Recovery Michigan

The Sunday San Diego Union-Tribune on Dec. 18, 2016, carried two stories related to opioid overdoses.

In November, Kaiser Health News reporter Michelle Andrews shared her own experience, in which her surgeon prescribed 90 oxycodone/acetaminophen (Percocet) tablets after what she termed a minor laparoscopic knee surgery. When she asked her surgeon why so many, he said it was the default in his hospital's ordering system for knee procedures. "If you had real surgery, like a knee replacement, you wouldn't think [90] was so many," she quoted him as saying.

Andrews didn't say what she had done with her unused pills, but Bicket's group said safe disposal is uncommon. People who do want to get rid of them usually throw them in the trash or flush them down the toilet, but it's just as common, if not more so, to hoard them for some future pain episode. Or give them to friends and relatives who complain of pain.

Still another study, published in December in JAMA Surgery by a group in Boston, found a high rate of "potential overprescription:" patients discharged with opioid prescriptions even though they hadn't received any opioids during their last 24 hours as inpatients. More than 40% of patients who were opioid-free at discharge in the study still went home with prescriptions.

This isn't shock therapy.....

https://goo.gl/pofR6v

Transcranial direct current stimulation (tDCS) is a safe and effective add-on therapy for type I or II bipolar depression, researchers found.

"We were excited to show evidence that tDCS can be clinically effective for this population," Brunoni told MedPage Today, adding that in their study, the rate of treatment-emergent affective switches (TEAS) was similar between groups. "Nonetheless," he said, "I would recommend extra caution when applying tDCS for bipolar depressed patients who frequently present manic switches."

The study of tDCS was devised as an add-on trial in patients with bipolar depression receiving a stable pharmacologic regimen in the sham-controlled BETTER trial, which was conducted from July 1, 2014, to March 30, 2016. A parallel design was used to randomly assign 59 patients to either sham or active tDCS.

All patients had type I or II bipolar disorder with a major depressive episode and were receiving a stable pharmacologic regimen with Hamilton Depression Rating Scale-17 (HDRS-17) scores scores higher than 17. There was also a high prevalence of comorbid anxiety disorders in the study population. A third of patients had experienced an acute depressive episode that was unresponsive to at least two treatment regimens.

Of the 59 patients, a total of 52 (26 active and 26 sham) received all 12 tDCS treatment sessions. This included 10 daily 30-minute sessions of active or sham tDCS on weekdays and then one session every 2 weeks until week 6.

Participants lay in comfortable reclining chairs while scalp electrodes delivered weak, direct currents into the dorsolateral prefrontal cortex (DLPFC) region of the brain -- an area responsible for cognitive control and emotion regulation, which is hypoactive in depression. Patients were allowed to read or use their smartphones but not sleep. Talking with staff was minimal.

Food poisoning may be the unwanted gift that keeps on giving — at least according to a new study. A startling discovery by UC Santa Barbara scientists, published today in the journal Science, reveals how a past history of bacterial infections adds up with age to cause severe inflammatory disease.

“We have discovered an environmental and pathogenic origin of chronic intestinal inflammation in the course of modeling human food poisoning as it occurs repeatedly over the adult lifespan,” co-author Marth explained. “Remarkably, salmonellae have figured out a way to disrupt a previously unknown protective mechanism in the gut that normally prevents intestinal inflammation.”

A breakthrough eight years in the making, the multi-institution collaboration was launched to investigate the origin of chronic inflammatory diseases spanning colitis and IBD. The group’s radically different hypothesis took shape from a few possible clues, starting with increasing evidence that the genetic makeup of an individual plays a limited role in common inflammatory diseases, including colitis and IBD. Twins show relatively small concordance for both developing IBD, for example. Such findings implicate unknown environmental factors in disease origins.

An intranasal formulation of ketamine quickly diminished depressive symptoms in patients with treatment-resistant depression, researchers found.

Those improvements persisted despite reduced dosing frequency in a subsequent open-label phase that lasted about two months, the researchers said.

Several studies have shown ketamine to have antidepressant effects, and there's been growing interest in this and other NMDA receptor antagonists, in the class of glutamate receptor modulators, to treat depression and suicidality -- especially since about a third of patients don't respond to current treatment options.

Exposure to higher levels of lead during early childhood can affect neurological development -- but does that mean affected kids are doomed to delinquency?

The researchers noted that New Zealanders are particularly appropriate to study regarding this issue because high exposure to lead has been observed among children of all levels of family income. That would help eliminate economic class as a mitigating factor.

In Pakistan, it is not uncommon to see large families, including children, piled up on a motorbike. Three percent of households have cars, but 43 percent of households have motorcycles, according to the Pew Research Center. The reality is that most Pakistanis cannot afford to buy a car, and motorcycles are a relatively inexpensive alternative. Yet motorcycle accidents are frequently deadly.

This helmet, known as the HELLI, was created by Waqas Khalil, Ali Syed, Awais Azhar, and Syed Abdullah at Let’s Innovate. If a rider falls off the bike, the helmet automatically notifies emergency services nearby using its GPS. It comes equipped with Bluetooth, speakers, a heart rate sensor (which measures the heartbeat from the head via a blood oxygen sensor), and a dashcam on the front of the helmet. It’s also designed to withstand Pakistan’s monsoon rains.

“If you fall off the bike, it sends a text message to your next of kin and calls an ambulance,” said Khalil, who is 30, in a phone interview from Islamabad.

While only 21 percent of Pakistanis have access to mobile data, 67 percent of the population can access a cell phone. To address this issue, HELLI does not rely on mobile data. It instead connects to the phone via Bluetooth and calls the number you have saved in the app.

Most estimates suggest that at least 25 percent or 1 in 4 of American women have been sexually assaulted or raped. Someone the victim knows, sometimes with the assistance of a date rape drug, commits most rapes.

Knowing the most common date rape drugs, their side effects, and the signs of a perpetrator planning to use one can prevent victimization.

Types and their side effects

Date rape drugs make a sexual assault, including rape easier in one or more ways, such as:

• making a victim more compliant and less able to say no
• weakening a victim so they are unable to resist or fight back
• making a victim fully or partially unconscious
• weakening a victim's inhibitions, so they consent to sexual activity they may otherwise decline

Any drug that changes a potential victim's state of mind, including some prescription drugs, street drugs such as heroin, and popular drugs such as marijuana, can be a date rape drug.

Lupe Gonzalo works in the tomato fields of Immokalee, Fla., worlds apart from the Hollywood celebrities whose #MeToo testimony is exposing widespread sexual violence and toppling powerful men. Yet, Gonzalo says that it is women like her, “with no platform and no voice, invisible and vulnerable,” who bear the brunt of workplace sexual assault—and who offer lessons in how to band together to defeat it.

“Of course, it is incredibly important to pay attention to the suffering of all women, particularly women who work in industries and live in a society that doesn’t have protections, basic rights, where abuse is incredibly rampant,” says Gonzalo, referring to the #MeToo movement, first sparked in 2007 by Tarana Burke. “Looking at the extremity of that violence here, farmworkers began to create a solution and built a program to ensure our own rights.”

Identifying individuals with serious mental illness early, keeping them out of emergency rooms and jails, and increasing their access to quality care formed the basis of the recommendations of a new committee charged with improving mental health care across the country in a report released Thursday.

"I can tell you as a physician who's worked in the system for many, many years, that the emergency room is not a place for people that are experiencing exacerbations of mental health conditions," said Elinore McCance-Katz, MD, PhD, assistant secretary for Mental Health and Substance Use at the Substance Abuse and Mental Health Services Administration (SAMHSA) and chair of the committee that authored the report.

The solution, she said, is a "national system of crisis intervention services."

"We need a continuum of care with outpatient services as alternatives to inpatient care ... because we don't have enough beds in this country to accommodate people with serious mental illness."

And if the right system, one that included community interventions and adequate resources, were in place, "we might not need so many beds," she added.