Chapter 4. The Chemistry of Behavior: Neurotransmitters and Neuropharmacology

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By Zachary Siegel Why do people use drugs? It’s one of those neglected questions with answers right in front of our noses. We just refuse to look. Getting high—and overdosing—is after all, as American as apple pie. Over 46 million people in the U.S. have an alcohol- or drug-use disorder. Everyone knows someone who died, or who lost a son or daughter, mother or father, to a drug overdose, one of the 100,000-plus now yearly recorded nationwide. Lost in today’s raging debate over drug policy and how to curb this spiraling mortality is the deep malaise that lies at the root of substance use in America. We are stuck on a loop, veering from “drug war” to legalization to backlash against legalization, without a record of improving lives and setting people on a successful path of recovery. And that’s because we are frankly unwilling to fix the economic cruelty that drives and keep people locked in dangerous drug use. In a 2022 photographic-ethnography published in the journal Criminology, investigators did the obvious thing and asked people using meth in rural Alabama how they made sense of their tumultuous lives. Rather than gathering post-hoc justifications for using meth, the study aimed to hear people who use drugs tell their own stories. The results painted a remarkably vivid portrait of poverty and drug use in 21st-century rural America. Across small towns in the northern tier of Alabama, a state with the sixth lowest median household income and seventh highest poverty rate, the researchers observed lives caught in repetitive and destructive patterns. Women felt trapped in relationships that were volatile and often violent. They would flee but have nowhere to go. People felt a pervasive sense that they lacked freedom and agency to improve their circumstances. If you feel boxed in by the absence of opportunity and mobility, then daily meth use, adding a synthetic buzz and thrill to otherwise boring or dreadful moments, isn’t such a stretch. © 2024 SCIENTIFIC AMERICAN,

Keyword: Drug Abuse
Link ID: 29384 - Posted: 07.09.2024

By Susan Dominus About a year ago, a friend of mine started evading my invitations to grab a drink. It was only when we caught up for a walk that she explained she wasn’t putting me off for any personal reason — it was just that she had stopped drinking. She wasn’t a heavy drinker — she had a glass of wine with dinner, the occasional Aperol spritz — but she’d been hearing on podcasts and reading in the news that even a small amount of alcohol was much worse for her health than had previously been understood. Listen to this article, read by Kirsten Potter My friend was picking up on a swing in the public-health messaging around alcohol. For many years, she might have felt that she was making a healthy choice in having a glass of wine or a beer with dinner. Right around the time when she came of legal age to drink, the early 1990s, some prominent researchers were promoting, and the media helped popularize, the idea that moderate drinking — for women, a drink a night; for men, two — was linked to greater longevity. The cause of that association was not clear, but red wine, researchers theorized, might have anti-inflammatory properties that extended life and protected cardiovascular health. Major health organizations and some doctors always warned that alcohol consumption was linked to higher cancer risk, but the dominant message moderate drinkers heard was one of not just reassurance but encouragement. More recently, though, research has piled up debunking the idea that moderate drinking is good for you. Last year, a major meta-analysis that re-examined 107 studies over 40 years came to the conclusion that no amount of alcohol improves health; and in 2022, a well-designed study found that consuming even a small amount brought some risk to heart health. That same year, Nature published research stating that consuming as little as one or two drinks a day (even less for women) was associated with shrinkage in the brain — a phenomenon normally associated with aging. © 2024 The New York Times Company

Keyword: Drug Abuse
Link ID: 29359 - Posted: 06.15.2024

By Janna Levin During traumatic periods and their aftermath, our brains can fall into habitual ways of thinking that may be helpful in the short run but become maladaptive years later. For the brain to readjust to new situations later in life, it needs to be restored to the malleable state it was in when the habits first formed. That is exactly what Gül Dölen, a neuroscientist and psychiatric researcher at the University of California, Berkeley, is working toward in her lab. What is her surprising tool? Psychedelics. JANNA LEVIN: Welcome to “The Joy of Why.” This is Janna Levin. On June 4th, an advisory panel for the Federal Drug Administration recommended against approving the use of the psychedelic drug MDMA as a treatment for post-traumatic stress disorder. Various concerns, some about safety, overshadowed the demonstrable value of the drug in the opinion of the panel. The path to approval for drug therapies is notoriously fraught with profound complexities, a high bar on proof in clinical trials, the medical injunction to “do no harm,” as well as social and political nuances. But, what’s the fundamental neuroscience behind the news story? Why are so many psychiatric researchers enthusiastic about the promise of psychedelics? We happened to take on this subject a few weeks ago with neuroscientist Gül Dölen. Here is that episode. New drug leads can come from practically anywhere. Penicillin’s discovery was spurred from mold spores that accidentally landed in a petri dish. Cancer treatments can be dredged from the bottom of the sea. And synthetic antibodies can now be engineered from scratch. But there’s a class of drugs that mainstream medicine has generally overlooked that could prove life-changing for many people facing addiction, depression, post-traumatic stress — if scientists embrace the potential power of psychedelics. © 2024 the Simons Foundation.

Keyword: Stress; Depression
Link ID: 29351 - Posted: 06.08.2024

By Andrew Jacobs An independent advisory panel of the Food and Drug Administration rejected the use of MDMA-assisted therapy for post-traumatic stress disorder on Tuesday, highlighting the unparalleled regulatory challenges of a novel therapy using the drug commonly known as Ecstasy. Before the vote, members of the panel raised concerns about the designs of the two studies submitted by the drug’s sponsor, Lykos Therapeutics. Many questions focused on the fact that study participants were by and large able to correctly guess whether they had been given MDMA, also known by the names of Ecstasy or molly. The panel voted 9-2 on whether the MDMA-assisted therapy was effective, and voted 10-1 on whether the proposed treatment’s benefits outweighed its risks. Other panelists expressed concerns over the drug’s potential cardiovascular effects, and possible bias among the therapists and facilitators who guided the sessions and may have positively influenced patient outcomes. A case of misconduct involving a patient and therapist in the study also weighed on some panelists’ minds. Many of the committee members said they were especially worried about the failure of Lykos to collect detailed data from participants on the potential for abuse of a drug that generates feelings of bliss and well-being. “I absolutely agree that we need new and better treatments for PTSD,” said Paul Holtzheimer, deputy director for research at the National Center for PTSD, a panelist who voted no on the question of whether the benefits of MDMA-therapy outweighed the risks. “However, I also note that premature introduction of a treatment can actually stifle development, stifle implementation and lead to premature adoption of treatments that are either not completely known to be safe, not fully effective or not being used at their optimal efficacy,” he added. © 2024 The New York Times Company

Keyword: Stress; Drug Abuse
Link ID: 29343 - Posted: 06.06.2024

By Andrew Jacobs and Christina Jewett The Food and Drug Administration on Friday raised concerns about the health effects of MDMA as a treatment for post-traumatic stress disorder, citing flaws in a company’s studies that could pose major obstacles to approval of a treatment anticipated to help people struggling with the condition. The agency said that bias had seeped into the studies because participants and therapists were readily able to figure out who got MDMA versus a placebo. It also flagged “significant increases” in blood pressure and pulse rates that could “trigger cardiovascular events.” The staff analysis was conducted for an independent advisory panel that will meet Tuesday to consider an application by Lykos Therapeutics for the use of MDMA-assisted therapy. The agency’s concerns highlight the unique and complex issues facing regulators as they weigh the therapeutic value of an illegal drug commonly known as Ecstasy that has long been associated with all-night raves and cuddle puddles. Approval would mark a seismic change in the nation’s tortuous relationship with psychedelic compounds, most of which the Drug Enforcement Administration classifies as illegal substances that have “no currently accepted medical use and a high potential for abuse.” Research like the current studies on MDMA therapy have corralled the support of various groups and lawmakers from both parties for treatment of PTSD, a condition affecting millions of Americans, especially military veterans who face an outsize risk of suicide. No new therapy has been approved for PTSD in more than 20 years. “What’s happening is truly a paradigm shift for psychiatry,” said David Olson, director of the U.C. Davis Institute for Psychedelics and Neurotherapeutics. “MDMA is an important step for the field because we really lack effective treatments, period, and people need help now.” © 2024 The New York Times Company

Keyword: Drug Abuse; Depression
Link ID: 29332 - Posted: 06.02.2024

By Jennifer Hassan More people in the United States say they are using marijuana daily or near daily, compared with people who say they are drinking alcohol that often, according to a new study. In 2022, about 17.7 million people reported daily or near-daily marijuana use, compared with 14.7 million people who reported drinking at the same frequency, said the report, which was based on more than four decades of data from the National Survey on Drug Use and Health. It was the first time the survey recorded more frequent users of cannabis than alcohol, the report added. The research was published Wednesday in the peer-reviewed journal Addiction. The research window spans the years 1979 to 2022, and the 27 surveys that were analyzed involved more than 1.6 million participants during that time frame. The study described the growth in daily or near-daily cannabis use as “striking.” While “far more people drink” than use marijuana, high-frequency drinking among Americans is less common, the report said. The 2022 survey found that the median drinker reported drinking on four to five days in a month, compared with 15 to 16 days in a month for cannabis. The study noted that changing trends in cannabis use “parallel corresponding changes in cannabis policy, with declines during periods of greater restriction and growth during periods of policy liberalization.” It stressed, however, that this did not mean there was a causal link, as “both could have been manifestations of changes in underlying culture and attitudes.” Thirty-eight states and D.C. have legalized medical marijuana programs, and 24 states have approved recreational cannabis use.

Keyword: Drug Abuse
Link ID: 29323 - Posted: 05.25.2024

By Claudia López Lloreda Fentanyl’s powerful pull comes from both the potent, rapid euphoria people feel while on the drug and the devastating symptoms of withdrawal. Researchers have now zeroed in on brain circuits responsible for these two forces of fentanyl addiction. The study in mice, reported May 22 in Nature, suggests two distinct brain pathways are in play. “Addiction is not a simple disorder — it’s very complex and dynamic,” says Mary Kay Lobo, a neuroscientist at the University of Maryland School of Medicine in Baltimore who was not involved with the new research. She appreciates that the study looks not only at reward in the brain, but also at the withdrawal symptoms, which are “this dark side of addiction.” Fentanyl and other synthetic opioids are highly addictive (SN: 4/28/23). About one of every four fentanyl users becomes addicted. And in 2022 in the United States alone, there were more than 70,000 deaths from synthetic opioid overdoses, primarily fentanyl. Researchers have known that dopamine-releasing neurons in an area of the midbrain called the ventral tegmental area, or VTA, mediate feelings like euphoria. But the circuits driving withdrawal symptoms were less clear. Such symptoms include nausea, pain, irritability and an inability to feel pleasure. To find out more, neuroscientist Christian Lüscher of the University of Geneva and colleagues injected mice with fentanyl for three consecutive days then stopped, inducing withdrawal by giving the mice naloxone. © Society for Science & the Public 2000–2024.

Keyword: Drug Abuse
Link ID: 29319 - Posted: 05.23.2024

By Matt Richtel With weed these days, it’s a Willy Wonka world: chocolate bars, lollipops, exotic-flavored gummies — to say nothing of joints, vapes, drinks and the rest. Twenty-four states and the District of Columbia have now legalized the sale of marijuana for recreational use, prompting innovation, lowering prices and making the drug — more potent than ever — more widely available. The Biden administration this week recommended easing the federal regulations on cannabis. What does all of this mean for adolescents? Studies have demonstrated that marijuana use can harm the developing brain. Some new strains have been linked to psychosis. Many health experts have worried that relaxing the laws around cannabis will lead to more use of the drug among minors. But Rebekah Levine Coley, a developmental psychologist at Boston College, is less certain. In April, she and colleagues published a study in JAMA that examined drug use patterns among 900,000 high school students from 2011 to 2021, using self-reported data from the Youth Risk Behavior Survey. They found that fewer minors reported having used cannabis in the previous month in states where the drug had been legalized. But they also found that in the 18 states that had both legalized cannabis and allowed retail sales of the drug, some adolescents who were users of the drug used it more frequently. The net effect was a flat or slight decline in cannabis use among adolescents. Dr. Coley spoke to The New York Times about the study, and its implications for state and federal drug policy. This conversation has been edited and condensed for clarity. It seems sensible to assume that legalizing marijuana would lead to more use by young people. Yes, common sense might argue that as cannabis becomes legalized, it will be more accessible. There will be fewer potential legal repercussions, hence availability would increase and use would increase. © 2024 The New York Times Company

Keyword: Drug Abuse
Link ID: 29314 - Posted: 05.21.2024

By Darren Incorvaia Wouldn’t it be nice if you could stave off the miserable effects from a night out drinking by simply popping a pill? Researchers are now one step closer to that reality, developing a gel that helped mice quickly and safely break down alcohol. The gel is a combination of iron atoms and the milk protein beta-lactoglobulin. When it encounters alcohol in the digestive system, this combo mimics the behavior of an enzyme that converts ethanol into acetate, food scientist Jiaqi Su of ETH Zurich and colleagues report May 13 in Nature Nanotechnology. As the body naturally breaks down alcohol, it produces the by-product acetaldehyde, which causes hangovers and can damage the liver. “One really nice feature of [the new gel] is they’re able to convert alcohol directly to acetate, which means there’s no accumulation of the toxic intermediate,” says biochemist Duo Xu of Stanford University. “It’s like a hydrogel-based nano-liver that does the work for us.” If the gel works in humans, Su and colleagues say, it could be used to prevent hangovers and potentially the harms of chronic drinking (SN: 3/22/23). Over time, excessive alcohol use can damage vital organs such as the heart, liver and brain. A 2023 study found that about 5 percent of the global population suffers from liver diseases related to drinking too much alcohol. To test the gel, Su’s team fed it to eight mice and then waited 20 minutes before plying the rodents with booze. Eight other mice received gel without iron and eight more were given a saline solution and force-fed alcohol 20 minutes later. © Society for Science & the Public 2000–2024.

Keyword: Drug Abuse
Link ID: 29301 - Posted: 05.14.2024

By Lauren Schenkman Repeated exposure to cocaine and morphine subverts the reward-system neurons that underlie hunger and thirst, according to a new study in mice. “The nerve cells get scrambled at the neural level in terms of their responses to food and water,” says lead investigator Eric Nestler, professor of neuroscience at the Icahn School of Medicine at Mount Sinai. “So the ability of the brain, in a way, to compute that the individual is hungry or thirsty becomes lost.” In addiction research, there has been a “long-appreciated hypothesis that drugs of abuse hijack the natural reward circuitry of the brain,” says Marcelo Wood, professor of neurobiology and behavior at the University of California, Irvine, who was not involved in the new work. “It’s something that everyone talks about and writes about,” he says, but the exact physiology behind it “remained rather unknown.” In the new work, mice injected daily with morphine or cocaine for up to five days showed progressively increased activity in neurons in the nucleus accumbens that also respond to food and water, according to measures of FOS protein, a marker of neuronal activation. The drugs also elicited a stronger response than the natural rewards, two-photon calcium images showed, confirming what scientists have thought based on behavioral evidence, Nestler says. These alterations ultimately curbed the animals’ urge for sustenance, the study also shows: The mice ate less food and drank less water than mice given a saline solution, and lost weight—even after withdrawing from the drugs for three days. That confirms the hijacking hypothesis “pretty convincingly,” Wood says. “I thought that was brilliant.” © 2024 Simons Foundation

Keyword: Drug Abuse
Link ID: 29299 - Posted: 05.09.2024

By Gina Kolata At 7 p.m. on May 7, 1824, Ludwig van Beethoven, then 53, strode onto the stage of the magnificent Theater am Kärntnertor in Vienna to help conduct the world premiere of his Ninth Symphony, the last he would ever complete. That performance, whose 200th anniversary is on Tuesday, was unforgettable in many ways. But it was marked by an incident at the start of the second movement that revealed to the audience of about 1,800 people how deaf the revered composer had become. Ted Albrecht, a professor emeritus of musicology at Kent State University in Ohio and author of a recent book on the Ninth Symphony, described the scene. The movement began with loud kettledrums, and the crowd cheered wildly. But Beethoven was oblivious to the applause and his music. He stood with his back to the audience, beating time. At that moment, a soloist grasped his sleeve and turned him around to see the raucous adulation he could not hear. It was one more humiliation for a composer who had been mortified by his deafness since he had begun to lose his hearing in his twenties. But why had he gone deaf? And why was he plagued by unrelenting abdominal cramps, flatulence and diarrhea? A cottage industry of fans and experts has debated various theories. Was it Paget’s disease of bone, which in the skull can affect hearing? Did irritable bowel syndrome cause his gastrointestinal problems? Or might he have had syphilis, pancreatitis, diabetes or renal papillary necrosis, a kidney disease? After 200 years, a discovery of toxic substances in locks of the composer’s hair may finally solve the mystery. © 2024 The New York Times Company

Keyword: Hearing; Neurotoxins
Link ID: 29293 - Posted: 05.07.2024

By Eileen Sullivan, Glenn Thrush and Zolan Kanno-Youngs The Justice Department said on Tuesday that it had recommended easing restrictions on marijuana in what could amount to a major change in federal policy. Even though the move, which kicks off a lengthy rule-making process, does not end the criminalization of the drug, it is a significant shift in how the government views the safety and use of marijuana for medical purposes. It also reflects the Biden administration’s effort to liberalize marijuana policy in a way that puts it more in line with the public as increasingly more Americans favor legalizing the drug. The decision comes at an opportune time for President Biden, who is trailing the presumptive Republican nominee, former President Donald J. Trump, as they approach the November election, according to a recent CNN poll. It could also lead to the softening of other laws and regulations that account for the use or possession of cannabis, including sentencing guidelines, banking and access to public housing. People familiar with the recommendation, speaking on the condition of anonymity, said Attorney General Merrick B. Garland planned to tell the White House Office of Management and Budget that the government should change the drug’s categorization. After the office assesses the recommendation, it will still face a long road before taking effect, including being subject to public comment. The Associated Press earlier reported the Justice Department decision. For more than half a century, marijuana has been considered a Schedule I drug, classified on the same level as highly addictive substances like heroin that the Drug Enforcement Administration describes as having no currently accepted medical use. Moving marijuana to Schedule III, as the Department of Health and Human Services recommended in August, would put it alongside less addictive substances like Tylenol with codeine, ketamine and testosterone, meaning that it would be subject to fewer restrictions on production and research, and that eventually it could be prescribed by a doctor. © 2024 The New York Times Company

Keyword: Drug Abuse
Link ID: 29283 - Posted: 05.02.2024

By Kristen French Combat in nature is often a matter of tooth and claw, fang and talon. But some creatures have devised devious and dramatic ways to weaponize their bodily fluids, expelling them in powerful streams for the purposes of attack or self-defense. Researcher Elio Challita became fascinated by fluid ejections in nature when he began studying an insect called the sharpshooter, which pees one droplet at a time using a method called superpropulsion. These insects consume 300 times their own body weight per day in xylem sap, a watery solution of minerals and other nutrients found in the roots, stems, and leaves of plants. To efficiently expel the resulting waste, they use a kind of internal catapult that helps overcome the surface tension in the droplets. Challita and a team of researchers from the Bhamla Lab at Georgia Tech decided to survey the biomechanics and fluid dynamics that govern fluid ejections across the animal kingdom to see what commonalities they could find. Among others, they identified a number of creatures that use bodily fluids as powerful weapons in the fight for survival. These fluid ejections defy gravity and rebel against traditional notions of predator-prey tactics. The team’s review, “Fluid Ejections in Nature,” is forthcoming in the Annual Review of Chemical and Biological Engineering. 1. Ringnecked Spitting Cobra Cobras of the Naja genus defend against threats by spitting venom with extreme precision toward the eyes of an enemy, up to 6.5 feet away. These snakes release the venom through hollow microscopic fangs and can adjust the distribution of their spit with rapid movements. Spitting cobras have a venom discharge orifice that is more circular in shape than non-spitting species, which gives the venom more forward force. Contraction in the venom gland also helps. A 90-degree bend near the lip of the orifice gives the snake more precise control over venom flow. Naja pallida cobras can spit venom at average speeds of 1.27 milliliters per second. © 2024 NautilusNext Inc.,

Keyword: Neurotoxins; Evolution
Link ID: 29278 - Posted: 04.30.2024

By Christina Caron Antidepressants are among the most prescribed medications in the United States. This is, in part, because the number of people diagnosed with depression and anxiety has been on the rise, and prescriptions jumped sharply among some age groups during the pandemic. Despite the prevalence of these medications, some patients have “significant misconceptions” about how the drugs work, said Dr. Andrew J. Gerber, a psychiatrist and the president and medical director of Silver Hill Hospital in New Canaan, Conn. About 80 percent of antidepressants are prescribed by primary care doctors who have not had extensive training in managing mental illness. Dr. Paul Nestadt, an associate professor of psychiatry at the Johns Hopkins School of Medicine, said patients tell him, “‘You know, Doc, I’ve tried everything.’” But often, he said, “they never got to a good dose, or they were only on it for a week or two.” Here are some answers to frequently asked questions about antidepressants. How do antidepressants work? There are many types of antidepressants, and they all work a bit differently. In general, they initiate a change in the way brain cells — and different regions of the brain — communicate with one another, said Dr. Gerard Sanacora, a professor of psychiatry at the Yale School of Medicine. Clinical trials have shown that antidepressants are generally more effective with moderate, severe and chronic depression than with mild depression. Even then, it’s a modest effect when compared with placebo. © 2024 The New York Times Company

Keyword: Depression
Link ID: 29275 - Posted: 04.30.2024

By Ingrid Wickelgren Ishmail Abdus-Saboor has been fascinated by the variety of the natural world since he was a boy growing up in Philadelphia. The nature walks he took under the tutelage of his third grade teacher, Mr. Moore, entranced him. “We got to interact and engage with wildlife and see animals in their native environment,” he recalled. Abdus-Saboor also brought a menagerie of creatures — cats, dogs, lizards, snakes and turtles — into his three-story home, and saved up his allowance to buy a magazine that taught him about turtles. When adults asked him what he wanted to be when he grew up, “I said I wanted to become a scientist,” he said. “I always raised eyebrows.” Abdus-Saboor did not stray from that goal. Today, he is an associate professor of biological sciences at the Mortimer B. Zuckerman Mind Brain Behavior Institute at Columbia University, where he studies how the brain determines whether a touch to the skin is painful or pleasurable. “Although this question is fundamental to the human experience, it remains puzzling to explain with satisfying molecular detail,” he said. Because the skin is our largest sensory organ and a major conduit to our environment, it may hold clues for treating conditions from chronic pain to depression. To find those clues, Abdus-Saboor probes the nervous system at every juncture along the skin-to-brain axis. He does not focus on skin alone or home in on only the brain as many others do. “We merge these two worlds,” he said. That approach, he added, requires mastering two sets of techniques, reading two sets of literature and attending two sets of scientific meetings. “It gives us a unique leg up,” he said. It has led to a landmark paper published last year in Cell that laid out the entire neural circuit for pleasurable touch. © 2024 Simons Foundation.

Keyword: Pain & Touch; Emotions
Link ID: 29262 - Posted: 04.20.2024

By Helen Bradshaw Walk into a gas station in the United States, and you may see more than just boxes of cigarettes lining the back wall. Colorful containers containing delta-8, a form of the substance THC, are sold in gas stations and shops across the country, and teens are buying them. A recent survey of more than 2,000 U.S. high school seniors found that more than 11 percent of them had used delta-8 in the past year, researchers report March 12 in JAMA. This is the first year the Monitoring the Future study, one of the leading nationally representative surveys of drug use trends among adolescents in the United States, looked at delta-8 use. Because more than 1 in 10 senior students said they used the drug, the survey team plans to monitor delta-8 use every year going forward. “We don’t really want to see any kids being exposed to cannabis, because it potentially increases their risk for developmental harms … and some psychiatric reactions” such as suicidal thoughts, says Alyssa Harlow, a researcher on the survey and an epidemiologist at the University of Southern California Keck School of Medicine in Los Angeles. Despite its prevalence, especially in the South and the Midwest, delta-8 is still new to consumers and research. Science News talked with Harlow and addiction researcher Jessica Kruger of the University of Buffalo in New York to help explain the delta-8 craze and its effects on kids. What is delta-8-THC? Cannabis plants contain over 100 compounds known as cannabinoids. Delta-8 is one of them. The most well-known is delta-9-tetrahydrocannabinol, or delta-9-THC. © Society for Science & the Public 2000–2024.

Keyword: Drug Abuse
Link ID: 29248 - Posted: 04.11.2024

By Christina Caron Anxious ahead of a big job interview? Worried about giving a speech? First date nerves? The solution, some digital start-ups suggest, is a beta blocker, a type of medication that can slow heart rate and lower blood pressure — masking some of the physical symptoms of anxiety. Typically a trip to the doctor’s office would be necessary to get a prescription, but a number of companies are now connecting patients with doctors for quick virtual visits and shipping the medication to people’s homes. “No more ‘Shaky and Sweaty,’” one online ad promised. “Easy fast 15 minute intake.” That worries Dr. Yvette I. Sheline, a professor of psychiatry at the University of Pennsylvania Perelman School of Medicine. “The first question is: What is going on with this person?” Dr. Sheline said. Are they depressed in addition to anxious? Do they have chronic anxiety or is it just a temporary case of stage fright? “You don’t want to end up prescribing the wrong thing,” she added. In addition, although beta blockers are generally considered safe, experts say they can carry unpleasant side effects and should be used with caution. What are beta blockers? Beta blockers such as propranolol hydrochloride have been approved by the Food and Drug Administration for chest pain, migraine prevention, involuntary tremors, abnormal heart rhythms and other uses. Some are still prescribed for hypertension, although they’re no longer considered the preferred treatment, mainly because other medications are more effective in preventing stroke and death. © 2024 The New York Times Company

Keyword: Emotions; Stress
Link ID: 29247 - Posted: 04.06.2024

By Matt Richtel Historically speaking, it’s not a bad time to be the liver of a teenager. Or the lungs. Regular use of alcohol, tobacco and drugs among high school students has been on a long downward trend. In 2023, 46 percent of seniors said that they’d had a drink in the year before being interviewed; that is a precipitous drop from 88 percent in 1979, when the behavior peaked, according to the annual Monitoring the Future survey, a closely watched national poll of youth substance use. A similar downward trend was observed among eighth and 10th graders, and for those three age groups when it came to cigarette smoking. In 2023, just 15 percent of seniors said that they had smoked a cigarette in their life, down from a peak of 76 percent in 1977. Illicit drug use among teens has remained low and fairly steady for the past three decades, with some notable declines during the Covid-19 pandemic. In 2023, 29 percent of high school seniors reported using marijuana in the previous year — down from 37 percent in 2017, and from a peak of 51 percent in 1979. There are some sobering caveats to the good news. One is that teen overdose deaths have sharply risen, with fentanyl-involved deaths among adolescents doubling from 2019 to 2020 and remaining at that level in the subsequent years. Dr. Nora Volkow has devoted her career to studying use of drugs and alcohol. She has been the director of the National Institute on Drug Abuse since 2003. She sat down with The New York Times to discuss changing patterns and the reasons behind shifting drug-use trends. What’s the big picture on teens and drug use? People don’t really realize that among young people, particularly teenagers, the rate of drug use is at the lowest risk that we have seen in decades. And that’s worth saying, too, for legal alcohol and tobacco. © 2024 The New York Times Company

Keyword: Drug Abuse
Link ID: 29243 - Posted: 04.06.2024

By Paula Span The phone awakened Doug Nordman at 3 a.m. A surgeon was calling from a hospital in Grand Junction, Colo., where Mr. Nordman’s father had arrived at the emergency room, incoherent and in pain, and then lost consciousness. At first, the staff had thought he was suffering a heart attack, but a CT scan found that part of his small intestine had been perforated. A surgical team repaired the hole, saving his life, but the surgeon had some questions. “Was your father an alcoholic?” he asked. The doctors had found Dean Nordman malnourished, his peritoneal cavity “awash with alcohol.” The younger Mr. Nordman, a military personal finance author living in Oahu, Hawaii, explained that his 77-year-old dad had long been a classic social drinker: a Scotch and water with his wife before dinner, which got topped off during dinner, then another after dinner, and perhaps a nightcap. Having three to four drinks daily exceeds current dietary guidelines, which define moderate consumption as two drinks a day for men and one for women, or less. But “that was the normal drinking culture of the time,” said Doug Nordman, now 63. At the time of his 2011 hospitalization, though, Dean Nordman, a retired electrical engineer, was widowed, living alone and developing symptoms of dementia. He got lost while driving, struggled with household chores and complained of a “slipping memory.” He had waved off his two sons’ offers of help, saying he was fine. During that hospitalization, however, Doug Nordman found hardly any food in his father’s apartment. Worse, reviewing his father’s credit card statements, “I saw recurring charges from the Liquor Barn and realized he was drinking a pint of Scotch a day,” he said. Public health officials are increasingly alarmed by older Americans’ drinking. The annual number of alcohol-related deaths from 2020 through 2021 exceeded 178,000, according to recently released data from the Centers for Disease Control and Prevention: more deaths than from all drug overdoses combined. © 2024 The New York Times Company

Keyword: Drug Abuse; Alzheimers
Link ID: 29234 - Posted: 04.02.2024

By David Adam The drug ketamine is enjoying a second life. First developed as an anaesthetic that was used widely by US battlefield surgeons during the Vietnam war, it is growing in popularity as a treatment for depression and other mental-health conditions. And this week, the drug got its highest-profile endorsement yet. In an interview with US journalist Don Lemon that was released online on Monday, Elon Musk, founder of SpaceX and head of social-media platform X (formerly Twitter), spoke about his own experiences of using the drug to manage what he called a “negative chemical state” similar to depression. Musk said he has a prescription for the drug from “a real doctor” and uses “a small amount once every other week or something like that”. His comments follow the fatal drowning of Friends actor Matthew Perry last October, an incident that an investigation blamed on the drug’s acute effects. It’s complicated. Approved as an anaesthetic by the US Food and Drug Administration in 1970, the drug was delivered intravenously to people undergoing surgery. Ketamine is often still given that way for depression. That requires supervision — typically people attend a private clinic and are monitored by an anaesthetist as well as the prescribing psychiatrist and members of the support staff. Because it’s long out of patent, there’s little commercial interest in developing new versions of the drug. Some companies are trying to package it into more-convenient oral lozenges, but that’s a challenging formulation. “The problem with ketamine is if you take it orally, by and large it doesn’t get through to the system because it’s got low bioavailability,” says Allan Young, a consultant psychiatrist at King’s College London who studies mood disorders.

Keyword: Depression; Drug Abuse
Link ID: 29210 - Posted: 03.23.2024