Update: Changes to site, Cocaine review article

Good-bye NYC! (Photo © Derek Simon 2015)
Good-bye NYC!
(Photo © Derek Simon 2015)

Change is coming!

After a several month hiatus, I’m happy to be posting again!

I wanted to announce that I recently switched fields from basic neuroscience research to a fellowship position in the LGBTI Office at the US Agency for International Development (USAID)!

This means good-bye NYC and hello Washington DC! It also means that the scope, style, and range of topics I’ll write about will greatly expand beyond just drug addiction. I’m still figuring out those details….

But in the mean time:

Cocaine Addiction Review Article

About two years ago I wrote a review article for a new academic book about addiction. Finally, the book and the article have been published!

The book is Neuropathology of Drug Addictions and Substance Misuse. My article appears in Volume 2.

Feel free to download a pdf of my article for free!

PDF of Cocaine Review Article.

I first present an overview of the pathology and neurobiology of cocaine addiction and then discuss some of the research findings about changes that occur in the brain because of cocaine addiction.

A summary of key points discussed in the article:

  • Cocaine is a widely abused drug that has significant economic, medical, and social costs and no effective pharmacotherapeu­tic treatments.
  • Cocaine addiction progresses from initial use to repetitive cycles of heavy, short-term use (“binge” use), abstinence, and relapse.
  • Unlike other drugs of abuse (which only primarily affect DA release), cocaine’s mechanism of action consists of blocking the reuptake of all monoamine neurotransmitters (DA, 5HT, and NE) by antagonizing the monoamine transporters (DAT, SERT, and NET) thus leading to an accumulation of these neu­rotransmitters in the synapse of the mesolimbic reward path­way and other regions of the brain.
  • Genetic and environmental factors contribute to the suscepti­bility of an individual to becoming addicted to cocaine, and based on twin studies, it has been estimated that genetics may account for 30–60%, and as high as 78% of this susceptibility.
  • Acute cocaine use activates the HPA axis while chronic cocaine use sensitizes the HPA axis and blunts the stress response, which contributes to relapse behavior.
  • Accurate behavioral models used to study cocaine addiction, such as self-administration and the “binge” model, are useful because they attempt to recapitulate the human disease.
  • Cocaine use results in upregulation of dynorphin mRNA and protein and subsequent elevation of KOPR/dynorphin tone in the VTA/CPu/NAc circuit in virtually every behavioral model tested.
  • Modulation of the KOPR/dynorphin system may represent a viable pharmacotherapeutic target for treatment of cocaine addiction.

Tragedy in Orlando: A Call to End Gun Violence, Terror, and Homophobia.

Orlando imagePulse

Once again an American citizen (not an immigrant or refugee of any kind) has mass murdered other American citizens using a legally purchased weapon, a weapon that exists for no other reason than to be used to kill as many people as possible. The attack in Orlando is a confluence of so many problems in the US and world today: gun violence, homophobia, racism, religious extremism and Islamist terrorism. Sadly, there will be a portion of this country that won’t really care about these attacks because 1) they specifically targeted gay people and 2) minority men were primarily killed in the attacks. Narcissistic demagogues like Donald Trump will use the attacks to expand his racist rhetoric and hate speech in order to galvanize the furor of his supporters—he’ll profiteer from the loss of human life to boost his poll numbers (by the way, Trump was endorsed by the NRA so don’t expect any comments on gun control).

I could spend my time talking about how attacks like these are only possible because of the ease in which guns can be purchased in the United States but why? Supporters of stricter gun control already know these arguments while the people that need to hear them never will. But there’s another issue here.

The massacre in Orlando brought to national attention something that is common but unknown by many. Gay people are the victims of violence, hate and terror all over the world. Terrorist groups such as ISIS specifically target gay people and murder them in horrific ways. But it’s not just the Islamist philosophy that promotes homophobia. The silent victimization of gay people is promoted by religious extremism in all its forms. I’ll even go one step further and make the claim that homophobia’s ONLY proponent is archaic religious beliefs. All adult humans beings have a capacity for love and all adult human beings should be allowed to express their love however way they want without fear of reprisal or intimidation from bigots.

In this Pride month is important to remember the progress that has been made but the shadows of the past follow us no matter how far forward we march. The Nazi’s used the pink triangle to mark gay men in the same way the Star of David was used to mark Jews. That symbol has been reclaimed as reminder of how the horror of the past can motivate strength in the present.

Stay united in support for the victims of the Orlando attacks. Mourn their loss and celebrate their lives. But be angry too. Use that anger to fight for an end to gun violence, an end to Islamist and religious extremism, an end to homophobia and persecution of LGBT people around the world.

 

Is a Lack of Bonding the Cause of Addiction?

A well-written criticism of Johann Hari’s popular yet woefully inaccurate book “Chasing the Scream”. The piece is written by fellow addiction blogger Katie Mac Bride for addiction.com. Thanks to Katie for quoting me in the piece!

The Irrationality of Alcoholics Anonymous

Interesting article in the Atlantic dealing with another example of how addiction treatment does not use an evidence-based approach.

All Things Chronic

http://www.theatlantic.com/features/archive/2015/03/the-irrationality-of-alcoholics-anonymous/386255/?src=longreads

Nowhere in the field of medicine is treatment less grounded in modern science. A 2012 report by the National Center on Addiction and Substance Abuse at Columbia University compared the current state of addiction medicine to general medicine in the early 1900s, when quacks worked alongside graduates of leading medical schools. The American Medical Association estimates that out of nearly 1 million doctors in the United States, only 582 identify themselves as addiction specialists. (The Columbia report notes that there may be additional doctors who have a subspecialty in addiction.) Most treatment providers carry the credential of addiction counselor or substance-abuse counselor, for which many states require little more than a high-school diploma or a GED. Many counselors are in recovery themselves. The report stated: “The vast majority of people in need of addiction treatment do not receive anything that approximates evidence-based care.”

This begs the question:  Dr. Kolodny, are…

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