Saturday, August 31, 2019

Tyler Skagg's Death: Behind the Exploding Opioid Crisis


How drugs affect the brain in deadly ways. Click here.



According to the coroner's report, Los Angeles Angels pitcher Tyler Skaggs died from accidental overdoes of fentanyl, oxycodone, and alcohol. With an unprecedented death toll, unique strategies needed to reverse tide, study finds.

August 29, 2019

 

August 29, 2019

RAND Corporation

The sudden appearance of the drug fentanyl in the US has driven up overdose deaths dramatically, even as the abuse of heroin and other opioids has shown signs of stabilizing. In the most-comprehensive analysis yet of the crisis, researchers urge that innovative new strategies be pursued because the epidemic is unlike others that have struck the nation.
    
FULL STORY


The U.S. overdose crisis worsened dramatically with the arrival of synthetic opioids like fentanyl -- now responsible for tens of thousands of deaths annually -- and the problem requires innovative new strateges because the epidemic is unlike others that have struck the nation, according to a new RAND Corporation study.

"This crisis is different because the spread of synthetic opioids is largely driven by suppliers' decisions, not by user demand," said Bryce Pardo, lead author of the study and an associate policy researcher at RAND, a nonprofit research organization. "Most people who use opioids are not asking for fentanyl and would prefer to avoid exposure."

While fentanyl had appeared in U.S. illicit drug markets before, production was limited to one or a few capable chemists, and bottlenecks in production and distribution slowed the drug's diffusion. Law enforcement was able to detect and shut down illicit manufacture to contain these outbreaks.
RAND researchers found that today's synthetic opioid surge is fueled by multiple sources. Mexican drug trafficking organizations smuggle fentanyl into the U.S., and China's pharmaceutical and chemical industries are inadequately regulated, allowing producers to advertise and ship synthetic opioids to buyers anywhere in the world.

While traditional criminal organizations play a role in the spread of fentanyl, the internet also has made it easier to traffic these drugs and to share information about their synthesis.

Overdose deaths involving fentanyl and other synthetic opioids have increased from about 3,000 in 2013 to more than 30,000 in 2018. These deaths have remained concentrated in Appalachia, the mid-Atlantic and New England.

"While synthetic opioids have not yet become entrenched in illicit drug markets west of the Mississippi River, authorities must remain vigilant," said Jirka Taylor, study co-author and senior policy analyst at RAND. "Even delaying the onset in these markets by a few years could save thousands of lives."

For U.S. policymakers, nontraditional strategies may be required to address this new challenge. The researchers avoid making specific policy recommendations, but advocate consideration of a broad array of innovative approaches such as supervised consumption sites, creative supply disruption, drug content testing, and increasing access to novel treatments that are available in other countries, such as heroin-assisted treatment.
"Indeed, it might be that the synthetic opioid problem will eventually be resolved with approaches or technologies that do not currently exist or have yet to be tested," said Beau Kilmer, study co-author and director of the RAND Drug Policy Research Center. "Limiting policy responses to existing approaches will likely be insufficient and may condemn many people to early deaths."
RAND researchers say that since the diffusion of fentanyl is driven by suppliers' decisions, it makes sense to consider supply disruption as one piece of a comprehensive response, particularly where that supply is not yet firmly entrenched.



How drugs affect the brain in deadly ways. Click here.

Monday, August 26, 2019

How memories form and fade

Strong memories are encoded by teams of brain cells working together in synchrony

                  
 
   
   
August 23, 2019:   
California Institute of Technology
Researchers have identified the neural processes that make some memories fade rapidly while other memories persist over time.
                               
                                       
FULL STORY
                   

                   
           
Memories in the brain concept (stock image).
Credit: © metamorworks / Adobe Stock
          
Why is it that you can remember the name of your childhood best friend that you haven't seen in years yet easily forget the name of a person you just met a moment ago? In other words, why are some memories stable over decades, while others fade within minutes?               
Using mouse models, Caltech researchers have now determined that strong, stable memories are encoded by "teams" of neurons all firing in synchrony, providing redundancy that enables these memories to persist over time. The research has implications for understanding how memory might be affected after brain damage, such as by strokes or Alzheimer's disease.
The work was done in the laboratory of Carlos Lois, research professor of biology, and is described in a paper that appears in the August 23 of the journal Science. Lois is also an affiliated faculty member of the Tianqiao and Chrissy Chen Institute for Neuroscience at Caltech.
Led by postdoctoral scholar Walter Gonzalez, the team developed a test to examine mice's neural activity as they learn about and remember a new place. In the test, a mouse was placed in a straight enclosure, about 5 feet long with white walls. Unique symbols marked different locations along the walls -- for example, a bold plus sign near the right-most end and an angled slash near the center. Sugar water (a treat for mice) was placed at either end of the track. While the mouse explored, the researchers measured the activity of specific neurons in the mouse hippocampus (the region of the brain where new memories are formed) that are known to encode for places.
When an animal was initially placed in the track, it was unsure of what to do and wandered left and right until it came across the sugar water. In these cases, single neurons were activated when the mouse took notice of a symbol on the wall. But over multiple experiences with the track, the mouse became familiar with it and remembered the locations of the sugar. As the mouse became more familiar, more and more neurons were activated in synchrony by seeing each symbol on the wall. Essentially, the mouse was recognizing where it was with respect to each unique symbol.
To study how memories fade over time, the researchers then withheld the mice from the track for up to 20 days. Upon returning to the track after this break, mice that had formed strong memories encoded by higher numbers of neurons remembered the task quickly. Even though some neurons showed different activity, the mouse's memory of the track was clearly identifiable when analyzing the activity of large groups of neurons. In other words, using groups of neurons enables the brain to have redundancy and still recall memories even if some of the original neurons fall silent or are damaged.
Gonzalez explains: "Imagine you have a long and complicated story to tell. In order to preserve the story, you could tell it to five of your friends and then occasionally get together with all of them to re-tell the story and help each other fill in any gaps that an individual had forgotten. Additionally, each time you re-tell the story, you could bring new friends to learn and therefore help preserve it and strengthen the memory. In an analogous way, your own neurons help each other out to encode memories that will persist over time."
Memory is so fundamental to human behavior that any impairment to memory can severely impact our daily life. Memory loss that occurs as part of normal aging can be a significant handicap for senior citizens. Moreover, memory loss caused by several diseases, most notably Alzheimer's, has devastating consequences that can interfere with the most basic routines including recognizing relatives or remembering the way back home. This work suggests that memories might fade more rapidly as we age because a memory is encoded by fewer neurons, and if any of these neurons fail, the memory is lost. The study suggests that one day, designing treatments that could boost the recruitment of a higher number of neurons to encode a memory could help prevent memory loss.
"For years, people have known that the more you practice an action, the better chance that you will remember it later," says Lois. "We now think that this is likely, because the more you practice an action, the higher the number of neurons that are encoding the action. The conventional theories about memory storage postulate that making a memory more stable requires the strengthening of the connections to an individual neuron. Our results suggest that increasing the number of neurons that encode the same memory enables the memory to persist for longer."



Monday, August 19, 2019

Hoarding tied to memories


Memories form 'barrier' to letting go of objects for people who hoard   

Source: University of Bath            
Summary:     
Researchers hope that the findings could help develop new ways to train people with hoarding difficulties to discard clutter.
                              
FULL STORY
                   

                     
New research conducted at the University of Bath has demonstrated important differences in how people with and without hoarding problems discard objects and the role their memories play.
                                                               
It was already known that hoarding behavior is driven by a strong emotional connection with objects. But the new experimental findings, published online in the journal Behavior Therapy, show that for people who hoard this connection may be in part attributable to the vivid, positive memories associated with those objects.
In essence, for those with hoarding problems, individual items become an extension of a given memory, becoming a barrier to decluttering and hence exacerbating an individual's problems. Drawing on the new findings, the team behind the study hope that cognitive-behavioral therapy (CBT) for hoarding might be enhanced by training individuals to respond differently to those memories.
Hoarding describes a problem where individuals have considerable difficulty letting go of possessions. Consequently, rooms can become so cluttered over time that living spaces becomes no longer usable for their intended purpose.
According to the Royal College of Psychiatrists, hoarding can be a mental health problem in its own right (known as 'hoarding disorder'). The clutter associated with hoarding can have profound negative effects on the lives of people living with the problem and those around them, particularly with respect to emotional and physical well-being, health and safety, and finances. The fire risks associated with clutter are also be of particular concern.
Lead researcher Dr. Nick Stewart, who now works as a Clinical Psychologist at Avon & Wiltshire Mental Health Partnership NHS Trust, explains: "People who hoard are often offered CBT to help them understand the thoughts and feelings associated with their saving and acquiring behaviors. This approach is very beneficial for some people, but not all. Our aim is to understand better the psychological factors that drive hoarding behavior, to give us clues for how therapy for hoarding might be improved."
The researchers conducted structured interviews with 27 people with clinically-significant hoarding problems, and 28 without such difficulties (the 'control' group).
Participants were asked to recall the memories that came to mind the last time they discarded, or tried to discard, items at home.
Both groups reported positive memories while discarding possessions that they valued (which may describe most possessions in the case of people who hoard). These memories included recollections of acquiring the object, or memories of an event or person associated with the object. Crucially, the control participants (those without a hoarding problem) reported attempts to avoid this positive imagery, while the hoarding participants did not.
Dr. Stewart explains: "We can all relate to the experience of being flooded with positive memories when we hold valued possessions in our hands. However, our findings suggest that it's the way in which we respond to these object-related memories that dictates whether we hold onto an object or let it go. The typical population appears to be able to set aside these memories, presumably to ease the task of discarding the objects, and so manage to avoid the accumulation of clutter. The hoarding participants enjoyed the positive memories but reported that they got in the way of their attempts to discard objects."
In the paper, the researchers have suggested ways in which this new insight could be used to enhance CBT for hoarding.
Dr. James Gregory, Clinical Research Tutor and Clinical Psychologist at the University of Bath, who supervised the research, said: "Where positive memories, and the mental images associated with them, are getting in the way of discarding objects, therapists could work with people to develop an alternative image to 'compete' with the one that's causing difficulty. This competing image could capture the positive consequences of discarding items, for example, eating a meal with loved ones at a dinner table once it is clear of possessions."
The next step is a follow-on experimental study to see if helping people to 'rescript' memories in this way is helpful for enabling people to let go of objects more easily.
Dr. Gregory added: "While memories associated with objects can afford a sense of comfort and security to people who hoard, the resulting clutter can rob people of their quality of life.
"This study is part of a wider effort at Bath to to better understand the special relationship that people have with their possessions. Ultimately we hope to use this knowledge to improve psychological support available and to enhance the wellbeing of people who hoard."
Notes on hoarding:
  • Up to 1.3 million people in the UK may have a significant hoarding problem (or develop one in the future);
  • People with hoarding problems may keep items for sentimental reasons or because they find objects beautiful or useful. Most people with hoarding problems have a very strong emotional attachment to objects;
  • Hoarding can become problematic for several reasons. It can take over a person's life, making it very difficult for them to get around their house. It can also affect work performance, personal hygiene and cause relationships to suffer;
  • Household clutter can also pose a health risk to the person and anyone who lives in or visits their house. For example, it can become a fire risk and block exits in the event of a fire, or cause trips and falls;
  • The main treatment is cognitive behavioral therapy (CBT). The therapist will help the person to understand what makes it difficult to throw things away and the reasons why the clutter has built up. This will be combined with practical tasks and a plan to work on.
On hoarding research at Bath:
  • The Bath team is currently leading work to explore the potential of immersive VR technologies in modelling treasured items, giving those with hoarding tendencies a form of exposure therapy and the opportunity to discard items in a virtual world.