Carfentanil: The next step in the opioid crisis?

The US is in the midst of a national opioid epidemic. The use of opioids, which includes prescription drugs and heroin, has quadrupled since 1999. The Centres for Disease Control and Prevention (CDC) has confirmed that these drugs now kill more people than car accidents in the US, making it the most common form of preventable death.

Opioids are a class of opium-derived compounds that relieve pain. These drugs use the same receptors as endorphins, eliciting analgesic effects by inhibiting the release of neurotransmitters in the spinal cord. Exploited for centuries, they are still considered one of the most efficacious treatments for pain, despite serious side effects including physical and psychological addiction.

Fentanyl, a synthetic opioid developed for use in surgery, was first linked with overdose deaths in 2005 . Alarmingly, the number of overdose cases involving fentanyl have escalated in recent years, with its misuse regularly making the headlines due the sheer number of deaths associated with this drug. High profile cases, such as the death of the global star Prince have only added to this.

Carfentanil, another drug with a similar structure to fentanyl, has recently exploded onto the scene as carfentanil-laced drugs rear their toxic heads. An analogue of fentanyl, carfentanyl was first synthesised in the US in 1974 by Janssen Pharmaceutica (owned by Johnson & Johnson). This opiate was designed for use as a general anaesthetic in large animals such as rhinos – just 2mg of carfentanil can knock out an African elephant. Due to its extreme potency the lethal dose range of this drug is unknown in humans, which greatly amplifies the risk involved in taking the drug.  Carfentanil is 10,000 times more potent than morphine, and 100 times more potent than fentanyl. As with other opioids, carfentanil causes death by respiratory distress or cardiac arrest, leading to death within minutes.

So, why are these drugs being increasingly abused? One explanation is that prescription of opioid drugs have increased since the 1970s – this being the result of a series of papers published downplaying the risk of addiction associated with use of opioid painkillers such as oxycontin and fentanyl. They were marketed to doctors as wonder drugs for treating day-to-day pain, with little addiction potential. As we now know, this turned out not to be the case. The resulting willingness of doctors to prescribe opioid painkillers increased the availability of these drugs. This problem was in turn worsened by a subset of pharmacies illegally filling out multiple prescriptions and the phenomenon of ‘doctor shopping’, where patients obtain prescriptions from multiple doctors at once. Currently, over 650,000 new opioid prescriptions are dispensed every day in the US by doctors.

A number of recent studies found that almost half of young people using heroin had abused prescription opioids beforehand. This comes as no surprise when such potent drugs are used routinely to treat even minor sports injuries in young people. As a result of this alarming trend, new regulations were implemented in the US in 2014 to attempt to restrict the misuse of prescription painkillers. Unfortunately, this has forced many people experiencing drug addiction to turn to prescription fraud and illegally produced pills. Cartels in Mexico, the primary supplier of heroin to the US, have stepped in to provide cheaper and more potent opiate alternatives. Evidently, the reduction in the availability of legally-produced drugs has failed to remedy the issue of opioid misuse.

The unknown quantity and composition of the drugs bought on the street, combined with the recent explosion in recreational use, has led to a surge in accidental overdoses. In 2016, both fentanyl and carfentanil have been found as additives in heroin, cocaine and counterfeit Xanax pills in Florida, Ohio and neighbouring Michigan (including Detroit) among other states. Like any other illicit drug, users have no way of determining the strength or purity of what they have bought to any degree of accuracy.

The latest spike in overdoses has led to the DEA issuing a public health warning, with the Acting Administrator Chuck Rosenberg describing carfentanil as ‘crazy dangerous’ . It is hard to put a figure on the number of cases involving carfentanil as there are issues with obtaining samples and identifying how much was taken, with some facilities also unable to identify the compound in toxicology reports at post mortems.
The opioid antagonist naloxone (sold as Narcan™ nasal spray) also struggles to reverse the effects of fentanyl and carfentanil, with reports of patients needing up to five times the recommended amount of naloxone for a heroin overdose. As a result it can take up to five minutes to revive a patient, an effect that normally takes a matter of seconds, vastly increasing the chance of lasting brain damage and death.

On average, opioid overdoses kill 91 Americans every day. This disturbing figure will continue to rise unless rapid change is seen in both government policy and in society as a whole. There remains no easy solution to opioid problem, and with a single gram of carfentanil able to cause 50,000 fatal overdoses, it seems the situation will only worsen unless dramatic changes are put into effect. Continued research into addiction causes and treatments, coupled with investigation into new medications to treat pain are also necessary for long-term management of this devastating crisis.

Post by: Sarah Lambert

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Why the rat pack don’t do drugs

From awkward school seminars to the topical banter of South Park, we’ve all heard the message loud and clear ‘Drugs are bad….ok?’. And yes, as a rule messing with your brain chemistry is probably not a great idea. But, there are certain nuances surrounding drug use and addiction that you may not be aware of and which could have important implications for how we understand addiction and work with addicts.

Many of us may have heard about studies in the 1960’s involving lab rats and cocaine. In these relatively simplistic studies researchers offered caged rats a choice between regular drinking water and water laced with cocaine. Most animals studied didn’t just favour the drug-laced drinking water, they actively drank so much they eventually killed themselves. These shocking findings lead many researchers and politicians to believe that drugs such as heroine and cocaine were so dangerously addictive that they caused individuals to loose control over their own behaviour. And yes, these drugs can certainly be dangerous however, there was more to this story than these researchers realised.

In the 1970’s Bruce Alexander, a curious psychologist from Vancouver, noticed a big problem with this research. He recognised that all the rats studied in these addiction experiments were housed in small wire cages with no access to any of the things that make a wild rat’s life worth living (i.e. space to explore, a network of furry friends and lovers and things to play with). So Alexander re-ran these early experiments but with one important difference, his rats all lived in the lap of rodent luxury. These lucky rats were residents of Alexander’s Rat Park, where they had space to explore, tunnels to scamper through and friends to interact with. Amazingly, although the residents of Rat Park were curious enough to try drug-laced drinking water, most would then shun this water – consuming less than a quarter of the drugs isolated rats used; and, most importantly, none of Alexander’s rats died from overdoses.

On top of these findings Alexander also discovered that isolated and addicted rats which were subsequently released from their enforced isolation and introduced into Rat Park soon gave up their destructive habits in favour of a normal life.

So how does this change our understanding of addiction?

Professor Alexander argued that his discovery showed that addiction was more than simply a disease which chemically hijacked the brain, instead it could be an adaptation to an individual’s environment and social situation – i.e. addiction is not about you, it’s all about your cage.

In favour of Alexander’s ‘Rat Park theory’ we know that, although following an injury many individuals are prescribed the pain killer diamorphine (a medical name for heroin), we rarely have problems with these patients becoming addicts. Could this be because the patients are able to return home after their stay in hospital to loving supportive families and rewarding careers so no-longer need to rely on these drugs?

Although these finding are compelling and perhaps suggest useful social interventions with regard to treating addicts, it is still important to understand the limitations of the Rat Park and Alexander’s theory. Indeed, it is important to recognise that ‘Rat Park’ oversimplifies a complex societal and biological problem and that this oversimplification may not be beneficial. Research still suggests that certain people have a physical predisposition towards addiction and, despite living socially enriched lives, these individuals can still fall fowl to the addiction cycle. The myriad of research into the biological substrates of addiction could make-up a post in it’s own right, so I will attempt to cover this in more detail in a later article. However, for now it’s important to recognise that even though environment is likely to play a role in addictive behaviours, biology is also important in shaping our vulnerability to addictive drugs and our subsequent success in kicking the habits. This research should all be considered together if we really want to successfully tackle the problems raised by drugs in our society.

Post by: Sarah Fox

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The Adventures of Cornish Cod in the land of Scousers

Over two years ago I began a University course in Liverpool, having traveled across the Pennines from the glorious lands of Yorkshire my accent stood out while I also found the scouse accent particularly confusing – especially when drunk (student life). But it’s not just students living far from home who are getting confused. Climate change has been warming our oceans so much that cold water species have started to migrate further North. This means that the Cornish Cod are now visiting Liverpudlion waters. It’s the start of a real North/South aquatic mixer! We all recognise the differences in culture between the North and South of England but it’s also likely that these differences appear in fish culture, especially regional accents. I know aquatic accents may sound a bit fishy but this is a real phenomenon.

Cod attract a mate by making sounds, a highly specialised ‘sonic muscle’ is drummed against the swim bladder to produce a thumping sound. But, as the Cornish cod and the Scouse cod start to mingle, the differences in their ‘accents’ could actually prevent them from communicating. Reminds me of on a night out in Liverpool when the native guys try to chat you up – can anyone understand them or are the chat up lines just so bad that you’re really better off not understanding?

Males produce sounds (back to Cod now in case anyone was confused) which stimulates females to release their eggs, this allows the males to synchronise when they release their sperm to fertilise the eggs. If the fish aren’t able to understand each other it could seriously damage their reproductive success. Even if Cornish Cod and Scouse Cod can set aside their differences and develop an understanding, there is still the issue of noise pollution.

Noise pollution in an area can drown out sweet mating sounds of male cod. Boats being driven past spawning grounds could have serious effects on the cod communication. It could be that the species manages to adapt over time to overcome this dilemma (similarly to how we over act our gestures when the music is too loud for you to ask your mates if they want a drink). Perhaps the male cod will develop some epic dance moves to seduce their lady friends, or they may have to start signalling louder to be heard. This would however require more energy, meaning the Cod would need to hunt more often which could have detrimental effects on the rest of the ecosystem.

Poor Scouse Cod not only do they have to cope with noise pollution but now they are being invaded by Southerners! Could life get any worse for them? Let’s just hope there isn’t a boom in the fish and chip shop trade…

Post by: Jennifer Rasal

References:

http://www.telegraph.co.uk/news/2016/10/04/cod-speak-with-regional-accents-scientists-believe/

https://commons.wikimedia.org/wiki/File:Portrait_of_Cod.jpg

http://www.bbc.co.uk/news/science-environment-37557945

http://www.fishecology.org/soniferous/waquoitposter.htm

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How a little Christmas spirit can be good for you

Faced with a disappointing combination of mild wet weather, long working days and the frustrating realisation that Costa have changed their Black Forest Hot Chocolate recipe (spoiler alert it’s no where near as tasty); this year Christmas spirit has so far eluded me. But, this mild winter malaise did get me thinking. What causes seasonal nostalgia, what does it look like in your brain and does it serve any beneficial purpose? So please enjoy a bit of Brain Bank festive research as we search for the true spirit of Christmas.

It has been suggested that the key to Christmas spirit may be familiarity and a sense of nostalgia for times long gone. Indeed, what gets the festive juices flowing more than cheesy Christmas movies, twinkling lights and festive family gatherings – experiences we most likely all share and repeat year after year. Krystine Batcho, nostalgia expert and professor of psychology at Le Moyne College in New York, thinks that this bittersweet sense of seasonal nostalgia really embodies the Christmas spirit and that this feeling may also hold some emotional benefit.

But what exactly is nostalgia?

There was a time when nostalgia was though of as a physical illness. This was exemplified by feelings of home sickness experienced by young soldiers serving away from their families for the first time, often culminating in varying physical symptoms including anorexia resulting from loss of appetite. However, we now appreciate that nostalgia is actually linked with a range of emotions, both positive and negative. One study suggests that the predominant profile of nostalgia is a mix of happiness and sentimentality but, it is also recognised that this can be tempered by the sadness of loss and yearnings for a different time. One thing that is pretty much agreed upon however is that the feeling of nostalgia is universal, cutting across cultures, historical periods and developmental stages – even a child can be nostalgic.

Krystine thinks that nostalgia can also be beneficial. Specifically, she suggests that it helps us to maintain a constant sense of identity in the face of large and often traumatic life changes. It provides us with a tangible link to our own personal past and helps us remember who we are. In fact nostalgia is thought to peak in early adulthood, a time when transition and change can become a big part of our lives (think marriage, college, new jobs!).

The holiday season in particular can evoke strong feelings of nostalgia due to repeated experiences shared year on year. This is especially true in regard to relationships. So many of our holiday experiences centre around interpersonal relationships, family gatherings, religious traditions and cultural customs. Think of the festive classic “Driving home for Christmas” and the nostalgic feelings it summons up regarding reuniting with loved ones for the festive season. In fact, this form of nostalgia can help decrease feelings of loneliness by helping people feel connected to family again, even when they are not physically present.

So what is happening in our brains when we experience festive nostalgia?

One study by Kentaro Oba, from the Department of Frontier Health Science, Division of Human Health Science, Graduate School of Tokyo Metropolitan University, shows a relationship between memory and reward systems in the brain, specifically in relation to childhood nostalgia. This study observes co-activation of both the hippocampal formation and ventral striatum during nostalgic experiences. The connection also appeared to be stronger in people who report feeling a strong sense of nostalgia. This suggests that hippocampal memory and ventral striatum reward systems may work together to produce the beneficial and rewarding feelings linked with nostalgia. The researchers suggest that memory retrieval via the hippocampus during nostalgia can trigger a cascade of reward processes including activity in the hippocampal-VTA (ventral tegmental area) loop and culminating in release of the neurotransmitter dopamine. It is therefore speculated that, based on the function of this loop, memory and dopaminergic reward during nostalgia may be involved in psychological resilience. Specifically nostalgia strengthens the association between an autobiographical memory and the feeling of reward. This cycle can induce feelings of positivity and may help those experiencing nostalgia to overcome adversity.

Finally, when it comes to the Christmas spirit one group of researchers from Denmark used functional magnetic resonance imaging to pinpoint how festive imagery can affect the brain. Although only four people took part in this unusual study, the work suggests that festive feelings may be linked with activation of the frontal, parieto-occipital and subcortical brain regions.

Perhaps Christmas is all in the mind but this is proof enough for me that festive feelings are probably good for you – so pass me another mince pie I think E.T is on TV….

Post by: Sarah Fox

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Top ten Astronomy fails

In this post I have decided to inject a bit of comedy and concentrate on some of the funny and embarrassing things that have happened to me or to others whilst trying (and sometimes failing) to do astronomy. I must begin with a confession: many of the methods I use to observe the stars have been learned through mistakes and failure some of which are infuriating and others hilarious. So, without further delay here are my ten most embarrassing, costly and idiotic astronomy fails.

1. Right place right time, wrong year.
About a year ago I was setting up my scope, which is electronically controlled. In order to work properly, it must know your precise location, time and the position of at least one star in the sky. After inputting this data, I began locating my first target but there was a problem, the telescope moved below the horizon. However, I knew from my sky map that the target was about 10 degrees above the horizon. I spent about 2 hours re-aligning my scope with known stars but still the problem persisted. Eventually, I decided to start setting the telescope up from scratch when I noticed the date I inputted was wrong…very wrong! The year was 2015 but I typed in 20015, an error of 18000 years. Over this period of time, stars move substantially around the sky, familiar constellations will morph into new shapes and the polar axis of the Earth’s spin will also change. To be honest, I was shocked the telescope had data on star locations this far in the future!

2. A long trip for nothing.
This mistake is also mine. I planned a long trip into the peak district to do some dark sky astronomy. After a 90-minute drive I realised I forgot my telescope’s counterweight bar. Without that single steel bar, no astronomy could happen. I arrived home later that night and didn’t speak of my error for the next two days.

3. The ultimate light pollution blocker.
Many years ago when I was just starting my hobby I wanted to show some of my family and friends what great things could be seen through the telescope eyepiece. There was an ulterior motive of course, I wanted to make sure Christmas presents would benefit my astronomy hobby not my sock draw. I had lined the finder scope on the Orion nebula and started searching for it in the main scope. I noticed the sky was particularly black and I started explaining how my light pollution filter (a recent purchase) was great at removing the orange skyglow from the streetlights. A few minutes later and in front of everyone, my friend gleefully removed the lens cap from the end of the telescope explaining how this was the ultimate light pollution filter, unfortunately it also filters out all other forms of light!

4. The Walnut filter.
Earlier this year a stargazer was observing Venus low in the southwest. After a short time he noticed that the planet started showing very interesting distortions which he attributed to freak atmospheric effects. Most astronomers are familiar with the shimmering effect the atmosphere has when observing planets, but this was different. Unfortunately before he could conclude a new scientific observation, he took his eye away from the eyepiece and noticed that Venus had moved behind a nearby Walnut tree. The light was passing between its branches and diffracting, causing the strange effect.

5. That’s not Jupiter!
I usually find that people are quite excited to discover something new about the night sky, so perhaps this next story is just the exception which proves this rule. A few years ago, I was walking home with my girlfriend when I pointed to a bright point of light in the sky and said ‘Look there’s Jupiter’.  A woman passing by interjected saying, ‘no it’s not!’ I was quite shocked and politely said that I had already seen it in binoculars and in a telescope so I was quite sure. To which she replied that it was just a bright star and that if it were Jupiter you would see its disk and the great red spot. I didn’t have a pair of binoculars on me so I suggested she take a look using binoculars when she gets home. I wanted to mention that because Jupiter is very distant from us it appears as a bright star, but you can see its disk even with a cheap pair of binoculars. Unfortunately, she was not open to furthering our discussion so we left it there. I went home thinking that before I knew where the planets were or what they looked like in the sky I assumed that they were too faint to see. She assumed they would be so obvious that they would not need to be pointed out in the sky. I am not counting her misconception about Jupiter as the astronomy fail but here unwillingness to consider what other people are saying certainly deserves a place on this list!

For a German Equatorial mounted telescope like the one above, the counterweights allow the telescope to move easily around its polar axis. If you remove them, bad things will happen.

6. Don’t forget the counterweights.
An astronomer had set up his scope (a large and heavy 10 inch diameter Schmidt-Cassegrain) and began to align his kit. This involved kneeling down under the scope and adjusting the angle of the mount so that it pointed towards the Earth’s north celestial pole. Sadly for him, he forgot to attach the counterweights to the mount and consequently, the telescope swung round and crashed into his head, smashing his glasses, breaking the camera attached to the telescope and probably leaving him seeing stars. This is quite a graphic reminder to always put counterweights on your mount before the telescope to avoid this type of accident.

7. A burning passion for solar observing.
I’m not sure when or where this happened but this story is certainly part of astronomy folk law. An astronomer was safely observing the Sun with a properly attached Solar filter over the front of the telescope – solar observing without the correct kit could result in instant and permanent blindness. However, despite being safety conscious, after a short time he noticed a painful sensation on his head. Unfortunately he had left the finder scope without any lens caps and it acted like a magnifying glass – burning a small painful spot onto his scalp.

8. Temperature difficulties
In order to get the best performance out of a telescope, you must first allow it to cool down to ambient temperature. This reduces turbulent air around the telescope and produces a clearer image. Unfortunately, as a telescope cools down other issues can arise. An astronomer was waiting for his equipment to cool down when the metal screw that holds the telescope onto its mount contracted just enough to release the telescope tube. The resulting crash smashed both the telescope and the £2000 camera attached to it. Take home message, always check your connections after cooling your scope!

9. Hubble space telescope error
This is the most expensive mistake on the list, you may even be aware of it. Nowadays, we take the ground-breaking image quality of the Hubble Space Telescope (HST) for granted. When it was launched in 1991, engineers found that its main mirror was very slightly flatter near its edge (an error of 2.2um or 0.0022mm). This meant that it could not focus light precisely at one point, reducing the overall image quality and leaving a $4 billion telescope almost useless. The cause of the problem was mainly down to NASA relying on test data from only one instrument. To solve the problem NASA replaced the camera with a new version containing a corrective lens that compensated for the incorrect mirror. The cost of which involved commissioning new imaging equipment, an extra shuttle launch and losing the opportunity to use the HST for high-contrast imaging for two years.

HST’s misshaped mirror was only corrected two years after launch with a new, specially designed camera.

10. Great expectations.
This one is an error many newcomers to the hobby make, partly because of some pretty dodgy marketing – see the unobtainable views pictured on the very basic telescope above. Put simply, it is the expectation that a small telescope operated by someone with little experience will produce celestial views equaling the HST. If you search for a beginner telescope online and run through its reviews there will be a number complaining of blurry images, poor zoom and undefined galaxies. These limitations are sadly just unavoidable consequences of living under a turbulent atmosphere or owning a telescope that doesn’t have the HST’s 2.4m diameter aperture. In the end, I class this as one of the most damaging errors here because for those who make it astronomy becomes a frustration rather than a fascination. However, once you get familiar with the capabilities of your telescope/binoculars you quickly start to appreciate the significance of those faint smudges of light!

So there we are, conclusive evidence that astronomy doesn’t always go to plan even when the weather behaves itself. If you have any other interesting stories please put them in the comments. Have a great Christmas and don’t knock yourself out with a non-counterweighted telescope!

Post by: Daniel Elijah

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Tolerating distress: why is it so difficult to quit smoking?

I remember how relieved I was when the smoking ban came into effect and the air in pubs and restaurants was no longer filled with cigarette smoke. I guess the aim of the policy was not only to protect the health of those of us who don’t smoke but also to encourage smokers to quit. Most of us understand that discontinuing an addictive habit is not that simple but what exactly is involved in quitting and why is it more difficult for some?

Most attempts to quit smoking, especially without help, result in failure (West, 2012). This is at least partly due to unpleasant withdrawal symptoms such as irritability, anxiety, low

Most of us are aware of the harmful effects of cigarette smoking. Image by Helgi Halldórsson from Reykjavík, Iceland - Dangers Of Smoking, CC BY-SA 2.0, https://commons.wikimedia.org/w/index.php?curid=33780867

Most of us are aware of the harmful effects of cigarette smoking. Image by Helgi Halldórsson from Reykjavík, Iceland – Dangers Of Smoking, CC BY-SA 2.0, https://commons.wikimedia.org/w/index.php?curid=33780867

mood, problems with concentration and difficulty sleeping (Hughes, 2007). However, success also depends on an individuals characteristics such as their ability to tolerate discomfort (Sirota, Rohsenow, Dolan, Martin, & Kahler, 2013) and distress, i.e. unpleasant psychological states (Leyro, Zvolensky, & Bernstein, 2010). If we believe that we can withstand the withdrawal symptoms, then we are much more likely to be successful, especially if we also reappraise the experience and tell ourselves that it will be worth it in the end. Some research also suggests that people smoke in order to soothe anxiety and negative feelings in the absence of better ways of coping with these unpleasant emotional experiences (Leyro et al., 2010). Thus, the nicotine users becomes trapped in a vicious cycle where they smoke because they believe that a cigarette will soothe their negative feelings, and smoking  becomes a rewarding activity through its association with reduced distress. In other words, the less we can tolerate unpleasant feelings, the more rewarding smoking becomes.

Certain health problems, such as posttraumatic stress disorder (PTSD), can also make quitting smoking harder. This is due to the increased negative emotions, greater arousal, anger, and anxiety associated with such disorders. With regard to anxiety, a ‘fear of fear’ can also cause elevated worry, specifically worrying that stress/anxiety could have a harmful effect on our health (Kashdan, Zvolensky, & McLeish, 2008; Powers et al., 2016) therefore further diminishing an individual’s ability to cope (Leyro et al., 2010). Increased negative affect and severity of withdrawal symptoms also plague those with social anxiety who attempt to quit smoking (Buckner, Langdon, Jeffries, & Zvolensky, 2016). These additional difficulties are particularly important considering that those of us who have mental illness tend to smoke more and die earlier (Ziedonis et al., 2008). In addition, PTSD affects up to 30% of women who give birth (Grekin & O’Hara, 2014), and can therefore interfere with smoking abstinence among the new mothers addicted to nicotine.

Psychological therapy which teaches smokers to accept their internal feelings and sensations can considerably improve chances of quitting compared with standard intervention (quit planning, skills training, advice on pharmacotherapy, and social support for quitting) for smoking cessation (Bricker, Wyszynski, Comstock, & Heffner, 2013). For example, Acceptance and Commitment Therapy (ACT) encourages the individual to allow the thoughts, emotions and sensations that trigger smoking to come and go without attempting to control them. The resulting increased acceptance of these feelings allowed 23% of participants to remain smoke free up to 3 months after the therapy, compared with only 10% of those relying upon standard intervention alone. ACT also performed better than cognitive behavioural therapy (30% vs. 13% abstinence rate at 1 year) (Hernandez-Lopez, Luciano, Bricker, Roales-Nieto, & Montesinos, 2009).

It seems that the struggles with our own unpleasant feelings and the need to escape them play an important role in managing addiction: quitting smoking is not just about willpower or awareness of its harmful effect. Although this area needs a lot more research, it might be worth looking for help in increasing acceptance and mindfulness when battling withdrawal symptoms.

Post by: Jadwiga Nazimek

References:

Bricker, J., Wyszynski, C., Comstock, B., & Heffner, J. L. (2013). Pilot randomized controlled trial of web-based acceptance and commitment therapy for smoking cessation. Nicotine & Tobacco Research, 15(10), 1756-1764. doi: 10.1093/ntr/ntt056

Buckner, J. D., Langdon, K. J., Jeffries, E. R., & Zvolensky, M. J. (2016). Socially anxious smokers experience greater negative affect and withdrawal during self-quit attempts. Addictive Behaviors, 55, 46-49. doi: 10.1016/j.addbeh.2016.01.004

Grekin, R., & O’Hara, M. W. (2014). Prevalence and risk factors of postpartum posttraumatic stress disorder: a meta-analysis. Clin Psychol Rev, 34(5), 389-401. doi: 10.1016/j.cpr.2014.05.003

Hernandez-Lopez, M., Luciano, M. C., Bricker, J. B., Roales-Nieto, J. G., & Montesinos, F. (2009). Acceptance and commitment therapy for smoking cessation: a preliminary study of its effectiveness in comparison with cognitive behavioral therapy. Psychol Addict Behav, 23(4), 723-730. doi: 10.1037/a0017632

Hughes, J. R. (2007). Effects of abstinence from tobacco: Valid symptoms and time course. Nicotine & Tobacco Research, 9(3), 315-327. doi: 10.1080/14622200701188919

Kashdan, T. B., Zvolensky, M. J., & McLeish, M. C. (2008). The toxicity of anxiety sensitivity and worry as a function of emotion regulatory strategies. Journal of Anxiety Disorders, 22, 429–440.

Leyro, T. M., Zvolensky, M. J., & Bernstein, A. (2010). Distress tolerance and psychopathological symptoms and disorders: a review of the empirical literature among adults. Psychol Bull, 136(4), 576-600. doi: 10.1037/a0019712

Powers, M. B., Kauffman, B. Y., Kleinsasser, A. L., Lee-Furman, E., Smits, J. A., Zvolensky, M. J., & Rosenfield, D. (2016). Efficacy of smoking cessation therapy alone or integrated with prolonged exposure therapy for smokers with PTSD: Study protocol for a randomized controlled trial. Contemp Clin Trials, 50, 213-221. doi: 10.1016/j.cct.2016.08.012

Sirota, A. D., Rohsenow, D. J., Dolan, S. L., Martin, R. A., & Kahler, C. W. (2013). Intolerance for discomfort among smokers: Comparison of smoking-specific and non-specific measures to smoking history and patterns. Addictive Behaviors, 38(3), 1782-1787. doi: 10.1016/j.addbeh.2012.10.009

West, R. (2012). Estimates of 52-week continuous abstinence rates following selected smoking cessation interventions in England.

Ziedonis, D., Hitsman, B., Beckham, J., Zvolensky, M., Adler, L., Audrain-McGovern, J., . . . Riley, W. (2008). Tobacco use and cessation in psychiatric disorders: National Institute of Mental Health report. Nicotine & Tobacco Research, 10(12), 1691-1715. doi: Pii 905756217

10.1080/14622200802443569

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Have yourself a wild winter: Preparing your garden for winter wildlife

screen-shot-2016-11-20-at-19-42-10As the last leaves fall from our trees and the outside world beds down for winter, we at the Brain Bank are turning our thoughts to the UK’s wild critters braving this cruel and often unpredictable season.

A quick peek at the BBC’s monthly weather outlook, taking us into the early part of December, shows the typical British weather pattern of unpredictability continuing forward. The jet stream is likely to develop a blocking pattern which prevents prevailing westerly winds blowing low pressure systems across our shores – this should favour a period of quiet weather, although whether this will be cold or mild is still open to doubt.

One thing I do know, however, is that over the last two weeks my garden has experienced mild sunshine, torrential rain, flooding, hail, snow and everything in-between. As I glance from the window to my wardrobe, grumbling about what to wear I can’t help but think – however hard we find this season, the wildlife fighting for survival just outside our doors are undoubtedly having a much harder time than us.

So what can we do to make the festive season just a bit jollier for them?

Birds:

For birds struggling through the winter months berries can be a lifeline. However, as the season draws on, berry supplies are dwindling and many birds will be in search of another food source – this is where you come in. A well stocked, clean and reliable bird feeder could be the difference between life and death for wintering British birds.

screen-shot-2016-11-20-at-19-46-09If you are unsure of what to feed your garden visitors you can find an extensive list of common British birds and their dietary idiosyncrasies here. Briefly, sparrows and finches have a preference for seeds while tits enjoy fat unlike thrushes and robins who have an appetite for fruit and worms.

Many feathered garden visitors also have an appetite for our leftovers: fruit cake, mince pie, dried fruit, unsalted nuts, apples and pears are all excellent appetisers for garden birds. Some more timid species like wrens and dunnocks can even be tempted to snack on grated mild cheese sprinkled under trees and bushes.

But be sure you choose the right stuff for your garden gang. Be mindful that birds will not eat anything mouldy or salty (too much salt can be poisonous to small birds). Also, however much you may have enjoyed your Christmas dinner, few birds have a taste for leftover sprouts and turkey fat can stick to their feathers making it harder for them to stay warm and dry. Finally, if you have dogs be very careful of feeding your garden birds grapes or currents since vine fruits can be toxic to dogs.

Finally, although an outdoor winter dip may sound horrific to us, birds need to bathe and drink every day – even when it’s cold outside. So if you can, try to make sure there is fresh unfrozen water somewhere in your garden.

Bees:

Although our minds may now be firmly fixed on snuggly jumpers and hot chocolate, it’s not uncommon for the UK to experience unseasonably warm days at the end of autumn and in early spring. This unseasonable warmth will often bring bees buzzing out of their winter homes and into your garden. So, to give our buzzing buddies a helping hand it’s always good to ensure your garden has it’s fair share of late and early-flowering plants. Ivy is in flower at this time of year and bulbs, which you can plant now, are a good source of food for bees early in the spring – fritillaries, crocus and snowdrops can also all be buzzing with bees on a sunny day.

screen-shot-2016-11-20-at-19-48-36A fun, if slightly unusual Christmas activity, would be to make yourself a solitary bee house. With bee numbers dwindling, it’s never been more important for us to take care of these hard working pollinators, this includes providing them with safe winter accommodation. Bee houses can be bought from your local garden center and hung somewhere warm and dry, however it’s also great fun to make one of these yourself. I recently ran a small event at a local botanical garden where we taught youngsters to make their own bee homes. The activity only took 15 minutes, was relatively cheep and of course the kids all enjoyed getting a bit messy – I’m pretty sure the local bee population were quite pleased with the results too! Instructions for two types of homemade bee houses can be found here.

Other wildlife:

It’s also important that we try to create habitats in the sunniest most sheltered parts of our gardens to benefit a wide range of wildlife. Never underestimate the winter warming powers of an old stack of bricks or plant pots in a sunny corner (a favourite of toads and newts) or a pile of wood and leaves (the preferred hidey-hole of hedgehogs and frogs). But, perhaps the most important advice we can offer our winter gardeners is to be a little bit messy… Strategically forget to rake leaves from a sunny corner of your garden or perhaps decide against cutting down the perennials in December. Then make sure you leave all these habitats undisturbed until well into spring. Your local wildlife will undoubtedly thank you for it.

Post by: Sarah Fox

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