Wednesday, May 23, 2007

Morphine & Addiction; Caregivers Blog

1) Nature published a study out of Brown demonstrating the persistent effects of morphine in the brains of mice. Reading the study (quite dense on the receptor type stuff) they basically found that morphine inhibits long term potentiation of GABA mediated synaptic transmission. In a press release they describe it as this:

So the net effect of morphine and other opioids, Kauer found, is that they boost the brain’s reward response. “It’s as if a brake were removed and dopamine cells start firing,” she explained. “That activity, combined with other brain changes caused by the drugs, could increase vulnerability to addiction. The brain may, in fact, be learning to crave drugs.” (emphasis mine)
This is important research to figure out the chemical signaling that may contribute to addiction and may help us prevent addiction in the future. But the press release from Brown has some pretty sensational claims, like the one above, and the one that really caught me off guard:
“The persistence of the effect was stunning,” Kauer said. “This is your brain on drugs.” (emphasis mine)
Now these quotes were not in the research study, but they were picked up by the medical media and the mainstream media. How is that, you may ask? Did they all interview the researchers?

Here are some quotes and links from some news sources:

The Journal of Young Investigators has probably the best and most original articles on this research.

Scitizen starts the article with a common fear of opioids:
The power of morphine, indeed any opiates in pain management is invaluable yet dangerous. Opiates are the primary pain killer in a medical toolkit; few chemicals can come close to their effectiveness in subduing pain. I stopped taking morphine after several days but a substance abuser still keeps self-administering opiates because the drug makes him or her feel so good.
Science Daily here with a review that looks a lot like the press release.

Some of you may not realize that a lot of the news you read was never written by a responsible unbiased journalist. But in fact the news article you read is a just a rehasing or direct copy of a press release. (Brown press release here) In this case many of the articles reporting on this basically take the press release and rearrange things a bit, but in essence take the whole press release as it is. I can bet you few of the news sources read the article. The article is technically very difficult and I will admit, I had much trouble trying to wrap my head around sentences like this, and I was almost on Jeopardy once. (That is a story for another time.)

So in conclusion, beware press reports of articles that they likely have never read/understood, and lets keep researching to figure out more about this issue before we make amazing claims about human behavior from a few slices of rat brain.

2) A daughter blogs about being present as her father dies. It is nice to get these uncensored insights to the viewpoint of the family caregivers. One tip for those who read the post: to pronounce a patient deceased, you do not have to test their corneal reflex with gauze as the nurse did in this story. Checking for heart rate and respiratory rate in an expected death is appropriate enough.

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