Recovery Michigan

Five states that have implemented multi-faceted prescription drug abuse prevention programs in recent years showed the highest rate of decline in prescription drug misuse rates nationwide, according to a new study issued by Quest Diagnostics, the world's leading provider of diagnostic information services. The findings suggest that broad, collaborative measures that include prescription drug databases and physician and patient education may be effective at curbing the nation's epidemic of prescription drug abuse.

Florida, Georgia, Kentucky, New York and Tennessee showed the highest rates of decline in misuse rates over the last three years, according to the study of more than 1.4 million drug test results between 2011 and 2013. The average decline for these states was 10.7%, nearly 2.5 times higher than the average decline of 4.4% for all other states combined, in the 46-state study

Mental health patients are at their highest risk of dying by suicide in the first two weeks after leaving hospital - a report out today shows. Around 3,225 patients died by suicide in the UK within the first three months of their discharge from hospital - 18% of all patient suicides, between 2002-2012.

"This increased risk has been linked to short admissions and to life events so our recommendations are that careful and effective care planning is needed including for patients before they are discharged and for those who self-discharge.

"Early follow-up appointments should be strengthened and reducing the length of in-patient stay to ease pressure on beds should not be an aim in itself. Instead health professionals should ensure the adverse events that preceded the admission have been addressed.

Social integration, such as being married, attending religious services, and having a large network of friends protects men against suicide, according to a study being published in Annals of Internal Medicine.

Suicide is one of the top 10 leading causes of death among men in the United States. Prevention efforts usually emphasize the study of psychiatric, psychological, or biological determinants. However, research has shown that a substantial proportion of suicidal behaviors occur in the absence of a formally diagnosed mental disorder, suggesting that a deeper understanding of factors driving suicide is needed.

However, even after successful extinction, old fear associations can return under other stressful circumstances. This might involve the development of PTSD or a relapse after successful psychotherapy. Kalisch has found that L-dopa, a drug to treat Parkinson's disease, can prevent this effect and could therefore possibly be used to prevent relapse in treated PTSD or phobia patients. L-dopa is taken up by the brain and transformed into dopamine that not only controls the brain's reward and pleasure centers and helps regulate movement, but also affects memory formation. The person receiving L-dopa after extinction will thus create a stronger secondary positive memory of the extinction experience and will thus be able to more easily replace the negative memory. This raises new questions about the role of primary fear memories and secondary prevention by L-dopa. "We would like to be able to enhance the long-term effects of psychotherapy by combining it with L-dopa," said Professor Raffael Kalisch. To this end, he is about to start a clinical study of people with a spider phobia to determine the effects of L-dopa on therapy outcome. "Manipulating the dopamine system in the brain is a promising avenue to boost primary and secondary preventive strategies based on the extinction procedure," he continued.

Professor Jorge Manzanares explained that "an early disorder of the stress circuit caused by maltreatment affects how people receive situations." Also, Manzanares said that "the consumption of a substance in a problematic manner is due to an altered effect between a person's genetics and their environment. Thus, we know that people who come from an alcoholic parent and who are also mistreated have a higher vulnerability to developing substance use disorders."

Moreover, the psychiatrist Gabriel Rubio noted that "the abuse suffered during childhood predisposes adolescents to substance use because of the activation of mechanisms and brain circuits that motivates them to try more and to underestimate risk." Rubio explained that "the sequence of this process begins with the abuse which is to blame for activating the stress mechanisms and at the same time responsible for causing a change in brain circuits that predisposes adolescents to adopt consumer behaviour and ultimately be hooked".

According to Richard Tedeschi, a psychologist at the University of North Carolina who studies PTG, people are routinely reporting positive changes from trauma in five areas:

• A renewed appreciation for life

• New possibilities for themselves

• More personal strength

• Improved relationships

• More spiritual satisfaction

Tedeschi's research and other similar studies should sound a positive note and offer some hope for people with PTSD. So why don't we hear more about this?

The response is helpful for warming up the muscles during "fight or flight" situations, such as when wild animals face their enemies; however, stress for people in today's society can last a long time and cause a chronic increase in body temperature, a condition called psychogenic fever, which brings on intense fatigue.

Now researchers published online in the Cell Press journal Cell Metabolism have identified a key neural circuit connection in the brain that's responsible for the development of psychological stress-induced hyperthermia and likely also plays a role in chronic psychogenic fever.

We identified 1527 cases of violence disproportionally reported for 31 drugs. Primary suspect drugs included varenicline (an aid to smoking cessation), 11 antidepressants, 6 sedative/hypnotics and 3 drugs for attention deficit hyperactivity disorder. The evidence of an association was weaker and mixed for antipsychotic drugs and absent for all but 1 anticonvulsant/mood stabilizer. Two or fewer violence cases were reported for 435/484 (84.7%) of all evaluable drugs suggesting that an association with this adverse event is unlikely for these drugs.

Conclusions

Acts of violence towards others are a genuine and serious adverse drug event associated with a relatively small group of drugs. Varenicline, which increases the availability of dopamine, and antidepressants with serotonergic effects were the most strongly and consistently implicated drugs. Prospective studies to evaluate systematically this side effect are needed to establish the incidence, confirm differences among drugs and identify additional common features.

From 2006 through 2010, an annual average of 87,798 (27.9/100,000 population) AAD and 2.5 million (831.6/100,000) YPLL occurred in the United States. Age-adjusted state AAD rates ranged from 51.2/100,000 in New Mexico to 19.1/100,000 in New Jersey. Among working-age adults, 9.8% of all deaths in the United States during this period were attributable to excessive drinking, and 69% of all AAD involved working-age adults.

Conclusions
Excessive drinking accounted for 1 in 10 deaths among working-age adults in the United States. AAD rates vary across states, but excessive drinking remains a leading cause of premature mortality nationwide. Strategies recommended by the Community Preventive Services Task Force can help reduce excessive drinking and harms related to it.