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Officials move to strip Calif. doctor of license

August 31st, 2010 by admin

A California doctor is about to have her medical license revoked by the state of California.  The do

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Ind. opiate abuse increasing faster than national average

August 30th, 2010 by admin

According to figures released by Centers for Disease Control and Prevention, fatal overdoses of opiates–including OxyContin–outnumber those caused by other drugs. In Indiana, the Journal Gazette reports that compared to the national average, the abuse of prescription drugs is climbing higher faster than that of illegal drugs. In 2008, the use of OxyContin alone had increased by 712 percent in the state. One major cause for the change is that unlike “street drugs” such as cocaine and marijuana which are smuggled in from other countries, prescription narcotics are readily available at local pharmacies.

“People have the perception that it’s a prescription drug, it’s approved by the FDA, so it’s safer than crack or whatever,” said Mary Hendrickson, director of quality/regulatory affairs for GENCO Pharmaceutical Services in Milwaukee.

To read about the national trend of increased prescription drug abuse, go here.

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More OxyContin Please

August 29th, 2010 by admin

Now. Or I swear to christ I’ll kill every hooker in this cabana.

That is all.

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Canada cracks down on highest narcotic usage in the world

August 29th, 2010 by admin

Facing the highest per capita usage of narcotics in the world, and double the rate of abuse than the rest of the country, the province of Ontario, Canada is implementing a prescription drug monitoring program similar to those already in place in the U.S. Ontario has seen the use of prescription oxycodone increase 900 percent since 1991, claiming more deaths than HIV each year, reports the Winnipeg Free Press. According to a study published in the Canadian Medical Association Journal late last year, the death toll has increased dramatically since the new slow-release version of OxyContin hit the market—supposedly a version less prone to abuse.

To read more about the new version of slow-release OxyContin, go here.

Find out more about prescription drug monitoring programs in the U.S. here.

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Oxy-to-heroin abuse more prevalent small towns

August 27th, 2010 by admin

An upswing the use of heroin in small towns can be linked to the growing abuse of prescription drugs, such as OxyContin, and the high price associated with them, reports HeraldNet.   Also an opiate, heroin is often used as a substitute drug for oxy abusers as it costs significantly less and can be easier to obtain.  As an example, NWCN News reported drastic growth in drug-related crimes in the small town of Snomish, Wash. including a pharmacy being robbed of $50,000 worth of OxyContin.

Read about the 400% increase in prescription pill abuse here

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Five Cars Around You? A New Report Warns- One Of The Drivers Is Drunk

August 26th, 2010 by admin

Miami Police Erect DUI Checkpoints During Holiday Season

(Photo by Joe Raedle/Getty Images)

Startling numbers are out about the number of Americans who admit to drinking and driving.  Giving sight to the blind is more of a reality now by using the properties of one word: plastic. Get details on this and a new drug that shrinks skin cancer tumors in today’s Health Notes. Read the rest of this entry »

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Strengthened Mass. law targets Oxy abuse

August 26th, 2010 by admin

Through an updated electronic monitoring system, Mass. doctors will keep closer tabs on potential prescription drug abuse, including OxyContin–the abuse of which is a particular problem in the state. According to DOTmed News, the law will limit doctors prescribing unnecessary drugs, increases the number of drugs that are monitored, and report when patients are receiving the same prescription from multiple sources, among other changes. At least 9,000 Mass. residents are suspected of engaging in “doctor shopping” annually, reports the GovMonitor. According to the U.S. Drug Enforcement Administration, the state joins 34 others in the U.S. with existing prescription monitoring programs.

Decisions leading up to Mass. prescription monitoring program can be found here.

Reports on opiate abuse in Mass can be read here.

Read about Oregon’s implementation of the program here.

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Makers of OxyContin supress generic brands

August 25th, 2010 by admin

Australian company Mundipharma fights patents on generic forms of oxycodone, reports the American Chronicle. A generic version of the drug would drastically cut the pharmaceutical company’s profits of OxyContin–the highest selling opiate in Australia with reported sales of $42 million in 2009. A similar situation is echoed with the U.S. manufacturer of OxyContin, Purdue Pharma LP, which recently submitted a new patent for the reformulated version of the painkiller. The new patent ensures other companies will not be able to create generic forms of oxycodone, reports ABC News.

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14 days, starts today…..

August 24th, 2010 by admin

My daughter is in the capable hands of a wonderful Detox facility. My daughter hugged me and cried her eyes out as she said goodbye, asking me to promise her that I will be there when she gets out.

Last night was brutal. My daughter was in my bed but not sleeping, more like sleep wrestling. I couldn’t believe how many times she sat up, screamed in pain, cuddled up to me and asked me to hold her tightly then followed by another scream, sitting up, twisting in bed, rolling over and over and over, kicking covers off, pulling them back on, lights off, lights on, hot then cold, awake and then asleep. Withdrawals are terrifying!!

I feel so relieved today because she is in much more capable hands. My husband and I are looking into Al Anon (are there meetings for co-dependants of NA?). We both feel like our whole family needs to go to meetings so we are speaking the same language when she gets out. We are also looking into a Rehab Clinic for her following the Detox.

I am exhausted…but I wanted to reach out and thank everyone for their support and kind words. I rely upon all of you so much now, so please know how much I love your comments and honest feedback.

xoxo

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SOBA Review of EEG Neurofeedback-Malibu, CA

August 24th, 2010 by admin

Efficacy of SMR-Beta Neurofeedback for Attentional Processes

David A. Kaiser and Siegfried Othmer
EEG Spectrum, Inc. Encino, CA

November 1997

ABSTRACT
The effect of sensorimotor or beta neurofeedback on attentional processes was investigated using the Test of Variables of Attention (TOVA) for 530 children and adults with attentional problems. EEG neurofeedback training produced significant improvement in measures of inattention, impulsivity, and response variability. The greatest improvements occurred for subjects who exhibited severe deficits prior to training. Three-quarters of all subjects exhibited significant clinical improvement (i.e., half a standard deviation increase in one or more measures). Three models which directly or indirectly address the efficacy of EEG neurofeedback were discussed.

INTRODUCTION
In recent years EEG biofeedback training has been applied to an increasing number of psychological, neurological, and psychosomatic conditions (e.g., Fleischman, 1997; James & Folen, 1996; Byers, 1995; Tansey, 1993). Sensorimotor (SMR; typically 12-15 Hz) and beta (15-18 Hz) neurofeedback, a form of training designed to enhance intermediate frequency EEG instantaneous amplitudes, has been reported to improve epilepsy (Lantz & Sterman, 1988; Tozzo, Elfner, & May, 1988; Sterman & MacDonald, 1978), attention deficit hyperactivity disorder (ADHD) (Lubar, Swartwood, Swartwood, & O’Donnell, 1995; Rossiter & LaVaque, 1995; Lubar & Shouse, 1976), specific learning disabilities (Tansey, 1985; Linden, Habib, & Radojevic, 1996), and some conditions associated with ADHD such as bruxism, tics, and mood swings (Alhambra, Fowler, & Alhambra, 1995; Tansey, 1986). Minor closed head injury, multiple sclerosis, autism, chronic fatigue syndrome, and pre-menstrual syndrome, head a growing list of conditions reported by clinicians to be partly or fully remediated by SMR-beta neurofeedback training (cf. Othmer, in prep).

The apparent diversity of disorders impacted by SMR-beta neurofeedback training suggests a commonality of mechanisms for these conditions, a fact that should be addressed by any theory that attempts to identify the therapeutic mechanism of SMR-beta neurofeedback. Sterman (1982) proposed that SMR neurofeedback may restore regulated function of thalamocortical mechanisms associated with arousal. In particular, abnormal sensorimotor arousal or excitability may interfere with higher cognitive functions in a resource-limited competive model (Sterman, 1996). Abarbanel (1995) formulated a similar model of self-regulation in which attentional processing were modulated by thalamocortical and limbic circuitry. In his model long-term potentiation was responsible for any functional permanence associated with training. Both models presume SMR-beta neurofeedback impacts functions that modulate arousal (Sterman, 1982; Abarbanel, 1995). Both models readily address the symptomatology and possible mechanisms of ADHD and epilepsy. The primary symptoms of ADHD, inattention, impulsivity, or hyperactivity, are associated with decreased arousal in frontal cortex and subcortical regions (Zametkin et al., 1990; Mann, Lubar, Zimmerman, Miller, & Muenchen, 1991). The cortical hyperexcitability associated with epilepsy may reflect an arousal dyfunction, possibly due to a loss of integrity in the thalamic gating mechanism (Sterman, 1982). In addition to motor or vocal tics, sufferers of Tourette’s Syndrome often exhibit somnambulism, night terrors, and other disorders of arousal (Barabas, Matthews, & Ferrari, 1984). Attentional processes in particular appear to be uniquely sensitive to problems of arousal, and thus they serve to be a good measure of effectiveness in restoring such functions.

The Test of Variables of Attention (TOVA) is a continuous performance task that assesses attentional processes relative to a normative database. The TOVA provides a quantifiable measure of effectiveness of SMR and beta biofeedback training for improving specific attentional properties such as impulse control and response consistency. The lack of test-retest practice effects, the use of language-independent nonverbal stimuli, and an extended test length (22.5 min), all make the TOVA especially useful in evaluating treatment effects in an ADHD, learning disabled, or like population (Greenberg, 1987).

The purpose of the present study is to evaluate the efficacy of SMR-beta neurofeedback for children and adults suffering from attentional problems as measured by the TOVA.

David A. Kaiser and Siegfried Othmer
EEG Spectrum, Inc. Encino, CA
November 1997

Subjects
Four hundred and eight children and adolescents (age 6 to 16 years, mean 10.7) and 122 adults (17 to 67 years, mean 37.2) participated in this study. Females comprised less than one-quarter of the child and adolescents group and nearly one-half of the adults (92 and 58, respectively). Subjects were obtained in nine clinical settings affiliated with EEG Spectrum, Inc. and were selected based on the availability of pre- and post-training data for the TOVA. None of these subjects were on any stimulant or antidepressant medications during the test. Although a plurality of subjects suffered from ADHD, many also exhibited comorbid conditions of more severe behavioral disorders (ODD and Conduct Disorder), Tourette’s Syndrome, minor traumatic brain injury, epilepsy, anxiety disorders, and depression. The subjects also included some who were referred for ADHD but may not have met the classical diagnostic criteria for the condition. Adults varied on diagnosis with the majority exhibiting some form of ADD. Materials
EEG biofeedback training was performed on Neurocybernetics 2-Channel EEG systems. All subjects were evaluated with the Test of Variables of Attention (TOVA) (Greenberg, 1987), a continuous performance task (CPT) that presents to a subject a geometric target or non-target. The use of a single non-target allows this test to be conceptualized as a Go/No-Go task, a form of test which is associated with frontal lobe function (e.g., Levin et al., 1991). Results from the TOVA include measures of omission errors (inattention), commission errors (impulsivity), response time (speed of information processing), and response time variability (consistency of response). Scores are presented in standard scores with every standard deviation presented as 15 points above or below the mean. This test was administered on a PC computer and used a single switch for response. This test consists of only two non-verbal stimuli which requires a subject to pay attention for 22.5 min without prolonged rest. Presentation probabilities for targets and non-targets are mixed between test halves in order to evaluate high-likelihood and low- likelihood response conditions (i.e., 20% targets first half of test, 80% targets second half), and thereby provide measures of impulsivity and inattention, respectively. Normative age-based data is available for each gender; for children, in single-year age groups, and for adults in 10-year age groups (Greenberg & Waldman, 1993).

Procedure
The training protocol consisted of rewarding enhanced EEG amplitudes in the 12-18 Hz frequency regime, while simultaneously inhibiting excessive amplitudes in the low frequency (4-7 Hz) and high-frequency (22-30 Hz) regimes. Electrode placement always included one electrode site on the sensorimotor strip (at either C3 or C4 in the standard 10-20 system) and less commonly one electrode with either frontal or parietal placement. If training was done solely at C3 and C4, then the montage was referential to the proximate ear. If training involved frontal or parietal placement, the montage was bipolar with either C3-Fpz or C4-Pz. Left-side (C3) and right-side (C4) training involved rewarding activity in the 15-18 Hz and 12-15 Hz, respectively. Occasionally, these two protocols were used in succession during a single training session with the respective duration (e.g., 10 min SMR, 20 min Beta) of the two protocols titrated on the basis of changing symptomatology and TOVA results (Greenberg, 1987). Left-hemisphere training (e.g., C3) involved Beta reward only whereas right-hemisphere training involved SMR reward only.

Training consisted of 30 min of visual and auditory feedback on the instrument, within a 45-min contact hour. Visual feedback was provided by a variety of means which map the EEG amplitude in the reward and inhibit bands into the brightness, size, and/or velocity of objects on a computer monitor. Most commonly, information about the amplitude of signals in each of the bands was given independently. Alternatively, the subject was simply be notified that an inhibit threshold was exceeded by the withholding of the conventional reward. When all reward conditions were satisfied for a minimum of 0.5 s, an auditory beep and visual incentive (e.g., highway stripe, star in sky) was provided as reinforcement. The visual feedback signal was occasionally complemented with direct tactile and auditory feedback of EEG amplitude in the reward band.

Subjects were evaluated prior to training and after approximately 20 sessions. Those subjects who were further treated were retested after approximately 40 training sessions. Most subjects completed or discontinued training after 20 sessions (mean 24.1, range 18 to 61 sessions).

A Huynh-Feldt correction for degrees of freedom was applied to all interactions to counter potential nonsphericity of the four dependent measures. When an interaction of condition (treatment by dependent measures) was significant at the .01 level, planned comparison t-tests were used to evaluate differences for each dependent measure. The Bonferroni correction for multiple tests was consequently applied to planned comparisons.

RESULTS
Repeated measures analyses of variance (ANOVA) were used to evaluate the effect of group membership for three factors: medication, gender, and age. Medication refers to whether subjects took condition-specific medication at any time during their EEG biofeedback training. Medication information was only present for 324 subjects and only the data from these individuals were analyzed. No effect of medication, F (2,551)=1.884, ns ; gender, F (2,417)=0.949, ns ; nor age F (2,447)=3.754, p >.01; was found on the TOVA measures. As no significant differences were found between groups, all groups were combined into a single group. Repeated measures ANOVAs were then used to evaluate the effect of EEG biofeedback training on four dependent measures of the TOVA: Inattention (percent omission), Impulsivity (percent commission), Response Time, and Response Variability. Low scores were truncated at four standard deviations below normal (i.e., 40 points). Mean pre- and post-training TOVA scores are presented in Table 1.Table 1.
Mean standard scores for TOVA measures before and after approximately 20 EEG biofeedback sessions for 324 subjects with attentional deficits .

Pre-Training
Post-Training
Inattention
83.4
91.7
Impulsivity
85.5
98.9
Response Time
89.9
88.4
Resp. Variability
79.7
86.6

EEG biofeedback training produced significant improvement in inattention scores; F (1,323)= 38.678, p <.001; impulsivity scores, F (1,323)= 191.266, p <.001; and variability of response time, F (1,323)= 32.175, p <.001. Results are even more dramatic when individual data are observed. As can be seen in Figure 1, only a handful of subjects demonstrated declines in impulsivity scores while the majority improved greatly and in proportion to pre-treatment values. Improvement extended above and beyond the normal range for many individuals.

Figure 1. Pre- and post-treatment TOVA impulsivity standard scores for 530 children, adolescents, and adults. Each line segment represents a single subject’s change from pre-training to post-training scores. The data are sorted by pre-training score. Improvement is indicated when the line segment rises above the pre-training value.

Those subjects with pre-treatment impulsivity scores less than two standard deviations below the mean (i.e., scores of 70 and below) improved more than 25 points in measures of inattention, F(1,92)=97.414, p<.001; and impulsivity, F(1,79)=107.451, p<.001. Improvement was less marked but still impressive in response time, F(1,60)=15.587, p<.001; and response variability, F(1,110)=80.249, p<.001 (see Figure 2). In all, EEG biofeedback training produced clinically significant improvement (i.e., half a standard deviation increase or more on one or more measures), in 75 % of all subjects, a value comparable to the approximately 70% response rate of psychostimulants (Cantwell, 1994; Barkley, 1990).

Figure 2. Pre- and post-treatment TOVA standard scores for all four dependent measures for subjects with pre-treatment deficits of two standard deviation or more below the mean.

Sixty-two subjects underwent an additional period of training after 20 sessions were completed. Understandably, these were individuals who had achieved only modest progress in 20 sessions. Impulsivity was found to improve from pre-treatment levels after 20 sessions and then continued to improve after 40 sessions. Response variability exhibited significant improvement only after 40 training sessions were completed (see Figure 3).

Figure 3. TOVA standard scores for 62 subjects at pre- treatment,
after 20 sessions, and after approximately 40 sessions.

METHOD
Efficacy of SMR-Beta Neurofeedback for Attentional Processes

David A. Kaiser and Siegfried Othmer
EEG Spectrum, Inc. Encino, CA
November 1997

Page 4 of 5
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DISCUSSION
The present study demonstrated the efficacy of SMR-beta neurofeedback in treating attentional deficiencies using an outcome study. Significant improvement was found for measures of inattention, impulse control, and consistency of response after approximately 20 training sessions. There was a systematic tendency toward improvement in attention, with the most significant improvements occurring where the pre-treatment test scores are in most severe deficit. More than three-quarters of all subjects in deficit improved on one or more measures, a response rate comparable with psychostimulant therapy for ADHD. Impulse control improved from a borderline functional level (a score of 85.5) prior to training to the population norm (98.9). When only those individuals with severe pre-treatment deficits in a measure were analyzed, significant improvement was seen in all measures. Inattention scores improved nearly two standard deviations in response to treatment. For those individuals who chose to continue treatment until 40 sessions (n=72), impulse control and response consistency continued to improve after 20 sessions.

Malone, Kershner, and Swanson (1994) proposed a neurochemical model to explain medical effects on ADHD, a model which holds promise for understanding the efficacy of EEG biofeedback according to the present protocols. Malone et al. (1994) elaborate a bi-hemispheric model of regulation of attention and arousal by Tucker and Williamson (1984). In this model, the dopaminergic system, linked to left hemisphere function, is involved in maintenance of tonic activation, of sustained attentional activity, sequencing, and motor planning; whereas the norepinephrine system, linked to right hemisphere function, is involved in phasic arousal, orientation to novelty, alertness, and shifts of attention in general. ADHD is postulated to result from dysregulation in this asymmetric neural control system for attention and arousal. This may consist of a failure of bihemispheric coordination of attentional processes, in particular due to lack of left hemisphere inhibitory control over the right hemisphere. ADHD is seen as generally characterized by dopamine-mediated under-activation at the left frontal cortical region, concurrent with norepinephrine-mediated overarousal at the right parietal region. Stimulant medication such as with methylphenidate is seen as impacting on both the dopamine and norepinephrine systems so as to restore them to regulatory balance.

The present study does not explicitly confirm the validity of this model, since the data were not derived by random assignment, and since subjects were not treated with only a single protocol. Moreover, the presence of comorbidities such as Tourette Syndrome, minor traumatic brain injury, Conduct Disorder, anxiety or depression, in our sample population has their own implications for protocol selection and thus the outcome for TOVA measures were often mixed, as shown in Figure 1. Declines in impulsivity measures were obtained in several instances. However, EEG biofeedback is the only intervention for ADHD which involves explicit hemispheric localization, and thus is specially suited for evaluating the Malone model. Future research on the specificity of EEG biofeedback protocols should shed further light on the mechanisms involved.

34.005008 -118.810089

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