Category Archives: Brain

Addiction: A Brain Disease

Last year, a landmark report from former U.S. Surgeon General Vivek Murthy officially categorized addiction as a brain disease, citing that nearly 21 million Americans were directly affected by drug and/or alcohol addiction in the past year—approximately the same amount of Americans who suffer from diabetes. 

Dr. Murthy’s primary argument advocated for a global, cultural shift in perception: changing the way we view those who struggle with addiction. Instead of regarding addiction as an inherent moral failing, Dr. Murthy urged people to understand the ways in which addiction actually manifests as a chronic illness, and one that must be approached with the “same skill and compassion” as heart disease, diabetes, and cancer.

The American Society of Addiction Medication reports that drug overdose is the leading cause of accidental death in the United States, driven by the opioid addiction epidemic that has resulted in 47,055 lethal drug overdoses in 2014. A 2016 publication revealed statistics that confirmed the direct correlation between overdose rates, sales, and substance use disorders, and prescription pain relievers. As the number of sales of prescription pain relievers has increased, so too has the overdose death rate. Research shows that while the overdose rate in 2008 quadrupled from 1999, so too did the sale of prescription pain pills—in an almost exact parallel. Moreover, the treatment admission rate for substance use disorder in 2009 was six times the 1999 rate. More recent data, according to a report released Tuesday by the Centers for Disease Control and Prevention, indicate that the nation’s opioid epidemic continues to worsen and accelerate. Emergency department visits for overdoses rose 30% in all parts of the U.S. from July 2016 through September 2017.

Perhaps even more troubling is the data that points to the shift from prescription opioids to illicit drugs like heroin, due to the high pricing and difficulty in obtaining pills. The most disconcerting aspect of the problem, however, likely lies its complexity: while the abuse of both prescription and non-prescription opioids is incontrovertibly resulting in greater rates of addiction and an increase in the number of overdoses, prescription medications are also critically important for many people who suffer from chronic pain. The challenge lies in reconciling the many facets and dimensions of the problem—starting with lessening the stigma of addiction, and alleviating the burden of shame that makes many people with substance use disorders less likely to seek help.

Our Spring Congress keynote presenter Brennan Spiegel, MD, MSHS will deliver a lecture titled: “Opioids Haven’t Solved Chronic Pain, Maybe Virtual Reality Can?” Spiegel will discuss the application of digital technologies to chronic disease, as more clinicians and companies attempt to curb and mitigate the worsening opioid epidemic through new adherence technologies.

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The Science of Mindfulness

In a heavily peer-reviewed environment, Jon Kabat-Zinn, often termed the ‘father of mindfulness,’ proved beyond reasonable doubt that practices of Integrative Medicine—including the marriage of meditation and medicine—made Western medical science twice as curative.

More recent studies confirm that both prayer and meditation are highly reactive in both lowering our reactivity to traumatic and negative events, and also helping preserve the aging brain. Dr. David Spiegel, associate chair of psychiatry and behavioral sciences and medical director of the center for integrative medicine at Stanford University School of Medicine, explained: “Praying involves the deeper parts of the brain: the medial prefrontal cortex and the posterior cingulate cortex — the mid-front and back portions,” says Dr. Spiegel, adding that this can be seen through magnetic image resonance (MRI), which render detailed anatomical pictures. “These parts of the brain are involved in self-reflection and self-soothing.”

In another study conducted by NYU Langone Medical Center, members of Alcoholics Anonymous were placed in an MRI scanner and then shown drinking-related images to stimulate cravings—which were soon after reduced when the participants prayed. The MRI data demonstrated changes in parts of the prefrontal cortex, which is responsible for the control of emotion and “the semantic reappraisal of emotion.”

Last month, researchers from UCLA found that long-term meditators had better-preserved brains than non-meditators as they aged. Participants who had been meditating for an average of 20 years had more grey matter volume throughout the brain — although older meditators still had some volume loss compared to younger meditators, it wasn’t as pronounced as the non-meditators. “We expected rather small and distinct effects located in some of the regions that had previously been associated with meditating,” said study author Florian Kurth. “Instead, what we actually observed was a widespread effect of meditation that encompassed regions throughout the entire brain.”

There is further data backing the idea that meditation and prayer can trigger the release of feel-good chemicals in the brain. Dr. Loretta G. Breuning, founder of the Inner Mammal Institute and the author of The Science of Positivity and Habits of a Happy Brain, explains that when we pray, we can activate neural pathways developed when young to release hormones such as oxytocin. “Oxytocin is known for its role in maternal labor and lactation, but it also [enables] social trust and attachment, giving us a good feeling despite living in a world of threat,” says Dr. Breuning. “It’s the idea of ‘I can count on something to protect me.’ So when a situation comes up and you’re out of ideas and you are helpless, feeling much like you did when you were a baby, prayer can provide some other source of hope.”

While meditation is not a panacea or cure-all, there is ample evidence that it may benefit those who practice it regularly. If you have a few minutes in the morning or evening, rather than turning on your phone or going online, see what happens if you try quieting down your mind, and paying attention to your thoughts while letting them go without reactions. If the research is accurate, a few minutes of mindful meditation may make a big difference.

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Artificial Sweeteners: Tied to Stroke & Dementia

A new study published in the American Heart Association’s journal Stroke suggests that artificial sweeteners, found in diet sodas, have considerable health risks for both the body and the brain.

The data was collected from the Framingham Heart Study, a project of the National Heart, Lung, and Blood Institute and Boston University, and involved data on 2,888 adults older than 45 and 1,484 adults older than 60 from Framingham, Massachusetts. In the group aged 45-and-older, researchers measured for increased risk of stroke; in the group aged 60-and-older, researchers measured for dementia.

The statistics analyzed how many sugary beverages and artificially sweetened soft drinks each person in the two different age groups drank, between the years 1991 and 2001. That data was than compared against the number of people who suffered from stroke or dementia in the next decade.

Researchers found that—juxtaposed against people who never drank artificially sweetened soft drinks—those who drank one per day were almost three times as likely to have an ischemic stroke. Those who drank one per day were also almost three times as likely to be diagnosed with dementia.

Previous studies have shown a strong association between the intake of sugar-sweetened beverages and a host of adverse health effects, including type 2 diabetes, obesity, and cardiovascular disease. Professor and chair of neurology at the University of Miami Miller School of Medicine Dr. Ralph Sacco confirms that this article “provides further evidence on artificially sweetened beverages and their possibly effects on vascular health…we believe the pathways of which artificially sweetened beverages would affect the brain are probably through vascular mechanisms.”

Moreover, artificial sweeteners have been shown to cause glucose intolerance in mice by altering gut microbiota, and have been associated with dysbiosis and glucose intolerance in humans. The cumulative research strongly indicates that there is no benefit to using artificial sweeteners, or drinking diet soda, compared to regular sucrose or sugary drinks.

To learn more about the gut-immune-brain connection, and the different ways in which various types of inflammation can affect the body and brain, register for Module VII: Autoimmune Disease & Inflammation, from August 10-12.

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