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New Interesting Research in Schizophrenia!

7/25/2014

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New Research in Schizophrenia

One of the harder problems we face in medicine and Biblical counseling is deciding which diagnostic labels represent disease and which are simply descriptions of inconvenient behavior.  The one thing that has helped us sort out the difference has been pathology. Pathology is the study of disease. It looks at how changes at the cell level in our bodies result in abnormal function.

Understanding the pathology or change at the cell level is very important if we hope to help those who suffer from disease. When we know the process that causes the change in our body function, we have the opportunity to look for a cure or better care. This is particularly true in the arena of mental illness.

This week new research published in Nature[i] offered a new insight into the cause of schizophrenia that may open the door to better treatment. While the lifetime risk of schizophrenia is around 1%, those affected account for as much as 25% of costs for inpatient hospitalizations. Those who struggle with the delusions, hallucinations and personality changes are often unable to work or relate in a normal way to their families.  It is likely that they make up from one third to one half of the homeless.  It is an enormous burden for those affected and those who love them.

The last major advance in treatment for schizophrenia came 60 years ago with the introduction of Thorazine.  This drug literally emptied the mental hospitals of the day, but since then most of the new drugs used have been variations of the original. Currently there is no new novel medical treatment on the horizon. 

The reason why we are struggling to find new and better medicine is that we do not have a good understanding of the underlying pathology in schizophrenia.  Pathology is the change at the cell level in the brain that causes the problem. Without that understanding it is nearly impossible to find new treatment. This may be changing.

New research in the genetics of schizophrenia has shown that there may be a connection between genes that govern brain tissue and tissue that play “important roles in immunity.”[ii] This connection may support the speculation that schizophrenia is a disorder of the brain in which our immune system attacks brain tissue resulting in symptoms.

This is important research because it is looking for the underlying cause and not another palliative treatment for symptoms. If we find the underlying cause and the change at the cell level in the brain that results in the damage, it offers the possibility of a real cure. 

Along the same line a case report that was presented at the American Psychiatric Associations May 2014 meeting also offered another insight into schizophrenia.[iii]  Patients in a long term warfarin clinic for blood thinning who were also diagnosed with schizophrenia were found to be in remission and no longer required anti-psychotic medication.  The report included five patients and by no means does it suggest that all schizophrenics should be treated with anti-coagulants. But, it if it proves out in further research it may give an insight into the process that damages the brain and causes the hallucinations.

This is the kind of research that is desperately needed in the area of mental illness. Instead of trying to using surveys to count symptoms, this research is trying to find the cause. Medical research is at its best when starts with the change that a disease causes in the structure and function of human tissue at the cell level.  If offers the hope of really understanding the patients problem and finding a cure.

 


[i] Biological Insights from 108 Schizophrenia-associated Genetic Loci. Nature 511, 421-427 (24July 2014)

[ii] Ibid.

[iii][iii] Warfarin for Long-Term Psychosis Remission? Medscape.com, Deborah Brauser, May 15, 2014.

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Settle Your Arguments By Sundown or Else!

7/4/2014

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Settle you arguments by Sundown!

New research published this week tells us something that we probably have known all along. Problems at home can lead to arguments at work that then result in more disputes at home. Researchers at the University of Madrid examined the relationship between struggles at home and attitudes at work.[i]

What they found was not surprising. "The difficulty of focusing on work when distracted by family worries made employees irritable. This led to them reacting negatively towards colleagues instead of using more adaptive strategies…This negativity is transferred to the home in the form of increased conflict with their partners,” said Dr Sanz Vergel.[ii]

In English, when we struggle at home and take those struggles with us to work, we will have problems at work. And, if we fail to deal with them in a biblical manner we will take them home. Then the cycle just starts over in a worsening spiral of home and work struggles.

Paul told us this would be the case two thousand years ago in his letter to the Ephesian church. He warned them as follows. “Be angry, and yet do not sin; do not let the sun go down on your anger, and do not give the devil an opportunity. Let no unwholesome word proceed from your mouth, but only such a word as is good for edification according to the need of the moment, so that it will give grace to those who hear…Let all bitterness and wrath and anger and clamor and slander be put away from you, along with all malice. Be kind to one another, tender-hearted, forgiving each other, just as God in Christ also has forgiven you.

 (Eph 4:26-29, 31-32 NASB)

There are several important things Paul tells us that can break up the cycle of work home problems. First, do not let problems go past sundown! Reconcile your disputes before bedtime and start the next day with a clean slate. Second, choose your words in careful kind godly way. Everything we say impacts someone who hears it. We ought to choose our words to glorify God and help others. And third, we should forgive one another in the same way God forgives us.

These are simple solutions Paul gives but they are profoundly useful if we don’t want to spend our lives carrying problems from home to work and back.

 


[i] Ana Isabel Sanz-Vergel, Alfredo Rodríguez-Muñoz, Karina Nielsen. The thin line between work and home: the spillover and crossover of daily conflicts. Journal of Occupational and Organizational Psychology, 2014; DOI: 10.1111/joop.12075

 

[ii] British Psychological Society (BPS). "Family worries can cause conflict at work." ScienceDaily. ScienceDaily, 30 June 2014. <www.sciencedaily.com/releases/2014/06/140630094654.htm>.

 

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To Drink or not To Drink: Alcohol is the Question!

6/24/2014

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To Drink or Not to Drink: Alcohol is the Question.

When it comes to drinking alcohol, I must admit that I have very little experience. I gave it up at the age of 19 when I realized that there really was not enough time to party hardy and study enough to get into medical school. So, I cannot speak as one with firsthand knowledge of the benefits and penalties associated with regular daily alcohol consumption.

But, I am a doctor and this week I came across a research study that discusses the real downside to drinking. It is cancer. “…when it comes to cancer, no amount of alcohol is safe”[i] according to a recent report by the World Health Organization.[ii] No, this is not an urban legend conjured up by a wild eyed member of the WCTU[iii]. It is simply what medical science has to say about a habit of life that is growing in popularity among evangelicals.

I am old enough to have lots of stories about how we used to do things at church when I was a child. I will not inflict them on you.  I have watched in wonder at times as churches that I know used to preach against the evils of beverage alcohol, now allow that it is acceptable in moderation as long as one does not drink to drunkenness.  And, please do understand that I do not believe for a minute that the Bible prohibits drinking wine.

That however is not what I am here to tell you. No, the message today from medical science is that when comes to cancer there is no safe amount of alcohol for daily consumption. Drink any amount of alcohol in any form on a daily basis and you raise your risk of cancer of the mouth, pharynx, larynx, esophagus, colon-rectum, liver and the female breast.[iv]  This is a causal relationship in that the alcohol and its metabolites cause cancer.

As one writer said, the best advice he could give was that if you drink daily it should be no more than 1.5oz of alcohol (one and a half beers, 7.5oz of wine, or one and a half mixed drinks containing 1oz of ethanol.) per day. Women should only have 1 ounce. If you do not drink alcohol, don’t start. Light or moderate drinking does not eliminate the risk. The risk for cancer is dose dependent so if you do drink, drink less or even better still, stop.

Alcoholic beverages contain 15 compounds that cause cancer including acetaldehyde, acrylamide, aflatoxins, arsenic, benzene, cadmium, ethyl carbamate, formaldehyde, lead and finally ethanol.[v] (That is alcohol for those who never suffered through organic chemistryJ)  The areas of the body at risk are those that come into contact with the alcohol first and in highest concentration and include the oral cavity and esophagus.

As a physician, I guess I would tell my friends who have been sitting on the sidelines of alcohol consumption to stay there. When first century Christians drank wine there were some compelling reasons that included the lack of safe drinking water. We have solved that problem with iron pipe, so the benefit of avoiding water borne disease does not exist in most parts of this country.

That leaves us with the risk, or rather the risks. Cancer is just one and if I had a bigger blog I could fill it with others.[vi] But, let’s leave it with cancer. In the 1960’s our nation came to grips with the idea that smoking caused cancer and has spent billions to convince us not to smoke. I think cancer is a good enough reason not to drink something that causes it. Maybe this is one of those, all things are lawful, but not all things are profitable moments that Paul wrote about. [vii]

 


[i] Rehm J, Shield K. Alcohol consumption. In: Stewart BW, Wild CB, eds. World Cancer Report 2014. Lyon, France: International Agency for Research on Cancer; 2014.

[ii] All of the factual information in this blog came from the following Medscape article. Medscape Oncology

No Amount of Alcohol Is Safe Laura A. Stokowski, RN, MS April 30, 2014

http://www.medscape.com/viewarticle/824237?src=wnl_edit_tp10&uac=16048SY

[iii] Women’s Christian Temperance Union. A noble organization that fought alcohol abuse and the devastating effects it had on women and children in the late 1800’s and early 1900’s.

[iv] Bagnardi V, Rota M, Botteri E, et al. Light alcohol drinking and cancer: a meta-analysis. Ann Oncol. 2013;24:301-308. Abstract

[v] Lachenmeier DW, Przbylski MC, Rehm J. Comparative risk assessment of carcinogens in alcoholic beverages using the margin of exposure approach. Int J Cancer. 2012;131:E995-E1003. Abstract

[vi] Renaud S, de Lorgeril M. Wine, alcohol, platelets, and the French paradox for coronary heart disease. Lancet. 1992;339:1523-1526. Abstract

[vii] 1Corinthians 6:12

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Contagious Emotions & Social Media: Our Words Matter!

6/14/2014

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My earliest introduction to the importance of the words I chose came from my mother who told me things that her mother had told her. They were quaint little sayings whose importance would take years for me to understand. “If you can’t say something good, don’t say anything at all.” “Bad company corrupts good manners.” Both came to mind this week when I saw research that said the social network can have a profound effect on my emotions.[i]

In an article published in the Proceedings of the National Academy of Science, researchers told how the positive and negative content of the posts we read on Facebook will push our emotional responses in a positive or negative direction. In this large study some subjects had the content mix of the posts they read altered so that they were either more positive or more negative posts.[ii]

As we might expect when the content was mostly positive, the individuals in the study responded more positively, and when it was negative, they responded negatively. There are all kinds of lessons for in this study. The first I see is that as Christians were are responsible for the words we choose and things we write in social media. We ought to choose those words for the benefit of others. As Paul said, “no one should seek his own good first, but the good of others.”(1Cor.10:24)

So when we post on Facebook and other social media sites, we should pick those words carefully and aim them to encourage others. In the past year I have watched several of my friends post things that were not only negative, but at times somewhat destructive in nature. I do not respond to them in comments, but send them private direct messages. I do that because as the study showed, the comments that follow a significantly negative post can become a free for all.

I know that some will say that if we only post positive things that social media will start to resemble a scene from the Disney movie Pollyanna. And, I agree that there are times when life is difficult and I feel inclined to unload my angst into those 140 character tweets and Facebook statuses. But, then I remember the words of my dear Grandmother Holcomb who considered the over sharing and gossip of her time and said, “We all take baths, but not in public.”

Maybe the best lessons from all of this come to us from scripture. As Jesus said in Matthew 18:15, when we have disputes with our brothers and sisters, we should go to them in private. Of all things I can say, Facebook is not private!

Then, as we struggle with the difficulties of life and feel the need to comment, we should choose our words carefully so that those who read will be “stimulated to love and good deeds” (Hebrews10:24) and not nasty replies and tweets in the comment sections. As Paul said in Ephesians 4:29 “Let no unwholesome word proceed from your mouth, but that which is good to the need of the moment, that it will give grace to those who hear.” As my brother used to say, “If the person who is going to hear (or read) these words would not consider it a gift, maybe you should not say it.”

The Psalmist said it well. “Let the words of my mouth and the meditation of my heart be acceptable in your sight, O Lord, my rock and my Redeemer.” (Psalm 19:14)

I urge you friends to pick your words carefully for the benefit of others.



[i] Cornell University. "Emotional contagion sweeps Facebook, finds new study." ScienceDaily. ScienceDaily, 13 June 2014. <www.sciencedaily.com/releases/2014/06/140613142533.htm>.

[ii] A. D. I. Kramer, J. E. Guillory, J. T. Hancock. Experimental evidence of massive-scale emotional contagion through social networks. Proceedings of the National Academy of Sciences, 2014; DOI: 10.1073/pnas.1320040111

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Can I Change? New Research Says Yes!

6/3/2014

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Can I Change?

 

Can I change? This is a familiar question that comes up in counseling. We live in a time when the answer depends a lot on what a person's goal is in asking the question.

Some would tell us that they were born they way they are and that they cannot change. I have talked with any number of angry people who have forcefully informed me that they are the way they are and that I will just have to accept it! We tend to blame our genes for our overindulgence, inattention, proneness to worry, and an ever increasing number of behaviors.

So then, can we change or are we stuck with whatever we are born with and doomed to become what our DNA dictates?  Well, new research would tell us no!
In an article published last week, researchers the University of Southampton asked that question of people who are thought to be one of the most of the most difficult to change.
[i]

Narcissists are individuals who think only about themselves. They are "a bit full of themselves, self-centered, and don't seem too concerned about the effects they have on other people," according to Erica Hopper one of the researchers.
[ii] The question the project asked was could even narcissists, the most dedicated to themselves people on earth, learn to care about others?

The study found that even people who are highly narcissistic can learn to care about others in the right setting. When highly self centered individuals were asked to watch a video that dealt with the suffering of another they initially responded as we might expect without much empathy. But, when they were asked to put themselves in the place of the individual, the researchers found that they responded differently. Not only did the self centered participants express emotional concern for the sufferer, their heart rates increased in the same way it would in unselfish people.

When normally self centered and selfish people were asked to put themselves in the "shoes" of another sufferer, it changed them. And, that is exactly what we might expect in counseling.  People can change.  As Paul said, If any man be in Christ he is a new creature, old things pass away, new things are coming. (2Corinthians 5:17)

When any man or woman confesses Jesus Christ as Lord and Savior, they are freed from the slavery of sinful selfishness.  The first and great command is to "Love The Lord your God with all your heart..., and your neighbor." (Matthew 22:37-39) Christians can and do choose to abandon selfish self-centeredness by God's grace. As Paul would tell us, "Nobody should seek his own good, but the good of others. (1Corinthians 10:24)  
And he also told us, that we could do this as Christ strengthens us! (Philippians 4:13)

It is always great when science invests grant money to prove something that we could have told them from the scriptures.
J

 



[i] Erica G. Hepper, Claire M. Hart, and Constantine Sedikides. Moving Narcissus: Can Narcissists Be Empathic? Personality and Social Psychology Bulletin, May 30, 2014 DOI: 10.1177/0146167214535812

[ii] Society for Personality and Social Psychology. "Can narcissists be moved to show empathy?." ScienceDaily. ScienceDaily, 30 May 2014. <www.sciencedaily.com/releases/2014/05/140530124323.htm>.

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Training Our Brains: As a Man Thinks in His Heart

5/26/2014

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 Training our Brains: As a man thinks in his heart…

What we choose to think about matters. How we decide to think about people matters a lot. It matters so much that our Savior Jesus Christ warned us against dwelling on bad thoughts about others. Anger towards another is placed in the same category as murder!

“Ye have heard that it was said by them of old time, Thou shalt not kill; and whosoever shall kill shall be in danger of the judgment: But I say unto you, That whosoever is angry with his brother without a cause shall be in danger of the judgment…” (Mat 5:21-22 KJV)

Unjustified, unbiblical anger can lead to murder.

At the same time over and over again we are commanded to love each other! “A new commandment I give unto you, That ye love one another; as I have loved you, that ye also love one another. By this shall all men know that ye are my disciples, if ye have love one to another.” (John 13:34-35 KJV)

 

The idea that God can change us from people who hate others to people who love is the heart of Christianity. While part of our society is busy about redefining behavior spoken of in scripture as sin into “normal” behavior that cannot change, the authors of the New Testament did not see it that way. Paul tells us that if we are in Christ, we are new creatures with old things passing away and new things coming. (see 2Corinthians 5:17) Instead of being stuck doing the same old sins, Christians can look forward to change. And, research published this week agrees.

 

A study published in PLoS ONE, that examined the ability of test subjects to change how they felt about others. “Volunteers who received real time information of their ongoing neural activity could change brain network function among connected areas related to tenderness and affection felt toward loved ones, while the control group who performed the same fMRI task without neurofeedback did not show such improvement.”[i] In plain English, the volunteers were given information from their fMRI brain scans that showed how the part of their brain would light up in response to positive feelings about their loved ones. Practice thinking about their affection for their loved ones strengthened the response seen in the brain.

 

An important note about the research was that the control group in the study was not given any feedback on their brain scans. And, as they practiced the tasks given their brain activity did not change. The researchers believed that this kind of brain training activity could have application for those who struggled with post-partum depression and personality disorders.[ii]

 

It is always interesting when science goes to great effort to demonstrate something the Bible has already told us. Paul told us to “lay aside the old self… to be renewed in the spirit of your mind,

 and put on the new self…” (Eph 4:22-24 NAU) This process in the Christian is powered by the grace of God and it is powered by the Holy Spirit who lives in our hearts. The whole process is tied to studying the scriptures as Christ said, “Sanctify them through Your truth, Your word is truth.” (John 17:17) It is implemented by doing what we learn in that word by grace. (James 1:22)

 

The good news of the gospel is that those who trust in Christ are no longer slaves to sinful habits, but have the privilege to choose to serve instead. As Paul said “But thanks be to God that though you were slaves of sin, you became obedient from the heart to that form of teaching to which you were committed, and having been freed from sin, you became slaves of righteousness.”

 (Rom 6:17-18 NASB)

 



[i] Instituto D'Or de Pesquisa e Ensino (IDOR). "Training brain patterns of empathy using functional brain imaging." ScienceDaily. ScienceDaily, 21 May 2014. <www.sciencedaily.com/releases/2014/05/140521180016.htm>.

[ii] Jorge Moll, Julie H. Weingartner, Patricia Bado, Rodrigo Basilio, João R. Sato, Bruno R. Melo, Ivanei E. Bramati, Ricardo de Oliveira-Souza, Roland Zahn. Voluntary Enhancement of Neural Signatures of Affiliative Emotion Using fMRI Neurofeedback. PLoS ONE, 2014; 9 (5): e97343 DOI: 10.1371/journal.pone.0097343

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Blog Trotter

5/26/2014

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I have no idea why, but blog trotter decided to send out email notification for 10 of past blog posts this morning at 8:45am. It reminds of Hal and the concept that computers can develop a will of their own. Sorry for any inconvenience! :-)
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Family Life Today & Good Mood Bad Mood

5/26/2014

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The blog today can be found at the Biblical Counseling Coalition Website at http://t.co/QiuaTVTjKo. I had the privilege of talking with Dennis Rainey and Bob Lepine in January about Good Mood Bad Mood and from that conversation came 3 radio programs which will air this Wednesday 5/28 through Friday 5/30.

In the BCC blog there is a description of those programs. Please click the link and read about them there.

The blog at goodmoodbadmood.com will return this week with more comments about scientific articles that are important to Biblical counselors.

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Antidepressants and Self Harm Risk in Children and Young Adults.

5/3/2014

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A recent article published in JAMA Internal medicine is a reminder that current antidepressant drugs are not free of side effects or risks.[i] Researchers found that individuals age 10 to 24 treated with higher than normal starting doses were twice has likely to have suicidal thinking as compared to those treated with placebo. (A pill that looked like but did not contain the active ingredient) In this same age group those treated with the higher starting doses were twice as likely to harm themselves.[ii] [iii]

This is very important information for lots of reasons. The first is that no one should think that the selective serotonin reuptake inhibitors such as Prozac, Zoloft, Celexa and Lexapro are as safe as taking Tylenol or a couple of aspirin. These are serious medicines that bring with them significant side effects. Patients who are offered these medicines should be asking their doctors to carefully inform them about the possible side effects.

Second, it is vitally important to be certain that the individual being treated is actually struggling with depression. This is a real problem today because since 1980 normal sadness has been turned into depression. Individuals who are struggling with normal grieving over loss do not have a disease. When they are treated with medication that is meant for a disease they will often simply be sad and then have the side effects of the medicine.

Third, it is important to note that younger individuals seem to have more trouble with this side effect of the SSRI antidepressant than older ones. As the researchers noted, “…the efficacy of antidepressant therapy for youth seems to be modest.” With that being said, taking medicine that has significant side effects and risks should be a last resort, not the first thing we reach for.

In Good Mood Bad Mood, I outline the research that deals with the importance of dealing with people grieving over loss differently than with those who cannot tell us why they are sad.[iv] The latter has been described for years as disordered sadness and used to be the one of the main criteria for making a diagnosis of depression.

Up to 90% of individuals who carry the label of depression today can tell us when it started and what they lost. They are far more likely to be struggling with normal sadness than a disease.  And at the same time, it appears that that nearly 90% of people who take the currently available antidepressant do not benefit from them any more than they would from taking a placebo pill.[v]

The first principle of medicine that all physicians must learn is “first do no harm.” Few of us in medicine would be satisfied with just leaving it at that. I would say that most of us in medicine are always looking for better ways to help and yes, to cure. But, the benefit of taking medicine must be worth the risk.

When we add in the significant problem of side effects, most of these strugglers would probably do better just talking to anyone with training, compassion and skill. And, many could profit greatly from counseling from the Bible that deals with how God wants to love and help them in the middle of their sorrow. 


[i] The JAMA Network Journals. "High doses of antidepressants appear to increase risk of self-harm in children young adult." ScienceDaily. ScienceDaily, 28 April 2014. <www.sciencedaily.com/releases/2014/04/140428164111.htm>.

[ii] Matthew Miller, Sonja A. Swanson, Deborah Azrael, Virginia Pate, Til Stürmer. Antidepressant Dose, Age, and the Risk of Deliberate Self-harm. JAMA Internal Medicine, 2014; DOI: 10.1001/jamainternmed.2014.1053

[iii] David A. Brent, Robert Gibbons. Initial Dose of Antidepressant and Suicidal Behavior in Youth. JAMA Internal Medicine, 2014; DOI: 10.1001/jamainternmed.2013.14016

[iv]  Good Mood Bad Mood, Shepherd Press, Chapter 5.

[v] Ibid. p.49.

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Marijuana Changes Brains: I Told You So!

4/17/2014

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Marijuana Changes Brains: I Told You So!

It is time once again for my semi-regular harangue on the subject of pot. I have several blogs in which I have risked the wrath of those who believe it is their libertarian free born American right to smoke dope, I mean pot. J I have also been chastised by those who believe that it should be their right as a Christian to smoke marijuana if it is not against the law. Somehow they think whacky tobacchy (as a friend of mine once called it) fits well in the Paul’s Romans 14 construct of Christian Liberty.

I have consistently warned anyone who will listen that there is little to nothing good about humans smoking marijuana. I’ve spent the better part of 4 decades telling patients that if they smoke tobacco it will kill them. Why people think that smoking marijuana will be harmless is beyond my understanding. I have listened to people give personal testimony to the medicinal benefits of smoking marijuana or consuming marijuana laced products. I have said and continue to say that real research on medical benefits of cannabis should be done for the few it might help.

On the other hand for the general public marijuana is a danger. Research published today shows what many of us have noticed in friends or loved ones who regularly smoke weed.[i] They change. Their personalities change. The abilities to think, their desire to work, and their memories are affected. The reason they change is that even once a week use of marijuana appears to change the human brain.[ii]

The study examined the brains of young people who smoked marijuana at least once a week and those who did not. MRI Brain-scans were used to look for changes. What the researchers found was that two areas of the brain changed as compared to non-users. The nucleus accumbens and the amygdala thickened. “These data suggest that marijuana exposure, even in young recreational users, is associated with exposure-dependent alterations of the neural matrix…” In other words it changes your brain!

In a study published in December of 2013, it was shown that areas of the brain that support memory were changed in heavy users of marijuana and that those changes remained even after 2 years of abstinence from pot.[iii] The current study would indicate that smoking marijuana for any reason is a threat to the ability to think.

There may be individuals with seizure disorders that will not respond to anything but the CBD portion of Marijuana and individuals in that situation should be able to use the drug in a form that does not require smoking. But, for the rest of us with normal healthy brains, marijuana poses real danger.

We know that 25% of young people who regularly smoke pot will be addicted and many of them will suffer brain changes that result in psychosis. Why would any Christian support the use, sale and taxation of recreational marijuana?

Paul specifically tells us in Ephesians 5:18 to not be drunk with wine but be filled/controlled by the Holy Spirit. Paul is telling us that Christians should not give themselves over to the control of addictive substances. We should certainly not use substances such as marijuana that damage the body that God has given us to serve Him. It reminds of wise words an old friend told me once. “Will you be able to serve the Lord better if you make that choice, or serve Him better if you do not?”

So, the question for the believer must be will I be able to serve God better intoxicated with marijuana, or sober? 


[i] Jodi M. Gilman, John K. Kuster, Sang Lee, Myung Joo Lee, Byoung Woo Kim, Nikos Makris, Andre Van Der Kouwe, Anne J. Blood and Hans C. Breiter. Cannabis Use is Quantitatively Associated with Nucleus Accumbens and Amygdala Abnormalities in Young Adult Recreational Users. Journal of Neuroscience, April 16, 2014 (in press)

[ii] Society for Neuroscience (SfN). "Brain changes associated with casual marijuana use in young adults: More 'joints' equal more damage." ScienceDaily. ScienceDaily, 15 April 2014. <www.sciencedaily.com/releases/2014/04/140415181156.htm>.

[iii] Northwestern University. "Casual marijuana use linked to brain abnormalities in students: Dramatic effects of small time use; more 'joints' equal more damage." ScienceDaily. ScienceDaily, 15 April 2014. <www.sciencedaily.com/releases/2014/04/140415203807.htm>.

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    Charles D Hodges Jr. MD
    I have been counseling people with mood problems and other family issues  for 25 years.  

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