Tuesday, February 23, 2016

For Mark Willenbring, Substance Abuse Treatment Begins With Research

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Dr. Mark Willenbring at his Alltyr outpatient clinic for substance abuse in St. Paul. CreditDavid Bowman for The New York Times
On the rainy fall morning of their first appointment, Dr. Mark Willenbring, a psychiatrist, welcomed a young web designer into his spacious office with a firm handshake and motioned for him to sit. The slender 29-year-old patient, dressed in a plaid shirt, jeans and a baseball cap, slouched into his chair and began pouring out a story of woe stretching back a dozen years.
Addicted to heroin, he had tried more than 20 traditional faith- and abstinence-based rehabilitation programs. In 2009, a brother died of an OxyContin overdose. Last summer, he attempted suicide by swallowing a fistful of Xanax. When he woke up to find he was still alive, he overdosed on heroin.
At a boot camp for troubled teenagers, he said, staffers beat him and withheld food. After he refused to climb a mountain in a team-buildingexercise, they strapped him to a gurney and dragged him up themselves.
The young man in the psychiatrist’s office paused, tears sliding down his cheeks.
“Sounds like a prison camp,” Dr. Willenbring said softly, leaning forward in his chair to pass a box of tissues.
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He began explaining the neuroscience of alcohol and drug dependence, 60 percent of which, he said, is attributable to a person’s genetic makeup. Listening intently, the young patient seemed relieved at the idea that his previous failures in rehab might reflect more than a lack of will.
Dr. Willenbring, 66, has repeated this talk hundreds of times. But while scientifically unassailable, it is not what patients usually hear at addiction treatment centers.
Rehabilitation programs largely adhere to the 12-step principles of the 80-year-old Alcoholics Anonymous and its offshoot, Narcotics Anonymous. Addicts have a moral and spiritual defect, they are told; they must abstain from alcohol and drugs and surrender to a higher power to escape substance abuse.

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Friday, February 19, 2016

China finds restaurants using opium poppies in food

  • 22 January 2016
  •  
  • From the sectionChina
Huda Restaurant in Beijing. 22 Jan 2016Image copyrightAP
Image captionThe Huda Restaurant in Beijing says it may have unknowingly bought illegal seasoning
Thirty-five restaurants across China have been found illegally using opium poppies as a seasoning, officials have revealed.
Five are being prosecuted while 30 are under investigation, the China Food and Drug Administration said.
Local authorities are being urged to help investigators find the sources of the poppies, the China Daily reported.
Poppy powder, which contains low amounts of opiates, is banned as a food additive in China.
However, restaurants have previously been caught using it.
In 2012, seven restaurants in Ningxia province were closed for using opium poppies and in Guizhou province in 2004 authorities shut down 215 establishments for similar offences.
One of the businesses affected by the latest crackdown is reported to be the popular Huda Restaurant chain in Beijing.
General manager Hu Ling confirmed the company was under investigation and said it may have unwittingly bought seasoning contaminated with opiates. She declined to comment further.
China has been hit by a series of food scandals in recent years.
In 2014 a Shanghai-based supplier was found to have sold unsanitary and expired chicken meat to food chains including KFC, Starbucks and McDonald's.
In 2008, six children died and more than 300,000 were made ill from milk powder contaminated with melamine, an industrial chemical used to make plastics and fertiliser.
Article found by Jane Wang

Wednesday, February 17, 2016

A Parasite, Leopards, and a Primate’s Fear and Survival

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A leopard in Moremi National Park in Botswana. Leopards are a predator of chimpanzees.CreditFrancois Savigny/Minden Pictures
Many of our primate ancestors probably ended up in the bellies of big cats. How else to explain bite marks on the bones of ancient hominins, the apparent gnawing of leopards or other African felines?
Big cats still pose a threat to primates. In one study of chimpanzees in Ivory Coast, for example, scientists estimated that each chimp ran a 30 percent risk of being attacked by a leopard every year.
new study suggests that the big cats may be getting some tiny help on the hunt. A parasite infecting the brains of some primates, including perhaps our forebears, may make them less wary.
What does the parasite get out of it? A ride into its feline host.
The parasite is Toxoplasma gondii, a remarkably successful single-celled organism. An estimated 11 percent of Americans have dormant Toxoplasma cysts in their brains; in some countries, the rate is as high as 90 percent. Infection with the parasite poses a serious threat to fetuses and to people with compromised immune systems. But the vast majority of those infected appear to show no serious symptoms. Their healthy immune systems keep the parasite in check.
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Mammals and birds can also be infected. But cats in particular play a crucial part in the life cycle of the parasite: When a cat eats an infected animal, Toxoplasma gondii ends up in its gut. It reproduces there, generating offspring called oocysts that are shed in the cat’s feces. The oocysts can last for months in the environment, where they can be taken up by new hosts.
In the 1990s, scientists discovered that mice and rats infected with Toxoplasma gondii lose their natural fear of cat odors — and in some cases even appear to become attracted to them. It was possible, researchers speculated, that the parasite had evolved an ability to influence the behavior of its rodent hosts, to raise the chances they might be eaten by cats.
Subsequent studies have shown that the parasite can change the wiring of fear-related regions of the rat brain. Robert M. Sapolsky, a biologist at Stanford University, said that these findings led many researchers to see Toxoplasma gondii as a parasite exquisitely adapted to rodents. According to this view, he said, “Toxo being able to infect a zillion nonrodent species is just some sort of irrelevant evolutionary dead end.”
Even so, Toxoplasma gondii can cause intriguing changes in our brains as well. In a 2015 study, for example, researchers found that women infected with the parasite are more aggressive than those without it; infected men behave more impulsively than parasite-free men.
Clémence Poirotte, an evolutionary biologist at the Center for Functional and Evolutionary Ecology in Montpellier, France, wondered if our understanding of Toxoplasma might be limited by the paltry number of species in which its manipulations had been studied. She and her colleagues decided to focus on chimpanzees, running an experiment on 33 apes at a primate research center in Gabon, nine of which had Toxoplasma infections.
Instead of testing the reactions of chimpanzees to the odor of house cats, Ms. Poirotte and her colleagues turned to leopards, their natural predators. A veterinarian at a Gabon zoo supplied them with leopard urine, and they poured drops of it on the fence enclosing the space in which the chimpanzees lived.
Stepping back from the fence, the scientists observed the apes to see how they responded. They also ran the same experiment with urine from three species that are not chimpanzees’ natural predators: humans, lions and tigers.
Sometimes, the chimpanzees would approach the fence and investigate the smell; other times, they would ignore it. Ms. Poirotte and her colleagues found that chimpanzees not infected with Toxoplasma investigated the smell of leopard urine less than the smell of humans.
That’s the sort of behavior you would expect if the smell of leopard urine alarmed the chimpanzees — a healthy instinct that could keep them out of leopard territory and reduce their chances of getting killed.
The Toxoplasma-infected chimpanzees, on the other hand, checked out the leopard urine more often than that of humans, not less. They appeared to have developed the same recklessness observed in Toxoplasma-infected rodents.
“It’s so interesting to see that Toxo seems to have evolved the same manipulation ability in an ape with respect to its natural feline predator,” said Dr. Sapolsky, who was not involved in the new study.
Other experts were also intrigued by the report. But Michael B. Eisen, a biologist at the University of California, Berkeley, said he didn’t think it was powerful enough to rule out other explanations for how the chimpanzees behaved.
There might be innate differences in how the chimpanzees respond to odors, for example, that have nothing to do with being infected with Toxoplasma. “I’d have to file this, at best, in the ‘interesting but nowhere near convincing’ file,” Dr. Eisen said.
Ms. Poirotte acknowledged that it might be possible to tease apart these different possibilities by testing the chimpanzees before and after being infected with Toxoplasma. That would be a very challenging experiment to set up, however.
But the current study provided another piece of evidence that the parasite really was manipulating the chimpanzees. “It works only with leopard urine, and not with other felines which aren’t their natural predator,” Ms. Poirotte said.
That’s the kind of precision you’d expect from a parasite that has evolved a strategy for getting into one particular animal. “It’s so specific that it suggests it’s Toxoplasma causing the behavior modification,” Ms. Poirotte said.
She added that it would be useful now to study Toxoplasma’s effects on other primate species. It may even turn out that our primate ancestors were once the primary targets of the parasite.
When domesticated cats emerged several thousand years ago, the parasite might have expanded into a new host population that favored rodents rather than primates.
“It certainly suggests that Toxo’s behavioral effects in humans may be less of an irrelevant dead end than was always assumed,” Dr. Sapolsky said.

Tuesday, February 16, 2016

Tasked With Combating Opium, Afghan Officials Profit From It


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Afghan farmers harvested poppies last spring in the Nad Ali district of Helmand Province.CreditBryan Denton for The New York Times
GARMSIR, Afghanistan — The United States spent more than $7 billion in the past 14 years to fight the runaway poppy production that has made Afghan opium the world’s biggest brand. Tens of billions more went to governance programs to stem corruption and train a credible police force. Countless more dollars and thousands of lives were lost on the main thrust of the war: to put the Afghan government in charge of district centers and to instill rule of law.
But here in one of the few corners of Helmand Province that is peaceful and in firm government control, the green stalks and swollen bulbs of opium were growing thick and high within eyeshot of official buildings during the past poppy season — signs of a local narco-state administered directly by government officials.
In the district of Garmsir, poppy cultivation not only is tolerated, but is a source of money that the local government depends on. Officials have imposed a tax on farmers practically identical to the one the Taliban use in places they control.
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The Opium War
This is the first article of a two-part series examining the fight to control the Afghan drug trade.
    Some of the revenue is kicked up the chain, all the way to officials in Kabul, the capital, ensuring that the local authorities maintain support from higher-ups and keeping the opium growing. And Garmsir is just one example of official involvement in the drug trade.
    Multiple visits to Afghan opium country over the past year, and extensive interviews with opium farmers, local elders, and Afghan and Western officials, laid bare the reality that even if the Western-backed government succeeds, the opium seems here to stay.
    More than ever, Afghan government officials have become directly involved in the opium trade, expanding their competition with the Taliban beyond politics and into a struggle for control of the drug traffic and revenue. At the local level, the fight itself can often look like a turf war between drug gangs, even as American troops are being pulled back into the battle on the government’s behalf, particularly in Helmand, in southern Afghanistan.
    “There are phases of government complicity, starting with accommodation of the farmers and then on to cooperation with them,” said David Mansfield, a researcher who conducted more than 15 years of fieldwork on Afghan opium. “The last is predation, where the government essentially takes over the business entirely.”
    The huge boom in poppy production that began a dozen years ago was strongly identified with the new Taliban insurgency, as the means through which the militants bought their bullets, bombs and vehicles. In recent years, the insurgents have committed more and more working hours to every facet of the opium business. That fact was built into a mantra of Western officials in Afghanistan: When security improves, opium will be easier to take down.
    That the Afghan government is now also competing in the opium business, in the absence of other reliable economic successes, has ramifications beyond the nation’s borders. Governments across the region are struggling with the health and security problems brought by the increased opium flow. And as the trade becomes more institutionalized in Afghanistan, it has undercut years of anticorruption efforts, perpetuating its status as a source of regional instability, crime and intrigue.
    An Entrenched Process
    The administration of President Ashraf Ghani has made fighting corruption a central promise. A spokesman for his government, asked about official involvement in opium trafficking, including in Garmsir, insisted that there was “zero tolerance” for such behavior. “The president has been decisive in acting on information that indicates involvement of government officials in illegal acts, including taxation of opium,” said the spokesman, Sayed Zafar Hashemi.
    But in Garmsir and other places in the Helmand opium belt, the system is firmly in place and remarkably consistent.
    It relies on a network of village leaders and people employed by farmers to manage the water supply, men known as mirabs. These men survey the land under cultivation and collect money on behalf of officials, both in district-level government and in Kabul.
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    Washir
    HELMAND
    RIVER VALLEY
    Agricultural areas
    HELMAND
    PROVINCE
    Nad Ali
    Loy Bagh
    Kandahar
    Lashkar
    Gah
    Marja
    ARGHANDAB
    RIVER VALLEY
    Kabul
    AFGHANISTAN
    Helmand
    River
    KANDAHAR
    PROVINCE
    Detail
    Garmsir
    20 Miles
    HELMAND
    The connections run deeply into the national government, officials acknowledge privately. In some cases, the money is passed up to senators or assembly members with regional connections. In others, employees in the Independent Directorate of Local Governance, the agency that oversees provincial and district governments, pocket the payoffs, officials said. Some of the most important regional police and security commanders, including allies of American military and intelligence officials, are closely identified with the opium trade.
    But the real money often stays local, with provincial and district officials. In the case of Garmsir, the district governor and police chief reaped the largest share of the rewards, according to local officials and farmers. The local police were also included in the profits.
    Farmers said they paid about $40 for each acre of poppies under cultivation. In 2015, that meant nearly $3 million in payments from the district of Garmsir alone, according to officials familiar with the process.
    Garmsir is just one of several districts in Helmand Province, the heart of poppy country and the center of the 2010 American troop “surge,” where the government has built local opium alliances with farmers. The district of Marja has a system similar to the one in Garmsir, in which locals pay a flat rate based on how much poppy they grow, according to interviews with more than a dozen farmers and officials. In the district of Nad Ali, the same conditions exist to a lesser extent.
    That the Taliban have closed in on some of those districts in recent weeks will mean little to the local growers. They paid their tax to the insurgents before the American troop surge and to the government after it. They will adjust again.
    And the money to be made is only increasing. Already, experts say, satellite imagery from the past growing season across southern Helmand showed that opium cultivation was occurring openly within sight of military and police bases.
    “Over the years, I have seen the central government, the local government and the foreigners all talk very seriously about poppy,” said Hakim Angar, a former two-time police chief of Helmand Province. “In practice, they do nothing, and behind the scenes, the government makes secret deals to enrich themselves.”
    Lucrative Arrangements
    By the most basic metric, the international effort to curb poppy production in Afghanistan has failed. More opium was cultivated in 2014, the last year of the NATO combat mission, than in any other year since the United Nations began keeping records in 2002.
    If there was a bright spot in 2015, it was that a poppy fungus or weevil reduced the harvest by as much as half in some places. But the lower production is likely to mean even more desperate attempts to increase cultivation next year, if the past is any guide.
    Photo
    Opium poppies in Garmsir, a district of Helmand Province.CreditBryan Denton for The New York Times
    Highlighting the efficiency of the government poppy tax, officials in Marja decided this year to halve it from the year before — precisely the proportion of the harvest that the fungus blighted.
    “In the case of the opium trade, they try harder,” said one counternarcotics law enforcement official in southern Afghanistan. “There’s just too much money to ignore it.”
    Government complicity in the opium trade is not new. Power brokers, often working for the government, have long operated behind the scenes, producing, refining and smuggling opium or heroin across one of the many porous borders of Afghanistan. That kind of corruption has been seen nationwide.
    Taxation on a districtwide level in the main opium-growing centers, however, has been less common. Most who spoke about it did so on the condition of anonymity, fearing reprisals. Those who spoke openly tended to have enough resources to deter official blowback.
    “Of course it happens here,” said a local police commander in Marja, Baz Gul, who oversees a few dozen men and was one of the residents who first took up arms against the Taliban. “But the police chief, the local police commander, they don’t take the money directly. They do it through influential figures.”
    As it happens, Marja — one of the most violent districts during the 2010 troop surge, and the site of pitched battles recently between the Taliban and Afghan forces backed by American Special Operations troops — is a case study in opium economics.
    One elder in Marja, who collects money from villagers who cultivate poppy in his block of 44 acres, said poppy was simply too alluring to ignore. Even with the tax, even with the blight, opium outstripped the next most lucrative crop by a ratio of more than three to one.
    In 2015, the elder said, the group’s earnings came close to $62,000, less than half as much as the year before. With a tax of $60 per acre, the final profit for all 44 acres was roughly $59,000. By comparison, the average income for an Afghan, according to the World Bank, is $681 a year.
    “Most other crops would have earned about $20,000 for 44 acres,” said the elder, seated in the home of another tribal elder in Marja. A dozen men arrayed in the room nodded quietly at his accounting.
    Blight and Turbulence
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    The district of Nad Ali, a short drive from the provincial capital, Lashkar Gah, appears less organized than Garmsir or Marja. In April, on a drive through open farmland in government-controlled areas, much of the poppy crop had been plowed through because of an early harvest or because the plants were so disease-ridden that the farmers saw no point in keeping them standing.
    Farmers in Nad Ali said tax collection depended on a number of factors, including one’s relationship with the local police commander, proximity to the district center and how badly crops were hurt by disease. In some cases, the teams sent by the government to eradicate crops collected the funds. In others, it was the local or national police.
    Payments ranged from about $90 to $100 for every acre, according to six farmers.
    “All of our poppies were disease-affected,” said one farmer in the Loy Bagh area of Nad Ali. “What people paid depended on how much they cultivated and how much was destroyed by the disease.”
    The system in Garmsir, however, appears to leave little to chance. The district, farther from the provincial capital than Marja or Nad Ali, enjoys more autonomy than most under government control.
    Interviews conducted in mid-March, before the blight appeared, showed a system of accommodation that was settling in comfortably. While farmers were not happy about paying the government, most saw it as inevitable and noted that the profit margin for opium was still considerably better than for wheat or cotton.
    “We understand that the officials will charge us money,” said Juma Khan, a 35-year-old farmer in Garmsir, shrugging.
    The system ran into turbulence in the spring, when two members of Parliament caught wind of the arrangement. After their demand for a cut of the profits was rebuffed, they went public, according to Afghan officials familiar with the case.
    Officials in Kabul quickly fired the district governor, police chief and intelligence director, who were accused of dividing the profits. In a small ceremony, the Helmand deputy governor returned wads of cash to cheering farmers outside the provincial governor’s offices and promised to crack down on such exploitation.
    Officials said that all of the money had been returned to farmers and that the responsible parties had been removed from power. But neither promise was entirely true.
    The governor of Garmsir — who, in an interview, denied that he had created or collected any tax — was quietly moved to Washir, a neighboring district. Months later, he was moved back to Garmsir, where he has returned to his old job. Government officials in Kabul said he had been cleared of wrongdoing after a thorough investigation.
    A later visit to Garmsir unearthed a second inconsistency: Farmers said they had received only half of their money back. Still, that was something of a rebate. After all, they had lost nearly half of their crop to blight.