barrier — holes that quickly sealed back up. It's a step toward one day using the non-invasive device to push brain treatments through. "It's been a major goal of neuroscience for decades, this idea of a safe and reversible and precise way of breaching the blood-brain barrier," said Dr. Nir Lipsman, a neurosurgeon at Toronto's Sunnybrook Health Sciences Centre who led the study. "It's exciting." The findings were presented at the Alzheimer's Association international conference in Chicago and published Wednesday in Nature Communications. This first-step research, conducted in just six people with mild to moderate Alzheimer's, didn't test potential therapies; its aim was to check whether patients' fragile blood vessels could withstand the breach without bleeding or other side-effects. ©2018 CBC/Radio-Canada

Keyword: Brain imaging
Link ID: 25249 - Posted: 07.26.2018