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How psilocybin, the psychedelic in mushrooms, may rewire the brain to ease depression, anxiety and more | CNN

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CNN
—

Shrooms, Alice, tweezes, mushies, hongos, pizza toppings, magic mushrooms — everyday lingo for psychedelic mushrooms seems to grow with each generation. Yet leading mycologist Paul Stamets believes it’s time for fans of psilocybin mushrooms to leave such childish slang behind.

“Let’s be adults about this. These are no longer ‘shrooms.’ These are no longer party drugs for young people,” Stamets told CNN. “Psilocybin mushrooms are nonaddictive, life-changing substances.”

Small clinical trials have shown that one or two doses of psilocybin, given in a therapeutic setting, can make dramatic and long-lasting changes in people suffering from treatment-resistant major depressive disorder, which typically does not respond to traditional antidepressants.

Based on this research, the US Food and Drug Administration has described psilocybin as a breakthrough medicine, “which is phenomenal,” Stamets said.

Psilocybin, which the intestines convert into psilocin, a chemical with psychoactive properties, is also showing promise in combating cluster headaches, anxiety, anorexia, obsessive-compulsive disorder and various forms of substance abuse.

“The data are strong from depression to PTSD to cluster headaches, which is one of the most painful conditions I’m aware of,” said neurologist Richard Isaacson, director of the Alzheimer’s Prevention Clinic in the Center for Brain Health at Florida Atlantic University.

“I’m excited about the future of psychedelics because of the relatively good safety profile and because these agents can now be studied in rigorous double-blinded clinical trials,” Isaacson said. “Then we can move from anecdotal reports of ‘I tripped on this and felt better’ to ‘Try this and you will be statistically, significantly better.’ “

Classic psychedelics such as psilocybin and LSD enter the brain via the same receptors as serotonin, the body’s “feel good” hormone. Serotonin helps control body functions such as sleep, sexual desire and psychological states such as satisfaction, happiness and optimism.

People with depression or anxiety often have low levels of serotonin, as do people with post-traumatic stress disorder, cluster headaches, anorexia, smoking addiction and substance abuse. Treatment typically involves selective serotonin reuptake inhibitors, or SSRIs, which boost levels of serotonin available to brain cells. Yet it can take weeks for improvement to occur, experts say, if the drugs even work at all.

With psychedelics such as psilocybin and LSD, however, scientists can see changes in brain neuron connectivity in the lab “within 30 minutes,” said pharmacologist Brian Roth, a professor of psychiatry and pharmacology at the University of North Carolina at Chapel Hill.

“One of the most interesting things we’ve learned about the classic psychedelics is that they have a dramatic effect on the way brain systems synchronize, or move and groove together,” said Matthew Johnson, a professor in psychedelics and consciousness at Johns Hopkins Medicine.

“When someone’s on psilocybin, we see an overall increase in connectivity between areas of the brain that don’t normally communicate well,” Johnson said. “You also see the opposite of that – local networks in the brain that normally interact with each other quite a bit suddenly communicate less.”

It creates a “very, very disorganized brain,” ultimately breaking down normal boundaries between the auditory, visual, executive and sense-of-self sections of the mind – thus creating a state of “altered consciousness,” said David Nutt, director of the Neuropsychopharmacology Unit in the Division of Brain Sciences at Imperial College London.

And it’s that disorganization that is ultimately therapeutic, according to Nutt: “Depressed people are continually self-critical, and they keep ruminating, going over and over the same negative, anxious or fearful thoughts.

“Psychedelics disrupt that, which is why people can suddenly see a way out of their depression during the trip,” he added. “Critical thoughts are easier to control, and thinking is more flexible. That’s why the drug is an effective treatment for depression.”

There’s more. Researchers say psychedelic drugs help neurons in the brain sprout new dendrites, which look like branches on a tree, to increase communication between cells.

“These drugs can increase neuronal outgrowth, they can increase this branching of neurons, they can increase synapses. That’s called neuroplasticity,” Nutt said.

That’s different from neurogenesis, which is the development of brand-new brain cells, typically from stem cells in the body. The growth of dendrites helps build and then solidify new circuits in the brain, allowing us to, for example, lay down more positive pathways as we practice gratitude.

“Now our current thinking is this neuronal outgrowth probably doesn’t contribute to the increased connectivity in the brain, but it almost certainly helps people who have insights into their depression while on psilocybin maintain those insights,” Nutt said.

“You shake up the brain, you see things in a more positive way, and then you lay down those positive circuits with the neuroplasticity,” he added. “It’s a double whammy.”

Interestingly, SSRIs also increase neuroplasticity, a fact that science has known for some time. But in a 2022 double-blind phase 2 randomized controlled trial comparing psilocybin to escitalopram, a traditional SSRI, Nutt found the latter didn’t spark the same magic.

“The SSRI did not increase brain connectivity, and it actually did not improve well-being as much as psilocybin,” Nutt said. “Now for the first time you’ve got the brain science lining up with what patients say after a trip: ‘I feel more connected. I can think more freely. I can escape from negative thoughts, and I don’t get trapped in them.’ “

Taking a psychedelic doesn’t work for everyone, Johnson stressed, “but when it works really well it’s like, ‘Oh my god, it’s a cure for PTSD or for depression.’ If people really have changed the way their brain is automatically hardwired to respond to triggers for anxiety, depression, smoking — that’s a real thing.”

How long do results last? In studies where patients were given just one dose of a psychedelic “a couple of people were better eight years later, but for the majority of those with chronic depression it creeps back after four or five months,” Nutt said.

“What we do with those people is unknown,” he added. “One possibility is to give another dose of the psychedelic — we don’t know if that would work or not, but it might. Or we could put them on an SSRI as soon as they’ve got their mood improved and see if that can hold the depression at bay.

“There are all sorts of ways we could try to address that question,” Nutt said, “but we just don’t know the answer yet.”

The mycelium, or rootlike structure, of Lion's mane mushroom is part of the

Stamets, who over the last 40 years has discovered four new species of psychedelic mushrooms and written seven books on the topic, said he believes microdosing is a solution. That’s the practice of taking tiny amounts of a psilocybin mushroom several times a week to maintain brain health and a creative perspective on life.

A typical microdose is 0.1 to 0.3 grams of dried psilocybin mushrooms, as compared with the 25-milligram pill of psilocybin that creates the full-blown psychedelic experience.

Stamets practices microdosing and has focused on a process called “stacking” in which a microdose of mushrooms is taken with additional substances believed to boost the fungi’s benefits. His famous “Stamets Stack” includes niacin, or vitamin B3, and the mycelium, or rootlike structure, of an unusual mushroom called Lion’s mane.

Surveys of microdosers obtained on his website have shown significantly positive benefits from the practice of taking small doses.

“These are self-reported citizen scientists’ projects, and we have now around 14,000 people in our app where you register yourself and report your microdose,” Stamets told an audience at the 2022 Life Itself conference, a health and wellness event presented in partnership with CNN.

“I’m going to say something provocative, but I believe it to my core: Psilocybin makes nicer people,” Stamets told the audience. “Psilocybin will make us more intelligent and better citizens.”

Scientific studies so far have failed to find any benefits from microdosing, leaving many researchers skeptical. “People like being on it, but that doesn’t validate the claims of microdosing,” Johnson said. “People like being on a little bit of cocaine, too.”

Experimental psychologist Harriet de Wit, a professor of psychiatry and behavioral science at the University of Chicago, was excited to study microdosing because it solves a key problem of scientific research in the field – it’s hard to blind people to what they are taking if they begin to trip. Microdosing solves that problem because people don’t feel an effect from the tiny dose.

De Wit specializes in determining whether a drug’s impact is due to the drug or what scientists call the “placebo effect,” a positive expectation that can cause improvement without the drug.

She published a study in 2022 that mimicked real-world microdosing of LSD, except neither the participants nor researchers knew what was in the pills the subjects took.

“We measured all kinds of different behavioral and psychological responses, and the only thing we saw is that LSD at very low doses produced some stimulant-like effects at first, which then faded,” de Wit said.

The placebo effect is powerful, she added, which might explain why the few additional studies done on it have also failed to find any positive results.

“I suspect microdosing may have an effect on mood, and over time it might build up resilience or improve well-being,” Nutt said. “But I don’t think it will rapidly fragment depression like macrodosing and going on a trip.”

Obviously, not all hallucinogenic experiences are positive, so nearly every study on psychedelic drugs has included therapists trained to intercede if a trip turns bad and to maximize the outcome if the trip is good.

“This is about allowing someone access into deeper access into their own mental processes, with hopefully greater insight,” Johnson said. “While others might disagree, it does seem very clear that you need therapy to maximize the benefits.”

There are also side effects from psychedelics that go beyond a bad trip. LSD, mescaline and DMT, which is the active ingredient in ayahuasca tea, can increase blood pressure, heart rate, and body temperature, according to the National Institute on Drug Abuse. Ayahuasca tea can also induce vomiting. LSD can cause tremors, numbness and weakness, while the use of mescaline can lead to uncoordinated movements. People hunting for psychedelic mushrooms can easily mistake a toxic species for one with psilocybin, “leading to unintentional, fatal poisoning.”

Another issue: Not everyone is a candidate for psychedelic treatment. It won’t work on people currently on SSRIs — the receptors in their brains are already flooded with serotonin. People diagnosed with bipolar disorder or schizophrenia, or who have a family history of psychosis are always screened out of clinical trials, said Frederick Barrett, associate director of the Center for Psychedelic and Consciousness Research at Johns Hopkins.

“If you have a vulnerability to psychosis, it could be that exposing you to a psychedelic could unmask that psychosis or could lead to a psychotic event,” Barnes said.

Then there are the thousands of people with mental health concerns who will never agree to undergo a psychedelic trip. For those people, scientists such as Roth are attempting to find an alternative approach. He and his team recently identified the mechanisms by which psychedelics bond to the brain’s serotonin receptors and are using the knowledge to identify new compounds.

“Our hope is that we can use this information to ultimately make drugs that mimic the benefits of psychedelic drugs without the psychedelic experience,” Roth said.

“What if we could give people who are depressed or suffer from PTSD or anxiety or obsessive-compulsive disorder a medication, and they could wake up the next day and be fine without any side effects? That would be transformative.”

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Millions of people are prescribed antidepressants for chronic pain. Do they work? | CNN

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CNN
—

Around one-third of people globally live with chronic pain — pain experienced for more than three months — and millions of people are prescribed antidepressants to relieve the condition.

However, a new review of prior research published Tuesday has found that most antidepressants used to relieve chronic pain are being prescribed without sufficient reliable evidence of their effectiveness. What’s more, potential harms haven’t been well studied.

A two-year study by the nonprofit group Cochrane found that only one antidepressant, duloxetine, was effective for short-term pain relief based on the available evidence. Cochrane is an international collaboration of researchers that produces the Cochrane Library, which includes a database of systematic summaries addressing key questions in health care.

Sold under the brand names Irenka and Cymbalta, duloxetine is a serotonin and norepinephrine reuptake inhibitor, or SNRI, and also boosts levels of the feel-good neurochemical dopamine.

“This is a global public health concern,” said lead author Tamar Pincus, a professor and chronic pain researcher at the University of Southampton in the United Kingdom.

“Chronic pain is a problem for millions who are prescribed antidepressants without sufficient scientific proof they help, nor an understanding of the long-term impact on health.”

The review included 176 studies with a total of 28,664 participants and looked at 25 different antidepressants. The studies mainly investigated three types of chronic pain: fibromyalgia, nerve pain and musculoskeletal pain.

The average length of the study was 10 weeks, and the studies were randomized controlled trials — regarded as the gold standard in medical research. Seventy-two of the studies were funded by pharmaceutical companies.

The most commonly prescribed antidepressant for chronic pain globally was amitriptyline, the study said. Sold in the United States under the brand names Elavil and Vanatrip, the antidepressant was approved in 1961 by the US Food and Drug Administration to treat depression in adults. The medication has significant side effects, so it is not commonly used for depression, but is prescribed to treat migraines and chronic pain such as diabetic neuropathy.

However, the authors found most of the studies on amitriptyline’s effectiveness were small and the evidence was not reliable.

Milnacipran, which is approved by the FDA for fibromyalgia, was also effective at reducing pain, the review found, but the scientists were not as confident about this drug compared with duloxetine due to limited studies with few people.

Anyone taking antidepressants for chronic pain relief should speak to their doctor before stopping their medication due to concerns over the new report, the authors stressed.

Antidepressants are thought to help with pain because the bodily systems that regulate mood and pain overlap, explained Ryan Patel, a research fellow studying chronic pain at the Wolfson Centre for Age-Related Diseases at King’s College London.

He said the key question for researchers to answer was not whether antidepressant drugs were effective for treating pain but “for whom are antidepressants effective?”

“Even when the cause of chronic pain is the same, the biological changes that occur in the nervous system are varied and so it is no surprise that pain presents differently from person to person, and not everyone will respond to the same drugs,” said Patel, who wasn’t involved in the review.

“What this comprehensive analysis demonstrates is that when clinical trials are designed poorly under the assumption that everyone’s experience of pain is uniform, most antidepressants appear to have limited use for treating chronic pain,” Patel added in a statement.

Even for the antidepressant duloxetine, there was no research looking at long-term use of the drug, the review found.

“Though we did find that duloxetine provided short-term pain relief for patients we studied, we remain concerned about its possible long-term harm due to the gaps in current evidence,” Pincus said.

The report said future research should address any unwanted effects of using antidepressants for chronic pain, noting that the existing data on this was “poor.”

“It (duloxetine) does look really good at the moment for short term pain relief, but I want to emphasize that patients aren’t prescribed duloxetine or any antidepressant for three weeks, four weeks, six weeks, they’re prescribed it for six months. So it’s really shocking that we don’t have any evidence for long term use of even duloxetine,” Pincus said.

Dr. Cathy Stannard, the clinical lead for the UK National Institute for Health and Care Excellence (NICE) guideline for chronic pain, and a pain specialist for NHS Gloucestershire’s Integrated Care Board in the UK, said that it was important to emphasize the social and psychological influences on how people experience pain and the importance of a patient’s relationship with their doctor.

“There is good evidence that for people with pain, compassionate and consistent relationships with clinicians remain the foundations of successful care,” Stannard, who wasn’t involved in the research, said in a statement.

“Research shows that what people want most is a strong, empathic relationship with their care provider. They want time to discuss what matters to them and they want easy access to support and to be partners in their care.”

Non-pharmaceutical interventions, such as support with mobility, debt management, trauma and social isolation, were also likely to help people living with pain, she added.

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Covid-19 Pandemic Timeline Fast Facts | CNN

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CNN
—

Here’s a look at the coronavirus outbreak, declared a worldwide pandemic by the World Health Organization. The coronavirus, called Covid-19 by WHO, originated in China and is the cousin of the SARS virus.

Coronaviruses are a large group of viruses that are common among animals. The viruses can make people sick, usually with a mild to moderate upper respiratory tract illness, similar to a common cold. Coronavirus symptoms include a runny nose, cough, sore throat, possibly a headache and maybe a fever, which can last for a couple of days.

WHO Situation Reports

Coronavirus Map

CNN’s early reporting on the coronavirus

December 31, 2019 – Cases of pneumonia detected in Wuhan, China, are first reported to WHO. During this reported period, the virus is unknown. The cases occur between December 12 and December 29, according to Wuhan Municipal Health.

January 1, 2020 – Chinese health authorities close the Huanan Seafood Wholesale Market after it is discovered that wild animals sold there may be the source of the virus.

January 5, 2020 – China announces that the unknown pneumonia cases in Wuhan are not SARS or MERS. In a statement, the Wuhan Municipal Health Commission says a retrospective probe into the outbreak has been initiated.

January 7, 2020 – Chinese authorities confirm that they have identified the virus as a novel coronavirus, initially named 2019-nCoV by WHO.

January 11, 2020 – The Wuhan Municipal Health Commission announces the first death caused by the coronavirus. A 61-year-old man, exposed to the virus at the seafood market, died on January 9 after respiratory failure caused by severe pneumonia.

January 17, 2020 – Chinese health officials confirm that a second person has died in China. The United States responds to the outbreak by implementing screenings for symptoms at airports in San Francisco, New York and Los Angeles.

January 20, 2020 – China reports 139 new cases of the sickness, including a third death. On the same day, WHO’s first situation report confirms cases in Japan, South Korea and Thailand.

January 20, 2020 – The National Institutes of Health announces that it is working on a vaccine against the coronavirus. “The NIH is in the process of taking the first steps towards the development of a vaccine,” says Dr. Anthony Fauci, director of the National Institutes of Allergy and Infectious Diseases.

January 21, 2020 – Officials in Washington state confirm the first case on US soil.

January 23, 2020 – At an emergency committee, WHO says that the coronavirus does not yet constitute a public health emergency of international concern.

January 23, 2020 – The Beijing Culture and Tourism Bureau cancels all large-scale Lunar New Year celebrations in an effort to contain the growing spread of coronavirus. On the same day, Chinese authorities enforce a partial lockdown of transport in and out of Wuhan. Authorities in the nearby cities of Huanggang and Ezhou Huanggang announce a series of similar measures.

January 28, 2020 – Chinese President Xi Jinping meets with WHO Director General Tedros Adhanom in Beijing. At the meeting, Xi and WHO agree to send a team of international experts, including US Centers for Disease Control and Prevention staff, to China to investigate the coronavirus outbreak.

January 29, 2020 – The White House announces the formation of a new task force that will help monitor and contain the spread of the virus, and ensure Americans have accurate and up-to-date health and travel information, it says.

January 30, 2020 – The United States reports its first confirmed case of person-to-person transmission of the coronavirus. On the same day, WHO determines that the outbreak constitutes a Public Health Emergency of International Concern (PHEIC).

January 31, 2020 – The Donald Trump administration announces it will deny entry to foreign nationals who have traveled in China in the last 14 days.

February 2, 2020 – A man in the Philippines dies from the coronavirus – the first time a death has been reported outside mainland China since the outbreak began.

February 3, 2020 – China’s Foreign Ministry accuses the US government of inappropriately reacting to the outbreak and spreading fear by enforcing travel restrictions.

February 4, 2020 – The Japanese Health Ministry announces that ten people aboard the Diamond Princess cruise ship moored in Yokohama Bay are confirmed to have the coronavirus. The ship, which is carrying more than 3,700 people, is placed under quarantine scheduled to end on February 19.

February 6, 2020 – First Covid-19 death in the United States: A person in California’s Santa Clara County dies of coronavirus, but the link is not confirmed until April 21.

February 7, 2020 – Li Wenliang, a Wuhan doctor who was targeted by police for trying to sound the alarm on a “SARS-like” virus in December, dies of the coronavirus. Following news of Li’s death, the topics “Wuhan government owes Dr. Li Wenliang an apology,” and “We want freedom of speech,” trend on China’s Twitter-like platform, Weibo, before disappearing from the heavily censored platform.

February 8, 2020 – The US Embassy in Beijing confirms that a 60-year-old US national died in Wuhan on February 6, marking the first confirmed death of a foreigner.

February 10, 2020 – Xi inspects efforts to contain the coronavirus in Beijing, the first time he has appeared on the front lines of the fight against the outbreak. On the same day, a team of international experts from WHO arrive in China to assist with containing the coronavirus outbreak.

February 10, 2020 – The Anthem of the Seas, a Royal Caribbean cruise ship, sets sail from Bayonne, New Jersey, after a coronavirus scare had kept it docked and its passengers waiting for days.

February 11, 2020 – WHO names the coronavirus Covid-19.

February 13, 2020 – China’s state-run Xinhua News Agency announces that Shanghai mayor Ying Yong will be replacing Jiang Chaoliang amid the outbreak. Wuhan Communist Party chief Ma Guoqiang has also been replaced by Wang Zhonglin, party chief of Jinan city in Shandong province, according to Xinhua.

February 14, 2020 – A Chinese tourist who tested positive for the virus dies in France, becoming the first person to die in the outbreak in Europe. On the same day, Egypt announces its first case of coronavirus, marking the first case in Africa.

February 15, 2020 – The official Communist Party journal Qiushi publishes the transcript of a speech made on February 3 by Xi in which he “issued requirements for the prevention and control of the new coronavirus” on January 7, revealing Xi knew about and was directing the response to the virus on almost two weeks before he commented on it publicly.

February 17, 2020 – A second person in California’s Santa Clara County dies of coronavirus, but the link is not confirmed until April 21.

February 18, 2020 – Xi says in a phone call with British Prime Minister Boris Johnson that China’s measures to prevent and control the epidemic “are achieving visible progress,” according to state news Xinhua.

February 21, 2020 – The CDC changes criteria for counting confirmed cases of novel coronavirus in the United States and begins tracking two separate and distinct groups: those repatriated by the US Department of State and those identified by the US public health network.

February 25, 2020 – The NIH announces that a clinical trial to evaluate the safety and effectiveness of the antiviral drug remdesivir in adults diagnosed with coronavirus has started at the University of Nebraska Medical Center in Omaha. The first participant is an American who was evacuated from the Diamond Princess cruise ship docked in Japan.

February 25, 2020 – In an effort to contain the largest outbreak in Europe, Italy’s Lombardy region press office issues a list of towns and villages that are in complete lockdown. Around 100,000 people are affected by the travel restrictions.

February 26, 2020 – CDC officials say that a California patient being treated for novel coronavirus is the first US case of unknown origin. The patient, who didn’t have any relevant travel history nor exposure to another known patient, is the first possible US case of “community spread.”

February 26, 2020 – Trump places Vice President Mike Pence in charge of the US government response to the novel coronavirus, amid growing criticism of the White House’s handling of the outbreak.

February 29, 2020 – A patient dies of coronavirus in Washington state. For almost two months, this is considered the first death due to the virus in the United States, until autopsy results announced April 21 reveal two earlier deaths in California.

March 3, 2020 – The Federal Reserve slashes interest rates by half a percentage point in an attempt to give the US economy a jolt in the face of concerns about the coronavirus outbreak. It is the first unscheduled, emergency rate cut since 2008, and it also marks the biggest one-time cut since then.

March 3, 2020 – Officials announce that Iran will temporarily release 54,000 people from prisons and deploy hundreds of thousands of health workers as officials announced a slew of measures to contain the world’s deadliest coronavirus outbreak outside China. It is also announced that 23 members of Iran’s parliament tested positive for the virus.

March 4, 2020 – The CDC formally removes earlier restrictions that limited coronavirus testing of the general public to people in the hospital, unless they had close contact with confirmed coronavirus cases. According to the CDC, clinicians should now “use their judgment to determine if a patient has signs and symptoms compatible with COVID-19 and whether the patient should be tested.”

March 8, 2020 – Italian Prime Minister Giuseppe Conte signs a decree placing travel restrictions on the entire Lombardy region and 14 other provinces, restricting the movements of more than 10 million people in the northern part of the country.

March 9, 2020 – Conte announces that the whole country of Italy is on lockdown.

March 11, 2020 – WHO declares the novel coronavirus outbreak to be a pandemic. WHO says the outbreak is the first pandemic caused by a coronavirus. In an Oval Office address, Trump announces that he is restricting travel from Europe to the United States for 30 days in an attempt to slow the spread of coronavirus. The ban, which applies to the 26 countries in the Schengen Area, applies only to foreign nationals and not American citizens and permanent residents who’d be screened before entering the country.

March 13, 2020 – Trump declares a national emergency to free up $50 billion in federal resources to combat coronavirus.

March 18, 2020 – Trump signs into law a coronavirus relief package that includes provisions for free testing for Covid-19 and paid emergency leave.

March 19, 2020 – At a news conference, officials from China’s National Health Commission report no new locally transmitted coronavirus cases for the first time since the pandemic began.

March 23, 2020 – United Nations Secretary-General António Guterres calls for an immediate global ceasefire amid the pandemic to fight “the common enemy.”

March 24, 2020 – Japan’s Prime Minister Shinzo Abe and International Olympic Committee (IOC) president Thomas Bach agree to postpone the Olympics until 2021 amid the outbreak.

March 25, 2020 – The White House and Senate leaders reach an agreement on a $2 trillion stimulus deal to offset the economic damage of coronavirus, producing one of the most expensive and far-reaching measures in the history of Congress.

March 27, 2020 – Trump signs the stimulus package into law.

April 2, 2020 – According to the Department of Labor, 6.6 million US workers file for their first week of unemployment benefits in the week ending March 28, the highest number of initial claims in history. Globally, the total number of coronavirus cases surpasses 1 million, according to Johns Hopkins University’s tally.

April 3, 2020 – Trump says his administration is now recommending Americans wear “non-medical cloth” face coverings, a reversal of previous guidance that suggested masks were unnecessary for people who weren’t sick.

April 8, 2020 – China reopens Wuhan after a 76-day lockdown.

April 14, 2020 – Trump announces he is halting funding to WHO while a review is conducted, saying the review will cover WHO’s “role in severely mismanaging and covering up the spread of coronavirus.”

April 20, 2020 – Chilean health officials announce that Chile will begin issuing the world’s first digital immunity cards to people who have recovered from coronavirus, saying the cards will help identify individuals who no longer pose a health risk to others.

April 21, 2020 – California’s Santa Clara County announces autopsy results that show two Californians died of novel coronavirus in early and mid-February – up to three weeks before the previously known first US death from the virus.

April 28, 2020 – The United States passes one million confirmed cases of the virus, according to Johns Hopkins.

May 1, 2020 – The US Food and Drug Administration issues an emergency-use authorization for remdesivir in hospitalized patients with severe Covid-19. FDA Commissioner Stephen Hahn says remdesivir is the first authorized therapy drug for Covid-19.

May 4, 2020 – During a virtual pledging conference co-hosted by the European Union, world leaders pledge a total of $8 billion for the development and deployment of diagnostics, treatments and vaccines against the novel coronavirus.

May 11, 2020 – Trump and his administration announce that the federal government is sending $11 billion to states to expand coronavirus testing capabilities. The relief package signed on April 24 includes $25 billion for testing, with $11 billion for states, localities, territories and tribes.

May 13, 2020 – Dr. Mike Ryan, executive director of WHO’s health emergencies program, warns that the coronavirus may never go away and may just join the mix of viruses that kill people around the world every year.

May 19, 2020 – WHO agrees to hold an inquiry into the global response to the coronavirus pandemic. WHO member states adopt the proposal with no objections during the World Health Assembly meeting, after the European Union and Australia led calls for an investigation.

May 23, 2020 – China reports no new symptomatic coronavirus cases, the first time since the beginning of the outbreak in December.

May 27, 2020 – Data collected by Johns Hopkins University reports that the coronavirus has killed more than 100,000 people across the US, meaning that an average of almost 900 Americans died each day since the first known coronavirus-related death was reported nearly four months earlier.

June 2, 2020 – Wuhan’s Health Commission announces that it has completed coronavirus tests on 9.9 million of its residents with no new confirmed cases found.

June 8, 2020 – New Zealand Prime Minister Jacinda Ardern announces that almost all coronavirus restrictions in New Zealand will be lifted after the country reported no active cases.

June 11, 2020 – The United States passes 2 million confirmed cases of the virus, according to Johns Hopkins.

June 16, 2020 – University of Oxford scientists leading the Recovery Trial, a large UK-based trial investigating potential Covid-19 treatments, announce that a low-dose regimen of dexamethasone for 10 days was found to reduce the risk of death by a third among hospitalized patients requiring ventilation in the trial.

June 20, 2020 – The NIH announces that it has halted a clinical trial evaluating the safety and effectiveness of drug hydroxychloroquine as a treatment for the coronavirus. “A data and safety monitoring board met late Friday and determined that while there was no harm, the study drug was very unlikely to be beneficial to hospitalized patients with Covid-19,” the NIH says in a statement.

June 26, 2020 – During a virtual media briefing, WHO announces that it plans to deliver about 2 billion doses of a coronavirus vaccine to people across the globe. One billion of those doses will be purchased for low- and middle-income countries, according to WHO.

July 1, 2020 – The European Union announces it will allow travelers from 14 countries outside the bloc to visit EU countries, months after it shut its external borders in response to the pandemic. The list does not include the US, which doesn’t meet the criteria set by the EU for it to be considered a “safe country.”

July 6, 2020 – In an open letter published in the journal Clinical Infectious Diseases, 239 scientists from around the world urge WHO and other health agencies to be more forthright in explaining the potential airborne transmission of coronavirus. In the letter, scientists write that studies “have demonstrated beyond any reasonable doubt that viruses are released during exhalation, talking, and coughing in microdroplets small enough to remain aloft in air and pose a risk of exposure at distances beyond 1 to 2 meters (yards) from an infected individual.”

July 7, 2020 – The Trump administration notifies Congress and the United Nations that the United States is formally withdrawing from WHO. The withdrawal goes into effect on July 6, 2021.

July 21, 2020 – European leaders agree to create a €750 billion ($858 billion) recovery fund to rebuild EU economies ravaged by the coronavirus.

July 27, 2020 – A vaccine being developed by the Vaccine Research Center at the National Institutes of Health’s National Institute of Allergy and Infectious Diseases, in partnership with the biotechnology company Moderna, enters Phase 3 testing. The trial is expected to enroll about 30,000 adult volunteers and evaluates the safety of the vaccine and whether it can prevent symptomatic Covid-19 after two doses, among other outcomes.

August 11, 2020 – In a live teleconference, Russian President Vladimir Putin announces that Russia has approved a coronavirus vaccine for public use before completion of Phase 3 trials, which usually precedes approval. The vaccine, which is named Sputnik-V, is developed by the Moscow-based Gamaleya Institute with funding from the Russian Direct Investment Fund (RDIF).

August 15, 2020 – Russia begins production on Sputnik-V, according to Russian state news agency TASS.

August 23, 2020 – The FDA issues an emergency use authorization for the use of convalescent plasma to treat Covid-19. It is made using the blood of people who have recovered from coronavirus infections.

August 27, 2020 – The CDC notifies public health officials around the United States to prepare to distribute a potential coronavirus vaccine as soon as late October. In the documents, posted by The New York Times, the CDC provides planning scenarios to help states prepare and advises on who should get vaccinated first – healthcare professionals, essential workers, national security “populations” and long-term care facility residents and staff.

September 4, 2020 – The first peer-reviewed results of Phase 1 and Phase 2 clinical trials of Russia’s Covid-19 vaccine are published in the medical journal The Lancet. The results “have a good safety profile” and the vaccine induced antibody responses in all participants, The Lancet says.

October 2, 2020 – Trump announces that he and first lady Melania Trump have tested positive for Covid-19. He spends three nights at Walter Reed National Military Medical Center receiving treatment before returning to the White House.

October 12, 2020 – Drugmaker Johnson & Johnson announces it has paused the advanced clinical trial of its experimental coronavirus vaccine because of an unexplained illness in one of the volunteers.”Following our guidelines, the participant’s illness is being reviewed and evaluated by the ENSEMBLE independent Data Safety Monitoring Board (DSMB) as well as our internal clinical and safety physicians,” the company said in a statement. ENSEMBLE is the name of the study. The trial resumes later in the month.

December 10, 2020 – Vaccine advisers to the FDA vote to recommend the agency grant emergency use authorization to Pfizer and BioNTech’s coronavirus vaccine.

December 14, 2020 – US officials announce the first doses of the FDA authorized Pfizer vaccine have been delivered to all 50 states, the District of Columbia and Puerto Rico.

December 18, 2020 – The FDA authorizes a second coronavirus vaccine made by Moderna for emergency use. “The emergency use authorization allows the vaccine to be distributed in the U.S. for use in individuals 18 years and older,” the FDA said in a tweet.

January 14, 2021 – The WHO team tasked with investigating the origins of the outbreak in Wuhan arrive in China.

January 20, 2021 – Newly elected US President Joe Biden halts the United States’ withdrawal from WHO.

February 22, 2021 – The death toll from Covid-19 exceeds 500,000 in the United States.

February 27, 2021 – The FDA grants emergency use authorization to Johnson & Johnson’s Covid-19 vaccine, the first single dose Covid-19 vaccine available in the US.

March 30, 2021 – According to a 120-page report from WHO, the novel coronavirus that causes Covid-19 probably spread to people through an animal, and probably started spreading among humans no more than a month or two before it was noticed in December of 2019. The report says a scenario where it spread via an intermediate animal host, possibly a wild animal captured and then raised on a farm, is “very likely.”

April 17, 2021 – The global tally of deaths from Covid-19 surpasses 3 million, according to data compiled by Johns Hopkins.

August 3, 2021 – According to figures published by the CDC, the more contagious Delta variant accounts for an estimated 93.4% of coronavirus circulating in the United States during the last two weeks of July. The figures show a rapid increase over the past two months, up from around 3% in the two weeks ending May 22.

August 12, 2021 – The FDA authorizes an additional Covid-19 vaccine dose for certain immunocompromised people.

August 23, 2021 – The FDA grants full approval to the Pfizer/BioNTech Covid-19 vaccine for people age 16 and older, making it the first coronavirus vaccine approved by the FDA.

September 24, 2021 – CDC Director Dr. Rochelle Walensky diverges from the agency’s independent vaccine advisers to recommend boosters for a broader group of people – those ages 18 to 64 who are at increased risk of Covid-19 because of their workplaces or institutional settings – in addition to older adults, long-term care facility residents and some people with underlying health conditions.

November 2, 2021 – Walensky says she is endorsing a recommendation to vaccinate children ages 5-11 against Covid-19, clearing the way for immediate vaccination of the youngest age group yet in the US.

November 19, 2021 – The FDA authorizes boosters of the Pfizer/BioNTech and Moderna Covid-19 vaccines for all adults. The same day, the CDC also endorses boosters for all adults.

December 16, 2021 – The CDC changes its recommendations for Covid-19 vaccines to make clear that shots made by Moderna and Pfizer/BioNTech are preferred over Johnson & Johnson’s vaccine.

December 22, 2021 – The FDA authorizes Pfizer’s antiviral pill, Paxlovid, to treat Covid-19, the first antiviral Covid-19 pill authorized in the United States for ill people to take at home, before they get sick enough to be hospitalized. The following day, the FDA authorizes Merck’s antiviral pill, molnupiravir.

December 27, 2021 – The CDC shortens the recommended times that people should isolate when they’ve tested positive for Covid-19 from 10 days to five days if they don’t have symptoms – and if they wear a mask around others for at least five more days. The CDC also shortens the recommended time for people to quarantine if they are exposed to the virus to a similar five days if they are vaccinated.

January 31, 2022 – The FDA grants full approval to Moderna’s Covid-19 vaccine for those ages 18 and older. This is the second coronavirus vaccine given full approval by the FDA.

March 29, 2022 – The FDA authorizes a second booster of the Pfizer/BioNTech and Moderna Covid-19 vaccines for adults 50 and older. That same day, the CDC also endorses a second booster for the same age group.

April 25, 2022 – The FDA expands approval of the drug remdesivir to treat patients as young as 28 days and weighing about seven pounds.

May 17, 2022 – The FDA authorizes a booster dose of Pfizer/BioNTech’s Covid-19 vaccine for children ages 5 to 11 at least five months after completion of the primary vaccine series. On May 19, the CDC also endorses a booster dose for the same age group.

June 18, 2022 – The CDC recommends Covid-19 vaccines for children as young as 6 months.

August 31, 2022 – The FDA authorizes updated Covid-19 vaccine booster shots from Moderna and Pfizer. Both are bivalent vaccines that combine the companies’ original vaccine with one that targets the BA.4 and BA.5 Omicron sublineages. The CDC signs off on the updated booster shots the following day.

May 5, 2023 – The WHO says Covid-19 is no longer a global health emergency.

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Getting prescription meds via telehealth might change soon. Here’s how to prepare | CNN

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CNN
—

For three years now, the expansion of telehealth has made care more accessible for many people, especially those in rural areas. Patients have been able to receive prescriptions from providers without seeing them in person. But that may change come May 11 when the federal government is set to end the Covid-19 public health emergency declaration that made this convenience possible.

Before the pandemic, medical practitioners were subject to the conditions of the Ryan Haight Act, which required at least one in-person examination before prescribing a controlled medicine, said Dr. Shabana Khan, chair of the American Psychiatric Association’s Committee on Telepsychiatry.

“There are seven exceptions, and one of them is a public health emergency declared by the secretary of (health and human services), which is what we’ve had for the past three years,” Khan said. “It was immensely helpful … and allowed many Americans to get their medical care without having to come in person, so we could treat patients completely remotely.”

“The administration and HHS has put out a notice that they don’t intend to renew it any further,” Khan said, “so the federal public health emergency is going to be expiring May 11.”

Returning to pre-pandemic rules means people who were prescribed controlled medications via telehealth — such as stimulant medications for attention-deficit/hyperactivity disorder, benzodiazepines for anxiety, or medications for opioid use disorder, sleep or pain — will need one in-person medical examination to continue these prescriptions or start new ones.

The US Drug Enforcement Administration’s website has a general list of controlled substances, and an exhaustive list can be found here.

Patients will still be able to get prescriptions for non-controlled medications, such as antibiotics or birth control, via telehealth. The pre-pandemic rules also wouldn’t affect telehealth care by a practitioner who has already conducted an in-person examination of a patient.

To establish some flexibility in the telehealth framework moving forward, Khan said, the DEA has put forth proposals (PDF) that would allow telehealth practitioners to prescribe one 30-day supply of buprenorphine — a medication for opioid use disorder — or Schedule III-V non-narcotic controlled medications without doing an in-person examination first. A patient would have to do an in-person exam before the second prescription of either type of medication, according to those proposals.

But there’s no guarantee that will happen — public comment on the proposals was open through March; since then, the DEA has been considering comments before drafting final regulations.

“It is really important to start planning now,” Khan said. “For many medicines, it can be a risk to abruptly stop treatment.”

People who are on medications for opioid use disorder, ADHD or anxiety and don’t get an in-person exam between May 11 and the next time they need a prescription refill could experience withdrawal requiring a trip to the hospital, or negative effects on health, relationships, employment or academics, she added.

Here’s what else you should know about the changes and steps you should take, according to Khan.

This conversation has been lightly edited and condensed for clarity.

CNN: How should people prepare to ensure their prescription routine isn’t disrupted?

Khan: It’s important for patients who may be prescribed one of these types of medicines by a telemedicine physician or other practitioner to reach out to that practitioner to discuss this issue and make sure that they have a plan. And if it’s feasible to see that telemedicine physician in person, schedule that as soon as possible.

CNN: What if you can’t see your telehealth provider in person?

Khan: Let’s say a telemedicine physician practices completely remotely — then the patient would discuss with them what next steps would be.

In the proposed rule, the qualifying telemedicine referral may allow a patient to be seen by a local DEA-registered practitioner. So, for example, perhaps their primary care doctor or pediatrician — if they are DEA-registered — might be able to go through the qualifying telemedicine referral process so that they can see them in person and continue to be prescribed the medicine. Or patients can contact their health insurance provider to get a list of local referrals.

CNN: Are there any drawbacks to seeing general physicians or pediatricians for controlled medication prescriptions?

Khan: Some may say they aren’t going to prescribe certain medications, like psychiatric medications. Some may say they are comfortable with it, and some may say they will prescribe for a short period of time until you connect with a specialist. So there is variability.

CNN: Would the patient have to continue seeing the referral provider after that first in-person appointment?

Khan: In terms of what’s required at the federal level, if a patient has that one in-person exam with a provider through that qualifying telemedicine referral process, they wouldn’t necessarily have to see that provider again unless that’s part of their treatment plan that’s discussed.

With the qualifying telemedicine referral in the proposed rule, the way it’s written, it doesn’t necessarily have to be the referral practitioner prescribing the medicine; they just need to do the in-person exam. The referral practitioner can refer the patient back to the telemedicine doctor, who can prescribe the medicine.

The other factor that’s significant here is we discussed all the proposed rules and the status at the federal level, but there’s also the state level. States also have rules around controlled medicine prescribing, and they may not always align with federal law. Let’s say the DEA puts out their final rule, and there’s some flexibility — some states might adopt the older Ryan Haight Act language from the federal level, so they might actually be stricter than what we’ll be seeing at the federal level. When federal and state laws don’t align, providers generally have to follow whatever is stricter.

CNN: Will patients need to see their provider in person every time they need a prescription refill?

Khan: The DEA has indicated that the absolute requirement at the federal level is one in-person examination. Beyond that, it would be left to the discretion of whoever the patient is seeing.

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New approach gets newborns with opioid withdrawal out of the hospital sooner and with less medication | CNN

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CNN
—

Rates of neonatal abstinence syndrome surged in recent years, but a newer approach to caring for newborn babies exposed to opioids during pregnancy gets them out of the hospital sooner and with less medication, according to a study published on Sunday in the New England Journal of Medicine.

Newborns in opioid withdrawal may experience upset stomach, inconsolable crying, seizures and extreme discomfort. The study looked at the impacts of the Eat, Sleep, Console care approach on 1,300 infants at 26 US hospitals, and compared them with the current standard for caring for infants exposed to opioids.

Eat, Sleep, Console encourages involvement from parents, and prioritizes care that doesn’t involve medication, such as swaddling, skin-to-skin contact and breastfeeding. The usual approach involves a nurse measuring a baby’s withdrawal symptoms – such as their level of irritability, pitch of crying, fever or tremors – before providing treatment such as methadone or morphine.

“Compared to usual care, use of the Eat, Sleep, Console care approach substantially decreased time until infants with neonatal opioid withdrawal syndrome were medically ready for discharge, without increasing specified adverse outcomes,” the researchers wrote in the study.

The infants assessed with the Eat, Sleep, Console care method were discharged after eight days on average, compared with almost 15 days for the infants who were cared for by the standard approach, the researchers said. Additionally, infants in the Eat, Sleep, Console care group were 63% less likely to receive opioid medication – 19.5% received medication compared with 52% in the group receiving usual care.

The current approach to usual care “is a very comprehensive and nurse-led way of assessing the infant, whereas the Eat, Sleep, Console approach involves the mom in the way that you assess the infant, and allows the mom to take part in trying to soothe the infants and see if the infant is able to be soothed or is able to eat or is able to sleep,” according to Rebecca Baker, the director of the NIH HEAL Initiative, which provides grants to researchers studying ways to alleviate the country’s opioid health crisis.

“So, in that way, it’s a little bit more functional, like looking at the abilities of the infants versus how severely the infant is affected.”

Assessment results determine whether a baby should receive medication to control withdrawal symptoms, Baker said.

“So even with Eat, Sleep, Console, some infants that were exposed to a lot of opioids during a mother’s pregnancy, they’ll still need medication-based treatment for withdrawal. It’s just fewer of them need it and when they need it, they need less medication to manage the withdrawal symptoms,” she said.

The Eat, Sleep, Console method was developed about eight years ago, and some hospitals have already implemented it. But Baker said the study’s findings could change how more hospitals practice caring for infants with neonatal abstinence syndrome, which primarily occurs in infants who were exposed to opioids while in utero.

“The rise of really powerful fentanyl, the synthetic opioid, means that if a mother has used drugs during pregnancy, the baby will be exposed to more powerful drugs, which likely has an effect. We haven’t had a chance to study it in detail yet, but it will affect how they feel when they’re born and separated from the mom,” Baker said.

Findings from the study, which were presented at the PAS 2023 Meeting on Sunday, could have a big impact on hospitals by freeing up bed space in the neonatal intensive care unit and boosting morale among nurses at risk of burnout.

“We trained over 5,000 nurses as part of the study. They felt really empowered to help the mom care for the infant to help the infant recover, and so I think from a morale perspective, that’s incredibly important and valuable,” Baker said. “And as you know, nurses are facing really severe staffing shortages and morale challenges so having this tool available to them where they are kind of able to do something positive in the life of the infant and the connection with the mom is really important.”

The researchers are currently following up with a subgroup of the infants from the study for up to two years to see how they grow and develop.

“One of the things that we want to be really sure of is that there are no negative consequences associated with taking less medication, so we’ll be looking for that,” Baker said.

The United States has seen an explosion in the number of infants born with neonatal abstinence syndrome in recent years, swelling by about 82% between 2010 and 2017, according to the US Centers for Disease Control and Prevention. The number of maternal opioid-related diagnoses is also on the rise, increasing by 131% during that same time frame.

Nearly 60 infants are diagnosed with NAS each day, based on data from the U.S. Agency for Healthcare Research and Quality in 2020.

The United States’ opioid epidemic has been expanding in recent years and opioid deaths are the leading cause of accidental death in the US.

More than a million people have died of drug overdoses – mostly opioids – in the two decades since the US Centers for Disease Control and Prevention began collecting that data. Deaths from opioid overdoses rose more than 17% in just one year, from about 69,000 in 2020 to about 81,020 in 2021, the CDC found.

Most are among adults, but children are also dying, largely after ingesting synthetic opioids such as fentanyl. Between 1999 and 2016, nearly 9,000 children and adolescents died of opioid poisoning, with the highest annual rates among adolescents 15 to 19, the CDC found.

Opioid use during pregnancy has been linked to maternal mortality and risk of overdose for the mother, according to the CDC, while infants risk preterm birth, low birthweight, breathing problems and feeding problems.

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Potentially dangerous doses of melatonin and CBD found in gummies sold for sleep | CNN

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CNN
—

Testing of over two dozen melatonin “gummies” sold as sleep aids found some had potentially dangerous amounts of the hormone that helps regulate sleep, according to a new study.

“One product contained 347% more melatonin than what was actual listed on the label of the gummies,” said study coauthor Dr. Pieter Cohen, an associate professor of medicine at the Cambridge Health Alliance in Somerville, Massachusetts.

A jar of gummies might also contain ingredients you didn’t count on, Cohen said: “One of the products that listed melatonin contained no melatonin at all. It was just cannabidiol, or CBD.”

According to the US Food and Drug Administration, “it is currently illegal to market CBD by adding it to a food or labeling it as a dietary supplement.” Yet several of the tested products containing CBD in the study openly advertised the addition of that compound to their melatonin product, Cohen said.

“Four of the tested products contained levels of CBD that were between 4% and 18% higher than on the label,” Cohen said.

The use of CBD in over-the-counter aids is particularly concerning because parents might purchase gummy products to give to their children to help them sleep, said Dr. Cora Collette Breuner, a professor of pediatrics at Seattle Children’s Hospital at the University of Washington.

“There’s no data that supports the use of CBD in children,” said Breuner, who was not involved in the study. “It’s currently only recommended for a very specific use in children over 1 with intractable seizure disorders.”

Aside from CBD, consuming a gummy that unknowingly contains extremely high levels of melatonin — well over the daily 0.5 to 1 milligram per night that has been shown to induce sleep in kids — is also dangerous, said Breuner, who serves on the integrative medicine committee of the American Academy of Pediatrics, which is currently writing new guidelines on supplements in children.

Side effects of melatonin use in children can include drowsiness, headaches, agitation, and increased bed-wetting or urination in the evening. There is also the potential for harmful interactions with medications and allergic reactions to the melatonin, according to the National Center for Complementary and Integrative Health, a department of the National Institutes of Health.

The agency also warns supplements could affect hormonal development, “including puberty, menstrual cycles, and overproduction of the hormone prolactin,” which causes breast and milk development in women.

In the study, published Tuesday in the journal JAMA, researchers sent 25 products labeled as melatonin gummies to an outside lab that tested for levels of melatonin and other substances.

However, the research team didn’t pick products “willy-nilly” off the internet, Cohen said. The scientists carefully chose the first 25 gummy melatonin products displayed on the National Institutes of Health database, which the public can check to see labels of dietary supplements sold in the United States.

“We choose gummies over other products because we thought parents would chose edibles to give to their children,” Cohen said. “”We also wanted to take a closer look at those products after last year’s report that poison centers have had over a quarter million calls about pediatric ingestion, thousands of hospitalizations, ICU visits, even some deaths.”

A 2022 report by the US Centers of Disease Control and Prevention found calls to poison control about melatonin ingestion by children rose 530% between 2012 to 2021. The largest spike in calls — 38% — occurred between 2019 and 2020, the report said.

Most of the calls were about children younger than 5 years old who had accidentally eaten gummies caregivers had not properly locked away.

“Gummies are enticing to young children, who see them as candy,” Cohen said. “We wondered if there was something going on with the products that might be contributing to the calls to the poison control centers.”

The new study found 88% of the gummies were inaccurately labeled, and only three contained a quantity of melatonin that was within 10% of what was listed on the label, said Cohen, who has studied invalid labeling of supplements for years.

“The regulatory framework for supplements is broken,” he said, “The manufacturers are not complying with the law, and the FDA is not enforcing the law. So what that means is that we have a lot of poor-quality products out there.”

A spokesperson for the FDA told CNN the agency would review the findings of the study, adding that the FDA generally doesn’t comment on specific studies, but “evaluates them as part of the body of evidence to further our understanding about a particular issue.”

“It’s important to underscore that under current law, the FDA does not have the authority to approve dietary supplements before they are marketed, and firms have the primary responsibility to make sure their products are not adulterated or misbranded before they are distributed,” the spokesperson said via email.

Steve Mister, president and CEO of the Council for Responsible Nutrition, a trade association for the dietary supplement industry, released a statement saying that manufacturers may add additional melatonin to be sure the product remains at the levels on the label as degradation naturally occurs over time.

“While there may be some variability in overages as companies adhere to the FDA’s requirements regarding shelf life and potency, it does not mean there is a risk in taking these products as intended,” Mister said.

People often view melatonin as an herbal supplement or vitamin, experts say. Instead, melatonin is a hormone that is made by the pineal gland, located deep within the brain, and released into the bloodstream to regulate the body’s sleep cycles.

Studies have found that while using melatonin can be helpful in inducing sleep if used correctly — taking a small amount at least two hours before bed — but the actual benefit is small, Breuner said.

In six randomized controlled trials on melatonin treatment in the pediatric population, she said, melatonin decreased the time it took to fall asleep, ranging from 11 minutes to 51 minutes.

“However, these were very small studies with widely variable results,” Breuner said. “So I say to the parents, ‘You’re really looking at as little as 11 minutes in decreasing the amount of time it takes your child to fall asleep.’”

Anyone considering melatonin should be sure that the bottle has the stamp of the United States Pharmacopeia (USP), which manufacturers hire to test and verify products.

“If it has a USP stamp on the label, you can be sure the product is accurately labeled,” Cohen said. “However, that doesn’t mean melatonin products are going to work or they’re a good idea to take.

“That’s not what the USP is about,” he said. “But at least the verification of the label should eliminate the problems we’re seeing here in our study.”

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These women ran an underground abortion network in the 1960s. Here’s what they fear might happen today | CNN

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CNN
—

The voice on the phone in 1966 was gruff and abrupt: “Do you want the Chevy, the Cadillac or the Rolls Royce?”

A Chevy abortion would cost about $200, cash in hand, the voice explained. A Cadillac was around $500, and the Rolls Royce was $1,000.

“You can’t afford more than the Chevy? Fine,” the voice growled. “Go to this address at this time. Don’t be late and don’t forget the cash.” The voice disappeared.

Dorie Barron told CNN she recalls staring blankly at the phone in her hand, startled by the sudden empty tone. Then it hit her: She had just arranged an illegal abortion with the Chicago Mafia.

The motel Barron was sent to was in an unfamiliar part of Chicago, a scary “middle of nowhere,” she said. She was told to go to a specific room, sit on the bed and wait. Suddenly three men and a woman came in the door.

“I was petrified. They spoke all of three sentences to me the entire time: ‘Where’s the money?’ ‘Lie back and do as I tell you.’ And finally ‘Get in the bathroom,’” when the abortion was over, Barron said. “Then all of a sudden they were gone.”

Bleeding profusely, Barron managed to find a cab to take her home. When the bleeding didn’t stop, her bed-ridden mother made her go to the hospital.

At 24, Barron was taking care of her ailing mother and her 2-year-old daughter when she discovered she was pregnant. Her boyfriend, who had no job and lived with his parents, “freaked,” said Barron, who appears in a recent HBO documentary. The boyfriend suggested she get an abortion. She had never considered that option.

“But what was I to do? My mom was taking care of my daughter from her bed while I worked — they would read and play games until I got home,” Barron said.”How was either of us going to cope with a baby?

“Looking back, I realize I was taking my life in my hands,” said Barron, now an 81-year-old grandmother. “To this day it gives me chills. If I had died, what in God’s green earth would have happened to my mom and daughter?”

Women in the 1960s endured restrictions relatively unknown to women today. The so-called “fairer sex” could not serve on juries and often could not get an Ivy League education. Women earned about half as much as a man doing the same job and were seldom promoted.

Women could not get a credit card unless they were married — and then only if their husband co-signed. The same applied to birth control — only the married need apply. More experienced women shared a workaround with the uninitiated: “Go to Woolworth, buy a cheap wedding-type ring and wear it to your doctor’s appointment. And don’t forget to smile.”

Marital rape wasn’t legally considered rape. And, of course, women had no legal right to terminate a pregnancy until four states — Alaska, Hawaii, New York and Washington — legalized abortion in 1970, three years before Roe v. Wade became the law of the land.

Illinois had no such protection, said Heather Booth, a lifelong feminist activist and political strategist: “Three people discussing having an abortion in Chicago in 1965 was a conspiracy to commit felony murder.”

Despite that danger, a courageous band of young women — most in their 20’s, some in college, some married with children — banded together in Chicago to create an underground abortion network. The group was officially created in 1969 as the “Abortion Counseling Service of Women’s Liberation.”

But after running ads in an underground newspaper: “Pregnant? Don’t want to be? Call Jane,” each member of the group answered the phone as “Jane.”

Despite their youth, members of Jane managed to run an illegal abortion service dedicated to each woman's needs.
From left: Martha Scott, Jeanne Galatzer-Levy, Abby Pariser, Sheila Smith and Madeline Schwenk.

“We were co-conspirators with the women who called us,” said 75-year-old Laura Kaplan, who published a book about the service in 1997 entitled “The Story of Jane: The Legendary Underground Feminist Abortion Service.”

“We’ll protect you; we hope you’ll protect us,” Kaplan said. “We’ll take care of you; we hope you’ll take care of us.”

What started as referrals to legitimate abortion providers changed to personalized service when some members of Jane learned to safely do the abortions themselves. Between the late 1960s and 1973, the year that the Supreme Court decided Roe v. Wade, Jane had arranged or performed over 11,000 abortions.

“Our culture is always searching for heroes,” said Kaplan. “But you don’t have to be a hero to do extraordinary things. Jane was just ordinary people working together — and look what we could accomplish, which is amazing, right?”

Even after several members were caught and arrested, the group continued to provide abortions for women too poor to travel to states where abortion had been legalized.

“I prayed a lot. I didn’t want to go to jail,” said 80-year-old Marie Learner, who allowed the Janes to perform abortions at her apartment.

“Some of us had little children. Some were the sole breadwinners in their home,” Learner said. “It was fearlessness in the face of overwhelming odds.”

Marie Learner opened her home to women undergoing abortions. Her neighbors knew, she said, but did not tell police.

The story of Jane has been immortalized in Kaplan’s book, numerous print articles, a 2022 movie, “Call Jane,” starring Elizabeth Banks and Sigourney Weaver, and a documentary on HBO (which, like CNN, is owned by Warner Bros. Discovery).

Today the historical tale of Jane has taken on a new significance. After the 2022 Supreme Court reversal of Roe v. Wade and the mid-term takeover of the US House of Representatives by Republicans, emboldened conservative lawmakers and judges have acted on their anti-abortion beliefs.

Currently more than a dozen states have banned or imposed severe restrictions on abortion. Georgia has banned abortions after six weeks, even though women are typically unaware they are pregnant at that stage. In mid-April, Florida Governor Ron DeSantis signed a bill that would ban most abortions after six weeks. It won’t go into effect until the state Supreme Court overturns its previous precedent on abortion. Several other states are considering similar legislation. In other states, judicial battles are underway to protect abortion access.

“It’s a horrific situation right now. People will be harmed, some may even die,” said Booth, who helped birth the Jane movement while in college.

“Women without family support, without the information they need, may be isolated and either harm themselves looking to end an unwanted pregnancy or will be harmed because they went to an unscrupulous and illegal provider,” said Booth, now 77.

A key difference between the 60s and today is medication abortion, which 54% of people in the United States used to end a pregnancy in 2022. Available via prescription and through the mail, use of the drugs is two-fold: A person takes a first pill, mifepristone, to block the hormone needed for a pregnancy to continue.  A day or two later, the patient takes a second drug, misoprostol, which causes the uterus to contract, creating the cramping and bleeding of labor.

In early April a Texas judge, US District Judge Matthew Kacsmaryk – a Trump appointee who has been vocal about his anti-abortion stance — suspended the US Food and Drug Administration’s approval of mifepristone despite 23 years of data showing the drug is safe to use, safer even than penicillin or Viagra.

On Friday, the Supreme Court froze the ruling and a subsequent decision by the Fifth US Circuit Court of Appeals at the request of the Justice Department and the drug manufacturer. The action allows access to mifepristone in states where it’s legal until appeals play out over the months to come.

However, 15 states currently restrict access to medication abortion, even by mail.

The actions of anti-abortion activists, who have been accused of “judge shopping” to get the decisions they want, is “an unprecedented attack on democracy meant to undermine the will of the vast majority of Americans who want this pill — mifepristone — to remain legal and available,” Heather Booth told CNN.

“This is a further weaponization of the courts to brazenly advance the end goal of banning abortion entirely,” she added.

If women in her day could have had access to medications that could be used safely in their homes, they would not have been forced to risk their lives, said Dorie Barron, thinking back to her own terrifying abortion in a sketchy Chicago motel.

“I’m depressed as hell, watching stupid, indifferent men control and destroy women’s lives all over again,” she said. “I really fear getting an abortion could soon be like 1965.”

Chicago college student Heather Booth had just finished a summer working with civil rights activists in Mississippi when she was asked to help with a different kind of injustice.

Heather Booth, 18, with civil rights heroine Fannie Lou Hamer during

A girl in another dorm was considering suicide because she was pregnant. Booth, who excelled at both organization and chutzpah, found a local doctor and negotiated an abortion for the girl. Word spread quickly.

“There were about 100 women a week calling for help, much more than one person could handle,” Booth said. “I recruited about 12 other people and began training them how to do the counseling.”

Counseling was a key part of the new service. This was a time when people “barely spoke about sex, how women’s bodies functioned or even how people got pregnant,” Booth said. To help each woman understand what was going to happen to them, Booth quizzed the abortion provider about every aspect of the procedure.

“What do you do in advance? Will it be painful? How painful? Can you walk afterwards? Do you need someone to be with you to take you home?” The questions continued: “What amount of bleeding is expected, and can a woman handle it on their own? If there’s a problem is there an urgent number they can call?”

Armed with details few if any physicians provided, the counselors at Jane could fully inform each caller about the abortion experience. The group even published a flyer describing the procedure, long before the groundbreaking 1970 book “Our Bodies, Ourselves” began to educate women about their sexuality and health.

“I don’t particularly like doctors because I always feel dissatisfied with the experience,” said Marie Learner, who spoke to many of the women who underwent an abortion at her home.

“But after their abortion at Jane, women told me, ‘Wow, that was the best experience I’ve ever had with people helping me with a medical issue.’”

Eileen Smith, now 73, was one of those women. “Jane made you feel like you were part of this bigger picture, like we were all in this together,” she said. “They helped me do this illegal thing and then they’re calling to make sure I’m OK? Wow!

“For me, it helped battle the feeling that I was a bad person, that ‘What’s wrong with me? Why did I get pregnant? I should know better’ voice in my head,” said Smith. “It was priceless.”

Like many young women in the 60s, Heather Booth often protested for civil and women's rights.

Many of the women who joined Jane had never experienced an abortion. Some viewed the work as political, a part of the burgeoning feminist movement. Others considered the service as simply humanitarian health care. All saw the work as an opportunity to respect each woman’s choice.

“I was a stay-at-home mom with four kids,” said Martha Scott, who is now in her 80s. “We knew the woman needed to feel as though she was in control of what was happening to her. We were making it happen for her, but it was not about us. It was about her.”

Some volunteers, like Dorie Barron, experienced the Jane difference firsthand when she found herself pregnant a few years after her abortion at the hands of the Mafia.

“It was a 100% total reversal — I had never experienced such kindness,” Barron said. Not only did a Jane hold each woman’s hand and explain every step of the process, “they gave each of us a giant supply of maternity sanitary pads, and a nice big handful of antibiotics,” she said. “And for the next week, I got a phone call every other day to see how I was.”

Barron soon began volunteering for Jane by providing pregnancy testing for women in the back of a church in Chicago’s Hyde Park.

“It wasn’t just abortion,” Barron explained. “We also said, ‘You could consider adoption,’ and gave adoption referrals. And if the woman wanted to continue with her pregnancy, we said, ‘Fine, please by all that is holy make sure you get prenatal care, take your vitamins, and eat as best you can.’ It was women helping women with whatever they needed.”

Most of the women who contacted Jane were unable to support themselves, in unhealthy relationships, or already had children at home, so the service was a way of “helping them get back on track,” said Smith, who, like Barron, had begun working for Jane after her abortion.

“We were telling them ‘This isn’t the end of the world. You can continue to leave your boyfriend or your husband or continue to just take care of those kids you have.’ We were there to help them get through this,” said Smith, who later became a homecare nurse.

From left: Eileen Smith, Diane Stevens and Benita Greenfield were three of the dozens of women who volunteered for Jane.

Diane Stevens says she came to work for Jane after experiencing an abortion in 1968 at the age of 19. She was living in California at the time, which provided “therapeutic abortions” if approved in advance by physicians.

“I’d had a birth control failure, and I was coached by Planned Parenthood on how to do this,” said Stevens, now 74. “I had to see two psychiatrists and one doctor and tell them I was not able to go through with the pregnancy because it would a danger to both my physical and mental health.

“I was admitted to the psychiatric ward, although I didn’t really know that — I thought I was just in a hospital bed. But oh no, ‘I was mentally ill,’ so that’s where they put me,” said Stevens, who later went to nursing school with Smith. “Then they wheeled me off for the abortion. I had general anesthesia, was there for two days, and then I was discharged. Isn’t that crazy?”

Sakinah Ahad Shannon, now 75, was one of the few Black women who volunteered as a counselor at Jane. She joined after accompanying a friend who was charged a mere $50 for her abortion. At that time, Jane’s fee was between $1 and $100, based on what the woman could afford to pay, Shannon said.

“When I walked in, I said, ‘Oh my God, here we go again. It’s a room of White women, archangels who are going to save the world,’” said Shannon, a social worker and member of the Congress of Racial Equality, an interracial group of non-violent activists who pioneered “Freedom Rides” and helped organize the March on Washington in 1963.

What she heard and saw at her friend’s counseling session was so impressive it “changed my life,” Shannon said. She and her family later opened and operated three Chicago abortion clinics for over 25 years, all using the Jane philosophy of communication and respect.

“It was a profoundly amazing experience for me,” she said. “I call the Janes my sisters. The color line didn’t matter. We were all taking the same risk.”

Sakinah Ahad Shannon and her daughters went on to open and run three abortion clinics in Chicago.

It wasn’t long before the women discovered a “doctor” performing abortions for Jane had been lying about his credentials. There was no medical degree — in the HBO documentary, he admitted he had honed his skills by assisting an abortion provider.

The group imploded. A number of members quit in horror and dismay. For the women who stayed, it was an epiphany, said Martha Scott. Like her, several of the Janes had been assisting this fake doctor for years, learning the procedures step by step.

“You’d learn how to insert a speculum, then how to swap out the vagina with an antiseptic, then how to give numbing shots around the cervix and then how to dilate the cervix. You learned and mastered each step before you moved on to the next,” said Laura Kaplan, who chronicled the procedure in her book.

By now, several of the Janes were quite experienced and willing to do the work. Why not perform the abortions themselves?

“Clearly, this was an intense responsibility,” said Judith Acana, a 27-year-old high school teacher who joined Jane in 1970. She started her training by helping “long terms,” women who were four or five months along in the pregnancy.

“Remember, abortion was illegal (in Illinois) so it could take weeks for a woman to find help,” said Arcana, now 80. “Frequently women who wanted an abortion at 8 or 10 weeks wound up being 16 or 18 weeks or more by the time they found Jane.”

The miscarriage could happen quickly, but it rarely did, she said. It usually took anywhere from one to two days.

“Women who had no one to help them would come back when contractions started,” Arcana said. “One of my strongest memories is of a teenage girl who had an appointment to have her miscarriage on my living room floor.”

The group also paid two Janes to live in an apartment and be on call 24/7 to assist women who had no one to help them miscarry at home, said Arcana, a lifelong educator, author and poet. “But many women took care of it on their own, in very amazing and impressive and powerful ways,” she said.

Judith Arcana learned how to do abortions herself and wrote about the Jane experience in poems, stories, essays and books.

Any woman who had concerns or questions while miscarrying alone could always call Jane for advice any time of the day or night.

“People would call in a panic: ‘The bleeding won’t stop,’” Smith recalled. “I would tell them, ‘Get some ice, put it on your stomach, elevate your legs, relax.’ And they would say ‘Oh my gosh, thank you!’ because they were so scared.”

For women who were in their first trimester, Jane offered traditional D&C abortions — the same dilation and curettage used by hospitals then and today, said Scott, who performed many of the abortions for Jane. Later the group used vacuum aspiration, which was over in a mere five to 10 minutes.

“Vacuum aspiration was much easier to do, and I think it’s less difficult for the woman,” Scott said. “Abortion is exactly like any other medical procedure. It’s the decision that’s an issue — the doing is very straightforward. This was something a competent, trained person could do.”

It was May 3, 1972. Judith Arcana was the driver that day, responsible for relocating women waiting at what was called “the front” to a separate apartment or house where the abortions were done, known as “the place.”

On this day, a Wednesday, the “place” was a South Shore high-rise apartment. Arcana was escorting a woman who had completed her abortion when they were stopped by police at the elevator.

“They asked us, ‘Which apartment did you come out of?’ And the poor woman burst into tears and blurted out the apartment number,” Arcana said. “They took me downstairs, put cuffs on me and hooked me to a steel hook inside of the police van.”

Inside the apartment on the 11th floor, Martha Scott said she was setting up the bedroom for the next abortion when she heard a knock at the door, followed by screaming: “You can’t come in!”

“I shut the bedroom door and locked it,” Scott said, then hid the instruments and sat on the bed to wait. It wasn’t long until a cop kicked the door in and made her join the other women in the living room.

“We tell this joke about how the cops came in, saw all these women and said, ‘Where’s the abortionist?’ You know, assuming that it would be a man,” Scott said.

By day’s end, seven members of Jane were behind bars: Martha Scott, Diane Stevens, Judy Arcana, Jeanne Galatzer-Levy, Abby Pariser, Sheila Smith and Madeleine Schwenk. Suddenly what had been an underground effort for years was front page headlines.

“Had we not gotten arrested, I think no one would ever have known about Jane other than the women we served,” Scott said.

Top: Sheila Smith and Martha Scott.
Bottom: Diane Stevens and Judith Arcana.

An emergency meeting of Jane was called. The turnout was massive — even women who had not been active in months showed up, anxious to know the extent of the police probe, according to the women with whom CNN spoke.

Despite widespread fear and worry, the group immediately began making alternate plans for women scheduled for abortions at Jane in the next few days to weeks. The group even paid for transportation to other cities where abortion had already been legalized, they said.

News reports over the next few days gave further details of the bust: There was no widespread investigation by the police. It was a single incident, triggered by a call from a sister-in-law who was upset with her relative’s decision to have an abortion, they said.

“It wasn’t long after I was arrested that I came back and worked for quite a few months,” said Scott, one of the few fully trained to do abortions.

“I like to think I was a good soldier,” Scott said. “I like to think what did made a difference not only to a whole bunch of people, but also to ourselves. It gave us a sense of empowerment that comes when you do something that is hard to do and also right.”

As paranoia eased, women began to come back to work at Jane, determined to carry on.

“After the bust, we had a meeting and were told ‘Everybody needs to start assisting and learn how to do abortions.’ I was like, ‘Whoa, whoa, whoa!’” said Eileen Smith, who had not been arrested. “But you felt like you really didn’t have much of a choice. We had to keep the service running.”

Laura Kaplan volunteered for the Janes, later immortalizing the group in her book,

The preliminary hearing for the arrested seven was in August. Several of the women in the apartment waiting for abortions the day of the arrest suddenly developed amnesia and refused to testify. According to Kaplan’s book, one of the women later said, “The cops tried to push me around, but f**k them. I wasn’t going to tell on you.”

It didn’t matter. Each Jane was charged with 11 counts of abortion and conspiracy to commit abortion, with a possible sentence of up to 110 years in prison.

As they waited for trial, the lawyer for the seven, Jo-Anne Wolfson, adopted delaying tactics, Kaplan said. A case representing a Texas woman, cited as “Jane Roe” to protect her privacy, was being considered by the US Supreme Court. If the Court ruled in Roe’s favor, the case against the Jane’s might be thrown out.

That’s exactly what happened. On March 9, 1973, three months after the Supreme Court had legalized abortion in the US, the case against the seven women was dropped and their arrest records were expunged.

Later that spring, a majority of Janes, burned out by the intensity of the work over the last few years, voted to close shop. An end of Jane party was held on May 20. According to Kaplan’s book, the invitation read:

“You are cordially invited to attend The First, Last and Only Curette Caper; the Grand Finale of the Abortion Counseling Service. RSVP: Call Jane.”

Today, most of the surviving members of Jane are in their 70s and 80s, shocked but somehow not surprised by the actions of abortion opponents.

“This is a country of ill-educated politicos who know nothing about women’s bodies, nor do they care,” said Dorie Barron. “It will take generations to even begin to undo the devastating harm to women’s rights.”

In the meantime, women should research all available options, keep that information confidential, seek support from groups working for abortion rights, and “share your education with as many women as you can,” Barron added.

As more and more reproductive freedoms have been rolled back over the past year, many of the Janes are angry and fearful for the future.

Abortion rights demonstrators walk across the Brooklyn Bridge in New York nearly two weeks after the leak of a draft Supreme Court opinion that would overturn Roe v. Wade.

“This is about the most intimate decision of our lives — when, whether and with whom we have a child. Everyone should have the ability to make decisions about our own lives, bodies, and futures without political interference,” said Heather Booth, who has spent her life after leaving Jane fighting for civil and women’s rights.

“We need to organize, raise our voices and our votes, and overturn this attack on our freedom and our lives. I have seen that when we take action and organize we can change the world.”

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On ‘weed day,’ our medical analyst urges caution on recreational marijuana use | CNN

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CNN
—

As some people mark 4/20 as “weed day,” a day of celebration of marijuana use, I don’t want to bum you out — but I might.

Over the past decade, there has been a trend toward legalizing marijuana in the United States. Currently, at least 37 states, plus Washington, DC, have a comprehensive medical cannabis program. A growing number of states, currently at 21, have legalized recreational marijuana use.

I wanted to learn about the research around marijuana use, including the effects it has on the user and the medicinal uses for cannabis. I turned to CNN Medical Analyst Dr. Leana Wen, who has many concerns about recreational cannabis use, especially for certain populations such as young people and pregnant people.

Wen, who urged users and would-be users to be cautious, is an emergency physician and professor of health policy and management at the George Washington University Milken Institute School of Public Health. She previously served as Baltimore’s health commissioner and as chair of Behavioral Health System Baltimore, where she oversaw policy and services around substances that can cause addiction, including marijuana.

CNN: What are the physiological effects of marijuana?

Dr. Leana Wen: Marijuana is a plant that has many active ingredients. One of the principal ones is a psychoactive compound called tetrahydrocannabinol. Often called THC, it’s similar to compounds that are naturally occurring in the body called cannabinoids and can mimic their function by attaching to cannabinoid receptors in the brain. In so doing, THC can disrupt normal mental and physical functions, including memory, concentration, movement and coordination.

Using marijuana can cause impaired thinking and interfere with someone’s ability to learn, according to the National Institute on Drug Abuse. Smoking cannabis can also impair the function of the parts of the brain that regulate balance, posture and reaction time. And THC stimulates the neurons involved in the reward system that release dopamine, or the “feel-good” brain chemical, which contributes to its addictive potential.

CNN: Marijuana is thought to have some positive and medicinal benefits. How can it be used for therapeutic purposes?

Wen: Short-term, many users report pleasant feelings, including happiness and relaxation. As a result, some people use marijuana to self-treat anxiety or depression. This is not a recommended use. What often ends up happening is that the person develops tolerance, requiring more and more of the drug to get the same effect.

There are some approved medicinal uses of marijuana for very specific indications. The US Food and Drug Administration has approved THC-based medications that are prescribed in pill form for treatment of nausea in patients with cancer undergoing chemotherapy and to stimulate appetite in patients with AIDS. There are several marijuana-based medications that are undergoing clinical trials for conditions like neuropathic pain, overactive bladder and muscle stiffness.

I think it’s really important for these and many more studies to continue. Researchers should continue to look not just at marijuana itself but its specific chemical components, since botanicals in their natural form can contain hundreds of active chemicals and obtaining the correct dosages may be challenging. In the meantime, users should use caution in evaluating supposed medicinal claims and clearly understand the risks of cannabis use.

CNN: What are the risks of marijuana use, and who may be particularly vulnerable to them?

Wen: The main concern about marijuana use is its impact on the developing brain. As the US Centers for Disease Control and Prevention states on its website, “Marijuana affects brain development. Developing brains, such as those in babies, children, and teenagers, are particularly susceptible to the harmful effects of marijuana and tetrahydrocannabinol.”

Numerous studies have linked marijuana use in women during pregnancy to a variety of cognitive and behavioral problems in their children. The CDC even warns against secondhand marijuana smoke exposure, and it also encourages breastfeeding individuals to avoid marijuana use.

Marijuana affects young people throughout adolescence and young adulthood. Much research has shown how marijuana use in childhood impacts memory, attention, learning and motivation. Regular cannabis use in adolescence is associated with higher likelihood of not completing high school and even lower IQ later in life. The negative impacts persist beyond the teen years. Some studies of university students have found that the regularity of marijuana use is correlated with lower grade point average in college.

I want to emphasize here that there is still a lot that we don’t know about the effects of marijuana, in particular long-term consequences. A recent study found that in adults, daily use of regular marijuana can increase the risk of coronary artery disease by as much as one-third. That’s the point, though; all the unknowns are exactly why I and many other clinicians and scientists urge caution.

To be clear, there are many reasons to support policy changes of decriminalizing marijuana, including to rectify the decades-long injustices of disproportionately incarcerating minority individuals for marijuana possession. However, supporting decriminalization should not be equated with believing that marijuana is totally safe. It’s not. Marijuana has the potential to cause real and lasting harm, especially to young people.

CNN: Could someone become addicted to marijuana?

Wen: Yes. There is a condition known as marijuana use disorder. Signs of this disorder include trying but failing to quit using marijuana;, continuing to use it even though it is causing problems at home, school or work;, and using marijuana in high-risk situations, including while driving. Some individuals, especially those who use large amounts, experience withdrawal symptoms when they try to stop.

As many as 3 in 10 people who use marijuana have marijuana use disorder, according to the CDC. The risk of developing marijuana use disorder is greater among those who use it more frequently and for those who started earlier in life.

CNN: Some people say that marijuana is no big deal, especially in comparison with other substances like alcohol and opioids. Would you agree that cannabis use is at least better than using those substances?

Wen: I wouldn’t frame it that way. It is true that marijuana doesn’t cause liver damage the way that high amounts of alcohol does, and it doesn’t have the lethality of opioids. If an adult is using marijuana once in a while, and not while driving, it’s probably not going to have lasting consequences.

However, there are harms associated with more frequent use of marijuana and in particular its use in children. In my opinion, the legalization movement has shifted the conversation so much towards acceptance of cannabis that we are neglecting the fact that it is a drug and, I believe, should be regulated just like alcohol, tobacco and opioids.

There should also be much more messaging and education so that people, including young people and their parents or guardians, can be aware of the harms of marijuana — just as they are aware of the harms of other drugs.

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Suicides and suicide attempts by poisoning rose sharply among children and teens during the pandemic | CNN

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CNN
—

The rate of suspected suicides and suicide attempts by poisoning among young people rose sharply during the Covid-19 pandemic, a new study says. Among children 10 to 12 years old, the rate increased more than 70% from 2019 to 2021.

The analysis, published Thursday in the US Centers for Disease Control and Prevention’s Morbidity and Mortality Weekly Report, looked at what the National Poison Data System categorized as “suspected suicides” by self-poisoning for 2021 among people ages 10 to 19; the records included both suicide attempts and deaths by suicide.

The data showed that attempted suicides and suicides by poisoning increased 30% in 2021 compared with 2019, before the pandemic began.

Younger children, ages 10 to 12, had the biggest increase at 73%. For 13- to 15-year-olds, there was a 48.8% increase in suspected suicides and attempts by poisoning from 2019 to 2021. Girls seemed to be the most affected, with a 36.8% increase in suspected suicides and attempts by poisoning.

“I think the group that really surprised us was the 10- to 12-year-old age group, where we saw a 73% increase, and I can tell you that from my clinical practice, this is what we’re seeing also,” said study co-author Dr. Chris Holstege, professor of emergency medicine and pediatrics chief at the University of Virginia School of Medicine. “We’re seeing very young ages ages that I didn’t used to see attempting suicide by poisoning.

“It was pretty stunning from our perspective,” he said.

Twenty or so years ago, when he started working at the University of Virginia, he said, they rarely treated anyone ages 9 to 12 for suicide by poisoning. Now, it’s every week.

“This is an aberration that’s fairly new in our practice,” Holstege said.

The records showed that many of the children used medicines that would be commonly found around the house, including acetaminophen, ibuprofen and diphenhydramine, which is sold under brand names including Benadryl.

There was a 71% jump from 2019 to 2021 in attempts at suicide using acetaminophen alone, Holstege said.

The choice of over-the-counter medications is concerning because children typically have easy access to these products, and they often come in large quantities.

Holstege encourages caregivers to keep all medications in lock boxes, even the seemingly innocuous over-the-counter ones.

If a child overdoses on something like acetaminophen or diphenhydramine, Holstege encourages parents to bring their children into the hospital without delay, because the toxicity of the drug worsens over time. It’s also a good idea to call a poison center, a confidential resource that is available around the clock.

“We want to make sure that the children are taken care of in regards to their mental health but also in regards to the poisoning if there’s suspicion that they took an overdose,” he said.

There were limitations to the data used in the new study. It captured only the number of families or institutions that reached out to the poison control line; it cannot account for those who attempted suicide by means other than poison. It also can’t capture exactly how many children or families sought help from somewhere other than poison control, so the increase in suspected suicides could be higher.

The American Academy of Pediatrics has noted that the Covid-19 pandemic exacerbated existing mental health struggles that existed even. In 2021, the group called child and adolescent mental health a “national emergency.” Emergency room clinicians across the country have also said they’ve seen record numbers of children with mental health crises, including attempts at suicide.

In 2020, suicide was the second leading cause of death among children ages 10 to 14 and the third leading cause among those 15 to 24, according to the CDC.

Although the height of the pandemic is over, kids are still emotionally vulnerable, experts warn. Previous attempts at suicide have been found to be the “strongest predictor of subsequent death by suicide,” the study said.

“An urgent need exists to strengthen programs focused on identifying and supporting persons at risk for suicide, especially young persons,” the study said.

Research has shown that there is a significant shortage of trained professionals and treatment facilities that can address the number of children who need better mental health care. In August, the Biden administration announced a plan to make it easier for millions of kids to get access to mental and physical health services at school.

At home, experts said, families should constantly check in with children to see how they are doing emotionally. Caregivers also need to make sure they restrict access to “lethal means,” like keeping medicines – even over-the-counter items – away from children and keeping guns locked up.

Dr. Aron Janssen, vice chair of clinical affairs at the Pritzker Department of Psychiatry and Behavioral Health at Lurie Children’s in Chicago, said he is not surprised to see the increase in suspected suicides, “but it doesn’t make it any less sad.”

Janssen, who did not work on the new report, called the increase “alarming.”

The rates of suicide attempts among kids had been increasing even prior to the pandemic, he said, “but this shows Covid really supercharged this as a phenomenon.

“We see a lot of kids who lost access to social supports increasingly isolated and really struggling to manage through day to day.”

Janssen said that he and his colleagues believe these suspected suicides coincide with increased rates of depression and anxiety and a sense of real dread about the future.

One of the biggest concerns is that “previous suicide attempts is the biggest predictor of later suicide completion,” he said. “We really want to follow these kids over time to better understand how to support them, to make sure that we’re doing everything within our power to help steer them away from future attempts.”

Janssen said it’s important to keep in mind that the vast majority of children survived even the worst of the pandemic and did quite well. There are treatments that work, and kids who can get connected to the appropriate care – including talk therapy and, in some cases, medication – can and do get better.

“We do see that. We do see improvement. We do see efficacy of our care,” Janssen said. “We just have to figure out how we can connect kids to care.”

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ADHD medication abuse in schools is a ‘wake-up call’ | CNN

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At some middle and high schools in the United States, 1 in 4 teens report they’ve abused prescription stimulants for attention deficit hyperactivity disorder during the year prior, a new study found.

“This is the first national study to look at the nonmedical use of prescription stimulants by students in middle and high school, and we found a tremendous, wide range of misuse,” said lead author Sean Esteban McCabe, director of the Center for the Study of Drugs, Alcohol, Smoking and Health at the University of Michigan in Ann Arbor.

“In some schools there was little to no misuse of stimulants, while in other schools more than 25% of students had used stimulants in nonmedical ways,” said McCabe, who is also a professor of nursing at the University of Michigan School of Nursing. “This study is a major wake-up call.”

Nonmedical uses of stimulants can include taking more than a normal dose to get high, or taking the medication with alcohol or other drugs to boost a high, prior studies have found.

Students also overuse medications or “use a pill that someone gave them due to a sense of stress around academics — they are trying to stay up late and study or finish papers,” said pediatrician Dr. Deepa Camenga, associate director of pediatric programs at the Yale Program in Addiction Medicine in New Haven, Connecticut.

“We know this is happening in colleges. A major takeaway of the new study is that misuse and sharing of stimulant prescription medications is happening in middle and high schools, not just college,” said Camenga, who was not involved with the study.

Published Tuesday in the journal JAMA Network Open, the study analyzed data collected between 2005 and 2020 by Monitoring the Future, a federal survey that has measured drug and alcohol use among secondary school students nationwide each year since 1975.

In the data set used for this study, questionnaires were given to more than 230,000 teens in eighth, 10th and 12th grades in a nationally representative sample of 3,284 secondary schools.

Schools with the highest rates of teens using prescribed ADHD medications were about 36% more likely to have students misusing prescription stimulants during the past year, the study found. Schools with few to no students currently using such treatments had much less of an issue, but it didn’t disappear, McCabe said.

“We know that the two biggest sources are leftover medications, perhaps from family members such as siblings, and asking peers, who may attend other schools,” he said.

Schools in the suburbs in all regions of the United States except the Northeast had higher rates of teen misuse of ADHD medications, as did schools where typically one or more parent had a college degree, according to the study.

Schools with more White students and those who had medium levels of student binge drinking were also more likely to see teen abuse of stimulants.

On an individual level, students who said they had used marijuana in the past 30 days were four times as likely to abuse ADHD medications than teens who did not use weed, according to the analysis.

In addition, adolescents who said they used ADHD medications currently or in the past were about 2.5% more likely to have misused the stimulants when compared with peers who had never used stimulants, the study found.

“But these findings were not being driven solely by teens with ADHD misusing their medications,” McCabe said. “We still found a significant association, even when we excluded students who were never prescribed ADHD therapy.”

Data collection for the study was through 2020. Since then, new statistics show prescriptions for stimulants surged 10% during 2021 across most age groups. At the same time, there has been a nationwide shortage of Adderall, one of the most popular ADHD drugs, leaving many patients unable to fill or refill their prescriptions.

The stakes are high: Taking stimulant medications improperly over time can result in stimulant use disorder, which can lead to anxiety, depression, psychosis and seizures, experts say.

If overused or combined with alcohol or other drugs, there can be sudden health consequences. Side effects can include “paranoia, dangerously high body temperatures, and an irregular heartbeat, especially if stimulants are taken in large doses or in ways other than swallowing a pill,” according to the Substance Abuse and Mental Health Services Administration.

Research has also shown people who misuse ADHD medications are highly likely to have multiple substance use disorders.

Abuse of stimulant drugs has grown over the past two decades, experts say, as more adolescents are diagnosed and prescribed those medications — studies have shown 1 in every 9 high school seniors report taking stimulant therapy for ADHD, McCabe said.

For children with ADHD who use their medications appropriately, stimulants can be effective treatment. They are “protective for the health of a child,” Camenga said. “Those adolescents diagnosed and treated correctly and monitored do very well — they have a lower risk of new mental health problems or new substance use disorders.”

The solution to the problem of stimulant misuse among middle and high school teens isn’t to limit use of the medications for the children who really need them, McCabe stressed.

“Instead, we need to look very long and hard at school strategies that are more or less effective in curbing stimulant medication misuse,” he said. “Parents can make sure the schools their kids attend have safe storage for medication and strict dispensing policies. And ask about prevalence of misuse — that data is available for every school.”

Families can also help by talking to their children about how to handle peers who approach them wanting a pill or two to party or pull an all-night study session, he added.

“You’d be surprised how many kids do not know what to say,” McCabe said. “Parents can role-play with their kids to give them options on what to say so they are ready when it happens.”

Parents and guardians should always store controlled medications in a lockbox, and should not be afraid to count pills and stay on top of early refills, he added.

“Finally, if parents suspect any type of misuse, they should contact their child’s prescriber right away,” McCabe said. “That child should be screened and assessed immediately.”

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