Publications - Substance Abuse and Addictions

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. ”

Drinking On The Rise In U.S., Especially For Women, Minorities, Older Adults, by Camila Domonoske, NPR, Aug 10 2017.

“More Americans are drinking alcohol, and a growing number of them are drinking to a point that's dangerous or harmful, according to a new study published in JAMA Psychiatry this week...They found that drinking, in general, rose substantially over that time frame. Problem drinking increased by an even greater percentage, and women, racial minorities, older adults and the poor saw particularly large spikes. The findings suggest 'a public health crisis,' the researchers say, given the fact that high-risk drinking is linked to a number of diseases and psychiatric problems, as well as violence, crime and crashes. ”

Adult gambling addiction tied to childhood trauma, by Lisa Rapaport, Reuters, Aug 2017.

“Men with gambling addictions are more likely than their peers to have endured childhood traumas like physical abuse or violence at home, and treatment needs to address this underlying stressor, researchers say...Compared with men who rarely if ever placed wagers, the men with a pathological addiction to gambling were more than twice as likely to have witnessed violence at home or to have experienced physical abuse or assault growing up. They were also more than three times as likely to have suffered a serious or life-threatening injury as kids. ”

Mindfulness Training Helps People with Chronic Pain Reduce Opioid Use, by Rick Nauert, PhD, Psych Central, Jun 29 2017.

“Emerging research suggests psychological support can help patients at high risk of developing chronic pain reduce use of opioids and live a fulfilling life...A new Canadian study of 343 post-surgical patients shows that an innovative, multidisciplinary hospital-integrated pain program can achieve reductions in pain and anxiety. In the two-year study, researchers found that patients who received psychological services in addition to medical pain-management strategies had greater reductions in opioid use, and their mood improved. ”

Teens’ Poor Body Image Tied to More Drinking, Smoking, by Rick Nauert, PhD, Psych Central, Jun 22 2017.

“New research finds that the way a teen feels about their appearance can significantly impact their health and wellness...The finding supports prior work that discovered people with negative body image are more likely to develop eating disorders and are more likely to suffer from depression and low self-esteem. ”

Drinking in pregnancy tied to subtle changes in babies’ faces, by Lisa Rapaport, Reuters, Jun 9 2017.

“Women who drink even a little bit of alcohol during pregnancy may be more likely than other mothers to have babies with slight facial abnormalities that have been linked to developmental problems, a recent study suggests...'We are surprised to see these differences in facial shape with low doses of alcohol exposure, which in our study was defined as two standard drinks on any one occasion and no more than seven in a week,' said lead study author Evelyne Muggli of the Murdoch Children’s Research Institute and the University of Melbourne in Australia. 'This means that any level of alcohol contributes to the way the face is formed and raises questions about the possible impact on brain development, which is the subject of further research,' Muggli said by email. ”

Drug Deaths in America Are Rising Faster Than Ever, by Josh Katz, The New York Times, Jun 5 2017.

“Drug overdose deaths in 2016 most likely exceeded 59,000, the largest annual jump ever recorded in the United States, according to preliminary data compiled by The New York Times.The death count is the latest consequence of an escalating public health crisis: opioid addiction, now made more deadly by an influx of illicitly manufactured fentanyl and similar drugs. Drug overdoses are now the leading cause of death among Americans under 50. Although the data is preliminary, the Times’s best estimate is that deaths rose 19 percent over the 52,404 recorded in 2015. And all evidence suggests the problem has continued to worsen in 2017. ”

How Untreated Depression Contributes to the Opioid Epidemic, by Olga Khazan, The Atlantic, May 15 2017.

“Several researchers now believe depression, one of the most common medical diagnoses in the U.S., might be one underlying cause that’s driving some patients to seek out prescription opioids and to use them improperly...Sullivan and other researchers from Washington and California found in 2012 that depressed people were about twice as likely as non-depressed ones to misuse their painkillers for non-pain symptoms, and depressed individuals were between two and three times more likely to ramp up their own doses of painkillers. Adolescents with depression were also more likely, in one study, to use prescription painkillers for non-medical reasons and to become addicted. ”

Opioid Addicts in Primary Care 10 Times More Likely to Die, by Traci Pedersen, Psych Central, Apr 24 2017.

“A new study finds that people with opioid addiction who received medical care through a general health care system, such as a primary care practitioner or a large research hospital, were more than 10 times as likely to die during a four-year period than those without substance abuse problems....'The high rates of death among patients with opioid use disorder in a general health care system reported in this study suggest we need strategies to improve detection and treatment of this disorder in primary care settings,' said Dr. Yih-Ing Hser, professor of psychiatry and behavioral sciences at the David Geffen School of Medicine at the University of California, Los Angeles (UCLA).”

The Link Between Opioids and Unemployment, by Olga Khazan, The Atlantic, Apr 18 2017.

“In 2015, more Americans died from drug overdoses than from car accidents and gun homicides combined...A new study suggests unemployment might be one of the factors behind that dramatic rise. The paper, published by NBER last week, finds that as the unemployment rate increases by one percentage point in a given county, the opioid-death-rate rises by 3.6 percent, and emergency-room visits rise by 7 percent. Rather than more people getting injured when jobs are scarce, the authors suspect that the increased use of painkillers is a 'physical manifestation of mental-health problems that have long been known to rise during periods of economic decline.' ”

Alcohol Use Among Vets with Schizophrenia Is Limited But Troubling, by Traci Pedersen, Psych Central, Apr 3 2017.

“Although veterans with schizophrenia are much more likely to abstain from alcohol than the general population, around 15 percent still report some use and another seven percent report misuse and intoxication, according to a new study at the University of California, Los Angeles (UCLA)...The study shows that there is no safe level of alcohol use for people with schizophrenia, suggesting that clinicians should ask patients with schizophrenia about their drinking habits and advise them about risks. ”

Opioid abuse tied to higher suicide risk in veterans, by Lisa Rapaport, Reuters, Mar 24 2017.

“While drug and alcohol problems are associated with a higher risk of suicide among veterans, the increased danger is particularly high with opioid abuse, a U.S. study suggests...The suicide risk is particularly high when veterans misuse prescription sedatives, with more than quadrupled odds of suicide for men and more than 11 times the risk for women, the study also found. Among female veterans, opioids were also tied to a nearly eight-times-higher risk of suicide, while amphetamines and stimulants were tied to almost six times the risk. ”