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Sunday, September 29, 2013
Addiction: Can you ever really completely leave it behind?
It is often said that once people develop an addiction, they can never completely eliminate their attraction to the abused substance. New findings provide further support for this notion by suggesting that even long-term abstinence from cocaine does not result in a complete normalization of brain circuitry.
Scientists are currently trying to answer some of the ‘chicken and egg’ questions surrounding the abuse of drugs. In particular, one of those questions is whether individuals who abuse psychostimulants like cocaine are more impulsive and show alterations in brain reward circuits as a consequence of using the drug, or whether such abnormalities existed prior to their drug use. In the former case, one might expect brain alterations to normalize following prolonged drug abstinence.
To address these questions, Krishna Patel at Institute of Living/Hartford Hospital and colleagues compared neural responses between three groups of people who were asked to complete a task that resembles bidding on eBay items. The 3 groups consisted of 47 healthy controls, 42 currently drug-abusing cocaine users, and 35 former cocaine users who had been abstinent an average of 4 years. They also compared all three groups on their levels of impulsivity and reward responding.
They found that active users showed abnormal activation in multiple brain regions involved with reward processing, and that the abstinent individuals who were previously cocaine dependent manifested differences in a subset of those regions. Both current and former cocaine users displayed similarly elevated impulsivity measures compared to healthy controls, which may indicate that these individuals had a pre-existing risk for addiction. Indeed, the degree of impulsivity correlated with several of the brain activation abnormalities.
These findings suggest that prolonged abstinence from cocaine may normalize only a subset of the brain abnormalities associated with active drug use.
“The knowledge that some neural changes associated with addiction persist despite long periods of abstinence is important because it supports clinical wisdom that recovery from addiction is a lifelong process,” says Dr. John Krystal, Editor ofBiological Psychiatry. “Further, it is the start of a deeper question: How do these persisting changes develop and how can they be reversed?”
The authors agree that further studies will be needed to investigate such questions, including the continued attempt to determine the extent to which differences in former cocaine users reflect aspects of pre-existing features, exposure to cocaine, or recovery.
What Should I Do Next with My Life? New Ways to Define Success
Friday, September 27, 2013
President Obama said he and Iranian President Hassan Rouhani spoke by phone Friday, marking the first president-to-president communication since 1979.
Mr. Obama said he and Mr. Rouhani spoke about Iran’s nuclear program and said they would both try to pursue a deal that would defuse a potential crisis over the U.S.’s belief that Iran is pursuing nuclear weapons.
“I do believe that there is the basis for a resolution,” Mr. Obama said, though he warned of difficulties.
Mr. Obama said the challenges are underscored by the fact that this was the first direct communication between a U.S. president and an Iranian president since 1979, when the Shah was overthrown and the Islamic Republic was installed.
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U.N. reaches deal to eliminate Syria’s chemical weapons; U.S. and Iran open talks
The U.N. Security Council’s five permanent members reached an agreement Thursday to push through a resolution calling for the swift elimination of Syria’s chemical weapons stockpile, a key development in fast-paced day of diplomacy that also featured the highest-level U.S.-Iranian meeting in years.
While questions remained Thursday night about specific language the Security Council will adopt toward Syria, the Obama administration said there had been a “breakthrough” after “hard-fought diplomacy” geared toward bolstering the deal struck between the U.S. and Russia to persuade embattled Syrian President Bashar Assad to give up his chemical weapons stockpile.
“The Russians have agreed to support a strong, binding and enforceable resolution that unites the pressure and focus of the international community on the Syrian regime to ensure the elimination of Syria’s chemical weapons,” the administration said in a statement.
At the same time, Secretary of State John F. Kerry met with his Iranian counterpart Thursday and, according to Foreign Minister Javad Zarif, the two men and several other great-power diplomats agreed to try for a swift end to the lengthy standoff over Tehran’s nuclear program. Diplomats all around praised the new tone in the meeting, compared with the often belligerent rhetoric of past Iranian officials.
Force against Syria?
What was unclear on the Syria resolution was whether it will specifically threaten military action if Damascus does not comply — something the Obama administration sought heading into U.N. negotiations this week but which Russia, Syria’s patron for decades stretching back into the Soviet era, has consistently rejected.
The statement circulated by the White House on Thursday night said only that the resolution will make “absolutely clear that the failure of the Assad regime to comply will have consequences.”
Asserting that forces loyal to Mr. Assad carried out last month’s horrific chemical weapons attack outside Damascus, the Obama administration spent recent days pushing for the “binding” resolution that would leave the door open for a military strike on Syria.
But Russia, which has declared that there is no proof tying Mr. Assad and his military to the Aug. 21 attack and has blamed the Islamist-backed rebels for the attack, has resisted the inclusion of such a threat in any security council resolution, most recently in words Wednesday from Deputy Foreign Minister Gennady Gatilov.
Winning over Moscow
Since then, some Western diplomatic sources have suggested that the final Security Council resolution likely would include a careful language workaround designed to appease both Russia and the U.S.
Under the terms of the resolution being negotiated, according to media reports, if Syria does not comply with international operatives in destroying its chemical weapons, the Security Council would meet again to vote on whether to adopt a second resolution that could include the threat of a military strike.
However, such language would leave the door open for a Russian veto in that event.
For more than two years, the Security Council has been paralyzed over Syria — with Russia and China consistently backing the Assad government, while the U.S., Britain and France have, to varying degrees, supported opposition groups fighting for Mr. Assad’s ouster.
Russia and China have vetoed three proposed Western-backed resolutions that the U.S. had pushed in hopes of pressuring Mr. Assad to end the violence in his nation.