Natural Human Hormone The Next Antidepressant

ScienceDaily (Dec. 12, 2007) — Novel treatment strategies for major depression with broader treatment success or a more rapid onset of action would have immense impact on public health, a new study published in the December 1st issue of Biological Psychiatry explains. This new study reports findings that support the evaluation of a potential new antidepressant agent.

According to the lead author on this study, Kamilla Miskowiak, MSc: "Although depression is often related to problems in the chemistry of the brain, recent evidence also suggests that there may be structural problems as well with nerve cells not being regenerated as fast as normal or suffering from toxic effects of stress and stress hormones." This led the researchers to evaluate the effects of erythropoietin (Epo), a hormone naturally produced by the kidneys that stimulates the formation of red blood cells and is known as a treatment for anemia. The authors explain that new evidence shows that Epo also "has neuroprotective and neurotrophic effects in animal models and affects cognitive and associated neural responses in humans," suggesting that it may be a candidate in the treatment of depression.

In this study, Miskowiak and colleagues evaluated the effects of Epo on the neural and cognitive processing of emotional information in healthy volunteers using functional magnetic resonance imaging (fMRI). They found that Epo regulated the emotional responses of those volunteers that received it, similar to the effects of current antidepressants.

Ms. Miskowiak explains that "this finding provides support to the idea that Epo affects neural function and may be a candidate agent for future treatment strategies for depression." John H. Krystal, M.D., Editor of Biological Psychiatry and affiliated with both Yale University School of Medicine and the VA Connecticut Healthcare System, confirms its potential: "Epo appears to have neurotrophic effects in the brain in animals. The current data suggest that Epo may modulate human brain activity associated with the processing of emotion. Together, there may now be sufficient evidence to justify evaluating the antidepressant effects of Epo and related compounds in humans."

The article is "Erythropoietin Reduces Neural and Cognitive Processing of Fear in Human Models of Antidepressant Drug Action" by Kamilla Miskowiak, Ursula O'Sullivan and Catherine J. Harmer. Drs. Miskowiak, O'Sullivan, and Harmer are affiliated with the Department of Psychiatry, University of Oxford, Warneford Hospital, Oxford, United Kingdom. Drs. Miskowiak and Harmer are also with the Department of Experimental Psychology, University of Oxford, South Parks Road, in Oxford, United Kingdom. The article appears in Biological Psychiatry, Volume 62, Issue 11 (December 1, 2007), published by Elsevier.

Adapted from materials provided by Elsevier.

People addicted to alcohol more impulsive in their decision-making

New research involving brain imaging and genetic studies has for the first time established an association between thinking patterns and liquor addiction.

Published in the Journal of Neuroscience, the study was based on a comparison between brain activity of sober alcoholics and non-addicted people, while they made financial decisions.

It showed that sober alcoholics tended to show significantly more "impulsive" neural activity in some areas of the brain, as they made financial decisions. The study also discovered that a specific gene mutation boosted activity in these brain regions when people made impulsive choices.

Lead researcher Dr. Charlotte Boettiger, assistant professor of psychology at the University of North Carolina at Chapel Hill, says that this mutation is already known to reduce brain levels of the neurotransmitter dopamine.

"Our data suggest there may be a cognitive difference in people with addictions. Their brains may not fully process the long-term consequences of their choices. They may compute information less efficiently," said Boettiger, who led the study as a scientist at UCSF's Ernest Gallo Clinic and Research Center.

"What's exciting about this study is that it suggests a new approach to therapy. We might prescribe medications, such as those used to treat Parkinson's or early Alzheimer's disease, or tailor cognitive therapy to improve executive function," she added.

Dr. Howard Fields, the senior author of the study, said that the newly found link involving the gene, impulsive behaviour and brain activity suggests that raising dopamine levels may be an effective treatment for addiction.

"I am very excited about these results because of their clinical implications. The genetic findings raise the hopeful possibility that treatments aimed at raising dopamine levels could be effective treatments for some individuals with addictive disorders," Fields said.

During the study, the subjects were asked either to choose less money then and there or to get more money later. Their brain activity was scanned using functional magnetic resonance imaging (fMRI), as the participants made their choices.

The researchers revealed that while decisions were being made, the imaging detected activity in the posterior parietal cortex, the dorsal prefrontal cortex, the anterior temporal lobe and the orbital frontal cortex.

They said that sober alcoholics tended to chose the "now" reward almost three times more often than the control group, reflecting more impulsive behaviour.

The authors noted that the imaging detected reduced activity in the orbital frontal cortex in the brains of subjects who preferred "now" over "later", most of whom had a history of alcoholism.

"Think of the orbital frontal cortex as the brakes. With the brakes on, people choose for the future. Without the brakes they choose for the short-term gain," Boettiger said.

The dorsal prefrontal cortex and the parietal cortex often form cooperative circuits, and the study found that high activity in both is associated with a bias toward choosing immediate rewards.

The study also showed that people with two copies of the mutation in a gene called COMT, which is associated with lower dopamine levels, had significantly higher frontal and parietal activity, and chose "now" over "later" significantly more often.

"We have a lot to learn. But the data takes a significant step toward being able to identify subtypes of alcoholics, which could help tailor treatments, and may provide earlier intervention for people who are at risk for developing addictions," Boettiger said.

source: Journal of Neuroscience

Doctors say government needs to implement tougher alcohol laws

Leading doctors feel that measures to curb alcohol drinking through education have failed and that the government must adopt tougher laws to curb binge drinking in the country. Suggested measures include banning alcohol, increasing its price and barring its widespread distribution.

Dr Ian Gilmore, President of the Royal College of Physicians and Dr Nick Sheron, a liver specialist at Southampton University Hospital said that alcohol had become a major public health concern and attempts to change public behavior by encouraging quitting were not working.

"How many more lives will be damaged by alcohol in the UK before our governments decide to tackle the problem with measures that are likely to work?" the doctors asked in the Christmas edition of the British Medical Journal.

They added that the deaths linked to alcohol use were in fact more than those caused by a combination of breast cancer, cervical cancer and MRSA. In 2003 alcohol was lined to over 22,000 deaths and 150,000 hospital admissions.

"Between 780,000 and 1.3 million children are affected by their parents' use of alcohol - 30 to 60 per cent of child protection cases and 23 per cent of calls to the National Society for the Prevention of Cruelty to Children about child abuse or child neglect involved drunken adults," they argued.

The doctors also said that the UK government would be benefitted by following the actions of erstwhile Russian President Mikhail Gorbachev, whose alcohol policies saved an estimated 1.2 million lives.

source: Earth Times

Preventing Holiday Blues

Most people know the holidays can be a period of emotional highs and lows. Loneliness, anxiety, happiness and sadness are common feelings, sometimes experienced in startling succession. The bad news is the holiday blues can trigger relapse for people recovering from alcoholism and other drug addiction. The good news is the blues can be remedied by planning ahead.

Why do the blues hit during this otherwise festive season? Doing too much or too little and being separated from loved ones at this special time can lead to sadness during the holiday season. Many recovering people associate the holidays with memories of overindulgence, perhaps of big benders that resulted in relationship problems or great personal losses.

People experience feelings of melancholy, sadness and grief tied to holiday recollections. Unlike clinical depression, which is more severe and can last for months or years, those feelings are temporary, says Sue Hoisington, a licensed psychologist and executive director of Hazelden's Mental Health Centers. Anyone experiencing major symptoms of depression, such as persistent sadness, anxiety, guilt or helplessness; changes in sleep patterns; and a reduction in energy and libido, should seek help from a trusted mental health professional, she adds.

Whether you're in recovery or not, Hoisington suggests developing a holiday plan to help prevent the blues, one that will confront unpleasant memories before they threaten your holiday experience. Your plan should include improved self-care, enhanced support from others, and healthy ways to celebrate. Hoisington offers a few suggestions to achieve a happy, sober holiday season:

Good self-care is vital. Remember to slow down. Take some quiet time each day and work on an attitude of gratitude. Plan relaxation and meditation into your day, even for a few minutes, no matter how busy you are. Relax your standards and reduce overwhelming demands and responsibilities.

Don't overindulge. Go easy on the holiday sweets and follow a balanced diet. Monitor your intake of caffeine, nicotine and sugar. Exercise regularly to help maintain your energy level amid a busier schedule. Don't try to do too much. Get plenty of sleep. Fatigue is a stressor. Maintain some kind of schedule and plan ahead; don't wait until the last minute to purchase gifts or prepare to entertain.

Enhance your support system. Holidays are a good time to reach out more frequently to your therapist, sponsor, spiritual advisor, or support group. If you're in recovery, spend time with fellow recovering people. Let others help you realize your personal limits. Learn to say "no" in a way that is comfortable for you.

Find new ways to celebrate. Create some new symbols and rituals that will help redefine a joyful holiday season. You might host a holiday gathering for special recovering friends and/or attend celebrations of your Twelve Step group. Avoid isolation and spend time with people you like who are not substance users. Don't expose yourself to unnecessary temptations, such as gatherings where alcohol is the center of entertainment. If there are people who have a negative influence on you, avoid them.

Focus on your recovery program. Holidays are also an important time to focus on your recovery program. For example, ask, "What am I working on in my program now?" Discuss this with your sponsor.

Release your resentments. Resentment has been described as allowing a person you dislike to live in your head, rent-free. Resentments that gain steam during the holidays can be disastrous for anyone, especially recovering people. The Big Book of "Alcoholics Anonymous" refers to resentment as the No. 1 offender, or the most common factor in failed sobriety.

Holidays may also be a time to evaluate your spirituality and find a personal way to draw support from the spirit of the season. Return the holidays to a spiritual base, and stress the power of unselfish giving.

Recovery is serious work, but it is also important to have fun. Laugh a little and a little more. Start seeing the humor in those things that annoy you. Take from the holiday season what is important for you and leave the rest.

--Published December 2, 2002 by:http://www.hazelden.org/web/public/hol21202.page

Traditional Medicine for Mental Health

FRISCO — Often times clients ask psychiatrist Sloan Burton about alternatives to medications.

“I’m the last person people generally want to see... I want people to know that there are other things available ... (and) if they can do things before they get to me, I think that’s great,” said Burton, MD, child and adolescent psychiatrist who is also co-chairwoman of the local Mental Health America of Colorado chapter.

So, this week the organization is tackling that subject. They are holding a forum that will help people see their options. It is “A Look at Alternative and Traditional Approaches to Depression and other Mental Health Issues” Thursday from 6:30 p.m. to 9 p.m. the Summit County Community and Senior Center near Frisco.

During the forum, community practitioners will address a case study of a man with depression and other mental health issues. The panel of speakers includes Burton, Ken Adnan, MD, family practice, traditional and alternative medicine; Justin Pollack, ND and nutrition; Barbara Leffler, Ph.D., RN, clinical psychologist and advanced practice nursing; Kevin Waldron, MSAOM, acupuncture and Chinese medicine; and William J. van Doorninck, Ph.D., clinical psychologist.

According to Mental Health America of Colorado, clinical depression is one of the most common mental illnesses, affecting more than 19 million Americans each year.

And at a recent health meeting, Leffler said more people miss work for depression than they do for pain. Also, 50 percent of people who experience depression are likely to become depressed again and with each additional episode, the risk of another increases by 16 percent, she said.

Leffler will be presenting on breaking the cycle of reoccurring depression by using mindfulness-based cognitive therapy, a method that even those who don’t have a specific problem with depression can benefit from, she said in a letter.

She will also be available along with the other health professionals to answer questions those who attend may have about mental health treatment.

“Consumers of mental health services have important questions about the benefits and complications of patent medicines as well as herbal and nutritional interventions,” van Doorninck, who is moderating the event, wrote in a letter. “The forum speakers will help sort out the pros and cons of these interventions.”

And all bases will be covered from traditional to alternative medicine. Pollack, who will be presenting research about nutrients that could help someone with depression or alcoholism, said, “It’s really exciting that the whole forum is so diverse to help people understand what their options are.”
Waldron, who will be giving an overview of acupuncture, traditional Chinese herbs and Chinese medicine, agreed, saying, “I just feel this is what the future of medicine should be like — a multi-discipline look at complex chronic illness.”

FRISCO — Often times clients ask psychiatrist Sloan Burton about alternatives to medications.

“I’m the last person people generally want to see... I want people to know that there are other things available ... (and) if they can do things before they get to me, I think that’s great,” said Burton, MD, child and adolescent psychiatrist who is also co-chairwoman of the local Mental Health America of Colorado chapter.

So, this week the organization is tackling that subject. They are holding a forum that will help people see their options. It is “A Look at Alternative and Traditional Approaches to Depression and other Mental Health Issues” Thursday from 6:30 p.m. to 9 p.m. the Summit County Community and Senior Center near Frisco.

During the forum, community practitioners will address a case study of a man with depression and other mental health issues. The panel of speakers includes Burton, Ken Adnan, MD, family practice, traditional and alternative medicine; Justin Pollack, ND and nutrition; Barbara Leffler, Ph.D., RN, clinical psychologist and advanced practice nursing; Kevin Waldron, MSAOM, acupuncture and Chinese medicine; and William J. van Doorninck, Ph.D., clinical psychologist.

According to Mental Health America of Colorado, clinical depression is one of the most common mental illnesses, affecting more than 19 million Americans each year.

And at a recent health meeting, Leffler said more people miss work for depression than they do for pain. Also, 50 percent of people who experience depression are likely to become depressed again and with each additional episode, the risk of another increases by 16 percent, she said.

Leffler will be presenting on breaking the cycle of reoccurring depression by using mindfulness-based cognitive therapy, a method that even those who don’t have a specific problem with depression can benefit from, she said in a letter.

She will also be available along with the other health professionals to answer questions those who attend may have about mental health treatment.

“Consumers of mental health services have important questions about the benefits and complications of patent medicines as well as herbal and nutritional interventions,” van Doorninck, who is moderating the event, wrote in a letter. “The forum speakers will help sort out the pros and cons of these interventions.”

And all bases will be covered from traditional to alternative medicine. Pollack, who will be presenting research about nutrients that could help someone with depression or alcoholism, said, “It’s really exciting that the whole forum is so diverse to help people understand what their options are.”
Waldron, who will be giving an overview of acupuncture, traditional Chinese herbs and Chinese medicine, agreed, saying, “I just feel this is what the future of medicine should be like — a multi-discipline look at complex chronic illness.”

ScienceDaily (Dec. 18, 2007) — Here's another reason to "keep off the grass." Researchers in Canada report that marijuana smoke contains significantly higher levels of several toxic compounds -- including ammonia and hydrogen cyanide -- than tobacco smoke and may therefore pose similar health risks.

David Moir and colleagues note that researchers have conducted extensive studies on the chemical composition of tobacco smoke, which contains a host of toxic substances, including about 50 that can cause cancer. However, there has been relatively little research on the chemical composition of marijuana smoke.

In this new study, researchers compared marijuana smoke to tobacco smoke, using smoking machines to simulate the smoking habits of users. The scientists found that ammonia levels were 20 times higher in the marijuana smoke than in the tobacco smoke, while hydrogen cyanide, nitric oxide and certain aromatic amines occurred at levels 3-5 times higher in the marijuana smoke, they say. The finding is "important information for public health and communication of the risk related to exposure to such materials," say the researchers.

The study, "A Comparison of Mainstream and Sidestream Marijuana and Tobacco Cigarette Smoke Produced under Two Machine Smoking Conditions," is scheduled for the Dec. 17 issue of ACS' Chemical Research in Toxicology.

Adapted from materials provided by American Chemical Society.

Ketamine

Ketamine has been around for about 30 years and was initially used only in veterinary medicine. Over the past 2 decades, it has become known that ketamine is a general anesthetic with hallucinogenic and analgesic (pain relieving properties). The drug has a unique ability to differentiate perception from sensation. It is currently widely used in pediatric anesthesia. Ketamine is structurally related to PCP, a drug known for its psychedelic effects and vivid hallucinations. The drug has a tendency to produce a feeling of an out-of-body experience.
Pharmacology of Ketamine

When injected ketamine can cause profound analgesia, respiratory depression, cardiovascular stimulation and amnesia. However, despite the anesthesia, the protective reflexes are maintained. It has excellent analgesic activity and useful for control of severe pain.

Ketamine causes an insensate feeling throughout the body. Prolonged use has been associated with physical and psychological addiction. In the majority of individuals who frequently use ketamine, tolerance does develop to these effects, thus requiring the addicts to consume higher doses.

Dosing

In clinical medicine, ketamine is administered either intravenously or intramuscularly. For illicit uses, ketamine is prepared by evaporating the liquid from the legitimate pharmaceutical product and pulverizing the residue into a powder. All of the ketamine abused has been diverted from legal sources. Theft of veterinary/pharmacy clinics is the most frequently reported source of illicit ketamine.

Ketamine is commonly snorted by abusers. Intra-muscular injection is also a widely used method for abuse. Injected Ketamine takes a few seconds to work whereas snorted ketamine takes 5-15 minutes to take effect.

Symptoms of Ketamine Use

Ketamine is known to cause hallucinations, nausea, mental clouding, loss of memory and an amnestic feeling may occur. Numerous individuals report out of body experiences after having undergone anesthesia with ketamine. Physical features of ketamine use include increased heart rate, paralyzed feeling, numbness, impaired attention, delirium, and high blood pressure

Is Ketamine Addictive?

Although ketamine does not give rise to physical dependence like that seen with morphine, heroin or alcohol, it is associated with a powerful psychological addiction- like that seen with cocaine. Because of its ability to produce intense vivid psychedelic effects it is frequently abused. The psychedelic effects and out of body experiences have been primary reasons why the drug is abused.
Ketamine Abuse

The dose of ketamine which is used by drug addicts is only about 10-25% of the therapeutic dose required to induce anesthesia. At these low doses, it behaves more like a stimulant than a sedative and does not affect the breathing or heart rate, although exceptions do occur. At very high doses, ketamine behaves more like other anesthetics and can induce respiratory arrest and increase blood pressure.
Deaths with abuse of ketamine alone are rare. The majority of fatalities occur when ketamine is combined with other CNS depressants like alcohol, benzodiazepines and a mixture of other illicit drugs.

Side Effects

Prolonged use of ketamine can result in amnesia, impaired motor function, delirium, and respiratory problems that can be fatal. Ketamine can cause loss of in consciousness, neuroses or other mental clouding. Other common side effects include confusion, delirium, vivid dreams, hallucinations and feelings of detachment from the body. Some physicians routinely use haloperidol or a benzodiazepine to alleviate these distressing symptoms.
When injected, ketamine can also cause a significant increase in blood pressure, abnormal heart rhythms, respiratory depression, airway obstruction, visual problems, seizures, skin rash and pain at the injected site.

Drug Interactions

Treatment Options

Ketamine addiction, like all addiction begins with the acceptance of a problem by the individual. Several drug rehabilitation and treatment facilities are available for ketamine treatment. There are no antidotes to ketamine and the majority of therapy is based on psychotherapy and behavior modification.

Why People Abuse

For most of us, it’s a no-brainer to avoid misuse of drugs: we see that the dangers and destructive long-term effects outweigh any momentary pleasure drugs afford and act accordingly. But it’s also easy to understand why people use and abuse drugs that pose risks to health and well-being. It’s a matter of brain chemistry.

Drugs are chemicals that enter the brain and mess with the way nerve cells normally send, receive, and process information. Some imitate natural neurotransmitters; for example, narcotic pain relievers mimic the effects of endorphins, the body’s natural “feel-good” chemical. Or they are similar enough to the brain’s natural chemical messengers that they trick brain receptors into activating nerve cells. Stimulants such as cocaine and methamphetamines cause the neurons to release too much of the neurotransmitters, causing the sensation users describe as the brain “racing.”

And, in one way or another, almost all drugs overstimulate the pleasure center of the brain, flooding it with the neurotransmitter dopamine. That produces euphoria, and that heightened pleasure can be so compelling that the brain wants that feeling back again and again. Unfortunately, with repeated use of a drug, the brain becomes accustomed to the dopamine surges by producing less of it, so the user has to take more of the drug to feel the same pleasure — the phenomenon known as tolerance.

But what causes people to want to tinker with their brain chemistry in the first place? Some are thrill-seekers, some just curious; some try drugs because their friends use, or they want to be perceived as cool. Even more susceptible, though, are the many people who use drugs in order to cope with unpleasant emotions and the difficulties of life. The National Alliance on Mental Illness estimates that about half of all drug abusers also suffer from a mental illness such as depression, anxiety, bipolar disorder, or schizophrenia.

People who are suffering emotionally use drugs not so much for the rush but to escape from their problems. They’re trying to self-medicate themselves out of loneliness, low self-esteem, unhappy relationships, stress, and many other types of problems. Drug use doesn’t solve any of those problems, and it can easily make them worse or create new ones. But even if the user knows that, the short-term escape drugs provide can be so attractive that the dangerous consequences of abuse can seem unimportant.

Alcohol Deaths in Women

ALCOHOL-RELATED diseases are killing almost twice as many women as at the beginning of the 1990s, official figures to be published tomorrow will show.
In the 35-54 age group, about 14 women per 100,000 die from conditions such as liver failure and cirrhosis, well above the European average.
The report from the Office for National Statistics on health trends since the 1970s will also reveal just how badly “casual alcoholism” has hit the British population.
Thirty years ago death rates for men and women were about two per 100,000, the lowest in western Europe. The figure for men is now 18, although this is still less than the European average.
Ireland, France and Spain consume more alcohol per head than Britain, but deaths from alcohol-related diseases are far lower, suggesting that Britain’s problem is related to a culture of binge drinking and casual alcoholism.
The sharp upward trend since the early 1990s is attributed by experts to people having more spending money, drinks being cheaper since the introduction of the European single market, and pubs and off-licences staying open longer.
Gordon Brown has signalled that curbing alcohol abuse is one of his top priorities, and has ordered a review of the rules allowing 24-hour opening of pubs and drink shops.
He has also ordered the Home Office to prepare a preChristmas “blitz” on retailers who sell alcohol to drunks and underage drinkers.

Source:http://www.timesonline.co.uk/tol/news/uk/health/article2702913.ece

Empty chair a reminder of addiction's toll

David Chalmers' parents, officials and Albany Drug Court graduates share bittersweet ceremony

ALBANY -- Graduates of Albany Drug Court remembered a "ray of sunshine," David Julian Chalmers.

He was 24 when he took his own life on Nov. 26, less than two weeks before graduation. His parents accepted their son's diploma posthumously at Friday's ceremony.

"David Chalmers has given all of us a life lesson here," said Albany County Judge Stephen Herrick, who asked for a moment of silence in his memory.

Chalmers, of Loudonville, was an honors student who attended prep schools and colleges while cultivating a wide circle of friends. But he began abusing alcohol and drugs when he was 12 and later was diagnosed with psychological problems. He relapsed during previous attempts at sobriety before completing residential rehab and other requirements of drug court.

"Every one of you has to deal with your demons every day," Herrick said. "Do not become overwhelmed, and please remember, we're here to help you."

Dr. Paul Chalmers thanked Herrick and his drug court staff for treating his son and the others "with respect and dignity and love," and he congratulated the 22 graduates who accepted a diploma from the judge.

"You've all earned this day," he said, with his wife, Susan, and daughter, Anne, at his side. "We pray you continue to make the right decisions."

In an overflowing courtroom, the hourlong program was marked by laughter and tears and the occasional wail of a cranky toddler. Even the judge frequently dabbed a handkerchief at misty eyes.

One by one, 22 graduates shared grim tales of addiction and the toll it had exacted on families. Each expressed elation, albeit tentatively, over their momentary success.

Herrick noted that only 11 had reached graduation without an infraction, and that relapse and recidivism are not uncommon.

It was Herrick's largest class of graduates and its most diverse. They were black, white and Hispanic, women and men, ranging in age from 21 to 55, with addictions that included alcohol, crack, heroin and prescription drugs.

Among the group, 20 are employed, one is retired and one is a full-time college student.

There was one substance-free infant born to a graduate.

Herrick gave the best-dressed prize to Bruce Maddox, who wore a tuxedo. "Drug court is a miracle worker," Maddox said.

Linda Brace had the standing-room-only audience reaching for tissues when she described relapses, and losses of family members and property to addiction.

She expressed condolences to the Chalmers family and called David "a ray of sunshine."

Herrick urged the graduates to bask in their moment of hopefulness, but to beware of dark clouds ahead.

He urged them to establish "sober support networks" and to continue to work with an Alcoholics Anonymous sponsor to resist the temptation to drink and use drugs again.

A block away, on North Pearl Street, the bars were beginning to fill with early happy hour patrons, lured by drink specials.

source: Albany Times Union

By PAUL GRONDAHL, Staff writer. Grondahl can be reached at 454-5623 or by e-mail at pgrondahl@timesunion.com.

Military at Increased Risk for Alcohol Abuse

Military service in a war zone increases service members' chances of developing post-traumatic stress disorder (PTSD), other anxiety disorders, and depression, says a new report from the Institute of Medicine. Serving in a war also increases the chances of alcohol abuse, accidental death, and suicide within the first few years after leaving the war zone, and marital and family conflict, including domestic violence, said the committee that wrote the report at the request of the U.S. Department of Veterans Affairs, which asked for a comprehensive analysis of the scientific and medical evidence concerning associations between deployment-related stress and long-term, adverse effects on health.

Drug abuse, incarceration, unexplained illnesses, chronic fatigue syndrome, gastrointestinal symptoms, skin diseases, fibromyalgia, and chronic pain may also be associated with the stresses of being in a war, but the evidence to support these links is weaker. For other health problems and adverse effects that the committee reviewed, the data are lacking or contradictory; the committee could not determine whether links between these ailments and deployment-related stress exist.

Although the report cannot offer definitive answers about the connections between many health problems and the stresses of war, it is clear that veterans who were deployed to war zones self-report more medical conditions and poorer health than veterans who were not deployed. Those who were deployed and have PTSD in particular tend to report more symptoms and poorer health, the committee found. PTSD often occurs in conjunction with other anxiety disorders, depression, and substance abuse; its prevalence and severity is associated with increased exposure to combat.

A persistent obstacle to obtaining better evidence that would yield clearer answers is lack of pre- and post-deployment screenings of physical, mental, and emotional status. The U.S. Department of Defense should conduct comprehensive, standardized evaluations of service members' medical conditions, psychiatric symptoms and diagnoses, and psychosocial status and trauma history before and after they deploy to war zones. Such screenings would provide baseline data for comparisons and information to determine the long-term consequences of deployment-related stress. In addition, they would help identify at-risk personnel who might benefit from targeted intervention programs during deployment -- such as marital counseling or therapy for psychiatric or other disorders -- and help DOD and VA choose which intervention programs to implement for veterans adjusting to post-deployment life.

Pre-Teens Abusing Inhalants

While overall teen drug use is declining, new data analysis show fewer pre-teens see risk in Inhalants and more are willing to experiment

NEW YORK - Abuse of inhalants by middle school children has increased by as much as 44 percent over a two-year period, driven by fewer and fewer children seeing risk in experimenting with inhalants to get high, according to a new data analysis conducted and released today by the Partnership for a Drug-Free America.

"It's clear that this new generation of pre-teens has a lot to learn about the lethal nature of inhalant abuse," said Steve Pasierb, president & CEO of the Partnership. "We've got two concerns to contend with: 1) the fact that more kids are using inhalants to get high, and 2) fewer kids seeing risk in this behavior, which suggests more kids will experiment in the future."

Drawn from the Partnership's latest national survey on drug use, the new analysis reports that over the past two years inhalant abuse increased by 18 percent (from 22 to 26 percent) among 8th graders and by 44 percent (from 18 to 26 percent) among 6th graders.

Commonly known among adolescents as "sniffing," "inhaling" or "huffing," inhalant abuse is the deliberate inhalation of fumes from common products found in homes, offices and schools to get high. Approximately one in four 8th graders - or almost one million youngsters - has reported trying an inhalant at least once in their lives. Inhalant abuse can cause brain damage and can lead to death, even at the trial stage.

The percentage of kids associating risk with using inhalants also dropped significantly over the past two years. The perception that sniffing of huffing inhalants can kill you fell 14 percent among 8th graders (from 73 to 63 percent) and decreased 29 percent among 6th graders (from 68 to 48 percent).

New Inhalant Education Initiative

The Partnership is re-launching its inhalant education campaign as part of a nationwide effort across all major media markets with a renewed focus on preventing inhalant abuse.

The Partnership and the Alliance for Consumer Education (ACE) are discussing ways to help educate parents about the dangers of inhalant abuse by building awareness through prevention efforts.

"Working closely with The Partnership as an alliance partner, we will be able to reach millions of parents and educators to help stem the tide of increased inhalant abuse among preteens," said Carleen Kreider, president of the Alliance for Consumer Education (ACE). "We have dedicated our efforts at ACE to educate as many parents and other adults nationwide about this risky behavior. We hope to help empower parents to talk to their children about the dangers of inhalants because we know that the threat of inaction can be even more dangerous."

Overall, teen drug use is trending downward in the United States. Lifetime use of any illegal drug is down by 10 percent over the last five years (from 51 percent in 1998 to 46 percent in 2003). Over the past five years, Marijuana trial or lifetime use has declined from 42 to 39 percent, a seven percent reduction. And teen trial or lifetime of Ecstasy , which peaked in 2001, has declined by 25 percent (from 12 to 9 percent). The one exception to this positive trend is the up-tick in inhalant abuse among pre-teens.

"The Partnership's findings are quite alarming and confirm what we are seeing at the state and local levels," said Harvey Weiss, executive director of the National Inhalant Prevention Coalition (NIPC) in Austin, Texas. "We must talk about the very real threats of inhalants with our children; to do nothing about this now invites needless tragedies."

The 2003 PATS study, conducted for the Partnership by Roper Public Affairs & Media, under grants from the Robert Wood Johnson Foundation, interviewed 7,270 adolescents nationwide. An additional teen sample of 1140 adolescents in the 6th grade was also included. Data are nationally projectable with a +/- 1.5 percent margin of error.

ACE is a nonprofit foundation dedicated to advancing community health and well being. The flagship program of ACE is Inhalant Abuse Education and Prevention.

The National Inhalant Prevention Coalition (NIPC) was founded in 1992 and views inhalant abuse as a public health problem. It provides all segments of a community with resources, materials and referrals and leads National Inhalants & Poisons Awareness Week. The NIPC has established a grief support network for parents who have lost their child to inhalants.

For parents and those who care for children, resources, tips and the latest information about drugs and inhalant abuse are available at the Partnership's parent resource center on-line at www.drugfree.org or ACE at www.consumered.org or NIPC at www.inhalants.org.

Source: JoinTogether Online

Mental Illness And Drug Addiction May Co-occur Due To Disturbance In Part Of The Brain

Why do mental illness and drug addiction so often go together? New research reveals that this type of dual diagnosis may stem from a common cause: developmental changes in the amygdala, a walnut-shaped part of the brain linked to fear, anxiety and other emotions.

Dual diagnosis is common yet difficult to treat. Addiction of all types -- to nicotine, alcohol and drugs -- is often found in people with a wide variety of mental illnesses, including anxiety disorders, unipolar and bipolar depression, schizophrenia, and borderline and other personality disorders. Lead author Andrew Chambers, MD, cites clinical reports that at least half the people who seek help with addiction or mental-health treatment have co-occurring disorders. Epidemiological data says that from two to five of every 10 anxious or depressed people, and from four to eight of every 10 people with schizophrenia, bipolar disorder, or antisocial personality, also have some type of addiction.

To find the scientific basis for this complex, seemingly intractable pairing, which has in the past been attributed to "self-medication," Chambers' team at the Indiana University medical school compared the adult mood- and drug-related behavior of two groups of adult rats: those whose amygdalas were surgically damaged in infancy and those whose amygdalas were left intact but who underwent a sham surgery, to equalize their treatment.

Rats with damaged (lesioned) amygdalas grew up abnormally under-responsive to ambiguous or potentially threatening stimuli. Not showing the normal caution, they moved significantly more in response to novelty, showed significantly less fear in an elevated maze, and kept socializing even when exposed to the scent of a predator.

Crucially, these same rats also were significantly more sensitive to cocaine after just one exposure. And rats given repeated cocaine injections later showed even stronger expressions of the enduring changes in behavior -- suggesting an overall hypersensitivity to the addictive process.

Given that the experimental and control rats were raised in the same tightly controlled conditions, the only difference being their brain status, researchers concluded that the integrity of the amygdala was the root cause of both impaired fear behavior and heightened drug response.

"Brain conditions may alter addiction vulnerability independently of drug history," says Chambers. He and his colleagues concluded that someone's greater vulnerability to addiction, rather than a given drug's ability to alter the symptoms of mental illness for better or worse (usually worse), more fully explains the high rates of dual diagnosis.

For these reasons, and given the lab evidence and the fact that dual diagnosis patients do less well on psychiatric medication than other patients, Chambers wondered whether the underlying problems in the brain -- what he calls "neural inflexibility" -- make it harder for these people to respond.

To improve the effectiveness of treatments for dual diagnosis, Chambers would like to see educators, counselors, physicians, and scientific researchers integrate insights into both mental health and addiction. Funding the simultaneous treatment of both disorders would also help, he observes, given that "dual-diagnosis cases are the mainstream among these patients, probably because addiction and mental illness are strongly linked by neurobiology."

What may harm the amygdala early in human development? Dr. Chambers cites the relatively rare cases of temporal lobe epilepsy, tumors or early brain injury. Far more common, he speculates, are complex interactions among subtle genetic and environmental factors that change the way the amygdala functions or is connected to the rest of the brain during childhood and adolescence. For example, he says, "Early emotional trauma, paired with a certain genetic background, may alter the early development of neural networks intrinsic to the amygdala, resulting in a cascade of brain effects and functional changes that present in adulthood as a dual-diagnosis disorder."

A full report on why these "comorbid" disorders may develop appears in the December Behavioral Neuroscience, published by the American Psychological Association.

Source: Science Daily, http://www.sciencedaily.com/

Why Caffeine Won’t Sober Up An Alcoholic

Excessive alcohol consumption poses a risk to ones health. Discover how caffeine has no effect on recovery.

It is not uncommon for someone who spent the evening drinking heavily to settle for a cup of coffee in an attempt to sober up. This is based on folk belief that the stimulating effects of caffeine will counteract the lethargic and drowsy effects of alcohol. Alcohol and caffeine have opposite effects on the central nervous system - while alcohol is depressant, caffeine is a stimulant. While the understanding of the effect alcohol and caffeine have on the body is correct, the belief that one cancels out the effect of the other and that an interaction of the two is beneficial is incorrect and misguided.

Drinking caffeine after a night out will not help someone sober up. Sobering up requires the lowering of the level of alcohol in one’s blood stream. Caffeine and other substances cannot lower blood alcohol level, what they do is make the person feel more alert. In order for the alcohol to leave the blood stream, it either has to work its way out through absorption or excretion. Thus, with caffeine and alcohol in the blood stream, the person will be more alert but still be impaired and not have gained control over coordination or psychomotor activity. The alertness that caffeine provides can make people feel like they have sobered up and give them the incentive to do certain things they should not do when drunk. For example, this false sense of alertness and wakefulness will make someone feel that they are sober enough to drive.

Caffeine, on its own, has bad effects on people with certain diseases, such as diabetes and heart conditions. Those with heart conditions should be especially careful when mixing caffeine and alcohol. Both caffeine and alcohol increase heart rate and when taken together, the effect is greater than either one taken alone. Cardiac arrhythmia, meaning irregular heart beats, can result and for people with damaged or weak hearts, the effects can be extremely dangerous.

Various studies have examined the relationship between alcohol and caffeine and found that caffeine does not help a drunk person become sober.

A study in Finland had volunteers drink coffee after becoming drunk. The volunteers were then tested on various motor skills and observed to see if their personality changes. No significant changes were found and they concluded that caffeine and alcohol do not cancel out or enhance each other’s effect. A second study repeated the tests conducted in Finland and corroborated the findings of the Finnish study. This study used volunteers in the United States and tested the manual dexterity, reasoning, reaction times and verbal fluency of volunteers who first ingested alcohol and then caffeine.

Another study tested intoxicated mice. Once intoxicated, the mice were given caffeine and it was found that alcohol and caffeine aletered the metabolism of brain catecholamines but that caffeine does not reverse the effects of alcohol.

Another study found that while caffeine does not alter the effects of alcohol on the body, the presence of both substances in the body makes it difficult to eliminate caffeine. It appears that the substances interact to affect the absorption and metabolism functions of the body, leading to higher levels of caffeine in the blood stream and by default, long lasting effects of caffeine on the central nervous system.

None of the scientific studies found that caffeine reverses the effects of alcohol. Instead, the interaction of the two simply serves to slightly alter the way the body carries out certain activities.

For more information visit www.Truthaboutcaffeine.com or www.CaffeineAnonymous.org

source: buzzle.com

Buprenorphine Addiction

Buprenorphine Addiction Treatment Wonder Medication

By Olasimbo Olanusi, MD, FASAM

Opioid dependence is a result of negative neuron-adaptive changes induced in the brain, which leads to drug-taking behavior.

• An estimated 3.1 million Americans 12 years and older have used heroin at some time in their lives.
• A new generation of heroin abusers is emerging in America; these are teenagers who snort heroin for its "high" effects rather than inject it.
• An estimated 4.4 million people abuse prescription opiate medication.

Buprenorphine is a derivative of thebaine alkaloid extracted from opium poppy (papaver somniferum). The medication was approved in 2000 by the Drug Addiction Treament Act {DATA} as another alternative to methadone in treating heroin and opiate addiction. It includes, but is not limited to, Vicodin, Percocet, Oxycontin, morphine, Demerol and codeine.
Q: Do people have to go to a special clinic, like methadone, to obtain buprenorphine?
A: Buprenorphine is the first medication for opioid addiction treatment that can be dispensed by physicians in an office based setting.

Q: Will buprenorphine replace methadone as a treatment option for opioid addiction?
A: Methadone clinics will continue to play a vital role in treating opioid addiction. However methadone therapy is only able to treat one fifth of the estimated one million Americans who are dependent on opiates. Office-based treatment with buprenorphine will help fill this treatment gap by making more treatment options available to the remaining opiate-addicted individuals not being treated. The medication will also expand treatment opportunities for those opioid dependent people who have avoided methadone clinics because of the stigma associated with them.

Q: In what type of drug formulation is buprenorphine made available?
A: Buprenorphine is available in tablet form which is present in two preparations.

• Subutex: This contains only buprenorphine prescribed for patient in early stage of treatment
• Suboxone: This is a combination of buprenorphine and naloxone which are given to patients later on in their treatment once they are on stable dose of buprenorphine.

Q: What is the route of administration of buprenorphine?
A: Buprenorphine medications are placed under the tongue and absorbed through the veins lying under the tongue.

Q: Why can't I swallow buprenorphine like other medications?
A: It is poorly absorbed into the body when swallowed.

Q: What is the mechanism of action of buprenorphine?
A: Buprenorphine addresses the neurobiological basis of dependence by acting as a partial opioid receptor agonist. It blocks heroin and other prescription opiate effects, reducing the craving for these medications and prevents their unpleasant withdrawal effects.

Q: How safe is buprenorphine medication?
A: As a partial agonist, its profile of effects including respiratory depression, physical dependence, euphoria and constipation are less risky than other opioid full agonists, which include but not limited to morphine, heroin, codeine, and fentanyl.

Q: Is it possible to abuse buprenorphine medication?
A: When buprenorphine is used as prescribed, by placing it under the tongue, it produces less stimulation and physical dependence than full agonist medications like methadone. The "high" effect of buprenorphine peaks at a lower level in comparison with methadone and other full agonist medications, no matter how much of buprenorphine is used, thereby reducing its abuse potential.
There were reports of misuse of buprenorphine when injected into the body in Europe. To circumvent the illicit diversion of the medication it is combined with naloxone, an opioid antagonist. As long as the medication is used as prescribed by placing it under the tongue only buprenorphine will be absorbed. However, crushing the tablet and injecting it into the body causes the absorption of naloxone into the body, which will trigger a precipitated withdrawal effect and the person becomes very sick.

Q: How do I find physicians who are trained to prescribe buprenorphine?
A: The lists of the physicians are on line at the physician locator on the website at www.buprenorphine.samhsa.gov.

Q: What do I expect during my office visit to the physician for buprenorphine treatment?
A: The treatment of buprenorphine is divided into the different stages listed below.

1. Intake: This involves a comprehensive substance dependence assessment, mental status and physical examination. You also receive medication education about buprenorphine. The intake is to evaluate if one is appropriate for buprenorphine treatment.
2. Induction: You are expected to have ceased taking your current street drug or prescribed opiate medication and arrive in the physician's office experiencing withdrawal symptoms. Arrangements will be made for you to receive your first dose of buprenorphine in your doctor's office. You will then be monitored for a couple of hours by your physician. An additional dose of medication may be given to you to reduce withdrawal symptoms. You may have to visit your physician more frequently to monitor your tolerance reactions and adjust the dose of your buprenorphine until you no longer experience withdrawal symptoms and cravings.
3. Stabilization: This is the period that your buprenorphine dose is established and you no longer experience cravings or withdrawal symptoms.
4. Maintenance: Treatment compliance and progress will be monitored continuously during this phase which may last from weeks to years depending on the need of the patient.
5. Detoxification: Depending on your progress, a joint decision may be made between you and your physician to taper you off your buprenorphine over a period of time.

Q: What are people's experiences with buprenorphine treatment?
A: "Bup" as fondly called by people who have regained their life back from opioid addiction, is described as the best thing that ever happened to them.

Q: What is the most common myth surrounding opioid addiction?
A: That it only happens in inner city areas. The truth is opioid addiction cuts across all socioeconomic class and geographical boundaries. The disease of addiction is no respecter of persons.

Q: What happens if I take illicit opioid or prescribed opiate first and then use buprenorphine afterwards?
A: There may be occurrence of precipitated withdrawal which may cause the person to become sick.

Q: What are the common side effects of buprenorphine?
A: The common side effects include nausea, headache, constipation, body ache and pain. These profiles of side effects usually subside during the first few weeks of starting the treatment.

Q: What are the benefits of buprenorphine treatment?
A: The medication serves as another alternative for managing opioid addiction with easier access to the treatment providers.

• Continuity of their health care needs from familiar physicians
• Decreased criminal tendencies
• Ability to have better control of one's time and live a normal lifestyle.
• Reduced drug use and increased chances of successful transition to a drug free lifestyle.
• Reduced drug related risks and fatalities that commonly includes HIV, hepatitis C, hepatitis B, drug induced homicidal and suicidal situations.
• Reduced stigma issues often associated with the treatment of opioid addiction.

Q: What are the barriers to buprenorphine treatment?
A: Bias about using medications to treat opioid addiction

• Lack of medication coverage by major insurance companies
• Low awareness of the medication
• Some physicians stay away from treating addictive disorders because they believe this group of patients could be unruly and disruptive.

Q: Do I need counseling for substance abuse while on buprenorphine?
A: Buprenorphine with counseling or attending peer support groups like AA/ NA increases the success rate of overcoming drug addiction. Buprenorphine is a safe medication that reduces cravings and potential for opioid addiction. Let us all embrace this medication as another effective recovery tool to help us eradicate the disease of opioid addiction within our society.

Source: http://www.recoverysolutionsmag.com