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Background: Professional society guidelines recommend limiting the use of antipsychotics in older patients with postoperative delirium. How these recommendations affected the use of antipsychotics and other psychoactive drugs in the postoperative period has not been studied. Methods: This retrospective cohort study included patients 65 years or older without psychiatric diagnoses who underwent major surgery in community hospitals (CHs) and academic medical centers (AMCs) in the United States. The outcome was the rate of hospital days exposed to antipsychotics, antidepressants, antiepileptics, benzodiazepines, hypnotics, and selective alpha‐2 receptor agonist dexmedetomidine in the postoperative period by hospital type. Results: The study included 4,098,431 surgical admissions from CHs (mean age 75.0 [standard deviation, 7.1] years; 50.8% female) during 2008–2018 and 2,310,529 surgical admissions from AMCs (75.0 [7.4] years; 49.4% female) during 2009–2018. In the intensive care unit (ICU) setting, the number of exposed days per 1000 hospital‐days declined for haloperidol (CHs: 33–21 days [p < 0.01]; AMCs: 24–15 days [p < 0.01]) and benzodiazepines (CHs: 261–136 days [p < 0.01]; AMCs: 150–77 days [p < 0.01]). The use of atypical antipsychotics, antidepressants, antiepileptics, and dexmedetomidine increased, while hypnotic use varied by the hospital type. In the non‐ICU setting, the rate declined for haloperidol in CHs but not in AMCs (CHs: 10–6 days [p < 0.01]; AMCs: 4–3 days [p = 0.52]) and for benzodiazepines in both settings (CHs: 126–56 days [p < 0.01]; AMCs: 30–27 days [p < 0.01]). The use of antiepileptics and antidepressants increased, while the use of atypical antipsychotics and hypnotics varied by the hospital type. Conclusions: The use of haloperidol and benzodiazepines in the postoperative period declined at both CHs and AMCs. These trends coincided with the increasing use of other psychoactive drugs. [ABSTRACT FROM AUTHOR]

This article—informed by science studies scholarship and consonant with the emerging enterprise of “critical neuroscience”—critiques recent neuroscience research, and its current and potential applications in the national security context. The author expresses concern about the subtle interplay between the national security and neuroscience communities, and the hazards of the mutual enchantment that may ensue. The Bush Administration's “war on terror” has provided numerous examples of the abuse of medicine, behavioral psychology, polygraphy, and satellite imagery. The defense and national security communities have an ongoing interest in neuroscience too—in particular, neuroimaging and psychoactive drugs (including oxytocin) as aids to interrogation. Given the seductive allure of neuroscientific explanations and colorful brain images, neuroscience in a national security context is particularly vulnerable to abuse. The author calls for an urgent reevaluation of national security neuroscience as part of a broader public discussion about neuroscience's nontherapeutic goals. [ABSTRACT FROM AUTHOR]

Context: During the 1950s and 1960s, anxiety was the emblematic mental health problem in the United States, and depression was considered to be a rare condition. One of the most puzzling phenomena regarding mental health treatment, research, and policy is why depression has become the central component of the stress tradition since then. Methods: This article reviews statistical trends in diagnosis, treatment, drug prescriptions, and textual readings of diagnostic criteria and secondary literature. Findings: The association of anxiety with diffuse and amorphous conceptions of “stress” and “neuroses” became incompatible with professional norms demanding diagnostic specificity. At the same time, the contrasting nosologies of anxiety and depression in the Diagnostic and Statistical Manual of Mental Disorders III ( DSM-III) extended major depressive disorder to encompass far more patients than any particular anxiety disorder. In addition, antidepressant drugs were not associated with the stigma and alleged side effects of the anxiolytic drugs. Conclusion: Various factors combined between the 1970s and the 1990s to transform conditions that had been viewed as “anxiety” into “depression.” New interests in the twenty-first century, however, might lead to the reemergence of anxiety as the signature mental health problem of American society. [ABSTRACT FROM AUTHOR]

Background: Survey data on adolescent drug use trends have limitations evaluating the impact of drug use on health and may lag current trends. The objective was to describe National Poison Data System (NPDS) trends, medical outcomes, and healthcare encounters from adolescent exposures of traditional and novel psychoactive drugs., Methods: Retrospective review of adolescent (10-18 years of age) exposure calls to all U.S. poison centers, from January 1, 2007 through December 31, 2017, using generic codes for traditional and novel psychoactive drugs. Descriptive statistics and univariate Poisson regression modeling were used for analysis., Results: There were 49,757 exposure calls for the included psychoactive drugs. The median age was 16 years (IQR 15,17), 64% were male, and the majority were evaluated in a healthcare facility (92%). Marijuana had the most exposure calls (36.6%), followed by synthetic cannabinoids (e.g., spice; 21.3%). There were 181 (<1%) deaths; the highest fatality rates were from fentanyl, 2C drugs (phenylethylamine derivatives), and heroin. LSD exposure calls have had the most significant increase over the past 10 years., Conclusion: U.S. Poison Centers reported almost 50,000 exposure calls and 181 deaths over 10 years for adolescent exposures of both traditional and novel psychoactive drugs, demonstrating the significant health impact on this vulnerable population. Opioids and 2C drugs contributed to the highest mortality rates, moderate/major symptoms and healthcare utilization, and LSD had the most significant increase in calls. Multi-source surveillance methodology is critical in understanding the public health impact on drug abuse in the adolescent population., (Copyright © 2019 Elsevier B.V. All rights reserved.)