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Here’s one very compelling reason to quit opiates sooner rather than later.

Need a good reason to seek treatment for an opiate addiction?

Well you might find the inspiration you’ve been looking for in a new study out of the Kaiser Center for Health Research that links just three to four months of high dose opiate use with a significantly increased likelihood of erectile dysfunction…50% higher!!!

The Study

The researchers examined the medical records of 11 327 men with back pain who were enrolled with Kaiser Permanente in Portland Oregon. Many of these men received prescriptions for opiates to control their pain.

The study looked to investigate:

1. Did getting prescribed opiates increase a man’s likelihood to request erectile dysfunction (ED) medication, such as sildenafil, tadalafil or testosterone replacement within 6 months?
2. What factors influenced an increased likelihood to require ED medication?

The Results

Over a 12 month time period around seeing a doctor for back pain

• 6.7% of men not prescribed opiates received a prescription for an ED medication
• 12.5% of men prescribed low dose opiates for 120 days or longer (or 90 days or longer with 10 or more prescription refills) received a prescription for an ED medication
• 19.3% of men on higher doses of opiates (120 morphine equivalents or greater per day) for 120 days or longer (or 90 days or longer with 10 or more prescription refills) received a prescription for an ED medication
• Having depression and taking sedative hypnotics, like benzodiazepines, also increased a man’s likelihood of requiring an ED medication
• Surprisingly, neither obesity nor smoking were associated with an increased likelihood to require an ED medication

Commentary

The study authors recommend that primary care physicians weigh the risks of sexual dysfunction when making prescribing decisions and that patients receive information about these sexual risks and about possible alternative therapies, such as cognitive behavioral therapy and physiotherapy exercises.

Opiates are known to decrease testosterone levels. The study authors suggest that this is the most probable explanation for their negative influence on erectile functioning.

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Yale University researchers say that alcoholics who display abnormal activity in the prefrontal cortex during an MRI brain scan are as much as 8 times more likely to relapse.

Recovering alcoholic? Worried about relapse?

Well, you might find this interesting then - researchers at Yale University say that after scanning your brain in an MRI machine they can predict your odds of relapse.

Apparently, people who show excessive brain activity in parts of the prefrontal cortex during a relaxation exercise are as much as 8 times more likely to relapse within 3 months as people with more normal activation in that area.

The Study

• The Yale team recruited 45 alcoholics about to start a residential treatment program and 30 non-alcoholic control subjects.
• Each subject was given an MRI scan, and during the scan each was asked to imagine recent very stressful situations, as well as to imagine themselves in a very serene and relaxing situation, such as on a tropical beach.
• The researchers then followed the study subjects for three months after the successful completion of treatment.

The Results

• Subjects who displayed high activity in certain areas of the prefrontal cortex experienced more alcohol cravings after the completion of treatment than subjects with more normal relaxation responses and this translated into an 8.5 fold greater likelihood of relapse and an 8.7  fold greater likelihood of a return to heavy drinking.

Commentary

Chronic alcohol abuse can damage the prefrontal cortex, and since this area of the brain manages decision making, emotional regulation and impulse control, it is unsurprising that abnormal prefrontal cortex functioning increases a person’s risk of relapse.

Lead researcher Rajita Sinha, Ph.D commented on the significance of the study findings, saying, "The patterns of brain activity we observed may one day serve as a neural marker that could help clinicians identify alcohol-dependent patients in recovery who are most at risk of relapse. Our findings may also have implications for the use of medications and behavioral treatments that restore prefrontal function, as they could potentially benefit people at high risk of relapse."

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Because so many young adults use drugs or alcohol young people sometimes have trouble forging sober social support networks after treatment. AA and NA can provide this sober support, but many groups are comprised of middle aged adults. A new research study suggests that this age gap does not matter and that 12 steps meetings do offer younger adults effective social support.

Young adults coming out of treatment often have a tough time finding sober social support due to high rates of drug and alcohol use among people in this age bracket.

So can young adults find effective recovery support from AA and NA groups comprised largely of middle aged and older adults?

That’s what researchers at the Centre for Addiction Medicine at Harvard Medical School wanted to know, and to find out they followed 300 young adult (aged 18 to 24) residential program graduates for a full year post treatment.

The results:

• The average subject attended 3 AA or NA meetings a week at 3 months post treatment and 1 meeting a week at a year post treatment.
• Even after controlling for variables such as motivation etc., subjects who attended the most meetings over the year had the highest numbers of abstinent days
• Subjects who became actively involved, such as by speaking at meetings, were the most likely to stay sober.

Commentary

Lead author John F. Kelly commented on the importance of 12 step resources for young adults, noting, “Our study shows that Twelve Step community resources, such as Alcoholics Anonymous (AA) and Narcotics Anonymous (NA), can provide local, accessible and cost-effective recovery resources for young adults during a stage in life when such support is rare.”

Read the full study results in Drug and Alcohol Dependence

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At certain periods in life, living with a person who uses maladaptive thinking styles increases your risk of depression. Fortunately, the opposite is also true.

Trying to avoid depression? Well be careful who you live with…

Certain thinking styles increase your risk for depression. For example, people who blame themselves for negative and stressful events beyond their control and those who imagine they have little control over their fate are at greater risk of depression than people with more adaptive thinking styles.

• At certain periods of life, such as when we first attend university, we are strongly influenced by our peers and research shows that we even tend to adopt some of the thinking styles of those around us.
• So if you get close to a person who makes use of thinking strategies that increase the risk of depression, you are more likely to also experience an increased depression risk.

The Study

Once past adolescence, most people don’t change their thinking strategies much – you’re just either a glass half-empty kind of person, or you’re not.

But in times of major transition, such as when moving away from home for the first time to a university dorm room, do such thinking styles then become contagious?

That’s what researchers at the University of Notre Dame wanted to know, and to find out they enlisted 103 pairs of randomly assigned college roommates to participate in a study.

• Each student was given a questionnaire to fill out within a month of arriving on campus and then two more, at 3 and 6 months later.
• The questionnaires measured for cognitive vulnerability to depression and indices of depression

The Results

• Students who got randomly assigned a roommate with maladaptive thinking styles (someone who was at risk of developing depression) were likely to ‘catch’ some of this negative thinking, and you could see this increase in cognitive vulnerability at both 3 and 6 months.
• Conversely, students with higher vulnerability scores assigned to live with students exhibiting very little negative thinking actually reduced their risk of depression by 3 and 6 months of co-habitation
• Students who ‘caught’ negative thinking patterns by 3 months exhibited twice the level of depressive symptoms by 6 months as students who had not increased their negative thinking patterns.

Discussion

The study authors write, "Our findings suggest that it may be possible to use an individual's social environment as part of the intervention process, either as a supplement to existing cognitive interventions or possibly as a stand-alone intervention. Surrounding a person with others who exhibit an adaptive cognitive style should help to facilitate cognitive change in therapy."

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A Canadian study shows that raising the costs of the cheapest alcohol by 10% cuts alcohol related deaths by as much as a third.

So what if that beer costs a few cents more…could a small price increase really affect people’s drinking habits?

Well, according to researchers at The University of Victoria’s Centre for Addictions Research, between 2002 and 2009 in British Columbia, Canada, a 10% increase in average minimum alcohol pricing resulted in a 32% drop in alcohol related deaths.

To come to this conclusion, the researchers sifted through provincial death medical records over the 7 year study period to identify people who died wholly or partly because of alcohol consumption, and they grouped these people into one of three categories:

1. Completely Alcohol Caused Deaths – people who died from alcohol poisoning, fetal alcohol syndrome, alcoholic gastritis, alcohol psychosis, alcoholic pancreatitis and alcoholic cardiomyopathy
2. Acute Alcohol Attributable Deaths – Alcohol related suicides and accidental injuries leading to death
3. Chronic Alcohol Attributable Death – Deaths caused by chronic alcohol related diseases, such as cirrhosis of the liver and stomach, mouth, esophagus and breast cancers

Key Study Findings

Raising the average minimum price by 10%:

• Caused a 32% reduction in completely alcohol caused deaths
• Caused a substantial decrease in chronic alcohol deaths, though the death rate here didn’t start to go down until a couple of years following the introduction of raised minimum pricing

Commentary

A common argument raised against upping average minimum alcohol pricing is that it punishes healthy consumers while failing to dissuade problem drinkers.

The researchers argue, however, that by raising the costs of the cheapest alcoholic drinks you decrease consumption most among the heaviest drinkers, who tend to buy these better ‘value’ alcoholic drinks. 

Commenting on the findings, lead researcher Dr. Tim Stockwell notes, "This study adds to the scientific evidence that, despite popular opinion to the contrary, even the heaviest drinkers reduce their consumption when minimum alcohol prices increase. It is hard otherwise to explain the significant changes in alcohol-related deaths observed in British Columbia."

Read the full study results in the journal, Addiction.

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A new study shows that Nalmefene helps alcoholics who can’t quit, or aren’t ready to quit, to reduce their consumption.

Alcoholics who just can’t or won’t stop drinking entirely might find the drug Nalemfene helpful.

Nalemfene is an opiate antagonist that works similarly to Naltrexone. If you take Nalemfene, and then go drinking, you don’t get that same pleasurable buzz and you don’t have much of an incentive to continue with it. This way, in theory, it helps people cut down.

But how well does it work? To find out, researchers at the Central Institute of Mental Health in Germany recruited 604 alcoholics for a 24 week experiment on the medication’s usefulness.

The Study

• The study subjects (alcoholics) were divided into 2 groups. Half received Nalemfene and half received a visually identical placebo medication.
• The subjects were instructed to take a pill (either Nalemfene or a placebo) on any day they felt like they might be at risk of drinking, on an as needed basis.
• Results were measured by self reports of alcohol consumption and liver enzyme testing.

The Results

• Subjects taking Nalemfene reduced their alcohol consumption significantly more than subjects taking a placebo.
• Subjects taking Nalemfene showed greater improvements in liver functioning (as measured by liver enzymes)
• Subjects reported few or no mild side effects.

Commentary

The study authors wrote, “Our new findings may mark a true paradigm shift in the treatment of men and women who suffer from alcohol related disorders. While abstinence should be the best bet, a reduction in consumption may be a valuable alternative for the many patients who cannot attain abstinence or are not (yet) capable of doing so.”

Read the full study findings in Biological Psychology

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Heavy drinkers given Nalmefene to take as needed reduced the amount they consumed by 66%.

Need some medicine to help you drink less? Well, through Nalmefene isn’t yet approved for use, based on the results of phase 3 clinical trials, it might be exactly what you’re looking for.

Nalmefene is an experimental drug which can be taken as needed and which takes the fun out of drinking - and in doing so, it helps heavy drinkers consume less alcohol.  

The Study

According to research presented at the 2012 European Conference of Psychiatry, 600 people who were given access to Nalmefene to be used as needed for 6 months (as well as motivational counseling and support) were able to reduce their drinking by 66% by the 6^th month of the study.

The researchers say that not everyone wants or is able to maintain abstinence but there are still significant harm reduction benefits associated with a substantial reduction in the amount of alcohol consumed by someone with an alcohol dependence problem.

Commenting on the findings, study researcher Dr. David Collier said that the medication could fill a treatment need to help people who are suffering from their alcohol use but who can’t achieve or sustain abstinence, saying, “The people volunteering for these trials had real problems with alcohol dependence, most had never sought help before, and others had tried and failed with abstinence strategies - stopping drinking for good. Abstinence is the right option for many people, but not everyone wants to do that, and in those that do try, it helps only about half of them.”

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Problem sports betters tend to overestimate their abilities to predict outcomes. Cognitive behavioral therapy can help problem sports gamblers overcome this illusion of control.

People who gamble in casinos tend to understand the random chance element of gambling better than sports betters, who tend to overestimate their ability to predict outcomes.

The Study

People with extensive experience and knowledge of a sport may overestimate their ability to predict the outcome of games and this may influence their gambling behaviors. To see whether sports knowledge confers a gambling advantage, researchers at Tel Aviv University recruited three groups of people to participate in a study on sports betting:

• The 53 subjects in group 1 were all professional sports gamblers
• The 34 subjects in group 2 were very knowledgeable soccer fans, who had never gambled
• The 78 subjects in group 3 were neither soccer fans nor gamblers

For the study, all subjects were asked to bet imaginary money on the outcome scores of the 16 games of the UEFA Champions League second round playoff.

The Outcome

All groups had the same performance.

• No group performed better at predicting the outcome scores of soccer games. In fact, the 2 subjects with the best performance in the study came from the group of non-fans.
• Although people who have extensive sports knowledge believe they hold a gambling advantage over the sports naive, this belief is incorrect.

The Significance

The study authors write, “Sports gamblers seem to believe themselves the cleverest of all gamblers. They think that with experience and knowledge -- such as player's statistics, manager's habits, weather conditions, and stadium capacity -- they can predict the outcome of a game better than the average person."

The researchers argue that conventional gambling therapies, which treat the gambling as an impulse control problem, won’t work for problem sports betters, who really need cognitive behavioral therapy to overcome their mistaken illusion of control problem.

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Researchers say that not only do random acts of kindness make us feel happier; they can also reduce the severity of social anxiety disorder symptoms.

Researchers at UBC say simple acts of kindness produce big happiness rewards and seem to alleviate some of the distress associated with conditions like social anxiety disorder.

The Study

A pool of socially anxious study subjects were split into three groups

1. Researchers instructed subjects from the first group to engage in multiple small acts of kindness, like buying someone a small gift or cup of coffee or offering a co-worker a ride, two days per week for four weeks
2. Subjects in the second group received belief challenging (CBT) instruction and exercises, two days per week, for four weeks
3. A third group received no therapy or instructions to engage in random acts of kindness

The Results

Subjects in the acts of kindness group experienced increased levels of positive mood that lasted over the entire four weeks of the study period. Subjects in the other two groups experienced no equivalent increase in positive mood.

Only subjects in the acts of kindness group also reported decreased social avoidance and increased relationship satisfaction

Read the full study results in the journal Emotion 

Why Do Acts of Kindness Improve Mental Health?

According to the Mental Health Foundation, some reasons why acts of kindness increase mental health include:

• They distract us from our own problems and help us keep a sense of perspective
• They help us feel grateful for what we have
• They get us more socially engaged and involved
• They improve our self esteem and feelings of competence
• Memories of your act of kindness produce feelings of happiness that last for long after the act is completed
• Positive acts reduce stress and negativity (such as anger and frustration)

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Obese people rewarded with $20 for losing 4 pounds in a month were far more likely to lose significant weight than people given no such cash incentives.

It is incredible how a small cash incentive can help people achieve a goal they’d happily pay far more to achieve.

Reinforcement techniques are an effective, if controversial, technique known to increase the success of addiction treatment programs – for example, by rewarding the passing of drug tests with movie vouchers or restaurant gift certificates.

Well it turns out the same principle holds true for people enrolled in weight loss programs – in a study at the Mayo Clinic, participants who got a $20 reward for meeting weight loss targets each month were far more likely to lose weight than people who received no such incentives.

The Study

A group of obese Mayo Clinic employees agreed to participate in a 1 year weight loss program study.

Half of the participants were told they’d get a $20 reward for each month they achieved a 4 pound weight loss (up to a target weight) but they’d have to pay a $20 penalty for each month they failed to lose at least 4 pounds.

The other half of the participants received no financial rewards or penalties.

The Results

62% of participants in the financial reward group achieved their target weight, compared to just 26% of those in the no-reward group.

Participants in the financial reward group lost an average of 9.08 pounds compared to just 2.34 pounds lost by those in the no-reward group.

Participants in the incentive group were more likely to continue on with the program. Surprisingly, even participants who paid the $20 failure penalty each month were more likely to stay enrolled than people in the no incentive group.

Commentary

Lead study author Steven Driver, M.D. commented on the significance of the findings, saying, "The take-home message is that sustained weight loss can be achieved by financial incentives. The financial incentives can improve results, and improve compliance and adherence."

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Though alcohol helps you to fall asleep, it disrupts total REM sleep and causes sleep disruptions in the second half of the night. In summary – it does more harm than good.

A lot of people use a drink or two (or more) as a way to ease into sleep. But though alcohol helps you to fall asleep more quickly, it probably makes you more tired the next day.

Researchers at The London Sleep Center have consolidated the findings of more than 20 studies to come up with an overview report on what we know so far about alcohol’s impact on sleep quality.

All studies accepted into the review were methodologically sound and were performed on healthy individuals (people without mental or physical health concerns that might compromise sleep quality).

Here’s what they found out:

Findings - How Alcohol Affects Sleep Quality

At all dosages, Alcohol:

1. Decreases the amount of time it takes to fall asleep
2. Causes deeper sleep in the first half of the night
3. Causes more disrupted sleep in the second half of the night

and:

• Alcohol increases the amount of slow wave sleep we get during the first half of the night. During slow wave sleep the body repairs tissue, strengthens the immune system and builds bone and muscle.
• Because alcohol causes deeper sleep in the first part of the night it can increase problems with sleep apnea and sleepwalking, among people susceptible to these problems
• At low doses, alcohol causes little disruption to REM sleep. At high doses, alcohol causes a reduction in the amount of REM sleep you get in the first and second half of a night’s sleep. At moderate doses, you get disrupted REM sleep in the second half of the night only. (So both moderate and high doses cause a reduction in total REM sleep)
• Insufficient REM sleep leads to a non-restful night’s rest. Other consequences of insufficient REM sleep include memory and motor problems and impaired concentration abilities

In Summary

Lead researcher Irshaad Ebrahim notes that although many people believe that alcohol helps with sleep, that, “alcohol on the whole is not useful for improving a whole night's sleep. Sleep may be deeper to start with, but then becomes disrupted. Additionally, that deeper sleep will probably promote snoring and poorer breathing. So, one shouldn't expect better sleep with alcohol."

The full results will be available in the study April 2013 edition of Alcoholism: Clinical & Experimental Research

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For people already predisposed to mental illness (people with mental illness in the immediate family, for example) experiencing stress during adolescence likely increases the risk of experiencing mental illness as an adult.

Could teen angst cause adult schizophrenia, major depression and other serious mental illnesses?

Well if people are anything like mice (and apparently we are) for people already predisposed to mental illness, experiencing stress while a teen greatly increases the odds of developing full-blown mental illness as an adult.

The Experiment

John Hopkins Medical School researchers started off with a group of mice that had a genetic predisposition to serious mental illness.

• Half of the mice served as a control group, and were raised through adolescence as normal
• The other half served as the experimental group. During adolescence, these mice were placed in isolation for 3 weeks (Inducing stress)

The Results

• The mice that were stressed during adolescence were far more likely to exhibit symptoms of mental illness in adulthood than the mice that were raised as normal to adulthood.
• When the researchers examined the brains of the experimental mice they found that mice exposed to stress during adolescence had higher levels of the stress hormone cortisol and lower levels of the neurotransmitter dopamine in areas of the brain related to higher order brain function, like emotional regulation and thinking.
• To see if it was cortisol that was causing the reduction in dopamine, the researchers then chemically blocked cortisol transmission. This caused dopamine levels to normalize.

The Significance

Commenting on the significance of the research, the study authors point out that:

1. Gaining an understanding of the biological causes of elevated cortisol levels in the brain may help in the development of medications to control stress hormone levels and treat certain mental illnesses.
2. To prevent mental illness, we need to do a better job of protecting people already predisposed to mental illness from stress during adolescence, for example, by protecting children growing up in families with mental illness from experiencing neglect.

Read the full study results in Science.

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New Jersey Governor Chris Christie calls the drug war a failure and uses a pro-life argument to call for treatment instead of jail.

In a speech given Monday at The Brookings Institution, New Jersey Governor Chris Christie slammed the war on drugs – calling it a well intentioned failure – and praised recent New Jersey legislation that imposes a year of mandatory treatment on first time non violent drug offenders as an alternative to jail time.

Calling for a wider change from current law and order based drug policy, Christie argued that not only does incarceration not deter drug use, it also costs taxpayers more than more effective alternatives like addiction treatment, saying, "It costs us $49,000 a year to warehouse a prisoner in New Jersey state prisons last year. A full year of inpatient drug treatment costs $24,000 a year."

And bringing kindness into the discussion, Christie called compassionate programs that divert addicted offenders to treatment instead of prison congruent with pro-life morality, saying, "If you're pro-life, as I am, you can't be pro-life just in the womb. Every life is precious and every one of God's creatures can be redeemed, but they won't if we ignore them."

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Researchers say that people with the DRD4 7R gene are at an increased risk of ADHD and addiction but also more likely to live to extreme old age.

For those prone to addiction…finally some good news!

Researchers say having a gene that predisposes you to conditions like ADHD and addiction may also keep you fit and healthy into extreme old age.

The DRD4 Gene

The DRD4 gene plays a role in regulating the body’s response to dopamine (a natural pleasure producing chemical).

People with the DRD4 7R allele do not respond as strongly to dopamine, and as a result, experience less pleasure from everyday stimuli (enjoying palatable foods, for example).

• People with this genotype have also been shown to have an increased risk of ADHD and addiction. The increased addiction risk likely occurs as people seek out more intense dopamine-releasing experiences as a way to compensate for their under-performing dopamine systems.
• However, people with this genotype are also more prone to greater activity as they seek out pleasure and arousal, and over the long term, especially once you pass the risky adolescent and young adulthood period, this seems to encourage longevity.

So a genotype which increases your risk of problems in early life may decrease your risk of problems in older age by keeping you more active and healthy.

The Experiment

Researchers collected genotype information from more than 1000, 90 to 109 year old study subjects.

They found that:

• The oldest study subjects were most likely to have the DRD4 7R allele.
• Compared to people who died at a younger age, people who lived past 90 were 66% more likely to have the DRD4 7R allele

To further test the link between the DRDR gene and longevity, the researchers eliminated the gene from a group of mice.

• The mice missing the DRD4 gene didn’t live as long (7%  to 9.7% fewer days) as the mice with this gene expression.

Read the full study results in the Journal of Neuroscience

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In a study which shows an association, but no causality – researchers find that people who drink 4 or more cans of diet soda per day are 31% more likely to get depression than people who do not drink sweetened beverages.

Do diet sodas and fruit drinks cause depression?

Well, researchers presenting findings at the American Academy of Neurology’s 65th Annual Meeting in San Diego later this year won’t go as far as saying that, but they do say that there’s a noteworthy linkage between increased diet drink consumption and an increased prevalence of depression.

More coffee drinking, by the way, seems to slightly lower a person’s risk of depression.

The Study

• NIH researchers polled more than 250 000, 50 to 71 year old study subjects about their drinking habits during 1995 and 1996.
• 10 years later, researchers followed up with all subjects to find out how many had been diagnosed with depression since the year 2000.

The Results

• 11 311 of the 263 925 subjects had been diagnosed with depression

Compared to people who did not regularly drink sweetened drinks:

• People who drank 4 or more cans of diet soda per day were 31% more likely to have been diagnosed with depression (People who drank 4 or more cans of regular soda were 22% more likely)
• People who drank 4 or more cans of diet fruit drinks per day were 51% more likely to have been diagnosed with depression

People who drank 4 or more cups of coffee per day were 10% less likely than non coffee drinkers to have been diagnosed with depression.

The Commentary

The researchers state, "Our research suggests that cutting out or down on sweetened diet drinks or replacing them with unsweetened coffee may naturally help lower your depression risk More research is needed to confirm these findings, and people with depression should continue to take depression medications prescribed by their doctors."

They also stress that that although results show an association between sweetened drinks and an increased incidence rate of depression – there is no way of knowing from this study whether consumption of sweetened drinks causes an increased depression risk.

As an alternate theory, some experts have suggested that depression may lead to increased cravings for sweetened foods and drink s and this is a more plausible explanation for the association than suggestions that sweetened drinks might cause depression in some way.