Leslie Glass's Blog, page 366

FDA Approves First Medication for Opioid Withdrawal

Withdrawal is notoriously hard to endure for people addicted to opioids. Physical symptoms can start a few hours after last taking the drug and may include stomach cramps, aches and pains, coldness, muscle spasms or tension, pounding heart, insomnia, and many others. These symptoms, along with mood changes, like depression and anxiety, are a major reason people with opioid addiction may relapse. Yet until now, no medication has been approved to treat withdrawal.

Courtesy of US WorldMeds, LLC

 

In 2016, 115 Americans died every day from an overdose involving prescription or illicit opioids. Addiction to any drug has multiple components—altered functioning of the reward system, learned associations with drug cues that promote preoccupation and craving, and changes to prefrontal circuits necessary for proper exertion of self-control. But physiological and psychological withdrawal symptoms play a major role in driving users repeatedly back to the drug, despite efforts to stop using.

The Food and Drug Administration (FDA) approved lofexidine, the first medication targeted specifically to treat the physical symptoms associated with opioid withdrawal. NIDA’s medications development program helped fund the science leading to the drug’s approval. Lofexidine could benefit the thousands of Americans seeking medical help for their opioid addiction, by helping them stick to their detoxification or treatment regimens.

Two of the three FDA-approved medications to treat opioid use disorder, methadone and buprenorphine, can be initiated while a person is experiencing withdrawal symptoms, and can help curb craving. However, these medications are not always easy to access, and at this point are only received by a minority of people with opioid use disorder. The third FDA-approved drug, extended-release naltrexone, has also been found effective, but only after people have been fully detoxified.  The need to detox first—and endure those symptoms—prevents many patients from being treated with naltrexone. Lofexidine could make a big difference in making the latter treatment option more widely used.

Lofexidine is not an opioid. It acts to inhibit the release of norepinephrine in the brain and elsewhere in the nervous system. It was originally developed as a medication for hypertension, but has mainly been used for opioid withdrawal in the United Kingdom since the early 1990s. US WorldMeds acquired a license for lofexidine from Britannia Pharmaceuticals in 2003 and will market it in the US under the brand name LUCEMYRATM beginning this summer. NIDA helped fund the clinical trials to test lofexidine’s pharmacological properties, safety, and efficacy in patients who were discontinuing opioid use under medical supervision.

Lofexidine cannot address the psychological symptoms of opioid withdrawal; further research is needed to develop medications that could address mood problems during detoxification and after. But approval of the first medication to treat the physical symptoms of opioid withdrawal is a major milestone, one that could improve the lives and treatment success of thousands of people living with opioid addiction. And by helping prevent relapse, it could save lives. The approval of lofexidine is also a welcome example of the power of public-private collaborations in developing new treatments.

From National Institute of Drug Abuse May 2018

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Why Can’t We Treat Addiction Like Cancer

From the NY Times by Laura Hilgers

Two years ago, I spent a week in Houston helping my stepbrother while he underwent treatment for Stage 4 lymphoma at the University of Texas MD Anderson Cancer Center. I sat with him while a nurse cleaned his chemo port and made records of her work, to keep his medical team updated. I accompanied him for the blood tests that determined his readiness for the next treatment. I stayed by his bed as his stem cells were harvested for a transplant, one of the cutting-edge, evidence-based therapies that ultimately saved his life.

ImageCreditManshen Lo

Around the same time, I was helping my 22-year-old daughter, who struggled with alcohol and drug addiction. The contrast between the two experiences was stark. While my stepbrother received a doctor’s diagnosis, underwent a clearly defined treatment protocol and had his expenses covered by insurance, there was no road map for my daughter. She had gone undiagnosed for several years, despite my reaching out to her health care providers, who either minimized my concerns or weren’t sure what to do.

I had to hire an expensive interventionist — a professional who helps families find appropriate care and runs interventions — to find names of treatment centers. I spent weeks calling programs, asking questions and waiting to learn what insurance would cover. Finally, after my daughter agreed to treatment and we paid all costs up front, I sent her to a 45-day Arizona inpatient program, praying it would work.

Addiction, like cancer, is a complex disease that requires a multipronged approach. It also affects 1.5 times as many people as those with all cancers combined, and it was pivotal in causing some 64,000 overdose deaths in 2016 alone. It makes no sense that what is fast becoming our greatest health care crisis is still dealt with mostly outside the mainstream medical system.

According to a 2016 surgeon general’s report, 10 percent of the 21 million Americans with substance-use disorders will receive treatment. This is in part because there are no national standards of care for treating addiction, and the $35 billion rehab industry is regulated piecemeal, state by state. While many treatment programs offer excellent care, others are motivated by profit and engage in practices such as patient brokering (in which hefty sums are paid to those who refer an addict to a program) and charging insurers exorbitant fees.

On average, medical schools in the United States devote 12 hours to substance abuse, and little of that on diagnosing or treating the condition. Many doctors also struggle to get reimbursed for providing this care.

Addiction treatment has a long, fraught history. In the 19th and early 20th centuries, when addiction was, for the most part, considered a moral failing, people sought cures in asylums and “inebriate homes.” They also relied on doctors, who sometimes prescribed opiates to help morphine addicts slowly withdraw.

But with the passage of the Harrison Narcotics Tax Act of 1914, and several Supreme Court decisions, the government began to prosecute these doctors. William L. White’s book “Slaying the Dragon: The History of Addiction Treatment and Recovery in America” reports that more than 25,000 physicians were indicted between 1914 and 1938. Some 3,000 were jailed. “The practical effect of such enforcement,” wrote Mr. White, “was that physicians stopped treating addicted patients.”

Our understanding of addiction is different now. The surgeon general’s report defines it as a “chronic neurological disorder” and outlines evidence-based treatments. These include drugs like methadone and buprenorphine; individual and group counseling; step-down services after residential treatment; mutual aid groups like Alcoholics Anonymous; and long-term, coordinated care that includes recovery coaches.

Unfortunately, much of this knowledge isn’t being applied in doctors’ offices or even many treatment centers. “There’s a wealth of literature collected over many decades, along with a robust medical evidence base, showing what works and what doesn’t,” Dr. Anna Lembke, chief of the Stanford University Addiction Medicine Dual Diagnosis Clinic, told me. “Treatment for addiction works, on par with treatment for other chronic relapsing disorders. So, it’s not really that there’s no road map. It’s that the road map has not been recognized or embraced by the house of medicine.”

Dr. Lembke would like for a person afflicted with addiction to be able to arrive in an emergency room or a doctor’s office and find a protocol in place for immediate treatment, just as my stepbrother experienced with lymphoma. “That’s what we don’t have,” she said. “We have very high-end, and very expensive care, which is good care for those who can afford it, and then we have everybody else pretty much, for whom there’s limited care.”

Efforts are underway to create this much-needed change. The advocacy group Facing Addiction, along with the health care consulting firm Leavitt Partners, has assembled a team of experts and industry leaders to promote care models that help patients achieve long-term recovery and reward providers based on how well patients hit “recovery-linked performance measures.”

Another organization, Shatterproof, is working with 16 health insurers, which collectively cover 248 million people, to adopt national principles of care, including universal screening, access to medications and continuing long-term outpatient care. Gary Mendell, Shatterproof’s chief executive, believes that once private insurers recognize these standards and create financial incentives to meet them, the rest of the health care system will follow. It would be good if that included Medicaid and Medicare, which cover 69 percent of Americans’ addiction treatment.

The staggering economics of the opioid epidemic may be what forces our system to change. According to the nonprofit group FAIR Health, which draws on data from more than 21 billion privately billed health care claims, “Professional charges and allowed amounts for services for patients diagnosed with opioid abuse or dependence rose more than 1,000 percent from 2011 to 2015.” This increase, partly the result of addiction treatment coverage mandated by the Affordable Care Act, may spur health care systems to create their own treatment centers.

Cost-effective health care providers like Kaiser Permanente and the Department of Veterans Affairs have been doing this for years, and at least one other major provider, Massachusetts General Hospital, recently integrated substance-use disorder care into its system. Another bright spot is the federal prison system, which offers a residential drug abuse program, typically lasting nine months, in 76 locations.

There is a risk, of course, in urging the very medical system that helped create the opioid epidemic to treat it. “What we don’t want to do is go from OxyContin pill mills to buprenorphine pill mills,” Dr. Lembke said. “I think the way to try to avoid that difficulty or disastrous unintended consequence is to really carefully and judiciously prescribe.”

It’s a risk we may have to take. Evidence-based research should not be perishing in peer-reviewed journals while people are dying or struggling to find effective care. The millions of people still suffering from addiction, and those in recovery, deserve the same level of gold-standard care that saved my stepbrother and my daughter, both of whom are now in remission.

Laura Hilgers (@Lhilgers) is a freelance journalist.

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How Is Chronic Pain Different

What is the difference between chronic pain and acute pain. We’re glad you asked. All of us have had acute pain at some point in our lives beginning at birth. Acute pain is short-lived pain from something as simple as a cut or bruise or severe pain associated with a kidney stone, a broken leg, or an ACL tear. Acute pain is normal pain. When we are injured in some way, our nerves send signals to the brain which reads this pain and reacts. Acute pain is necessary so that we can respond to it. For example, the signal goes to the brain from the nerves in the hand of a child who has just placed his hand on a hot stove. This signal immediately messages the child to immediately remove his hand and while he suffers from a burn, the pain is severe and acute to that moment and may last for a few days and then is less painful and eventually, the pain goes away. There is a reason for acute pain as it is a warning sign to tell you that something is wrong.

Chronic Pain Is Different

Chronic pain is pain that is longer-lasting and may last from months to years and often is pain which is unnecessary. For some chronic pain conditions, there are medical reasons for the chronicity of the pain. For example, osteoarthritis, a common ailment of growing older, is a chronic condition evidenced by ongoing pain. There are other medical illnesses that may be chronic such as back pain and headaches. For chronic pain conditions, the chronic pain stays on a “go” pattern as it doesn’t shut down when needed. Fibromyalgia is a common condition that stays ongoing and it is a condition that doesn’t need the pain warning as the pain is always there. It’s as if some conditions stay stuck in this pain and both you and your doctor may be frustrated because the cause and treatment of such pain is unknown or untreatable.

The National Institute of Health (NIH) reports that chronic pain is very common. Study results indicate:

About 25.3 million U.S adults (11.2 percent) had pain every day for the previous 3 months.
Nearly 40 million adults (17.6 percent) had severe pain.
Individuals with severe pain had worse health, used more health care, and had more disability than those with less severe pain.

NIH also notes that chronic pain may:

“result from an underlying disease or health condition, an injury, medical treatment (such as surgery), inflammation, or a problem in the nervous system (in which case it is called ‘neuropathic pain’), or the cause may be unknown.”

Chronic Pain And Disability

Pain is the leading cause of long-term disability and is the most common complaint in the medical system. Also, pain affects 100 million Americans (American Academy of Pain Medicine). Chronic pain can also become a disease in its own right. Chronic pain can also lead to less physical activity, grief, depression, poor sleep, anxiety, and more health-related problems due to inactivity.

 

If you have chronic pain or know someone who has it, remember that there are healthy ways to cope. It is important to remember that there is a difference between pain and suffering for while pain is inevitable, suffering is optional. Even if we have chronic pain, we can usually still go about our daily activities, but perhaps with accommodations. Yet suffering puts more strain on you for suffering relates to our emotional response to pain. When we focus on suffering, we get more suffering as we now believe that nothing is going to help and that we will always be in misery. Focusing on healthy activities; using distraction skills such as walking, reading, or playing video games; using positive thoughts; and focusing on what you can do will take you a long way towards coping.

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Chronic Pain Vs Acute Pain

What is the difference between chronic pain and acute pain. We’re glad you asked. All of us have had acute pain at some point in our lives beginning at birth. Acute pain is short-lived pain from something as simple as a cut or bruise or severe pain associated with a kidney stone, a broken leg, or an ACL tear. Acute pain is normal pain. When we are injured in some way, our nerves send signals to the brain which reads this pain and reacts. Acute pain is necessary so that we can respond to it. For example, the signal goes to the brain from the nerves in the hand of a child who has just placed his hand on a hot stove. This signal immediately messages the child to immediately remove his hand and while he suffers from a burn, the pain is severe and acute to that moment and may last for a few days and then is less painful and eventually, the pain goes away. There is a reason for acute pain as it is a warning sign to tell you that something is wrong.

Chronic Pain Is Different

Chronic pain is pain that is longer-lasting and may last from months to years and often is pain which is unnecessary. For some chronic pain conditions, there are medical reasons for the chronicity of the pain. For example, osteoarthritis, a common ailment of growing older, is a chronic condition evidenced by ongoing pain. There are other medical illnesses that may be chronic such as back pain and headaches. For chronic pain conditions, the chronic pain stays on a “go” pattern as it doesn’t shut down when needed. Fibromyalgia is a common condition that stays ongoing and it is a condition that doesn’t need the pain warning as the pain is always there. It’s as if some conditions stay stuck in this pain and both you and your doctor may be frustrated because the cause and treatment of such pain is unknown or untreatable.

The National Institute of Health (NIH) reports that chronic pain is very common. Study results indicate:

About 25.3 million U.S adults (11.2 percent) had pain every day for the previous 3 months.
Nearly 40 million adults (17.6 percent) had severe pain.
Individuals with severe pain had worse health, used more health care, and had more disability than those with less severe pain.

NIH also notes that chronic pain may:

“result from an underlying disease or health condition, an injury, medical treatment (such as surgery), inflammation, or a problem in the nervous system (in which case it is called ‘neuropathic pain’), or the cause may be unknown.”

Chronic Pain And Disability

Pain is the leading cause of long-term disability and is the most common complaint in the medical system. Also, pain affects 100 million Americans (American Academy of Pain Medicine). Chronic pain can also become a disease in its own right. Chronic pain can also lead to less physical activity, grief, depression, poor sleep, anxiety, and more health-related problems due to inactivity.

 

If you have chronic pain or know someone who has it, remember that there are healthy ways to cope. It is important to remember that there is a difference between pain and suffering for while pain is inevitable, suffering is optional. Even if we have chronic pain, we can usually still go about our daily activities, but perhaps with accommodations. Yet suffering puts more strain on you for suffering relates to our emotional response to pain. When we focus on suffering, we get more suffering as we now believe that nothing is going to help and that we will always be in misery. Focusing on healthy activities; using distraction skills such as walking, reading, or playing video games; using positive thoughts; and focusing on what you can do will take you a long way towards coping.

The post Chronic Pain Vs Acute Pain appeared first on Reach Out Recovery.

Bitterness, Blame, and Banana Bread

Some ingredients, like lemons, are naturally bitter. That’s why we balance them with something that’s naturally sweet. The same principle applies to bitterness, like the time when my sister-in-law bit my son.

When my son was two, he was a biter. One day he bit my sister-in-law, and she bit him back! I watched in horror, then I said nothing. Not a word. I was shocked, angry, and paralyzed in fear.

That day, my fear of causing an argument was stronger than protecting my son. I hate that about myself. My remembering this doesn’t hurt her, or my son, but it hurts me because:

Each time we recall an angry memory, the anger starts the same bio-chemical reactions with the same intensity even if it was an incident from long ago.

Why Does Bitterness Remain?

When I look back on this, I’m still so disgusted. Why can’t I let this go?

The Serenity Prayer is one of my favorite recovery tools. If I look at this problem using the Serenity Prayer, I see I’m struggling to accept what happened.

This simple answer often causes me big problems. When I fight against reality, I lose my serenity. I can’t change the past. I didn’t know how to stand up to anyone, and I didn’t know how to make my son quit bitting. It’s time to accept that what happened, happened – even if I didn’t want it to.

If it happened today, I would at least have the courage to ask someone to help me stand up to my adorable bitter and my boundary-busting sister-in-law. I also would be wise enough to know that none of that behavior works for me. I would handle it differently.

Recovery tools offer a sweet offset to balance out my bitter memories, just like over-ripe bananas balance out the lemon’s bitter juice. The result is a brightness of flavors that can’t be achieved alone.

Banana Bread

Ingredients:

¼ cup (1 stick) of melted butter
3 over-ripe bananas
½ cup sugar
1 lemon
1 teaspoon vanilla extract
½ teaspoon coconut extract
½ teaspoon pink Himalayan sea salt
1 teaspoon baking soda dissolved into a tablespoon of water
1 egg
2 cups unbleached flour
2 cups tropical trail mix, chopped

This is my Grandma’s banana bread recipe with a fresh twist. First, melt butter in a mixing bowl. While the butter cools, zest the lemon.

Next, cut lemon in half, and squeeze half of the juice into the butter. Then add the sugar, bananas, lemon zest, flavorings and salt. Mix on medium until well combined. Add baking soda, egg, and flour. Mix again on medium.

Pre-heat oven to 350 degrees. Grease loaf pan with coconut oil and dust with sugar.  Pour batter into the pan.

Bake for 45 minutes. The bread will start to crack when done. You can also check for doneness by inserting a toothpick. It should come out clean – not goopy.

Want more of Pam’s delicious recipes seasoned with recovery tools? Check out our cookbook, the Codependent in The Kitchen.

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FDA Cracks Down on Youth E-Cigarette Use

 

From Time The Food and Drug Administration (FDA) is ramping up its efforts to curtail youth use of e-cigarettes — and demanding answers from some of the companies that make them.

The FDA on Thursday announced that official requests for information were sent to five e-cigarette manufacturers: J Well, for Bo Starter Kit; YGT Investment LLC and 7 Daze LLC, for Zoor Kit; Liquid Filling Solutions LLC, for Myle Products; and SVR Inc., for SMPO Kit. The agency is requesting information about the companies’ marketing practices, product design and consumer complaints, in an effort to understand the youth appeal of their products, which are not legally available to minors.

The requests come about a month after the FDA sent a similar letter to the makers of the wildly popular Juul e-cigarette.

“Too many kids continue to experiment with e-cigarette and vaping products, putting them at risk for developing a lifelong nicotine addiction,” FDA Commissioner Scott Gottlieb said in a statement. “These products should never be marketed to, sold to, or used by kids and it’s critical that we take aggressive steps to address the youth use of these products.”

TIME could not immediately reach the companies for comment.

The FDA said the companies included in the latest batch of requests were selected because, like Juul Labs, their products use high-nicotine e-liquids, are small and easily hidden and are designed for simple use. The companies have until July 12 to respond.

Through its Youth Tobacco Prevention Plan, the FDA is also cracking down on brick-and-mortar retailers that sell e-cigarettes to minors, and exploring means of making tobacco products less toxic and addictive.

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Cannabis: It Matters How Young You Start

From Science Daily:

What a difference a year or two can make: If you started smoking marijuana at the start of your teens, your risk of having a drug abuse problem by age 28 is 68 per cent, but if you started smoking between 15 and 17 your risk drops to 44 per cent, according to a new study by Université de Montréal researchers.

All the more reason, they say, to educate kids early, in primary school, about the risks of starting pot smoking, especially now that the potency is much greater than it was in decades past and that public acceptance is being spurred by legalization in jurisdictions such as Canada.

“The odds of developing any drug abuse symptoms by age 28 were reduced by 31 per cent for each year of delayed onset of cannabis use in adolescence,” the researchers at UdeM’s Department of Psychology, School of Psychoeducation and the CHU Saint-Justine Hospital Research Centre found.

Their study was publishedApril 22 in the Canadian Journal of Psychiatry.

Percentage nearly tripled

According to a 2011 study by University of Waterloo researchers in the journal Addictive Behaviors, 10 per cent of Canadian adolescents consumed cannabis in Grade 8. By Grade 12, that percentage nearly tripled to 29 per cent. Early-onset cannabis use has been linked to further drug abuse problems later in life.

The new study, done by UdM doctoral student Charlie Rioux under the supervision of professors Natalie Castellanos-Ryan and Jean Séguin, shows just how much.

The researchers looked at data for 1,030 boys in the Montreal Longitudinal and Experimental Study of white francophones from some of the city’s impoverished neighbourhoods begun in the early 1980s. Every year between ages 13 and 17, the boys were asked if they had consumed cannabis at all in the previous year.

At 17, and again at 20 and 28, they were asked not only whether they consumed cannabis, but also other drugs, including hallucinogens, cocaine, amphetamines, barbiturates, tranquilizers, heroin and inhalants. Then the data were correlated with the age at which they started using cannabis.

Double the chance if frequent use

The results confirmed the researchers’ suspicions: the younger they started, the more likely the boys had a drug problem later as young men. This is partly explained by the frequency with which they consumed cannabis and other drugs, but those who started before age 15 were at higher risk regardless of how often they consumed.

“The odds of developing any drug abuse symptoms by age 28 were non-significant if cannabis use had its onset at ages 15 to 17, but were significant and almost doubled each year if onset was before age 15,” the study says. Even if those who start smoking cannabis at 17 years were at lower risk, frequent users (20 or more times a year) at age 17 had almost double the chance of abuse by age 28 than occasional users.

And that may be underestimating the problem, the researchers say.

“Notably, considering that the potency of cannabis products increased over the last two decades and that [inthis study] adolescent cannabis use was assessed from 1991 to 1995, it is possible that the higher content of ?-9-tetrahydrocannabinol in the cannabis available today would be associated with higher rates of drug abuse symptoms.”

Gangs, thievery, drinking

The researchers also found that the earlier that boys were involved in gangs, drank alcohol, got into fights, stole or vandalized property, the earlier they used cannabis and the higher their odds of having drug abuse issues by 28. Those who started drinking at 17 also were at higher risk of having an alcohol problem at 28.

The finding that starting pot smoking between ages 13 and 15 increases the odds of developing a drug problem later on makes it all the more important to prevent or reducing cannabis use as early as possible, the researchers say.

“It may be important to implement these programs by the end of elementary school to prevent early onset of cannabis use,” said Rioux. “Since peer influence and delinquency were identified as early risk factors for earlier cannabis onset and adult drug abuse, targeting these risk factors in prevention programs may be important, especially since prevention strategies working on the motivators of substance use have been shown to be effective.”

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Humor Is Part Of A Good Life

From Psychology Today:

Aristotle (384-324 BCE) claims that wit or good humor is a virtue and part of a good life. All virtues are means between the extremes of excess and deficiency, which means the right sort of humor hits a sweet spot between too much and too little. Aristotle calls those who go to the excess in raising laughs “vulgar buffoons.” These people go too far in getting people to laugh; they care more about getting the laughs than they do about how a joke might hurt, harm, or offend someone. Some buffoons try to ingratiate themselves with others or score points by using humor to take people down. There’s also a category of people who turn themselves into the butt of their own jokes. Their goal may be to ingratiate themselves to others or to make the jokes before someone else does. Buffoonery, when directed at oneself, does cause harm to a person, but that harm is often ignored or taken as the price one must pay to be accepted.

A person who is deficient in humor is boorish, according to Aristotle. A boor laughs very little, in part because he finds very little amusing. Furthermore, the boorish person may be impatient with people who laugh and see the humor in a situation. A boor most certainly will never laugh at himself. The boor emits more than a whiff of disapproval with a distinct undertone of superiority.

Both buffoonery and boorishness are unpleasant and even painful to others in related ways. The buffoon may take nothing (including himself) seriously enough, while the boor takes everything (including himself) too seriously. The buffoon and boor each take themselves out of much of the everyday social traffic of life.

What is the right sort of wit? Aristotle would say it is pleasant as opposed to buffoonery and boorishness. It is a gentle good humor not intended to harm or exclude. Right wit is not at another’s expense or one’s own expense. Wit connects people rather than severing or tearing them apart. Many people say they tease only the people they love or that gentle teasing is one way to show love. One must be careful with teasing because people’s tolerance for it varies tremendously. One needs to know someone fairly well before she teases him.

A person may also have the right wit about him or herself. Many of us tell on ourselves not because we are afraid someone will tell first (though that may be true in some cases), but rather because it is a way to make a connection to other people. Some of us can’t wait to tell on ourselves because we know others will appreciate our stories and that will only make them funnier.

There most certainly are different senses of humor and this can cause a variety of problems ranging from harmless to devastating. Wittgenstein (1889-1951) wrote, “What is it like for people not to have the same sense of humor? They do not properly react to each other. It’s as though there were a custom amongst certain people for one person to throw to another a ball which he is supposed to catch and throw back; but for some people, instead of throwing it back, put it in their pocket.”  Not all people love wordplay and puns. Some love knock-knock jokes while others love seeing the absurd in a situation. Some people love sarcasm, which is a form of humor that easily becomes a weapon. The Greek root for “sarcasm,” is to tear or shred. Sarcasm most certainly builds connections within a group of people who delight in it while it can be utterly alienating and hurtful to those who do not. People who love sarcasm will toss the ball back and forth to each other. To the person who does not like sarcasm, it isn’t so much the other person puts the ball in his pocket but rather throws it at your head when you are not looking. This is not to say that sarcasm doesn’t have a place on the terrain of humor. It means a person must carefully wield it and not just because some people find it hurtful. Many people do not understand irony and sarcasm and may as a consequence take another literally. The claim, “I was only kidding and being sarcastic,” or “I was only joking,” may do little to redress a perceived or actual harm.

A person needs to be sensitive to the reasons why she is using wit and what she aims to accomplish in using it. The context is always crucial.  A shared wit can defuse a situation or make people feel comfortable and welcomed. Humor can be used to call out a wrong or harm; comedians offer political commentary. People of the same persuasion find it humorous while others with a different orientation do not. The upshot is that humor may include and it may exclude; it may connect you to some and distance you from others.

Your sense of humor is a good barometer of how you see yourself and others. Aristotle might tell us to pay attention to what we find amusing and to whom it connects us. The company a person keeps says a lot (if not everything) about a person’s character. Aristotle might also counsel us to pay attention to when we lose our sense of humor, which may feel like losing a part of yourself. On the flip side, in regaining a sense of humor, you may get an old part of yourself back or make a new part of yourself. Wit is seriously important to our happiness.

 

Photo Adobe

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Drug Addiction: Is Brain Stimulation The Answer?

From Medical News Today: Transcranial magnetic brain stimulation has allowed researchers to reduce how “excited” the brains of chronic cocaine and alcohol users become in response to drug cues. Drug addiction is a chronic disease affecting 5.4 percent of the population worldwide. In 2016, more than 64,000 people in the United States are thought to have died from a drug overdose.

According to most recent estimates, about 21.5 million U.S. individuals aged 12 and above live with a substance abuse disorder.

While the exact causes of drug addiction are unknown and researchers do not yet fully understand what causes someone to become addicted to a drug, we do know that, over time, drug abuse triggers changes in the brain that perpetuate the addiction cycle.

For example, we now know that the brain’s reward-processing circuits are thrown off balance in drug addiction, as the brain gets an excessive amount of the neurotransmitter dopamine.

Sometimes dubbed the “sex, drugs, and rock ‘n’ roll” neurotransmitter, dopamine plays a crucial role in reward-mediated motivation and learning, as well as in experiencing pleasure.

When the brain gets too much dopamine from drugs, it learns to continue to search for that “high” in favor of the “lesser” pleasure that it would normally get from other, daily rewards, such as consuming a chocolate bar or getting recognition at work.

These neurobiological underpinnings make addiction a so-called brain disease. Despite this, until now, researchers had not come up with treatments aimed at the neural circuits involved in the condition.

Now, however, researchers at the Medical University of South Carolina in Charleston may have found a treatment that successfully targets these brain circuits.

Supervised by Colleen Hanlon, Ph.D., researchers successfully used a noninvasive brain stimulation technique called transcranial magnetic stimulation (TMS) to blunt the brain’s response to the appeal of alcohol and cocaine in chronic users.

The findings were published in the journal Biological Psychiatry: Cognitive Neuroscience and Neuroimaging.

Treating the brain’s reward center

The researchers carried out two experiments at once, both of which were led by first study author Tonisha Kearney-Ramos, Ph.D. One study involved 24 participants with alcohol use disorder, and the second involved 25 participants with cocaine use disorder.

The study participants had one session of TMS and one control, or “sham,” session that imitated a TMS session without delivering any stimulation to the brain.

TMS allows for specific targeting of brain areas. In these experiments, both groups of participants received stimulation that focused on a brain region key for addiction and reward-processing: the ventromedial prefrontal cortex.

After the sessions, Kearney-Ramos and colleagues took scans of the participants’ brains using functional MRI in an effort to assess their response to drug cues such as seeing a liquor bottle.

TMS was found to have significantly reduced the brain’s reactivity to drug cues.

Dr. Cameron Carter, the editor of the journal that published the findings, explains what the results mean for treating drug addiction.

“Since cue reactivity has previously been associated with abstinence,” he says, “these [findings] suggest a common mechanism for treatment effects across disorders.”

Kearney-Ramos and her colleagues conclude, “This is the first sham-controlled investigation to demonstrate, in two populations, that VMPFC [stimulation] can attenuate neural reactivity to drug and alcohol cues in frontostriatal circuits.”

Hanlon also weighs in, saying, “Here, for the first time, we demonstrate that a new noninvasive brain stimulation technique may be the first tool available to fill [a] critical void in addiction treatment development.”

“Therefore, these results have a tremendous potential to impact both basic discovery neuroscience as well as targeted clinical treatment development for substance dependence.”

Colleen Hanlon, Ph.D.

“These results,” the study authors conclude, “provide an empirical foundation for future clinical trials that may evaluate the efficacy, durability, and clinical implications of VMPFC [stimulation] to treat addictions.”

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Eve Opens Up About Past Struggles With Alcohol, Xanax

From The Fix: Grammy award-winning rapper and actress Eve opened up about a “dark period” from her past, revealing that she had abused prescription pills and alcohol to cope with life.

According to People, the 39-year-old discussed her addictions on the CBS series The Talk, which she has co-hosted since last year.

The show’s hosts were talking about 17-year-old Willow Smith’s recent admission that she began cutting herself shortly after 2010’s “Whip My Hair”—a hit track that took Smith around the world.

“After the tour and the promotion and all of that, they wanted me to finish my album,” Smith said. “And I was like, I’m not gonna do that. And after all of that kinda settled down and it was like a kind of lull, I was just listening to a lot of dark music. It was just so crazy and I was plunged into this black hole, and I was cutting myself.”

The words immediately resonated with Eve who shared with her co-hosts that she understood Smith’s situation all too well.

“At a time in my life, at a point in my life, I’d gone through, and like [Smith] says, a dark hole,” Eve admitted. “I call it my ‘dark hole’ period, my dark period.”

Eve, whose song “Let Me Blow Ya Mind” (with Gwen Stefani) won the Grammy for Best Rap/Sung Collaboration in 2002, starred in a self-titled UPN sitcom as well as all three Barbershop films.

Success, she discovered, isn’t guaranteed to last. “I was out of a toxic relationship, I didn’t have a TV show, I didn’t have a record deal. I was just kinda like, what is happening with my life?” she explained. “So I started drinking, a lot.” (In 2007, Eve made headlines with a DUI charge.)

“I started drinking, and drinking, and drinking because I didn’t want to deal with my emotions,” Eve continued. “I didn’t have anybody to really talk to. I was even popping Xanax and drinking to numb my pain.”

“I just felt like I was coping, but I really wasn’t,” she noted. “You know, you think of harming yourself as cutting or something, but drinking and drugs is exactly the same thing in many ways.”

Her DUI charge, Eve said on The Talk, was the moment everything changed for her. (After leaving a nightclub in Hollywood, she crashed her gold Maserati into a concrete divider, with a blood alcohol level that was twice the legal limit.)

“It took my DUI, and I’ve talked about this on the show before, I got a DUI, and it took my DUI to wake me up because I had to wear one of those ankle things,” Eve observed. “And I didn’t want to because I knew it would force me to deal with my ‘S’, my stuff, and I did, and thankfully, I did and was able to get healthy.”

She added that “I prayed myself through it” and “I finally started figuring out the things that I needed to do to make myself healthy.”

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