By Dawn MacKeen The CBD industry is flourishing, conservatively projected to hit $16 billion in the United States by 2025. Already, the plant extract is being added to cheeseburgers, toothpicks and breath sprays. More than 60 percent of CBD users have taken it for anxiety, according to a survey of 5,000 people, conducted by the Brightfield Group, a cannabis market research firm. Chronic pain, insomnia and depression follow behind. Kim Kardashian West, for example, turned to the product when “freaking out” over the birth of her fourth baby. The professional golfer Bubba Watson drifts off to sleep with it. And Martha Stewart’s French bulldog partakes, too. What is CBD? Cannabidiol, or CBD, is the lesser-known child of the cannabis sativa plant; its more famous sibling, tetrahydrocannabinol, or THC, is the active ingredient in pot that catapults users’ “high.” With roots in Central Asia, the plant is believed to have been first used medicinally — or for rituals — around 750 B.C., though there are other estimates too. Cannabidiol and THC are just two of the plant’s more than 100 cannabinoids. THC is psychoactive, and CBD may or may not be, which is a matter of debate. THC can increase anxiety; it is not clear what effect CBD is having, if any, in reducing it. THC can lead to addiction and cravings; CBD is being studied to help those in recovery. Cannabis containing 0.3 percent or less of THC is hemp. Although last year’s Farm Bill legalized hemp under federal law, it also preserved the Food and Drug Administration’s oversight of products derived from cannabis. What are the claims? CBD is advertised as providing relief for anxiety, depression and post-traumatic stress disorder. It is also marketed to promote sleep. Part of CBD’s popularity is that it purports to be “nonpsychoactive,” and that consumers can reap health benefits from the plant without the high (or the midnight pizza munchies). © 2019 The New York Times Company

Keyword: Drug Abuse; Stress
Link ID: 26707 - Posted: 10.16.2019

By Amanda Chicago Lewis In June of 2018, Mark Pennington received troubling news from his ex-girlfriend, with whom he shared custody of their 2-year-old son. She had taken a hair follicle from the boy, she said, and had it analyzed at a lab. A drug test had returned positive for THC, the intoxicating compound in marijuana; evidently their son had been exposed to it, presumably in Mr. Pennington’s presence. He was told that, from then on, he would be permitted to see the child only once a week, and under supervision. “I was mortified,” Mr. Pennington recalled recently. “My jaw hit the floor. I just knew from the bottom of my heart I hadn’t gotten any THC in my son’s system.” However, Mr. Pennington had been providing his son with honey infused with cannabidiol, or CBD, a nonintoxicating compound that, like THC, is found in varying amounts in the plant known as cannabis. THC is federally illegal, and until recently so was all cannabis. But last December, the Farm Bill legalized hemp — cannabis that contains less than 0.3 percent THC. With that, CBD became legal. It can now be found at stores across the country, in everything from tinctures and massage oils to coffee and makeup. Mr. Pennington, who lives in Colorado, where growing hemp for CBD has been legal since 2014, worked for Colorado Hemp Honey, a company that sells CBD-infused raw honey across the country. Mr. Pennington was despondent about possibly losing custody of his child, until he spoke with Frank Conrad, the chief technology officer and lab director at Colorado Green Lab, a scientific consultant to the cannabis industry. Mr. Conrad directed him to a little-known study published in 2012 in the Journal of Analytical Toxicology that showed that a common forensic drug testing method could easily mistake the presence of CBD for THC. In short, the drug testing lab may have erred; it was entirely possible that the CBD Mr. Pennington had given his child had caused the drug test to produce a false positive for THC. © 2019 The New York Times Company

Keyword: Drug Abuse
Link ID: 26702 - Posted: 10.15.2019

Madeline K. Sofia Carine Chen-McLaughlin smoked for more than 40 years. She didn't want to be a smoker. She'd tried to stop literally dozens of times over the decades. But she always came back. Smoking was "one of my oldest, dearest friends," she said of her habit. "To not have that relationship was very, very scary." Then she heard about a clinical trial to treat nicotine addiction with something a little unusual: magic mushrooms. Well, not actual magic mushrooms, but a little pill of a drug called psilocybin. It's the ingredient in mushrooms that gives people hallucinogenic visions. New research shows that psilocybin may be an effective treatment for diseases like depression and addiction. While the work is still in its early stages, there are signs that psilocybin might help addicts shake the habit by causing the brain to talk with itself in different ways. "These brain changes lead to, often times, a sense of unity," says Matthew Johnson, an experimental psychologist at Johns Hopkins University. It all may sound a little "woo-woo," he admits, but it seems to be working. Early results suggest that psilocybin, coupled with therapy, may be far more effective than other treatments for smoking, such as the nicotine patch. Magic mushrooms have been used by indigenous communities for thousands of years, and research on psilocybin isn't all that new, either. Work began in the 1950s and 1960s. But studies involving it and other psychedelics dropped off following the passage of the Controlled Substance Act in 1970, which outlawed hallucinogens and other drugs. "The medical applications became, really, a casualty of a political war," Johnson says. © 2019 npr

Keyword: Drug Abuse
Link ID: 26700 - Posted: 10.15.2019

By Katie Thomas and Sheila Kaplan In 2009, not long after Dr. Margaret Hamburg became commissioner of the Food and Drug Administration, a package arrived at her home. Inside was a clunky device called an e-cigarette. “It was my first exposure to this emerging, new technology,” Dr. Hamburg recalled. The package was sent by an antismoking activist as a warning about a product that was taking off in the United States. But over the next decade, the federal government — across the span of two presidential administrations — allowed the rise of a largely unregulated industry that may be addicting a new generation to nicotine. E-cigarettes and vaping devices, with $7 billion in annual sales, have become a part of daily life for millions of Americans. Youth use has skyrocketed with the proliferation of flavors targeting teenagers, such as Bazooka Joe Bubble Gum and Zombie Blood. And nearly 1,300 people have been sickened by mysterious vaping-related lung injuries this year. Yet the agency has not vetted the vast majority of vaping devices or flavored liquids for safety. In dozens of interviews, federal officials and public health experts described a lost decade of inaction, blaming an intense lobbying effort by the e-cigarette and tobacco industries, fears of a political backlash in tobacco-friendly states, bureaucratic delays, and a late reprieve by an F.D.A. commissioner who had previously served on the board of a chain of vaping lounges. “The minute you saw cotton candy flavors — come on,” said Dr. Thomas R. Frieden, the former director of the Centers for Disease Control and Prevention, who had warned since 2013 of the harms to adolescents. “Everything that could have been done should have been done to get them off the market.” © 2019 The New York Times Company

Keyword: Drug Abuse
Link ID: 26699 - Posted: 10.14.2019

Heidi Ledford Until a few months ago, pulmonologist Sean Callahan didn’t typically ask his patients if they vaped. He thought that e-cigarettes might help smokers wean themselves off cigarettes, and that the risks of vaping would probably take years to become clear. The emergence of a mysterious, sometimes lethal, lung injury associated with vaping has changed his mind. Callahan works at the University of Utah Health in Salt Lake City, which has treated about 20 victims of the outbreak. “It was surprising: the overwhelming number of them — and how young they were,” he says. Researchers and physicians alike were caught unprepared by the illness, which has now sickened about 1,300 US vapers and killed 26. Scientists are scrambling to find out why, and to save other vapers from the same fate. “Everything is rapidly evolving,” says Brandon Larsen, a pulmonary pathologist at the Mayo Clinic in Phoenix, Arizona. “I could tell you something today and next week it could be totally wrong.” A paper1 published by Larsen and his colleagues in the New England Journal of Medicine on 2 October undercut a popular theory behind the outbreak — and underscored how far researchers still have to go to pinpoint its cause. Many of those sickened in the outbreak had vaped cartridges containing tetrahydrocannabinol (THC) — the active ingredient in marijuana — that was diluted with oily chemicals. Larsen’s study is the largest analysis to date of lung tissue taken from sickened vapers. The scientists searched for evidence of lipoid pneumonia, a condition that arises when oil enters the lungs. It is marked by lipid found in lung tissue and also in cells called macrophages, which normally sweep up debris in the lungs. But Larsen and his colleagues did not find substantial lipid droplets in any of their samples from 17 patients. Instead, their findings point to general lung damage and inflammation caused by exposure to toxic chemicals. © 2019 Springer Nature Limited

Keyword: Drug Abuse
Link ID: 26698 - Posted: 10.14.2019

By Denise Grady The outbreak of lung illnesses linked to vaping grew by more than 200 cases in a week, now totaling 1,299, the Centers for Disease Control and Prevention reported on Thursday. Twenty-nine people have died from vaping-related illnesses, health officials said. The figures mean that 219 new cases and seven new deaths were reported. Cases have occurred in 49 states, the District of Columbia and the United States Virgin Islands. A 17-year-old boy died in the Bronx last week, the youngest death so far linked to vaping. Utah and Massachusetts officials confirmed their states’ first vaping deaths this week. Indiana health officials announced late Thursday afternoon that two more people had died. The ages of those who died range from 17 years to 75 years, with a median of 49. The exact cause of the illness is still unknown. Many of those who became ill had vaped THC, some had used both THC and nicotine, and others report vaping only nicotine. Federal and state health authorities are testing vaping materials and studying tissue samples from patients in an effort to find the cause of the outbreak. They are particularly concerned about the huge amount of illicit THC products in circulation, which contain unknown mixtures of solvents, diluting agents and flavorings that may be toxic to the lungs. The United States Army said it was treating two soldiers for vaping-related illness. The Army did not say what products the two soldiers had been using, according to an earlier report in The Wall Street Journal. The military has banned e-cigarettes from the exchanges on bases. © 2019 The New York Times Company

Keyword: Drug Abuse
Link ID: 26694 - Posted: 10.11.2019

Between 1999 and 2017, the United States experienced a 10-fold increase in the number of people who died from overdoses of Valium and other benzodiazepines. For years, scientists thought that these powerful sedatives, which are used to treat anxiety, muscle spasms, and sleeping disorders, worked alone to calm nerves. Now, in an article published in Science, researchers from the National Institutes of Health show that this view of the drugs and the neural circuits they affect may have to change. In a study of mice, scientists discovered that both may need the assistance of a ‘sticky’ gene, named after a mythological figure, called Shisa7. “We found that Shisa7 plays a critical role in the regulation of inhibitory neural circuits and the sedative effects some benzodiazepines have on circuit activity,” said Wei Lu, Ph.D., a Stadtman Investigator at NIH’s National Institute of Neurological Disorders and Stroke (NINDS) and the senior author of the study. “We hope the results will help researchers design more effective treatments for a variety of neurological and neuropsychiatric disorders that are caused by problems with these circuits.” Dr. Lu’s lab studies the genes and molecules used to control synapses; the trillions of communications points made between neurons throughout the nervous system. In this study, his team worked with researchers led by Chris J. McBain, Ph.D., senior investigator at NIH’s Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), to look at synapses that rely on the neurotransmitter gamma-aminobutyric acid (GABA) to calm nerves. Communication at these synapses happens when one neuron fires off packets of GABA molecules that are then quickly detected by proteins called GABA type A (GABAA) receptors on neighboring neurons.

Keyword: Drug Abuse; Stress
Link ID: 26692 - Posted: 10.11.2019

Will Stone & Allison Aubrey There's no doubt that opioids have been massively overprescribed in U.S. In the haste to address the epidemic, there's been pressure on doctors to reduce prescriptions of these drugs — and in fact prescriptions are declining. But along the way, some chronic pain patients have been forced to rapidly taper or discontinue the drugs altogether. Now, the U.S. Department of Health and Human Services has a new message for doctors: Abrupt changes to a patient's opioid prescription could harm them. On Thursday, the agency issued new guidelines for physicians on how best to manage opioid prescriptions. They recommend a deliberate approach to lowering doses for chronic pain patients who have been on long-term opioid therapy. "It must be done slowly and carefully," says Adm. Brett P. Giroir, MD, assistant secretary for health for HHS. "If opioids are going to be reduced in a chronic patient it really needs to be done in a patient-centered, compassionate, guided way." This is a course correction of sorts. In 2016, the Centers for Disease Control and Prevention issued prescribing guidelines. Those highlighted the risks of addiction and overdose and encouraged providers to lower doses when possible. In response, many doctors began to limit their pain pill prescriptions, and in some cases cut patients off. These guidelines led to rigid rules in some cases. Giroir says it's concerning that some clinicians, policymakers, and health systems are "interpreting guidelines as mandates." © 2019 npr

Keyword: Pain & Touch; Drug Abuse
Link ID: 26691 - Posted: 10.11.2019

Heidi Ledford An outbreak of deadly lung injuries in vapers in the United States — many of them adolescents — shows no signs of stopping. So far, 805 e-cigarettes users have fallen ill, 12 of whom have died. The illnesses are fuelling a push among lawmakers and regulators to rein in the sale of e-cigarettes, in particular those with flavours that could be contributing to a worrying surge in youth vaping. It’s illegal for vendors in the United States to sell e-cigarettes to those younger than 18; in some states and cities, the age limit is 21. Yet more than a third of the sick vapers are younger than 21, according to the US Centers for Disease Control and Prevention (CDC). Public-health officials have yet to find a definitive cause for the lung injuries, according to the CDC. And they worry that some of the affected adolescents might never fully recover. But it’s unclear what impact, if any, the new restrictions on e-cigarette sales will have on the health crisis or the problem of youth vaping. In response to the recent spate of lung injuries, the US Food and Drug Administration (FDA) — which regulates tobacco products including e-cigarettes — announced on 11 September that it plans to remove flavoured devices from the market, at least temporarily. The decision came as the agency was already seeking to regulate e-cigarettes after years of lax enforcement. Under FDA regulations, e-cigarette manufacturers must apply for agency approval to market their products. So far, none of the companies has submitted an application, but the FDA has nevertheless allowed their devices to stay on the market. The agency has given manufacturers until May 2020 to submit applications to continue selling their products.

Keyword: Drug Abuse
Link ID: 26666 - Posted: 10.03.2019

Catherine Offord When Lilian Calderón-Garcidueñas discovered abundant hallmarks of Alzheimer’s disease in a batch of human brain samples a few years ago, she initially wasn’t sure what to make of it. The University of Montana neuropathologist had been studying the brains as part of her research on environmental effects on neural development, and this particular set of samples came from autopsy examinations carried out on people who had died suddenly in Mexico City, where she used to work as a researcher and physician. Although Calderón-Garcidueñas had collected much of the tissue herself while attending the autopsies in Mexico, the light-microscope slides she was analyzing had been prepared by her colleagues, so she was in the dark about what patient each sample came from. By the end of the project, she’d identified accumulations of the Alzheimer’s disease–associated proteins amyloid-ß and hyperphosphorylated tau in almost all of the 203 brains she studied. “When I started opening envelopes to see who [each sample] belonged to . . . I was devastated,” she says. The people whose brains she’d been studying were not only adults, but teens and even children. The youngest was 11 months old. “My first thought was, ‘What am I going to do with this? What am I going to tell people?’” she says. “I was not expecting such a devastating, extreme pathology.” Despite her shock, Calderón-Garcidueñas had a reason to be on the lookout for signs of a disease usually associated with the elderly in these samples. For the last three decades, she’d been studying the health effects of Mexico City’s notoriously polluted air—a blight that earned the capital the dubious distinction of most polluted megacity on the planet from the United Nations in 1992. During that time, she’s discovered many links between exposure to air pollution and signs of neural damage in animals and humans. Although her findings are observational, and the pathology of proteins such as amyloid-ß is not fully understood, Calderón-Garcidueñas argues that air pollution is the most likely culprit behind the development of the abnormalities she saw in her postmortem samples—plus many other detrimental changes to the brains of Mexico City’s residents. © 1986–2019 The Scientist

Keyword: Neurotoxins; Alzheimers
Link ID: 26665 - Posted: 10.02.2019

Alex Smith When children are diagnosed with attention deficit hyperactivity disorder, stimulant medications like Ritalin or Adderall are usually the first line of treatment. The American Academy of Pediatrics issued new guidelines on Monday that uphold the central role of medication, accompanied by behavioral therapy, in ADHD treatment. However, some parents, doctors and researchers who study kids with ADHD say they are disappointed that the new guidelines don't recommend behavioral treatment first for more children, as some recent research has suggested might lead to better outcomes. When 6-year-old Brody Knapp of Kansas City, Mo., was diagnosed with ADHD last year, his father, Brett, was skeptical. Brett didn't want his son taking pills. "You hear of losing your child's personality, and they become a shell of themselves, and they're not that sparkling little kid that you love," Brett says. "I didn't want to lose that with Brody, because he's an amazing kid." Brody's mother, Ashley, had other ideas. She's a school principal and has ADHD herself. "I was all for stimulants at the very, very beginning," Ashley says, "just because I know what they can do to help a neurological issue such as ADHD." More and more families have been facing the same dilemma. The prevalence of diagnosed ADHD has shot up in the U.S. in the past two decades; 1 in 10 children now has that diagnosis. The updated guidelines from the AAP recommend that children with ADHD should also be screened for other conditions, and monitored closely. But the treatment recommendations regarding medication are essentially unchanged from the previous guidelines, which were published in 2011. © 2019 npr

Keyword: ADHD; Drug Abuse
Link ID: 26657 - Posted: 10.01.2019

Alex Smith Lori Pinkley, a 50-year-old from Kansas City, Mo., has struggled with puzzling chronic pain since she was 15. She's had endless disappointing visits with doctors. Some said they couldn't help her. Others diagnosed her with everything from fibromyalgia to lipedema to the rare Ehlers-Danlos syndrome. Pinkley has taken opioids a few times after surgeries but says they never helped her underlying pain. "I hate opioids with a passion," Pinkley says. "An absolute passion." Recently, she joined a growing group of patients using an outside-the-box remedy: naltrexone. It is usually used to treat addiction, in a pill form for alcohol and as a pill or a monthly shot for opioids. As the medical establishment tries to do a huge U-turn after two disastrous decades of pushing long-term opioid use for chronic pain, scientists have been struggling to develop safe, effective alternatives. When naltrexone is used to treat addiction in pill form, it's prescribed at 50 mg, but chronic-pain patients say it helps their pain at doses of less than a tenth of that. Low-dose naltrexone has lurked for years on the fringes of medicine, but its zealous advocates worry that it may be stuck there. Naltrexone, which can be produced generically, is not even manufactured at the low doses that seem to be best for pain patients. Instead, patients go to compounding pharmacies or resort to DIY methods — YouTube videos and online support groups show people how to turn 50 mg pills into a low liquid dose. Some doctors prescribe it off-label even though it's not FDA-approved for pain. © 2019 npr

Keyword: Pain & Touch; Drug Abuse
Link ID: 26641 - Posted: 09.24.2019

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