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Friday, May 1, 2015

Cocaine Users Altered Brain Function

The use of any mind altering substance has an impact on the brain. Understanding how certain drugs affect the brain may help researchers develop more effective treatments and drugs that may reduce the potential for relapse. A new study has found that the brain function of cocaine addicts is different from non-users, and is linked to highly impulsive behavior, Science Daily reports.

A joint study, conducted by researchers at The University of Texas Medical Branch at Galveston and Virginia Commonwealth University, who used functional magnetic resonance imaging (fMRI) determined the connections and direction of information flow between brain regions in both cocaine and non-cocaine users. They found that the brains of cocaine users differed from non-users regarding the strength of communication between key brain structures.

Currently, there are no FDA approved medications for the treatment of cocaine addiction, which affects an estimated 800,000 people in the U.S., according to the article. Disregarding negative consequences, cocaine addicts are often highly impulsive and prone to act rashly, which often leads to relapse among those attempting to recover from the disease. Finding ways to diminish impulsivity may lead to better success rates as the result of relapse prevention medications.

"These findings suggest that, while some cortical brain regions show altered activity in cocaine users, other regions may compensate for cocaine-associated deficits in function," said UTMB lead author Kathryn A. Cunningham, Chauncey Leake Distinguished Professor of Pharmacology and Director of the Center for Addiction Research. "Targeting altered brain connections in cocaine use disorder for therapeutic development is a fresh idea, offering a whole new arena for research and the potential to promote abstinence and prevent relapse in these vulnerable individuals."

The findings were published in NeuroImage: Clinical.

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Thursday, April 30, 2015

NAS Cases Have Almost Quadrupled

The prescription drug epidemic has had a far reaching effect on society, impacting millions of families - even the unborn. While it may seem like common knowledge that exposing developing babies to mind-altering substances is dangerous, there has been a dramatic rise in babies being born with opioids in their system, what’s known as Neonatal Abstinence Syndrome (NAS). In fact, new research has found that over the last ten years, babies treated for NAS has almost quadrupled, HealthDay reports. The research was conducted by the Baylor University Medical Center.

When mothers expose their fetuses to prescription opioids, dependence develops. After the baby is born their supply to the drugs is cut off - withdrawal ensues. If left untreated the results can be dire, doctors need to slowly taper the infant off the narcotics.

The researchers found that NAS affected only seven babies for every 1,000 admitted to a neonatal intensive care unit (NICU) in 2004. In 2013, 27 infants for every 1,000 babies in the NICU were treated for NAS. In the same year, eight centers with NICUs reported that more than 20 percent of days were spent caring for babies with NAS, according to the article.

A previous study found that almost 28 percent, of more than 112,000 pregnant women in Tennessee, used at least one prescription opioid, such as hydrocodone or oxycodone. The researchers found that mothers who smoked and/or used antidepressants increased their babies' risk of developing NAS.

"I was surprised by the number of women prescribed opioid pain relievers in pregnancy," said lead author Dr. Stephen Patrick, a neonatologist and assistant professor of pediatrics at Vanderbilt University in Nashville. "I was also surprised by how commonly women smoked in pregnancy, and how much that increased the risk of neonatal abstinence syndrome among those who also used opioid pain relievers in pregnancy."

The first study's findings were published in The New England Journal of Medicine.

The second study's findings were published in the journal Pediatrics.

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Thursday, April 23, 2015

Naltrexone Reduces Relapse Rates

One of the major problems with the “war on drugs” is the fact that incarceration is not substance use disorder treatment. Locking someone up for an extended period of time without addressing the addiction will almost certainly result in recidivism. A new study has found that giving the drug naltrexone (XR-NTX) to inmates incarcerated for opioid related offenses, resulted in a much lower rate of heroin relapse upon release, Forbes reports.

The study was conducted by researchers at NYU Langone Medical Center and involved 33 men who had been incarcerated by the New York City Department of Corrections. The researchers found that of those inmates given XR-NTX, only 38 percent relapsed after their release, compared to 88 percent among those not provided the medication.

“There has been a lot of interest in Vivitrol as post-incarceration relapse prevention, but not much actual data,” said lead investigator and associate professor of Population Health and Department of Medicine at NYU Langone, Joshua Lee, in a news release. “This randomized trial was designed to examine the impact of the medication on relapse to heroin in the first few weeks after release from jail, and it showed substantial benefits.”

Naltrexone comes in a pill form and an injection form sold under the brand name Vivitrol, according to the article. The drug blocks the effects of opioids on the brain, and prevents relapse by reducing:
  • Euphoria
  • Pain Relief
  • Sedation
  • Physical Dependence
  • Cravings
Lee, points out that “more research is needed to characterize the optimal time in treatment and rates of important post-treatment outcomes such as relapse once the medication is discontinued.”

“XR-NTX is still relatively new in the opioid treatment role and not yet widely used in most public sector community treatment programs,” Lee said. “Generic barriers to CJS[criminal justice system] expansion would include limited medical, psychiatric and addiction treatment services during incarceration, poorly developed links from incarceration to community treatment providers, and a lack of awareness or an institutional mission regarding post-release opioid relapse rates.”

The findings were published in the journal Addiction.

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Tuesday, April 21, 2015

Using Stimulants to get Ahead at Work

Amphetamine-based stimulants, prescribed for attention deficit hyperactivity disorder (ADHD), have long been a staple of many college student diets. The use of drugs like Adderall and Ritalin increase the user's energy levels and focus, giving a number of students the extra edge they need to get the job done. The majority of students using these drugs in college lack a prescription for such drugs, acquiring the drugs illicitly. The non-prescribed use of amphetamine-based stimulants begs the question, is the use of these types of drugs unique to college students and do college users stop after completing their studies?

While there is limited data on the subject, experts say that there is a growing number of people using these types of drugs for work, The New York Times reports. Stimulant use gives workers a competitive edge, leading many to feign ADHD symptoms in order to acquire prescriptions from the doctor.

Like all narcotic medications, prescription stimulants carry with them side effects, some of which can be detrimental to one’s quality of life. When taken in high doses, stimulants can cause anxiety, addiction and hallucinations. Some in the field of medicine are concerned that there is pressure in some workplaces to use stimulants to become more productive.

“You’d see addiction in students, but it was pretty rare to see it in an adult,” said Dr. Kimberly Dennis, the medical director of a substance-abuse treatment facility for women outside Chicago. “We are definitely seeing more than one year ago, more than two years ago, especially in the age range of 25 to 45,” she said.

“Given the increase in rates of abuse in college students over the last decade, it is essential that we understand the outcomes as they leave college and assume adult roles,” said Dr. Wilson Compton, the Deputy Director of the National Institute on Drug Abuse.

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Thursday, April 16, 2015

Homeless Shelters Struggle With Substance Abuse

Homelessness is a problem in every state in America, a demographic that is, perhaps, the most overlooked by both federal and state agencies. Sadly, homelessness is often a symptom of other problems, such as mental health and substance abuse issues. While some shelters focus on treating those issues on top of putting roofs over the heads of the countless homeless in America, the reality is that most homeless shelters are ill equipped to handle the load. In fact, many shelters turn away the homeless that show signs of alcohol and substance abuse.

A shelter in Manchester, Conn. recently closed down as opposed to accepting people using drugs and alcohol, NPR reports. More than half of the shelter's budget was funded by the state, but a rule that links funding to the admission of people using drugs or alcohol put the shelter in a tight spot. The shelter argues that it does not have the manpower to both house the homeless and look after lose abusing drugs and alcohol.

The Manchester Area Conference of Churches (MACC) executive director, Beth Stafford, told The Hartford Courant:

"Other than in periods of extreme cold or heat, the longtime policy at the Manchester shelter has been to deny admission to people who are drinking and using drugs. MACC Charities and other 'dry' shelters use Breathalyzer tests to screen people."

"The organization lacks the staff and funding to supervise active alcohol- and drug-abusers overnight, Stafford said, and there are concerns about the safety of the two people — a staff member and a volunteer — who manage the place each night."

Clearly, the closing of the Connecticut shelter is a sign of a much bigger problem that needs to be addressed. In most cases current funding is too low to provide both shelter and substance use disorder treatment to the homeless. The U.S. Interagency Council on Homelessness estimates that nearly half of all the homeless, and 70 percent of Veterans experiencing homelessness, suffer from substance use disorders, according to the article.

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Tuesday, April 14, 2015

The Risks of Using Opioids While Pregnant

The use of any mind altering substance can have serious affects on a fetus, leading to a host of birth defects such as fetal alcohol spectrum disorder. With the ever growing opioid crisis in America, more and more babies are being born that show signs of opioid exposure. New research indicates that women who use prescription opioids during pregnancy increase the risk that the baby will be born small or early, HealthDay reports. The babies are also more likely to go through drug withdrawal, known as neonatal abstinence syndrome.

A study of more than 112,000 pregnant women in Tennessee showed that almost 28 percent used at least one prescription opioid during the duration of their pregnancy, according to the article. What’s more, the researchers found 65 percent of mothers, who had babies with neonatal abstinence syndrome, legally filled prescriptions for opioid painkillers.

“Historically, drug withdrawal for newborns has been described among illicit drug use such as heroin or women treated for previous opioid abuse, but this is really one of the first studies to look at legal prescriptions for pregnant women,” lead author Dr. Stephen Patrick of Vanderbilt University in Nashville said in a news release.

"I was surprised by the number of women prescribed opioid pain relievers in pregnancy," said Patrick, a neonatologist and assistant professor of pediatrics at Vanderbilt University in Nashville. "I was also surprised by how commonly women smoked in pregnancy, and how much that increased the risk of neonatal abstinence syndrome among those who also used opioid pain relievers in pregnancy."

The study found 42 percent of the women prescribed opioids smoked during pregnancy, compared with 26 percent of the women not prescribed opioids, according to the report. Women who were prescribed selective serotonin reuptake inhibitors (SSRI) antidepressants along with prescription opioids also doubled the risk of the syndrome.

“Infants with neonatal abstinence syndrome have longer, more complicated birth hospitalizations,” Patrick said. However, there are instances when women need to continue using opioids throughout the pregnancy.

"Some women need to take opioids in pregnancy to improve their infant's outcome," Patrick said. "For women with opioid dependency, we know that use of maintenance opioids like methadone decrease rates of preterm birth compared to heroin. For these women, neonatal abstinence syndrome may occur in their infants, but it is much better than the alternative, which is preterm birth."

The findings were published in Pediatrics.

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Thursday, April 9, 2015

Seattle Drug Diversion Program Shows Promise

In the United States the majority of people behind bars are there because of drug charges. The unfortunate reality is that many who are released from prison often find their way back, indicating that incarceration is not the answer to addiction. In 2011, the city of Seattle launched a program called Law Enforcement Assisted Diversion (LEAD), with the goal of keeping addicts out of jail, the Associated Press reports. Instead, offenders were offered housing, counseling, and job training.

A new study conducted by the University of Washington found that 60 percent of participants were less likely to be arrested than a control group. The findings prove that prison and jails are only a minor deterrent in combating addiction in the United States. Advocates of the program are calling upon the president for an expansion of drug court programs and copy the Seattle program nationwide, according to the article.

"This is a big deal — bigger reductions than are seen in almost any criminal justice interventions," wrote Lisa Daugaard, policy director at King County's Public Defender Association. "This makes the case for 'system as usual' processing (even with drug courts) very weak."

The problem with most drug court programs throughout the country is their strict rules regarding relapse. They do not take into consideration just how powerful addiction is; threatening jail time to an addict if they relapse is not always a big enough deterrent. Which is why the Seattle program takes a different approach, participants aren't threatened with jail time or with being kicked out if they relapse. Without the fear of messing up here and there, addicts are able to focus on their recovery and putting the pieces of their life back together.

The study found that between October 2011 and July 2014, Seattle police assisted 203 people enroll in LEAD, the article reports. Instead of sending them to jail they were given case managers and provided with:

  • Motel Rooms
  • Groceries
  • Clothing
  • Drug Treatment
  • Job Training

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