The opioid epidemic is no longer concentrated among whites in Appalachian and Midwestern states, according to a new study from Stanford, Harvard and the University of Toronto.
Three components of successful treatment.
Extinction is unpleasant. Extinction, in behavioral parlance, refers to a situation where a reinforcer is no longer available. The coke machine that won’t deliver, the Chinese restaurant that refused to give its cook a raise and now serves mediocre food, and a lost dog are all extinction situations. They all share the essential structure of a rat pressing a lever that has been disconnected from food pellets. There is a lot of responding at first, but eventually, the behavior goes extinct, whether the behavior is pressing the soda button, going to the restaurant, or looking for the dog.
In middle school, I asked for a neuroscience textbook for Christmas. I understood maybe a few pages, but I loved the pictures. In high school, I asked for a neuroanatomy atlas. I can still hear my mother going “Mhmmmm” when I’d tell her the brain area she used if she so much as moved her pinky. In college, I planned to transform this fascination into a career committed to the betterment of others. And so, I came to Stanford Medicine thinking I’d be a surgeon, bringing to life my neuroscience flashcards in the operating room.
A 22-year-old man presented with 10 years of retrosternal burning and suspected gastroesophageal reflux. Despite taking omeprazole (20 mg once daily) 30 minutes before breakfast, avoiding foods that precipitated symptoms, and sleeping with his head elevated, heartburn and regurgitation while supine continued. He reported intermittent solid-food dysphagia for 2 years but no weight loss (254-lb [115 kg] body weight); physical examination results were unremarkable.