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Doctor Blunders

8/02/12 2:17pm

Many Doctors Don't Spot Drinking Problems

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Unless patients show up to their appointments intoxicated, alcohol problems often go overlooked by clinical staff, according to an overview of 39 studies from the UK's Leicester University. Published in the British Journal of Psychiatry, the findings suggest that in addition to failing to spot problem drinkers, doctors also misdiagnosed a reported 5% of "normal drinkers" by labeling them as problem ones. Out of 20,000 patients assessed, general practitioners identified 40% of problem drinkers, hospital doctors spotted 50%, and mental health specialists recognized 55%. Alarmingly, correct diagnosis rates didn't improve even when some patients had self-reported alcohol problems, suggesting that many doctors are failing to ask appropriate questions about patients' drinking habits. To their credit, doctors did note when their patients were drunk during their check-ups—but only 90% of the time. Dr. Alex J Mitchell, the researcher who led the study, said: "There needs to be a greater awareness of the importance of carefully assessing alcohol problems for non-intoxicated patients. Patient responses to questioning about drinking habits should not be assumed to be misleading but questioning must be handled sensitively".

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By Gabrielle Wuhl

Olympic Addicts

8/02/12 1:11pm

"Post-Olympics Let-Down" May Trigger Addiction

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Winning Olympic gold may trigger depression and addiction, according to a new study. Past research has found intensive exercise can be as addictive as heroin, which is why athletes with such demanding training often develop a dependence. A third of elite athletes have an "unhealthy preoccupation" with training, scientists in Melbourne found—and for many athletes, stopping exercise can lead to depression and anxiety, as well as drug-like withdrawal symptoms. “Exercise can be like a pill,” says David Bentley, a triathlete who teaches exercise physiology at the University of Adelaide. “It does similar things chemically to a number of different systems in the body, and if you exercise all the time, your body will change almost like it does in response to some pharmacological interventions.”

The findings shed light on why Olympic athletes may be more prone to eating disorders, substance abuse, and suicide than the rest of the general population and may need help adjusting to life when the games are over. “We call it the post-Olympics let-down," says Nicole Detling, a sport psychology consultant for the US Speed Skating team and the US Ski and Snowboard Association. She notes that the time period following retirement can be psychologically painful, and can drive many athletes in to clinical depression. “A lot of retired athletes report fairly significant mental health concerns and an increased level of substance dependence,” says Frances Quirk, co-editor-in-chief of the journal Performance Enhancement & Health. “There are other factors that contribute to that in terms of pressure, isolation and competition, but there is a biological story.”

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By Valerie Tejeda

tv Addicts

8/02/12 12:07pm

Breaking Bad Actors Inspired by Addiction

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Cranston and Paul have their own twisted
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Ever wonder how Breaking Bad actors Bryan Cranston (who plays Walter White) and Aaron Paul (who plays Jesse Pinkman) are able to deliver such loaded performances week after week? The actors have admitted they draw from their own personal experiences of loved ones who abused alcohol and drugs. When getting into character, Cranston says he thinks about the alcohol abuse in his family that led to his parents divorcing. "I have some anger issues," he tells Rolling Stone. "There was alcohol abuse. And there were broken lives. There were two broken people. It was ugly. I didn't see my father for 10 years." Meanwhile, Paul's character of Jesse, a meth dealer, hits painfully close to home because a former girlfriend of his suffered from meth addiction. "It went from coke and then it escalated to meth," says Paul. "Meth is the one that grabbed, like, nails-deep into her soul and slowly just ripped it out. She was this beautiful being, turned to this hollow shell." And while this acting method could potentially cost the actors some cash for therapy, it seems to be benefitting their careers. Cranston has won three Emmys for his work on the show and been nominated for two Golden Globes, while Paul picked up his own Emmy in 2010.

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By McCarton Ackerman

Meth Treatment

8/02/12 10:43am

Why Can't Most Meth Addicts Stay Clean?

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Most meth addicts relapse within three years of seeking treatment, according to a new study from Australia. And although those who attend residential rehab reportedly have more than double the success rate of those who go to detox, or receive no treatment, even those who go to rehab have a high rate of relapse—at 88%. The study, published in the journal Addiction, looked at long-term meth use in three categories: users treated in a residential rehab, those treated in a detox program, and those who weren't undergoing any treatment. Residential rehab programs, which typically integrate counseling and recreational activities with in-patient treatment, had a high short-term success rate—with 48% reportedly staying clean after three months. But those who went through short-term detox (usually a few days at a hospital or facility) were just as likely to relapse as those who had no treatment—with only 15% staying clean after three months. What's more, even those who went to rehab had a low rate of success when it came to the longer term: just 12% reported staying clean after three years, compared to 5% who did not go to rehab.

Rebecca McKetin, co-author of the study, says many rehabs and detox centers are tailored to users of alcohol and heroin, but few are geared towards meth users, which may help explain the higher rate of relapse. "Their utility for methamphetamine users is not well understood," she says. "Many people were disappointed with the outcomes for residential treatment, because there is an expectation that these types of long-stay residential treatments produce long-term recovery, and we found that this was not the case for most people." Despite the often-high cost of rehab, McKetin says it is worth it—and the short-term success rate is promising. "It may not be perfect, but in the absence of better [treatments], we need to offer people some respite from their addiction in times of crisis." According to the National Institute on Drug Abuse, 314,000 teens and adults in the US were current meth users in 2008, but use of the drug seems to have fallen in the last few years.

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By May Wilkerson

Headlines

8/02/12 5:00am

Morning Roundup: August 2, 2012

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Is R-Patz smoking again? Photo via

By Chrisanne Grise

Obit

8/01/12 5:31pm

Gore Vidal, Legendary Author and Patriot, Dies

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Gore Vidal, one of America's last great public intellectuals, died last night at age 86. Wielding his silver-tongued wit like a swashbuckler's dagger, Vidal cut as large a swath through our culture of the second half of the 20th century as any literary star. In his precocious and productive career, he wrote over a dozen works of fiction, including 1948's groundbreaking gay-coming-out novel The City and the Pillar, and Myra Breckenridge—a fierce satire of American values featuring our literature's first transsexual. His most enduring achievement was a series of six historical novels, Narratives of Empire, about national politics, celebrity and (his magnificent obsession) the terminal corruption of American democracy. When slammed as anti-American, he countered that it was his love and respect for the "original idea of America" that drove his disgust with reality. He also penned plays for much-reprised Broadway hits, screenplays for now-classic Hollywood films, memoirs and essays; he ran unsuccessfully for the senate, engaged in high-profile wars of words on TV with everyone from William F. Buckley to Norman Mailer, and conducted an intimate correspondence with convicted far-right terrorist Timothy McVeigh.

Born into political aristocracy—his grandfather was a senator, and he was related to Jacqueline Kennedy and Al Gore—Vidal detailed the virulent vices of high society mercilessly in his memoirs, starting with his mother's chronic alcoholism. As a self-defined enthusiast of "same-sex sex," he defied all conventions, with an early rejection of a life in the closet that was as brazen as his later refusal of the label "gay." A literary outlaw before the culture caught up to him, he was open about sex, drugs and just about everything else.

Among his (confirmable) claims were several that might prick up an addiction specialist's ears. He reported having had some 1,000 sexual encounters before the age of 25—"nothing special," he said, compared to the likes of pals John F. Kennedy and Tennessee Williams. Despite his liberated libido—and his advice to "never turn down an opportunity to have sex or go on television"—Vidal attributed his 55-year, apparently happy "marriage" to Howard Austen to its total absence of sex. "It's easy to sustain a relationship when sex plays no part and impossible, I have observed, when it does," he wrote. He was also a connoisseur of the cocktail hour (after hour after hour) in the time-honored tradition of literary lions.

In 1970 Vidal wrote a typically controversial column for The New York Times in which he advocated ending the US addiction scourge by legalizing not just marijuana but all drugs. He suggested selling drugs over the counter, at cost, with precise descriptions of their benefits and risks—which would, he acknowledged, require "heroic honesty." He displayed his own when he wrote, "For the record, I have tried—once—almost every drug and liked none, disproving the popular Fu Manchu theory that a single whiff of opium will enslave the mind."

Vidal's logic was that legalization would not only make drugs safer but remove the forbidden-fruit quality that renders them so tempting. But he ended the op-ed darkly, noting that such a sensible (as he saw it) anti-addiction policy would never fly in our spacious skies: "The American people are as devoted to the idea of sin and its punishment as they are to making money—and fighting drugs is nearly as big a business as pushing them. Since the combination of sin and money is irresistible (particularly to the professional politician), the situation will only grow worse."

Accepting a lifetime literary achievement award in 2009, he summed up his experience with two unexpectedly sunny words: "such fun." His legacy, by contrast, could not be more serious.

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By Walter Armstrong

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