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The Substance Abuse and Mental Health Services Administration (SAMHSA) is the agency within the U.S. Department of Health and Human Services that leads public health efforts to advance the behavioral health of the nation. SAMHSA's mission is to reduce the impact of substance abuse and mental illness on America's communities.
In prior work, it’s been noted how psychosis can follow methamphetamine use and last into abstinence. Varying levels of methamphetamine use can induce psychosis, depending in part on an individual’s background, and it can develop quickly or after 20 years of use. This psychosis can be quite similar to Schizophrenia - in some cases, violent behaviors have been connected to methamphetamine psychosis as well. A study of Japanese prisoners found that a subgroup of methamphetamine users experienced chronic psychosis. Lingering cognitive problems may cause other health complications, difficulty thinking or concentrating at work, and increasingly risky behavior, in addition to higher relapse rates. Furthermore, later-in-life stress can also revive psychotic symptoms. More research on methamphetamine and cognitive problems can help treatment providers understand these hidden tripwires for patients.
Some of the strategies currently used to treat traumatic brain injuries may be helpful, as may use of exercise, dance, and transcranial magnetic stimulation. Post drug abstinence psychoses may not be as reversible by medications used for naturally-occurring psychoses.
With methamphetamine this is even more important as medication assisted therapies do not exist. Time of abstinence, rehabilitation with healthy thinking, eating, sleeping, and diet are easier to prescribe or advise than find. Time of abstinence is of the essence as it appears that methamphetamine induces a drug use disorder with binges, relapses and cravings but also with loss of brain function and evidence of something that looks like a traumatic brain injury. Treating it like a neurological injury in addition to traditional addiction treatment, may be an idea worth looking at too.
Conclusions: These results show that subacute exposure to amphetamines is associated with an advancement of cardiovascular-organismal age both over age and over time, and is robust to adjustment. That this is associated with power functions of age implies a feed-forward positively reinforcing exacerbation of the underlying ageing process.
The rapidity of transition to SUD emphasizes the narrow opportunity to intervene.
Conclusion: The relative speed associated with the transition from use to SUD emphasizes the narrow window of time available to intervene, underscoring the urgency of early identification of mental health conditions and the timely provision of appropriate evidence-based interventions, which could potentially prevent the development of secondary SUDs.
There’s a figure that is often quoted by vaping enthusiasts: e-cigarettes are 5 per cent as harmful as traditional combustible cigarettes. That figure comes from Public Health England.
But according to Dr Sarah White, director of Quit Victoria (part of the Cancer Council), this is a “spurious made up figure”. She says the constant quoting of Public Health England is disingenuous. Most scientific studies find the risks outweigh the benefits.
“I have a box full of the position statements and evidence reports that are anti-e-cigarettes. The pile of paper is about 20 centimetres high, and there’s another one that’s pro, and it’s about 4 centimetres high. And all the stuff from the pro camp is all England with one exception, which is Canada.”
Most reports conclude the chemicals in the vapour inhaled from e-cigarettes probably have negative health impacts. The long-term effects of these health impacts won’t be known for many years.
The other major risk is that it will lead non-smokers, especially young non-smokers, to take up vaping, and that this could be a gateway to traditional cigarette smoking.
Dr White is critical of the British government’s bullish approach, calling it a “massive natural experiment”.
“I think they came to it with a concept that was coming from the right place and was a really good idea, but instead of testing it they kind of threw themselves in. And I think they’ve actually got themselves into a position where there was a lot of criticism from around the world and they’re just digging in now.
“When you look at the data, the number of people making quit attempts in the UK is dropping. The number of people using gum, patches, lozenges, all those sorts of things, is dropping. The number of people accessing stop smoking services is dropping. And we know that the most common form of use for e-cigarettes is to continue to use them along with cigarettes.
“We know that there’s just no safe level of cigarette smoking. So if we have what’s called dual use, we know that there’s no health benefit there.”
She warned Australia against following suit, because as the market grows, its lobbying power also grows. That would make it difficult to reverse – as has been seen with governments’ decades-long effort to regulate the sale of tobacco.
“If you let the genie out of the bottle, it’s going to be nigh on impossible to put it back in,” Dr White says.
Most health bodies in Australia agree with Dr White that caution and more research are needed. That includes the Australian Medical Association, the Royal Australian College of General Practitioners, the National Heart Foundation, and the government’s own health research body, the National Health and Medical Research Council.
Those who argue in favour tend to be tobacco companies, tobacco retailers, political libertarians, a handful of individual doctors – by far the most prominent being Sydney smoking cessation specialist Dr Colin Mendelsohn – and, of course, vapers like Margaretha and Adrian.
News Corp publications have also run many pro-vaping stories, most of which quote Dr Mendelsohn. News Corp denies this has anything to do with Rupert Murdoch once being on the board of Philip Morris, or the fact that his lead director, Peter L. Barnes, spent most of his career at Philip Morris. Read this 2014 piece by The New Daily’s Michael Pascoe to learn more about News Corp’s longstanding support of big tobacco.
So far the Australian government has listened to expert bodies rather than big tobacco, vapers, libertarians and News Corp.
In a statement to The New Daily, a spokesperson for Health Minister Greg Hunt said: “The overwhelming medical advice and evidence is that it [e-cigarette use] is likely to lead to the uptake of smoking and we cannot support that.
“This is the view of the Therapeutic Goods Administration, Australia’s chief medical officer, chief health officers from all Australian states and territories and the National Health and Medical Research Council.
“The Australian Medical Association and the Royal Australian College of GPs are also concerned and have presented clear evidence highlighting this.”
But this will not stop big tobacco – with the support of Liberal MPs like Tim Wilson, Eric Abetz and Trent Zimmerman – from lobbying energetically for a relaxation of the laws. Only last month, they appeared to gain a small victory, when Mr Hunt agreed to set up an independent inquiry into the health risks and benefits of e-cigarettes.
Regardless of whether or not e-cigarettes are a lifeline for smokers who can’t quit any other way, one thing is clear: big tobacco isn’t in it for the health benefits. It wants a piece of the action because it has sniffed a new opportunity to rake in billions off people’s addiction to nicotine. For that reason, most health experts agree that their nice-sounding words must be rigorously scrutinised.
In his submission to the parliamentary inquiry earlier this year, Renee Bittoun, a smoking cessation specialist at the University of Sydney, put it in no uncertain terms.
“It is naïve to believe that the tobacco industry, given its past history, will not endeavour to expand its market and sale of this highly addictive substance. In particular, the seductive and alluring marketing to gain an adolescent consumer who may become a life-long nicotine addict is reprehensible. No health worker should be complicit in this.”
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