Publications - Substance Abuse and Addictions

Why Are Older Americans Drinking So Much?, by Paula Span, The New York Times, Mar 30 2024.

“Public health officials are increasingly alarmed by older Americans’ drinking. The annual number of alcohol-related deaths from 2020 through 2021 exceeded 178,000, according to recently released data from the Centers for Disease Control and Prevention: more deaths than from all drug overdoses combined. An analysis by the National Institute on Alcohol Abuse and Alcoholism shows that people over 65 accounted for 38 percent of that total. From 1999 to 2020, the 237 percent increase in alcohol-related deaths among those over age 55 was higher than for any age group except 25- to 34-year-olds. Studies show a narrowing gender divide, too. “Women have been the drivers of change in this age group,” Dr. Humphreys said.  From 1997 to 2014, drinking rose an average of 0.7 percent a year for men over 60, while their binge drinking remained stable. Among older women, drinking climbed by 1.6 percent annually, with binge drinking up 3.7 percent.  “Contrary to stereotypes, upper-middle-class, educated people have higher rates of drinking,” Dr. Humphreys explained. In recent decades, as women grew more educated, they entered workplaces where drinking was normative; they also had more disposable income. “The women retiring now are more likely to drink than their mothers and grandmothers,” he said. ”

One Twin Was Hurt, the Other Was Not. Their Adult Mental Health Diverged., by Ellen Barry, The New York Times, Mar 6 2024.

“Why do twins, who share so many genetic and environmental inputs, diverge as adults in their experience of mental illness? On Wednesday, a team of researchers from the University of Iceland and Karolinska Institutet in Sweden reported new findings on the role played by childhood trauma. Their study of 25,252 adult twins in Sweden, published in JAMA Psychiatry, found that those who reported one or more trauma in childhood — physical or emotional neglect or abuse, rape, sexual abuse, hate crimes or witnessing domestic violence — were 2.4 times as likely to be diagnosed with a psychiatric illness as those who did not. If a person reported one or more of these experiences, the odds of being diagnosed with a mental illness climbed sharply, by 52 percent for each additional adverse experience. Among participants who reported three or more adverse experiences, nearly a quarter had a psychiatric diagnosis of depressive disorder, anxiety disorder, substance abuse disorder or stress disorder. To disentangle the effects of these traumas from genetic or environmental factors, the researchers narrowed the pool to “discordant” pairs, in which only one twin reported maltreatment in childhood. An analysis of 6,852 twins from these discordant pairs found that childhood maltreatment was still linked with adult mental illness, though not as strongly as in the full cohort. A twin who reported maltreatment was 1.2 times as likely to suffer from a mental illness as the unaffected twin in identical twin pairs, and 1.7 times as likely in fraternal twin pairs. This effect was especially pronounced among subjects who reported experiencing sexual abuse, rape and physical neglect. ”

People who are gay, lesbian or bi have more mental health and substance use problems, survey finds, by Jen Christensen, CNN, Jun 13 2023.

“Despite increasing acceptance of the LGBTQ+ community, at least in some circles, adults who identify as gay, lesbian or bisexual are more likely than those who identify as straight to have serious thoughts of suicide and mental health conditions including major depressive episodes, and they are more likely to misuse substances like alcohol or drugs, according to a new US government report. The report, published Tuesday, comes from the annual National Survey on Drug Use and Health, sponsored by the US Department of Health and Human Services’ Substance Abuse and Mental Health Services Administration. It’s included a question about how the participant identifies their sexual orientation since 2015. The data in the report, which focuses on LGB adults, comes from 2021 and 2022. ”

Does weed help with anxiety or cause it? Here’s what experts say., by Teddy Amenabar, The Washington Post, May 3 2023.

“Cannabis has different effects at lower doses than high doses. Generally, low doses of THC are well-tolerated, stimulating a release of dopamine, and higher doses of THC can cause people to feel anxious, said Peter Grinspoon, a primary care physician at Massachusetts General Hospital and the author of “Seeing Through The Smoke,” a book reviewing the latest medical research on cannabis.  “The main way you can get into mischief with cannabis is by using too high a dose and becoming very, very anxious,” said Grinspoon, who’s also an instructor at Harvard Medical School. “There are some patients who can’t use it at all, even a teeny bit, because any little bit makes them anxious.” Cannabis affects virtually every neural connection in the brain, even more so than stimulants such as cocaine and opioids, said Judy Grisel, a professor of psychology at Bucknell University and the author of “Never Enough: The Neuroscience and Experience of Addiction.” This, in turn, means cannabis can cause a wide array of reactions, depending on the person, she said.    Decades of clinical research has found THC can negatively effect the developing brain, and regular cannabis use in the teen years is associated with a higher likelihood of developing anxiety and depression later in life.  “Smoking early can catalyze anxiety and depression,” Grisel said. “It’s not exactly clear how that happens but the evidence for it is very strong.” ”

After a record high, overdose deaths may be declining slightly in Massachusetts, by Martha Bebinger, WBUR, Dec 14 2022.

“The record-breaking pace of the opioid overdose crisis may be slowing, according to preliminary numbers from the Massachusetts Department of Public Health. The agency estimated a 1.5% decrease in overdose deaths through September of this year, compared to the first nine months of 2021.  Last year, 2,301 Massachusetts residents died after drug overdoses, a 9.4% increase from 2020. State officials welcomed a decline, even if it is a small one. ”

The rate of alcohol-related deaths in the U.S. rose 30% in the first year of COVID, by The Associated Press, NPR, Nov 5 2022.

“The rate of deaths that can be directly attributed to alcohol rose nearly 30% in the U.S. during the first year of the COVID-19 pandemic, according to new government data.  The Centers for Disease Control and Prevention had already said the overall number of such deaths rose in 2020 and 2021. Two reports from the CDC this week provided further details on which groups have the highest death rates and which states are seeing the largest numbers.  "Alcohol is often overlooked" as a public health problem, said Marissa Esser, who leads the CDC's alcohol program. "But it is a leading preventable cause of death."  The rate of such deaths had been increasing in the two decades before the pandemic, by 7% or less each year.  In 2020, they rose 26%, to about 13 deaths per 100,000 Americans. That's the highest rate recorded in at least 40 years, said the study's lead author, Merianne Spencer. ”

What Porn Does to Teen Brains—and How to Keep It Off Their Devices, by Julie Jargon, The Wall Street Journal, Jul 2 2022.

“While there’s plenty to say about ways porn can affect the development of relationships and sexuality, this is a more focused look at children’s brain chemistry. Research shows that younger people’s brains are more wired for pleasure than adults, with higher spikes of the feel-good neurotransmitter dopamine released in anticipation of enjoyable activities.  Because of this, many researchers believe young people are more vulnerable to compulsive porn use, which can lead to unrealistic views on sex. [...] Psychologists say it’s important to talk to kids about porn without making them feel ashamed. Some exposure to it can be a natural part of development, they say, and porn shouldn’t be shunned in a way that creates a taboo. They do, however, recommend using tech guardrails to reduce the chances that younger kids see things they’re not ready to see. More on how to do that below. [...] Nicole Prause, a research scientist at University of California, Los Angeles, and a licensed psychologist, said she’s more concerned about what parents and authority figures tell kids about porn. She recently surveyed young adult men who had been in porn-abstinence programs and relapsed. Nearly 30% of the 228 respondents reported feeling suicidal afterward; many more said they felt shame because of the societal messages about porn being bad. ”

More states are allowing students to take mental health days off, by Giles Bruce, NPR, Jun 10 2022.

“The state allows K-12 students in public schools to have five excused absences per school year for mental health reasons, another example of the growing acknowledgment among lawmakers that emotional and physical health are intertwined. The new policy, which went into effect at the beginning of 2022, passed both chambers of the state legislature unanimously. But such novel policies are, in many ways, a half-step toward addressing the crisis of teenage mental health that has been highlighted and exacerbated by the educational interruptions caused by the pandemic. Many parts of the country are woefully short of therapists who can work with students to address mental health problems.  Seventy percent of schools that responded to a federal survey in April said more students had sought mental health services since the pandemic started. The National Center for Education Statistics' polling also showed that only 56% of schools said they effectively provide mental health services to all students in need and just 41% reported hiring new staff members to help address students' mental health needs. Nearly half the nation lives in a designated mental health worker shortage area, according to government data, and an estimated 7,550 new professionals are needed to fill that void nationwide. Even in places where mental health professionals are more plentiful, they often do not accept public insurance, making them inaccessible to many kids. ”

So you've watched 'Dopesick'. Here's what you can do to help ease the opioid crisis, by BRIAN MANN, NPR, Nov 19 2021.

“Like many things, the pandemic has acutely impacted the opioid crisis over the past two years. COVID-19 has disrupted every aspect of daily life, and left many struggling to find treatment and support. According to SAMHSA's 2020 National Survey on Drug Use and Health, not only did the coronavirus outbreak adversely impact many Americans' mental health, but it worsened their preexisting alcohol and drug abuse issues.   ”

College students reported record-high marijuana use and record-low drinking in 2020, study says, by Maria Luisa Paul, The Washington Post, Sep 13 2021.

“A newly released study found that nearly half of the country’s college-age students said they consumed marijuana last year, leading researchers to wonder whether the pandemic may have spurred the record in cannabis consumption. One says the trend underpins the changing practices during — and struggles to adapt to — the global health crisis.  “The pandemic seems to have actually made marijuana into an alternative to escape the monotony of isolation,” said Nora Volkow, director of the federal government’s National Institute on Drug Abuse (NIDA). “It’s made life become more boring, more stressful. So if drugs let you experience that completely different mental state, I wonder whether that would be a factor that leads people to use them.” ”

U.S. drug overdose deaths rise 30% to record during pandemic, by Julie Steenhuysen and Daniel Trotta, Reuters, Jul 14 2021.

“A record number of Americans died of drug overdoses last year as pandemic lockdowns made getting treatment difficult and dealers laced more drugs with a powerful synthetic opioid, according to data released on Wednesday and health officials.  U.S. deaths from drug overdoses leapt nearly 30% to more than 93,000 in 2020 - the highest ever recorded.  "During the pandemic, a lot of (drug) programs weren't able to operate. Street-level outreach was very difficult. People were very isolated," said Dr. Joshua M. Sharfstein, a health policy expert at the Johns Hopkins Bloomberg School of Public Health in Baltimore. ”

Addiction treatment had failed. Could brain surgery save him?, by Lenny Bernstein, The Washington Post, Jun 18 2021.

“More than 600 days after he underwent the experimental surgery, Buckhalter has not touched drugs again — an outcome so outlandishly successful that neither he nor his doctors dared hope it could happen. He is the only person in the United States to ever have substance use disorder relieved by deep brain stimulation. The procedure has reversed Parkinson’s disease, epilepsy and a few other intractable conditions, but had never been attempted for drug addiction here.  The device, known as a deep brain stimulator, also is recording the electrical activity in Buckhalter’s brain — another innovation that researchers hope will help locate a biomarker for addiction and allow earlier intervention with other people.  Yet for all the futuristic prospects, he is also proof of how difficult treatment of addiction remains. Quelling it with a scalpel helps refute the false belief that substance use disorder is a weakness or a moral failing, rather than a brain disease. But it does not address the psychological, social and socioeconomic factors that complicate the disease. ”

Women Now Drink As Much As Men — Not So Much For Pleasure, But To Cope, by Aneri Pattani, NPR, Jun 9 2021.

“For nearly a century, women have been closing the gender gap in alcohol consumption, binge-drinking and alcohol use disorder. What was previously a 3-1 ratio for risky drinking habits in men versus women is closer to 1-to-1 globally, a 2016 analysis of several dozen studies suggested.  And the latest U.S. data from 2019 shows that women in their teens and early 20s reported drinking and getting drunk at higher rates than their male peers — in some cases for the first time since researchers began measuring such behavior. ”

Exchanging COs For Clinicians, Mass. Makes Changes To Involuntary Addiction Treatment In Prison, by Deborah Becker, WBUR, Jun 30 2020.

“Correction officers will no longer be in charge of men involuntarily committed to addiction treatment at the Massachusetts Alcohol and Substance Abuse Center (MASAC) at the state prison in Plymouth. The Baker administration said MASAC is undergoing a "comprehensive transformation." The Massachusetts Executive Office of Public Safety and Security, which oversees the prison, said that as of last month, correction officers will maintain the perimeter of the facility and clinical staff work inside. EOPSS said clinically trained, non-uniformed staff will provide supervision and deliver more hours of programming each day. ”

Cannabis use rising faster among depressed Americans, by Lisa Rapaport, Reuters, Dec 26 2019.

“Regular cannabis use has risen more quickly among people with depression, and they’re less likely to perceive it as risky, compared with people who aren’t depressed, a U.S. study suggests. ”