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Tuesday
Feb042014

Why Is Heroin Abuse Rising While Other Drug Abuse Is Falling?

Peter Shumlin, Democratic governor of Vermont, moved heroin addiction to the front burner of national news by devoting his entire State of the State address to his state’s dramatic increase in heroin abuse. Shumlin described the situation as an “epidemic,” with heroin abuse increasing 770 percent in Vermont since 2000.

Vermont is a microcosm of the nation. Across the U.S., heroin abuse among first-time users has increased by nearly 60 percent in the last decade, from about 90,000 to 156,000 new users a year, according to the U.S. Substance Abuse and Mental Health Services Administration (SAMHSA).

At the same time, non-medical prescription opiate abuse has slowly decreased.  According to the SAMHSA 2012 National Survey on Drug Use and Health, the number of new non-medical users of pain killers in 2012 was 1.9 million; in 2002 it was 2.2 million. [It bears repeating that these stats are for abuse of non-medical prescription pain killers, not abuse of drugs obtained with a prescription.]

In the same time-frame, abuse of methamphetamine also decreased. The number of new users of meth among persons aged 12 or older was 133,000 in 2012, compared to about 160,000 in 2002.

Cocaine abuse also fell, from about 640,000 new users in 2012 from over 1 million in 2002. Crack abuse fell from over 200,000 users in 2002 to about 84,000 in 2012 (a number that’s held steady for the last three years).

The statistics suggest that heroin has taken up the slack from fall offs among other major drugs (only marijuana and hallucinogens like ecstasy have held steady or slightly increased among new users over the last decade; not surprising since they’re the drugs of choice among the youngest users, and since pot has been angling toward legalization for the last few years).

Most surprising in this sea of stats is the drop in non-medical prescription opiate abuse overlapping with an increase in heroin abuse. The reason may come down to basic economics: illegally obtained prescription pain killers have become more expensive and harder to get, while the price and difficulty in obtaining heroin have decreased.  An 80 mg OxyContin pill runs between $60 to $100 on the street. Heroin costs about $9 a dose. Even among heavy heroin abusers, a day’s worth of the drug is cheaper than a couple hits of Oxy.

Laws cracking down on non-medical prescription pain killers have also played a role. The amount of drugs like Oxy hitting the streets has decreased, but the steady flow of heroin hasn’t hiccupped.  Many cities are reporting that previous non-medical abusers of prescription pain killers—who are often high income professionals—have turned to heroin as a cheaper, easier-to-buy alternative.

One conclusion that can be drawn from the stats is that prescription opiates are serving as a gateway drug for heroin, not so much by choice but by default. The market moves to fill holes in demand, and heroin is effectively filling fissures in demand opened by legal pressures and cost.

Another interesting stat is that among first-time drug users, the mean age of initiation for non-medical prescription pain killers and heroin is virtually identical: 22 to 23 years old. That would also support an argument that there’s a cross-over effect from drugs like Oxy to heroin (in contrast, the mean ages for first-time users of pot and ecstasy are 18 and 20, respectively).

Vermont’s heroin problem would seem a foretelling of things to come in the more affluent parts of the country. According to the U.S. Census Bureau, Vermont’s median household income, home ownership rate, and percentage of people with graduate and professional degrees are all higher than the national averages, and Vermont’s percentage of those living at or below poverty level is significantly lower than the national average.

The bottom line: Vermont’s stratospheric heroin increase is happening where the money is, and the national drug abuse trends suggest that the same thing is happening across the country.

You can find David DiSalvo on Twitter @neuronarrative and at his website, The Daily Brain. His latest book is Brain Changer: How Harnessing Your Brain’s Power To Adapt Can Change Your Life.

Sunday
Jan262014

How Video Games Will Help Us Steal Back Our Focus 

I’ve become a focus junkie. If I see something written in a legit publication about techniques or technologies to improve mental focus, I freebase it—mainly because the forces draining focus are unrelenting, and I’m convinced that the only way to regain balance is by indulging measures that are just as intense. (My working philosophy: extreme forces call for extreme adaptation, using the best tools and strategies science can afford us.)

Enter author and psychologist Daniel Goleman, popularizer of “Emotional Intelligence”, and author of a new book about the power of focus called, simply, “Focus”.  Goleman is one of my favorite writers in the psychology space because his work is a true example of what I call “science-help” – he’s all about the research. When you glean takeaway knowledge from a Goleman book, you can be sure it’s been tested and credible enough to earn his writer’s brand.

Because I’m also a midnight snacker of business nibblets, I came across Goleman’s latest article in the Harvard Business Review, “The Focused Leader: How effective executives direct their own—and their organization's—attention". The entire piece is well worth the magazine's $17 cover price (or at least buying a PDF reprint online), but I was especially intrigued by a sidebar in the article about a new species of video games designed to help regain our focus in a focus-fragmenting world.

Dave Eggers or Michael Chabon couldn’t come up with a better ironic twist than video games—engaging and entertaining video games, no less(!)—being used to sharpen attention.  As Goleman discusses in HBR, neuroscientists at the University of Wisconsin-Madison have grabbed hold of this task like tics on a deerhound and produced a video game slated for a 2014 release called, fittingly, “Tenacity”.  Quoting Goleman:

“The game offers a leisurely journey through any of half a dozen scenes, from a barren desert to a fantasy staircase spiraling heavenward. At the beginner’s level you tap an IPad screen with one finger every time you exhale; the challenge is to tap two fingers with every fifth breath. As you move to higher levels, you’re presented with more distractions—a helicopter flies into view, a plane does a flip, a flock of birds suddenly scud by.”

The objective is the same as that of meditation—to draw attention back to a central point despite the number or intensity of distractions dive-bombing one’s focus.  Goleman adds, “When players are attuned to the rhythm of their breathing, they experience the strengthening of selective attention as a feeling of calm focus, as in meditation.”

University of Wisconsin-Madison researchers see this as just the beginning of a focus-enhancing revolution in digital tech.  Through an initiative called Games+Learning+Society (GLS), they are pioneering efforts that marry entertainment with enrichment, and building it all on a platform of solid science.

The team boasts members with serious science street cred, like neuroscientist Richard J. Davidson, founder of the Center for Investigating Healthy Minds, whose work on neuroplasticity (the brain’s ability to change at the neuronal level) could carry Promethean fire to the video game world.  Davidson is leading research to identify what’s happening in the brains of people who use games like Tenacity, with the hypothesis that the technology will help train our brains for enhanced focus, and—believe it or not—greater kindness.

“Modern neuroscientific research on neuroplasticity leads us to the inevitable conclusion that well-being, kindness and focused attention are best regarded as skills that can be enhanced through training,” says Davidson. “This study is uniquely positioned to determine if game playing can impact these brain circuits and lead to increases in mindfulness and kindness.”

Given the deluge of news about video games leading to violence, the idea that they could make us a bit nicer sounds, well, mighty nice. And the truth is that it's not even far-fetched: it's an outcome sitting at the crossroads of ancient wisdom traditions and focus-enhancing technology—as we learn to more consistently focus our attention, we experience a change in both awareness and attitude. As everyone from the Buddha to David Foster Wallace has observed, once our awareness is enhanced and broadened, we can get out of our heads and interact more conscientiously with others.

That's the pro-social goal that has the Wisconsin team fired up about the focus-enhancing power of digital tech.  According to Constance Steinkuehler, co-director of GLS and associate professor of education at UW-Madison: “We’re looking at pro-social skills, particularly being able to recognize human emotions and then respond to them in some productive fashion, which turns out to be harder than you might think.”

Armed with Davidson’s brain-imaging analysis, the team wants to know if playing the games they’ve designed will foster pro-social adaptation in our noggins.

“We look at pre- and post-test measures and see if there is a difference,” said Steinkuehler. “For example, in Tenacity, our mindfulness app, you might ask yourself ‘Is there a dosage effect? Can we see that more game play has more positive effect on kid’s attention?’”

If that's proven out, then GLS's technology-harnessing work could be the perfect counterbalance to the dubious video-game legacy the news media is so fond of blowhorning: that gaming does little more than foster anti-social behavior, everything from bullying to serial violence.

At a less radical level, the UW-Madison team’s work may also provide an antidote to the insular effects of digital tech. If doses of Tenacity, or similar games, leads to heightened focus and social awareness, then spending time buried in your smartphone or tablet could have an upside beyond accruing more gold and elixir for your barbarian clan.

“There’s this tremendous amount of time and energy investment in games and media,” says Steinkuehler. “So part of what we’ve been trying to figure out is how do we take some of that time and make it beneficial for the people engaged in it? We have examples from television or film of documentaries, of art pieces, of indie films, of shows like Sesame Street, that actually have documented benefits for their viewers. So games are another media, why not use them?”

It’s this pragmatic view of technology, as opposed to the absolutist view that too often creeps into our mindspace, that will eventually win the day. As Sesame Street proved decades ago amidst the clamor of “TV is an anti-educational evil!” fear mongering, we can make use of technology to enrich minds. The difficulty in doing so arises from fighting against path-of-least-resistance thinking—human nature's chronic disease of default—that turns us into willing slaves of our time-chewing vices.

The work of the GLS team and others crafting new uses for digital tech reminds us that how technology ultimately affects us is an outcome we can, and should, influence. If we punt on that responsibility, we shouldn't be surprised at the bad news that invariably follows.  But if we see the responsibility as an opportunity, we'll be surprised at how much good can come from the ones and zeroes in our hands.

David DiSalvo's newest book, Brain Changer, is now available at AmazonBarnes and Noble and other major booksellers.

Thursday
Jan162014

Study Shows That Electrical Stimulation Can Boost The Brain's Brakes 

Using harmless electrical stimulation, researchers have shown that they can boost self-control by amplifying the human brain’s “brakes.”

Researchers from The University of Texas Health Science Center at Houston (UTHealth) and the University of California, San Diego asked study participants to perform simple tasks in which they had to exert self-control to slow down their behavior. While doing so, the team used brain imaging to identify the areas of the participants’ prefrontal cortex (sometimes called the brain’s “command and control center”) associated with the behavior—allowing them to pinpoint the specific brain area that would need a boost to make each participant’s “braking” ability more effective.

They then placed electrodes on the surface of the participants’ brains associated with the prefrontal cortex areas linked with the behavior.  With an imperceptible, computer-controlled electrical charge, researchers were able to enhance self-control at the exact time the participants needed it.

"There is a circuit in the brain for inhibiting or braking responses," said Nitin Tandon, M.D., the study's senior author and associate professor in The Vivian L. Smith Department of Neurosurgery at the UTHealth Medical School. "We believe we are the first to show that we can enhance this braking system with brain stimulation."

To make sure that specifically stimulating the prefrontal cortex was really causing the effect, the researchers conducted a follow-up in which they placed the electrodes on other surface areas of the participants’ brains. Doing so had no effect.

That’s an important point, because it separates this study from past research that used electrical stimulation to disrupt general brain function.  In contrast, this study shows that particular parts of the prefrontal cortex form a self-control circuit that can be externally enhanced.

What also makes this study noteworthy is that it was double-blind-- neither the researchers nor participants knew when or where the electrical charges were being administered.  That’s critical because it means the participants would not know when to intentionally slow down their behavior to exaggerate the effect. They were, in a very real sense, being externally controlled by the stimulation, albeit only briefly.

The study has a few caveats. First, all of the participants were volunteers suffering from epilepsy who agreed to be monitored for seizures by hospital staff during the experiment.  Second, there were only four participants—though all four experienced the self-control boosting effect.  Obviously, placing electrodes on the surface of the brain is an invasive procedure, hence the small number of participants.

If this research sounds a little scary to you, you can relax knowing that we're a long way from externally controlling peoples' behavior. The true value of this study is to demonstrate that the brain's self-control circuit can be amplified, at least under certain conditions.

Placing electrodes on peoples' brains isn't a practical solution, but eventually the same effect may be triggered with scalp electrodes and, down the road, with medication that targets the self-control circuit. That may one day be promising news for sufferers of behavioral disorders like Tourette’s Syndrome and OCD.

The study was published in The Journal of Neuroscience.

David DiSalvo's newest book, Brain Changer, is now available at AmazonBarnes and Noble and other major booksellers.

Thursday
Jan092014

Eat More Of These Four Things For A Stronger, Healthier Brain 

Remember these four letters: DDFM.  If it’s easier, think of them as call letters for a cheesy radio station, “Double D FM!” The letters stand for four nutrients critical to brain health that you probably aren’t getting enough of: Vitamin D, DHA, Folate and Magnesium.

Research suggests that our diets are increasingly low in all four, and our brains are suffering for it.

Vitamin D

Why it’s important:  I stumbled across the importance of vitamin D when a routine blood test revealed that my level was low and my doctor recommended that I begin taking three 2000 i.u. vitamin D3 supplements a day. I’d always thought being out in the sun was enough to keep vitamin D levels high, because the human body uses sunlight to manufacture the vitamin. But research shows we’re frequently low in this essential vitamin and that’s potentially dangerous. Low levels are associated with free radical damage to brain cells and accelerated cognitive decline.  In addition to boosting brain health, there’s also evidence suggesting that vitamin D aids in muscle strength and repair.

Deutsch: Schweizer Emmentaler AOC, Block

How to get more of it:  Eat oily fish like wild salmon* and eggs. You can also get a boost by eating cheese, and if you go this route I recommend swiss cheese because it also contains a high level of Conjugated Linoleic Acid (CLA) that has shown promise in helping reduce abdominal fat.  Another decent source is Greek yogurt, but avoid brands with excess sugar (I’m not recommending milk for that reason – it’s naturally high in sugar). If your vitamin D levels are especially low—and it’s best to determine that via a blood test—consider taking a vitamin D3 supplement at a level your doctor recommends.**

DHA

Why it’s important:  DHA (Docosahexaenoic acid) plays a vital role in keeping cell membranes flexible, resilient and healthy. Healthy cell membranes are less susceptible to oxidative stress, the damage caused by free radicals, which can lead to cell mutation and, ultimately, cancer. DHA also appears to help brain cells regulate their energy use and protects them from inflammation—a condition linked to an array of degenerative diseases including Alzheimer's. In addition, low levels of DHA have been linked to depression, memory loss, and even elevated hostility. Suffice to say, there's enough credible research out there on DHA now to support a strong statement that it's essential to brain health.

How to get more of it: Eat more oily fish like wild salmon and sardines, though if you eat canned sardines try to find brands that are not packed in cans containing BPA, a chemical linked to a host of toxic badness. If you don't mind the taste, kelp (aka seaweed) is another excellent source. You can also get ample DHA in Omega 3 fish oil supplements. Just make sure that you are buying a brand that is filtered to remove mercury and has a high level of DHA (the EPA and DHA levels will be listed in the ingredients; try to get a supplement with at least 200mg of DHA per capsule).**

Folate

Why it’s important: Folate, a water-soluble B vitamin, has long been established as critical to brain development in infants; pregnant women are strongly advised to take a folate supplement to fend off birth defects. But research has also shown that folate is important to brains of all ages, and deficiencies are correlated with cognitive decline particularly in the elderly. Studies have linked folate to improved memory function and mental processing speed—two things that typically take a hit as we age. There's also evidence indicating that folate deficiency contributes to psychiatric disorders such as depression.

How to get more of it:  Eat unsalted peanuts. The little legumes are folate powerhouses, and they’re also packed with heart healthy monounsaturated fat.  If crunching nuts isn’t your thing, try natural peanut butter. Just stay away from peanut butter with added sugar and salt – stick to the kind that’s all peanuts. Other good sources include asparagus, black eyed peas, spinach, broccoli and egg yolks.

Magnesium

Why it’s important:  In the brain, magnesium acts as buffer between neuron synapses, particularly the NMDA receptor that plays a role in several cognitive functions including learning and memory. Magnesium “sits” on the receptor without activating it, in effect protecting the receptor from over-activation by other neurochemicals, especially the neurotransmitter glutamate. If there isn’t enough magnesium available to protect NMDA receptors, glutamate constantly triggers the receptors causing an “excitatory” response. That’s why you often see magnesium advertised as a calming nutrient, because it blocks glutamate from too-frequently activating the NMDA receptors in your brain. The most important thing to remember is that without magnesium, over-activation of NMDA receptors eventually becomes toxic to the brain, leading to progressively worse damage and steady cognitive decline.

Spinach

How to get more of it:  Eat spinach, it's loaded with magnesium. Other sources include almonds and black beans. Just be sure to eat raw or roasted almonds that are unsalted and not coated in sugar (even though those taste so good). Peanuts are also a decent source of magnesium, which makes them a double-whammy snack because they're also high in folate as mentioned above.

If you decide to take a magnesium supplement, be sure to find a readily absorbable form of magnesium such as magnesium citrate, and avoid the less absorbable (but widely sold) form of magnesium oxide. **

*In each case where I recommended eating more fish, you'll notice that I said "wild salmon," and that's because there's troubling evidence to suggest that farm-raised salmon are a significantly less healthy choice for the brain and the heart.

** Always check with your doctor before beginning any supplement regimen.

David DiSalvo's newest book, Brain Changer, is now available at AmazonBarnes and Noble and other major booksellers.

Tuesday
Dec312013

Two Incredible Speeches About Thinking To Begin 2014

Widely regarded as two of the most influential commencement addresses ever given, I offer you David Foster Wallace's speech "This is Water" from his commencement at Kenyon College in 2005, and Steve Job's commencement speech at Stanford, also in 2005.  As the New Year begins, I urge you to listen to both and spend some time thinking about the messages from these two remarkable thinkers from different parts of culture who had important lessons to teach us about our own thinking.

Happy New Year.