Addiction

Howard LeWine, M.D.

Addiction: It retrains the brain, is tougher on women

It’s hard for someone who has never battled an addiction to understand how or why a person can’t break free of one. An exchange on the radio about pop star Whitney Houston’s addictions underscores the misconceptions many people have about addiction. Addictions retrain the brain in a way that couples liking something with wanting it. There are important gender differences in addiction. Although men are more likely than women to become addicted to drugs or harmful behaviors, women who have an addiction face tougher challenges.

Christine Junge

Natural recoverers kick addiction without help

We tend to think that stopping an addictive behavior means joining a group, seeing a therapist, going to a treatment center, or taking a medication that helps with cravings. Some people manage to break an addiction without any help. These “natural recoverers” tend to take two key steps: They find a new hobby, challenge, or relationship to help fill the void left by the addiction. And they start exercising. Exercise is important because it acts as a natural antidepressant. It also prompts the body to release its own psychoactive substances—endorphins—that trigger the brain’s reward pathway and promote a feeling of well-being. Natural recovery isn’t a sure thing, and the more severe the addiction, the harder it is to do.

Carolyn Schatz

Anorexia, bulimia, and other eating disorders in midlife and beyond

Eating disorders don’t afflict only adolescents and young women, but plague older women, too, and may be shrouded in even greater shame and secrecy. Many women don’t seek help, especially if they fear being forced to gain weight or stigmatized as having a “teenager’s disease.” As reported in the February 2012 Harvard Women’s Health Watch, clinicians are reporting an upswing in requests from older women for help with eating disorders. For some of these women, the problem is new; others have struggled with anorexia, bulimia, binge eating, or another eating disorder for decades. Eating problems at midlife and beyond stem from a variety of causes, ranging from grief and divorce to illness, shifting priorities, and heightened awareness of an aging body.

Patrick J. Skerrett

Smokers with cancer benefit from quitting, but need extra help

Many people have trouble quitting smoking even after learning they have cancer, according to a new study from Harvard-affiliated Massachusetts General Hospital. Five months after learning they had cancer, just over one-third (37%) of smokers diagnosed with lung cancer and two-thirds (66%) of those with colorectal cancer were still smoking. The results underscore how difficult it can be to quit smoking. A diagnosis of cancer can be a powerful motivator, but it isn’t always enough—extra help is often needed to quit. Kicking a smoking habit is good for health anytime. It is even more important after a diagnosis of cancer.

Anthony Komaroff, M.D.

Three reports to help with holiday health and emotional challenges

With Veterans Day and Halloween behind us, we are moving full steam ahead to the holidays, the stretch from Thanksgiving to New Year’s Day (or Super Bowl Sunday, depending on your perspective). The holidays can be a wonderful time, full of friends, family, and fun. But they can also generate pressures and situations that undermine health. To help you enjoy a healthy and happy holiday season, Harvard Health Publications is offering three Special Health Reports that focus on common holiday challenges: depression, overuse of alcohol, and healthy eating.

Peter Wehrwein

Propofol: the drug that killed Michael Jackson

The manslaughter trial of Michael Jackson’s personal physician, Dr. Conrad Murray, focused a lot of attention on a powerful anesthetic agent called propofol. Propofol is sometimes called the “milk of anesthesia” because it comes in a white, oily solution. Propofol is used as an induction agent—the drug that causes loss of consciousness— for general anesthesia in major surgery. Propofol is also a very good anesthetic for milder sedation used for outpatient surgery because it puts people in a semi-conscious, drowsy state. It starts acting quickly, but also wears off quickly. Like many sedating anesthetics, propofol lowers blood pressure and suppresses breathing, so the heart function and breathing of patients need to be constantly monitored. With a lot of propofol around, opportunities exist for abuse, with possibly fatal consequences.

Patrick J. Skerrett

Pediatricians should ask teens about drug, alcohol use at every visit

Although current recommendations call for pediatricians to ask their adolescent patients about alcohol and drug use at every visit, many don’t. To make it easier for doctors and nurses to do this, the American Academy of Pediatrics has just published a set of questions to guide the confidential conversation, along with advice on what to do with the answers. The first question is a simple one about drug or alcohol use. If the answer is no, the health care provider should praise the teen and encourage him or her to continue making good decisions about health and safety. If the answer is yes, six follow-up questions called the CRAFFT questions) can help separate those who are experimenting from those who may be headed for serious trouble and need more in-depth help.

Harvey B. Simon, M.D.

Electronic cigarettes: Help or hazard?

Smokers who want to quit can turn to a nicotine replacement products, prescription medications, and counseling. What about the newest stop-smoking aid, the electronic cigarette? Despite its appeal, we don’t know enough about the safety or effectiveness of electronic cigarettes to give them the green light. Preliminary studies from the FDA, New Zealand, and Greece raise some concerns about the dose of nicotine delivered and potentially harmful chemicals that might be in the vapor. Until good studies have been done on electronic cigarettes, the best way to quit involves using nicotine replacement or a medication along with some sort of counseling or support, either in person, by telephone, or even by text message.

Ann MacDonald
Ann MacDonald

Painkillers and drug addiction: An ongoing dilemma

On October 16, 1846, Dr. John Collins Warren, a renowned surgeon at Massachusetts General Hospital, removed a tumor from a printer named Gilbert Abbott. The operation was noteworthy for one reason: Abbott did not scream out in pain, as virtually every surgical patient did in those days. The age of anesthesia was born. A Boston […]