Chapter 4. The Chemistry of Behavior: Neurotransmitters and Neuropharmacology

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By David Ovalle Keifer Geers was born with a hole in his diaphragm that led to painful surgeries in adulthood. Despite physical challenges that included deafness, Geers graduated from Texas A&M University with a degree in biomedical engineering. He hoped to one day create medical devices for disabled children and wounded veterans. On a spring day as Geers walked with his mother through an airport in Midland, Tex., he stumbled, then collapsed into a seizure, his face contorted in shock. Geers, 33, was pronounced dead at a hospital. His mother later found inside his suitcase several packages of powder kratom, an herbal product he consumed to manage pain from surgeries. Patricia Geers said she was stunned when an autopsy concluded that her son died from the toxic effects of kratom — levels in his blood were more than nine times what some experts believe can prove lethal. The death of Keifer Geers was hardly an isolated episode. A Washington Post review of federal and state statistics shows that medical examiners and coroners are increasingly blaming deaths on kratom — it was listed as contributing to or causing at least 4,100 deaths in 44 states and D.C. between 2020 and 2022. The vast majority of those cases involved other drugs in addition to kratom, which is made from the leaves of tropical trees. Still, the kratom-involved deaths account for a small fraction of the more than 300,000 U.S. overdose deaths recorded in those three years. Dozens of wrongful death lawsuits involving kratom have been filed nationwide — including by Geers’s mother, who in February sued a Nevada retailer. The suits illustrate increased scrutiny of deaths involving products made from kratom, which is banned in six states but remains widely available online and in vape and convenience stores despite health warnings from federal authorities.

Keyword: Drug Abuse
Link ID: 29155 - Posted: 02.22.2024

By Erin Garcia de Jesús DENVER — A weight-loss drug used to treat obesity and diabetes has shown promise to treat another disorder: opioid addiction. Early results from a small clinical trial, presented February 17 at the annual meeting of the American Association for the Advancement of Science, suggest that a close relative of the weight-loss drugs Wegovy and Ozempic significantly lessened cravings for opioids in people with opioid use disorder. “For them to have any time when they might be free of that craving seems to be very hopeful,” Patricia “Sue” Grigson, a behavioral neuroscientist at Penn State College of Medicine in Hershey said at the conference. The vast majority of drug overdose deaths in the United States are due to opioids (SN: 2/14/24). The drug, called liraglutide, mimics a hormone called GLP-1 that the body releases after people eat. Wegovy and Ozempic — brand names for semaglutide, a molecule that induces weight loss more effectively than liraglutide — also imitate the hormone. It’s unclear exactly how the drugs work when it comes to weight loss, but researchers think such GLP-1 dupes prompt the body and brain to make people feel full (SN: 12/13/23). There are hints that such drugs could work for addiction, too. People taking Wegovy or Ozempic have reported lessened desire for not just food but also alcohol and nicotine. What’s more, Grigson and colleagues showed in a previous study in rats that liraglutide can cut down on heroin-seeking behavior, perhaps by changing the animals’ brain activity (SN: 8/30/23). © Society for Science & the Public 2000–2024.

Keyword: Drug Abuse; Obesity
Link ID: 29150 - Posted: 02.20.2024

By Benjamin Breen When I began researching Tripping on Utopia in 2018, I was aware that many midcentury scientists and psychiatrists had shown a keen interest in the promise of psychedelics. But what I didn’t realize was how remarkably broad-based this interest was. As I dug deeper into the archival record, I was struck by the public enthusiasm for the use of substances like LSD and mescaline in therapy—as manifested not just in scientific studies, but in newspaper articles and even television specials. (My favorite is this remarkable 1957 broadcast which shows a woman taking LSD on camera, then uttering memorable lines like “I’ve never seen such infinite beauty in my life” and “I wish I could talk in Technicolor.”) Above all, I was surprised by the public response to the Hollywood actor Cary Grant’s reveal that he was regularly using LSD in psychedelic therapy sessions. In a series of interviews starting in 1959—the same year he starred in North by Northwest—Grant went public as an unlikely advocate for psychedelic therapy. It was the surprisingly positive reaction to Grant’s endorsement that most struck me. As recounted in my book, the journalist who broke the story was overwhelmed by phone calls and letters. “Psychiatrists called, complaining that their patients were now begging them for LSD,” he remembered. “Every actor in town under analysis wanted it.” Nor was this first wave of legal psychedelic therapy restricted to Hollywood. Two other very prominent advocates of psychedelic therapy in the late 1950s were former Congresswoman Clare Boothe Luce and her husband Henry Luce, the founder of Time and Life magazines. It is not an exaggeration to say that this married couple dominated the media landscape of the 20th century. Nor is it an exaggeration to say that psychedelics profoundly influenced Clare Boothe Luce’s life in the late 1950s. She credited LSD with transformative insights that helped her to overcome lasting trauma associated with her abusive childhood and the death of her only daughter in a car accident. © 2024 NautilusNext Inc.,

Keyword: Drug Abuse; Consciousness
Link ID: 29142 - Posted: 02.10.2024

Rhitu Chatterjee In recent years, there's been growing interest in psilocybin, the psychoactive ingredient in "magic mushrooms" or "shrooms" as a potentially beneficial therapy for mental health conditions. At the same time, drug busts of mushrooms went way up between 2017 and 2022, and the amount of the psychedelic substance seized by law enforcement more than tripled, according to a new study. "What I think the results indicate is that shroom availability has likely been increasing," says Joseph Palamar, an epidemiologist at NYU Langone Health and the main author of the new study published in the journal Drug and Alcohol Dependence. Sponsor Message The findings come at a time when there's a "psychedelic renaissance" happening in the country, says Dr. Joshua Siegel of Washington University in St. Louis, who wasn't involved in the new study. There's growing public and scientific interest in psychedelics' potential therapeutic effects on various mental and behavioral health issues, says Siegel, who also studies how psychedelics affect the human brain. At the same time, a small number of states have already decriminalized psychedelic drugs, and many more are looking into doing the same. The new study is "an important part of the bigger picture of where we are headed as a nation" with psychedelics, says Siegel. "It's important to understand what's happening in terms of the health care side of things. It's important to understand what's happening recreationally and legally." The new study found that the total amount of mushrooms seized by law enforcement across the country went from nearly 500 pounds in 2017 to more than 1,800 pounds in 2022. The largest amount (42.6% of total) seized was in the West, followed closely by the Midwest (41.8%). © 2024 npr

Keyword: Drug Abuse; Depression
Link ID: 29141 - Posted: 02.08.2024

By Ernesto Londoño Seizures of psychedelic mushrooms across the nation by law enforcement officials have increased significantly in recent years as attitudes regarding their use have grown more permissive, according to a government-funded study released Tuesday. Researchers found that law enforcement officials confiscated 844 kilos of mushrooms containing psilocybin in 2022, an increase of 273 percent from 2017. Psilocybin is the psychoactive component in the fungi commonly known as magic mushrooms. Officials at the National Institute on Drug Abuse, which commissioned the study, said that the increase in seizures of magic mushroom reflected rising use of the drugs, rather than an indication that counternarcotics officials were pursuing the substances more aggressively than before. The marketplace for magic mushrooms, which are illegal under federal law, has boomed in recent years as several clinical studies have shown that they may be effective as therapies to treat depression and other serious conditions. But many medical professionals say they worry that the hype surrounding psychedelics has moved faster than the science. Dr. Nora Volkow, the director of the N.I.D.A, said that preliminary clinical studies had shown that psychedelics might one day become an important tool for the treatment of psychiatric disorders, including addiction to other drugs. But she said she worried that many people were self-medicating with psychedelics. “Psychedelic drugs have been promoted as a potential cure for many health conditions without adequate research to support these claims,” Dr. Volkow said. “There are people who are very desperate for mental health care, and there are businesses that are very eager to make money by marketing substances as treatments or cures.” © 2024 The New York Times Company

Keyword: Drug Abuse; Depression
Link ID: 29130 - Posted: 02.06.2024

Dawn Megli In late 2022, Sarah Gutilla's treatment-resistant depression had grown so severe that she was actively contemplating suicide. Raised in foster care, the 34-year-old's childhood was marked by physical violence, sexual abuse and drug use, leaving her with life-threatening mental scars. Out of desperation, her husband scraped together $600 for the first of six rounds of intravenous ketamine therapy at Ketamine Clinics Los Angeles, which administers the generic anesthetic for off-label uses such as treating depression. When Gutilla got into an Uber for the 75-mile ride to Los Angeles, it was the first time she had left her home in Llano, Calif., in two years. The results, she says, were instant. "The amount of relief I felt after the first treatment was what I think 'normal' is supposed to feel like," she says. "I've never felt so OK and so at peace." For-profit ketamine clinics have proliferated over the past few years, offering infusions for a wide array of mental health issues, including obsessive-compulsive disorder, depression and anxiety. Although the off-label use of ketamine hydrochloride, a Schedule III drug approved by the Food and Drug Administration as an anesthetic in 1970, was considered radical just a decade ago, now between 500 and 750 ketamine clinics have cropped up across the United States. Market analysis firm Grand View Research pegged industry revenues at $3.1 billion in 2022, and it projects them to more than double to $6.9 billion by 2030. Most insurance doesn't cover ketamine for mental health, so patients must pay out-of-pocket. While it's legal for doctors to prescribe ketamine, the FDA hasn't approved it for mental health treatment, which means that individual practitioners develop their own treatment protocols. The result is wide variability among providers, with some favoring gradual, low-dosage treatments while others advocate larger amounts that can induce hallucinations, as the drug is a psychedelic at the right doses. "Ketamine is the Wild West," says Dustin Robinson, the managing principal of Iter Investments, a venture capital firm specializing in hallucinogenic drug treatments. © 2024 npr

Keyword: Depression; Drug Abuse
Link ID: 29129 - Posted: 02.03.2024

By Jyoti Madhusoodanan On July 12, 2015, Elena Daly was packing for a family vacation when she walked into her 16-year-old son’s room and found him unconscious. Her son, Max, had overdosed on opioids, aspirated vomit, and fallen into a coma. By that point, Max had struggled with addiction for about three years. He had tried medication, therapy, and residential treatment programs in France, where the family lives, as well as in the United States and the United Kingdom. In fact, his July relapse occurred just days after returning home from a six-month stint in an in-patient rehab program. The coma lasted three days and worsened a pre-existing movement disorder to a degree where Max was unable to attend high school. “I couldn’t hold a pen without throwing it across the room or hold a cup of coffee without spilling it on myself,” he recently recalled. Max’s struggles with opioid use are not unusual: An estimated 40 to 60 percent of people who have an addiction experience relapse after treatment. Some researchers have suggested that a substantial portion of those who relapse suffer from what might be considered a “treatment-resistant” form of the disorder, though that condition is not formally recognized as a medical diagnosis. In recent years, scientists have explored treating these intractable cases of opioid dependence with deep brain stimulation, an intervention that entails surgically implanting an electrode into a precisely determined region of the brain, where it delivers regular pulses to control problematic electric signals. The surgery has proven effective for neurological conditions such as Parkinson’s disease and essential tremor, a disorder that can cause a person’s limbs, head, trunk, and voice to quake. But for researchers attempting to study its efficacy for addiction, the procedure’s invasiveness and cost — typically in the hundreds of thousands of dollars — have raised steep hurdles. Work in the field has largely been limited to one-off treatments and small studies with one or a few participants, making it tough to ascertain how many people globally have received the treatment or how successful it has been for them.

Keyword: Drug Abuse
Link ID: 29121 - Posted: 01.31.2024

By Ewen Callaway Researchers have used the protein-structure-prediction tool AlphaFold to identify1 hundreds of thousands of potential new psychedelic molecules — which could help to develop new kinds of antidepressant. The research shows, for the first time, that AlphaFold predictions — available at the touch of a button — can be just as useful for drug discovery as experimentally derived protein structures, which can take months, or even years, to determine. The development is a boost for AlphaFold, the artificial-intelligence (AI) tool developed by DeepMind in London that has been a game changer in biology. The public AlphaFold database holds structure predictions for nearly every known protein. Protein structures of molecules implicated in disease are used in the pharmaceutical industry to identify and improve promising medicines. But some scientists had been starting to doubt whether AlphaFold’s predictions could stand in for gold standard experimental models in the hunt for new drugs. “AlphaFold is an absolute revolution. If we have a good structure, we should be able to use it for drug design,” says Jens Carlsson, a computational chemist at the University of Uppsala in Sweden. Efforts to apply AlphaFold to finding new drugs have been met with considerable scepticism, says Brian Shoichet, a pharmaceutical chemist at the University of California, San Francisco. “There is a lot of hype. Whenever anybody says ‘such and such is going to revolutionize drug discovery’, it warrants some scepticism.” Shoichet counts more than ten studies that have found AlphaFold’s predictions to be less useful than protein structures obtained with experimental methods, such as X-ray crystallography, when used to identify potential drugs in a modelling method called protein–ligand docking. © 2024 Springer Nature Limited

Keyword: Drug Abuse
Link ID: 29110 - Posted: 01.23.2024

Karla Kaun Many people are wired to seek and respond to rewards. Your brain interprets food as rewarding when you are hungry and water as rewarding when you are thirsty. But addictive substances like alcohol and drugs of abuse can overwhelm the natural reward pathways in your brain, resulting in intolerable cravings and reduced impulse control. A popular misconception is that addiction is a result of low willpower. But an explosion of knowledge and technology in the field of molecular genetics has changed our basic understanding of addiction drastically over the past decade. The general consensus among scientists and health care professionals is that there is a strong neurobiological and genetic basis for addiction. As a behavioral neurogeneticist leading a team investigating the molecular mechanisms of addiction, I combine neuroscience with genetics to understand how alcohol and drugs influence the brain. In the past decade, I have seen changes in our understanding of the molecular mechanisms of addiction, largely due to a better understanding of how genes are dynamically regulated in the brain. New ways of thinking about how addictions form have the potential to change how we approach treatment. Each of your brain cells has your genetic code stored in long strands of DNA. For all that DNA to fit into a cell, it needs to be packed tightly. This is achieved by winding the DNA around “spools” of protein called histones. Areas where DNA is unwound contain active genes coding for proteins that serve important functions within the cell. When gene activity changes, the proteins your cells produce also change. Such changes can range from a single neuronal connection in your brain to how you behave. This genetic choreography suggests that while your genes affect how your brain develops, which genes are turned on or off when you are learning new things is dynamic and adapts to suit your daily needs. © 2010–2024, The Conversation US, Inc.

Keyword: Drug Abuse; Epigenetics
Link ID: 29108 - Posted: 01.23.2024

By Lauren Peace Tampa Bay Times Nina Shand couldn’t stay awake. She had taken afternoon naps since she was a teenager to accommodate her “work hard, play hard” attitude, but when she was in her mid-20s the sleepiness became more severe. Menial computer tasks put her to sleep, and a 20-minute drive across her city, St. Petersburg, Florida, brought on a drowsiness so intense that her eyelids would flutter, forcing her to pull over. She knew something was really wrong when she no longer felt safe behind the wheel. In 2021, she received a diagnosis: narcolepsy, a rare disorder that causes excessive daytime sleepiness. Her doctor prescribed her Adderall, the brand-name version of the amphetamine-powered medication commonly known for treating attention-deficit/hyperactivity disorder. It worked. For the first time in years, Shand, now 28, felt energized. She was no longer struggling at work, sneaking naps, or downing coffees to trick her body into staying awake. She felt hope. But by 2022, a national Adderall shortage meant pharmacies were no longer able to fill her prescription. Shand and countless others across the country were being turned away, left to piece together a new — and often less effective — treatment plan with doctors scrambling to meet their needs. More than a year later, the shortage continues. In October, Democrats in the U.S. House of Representatives implored the FDA and Drug Enforcement Administration to work with drug manufacturers to ensure better supply. “We cannot allow this to be the continuing reality for Americans,” read their letter, led by Rep. Abigail Spanberger (D-Va.). But for now, it is.

Keyword: Sleep; Drug Abuse
Link ID: 29102 - Posted: 01.16.2024

By Meryl Davids Landau When Brian Meyer received a Stage 4 prostate cancer diagnosis three years ago at age 62, he was determined to make the most of his remaining years. He immediately retired from a decades-long career in the grocery business and took every opportunity to hike, camp and — his all-time favorite — fish for salmon. Brian and his wife, Cheryl, regularly visited their two grown children and three grandsons and spent time with their many friends. But it was sometimes hard to keep his mind off his pain and the reality that life was nearing an end. “It tugs at the heart all the time,” Meyer, from Vancouver Island, British Columbia, said in August. A calm person by nature, he found his anxiety skyrocketing. By November, though, despite a new, highly aggressive liver cancer that shrank his prognosis to months or weeks, Meyer felt calm much of the time. The prime reason: a 25-milligram dose of the psychedelic drug psilocybin he had taken several months earlier, due to a Canadian program being watched elsewhere for the emotional benefits it may offer people nearing death. In mid-August, Meyer and nine other people with terminal cancers had gathered in two rooms, and there, lying on plush floor mats with blankets covering their bodies, their eyes covered by sleeping masks and music piped in over headphones, they swallowed the psilocybin capsules. The consciousness-altering drug, administered by the nonprofit Vancouver Island wellness center Roots to Thrive, set Meyer and the others on a six-hour journey of fantastical images and thoughts. The hope was that this “trip” would lead to lasting improvements in mood and lessen their angst around death. It was accompanied by weeks of Zoom group therapy sessions before and after, along with an in-person gathering the evening before for a medical clearance and the opportunity for participants and their spouses to meet in person.

Keyword: Drug Abuse; Stress
Link ID: 29100 - Posted: 01.16.2024

By Christina Jewett and Noah Weiland Marijuana is neither as risky nor as prone to abuse as other tightly controlled substances and has potential medical benefits, and therefore should be removed from the nation’s most restrictive category of drugs, federal scientists have concluded. The recommendations are contained in a 250-page scientific review provided to Matthew Zorn, a Texas lawyer who sued Health and Human Services officials for its release and published it online on Friday night. An H.H.S. official confirmed the authenticity of the document. The records shed light for the first time on the thinking of federal health officials who are pondering a momentous change. The agencies involved have not publicly commented on their debates over what amounts to a reconsideration of marijuana at the federal level. Since 1970, marijuana has been considered a so-called Schedule I drug, a category that also includes heroin. Schedule I drugs have no medical use and a high potential for abuse, and they carry severe criminal penalties under federal trafficking laws. The documents show that scientists at the Food and Drug Administration and the National Institute on Drug Abuse have recommended that the Drug Enforcement Administration make marijuana a Schedule III drug, alongside the likes of ketamine and testosterone, which are available by prescription. The review by federal scientists found that even though marijuana is the most frequently abused illicit drug, “it does not produce serious outcomes compared to drugs in Schedules I or II.” Marijuana abuse does lead to physical dependence, the analysis noted, and some people develop a psychological dependence. “But the likelihood of serious outcomes is low,” the review concluded. The review also said there is some “scientific support” for therapeutic uses of marijuana, including treatment of anorexia, pain, and nausea and vomiting related to chemotherapy. © 2024 The New York Times Company

Keyword: Drug Abuse
Link ID: 29097 - Posted: 01.13.2024

By Aimee Cunningham Ask thousands of teens whether frequent use of certain substances brings a high risk of harm, and they mostly nail it: a majority say yes for cigarettes, alcohol, cocaine and heroin. But there’s one substance that many skip over — cannabis. Only 35 percent of 12- to 17-year-olds perceive a “great risk of harm” from smoking marijuana once or twice a week, according to the National Survey on Drug Use and Health. It’s a sentiment that some of their parents may share. Parents often don’t understand that the products used today “are not what they knew when they were in high school,” says Kelly Young-Wolff, a licensed clinical psychologist and research scientist at Kaiser Permanente Northern California Division of Research in Oakland. If their children are using cannabis, parents may think, “‘it’s not that bad, at least they’re not using this other drug that’s worse.’” But the cannabis products available now are leaps and bounds more potent — which may increase the risks for addiction and psychosis — than in the past. Marijuana plants have been bred to contain more delta-9-tetrahydrocannabinol, or THC, the main psychoactive chemical. In 1995, the total percent of THC by weight of marijuana plant material was around 4 percent; now marijuana with a THC potency of 20 percent or more is available. Trouncing that are concentrated cannabis products, including wax, budder and shatter, which can have a THC potency as high as 95 percent. Cannabis is legal for adults to use recreationally in 24 states and Washington, D.C., and is allowed for medical use in 38 states and D.C. The widespread availability of cannabis “promotes the idea that it’s safe,” says pediatrician Beth Ebel of the University of Washington School of Medicine and Seattle Children’s Hospital. But that “is an incorrect assumption.” THC can impact brain chemistry “in a way that wasn’t intended,” Ebel says. “Some of the worst effects can have lifelong health consequences, especially for a young person.” © Society for Science & the Public 2000–2024.

Keyword: Drug Abuse; Development of the Brain
Link ID: 29083 - Posted: 01.06.2024

By Catherine Pearson Dry January sounds like a simple proposition: No alcohol. For 31 days. And some enthusiasts jump in without much planning — perhaps even hungover after a rowdy New Year’s Eve. There is no data suggesting that those folks won’t be able to abstain from drinking, said Dr. David Wolinsky, an assistant professor of psychiatry and behavioral sciences with Johns Hopkins Medicine, who specializes in addiction. But starting the month with a few strategies in your back pocket — and with a clear sense of your goals — may help you get the most out of the challenge. “Most of the benefits of Dry January are probably going to be related to the intention with which you go into Dry January,” Dr. Wolinsky said. The challenge isn’t a stand-in for treatment for people with alcohol use disorder, he stressed, but those who are looking to get a fresh start to the year may benefit from the mental and physical reset it can offer, and the opportunity to adopt new habits. For instance, a 2016 study found that six months after Dry January ended, participants were drinking less than they were before. We spoke to Dr. Wolinsky and other experts about some strategies for a successful month. One of the simplest steps is to spread the word among friends and family that you intend to take the month off, said Casey McGuire Davidson, a sobriety coach and host of “The Hello Someday Podcast,” which focuses on “sober-curious” topics. Research has shown that accountability can play a critical role in helping habits stick, and you might find a friend or partner to join you, Ms. Davidson suggested. Even if you don’t, you may be surprised by how encouraging people are of your goal (though she said you should share it only with people you trust). “Dry January gives people a period of time when they can stop drinking with community and support,” she said, “without a lot of questions.” Ms. Davidson also recommended reading books that may help you evaluate your relationship with alcohol, or listening to sobriety podcasts. © 2023 The New York Times Company

Keyword: Drug Abuse
Link ID: 29071 - Posted: 12.31.2023

By Andrew Jacobs An autopsy report released by the Los Angeles County medical examiner on Friday said the death of “Friends” actor Matthew Perry, who was found face down and unresponsive in a hot tub at his home on Oct. 28, resulted from the “acute effects” of ketamine, an anesthetic with psychedelic properties. Ketamine has become increasingly popular as a therapy for treatment-resistant depression and other mental health issues. It is also used recreationally. Mr. Perry had publicly acknowledged his long struggle with alcohol and drug use, but the report said he had been sober for 19 months and little was known about his relationship to ketamine. What is ketamine, and is it legal? Ketamine is an injectable, short-acting dissociative anesthetic that can have hallucinogenic effects at certain doses. It distorts perceptions of sight and sound and makes users feel detached from pain and their surroundings. Developed as a battlefield anesthetic in the 1960s, ketamine has been legal since 1970 for use in both people and animals. It is frequently used as an anesthetic for children, especially in the developing world. But the psychiatric use of ketamine is still unapproved and unregulated, although it is increasingly used off label for treating depression, suicidal ideation and chronic pain In 2019, the Food and Drug Administration approved a derivative of ketamine called esketamine in a nasal spray for treatment-resistant depression. Ketamine has the potential for abuse, which may lead to moderate or low physical dependence or high psychological dependence, but experts consider it a safe medication. Those who use it recreationally often snort the drug in powder form or administer it intranasally by spray. © 2023 The New York Times Company

Keyword: Drug Abuse
Link ID: 29057 - Posted: 12.19.2023

By Anil Oza Krista Lisdahl has been studying cannabis use among adolescents for two decades, and what she sees makes her worried for her teenage son. “I see the data coming in, I know that he is going to come across it,” she says. As a clinical neuropsychologist at the University of Wisconsin–Milwaukee, she sees plenty of young people who have come into contact with the drug to varying degrees, from trying it once at a party to using potent preparations of it daily. The encounters have become more frequent as efforts to legalize cannabis for recreational use intensify around the world. In some of her studies, around one-third of adolescents who regularly use cannabis show signs of a cannabis use disorder — that is, they can’t stop using the drug despite negative impacts on their lives. But she wants more conclusive evidence when it comes to talking about the drug and its risks to young people, including her son. Deciding what to say is difficult, however. Anti-drug messaging campaigns have dwindled, and young people are forced to consider sometimes-conflicting messages on risks in a culture that increasingly paints cannabis and other formerly illicit drugs as harmless or potentially therapeutic. “Teenagers are pretty smart, and they see that adults use cannabis,” Lisdahl says. That makes blanket warnings and prohibitions practically useless. It’s now a decade since the drug was officially legalized for recreational use by adults aged 18 and older in Uruguay, and aged 21 and older in the states of Colorado and Washington. Many other states and countries have followed, and researchers are desperately trying to get a handle on how usage patterns are changing as a result; how the drug impacts brain development; and how cannabis use correlates with mental-health conditions such as depression, anxiety and schizophrenia. The data so far don’t tell clear stories: young people don’t seem to be using in greater numbers than before legalization, but there seem to be trends towards more problematic use. © 2023 Springer Nature Limited

Keyword: Drug Abuse; Schizophrenia
Link ID: 29041 - Posted: 12.13.2023

By Sabrina Malhi Cannabis use is associated with a greater risk of an unhealthy pregnancy outcomes, especially low birth weight, according to a study funded by the National Institutes of Health. While the study did not identity why cannabis use might have these effects, it underscores the potentially damaging impact of the substance on fetal health, the authors say. Many pregnant people use cannabis to help manage symptoms, including nausea and pain. The prevalence of the drug has surged in the past decade as more states have legalized its use for medicine or recreation, and many people believe it is relatively safe. But the impact cannabis has on pregnancy has been understudied. For the new study, researchers analyzed urine samples from more than 9,000 pregnant people between 2010 and 2013 to determine whether cannabis was used at any point during pregnancy, at how many weeks of gestation it was used and the amount. The team measured THC, the psychoactive substance in cannabis, at three different periods roughly tracking with trimesters and used that data to calculate total cannabis exposure throughout the entire pregnancy. Their findings were published in JAMA on Tuesday. The authors determined that pregnant people who used cannabis experienced unfavorable birth outcomes at rates of 25.9 percent, compared with 17.4 percent among those who did not use cannabis. Low birth weight and cannabis use had the strongest association out of all the adverse outcomes, the study found. Low birth weight is defined as weighing less than 5 lbs., 8 ounces at birth. This can lead to a range of health complications and long-term risks, including an increased likelihood of chronic conditions later in life. Experts say the study adds to a growing body of evidence that no amount of cannabis is safe during pregnancy.

Keyword: Drug Abuse; Development of the Brain
Link ID: 29040 - Posted: 12.13.2023

By Yasemin Saplakoglu Erin Calipari comes from a basketball family. Her father, John Calipari, has coached college and professional basketball since 1998, leading six teams to the NCAA Final Four, and her brother coaches men’s basketball at Vanderbilt University in Nashville, Tennessee, where she now works. But when she joined her college team as an undergraduate, she realized her strengths lay elsewhere. “I was fine. I wasn’t great,” she said. “It was pretty clear to me a couple years in that it was not a career path.” Off the court, as a biology major she gravitated toward hormones and neurotransmitters. She grew fascinated with the neurobiology of how and why drugs such as cocaine and opioids are addictive, as she learned about the effects of ecstasy on the serotonin system. “I thought drugs were so cool because they hijack the brain,” she said. “Drugs essentially take the normal systems we have in our body and drive them in a way that makes you want to take drugs again.” After pursuing graduate work in neuroscience, in 2017 Calipari set up her lab at Vanderbilt to explore how addiction is connected to the ways the brain learns and makes decisions. “Deciding what to do and what not to do is really fundamental to everything we do,” Calipari said. “You put your hand on a hot stove, you learn really quickly not to do that again.” Addiction can diminish a person’s ability to learn that drug use is hurting them, and also their ability to learn anything at all. Her world still collides with sports, for instance when she gives talks to athletes about the dangers of substance use. Athletes can be vulnerable to addiction when they are prescribed pain medicines, such as opioids, for injuries. There is a risk of dependence if opioids are taken for long periods of time, even when patients follow doctors’ orders — a fact that has led to a nationwide public health emergency. Tennessee is an epicenter of the opioid epidemic. In 2022, Nashville had the second-highest rate of overdose deaths in the country. All Rights Reserved © 2023

Keyword: Drug Abuse
Link ID: 29039 - Posted: 12.09.2023

Lilly Tozer By analysing more than one million people’s genomes, researchers have identified stretches of DNA that could be linked to cannabis addiction. They also found that some of the same regions in the genome are associated with other health conditions, such as lung cancer and schizophrenia. The findings are evidence that cannabis addiction “could have substantial public-health risks if the usage increases”, says Daniel Levey, a medical neuroscientist at Yale University in New Haven, Connecticut, and a co-author of the study, published today in Nature Genetics1. Taking cannabis recreationally is legal in at least 8 countries, and 48 countries have legalized medicinal use of the drug for conditions including chronic pain, cancer and epilepsy. But one-third of people who take cannabis end up becoming addicted, or using the drug in a way that is damaging to their health. Previous studies have suggested that there is a genetic component, and have shown links between problematic cannabis use and some cancers and psychiatric disorders. Weighing the dangers of cannabis Drug taking and addiction can be influenced both by people’s genes and by their environment, which makes them extremely difficult to study, says Levey. But the team was able to build on data from previous work2 by including genetic information from additional sources, predominantly the Million Veteran Program — a US-based biobank with a large genetic database that aims to improve health care for former military service members. The analysis encompassed multiple ethnic groups, a first for a genetic study looking at cannabis misuse. As well as identifying regions of the genome that might be involved, the researchers saw a bi-directional link between excessive cannabis use and schizophrenia, meaning that the two conditions can influence each other. This finding is intriguing, says Marta Di Forti, a psychiatrist-scientist at King’s College London. Cannabis use “is the most preventable risk factor” for schizophrenia, she says, adding that the type of genetic data examined in the study could be used in future to identify and support people at increased risk of developing psychiatric disorders through cannabis use. © 2023 Springer Nature Limited

Keyword: Drug Abuse; Genes & Behavior
Link ID: 29015 - Posted: 11.22.2023

By Jan Hoffman Dr. Nic Helmstetter crab-walked down a steep, rain-slicked trail into a grove of maple and cottonwood trees to his destination: a dozen tents in a clearing by the Kalamazoo River, surrounded by the detritus of lives perpetually on the move. Discarded red plastic cups. A wet sock flung over a bush. A carpet square. And scattered across the forest floor: orange vial caps and used syringes. Kalamazoo, a small city in Western Michigan, is a way station along the drug trafficking corridor between Chicago and Detroit. In its parks, under railroad overpasses and here in the woods, people ensnared by drugs scramble to survive. Dr. Helmstetter, who makes weekly primary care rounds with a program called Street Medicine Kalamazoo, carried medications to reverse overdoses, blunt cravings and ease withdrawal-induced nausea. But increasingly, the utility of these therapies, developed to address the decades-old opioid crisis, is diminishing. They work to counteract the most devastating effects of fentanyl and heroin, but most users now routinely test positive for other substances too, predominantly stimulants such as cocaine and methamphetamine, for which there are no approved medications. Rachel, 35, her hair dyed a silvery lavender, ran to greet Dr. Helmstetter. She takes the medicine buprenorphine, which acts to dull her body’s yearning for opioids, but she was not ready to let go of meth. “I prefer both, actually,” she said. “I like to be up and down at the same time.” The United States is in a new and perilous period in its battle against illicit drugs. The scourge is not only opioids, such as fentanyl, but a rapidly growing practice that the Centers for Disease Control and Prevention labels “polysubstance use.” Over the last three years, studies of people addicted to opioids (a population estimated to be in the millions) have consistently shown that between 70 and 80 percent also take other illicit substances, a shift that is stymieing treatment efforts and confounding state, local and federal policies. “It’s no longer an opioid epidemic,” said Dr. Cara Poland, an associate professor at the Michigan State University College of Human Medicine. “This is an addiction crisis.” © 2023 The New York Times Company

Keyword: Drug Abuse
Link ID: 29001 - Posted: 11.13.2023