Summary: Opioid epidemic has been causing more deaths in the last few years than street drugs. Thus, everyone has quickly blamed doctors and pharmaceutical companies for this epidemic. Opioids are the most potent painkillers; without them, patients may suffer from severe pain. However, law enforcement agencies have been pressurizing doctors to reduce opioid prescriptions. Now, new studies suggest that medical prescription of these drugs may not have anything to do with the opioid epidemic. Even if opioids become hard to get, those prone to substance abuse would switch to other drugs. Therefore, there is no evidence that reducing opioid prescriptions would reduce drug overdose-related deaths. It will only result in the change of name of the substance that causes an overdose crisis.

Prescription drugs have been responsible for many deaths in the last decade or so. Almost all of these deaths have occurred due to drug overdose and misuse. Everyone seems to be blaming doctors and the pharmaceutical industry for the epidemics. However, many think that this epidemic has occurred due to widespread prescription of these medications, causing opioid addiction and increased misuse of these medications.

Opioids are one of the most potent painkillers. And in many clinical conditions, managing pain without these powerful pain killers is challenging. If doctors completely stop prescribing these drugs, it would result in poorly managed pain and other health harms.

However, new studies suggest that doctors prescribing opioids may have nothing to do with the epidemic. In one of the studies, researchers followed patients who were prescribed opioids for the first time to control severe pain. After six months of follow-up, less than one percent of the patients used opioids consistently.

People prescribed opioids are not likely to abuse them significantly

This is not the first study to show that opioid prescription is not to be blamed for the present epidemic. In one of the more extensive studies published in the reputed journal BMJ, researchers analyzed the data of 560 000 opioid naïve patients who were prescribed opioids for pain relief. The study found that in the long run, just about 0.6% were found to be misusing opioids.

Many studies show that there is no correlation between opioid misuse and prescription by doctors. It means that if doctors prescribe these drugs for pain relief, this does not contribute much to opioid epidemics. However, this also means that there are other less-known factors causing this epidemic.

However, despite the emerging data that doctors have nothing to do with an opioid epidemic, policymakers and law enforcement agencies are continually pressuring the medical community to stop prescribing these drugs or use them sparingly. However, doctors think that reducing their prescriptions would reduce their patients’ quality of life. In many cases, the situation in the US may become like that in some developing nations.

Since law enforcement agencies are pressuring doctors, CDC has even come up with a statement that agencies should stop misinterpreting its guidelines. Although CDC suggests that doctors should practice caution when prescribing these medications, doctors are in the best situation to decide when to prescribe and when not.

However, things in practice are quite complicated. For example, despite the clarification from CDC, pharmacies are not dispensing opioids in sufficient amounts to the patients.

Researchers further noted that restricting opioid use may help reduce opioid overdose rates. However, it would not result in a decline in substance abuse and related deaths since most people who misuse substances would switch to something else like fentanyl or heroin.

Also, since the regulatory agencies have started discouraging doctors from prescribing opioids, many other street drugs have come back. Thus, methamphetamine misuse has risen considerably in the last few years.

Experts suggest that law enforcement agencies should focus on their war on drugs instead of pressuring doctors and pharmacists. Since pressurizing, doctors would not result in less substance abuse. All it will cause is that addicts or those living with substance misuse disorder would shift to another substance. Hence, the name of the substances causing harm would keep changing, but the overall mortalities caused by substance misuse or overdose would not change.

Summary: Many people are living with chronic pain and need opioids to manage their condition. However, if, for some reason, they need to find a new physician, it becomes very difficult. People find it hard to find a physician who is ready to prescribe opioids for their chronic pain. A new survey of 452 primary clinics confirms that almost half of all clinics in the US do not want to take patients who use opioids to manage their pain. There are worries that they might have legal problems. They also think that patients must be abusing opioids leading to some serious opioid addiction. However, even if the patient is abusing opioids, it is not the reason to refuse care, as refusal may result in patients turning to illicit drugs.

Most Americans already know that it is pretty hard to find a physician who would readily treat their chronic pain, especially if they are on opioids. People often have to call many clinics before getting an appointment or finding a physician ready to help them. However, this is not just an imagination of some patients. A new study now confirms that it is a significant problem for those living with chronic pain and requiring opioids for pain treatment. If they need to change their physician for some reason, they are in trouble.
The new study shows that almost half of all clinics in the US are hesitant to treat patients living with chronic pain if they are on opioids. In the new study carried out by researchers at the University of Michigan, researchers used a technique called “secret shopper.” In the study, one poses as a female patient living with chronic pain and taking opioids. Then, experts called 452 primary clinics in nine states to ask if they were taking new patients.

Finding medical care for those using opioids for their chronic pain is challenging

If the clinic said “yes, ” the person would say that she is covered by insurance and looking for a new healthcare provider to treat her chronic pain, as her earlier physician has retired or stopped prescribing opioids. So the researchers made two calls to each clinic and talked about one of the scenarios.

To the researchers’ amazement, 43% of all clinics said they would not prescribe opioids in both scenarios (early physician retirement or physician stopped prescribing opioids). Only about 32% said that their primary care providers (PCPs) might prescribe opioids in these scenarios. However, another 25% gave mixed signals.

Here it is clear that doctors are hesitant to take patients that are taking opioids, and they are rejecting them without even considering their health condition. The study also found that clinics were twice more likely to reject these patients if they said their doctor stopped prescribing them opioids for some reason. In such instances, clinics assume that a person might be having problems related to opioid misuse.

The study suggests that there is a significant challenge in finding the proper medical care for living with chronic pain. However, the chances of finding care for chronic pain are further reduced if there are some indications that a person may abuse opioids. Healthcare experts warn that such a kind of refusal may significantly increase the risk of a patient’s conversion to illicit substances.

Researchers went further to explore why some clinics are so hesitant to treat such patients. They said that it is due to new legal norms and fear that they may get into some kind of trouble for prescribing these drugs.

The study results are consistent with another study done in 2019, in which researchers also found that 40% of primary care physicians are highly reluctant to treat patients who need opioids for their chronic pain.

However, this discrimination against opioid users is incorrect and poses some significant problems. Therefore, this study aims to show the existence of so-called bias towards opioid users and poor healthcare access.

Health experts say that even if a person is using opioids for other reasons than pain management, they still need medical help. In fact, those addicted to opioids need greater medical assistance, and those are the patients that primary care physicians must be treating.

Summary: Alcohol consumption is socially accepted; in many cultures, it is even a sign of adulthood. However, many people start drinking alcohol excessively. It seems that some people are susceptible to alcoholism. Alcoholism is a severe health issue. However, there is still a lack of good understanding of the problem. There is no single test that can help confirm the diagnosis. Nonetheless, there are now clearly defined alcoholism stages and proven ways to manage alcohol addiction. Thus, those addicted to alcohol must seek suboxone treatment, understanding that being sober is the new high.

Humans have consumed alcohol for ages. Its consumption is socially accepted. Not only that, in many societies, particularly in western nations, drinking alcohol is considered a sign of growing up as some say that only children must be sober.

All this means that millions of people consume alcohol regularly. Studies suggest that almost 85% of adults in the US consume alcohol. About five to six percent of the total US adults are addicted to alcohol. It means that they are living with alcoholism.

One of the issues with alcoholism is that it does not have well-defined boundaries. It is unclear who is an alcoholic. There are no tests or biomarkers that can be done to diagnose alcoholism. It means that alcoholism is mainly diagnosed clinically or indirectly.

There is also good news. Studies also show that consuming alcohol is not considered chic anymore. Therefore, there is some decline in excessive alcohol drinking. There has been a decline in alcohol consumption even in the last few years. 

It means that an increasing number of people realize the dangers of excessive alcohol drinking. And thus, many people now recognize that drinking alcohol is not essentially cool. 

Alcohol addiction is a severe health problem

These days, excessive alcohol consumption is not more regarded as a habit or a lack of willpower to control oneself. Instead, medical science now views excessive alcohol consumption as a health disorder.

In fact, medical science now defines the three stages of alcohol dependence. It starts with the first stage, when a person begins consuming alcohol frequently. Although, at this stage, a person does not have many issues with alcohol, nonetheless, they seek a reason to drink. For example, during the first stage, a person starts drinking alcohol to combat boredom, celebrate something, and combat loneliness.

During the first stage, the body starts adapting to alcohol. It means that such individuals do not show many signs of alcohol consumption and can even function well when intoxicated. In addition, these people can resist some of the effects of alcohol.

These individuals start developing physical and mental dependence from the middle or second stage. Their organs start becoming dependent on alcohol. Their heart starts beating irregularly, which causes damage to their heart muscles. Excessive drinking causes changes in the liver and gastrointestinal tract. They start drinking habitually and start developing erratic behavior. They also show withdrawal symptoms like nausea, sweating, and severe irritability.

Finally, many develop late-stage alcohol dependence. It is a full-blown alcohol dependency. It is a stage that is called alcoholism. These people live with severe malnutrition, liver disease, low immunity, heart disease, and other physical and mental ailments. They often suffer from blackouts and memory loss. 

As one can understand, the third stage of alcohol dependence is a full-blown health disorder that requires medical treatment. 

Overcoming alcohol addiction

It is vital to understand that alcohol addiction shares many traits with drug addiction. Therefore, one must be similarly treated for alcohol addiction. In the US, a 12-step program for addiction treatment is commonly used. But, of course, it is not the only way to treat addiction, but one of the recommendations.

It has some important components, like realizing helplessness in overcoming addiction. It is also about believing that higher power can help and then asking the higher power to help. Finally, it is about making a list of shortcomings and then trying to overcome them. This 12-step program is also about maintaining the personal inventory, admitting when one is wrong, and more.

The good thing about the 12-step program is that it focuses much on boosting inner strength and enabling people to overcome their addiction by themselves. Of course, no single method may work for all. Many people cannot overcome addictions through this program or sheer willpower. In such cases, seeking specialized treatment for the addiction is the way forward. It is vital to understand that being sober is the new high.

Summary: Understanding mental health disorder risk and pathogenesis is complex. New studies show that adverse childhood experiences may also increase the risk of mental health disorders, as they can result in altered stress responses. In the new study, researchers focused on microglial cells in the brain rather than focusing on neurons. Since microglial cells play a vital role in brain development, researchers found that adverse childhood conditions cause increased pruning of neuronal synapses by microglial cells, thus altering stress responses. This ultimately increases the risk of mental health disorders in adults.

Most people imagine the brain as an organ that contains neurons that are interconnected in a particular way, which creates a most powerful supercomputer. Whereas cognitive function depends on how these neurons are connected via synapses, thus forming specific kinds of circuits, memories, and functional units.

Although, this is absolutely true. However, it is worth noting that the brain has non-neuronal cells that play a vital role in brain development and maintaining cognition throughout life. Therefore, dysfunction of these non-neuronal cells may increase the risk of various brain disorders, neurodegenerative diseases, and even mental health disorders.

These non-neuronal cells do not produce impulses. However, they support neurons, provide them with vital nutrients, and defend neurons from toxins, infection, and so on. They play a vital role in maintaining brain structure. These cells are glial cells. Depending on the species, they form 35-60% of all brain cells.

Among the glial cells, microglia are most abundant in the brain. They play a vital role in brain development and are also an important part of the brain’s immune system.

Researchers have been paying significant attention to microglia, their role in neurodegeneration, and mental health disorders in recent years. Since many changes in the brain are difficult to explain by focusing solely on neurons. Moreover, the role of one of the most abundant brain cells cannot be neglected in brain disorders and mental health issues.

A study shows that early life adversity causes microglia dysfunction and thus altered stress responses and mental health issues in adults

Researchers at the Departments of Anatomy & Neurobiology, Pediatrics, Neurology, and Physiology & Biophysics at the UCI School of Medicine say that neuroscience has focused much on neurons, neglecting the role of microglial cells.

However, now neurobiologists realize that a lack of understanding of the role of glial cells in brain health may be the missing link. Thus, understanding these cells that do not produce impulses but play a vital role in brain development and maintenance may help understand various neurological disorders and common mental health problems.

Researchers conducted an experimental study on mice to understand how early life adversity (ELA) can influence stress responses in later life. One group of mice was kept under close to ideal conditions, with adequate light, rest time, and food. However, another group of mice was exposed to adverse condition.

Researchers found that the group that was exposed to ELA has significant changes in the brain, especially in the stress-sensitive hypothalamic corticotropin-releasing hormone-(CRH) expressing neurons. These changes occurred due to the pruning of synapses by microglial cells.

Researchers could establish that in the developing brain, microglial cells play an important role in the formation of neuronal synapses, brain development, and, thus, stress responses. Hence, ELA causes altered brain function and stress responses.

However, researchers noted that although they could identify the role of microglial cells and altered stress responses caused due to adverse conditions in early childhood and their role in mental health disorders later in life, they are still to identify underlying molecular pathways.

Researchers still need to understand what molecules are causing microglial dysfunction. Understanding this molecular mechanism is essential for finding preventive measures and even remedies such as mental disorder treatments and childhood trauma treatment.