1 in 4 teens misused or abused a prescription drug at least once in their lifetime

New, nationally projectable survey results released today by The Partnership at Drugfree.org and MetLife Foundation confirmed that one in four teens has misused or abused a prescription (Rx) drug at least once in their lifetime - a 33 percent increase over the past five years. The Partnership Attitude Tracking Study (PATS) also found troubling data on teen misuse or abuse of prescription stimulants. One in eight teens (13 percent) now reports that they have taken the stimulants Ritalin or Adderall when it was not prescribed for them, at least once in their lifetime.

Contributing to this sustained trend in teen medicine abuse are the lax attitudes and beliefs of parents and caregivers. In fact, nearly one-third of parents say they believe Rx stimulants like Ritalin or Adderall, normally prescribed for attention deficit hyperactivity disorder (ADHD), can improve a teen's academic performance, even if the teen does not have ADHD. Parents are not effectively communicating the dangers of Rx medicine misuse and abuse to their kids, nor are they safeguarding their medications at home and disposing of unused medications properly.

The Partnership at Drugfree.org Responds to Rx Epidemic with The Medicine Abuse Project

In response to the continued high prevalence of teen prescription medicine abuse as reported in the 2012 PATS data, The Partnership at Drugfree.org is helping educate parents, community stakeholders and others about the risks of this dangerous behavior. The Partnership at Drugfree.org leads The Medicine Abuse Project, a multi-year initiative with the goal of preventing half a million teens from abusing prescription medicine by 2017.

The Medicine Abuse Project provides comprehensive resources to parents, educators, health care providers, law enforcement officials and others about the growing problem of teen medicine abuse. The Project aims to mobilize parents and the public at large to take action and help solve the problem of teen substance abuse. This includes learning about the issue, talking with their kids about the dangers of misuse and abuse of prescription drugs and properly monitoring, safeguarding and disposing of excess Rx drugs in their homes.

Drug Enforcement Administration (DEA) Holds Nationwide Prescription Take-Back Day on April 27th

One way parents, grandparents and other caretakers can take immediate action is by participating in the upcoming DEA-facilitated National Prescription Drug Take-Back Day, taking place this Saturday, April 27, 2013.

"Medicine cabinets are the number one access point for teens who want to misuse and abuse prescription drugs. That's why we are making a concerted effort to let parents and caregivers know how important it is to safely dispose of their unused, unwanted or expired medicines. Doing so can literally save a life," said Marcia Lee Taylor,

SVP of Government Affairs at The Partnership at Drugfree.org. "This Saturday's DEA Take-Back event gives everyone a chance to protect their kids from the dangers that medicine abuse poses in their own homes. We should all take this simple step and clean out our medicine cabinets."

Collection sites will be set up around the country, open for medicine drop-off between the hours of 10:00 a.m. and 2:00 p.m. Those interested in disposing of their medicine at a take-back location this Saturday can visit The Medicine Abuse Project website to find the nearest site to safely drop off their unused, unwanted or expired prescription medicines. In the five previous Take-Back events, more than 2 million pounds of prescription medicines were safely dropped off and removed from circulation.

The DEA Take-Back Day provides a tangible way for parents to help curb medicine abuse. The PATS data released today confirms that misuse and abuse of prescription drugs is now a normalized behavior among teens.

Concerning Trends in Teen Prescription Drug Abuse According to the New PATS Data (2008-2012)

One in four teens (24 percent) reports having misused or abused a prescription drug at least once in their lifetime (up from 18 percent in 2008 to 24 percent in 2012), which translates to about 5 million teens. That is a 33 percent increase over a five-year period:

• Of those kids who said they abused Rx medications, one in five (20 percent) has done so before the age of 14.


• 
  

  More than a quarter of teens (27 percent) mistakenly believe that "misusing and abusing prescription drugs to get high is safer than using street drugs," and one-third of teens (33 percent) say they believe "it's okay to use prescription drugs that were not prescribed to them to deal with an injury, illness or physical pain."

  
  

"These data make it very clear: the problem is real, the threat immediate and the situation is not poised to get better," said Steve Pasierb, President and CEO of The Partnership at Drugfree.org. "Parents fear drugs like cocaine or heroin and want to protect their kids. But the truth is that when misused and abused, medicines - especially stimulants and opioids - can be every bit as dangerous and harmful as illicit street drugs. Medicine abuse is one of the most significant and preventable adolescent health problems facing our families today. As parents and caring adults, we need to take action to address the risks that intentional medicine abuse poses to the lives and the long-term health of our teens."

Significant Increase in Teen Abuse of Stimulants Ritalin and Adderall, Rx Painkiller Abuse Flattening

Rx stimulants are a key area of concern, with misuse and abuse of Ritalin and Adderall in particular driving the noted increases in teen medicine abuse. Stimulants are a class of drugs that enhance brain activity and are commonly prescribed to treat health conditions including ADHD and obesity. The 2012 data found:

• One in eight teens (about 2.7 million) now reports having misused or abused the Rx stimulants Ritalin or Adderall at least once in their lifetime.


• 
  

  9 percent of teens (about 1.9 million) report having misused or abused the Rx stimulants Ritalin or Adderall in the past year (up from 6 percent in 2008) and 6 percent of teens (1.3 million) report abuse of Ritalin or Adderall in the past month (up from 4 percent in 2008).

  
  


• 
  

  One in four teens (26 percent) believes that prescription drugs can be used as a study aid.

  
  

Biological Psychiatry special issue tackles the question on food addiction

Biological Psychiatry is proud to announce this week's publication of a special issue focusing on the question of food as an addiction.

Addiction is the continued or compulsive use of a substance, despite negative and/or harmful consequences. Over the years, addiction has come to be re-defined to include behaviors, as well as substances, and the term is now used to describe significant problems with alcohol, nicotine, drugs, gambling, internet use, and sex. The 'major' addictions, like alcoholism and drug abuse, stimulate significant amounts of research and are now largely well characterized, but others, like pathological gambling and internet addiction, are much less understood.

And then there is food. Food is a biological necessity, a distinction that makes it unlike any of the other substances or behaviors typically considered as addictive. It therefore also doesn't qualify when considering the typical conditions of abnormal dependence upon a substance - tolerance and withdrawal.

At the same time, research has long found similarities between food intake and addiction. And just recently announced, the updated version of the Diagnostic and Statistical Manual of Mental Disorders, commonly called the DSM, will now formally include binge eating disorder as a new diagnosis.

Neuroimaging work has revealed that the same regions of the brain process the reinforcing effects of food and the consumption of drugs of abuse. The overlap of these neural circuits, however, does not necessarily mean that food is, or can be, addictive.

This lack of clarity in the scientific literature prompted the publication of this cohesive look at the support for and against the application of the addiction model to food. This Biological Psychiatry issue was led by guest editors Drs. Dana Small and Ralph DiLeone, at the Yale School of Medicine. Their goal was to bring together original research findings, systematic reviews and opinions of key leaders in the field to objectively represent the state of the field and both sides of the debate.

"While it is attractive to use the addiction framework to 'jump start' and guide our understanding of how neural circuits of reward and self-control might contribute to understanding overeating and the obesity epidemic, the price of adopting an inappropriate framework would be high," note Small and DiLeone. "For example, an inappropriate adaptation might steer research towards evaluating variables that have been shown to be critical for addiction at the expense of those that are unique to obesity and perhaps key to understanding overeating."

Family Doctor Helps Three Die, Could Face Jail

Dr. Eric Kress has been a family physician for 26 years, but he will never forget the terminally ill patient who called him a "coward" for hesitating to prescribe him lethal medication that would ease his pain and help him die.

The man was a "rugged individualist," dying a "hard death" from amyotrophic lateral sclerosis, or ALS, a progressive neurodegenerative disease that affects nerve cells in the brain and the spinal cord and eventually ends in death.

"This once-strong man had been reduced to 120 pounds of skin and bone," said Kress, 50, of Missoula, Mont. "He could not swallow or walk. He would often be found weeping and bemoaning the miserable fate that had befallen him. He begged his wife to end his suffering."

Weeks later the man took his own life with pain-killing medication he had stockpiled, but Kress never forgot his words. Since then, he has helped three other patients end their lives -- all with the consent of their families.

In 2009, the state Supreme Court ruled narrowly in Baxter v. Montana that state law protects doctors from prosecution when helping terminally ill patients die, but it fell short of addressing the larger question of whether physician-assisted suicide was a guaranteed right under the state constitution.

But on Thursday, the Montana Senate gave a preliminary nod to a House-passed bill that would criminalize physician-assisted suicide. If it passes two more readings today and Saturday, HB 505 could soon be on the desk of Gov. Steve Bullock, a Democrat.

Kress has become the public face of that raging debate, testifying in the legislature and writing an April 7 column in the local newspaper, the Missoulian.

"This man affected me," Kress wrote about the man with ALS. "What kind of man or doctor am I? Am I just going to sit idly by watching a proud man suffer and die, or am I going to be brave and do what it takes to help people at the end of life? I spent many sleepless nights pondering this question."

Now, Kress could face 10 years in prison if he continues to help patients die.

Courtesy of Compassion & Choices

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Supporters of HB 505, such as Montanans Against Assisted Suicide, argue that if the bill is enacted "there will be a clear statement going forward that assisted suicide is not legal."

"The issue deserves the governor's attention, and he needs to address it," said organization coordinator Bradley D. Williams.

The move comes as at least five states are considering legalizing the practice: Vermont, New Jersey, Kansas, Hawaii and Massachusetts. Already, both Oregon and Washington state have so-called Death With Dignity laws in place.

Kress told ABCNews.com that he would not continue to help terminally ill patients die if the bill becomes law. "I am not a physician that wants to go to jail," he said.

"I always stress that the issue of suicide is a very small part of my practice," he said. "Every day I see depressed patients, and I spend so much time with them figuring out who is suicidal and who isn't than with aiding in dying. At times, I've had the privilege, but the majority of my work is preventing them from dying."

If HB 505 becomes law, it would gut the Baxter ruling, according to Compassion and Choices, the advocacy group that represented Robert Baxter, a truck driver and once avid outdoorsman whose health was ravaged for 12 years by cancer. He died in 2008, at nearly the same hour the First District Judicial Court upheld his right to seek help in dying.

"My dad said to us that he didn't want to die, but cancer was killing him," his daughter, Roberta King, told ABCNews.com. "Eventually, he was wasting away piece by piece. … He did fight it, but he couldn't fight any longer.

"He really felt it was a personal choice, and no one else's business, and that's what he was fighting for," she said. "He wanted to make it legal so family and those left behind would not be prosecuted."

In states where the practice is legal, doctors prescribe the quick-acting drug Seconal, a barbiturate once used as a sleeping pill, which was responsible for the overdose deaths of actresses Judy Garland and Marilyn Monroe. A terminal patient's wishes must be confirmed by two doctors, and the patient must self-administer the drug.

Both sides of the issue have run powerful ads. The Montana ProLife Coalition uses cancer survivor Jeanette Hall of King City, Ore., to deliver its message. Her state has allowed doctors to prescribe lethal medication in cases of terminal illness since 1997.

"In 2000, I was diagnosed with cancer and told that I had six months to a year to live. I did not want to suffer, and I did not want to do radiation," she says in the ad, signed by more than 100 physicians. "If my doctor believed in assisted suicide, I would be dead."

Disability groups have also supported the bill on moral grounds. Others argue that legalizing physician-assisted suicide would lead to elder abuse.

An ad by Compassion and Choices includes an image of Kress with testimony from other doctors who oppose HB 505. They argue that helping terminally ill patients of sound mind to die without pain is an "essential act of medical care."

Kress said such a law would undermine "one of the most sacred relationships," that between a doctor and patient.

Did Deceased Dentist Expose Patients to Infection?

The Arkansas health department's announcement that a dentist who died more than a year ago may have exposed his patients to "infectious material" has thrust his history of drug abuse into the national spotlight, but the state dentistry board says it's not clear the dentist did anything wrong.

The Arkansas Department of Health announced this week that it would contact the 100 patients Dr. William Jarrod Stewart treated with the intravenous painkiller meperidine -- known as Demoral -- between Nov. 20, 2011 and Feb. 20, 2012. Stewart committed suicide on Feb. 29, 2012 at age 40 shortly after he lost his job, according to his father.

"Anybody around him would tell you he was a great dentist," Stewart's father, Larry Stewart, told ABCNews.com. "He just had a problem with drugs. That's mainly what caused all this."

RELATED: Oklahoma Dentist Could Face Criminal Charges

Stewart had issues with substance abuse in the 1990s when he was living and practicing dentistry in Louisiana, and he eventually surrendered his dentistry license there, said Arkansas Board of Dentistry attorney Bill Trice. After completing a rehabilitation program in 2000, he asked for a dentistry license in Arkansas. It was granted on the condition that he complete a five-year program with daily drug testing.

Stewart was drug-free for the full five years, but he relapsed and had to complete the five-year program again, Trice said. In 2010, Stewart completed the program a second time. For the next two years, the dentistry board didn't hear about any problems.

ABC News

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Ocean Dental, which owned several clinics where Stewart worked, asked Stewart to take a drug test on Monday, Feb. 20, 2012 after he appeared to be impaired during Sunday communications with Ocean Dental employees. He was told he would be fired immediately if he refused, but he refused anyway, according to a statement from Ocean Dental.

The dental board did not know why Stewart was fired, Trice said.

Then, Stewart committed suicide by overdosing on drugs on Feb. 29, 2012, according to Pulaski County Coroner Gerone Hobbs.

Six months later, in August, the Drug Enforcement Agency got a complaint from a former employee of the dental clinic where Stewart worked, prompting the agency to visit the clinic, Trice said. Investigators found evidence that two vials were tampered with, but they didn't find evidence of any disease.

Trice, who has been a prosecutor on behalf of the dentistry board since the early 1980s, said he's not convinced Stewart contaminated any drugs.

"They've got all these isolated facts out there, but I'm not sure the dots connect," Trice said.

RELATED: Okla. Dentist's Former Assistant Gave Anesthesia, Didn't Know It Was Illegal

DEA spokesman William Bryant said two separate sources called to say the single doses of these drugs were compromised. The second call came in as late as last week, he said.

Stewart's former patients were advised to seek tests for blood borne diseases like HIV and hepatitis b, but Larry Stewart said his son was tested and the results were negative. Given the length of time between the death and the announcement, he said he felt his son's name was "truly smeared."

"We feel like we've been violated," Larry Stewart said. "These things would have already come to light if there had been any diseases, yet they took it upon themselves to put it out to the public nationwide 13 months after the fact."

The Arkansas Department of Health was notified eight days ago, but it needed the time to determine how best to inform patients and convey the low level of risk, according to state epidemiologist Dr. Dirk Haselow.

"We definitely believe that people needed to be notified," Haselow said. "No one else in those facilities had sedation privileges, therefore no one else had access to those medications."

Up to 12 percent of all physicians in the United States develop a substance abuse disorder, according to a 2008 study published in the British Medical Journal, BMJ.

The public health scare comes less than two weeks after an Oklahoma dentist was accused of exposing 7,000 of his patients to HIV, hepatitis B and hepatitis C.

Johns Hopkins scientists create Web-based tool to help patients decide on kidney transplantation

Johns Hopkins scientists have created a free, Web-based tool to help patients decide whether it's best to accept an immediately available, but less-than-ideal deceased donor kidney for transplant, or wait for a healthier one in the future.

Historically, the researchers say, it has been difficult, if not impossible, to accurately quantify the risk of accepting a deceased-donor kidney that may have been infected by hepatitis C, as compared to waiting what could be months or years for a better organ. There is a 5 to 15 percent chance of dying every year on the waiting list. Often, organs that may have been at risk of infection are thrown away and never transplanted.

In a new study described online in the American Journal of Transplantation, the Johns Hopkins researchers showed there are some types of patients for whom survival benefit outweighs the risks of accepting a possibly infected organ. They then developed a Web-based mathematical model to help predict which patients they would be. The easy-to-use website can be found at www.transplantmodels.com/ird.

"Because the supply of the healthiest donor organs is too small, patients need to consider all organ offers or risk dying while waiting for an organ. But this is a very hard decision, and many people turn down transplant offers that, in reality, would provide them significant benefit. Often they would have done much better taking the organ at hand than waiting for the next available one," says study leader Dorry L. Segev, M.D., Ph.D., an associate professor of surgery at the Johns Hopkins University School of Medicine. "This is the most important decision of a transplant candidate's life, and we have developed a novel tool we believe can help patients make the best choice."

Before they are made available for transplant, kidneys and other organs from deceased donors are tested for infectious diseases such as HIV and hepatitis C. But even when the tests come back negative, there is still a chance that some kidneys could be infected, more commonly with hepatitis C, because of donor risks such as intravenous drug abuse, prostitution, imprisonment and other criteria established by the U.S. Centers for Disease Control and Prevention. Although the risk of transmission of hepatitis C is low for transplanted kidneys, more than 10 percent of deceased donors in 2011 met the CDC criteria for infectious risk.

To develop the model, Segev and his colleagues pooled data from dozens of published papers and national databases of hundreds of thousands of patients. When information was missing, they sought out expert opinion to fill in the holes. They considered how long patients had been on a waiting list, whether they had undergone previous transplants, their age and whether they had diabetes, among other factors. Finally, they developed a complex statistical model and computer program to take all the factors into account and present it in a user-friendly manner.

Obama Budget Includes $235M For Mental Health

President Obama is asking for $235 million as part of his new budget proposal to fund mental health initiatives. Of the funds, $130 million will be used to train teachers and others to identify signs of mental illness in students and provide them with access to treatment.

Secretary of Health and Human Services Kathleen Sebelius wrote in a blog on her agency's website Tuesday that the funds include $205 million to help identify mental health problems, improve access to mental health services and support safer school environments. The plan would affect at least 8,000 schools according to Sebelius. Another $30 million will go toward public health research on gun violence.

"We cannot ignore the fact that 60 percent of people with mental health conditions and nearly 90 percent of people with substance use disorders don't receive the care they need," Sebelius said in the post.

According to a January report the Obama administration planned to spend $50 million to fund Project AWARE (Advancing Wellness and Resilience in Education), which would train teachers to identify signs of mental illness or provide "Mental Health First Aid" and ensure that students have access to mental health care. According to the report, Project AWARE would reach 750,000 young people.

Charles Dharapak/AP Photo

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Another $50 million would go to training 5,000 people to become mental health experts at the master's level to help alleviate the shortage of mental health professionals. The funds would also support state-based strategies aimed at helping those between the ages of 16-25 get access to and navigate behavioral treatment programs.

Mental health experts say it is vital to treat mental illnesses as early as possible. According to the National Institute of Mental Health, half of all lifetime cases of mental illness can be diagnosed by age 14 and approximately three-quarters of these cases are diagnosed by age 24.

Dr. Paramjit Joshi, chair of Behavioral Health, Children's National Medical Center in Washington D.C., says there is on average eight years between a person showing signs of mental illness and getting diagnosed with a disease. She says if children and teens are diagnosed early, they are less likely to drop out of school or turn to substance abuse.

"Like other illnesses if you can catch this early, the benefits are monumental," said Joshi. "Children spend the majority of their day in the school setting. I think it will be wonderful for teachers to be better prepared and be aware what are signs and symptoms of these conditions early and refer them for appropriate services."

By centering the initiative in schools throughout the country, Joshi says it could also help make mental illness a less taboo topic.

"I think I also there's a lot of stigma attached to mental illness, if there is service provided in that school it puts a dent in that stigma," said Joshi. "It would be great if mental health is incorporated into overall health of the child."

Mel Riddile, associate director for the National Association of Secondary School Principals, says in order for these initiatives to work they need to be more than just short training sessions.

Riddile says it's important schools have relationships with parents and the local mental health care system so that teachers and school officials feel there is someone that can help them if they have concerns about a student.

"When people have nobody to talk to, they won't ask the question if they don't think they're going to get [help.]," said Riddile. "It's a matter of creating a network, where when issues come up they can ask a question."

Researcher awarded NIH grant to study drug-related health disparities in African-Americans

Your body's ability to effectively respond to stress may be an indicator of your vulnerability to use and abuse drugs.

A five-year, $2.5 million grant from the National Institute of Health (NIH) / National Institute of Drug Abuse (NIDA) will support research from the University of Houston College of Education to investigate mechanisms that influence drug-related health disparities in the African-American community.

Ezemenari M. Obasi, associate professor in counseling psychology and director of the Hwemudua Addictions and Health Disparities Lab (HAHDL) at UH, will lead research in Harris county and eight surrounding urban and rural counties. He says the development of drug use and abuse in the African-American community is often informed by research that rarely include African-Americans or their social and cultural experiences.

"It's a longitudinal study that will include 350 participants between the ages of 18 and 25," he said. "We'll be partnering with the community to learn how a person's social environment and related stressors can 'get-under-the-skin' and have a harmful impact on the body's regulatory system or its capacity to effectively cope with day-to-day stressors across time."

Those stressors, he says, could include exposure to violent crimes, experiences of discrimination, lack of green space, unemployment, substandard housing, substandard educational systems, pollution, high density of drug-retail outlets, and ability to pay bills and/or put food on the table.

A focal point of the research is measuring how the body reacts to environmental stressors. The body has a complex network between organs that control how we deal with stress, among other things, by regulating the production and elimination of stress-related hormones. However, chronic exposure to stressors may lead to "wear-and-tear" on this system and compromise the body's ability to effectively cope with stress. Those who have fallen into substance abuse may produce too little - or too much - of these stress-related hormones, what Obasi calls a "dysregulated human stress response."

"We are hypothesizing that people are finding ways of coping with stressors through other means as their natural human stress response begins to break down," he said. "While seemingly effective in the short-term, substance use may accelerate the breakdown and increase one's susceptibility to drug-related health disparities 20 or so years down the line."

Five cohorts (70 participants each) will be assessed and monitored for two years. While much of the research will be done in their communities and home, a great deal also will be conducted at his HAHDL.

Rutgers' Mike Rice Rage: Bad Behavior or a Disorder?

Throwing balls, kicking players, shouting gay slurs -- all of these outbursts caught on videotape of Rutgers basketball coach Mike Rice reveal the abusive nature of uncontrollable anger.

Rice was fired this week, and faculty and alumni have been in an uproar. But was his angry performance during a men's basketball team practice last year just bad boy behavior or something more diagnosable?

"There is a misconception that getting anger out helps you calm down, but ironically, it makes you more angry," said Camp Hill, Pa., psychologist Pauline Wallin, author of the 2004 book "Taming Your Inner Brat."

Watch more on this story on "20/20: Losing It!" Friday at 10 ET

"The angrier you get, it gets increasingly harder as you are pumping more adrenaline, and there is more energy to discharge. Yelling and screaming don't get you calmer, they rile you up."

The university's reputation is still stinging from the 2010 suicide of gay student Tyler Clemente, whose roommate had secretly videotaped the freshman having sex and was convicted of a hate crime..

Today, a group of 13 faculty and alumni demanded that university president Robert Barchi resign, because it took months for him to take action.

Barchi first viewed the video in November and sent Rice to anger management counseling. He fired the coach on April 3, when the video again resurfaced.

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Even New Jersey Gov. Chris Christie weighed in on Rice, applauding the firing in the New York Times: "The way these young men were treated by the head coach was completely unacceptable and violates the trust parents put in Rutgers University."

Experts say the most common form of aggressive anger is rage, which is a psychological and physiological response to a stressor event. A person can lose his or her capacity for rational thought. The capacity for rage often begins early in life and continues through adulthood.

A person in rage may also experience tunnel vision, muffled hearing, increased heart rate and hyperventilation. The large amounts of adrenaline and oxygen in the bloodstream may cause a person's extremities to shake.

Psychiatrists say the most extreme form of rage is intermittent explosive disorder, or IED. "It's somebody who really lacks control and is way over the top," said Wallin, who did not speculate on why Rice behaved as he did.

According to the Mayo Clinic, the disorder, which is listed in the DSM-V, involves repeated episodes of "impulsive, aggressive, violent behavior or angry verbal outbursts in which you react grossly out of proportion to the situation."

Recurrent, problematic, impulsive aggression affects 5 to 7 percent of the population, but many Americans do not seek treatment, according to a study published by the American Medical Association.

Research shows that chemical abnormalities are associated with this disorder. People with IED can suddenly explode without provocation.

Examples can include road rage, domestic abuse, throwing or breaking objects, or other temper tantrums. Those affected may attack others, cause bodily injury and property damage. They may also hurt themselves. Later, when they have calmed down, they can feel remorse, regret or shame. Effective treatments can include antidepressants and cognitive behavior therapy.

Wallin admits she is not an expert in IED, but she has witnessed plenty of anger, including physical fights, at sporting events like hockey.

"They are yelling at each other, sitting down and getting rough with each other and all excited with the adrenaline," she said. "The reason they have no control is they are really hyped up. Even the fans love to see the fights."

Experts caution that IED goes outside the bounds of normal anger and is considered an impulse disorder.

Study: Altering brain activity with laser light eliminates addictive behavior in rats

By stimulating one part of the brain with laser light, researchers at the National Institutes of Health (NIH) and the Ernest Gallo Clinic and Research Center at UC San Francisco (UCSF) have shown that they can wipe away addictive behavior in rats - or conversely turn non-addicted rats into compulsive cocaine seekers.

"When we turn on a laser light in the prelimbic region of the prefrontal cortex, the compulsive cocaine seeking is gone," said Antonello Bonci, MD, scientific director of the intramural research program at the NIH's National Institute of Drug Abuse (NIDA), where the work was done. Bonci is also an adjunct professor of neurology at UCSF and an adjunct professor at Johns Hopkins University.

Described this week in the journal Nature, the new study demonstrates the central role the prefrontal cortex plays in compulsive cocaine addiction. It also suggests a new therapy that could be tested immediately in humans, Bonci said.

Any new human therapy would not be based on using lasers, but would most likely rely on electromagnetic stimulation outside the scalp, in particular a technique called transcranial magnetic stimulation (TMS). Clinical trials are now being designed to test whether this approach works, Bonci added.

The High Cost of Cocaine Abuse

Cocaine abuse is a major public health problem in the United States today, and it places a heavy toll on society in terms of lost job productivity, lost earnings, cocaine-related crime, incarcerations, investigations, and treatment and prevention programs.

The human toll is even greater, with an estimated 1.4 million Americans addicted to the drug. It is frequently the cause of emergency room visits - 482,188 in 2008 alone - and it is a top cause of heart attacks and strokes for people under 35.

One of the hallmarks of cocaine addiction is compulsive drug taking - the loss of ability to refrain from taking the drug even if it's destroying one's life.

What makes the new work so promising, said Bonci, is that Billy Chen of NIDA, the lead author of the study, and his colleagues were working with an animal model that mimics this sort of compulsive cocaine addiction. The animals, like human addicts, are more likely to make bad decisions and take cocaine even when they are conditioned to expect self-harm associated with it.

Study shows relationship between cocaine-induced brain deficits in prefrontal cortex and cocaine-seeking

Could drug addiction treatment of the future be as simple as an on/off switch in the brain? A study in rats has found that stimulating a key part of the brain reduces compulsive cocaine-seeking and suggests the possibility of changing addictive behavior generally. The study, published in Nature, was conducted by scientists at the Intramural Research Program of the National Institute on Drug Abuse (NIDA), part of the National Institutes of Health, and the University of California, San Francisco.

"This exciting study offers a new direction of research for the treatment of cocaine and possibly other addictions," said NIDA Director Dr. Nora D. Volkow. "We already knew, mainly from human brain imaging studies, that deficits in the prefrontal cortex are involved in drug addiction. Now that we have learned how fundamental these deficits are, we feel more confident than ever about the therapeutic promise of targeting that part of the brain."

Compulsive drug-taking, despite negative health and social consequences, has been the most difficult challenge in human drug addiction. NIDA researchers used an animal model of cocaine addiction, in which some rats exhibited addictive behavior by pushing levers to get cocaine even when followed by a mild electric shock to the foot. Other rats did not exhibit addictive responses.

The NIDA scientists compared nerve cell firing patterns in both groups of rats by examining cells from the prefrontal cortex. They determined that cocaine produced greater functional brain deficits in the addicted rats. Scientists then used optogenetic techniques on both groups of rats -- essentially shining a light onto modified cells to increase or lessen activity in that part of the brain. In the addicted rats, activating the brain cells (thereby removing the deficits) reduced cocaine-seeking. In the non-addicted rats, deactivating the brain cells (thereby creating the deficits) increased compulsive cocaine seeking.

Kind Hearted Woman, Raped at 3, Helps Others Heal

When Robin Poor Bear was in her 20s, she asked for a Native American name. The Road Man, or spiritual leader, came up with Kind Hearted Woman.

There was good reason: After a lifetime of physical and sexual abuse, her heart was still bursting with empathy for others.

The daughter of an alcoholic mother, Poor Bear was molested by her foster father at age 3. But today, at 35, she gives a voice to others who have suffered sexual abuse.

"I remember it -- not the rape itself, but the emergency room and the nurses trying to hold me down to examine me," Poor Bear, now living in Minnesota, told ABC News. "I remember the door and being so terrified it would fly open and someone would get me."

Poor Bear suffered repeated sexual abuse at the hands of her foster father and two uncles until she was 13. Then, as a young wife, she was beaten by her husband.

That pain is revisited after the couple divorces and her ex-husband is convicted of molesting their 12-year-old daughter, as well as a teenage foster daughter.

The psychological anguish caused Poor Bear, an Oglala Sioux and member of North Dakota's Spirit Lake tribe in North Dakota, to turn to alcohol. And when Poor Bear eventually spoke up about the abuse, her daughter and son, now 17 and 14, were taken away from her.

On Monday, April 1, and Tuesday, April 2 at 9 ET, PBS's "Frontline" will air a powerful documentary, "Kind Hearted Woman," about Poor Bear's struggle to stay sober, further her education and heal herself from the deep wounds of sexual abuse.

David Sutherland, whose films "The Farmer's Wife" (1998) and "Country Boys" (2005) also offer a cinema verite look at poor, rural life, spent three years with Poor Bear and her children.

The centerpiece of the film is Poor Bear's battle to gain custody of her children while improving her own life.

Kimmer Olesak

Oglala Sioux Robin Poor Bear struggles to... View Full Size

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Sutherland, 67, followed the family from Poor Bear's first day out of alcohol rehab, through school and jobs, juggling being a mother and trying to become a social worker. Frustrated at every turn, Poor Bear fights a corrupt tribal legal system and a culture of domestic violence that pervades many Native American communities.

Native American women have the second-highest rate of rape of all races and ethnicities, at 27 percent, second only to mixed-race women, according to the Centers for Disease Control's 2011 National Intimate Partner and Sexual Violence Survey. Nearly half of all of these women have experienced rape, physical violence and/or stalking in their lifetime.

"There are two or three thousand enrolled members living on the reservation and just a small handful of law enforcement to get calls," Poor Bear said about the time she spent a Spirit Lake Reservation. "Some reports are not taken seriously and some are not followed through the proper protocols."

Last year, unrelated to the documentary, the federal Bureau of Indian Affairs took over social services at Spirit Lake because of concerns that tribal mismanagement had contributed to abuse of children.

But Poor Bear said that the causes of domestic violence and abuse go deeper than scarce funding and little oversight on Native American reservations. She blames the "rape" of the indigenous culture when it was "Christianized."

"Who taught us how to be parents and how to be loving and caring and kind to each other when they took away all the traditions and we couldn't speak our language without being beaten?" Poor Bear asked.

A former singer, Poor Bear said that she comes from a legacy of heartbreak, but also of generosity.

Her mother, an alcoholic, froze to death in her 30s banging on the door of Poor Bear's foster family, who refused to let her in, Poor Bear tells an audience of abused women in the film.

Her grandfather died saving children in a log cabin fire, she tells ABCNews.com. "The doorway collapsed and when they found him, he was still protecting and holding a baby," she said.

Sutherland did not intend to make a film about Native Americans and was hesitant to reinforce negative stereotypes about life on the reservation. He had singled out several other battered women in his search for an authentic character-driven story about abuse, but Poor Bear's rose to the top.

"She had an associate's degree and was smart," he said. "I liked her sense of humor and she was always upbeat, even in the saddest moments, with the kids."

Sutherland never expected the turn the dramatic narrative would take. When Poor Bear's daughter Darian reveals she was molested by her father at the age of 12, she is required to testify in federal court.

'Stalking the Bogeyman': Plot to Kill Child Rapist Comes Alive

David Holthouse said he had the murder meticulously planned. He bought a Beretta 9 mm with a silencer and had the serial number removed, then tested it in the Arizona desert. He said he stalked the intended victim's Colorado home and came within a hair's breadth of killing the man who brutally raped him as a 7-year-old.

"This wasn't just a revenge fantasy, though it's tempting to lie about it now," said Holthouse, now 41 and working as a documentary filmmaker and investigative reporter in Alaska. "If I had gone through with it, I most certainly would have been caught."

Instead, Holthouse said, he confronted his childhood assailant face-to face and found not the "bogeyman" who had haunted his psyche for 25 years but a "frightened, damaged man" begging for his forgiveness.

And were it not for a serendipitous discovery of that awful truth by his mother, Holthouse swears he, too, would have been a dead man.

Holthouse first went public with a story in 2004 in the weekly Denver Westword. Later, in 2011, he told about his ordeal on National Public Radio's "This American Life."

Now, the story of his sexual assault and the shame and venomous anger that followed has been adapted for the stage in "Stalking the Bogeyman," which is in production for a February 2014 opening Off Broadway.

"I just happened to be listening to a 'This American Life' podcast and I stopped in my tracks, kind of paralyzed," said writer and director Markus Potter ("A Perfect Future"), artistic director of NewYorkRep. "Immediately, I thought this story needs to be told. It needs to reach a wider audience."

Courtesy David Holthouse

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Holthouse's story is a powerful one, as he describes in detail about "coming to grips with the killer inside of me."

He was in the second grade in Alaska when the attack occurred. The alleged rapist was 10 years older and a star high school football player, the son of his parents' close friends.

One night in 1978, Holthouse said, when the grownups were "drinking wine and playing board games," the 17-year-old whisked young David away to his room under the guise of teaching him some karate moves and closed the door.

"I didn't know what was going on, but I knew it was bad, so I started crying, and he told me to shut up and then started chasing me around the room, waving the sword," he wrote. "He put the blade to my throat and backed me into a corner, where I dropped into a crouch and cowered. Then, he told me to take off my pants.

"It wasn't Michael Jackson gently introducing my hand to his magical giraffe, and it wasn't anything like a Catholic priest masturbating an altar boy. I was seven, and it was violent, sick, pedophiliac rape. ... I no longer believed in Santa Claus, the Easter Bunny or the Tooth Fairy, but from that night on, I had no such doubts about the Bogeyman."

Out of fear and shame, Holthouse never spoke about it, though he claimed there were other attempts to abuse him.

"Part of it was I didn't really have a firm concept of what had happened," he told ABCNews.com. "Nobody ever talked to me about sex or rape. I don't think it was a function of the era. Most 7-year-olds don't know what rape is. I didn't have the words to apply to it. ... It was easier to keep quiet."

He wrote that he didn't want to upset his parents: "I didn't want their memories of my childhood tarnished with this scum."

Nearly half of all victims of sexual assault are under the age of 18, according to statistics from the Department of Justice. Of those, 10 percent are boys. Other studies have shown rates as high as one in six boys. An alarming 93 percent of them have been abused by someone they know -- a friend or family member.

"There is no standard reaction or response to sexual abuse," said Jennifer Marsh, vice president of victim services at the Rape, Abuse and Incest National Network. "It can range from anger to denial to a sense of hopelessness. Some of the time we see that anger projected inward.

"We hear folks every day who are angry and talk about hurting their perpetrators," she said. "Usually, it's more a figure of speech than a plan."

As a teen, Holthouse researched rape, learned about the "vicious cycle" of abuse and feared that he, too, might turn into pedophile.

"I felt like a werewolf had bitten me and it was only a matter of time before the full moon rose," he wrote.

He said that if those desires surfaced, he would kill himself and make it look like a mountaineering accident.

After college, Holthouse moved to Colorado, but the memory of the rape "festered." When his mother mentioned that the alleged rapist was also living in Denver with his wife and children, he imagined the man was continuing to assault children, perhaps even his own.