Public health
fromwww.aljazeera.com
2 days agoAs fentanyl crisis evolves, experts say US is still behind the eight ball'
The Trump administration's policies and health program cuts jeopardize progress against fentanyl overdoses in the U.S.
Jasveen Sangha pleaded guilty to one count of maintaining a drug-involved premises, three counts of distribution of ketamine, and one count of distribution of ketamine resulting in death or serious bodily injury.
Yes, there has been a shocking lack of progress in developing transformative psychiatric medicine (We need new drugs for mental ill-health, 5 February), but this may be because in mental health, drugs are not always the answer (see, for example, Richard P Bentall's Doctoring the Mind). Huge progress has been made in the effectiveness of talking therapies for example, free effective treatment for post-traumatic stress disorder (PTSD) is available to all UK army veterans through the charity PTSD Resolution.
Some experts have mischaracterized smoking fentanyl as "safer" than injecting, seeking to reduce risks among users. Narrowly considered, the statement is accurate, as inhalation avoids needle-sharing, reducing risks for HIV, hepatitis C, bacteremia, abscess formation, and infective endocarditis among users. However, there's no clinical-trial-level evidence (randomized trials with real patients) showing smoking illicit fentanyl is safer than injecting it. It isn't, and that conclusion is unsupported by toxicology, environmental exposure science, or emerging data.
Statistics show that about one-third of people with depression achieve remission-meaning their symptoms are gone-with traditional antidepressant medications. This matched my experience treating people, and I had grown to accept that this was as good as it gets. Although I wasn't thrilled with the fact that many people continued to struggle with significant symptoms of persistent depression, it seemed this was as good as we could do.
Almost all Americans are familiar with posttraumatic stress disorder ( PTSD) and its long-term, sometimes devastating effects on people's lives-crippling anxiety, depression, disturbing flashbacks, sleep problems, irritability, concentration difficulties, and much, much more. About 70 percent of U.S. adults have experienced at least one major life trauma. The fact that so many of us experience trauma makes it easier to empathize with the 10 or so percent of people who go on to develop PTSD.
The standard explanation is that ketamine blocks NMDA receptors. These receptors bind glutamate, which is a chemical messenger found throughout the brain and body. By blocking NMDA receptors, ketamine increase "brain-derived neurotrophic factor" (BDNF), a protein which I refer to as "Miracle-Grow for the brain." BDNF promotes neuroplasticity-which is the growth of new connections (synapses) in the brain. This has traditionally been viewed as the primary mechanism responsible for ketamine's therapeutic benefits. But ketamine does so much more!