Publications - Substance Abuse and Addictions

Gaming addiction classified as mental health disorder by WHO, by Kate Kelland, Reuters, Jun 18 2018.

“Many parents already have concerns, but some may now have a new argument for limiting their children’s ‘screen time’ - addiction to video games has been recognised by World Health Organization as a mental health disorder. The WHO’s International Classification of Diseases (ICD), a reference bible of recognised and diagnosable diseases, describes addiction to digital and video gaming as “a pattern of persistent or recurrent gaming behaviour” that becomes so extensive it “takes precedence over other life interests”. ”

More Talking with Parents May Protect Kids Against Later Alcohol Misuse, by Janice Wood, Psych Central, May 5 2018.

“A new study has found that children with greater communication with their parents in early adolescence have less harmful alcohol use and emotional eating in young adulthood...Greater parent-child communication in early adolescence predicted greater connectivity of the ASN at age 25, supporting the idea that high-quality parenting is important for long-term brain development, according to the study’s findings. Greater ASN connectivity was, in turn, associated with lower harmful alcohol use and emotional eating at age 25. ”

A Drug to End Addiction? Scientists Are Working on It., by Clyde Haberman, New York Times, Apr 15 2018.

“Scrambling for ways to contain America’s out-of-control opioid crisis, some experts in the field are convinced that one bit of good advice is to just say no to the enduring “just say no” antidrug message. Addiction, they say, is not a question of free will or a correctable character flaw...Rather, it is an affliction of the brain that needs to be treated as one would any chronic illness...One possible approach, an experimental vaccine...intended principally for men and women already hooked on heroin or related opioids like Oxycodone and fentanyl — people who would be at risk of death should they detoxify and then relapse...would stop opioids by effectively blocking them from reaching the brain by way of the circulatory system. At the same time, it would not interfere with other treatments for addicts, like methadone and buprenorphine, or with a compound like naloxone that reverses overdoses. ”

Where marijuana is legal, opioid prescriptions fall, studies find, by Kate Sheridan, Stat News, Apr 2 2018.

“As more states legalize medical and recreational marijuana, doctors may be replacing opioid prescriptions with suggestions to visit a local marijuana dispensary...One of the two new studies found that people on Medicare filled 14 percent fewer prescriptions for opioids after medical marijuana laws were passed in their states. The second study found that Medicaid enrollees filled nearly 40 fewer opioid prescriptions per 1,000 people each year after their state passed any law making cannabis accessible — with greater drops seen in states that legalized both medical and recreational marijuana. ”

A Quiet Drug Problem Among the Elderly, by Paula Span, New York Times, Mar 16 2018.

“For years, geriatricians and researchers have sounded the alarm about the use of benzodiazepines among older adults. Often called “benzos,” the problem drugs include Valium (diazepam), Klonopin (clonazepam), Xanax (alprazolam) and Ativan (lorazepam). The cautions have had scant effect: Use of the drugs has risen among older people, even though they are particularly vulnerable to the drugs’ ill effects...Numbers from the Centers for Disease Control and Prevention tell the story: In 1999, it tallied just 63 benzodiazepine-related deaths among those aged 65 and older. Almost 29 percent also involved an opioid. By 2015, benzo deaths in that age group had jumped to 431, with more than two-thirds involving an opioid.  ”

Jump In Overdoses Shows Opioid Epidemic Has Worsened, by Rob Stein, NPR, Mar 6 2018.

“There's more bad news about the nation's devastating opioid epidemic. In just one year, overdoses from opioids jumped by about 30 percent, according to the a report released Tuesday by the Centers for Disease Control and Prevention. The overall increase in opioid overdoses seen in hospital emergency rooms between the third quarter of 2016 and 2017 occurred across the nation. Some parts of the country experienced far greater increases than others while a few reported declines, the analysis shows...'We saw, sadly, that in every region, in every age group of adults, in both men and women, overdoses from opioids are increasing,' Schuchat says. The latest data could underestimate the overdoses, since many people who overdose never end up in the emergency room. 'It might be even worse,' Schuchat says. ”

Opioids no better than NSAIDs for chronic back or arthritis pain, by Lisa Rapaport, Reuters, Mar 6 2018.

“Acetaminophen, ibuprofen and other nonsteroidal anti-inflammatory drugs (NSAIDs) are better than opioids at easing the intensity of chronic pain in the back, knees or hips, a U.S. experiment suggests. And opioids are no better than these other drugs at reducing how much pain interferes with daily activities like walking, working, sleeping or enjoying life, researchers report in JAMA, online March 6...'We already knew opioids were more dangerous than other treatment options, because they put people at risk for accidental death and addiction,' said lead study author Dr. Erin Krebs of the Minneapolis VA Health Care System and the University of Minnesota. 'This study shows that extra risk doesn’t come with any extra benefit,' Krebs said by email. ”

Fetal Alcohol Syndrome May be More Common Than Thought, by Traci Pedersen, Psych Central, Feb 7 2018.

“Up to five percent of American children in a new study were found to be affected by fetal alcohol spectrum disorders (FASD). The research involved more than 6,000 first-graders in the Pacific Southwest, Midwest, Rocky Mountain, and Southeast regions of the U.S...“Our findings suggest that FASD is a critical health problem that often goes undiagnosed and misdiagnosed,” said Chambers. “Prenatal alcohol exposure is the leading preventable cause of birth defects and neurological abnormalities in the United States. It can cause a range of developmental, cognitive, and behavioral problems, which may be recognized at any time during childhood and can last a lifetime.” ”

The Link Between Opioid Overdoses and Amnesia Is Only Getting Stronger, by Lauren Aguirre, The Atlantic, Jan 30 2018.

“Just over five years ago, a man suffering from amnesia following a suspected drug overdose appeared at Lahey Hospital and Medical Center in Burlington, Massachusetts, a Boston suburb. He was 22, and had injected what he believed to be heroin. When he woke up the next morning, he was extremely confused, repeatedly asking the same questions and telling the same stories. Doctors at Lahey quickly diagnosed the man with anterograde amnesia—the inability to form new memories. ”

Desperate Cities Consider 'Safe Injection' Sites For Opioid Users, by Bobby Allyn, NPR, Jan 10 2018.

“Top Philadelphia officials are advocating that the city become the first in the U.S. to open a supervised injection site, where people suffering from heroin or opioid addiction could use the drugs under medical supervision...It's a divisive idea: People bring their own drugs to shoot up under the watch of medical staff, in a facility that provides clean needles and other equipment. Advocates say the goal is to provide a bridge to treatment. ”

Is Alcohol A Problem? Online Tool Helps Assess Risk And Find Help, by Allison Aubrey , NPR, Jan 8 2018.

“The thinking about problem drinking and alcoholism has changed. It's no longer considered a black-and-white, you have it or you don't condition. "We now know that there's a full spectrum in alcohol use disorder," says George Koob, the director of the National Institute on Alcohol Abuse and Alcohohlism, part of the National Institutes of Health. You can have a mild, moderate or severe problem. And there's not a one-size-fits-all approach to getting help. There is a wide range of options — from residential "detox" programs to cognitive behavioral therapy, to medications such as naltrexone that can help people drink less, or acamprosate, which can help people stay dry. But many people who might need help don't know these options exist. It's a big obstacle to treatment. ”

Life Expectancy Drops Again As Opioid Deaths Surge In U.S., by Rob Stein, NPR, Dec 21 2017.

“Life expectancy in the U.S. fell for the second year in a row in 2016, nudged down again by a surge in fatal opioid overdoses, federal officials report Thursday. 'I'm not prone to dramatic statements," says Robert Anderson, chief of the mortality statistics branch at the National Center for Health Statistics. 'But I think we should be really alarmed. The drug overdose problem is a public health problem and it needs to be addressed. We need to get a handle on it.' ”

Chronic Pain + Mental Health Disorder = Risk of Opioid Overdose, by Rick Nauert, PhD, Psych Central, Nov 29 2017.

“A new study finds that over 60 percent of individuals who died from an opioid overdose had been diagnosed with a chronic pain condition, and many had been diagnosed with a psychiatric disorder...The analysis is timely as according to the US Centers for Disease Control, the number of opioid-related deaths has quadrupled, from 8,048 in 1999 to 33,091 in 2015. The findings underscore the importance of providing substance use treatment services in conjunction with behavioral interventions for people with chronic pain...'Such a strategy might increase early clinical intervention in patients who are at high risk for fatal opioid overdose,' said Mark Olfson, M.D., professor of psychiatry at CUMC and lead investigator of the study. ”

Telemedicine For Addiction Treatment? Picture Remains Fuzzy, by Emily Forman, NPR, Nov 24 2017.

“When President Trump declared the opioid epidemic a public health emergency, it came with a regulatory change intended to make it easier for people to get care. Doctors are now allowed to prescribe addiction medicine virtually, without ever seeing the patient in person. In Indiana, this kind of virtual visit has been legal since early 2017. So I called about a dozen addiction specialists in Indiana to find out how it was going.  ”

Women With Opioid Addiction Live With Daily Fear Of Assault, Rape, by Marta Bebinger, NPR, Sep 21 2017.

“In Cambridge, Mass., a woman named Kristin sits down on a stone bench to talk about a common but rarely discussed injury that's starting to grow along with the opioid epidemic: rape...It's an assault active drug users often don't report out of shame, distrust of police, or fear they'll be labeled a "cop caller" and have trouble buying heroin. It's an injury women say they can't figure out how to prevent. And it's one few doctors think to ask about, and thus rarely treat...One Boston physician says virtually all of her patients, mostly homeless women, have stories about sexual assaults. I wasn't aware of this until more recently but I'm just struck by how common it is. In fact, it seems ubiquitous," says Dr. Jessie Gaeta, medical director at the Boston Health Care for the Homeless Program. Few emergency room doctors routinely ask overdose patients if they've been raped. Gaeta says this is understandable in the chaos of trying to save a life, stabilize the person, and persuade them to consider treatment. But she says screening must become routine, because there are many reasons to worry about a patient who's been raped. ”