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NHS hopes to save thousands of lives with pill that helps smokers quit

Denis Campbell Health policy editor Hundreds of thousands of smokers will be given a pill that increases people’s chances of quitting, in a move that NHS bosses believe will save thousands of lives. About 85,000 people a year in England will be offered the chance to use varenicline, a once-a-day tablet that experts say is as effective as vapes at helping people to kick the habit. Amanda Pritchard, the chief executive of NHS England, hailed the pill as a potential “gamechanger” in the fight to tackle smoking and the huge harm to health it causes. The drug helps people to quit by reducing their cravings for nicotine and ensuring that it cannot affect the brain in its usual way. It has also been found to reduce the side-effects smokers can experience when they stop using tobacco, such as trouble sleeping and irritability. The NHS in England will give varenicline as part of its efforts to keep driving down the number of people who smoke. A decline in smoking rates over the past 20 years means that only 11.6% of adults in England still have the habit – about 6 million people. Health service bosses hope its use will lead to 9,500 fewer smoking-related deaths over the next five years. The drug – known at the time as Champix – began being used in 2006 and was taken by about 85,800 people a year until July 2021. It then became unavailable after the Medicines and Healthcare products Regulatory Agency (MHRA), which regulates drugs, found impurities in it. That problem has now been addressed to the MHRA’s satisfaction and it has recently approved a generic version of the drug, which NHS England will use. It cited research by University College London that found it would save £1.65 in healthcare costs for every £1 it spent on the pill. © 2024 Guardian News & Media Limited

Related chapters from BN: Chapter 4: The Chemistry of Behavior: Neurotransmitters and Neuropharmacology
Related chapters from MM:Chapter 4: Development of the Brain
Link ID: 29554 - Posted: 11.13.2024

The agony of ketamine addiction: ‘I felt like I was peeing glass’

By Elle Hunt The first time Nick (not his real name) tried ketamine, he felt as if he’d entered another dimension. Though he smoked marijuana regularly and had experimented with other drugs, Nick had never even heard of ketamine. But when his friend pulled out a bag of white powder, “I did what anybody else would do at 20 years old. I tried it,” he says. “And I found it really fun, to be honest.” The floaty feeling, like he’d been lifted out of his own body, was “euphoric”, he says. “Like you’re in a fairy world.” Sixteen years later, reality is biting hard. Nick, now 36, has spent the past three months in recovery for ketamine addiction after more than a decade of heavy use. His bladder is a fifth of the size it should be, he says. It’s “more than likely” that it will have to be removed and replaced with a urostomy bag. That’s setting aside all the other “brutal things” he’s gone through as a consequence of ketamine addiction – from being bed-bound by pain to embarrassing bladder failures. Now six months clean, Nick still cannot last half an hour without needing to use the toilet. “I am now a disabled person, having been such a fit lad,” he says. Nick is sharing his story to warn others of the dangers of ketamine, which is rapidly emerging as gen Z’s recreational drug of choice. Widely used in human and veterinary medicine as an anaesthetic, in illicit use the class B substance is typically snorted for its dissociative effects. According to the most recent government figures, use in England and Wales has more than doubled since 2016; among 16- to 24-year-olds, it has more than tripled, and there are stories of addicts as young as 12 or 13. The story is similar elsewhere. In Australia, recreational use of ketamine was reported to have reached a record high last year. In the US, seizures of illicit ketamine grew by 349% between 2017 and 2022. The death of Friends actor Matthew Perry at the age of 54 from “acute effects” of ketamine raised awareness of the risks of addiction. © 2024 Guardian News & Media Limited o

Alcohol consumption abundant in the natural world

Ian Sample Science editor Humans may have turned drinking into something of an art form but when it comes to animals putting alcohol away, Homo sapiens are not such an outlier, researchers say. A review of published evidence shows that alcohol occurs naturally in nearly every ecosystem on Earth, making it likely that most animals that feast on sugary fruits and nectar regularly imbibe the intoxicating substance. Although many creatures have evolved to tolerate a tipple and gain little more than calories from their consumption, some species have learned to protect themselves with alcohol. Others, however, seem less able to handle its effects. “We’re moving away from this anthropocentric view that alcohol is used by just humans and that actually ethanol is quite abundant in the natural world,” said Anna Bowland, a researcher in the team at the University of Exeter. After trawling research papers on animals and alcohol, the scientists arrived at a “diverse coterie” of species that have embraced and adapted to ethanol in their diets, normally arising through fermented fruits, sap and nectar. Ethanol became plentiful on Earth about 100m years ago when flowering plants began to produce sugary fruits and nectar that yeast could ferment. The alcohol content is typically low, at around 1% to 2% alcohol by volume (ABV), but in over-ripe palm fruit the concentration can reach 10% ABV. In one study, wild chimpanzees in south eastern Guinea were caught on camera bingeing on the alcoholic sap of raffia palms. Meanwhile, spider monkeys on Barro Colorado Island, Panama, are partial to ethanol-laden yellow mombin fruit, revealed to contain between 1% and 2.5% alcohol. “Evidence is growing that humans are not drinking alone,” the authors write in Trends in Ecology and Evolution. © 2024 Guardian News & Media Limited

Related chapters from BN: Chapter 4: The Chemistry of Behavior: Neurotransmitters and Neuropharmacology; Chapter 6: Evolution of the Brain and Behavior
Related chapters from MM:Chapter 4: Development of the Brain
Link ID: 29537 - Posted: 11.02.2024

‘It Took Over Everything’: Stories of Marijuana’s Little-Known Risks

By Megan TwoheyDanielle Ivory and Carson Kessler As marijuana legalization spreads across the country, people are consuming more of the drug, more often and at ever-higher potencies. Most of the tens of millions of people using marijuana, for health benefits or for fun, don’t experience problems. But a growing number, mainly heavy users, have experienced addiction, psychosis and other harmful effects, The New York Times found. “Cannabis is a lot of things at once,” said Dr. Kevin Gray, a psychiatrist and specialist in bio-behavioral medicine at Medical University of South Carolina Health. “It can be medically therapeutic. It also can be highly problematic.” In interviews and surveys, hundreds of people told The Times about serious — sometimes frightening — symptoms that they were stunned to learn could be caused by cannabis. Here are some of their stories. David Krumholtz, an actor known for films like “10 Things I Hate About You” and TV shows like “Numb3rs,” resumed smoking marijuana in 2016, after a decade-long break. Within months, he started to experience cycles of intense nausea and vomiting — a sometimes debilitating condition called cannabinoid hyperemesis syndrome. It can lead to dehydration, seizures, kidney failure, cardiac arrest and even death in rare instances. He lost 100 pounds and was in and out of emergency departments. At home in New Jersey, he would spend 10 hours at a time in hot baths, which for unknown reasons can temporarily relieve symptoms. “I had numbness in my extremities, pain in my chest and my blood pressure skyrocketed,” he said. Mr. Krumholtz, 46, believes he would have eventually died had he not suffered an episode that almost derailed his dream job, a role in the blockbuster 2023 film “Oppenheimer,” and inspired him to quit marijuana for good. © 2024 The New York Times Company

5 things to know from this week’s big report on cannabis

Pien Huang More than half of all U.S. states have legalized cannabis, be it for medical purposes, recreational use, or both. The shelves of cannabis dispensaries offer an ever-widening array of gummies, drinks and joints. Meanwhile, the federal government still considers most types of cannabis illegal. A new report from the National Academies of Sciences, Engineering and Medicine, released this week, finds this disconnect between the states and the federal government is leading to fragmented policies, and risks to the public. As states built new commercial markets for cannabis, they initially focused on regulating sales and revenue. “The consequence of that is the public health aspects were often given a backseat and we're now playing catch up for that,” says Dr. Steven Teutsch, chair of the National Academies committee that wrote the report on how cannabis impacts public health. The report calls for federal leadership and national standards on cannabis quality and potency, to safeguard public health. Here are five takeaways: 1. People consume cannabis more regularly than alcohol in the U.S. In 2022, more U.S. adults reported using cannabis than alcohol on a near-daily basis, according to the National Survey on Drug Use and Health. It was the first time that regular marijuana use surpassed regular alcohol use. © 2024 npr

How Fentanyl Drove a Tsunami of Death in America

By Maia Szalavitz Last year over 70,000 Americans died from taking drug mixtures that contained fentanyl or other synthetic opioids. The good news is that recent data suggests a decline in overdose deaths, the first significant drop in decades. But this is not a uniform trend across the nation. To understand this disparity, it’s important to examine how we got here. Today’s crisis is often described as a series of waves. But if you look at the data, it was more like a couple of breakers followed by a tsunami. First, prescription opioid fatalities rose. Then heroin deaths surged. And finally, illicitly manufactured fentanyl overtook all that preceded it. Once fentanyl and other synthetic opioids dominate a market, whether a state is red or blue doesn't matter. Skyrocketing overdose deaths are nearly unavoidable, regardless of whether a state enforces tough penalties for drug possession or decriminalizes it. Understanding how fentanyl saturated the drug supply, moving from the East Coast of the United States to the West, is critical to ending the worst drug crisis in American history. In 2000, America was in its first wave of the opioid crisis. This was dominated by deaths from prescription painkillers like OxyContin. As you can see in the first map, though not entirely new to the country, illicitly manufactured fentanyl made up a tiny percentage of total drug seizures nationwide. Because escalations in opioid prescribing to treat pain were seen as the cause of the overdose problem, doctors began cutting off patients and law enforcement shuttered so-called pill mills. The number of opioid prescriptions began plummeting. © 2024 The New York Times Company

NPR Exclusive: U.S. overdose deaths plummet, saving thousands of lives

Brian Mann For the first time in decades, public health data shows a sudden and hopeful drop in drug overdose deaths across the U.S. "This is exciting," said Dr. Nora Volkow, head of the National Institute On Drug Abuse [NIDA], the federal laboratory charged with studying addiction. "This looks real. This looks very, very real." National surveys compiled by the Centers for Disease Control and Prevention already show an unprecedented decline in drug deaths of roughly 10.6 percent. That's a huge reversal from recent years when fatal overdoses regularly increased by double-digit percentages. Some researchers believe the data will show an even larger decline in drug deaths when federal surveys are updated to reflect improvements being seen at the state level, especially in the eastern U.S. "In the states that have the most rapid data collection systems, we’re seeing declines of twenty percent, thirty percent," said Dr. Nabarun Dasgupta, an expert on street drugs at the University of North Carolina. According to Dasgupta's analysis, which has sparked discussion among addiction and drug policy experts, the drop in state-level mortality numbers corresponds with similar steep declines in emergency room visits linked to overdoses. Dr. Nabarun Dasgupta, a researcher at the University of North Carolina, is an expert on the U.S. street drug supply. He believes data shows a sudden drop in drug overdose deaths nationwide that could already by saving Dr. Nabarun Dasgupta, a researcher at the University of North Carolina, is an expert on the U.S. street drug supply. He believes data shows a sudden drop in drug overdose deaths nationwide that could already by saving "roughly 20,000 lives" per year. © 2024 npr

Deep Links Between Alcohol and Cancer Are Described in New Report

By Roni Caryn Rabin Adults under age 50 have been developing breast cancer and colorectal cancer at increasingly higher rates over the last six decades, and alcohol use may be one factor driving the trend, according to a scientific report published on Wednesday. The report, by the American Association for Cancer Research, highlights scientific breakthroughs that have led to new anticancer drugs and improved overall survival. But the authors also described a troubling pattern: Even as cancer death rates have declined, the overall incidence of several cancers has been rising inexplicably, with an especially alarming increase among younger adults in cancers of the gastrointestinal system, like colorectal cancer. The report estimates that 40 percent of all cancer cases are associated with modifiable risk factors. It recommends reducing alcohol consumption, along with making lifestyle changes such as avoiding tobacco, maintaining a healthy diet and weight, exercising, avoiding ultraviolet radiation and minimizing exposure to pollutants. The authors called for raising awareness through public messaging campaigns and adding cancer-specific warning labels to alcoholic beverages. The recommendations come amid a radical rethinking of the putative health benefits of moderate alcohol consumption, which for years was considered to be protective against heart disease. Just last month, a large study that followed more than 135,000 older British adults for over a decade found that moderate and light drinkers did not benefit from a reduction in heart disease when compared with occasional drinkers. And both moderate and light drinkers experienced more cancer deaths than occasional drinkers, a finding accentuated among low-income seniors and those with existing health problems. © 2024 The New York Times Company

Teenage E-Cigarette Use Drops to a 10-Year Low

By Christina Jewett The number of teenagers who reported using e-cigarettes in 2024 has tumbled from a worrisome peak reached five years ago, raising hopes among public health officials for a sustained reversal in vaping trends among adolescents. In an annual survey conducted from January through May in schools across the nation, fewer than 8 percent of high school students reported using e-cigarettes in the past month, the lowest level in a decade. That’s far lower than the apex, in 2019, when more than 27 percent of high school students who took the survey reported that they vaped — and an estimated 500,000 fewer adolescents than last year. The data is from the National Youth Tobacco Survey, a questionnaire filled out by thousands of middle and high school students that is administered each year by the Food and Drug Administration and the Centers for Disease Control and Prevention. Overall, it found that just under 6 percent of middle and high school students reported vaping in the last month, down from nearly 8 percent among those surveyed last year. Use among high school students largely accounted for this year’s decline; middle school use stayed fairly steady with 3.5 percent reporting they had vaped compared to 4.6 percent the year before. “I want to be unequivocally clear that this continued decline in e-cigarette use among our nation’s youth is a monumental public health win,” Brian King, the director of the F.D.A.’s tobacco division, said during a news briefing on Wednesday. Public health experts said several factors may have contributed to the decline in teenage vaping, including city and state flavored tobacco bans, a blitz of enforcement against sellers of flavored vapes and three public messaging campaigns aimed at young people about the dangers of vaping. © 2024 The New York Times Company

Rethinking Addiction as a Chronic Brain Disease

By Jan Hoffman The message emblazoned on a walkway window at the airport in Burlington, Vt., is a startling departure from the usual tourism posters and welcome banners: “Addiction is not a choice. It’s a disease that can happen to anyone.” The statement is part of a public service campaign in yet another community assailed by drug use, intended to reduce stigma and encourage treatment. For decades, medical science has classified addiction as a chronic brain disease, but the concept has always been something of a hard sell to a skeptical public. That is because, unlike diseases such as Alzheimer’s or bone cancer or Covid, personal choice does play a role, both in starting and ending drug use. The idea that those who use drugs are themselves at fault has recently been gaining fresh traction, driving efforts to toughen criminal penalties for drug possession and to cut funding for syringe-exchange programs. But now, even some in the treatment and scientific communities have been rethinking the label of chronic brain disease. In July, behavior researchers published a critique of the classification, which they said could be counterproductive for patients and families. “I don’t think it helps to tell people they are chronically diseased and therefore incapable of change. Then what hope do we have?” said Kirsten E. Smith, an assistant professor of psychiatry and behavioral sciences at Johns Hopkins School of Medicine and a co-author of the paper, published in the journal Psychopharmacology. “The brain is highly dynamic, as is our environment.” The recent scientific criticisms are driven by an ominous urgency: Despite addiction’s longstanding classification as a disease, the deadly public health disaster has only worsened. © 2024 The New York Times Company

Out of Your Head

By Steve Paulson Oliver Sacks wasn’t always the beloved neurologist we remember today, sleuthing around the backwaters of the mind in search of mysterious mental disorders. For a few years in the 1960s, he was a committed psychonaut, often spending entire weekends blitzed out of his mind on weed, LSD, morning glory seeds, or mescaline. Once, after injecting himself with a large dose of morphine, he found himself hovering over an enormous battlefield, watching the armies of England and France drawn up for battle, and then realized he was witnessing the 1415 Battle of Agincourt. “I completely lost the sense that I was lying on my bed stoned,” he told me in 2012, a few years before he died. “I felt like a historian, seeing Agincourt from a celestial viewpoint. This was not ordinary imagination. It was absolutely real.” The vision seemed to last only a few minutes, but later, he discovered he’d been tripping for 13 hours. These early experiences with hallucinogens gave Sacks an appreciation for the strange turns the mind can take. He had a craving for direct experience of the numinous, but he believed his visions were nothing more than hallucinations. “At the physiological level, everything is electricity and chemistry, but it was a wonderful feeling,” he said. When I asked if he ever thought he’d crossed over into some transpersonal dimension of reality, he said, “I’m an old Jewish atheist. I have no belief in heaven or anything supernatural or paranormal, but there’s a mystical feeling of oneness and of beauty, which is not explicitly religious, but goes far beyond the aesthetic.” I’ve often thought about this conversation as I’ve watched today’s psychedelic renaissance. Clinical trials with psychedelic-assisted therapy show great promise for treating depression, addiction, and PTSD, and a handful of leading universities have recently created their own heavily endowed psychedelic centers. © 2024 NautilusNext Inc.,

Related chapters from BN: Chapter 18: Attention and Higher Cognition; Chapter 4: The Chemistry of Behavior: Neurotransmitters and Neuropharmacology
Related chapters from MM:Chapter 14: Attention and Higher Cognition; Chapter 4: Development of the Brain
Link ID: 29453 - Posted: 08.28.2024

FDA rejects ecstasy as a therapy: what’s next for psychedelics?

By Sara Reardon Last week’s decision by the US Food and Drug Administration (FDA) to reject MDMA, also known as ecstasy, as a psychiatric treatment surprised many researchers. Lykos Therapeutics, the company that has been testing MDMA, plans to ask the FDA to reconsider the decision, but scientists are now wondering what the agency’s ruling will mean for other potential psychedelic therapies. In a press release posted on 9 August, Lykos, which is based in San Jose, California, said that the FDA had sent a letter requesting that the company undertake another large-scale trial of the drug in people with post-traumatic stress disorder (PTSD) and resubmit its application. “The FDA request for another study is deeply disappointing,” Lykos chief executive Amy Emerson said in the press release, adding that the company plans to work with the agency to “resolve scientific disagreements”. Conducting another study “would take several years”, she said, adding that Lykos has already addressed many of the FDA’s concerns. In an e-mail to Nature, Lykos declined to provide the complete letter detailing the agency’s specific concerns and directed the news team instead to its press release. Experts say that without access to the letter, it’s hard to determine why the FDA reached the decision it did. “We really are going off incomplete information,” says Mason Marks, who studies drug policy at Florida State University in Tallahassee, adding that he was “a little surprised” by the agency’s decision. Trial concerns But Marks points out that the FDA typically follows the advice of its independent advisory committees — and the one that evaluated MDMA in June overwhelmingly voted against approving the drug, citing problems with clinical trial design that the advisers felt made it difficult to determine the drug’s safety and efficacy. One concern was about the difficulty of conducting a true placebo-controlled study with a hallucinogen: around 90% of the participants in Lykos’s trials guessed correctly whether they had received the drug or a placebo, and the expectation that MDMA should have an effect might have coloured their perception of whether it treated their symptoms. © 2024 Springer Nature Limited

Related chapters from BN: Chapter 4: The Chemistry of Behavior: Neurotransmitters and Neuropharmacology; Chapter 16: Psychopathology: Biological Basis of Behavior Disorders
Related chapters from MM:Chapter 4: Development of the Brain; Chapter 12: Psychopathology: The Biology of Behavioral Disorders
Link ID: 29433 - Posted: 08.15.2024

Older Adults Do Not Benefit From Moderate Drinking

By Roni Caryn Rabin Even light drinking was associated with an increase in cancer deaths among older adults in Britain, researchers reported on Monday in a large study. But the risk was accentuated primarily in those who had existing health problems or who lived in low-income areas. The study, which tracked 135,103 adults aged 60 and older for 12 years, also punctures the long-held belief that light or moderate alcohol consumption is good for the heart. The researchers found no reduction in heart disease deaths among light or moderate drinkers, regardless of this health or socioeconomic status, when compared with occasional drinkers. The study defined light drinking as a mean alcohol intake of up to 20 grams a day for men and up to 10 grams daily for women. (In the United States, a standard drink is 14 grams of alcohol.) “We did not find evidence of a beneficial association between low drinking and mortality,” said Dr. Rosario Ortolá, an assistant professor of preventive medicine and public health at Universidad Autónoma de Madrid and the lead author of the paper, which was published in JAMA Network Open. On the other hand, she added, alcohol probably raises the risk of cancer “from the first drop.” The findings add to a mounting body of evidence that is shifting the paradigm in alcohol research. Scientists are turning to new methodologies to analyze the risks and benefits of alcohol consumption in an attempt to correct what some believe were serious flaws in earlier research, which appeared to show that there were benefits to drinking. © 2024 The New York Times Company

Psilocybin desynchronization persists in the human brain

Jake Rogers Nature Reviews Neuroscience (2024)Cite this article To better understand the therapeutic potential of the psychedelic drug psilocybin, we need a fuller understanding of its short-term and long-term effects on the human brain. In this study, Siegel et al. reveal individual-specific psilocybin-induced acute and persistent brain network changes in neurotypical young adults. The authors used longitudinal precision functional mapping — involving ~18 sessions of fMRI per individual — to capture individual-specific functional brain networks. Through this approach, acute (during) and persistent (between or after) intervention-induced changes to individual-specific network organization could be detected in young adult participants who received either high-dose psilocybin or dose-matched methylphenidate (a non-psychedelic stimulant chosen as an active control for psilocybin-induced cardiovascular and arousal effects) and who then, 1–2 weeks later, received the compound not administered first. Acutely, psilocybin caused not only widespread cortical functional connectivity (FC) changes (most prominently in association areas), but also disruption in subcortical regions connected with the default mode network (DMN), including the thalamus, basal ganglia, cerebellum and hippocampus. Furthermore, FC changes correlated with the intensity of the subjective experience documented using the 30-item mystical experience questionnaire (MEQ30). Several participants also received a second high dose of psilocybin and repeated an acute fMRI session six months later. Despite it being entirely plausible in a second acute session that individuals might experience the same effect, this repeated session revealed that individuals had substantially reduced or increased MEQ30 scores compared to their first acute session, and that the degree of the widespread brain changes and intensity of subjective experience correlated across and within individuals. By contrast, acute methylphenidate was associated with substantially less whole-brain FC disruption and most FC changes localized to sensorimotor systems. © 2024 Springer Nature Limited

This Is Literally Your Brain on Drugs

By Andrew Jacobs July 17, 2024 If you had to come up with a groovy visualization of the human brain on psychedelic drugs, it might look something like this. The image, as it happens, comes from dozens of brain scans produced by researchers at Washington University School of Medicine in St. Louis who gave psilocybin, the compound in “magic mushrooms,” to participants in a study before sending them into a functional M.R.I. scanner. The kaleidoscopic whirl of colors they recorded is essentially a heat map of brain changes, with the red, orange and yellow hues reflecting a significant departure from normal activity patterns. The blues and greens reflect normal brain activity that occurs in the so-called functional networks, the neural communication pathways that connect different regions of the brain. The scans, published Wednesday in the journal Nature, offer a rare glimpse into the wild neural storm associated with mind-altering drugs. Researchers say they could provide a potential road map for understanding how psychedelic compounds like psilocybin, LSD and MDMA can lead to lasting relief from depression, anxiety and other mental health disorders. “Psilocybin, in contrast to any other drug we’ve tested, has this massive effect on the whole brain that was pretty unexpected,” said Dr. Nico Dosenbach, a professor of neurology at Washington University and a senior author of the study. “It was quite shocking when we saw the effect size.” The study included seven healthy adults who were given either a single dose of psilocybin or a placebo in the form of methylphenidate, the generic version of the amphetamine Ritalin. Each participant underwent a total of 18 brain scans, taken before, during and after the initial dosing. © 2024 The New York Times Company

Related chapters from BN: Chapter 4: The Chemistry of Behavior: Neurotransmitters and Neuropharmacology; Chapter 18: Attention and Higher Cognition
Related chapters from MM:Chapter 4: Development of the Brain; Chapter 14: Attention and Higher Cognition
Link ID: 29398 - Posted: 07.18.2024

We’re Not Asking the Right Question to Solve the Overdose Crisis

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,

Is That Drink Worth It to You?

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

F.D.A.’s Review of MDMA Cites Health Risks and Study Flaws

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

Marijuana surpasses alcohol in daily use for Americans

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.

Two distinct neural pathways may make opioids like fentanyl so addictive

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.

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