Overdoses on the rise

imagesBetween 2000 and 2010 the number of people that died from drug overdoses more than doubled from 17,000 to 38,000, according to the most recent figures from the Centers for Disease Control and Prevention.

In 2009, for the first time in US history, more people died from drugs overdoses than from traffic accidents or firearms, although that is partly because the numbers of gun deaths and road deaths are both decreasing, the BBC reports. So what is causing this epidemic?

“The data suggests the number of people overdosing from pharmaceutical – or prescription – drugs has trebled over that decade, just as the quantity of prescription painkillers sold to pharmacies, hospitals, and doctors’ offices has quadrupled over the same period.As a result in 2010, prescription drugs killed more than 22,100 people in the US, more than twice as many as cocaine and heroin combined.

“Explaining the rise, Dr Len Paulozzi of the CDC says: “The use of opioid pain relievers has been increasing since the early 1990s and that increase has been driven by a change in the attitude of health care providers about the effectiveness of those kind of painkillers. Continue reading “Overdoses on the rise”

Anti-depressants and diabetes

The link may be indirect, but there is yet another health risk associated with being depressed.images

The University of Southampton team looked at available medical studies and found evidence the two were linked., reports the BBC today. But there was no proof that one necessarily caused the other.

“It may be that people taking anti-depressants put on weight which, in turn, increases their diabetes risk, the team told Diabetes Care journal. Or the drugs themselves may interfere with blood sugar control. Their analysis of 22 studies involving thousands of patients on anti-depressants could not single out any class of drug or type of person as high risk. Prof Richard Holt and colleagues say more research is needed to investigate what factors lie behind the findings.

“And they say doctors should keep a closer check for early warning signs of diabetes in patients who have been prescribed these drugs. With 46 million anti-depressant prescriptions a year in the UK, this potential increased risk is worrying, they say. Prof Holt said: “Some of this may be coincidence but there’s a signal that people who are being treated with anti-depressants then have an increased risk of going on to develop diabetes. “We need to think about screening and look at means to reduce that risk.” Diabetes is easy to diagnose with a blood test, and Prof Holt says this ought to be part of a doctor’s consultation.

“Diabetes is potentially preventable by changing your diet and being more physically active.  Continue reading “Anti-depressants and diabetes”

Stunning findings about addiction treatment

Intensive drug and alcohol treatment may be no more effective than a single appointment, according to a new study reported today in Journal of the American Medical Association.

WebMD reports that “Results of the year-long study are likely to disappoint those who believe treating addiction more like a chronic disease — with a systematic approach and follow-up — is the better way to go.

“We were completely surprised by the result,” said lead researcher Dr. Richard Saitz, a Boston University professor of medicine and epidemiology. “We put everything into this, and we were surprised that even doing that didn’t lead to differences compared to not doing any of it.”

“In the study of nearly 600 adult substance abusers, those receiving chronic care management got intensive medical care at a primary-care clinic plus relapse-prevention counseling and addiction and psychiatric treatment. Others in the study had one medical visit at which they received a list of addiction-treatment resources.

“After 12 months, 44 percent of those in the chronic care management group had stopped drinking or using drugs, as did 42 percent of those not receiving intensive care, the researchers said. Despite these similar findings, Saitz said he still believes chronic care management can be useful for some addictions. However, “we don’t want people to assume that it’s going to be effective when applied everywhere for every person,” he said. More work is needed to determine the best way to use chronic care management and to identify those who will benefit most from the approach, he said.

“We have to recognize that people with drug or alcohol addictions may be different and it’s not one monolithic disorder,” Saitz said. “I do think that integrated chronic care management, in the future, is going to be efficacious for people with addictions.”The report was published in the Sept. 18 issue of the Journal of the American Medical Association. Advocates of chronic care management point out that many substance abusers suffer serious health consequences but receive poor care. By addressing medical, emotional and dependence issues in a coordinated manner, patients would achieve better results, the thinking goes. One expert thinks motivation is the key to any program to treat addiction. People who are motivated are most likely to start and stick with a program or join a clinical trial, said Dr. James Garbutt, a professor of psychiatry at the University of North Carolina at Chapel Hill. “That’s an important point because that’s saying they already wanted to make some changes,” Garbutt said. “That’s a huge step in substance-abuse treatment.” Continue reading “Stunning findings about addiction treatment”

Dopamine and addiction

In a brain that people love to describe as “awash with chemicals,” one chemical always seems to stand out, writes Bethany Brookshire in Slate.com:images-1

“Dopamine: the molecule behind all our most sinful behaviors and secret cravings.Dopamine is love. Dopamine is lust. Dopamine is adultery. Dopamine is motivation. Dopamine is attention. Dopamine is feminism. Dopamine is addiction.

“Dopamine is the one neurotransmitter that everyone seems to know about. Vaughn Bell once called it the Kim Kardashian of molecules, but I don’t think that’s fair to dopamine. Suffice it to say, dopamine’s big. And every week or so, you’ll see a new article come out all about dopamine.

“So is dopamine your cupcake addiction? Your gambling? Your alcoholism? Your sex life? The reality is dopamine has something to do with all of these. But it isnone of them. Dopamine is a chemical in your body. That’s all. But that doesn’t make it simple.

“What is dopamine? Dopamine is one of the chemical signals that pass information from one neuron to the next in the tiny spaces between them. When it is released from the first neuron, it floats into the space (the synapse) between the two neurons, and it bumps against receptors for it on the other side that then send a signal down the receiving neuron. That sounds very simple, but when you scale it up from a single pair of neurons to the vast networks in your brain, it quickly becomes complex. The effects of dopamine release depend on where it’s coming from, where the receiving neurons are going and what type of neurons they are, what receptors are binding the dopamine (there are five known types), and what role both the releasing and receiving neurons are playing.

“And dopamine is busy! It’s involved in many different important pathways. But when most people talk about dopamine, particularly when they talk about motivation, addiction, attention, or lust, they are talking about the dopamine pathway known as the mesolimbic pathway, which starts with cells in the ventral tegmental area, buried deep in the middle of the brain, which send their projections out to places like the nucleus accumbens and the cortex. Increases in dopamine release in the nucleus accumbens occur in response to sex, drugs, androck and roll. And dopamine signaling in this area is changed during the course of drug addiction.  All abused drugs, from alcohol to cocaine to heroin, increase dopamine in this area in one way or another, and many people like to describe a spike in dopamine as “motivation” or “pleasure.” But that’s not quite it. Really, dopamine is signaling feedback for predicted rewards. If you, say, have learned to associate a cue (like a crack pipe) with a hit of crack, you will start getting increases in dopamine in the nucleus accumbens in response to the sight of the pipe, as your brain predicts the reward. But if you then don’t get your hit, well, then dopamine can decrease, and that’s not a good feeling. So you’d think that maybe dopamine predicts reward. But again, it gets more complex. For example, dopamine can increase in the nucleus accumbens in people with post-traumatic stress disorder when they are experiencing heightened vigilance and paranoia. So you might say, in this brain area at least, dopamine isn’t addiction or reward or fear. Instead, it’s what we call salience. Salience is more than attention: It’s a sign of something that needs to be paid attention to, something that stands out. This may be part of the mesolimbic role in attention deficit hyperactivity disorder and also a part of its role in addiction.”

More at: http://www.slate.com/articles/health_and_science/science/2013/07/what_is_dopamine_love_lust_sex_addiction_gambling_motivation_reward.html

Obama budget: Jail before drug treatment

The Obama administration budget released Wednesday emphasizes drug abuse punishment and interdiction over treatment and prevention, despite recent rhetoric from the Office of National Drug Control Policy on a “21st century” approach, reports Huffington Post

“The White House budget proposal for fiscal 2014 devotes 58 percent of drug-control spending to punishment and interdiction, compared with 42 percent to treatment and prevention. The drug control spending ratio in this year’s budget is even more lopsided, 62 percent to 38 percent.

“The administration deserves some credit for moving this ratio slightly in the right direction over the years, but a drug control budget that increases funding for the DEA and the Bureau of Prisons is simply not the kind of strategy we need in the 21st century,” said Marijuana Majority spokesman Tom Angell. “At a time when a majority of Americans support legalizing marijuana, and states are moving to end prohibition, this president should be spending less of our money paying narcs to send people to prison, not more. If, as administration officials say, ‘We can’t arrest our way out of the drug problem,’ then why are they continuing to devote so many resources to arresting people for drug problems?” Continue reading “Obama budget: Jail before drug treatment”

The House I live In – The “War on Drugs”

Over the past 40 years, the War on Drugs has cost more than $1 trillion and accounted
for over 45 million arrests.

The U.S. holds 25% of the world’s prisoners, yet accounts for
only 5% of the world’s population.imgres

Black individuals comprise 13% of the U.S. population and 14% of drug users, yet they are 37%
of the people arrested for drug offenses and 56% of those incarcerated for drug crimes.

As America remains embroiled in conflict overseas, a less visible war is taking place at
home, costing countless lives, destroying families, and inflicting untold damage upon
future generations of Americans. In forty years, the War on Drugs has accounted for
more than 45 million arrests, made America the world’s largest jailer, and damaged poor
communities at home and abroad. Yet for all that, drugs are cheaper, purer, and more
available today than ever before. Continue reading “The House I live In – The “War on Drugs””

Treatment rather than jail for addiction

It’s widely acknowledged that when it come to drug addiction, treatment is more efficient and effective than jail or other punitive measures. Rather than punishing a human being who is already suffering, society should move to more therapeutic and restorative strategies.imgres

Federal judges around the country are teaming up with prosecutors to create special treatment programs for drug-addicted defendants who would otherwise face significant prison time, an effort intended to sidestep drug laws widely seen as inflexible and overly punitive, reports today’s New York Times. Continue reading “Treatment rather than jail for addiction”

Temper tantrums mean the child is crazy

Anyone paying attention knows that the forthcoming DSM-5 guide book for psychiatrists been getting plenty of advance criticism.

Because this medical volume influences very non-medical factors like insurance coverage and definitions of mental “health,” exactly who gets classified and in what manner can have huge material and social consequences.  The new DSM will redraw the lines on conditions ranging from autism to transgender identity. As Slate reports today, yet another diagnosis is drawing fire:

“Nothing burns the critics worse than “Disruptive Mood Dysregulation Disorder,” a new diagnosis for kids 6 to 18 years old who three or more times a week have “temper outbursts that are grossly out or proportion in intensity or duration to the situation.” It actually started out as “temper dysregulation disorder with dysphoria” (tantrums, plus you feel bad) but got changed so as not to openly malign tantrums. But the diagnosis still focuses on them, and critics say it is Continue reading “Temper tantrums mean the child is crazy”