Category Archives: Medicine

All, Medicine, Recent posts

Is substance misuse a choice or a disease?

Leave a comment

Various different types of pill capsules lay scattered on a wooden table.

Image from www.northwell.edu

Some people talk as if substance misuse is a moral failing. Science suggests that substance misuse is a disease similar to many other health conditions that affect the brain’s reward pathway. When one performs enjoyable activities like running or eating a tasty meal, dopamine and endorphins are released, and an individual may feel some euphoria. Drug use increases similar chemicals in brain pathways at a much greater magnitude. Furthermore, some drugs alter these functions after a single use. With ongoing usage, the brain pathways are modified, making it difficult for people to feel happy without the drug. In other words, one may get little enjoyment from everyday activities, and drug-taking becomes the only source of pleasure. Tolerance also develops as the brain adjusts to drug use, so more is needed.

The choice to try a drug may occur in a moment of vulnerability. There may be peer pressure. Individuals may begin taking a drug as a coping method for stress or distress. 

As substance misuse develops, it causes a loss of control over behaviors that impair the individual. It’s not just a matter of willpower to stop taking the drug. Moreover, people with altered brain chemistry may experience withdrawal symptoms if they stop using the drug. Avoiding the drug may become as challenging as going without food or water. 

Substance use disorder, like heart disease, results from a combination of factors. Genetic factors, frequency, duration, type of drug, ease of availability, and feelings of worry or depression are all factors that may be associated with the potential to develop a substance misuse disorder.

By treating those struggling with substance use disorder with the same compassion we extend to patients with a chronic disease like diabetes or heart failure, we can help them overcome this challenge and restore their health. 

 

https://www.cdc.gov/stopoverdose/stigma/index.html

https://drugfree.org/article/is-addiction-a-disease/

https://americanaddictioncenters.org/rehab-guide/is-drug-addiction-a-disease

https://iuhealth.org/thrive/is-addiction-really-a-disease

All, Medicine

When does the brain stop developing?

Leave a comment

Image from scmp.com

As early as 5 years of age, our brains have reached 90% of their potential volume. However, we all know that our brains continue to develop for many years; in fact, our brains continue evolving until death. So why then, do many people worry about cognitive decline with aging, and are their fears misplaced?

While it is evident and typical that specific cognitive functions decline with age, this is not necessarily associated with a cease in brain growth or weakened memory formation. General intelligence is complicated. It can be subdivided into two categories: crystallized and fluid intelligence.

Fluid intelligence allows you to solve problems without experience or knowledge—this type of intelligence peaks early in adulthood and declines later in life. Crystalized intelligence uses experience and prior knowledge to assess future relationships. This type of intelligence increases until approximately 60 years of age and then declines slightly. Therefore, skills like vocabulary, comprehension of new information, and arithmetic improve long after the brain ceases to grow in size and remain relatively stable throughout life. Other crystalized skills, such as conflict resolution and emotional regulation can continue to improve beyond 60 years of age.

The brain is an evolving organ as our lives go on. There might not be a moment in which our brains operate at maximum cognitive function in every specific area. So, next time you lose your keys, remember that just because your brain has stopped growing does not mean that your cognitive function is declining. 

 

https://azpbs.org/2017/11/early-childhood-brain-development-lifelong-impact/

https://www.nm.org/healthbeat/healthy-tips/ten-surprising-facts-about-your-brain

https://www.urmc.rochester.edu/encyclopedia/content.aspx?ContentTypeID=1&ContentID=3051

https://www.simplypsychology.org/fluid-crystallized-intelligence.html
https://www.psychologicalscience.org/observer/the-cognitive-upside-of-aging

All, Coronavirus, Medicine

Antibody Testing For COVID-19

Leave a comment

Image from sfgate.com

 

There’s a lot of talk about antibody levels as a measure of immunity against COVID-19 after infection or vaccination. This clashes with the knowledge that the immune system remembers prior invaders and can be reactivated if there is a new exposure. 

Antibodies are proteins the body uses to recognize foreign substances that should not be in your blood and flag down immune cells to destroy the invader. When a pathogen, such as a virus or bacterium, enters the body, the immune system is triggered to produce more antibodies. Vaccines often work by introducing an unharmful or artificial part of a pathogen into your body to make it produce antibodies. The level of antibodies may wane, but the B-type immune cells remember and can ramp up production of the invader returns. 

 Antibody tests detect whether a specific antibody is currently circulating in your body which is generally considered a marker of recent infection of immunization. Initially, COVID-19 antibody testing was used as one measure of whether or not a person had been infected with the virus. However, because it can take 1 to 3 weeks after the initial infection for antibodies to be measurable in your body, the tests are not used to detect a recent or active infection.  

The way antibody tests are often discussed in the media gives the impression that circulating antibodies are a measure of immunity against the virus. The real measure is whether or not your immune system is capable of mounting a new response to the virus, not whether a response is currently underway.  Circulating antibodies are a marker of an active immune response. 

So, antibody testing cannot tell you if your body is capable of producing an effective immune response against COVID-19. You may be able to mount a strong response even if you have no measurable antibodies in your blood.   

 

https://www.cdc.gov/coronavirus/2019-ncov/lab/resources/antibody-tests.html

https://www.cdc.gov/vaccines/covid-19/clinical-considerations/covid-19-vaccines-us.html?CDC_AA_refVal=https%3A%2F%2Fwww.cdc.gov%2Fvaccines%2Fcovid-19%2Finfo-by-product%2Fclinical-considerations.html

https://www.mayoclinic.org/diseases-conditions/coronavirus/expert-answers/covid-antibody-tests/faq-20484429

https://jamanetwork.com/journals/jama/fullarticle/2785530?guestAccessKey=63cc3fb6-a5f2-4a8c-af81-12e27cce9e77&utm_source=silverchair&utm_campaign=jama_network&utm_content=covid_weekly_highlights&utm_medium=email