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Saturday, December 3, 2016

Addiction Treatment Covered By Cures Act

In this day and age, it seems a rare occasion when the White House Administration and Congress agree on something. But, when it does happen some good can come out of it. In the United States the push to de-stigmatize addiction and provide access to substance use disorder treatment services has become a top priority in the wake of the American opioid epidemic. With over 2 million people battling opioid use disorder, such efforts are of the utmost importance. Naturally, accomplishing such a goal is the farthest thing from an easy task.

Regardless of which side of the aisle one’s political sympathies lay, addiction has the power to wreak havoc. Which is why it is vital that lawmakers work together to create bipartisan solutions for the crisis. Greater access to addiction treatment is, and should be, the weapon of choice against the opioid epidemic. Yet, providing the necessary support requires billions of dollars in funding, something that has proved difficult to garner. It turns out that funding may be found in a comprehensive health bill that was approved in U, S House of Representatives this week.

The 21st Century Cures Act aims to strengthen existing mental health parity laws, ensuring that coverage providers treat mental illness the same way they would any other health condition, USA Today reports. What’s more, the bill calls for $1 billion in funding for addiction treatment and prevention over the next two-years. The White House supports the Cures Act, stating:

“The resources included in the bill will allow states to expand access to treatment to help individuals seeking help to find it and to start the road to recovery, with preference given to states with an incidence or prevalence of opioid use disorders that is substantially higher relative to other states.”

The Cures Act, which will now move on to the Senate for approval, may end up picking up the slack of the Comprehensive Addiction and Recovery Act of 2016 (CARA). If you have been following the news, you may be aware that while CARA was written to specifically address the American opioid epidemic, it was severely underfunded to ensure that it met its goals. With the addition of the Cures Act, funding a widespread expansion in addiction treatment may be possible.

Tuesday, November 15, 2016

Stress and Heavy Drinking

At the end of a stressful day, many adults will imbibe to blow off some steam. It is a practice that millions of Americans engage in every day. Did you ever wonder why people turn to alcohol to cope with stress? Sure alcohol may cause euphoria which does in fact take your mind off of your problems, but there is more at play than meets the eye. There are other mechanisms operating that explain why people who are stressed tend to drink more, a coping mechanism that can be both habit forming and harmful to one's health.

Research has shown that stress weakens the alcohol-induced dopamine response in rats, ScienceDaily reports. Researchers at the department of Neuroscience in the Perelman School of Medicine at the University of Pennsylvania observed that rodents exposed to stress voluntarily drank more alcohol compared to controls. The research team, led by John Dani, PhD, believe that the findings could lead to a better understanding of post-traumatic stress disorder (PTSD) and more effective treatments.

Stress alters neural circuitry, “addictive drugs use those mechanisms and trick our brains to keep us coming back for more," said Dani. When the rodents exposed to stress were given a chemical called CLP290, it corrected the stress-altered circuitry, it stopped stress from causing increased drinking behavior.

People with PTSD are far more likely to use drugs and alcohol, than those who are not afflicted. The symptoms of the disorder can be severe, and mind altering substances can mitigate such symptoms for a time. However, in the long run, one needs more and more of a drug or drink to cope, both leading to addiction and worsened PTSD symptoms. Blocking the effect that stress has on the circuitry of the brain's reward system, could have a huge impact.

"This line of research has implications for people with PTSD who have an increased risk for over-use of alcohol and drugs," Dani said.

The research was published in Neuron.

Wednesday, November 2, 2016

Substance Use and Schizophrenia

There has long been a recognized association between marijuana and schizophrenia, in part due to studies which have attempted to link the two. The causal relationship between drug use and mental illness has been a subject for debate for eons. While many people who abuse mind altering substances have co-occurring mental health disorders, there is evidence which suggests that some mental health disorders may actually be caused by the use of drugs or alcohol.

It goes without saying, it is a difficult task to determine whether or not someone developed a mental health problem by using drugs and/or alcohol, or the drugs and alcohol actually caused the mental health disorder. There has been a large amount of research to determine the link, if one exists, between substance use and the risk of developing psychiatric disorders. At times, such research has been both controversial and contradictory, which is why a team of researchers in Denmark put themselves to the task of making sense of the possible link, MNT reports. The findings were published in The Lancet.

Unsurprisingly, the researchers found that substance abuse of any kind heightened the risk of developing schizophrenia, according to the article. Below you can find a breakdown of the increased risks:
  • Cannabis (5.2 times greater risk)
  • Alcohol (3.4 times)
  • Hallucinogens (1.9 times)
  • Sedatives (1.7 times)
  • Amphetamines: 1.24 times
  • Other substances (2.8 times)
The researchers came to their findings by looking at data from 3,133,968 individuals born in Denmark between 1955-1999, the article reports. The researchers write:

"We present a large scaled population-based cohort study analyzing a wide variety of substances. Our results illustrate a robust association between almost any type of substance abuse and an increased risk of developing schizophrenia later in life." 

While the findings were insightful, the researchers believe that it may be “impossible to prove whether the abuse caused the schizophrenia or vice versa.”

Tuesday, October 18, 2016

Drug Abuse Arrests in 2015

Addiction is a mental illness. A condition with a set of criteria delineated in the Diagnostic and Statistical Manual of Mental Disorders (DSM-V). While there is no cure for the disease, one which take tens of thousands of American lives every year, with treatment and continued maintenance people can and do recover.

The United States has been waging a “war on drugs” since the 1970’s. Millions of people’s lives have been devastated by the enactment of draconian drug sentencing laws. Legislation which does little, if anything, to address the problem of addiction. It would be nice to think that people who serve time for drug related offenses, will come through on the other side reformed and dead set on not repeating the same mistakes. Unfortunately, that is far from the case. The vast majority of people who go to prison or jail for drug use related offenses, end up being incarcerated in the future for a similar offense.

It is little secret that the U.S. has been in the grips of an opioid use epidemic. Between prescription opioids and heroin, there are over 2 million Americans who meet the criteria for an opioid use disorder. Naturally, our prisons and jails are already overpopulated with nonviolent drug offenders. There simply is not room, nor would it do any good to try to imprison the millions of opioid addicts. That does not mean that law enforcement agencies will not try, despite the call from many lawmakers to offer treatment over jail.

The President, politicians on both sides of the aisle and addiction experts all agree that we can no longer delude ourselves into thinking that the war on drugs is a fight that can be won. They understand that treatment is the best weapon against addiction. You might think that the more enlightened stance on addiction would result in fewer arrests for nonviolent drug offenses, yet that is far from the case. In fact, many states still lock up people every day for drug crimes.

The Federal Bureau of Investigation (FBI) recently released a report that showed there were nearly 1.5 million arrests for drug abuse in 2015, Newsweek reports. The majority of the arrests were for simple possession of drugs, primarily marijuana. Below is a breakdown of the arrests:
  • Marijuana (38.6 percent or 574,641 people)
  • Heroin / Cocaine (19.9 percent or 296,252 people). 
  • Possession of Other Dangerous Non-Narcotics (20.2 percent)
  • Synthetic Drugs (5.1 percent)

Tuesday, October 4, 2016

Experimental Drug Could Help Alcoholics

There are a couple of medications available that have shown promise with regard to reducing alcohol cravings and the symptoms of alcohol withdrawal, Vivitrol (naltrexone) and Acamprosate. While these medications are commonly prescribed in addiction treatment settings, the majority of alcoholics never see the inside of such facilities. Since those types of drugs are considered to be under-utilized, a significant number of people with alcohol use disorder who could benefit from such medications rarely are offered the drugs by their primary care physician.

Acamprosate, with some individuals, has been found to mitigate the symptoms that typically accompany post-acute alcohol withdrawal, such as insomnia, anxiety and restlessness. All three of those symptoms have lead people to consider, or worse actually, relapse. Which is why public health officials are encouraging doctors to utilize alcohol use disorder medications, as it may give certain patients a better chance at prolonged recovery, NPR reports.

“They’re very safe medications, and they’ve shown efficacy,” said George Koob, Director of the National Institute of Alcohol Abuse and Alcoholism. 

Alcoholism plagues millions of people around the globe every year. It practically goes without saying that “booze” is pervasive, people are exposed to practically everywhere. Being one of the reasons that relapse rates are so high, external triggers are everywhere. It is unfortunate that there isn’t a plethora of medication options available for the treatment of alcohol use disorder. But, fortunately researchers continue to work on new drugs that could help people abstain from drinking.

New research suggests that an experimental drug, ABT-436, could be a promising aid for people with alcohol use disorder who experience high levels of stress, according to Live Science. On average, participants in the study who were given ABT-436 were able to abstain for 51 days, compared to 42 days in the placebo group. The findings were published in the journal Neuropsychopharmacology.

“Our findings suggest that potential future studies with drugs targeting vasopressin blockade should focus on populations of people with [alcohol use disorder] who also report high levels of stress,” study co-author Megan Ryan, a clinical project manager at the National Institute on Alcohol Abuse and Alcoholism (NIAAA).