Primary care clinicians and mental health providers face a particular set of challenges when treating individuals with chronic pain. These problems are compounded by concerns regarding medication efficacy and misuse, as well as a feeling among clinicians that they lack appropriate training. The Center for Disease Control & Prevention’s Guideline for Prescribing Opioids for Chronic Pain was published in March with the goal of improving communication “between providers and patients about the risks and benefits of opioid therapy for chronic pain…” The authors conclude the report with twelve recommendations, the first being to avoid using opioid therapy as the first line of treatment for chronic pain, as well as discussing the risks of long-term opioid therapy.
An investigative report finds that the over-prescription of ADHD drugs is causing “a trail of misuse, addiction, and death.” “At morgues in Florida, a bellwether state for drug abuse problems, overdose deaths involving amphetamines increased more than 450% between 2008 and 2014,” for example.
The US Drug Enforcement Agency (DEA) is moving to place Kratom, a southeast Asian plant often used in teas, on the schedule 1 banned substances list without public comment. There have been several reports of individuals using Kratom teas to successfully recover from addictions to prescription opioids and heroin.
For The Chronicle of Higher Education, David Schimke reports on how debate erupted at a substance abuse conference over whether or not addiction should be considered a disease. "Is there a biomarker that tells you that you have a disease? No. Is there a definitive set of circumstances? No," says Hugh Garavan, a professor of psychiatry at the University of Vermont. "There’s no biological test for it. We don’t have a single medical test."
The use of antidepressants has increased substantially in recent years, yet relatively few studies have asked patients about their experiences with these drugs. A new study, published open-access this week, does just that. After interviewing 180 long-term users of antidepressants, the researchers found that while the majority reported an improvement in depression, many also experienced problems with withdrawal symptoms, and others said they “felt addicted.”
Neuroscientist and psychologist Marc Lewis, author of “The Biology of Desire: Why Addiction Is Not A Disease,” suggests in the Guardian that treating addiction as if it is a learned pattern of thinking, rather than a medical illness, gives addicts the chance to stay clean. “As a neuroscientist, I recognise that the brain changes with addiction, but I see those changes as an expression of ongoing plasticity in an organ designed to change with strong emotions and repeated experiences. Similar changes have been recorded when people fall in love, become obese, gamble compulsively, or overindulge on the internet,” Lewis writes. “And as a developmental psychologist (my other hat), I see addiction as an attitude or self-concept that grows and crystallises with experience, often initiated by difficulties in childhood or adolescence.”
A new study suggests that most people diagnosed with depressive, anxiety, and substance abuse disorders recover without treatment within a year of diagnosis. “This study further supports the argument that meeting diagnostic criteria for a mental disorder does not necessarily indicate a need for mental health treatment,” the researchers, led by Jitender Sareen from the University of Manitoba, write.
Historian Peter Frankopan delves into the use of drugs to fuel combat “from berserkers to jihadis.” “Of the US pilots who took part in Operation Desert Storm in 1991, 65 percent used stimulants, with just over half reporting that they were either beneficial or essential to operations,” he writes. “Not all experiences proved positive. Serious side-effects can include confusion and psychosis.”
For The Influence, addiction expert Stanton Peele criticizes our current genetic and biological “brain disease” approaches to addiction and mental health.
In the Room for Debate section of this weekend's New York Times, specialists in ethics, psychiatry, social work, addiction, and human rights hash out their opinions on the state of inpatient psychiatric treatment.
A new LA Times investigation finds that Purdue Pharma’s claims that OxyContin, a chemical cousin of heroin, could relieve pain for twelve hours led some patients to experience excruciating withdrawal, including intense craving for the drug. “Purdue has known about the problem for decades,” the investigators write. “Even before OxyContin went on the market, clinical trials showed many patients weren’t getting 12 hours of relief.”
"During the Vietnam War, the U.S. military plied its servicemen with speed, steroids, and painkillers to help them handle extended combat,” Lukasz Kamienski writes for The Atlantic. Vietnam was the first “pharmacological war” and the level of consumption of psychoactive substances by soldiers was unprecedented in American history.
A new study published in the journal Neuroscience finds that rats given regular doses of amphetamines during adolescence have brain and behavioral changes in adulthood. When translated into humans, this study suggests that young people using amphetamines may have changes in memory and attention well into their thirties.
New research published in JAMA Pediatrics reveals that transgender women have more than double the prevalence of psychiatric diagnoses than the general US population. The study found that the women, who had been assigned male at birth and now identified as female, had a high prevalence of suicidality, post-traumatic stress disorder, substance abuse, generalized anxiety and major depressive disorder.
For AlterNet, Evelyn Pringle and Martha Rosenberg reveal how addiction psychiatry is becoming big business. Addiction is thought of “like often-cited diabetes and hypertensive heart disease, with the following logic: chronic conditions need chronic care and we have drugs that can treat those conditions.”
This week, the National Institute of Health (NIH) released a summary of new research on the effects of early childhood on substance abuse and unhealthy behaviors. “Thanks to more than three decades of research into what makes a young child able to cope with life’s inevitable stresses, we now have unique opportunities to intervene very early in life to prevent substance use disorders,” said NIDA Director Nora D. Volkow, M.D. “We now know that early intervention can set the stage for more positive self-regulation as children prepare for their school years.”
A study published in the journal Computers in Human Behavior found that addictions to mobile devices are linked to anxiety and depression in college students. "People who self-described as having really addictive style behaviors toward the Internet and cellphones scored much higher on depression and anxiety scales," according to the researchers.
Last year the British Medical Association (BMA) released a report on dependence and withdrawal from prescription drugs including benzodiazepines, z-drugs, opioids, and antidepressants. Now, in light of their findings, the BMA is commiting to changes to medical practice, policy, and research.
A woman in Texas attempted suicide while in the active group of a clinical trial for smoking-cassation drugs Chantix and Zyban, both known to exacerbate depression. An appeals court ruled Thursday that she is able to sue the University that admitted her into the study.
Mad In America contributor and prescription drug addiction reformer Barry Haslam has “taken his fight to the world stage by helping create an international awareness day.” The Oldham Evening Chronicle announces the founding of World Benzo Day, which “aims to highlight the plight of all patients worldwide who have become prescribed drug dependent addicts through no fault of their own, who are denied right of access to dedicated withdrawal clinics and after care, who are left to struggle off these drugs without support.”
Writing for Huffpost, medical doctor Lawrence Diller looks at the effects of the ever increasing diagnoses for ADHD and the addiction and abuse issues associated with Adderall. "I have had some dark times on this stuff," a student tells Dr. Diller. "Laying in my bed coming down every night, crying to myself, feeling more alone than ever. Pushing people away in my life. Severe depression. The list goes on. Never in my life would I have thought that I'd become addicted to this awful stuff, let alone any kind of drug. I've never been that kind of person - until now."
Plaintiffs allege that Bristol-Myers Squibb and Otsuka Pharmaceutical failed to warn doctors and patients about the risk for compulsive behaviors when taking the atypical antipsychotic Abilify.
Nora Volkow, the director of the National Institute on Drug Abuse (NIDA), authored an editorial for BMJ this month warning that the opioid abuse epidemic could have dangerous consequences for pregnant women. While the effects of opioid exposure on the developing brain are yet unknown, research suggests that infants may suffer from withdrawal syndrome, nervous system defects, and impaired attachment with the mother.
“The rising death rates for those young white adults, ages 25 to 34, make them the first generation since the Vietnam War years of the mid-1960s to experience higher death rates in early adulthood than the generation that preceded it,” the ‘Times reports.
Watch: “CBS News went to West Virginia, a state that is attempting a drastic solution: allowing addicts to sue the doctors who got them hooked.”
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