Damage to the Insula Leads to Decreased Nicotine Withdrawal During Abstinence Addiction Current smokers with damage to their insular cortex from ischemic stroke appear to experience fewer and less severe tobacco withdrawal symptoms, and appear to be less likely to require nicotine replacement therapy during hospitalization, compared with smokers with non-insular damage. These findings support the potential role of the insular cortex in regulating withdrawal during abstinence; the implications may extend to other addictive disorders.
Editorial Comments William Haning, MD, FASAM, DFAPA Readers will note the emphasis on smoking, nicotine, and adolescents in this week’s ASAMW. The reliability of current epidemiological data is very high, respecting the impact of nicotine restrictions on children, and very encouraging. There is a temptation in open discussions to drag the experience of alcohol Prohibition into the discussion, but that leads to a false syllogism. The prevention of access to nicotine and even delivery systems is an altogether different matter in kids than in adults, for the same reasons that we identify and prohibit other harmful practices. It is a population untrammeled by caution, or by a clear understanding of mortality and risk.
FROM JOURNAL OF ADDICTION MEDICINE
Age and Cohort Patterns of Medical and Nonmedical Use of Controlled Medication Among Adolescents Journal of Addiction Medicine (free ASAM member resource) An adolescent cohort analysis suggests progressively earlier initiation of both medical and non-medical use of scheduled, abusable substances: opioid analgesics, stimulants, sedatives, and anxiolytics. Aside from the call for earlier initiation of misuse interventions, the study is disturbing for the implication of regressive physician prescribing practices with children.
Editor-in-Chief: Jeffrey Samet, Boston University School of Medicine
Addiction Science & Clinical Practice provides a forum for clinically relevant research and perspectives that contribute to improving the quality of care for people with unhealthy alcohol, tobacco, or other drug use and addictive behaviours across a spectrum of clinical settings.
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Association of Smoke-Free Laws w/Lower Percentages of New & Current Smokers Among Adolescents & Young Adults JAMA Pediatrics Analysis of the National Longitudinal Survey of Youth 1997-2007: Importantly, this demonstrates that smoke-free laws are an effective and important tobacco control tool, not only protecting bystanders from secondhand smoke but also contributing to less smoking among adolescents and young adults.
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Frequency of Tobacco Use Among Middle and High School Students — United States, 2014 CDC Morbidity and Mortality Weekly Report This study of youth nicotine use is important for including electronic vaporizer data, where many have centered on tobacco per se. In 2014, among middle and high school students who used at least one of these four products, an estimated 480,000 middle school and high school students smoked cigarettes, 390,000 used smokeless tobacco, 340,000 used e-cigarettes, and 170,000 smoked cigars on ≥20 of the preceding 30 days. The study describes initiation and peak use onsets, and is important background in the support of nicotine control legislation.
Progression to Traditional Cigarette Smoking After Electronic Cigarette Use Among US Adolescents and Young Adults JAMA Pediatrics Electronic cigarettes (e-cigarettes) may help smokers reduce the use of traditional combustible cigarettes. However, adolescents and young adults who have never smoked traditional cigarettes are now using e-cigarettes, and these individuals may be at risk for subsequent progression to traditional cigarette smoking.
High School Students’ Use of Electronic Cigarettes to Vaporize Cannabis Pediatrics This is an excellent quantification of the outcome of having access to e-vaporizers, in a cannabis-using adolescent population. It puts numbers to a source of apprehension that has been present for years. The authors evaluated lifetime rates of using e-cigarettes to vaporize cannabis among all lifetime e-cigarette users (27.9%), all lifetime cannabis users (29.2%), and lifetime users of both e-cigarettes and cannabis (18.8%).
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Chicago: Police Investigate Possibility of Tainted Heroin After Spike In Overdoses CBS Chicago Chicago police and federal agents have launched an investigation into the cause of a spike in heroin overdoses this week on the city’s West Side. The Chicago Fire Department said paramedics saw heroin overdoses skyrocket last week. In a span of 24 hours, at least 23 people overdosed on heroin on the West Side. So far, one of those victims has died.
Ketamine and Other NMDA Antagonists: Early Clinical Trials and Possible Mechanisms in Depression American Journal of Psychiatry The antidepressant efficacy of ketamine, and perhaps D-cycloserine and rapastinel, holds promise for future glutamate-modulating strategies; however, the ineffectiveness of other NMDA antagonists suggests that any forthcoming advances will depend on improving our understanding of ketamine’s mechanism of action. The fleeting nature of ketamine’s therapeutic benefit, coupled with its potential for abuse and neurotoxicity, suggest that its use in the clinical setting warrants caution.
Brain Stimulation as a Potential Treatment for Addiction ASAM Magazine The authors have reviewed 3 current transcranial stimulation modalities being explored in management of psychiatric disorders, and raise the question of their suitability for addictive disorders. The recommendation for further research is well-founded, as the present studies’ outcomes are less than robust. Coupled with the tendency of the SUD population to seek rapid cures and to notoriously respond briefly to any novel intervention, a therapeutic recommendation is premature.
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Articles included are reviewed on their merit at the discretion of ASAM Weekly’s Editor-in-Chief. Any relationship that exists with products or services advertised with content is coincidental and not an endorsement, guarantee or condemnation of said products or services. Similarly, the views and positions of any content published in ASAM Weekly are not necessarily endorsed by ASAM nor a reflection of ASAM's beliefs and policies. The features are presented as a summary of the contemporary issues being represented and expressed in scientific, governmental, commercial, and media sources across the specialty field of addiction medicine. Contact ASAM Weekly with any comments or feedback.