Addiction Archive

It's common for doctors to prescribe opioid pain medications for their patients after surgery; however, prescribing large numbers of pills increases the possibility of dependence and overdose. Writing prescriptions for smaller quantities of pills while still monitoring people's pain is one way to reduce the likelihood that a person develops a problem.

Addiction is now understood to be a neurological disorder that results from changes to the brain's reward center caused by addictive substances. Ideally, treatment for nicotine addiction combines medication to suppress cravings with counseling to help patients reprogram their behavior.

Research we're watching

While opioid use disorders have gotten a lot of attention in recent years, the number of people dying as a result of methamphetamine use is on the rise. A study published Jan. 14, 2021, in The New England Journal of Medicine found that a combination drug therapy may provide some hope in helping people with this difficult-to-treat disorder.

In the trial, half of the 403 adult volunteers were given a combination of two drugs: naltrexone, which is used to treat both opioid and alcohol use disorders, and bupropion, an antidepressant. The other half of the group received a placebo. The treatment period began in 2017 and ended in 2019. During that time people were given periodic urine tests to gauge whether they used methamphetamines. Those who had at least three of four drug-free tests were defined as having responded to treatment. Researchers found that by weeks five and six, 16.5% of the treatment group had responded to treatment, compared with 3.4% of the control group. By weeks 11 and 12, 11.4% of the treatment group met the urine test criteria for successful treatment, compared with less than 2% of the control group. Most people who received the drug treatment didn't have any serious side effects.

Because change is so difficult, it's useful to have a guide when attempting to kick an addiction to drugs, alcohol or behavior. Research shows that the following steps can help you move toward your recovery goals. You have the greatest chance of success if you adopt all five steps.

1. Set a quit date. It might be helpful to choose a meaningful date like a special event, birthday, or anniversary.

Research we're watching

A recent study found that nearly one in 10 people who received opioid pain relievers following heart surgery continued to take them for three to six months — a time point when no one should still be experiencing pain from the operation.

The study included nearly 36,000 people with private health insurance who had a coronary artery bypass graft (known as CABG or bypass surgery) or a heart valve replacement between 2003 and 2016. People who were prescribed more than 40 5-mg tablets of oxycodone (Oxycontin, Roxicodone, others) or an equivalent amount of a similar drug were at a much higher risk of prolonged opioid use than people who were prescribed lower doses. Other factors that increased a person's odds of taking opioids long-term included having CABG, being female, or having a history of chronic pain or alcoholism.

A reasonable and well-intentioned effort to reduce and relieve pain can inadvertently lead to a potentially life-threatening addiction, but there are some surprisingly simple ways to avoid such scenarios.

News briefs

The United States is reporting increasing numbers of "deaths from despair" (suicide, drug overdose, or alcohol poisoning). Antidepressants and psychotherapy are often used to help people who are having a hard time coping with extremely difficult times and who are at risk for dying because of it. A recent Harvard study found that another strategy may also play a part in countering despair: attending religious services. The study, published online May 6, 2020, by JAMA Psychiatry, evaluated self-reported religious service attendance among 110,000 white, middle-aged men and women who were followed for about 30 years. Compared with never attending religious services, going at least once per week was associated with a much lower risk of death from despair: 68% lower for women and 37% lower for men. Researchers say that religious participation — regardless of affiliation — may serve as an antidote to despair and provide a sustained sense of hope, meaning, peace, and positive outlook. Also, faith-based organizations promote social engagement and connectedness and preach against self-injury and substance use. The study was observational and does not prove that regularly going to a religious service prevents death from despair. However, we know from other Harvard research that using religion to cope is associated with improved outcomes for people with severe psychiatric illness. Due to the pandemic, it may be difficult to attend your usual place of worship. Consider attending services via teleconference. If you attend in-person services, wear a mask and try to stay six feet away from others.

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Stress can raise your risk of developing a substance use disorder. Here's how to get help when you need it.

In recent months, Americans' collective stress level has risen in response to the pandemic and economic fallout. Many people are looking for ways to help themselves feel better. Unfortunately, stress can trigger a number of unhealthy coping strategies — drinking alcohol to excess, bingeing on junk food, engaging in drug use, or other harmful behaviors. If you've ever had a substance use disorder, a bout of significant stress may even put your recovery at risk.

This is likely due to the shift the human brain makes in times of trauma. Instead of focusing on long-term goals, your brain zeroes in on short-term objectives.