Brain scans of people under the influence of the psilocybin, the active ingredient in magic mushrooms, have given scientists the most detailed picture to date of how psychedelic drugs work. The findings of two studies being published in scientific journals this week identify areas of the brain where activity is suppressed by psilocybin and suggest that it helps people to experience memories more vividly.

In the first study, published today in Proceedings of the National Academy of Sciences (PNAS), 30 healthy volunteers had psilocybin infused into their blood while inside magnetic resonance imaging (MRI) scanners, which measure changes in brain activity. The scans showed that activity decreased in "hub" regions of the brain – areas that are especially well-connected with other areas. The second study, due to be published online by the British Journal of Psychiatry on Thursday, found that psilocybin enhanced volunteers' recollections of personal memories, which the researchers suggest could make it useful as an adjunct to psychotherapy.

Professor David Nutt, from the Department of Medicine at Imperial College London, the senior author of both studies, said: "Psychedelics are thought of as 'mind-expanding' drugs so it has commonly been assumed that they work by increasing brain activity, but surprisingly, we found that psilocybin actually caused activity to decrease in areas that have the densest connections with other areas. These hubs constrain our experience of the world and keep it orderly. We now know that deactivating these regions leads to a state in which the world is experienced as strange." The intensity of the effects reported by the participants, including visions of geometric patterns, unusual bodily sensations and altered sense of space and time, correlated with a decrease in oxygenation and blood flow in certain parts of the brain.

The function of these areas, the medial prefrontal cortex (mPFC) and the posterior cingulate cortex (PCC), is the subject of debate among neuroscientists, but the PCC is proposed to have a role in consciousness and self-identity. The mPFC is known to be hyperactive in depression, so psilocybin's action on this area could be responsible for some antidepressant effects that have been reported. Similarly, psilocybin reduced blood flow in the hypothalamus, where blood flow is increased during cluster headaches, perhaps explaining why some sufferers have said symptoms improved under psilocybin.

In the British Journal of Psychiatry study 10 volunteers viewed written cues that prompted them to think about memories associated with strong positive emotions while inside the brain scanner. The participants rated their recollections as being more vivid after taking psilocybin compared with a placebo, and with psilocybin there was increased activity in areas of the brain that process vision and other sensory information.

Participants were also asked to rate changes in their emotional well-being two weeks after taking the psilocybin and placebo. Their ratings of memory vividness under the drug showed a significant positive correlation with their well-being two weeks afterwards. In a previous study of 12 people in 2011, researchers found that people with anxiety who were given a single psilocybin treatment had decreased depression scores six months later. Dr Robin Carhart-Harris, from the Department of Medicine at Imperial College London, the first author of both papers, said: "Psilocybin was used extensively in psychotherapy in the 1950s, but the biological rationale for its use has not been properly investigated until now. Our findings support the idea that psilocybin facilitates access to personal memories and emotions. "Previous studies have suggested that psilocybin can improve people's sense of emotional well-being and even reduce depression in people with anxiety. This is consistent with our finding that psilocybin decreases mPFC activity, as many effective depression treatments do. The effects need to be investigated further, and ours was only a small study, but we are interested in exploring psilocybin's potential as a therapeutic tool."

The researchers acknowledged that because the participants in this study had volunteered after having previous experience of psychedelics, they may have held prior assumptions about the drugs which could have contributed to the positive memory rating and the reports of improved well-being in the follow-up.

Functional MRI measures brain activity indirectly by mapping blood flow or the oxygen levels in the blood. When an area becomes more active, it uses more glucose, but generates energy in rapid chemical reactions that do not use oxygen. Consequently, blood flow increases but oxygen consumption does not, resulting in a higher concentration of oxygen in blood in the local veins.

In the PNAS study, the volunteers were split into two groups, each studied using a different type of fMRI: 15 were scanned using arterial spin labelling (ASL) perfusion fMRI, which measures blood flow, and 15 using blood-oxygen level-dependent (BOLD) fMRI. The two modalities produced similar results, strongly suggesting that the observed effects were genuine.

Using marijuana carries legal risks, but a new study shows that the consequences of occasionally lighting up do not include long-term loss of lung function, according to a new study by University of Alabama at Birmingham researchers published in the January 11, 2012, issue of the Journal of the American Medical Association.

Marijuana is the most commonly used illicit drug in the United States, according to the National Survey on Drug Use and Health. In 2009, 16.7 million Americans ages 12 and older reported using marijuana at least once in the month prior to being surveyed. In addition, since 1996, 16 states and Washington, D.C., have legalized the medical use of marijuana to help manage the symptoms of many diseases, including cancer, AIDS and glaucoma. "With marijuana use increasing and large numbers of people who have been and continue to be exposed, knowing whether it causes lasting damage to lung function is important for public-health messaging and medical use of marijuana," says the study's senior author, Stefan Kertesz, M.D., associate professor in the UAB Division of Preventive Medicine and with the Center for Surgical, Medical and Acute Care Research and Transitions at the Veterans Affairs Medical Center in Birmingham. Kertesz says it's long been known that marijuana smoke has many irritant chemicals found in tobacco smoke and can cause lung irritation, wheezing and cough immediately after use; however, the research on long-term effects on lung function have inconsistencies.

Using a large national database, the research team compared the lung function of marijuana and tobacco smokers during a 20-year period. The data revealed that tobacco smoke had exactly the effect shown in all prior studies — increasing a person's cumulative exposure to cigarettes results in loss of air flow and lung volumes; the opposite was true for marijuana smoke. "At levels of marijuana exposure commonly seen in Americans, occasional marijuana use was associated with increases in lung air flow rates and increases in lung capacity," Kertesz says. "Those increases were not large, but they were statistically significant. And the data showed that even up to moderately high-use levels — one joint a day for seven years — there is no evidence of decreased air-flow rates or lung volumes."

Kertesz cautions that smoking marijuana is not an avenue to better lung health. "It's not enough of an increase that would make you feel better," he says "Healthy adults can blow out 3 to 4 liters of air in one second. The amount of gain, on average, from marijuana is small, 50 ccs or roughly a fifth of a can of coke. So it's not something that would be noticeable."

Also, Kertesz says, the increase does not hold steadfast over time. "The relationship changes for people who get to high levels of lifetime exposure," he says. "At that point, the data suggests there is a decline in lung air-flow rate. There also may be other damaging effects that don't manifest until extremely high levels of exposure; we did not have enough very heavy marijuana smokers in this study to determine this."

To perform their analysis, Kertesz and a research team from other universities looked at data from the Coronary Artery Risk Development in Young Adults Study. CARDIA, funded by the National Heart, Lung and Blood Institute, is a long-term research project involving more than 5,000 black and white men and women from Birmingham, Chicago, Minneapolis and Oakland, designed to examine the development and determinants of cardiovascular disease and its risk factors. Participants were recruited when they were ages 18-30 and followed from 1985 to 2006. The researchers looked closely at the reported use of both marijuana and tobacco and asked participants repeatedly during years of follow-up about their use of these substances. Marijuana and tobacco use were both commonly reported — 37 percent said they used marijuana at some point during the study. This is similar, the researchers say, to what many Americans have said in other national surveys.

As part of the CARDIA protocol, participants' lung function was measured for air flow and lung volume at years 0, 2, 5, 10 and 20 using standard pulmonary function tests. The air flow measure is the amount of air you can blow out of your lungs in one second after taking the deepest breath possible. The volume measure is the total amount of air you can blow out after taking the deepest breath possible.

Lead author, Mark J. Pletcher, M.D., of the Department of Epidemiology and Biostatistics, and Department of Medicine at the University of California, San Francisco, who led the statistical analysis, says what sets this study apart from any others is both the number of participants and duration of the study. "This is not the first study to show that marijuana has a complicated relationship with lung function. However, the size of the study and the long duration of follow-up help us to paint a clearer picture of the ways in which the relationship changes over time," he says.

As a final note, Kertesz clarified that the study did not examine other ways in which smoking marijuana could affect a person's health and insisted this study does not advocate the use of marijuana. "Marijuana is still an illegal drug, and it has many complicated effects on the human body and its function," he says. "In our findings we see hints of harm in pulmonary function with heavy use, and other studies have shown that marijuana use increases a user's likelihood of a heart attack, according to the American Heart Association, and impairs the immune system's ability to fight disease, according to the National Institute on Drug Abuse."

Nicotine replacement therapies (NRTs) designed to help people stop smoking, specifically nicotine patches and nicotine gum, do not appear to be effective in helping smokers quit long-term, even when combined with smoking cessation counseling, according to a new study by researchers at Harvard School of Public Health (HSPH) and the University of Massachusetts Boston. The study appears January 9, 2012 in an advance online edition of Tobacco Control and will appear in a later print issue.

"What this study shows is the need for the Food and Drug Administration, which oversees regulation of both medications to help smokers quit and tobacco products, to approve only medications that have been proven to be effective in helping smokers quit in the long-term and to lower nicotine in order to reduce the addictiveness of cigarettes," said co-author Gregory Connolly, director of the Center for Global Tobacco Control at HSPH.

In the prospective cohort study the researchers, including lead author Hillel Alpert, research scientist at HSPH, and co-author Lois Biener of the University of Massachusetts Boston's Center for Survey Research, followed 787 adult smokers in Massachusetts who had recently quit smoking. The participants were surveyed over three time periods: 2001-2002, 2003-2004, and 2005-2006. Participants were asked whether they had used a nicotine replacement therapy in the form of the nicotine patch (placed on the skin), nicotine gum, nicotine inhaler, or nasal spray to help them quit, and if so, what was the longest period of time they had used the product continuously. They also were asked if they had joined a quit-smoking program or received help from a doctor, counselor, or other professional.

The results showed that, for each time period, almost one-third of recent quitters reported to have relapsed. The researchers found no difference in relapse rate among those who used NRT for more than six weeks, with or without professional counseling. No difference in quitting success with use of NRT was found for either heavy or light smokers. "This study shows that using NRT is no more effective in helping people stop smoking cigarettes in the long-term than trying to quit on one's own," Alpert said. He added that even though clinical trials (studies) have found NRT to be effective, the new findings demonstrate the importance of empirical studies [emphasis added] regarding effectiveness when used in the general population.

Biener said that using public funds to provide NRT to the population at large is of questionable value, particularly when it reduces the amount of money available for smoking interventions shown in previous studies to be effective, such as media campaigns, promotion of no smoking policies, and tobacco price increases. Smoking cessation medications have been available over the counter since 1996, yet U.S. Centers for Disease Control and Prevention statistics show that the previous adult smoking rate decline and quitting rates have stalled in the past five years.  

Urgently needed tests which could help identify the manufacturers of designer 'legal high' drugs are being developed in research led at the University of Strathclyde in Glasgow.

The drugs, known by names such as 'ivory wave' and NRG-1" and sold labelled as bath salts, plant food and incense, mimic the effects of illegal drugs such as amphetamine, cocaine and ecstasy. Although these so-called 'designer drugs' can be dangerous, many have not yet been made illegal and are difficult to detect with current drug tests. A means of potentially tracing the source of the raw materials, and consequently providing information as to who is making the 'bath salts,' is being developed by scientists at Strathclyde and The James Hutton Institute.

The bath salts drug can cause euphoria, paranoia, anxiety and hallucinations. It often contains mephedrone, a synthetic compound structurally related to methcathinone, which is found in Khat - a plant which, like mephedrone itself, is illegal in many countries. The bath salts drug is labelled as being not for human consumption and is not illegal in the UK but its import has been banned. The term 'bath salts' is used by those who sell the drug as a way of circumventing legislation when supplying it.

The researchers developing tests for the drug are using a technique known as isotope ratio mass spectrometry (IRMS) to reveal the course of a drug's manufacture. The research is being carried out by Dr Oliver Sutcliffe, at the Strathclyde Institute of Pharmacy and Biomedical Sciences, and Professor Niamh Nic Daeid and Dr Katy Savage at the Centre for Forensic Science in the Department of Pure and Applied Chemistry, in collaboration with Dr Wolfram Meier-Augenstein at The James Hutton Institute.

Dr Sutcliffe said: "The legal status of designer drugs varies around the world but they present many dangers to users and these are borne out by the Home Office's decision to ban the import of 'bath salts. The new method we have used has enabled us to work backwards and trace the substances back to their starting materials. IRMS measures the relative amounts of an element's different forms- it is successful because these relative amounts are transferred like a fingerprint through the synthesis of the drug."

Le Strat, Y. and Le Foll, B. (2011). Obesity and Cannabis Use: Results From 2 Representative National Surveys.
American Journal of Epidemiology: kwr200v1-kwr200.

Abstract: The role of cannabis and endocannabinoids in appetite regulation has been extensively studied, but the association of cannabis use with weight in the general population is not known. The authors used data from 2 representative epidemiologic studies of US adults aged 18 years or older, the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC; 2001–2002) and the National Comorbidity Survey–Replication (NCS-R; 2001–2003), to estimate the prevalence of obesity as a function of cannabis use. The adjusted prevalences of obesity in the NESARC and the NCS-R were 22.0% and 25.3%, respectively, among participants reporting no use of cannabis in the past 12 months and 14.3% and 17.2%, respectively, among participants reporting the use of cannabis at least 3 days per week. These differences were not accounted for by tobacco smoking status. Additionally, after adjustment for sex and age, the use of cannabis was associated with body mass index differences in both samples. The authors conclude that the prevalence of obesity is lower in cannabis users than in nonusers.

A study published today in the journal Addiction reveals that drunkenness increases the risk for violent behavior, but only for individuals with a strong inclination to suppress anger.

The two authors, Thor Norström and Hilde Pape, applied an approach that reduces the risk of drawing erroneous conclusions about cause and effect. They conclude that their study adds to the body of evidence suggesting that drinking may in fact inflict physical aggression. The authors elaborate this conclusion: "Only a tiny fraction of all drinking events involve violence and whether intoxicated aggression is likely to occur seems to depend on the drinkers' propensity to withhold angry feelings when sober."

The study is based on self-reported data from a general population survey of young people in Norway. Nearly 3000 individuals were assessed twice, first at 16-17 years of age and again at ages 21-22. The participants were divided into 3 equally large groups with respect to anger suppression. Among individuals who reported a high inclination to suppress feelings of anger, a 10% increase in drinking to the point of intoxication was associated with a 5% increase in violence. Researchers observed no such association among those who did not habitually suppress their angry feelings.

The first ever large-scale, longitudinal study of ketamine users has been published online today in the journal Addiction. With Ketamine (K, Special K) use increasing faster than any other drug in the UK (British Crime Survey, 2008) this research showing the consequences of repeated ketamine use provides valuable information for users and addiction professionals alike.

For the study, researchers from University College London followed 150 people over a year to see if changes in their ketamine use could predict changes in their psychological well-being, memory and concentration. Of these 150 people, 30 were taking large quantities of the drug nearly every day, 30 were taking it 'recreationally' (once or twice a month), 30 were former users, 30 used illicit drugs apart from ketamine and 30 did not use any illicit drugs.

The authors found that the heavy ketamine users were impaired on several measures, including verbal memory. Short term memory and visual memory in this group decreased over the year as ketamine use increased. These individuals also performed more poorly overall on verbal memory, displaying symptoms such as forgetfulness and experiencing difficulty recalling conversations and people's names.

The amount of increase in ketamine use over the course of one year was also a source of concern. Hair analysis showed that ketamine levels among recreational users doubled at follow-up compared to initial testing, a pattern seen with other addictive drugs. Ketamine levels in the frequent using group did not change across the year, but this group was already using up to ten grams per day at initial testing.

Interestingly, the recreational ketamine users and ex-ketamine users did not differ from non-drug-taking controls on memory, attention and measures of psychological well-being, suggesting that occasional ketamine use does not lead to prolonged harms to cognitive function and that any damage may be reversed when people quit using the drug. However, all groups of ketamine users showed evidence of unusual beliefs or mild 'delusions', with these being greatest in the frequent users and least in ex-users (i.e. it appeared dependent on the amount of the drug used). It is not clear to what extent this is a pre-existing difference in ketamine users, something that develops from using the drug or a mixture of both.

Says lead author Dr. Celia Morgan: "These findings have implications for the growing number of ketamine users in the UK as well as addiction professionals who may encounter increasing numbers of ketamine dependent users. These findings suggest these frequent ketamine users will be impaired, albeit transiently, in a variety of psychological domains."

Women and men tend to have different types of stress-related psychological disorders. Women have greater rates of depression and some types of anxiety disorders than men, while men have greater rates of alcohol-use disorders than women. A new study of emotional and alcohol-craving responses to stress has found that when men become upset, they are more likely than women to want alcohol.

Results will be published in the July issue of Alcoholism: Clinical & Experimental Research.

“We know that women and men respond to stress differently,” said Tara M. Chaplin, associate research scientist at Yale University School of Medicine and first author of the study. “For example, following a stressful experience, women are more likely than men to say that they feel sad or anxious, which may lead to risk for depression and anxiety disorders. Some studies have found that men are more likely to drink alcohol following stress than women. If this becomes a pattern, it could lead to alcohol-use disorders.”

As part of a larger study, the researchers exposed 54 healthy adult social drinkers (27 women, 27 men) to three types of imagery scripts – stressful, alcohol-related, and neutral/relaxing – in separate sessions, on separate days and in random order. Chaplin and her colleagues then assessed participants’ subjective emotions, behavioral/bodily responses, cardiovascular arousal as indicated by heart rate and blood pressure, and self-reported alcohol craving.

“After listening to the stressful story, women reported more sadness and anxiety than men,” said Chaplin, “as well as greater behavioral arousal. But, for the men … emotional arousal was linked to increases in alcohol craving. In other words, when men are upset, they are more likely to want alcohol.”

These findings – in addition to the fact that the men drank more than the women on average – meant that the men had more experience with alcohol, perhaps leading them to turn to alcohol as a way of coping with distress, added Chaplin. “Men’s tendency to crave alcohol when upset may be a learned behavior or may be related to known gender differences in reward pathways in the brain,” she said. “And this tendency may contribute to risk for alcohol-use disorders.”

There is a greater societal acceptance of “emotionality,” particularly sadness and anxiety, in women than in men, noted Chaplin.

“Women are more likely than men to focus on negative emotional aspects of stressful circumstances, for example, they tend to ‘ruminate’ or think over and over again about their negative emotional state,” she said. “Men, in contrast, are more likely to distract themselves from negative emotions, to try not to think about these emotions. Our finding that men had greater blood pressure response to stress, but did not report greater sadness and anxiety, may reflect that they are more likely to try to distract themselves from their physiological arousal, possibly through the use of alcohol.”

A silver dollar-sized region deep in the brain called the insula is intimately involved in smoking addiction, and damage to this structure can completely erase the body's urge to smoke, researchers have discovered. The findings appear in the 26 January 2007 issue of the journal Science, published by AAAS, the nonprofit science society.

Obviously brain damage is not a treatment option for nicotine addiction, but the new results may offer leads for therapies to help smokers kick the habit or for monitoring smokers' progress while using existing therapies.

The study was largely inspired by a patient who had smoked around 40 cigarettes a day before his insula was damaged by a stroke and then quit immediately after. He told the researchers that his body "forgot the urge to smoke." [read more]

The news media seriously underreport the role alcohol plays in violent crimes, injuries and traffic accidents, according to a new national study. While alcohol is believed to play a role in about one-third of homicides and fatal motor vehicle accidents, media reports linked alcohol to specific accidents or crimes significantly less frequently.

Some of the largest discrepancies occurred in reporting alcohol use in violent crimes, particularly for television news. Only 1.4 percent of television news stories in the sample mentioned the role of alcohol in their reporting of homicides, according to Michael Slater, co-author of the study and professor of communication at Ohio State University.

The result is that the public may underestimate the dangers of alcohol use, Slater said. “People's perceptions of risk are strongly shaped by what they see in the media, so many people may have distorted views about the risks of alcohol use,” he said. “If the media doesn't report on the link between alcohol and violent crime and accidents, most people won't be fully aware of the risks. This may also decrease public support for alcohol control measures that can significantly reduce alcohol-related problems”

Slater conducted the study with Marilee Long and Valerie Ford of Colorado State University. Their results appear in the November 2006 issue of the Journal of Studies on Alcohol.

The link between violent crime and alcohol use was also rarely acknowledged. Estimates suggest alcohol plays a role in 31 percent of homicides, but it is mentioned in only 2.6 percent of television reports, 7.3 percent of newspaper accounts, and 5.6 percent of magazine reports of violent crime, with even lower percentages in the reporting of homicides.

For this study, the researchers used estimates that alcohol plays a role in about one third (31.1 percent) of homicides and a third (31 percent)of fatal non-traffic injuries. The estimates come from a study of data from 331 medical examiner studies conducted between 1975 and 1995.

They used statistics from the National Highway Traffic Safety Administration which estimated that 34 percent of accidents involved people who were legally intoxicated.

The researchers then examined coverage of crimes and accidents appearing in a national sample of daily newspaper, magazine and local television news, as well as national television news during a two-year period (2002-03). They determined the percentage of stories that linked alcohol use to specific violent crimes, injuries and motor vehicle accidents.

In all, they analyzed the content of about 1,000 daily newspaper editions, 550 television news programs, and 72 magazine issues. Newspapers and television stations were selected so they represented all regions of the country, in cities of various sizes. Three news magazines – Newsweek, Time and U.S. News & World Report -- were also sampled, as were the three major television networks, CNN and USA Today. This sample more closely approximates a truly representative national sample of media outlets than any previous study of which the researchers are aware, Slater said.

As expected, the media was most likely to report on alcohol use in motor vehicle accidents, but even then, they fell far short of estimated numbers, Slater said. While alcohol is linked to 34 percent of motor vehicle accidents, only 12.8 percent of television stories, 19.2 percent of newspaper articles, and 22.2 percent of magazine articles about such accidents mentioned the use of alcohol, the study revealed.

For stories about fatal accidents not involving motor vehicles, alcohol was mentioned in 1.4 percent of television reports, 4.8 percent of newspaper stories and 13.6 percent of magazine articles. However, statistics suggest 31 percent of these accidents involve the use of alcohol. The link between violent crime and alcohol use was also rarely acknowledged.

Estimates suggest alcohol plays a role in 31 percent of homicides, but it is mentioned in only 2.6 percent of television reports, 7.3 percent of newspaper accounts, and 5.6 percent of magazine reports of violent crime, with even lower percentages in the reporting of homicides. As these figures show, television does the poorest job in reporting when accidents or crimes have a connection to alcohol use.

“The percentage of TV news stories about violent crime that mention the role of alcohol was less than one-tenth the estimated percentage that had such a link,” Slater said. “By just watching TV news, most people would have little idea about the dangers of alcohol abuse when it comes to crime and accidents,” he said. “Even the print media doesn't give the complete story.”

The study also looked at media coverage of drug use and found that between 1.8 and 18.1 percent of reports about crimes or accidents mentioned the use of drugs. However, there were no estimates available about how often drug use was actually involved in these incidents.

The underreporting of the alcohol connection to crimes and accidents can be blamed on both police and news reporters, Slater said. Police departments may not mandate that officers mention in their reports if alcohol is suspected of playing a role in a violent crime or some types of accidental deaths. And reporters and their editors don't make it a habit to ask.

Whatever the reasons, Slater said it does make a difference. “The underreporting of the contribution of alcohol to crime and accidents may make it more difficult for wide acceptance of strategies to control alcohol use,” he said.

23 October 2006
Ohio State University Research News

Researchers at Rush University Medical Center found prescription pain medication (PPM) abuse is a rapidly growing problem with surprising and often unpredictable distribution patterns. The research was presented at the Annual Meeting of the American Society for Anesthesiologists in Chicago, October 13, 2006.

Mario Moric, PhD, a researcher in the department of Anesthesiology at Rush, and colleagues used survey data from the National Survey on Drug Use and Health for 2002-04 to estimate the prevalence of drug abuse across the United States for various illicit and prescription substances.

Moric found that PPM abuse did not follow traditional patterns. “Individual states with high levels of PPM abuse may not recognize the problem. The prevailing assumption that only those states with high levels of traditional illicit drug abuse should be vigilant is clearly misleading.”

The researchers found distribution of PPM abuse across the United States varied greatly and differed from other seemingly similar drug abuse trends. PPM distribution differed substantially from inhalants, heroin and sedatives, was somewhat similar to cocaine and stimulants and was closely related to distribution of tranquilizers.

Furthermore, the researchers found that states with large metropolitan areas (New York, Illinois, Texas and California) did not have a high distribution of abuse, despite the common view that drug abuse is associated with the fast-paced lifestyle of city dwellers.

“Distribution of PPM abuse across the states differs from high-profile street drugs and even particular PPMs such as oxycodone, which has its own specific pattern,” Moric said. “It is for this reason that PPM abuse must be monitored separately from other illicit substances, and the most commonly abused or most problematic PPMs should be monitored individually.”

Oxycodone, in particular, was singled out by Moric’s group because of its highly addictive nature and specific distribution pattern, which differed from many other PPMs and illicit drugs. Similar to heroin in both its effect on the body and addictive nature, oxycodone is often crushed or mixed with other drugs and used for its heroin-like “rush.” Moric warned that the key to understanding and identifying abuse requires a more sophisticated understanding than that abusers simply want to “feel good.”

“As users become addicts, they undergo a fundamental neurobiological change,” Moric said. “Processes such as learning, memory, perception, arousal and motivation all drastically change, and to classify abuse purely as ‘pleasure seeking’ is a gross oversimplification.”

The surprising results from the study should offer something of a wake-up call to physicians and other health care workers everywhere in the country. “Clinicians need to be aware of the level of abuse in their area and moderate their vigilance accordingly,” Moric said.

If PPM abuse is identified in a particular area, a multifaceted response should be implemented, he said. “Drug abuse prevention, outreach and information dissemination programs by federal, state and nonprofit agencies should be notified so that public awareness can be heightened and action be taken to reduce the problem.”

According to Moric, anesthesiologists who practice pain medicine play a particularly crucial role in combating PPM abuse. “We feel that the most important function of anesthesiologists with respect to PPM abuse is in education. Anesthesiologists are the most relevant spokespersons for both the benefits of PPMs and the potential abuses,” Moric said.

16 October 2006
Rush News Room