Recovery Michigan

A new study of hundreds of emergency department visits finds that the links between substance misuse and suicide risk are complex, but that use of cocaine and alcohol together was particularly significant.

In a general sense, medical studies support the popular intuition — a staple of movies and literature — that suicidal behavior and substance misuse are linked. But the relationship between the two is not so simple. A new study of hundreds of suicidal emergency department (ED) patients from around the U.S. found that the significance of the link varied with age, gender and race. Across the board, however, the use of cocaine and alcohol together was a red flag.

“One unexpected finding was that, when examined independently, alcohol use had no significant association and cocaine use had a borderline significant association,” wrote authors of the study in the journal Crisis. “However, reporting both alcohol misuse and cocaine use was significantly associated with a future suicide attempt.”

Specifically, facing a mortgage foreclosure was shown to increase the probability of suffering noticeable poor health by 13 times (57.3% of the men and 80.9% of the women that participated in the study reported poor health). It also tripled the risk of suffering cardiovascular disease and nearly doubled the use of tobacco. The researchers also observed a greater proportion of individuals with depression, anxiety and other mental disorders among those who were evicted.

Additionally, women who underwent eviction showed a worse result than men in all the criteria analysed according to the study, which was published in the latest issue of Gaceta Sanitaria.

A 2013 study on mice published in the journal Brain, Structure and Functionused differed types of noise and silence and monitored the effect the sound and silence had on the brains of the mice. The silence was intended to be the control in the study but what they found was surprising. The scientists discovered that when the mice were exposed to two hours of silence per day they developed new cells in the hippocampus. The hippocampus is a region of the brain associated with memory, emotion and learning.

The growth of new cells in the brain does not necessarily translate to tangible health benefits. However, in this instance, researcher Imke Kirste says that the cells appeared to become functioning neurons.

“We saw that silence is really helping the new generated cells to differentiate into neurons, and integrate into the system.”

In this sense silence can quite literally grow your brain.

A 2001 study defined a “default mode” of brain function that showed that even when the brain was “resting” it was perpetually active internalizing and evaluating information.

Follow-up research found that the default mode is also used during the process of self-reflection. In 2013, in Frontiers in Human Neuroscience, Joseph Moran et al. wrote, the brain’s default mode network “is observed most closely during the psychological task of reflecting on one’s personalities and characteristics (self-reflection), rather than during self-recognition, thinking of the self-concept, or thinking about self-esteem, for example.”

When the brain rests it is able to integrate internal and external information into “a conscious workspace,” said Moran and colleagues

The results showed that around 86% of participants reported having no suicidal thoughts in the previous 2 weeks at both times they were surveyed.

Among military veterans identifying as transgender, 90 percent have at least one mental health diagnosis, such asposttraumatic stress disorder (PTSD) or depression, and nearly 50 percent had a hospitalization after a suicide attempt or suicidal thoughts. These study findings, from a single veterans' hospital, were presented Friday at The Endocrine Society's 98th annual meeting in Boston.

"As more of our active military returns from deployment and transitions to veteran status, the health care system will be faced with treating more transgender veterans who have mental health issues," said principal investigator Marissa Grotzke, MD, an endocrinologist at Salt Lake City Veterans Affairs Medical Center (VAMC), Salt Lake City.

Compared with the general U.S. population, the military and its veterans have a fourfold higher rate of gender dysphoria, according to Grotzke. Formerly called gender identity disorder, gender dysphoria is substantial distress associated with nonconformity to one's assigned sex.

Patients with gender dysphoria have unique health care concerns, Grotzke said. In general, they have high rates of depression, anxiety and suicidal thoughts. Past research also has shown high rates of mental health disorders in military veterans, including PTSD and depression. Less is known, however, about the mental health of veterans with gender dysphoria, she noted.

Dialectical behavioral therapy (DBT) was found to attenuate amygdala hyperactivity at baseline, which correlated with changes in a measure of emotion regulation and increased use of emotion regulation strategies.5 Taken together, these findings highlight that dysfunctional circuits involving hyperactive limbic regions and hypoactive prefrontal modulation—most pronounced in the dorsal lateral prefrontal cortex—represent the anatomical corollaries to BPD. 

Functional connectivity analyses provide information about which brain regions are co-activated and can be studied using seed-based correlations (most often with the amygdala and dorsal anterior cingulate cortex) and independent component analysis. The 3 networks most salient in BPD are:

Of the 5,000 people who visit the San Francisco Public Library every day, about 15 percent of them are homeless, PBS reported. After years of watching this underserved demographic float through to get Internet access, a restroom and often, just refuge from the cold, the library realized it was in an auspicious position to stage effective interventions.

So, in 2009, the library hired Leah Esguerra, who is believed to be the nation’s first psychiatric social worker to be employed full time at a library, SFGate reported. Since the program started, about 150 homeless people have received permanent housing, and another 800 have enrolled in social and mental health services, according to PBS.

The success is due in part to the fact that the library has become a hub for homeless people, and that those involved in the program approach homeless patrons with empathy.

“I always say that it’s easier to do outreach on the streets because it’s a neutral territory. You can just approach people,” Esguerra told PBS. “But, here, it’s their safe place, it’s their sanctuary. So I try to be very respectful.”

Opioid addiction is a rapidly escalating public health crisis in the United States. According to the Centers for Disease Control and Prevention, drug overdoses accounted for more deaths nationwide in 2013 than automobile accidents - with 71 percent of these overdose deaths attributed to opioid painkillers.

Now, new research findings could shed important light in addressing this epidemic. A study from NYU Langone Medical Center, in collaboration with lead site, the Center for Studies of Addiction at the Perelman School of Medicine at the University of Pennsylvania, and three other sites, publishing online in the New England Journal of Medicine, showed that in a randomized controlled clinical trial an extended-release version of the opioid addiction medication naltrexone (Vivitrol) significantly prevented relapses in men with previous involvement with the criminal justice system.

"We believe our study is the first of its kind to look at the real-world effectiveness of extended-release naltrexone in community settings," says lead author Joshua D. Lee, MD, MSc, associate professor in the Departments of Population Health and Medicine at NYU Langone. "It may be particularly effective with populations, such as recently released prisoners, who typically don't have access to other evidence-based daily medications for opiate disorders, like methadone or buprenorphine."

Extended-release naltrexone is the most recently FDA-approved product for the treatment of opiate addiction, and the only product labeled for prevention of relapse. A daily, oral form of naltrexone has been on the market since 1994 - but opioid cravings present challenges to daily compliance. Extended-release naltrexone, approved by the FDA in 2010, requires only one monthly injection, making it an important option.

Candi Darley, now 52, was working as a nurse and living in Washington, D.C., with her new husband, when, she said, “something started happening to me.” She began to have chronic pain and allergic reactions to common chemicals.

“Something started bothering me mentally. I also became physically ill,” she told Healthline.

When her husband left her several years later, Darley’s problems snowballed. Her mental and physical illness, later diagnosed as depression, fibromyalgia, and chronic fatigue syndrome, led her to miss work. She was eventually fired from her job. With no job, she could no longer make her mortgage payments.

In 2003, she took her son to a relative’s house and went to a homeless shelter for what she thought would be a few months. She was homeless for seven years.

While homeless, Darley made repeated trips to the emergency room seeking help and a diagnosis for her symptoms.

“You don’t get the right kind of care,” she said. “It would be this look of condescension. Sometimes I didn’t go.”

An elaborate computer model measured participants' uncertainty that a snake would be hiding under any specific rock.

To measure stress, the researchers looked at pupil dilation, perspiration and reports by participants.

The higher the levels of uncertainty, say the findings, the more stress people experienced. The most stressful moments were when subjects had a 50% chance of receiving a shock, while a 0% or 100% chance produced the least stress.

People whose stress levels correlated closely with their uncertainty levels were better at guessing whether or not they would receive a shock, suggesting that stress may help us to judge how risky something is.

Lead author Archy de Berker comments:

"It turns out that it's much worse not knowing you are going to get a shock than knowing you definitely will or won't. We saw exactly the same effects in our physiological measures: people sweat more, and their pupils get bigger when they are more uncertain."

While many people will find the concept familiar, this is the first time for research to quantify the effect of uncertainty on stress.