Medications Are Effective For Quitting Smoking

By Alexandra Sifferlin

FABPHOTO / GETTY IMAGES

It’s a good thing that there are cessation methods that work, according to a recent review of 267 studies involving 101,804 people published in the Cochrane Library. The study offers hope to people who want to kick the habit: it shows currently licensed medications are effective.In the U.S., 68.8% of current adult smokers want to quit for good, according to the U.S. Centers For Disease Control and Prevention (CDC). Since 2002, the number of former smokers exceeds the number of current smokers in the U.S., but there’s still work to be done, with one in every five U.S. deaths credited to tobacco.

Currently there are three medications in the U.S. and Europe that are licensed to help smokers quit. These include nicotine replacement therapies (NRTs) like nicotine patches, gums and inhalers, the antidepressant drug bupropion and the drug varenicline. The goals of the medications are to curb the effects of nicotine in the brain.

Russia and other spots in Eastern Europe also have a widely used cessation drug called cytisine that is similar to the drug varenicline.

In the review, researchers looked at the success rates of the cessation medications compared to placebos. They defined success as an individual who stopped smoking for six months or more.

Based on the findings, all the drugs were successful at improving the odds for smokers who wanted to quit. Participants were 80% more likely to quit when using a single NRT or taking bupropion compared to those using a placebo. Those using varenicline as well as an NRT had two to three times greater odds.

Participants taking only varenicline had a 50% greater likelihood of successfully quitting compared to patients taking any NRT and experienced similar results to patients taking any combination of two NRTs. Although all the drugs are considered low-risk, the researchers say more safety information would be valuable for varenicline.

(MORE: Exercise Helps Young Smokers Quit)

“This review provides strong evidence that the three main treatments, nicotine replacement therapy, bupropion and varenicline, can all help people to stop smoking,” said lead researcher Kate Cahill of the Department of Primary Care Health Sciences at the University of Oxford in a statement. “Although cytisine is not currently licensed for smoking cessation in most of the world, these data suggest it has potential as an effective and affordable therapy.”

The review is encouraging for anyone trying to quit. Even though smoking cessation can be extremely difficult, studies show quitting can extend lives by up to 10 years. Other non-medication methods have also been found to help smokers stay on track to quit for good. For more information on the effects of smoking and how to quit, visit the CDC’s Tips From Former Smokers page here.

USSR's Old Domain Name Attracts Cybercriminals

USSR's Old Domain Name Attracts Cybercriminals

LISTED UNDER:RAPHAEL SATTER, Associated Press

MOSCOW (AP) — The Soviet Union disappeared from the map more than two d Employees of Moscow’s Group-IB, which is responsible for one of Russia’s two official Internet watchdogs, work in their laboratory in Moscow, Russia on Thursday, May 30, 2013. Figures supplied by Group-IB suggest that the number of malicious websites hosted across the Soviet Union’s old domain doubled in 2011 and doubled again in 2012, surpassing even the vast number of renegade sites on .ru and its newer Cyrillic-language counterpart. (AP Photo/Alexander Zemlianichenko)ecades ago. But online an 'e-vil empire' is thriving.

Security experts say the .su Internet suffix assigned to the USSR in 1990 has turned into a haven for hackers who've flocked to the defunct superpower's domain space to send spam and steal money.

Capitalist concerns, rather than Communist nostalgia, explain the move.

"I don't think that this is really a political thing," Oren David, a manager at security firm RSA's anti-fraud unit, said in a recent telephone interview. David noted that other obscure areas of the Internet, such as the .tk domain associated with the South Pacific territory of Tokelau, have been used by opportunistic hackers.

"It's all about business," he said.

David and others say scammers began to move to .su after the administrators of Russia's .ru space toughened their rules back in late 2011.

Group-IB, which runs one of Russia's two official Internet watchdogs, says that the number of malicious websites hosted across the Soviet Union's old domain doubled in 2011 and doubled again in 2012, surpassing even the vast number of renegade sites on .ru and its newer Cyrillic-language counterpart.

The Soviet domain has "lots of problems," Group-IB's Andrei Komarov said in a phone interview. "In my opinion more than half of cybercriminals in Russia and former USSR use it."

The most notorious site was Exposed.su, which purportedly published credit records belonging to President Barack Obama's wife, Michelle, Republican presidential challengers Mitt Romney and Donald Trump, and celebrities including Britney Spears, Jay Z, Beyonce and Tiger Woods. The site is now defunct.

Other Soviet sites are used to control botnets — the name given to the networks of hijacked computers used by criminals to empty bank accounts, crank out spam, or launch attacks against rival websites.

Internet hosting companies generally eliminate such sites as soon as they're identified. But Swiss security researcher Roman Huessy, whose abuse.ch blog tracks botnet control sites, said hackers based in Soviet cyberspace can operate with impunity for months at a time.

Asked for examples, he rattled off a series of sites actively involved in ransacking bank accounts or holding hard drives hostage in return for ransom — brazenly working in the online equivalent of broad daylight.

"I can continue posting this list for ages," he said via Skype.

The history of .su goes back to the early days of the Internet, when its architects were creating the universe of country code suffixes meant to mark out a website's nationality. Each code — like .fr for France or .ca for Canada — was meant to correspond to a country.

Some Cold War-era domain names — such as .yu for Yugoslavia or .dd for East Germany — evaporated after the countries behind them disappeared. But the .su domain survived the dissolution of the Soviet Union in 1991 and the creation of a .ru domain in 1994, resisting repeated attempts to wipe it from the Web because, unlike other defunct domains, those behind .su refused to pull the plug — on both commercial and patriotic grounds.

With more than 120,000 domains currently registered, mothballing .su now would be a messy operation.

"It's like blocking .com or .org," said Komarov. "Lots of legitimate domains are registered there."

Among them are stalin.su, which eulogizes the Soviet dictator and the English-language chronicle.su, an absurdist parody site.

But experts say many are fraudulent, and even the organization behind .su accepts it has a problem on its hands.

"We realize it's a threat for our image," said Sergei Ovcharenko, whose Moscow-based nonprofitFoundation for Internet Development took responsibility for .su in 2007.

Ovcharenko insisted that only a small number of .su sites are malicious, although he acknowledged that criminal sites can stay online for extremely long periods of time.

He said his hands were tied by weak Russian legislation and outdated terms of service. But he promised that stricter rules are on their way after months of legal leg work.

"We are almost there," he said. "This summer, we'll be rolling out our new policy."

Meanwhile .su has become an increasingly notorious corner of the Internet, an online echo of the evil empire moniker assigned to the Soviet Union by U.S. President Ronald Reagan 30 years ago.

David, the RSA manager, said the emergence of a Communist relic as a 21st century security threat was a bizarre blast from the past.

"I thought that the Berlin Wall and my grandma's borscht are the only remnants of the Soviet Union," he said. "I was wrong.
"

Teens with Social Anxiety Engage in Earlier Alcohol, Marijuana Use

TRACI PEDERSEN

Among teens with substance use disorders, those who also have socialanxiety disorder begin using marijuana at a mean age of 10.6 years — an average of 2.2 years earlier than teens without anxiety, according to a study conducted at Case Western Reserve University School of Medicine.

“This finding surprised us,” said principal investigator Alexandra Wang, a third-year medical student at the university. “It shows we need to start earlier with prevention of drug and alcohol use and treatment of social phobia [in children].”

The study involved 195 teens (102 girls, 52 percent), aged 14 to 18 years, who met the current diagnosis of substance use disorder and had received medical detoxification if needed.

Researchers assessed the teens’ history of drug and alcohol use and looked into whether they’d had any of three anxiety disorders: social anxiety disorder, panic disorder, and agoraphobia.

Marijuana was the most popular drug of choice.  Of the 195 participants, 92 percent had marijuana dependence, starting at a mean age of 13 years; 61 percent were alcohol-dependent, having started drinking at 13.5 years on average.

Teens with either social anxiety disorder or panic disorder were far more likely to have marijuana dependence, Wang said. Both of these disorders were more likely to occur before marijuana dependence.

Approximately 80 percent of teens with social anxiety disorder and 85 percent with panic disorder had symptoms of that disorder before the onset of their substance abuse.  Furthermore, panic disorder tended to start before alcohol dependence and occurred in 75 percent of alcohol-dependent adolescents.

There was no clear evidence showing whether agoraphobia came before or after either marijuana use or the first drink, according to the authors.

A limitation of the study, according to the research team, was that 128 (66 percent) of the teens were juvenile offenders who had received court-referred treatment for their substance abuse. These findings might not generalize to a less severely addicted population.

Still, interventions to reduce social anxiety might help prevent substance abuse in teens.

“We need to treat these young patients initially with nonpharmacologic means, such as cognitive behavioral therapy or mindfulness meditation,” said Christina Delos Reyes, M.D., a psychiatrist specializing in addictions at University Hospitals Case Medical Center.

Patrick Bordeaux, M.D., a child and adolescent psychiatrist in Quebec, Canada, said that “comorbidities tend to be the rule in adolescents, not the exception.”

“Adolescents are more likely to have social and mental disorders that make them more likely to use drugs,” said Bordeaux, who was not involved with the study.

Source:  Case Western Reserve University School of Medicine

Substance Use Tied to Overactive Brain Reward Areas

RICK NAUERT 

New research suggests overactivity of specific brain reward regions may cause an individual to have greater cravings for drugs.

Investigators from the Oregon Research Institute (ORI) used what they called a “reward surfeit model” to investigate if such heightened brain activity can cause individuals to develop food or drug addictions.

The results indicated that elevated responsivity of reward regions in the brain increased the risk for future substance use, which has never been tested before prospectively with humans.

However, results also provide evidence that even a limited history of substance use was related to less responsivity in the reward circuitry, as has been suggested by experiments with animals.

The research will appears in a future issue of the journal Biological Psychiatry.

The research team of Eric Stice, Ph.D., used functional magnetic resonance imaging (fMRI) to test whether individual differences in reward region responsivity predicted overweight/obesity onset among initially healthy weight adolescents.

Researchers also used fMRI to determine if differences in reward center responsivity influcenced substance use onset among initially abstinent adolescents.

The neural response to food and monetary reward was measured in 162 adolescents. Body fat and substance use were assessed at the time of the fMRI and again one year later.

“The findings are important because this is the first test of whether atypical responsivity of reward circuitry increases risk for substance use,” Stice said.

“Although numerous researchers have suggested that reduced responsivity is a vulnerability factor for substance use, this theory was based entirely on cross-sectional studies comparing substance abusing individuals to healthy controls; no studies have tested this thesis with prospective data.”

Investigators first examined the extent to which reward circuitry was activated in response to receipt and anticipated receipt of money.

Monetary reward is a general reinforcer and has been used frequently to assess reward sensitivity.

The team also used another paradigm to assess brain activation in response to the individual’s consumption and anticipated consumption of a chocolate milkshake. Results showed that greater activation in the brain region called the striatum during monetary reward receipt at baseline predicted future substance use onset over a one-year follow-up.

Investigators discovered that adolescents who had already begun using substances showed less brain response to monetary reward. This finding provides the first evidence that even a relatively short period of moderate substance use might reduce reward region responsivity.

“The implications are that the more individuals use psychoactive substances, the less responsive they will be to rewarding experiences, meaning that they may derive less reinforcement from other pursuits, such as interpersonal relationships, hobbies, and school work,” Stice said. “This may contribute to the escalating spiral of drug use that characterizes substance use disorders.”

Researchers did not find a similar reward system response for food. Investigators say that it is possible that these effects are weaker and that a longer follow-up period will be necessary to better differentiate who will gain weight and who will remain at a healthy weight.

Source: Oregon Research Institute

Greater Marijuana Use Linked to More Severe Schizophrenia

TRACI PEDERSEN

New research reveals thatschizophrenia patients with a history of cannabis use have longer hospital stays and a higher rate of hospital readmission.

They may also have a type of schizophrenia “that may be more severe than schizophrenia cases in general,” according to Peter Allebeck, M.D., Ph.D., professor of social medicine in the Department of Public Health Sciences at the Karolinska Institute in Stockholm, Sweden.

For the study, 50,087 male Swedish army recruits (ages 18 to 19 years) underwent medical assessments as well as structured interviews by psychologists, including questions on family and socioeconomic background, work, leisure activities, and use of alcohol, drugs, and tobacco.

At baseline, there were no statistically significant differences between cannabis users and nonusers in terms of psychiatric diagnoses.

Of the 50,087 participants, 5391 used cannabis. During follow-up, 350 patients were identified as having schizophrenia, and of these, 58 used cannabis.

At first admission for schizophrenia, the only schizophrenia subtype showing a difference was paranoid schizophrenia, for which cannabis users had a lower rate compared with nonusers.

The length of stay during the first hospital admission was almost twice as long for users as for nonusers (59 days vs 30 days). One third of users (34 percent) required more than 90 days, whereas only 20 percent of nonusers were hospitalized that long on first admission.

Similarly, cannabis users had a median of 10 readmissions compared to 4 readmissions for nonusers. Nearly a third of the cannabis users had more than 20 readmissions — 29 percent of users vs 10 percent of nonusers.

“Those who had schizophrenia after cannabis use had many more hospital days…more than a third [38 percent] of those who had cannabis use had more than 2 years in total in hospital stay” compared with 21 percent of nonusers, said Allebeck. The median number of hospital days was 547 for cannabis users and 184 for nonusers.

After controlling for socioeconomic factors, personality disorders, IQ, and other factors associated with cannabis use, “there was more than three-fold increased risk of such long hospital days among cannabis users,” said Allebeck.

“The number of readmissions is also about three-fold increased of those with many readmissions after the first admission for schizophrenia,” he said.

“Schizophrenia caused by or contributed by cannabis may be more severe than schizophrenia in general,” he concluded.

“Patients with cannabis history seem to have more severe and more persistent history of schizophrenia, as indicated by duration of first admission, total duration of hospital days, number of readmissions. And these of course are true measures of severity and prognosis.”

The findings were reported at EPA 2013: 21st European Congress of Psychiatry.

Source:  21st European Congress of Psychiatry

10 Tips to Mend a Broken Heart

By THERESE J. BORCHARD

Bess Myerson once wrote that “to fall in love is awfully simple, but to fall out of love is simply awful.” Especially if you are the one who wanted the relationship to last.
Mending a broken heart is never easy. There is no quick way to stop your heart from hurting so much.
To stop loving isn’t an option. Author Henri Nouwen writes, “When those you love deeply reject you, leave you, or die, your heart will be broken. But that should not hold you back from loving deeply. The pain that comes from deep love makes your love ever more fruitful.”
But how do we get beyond the pain? Here are 10 tips I’ve gathered from experts and from conversations with friends on how they patched up their heart and tried, ever so gradually, to move on.
1. Go through it, not around it.
I realize the most difficult task for a person with a broken heart is to stand still and feel the crack. But that is exactly what she must do. Because no shortcut is without its share of obstructions. Here’s a simple fact: You have to grieve in order to move on. During the 18 months of my severe depression, my therapist repeated almost every visit: “Go through it. Not around it.” Because if I went around some of the issues that were tearing me apart inside, then I would bump into them somewhere down the line, just like being caught in the center of a traffic circle. By going through the intense pain, I eventually surfaced as a stronger person ready to tackle problems head on. Soon the pain lost its stronghold over me.

2. Detach and revel in your independence again.
Attempting to fill the void yourself — without rushing to a new relationship or trying desperately to win your lover back — is essentially what detaching is all about. The Buddha taught that attachment that leads to suffering. So the most direct path to happiness and peace is detachment. In his book, Eastern Wisdom for Western Minds, Victor M. Parachin tells a wonderful story about an old gardener who sought advice from a monk. Writes Parachin:

“Great Monk, let me ask you: How can I attain liberation?” The Great Monk replied: “Who tied you up?” This old gardener answered: “Nobody tied me up.” The Great Monk said: “Then why do you seek liberation?”

One of the most liberating thoughts I repeat to myself when I’m immersed in grief and sadness is this: I don’t need anyone or anything to make me happy. When I’m experiencing the intense pangs of grief, it is so difficult to trust that I can be whole without that person in my life. But I have learned over and over again that I can. I really can. It is my job to fill the emptiness, and I can do it… creatively, and with the help of my higher power.
3. List your strengths.
As I wrote in my “12 Ways to Keep Going” post, a technique that helps me when I feel raw and defeated to try anymore is to list my strengths. I say to myself, “Self, you have been sober for 20 years!! Weaklings can’t pull off that! And here you are, alive, after those 18 months of intense suicidal thoughts. Plus you haven’t smoked a cigarette since that funeral back in December of last year!” I say all of that while listening to the “Rocky” soundtrack, and by the last line, I’m ready to tackle my next challenge: move on from this sadness and try to be a productive individual in this world. If you can’t list your strengths, start a self-esteem file. Click here to learn how you build one.
4. Allow some fantasizing.
Grief wouldn’t be the natural process that it should be without some yearning for the person you just lost. Dr. Christine Whelan, who writes the “Pure Sex, Pure Column” on BustedHalo.com, explains the logic of allowing a bit of fantasy. She writes:

If you are trying to banish a sexual fantasy from your head, telling yourself “I’m not going to fantasize about her” or “I won’t think about what it would be like to be intimate with him” might make it worse… In a famous psychological study from the 1980s, a group of subjects were told to think about anything but whatever they did, they were not supposed to think about a white bear. Guess what they all thought about? [A white bear.]

5. Help someone else.
When I’m in pain, the only guaranteed antidote to my suffering is to box up all of my feelings, sort them, and then try to find a use for them. That’s why writing Beyond Blue contributes a big chunk to my recovery, why moderating Group Beyond Blue has me excited to wake up every day. When you turn your attention to another person — especially someone who is struggling with the same kind of pain — you forget about yourself for a split moment. And let’s face it, that, on some days, feels like a miracle.
6. Laugh. And cry.
Laughter heals on many levels as I explain in my “9 Ways Humor Heals” post, and so does crying. You think it’s just a coincidence that you always feel better after a good cry? Nope, there are many physiological reasons that contribute to the healing power of tears. Some of them have been documented by biochemist William Frey who has spent 15 years as head of a research team studying tears. Among their findings is that emotional tears (as compared to tears of irritation, like when you cut an onion) contain toxic biochemical byproducts, so that weeping removes these toxic substances and relieves emotional stress. So go grab a box of Kleenex and cry your afternoon away.
7. Make a good and bad list.
You need to know which activities will make you feel good, and which ones will make you want to toilet paper your ex-lover’s home (or apartment). You won’t really know which activity belongs on which list until you start trying things, but I suspect that things like checking out his wall on Facebook and seeing that he has just posted a photo of his gorgeous new girlfriend is not going to make you feel good, so put that on the “don’t attempt” list, along with e-mails and phone calls to his buddies fishing for information about him. On the “feels peachy” list might be found such ventures as: deleting all of his e-mails and voicemails, pawning off the jewelry he gave you (using the cash for a much-needed massage?), laughing over coffee with a new friend who doesn’t know him from Adam (to ensure his name won’t come up).
8. Work it out.
Working out your grief quite literally — by running, swimming, exercising, walking, or kick-boxing — is going to give you immediate relief. On a physiological level — because exercise increases the activity of serotonin and/or norepinehrine and stimulates brain chemicals that foster growth of nerve cells — but also on an emotional level, because you are taking charge and becoming the master of your mind and body. Plus you can visualize the fellow who is responsible for your pain and you can kick him in the face. Now doesn’t that feel good?
9. Create a new world.
This is especially important if your world has collided with his, meaning that mutual friends who have seen him in the last week feel the need to tell you about it. Create your own safe world — full of new friends who wouldn’t recognize him in a crowd and don’t know how to spell his name — where he is not allowed to drop by for a figurative or literal surprise visit. Take this opportunity to try something new — scuba diving lessons, an art class, a book club, a blog — so to program your mind and body to expect a fresh beginning… without him (or her).
10. Find hope.
There’s a powerful quote in the movie The Tale of Despereaux that I’ve been thinking about ever since I heard it: “There is one emotion that is stronger than fear, and that is forgiveness.” I suppose that’s why, at my father’s deathbed, the moment of reconciliation between us made me less scared to lose him. But forgiveness requires hope: believing that a better place exists, that the aching emptiness experienced in your every activity won’t be with you forever, that one day you’ll be excited to make coffee in the morning or go to a movie with friends. Hope is believing that the sadness can evaporate, that if you try like hell to move on with your life, your smile won’t always be forced. Therefore in order to forgive and to move past fear, you need to find hope.

And remember to love again…

Once our hearts are bruised and burned from a relationship that ended, we have two options: we can close off pieces of our heart so that one day no one will be able to get inside. Or we can love again. Deeply, just as intensely as we did before. Henri Nouwen urges to love again because the heart only expands with the love we are able to pour forth. He writes:

The more you have loved and have allowed yourself to suffer because of your love, the more you will be able to let your heart grow wider and deeper. When your love is truly giving and receiving, those whom you love will not leave your heart even when they depart from you. The pain of rejection, absence, and death can become fruitful. Yes, as you love deeply the ground of your heart will be broken more and more, but you will rejoice in the abundance of the fruit it will bear.

Signs of Emotional Abuse

By MARIA BOGDANOS 

Emotional abuse is elusive. Unlike physical abuse, the people doing it and receiving it may not even know it’s happening.
It can be more harmful than physical abuse because it can undermine what we think about ourselves. It can cripple all we are meant to be as we allow something untrue to define us. Emotional abuse can happen between parent and child, husband and wife, among relatives and between friends.
The abuser projects their words, attitudes or actions onto an unsuspecting victim usually because they themselves have not dealt with childhood wounds that are now causing them to harm others.

In the following areas, ask these questions to see if you are abusing or being abused:

1. Humiliation, degradation, discounting, negating. judging, criticizing:
   • Does anyone make fun of you or put you down in front of others?
   • Do they tease you, use sarcasm as a way to put you down or degrade you?
   • When you complain do they say that “it was just a joke” and that you are too sensitive?
   • Do they tell you that your opinion or feelings are “wrong?”
   • Does anyone regularly ridicule, dismiss, disregard your opinions, thoughts, suggestions, and feelings?
2. Domination, control, and shame:
   • Do you feel that the person treats you like a child?
   • Do they constantly correct or chastise you because your behavior is “inappropriate?”
   • Do you feel you must “get permission” before going somewhere or before making even small decisions?
   • Do they control your spending?
   • Do they treat you as though you are inferior to them?
   • Do they make you feel as though they are always right?
   • Do they remind you of your shortcomings?
   • Do they belittle your accomplishments, your aspirations, your plans or even who you are?
   • Do they give disapproving, dismissive, contemptuous, or condescending looks, comments, and behavior?
3. Accusing and blaming, trivial and unreasonable demands or expectations, denies own shortcomings:
   • Do they accuse you of something contrived in their own minds when you know it isn’t true?
   • Are they unable to laugh at themselves?
   • Are they extremely sensitive when it comes to others making fun of them or making any kind of comment that seems to show a lack of respect?
   • Do they have trouble apologizing?
   • Do they make excuses for their behavior or tend to blame others or circumstances for their mistakes?
   • Do they call you names or label you?
   • Do they blame you for their problems or unhappiness?
   • Do they continually have “boundary violations” and disrespect your valid requests?
4. Emotional distancing and the “silent treatment,” isolation, emotional abandonment or neglect:
   • Do they use pouting, withdrawal or withholding attention or affection?
   • Do they not want to meet the basic needs or use neglect or abandonment as punishment?
   • Do they play the victim to deflect blame onto you instead of taking responsibility for their actions and attitudes?
   • Do they not notice or care how you feel?
   • Do they not show empathy or ask questions to gather information?
5. Codependence and enmeshment:
   • Does anyone treat you not as a separate person but instead as an extension of themselves?
   • Do they not protect your personal boundaries and share information that you have not approved?
   • Do they disrespect your requests and do what they think is best for you?
   • Do they require continual contact and haven’t developed a healthy support network among their own peers?