Mara Kardas-Nelson
Published: 27 July 2010
Two scientific lectures presented at the Eighteenth International AIDS Conference in Vienna last week, demonstrated that drug use in and of itself is linked to increased rates of HIV transmission, giving support for evidence that substitution therapy programmes could help to stem the HIV epidemic.
Currently, ten million injecting drug users (IDUs) are living with the virus worldwide. While needle sharing is a strong predictor of HIV seroconversion, non-injecting drug users also experience increased rates of transmission when compared to the general population. This is a result of drugs’ impact on brain chemistry and function, as they diminish inhibitory responses and therefore lead to riskier behaviour.
Nora Volkow of the US National Institute on Drug Abuse, or NIDA, noted, “the prevalence rates of substance abusers are in many instances equivalent whether they inject or don’t inject.”
Charles O’Brien from the University of Pennsylvania agreed, stating, “Even oral drugs greatly increase the risk of being… positive.” As such, combating HIV transmission among non-injecting drug users “is even more complex than addressing just injecting drug use, [in which] you only have to address contaminated equipment”, said Volkow.
Discussing alcohol, cocaine, heroin and methamphetamine use, Volkow noted that many drugs increase sexual desire and impulsivity while decreasing the function of the inhibitory and controlling systems of the brain, with acute and chronic drug use affecting the prefrontal cortex. Brain and behaviour changes can often last several years after use is discontinued.
Addiction is a “chronic disease”, said Volkow. People take the drug “not because the individual [wants to], but because they have lost their ability to control”.
According to O’Brien, the notion that drug addiction is a disease of the brain is not a novel concept. “We have very good evidence [that addiction] is governed in large measure by our genes. A lot of people who are addicts are not guilty of anything that the rest of us don’t do, like experimenting with drugs,” he said.
While “it should not be any surprise that sexual behaviours increase when intoxicated”, the pinpointing of changing brain behaviour and chemistry is a relatively new phenomenon, according to Volkow. Such data demonstrate “that you actually can very specifically identify the biochemical changes in the brain that lead us to understand the disruptive behaviour”, she explained.
In addition to increasing the risk of HIV transmission, some psychoactive drugs actually exacerbate the neurotoxic effects of HIV. Volkow explained that this “combination of two very different vectors… collide to disrupt [brain function] even further”.
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WomensAccounts.com
Your Neurotransmitter Levels and Emotional Health
Your emotional health is a combination of attitudes, personality, support systems, and your brain’s neurotransmitter levels. Positive attitudes and a healthy personality help us through life’s difficulties and a good support system of family and friends is also valuable during times of trouble. Despite having these resources, there are times when coping with our experiences and life events changes our neurotransmitter status. Like an overheated automobile, we begin to have difficulty operating properly.
We are all at-risk for changes in our brain’s chemistry. Mostly commonly, we will experience depression, anxiety, or stress reactions. As our neurotransmitters change, they bring with them additional symptoms, behaviors, and sensations that add to our on-going difficulties. Recognizing these changes is an important part of treatment and returning your life to normal and reducing our stress.
This discussion is offered to explain how the neurotransmitter system in the brain can create psychiatric conditions and mental health problems. It is hoped the discussion will provide information that will be of value to those who suspect their neurotransmitter system is creating problems.
The following is a discussion of neurotransmitters and current thoughts about how these neurochemicals are involved in psychiatric illness. Four neurotransmitters, out of over fifty, are well researched and known to be related to psychiatric conditions.
Dopamine: Parkinson’s Disease and ADHD to Smoking and Paranoia
Dopamine is a neurotransmitter linked to motor/movement disorders, ADHD, addictions, paranoia, and schizophrenia. Dopamine strongly influences both motor and thinking areas of the brain.
One type of Dopamine works in the brain movement and motor system. As this level of dopamine decreases below the “normal range” we begin to experience more motor and gross-movement problems. Very low levels of Dopamine in the motor areas of the brain are known to produce Parkinson’s Disease with symptoms such as:
- Muscle rigidity and stiffness
- Stooped/unstable posture
- Loss of balance and coordination
- Gait (walking pattern) disturbance
- Slow movements and difficulty with voluntary movements
- Small-step gait/walking
- Aches in muscles
- Tremors and shaking
- Fixed, mask-like facial expression
- Slow, monotone speech
- Impairment of fine-motor skills
- Falling when walking
- Impairment in cognitive/intellectual ability
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Physicians Practice
By Keith L. Martin | July 15, 2010
You may have an obligation to report a colleague who is impaired or incompetent, but it turns out most of you are reluctant to do so.
Why? Because physicians are “unprepared” to deal with it.
In a new study, published in the most recent edition of the Journal of the American Medical Association, of physicians who knew a colleague was unfit to perform medicine, only two-thirds reported this to the relevant authorities, leaving one-third who let it go unreported.
The authors of the research did ask those who shunned reporting impaired or incompetent colleagues why they chose to stay mum. Of those offering an answer, 19 percent said they thought someone else was taking care of the issue. Another 15 percent said they thought nothing would come of being a whistleblower and 12 percent feared some kind of retribution.
The study defined “impaired” and “incompetent” based on several factors, including drug addiction to those unaware of the latest ways to treat a patient’s condition.
The JAMA article notes that peer monitoring and reporting are “primary mechanisms” for identifying docs who cannot or should not perform medicine and 64 percent of the 2,938 eligible respondents (covering practices like family practice, internal medicine and pediatrics) agreed with their duty to respond. But only 69 percent reported being “prepared” to effectively deal with an impaired colleague and 64 percent to deal with an incompetent doc in their practice.
The authors recommend promoting further education on who to call and how to report at both practices and hospitals as a way to increase awareness.
The Star Online
Malaysia
May 17, 2010
TIGER Woods and Sandra Bullock’s ex-husband Jesse James are the latest names to wear the “sex addict” tag. They join a long line of celebrities like actors David Duchovny, Jude Law, Bill Murray, Charlie Sheen, Woody Harrelson and Tom Sizemore; British comedian/presenter Russell Brand; singer Eric Benet (former Mr Halle Berry) and Chelsea footballer Ashley Cole, to name just a few.
They probably overdosed on serotonin and endorphins, the brain’s feel-good chemicals released during sex.
Is there such a thing as sex addiction? Or could it be a convenient excuse for philandering husbands, Lotharios and porn purveyors, to justify their behaviour?
According to a Reuters report, “sex addiction” is still not recognised as an official diagnosis in the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders.
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The Cleveland Leader
February 16, 2010
According to the results of a new study conducted by researchers in the United States and Switzerland, popular anti-anxiety drugs such as Valium and Xanax have powerful "reward pathways" that can lead users to addiction.
Well-known medications in the benzodiazepine class of drugs, Valium and Xanax boost the action of a neurotransmitter in the brain, which then activates the gratification hormone known as dopamine. This is the same "reward pathway" that illegal drugs such as heroine activate.
Researchers believe that these findings, which were recently published in the journal "Nature", may help scientists develop a new generation of anti-anxiety drugs that would not be addictive. They hope to come up with similar drugs that bind to a different part of the brain while still offering the calming benefit of Valium without the addictive side effects.
Drug companies have tried to develop benzodiazepines that are not addictive, but to date their efforts have not been successful.
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