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The Conundrum of Chronic Pain, Opioid Use and the Consequences

Thursday, June 15, 2017  
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Research You Can Use

Summaries of the latest addiction research
provided by Mark Gold, MD

June 15, 2017

The Conundrum of Chronic Pain, Opioid Use and the Consequences

Mortality resulting from opioid use (over 33,000 in 2015) is now epidemic in the U.S., exceeding drug-related deaths from all other intoxicants. Dr. Ted Cicero of Washington University, Dr. William Jacobs, Medical Director of Bluff Plantation, and I discussed the opioid over-prescribing and switch to heroin at DEA Headquarters on November 17, 2015. Things have gone from bad to worse.Read More »


The Neuroscience of Disordered Gambling

The functional interconnectivity between differing brain circuitry is what governs all complex cognitive functioning and addictive behavior. We know that this circuitry is both genetically determined and can be modified by environment and experience (phenotypical changes). Pathological gambling is associated with several cognitive impairments, including diminished reward sensitivity that is similar to the neuroadaptive changes that result from abusing alcohol or other drugs.Read More »


Variance in Cannabis Use and Gender Affect Size of Important Brain Regions

Cannabis is the most widely used illicit drug in the U.S. and, as a result of legalization efforts for both medical remedy and for recreational use, is now the second leading reason (behind alcohol) for admission to addiction treatment in the U.S. The health consequences, cognitive changes, academic performance and numerous neuroadaptations have been debated ad nauseam. Like other drugs and medications, effects are different if exposure occurs in the young vs. the old or in males vs. females.Read More »


Pain, Survival, Opioids and Addiction: Activation of Opioidergic and Dopaminergic Circuitry in the Mid-Brain

At present, opioids are the most widely used and effective medications for the treatment of moderate-to-severe pain. The recent opioid crisis has caused many to reevaluate this practice. Yet the mechanisms of acute versus chronic pain, and how pain relief may involve activation of opioidergic and dopaminergic circuitry in the cortico-limbic regions has resulted in renewed interest and investigation regarding what pain is and is not.
Read More »


From Anesthesia to Popular Club Drug to Fast-Acting Antidepressant: Ketamine Continues to Impress and Confound Researchers

A novel glutamatergic hypothesis of depression, using a 50-year-old anesthesia medicine, has had a remarkable run as of late. First an anesthetic, then a popular club drug in the 90s known as “Special K” (and currently still popular in Hong Kong as a “Rave Drug”), and now a novel, fast acting antidepressant, ketamine is a N-Methyl D-Aspartame (NMDA) receptor antagonist.Read More »

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