CDEP: A Half Glass of Wine Daily May Add Years to Life
By Peggy Peck, Managing Editor, MedPage Today
Reviewed by Robert Jasmer, MD; Associate Clinical Professor of Medicine, University of California, San Francisco
March 01, 2007
Martinette T. Streppel, Ph.D. cand., Wageningen U., The Netherlands
ORLANDO, Fla., March 1 -- Men who limited alcohol intake to less than a glass of wine a day lived about four years longer than those who consumed similar amounts of beer or spirits, researchers here reported.
A number of studies have linked alcohol consumption-especially red wine consumption-to decreased risk of cardiovascular events, but Martinette T. Streppel, a Ph.D., student at Wageningen University in Bilhoven, The Netherlands, said this study may be the first to suggest that wine itself confers a survival benefit.
Action Points
§ Explain to interested patients that this report was derived from an observational study and the findings need to be confirmed in a prospective study.
§ This study was published as an abstract and presented orally at a conference. These data and conclusions should be considered to be preliminary as they have not yet been reviewed and published in a peer-reviewed publication.
Compared with non-drinkers, men who consumed wine, beer, or spirits had a 36% lower risk of all-cause mortality and a 34% lower risk of cardiovascular mortality, she said at the Conference on Cardiovascular Disease Epidemiology and Prevention, which is sponsored by the American Heart Association.
"But men who drank about a half a glass of wine a day had a 40% reduction in all cause mortality and a 48% lower incidence of cardiovascular death," said Daan Kromhout, Ph.D., a professor of public health at Wageningen University and vice president of the Health Council of The Netherlands. Dr. Kromhout was senior author of the paper.
The finding emerged from analysis of data collected in the Zutphen Study, a cohort study of 1,373 men born between 1900 and 1920, which Streppel and colleagues reported. The men were enrolled in the study at age 40 and were followed for an average of 40 years.
Information about alcohol consumption as well as dietary habits, smoking, body mass index, and prevalence of heart disease, stroke, diabetes, and cancer, was collected by seven surveys conducted over the course of the study.
Light alcohol intake was defined as 20 grams or less a day, or about two glasses of wine. The average long-term intake was six grams of alcohol daily, which was equal to four ounces of beer, two ounces of wine, or one ounce of spirits.
Compared with men who did not consume alcoholic beverages, wine drinkers lived 3.8 years longer.
Among the findings:
· 45% of the men used alcohol in 1960, when they were 40 to 60 years old, but 85% of the men who survived until the year 2000 used alcohol.
· In 1960, the average consumption was eight grams of alcohol daily, which increased to 18 grams a day in 1985 and decreased to 13 grams.
· In 1960, 2% of the men were wine drinkers versus more than 40% of the men in the final survey in 2000.
The study did not differentiate between type of wine consumed, said Dr. Kromhout, who added "the type of wine consumed-red or white-usually varies by the season with red wine being more popular during the winter months."
Streppel speculated that the benefit observed for light wine drinkers might be linked to an increase in HDL cholesterol-a finding that has already been reported in other wine studies-or to "inhibition of platelet aggregation associated with wine."
The study was funded by the The Netherlands Food and Consumer Product Safety Authority and The Netherlands National Institute for Public Health and the Environment.
Primary source: Cardiovascular Disease Epidemiology and Prevention
Source reference:
Streppel MT "Long-Term Wine Consumption Is Independent of Moderate Alcohol Related to Cardiovascular Mortality and Live Expectance: the Zutphen Study" P57
Friday
ONDCP vs. DPA on Student Drug Testing
Bertha Madras left the bench (at Harvard) two years ago to go work for ONDCP. Here's an interview with her (sparring with a rep from DPA) on the issue of student drug testing.
After the interview article, there is the statement of the American Academy of Pediatrics on student drug testing.
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http://www.msnbc.msn.com/id/16893833/site/newsweek/
WEB EXCLUSIVE
Should Schools Conduct Random Drug Tests?
The White House wants more schools to adopt random student drug-testing programs. NEWSWEEK talks to advocates on both sides of the issue.
By Alexandra Gekas Newsweek Jan. 30, 2007
The White House Office of National Drug Control Policy announced last week that it will be holding four regional summits promoting random student drug testing in public middle and high schools. The controversial program, which has already been implemented in nearly 1,000 middle and high schools across the country, requires that kids submit to random drug testing if they want to participate in competitive extracurricular activities like athletics. The Department of Education offers grants to schools that want to develop or expand a drug-testing programs for children in grades 6-12, but decisions about whether to test and which drugs to test for are made on an individual school level. The testing is usually done by a school nurse with a urine sample taken on school premises. If there's a positive result, the sample is sent out for verification by a lab. Tests can also be done with blood or saliva. Samples are generally tested for cocaine, marijuana, ecstasy, opium-based substances, oxycontin and, in some cases, steroids.
\u003c/p\>\n\u003cp\>\u003cfont size\u003d\"2\"\>The proposed expansion of the program has prompted fierce debate and raised both privacy and efficacy questions. NEWSWEEK's Alexandra Gekas spoke with advocates on both sides of the issue: Dr. Bertha Madras, the deputy director of Demand Reduction in the ONDCP, which coordinates and promotes President Bush's drug prevention and treatment initiatives; and Jennifer Kern, a research associate with the Drug Policy Alliance, a group opposed to the program. (The interviews were conducted separately, but we've presented the participants' answers side by side.) Excerpts:\u003c/font\>\u003c/p\>\n\u003cp\>\u003cfont size\u003d\"2\"\>NEWSWEEK: How does student drug testing work?\u003c/font\> \u003cbr\>\u003cfont size\u003d\"2\"\>Dr. Bertha Madras: Under ideal conditions the testing is random, which is critical. If it's a urine test, the child is asked to come down to the nurse's office. They walk in solo, they deposit a sample as they would in any doctor's office, they give the sample to the nurse who puts a little dip stick in, and the dip stick will say positive or negative. \u003c/font\>\u003c/p\>\n\u003cp\>\u003cfont size\u003d\"2\"\>Jennifer Kern: They are removed from their classrooms and are escorted to take a drug test, and if they end up with a positive test result they are removed from their extracurricular activity. And because this is a very public removal from the classroom and often a public removal from the extracurricular activity, the testing is not as confidential as promised.\u003c/font\>\u003c/p\>\u003cbr\>\u003cbr\>\n\u003cp\>\u003cfont size\u003d\"2\"\>Is there a standard model for schools to follow when implementing the random testing?\u003c/font\> \u003cbr\>\u003cfont size\u003d\"2\"\>Madras: Schools have done it voluntarily without any federal assistance for a number of years since the 1990s. Once the Supreme Court weighed in, then it became more of a formalized procedure on how you do it and how you develop policies. [In 2002, the Supreme Court ruled that random drug testing of students participating in extracurricular activities does not violate the Constitution.] When grants became available in the Department of Education, then there were guidelines on how to do it. ",1]
);
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The proposed expansion of the program has prompted fierce debate and raised both privacy and efficacy questions. NEWSWEEK's Alexandra Gekas spoke with advocates on both sides of the issue: Dr. Bertha Madras, the deputy director of Demand Reduction in the ONDCP, which coordinates and promotes President Bush's drug prevention and treatment initiatives; and Jennifer Kern, a research associate with the Drug Policy Alliance, a group opposed to the program. (The interviews were conducted separately, but we've presented the participants' answers side by side.) Excerpts:
NEWSWEEK: How does student drug testing work? Dr. Bertha Madras: Under ideal conditions the testing is random, which is critical. If it's a urine test, the child is asked to come down to the nurse's office. They walk in solo, they deposit a sample as they would in any doctor's office, they give the sample to the nurse who puts a little dip stick in, and the dip stick will say positive or negative.
Jennifer Kern: They are removed from their classrooms and are escorted to take a drug test, and if they end up with a positive test result they are removed from their extracurricular activity. And because this is a very public removal from the classroom and often a public removal from the extracurricular activity, the testing is not as confidential as promised.
Is there a standard model for schools to follow when implementing the random testing? Madras: Schools have done it voluntarily without any federal assistance for a number of years since the 1990s. Once the Supreme Court weighed in, then it became more of a formalized procedure on how you do it and how you develop policies. [In 2002, the Supreme Court ruled that random drug testing of students participating in extracurricular activities does not violate the Constitution.] When grants became available in the Department of Education, then there were guidelines on how to do it.
\u003c/p\>\n\u003cp\>\u003cfont size\u003d\"2\"\>Kern: There are model policies that are put out, but there is no legislation or guidelines for schools beyond the Supreme Court decision. [Schools] are not allowed to use the test results in certain ways legally, but in terms of how it is implemented, it varies. For some schools there's no verification on the type of labs they're using so there's a lot of concern that schools are using labs that are not certified or they are using their own staff. No protocol on how schools have to do it exists, so there is concern about schools not knowing what to do, leading to breaches of confidentiality and false positives.\u003c/font\>\u003c/p\>\n\u003cp\>\u003cfont size\u003d\"2\"\>Is anyone monitoring the schools to make sure they are doing it correctly?\u003c/font\> \u003cbr\>\u003cfont size\u003d\"2\"\>Madras: For the federal grants, there are project officers who keep in touch with the schools to see if they're going well. So when it's a federal program there clearly is oversight of the grant. If it's a grass-roots program, of which there are many in the country, then the monitoring is self-monitoring by the schools themselves. The critical thing to bear in mind with this program is the confidential nature of the information. \u003c/font\>\u003c/p\>\n\u003cp\>\u003cfont size\u003d\"2\"\>Kern: There's no outside monitoring. There's no regulation and there's no check or balance. While some schools describe the program as non-punitive, some schools have very harsh repercussions as far as removing kids from their extracurricular activities for the rest of the year or the rest of their school career. Some schools provide counseling but some provide no services to the students if they test positive. In a lot of places there isn't much money and there aren't many resources for students who test positive.\u003c/font\>\u003c/p\>\u003cbr\>\u003cbr\>\n\u003cp\>\u003cfont size\u003d\"2\"\>What are the penalties or repercussions for positive tests?\u003c/font\> \u003cbr\>\u003cfont size\u003d\"2\"\>Madras: The first repercussion is that the parents are called in and they're told that there is a positive test and we'd like to get help for the child. We can recommend a medical review officer who can go over what the test means and who can provide counseling. Sometimes the counseling is quick because it appears that the problem is not a profound one. At some schools there's no other repercussions in regard to their extracurricular activities, and in some schools the child is not allowed to play competitively for a period of time, but they can continue to practice with the team. ",1]
);
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Kern: There are model policies that are put out, but there is no legislation or guidelines for schools beyond the Supreme Court decision. [Schools] are not allowed to use the test results in certain ways legally, but in terms of how it is implemented, it varies. For some schools there's no verification on the type of labs they're using so there's a lot of concern that schools are using labs that are not certified or they are using their own staff. No protocol on how schools have to do it exists, so there is concern about schools not knowing what to do, leading to breaches of confidentiality and false positives.
Is anyone monitoring the schools to make sure they are doing it correctly? Madras: For the federal grants, there are project officers who keep in touch with the schools to see if they're going well. So when it's a federal program there clearly is oversight of the grant. If it's a grass-roots program, of which there are many in the country, then the monitoring is self-monitoring by the schools themselves. The critical thing to bear in mind with this program is the confidential nature of the information.
Kern: There's no outside monitoring. There's no regulation and there's no check or balance. While some schools describe the program as non-punitive, some schools have very harsh repercussions as far as removing kids from their extracurricular activities for the rest of the year or the rest of their school career. Some schools provide counseling but some provide no services to the students if they test positive. In a lot of places there isn't much money and there aren't many resources for students who test positive.
What are the penalties or repercussions for positive tests? Madras: The first repercussion is that the parents are called in and they're told that there is a positive test and we'd like to get help for the child. We can recommend a medical review officer who can go over what the test means and who can provide counseling. Sometimes the counseling is quick because it appears that the problem is not a profound one. At some schools there's no other repercussions in regard to their extracurricular activities, and in some schools the child is not allowed to play competitively for a period of time, but they can continue to practice with the team.
\u003c/p\>\n\u003cp\>\u003cfont size\u003d\"2\"\>Kern: It's determined by the local school district, so typically it is suspension from an extracurricular activity, although I don't believe they are allowed to punish them in a way that would cause them to not be able to finish their education. Sometimes it can be very harsh and the concern is that extracurricular activities have been proven to keep students engaged and in school during the peak drug hours of 3 p.m. to 6 p.m., when parents are not home.\u003c/font\>\u003c/p\>\n\u003cp\>\u003cfont size\u003d\"2\"\>Is there a risk that kids who test positive for drugs will be stigmatized?\u003c/font\> \u003cbr\>\u003cfont size\u003d\"2\"\>Madras: The thing that I have heard is that everyone knows who's using drugs; there are no surprises amongst the kids. Kids know who are the users, their friends know, so when a kid is not engaged in sports for one game, nobody is surprised. I've been a parent all my life, and I knew which one of the kids I didn't want my kids near. I think the far greater risk is using the drug that can have adverse consequences on brain, body and behavior. \u003c/font\>\u003c/p\>\n\u003cp\>\u003cfont size\u003d\"2\"\>Kern: What is the point of removing the kids from extracurricular activities when they are most in need of that support and there is the question of confidentiality and those students being labeled as the 'bad kid' and how that effects them?\u003c/font\>\u003c/p\>\u003cbr\>\n\u003cp\>\u003cfont size\u003d\"2\"\>The ONDCP cites a random drug-testing program that was put in place for the military more than 20 years ago as evidence that testing can be effective in reducing drug use.\u003c/font\>\u003c/p\>\n\u003cp\>\u003cfont size\u003d\"2\"\>Madras: When the military began random mandatory testing the tests were 27 percent positive and now they are 1.5 percent. It didn't disappear in one year or two or five, but it declined very steeply and it's been steady for years.\u003c/font\>\u003c/p\>\n\u003cp\>\u003cfont size\u003d\"2\"\>Kern: Military testing has been in place, but some people coming back from certain situations certainly do continue to have substance-abuse problems.\u003c/font\>\u003c/p\>\n\u003cp\>\u003cfont size\u003d\"2\"\>Should a program from the military be applied to kids?",1]
);
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Kern: It's determined by the local school district, so typically it is suspension from an extracurricular activity, although I don't believe they are allowed to punish them in a way that would cause them to not be able to finish their education. Sometimes it can be very harsh and the concern is that extracurricular activities have been proven to keep students engaged and in school during the peak drug hours of 3 p.m. to 6 p.m., when parents are not home.
Is there a risk that kids who test positive for drugs will be stigmatized? Madras: The thing that I have heard is that everyone knows who's using drugs; there are no surprises amongst the kids. Kids know who are the users, their friends know, so when a kid is not engaged in sports for one game, nobody is surprised. I've been a parent all my life, and I knew which one of the kids I didn't want my kids near. I think the far greater risk is using the drug that can have adverse consequences on brain, body and behavior.
Kern: What is the point of removing the kids from extracurricular activities when they are most in need of that support and there is the question of confidentiality and those students being labeled as the 'bad kid' and how that effects them?
The ONDCP cites a random drug-testing program that was put in place for the military more than 20 years ago as evidence that testing can be effective in reducing drug use.
Madras: When the military began random mandatory testing the tests were 27 percent positive and now they are 1.5 percent. It didn't disappear in one year or two or five, but it declined very steeply and it's been steady for years.
Kern: Military testing has been in place, but some people coming back from certain situations certainly do continue to have substance-abuse problems.
Should a program from the military be applied to kids?
\u003cbr\>\u003cfont size\u003d\"2\"\>Madras: I think it's very relevant because what you know is that behavioral modification is always a hybrid of positive and negative reinforcement. If you have a policy that says that drugs are not good for people then you institute a way of trying to modify behavior. The military did it just by random drug testing with consequence, and the same random testing in schools with very, very gentle outcomes or consequences, which are really targeted for the benefit of the child and not for the benefit of the school. And this is a way of enlisting the parents and saying we have to help this child. The deterrent factor in the schools is different than in the military. For the kids, one of the things that deter them is that they don't want to disappoint their parents.\u003c/font\>\u003c/p\>\n\u003cp\>\u003cfont size\u003d\"2\"\>Kern: People who elect to be in the military are going to be very different from people who need to be in high school and they are going to be at very different developmental stages in life, so how drugs affect them are going to be very different. Random drug testing has not been proven to deter drug use. In 2003, the National Institute on Drug Abuse funded the largest study ever conducted on the topic, and the Robert Wood Johnson Foundation backed it up with a second study that same year. Seasoned researchers compared a total of 94,000 students in almost 900 American schools with and without a drug-testing program, and found no differences in illegal drug use among students from both sets of schools.\u003c/font\>\u003c/p\>\u003cbr\>\n\u003cp\>\u003cfont size\u003d\"2\"\>What kind of a message are we sending to kids by saying that we don't trust them when they tell us they aren't doing drugs?\u003c/font\>\u003c/p\>\n\u003cp\>\u003cfont size\u003d\"2\"\>Madras: I don't think there's a negative message. When I go to schools that have the federal grant they say, "We love it! It gives me an excuse not to use at parties because kids are always pushing on us," but none of them say they're angry with the school. What I've heard above all is "thank you."",1]
);
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Madras: I think it's very relevant because what you know is that behavioral modification is always a hybrid of positive and negative reinforcement. If you have a policy that says that drugs are not good for people then you institute a way of trying to modify behavior. The military did it just by random drug testing with consequence, and the same random testing in schools with very, very gentle outcomes or consequences, which are really targeted for the benefit of the child and not for the benefit of the school. And this is a way of enlisting the parents and saying we have to help this child. The deterrent factor in the schools is different than in the military. For the kids, one of the things that deter them is that they don't want to disappoint their parents.
Kern: People who elect to be in the military are going to be very different from people who need to be in high school and they are going to be at very different developmental stages in life, so how drugs affect them are going to be very different. Random drug testing has not been proven to deter drug use. In 2003, the National Institute on Drug Abuse funded the largest study ever conducted on the topic, and the Robert Wood Johnson Foundation backed it up with a second study that same year. Seasoned researchers compared a total of 94,000 students in almost 900 American schools with and without a drug-testing program, and found no differences in illegal drug use among students from both sets of schools.
What kind of a message are we sending to kids by saying that we don't trust them when they tell us they aren't doing drugs?
Madras: I don't think there's a negative message. When I go to schools that have the federal grant they say, "We love it! It gives me an excuse not to use at parties because kids are always pushing on us," but none of them say they're angry with the school. What I've heard above all is "thank you."
\u003c/p\>\n\u003cp\>\u003cfont size\u003d\"2\"\>Kern: They are undermining the very protective factors that are shown to keep people out of trouble with drugs. For instance, [there are] concerns that the testing breaks down relationships of trust between students and adults at school, hinders open communication and contributes to a hostile school environment and it risks deterring students from extracurricular activities.\u003c/font\>\u003c/p\>\n\u003cp\>\u003cfont size\u003d\"2\"\>Is mandatory drug testing a violation of a student's right to privacy?\u003c/font\> \u003cbr\>\u003cfont size\u003d\"2\"\>Madras: I think that privacy issues are really interesting for adolescents. If a child is doing something that is illegal, then how do we weigh the more important value, which is how to protect a child? Really, ask yourself logically, do you feel young people who don't have a fully developed sense of self should be able to do things that are illegal to harm themselves? \u003c/font\>\u003c/p\>\n\u003cp\>\u003cfont size\u003d\"2\"\>Kern: [Drug testing ] is only for students who participate in extracurricular activities because the Supreme Court ruled it is permissible to [test] students in those activities because it described them as a privilege. But students in those programs are shown to have fewer problems with drugs so there is concern that it will deter kids from participating in those activities, which help kids feel connected and engaged with school. The Supreme Court decision is treating students like they are guilty until proven innocent.\u003c/font\>\u003c/p\>\n\u003cp\>\u003cfont size\u003d\"2\"\>-------------\u003c/font\> \u003c/p\>\n\u003cp\>\u003cfont size\u003d\"2\"\>entire article:\u003c/font\> \u003c/p\>\n\u003cp\>\u003cfont size\u003d\"2\"\>\u003ca href\u003d\"http://pediatrics.aappublications.org/cgi/reprint/119/3/627\" target\u003d\"_blank\" onclick\u003d\"return top.js.OpenExtLink(window,event,this)\"\>http://pediatrics.aappublicatio\u003cWBR\>ns.org/cgi/reprint/119/3/627\u003c/a\>\u003c/font\> \u003c/p\>\u003cbr\>\n\u003cp\>\u003cfont size\u003d\"2\"\>short statement:\u003c/font\> \u003c/p\>\n\u003cp\>\u003cfont size\u003d\"2\"\>\u003ca href\u003d\"http://pediatrics.aappublications.org/cgi/content/short/119/3/627\" target\u003d\"_blank\" onclick\u003d\"return top.js.OpenExtLink(window,event,this)\"\>http://pediatrics.aappublicatio",1]
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Kern: They are undermining the very protective factors that are shown to keep people out of trouble with drugs. For instance, [there are] concerns that the testing breaks down relationships of trust between students and adults at school, hinders open communication and contributes to a hostile school environment and it risks deterring students from extracurricular activities.
Is mandatory drug testing a violation of a student's right to privacy? Madras: I think that privacy issues are really interesting for adolescents. If a child is doing something that is illegal, then how do we weigh the more important value, which is how to protect a child? Really, ask yourself logically, do you feel young people who don't have a fully developed sense of self should be able to do things that are illegal to harm themselves?
Kern: [Drug testing ] is only for students who participate in extracurricular activities because the Supreme Court ruled it is permissible to [test] students in those activities because it described them as a privilege. But students in those programs are shown to have fewer problems with drugs so there is concern that it will deter kids from participating in those activities, which help kids feel connected and engaged with school. The Supreme Court decision is treating students like they are guilty until proven innocent.
-------------
entire article:
http://pediatrics.aappublications.org/cgi/reprint/119/3/627
short statement:
http://pediatrics.aappublicatio
ns.org/cgi/content/short/119/3\u003cWBR\>/627\u003c/a\>\u003c/font\> \u003c/p\>\n\u003cp\>\u003cfont size\u003d\"2\"\>PEDIATRICS Vol. 119 No. 3 March 2007, pp. 627-630\u003c/font\> \u003c/p\>\n\u003cp\>\u003cfont size\u003d\"2\"\>POLICY STATEMENT \u003c/font\>\u003c/p\>\n\u003cp\>\u003cfont size\u003d\"2\"\>Testing for Drugs of Abuse in Children and Adolescents: Addendum—Testing in Schools and at Home\u003c/font\> \u003c/p\>\n\u003cp\>\u003cfont size\u003d\"2\"\>Committee on Substance Abuse and Council on School Health \u003c/font\>\u003c/p\>\u003cbr\>\n\u003cp\>\u003cfont size\u003d\"2\"\>The American Academy of Pediatrics continues to believe that adolescents should not be drug tested without their knowledge and consent. \u003c/font\>\u003c/p\>\n\u003cp\>\u003cfont size\u003d\"2\"\>Recent US Supreme Court decisions and market forces have resulted in recommendations for drug testing of adolescents at school and products for parents to use to test adolescents at home. \u003c/font\>\u003c/p\>\n\u003cp\>\u003cfont size\u003d\"2\"\>The American Academy of Pediatrics has strong reservations about testing adolescents at school or at home and believes that more research is needed on both safety and efficacy before school-based testing programs are implemented. \u003c/font\>\u003c/p\>\n\u003cp\>\u003cfont size\u003d\"2\"\>The American Academy of Pediatrics also believes that more adolescent-specific substance abuse treatment resources are needed to ensure that testing leads to early rehabilitation rather than to punitive measures only. \u003c/font\>\u003c/p\>\u003cbr\>\u003cbr\>\u003cbr\>\u003cbr\>\u003c/div\>\u003c/div\>",0]
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ns.org/cgi/content/short/119/3/627
PEDIATRICS Vol. 119 No. 3 March 2007, pp. 627-630
POLICY STATEMENT
Testing for Drugs of Abuse in Children and Adolescents: Addendum—Testing in Schools and at Home
Committee on Substance Abuse and Council on School Health
The American Academy of Pediatrics continues to believe that adolescents should not be drug tested without their knowledge and consent.
Recent US Supreme Court decisions and market forces have resulted in recommendations for drug testing of adolescents at school and products for parents to use to test adolescents at home.
The American Academy of Pediatrics has strong reservations about testing adolescents at school or at home and believes that more research is needed on both safety and efficacy before school-based testing programs are implemented.
The American Academy of Pediatrics also believes that more adolescent-specific substance abuse treatment resources are needed to ensure that testing leads to early rehabilitation rather than to punitive measures only.
After the interview article, there is the statement of the American Academy of Pediatrics on student drug testing.
----------
http://www.msnbc.msn.com/id/16893833/site/newsweek/
WEB EXCLUSIVE
Should Schools Conduct Random Drug Tests?
The White House wants more schools to adopt random student drug-testing programs. NEWSWEEK talks to advocates on both sides of the issue.
By Alexandra Gekas Newsweek Jan. 30, 2007
The White House Office of National Drug Control Policy announced last week that it will be holding four regional summits promoting random student drug testing in public middle and high schools. The controversial program, which has already been implemented in nearly 1,000 middle and high schools across the country, requires that kids submit to random drug testing if they want to participate in competitive extracurricular activities like athletics. The Department of Education offers grants to schools that want to develop or expand a drug-testing programs for children in grades 6-12, but decisions about whether to test and which drugs to test for are made on an individual school level. The testing is usually done by a school nurse with a urine sample taken on school premises. If there's a positive result, the sample is sent out for verification by a lab. Tests can also be done with blood or saliva. Samples are generally tested for cocaine, marijuana, ecstasy, opium-based substances, oxycontin and, in some cases, steroids.
\u003c/p\>\n\u003cp\>\u003cfont size\u003d\"2\"\>The proposed expansion of the program has prompted fierce debate and raised both privacy and efficacy questions. NEWSWEEK's Alexandra Gekas spoke with advocates on both sides of the issue: Dr. Bertha Madras, the deputy director of Demand Reduction in the ONDCP, which coordinates and promotes President Bush's drug prevention and treatment initiatives; and Jennifer Kern, a research associate with the Drug Policy Alliance, a group opposed to the program. (The interviews were conducted separately, but we've presented the participants' answers side by side.) Excerpts:\u003c/font\>\u003c/p\>\n\u003cp\>\u003cfont size\u003d\"2\"\>NEWSWEEK: How does student drug testing work?\u003c/font\> \u003cbr\>\u003cfont size\u003d\"2\"\>Dr. Bertha Madras: Under ideal conditions the testing is random, which is critical. If it's a urine test, the child is asked to come down to the nurse's office. They walk in solo, they deposit a sample as they would in any doctor's office, they give the sample to the nurse who puts a little dip stick in, and the dip stick will say positive or negative. \u003c/font\>\u003c/p\>\n\u003cp\>\u003cfont size\u003d\"2\"\>Jennifer Kern: They are removed from their classrooms and are escorted to take a drug test, and if they end up with a positive test result they are removed from their extracurricular activity. And because this is a very public removal from the classroom and often a public removal from the extracurricular activity, the testing is not as confidential as promised.\u003c/font\>\u003c/p\>\u003cbr\>\u003cbr\>\n\u003cp\>\u003cfont size\u003d\"2\"\>Is there a standard model for schools to follow when implementing the random testing?\u003c/font\> \u003cbr\>\u003cfont size\u003d\"2\"\>Madras: Schools have done it voluntarily without any federal assistance for a number of years since the 1990s. Once the Supreme Court weighed in, then it became more of a formalized procedure on how you do it and how you develop policies. [In 2002, the Supreme Court ruled that random drug testing of students participating in extracurricular activities does not violate the Constitution.] When grants became available in the Department of Education, then there were guidelines on how to do it. ",1]
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The proposed expansion of the program has prompted fierce debate and raised both privacy and efficacy questions. NEWSWEEK's Alexandra Gekas spoke with advocates on both sides of the issue: Dr. Bertha Madras, the deputy director of Demand Reduction in the ONDCP, which coordinates and promotes President Bush's drug prevention and treatment initiatives; and Jennifer Kern, a research associate with the Drug Policy Alliance, a group opposed to the program. (The interviews were conducted separately, but we've presented the participants' answers side by side.) Excerpts:
NEWSWEEK: How does student drug testing work? Dr. Bertha Madras: Under ideal conditions the testing is random, which is critical. If it's a urine test, the child is asked to come down to the nurse's office. They walk in solo, they deposit a sample as they would in any doctor's office, they give the sample to the nurse who puts a little dip stick in, and the dip stick will say positive or negative.
Jennifer Kern: They are removed from their classrooms and are escorted to take a drug test, and if they end up with a positive test result they are removed from their extracurricular activity. And because this is a very public removal from the classroom and often a public removal from the extracurricular activity, the testing is not as confidential as promised.
Is there a standard model for schools to follow when implementing the random testing? Madras: Schools have done it voluntarily without any federal assistance for a number of years since the 1990s. Once the Supreme Court weighed in, then it became more of a formalized procedure on how you do it and how you develop policies. [In 2002, the Supreme Court ruled that random drug testing of students participating in extracurricular activities does not violate the Constitution.] When grants became available in the Department of Education, then there were guidelines on how to do it.
\u003c/p\>\n\u003cp\>\u003cfont size\u003d\"2\"\>Kern: There are model policies that are put out, but there is no legislation or guidelines for schools beyond the Supreme Court decision. [Schools] are not allowed to use the test results in certain ways legally, but in terms of how it is implemented, it varies. For some schools there's no verification on the type of labs they're using so there's a lot of concern that schools are using labs that are not certified or they are using their own staff. No protocol on how schools have to do it exists, so there is concern about schools not knowing what to do, leading to breaches of confidentiality and false positives.\u003c/font\>\u003c/p\>\n\u003cp\>\u003cfont size\u003d\"2\"\>Is anyone monitoring the schools to make sure they are doing it correctly?\u003c/font\> \u003cbr\>\u003cfont size\u003d\"2\"\>Madras: For the federal grants, there are project officers who keep in touch with the schools to see if they're going well. So when it's a federal program there clearly is oversight of the grant. If it's a grass-roots program, of which there are many in the country, then the monitoring is self-monitoring by the schools themselves. The critical thing to bear in mind with this program is the confidential nature of the information. \u003c/font\>\u003c/p\>\n\u003cp\>\u003cfont size\u003d\"2\"\>Kern: There's no outside monitoring. There's no regulation and there's no check or balance. While some schools describe the program as non-punitive, some schools have very harsh repercussions as far as removing kids from their extracurricular activities for the rest of the year or the rest of their school career. Some schools provide counseling but some provide no services to the students if they test positive. In a lot of places there isn't much money and there aren't many resources for students who test positive.\u003c/font\>\u003c/p\>\u003cbr\>\u003cbr\>\n\u003cp\>\u003cfont size\u003d\"2\"\>What are the penalties or repercussions for positive tests?\u003c/font\> \u003cbr\>\u003cfont size\u003d\"2\"\>Madras: The first repercussion is that the parents are called in and they're told that there is a positive test and we'd like to get help for the child. We can recommend a medical review officer who can go over what the test means and who can provide counseling. Sometimes the counseling is quick because it appears that the problem is not a profound one. At some schools there's no other repercussions in regard to their extracurricular activities, and in some schools the child is not allowed to play competitively for a period of time, but they can continue to practice with the team. ",1]
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Kern: There are model policies that are put out, but there is no legislation or guidelines for schools beyond the Supreme Court decision. [Schools] are not allowed to use the test results in certain ways legally, but in terms of how it is implemented, it varies. For some schools there's no verification on the type of labs they're using so there's a lot of concern that schools are using labs that are not certified or they are using their own staff. No protocol on how schools have to do it exists, so there is concern about schools not knowing what to do, leading to breaches of confidentiality and false positives.
Is anyone monitoring the schools to make sure they are doing it correctly? Madras: For the federal grants, there are project officers who keep in touch with the schools to see if they're going well. So when it's a federal program there clearly is oversight of the grant. If it's a grass-roots program, of which there are many in the country, then the monitoring is self-monitoring by the schools themselves. The critical thing to bear in mind with this program is the confidential nature of the information.
Kern: There's no outside monitoring. There's no regulation and there's no check or balance. While some schools describe the program as non-punitive, some schools have very harsh repercussions as far as removing kids from their extracurricular activities for the rest of the year or the rest of their school career. Some schools provide counseling but some provide no services to the students if they test positive. In a lot of places there isn't much money and there aren't many resources for students who test positive.
What are the penalties or repercussions for positive tests? Madras: The first repercussion is that the parents are called in and they're told that there is a positive test and we'd like to get help for the child. We can recommend a medical review officer who can go over what the test means and who can provide counseling. Sometimes the counseling is quick because it appears that the problem is not a profound one. At some schools there's no other repercussions in regard to their extracurricular activities, and in some schools the child is not allowed to play competitively for a period of time, but they can continue to practice with the team.
\u003c/p\>\n\u003cp\>\u003cfont size\u003d\"2\"\>Kern: It's determined by the local school district, so typically it is suspension from an extracurricular activity, although I don't believe they are allowed to punish them in a way that would cause them to not be able to finish their education. Sometimes it can be very harsh and the concern is that extracurricular activities have been proven to keep students engaged and in school during the peak drug hours of 3 p.m. to 6 p.m., when parents are not home.\u003c/font\>\u003c/p\>\n\u003cp\>\u003cfont size\u003d\"2\"\>Is there a risk that kids who test positive for drugs will be stigmatized?\u003c/font\> \u003cbr\>\u003cfont size\u003d\"2\"\>Madras: The thing that I have heard is that everyone knows who's using drugs; there are no surprises amongst the kids. Kids know who are the users, their friends know, so when a kid is not engaged in sports for one game, nobody is surprised. I've been a parent all my life, and I knew which one of the kids I didn't want my kids near. I think the far greater risk is using the drug that can have adverse consequences on brain, body and behavior. \u003c/font\>\u003c/p\>\n\u003cp\>\u003cfont size\u003d\"2\"\>Kern: What is the point of removing the kids from extracurricular activities when they are most in need of that support and there is the question of confidentiality and those students being labeled as the 'bad kid' and how that effects them?\u003c/font\>\u003c/p\>\u003cbr\>\n\u003cp\>\u003cfont size\u003d\"2\"\>The ONDCP cites a random drug-testing program that was put in place for the military more than 20 years ago as evidence that testing can be effective in reducing drug use.\u003c/font\>\u003c/p\>\n\u003cp\>\u003cfont size\u003d\"2\"\>Madras: When the military began random mandatory testing the tests were 27 percent positive and now they are 1.5 percent. It didn't disappear in one year or two or five, but it declined very steeply and it's been steady for years.\u003c/font\>\u003c/p\>\n\u003cp\>\u003cfont size\u003d\"2\"\>Kern: Military testing has been in place, but some people coming back from certain situations certainly do continue to have substance-abuse problems.\u003c/font\>\u003c/p\>\n\u003cp\>\u003cfont size\u003d\"2\"\>Should a program from the military be applied to kids?",1]
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Kern: It's determined by the local school district, so typically it is suspension from an extracurricular activity, although I don't believe they are allowed to punish them in a way that would cause them to not be able to finish their education. Sometimes it can be very harsh and the concern is that extracurricular activities have been proven to keep students engaged and in school during the peak drug hours of 3 p.m. to 6 p.m., when parents are not home.
Is there a risk that kids who test positive for drugs will be stigmatized? Madras: The thing that I have heard is that everyone knows who's using drugs; there are no surprises amongst the kids. Kids know who are the users, their friends know, so when a kid is not engaged in sports for one game, nobody is surprised. I've been a parent all my life, and I knew which one of the kids I didn't want my kids near. I think the far greater risk is using the drug that can have adverse consequences on brain, body and behavior.
Kern: What is the point of removing the kids from extracurricular activities when they are most in need of that support and there is the question of confidentiality and those students being labeled as the 'bad kid' and how that effects them?
The ONDCP cites a random drug-testing program that was put in place for the military more than 20 years ago as evidence that testing can be effective in reducing drug use.
Madras: When the military began random mandatory testing the tests were 27 percent positive and now they are 1.5 percent. It didn't disappear in one year or two or five, but it declined very steeply and it's been steady for years.
Kern: Military testing has been in place, but some people coming back from certain situations certainly do continue to have substance-abuse problems.
Should a program from the military be applied to kids?
\u003cbr\>\u003cfont size\u003d\"2\"\>Madras: I think it's very relevant because what you know is that behavioral modification is always a hybrid of positive and negative reinforcement. If you have a policy that says that drugs are not good for people then you institute a way of trying to modify behavior. The military did it just by random drug testing with consequence, and the same random testing in schools with very, very gentle outcomes or consequences, which are really targeted for the benefit of the child and not for the benefit of the school. And this is a way of enlisting the parents and saying we have to help this child. The deterrent factor in the schools is different than in the military. For the kids, one of the things that deter them is that they don't want to disappoint their parents.\u003c/font\>\u003c/p\>\n\u003cp\>\u003cfont size\u003d\"2\"\>Kern: People who elect to be in the military are going to be very different from people who need to be in high school and they are going to be at very different developmental stages in life, so how drugs affect them are going to be very different. Random drug testing has not been proven to deter drug use. In 2003, the National Institute on Drug Abuse funded the largest study ever conducted on the topic, and the Robert Wood Johnson Foundation backed it up with a second study that same year. Seasoned researchers compared a total of 94,000 students in almost 900 American schools with and without a drug-testing program, and found no differences in illegal drug use among students from both sets of schools.\u003c/font\>\u003c/p\>\u003cbr\>\n\u003cp\>\u003cfont size\u003d\"2\"\>What kind of a message are we sending to kids by saying that we don't trust them when they tell us they aren't doing drugs?\u003c/font\>\u003c/p\>\n\u003cp\>\u003cfont size\u003d\"2\"\>Madras: I don't think there's a negative message. When I go to schools that have the federal grant they say, "We love it! It gives me an excuse not to use at parties because kids are always pushing on us," but none of them say they're angry with the school. What I've heard above all is "thank you."",1]
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Madras: I think it's very relevant because what you know is that behavioral modification is always a hybrid of positive and negative reinforcement. If you have a policy that says that drugs are not good for people then you institute a way of trying to modify behavior. The military did it just by random drug testing with consequence, and the same random testing in schools with very, very gentle outcomes or consequences, which are really targeted for the benefit of the child and not for the benefit of the school. And this is a way of enlisting the parents and saying we have to help this child. The deterrent factor in the schools is different than in the military. For the kids, one of the things that deter them is that they don't want to disappoint their parents.
Kern: People who elect to be in the military are going to be very different from people who need to be in high school and they are going to be at very different developmental stages in life, so how drugs affect them are going to be very different. Random drug testing has not been proven to deter drug use. In 2003, the National Institute on Drug Abuse funded the largest study ever conducted on the topic, and the Robert Wood Johnson Foundation backed it up with a second study that same year. Seasoned researchers compared a total of 94,000 students in almost 900 American schools with and without a drug-testing program, and found no differences in illegal drug use among students from both sets of schools.
What kind of a message are we sending to kids by saying that we don't trust them when they tell us they aren't doing drugs?
Madras: I don't think there's a negative message. When I go to schools that have the federal grant they say, "We love it! It gives me an excuse not to use at parties because kids are always pushing on us," but none of them say they're angry with the school. What I've heard above all is "thank you."
\u003c/p\>\n\u003cp\>\u003cfont size\u003d\"2\"\>Kern: They are undermining the very protective factors that are shown to keep people out of trouble with drugs. For instance, [there are] concerns that the testing breaks down relationships of trust between students and adults at school, hinders open communication and contributes to a hostile school environment and it risks deterring students from extracurricular activities.\u003c/font\>\u003c/p\>\n\u003cp\>\u003cfont size\u003d\"2\"\>Is mandatory drug testing a violation of a student's right to privacy?\u003c/font\> \u003cbr\>\u003cfont size\u003d\"2\"\>Madras: I think that privacy issues are really interesting for adolescents. If a child is doing something that is illegal, then how do we weigh the more important value, which is how to protect a child? Really, ask yourself logically, do you feel young people who don't have a fully developed sense of self should be able to do things that are illegal to harm themselves? \u003c/font\>\u003c/p\>\n\u003cp\>\u003cfont size\u003d\"2\"\>Kern: [Drug testing ] is only for students who participate in extracurricular activities because the Supreme Court ruled it is permissible to [test] students in those activities because it described them as a privilege. But students in those programs are shown to have fewer problems with drugs so there is concern that it will deter kids from participating in those activities, which help kids feel connected and engaged with school. The Supreme Court decision is treating students like they are guilty until proven innocent.\u003c/font\>\u003c/p\>\n\u003cp\>\u003cfont size\u003d\"2\"\>-------------\u003c/font\> \u003c/p\>\n\u003cp\>\u003cfont size\u003d\"2\"\>entire article:\u003c/font\> \u003c/p\>\n\u003cp\>\u003cfont size\u003d\"2\"\>\u003ca href\u003d\"http://pediatrics.aappublications.org/cgi/reprint/119/3/627\" target\u003d\"_blank\" onclick\u003d\"return top.js.OpenExtLink(window,event,this)\"\>http://pediatrics.aappublicatio\u003cWBR\>ns.org/cgi/reprint/119/3/627\u003c/a\>\u003c/font\> \u003c/p\>\u003cbr\>\n\u003cp\>\u003cfont size\u003d\"2\"\>short statement:\u003c/font\> \u003c/p\>\n\u003cp\>\u003cfont size\u003d\"2\"\>\u003ca href\u003d\"http://pediatrics.aappublications.org/cgi/content/short/119/3/627\" target\u003d\"_blank\" onclick\u003d\"return top.js.OpenExtLink(window,event,this)\"\>http://pediatrics.aappublicatio",1]
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Kern: They are undermining the very protective factors that are shown to keep people out of trouble with drugs. For instance, [there are] concerns that the testing breaks down relationships of trust between students and adults at school, hinders open communication and contributes to a hostile school environment and it risks deterring students from extracurricular activities.
Is mandatory drug testing a violation of a student's right to privacy? Madras: I think that privacy issues are really interesting for adolescents. If a child is doing something that is illegal, then how do we weigh the more important value, which is how to protect a child? Really, ask yourself logically, do you feel young people who don't have a fully developed sense of self should be able to do things that are illegal to harm themselves?
Kern: [Drug testing ] is only for students who participate in extracurricular activities because the Supreme Court ruled it is permissible to [test] students in those activities because it described them as a privilege. But students in those programs are shown to have fewer problems with drugs so there is concern that it will deter kids from participating in those activities, which help kids feel connected and engaged with school. The Supreme Court decision is treating students like they are guilty until proven innocent.
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entire article:
http://pediatrics.aappublications.org/cgi/reprint/119/3/627
short statement:
http://pediatrics.aappublicatio
ns.org/cgi/content/short/119/3\u003cWBR\>/627\u003c/a\>\u003c/font\> \u003c/p\>\n\u003cp\>\u003cfont size\u003d\"2\"\>PEDIATRICS Vol. 119 No. 3 March 2007, pp. 627-630\u003c/font\> \u003c/p\>\n\u003cp\>\u003cfont size\u003d\"2\"\>POLICY STATEMENT \u003c/font\>\u003c/p\>\n\u003cp\>\u003cfont size\u003d\"2\"\>Testing for Drugs of Abuse in Children and Adolescents: Addendum—Testing in Schools and at Home\u003c/font\> \u003c/p\>\n\u003cp\>\u003cfont size\u003d\"2\"\>Committee on Substance Abuse and Council on School Health \u003c/font\>\u003c/p\>\u003cbr\>\n\u003cp\>\u003cfont size\u003d\"2\"\>The American Academy of Pediatrics continues to believe that adolescents should not be drug tested without their knowledge and consent. \u003c/font\>\u003c/p\>\n\u003cp\>\u003cfont size\u003d\"2\"\>Recent US Supreme Court decisions and market forces have resulted in recommendations for drug testing of adolescents at school and products for parents to use to test adolescents at home. \u003c/font\>\u003c/p\>\n\u003cp\>\u003cfont size\u003d\"2\"\>The American Academy of Pediatrics has strong reservations about testing adolescents at school or at home and believes that more research is needed on both safety and efficacy before school-based testing programs are implemented. \u003c/font\>\u003c/p\>\n\u003cp\>\u003cfont size\u003d\"2\"\>The American Academy of Pediatrics also believes that more adolescent-specific substance abuse treatment resources are needed to ensure that testing leads to early rehabilitation rather than to punitive measures only. \u003c/font\>\u003c/p\>\u003cbr\>\u003cbr\>\u003cbr\>\u003cbr\>\u003c/div\>\u003c/div\>",0]
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ns.org/cgi/content/short/119/3/627
PEDIATRICS Vol. 119 No. 3 March 2007, pp. 627-630
POLICY STATEMENT
Testing for Drugs of Abuse in Children and Adolescents: Addendum—Testing in Schools and at Home
Committee on Substance Abuse and Council on School Health
The American Academy of Pediatrics continues to believe that adolescents should not be drug tested without their knowledge and consent.
Recent US Supreme Court decisions and market forces have resulted in recommendations for drug testing of adolescents at school and products for parents to use to test adolescents at home.
The American Academy of Pediatrics has strong reservations about testing adolescents at school or at home and believes that more research is needed on both safety and efficacy before school-based testing programs are implemented.
The American Academy of Pediatrics also believes that more adolescent-specific substance abuse treatment resources are needed to ensure that testing leads to early rehabilitation rather than to punitive measures only.
Wednesday
Trans-Fat in the Montgomery Gazette
Leggett proposes aid for courthouse, tennis bubble
Proposal to ban trans fats set for next week;
council will consider changing who decides arts funding
Janel Davis
The amendments come a week after the executive released his record $4.1 billion spending proposal for fiscal 2008, which begins July 1.
The proposed changes to the capital budget do not add spending or meet the higher borrowing limits set by the council in February. Instead, they fit within the previously approved — and lower — spending limits, according to a March 19 memo Leggett (D) sent the council.
Among the adjustments is $200,000 for structural repairs to the Red Brick Courthouse in Rockville and $468,000 for renovation of the Wheaton Tennis Bubble.
The council will hold public hearings on the operating and construction budgets in April. It also will determine whether to include Leggett’s changes with projects requested by council members. Some council members’ requests include money to accelerate the Germantown Town Center’s Urban Park project by one year, proposed by Councilman Michael J. Knapp (D-Dist. 2) of Germantown.
The county budget must be approved by June 1.
Trans fats
Next week, Councilwoman Duchy Trachtenberg plans to propose a ban on trans fats in county restaurants. Trans fats have been found to raise bad cholesterol. If approved, Montgomery County will be the first county in the nation to levy such a ban. New York City enacted a similar ban in December.
‘‘This is a solid example of when government protects public health and at the same time catches up to public demand,” said Trachtenberg (D-At large) of North Bethesda.
In conjunction with introducing her ban, Trachtenberg is hosting a healthy cooking demonstration on Monday in the Executive Office Building cafeteria with chefs from Marriott and the Silver Diner.
Trachtenberg’s bill would require restaurants to change their cooking habits by Jan. 1.
Proposal to ban trans fats set for next week;
council will consider changing who decides arts funding
Janel Davis
The amendments come a week after the executive released his record $4.1 billion spending proposal for fiscal 2008, which begins July 1.
The proposed changes to the capital budget do not add spending or meet the higher borrowing limits set by the council in February. Instead, they fit within the previously approved — and lower — spending limits, according to a March 19 memo Leggett (D) sent the council.
Among the adjustments is $200,000 for structural repairs to the Red Brick Courthouse in Rockville and $468,000 for renovation of the Wheaton Tennis Bubble.
The council will hold public hearings on the operating and construction budgets in April. It also will determine whether to include Leggett’s changes with projects requested by council members. Some council members’ requests include money to accelerate the Germantown Town Center’s Urban Park project by one year, proposed by Councilman Michael J. Knapp (D-Dist. 2) of Germantown.
The county budget must be approved by June 1.
Trans fats
Next week, Councilwoman Duchy Trachtenberg plans to propose a ban on trans fats in county restaurants. Trans fats have been found to raise bad cholesterol. If approved, Montgomery County will be the first county in the nation to levy such a ban. New York City enacted a similar ban in December.
‘‘This is a solid example of when government protects public health and at the same time catches up to public demand,” said Trachtenberg (D-At large) of North Bethesda.
In conjunction with introducing her ban, Trachtenberg is hosting a healthy cooking demonstration on Monday in the Executive Office Building cafeteria with chefs from Marriott and the Silver Diner.
Trachtenberg’s bill would require restaurants to change their cooking habits by Jan. 1.
Tuesday
Sunday
Saturday
Review of Addiction on HBO from the NY Times
Review of Addiction on HBO from the NY Times----http://www.nytimes.com/2007/03/15/arts/television/15addi.html?_r=1&oref=sloginMarch 15, 2007TV Review 'Addiction'When the Cravings Won't Quit, Turn On the CameraBy VIRGINIA HEFFERNANThis just in from pseudoscience: Addiction documentaries contain an element that excites dopamine receptors, shuts down the frontal lobe and causes intense cravings.Pseudoscientists don't know yet whether drug-documentary addicts are hooked by the gruesomely thrilling scenes of tourniquets and needles, the photos of pre-Vicodin fifth graders or the promise of redemption through higher powers. But something definitely sets the brain reeling with manic questions: How could they fall so far? How could so many of us? Whom will addiction strike next, and will the culprit be the demon rum or the demon OxyContin?The American addiction story, as refined by Alcoholics Anonymous, tells of good folks turned bad - of men taking drinks and drinks taking men. No wonder we crave this story: It's the master narrative of innocence and fall, complete with the possibility of deliverance. Nor is it any wonder that HBO has embraced the genre with its current authoritarian gusto. That channel's "Addiction," an anthology of short films by famous documentary filmmakers, has its premiere tonight.
The blunt title holds promise. As a story, addiction to drugs and alcohol has a chilling and ritualistic arc. Typically, the variable is the drug. Some viewers go for the methamphetamine documentaries, with their slightly high-handed attitude toward the Midwest, their contested statistics and their focus on dental issues. Other viewers prefer the shadowy, stylish heroin ones, with the sexy, skinny kids and "Requiem for a Dream" fashion.\u003cbr /\>\u003cbr /\>When it comes to drug-addiction TV, I\'m a garbagehead: I watch it all. But to my amazement, "Addiction" doesn\'t quite hit the spot. Someone at HBO seems to have instructed the esteemed filmmakers - auteurs like Albert Maysles and D. A. Pennebaker, even - to deny ravenous viewers what they want. The film is bereft of feel-good scenes and drug-movie clichés. As such, the shorts can build a cumulative sense of deprivation.\u003cbr /\>\u003cbr /\>Don\'t expect needles here, in other words, or ravaged street kids turning tricks, or spectacular scenes of delirium tremens. No one even gets high in "Addiction"; no fervid expression gives way to one of stoned beatitude. It\'s enough to make you kind of mad: "Addiction" is holding out on us. And, surely, this is the point.\u003cbr /\>\u003cbr /\>The program is part of a solemn project, something that Sheila Nevins, the enterprising president of HBO Documentary Films, has called "didactic television." It is also devised to be more accessible than past HBO projects, with some cable systems, including RCN in the New York City area, showing it free during its first four-day run.\u003cbr /\>\u003cbr /\>Intended to do more than entertain or alarm, then, "Addiction" is meant to sober people up. To that end, its message is this: Drug and alcohol addiction are diseases of the brain, and they can be treated, at least partly, with medicine.\u003cbr /\>\u003cbr /\>This straightforward message is remarkable for at least two reasons. First, it\'s intrinsically controversial, since A.A. for a long time expected its participants to refrain entirely from drug use, even prescription pills. The model of addiction presented here - addiction as a brain disease - is somewhat at odds with the cognitive model used in classic 12-step programs.\u003cbr /\>",1]
);
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The blunt title holds promise. As a story, addiction to drugs and alcohol has a chilling and ritualistic arc. Typically, the variable is the drug. Some viewers go for the methamphetamine documentaries, with their slightly high-handed attitude toward the Midwest, their contested statistics and their focus on dental issues. Other viewers prefer the shadowy, stylish heroin ones, with the sexy, skinny kids and "Requiem for a Dream" fashion.When it comes to drug-addiction TV, I'm a garbagehead: I watch it all. But to my amazement, "Addiction" doesn't quite hit the spot. Someone at HBO seems to have instructed the esteemed filmmakers - auteurs like Albert Maysles and D. A. Pennebaker, even - to deny ravenous viewers what they want. The film is bereft of feel-good scenes and drug-movie clichés. As such, the shorts can build a cumulative sense of deprivation.Don't expect needles here, in other words, or ravaged street kids turning tricks, or spectacular scenes of delirium tremens. No one even gets high in "Addiction"; no fervid expression gives way to one of stoned beatitude. It's enough to make you kind of mad: "Addiction" is holding out on us. And, surely, this is the point.The program is part of a solemn project, something that Sheila Nevins, the enterprising president of HBO Documentary Films, has called "didactic television." It is also devised to be more accessible than past HBO projects, with some cable systems, including RCN in the New York City area, showing it free during its first four-day run.Intended to do more than entertain or alarm, then, "Addiction" is meant to sober people up. To that end, its message is this: Drug and alcohol addiction are diseases of the brain, and they can be treated, at least partly, with medicine.This straightforward message is remarkable for at least two reasons. First, it's intrinsically controversial, since A.A. for a long time expected its participants to refrain entirely from drug use, even prescription pills. The model of addiction presented here - addiction as a brain disease - is somewhat at odds with the cognitive model used in classic 12-step programs.
Second, it\'s remarkable that so many top-notch filmmakers have consented to push someone else\'s point so hard. It\'s almost ominous. The sameness of the films in "Addiction" might aid its effectiveness as propaganda, but as art it\'s monotone; it\'s hard to believe it\'s the collaborative work of so many otherwise individualistic artists.\u003cbr /\>\u003cbr /\>Evidently, filmmakers submitted film to HBO, which took over postproduction. As a result, each installment mixes vérité and to-the-camera interviews in precisely the same proportions; employs explanatory title cards and interviews with experts; showily defers to the experts, most of them M.D.\'s and Ph.D.\'s; refrains from using graphics, humor or archival photographs; and keeps sound bites short.\u003cbr /\>\u003cbr /\>An exception here is Barbara Kopple. Her short film "Steamfitters Local Union 638" is crisp tonic with lime. Unlike the other filmmakers, she has stuck to her interests and her aesthetic, making a film about a labor union that now actively supports its members who want treatment for addictions. The faces and voices of the union members, many of whom have been installing heating, ventilation and air-conditioning systems for decades, are like nobody else\'s in "Addiction," and indeed like those of few other people\'s on television.\u003cbr /\>\u003cbr /\>"We were the hardest-working," says one union lifer, remembering the \'60s, when he was drinking daily on the job. "We were the biggest drinkers." He recalls how the members used to enable one another as drinkers, helping them lie to their wives and families and still be paid.\u003cbr /\>\u003cbr /\>Now the union uses the same infrastructure of loyalty to help people into detox and rehabilitation. Steamfitters like them - with mustaches and paunches like theirs - join them in meetings; there\'s no interference from management or doctors. As rendered, this is an extremely effective, and good-natured, program.\u003cbr /\>\u003cbr /\>By presenting both addiction and recovery as community affairs, only "Steamfitters Local Union 638" has added something beyond the brain-scan science to these drug and alcohol stories. Still, as I detoxed from the sensationalism I had gotten from other films and had been hoping for in "Addiction," I also came to appreciate other parts of the program. One was the short by Chris Hegedus and Mr. Pennebaker. In their story of two young addicts who try a new Methadone-like drug to treat their cravings for prescription pills, the melancholy Amanda caught my eye. She\'s kind of a lazy oracle.\u003cbr /\>\u003cbr /\>As she\'s driving to the clinic for the first time, contemplating the new drug that she\'s hoping will relieve her dopesickness, she seems to speak for every kind of addict, as well as about the paradox of treating drug addiction with drugs.\u003cbr /\>\u003cbr /\>As Amanda says, "I hope it works as good as everybody says it does, so I don\'t have to worry about feeling like this anymore."\u003cbr /\>\u003cbr /\>\u003cbr /\>\u003cbr /\>\u003c/div\>",0]
);
//-->
Second, it's remarkable that so many top-notch filmmakers have consented to push someone else's point so hard. It's almost ominous. The sameness of the films in "Addiction" might aid its effectiveness as propaganda, but as art it's monotone; it's hard to believe it's the collaborative work of so many otherwise individualistic artists.Evidently, filmmakers submitted film to HBO, which took over postproduction. As a result, each installment mixes vérité and to-the-camera interviews in precisely the same proportions; employs explanatory title cards and interviews with experts; showily defers to the experts, most of them M.D.'s and Ph.D.'s; refrains from using graphics, humor or archival photographs; and keeps sound bites short.An exception here is Barbara Kopple. Her short film "Steamfitters Local Union 638" is crisp tonic with lime. Unlike the other filmmakers, she has stuck to her interests and her aesthetic, making a film about a labor union that now actively supports its members who want treatment for addictions. The faces and voices of the union members, many of whom have been installing heating, ventilation and air-conditioning systems for decades, are like nobody else's in "Addiction," and indeed like those of few other people's on television."We were the hardest-working," says one union lifer, remembering the '60s, when he was drinking daily on the job. "We were the biggest drinkers." He recalls how the members used to enable one another as drinkers, helping them lie to their wives and families and still be paid.Now the union uses the same infrastructure of loyalty to help people into detox and rehabilitation. Steamfitters like them - with mustaches and paunches like theirs - join them in meetings; there's no interference from management or doctors. As rendered, this is an extremely effective, and good-natured, program.By presenting both addiction and recovery as community affairs, only "Steamfitters Local Union 638" has added something beyond the brain-scan science to these drug and alcohol stories. Still, as I detoxed from the sensationalism I had gotten from other films and had been hoping for in "Addiction," I also came to appreciate other parts of the program. One was the short by Chris Hegedus and Mr. Pennebaker. In their story of two young addicts who try a new Methadone-like drug to treat their cravings for prescription pills, the melancholy Amanda caught my eye. She's kind of a lazy oracle.As she's driving to the clinic for the first time, contemplating the new drug that she's hoping will relieve her dopesickness, she seems to speak for every kind of addict, as well as about the paradox of treating drug addiction with drugs.As Amanda says, "I hope it works as good as everybody says it does, so I don't have to worry about feeling like this anymore."
NIDA Conference on Pain, Opioids and Addiction
Video now Available: NIDA Conference on Pain, Opioids and Addiction: An Urgent Problem for Doctors and Patients
http://videocast.nih.gov/ram/nida030507.ram Day 1
http://videocast.nih.gov/ram/nida030607.ram Day 2
More Info:
http://videocast.nih.gov/PastEventDetail.asp?13696
Title: Pain, Opioids and Addiction: An Urgent Problem for Doctors and Patients (Day 1)
Date: Tuesday, March 06, 2007, 8:30:00 AM
Category: Conferences
Description: This joint NIH/NIDA/AMA meeting will bring together the research and clinical practice communities through its co-sponsorship with the AMA, and supported by the NIH Pain Consortium to draw attention to the growing problem of prescription opioid misuse by patients with chronic non-malignant pain conditions. The most powerful treatments available for most forms of pain are opioids. However, opioid treatment can produce negative health consequences, such as intoxication and physical dependence, and may result in opioid abuse and addiction. The prevalence of, and the process of how to prevent, reduce and treat these negative health consequences are not well understood. The goal is to inform practitioners and scientists on emerging research on pain and addiction and what we are learning about how to most effectively and compassionately treat these conditions, while minimizing the risk of abuse and addiction.
http://conferences.masimax.com/opioid
Author: National Institute on Drug Abuse and American Medical Association
Runtime: 04:08:44
Electronic Links: http://videocast.nih.gov/launch.asp?13698
CIT ID: 13698
http://videocast.nih.gov/PastEventDetail.asp?13698
Pain, Opioids and Addiction: An Urgent Problem for Doctors and Patients (Day 2)
Date: Tuesday, March 06, 2007, 8:30:00 AM
Category: Conferences
Description: This joint NIH/NIDA/AMA meeting will bring together the research and clinical practice communities through its co-sponsorship with the AMA, and supported by the NIH Pain Consortium to draw attention to the growing problem of prescription opioid misuse by patients with chronic non-malignant pain conditions. The most powerful treatments available for most forms of pain are opioids. However, opioid treatment can produce negative health consequences, such as intoxication and physical dependence, and may result in opioid abuse and addiction. The prevalence of, and the process of how to prevent, reduce and treat these negative health consequences are not well understood. The goal is to inform practitioners and scientists on emerging research on pain and addiction and what we are learning about how to most effectively and compassionately treat these conditions, while minimizing the risk of abuse and addiction.
http://conferences.masimax.com/opioid
Author: National Institute on Drug Abuse and American Medical Association
Runtime: 04:08:44
Electronic Links: http://videocast.nih.gov/launch.asp?13698
CIT ID: 13698
http://videocast.nih.gov/ram/nida030507.ram Day 1
http://videocast.nih.gov/ram/nida030607.ram Day 2
More Info:
http://videocast.nih.gov/PastEventDetail.asp?13696
Title: Pain, Opioids and Addiction: An Urgent Problem for Doctors and Patients (Day 1)
Date: Tuesday, March 06, 2007, 8:30:00 AM
Category: Conferences
Description: This joint NIH/NIDA/AMA meeting will bring together the research and clinical practice communities through its co-sponsorship with the AMA, and supported by the NIH Pain Consortium to draw attention to the growing problem of prescription opioid misuse by patients with chronic non-malignant pain conditions. The most powerful treatments available for most forms of pain are opioids. However, opioid treatment can produce negative health consequences, such as intoxication and physical dependence, and may result in opioid abuse and addiction. The prevalence of, and the process of how to prevent, reduce and treat these negative health consequences are not well understood. The goal is to inform practitioners and scientists on emerging research on pain and addiction and what we are learning about how to most effectively and compassionately treat these conditions, while minimizing the risk of abuse and addiction.
http://conferences.masimax.com/opioid
Author: National Institute on Drug Abuse and American Medical Association
Runtime: 04:08:44
Electronic Links: http://videocast.nih.gov/launch.asp?13698
CIT ID: 13698
http://videocast.nih.gov/PastEventDetail.asp?13698
Pain, Opioids and Addiction: An Urgent Problem for Doctors and Patients (Day 2)
Date: Tuesday, March 06, 2007, 8:30:00 AM
Category: Conferences
Description: This joint NIH/NIDA/AMA meeting will bring together the research and clinical practice communities through its co-sponsorship with the AMA, and supported by the NIH Pain Consortium to draw attention to the growing problem of prescription opioid misuse by patients with chronic non-malignant pain conditions. The most powerful treatments available for most forms of pain are opioids. However, opioid treatment can produce negative health consequences, such as intoxication and physical dependence, and may result in opioid abuse and addiction. The prevalence of, and the process of how to prevent, reduce and treat these negative health consequences are not well understood. The goal is to inform practitioners and scientists on emerging research on pain and addiction and what we are learning about how to most effectively and compassionately treat these conditions, while minimizing the risk of abuse and addiction.
http://conferences.masimax.com/opioid
Author: National Institute on Drug Abuse and American Medical Association
Runtime: 04:08:44
Electronic Links: http://videocast.nih.gov/launch.asp?13698
CIT ID: 13698
Wednesday
reward and compulsion
http://www.sciencedirect.com/science?_ob=ArticleURL&_udi=B6T1K-4N08M2P-2&_user=861681&_rdoc=1&_fmt=&_orig=search&_sort=d&view=c&_acct=C000046147&_version=1&_urlVersion=0&_userid=861681&md5=5183a2479d1cd527aa2257322567bbe7
Brain reward systems and compulsive drug use
Paul J. Kennya, aDepartment of Biochemistry, The Scripps Research Institute, Jupiter, FL 33458, USA Available online 5 February 2007.
Compulsive drug intake is a hallmark of addiction, yet a mechanistic understanding of this process has been elusive. Drug use is initiated primarily to obtain the excitatory actions of addictive drugs on brain reward systems. Paradoxically, excessive drug intake can decrease the activity of reward systems, reflected in elevated intracranial self-stimulation thresholds in rats, probably by engaging compensatory mechanisms to counter drug effects. Recent evidence suggests that compulsive drug intake might develop in response to such adaptive decreases in brain reward systems. Further, the actions of addictive drugs on reward systems are susceptible to classical conditioning processes, providing a potential mechanism by which drug-paired stimuli can induce powerful cravings and precipitate relapse in abstinent drug users. These findings provide a conceptual framework for improving our understanding of compulsive drug use, and might facilitate the development of novel therapeutics for substance abuse disorders.
Glossary
Action–outcome (goal-directed) responding
behavior directed toward achieving a goal, and is under voluntary control (i.e. sensitive to the relative value of the goal). Action-outcome responding is dependent upon the animal learning the causal relationship between its actions and the likelihood of achieving the goal.
Classical conditioning
originally characterized by the Russian physiologist Ivan Pavlov, and involves the learning process in which a previously neutral environmental cue (CS) can attain motivational salience and elicit a conditioned response after being repeatedly associated with an intrinsically salient stimulus (unconditioned stimulus; US) that induces an automatic response (unconditioned response). In our experiments, a CS (previously neutral flashing light and tone) is repeatedly paired with a US, usually a drug of abuse or a receptor antagonist that precipitates withdrawal in drug-dependent animals, during daily conditioning sessions. The CS can eventually elicit responses similar to those induced by the US.
Escalation of drug intake
in rats is the process by which extended daily access to a drug results in the gradual increase of drug intake over time, a process reminiscent of the loss of control over intake usually observed in human drug addicts.
Intracranial self-stimulation (ICSS)
a behavioral procedure that provides a sensitive measure of the effects of addictive drugs on brain reward systems. Rats turn a response wheel to receive electrical pulses directly into their brain through indwelling stimulating electrodes located within components of the reward system of the brain. In our experiments, the stimulating electrode is located within the posterior lateral hypothalamus, targeting the medial forebrain bundle. The intensity of the electrical pulse is varied (according to the method of limits), such that the minimal electrical intensity (termed the ‘reward threshold’) for which the animal is prepared to respond can be identified for each rat. Acute administration of major drugs of abuse lowers the reward threshold, whereas withdrawal from addictive drugs after chronic administration usually elevates the reward threshold.
Precipitated withdrawal
the process by which withdrawal might be transiently ‘precipitated’ in drug-dependent animals (or humans) by administration of a compound that antagonizes the actions of that particular drug. For example, withdrawal might be precipitated in opiate-dependent rats by administration of the opioid receptor antagonist naloxone.
Reinforcer
an object or event that is obtained or that occurs in response to a particular behavior, is contiguous with that behavioral response in a temporal and spatial manner and is associated with an increased probability that the behavior response will occur again. Put simply, a reinforcer is anything that increases the likelihood that a given response will be repeated.
Stimulus–response (habit) responding
usually emerges after goal-directed responding has been repeated on many occasions, until such responding becomes more habitual and sensitive to goal-associated conditioned stimuli, and less under voluntary control (i.e. insensitive to the relative value of the goal).
Brain reward systems and compulsive drug use
Paul J. Kennya, aDepartment of Biochemistry, The Scripps Research Institute, Jupiter, FL 33458, USA Available online 5 February 2007.
Compulsive drug intake is a hallmark of addiction, yet a mechanistic understanding of this process has been elusive. Drug use is initiated primarily to obtain the excitatory actions of addictive drugs on brain reward systems. Paradoxically, excessive drug intake can decrease the activity of reward systems, reflected in elevated intracranial self-stimulation thresholds in rats, probably by engaging compensatory mechanisms to counter drug effects. Recent evidence suggests that compulsive drug intake might develop in response to such adaptive decreases in brain reward systems. Further, the actions of addictive drugs on reward systems are susceptible to classical conditioning processes, providing a potential mechanism by which drug-paired stimuli can induce powerful cravings and precipitate relapse in abstinent drug users. These findings provide a conceptual framework for improving our understanding of compulsive drug use, and might facilitate the development of novel therapeutics for substance abuse disorders.
Glossary
Action–outcome (goal-directed) responding
behavior directed toward achieving a goal, and is under voluntary control (i.e. sensitive to the relative value of the goal). Action-outcome responding is dependent upon the animal learning the causal relationship between its actions and the likelihood of achieving the goal.
Classical conditioning
originally characterized by the Russian physiologist Ivan Pavlov, and involves the learning process in which a previously neutral environmental cue (CS) can attain motivational salience and elicit a conditioned response after being repeatedly associated with an intrinsically salient stimulus (unconditioned stimulus; US) that induces an automatic response (unconditioned response). In our experiments, a CS (previously neutral flashing light and tone) is repeatedly paired with a US, usually a drug of abuse or a receptor antagonist that precipitates withdrawal in drug-dependent animals, during daily conditioning sessions. The CS can eventually elicit responses similar to those induced by the US.
Escalation of drug intake
in rats is the process by which extended daily access to a drug results in the gradual increase of drug intake over time, a process reminiscent of the loss of control over intake usually observed in human drug addicts.
Intracranial self-stimulation (ICSS)
a behavioral procedure that provides a sensitive measure of the effects of addictive drugs on brain reward systems. Rats turn a response wheel to receive electrical pulses directly into their brain through indwelling stimulating electrodes located within components of the reward system of the brain. In our experiments, the stimulating electrode is located within the posterior lateral hypothalamus, targeting the medial forebrain bundle. The intensity of the electrical pulse is varied (according to the method of limits), such that the minimal electrical intensity (termed the ‘reward threshold’) for which the animal is prepared to respond can be identified for each rat. Acute administration of major drugs of abuse lowers the reward threshold, whereas withdrawal from addictive drugs after chronic administration usually elevates the reward threshold.
Precipitated withdrawal
the process by which withdrawal might be transiently ‘precipitated’ in drug-dependent animals (or humans) by administration of a compound that antagonizes the actions of that particular drug. For example, withdrawal might be precipitated in opiate-dependent rats by administration of the opioid receptor antagonist naloxone.
Reinforcer
an object or event that is obtained or that occurs in response to a particular behavior, is contiguous with that behavioral response in a temporal and spatial manner and is associated with an increased probability that the behavior response will occur again. Put simply, a reinforcer is anything that increases the likelihood that a given response will be repeated.
Stimulus–response (habit) responding
usually emerges after goal-directed responding has been repeated on many occasions, until such responding becomes more habitual and sensitive to goal-associated conditioned stimuli, and less under voluntary control (i.e. insensitive to the relative value of the goal).
Monday
Student Drug Testing
Student Drug Testing
Many of you will recall that Bertha Madras left the bench (at Harvard) two years ago to go work for ONDCP. Here's an interview with her (sparring with a rep from DPA) on the issue of student drug testing.
After the interview article, there is the statement of the American Academy of Pediatrics on student drug testing.
----------
http://www.msnbc.msn.com/id/16893833/site/newsweek/
WEB EXCLUSIVE
Should Schools Conduct Random Drug Tests?
The White House wants more schools to adopt random student drug-testing programs. NEWSWEEK talks to advocates on both sides of the issue.
By Alexandra Gekas Newsweek Jan. 30, 2007
The White House Office of National Drug Control Policy announced last week that it will be holding four regional summits promoting random student drug testing in public middle and high schools. The controversial program, which has already been implemented in nearly 1,000 middle and high schools across the country, requires that kids submit to random drug testing if they want to participate in competitive extracurricular activities like athletics. The Department of Education offers grants to schools that want to develop or expand a drug-testing programs for children in grades 6-12, but decisions about whether to test and which drugs to test for are made on an individual school level. The testing is usually done by a school nurse with a urine sample taken on school premises. If there's a positive result, the sample is sent out for verification by a lab. Tests can also be done with blood or saliva. Samples are generally tested for cocaine, marijuana, ecstasy, opium-based substances, oxycontin and, in some cases, steroids.
The proposed expansion of the program has prompted fierce debate and raised both privacy and efficacy questions. NEWSWEEK's Alexandra Gekas spoke with advocates on both sides of the issue: Dr. Bertha Madras, the deputy director of Demand Reduction in the ONDCP, which coordinates and promotes President Bush's drug prevention and treatment initiatives; and Jennifer Kern, a research associate with the Drug Policy Alliance, a group opposed to the program. (The interviews were conducted separately, but we've presented the participants' answers side by side.) Excerpts:
NEWSWEEK: How does student drug testing work? Dr. Bertha Madras: Under ideal conditions the testing is random, which is critical. If it's a urine test, the child is asked to come down to the nurse's office. They walk in solo, they deposit a sample as they would in any doctor's office, they give the sample to the nurse who puts a little dip stick in, and the dip stick will say positive or negative.
Jennifer Kern: They are removed from their classrooms and are escorted to take a drug test, and if they end up with a positive test result they are removed from their extracurricular activity. And because this is a very public removal from the classroom and often a public removal from the extracurricular activity, the testing is not as confidential as promised.
Is there a standard model for schools to follow when implementing the random testing? Madras: Schools have done it voluntarily without any federal assistance for a number of years since the 1990s. Once the Supreme Court weighed in, then it became more of a formalized procedure on how you do it and how you develop policies. [In 2002, the Supreme Court ruled that random drug testing of students participating in extracurricular activities does not violate the Constitution.] When grants became available in the Department of Education, then there were guidelines on how to do it.
Kern: There are model policies that are put out, but there is no legislation or guidelines for schools beyond the Supreme Court decision. [Schools] are not allowed to use the test results in certain ways legally, but in terms of how it is implemented, it varies. For some schools there's no verification on the type of labs they're using so there's a lot of concern that schools are using labs that are not certified or they are using their own staff. No protocol on how schools have to do it exists, so there is concern about schools not knowing what to do, leading to breaches of confidentiality and false positives.
Is anyone monitoring the schools to make sure they are doing it correctly? Madras: For the federal grants, there are project officers who keep in touch with the schools to see if they're going well. So when it's a federal program there clearly is oversight of the grant. If it's a grass-roots program, of which there are many in the country, then the monitoring is self-monitoring by the schools themselves. The critical thing to bear in mind with this program is the confidential nature of the information.
Kern: There's no outside monitoring. There's no regulation and there's no check or balance. While some schools describe the program as non-punitive, some schools have very harsh repercussions as far as removing kids from their extracurricular activities for the rest of the year or the rest of their school career. Some schools provide counseling but some provide no services to the students if they test positive. In a lot of places there isn't much money and there aren't many resources for students who test positive.
What are the penalties or repercussions for positive tests? Madras: The first repercussion is that the parents are called in and they're told that there is a positive test and we'd like to get help for the child. We can recommend a medical review officer who can go over what the test means and who can provide counseling. Sometimes the counseling is quick because it appears that the problem is not a profound one. At some schools there's no other repercussions in regard to their extracurricular activities, and in some schools the child is not allowed to play competitively for a period of time, but they can continue to practice with the team.
Kern: It's determined by the local school district, so typically it is suspension from an extracurricular activity, although I don't believe they are allowed to punish them in a way that would cause them to not be able to finish their education. Sometimes it can be very harsh and the concern is that extracurricular activities have been proven to keep students engaged and in school during the peak drug hours of 3 p.m. to 6 p.m., when parents are not home.
Is there a risk that kids who test positive for drugs will be stigmatized? Madras: The thing that I have heard is that everyone knows who's using drugs; there are no surprises amongst the kids. Kids know who are the users, their friends know, so when a kid is not engaged in sports for one game, nobody is surprised. I've been a parent all my life, and I knew which one of the kids I didn't want my kids near. I think the far greater risk is using the drug that can have adverse consequences on brain, body and behavior.
Kern: What is the point of removing the kids from extracurricular activities when they are most in need of that support and there is the question of confidentiality and those students being labeled as the 'bad kid' and how that effects them?
The ONDCP cites a random drug-testing program that was put in place for the military more than 20 years ago as evidence that testing can be effective in reducing drug use.
Madras: When the military began random mandatory testing the tests were 27 percent positive and now they are 1.5 percent. It didn't disappear in one year or two or five, but it declined very steeply and it's been steady for years.
Kern: Military testing has been in place, but some people coming back from certain situations certainly do continue to have substance-abuse problems.
Should a program from the military be applied to kids? Madras: I think it's very relevant because what you know is that behavioral modification is always a hybrid of positive and negative reinforcement. If you have a policy that says that drugs are not good for people then you institute a way of trying to modify behavior. The military did it just by random drug testing with consequence, and the same random testing in schools with very, very gentle outcomes or consequences, which are really targeted for the benefit of the child and not for the benefit of the school. And this is a way of enlisting the parents and saying we have to help this child. The deterrent factor in the schools is different than in the military. For the kids, one of the things that deter them is that they don't want to disappoint their parents.
Kern: People who elect to be in the military are going to be very different from people who need to be in high school and they are going to be at very different developmental stages in life, so how drugs affect them are going to be very different. Random drug testing has not been proven to deter drug use. In 2003, the National Institute on Drug Abuse funded the largest study ever conducted on the topic, and the Robert Wood Johnson Foundation backed it up with a second study that same year. Seasoned researchers compared a total of 94,000 students in almost 900 American schools with and without a drug-testing program, and found no differences in illegal drug use among students from both sets of schools.
What kind of a message are we sending to kids by saying that we don't trust them when they tell us they aren't doing drugs?
Madras: I don't think there's a negative message. When I go to schools that have the federal grant they say, "We love it! It gives me an excuse not to use at parties because kids are always pushing on us," but none of them say they're angry with the school. What I've heard above all is "thank you."
Kern: They are undermining the very protective factors that are shown to keep people out of trouble with drugs. For instance, [there are] concerns that the testing breaks down relationships of trust between students and adults at school, hinders open communication and contributes to a hostile school environment and it risks deterring students from extracurricular activities.
Is mandatory drug testing a violation of a student's right to privacy? Madras: I think that privacy issues are really interesting for adolescents. If a child is doing something that is illegal, then how do we weigh the more important value, which is how to protect a child? Really, ask yourself logically, do you feel young people who don't have a fully developed sense of self should be able to do things that are illegal to harm themselves?
Kern: [Drug testing ] is only for students who participate in extracurricular activities because the Supreme Court ruled it is permissible to [test] students in those activities because it described them as a privilege. But students in those programs are shown to have fewer problems with drugs so there is concern that it will deter kids from participating in those activities, which help kids feel connected and engaged with school. The Supreme Court decision is treating students like they are guilty until proven innocent.
-------------
entire article:
http://pediatrics.aappublications.org/cgi/reprint/119/3/627
short statement:
http://pediatrics.aappublications.org/cgi/content/short/119/3/627
PEDIATRICS Vol. 119 No. 3 March 2007, pp. 627-630
POLICY STATEMENT
Testing for Drugs of Abuse in Children and Adolescents: Addendum—Testing in Schools and at Home
Committee on Substance Abuse and Council on School Health
The American Academy of Pediatrics continues to believe that adolescents should not be drug tested without their knowledge and consent.
Recent US Supreme Court decisions and market forces have resulted in recommendations for drug testing of adolescents at school and products for parents to use to test adolescents at home.
The American Academy of Pediatrics has strong reservations about testing adolescents at school or at home and believes that more research is needed on both safety and efficacy before school-based testing programs are implemented.
The American Academy of Pediatrics also believes that more adolescent-specific substance abuse treatment resources are needed to ensure that testing leads to early rehabilitation rather than to punitive measures only.
Many of you will recall that Bertha Madras left the bench (at Harvard) two years ago to go work for ONDCP. Here's an interview with her (sparring with a rep from DPA) on the issue of student drug testing.
After the interview article, there is the statement of the American Academy of Pediatrics on student drug testing.
----------
http://www.msnbc.msn.com/id/16893833/site/newsweek/
WEB EXCLUSIVE
Should Schools Conduct Random Drug Tests?
The White House wants more schools to adopt random student drug-testing programs. NEWSWEEK talks to advocates on both sides of the issue.
By Alexandra Gekas Newsweek Jan. 30, 2007
The White House Office of National Drug Control Policy announced last week that it will be holding four regional summits promoting random student drug testing in public middle and high schools. The controversial program, which has already been implemented in nearly 1,000 middle and high schools across the country, requires that kids submit to random drug testing if they want to participate in competitive extracurricular activities like athletics. The Department of Education offers grants to schools that want to develop or expand a drug-testing programs for children in grades 6-12, but decisions about whether to test and which drugs to test for are made on an individual school level. The testing is usually done by a school nurse with a urine sample taken on school premises. If there's a positive result, the sample is sent out for verification by a lab. Tests can also be done with blood or saliva. Samples are generally tested for cocaine, marijuana, ecstasy, opium-based substances, oxycontin and, in some cases, steroids.
The proposed expansion of the program has prompted fierce debate and raised both privacy and efficacy questions. NEWSWEEK's Alexandra Gekas spoke with advocates on both sides of the issue: Dr. Bertha Madras, the deputy director of Demand Reduction in the ONDCP, which coordinates and promotes President Bush's drug prevention and treatment initiatives; and Jennifer Kern, a research associate with the Drug Policy Alliance, a group opposed to the program. (The interviews were conducted separately, but we've presented the participants' answers side by side.) Excerpts:
NEWSWEEK: How does student drug testing work? Dr. Bertha Madras: Under ideal conditions the testing is random, which is critical. If it's a urine test, the child is asked to come down to the nurse's office. They walk in solo, they deposit a sample as they would in any doctor's office, they give the sample to the nurse who puts a little dip stick in, and the dip stick will say positive or negative.
Jennifer Kern: They are removed from their classrooms and are escorted to take a drug test, and if they end up with a positive test result they are removed from their extracurricular activity. And because this is a very public removal from the classroom and often a public removal from the extracurricular activity, the testing is not as confidential as promised.
Is there a standard model for schools to follow when implementing the random testing? Madras: Schools have done it voluntarily without any federal assistance for a number of years since the 1990s. Once the Supreme Court weighed in, then it became more of a formalized procedure on how you do it and how you develop policies. [In 2002, the Supreme Court ruled that random drug testing of students participating in extracurricular activities does not violate the Constitution.] When grants became available in the Department of Education, then there were guidelines on how to do it.
Kern: There are model policies that are put out, but there is no legislation or guidelines for schools beyond the Supreme Court decision. [Schools] are not allowed to use the test results in certain ways legally, but in terms of how it is implemented, it varies. For some schools there's no verification on the type of labs they're using so there's a lot of concern that schools are using labs that are not certified or they are using their own staff. No protocol on how schools have to do it exists, so there is concern about schools not knowing what to do, leading to breaches of confidentiality and false positives.
Is anyone monitoring the schools to make sure they are doing it correctly? Madras: For the federal grants, there are project officers who keep in touch with the schools to see if they're going well. So when it's a federal program there clearly is oversight of the grant. If it's a grass-roots program, of which there are many in the country, then the monitoring is self-monitoring by the schools themselves. The critical thing to bear in mind with this program is the confidential nature of the information.
Kern: There's no outside monitoring. There's no regulation and there's no check or balance. While some schools describe the program as non-punitive, some schools have very harsh repercussions as far as removing kids from their extracurricular activities for the rest of the year or the rest of their school career. Some schools provide counseling but some provide no services to the students if they test positive. In a lot of places there isn't much money and there aren't many resources for students who test positive.
What are the penalties or repercussions for positive tests? Madras: The first repercussion is that the parents are called in and they're told that there is a positive test and we'd like to get help for the child. We can recommend a medical review officer who can go over what the test means and who can provide counseling. Sometimes the counseling is quick because it appears that the problem is not a profound one. At some schools there's no other repercussions in regard to their extracurricular activities, and in some schools the child is not allowed to play competitively for a period of time, but they can continue to practice with the team.
Kern: It's determined by the local school district, so typically it is suspension from an extracurricular activity, although I don't believe they are allowed to punish them in a way that would cause them to not be able to finish their education. Sometimes it can be very harsh and the concern is that extracurricular activities have been proven to keep students engaged and in school during the peak drug hours of 3 p.m. to 6 p.m., when parents are not home.
Is there a risk that kids who test positive for drugs will be stigmatized? Madras: The thing that I have heard is that everyone knows who's using drugs; there are no surprises amongst the kids. Kids know who are the users, their friends know, so when a kid is not engaged in sports for one game, nobody is surprised. I've been a parent all my life, and I knew which one of the kids I didn't want my kids near. I think the far greater risk is using the drug that can have adverse consequences on brain, body and behavior.
Kern: What is the point of removing the kids from extracurricular activities when they are most in need of that support and there is the question of confidentiality and those students being labeled as the 'bad kid' and how that effects them?
The ONDCP cites a random drug-testing program that was put in place for the military more than 20 years ago as evidence that testing can be effective in reducing drug use.
Madras: When the military began random mandatory testing the tests were 27 percent positive and now they are 1.5 percent. It didn't disappear in one year or two or five, but it declined very steeply and it's been steady for years.
Kern: Military testing has been in place, but some people coming back from certain situations certainly do continue to have substance-abuse problems.
Should a program from the military be applied to kids? Madras: I think it's very relevant because what you know is that behavioral modification is always a hybrid of positive and negative reinforcement. If you have a policy that says that drugs are not good for people then you institute a way of trying to modify behavior. The military did it just by random drug testing with consequence, and the same random testing in schools with very, very gentle outcomes or consequences, which are really targeted for the benefit of the child and not for the benefit of the school. And this is a way of enlisting the parents and saying we have to help this child. The deterrent factor in the schools is different than in the military. For the kids, one of the things that deter them is that they don't want to disappoint their parents.
Kern: People who elect to be in the military are going to be very different from people who need to be in high school and they are going to be at very different developmental stages in life, so how drugs affect them are going to be very different. Random drug testing has not been proven to deter drug use. In 2003, the National Institute on Drug Abuse funded the largest study ever conducted on the topic, and the Robert Wood Johnson Foundation backed it up with a second study that same year. Seasoned researchers compared a total of 94,000 students in almost 900 American schools with and without a drug-testing program, and found no differences in illegal drug use among students from both sets of schools.
What kind of a message are we sending to kids by saying that we don't trust them when they tell us they aren't doing drugs?
Madras: I don't think there's a negative message. When I go to schools that have the federal grant they say, "We love it! It gives me an excuse not to use at parties because kids are always pushing on us," but none of them say they're angry with the school. What I've heard above all is "thank you."
Kern: They are undermining the very protective factors that are shown to keep people out of trouble with drugs. For instance, [there are] concerns that the testing breaks down relationships of trust between students and adults at school, hinders open communication and contributes to a hostile school environment and it risks deterring students from extracurricular activities.
Is mandatory drug testing a violation of a student's right to privacy? Madras: I think that privacy issues are really interesting for adolescents. If a child is doing something that is illegal, then how do we weigh the more important value, which is how to protect a child? Really, ask yourself logically, do you feel young people who don't have a fully developed sense of self should be able to do things that are illegal to harm themselves?
Kern: [Drug testing ] is only for students who participate in extracurricular activities because the Supreme Court ruled it is permissible to [test] students in those activities because it described them as a privilege. But students in those programs are shown to have fewer problems with drugs so there is concern that it will deter kids from participating in those activities, which help kids feel connected and engaged with school. The Supreme Court decision is treating students like they are guilty until proven innocent.
-------------
entire article:
http://pediatrics.aappublications.org/cgi/reprint/119/3/627
short statement:
http://pediatrics.aappublications.org/cgi/content/short/119/3/627
PEDIATRICS Vol. 119 No. 3 March 2007, pp. 627-630
POLICY STATEMENT
Testing for Drugs of Abuse in Children and Adolescents: Addendum—Testing in Schools and at Home
Committee on Substance Abuse and Council on School Health
The American Academy of Pediatrics continues to believe that adolescents should not be drug tested without their knowledge and consent.
Recent US Supreme Court decisions and market forces have resulted in recommendations for drug testing of adolescents at school and products for parents to use to test adolescents at home.
The American Academy of Pediatrics has strong reservations about testing adolescents at school or at home and believes that more research is needed on both safety and efficacy before school-based testing programs are implemented.
The American Academy of Pediatrics also believes that more adolescent-specific substance abuse treatment resources are needed to ensure that testing leads to early rehabilitation rather than to punitive measures only.
Two papers on MDMA psychotherapy
Two papers on MDMA psychotherapy
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&dopt=AbstractPlus&list_uids=17329304&query_hl=8&itool=pubmed_docsum
J Psychopharmacol. 2007 Mar;21(2):220-4.
Is there a case for MDMA-assisted psychotherapy in the UK?
Sessa B. Psychopharmacology Unit, Dorothy Hodgkin Building, Bristol, UK.
ABSTRACT
Much has been written in scientific and popular literature in recent years about the dangers surrounding the recreational use of the drug MDMA/ecstasy.
What is little known and understood however is the history of the apparently safe and effective use of MDMA as a therapeutic tool for psychotherapy.
In this paper the author explores this history and describes the recent re-emergence of scientific interest in MDMA and other psychedelic drugs.
There are currently several new double-blind randomised controlled trials underway re-visiting the subject.
By acknowledging the limitations of this new research and emphasising the importance of exercising appropriate but realistic caution, the author asks that the medical profession consider a dispassionate and open-minded debate to examine whether MDMA might have a legitimate place as an adjunct to psychotherapy in modern psychiatric practice.
----
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&dopt=AbstractPlus&list_uids=17297639&query_hl=8&itool=pubmed_docsum
Psychopharmacology (Berl). 2007 Apr;191(2):181-93. Epub 2007 Feb 13
The psychotherapeutic potential of MDMA (3,4-methylenedioxymethamphetamine): an evidence-based review.
Parrott AC. Department of Psychology, University of Wales Swansea, Swansea, SA2 8PP, Wales, UK, a.c.parrott@swansea.ac.uk.
ABSTRACT
AIMS AND RATIONALE: The purpose of this study was to review whether methylenedioxy-methamphetamine (MDMA) has the appropriate pharmacodynamic profile to be a therapeutic agent.
MATERIALS AND METHODS: Empirical descriptions of MDMA's subjective effects in humans will be reviewed to evaluate the proposal that MDMA has psychotherapeutic properties. The focus will be published evidence on its functional effects in therapeutic, medical, and other situations.
RESULTS: MDMA is a powerful central nervous system (CNS) stimulant which affects several neurotransmitter systems and intensifies a range of psychobiological functions. Its acute mood effects can be very positive and life enhancing, and the affirmative cognitions engendered during MDMA therapy may well endure afterwards.
However, MDMA also has a number of potential anti-therapeutic characteristics. Acutely, it can also intensify negative cognitions, and these may similarly endure over time. Psychotherapists have found that setting, intention, and expectancy are crucial for a positive outcome, but these factors cannot be guaranteed. Post-MDMA, there is a period of neurotransmitter recovery when low moods predominate, and these may exacerbate psychiatric distress.
The explanations proposed for MDMA-assisted therapy are all psychodynamic, and a neurochemical model needs to be outlined. It has been suggested that enduring therapeutic gains can follow a single session, but again, this lacks a clear psychopharmacological rationale.
Finally, diathesis-stress models suggest that psychiatric individuals are more prone to acute and chronic abreactions to CNS stimulants such as MDMA.
CONCLUSIONS: There are a number of issues which need to be addressed before it can be argued that MDMA might be clinically useful for psychotherapy.Parrott AC.
Department of Psychology, University of Wales Swansea, Swansea, SA2 8PP, Wales,
UK, a.c.parrott@swansea.ac.uk.
ABSTRACT
AIMS AND RATIONALE: The purpose of this study was to review whether methylenedioxy-methamphetamine (MDMA) has the appropriate pharmacodynamic profile to be a therapeutic agent.
MATERIALS AND METHODS: Empirical descriptions of MDMA's subjective effects in humans will be reviewed to evaluate the proposal that MDMA has psychotherapeutic properties. The focus will be published evidence on its functional effects in therapeutic, medical, and other situations.
RESULTS: MDMA is a powerful central nervous system (CNS) stimulant which affects several neurotransmitter systems and intensifies a range of psychobiological functions. Its acute mood effects can be very positive and life enhancing, and the affirmative cognitions engendered during MDMA therapy may well endure afterwards.
However, MDMA also has a number of potential anti-therapeutic characteristics. Acutely, it can also intensify negative cognitions, and these may similarly endure over time. Psychotherapists have found that setting, intention, and expectancy are crucial for a positive outcome, but these factors cannot be guaranteed. Post-MDMA, there is a period of neurotransmitter recovery when low moods predominate, and these may exacerbate psychiatric distress.
The explanations proposed for MDMA-assisted therapy are all psychodynamic, and a neurochemical model needs to be outlined. It has been suggested that enduring therapeutic gains can follow a single session, but again, this lacks a clear psychopharmacological rationale.
Finally, diathesis-stress models suggest that psychiatric individuals are more prone to acute and chronic abreactions to CNS stimulants such as MDMA.
CONCLUSIONS: There are a number of issues which need to be addressed before it can be argued that MDMA might be clinically useful for psychotherapy.
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&dopt=AbstractPlus&list_uids=17329304&query_hl=8&itool=pubmed_docsum
J Psychopharmacol. 2007 Mar;21(2):220-4.
Is there a case for MDMA-assisted psychotherapy in the UK?
Sessa B. Psychopharmacology Unit, Dorothy Hodgkin Building, Bristol, UK.
ABSTRACT
Much has been written in scientific and popular literature in recent years about the dangers surrounding the recreational use of the drug MDMA/ecstasy.
What is little known and understood however is the history of the apparently safe and effective use of MDMA as a therapeutic tool for psychotherapy.
In this paper the author explores this history and describes the recent re-emergence of scientific interest in MDMA and other psychedelic drugs.
There are currently several new double-blind randomised controlled trials underway re-visiting the subject.
By acknowledging the limitations of this new research and emphasising the importance of exercising appropriate but realistic caution, the author asks that the medical profession consider a dispassionate and open-minded debate to examine whether MDMA might have a legitimate place as an adjunct to psychotherapy in modern psychiatric practice.
----
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&dopt=AbstractPlus&list_uids=17297639&query_hl=8&itool=pubmed_docsum
Psychopharmacology (Berl). 2007 Apr;191(2):181-93. Epub 2007 Feb 13
The psychotherapeutic potential of MDMA (3,4-methylenedioxymethamphetamine): an evidence-based review.
Parrott AC. Department of Psychology, University of Wales Swansea, Swansea, SA2 8PP, Wales, UK, a.c.parrott@swansea.ac.uk.
ABSTRACT
AIMS AND RATIONALE: The purpose of this study was to review whether methylenedioxy-methamphetamine (MDMA) has the appropriate pharmacodynamic profile to be a therapeutic agent.
MATERIALS AND METHODS: Empirical descriptions of MDMA's subjective effects in humans will be reviewed to evaluate the proposal that MDMA has psychotherapeutic properties. The focus will be published evidence on its functional effects in therapeutic, medical, and other situations.
RESULTS: MDMA is a powerful central nervous system (CNS) stimulant which affects several neurotransmitter systems and intensifies a range of psychobiological functions. Its acute mood effects can be very positive and life enhancing, and the affirmative cognitions engendered during MDMA therapy may well endure afterwards.
However, MDMA also has a number of potential anti-therapeutic characteristics. Acutely, it can also intensify negative cognitions, and these may similarly endure over time. Psychotherapists have found that setting, intention, and expectancy are crucial for a positive outcome, but these factors cannot be guaranteed. Post-MDMA, there is a period of neurotransmitter recovery when low moods predominate, and these may exacerbate psychiatric distress.
The explanations proposed for MDMA-assisted therapy are all psychodynamic, and a neurochemical model needs to be outlined. It has been suggested that enduring therapeutic gains can follow a single session, but again, this lacks a clear psychopharmacological rationale.
Finally, diathesis-stress models suggest that psychiatric individuals are more prone to acute and chronic abreactions to CNS stimulants such as MDMA.
CONCLUSIONS: There are a number of issues which need to be addressed before it can be argued that MDMA might be clinically useful for psychotherapy.Parrott AC.
Department of Psychology, University of Wales Swansea, Swansea, SA2 8PP, Wales,
UK, a.c.parrott@swansea.ac.uk.
ABSTRACT
AIMS AND RATIONALE: The purpose of this study was to review whether methylenedioxy-methamphetamine (MDMA) has the appropriate pharmacodynamic profile to be a therapeutic agent.
MATERIALS AND METHODS: Empirical descriptions of MDMA's subjective effects in humans will be reviewed to evaluate the proposal that MDMA has psychotherapeutic properties. The focus will be published evidence on its functional effects in therapeutic, medical, and other situations.
RESULTS: MDMA is a powerful central nervous system (CNS) stimulant which affects several neurotransmitter systems and intensifies a range of psychobiological functions. Its acute mood effects can be very positive and life enhancing, and the affirmative cognitions engendered during MDMA therapy may well endure afterwards.
However, MDMA also has a number of potential anti-therapeutic characteristics. Acutely, it can also intensify negative cognitions, and these may similarly endure over time. Psychotherapists have found that setting, intention, and expectancy are crucial for a positive outcome, but these factors cannot be guaranteed. Post-MDMA, there is a period of neurotransmitter recovery when low moods predominate, and these may exacerbate psychiatric distress.
The explanations proposed for MDMA-assisted therapy are all psychodynamic, and a neurochemical model needs to be outlined. It has been suggested that enduring therapeutic gains can follow a single session, but again, this lacks a clear psychopharmacological rationale.
Finally, diathesis-stress models suggest that psychiatric individuals are more prone to acute and chronic abreactions to CNS stimulants such as MDMA.
CONCLUSIONS: There are a number of issues which need to be addressed before it can be argued that MDMA might be clinically useful for psychotherapy.
Friday
Brain changes after first MDMA use
http://www.nature.com/npp/journal/v32/n2/full/1301225a.html
Neuropsychopharmacology (2007) 32, 458–470.
A Prospective Cohort Study on Sustained Effects of Low-Dose Ecstasy Use on the Brain in New Ecstasy Users
Maartje M L de Win, Liesbeth Reneman, Gerry Jager, Erik-Jan P Vlieger, Sílvia D Olabarriaga, Cristina Lavini, Ivo Bisschops, Charles B L M Majoie, Jan Booij, Gerard J den Heeten and Wim van den Brink
Abstract
It is debated whether ecstasy use has neurotoxic effects on the human brain and what the effects are of a low dose of ecstasy use.
We prospectively studied sustained effects (>2 weeks abstinence) of a low dose of ecstasy on the brain in ecstasy-naive volunteers using a combination of advanced MR techniques and self-report questionnaires on psychopathology as part of the NeXT (Netherlands XTC Toxicity) study.
Outcomes of proton magnetic resonance spectroscopy (1H-MRS), diffusion tensor imaging (DTI), perfusion-weighted imaging (PWI), and questionnaires on depression, impulsivity, and sensation seeking were compared in 30 subjects (12M, 21.8 +/- 3.1 years) in two sessions before and after first ecstasy use (1.8 +/- 1.3 tablets).
Interval between baseline and follow-up was on average 8.1 +/- 6.5 months and time between last ecstasy use and follow-up was 7.7 +/- 4.4 weeks.
Using 1H-MRS, no significant changes were observed in metabolite concentrations of N-acetylaspartate (NAA), choline (Cho), myo-inositol (mI), and creatine (Cr), nor in ratios of NAA, Cho, and mI relative to Cr.
However, ecstasy use was followed by a sustained 0.9% increase in fractional anisotropy (FA) in frontoparietal white matter, a 3.4% decrease in apparent diffusion (ADC) in the thalamus and a sustained decrease in relative regional cerebral blood volume (rrCBV) in the thalamus (-6.2%), dorsolateral frontal cortex (-4.0%), and superior parietal cortex (-3.0%) (all significant at p<0.05, paired t-tests).
After correction for multiple comparisons, only the rrCBV decrease in the dorsolateral frontal cortex remained significant.
We also observed increased impulsivity (+3.7% on the Barratt Impulsiveness Scale) and decreased depression (-28.0% on the Beck Depression Inventory) in novel ecstasy users, although effect sizes were limited and clinical relevance questionable.
As no indications were found for structural neuronal damage with the currently used techniques, our data do not support the concern that incidental ecstasy use leads to extensive axonal damage.
However, sustained decreases in rrCBV and ADC values may indicate that even low ecstasy doses can induce prolonged vasoconstriction in some brain areas, although it is not known whether this effect is permanent. Additional studies are needed to replicate these findings.
Neuropsychopharmacology (2007) 32, 458–470.
A Prospective Cohort Study on Sustained Effects of Low-Dose Ecstasy Use on the Brain in New Ecstasy Users
Maartje M L de Win, Liesbeth Reneman, Gerry Jager, Erik-Jan P Vlieger, Sílvia D Olabarriaga, Cristina Lavini, Ivo Bisschops, Charles B L M Majoie, Jan Booij, Gerard J den Heeten and Wim van den Brink
Abstract
It is debated whether ecstasy use has neurotoxic effects on the human brain and what the effects are of a low dose of ecstasy use.
We prospectively studied sustained effects (>2 weeks abstinence) of a low dose of ecstasy on the brain in ecstasy-naive volunteers using a combination of advanced MR techniques and self-report questionnaires on psychopathology as part of the NeXT (Netherlands XTC Toxicity) study.
Outcomes of proton magnetic resonance spectroscopy (1H-MRS), diffusion tensor imaging (DTI), perfusion-weighted imaging (PWI), and questionnaires on depression, impulsivity, and sensation seeking were compared in 30 subjects (12M, 21.8 +/- 3.1 years) in two sessions before and after first ecstasy use (1.8 +/- 1.3 tablets).
Interval between baseline and follow-up was on average 8.1 +/- 6.5 months and time between last ecstasy use and follow-up was 7.7 +/- 4.4 weeks.
Using 1H-MRS, no significant changes were observed in metabolite concentrations of N-acetylaspartate (NAA), choline (Cho), myo-inositol (mI), and creatine (Cr), nor in ratios of NAA, Cho, and mI relative to Cr.
However, ecstasy use was followed by a sustained 0.9% increase in fractional anisotropy (FA) in frontoparietal white matter, a 3.4% decrease in apparent diffusion (ADC) in the thalamus and a sustained decrease in relative regional cerebral blood volume (rrCBV) in the thalamus (-6.2%), dorsolateral frontal cortex (-4.0%), and superior parietal cortex (-3.0%) (all significant at p<0.05, paired t-tests).
After correction for multiple comparisons, only the rrCBV decrease in the dorsolateral frontal cortex remained significant.
We also observed increased impulsivity (+3.7% on the Barratt Impulsiveness Scale) and decreased depression (-28.0% on the Beck Depression Inventory) in novel ecstasy users, although effect sizes were limited and clinical relevance questionable.
As no indications were found for structural neuronal damage with the currently used techniques, our data do not support the concern that incidental ecstasy use leads to extensive axonal damage.
However, sustained decreases in rrCBV and ADC values may indicate that even low ecstasy doses can induce prolonged vasoconstriction in some brain areas, although it is not known whether this effect is permanent. Additional studies are needed to replicate these findings.
UK drug data
http://image.guardian.co.uk/sys-files/Guardian/documents/2005/07/05/Report.pdf
A report on UK drug use from the British government, published by the Guardian newspaper.
Some very interesting takes on things. Like this, on page 2 of the summary:
"Even if supply side interventions were more effective, it is not clear that the impact on the harms caused by serious drug users would be reduced."
And on page 30, chart showing that individuals who abuse both heroin and crack commit 75% of all crime associated with these drugs.
See page 35 regarding comparable harms from drugs of abuse.
A report on UK drug use from the British government, published by the Guardian newspaper.
Some very interesting takes on things. Like this, on page 2 of the summary:
"Even if supply side interventions were more effective, it is not clear that the impact on the harms caused by serious drug users would be reduced."
And on page 30, chart showing that individuals who abuse both heroin and crack commit 75% of all crime associated with these drugs.
See page 35 regarding comparable harms from drugs of abuse.
Venom Abuse
The last sentence pretty much sums it up.
---------
http://www.jpgmonline.com/article.asp?issn=0022-3859;year=2006;volume=52;issue=4;spage=325;epage=326;aulast=Varghese
J Postgrad Med 2006;52:325-326 Unconventional substances of abuse: Scorpions and lizards
Varghese ST, Balhara Y, Mondal A.
Sir,
Although it is common knowledge that many plants contain psychoactive substances, the fact that certain animals also do is barely known. The use of various insects as substances of abuse is interesting and has not been reported in detail in medical literature. We would like to illustrate two cases of animals used for their psychoactive properties and a brief review is provided.
A 60-year-old man with a 35-year history of heroin dependence was admitted for detoxification. On detailed evaluation the patient admitted to using scorpions on many occasions when heroin was not available. He described a distinct pleasurable effect of the sting that was more potent than heroin. He experienced an instant rush and would feel relaxed and would be under its effects for almost six hours. The patient used to collect the scorpions from the crevices in the rocks and would make it sting his hands before disposing them. He did not report any hallucinations or loss of consciousness any time during his sojourns.
A 35-year-old man with a 15-year history of heroin use was imprisoned for alleged illegal activities. While serving his term, the patient shifted his drug of use to lizards due to non-availability of heroin. He would catch lizards pull out their internal organs and burn them. He would later take the charred remains and fill them in a cigarette and inhale deeply. He claimed instant high on this substance and claimed it to be as pleasurable as heroin. On his release from the prison he continued using heroin. Both the patients were assessed for any psychopathology and did not have any co-morbid psychiatric illness.
Scorpion venom contains low molecular weight basic polypeptides, neurotoxins that are the principal toxic agents. These toxins act on ion channels, promoting a derangement that may result in an abnormal release of neuro-transmitters.[1] The release of serotonin caused by the poison may be the reason for the pleasurable feeling associated with the poison. The effects of poison on the sodium-potassium pumps in the nerves may also explain these effects. The acute effects of scorpion envenomation include extreme anxiety, pain at the bite site, acute renal failure, myocardial toxicity, left ventricular dysfunction and pulmonary edema.[2] Agitation, seizures, squint, miosis, mydriasis and coma are the acute neurological manifestations of toxicity.[3] Literature is sparse on the long-term effects of these toxins in humans.
Other creatures that have been used for their psycho-active properties include fish, wasps, toads, snakes and even human body parts.[4] Newspaper reports are available of rising scorpion sting use in Gujarat, India for their psychoactive properties. The practice of medicine is made interesting by these occasional cases and in addiction medicine some patients never fail to surprise you.
References
1. Nencioni AL, Carvalho FF, Lebrun I, Dorce VA, Sandoval MR. Neurotoxic effects of three fractions isolated from Tityus serrulatus scorpion venom. Pharmacol Toxicol 2000;86:149-55.
2. Rajasekhar D, Mohan A. Clinical and echocardiographic findings in patients with myocardial toxicity due to scorpion sting. Natl Med J India. 2004;17: 307-9.
3. Bahloul M, Rekik N, Chabchoub I, Chaari A, Ksibi H, Kallel H, et al . Neurological complications secondary to severe scorpion envenomation. Med Sci Monit 2005;11:196-202.
4. Rudgley R. The Encyclopedia of Psychoactive Substances. 1st ed. Little Brown and Co: Great Britain; 2000.
---------
http://www.jpgmonline.com/article.asp?issn=0022-3859;year=2006;volume=52;issue=4;spage=325;epage=326;aulast=Varghese
J Postgrad Med 2006;52:325-326 Unconventional substances of abuse: Scorpions and lizards
Varghese ST, Balhara Y, Mondal A.
Sir,
Although it is common knowledge that many plants contain psychoactive substances, the fact that certain animals also do is barely known. The use of various insects as substances of abuse is interesting and has not been reported in detail in medical literature. We would like to illustrate two cases of animals used for their psychoactive properties and a brief review is provided.
A 60-year-old man with a 35-year history of heroin dependence was admitted for detoxification. On detailed evaluation the patient admitted to using scorpions on many occasions when heroin was not available. He described a distinct pleasurable effect of the sting that was more potent than heroin. He experienced an instant rush and would feel relaxed and would be under its effects for almost six hours. The patient used to collect the scorpions from the crevices in the rocks and would make it sting his hands before disposing them. He did not report any hallucinations or loss of consciousness any time during his sojourns.
A 35-year-old man with a 15-year history of heroin use was imprisoned for alleged illegal activities. While serving his term, the patient shifted his drug of use to lizards due to non-availability of heroin. He would catch lizards pull out their internal organs and burn them. He would later take the charred remains and fill them in a cigarette and inhale deeply. He claimed instant high on this substance and claimed it to be as pleasurable as heroin. On his release from the prison he continued using heroin. Both the patients were assessed for any psychopathology and did not have any co-morbid psychiatric illness.
Scorpion venom contains low molecular weight basic polypeptides, neurotoxins that are the principal toxic agents. These toxins act on ion channels, promoting a derangement that may result in an abnormal release of neuro-transmitters.[1] The release of serotonin caused by the poison may be the reason for the pleasurable feeling associated with the poison. The effects of poison on the sodium-potassium pumps in the nerves may also explain these effects. The acute effects of scorpion envenomation include extreme anxiety, pain at the bite site, acute renal failure, myocardial toxicity, left ventricular dysfunction and pulmonary edema.[2] Agitation, seizures, squint, miosis, mydriasis and coma are the acute neurological manifestations of toxicity.[3] Literature is sparse on the long-term effects of these toxins in humans.
Other creatures that have been used for their psycho-active properties include fish, wasps, toads, snakes and even human body parts.[4] Newspaper reports are available of rising scorpion sting use in Gujarat, India for their psychoactive properties. The practice of medicine is made interesting by these occasional cases and in addiction medicine some patients never fail to surprise you.
References
1. Nencioni AL, Carvalho FF, Lebrun I, Dorce VA, Sandoval MR. Neurotoxic effects of three fractions isolated from Tityus serrulatus scorpion venom. Pharmacol Toxicol 2000;86:149-55.
2. Rajasekhar D, Mohan A. Clinical and echocardiographic findings in patients with myocardial toxicity due to scorpion sting. Natl Med J India. 2004;17: 307-9.
3. Bahloul M, Rekik N, Chabchoub I, Chaari A, Ksibi H, Kallel H, et al . Neurological complications secondary to severe scorpion envenomation. Med Sci Monit 2005;11:196-202.
4. Rudgley R. The Encyclopedia of Psychoactive Substances. 1st ed. Little Brown and Co: Great Britain; 2000.
California's 1906 Pharmacy and Poison Act
http://www.sfgate.com/cgi-bin/article.cgi?file=/c/a/2007/03/04/ING44OD4AU1.DTL&type=printable
CA 1906 Pharmacy and Poison Act
"State's war on drugs a 100-year-old bust
Rate of addiction has doubled since crackdown on use"
Dale Gieringer
Sunday, March 4, 2007
San Francisco Chronicle
Tuesday marks the centennial of a fateful but forgotten watershed in
state history: the start of California's war on drugs.
On March 6, 1907, Gov. James Gillett signed amendments to the Pharmacy
and Poison Act making it a crime to sell opiates or cocaine in the state
without a prescription. The act made California a national leader in the
war on drugs seven years before Congress enacted national drug
prohibition with the Harrison Act.
Many Americans don't know there was a time when people could freely buy
any drug they wanted, including opium, cocaine, cannabis and other
so-called narcotics. For most of the nation's history, there was no such
thing as an illegal drug. That began to change after the turn of the
20th century, when an alliance of Progressive Era bureaucrats and moral
crusaders began to push for prohibition of narcotics and alcohol.
California's law was engineered by the state Board of Pharmacy, a
national pioneer in drug enforcement whose exploits have been largely
lost to history. The board was established in 1891 to regulate
pharmacies and the sale of poisons. The 1891 law required that narcotics
carry warning labels and that their sales be recorded in a register, but
it did not restrict purchases.
However, a rising national tide for pure food and drug legislation
prompted the board to propose stronger measures to the Legislature. In
1907, the law was quietly amended without any press coverage or public
debate -- or any discussion of possible adverse effects. As soon as the
law took effect, the board began a high-profile enforcement campaign,
dispatching its agents from city to city, investigating and busting
offending pharmacists, raiding opium dens, and publicizing their arrests
in the newspapers.
The campaign proved to be the opening battle in a 100-year war that
still rages with no signs of ultimate victory.
California's anti-drug efforts go even further back. In 1875, San
Francisco passed the nation's first anti-drug law, the Opium Den
Ordinance, aimed specifically at Chinese opium smoking. Passed at the
height of anti-Chinese hysteria, the law was the legacy of the city's
shortest serving mayor, Dr. George Hewston, who was in office for a
month after the sudden death of Mayor James Otis.
Although the dens had been around for years, Hewston decried the
increase in dens "frequented by white males and females of various
ages," and called on the supervisors to suppress practices "which are
against good morals and contrary to public order." The ordinance did not
prohibit sale or private use of opium, but banned dens for public
smoking. Conscious that the city remained a lucrative center of the
opium trade, the supervisors went on to impose a license fee on opium
dealers, which the Chinese adeptly evaded.
For years, the dens continued to thrive underground, a lucrative
industry of vice and a source of bribery and corruption, like
prostitution and gambling. The Chinese were typically left alone, but
dens that catered to whites were considered fair game for law
enforcement.
Other cities began to ban the dens, and in 1881 the Legislature enacted
a statewide ban. Nonetheless, the dens persisted, as did anti-Chinese
sentiment, and stricter measures were proposed. Among them was an
opium-prohibition bill by state Sen. George Perry of San Francisco, that
managed to pass the 1885 Legislature but was vetoed.
The Perry bill would have banned sale of the drug except with a doctor's
prescription. Opponents charged it was secretly aimed at extracting a
bribe from the opium dealers to stop it -- charges that gained momentum
when the bill was obligingly vetoed by Gov. George Stoneman, a crony of
Perry's. The next session, another opium-prohibition bill was withdrawn
amid renewed charges of bribery. The Legislature finally washed its
hands of the matter by passing a resolution calling on Congress to act,
but there was little interest in Washington.
San Francisco enacted a pioneering anti-narcotics law of its own in
1889. The move came in response to a petition from the San Francisco
Medical Society, which, lamenting the ruination of the city's young men
and women by Chinese opium, called for sales to be restricted to
pharmacies and used for medical purposes only.
Meanwhile, the superintendent of the local House of Corrections reported
a disturbing influx of inmates who were addicted to the newly
popularized hypodermic use of morphine and cocaine. The supervisors
responded with one of the nation's first comprehensive anti-narcotics
laws, the Morphine/Cocaine Ordinance.
The ordinance, in effect a prototype of the 1907 law, banned the sale of
opium, morphine and cocaine except by pharmacies on a doctor's
prescription. Ironically for a city destined to become the mecca of the
1960s drug culture, the ordinance specifically forbade recreational use,
disallowing prescriptions for the purpose of satisfying "curiosity or to
experience any of the sensations produced thereby."
The ordinance proved unsuccessful. It faced significant opposition from
the city's druggists, who objected to the hardship of requiring
suffering patients to get a doctor's prescription. An initial flurry of
arrests drove the drug fiends to Oakland, which in turn passed its own
law.
However, enforcement efforts soon lagged, as police were reluctant to
hassle otherwise peaceable pharmacists. By 1893, The Chronicle declared
the ordinance a "dead letter."
California's war on drugs began in earnest with the 1907 amendments. The
Board of Pharmacy launched an aggressive campaign and pioneered the
modern tactics of drug enforcement. The board hired undercover agents
who posed as suffering patients, wheedling drugs from unsuspecting
pharmacists, then arresting them.
The board swept down on the Chinatown dens, busting down doors and
arresting hundreds. It strategically expanded its powers through new
legislation. In a crucial move, possession was outlawed in 1909. This
set the stage for the criminalization of users, today the largest single
class of criminals in California.
The board also moved to ban possession of opium pipes. It then garnered
headlines by staging gigantic public bonfires of confiscated
paraphernalia and drugs in the heart of Chinatown.
The raids broke the back of the opium-smoking culture, but the addicts
moved on to morphine and heroin. The board proceeded to launch a
pre-emptive attack on "Indian hemp" or cannabis in 1913.
At the time, cannabis was virtually unheard of in California.
Nonetheless, the board warned of an influx of cannabis-using "Hindoos"
(actually Sikhs) from India, and prevailed on the Legislature to ban the
drug lest the habit spread to whites. Ironically, only after being
outlawed did marijuana become popular, eventually being used by millions
of Californians.
To a public unaccustomed to drug enforcement, the board's conduct
initially stirred consternation. The public "has been disgusted with the
sending of spies and stool-pigeons to gather evidence," the Santa Cruz
News said in an editorial. Board inspectors were accused of brutal
beatings and violence of a kind unknown in pre-prohibition days.
Inevitably, corruption also ensued. The board's chief inspector,
Frederick Sutherland, was fired amid allegations of bribery after he
married a drug-dealing widow.
In subsequent years, attitudes hardened. As black market dealers moved
in, drugs were increasingly viewed as a criminal problem. At first,
penalties were relatively mild: Sale was classified as only a
misdemeanor. Later, possession became punishable by up to six years in
prison. Originally, the board had envisioned that drug fiends would be
treated in asylums rather than sent to jail. However, funding for
asylums was repeatedly vetoed, sending addicts to prison.
As the screws tightened, the problem got worse. Federal and state laws
forced prices out of sight, pushing addicts into crime. By 1919, the Los
Angeles Times reported a "saturnalia of violent crime" caused by drug
fiends desperate to get narcotics. Stories of drug crime and violence,
rarely seen before prohibition, became a staple item in the press.
In the end, the drug laws became a giant crime-creation program.
Before 1907, the state's drug crime involved a few hundred opium den
misdemeanors. Today, the state records 400,000 drug arrests per year,
250,000 of them felonies. Drug felons -- nonexistent in 1906 -- now
account for 36,000 prisoners, 20 percent of the state's prison
population. Drug gangs plague our cities, thousands of innocent people
are victimized by prohibition-related theft and violence, and the rough
stuff has escalated into outright war in Afghanistan, Colombia and
Mexico.
Today's addiction rate is more than twice what existed during the free
market a century ago -- only about one-half percent.
After 100 years, it is hard to escape the conclusion that drug
prohibition has failed. In recent years, Californians have begun to show
second thoughts, approving initiatives to re-legalize medical cannabis
and to send drug users for treatment rather than to prison. As the state
with the longest historical experience with drug laws, it is fitting
that California should be exploring new directions out of its 100-year
war on drugs.
Dale Gieringer is California director of NORML. Contact us at
insight@sfchronicle.com.
CA 1906 Pharmacy and Poison Act
"State's war on drugs a 100-year-old bust
Rate of addiction has doubled since crackdown on use"
Dale Gieringer
Sunday, March 4, 2007
San Francisco Chronicle
Tuesday marks the centennial of a fateful but forgotten watershed in
state history: the start of California's war on drugs.
On March 6, 1907, Gov. James Gillett signed amendments to the Pharmacy
and Poison Act making it a crime to sell opiates or cocaine in the state
without a prescription. The act made California a national leader in the
war on drugs seven years before Congress enacted national drug
prohibition with the Harrison Act.
Many Americans don't know there was a time when people could freely buy
any drug they wanted, including opium, cocaine, cannabis and other
so-called narcotics. For most of the nation's history, there was no such
thing as an illegal drug. That began to change after the turn of the
20th century, when an alliance of Progressive Era bureaucrats and moral
crusaders began to push for prohibition of narcotics and alcohol.
California's law was engineered by the state Board of Pharmacy, a
national pioneer in drug enforcement whose exploits have been largely
lost to history. The board was established in 1891 to regulate
pharmacies and the sale of poisons. The 1891 law required that narcotics
carry warning labels and that their sales be recorded in a register, but
it did not restrict purchases.
However, a rising national tide for pure food and drug legislation
prompted the board to propose stronger measures to the Legislature. In
1907, the law was quietly amended without any press coverage or public
debate -- or any discussion of possible adverse effects. As soon as the
law took effect, the board began a high-profile enforcement campaign,
dispatching its agents from city to city, investigating and busting
offending pharmacists, raiding opium dens, and publicizing their arrests
in the newspapers.
The campaign proved to be the opening battle in a 100-year war that
still rages with no signs of ultimate victory.
California's anti-drug efforts go even further back. In 1875, San
Francisco passed the nation's first anti-drug law, the Opium Den
Ordinance, aimed specifically at Chinese opium smoking. Passed at the
height of anti-Chinese hysteria, the law was the legacy of the city's
shortest serving mayor, Dr. George Hewston, who was in office for a
month after the sudden death of Mayor James Otis.
Although the dens had been around for years, Hewston decried the
increase in dens "frequented by white males and females of various
ages," and called on the supervisors to suppress practices "which are
against good morals and contrary to public order." The ordinance did not
prohibit sale or private use of opium, but banned dens for public
smoking. Conscious that the city remained a lucrative center of the
opium trade, the supervisors went on to impose a license fee on opium
dealers, which the Chinese adeptly evaded.
For years, the dens continued to thrive underground, a lucrative
industry of vice and a source of bribery and corruption, like
prostitution and gambling. The Chinese were typically left alone, but
dens that catered to whites were considered fair game for law
enforcement.
Other cities began to ban the dens, and in 1881 the Legislature enacted
a statewide ban. Nonetheless, the dens persisted, as did anti-Chinese
sentiment, and stricter measures were proposed. Among them was an
opium-prohibition bill by state Sen. George Perry of San Francisco, that
managed to pass the 1885 Legislature but was vetoed.
The Perry bill would have banned sale of the drug except with a doctor's
prescription. Opponents charged it was secretly aimed at extracting a
bribe from the opium dealers to stop it -- charges that gained momentum
when the bill was obligingly vetoed by Gov. George Stoneman, a crony of
Perry's. The next session, another opium-prohibition bill was withdrawn
amid renewed charges of bribery. The Legislature finally washed its
hands of the matter by passing a resolution calling on Congress to act,
but there was little interest in Washington.
San Francisco enacted a pioneering anti-narcotics law of its own in
1889. The move came in response to a petition from the San Francisco
Medical Society, which, lamenting the ruination of the city's young men
and women by Chinese opium, called for sales to be restricted to
pharmacies and used for medical purposes only.
Meanwhile, the superintendent of the local House of Corrections reported
a disturbing influx of inmates who were addicted to the newly
popularized hypodermic use of morphine and cocaine. The supervisors
responded with one of the nation's first comprehensive anti-narcotics
laws, the Morphine/Cocaine Ordinance.
The ordinance, in effect a prototype of the 1907 law, banned the sale of
opium, morphine and cocaine except by pharmacies on a doctor's
prescription. Ironically for a city destined to become the mecca of the
1960s drug culture, the ordinance specifically forbade recreational use,
disallowing prescriptions for the purpose of satisfying "curiosity or to
experience any of the sensations produced thereby."
The ordinance proved unsuccessful. It faced significant opposition from
the city's druggists, who objected to the hardship of requiring
suffering patients to get a doctor's prescription. An initial flurry of
arrests drove the drug fiends to Oakland, which in turn passed its own
law.
However, enforcement efforts soon lagged, as police were reluctant to
hassle otherwise peaceable pharmacists. By 1893, The Chronicle declared
the ordinance a "dead letter."
California's war on drugs began in earnest with the 1907 amendments. The
Board of Pharmacy launched an aggressive campaign and pioneered the
modern tactics of drug enforcement. The board hired undercover agents
who posed as suffering patients, wheedling drugs from unsuspecting
pharmacists, then arresting them.
The board swept down on the Chinatown dens, busting down doors and
arresting hundreds. It strategically expanded its powers through new
legislation. In a crucial move, possession was outlawed in 1909. This
set the stage for the criminalization of users, today the largest single
class of criminals in California.
The board also moved to ban possession of opium pipes. It then garnered
headlines by staging gigantic public bonfires of confiscated
paraphernalia and drugs in the heart of Chinatown.
The raids broke the back of the opium-smoking culture, but the addicts
moved on to morphine and heroin. The board proceeded to launch a
pre-emptive attack on "Indian hemp" or cannabis in 1913.
At the time, cannabis was virtually unheard of in California.
Nonetheless, the board warned of an influx of cannabis-using "Hindoos"
(actually Sikhs) from India, and prevailed on the Legislature to ban the
drug lest the habit spread to whites. Ironically, only after being
outlawed did marijuana become popular, eventually being used by millions
of Californians.
To a public unaccustomed to drug enforcement, the board's conduct
initially stirred consternation. The public "has been disgusted with the
sending of spies and stool-pigeons to gather evidence," the Santa Cruz
News said in an editorial. Board inspectors were accused of brutal
beatings and violence of a kind unknown in pre-prohibition days.
Inevitably, corruption also ensued. The board's chief inspector,
Frederick Sutherland, was fired amid allegations of bribery after he
married a drug-dealing widow.
In subsequent years, attitudes hardened. As black market dealers moved
in, drugs were increasingly viewed as a criminal problem. At first,
penalties were relatively mild: Sale was classified as only a
misdemeanor. Later, possession became punishable by up to six years in
prison. Originally, the board had envisioned that drug fiends would be
treated in asylums rather than sent to jail. However, funding for
asylums was repeatedly vetoed, sending addicts to prison.
As the screws tightened, the problem got worse. Federal and state laws
forced prices out of sight, pushing addicts into crime. By 1919, the Los
Angeles Times reported a "saturnalia of violent crime" caused by drug
fiends desperate to get narcotics. Stories of drug crime and violence,
rarely seen before prohibition, became a staple item in the press.
In the end, the drug laws became a giant crime-creation program.
Before 1907, the state's drug crime involved a few hundred opium den
misdemeanors. Today, the state records 400,000 drug arrests per year,
250,000 of them felonies. Drug felons -- nonexistent in 1906 -- now
account for 36,000 prisoners, 20 percent of the state's prison
population. Drug gangs plague our cities, thousands of innocent people
are victimized by prohibition-related theft and violence, and the rough
stuff has escalated into outright war in Afghanistan, Colombia and
Mexico.
Today's addiction rate is more than twice what existed during the free
market a century ago -- only about one-half percent.
After 100 years, it is hard to escape the conclusion that drug
prohibition has failed. In recent years, Californians have begun to show
second thoughts, approving initiatives to re-legalize medical cannabis
and to send drug users for treatment rather than to prison. As the state
with the longest historical experience with drug laws, it is fitting
that California should be exploring new directions out of its 100-year
war on drugs.
Dale Gieringer is California director of NORML. Contact us at
insight@sfchronicle.com.
Thursday
SAMHSA's Prevention Platform: an online resource for substance abuse prevention.
SAMHSA's Prevention Platform: an online resource for substance abuse prevention. http://preventionplatform.samhsa.gov/
SAMHSA Launches Searchable Database of Evidence-Based Practices in Prevention and Treatment of Mental Health and Substance Use Disorders
The new National Registry of Evidence-based Programs and Practices (NREPP) debuts online today, greatly expanding the Substance Abuse and Mental Health Services Administration’s efforts to help local organizations make informed decisions about evidence-based interventions for the prevention and treatment of mental health and substance use disorders.
NREPP (http://www.nrepp.samhsa.gov/) is a searchable database with up-to-date, reliable information on the scientific basis and practicality of interventions. Users, such as community organizations and state and local officials, can perform custom searches to identify specific interventions based upon desired outcomes, target populations and service settings
SAMHSA Launches Searchable Database of Evidence-Based Practices in Prevention and Treatment of Mental Health and Substance Use Disorders
The new National Registry of Evidence-based Programs and Practices (NREPP) debuts online today, greatly expanding the Substance Abuse and Mental Health Services Administration’s efforts to help local organizations make informed decisions about evidence-based interventions for the prevention and treatment of mental health and substance use disorders.
NREPP (http://www.nrepp.samhsa.gov/) is a searchable database with up-to-date, reliable information on the scientific basis and practicality of interventions. Users, such as community organizations and state and local officials, can perform custom searches to identify specific interventions based upon desired outcomes, target populations and service settings
Monday
methadone ODs
http://www.latimes.com/news/nationworld/nation/la-me-methadone26feb26,0,4449874.story?coll=la-home-headlines
Methadone emerges as new killer Patients and addicts are mixing the opiate with other drugs, as did Anna Nicole Smith's son.
By Charles Proctor LA Times Staff Writer
February 26, 2007
Methadone, a potent opiate once used almost exclusively to treat heroin addicts, is increasingly being prescribed by doctors as a pain medication and abused by drug users searching for a cheap, easy way to get high, physicians and federal drug officials say.
The drug, which comes in pill or liquid form, recently has come under scrutiny in the death of former Playboy model Anna Nicole Smith. A doctor in Studio City prescribed methadone to Smith for pain treatment before she was found dead Feb. 8 in her Hollywood, Fla., hotel suite.
A coroner has yet to determine her cause of death, and the doctor said his treatment was "medically sound and appropriate."
Months earlier, Smith's 20-year-old son died in the Bahamas after taking a lethal mixture of methadone and two antidepressants, Zoloft and Lexapro.
Well before these deaths, however, drug counselors and clinicians were concerned about increased abuse of the drug on the streets, in group homes and even in middle schools.
It is an ironic turn in the history of methadone, which for years has been used to treat heroin addiction.
A synthetic opiate, methadone is similar to heroin in chemistry, curbing a user's craving for the illegal opiate by blocking the sensors that heroin stimulates without producing a heroin high.
In recent years, methadone has proved lethal to a growing number of patients or addicts who use it in conjunction with prescription drugs including Valium, Xanax or, in the case of addicts, illegal narcotics such as cocaine.
Sometimes users swallow methadone before or after they "puff," when they seek to get high by slowly inhaling the chemicals from an aerosol can.
"Every year, we see hundreds of these deaths, and the numbers continue to increase," said Bruce Goldberger, director of toxicology at the University of Florida, who has been at the forefront of tracking methadone-related deaths. "It is absolutely the fastest-growing drug problem."
A federal government study found that nationwide methadone-related deaths climbed to more than 3,800 in 2004 from about 780 in 1999. Among all narcotic-related deaths in 2004, only cocaine killed more people in the United States than methadone.
Physicians and others point out that methadone's potential for abuse isn't as high as that of opiates like heroin because it does not induce a strong euphoria on its own.
But repeated use can still cause a physical dependence, doctors say, and when users stop taking it, withdrawal-like symptoms can occur.
Given its low cost compared with heroin and other drugs, its recent proliferation and its potentially lethal potency when mixed with other drugs, officials worry that methadone is largely evading the scrutiny applied to other abused prescription medications, such as OxyContin and Vicodin.
The drug can be lethal even when mixed with antidepressants, or grapefruit juice, experts and federal drug authorities say.
Methadone can linger in body tissue for an unusually long time — 24 to 59 hours in some cases. Sometimes users assume it has worn off, then take other drugs or more methadone, leading to respiratory depression, coma and eventual death.
Methadone is available at clinics that prescribe it to treat heroin addiction, from doctors who can prescribe it for pain or to treat addictions and, increasingly, as a street drug.
The clinics face stringent federal and state regulations as to how much methadone they can administer to patients, but physicians don't go beyond a general rule that says they can't prescribe more than a 30-day supply, said Mark Parrino, president of the American Assn. for the Treatment of Opioid Dependence.
In Southern California, parts of downtown, East and South Los Angeles have emerged as places to buy and sell methadone, said Kalante Holmes, a counselor at a methadone clinic in West Los Angeles. "It's one of those easy-to-get things right now," he said.
It's the "easy-to-get" nature of the drug that has led to the recent spike in methadone deaths, experts and government officials say.
As the study of pain has grown over the last five to 10 years, more physicians are prescribing methadone to patients to treat pain, especially chronic and nerve pain.
The Food and Drug Administration issued a warning in November to all physicians saying that misuse of the drug could lead to breathing problems and possible death.
Patients might prefer methadone to other painkillers because not only is it powerful, but it's also less expensive.
For example, a pharmacy can buy a month's supply of methadone for one patient for as little as $8, whereas it would have to pay more than $170 for a similar amount of OxyContin, according to wholesale pharmaceutical price books.
As the availability of the drug increases, so does abuse and misuse of it, experts and drug officials say. Problems usually don't arise from physicians who specialize in pain treatment and know how to safely prescribe and monitor methadone use, but from general and family practice physicians who may prescribe the drug more often than they should.
"My hunch is that some of what we're seeing with the current problems are the administration of [methadone] by physicians who don't understand how powerful it is to a patient population who might not necessarily need it," said Richard Rawson, an associate director of Integrated Substance Abuse Programs at UCLA.
Data compiled by the federal government show a steady increase in the number of people nationwide admitted to clinics and programs for methadone treatment, from about 1,000 in 1995 to more than 3,700 in 2005.
"This is an emerging problem," said Bertha Madras of the White House Office of National Drug Control Policy.
It's been a persistent problem for people like Sean, 20, a resident of West Los Angeles and a former heroin addict.
Sean, who asked that only his first name be used because of the stigma associated with drug abuse, carved a steady path to heroin use at a young age. He tried marijuana when he was 11, cocaine at 14 and heroin at 17.
When he was 19, living in a downtown L.A. apartment and experiencing heroin withdrawals, he tried methadone.
Mostly, he said, he used it to satiate his desire for heroin. At least once he took it with Klonopin, a muscle relaxant.
"I don't want to say the feeling was similar to alcohol," said Sean, who is in drug treatment and was interviewed in the presence of his counselor. "But that's sort of what it was like. Your body feels relaxed."
Though he said he had not used methadone lately because he'd heard it had been responsible for a rash of deaths, Sean said he could easily get it on the street.
Recently, on a bus in Santa Monica, he was approached by a methadone pusher who offered him a deal: one pill for $45 or two for $60, he said.
Sean said he declined. But he knows it won't be so easy for others.
"The fact of the matter is, if you're a drug addict and you don't want treatment, you're going to go try to get high off something," he said. "You're broke, you can't afford heroin, so you go get methadone."
gateway theory
http://www.nature.com/npp/journal/v32/n3/abs/1301127a.html
Neuropsychopharmacology (2007) 32, 607–615
Adolescent Cannabis Exposure Alters Opiate Intake and Opioid Limbic Neuronal Populations in Adult Rats
Maria Ellgren et al.
ABSTRACT
Cannabis use is a hypothesized gateway to subsequent abuse of other drugs such as heroin.
We currently assessed whether delta-9-tetrahydrocannabinol (THC) exposure during adolescence modulates opiate reinforcement and opioid neural systems in adulthood. Long–Evan male rats received THC (1.5 mg/kg intraperitoneally (i.p.)) or vehicle every third day during postnatal days (PNDs) 28–49.
Heroin self-administration behavior (fixed ratio-1; 3-h sessions) was studied from young adulthood (PND 57) into full adults (PND 102).
THC-pretreated rats showed an upward shift throughout the heroin self-administration acquisition (30 microg/kg/infusion) phase, whereas control animals maintained the same pattern once stable intake was obtained. Heightened opiate sensitivity in THC animals was also evidenced by higher heroin consumption during the maintenance phase (30 and 60 microg/kg/infusion) and greater responding for moderate–low heroin doses (dose–response curve: 7.5, 15, 30, 60, and 100 microg/kg/injection).
Specific disturbance of the endogenous opioid system was also apparent in the brain of adults with adolescent THC exposure. Striatal preproenkephalin mRNA expression was exclusively increased in the nucleus accumbens (NAc) shell; the relative elevation of preproenkephalin mRNA in the THC rats was maintained even after heroin self-administration. Moreover, mu opioid receptor GTP-coupling was potentiated in mesolimbic and nigrostriatal brainstem regions in THC-pretreated animals. mu opioid receptor function in the NAc shell was specifically correlated to heroin intake.
The current findings support the gateway hypothesis demonstrating that adolescence cannabis exposure has an enduring impact on hedonic processing resulting in enhanced opiate intake, possibly as a consequence of alterations in limbic opioid neuronal populations.
------------------
http://www.sciencedirect.com/science?_ob=ArticleURL%26_udi=B6SYR-4MRG0C3-5%26_user=861681%26_rdoc=1%26_fmt=%26_orig=search%26_sort=d%26view=c%26_acct=C000046147%26_version=1%26_urlVersion=0%26_userid=861681%26md5=10caba2d4003213938bb5bc66d5c5d46
Brain Research Volume 1139 , 30 March 2007, Pages 245-253
Effects of early methylphenidate exposure on morphine- and sucrose-reinforced behaviors in adult rats: Relationship to dopamine D2 receptors
Cynthia A. Crawford et al.
Abstract
Methylphenidate is commonly used to treat Attention Deficit Hyperactivity Disorder (ADHD) in school-aged children, and there is an increasing trend to prescribe methylphenidate to younger preschool-aged children.
While the efficacy of methylphenidate is not in question, there is evidence that early methylphenidate treatment may have long-term effects on later drug responsiveness. The goal of this study was to determine whether early exposure to methylphenidate would alter morphine-induced conditioned place preference (CPP) and sucrose-reinforced lever-pressing in young adult rats. We also assessed whether early methylphenidate exposure would impact dopamine D2 binding sites.
Sprague–Dawley rats were treated with methylphenidate (0, 2, or 5 mg/kg) once a day from PD 11–PD 20. On PD 60, morphine-induced CPP or sucrose-reinforced lever-pressing was assessed. A 10-day CPP procedure was used, which included 1 preconditioning day, 8 conditioning days, and 1 test day. After CPP testing, D2 receptor binding was determined in striatal and accumbal tissue samples. In the sucrose experiment, rats were trained to lever-press on a progressive ratio schedule for one sucrose pellet.
Results showed that early exposure to methylphenidate (5 mg/kg) increased the magnitude of morphine-induced CPP. Exposure to methylphenidate did not alter the number of D2 binding sites, however, there were positive correlations between the number of D2 binding sites and the strength of the CPP.
In the sucrose-reinforced lever-press experiment, rats exposed to methylphenidate (2 and 5 mg/kg) had higher break points than saline controls.
These results suggest that early exposure to methylphenidate alters reward system functioning, thereby making these systems more sensitive to appetitive stimuli.
ONDCP on drug disposal
http://www.whitehousedrugpolicy.gov/news/press07/022007.html
FOR IMMEDIATE RELEASE: Tuesday, February 20, 2007
CONTACT: Jennifer de Vallance, ONDCP (202) 395–6648 / (202) 368–8422
FEDERAL GOVERNMENT ISSUES NEW GUIDELINES FOR PROPER DISPOSAL OF PRESCRIPTION DRUGS:
WHAT EVERY AMERICAN CAN DO TO PREVENT MISUSE OF PRESCRIPTION DRUGS
(Washington, DC)—In the face of rising trends in prescription drug abuse, the Federal government today issued new guidelines for the proper disposal of unused, unneeded, or expired prescription drugs. The White House Office of National Drug Control Policy (ONDCP), the Department of Health and Human Services (HHS), and the Environmental Protection Agency (EPA) jointly released the new guidelines, which are designed to reduce the diversion of prescription drugs, while also protecting the environment.
The new Federal prescription drug disposal guidelines urge Americans to:
Take unused, unneeded, or expired prescription drugs out of their original containers Mix the prescription drugs with an undesirable substance, like used coffee grounds or kitty litter, and put them in impermeable, non-descript containers, such as empty cans or sealable bags, further ensuring that the drugs are not diverted or accidentally ingested by children or pets
Throw these containers in the trash Flush prescription drugs down the toilet only if the accompanying patient information specifically instructs it is safe to do so
Return unused, unneeded, or expired prescription drugs to pharmaceutical take-back locations that allow the public to bring unused drugs to a central location for safe disposal
Abuse of prescription drugs to get high has become increasingly prevalent among teens and young adults. Past year abuse of prescription pain killers abuse now ranks second—only behind marijuana—as the Nation's most prevalent illegal drug problem. While overall youth drug use is down by 23 percent since 2001, approximately 6.4 million Americans report non-medical use of prescription drugs. New abusers of prescription drugs have caught up with the number of new users of marijuana. Much of this abuse appears to be fueled by the relative ease of access to prescription drugs. Approximately 60 percent of people who abuse prescription pain killers indicate that they got their prescription drugs from a friend or relative for free.
John Walters, Director of National Drug Control Policy, said, "Millions of Americans benefit from the tremendous scientific achievements represented by modern pharmaceutical products. But, when abused, some prescription drugs can be as addictive and dangerous as illegal street drugs. The new prescription drug disposal guidelines will help us stop and prevent prescription drug abuse, and the harm it can cause.
Health and Human Services Secretary Michael Leavitt said, "Health care providers, pharmacists, and family should be alert to the potential for prescription drug misuse, abuse, and dependence. In addition to supporting the new prescription drug disposal guidelines, they should address prescription drug misuse honestly and directly with their patients or loved ones when they suspect it. People in need should be encouraged to seek help for drug problems and if needed, enter treatment."
The new Federal guidelines are a balance between public health concerns and potential environmental concerns.
While EPA continues to research the effects of pharmaceuticals in water sources, one thing is clear: improper drug disposal is a prescription for environmental and societal concern," said EPA Administrator Stephen L. Johnson. "Following these new guidelines will protect our Nation's waterways and keep pharmaceuticals out of the hands of potential abusers."
The new Federal prescription drug disposal guidelines go into effect immediately. As part of the National Drug Control Strategy, the Bush Administration has set a goal of reducing prescription drug abuse by 15 percent over three years. In addition to promoting awareness of the risks involved with using prescription drugs for non-medical purposes as well as they need for adults to strictly control access to pharmaceuticals within their homes, the Administration supports the implementation of Prescription Drug Monitoring Programs at the State level. Currently, 33 States have such programs in place.
in love with DA
http://www.washingtonpost.com/wp-dyn/content/article/2007/02/12/AR2007021201657_pf.html
An Affair Of the Head They Say Love Is All About Brain Chemistry. Will You Be Dopamine?
By Neely Tucker Washington Post Staff Writer Tuesday, February 13, 2007; C01
It's all about dopamine, baby, this One Great True Love, this passionate thing we'd burn down the house and blow up the car and drive from Houston to Orlando just to taste on the tip of the tongue.
You crave it because your brain tells you to. Because if a wet kiss on the suprasternal notch -- while, say, your lover has you pinned against a wall in the corner of a dance club -- doesn't fire up the ventral tegmentum in the Motel 6 of your mind, well, he's not going to send you roses tomorrow.
Dopamine.
God's little neurotransmitter. Better known by its street name, romantic love.
Also, norepinephrine. Street name, infatuation.
These chemicals are natural stimulants. You fall in love, a growing amount of research shows, and these chemicals and their cousins start pole-dancing around the neurons of your brain, hopping around the limbic system, setting off craving, obsessive thoughts, focused attention, the desire to commit possibly immoral acts with your beloved while at a stoplight in the 2100 block of K Street during lunch hour, and so on.
"Love is a drug," says Helen Fisher, an anthropologist at Rutgers University and author of "Why We Love: The Nature and Chemistry of Romantic Love." "The ventral tegmental area is a clump of cells that make dopamine, a natural stimulant, and sends it out to many brain regions" when one is in love. "It's the same region affected when you feel the rush of cocaine."
Passion! Sex! Narcotics!
Why do we suspect this isn't going to end well?
Because these things are hard-wired not to last, all of them. Short shelf lives. The passion you fulfill is the passion you kill. The most wonderful, soaring feeling known to all mankind . . . amounts to no more than a narcotic high, a temporal state of mania.
"Being in love, having a crush on someone is wonderful . . . but our bodies can't be in that state all the time," says Pamela C. Regan, a professor of psychology at California State University, Los Angeles, and author of "Mind Games: A Primer on Love, Sex and Marriage." "Your body would fizzle out. As a species, we'd die."
Some of these love chemicals in the brain, scientists measure by the picogram, which is a trillionth of a gram.
How fragile, this thing called love.
* * *
Just about all writing about love stinks, maybe because so much of it begins with something like "O!" or maybe because people are (a) in love when they write it, which makes for a lot of senseless mooning the rest of us couldn't care less about; or (b) they have just been Kicked to the Curb of Romance, in which case they would rather be pinned to an insect board and labeled than live another minute on this godawful Planet of Hate.
Sigh.
Stendhal was onto something in the 19th century when he observed that "The pleasures of love are always in proportion to our fears," because passionate love is also partly about terror. Bill Shakespeare had it down cold, when he had Friar Laurence warn young Romeo of the perils of passion: "These violent delights have violent ends."
And did Romeo listen?
Shucks, no! Wise counsel, patience, foresight, prune juice -- who wants that ? Is there one among us who, at least once in this life, does not want to throw everything out the door and sprint to the Disco Ball of the Brain, where there are big white piles of dopamine, where a hot and sweaty Barry White is always on stage, thumping out "You're My First! My Last! My Everything!" And there's that new girl in class! Scantily clad! She's on the floor, beckoning you! Yes, Bubba, you! Out you go, and she's saying your name and her hand slips to the small of your back, and this is going to last FOREVER AND EVER!
Here it goes, a long time ago, Abelard and Heloise, two of history's most famous lovers:
Abelard to Heloise: "So intense were the fires of lust which bound me to you that I set those wretched, obscene pleasures, which we blush even to name, above God as above myself."
She to he: "Even during the celebration of the Mass, when our prayers should be purest, lewd visions of the pleasures we shared take . . . a hold on my unhappy soul."
HONEY! BABY! SWEETIE! CALL ME!
Did we mention Abelard was castrated as a result of their affair? And Heloise went off to a convent for the rest of her life? That they named their child "Astrolabe"? What people! What passion! What the hell were they thinking?
Actually they weren't, and neither are you, not really, when you fall passionately in love.
In her most recent research, Fisher and colleagues gave 32 love-struck subjects an MRI scan while they viewed a picture of their beloved.
Boy, did their brains light up!
There are two shrimp-size things on either side of your brain called the caudate nuclei. This is the gear that operates bodily movements and the body's reward system: "the mind's network for general arousal, sensations of pleasure, and the motivation to acquire rewards," Fisher writes. And when the test subjects looked at their sweeties, these things started singing "Loosen Up My Buttons" with the Pussycat Dolls!
This, then, kicked the party over to the tiny ventral tegmental area, a little peapod-size thingy that sends dopamine bopping around your head.
This is what scientists call lots of fun.
A separate study by Italian researchers several years ago showed something else.
Serotonin, another neurotransmitter in the brain associated with obsession, depression and racing thoughts, was greatly affected -- right down to the molecular level -- by romance and surging dopamine. People newly in love and people with obsessive-compulsive disorder showed the same lowered levels of the "platelet 5-HT transporter." In other words, dopamine appears to suppress serotonin, which in turn triggers obsessive-compulsive thought patterns.
You can't stop thinking about Dave. No wonder! Dave's hiding under a wet flap of cortex!
Your brain is officially in love, and it officially is driving you crazy.
Oliver Sacks, the famed neurologist and author, once cited the case of a 90-year-old woman who had suddenly become radiant, flirty, even frisky. The diagnosis: a long-delayed onset of neurosyphilis had loosed the reins on her inhibitions.
She did not want to be treated.
"What a paradox, what a cruelty, what an irony," Sacks wrote. "That inner life and imagination may lie dull and dormant unless released, awakened, by an intoxication or a disease . . . it is the very realm of Cupid and Dionysus."
* * *
Cupid can't last, you know.
Oxytocin and other chemicals kick in, running around your brain to make you bond with your lover, producing a mellower, more sustainable relationship.
Women: contented sigh. Men: light snoring.
Or, your Previously Perfect Love Pumpkin turns into possibly the most selfish, cheating, low-down dirty dog this side of Amarillo. You get dumped. This is what produces "drama."
"Drama" is not good for your "brain."
What it feels like:
A one-way ticket to the Tex-Mex Border Bar of the Mind. It's always dark in here, stinks of old cigars. The clock on the wall always reads Beer:30. Your caudate nucleus is now slouched over a bar stool in the dark. Sitting next to it is Freddy Fender.
Suddenly your brain bellows, off-key:
WASTED DAYS AND WASTED NIGHTS!
Freddy looks up from his beer.
I HAVE LEFT FOR YOU BEHIND!
Freddy throws his arm around your brain and joins in:
FOR YOU DON'T BELONG TO ME!
YOUR HEART BELONGS TO SOMEONE ELSE!
Your brain can spend entire days doing this.
This is because your brain has kicked into reverse, and love is long gone.
O!
Rejection, rage, despair!
Dopamine leaves the scene of the affair, now running off into the nucleus accumbens, the insular cortex, the lateral orbitofrontal cortex, research by Fisher and others shows. Jilted lovers' brains now light up in these areas when they look at pictures of their former flames -- this brain matter is associated with taking big risks, addiction, physical pain and obsessive-compulsive disorders. This is why, researchers theorize, people become obsessed with lost love, and are driven, in extreme cases, to stalking, suicide, homicide, rubber tubing.
Regan, the California researcher, notes that such cases are rare, and may have more to do with existing mental issues than simple unrequited love. Still, she says, passion is destined to end, whether mellowing into long-term love or blowing up on the freeway at 4 a.m. Given this, she wonders if "we do our self a disservice by glorifying passionate love so much."
"The search for eternal passion is very misguided," she says. "It's the search for the perfect high that keeps people discarding relationships right and left . You don't feel the same way you did; people want to break up, instead of seeing it as normal."
And so, alas. Even neurologists, to go with Shakespeare's priest, now tell us passion is true love's fool's gold, a flamboyant dead end on the evolutionary chain of primate happiness.
The only problem with this insight is that no one pays it any mind. Doomed passion may not make us right, and it may not even make us very happy.
It only makes us human. It only makes us who we are.
MDMA and mood disorders
http://www.sciencedirect.com/science?_ob=ArticleURL%26_udi=B6T63-4M7CMF6-1%26_user=861681%26_rdoc=1%26_fmt=%26_orig=search%26_sort=d%26view=c%26_acct=C000046147%26_version=1%26_urlVersion=0%26_userid=861681%26md5=a62148eb7055ddcf67286fc8d3eaeb15
Drug and Alcohol Dependence Volume 87, Issues 2-3 , 16 March 2007, Pages 303-311
Anxiety, depression, and behavioral symptoms of executive dysfunction in ecstasy users: Contributions of polydrug use
Krista Lisdahl Medina and Paula K. Shear
Abstract
Background Given ecstasy's (MDMA) potential serotonergic neurotoxicity, it is plausible that regular ecstasy users would have an elevated prevalence of behavioral executive dysfunction or mood symptoms. However, recent studies have found that the relationship between ecstasy use and psychological symptoms was no longer significant after controlling for marijuana use (e.g., Morgan et al., 2002). The goal of the present study was to examine the relationship between ecstasy exposure and self-reported executive functioning and psychological symptoms after controlling for gender, ethnicity, and other drug use.
Methods Data were collected from 65 men and women with a wide range of ecstasy use (including 17 marijuana-using controls). Participants were administered the Frontal Systems Behavioral Scale, State-Trait Anxiety Inventory for adults, and the Beck Depression Inventory-2nd edition.
Results Although 19–63% of the ecstasy users demonstrated clinically elevated psychological symptoms, frequency of ecstasy use did not predict the psychological symptoms. No gender differences or interactions were observed.
Conclusions These results revealed that, although ecstasy users demonstrate elevated levels of psychological symptoms and executive dysfunction, these symptoms are not statistically associated with their ecstasy consumption. Instead, other drug use (alcohol, marijuana, opioids, and inhalants) significantly predict psychological symptoms in this sample of polydrug users.
I am the very model of a psychopharmacologist
PS -- it's in the upper right hand corner of the banner ad at the top.
futz with the sound mechanism for awhile in order to get it to play
http://www.neiglobal.com/Default.aspx
I Am the Very Model of a Psychopharmacologist"
Addiction on HBO
http://www.jointogether.org/news/yourturn/announcements/2007/hbo-the-addiction-project.html
HBO's Groundbreaking 14-Part Series, The ADDICTION Project, Kicks Off March 15
"How can we comprehend the concept of a person who wants to stop doing something and cannot, despite catastrophic consequences? That is what we are up against. Some people don't want to speak about addiction, or compare it to other chronic diseases. Well, this is a disease, a treatable disease, and it needs to be understood. HBO's ADDICTION project is an initiative that will help people understand more about this illness, its advancements and how to find help."
-- Nora Volkow, MD, Director of the National Institute on Drug Abuse
Los Angeles, CA –- One in four Americans has a family member who is struggling with addiction. Over 80% of people with substance abuse or dependence disorder started using before age 18. Currently, addiction affects 22.2 million Americans. Yet only 9% are receiving the treatment they need.
In partnership with the Robert Wood Johnson Foundation, the National Institute on Drug Abuse (NIDA), and the National Institute on Alcohol Abuse and Alcoholism (NIAAA), HBO launches the ADDICTION project, an unprecedented multi-media campaign aimed at helping Americans understand addiction as a treatable brain disease, as well as spotlighting new medical advancements.
Debuting THURSDAY, MARCH 15 (9:00-10:30 p.m. ET/PT), with the centerpiece documentary ADDICTION, the series is eye-opening and ultimately hopeful, providing guidance in navigating the often confusing world of addiction treatment and recovery.
For the first time, HBO will use all of its digital platforms, including the HBO main service, multiplex channels, HBO On Demand, podcasts, web streams, and DVD sales to support a campaign that includes a 14-part documentary series, a book published by Rodale Press, four independent addiction-themed films, a robust website and a national community grassroots outreach campaign funded by the Robert Wood Johnson Foundation.
All films will initially be offered during a free HBO preview weekend from Thursday, March 15 to Sunday, March 18 in participating cable systems.
"HBO is utilizing all of its platforms to develop programming directly targeted to the various needs of the American public on this complex public health issue," says Chris Albrecht, HBO's chairman and CEO. "Our resources are committed to illuminating, demystifying and defining addiction – a problem that is riddled with misconceptions."
The ADDICTION project showcases the work of many of today's leading documentary filmmakers, including Jon Alpert; Kate Davis and David Heilbroner; Susan Froemke; Liz Garbus and Rory Kennedy; Eugene Jarecki; Barbara Kopple; Albert Maysles; D.A. Pennebaker and Chris Hegedus; and Alan and Susan Raymond.
ADDICTION brings together leading thinkers and organizations that are at the threshold of new treatments. Current advances in brain imaging science make it possible to see inside the brain of an addicted person, pinpoint the parts of the brain affected by addiction, and see how the addict's brain differs, ushering in a great many advances in medical treatment. In fact, treatments for addiction are now as effective as treatments for other chronic relapsing diseases such as diabetes, hypertension or asthma.
A candid depiction of the emotional, psychological, social and political toll that addiction takes on the country, the ADDICTION project demonstrates conclusively that the disease is treatable and shows that there are millions of Americans in long-term recovery.
Topics covered include: the nature of addiction, addiction in the workplace, and the protracted insurance battles waged by families, as well as the difficulty of finding and getting adequate treatment.
The ADDICTION project will be supported by an unprecedented 30-city nationwide community outreach campaign funded by the Robert Wood Johnson Foundation and coordinated by Join Together, Faces and Voices of Recovery, and the Community Anti-Drug Coalitions of America (CADCA).
The ADDICTION project is produced by John Hoffman and Susan Froemke and executive produced by Sheila Nevins.
NYT on insula
http://www.nytimes.com/2007/02/06/health/psychology/06brain.html?n=Top%252fNews%252fHealth%252fDiseases%252c%2520Conditions%252c%2520and%2520Health%2520Topics%252fBrain%26pagewanted=print
February 6, 2007 A Small Part of the Brain, and Its Profound Effects
By SANDRA BLAKESLEE New York Times
The recent news about smoking was sensational: some people with damage to a prune-size slab of brain tissue called the insula were able to give up cigarettes instantly.
Suppose scientists could figure out how to tweak the insula without damaging it. They might be able to create that famed and elusive free lunch — an effortless way to kick the cigarette habit.
That dream, which may not be too far off, puts the insula in the spotlight. What is the insula and how could it possibly exert such profound effects on human behavior?
According to neuroscientists who study it, the insula is a long-neglected brain region that has emerged as crucial to understanding what it feels like to be human.
They say it is the wellspring of social emotions, things like lust and disgust, pride and humiliation, guilt and atonement. It helps give rise to moral intuition, empathy and the capacity to respond emotionally to music.
Its anatomy and evolution shed light on the profound differences between humans and other animals.
The insula also reads body states like hunger and craving and helps push people into reaching for the next sandwich, cigarette or line of cocaine. So insula research offers new ways to think about treating drug addiction, alcoholism, anxiety and eating disorders.
Of course, so much about the brain remains to be discovered that the insula’s role may be a minor character in the play of the human mind. It is just now coming on stage.
The activity of the insula in so many areas is something of a puzzle. “People have had a hard time conceptualizing what the insula does,” said Dr. Martin Paulus, a psychiatrist at the University of California, San Diego.
If it does everything, what exactly is it that it does?
For example, the insula “lights up” in brain scans when people crave drugs, feel pain, anticipate pain, empathize with others, listen to jokes, see disgust on someone’s face, are shunned in a social settings, listen to music, decide not to buy an item, see someone cheat and decide to punish them, and determine degrees of preference while eating chocolate.
Damage to the insula can lead to apathy, loss of libido and an inability to tell fresh food from rotten.
The bottom line, according to Dr. Paulus and others, is that mind and body are integrated in the insula. It provides unprecedented insight into the anatomy of human emotions.
Of course, like every important brain structure, the insula — there are actually two, one on each side of the brain — does not act alone. It is part of multiple circuits.
The insula itself is a sort of receiving zone that reads the physiological state of the entire body and then generates subjective feelings that can bring about actions, like eating, that keep the body in a state of internal balance. Information from the insula is relayed to other brain structures that appear to be involved in decision making, especially the anterior cingulate and prefrontal cortices.
The insula was long ignored for two reasons, researchers said. First, because it is folded and tucked deep within the brain, scientists could not probe it with shallow electrodes. It took the invention of brain imaging techniques, such as functional magnetic resonance imaging, or fMRI, to watch it in action.
Second, the insula was “assigned to the brain’s netherworld,” said John Allman, a neuroscientist at the California Institute of Technology. It was mistakenly defined as a primitive part of the brain involved only in functions like eating and sex. Ambitious scientists studied higher, more rational parts of the brain, he said.
The insula emerged from darkness a decade ago when Antonio Damasio, a neuroscientist now at the University of Southern California, developed the so-called somatic marker hypothesis, the idea that rational thinking cannot be separated from feelings and emotions. The insula, he said, plays a starring role.
Another neuroscientist, Arthur D. Craig at the Barrow Neurological Institute in Phoenix, went on to describe exactly the circuitry that connects the body to the insula.
According to Dr. Craig, the insula receives information from receptors in the skin and internal organs. Such receptors are nerve cells that specialize in different senses. Thus there are receptors that detect heat, cold, itch, pain, taste, hunger, thirst, muscle ache, visceral sensations and so-called air hunger, the need to breathe. The sense of touch and the sense of the body’s position in space are routed to different brain regions, he said.
All mammals have insulas that read their body condition, Dr. Craig said. Information about the status of the body’s tissues and organs is carried from the receptors along distinct spinal pathways, into the brain stem and up to the posterior insula in the higher brain or cortex.
As such, all mammals have emotions, defined as sensations that provoke motivations. If an animal is hot, it seeks shade. If hungry, it looks for food. If hurt, it licks the wound.
But animals are not thought to have subjective feelings in the way that humans do, Dr. Craig said. Humans, and to a lesser degree the great apes, have evolved two innovations to their insulas that take this system of reading body states to a new level.
One involves circuitry, the other a brand new type of brain cell.
In humans, information about the body’s state takes a slightly different route inside the brain, picking up even more signals from the gut, the heart, the lungs and other internal organs. Then the human brain takes an extra step, Dr. Craig said. The information on bodily sensations is further routed to the front part of the insula, especially on the right side, which has undergone a huge expansion in humans and apes.
It is in the frontal insula, Dr. Craig said, that simple body states or sensations are recast as social emotions. A bad taste or smell is sensed in the frontal insula as disgust. A sensual touch from a loved one is transformed into delight.
The frontal insula is where people sense love and hate, gratitude and resentment, self-confidence and embarrassment, trust and distrust, empathy and contempt, approval and disdain, pride and humiliation, truthfulness and deception, atonement and guilt.
People who are better at reading these sensations — a quickened heart beat, a flushed face, slow breathing — score higher on psychological tests of empathy, researchers have found. The second major modification to the insula is a type of cell found in only humans, great apes, whales and possibly elephants, Dr. Allman said. Humans have by far the greatest number of these cells, which are called VENs, short for Von Economo neurons, named for the scientist who first described them in 1925. VENs are large cigar-shaped cells tapered at each end, and they are found exclusively in the frontal insula and anterior cingulate cortex.
Exactly what VENs are doing within this critical circuit is not yet known, Dr. Allman said. But they are in the catbird seat for turning feelings and emotions into actions and intentions.
The human insula, with its souped-up anatomy, is also important for processing events that have yet to happen, Dr. Paulus said. “When you decide to go outside on a cold day, your body gets ready before you hit the cold air,” he said. “It starts pumping blood to where you need it and adjusts your metabolism. Your insula tells you what it will feel like before you step outside.”
The same goes for drug addicts. When an addict is confronted with sights, sounds, smells, situations or other stimuli associated with drug use, the insula is activated before using the drug.
“If you give cocaine to an addict, you are affecting their brain’s reward system, but this is not what drives the person to keep using cocaine,” Dr. Paulus said. The craving is what gets people to use.
For example, smokers enjoy whole-body effects, said Nasir Naqvi, a student at the University of Iowa Medical Scientist Training Program, who was the lead author of the recent article on smoking. It is not just nicotine binding to parts of the brain, he said, but sensations — heart rate, blood pressure, a tickle in the lungs, a taste in the mouth, the position of the hands, all the rituals.
The insula’s importance makes it an ideal target for many kinds of treatment, Dr. Paulus said, including drugs and sophisticated biofeedback. But methods to quell insular activity must be approached carefully, he said. People might lose the craving to smoke, drink alcohol or take other drugs, but they could simultaneously lose interest in sex, food and work.
As clinicians explore the possibilities, Dr. Craig is thinking about the insula in grander terms.
For example, lesions in the frontal insula can wipe out the ability to appreciate the emotional content of music. It may also be involved in the human sense of the progress of time, since it can create an anticipatory signal of how people may feel as opposed to how they feel now. Intensely emotional moments can affect our sense of time. It may stand still, and that may be happening in the insula, a crossroads of time and desire.
Ergot
Latest Microgram is out:
http://www.dea.gov/programs/forensicsci/microgram/mg0107/mg0107.html
The Scientist Volume 21 Issue 2 Page 24
'Shroom Science: Safe and Effective?
Fifty years after its introduction to science, psilocybin returns to mainstream clinical research.
Glenn McGee is the director of the Alden March Bioethics Institute at Albany Medical College, where he holds the John A. Balint Endowed Chair in Medical Ethics.
gmcgee@the-scientist.com
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http://www.the-scientist.com/article/display/43641/
Are Ritalin and psilocybin equivalent in terms of effect and safety? In the August issue of Psychopharmacology, Johns Hopkins researchers published a study in which some subjects were given psilocybin and then asked to relate their experiences. Francisco Moreno of the University of Arizona published in the November issue of the Journal of Clinical Psychiatry his patients' reports that psilocybin helped them with migraine headaches. Harbor-UCLA Medical Center psychiatrist Charles Grob told the Chronicle of Higher Education that he is giving the compound to patients dying of cancer to see whether it eases pain by relieving anxiety.
The study of so-called magic mushrooms isn't new; it could be argued that it is celebrating its 50th anniversary this year. It began, as best anyone can tell, when Wall Street banker R. Gordon Wasson documented his trip to a healer in Oaxaca, Mexico, whose brew, he claimed, enabled him to see the reality of ideas and concepts. His 1957 essay in Life magazine excited the imaginations of scientists around the world. Sandoz patented the two active chemicals in the mushrooms, calling the compounds psilocin and psilocybin. Chaos ensued as researchers struggled to do excellent scientific work using a family of substances whose effects - to put it mildly - were not easily measurable using the tools of the time.
The scientists who used psilocybin in their research in the 1960s poked at the nature of consciousness, but this particular compound just refused to be caged by ordinary scientific conventions. Paper after paper stabbed at descriptions of the effects and utility of psilocybin, but scalar measures of transcendence just could not capture its effects, or side effects. A few of the leading scientists engaged in its study, most notoriously Harvard psychologist Timothy Leary, simply abandoned the strictures of scientific research as insufficient to grasp the power of psilocybin.
By the time the FDA banned hallucinogenic drugs in 1970, the majority of those experimenting with mushrooms were not in universities. Hallucinogens became part of a counterculture that aged quickly. By the 1980s, the next counterculture devoted to brain modification was moving in a completely different direction, experimenting with highly addictive stimulants, such as cocaine, which assist in thinking faster, concentrating harder, and intensifying ordinary experiences.
Time passes, and what's old becomes new again. In 2007 millions of people take legal stimulants and antidepressants. A decades-long quest for endless work capacity, unfettered concentration, and happiness on-demand has perhaps hastened the return of those who wonder whether the touch of transcendence could provide new insights into treating the maladies that have become rampant in our time. And indeed, new studies suggest that psilocybin may offer hope in treating a few of them, ranging from obsessive-compulsive disorder to rampant addiction.
With the dramatically enhanced ability of neural imaging to identify changes in brain state, and advances in the genetics of neuroscience, it is no wonder that some of those who researched psilocybin in the 1970s have begun to point again to the potential of that compound. Magic mushrooms are not addictive and have been around more than half a century. So should we really be worried about the potential that new research will lead a new generation to "turn on, tune in, and drop out"? Yes.
Ethics committees examining the research programs underway with hallucinogens need to be mindful that what sparked the widespread illegal use of psilocybin in the 1970s was not its mystical power but the reports of its safety and efficacy coming out of the leading institutions of higher learning in the United States. Scientists are acting with great care this time around, but let's avoid a bad trip.
Hallucinogens have not been scientifically demonstrated to be either safe or effective enough to be used in the treatment of any disease. Studies of them should be undertaken only when investigators avoid sending subtle messages about the safety or delight of chewing on backyard mushrooms. For example, in the Hopkins study subjects were given either Ritalin or psilocybin, sending the terribly premature message that the two substances are in any sense equivalent in terms of effect or safety. It would have been much better to compare psilocybin with, well, anything other than a compound prescribed to tens of millions and often abused by those seeking better cognition.
Thankfully that study was all but ignored by the media. When it comes to hallucinogens, if the research sends the wrong message, drop it. Or rather, don't.
Comment on this article
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comment: Shrooms and science, pain and ethics by Tom DiStefano
[Comment posted 2007-02-02 15:06:37]
You want a bad trip? Try a headache syndrome so severe sufferers sometimes commit suicide to escape the recurring pain... THAT’s a bad trip.
Cluster headache sufferers have found psilocybin and other tryptamine hallucinogens to be extradordinarily effective at relieveing cluster headache attacks and cycles, and a case review study by John Halpern and Andrew Sewell at McLean determined more research is warranted. Not yet proven, but that’s just a matter of time and money. I am personally sure tryptamines have saved me from a life of misery.
Should your speculative fears prevent the millions of cluster headache sufferers around the world from finding relief from one of the worst pain sysndromes known to medicine? Wrap your ethics around that one.
By they way, “magic mushroom” have been around for much longer than half a century, I would assume, and some anthopologists say humans have been using them since pre-history, for spirtual exploration as well as, yes, headache relief. They seem to work on migraines, too, and at subhallucinogenic dosages.
I’m not sure what you mean in your criticism of using Ritalin as the placebo. If you meant that psilocybin is much safer than Ritalin, you would probably be right. And what would you use as a placebo for a hallucinogen?
Tom DiStefano Clarion, PA
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comment: Mistakes abound in this piece by One who knows that facts are more imporant than pseudo-ethics
[Comment posted 2007-02-02 21:33:49]
What we find above has some useful advice but mostly it strays far and wide from the author's stated work as an ethicist into a mere piece of opinion and one that is not based on the principles of medical ethics and research.
To wit: 1. There is zero factual proof to support the goofy claim that it was research results claiming safety that drove vast uncontrolled illicit use of hallucinogens in the 1970's or in any decade. Is this ethicist also claiming that we have a rampant abuse of cocaine or methamphetamine in the United States because both of these drugs also remain Schedule II prescription medications? This is a shameful failure of fact checking on the author's part.
2. The FDA has NEVER banned hallucinogens. Should the author have any expert credentials in medical research of drugs of abuse he would be aware that it is the DEA that places substances in the Scheduling system of the Controlled Substances Act and NOT the FDA. Moreover, placement in Schedule I is not a ban. The law specifically states that drugs in Schedule I are "approved for research use only." The world is not flat, Mr. McGee, though you apparently wish to foist your opinion on us in place of fact.
3. He writes, as well that "Studies of them [hallucinogens] should be undertaken only when investigators avoid sending subtle messages about the safety or delight of chewing on backyard mushrooms." This statement alone should make us all marvel how someone so esteemed as to sit as Chair of Medical Ethics for an American medical school could stray so far from the actual debate of potential risks and benefits that are used to deduce whether a study is in the public interest and should proceed. The behavior that is cautioned against - the promotion of a drug - any drug - before empirical evidence has been published in peer-reviewed medical journals is without doubt unethical and could open up a researcher to censure if not worse. However this swipe taken in this piece is even more unethical as it hides from the reader the true issues that are weighed on moving forward or not with research. We should not subject credible medical research to some litmus test to be vetted by pointy heads like this guy. We need medical research to rise or fall on the methodology. Methodology that can be read and replicated by even skeptics like Mr. McGee because the truth is in the facts as found by the science. These polemics are harmful to the ongoing protection of sound medical research.
4. the comments about psilocybin and ritalin reveal a person who comments before either reading the primary text or who doesn't understand the reseach conducted. it is Mr. McGee who distorts what methylphenidate (ritalin) was used for and it was used for research and not trying to equate ritalin and psilocybin. This is Mr. McGee's thoughts and not the authors of that study! He promotes then exactly what he complains about - because it is his creation to begin with.
5. Finally, the media will ignore this column of ignorance but the media DEFINITELY covered the Hopkins study he writes as "thankfully" not covered. That paper has been publicized all over the world in thousands of papers. Had Mr. McGee bothered to google, he would see 30,000 plus distinct entries. Or just take a peak at the competing Discover Magazine. Their January 2007 issue list "The Top 100 Science Stories of 2006" with the Hopkins psilocybin study ranked #49:
http://www.discover.com/issues/jan-07/cover/?page=2 So... I agree with the conclusion: "Drop it" Mr. McGee as you don't know what you write. Or don't drop it and still be irrelevant to what is in fact important in the discovery process for medical reseach.
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comment: psilocybin mushrooms: no evidence of substantial risk by Jeffrey Ustaath
[Comment posted 2007-02-02 21:36:19]
McGee writes, "For example, in the Hopkins study subjects were given either Ritalin or psilocybin, sending the terribly premature message that the two substances are in any sense equivalent in terms of effect or safety."
The study sent no such message. Some control substance had to be chosen, and I believe ritalin was a good choice. What would you have proposed as an alternative?
The Hopkins experiment received a great deal of positive publicity, and reports about it have appeared in the Economist, Washington Post, Wall Street Journal, LA Times, and ABC News.
Our society has established a baseline of acceptable risk by legalizing nicotine and alcohol. Thousands of people die every year by consuming both substances. I have yet to hear of a single psilocybin related death. Review of causes of death alone shows, in my opinion, that consumption of psilocybin mushrooms poses no more risk than consuming the edible culinary variety.
The idea that people consumed psychoactives in the seventies because scientists gave it the green light is absurd. Study after study show that people consume psychoactives regardless of what authority figures, be they politicians, academicians, or police, say about it. You appear to be advocating that scientific studies that show psychedelics to be relatively safe should be kept from the public view.
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comment: Replies to the First Volley of Comments [From Glenn McGee] by Press Pass
[Comment posted 2007-02-03 14:42:11]
Reply to Tom DiStefano: There is no question that cluster headaches warrant research including the surveillance of the use of psilocybin by sufferers that was conducted, and additional clinical research using the same compound. The point was that "Studies of [the substance] should be undertaken only when investigators avoid sending subtle messages about the safety or delight of chewing on backyard mushrooms." I didn't make a claim about the etymology of the term magic mushroom. And the point about Ritalin was not that it was an inappropriate placebo or inappropriate for use in any form of comparative research from a scientific standpoint. The point was sociological, that the choice of this particularl substance sent the "terribly premature message that the two substances are in any sense equivalent in terms of effect or safety. It would have been much better to compare psilocybin with, well, anything other than a compound prescribed to tens of millions and often abused by those seeking better cognition." I stand by the comment.
Reply to "One who knows..." [anonymous flame comment]: 1) "proof to support claim..." - I didn't make this claim. The point was that the research conducted on these substances morphed into a kind of pseudoscience that then very obviously and by all accounts became a social phenomenon. 2) FDA did in fact issue statements on the use of halucinogens in research. Wrong again. I said nothing about Schedule I or the DEA because it isn't germaine. Whether the world is flat or not.
3) I can't find a claim in this sophistry. If the point is that there is some sort of inappropriate precaution inherent in my claim that investigators should be careful (mindful of history) with regard to how the public will understand research involving hallucinogens, then there's no support for that claim in the comment.
4) There was no comment in the piece about the purpose of use of ritalin as control to the effect that the idea of the study was to compare them. The point was sociological and you don't need to be an ethicist to see the reason it is of concern. There were dozens of other available controls and the message sent in the work is obvious and I am not the only one who has noticed it.
5) It is true that after I authored the column, Discover ranked the study #49. It is also the case that one can find 30,000 entries if one uses Hopkins and psilocybin into Google. But again I am not the only one who has noticed - in fact study of the phenomenon has been conducted - that the Hopkins study did not receive much media attention. Which remains true unless you think that this notation in Discover pushes it into the real limelight.
Reply to Jeffrey Ustaah: Mr. Ustaah, who promotes the recreational use of mushrooms on his blog, offers up the same claim concerning that ritalin was a good choice (dealt with above) and that there was loads of coverage of the Hopkins study (run a Lexis comparison between this study and any major piece from the past year; the point at any rate was that there has not been a public backlash grounded in irrational fears of the Hopkins research, not that Hopkins' research was somehow irrelevant. I am surprised that Mr. Ustaah believes that it is as safe to use psilocybin mushrooms as to eat the "edible culinary variety," because not only is this false it is rejected by the most ardent advocates of mushroom experimentation as a comparator. And finally claim that Mr. Ustaah makes to the effect that people who consume psychoactives in a social vacuum is preposterous and there is no citation to a study to ground the claim.
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comment: Response to Dr. McGee from Ustaath by Jeffrey Ustaath
[Comment posted 2007-02-04 15:10:25]
Dr. McGee writes:
"Mr. Ustaah, who promotes the recreational use of mushrooms on his blog,"
My blog www.consciousnesscafe.org only promotes the dissemination of information regarding consciousness and its study in all its forms. I offer information related to psychedelic culture and its history.
I have never advocated "recreational use" of mushrooms and personally find this characterization of the psychedelic community as a whole a misrepresentation. The psychedelic community often regards psilocybin mushrooms as a sacred sacrament and a means of communication with divinity.
I regard the consumption of psilocybin mushrooms within a clearly established system of religious faith to be a religious practice and covered as such by the First Amendment within the United States.
I have never advocated consumption of psilocybin mushrooms as a recreation, and would regard that as a desecration to those for whom psilocybin mushrooms comprise a vehicle for the Divine.
Ustaath
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comment: Ethnocentrism Alert! by Bruce Gould
[Comment posted 2007-02-04 15:11:01]
There's a very subtle touch of ethnocentrism in this article -
"The study of so-called magic mushrooms isn't new; it could be argued that it is celebrating its 50th anniversary this year. It began, as best anyone can tell, when Wall Street banker R. Gordon Wasson documented his trip to a
healer in Oaxaca, Mexico, whose brew, he claimed, enabled him to see the reality of ideas and concepts."
Didn't the natives in Mexico study mushrooms? Things don't _really_ exist until we westerners notice! Now, of course they mean _scientific_ study, but even in that light - Wasson wasn't a psychologist or biochemist, he was an amateur mycologist - why would his experience count any more than that of the Oaxacan healers?
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comment: He still doesn't know what he writes by One who knows that facts are more imporant than pseudo-ethics
[Comment posted 2007-02-04 15:19:46]
Gleeful McGee can't admit a mistake. 1.He fails to acknowledge that he wrote, completely in error, that the "FDA banned hallucinogenic drugs in 1970." They never did.
2. Mr. McGee is a Ph.D. and not weighted down by the heavy burden of being a physician or clinical medicine researcher. That is why he wastes his breath waxing on and on about the choice of ritalin and its impact on greater society. Hogwash. This is about clinical research Mr. McGee and not about further messages you wish to extrude from the study that are extraneous to the needs of the study. You don't like the choice of ritalin? fine... you can do your study... but, oh, wait... that's right, you just prefer to be a backseat driver with your complaints... you don't have the skillset to do any of this work... Correct? Or are you planning to go to medical school now, too? These researchers have an obligation to do the very best study possible and your issues of impact on society are not directly relevant. They are made up by you for an opinion column.
3. McGee thinks that the social upheaval of the 60's on forward occured because LSD and other hallucinogens escaped the lab and were promoted as well by unscrupulous researchers. This is a simplistic history and a flawed one at best. Back then, btw, people blamed these drugs for the loss of conformity and resultant problems of the environmental movement, the anti-war movement, the civil rights movement, and the women's liberation movement. Ah, if only we could have put this genie back in the bottle because what happened was all so bad, bad, bad... Has this guy even heard of MKUltra? Who did those experiments? Who paid for them? He just doesn't know what he writes. Read the Church Commission.
4. In July, when the Hopkins study came out, and before this present stupid piece got published, articles appeared in the: L.A. Times, the Wall Street Journal, The Independent (England), the Times (London), the Daily Record (England), the Atlanta Journal-Constitution, the Hobart Mercury (Australia), Canberra Times (Australia), Sydney MX (Australia), The Age (Australia), the Gold Coast Bulletin (Australia), Manila Times, the Hindustan Times (India), the Houston Chronicle, the Boston Globe, the Toronto Star, the Vancouver Sun, the Edmonton Journal (Canada), the South China Morning Post, the San Francisco Chronicle, the Nation, the Irish Times, the Belfast Telegraph, the San Diego Union-Tribune, the Baltimore Sun, New York Newsday, the Hartford Courant and 100's of other local papers because an article was written for and posted by the AP Wire...
Then there is an article appearing in the July 15th edition of the Economist (The God Pill; Psychedelic Drugs) - but maybe an article in the Economist printed all over the world isn't major enough press... Well, how about an article in December in the Chronicle for Higher Education? McGee might read that...
articles also appeared in professional magazines/newsletters including: Pharma Investments, Ventures & Law; Medical Imaging Week; Life Science Weekly; Drug Week; Mental Health Business Week; Hospital & Nursing Home Week; Physician Law Weekly; World Disease Weekly; Mental Health Weekly Digest; Pain & Central Nervous System Week; Health & Medicine Week; Telemedicine Law Weekly; Medical Imaging Business Week; State & Local Health Law Weekly; Telemedicine Business Week; Medical Imaging Law Weekly; Pharma Law Weekly; Telemedicine Week; Biotech Business Week and Science Letter.
Other news wire services in addition to the AP Wire include: the AP Worldstream; the AP State & Local Wire; the AP Online; University Wire (resulting in articles in college newspapers everywhere); The Religion News Service (an important article written by religion scholar Huston Smith); Press Association; oh the ever so small UPI; US States News; and Ascribe Newswire.
TV coverage included news programs on CTV (Canada), CBS, and ABC. Countless major websites also posted articles - Forbes.com; sciencenews.org; wikipedia.org; answers.com; FoxNews.com; and many, many more.
Above isn't meant to be comprehensive but I did find all this within 10 minutes of searching and it proves that the Hopkins article got a tremendous amount of news coverage... maybe you need to adjust your aerial antenna up in Albany Mr. McGee.
5. "I am not the only one to notice" - I say notice how Mr. McGee runs from fact to hide behind his circle of friends who didn't notice the piece either. Totally weak to offer that up as some sort of defense of your lack of homework for this column.
6. It is crucially important that readers understand that Mr. McGee is without any clinical medical credentials. He has no direct experience prescribing medications or in the practice of medicine, in general. He refers to me as an "annonymous flame comment" and very much am I glad to pierce this hot air balloon annonymously. Look how McGee uses libel to go after Jeffrey Ustaah! I mean if McGee can't defend his facts, let's watch him obfuscate his failures by going on the offensive and distort what others do. Hardly becoming of one trained in philosophy but there you have it.
7. It remains obvious to careful readers that McGee does not know of what he speaks in this particular column. How dare he continue to hold up his litmus test of restricting free speech on the backs of suffering cluster patients. Moreover, he clearly states that none of the current crop of researchers are committing these offenses he speaks of so his warnings are perhaps more for himself. Maybe he wants to generate more attention for himself so that a few more of his books might sell. The Scientist would do well to either hire a new columnist or a better editor to keep the excesses of this man in check. You failed here Mr. McGee... teach your mistakes to your students as well please.
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comment: Shroom Science by Bruce Sewick
[Comment posted 2007-02-04 15:20:05]
One way to consider safety is to look at the ratio of effective dose to lethal dose
http://www.americanscientist.org/template/AssetDetail/assetid/50773?%26print=yes%2350979
Psilocybin has an effective dose to lethal dose of 1 to 1000! Certainly safer than many other substances like alcohol for example. LSD, Psilocybin and Marijuana are three of the safest substances listed in the chart!
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comment: glaring errors by Lux
[Comment posted 2007-02-04 15:20:43]
Of the many substantively misinformed claims in this opinion piece, two errors are so glaring that I can't let them pass without comment.
1) As explained in the Psychopharmacology article, the use of methylphenidate as an active placebo was a deliberate decision made for sound methodological reasons. The issue was one of preserving the integrity of the double-blind in the study in order to control for expectancy effects. If the author of this piece had bothered to read any of the four commentaries simultaneously published with the Psychopharmacology article, he would have seen that several distinguished researchers praised the wisdom and effectiveness of using methylphenidate as a control substance. Its mild physical symptoms were so effective and effects that could be mistaken for the influence of psilocybin that a full 22% of the double-blind placebo sessions were mistaken by the trained session monitors for psilocybin sessions. This is one of the conspicuous triumphs of the study.
Beyond this, the suggestion that drug research in any way explicitly or implicitly implies an equivalence of safety and efficacy between the test compound and comparison substance is so absurd that I wonder if the author has a basic understanding of research methodology. If this contention is accurate, then pharmaceutical companies are sending a dangerous message that experimental drugs are as safe and effective as sugar pills.
2) The author's contention that this study did not receive much media attention is simply false. This study was not only covered in a detailed piece by the AP, but independently covered by dozens of media outlets including the Wall Street Journal, The Economist, the Japan Times, the LA Times, Forbes, and New Scientist magazine. In addition, this story was the headline entry on the CNN Science page for days after it was written.
In addition to these glaring faults, I notice that the author lets pass without comment the stunning findings of the study, in which 66% of the subjects in a two-month follow up reported their experience with psilocybin as one of the most important experiences of their lives, on the same scale as the birth of a child. Perhaps these remarkable findings warrant a reassessment of the author's concerns regarding the dangers of the use of serotonergic hallucinogens.
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comment: everything else aside this statement alone shows how misguided the author is. by sambo
[Comment posted 2007-02-04 15:21:08]
"It would have been much better to compare psilocybin with, well, anything other than a compound prescribed to tens of millions and often abused by those seeking better cognition"
I have only one question. How does one "seek better cognition" and or what does that exactly entail. I personally suffer from cluster headaches and ADHD and I think using ritalin in these placebos is a great call on the part of the doctors for many reasons.
Drugs in Cyberspace
Organization of American States report
"Drugs in Cyberspace"
(look at the bottom group of reports)
http://www.cicad.oas.org/Reduccion_Oferta/ENG/Reference.asp
Also....
DHHS webcast entitled "Drugs in Cyberspace".
http://ncadi.samhsa.gov/multimedia/webcasts/w.aspx?ID=465
Microgram and Ergot
Latest Microgram is out:
http://www.dea.gov/programs/forensicsci/microgram/mg0107/mg0107.html
with this interested article noted:
http://www.ajpe.org/aj7005/aj700598/aj700598.pdf
Ergot and Its Alkaloids
Paul L. Schiff PhD School of Pharmacy, University of Pittsburgh
ABSTRACT
This manuscript reviews the history and pharmacognosy of ergot, and describes the isolation/preparation, chemistry, pharmacodynamics, and pharmacotherapeutics of the major ergot alkaloids and their derivatives.
A brief discussion of the hallucinogenic properties of lysergic acid diethylamide is also featured.
An abbreviated form of the material found in this paper is presented in a 4-hour didactic format to third-professional year PharmD students as part of their study of vascular migraine headaches, Parkinson's disease, and naturally occurring hallucinogens/hallucinogen derivatives in the modular course offering Neurology/Psychiatry.
insula and ego
http://www.sciam.com/article.cfm?chanID=sa003%26articleID=5A961D91-E7F2-99DF-3CCCA8DBF29BBC74
January 25, 2007 Stroke Damage May Help Smokers Kick the Habit The insula, an area of the brain largely ignored by researchers, may hold the key to breaking harmful addictions A patient who damaged his left insula, a region of the brain located deep within the cortex on either lateral side, may have opened the door to kick the habit without even trying. The day after suffering a stroke the 38-year-old man, who had a 40-cigarette-a-day addiction, reported to doctors that his "body forgot the urge to smoke." This revelation prompted a study that found the insula is intimately linked to smoking addiction.
In fact, the authors report in Science this week that damage to that region is 136 times more likely to result in a "disruption of smoking addiction"—defined as the ability to quit easily without relapse—than injury to other parts of the brain.
"Finding the insula may not be surprising in a way, because there was knowledge that preceded that and it makes sense," says senior study author Antoine Bechara, a neuroscientist at the University of Southern California and the University of Iowa's Carver College of Medicine. "But, it's surprising in another way because nobody was looking there."
The insula has long been associated with conscious urges and visceral sensations. According to Steven Grant, a researcher at the National Institutes of Health's National Institute on Drug Abuse, it is also believed to act as a sensory receptor for the internal organs, perhaps remembering the way something tastes or if it upsets the stomach. During imaging studies probing the causes of addiction, the insula often was activated when drug abusers were shown movies of others taking drugs or shown pictures of cocaine, heroin or nicotine.
But until now researchers had ignored the silver dollar–size region because it was not implicated in reinforcement pathways and did not affect the signaling of dopamine, the neurotransmitter associated with motivation and pleasure.
Bechara and his team studied 69 stroke patients culled from a registry at the University of Iowa that was assembled to study the effect of brain damage on cognition, memory and motion; they selected subjects who, at the time of their strokes, had been smoking at least five cigarettes daily for more than two years. Of this group, 19 patients had suffered damage to either their right or left insula.
Twelve of the 19 patients with insula damage reported a sudden end to their smoking habit, and none had relapsed over the past year. While many other stroke victims had also quit smoking, most of them cited health reasons such as fear of another stroke for doing so. "This is not a 100 percent proof, not every single insula damaged caused the disruption and vice versa," Berecha points out. "There was damage in things that did not involve the insula and there was a disruption of addiction" as well as people who suffered insula damage but did not suddenly stop smoking.
Berecha speculates that these disparities may be caused due to some gender differences in the way the brain is wired. He points to studies that found diminished decision-making capacity in women with damage to their left prefrontal cortex and men with injuries to their right side, but not vice versa. He notes, however, that the sample size in this study was not enough to draw those sorts of conclusions.
Still, Grant believes the study points to the insula as key to addiction. "It really now calls upon the research field to start focusing on this area," he says, "to look at drug effects in this area, to look at the types of changes that go on during addiction in this area, to understand what the basic function of this area is and why it would be important in this kind of context."
Berecha also believes that the insula may also play a role in other addictions such as alcoholism, drug abuse and compulsive eating. While inducing a stroke clearly is not the answer, Berecha says that safe therapies designed to disrupt the insula's activity may eventually be able to help people at least quit smoking.
MPTP and acupuncture
This article shows that acupuncture can significantly reduce the neurotoxic effects of a pharmacological agent!
What does this suggest about preventing "neurotoxicity" from MDMA?
[For those of you who are not scientists: Parkinson's disease is caused by a deficit of dopamine in certain parts of the brain, like the striatum and the substantia nigra. MPTP is a neurotoxin that decreases dopamine, and thus produces Parkinson-like effects. (You may recall MPTP because it was an impurity in a meperidine analog decades back that caused severe movement disorders in opioid addicts.) Tyrosine hydroxylase is the first enzyme needed to convert the amino acid tyrosine into dopamine. COX-2 is a mediator of inflammation.]
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Brain Research Volume 1131, Issue 1, 2 February 2007, Pages 211-219 Acupuncture inhibits microglial activation and inflammatory events in the MPTP-induced mouse model
Jun Mo Kang, Hi Joon Park, Yeong Gon Choi, Il Hwan Choe, Jae Hyun Park, Yong Sik Kim and Sabina Lim
Abstract
Using a mouse model of MPTP-induced Parkinson’s disease (PD), this study investigated on the neuroprotective effects of acupuncture by examining whether acupuncture contributed to inhibiting microglial activation and inflammatory events.
C57BL/6 mice were treated with MPTP (30 mg/kg, i.p.) for 5 consecutive days.
Acupuncture was then applied to acupoints Yanglingquan (GB34) and Taichong (LR3) starting 2 h after the first MPTP administration and then at 48 h intervals until the mice were sacrificed for analyses at 1, 3, and 7 days after the last MPTP injection.
These experiments demonstrated that acupuncture inhibited the decreased of the tyrosine hydroxylase (TH) immunoreactivity (IR) and generated a neuroprotective effects in the striatum (ST) and the substantia nigra (SN) on days 1, 3, and 7 post-MPTP injections.
Acupuncture attenuated the increase of macrophage antigen complex-1 (MAC-1), a marker of microglial activation, at 1 and 3 days and reduced the increases in cyclooxygenase-2 (COX-2) and inducible nitric oxide synthase (iNOS) expression on days 1, 3, and 7.
In MPTP group, striatal dopamine (DA) was measured by 46% at 7 days, whereas DA in the acupuncture group was 78%.
On the basis of these results, we suggest that acupuncture could be used as a neuroprotective intervention for the purpose of inhibiting microglial activation and inflammatory events in PD.
http://www.sciencedirect.com/science?_ob=ArticleURL%26_udi=B6SYR-4MK0HX5-9%26_user=861681%26_coverDate=02%252F02%252F2007%26_rdoc=25%26_fmt=full%26_orig=browse%26_srch=doc-info(%2523toc%25234841%25232007%2523988689998%2523641121%2523FLA%2523display%2523Volume)%26_cdi=4841%26_sort=d%26_docanchor=%26_ct=28%26_acct=C000046147%26_version=1%26_urlVersion=0%26_userid=861681%26md5=1d79da6ae344cac9376acd48f81e49d3
US military and drug war
http://www.latimes.com/news/nationworld/nation/la-na-drugwar22jan22,0,7593287.story?coll=la-home-headlines
Burdened U.S. military cuts role in drug war Air and sea patrolling is slashed on southern smuggling routes. By Josh Meyer LA Times Staff Writer
January 22, 2007
WASHINGTON — Stretched thin from fighting in Iraq and Afghanistan, the U.S. military has sharply reduced its role in the war on drugs, leaving significant gaps in the nation's narcotics interdiction efforts.
Since 1989, Congress has directed the Pentagon to be the lead federal agency in detecting and monitoring illegal narcotics shipments headed to the United States by air and sea and in supporting Coast Guard efforts to intercept them. In the early 1990s, at the height of the drug war, U.S. military planes and boats filled the southern skies and waters in search of cocaine-laden vessels coming from Colombia and elsewhere in South America.
But since 2002, the military has withdrawn many of those resources, according to more than a dozen current and former counter-narcotics officials, as well as a review of congressional, military and Homeland Security documents.
Internal records show that in the last four years the Pentagon has reduced by more than 62% its surveillance flight-hours over Caribbean and Pacific Ocean routes that are used to smuggle cocaine, marijuana and, increasingly, Colombian-produced heroin. At the same time, the Navy is deploying one-third fewer patrol boats in search of smugglers.
The Defense Department also plans to withdraw as many as 10 Black Hawk helicopters that have been used by a multi-agency task force to move quickly to make drug seizures and arrests in the Caribbean, a major hub for drugs heading to the United States.
And the military has deactivated many of the high-tech surveillance "aerostats," or radar balloons, that once guarded the entire southern border, saying it lacks the funds to restore and maintain them.
The Department of Defense defended its policy shift in a budget document sent to Congress in October: "The DOD position is that detecting drug trafficking is a lower priority than supporting our service members on ongoing combat missions."
Members of Congress and drug-control officials have said the Pentagon's cuts and redeployments have hamstrung the U.S. drug interdiction effort at a time when an estimated 1,000 metric tons of inexpensive, high-quality cocaine is entering the country each year.
It's hard to gauge the precise effect of the pullback because authorities say they only know the amount of narcotics they are seizing, not how much is getting through — especially with fewer surveillance planes and boats to gather intelligence.
In the budget report to Congress, the Pentagon estimated recently that it detected only 22% of the "actionable maritime events" in fiscal 2006 because it "lacks the optimal number of assets."
Even when they did detect suspected smuggling vessels, U.S. authorities had to let one in every five go because they lacked the resources to chase them, Pentagon officials conceded in their report.
"We have not stopped trying to fix that gap. We're very much concerned about it, and working very hard to try and fix these problems," Edward Frothingham III, acting deputy assistant Defense secretary for counter-narcotics, said in an interview. "DOD is in no way lessening our support" for the war on drugs, he said. "But in the post-9/11 world, some of these assets are needed elsewhere."
With Pentagon support dropping, the Coast Guard and other Homeland Security agencies such as U.S. Customs and Border Protection are trying to play a greater role in the interdiction effort. But current and former officials within those agencies say they do not have the resources to do the job because they, too, have had to dramatically redistribute resources since the sweeping post-Sept. 11 reorganization that made Homeland Security the front line in keeping terrorists out of the United States.
"I can't stand here and tell you drugs aren't coming into the U.S. by sea. It happens," said Cmdr. Jeff Carter, a Coast Guard spokesman. "There are huge challenges, but we are making a dent."
(The Justice Department, through the FBI and Drug Enforcement Administration, also has a central role in the drug war, but it is more focused on arresting narcotics traffickers in the U.S. than on interdiction.)
The cutbacks continue at a time when the Pentagon has officially reclassified the drug interdiction effort as part of the broader war on terrorism, citing intelligence showing growing ties among terrorists, drug dealers and organized-crime syndicates.
"In the post-9/11 world, where both securing and detecting threats to our nation's borders have become critical national security objectives, we cannot continue to neglect the fact that narco-traffickers are breaching our borders on a daily basis," according to a report that was quietly issued last month by the House Subcommittee on Criminal Justice, Drug Policy and Human Resources.
At a November 2005 hearing before another House subcommittee, Rep. Dan Burton (R-Ind.) said the lack of available military assets and the amount of drugs getting through "just boggled my mind."
"The spike in narcotics shipments via Central America we ignore at our own peril," said Burton, who at the time was chairman of the international relations subcommittee on the Western Hemisphere. "They could be carrying weapons, terrorists and other things that could destroy not only the youth of America, but American cities."
The weakening of the U.S. drug interdiction effort comes just as U.S. authorities have had some major successes in the drug war, led by the Pentagon's Joint Interagency Task Force-South, based on Key West, Fla. Authorities have seized increasing amounts of cocaine since 2001, including a record 300,000 pounds in 2005, although records show that seizures dropped off sharply in 2006, to 230,000 pounds.
Counter-narcotics officials, including some in the Pentagon, acknowledge that the large recent seizures are only masking more fundamental problems caused by the sharp decline in drug interdiction assets.
The recent successes were due in part to improved interagency cooperation and U.S. efforts to bolster the Colombian government's counter-narcotics program. They were also aided by a windfall of intelligence gained from a program known as Operation Panama Express, which allowed authorities to pinpoint major shipments of drugs, documents show. That intelligence has largely dried up as Colombian drug lords have tightened their operational security, making the Pentagon's detection and monitoring assets in the so-called transit zones ever more crucial, according to U.S. documents and officials.
"What you've had is a significant downsizing of the counter-narcotics effort in the transit zones, and that has very direct national security implications," said Robert B. Charles, assistant secretary of State for international narcotics and law enforcement affairs from 2003 to 2005. He said the loss of resources threatened to "consign future generations of young Americans to a deluge of cocaine and heroin."
Perhaps the most important link in the drug interdiction chain is the Pentagon's aerial patrols. Without them, a U.S. military ship can detect only about one out of every 10 suspected drug vessels (one out of five if the ship has a helicopter on board), according to statistics from the Joint Interagency Task Force-South. With the planes, whose radars can cover hundreds of miles, the military's odds improve to seven out of 10.
Department of Defense aerial patrol-hours in the transit zones declined from 6,062 hours in fiscal 2002 to a low of 1,432 in 2005. They rose to 2,296 in the most recent fiscal year, which ended in October, but since then, the Pentagon has grounded much of its fleet of P-3s for long stretches because of a lack of pilots, money for flying time or maintenance issues, documents show.
Military officials say the aerial surveillance situation is dire, and likely to get much worse. That's because most of the Pentagon's drug planes are Vietnam-era P-3s that were mothballed for years before being brought back into service for the drug war. Many of them have been redeployed to war zones or for use in counter-terrorism operations, Frothingham said. Those remaining have such severe wing corrosion that they're in the shop much of the time, U.S. documents and officials say. Many of them have no working radar. But their replacements won't be ready until at least 2012.
The Pentagon has also redirected other planes used to spot smugglers — including fighter jets and high-flying reconnaissance planes — toward other missions, and turned down requests to use unmanned drones in the drug war.
Things aren't much better at sea, where there is a continuing lack of Navy resources to intercept drug runners who are using "go fast" multi-engine boats that are often 40 feet long, travel at up to 40 knots, and can carry several tons of cocaine.
In the Eastern Pacific transit area, four U.S. ships are dedicated to patrolling an area larger than the continental United States.
Two years ago, U.S. authorities discovered that smugglers were easily avoiding military boats by navigating far into the eastern Pacific Ocean with the help of at-sea refueling vessels. In comparison, for every four days of patrol, U.S. military ships spend an average of eight days traveling to and from the transit zone to refuel, said Rear Adm. Jeffrey J. Hathaway, director of the JIATF-South.
Frothingham's tiny counter-narcotics office at the Pentagon is still looking for a solution because the department's leadership won't commit military tankers for the task. A senior Pentagon budget official said the British government recently pledged to provide a tanker in the Pacific, but only temporarily.
Homeland Security agencies, the Coast Guard in particular, have moved boats and planes to the region to intercept smugglers, but documents show that in most cases, the U.S. presence remains far below what it was before Sept. 11, 2001.
In May, the Pentagon decided to withdraw its Caribbean-based Black Hawk helicopters for use elsewhere.
The Justice Department protested, calling the helicopters a linchpin in the U.S. counter-drug effort because they ferried law enforcement agents among the thousands of islands that cocaine traffickers use as transshipment points.
That opposition has pushed back the withdrawal of the Black Hawks until October, but counter-narcotics officials say the larger problem is that no other agency has received funding to keep them operating.
As the U.S. fortifies its border with Mexico, counter-narcotics officials warn that smugglers could simply move east and penetrate the vast Gulf Coast.
In response to such threats, various U.S. agencies had for years been using radar-equipped tethered aerostats to provide continuous and long-range monitoring of smugglers by land, air and sea.
The Pentagon took over the Tethered Aerostat Radar System, or TARS, in 1992 and shut down three of the balloons in the Bahamas in 1994.
Then, in 2001 and 2002, it shut down three others in Texas, Louisiana and Florida, leaving virtually the entire Gulf Coast uncovered — from Florida to east Texas, and part of the Caribbean as well.
The Pentagon won't put the radar balloons back up because it believes the money is better spent elsewhere, Frothingham said.
In November 2005, the Government Accountability Office raised serious concerns about the shortcomings in the interdiction effort, and said it was particularly troubled by the lack of strategic planning by the Pentagon and Homeland Security to deal with a major redeployment of drug war assets that it believed would only get worse, not better.
The GAO, the independent investigative arm of Congress, requested that the Pentagon and Homeland Security Department devise comprehensive plans on how to maintain the drug interdiction effort with dramatically fewer resources.
More than a year later, the GAO's Jess T. Ford said in an interview that he had seen few signs of progress.
"If that trend continues," he said, "it just means we are going to miss more and more opportunities."
Neuroscience of Behavior Change
http://online.wsj.com/article/SB116915058061980596.html
THE WALL STREET JOURNAL SCIENCE JOURNAL
How Thinking Can Change the Brain
Dalai Lama Helps Scientists Show the Power of the Mind To Sculpt Our Gray Matter January 19, 2007; Page B1
Although science and religion are often in conflict, the Dalai Lama takes a different approach. Every year or so the head of Tibetan Buddhism invites a group of scientists to his home in Dharamsala, in Northern India, to discuss their work and how Buddhism might contribute to it. In 2004 the subject was neuroplasticity, the ability of the brain to change its structure and function in response to experience. The following are vignettes adapted from "Train Your Mind, Change Your Brain," which describes this emerging area of science:
BOOK EXCERPT Adapted from "Train Your Mind, Change Your Brain", by Sharon Begley.
Ms. Begley writes the weekly Science column for The Wall Street Journal.
The Dalai Lama, who had watched a brain operation during a visit to an American medical school over a decade earlier, asked the surgeons a startling question: Can the mind shape brain matter?
Over the years, he said, neuroscientists had explained to him that mental experiences reflect chemical and electrical changes in the brain. When electrical impulses zip through our visual cortex, for instance, we see; when neurochemicals course through the limbic system we feel.
But something had always bothered him about this explanation, the Dalai Lama said. Could it work the other way around? That is, in addition to the brain giving rise to thoughts and hopes and beliefs and emotions that add up to this thing we call the mind, maybe the mind also acts back on the brain to cause physical changes in the very matter that created it. If so, then pure thought would change the brain's activity, its circuits or even its structure.
One brain surgeon hardly paused. Physical states give rise to mental states, he asserted; "downward" causation from the mental to the physical is not possible. The Dalai Lama let the matter drop. This wasn't the first time a man of science had dismissed the possibility that the mind can change the brain. But "I thought then and still think that there is yet no scientific basis for such a categorical claim," he later explained. "I am interested in the extent to which the mind itself, and specific subtle thoughts, may have an influence upon the brain."
The Dalai Lama had put his finger on an emerging revolution in brain research. In the last decade of the 20th century, neuroscientists overthrew the dogma that the adult brain can't change. To the contrary, its structure and activity can morph in response to experience, an ability called neuroplasticity. The discovery has led to promising new treatments for children with dyslexia and for stroke patients, among others. But the brain changes that were discovered in the first rounds of the neuroplasticity revolution reflected input from the outside world. For instance, certain synthesized speech can alter the auditory cortex of dyslexic kids in a way that lets their brains hear previously garbled syllables; intensely practiced movements can alter the motor cortex of stroke patients and allow them to move once paralyzed arms or legs.
The kind of change the Dalai Lama asked about was different. It would come from inside. Something as intangible and insubstantial as a thought would rewire the brain. To the mandarins of neuroscience, the very idea seemed as likely as the wings of a butterfly leaving a dent on an armored tank.
* * *
Neuroscientist Helen Mayberg had not endeared herself to the pharmaceutical industry by discovering, in 2002, that inert pills -- placebos -- work the same way on the brains of depressed people as antidepressants do. Activity in the frontal cortex, the seat of higher thought, increased; activity in limbic regions, which specialize in emotions, fell. She figured that cognitive-behavioral therapy, in which patients learn to think about their thoughts differently, would act by the same mechanism.
At the University of Toronto, Dr. Mayberg, Zindel Segal and their colleagues first used brain imaging to measure activity in the brains of depressed adults. Some of these volunteers then received paroxetine (the generic name of the antidepressant Paxil), while others underwent 15 to 20 sessions of cognitive-behavior therapy, learning not to catastrophize. That is, they were taught to break their habit of interpreting every little setback as a calamity, as when they conclude from a lousy date that no one will ever love them.
All the patients' depression lifted, regardless of whether their brains were infused with a powerful drug or with a different way of thinking. Yet the only "drugs" that the cognitive-therapy group received were their own thoughts.
The scientists scanned their patients' brains again, expecting that the changes would be the same no matter which treatment they received, as Dr. Mayberg had found in her placebo study. But no. "We were totally dead wrong," she says. Cognitive-behavior therapy muted overactivity in the frontal cortex, the seat of reasoning, logic, analysis and higher thought. The antidepressant raised activity there. Cognitive-behavior therapy raised activity in the limbic system, the brain's emotion center. The drug lowered activity there.
With cognitive therapy, says Dr. Mayberg, the brain is rewired "to adopt different thinking circuits."
* * *
Such discoveries of how the mind can change the brain have a spooky quality that makes you want to cue the "Twilight Zone" theme, but they rest on a solid foundation of animal studies. Attention, for instance, seems like one of those ephemeral things that comes and goes in the mind but has no real physical presence. Yet attention can alter the layout of the brain as powerfully as a sculptor's knife can alter a slab of stone.
That was shown dramatically in an experiment with monkeys in 1993. Scientists at the University of California, San Francisco, rigged up a device that tapped monkeys' fingers 100 minutes a day every day. As this bizarre dance was playing on their fingers, the monkeys heard sounds through headphones. Some of the monkeys were taught: Ignore the sounds and pay attention to what you feel on your fingers, because when you tell us it changes we'll reward you with a sip of juice. Other monkeys were taught: Pay attention to the sound, and if you indicate when it changes you'll get juice. Matthieu Ricard, a Buddhist monk, undergoing an EEG during a study of compassion meditation
After six weeks, the scientists compared the monkeys' brains. Usually, when a spot on the skin receives unusual amounts of stimulation, the amount of cortex that processes touch expands. That was what the scientists found in the monkeys that paid attention to the taps: The somatosensory region that processes information from the fingers doubled or tripled. But when the monkeys paid attention to the sounds, there was no such expansion. Instead, the region of their auditory cortex that processes the frequency they heard increased.
Through attention, UCSF's Michael Merzenich and a colleague wrote, "We choose and sculpt how our ever-changing minds will work, we choose who we will be the next moment in a very real sense, and these choices are left embossed in physical form on our material selves."
The discovery that neuroplasticity cannot occur without attention has important implications. If a skill becomes so routine you can do it on autopilot, practicing it will no longer change the brain. And if you take up mental exercises to keep your brain young, they will not be as effective if you become able to do them without paying much attention.
* * * Since the 1990s, the Dalai Lama had been lending monks and lamas to neuroscientists for studies of how meditation alters activity in the brain. The idea was not to document brain changes during meditation but to see whether such mental training produces enduring changes in the brain. All the Buddhist "adepts" -- experienced meditators -- who lent their brains to science had practiced meditation for at least 10,000 hours. One by one, they made their way to the basement lab of Richard Davidson at the University of Wisconsin, Madison. He and his colleagues wired them up like latter-day Medusas, a tangle of wires snaking from their scalps to the electroencephalograph that would record their brain waves.
Eight Buddhist adepts and 10 volunteers who had had a crash course in meditation engaged in the form of meditation called nonreferential compassion. In this state, the meditator focuses on unlimited compassion and loving kindness toward all living beings.
As the volunteers began meditating, one kind of brain wave grew exceptionally strong: gamma waves. These, scientists believe, are a signature of neuronal activity that knits together far-flung circuits -- consciousness, in a sense. Gamma waves appear when the brain brings together different features of an object, such as look, feel, sound and other attributes that lead the brain to its aha moment of, yup, that's an armadillo.
Some of the novices "showed a slight but significant increase in the gamma signal," Prof. Davidson explained to the Dalai Lama. But at the moment the monks switched on compassion meditation, the gamma signal began rising and kept rising. On its own, that is hardly astounding: Everything the mind does has a physical correlate, so the gamma waves (much more intense than in the novice meditators) might just have been the mark of compassion meditation.
Except for one thing. In between meditations, the gamma signal in the monks never died down. Even when they were not meditating, their brains were different from the novices' brains, marked by waves associated with perception, problem solving and consciousness. Moreover, the more hours of meditation training a monk had had, the stronger and more enduring the gamma signal.
It was something Prof. Davidson had been seeking since he trekked into the hills above Dharamsala to study lamas and monks: evidence that mental training can create an enduring brain trait. Prof. Davidson then used fMRI imaging to detect which regions of the monks' and novices' brains became active during compassion meditation. The brains of all the subjects showed activity in regions that monitor one's emotions, plan movements, and generate positive feelings such as happiness. Regions that keep track of what is self and what is other became quieter, as if during compassion meditation the subjects opened their minds and hearts to others.
More interesting were the differences between the monks and the novices. The monks had much greater activation in brain regions called the right insula and caudate, a network that underlies empathy and maternal love. They also had stronger connections from the frontal regions to the emotion regions, which is the pathway by which higher thought can control emotions.
In each case, monks with the most hours of meditation showed the most dramatic brain changes. That was a strong hint that mental training makes it easier for the brain to turn on circuits that underlie compassion and empathy.
"This positive state is a skill that can be trained," Prof. Davidson says. "Our findings clearly indicate that meditation can change the function of the brain in an enduring way."
off-label Actiq
http://www.primetherapeutics.com/PDF/actiq.pdf
90% of Actiq is prescribed off-label
change and dopamine
http://www.nasw.org/users/skloot/ChangeStory.pdf
Why is it So Damn Hard to Change By Rebecca Skloot Published in O The Oprah Magazine January, 2007
Nora Volkow wants my chocolate. I’m sitting at a round conference table in her largewindowed office at the National Institute on Drug Abuse, where she’s the director. Volkow is telling me about her research into the neurology of eating and how, for some people, quitting foods—like, say, chocolate—can be as hard as kicking heroin is for a junkie. Food, she says, hooks people by triggering the exact chemical reactions triggered in the brain by hard drugs. Or nicotine. Or alcohol. Or shopping. Or sex. “I can’t stop looking at your chocolate,” Volkow says, her eyes darting from me to the chocolate and back. It’s a Hershey’s Kiss Volkow’s secretary gave me moments earlier. I took it with a smile and a thank-you, but I’m one of the few women in the world who actually don’t like chocolate. So I bit off the tip to be polite, put the rest back in its metallic wrapper, and slid it onto the table next to my notebook. This makes Volkow uncomfortable, which isn’t what I expected. Most articles about Volkow focus on her childhood in Mexico City. They say, Isn’t it amazing she was raised in the same house where Stalin had her great-grandfather —Leon Trotsky, the exiled Russian revolutionary—murdered with an ice ax? They talk about how Volkow started medical school at 18, then went to the United States and became one of the nation’s leading research psychiatrists. But to me, the most fascinating thing about Volkow is the fact that she—the head of the country’s national drug abuse agency—is not just a chocolate junkie. She’s also a chocolate pusher. Volkow paces back and forth in her Bethesda, Maryland, office—frizzy hair bouncing, black knee-high boots clacking—then stops, narrows her eyes, and grins. “I have some good stuff,” she says, reaching into her desk drawer. “Seventy-seven percent pure cocoa.” She throws a quartereaten bar on the table next to me. “Go ahead,” she says, “have some.” I tell her no thanks, and she raises her eyebrows. “I do experiments with people,” she says. “I put the chocolate there and see how long it takes them to pick it up.” She shakes her head. “I am very bad with chocolate. I take it immediately. I fail my own test. But you,” she says, pointing at my Kiss, “you have very good inhibitory control!” This makes me laugh, because if she’d offered cheesecake or Swedish Fish, I wouldn’t have lasted five seconds. But my problem isn’t food; it’s exercise and the fact that I seem incapable of doing it. No matter how many times I join a gym or buy new workout clothes or make workout dates with friends, I simply don’t exercise. I’ve always got good reasons: I’m too busy, it’s raining, I need better shoes, there’s no gym in my neighborhood. I have a deadline, a headache, or cramps; it’s too hot or too cold, running hurts my feet, weights are heavy…I could go on. The rational part of my brain knows I should exercise: I’ve read articles saying it prevents nearly every human disease, fights depression, and strengthens the immune system. I hear it reduces stress and anxiety, that it helps you focus and sleep and have better sex. I want all that—who doesn’t? But apparently, another part of my brain—which happens to be the dominant part—wants everything to stay exactly as it is. And clearly, I’m not alone. At this point, it’s common knowledge that the leading causes of death in the United States—heart disease, diabetes, and several cancers—can be preventable through behavior change. Hundreds of thousands of people wake up each January 1st and say, “Starting today, I’m going to diet/exercise/quit smoking/taking drugs/gambling/whatever.” They try, often very hard, but most fail. I want to know why. And I’m not talking about external factors, like too much work and not enough time. I’m looking for what happens in our brains when we try to change, and how we can use that knowledge to actually succeed. This is how I ended up in Nora Volkow’s office listening to her obsess about my chocolate. Volkow and colleagues have spent the past 15 years researching the link between drug abuse and obesity by studying one thing that makes it so freakin’ hard to change a habit: dopamine, a chemical in the brain that transmits signals from cell to cell and gets us hooked on everything from food to cigarettes to shopping to sex. Dopamine teaches your brain what you want, then drives you to get it, regardless of what’s good for you. It does this in two steps. First you experience something that gives you pleasure (say, McDonald’s French fries), which causes a dopamine surge. Some of that dopamine travels to the area of your brain where memories are formed and creates a memory connecting those fries with getting a reward. At that point, in science-speak, the fries have become “salient.” And when you’re exposed to something that’s salient, you may think, That’s bad for me, I shouldn’t, but your brain registers, Dopamine jackpot! Which is where step two comes in: On top of creating memories, dopamine controls the areas of the brain responsible for desire, decision making, and motivation. So once fries become salient, the next time you see or smell them, your brain releases a surge of dopamine that drives you to get some. When you succeed, your brain produces more dopamine, which reinforces the memory that made fries salient in the first place, etching it further into your brain. It’s a never-ending cycle: The more you do something that’s rewarding, the more dopamine makes sure you do it again. This is precisely how habits form. Eventually, if the fries become salient enough, your brain will release dopamine and push you to get fries anytime you see the colors yellow and red, even if you’re nowhere near McDonald’s. And this is true for any behavior that results in a reward: Orgasms cause dopamine surges. So does hitting the jackpot when you gamble, winning a race, acing a test, doing cocaine or methamphetamines, smoking, drinking. “Dopamine is motivation,” Volkow tells me. “If you create animals in the lab that don’t have dopamine, they have no drive. They can eat food and it tastes good, but they have no motivation to actually do anything, so they won’t eat, and they’ll die.” As she’s talking, I nod and take notes until, suddenly, her computer dings: She’s got an e-mail. I am not compulsive when it comes to food, but e-mail? Forget it. Volkow doesn’t share my obsession. She keeps talking about dopamine, I go back to taking notes, then there’s that ding again, and I think, She has two new e-mails. Volkow is unfazed. We go on like this until she must have ten messages and I can barely resist getting up and reading them myself. Then it hits me: E-mail is as salient for me as chocolate is for Volkow. I often work months, sometimes years before seeing my work in print, but email gives me the reward of instant gratification. I tell Volkow this and she laughs. “You’re right,” she says. “I bet if I put you in an MRI machine and played that e-mail noise, you’d get the same dopamine surges I see in cocaine addicts when they think someone else is getting high.” This is why it’s so hard to change. Doing so means fighting one of the most fundamental neurological systems in the brain. “Think about it,” Volkow says. “If you’re designing a species and you want to make sure it does things that are crucial for survival—like eating and reproducing—you create a system that’s all about pleasure so they want to repeat those things. Then you have dopamine make those behaviors become automatic. It’s brilliant, really.” Although she hasn’t proved it yet, Volkow has a theory about why diets often fail: Based on animal studies, she thinks people may experience withdrawal when they try to kick certain foods their brains have become dependent on. “This makes it hard to eliminate those foods,” she tells me, “because people may feel depressed or sluggish or generally horrible.” If this turns out to be the case, she says, perhaps changing your diet more slowly will help. But my big question for Volkow is this: How do you get yourself hooked on something that’s not inherently pleasurable to you—like living on salads and broccoli, or, in my case, exercising? Many people get a natural high from working out. I, however, am not one of them. “Isn’t there some way to trick the dopamine system?” I ask her. “Some way to fool my brain into craving exercise?” Sure, she says: The secret is thinking up rewards. My payoff for working out could be a pedicure or a new pair of shoes. For someone trying to diet: Maybe you get a massage after a week of good eating, or have a friend dole out gift certificates if you stay on track (you pay, but she controls the vouchers). “Giving yourself rewards for a behavior engages the dopamine system so your brain will associate the positive outcome with it, which will help you form the habit.” When I get home, I try it. I make a deal with myself: If I exercise every day for a week, I get a new mini MP3 player. I wake up in the morning and it’s raining. I remind myself about the MP3 player. After several confused minutes of figuring out what a person wears to exercise in the rain (a poncho? an umbrella?), I end up in waterproof hiking boots and my boyfriend’s hooded sweatshirt, which is three times my size. I leash the dog and we start running, but my boots are too heavy and my lungs burn, plus I can’t see because the hood keeps falling over my eyes. And of course, there’s the rain. So we drop to a speed walk. An hour later we get home looking like we’ve been dunked in a river. I strip off my wet clothes and tell myself, Do that six more times and you get an MP3 player. Then I think, Yeah, right, you can’t possibly exercise again without music. So I buy an MP3 player and tell myself I really need exercise clothes before I try something like running again. The next day, I find myself in a very green and blue cafeteria at the Kennedy Krieger Institute in Baltimore, the renowned center for children and adolescents with developmental disabilities. I’m sitting across from Michael Schlund, PhD, a research psychologist who divides his time among several scientific institutions where he explores areas of the brain involved in learning and behavior change. For Schlund, this work is part of a larger project aimed at helping people with autism learn. But what I’m interested in is a study he recently finished at the University of North Texas, where he spent months observing the brains of healthy adults as they learned new behaviors based on rewards. Here’s what happened: After sliding the volunteers into an MRI machine, he gave them two buttons—one for the right hand, one for the left—then said, “You’ll have to make some decisions. If you’re correct, you earn money. If you’re wrong, no money.” He fired up the machine, which rattled and clanged as it began scanning their brains. Inside the machine, on a computer screen above the volunteers’ heads, a circle appeared and vanished. Next, the word CHOOSE flashed, which meant they had to pick a button, right or left. The game made no sense. There was no correct response: All they could do was click a button randomly, then the computer said WRONG and the circle appeared again. So they picked the other button and the computer flashed, CORRECT. YOU’VE EARNED 50 CENTS. Once the volunteers knew which button to press in response to the circle, they repeated the process over and over. Circle. Correct button. Reward. Circle. Correct button. Reward. This is where it got interesting for Schlund, because he wants to know what happens in the brain when you learn a new behavior based on rewards, which parts light up, how big that activation is, and how it changes over time as the behavior becomes habitual. On the first click, when they were guessing, the volunteers’ brains lit up a little in the frontal lobe—an area associated with self-control, decision making, and behavior change. After the second click, when they got the reward for answering correctly, suddenly their brains kicked into high gear, and with each repetition, their frontal lobes lit up more and more, which meant their brain activity continued to increase as they learned the new behavior. But—and this is the good news—within about 50 repetitions, Schlund says, the reverse will start happening—the frontal lobe lights up less and less until the brain is exerting minimum effort, which means the new task has officially become a habit. When Schlund tells me this, I ask if it means I only have to force myself to exercise 50 times and then it will be a habit. “I wish I could say yes,” he answers. “But we really have no idea. What I can tell you is, there are many variables.” The biggest one is stress. It turns out that the hormones released by the body in response to stress are our worst enemy when it comes to change: They actually inhibit the frontal lobe, which makes the brain revert to behaviors that don’t require conscious decisions (eating our familiar foods, drinking, smoking). Not only do stress hormones impair the areas of our brains that need to be active to change, they also stimulate our emotional centers, which send out signals telling us to decrease the stress. And what decreases stress? Food (because it releases natural opiates), alcohol, cigarettes, shopping. So successful change depends in part on stress management. But, Schlund says, it also depends on finding the right rewards. “If people got paid to exercise,” he tells me, “everyone would do it. And this country would be much better off.” I ask if he’ll pay me to exercise. He folds his hands on the Formica table between us, looks me in the eye, and says, “If you want to convince your brain you should exercise, you have to treat yourself the way you’d treat your dog.” It’s hardly what I expected him to say, but at this point, I’m open to anything. “Imagine she’s wetting on the floor every day,” he says. “Are you going to say, ‘Hey dog, if you don’t wet on the floor for a week, I’ll buy you a rawhide bone?’ That would be like your boss saying, ‘If you work five years, then you’ll get your check.’ It’s too far off.” Obviously, this is why my MP3 player failed: A week was too long to wait. If I’m going to associate exercise with a positive payoff, the reward has to be immediate. But beyond that, Schlund tells me, I have to unlearn the rewards I’ve already associated with not exercising (no pain, more time for other things). Doing this actually requires changing my neural circuitry. And rewiring an adult brain, I am about to discover, is very tricky. A few days after my meeting with Schlund, I’m sitting at a small desk in a psychiatric ward at Yale, staring at a computer screen with two clickable buttons: CHE and SHE. The computer says “Che” (or is it “she”?), and I’m supposed to press the appropriate button. I click CHE. The computer buzzes and tells me to try again. “Che” or “she”? I click SHE. Buzz. Over and over, I get the buzz. I’m thinking this must be a joke, but then I squint, listen hard, and finally hear it. I hit CHE. The computer dings, then two pink kissing fish appear on the screen and do a funky dance with a hermit crab. That’s my reward, which clearly gets my dopamine going: I start playing compulsively, completely hooked on picking the right answer so I can see what my next goofy reward will be. After a while, my attention starts wandering.… Buzz. So I squint, listen hard, and hear it again: “Che.” A spaghetti-thin man suddenly appears on the computer screen playing a xylophone, until a musical note hits him on the head. Then Bruce Wexler, MD, walks in the room. Wexler, a leading neuroscientist and the author of Brain and Culture, studies brain plasticity and how it affects our ability to change. I’ve come to try out this program, which he uses to help patients with schizophrenia improve their audio processing and memory. “You’re very good at that,” Wexler tells me. Not really, I say, pointing out how many errors I made before figuring it out. But actually, that’s the whole idea of the program: Successful change requires abnormally intense, uninterrupted concentration and repetition. Why? Because we’re working against evolution: Our brains are designed to conserve energy for really important things, like breathing and coordinated motion, even though sometimes, altering behavior is just as important as breathing. Our brains revert to habits when given the chance because habits require less energy than change. That silly exercise with “che” and “she” actually alters the way adults hear because it doesn’t let that happen. It forces intense concentration resulting in instant rewards that make you want to repeat the exercise over and over again. “You want to know why it’s hard to change?” Wexler asked when I first walked into his office. “There are a hundred billion neurons in your brain. Each one is connected to thousands of others. Everything you’re talking about—behaviors and learning and memory—involves the integrated actions of hundreds of thousands of cells in intricate systems throughout the brain.” In adults those systems are hardwired. When you’re a kid, it’s a different story: Young brains are constantly forming new connections between neurons, changing the way children process information based on their experiences. That’s plasticity, and it’s why kids soak up language and adapt to new cultures at rates that put adults to shame. “By the time we hit our 20s,” Wexler says, “our brains have lost most of their plasticity.” But fortunately, they haven’t lost all of it. Imagine you’ve got one strong eye and one weak eye, he tells me. If you cover the good eye with a patch, so it gets no stimulus, the weak eye will get stronger. But the second you remove the patch, the strong eye kicks in again and the weak one gets weaker. The same is true of all pathways in the brain. Once established, they stick around and remain strong as long as they’re being used. So the first step toward change, Wexler says, is putting a “patch” over the pathway you want to lose (like, say, a chocolate obsession), which means eliminating anything that activates it (having chocolate in the house, going places where you usually buy chocolate). This is why, for many people who try to quit drinking or smoking, it’s impossible to have just one glass of wine or cigarette. It’s why heroin and coke addicts must avoid places and people connected to their drug days. For dieters, just walking into your regular grocery store can activate an old familiar food pathway and keep it alive. So successful weight loss is as much about lifestyle change as it is about what you eat: Shop at a new store; buy new brands of food; use a new set of plates; eat in another room, at a different time of day. All these things will help starve an old unhealthy pathway so you can develop a new one. “The more drastically you restructure your habits,” Wexler says, “the more the established pathway that you’re trying to change is weakened.” But eliminating the old pathway isn’t everything. You’ll make things much easier if you search your brain for an existing healthy pathway—even a tiny weak one—then strengthen it. Wexler tells me to find an “I like exercise” pathway. I tell him I don’t think I have one. He doesn’t buy it. “Wasn’t there some activity you loved as a kid?” he asks. I don’t think so. On the train ride home, however, as I stare out the window listening to my new MP3 player, David Bowie’s “Changes” comes on and I start laughing. Appropriate, yes. But it was also the song my next-door neighbor and I skated to in my backyard when I was a girl. For my entire young life, I was obsessed with roller-skating. My first kiss was on skates; I roller-skated to high school every day, then rolled down the hall from class to class. I actually convinced my high school to waive my PE requirement and give me credit for my constant skating. Sitting on the train remembering all this, I smile and think, I just hit my dopamine jackpot. When I get home, I strap on my ten-year-old Rollerblades and give it a try. I turn on some disco and start rolling. It’s sunny; my dog is running next to me. I can practically feel the dopamine coursing through my veins. My exercise problem is solved. Life couldn’t be better. The next day I wake up, walk into my living room, then sit down at my computer thinking, Oh my God, I have so much to do. A few hours later I think, I should go Rollerblade now. But I’m busy. I’ve got a deadline, I exercised yesterday, and besides, it looks like it’s going to rain. I’ll do it later. But when later comes, I’m tired from working all day, and now it’s getting dark. Then I think, Wait a minute. Why isn’t all that dopamine from yesterday driving me to get up and Rollerblade again? Did my brain forget? A week later, I call Monika Fleshner, PhD, a neuroimmunophysiologist at the University of Colorado at Boulder who has done extensive research into the physiology of exercise. I explain my situation. I say I found an exercise I like, and I think I’ve got the dopamine thing solved, but funny thing is: I’m still not doing it. You know what her bottom line is? Suck it up—just make yourself exercise. Fleshner is very clear: It’s not like you find your dopamine jackpot and your brain immediately says, Now we exercise every day. For a while, you still have to force yourself to do it. But, I tell her, I have a very good reason not to: I know her research found that in animals, forced exercise doesn’t lead to the same physiologic benefits that voluntary exercise does. In fact, it actually weakens the animals’ immune systems by causing an increase in stress hormones in the body. I ask her about this, and she says it’s true, but I don’t have to worry about that. Why? Because I won’t have to make myself exercise long enough to cause problems. To which I say, “Excuse me?” Then she tells me something wonderful: All I have to do is force myself to exercise regularly for about two weeks, maybe three, and my brain will start producing a protein called brain derived neurotrophic factor (BDNF), which she calls Miracle-Gro for the brain. It increases brain plasticity, so you can learn, think clearly and focus for longer periods of time. It also increases dopamine neurotransmission, which means the more I exercise, the more reward I get, and the more my dopamine system is activated to make exercising a habit I’ll soon crave. “Just put on your Rollerblades,” Fleshner tells me. “Strap on some headphones, leash up your dog, go outside, and start exercising right now.” Long, silent pause. “I’m serious,” she says. I sit holding the phone for a second before thinking, Oh, what the hell. Three weeks isn’t that bad. So I head out for day one. And yes, it’s day one again, because I didn’t go out for day two last time, which means I’m starting from scratch. When I began this quest to find out why it’s so hard to change unhealthy behaviors, I talked with more than a dozen scientists. Each one laughed and said some version of this: “If I could answer that question, I’d win a Nobel Prize and have drug companies lining up at my door for miles.” But the truth is, scientists have uncovered some very important things. To begin with, change is monumentally difficult. Some people can just wake up one morning, decide to change, and stick with it. But many, perhaps most, can’t. The reason may be genetic; it may be the way you’re raised; perhaps some people have stronger frontal lobes than others. Scientists still aren’t sure. What they do know is, if you’re one of those people who struggle, that’s nothing to beat yourself up over—it’s just the way your brain works. But it’s also not an excuse to toss in the towel and say, Well, I don’t have enough dopamine, or My bad pathways are too strong. As Bruce Wexler told me, “The more we understand what we’re up against, the more we can develop strategies that will help us work with our brains to change successfully.” So, instead of waking up New Year’s morning and saying, “I’m going to do X now,” then berating yourself a month later when that resolution didn’t work, remember: You’re doing nothing less than rewiring your brain. Approach change as if you’re learning a new language or a new instrument. Obviously, you’re not going to be fluent or play symphonies instantly; you’ll need constant focus and practice. Overcoming an unhealthy habit involves changing the behaviors associated with it and managing stress, because stressing about change (or anything else) will knock you off the wagon faster than you realize. Above all, get that dopamine system going: Find rewards—make them instant, and don’t be stingy. Your brain needs them. And I promise (well, Volkow, Schlund, Wexler, and Fleshner promise) it gets easier. That’s not a bunch of self-help nonsense. It’s biology.
http://www.latimes.com/news/nationworld/nation/la-me-methadone26feb26,0,4449874.story?coll=la-home-headlines
Methadone emerges as new killer Patients and addicts are mixing the opiate with other drugs, as did Anna Nicole Smith's son.
By Charles Proctor LA Times Staff Writer
February 26, 2007
Methadone, a potent opiate once used almost exclusively to treat heroin addicts, is increasingly being prescribed by doctors as a pain medication and abused by drug users searching for a cheap, easy way to get high, physicians and federal drug officials say.
The drug, which comes in pill or liquid form, recently has come under scrutiny in the death of former Playboy model Anna Nicole Smith. A doctor in Studio City prescribed methadone to Smith for pain treatment before she was found dead Feb. 8 in her Hollywood, Fla., hotel suite.
A coroner has yet to determine her cause of death, and the doctor said his treatment was "medically sound and appropriate."
Months earlier, Smith's 20-year-old son died in the Bahamas after taking a lethal mixture of methadone and two antidepressants, Zoloft and Lexapro.
Well before these deaths, however, drug counselors and clinicians were concerned about increased abuse of the drug on the streets, in group homes and even in middle schools.
It is an ironic turn in the history of methadone, which for years has been used to treat heroin addiction.
A synthetic opiate, methadone is similar to heroin in chemistry, curbing a user's craving for the illegal opiate by blocking the sensors that heroin stimulates without producing a heroin high.
In recent years, methadone has proved lethal to a growing number of patients or addicts who use it in conjunction with prescription drugs including Valium, Xanax or, in the case of addicts, illegal narcotics such as cocaine.
Sometimes users swallow methadone before or after they "puff," when they seek to get high by slowly inhaling the chemicals from an aerosol can.
"Every year, we see hundreds of these deaths, and the numbers continue to increase," said Bruce Goldberger, director of toxicology at the University of Florida, who has been at the forefront of tracking methadone-related deaths. "It is absolutely the fastest-growing drug problem."
A federal government study found that nationwide methadone-related deaths climbed to more than 3,800 in 2004 from about 780 in 1999. Among all narcotic-related deaths in 2004, only cocaine killed more people in the United States than methadone.
Physicians and others point out that methadone's potential for abuse isn't as high as that of opiates like heroin because it does not induce a strong euphoria on its own.
But repeated use can still cause a physical dependence, doctors say, and when users stop taking it, withdrawal-like symptoms can occur.
Given its low cost compared with heroin and other drugs, its recent proliferation and its potentially lethal potency when mixed with other drugs, officials worry that methadone is largely evading the scrutiny applied to other abused prescription medications, such as OxyContin and Vicodin.
The drug can be lethal even when mixed with antidepressants, or grapefruit juice, experts and federal drug authorities say.
Methadone can linger in body tissue for an unusually long time — 24 to 59 hours in some cases. Sometimes users assume it has worn off, then take other drugs or more methadone, leading to respiratory depression, coma and eventual death.
Methadone is available at clinics that prescribe it to treat heroin addiction, from doctors who can prescribe it for pain or to treat addictions and, increasingly, as a street drug.
The clinics face stringent federal and state regulations as to how much methadone they can administer to patients, but physicians don't go beyond a general rule that says they can't prescribe more than a 30-day supply, said Mark Parrino, president of the American Assn. for the Treatment of Opioid Dependence.
In Southern California, parts of downtown, East and South Los Angeles have emerged as places to buy and sell methadone, said Kalante Holmes, a counselor at a methadone clinic in West Los Angeles. "It's one of those easy-to-get things right now," he said.
It's the "easy-to-get" nature of the drug that has led to the recent spike in methadone deaths, experts and government officials say.
As the study of pain has grown over the last five to 10 years, more physicians are prescribing methadone to patients to treat pain, especially chronic and nerve pain.
The Food and Drug Administration issued a warning in November to all physicians saying that misuse of the drug could lead to breathing problems and possible death.
Patients might prefer methadone to other painkillers because not only is it powerful, but it's also less expensive.
For example, a pharmacy can buy a month's supply of methadone for one patient for as little as $8, whereas it would have to pay more than $170 for a similar amount of OxyContin, according to wholesale pharmaceutical price books.
As the availability of the drug increases, so does abuse and misuse of it, experts and drug officials say. Problems usually don't arise from physicians who specialize in pain treatment and know how to safely prescribe and monitor methadone use, but from general and family practice physicians who may prescribe the drug more often than they should.
"My hunch is that some of what we're seeing with the current problems are the administration of [methadone] by physicians who don't understand how powerful it is to a patient population who might not necessarily need it," said Richard Rawson, an associate director of Integrated Substance Abuse Programs at UCLA.
Data compiled by the federal government show a steady increase in the number of people nationwide admitted to clinics and programs for methadone treatment, from about 1,000 in 1995 to more than 3,700 in 2005.
"This is an emerging problem," said Bertha Madras of the White House Office of National Drug Control Policy.
It's been a persistent problem for people like Sean, 20, a resident of West Los Angeles and a former heroin addict.
Sean, who asked that only his first name be used because of the stigma associated with drug abuse, carved a steady path to heroin use at a young age. He tried marijuana when he was 11, cocaine at 14 and heroin at 17.
When he was 19, living in a downtown L.A. apartment and experiencing heroin withdrawals, he tried methadone.
Mostly, he said, he used it to satiate his desire for heroin. At least once he took it with Klonopin, a muscle relaxant.
"I don't want to say the feeling was similar to alcohol," said Sean, who is in drug treatment and was interviewed in the presence of his counselor. "But that's sort of what it was like. Your body feels relaxed."
Though he said he had not used methadone lately because he'd heard it had been responsible for a rash of deaths, Sean said he could easily get it on the street.
Recently, on a bus in Santa Monica, he was approached by a methadone pusher who offered him a deal: one pill for $45 or two for $60, he said.
Sean said he declined. But he knows it won't be so easy for others.
"The fact of the matter is, if you're a drug addict and you don't want treatment, you're going to go try to get high off something," he said. "You're broke, you can't afford heroin, so you go get methadone."
gateway theory
http://www.nature.com/npp/journal/v32/n3/abs/1301127a.html
Neuropsychopharmacology (2007) 32, 607–615
Adolescent Cannabis Exposure Alters Opiate Intake and Opioid Limbic Neuronal Populations in Adult Rats
Maria Ellgren et al.
ABSTRACT
Cannabis use is a hypothesized gateway to subsequent abuse of other drugs such as heroin.
We currently assessed whether delta-9-tetrahydrocannabinol (THC) exposure during adolescence modulates opiate reinforcement and opioid neural systems in adulthood. Long–Evan male rats received THC (1.5 mg/kg intraperitoneally (i.p.)) or vehicle every third day during postnatal days (PNDs) 28–49.
Heroin self-administration behavior (fixed ratio-1; 3-h sessions) was studied from young adulthood (PND 57) into full adults (PND 102).
THC-pretreated rats showed an upward shift throughout the heroin self-administration acquisition (30 microg/kg/infusion) phase, whereas control animals maintained the same pattern once stable intake was obtained. Heightened opiate sensitivity in THC animals was also evidenced by higher heroin consumption during the maintenance phase (30 and 60 microg/kg/infusion) and greater responding for moderate–low heroin doses (dose–response curve: 7.5, 15, 30, 60, and 100 microg/kg/injection).
Specific disturbance of the endogenous opioid system was also apparent in the brain of adults with adolescent THC exposure. Striatal preproenkephalin mRNA expression was exclusively increased in the nucleus accumbens (NAc) shell; the relative elevation of preproenkephalin mRNA in the THC rats was maintained even after heroin self-administration. Moreover, mu opioid receptor GTP-coupling was potentiated in mesolimbic and nigrostriatal brainstem regions in THC-pretreated animals. mu opioid receptor function in the NAc shell was specifically correlated to heroin intake.
The current findings support the gateway hypothesis demonstrating that adolescence cannabis exposure has an enduring impact on hedonic processing resulting in enhanced opiate intake, possibly as a consequence of alterations in limbic opioid neuronal populations.
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http://www.sciencedirect.com/science?_ob=ArticleURL%26_udi=B6SYR-4MRG0C3-5%26_user=861681%26_rdoc=1%26_fmt=%26_orig=search%26_sort=d%26view=c%26_acct=C000046147%26_version=1%26_urlVersion=0%26_userid=861681%26md5=10caba2d4003213938bb5bc66d5c5d46
Brain Research Volume 1139 , 30 March 2007, Pages 245-253
Effects of early methylphenidate exposure on morphine- and sucrose-reinforced behaviors in adult rats: Relationship to dopamine D2 receptors
Cynthia A. Crawford et al.
Abstract
Methylphenidate is commonly used to treat Attention Deficit Hyperactivity Disorder (ADHD) in school-aged children, and there is an increasing trend to prescribe methylphenidate to younger preschool-aged children.
While the efficacy of methylphenidate is not in question, there is evidence that early methylphenidate treatment may have long-term effects on later drug responsiveness. The goal of this study was to determine whether early exposure to methylphenidate would alter morphine-induced conditioned place preference (CPP) and sucrose-reinforced lever-pressing in young adult rats. We also assessed whether early methylphenidate exposure would impact dopamine D2 binding sites.
Sprague–Dawley rats were treated with methylphenidate (0, 2, or 5 mg/kg) once a day from PD 11–PD 20. On PD 60, morphine-induced CPP or sucrose-reinforced lever-pressing was assessed. A 10-day CPP procedure was used, which included 1 preconditioning day, 8 conditioning days, and 1 test day. After CPP testing, D2 receptor binding was determined in striatal and accumbal tissue samples. In the sucrose experiment, rats were trained to lever-press on a progressive ratio schedule for one sucrose pellet.
Results showed that early exposure to methylphenidate (5 mg/kg) increased the magnitude of morphine-induced CPP. Exposure to methylphenidate did not alter the number of D2 binding sites, however, there were positive correlations between the number of D2 binding sites and the strength of the CPP.
In the sucrose-reinforced lever-press experiment, rats exposed to methylphenidate (2 and 5 mg/kg) had higher break points than saline controls.
These results suggest that early exposure to methylphenidate alters reward system functioning, thereby making these systems more sensitive to appetitive stimuli.
ONDCP on drug disposal
http://www.whitehousedrugpolicy.gov/news/press07/022007.html
FOR IMMEDIATE RELEASE: Tuesday, February 20, 2007
CONTACT: Jennifer de Vallance, ONDCP (202) 395–6648 / (202) 368–8422
FEDERAL GOVERNMENT ISSUES NEW GUIDELINES FOR PROPER DISPOSAL OF PRESCRIPTION DRUGS:
WHAT EVERY AMERICAN CAN DO TO PREVENT MISUSE OF PRESCRIPTION DRUGS
(Washington, DC)—In the face of rising trends in prescription drug abuse, the Federal government today issued new guidelines for the proper disposal of unused, unneeded, or expired prescription drugs. The White House Office of National Drug Control Policy (ONDCP), the Department of Health and Human Services (HHS), and the Environmental Protection Agency (EPA) jointly released the new guidelines, which are designed to reduce the diversion of prescription drugs, while also protecting the environment.
The new Federal prescription drug disposal guidelines urge Americans to:
Take unused, unneeded, or expired prescription drugs out of their original containers Mix the prescription drugs with an undesirable substance, like used coffee grounds or kitty litter, and put them in impermeable, non-descript containers, such as empty cans or sealable bags, further ensuring that the drugs are not diverted or accidentally ingested by children or pets
Throw these containers in the trash Flush prescription drugs down the toilet only if the accompanying patient information specifically instructs it is safe to do so
Return unused, unneeded, or expired prescription drugs to pharmaceutical take-back locations that allow the public to bring unused drugs to a central location for safe disposal
Abuse of prescription drugs to get high has become increasingly prevalent among teens and young adults. Past year abuse of prescription pain killers abuse now ranks second—only behind marijuana—as the Nation's most prevalent illegal drug problem. While overall youth drug use is down by 23 percent since 2001, approximately 6.4 million Americans report non-medical use of prescription drugs. New abusers of prescription drugs have caught up with the number of new users of marijuana. Much of this abuse appears to be fueled by the relative ease of access to prescription drugs. Approximately 60 percent of people who abuse prescription pain killers indicate that they got their prescription drugs from a friend or relative for free.
John Walters, Director of National Drug Control Policy, said, "Millions of Americans benefit from the tremendous scientific achievements represented by modern pharmaceutical products. But, when abused, some prescription drugs can be as addictive and dangerous as illegal street drugs. The new prescription drug disposal guidelines will help us stop and prevent prescription drug abuse, and the harm it can cause.
Health and Human Services Secretary Michael Leavitt said, "Health care providers, pharmacists, and family should be alert to the potential for prescription drug misuse, abuse, and dependence. In addition to supporting the new prescription drug disposal guidelines, they should address prescription drug misuse honestly and directly with their patients or loved ones when they suspect it. People in need should be encouraged to seek help for drug problems and if needed, enter treatment."
The new Federal guidelines are a balance between public health concerns and potential environmental concerns.
While EPA continues to research the effects of pharmaceuticals in water sources, one thing is clear: improper drug disposal is a prescription for environmental and societal concern," said EPA Administrator Stephen L. Johnson. "Following these new guidelines will protect our Nation's waterways and keep pharmaceuticals out of the hands of potential abusers."
The new Federal prescription drug disposal guidelines go into effect immediately. As part of the National Drug Control Strategy, the Bush Administration has set a goal of reducing prescription drug abuse by 15 percent over three years. In addition to promoting awareness of the risks involved with using prescription drugs for non-medical purposes as well as they need for adults to strictly control access to pharmaceuticals within their homes, the Administration supports the implementation of Prescription Drug Monitoring Programs at the State level. Currently, 33 States have such programs in place.
in love with DA
http://www.washingtonpost.com/wp-dyn/content/article/2007/02/12/AR2007021201657_pf.html
An Affair Of the Head They Say Love Is All About Brain Chemistry. Will You Be Dopamine?
By Neely Tucker Washington Post Staff Writer Tuesday, February 13, 2007; C01
It's all about dopamine, baby, this One Great True Love, this passionate thing we'd burn down the house and blow up the car and drive from Houston to Orlando just to taste on the tip of the tongue.
You crave it because your brain tells you to. Because if a wet kiss on the suprasternal notch -- while, say, your lover has you pinned against a wall in the corner of a dance club -- doesn't fire up the ventral tegmentum in the Motel 6 of your mind, well, he's not going to send you roses tomorrow.
Dopamine.
God's little neurotransmitter. Better known by its street name, romantic love.
Also, norepinephrine. Street name, infatuation.
These chemicals are natural stimulants. You fall in love, a growing amount of research shows, and these chemicals and their cousins start pole-dancing around the neurons of your brain, hopping around the limbic system, setting off craving, obsessive thoughts, focused attention, the desire to commit possibly immoral acts with your beloved while at a stoplight in the 2100 block of K Street during lunch hour, and so on.
"Love is a drug," says Helen Fisher, an anthropologist at Rutgers University and author of "Why We Love: The Nature and Chemistry of Romantic Love." "The ventral tegmental area is a clump of cells that make dopamine, a natural stimulant, and sends it out to many brain regions" when one is in love. "It's the same region affected when you feel the rush of cocaine."
Passion! Sex! Narcotics!
Why do we suspect this isn't going to end well?
Because these things are hard-wired not to last, all of them. Short shelf lives. The passion you fulfill is the passion you kill. The most wonderful, soaring feeling known to all mankind . . . amounts to no more than a narcotic high, a temporal state of mania.
"Being in love, having a crush on someone is wonderful . . . but our bodies can't be in that state all the time," says Pamela C. Regan, a professor of psychology at California State University, Los Angeles, and author of "Mind Games: A Primer on Love, Sex and Marriage." "Your body would fizzle out. As a species, we'd die."
Some of these love chemicals in the brain, scientists measure by the picogram, which is a trillionth of a gram.
How fragile, this thing called love.
* * *
Just about all writing about love stinks, maybe because so much of it begins with something like "O!" or maybe because people are (a) in love when they write it, which makes for a lot of senseless mooning the rest of us couldn't care less about; or (b) they have just been Kicked to the Curb of Romance, in which case they would rather be pinned to an insect board and labeled than live another minute on this godawful Planet of Hate.
Sigh.
Stendhal was onto something in the 19th century when he observed that "The pleasures of love are always in proportion to our fears," because passionate love is also partly about terror. Bill Shakespeare had it down cold, when he had Friar Laurence warn young Romeo of the perils of passion: "These violent delights have violent ends."
And did Romeo listen?
Shucks, no! Wise counsel, patience, foresight, prune juice -- who wants that ? Is there one among us who, at least once in this life, does not want to throw everything out the door and sprint to the Disco Ball of the Brain, where there are big white piles of dopamine, where a hot and sweaty Barry White is always on stage, thumping out "You're My First! My Last! My Everything!" And there's that new girl in class! Scantily clad! She's on the floor, beckoning you! Yes, Bubba, you! Out you go, and she's saying your name and her hand slips to the small of your back, and this is going to last FOREVER AND EVER!
Here it goes, a long time ago, Abelard and Heloise, two of history's most famous lovers:
Abelard to Heloise: "So intense were the fires of lust which bound me to you that I set those wretched, obscene pleasures, which we blush even to name, above God as above myself."
She to he: "Even during the celebration of the Mass, when our prayers should be purest, lewd visions of the pleasures we shared take . . . a hold on my unhappy soul."
HONEY! BABY! SWEETIE! CALL ME!
Did we mention Abelard was castrated as a result of their affair? And Heloise went off to a convent for the rest of her life? That they named their child "Astrolabe"? What people! What passion! What the hell were they thinking?
Actually they weren't, and neither are you, not really, when you fall passionately in love.
In her most recent research, Fisher and colleagues gave 32 love-struck subjects an MRI scan while they viewed a picture of their beloved.
Boy, did their brains light up!
There are two shrimp-size things on either side of your brain called the caudate nuclei. This is the gear that operates bodily movements and the body's reward system: "the mind's network for general arousal, sensations of pleasure, and the motivation to acquire rewards," Fisher writes. And when the test subjects looked at their sweeties, these things started singing "Loosen Up My Buttons" with the Pussycat Dolls!
This, then, kicked the party over to the tiny ventral tegmental area, a little peapod-size thingy that sends dopamine bopping around your head.
This is what scientists call lots of fun.
A separate study by Italian researchers several years ago showed something else.
Serotonin, another neurotransmitter in the brain associated with obsession, depression and racing thoughts, was greatly affected -- right down to the molecular level -- by romance and surging dopamine. People newly in love and people with obsessive-compulsive disorder showed the same lowered levels of the "platelet 5-HT transporter." In other words, dopamine appears to suppress serotonin, which in turn triggers obsessive-compulsive thought patterns.
You can't stop thinking about Dave. No wonder! Dave's hiding under a wet flap of cortex!
Your brain is officially in love, and it officially is driving you crazy.
Oliver Sacks, the famed neurologist and author, once cited the case of a 90-year-old woman who had suddenly become radiant, flirty, even frisky. The diagnosis: a long-delayed onset of neurosyphilis had loosed the reins on her inhibitions.
She did not want to be treated.
"What a paradox, what a cruelty, what an irony," Sacks wrote. "That inner life and imagination may lie dull and dormant unless released, awakened, by an intoxication or a disease . . . it is the very realm of Cupid and Dionysus."
* * *
Cupid can't last, you know.
Oxytocin and other chemicals kick in, running around your brain to make you bond with your lover, producing a mellower, more sustainable relationship.
Women: contented sigh. Men: light snoring.
Or, your Previously Perfect Love Pumpkin turns into possibly the most selfish, cheating, low-down dirty dog this side of Amarillo. You get dumped. This is what produces "drama."
"Drama" is not good for your "brain."
What it feels like:
A one-way ticket to the Tex-Mex Border Bar of the Mind. It's always dark in here, stinks of old cigars. The clock on the wall always reads Beer:30. Your caudate nucleus is now slouched over a bar stool in the dark. Sitting next to it is Freddy Fender.
Suddenly your brain bellows, off-key:
WASTED DAYS AND WASTED NIGHTS!
Freddy looks up from his beer.
I HAVE LEFT FOR YOU BEHIND!
Freddy throws his arm around your brain and joins in:
FOR YOU DON'T BELONG TO ME!
YOUR HEART BELONGS TO SOMEONE ELSE!
Your brain can spend entire days doing this.
This is because your brain has kicked into reverse, and love is long gone.
O!
Rejection, rage, despair!
Dopamine leaves the scene of the affair, now running off into the nucleus accumbens, the insular cortex, the lateral orbitofrontal cortex, research by Fisher and others shows. Jilted lovers' brains now light up in these areas when they look at pictures of their former flames -- this brain matter is associated with taking big risks, addiction, physical pain and obsessive-compulsive disorders. This is why, researchers theorize, people become obsessed with lost love, and are driven, in extreme cases, to stalking, suicide, homicide, rubber tubing.
Regan, the California researcher, notes that such cases are rare, and may have more to do with existing mental issues than simple unrequited love. Still, she says, passion is destined to end, whether mellowing into long-term love or blowing up on the freeway at 4 a.m. Given this, she wonders if "we do our self a disservice by glorifying passionate love so much."
"The search for eternal passion is very misguided," she says. "It's the search for the perfect high that keeps people discarding relationships right and left . You don't feel the same way you did; people want to break up, instead of seeing it as normal."
And so, alas. Even neurologists, to go with Shakespeare's priest, now tell us passion is true love's fool's gold, a flamboyant dead end on the evolutionary chain of primate happiness.
The only problem with this insight is that no one pays it any mind. Doomed passion may not make us right, and it may not even make us very happy.
It only makes us human. It only makes us who we are.
MDMA and mood disorders
http://www.sciencedirect.com/science?_ob=ArticleURL%26_udi=B6T63-4M7CMF6-1%26_user=861681%26_rdoc=1%26_fmt=%26_orig=search%26_sort=d%26view=c%26_acct=C000046147%26_version=1%26_urlVersion=0%26_userid=861681%26md5=a62148eb7055ddcf67286fc8d3eaeb15
Drug and Alcohol Dependence Volume 87, Issues 2-3 , 16 March 2007, Pages 303-311
Anxiety, depression, and behavioral symptoms of executive dysfunction in ecstasy users: Contributions of polydrug use
Krista Lisdahl Medina and Paula K. Shear
Abstract
Background Given ecstasy's (MDMA) potential serotonergic neurotoxicity, it is plausible that regular ecstasy users would have an elevated prevalence of behavioral executive dysfunction or mood symptoms. However, recent studies have found that the relationship between ecstasy use and psychological symptoms was no longer significant after controlling for marijuana use (e.g., Morgan et al., 2002). The goal of the present study was to examine the relationship between ecstasy exposure and self-reported executive functioning and psychological symptoms after controlling for gender, ethnicity, and other drug use.
Methods Data were collected from 65 men and women with a wide range of ecstasy use (including 17 marijuana-using controls). Participants were administered the Frontal Systems Behavioral Scale, State-Trait Anxiety Inventory for adults, and the Beck Depression Inventory-2nd edition.
Results Although 19–63% of the ecstasy users demonstrated clinically elevated psychological symptoms, frequency of ecstasy use did not predict the psychological symptoms. No gender differences or interactions were observed.
Conclusions These results revealed that, although ecstasy users demonstrate elevated levels of psychological symptoms and executive dysfunction, these symptoms are not statistically associated with their ecstasy consumption. Instead, other drug use (alcohol, marijuana, opioids, and inhalants) significantly predict psychological symptoms in this sample of polydrug users.
I am the very model of a psychopharmacologist
PS -- it's in the upper right hand corner of the banner ad at the top.
futz with the sound mechanism for awhile in order to get it to play
http://www.neiglobal.com/Default.aspx
I Am the Very Model of a Psychopharmacologist"
Addiction on HBO
http://www.jointogether.org/news/yourturn/announcements/2007/hbo-the-addiction-project.html
HBO's Groundbreaking 14-Part Series, The ADDICTION Project, Kicks Off March 15
"How can we comprehend the concept of a person who wants to stop doing something and cannot, despite catastrophic consequences? That is what we are up against. Some people don't want to speak about addiction, or compare it to other chronic diseases. Well, this is a disease, a treatable disease, and it needs to be understood. HBO's ADDICTION project is an initiative that will help people understand more about this illness, its advancements and how to find help."
-- Nora Volkow, MD, Director of the National Institute on Drug Abuse
Los Angeles, CA –- One in four Americans has a family member who is struggling with addiction. Over 80% of people with substance abuse or dependence disorder started using before age 18. Currently, addiction affects 22.2 million Americans. Yet only 9% are receiving the treatment they need.
In partnership with the Robert Wood Johnson Foundation, the National Institute on Drug Abuse (NIDA), and the National Institute on Alcohol Abuse and Alcoholism (NIAAA), HBO launches the ADDICTION project, an unprecedented multi-media campaign aimed at helping Americans understand addiction as a treatable brain disease, as well as spotlighting new medical advancements.
Debuting THURSDAY, MARCH 15 (9:00-10:30 p.m. ET/PT), with the centerpiece documentary ADDICTION, the series is eye-opening and ultimately hopeful, providing guidance in navigating the often confusing world of addiction treatment and recovery.
For the first time, HBO will use all of its digital platforms, including the HBO main service, multiplex channels, HBO On Demand, podcasts, web streams, and DVD sales to support a campaign that includes a 14-part documentary series, a book published by Rodale Press, four independent addiction-themed films, a robust website and a national community grassroots outreach campaign funded by the Robert Wood Johnson Foundation.
All films will initially be offered during a free HBO preview weekend from Thursday, March 15 to Sunday, March 18 in participating cable systems.
"HBO is utilizing all of its platforms to develop programming directly targeted to the various needs of the American public on this complex public health issue," says Chris Albrecht, HBO's chairman and CEO. "Our resources are committed to illuminating, demystifying and defining addiction – a problem that is riddled with misconceptions."
The ADDICTION project showcases the work of many of today's leading documentary filmmakers, including Jon Alpert; Kate Davis and David Heilbroner; Susan Froemke; Liz Garbus and Rory Kennedy; Eugene Jarecki; Barbara Kopple; Albert Maysles; D.A. Pennebaker and Chris Hegedus; and Alan and Susan Raymond.
ADDICTION brings together leading thinkers and organizations that are at the threshold of new treatments. Current advances in brain imaging science make it possible to see inside the brain of an addicted person, pinpoint the parts of the brain affected by addiction, and see how the addict's brain differs, ushering in a great many advances in medical treatment. In fact, treatments for addiction are now as effective as treatments for other chronic relapsing diseases such as diabetes, hypertension or asthma.
A candid depiction of the emotional, psychological, social and political toll that addiction takes on the country, the ADDICTION project demonstrates conclusively that the disease is treatable and shows that there are millions of Americans in long-term recovery.
Topics covered include: the nature of addiction, addiction in the workplace, and the protracted insurance battles waged by families, as well as the difficulty of finding and getting adequate treatment.
The ADDICTION project will be supported by an unprecedented 30-city nationwide community outreach campaign funded by the Robert Wood Johnson Foundation and coordinated by Join Together, Faces and Voices of Recovery, and the Community Anti-Drug Coalitions of America (CADCA).
The ADDICTION project is produced by John Hoffman and Susan Froemke and executive produced by Sheila Nevins.
NYT on insula
http://www.nytimes.com/2007/02/06/health/psychology/06brain.html?n=Top%252fNews%252fHealth%252fDiseases%252c%2520Conditions%252c%2520and%2520Health%2520Topics%252fBrain%26pagewanted=print
February 6, 2007 A Small Part of the Brain, and Its Profound Effects
By SANDRA BLAKESLEE New York Times
The recent news about smoking was sensational: some people with damage to a prune-size slab of brain tissue called the insula were able to give up cigarettes instantly.
Suppose scientists could figure out how to tweak the insula without damaging it. They might be able to create that famed and elusive free lunch — an effortless way to kick the cigarette habit.
That dream, which may not be too far off, puts the insula in the spotlight. What is the insula and how could it possibly exert such profound effects on human behavior?
According to neuroscientists who study it, the insula is a long-neglected brain region that has emerged as crucial to understanding what it feels like to be human.
They say it is the wellspring of social emotions, things like lust and disgust, pride and humiliation, guilt and atonement. It helps give rise to moral intuition, empathy and the capacity to respond emotionally to music.
Its anatomy and evolution shed light on the profound differences between humans and other animals.
The insula also reads body states like hunger and craving and helps push people into reaching for the next sandwich, cigarette or line of cocaine. So insula research offers new ways to think about treating drug addiction, alcoholism, anxiety and eating disorders.
Of course, so much about the brain remains to be discovered that the insula’s role may be a minor character in the play of the human mind. It is just now coming on stage.
The activity of the insula in so many areas is something of a puzzle. “People have had a hard time conceptualizing what the insula does,” said Dr. Martin Paulus, a psychiatrist at the University of California, San Diego.
If it does everything, what exactly is it that it does?
For example, the insula “lights up” in brain scans when people crave drugs, feel pain, anticipate pain, empathize with others, listen to jokes, see disgust on someone’s face, are shunned in a social settings, listen to music, decide not to buy an item, see someone cheat and decide to punish them, and determine degrees of preference while eating chocolate.
Damage to the insula can lead to apathy, loss of libido and an inability to tell fresh food from rotten.
The bottom line, according to Dr. Paulus and others, is that mind and body are integrated in the insula. It provides unprecedented insight into the anatomy of human emotions.
Of course, like every important brain structure, the insula — there are actually two, one on each side of the brain — does not act alone. It is part of multiple circuits.
The insula itself is a sort of receiving zone that reads the physiological state of the entire body and then generates subjective feelings that can bring about actions, like eating, that keep the body in a state of internal balance. Information from the insula is relayed to other brain structures that appear to be involved in decision making, especially the anterior cingulate and prefrontal cortices.
The insula was long ignored for two reasons, researchers said. First, because it is folded and tucked deep within the brain, scientists could not probe it with shallow electrodes. It took the invention of brain imaging techniques, such as functional magnetic resonance imaging, or fMRI, to watch it in action.
Second, the insula was “assigned to the brain’s netherworld,” said John Allman, a neuroscientist at the California Institute of Technology. It was mistakenly defined as a primitive part of the brain involved only in functions like eating and sex. Ambitious scientists studied higher, more rational parts of the brain, he said.
The insula emerged from darkness a decade ago when Antonio Damasio, a neuroscientist now at the University of Southern California, developed the so-called somatic marker hypothesis, the idea that rational thinking cannot be separated from feelings and emotions. The insula, he said, plays a starring role.
Another neuroscientist, Arthur D. Craig at the Barrow Neurological Institute in Phoenix, went on to describe exactly the circuitry that connects the body to the insula.
According to Dr. Craig, the insula receives information from receptors in the skin and internal organs. Such receptors are nerve cells that specialize in different senses. Thus there are receptors that detect heat, cold, itch, pain, taste, hunger, thirst, muscle ache, visceral sensations and so-called air hunger, the need to breathe. The sense of touch and the sense of the body’s position in space are routed to different brain regions, he said.
All mammals have insulas that read their body condition, Dr. Craig said. Information about the status of the body’s tissues and organs is carried from the receptors along distinct spinal pathways, into the brain stem and up to the posterior insula in the higher brain or cortex.
As such, all mammals have emotions, defined as sensations that provoke motivations. If an animal is hot, it seeks shade. If hungry, it looks for food. If hurt, it licks the wound.
But animals are not thought to have subjective feelings in the way that humans do, Dr. Craig said. Humans, and to a lesser degree the great apes, have evolved two innovations to their insulas that take this system of reading body states to a new level.
One involves circuitry, the other a brand new type of brain cell.
In humans, information about the body’s state takes a slightly different route inside the brain, picking up even more signals from the gut, the heart, the lungs and other internal organs. Then the human brain takes an extra step, Dr. Craig said. The information on bodily sensations is further routed to the front part of the insula, especially on the right side, which has undergone a huge expansion in humans and apes.
It is in the frontal insula, Dr. Craig said, that simple body states or sensations are recast as social emotions. A bad taste or smell is sensed in the frontal insula as disgust. A sensual touch from a loved one is transformed into delight.
The frontal insula is where people sense love and hate, gratitude and resentment, self-confidence and embarrassment, trust and distrust, empathy and contempt, approval and disdain, pride and humiliation, truthfulness and deception, atonement and guilt.
People who are better at reading these sensations — a quickened heart beat, a flushed face, slow breathing — score higher on psychological tests of empathy, researchers have found. The second major modification to the insula is a type of cell found in only humans, great apes, whales and possibly elephants, Dr. Allman said. Humans have by far the greatest number of these cells, which are called VENs, short for Von Economo neurons, named for the scientist who first described them in 1925. VENs are large cigar-shaped cells tapered at each end, and they are found exclusively in the frontal insula and anterior cingulate cortex.
Exactly what VENs are doing within this critical circuit is not yet known, Dr. Allman said. But they are in the catbird seat for turning feelings and emotions into actions and intentions.
The human insula, with its souped-up anatomy, is also important for processing events that have yet to happen, Dr. Paulus said. “When you decide to go outside on a cold day, your body gets ready before you hit the cold air,” he said. “It starts pumping blood to where you need it and adjusts your metabolism. Your insula tells you what it will feel like before you step outside.”
The same goes for drug addicts. When an addict is confronted with sights, sounds, smells, situations or other stimuli associated with drug use, the insula is activated before using the drug.
“If you give cocaine to an addict, you are affecting their brain’s reward system, but this is not what drives the person to keep using cocaine,” Dr. Paulus said. The craving is what gets people to use.
For example, smokers enjoy whole-body effects, said Nasir Naqvi, a student at the University of Iowa Medical Scientist Training Program, who was the lead author of the recent article on smoking. It is not just nicotine binding to parts of the brain, he said, but sensations — heart rate, blood pressure, a tickle in the lungs, a taste in the mouth, the position of the hands, all the rituals.
The insula’s importance makes it an ideal target for many kinds of treatment, Dr. Paulus said, including drugs and sophisticated biofeedback. But methods to quell insular activity must be approached carefully, he said. People might lose the craving to smoke, drink alcohol or take other drugs, but they could simultaneously lose interest in sex, food and work.
As clinicians explore the possibilities, Dr. Craig is thinking about the insula in grander terms.
For example, lesions in the frontal insula can wipe out the ability to appreciate the emotional content of music. It may also be involved in the human sense of the progress of time, since it can create an anticipatory signal of how people may feel as opposed to how they feel now. Intensely emotional moments can affect our sense of time. It may stand still, and that may be happening in the insula, a crossroads of time and desire.
Ergot
Latest Microgram is out:
http://www.dea.gov/programs/forensicsci/microgram/mg0107/mg0107.html
The Scientist Volume 21 Issue 2 Page 24
'Shroom Science: Safe and Effective?
Fifty years after its introduction to science, psilocybin returns to mainstream clinical research.
Glenn McGee is the director of the Alden March Bioethics Institute at Albany Medical College, where he holds the John A. Balint Endowed Chair in Medical Ethics.
gmcgee@the-scientist.com
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http://www.the-scientist.com/article/display/43641/
Are Ritalin and psilocybin equivalent in terms of effect and safety? In the August issue of Psychopharmacology, Johns Hopkins researchers published a study in which some subjects were given psilocybin and then asked to relate their experiences. Francisco Moreno of the University of Arizona published in the November issue of the Journal of Clinical Psychiatry his patients' reports that psilocybin helped them with migraine headaches. Harbor-UCLA Medical Center psychiatrist Charles Grob told the Chronicle of Higher Education that he is giving the compound to patients dying of cancer to see whether it eases pain by relieving anxiety.
The study of so-called magic mushrooms isn't new; it could be argued that it is celebrating its 50th anniversary this year. It began, as best anyone can tell, when Wall Street banker R. Gordon Wasson documented his trip to a healer in Oaxaca, Mexico, whose brew, he claimed, enabled him to see the reality of ideas and concepts. His 1957 essay in Life magazine excited the imaginations of scientists around the world. Sandoz patented the two active chemicals in the mushrooms, calling the compounds psilocin and psilocybin. Chaos ensued as researchers struggled to do excellent scientific work using a family of substances whose effects - to put it mildly - were not easily measurable using the tools of the time.
The scientists who used psilocybin in their research in the 1960s poked at the nature of consciousness, but this particular compound just refused to be caged by ordinary scientific conventions. Paper after paper stabbed at descriptions of the effects and utility of psilocybin, but scalar measures of transcendence just could not capture its effects, or side effects. A few of the leading scientists engaged in its study, most notoriously Harvard psychologist Timothy Leary, simply abandoned the strictures of scientific research as insufficient to grasp the power of psilocybin.
By the time the FDA banned hallucinogenic drugs in 1970, the majority of those experimenting with mushrooms were not in universities. Hallucinogens became part of a counterculture that aged quickly. By the 1980s, the next counterculture devoted to brain modification was moving in a completely different direction, experimenting with highly addictive stimulants, such as cocaine, which assist in thinking faster, concentrating harder, and intensifying ordinary experiences.
Time passes, and what's old becomes new again. In 2007 millions of people take legal stimulants and antidepressants. A decades-long quest for endless work capacity, unfettered concentration, and happiness on-demand has perhaps hastened the return of those who wonder whether the touch of transcendence could provide new insights into treating the maladies that have become rampant in our time. And indeed, new studies suggest that psilocybin may offer hope in treating a few of them, ranging from obsessive-compulsive disorder to rampant addiction.
With the dramatically enhanced ability of neural imaging to identify changes in brain state, and advances in the genetics of neuroscience, it is no wonder that some of those who researched psilocybin in the 1970s have begun to point again to the potential of that compound. Magic mushrooms are not addictive and have been around more than half a century. So should we really be worried about the potential that new research will lead a new generation to "turn on, tune in, and drop out"? Yes.
Ethics committees examining the research programs underway with hallucinogens need to be mindful that what sparked the widespread illegal use of psilocybin in the 1970s was not its mystical power but the reports of its safety and efficacy coming out of the leading institutions of higher learning in the United States. Scientists are acting with great care this time around, but let's avoid a bad trip.
Hallucinogens have not been scientifically demonstrated to be either safe or effective enough to be used in the treatment of any disease. Studies of them should be undertaken only when investigators avoid sending subtle messages about the safety or delight of chewing on backyard mushrooms. For example, in the Hopkins study subjects were given either Ritalin or psilocybin, sending the terribly premature message that the two substances are in any sense equivalent in terms of effect or safety. It would have been much better to compare psilocybin with, well, anything other than a compound prescribed to tens of millions and often abused by those seeking better cognition.
Thankfully that study was all but ignored by the media. When it comes to hallucinogens, if the research sends the wrong message, drop it. Or rather, don't.
Comment on this article
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comment: Shrooms and science, pain and ethics by Tom DiStefano
[Comment posted 2007-02-02 15:06:37]
You want a bad trip? Try a headache syndrome so severe sufferers sometimes commit suicide to escape the recurring pain... THAT’s a bad trip.
Cluster headache sufferers have found psilocybin and other tryptamine hallucinogens to be extradordinarily effective at relieveing cluster headache attacks and cycles, and a case review study by John Halpern and Andrew Sewell at McLean determined more research is warranted. Not yet proven, but that’s just a matter of time and money. I am personally sure tryptamines have saved me from a life of misery.
Should your speculative fears prevent the millions of cluster headache sufferers around the world from finding relief from one of the worst pain sysndromes known to medicine? Wrap your ethics around that one.
By they way, “magic mushroom” have been around for much longer than half a century, I would assume, and some anthopologists say humans have been using them since pre-history, for spirtual exploration as well as, yes, headache relief. They seem to work on migraines, too, and at subhallucinogenic dosages.
I’m not sure what you mean in your criticism of using Ritalin as the placebo. If you meant that psilocybin is much safer than Ritalin, you would probably be right. And what would you use as a placebo for a hallucinogen?
Tom DiStefano Clarion, PA
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comment: Mistakes abound in this piece by One who knows that facts are more imporant than pseudo-ethics
[Comment posted 2007-02-02 21:33:49]
What we find above has some useful advice but mostly it strays far and wide from the author's stated work as an ethicist into a mere piece of opinion and one that is not based on the principles of medical ethics and research.
To wit: 1. There is zero factual proof to support the goofy claim that it was research results claiming safety that drove vast uncontrolled illicit use of hallucinogens in the 1970's or in any decade. Is this ethicist also claiming that we have a rampant abuse of cocaine or methamphetamine in the United States because both of these drugs also remain Schedule II prescription medications? This is a shameful failure of fact checking on the author's part.
2. The FDA has NEVER banned hallucinogens. Should the author have any expert credentials in medical research of drugs of abuse he would be aware that it is the DEA that places substances in the Scheduling system of the Controlled Substances Act and NOT the FDA. Moreover, placement in Schedule I is not a ban. The law specifically states that drugs in Schedule I are "approved for research use only." The world is not flat, Mr. McGee, though you apparently wish to foist your opinion on us in place of fact.
3. He writes, as well that "Studies of them [hallucinogens] should be undertaken only when investigators avoid sending subtle messages about the safety or delight of chewing on backyard mushrooms." This statement alone should make us all marvel how someone so esteemed as to sit as Chair of Medical Ethics for an American medical school could stray so far from the actual debate of potential risks and benefits that are used to deduce whether a study is in the public interest and should proceed. The behavior that is cautioned against - the promotion of a drug - any drug - before empirical evidence has been published in peer-reviewed medical journals is without doubt unethical and could open up a researcher to censure if not worse. However this swipe taken in this piece is even more unethical as it hides from the reader the true issues that are weighed on moving forward or not with research. We should not subject credible medical research to some litmus test to be vetted by pointy heads like this guy. We need medical research to rise or fall on the methodology. Methodology that can be read and replicated by even skeptics like Mr. McGee because the truth is in the facts as found by the science. These polemics are harmful to the ongoing protection of sound medical research.
4. the comments about psilocybin and ritalin reveal a person who comments before either reading the primary text or who doesn't understand the reseach conducted. it is Mr. McGee who distorts what methylphenidate (ritalin) was used for and it was used for research and not trying to equate ritalin and psilocybin. This is Mr. McGee's thoughts and not the authors of that study! He promotes then exactly what he complains about - because it is his creation to begin with.
5. Finally, the media will ignore this column of ignorance but the media DEFINITELY covered the Hopkins study he writes as "thankfully" not covered. That paper has been publicized all over the world in thousands of papers. Had Mr. McGee bothered to google, he would see 30,000 plus distinct entries. Or just take a peak at the competing Discover Magazine. Their January 2007 issue list "The Top 100 Science Stories of 2006" with the Hopkins psilocybin study ranked #49:
http://www.discover.com/issues/jan-07/cover/?page=2 So... I agree with the conclusion: "Drop it" Mr. McGee as you don't know what you write. Or don't drop it and still be irrelevant to what is in fact important in the discovery process for medical reseach.
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comment: psilocybin mushrooms: no evidence of substantial risk by Jeffrey Ustaath
[Comment posted 2007-02-02 21:36:19]
McGee writes, "For example, in the Hopkins study subjects were given either Ritalin or psilocybin, sending the terribly premature message that the two substances are in any sense equivalent in terms of effect or safety."
The study sent no such message. Some control substance had to be chosen, and I believe ritalin was a good choice. What would you have proposed as an alternative?
The Hopkins experiment received a great deal of positive publicity, and reports about it have appeared in the Economist, Washington Post, Wall Street Journal, LA Times, and ABC News.
Our society has established a baseline of acceptable risk by legalizing nicotine and alcohol. Thousands of people die every year by consuming both substances. I have yet to hear of a single psilocybin related death. Review of causes of death alone shows, in my opinion, that consumption of psilocybin mushrooms poses no more risk than consuming the edible culinary variety.
The idea that people consumed psychoactives in the seventies because scientists gave it the green light is absurd. Study after study show that people consume psychoactives regardless of what authority figures, be they politicians, academicians, or police, say about it. You appear to be advocating that scientific studies that show psychedelics to be relatively safe should be kept from the public view.
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comment: Replies to the First Volley of Comments [From Glenn McGee] by Press Pass
[Comment posted 2007-02-03 14:42:11]
Reply to Tom DiStefano: There is no question that cluster headaches warrant research including the surveillance of the use of psilocybin by sufferers that was conducted, and additional clinical research using the same compound. The point was that "Studies of [the substance] should be undertaken only when investigators avoid sending subtle messages about the safety or delight of chewing on backyard mushrooms." I didn't make a claim about the etymology of the term magic mushroom. And the point about Ritalin was not that it was an inappropriate placebo or inappropriate for use in any form of comparative research from a scientific standpoint. The point was sociological, that the choice of this particularl substance sent the "terribly premature message that the two substances are in any sense equivalent in terms of effect or safety. It would have been much better to compare psilocybin with, well, anything other than a compound prescribed to tens of millions and often abused by those seeking better cognition." I stand by the comment.
Reply to "One who knows..." [anonymous flame comment]: 1) "proof to support claim..." - I didn't make this claim. The point was that the research conducted on these substances morphed into a kind of pseudoscience that then very obviously and by all accounts became a social phenomenon. 2) FDA did in fact issue statements on the use of halucinogens in research. Wrong again. I said nothing about Schedule I or the DEA because it isn't germaine. Whether the world is flat or not.
3) I can't find a claim in this sophistry. If the point is that there is some sort of inappropriate precaution inherent in my claim that investigators should be careful (mindful of history) with regard to how the public will understand research involving hallucinogens, then there's no support for that claim in the comment.
4) There was no comment in the piece about the purpose of use of ritalin as control to the effect that the idea of the study was to compare them. The point was sociological and you don't need to be an ethicist to see the reason it is of concern. There were dozens of other available controls and the message sent in the work is obvious and I am not the only one who has noticed it.
5) It is true that after I authored the column, Discover ranked the study #49. It is also the case that one can find 30,000 entries if one uses Hopkins and psilocybin into Google. But again I am not the only one who has noticed - in fact study of the phenomenon has been conducted - that the Hopkins study did not receive much media attention. Which remains true unless you think that this notation in Discover pushes it into the real limelight.
Reply to Jeffrey Ustaah: Mr. Ustaah, who promotes the recreational use of mushrooms on his blog, offers up the same claim concerning that ritalin was a good choice (dealt with above) and that there was loads of coverage of the Hopkins study (run a Lexis comparison between this study and any major piece from the past year; the point at any rate was that there has not been a public backlash grounded in irrational fears of the Hopkins research, not that Hopkins' research was somehow irrelevant. I am surprised that Mr. Ustaah believes that it is as safe to use psilocybin mushrooms as to eat the "edible culinary variety," because not only is this false it is rejected by the most ardent advocates of mushroom experimentation as a comparator. And finally claim that Mr. Ustaah makes to the effect that people who consume psychoactives in a social vacuum is preposterous and there is no citation to a study to ground the claim.
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comment: Response to Dr. McGee from Ustaath by Jeffrey Ustaath
[Comment posted 2007-02-04 15:10:25]
Dr. McGee writes:
"Mr. Ustaah, who promotes the recreational use of mushrooms on his blog,"
My blog www.consciousnesscafe.org only promotes the dissemination of information regarding consciousness and its study in all its forms. I offer information related to psychedelic culture and its history.
I have never advocated "recreational use" of mushrooms and personally find this characterization of the psychedelic community as a whole a misrepresentation. The psychedelic community often regards psilocybin mushrooms as a sacred sacrament and a means of communication with divinity.
I regard the consumption of psilocybin mushrooms within a clearly established system of religious faith to be a religious practice and covered as such by the First Amendment within the United States.
I have never advocated consumption of psilocybin mushrooms as a recreation, and would regard that as a desecration to those for whom psilocybin mushrooms comprise a vehicle for the Divine.
Ustaath
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comment: Ethnocentrism Alert! by Bruce Gould
[Comment posted 2007-02-04 15:11:01]
There's a very subtle touch of ethnocentrism in this article -
"The study of so-called magic mushrooms isn't new; it could be argued that it is celebrating its 50th anniversary this year. It began, as best anyone can tell, when Wall Street banker R. Gordon Wasson documented his trip to a
healer in Oaxaca, Mexico, whose brew, he claimed, enabled him to see the reality of ideas and concepts."
Didn't the natives in Mexico study mushrooms? Things don't _really_ exist until we westerners notice! Now, of course they mean _scientific_ study, but even in that light - Wasson wasn't a psychologist or biochemist, he was an amateur mycologist - why would his experience count any more than that of the Oaxacan healers?
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comment: He still doesn't know what he writes by One who knows that facts are more imporant than pseudo-ethics
[Comment posted 2007-02-04 15:19:46]
Gleeful McGee can't admit a mistake. 1.He fails to acknowledge that he wrote, completely in error, that the "FDA banned hallucinogenic drugs in 1970." They never did.
2. Mr. McGee is a Ph.D. and not weighted down by the heavy burden of being a physician or clinical medicine researcher. That is why he wastes his breath waxing on and on about the choice of ritalin and its impact on greater society. Hogwash. This is about clinical research Mr. McGee and not about further messages you wish to extrude from the study that are extraneous to the needs of the study. You don't like the choice of ritalin? fine... you can do your study... but, oh, wait... that's right, you just prefer to be a backseat driver with your complaints... you don't have the skillset to do any of this work... Correct? Or are you planning to go to medical school now, too? These researchers have an obligation to do the very best study possible and your issues of impact on society are not directly relevant. They are made up by you for an opinion column.
3. McGee thinks that the social upheaval of the 60's on forward occured because LSD and other hallucinogens escaped the lab and were promoted as well by unscrupulous researchers. This is a simplistic history and a flawed one at best. Back then, btw, people blamed these drugs for the loss of conformity and resultant problems of the environmental movement, the anti-war movement, the civil rights movement, and the women's liberation movement. Ah, if only we could have put this genie back in the bottle because what happened was all so bad, bad, bad... Has this guy even heard of MKUltra? Who did those experiments? Who paid for them? He just doesn't know what he writes. Read the Church Commission.
4. In July, when the Hopkins study came out, and before this present stupid piece got published, articles appeared in the: L.A. Times, the Wall Street Journal, The Independent (England), the Times (London), the Daily Record (England), the Atlanta Journal-Constitution, the Hobart Mercury (Australia), Canberra Times (Australia), Sydney MX (Australia), The Age (Australia), the Gold Coast Bulletin (Australia), Manila Times, the Hindustan Times (India), the Houston Chronicle, the Boston Globe, the Toronto Star, the Vancouver Sun, the Edmonton Journal (Canada), the South China Morning Post, the San Francisco Chronicle, the Nation, the Irish Times, the Belfast Telegraph, the San Diego Union-Tribune, the Baltimore Sun, New York Newsday, the Hartford Courant and 100's of other local papers because an article was written for and posted by the AP Wire...
Then there is an article appearing in the July 15th edition of the Economist (The God Pill; Psychedelic Drugs) - but maybe an article in the Economist printed all over the world isn't major enough press... Well, how about an article in December in the Chronicle for Higher Education? McGee might read that...
articles also appeared in professional magazines/newsletters including: Pharma Investments, Ventures & Law; Medical Imaging Week; Life Science Weekly; Drug Week; Mental Health Business Week; Hospital & Nursing Home Week; Physician Law Weekly; World Disease Weekly; Mental Health Weekly Digest; Pain & Central Nervous System Week; Health & Medicine Week; Telemedicine Law Weekly; Medical Imaging Business Week; State & Local Health Law Weekly; Telemedicine Business Week; Medical Imaging Law Weekly; Pharma Law Weekly; Telemedicine Week; Biotech Business Week and Science Letter.
Other news wire services in addition to the AP Wire include: the AP Worldstream; the AP State & Local Wire; the AP Online; University Wire (resulting in articles in college newspapers everywhere); The Religion News Service (an important article written by religion scholar Huston Smith); Press Association; oh the ever so small UPI; US States News; and Ascribe Newswire.
TV coverage included news programs on CTV (Canada), CBS, and ABC. Countless major websites also posted articles - Forbes.com; sciencenews.org; wikipedia.org; answers.com; FoxNews.com; and many, many more.
Above isn't meant to be comprehensive but I did find all this within 10 minutes of searching and it proves that the Hopkins article got a tremendous amount of news coverage... maybe you need to adjust your aerial antenna up in Albany Mr. McGee.
5. "I am not the only one to notice" - I say notice how Mr. McGee runs from fact to hide behind his circle of friends who didn't notice the piece either. Totally weak to offer that up as some sort of defense of your lack of homework for this column.
6. It is crucially important that readers understand that Mr. McGee is without any clinical medical credentials. He has no direct experience prescribing medications or in the practice of medicine, in general. He refers to me as an "annonymous flame comment" and very much am I glad to pierce this hot air balloon annonymously. Look how McGee uses libel to go after Jeffrey Ustaah! I mean if McGee can't defend his facts, let's watch him obfuscate his failures by going on the offensive and distort what others do. Hardly becoming of one trained in philosophy but there you have it.
7. It remains obvious to careful readers that McGee does not know of what he speaks in this particular column. How dare he continue to hold up his litmus test of restricting free speech on the backs of suffering cluster patients. Moreover, he clearly states that none of the current crop of researchers are committing these offenses he speaks of so his warnings are perhaps more for himself. Maybe he wants to generate more attention for himself so that a few more of his books might sell. The Scientist would do well to either hire a new columnist or a better editor to keep the excesses of this man in check. You failed here Mr. McGee... teach your mistakes to your students as well please.
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comment: Shroom Science by Bruce Sewick
[Comment posted 2007-02-04 15:20:05]
One way to consider safety is to look at the ratio of effective dose to lethal dose
http://www.americanscientist.org/template/AssetDetail/assetid/50773?%26print=yes%2350979
Psilocybin has an effective dose to lethal dose of 1 to 1000! Certainly safer than many other substances like alcohol for example. LSD, Psilocybin and Marijuana are three of the safest substances listed in the chart!
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comment: glaring errors by Lux
[Comment posted 2007-02-04 15:20:43]
Of the many substantively misinformed claims in this opinion piece, two errors are so glaring that I can't let them pass without comment.
1) As explained in the Psychopharmacology article, the use of methylphenidate as an active placebo was a deliberate decision made for sound methodological reasons. The issue was one of preserving the integrity of the double-blind in the study in order to control for expectancy effects. If the author of this piece had bothered to read any of the four commentaries simultaneously published with the Psychopharmacology article, he would have seen that several distinguished researchers praised the wisdom and effectiveness of using methylphenidate as a control substance. Its mild physical symptoms were so effective and effects that could be mistaken for the influence of psilocybin that a full 22% of the double-blind placebo sessions were mistaken by the trained session monitors for psilocybin sessions. This is one of the conspicuous triumphs of the study.
Beyond this, the suggestion that drug research in any way explicitly or implicitly implies an equivalence of safety and efficacy between the test compound and comparison substance is so absurd that I wonder if the author has a basic understanding of research methodology. If this contention is accurate, then pharmaceutical companies are sending a dangerous message that experimental drugs are as safe and effective as sugar pills.
2) The author's contention that this study did not receive much media attention is simply false. This study was not only covered in a detailed piece by the AP, but independently covered by dozens of media outlets including the Wall Street Journal, The Economist, the Japan Times, the LA Times, Forbes, and New Scientist magazine. In addition, this story was the headline entry on the CNN Science page for days after it was written.
In addition to these glaring faults, I notice that the author lets pass without comment the stunning findings of the study, in which 66% of the subjects in a two-month follow up reported their experience with psilocybin as one of the most important experiences of their lives, on the same scale as the birth of a child. Perhaps these remarkable findings warrant a reassessment of the author's concerns regarding the dangers of the use of serotonergic hallucinogens.
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comment: everything else aside this statement alone shows how misguided the author is. by sambo
[Comment posted 2007-02-04 15:21:08]
"It would have been much better to compare psilocybin with, well, anything other than a compound prescribed to tens of millions and often abused by those seeking better cognition"
I have only one question. How does one "seek better cognition" and or what does that exactly entail. I personally suffer from cluster headaches and ADHD and I think using ritalin in these placebos is a great call on the part of the doctors for many reasons.
Drugs in Cyberspace
Organization of American States report
"Drugs in Cyberspace"
(look at the bottom group of reports)
http://www.cicad.oas.org/Reduccion_Oferta/ENG/Reference.asp
Also....
DHHS webcast entitled "Drugs in Cyberspace".
http://ncadi.samhsa.gov/multimedia/webcasts/w.aspx?ID=465
Microgram and Ergot
Latest Microgram is out:
http://www.dea.gov/programs/forensicsci/microgram/mg0107/mg0107.html
with this interested article noted:
http://www.ajpe.org/aj7005/aj700598/aj700598.pdf
Ergot and Its Alkaloids
Paul L. Schiff PhD School of Pharmacy, University of Pittsburgh
ABSTRACT
This manuscript reviews the history and pharmacognosy of ergot, and describes the isolation/preparation, chemistry, pharmacodynamics, and pharmacotherapeutics of the major ergot alkaloids and their derivatives.
A brief discussion of the hallucinogenic properties of lysergic acid diethylamide is also featured.
An abbreviated form of the material found in this paper is presented in a 4-hour didactic format to third-professional year PharmD students as part of their study of vascular migraine headaches, Parkinson's disease, and naturally occurring hallucinogens/hallucinogen derivatives in the modular course offering Neurology/Psychiatry.
insula and ego
http://www.sciam.com/article.cfm?chanID=sa003%26articleID=5A961D91-E7F2-99DF-3CCCA8DBF29BBC74
January 25, 2007 Stroke Damage May Help Smokers Kick the Habit The insula, an area of the brain largely ignored by researchers, may hold the key to breaking harmful addictions A patient who damaged his left insula, a region of the brain located deep within the cortex on either lateral side, may have opened the door to kick the habit without even trying. The day after suffering a stroke the 38-year-old man, who had a 40-cigarette-a-day addiction, reported to doctors that his "body forgot the urge to smoke." This revelation prompted a study that found the insula is intimately linked to smoking addiction.
In fact, the authors report in Science this week that damage to that region is 136 times more likely to result in a "disruption of smoking addiction"—defined as the ability to quit easily without relapse—than injury to other parts of the brain.
"Finding the insula may not be surprising in a way, because there was knowledge that preceded that and it makes sense," says senior study author Antoine Bechara, a neuroscientist at the University of Southern California and the University of Iowa's Carver College of Medicine. "But, it's surprising in another way because nobody was looking there."
The insula has long been associated with conscious urges and visceral sensations. According to Steven Grant, a researcher at the National Institutes of Health's National Institute on Drug Abuse, it is also believed to act as a sensory receptor for the internal organs, perhaps remembering the way something tastes or if it upsets the stomach. During imaging studies probing the causes of addiction, the insula often was activated when drug abusers were shown movies of others taking drugs or shown pictures of cocaine, heroin or nicotine.
But until now researchers had ignored the silver dollar–size region because it was not implicated in reinforcement pathways and did not affect the signaling of dopamine, the neurotransmitter associated with motivation and pleasure.
Bechara and his team studied 69 stroke patients culled from a registry at the University of Iowa that was assembled to study the effect of brain damage on cognition, memory and motion; they selected subjects who, at the time of their strokes, had been smoking at least five cigarettes daily for more than two years. Of this group, 19 patients had suffered damage to either their right or left insula.
Twelve of the 19 patients with insula damage reported a sudden end to their smoking habit, and none had relapsed over the past year. While many other stroke victims had also quit smoking, most of them cited health reasons such as fear of another stroke for doing so. "This is not a 100 percent proof, not every single insula damaged caused the disruption and vice versa," Berecha points out. "There was damage in things that did not involve the insula and there was a disruption of addiction" as well as people who suffered insula damage but did not suddenly stop smoking.
Berecha speculates that these disparities may be caused due to some gender differences in the way the brain is wired. He points to studies that found diminished decision-making capacity in women with damage to their left prefrontal cortex and men with injuries to their right side, but not vice versa. He notes, however, that the sample size in this study was not enough to draw those sorts of conclusions.
Still, Grant believes the study points to the insula as key to addiction. "It really now calls upon the research field to start focusing on this area," he says, "to look at drug effects in this area, to look at the types of changes that go on during addiction in this area, to understand what the basic function of this area is and why it would be important in this kind of context."
Berecha also believes that the insula may also play a role in other addictions such as alcoholism, drug abuse and compulsive eating. While inducing a stroke clearly is not the answer, Berecha says that safe therapies designed to disrupt the insula's activity may eventually be able to help people at least quit smoking.
MPTP and acupuncture
This article shows that acupuncture can significantly reduce the neurotoxic effects of a pharmacological agent!
What does this suggest about preventing "neurotoxicity" from MDMA?
[For those of you who are not scientists: Parkinson's disease is caused by a deficit of dopamine in certain parts of the brain, like the striatum and the substantia nigra. MPTP is a neurotoxin that decreases dopamine, and thus produces Parkinson-like effects. (You may recall MPTP because it was an impurity in a meperidine analog decades back that caused severe movement disorders in opioid addicts.) Tyrosine hydroxylase is the first enzyme needed to convert the amino acid tyrosine into dopamine. COX-2 is a mediator of inflammation.]
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Brain Research Volume 1131, Issue 1, 2 February 2007, Pages 211-219 Acupuncture inhibits microglial activation and inflammatory events in the MPTP-induced mouse model
Jun Mo Kang, Hi Joon Park, Yeong Gon Choi, Il Hwan Choe, Jae Hyun Park, Yong Sik Kim and Sabina Lim
Abstract
Using a mouse model of MPTP-induced Parkinson’s disease (PD), this study investigated on the neuroprotective effects of acupuncture by examining whether acupuncture contributed to inhibiting microglial activation and inflammatory events.
C57BL/6 mice were treated with MPTP (30 mg/kg, i.p.) for 5 consecutive days.
Acupuncture was then applied to acupoints Yanglingquan (GB34) and Taichong (LR3) starting 2 h after the first MPTP administration and then at 48 h intervals until the mice were sacrificed for analyses at 1, 3, and 7 days after the last MPTP injection.
These experiments demonstrated that acupuncture inhibited the decreased of the tyrosine hydroxylase (TH) immunoreactivity (IR) and generated a neuroprotective effects in the striatum (ST) and the substantia nigra (SN) on days 1, 3, and 7 post-MPTP injections.
Acupuncture attenuated the increase of macrophage antigen complex-1 (MAC-1), a marker of microglial activation, at 1 and 3 days and reduced the increases in cyclooxygenase-2 (COX-2) and inducible nitric oxide synthase (iNOS) expression on days 1, 3, and 7.
In MPTP group, striatal dopamine (DA) was measured by 46% at 7 days, whereas DA in the acupuncture group was 78%.
On the basis of these results, we suggest that acupuncture could be used as a neuroprotective intervention for the purpose of inhibiting microglial activation and inflammatory events in PD.
http://www.sciencedirect.com/science?_ob=ArticleURL%26_udi=B6SYR-4MK0HX5-9%26_user=861681%26_coverDate=02%252F02%252F2007%26_rdoc=25%26_fmt=full%26_orig=browse%26_srch=doc-info(%2523toc%25234841%25232007%2523988689998%2523641121%2523FLA%2523display%2523Volume)%26_cdi=4841%26_sort=d%26_docanchor=%26_ct=28%26_acct=C000046147%26_version=1%26_urlVersion=0%26_userid=861681%26md5=1d79da6ae344cac9376acd48f81e49d3
US military and drug war
http://www.latimes.com/news/nationworld/nation/la-na-drugwar22jan22,0,7593287.story?coll=la-home-headlines
Burdened U.S. military cuts role in drug war Air and sea patrolling is slashed on southern smuggling routes. By Josh Meyer LA Times Staff Writer
January 22, 2007
WASHINGTON — Stretched thin from fighting in Iraq and Afghanistan, the U.S. military has sharply reduced its role in the war on drugs, leaving significant gaps in the nation's narcotics interdiction efforts.
Since 1989, Congress has directed the Pentagon to be the lead federal agency in detecting and monitoring illegal narcotics shipments headed to the United States by air and sea and in supporting Coast Guard efforts to intercept them. In the early 1990s, at the height of the drug war, U.S. military planes and boats filled the southern skies and waters in search of cocaine-laden vessels coming from Colombia and elsewhere in South America.
But since 2002, the military has withdrawn many of those resources, according to more than a dozen current and former counter-narcotics officials, as well as a review of congressional, military and Homeland Security documents.
Internal records show that in the last four years the Pentagon has reduced by more than 62% its surveillance flight-hours over Caribbean and Pacific Ocean routes that are used to smuggle cocaine, marijuana and, increasingly, Colombian-produced heroin. At the same time, the Navy is deploying one-third fewer patrol boats in search of smugglers.
The Defense Department also plans to withdraw as many as 10 Black Hawk helicopters that have been used by a multi-agency task force to move quickly to make drug seizures and arrests in the Caribbean, a major hub for drugs heading to the United States.
And the military has deactivated many of the high-tech surveillance "aerostats," or radar balloons, that once guarded the entire southern border, saying it lacks the funds to restore and maintain them.
The Department of Defense defended its policy shift in a budget document sent to Congress in October: "The DOD position is that detecting drug trafficking is a lower priority than supporting our service members on ongoing combat missions."
Members of Congress and drug-control officials have said the Pentagon's cuts and redeployments have hamstrung the U.S. drug interdiction effort at a time when an estimated 1,000 metric tons of inexpensive, high-quality cocaine is entering the country each year.
It's hard to gauge the precise effect of the pullback because authorities say they only know the amount of narcotics they are seizing, not how much is getting through — especially with fewer surveillance planes and boats to gather intelligence.
In the budget report to Congress, the Pentagon estimated recently that it detected only 22% of the "actionable maritime events" in fiscal 2006 because it "lacks the optimal number of assets."
Even when they did detect suspected smuggling vessels, U.S. authorities had to let one in every five go because they lacked the resources to chase them, Pentagon officials conceded in their report.
"We have not stopped trying to fix that gap. We're very much concerned about it, and working very hard to try and fix these problems," Edward Frothingham III, acting deputy assistant Defense secretary for counter-narcotics, said in an interview. "DOD is in no way lessening our support" for the war on drugs, he said. "But in the post-9/11 world, some of these assets are needed elsewhere."
With Pentagon support dropping, the Coast Guard and other Homeland Security agencies such as U.S. Customs and Border Protection are trying to play a greater role in the interdiction effort. But current and former officials within those agencies say they do not have the resources to do the job because they, too, have had to dramatically redistribute resources since the sweeping post-Sept. 11 reorganization that made Homeland Security the front line in keeping terrorists out of the United States.
"I can't stand here and tell you drugs aren't coming into the U.S. by sea. It happens," said Cmdr. Jeff Carter, a Coast Guard spokesman. "There are huge challenges, but we are making a dent."
(The Justice Department, through the FBI and Drug Enforcement Administration, also has a central role in the drug war, but it is more focused on arresting narcotics traffickers in the U.S. than on interdiction.)
The cutbacks continue at a time when the Pentagon has officially reclassified the drug interdiction effort as part of the broader war on terrorism, citing intelligence showing growing ties among terrorists, drug dealers and organized-crime syndicates.
"In the post-9/11 world, where both securing and detecting threats to our nation's borders have become critical national security objectives, we cannot continue to neglect the fact that narco-traffickers are breaching our borders on a daily basis," according to a report that was quietly issued last month by the House Subcommittee on Criminal Justice, Drug Policy and Human Resources.
At a November 2005 hearing before another House subcommittee, Rep. Dan Burton (R-Ind.) said the lack of available military assets and the amount of drugs getting through "just boggled my mind."
"The spike in narcotics shipments via Central America we ignore at our own peril," said Burton, who at the time was chairman of the international relations subcommittee on the Western Hemisphere. "They could be carrying weapons, terrorists and other things that could destroy not only the youth of America, but American cities."
The weakening of the U.S. drug interdiction effort comes just as U.S. authorities have had some major successes in the drug war, led by the Pentagon's Joint Interagency Task Force-South, based on Key West, Fla. Authorities have seized increasing amounts of cocaine since 2001, including a record 300,000 pounds in 2005, although records show that seizures dropped off sharply in 2006, to 230,000 pounds.
Counter-narcotics officials, including some in the Pentagon, acknowledge that the large recent seizures are only masking more fundamental problems caused by the sharp decline in drug interdiction assets.
The recent successes were due in part to improved interagency cooperation and U.S. efforts to bolster the Colombian government's counter-narcotics program. They were also aided by a windfall of intelligence gained from a program known as Operation Panama Express, which allowed authorities to pinpoint major shipments of drugs, documents show. That intelligence has largely dried up as Colombian drug lords have tightened their operational security, making the Pentagon's detection and monitoring assets in the so-called transit zones ever more crucial, according to U.S. documents and officials.
"What you've had is a significant downsizing of the counter-narcotics effort in the transit zones, and that has very direct national security implications," said Robert B. Charles, assistant secretary of State for international narcotics and law enforcement affairs from 2003 to 2005. He said the loss of resources threatened to "consign future generations of young Americans to a deluge of cocaine and heroin."
Perhaps the most important link in the drug interdiction chain is the Pentagon's aerial patrols. Without them, a U.S. military ship can detect only about one out of every 10 suspected drug vessels (one out of five if the ship has a helicopter on board), according to statistics from the Joint Interagency Task Force-South. With the planes, whose radars can cover hundreds of miles, the military's odds improve to seven out of 10.
Department of Defense aerial patrol-hours in the transit zones declined from 6,062 hours in fiscal 2002 to a low of 1,432 in 2005. They rose to 2,296 in the most recent fiscal year, which ended in October, but since then, the Pentagon has grounded much of its fleet of P-3s for long stretches because of a lack of pilots, money for flying time or maintenance issues, documents show.
Military officials say the aerial surveillance situation is dire, and likely to get much worse. That's because most of the Pentagon's drug planes are Vietnam-era P-3s that were mothballed for years before being brought back into service for the drug war. Many of them have been redeployed to war zones or for use in counter-terrorism operations, Frothingham said. Those remaining have such severe wing corrosion that they're in the shop much of the time, U.S. documents and officials say. Many of them have no working radar. But their replacements won't be ready until at least 2012.
The Pentagon has also redirected other planes used to spot smugglers — including fighter jets and high-flying reconnaissance planes — toward other missions, and turned down requests to use unmanned drones in the drug war.
Things aren't much better at sea, where there is a continuing lack of Navy resources to intercept drug runners who are using "go fast" multi-engine boats that are often 40 feet long, travel at up to 40 knots, and can carry several tons of cocaine.
In the Eastern Pacific transit area, four U.S. ships are dedicated to patrolling an area larger than the continental United States.
Two years ago, U.S. authorities discovered that smugglers were easily avoiding military boats by navigating far into the eastern Pacific Ocean with the help of at-sea refueling vessels. In comparison, for every four days of patrol, U.S. military ships spend an average of eight days traveling to and from the transit zone to refuel, said Rear Adm. Jeffrey J. Hathaway, director of the JIATF-South.
Frothingham's tiny counter-narcotics office at the Pentagon is still looking for a solution because the department's leadership won't commit military tankers for the task. A senior Pentagon budget official said the British government recently pledged to provide a tanker in the Pacific, but only temporarily.
Homeland Security agencies, the Coast Guard in particular, have moved boats and planes to the region to intercept smugglers, but documents show that in most cases, the U.S. presence remains far below what it was before Sept. 11, 2001.
In May, the Pentagon decided to withdraw its Caribbean-based Black Hawk helicopters for use elsewhere.
The Justice Department protested, calling the helicopters a linchpin in the U.S. counter-drug effort because they ferried law enforcement agents among the thousands of islands that cocaine traffickers use as transshipment points.
That opposition has pushed back the withdrawal of the Black Hawks until October, but counter-narcotics officials say the larger problem is that no other agency has received funding to keep them operating.
As the U.S. fortifies its border with Mexico, counter-narcotics officials warn that smugglers could simply move east and penetrate the vast Gulf Coast.
In response to such threats, various U.S. agencies had for years been using radar-equipped tethered aerostats to provide continuous and long-range monitoring of smugglers by land, air and sea.
The Pentagon took over the Tethered Aerostat Radar System, or TARS, in 1992 and shut down three of the balloons in the Bahamas in 1994.
Then, in 2001 and 2002, it shut down three others in Texas, Louisiana and Florida, leaving virtually the entire Gulf Coast uncovered — from Florida to east Texas, and part of the Caribbean as well.
The Pentagon won't put the radar balloons back up because it believes the money is better spent elsewhere, Frothingham said.
In November 2005, the Government Accountability Office raised serious concerns about the shortcomings in the interdiction effort, and said it was particularly troubled by the lack of strategic planning by the Pentagon and Homeland Security to deal with a major redeployment of drug war assets that it believed would only get worse, not better.
The GAO, the independent investigative arm of Congress, requested that the Pentagon and Homeland Security Department devise comprehensive plans on how to maintain the drug interdiction effort with dramatically fewer resources.
More than a year later, the GAO's Jess T. Ford said in an interview that he had seen few signs of progress.
"If that trend continues," he said, "it just means we are going to miss more and more opportunities."
Neuroscience of Behavior Change
http://online.wsj.com/article/SB116915058061980596.html
THE WALL STREET JOURNAL SCIENCE JOURNAL
How Thinking Can Change the Brain
Dalai Lama Helps Scientists Show the Power of the Mind To Sculpt Our Gray Matter January 19, 2007; Page B1
Although science and religion are often in conflict, the Dalai Lama takes a different approach. Every year or so the head of Tibetan Buddhism invites a group of scientists to his home in Dharamsala, in Northern India, to discuss their work and how Buddhism might contribute to it. In 2004 the subject was neuroplasticity, the ability of the brain to change its structure and function in response to experience. The following are vignettes adapted from "Train Your Mind, Change Your Brain," which describes this emerging area of science:
BOOK EXCERPT Adapted from "Train Your Mind, Change Your Brain", by Sharon Begley.
Ms. Begley writes the weekly Science column for The Wall Street Journal.
The Dalai Lama, who had watched a brain operation during a visit to an American medical school over a decade earlier, asked the surgeons a startling question: Can the mind shape brain matter?
Over the years, he said, neuroscientists had explained to him that mental experiences reflect chemical and electrical changes in the brain. When electrical impulses zip through our visual cortex, for instance, we see; when neurochemicals course through the limbic system we feel.
But something had always bothered him about this explanation, the Dalai Lama said. Could it work the other way around? That is, in addition to the brain giving rise to thoughts and hopes and beliefs and emotions that add up to this thing we call the mind, maybe the mind also acts back on the brain to cause physical changes in the very matter that created it. If so, then pure thought would change the brain's activity, its circuits or even its structure.
One brain surgeon hardly paused. Physical states give rise to mental states, he asserted; "downward" causation from the mental to the physical is not possible. The Dalai Lama let the matter drop. This wasn't the first time a man of science had dismissed the possibility that the mind can change the brain. But "I thought then and still think that there is yet no scientific basis for such a categorical claim," he later explained. "I am interested in the extent to which the mind itself, and specific subtle thoughts, may have an influence upon the brain."
The Dalai Lama had put his finger on an emerging revolution in brain research. In the last decade of the 20th century, neuroscientists overthrew the dogma that the adult brain can't change. To the contrary, its structure and activity can morph in response to experience, an ability called neuroplasticity. The discovery has led to promising new treatments for children with dyslexia and for stroke patients, among others. But the brain changes that were discovered in the first rounds of the neuroplasticity revolution reflected input from the outside world. For instance, certain synthesized speech can alter the auditory cortex of dyslexic kids in a way that lets their brains hear previously garbled syllables; intensely practiced movements can alter the motor cortex of stroke patients and allow them to move once paralyzed arms or legs.
The kind of change the Dalai Lama asked about was different. It would come from inside. Something as intangible and insubstantial as a thought would rewire the brain. To the mandarins of neuroscience, the very idea seemed as likely as the wings of a butterfly leaving a dent on an armored tank.
* * *
Neuroscientist Helen Mayberg had not endeared herself to the pharmaceutical industry by discovering, in 2002, that inert pills -- placebos -- work the same way on the brains of depressed people as antidepressants do. Activity in the frontal cortex, the seat of higher thought, increased; activity in limbic regions, which specialize in emotions, fell. She figured that cognitive-behavioral therapy, in which patients learn to think about their thoughts differently, would act by the same mechanism.
At the University of Toronto, Dr. Mayberg, Zindel Segal and their colleagues first used brain imaging to measure activity in the brains of depressed adults. Some of these volunteers then received paroxetine (the generic name of the antidepressant Paxil), while others underwent 15 to 20 sessions of cognitive-behavior therapy, learning not to catastrophize. That is, they were taught to break their habit of interpreting every little setback as a calamity, as when they conclude from a lousy date that no one will ever love them.
All the patients' depression lifted, regardless of whether their brains were infused with a powerful drug or with a different way of thinking. Yet the only "drugs" that the cognitive-therapy group received were their own thoughts.
The scientists scanned their patients' brains again, expecting that the changes would be the same no matter which treatment they received, as Dr. Mayberg had found in her placebo study. But no. "We were totally dead wrong," she says. Cognitive-behavior therapy muted overactivity in the frontal cortex, the seat of reasoning, logic, analysis and higher thought. The antidepressant raised activity there. Cognitive-behavior therapy raised activity in the limbic system, the brain's emotion center. The drug lowered activity there.
With cognitive therapy, says Dr. Mayberg, the brain is rewired "to adopt different thinking circuits."
* * *
Such discoveries of how the mind can change the brain have a spooky quality that makes you want to cue the "Twilight Zone" theme, but they rest on a solid foundation of animal studies. Attention, for instance, seems like one of those ephemeral things that comes and goes in the mind but has no real physical presence. Yet attention can alter the layout of the brain as powerfully as a sculptor's knife can alter a slab of stone.
That was shown dramatically in an experiment with monkeys in 1993. Scientists at the University of California, San Francisco, rigged up a device that tapped monkeys' fingers 100 minutes a day every day. As this bizarre dance was playing on their fingers, the monkeys heard sounds through headphones. Some of the monkeys were taught: Ignore the sounds and pay attention to what you feel on your fingers, because when you tell us it changes we'll reward you with a sip of juice. Other monkeys were taught: Pay attention to the sound, and if you indicate when it changes you'll get juice. Matthieu Ricard, a Buddhist monk, undergoing an EEG during a study of compassion meditation
After six weeks, the scientists compared the monkeys' brains. Usually, when a spot on the skin receives unusual amounts of stimulation, the amount of cortex that processes touch expands. That was what the scientists found in the monkeys that paid attention to the taps: The somatosensory region that processes information from the fingers doubled or tripled. But when the monkeys paid attention to the sounds, there was no such expansion. Instead, the region of their auditory cortex that processes the frequency they heard increased.
Through attention, UCSF's Michael Merzenich and a colleague wrote, "We choose and sculpt how our ever-changing minds will work, we choose who we will be the next moment in a very real sense, and these choices are left embossed in physical form on our material selves."
The discovery that neuroplasticity cannot occur without attention has important implications. If a skill becomes so routine you can do it on autopilot, practicing it will no longer change the brain. And if you take up mental exercises to keep your brain young, they will not be as effective if you become able to do them without paying much attention.
* * * Since the 1990s, the Dalai Lama had been lending monks and lamas to neuroscientists for studies of how meditation alters activity in the brain. The idea was not to document brain changes during meditation but to see whether such mental training produces enduring changes in the brain. All the Buddhist "adepts" -- experienced meditators -- who lent their brains to science had practiced meditation for at least 10,000 hours. One by one, they made their way to the basement lab of Richard Davidson at the University of Wisconsin, Madison. He and his colleagues wired them up like latter-day Medusas, a tangle of wires snaking from their scalps to the electroencephalograph that would record their brain waves.
Eight Buddhist adepts and 10 volunteers who had had a crash course in meditation engaged in the form of meditation called nonreferential compassion. In this state, the meditator focuses on unlimited compassion and loving kindness toward all living beings.
As the volunteers began meditating, one kind of brain wave grew exceptionally strong: gamma waves. These, scientists believe, are a signature of neuronal activity that knits together far-flung circuits -- consciousness, in a sense. Gamma waves appear when the brain brings together different features of an object, such as look, feel, sound and other attributes that lead the brain to its aha moment of, yup, that's an armadillo.
Some of the novices "showed a slight but significant increase in the gamma signal," Prof. Davidson explained to the Dalai Lama. But at the moment the monks switched on compassion meditation, the gamma signal began rising and kept rising. On its own, that is hardly astounding: Everything the mind does has a physical correlate, so the gamma waves (much more intense than in the novice meditators) might just have been the mark of compassion meditation.
Except for one thing. In between meditations, the gamma signal in the monks never died down. Even when they were not meditating, their brains were different from the novices' brains, marked by waves associated with perception, problem solving and consciousness. Moreover, the more hours of meditation training a monk had had, the stronger and more enduring the gamma signal.
It was something Prof. Davidson had been seeking since he trekked into the hills above Dharamsala to study lamas and monks: evidence that mental training can create an enduring brain trait. Prof. Davidson then used fMRI imaging to detect which regions of the monks' and novices' brains became active during compassion meditation. The brains of all the subjects showed activity in regions that monitor one's emotions, plan movements, and generate positive feelings such as happiness. Regions that keep track of what is self and what is other became quieter, as if during compassion meditation the subjects opened their minds and hearts to others.
More interesting were the differences between the monks and the novices. The monks had much greater activation in brain regions called the right insula and caudate, a network that underlies empathy and maternal love. They also had stronger connections from the frontal regions to the emotion regions, which is the pathway by which higher thought can control emotions.
In each case, monks with the most hours of meditation showed the most dramatic brain changes. That was a strong hint that mental training makes it easier for the brain to turn on circuits that underlie compassion and empathy.
"This positive state is a skill that can be trained," Prof. Davidson says. "Our findings clearly indicate that meditation can change the function of the brain in an enduring way."
off-label Actiq
http://www.primetherapeutics.com/PDF/actiq.pdf
90% of Actiq is prescribed off-label
change and dopamine
http://www.nasw.org/users/skloot/ChangeStory.pdf
Why is it So Damn Hard to Change By Rebecca Skloot Published in O The Oprah Magazine January, 2007
Nora Volkow wants my chocolate. I’m sitting at a round conference table in her largewindowed office at the National Institute on Drug Abuse, where she’s the director. Volkow is telling me about her research into the neurology of eating and how, for some people, quitting foods—like, say, chocolate—can be as hard as kicking heroin is for a junkie. Food, she says, hooks people by triggering the exact chemical reactions triggered in the brain by hard drugs. Or nicotine. Or alcohol. Or shopping. Or sex. “I can’t stop looking at your chocolate,” Volkow says, her eyes darting from me to the chocolate and back. It’s a Hershey’s Kiss Volkow’s secretary gave me moments earlier. I took it with a smile and a thank-you, but I’m one of the few women in the world who actually don’t like chocolate. So I bit off the tip to be polite, put the rest back in its metallic wrapper, and slid it onto the table next to my notebook. This makes Volkow uncomfortable, which isn’t what I expected. Most articles about Volkow focus on her childhood in Mexico City. They say, Isn’t it amazing she was raised in the same house where Stalin had her great-grandfather —Leon Trotsky, the exiled Russian revolutionary—murdered with an ice ax? They talk about how Volkow started medical school at 18, then went to the United States and became one of the nation’s leading research psychiatrists. But to me, the most fascinating thing about Volkow is the fact that she—the head of the country’s national drug abuse agency—is not just a chocolate junkie. She’s also a chocolate pusher. Volkow paces back and forth in her Bethesda, Maryland, office—frizzy hair bouncing, black knee-high boots clacking—then stops, narrows her eyes, and grins. “I have some good stuff,” she says, reaching into her desk drawer. “Seventy-seven percent pure cocoa.” She throws a quartereaten bar on the table next to me. “Go ahead,” she says, “have some.” I tell her no thanks, and she raises her eyebrows. “I do experiments with people,” she says. “I put the chocolate there and see how long it takes them to pick it up.” She shakes her head. “I am very bad with chocolate. I take it immediately. I fail my own test. But you,” she says, pointing at my Kiss, “you have very good inhibitory control!” This makes me laugh, because if she’d offered cheesecake or Swedish Fish, I wouldn’t have lasted five seconds. But my problem isn’t food; it’s exercise and the fact that I seem incapable of doing it. No matter how many times I join a gym or buy new workout clothes or make workout dates with friends, I simply don’t exercise. I’ve always got good reasons: I’m too busy, it’s raining, I need better shoes, there’s no gym in my neighborhood. I have a deadline, a headache, or cramps; it’s too hot or too cold, running hurts my feet, weights are heavy…I could go on. The rational part of my brain knows I should exercise: I’ve read articles saying it prevents nearly every human disease, fights depression, and strengthens the immune system. I hear it reduces stress and anxiety, that it helps you focus and sleep and have better sex. I want all that—who doesn’t? But apparently, another part of my brain—which happens to be the dominant part—wants everything to stay exactly as it is. And clearly, I’m not alone. At this point, it’s common knowledge that the leading causes of death in the United States—heart disease, diabetes, and several cancers—can be preventable through behavior change. Hundreds of thousands of people wake up each January 1st and say, “Starting today, I’m going to diet/exercise/quit smoking/taking drugs/gambling/whatever.” They try, often very hard, but most fail. I want to know why. And I’m not talking about external factors, like too much work and not enough time. I’m looking for what happens in our brains when we try to change, and how we can use that knowledge to actually succeed. This is how I ended up in Nora Volkow’s office listening to her obsess about my chocolate. Volkow and colleagues have spent the past 15 years researching the link between drug abuse and obesity by studying one thing that makes it so freakin’ hard to change a habit: dopamine, a chemical in the brain that transmits signals from cell to cell and gets us hooked on everything from food to cigarettes to shopping to sex. Dopamine teaches your brain what you want, then drives you to get it, regardless of what’s good for you. It does this in two steps. First you experience something that gives you pleasure (say, McDonald’s French fries), which causes a dopamine surge. Some of that dopamine travels to the area of your brain where memories are formed and creates a memory connecting those fries with getting a reward. At that point, in science-speak, the fries have become “salient.” And when you’re exposed to something that’s salient, you may think, That’s bad for me, I shouldn’t, but your brain registers, Dopamine jackpot! Which is where step two comes in: On top of creating memories, dopamine controls the areas of the brain responsible for desire, decision making, and motivation. So once fries become salient, the next time you see or smell them, your brain releases a surge of dopamine that drives you to get some. When you succeed, your brain produces more dopamine, which reinforces the memory that made fries salient in the first place, etching it further into your brain. It’s a never-ending cycle: The more you do something that’s rewarding, the more dopamine makes sure you do it again. This is precisely how habits form. Eventually, if the fries become salient enough, your brain will release dopamine and push you to get fries anytime you see the colors yellow and red, even if you’re nowhere near McDonald’s. And this is true for any behavior that results in a reward: Orgasms cause dopamine surges. So does hitting the jackpot when you gamble, winning a race, acing a test, doing cocaine or methamphetamines, smoking, drinking. “Dopamine is motivation,” Volkow tells me. “If you create animals in the lab that don’t have dopamine, they have no drive. They can eat food and it tastes good, but they have no motivation to actually do anything, so they won’t eat, and they’ll die.” As she’s talking, I nod and take notes until, suddenly, her computer dings: She’s got an e-mail. I am not compulsive when it comes to food, but e-mail? Forget it. Volkow doesn’t share my obsession. She keeps talking about dopamine, I go back to taking notes, then there’s that ding again, and I think, She has two new e-mails. Volkow is unfazed. We go on like this until she must have ten messages and I can barely resist getting up and reading them myself. Then it hits me: E-mail is as salient for me as chocolate is for Volkow. I often work months, sometimes years before seeing my work in print, but email gives me the reward of instant gratification. I tell Volkow this and she laughs. “You’re right,” she says. “I bet if I put you in an MRI machine and played that e-mail noise, you’d get the same dopamine surges I see in cocaine addicts when they think someone else is getting high.” This is why it’s so hard to change. Doing so means fighting one of the most fundamental neurological systems in the brain. “Think about it,” Volkow says. “If you’re designing a species and you want to make sure it does things that are crucial for survival—like eating and reproducing—you create a system that’s all about pleasure so they want to repeat those things. Then you have dopamine make those behaviors become automatic. It’s brilliant, really.” Although she hasn’t proved it yet, Volkow has a theory about why diets often fail: Based on animal studies, she thinks people may experience withdrawal when they try to kick certain foods their brains have become dependent on. “This makes it hard to eliminate those foods,” she tells me, “because people may feel depressed or sluggish or generally horrible.” If this turns out to be the case, she says, perhaps changing your diet more slowly will help. But my big question for Volkow is this: How do you get yourself hooked on something that’s not inherently pleasurable to you—like living on salads and broccoli, or, in my case, exercising? Many people get a natural high from working out. I, however, am not one of them. “Isn’t there some way to trick the dopamine system?” I ask her. “Some way to fool my brain into craving exercise?” Sure, she says: The secret is thinking up rewards. My payoff for working out could be a pedicure or a new pair of shoes. For someone trying to diet: Maybe you get a massage after a week of good eating, or have a friend dole out gift certificates if you stay on track (you pay, but she controls the vouchers). “Giving yourself rewards for a behavior engages the dopamine system so your brain will associate the positive outcome with it, which will help you form the habit.” When I get home, I try it. I make a deal with myself: If I exercise every day for a week, I get a new mini MP3 player. I wake up in the morning and it’s raining. I remind myself about the MP3 player. After several confused minutes of figuring out what a person wears to exercise in the rain (a poncho? an umbrella?), I end up in waterproof hiking boots and my boyfriend’s hooded sweatshirt, which is three times my size. I leash the dog and we start running, but my boots are too heavy and my lungs burn, plus I can’t see because the hood keeps falling over my eyes. And of course, there’s the rain. So we drop to a speed walk. An hour later we get home looking like we’ve been dunked in a river. I strip off my wet clothes and tell myself, Do that six more times and you get an MP3 player. Then I think, Yeah, right, you can’t possibly exercise again without music. So I buy an MP3 player and tell myself I really need exercise clothes before I try something like running again. The next day, I find myself in a very green and blue cafeteria at the Kennedy Krieger Institute in Baltimore, the renowned center for children and adolescents with developmental disabilities. I’m sitting across from Michael Schlund, PhD, a research psychologist who divides his time among several scientific institutions where he explores areas of the brain involved in learning and behavior change. For Schlund, this work is part of a larger project aimed at helping people with autism learn. But what I’m interested in is a study he recently finished at the University of North Texas, where he spent months observing the brains of healthy adults as they learned new behaviors based on rewards. Here’s what happened: After sliding the volunteers into an MRI machine, he gave them two buttons—one for the right hand, one for the left—then said, “You’ll have to make some decisions. If you’re correct, you earn money. If you’re wrong, no money.” He fired up the machine, which rattled and clanged as it began scanning their brains. Inside the machine, on a computer screen above the volunteers’ heads, a circle appeared and vanished. Next, the word CHOOSE flashed, which meant they had to pick a button, right or left. The game made no sense. There was no correct response: All they could do was click a button randomly, then the computer said WRONG and the circle appeared again. So they picked the other button and the computer flashed, CORRECT. YOU’VE EARNED 50 CENTS. Once the volunteers knew which button to press in response to the circle, they repeated the process over and over. Circle. Correct button. Reward. Circle. Correct button. Reward. This is where it got interesting for Schlund, because he wants to know what happens in the brain when you learn a new behavior based on rewards, which parts light up, how big that activation is, and how it changes over time as the behavior becomes habitual. On the first click, when they were guessing, the volunteers’ brains lit up a little in the frontal lobe—an area associated with self-control, decision making, and behavior change. After the second click, when they got the reward for answering correctly, suddenly their brains kicked into high gear, and with each repetition, their frontal lobes lit up more and more, which meant their brain activity continued to increase as they learned the new behavior. But—and this is the good news—within about 50 repetitions, Schlund says, the reverse will start happening—the frontal lobe lights up less and less until the brain is exerting minimum effort, which means the new task has officially become a habit. When Schlund tells me this, I ask if it means I only have to force myself to exercise 50 times and then it will be a habit. “I wish I could say yes,” he answers. “But we really have no idea. What I can tell you is, there are many variables.” The biggest one is stress. It turns out that the hormones released by the body in response to stress are our worst enemy when it comes to change: They actually inhibit the frontal lobe, which makes the brain revert to behaviors that don’t require conscious decisions (eating our familiar foods, drinking, smoking). Not only do stress hormones impair the areas of our brains that need to be active to change, they also stimulate our emotional centers, which send out signals telling us to decrease the stress. And what decreases stress? Food (because it releases natural opiates), alcohol, cigarettes, shopping. So successful change depends in part on stress management. But, Schlund says, it also depends on finding the right rewards. “If people got paid to exercise,” he tells me, “everyone would do it. And this country would be much better off.” I ask if he’ll pay me to exercise. He folds his hands on the Formica table between us, looks me in the eye, and says, “If you want to convince your brain you should exercise, you have to treat yourself the way you’d treat your dog.” It’s hardly what I expected him to say, but at this point, I’m open to anything. “Imagine she’s wetting on the floor every day,” he says. “Are you going to say, ‘Hey dog, if you don’t wet on the floor for a week, I’ll buy you a rawhide bone?’ That would be like your boss saying, ‘If you work five years, then you’ll get your check.’ It’s too far off.” Obviously, this is why my MP3 player failed: A week was too long to wait. If I’m going to associate exercise with a positive payoff, the reward has to be immediate. But beyond that, Schlund tells me, I have to unlearn the rewards I’ve already associated with not exercising (no pain, more time for other things). Doing this actually requires changing my neural circuitry. And rewiring an adult brain, I am about to discover, is very tricky. A few days after my meeting with Schlund, I’m sitting at a small desk in a psychiatric ward at Yale, staring at a computer screen with two clickable buttons: CHE and SHE. The computer says “Che” (or is it “she”?), and I’m supposed to press the appropriate button. I click CHE. The computer buzzes and tells me to try again. “Che” or “she”? I click SHE. Buzz. Over and over, I get the buzz. I’m thinking this must be a joke, but then I squint, listen hard, and finally hear it. I hit CHE. The computer dings, then two pink kissing fish appear on the screen and do a funky dance with a hermit crab. That’s my reward, which clearly gets my dopamine going: I start playing compulsively, completely hooked on picking the right answer so I can see what my next goofy reward will be. After a while, my attention starts wandering.… Buzz. So I squint, listen hard, and hear it again: “Che.” A spaghetti-thin man suddenly appears on the computer screen playing a xylophone, until a musical note hits him on the head. Then Bruce Wexler, MD, walks in the room. Wexler, a leading neuroscientist and the author of Brain and Culture, studies brain plasticity and how it affects our ability to change. I’ve come to try out this program, which he uses to help patients with schizophrenia improve their audio processing and memory. “You’re very good at that,” Wexler tells me. Not really, I say, pointing out how many errors I made before figuring it out. But actually, that’s the whole idea of the program: Successful change requires abnormally intense, uninterrupted concentration and repetition. Why? Because we’re working against evolution: Our brains are designed to conserve energy for really important things, like breathing and coordinated motion, even though sometimes, altering behavior is just as important as breathing. Our brains revert to habits when given the chance because habits require less energy than change. That silly exercise with “che” and “she” actually alters the way adults hear because it doesn’t let that happen. It forces intense concentration resulting in instant rewards that make you want to repeat the exercise over and over again. “You want to know why it’s hard to change?” Wexler asked when I first walked into his office. “There are a hundred billion neurons in your brain. Each one is connected to thousands of others. Everything you’re talking about—behaviors and learning and memory—involves the integrated actions of hundreds of thousands of cells in intricate systems throughout the brain.” In adults those systems are hardwired. When you’re a kid, it’s a different story: Young brains are constantly forming new connections between neurons, changing the way children process information based on their experiences. That’s plasticity, and it’s why kids soak up language and adapt to new cultures at rates that put adults to shame. “By the time we hit our 20s,” Wexler says, “our brains have lost most of their plasticity.” But fortunately, they haven’t lost all of it. Imagine you’ve got one strong eye and one weak eye, he tells me. If you cover the good eye with a patch, so it gets no stimulus, the weak eye will get stronger. But the second you remove the patch, the strong eye kicks in again and the weak one gets weaker. The same is true of all pathways in the brain. Once established, they stick around and remain strong as long as they’re being used. So the first step toward change, Wexler says, is putting a “patch” over the pathway you want to lose (like, say, a chocolate obsession), which means eliminating anything that activates it (having chocolate in the house, going places where you usually buy chocolate). This is why, for many people who try to quit drinking or smoking, it’s impossible to have just one glass of wine or cigarette. It’s why heroin and coke addicts must avoid places and people connected to their drug days. For dieters, just walking into your regular grocery store can activate an old familiar food pathway and keep it alive. So successful weight loss is as much about lifestyle change as it is about what you eat: Shop at a new store; buy new brands of food; use a new set of plates; eat in another room, at a different time of day. All these things will help starve an old unhealthy pathway so you can develop a new one. “The more drastically you restructure your habits,” Wexler says, “the more the established pathway that you’re trying to change is weakened.” But eliminating the old pathway isn’t everything. You’ll make things much easier if you search your brain for an existing healthy pathway—even a tiny weak one—then strengthen it. Wexler tells me to find an “I like exercise” pathway. I tell him I don’t think I have one. He doesn’t buy it. “Wasn’t there some activity you loved as a kid?” he asks. I don’t think so. On the train ride home, however, as I stare out the window listening to my new MP3 player, David Bowie’s “Changes” comes on and I start laughing. Appropriate, yes. But it was also the song my next-door neighbor and I skated to in my backyard when I was a girl. For my entire young life, I was obsessed with roller-skating. My first kiss was on skates; I roller-skated to high school every day, then rolled down the hall from class to class. I actually convinced my high school to waive my PE requirement and give me credit for my constant skating. Sitting on the train remembering all this, I smile and think, I just hit my dopamine jackpot. When I get home, I strap on my ten-year-old Rollerblades and give it a try. I turn on some disco and start rolling. It’s sunny; my dog is running next to me. I can practically feel the dopamine coursing through my veins. My exercise problem is solved. Life couldn’t be better. The next day I wake up, walk into my living room, then sit down at my computer thinking, Oh my God, I have so much to do. A few hours later I think, I should go Rollerblade now. But I’m busy. I’ve got a deadline, I exercised yesterday, and besides, it looks like it’s going to rain. I’ll do it later. But when later comes, I’m tired from working all day, and now it’s getting dark. Then I think, Wait a minute. Why isn’t all that dopamine from yesterday driving me to get up and Rollerblade again? Did my brain forget? A week later, I call Monika Fleshner, PhD, a neuroimmunophysiologist at the University of Colorado at Boulder who has done extensive research into the physiology of exercise. I explain my situation. I say I found an exercise I like, and I think I’ve got the dopamine thing solved, but funny thing is: I’m still not doing it. You know what her bottom line is? Suck it up—just make yourself exercise. Fleshner is very clear: It’s not like you find your dopamine jackpot and your brain immediately says, Now we exercise every day. For a while, you still have to force yourself to do it. But, I tell her, I have a very good reason not to: I know her research found that in animals, forced exercise doesn’t lead to the same physiologic benefits that voluntary exercise does. In fact, it actually weakens the animals’ immune systems by causing an increase in stress hormones in the body. I ask her about this, and she says it’s true, but I don’t have to worry about that. Why? Because I won’t have to make myself exercise long enough to cause problems. To which I say, “Excuse me?” Then she tells me something wonderful: All I have to do is force myself to exercise regularly for about two weeks, maybe three, and my brain will start producing a protein called brain derived neurotrophic factor (BDNF), which she calls Miracle-Gro for the brain. It increases brain plasticity, so you can learn, think clearly and focus for longer periods of time. It also increases dopamine neurotransmission, which means the more I exercise, the more reward I get, and the more my dopamine system is activated to make exercising a habit I’ll soon crave. “Just put on your Rollerblades,” Fleshner tells me. “Strap on some headphones, leash up your dog, go outside, and start exercising right now.” Long, silent pause. “I’m serious,” she says. I sit holding the phone for a second before thinking, Oh, what the hell. Three weeks isn’t that bad. So I head out for day one. And yes, it’s day one again, because I didn’t go out for day two last time, which means I’m starting from scratch. When I began this quest to find out why it’s so hard to change unhealthy behaviors, I talked with more than a dozen scientists. Each one laughed and said some version of this: “If I could answer that question, I’d win a Nobel Prize and have drug companies lining up at my door for miles.” But the truth is, scientists have uncovered some very important things. To begin with, change is monumentally difficult. Some people can just wake up one morning, decide to change, and stick with it. But many, perhaps most, can’t. The reason may be genetic; it may be the way you’re raised; perhaps some people have stronger frontal lobes than others. Scientists still aren’t sure. What they do know is, if you’re one of those people who struggle, that’s nothing to beat yourself up over—it’s just the way your brain works. But it’s also not an excuse to toss in the towel and say, Well, I don’t have enough dopamine, or My bad pathways are too strong. As Bruce Wexler told me, “The more we understand what we’re up against, the more we can develop strategies that will help us work with our brains to change successfully.” So, instead of waking up New Year’s morning and saying, “I’m going to do X now,” then berating yourself a month later when that resolution didn’t work, remember: You’re doing nothing less than rewiring your brain. Approach change as if you’re learning a new language or a new instrument. Obviously, you’re not going to be fluent or play symphonies instantly; you’ll need constant focus and practice. Overcoming an unhealthy habit involves changing the behaviors associated with it and managing stress, because stressing about change (or anything else) will knock you off the wagon faster than you realize. Above all, get that dopamine system going: Find rewards—make them instant, and don’t be stingy. Your brain needs them. And I promise (well, Volkow, Schlund, Wexler, and Fleshner promise) it gets easier. That’s not a bunch of self-help nonsense. It’s biology.
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