Chapter 4. The Chemistry of Behavior: Neurotransmitters and Neuropharmacology

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Regina Denney's 17-year-old son Brian called her in a panic; he couldn't stop throwing up. It was April 7, 2018 and the Indianapolis teen asked her to take him to the emergency room — but doctors there couldn't figure out what was wrong. He was severely dehydrated and constantly vomiting. "As we're sitting there talking, another doctor happens to walk by our room and she pokes her head in and she says, 'Do you smoke marijuana?'" Denney said. "And he said yes. And she said, 'Does it get better with hot showers or hot baths?' And he said yes." Brian Smith Jr. was diagnosed with a rare condition called cannabinoid hyperemesis syndrome (CHS). When his lab results came back, his mother said the teen's kidneys were shutting down and his liver wasn't functioning properly. "It was just crazy," Denney said. "They were able to rehydrate him. And [the results] improved. So they released him the next day, but didn't give us any information about what CHS was, what causes it, what to look for." He was a heavy cannabis smoker and his mother convinced him to stop, at least until they could see a gastroenterologist 45 days later. Denney said he still had symptoms leading up to that appointment and thought if they were related to his cannabis use, he would have been symptom free. So he started smoking again. What they didn't know was CHS can present symptoms weeks or months after stopping cannabis use. By October, Denney said her son had lost more than 40 pounds. "You could see his bones. He looked sick," she said. "It's torture." ©2019 CBC/Radio-Canada

Keyword: Drug Abuse
Link ID: 26824 - Posted: 11.16.2019

By Denise Grady A form of vitamin E has been identified as a “very strong culprit” in lung injuries related to vaping THC, health officials reported on Friday, a major advance in a frightening outbreak that has killed 40 people and sickened 2,051. Many patients with the mysterious illness have wound up hospitalized in intensive care units, needing ventilators or even more desperate measures to help them breathe. Most are young, male adults or even teenagers. “For the first time, we have detected a potential toxin of concern, vitamin E acetate, from biological samples from patients,” with lung damage linked to vaping, Dr. Anne Schuchat, principal deputy director of the Centers for Disease Control and Prevention, said at a news briefing. The new report, based on samples taken from the lungs of 29 patients, including two who died, she said, “provided evidence of vitamin E acetate at the primary site of injury in the lungs.” She added, “These findings tell us what entered the lungs of some patients with these injuries.” The patients came from 10 states scattered around the country, so the findings are considered broadly applicable and unlikely to have resulted from a single vaping product or supplier. The results mesh with other research that found the vitamin compound in vaping products. But Dr. Schuchat left open the possibility that other chemicals or toxins from vaping fluids or devices could also be causing the severe respiratory ailments. The outbreak has revealed the existence of a vast, unregulated, shadowy marketplace of illicit or bootleg vaping products that are essentially a stew of unknown chemicals concocted, packed and sold by unknown manufacturers and sellers. © 2019 The New York Times Company

Keyword: Drug Abuse; Neurotoxins
Link ID: 26808 - Posted: 11.09.2019

New preclinical research reported in animal models shows that exposure to compounds found in marijuana called cannabinoids (CBs), which includes cannabidiol (CBD) and tetrahydrocannabinol (THC), during early pregnancy can cause malformations in the developing embryo. The research also demonstrated that co-exposure to CBs and alcohol increased the likelihood of birth defects involving the face and brain. The study, funded by the National Institute on Alcohol Abuse and Alcoholism (NIAAA), part of the National Institutes of Health, was published in Scientific Reports. “Prenatal alcohol exposure is a leading preventable cause of birth defects and neurodevelopmental abnormalities in the United States,” said NIAAA Director, George F. Koob, Ph.D. “Since marijuana and alcohol are frequently used simultaneously, the combined effects of cannabinoids and alcohol are worrisome as well as the dangers of either substance alone.” The detrimental effects of prenatal alcohol exposure on human development are well known and include an array of lifelong physical, cognitive, and behavioral problems collectively called fetal alcohol spectrum disorders (FASD). Alcohol can disrupt fetal development at any stage during pregnancy, even the earliest stages before a woman knows she is pregnant. The effects of marijuana exposure during pregnancy and the combined effect of alcohol and marijuana are less known. In the study, scientists led by Scott Parnell, Ph.D., at the Bowles Center for Alcohol Studies at the University of North Carolina in Chapel Hill, administered a variety of CBs alone and in combination with alcohol in varying amounts to mice on day eight of pregnancy, which is similar to the third and fourth weeks of pregnancy in humans. The CBD amounts administered were within what is considered a therapeutic range for several medical conditions in humans. The THC concentration administered was similar to levels reached by a person smoking marijuana.

Keyword: Development of the Brain; Drug Abuse
Link ID: 26806 - Posted: 11.09.2019

Sean McMinn Three years ago, only about one in ten high school students reported having recently used e-cigarettes. But a study published this week in JAMA shows the proportion of students vaping nicotine has now grown to more than one in four. Researchers from the Food and Drug Administration and Centers for Disease Control and Prevention analyzed data from the 2019 National Youth Tobacco Survey, which is conducted annually. They drilled down on e-cigarette use among high school and middle school students based on data from 19,000 students in the eighth, tenth and twelfth grades. Teen nicotine vaping has become so prevalent in recent years that the Food and Drug Administration has called it an "epidemic." An estimated 5.3 million teens use e-cigarettes, according to the study. It is illegal in all states for people under 18 to purchase e-cigarettes, and some states have raised that age to 21. Despite this and recent efforts to crack down on retailers selling to youth, rates of teen vaping have continued to rise. "For young people, this is of particular concern," the study's authors wrote, "because it could promote ... nicotine dependence, making it easier to initiate and proceed to regular e-cigarette use or transition to cigarette or other combustible tobacco product use." Students who took the survey, however, didn't appear to have moved on to traditional cigarettes yet. Just 6% of high schoolers reported having smoked a cigarette in the last month — a decrease from last year's survey. © 2019 npr

Keyword: Drug Abuse
Link ID: 26801 - Posted: 11.08.2019

Lenny Bernstein A surgeon has implanted electrodes in the brain of a patient suffering from severe opioid use disorder, hoping to cure the man’s in­trac­table craving for drugs in the first such procedure performed in the United States. The device, known as a deep brain stimulator, is designed to alter the function of circuits in the man’s brain. It has been used with varying degrees of success in the treatment of Parkinson’s disease, dystonia, epilepsy, obsessive-compulsive disorder and even depression. It is seen as a last-resort therapy after the failure of standard care, such as medication that reduces the craving for drugs. The deep brain stimulator, which functions much like a heart pacemaker, was implanted by Ali Rezai, executive chairman of the West Virginia University Rockefeller Neuroscience Institute. His patient, 33-year-old hotel worker Gerod Buckhalter, said he had been unable to remain sober for more than four months since the age of 15, despite trying a variety of medications and other inpatient and outpatient treatments. Buckhalter is the first of four people in a pilot program, which aims to demonstrate that the technique is safe so that a full-scale clinical trial can be conducted. It is aimed at a small percentage of opioid abusers with the most treatment-resistant cravings for opioids, who may face a lifetime of overdoses, relapses, inability to hold a job and other consequences of addiction.

Keyword: Drug Abuse
Link ID: 26798 - Posted: 11.07.2019

Darian Woods Recently, Purdue Pharma filed for bankruptcy as part of a tentative multi-billion dollar settlement with state and local governments over lawsuits alleging that the company misled doctors and the public about the addictive nature of their well-known painkiller, Oxycontin. But Purdue Pharma's story is part of a pattern that has repeated itself throughout the history of the opium trade. It's a pattern documented by the book Opium: How An Ancient Flower Shaped And Poisoned Our World by Dr. John H. Halpern and David Blistein. The cycle begins when an opium product proves devastating to users. Innovators come along, promising a safer alternative, and virtually every time, they downplay the risks of addiction. Addiction ensues. Then come new innovators, promising something better and less addictive, and the cycle continues. This cycle, Halpern and Blistein recount, goes all the way back to Ancient Greece. Aulus Cornelius Celsus was a doctor famous for writing one of the world's first medical encyclopedias, which included a recipe for opium pills. He recommended it for insomnia, bad headaches, and joint pain. It didn't turn out so well. Opium addiction spread, and its victims included Roman emperor Marcus Aurelius. Around 1000 AD, Persian physician Avicenna developed standard opium doses the size of chickpeas. Dose standardization helped prevent overdoses but opium addiction rose in Persia over the following centuries. Avicenna himself died of an opium overdose. © 2019 npr

Keyword: Drug Abuse; Pain & Touch
Link ID: 26791 - Posted: 11.05.2019

Kas Roussy · CBC News · At the Toronto Rehabilitation Institute, Dr. Andrea Furlan, a pain specialist, is holding a regular meeting with some of her colleagues. Sitting around the table are physiotherapists, pharmacists, doctors and nurses. Other health-care professionals have joined in via teleconferencing. The discussion focuses on chronic pain and the role opioids have in treating the condition at a time when current prescribing guidelines in Canada advises doctors to put the prescription pad down. On a monitor, someone asks Furlan how she should start tapering her patient who is prescribed opioids. "Each patient is different," Furlan said. "I don't have a recipe for everyone. The patients are afraid of the pain getting worse. They are afraid of the withdrawal symptoms. You need to provide a lot of education." She also suggests exercise and physiotherapy — even diet and sleep can have an impact on chronic pain. One in five Canadians suffers from chronic pain (i.e., pain that is ongoing and lasts longer than six months like low back pain, nerve damage or arthritis). For these pain sufferers, opioids are a lifesaver. But access to the pain medication is getting harder because of doctors' concerns about addiction and abuse. More than 12,800 apparent opioid-related deaths occurred from January 2016 to March 2019, according to the Public Health Agency of Canada, the vast majority from illicit fentanyl use. "I have had patients referred to us because their doctors cut them from opioids," said Furlan. "That's ridiculous because they were not addicted. They were not having any complications. They were not on a high dose." ©2019 CBC/Radio-Canada

Keyword: Pain & Touch; Drug Abuse
Link ID: 26786 - Posted: 11.04.2019

This is an excerpt from Second Opinion, a weekly roundup of eclectic and under-the-radar health and medical science news emailed to subscribers every Saturday morning. If you haven't subscribed yet, you can do that by clicking here. A review of 40 years' worth of studies suggests cannabis may not be effective in treating mental health disorders, but experts say that might have more to do with the lack of high-quality research than the drug itself. The review, published in Lancet Psychiatry this week, looked at 83 studies dating back to 1980 on cannabis and constituent cannabinoids as a treatment for depression, anxiety, attention-deficit hyperactivity disorder, Tourette syndrome, post-traumatic stress disorder and psychosis. The study concluded there was "scarce evidence" to suggest cannabis, including active ingredients such as cannabinoids tetrahydrocannabinol (THC) and cannabidiol (CBD), improves the symptoms of any of these conditions based on 3,513 participants. There was also "very low-quality evidence" that it leads to a "small improvement" in anxiety symptoms for individuals, but only in those with other medical conditions like chronic pain and multiple sclerosis. "There remains insufficient evidence to provide guidance on the use of cannabinoids for treating mental disorders," Prof. Michael Farrell, co-author of the report and director of the National Drug and Alcohol Research Centre in New South Wales, Australia, said in an email. 'Risk of error' in research While experts say the review itself is credible, the decades-old research could be flawed due to a number of challenges — including the fact that cannabis is still illegal in much of the world, which has made securing funding for research challenging. "The research in these conditions, in general, have been hampered by, obviously, the illegality of these compounds and these products," said Dr. Peter Selby, chief of medicine in the psychiatry division of the Centre for Addiction and Mental Health in Toronto. ©2019 CBC/Radio-Canada

Keyword: Drug Abuse; Stress
Link ID: 26783 - Posted: 11.02.2019

By Derek Lowe So Amgen has exited the neuroscience area, with a good-sized round of layoffs at their research site Cambridge. The company has a migraine drug (Aimovig) that they’ll continue to support, and they’ll stick with their existing clinical programs, but it looks like all the early-stage stuff is gone. What does this mean? Not as much as you might think. Neuroscience is indeed hard, and Amgen’s not the only company to rethink its commitment to it (Eli Lilly did something similar last month with their neuro efforts in the UK). But there are still plenty of participants, large and small – it’s not that the field is being totally abandoned by pharma. It’s just being abandoned by Amgen, because they have other areas that look a lot more promising for them. And let’s face it, Amgen is a bit of an oddity, anyway – it’s not for nothing that they get referred to as a law firm with fume hoods. Enbrel is what pays a lot of the bills over there, and Enbrel is (and has long been) a patent-court story, not a research one. Inflammation, cardiovascular disease, and oncology are going to be the focus there, and given the company’s portfolio, that makes a lot of sense. It looks like the only neuro programs going on will be the ones that intersect with the larger inflammation area. One interesting thing that came out of the company’s statements was that management felt that a lot of the neuroscience landscape is focused on what their CFO David Meline called “orphan or niche diseases”, and that the company wants to work on things that will have a broader impact. Now, it’s not like there isn’t a neuroscience disease with a huge health impact, and it’s one that even has some inflammation and cardiovascular connections. So one of the things that Amgen is saying is “No Alzheimer’s research for us, thanks”. © 2017 American Association for the Advancement of Science

Keyword: Alzheimers
Link ID: 26777 - Posted: 11.01.2019

Sarah Boseley Health editor The use of cannabis medicines to treat people with depression, anxiety, psychosis or other mental health issues cannot be justified because there is little evidence that they work or are safe, according to a major new study. A review of evidence from trials conducted over nearly 40 years, published in the journal Lancet Psychiatry, concludes that the risks outweigh the benefits. And yet, say the authors, they are being given to people with mental health problems in Australia, the US and Canada, and demand is likely to grow. Prof Louisa Degenhardt of the National Drug and Alcohol Research Centre at UNSW Sydney, Australia, lead author of the study, said the findings had important implications in countries where medical use was allowed. “There is a notable absence of high-quality evidence to properly assess the effectiveness and safety of medicinal cannabinoids compared with placebo, and until evidence from randomised controlled trials is available, clinical guidelines cannot be drawn up around their use in mental health disorders,” she said. “In countries where medicinal cannabinoids are already legal, doctors and patients must be aware of the limitations of existing evidence and the risks of cannabinoids. These must be weighed when considering use to treat symptoms of common mental health disorders. Those who decide to proceed should be carefully monitored for positive and negative mental health effects of using medicinal cannabinoids.” © 2019 Guardian News & Media Limited

Keyword: Drug Abuse; Schizophrenia
Link ID: 26769 - Posted: 10.30.2019

Marisa Iati Police and doctors didn’t believe the 46-year-old man when he swore that he hadn’t had alcohol before he was arrested on suspicion of drunken driving. His blood alcohol level was 0.2, more than twice the legal limit for operating a car. He refused a breathalyzer test, was hospitalized and later released. But the facts remained in contention. Then researchers discovered the unusual truth: Fungi in the man’s digestive system were turning carbohydrates into alcohol — a rarely diagnosed condition known as “auto-brewery syndrome.” In people with the syndrome, fermenting fungi or bacteria in the gut produce ethanol and can cause the patients to show signs of drunkenness. The condition, also known as gut fermentation syndrome, can occur in otherwise healthy people but is more common in patients with diabetes, obesity or Crohn’s disease. “A person is intoxicated from this fermenting yeast, and it’s a horrible illness,” said Barbara Cordell, a researcher of auto-brewery syndrome and the author of “My Gut Makes Alcohol.” The condition has rarely been studied and is diagnosed infrequently. Researchers at Richmond University Medical Center in New York, however, wrote in the journal BMJ Open Gastroenterology that they believe the syndrome is underdiagnosed. The condition made news in 2014, when the driver of a truck that spilled 11,000 salmon onto a highway claimed to have auto-brewery syndrome. The next year, a New York woman was charged with driving under the influence after she registered a blood alcohol level that was more than four times the legal limit, CNN reported. A judge dismissed the charges after being shown evidence that she had auto-brewery syndrome.

Keyword: Drug Abuse
Link ID: 26757 - Posted: 10.26.2019

Lena H. Sun Most people who died from vaping-related injuries used products containing THC, the psychoactive ingredient in marijuana, federal health officials said Friday, offering another data point tying the outbreak of lung illnesses to products made with that compound. Based on data available from 860 of the 1,604 patients who have fallen ill with the disease, about 85 percent reported using THC-containing products, compared to about 10 percent who reported exclusively vaping nicotine-containing products, officials said. Many sick patients said they bought THC vape products on the black market, and those have come under increased scrutiny. “The data do continue to point towards THC-containing products as the source of individuals’ injury,” said Anne Schuchat, principal deputy director at the Centers for Disease Control and Prevention, which is leading the investigation. Officials don’t know what about the products are harmful, “but we’re seeing THC as a marker for products that are risky,” she said. It is also becoming clearer that the surge in cases in recent months is not the result of better recognition of an existing disease, but “something riskier that is in much more frequent use,” she said. Schuchat cited the use of cutting agents that are added to THC-containing products to increase profit, and the increased availability of online videos that may have “skyrocketed” do-it-yourself instructions. One substance that has turned up in many product samples is vitamin E oil, known as vitamin E acetate. Experts in the legal marijuana industry have said it has been added to THC oil used to fill vape cartridges.

Keyword: Drug Abuse
Link ID: 26755 - Posted: 10.26.2019

By Perri Klass, M.D. It’s a pretty safe bet that most of our children, in high school and in college, will be in social situations in which people drink in unwise and sometimes downright dangerous ways. Even if they don’t drink, they will at least be exposed to friends and classmates and roommates who do. What makes alcohol more problematic for some kids — and some adults? There’s been a good deal of research on the development of what is now called alcohol use disorder, and its precursors — what do we now understand, and can that understanding help us as parents to worry less, or at least, to direct our worries in the right directions? Frances Wang, a postdoctoral scholar at the University of Pittsburgh who studies genetic and environmental causes of alcohol use disorders, said that often people blame only the home environment — that is to say, the parenting. But there are genetic risk factors that seem to be common across a number of disorders, she said, including alcohol use disorder, but also depression and conduct problems, like aggression and antisocial behavior, which can be predecessors of alcohol problems. Dr. Wang was the first author on a study published in 2018 in the journal Development and Psychopathology, which looks at a particular biological attribute — the functioning of serotonin, a neurotransmitter — determined by a combination of genetic factors. Investigating these common genetic risk factors might help us understand the connections. But bear in mind that there are no simple cause-and-effect stories here. And while there may be times when the home environment really is the driving force, Dr. Wang said, “for most people it’s the interaction between already having that genetic risk and an environment that increases genetic risk or makes genetic risk come out.” © 2019 The New York Times Company

Keyword: Drug Abuse
Link ID: 26724 - Posted: 10.21.2019

Nicoletta Lanese Cell transplantation therapy offers a promising route to recovery after stroke, but the grafted cells face a harsh environment, with elevated levels of free radicals and proinflammatory cytokines, compromised blood supply, and degraded neural connectivity, says Shan Ping Yu, a neurology researcher at Emory University School of Medicine. He and his colleagues aimed to build a new tool to help stem cells integrate with host neural circuitry after implantation. Scientists have long known that stimulating transplanted neural stem cells encourages them to differentiate into neurons and connect with nearby host cells. Many researchers turn to optogenetics to excite grafted stem cells, but because light travels poorly through dense tissue, the technique requires researchers to stick a laser into their subjects’ brains. So Yu and his coauthors turned instead to a type of enzyme that grants fireflies and jellyfish their glow: luciferase. “These proteins carry their own light, so they do not need a light source,” says Yu. The researchers injected neural progenitor cells that had been derived from induced pluripotent stem cells (iPSCs) into the brains of mouse models of stroke. The cells were genetically engineered to express a fusion protein called luminopsin 3 (LMO3), crafted from the bioluminescent enzyme Gaussia luciferase and the light-sensitive protein VChR1. LMO3 activates in response to either physical light or a molecule called CTZ, which can be delivered noninvasively through the nose into the brain tissue. The fusion protein can be hooked up to either excitatory or inhibitory channels in the neurons to either stimulate or tamp down the cells’ function. Yu and his colleagues dubbed the new technique “optochemogenetics.” © 1986–2019 The Scientist.

Keyword: Stroke
Link ID: 26712 - Posted: 10.17.2019

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