Archive for the ‘Mental Health’ Category
Philip Smith reports in the Drug War Chronicles:
Florida state Rep. Kristin Jacobs (D-Coconut Creek) is a woman on a mission, albeit a strange and misinformed one. For the last three years, Jacobs has waged a lonely crusade in Tallahassee to ban kratom, the herb derived from a Southeast Asian tree and widely used for pain relief, withdrawal from opiates, and as a less harmful alternative to opiates.
She’s at it again this year, having just introduced a measure, House Bill 183, that would add mitragynine and hydroxymitragynine, the active constituents of kratom, to the state’s controlled substances list. And she’s invoking the specter of Hitler as she does so.
Saying the kratom ban was a “fall on the sword issue” for her, Jacobs railed against the people who have opposed her prohibitionist efforts, accusing them of Goebbels-like propaganda.
“They have a story,” she told the St. Peters Blog. “Just like Hitler believed if you tell a lie over and over again, it becomes the truth.”
Portraying herself as a bravely challenging a “lie machine… a powerful lobby with lots of money,” Jacobs warned against “Big Kratom.” “It’s not just what they’re doing here,” she said. “They’re doing the same thing around the country.”
“They” would be the American Kratom Association and the Botanical Education Alliance. The former was founded by Susan Ash, a 46-year-old who began taking kratom while being treated for dependence on prescription pain relievers and now takes a small dose daily to ease chronic pain and depression. She was so impressed with the results, she founded the group in 2015 to represent kratom consumers. The group now has more than 2,000 members and lobbies against efforts to ban the drug.
The latter is a small nonprofit organization “dedicated to educating consumers, lawmakers, law enforcement, and the media aboutstyl safe and therapeutic natural supplements including Mitragyna speciosa, also known as Kratom,” the group says on its web page. “Our mission is to increase understanding in order to influence public policy and protect natural supplements. Our vision is to create a society where every adult has the right to access safe and effective natural supplements.”
According to the American Kratom Association, “Kratom is not a drug. Kratom is not an opiate. Kratom is not a synthetic substance. Naturally occurring Kratom is a safe herbal supplement that’s more akin to tea and coffee than any other substances. Kratom behaves as a partial mu-opioid receptor agonist and is used for pain management, energy, even depression and anxiety that are so common among Americans. Kratom contains no opiates, but it does bind to the same receptor sites in the brain. Chocolate, coffee, exercise and even human breast milk hit these receptor sites in a similar fashion.”
Unsurprisingly, Jacobs disagrees. She calls the herb a “scourge on society” and says it “is an opiate,” breezily lumping it in with heroin and pain pill mills.
In Jacobs’ dystopian vision, she foresees babies born with withdrawal symptoms, emergency room doctors treating strung-out kratom junkies in the throes of withdrawal, and “addicts with glassy eyes and shaky hands” lurking about until the dreaded kratom overdose gets them. “How many more are going to die?” she asks.
Well, not many, actually. Like opiates, kratom relieves pain, slows bowel activity, produces euphoric feelings, and creates physical addiction and a withdrawal syndrome. But unlike opiates, it causes a pleasant, caffeine-type buzz in small doses and, more significantly, it is apparently very difficult — if not impossible — to overdose on it. The few deaths where kratom is implicated include poly-drug use, or as in a case reported by the New York Times, suicide by a young kratom user who was also being treated for depression.
“Direct kratom overdoses from the life-threatening respiratory depression that usually occurs with opioid overdoses have not been reported,” says Oliver Grundmann, clinical associate professor of medicinal chemistry at the University of Florida, told journalist Maia Szalavitz at Vice. Grundmann should know; he just reviewed the research on kratom for the International Journal of Legal Medicine.
Szalavitz also consulted Mark Swogger, an assistant professor of psychiatry at the University of Rochester Medical Center, who with his colleagues analyzed 161 “experience reports” posted by kratom users on the drug information site Erowid.org for a recent study in the Journal of Psychoactive Drugs.
“I think it’s pretty safe to say that kratom has at least some addiction potential. The data is fairly strong on that and our study also found that people are reporting addiction,” but “overall, we found that it’s really mild compared to opioid addiction and it didn’t seem to last as long.”
Jacobs’ inflammatory and ill-founded comments generated a quick and strong reaction from kratom advocates. . .
It is amazing how often something that is scientifically known and demonstrated to work will be ignored in favor of approaches that in fact make the problem worse. (I blogged one interesting example a few days ago.) Iceland took some findings of behavioral science and applied them. Emma Young reports in Mosaic what happened:
Today, Iceland tops the European table for the cleanest-living teens. The percentage of 15- and 16-year-olds who had been drunk in the previous month plummeted from 42 per cent in 1998 to 5 per cent in 2016. The percentage who have ever used cannabis is down from 17 per cent to 7 per cent. Those smoking cigarettes every day fell from 23 per cent to just 3 per cent.
The way the country has achieved this turnaround has been both radical and evidence-based, but it has relied a lot on what might be termed enforced common sense. “This is the most remarkably intense and profound study of stress in the lives of teenagers that I have ever seen,” says Milkman. “I’m just so impressed by how well it is working.”
Read the article for what they did and why. It really is a matter of asking basic questions: Why do teens get high? For the feelings. What causes the feelings? Brain chemistry. Can the same brain chemistry be triggered by other, more benign causes?
Well, there are sports, and learning things, and so on…
It’s quite a fascinating article, and note the many benefits of Iceland’s approach as compared to the approach the US uses (break into people’s houses, steal their possessions through asset forfeiture, lock people up, create cause for cop corruption, and so on). That is, not just lower use of alcohol, tobacco, and other drugs, but also the development of more skills and knowledge in teens (who soon will be adults, and probably more successful as a result of a more productive adolescence).
In the context of the article, watch again this video—but read the article first:
Depression is not a rare ailment (more than 20% of Americans each year suffer from depression and/or anxiety: that’s about 65,000,000 people—perhaps coincidentally, about the same number as those voting against Trump: 65,844,610), and it can be a dangerous disorder (recall the depress Lufthansa pilot that flew his plane into the ground in Italy, commiting suicide while murdering a plane full of people). There are a number of chemical and non-chemical treatments, including Cognitive Behavioral Therapy that works to undo the “capture” that results in the depression. ScienceDaily has a report by Maria Paul, written with materials provided by Northwestern University. The summary:
Now you can find help for depression and anxiety on your smartphone as quickly as finding a good sushi restaurant. A novel suite of 13 speedy mini-apps called IntelliCare significantly reduced depression and anxiety in study participants, who used the apps on their smartphones up to four times a day. The reductions of 50 percent in anxiety and depression are comparable to results expected in clinical practice using psychotherapy or with antidepressant medication.
The full report begins:
A novel suite of 13 speedy mini-apps called IntelliCare resulted in participants reporting significantly less depression and anxiety by using the apps on their smartphones up to four times a day, reports a new Northwestern Medicine study.
The apps offer exercises to de-stress, reduce self-criticism and worrying, methods to help your life feel more meaningful, mantras to highlight your strengths, strategies for a good night’s sleep and more.
Most apps designed for mental health typically offer a single strategy to feel better or provide too many features that make them difficult to navigate. Users may get bored or overwhelmed and may stop using the apps after a few weeks.
But participants robustly used the IntelliCare interactive apps as many as four times daily — or an average of 195 times — for eight weeks of the study. They spent an average of one minute using each app, with longer times for apps with relaxation videos.
The 96 participants who completed the research study reported that they experienced about a 50 percent decrease in the severity of depressive and anxiety symptoms. The short-term study-related reductions are comparable to results expected in clinical practice using psychotherapy or with that seen using antidepressant medication.
The study will be published Jan. 5 in the Journal of Medical Internet Research.
“We designed these apps so they fit easily into people’s lives and could be used as simply as apps to find a restaurant or directions,” said lead study author David Mohr, professor of preventive medicine and director of the Center for Behavioral Intervention Technologies at Northwestern University Feinberg School of Medicine.
“Some of the participants kept using them after the study because they felt that the apps helped them feel better,” Mohr said. “There were many apps to try during the study, so there was a sense of novelty.”
Participants had access to the 13 IntelliCare apps from Google Play and received eight weeks of coaching for the use of IntelliCare. Coaching included an initial phone call plus two or more text messages per week over the eight weeks. In the study, 105 participants were enrolled and 96 of them completed the study.
The preliminary study did not include a control arm, so it’s possible that some people who enrolled in the trial would have improved anyway, partly because they may have been motivated to try something new, Mohr said. He now has launched a larger trial, recruiting 300 participants, with a control arm.
Some of the IntelliCare apps include:
- Daily Feats: designed to motivate you to add worthwhile and rewarding activities into your day to increase your overall satisfaction in life.
- Purple Chill: designed to help you unwind with audio recordings that guide you through exercises to de-stress and worry less.
- Slumber Time: designed to ease you into a good night’s rest.
- My Mantra: designed to help you create motivating mantras to highlight your strengths and values.
“Using digital tools for mental health is emerging as an important part of our future,” Mohr said. “These are designed to help the millions of people who want support but can’t get to a therapist’s office.”
More than 20 percent of Americans have significant symptoms of depression or anxiety each year, but only around 20 percent of people with a mental health problem get adequate treatment. . .
It’s hard not to see meme activity in this. Video extremely worth watching. It explains a lot by one simple concept:
That’s from an OpenCulture post by Dan Colman, and really you should click and read it. And also read the comments, which provide different ways of viewing the video.
Wow. This will have a cumulative effect, I bet. And it makes a ton of sense: help them learn something that can help with whatever stresses are driving them to bad behavior. Much more constructive than simply punishing them, which doesn’t really address the problem but may in fact add to it. Much more like what Friends would do. It’s hard to go wrong by being kind.
If you have kids in school, I think in your place I would encourage the school to adopt a similar policy and program.
Josh Jones writes at OpenCulture:
By now, most people are familiar with the term “school-to-prison pipeline,” the description of a system that funnels troubled students through disciplinary program after program. Detentions, suspensions, and often expulsions further aggravate many students’ already difficult lives, and send them “back to the origin of their angst and unhappiness—their home environments or their neighborhoods,” writes Carla Amurao for PBS’ Tavis Smiley Reports. Harsh disciplinary policies don’t actually change behavior, and “statistics reflect that these policies disproportionately target students of color and those with a history of abuse, neglect, poverty or learning disabilities.”
In short, students come to school with significant stresses and setbacks, and are themselves treated as problems to be quarantined or forced out. But why not instead teach those students—why not teach all students—effective means of coping with stress and setbacks? I can think of almost no more useful a set of skills to carry into adulthood, or into a troubled home or neighborhood situation. As the CBS This Morning segment above reports, one school in Baltimore is attempting to so equip their students, with a yoga and meditation program during and after school that takes the place of detention and other punishments.
The Robert W. Coleman Elementary School adopted a twice-a-day yoga and mindfulness practice during school hours for all students, called “Mindful Moments”; and an after-school program called Holistic Me, which “hosts 120 male and female students,” writes Newsweek, “and involves yoga, breathing exercises and meditative activities. Disruptive students are brought to the Mindful Moment Room for breathing practices and discussion with a counselor and are instructed on how to manage their emotions.” As we’ve previously noted on this site, these kinds of activities have been shown in research studies to significantly reduce stress, anxiety, and depression and to improve concentration and memory.
I have to admit that I doubt that Trump supporters will like this. And yet I bet it would help them, TBH.
Republicans’ Obamacare repeal plan will add $9 trillion to national debt, but that may not bother them
It is difficult for me to understand the thought processes (if any) of the GOP, but one thing is clear: the GOP is willing to spend handsomely in order to avoid helping the poor and improving the general welfare. We say that in the way many Red states refused to expand Medicaid, even though that refusal cost them money. Not helping the poor was worth it, apparently.
And now the GOP, which has claimed to hate any increase in the national debt, and ready to pile on the debt if it will put a stop to helping the poor get healthcare insurance.
I think you can see why I find that hard to understand. Normally, being able to do something worthwhile and at the same time saving trillions of daollars? That would be what one calls a “no-brainer.” My conclusion: the GOP has, in effect, less than no brain: a negative amount of brains.
Matthew Rozsa writes in Salon:
If Republicans use budget reconciliation to fast-track their repeal of the Affordable Care Act (colloquially known as Obamacare), they will have to accept a $9 trillion increase in the national deficit by 2026. By then, the national debt would reach $29 trillion.
— Steven Dennis (@StevenTDennis) January 4, 2017
Kansas Sen. Rand Paul, a Republican with libertarian leanings, has already vowed to oppose the reconciliation plan on the grounds that the budget resolution will add so much to the deficit.
“It never gets to balance. Not in 10 years, not in 100 years, not in 1,000,” Paul told Bloomberg on Tuesday. “Every Republican that was here voted for a balanced budget amendment to the Constitution that said it should balance in five years, but yet they are putting together a budget that never balances.”
Paul also pointed out that, before Vice President-elect Mike Pence is sworn in and can cast tie-breaking votes in the Senate, a single other Republican voting against the budget resolution would stymie the Republican plan. Reconciliation is a budgetary procedure that, because it cannot be filibustered, could allow the Republicans to repeal a great deal of the Affordable Care Act before Trump is even sworn in on Jan. 20. That said, the process is very complex — a budget resolution must be passed with instructions to committees from both chambers, each chamber must draft its own reconciliation package, both packages are combined into a single bill, and then that bill must pass both chambers. If there are any differences between the bill produced by either chamber, nothing can be passed until they’re resolved. . .
At Mothe Jones Kevin Drum notes the sharp decline in police killings by young people:
Let’s end the day with some good news. As you all know, violent crime began falling after leaded gasoline began its phaseout in the mid-70s. And because lead affects the brain development of infants and toddlers, the fall in crime began with the youngest kids. In the mid-80s, only young children were showing signs of reduced violence. By the mid-90s, everyone under 20 started to show effects. By the mid-aughts everyone under 30 was starting to get less violent.
In other words, the first cohort to benefit from reduced lead was juveniles. Kids born in the late-70s showed only small improvements because lead had been only slightly reduced during their childhood. Kids born in the late-80s showed more improvement because ambient lead had decreased quite a bit during their childhood. Kids born in the late-90s showed yet more improvement, etc.
Rick Nevin has sent me a new chart that shows this vividly:
In the early 90s, young people between the age of 18-24 killed an average of 33 police officers per year. By 2015 that was down to 4. For juveniles under the age of 18, the number was zero. . .