Archive for August, 2015

Opiate addiction spreading, becoming more complex

The growing availability of heroin, combined with programs aimed at curbing prescription painkiller abuse, may be changing the face of opiate addiction in the U.S., according to sociologists.

While heroin abuse is still relatively rare, the use of the drug is not only increasing, but it is now being coupled with the abuse of prescription painkillers, said Shannon Monnat, assistant professor of rural sociology, demography, and sociology, Penn State. She added that the heroin-prescription drug combination is also hitting groups that were not traditionally viewed as widespread opiate users.

Painkiller and Heroin Use Increasing

“One of the things we’ve found is that the simultaneous use of heroin and prescription painkillers together has increased dramatically among whites and especially among young white men,” said Monnat, who worked with Khary K. Rigg, assistant professor of mental health law and policy, University of Southern Florida.

Monnat described the recent trend as a domino effect of addiction that began in the 1980s and 1990s when the over-prescription of painkillers led to an increase in addiction to those drugs.

“Over the last several years there have been more restrictions put in place, including prescription-drug monitoring programs and the introduction of a tamper-proof opioid, making it difficult to crush, liquefy and inject the substance,” said Monnat. “What this has done is restrict access to prescription painkillers for people who previously became addicted to them. These people sometimes transition into heroin, which has become incredibly cheap and easily accessible.”

Number of Addicts Increasing

Some addicts who were introduced to heroin also turn to abusing both painkillers and heroin at the same time. While most opiate addicts are still addicted to only painkillers, the number of addicts using heroin and the number of users who are addicted to both painkillers and heroin are increasing faster than painkiller-only abusers.

“You don’t eliminate the addiction simply by eliminating access to the drug,” said Monnat. “People who are addicted to the morphine substance will find a substitute.”

The three groups of opiate abusers are distinct demographically, socioeconomically and psychologically, Monnat added. While heroin abuse is typically characterized as being a problem in black, poor and urban areas, an increasing number of heroin and painkiller-heroin addicts are white, employed and live in rural and small urban areas.

Painkiller Addicts Least Disadvantaged

The researchers, who released their findings in Addictive Behaviors, currently online, said that people who are addicted to painkillers alone tend to be the most socially connected of the three groups. Painkiller addicts are also the least socioeconomically disadvantaged and have better physical and mental health.

Professionals who treat drug addiction should recognize the unique needs of each group of addicts, according to the researchers.

Addicts At Risk

“It’s not enough to know whether someone is just using a prescription painkiller, but the practitioner would also want to know if they are using heroin,” Monnat said. “The use of heroin puts the patient at risk of all kinds of other complications, such as HIV and sexual risk-taking behaviors and a very high risk of overdose.”

The researchers used data from the 2010-2013 National Survey on Drug Use and Health. Respondents in the survey were grouped in three categories: heroin only users, prescription painkiller only users, and combination heroin and prescription painkiller users. Prescription painkiller-only users were the largest group, with 9,516 respondents. Combination heroin and prescription painkiller users were the next largest group, with 506 respondents, followed by 179 heroin-only respondents.

August 18th, 2015  in Prescription Drugs No Comments »

New therapy could ‘erase’ drug-using memories

Recovering addicts often grapple with the ghosts of their addiction–memories that tempt them to relapse even after rehabilitation and months, or even years, of drug-free living. Now, scientists from the Florida campus of The Scripps Research Institute (TSRI) have made a discovery that brings them closer to a new therapy based on selectively erasing these dangerous and tenacious drug-associated memories.

“We now have a viable target and by blocking that target, we can disrupt, and potentially erase, drug memories, leaving other memories intact,” said TSRI Associate Professor Courtney Miller. “The hope is that, when combined with traditional rehabilitation and abstinence therapies, we can reduce or eliminate relapse for meth users after a single treatment by taking away the power of an individual’s triggers.”

Injection to Prevent Relapse

The new study, published by the journal Molecular Psychiatry, demonstrates the effectiveness of a single injection of an early drug candidate called blebbistatin in preventing relapse in animal models of methamphetamine addiction.

The new study builds on previous work in Miller’s lab. In 2013, the team made the surprising discovery that drug-associated memories could be selectively erased by targeting actin, the protein that provides the structural scaffold supporting memories in the brain. However, the therapeutic potential of the finding seemed limited by the problem that actin is critically important throughout the body–taking a pill that generally inhibits actin, even once, would likely be fatal.

Blebbistatin May Block Drug Memories

In the new study, Miller and her colleagues report a major advance–the discovery of a safe route to selectively targeting brain actin through nonmuscle myosin II (NMII), a molecular motor that supports memory formation. To accomplish this, the researchers used a compound called blebbistatin that acts on this protein.

The results showed that a single injection of blebbistatin successfully disrupted long-term storage of drug-related memories–and blocked relapse for at least a month in animal models of methamphetamine addiction.

“What makes myosin II such an exciting therapeutic target is that a single injection of blebbistatin makes methamphetamine-associated memories go away, along with dendritic spines, the structures in the brain that store memory,” said Research Associate Erica Young, a member of the Miller lab and a key author of the new study, along with Research Associates Ashley M. Blouin and Sherri B. Briggs.

Other Memories Left Intact

Blouin added, “Drugs targeting actin usually have to be delivered directly into the brain. But blebbistatin reaches the brain even when injected into the body’s periphery and, importantly, the animals remained healthy.”

Moreover, the effect of this novel treatment approach was specific to drug-associated memories (not affecting other memories), and the animals were still able to form new recollections.

“Our results argue for developing small molecule inhibitors of nonmuscle myosin II as potential therapeutics for relapse prevention, and that’s exactly what we’re doing with our colleagues here at Scripps with expertise in drug development,” said Briggs.

August 8th, 2015  in Substance Abuse No Comments »

Gastric bypass surgery lowers women’s alcohol tolerance

Women who have gastric bypass surgery to lose weight should keep a close eye on their alcohol consumption, according to new research at Washington University School of Medicine in St. Louis.

A small study indicates that changes in how alcohol is metabolized after surgery can speed its delivery into the bloodstream, resulting in earlier and higher peaks in blood-alcohol levels. Studying women who had undergone gastric bypass surgery, the researchers found that those who had consumed the equivalent of two drinks in a short period of time had blood-alcohol contents similar to women who had consumed four drinks but had not had the operation.

The research is published Aug. 5 in the journal JAMA Surgery.

Changes in Alcohol Metabolism

“The findings tell us we need to warn patients who have gastric bypass surgery that they will experience changes in the way their bodies metabolize alcohol,” said first author M. Yanina Pepino, PhD, an assistant professor of medicine in the Division of Geriatrics and Nutritional Science. “Consuming alcohol after surgery could put patients at risk for potentially serious problems, even if they consume only moderate amounts of alcohol.”

Although this study included only women, it is likely that men who have gastric bypass surgery experience similar changes in how their bodies metabolize alcohol.

The researchers studied alcohol’s effects in 17 obese women. Eight of the women had undergone Roux-en-Y gastric bypass surgery — the most common bariatric surgical procedure worldwide — one to five years before the study began. The other nine participants had not yet had the operation.

Significantly Higher BAC

As part of the study, the women spent two days, about one week apart, at Washington University’s Clinical Research Center. On one visit, each woman randomly consumed either the equivalent of two alcoholic drinks or two nonalcoholic beverages during a 10-minute period. At the second visit, each was given the beverages not received during the first visit. At both visits, the researchers measured the women’s blood-alcohol contents and used a survey to assess their feelings of drunkenness.

The women in the gastric bypass group had an average body mass index (BMI) of 30, which is considered obese, but it compared with an average BMI of 44 for the women who had not yet had the surgery. Among those who had not undergone surgery, blood-alcohol content peaked about 25 minutes after they finished consuming the alcohol and measured 0.60. In women who had the surgery, blood-alcohol content peaked at 5 minutes after drinking and reached 1.10, significantly above the legal driving limit of 0.80.

Public Safety Implications

“These findings have important public safety and clinical implications,” said senior investigator Samuel Klein, MD, the William H. Danforth Professor of Medicine and director of the Center for Human Nutrition. “After just two drinks, the blood-alcohol content in the surgery group exceeded the legal driving limit for 30 minutes, but the levels in the other group never reached the legal limit.

“The peak blood-alcohol content in the surgery group also met the criteria that the National Institute on Alcohol Abuse and Alcoholism uses to define an episode of binge drinking, which is a risk factor for developing alcohol problems.”

Felt Alcohol Effects Earlier

Women who had undergone gastric bypass also reported feeling the effects of alcohol earlier and for longer periods of time than women who had not had the surgery.

The study is not the first to find that gastric bypass surgery can alter alcohol metabolism, but Pepino said it is significant because earlier studies had measured blood alcohol less vigorously and were less clear about the extent of the changes in alcohol metabolism.

“The women who had the surgery only received the equivalent of two drinks, but it was as if they had consumed twice that amount,” she said. “Consuming alcohol after surgery the way one did before the operation could put patients at risk for potentially serious consequences, even when they drink only moderate amounts of alcohol.”

August 5th, 2015  in Alcohol No Comments »