Chapter 4. The Chemistry of Behavior: Neurotransmitters and Neuropharmacology

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by Kate Travis Nearly 5 percent of U.S. adults misused prescription opioids in 2015, a new study shows. Based on the National Survey on Drug Use and Health, an in-person survey of more than 50,000 people, researchers estimated that 91.8 million, or 37.8 percent, of adults used prescription opioids in 2015. Some 11.5 million people misused the painkillers and 1.9 million people reported opioid dependence or abuse, Beth Han of the Substance Abuse and Mental Health Services Administration in Rockville, Md., and colleagues report online August 1 in Annals of Internal Medicine. Among people reporting opioid misuse, nearly 60 percent used the painkillers without a prescription, 22 percent took a bigger dose than prescribed, about 15 percent used them more frequently than directed, and 13 percent of people used them for longer than directed. Relieving pain was the most commonly cited reason for misusing opioids — for 66 percent of people reporting misuse and nearly 49 percent of those with opioid dependence or abuse. These results underscore the urgent need for better approaches to pain management, the authors conclude. As part of the efforts to curb the nation’s opioid epidemic — and pain problem — scientists are searching for safer opioids and opioid alternatives. Misuse motivators Pain relief was the top reason cited for misusing or abusing opioid painkillers. Other reasons included to relax, sleep or get high. B. Han et al/Annals of Internal Medicine 2017 © Society for Science & the Public 2000 - 2017.

Keyword: Drug Abuse
Link ID: 23907 - Posted: 08.02.2017

By Laurie McGinley and William Wan An electronic cigarette is demonstrated in Chicago. (AP Photo/Nam Y. Huh, File) The Food and Drug Administration said Friday it wants to reduce the nicotine in cigarettes to make them less addictive. The unexpected announcement sent shares of tobacco companies plummeting and sparked praise among some public health advocates. If successful, the effort would be the first time the government has tried to get the Americans to quit cigarettes by reaching beyond warning labels or taxes to attacking the actual addictive substance inside. The FDA rolled out a second major announcement at the same time: It is delaying for several years a key regulation affecting cigars and e-cigarettes, including flavored vaping products that studies show are especially enticing to youth. Specifically, it postponed the requirement that such products be approved by the agency. FDA’s commissioner Scott Gottlieb said both actions are part of a comprehensive plan to eventually wean smokers off conventional cigarettes and steer them toward less harmful alternative forms of nicotine like vaping. “The overwhelming amount of death and disease attributable to tobacco is caused by addiction to cigarettes — the only legal consumer product that, when used as intended, will kill half of all long-term users,” he said. Some health proponents, however, expressed caution, pointing out that the nicotine-reduction proposal could take years to enact and could be derailed by major hurdles, including the significant lobbying power of tobacco industry. © 1996-2017 The Washington Post

Keyword: Drug Abuse
Link ID: 23893 - Posted: 07.29.2017

People who drink three to four times a week are less likely to develop type 2 diabetes than those who never drink, Danish researchers suggest. Wine appears to be particularly beneficial, probably as it plays a role in helping to manage blood sugar, the study, published in Diabetologia, says. They surveyed more than 70,000 people on their alcohol intake - how much and how often they drank. But experts said this wasn't a "green light" to drink more than recommended. And Public Health England warned that consuming alcohol contributed to a vast number of other serious diseases, including some cancers, heart and liver disease. "People should keep this in mind when thinking about how much they drink," a spokeswoman said. Prof Janne Tolstrup, from the National Institute of Public Health of the University of Southern Denmark, who led the research, said: "We found that drinking frequency has an independent effect from the amount of alcohol taken. "We can see it's a better effect to drink the alcohol in four portions rather than all at once." After around five years, study participants were followed up and a total of 859 men and 887 women group had developed diabetes - either type 1 or the more common type 2. The researchers concluded that drinking moderately three to four times a week reduced a woman's risk of diabetes by 32% while it lowered a man's by 27%, compared with people drinking on less than one day a week. Findings also suggest that not all types of alcohol had the same effect. Wine appeared to be particularly beneficial because polyphenols, particularly in red wine, play a role in helping to manage blood sugar. © 2017 BBC.

Keyword: Drug Abuse
Link ID: 23892 - Posted: 07.29.2017

By BENEDICT CAREY Dr. Herbert Needleman, whose studies of children exposed to low levels of lead prompted regulations that limited or banned the metal in a range of common products, like gasoline and paint, and set a standard for the modern study of environmental toxins, died on July 18 in Pittsburgh. He was 89. His son, Dr. Joshua Needleman, said the cause was lung failure resulting from edema, an excess of fluid. Dr. Needleman was working at a community psychiatric clinic in North Philadelphia after medical school when he met a young man who would become a touchstone for a crusading career. The boy approached Dr. Needleman and explained his ambitions, which were large, even as the boy struggled with words. He was bright and open; nonetheless he had deficits that struck Dr. Needleman as similar to those found in children with lead poisoning. “I thought, how many of these kids who are coming to the clinic are in fact a missed case of lead poisoning?” he said in a later interview. His clinic office overlooked a school playground; the view gave him an idea. Doctors had long known that exposure to high doses of lead caused mental lapses, even permanent brain damage and death. But what about the low-level exposure that many children, like the ones playing in the yard, absorbed every day — merely by living in older urban neighborhoods thick with lead paint and industrial contamination? No one knew. No one could study the effects carefully, because the available tests for lead exposure were of hair, blood, or fingernails — each flawed in its own way. Bone is the most accurate long-term repository: Once absorbed into the body, lead circulates in the blood and accumulates in the skeleton. But taking bone samples — biopsies — is painful and hardly justifiable for the sake of a hypothesis, especially in young children. Yet Dr. Needleman had seen an earlier study of lead poisoning, a small one, which measured accumulated lead exposure in teeth. Teeth are a part of the human skeleton. And young children shed them. “That was the insight that changed everything,” said Dr. Bernard Goldstein, former dean of the University of Pittsburgh’s graduate school of public health. “Herb became the Tooth Fairy.” © 2017 The New York Times Company

Keyword: Neurotoxins; Development of the Brain
Link ID: 23887 - Posted: 07.28.2017

By Megan Scudellari Neuropharmacology postdoc Nick DiPatrizio was stumped. His advisor, University of California, Irvine, researcher Daniele Piomelli, had discovered eight years earlier that hungry rats have high levels of endocannabinoids, endogenous molecules that bind to the same receptors as the active ingredient in marijuana. Now, in 2009, DiPatrizio was trying to identify exactly where and how those molecules were controlling food intake in rats. But under specific feeding conditions, he couldn’t locate any changes in endocannabinoid levels in the brain, which is flush with endocannabinoid receptors and the obvious place to look for behavioral signals. Piomelli gently chastised his mentee. “He said, ‘You’re being neurocentric. Remember, there’s a body attached to the head. Look in the other organs of the body,’ ” recalls DiPatrizio. So the young scientist persisted, and eventually discovered that hunger—and the taste of fat—leads to increased endocannabinoid levels in the jejunum, a part of the small intestine. Endocannabinoid signaling in the gut, not the brain, was controlling food intake in the rodents in response to tasting fats.1 The evolution of endocannabinoid research has mirrored DiPatrizio’s early thinking: ever since the first endocannabinoid receptor was identified in the late 1980s, the field has been overwhelmingly focused on the central nervous system. The main endocannabinoid receptor, CB1, was first discovered in a rat brain and is now known to be among the most abundant G protein–coupled receptors in neurons there. Plus, cannabis is well-known for its psychotropic effects. “That has led the research field to be very CNS-oriented,” says Saoirse O’Sullivan, who studies endocannabinoids at the University of Nottingham in the U.K. © 1986-2017 The Scientist

Keyword: Drug Abuse; Obesity
Link ID: 23870 - Posted: 07.25.2017

By Jack Turban Fourteen-year-old Nicole, whose name I changed for her privacy, told her mother every day for years that she wanted to end her own life. Between suicide attempts were more psychiatric hospital visits than she or her mother could count. She refused to get out of bed, shower, or go to school, missing sixty school days in a single year. In one visit with her therapist, she admitted to praying every night that she would not wake up the next morning. After countless psychiatrists and psychotherapists were unable to improve her depression, her mother converted a bathroom cabinet into a locked safe, containing all of the sharp objects and pills in the house. Her parents were certain it was only a matter of time until Nicole killed herself. Today, a now seventeen-year-old Nicole greets me with a big smile. Her blonde hair is pulled back into a ponytail to reveal her bright blue eyes. She tells me she hasn’t missed a day of school and is preparing for college. Blushing, she lets me know that her first date is coming up, a prom date to be precise. For the first time in years, she is happy and wants to live. What happened to cause this dramatic change? In December, Nicole started infusions of a psychedelic drug called ketamine. Though she had failed to respond to endless medication trials for her depression (selective serotonin reuptake inhibitors, mirtazapine, topiramate, antipsychotics, and lithium to name just a few), ketamine cleared her depression within hours. The effect lasts about two weeks before she needs a new infusion. © 2017 Scientific America

Keyword: Depression; Development of the Brain
Link ID: 23850 - Posted: 07.19.2017

Laurel Hamers A common blood sugar medication or an extra dose of a thyroid hormone can reverse signs of cognitive damage in rats exposed in utero to alcohol. Both affect an enzyme that controls memory-related genes in the hippocampus, researchers report July 18 in Molecular Psychiatry. That insight might someday help scientists find an effective human treatment for fetal alcohol spectrum disorders, which can cause lifelong problems with concentration, learning and memory. “At this moment, there’s really no pharmaceutical therapy,” says R. Thomas Zoeller, a neurobiologist at the University of Massachusetts Amherst. Fetal alcohol syndrome disorders may affect up to 5 percent of U.S. kids, according to estimates from the U.S. Centers for Disease Control and Prevention. Scientists don’t know exactly why alcohol has such a strong effect on developing brains. But the lower thyroid hormone levels commonly induced by alcohol exposure might be one explanation, suggests study coauthor Eva Redei, a psychiatrist at Northwestern University Feinberg School of Medicine in Chicago. “The mother has to supply the thyroid hormones for brain development,” says Redei. So, pregnant women who drink might not be providing their fetuses with enough hormones for normal brain development. That could disrupt the developing hippocampus, a brain region involved in learning and memory. To counter alcohol’s effects, Redei and her colleagues gave doses of thyroxine, a thyroid hormone, to newborn rats that had been exposed to alcohol before birth. (That timing coincides developmentally with the third trimester of pregnancy in humans.) The amount of alcohol fed to the rat moms corresponded roughly to a woman drinking a glass or two of wine a day. |© Society for Science & the Public 2000 - 2017

Keyword: Drug Abuse; Development of the Brain
Link ID: 23849 - Posted: 07.19.2017

By PERRI KLASS, M.D. We want to believe we’re raising our kids to think for themselves, and not to do dumb or unhealthy things just because the cool kids are doing them. But research shows that when it comes to smoking, children are heavily influenced by some of the folks they consider the coolest of the cool: actors in movies. “There’s a dose-response relationship: The more smoking kids see onscreen, the more likely they are to smoke,” said Dr. Stanton Glantz, a professor and director of the University of California, San Francisco, Center for Tobacco Control Research and Education. He is one of the authors of a new study that found that popular movies are showing more tobacco use onscreen. “The evidence shows it’s the largest single stimulus,” for smoking, he said; “it overpowers good parental role modeling, it’s more powerful than peer influence or even cigarette advertising.” He said that epidemiological studies have shown that if you control for all the other risk factors of smoking (whether parents smoke, attitudes toward risk taking, socioeconomic status, and so on), younger adolescents who are more heavily exposed to smoking on film are two to three times as likely to start smoking, compared with the kids who are more lightly exposed. Those whose parents smoke are more likely to smoke, he said, but exposure to smoking in movies can overcome the benefit of having nonsmoking parents. In one study, the children of nonsmoking parents with heavy exposure to movie smoking were as likely to smoke as the children of smoking parents with heavy movie exposure. To Dr. Glantz, and the other people who study this topic, that makes smoking in movies an “environmental toxin,” a factor endangering children. © 2017 The New York Times Company

Keyword: Drug Abuse; Attention
Link ID: 23844 - Posted: 07.18.2017

Nicola Davis People who drink coffee have a lower risk of dying from a host of causes, including heart disease, stroke and liver disease, research suggests – but experts say it’s unclear whether the health boost is down to the brew itself. The connection, revealed in two large studies, was found to hold regardless of whether the coffee was caffeinated or not, with the effect higher among those who drank more cups of coffee a day. But scientists say that the link might just be down to coffee-drinkers having healthier behaviours. “It is plausible that there is something else behind this that is causing this relationship,” said Marc Gunter, a co-author of one of the studies, from the International Agency for Research on Cancer. But, he added, based on the consistency of the results he would be surprised if coffee itself didn’t play a role in reducing the risk of death. About 2.25bn cups of coffee are consumed worldwide every day. While previous studies have suggested coffee might have health benefits, the latest research involves large and diverse cohorts of participants. The first study looked at coffee consumption among more than 185,000 white and non-white participants, recruited in the early 1990s and followed up for an average of over 16 years. The results revealed that drinking one cup of coffee a day was linked to a 12% lower risk of death at any age, from any cause while those drinking two or three cups a day had an 18% lower risk, with the association not linked to ethnicity. © 2017 Guardian News and Media Limited

Keyword: Drug Abuse; Stroke
Link ID: 23823 - Posted: 07.11.2017

Dean Burnett Antidepressants; the go-to treatment for depression, or generalised anxiety. It’s incredible when you think about it, the fact that you can have a debilitating mood disorder, take a few pills, and feel better. It’s unbelievable that medical science has progressed so far that we now fully understand how the human brain produces moods and other emotions, so can manipulate them with designer drugs. That’s right, it is unbelievable. Because it isn’t the case. The fact that antidepressants are now so common is something of a mixed blessing. On one hand, anything that helps reduce stigma and lets those afflicted know they aren’t alone can only be helpful. Depression is incredibly common, so this awareness can literally save many lives. On the other hand, familiarity does not automatically mean understanding. Nearly everyone has a smartphone these days, but how many people, if pushed, could construct a touchscreen? Not many, I’d wager. And so it is with depression and antidepressants. For all the coverage and opinion pieces produced about them, the details around how they work remain somewhat murky and elusive. Actually, in the case of antidepressants, it’s more a question of why they work, rather than how. Most antidepressants, from the earliest Trycyclics and Monamine Oxidase inhibitors, to the ubiquitous modern day selective serotonin reuptake inhibitors (SSRIs), work by increasing the levels of specific neurotransmitters in the brain, usually by preventing them from being broken down and reabsorbed into the neurons, meaning they linger in the synapses longer, causing more activity, so “compensating” for the reduced overall levels. Antidepressants make the remaining neurotransmitters work twice as hard, so overall activity is more “normal”, so to speak. © 2017 Guardian News and Media Limited

Keyword: Depression
Link ID: 23822 - Posted: 07.11.2017

By Clare Wilson A patient-led movement is helping people taking psychiatric medicines to hack their dosing regimens so they can wean themselves off the drugs without any side effects. Now a Dutch website that sells kits to help people do this is about to launch an English-language site, triggering safety concerns among UK regulators and doctors. Some people find it impossible to stop taking certain antidepressants and anti-anxiety medicines such as valium because, unless the dose is reduced very gradually, they get severe mental and physical side-effects. The problem is these medicines aren’t sold in small enough tablets to allow for tapering. This has prompted some people to flout mainstream medical advice and use DIY methods for reducing their doses, such as grinding up tablets and dissolving them in water, or breaking open capsules of tiny beads and counting them out. The UK mental health charity Mind advises people who want to stop taking antidepressants of some techniques to try, but recommends they get advice from their doctor or pharmacist first. To help people taper their dose more easily, a Dutch medical charity, called Cinderella Therapeutics, creates personalised “tapering kits”, with precisely weighed out tablets in labelled packets that gradually reduce over several months. The website recommends people do this under medical supervision and must first receive a doctor’s prescription. © Copyright New Scientist Ltd.

Keyword: Depression
Link ID: 23817 - Posted: 07.09.2017

Hannah Devlin A Catholic priest, a Rabbi and a Buddhist walk into a bar and order some magic mushrooms. It may sound like the first line of a bad joke, but this scenario is playing out in one of the first scientific investigations into the effects of psychedelic drugs on religious experience – albeit in a laboratory rather than a bar. Scientists at Johns Hopkins University in Baltimore have enlisted two dozen religious leaders from a wide range of denominations, to participate in a study in which they will be given two powerful doses of psilocybin, the active ingredient in magic mushrooms. Dr William Richards, a psychologist at Johns Hopkins University in Baltimore, Maryland who is involved in the work, said: “With psilocybin these profound mystical experiences are quite common. It seemed like a no-brainer that they might be of interest, if not valuable, to clergy.” The experiment, which is currently under way, aims to assess whether a transcendental experience makes the leaders more effective and confident in their work and how it alters their religious thinking. Despite most organised religions frowning on the use of illicit substances, Catholic, Orthodox and Presbyterian priests, a Zen Buddhist and several rabbis were recruited. The team has yet to persuade a Muslim imam or Hindu priest to take part, but “just about all the other bases are covered,” according to Richards. After preliminary screening, including medical and psychological tests, the participants have been given two powerful doses of psilocybin in two sessions, one month apart. © 2017 Guardian News and Media Limited

Keyword: Drug Abuse; Attention
Link ID: 23814 - Posted: 07.09.2017

Elana Gordon By the time Elvis Rosado was 25, he was addicted to opioids and serving time in jail for selling drugs to support his habit. "I was like, 'I have to kick this, I have to break this,' " he says. For Rosado, who lives in Philadelphia, drugs had become a way to disassociate from "the reality that was life." He'd wake up physically needing the drugs to function. His decision to finally stop using propelled him into another challenging chapter of his addiction and one of the most intense physical and mental experiences he could have imagined: detoxing. "The symptoms are horrific," Rosado says. There are recovery and treatment centers that can help people quit using drugs — in fact, it's a multi-billion-dollar industry. But this help can be expensive, and waiting lists for state and city-funded programs are often extremely long. So can detoxing on your own be the solution? In most cases, the answer is no. In fact, a growing movement within the field of addiction medicine is challenging the entire notion of detox and the assumption that when people cleanse themselves of chemicals, they're on the road to recovery. Article continues after sponsorship "That's a really pernicious myth, and it has erroneous implications," says Dr. Frederic Baurer, president of the Pennsylvania Society of Addiction Medicine. But at the time, Rosado says, he needed to end his "longtime love affair" with codeine. Like Oxycontin and morphine, it's an opioid. In jail, these drugs were easily available, Rosado recalls, through friends and cell mates. © 2017 npr

Keyword: Drug Abuse
Link ID: 23803 - Posted: 07.04.2017

By RONI CARYN RABIN It may be the most palatable advice you will ever get from a doctor: Have a glass of wine, a beer or a cocktail every day, and you just might prevent a heart attack and live longer. But the mantra that moderate drinking is good for the heart has never been put to a rigorous scientific test, and new research has linked even modest alcohol consumption to increases in breast cancer and changes in the brain. That has not stopped the alcoholic beverage industry from promoting the alcohol-is-good-for-you message by supporting scientific meetings and nurturing budding researchers in the field. Now the National Institutes of Health is starting a $100 million clinical trial to test for the first time whether a drink a day really does prevent heart attacks. And guess who is picking up most of the tab? Five companies that are among the world’s largest alcoholic beverage manufacturers — Anheuser-Busch InBev, Heineken, Diageo, Pernod Ricard and Carlsberg — have so far pledged $67.7 million to a foundation that raises money for the National Institutes of Health, said Margaret Murray, the director of the Global Alcohol Research Program at the National Institute on Alcohol Abuse and Alcoholism, which will oversee the study. The decision to let the alcohol industry pay the bulk of the cost has raised concern among researchers who track influence-peddling in science. “Research shows that industry-sponsored research almost invariably favors the interests of the industry sponsor, even when investigators believe they are immune from such influence,” said Marion Nestle, a professor of nutrition and food studies at New York University who is the author of several books on the topic, including “Food Politics: How the Food Industry Influences Nutrition and Health.” © 2017 The New York Times Company

Keyword: Drug Abuse
Link ID: 23800 - Posted: 07.04.2017

By Wallis Snowdon, Ariel Fournier The seizure of a controversial drug in Edmonton is evidence that more research is required on kratom as a possible antidote in Alberta's deadly opioid epidemic, says a leading researcher in the field. "Everything has to be taken with caution, but does that mean you take it off the streets?" said Susruta Majumdar, a chemist who has worked on numerous studies into the drug. "Probably not," said Majumdar, who works in the department of neurology at Sloan Kettering Cancer Center in New York. "It's a little premature to ban it right away and take it out of the public scenario because very little research has been done. It's a weak alkaloid but we need to be cautious about it." In a news release Tuesday, Health Canada said it had seized unauthorized kratom products from two Edmonton head shops. The packets were confiscated from a store called Jupiter on Whyte Avenue and from another called Bogart's Pipes and Papers on 132nd Avenue. Kratom is a coffee-like plant native to southeast Asia. The drug is traditionally consumed by chewing on the leaves, but can also be ingested as a capsule or powder or as a tea. Health Canada said the herbal product has been linked to both "narcotic and stimulant-like effects," and may pose serious health risks including nausea, vomiting, seizures, and liver toxicity. ©2017 CBC/Radio-Canada.

Keyword: Drug Abuse
Link ID: 23799 - Posted: 07.01.2017

ByMaia Szalavitz George Sarlo is throwing cash at research into how drugs like magic mushrooms can help people overcome trauma like his own. Deep in the Mexican jungle, in a village so remote it's only accessible by boat, 74-year-old venture capitalist George Sarlo waited to meet his father. It was the fall of 2012, and Sarlo knew his quest seemed absurd. After all, his father had been dead for decades, and he had no connection to this region of rainforests and beaches and its indigenous peoples. As the financier watched a shaman prepare a ceremonial cup of bitter brown ayahuasca, he couldn't believe that he'd agreed to swallow this nauseating psychedelic brew for a second time. But he had traveled for 12 hours—via plane, boat, and finally on foot—to this primeval place, a newly-built gazebo-like wood platform without walls. He had expressed his intentions in a group therapy session in preparation; he had eaten a special, bland diet and even halted other medications. He also trusted his friend, Dr. Gabor Maté, a fellow Hungarian Holocaust survivor, who led the therapy and had arranged the trip. Maté is perhaps best known for his book, In the Realm of Hungry Ghosts, which explores his work with extremely traumatized injection drug users in Vancouver. He's been offering psychedelic therapy to trauma survivors since learning about the potential of ayahuasca in 2008.

Keyword: Drug Abuse; Stress
Link ID: 23798 - Posted: 07.01.2017

Hannah Devlin Doctors in Bristol are set to begin the world’s first clinical study into the use of MDMA to treat alcohol addiction. Researchers are testing whether a few doses of the drug, in conjunction with psychotherapy, could help patients overcome addiction more effectively than conventional treatments. The small trial was granted ethical approval a few weeks ago and the team expects to give the first dose of MDMA, the active ingredient in ecstasy pills, within the next two months. Ben Sessa, a clinical psychiatrist on the trial and senior research fellow at Imperial College London said: “We know that MDMA works really well in helping people who have suffered trauma and it helps to build empathy. Many of my patients who are alcoholics have suffered some sort of trauma in their past and this plays a role in their addiction.” Twenty patients, recruited through the recreational drug and alcohol services in Bristol, will be given the drug in capsule form during two supervised treatment sessions. The participants will be heavy drinkers – typically consuming the equivalent of five bottles of wine a day – who have relapsed into alcoholism repeatedly after trying other forms of treatment. “After 100 years of modern psychiatry our treatments are really poor,” said Sessa, speaking at the Breaking Convention conference in London. “The chances of relapse for these patients are really high – 90% at three years. No one has ever given MDMA to treat alcoholism before.” © 2017 Guardian News and Media Limited

Keyword: Drug Abuse
Link ID: 23797 - Posted: 07.01.2017

By ABBY GOODNOUGH WASHINGTON — The Senate leadership’s efforts to salvage the Republican health care bill have focused in part on adding $45 billion for states to spend on opioid addiction treatment. That is a big pot of money. But addiction specialists said it was drastically short of what would be needed to make up for the legislation’s deep cuts to Medicaid, which has provided treatment for hundreds of thousands of people caught up in a national epidemic of opioid abuse. The new money would most likely flow to states in the form of grants over 10 years, averaging out to $4.5 billion per year. With hundreds of people dying every week from overdoses of heroin, fentanyl and opioid painkillers, some specialists say a fixed amount of grant money is simply inadequate compared with the open-ended funding stream that Medicaid provides to treat all who qualify for the coverage. “When it comes to other illnesses like breast cancer or heart disease, we’d never rely solely on grants for treatment — because we know that grants are not substitutes for health coverage,” said Linda Rosenberg, president and chief executive of the National Council for Behavioral Health, which represents treatment providers. “Addiction is no different.” The Affordable Care Act vastly expanded access to addiction treatment by designating those services as “essential benefits.” That means they had to be covered through both an expansion of Medicaid to far more low-income adults and the marketplaces set up under the law for people to buy private plans. Both the House and Senate health bills would effectively end the expansion and cap federal Medicaid spending, resulting in the loss of coverage for millions of people, according to the Congressional Budget Office. © 2017 The New York Times Company

Keyword: Drug Abuse
Link ID: 23796 - Posted: 07.01.2017

By Kathryn Casteel It’s no secret that heroin has become an epidemic in the United States. Heroin overdose deaths have risen more than sixfold in less than a decade and a half.1 Yet according to one of the most widely cited sources of data on drug use, the number of Americans using heroin has risen far more slowly, roughly doubling during the same time period.2 Most major researchers believe that source, the National Survey on Drug Use and Health, vastly understates the increase in heroin use. But many rely on the survey anyway for a simple reason: It’s the best data they have. Several other sources that researchers once relied on are no longer being updated or have become more difficult to access. The lack of data means researchers, policymakers and public health workers are facing the worst U.S. drug epidemic in a generation without essential information about the nature of the problem or its scale. “We’re simply flying blind when it comes to data collection, and it’s costing lives,” said John Carnevale, a drug policy expert who served at the federal Office of National Drug Control Policy under both Republican and Democratic administrations. There is anecdotal evidence of how patterns of drug use are changing, Carnevale said, and special studies conducted in various localities are identifying populations of drug users. “But the national data sets we have in place now really don’t give us the answers that we need,” he said.

Keyword: Drug Abuse
Link ID: 23792 - Posted: 06.30.2017

By Alice Klein Women are missing out on optimum medical treatment because most pre-clinical drug research is done in male animals, a new study suggests. New drugs must be evaluated in animals before being considered for human trials. Over three-quarters of these studies use only male animals because of concerns that female hormone cycles will affect experiments. It is also widely assumed that what works for males will work for females. However, research by Natasha Karp at the Wellcome Trust Sanger Institute in Cambridge and her colleagues casts doubt on this assumption. They compared 234 physical traits in 14,000 male and female lab mice. Sex differences were identified for 57 per cent of quantifiable traits – like cholesterol level and bone mass – and for 10 per cent of qualitative traits, like head shape. In another 40,000 mice, they found that when they switched off specific genes, the effects varied according to sex. This suggests that genetic diseases may manifest themselves differently in males and females and require different treatments, says Karp. These sex nuances mean that drugs optimised for male animals may be less effective in females, or even cause harm, says Karp. Between 1997 and 2001, 8 of the 10 drugs that were pulled from the market in the US posed greater health risks for women – possibly as a result of male-biased animal research, she says. © Copyright New Scientist Ltd.

Keyword: Sexual Behavior
Link ID: 23780 - Posted: 06.27.2017