Benzodiazepine-type drugs (benzodiazepines and newer non-benzodiazepines, such as “Z drugs”) are important therapeutic tools in psychiatric medicine, being among the most highly prescribed psychiatric medications. Despite their clinical usefulness, benzodiazepines also induce several unwanted side effects, including abuse and dependence. In fact, the misuse and abuse of benzodiazepines have increased dramatically in recent years, with overdose deaths due to the combination of benzodiazepines and opioids reaching an all-time high, emphasizing that benzodiazepine abuse is cause for concern. Critically, no approved and broadly effective pharmacotherapy exists for the treatment of benzodiazepine misuse/use disorder.
The disturbing connection between well-meaning physicians and the prescription drug epidemic. Three out of four people addicted to heroin probably started on a prescription opioid, according to the director of the Centers for Disease Control and Prevention. In the United States alone, 16,000 people die each year as a result of prescription opioid overdose. But perhaps the most frightening aspect of the prescription drug epidemic is that it’s built on well-meaning doctors treating patients with real problems. In Drug Dealer, MD, Dr. Anna Lembke uncovers the unseen forces driving opioid addiction nationwide. Combining case studies from her own practice with vital statistics drawn from public policy, cultural anthropology, and neuroscience, she explores the complex relationship between doctors and patients, the science of addiction, and the barriers to successfully addressing drug dependence and addiction. Even when addiction is recognized by doctors and their patients, she argues, many doctors don’t know how to treat it, connections to treatment are lacking, and insurance companies won’t pay for rehab. Full of extensive interviews—with health care providers, pharmacists, social workers, hospital administrators, insurance company executives, journalists, economists, advocates, and patients and their families—Drug Dealer, MD, is for anyone whose life has been touched in some way by addiction to prescription drugs. Dr. Lembke gives voice to the millions of Americans struggling with prescription drugs while singling out the real culprits behind the rise in opioid addiction: cultural narratives that promote pills as quick fixes, pharmaceutical corporations in cahoots with organized medicine, and a new medical bureaucracy focused on the bottom line that favors pills, procedures, and patient satisfaction over wellness. Dr. Lembke concludes that the prescription drug epidemic is a symptom of a faltering health care system, the solution for which lies in rethinking how health care is delivered.
The brain is the most complex organ in our body. Indeed, it is perhaps the most complex structure we have ever encountered in nature. Both structurally and functionally, there are many peculiarities that differentiate the brain from all other organs. The brain is our connection to the world around us and by governing nervous system and higher function, any disturbance induces severe neurological and psychiatric disorders that can have a devastating effect on quality of life. Our understanding of the physiology and biochemistry of the brain has improved dramatically in the last two decades. In particular, the critical role of cations, including magnesium, has become evident, even if incompletely understood at a mechanistic level. The exact role and regulation of magnesium, in particular, remains elusive, largely because intracellular levels are so difficult to routinely quantify. Nonetheless, the importance of magnesium to normal central nervous system activity is self-evident given the complicated homeostatic mechanisms that maintain the concentration of this cation within strict limits essential for normal physiology and metabolism. There is also considerable accumulating evidence to suggest alterations to some brain functions in both normal and pathological conditions may be linked to alterations in local magnesium concentration. This book, containing chapters written by some of the foremost experts in the field of magnesium research, brings together the latest in experimental and clinical magnesium research as it relates to the central nervous system. It offers a complete and updated view of magnesiums involvement in central nervous system function and in so doing, brings together two main pillars of contemporary neuroscience research, namely providing an explanation for the molecular mechanisms involved in brain function, and emphasizing the connections between the molecular changes and behavior. It is the untiring efforts of those magnesium researchers who have dedicated their lives to unraveling the mysteries of magnesiums role in biological systems that has inspired the collation of this volume of work.
The Gaba Receptors, Third Edition, presents a critical appraisal of our current understanding of the molecular, behavioral, biochemical, clinical, and pharmacological properties of GABA receptors. Emphasis is placed on exploring cutting-edge findings on the structureal properties of receptor sites, mechanisms of receptor expression, chemical agents that differentiate receptor subtypes, and phenotypes displayed by GABA receptor null mice. Chapters in this updated and expanded edition examine such topics as GABA receptor subypes, trafficking postsynaptic GABA receptors, GABA receptor mutations associated with idiopathic generalized epilepsies and febrile seizures, and GABA receptors as a potential therapeutic target.
In recent years, patients, lay publications, and consumer groups have expressed concern about whether benzodiazepines are overprescribed. Psychiatrists have raised questions about the potential for these medications -- especially some of the newer, high-potency, short half-life compounds -- to produce serious side effects as well as to induce drug dependence. Benzodiazepine Dependence, Toxicity, and Abuse provides clinicians with a review of the available information on the potential hazards of benzodiazepine treatment and offers suggestions for the rational prescription of these medications.
When this series was conceived, a book on substance abuse, including alcohol and alcoholism, was to be of highest priority. This priority was a reflection of my view that the subject is often taught inadequately or insufficiently in many training programs. Yet these problems are com monly encountered in clinical practice, and all too often in situations where accurate diagnosis and rapid treatment are of critical importance. We wanted a book that would be concise and easily readable but also comprehensive in its presentation of the basic principles underlying clinical manifestations, diagnosis, and management. It was of particular importance that the book also serve as an easy reference guide in emergency situations. Marc Schuckit, a man with impeccable credentials as a scholar and an experienced clinician in this field, has produced just such a book! Few psychiatrists, psychotherapists, or physicians will want to be without it. The presentation is comprehensive and in depth, yet so clear and well organized that it will also likely be of interest to medical students, nurses, and emergency personnel.
Drug overdose, driven largely by overdose related to the use of opioids, is now the leading cause of unintentional injury death in the United States. The ongoing opioid crisis lies at the intersection of two public health challenges: reducing the burden of suffering from pain and containing the rising toll of the harms that can arise from the use of opioid medications. Chronic pain and opioid use disorder both represent complex human conditions affecting millions of Americans and causing untold disability and loss of function. In the context of the growing opioid problem, the U.S. Food and Drug Administration (FDA) launched an Opioids Action Plan in early 2016. As part of this plan, the FDA asked the National Academies of Sciences, Engineering, and Medicine to convene a committee to update the state of the science on pain research, care, and education and to identify actions the FDA and others can take to respond to the opioid epidemic, with a particular focus on informing FDA's development of a formal method for incorporating individual and societal considerations into its risk-benefit framework for opioid approval and monitoring.
