Behavioral Health and Substance Dependence

Chronic Cocaine Use Rewires the Brain

Tue, 22 May 2012 15:53:00 GMT

By Janice Wood
The chronic use of cocaine can lead to structural changes in the brain that make the user more susceptible to addiction. Researchers at the University of Buffalo and Mount Sinai School of Medicine found that chronic cocaine use reduces the expression of a protein known to regulate brain plasticity in mice, which drives structural changes in the brain, including creating greater sensitivity to the rewarding effects of the drug.

“We found that chronic cocaine exposure in mice led to a decrease in this protein’s signaling,” says David Dietz, Ph.D., assistant professor of pharmacology and toxicology in the School of Medicine and Biomedical Sciences.

“The reduction of the expression of the protein, called Rac1, then set in motion a cascade of events involved in structural plasticity of the brain — the shape and growth of neuronal processes in the brain. Among the most important of these events is the large increase in the number of physical protrusions or spines that grow out from the neurons in the reward center of the brain. This suggests that Rac1 may control how exposure to drugs of abuse, like cocaine, may rewire the brain in a way that makes an individual more susceptible to the addicted state.”

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Opioid Abuse a Big Problem for Utah

Tue, 22 May 2012 15:53:00 GMT

By Shara Park
Chances are you or someone you know is being affected by prescription drug abuse. Hundreds of Utahns die each year from prescription drug overdose, and some of them are children who are too young to even know what they're getting into.

Prescription pain medications are the most frequently abused substances in the state. And it's the addicting power of opioids, found in prescriptions like OxyContin and Lortab that takes even the youngest users down a dark and sometimes unforgiving path.

Angela Watson cherishes the mementos and memories of her son Connor. He died last year of a prescription drug overdose. He was 13.

Connor discovered oxycodone while playing at a friend's house. It was left on a counter with other medications. The night he died, he texted a friend saying he was taking a couple pills.

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Kids Most Likely to Start Abusing Painkillers at 16: Study

Tue, 22 May 2012 15:53:00 GMT

Prevention efforts that begin later are 'too little, too late,' researchers say

By Alan Mozes; HealthDay Reporter
Among U.S. adolescents, misuse of prescription painkillers peaks at age 16, earlier than thought, a new large survey analysis reveals.

"What our findings suggest is that if we wait until the last year of high school or college to take some kind of action that could prevent the misuse of opioid painkillers, it'll be a case of too little, too late," cautioned study co-author James Anthony, a professor of epidemiology and biostatistics in the department of epidemiology and biostatistics at Michigan State University in East Lansing.

Many experts consider "extramedical" painkiller abuse -- taking pain drugs such as OxyContin (oxycodone) and Vicodin (hydrocodone) to get high rather than to relieve extreme pain -- the country's most serious drug challenge. Some kids had already misused these drugs by age 13 or 14, or eighth grade, the researchers found.

Anthony and his colleagues discuss their work, co-funded by the university and the U.S. National Institute on Drug Abuse, in the May 7 online edition of the Archives of Pediatrics & Adolescent Medicine.

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Five Signs a Loved One is Abusing Painkillers

Tue, 22 May 2012 15:54:00 GMT

By HeathPop Staff
Abusing painkillers is a big problem in the U.S. - about 12 million people said they used painkillers for non-medical reasons in the past year, according to recent CDC estimates.

A new study found rates of newborns born addicted to opiate drugs tripled over the past decade, driven by legal and illegal use of opioids like hydrocodone and oxycodone, CBS News reported. The number of newborns with withdrawal symptoms increased from a little more than 1 per 1,000 babies in 2000 to more than 3 per 1,000 in 2009, according to the study.

Opioid addiction is a chronic medical condition caused in part by brain changes that can result from regularly using drugs such as oxycodone, codeine, hydrocodone and morphine. Opioid dependence is even considered a chronic brain disease by the American Society for Addiction Medicine and the National Institute on Drug Abuse and left untreated, can be fatal.

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High Cost of Cutting Mental Health

Tue, 22 May 2012 15:54:00 GMT

By Ratan Bhavnani
Ratan Bhavnani of Newbury Park is executive director of NAMI Ventura County, the local affiliate of the National Alliance on Mental Illness.

Tough times require tough choices.

We hear this phrase often during the state's budget debate, but legislators need to be reminded that budget cuts can sometimes be penny-wise but pound-foolish.

For example, we know there is a high cost to cutting mental health.

When mental health is cut, burdens only get shifted elsewhere — to emergency rooms, hospitals, schools, police and local courts. Businesses lose productivity. Families are broken. People end up living on the street or dead.

Since economic distress began in 2008, the need for mental health services increased, but California continued to cut funding between 2009 and 2012 by $765 million or 21 percent. And now the Republican budget plan includes, among other proposals, a $1.3 billion diversion of voter-approved Mental Health Services Act funds to help balance the state budget.

Throughout the United States, the month of May is observed as Mental Health Awareness Month. During this month, doctors, counselors and the families of those with mental illness work together to raise awareness of known mental disorders.

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Daybreak - The Medical Benefits of Healthy Living

Tue, 22 May 2012 15:54:00 GMT

By Mike Stobbe
A cancer diagnosis often inspires people to exercise and eat healthier. Now the experts say there’s strong evidence that both habits may help prevent the disease from coming back.

New guidelines issued Thursday by the American Cancer Society urge doctors to talk to their cancer patients about eating right, exercising and slimming down if they’re too heavy.

That’s not something most doctors do, said Dr. Omer Kucuk, an Emory University oncologist who has researched the effect of nutrition on prostate cancer. They’re focused on surgery, chemotherapy or other treatments for their patients, he added.

“Usually the last thing on their mind is to talk about diet and exercise,” Kucuk said.

Cancer society officials have long encouraged healthy eating and exercise as a way to prevent certain cancers. They and others have tried to spread that gospel to cancer survivors as well. Indeed, the cancer society has a certification program for fitness professionals who work with cancer survivors. But until now, the group didn’t think there was enough research to support a strong statement for cancer survivors.

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The Simple Idea That Is Transforming Health Care

Tue, 22 May 2012 15:55:00 GMT

A focus on quality of life helps medical providers see the big picture—and makes for healthier, happier patients

By Laura Landro
A very simple question is changing the delivery of medical care:

How is your health affecting your quality of life?

For decades, numbers drove the treatment of diseases like asthma, heart disease, diabetes, and arthritis. Public-health officials focused on reducing mortality rates and hitting targets like blood-sugar levels for people with diabetes or cholesterol levels for those with heart disease.

Doctors, of course, are still monitoring such numbers. But now health-care providers are also adding a whole different, more subjective measure—how people feel about their condition and overall well-being. They're pushing for programs where nurses or trained counselors meet with people and ask personal questions like: Is your condition inhibiting your life? Is it making you less happy? Does it make it hard to cope day to day? Then the counselors offer advice about managing those problems and follow up regularly.

The logic is simple. People are more likely to manage their condition properly when they have more accessible, personal goals, like being able to do more at work or keep up with their kids, instead of focusing only on comparatively abstract targets like blood-sugar levels. And that, in turn, leads to much better health. Numerous studies show that when people have a higher sense of well-being, they have fewer hospitalizations and emergency-room visits, miss fewer days of work and use less medication. They're also more productive at work and more engaged in the community.

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More In-Hospital Deaths in MI Patients With Diabetes

Tue, 22 May 2012 15:55:00 GMT

By Bruce Jancin, Family Practice News Digital Network
CHICAGO – Acute myocardial infarction patients who have diabetes are less likely to present with an ST-elevation MI, yet they run a significantly increased risk for in-hospital death, compared with nondiabetic MI patients.

Moreover, MI patients with diabetes are more likely to experience in-hospital stroke, recurrent MI, and heart failure or pulmonary edema, according to Dr. Quang T. Bui of Harbor-UCLA Medical Center, Los Angeles.

Dr. Bui presented an analysis of 232,927 patients presenting with acute MI to 823 hospitals participating in the National Registry of Myocardial Infarction (NRMI) 4-5. A history of diabetes was noted in 31%.

The in-hospital mortality rate was 10.1% in diabetic patients and 8.3% in nondiabetic patients. In-hospital strokes occurred in 1.4% of diabetics compared with 1.0% of nondiabetic patients. The in-hospital rate of recurrent MI was 1.5% in the diabetic patients and 1.3% in those without diabetes.

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Teen’s loss: ‘I miss him so much’

Tue, 22 May 2012 15:56:00 GMT

By Deanna Pan

Something was wrong with Cole.

On a Saturday afternoon in mid-February 2011, Danielle Smoot walked into her 16-year-old son’s bedroom and found him curled under his New England Patriots bedspread.

Cole was a kid who could sleep until dinnertime if he wanted, but with school Monday through Friday, wrestling meets on Saturdays and church on Sundays, he hadn’t had much opportunity for that since winter break.

But this wasn’t teenage lethargy.

A foot peaking from beneath the comforter was mottled purple and beige, like human marble. His lips were blue; his face ashen.

Danielle reached for his neck, fumbling for a pulse.

Nothing.

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A 'systemic suicide': mental illness' stigma major roadblock to getting help

Tue, 22 May 2012 15:56:00 GMT

By Bobby Magill
For Susan Barnes, having her son slip away from her for eight long years was like watching a slow death.

“I knew it was coming,” she said. “As if it was somebody who had Alzheimer’s or Parkinson’s, it was coming, and I saw it.”

Susan’s son, Alex Barnes, first showed signs of schizophrenia when he was 16. On March 12, after receiving periodic treatment for years, he parked his bike on the shoulder of Mason Street, knelt down beside a slow-moving freight train and ended his life beneath a box car. He was 24.

Alex’s death was one of the 20 suicides Larimer County has seen so far in 2012 — a year on pace to break a record in the county, which saw 62 suicide deaths in 2011.

Susan Barnes said she wants to speak out as a way to call attention to a need for greater funding for mental health services in Larimer County and to help erase the stigma surrounding mental illness.

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Veterans With PTSD at Increased Risk for Receiving, Abusing Opioids, Study Finds

Tue, 22 May 2012 15:56:00 GMT

FPs Can Play Key Role in Treating These Patients

By Matt Brown
U.S. veterans suffering from posttraumatic stress disorder (PTSD) have a new battle waiting for them when they return home, but family physicians are well-positioned to aid them in the fight.

A recent study (abstract) in JAMA: the Journal of the American Medical Association, investigated the effect of mental health disorders, such as PTSD, on the risks and adverse clinical outcomes associated with prescription opioid use. The study concluded that soldiers returning from Iraq and Afghanistan who have such mental health diagnoses, particularly PTSD, are at an "increased risk of receiving opioids for pain, high-risk opioid use and adverse clinical outcomes."

According to the study authors, returning combat veterans likely will be visiting primary care physicians in large numbers, and extra care should be taken when prescribing opioids to relieve physical symptoms.

"These patients may benefit from biopsychosocial models of pain care, including evidence-based nonpharmacologic therapies and nonopioid analgesics," the authors wrote. "Integrated treatments that target both mental health disorders and pain simultaneously are effective for both problems and may decrease harms resulting from opioid therapy."

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Evidence Mounts for Link Between Opioids and Cancer Growth

Tue, 22 May 2012 15:56:00 GMT

Provided by University of Chicago Medical Center
Opioid drugs used to relieve pain in postoperative and chronic cancer patients may stimulate the growth and spread of tumors, according to two studies and a commentary in the 2012 annual Journal Symposium issue of Anesthesiology, the academic journal of the American Society of Anesthesiologists.

"Epidemiologic findings suggest that the type of anesthesia we do for cancer surgery influences recurrence rate, and laboratory studies demonstrate that opioids influence tumor progression and metastasis," said Jonathan Moss, MD, PhD, professor of anesthesiology and critical care at the University of Chicago Medicine and co-author of the commentary, a summary of research on the topic. "These studies have caused anesthesiologists to re-evaluate how best to do anesthesia and pain control for cancer patients."

New studies provide new clues

Opioid-based painkillers, such as morphine, have been the gold standard for treatment of postoperative and chronic cancer pain for 200 years. Several studies published since 2002, however, suggest that opioids can stimulate the growth and spread of cancer cells. Laboratory research from the University of Chicago Medicine and a genetic study from the University of North Carolina Medical Center both argue that the mu opioid receptor plays an important role in tumor progression and support a therapeutic role for opioid antagonists.

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The Mental Health Gender Gap: Women Far Exceed Men in their Use of Psychotropic Medications as Utilization Increases Among Both Sexes

Tue, 22 May 2012 15:57:00 GMT

More than One-in-Four Women take Medication to Treat a Mental Health Condition

WASHINGTON, March 19, 2012 /PRNewswire via COMTEX/ -- Women far outpace their male counterparts when it comes to the consumption of mental health medications, with 25 percent using at least one psychotropic drug as compared to 15 percent of men. These are findings from research by Medco Health Solutions, Inc. MHS +0.64% that were presented Saturday at the 2012 Women's Health Congress.

The study reviewed the pharmacy claims of more than two million insured Americans and assessed the use of antidepressants, antipsychotics, anti-anxiety medications and drugs to treat attention deficit hyperactivity disorder (ADHD) between 2001 and 2010.

"Some mental health medications such as antidepressants have historically been more widely used by women than men," said lead researcher, Dr. David Muzina, a psychiatrist and national practice leader of the Medco Neuroscience Therapeutic Resource Center®. "However, what is surprising is how many women are taking these medications and the substantial increase in the number of women on treatments that have traditionally not been heavily used by females, like ADHD drugs."

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Colorado Medical Community Tries to Slow Flood of Painkiller Misuse

Tue, 22 May 2012 15:57:00 GMT

By Michael Booth, The Denver Post
Deaths linked to prescription opioid use have doubled in 10 years in Colorado, and the steep increases in both legal use and dangerous abuse of painkillers are forcing the medical community to rethink the way it treats chronic pain.

Painkiller prescriptions written by the top 10 Medicaid prescribers for one popular drug, Roxicodone, shot up 46 percent last year, according to state records. Denver's Office of Drug Strategy found that prescriptions filled for oxycodone rose 58 percent from 2007 to 2011.

Nonmedical use of painkillers in Colorado is 19 percent higher than the national average, according to the Centers for Disease Control and Prevention. To illustrate the "epidemic" nature of opioid abuse, the CDC said enough of the painkillers were sold in 2010 to medicate every American adult with a typical 5-milligram dose of hydrocodone every four hours for a month.

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Study: Opioids After Minor Surgery Can Lead to Addiction

Tue, 22 May 2012 15:57:00 GMT

By Daniel Cook
Older patients who are prescribed opioids following ambulatory surgery are more likely to become addicted to the powerful painkillers, according to a study in the Archives of Internal Medicine.

Canadian researchers say about 10% of the nearly 28,000 patients, 66 years of age and older, who were given opioids within 7 days of cataract surgery, laparoscopic cholecystectomy, transurethral resection of the prostate or varicose vein stripping were identified as long-term opioid users at 1 year post-op.

The researchers note that patients who were prescribed opioids were 44% more likely to become long-term users than patients who didn't receive a prescription. Codeine and oxycodone were the most commonly prescribed opioids, say the researchers, who observed an increase in oxycodone use from about 5% to nearly 16% at 1 year post-op.

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