Recovery Michigan

Guerilla tactics such as suicide attacks and roadside bombs may trigger more posttraumatic stress than conventional warfare, suggests a Veterans Affairs study of 738 men and women who served in Iraq.

The findings appear online in the journal Psychological Trauma: Theory, Research, Practice, and Policy.

The study authors are with the Behavioral Science Division of the National Center for PTSD, based at the VA Boston Healthcare System, and with Boston University School of Medicine.

They identified three distinct phases of the Iraq War, based on previous reports. Then they analyzed whether veterans who fought during the insurgency phase, during which more guerilla-style tactics were used, were more likely to develop PTSD than those who deployed during the initial invasion phase of the war, or the more recent surge phase.

The study found that among the men - about half the overall group - the insurgency-phase veterans were more than twice as likely to have a diagnosis of PTSD, compared with those who served in either of the other two phases.

The finding held true even after the researchers adjusted for a range of other demographic and deployment-related risk factors.

Currently cocaine is the only illicit drug in the U.S. that does not have a long-term preventive treatment option approved by the U.S. Food and Drug Administration—scientists have tried for years to find or develop one but until now, those efforts have come up short. In this new effort, the researchers began with cocaine hydrolase enzymes, because prior studies have shown they can prevent the high associated with cocaine use—its limiting factor was that it would not remain in the body long enough to serve as a reasonable thereby treatment. The group's idea was to add another element to the enzymes to cause them to hang around longer. After much work, the team settled on human immunoglobulin G antibodies, because they are known to remain in the body for periods of time long enough to be useful as a treatment option. To make the new treatment, the researchers fused the enzymes with the antibodies to produce a therapy that would offer the benefits of both.

Testing of the new compound showed that the treatment could remain in the body of rats for up to 107 hours, whereas Cocaine hydrolase enzymes alone would last for only 8 hours. Further testing showed that in addition to preventing the rats from feeling the effects of cocaine, a single dose of the treatment also prevented the rats from suffering a lethal overdose.

The team explains that the new compound works by breaking down the cocaine metabolites, which prevents the rats from feeling the effects of cocaine administration—for up to 20 days. They note also that because of differences in metabolism, the same treatment would have to be administered to a human being every two to four weeks to be effective.

A new study of an intervention called Recovery after an Initial Schizophrenic Episode (RAISE) offers promising results for an early, comprehensive intervention for schizophrenia. The study examined outcomes for people treated with this intervention, which essentially consists of providing medication and psychotherapy along with case management upon the identification of a psychotic episode (ideally while the person is still experiencing first-episode psychosis or immediately after).

What makes this intervention different from previous treatment approaches is its response time and a decreased reliance on medication-heavy approaches.

The study showed that patients treated at a RAISE site experienced improved quality of life and increased employment and education. The study also indicates improved outcomes for housing retention.

If a patient has a nonfatal opioid overdose, it should be a warning sign and an opportunity to identify and treat any substance use disorders; but there is little information about treatment patterns after the overdose.

Researchers used information from Optum, a large national commercial insurance claims database with data on 50 million individuals over a 12-year period, to identify nearly 3,000 patients who experienced a nonfatal overdose while taking opioids prescribed for chronic pain.

The data showed that, following the overdose, prescription of opioids continued for 91% of patients. In addition, 70% of patients received prescriptions from the same provider who prescribed the opioids before their initial overdose.

Then, 2 years later, patients who continued taking high dosages of opioids were twice as likely to have another overdose, compared with those who stopped using opioids after the overdose.

People with chronic pain generally suffer associated complications in their relationships with their spouses or partners. An interestingstatistic by the National Health Interview Survey revealed that the divorce rate among chronically ill patients is more than 75 percent. 

The key to all your problems is communication. That doesn’t mean you give updates to your partner about your health all the time, instead make a conscious effort to “take pain off the agenda”. You and your partner will want to spend quality time with each other, so try talking about things that make you feel good and not grumpy.

At times the anger and frustration emerges when you are in pain and don’t get the expected attention from you partner or spouse. It may be because your spouse interprets your response to pain as “exaggeration” or even “acting childish”.

Condition	Number of U.S. Sufferers	Source
Chronic Pain	100 million	Institute of Medicine of The National Academies (2)
Diabetes	25.8 million (diagnosed and estimated undiagnosed)	American Diabetes Association (3)
Coronary Heart Disease (heart attack and chest pain) Stroke	16.3 million 7.0 million	American Heart Association (4)

A lot more at the site......

"Even after a long period of chronic stress, the brain retains the ability to change and adapt. In experiments with mice, we discovered the mechanism that alters expression of key glutamate-controlling genes to make windows of stress-related neuroplasticity--and potential recovery--possible,"

"This sensitive window could provide an opportunity for treatment, when the brain is most responsive to efforts to restore neural circuitry in the affected areas," he adds.

"Here again, in experiments relevant to humans, we saw the same window of plasticity, with the same up-then-down fluctuations in mGlu2 and P300 in the hippocampus," Nasca says. "This result suggests we can take advantage of these windows of plasticity through treatments, including the next generation of drugs, such as acetyl carnitine, that target mGlu2--not to 'roll back the clock' but rather to change the trajectory of such brain plasticity toward more positive directions."

The pharmaceutical companies that manufacture and market OxyContin, Vicodin, and other highly addictive opioid painkillers — drugs that have fueled the epidemic of overdoses and heroin addiction — are funding nonprofit groups fighting furiously against efforts to reform how these drugs are prescribed.

While the Centers for Disease Control and Prevention was close to finalizing voluntary prescribing guidelines for opioid painkillers next month, it abruptly changed course. According to a report from the Associated Press, the CDC “abandoned its January target date, instead opening the guidelines to public” comment after a number of “industry-funded groups like the U.S. Pain Foundation and the American Academy of Pain Management warn[ed] that the CDC guidelines could block patient access to medications.”

The new guidelines would encourage doctors to prescribe opioids as a last choice for chronic pain, a sharp departure from the status quo, in which many doctors, under pressure from pharmaceutical sales representatives, often prescribe painkillers for mild back pain or a toothache. As expertsnote, many painkiller and heroin addicts start abusing opioids after receiving a legitimate prescription for pain-related medical issues.

Very interesting idea. I hope it pans out...

A brain region controlling whether we feel happy or sad, as well as addiction, is remodeled by chronic pain, reports a new Northwestern Medicine study.

And in a significant breakthrough for the millions of Americans suffering fromchronic pain, scientists have developed a new treatment strategy that restores this region and dramatically lessens pain symptoms in an animal model.

The new treatment combines two FDA-approved drugs: a Parkinson's drug, L-dopa, and a non-steroidal anti-inflammatory drug. The combined drugs target brain circuits in the nucleus accumbens and completely eliminate chronic pain behavior when administered to rodents with chronic pain. The key is administering the drugs together and shortly after an injury.

As a result of the study's findings, the scientists are pursuing a clinical trial. The treatment has the potential to prevent chronic pain if used early enough after injury, the scientists said.

"It was surprising to us that chronic pain actually rewires the part of the brain controlling whether you feel happy or sad," said corresponding author D. James Surmeier, chair of physiology at Northwestern University Feinberg School of Medicine. "By understanding what was causing these changes, we were able to design a corrective therapy that worked remarkably well in the models. The question now is whether it will work in humans."

"The study shows you can think of chronic pain as the brain getting addicted to pain," said A. Vania Apkarian, also a corresponding author and a professor of physiology at Feinberg. "The brain circuit that has to do with addiction has gotten involved in the pain process itself."

Chronic inflammation in the bloodstream can 'fan the flames' of depression, much like throwing gasoline on a fire, according to a new paper from researchers at Rice University and Ohio State University.

'Inflammation: Depression Fans the Flames and Feasts on the Heat' appeared in a recent edition of the American Journal of Psychiatry. The study reviewed 200 existing papers on depression and inflammation.

"In the health area of psychology at Rice, we're very focused on the intersection of health behavior, psychology and medicine," said Christopher Fagundes, an assistant professor of psychology and co-author of the paper. "One thing that we're particularly interested in is how stress affects the immune system, which in turn affects diseases and mental healthoutcomes, the focus of this paper."

Among patients suffering from clinical depression, concentrations of two inflammatory markers, CRP and IL-6, were elevated by up to 50 percent.

Fagundes said chronic inflammation is most common in individuals who have experienced stress in their lives, including lower socio-economic status or those who experienced abuse or neglect as children. Other contributing factors are a high-fat diet and high body mass index.

The study also found that depression caused by chronic inflammation is resistant to traditional therapy methods, but can be treated with activities such as yoga, meditation NSAIDS and exercise.